[Federal Register Volume 63, Number 173 (Tuesday, September 8, 1998)]
[Proposed Rules]
[Pages 47552-48036]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-23383]
[[Page 47551]]
_______________________________________________________________________
Part II
Department of Health and Human Services
_______________________________________________________________________
Health Care Financing Administration
Office of Inspector General
_______________________________________________________________________
42 CFR Part 409, et al.
Medicare Program; Prospective Payment System for Hospital Outpatient
Services; Proposed Rules
Federal Register / Vol. 63, No. 173 / Tuesday, September 8, 1998 /
Proposed Rules
[[Page 47552]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
Office of Inspector General
42 CFR Parts 409, 410, 411, 412, 413, 419, 489, 498, and 1003
[HCFA-1005-P]
RIN 0938-AI56
Medicare Program; Prospective Payment System for Hospital
Outpatient Services
AGENCY: Health Care Financing Administration (HCFA), HHS, and Office of
Inspector General (OIG), HHS.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: As required by sections 4521, 4522, and 4523 of the Balanced
Budget Act of 1997, this proposed rule would eliminate the formula-
driven overpayment for certain outpatient hospital services, extend
reductions in payment for costs of hospital outpatient services, and
establish in regulations a prospective payment system for hospital
outpatient services (and for Medicare Part B services furnished to
inpatients who have no Part A coverage). The prospective payment system
would simplify our current payment system and apply to all hospitals,
including those that are excluded from the inpatient prospective
payment system. The Balanced Budget Act provides for implementation of
the prospective payment system effective January 1, 1999, but delays
application of the system to cancer hospitals until January 1, 2000.
The hospital outpatient prospective payment system would also apply to
partial hospitalization services furnished by community mental health
centers.
Although the statutory effective date for the outpatient
prospective payment system is January 1, 1999, implementation of the
new system will have to be delayed because of year 2000 systems
concerns. The demands on intermediary bill processing systems and HCFA
internal systems to become compliant for the year 2000 preclude making
the major systems changes that are required to implement the
prospective payment system. The outpatient prospective payment system
will be implemented for all hospitals and community mental health
centers as soon as possible after January 1, 2000, and a notice of the
anticipated implementation date will be published in the Federal
Register at least 90 days in advance.
This document also proposes new requirements for provider
departments and provider-based entities. These proposed changes, as
revised based on our consideration of public comments, will be
effective 30 days after publication of a final rule.
This proposed rule would also implement section 9343(c) of the
Omnibus Budget Reconciliation Act of 1986, which prohibits Medicare
payment for nonphysician services furnished to a hospital outpatient by
a provider or supplier other than a hospital, unless the services are
furnished under an arrangement with the hospital. This section also
authorizes the Department of Health and Human Services' Office of
Inspector General to impose a civil money penalty, not to exceed
$10,000, against any individual or entity who knowingly and willfully
presents a bill for non-physician or other bundled services not
provided directly or under such an arrangement.
This proposed rule also addresses the requirements for designating
certain entities as provider-based or as a department of a hospital.
DATES: Comments will be considered if we receive them at the
appropriate address, as provided below, no later than 5 p.m. on
November 9, 1998.
ADDRESSES: Mail written comments (1 original and 3 copies) to the
following address: Health Care Financing Administration, Department of
Health and Human Services, Attention: HCFA-1005-P, P.O. Box 26688,
Baltimore, MD 21207-0488.
If you prefer, you may deliver your written comments (1 original
and 3 copies) to one of the following addresses:
Room 309-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW.,
Washington, DC 20201, or
Room C5-09-26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Because of staffing and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. In commenting, please refer
to file code HCFA-1005-P. Comments received timely will be available
for public inspection as they are received, generally beginning
approximately 3 weeks after publication of a document, in Room 309-G of
the Department's offices at 200 Independence Avenue, SW., Washington,
DC, on Monday through Friday of each week from 8:30 a.m. to 5 p.m.
(phone: (202) 690-7890).
Copies: To order copies of the Federal Register containing this
document, send your request to: New Orders, Superintendent of
Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date
of the issue requested and enclose a check or money order payable to
the Superintendent of Documents, or enclose your Visa or Master Card
number and expiration date. Credit card orders can also be placed by
calling the order desk at (202) 512-1800 or by faxing to (202) 512-
2250. The cost for each copy is $8. As an alternative, you can view and
photocopy the Federal Register document at most libraries designated as
Federal Depository Libraries and at many other public and academic
libraries throughout the country that receive the Federal Register.
This Federal Register document is also available from the Federal
Register online database through GPO Access, a service of the U.S.
Government Printing Office. Free public access is available on a Wide
Area Information Server (WAIS) through the Internet and via
asynchronous dial-in. Internet users can access the database by using
the World Wide Web; the Superintendent of Documents home page address
is
http://www.access.gpo.gov/nara/index.html, by using local WAIS client
software, or by telnet to swais.access.gpo.gov, then login as guest (no
password required). Dial-in users should use communications software
and modem to call 202-512-1661; type swais, then login as guest (no
password required).
FOR FURTHER INFORMATION CONTACT:
Janet Wellham, (410) 786-4510 (for general information). Joel Schaer
(OIG), (202) 619-0089 (for information concerning civil money
penalties).
Kitty Ahern, (410) 786-4515 (for information related to the
classification of services into ambulatory payment classification (APC)
groups).
Suzanne Letsch (410) 786-4558 (for information related to volume
control measures and updates).
George Morey (410) 786-4653 (for information related to the
determination of provider-based status).
Janet Samen (410) 786-9161 (for information on the application of APCs
to community mental health centers).
SUPPLEMENTARY INFORMATION: To assist readers in referencing sections
contained in this document, we are providing the following table of
contents.
Table of Contents
I. Background
[[Page 47553]]
II. Elimination of Formula-Driven Overpayment
III. Extension of Cost Reductions
IV. Prohibition Against Unbundling of Hospital Outpatient Services
A. Background
B. Previous Medicare Regulations Affecting Bundling
C. Office of Inspector General (OIG) Civil Money Penalty
Authority
D. Proposed Regulations Published August 5, 1988
1. Bundling of Hospital Outpatient Services
2. Civil Money Penalties for Unbundling Hospital Outpatient
Services
E. Revised Proposed Regulations on Bundling of Hospital Services
V. Hospital Outpatient Prospective Payment System (PPS)
A. Scope of Services Within the Outpatient PPS
1. Services Excluded from the Hospital Outpatient PPS
2. Services Included Within the Scope of the Hospital Outpatient
PPS
a. Services for Patients Who Have Exhausted Their Part A
Benefits
b. Partial Hospitalization Services
c. Services Designated by the Secretary
3. Hospital Outpatient PPS Payment Indicators
B. Description of the Ambulatory Payment Classification (APC)
Groups
1. Setting Payment Rates Based on Groups of Services Rather than
on Individual Services
2. How the Groups Were Constructed
3. Packaging Under the Groups
4. Treatment of Clinic and Emergency Visits
5. Treatment of Partial Hospitalization Services
6. Comments on Specific APCs
7. Discounting of Surgical Procedures
a. Reduced Payment for Multiple Procedures
b. Discounted Payment for Terminated Procedures
8. Inpatient Care
C. Calculation of Group Weights and Rates
1. Group Weights
2. Conversion Factor
a. Calculating Aggregate Calendar Year 1996 Medicare and
Beneficiary Payments for Hospital Outpatient Services (Current Law)
b. Sum of the Relative Weights
D. Calculation of Medicare Payment Amount and Copayment Amount
1. Introduction
2. Determination of Unadjusted Copayment Amount, Program Payment
Percentage, and Copayment Percentage
3. Calculation of Medicare Payment Amount and Beneficiary
Copayment Amount
4. Hospital Election to Offer Reduced Copayment
E. Adjustment for Area Wage Differences
1. Proposed Wage Index
2. Labor-Related Portion of Hospital Outpatient Department PPS
Payment Rates
3. Adjustment of Hospital Outpatient Department PPS Payment and
Copayment Amounts for Geographic Wage Variations
F. Claims Submission and Processing
G. Updates
1. Revisions to Weights and the Wage and Other Adjustments
2. Revisions to APC Groups
3. Annual Update to Conversion Factor
H. Outlier Payments
I. Adjustments for Specific Classes of Hospitals
J. Volume Control Measures
K. Prohibition Against Administrative or Judicial Review
VI. Hospital Outpatient Departments and Provider-Based Entities
A. Background
B. Effects on Medicare
C. Relationship of the ``Provider-Based'' Proposals to
Prospective Payment for Outpatient Hospital Services and Effective
Date of ``Provider-Based'' Proposals
D. Basis for Current Provider-Based Policy
E. Provisions of this Proposed Rule
F. Requirements for Payment
1. Prerequisites for Payment for Outpatient Hospital Services
and Supplies Incident to Physician Services
2. Prerequisites for Payment for Hospital or Critical Access
Hospital Diagnostic Services Furnished to Outpatients
3. Payment for Ambulatory Surgical Services
VII. MedPAC Recommendations
VIII. Collection of Information Requirements
IX. Response to Comments
X. Regulatory Impact Analysis
A. Introduction
B. Estimated Impact on Medicare Program
C. Objectives
D. Limitations of Our Analysis
E. Hospitals Included In and Excluded From the Prospective
Payment System
F. Quantitative Impact Analysis of the Proposed Policy Changes
Under the Prospective Payment System for Operating Costs and Capital
Costs
G. Estimated Impact of the New APC System
XI. Delay in Implementation
Regulations Text
Addenda
Addendum A--List of Proposed Hospital Outpatient Ambulatory Payment
Classes with Status Indicators, Relative Weights, Payment Rates, and
Coinsurance Amounts
Addendum B--Proposed Hospital Outpatient Department (HOPD) Payment
Status by HCPCS and Related Information
Addendum C--Proposed Hospital Outpatient Payment for Procedures by
APC
Addendum D--Summary of Medical APCs
Addendum E--Major Diagnostic Categories
Addendum F--ICD-9 Codes with Major Diagnostic Categories (MDCs) for
Payment of Medical Visits under the Hospital Outpatient PPS
Addendum G--CPT Codes Which Will Be Paid Only As Inpatient
Procedures
Addendum H--Status Indicators
Addendum I--Service Mix Indices by Hospital
Addendum J--Wage Index for Urban Areas
Addendum K--Wage Index for Rural Areas
Addendum L--Wage Index for Hospitals That Are Reclassified
In addition, because there are many terms to which we refer by
acronym in this rule, we are listing these acronyms and their
corresponding terms in alphabetical order below:
APC Ambulatory payment classification
APG Ambulatory patient group
ASC Ambulatory surgical center
BBA Balanced Budget Act of 1997
CAH Critical access hospital
CCI [HCFA's] Correct Coding Initiative
CCR Cost center specific cost-to-charge ratio
CHAMPUS Civilian Health and Medical Program of the Uniformed
Services
CMHC Community mental health center
CMP Civil money penalty
CORF Comprehensive outpatient rehabilitation facility
CPT [Physicians'] Current Procedural Terminology, 4th Edition,
1998, copyrighted by the American Medical Association
DME Durable medical equipment
DMEPOS DME, orthotics, prosthetics, prosthetic devices, prosthetic
implants and supplies
DRG Diagnosis-related group
EACH Essential access community hospital
ESRD End-stage renal disease
FDO Formula-driven overpayment
FQHC Federally qualified health center
HCPCS HCFA Common Procedure Coding System
HHA Home health agency
ICD-9-CM International Classification of Diseases, Ninth Edition,
Clinical Modification
IME Indirect medical education
IOL Intraocular lens
MDC Major diagnostic category
MDH Medicare dependent hospital
MedPAC Medicare Payment Advisory Commission
MSA Metropolitan statistical area
NECMA New England County Metropolitan Area
OBRA Omnibus Budget Reconciliation Act
PPS Prospective payment system
RHC Rural health clinic
RPCH Rural primary care hospital
RRC Rural referral center
SCH Sole community hospital
SGR Sustainable growth rate
SNF Skilled nursing facility
TEFRA Tax Equity and Fiscal Responsibility Act of 1982
I. Background
As the Medicare statute was originally enacted, Medicare payment
for hospital services (inpatient and outpatient) was based on hospital-
specific reasonable costs attributable to serving Medicare
beneficiaries. Later, the law was amended to limit payment to the
lesser of a hospital's reasonable costs or to its customary charges. In
1983, section 601 of the Social Security Amendments of 1983 (Public Law
98-21) completely revised the cost-based payment system for most
hospital inpatient services by enacting section 1886(d) of the Social
[[Page 47554]]
Security Act (the Act). This section provided for a prospective payment
system (PPS) for acute inpatient hospital stays, effective with
hospital cost reporting periods beginning on or after October 1, 1983.
Although payment for most inpatient services became subject to a
PPS, hospital outpatient services continued to be paid based on
hospital-specific costs, which provided little incentive for hospital
efficiency for outpatient services. At the same time, advances in
medical technology and changes in practice patterns were bringing about
a shift in the site of medical care from the inpatient to the
outpatient setting. During the 1980s, the Congress took steps to
control the escalating costs of providing outpatient care. The Congress
amended the statute to implement across-the-board reductions of 5.8
percent and 10 percent to the amounts otherwise payable for hospital
operating costs and capital costs, respectively, and legislated a
number of different payment methods for specific types of hospital
outpatient services. These methods included fee schedules for clinical
diagnostic laboratory tests, orthotics, prosthetics, and durable
medical equipment (DME); composite rate payment for dialysis for
persons with end-stage renal disease (ESRD); and payments based on
blends of hospital costs and the rates paid in other ambulatory
settings such as separately certified ambulatory surgical centers
(ASCs) or physician offices for certain surgery, radiology, and other
diagnostic procedures. Nevertheless, Medicare payment for services
performed in the hospital outpatient setting remains largely cost-
based.
In section 9343(f) of the Omnibus Budget Reconciliation Act of 1986
(OBRA 1986) (Public Law 99-509) and in section 4151(b)(2) of the
Omnibus Budget Reconciliation Act of 1990 (Public Law 101-508), the
Congress required the Secretary to develop a proposal to replace the
current hospital outpatient payment system with a PPS and to submit a
report to the Congress on the proposed system. In OBRA 1986, the
Congress paved the way for development of a PPS, under section 9343(g),
by requiring fiscal intermediaries to require hospitals to report
claims for services under the HCFA Common Procedure Coding System
(HCPCS), and, under section 9343(c), by extending the prohibition
against unbundling of hospital services under section 1862(a)(14) of
the Act to include outpatient services as well as inpatient services.
HCPCS coding enabled us to determine what specific procedures and
services were being billed, while the extension of the prohibition
against unbundling ensured that all nonpractitioner services provided
to hospital outpatients would be billed only by the hospital, not by an
outside supplier, and, therefore, would be reported on hospital bills
and captured in the hospital outpatient data that could be used to
develop an outpatient PPS.
Section 1866(g) of the Act, as added by section 9343(c) of OBRA
1986, and amended by section 4085(i)(17) of the Omnibus Budget
Reconciliation Act of 1987 (OBRA 1987) (Public Law 100-203), also
authorizes the Department of Health and Human Services' Office of
Inspector General to impose a civil money penalty (CMP), not to exceed
$2,000, against any individual or entity who knowingly and willfully
presents a bill in violation of an arrangement (as defined in section
1861(w)(1) of the Act).
A proposed rule to implement section 9343(c) was published in the
Federal Register on August 5, 1988. However, those regulations were
never published as a final rule, so we are including them in this
regulation and will implement them as part of the final regulation
implementing the hospital outpatient PPS.
The Secretary submitted a Report to Congress on March 17, 1995. The
report summarized the research HCFA conducted in searching for a way to
classify outpatient services for purposes of developing an outpatient
PPS. The report cited Ambulatory Patient Groups (APGs), developed by
3M-Health Information Systems under a cooperative grant with HCFA, as
the most promising classification system for grouping outpatient
services and recommended that APG-like groups be used in designing a
hospital outpatient PPS.
The report also presented a number of options that could be used,
once a PPS was in place, for addressing the issue of rapidly growing
beneficiary copayment. As a separate issue, we recommended that the
Congress amend the provisions of the law pertaining to the blended
payment methods for ASC surgery, radiology, and other diagnostic
services to correct an anomaly that resulted in a less than full
recognition of the amount paid by the beneficiary in calculating
program payment (referred to as the formula-driven overpayment).
The Balanced Budget Act of 1997 (BBA) (Public Law 105-33), enacted
on August 5, 1997, contains a number of provisions that affect Medicare
payment for hospital outpatient services. The purpose of this proposed
rule is to implement sections 4521, 4522, and 4523 of the BBA and
section 9343(c) of OBRA 1986. Section 4521 of the BBA eliminates the
formula-driven overpayment effective for services furnished on or after
October 1, 1997. Because of the October 1, 1997 effective date, HCFA
has already taken action to implement this provision. Section 4522
extends the current cost reductions of 5.8 percent and 10 percent
(applicable to hospital outpatient operating costs and hospital capital
costs, respectively) through and including December 31, 1999.
Section 4523 of the BBA amends section 1833 of the Act by adding
subsection (t), which provides for implementation of a PPS for most
hospitals for outpatient services furnished on or after January 1, 1999
and for cancer hospitals that are excluded from inpatient PPS for
services furnished on or after January 1, 2000. We note that while the
statutory effective date for the outpatient PPS is January 1, 1999,
implementation of the new payment system will have to be delayed
because of year 2000 systems concerns. The demands on intermediary bill
processing systems and HCFA internal systems to become compliant for
the year 2000 preclude making the major systems changes that are
required to implement the PPS. See Section XI of this preamble (``Delay
in Implementation'') for a more detailed explanation of the reasons for
delay. The outpatient PPS will be implemented as soon as possible after
January 1, 2000. A notice of the anticipated implementation date will
be published in the Federal Register at least 90 days in advance. The
rates that will go into effect on the implementation date will apply to
all hospitals including cancer hospitals described in section
1886(d)(1)(B)(v) of the Act. The rates will be based on the rates that
would have been in effect January 1, 1999 updated by the rate of
increase in the hospital market basket minus one percentage point.
Section 1833(t)(1)(B) of the Act authorizes the Secretary to
designate the hospital outpatient services that would be paid under the
PPS. Section 1833(t)(1)(B) also requires that the outpatient PPS
include inpatient services covered under Part B for beneficiaries who
are entitled to Part A benefits but who have exhausted their Part A
benefits or otherwise are not in a covered Part A stay. However,
section 1833(t)(1)(B) specifically excludes as covered services under
the outpatient PPS ambulance services and physical and occupational
therapy, and speech-language pathology services, for which separate fee
schedules are required by
[[Page 47555]]
statute. (See section 4531 of the BBA for amendments pertaining to
ambulance services and section 4541 for amendments pertaining to
outpatient rehabilitation services.)
Section 1833(t)(2) of the Act stipulates certain requirements for
the hospital outpatient PPS. The Secretary is required to develop a
classification system for covered outpatient services which may consist
of groups arranged so that the services within each group are
comparable clinically and with respect to the use of resources. In
addition, this section specifies data requirements for establishing
relative payment weights, which are to be based on median hospital
costs determined by data from the most recent available cost reports;
requires that the portion of the Medicare payment and the beneficiary
copayment that are attributable to labor and labor-related costs be
adjusted for geographic wage differences; and authorizes the
establishment of other adjustments, such as outlier adjustments or
adjustments for certain classes of hospitals, that are necessary to
ensure equitable payments. All adjustments are required to be made in a
budget neutral manner. This section concludes with the requirement that
a control on unnecessary increases in the volume of covered services be
established.
Section 1833(t)(3) provides for a new method of calculating
beneficiary copayment. It freezes beneficiary copayment at 20 percent
of the national median charges for covered services (or group of
covered services) furnished during 1996 and updated to 1999 using the
Secretary's estimated charge growth from 1996 to 1999. This section
specifies how beneficiary deductibles are to be treated in calculating
the Medicare payment and beneficiary copayment amounts and requires
that rules be established regarding determination of copayment amounts
for covered services that were not furnished in 1996. Further, it
prescribes the formula for calculating the initial conversion factor
used to determine Medicare payment amounts for 1999 and the method for
updating the conversion factor in subsequent years.
Sections 1833(t)(4) and (t)(5) describe the basis for determining
the Medicare payment amount and the beneficiary copayment amount for
services covered under the outpatient PPS. The latter section requires
the Secretary to establish a procedure whereby hospitals may
voluntarily elect to reduce beneficiary copayment for some or all
covered services to an amount not less than 20 percent of the Medicare
payment amount. Hospitals are further allowed to advertise any such
reductions of copayment amounts. Section 4451 of the BBA added section
1861(v)(1)(T) to the Act, which stipulates that bad debts will not be
recognized on any copayment the hospital elects to reduce.
Section 1833(t)(6) authorizes periodic review and revision of the
payment groups, relative payment weights, wage index, and conversion
factor.
Section 1833(t)(7) describes how payment is to be made for
ambulance services, which are specifically excluded from the outpatient
PPS under section 1833(t)(1)(B).
Section 1833(t)(8) provides that the Secretary may establish a
separate conversion factor for determining services furnished by cancer
hospitals excluded from inpatient PPS under this PPS.
Section 1833(t)(9) prohibits administrative or judicial review of
the PPS classification system, the groups, relative payment weights,
adjustment factors, other adjustments, calculation of base amounts,
periodic adjustments, and the establishment of a separate conversion
factor for those cancer hospitals excluded from inpatient PPS.
Section 4523(d) of the BBA amends section 1833(a)(2)(B) of the Act
to require payment under the PPS for some services described in section
1832(a)(2) that are currently paid on a cost basis and furnished by
providers of services such as comprehensive outpatient rehabilitation
facilities (CORFs), home health agencies (HHAs), hospices, and
community mental health centers (CMHCs). This amendment requires that
partial hospitalization services furnished by CMHCs beginning January
1, 1999 be paid under the PPS. As noted earlier, implementation of the
PPS will be delayed. Implementation will occur as soon as possible
after January 1, 2000.
II. Elimination of Formula-Driven Overpayment
Before enactment of section 4521 of the BBA, under the blended
payment formulas for ASC procedures, radiology, and other diagnostic
services, the ASC or physician fee schedule portion of the blends was
calculated as if the beneficiary paid 20 percent of the ASC rate or
physician fee schedule amount instead of the actual amount paid, which
was 20 percent of the hospital's billed charges. Section 4521 corrects
this anomaly by changing the blended calculations so that all amounts
paid by the beneficiary are subtracted from the total payment in
determining the amount due from the program. Effective for services
furnished on or after October 1, 1997, payment for surgery, radiology,
and other diagnostic services under blended payment methods will be
calculated by subtracting the full amount of copayment due from the
beneficiary (based on 20 percent of the hospital's billed charges).
III. Extension of Cost Reductions
Section 1861(v)(1)(S)(ii) of the Act requires that the amounts
otherwise payable for hospital outpatient operating costs and capital
costs be reduced by 5.8 percent and 10 percent, respectively. These
reductions were scheduled to sunset at the end of fiscal year 1998, but
section 4522 of the BBA extended the reductions through December 31,
1999.
IV. Prohibition Against Unbundling of Hospital Outpatient Services
A. Background
The Social Security Amendments of 1965 (Public Law 89-97), enacted
on July 30, 1965, established title XVIII of the Act, which authorized
the establishment of the Medicare program to pay part of the costs of
health care services furnished to eligible beneficiaries. Part A of the
program (Hospital Insurance) provides basic health insurance protection
against the costs of inpatient or home health care. Part B of the
program (Supplementary Medical Insurance) provides voluntary
supplementary insurance covering most physician services and certain
other items and services not covered under Part A, including hospital
outpatient services.
Before the enactment of Public Law 98-21 on April 7, 1983, which
established the Medicare PPS for inpatient hospital services,
nonphysician services furnished to Medicare beneficiaries who were
hospital patients were generally billed by the hospitals. Under certain
circumstances, however, Part B of the Medicare statute permitted
payments to be made to an outside supplier or another provider for
certain nonphysician services otherwise covered by Medicare Part B that
were furnished to a hospital patient. When payments were made under
these circumstances, some nonphysician services were billed as hospital
services in one hospital and billed by an outside supplier in another.
The practice of billing by suppliers outside the hospital for these
services has been referred to in the legislative history as the
``unbundling'' of hospital services.
Since the enactment of Public Law 98-21 and the publication of
implementing regulations on September 1, 1983 (48 FR 39752), the
Medicare program has required that nonphysician
[[Page 47556]]
services furnished to hospital inpatients be covered and paid for under
Medicare as hospital services. This practice of covering nonphysician
services furnished to hospital inpatients by an outside supplier as
hospital services is referred to as ``bundling.'' Under the PPS for
inpatient hospital services, a single predetermined payment is made for
a case based on the diagnosis-related group (DRG) to which the case is
assigned. Bundling ensures that the DRG payments to all hospitals cover
a comparable ``bundle'' of services related to the hospital stay.
Specifically, Public Law 98-21 added section 1862(a)(14) to the Act
to prohibit payment for services (other than physician services)
furnished to an inpatient of a hospital by an entity other than the
hospital, unless the services are furnished under an arrangement (as
defined in section 1861(w)(1) of the Act). (Section 1861(w)(1) of the
Act specifies that the term ``arrangements'' is limited to arrangements
under which receipt of payment by the hospital or other provider for
Medicare-covered services to an individual discharges the liability of
the individual or any other person to pay for the services.) Public Law
98-21 also added section 1866(a)(1)(H) to the Act to provide that a
hospital is eligible to participate in the Medicare program only if the
hospital agrees to furnish to inpatients either directly or under an
arrangement all Medicare-covered items and services, other than
physician services.
Regardless of whether the hospital furnishes the services directly
or arranges for furnishing the services, the hospital assumes financial
responsibility for the services. The Medicare program makes payment
only to hospitals and not to other providers or suppliers that furnish
inpatient services on behalf of the hospitals.
In Public Law 98-21, the Congress addressed only nonphysician
services furnished to Medicare beneficiaries who are hospital
inpatients. The Congress did not address at that time nonphysician
services furnished to Medicare beneficiaries who are hospital
outpatients, for which payment is made, usually on a cost basis, under
Part B of Medicare. Thus, services to hospital outpatients continued to
be unbundled in some hospitals. Subsequently, in section 9343(c) of
OBRA 1986, the Congress extended the bundling provision to all
nonphysician services furnished to hospital ``patients,'' thus also
including nonphysician services furnished to Medicare beneficiaries who
are hospital outpatients.
Sections 9343(c)(1) and (c)(2) of OBRA 1986 amended sections
1862(a)(14) and 1866(a)(1)(H) of the Act, respectively. As revised,
section 1862(a)(14) of the Act prohibits payment for nonphysician
services furnished to hospital patients (inpatients and outpatients),
unless the services are furnished by the hospital, either directly or
under an arrangement (as defined in section 1861(w)(1) of the Act). As
revised, section 1866(a)(1)(H) of the Act requires each Medicare-
participating hospital to agree to furnish directly all covered
nonphysician services required by its patients (inpatients and
outpatients) or to have the services furnished under an arrangement (as
defined in section 1861(w)(1) of the Act). Section 9338(a)(3) of OBRA
1986 affected implementation of the bundling mandate by amending
section 1861(s)(2)(K) of the Act to permit services of physician
assistants to be covered and billed separately.
Bundling of outpatient hospital services was required in order to
provide a basis for implementing another provision of OBRA 1986, which
required the development of a prospective payment methodology for
outpatient hospital services. Section 9343(f) of OBRA 1986 amended
section 1135 of the Act to require the Secretary to submit to the
Congress by April 1, 1988, an interim report concerning development of
a fully prospective payment system for ambulatory surgery. The
legislation also specified that a final report was due to the Congress
no later than April 1, 1989, with recommendations concerning
implementation of a fully prospective payment mechanism for ambulatory
surgery services by October 1, 1989. We released an interim report in
June of 1988 and the final report in September of 1990. The final
report summarized our research findings relating to hospital outpatient
prospective payment and did not contain specific recommendations
regarding a PPS for ambulatory surgical services. Later, in section
4151(b)(2) of OBRA 1990, the Congress expanded its earlier request and
required HCFA to develop a PPS that included all hospital outpatient
services. That legislation also directed us to submit a report to the
Congress concerning this proposal. We submitted a report to the
Congress on March 17, 1995.
In order for us to be able to develop a PPS for hospital outpatient
services, it was necessary to have available clear and consistent rules
about the range of services that would be included in this payment
system. Previous policies on coverage of hospital outpatient services
permitted services to be unbundled and thus allowed providers to vary
their practices concerning the furnishing of services. The Congress
recognized the inconsistencies of the current payment system and
required bundling as a first step toward payment reform.
B. Previous Medicare Regulations Affecting Bundling
Previous regulations set forth at 42 CFR 405.310(m) concerning
noncoverage of certain services furnished to hospital inpatients
(redesignated as Sec. 411.15(m)) implemented the statutory requirement
for bundling of inpatient hospital services. They excluded from
coverage nonphysician services furnished to hospital inpatients by an
entity other than the hospital, unless the services were furnished
under an arrangement. The exclusion from coverage in effect at that
time did not apply to physician services that met the conditions for
payment for physician services to provider patients in Sec. 405.550(b)
(redesignated as Sec. 415.102(a)), or services of anesthetists employed
by physicians that met the conditions for payment in Sec. 405.553(b)(4)
concerning reasonable charges for anesthesiology services furnished by
the anesthesiologist or by an anesthetist employed by the
anesthesiologist. (The regulation is now deleted as the payment
structure for anesthesiologists has changed.) The exception for
physician services is required by section 1862(a)(14) of the Act.
Services of physician-employed anesthetists were exempted from bundling
as an administrative measure to prevent disruption of long-standing
physician-anesthetist team relationships. However, in a final rule
published on May 26, 1993 (58 FR 30630), the regulations set forth at
Sec. 411.15(m) and Sec. 489.20(d) were revised to reflect the statutory
exclusion of certified registered nurse anesthetist (CRNA) services
(including services of anesthesiologist assistants), physician
assistant services, certified nurse midwife services, and qualified
psychologist services from the inpatient bundling requirement. Section
411.15(m) concerns services to hospital inpatients excluded from
coverage, and Sec. 489.20(d) concerns a provider agreement in the case
of a hospital or critical access hospital (CAH) to furnish directly or
make arrangements for Medicare-covered services to inpatients of a
hospital or a CAH.
C. Office of Inspector General (OIG) Civil Money Penalty Authority
In order to prevent the unbundling of nonphysician hospital
services, section 9343(c)(3) of OBRA 1986 amended section 1866 of the
Act by adding a new paragraph (g). Specifically, this
[[Page 47557]]
authority provided for the imposition of a civil money penalty (CMP),
not to exceed $2,000, against any person who knowingly and willfully
presents, or causes to be presented, a bill or request for payment for
a hospital outpatient service under Part B of Medicare that violates
the requirement for billing under arrangements specified in section
1866(a)(1)(H) of the Act. Section 1866(g) was further amended by
section 4085(i)(17) of OBRA 1987. Section 4085(i)(17) of OBRA 1987
deleted all references to hospital outpatient services under Part B of
Medicare and authorized imposition of a CMP when arrangements should
have been made but were not. Section 1866(g) of the Act authorizes
imposition of a CMP against any person who knowingly and willfully
presents, or causes to be presented, a bill or request for payment
inconsistent with an arrangement under section 1866(a)(1)(H) or in
violation of the requirement for an arrangement. The result of this
amendment is that the CMP is now applicable for all services furnished
to hospital patients, whether paid for under Medicare Part A or B. The
statute also requires that a CMP be imposed in the same manner as other
CMPs are imposed under section 1128A of the Act. Section 231(c) of the
Health Insurance Portability and Accountability Act of 1996 (Public Law
104-191) revised section 1128A of the Act to increase the CMP maximum
amount for each false claim or prohibited practice from $2,000 to
$10,000. Implementing regulations for this authority are set forth in
42 CFR parts 1003 and 1005.
To implement the provisions of section 9343(c) of OBRA 1986, we
published a proposed rule in the Federal Register on August 5, 1988 (53
FR 29486). Those regulations have not been published in final, but we
are proposing revised implementing regulations as part of this
regulation.
D. Proposed Regulations Published August 5, 1988
1. Bundling of Hospital Outpatient Services
We proposed to implement the requirement for bundling of outpatient
hospital services by amending then existing Medicare regulations
(Sec. 405.310 concerning particular services excluded from coverage,
and part 410 concerning supplementary medical insurance benefits) to
exclude coverage of any services that are furnished in a hospital to an
outpatient of the hospital by an entity other than the hospital during
or as a result of an encounter in the hospital, unless the services are
furnished under an arrangement. In addition, we proposed to require
bundling of those diagnostic procedures or tests (for example, magnetic
resonance imaging procedures) that are furnished outside the hospital
by an entity other than the hospital but are ordered during an
encounter in the hospital with the patient or as a result of such an
encounter.
In the proposed rule, in Sec. 405.310(n)(1) concerning definitions
of services to hospital outpatients excluded from coverage (now
redesignated as Sec. 411.15(m)), we defined a hospital outpatient as an
individual who is not an inpatient of the hospital but who is
registered as an outpatient.
We proposed to define, in Sec. 410.2 (``Definitions''), the term
``encounter'' as a direct personal contact between a patient and a
physician, or other person who is authorized by State licensure law
and, where applicable, by hospital staff bylaws, to order or furnish
services for the patient for the purpose of diagnosis or treatment of
the patient. The use of the ``encounter'' as a basis for identifying
the services to be bundled is not specifically required by OBRA 1986
but is needed in order to implement the bundling requirement in a
uniform and equitable manner, as explained further in section III. of
the preamble of the August 5, 1988 proposed rule (53 FR 29489).
As in the case of services to hospital inpatients, physician
services that meet the conditions for payment for services of
physicians to provider patients in Sec. 415.102(a) would not be bundled
under our proposal. (The exception for physician services is required
by section 1862(a)(14) of the Act.) We also proposed, as an
administrative measure, to exempt from outpatient bundling the services
of physician-employed anesthetists that meet the conditions for payment
for services furnished by an anesthesiologist or by an anesthetist
employed by the anesthesiologist in Sec. 405.553(b)(4). These services
were exempted from bundling to prevent disruption of long-standing
physician-anesthetist team relationships. We also proposed to exempt
physician assistant services as defined in section 1861(s)(2)(K)(i) of
the Act from inpatient and outpatient bundling. We proposed this change
to help accomplish the objective of section 1861(s)(2)(K)(i) of the
Act, as amended by section 9338(a)(3) of OBRA 1986, which permits
physician assistant services to be covered and to be billed separately.
As noted earlier, we have made the changes in the types of services
excluded from bundling of inpatient services in the May 1993 final rule
(58 FR 30630).
We also proposed to revise the regulations set forth at
Sec. 489.20, which describe the basic commitments included in the
provider agreement. They would require a hospital that furnishes
services to a beneficiary who is not currently an inpatient of a
hospital but who is registered by the hospital as an outpatient to
agree either to furnish directly or to make arrangements (in accordance
with section 1861(w)(1) of the Act) for all items and services for
which bundling is required under the proposed revision described above,
and for which the beneficiary is entitled to have payment made under
Medicare.
We proposed in the August 5, 1988 proposed rule that if a Medicare
outpatient is referred to another provider or supplier for further
diagnostic testing or other diagnostic services as a result of an
encounter that occurs in the hospital, the hospital would be
responsible for arranging with the other entity for the furnishing of
services. (We have now changed our view on bundling of these services
as discussed in the following section IV.E.) Also, the hospital would
be responsible for furnishing or arranging for the furnishing of
prostheses and prosthetic devices (other than dental) that replace all
or part of an internal body organ (for example, intraocular lenses
(IOLs)) and are implanted or fitted during an encounter. For example,
in the absence of a bundling provision, the physician who implants an
IOL during surgery performed on an outpatient of a hospital also could
be the supplier of the IOL and could bill Medicare under Part B for it.
As proposed in our August 1988 rule, this practice would be prohibited,
and the hospital would have to furnish the IOL, either directly or
under an arrangement (that is, would have to pay for the lens). The
same policies would apply to other items and services, such as
artificial limbs, knees, and hips; orthotics; equipment and supplies
covered under the prosthetic device benefit; and services incident to
physician services. Thus, hospitals would be required to assume
financial liability for prostheses and prosthetic devices (which are
regarded as ``services'' for Medicare coverage purposes) and for other
services furnished by an outside entity to their outpatients, and the
practice of unbundling these services would be prohibited.
Sometimes a hospital may furnish an item or service for which a
patient will have a continuing need. For example, a hospital may
furnish a DME item such as a wheelchair. When this situation occurs,
the proposed rule required that
[[Page 47558]]
the hospital would be responsible for bundling the items and services
it furnishes on-site. In adopting the view that these types of items
are subject to bundling, we did not discount the patient's continuing
need for them after leaving the hospital. However, the bundling
provisions in sections 1862(a)(14) and 1866(a)(1)(H) of the Act
prohibit unbundling of services to an individual who is a patient of a
hospital and do not provide any specific exception to these provisions
for DME. Therefore, we did not believe it would be appropriate to
exclude DME from bundling when it was furnished to a hospital patient.
(We have now changed our previous position on bundling of DME as
discussed in section IV.E.)
2. Civil Money Penalties for Unbundling Hospital Outpatient Services
In order to implement section 1866(g) of the Act, in our August 5,
1988 proposed rule, we proposed that the OIG would impose a CMP against
any person who knowingly and willfully presents, or causes to be
presented, a bill or request for payment for a hospital outpatient
service under Part B of Medicare that violates the billing arrangement
under section 1866(a)(1)(H) of the Act or the requirement for an
arrangement. The amount of the CMP was to be limited to $2,000 for each
improper bill or request, even if the bill or request included more
than one item or service. However, in accordance with the Health
Insurance Portability and Accountability Act of 1996, which increased
the minimum penalty amount to $10,000, the increased amount will now be
reflected in the regulations.
E. Revised Proposed Regulations on Bundling of Hospital Services
This proposed rule incorporates most of the provisions of the
August 5, 1988 proposed rule. The following describes how the
regulations published in this proposed rule to implement the rebundling
of outpatient hospital services differ from the regulations we proposed
and published on August 5, 1988:
We are not including any of the changes in the regulations
relating to payment for physician laboratory services (Secs. 405.555(a)
through (c), and 405.556(c) of the August 5, 1988 proposed rule),
because these regulations were deleted as a result of publication of
regulations to implement the Medicare physician fee schedule published
on November 25, 1991 (56 FR 59502).
We are revising Sec. 409.10(b), which describes services
that are not included in the definition of ``hospital inpatient or
inpatient CAH services'' to include all of the services that are now
exceptions from the bundling rule under section 1862(a)(14) of the Act.
Section 4511 of the BBA revised sections 1862(a)(14) and 1866(a)(1)(H)
of the Act to exclude services of nurse practitioners and clinical
nurse specialists described in section 1861(s)(2)(K) of the Act from
the bundling requirement.
As previously indicated, proposed Sec. 410.2 had been
revised in the earlier proposed rule to include a definition of an
``encounter.'' The definition of an encounter is expanded to include
encounters in a CAH. That section is further amended to include a
definition of an ``outpatient'' as a person who has not been admitted
as an inpatient but who is registered on the hospital or CAH records as
an outpatient and receives services (rather than supplies alone)
directly from the hospital or CAH. The revision to include CAHs in
these definitions is made to comply with sections 1862(a)(14) and
1866(a)(1)(H) of the Act, which require that CAHs be treated as
hospitals for purposes of the bundling provisions. (The BBA eliminated
rural primary care hospitals (RPCHs) and created CAHs. The Congress
intended, under section 4201(c) of the BBA, that CAHs be subject to the
same Medicare requirements to which RPCHs were subject.)
The revision to Sec. 410.27 is the same as in the earlier
proposed rule except that the revision is now designated as paragraph
(e) instead of paragraph (c).
We are removing paragraph (a)(4) of Sec. 410.28
(``Hospital or CAH diagnostic services furnished to outpatients:
Conditions'') to reflect a change made by section 4085(i)(11) of OBRA
1987 regarding provisions of diagnostic services furnished to
outpatients.
Proposed Sec. 410.30 (redesignated as Sec. 416.39 in this
proposed rule) is being significantly revised. In Sec. 410.30(a) and
(b) (now Sec. 410.39 (a) and (b) of regulations published on August 5,
1988, we proposed to require the hospital to furnish directly or under
arrangements all services furnished to its outpatients during an
encounter as well as any diagnostic services furnished outside the
hospital that were ordered during or as a result of an encounter in the
hospital. In this rule, we are not extending the bundling requirements
to include diagnostic services ordered during an encounter in the
hospital that are furnished outside the hospital. Thus, the hospital
will not be required to furnish such diagnostic services directly or
under arrangements. We are proposing a more limited approach to
bundling because the PPS we are proposing involves less ``packaging''
than we anticipated when we published the August 1988 proposed
regulations. At that time, we believed that a PPS payment for a
surgical procedure was likely to include preoperative tests and that
payment for a clinic visit was likely to include the ancillary services
(for example, laboratory tests and x-rays) that were needed to make a
diagnosis. Therefore, by requiring bundling of off-site diagnostic
tests that were ordered during an outpatient encounter at the hospital,
we believed we could ensure that: (1) We had sufficient data to set
payment rates that included the ancillary tests, and (2) once the
system was implemented, the bundling rules would prevent any
duplication of program payments. That is, a service packaged into a PPS
payment to the hospital could not also be billed to the program as an
ancillary test by an outside entity.
As noted above, the PPS we are proposing now does not include
extensive packaging; therefore, the payment for related diagnostic
tests is not included in the payments under the ambulatory payment
classification (APC) groups for surgical procedures, clinic visits,
emergency room visits, etc. Any diagnostic tests that are furnished
will result in a separate payment. The program will pay the entity that
actually furnishes the service--the hospital, if the service is
provided directly or under arrangements made by the hospital; or
another Medicare recognized entity, if the patient leaves the hospital
and obtains the service elsewhere. Because diagnostic tests are not
being packaged into another hospital service, we no longer need to
require that a hospital furnish directly or under arrangements the
services ordered during, or as a result of, an encounter, but furnished
outside the hospital. If the PPS is changed in future years to require
a more packaged approach to payment, the bundling regulations will be
revised. Proposed Sec. 410.30 (now Sec. 410.39) is also revised to
require that the bundling rules apply to CAHs, and the list of services
that are excepted from the bundling requirements, in Sec. 410.30(b)
(now Sec. 410.39(b)) (previously designated in the August 5, 1988,
proposed rule as Sec. 410.30(c)), is expanded to include all of the
services that are currently excepted under section 1862(a)(14) of the
Act.
We are revising Sec. 411.15(m) (previously designated as
Sec. 405.310(m)) significantly. We are eliminating proposed
Sec. 405.310(n). That section, which had described the hospital
[[Page 47559]]
outpatient services that were excluded from coverage if not furnished
directly or under arrangements, has been revised so that we will not
require that hospitals bundle diagnostic services ordered during or as
a result of an encounter in the hospital if furnished outside the
hospital. The requirements of that section have been incorporated into
Sec. 411.15(m)(1). We are revising Sec. 411.15(m)(2), which describes
the services that are exceptions to the bundling rule, to include all
of the services that are now exceptions under section 1862(a)(14) of
the Act. We are further revising Sec. 411.15(m)(3), ``Scope of
exclusion,'' to delete the reference to DME as a service that must be
bundled. DME is defined under section 1861(n) of the Act as equipment
used in the patient's home or in another institution used as his home
other than a hospital or skilled nursing facility (SNF). By definition,
DME is not something that is provided for use in the hospital setting.
Therefore, we do not believe that the DME benefit provides for any item
or service that is expected to be used by the patient while in the
hospital as an inpatient or outpatient. Section 1862(a)(14) of the Act
requires the hospital to provide directly or under arrangements
services furnished to the patients of a hospital or CAH. We did not
provide an exception for DME in our earlier proposed rule, because the
bundling requirements under sections 1862(a)(14) and 1866(a)(1)(H) of
the Act did not provide an exception for DME. However, we now believe
that a statutory exception is not required because the bundling
requirements apply to the services a hospital furnishes to its
patients, and DME is not a hospital service. The covered Part B benefit
for DME as described under section 1861(n) of the Act is intended for
equipment used in the home, so a hospital that furnishes DME to its
patients is not providing a hospital service to its patients, but is
acting in the capacity of a supplier of DME, not a provider of hospital
services. For these reasons, we will not require bundling of DME for
hospital patients.
Section 412.50 was not amended in the earlier proposed
rule, but we are revising it in this rule to specify that hospital
inpatient services do not include the services that are exceptions to
the bundling requirements under section 1862(a)(14) of the Act.
We are revising proposed Sec. 489.20(d) to incorporate as
exceptions to the bundling requirements all of the services that are
now exceptions under section 1866(a)(1)(H) of the Act.
In addition to minor wording changes in introductory
paragraph (b), proposed Sec. 1003.102 remains the same as in the August
5, 1988 proposed rule, with the exception that the revision is now
designated as paragraph (b)(14) rather than as paragraph (b)(4), as
originally indicated in the August 5, 1988 proposed rule. Paragraphs
(b)(11) through (b)(13) of Sec. 1003.102 are being reserved. We are
also amending Sec. 1003.103(a) to indicate, in accordance with section
231(c) of the Health Insurance Portability and Accountability Act, that
the maximum CMP for each improper bill or request has been increased to
$10,000.
We are also amending Sec. 1003.105 (Exclusion from
participation in Medicare and State health care programs) by revising
paragraph (a)(1)(i) to reflect that this basis for imposition of a CMP
is also a basis for an exclusion from participation in Medicare and the
State health care programs.
V. Hospital Outpatient Prospective Payment System (PPS)
In this proposed rule, we delineate the services that are covered
under the hospital outpatient prospective payment system (PPS) that we
are required to establish under section 1833(t) of the Act. We also
propose Medicare payment rates when those services are ordered or
furnished for diagnosis or treatment of a Medicare beneficiary who is
registered on hospital records as an outpatient, and who receives
services directly from the hospital.
In this section, we explain the framework for the hospital
outpatient PPS. This framework rests on Medicare's definition of an
outpatient, which we discuss in section IV.E, above, and on Medicare's
definition of what constitutes a hospital outpatient department or
clinic. In section VI., below, we address requirements to define and
distinguish among the various sites where services that are covered
under the hospital outpatient PPS could be furnished. For example, a
service furnished at an outpatient department or clinic located within
a hospital can also be furnished at a ``provider-based'' entity, at a
site away from a hospital that functions as though it were a department
within the hospital, at an ASC, and at a physician office. Under the
statute as it is currently written, in order to determine whether
Medicare makes payment for a service under the hospital outpatient PPS
that is the subject of this proposed rule or under another provision of
Medicare Part B, such as the ASC benefit or the physician fee schedule,
it is essential to clarify exactly where and under what conditions the
service was furnished.
This PPS will apply to covered hospital outpatient services
furnished by any hospital participating in the Medicare program, except
for those hospitals discussed below. Partial hospitalization services
in community mental health centers (CMHCs) will also be paid under this
PPS.
The cancer hospitals that are excluded from inpatient PPS will be
paid under hospital outpatient PPS. Although the BBA provides for a
separate conversion factor if necessary, we intend to pay cancer
hospitals using the same conversion factor and rates as all other
hospitals. Certain hospitals in Maryland furnish services that are
exempt from this system because they qualify under section 1814(b)(3)
of the Act for payment under the State's payment system. Such excluded
services are limited to the services paid under the State's payment
system as described in section 1814(b)(3) of the Act. Any other
outpatient services furnished by the hospital will be paid under the
outpatient PPS. Critical access hospitals are excluded from the
outpatient PPS because they are paid under a reasonable cost based
system, as required under section 1834(g) of the Act. All other
participating hospitals will be paid under hospital outpatient PPS.
Distinct parts of hospitals that are excluded under inpatient PPS
will be included in the outpatient PPS, to the extent that outpatient
services are furnished by the hospital. For example, a hospital with an
excluded inpatient psychiatric unit will have payment made under this
PPS for outpatient psychiatric services including to inpatients who are
not in a covered Part A stay.
A. Scope of Services Within the Outpatient PPS
Section 1833(t)(1)(B)(i) of the Act gives the Secretary the
authority to designate which services are to be covered under the
hospital outpatient PPS. In this section, we indicate the types of
services for which we are proposing to make payment under the hospital
outpatient PPS and the types of services we are proposing to exclude
from the scope of the hospital outpatient PPS.
Section 1833(t)(2)(A) of the Act requires the Secretary to develop
a classification system for the services that she designates are
covered under the hospital outpatient PPS. Section 1833(t)(2)(B) of the
Act allows the Secretary to classify covered outpatient services by
groups so that the services within each are comparable clinically and
with respect to the use of resources.
[[Page 47560]]
We refer to the hospital outpatient PPS classification system that we
have developed as the Ambulatory Payment Classification (APC) system.
The APC system consists of 346 groups of services that are covered
under the hospital outpatient PPS.
In section V.B., below, we explain how we assigned services and
procedures to APC groups and in sections V.C. and V.D., below, we
explain how we used the APC groups to determine hospital outpatient PPS
payment rates.
1. Services Excluded From the Hospital Outpatient PPS
Section 1833(t)(1)(B)(iii) of the Act excludes the following from
payment under the hospital outpatient PPS: ambulance services, physical
and occupational therapy, and speech-language pathology services. These
services will be paid under fee schedules in all settings.
Section 1833(t)(1)(B)(i) of the Act gives the Secretary the
authority to designate which hospital outpatient services are covered
under the outpatient PPS. In considering which services to include
under the outpatient PPS, we wanted to ensure that all hospital
outpatient services are paid under a prospectively determined amount.
Some hospital outpatient services (for example, clinical diagnostic
laboratory services, orthotics and prosthetics, ESRD dialysis services)
are currently paid based on fee schedules or other prospective rates.
Payments under these fee schedules apply not only to hospital
outpatient services, but the same or very similar payment rates apply
across a number of sites of ambulatory care. Such similar payments
across various settings creates a level playing field where HCFA pays
virtually the same payment for the same service, without regard to
where the service is furnished. So that we do not disrupt an existing
level playing field, we propose to exclude from our PPS, hospital
outpatient services that are currently paid prospectively determined
rates that are the same rates paid in other settings.
We are proposing to exclude from the hospital outpatient PPS the
following:
a. Certain services already paid for under fee schedules or other
payment systems including, but not limited to, services for patients
with ESRD that are paid for under the ESRD composite rate; laboratory
services paid under the clinical diagnostic laboratory fee schedule;
and DME, orthotics, prosthetics, prosthetic devices, prosthetic
implants and supplies (DMEPOS) paid for under the DMEPOS fee schedule
when the hospital is acting as a supplier of these items. An item such
as crutches or a walker that is given to the patient to take home, but
that may also be used while the patient is at the hospital, would be
billed to the DME regional carrier rather than being paid for under the
hospital outpatient PPS.
b. Hospital outpatient services furnished to inpatients of an SNF
regardless of whether the person is in a Part A covered stay and
furnished pursuant to the resident assessment or comprehensive care
plan and that are covered under the SNF PPS, furnished ``under
arrangements'' and billable only by the SNF.
c. Services and procedures that require inpatient care.
MedPAC Recommendation: In its March 1998 report to the Congress,
the Medicare Payment Advisory Commission (MedPAC) recommends that costs
associated with allied health professions training, such as nursing
schools and paramedical education, be excluded from the calculation of
the relative weights and the conversion factor used to set outpatient
PPS payment rates. MedPAC further recommends that Medicare make
separate payment for these costs, consistent with the manner in which
Medicare pays for allied health professions training costs under the
inpatient PPS.
Response: We agree with MedPAC's recommendation. We did not include
costs associated with allied health professions training in the
calculation of outpatient PPS relative weights and conversion factors.
We propose to pay hospitals that have allied health professions
training programs on a cost-pass-through basis similar to the way we
treat these costs under the hospital inpatient PPS.
2. Services Included Within the Scope of the Hospital Outpatient PPS
a. Services for Patients Who Have Exhausted Their Part A Benefits
Section 1833(t)(1)(B)(ii) of the Act provides for Medicare payment
under the hospital outpatient PPS for certain services furnished to
inpatients who have exhausted Part A benefits or otherwise are not in a
covered Part A stay. Examples of services covered under this provision
include diagnostic x-rays and certain other diagnostic services and
radiation therapy covered under section 1832 of the Act.
b. Partial Hospitalization Services
Section 1833(a)(2)(B) of the Act provides that partial
hospitalization services furnished in CMHCs be paid for under the
hospital outpatient PPS. Partial hospitalization is a distinct and
organized intensive psychiatric outpatient day treatment program,
designed to provide patients with profound and disabling mental health
conditions an individualized, coordinated, comprehensive, and
multidisciplinary treatment program.
c. Services Designated by the Secretary
Under the authority established by the statute at section
1833(t)(1)(B)(i), we further are proposing to include within the scope
of services for which payment is made under the hospital outpatient PPS
the following:
Services that are included within the outpatient PPS
system are all hospital outpatient services that have not been
identified for exclusion as described in section V.A.1., above. Among
the types of services that we have classified into APC groups for
payment under the hospital outpatient PPS are the following: surgical
procedures; radiology, including radiation therapy; clinic visits;
emergency department visits; diagnostic services and other diagnostic
tests; partial hospitalization for the mentally ill; surgical
pathology; cancer chemotherapy.
Services furnished to SNF inpatients that are not packaged
into SNF consolidated billing precisely because they are services that
are commonly furnished by hospital outpatient departments and that SNFs
would not be able to provide, such as CT scans, magnetic resonance
imaging, or ambulatory surgery requiring the use of an operating room.
Supplies such as surgical dressings that can be used
during surgery or other treatments in the hospital outpatient setting
that are also on the DMEPOS fee schedule. Payment for such supplies,
when they are used in the hospital, is packaged into the APC payment
rate for the procedure or service with which the items are associated.
Certain preventive services furnished to healthy persons,
such as colorectal cancer screening.
Section 4523(d)(3) of the BBA provides that we will make Part B
payment for certain medical and other health services, when furnished
by a provider of services or by others under arrangement with a
provider of services, under the outpatient PPS, if we would otherwise
pay those providers on a reasonable cost basis for those services.
Specifically, we are proposing that we would pay for the following
medical and other health services under the
[[Page 47561]]
outpatient PPS when furnished by a provider of services:
Antigens (as defined in 1861(s)(2)(G) of the Act);
Splints and casts (1861(s)(5));
Pneumococcal vaccine, influenza vaccine, hepatitis B
vaccine (1861(s)(10)).
We make Part B payment for the above services under the outpatient
PPS when those services are provided by a CORF, HHA, or hospice
program. However, this provision does not apply to services, furnished
by a CORF, that fall within the definition of CORF services at section
1861(cc)(1) of the Act. It also does not apply to services furnished by
a hospice within the scope of the hospice benefit. Nor does it apply to
services furnished by HHAs to individuals under an HHA plan of
treatment within the scope of the home health benefit.
3. Hospital Outpatient PPS Payment Indicators
Column B in Addendum B indicates the payment status of each HCPCS
code. Addendum B displays all HCPCS codes, including those incidental
services that are packaged into APC payment rates. Addendum G
identifies inpatient services not payable under outpatient PPS.
We use ``A'' to indicate services that are paid under some
other method such as the DMEPOS fee schedule or the physician fee
schedule.
We use ``E'' to indicate services for which payment is not
allowed under the hospital outpatient PPS or is not covered by
Medicare.
We use ``C'' to indicate inpatient services that are not
payable under the outpatient PPS.
We use ``N'' to indicate services that are incidental,
with payment packaged into another service or APC group.
We use ``P'' to indicate services that are paid only in
partial hospitalization programs.
We use ``S'' to indicate significant procedures for which
payment is allowed under the hospital outpatient PPS but to which the
multiple procedure reduction does not apply.
We use ``T'' to indicate surgical services for which
payment is allowed under the hospital outpatient PPS. Services with a
payment indicator ``T'' are the only services to which the multiple
procedure payment reduction applies.
We use ``V'' to indicate medical visits for which payment
is allowed under the hospital outpatient PPS. Providers must use ICD-9-
CM (International Classification of Diseases, Ninth Edition, Clinical
Modification) codes to determine the level of payment for services with
a payment indicator ``V''.
We use ``X'' to indicate ancillary services for which
payment is allowed under the hospital outpatient PPS.
The table below lists all of the outpatient PPS indicators and what
they designate.
Status Indicators
[How Medicare Pays for Various Services When They Are Billed for Hospital Outpatients]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Indicator Service Status
--------------------------------------------------------------------------------------------------------------------------------------------------------
A..................................... Pulmonary Rehabilitation; Non-paid.
Clinical Trial.
C..................................... Inpatient Procedures............ Bill as Inpatient.
A..................................... Durable Medical Equipment, DMEPOS Fee Schedule.
Prosthetics and Orthotics.
E..................................... Non-covered Items and Services.. Non-paid.
A..................................... Physical, Occupational and Rehab Fee Schedule.
Speech Therapy.
A..................................... Ambulance....................... Ambulance Fee Schedule.
A..................................... EPO for ESRD patients........... National Rate.
A..................................... Clinical Diagnostic Laboratory Lab Fee Schedule.
Services.
A..................................... Physician Services for ESRD Bill to carrier.
patients.
A..................................... Screening Mammography........... Lower of Charge or National Rate.
N..................................... Incidental Services, packaged Packaged; no additional payment allowed.
into APC Rate.
P..................................... Partial Hospitalization Services Paid per diem.
S..................................... Significant Procedure, not Paid under hospital outpatient PPS (APC rate).
reduced when multiple.
T..................................... Significant Procedure, multiple Paid under hospital outpatient PPS (APC rate).
procedure reduction applies.
V..................................... Visit to Clinic or Emergency Paid under hospital outpatient PPS (APC rate).
Department.
X..................................... Ancillary Service............... Paid under hospital outpatient PPS (APC rate).
--------------------------------------------------------------------------------------------------------------------------------------------------------
B. Description of the Ambulatory Payment Classification (APC) Groups
In response to OBRA 1986 and OBRA 1990 requirements to develop a
hospital outpatient PPS, we examined systems that were in place or
under development, and we entered into a cooperative agreement with 3M-
Health Information Systems to develop a classification system for
outpatient services. The results of our review of existing systems are
outlined in a Report to Congress dated March 17, 1995. The report
identified the Ambulatory Patient Groups (APGs), which were developed
by 3M-Health Information Systems, as the most promising classification
system, and we recommended that APG-like groups be used as the basis
for the hospital outpatient PPS. Soon after the report was submitted to
the Congress, 3M-Health Information Systems released an updated version
(known as Version 2.0) of the APGs. Since the release of Version 2.0,
HCFA has revised the APGs based on more recent Medicare data. These
revisions constitute what we are calling the Ambulatory Payment
Classification (APC) system or groups that are proposed in this rule.
Services within the APC system are identified by HCPCS codes and
descriptions.
1. Setting Payment Rates Based on Groups of Services Rather Than on
Individual Services
MedPAC Recommendation: In its March 1998 report to the Congress
entitled ``Report to the Congress: Medicare Payment Policy,'' MedPAC
recommends that payment rates under the hospital outpatient PPS be
based upon relative weights for each individual service rather than
upon groups of similar services to help ensure consistent payments
across ambulatory settings. MedPAC gives several reasons to support
this recommendation:
If services in a group are not homogeneous, a single
payment rate for
[[Page 47562]]
all services in the group would not be accurate.
Hospitals whose case mix includes a greater than average
volume of higher-cost procedures in a group with a payment rate based
on median costs for all procedures in the group could face losses and
would have a financial incentive to provide only the lower-cost
procedures within a group and to avoid the higher-cost procedures.
Grouping services creates considerable administrative
burdens and problems related to data consistency, provider education,
the need for extensive technical assistance, and modification of claims
processing systems.
If costs for services in a group change at different
rates, the price for the group may become distorted over time,
necessitating periodic rebasing of group weights.
Using groups to set rates for services under the hospital
outpatient PPS moves away from standardizing payment systems across
ambulatory settings.
Response: We have carefully reviewed MedPAC's concerns about using
groups of services rather than individual services as the basis for
setting weights under the hospital outpatient PPS, and we believe that
we have addressed most of these concerns in our approach to ratesetting
using APC groups.
Section 1833(t)(2)(A) of the Act requires the Secretary to develop
a classification system for covered outpatient services. Section
1833(t)(2)(B) provides that this classification system may be composed
of groups, so that services within each group are comparable clinically
and with respect to the use of resources. The statute refers to ``each
such service (or group of services),'' implying that we may choose or
not choose to group services. We have chosen to set rates for groups of
similar services rather than setting rates for individual services for
several reasons:
The composition of the APC groups is based on two
premises: the procedures within each group must be similar clinically,
and the procedures must be similar in terms of resource costs. As we
explain below, we used 3M's APGs as a starting point, but we have
subsequently made changes to most of the 3M groups, taking into account
1996 outpatient claims data; data collected in a 1994 survey of ASC
costs and charges; data collected in 1995 and 1996 to establish
resource-based practice expense relative values under the Medicare
physician fee schedule; comments on surgical groupings following an ASC
town meeting held at HCFA in July 1996 at which participants reviewed
3M's Version 2.0 surgical APGs for consistency in terms of clinical
characteristics and resource costs; and the medical judgment of HCFA's
medical advisors. Further, we invite comments on the composition of all
the APC groups that are presented in this proposed rule and whether
readers believe that further refinements are needed. We request that
commenters support their recommendations for changes in the APC groups
with data regarding resource costs (time, supplies, equipment, labor
requirements) as well as clinical arguments.
We have also solicited comments on the same surgical APC groups
that are proposed in this rule as part of a proposed rule entitled
``Update of Ratesetting Methodology, Payment Rates, Payment Policies,
and the List of Covered Surgical Procedures for Ambulatory Surgical
Centers Effective October 1, 1998'' (HCFA-1885-P), published in the
Federal Register June 12, 1998 (63 FR 32290). We intend to coordinate
our review of all comments submitted timely during the comment period
for the hospital outpatient PPS proposed rule and the ASC proposed
rule. Any subsequent changes to the APC groups will be used by both
payment systems when we set their respective final rates. We have a
high level of confidence in the homogeneity of the APC groups that will
emerge from this exhaustive review process.
We have found that, in this context, setting weights at a
single code level suggests a level of precision that is often not
warranted due either to low procedure volume or questionable cost data.
Of the 10,500 codes in the HCPCS, over 5,000 describe
services that are covered under the hospital outpatient PPS. However,
an examination of outpatient claims data for 1997 reveals that as few
as 100 HCPCS codes account for more than a third of all coded services
billed during that year. MedPAC states in its report to the Congress
that its analysis of physician claims for 1996 revealed that more than
90 percent of hospital outpatient volume was accounted for by 300 high
volume services. Because so many codes were billed infrequently or not
at all, we found ratesetting to be facilitated by grouping together the
data that were available for codes that are similar clinically. We
disagree with MedPAC's suggestion that we establish payment groups
composed only of low-volume procedures. If we were to establish such
groups, we would either have to except these groups from the principle
of clinical consistency that applies to other APC groups or greatly
increase the number of APC groups within the outpatient PPS. And, this
approach does not solve the problem of how to establish weights for
procedures, whether they are taken individually or in groups, for which
we have inadequate cost data. Placing low Medicare volume procedures in
APC groups with which they are similar clinically and in terms of
resource consumption does not affect the weight established for the
group to any appreciable extent because the weight derives from the
higher volume procedures within the group.
Grouping closely related services, and paying the median
cost of the group, discourages the upcoding that occurs when individual
services that are similar have disparate median costs.
Using APC groups to set outpatient weights is consistent
with the ratesetting method we are proposing for ASCs. In a proposed
rule entitled ``Update of Ratesetting Methodology, Payment Rates,
Payment Policies, and the List of Covered Surgical Procedures for
Ambulatory Surgical Centers Effective October 1, 1998'' (HCFA-1885-P),
published in the Federal Register June 12, 1998 (63 FR 32290), we
propose payment rates for surgical procedures performed in Medicare-
approved ASCs using APC surgical groups proposed in this rule.
Payment rates for new or redefined services can be more
reliably established by assigning codes for these services to an
existing group of several codes that share characteristics with the new
code rather than trying to match it to an equivalent single procedure
for which we may or may not have reliable cost data.
Our experience basing ASC payment rates on groups of codes
has proved to be no more burdensome administratively than has our
experience with setting weights on a single code basis under the
Medicare physician fee schedule. Under the outpatient PPS, with weights
set by APC groups, hospitals will continue to use the same HCPCS coding
and the same claims forms that they use currently. Any burdens on HCFA
or on hospitals necessitating additional technical assistance or
systems changes are more a function of implementing an entirely new
payment system than of our setting weights on the basis of groups of
services instead of on the basis of single procedures or services.
We invite comments on our setting rates on the basis of groups of
services rather than on individual codes.
[[Page 47563]]
2. How the Groups Were Constructed
3M created APGs by combining procedure codes and diagnosis codes
into groups that were clinically related (such as all codes for repair
of fractured legs) and analyzing claims data to determine if the codes
that were clinically similar also used resources in similar ways (for
example, surgical repair would likely be more resource intensive than
closed manipulation and casting). The resources that were examined were
based on a 3-month sample of all Medicare claims for outpatient
services. The sample of nearly 15 million claims was selected from
claims paid in 1992 with the charges on each claim matched to
departmental cost-to-charge ratios from the hospital that provided the
services. The costs that were calculated using billed charges and
department cost-to-charge ratios included direct costs, as well as the
overhead for performing the services. The APGs were clustered into
significant procedures (both surgical and nonsurgical), medical visits
(in both clinics and emergency departments), and ancillary services.
Other groups captured incidental services (those that would not be paid
separately) and procedures for which no payment is made, such as
services specifically excluded from Medicare payment by statute.
Our Report to Congress recommended the use of APG-like groups for a
hospital outpatient prospective payment system. When the time came to
update payment groups for ASCs, which already were paid under a PPS, we
decided to propose the use of APG-like groups. The ASC industry was
accustomed to eight payment groups, with rates ranging from about $300
to about $900 in roughly $75 increments, without clinical coherence.
While interested in our proposal, the ASCs were concerned about
perceived misclassifications, with groups containing codes they
believed represented divergent resources. To accommodate these
concerns, we regrouped many surgical codes, creating more levels within
some ranges of groups and otherwise changing 3M's system. We also found
it necessary to change the medical APGs. The medical visit groups,
which under the APGs were grouped based on the patient's diagnosis,
were clearly distinct when laboratory services and plain film x-rays
were packaged in, but were much less distinct when those ancillary
services related to the visit were not packaged, as will be the case
initially under our system. We therefore investigated other approaches
to categorizing medical visits that would result in clearly defined
payment groups without extensive packaging. We discuss these approaches
in section V.B.4., below.
This process of revising 3M's APGs resulted in the development of
the set of 346 mutually-exclusive and exhaustive service categories
called ambulatory payment classification groups or APCs. The weights of
the groups proposed in this rule are based on new data, as required by
the BBA. We matched the database of 98 million hospital outpatient
claims paid in 1996 to the most recent available cost reports for each
hospital, and constructed the groups using these cost data. We defined
each outpatient service under the PPS by a HCPCS code and classified it
either into one of the APC groups for which an outpatient PPS payment
rate is established or into a non-payment category of services that are
excluded from the outpatient PPS. A weight is associated with each APC
group. See section V.C. of this rule for details on how we calculated
the weights. Procedures and services assigned a non-payment
classification include services that can be provided only on an
inpatient basis; codes or services that are not covered by Medicare;
and procedures and services paid under fee schedules or other payment
method.
3. Packaging Under the Groups
Packaged services are those that are recognized as contributing to
the cost of the services in an APC, but that we do not pay for
separately. Under the APC system, packaged services include the
operating room, recovery room, anesthesia, medical/surgical supplies,
pharmaceuticals, observation, blood, intraocular lenses, casts and
splints, donor tissue, and various incidental services such as
venipuncture. We ``packaged'' the services (and their costs) within the
APC group of procedures with which they were delivered in the base
year. Below is a list of the hospital revenue centers from which we
derived costs that were packaged within the APC groups. For example, a
given surgical procedure would have a cost for the use of the operating
and recovery rooms in every case. However, supply costs might vary,
with some patients requiring special drains and dressings and others
needing minimal dressings. The average packaged cost for supplies might
represent, for example, $200 for the former group 40 percent of the
time, and $150 for the rest. Thus, the APC would include $170 for
supplies. Similarly, only a few cases would have included observation
in the base year, but each case in the group would include a small
amount for the times we associated observation with the cases in the
group.
We have packaged the cost of pharmaceuticals and biologicals within
APC groups. We did this because we believe drugs are usually provided
in connection with some other treatment or procedure. We have captured
aggregate cost data on all drugs that were billed with HCPCS codes and
those billed with revenue center codes, whether or not a HCPCS was
entered. Thus, historical patterns of drug use are captured within the
APC groups with which the drugs were billed during the base year. The
only separate drug groups we have created are for chemotherapeutic
agents, because those were separately identified in 3M's APG system.
Because we intended to use an APG-like system, we required detailed
coding of chemotherapeutic agents in order to be able to capture the
costs of the specific drugs. We did not require HCPCS coding of other
drugs, so we cannot specifically identify costs of non-chemotherapy
drugs. We understand, however, that some rarely-used drugs are both
expensive and used in only a few hospitals. In those instances, APC
payment rates may not adequately represent costs for hospitals that
treat patients who require infusions of very costly drugs or
biologicals. Because we do not have bills that were coded to identify
these high-cost drugs individually, we cannot evaluate the impact of
paying separately for high-cost drugs. We could require HCPCS coding of
all drugs or certain categories of drugs in order to gather the data,
but we know hospitals could find such a requirement burdensome. We
solicit comments on this issue.
Currently, drugs that can be self-administered are not covered
under Part B of Medicare (with certain specific exemptions for blood-
clotting factors, immunosuppresives, erythropoietin for dialysis
patients, and certain oral chemotherapeutic agents and antiemetics).
This presents problems in the outpatient hospital setting because even
a pain killer given to a groggy patient postoperatively would not be
covered. The only way such drugs can be paid for is for the hospital to
bill the beneficiary. In many cases, the hospital does not, both
because keeping track of such small charges for billing purposes is
burdensome and because beneficiaries would not understand why they are
being asked to pay for, for example, pain medication that was clearly
related to the procedure they had undergone.
We propose to allow hospitals to provide drugs to patients without
requiring that the hospital bill the
[[Page 47564]]
patient, and without Medicare's paying the hospital. Normally,
hospitals are not allowed to waive such billing, since not charging a
patient could be seen as an inducement to the patient to use other
services at the hospital, for which the hospital would be paid.
However, if the benefit is not advertised, we believe that provision of
the self-administered drugs at no charge to the beneficiary need not
constitute an inducement in violation of the anti-kickback rules. The
hospital may not advertise this to the public or in any other way
induce patients to use the hospital's service in return for forgoing
payment.
Recommendation: MedPAC recommends that the unit of payment under
the outpatient PPS be the individual service or procedure that is
furnished and that payment for services and supplies integral to the
individual service or procedure be bundled within that single unit of
payment.
Response: We agree both with MedPAC's recommendation regarding what
should constitute the unit of payment under the outpatient PPS, and
with MedPAC's recommendation regarding the ``bundling'' of payment,
which we call ``packaging,'' for supplies and services that are
integral to the individual service or procedure that constitutes the
unit of payment. All services and procedures for which payment is to be
made under the outpatient PPS are identified by HCPCS codes and
descriptions. This approach of identifying individual services by HCPCS
as the unit for payment parallels the unit for payment under both the
Medicare physician fee schedule and the ASC facility services benefit.
In addition, as we explain above, the payment amount for each HCPCS
code is a packaged payment that takes into account the costs associated
with services and supplies that are integral to the primary HCPCS-coded
service or procedure and that are furnished at the same time and in the
same place as the primary service or procedure. Because we modeled the
outpatient PPS package of services for surgical procedures on the
package of services that is the basis for payments for facility
services furnished by Medicare approved ASCs, the definition of
packaging will become standardized across both settings upon
implementation of the outpatient PPS.
MedPAC cites as a disadvantage of using individual services or
procedures as the unit for payment the limited options that are
available to control the volume of unnecessary ancillary services. We
discuss in section V.J. how we intend to address volume control under
the outpatient PPS. While a broader definition of packaging that
includes related ancillaries such as diagnostic x-rays and other
diagnostic tests that are furnished in other settings or at a different
time than the primary service or procedures may have potential benefits
not realized by the more limited packaging that we are using, we are
concerned that applying different definitions of packaging to payments
for the same primary service furnished in different settings would
defeat the goal of establishing a unified payment structure across
sites. One component of achieving this goal is to employ a consistent
definition of packaging across all sites of ambulatory services. We
solicit comments on the packaging options and the implications for
ratesetting and volume control of using the same or different
definitions of packaging across different settings.
The following table identifies by revenue code the services and
items that are packaged into the various categories of APC groups
(surgery, radiology, other diagnostic, medical visits, and all other
APC groups).
Packaged Services by Revenue Center
------------------------------------------------------------------------
SURGERY
------------------------------------------------------------------------
250.................................... PHARMACY.
251.................................... GENERIC.
252.................................... NONGENERIC.
257.................................... NONPRESCRIPTION DRUGS.
258.................................... IV SOLUTIONS.
259.................................... OTHER.
270.................................... M&S SUPPLIES.
271.................................... NONSTERILE SUPPLIES.
272.................................... STERILE SUPPLIES.
360.................................... OPERATING ROOM.
361.................................... MINOR SURGERY.
369.................................... OTHER.
370.................................... ANESTHESIA.
379.................................... OTHER.
380.................................... ``BLOOD, GENERAL CLASS''.
381.................................... PACKED RED CELLS.
382.................................... WHOLE BLOOD.
383.................................... PLASMA.
384.................................... PLATELETS.
385.................................... LEUCOCYTES.
386.................................... OTHER COMPONENTS.
387.................................... OTHER DERIVATIVES.
389.................................... OTHER BLOOD.
390.................................... BLOOD STORAGE AND PROCESSING.
391.................................... BLOOD ADMINISTRATION.
399.................................... OTHER BLOOD PROC/STORAGE.
490.................................... ``AMBULATORY SURGERY, GENERAL
CLASS''.
491.................................... OTHER AMBULATORY SURGICAL CARE.
630.................................... DRUGS REQUIRING ID.
631.................................... SINGLE SOURCE DRUG.
632.................................... MULTIPLE SOURCE DRUG.
636.................................... DRUGS REQUIRING DETAILED
CODING.
700.................................... CAST ROOM.
709.................................... OTHER.
710.................................... RECOVERY ROOM.
719.................................... OTHER.
720.................................... LABOR ROOM.
721.................................... LABOR.
722.................................... DELIVERY.
723.................................... CIRCUMCISION.
724.................................... BIRTHING CENTER.
729.................................... OTHER.
750.................................... GASTROINTESTINAL.
759.................................... OTHER.
760.................................... OBSERVATION ROOM.
761.................................... TREATMENT ROOM.
762.................................... OBSERVATION ROOM.
769.................................... OTHER TREATMENT ROOM.
890.................................... OTHER DONOR BANK.
891.................................... BONE.
892.................................... ORGAN.
893.................................... SKIN.
899.................................... OTHER.
920.................................... ``OTHER DIAGNOSTIC SERVICES,
GENERAL CLASS''.
929.................................... OTHER DIAGNOSTIC SERVICES.
940.................................... ``OTHER THERAPEUTIC SERVICES,
GENERAL CLASS''.
949.................................... OTHER THERAPEUTIC SERVICES.
------------------------------------------------------------------------
MEDICAL VISIT
------------------------------------------------------------------------
250.................................... PHARMACY.
251.................................... GENERIC.
252.................................... NONGENERIC.
257.................................... NONPRESCRIPTION DRUGS.
258.................................... IV SOLUTIONS.
259.................................... OTHER.
270.................................... M&S SUPPLIES.
271.................................... NONSTERILE SUPPLIES.
272.................................... STERILE SUPPLIES.
279.................................... OTHER.
380.................................... ``BLOOD, GENERAL CLASS''.
381.................................... PACKED RED CELLS.
382.................................... WHOLE BLOOD.
383.................................... PLASMA.
384.................................... PLATELETS.
385.................................... LEUCOCYTES.
386.................................... OTHER COMPONENTS.
387.................................... OTHER DERIVATIVES.
389.................................... OTHER BLOOD.
390.................................... BLOOD STORAGE AND PROCESSING.
391.................................... BLOOD ADMINISTRATION.
399.................................... OTHER BLOOD PROC/STORAGE.
630.................................... DRUGS REQUIRING ID.
631.................................... SINGLE SOURCE DRUG.
632.................................... MULTIPLE SOURCE DRUG.
636.................................... DRUGS REQUIRING DETAILED
CODING.
762.................................... OBSERVATION ROOM.
------------------------------------------------------------------------
DIAGNOSTIC
------------------------------------------------------------------------
250.................................... PHARMACY.
251.................................... GENERIC.
252.................................... NONGENERIC.
254.................................... INCIDENT TO OTHER DIAGNOSTIC.
257.................................... NONPRESCRIPTION DRUGS.
258.................................... IV SOLUTIONS.
259.................................... OTHER.
270.................................... M&S SUPPLIES.
271.................................... NONSTERILE SUPPLIES.
272.................................... STERILE SUPPLIES.
360.................................... OPERATING ROOM.
361.................................... MINOR SURGERY.
369.................................... OTHER.
370.................................... ANESTHESIA.
372.................................... INCIDENT TO OTHER DIAGNOSTIC.
379.................................... OTHER.
380.................................... ``BLOOD, GENERAL CLASS''.
381.................................... PACKED RED CELLS.
382.................................... WHOLE BLOOD.
383.................................... PLASMA.
384.................................... PLATELETS.
385.................................... LEUCOCYTES.
386.................................... OTHER COMPONENTS.
387.................................... OTHER DERIVATIVES.
389.................................... OTHER BLOOD.
390.................................... BLOOD STORAGE AND PROCESSING.
391.................................... BLOOD ADMINISTRATION.
399.................................... OTHER BLOOD PROC/STORAGE.
[[Page 47565]]
450.................................... ER.
459.................................... OTHER.
622.................................... INCIDENT TO OTHER DIAGNOSTIC.
630.................................... DRUGS REQUIRING ID.
631.................................... SINGLE SOURCE DRUG.
632.................................... MULTIPLE SOURCE DRUG.
636.................................... DRUGS REQUIRING DETAILED
CODING.
710.................................... RECOVERY ROOM.
719.................................... OTHER.
762.................................... OBSERVATION ROOM.
------------------------------------------------------------------------
RADIOLOGY
------------------------------------------------------------------------
250.................................... PHARMACY.
251.................................... GENERIC.
252.................................... NONGENERIC.
255.................................... INCIDENT TO RADIOLOGY.
257.................................... NON-PRESCRIPTION DRUGS.
258.................................... IV SOLUTIONS.
259.................................... OTHER.
270.................................... M&S SUPPLIES.
271.................................... NONSTERILE SUPPLIES.
272.................................... STERILE SUPPLIES.
360.................................... OPERATING ROOM.
361.................................... MINOR SURGERY.
369.................................... OTHER.
370.................................... ANESTHESIA.
371.................................... ANESTHESIA INCIDENT TO
RADIOLOGY.
379.................................... OTHER.
380.................................... ``BLOOD, GENERAL CLASS''.
381.................................... PACKED RED CELLS.
382.................................... WHOLE BLOOD.
383.................................... PLASMA.
384.................................... PLATELETS.
385.................................... LEUCOCYTES.
386.................................... OTHER COMPONENTS.
387.................................... OTHER DERIVATIVES.
389.................................... OTHER BLOOD.
390.................................... BLOOD STORAGE AND PROCESSING.
391.................................... BLOOD ADMINISTRATION.
399.................................... OTHER BLOOD PROC/STORAGE.
621.................................... SUPPLIES INCIDENT TO RADIOLOGY.
630.................................... DRUGS REQUIRING ID.
631.................................... SINGLE SOURCE DRUG.
632.................................... MULTIPLE SOURCE DRUG.
636.................................... DRUGS REQUIRING DETAILED
CODING.
710.................................... RECOVERY ROOM.
719.................................... OTHER.
762.................................... OBSERVATION ROOM.
------------------------------------------------------------------------
ALL OTHER APC GROUPS
------------------------------------------------------------------------
250.................................... PHARMACY.
251.................................... GENERIC.
252.................................... NONGENERIC.
257.................................... NONPRESCRIPTION DRUGS.
258.................................... IV SOLUTIONS.
259.................................... OTHER.
270.................................... M&S SUPPLIES.
271.................................... NONSTERILE SUPPLIES.
272.................................... STERILE SUPPLIES.
279.................................... OTHER.
380.................................... ``BLOOD, GENERAL CLASS''.
381.................................... PACKED RED CELLS.
382.................................... WHOLE BLOOD.
383.................................... PLASMA.
384.................................... PLATELETS.
385.................................... LEUCOCYTES.
386.................................... OTHER COMPONENTS.
387.................................... OTHER DERIVATIVES.
389.................................... OTHER BLOOD.
390.................................... BLOOD STORAGE AND PROCESSING.
391.................................... BLOOD ADMINISTRATION.
399.................................... OTHER BLOOD PROC/STORAGE.
630.................................... DRUGS REQUIRING ID.
631.................................... SINGLE SOURCE DRUG.
632.................................... MULTIPLE SOURCE DRUG.
636.................................... DRUGS REQUIRING DETAILED
CODING.
762.................................... OBSERVATION ROOM.
------------------------------------------------------------------------
4. Treatment of Clinic and Emergency Visits
The major issue we face in determining payment for clinic and
emergency room visits is whether to include diagnosis as well as
Physicians' Current Procedural Terminology (CPT) codes in setting
payment rates. We solicit comments on the approaches that we discuss
below and on other possible alternatives.
Determining payment for clinic and emergency room visits requires a
variety of considerations and trade-offs. These include:
The impact of packaging on setting payment rates (for
example, the more packaging, the greater the difference among APC
payments; however, we are not proposing a fully packaged system
initially, which reduces payment differences and may necessitate
additional policies to increase differences across payment groups);
How to code visits in a manner that recognizes variations
in service intensity and levels of resource consumption (for example,
how to pay more for visits that cost more);
How to keep the system administratively manageable (for
payment purposes, we assign 31 CPT codes that describe different levels
of evaluation and management services to 7 APC groups);
How to define critical care in terms of facility as
opposed to physician inputs (for example, what is an appropriate
facility payment for critical care when critical care CPT codes are
currently determined to reflect physician inputs);
Data problems associated with identifying costs from
claims that list multiple services (for example, the data analysis we
have conducted so far reflects only data from claims for single visits;
we are analyzing data from multiple visit claims to glean additional
information relevant to these policies);
How to move toward greater uniformity of payments across
ambulatory settings so as to remove payment as an incentive for
determining site of service (for example, the trade-off that could
result if, by enhancing differentiation of payments for services within
the hospital outpatient setting, we were to increase payment
differences across settings for services that are provided in both
hospital outpatient departments and physician offices).
Given the range of issues surrounding payments for clinic and
emergency room visits, we are continuing to weigh different options. We
are concerned that using diagnosis coding to set rates for hospital
outpatient clinic visits could increase disparities in payment
methodology between outpatient departments and physician offices, for
which a new system of resource based practice costs is just now being
proposed. (These concerns do not extend as much to emergent and
critical care, which are not routinely furnished in physician office
settings.) Diagnostic coding has not been used in the past to adjust
payments in the physician office setting and there is no general
evidence that practice expense (or work) in physician office settings
varies by the patient's diagnosis. Moreover, because patients in the
hospital outpatient department can be shifted easily to alternative
outpatient settings, adjustment of facility costs to take diagnosis
into account in one setting but not others may create incentives to
shift patients among ambulatory settings in unknown ways.
Coding Visits
We have considered several approaches to setting prospective
payment rates for hospital clinic and emergency visits. We reviewed the
medical visit groups in 3M's version 2.0 of APGs that are based solely
on ICD-9 diagnosis codes, with 80 APGs providing several groups for
each body system; we analyzed the effect on ratesetting of defining
clinic and emergency visits solely by CPT code; and, we analyzed the
effect of using a matrix that combines patient diagnosis with a CPT
code to describe the nature of the outpatient encounter. We discuss
these various approaches in more detail here and some of the advantages
and disadvantages of each. Again, we solicit comments on these
approaches to setting payment rates for clinic and emergency room
visits as well as comments on alternative approaches that are not
mentioned here.
Approach 1: Using Diagnosis Codes Only
3M's approach of using only ICD-9 diagnosis codes with extensive
packaging results in a wide range of group payment rates. The group
that pays the most is almost 13 times as costly as the lowest-paid
group. However, when we removed minor laboratory tests, x-rays, and
certain other minor procedures that had been packaged into 3M's medical
visit APGs in order to conform with the packaging that we propose in
this proposed rule,
[[Page 47566]]
the difference between the highest and the lowest paid group dropped to
not quite five times. (Fully packaged APGs are sufficiently
differentiated for payment purposes, while partially packaged APGs are
not; therefore, if we were to move to a fully packaged system, we would
re-evaluate approaches using diagnosis.)
We also found that grouping clinic and emergency visits solely on
the basis of diagnoses tends to result in visits that require major
resources for critical cases clustering together with less resource-
intensive follow-up visits after the crisis has passed.
Approach 2: Using CPT Codes Only
The APC groups that we propose in this proposed rule as the basis
for setting rates for surgical services consist solely of CPT codes. We
looked at using only CPT codes to establish payment groups for
outpatient clinic and emergency room visits, but we found that the
variation between the most costly and the least costly encounter was
quite flat, with the former only 4.5 times greater than the latter.
When basing payment on CPT codes alone, the range reflects hospitals'
billing patterns in increasing level of intensity, but cases at the
margin are overwhelmed by the numbers of visits billed so that
individual cases with low or high costs are not discernible. Also,
billing patterns reflect standard bills, not the resources used in any
particular case.
Approach 3: CPT and Diagnosis Hybrid
We looked at another approach that bases payment rates on a hybrid
of CPT codes and patient diagnoses. We first assigned 31 CPT codes that
describe physician encounters with patients in the outpatient setting
to seven APC groups: three for clinic visits, three for emergency
department visits, and one for critical care. We also collapsed
approximately 12,000 ICD-9 codes into 20 major diagnostic categories
(MDCs), arranged generally by body system. Classifying services in this
fashion produces a more manageable number of groups, and results in a
matrix of 121 CPT/diagnosis combinations, in which the most costly
combination is more than 10 times as costly as the least.
Our grouping of evaluation and management CPT codes was based on
several factors. As we note above, we grouped 31 CPT codes that
represent different levels of physician ``evaluation and management''
of patients into seven APC groups. (For a more complete discussion,
refer to the evaluation and management services guidelines in
Physicians' Current Procedural Terminology 1998 edition (CPT '98)
published by the American Medical Association.) CPT codes are more
descriptive of physician effort than of facility use, and our cost data
showed little difference between level 1 and level 2 visits or between
level 4 and level 5 visits. Therefore, we elected to combine some of
the CPT codes into a single group, for example, the two least intensive
outpatient visit codes, 99201 and 99202, are both in APC 911, which is
the lowest level of clinic visits, etc. Grouping CPT codes together in
this fashion reduces administrative burden, and our data analysis shows
only small additional cost differences among the complete set of CPT
medical visit codes. Moreover, we found that grouping CPT codes in this
fashion evens out certain anomalies that arise when an emergency
department furnishes services that would not typically be thought of as
emergency care, such as suture removal, or treatment of a skin disease.
Even though suture removal or treatment of conditions such as impetigo,
conjunctivitis, etc. is performed in emergency departments, these types
of services are more appropriately furnished at a clinic because they
do not require the more elaborate resources of the emergency
department. Assigning codes to APC groups would allow us to set payment
for care of patients with minor problems in the emergency department at
a level equivalent to payment for the same care when it is furnished at
a clinic. We welcome comments on payment for services that do not
require emergency room use.
Using a matrix of evaluation and management codes with patient
diagnosis would offset the disadvantages noted above of grouping solely
by CPT code (too little payment variation) or solely by patient
diagnosis (reduced payment variation and commingling of resource
intensive and non-resource intensive visits). Defining a clinic or
emergency visit APC in terms of both CPT code and diagnosis, even when
grouping codes to provide a manageable number of groups, would better
recognize the facility resources consumed in providing emergency and
critical care visits. Many such visits, of course, cluster around the
same dollar amount, but this is expected because many visits involve
typical care and standard resources. The cases that represent care at
higher or lower levels of intensity appear to represent real
differences in resource consumption. We used the CPT/patient diagnosis
hybrid to model impacts. We do not believe that payment to individual
hospitals would be significantly affected, whether we base payment
rates on groups of CPT codes only or on groups that combine CPT codes
and patient diagnosis.
Using a matrix that combines CPT codes with patient diagnosis to
set payment rates for clinic and emergency department visits would also
improve the coding of diagnoses in the hospital outpatient setting
generally. Such improved diagnosis coding is critical to evaluating
future degrees of packaging in the APC system, and we have already
noted that more packaging tends to increase the measured cost
differences across APC groups.
However, as we discussed earlier, there are also problems with
using a matrix that includes diagnosis codes for hospital outpatient
visits. We are concerned about the effect of using a method to pay for
clinic visits in the hospital outpatient setting that is at variance
with the method we use to pay for the same service in a physician
office. A possible alternative to using diagnosis codes as an indicator
of resource consumption in connection with medical visits in hospital
outpatient departments is to create a uniform fee schedule for
physician visits across all ambulatory settings, paying the site at
which the service is furnished the physician practice expense component
as a ``facility fee.'' However, the latter option would require
legislation and a possible reallocation of the overhead currently
associated with medical visits in the outpatient department to other
outpatient services. Given the complexity of these issues, it may not
be desirable to introduce additional differences, such as diagnosis,
among payments in medical visits at this time. We invite public comment
on all of the issues raised in the discussion in this section. In
addition, after this rule is published, we will be reexamining our
outpatient database and extending our analysis to multiple visit data.
We will incorporate the findings of these additional analyses into our
final decision.
Hypothetical Case Using the Hybrid
The following is a hypothetical case presented to illustrate how
payment would be determined using the CPT code/diagnosis code hybrid. A
new patient, an elderly woman who has recently come to live with her
family in the area, presents to the primary care clinic complaining of
fatigue, shortness of breath, swollen ankles, and loss of vision. The
physician spends 45 minutes eliciting the patient's medical, family,
and social history and performing an extensive physical examination.
Suspecting cataracts as the
[[Page 47567]]
cause of her loss of vision, the physician suggests she make an
appointment in the eye clinic. Suspecting congestive heart failure as
the cause of her other symptoms, but also suspicious of coexisting
diabetes and hypertension, the physician orders laboratory tests and an
electrocardiogram (ECG) to be performed that day, and schedules an
appointment in the cardiovascular clinic for a later date. If payment
to the hospital were to be made on the basis of a CPT code/ICD-9 code
matrix, the hospital's claim for services furnished in connection with
this visit would identify the following information: CPT code 99204,
comprehensive outpatient visit, new patient, and ICD-9 diagnosis code
401.1, benign hypertension. Payment would be determined by mapping CPT
code 99204 to APC group 915, levels 4 and 5 clinic visit, and ICD-9
code 4011 to MDC 36, cardiovascular system diseases. Payment would be
the rate established for the resulting hybrid group identifier, 91536.
Addendum A lists the payment rates for the proposed hospital clinic and
emergency room payment groups. Separate payment would be made under the
clinical diagnostic laboratory fee schedule for the laboratory work;
the ECG would be paid for separately on the basis of the payment rate
established for APC 950.
Several months later, the same patient, who now is known to have
congestive heart failure, returns to the primary care clinic
complaining of a cough and runny nose. The physician, having determined
that the symptoms are due to a virus, recommends using a humidifier and
drinking extra fluids. The hospital would code this visit with CPT code
99212 (problem-focused outpatient visit, established patient) and with
ICD-9 diagnosis code 460 (acute nasopharyngitis, or common cold). This
combination, in turn, would map to APC 911, levels 1 and 2 clinic
visit, plus MDC 31, ear, nose, mouth and throat diseases, and payment
for this patient's second visit to the hospital clinic would be based
on the rate established for hybrid group 91131.
Payment for Screening Services
Every patient who presents to an emergency department and requests
(or has requested on his or her behalf) a screening must be screened in
accordance with section 1867(a) of the Act. If the physician or other
hospital staff who performs the screening determines that no medical
emergency exists, the patient can be referred to one of the hospital's
clinics or to another provider such as a physician office for further
treatment, or the emergency department personnel can decide to treat
the patient in the emergency department. We propose to create a HCPCS
code to be used to bill the screening. Payment for this new code will
be low because no treatment is included in the screening. Payment for
the screening APC is made only when no additional services are
furnished by the emergency department. If non-emergency treatment is
furnished, the appropriate emergency room visit should be billed, and
not the screening. Similarly, if the screening reveals that an
emergency does exist and treatment is instituted immediately, the
screening should not be billed; the screening is subsumed into the
further treatment. If an emergency room physician feels the need to
consult with another physician before deciding whether the patient
needs emergency treatment, the consultation is part of the original
screening, and the hospital should bill for only one screening visit,
if a bill for screening is appropriate, as described above.
Payment for Critical Care
We propose to have hospitals use CPT code 99291 to bill for
outpatient encounters in which critical care services are furnished. We
use the CPT definition of ``critical care,'' which is the evaluation
and management of the unstable critically ill or injured patient who
requires the constant attendance of a physician. Under the outpatient
PPS, we would allow the hospital to use CPT 99291 in place of, but not
in addition to, a code for a medical visit or for an emergency
department service. However, the entire duration of the hospital
outpatient department's critical care services for an individual
patient is represented by CPT 99291, and we would not allow the
facility to use CPT 99292 to bill for critical care services extended
in 30-minute increments, as would the attending physician. (We have
packaged the costs associated with subsequent hours of critical care
billing into the APG group of services with which the critical care
hours were billed in the base year.) If other services, such as
surgery, x-rays, or cardiopulmonary resuscitation, are furnished on the
same day as the critical care services, we would allow the hospital to
bill for them separately.
We expect that the numbering scheme proposed in this rule to
distinguish clinic and emergency room visits would be changed in the
final rule. Although we believe the 5-digit identifier used in this
proposal makes it easier to see the relationship between the CPT code
for the level of the visit and the ICD-9-CM code for the diagnosis, for
claims processing purposes, we would have to replace 5-digit
identifiers with 3-digit ones.
5. Treatment of Partial Hospitalization Services
In accordance with section 1861(ff) of the Act, partial
hospitalization services may be furnished only by a hospital to its
outpatients or by a community mental health center (CMHC). We published
an interim final rule on February 11, 1994 (59 FR 6570) to establish
coverage criteria and payment requirements for partial hospitalization
programs. In that rule, we indicated that physician services and
certain nonphysician practitioner services are not considered to be
partial hospitalization services. Payment for these services is outside
the scope of this proposed rule.
The partial hospitalization program of services is organized and
furnished similarly, whether the program is administered by a hospital
or by a CMHC. Section 1833(a)(2)(B) of the Act requires that payment
for CMHC partial hospitalization services be based on the hospital
outpatient PPS. Thus, the methodology we are proposing would apply to
hospital outpatient and to CMHC partial hospitalization programs. The
current rules governing CMHC payment appear in 42 CFR part 413. This
proposed rule would amend Sec. 413.1 to indicate that payment for
partial hospitalization services furnished by CMHCs is made in
accordance with the hospital outpatient prospective payment system
described in part 419 of this chapter.
Patients eligible for the Medicare partial hospitalization benefit
comprise two groups: patients who have been discharged from a
psychiatric hospital for whom partial hospitalization services are
provided in lieu of continued inpatient treatment; and patients who
exhibit disabling psychiatric/psychological symptoms as a result of an
acute exacerbation of a severe and persistent mental illness for whom
the partial hospitalization services are provided in lieu of admission
to an inpatient psychiatric hospital.
As required by section 1835(a)(2) of the Act, admission to a
partial hospitalization program is limited to patients whose physicians
certify that: (1) the individual would require inpatient psychiatric
care in the absence of partial hospitalization services; (2) an
individualized, written plan of care has been established by a
physician and is reviewed periodically by a physician; and (3) the
patient is or was under the care of a physician. This certification
would be made when the physician
[[Page 47568]]
believes that the course of the patient's current episode of illness
would result in psychiatric hospitalization if the partial
hospitalization services are not substituted.
The acute psychiatric condition being treated by a partial
hospitalization program must require intensive active treatment,
including a combination of medical and nursing interventions,
individual and group psychotherapy, occupational therapy, family
counseling, and various adjunctive therapeutic activities that are not
primarily recreational or diversionary. The patient's degree of
impairment must be severe enough to require a multidisciplinary
structured day program, but not so severe that patients are incapable
of participating in and benefitting from an active treatment program.
Patients must require partial hospitalization services at levels of
intensity and frequency comparable to patients in an inpatient setting
for similar psychiatric illnesses. In addition, the patient must have
an adequate community-based network to support the patient outside the
partial hospitalization program.
Typically, patients admitted to a partial hospitalization program
initially require full-time participation in order to provide crisis
stabilization, that is, 6 hours of programming for 5 days per week. In
some cases, the patient may ultimately require inpatient psychiatric
care despite the partial hospitalization services. However, in most
cases, as the patient's symptoms diminish and functional goals are
achieved, the frequency of attendance is reduced to 4 days and, later,
to 3 days. Once the patient's participation drops to this level, the
need for partial hospitalization services in lieu of inpatient
psychiatric care is not generally indicated and the patient would be
discharged to a lower level of outpatient psychiatric care.
Under the current reasonable cost payment system, providers report
the total number of units for each partial hospitalization service
furnished during the billing period. As noted earlier, hospitals are
also required to report claims for services using HCPCS codes. Payment
for the additional overhead cost of supportive staff and recordkeeping
for a comprehensive day program of services would be built into the
provider's charge structure for covered partial hospitalization
services and paid through the cost report settlement process.
Because a day of care is the unit that defines the structure and
scheduling of partial hospitalization services, we believe that a per
diem payment for partial hospitalization services is a more appropriate
methodology than billing for each component of a partial
hospitalization program. A packaged, per diem approach is used by other
governmental and private payers when paying for partial hospitalization
services. In order to determine the median cost for the partial
hospitalization APC group, we analyzed the components reported for each
partial hospitalization service over the course of a billing period and
established a per diem payment rate. This analysis resulted in an APC
payment rate of $208.25 per day, of which $46.78 is the beneficiary's
copayment.
As noted above, partial hospitalization providers currently report
the total number of units for each service billed. We have revised the
billing instructions to require CMHCs to report HCPCS codes and to
require hospitals and CMHCs to report the date of each service,
effective October 1, 1998. We welcome information from the public to
assist us in refining the median cost for a day of partial
hospitalization. We are particularly interested in information
concerning the mix of services that constitute a typical partial
hospitalization day.
We have not established a group to represent a half-day of partial
hospitalization, although we are aware that other governmental and
private payers have adopted both a full and half-day rate for partial
hospitalization. For example, CHAMPUS (Civilian Health and Medical
Program of the Uniformed Services) recognizes a day with at least 6
hours of programming as a full day, while days with at least 3
programmed hours, but less than 6, are paid a per diem rate equal to 75
percent of the full day rate. However, the CHAMPUS per diem is not tied
to the cost of certain covered services, but rather to the number of
programmed hours the patient attends. As noted above, we will begin to
collect information October 1, 1998, regarding which services are
furnished each day. Once we have analyzed this information, we will be
able to determine the extent to which half-days are used typically in
partial hospitalization treatment planning. We are interested in public
comments regarding whether we should establish a half-day partial
hospitalization group.
We have also decided not to propose a minimum number of hours or
units of covered services that constitute a partial hospitalization day
at this time. However, we are concerned that a low frequency of
participation, either very few days per week or few covered services
per day, indicate that the partial hospitalization program is no longer
reasonable and necessary and the patient could be managed in a less
intensive level of outpatient treatment or periodic office visits.
Fiscal intermediaries in performing medical review of claims will
continue to make decisions regarding whether the services furnished a
patient are covered and payable as partial hospitalization services. As
noted above, CHAMPUS has established a minimum of 3 hours of service
for payment of their partial hospitalization per diem amount. We are
specifically requesting public comment on adopting a minimum number of
services for Medicare payment purposes.
We note that many other payers have established an annual limit on
the number of covered partial hospitalization days. There is currently
no duration limit on the Medicare partial hospitalization benefit.
Rather, in order to be covered by Medicare, partial hospitalization
services must be reasonably expected to improve or maintain the
patient's condition and to prevent relapse or hospitalization. For most
psychiatric patients, particularly those with long term, chronic
conditions, control of symptoms and maintenance of a functional level
to avoid hospitalization is an acceptable expectation of improvement.
It is not necessary for a course of partial hospitalization services to
have, as its goal, restoration of the patient to the level of
functioning exhibited prior to the onset of the illness. Some patients
may undergo a course of treatment that increases their level of
functioning but then reach a point where further significant
improvement is not expected. Continued coverage after this point may be
dependent upon evidence that the patient is not able to maintain
stability with less intensive treatment. Although we are not proposing
a duration standard for partial hospitalization at this time, we are
concerned that there is significant variation in duration of treatment.
We solicit data that show treatment duration from providers of partial
hospitalization services. We are also considering specifying a
timeframe for periodic physician recertification of need for partial
hospitalization services as a method to ensure that a patient's
individual needs continue to require the intensity of a partial
hospitalization program.
Finally, we are concerned about the impact of establishing a per
diem payment for partial hospitalization on the provision of other
outpatient mental health services. Patients should be
[[Page 47569]]
referred to the outpatient mental health treatment program that best
suits their individual needs. Partial hospitalization programs differ
from other outpatient mental health treatment programs in the intensity
of the program, the frequency of participation, and the patient's need
for a comprehensive structured program of services. Upon discharge from
a partial hospitalization program, a patient's symptoms and level of
functioning will have stabilized to the point that the intensity of a
partial hospitalization program is no longer necessary. We are
concerned that providing a per diem payment for partial hospitalization
services may discourage timely discharge. For this reason, medical
review by fiscal intermediaries will continue to focus on patients'
initial and continued eligibility for partial hospitalization services.
As noted previously, once we have complete encounter data on which
to base the per diem partial hospitalization rate, the per diem will
represent the median cost of services furnished on a typical day. As
such, it will not be based on the cost of each service furnished on a
particular day. Since partial hospitalization represents the most
intensive outpatient program and we will have established the median
cost of furnishing a day of partial hospitalization services, it does
not seem appropriate to pay more for other, less intensive outpatient
psychiatric programs. For this reason, we are specifically requesting
public comment on establishing a limit on routine outpatient mental
health services furnished on a given day to equal the partial
hospitalization per diem amount.
6. Comments on Specific APCs
APCs 061-064. We created separate (that is, unpackaged) groups for
various chemotherapeutic agents because we believed that some agents
had high costs that would not be recognized if those drugs were
packaged into the median cost for the chemotherapy administration. We
solicit comment on whether to package these costs into the chemotherapy
delivery codes in the final rule. We request that commenters identify
high-cost chemotherapeutic agents that would not be adequately
recognized if packaged or that may require a separate payment or higher
payment grouping.
APC 226: This group represents the facility costs for making custom
maxillofacial prosthetics. There are few claims, and the median cost is
very low compared to the practice expenses associated with these claims
on the Medicare physician fee schedule. We assume poor coding accounts
for the anomalous cost. However, it may be that these services are not
performed in hospital outpatient departments; they may actually be
performed by maxillofacial surgeons in their offices or by dental
laboratories. We welcome comments on whether these services are
actually provided in the outpatient hospital setting and the resources
involved.
APC 317 (Cochlear device implantation): The few claims in our
database for this procedure have such disparate costs that we are
uncertain of the appropriate assignment of the surgery. The device is
paid for from the DMEPOS fee schedule. We solicit comments on whether
the implant procedure itself resembles procedures in another APC group
to which it could be appropriately assigned.
APCs with a status indicator of ``V'': The groups that represent
medical visits in clinics and emergency departments are based on a
matrix, with intensity represented by six levels of CPT codes combined
with 20 categories of ICD-9 codes indicating diagnosis or condition.
Although current instructions require hospitals to use a CPT code to
bill for medical visits, we permit hospitals to bill for all medical
visits under a single code (99201) unless a hospital chooses to be more
specific. In 1997, our data show code 99201 accounting for 22 percent
of all medical visits billed, which we surmise is an overstatement of
the incidence of the lowest level clinic visit. With the implementation
of the hospital outpatient PPS, we will require hospitals to begin
coding medical visits with greater specificity. As a result, we expect
to see an increase in the relative incidence of higher level medical
visits and emergency visits and a proportional decrease in the relative
incidence of the lowest level clinic visit. We will monitor claims by
provider for unexplained increases in the total number of visits or in
the proportion of visits billed at the highest levels. Use of HCPCS
codes should conform with the CPT clinical examples of cases in each
code level.
Because the layout of the outpatient claim form does not allow a
HCPCS code to be linked to more than one ICD-9-CM code, the form
properly accounts for only one medical visit per claim. When two or
more medical visits occur on the same day for different diagnoses, a
separate claim would be created for each visit, showing the appropriate
level of CPT code and the related diagnosis. We would expect this to
occur only in those hospitals that operate many outpatient clinics
dedicated to various conditions, such as a diabetes clinic, arthritis
clinic, etc. Clinics in which a patient is seen for one or a number of
conditions by one health care professional, such as in a primary care
clinic, would bill for only one clinic visit for that encounter.
A medical visit would not be billed simply because a patient has
presented to a hospital for a service such as chemotherapy, cardiac
rehabilitation, an x-ray, etc.
We propose not to pay for a medical visit that takes place on the
same date of service as a scheduled outpatient surgery. Registration of
the patient, taking of vital signs, insertion of an IV, preparation for
surgery, etc., are packaged into and paid for as part of the APC group
to which the surgical procedure or service is classified.
In cases where a surgical procedure or service is performed as the
immediate result of an outpatient visit (such as the removal of skin
lesions following a visit to a dermatology clinic) or from an emergency
department visit, the visit would be billed with a modifier -25,
indicating that a separately identifiable evaluation and management
service was furnished.
APCs 667 and 668: These groups, for cataract surgery without and
with insertion of an IOL, should require different resources, because
667 should not include the cost of an IOL. Because the median costs of
the two groups are identical, we assume that hospitals were not
correctly coding some cases. Therefore, we have reduced the median cost
of 667 by $200 to reflect the resources associated with an IOL. We
arrived at this figure by allowing the $150 that was allowed for an IOL
as the ASC portion of the blended amount formerly paid, and by assuming
that the recognition of hospitals' costs under the blend would result
in the hospital IOL ``allowance'' being higher than the ASC's. This
reduction will have a very small overall effect, because the services
in APC 668 were billed more than 225 times as often as those in APC
667. This also leads us to believe that the data we have for the
services in APC 668 are more likely to represent accurate information.
APC 670: This group packages payment for the acquisition costs of
corneal tissue with the payment for the corneal transplant surgery. It
has been brought to our attention that the costs of acquiring corneal
tissue vary widely from one locality to another, so that packaging may
not be a reasonable way to handle these costs. We are specifically
soliciting comments on the issue of packaging corneal tissue costs. We
are also soliciting suggestions for alternate ways to pay for corneal
tissue, if the comments and supporting data we
[[Page 47570]]
receive indicate that packaging is not an appropriate way to treat
these costs.
APCs 761 and 762, and 791 and 792: These groups are anomalous,
because the group entitled ``Complex'' in each case has a lower weight
than the one entitled ``Standard.'' This has to do with the cost of the
procedure itself compared to the cost of the radionuclide involved. We
are working with the Society for Nuclear Medicine to correct these
anomalies.
APCs 902 and 903: We had very few bills for the vaccines in these
groups (902 includes polio vaccine and DPT; 903 includes vaccines for
rabies and plague). We are considering combining the two groups. We
solicit comments on vaccine costs to supplement our data.
APCs 091 and 91191: Brief psychotherapy encounters can be
identified by either a CPT code (as in APC 091) or a low- or mid-level
visit with a psychiatric diagnosis (APC 91191). We determined the
median costs for these bills taken together, because we believe that
there are no differences in the facility resources used in these
instances. In the case of other psychiatric encounters, we believe that
clinic services at the highest level should be the equivalent of an
extended psychotherapy encounter. Mid- and high-level emergency room
encounters should be billed by evaluation and management CPT codes and
psychiatric diagnoses.
APC 921: Although the addenda refer to this APC, in fact diabetic
education services will be paid under the physician fee schedule, which
will establish rates for one-on-one sessions and group sessions. The
addenda will be corrected in the final rule. (A proposed rule titled
``Medicare Program; Expanded Coverage for Diabetes Outpatient Self-
Management Training Services'' is under development.)
APCs 981 and 982: These groups represent nerve and muscle tests. We
are continuing to evaluate whether these two groups should be combined
in the final rule, because there is very little distinction between
them in our cost data.
We are still examining ways to pay for drugs outside the composite
rate for ESRD patients, and the services to be paid under our system in
CORFs, HHAs, and hospices. These will be APCs, based on services that
are packaged in our system.
7. Discounting of Surgical Procedures
Under hospital outpatient PPS, we will discount payment amounts
when more than one procedure is performed during a single operative
session or when a surgical procedure is terminated prior to completion.
The discount policy explained below is consistent with Medicare policy
and regulations governing payment for physician and ASC surgical
services.
a. Reduced Payment for Multiple Procedures
When more than one surgical procedure (defined as those HCPCS codes
in APC groups with status ``T'') is performed during a single operative
session, we propose that the full Medicare payment amount and
beneficiary copayment amount would be paid for the procedure having the
highest APC payment rate. Fifty percent of the normal Medicare payment
amount and beneficiary copayment amount would be paid for all other
procedures performed during the same operative session to reflect the
savings associated with having to prepare the patient only once and the
incremental costs associated with anesthesia, operating and recovery
room use, and other services required for the second and subsequent
procedures.
b. Discounted Payment for Terminated Procedures
Under outpatient PPS, the hospital will use modifiers to indicate
procedures that are terminated prior to completion. Modifier-52
(Reduced Services) is used to identify a procedure that is terminated
after the patient has been prepared for surgery, including sedation
when provided, and taken to the room where the procedure is to be
performed, but before anesthesia is induced (for example, local,
regional block(s), or general anesthesia). Fifty percent of the normal
Medicare payment amount and beneficiary copayment amount would be paid
for a procedure terminated before anesthesia is induced.
Modifier-53 (Discontinued Procedure) is used to indicate that a
surgical procedure was started but discontinued after the induction of
anesthesia (for example, local, regional block, or general anesthesia),
or after the procedure was started (incision made, intubation begun,
scope inserted) due to extenuating circumstances or circumstances that
threatened the well-being of the patient. To recognize the costs
incurred by the hospital to prepare the patient for surgery and the
resources expended in the operating room and recovery room, the full
Medicare payment amount and beneficiary copayment amount would be paid
for a procedure that was started but discontinued after the induction
of anesthesia or after the procedure was started, as indicated by a
modifier-53.
The elective cancellation of procedures would not be reported. If
multiple procedures were planned, only the procedure actually initiated
would be billed. A pattern of canceled procedures will prompt medical
review of the reasons for cancellation and may trigger review of the
appropriateness of patient selection for outpatient surgery.
8. Inpatient Care
In recent years, the distinction between inpatient and outpatient
care has been blurred by the retention of outpatients in the hospital
overnight, sometimes for many days in a row. Medicare paid for
observation services while the hospital determined whether an
outpatient needed admission for further treatment. Frequently, the
patients did not understand that they were not inpatients until they
were billed for 20 percent of outpatient charges as copayment. In
November 1996, we put in place a policy limiting outpatient observation
services to a maximum of 48 hours. We made clear at that time that
observation was not a means to make it possible to perform inpatient
surgery on an outpatient basis, nor was it appropriate to retain
chemotherapy patients in long-term observation. Because observation is
not provided as the sole service a patient receives, we packaged costs
associated with observation into the median costs for the services, for
example, surgery or chemotherapy, with which they were furnished in
1996.
There are procedures that, by their nature, require inpatient care.
Open abdominal surgery requires a postoperative recovery period, for
example, to ensure that bowel function resumes. Certain major surgeries
require monitoring in an intensive care unit until the patient's
neurological or other function returns. Yet other surgeries involve
large or delicate surgical wounds that require monitoring, skilled
dressing changes, and fluid replacement. These procedures obviously
require inpatient care, and performing them on an outpatient basis
would clearly jeopardize patient health and safety. Other procedures
are not as clearly defined as inpatient, but we have classified them as
inpatient because they are performed on an inpatient basis virtually
all the time for the Medicare population, either because of the
invasive nature of the procedures, the need for postoperative care, or
the underlying physical condition of the patient who would require such
surgery. These procedures are not classified in an outpatient APC
group, and no payment is provided for these procedures under the
hospital
[[Page 47571]]
outpatient PPS. We will deny payment for claims that are submitted for
these procedures furnished as outpatient services because performing
these procedures on an outpatient basis is not safe or appropriate, and
therefore not reasonable and necessary under Medicare rules. Because we
base these denials on the exclusion in section 1862(a)(1)(A) of the Act
and in Sec. 411.15(k)(1), beneficiaries may be protected from liability
by the limitation on liability provision of section 1879 of the Act.
The procedures that we consider appropriate and safe only in an
inpatient setting and for which we are excluding payment under the
hospital outpatient PPS are listed in Addendum H to enable hospitals to
make appropriate site of care decisions. This list represents national
Medicare policy and is binding on fiscal intermediaries and peer review
organizations, as well as on hospitals and Medicare participating ASCs.
We acknowledge that we have classified in outpatient APC groups
some procedures that may seem closely related to procedures that we are
excluding from the outpatient PPS on the basis of their status as
inpatient procedures. We expect that when the former are performed in
the outpatient setting, they will be only the simplest, least intense
cases. The fact that a service is included in an APC group under the
hospital outpatient PPS should not be construed to mean that the
procedure may only be performed in an outpatient setting. In every
case, we expect the surgeon and the hospital to assess the risk to the
individual patient and to act in that patient's best interests.
C. Calculation of Group Weights and Rates
1. Group Weights
Section 1833(t)(2)(C) of the Act requires the Secretary to develop
relative payment weights for covered groups of hospital outpatient
services. The statute requires that such weights be developed using
1996 hospital outpatient claims and the most recent available hospital
cost reports. We are required to base these weights on median hospital
costs. In constructing the database to model the outpatient PPS
proposal, we used a universe of approximately 98 million calendar year
1996 final action claims for hospital outpatient department services
received through June 1997 to match to the most recent hospital cost
reports available.
To derive weights based on median hospital costs for services in
the hospital outpatient APC groups, we needed to convert billed charges
to costs and aggregate them to the procedure or visit level. To do
this, we first identified the cost-to-charge ratio that was specific to
each hospital's cost centers (``cost center specific cost-to-charge
ratios'' or CCRs). We then developed a crosswalk to match the
hospital's CCRs to revenue centers used on the hospital's 1996
outpatient bills. The CCRs included operating and capital costs but
excluded costs associated with direct graduate medical education and
allied health education. (Medicare payment for direct graduate medical
education is made as a pass-through under the inpatient PPS and
includes the costs associated with approved educational activities for
residents assigned to the hospital's outpatient department. We discuss
in elsewhere in this proposed rule how we would make payment for allied
health education.)
Our next task was to identify each hospital's most recent available
cost report from which to determine the hospital's CCRs. Because there
is generally a 2-year lag between claims adjudication and cost report
filing, the most recent cost reports that we could expect to be
available to associate with calendar year 1996 claims were those from
PPS-12 (cost reporting periods beginning on or after October 1, 1994
and before October 1, 1995). We searched the PPS-12 period first to
match the 1996 final action claims to a cost report. If we achieved a
match, no other action was needed. However, if no match was found, we
next searched for a cost report in the PPS-11 period and subsequently
in the PPS-10 period, if necessary.
If the most recent available cost report that we used for a
provider was one that had been submitted but not settled, we calculated
an adjustment factor to adjust for the differences that exist between
settled and ``as submitted'' cost reports. We determined the adjustment
factor by dividing the outpatient department cost-to-charge ratio from
the hospital's most recent settled cost report by the outpatient
department cost-to-charge ratio from the hospital's ``as submitted''
cost report for the same period. We used the resulting ratio to adjust
each of the CCRs in the hospital's most recent ``as submitted'' cost
report. We repeated this process for every hospital for which the most
recent available cost report was a cost report that had not been
settled.
The Office of Inspector General (OIG) is concerned that the cost
reports we are using may reflect some unallowable costs. Therefore, the
OIG, in conjunction with HCFA, is proposing to examine the extent to
which the cost reports used reflect costs that were inappropriately
allowed. If this examination reveals excessive inappropriate costs, we
would address this issue in a future proposed rule, or perhaps seek
legislation to adjust future payment rates downward.
When this process was completed, we were able to match revenue
centers from approximately 83 million claims to CCRs of approximately
5,600 hospitals. We excluded from the crosswalk approximately 15
million claims in which the bill type denoted services that would not
be covered under the PPS, for example, bill type 72X for dialysis
services for patients with ESRD. The table below shows the three cost
reporting periods we used and the percentage of the cost reports within
each PPS period with which we were able to match 1996 claims. The most
recent cost reports available to us were from the hospital inpatient
PPS-12 period, and 95.8 percent of the most recent cost reports
available to us matched the 1996 claims that we are required to use as
the basis for establishing relative payment weights for the APC groups
in the outpatient PPS.
------------------------------------------------------------------------
Percentage
of cost
Reporting period reports
matched
------------------------------------------------------------------------
PPS-12 (cost reporting period beginning on or after 10/1/94
and before 10/1/95)........................................ 95.8
PPS-11 (cost reporting period beginning on or after 10/1/93
and before 10/1/94)........................................ 3.7
PPS-10 (cost reporting period beginning on or after 10/1/92
and before 10/1/93)........................................ 0.5
-----------
100.0
------------------------------------------------------------------------
We next separated the estimated 83 million claims that we had
matched with a cost report into two distinct groups: single-procedure
claims and multiple-procedure claims. Single-procedure claims are those
for which the HCPCS to be grouped to an APC is the only code that
appears on the bill, other than laboratory and incidentals such as
venipuncture. Multi-procedure claims included more than one HCPCS code
that could be mapped to an APC. There were approximately 37 million
single-procedure claims and 46 million multiple-procedure claims.
To calculate median costs for services within an APC, we used only
the single-procedure bills. (Of the roughly 37 million single-procedure
claims, about 11 million were excluded from the conversion process
largely because the only HCPCS codes reported on the claims were for
laboratory procedures.)
[[Page 47572]]
This approach was taken because of our inability to specifically
allocate charges or costs for packaged items and services such as
anesthesia, recovery room, drugs, or supplies to a particular procedure
when more than one significant procedure or medical visit was billed on
a claim. Use of the single-procedure bills minimizes the risk of
improperly assigning costs to the wrong procedure or visit. Although
single-procedure/visit bills were used for determining APC relative
payment weights, the multiple-procedure bills were used in the service
mix calculations, regressions, and impact analyses.
For each single-procedure claim, we calculated a cost for every
billed line item charge by multiplying each revenue center charge by
the appropriate hospital-specific CCR. If the appropriate cost center
did not exist for a given hospital, we crosswalked the revenue center
to a secondary cost center when possible, or to the hospital's overall
cost-to-charge ratio for outpatient department services. We excluded
from this calculation all charges associated with HCPCS codes
previously defined as noncovered under this PPS, for example,
laboratory, ambulance, and therapy services.
To calculate the per-procedure or per-visit costs, we used the
charges shown in the revenue centers that contained items integral to
performing the procedure or visit. These included those items that we
previously discussed as being subject to our proposed packaging
provision. For example, in calculating the surgical procedure cost, we
included charges for the operating room, treatment rooms, recovery,
observation, medical and surgical supplies, blood, pharmacy,
anesthesia, cast and splints, and donor tissue, bone, and organ. For
medical visit cost estimates, we included charges for items such as
medical and surgical supplies, drugs, observation, and blood. A
complete listing of the revenue centers we used is included elsewhere
in this preamble.
To standardize costs for geographic wage variation, we divided the
labor-related portion of the operating and capital costs for each
billed item by the hospital inpatient prospective payment system wage
index published in the Federal Register on May 8, 1998 (63 FR 25575).
We used 60 percent to represent our estimate of that portion of costs
attributable, on average, to labor, but this factor is sensitive to
other payment adjustments. Therefore, we will restandardize costs in
the final rule using FY 1999 hospital inpatient PPS wage index values
and the final labor market share value. A more detailed discussion of
wage index adjustments is found below (section V.E. of this document).
We then added the standardized labor-related cost to the non-labor-
related cost component for each billed item to derive the total
standardized cost for each procedure or medical visit. We trimmed
standardized procedure and visit costs to remove extremely unusual
costs that appeared to be errors in the data. The trimming methodology
is analogous to that used in calculating the DRG weights for the
inpatient PPS: any bills with costs outside of 3 standard deviations
from the geometric mean were eliminated. The geometric mean and the
associated standard deviation are used because the distribution of
costs more closely resembles a lognormal distribution than a normal
distribution: there are no negative costs, and the average cost is
greater than the median cost. Using the geometric mean has the effect
of minimizing the impact of the most unusual bills in the determination
of the mean. The geometric mean is calculated by taking the mean of the
natural logarithm cost. Since the distribution of the natural
logarithms of a set of numbers is more compact than the distribution of
the numbers themselves, bills with extreme costs do not appear as
extreme as they would if non-logged costs were examined. This ensures
that only the most unusual data will be removed from the calculation.
After we trimmed the procedure and visit level costs, we mapped
each procedure or visit cost to its assigned APC. We calculated the
median cost for each APC weighted by procedure volume.
Using these median APC costs, we then calculated the relative
payment weights for each APC. We decided to scale all the relative
payment weights to APC 91336, a mid-level clinic visit for
cardiovascular services because it is one of the most frequently
performed services. This approach is consistent with that used in
developing relative value units for the Medicare physician fee
schedule. By assigning APC 91336 a relative payment weight of ``1.0,''
hospitals can easily compare the relative relationship of one APC to
another. Next, we divided the median cost for each APC by the median
cost for APC 91336 to derive the relative payment weight for each APC.
2. Conversion Factor
Section 1833(t)(3)(C)(i) of the Act requires that we establish a
conversion factor for 1999 to determine the Medicare amounts for each
covered group of services. The statute mandates that the conversion
factor be established on the basis of the weights and aggregate
projected utilization for 1999 and based on the base amount of payments
described in section 1833(t)(3)(A) of the Act. Such base amount is
calculated for the services included in the outpatient PPS, as an
estimate of the sum of (1) total payments that would be payable from
the Trust Fund under the current (non-PPS) payment system in 1999 plus
(2) the beneficiary copayments that would have been made under the new
(PPS) system in 1999. Section 1833(t)(3)(C)(ii) of the Act further
requires that the Medicare amount take into account all appropriate
adjustments.
Although section 1833(t)(2)(C) of the Act requires us to project
utilization for hospital outpatient services, we were unable to project
precisely increases in the volume and intensity of services because we
were not able to quantify some of the factors that affect utilization.
For instance, we would anticipate that Medicare beneficiaries that
choose to migrate to managed care plans may be healthier than those who
choose to stay in fee-for-service plans. Thus, we could assume a
decrease in the volume of services but an increase in the intensity of
services furnished for Medicare beneficiaries enrolled in fee-for-
service plans. Another factor that we believe will affect future
utilization is the incentive to code HCPCS accurately to receive
payment. Currently, hospitals are paid for the majority of the
outpatient services they furnish on a cost basis. Claims without a
HCPCS or an invalid HCPCS are not always rejected. In contrast, under
the new PPS, hospitals would be required to use HCPCS codes and, for
medical visits and emergency room services, ICD-9 codes, in order to
receive payment. We expect that frequencies may increase as a result of
the coding requirements. All in all, these are factors we believe will
affect the reporting of volume and intensity of services, but we were
not able to quantify these assumptions individually to project 1999
utilization. Therefore, we used what we believe to be a more reliable
and valid approach to computing the conversion factor under the
methodology described below.
Setting the Rates
In order to convert the relative weights determined for each APC
(see previous section) into payment rates, we calculated a conversion
factor that would result in payments to hospitals under the PPS in 1999
equaling the total projected payment specified in section 1833(t)(3)(A)
of the Act. The prospective payment rate set for each APC is
[[Page 47573]]
calculated by multiplying the APC's relative weight by a conversion
factor. We computed the conversion factor by first adding together for
calendar year 1996 the aggregate Medicare hospital outpatient payments
paid under the current cost-based payment system (referred to in this
section as current law payments) plus the estimated beneficiary
copayment amounts that would be paid under the outpatient PPS for the
same services. We then divided that amount by the sum of the relative
weights for all APCs under the hospital outpatient PPS. The methodology
we followed to determine current law Medicare hospital outpatient
payments and beneficiary copayments is discussed in section V.C.2.a.,
below, which is followed in section V.C.2.b. by a discussion of the sum
of the relative weights.
a. Calculating Aggregate Calendar Year 1996 Medicare and Beneficiary
Payments for Hospital Outpatient Services (Current Law)
First, to calculate Medicare hospital outpatient payment amounts
under current law (that is, before PPS), we identified calendar year
1996 single and multiple procedure bills for all the services that we
will recognize under the outpatient PPS. As we identified services that
will be paid under the outpatient PPS, we eliminated invalid or
noncovered HCPCS codes.
Hospital payments include both operating and capital costs for the
HCPCS coded services for which payment is to be made under the
outpatient PPS. We summed both of these types of costs by HCPCS at the
provider level. Summarizing the data in this manner allows us to
simulate provider payment on an aggregate basis. We then applied the
legislated capital cost reductions of 10 percent and operating cost
reductions of 5.8 percent, as required by section 4522 of the BBA.
We determined for each HCPCS code the applicable payment
methodology under current law. We then calculated current law payment
for procedures in the baseline using one of the following equations, as
appropriate:
For radiology procedures paid for under the radiology fee
schedule, payment is determined in the aggregate for each provider as
the lower of cost, charge, or blended amount. The radiology blended
amount is determined by the following equation:
(0.42 x lower of cost or charge minus beneficiary copayment) + (0.58
x ((0.62 x global physician fee schedule amount)-beneficiary
copayment))
For surgical procedures for which Medicare pays an ASC
facility fee, payment is determined in the aggregate for each provider
as the lower of the cost, charge, or blended amount. The ASC blended
amount is determined by the following equation:
(0.42 x lower of cost or charge minus beneficiary copayment) + (0.58
x (ASC payment rate-beneficiary copayment))
For diagnostic procedures paid under the diagnostic fee
schedule, payment is determined in the aggregate for each provider as
the lower of cost, charge, or blended amount. The blended amount is
determined by the following equation:
(0.50 x lower of cost or charge minus beneficiary copayment) + (0.50
x ((0.42 x global physician fee schedule amount)-beneficiary
copayment))
For all other covered services not subject to one of the blended
payment method categories, payment is determined to be the lower of
costs or charges less beneficiary copayment. Because the formula-driven
overpayment (FDO) was corrected beginning October 1, 1997, the blended
equations eliminate FDO.
We then determined each provider payment. We summed the aggregate
amounts computed for each of the four types of payment methodologies
discussed above to determine the Medicare payment amount for each
provider. In addition, we also determined the amount of the beneficiary
copayment for each provider using the beneficiary copayment amounts
that would be paid under the PPS. Summing both the Medicare payment and
the beneficiary copayment amounts at the provider level is necessary in
order to determine the impact of the outpatient PPS on individual
hospitals. In addition to calculating provider payments under the
current law and PPS payment systems, we calculated the aggregate
Medicare payments under the current system and beneficiary copayments
under the PPS for all hospitals for services that are within the scope
of the outpatient PPS. The total amount reflects the amount hospitals
would be paid under the PPS in accordance with section 1833(t)(3)(A) of
the Act and is the numerator in the equation for calculating the
unadjusted conversion factor.
b. Sum of the Relative Weights
Next we summed the relative weights. Specifically, we multiplied
the volume of procedures or visits (excluding the volume of packaged
services) for each group by the relative weights for each group. We
then calculated the conversion factor by dividing the sum of the volume
multiplied by the relative weights for each APC into the total payment
explained above, including both Medicare payment and beneficiary
copayment. The calendar year 1996 conversion factor is $46.32. To trend
forward the 1996 conversion factor to 1999, HCFA's Office of the
Actuary estimated an update factor of 1.0939. The update factor
represents the estimated per service increase in outpatient Medicare
payments and beneficiary copayment between 1996 and 1999 net of changes
in the volume and intensity of services. Medicare payments per service
were increased by projected CPI-medical items for cost-based services
and for blend services mandated updates. Beneficiary copayments were
increased by projected increases in CPI-outpatient charges. In
estimating the update factor, HCFA's Office of the Actuary assumed that
using the national median of the charges for PPS services to establish
the unadjusted copayment amount would result in beneficiaries paying
6.9 percent less in coinsurance payments in 1999 than what they would
have been expected to pay otherwise, which would create an incentive
for a behavioral offset by hospitals of 10 percent of the coinsurance
reduction. It was assumed that 45 percent of this offset would apply to
the services subject to the PPS and, therefore, would be included in
setting the 1999 conversion factor. The remaining 55 percent of the
offset would be reflected in expenditures for non-PPS services with
both the beneficiary and Medicare absorbing this impact. The adjusted
1999 conversion factor is $50.67.
D. Calculation of Medicare Payment Amount and Copayment Amount
1. Introduction
In the previous section, section V.C, we explain how we determined
national prospective payment rates, standardized for area wage
variations, for the APC groups. In this section, we explain how we are
proposing to calculate Medicare program payment amounts and beneficiary
copayment amounts for each APC group.
Under the statutory provision currently in effect, copayment for
hospital outpatient department services is based on 20 percent of the
hospital's billed charges. Because most hospital outpatient services
have been paid, at least in part, on the basis of retrospectively
calculated cost, Medicare payment amounts for most
[[Page 47574]]
hospital outpatient services are not known at the time the services are
furnished. For that reason, coinsurance could not be based on 20
percent of the payment amount. Accordingly, the statute required that
copayment be based on 20 percent of charges. Because charges for
hospital outpatient services have increased faster than costs for those
services, beneficiaries' copayments of 20 percent of charges have, for
some services, accounted for 50 percent or more of the total (Medicare
program plus beneficiary) payments to the hospitals. Because of
extensive secondary insurance coverage, a large share of the copayments
made to hospitals is not direct out-of-pocket expenditures by the
beneficiaries. There has, however, been concern that premiums for
Medigap policies may be affected by the growing copayment liability. In
addition, copayments most directly affect those beneficiaries who do
not have supplemental insurance. This group of beneficiaries cannot
afford to purchase supplemental insurance, and high copayment rates can
be a hardship for those needing services. The outpatient PPS created by
section 4523 of the BBA, which added section 1833(t) to the Act,
includes a mechanism that is designed to eventually achieve a
beneficiary copayment level equal to 20 percent of the prospectively
determined payment rate that has been established for the service.
MedPAC Comment: In its March 1998 report to the Congress, MedPAC
expresses concern about the inequity represented by the current level
of beneficiary copayment liability, which generally exceeds 20 percent
of the total payment to hospitals for outpatient services. MedPAC,
recognizing that immediate beneficiary copayment reductions to 20
percent of payments made to hospitals would result either in
unacceptable increases in program outlays and/or unacceptable
reductions in payments to hospitals, agrees with the need for a phased-
in approach to the copayment reductions. However, MedPAC recommends
that the Congress specify a shorter timeframe than that which results
from the provisions of the BBA to phase in fully the appropriate
beneficiary copayment contribution of 20 percent for hospital
outpatient services paid for under the outpatient PPS.
Response: While we do not disagree with MedPAC's recommendation
with respect to beneficiary copayment, because of the budgetary
implications and the existing statutory requirements resulting from the
BBA, implementation of this recommendation would ultimately require
action by the Congress.
The next sections describe the steps that we followed in accordance
with statutory requirements to determine the beneficiary copayment
amount and the Medicare program payment amount for services paid for
under the hospital outpatient PPS.
2. Determination of Unadjusted Copayment Amount, Program Payment
Percentage, and Copayment Percentage
In order to calculate program payment amounts and beneficiary
copayment amounts, we first determined for each APC group two base
amounts, in accordance with statutory provisions:
An unadjusted copayment amount, described in section
1833(t)(3)(B) of the Act.
The ``pre-deductible payment percentage,'' which we call
the program payment percentage, described in section 1833(t)(3)(E).
The steps that we followed to calculate these two base amounts for
each APC group are explained below.
(a) Calculate the unadjusted copayment amount for each APC group.
(i) Determine the national median of the charges billed in 1996 for
the services that constitute the APC group after standardizing charges
for geographic variations attributable to labor costs. (To make the
labor adjustment, we divided the portion of each charge that we
estimated was attributable to labor costs (60 percent) by the
provider's hospital inpatient wage index value, and we added the result
to the non-labor portion of the charge (40 percent). Section V.F.
provides a detailed discussion of the adjustments made within the
outpatient PPS to offset regional differences in labor costs.)
(ii) Update charge values to projected 1999 levels by multiplying
the 1996 median charge for the APC group by 29.2 percent, which the
HCFA Office of the Actuary estimates to be the rate of growth of
charges between 1996 and 1999.
(iii) Multiply the estimated 1999 national median charge for the
APC group by 20 percent, which becomes the unadjusted copayment amount
for the APC group. The unadjusted copayment amount is frozen at the
1999 level until such time as the program payment percentage (see
below) equals or exceeds 80 percent (section 1833(t)(3)(B)(ii) of the
Act).
(b) Calculate the program payment percentage (pre-deductible
payment percentage). In this proposed rule, we use the term program
payment percentage to replace the term ``pre-deductible payment
percentage,'' which is referred to in section 1833(t)(3)(E) of the Act.
The program payment percentage is calculated annually for each APC
group, until the value of the program payment percentage equals 80
percent. To determine the program payment percentage for each APC
group, we followed these steps:
(i) Subtract the APC group's unadjusted copayment amount from the
payment rate set for the APC group;
(ii) Divide the difference [(APC payment rate) minus (unadjusted
copayment amount)] by the APC payment rate, and multiply by 100. The
resulting percentage is the program payment percentage.
Calculation of the program payment percentage allows us to
determine a ``copayment percentage,'' which equals the difference
between the program payment percentage and 100 percent. As the program
payment percentage for an APC group approaches 80 percent due to annual
market basket increases of the APC payment rates, the copayment
percentage, conversely, approaches 20 percent, which is ultimately the
target copayment percentage for all services paid for under the
hospital outpatient PPS. When the copayment percentage equals 20
percent of the APC payment rate, we consider the copayment amount for
that APC to be fully phased in at the standard Medicare copayment
level, as we explain in the next section.
3. Calculation of Medicare Payment Amount and Beneficiary Copayment
Amount
a. Calculate the Medicare payment amount. A Medicare payment amount
is calculated for every APC group. The Medicare payment amount takes
into account wage index and other applicable adjustments and applicable
beneficiary deductible amounts. The Medicare payment amount calculated
for an APC group applies to all the services that are classified within
that APC group. The Medicare payment amount for a specific service
classified to an APC group under the outpatient PPS is calculated as
follows:
(i) Apply to the national payment rate that is set annually for
each APC group the appropriate wage index adjustment (see section V.E.
for a discussion of how national APC rates are to be adjusted for
geographic wage differences) and any other adjustments applicable to
the provider;
(ii) Subtract from the adjusted APC group payment rate the amount
of any applicable deductible as provided under Sec. 410.160; and
(iii) Multiply the adjusted APC group payment rate, from which the
applicable
[[Page 47575]]
deductible has been subtracted, by the program payment percentage
determined for the APC group or 80 percent, whichever is lower. The
result is the Medicare payment amount.
b. Calculate the copayment amount.
A copayment amount is calculated annually for each APC group. The
copayment amount calculated for an APC group applies to all the
services that are classified within the APC group. The copayment amount
for an APC is calculated as follows:
Subtract the APC group's Medicare payment amount from the
adjusted APC group payment rate less deductible, for example,
COPAYMENT AMOUNT equals [(adjusted APC group payment rate less
deductible) minus (APC group Medicare payment amount). The resulting
difference is the beneficiary copayment amount.
Again, as soon as the Medicare program payment percentage of an
adjusted APC payment rate less deductible equals or exceeds 80 percent,
we set the copayment amount at 20 percent of the adjusted APC group
payment rate, and we consider the standard Medicare 20 percent
copayment level to be fully phased in for that APC group (section
1833(t)(3)(B)(ii) of the Act). Thereafter, for those APC groups whose
program payment percentage has become 80 percent of the APC payment
rate (and whose copayment percentage is 20 percent), the unadjusted
copayment amount for the APC ceases to be frozen at the 1999 level. The
copayment amount for the APC group is permanently established at 20
percent of the adjusted APC group payment rate. Because the copayment
amount is now tied directly to the APC payment rate, the copayment
dollar amount increases as annual updates increase the APC group
payment rate.
For example, assume that the wage-adjusted payment rate for an APC
is $300; the program payment percentage for the APC group is 60
percent; the wage-adjusted copayment amount for the APC group is $120;
and the beneficiary has not yet satisfied any portion of his or her
annual $100 deductible.
(A) Adjusted APC payment rate: $300
(B) Subtract the applicable deductible: $300 - $100 = $200
(C) Multiply the remainder by the program payment percentage to
determine the Medicare payment amount: 0.6 x $200 = $120
(D) Subtract the Medicare payment amount from the adjusted APC payment
rate less deductible to determine the copayment amount: $200 - $120 =
$80
In this case, the beneficiary pays a deductible of $100 and an $80
copayment. The program also pays $120, for a total payment to the
hospital of $300. Applying the program payment percentage ensures that
the program and the beneficiary pay the same proportion of payment that
they would have paid if no deductible were taken.
In the event that the annual deductible has already been satisfied,
the calculation runs as follows:
(A) Adjusted APC payment rate: $300
(B) Subtract the applicable deductible: N/A
(C) Multiply by the program payment percentage to determine the
Medicare payment amount: 0.6 x $300 = $180
(D) Subtract the Medicare payment amount from the adjusted APC payment
rate less deductible to determine the copayment amount: $300 - $180 =
$120
In this case, the beneficiary makes a $120 copayment. The program
also pays $180, for a total payment to the hospital of $300.
4. Hospital Election To Offer Reduced Copayment
The transition to the standard Medicare copayment rate (20 percent
of the wage-adjusted APC payment rate) will obviously be gradual. For
those APC groups for which copayment is currently a relatively high
proportion of the total payment, the process will be correspondingly
lengthy. Therefore, the Act offers hospitals the option of electing to
reduce copayment amounts and allows the hospital to advertise these
reduced rates. In this section, we discuss the procedure by which
hospitals can elect to offer a reduced copayment amount, and the effect
of such election on calculation of the program payment and beneficiary
copayment.
Section 1833(t)(5)(B) of the Act requires the Secretary to
establish a procedure under which a hospital, before the beginning of a
year, may elect to reduce the copayment amount otherwise established
for some or all hospital outpatient department services to an amount
that is not less than 20 percent of the hospital outpatient prospective
payment amount. The statute further provides that the election of a
reduced copayment amount will apply without change for the entire year,
and that the hospital may advertise its reduced copayment levels.
Section 1833(t)(5)(C) of the Act provides that deductibles cannot be
waived. Finally, section 1861(v)(1)(T) of the Act (as established by
section 4451 of the BBA) provides that no reduction in copayment
elected by the hospital under section 1833(t)(5)(B) may be treated as a
bad debt.
In this rule, we are proposing that a hospital may make the
election to reduce copayments on a calendar year basis. The hospital
must notify its fiscal intermediary of its election to reduce
copayments no later than 90 days prior to the start of the calendar
year. This 90-day notification requirement is necessary in order to
give the intermediaries sufficient time to make the systems changes
required to implement the hospital's election. The hospital's
notification must be in writing. It must specifically identify the APC
groups to which the hospital's election will apply and the copayment
level (within the limits identified below) that the hospital has
selected for each group. The election of reduced copayment must remain
in effect unchanged during the year for which the election was made.
The hospital may advertise and otherwise disseminate information
concerning the reduced level of copayment that it has elected.
We also are proposing that a hospital may elect to reduce the
copayment amount for any or all APC groups. A hospital may not elect to
reduce the copayment amount for some, but not all, services within the
same APC group.
A hospital may not elect for an APC group a copayment amount that
is less than 20 percent of the adjusted APC payment rate for that
hospital. In determining whether to make such an election, hospitals
should note that the national copayment amount under this system, based
on 20 percent of national median charges for each APC, may yield
copayment amounts that are significantly higher or lower than the
copayment that the hospital has previously collected. This is because
the median of the national charges for an APC group, from which the
copayment amount is ultimately derived, may be higher or lower than the
hospital's historic charges. We, therefore, advise that hospitals, in
determining whether to exercise the option of electing lower copayment
and the level at which to make the election, carefully study the annual
copayment amounts for each APC group in relation to the copayment
amount that the hospital has previously collected.
Calculation of copayment amounts on the basis of a hospital's
election of reduced copayment for the most part follows the formula
described previously. For example, assume that the adjusted APC payment
rate is $300; the program payment percentage for the
[[Page 47576]]
APC group is 60 percent; the hospital has elected a $60 adjusted
reduced copayment amount for the APC group; and the beneficiary has not
satisfied the annual deductible.
(A) Adjusted APC payment rate: $300
(B) Subtract the applicable deductible: $300 - $100 = $200
(C) Multiply by the program payment percentage to determine the
Medicare payment amount: 0.6 x $200 = $120
(D) Beneficiary's copayment is the difference between the APC payment
rate reduced by any deductible amount and the Medicare payment amount,
but not to exceed the adjusted reduced copayment amount: $200 - $120 =
$80 (limited to $60 because of the hospital-elected reduced copayment
amount)
In this case, Medicare makes its regular payment of $120, but the
beneficiary pays a $100 deductible and a reduced copayment amount of
$60, for a total payment to the hospital of $280 instead of the $300
that the hospital would have received if it had not made its election.
E. Adjustment for Area Wage Differences
1. Proposed Wage Index
Section 1833(t)(2)(D) of the Act requires that, as part of the
methodology for determining prospective payments to hospitals for
outpatient services, the Secretary must determine a wage adjustment
factor to adjust the portion of payment and copayment attributable to
labor-related costs for relative differences in labor and labor-related
costs across geographic regions in a budget-neutral manner.
To determine which wage adjustment factor to incorporate into the
hospital outpatient department PPS, we considered several options. One
choice would be to use a wage index specific to hospital outpatient
department labor costs. However, the Congress did not require us to nor
did we have either the time or resources necessary to construct a
hospital-outpatient-department-specific wage index.
We next considered the hospital inpatient PPS wage index that HCFA
maintains under the Medicare program. The hospital inpatient PPS wage
index is well established, and it is constructed specifically for the
purpose of ``reflecting the relative hospital wage level in the
geographic area of the hospital compared to the national average
hospital wage level'' (section 1886(d)(3)(E) of the Act), a requirement
that is analogous to that set forth under the hospital outpatient
department PPS in section 1833(t)(2)(D) of the Act. The data upon which
the hospital inpatient PPS wage index is based are collected from
Medicare cost reports, and the wage index is updated annually. Any
changes in hospital inpatient PPS wage index values must be made in
such a manner as to assure budget neutrality (section 1886(d)(3)(E) of
the Act). The hospital inpatient PPS wage index for fiscal year 1998
reflects the following:
Total salaries and hours from short-term, acute care
hospitals.
Home office costs and hours.
Fringe benefits associated with hospital and home office
salaries.
Direct patient care contract labor costs and hours.
The exclusion of salaries and hours for nonhospital type
services such as SNF services, home health services, or other
subprovider components that are not subject to the PPS.
A detailed description of the fiscal year 1999 hospital inpatient
PPS wage index is contained in the proposed rule entitled ``Changes to
the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1999
Rates (HCFA-1003-P)'' published in the Federal Register on May 8, 1998
(63 FR 25575).
We decided that using the hospital inpatient PPS wage index as the
source of an adjustment factor for geographic wage differences for the
hospital outpatient department PPS was both reasonable and logical,
given the inseparable, subordinate status of the outpatient department
within the hospital overall. We then had to determine which version of
the hospital inpatient PPS wage index to use. There are several
possible wage indices that can be developed from the basic wage and
salary data taken from hospital cost reports, depending on changes that
are applied to the data. One modification takes into account the effect
of hospital redesignation under 1886(d)(8)(B) of the Act and hospital
reclassification under 1886(d)(10). A second modification results from
assigning to an urban hospital the statewide rural wage index value for
the State in which that hospital is located when the wage index of the
urban hospital would otherwise be lower than the statewide rural wage
index value (the ``floor''). (In fiscal year 1998, this particular
``hold harmless'' provision affected 128 hospitals in 32 metropolitan
statistical areas (MSAs).) Given the choice between the wage index that
we use under the hospital inpatient PPS, which reflects
reclassification and other changes, and a wage index that does not
incorporate these changes, we are proposing to adopt the wage index
that is used to determine payments to hospitals under the hospital
inpatient PPS to adjust for relative differences in labor and labor-
related costs across geographic areas under the hospital outpatient
department PPS. We note that hospital outpatient department services do
not fall under the category of either ``nonhospital type services'' or
of ``other subprovider components,'' which are excluded from
consideration in developing the hospital inpatient PPS wage index. We
also note that because hospital staff frequently provide services in
both the inpatient and outpatient departments, labor costs associated
with hospital outpatient department services are generally reflected in
the hospital wage and salary data that are the basis of the hospital
inpatient PPS wage index.
By statute, we implement the annual updates of the hospital
inpatient PPS on a fiscal year basis. However, updates to the hospital
outpatient department PPS will be made on a calendar year basis. We are
proposing to update the wage index values used to calculate hospital
outpatient department PPS Medicare payment and beneficiary copayment
amounts on a calendar year basis. In other words, the hospital
inpatient PPS wage index values that are updated annually on October 1
will be implemented for the hospital outpatient department PPS on the
January 1 immediately following. We are proposing this schedule so that
wage index changes are implemented concurrently with any other
revisions, such as changes in the APC groups resulting from new or
deleted CPT codes, that are implemented on a calendar year basis.
2. Labor-Related Portion of Hospital Outpatient Department PPS Payment
Rates
In calculating payments to hospitals under the hospital inpatient
PPS, the labor-related portion of expenses within the standardized
amounts used to establish the prospective payment rates is multiplied
by the hospital wage index value to offset regional wage differences.
The fiscal year 1998 labor-related portion under the hospital inpatient
PPS is 71.1 percent. The manner in which this portion was calculated is
explained in detail in the August 29, 1997 Federal Register (62 FR
45993). We note that compensation for wages, salaries, and employee
benefits accounts for 61.4 percent of expenses, with the other 9.7
percent attributable to professional fees, postal services, and all
other labor-intensive services, as explained in the August 29, 1997
Federal Register (62 FR 45995).
[[Page 47577]]
Current ASC payment rates are standardized for regional wage
differences, and carriers adjust the base rates to calculate payments
to individual facilities by multiplying the labor-related portion of
the base rate by the appropriate hospital inpatient PPS wage index
factor. The labor-related portion of current ASC payment rates is 34.45
percent based on 1986 ASC survey data.
Because of the sequence of steps that we followed to construct the
hospital outpatient department services PPS database, we had to
estimate the percentage of hospital outpatient department costs
attributable to labor in order to standardize hospital outpatient
department costs for geographic wage differences. We decided that 60
percent represented a reasonable estimate of outpatient costs
attributable to labor, as it falls between the hospital inpatient PPS
operating cost labor factor of 71.1 percent and the ASC labor factor of
34.45 percent and is within a percentage point of the labor-related
costs under the hospital inpatient operating cost PPS attributed
directly to wages, salaries, and employee benefits (61.4 percent) under
the rebased 1992 hospital market basket that was used to develop the
fiscal year 1997 update factor for inpatient PPS rates (published
August 30, 1996 at 61 FR 46187). In addition to considering what
percentage of costs is attributed to labor by other payment systems, we
considered health care market factors such as the shift of more complex
services from the inpatient to the outpatient setting, which could
influence labor intensity and costs, and 60 percent seemed appropriate.
(As we explain in section V.I. below, regression analysis confirmed the
labor percentage to be 60 percent.) We calculated 60 percent of each
hospital's total operating and capital costs. We then divided that
amount by the provider's 1996 hospital inpatient PPS wage index value
to standardize differences in costs that are attributable to geographic
wage differences. The total cost of performing a procedure/visit,
therefore, includes wage-standardized operating and capital costs, as
well as bundled ancillary costs (that is, operating room time, medical/
surgical supplies, pharmaceuticals, anesthesia, recovery room,
observation, biologicals, etc.) and minor ancillary procedures (for
example, venipuncture), as explained in greater detail in section V.C.
The final hospital outpatient department PPS payment rates that
would have been effective January 1, 1999 may differ slightly from
those proposed in this rule because we intend to adjust APC payment
rates using the fiscal year 1999 hospital inpatient PPS wage index
values that are implemented October 1, 1998. The hospital inpatient PPS
wage index values proposed for fiscal year 1999 are in the Federal
Register proposed rule published May 8, 1998 entitled ``Changes to the
Hospital Inpatient Prospective Payment Systems and Fiscal Year 1999
Rates (HCFA-1003-P)'' (63 FR 25575).
We are proposing to use the annually updated hospital inpatient PPS
wage index values to adjust both program payment and copayment amounts
for area wage variations, as we explain below.
3. Adjustment of Hospital Outpatient Department PPS Payment and
Copayment Amounts for Geographic Wage Variations
To adjust the APC payment rates and beneficiary copayment rates for
outpatient services for geographic wage variations, we are proposing to
use the same labor-related percentage (60 percent) that we used
initially to standardize costs for geographic wage differences. When
intermediaries calculate actual payment amounts, they will multiply the
prospectively determined APC payment rate and copayment amount by that
labor-related percentage to determine the labor-related portion of the
base payment and copayment rates that is to be adjusted using the
appropriate wage index factor. That labor-related portion will then be
multiplied by the hospital's inpatient PPS wage index factor, and the
resulting wage-adjusted labor-related portion will be added to the non-
labor-related portion, resulting in wage-adjusted payment and copayment
rates. The wage-adjusted copayment amount is then subtracted from the
wage-adjusted APC payment rate, and the result is the Medicare payment
amount for the service or procedure. Note that even if a hospital
elects to discount the copayment, the full copayment amount is assumed
for purposes of determining Medicare program payments. (See section
V.D. for a discussion of how Medicare program payments are calculated
when the Part B deductible applies.)
The following is an example of how an intermediary would calculate
the Medicare payment for a surgical procedure with a hypothetical APC
payment rate of $300 that is performed in the outpatient department of
a hospital located in Heartland, USA. The copayment amount for the
procedure is $105. The hospital inpatient PPS wage index value for
hospitals located in Heartland, USA is 1.0234. The labor-related
portion of the base payment rate is $180 ($300 x 60 percent), and the
non-labor-related portion of the base payment rate is $120 ($300 x 40
percent). The labor-related portion of the base copayment rate is $72
($120 x 60 percent), and the non-labor-related portion of the base
copayment rate is $48 ($120 x 40 percent). It is assumed that the
beneficiary deductible has been met.
Wage-Adjusted Base Payment Rate (rounded to nearest dollar):
= ($180 x 1.0234) + $120
= $184 + $120
= $304
Wage-Adjusted Base Copayment Rate (rounded to nearest dollar):
= ($72 x 1.0234) + $48
= $74 + $48
= $122
Calculate Medicare Program Payment Amount:
$304 - $122 = $182
F. Claims Submission and Processing
Hospitals will receive detailed instructions on claims submission
over the coming year. This section provides a brief overview of the
process.
In order for APCs to properly capture services furnished, hospitals
must assign HCPCS codes to services. Revenue center codes will capture
only packaged services (operating and recovery room, pharmaceuticals,
medical/surgical supplies, etc.). Correct assignment of codes requires
an understanding of the differences among surgical procedures, a
knowledge of the extent of effort expended in a clinic visit, etc. We
believe that many hospitals currently have surgical records coded using
HCPCS in the medical records department. However, many hospital coders
are much more familiar with the ICD-9-CM system of classification than
they are with HCPCS. Among the sources of education available to update
skills, hospitals may want to explore in-service education from a
credentialed coder with experience in billing for physicians' and
surgeons' services, classes available from local hospital associations
or medical record associations, formal classes in local colleges, etc.
Coding conventions in the outpatient setting differ slightly from
those in use in inpatient settings. The diagnosis identified on the
claim need not be the ``principal'' diagnosis, as required under DRGs.
Instead the diagnosis is the reason for the visit as identified at the
time of the visit. It is not necessary to wait to submit the claim
until laboratory or x-ray results are known, in an effort to more
clearly identify the diagnosis. In billing for clinic and emergency
[[Page 47578]]
department visits, the diagnosis should relate to the reason for the
visit. A patient who attends several different clinics in one day
should have separate claims submitted for each clinic visit, since at
this time only one diagnosis can be associated with each claim. We will
seek a change to the UB-92 allowing diagnoses to be identified by
number, so that each line item can have a diagnosis associated with it.
Another difference from inpatient reporting is that the DRG GROUPER
can take every procedure coded and identify the one highest in the
surgical hierarchy applicable to the diagnosis, then ignore those that
do not affect the DRG. The HCPCS codes, however, are both more numerous
and very specific and should be used appropriately, since each code
will trigger a payment.
We propose to apply to hospital outpatient claims HCFA's Correct
Coding Initiative (CCI). One of the purposes of the CCI is to ensure
that the most comprehensive of a group of codes is billed instead of
the component parts. For example, G0001 (routine venipuncture) is a
component part of 36430 (transfusion of blood or blood components) and
should not be separately billed. Similarly, 94760 (pulse oximetry)
should not be billed with surgical procedures for which it is a common
monitoring technique. In 1997, hospital outpatient claims showed it
more than 10,000 times with 45378 (diagnostic colonoscopy). The CCI
also checks for mutually-exclusive code pairs. For example, 93797
(cardiac rehabilitation without ECG monitoring) should not be billed
simultaneously with 93798 (cardiac rehabilitation with ECG monitoring),
which happened nearly 12,000 times in 1997 hospital outpatient claims.
We propose to use the CCI edits to ensure that only appropriate codes
are grouped and priced.
Carriers have used CCI as an editing tool since January 1996, and
have discovered that the vast majority of edits are rarely triggered.
However, as shown in the examples above, hospitals' coding patterns
could result in inappropriate payments unless such edits are applied.
Under the cost reimbursement system, these types of errors did not
ultimately result in higher payments to the hospitals; nor did
providing wrong numbers in the units field (for example, repeating the
revenue code). Again, under this PPS, each unit billed will trigger a
payment. Thus, we have created a second set of edits limiting the
number of units allowed for each HCPCS code. For example, only ``1''
will be accepted in the units field for cataract surgery, but for most
services the edit allows for the procedure to be performed a number of
times in a day, with an upper limit to reduce obvious errors. Of
course, hospitals should report only the actual number of times a
procedure was performed, keeping in mind that CPT and HCPCS definitions
sometimes specify the units. For example, code 11720 is for debridement
of nail(s) by any method; one to five. This code should be reported
only once for any number of nails debrided between one and five,
inclusive. If more than five nails are debrided, the appropriate code
is 11721, debridement of nail(s) by any method; six or more, billed
only once in place of 11720.
We propose to require that hospital outpatient and CMHC bills that
span more than one day indicate the date of the service for each line
item on the bill. Line item dates of service are needed in order to
implement the CCI and the units' edits, both of which are applied based
on services furnished on the same date.
Further information on billing line item dates of service, using
HCPCS to code all claims, and editing will be provided by instructions.
G. Updates
1. Revisions to Weights and the Wage and Other Adjustments
Section 1833(t)(6)(A) of the Act gives the Secretary authority to
periodically review and update the APC groups, the relative payment
weights, and the wage and the other adjustments that are components of
the outpatient PPS, to take into account changes in medical practice,
changes in technology, the addition of new services, new cost data, and
other relevant information and factors.
We explained above that we intend to update the wage index values
used to calculate program payment and copayment amounts on a calendar
year basis, adopting effective for services furnished each January 1
the wage index value established for a hospital under the inpatient PPS
the previous October 1.
Recalibration of the APC group weights is another type of revision
provided for under the statutory review authority. We define
recalibration as the updating of all the APC group weights based on
more recent information. We do not intend to make this type of update
on an annual basis. For example, we are required to rebase ASC payment
rates using survey data that are collected every 5 years. At this time,
we would like to solicit comments on how frequently to recalibrate the
hospital outpatient APC weights and on the method and data that should
be used.
Section 1833(t)(6)(B) of the Act requires that all revisions to APC
groupings, weights, and other adjustments be made in a budget-neutral
manner. Adjustments made for a particular year may not cause the
estimated amount of expenditures under the outpatient PPS to increase
or decrease from the expenditures that we estimate would have been made
under the outpatient PPS without any updates or revisions.
2. Revisions to APC Groups
It is our intent to use the same APC surgical groups in the payment
systems both for hospital outpatient services and for surgical services
furnished by Medicare-approved ASCs. A discussion of the use of APC
groups to set payment rates for Medicare-approved ASCs can be found in
the proposed rule entitled ``Update of Ratesetting Methodology, Payment
Rates, Payment Policies, and the List of Covered Surgical Procedures
for Ambulatory Surgical Centers Effective October 1, 1998'' (HCFA-1885-
P) that was published in the Federal Register June 12, 1998 (63 FR
32290). In order to maintain comparability of the APC groups across
both settings, we are proposing to coordinate our review of comments on
the composition of the APC groups that are submitted during the public
comment period following publication of both this proposed rule and the
ASC proposed rule. We are further proposing to coordinate any
adjustments to the composition of the APC surgical groups that may
result from our analysis of both sets of comments to ensure that the
final APC surgical groups not only reflect and take into account both
sets of comments, but also remain comparable for ASCs and hospital
outpatient departments to the maximum extent possible within the
constraints imposed by statutory and regulatory requirements.
Thereafter, we expect the composition of all the APC groups to
remain essentially intact from one year to the next with the exception
of the few changes that may be necessary as a consequence of annual
revisions to HCPCS and ICD-9 codes. We do not plan to routinely
reclassify services and procedures from one APC to another. HCFA will
make these changes based on evidence that a reassignment would improve
the group(s) either clinically or with respect to resource consumption.
All changes in APC groups must be budget neutral, and changes in APC
groups will only be made through notice and comment when we implement
the annual outpatient PPS update.
[[Page 47579]]
We are proposing to follow certain conventions when, as a result of
annual HCPCS and ICD-9 revisions, we add new services to the hospital
outpatient PPS. As part of the notice and comment process accompanying
the annual update of the outpatient PPS, we shall propose the
assignment of a newly created code to the existing APC that, in the
judgment of our medical advisors, is the most similar clinically and in
terms of resource requirements to the new service. Because a new
service will not have any charge history or cost data associated with
it, classification of a new service to an existing APC group will not
alter the APC payment rate, relative weight, and program payment and
copayment amounts that have been established for that APC group. The
new service will assume the same payment rate, relative weight, and
program and copayment amounts that have been established for the APC
group to which it is classified.
If the annual revision of HCPCS or ICD-9 result in the deletion of
a code or service that is classified in an APC group under the
outpatient PPS, we shall remove that service from the APC group and
discontinue paying for the service under the outpatient PPS. When a CPT
code that contributed cost data to our 1996 database is deleted, we
will continue to use the cost data in the APC. This in fact did occur
in the psychotherapy set of codes. The codes that were in effect in
1996 have been replaced. If we did not capture these data from those
codes, we would not be able to assign a weight to brief psychotherapy
visits. As long as the new codes belong in the same APC, in terms of
clinical coherence and related resource use, the data are relevant. If
the code that contributed data to the 1996 database were revised so
that it no longer belonged in the APC to which it was originally
assigned, the revised code would be placed in an APC that better
matched the new description. As in the case of an entirely new code, no
cost data would be available for the revised code, so it would be
assigned the weight, program payment rate, and copayment rate of the
codes in the new APC. We will not create an APC for an entirely new
code, but will assign it for at least 2 years to an existing group
while accumulating data on its costs relative to the other codes in the
APC.
When we do reclassify a service from one APC group to another, the
reclassification will affect the payment rate, the weight, and the
payment and copayment amounts for both of the ``donor'' APC group and
the ``receiving'' APC group if the service that is reclassified was
recognized in 1996 and is reflected in our database. As a result of
reclassifying a service that was recognized in 1996 and is reflected in
our database, we shall recalculate the payment rate, the weight, and
the payment and copayment amounts for both the ``donor'' APC group and
the APC group to which the service is reassigned. If the service that
is reclassified was not recognized in 1996 and is therefore not
reflected in our database, we shall treat it in the same manner that we
treat the addition of altogether new services and the removal of
services that are deleted from HCPCS and ICD-9, that is, reclassifying
the code will have no effect on the payment rate, relative weight, and
payment and copayment amounts for either the donor APC or the receiving
APC, and the reclassified code will assume the payment rate, relative
weight, and payment and copayment amounts of the APC to which the
service is reclassified.
3. Annual Update to Conversion Factor
Section 1833(t)(3)(C)(ii) of the Act requires us to update annually
the conversion factor used to determine APC payment rates. Section
1833(t)(3)(C)(iii) of the Act provides that the update be equal to the
hospital inpatient market basket percentage increase applicable to
hospital discharges under section 1886(b)(3)(B)(iii) of the Act,
reduced by one percentage point for the years 2000, 2001, and 2002. We
also have the option (under section 1833(t)(3)(C)(iii)) of developing a
market basket that is specific to hospital outpatient services. We are
considering this option, and we solicit comments on possible sources of
data that are suitable for constructing a market basket specific to
hospital outpatient services.
H. Outlier Payments
Section 1833(t)(2)(E) of the Act requires us to establish in a
budget-neutral manner other adjustments that we determine are necessary
to ensure equitable payments, such as outlier adjustments or
adjustments for certain classes of hospitals. We considered several
factors to evaluate the necessity of an outlier adjustment policy.
The most relevant factor is that the proposed system has minimal
packaging. Unlike the DRG system for inpatient services, where a
patient can be classified into only one payment group during an
inpatient stay, payment can be made for a number of APC groups for a
given patient on a given day. If multiple services are delivered,
payments will be made for multiple APCs. Because a hospital will
receive payment for each service furnished, we believe this greatly
reduces the need for an outlier adjustment.
Another relevant factor is that critical care services have been
isolated into their own APC. Payment for the critical care APC is based
on median hospital costs of critical care services. Therefore, payments
for this group will reflect the intensity and associated higher costs
of this type of medical care.
Even if critical care is not delivered, higher payment will be made
for more serious cases. Payments for medical visits to the emergency
room will be made at three incremental levels of intensity, and
additional payments will be made for any other laboratory work, x-rays,
or surgical interventions resulting from the visit.
Upon consideration of the above factors, we do not believe that an
outlier adjustment is necessary to ensure equitable payments.
I. Adjustments for Specific Classes of Hospitals
As part of the analysis to determine whether payment adjustments
would be proposed for the outpatient prospective payment system, we
conducted extensive regression analysis of the relationship between
outpatient hospital costs (calculated as hospital outpatient operating
and capital cost per unit) and several factors that affect costs. The
latter included variables used in estimating similar models for the
inpatient PPS, as well as several variables unique to hospital
outpatient departments. We considered all costs and services for each
hospital relevant to the proposed payment system. Ultimately, we
decided not to propose any adjustments to the Federal payment other
than the wage index used to adjust for local variation in labor costs
at this time. While this reflects a difference in policy relative to
inpatient PPS, the proposed outpatient PPS is fundamentally different.
Specifically, the outpatient system has limited packaging, so
variations in costs are limited to the resources used to produce a
single procedure. Cost variations in the inpatient system, however,
also can be attributed to variation in the intensity of services
bundled under a single rate. Therefore, variations in outpatient cost
per unit among hospitals are expected to be small relative to the
variations in inpatient cost per discharge that have been estimated in
the past.
We began our analysis by examining the distribution of service mix
and cost per unit (or cost per service) among various types of
hospitals. This analysis revealed some extreme values of cost per unit
among types of hospitals, especially major teaching hospitals,
[[Page 47580]]
hospitals with trauma centers, and eye and ear hospitals. These costs
were 200 percent to 400 percent higher than the average cost per unit
for all hospitals. Because costs are measured on a per unit basis,
values of this magnitude suggested problems both with identifying
procedure codes and properly entering the correct unit of measurement
(times performed, minutes of treatment, etc.). Under the current
payment system, hospitals will be fully reimbursed for their services
even if claims do not contain all the procedure codes that would be
associated with revenue centers billed. A consistent practice of such
under-coding would lead to very high costs associated with a single
unit.
The presence of these extreme values also suggested that a few
hospitals could unduly influence the distribution of hospital
outpatient cost per unit in our regression analysis. Individual bills
were not edited for extreme unit costs. However, even removing cost
outliers at the bill-level might not have eliminated these extreme
variations at the hospital level. A single under-coded bill might not
meet outlier thresholds, but the combined effects of coding differences
on all of a hospital's bills could create much higher or lower unit
costs.
In light of the lack of trimming for outlier/error costs at the
bill level, the possibility of outlier hospitals skewing the
distribution of cost per unit, and the hospital-level analysis for
payment adjustments argued for an edit on cost per unit at the hospital
level. The distribution of cost per unit more closely resembles a
lognormal distribution than a normal distribution; there are no
negative costs and the average cost is greater than the median cost. We
identified outliers using the mean and standard deviation of the
natural logarithm of cost per unit. Taking the natural logarithm of any
variable compresses the distribution and minimizes the impact of the
most unusual bills in the determination of the mean. The compressed
distribution also makes it more difficult to identify outliers.
We removed 83 hospitals through an edit of three standard
deviations from the mean of the logged unit costs: 51 hospitals with a
logged cost per unit exceeding three standard deviations above the mean
and 32 hospitals with a logged cost per unit less than three standard
deviations below the mean. Removing outlier hospitals greatly improved
the distribution of unit costs among types of hospitals. The exempted
Maryland hospitals were also excluded from the analysis. However, we
included the 10 cancer hospitals. After we removed the 54 exempted
Maryland hospitals, outlier hospitals, and hospitals for which we could
not identify payment variables, we were left with 5,419 hospitals for
analysis. Our regression analyses use this set of hospitals.
A variety of regression models have become the standard of practice
for examining hospital cost variation and analyzing potential payment
adjustments. We looked at two standard models: fully specified
explanatory models to examine the impact of all relevant factors that
might potentially affect outpatient hospital cost per unit and payment
models that examine the impacts of those factors used to determine
payment rates. The payment models standardize the dependent variable,
hospital outpatient cost per unit, by service mix to capture the
relationship between the APC weights and payment under the PPS, rather
than a statistical relationship between service mix and costs. Both
unweighted regressions and regressions weighted by volume were
examined. All regressions employed a double log or semi-log
specification. References to logs throughout this discussion refer to
the natural logarithm, and the geometric mean is the mean of the
natural logarithm of values. Our dependent variable was total hospital
outpatient cost per unit.
We used payment variables from the inpatient prospective payment
system, including disproportionate share patient percentage, both
capital and operating teaching variables (resident to average daily
census and resident to bed ratios respectively), and dummy variables to
account for location in a rural, large urban, and other urban area. We
also looked at a modified teaching variable that reflects outpatient
volume, several dummy variables unique to outpatient departments, such
as the presence of a trauma unit, and the difference in costs among
various types of TEFRA hospitals and cancer hospitals. A discussion of
the major payment variables and our findings appears below.
Service Mix Index
Using APC weights and the number of services provided in each APC,
we calculated an average APC weight, or service mix, for each hospital.
We also calculated a ``discounted'' service mix that considers the
reduced weight for additional surgical procedures performed at the same
time, which is consistent with the proposed payment system. The
national average service mix is 1.43, and the national average service
mix discounted for multiple procedures is 1.45. The differences between
the two are negligible due to the low volume of services subject to
discounting, and they proved almost interchangeable in the adjustment
regressions. We did use the discounted service mix for our regressions
because it reflects the proposed policy.
Since APC weights are calculated from costs, we would expect
approximately a one to one, or proportional, relationship between
service mix and hospital outpatient cost per unit. That is, we expect
the coefficient of the service mix to be one in a regression of
outpatient cost per unit on the service mix. However, initial payment
regressions of hospital outpatient cost per unit on service mix and the
wage index revealed a coefficient of 0.68, suggesting that the
calculated service mix increases faster than cost per unit; a 10
percent increase in the service mix is associated with a 6.8 percent
increase in costs.
This estimated relationship prompted a preliminary analysis of the
relationship between geometric means and median cost per unit within
each APC. If per unit cost within APCs is distributed log normally, the
median and the geometric mean are equivalent. However, if the
distribution of costs within APCs is skewed, then the median may differ
from the geometric mean. Because the dependent variable in the
regression models is the natural log of hospital outpatient cost per
unit, a systematic difference between the geometric mean of cost per
unit and median cost per unit could explain the lack of one to one
relationship between hospital service mix and hospital cost per
service. Weighting the regression equation by the volume of services,
essentially giving greater weight to the relationship between service
mix and unit costs for hospitals with a higher volume of services,
increases the relationship to 7.5 percent. Higher volume hospitals tend
to have a higher service mix and higher service costs.
A limited analysis of unit costs for selected APCs demonstrated
that, in general, in APCs with low relative weights, median hospital
cost per unit is lower than the geometric mean of logged hospital cost
per unit, and, in APCs with high relative weights, median hospital cost
per unit is generally higher than the geometric mean. This would lead
to a greater spread in a hospital's service mix than appears in their
actual cost per unit, and would provide an explanation for the less
than proportional relationship that was estimated to exist between
service mix and cost per unit. A regression of cost per unit on a
service mix derived from weights based on the geometric
[[Page 47581]]
mean and the wage index demonstrated better correlation; a 10 percent
increase in service mix led to a 7.7 percent increase in cost per unit.
Weighting this regression equation by the volume of services increases
the relationship to 9.1 percent, suggesting that the higher service mix
of higher volume hospitals better tracks those hospitals' cost per
unit.
Labor Share
The coefficient of the hospital wage index is the estimated
percentage change in costs attributable to a 1 percent increase in the
wage index. This coefficient provides an estimate of the share of
outpatient hospital unit costs that are attributable to labor.
Depending on the model specification, the coefficient ranged from 0.51
to 0.68 reflecting a labor share between 50 and 70 percent. The
coefficient from a fully specified payment regression of the hospital
cost per unit standardized for the service mix on the wage index,
disproportionate share patient percentage, modified teaching, rural,
and urban variables is approximately 0.60, suggesting a labor share of
60 percent. Even though we ultimately decided that we would not propose
additional adjustments, we believe that the coefficient from this
specification provides the best estimate of the labor share for the
proposed system. This judgment was based on a policy to use a labor
share that reflected the relationship between the wage index and costs,
rather than the effects of correlated factors. The explanatory
regression model that has a dependent variable of unstandardized
hospital outpatient cost per unit also implies a labor share of 60
percent across most specifications.
Teaching Intensity and Disproportionate Share Patient Percentage
For the inpatient PPS, the intensity of teaching programs has
typically been measured by the resident to bed ratio or resident to
average daily census ratio. Early in our regression analysis, we used
resident to the average daily census of inpatient days, the teaching
variable from inpatient capital PPS. The results suggested that costs
increase somewhat with the size of the teaching program (p<0.05).
However, we believed that this ratio could not adequately represent
teaching hospitals with large outpatient departments relative to the
size of their inpatient operations. We modified the resident to average
daily census variable to reflect the ratio of residents to combined
inpatient and outpatient utilization. To accomplish this, we calculated
the ratio of inpatient costs per day to outpatient costs per unit for
each hospital, and we used this ratio to convert hospital services into
inpatient day equivalents. We combined both inpatient days and
outpatient day equivalents to get a ratio of residents to inpatient and
outpatient days. Since we cannot, at this time, allocate residents to
inpatient and outpatient settings, we could not estimate a teaching
variable based on residents to outpatient volume alone.
We created the disproportionate share patient percentage variable
by adding the percentage of inpatient days attributable to Medicaid
patients to the percentage of Medicare patients receiving Supplemental
Security Income. In most regression specifications, the
disproportionate share percentage was positive, small in magnitude, and
significant (p<0.05). These coefficients imply that a hospital with a
40 percent disproportionate share percentage would be approximately 4.5
percent [calculated (e(DSHP*0.11-1)*100] more
costly than hospitals without any low-income patients. Teaching
intensity variables were not significant in un-weighted regressions
(p>0.05). However, they were positive and significant in regressions
weighted by number of services. The teaching coefficient implies that a
hospital with a resident to combined inpatient and outpatient ``days''
ratio of 0.35 would be 2.4 percent [calculated
((1+IME)0.08-1)*100] more costly than hospitals with no
residents.
We also estimated several regression specifications to determine if
there were thresholds for the estimated impacts of teaching and
disproportionate share patient percentage on costs. We determined that
positive and significant estimated differences do not occur for
hospitals whose disproportionate share percentage is less than 0.40.
Significant effects for the teaching variable do not occur for
hospitals whose ratio of residents to inpatient and outpatient days is
less than 0.32. We used these results to estimate a new
disproportionate share patient percentage based on a 0.30 threshold and
a ratio of residents to inpatient and outpatient ``days'' based on a
0.28 threshold. We chose these thresholds by identifying the point at
which the relationship between the unit costs and the teaching
intensity or disproportionate share patient percentage becomes positive
rather than significant because of the lack of significance associated
with the teaching variable and because the small coefficient for the
disproportionate share variable led to intermittent significance for
higher values. We subtracted these thresholds from the original
variable to create new teaching and disproportionate share patient
percentage variables. Subtracting the threshold removes the effect of
values that are not significantly related to cost per unit and
eliminates the sudden increase (notch effect) in the disproportionate
share patient percentage and teaching variable at the threshold level.
The new variables suggest that a hospital with a disproportionate share
patient percentage 10 points higher than the 30 percent threshold is
approximately 2.3 percent more costly [calculated
(eDSHP*0.23-1)*100] and that a hospital with a
ratio of residents to inpatient and outpatient utilization 0.07 higher
than the 0.28 threshold is approximately 0.75 percent more costly
[calculated ((1+IME)0.11-1)*100].
Urban and Rural Location
We also estimated difference in hospital outpatient costs between
rural, large urban, and other urban areas. In almost all of the
regression models, both explanatory and payment, the rural dummy
variable was positive and significant (p<0.05). Rural hospitals had
approximately 8 percent higher standardized unit costs than urban
hospitals. In all of the regression models, large urban hospitals were
not significantly different from other urban hospitals.
TEFRA and Cancer Hospitals
We also found that some types of TEFRA hospitals (long-term care,
children's, and psychiatric) and the ten cancer hospitals have
significantly (p<0.05) higher unit costs standardized for service mix.
Cancer, children's, and long term care hospitals demonstrated
standardized unit costs that were at least 20 percent higher than other
hospitals. We believe that these significantly higher costs largely can
be attributed to under-coding because proper coding is not required for
the payment of many services under the current system, especially
medical visits. Poor coding would affect calculations of both service
mix and cost per unit.
Estimated Payments
The appropriateness of potential payment adjustments must be based
on both cost effects estimated by regression analysis and other factors
including simulated payment impacts. We simulated the impact of the
proposed system on hospitals by calculating the percentage difference
between payments made under current law and payments
[[Page 47582]]
under the proposed system (column 3). Section X. contains a more
complete table that considers the impact of proposed payments on
additional classes of hospitals, including TEFRA and cancer hospitals.
Although Column 3 represents the net effect of the new PPS on
hospitals, we thought it was necessary to show the impacts on hospitals
of simply changing the payment system without including the effects of
the overall reduced payment to hospitals because the PPS system is not
budget neutral to current payment. To reiterate, the conversion factor
is set by summing Medicare payments under the current system and
beneficiary copayment under the new system and dividing by the sum of
the relative weights. Beneficiary copayments under the new system will
reduce overall payments to most hospitals because 20 percent of the
median group charges is less than 20 percent of actual charges.
Therefore, we simulated the impacts as though the conversion factor
were set as if the system were to be budget neutral. Column 4
demonstrates the distributional impacts resulting from implementing the
new system after eliminating the overall reduction in payment most
hospitals will experience due to the effect of the methodology used to
set the conversion factor. We believe the column 4 percentage
differences are what we should examine since any adjustment we would
consider should correct for inequities caused by moving to a PPS (not
the legislated reduction in total payment). Therefore, we based our
decision about adjustments on these percentage differences rather than
percentages combining the PPS and the overall reduction in coinsurance
amounts required by law. We also estimated payment to cost ratios
associated with the new payment methods and the percent change in total
Medicare payments. All simulations used a labor share of 60 percent.
The table below shows the results of two simulations. The first
contains only the wage index adjustment to the APC rates. The second
also includes the threshold adjustments for disproportionate share
patient percentage and teaching intensity discussed above.
BILLING CODE 4120-01-P
[[Page 47583]]
[GRAPHIC] [TIFF OMITTED] TP08SE98.000
[[Page 47584]]
[GRAPHIC] [TIFF OMITTED] TP08SE98.001
BILLING CODE 4120-01-C
[[Page 47585]]
Based on our analyses, we are not proposing to make adjustments to
the outpatient payment rates for disproportionate share patient
percentage and teaching intensity and rural location for the following
reasons.
1. Estimated effects of teaching intensity and disproportionate
share patient percentage on costs were small and, in some cases, not
statistically significant.
2. Payment impacts without such adjustments do not vary
considerably, the largest being a reduction of 5.8 percent for major
teaching hospitals. These impacts should also be evaluated in terms of
the overall effect on Medicare payments since on average, outpatient
services account for 10 percent of hospitals' Medicare payments. For
example, the associated reduction of total Medicare payments for major
teaching hospitals would be about 1 percent.
3. With the threshold adjustments we considered, estimated payment
reductions for rural hospitals would be 1.9 percent under the proposed
system, rather than 1.5 percent. These hospitals also receive a greater
percent of their Medicare income (14.7 percent) from providing
outpatient services. Similarly, payment reductions for low-volume rural
hospitals would be 13.9 percent of current payments, rather than 13.7
percent, and these hospitals also earn a greater percentage of their
Medicare income (18.2 percent) from providing outpatient services.
Because of these potential shifts in payments, any adjustment should be
based on stronger analytic results than those found with the current
data.
4. We also believe the issue of payment adjustments should be
reexamined using data from initial years of the implemented system
because current cost calculations and relationships among key factors
and costs probably are affected by variation in coding patterns.
5. HCFA is working towards standardizing payment across all sites
of service. Fewer adjustments to the outpatient PPS would allow HCFA to
move ahead more quickly with this approach.
6. We believe that we should further analyze the impact of basing
APC weight calculations on the median rather than the geometric mean
because better correlation between costs and service mix would impact
the size of adjustments.
Although the payment simulations show potentially large percentage
losses and low payment to cost ratios for low-volume hospitals, we are
not proposing an adjustment for volume. The low-volume hospitals get a
much greater percent of their Medicare income from the provision of
outpatient services than the average, and total Medicare payments would
drop by 3.1 percent for rural low-volume hospitals and 1.8 percent for
urban low-volume hospitals. Low-volume hospitals have higher than
average standardized unit costs, which may be attributable to economies
of scale, under-coding, or cost allocations to the outpatient
departments that are not volume related. However, an adjustment to the
rates based on volume alone might reward inefficiency and create
adverse incentives such as a reduction in services in order to increase
payment rates. Moreover, these hospitals do not comprise a large enough
proportion of other hospital types to substantially benefit from other
adjustments (for example, teaching or disproportionate share).
We are particularly concerned about the potential impact of the
outpatient PPS on low-volume rural hospitals that are sole community
hospitals or Medicare-dependent hospitals. Approximately 60 percent of
the rural hospitals furnishing fewer than 5,000 visits fall into these
categories. We are investigating the reasons for their higher costs and
are assessing whether a temporary adjustment is needed to moderate the
impact of moving to an outpatient PPS. One option we are considering
would be to phase-in the outpatient PPS for low-volume Medicare-
dependent and sole community hospitals by paying a portion of the
payment based on PPS rates and a portion based on the current payment
system. For example, payment could be based on 75 percent of payments
under the current system and 25 percent on PPS rates in the first year,
50 percent current system payments and 50 percent PPS rates in the
second year, 25 percent current system payments and 75 percent PPS
rates in the third year, and completely on PPS rates in subsequent
years. Another option we are considering would phase-in outpatient PPS
if a low-volume sole community hospital or Medicare-dependent hospital
has a negative Medicare margin for outpatient services. For example,
payment could be based on the amount payable under outpatient PPS plus
a percentage of the difference between those amounts and the amounts
payable under the current system. The percentage of the difference that
would be payable could phase down, for example, 75 percent in year one
of implementation, 50 percent in year 2, 25 percent in year 3, and no
adjustment in year 4 and subsequent years. We solicit comment on this
and other alternatives we might consider. By statute, any adjustment
would have to be budget neutral.
We also are not proposing adjustments for cancer or TEFRA hospitals
at this time. We believe that claims from cancer and TEFRA hospitals
have been under-coded for many of the services cancer hospitals provide
due to the lack of payment incentives for proper coding of these
services under the current system. Further analysis will be conducted
to determine if current coding practices explain the negative impact.
If we determine that cancer hospitals would be unduly harmed because of
the new outpatient PPS, we will consider whether an adjustment or
perhaps a transition period is needed to moderate the impact. By
statute, any adjustment would have to be budget neutral.
We do not believe that this action will restrict beneficiary access
because other hospitals provide many of the same services provided at
TEFRA hospitals. In addition, children's and free-standing psychiatric
hospitals are less dependent than other hospitals on Medicare revenues.
Finally, the remaining classes of TEFRA hospitals, rehabilitation and
long-term care, lose a much smaller percentage of their total Medicare
income, 3.7 and 3.5 percent respectively than the average for all
facilities.
We are not proposing adjustments for any eye and ear or trauma
hospitals because payment simulations demonstrated an increase in
payments under the proposed PPS. We will assess the need for additional
adjustments and make any appropriate changes as data become available
under the new system.
J. Volume Control Measures
Section 1833(t)(2)(F) of the Act requires us to develop a method
for controlling unnecessary increases in the volume of covered
outpatient department services, including partial hospitalization
services in CMHCs. If the volume of services paid for increases beyond
amounts established through methodologies determined in section
1833(t)(2)(F), section 1833(t)(6)(C) provides that the update to the
conversion factor may be adjusted. MedPAC recommends in its report to
the Congress that we implement an expenditure cap to help control
spending for hospital outpatient services and that we monitor hospital
outpatient volume to ensure that access to services and quality of care
are not reduced under a cap.
In this proposed rule, we are proposing a volume control measure
for services furnished in CY 2000. In the
[[Page 47586]]
proposed rule for rates that would be effective in CY 2001, we plan to
propose an appropriate method for determining expenditure targets for
services furnished in CY 2001 and subsequent years, following
completion of further analysis of how that target should be computed.
Later in this section, we discuss several possible approaches for
controlling the volume of hospital outpatient services furnished in CY
2001 and subsequent years.
Pursuant to section 1833(t)(2)(F) and consistent with section
1833(t)(6)(C), we are proposing to update the target amount specified
under section 1833(t)(3)(A) for CY 1999 as an expenditure target for
services furnished in CY 2000. We will update the CY 1999 target for
inflation (based on the projected change in the hospital market basket
minus one percentage point) and estimated changes in the volume and
intensity of hospital outpatient services and estimated Part B fee-for-
service changes in enrollment. If volume exceeds the target for CY
2000, we are proposing to adjust the update to the conversion factor
for CY 2002. We will compare the CY 2000 target to an estimate of CY
2000 actual payments to hospitals. (HCFA's Office of the Actuary will
determine the CY 2000 actual payments using the best available data.)
If unnecessary volume increases, as reflected by expenditure levels,
cause payments to exceed the target, we will determine the percentage
by which the target is exceeded, and adjust the CY 2002 update to the
conversion factor by the same percentage.
In conjunction with the Office of Inspector General, we are
proposing to do further work to assure that only payments made in
accordance with existing Medicare law and regulations were used in the
calculation of the target amount. If this work reveals that adjustments
to the target amount and expenditure ceiling are warranted, we will
address this issue in a future rule.
When the inpatient PPS was implemented, the packaging of all
services provided during an admission under a single rate was the
primary method of volume control. This method was appropriate because
the concern was the intensity of services per admission, rather than
the number of admissions, which was generally stable. For outpatient
department services, there has been rapid growth in the intensity of
ancillary services per procedure. We believe that greater packaging of
these services might provide volume control. However, because the
hospital outpatient PPS will not initially include a significant degree
of packaging, we are examining a number of mechanisms to control
unnecessary increases, as reflected by expenditure levels, in the
volume of covered outpatient department services. The volume of
services is a significant concern, particularly during the first few
years of the outpatient PPS, because of the possible incentives under
PPS to increase utilization.
Although the updated target amount provides a basis against which
we can measure year 2000 actual payments, we need to develop an
approach for establishing a volume control measure for years 2001 and
beyond. Because of the complexities involved in developing such a
system, we do not plan to propose a method for future years (2001 and
beyond) until we issue our notice of proposed rulemaking for CY 2001,
but we want to open a discussion now, so that we can obtain comments
that we can use in developing a proposal.
One possible mechanism to control unnecessary increases in the
volume of outpatient services paid for under the outpatient PPS is to
expand the sustainable growth rate (SGR) system for physician services,
which is required under section 1848(d)(3) of the Act, as amended by
section 4502 of the BBA, to take into account hospital outpatient
services. Physicians typically are responsible for ordering medical
services and are thus responsible for determining a substantial portion
of hospital outpatient volume. Expanding the SGR system for physician
services to include hospital outpatient services would provide added
incentives for physicians to evaluate the necessity of orders for
hospital outpatient services.
A second possible mechanism would be to expand the SGR system for
physician services to include all ambulatory services, for example,
services in hospital outpatient departments and ASCs, and to use this
expanded SGR system to establish updates for the ambulatory facility
payments as well as for physician fee schedule updates. This method
would spread volume control incentives more evenly across the
ambulatory sector. It would more closely align physician and facility
incentives and be less sensitive than a hospital-outpatient-department-
only SGR to shifts in site of service.
A third approach to controlling unnecessary growth in the volume of
hospital outpatient services is to modify the physician SGR method and
incorporate it into the hospital outpatient department payment system.
That is, as in the physician payment context, an SGR value for hospital
outpatient services would be calculated and payment updates for these
services would be reduced if volume increases result in expenditures
above target levels.
We believe the third option of linking updates of the outpatient
department conversion factor to an SGR system is the most feasible
approach to take initially. Additional study, analysis, and possible
legislative modification would be necessary before we could consider
implementing either of the first two options discussed above. We
acknowledge that, to the extent that hospital outpatient volume is
physician driven, an outpatient SGR could arguably be viewed as
unnecessarily and unfairly penalizing facilities. Moreover, because
sites of ambulatory care are relatively interchangeable with respect to
the delivery of outpatient services, setting appropriate targets for
hospital outpatient departments alone could be difficult. However, an
outpatient SGR system would parallel the SGR system created for
physician services under section 4502 of the BBA. Physician volume
issues have been extensively analyzed by MedPAC, and the SGR system for
physicians has evolved as a feasible method for volume control. Many
outpatient PPS issues are similar to physician issues because changes
in technology and places of service can affect expenditures for both
hospital outpatient departments and physicians.
The outpatient SGR system would base volume and intensity growth
allowances for services under the outpatient PPS on the growth in the
general economy. Other factors in determining the target rate of growth
include medical inflation, changes in enrollment, and changes in
spending due to changes in the law or regulations. The outpatient SGR
would be calculated as the product of--
(1) The annual update to the conversion factor (described in
section V.G.3. of this preamble), which is the outpatient market basket
percentage increase reduced by one percentage point for the years 2000,
2001, and 2002.
(2) The percentage increase or decrease in Part B enrollees
(excluding those enrolled in Medicare+Choice) from one year to the
next;
(3) The projected growth in the real gross domestic product per
capita (or real gross domestic product per capita plus an appropriate
factor for recent outpatient department services growth) from the
previous year to the year involved; and
(4) The percentage change in spending for outpatient department
services resulting from changes in law and regulations from one year to
the next.
[[Page 47587]]
This growth rate system would be used in setting annual updates to
the conversion factor for hospital outpatient services. Pursuant to
section 1833(t)(2)(F) of the Act, and consistent with section
1833(t)(6)(C), we would lower the annual update to the conversion
factor for a given year if volume increases cause expenditures to
exceed the target amount in a previous year. While we think using an
outpatient department SGR is the most feasible option in the short
term, in the long term we would like to develop a more integrated
approach that addresses physicians and ASCs, as well as outpatient
departments. In addition to requesting comments on our proposed volume
control measure for services furnished in CY 2000, we specifically
solicit comments on the appropriateness of applying the SGR method
directly to payments made under the outpatient PPS for future years. We
also welcome comments on the development of a long-term integrated
system that we would consider as we develop possible future proposals.
In our final rule, we will respond to comments on our proposed volume
control measure for services furnished in CY 2000. We do not intend to
respond to comments concerning the development of an SGR system for
services furnished after CY 2000, an integrated system, or any other
approach. However, we will use any comments we receive in developing a
proposal we will make next year for volume control measures to be
applied to services furnished after CY 2000.
K. Prohibition Against Administrative or Judicial Review
Section 1833(t)(9) of the Act prohibits administrative or judicial
review of the PPS classification system, the groups, relative payment
weights, adjustment factors, other adjustments, volume control methods,
calculation of base amounts, periodic control methods, periodic
adjustments, and the establishment of a separate conversion factor for
cancer hospitals.
VI. Hospital Outpatient Clinics and Other Provider-Based Entities
A. Background
The Medicare law (section 1861(u) of the Act) lists the types of
facilities that are regarded as providers of services, but does not use
or define the term ``provider-based.'' However, from the beginning of
the Medicare program, some providers, which are referred to in this
section as ``main providers,'' have owned and operated other
facilities, such as SNFs or HHAs, that were administered financially
and clinically by the main provider. The subordinate facilities may
have been located on the main provider campus or may have been located
away from the main provider. In order to accommodate the financial
integration of the two facilities without creating an administrative
burden, we have permitted the subordinate facility to be considered
provider-based. The determination of provider-based status allowed the
main provider to achieve certain economies of scale. To the extent that
overhead costs of the main provider, such as administrative, general,
housekeeping, etc. were shared by the subsidiary facility, these costs
were allowed to flow to the subordinate facility through the cost
allocation process in the cost report. This was considered appropriate
because these facilities were also operationally integrated, and the
provider-based facility was sharing the overhead costs and revenue
producing services controlled by the main provider.
Before implementation of the hospital inpatient PPS in 1983, there
was little incentive for providers to affiliate with one another merely
to increase Medicare revenues or to misrepresent themselves as being
provider-based, since at that time each provider was paid primarily on
a retrospective, cost-based system. At that time, it was in the best
interest of both the Medicare program and the providers to allow the
subordinate facilities to claim provider-based status, because the main
providers achieved certain economies, primarily on overhead costs, due
to the low incremental nature of the additional costs incurred. For
example, the billing department of a main provider could usually
accommodate the additional workload associated with a provider-based
facility by hiring an additional billing clerk, instead of incurring
the cost of a separate billing department for the provider-based
facility. This economy of scale would usually extend to the other
overhead costs incurred by the main provider, because the free-standing
facility was generally more costly to maintain than one that was
provider-based. This was due primarily to the savings on overhead costs
that were accomplished by the merging of the free-standing facility
into the main provider and having it integrated with the main provider.
Although there were several limited guidelines outlining the conditions
for certain provider-based situations, we devoted few resources to
reviewing provider compliance, because there was little incentive for
providers to use this designation inappropriately.
Since 1983, the number of provider-based facilities has increased
significantly. For example, in July of 1982, there were 481 provider-
based HHAs as compared with 2,577 provider-based HHAs in October of
1996. This was an increase of 435.75 percent in the 13 years since the
PPS was established. In addition, many hospitals now have a large
number of outpatient clinics, often located at various sites.
We believe the growth in the number of facilities and organizations
claiming to be provider-based has occurred for several reasons. First,
the PPS established payment rates using base year costs that included
provider overhead. Health care providers, looking for ways to increase
their Medicare revenues, realized that if they established provider-
based facilities or organizations that were still subject to the
reasonable cost principles, they would then be able to shift some of
the overhead from the hospital inpatient operating costs to these
provider-based facilities or organizations. The PPS main provider would
be paid a PPS payment that was intended to cover overhead costs, as
well as being reimbursed on a reasonable cost basis based on Medicare's
share of the overhead costs for the services furnished by the provider-
based facility or organization. A main provider that is excluded from
PPS and subject to the rate-of-increase limits would also benefit from
shifting its overhead to the subordinate provider-based facility or
organization. This cost shifting would enable it to increase its
payment by being paid for the Medicare share of the diverted overhead
on a cost-based methodology, as well as bringing its costs below the
rate-of-increase limit. The main provider could then share in the
incentive payment by having its costs come in below the target rate.
More recently, other factors have combined to create incentives for
providers to affiliate with one another and to acquire control of
nonprovider treatment settings, such as physician offices. Integrated
delivery systems offer a wide variety of health care services and can
assume responsibility for entire episodes of a patient's illness. These
systems are attractive to patients, who seek continuity of care, and to
businesses seeking a single source of health services for their
employees. The resulting growth in the number of patients enrolled by
these integrated delivery systems has created a powerful incentive for
affiliations. In addition, hospitals rely on referrals from physicians
to assure a steady stream of patients, and they have begun to purchase
physician practices and integrate them into their outpatient
operations. This trend also has created
[[Page 47588]]
incentives for hospitals to affiliate with physician practices.
B. Effects on Medicare
For several reasons, it is essential that we ensure that decisions
regarding provider-based status are made appropriately, and that
facilities or organizations are not recognized as provider-based unless
they are in fact integral and subordinate parts of the main provider.
As noted earlier, in cases where main providers are paid under the PPS
and subordinate facilities or organizations are paid under the
reasonable cost reimbursement method (section 1861(v)(1)(A) of the Act
and 42 CFR part 413), a provider-based determination could allow the
main provider to shift overhead costs to cost centers that are paid on
a cost basis and thereby increase Medicare payments with no
commensurate benefit to the Medicare program or its beneficiaries.
Payments for services furnished in a hospital outpatient clinic
generally include both a facility payment and payment for the
professional services of a physician. The combined payments are
typically higher than the payment for comparable services furnished in
a physician office, where a separate facility fee is not payable. In
many cases, there is also an increase in beneficiaries' out-of-pocket
expenses compared to services furnished in a physician office. For
example, when a beneficiary is treated in a physician office, the only
payment made is Part B payment to the physician for his or her
professional services, under the physician fee schedule. The single
payment made under the physician fee schedule pays for the physician's
work and includes a component for practice expense. The beneficiary's
coinsurance is based on 20 percent of the physician fee schedule
amount. However, if the same service is furnished in a hospital
outpatient clinic, Medicare Part B payment for a facility fee is also
made to the hospital, in addition to the physician's payment (which may
include a smaller practice expense component). Thus, for the same
visit, the beneficiary is also subject to the Part B coinsurance for
the hospital's facility fee. Beneficiaries are responsible for
coinsurance based on 20 percent of the hospital's charges (or, the
applicable coinsurance amounts under the hospital outpatient PPS).
Provider-based status also raises issues of Medicare coverage.
Generally, the services of nonphysician staff furnished in a physician
office are covered only as services ``incident to'' the professional
services of a physician under section 1861(s)(2)(A) of the Act. This
means that a physician must be available on the premises when the
service is furnished, in order to provide direct supervision of that
service. In hospital outpatient departments, however, we presume that
the ``incident to'' requirements are met with respect to hospital
services incident to physician services to outpatients (section
1861(s)(2)(B)). The policy assumed the outpatient department was co-
located on the hospital premises and staff physicians would be
available nearby to provide necessary oversight. It is possible that a
hospital outpatient clinic may not be in the immediate vicinity of the
hospital and may furnish nonphysician services without actually
providing for direct physician supervision of those services. We do not
believe that such services should be presumed to meet applicable
``incident to'' requirements. As explained below, it could also present
a health and safety risk at a time when the office is staffed with
nonphysician personnel who are furnishing medical care with no
physician present and available to attend to any unexpected emergency
situation that may arise.
Provider-based status for a facility or organization can have other
implications for the health and safety of its patients. Hospital
outpatient facilities are subject to the Medicare conditions of
participation in 42 CFR part 482, including specific requirements
covering such crucial areas as adequacy of physician care (Sec. 482.22,
``Conditions of participation: Medical staff''), and the safety of the
physical environment, including compliance with fire safety
requirements (Sec. 482.41, ``Conditions of participation: Physical
environment''). Beneficiaries have the right to expect that any
outpatient department of a hospital meets applicable conditions of
participation and that the facility is capable of providing care
commensurate with the general level of care furnished in a hospital
outpatient department that is co-located with the inpatient setting.
However, the facility claimed as an outpatient department may not have
been surveyed for compliance with the conditions of participation and,
in some cases, we may not even have been notified of its existence.
The BBA includes several new provisions that can be implemented
appropriately only if clear distinctions are made between free-standing
and provider-based facilities. Section 4205(a)(1) of the BBA amended
section 1833(f) of the Act to extend the per-visit payment limit for
rural health clinics (RHCs), which previously applied only to free-
standing RHCs, to most provider-based RHCs as well. (The law provides
that the limit does not apply to RHCs located in hospitals with less
than 50 beds.)
Section 4541 of the BBA amended section 1833 of the Act to
establish a prospective system of payment for outpatient physical
therapy services (including outpatient speech-language pathology
services) and outpatient occupational therapy services furnished after
1998, and to establish a $1,500 annual limit on the amount of payment
for such services to each beneficiary. Under sections 1833(g)(1) and
(g)(2) of the Act, however, that limit does not apply to services
furnished in hospital outpatient departments. Moreover, as explained
later in this section of the preamble, there are differences in payment
for ambulatory surgical services, depending on whether the services are
furnished in a hospital, by an approved ASC, or in a physician office.
Further, higher composite rate payments are made to hospital-based ESRD
facilities than to free-standing ESRD facilities. Thus, it is essential
that we have clear rules for identifying provider-based facilities.
C. Relationship of the ``Provider-Based'' Proposals to Prospective
Payment for Outpatient Hospital Services and Effective Date of
``Provider-Based'' Proposals
Although the proposed regulations set forth in new Sec. 413.65 and
in the amendment to Sec. 413.24 relate to providers generally, their
implementation is crucial to successful implementation of a PPS for
outpatient hospital services. No outpatient PPS can succeed if it does
not clearly define the services to which it applies. Experience
suggests that under the existing policies defining provider-based
status, many ambulatory services may be characterized either as
physician office services or as services of hospital outpatient
departments or clinics or an ASC, depending on the financial incentives
involved. Thus, we are publishing these proposed rules to permit
clearer distinctions to be made between various types of services, and
to ensure that services paid for under the outpatient PPS are of the
same type as those included in the data on which the system is based.
As explained in the previous section of this preamble, it is
essential that provider-based decisions be made appropriately in all
cases, not just those involving outpatient hospital services paid for
under a PPS. Therefore, the effective date of these proposals will not
be delayed until after an outpatient PPS is in effect. On the contrary,
we plan to
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implement proposed Secs. 413.24(d)(6)(i) and (ii), 413.65, 489.24(b),
and 498.3, as revised based on our consideration of public comments,
with respect to services furnished on or after 30 days following
publication of a final rule.
D. Basis for Current Provider-Based Policy
Although there is no direct statutory requirement to maintain
explicit criteria for determination as to provider-based status, there
are statutory references acknowledging the existence of this payment
outcome. For example, section 1881(b) of the Act provides for separate
payment rates for hospital-based (ESRD) facilities.
There is currently no general definition of ``provider-based
facility'' in the CFR. However, various sections of the CFR do contain
provisions for recognition of specific types of entities as provider-
based.
Section 405.2462(a) authorizes payment for RHCs and Federally
qualified health centers (FQHCs) as provider-based, if:
(1) The clinic or center is an integral and subordinate part of a
hospital, SNF, or HHA participating in Medicare, (that is, a provider
of services); and
(2) The clinic or center is operated with other departments of the
provider under common licensure, governance, and professional
supervision.
Definitions of hospital-based HHAs and SNFs were published in final
notices on cost limits for HHAs and SNFs, in the June 5, 1980 (45 FR
38014) and September 4, 1980 (45 FR 58699) issues of the Federal
Register, respectively. These criteria were identical to one another
and were similar to the RHC and FQHC definition but they provided
considerably more detail in their description of common governance.
Further, we have provided additional detail regarding the factors
to be considered in making determinations regarding provider-based
status in our manuals. The Medicare Regional Office Manual at section
6860 provides a list of criteria that should be considered in making a
determination regarding provider-based status for clinics. Also,
section 2186 of the State Operations Manual provides direction
regarding provider-based designation for HHAs.
Program Memorandum A-96-7, published on August 27, 1996, pulled
together the instructions previously manualized for specific entity
types into a general instruction for the designation of provider-based
status to all facilities or organizations. In developing this Program
Memorandum, we took information from the State Operations Manual
(sections 2024, 2186, and 2242), the Regional Office Manual (section
1060, 2020 and 6865), and Secs. 405.2462 and 413.170 of the CFR.
Under the policy we set forth in Program Memorandum A-96-7, the
following applicable requirements must be met before an entity can be
designated as provider-based for Medicare payment purposes:
1. The entity is physically located in close proximity of the
provider where it is based, and both facilities serve the same patient
population (for example, from the same service, or catchment area);
2. The entity is an integral and subordinate part of the provider
where it is based, and as such, is operated with other departments of
that provider under common licensure (except in situations where the
State separately licenses the provider-based entity);
3. The entity is included under the accreditation of the provider
where it is based (if the provider is accredited by a national
accrediting body) and the accrediting body recognizes the entity as
part of the provider;
4. The entity is operated under common ownership and control (that
is, common governance) by the provider where it is based, as evidenced
by the following:
The entity is subject to common bylaws and operating
decisions of the governing body of the provider where it is based;
The provider has final responsibility for administrative
decisions, final approval for personnel actions, and final approval for
medical staff appointments in the provider-based entity; and
The entity functions as a department of the provider where
it is based with significant common resource usage of buildings,
equipment, and service personnel on a daily basis.
5. The entity director is under the direct day-to-day supervision
of the provider where it is located, as evidenced by the following:
The entity director or individual responsible for day-to-
day operations at the entity maintains a daily reporting relationship
and is accountable to the Chief Executive Officer of the provider and
reports through that individual to the governing body of the provider
where the entity is based; and
Administrative functions of the entity, for example,
records, billing, laundry, housekeeping and purchasing are integrated
with those of the provider where the entity is based.
6. Clinical services of the entity and the provider where it is
located are integrated as evidenced by the following:
Professional staff of the provider-based entity have
clinical privileges in the provider where it is based;
The medical director of the entity (if the entity has a
medical director) maintains a day-to-day reporting relationship to the
chief medical officer or other similar official of the provider where
it is based;
All medical staff committees or the professional
committees at the provider where the entity is based are responsible
for all medical activities in the provider-based entity;
Medical records for patients treated in the provider-based
entity are integrated into the unified records system of the provider
where the entity is based;
Patients treated at the provider-based entity are
considered patients of the provider and have full access to all
provider services; and
Patient services provided in the entity are integrated
into corresponding inpatient and/or outpatient services, as
appropriate, by the provider where it is based.
7. The entity is held out to the public as part of the provider
where it is based (for example, patients know they are entering the
provider and will be billed accordingly).
8. The entity and the provider where it is based are financially
integrated as evidenced by the following:
The entity and the provider where it is based have an
agreement for the sharing of income and expenses, and
The entity reports its cost in the cost report of the
provider where it is based using the same accounting system and the
same cost reporting period as the provider where it is based.
Our policy will continue to follow the principles we articulated in
Program Memorandum A-96-7 until 30 days after this rule is published as
final in the Federal Register. After that date, we will apply the
policies set forth in the final regulations.
E. Provisions of This Proposed Rule
This proposed rule would add a new Sec. 413.65, stating the
appropriate definitions of, and the general requirements for, the
determination of ``provider-based'' status. In paragraph (a), we are
proposing to define the following terms for purposes of this section:
department of a provider, free-standing facility, main provider,
provider-based entity, and provider-based status. The definitions used
are as follows.
Department of a provider means a facility or organization or clinic
that is
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either created by, or acquired by, a main provider for the purpose of
furnishing health care services under the name, ownership, and
financial and administrative control of the main provider in accordance
with the provisions of proposed Sec. 413.65. A department of a provider
is not licensed or certified to provide services in its own right, and
Medicare conditions of participation do not apply to the department as
an independent entity. The term ``department of a provider'' does not
include an RHC or FQHC; however, an RHC or FQHC could qualify as a
provider-based entity.
Free-standing facility means an entity that furnishes health care
services to Medicare beneficiaries, and that is not integrated with any
other entity as a main provider, a department of a provider, or a
provider-based entity.
Main provider means a provider that either creates or acquires
ownership of another entity to deliver additional health care services
under its name, ownership, and financial and administrative control.
Provider-based entity means a provider, or an RHC or FQHC as
defined in Sec. 405.2401(b), that is either created by, or acquired by,
a main provider for the purpose of furnishing health care services
under the name, ownership, and administrative and financial control of
the main provider in accordance with the provisions of proposed
Sec. 413.65. A provider-based entity is certified to provide services
in its own right.
Provider-based status means the relationship between a main
provider and a provider-based entity, or a department of a provider,
that is in compliance with the provisions of proposed Sec. 413.65.
We are proposing to state explicitly, in new paragraph (b), that a
facility or organization is not entitled to be treated as provider-
based simply because it or the provider believe it to be provider-
based. We also would state that, if a facility or organization seeking
provider-based status is located off the campus of a provider, or
inclusion of the costs of the facility or organization on the
provider's cost report would increase the total costs on that report by
at least 5 percent, HCFA will not treat the facility or organization as
provider-based for purposes of billing or cost reporting unless the
provider has contacted HCFA and obtained a determination of provider-
based status. This means that we would not accept billings from the
facility or organization as if it were provider-based, and the provider
will not be permitted to include costs of the facility or organization
on its cost report, unless the acquisition or creation of the facility
or organization has been reported to us and we have determined that it
is either a department of a provider or a provider-based entity.
Further, a facility not located on the campus of a hospital and used as
a site of physician services of the kind ordinarily furnished in
physician offices will be presumed to be a free-standing facility
unless it is determined by HCFA to have provider-based status. For
example, a physician office practice purchased by a main provider would
not qualify for provider-based status unless it meets all applicable
criteria in proposed Sec. 413.65.
We are proposing to require, in new paragraph (c), that a main
provider that acquires a facility or organization for which it wishes
to claim provider-based status must report its acquisition of the
facility or organization to HCFA and furnish all information needed for
a determination as to whether the facility or organization meets the
criteria in this section for provider-based status. A main provider
that has had one or more facilities or organizations determined to have
provider-based status also must report to HCFA any material change in
the relationship between it and any department or provider-based
entity, such as a change in ownership of the entity or entry into a new
or different management contract, that could affect the provider-based
status of the department or entity.
In new paragraph (d), we propose the requirements for a
determination of ``provider-based status.'' In paragraph (d)(1), we
would set forth licensure requirements for facilities or organizations
seeking provider-based status. Any facility or organization seeking to
be a department of a provider would have to be operated under the same
license as the main provider. We note that if a State's licensure laws
establish restrictions on the type or location of facilities or
organizations that can be licensed as part of a provider, we would
defer to those restrictions in determining whether a particular
facility is a department of the provider. For example, if the hospital
licensure laws of a particular State precluded facilities located more
than 5 miles from a hospital from being licensed as part of the
hospital, we also would not consider those facilities to be a part of
the hospital. Provider-based entities would not have to be operated
under the same license as the main provider, since in most cases we
expect that they would be separately licensed by the State. To take
account of possible State-by-State differences in licensure, however,
we would require only that a prospective provider-based entity be
licensed in accordance with the law of the State in which it is
located.
In addition, if a State health facilities' cost review commission,
or other agency that has authority to regulate the rates charged by
hospitals or other providers in a State, finds that a particular
facility or organization is not part of a provider, we also would
determine that the facility or organization does not have provider-
based status. We believe it would be inappropriate for a facility or
organization to be considered free-standing for State ratesetting
purposes, but provider-based status under Medicare.
In paragraph (d)(2), we would require that a facility or
organization be under the ownership and control of the main provider.
In particular, we would require that the facility or organization be
100 percent owned by the provider, that the main provider and a
facility or organization seeking provider-based status have the same
governing body, and that the facility or organization be operated under
the same organizational documents as the main provider. For example,
the facility seeking provider-based status would have to be subject to
the bylaws and operating decisions of the governing body of the main
provider. In addition, we would require that the main provider have
final responsibility for administrative decisions, final approval for
outside contracts, final responsibility for personnel policies, and
final approval for medical staff appointments in the department or
entity.
In paragraph (d)(3), with respect to administration and direct
supervision of the main provider, we are proposing to require that a
facility or organization seeking provider-based status have a reporting
relationship to the main provider that is characterized by the same
frequency, intensity, and level of accountability that exists in the
relationship between the main provider and one of its departments. As
evidence of this relationship, we would look to whether the facility is
under the direct supervision of the provider where it is located,
whether it is operated under the same monitoring and oversight as any
other department of the provider, and is operated as any other
department with respect to supervision and accountability. We would
expect the director or individual responsible for daily operations at
the facility or organization to maintain a day-to-day reporting
relationship with a manager at the main provider and to be accountable
to the main provider's governing body in the same manner as any
department head of the provider. We also would require integration of
certain
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administrative functions, in particular, billing services, records,
human resources, payroll, employee benefit package, salary structure,
and purchasing services. Either the same employee or group of employees
would have to handle these administrative functions for both the
facility or organization and the main provider, or the administrative
functions for the entity and the main provider would have to be
contracted out under the same contractual agreement, or be handled
under different contract agreements, with the entity's contract being
managed by the main provider's billing department.
In paragraph (d)(4), we are proposing that a facility or
organization seeking provider-based status and the main provider share
integrated clinical services, as evidenced by privileging of the
professional staff of the department or entity at the main provider,
and the main provider's maintenance of the same monitoring and
oversight of the department or entity as of other departments. Also,
the medical director of the department or entity must maintain a day-
to-day reporting relationship with the chief medical officer (or
equivalent) of the main provider, and be under the same supervision as
any other director of the main provider. We also would expect medical
staff committees or other professional committees of the main provider
to be responsible for medical activities in the department or entity,
including quality assurance, utilization review, and the coordination
and integration of services. We also would expect medical records to be
integrated into a unified retrieval system. We would expect that
inpatient and outpatient services of the facility or organization and
the main provider be integrated and that patients treated at the
facility or organization who require further care have full access to
all services of the main provider, including all inpatient or
outpatient services of the main provider.
In paragraph (d)(5), we would require that the proposed department
or entity and the main provider be fully financially integrated within
the main provider's financial system, as evidenced by the sharing of
income and expenses. The department's or entity's costs should be
reported in a cost center of the provider, and the department's or
entity's financial status should be incorporated into, and readily
identifiable in, the main provider's trial balance.
In paragraph (d)(6), we would require that the main provider and
the facility seeking status as a department of the provider be held out
to the public as a single entity, so that when patients enter the
department they are aware that they are entering the provider and will
be billed accordingly. (This requirement would not apply to a provider-
based entity that is itself a provider, such as a SNF.)
In paragraph (d)(7), we would require that the department of a
provider or provider-based entity and the main provider be located on
the same campus. Alternatively, the main provider and facility seeking
provider-based status must demonstrate that they serve the same patient
population. The department or entity and the main provider would be
required to demonstrate that they serve the same patient population by
submitting patient lists and/or demographic data showing that a high
percentage of the patients of both come from the same geographic area,
or that patients of the entity also receive a preponderance of services
from the main provider. We would specify that a facility or
organization is not considered to be in the ``immediate vicinity'' of
the main provider if it is located in a different State than the main
provider. We welcome comments as to whether an exception should be made
for areas where a single metropolitan area may include two or more
States.
New paragraph (e) would specifically prohibit the approval of
provider-based status for any proposed department or entity that is
owned by two or more providers engaged in a joint venture. Some
hospitals, under joint venture arrangements, are jointly purchasing or
jointly creating free-standing facilities. Although the facility or
organization is operated by two or more hospitals, the dominant
hospital claims the free-standing facility or organization as a
department or provider-based entity. This is clearly unallowable,
because the facility or organization is owned by more than one
hospital, and in its own right must be considered as free-standing,
subject to all of the rules and certifications that govern that type of
operation.
In proposed paragraph (f), we would state that facilities or
organizations operated under management contracts will be considered
provider-based only if specific requirements for staff employment,
administrative functions, day-to-day control of operations, and holding
of the management contract by the provider itself rather than by a
parent organization are met. Generally, we believe it would be
difficult for any facility or organization operated under a management
contract to provide all services to be able to demonstrate the degree
of integration with a provider that would be needed to qualify for
provider-based status. Thus, we are proposing to adopt these
requirements, which are designed to ensure that we treat a facility or
organization under a management contract as provider-based only if it
clearly is operated by the provider, not by the management company or
by a common parent organization.
In proposed paragraph (g), we would specify nine obligations of
hospital outpatient departments and hospital-based entities. These
obligations are spelled out in detail to help us ensure that facilities
seeking recognition as hospital outpatient departments or hospital-
based entities are in fact what they represent themselves as being, and
are not simply the private offices of individual physicians or of
physicians in group practices. The obligations are--
--In the case of hospital outpatient departments located off the main
provider campus, compliance with the anti-dumping requirements in
Secs. 489.20 (l), (m), (q), and (r) and 489.24. If any individual comes
to any hospital-based entity (including an RHC) located on the main
hospital campus and a request is made on the individual's behalf for
examination or treatment of a medical condition, as described in
Sec. 489.24, the hospital must comply with the anti-dumping
requirements in Sec. 489.24. We would also revise Sec. 489.24(b) to
clarify that for purposes of the anti-dumping rules set forth in that
section, hospital property means the entire main hospital campus,
including the parking lot, sidewalk, and driveway, as well as any
facility or organization that is located off the main hospital campus
but has been determined under Sec. 413.65 to be a department of the
hospital.
--Billing of physician services in hospital outpatient departments or
hospital-based entities (other than RHCs) with the correct site-of-
service indicator, so that applicable site-of-service reductions to
physician and practitioner payment amounts can be applied;
--In the case of hospital outpatient departments, compliance with all
the terms of the provider agreement;
--Compliance by physician staff with the nondiscrimination provisions
in Sec. 489.10(b) of this chapter;
--In the case of hospital outpatient departments (other than RHCs),
representation to other payers as an outpatient department of the
hospital, and treatment of all patients, for billing purposes, as
hospital outpatients;
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--In the case of hospital outpatient departments or hospital-based
entities, compliance with the payment window provisions applicable
under Sec. 412.2(c)(5) (for PPS hospitals) or Sec. 413.40(c)(2) (for
PPS-excluded hospitals);
--In the case of hospital outpatient departments or hospital-based
entities (other than RHCs), notice to each beneficiary treated that he
or she will be liable for coinsurance for a facility visit as well as
for the physician service; and
--In the case of hospital outpatient departments, compliance with
applicable Medicare hospital conditions of participation for hospitals
in part 482 of this chapter.
We would also preclude any facility or organization that furnishes
all services under arrangements from qualifying as provider-based. We
believe the provision of services under arrangement was intended to be
allowed only to a limited extent, in situations where cost-
effectiveness or clinical considerations, or both, necessitate the
provision of services by someone other than the provider's own staff.
The ``under arrangement'' provision in section 1861(w)(1) of the Act
and Sec. 409.3 is not intended to allow a facility merely to act as a
billing agent for another. We are concerned that this would be the case
if all services at a facility or organization seeking provider-based
status were furnished under arrangement. We believe use of arranged-for
services could, if not limited, become a means of circumventing the
provider-based requirements. We are proposing in paragraph (g)(10) that
a facility or organization may not qualify for provider-based status if
all of the services furnished at the facility are furnished under
arrangements. We note that this approach is consistent with existing
policy under which a hospital outpatient is expected to receive
services, rather than supplies, directly from the hospital.
Proposed paragraph (h) states that if we learn of a provider that
has inappropriately treated a facility or organization as provider-
based, before obtaining our determination of provider-based status, we
would reconsider all payments to that main provider for periods subject
to reopening, investigate, and determine whether the designation was
appropriate. If we find it was not provider-based, we will recover all
payments in excess of those payments that should have been made in the
absence of the provider-based status. As explained further below,
however, recovery will not be made for any period prior to the
effective date of this rule if during all of that period the management
of the facility or organization made a good-faith effort to operate it
as a department of a provider or provider-based entity.
In proposed paragraph (i), we would detail the application of the
principles in paragraph (h) to situations involving inappropriate
billing for services furnished in a physician office or other facility
or organization as if they had been furnished in a hospital outpatient
or other department of a provider or in a provider-based entity.
Generally, when such cases of inappropriate billing are found, we will
recover any overpayments as described in the preceding paragraph. Under
certain circumstances, however, we will determine that the management
of a facility or organization has made a good faith effort to operate
it as a department of a provider or a provider-based entity and will
not recover past payments. We would take this action if we determine
that the requirements regarding licensure and public awareness in
paragraphs (d)(1) and (d)(6) are met, all facility services were billed
as if they had been furnished by a department of the main provider or a
provider-based entity of the main provider, and all professional
services of physicians and other practitioners were billed with the
correct site-of-service indicator, as described in paragraph (g)(4).
We are also proposing to add a new paragraph (j) that would allow
HCFA to review past determinations. If we find that a designation was
in error, and the facility or organization in question does not meet
the requirements of this section, we will notify the main provider that
the provider-based status will cease as of the first day of the next
cost report period following notification of the redetermination.
In addition, we are proposing to add to Sec. 413.24(d) new
paragraphs (6)(i) and (6)(ii) to clarify that main providers, in
completing their Medicare cost reports, may not allocate overhead costs
to the provider-based or other cost centers that incur similar costs
directly through management contracts or other arrangements. These
changes are needed to prevent mis-allocation of management costs, which
would result in excessive payment to those types of providers paid on a
reasonable cost basis.
As the number of affiliation agreements among various entities has
increased, there has been a noticeable shift in the way the HHAs and
clinics have been managed, resulting in increased Medicare payments.
Today, there are many management companies that enter into contracts
with main providers to manage their provider-based entities, and the
costs of these management services are being directly assigned to the
department or provider-based entity receiving the service. The
contracts typically call for the management company to provide the
billing and accounting services, and to procure services, such as
housekeeping, laundry and linen, to enable the department or provider-
based entity to operate away from the campus and supervision of the
main provider, even though these management companies must report to
the board of the main provider. In addition to directly assigning these
costs to the department or provider-based entity, the main provider,
through the cost report, is still allocating overhead costs to the
department or provider-based entity, even though these services are
being performed through the management contract and not through the
main provider. Under these circumstances, the provider could be paid
three times for the same overhead cost. The first payment would be made
through the PPS payment, which reflects overhead cost. The second
payment would come through the cost of the management contract, and the
third would come through the allocation of a share of the main
provider's overhead cost to the department or provider-based entity.
Our proposed changes to Sec. 413.24 are needed to prevent this result.
To provide an administrative appeals process for entities that have
been denied provider-based status, we are proposing to revise the
regulations on provider appeals at Sec. 498.3. As revised, these rules
would specify that a provider seeking a determination that a facility
or an organization is a department of the provider or a provider-based
entity under proposed Sec. 413.65 will be included in the definition of
``prospective provider'' for purposes of part 498, and will be afforded
the same appeal rights as a prospective provider, such as a hospital or
SNF, that has been found by HCFA not to qualify for participation as a
provider. We believe it is in the best interest of both HCFA and health
care organizations to have an explicit procedure for handling these
appeals.
F. Requirements for Payment
The following discussion sets out the requirements that must be met
to allow us to make payment under the outpatient PPS for various
services.
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1. Prerequisites for Payment for Outpatient Hospital Services and
Supplies Incident to Physician Services
Medicare Part B benefits include payment for services and supplies
that are furnished incident to the professional services of a
physician. Medicare makes payment for services and supplies furnished
in physician offices that are incident to a professional service of a
physician under the provisions of the Medicare physician fee schedule
(section 1848 and section 1861(s)(2)(A) of the Act; 42 CFR part 414).
Payment for the ``incident to'' services furnished in physician offices
is generally included within the fee for the physician services.
Medicare also makes payment for hospital services and supplies that are
incident to a physician service furnished to outpatients (section
1861(s)(2)(B) of the Act). Payment for ``incident to'' services
furnished to hospital outpatients is in addition to payment for the
professional services of a physician. The place where ``incident to''
services are furnished determines how Medicare pays for them.
We are proposing to add to the regulations certain prerequisites
that the hospital must fulfill before it can receive Medicare payment
under section 1861(s)(2)(B) of the Act for services and supplies
furnished ``incident to'' physician services at a site that is off the
premises of the main hospital complex. These prerequisites are intended
to adapt our current policy regarding payment for ``incident to''
services furnished to hospital outpatients to address the special
circumstances presented by a hospital outpatient department or clinic
that is not co-located on the hospital campus or within a short
distance of the hospital and that HCFA has designated is a department
of the hospital or ``provider-based.''
The first prerequisite is that the office/clinic meet the
responsibilities and criteria incumbent upon a provider-based entity as
defined in Sec. 413.65(g). We are proposing this requirement because
the fact that a hospital owns and/or operates a clinic does not
automatically make that clinic an integral, subordinate part of the
hospital. If the clinic does not conform with the responsibilities and
criteria at Sec. 413.65(g), that clinic would be paid as a physician
office, and Medicare payment for services furnished at that site would
be made accordingly.
The second prerequisite is that the hospital seek an official
determination from HCFA that the provider-based designation applies to
the proposed off-site hospital outpatient department/clinic as required
by Sec. 413.65(d). The authority to determine whether or not an entity
has provider-based status rests solely with HCFA. The criteria and
obligations that are a prerequisite of a provider-based hospital
outpatient designation are discussed earlier in this section.
Current regulations require that, in order to be paid for as
``incident to'' services, outpatient hospital services and supplies are
to be furnished as an integral though incidental part of a physician
service (Sec. 410.27(a)(1)(ii)). In addition, as a matter of policy, we
require that the services and supplies be furnished on a physician's
order by hospital personnel and under a physician's supervision
(Intermediary Manual, section 3112.4(A)). When ``incident to'' services
are furnished on hospital premises, we assume the physician supervision
requirement to be met because staff physicians would be present nearby
within the hospital. We also allow staff in a department of the
hospital other than that of the ordering physician to supervise the
services. We equate the location of the hospital outpatient department
or hospital clinic within the hospital's walls, or their co-location on
the same campus, with being ``on the hospital premises,'' and we assume
physician supervision is always at hand. In the interests of
beneficiary health and safety, we do not believe it is reasonable,
safe, or appropriate to extend these assumptions to a hospital
outpatient department or hospital clinic that is located off-site and
that is not on the hospital premises, even if that outpatient
department or clinic is accorded provider-based status. Therefore, we
are proposing as the third prerequisite for a hospital to receive
payment for ``incident to'' services under section 1861(s)(2)(B) of the
Act, when these services are furnished at a hospital outpatient
department or clinic that HCFA designates as provider-based: that the
``incident to'' services and supplies always be furnished under the
direct supervision of a physician.
Unless the three prerequisites are met, we are proposing to
continue to regard a clinic, even if it is owned or operated by a
hospital, as a physician office or physician clinic for Medicare
payment purposes. Payment for services and supplies incident to
physician services that are furnished to Medicare beneficiaries at that
site would only be paid in accordance with section 1848 and section
1861(s)(2)(A) of the Act, and payment would be subject to Medicare
physician fee schedule payment policies and regulations (part 410; part
414).
2. Prerequisites for Payment for Hospital or Critical Access Hospital
Diagnostic Services Furnished to Outpatients
Prerequisites for payment for diagnostic services furnished to
hospital outpatients are addressed in Sec. 410.28. We are proposing to
add a new paragraph to the regulation that would require, at a minimum,
a general level of physician supervision, and in some cases, direct or
personal physician supervision, when diagnostic x-ray tests and other
diagnostic tests are furnished at a hospital outpatient department or
clinic that HCFA has determined meets the criteria and obligations of a
provider-based entity in accordance with Sec. 413.65. The definitions
of general, direct, and personal supervision are contained in
Sec. 410.32. Although the levels of supervision defined in Sec. 410.32
apply specifically to diagnostic x-ray and other tests that are payable
under the Medicare physician fee schedule, we believe the same levels
of supervision are equally relevant and reasonable and necessary to
ensure that beneficiary health and safety are protected and that
diagnostic x-ray and other diagnostic tests are safe and effective when
they are furnished at a hospital outpatient department or clinic that
HCFA has designated to be provider-based.
We are also proposing to exclude from the supervision requirement
in provider-based outpatient settings the same three types of
diagnostic tests that are excluded from the supervision requirement
under the physician fee schedule:
Diagnostic mammography procedures, which are regulated by
the Food and Drug Administration.
Diagnostic tests personally furnished by a ``qualified
audiologist'' as defined in section 1861(ll)(3) of the Act. These
include ``audiology services'' as defined in section 1861(ll)(2) of the
Act. We exclude these diagnostic tests from the physician supervision
requirement because the Congress has defined these services without
requiring physician supervision of their performance.
Diagnostic psychological testing services personally
performed by a qualified psychologist practicing independently of an
institution, agency, or physician office as currently defined in
section 2070.2 of the Medicare Carriers Manual (HCFA Pub. 14-3). These
services are distinguished from services of a clinical psychologist,
which are covered under section 1861(ii) of the Act, rather than
section 1861(s)(3).
[[Page 47594]]
We are proposing to coordinate changes to the physician supervision
requirements for diagnostic tests performed in outpatient settings that
HCFA has designated to be provider-based with changes made to these
requirements under the Medicare physician fee schedule. Refer to the
final rule governing the 1998 physician fee schedule that was published
in the October 31, 1997 Federal Register (``Medicare Program; Revisions
to Payment Policies and Adjustments to the Relative Value Units Under
the Physician Fee Schedule, Other Part B Payment Policies, and
Establishment of the Clinical Psychologist Fee Schedule for Calendar
Year 1998'' (BPD-884-FC) (62 FR 59048)) for a full discussion.
Implementing instructions for physician supervision of diagnostic tests
are being developed. We note that these implementing instructions will
contain revisions in the supervision levels required for many
ultrasound services, stress tests, and some other services.
When diagnostic x-rays and other diagnostic tests are performed at
a hospital-owned and/or operated office or clinic that is off-site and
that HCFA does not designate as provider-based, we are proposing to pay
for these services under the provisions of the Medicare physician fee
schedule and the requirements of Sec. 410.32 or under the provisions of
Sec. 410.33, if applicable.
3. Payment for Ambulatory Surgical Services
Upon implementation of the hospital outpatient PPS, Medicare
payment for resource costs incurred in connection with performing
ambulatory surgical procedures would be made either under the
provisions of the hospital outpatient PPS; or, under the benefit
established at section 1832(a)(2)(F) of the Act for facility services
furnished by an approved ASC in connection with surgical procedures
specified by the Secretary; or, under the physician fee schedule as
established under section 1848 of the Act.
When ambulatory surgery is performed at the hospital on Medicare
beneficiaries who are registered at the hospital as outpatients,
Medicare would allow payment under the outpatient PPS, as explained in
this proposed rule. However, Medicare would make payment under the
outpatient PPS for surgical procedures performed at an off-site clinic
that the hospital owns and operates and for which it submits claims
only if the off-site clinic has been designated by HCFA as a department
of the hospital in accordance with proposed Sec. 413.65.
Alternatively, if the hospital-owned off-site facility is certified
or accredited in accordance with ASC conditions of coverage and the
requirements at part 416, Medicare would make payment for covered
surgical procedures performed at the off-site facility under the ASC
benefit.
However, for Medicare payment purposes, we consider an off-site
office, clinic, organization, or facility that is owned and operated by
a hospital but that does not meet the requirements at proposed
Sec. 413.65 or in part 416, to be a physician office or clinic, and
Medicare payment for surgical procedures performed at that site would
be limited to what Medicare allows for physician services furnished in
connection with the surgical procedure under the Medicare physician fee
schedule.
VII. MedPAC Recommendations
We reviewed the March 1998 report submitted by MedPAC to the
Congress and gave its recommendations careful consideration in
establishing the framework for the outpatient PPS that is the subject
of this proposed rule. We responded earlier to several MedPAC
recommendations that pertained directly to specific features of the
outpatient PPS. In this section, we address the more general MedPAC
recommendations on hospital outpatient payment policies.
Recommendation: MedPAC expresses its concern about the effects of
inappropriate payment levels that could, if they are too low, restrict
beneficiary access to care or prompt shifts of services for financial
rather than clinical reasons, or that could, if they are too high,
stimulate growth in the volume of outpatient services that is unrelated
to patient needs. MedPAC states that the initial level of payment
established in the BBA is a reasonable starting point for the
outpatient PPS, but recommends that the Secretary monitor access to
hospital outpatient services to ensure that the aggregate level of
payment under the outpatient PPS is appropriate.
Response: We agree with MedPAC that monitoring service patterns not
only in hospital outpatient departments but across all ambulatory
settings subsequent to implementation of the outpatient PPS is
essential in order to detect sudden changes and to identify variant
trends in where services are being furnished to Medicare beneficiaries.
As is MedPAC, we too are aware of how vividly any differences in
payment for services furnished in different ambulatory settings will be
revealed once the outpatient PPS is implemented, and we expect that
these differences will, not surprisingly, precipitate shifts in
services from one setting to another. It is the recognition of this
likely outcome that makes it all the more urgent that we resolve the
dilemma posed by two conflicting policy determinations raised by
MedPAC: whether to set Medicare payments to reflect the cost of
providing a service regardless of where the service is furnished or
whether to set Medicare payments to acknowledge that the site where a
service is furnished could affect the cost of furnishing the service.
As we discuss below, we clearly are inclined toward a position that
Medicare should determine payment on the basis of the service that is
furnished rather on the setting where that service is furnished, but
there are many factors still to be considered before making such a
determination final. In the meantime, we believe that the adjustments
provided for under the outpatient PPS will contribute to ensuring that
Medicare is paying adequately for services, especially in areas where a
hospital is the only provider of services to which beneficiaries have
access. We particularly welcome comments and suggestions regarding
methods by which we can enhance our monitoring of service delivery
patterns to ensure that the outpatient PPS is not adversely affecting
beneficiary access to hospital outpatient care in accordance with
MedPAC's recommendation. We agree with MedPAC's concern that payment
levels under the outpatient PPS be sufficient to support the provision
of services, especially in areas where a hospital is the only provider
of such services, but that payment levels under the outpatient PPS not
exceed payments for the same services at other ambulatory sites to such
a degree as to cause shifts in where services are provided for
financial rather than clinical reasons.
Recommendation: MedPAC recommends that HCFA continue to investigate
service classification systems that could be applied consistently to
all ambulatory care settings. In its 1998 report to Congress, MedPAC
expresses concern about the impact on service delivery of paying
different amounts for the same service based on where the service is
furnished. MedPAC appears to favor Medicare ambulatory care payment
systems that are standardized across hospital outpatient, physician
office, and ASC settings. MedPAC equates ``standardized'' with
``policies that are comparable for the same service, regardless of
setting,'' (p. 83) and ``* * * consistency of payment across all
ambulatory settings'' (p. 84).
Response: In principle, we agree that establishing Medicare payment
[[Page 47595]]
uniformity across ambulatory care settings is important. We have, to
the extent permitted by the statute, incorporated into the outpatient
PPS elements of Medicare payment policy for ASCs and for physician
services.
Upon implementation of the outpatient PPS, the same unit of payment
(HCPCS codes and descriptors) will be used for all three settings.
Packaging under the outpatient PPS parallels that for ASCs. At least
initially, volume control under the outpatient PPS parallels that which
is applied to physician services. The policy for discounting multiple
procedures will be comparable under the outpatient PPS, the ASC
benefit, and the physician fee schedule. APC groups will be used to set
rates for ASC payments and for hospital outpatient surgical services,
and we propose to pay for the same surgical procedures in both
settings. Notwithstanding these similarities, payment rates for most
procedures will not be the same for ASCs and under the outpatient PPS.
We use different data and methods to set rates for ASC services, for
physician services, and for hospital outpatient services. The latter is
attributable primarily to the fact that the statute sets forth criteria
that are to be considered when setting payment mechanisms that are
specific to each site of service.
Several fundamental issues must be addressed before we achieve the
goal of making consistent payment for the same service across all
ambulatory sites of service. First, consensus must be reached on what
constitutes ``consistent payment.'' Even MedPAC equivocates on this
point, noting that while it believes that ``Medicare's payment should
reflect the cost of efficiently providing a service, regardless of
where it is delivered * * * (b)ecause of access or quality concerns * *
* it may be appropriate to continue to pay different amounts for the
same service, depending on the setting in which it is furnished.'' Does
``consistent'' or ``comparable'' payment mean the same payment for a
service regardless of setting? Or would consistency be achieved by
using the same group weights for hospital outpatient and ASC payment
rates even though we used site-specific conversion factors, resulting
in different payment rates? Should we use ASC groups as the basis for
setting payments for physician services? Is there a single index that
is appropriate to standardize variations in costs attributable solely
to geographical differences? And which legislative changes would be
required to standardize payment for services across ambulatory
settings? These are but a few of the issues and options that we and
stakeholders across the spectrum of ambulatory care must thoroughly
examine and analyze as we move towards standardizing payments across
ambulatory sites of service. We solicit comments on this issue, on
options to be considered in restructuring Medicare payment provisions
towards the goal of establishing payment uniformity across ambulatory
sites, and on strategies for achieving consensus on the definition of
both goals and the means of attaining them.
VIII. Collection of Information Requirements
Under the Paperwork Reduction Act of 1995, we are required to
provide 60-day notice in the Federal Register and solicit public
comment before a collection of information requirement is submitted to
the Office of Management and Budget (OMB) for review and approval. In
order to fairly evaluate whether an information collection should be
approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act
of 1995 requires that we solicit comment on the following issues:
The need for the information collection and its usefulness
in carrying out the proper functions of our agency.
The accuracy of our estimate of the information collection
burden.
The quality, utility, and clarity of the information to be
collected.
Recommendations to minimize the information collection
burden on the affected public, including automated collection
techniques.
We are soliciting public comment on each of these issues for the
provisions summarized below that contain information collection
requirements:
Section 413.65 Requirements for a Determination That a Facility or an
Organization is a Department of a Provider or a Provider-Based Entity
Section 413.65(c)(1) and (c)(2) states that a main provider that
acquires a facility or organization for which it wishes to claim
provider-based status, including any physician offices that a hospital
wishes to operate as a hospital outpatient department or clinic, must
report its acquisition of the facility or organization to HCFA and must
furnish all information needed for a determination as to whether the
facility or organization meets the requirements in paragraph (d) of
this section for provider-based status. This requirement applies,
however, only if the facility or organization is located off the campus
of the provider, or inclusion of the costs of the facility or
organization on the provider's cost report would increase the total
costs on the report by at least 5 percent. Furthermore, a main provider
that has had one or more entities considered provider-based also must
report to HCFA any material change in the relationship between it and
any provider-based facility or organization, such as a change in
ownership of the facility or organization or entry into a new or
different management contract that could affect the provider-based
status of the facility or organization.
The burden associated with this requirement is the time for the
main provider to report its acquisition to HCFA, furnish all
information needed for a determination, report to HCFA any material
change in the relationship between it and any provider-based facility
or organization, such as a change in ownership of the facility or
organization or entry into a new or different management contract that
could affect the provider-based status of the facility or organization.
It is estimated that 105 main providers will take 10 hours for a total
of 1,050 hours.
Section 419.42 Hospital Election To Reduce Copayment
Section 419.42(b) and (c) states that a hospital must notify its
fiscal intermediary of its election to reduce copayments no later than
90 days prior to the start of the calendar year. The hospital's
election must be properly documented. It must specifically identify the
ambulatory payment classification to which it applies and the copayment
level (within the limits identified below) that the hospital has
selected for each group.
The burden associated with these requirements is the time it takes
a hospital to compile, review, and analyze data for both revenues and
copayments; prepare and present the data to the hospital board; make a
business decision as to whether the hospital would elect to reduce
copayments; and then notify its fiscal intermediary of its election. A
hospital would notify its fiscal intermediary of its election to reduce
copayments only if there were other providers, in close proximity, that
would attract a majority of the hospital's business if they did not
reduce their copayments. Since hospitals do not want to lose money by
absorbing copayments, we anticipate that this requirement will affect
750 hospitals and take them 10 hours each for a total of 7,500 hours.
Section 419.42(e) states that the hospital may advertise and
otherwise disseminate information concerning the reduced level(s) of
coinsurance that it has elected.
[[Page 47596]]
The burden associated with this requirement is the time for the
hospital to disseminate information concerning its coinsurance
election. It is estimated that 750 hospitals will each take 10 hours
annually to disseminate this information via newsletters and
information sessions at senior citizen centers for a total of 7,500
hours.
While the information collection requirements listed below are
subject to the Paperwork Reduction Act, the burden associated with
these requirements is captured under Sec. 413.65(c)(1) and (c)(2).
Section 413.65(b)(2) states that a provider or a facility or
organization must contact HCFA and the facility or organization must be
determined by HCFA to be provider-based before the main provider begins
billing for services of the facility or organization as if they were
furnished by a department of the provider-based entity, or before it
includes costs of those services on its cost report.
Section 413.65(d)(7)(i) requires that the facility or organization
demonstrates a high level of integration with the main provider by
showing that it meets all of the other provider-based criteria, and
demonstrates that it serves the same patient population as the main
provider, either by submitting records such as common patient lists
and/or demographic data showing that a high percentage of patients of
both the main provider and the applicant entity come from the same
geographic area, or by submitting data substantiating that the patients
served by the entity also receive services from the main provider (for
example, the patients of an RHC receive inpatient hospital services
from the main provider).
While the information collection requirements listed below are
subject to the Paperwork Reduction Act, we believe the burden
associated with these requirements is not subject to the Act, as
defined by 5 CFR 1320.3(b)(2), because the time, effort, and financial
resources necessary to comply with these requirements would be incurred
by persons in the normal course of their activities.
Section 413.65(g)(7) states that when a Medicare beneficiary is
treated in a hospital outpatient department or hospital-based entity,
the hospital has a duty to notify the beneficiary, prior to the
delivery of services, of the beneficiary's potential financial
liability (that is, a coinsurance liability for a facility visit as
well as for the physician service).
We believe the information collection requirement below is exempt
from the Paperwork Reduction Act, as defined by 5 CFR 1320.4(a)(2),
since this activity is pursuant to the conduct of an investigation or
audit against specific individuals or entities.
Section 413.65(i)(1) states that if HCFA determines that a provider
has been inappropriately billing Medicare for services furnished in a
physician office or other facility or organization as if they had been
furnished in a hospital outpatient department or other department of a
provider or in a provider-based entity, HCFA stops all payments to the
provider for outpatient services until the provider can demonstrate
which payments are proper.
The table below indicates the annual number of responses for each
regulation section in this proposed rule containing information
collection requirements, the average burden per response in minutes or
hours, and the total annual burden hours.
Estimated Annual Burden
----------------------------------------------------------------------------------------------------------------
Average
burden per Annual burden
CFR section Responses response hours
(hours)
----------------------------------------------------------------------------------------------------------------
413.65(c)(1) and (c)(2)......................................... 105 10 1,050
419.42(b) and (d)............................................... 750 10 7,500
419.42(f)....................................................... 750 10 7,500
-----------------------------------------------
Total....................................................... 16,050
----------------------------------------------------------------------------------------------------------------
We have submitted a copy of this proposed rule to OMB for its
review of the information collection requirements. These requirements
are not effective until they have been approved by OMB. A notice will
be published in the Federal Register when approval is obtained.
If you comment on any of these information collection and record
keeping requirements, please mail copies directly to the following:
Health Care Financing Administration, Office of Information Services,
Information Technology Investment Management Group, Division of HCFA
Enterprise Standards, Room C2-26-17, 7500 Security Boulevard,
Baltimore, MD 21244-1850, Attn: Louis Blank HCFA-1005-P, Fax number:
(410) 786-1415 and,
Office of Information and Regulatory Affairs, Office of Management and
Budget, Room 10235, New Executive Office Building, Washington, DC
20503, Attn.: Allison Herron Eydt, HCFA Desk Officer, Fax numbers:
(202) 395-6974 or (202) 395-5167.
IX. Response to Comments
Because of the large number of items of correspondence we normally
receive on Federal Register documents published for comment, we are not
able to acknowledge or respond to them individually. We will consider
all comments we receive by the date and time specified in the ``DATES''
section of this preamble, and, if we proceed with a subsequent
document, we will respond to the comments in the preamble to that
document.
X. Regulatory Impact Analysis
A. Introduction
We have examined the impacts of this proposed rule as required by
Executive Order 12866, the Unfunded Mandates Reform Act of 1995, and
the Regulatory Flexibility Act (RFA) (Public Law 96-354). Executive
Order 12866 directs agencies to assess all costs and benefits of
available regulatory alternatives and, when regulation is necessary, to
select regulatory approaches that maximize net benefits (including
potential economic, environmental, public health and safety effects,
distributive impacts, and equity). A regulatory impact analysis (RIA)
must be prepared for major rules with economically significant effects
($100 million or more annually). Because the projected savings
resulting from this proposed rule are
[[Page 47597]]
expected to exceed $100 million, it is considered a major rule.
The Unfunded Mandates Reform Act of 1995 also requires (in section
202) that agencies prepare an assessment of anticipated costs and
benefits for any rule that may result in an annual expenditure by
State, local, or tribal governments, in the aggregate, or by the
private sector, of $100 million. This proposed rule does not mandate
any requirements for State, local, or tribal governments. However, our
estimations indicate that the loss of income to the private sector as a
result of this rule should exceed $300 million total to all hospitals.
We generally prepare a regulatory flexibility analysis that is
consistent with the RFA (5 U.S.C. 601 through 612), unless we certify
that a proposed rule would not have a significant economic impact on a
substantial number of small entities. For purposes of the RFA, we
consider all hospitals to be small entities.
Also, section 1102(b) of the Social Security Act requires us to
prepare a regulatory impact analysis for any proposed rule that may
have a significant impact on the operations of a substantial number of
small rural hospitals. Such an analysis must conform to the provisions
of section 603 of the RFA. With the exception of hospitals located in
certain New England counties, for purposes of section 1102(b) of the
Act, we define a small rural hospital as a hospital with fewer than 100
beds that is located outside of a Metropolitan Statistical Area (MSA)
or New England County Metropolitan Area (NECMA). Section 601(g) of the
Social Security Amendments of 1983 (Public Law 98-21) designated
hospitals in certain New England counties as belonging to the adjacent
NECMA. Thus, for purposes of the proposed prospective payment system,
we classify these hospitals as urban hospitals.
B. Estimated Impact on Medicare Program
According to HCFA's Office of the Actuary, the benefit impacts of
the hospital outpatient PPS (including elimination of the formula-
driven overpayment (FDO) effective as of October 1, 1997, extension of
the 10 percent reduction in payments for hospital outpatient capital
cost and the 5.8 percent reduction for outpatient services paid on a
cost basis through CY 1999, and the implementation of a PPS for
hospital outpatient services on January 1, 1999 would be as follows:
------------------------------------------------------------------------
Impact ($
Fiscal year millions)
------------------------------------------------------------------------
1998.................................................... -940
1999.................................................... -1650
2000.................................................... -1330
2001.................................................... -1070
2002.................................................... -990
2003.................................................... -680
------------------------------------------------------------------------
The use of the national median of the charges for PPS services to
establish the unadjusted copayment amount would have resulted in the
beneficiaries paying 6.9 percent less in coinsurance payments in 1999
than what they would have been expected to pay otherwise. It was
assumed that there would have been a behavioral offset by the hospitals
of 10 percent of the coinsurance reduction. It was assumed that 45
percent of this offset would apply to the services subject to the PPS
and, therefore, would have been included in setting the 1999 conversion
factor. The remaining 55 percent of the offset would be reflected in
expenditures for non-PPS services with both the beneficiary and
Medicare absorbing this impact. With the delay in implementation of the
outpatient PPS, the behavioral offset will not occur in 1999, and,
therefore, there will be slightly higher program savings.
C. Objectives
The primary objective of the proposed prospective payment system is
to simplify the payment system while at the same time ensuring that
payments are sufficient to adequately compensate hospitals for their
legitimate costs. In addition, we share national goals of deficit
reduction and restraints on government spending in general.
We believe the proposed changes would further each of these goals
while maintaining the financial viability of the hospital industry and
ensuring access to high quality health care for Medicare beneficiaries.
We expect that these proposed changes would ensure that the outcomes of
this payment system are reasonable and equitable while avoiding or
minimizing unintended adverse consequences.
D. Limitations of our Analysis
The following quantitative analysis presents the projected effects
of our proposed policy changes, as well as statutory changes, on
various hospital groups. We use the best data available; in addition,
we do not make adjustments for future changes in such variables as
volume and intensity. As we have done in previous proposed rules, we
are soliciting comments and information about the anticipated effects
of these changes on hospitals and our methodology for estimating them.
E. Hospitals Included in and Excluded From the Prospective Payment
System
The outpatient prospective payment system encompasses nearly all
hospitals that participate in the Medicare program. However, those
services furnished by Maryland hospitals that are paid under a cost
containment waiver in accordance with section 1814(b)(3) of the Act are
excluded from the PPS. Critical access hospitals (CAHs) are also
excluded and are paid at cost under section 1834(g).
F. Quantitative Impact Analysis of the Proposed Policy Changes Under
the Prospective Payment System for Operating Costs and Capital Costs
Basis and Methodology of Estimates
The data used in developing the quantitative analyses presented
below are taken from the CY 1996 cost and charge data and the most
current provider-specific file that is used for payment purposes. Our
analysis has several qualifications. First, we draw upon various
sources for the data used to categorize hospitals in the tables. In
some cases, there is a fair degree of variation in the data from
different sources. We have attempted to construct these variables with
the best available source overall. For individual hospitals, however,
some miscategorizations are possible.
Using CY 1996 cost and charge data, we simulated payments using the
current and proposed payment methodologies. We used both single and
multiple bills to calculate current and proposed Medicare and
beneficiary hospital outpatient payment amounts. Both current and
proposed payment estimates include operating and capital costs. The
exempted Maryland hospitals were excluded from the simulations;
however, we included the 10 cancer hospitals that will be paid under
the proposed system.
We also trimmed outlier hospitals from the impact analysis because
we had indications that hospitals with extreme unit costs would not
allow us to assess the impacts among the various classes of hospitals
accurately. First, we identified all the outlier hospitals by using an
edit of three standard deviations from the mean of the logged unit
costs. Trimming the data in this manner ensures that only the hospitals
with extremely high and low costs are eliminated from the impacts. In
doing this, we removed 83 hospitals of which 32 hospitals had extremely
low unit costs and 51 hospitals had extremely
[[Page 47598]]
high unit costs. We conducted a thorough analysis of these hospitals to
ensure that we did not remove any particular type of hospital (for
example, teaching hospitals) that would further harm the integrity of
the data. We speculate many of these hospitals are not coding
accurately, and we will continue to perform further analysis in this
area after implementation of the new APC system.
After removing the 54 exempted Maryland hospitals, outlier
hospitals, and hospitals for which we could not identify payment
variables, we included 5,419 hospitals in our analysis. The impact
analysis focuses on this set of hospitals. The table below demonstrates
the results of our analysis. The table categorizes hospitals by various
geographic and special payment consideration groups to illustrate the
varying impacts on different types of hospitals. The first column
represents the number of hospitals in each category. The second column
is the hospitals' Medicare outpatient payments as a percentage of the
hospitals' total Medicare payment. The third column shows the
percentage change in Medicare outpatient payments comparing the current
and proposed payment systems. The fourth column shows the change in
total Medicare payments, resulting from implementing the PPS for
outpatient services.
The top row of the table shows the overall impact on the 5,419
hospitals included in the analysis. We included as much of the data as
possible to the extent that we were able to capture all the provider
information necessary to determine payment. Further, our estimates
include the same set of services for both current and proposed APC
payments so that we could determine the impact as accurately as
possible. Since payment under the proposed APC system can only be
determined if bills are accurately coded, the data upon which the
impacts were developed do not reflect all CY 1996 hospital outpatient
services, but only those that were coded using valid HCPCS.
The second row identifies the hospitals in our analysis with the
exception of psychiatric, long-term care, children, and rehabilitation
hospitals, which account for 4,864 hospitals.
The next four rows of the table contain hospitals categorized
according to their geographic location (all urban, which is further
divided into large urban and other urban, or rural). There are 2,677
hospitals located in urban areas (MSAs or NECMAs) included in our
analysis. Among these, there are 1,516 hospitals located in large urban
areas (populations over 1 million), and 1,161 hospitals in other urban
areas (populations of 1 million or fewer). In addition, there are 2,187
hospitals in rural areas. The next two groupings are by bed-size
categories, shown separately for urban and rural hospitals. The next
category includes the volume of outpatient services, also shown
separately for urban and rural hospitals. The final groupings by
geographic location are by census divisions, also shown separately for
urban and rural hospitals.
The next three groupings examine the impacts of the proposed
changes on hospitals grouped by whether or not they have residency
programs (teaching hospitals that receive an indirect medical education
(IME) adjustment), receive disproportionate share hospital (DSH)
payments, or some combination of these two adjustments. There are 3,847
non-teaching hospitals in our analysis, 766 teaching hospitals with
fewer than 100 residents, and 250 teaching hospitals with 100 or more
residents.
In the DSH categories, hospitals are grouped according to their DSH
payment status. The next category groups hospitals considered urban
after geographic reclassification, in terms of whether they receive the
IME adjustment, the DSH adjustment, both, or neither. The next five
rows examine the impacts of the proposed changes on rural hospitals by
special payment groups (rural referral centers (RRCs), sole community
hospitals/essential access community hospitals (SCHs/EACHs), Medicare
dependent hospitals (MDHs), and SCHs and RRCs), as well as rural
hospitals not receiving a special payment designation. The RRCs (168),
SCH/EACHs (625), MDHs (365), and SCH and RRCs (55) shown here were not
reclassified for purposes of the standardized amount.
The next grouping is based on type of ownership. These data are
taken primarily from the FY 1995 Medicare cost report files, if
available (otherwise, FY 1994 data are used).
The next groupings are the specialty hospitals. The first set
includes the categorizations of eye and ear hospitals and trauma
hospitals (hospitals having a level one trauma center) and cancer
hospitals. The final groupings are the TEFRA hospitals, specifically
rehabilitation, psychiatric, long-term care, and children hospitals.
G. Estimated Impact of the New APC System
Column 3 compares our estimate of payments, incorporating statutory
and policy changes reflected in this proposed rule for CY 1996, to our
estimate of payments in CY 1996 under the current payment system.
Percent differences between current and proposed payment reflect the
combined impact of a proportionally equal reduction in payments due to
the calculation of the conversion factor and distributional differences
attributable to variation in cost and charge structures among
hospitals. The methodology described in section 1833(t)(3)(C) of the
Act outlining the calculation of the conversion factor reduces payment
to hospitals overall by 3.8 percent relative to current law. As noted,
section 1833(t)(3)(C) of the Act requires us to set the conversion
factor so that total 1999 payments to hospitals under the proposed PPS
system equal Medicare payment amounts as calculated under the current
payment system plus beneficiary copayments as calculated under the
proposed system (20 percent of the APC median charge or, at minimum, 20
percent of the APC rate). The 3.8 percent loss implies that the
difference between the median and charges higher than the median was
proportionally larger than the difference between the median and
charges lower than the median. Because this reduction is incorporated
into the conversion factor, the 3.8 percent is distributed among
hospitals proportional to their total payments. After removing the
effect of the conversion factor calculation on total payments, the
remaining percent differences demonstrate the redistribution of
payments among hospitals and can be attributed to variation in both
costs and charge structures. Variation in costs among hospitals results
in differences between current and proposed Medicare payments, and
variation in charge structures results in differences between current
and proposed beneficiary copayment.
Redistributions may also occur as a result of current payment
methods. Total Medicare outpatient payments are less than reported
total costs because (in addition to the 5.8 and 10 percent reductions
for operating and capital costs) the blended payment methods applicable
to many surgical and diagnostic services often result in payments that
are less than reported costs. Other services such as medical visits,
chemotherapy services, partial hospitalization services, and non-ASC
approved surgeries are paid based on hospital costs. The new system
redistributes the current total Medicare payments, based in part on
cost-based payments and in part on blended
[[Page 47599]]
payment amounts, across all services. Hospitals, in the aggregate, will
receive proportionately less for services that are currently paid based
on costs and more for services that had been paid under blended payment
methods.
The impact on TEFRA hospitals is shown separately at the end of the
table; however, these hospitals were not included in determining the
impact on any of the other categories (for example, geographic
location, bed size, volume, etc.). These hospitals demonstrated a very
low service mix, but an average unit cost that is only somewhat smaller
than the national average. We believe that billing practices may
account for this phenomenon. Some TEFRA hospitals appear to under-code
HCPCS and units. This may be because correct coding is not required for
payment or because they bill an all-inclusive rate. Undercoding or
billing an all-inclusive rate could account for their low volume, low
service mix, and almost average cost per unit. We expect that once
these hospitals begin to code HCPCS according to the new payment
system, new payments will better reflect current payments.
In general, differences among hospital classifications for short-
term acute care hospitals were relatively small. That is, payments
under the proposed outpatient system were within a few percentage
points of payments made under current law. The following discussion
highlights some of the variation in payments among hospital
classifications.
Based on comparing current and proposed payment estimates, minor
teaching hospitals lose 1.8 percent, while major teaching hospitals
experience a reduction of 9.4 percent. Non-teaching hospitals
experience a decrease of 3.1 percent. However, major teaching hospitals
gain less of their total Medicare income (9.2 percent) from outpatient
services than the national average (10 percent). This results in a less
than 1 percent loss in their total Medicare income.
Hospitals with a high percentage of low income patients
(disproportionate share patient percentage 0.35) appear to
experience payment reductions of 6.8 percent relative to current law.
These hospitals have lower than average volume, and, like major
teaching hospitals, they receive a smaller than average percent of
their Medicare income from outpatient services.
Rural hospitals would lose about 5.2 percent and large urban
hospitals would lose about 5.0 percent under the new system while other
urban hospitals would lose 0.9 percent. These small differences
illustrate fairly equitable payment among these geographical settings.
However, rural hospitals get a greater percentage of their Medicare
income (14.7 percent) from outpatient services compared to the national
average of 10 percent.
Low-volume hospitals appear to lose a large percentage of their
payments under the new payment system (17 percent for rural and 15.6
percent for urban hospitals with less than 5,000 units of service). We
believe several factors are contributing to this outcome, including
undercoding, lack of economies of scale, and underpayment due to the
reliance on the median instead of the geometric mean in the calculation
of APC weights. The majority of these hospitals (about 75 percent) are
rural. These hospitals also have a service mix (1.03) lower than the
national average (1.45) and higher than average hospital cost per unit
standardized for service mix. For these small hospitals, some of the
higher standardized unit costs could be attributed to economies of
scale. These low-volume rural hospitals also receive a greater
percentage of their Medicare income (18.2 percent) from outpatient
services than the average. SCHs and MDHs comprise about 60 percent of
these low-volume rural hospitals.
As discussed previously in section V.I, the Adjustments section, we
are particularly concerned about the potential impact on the
approximately 60 percent of low-volume rural hospitals that are sole
community hospitals or Medicare-dependent hospitals. As previously
discussed, one option would be to phase-in the outpatient PPS for low-
volume Medicare-dependent and sole community hospitals by paying a
portion of the payment based on PPS rates and a portion based on the
current payment system. For example, payment could be based on 75
percent of payments under the current system and 25 percent on PPS
rates in the first year, 50 percent current system payments and 50
percent PPS rates in the second year, 25 percent current system
payments and 75 percent PPS rates in the third year, and completely on
PPS rates in subsequent years. If such an approach were adopted, the
impact on Medicare outpatient payment for these hospitals would be as
follows:
Estimated Impact of a Transition Policy on Medicare Outpatient Payments for Medicare-Dependent and Sole
Community Hospitals
[In percent]
----------------------------------------------------------------------------------------------------------------
Year 1 Year 2 Year 3 Year 4
----------------------------------------------------------------------------------------------------------------
MDH............................................. -2.1 -4.3 -6.4 -8.5
SCH............................................. -1.7 -3.3 -5.0 -6.7
SCH/RRC......................................... -0.5 -1.0 -1.6 -2.1
----------------------------------------------------------------------------------------------------------------
Another option discussed earlier in the adjustments section would
phase-in outpatient PPS if a low-volume sole community or Medicare-
dependent hospital has a negative Medicare margin for outpatient
services. For example, payment could be based on the amount payable
under outpatient PPS plus a percentage of the difference between those
amounts and the amounts payable under the current system. The
percentage of the difference that would be payable could phase down,
for example, 75 percent in the first year, 50 percent in the second
year, 25 percent in the third year, and no additional payment in
subsequent years. We solicit comments on these and other alternatives
we could consider.
As noted above, rural hospitals lose a larger percent of their
payments than urban hospitals. Among the census divisions, rural New
England hospitals experience the largest negative payment impact of
13.6 percent. This could be attributed to higher non-labor costs in New
England. West North Central hospitals also would experience a 7.7
percent payment loss.
Urban census division breakouts reveal that Middle Atlantic urban
hospitals lose 11.3 percent of payments while the other urban census
regions gain or lose modestly.
Hospitals located in Puerto Rico gain because of the change in the
beneficiary copayment. Previously these hospitals received 20 percent
of their charges from the beneficiary, whereas under the
[[Page 47600]]
new PPS they would receive 20 percent of the APC median charge or, at
minimum, they would receive 20 percent of the payment rate. Hospitals
in Puerto Rico gain under the new proposed system because 20 percent of
their charges are lower than 20 percent of the APC median charges or 20
percent of the rates.
Among special categories of rural hospitals, MDHs and SCHs/EACHs
would experience decreases of 8.5 and 6.7 percent, respectively. Some
of this decrease may be attributed to the impact on low-volume rural
hospitals.
Cancer hospitals experience a 29.2 percent loss. Several factors
may contribute to this loss. Under-coding could be a factor
contributing to the percentage loss. In addition, the current
requirements for batch billing of services such as chemotherapy and
radiation therapy and the fact that we used only single procedure bills
to calculate group weights may also have contributed to the impact on
these hospitals. Further analysis will be conducted to determine if
current coding practices explain the negative impact. We will be
verifying the accuracy of the rates for these types of procedures.
Specifically, the APC weights were calculated using single bill
procedures. Using single bill procedures to compute a weight for
services which are not typically billed as a single procedure could
result in rates that are not accurate for these services. We will
verify the accuracy of the rates for these types of procedures by
analyzing the costs from the multiple bills. If further analysis
reveals that cancer hospitals would be unduly harmed because of the new
outpatient PPS, we will consider whether an adjustment or perhaps a
transition period is needed to moderate the impact. By statute, any
adjustment would have to be budget neutral. Until further analysis can
be conducted we are not proposing an adjustment for cancer hospitals.
In accordance with the provisions of Executive Order 12866, this
regulation was reviewed by the Office of Management and Budget.
BILLING CODE 4120-01-P
[[Page 47601]]
[GRAPHIC] [TIFF OMITTED] TP08SE98.002
[[Page 47602]]
[GRAPHIC] [TIFF OMITTED] TP08SE98.003
[[Page 47603]]
[GRAPHIC] [TIFF OMITTED] TP08SE98.004
[[Page 47604]]
[GRAPHIC] [TIFF OMITTED] TP08SE98.005
BILLING CODE 4120-01-C
[[Page 47605]]
XI. Delay in Implementation Date
Like other public and private organizations that depend upon the
smooth functioning of computer systems, the Medicare program faces the
challenge making changes to assure that computers can recognize dates
in the year 2000 and later. Computer programming, which has commonly
employed only two digits to record the year in the date for
transactions and other entries, will not be able to distinguish the
year 2000 from the year 1900 without reprogramming. Such confusion in
the context of Medicare enrollment and claims processing could create
massive errors, as computers could mistakenly determine that
beneficiaries are not eligible for benefits or that services were
rendered before the effective date of benefit provisions.
For Medicare, achieving year 2000 (Y2K) compliance involves
renovating all computer and information systems. The year 2000
especially affects HCFA because of our extensive reliance on multiple
computer systems. More than 183 systems are used in administering the
Medicare and Medicaid programs, and 98 of these are considered
``mission critical'' for establishing beneficiary eligibility and
making payments to providers, plans, and states. Medicare is the most
automated health care payer in the country. The Medicare program
processes nearly one billion claims each year, or about 17 million
transactions each week. Fully 98 percent of inpatient hospital and
other Medicare Part A claims are processed electronically, as are 85
percent of physician and other Medicare Part B claims.
The renovation process is complicated because each piece in the
systems used by Medicare, its 60-plus claims processing contractors,
interfaces with state Medicaid programs, and some 1.6 million providers
must be thoroughly reviewed and renovated by those responsible for each
particular system. Programs must be tested, both alone and for the
complicated interfaces among them. To fix only the Medicare systems, 49
million lines of code must be renovated. All Medicare-specific software
must be renovated, and tested to assure that it continues to work with
new versions of vendor-supplied software, including operating systems
that drive the hardware. Some hardware must be upgraded, and our
telecommunications equipment and software must be compliant. We must
assure that all data exchanges with thousands of partners are
compliant. Testing of year 2000 changes presents a far greater burden
than testing of routine system changes because we must test multiple
times on a range of different dates. For example, February 29, 2000 and
March 1, 2000 must both be tested because CY 2000 is a leap year.
Because this process is necessary to keep program payments going
out to beneficiaries and providers, year 2000 work must take precedence
over other projects that require systems changes, including some
Balanced Budget Act provisions. The Y2K project must be completed
before other projects simply because activity on these other projects
would divert resources from the Y2K project and could even compromise
the effort to assure Y2K compliance if implemented in tandem. Many
other private and public organizations, including most major insurance
companies, have reached the same conclusion and are halting other
projects involving information technology changes to clear the decks
for the year 2000.
HCFA's independent year 2000 verification and validation
contractor, Intermetrics, has advised the agency to delay all projects
that could interfere with year 2000 work. Intermetrics specifically
advised the agency to ``seek necessary relief from Congressional
mandates, system transitions and version releases to allow near-term,
focused attention to achieving Y2K compliant systems.'' This includes
projects that are complex, or which would occur during a critical
window between October 1999 and March 2000. Otherwise, they warned,
``many of your most critical system renovations have risk of
significant schedule slippage.''
Implementation of outpatient PPS is one of the projects that must
be delayed by the year 2000 system renovations, because it requires
massive system changes. Major contractor systems will be affected: the
Fiscal Intermediary Standard Systems (FISS), the Arkansas Part A
Standard System (APASS), the Common Working File (CWF), the Outpatient
Code Editor (OCE), and the various systems operated by Fiscal
Intermediaries and their corporate entities. Several HCFA systems will
also be affected, including the National Claims History (NCH), the
Provider Statistical & Reimbursement System (PS&R), and the Electronic
Data Interchange (EDI). The scope of the required changes is also
substantial. Among the required changes are:
Expansion of the claim record of FISS, APASS, EDI, NCH and
CWF to accept and retain specific information related to how a service
is being paid or why it's denied.
Conversion of all claims history to correspond with
expanded format.
Rewriting the program for FISS to process claims using
line item dates of service.
Rewriting the program for CWF to accept non covered
charges by claim and line item.
Developing, installing and testing an outpatient PRICER
which determines payment amounts based on the HCFA Common Procedural
Codes (HCPCS).
Revision of interfaces with the fiscal intermediaries,
providers, Billing Agents, EDI, OCE, PS&R and NCH and create an
interface for PRICER.
Developing, installing and testing a program to calculate
the variable co-insurance per payment code grouping for each provider
who elects to accept a reduced co-insurance.
Revision of all claims processing output and interfaces
including: Medicare Summary Notices (MSN), Beneficiary Denial Letters
(BDL), Explanation of Medicare Benefits (EOMB), Notice of Utilization
(NOU), Remittance Advice (RA).
The consequence of all these required changes to basic systems will
be to change the entire way Fiscal Intermediaries process and pay
hospital outpatient and community mental health center claims. There is
also a major impact on the many systems that are required to receive
this revised output. Changes of this magnitude require massive testing
by all of the systems maintainers as well as each Fiscal Intermediary.
Additionally, the impact on the Fiscal Intermediary systems has a
domino effect. The intermediaries are doing business for Medicare under
the auspices of their respective corporate entities. These corporate
systems must be modified to accept, edit and relay the new information
necessary to process outpatient PPS claims. They are also working
toward becoming millennium compliant and competing for the same
resources to scope, program, test and rework these changes, as well as
the multitude of other BBA changes and Y2K. In the light of this, HCFA
has no choice but to suspend implementing such massive change while the
Intermediaries, their respective corporate entities, the standard
systems maintainers as well as the provider community are working
diligently to become Y2K compliant. It would be irresponsible to
continue activity that would create a real danger that basic enrollment
and claims processing activities will be disrupted, with far worse
consequences for providers and beneficiaries than delay in
implementation of outpatient PPS will cause.
[[Page 47606]]
We analyzed whether existing systems could be used to mimic
processing of bills under the outpatient PPS. In every case, there were
insuperable obstacles. In no case, for example, could these other
systems compute the coinsurance correctly: the other available systems
compute coinsurance as 20 percent of charges or 20 percent of a fee
schedule amount. We have therefore reluctantly concluded that there is
no alternative to a delay in implementation. As previously noted, the
outpatient PPS will be implemented as soon as possible after January 1,
2000. A notice of the anticipated implementation date will be published
in the Federal Register at least 90 days in advance.
We expect that there will be no negative impact on hospitals
generally from the delay in implementation. The effect on individual
hospitals will, of course, vary depending on how their current cost-
based reimbursement compares to the total payments they would receive
under the proposed system. Hospitals altogether should receive about
the same level of Medicare program payments under the existing payment
system, as they would have received in program payments under the
outpatient PPS. When beneficiary coinsurance is taken into account, we
expect that hospitals generally will receive about 3.8 percent more in
total payments under the existing payment system, than they would have
received in total payments under the outpatient PPS. We should note
that payment rates will be established at the level they would have
been if the PPS had been implemented on January 1, 1999.
The major impact of the delay in implementation will be on
beneficiaries who will continue to pay coinsurance based on 20 percent
of the hospital's charges. In the aggregate, we estimate beneficiary
coinsurance would have been 6.9 percent lower under the outpatient
prospective payment system in 1999 than under the current system. Under
the prospective payment system, coinsurance will be based on our
estimate of the median coinsurance amount for each APC under the
current system in 1999. In the aggregate, estimated median coinsurance
amounts are 6.9 percent lower than estimated mean coinsurance amounts
for each APC. The actual impact will depend on the extent to which
hospitals raise their charges in 1999. For example, the impact on
beneficiaries would be moderated if hospitals show restraint in
increasing charges (which have been increasing more rapidly than cost).
We will actively encourage hospitals to voluntarily restrain from
increasing their current charges. The actual impact on a given
beneficiary will also depend on the hospital's charge structure
relative to national charge levels. A beneficiary receiving services
from a hospital with relatively low charges could be advantaged by the
delay whereas a hospital with relatively high charges would be
disadvantaged by the delay. We note that the impact will not be carried
over to the prospective payment system.
List of Subjects
42 CFR Part 409
Health facilities, Medicare.
42 CFR Part 410
Health facilities, Health professions, Kidney diseases,
Laboratories, Medicare, Rural areas, X-rays.
42 CFR Part 411
Kidney diseases, Medicare, Reporting and recordkeeping
requirements.
42 CFR Part 412
Administrative practice and procedure, Health facilities, Medicare,
Puerto Rico, Reporting and recordkeeping requirements.
42 CFR Part 413
Health facilities, Kidney diseases, Medicare, Puerto Rico,
Reporting and recordkeeping requirements.
42 CFR Part 419
Health facilities, Hospitals, Medicare.
42 CFR Part 489
Health facilities, Medicare, Reporting and recordkeeping
requirements.
42 CFR Part 498
Administrative practice and procedure, Health facilities, Health
professions, Medicare, Reporting and recordkeeping requirements.
42 CFR Part 1003
Administrative practice and procedure, Archives and records, grant
program--social programs, Maternal and Child Health, Medicaid,
Medicare, Penalties.
For the reasons set forth in the preamble, 42 CFR chapters IV and V
would be amended as follows:
PART 409--HOSPITAL INSURANCE BENEFITS
A. Part 409 is amended as set forth below:
1. The authority citation for part 409 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395(hh)).
Subpart B--Inpatient Hospital Services and Inpatient Critical
Access Hospital Services
2. In Sec. 409.10, paragraph (b) is revised to read as follows:
Sec. 409.10 Included services.
* * * * *
(b) Inpatient hospital services does not include the following
types of services:
(1) Post-hospital SNF care, as described in Sec. 409.20, furnished
by a hospital or a critical access hospital that has a swing-bed
approval.
(2) Nursing facility services, described in Sec. 440.155 of this
chapter, that may be furnished as a Medicaid service under title XIX of
the Act in a swing-bed hospital that has an approval to furnish nursing
facility services.
(3) Physician services that meet the requirements of
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
(4) Physician assistant services, as defined in section
1861(s)(2)(K)(i) of the Act.
(5) Nurse practitioner and clinical nurse specialist services, as
defined in section 1861(s)(2)(K)(ii) of the Act.
(6) Certified nurse mid-wife services, as defined in section
1861(gg) of the Act.
(7) Qualified psychologist services, as defined in section 1861(ii)
of the Act.
(8) Services of an anesthetist, as defined in Sec. 410.69 of this
chapter.
PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
B. Part 410 is amended as set forth below:
1. The authority citation for part 410 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395(hh)), unless otherwise indicated.
Subpart A--General Provisions
2. In Sec. 410.2, the following definitions are added in
alphabetical order to read as follows:
Sec. 410.2 Definitions.
As used in this part--
* * * * *
Encounter means a direct personal contact between a patient and a
physician, or other person who is authorized by State licensure law
and, if applicable, by hospital or CAH staff bylaws, to order or
furnish hospital services for diagnosis or treatment of the patient.
* * * * *
[[Page 47607]]
Outpatient means a person who has not been admitted as an inpatient
but who is registered on the hospital or CAH records as an outpatient
and receives services (rather than supplies alone) directly from the
hospital or CAH.
* * * * *
Subpart B--Medical and Other Health Services
3. In Sec. 410.27, the section heading is revised, the introductory
text to paragraph (a) is revised, the introductory text to paragraph
(a)(1) is republished, and new paragraphs (a)(1)(iii), (e), and (f) are
added to read as follows:
Sec. 410.27 Outpatient hospital services and supplies incident to a
physician service: Conditions.
(a) Medicare Part B pays for hospital services and supplies
furnished incident to a physician service to outpatients, including
drugs and biologicals that cannot be self-administered, if--
(1) They are furnished--
* * * * *
(iii) In the hospital or at a location (other than an RHC or an
FQHC) that HCFA designates as qualifying as a department of a provider
under Sec. 413.65 of this chapter; and
* * * * *
(e) Services furnished by an entity other than the hospital are
subject to the limitations specified in Sec. 410.39(a).
(f) Services furnished at a location (other than an RHC or an FQHC)
that HCFA designates as having provider-based status under Sec. 413.65
of this chapter must be under the direct supervision of a physician as
defined in Sec. 410.32(b)(3)(ii).
4. In Sec. 410.28, paragraph (a)(4) is removed, paragraph (c) is
redesignated as paragraph (d), and new paragraphs (c) and (e) are added
to read as follows:
Sec. 410.28 Hospital or CAH diagnostic services furnished to
outpatients: Conditions.
* * * * *
(c) Diagnostic services furnished by an entity other than the
hospital or CAH are subject to the limitations specified in
Sec. 410.39(a).
* * * * *
(e) Medicare Part B makes payment under section 1833(t) of the Act
for diagnostic tests performed at a facility (other than an RHC or an
FQHC) that HCFA designates as having provider-based status only when
the diagnostic tests are furnished under the appropriate level of
physician supervision specified by HCFA in accordance with the
definitions in Sec. 410.32(b)(3)(i), (b)(3)(ii), and (b)(3)(iii).
5. A new Sec. 410.39 is added to read as follows:
Sec. 410.39 Limitations on coverage of certain services furnished to
hospital outpatients.
(a) Except as provided in paragraph (c) of this section, Medicare
Part B does not pay for any item or service that is furnished to a
hospital outpatient (as defined in Sec. 410.2) during an encounter (as
defined in Sec. 410.2) by an entity other than the hospital unless the
hospital has an arrangement (as defined in Sec. 409.3 of this chapter)
with that entity to furnish that particular service to its patients.
(b) As used in paragraph (a) of this section, the term ``hospital''
includes a CAH.
(c) The limitations stated in paragraphs (a) and (b) of this
section do not apply to the following services:
(1) Physician services that meet the requirements of
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
(2) Physician assistant services, as defined in section
1861(s)(2)(K)(i) of the Act.
(3) Nurse practitioner and clinical nurse specialist services, as
defined in section 1861(s)(2)(K)(ii) of the Act.
(4) Certified nurse mid-wife services, as defined in section
1861(gg) of the Act.
(5) Qualified psychologist services, as defined in section 1861(ii)
of the Act.
(6) Services of an anesthetist, as defined in Sec. 410.69.
PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE
PAYMENT
C. Part 411 is amended as set forth below:
1. The authority citation for part 411 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395(hh)).
Subpart A--General Exclusions and Exclusion of Particular Services
2. In Sec. 411.15, the introductory text is republished; the
section heading to paragraph (m) is revised; paragraph (m)(1) is
revised; the introductory text to paragraph (m)(2) is republished;
paragraphs (m)(2)(iii), (m)(2)(iv), and (m)(2)(v) are redesignated as
paragraphs (m)(2)(iv), (m)(2)(v), and (m)(2)(vi), respectively; and new
paragraphs (m)(2)(iii) and (m)(3) are added to read as follows:
Sec. 411.15 Particular services excluded from coverage.
The following services are excluded from coverage.
* * * * *
(m) Services to hospital patients--(1) Basic rule. Except as
provided in paragraph (m)(2) of this section, any service furnished to
an inpatient of a hospital or to a hospital outpatient (as defined in
Sec. 410.2 of this chapter) during an encounter (as defined in
Sec. 410.2 of this chapter) by an entity other than the hospital,
unless the hospital has an arrangement (as defined in Sec. 409.3 of
this chapter) with that entity to furnish that particular service to
the hospital's patients. (As used in this paragraph (m)(1), the term
``hospital'' includes a CAH.)
(2) Exceptions. The following services are not excluded from
coverage:
* * * * *
(iii) Nurse practitioner and clinical nurse specialist services, as
defined in section 1861(s)(2)(K)(ii) of the Act.
* * * * *
(3) Scope of exclusion. Services subject to exclusion under the
provisions of this paragraph (m) include, but are not limited to,
clinical laboratory services; pacemakers and other prostheses and
prosthetic devices (other than dental) that replace all or part of an
internal body organ (for example, intraocular lenses); artificial
limbs, knees, and hips; equipment and supplies covered under the
prosthetic device benefits; and services incident to a physician
service.
* * * * *
PART 412--PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL
SERVICES
D. Part 412 is amended as set forth below:
1. The authority citation for part 412 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395(hh)).
Subpart C--Conditions for Payment Under the Prospective Payment
Systems for Inpatient Operating Costs and Inpatient Capital-Related
Costs
2. In Sec. 412.50, paragraphs (a) and (b) are revised to read as
follows:
Sec. 412.50 Furnishing of inpatient hospital services directly or
under arrangements.
(a) The applicable payments made under the prospective payment
systems, as described in subparts H and M of this part, are payment in
full for all inpatient hospital services, as defined in Sec. 409.10
[[Page 47608]]
of this chapter. Inpatient hospital services do not include the
following types of services:
(1) Physician services that meet the requirements of
Sec. 415.102(a) of this chapter for payment on a fee schedule basis.
(2) Physician assistant services, as defined in section
1861(s)(2)(K)(i) of the Act.
(3) Nurse practitioner and clinical nurse specialist services, as
defined in section 1861(s)(2)(K)(ii) of the Act.
(4) Certified nurse mid-wife services, as defined in section
1861(gg) of the Act.
(5) Qualified psychologist services, as defined in section 1861(ii)
of the Act.
(6) Services of an anesthetist, as defined in Sec. 410.69 of this
chapter.
(b) HCFA does not pay any provider or supplier other than the
hospital for services furnished to a beneficiary who is an inpatient,
except for the services described in paragraphs (a)(1) through (a)(6)
of this section.
* * * * *
PART 413--PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR
END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED
PAYMENT RATES FOR SKILLED NURSING FACILITIES
E. Part 413 is amended as set forth below:
1. The authority citation for part 413 continues to read as
follows:
Authority: Secs. 1102, 1861(v)(1)(A), and 1871 of the Social
Security Act (42 U.S.C. 1302, 1395x(v)(1)(A), and 1395hh).
Subpart A--Introduction and General Rules
Sec. 413.1 [Amended]
2. In Sec. 413.1, paragraph (a)(2)(viii) is removed.
Subpart B--Accounting Records and Reports
3. In Sec. 413.24, the heading to paragraph (d) is published, and a
new paragraph (d)(6) is added to read as follows:
Sec. 413.24 Adequate cost data and cost finding.
* * * * *
(d) Cost finding methods. * * *
(6) Management contracts. (i) If the main provider purchases
services for a department of the provider or a provider-based entity
through a management contract or otherwise directly assigns costs to
the department or entity, the like costs of the main provider must be
carved out to ensure that they are not allocated to the department of
the provider or provider-based entity. However, if the like costs of
the main provider cannot be separately identified, the costs of the
services purchased through a management contract must be included in
the main provider's administrative and general costs and allocated
among the provider's overall statistics.
(ii) Costs of free-standing entities may not be shown in the
provider's trial balance for purposes of stepping down overhead costs
to such entities. The provider must develop detailed work papers
showing the exact cost of the services (including overhead) provided to
or by the free-standing entity and show those carved out costs as non-
reimbursable cost centers in the provider's trial balance.
* * * * *
Subpart E--Payments to Providers
4. A new Sec. 413.65 is added to read as follows:
Sec. 413.65 Requirements for a determination that a facility or an
organization is a department of a provider or a provider-based entity.
(a) Definitions. In this subpart E, unless the context indicates
otherwise--
Department of a provider means a facility or organization or a
physician office that is either created by, or acquired by, a main
provider for the purpose of furnishing health care services under the
name, ownership, and financial and administrative control of the main
provider, in accordance with the provisions of this section. A
department of a provider may not be licensed to provide health care
services in its own right, and Medicare conditions of participation do
not apply to a department as an independent entity. For purposes of
this part, the term ``department of a provider'' does not include an
RHC or an FQHC.
Free-standing facility means an entity that furnishes health care
services to Medicare beneficiaries and that is not integrated with any
other entity as a main provider, a department of a provider, or a
provider-based entity.
Main provider means a provider that either creates, or acquires
ownership of, another entity to deliver additional health care services
under its name, ownership, and financial and administrative control.
Provider-based entity means a provider of health care services, or
an RHC or an FQHC as defined in Sec. 405.2401(b) of this chapter, that
is either created by, or acquired by, a main provider for the purpose
of furnishing health care services under the name, ownership, and
administrative and financial control of the main provider, in
accordance with the provisions of this section.
Provider-based status means the relationship between a main
provider and a provider-based entity or a department of a provider,
that complies with the provisions of this section.
(b) Responsibility for obtaining provider-based determinations. (1)
A facility or organization is not entitled to be treated as provider-
based simply because it or the main provider believe it is provider-
based.
(2) A provider or a facility or organization must contact HCFA and
the facility or organization must be determined by HCFA to be provider-
based before the main provider begins billing for services of the
facility or organization as if they were furnished by a department of
the provider or provider-based entity, or before it includes costs of
those services on its cost report.
(3) A facility that is not located on the campus of a hospital and
is used as a site of physician services of the kind ordinarily
furnished in physician offices will be presumed to be a free-standing
facility, unless it is determined by HCFA to have provider-based
status.
(c) Reporting. (1) A main provider that acquires a facility or
organization for which it wishes to claim provider-based status,
including any physician offices that a hospital wishes to operate as a
hospital outpatient department or clinic, must report its acquisition
of the facility or organization to HCFA and must furnish all
information needed for a determination as to whether the facility or
organization meets the requirements in paragraph (d) of this section
for provider-based status.
(2) A main provider that has had one or more facilities or
organizations considered provider-based also must report to HCFA any
material change in the relationship between it and any provider-based
facility or organization, such as a change in ownership of the facility
or organization or entry into a new or different management contract
that could affect the provider-based status of the facility or
organization.
(d) Requirements. An entity must meet the following requirements to
be determined by HCFA to be a provider-based entity or a department of
a provider:
(1) Licensure. The department of the provider and the main provider
are operated under the same license, except in areas where the State
requires a separate license for the department of
[[Page 47609]]
the provider. If a State health facilities' cost review commission or
other agency that has authority to regulate the rates charged by
hospitals or other providers in a State finds that a particular
facility or organization is not part of a provider, HCFA will determine
that the facility or organization does not have provider-based status.
(2) Operation under the ownership and control of the main provider.
The facility or organization seeking provider-based status is operated
under the ownership and control of the main provider, as evidenced by
the following:
(i) The facility or organization is 100 percent owned by the
provider.
(ii) The main provider and the facility or organization seeking
status as a department of the provider have the same governing body.
(iii) The facility or organization is operated under the same
organizational documents as the main provider. For example, the
facility or organization seeking provider-based status must be subject
to common bylaws and operating decisions of the governing body of the
provider where it is based.
(iv) The main provider has final responsibility for administrative
decisions, final approval for contracts with outside parties, final
approval for personnel actions, final responsibility for personnel
policies (such as fringe benefits/code of conduct), and final approval
for medical staff appointments in the facility or organization.
(3) Administration and supervision. The reporting relationship
between the facility or organization seeking provider-based status and
the main provider must have the same frequency, intensity, and level of
accountability that exists in the relationship between the main
provider and one of its departments, as evidenced by compliance with
all of the following requirements:
(i) The facility or organization is under the direct supervision of
the provider where it is located.
(ii) The facility or organization is operated under the same
monitoring and oversight by the provider as any other department of the
provider, and is operated just as any other department of the provider
with regard to supervision and accountability. The facility or
organization director or individual responsible for daily operations at
the entity--
(A) Maintains a day-to-day reporting relationship with a manager at
the main provider; and
(B) Is accountable to the governing body of the main provider, in
the same manner as any department head of the provider.
(iii) The following administrative functions of the facility or
organization are integrated with those of the provider where the
facility or organization is based: billing services, records, human
resources, payroll, employee benefit package, salary structure, and
purchasing services. Either the same employees or group of employees
handle these administrative functions for the facility or organization
and the main provider, or the administrative functions for both the
facility or organization and the entity are--
(A) Contracted out under the same contract agreement; or
(B) Handled under different contract agreements, with the contract
of the facility or organization being managed by the main provider's
billing department.
(4) Clinical services. The clinical services of the facility or
organization seeking provider-based status and the main provider are
integrated as evidenced by the following:
(i) Professional staff of the facility or organization have
clinical privileges at the main provider.
(ii) The main provider maintains the same monitoring and oversight
of the facility or organization as it does for any other department of
the provider.
(iii) The medical director of the facility or organization seeking
provider-based status maintains a day-to-day reporting relationship
with the Chief Medical Officer or other similar official of the main
provider, and is under the same type of supervision and accountability
as any other director, medical or otherwise, of the main provider.
(iv) Medical staff committees or other professional committees at
the main provider are responsible for medical activities in the
facility or organization including quality assurance, utilization
review, and the coordination and integration of services, to the extent
practicable, between the facility or organization seeking provider-
based status and the main provider.
(v) Medical records for patients treated in the facility or
organization are integrated into a unified retrieval system (or cross
reference) of the main provider.
(vi) Inpatient and outpatient services of the facility or
organization and the main provider are integrated, and patients treated
at the facility or organization who require further care have full
access to all services of the main provider and are referred where
appropriate to the corresponding inpatient or outpatient department or
service of the main provider.
(5) Financial integration. The financial operations of the facility
or organization are fully integrated within the financial system of the
main provider, as evidenced by shared income and expenses between the
main provider and the facility or organization. The costs of the
facility or organization are reported in a cost center of the provider,
and the financial status of the facility or organization is
incorporated and readily identified in the main provider's trial
balance.
(6) Public awareness. The facility or organization seeking status
as a department of a provider is held out to the public and other
payers as part of the main provider. When patients enter the provider-
based facility or organization, they are aware that they are entering
the main provider and are billed accordingly.
(7) Location in immediate vicinity. The facility or organization
and the main provider are located on the same campus, except where the
following requirements are met:
(i) The facility or organization demonstrates a high level of
integration with the main provider by showing that it meets all of the
other provider-based criteria, and demonstrates that it serves the same
patient population as the main provider, either by submitting records
such as common patient lists and/or demographic data showing that a
high percentage of patients of both the main provider and the applicant
entity come from the same geographic area, or by submitting data
substantiating that the patients served by the entity also receive
services from the main provider (for example, the patients of an RHC
receive inpatient hospital services from the main provider).
(ii) A facility or organization is not considered to be in the
``immediate vicinity'' of the main provider if the facility or
organization and the main provider are located in different States.
(e) Provider-based status not applicable to joint ventures. A
facility or organization cannot be considered provider-based if the
entity is owned by two or more providers engaged in a joint venture.
For example, where a hospital has jointly purchased or jointly created
free-standing facilities under joint venture arrangements, neither
party to the joint venture arrangement can claim the free-standing
facility as a provider-based entity.
(f) Management contracts. Facilities and organizations operated
under management contracts are considered provider-based if all of the
following criteria are met:
(1) The staff of the facility or organization are employed by the
[[Page 47610]]
provider or by another organization other than the management company.
(2) The administrative functions of the facility or organization
are integrated with those of the main provider, as determined under
criteria in paragraph (b)(3)(iii) of this section.
(3) The main provider has significant day-to-day control over the
operations of the facility or organization as determined under criteria
in paragraph (b)(3)(ii) of this section.
(4) The management contract is held by the main provider itself,
not by a parent organization that has control over both the main
provider and the facility or organization.
(g) Obligations of hospital outpatient departments and hospital-
based entities. (1) Hospital outpatient departments located either on
or off the main premises of the hospital must comply with the anti-
dumping rules in Secs. 489.20(l), (m), (q), and (r) and 489.24 of this
chapter. If any individual comes to any hospital-based entity
(including an RHC) located on the main hospital campus, and a request
is made on the individual's behalf for examination or treatment of a
medical condition, as described in Sec. 489.24, the hospital must
comply with the anti-dumping rules in Sec. 489.24.
(2) Physician services furnished in hospital outpatient departments
or hospital-based entities (other than RHCs) must be billed with the
correct site-of-service indicator, so that applicable site-of-service
reductions to physician and practitioner payment amounts can be
applied.
(3) Hospital outpatient departments must comply with all the terms
of the hospital's provider agreement.
(4) Physicians who work in hospital outpatient departments or
hospital-based entities are obligated to comply with the non-
discrimination provisions in Sec. 489.10(b) of this chapter.
(5) Hospital outpatient departments (other than RHCs) must hold
themselves out to other payers as outpatient departments of that
hospital, and must treat all patients, for billing purposes, as
hospital outpatients. The department must not treat some patients as
hospital outpatients and others as physician office patients.
(6) In the case of a patient admitted to the hospital as an
inpatient after receiving treatment in the hospital outpatient
department or hospital-based entity, payments for services in the
hospital outpatient department or hospital-based entity are subject to
the payment window provisions applicable to PPS hospitals and to
hospitals and units excluded from PPS set forth at Sec. 412.2(c)(5) of
this chapter and at Sec. 413.40(c)(2), respectively.
(7) When a Medicare beneficiary is treated in a hospital outpatient
department or hospital-based entity (other than an RHC), the hospital
has a duty to notify the beneficiary, prior to the delivery of
services, of the beneficiary's potential financial liability (that is,
a coinsurance liability for an outpatient visit to the hospital as well
as for the physician service).
(8) Hospital outpatient departments must meet applicable hospital
health and safety rules for Medicare-participating hospitals in part
482 of this chapter.
(9) A facility or organization may not qualify for provider-based
status if all services furnished at the facility are furnished under
arrangement.
(h) Inappropriate treatment of a facility or organization as
provider-based. If HCFA learns of a provider treating a facility or
organization as provider-based without notifying HCFA to obtain a
determination of provider-based status, HCFA reconsiders all payments
to that provider for all cost reporting periods subject to re-opening
in accordance with Secs. 405.1885 and 405.1889 of this chapter. HCFA
then investigates and determines whether the requirements in paragraph
(d) of this section were met. If the facility or organization did not
qualify for a provider-based determination, HCFA recovers the
difference between the amount of payments that actually were made and
the amount of payments that should have been made in the absence of a
determination of provider-based status, except that recovery will not
be made for any period prior to [insert the effective date of final
rule] if during all of that period the management of the entity made a
good faith effort to operate it as a provider-based facility or
organization, as described in paragraph (i)(2) of this section.
(i) Inappropriate billing. (1) If HCFA determines that a provider
has been inappropriately billing Medicare for services furnished in a
physician office or other facility or organization as if they had been
furnished in a hospital outpatient department or other department of a
provider or in a provider-based entity, HCFA stops all payments to the
provider for outpatient services until the provider can demonstrate
which payments are proper. If overpayments have been made, HCFA
recovers the difference between the amount of payments that actually
were made and the amount of the payments that should have been made in
the absence of the determination of provider-based status. However,
past payments attributable to treatment as a department of a provider
or a provider-based entity for any period prior to [insert effective
date of final rule] are not recovered if during all of that period the
management of a facility or an organization made a good faith effort to
operate it as a department of a provider or a provider-based entity, as
described in paragraph (i)(2) of this section, prior to [insert
effective date of final rule].
(2) HCFA determines that the management of a facility has made a
good faith effort to operate it as a provider-based entity if--
(i) The requirements regarding licensure and public awareness in
paragraphs (d)(1) and (d)(6) of this section are met;
(ii) All facility services were billed as if they had been
furnished by a department of a provider or a provider-based entity of
the main provider; and
(iii) All professional services of physicians and other
practitioners were billed with the correct site-of-service indicator,
as described in paragraph (g)(7) of this section.
(j) Correction of errors. HCFA may review a past determination of
provider-based status if it believes that the determination may be
inappropriate, based on the provisions of this section. If HCFA
determines that a previous determination was in error, and the entity
should not be considered provider-based, HCFA notifies the main
provider. Treatment of the facility or organization as provider-based
ceases with the first day of the next cost report period following
notification of the redetermination.
Subpart F--Specific Categories of Costs
5. In Sec. 413.118, the heading to paragraph (d) is republished,
and a new paragraph (d)(5) is added to read as follows:
Sec. 413.118 Payment for facility services related to covered ASC
surgical procedures performed in hospitals on an outpatient basis.
* * * * *
(d) Blended payment amount. * * *
(5) For portions of cost reporting periods beginning on or after
October 1, 1997, for purposes of calculating the blended payment amount
under paragraph (d)(4) of this section, the ASC payment amount is the
sum of the standard overhead amounts reduced by deductibles and
coinsurance as defined in section 1866(a)(2)(ii) of the Act.
* * * * *
6. In Sec. 413.122, the heading to paragraph (b) is republished, a
new
[[Page 47611]]
paragraph (b)(5) is added, the heading to paragraph (c) is republished,
and a new paragraph (c)(4) is added to read as follows:
413.122 Payment for hospital outpatient radiology services and other
diagnostic procedures.
* * * * *
(b) Payment for hospital outpatient radiology services. * * *
(5) For hospital outpatient radiology services furnished on or
after October 1, 1997, the blended payment amount is equal to the sum
of--
(i) 42 percent of the hospital-specific amount; and
(ii) 58 percent of the fee schedule amount calculated as 62 percent
of the sum of the fee schedule amounts payable for the same services
when furnished by participating physicians in their offices in the same
locality, less deductible and coinsurance as defined in section
1866(a)(2)(A)(ii) of the Act.
(c) Payment for other diagnostic procedures. * * *
(4) For other diagnostic services furnished on or after October 1,
1997, the blended payment amount is equal to the sum of--
(i) 50 percent of the hospital-specific amount; and
(ii) 50 percent of the fee schedule amount calculated as 42 percent
of the sum of the fee schedule amounts payable for the same services
when furnished by participating physicians in their offices in the same
locality, less deductible and coinsurance as defined in section
1866(a)(2)(A)(ii) of the Act.
7. In Sec. 413.124, paragraph (a) is revised to read as follows:
Sec. 413.124 Reduction to hospital outpatient operating costs.
(a) Except for sole community hospitals, as defined in Sec. 412.92
of this chapter, and critical access hospitals, the reasonable costs of
outpatient hospital services (other than capital-related costs of such
services) are reduced by 5.8 percent for services furnished during
portions of cost reporting periods occurring on or after October 1,
1990 and before January 1, 2000.
* * * * *
Subpart G--Capital-Related Costs
8. In Sec. 413.130, the heading to paragraph (j) and the
introductory text to paragraph (j)(1) are republished, and paragraph
(j)(1)(ii) is revised to read as follows:
Sec. 413.130 Introduction to capital-related costs.
* * * * *
(j) Reduction to capital-related costs. (1) Except for sole
community hospitals and critical access hospitals, the amount of
capital-related costs of all hospital outpatient services is reduced
by--
* * * * *
(ii) 10 percent for portions of cost reporting periods occurring on
or after October 1, 1991 through December 31, 1999 and before January
1, 2000.
* * * * *
F. A new part 419, consisting of Secs. 419.1, 419.2, 419.20,
419.21, 419.22, 419.30, 419.31, 419.32, 419.40, 419.41, 419.42, 419.43,
419.44, 419.50, 419.51, and 419.60, is added to read as follows:
PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT
DEPARTMENT SERVICES
Subpart A--General Provisions
Sec.
419.1 Scope of part.
419.2 Basis of payment.
Subpart B--Services Subject to and Excluded From the Hospital
Outpatient Prospective Payment System
419.20 Hospitals subject to the hospital outpatient prospective
payment system.
419.21 Hospital outpatient services subject to the outpatient
prospective payment system.
419.22 Hospital outpatient services excluded from payment under the
hospital outpatient prospective payment system.
Subpart C--Basic Methodology for Determining Prospective Payment Rates
for Hospital Outpatient Services
419.30 Base expenditure target for calendar year 1999.
419.31 Ambulatory Payment Classification (APC) system and payment
weights.
419.32 Calculation of prospective payment rates for hospital
outpatient services.
Subpart D--Payments to Hospitals
419.40 Payment concepts.
419.41 Calculation of national beneficiary copayment amounts and
national Medicare program payment amounts.
419.42 Hospital election to reduce copayment.
419.43 Adjustments to national program payment and beneficiary
copayment amounts.
419.44 Payment reductions for surgical procedures.
Subpart E--Updates
419.50 Revisions to groups, weights, and other adjustments.
419.51 Volume control measures for services furnished in CY 2000.
Subpart F--Limitations on Review
419.60 Limitations on administrative and judicial review.
Authority: Secs. 1102, 1833(t), and 1871 of the Social Security
Act (42 U.S.C. 1302, 1395l(t), and 1395(hh)).
PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT
DEPARTMENT SERVICES
Subpart A--General Provisions
Sec. 419.1 Scope of part.
(a) Purpose. This part implements section 1833(t) of the Act by
establishing a prospective payment system for services furnished by
hospital outpatient departments to Medicare beneficiaries who are
registered on hospital records as outpatients, effective for services
furnished on or after the implementation date.
(b) Summary of content. This subpart describes the basis of payment
for outpatient hospital services under the prospective payment system.
Subpart B sets forth the categories of hospitals and services that are
subject to the outpatient hospital prospective payment system and those
categories of hospitals and services that are excluded from the
outpatient hospital prospective payment system. Subpart C sets forth
requirements and the basic methodology by which prospective payment
rates for hospital outpatient services are determined. Subpart D
describes Medicare payment amounts, beneficiary copayment amounts, and
methods of payment to hospitals under the hospital outpatient
prospective payment system. Subpart E describes how the hospital
outpatient prospective payment system may be revised to take into
account changes in medical practice and technology, the addition or
deletion of services, new cost data, and other relevant information and
factors.
Sec. 419.2 Basis of payment.
(a) Unit of payment. Under the hospital outpatient prospective
payment system, hospitals are paid a predetermined amount for
designated services, which are identified by codes established under
the Health Care Financing Administration Common Procedure Coding System
(HCPCS), furnished to Medicare beneficiaries. The prospective payment
rate for each service or procedure for which payment is allowed under
the hospital outpatient prospective payment system is determined
according to the methodology described in subpart C of this part. The
manner in which the Medicare payment amount and the beneficiary
copayment amount for each service or procedure are determined is
described in subpart D of this part.
(b) Costs included in determination of hospital outpatient
department payment rates. The prospective payment system establishes a
national payment rate,
[[Page 47612]]
standardized for geographic wage differences, for operating and
capital-related costs that are directly related and integral to
performing a procedure or furnishing a service on an outpatient basis,
including, but not limited to--
(1) Use of an operating suite, procedure room, or treatment room;
(2) Use of recovery room;
(3) Use of an observation bed;
(4) Anesthesia, drugs, biologicals, other pharmaceuticals, and
blood; medical and surgical supplies and equipment; surgical dressings;
splints, casts, and other devices used for reduction of fractures and
dislocations;
(5) Supplies and equipment for administering and monitoring
anesthesia or sedation;
(6) Intra-ocular lenses (IOLs);
(7) Incidental services such as venipuncture;
(8) Capital-related costs.
(c) Costs excluded from determination of hospital outpatient
prospective payment rates. The following costs are excluded from the
hospital outpatient prospective payment rates:
(1) Medical education costs for approved nursing and allied health
education programs.
(2) Costs for services listed in Sec. 419.22.
Subpart B--Services Subject to and Excluded From the Hospital
Outpatient Prospective Payment System
Sec. 419.20 Hospitals subject to the hospital outpatient prospective
payment system.
(a) Applicability. The hospital outpatient prospective payment
system is applicable to any hospital participating in the Medicare
program, except those specified in paragraph (b) of this section, for
services furnished on or after the implementation date.
(b) Hospitals excluded from the outpatient prospective payment
system. (1) Those services furnished by Maryland hospitals that are
paid under a cost containment waiver in accordance with section
1814(b)(3) of the Act are excluded from the hospital outpatient
prospective payment system.
(2) Critical access hospitals (CAHs) are excluded from the hospital
outpatient prospective payment system.
Sec. 419.21 Hospital outpatient services subject to the outpatient
prospective payment system.
Beginning on the implementation date, except for services
described in Sec. 419.22, payment is made under the hospital outpatient
prospective payment system for--
(a) Medicare Part B services furnished to hospital outpatients
designated by HCFA under this part that are not otherwise excluded
under Sec. 419.22;
(b) Services that are covered under Medicare Part B when furnished
to hospital inpatients who are either not entitled to benefits under
Part A or who have exhausted their Part A benefits, but are entitled to
benefits under Part B of the program;
(c) Partial hospitalization services furnished by community mental
health centers (CMHCs);
(d) The following medical and other health services furnished by a
comprehensive outpatient rehabilitation facility (CORF) when they fall
outside the definition of CORF services at section 1861(cc)(1) of the
Act; or by a home health agency (HHA) to patients who are not under an
HHA plan or treatment; or, by a hospice program furnishing services to
patients outside the hospice benefit:
(1) Antigens.
(2) Splints and casts.
(3) Pneumococcal vaccine, influenza vaccine, hepatitis B vaccine.
Sec. 419.22 Hospital outpatient services excluded from payment under
the hospital outpatient prospective payment system.
The following services are not paid for under the hospital
outpatient prospective payment system:
(a) Physician services.
(b) Nurse practitioner services.
(c) Physician assistant services.
(d) Certified nurse-midwife services.
(e) Services of qualified psychologists.
(f) Services of an anesthetist as defined in Sec. 410.69 of this
chapter.
(g) Clinical social worker services as defined in section
1861(hh)(2) of the Act.
(h) Rehabilitation services described in section 1833(a)(8) of the
Act.
(i) Ambulance services.
(j) Prosthetics and prosthetic supplies, prosthetic devices,
prosthetic implants (except IOLs), and orthotic devices.
(k) Durable medical equipment supplied by the hospital for the
patient to take home.
(l) Clinical diagnostic laboratory services.
(m) Dialysis services furnished to ESRD patients.
(n) Services and procedures that are not safely furnished in an
outpatient setting or that require inpatient care.
(o) Services specific to other sites such as nursing homes.
(p) Services furnished to persons who are inpatients of a SNF and
furnished pursuant to the resident assessment or comprehensive care
plan but that are covered under the SNF prospective payment system,
furnished ``under arrangement,'' and billable only by the SNF.
(q) Services that are not covered by Medicare by statute.
(r) Services that are not reasonable or necessary for the diagnosis
or treatment of an illness or disease.
Subpart C--Basic Methodology for Determining Prospective Payment
Rates for Hospital Outpatient Services
Sec. 419.30 Base expenditure target for calendar year 1999.
(a) HCFA estimates the aggregate amount that would be payable for
hospital outpatient services in calendar year 1999 by summing--
(1) The total amounts that would be payable from the Trust Fund for
covered hospital outpatient services without regard to the outpatient
prospective payment system described in this part; and
(2) The total amounts of copayments estimated to be paid by
beneficiaries, under the prospective payment system described in this
part, to hospitals for covered hospital outpatient services.
(b) The aggregate amount under paragraph (a) of this section is
determined as though the deductible required under section 1833(b) of
the Act did not apply.
Sec. 419.31 Ambulatory Payment Classification (APC) system and payment
weights.
(a) APC groups. (1) HCFA classifies hospital outpatient services
and procedures that are comparable clinically and similar in terms of
resource use into APC groups.
(2) The payment rate determined for an APC group in accordance with
Sec. 419.32 and the copayment amount and program payment amount
determined for an APC group in accordance with subpart D of this part
apply to every individual service or procedure within the APC group.
(b) APC weighting factors. (1) Using hospital claims data from
calendar year 1996 and data from the most recent available hospital
cost reports, HCFA determines the median costs for the services and
procedures within each APC group.
(2) HCFA assigns to each APC group an appropriate weighting factor
to reflect the relative median costs for the services within the APC
group compared to the median costs for the services in all APC groups.
(c) Standardizing amounts. (1) HCFA determines the portion of costs
determined in paragraph (b)(1) of this section that is labor-related.
This is known as the ``labor-related portion'' of hospital outpatient
costs.
(2) HCFA standardizes the median costs determined in paragraph
(b)(1) of
[[Page 47613]]
this section by adjusting for variations in hospital labor costs across
geographic areas.
Sec. 419.32 Calculation of prospective payment rates for hospital
outpatient services.
(a) Conversion factor for 1999. HCFA calculates a conversion factor
in such a manner as to ensure that payment for hospital outpatient
services furnished in 1999 would have equalled the base expenditure
target calculated in Sec. 419.30, taking APC group weights and
estimated service volume into account.
(b) Conversion factor for calendar years 2000, 2001, and 2002. (1)
Subject to paragraph (c)(2) of this section, the conversion factor for
each of the calendar years 2000, 2001, and 2002 is equal to the
conversion factor calculated under paragraph (a) of this section for
the previous year adjusted by the hospital inpatient market basket
percentage increase applicable under section 1886(b)(3)(B)(iii) of the
Act for fiscal years 2000, 2001, and 2002, respectively, reduced by one
percentage point.
(2) Beginning in calendar year 2000, HCFA may substitute for the
hospital inpatient market basket percentage in paragraph (c)(1) of this
section a market basket percentage increase that is determined and
applied to hospital outpatient services in the same manner that the
hospital inpatient market basket percentage increase is determined and
applied to inpatient hospital services.
(c) Payment rates. The payment rate for services and procedures for
which payment is made under the hospital outpatient prospective payment
system is the product of the conversion factor calculated under
paragraph (a) or paragraph (b) of this section and the relative weight
determined under Sec. 419.31(b).
Subpart D--Payments to Hospitals
Sec. 419.40 Payment concepts.
In addition to the payment rate described in Sec. 419.32, for each
APC group there is a predetermined beneficiary copayment amount as
described in Sec. 419.41(a). The Medicare payment for each APC is
calculated by applying the program payment percentage as described in
Sec. 419.41(b).
(b) For purposes of this section--
Copayment percentage is calculated as the difference between the
program payment percentage and 100 percent. The copayment percentage in
any year is thus defined for each APC group as the greater of the
following: the ratio of the APC group unadjusted copayment amount to
the annual APC group payment rate, or 20 percent.
Program payment percentage is calculated as the lower of the
following: the ratio of the APC group payment rate minus the APC group
unadjusted copayment amount, to the APC group payment rate, or 80
percent.
Unadjusted copayment amount is calculated as 20 percent of the
wage-adjusted national median of charges for services within an APC
group furnished during 1996, updated to 1999 using an actuarial
projection of charge increases for hospital outpatient department
services during the period 1996 to 1999.
Sec. 419.41 Calculation of national beneficiary copayment amounts and
national Medicare program payment amounts.
(a) Calculation of the national beneficiary copayment amount. To
calculate the unadjusted copayment amount for each APC group, HCFA--
(1) Standardizes 1996 hospital charges for the services within each
APC group to offset variations in hospital labor costs across
geographic areas;
(2) Identifies the median of the wage-neutralized 1996 charges for
each APC group; and,
(3) Determines the value equal to 20 percent of the wage-
neutralized 1996 median charge for each APC group and multiplies that
value by an actuarial projection of increases in charges for hospital
outpatient department services during the period 1996 to 1999. The
result is the unadjusted beneficiary copayment amount for the APC
group.
(b) Calculation of the program payment amount for each APC group.
(1) HCFA calculates annually the program payment percentage for every
APC group on the basis of each group's unadjusted copayment amount and
its payment rate after the payment rate is adjusted in accordance with
Sec. 419.32.
(2) The Medicare program payment amounts are calculated annually by
multiplying the updated APC group payment rates by the program payment
percentage.
(c) To determine payment amounts due for a service paid for under
the hospital outpatient prospective payment system, HCFA makes the
following calculations:
(1) Makes the wage index adjustment and any other adjustments that
are appropriate in accordance with Sec. 419.43.
(2) Subtracts the amount of the applicable Part B deductible
provided under Sec. 410.160 of this chapter.
(3) Multiplies the remainder by the program payment percentage for
the group to determine the program payment amount.
(4) Subtracts the program payment amount from the amount determined
in paragraph (c)(2) of this section to determine the copayment amount.
Sec. 419.42 Hospital election to reduce copayment.
(a) A hospital may elect to reduce copayments for any or all APC
groups on a calendar year basis. A hospital may not elect to reduce
copayment for some, but not all, services within the same group.
(b) A hospital must notify its fiscal intermediary of its election
to reduce copayments no later than 90 days prior to the start of the
calendar year.
(c) The hospital's election must be properly documented. It must
specifically identify the APCs to which it applies and the copayment
level (within the limits identified below) that the hospital has
selected for each group.
(d) The election of reduced copayment must remain in effect
unchanged during the year for which the election was made.
(e) The hospital may advertise and otherwise disseminate
information concerning the reduced level(s) of copayment that it has
elected.
(f) In electing reduced copayment, a hospital may elect a level
that is less than that year's national copayment amount for the group,
but not less than 20 percent of the APC payment rate as determined in
Sec. 419.32.
Sec. 419.43 Adjustments to national program payment and beneficiary
copayment amounts.
(a) General rule. HCFA determines national prospective payment
rates for hospital outpatient department services and determines a wage
adjustment factor to adjust the portion of the APC payment and national
beneficiary copayment amount attributable to labor-related costs for
relative differences in labor and labor-related costs across geographic
regions in a budget neutral manner.
(b) Labor-related portion of payment and copayment rates for
hospital outpatient services. HCFA determines the portion of hospital
outpatient costs attributable to labor and labor-related costs (known
as the ``labor-related portion'' of hospital outpatient costs) in
accordance with Sec. 419.31(c)(1).
(c) Wage index factor. HCFA uses the hospital inpatient prospective
payment system wage index established in accordance with section
1886(d)(3)(E) of the Act and part 412 of this chapter to make the
adjustment referred to in paragraph (a) of this section.
(d) Other adjustments. Any other adjustments to payment amounts
made by HCFA to ensure equitable payments are made in a budget neutral
manner.
[[Page 47614]]
Sec. 419.44 Payment reductions for surgical procedures.
(a) Multiple surgical procedures. When more than one surgical
procedure for which payment is made under the hospital outpatient
prospective payment system is performed during a single surgical
encounter, the Medicare program payment amount and the beneficiary
copayment amount are based on--
(1) The full amounts for the procedure with the highest APC payment
rate; and
(2) One half of the full program and beneficiary payment amounts
for all other covered procedures.
(b) Terminated procedures. When a surgical procedure is terminated
prior to completion due to extenuating circumstances or circumstances
that threaten the well-being of the patient, the Medicare program
payment amount and the beneficiary copayment amount are based on--
(1) The full amounts if the procedure is discontinued after the
induction of anesthesia or after the procedure is started; and
(2) One-half of the full program and beneficiary payment amounts if
the procedure is discontinued after the patient is prepared for surgery
and taken to the room where the procedure is to be performed, but
before anesthesia is induced.
Subpart E--Updates
Sec. 419.50 Revisions to groups, weights, and other adjustments.
(a) HCFA periodically reviews and updates groups, relative payment
weights, and the wage and other adjustments to take into account
changes in medical practice, changes in technology, the addition of new
services, new cost data, and other relevant information and factors.
(1) Changes in the APC system. HCFA may make a change in the group
composition of the APC system or recalibrate any APC weight, as needed,
but not more frequently than once a year. HCFA makes these changes
based on evidence that a reassignment would improve the consistency of
the group(s) either clinically or with respect to resource consumption.
(2) New services. HCFA assigns a new service to the APC group that
is most similar clinically and with respect to resource consumption.
(3) Budget neutrality. HCFA adjusts the conversion factor so that
any adjustments determined under paragraphs (a)(1) through (a)(3) of
this section do not increase or decrease the amount of expenditures
that would have been made under this section if the adjustments had not
been made.
(b) Annual update to conversion factor. HCFA updates the conversion
factor annually as specified in Sec. 419.32.
Sec. 419.51 Volume control measures for services furnished in CY 2000.
HCFA uses the target amount specified under section 1833(t)(3)(A)
of the Act as an expenditure target for services furnished in CY 1999.
HCFA updates the target amount to CY 2000 based on the adjustment to
the conversion factor in Sec. 419.32(b), estimated changes in the
volume and intensity of hospital outpatient services, and estimated
changes in beneficiary enrollment. HCFA compares the CY 2000 target to
an estimate of CY 2000 actual payments to hospitals. If unnecessary
volume increases cause payments to exceed the target, HCFA determines
the percentage by which the target is exceeded, and adjusts the CY 2002
update to the conversion factor by the same percentage.
Subpart F--Limitations on Review
Sec. 419.60 Limitations on administrative and judicial review.
There can be no administrative or judicial review under sections
1869 and 1878 of the Act, or otherwise of--
(a) The development of the APC system, including--
(1) Establishment of the groups and relative payment weights;
(2) Wage adjustment factors;
(3) Other adjustments; and
(4) Methods for controlling unnecessary increases in volume.
(b) The calculation of base amounts described in section 1833(t)(3)
of the Act;
(c) Periodic adjustments described in section 1833(t)(6) of the
Act; and
(d) The establishment of a separate conversion factor for hospitals
described in section 1886(d)(1)(B)(v) of the Act.
PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL
G. Part 489 is amended as set forth below:
1. The authority citation to part 489 continues to read as follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
Subpart B--Essentials of Provider Agreements
2. In Sec. 489.20, the introductory text to the section is
republished; the introductory text to paragraph (d) is revised;
paragraphs (d)(3), (d)(4), and (d)(5) are redesignated as paragraphs
(d)(4), (d)(5), and (d)(6), respectively; and a new paragraph (d)(3) is
added to read as follows:
Sec. 489.20 Basic commitments.
The provider agrees to the following:
* * * * *
(d) In the case of a hospital or a CAH that furnishes services to
Medicare beneficiaries, either to furnish directly or to make
arrangements (as defined in Sec. 409.3 of this chapter) for all
Medicare-covered services to inpatients and outpatients of a hospital
or a CAH except the following:
* * * * *
(3) Nurse practitioner and clinical nurse specialist services, as
defined in section 1861(s)(2)(K)(ii) of the Act.
* * * * *
3. In Sec. 489.24(b), the definition for ``Comes to the emergency
department'' is revised to read as follows:
Sec. 489.24 Special responsibilities of Medicare hospitals in
emergency cases.
* * * * *
(b) * * *
Comes to the emergency department means, with respect to an
individual requesting examination or treatment, that the individual is
on the hospital property. For purposes of this section, ``property''
means the entire main hospital campus, including the parking lot,
sidewalk, and driveway, as well as any facility or organization that is
located off the main hospital campus but has been determined under
Sec. 416.35 of this chapter to be a department of the hospital.
Property also includes ambulances owned and operated by the hospital,
even if the ambulance is not on hospital grounds. An individual in a
nonhospital-owned ambulance on hospital property is considered to have
come to the hospital's emergency department. An individual in a
nonhospital-owned ambulance off hospital property is not considered to
have come to the hospital's emergency department, even if a member of
the ambulance staff contacts the hospital by telephone or telemetry
communications and informs the hospital that they want to transport the
individual to the hospital for examination and treatment. In such
situations, the hospital may deny access if it is in ``diversionary
status,'' that is, it does not have the staff or facilities to accept
any additional emergency patients. If, however, the ambulance staff
disregards the hospital's instructions and transports the individual on
to hospital property, the individual is considered to have come to the
emergency department.
* * * * *
[[Page 47615]]
PART 498--APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT
PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT
AFFECT THE PARTICIPATION OF ICFs/MR AND CERTAIN NFs IN THE MEDICAID
PROGRAM
H. Part 498 is amended as set forth below:
1. The authority citation for part 498 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395(hh).
2. In Sec. 498.2, the introductory text is republished, and the
definition of ``Provider'' is revised to read as follows:
Sec. 498.2 Definitions.
As used in this part --
* * * * *
Provider means a hospital, critical access hospital (CAH), skilled
nursing facility (SNF), comprehensive outpatient rehabilitation
facility (CORF), home health agency (HHA), or hospice, that has in
effect an agreement to participate in Medicare, that has in effect an
agreement to participate in Medicaid, or a clinic, rehabilitation
agency, or public health agency that has a similar agreement but only
to furnish outpatient physical therapy or outpatient speech pathology
services, and prospective provider means any of the listed entities
that seeks to participate in Medicare as a provider or to have any
facility or organization determined to be a department of the provider
or provider-based entity under Sec. 412.65 of this chapter.
* * * * *
3. In Sec. 498.3, the introductory text to paragraph (b) is
republished; paragraphs (b)(2) through (b)(14) are redesignated as
paragraphs (b)(3) through (b)(15), respectively; and a new paragraph
(b)(2) is added to read as follows:
Sec. 498.3 Scope and applicability.
* * * * *
(b) Initial determinations by HCFA. HCFA makes initial
determinations with respect to the following matters:
* * * * *
(2) Whether a prospective department of a provider or provider-
based entity qualifies as a department of a provider or provider-based
entity under Sec. 413.65 of this chapter.
* * * * *
PART 1003--CIVIL MONEY PENALTIES, ASSESSMENTS AND EXCLUSIONS
I. Part 1003 is amended as set forth below:
1. The authority citation for part 1003 is revised to read as
follows:
Authority: 42 U.S.C. 1302, 1320-7, 1320a-7a, 1320b-10, 1395u(j),
1395u(k), 1395cc(g), 1395dd(d)(1), 1395mm, 1395nn(g), 1395ss(d),
1396b(m), 11131(c) and 11137(b)(2).
2. Section 1003.100 is amended by revising paragraph (a) to read as
follows:
Sec. 1003.100 Basis and purpose.
(a) Basis. This part implements sections 1102, 1128(c), 1128A,
1140, 1842(j), 1842(k), 1866(g), 1876(i)(6), 1877(g), 1882(d) and
1903(m)(5) of the Social Security Act, and sections 421(c) and
427(b)(2) of Pub. L. 99-660 (42 U.S.C. 1302, 1320a-7, 1320a-7a, 1320b-
10, 1395u(j), 1395u(k), 1395cc(g), 1395mm(i)(6), 1395nn(g), 1395ss(d),
1396d(m)(5), 11131(c) and 11137(b)(2)).
* * * * *
3. Section 1003.102 is amended by republishing the introductory
text to paragraph (b), by reserving paragraphs (b)(11) through (b)(13),
and by adding a new paragraph (b)(14) to read as follows:
Sec. 1003.102 Basis for civil money penalties and assessments.
* * * * *
(b) The OIG may impose a penalty, and where authorized, an
assessment against any person (including an insurance company in the
case of paragraphs (b)(5) and (b)(6) of this section) whom it
determines in accordance with this part--
* * * * *
(11) [Reserved]
(12) [Reserved]
(13) [Reserved]
(14) Has knowingly and willfully presented, or caused to be
presented, a bill or request for payment for an item or service
furnished to a hospital patient for which payment may be made under the
Medicare or another Federal health care program, if that bill or
request is inconsistent with an arrangement under section 1866(a)(1)(H)
of the Act, or violates the requirements for such an arrangement.
* * * * *
4. Section 1003.103 is amended by revising paragraph (a) to read as
follows:
Sec. 1003.103 Amount of penalty.
(a) Except as provided in paragraphs (b) through (f) of this
section, the OIG may impose a penalty of not more than $10,000 for each
item or service that is subject to a determination under Sec. 1003.102.
* * * * *
5. Section 1003.105 is amended by revising paragraph (a)(1)(i) to
read as follows:
Sec. 1003.105 Exclusion from participation in Medicare and State
health care programs.
(a)(1) * * *
(i) Any person who is subject to a penalty or assessment under
Sec. 1003.102(a), (b)(1) through (b)(4), or (b)(14).
* * * * *
(Catalog of Federal Domestic Assistance 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: June 29, 1998.
Nancy-Ann Min DeParle,
Administrator, Health Care Financing Administration.
Dated: June 29, 1998.
June G. Brown,
Inspector General, Department of Health and Human Services.
Approved: August 15, 1998.
Donna E. Shalala,
Secretary.
Note: The following addenda will not appear in the Code of
Federal Regulations.
[[Page 47615]]
Addendum A.--List of Proposed Hospital Outpatient Ambulatory Payment Classes With Status Indicators, Relative
Weights, Payment Rates, and Coinsurance Amounts
----------------------------------------------------------------------------------------------------------------
National Minimum
APC \1\ Group title Status Relative Payment unadjusted unadjusted
\2\ indicator weight rate coinsurance coinsurance
----------------------------------------------------------------------------------------------------------------
020...... Partial .................. S 4.11 $208.01 $46.78 $41.60
Hospitalization
per diem.
031...... Dental procedures. .................. S 1.34 $67.90 $13.58 $13.58
061...... Level I .................. X 1.04 $52.70 $36.61 $10.54
Chemotherapeutic
agents.
062...... Level II .................. X 1.69 $85.63 $36.61 $17.13
Chemotherapeutic
agents.
[[Page 47616]]
063...... Level III .................. X 2.89 $146.43 $110.97 $29.29
Chemotherapeutic
agents.
064...... Level IV .................. X 4.17 $211.29 $140.12 $42.26
Chemotherapeutic
agents.
089...... Neuropsychological .................. X 2.54 $128.70 $37.29 $25.74
Testing.
090...... Monitoring .................. X 0.85 $43.07 $12.43 $8.61
psychiatric drugs.
091...... Brief Individual .................. S 1.09 $55.23 $14.01 $11.05
Psychotherapy.
092...... Extended .................. S 1.57 $79.55 $21.92 $15.91
Individual
Psychotherapy.
093...... Family .................. S 1.54 $78.03 $20.11 $15.61
Psychotherapy.
094...... Group .................. S 1.24 $62.83 $20.11 $12.57
Psychotherapy.
121...... Level I needle .................. T 0.67 $33.95 $20.91 $6.79
biopsy/aspiration.
122...... Level II needle .................. T 4.87 $246.76 $115.03 $49.35
biopsy/aspiration.
131...... Level I incision & .................. T 1.94 $98.30 $36.61 $19.66
drainage.
132...... Level II incision .................. T 6.04 $306.04 $134.13 $61.21
& drainage.
137...... Nail procedures... .................. T 0.46 $23.31 $4.66 $4.66
141...... Level I .................. T 0.59 $29.90 $9.49 $5.98
Destruction of
lesion.
142...... Level II .................. T 3.77 $191.02 $73.00 $38.20
Destruction of
lesion.
151...... Level I .................. T 1.74 $88.16 $35.71 $17.63
debridement/
destruction.
152...... Level II .................. T 10.43 $528.48 $261.71 $105.70
debridement/
destruction.
161...... Level I excision/ .................. T 3.50 $177.34 $75.48 $35.47
biopsy.
162...... Level II excision/ .................. T 5.67 $287.30 $125.43 $57.46
biopsy.
163...... Level III excision/ .................. T 10.69 $541.66 $264.65 $108.33
biopsy.
181...... Level I skin .................. T 2.19 $110.97 $43.84 $22.19
repair.
182...... Level II skin .................. T 4.00 $202.68 $84.98 $40.54
repair.
183...... Level III skin .................. T 11.17 $565.98 $286.46 $113.20
repair.
184...... Level IV skin .................. T 15.17 $768.66 $396.40 $153.73
repair.
197...... Incision/excision .................. T 12.13 $614.62 $310.75 $122.92
breast.
198...... Breast .................. T 19.17 $971.33 $530.20 $194.27
reconstruction/
mastectomy.
200...... Arthrocentesis & .................. T 1.89 $95.77 $39.10 $19.15
Ligament/Tendon
Injection.
207...... Closed treatment .................. T 1.70 $86.14 $31.64 $17.23
fracture finger/
toe/trunk.
209...... Closed treatment .................. T 1.94 $98.30 $37.29 $19.66
fracture/
dislocation/
except finger/toe/
trunk.
210...... Bone/joint .................. T 10.46 $530.00 $283.40 $106.00
manipulation
under anesthesia.
216...... Open/percutaneous .................. T 20.13 $1,019.98 $520.82 $204.00
treatment
fracture or
dislocation.
217...... Arthroplasty...... .................. T 20.48 $1,037.71 $526.81 $207.54
218...... Arthroplasty with .................. T 27.49 $1,392.90 $715.52 $278.58
prosthesis.
*226..... Maxillofacial .................. T 1.59 $80.56 $21.92 $16.11
prostheses.
231...... Level I skull and .................. T 12.02 $609.05 $299.90 $121.81
facial bone
procedures.
232...... Level II skull and .................. T 23.93 $1,212.52 $639.35 $242.50
facial bone
procedures.
251...... Level I .................. T 14.26 $722.55 $366.12 $144.51
Musculoskeletal
Procedures.
252...... Level II .................. T 19.39 $982.48 $509.18 $196.50
Musculoskeletal
Procedures.
253...... Level III .................. T 26.33 $1,334.13 $699.24 $266.83
Musculoskeletal
Procedures.
254...... Level IV .................. T 34.37 $1,741.51 $937.11 $348.30
Musculoskeletal
Procedures.
261...... Level I Hand .................. T 10.54 $534.06 $261.48 $106.81
Musculoskeletal
Procedures.
262...... Level II Hand .................. T 18.35 $929.78 $480.82 $185.96
Musculoskeletal
Procedures.
271...... Level I Foot .................. T 14.41 $730.15 $368.38 $146.03
Musculoskeletal
Procedures.
272...... Level II Foot .................. T 16.56 $839.09 $409.74 $167.82
Musculoskeletal
Procedures.
276...... Bunion Procedures. .................. T 19.19 $972.35 $500.14 $194.47
280...... Diagnostic .................. T 22.20 $1,124.86 $581.72 $224.97
Arthroscopy.
281...... Level I Surgical .................. T 22.65 $1,147.66 $590.20 $229.53
Arthroscopy.
282...... Level II Surgical .................. T 23.94 $1,213.03 $614.04 $242.61
Arthroscopy.
286...... Arthroscopically- .................. T 26.76 $1,355.91 $802.41 $271.18
Aided Procedures.
311...... Level I ENT .................. T 1.43 $72.46 $20.57 $14.49
Procedures.
312...... Level II ENT .................. T 7.26 $367.86 $178.31 $73.57
Procedures.
313...... Level III ENT .................. T 15.81 $801.08 $411.09 $160.22
Procedures.
314...... Level IV ENT .................. T 25.65 $1,299.67 $693.37 $259.93
Procedures.
*317..... Implantation of .................. T ......... ......... ........... ...........
Cochlear Device.
318...... Nasal .................. T 2.07 $104.89 $38.65 $20.98
Cauterization/
Packing.
319...... Tonsil/Adenoid .................. T 17.30 $876.58 $480.02 $175.32
Procedures.
320...... Thoracentesis/ .................. T 3.17 $160.62 $79.33 $32.12
Lavage Procedures.
331...... Level I Endoscopy .................. T 0.69 $34.96 $14.01 $6.99
Upper Airway.
332...... Level II Endoscopy .................. T 9.74 $493.52 $244.98 $98.70
Upper Airway.
333...... Level III .................. T 17.24 $873.54 $464.20 $174.71
Endoscopy Upper
Airway.
336...... Endoscopy Lower .................. T 7.44 $376.98 $197.98 $75.40
Airway.
339...... Injection of .................. T 1.02 $51.68 $19.66 $10.34
Sclerosing
Solution.
341...... Level I Needle and .................. T 0.13 $6.59 $2.94 $1.32
Catheter
Placement.
342...... Level II Needle .................. T 3.20 $162.14 $80.23 $32.43
and Catheter
Placement.
343...... Level III Needle .................. T 9.52 $482.37 $224.87 $96.47
and Catheter
Placement.
346...... Placement .................. T 4.83 $244.73 $120.23 $48.95
Transvenous Caths/
Cutdown.
347...... Injection .................. T 2.93 $148.46 $62.15 $29.69
Procedures for
Interventional
Radiology.
360...... Removal/Revision, .................. T 6.09 $308.58 $140.12 $61.72
Pacemaker/
Vascular Device.
367...... Vascular Ligation. .................. T 17.59 $891.28 $449.06 $178.26
368...... Vascular Repair/ .................. T 22.83 $1,156.78 $648.85 $231.36
Fistula
Construction.
369...... Blood and Blood .................. T 4.33 $219.40 $97.18 $43.88
Product Exchange.
[[Page 47617]]
396...... Lymph Node .................. T 13.28 $672.89 $338.77 $134.58
Excisions.
397...... Thyroid/ .................. T 18.36 $930.29 $496.86 $186.06
Lymphadenectomy
Procedures.
406...... Esophageal .................. T 4.31 $218.39 $108.48 $43.68
Dilation without
Endoscopy.
407...... Esophagoscopy..... .................. T 7.06 $357.73 $189.84 $71.55
417...... Diagnostic Upper .................. T 6.44 $326.31 $181.70 $65.26
GI Endoscopy.
418...... Therapeutic Upper .................. T 7.59 $384.58 $214.25 $76.92
GI Endoscopy.
419...... Small Intestine .................. T 7.13 $361.27 $164.08 $72.25
Endoscopy.
426...... Diagnostic Lower .................. T 6.85 $347.09 $187.81 $69.42
GI Endoscopy.
427...... Therapeutic Lower .................. T 8.22 $416.50 $224.19 $83.30
GI Endoscopy.
437...... Therapeutic .................. T 2.91 $147.45 $76.61 $29.49
Anoscopy.
446...... Diagnostic .................. T 2.59 $131.23 $65.09 $26.25
Sigmoidoscopy.
447...... Therapeutic .................. T 6.87 $348.10 $184.76 $69.62
Proctosigmoidosco
py.
448...... Therapeutic .................. T 5.37 $272.09 $141.25 $54.42
Flexible
Sigmoidoscopy.
449...... Complex GI .................. T 7.80 $395.22 $215.38 $79.04
Endoscopy.
451...... Level I Anal/ .................. T 2.56 $129.71 $54.24 $25.94
Rectal Procedures.
452...... Level II Anal/ .................. T 4.82 $244.23 $109.61 $48.85
Rectal Procedures.
453...... Level III Anal/ .................. T 16.87 $854.79 $445.22 $170.96
Rectal Procedures.
456...... Endoscopic .................. T 9.78 $495.55 $257.19 $99.11
Retrograde
Cholangio-
Pancreatography
(ERCP).
458...... Percutaneous .................. T 7.23 $366.34 $181.59 $73.27
Biliary
Endoscopic
Procedures.
459...... Peritoneal and .................. T 18.06 $915.09 $496.52 $183.02
Abdominal
Procedures.
466...... Hernia/Hydrocele .................. T 21.43 $1,085.85 $562.97 $217.17
Procedures.
470...... Tube Procedures... .................. T 2.22 $112.49 $54.92 $22.50
521...... Level I .................. T 5.06 $256.39 $112.10 $51.28
Cystourethroscopy
and other
Genitourinary
Procedures.
522...... Level II .................. T 10.46 $530.00 $262.39 $106.00
Cystourethroscopy
and other
Genitourinary
Procedures.
523...... Level III .................. T 16.87 $854.79 $447.03 $170.96
Cystourethroscopy
and other
Genitourinary
Procedures.
524...... Level IV .................. T 28.89 $1,463.84 $833.38 $292.77
Cystourethroscopy
and other
Genitourinary
Procedures.
527...... Lithotripsy....... .................. T 51.56 $2,612.52 $1,372.95 $522.50
529...... Simple Urinary .................. T 2.50 $126.67 $63.05 $25.33
Studies and
Procedures.
530...... Genitourinary .................. T 2.52 $127.69 $54.69 $25.54
Procedures.
531...... Level I Urethral .................. T 18.94 $959.68 $527.26 $191.94
Procedures.
532...... Level II Urethral .................. T 25.50 $1,292.07 $602.18 $258.41
Procedures.
536...... Circumcision...... .................. T 13.17 $667.32 $326.57 $133.46
537...... Penile Procedures. .................. T 28.72 $1,455.23 $864.34 $291.05
538...... Insertion of .................. T 45.59 $2,310.02 $1,540.64 $462.00
Penile Prosthesis.
546...... Testes/Epididymis .................. T 17.14 $868.47 $453.81 $173.69
Procedures.
547...... Prostate Biopsy... .................. T 4.39 $222.44 $125.20 $44.49
550...... Surgical .................. T 16.89 $855.81 $447.93 $171.16
Hysteroscopy.
551...... Level I .................. T 24.78 $1,255.59 $711.67 $251.12
Laparoscopy.
552...... Level II .................. T 37.71 $1,910.75 $1,053.16 $382.15
Laparoscopy.
561...... Level I Female .................. T 1.52 $77.02 $24.63 $15.40
Reproductive
Procedures.
562...... Level II Female .................. T 12.76 $646.54 $330.75 $129.31
Reproductive
Procedures.
563...... Level III Female .................. T 16.90 $856.31 $464.88 $171.26
Reproductive
Procedures.
567...... D & C............. .................. T 13.61 $689.61 $364.09 $137.92
568...... Infertility .................. T 2.49 $126.17 $49.49 $25.23
Procedures.
578...... Pregnancy and .................. T 1.26 $63.84 $33.90 $12.77
Neonatal Care
Procedures.
580...... Vaginal Delivery.. .................. T 4.59 $232.57 $146.34 $46.51
586...... Therapeutic .................. T 12.50 $633.37 $431.89 $126.67
Abortion.
587...... Spontaneous .................. T 13.25 $671.37 $347.02 $134.27
Abortion.
600...... Spinal Tap........ .................. T 2.63 $133.26 $61.47 $26.65
601...... Level I Nervous .................. T 3.11 $157.58 $74.13 $31.52
System Injections.
602...... Level II Nervous .................. T 3.33 $168.73 $87.69 $33.75
System Injections.
616...... Implantation of .................. T 14.43 $731.16 $366.57 $146.23
Neurostimulator
Electrodes.
617...... Revision/Removal .................. T 11.56 $585.74 $287.59 $117.15
Neurological
Device.
618...... Implantation of .................. T 25.56 $1,295.11 $780.49 $259.02
Neurological
Device.
631...... Level I Nerve .................. T 12.98 $657.69 $333.80 $131.54
Procedures.
632...... Level II Nerve .................. T 18.13 $918.64 $461.04 $183.73
Procedures.
648...... Laser Retinal .................. T 3.94 $199.64 $95.15 $39.93
Procedures.
649...... Laser Eye .................. T 4.44 $224.97 $111.64 $44.99
Procedures except
Retinal.
651...... Level I Anterior .................. T 7.24 $366.85 $174.70 $73.37
Segment Eye
Procedures.
652...... Level II Anterior .................. T 16.48 $835.03 $433.69 $167.01
Segment Eye
Procedures.
667...... Cataract .................. T 15.33 $776.40 $521.72 $155.28
Procedures.
668...... Cataract .................. T 19.28 $976.91 $530.87 $195.38
Procedures with
IOL Insert.
670...... Corneal Transplant .................. T 29.23 $1,481.07 $847.50 $296.21
676...... Posterior Segment .................. T 6.30 $319.22 $140.35 $63.84
Eye Procedures.
677...... Strabismus/Muscle .................. T 16.26 $823.89 $436.63 $164.78
Procedures.
681...... Level I Eye .................. T 1.67 $84.62 $30.51 $16.92
Procedures.
682...... Level II Eye .................. T 3.54 $179.37 $81.36 $35.87
Procedures.
683...... Level III Eye .................. T 10.19 $516.32 $257.87 $103.26
Procedures.
684...... Level IV Eye .................. T 13.48 $683.02 $348.94 $136.60
Procedures.
[[Page 47618]]
690...... Vitrectomy........ .................. T 30.54 $1,547.45 $852.02 $309.49
700...... Plain Film........ .................. X 0.78 $39.52 $22.37 $7.90
706...... Miscellaneous .................. X 1.96 $99.31 $57.63 $19.86
Radiological
Procedures.
710...... Computerized Axial .................. S 5.06 $256.39 $176.28 $51.28
Tomography.
716...... Fluoroscopy....... .................. X 1.59 $80.56 $47.91 $16.11
720...... Magnetic Resonance .................. S 6.34 $321.24 $206.11 $64.25
Angiography.
726...... Magnetic Resonance .................. S 7.96 $403.33 $258.09 $80.67
Imaging.
728...... Myelography....... .................. S 4.07 $206.22 $113.23 $41.24
730...... Arthography....... .................. S 2.48 $125.66 $72.09 $25.13
736...... Digestive .................. S 1.85 $93.74 $54.24 $18.75
Radiology.
737...... Diagnostic .................. S 2.81 $142.38 $86.56 $28.48
Urography.
738...... Therapeutic .................. S 4.48 $227.00 $133.23 $45.40
Radiologic
Procedures.
739...... Diagnostic .................. S 5.83 $295.40 $168.71 $59.08
Angiography and
Venography.
746...... Mammography....... .................. S 0.69 $34.96 $19.44 $6.99
747...... Diagnostic .................. S 1.65 $83.60 $54.69 $16.72
Ultrasound Except
Vascular.
749...... Guidance under .................. X 2.44 $123.63 $76.16 $24.73
Ultrasound.
750...... Therapeutic .................. X 0.91 $46.11 $25.54 $9.22
Radiation
Treatment
Planning.
751...... Level I .................. X 1.15 $58.27 $33.22 $11.65
Therapeutic
Radiation
Treatment
Preparation.
752...... Level II .................. X 3.54 $179.37 $88.82 $35.87
Therapeutic
Radiation
Treatment
Preparation.
757...... Radiation Therapy. .................. S 2.30 $116.54 $52.43 $23.31
758...... Hyperthermic .................. S 3.41 $172.78 $76.84 $34.56
Therapies.
759...... Brachytherapy and .................. S 7.98 $404.34 $160.01 $80.87
Complex
Radioelement
Applications.
760...... PET Scans......... .................. S 17.26 $874.55 $419.46 $174.91
*761..... Standard Non- .................. S 2.04 $103.37 $61.47 $20.67
Imaging Nuclear
Medicine.
*762..... Complex Non- .................. S 1.78 $90.19 $51.53 $18.04
Imaging Nuclear
Medicine.
771...... Standard Planar .................. S 3.78 $191.53 $116.84 $38.31
Nuclear Medicine.
772...... Complex Planar .................. S 4.22 $213.83 $127.92 $42.77
Nuclear Medicine.
781...... Standard SPECT .................. S 5.26 $266.52 $145.77 $53.30
Nuclear Medicine.
782...... Complex SPECT .................. S 9.28 $470.21 $275.04 $94.04
Nuclear Medicine.
*791..... Standard .................. S 15.83 $802.10 $562.06 $160.42
Therapeutic
Nuclear Medicine.
*792..... Complex .................. S 4.80 $243.21 $144.19 $48.64
Therapeutic
Nuclear Medicine.
861...... Immunology Tests.. .................. X 0.13 $6.59 $3.62 $1.32
881...... Level I Pathology. .................. X 0.20 $10.13 $6.78 $2.03
882...... Level II Pathology .................. X 0.39 $19.76 $11.75 $3.95
883...... Level III .................. X 0.65 $32.94 $20.34 $6.59
Pathology.
900...... Critical Care..... .................. V 7.44 $376.98 $144.87 $75.40
901...... Level I .................. X 0.07 $3.55 $2.49 $0.71
Immunization.
*902..... Level II .................. X 1.78 $90.19 $41.47 $18.04
Immunization.
*903..... Level III .................. X 1.16 $58.78 $25.65 $11.76
Immunization.
906...... Infusion Therapy .................. X 1.46 $73.98 $42.49 $14.80
except
Chemotherapy.
907...... Intramuscular .................. X 0.85 $43.07 $11.98 $8.61
Injections.
+91111... Low Level Clinic Well care and V 1.06 $53.71 $12.66 $10.74
Visits. administrative.
91118.... Low Level Clinic Skin and breast V 0.83 $42.06 $9.27 $8.41
Visits. diseases.
91124.... Low Level Clinic Musculoskeletal V 0.87 $44.08 $9.49 $8.82
Visits. diseases.
91131.... Low Level Clinic Ear, nose, mouth V 0.81 $41.04 $9.04 $8.21
Visits. and throat
diseases.
91133.... Low Level Clinic Respiratory system V 0.80 $40.54 $8.59 $8.11
Visits. diseases.
91136.... Low Level Clinic Cardiovascular V 0.85 $43.07 $8.61 $8.61
Visits. system diseases.
91141.... Low Level Clinic Digestive system V 0.98 $49.66 $10.40 $9.93
Visits. diseases.
91153.... Low Level Clinic Kidney, urinary V 0.91 $46.11 $9.27 $9.22
Visits. tract and male
genital diseases.
91156.... Low Level Clinic Female genital V 0.93 $47.12 $9.42 $9.42
Visits. system diseases.
*91157... Low Level Clinic Pregnancy and V 1.33 $67.39 $14.46 $13.48
Visits. neonatal care.
91163.... Low Level Clinic Nervous system V 0.98 $49.66 $10.17 $9.93
Visits. diseases.
*91168... Low Level Clinic Eye diseases...... V 0.98 $49.66 $10.62 $9.93
Visits.
*91172... Low Level Clinic Trauma and V 1.06 $53.71 $14.24 $10.74
Visits. poisoning.
*91178... Low Level Clinic Major signs, V 1.52 $77.02 $21.58 $15.40
Visits. symptoms and
findings.
91182.... Low Level Clinic Endocrine, V 0.87 $44.08 $9.04 $8.82
Visits. nutritional and
metabolic
diseases.
*91186... Low Level Clinic Immunologic and V 1.09 $55.23 $11.30 $11.05
Visits. hematologic
diseases.
91188.... Low Level Clinic Malignancy........ V 0.72 $36.48 $8.14 $7.30
Visits.
+91191... Low Level Clinic Psychiatric V 1.09 $55.23 $14.01 $11.05
Visits. disorders.
91197.... Low Level Clinic Infectious disease V 1.02 $51.68 $11.53 $10.34
Visits.
+91199... Low Level Clinic Unknown cause of V 1.31 $66.38 $20.79 $13.28
Visits. mortality.
+91311... Mid Level Clinic Well care and V 1.06 $53.71 $12.66 $10.74
Visits. administrative.
91318.... Mid Level Clinic Skin and breast V 0.98 $49.66 $9.93 $9.93
Visits. diseases.
91324.... Mid Level Clinic Musculoskeletal V 0.98 $49.66 $9.93 $9.93
Visits. diseases.
91331.... Mid Level Clinic Ear, nose, mouth V 0.94 $47.63 $9.53 $9.53
Visits. and throat
diseases.
91333.... Mid Level Clinic Respiratory system V 0.93 $47.12 $9.42 $9.42
Visits. diseases.
91336.... Mid Level Clinic Cardiovascular V 1.00 $50.67 $10.13 $10.13
Visits. system diseases.
91341.... Mid Level Clinic Digestive system V 1.00 $50.67 $10.13 $10.13
Visits. diseases.
91353.... Mid Level Clinic Kidney, urinary V 1.04 $52.70 $10.54 $10.54
Visits. tract and male
genital diseases.
[[Page 47619]]
91356.... Mid Level Clinic Female genital V 1.06 $53.71 $10.74 $10.74
Visits. system diseases.
*91357... Mid Level Clinic Pregnancy and V 1.22 $61.82 $12.66 $12.36
Visits. neonatal care.
91363.... Mid Level Clinic Nervous system V 1.04 $52.70 $10.54 $10.54
Visits. diseases.
*91368... Mid Level Clinic Eye diseases...... V 0.87 $44.08 $8.82 $8.82
Visits.
*91372... Mid Level Clinic Trauma and V 1.06 $53.71 $10.85 $10.74
Visits. poisoning.
*91378... Mid Level Clinic Major signs, V 1.13 $57.26 $11.45 $11.45
Visits. symptoms and
findings.
91382.... Mid Level Clinic Endocrine, V 1.00 $50.67 $10.13 $10.13
Visits. nutritional and
metabolic
diseases.
*91386... Mid Level Clinic Immunologic and V 1.04 $52.70 $10.54 $10.54
Visits. hematologic
diseases.
91388.... Mid Level Clinic Malignancy........ V 0.83 $42.06 $8.41 $8.41
Visits.
+91391... Mid Level Clinic Psychiatric V 1.09 $55.23 $14.01 $11.05
Visits. disorders.
91397.... Mid Level Clinic Infectious disease V 1.06 $53.71 $10.74 $10.74
Visits.
+91399... Mid Level Clinic Unknown cause of V 1.31 $66.38 $20.79 $13.28
Visits. mortality.
+91511... High Level Clinic Well care and V 1.06 $53.71 $12.66 $10.74
Visits. administrative.
91518.... High Level Clinic Skin and breast V 1.69 $85.63 $19.21 $17.13
Visits. diseases.
91524.... High Level Clinic Musculoskeletal V 1.37 $69.42 $15.37 $13.88
Visits. diseases.
91531.... High Level Clinic Ear, nose, mouth V 1.31 $66.38 $14.92 $13.28
Visits. and throat
diseases.
91533.... High Level Clinic Respiratory system V 1.33 $67.39 $13.79 $13.48
Visits. diseases.
91536.... High Level Clinic Cardiovascular V 1.43 $72.46 $15.37 $14.49
Visits. system diseases.
91541.... High Level Clinic Digestive system V 1.50 $76.00 $16.05 $15.20
Visits. diseases.
91553.... High Level Clinic Kidney, urinary V 1.30 $65.87 $14.01 $13.17
Visits. tract and male
genital diseases.
91556.... High Level Clinic Female genital V 1.43 $72.46 $14.49 $14.49
Visits. system diseases.
91557.... High Level Clinic Pregnancy and V 1.81 $91.71 $22.15 $18.34
Visits. neonatal care.
91563.... High Level Clinic Nervous system V 1.50 $76.00 $16.72 $15.20
Visits. diseases.
91568.... High Level Clinic Eye diseases...... V 1.31 $66.38 $13.79 $13.28
Visits.
91572.... High Level Clinic Trauma and V 1.69 $85.63 $22.15 $17.13
Visits. poisoning.
91578.... High Level Clinic Major signs, V 1.89 $95.77 $29.15 $19.15
Visits. symptoms and
findings.
91582.... High Level Clinic Endocrine, V 1.41 $71.44 $15.14 $14.29
Visits. nutritional and
metabolic
diseases.
91586.... High Level Clinic Immunologic and V 1.65 $83.60 $18.98 $16.72
Visits. hematologic
diseases.
91588.... High Level Clinic Malignancy........ V 1.09 $55.23 $12.43 $11.05
Visits.
91591.... High Level Clinic Psychiatric V 1.57 $79.55 $21.92 $15.91
Visits. disorders.
91597.... High Level Clinic Infectious disease V 1.76 $89.18 $19.66 $17.84
Visits.
+91599... High Level Clinic Unknown cause of V 1.31 $66.38 $20.79 $13.28
Visits. mortality.
919...... Electroconvulsive .................. S 3.17 $160.62 $80.00 $32.12
Therapy.
920...... Biofeedback and .................. S 1.17 $59.28 $29.61 $11.86
other Training.
*921..... Diabetes Education .................. S ......... ......... ........... ...........
926...... Dialysis for other .................. S 4.28 $216.87 $69.83 $43.37
than ESRD
patients.
928...... Alimentary Tests.. .................. X 3.11 $157.58 $83.85 $31.52
930...... Minor Eye .................. X 1.02 $51.68 $22.83 $10.34
Examinations.
931...... Level I Eye Tests. .................. X 0.74 $37.50 $21.47 $7.50
932...... Level II Eye Tests .................. X 2.52 $127.69 $65.09 $25.54
936...... Fitting of Vision .................. X 0.52 $26.35 $9.49 $5.27
Aids.
940...... Otorhinolaryngolog .................. X 3.04 $154.04 $51.98 $30.81
ic Function Tests.
941...... Level I Audiometry .................. X 0.74 $37.50 $13.56 $7.50
942...... Level II .................. X 1.48 $74.99 $22.15 $15.00
Audiometry.
947...... Resuscitation and .................. S 4.07 $206.22 $109.61 $41.24
Cardioversion.
948...... Cardiac .................. X 0.81 $41.04 $16.95 $8.21
Rehabilitation.
949...... Cardiovascular .................. X 1.46 $73.98 $62.83 $14.80
Stress Test.
950...... Electrocardiogram .................. X 0.35 $17.73 $15.82 $3.55
(ECG).
+95111... Low Level ER Well care and V 1.06 $53.71 $12.66 $10.74
Visits. administrative.
95118.... Low Level ER Skin and breast V 1.17 $59.28 $19.21 $11.86
Visits. diseases.
95124.... Low Level ER Musculoskeletal V 1.17 $59.28 $19.89 $11.86
Visits. diseases.
95131.... Low Level ER Ear, nose, mouth V 1.11 $56.24 $17.63 $11.25
Visits. and throat
diseases.
95133.... Low Level ER Respiratory system V 1.15 $58.27 $18.31 $11.65
Visits. diseases.
95136.... Low Level ER Cardiovascular V 1.24 $62.83 $19.89 $12.57
Visits. system diseases.
95141.... Low Level ER Digestive system V 1.30 $65.87 $21.02 $13.17
Visits. diseases.
95153.... Low Level ER Kidney, urinary V 1.43 $72.46 $24.41 $14.49
Visits. tract and male
genital diseases.
95156.... Low Level ER Female genital V 1.41 $71.44 $23.73 $14.29
Visits. system diseases.
95157.... Low Level ER Pregnancy and V 1.44 $72.96 $24.18 $14.59
Visits. neonatal care.
95163.... Low Level ER Nervous system V 1.31 $66.38 $22.83 $13.28
Visits. diseases.
95168.... Low Level ER Eye diseases...... V 1.20 $60.80 $20.79 $12.16
Visits.
95172.... Low Level ER Trauma and V 1.28 $64.86 $22.15 $12.97
Visits. poisoning.
95178.... Low Level ER Major signs, V 2.02 $102.35 $37.97 $20.47
Visits. symptoms and
findings.
95182.... Low Level ER Endocrine, V 1.50 $76.00 $24.63 $15.20
Visits. nutritional and
metabolic
diseases.
95186.... Low Level ER Immunologic and V 1.43 $72.46 $25.76 $14.49
Visits. hematologic
diseases.
95188.... Low Level ER Malignancy........ V 1.52 $77.02 $26.44 $15.40
Visits.
95191.... Low Level ER Psychiatric V 1.09 $55.23 $14.01 $11.05
Visits. Disorders.
95197.... Low Level ER Infectious disease V 1.24 $62.83 $20.57 $12.57
Visits.
+95199... Low Level ER Unknown cause of V 1.31 $66.38 $20.79 $13.28
Visits. mortality.
+95311... Mid Level ER Well care and V 1.06 $53.71 $12.66 $10.74
Visits. administrative.
95318.... Mid Level ER Skin and breast V 1.89 $95.77 $34.80 $19.15
Visits. diseases.
[[Page 47620]]
95324.... Mid Level ER Musculoskeletal V 1.78 $90.19 $32.32 $18.04
Visits. diseases.
95331.... Mid Level ER Ear, nose, mouth V 1.81 $91.71 $31.64 $18.34
Visits. and throat
diseases.
95333.... Mid Level ER Respiratory system V 1.91 $96.78 $33.67 $19.36
Visits. diseases.
95336.... Mid Level ER Cardiovascular V 2.02 $102.35 $36.16 $20.47
Visits. system diseases.
95341.... Mid Level ER Digestive system V 2.02 $102.35 $36.61 $20.47
Visits. diseases.
95353.... Mid Level ER Kidney, urinary V 2.06 $104.38 $38.19 $20.88
Visits. tract and male
genital diseases.
95356.... Mid Level ER Female genital V 2.04 $103.37 $36.61 $20.67
Visits. system diseases.
95357.... Mid Level ER Pregnancy and V 2.06 $104.38 $39.78 $20.88
Visits. neonatal care.
95363.... Mid Level ER Nervous system V 2.00 $101.34 $37.29 $20.27
Visits. diseases.
95368.... Mid Level ER Eye diseases...... V 1.69 $85.63 $33.00 $17.13
Visits.
95372.... Mid Level ER Trauma and V 2.02 $102.35 $38.87 $20.47
Visits. poisoning.
95378.... Mid Level ER Major signs, V 3.07 $155.56 $58.76 $31.11
Visits. symptoms and
findings.
95382.... Mid Level ER Endocrine, V 2.30 $116.54 $43.62 $23.31
Visits. nutritional and
metabolic
diseases.
95386.... Mid Level ER Immunologic and V 2.39 $121.10 $47.01 $24.22
Visits. hematologic
diseases.
95388.... Mid Level ER Malignancy........ V 2.15 $108.94 $41.13 $21.79
Visits.
95391.... Mid Level ER Psychiatric V 2.00 $101.34 $35.93 $20.27
Visits. Disorders.
95397.... Mid Level ER Infectious disease V 1.98 $100.33 $36.61 $20.07
Visits.
+95399... Mid Level ER Unknown cause of V 1.31 $66.38 $20.79 $13.28
Visits. mortality.
+95511... High Level ER Well care and V 1.06 $53.71 $12.66 $10.74
Visits. administrative.
95518.... High Level ER Skin and breast V 2.61 $132.25 $46.56 $26.45
Visits. diseases.
95524.... High Level ER Musculoskeletal V 2.44 $123.63 $41.36 $24.73
Visits. diseases.
95531.... High Level ER Ear, nose, mouth V 2.56 $129.71 $44.07 $25.94
Visits. and throat
diseases.
95533.... High Level ER Respiratory system V 3.19 $161.64 $54.69 $32.33
Visits. diseases.
95536.... High Level ER Cardiovascular V 3.17 $160.62 $54.69 $32.12
Visits. system diseases.
95541.... High Level ER Digestive system V 2.89 $146.43 $54.69 $29.29
Visits. diseases.
95553.... High Level ER Kidney, urinary V 2.89 $146.43 $54.69 $29.29
Visits. tract and male
genital diseases.
95556.... High Level ER Female genital V 2.73 $138.33 $50.85 $27.67
Visits. system diseases.
95557.... High Level ER Pregnancy and V 2.93 $148.46 $54.92 $29.69
Visits. neonatal care.
95563.... High Level ER Nervous system V 3.04 $154.04 $58.08 $30.81
Visits. diseases.
95568.... High Level ER Eye diseases...... V 2.31 $117.05 $40.00 $23.41
Visits.
95572.... High Level ER Trauma and V 2.74 $138.83 $50.17 $27.77
Visits. poisoning.
95578.... High Level ER Major signs, V 6.85 $347.09 $148.48 $69.42
Visits. symptoms and
findings.
95582.... High Level ER Endocrine, V 3.28 $166.20 $64.64 $33.24
Visits. nutritional and
metabolic
diseases.
95586.... High Level ER Immunologic and V 3.70 $187.48 $74.35 $37.50
Visits. hematologic
diseases.
95588.... High Level ER Malignancy........ V 3.67 $185.96 $61.70 $37.19
Visits.
95591.... High Level ER Psychiatric V 3.48 $176.33 $62.38 $35.27
Visits. Disorders.
95597.... High Level ER Infectious disease V 2.81 $142.38 $53.34 $28.48
Visits.
+95599... High Level ER Unknown cause of V 1.31 $66.38 $20.79 $13.28
Visits. mortality.
956...... Continuous ECG and .................. X 1.11 $56.24 $55.82 $11.25
Blood Pressure
Monitoring.
957...... Echocardiography.. .................. S 2.83 $143.39 $117.07 $28.68
958...... Diagnostic Cardiac .................. T 26.11 $1,322.98 $659.47 $264.60
Catheterization.
960...... Cardiac .................. S 4.24 $214.84 $144.41 $42.97
Electrophysiologi
c Tests/
Procedures.
966...... Electronic .................. X 0.39 $19.76 $12.43 $3.95
Analysis of
Pacemakers/other
Devices.
967...... Non-Invasive .................. X 1.70 $86.14 $57.40 $17.23
Vascular Studies.
968...... Vascular .................. X 2.37 $120.09 $79.55 $24.02
Ultrasound.
969...... Hyperbaric Oxygen. .................. S 2.65 $134.27 $141.70 $26.85
971...... Level I Pulmonary .................. X 0.78 $39.52 $21.47 $7.90
Tests.
972...... Level II Pulmonary .................. X 1.02 $51.68 $29.38 $10.34
Tests.
973...... Level III .................. S 1.89 $95.77 $55.82 $19.15
Pulmonary Tests.
976...... Pulmonary Therapy. .................. S 0.44 $22.29 $14.92 $4.46
977...... Allergy Tests..... .................. X 0.63 $31.92 $12.66 $6.38
978...... Allergy Injections .................. X 0.31 $15.71 $3.39 $3.14
979...... Extended EEG .................. S 10.17 $515.31 $288.83 $103.06
Studies and Sleep
Studies.
980...... Electroencephalogr .................. S 2.15 $108.94 $57.86 $21.79
am.
*981..... Level I Nerve and .................. X 1.46 $73.98 $41.81 $14.80
Muscle Tests.
*982..... Level II Nerve and .................. X 1.39 $70.43 $38.87 $14.09
Muscle Tests.
987...... Subcutaneous or .................. S 0.65 $32.94 $13.33 $6.59
Intramuscular
Chemotherapy.
988...... Chemotherapy .................. S 4.15 $210.28 $97.52 $42.06
except by
Extended Infusion.
989...... Chemotherapy by .................. S 1.72 $87.15 $40.68 $17.43
Extended Infusion.
990...... Photochemotherapy. .................. S 0.43 $21.79 $8.14 $4.36
997...... Manipulation .................. S 0.69 $34.96 $7.23 $6.99
Therapy.
999...... Therapeutic .................. X 0.43 $21.79 $10.85 $4.36
Phlebotomy.
----------------------------------------------------------------------------------------------------------------
[[Page 47621]]
Addendum B.--Proposed Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information
----------------------------------------------------------------------------------------------------------------
Proposed National Minimum
CPT \1\/ HOPD status Description Proposed Relative payment unadjusted unadjusted
HCPCS indicator APC weight rate coinsurance coinsurance
---\2\----------------------------------------------------------------------------------------------------------
00100... N Anesth, skin surgery... ......... ......... ......... ........... ...........
00102... N Anesth, repair of cleft ......... ......... ......... ........... ...........
lip.
00103... N Anesth, blepharoplasty. ......... ......... ......... ........... ...........
00104... N Anesth for electroshock ......... ......... ......... ........... ...........
00120... N Anesthesia for ear ......... ......... ......... ........... ...........
surgery.
00124... N Anesthesia for ear exam ......... ......... ......... ........... ...........
00126... N Anesth, tympanotomy.... ......... ......... ......... ........... ...........
00140... N Anesth, procedures on ......... ......... ......... ........... ...........
eye.
00142... N Anesthesia for lens ......... ......... ......... ........... ...........
surgery.
00144... N Anesth, corneal ......... ......... ......... ........... ...........
transplant.
00145... N Anesth, vitrectomy..... ......... ......... ......... ........... ...........
00147... N Anesth, iridectomy..... ......... ......... ......... ........... ...........
00148... N Anesthesia for eye exam ......... ......... ......... ........... ...........
00160... N Anesth, nose, sinus ......... ......... ......... ........... ...........
surgery.
00162... N Anesth, nose, sinus ......... ......... ......... ........... ...........
surgery.
00164... N Anesth, biopsy of nose. ......... ......... ......... ........... ...........
00170... N Anesth, procedure on ......... ......... ......... ........... ...........
mouth.
00172... N Anesth, cleft palate ......... ......... ......... ........... ...........
repair.
00174... C Anesth, pharyngeal ......... ......... ......... ........... ...........
surgery.
00176... C Anesth, pharyngeal ......... ......... ......... ........... ...........
surgery.
00190... N Anesth, facial bone ......... ......... ......... ........... ...........
surgery.
00192... C Anesth, facial bone ......... ......... ......... ........... ...........
surgery.
00210... N Anesth, open head ......... ......... ......... ........... ...........
surgery.
00212... N Anesth, skull drainage. ......... ......... ......... ........... ...........
00214... C Anesth, skull drainage. ......... ......... ......... ........... ...........
00215... C Anesth, skull fracture. ......... ......... ......... ........... ...........
00216... N Anesth, head vessel ......... ......... ......... ........... ...........
surgery.
00218... N Anesth, special head ......... ......... ......... ........... ...........
surgery.
00220... N Anesth, spinal fluid ......... ......... ......... ........... ...........
shunt.
00222... N Anesth, head nerve ......... ......... ......... ........... ...........
surgery.
00300... N Anesth, skin surgery, ......... ......... ......... ........... ...........
neck.
00320... N Anesth, neck organ ......... ......... ......... ........... ...........
surgery.
00322... N Anesth, biopsy of ......... ......... ......... ........... ...........
thyroid.
00350... N Anesth, neck vessel ......... ......... ......... ........... ...........
surgery.
00352... N Anesth, neck vessel ......... ......... ......... ........... ...........
surgery.
00400... N Anesth, chest skin ......... ......... ......... ........... ...........
surgery.
00402... N Anesth, surgery of ......... ......... ......... ........... ...........
breast.
00404... C Anesth, surgery of ......... ......... ......... ........... ...........
breast.
00406... C Anesth, surgery of ......... ......... ......... ........... ...........
breast.
00410... N Anesth, correct heart ......... ......... ......... ........... ...........
rhythm.
00420... N Anesth, skin surgery, ......... ......... ......... ........... ...........
back.
00450... N Anesth, surgery of ......... ......... ......... ........... ...........
shoulder.
00452... C Anesth, surgery of ......... ......... ......... ........... ...........
shoulder.
00454... N Anesth, collarbone ......... ......... ......... ........... ...........
biopsy.
00470... N Anesth, removal of rib. ......... ......... ......... ........... ...........
00472... N Anesth, chest wall ......... ......... ......... ........... ...........
repair.
00474... C Anesth, surgery of ......... ......... ......... ........... ...........
rib(s).
00500... N Anesth, esophageal ......... ......... ......... ........... ...........
surgery.
00520... N Anesth, chest procedure ......... ......... ......... ........... ...........
00522... N Anesth, chest lining ......... ......... ......... ........... ...........
biopsy.
00524... C Anesth, chest drainage. ......... ......... ......... ........... ...........
00528... N Anesth, chest partition ......... ......... ......... ........... ...........
view.
00530... C Anesth, pacemaker ......... ......... ......... ........... ...........
insertion.
00532... N Anesth, vascular access ......... ......... ......... ........... ...........
00534... N Anesth, cardioverter/ ......... ......... ......... ........... ...........
defib.
00540... C Anesth, chest surgery.. ......... ......... ......... ........... ...........
00542... C Anesth, release of lung ......... ......... ......... ........... ...........
00544... C Anesth, chest lining ......... ......... ......... ........... ...........
removal.
00546... C Anesth, lung,chest wall ......... ......... ......... ........... ...........
surg.
00548... N Anesth, trachea,bronchi ......... ......... ......... ........... ...........
surg.
00560... C Anesth, open heart ......... ......... ......... ........... ...........
surgery.
00562... C Anesth, open heart ......... ......... ......... ........... ...........
surgery.
00580... C Anesth,heart/lung ......... ......... ......... ........... ...........
transplant.
00600... N Anesth, spine, cord ......... ......... ......... ........... ...........
surgery.
00604... C Anesth, surgery of ......... ......... ......... ........... ...........
vertebra.
00620... N Anesth, spine, cord ......... ......... ......... ........... ...........
surgery.
00622... C Anesth, removal of ......... ......... ......... ........... ...........
nerves.
00630... N Anesth, spine, cord ......... ......... ......... ........... ...........
surgery.
00632... C Anesth, removal of ......... ......... ......... ........... ...........
nerves.
00634... C Anesth for ......... ......... ......... ........... ...........
chemonucleolysis.
00670... C Anesth, spine, cord ......... ......... ......... ........... ...........
surgery.
00700... N Anesth, abdominal wall ......... ......... ......... ........... ...........
surg.
00702... N Anesth, for liver ......... ......... ......... ........... ...........
biopsy.
00730... N Anesth, abdominal wall ......... ......... ......... ........... ...........
surg.
00740... N Anesth, gi ......... ......... ......... ........... ...........
visualization.
[[Page 47622]]
00750... N Anesth, repair of ......... ......... ......... ........... ...........
hernia.
00752... N Anesth, repair of ......... ......... ......... ........... ...........
hernia.
00754... N Anesth, repair of ......... ......... ......... ........... ...........
hernia.
00756... N Anesth, repair of ......... ......... ......... ........... ...........
hernia.
00770... N Anesth, blood vessel ......... ......... ......... ........... ...........
repair.
00790... N Anesth, surg upper ......... ......... ......... ........... ...........
abdomen.
00792... C Anesth, part liver ......... ......... ......... ........... ...........
removal.
00794... C Anesth, pancreas ......... ......... ......... ........... ...........
removal.
00796... C Anesth, for liver ......... ......... ......... ........... ...........
transplant.
00800... N Anesth, abdominal wall ......... ......... ......... ........... ...........
surg.
00802... C Anesth, fat layer ......... ......... ......... ........... ...........
removal.
00810... N Anesth, intestine ......... ......... ......... ........... ...........
endoscopy.
00820... N Anesth, abdominal wall ......... ......... ......... ........... ...........
surg.
00830... N Anesth, repair of ......... ......... ......... ........... ...........
hernia.
00832... N Anesth, repair of ......... ......... ......... ........... ...........
hernia.
00840... N Anesth, surg lower ......... ......... ......... ........... ...........
abdomen.
00842... N Anesth, amniocentesis.. ......... ......... ......... ........... ...........
00844... C Anesth, pelvis surgery. ......... ......... ......... ........... ...........
00846... C Anesth, hysterectomy... ......... ......... ......... ........... ...........
00848... C Anesth, pelvic organ ......... ......... ......... ........... ...........
surg.
00850... C Anesth, cesarean ......... ......... ......... ........... ...........
section.
00855... C Anesth, hysterectomy... ......... ......... ......... ........... ...........
00857... C Analgesia, labor & c- ......... ......... ......... ........... ...........
section.
00860... N Anesth, surgery of ......... ......... ......... ........... ...........
abdomen.
00862... N Anesth, kidney, ureter ......... ......... ......... ........... ...........
surg.
00864... C Anesth, removal of ......... ......... ......... ........... ...........
bladder.
00865... C Anesth, removal of ......... ......... ......... ........... ...........
prostate.
00866... C Anesth, removal of ......... ......... ......... ........... ...........
adrenal.
00868... C Anesth, kidney ......... ......... ......... ........... ...........
transplant.
00870... N Anesth, bladder stone ......... ......... ......... ........... ...........
surg.
00872... N Anesth,kidney stone ......... ......... ......... ........... ...........
destruct.
00873... N Anesth,kidney stone ......... ......... ......... ........... ...........
destruct.
00880... N Anesth, abdomen vessel ......... ......... ......... ........... ...........
surg.
00882... C Anesth, major vein ......... ......... ......... ........... ...........
ligation.
00884... C Anesth, major vein ......... ......... ......... ........... ...........
revision.
00900... N Anesth, perineal ......... ......... ......... ........... ...........
procedure.
00902... N Anesth, anorectal ......... ......... ......... ........... ...........
surgery.
00904... C Anesth, perineal ......... ......... ......... ........... ...........
surgery.
00906... N Anesth, removal of ......... ......... ......... ........... ...........
vulva.
00908... C Anesth, removal of ......... ......... ......... ........... ...........
prostate.
00910... N Anesth, bladder surgery ......... ......... ......... ........... ...........
00912... N Anesth, bladder tumor ......... ......... ......... ........... ...........
surg.
00914... N Anesth, removal of ......... ......... ......... ........... ...........
prostate.
00916... N Anesth, bleeding ......... ......... ......... ........... ...........
control.
00918... N Anesth, stone removal.. ......... ......... ......... ........... ...........
00920... N Anesth, genitalia ......... ......... ......... ........... ...........
surgery.
00922... N Anesth, sperm duct ......... ......... ......... ........... ...........
surgery.
00924... N Anesth, testis ......... ......... ......... ........... ...........
exploration.
00926... N Anesth, removal of ......... ......... ......... ........... ...........
testis.
00928... C Anesth, removal of ......... ......... ......... ........... ...........
testis.
00930... N Anesth, testis ......... ......... ......... ........... ...........
suspension.
00932... C Anesth, amputation of ......... ......... ......... ........... ...........
penis.
00934... C Anesth, penis, nodes ......... ......... ......... ........... ...........
removal.
00936... C Anesth, penis, nodes ......... ......... ......... ........... ...........
removal.
00938... N Anesth, insert penis ......... ......... ......... ........... ...........
device.
00940... N Anesth, vaginal ......... ......... ......... ........... ...........
procedures.
00942... N Anesth, surgery on ......... ......... ......... ........... ...........
vagina.
00944... C Anesth, vaginal ......... ......... ......... ........... ...........
hysterectomy.
00946... N Anesth, vaginal ......... ......... ......... ........... ...........
delivery.
00948... N Anesth, repair of ......... ......... ......... ........... ...........
cervix.
00950... N Anesth, vaginal ......... ......... ......... ........... ...........
endoscopy.
00952... N Anesth, uterine ......... ......... ......... ........... ...........
endoscopy.
00955... C Analgesia, vaginal ......... ......... ......... ........... ...........
delivery.
01000... N Anesth, skin surgery, ......... ......... ......... ........... ...........
pelvis.
01110... N Anesth, skin surgery, ......... ......... ......... ........... ...........
pelvis.
01120... N Anesth, pelvis surgery. ......... ......... ......... ........... ...........
01130... N Anesth, body cast ......... ......... ......... ........... ...........
procedure.
01140... C Anesth, amputation at ......... ......... ......... ........... ...........
pelvis.
01150... C Anesth, pelvic tumor ......... ......... ......... ........... ...........
surgery.
01160... N Anesth, pelvis ......... ......... ......... ........... ...........
procedure.
01170... N Anesth, pelvis surgery. ......... ......... ......... ........... ...........
01180... N Anesth, pelvis nerve ......... ......... ......... ........... ...........
removal.
01190... C Anesth, pelvis nerve ......... ......... ......... ........... ...........
removal.
01200... N Anesth, hip joint ......... ......... ......... ........... ...........
procedure.
01202... N Anesth, arthroscopy of ......... ......... ......... ........... ...........
hip.
[[Page 47623]]
01210... N Anesth, hip joint ......... ......... ......... ........... ...........
surgery.
01212... C Anesth, hip ......... ......... ......... ........... ...........
disarticulation.
01214... C Anesth, replacement of ......... ......... ......... ........... ...........
hip.
01220... N Anesth, procedure on ......... ......... ......... ........... ...........
femur.
01230... N Anesth, surgery of ......... ......... ......... ........... ...........
femur.
01232... C Anesth, amputation of ......... ......... ......... ........... ...........
femur.
01234... C Anesth, radical femur ......... ......... ......... ........... ...........
surg.
01240... N Anesth, upper leg skin ......... ......... ......... ........... ...........
surg.
01250... N Anesth, upper leg ......... ......... ......... ........... ...........
surgery.
01260... N Anesth, upper leg veins ......... ......... ......... ........... ...........
surg.
01270... N Anesth, thigh arteries ......... ......... ......... ........... ...........
surg.
01272... C Anesth, femoral artery ......... ......... ......... ........... ...........
surg.
01274... C Anesth, femoral ......... ......... ......... ........... ...........
embolectomy.
01300... N Anesth, skin surgery, ......... ......... ......... ........... ...........
knee.
01320... N Anesth, knee area ......... ......... ......... ........... ...........
surgery.
01340... N Anesth, knee area ......... ......... ......... ........... ...........
procedure.
01360... N Anesth, knee area ......... ......... ......... ........... ...........
surgery.
01380... N Anesth, knee joint ......... ......... ......... ........... ...........
procedure.
01382... N Anesth, knee ......... ......... ......... ........... ...........
arthroscopy.
01390... N Anesth, knee area ......... ......... ......... ........... ...........
procedure.
01392... N Anesth, knee area ......... ......... ......... ........... ...........
surgery.
01400... N Anesth, knee joint ......... ......... ......... ........... ...........
surgery.
01402... C Anesth, replacement of ......... ......... ......... ........... ...........
knee.
01404... C Anesth, amputation at ......... ......... ......... ........... ...........
knee.
01420... N Anesth, knee joint ......... ......... ......... ........... ...........
casting.
01430... N Anesth, knee veins ......... ......... ......... ........... ...........
surgery.
01432... N Anesth, knee vessel ......... ......... ......... ........... ...........
surg.
01440... N Anesth, knee arteries ......... ......... ......... ........... ...........
surg.
01442... C Anesth, knee artery ......... ......... ......... ........... ...........
surg.
01444... C Anesth, knee artery ......... ......... ......... ........... ...........
repair.
01460... N Anesth, lower leg skin ......... ......... ......... ........... ...........
surg.
01462... N Anesth, lower leg ......... ......... ......... ........... ...........
procedure.
01464... N Anesth, ankle ......... ......... ......... ........... ...........
arthroscopy.
01470... N Anesth, lower leg ......... ......... ......... ........... ...........
surgery.
01472... N Anesth, achilles tendon ......... ......... ......... ........... ...........
surg.
01474... N Anesth, lower leg ......... ......... ......... ........... ...........
surgery.
01480... N Anesth, lower leg bone ......... ......... ......... ........... ...........
surg.
01482... N Anesth, radical leg ......... ......... ......... ........... ...........
surgery.
01484... N Anesth, lower leg ......... ......... ......... ........... ...........
revision.
01486... C Anesth, ankle ......... ......... ......... ........... ...........
replacement.
01490... N Anesth, lower leg ......... ......... ......... ........... ...........
casting.
01500... N Anesth, leg arteries ......... ......... ......... ........... ...........
surg.
01502... C Anesth, lowerleg ......... ......... ......... ........... ...........
embolectomy.
01520... N Anesth, lower leg vein ......... ......... ......... ........... ...........
surg.
01522... N Anesth, lower leg vein ......... ......... ......... ........... ...........
surg.
01600... N Anesth, shoulder skin ......... ......... ......... ........... ...........
surg.
01610... N Anesth, surgery of ......... ......... ......... ........... ...........
shoulder.
01620... N Anesth, shoulder ......... ......... ......... ........... ...........
procedure.
01622... N Anesth, shoulder ......... ......... ......... ........... ...........
arthroscopy.
01630... N Anesth, surgery of ......... ......... ......... ........... ...........
shoulder.
01632... C Anesth, surgery of ......... ......... ......... ........... ...........
shoulder.
01634... C Anesth, shoulder joint ......... ......... ......... ........... ...........
amput.
01636... C Anesth, forequarter ......... ......... ......... ........... ...........
amput.
01638... C Anesth, shoulder ......... ......... ......... ........... ...........
replacement.
01650... N Anesth, shoulder artery ......... ......... ......... ........... ...........
surg.
01652... C Anesth, shoulder vessel ......... ......... ......... ........... ...........
surg.
01654... C Anesth, shoulder vessel ......... ......... ......... ........... ...........
surg.
01656... C Anesth, arm-leg vessel ......... ......... ......... ........... ...........
surg.
01670... N Anesth, shoulder vein ......... ......... ......... ........... ...........
surg.
01680... N Anesth, shoulder ......... ......... ......... ........... ...........
casting.
01682... N Anesth, airplane cast.. ......... ......... ......... ........... ...........
01700... N Anesth, elbow area skin ......... ......... ......... ........... ...........
surg.
01710... N Anesth, elbow area ......... ......... ......... ........... ...........
surgery.
01712... N Anesth, upperarm tendon ......... ......... ......... ........... ...........
surg.
01714... N Anesth, upperarm tendon ......... ......... ......... ........... ...........
surg.
01716... N Anesth, biceps tendon ......... ......... ......... ........... ...........
repair.
01730... N Anesth, upperarm ......... ......... ......... ........... ...........
procedure.
01732... N Anesth, elbow ......... ......... ......... ........... ...........
arthroscopy.
01740... N Anesth, upper arm ......... ......... ......... ........... ...........
surgery.
01742... N Anesth, humerus surgery ......... ......... ......... ........... ...........
01744... N Anesth, humerus repair. ......... ......... ......... ........... ...........
01756... C Anesth, radical humerus ......... ......... ......... ........... ...........
surg.
01758... N Anesth, humeral lesion ......... ......... ......... ........... ...........
surg.
01760... N Anesth, elbow ......... ......... ......... ........... ...........
replacement.
01770... N Anesth, upperarm artery ......... ......... ......... ........... ...........
surg.
[[Page 47624]]
01772... C Anesth, upperarm ......... ......... ......... ........... ...........
embolectomy.
01780... N Anesth, upper arm vein ......... ......... ......... ........... ...........
surg.
01782... C Anesth, upperarm vein ......... ......... ......... ........... ...........
repair.
01784... N Anesth, av fistula ......... ......... ......... ........... ...........
repair.
01800... N Anesth, lower arm skin ......... ......... ......... ........... ...........
surg.
01810... N Anesth, lower arm ......... ......... ......... ........... ...........
surgery.
01820... N Anesth, lower arm ......... ......... ......... ........... ...........
procedure.
01830... N Anesth, lower arm ......... ......... ......... ........... ...........
surgery.
01832... N Anesth, wrist ......... ......... ......... ........... ...........
replacement.
01840... N Anesth, lowerarm artery ......... ......... ......... ........... ...........
surg.
01842... C Anesth, lowerarm ......... ......... ......... ........... ...........
embolectomy.
01844... N Anesth, vascular shunt ......... ......... ......... ........... ...........
surg.
01850... N Anesth, lower arm vein ......... ......... ......... ........... ...........
surg.
01852... C Anesth, lowerarm vein ......... ......... ......... ........... ...........
repair.
01860... N Anesth, lower arm ......... ......... ......... ........... ...........
casting.
01900... N Anesth, uterus/tube ......... ......... ......... ........... ...........
inject.
01902... C Anesth, burr holes, ......... ......... ......... ........... ...........
skull.
01904... C Anesth, skull x-ray ......... ......... ......... ........... ...........
inject.
01906... N Anesth, lumbar ......... ......... ......... ........... ...........
myelography.
01908... N Anesth, cervical ......... ......... ......... ........... ...........
myelography.
01910... N Anesth, skull ......... ......... ......... ........... ...........
myelography.
01912... N Anesth, lumbar ......... ......... ......... ........... ...........
discography.
01914... N Anesth, cervical ......... ......... ......... ........... ...........
discography.
01916... C Anesth, head ......... ......... ......... ........... ...........
arteriogram.
01918... C Anesth, limb ......... ......... ......... ........... ...........
arteriogram.
01920... N Anesth, catheterize ......... ......... ......... ........... ...........
heart.
01921... C Anesth, vessel surgery. ......... ......... ......... ........... ...........
01922... N Anesth, cat or MRI scan ......... ......... ......... ........... ...........
01990... C Support for organ donor ......... ......... ......... ........... ...........
01995... N Regional anesthesia, ......... ......... ......... ........... ...........
limb.
01996... N Manage daily drug ......... ......... ......... ........... ...........
therapy.
01999... N Unlisted anesth ......... ......... ......... ........... ...........
procedure.
10040... T Acne surgery of skin 131 1.94 $102.84 $36.61 $20.57
abscess.
10060... T Drainage of skin 131 1.94 $102.84 $36.61 $20.57
abscess.
10061... T Drainage of skin 131 1.94 $102.84 $36.61 $20.57
abscess.
10080... T Drainage of pilonidal 131 1.94 $102.84 $36.61 $20.57
cyst.
10081... T Drainage of pilonidal 131 1.94 $102.84 $36.61 $20.57
cyst.
10120... T Remove foreign body.... 131 1.94 $102.84 $36.61 $20.57
10121... T Remove foreign body.... 163 10.69 $565.14 $264.65 $113.03
10140... T Drainage of hematoma/ 131 1.94 $102.84 $36.61 $20.57
fluid.
10160... T Puncture drainage of 131 1.94 $102.84 $36.61 $20.57
lesion.
10180... T Complex drainage, wound 131 1.94 $102.84 $36.61 $20.57
11000... T Debride infected skin.. 151 1.74 $92.07 $35.71 $18.41
11001... T Debride infect skin add 151 1.74 $92.07 $35.71 $18.41
11010... T Debride skin, fx....... 163 10.69 $565.14 $264.65 $113.03
11011... T Debride skin/muscle, fx 163 10.69 $565.14 $264.65 $113.03
11012... T Debride skin/muscle/ 163 10.69 $565.14 $264.65 $113.03
bone, fx.
11040... T Debride skin partial... 151 1.74 $92.07 $35.71 $18.41
11041... T Debride skin full...... 151 1.74 $92.07 $35.71 $18.41
11042... T Debride skin/tissue.... 151 1.74 $92.07 $35.71 $18.41
11043... T Debride tissue/muscle.. 162 5.67 $299.71 $125.43 $59.94
11044... T Debride tissue/muscle/ 162 5.67 $299.71 $125.43 $59.94
bone.
11055... T Trim skin lesion....... 151 1.74 $92.07 $35.71 $18.41
11056... T Trim 2 to 4 skin 151 1.74 $92.07 $35.71 $18.41
lesions.
11057... T Trim over 4 skin 151 1.74 $92.07 $35.71 $18.41
lesions.
11100... T Biopsy of skin lesion.. 161 3.50 $185.12 $75.48 $37.02
11101... T Biopsy, each added 161 3.50 $185.12 $75.48 $37.02
lesion.
11200... T Removal of skin tags... 151 1.74 $92.07 $35.71 $18.41
11201... T Removal of added skin 151 1.74 $92.07 $35.71 $18.41
tags.
11300... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11301... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11302... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11303... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11305... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11306... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11307... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11308... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11310... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11311... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11312... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11313... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41
11400... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11401... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11402... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11403... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
[[Page 47625]]
11404... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94
11406... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11420... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11421... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11422... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11423... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11424... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94
11426... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11440... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11441... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11442... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11443... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11444... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94
11446... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11450... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03
lesion.
11451... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03
lesion.
11462... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03
lesion.
11463... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03
lesion.
11470... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03
lesion.
11471... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03
lesion.
11600... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11601... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11602... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11603... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11604... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94
11606... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11620... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11621... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11622... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11623... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11624... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11626... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11640... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11641... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11642... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11643... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02
11644... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11646... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03
11719... T Trim nail(s)........... 137 0.46 $24.49 $4.90 $4.90
11720... T Debride nail, 1-5...... 137 0.46 $24.49 $4.90 $4.90
11721... T Debride nail, 6 or more 137 0.46 $24.49 $4.90 $4.90
11730... T Removal of nail plate.. 151 1.74 $92.07 $35.71 $18.41
11731... T Removal of second nail 151 1.74 $92.07 $35.71 $18.41
plate.
11732... T Remove additional nail 151 1.74 $92.07 $35.71 $18.41
plate.
11740... T Drain blood from under 137 0.46 $24.49 $4.90 $4.90
nail.
11750... T Removal of nail bed.... 161 3.50 $185.12 $75.48 $37.02
11752... T Remove nail bed/finger 163 10.69 $565.14 $264.65 $113.03
tip.
11755... T Biopsy, nail unit...... 137 0.46 $24.49 $4.90 $4.90
11760... T Reconstruction of nail 181 2.19 $115.58 $43.84 $23.12
bed.
11762... T Reconstruction of nail 181 2.19 $115.58 $43.84 $23.12
bed.
11765... T Excision of nail fold, 151 1.74 $92.07 $35.71 $18.41
toe.
11770... T Removal of pilonidal 162 5.67 $299.71 $125.43 $59.94
lesion.
11771... T Removal of pilonidal 163 10.69 $565.14 $264.65 $113.03
lesion.
11772... T Removal of pilonidal 163 10.69 $565.14 $264.65 $113.03
lesion.
11900... T Injection into skin 151 1.74 $92.07 $35.71 $18.41
lesions.
11901... T Added skin lesions 151 1.74 $92.07 $35.71 $18.41
injection.
11920... T Correct skin color 181 2.19 $115.58 $43.84 $23.12
defects.
11921... T Correct skin color 181 2.19 $115.58 $43.84 $23.12
defects.
11922... T Correct skin color 181 2.19 $115.58 $43.84 $23.12
defects.
11950... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12
defects.
11951... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12
defects.
11952... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12
defects.
11954... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12
defects.
11960... T Insert tissue 183 11.17 $590.61 $286.57 $118.12
expander(s).
11970... T Replace tissue expander 183 11.17 $590.61 $286.57 $118.12
11971... T Remove tissue 163 10.69 $565.14 $264.65 $113.03
expander(s).
11975... E Insert contraceptive ......... ......... ......... ........... ...........
cap.
11976... T Removal of 131 1.94 $102.84 $36.61 $20.57
contraceptive cap.
11977... E Removal/reinsert contra ......... ......... ......... ........... ...........
cap.
12001... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12002... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12004... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12005... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12006... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12007... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
[[Page 47626]]
12011... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12013... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12014... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12015... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12016... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12017... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12018... T Repair superficial 181 2.19 $115.58 $43.84 $23.12
wound(s).
12020... T Closure of split wound. 181 2.19 $115.58 $43.84 $23.12
12021... T Closure of split wound. 181 2.19 $115.58 $43.84 $23.12
12031... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12032... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12034... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12035... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12036... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12037... T Layer closure of 183 11.17 $590.61 $286.57 $118.12
wound(s).
12041... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12042... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12044... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12045... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12046... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12047... T Layer closure of 183 11.17 $590.61 $286.57 $118.12
wound(s).
12051... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12052... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12053... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12054... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12055... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12056... T Layer closure of 181 2.19 $115.58 $43.84 $23.12
wound(s).
12057... T Layer closure of 183 11.17 $590.61 $286.57 $118.12
wound(s).
13100... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13101... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13120... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13121... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13131... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13132... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13150... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13151... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13152... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
13160... T Late closure of wound.. 182 4.00 $211.56 $84.98 $42.31
13300... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31
lesion.
14000... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14001... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14020... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14021... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14040... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14041... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14060... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14061... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14300... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
14350... T Skin tissue 183 11.17 $590.61 $286.57 $118.12
rearrangement.
15000... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12
15050... T Skin pinch graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15100... T Skin split graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15101... T Skin split graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15120... T Skin split graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15121... T Skin split graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15200... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15201... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15220... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15221... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15240... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15241... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15260... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15261... T Skin full graft 183 11.17 $590.61 $286.57 $118.12
procedure.
15350... T Skin homograft 183 11.17 $590.61 $286.57 $118.12
procedure.
15400... T Skin heterograft 183 11.17 $590.61 $286.57 $118.12
procedure.
15570... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12
15572... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12
15574... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12
15576... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12
15580... T Attach skin pedicle 183 11.17 $590.61 $286.57 $118.12
graft.
15600... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12
15610... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12
15620... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12
15625... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12
15630... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12
[[Page 47627]]
15650... T Transfer skin pedicle 183 11.17 $590.61 $286.57 $118.12
flap.
15732... T Muscle-skin graft, head/ 184 15.17 $802.17 $396.40 $160.43
neck.
15734... T Muscle-skin graft, 184 15.17 $802.17 $396.40 $160.43
trunk.
15736... T Muscle-skin graft, arm. 184 15.17 $802.17 $396.40 $160.43
15738... T Muscle-skin graft, leg. 184 15.17 $802.17 $396.40 $160.43
15740... T Island pedicle flap 184 15.17 $802.17 $396.40 $160.43
graft.
15750... T Neurovascular pedicle 184 15.17 $802.17 $396.40 $160.43
graft.
15756... C Free muscle flap, ......... ......... ......... ........... ...........
microvasc.
15757... C Free skin flap, ......... ......... ......... ........... ...........
microvasc.
15758... C Free fascial flap, ......... ......... ......... ........... ...........
microvasc.
15760... T Composite skin graft... 184 15.17 $802.17 $396.40 $160.43
15770... T Derma-fat-fascia graft. 184 15.17 $802.17 $396.40 $160.43
15775... T Hair transplant punch 183 11.17 $590.61 $286.57 $118.12
grafts.
15776... T Hair transplant punch 183 11.17 $590.61 $286.57 $118.12
grafts.
15780... T Abrasion treatment of 163 10.69 $565.14 $264.65 $113.03
skin.
15781... T Abrasion treatment of 163 10.69 $565.14 $264.65 $113.03
skin.
15782... T Abrasion treatment of 163 10.69 $565.14 $264.65 $113.03
skin.
15783... T Abrasion treatment of 151 1.74 $92.07 $35.71 $18.41
skin.
15786... T Abrasion treatment of 151 1.74 $92.07 $35.71 $18.41
lesion.
15787... T Abrasion, added skin 151 1.74 $92.07 $35.71 $18.41
lesions.
15788... T Chemical peel, face, 151 1.74 $92.07 $35.71 $18.41
epiderm.
15789... T Chemical peel, face, 151 1.74 $92.07 $35.71 $18.41
dermal.
15792... T Chemical peel, 151 1.74 $92.07 $35.71 $18.41
nonfacial.
15793... T Chemical peel, 151 1.74 $92.07 $35.71 $18.41
nonfacial.
15810... T Salabrasion............ 151 1.74 $92.07 $35.71 $18.41
15811... T Salabrasion............ 163 10.69 $565.14 $264.65 $113.03
15819... T Plastic surgery, neck.. 183 11.17 $590.61 $286.57 $118.12
15820... T Revision of lower 183 11.17 $590.61 $286.57 $118.12
eyelid.
15821... T Revision of lower 183 11.17 $590.61 $286.57 $118.12
eyelid.
15822... T Revision of upper 183 11.17 $590.61 $286.57 $118.12
eyelid.
15823... T Revision of upper 183 11.17 $590.61 $286.57 $118.12
eyelid.
15824... T Removal of forehead 184 15.17 $802.17 $396.40 $160.43
wrinkles.
15825... T Removal of neck 183 11.17 $590.61 $286.57 $118.12
wrinkles.
15826... T Removal of brow 184 15.17 $802.17 $396.40 $160.43
wrinkles.
15828... T Removal of face 184 15.17 $802.17 $396.40 $160.43
wrinkles.
15829... T Removal of skin 183 11.17 $590.61 $286.57 $118.12
wrinkles.
15831... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15832... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15833... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15834... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15835... T Excise excessive skin 183 11.17 $590.61 $286.57 $118.12
tissue.
15836... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15837... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15838... T Excise excessive skin 163 10.69 $565.14 $264.65 $113.03
tissue.
15839... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43
tissue.
15840... T Graft for face nerve 184 15.17 $802.17 $396.40 $160.43
palsy.
15841... T Graft for face nerve 184 15.17 $802.17 $396.40 $160.43
palsy.
15842... T Graft for face nerve 184 15.17 $802.17 $396.40 $160.43
palsy.
15845... T Skin and muscle repair, 184 15.17 $802.17 $396.40 $160.43
face.
15850... T Removal of sutures..... 151 1.74 $92.07 $35.71 $18.41
15851... T Removal of sutures..... 151 1.74 $92.07 $35.71 $18.41
15852... T Dressing change, not 151 1.74 $92.07 $35.71 $18.41
for burn.
15860... N Test for blood flow in ......... ......... ......... ........... ...........
graft.
15876... T Suction assisted 184 15.17 $802.17 $396.40 $160.43
lipectomy.
15877... T Suction assisted 184 15.17 $802.17 $396.40 $160.43
lipectomy.
15878... T Suction assisted 184 15.17 $802.17 $396.40 $160.43
lipectomy.
15879... T Suction assisted 184 15.17 $802.17 $396.40 $160.43
lipectomy.
15920... T Removal of tail bone 163 10.69 $565.14 $264.65 $113.03
ulcer.
15922... T Removal of tail bone 184 15.17 $802.17 $396.40 $160.43
ulcer.
15931... T Remove sacrum pressure 163 10.69 $565.14 $264.65 $113.03
sore.
15933... T Remove sacrum pressure 163 10.69 $565.14 $264.65 $113.03
sore.
15934... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15935... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15936... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15937... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15940... T Removal of pressure 163 10.69 $565.14 $264.65 $113.03
sore.
15941... T Removal of pressure 163 10.69 $565.14 $264.65 $113.03
sore.
15944... T Removal of pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15945... T Removal of pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15946... T Removal of pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15950... T Remove thigh pressure 163 10.69 $565.14 $264.65 $113.03
sore.
15951... T Remove thigh pressure 163 10.69 $565.14 $264.65 $113.03
sore.
15952... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15953... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15956... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43
sore.
[[Page 47628]]
15958... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43
sore.
15999... T Removal of pressure 163 10.69 $565.14 $264.65 $113.03
sore.
16000... T Initial treatment of 151 1.74 $92.07 $35.71 $18.41
burn(s).
16010... T Treatment of burn(s)... 152 10.43 $551.43 $261.71 $110.29
16015... T Treatment of burn(s)... 152 10.43 $551.43 $261.71 $110.29
16020... T Treatment of burn(s)... 151 1.74 $92.07 $35.71 $18.41
16025... T Treatment of burn(s)... 151 1.74 $92.07 $35.71 $18.41
16030... T Treatment of burn(s)... 151 1.74 $92.07 $35.71 $18.41
16035... T Incision of burn scab.. 162 5.67 $299.71 $125.43 $59.94
16040... T Burn wound excision.... 162 5.67 $299.71 $125.43 $59.94
16041... T Burn wound excision.... 162 5.67 $299.71 $125.43 $59.94
16042... T Burn wound excision.... 162 5.67 $299.71 $125.43 $59.94
17000... T Destroy benign/premal 141 0.59 $31.34 $9.49 $6.27
lesion.
17003... T Destroy 2-14 lesions... 141 0.59 $31.34 $9.49 $6.27
17004... T Destroy 15 & more 142 3.78 $199.81 $73.00 $39.96
lesions.
17106... T Destruction of skin 141 0.59 $31.34 $9.49 $6.27
lesions.
17107... T Destruction of skin 142 3.78 $199.81 $73.00 $39.96
lesions.
17108... T Destruction of skin 142 3.78 $199.81 $73.00 $39.96
lesions.
17110... T Destruct lesion, 1-14.. 141 0.59 $31.34 $9.49 $6.27
17111... T Destruct lesion, 15 or 142 3.78 $199.81 $73.00 $39.96
more.
17250... T Chemical cautery, 151 1.74 $92.07 $35.71 $18.41
tissue.
17260... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17261... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17262... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17263... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17264... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17266... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17270... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17271... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17272... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17273... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17274... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17276... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17280... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17281... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17282... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17283... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17284... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17286... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41
lesions.
17304... T Chemosurgery of skin 162 5.67 $299.71 $125.43 $59.94
lesion.
17305... T 2nd stage chemosurgery. 162 5.67 $299.71 $125.43 $59.94
17306... T 3rd stage chemosurgery. 162 5.67 $299.71 $125.43 $59.94
17307... T Followup skin lesion 162 5.67 $299.71 $125.43 $59.94
therapy.
17310... T Extensive skin 162 5.67 $299.71 $125.43 $59.94
chemosurgery.
17340... T Cryotherapy of skin.... 151 1.74 $92.07 $35.71 $18.41
17360... T Skin peel therapy...... 151 1.74 $92.07 $35.71 $18.41
17380... T Hair removal by 151 1.74 $92.07 $35.71 $18.41
electrolysis.
17999... T Skin tissue procedure.. 121 0.67 $35.26 $21.02 $7.05
19000... T Drainage of breast 121 0.67 $35.26 $21.02 $7.05
lesion.
19001... T Drain added breast 121 0.67 $35.26 $21.02 $7.05
lesion.
19020... T Incision of breast 132 6.04 $319.30 $134.24 $63.86
lesion.
19030... T Injection for breast x- 347 2.93 $154.75 $62.15 $30.95
ray.
19100... T Biopsy of breast....... 122 4.87 $257.60 $115.03 $51.52
19101... T Biopsy of breast....... 197 12.13 $641.54 $310.75 $128.31
19110... T Nipple exploration..... 197 12.13 $641.54 $310.75 $128.31
19112... T Excise breast duct 197 12.13 $641.54 $310.75 $128.31
fistula.
19120... T Removal of breast 197 12.13 $641.54 $310.75 $128.31
lesion.
19125... T Excision, breast lesion 197 12.13 $641.54 $310.75 $128.31
19126... T Excision, add'l breast 197 12.13 $641.54 $310.75 $128.31
lesion.
19140... T Removal of breast 197 12.13 $641.54 $310.75 $128.31
tissue.
19160... T Removal of breast 198 19.17 $1,013.73 $530.20 $202.75
tissue.
19162... T Remove breast tissue, 198 19.17 $1,013.73 $530.20 $202.75
nodes.
19180... T Removal of breast...... 198 19.17 $1,013.73 $530.20 $202.75
19182... T Removal of breast...... 198 19.17 $1,013.73 $530.20 $202.75
19200... C Removal of breast...... ......... ......... ......... ........... ...........
19220... C Removal of breast...... ......... ......... ......... ........... ...........
19240... C Removal of breast...... ......... ......... ......... ........... ...........
19260... C Removal of chest wall ......... ......... ......... ........... ...........
lesion.
19271... C Revision of chest wall. ......... ......... ......... ........... ...........
19272... C Extensive chest wall ......... ......... ......... ........... ...........
surgery.
19290... T Place needle wire, 197 12.13 $641.54 $310.75 $128.31
breast.
19291... T Place needle wire, 197 12.13 $641.54 $310.75 $128.31
breast.
19316... T Suspension of breast... 198 19.17 $1,013.73 $530.20 $202.75
19318... T Reduction of large 198 19.17 $1,013.73 $530.20 $202.75
breast.
19324... T Enlarge breast......... 198 19.17 $1,013.73 $530.20 $202.75
[[Page 47629]]
19325... T Enlarge breast with 198 19.17 $1,013.73 $530.20 $202.75
implant.
19328... T Removal of breast 198 19.17 $1,013.73 $530.20 $202.75
implant.
19330... T Removal of implant 198 19.17 $1,013.73 $530.20 $202.75
material.
19340... T Immediate breast 198 19.17 $1,013.73 $530.20 $202.75
prosthesis.
19342... T Delayed breast 198 19.17 $1,013.73 $530.20 $202.75
prosthesis.
19350... T Breast reconstruction.. 198 19.17 $1,013.73 $530.20 $202.75
19355... T Correct inverted 198 19.17 $1,013.73 $530.20 $202.75
nipple(s).
19357... T Breast reconstruction.. 198 19.17 $1,013.73 $530.20 $202.75
19361... C Breast reconstruction.. ......... ......... ......... ........... ...........
19364... C Breast reconstruction.. ......... ......... ......... ........... ...........
19366... T Breast reconstruction.. 198 19.17 $1,013.73 $530.20 $202.75
19367... C Breast reconstruction.. ......... ......... ......... ........... ...........
19368... C Breast reconstruction.. ......... ......... ......... ........... ...........
19369... C Breast reconstruction.. ......... ......... ......... ........... ...........
19370... T Surgery of breast 198 19.17 $1,013.73 $530.20 $202.75
capsule.
19371... T Removal of breast 198 19.17 $1,013.73 $530.20 $202.75
capsule.
19380... T Revise breast 198 19.17 $1,013.73 $530.20 $202.75
reconstruction.
19396... T Design custom breast 197 12.13 $641.54 $310.75 $128.31
implant.
19499... T Breast surgery 197 12.13 $641.54 $310.75 $128.31
procedure.
20000... T Incision of abscess.... 131 1.94 $102.84 $36.61 $20.57
20005... T Incision of deep 251 14.26 $754.18 $366.12 $150.84
abscess.
20100... C Explore wound, neck.... ......... ......... ......... ........... ...........
20101... C Explore wound, chest... ......... ......... ......... ........... ...........
20102... C Explore wound, abdomen. ......... ......... ......... ........... ...........
20103... C Explore wound, ......... ......... ......... ........... ...........
extremity.
20150... C Excise epiphyseal bar.. ......... ......... ......... ........... ...........
20200... T Muscle biopsy.......... 162 5.67 $299.71 $125.43 $59.94
20205... T Deep muscle biopsy..... 162 5.67 $299.71 $125.43 $59.94
20206... T Needle biopsy, muscle.. 122 4.87 $257.6 $115.03 $51.52
20220... T Bone biopsy, trocar/ 162 5.67 $299.71 $125.43 $59.94
needle.
20225... T Bone biopsy, trocar/ 162 5.67 $299.71 $125.43 $59.94
needle.
20240... T Bone biopsy, excisional 163 10.69 $565.14 $264.65 $113.03
20245... T Bone biopsy, excisional 163 10.69 $565.14 $264.65 $113.03
20250... T Open bone biopsy....... 251 14.26 $754.18 $366.12 $150.84
20251... T Open bone biopsy....... 251 14.26 $754.18 $366.12 $150.84
20500... T Injection of sinus 181 2.19 $115.58 $43.84 $23.12
tract.
20501... T Inject sinus tract for 347 2.93 $154.75 $62.15 $30.95
x-ray.
20520... T Removal of foreign body 161 3.50 $185.12 $75.48 $37.02
20525... T Removal of foreign body 163 10.69 $565.14 $264.65 $113.03
20550... T Inj tendon/ligament/ 200 1.89 $99.90 $39.10 $19.98
cyst.
20600... T Drain/inject joint/ 200 1.89 $99.90 $39.10 $19.98
bursa.
20605... T Drain/inject joint/ 200 1.89 $99.90 $39.10 $19.98
bursa.
20610... T Drain/inject joint/ 200 1.89 $99.90 $39.10 $19.98
bursa.
20615... T Treatment of bone cyst. 121 0.67 $35.26 $21.02 $7.05
20650... T Insert and remove bone 251 14.26 $754.18 $366.12 $150.84
pin.
20660... C Apply,remove fixation ......... ......... ......... ........... ...........
device.
20661... C Application of head ......... ......... ......... ........... ...........
brace.
20662... C Application of pelvis ......... ......... ......... ........... ...........
brace.
20663... C Application of thigh ......... ......... ......... ........... ...........
brace.
20664... C Halo brace application. ......... ......... ......... ........... ...........
20665... N Removal of fixation ......... ......... ......... ........... ...........
device.
20670... T Removal of support 162 5.67 $299.71 $125.43 $59.94
implant.
20680... T Removal of support 163 10.69 $565.14 $264.65 $113.03
implant.
20690... T Apply bone fixation 252 19.39 $1,025.49 $509.18 $205.10
device.
20692... T Apply bone fixation 252 19.39 $1,025.49 $509.18 $205.10
device.
20693... T Adjust bone fixation 251 14.26 $754.18 $366.12 $150.84
device.
20694... T Remove bone fixation 251 14.26 $754.18 $366.12 $150.84
device.
20802... C Replantation, arm, ......... ......... ......... ........... ...........
complete.
20805... C Replant forearm, ......... ......... ......... ........... ...........
complete.
20808... C Replantation, hand, ......... ......... ......... ........... ...........
complete.
20816... C Replantation digit, ......... ......... ......... ........... ...........
complete.
20822... C Replantation digit, ......... ......... ......... ........... ...........
complete.
20824... C Replantation thumb, ......... ......... ......... ........... ...........
complete.
20827... C Replantation thumb, ......... ......... ......... ........... ...........
complete.
20838... C Replantation, foot, ......... ......... ......... ........... ...........
complete.
20900... T Removal of bone for 252 19.39 $1,025.49 $509.18 $205.10
graft.
20902... T Removal of bone for 252 19.39 $1,025.49 $509.18 $205.10
graft.
20910... T Remove cartilage for 183 11.17 $590.61 $286.57 $118.12
graft.
20912... T Remove cartilage for 183 11.17 $590.61 $286.57 $118.12
graft.
20920... T Removal of fascia for 183 11.17 $590.61 $286.57 $118.12
graft.
20922... T Removal of fascia for 183 11.17 $590.61 $286.57 $118.12
graft.
20924... T Removal of tendon for 252 19.39 $1,025.49 $509.18 $205.10
graft.
20926... T Removal of tissue for 183 11.17 $590.61 $286.57 $118.12
graft.
20930... C Spinal bone allograft.. ......... ......... ......... ........... ...........
20931... C Spinal bone allograft.. ......... ......... ......... ........... ...........
[[Page 47630]]
20936... C Spinal bone autograft.. ......... ......... ......... ........... ...........
20937... C Spinal bone autograft.. ......... ......... ......... ........... ...........
20938... C Spinal bone autograft.. ......... ......... ......... ........... ...........
20950... T Record fluid 132 6.04 $319.30 $134.24 $63.86
pressure,muscle.
20955... C Fibula bone graft, ......... ......... ......... ........... ...........
microvasc.
20956... C Iliac bone graft, ......... ......... ......... ........... ...........
microvasc.
20957... C Mt bone graft, ......... ......... ......... ........... ...........
microvasc.
20962... C Other bone graft, ......... ......... ......... ........... ...........
microvasc.
20969... C Bone/skin graft, ......... ......... ......... ........... ...........
microvasc.
20970... C Bone/skin graft, iliac ......... ......... ......... ........... ...........
crest.
20972... C Bone-skin graft, ......... ......... ......... ........... ...........
metatarsal.
20973... C Bone-skin graft, great ......... ......... ......... ........... ...........
toe.
20974... A Electrical bone ......... ......... ......... ........... ...........
stimulation.
20975... T Electrical bone 251 14.26 $754.18 $366.12 $150.84
stimulation.
20999... N Musculoskeletal surgery ......... ......... ......... ........... ...........
21010... T Incision of jaw joint.. 232 23.93 $1,265.45 $639.35 $253.09
21015... T Resection of facial 231 12.02 $635.66 299.90 $127.13
tumor.
21025... T Excision of bone, lower 231 12.02 $635.66 299.90 $127.13
jaw.
21026... T Excision of facial 231 12.02 $635.66 299.90 $127.13
bone(s).
21029... T Contour of face bone 231 12.02 $635.66 299.90 $127.13
lesion.
21030... T Removal of face bone 231 12.02 $635.66 299.90 $127.13
lesion.
21031... T Remove exostosis, 231 12.02 $635.66 299.90 $127.13
mandible.
21032... T Remove exostosis, 231 12.02 $635.66 299.90 $127.13
maxilla.
21034... T Removal of face bone 232 23.93 $1,265.45 $639.35 $253.09
lesion.
21040... T Removal of jaw bone 231 12.02 $635.66 299.90 $127.13
lesion.
21041... T Removal of jaw bone 231 12.02 $635.66 299.90 $127.13
lesion.
21044... T Removal of jaw bone 232 23.93 $1,265.45 $639.35 $253.09
lesion.
21045... C Extensive jaw surgery.. ......... ......... ......... ........... ...........
21050... T Removal of jaw joint... 232 23.93 $1,265.45 $639.35 $253.09
21060... T Remove jaw joint 232 23.93 $1,265.45 $639.35 $253.09
cartilage.
21070... T Remove coronoid process 232 23.93 $1,265.45 $639.35 $253.09
21076... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21077... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21079... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21080... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21081... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21082... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21083... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21084... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21085... N Prepare face/oral ......... ......... ......... ........... ...........
prosthesis.
21086... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21087... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21088... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21089... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85
prosthesis.
21100... T Maxillofacial fixation. 231 12.02 $635.66 299.90 $127.13
21110... T Interdental fixation... 231 12.02 $635.66 299.90 $127.13
21116... T Injection, jaw joint x- 347 2.93 $154.75 $62.15 $30.95
ray.
21120... T Reconstruction of chin. 231 12.02 $635.66 299.90 $127.13
21121... T Reconstruction of chin. 232 23.93 $1,265.45 $639.35 $253.09
21122... T Reconstruction of chin. 232 23.93 $1,265.45 $639.35 $253.09
21123... T Reconstruction of chin. 232 23.93 $1,265.45 $639.35 $253.09
21125... T Augmentation lower jaw 231 12.02 $635.66 299.90 $127.13
bone.
21127... T Augmentation lower jaw 232 23.93 $1,265.45 $639.35 $253.09
bone.
21137... C Reduction of forehead.. ......... ......... ......... ........... ...........
21138... C Reduction of forehead.. ......... ......... ......... ........... ...........
21139... C Reduction of forehead.. ......... ......... ......... ........... ...........
21141... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21142... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21143... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21145... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21146... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21147... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21150... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21151... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21154... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21155... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21159... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21160... C Reconstruct midface, ......... ......... ......... ........... ...........
lefort.
21172... C Reconstruct orbit/ ......... ......... ......... ........... ...........
forehead.
21175... C Reconstruct orbit/ ......... ......... ......... ........... ...........
forehead.
21179... C Reconstruct entire ......... ......... ......... ........... ...........
forehead.
21180... C Reconstruct entire ......... ......... ......... ........... ...........
forehead.
21181... T Contour cranial bone 232 23.93 $1,265.45 $639.35 $253.09
lesion.
21182... C Reconstruct cranial ......... ......... ......... ........... ...........
bone.
21183... C Reconstruct cranial ......... ......... ......... ........... ...........
bone.
[[Page 47631]]
21184... C Reconstruct cranial ......... ......... ......... ........... ...........
bone.
21188... C Reconstruction of ......... ......... ......... ........... ...........
midface.
21193... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21194... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21195... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21196... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21198... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21206... T Reconstruct upper jaw 232 23.93 $1,265.45 $639.35 $253.09
bone.
21208... T Augmentation of facial 232 23.93 $1,265.45 $639.35 $253.09
bones.
21209... T Reduction of facial 232 23.93 $1,265.45 $639.35 $253.09
bones.
21210... T Face bone graft........ 232 23.93 $1,265.45 $639.35 $253.09
21215... T Lower jaw bone graft... 232 23.93 $1,265.45 $639.35 $253.09
21230... T Rib cartilage graft.... 232 23.93 $1,265.45 $639.35 $253.09
21235... T Ear cartilage graft.... 232 23.93 $1,265.45 $639.35 $253.09
21240... T Reconstruction of jaw 232 23.93 $1,265.45 $639.35 $253.09
joint.
21242... T Reconstruction of jaw 232 23.93 $1,265.45 $639.35 $253.09
joint.
21243... T Reconstruction of jaw 218 27.50 $1,454.49 $715.52 $290.90
joint.
21244... T Reconstruction of lower 232 23.93 $1,265.45 $639.35 $253.09
jaw.
21245... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09
21246... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09
21247... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21248... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09
21249... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09
21255... C Reconstruct lower jaw ......... ......... ......... ........... ...........
bone.
21256... C Reconstruction of orbit ......... ......... ......... ........... ...........
21260... T Revise eye sockets..... 232 23.93 $1,265.45 $639.35 $253.09
21261... C Revise eye sockets..... ......... ......... ......... ........... ...........
21263... C Revise eye sockets..... ......... ......... ......... ........... ...........
21267... T Revise eye sockets..... 232 23.93 $1,265.45 $639.35 $253.09
21268... C Revise eye sockets..... ......... ......... ......... ........... ...........
21270... T Augmentation cheek bone 232 23.93 $1,265.45 $639.35 $253.09
21275... T Revision orbitofacial 232 23.93 $1,265.45 $639.35 $253.09
bones.
21280... T Revision of eyelid..... 231 12.02 $635.66 $299.90 $127.13
21282... T Revision of eyelid..... 231 12.02 $635.66 $299.90 $127.13
21295... T Revision of jaw muscle/ 231 12.02 $635.66 $299.90 $127.13
bone.
21296... T Revision of jaw muscle/ 231 12.02 $635.66 $299.90 $127.13
bone.
21299... T Cranio/maxillofacial 231 12.02 $635.66 $299.90 $127.13
surgery.
21300... T Treatment of skull 231 12.02 $635.66 $299.90 $127.13
fracture.
21310... T Treatment of nose 231 12.02 $635.66 $299.90 $127.13
fracture.
21315... T Treatment of nose 231 12.02 $635.66 $299.90 $127.13
fracture.
21320... T Treatment of nose 231 12.02 $635.66 $299.90 $127.13
fracture.
21325... T Repair of nose fracture 231 12.02 $635.66 $299.90 $127.13
21330... T Repair of nose fracture 232 23.93 $1,265.45 $639.35 $253.09
21335... T Repair of nose fracture 232 23.93 $1,265.45 $639.35 $253.09
21336... T Repair nasal septal 216 20.13 $1,064.67 $520.93 $212.93
fracture.
21337... T Repair nasal septal 231 12.02 $635.66 $299.90 $127.13
fracture.
21338... T Repair nasoethmoid 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21339... T Repair nasoethmoid 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21340... T Repair of nose fracture 232 23.93 $1,265.45 $639.35 $253.09
21343... T Repair of sinus 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21344... C Repair of sinus ......... ......... ......... ........... ...........
fracture.
21345... T Repair of nose/jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21346... C Repair of nose/jaw ......... ......... ......... ........... ...........
fracture.
21347... C Repair of nose/jaw ......... ......... ......... ........... ...........
fracture.
21348... C Repair of nose/jaw ......... ......... ......... ........... ...........
fracture.
21355... T Repair cheek bone 231 12.02 $635.66 $299.90 $127.13
fracture.
21356... C Repair cheek bone ......... ......... ......... ........... ...........
fracture.
21360... C Repair cheek bone ......... ......... ......... ........... ...........
fracture.
21365... C Repair cheek bone ......... ......... ......... ........... ...........
fracture.
21366... C Repair cheek bone ......... ......... ......... ........... ...........
fracture.
21385... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21386... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21387... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21390... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21395... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21400... T Treat eye socket 231 12.02 $635.66 $299.90 $127.13
fracture.
21401... T Repair eye socket 231 12.02 $635.66 $299.90 $127.13
fracture.
21406... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21407... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21408... C Repair eye socket ......... ......... ......... ........... ...........
fracture.
21421... T Treat mouth roof 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21422... C Repair mouth roof ......... ......... ......... ........... ...........
fracture.
21423... C Repair mouth roof ......... ......... ......... ........... ...........
fracture.
21431... C Treat craniofacial ......... ......... ......... ........... ...........
fracture.
21432... C Repair craniofacial ......... ......... ......... ........... ...........
fracture.
[[Page 47632]]
21433... C Repair craniofacial ......... ......... ......... ........... ...........
fracture.
21435... C Repair craniofacial ......... ......... ......... ........... ...........
fracture.
21436... C Repair craniofacial ......... ......... ......... ........... ...........
fracture.
21440... T Repair dental ridge 231 12.02 $635.66 $299.90 $127.13
fracture.
21445... T Repair dental ridge 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21450... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21451... T Treat lower jaw 231 12.02 $635.66 $299.90 $127.13
fracture.
21452... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21453... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21454... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21461... T Repair lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21462... T Repair lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21465... T Repair lower jaw 232 23.93 $1,265.45 $639.35 $253.09
fracture.
21470... C Repair lower jaw ......... ......... ......... ........... ...........
fracture.
21480... T Reset dislocated jaw... 231 12.02 $635.66 $299.90 $127.13
21485... T Reset dislocated jaw... 231 12.02 $635.66 $299.90 $127.13
21490... T Repair dislocated jaw.. 232 23.93 $1,265.45 $639.35 $253.09
21493... T Treat hyoid bone 231 12.02 $635.66 $299.90 $127.13
fracture.
21494... T Repair hyoid bone 231 12.02 $635.66 $299.90 $127.13
fracture.
21495... C Repair hyoid bone ......... ......... ......... ........... ...........
fracture.
21497... T Interdental wiring..... 231 12.02 $635.66 $299.90 $127.13
21499... T Head surgery procedure. 231 12.02 $635.66 $299.90 $127.13
21501... T Drain neck/chest lesion 132 6.04 $319.30 $134.24 $63.86
21502... T Drain chest lesion..... 252 19.39 $1,025.49 $509.18 $205.10
21510... C Drainage of bone lesion ......... ......... ......... ........... ...........
21550... T Biopsy of neck/chest... 161 3.50 $185.12 $75.48 $37.02
21555... T Remove lesion neck/ 163 10.69 $565.14 $264.65 $113.03
chest.
21556... T Remove lesion neck/ 163 10.69 $565.14 $264.65 $113.03
chest.
21557... C Remove tumor, neck or ......... ......... ......... ........... ...........
chest.
21600... T Partial removal of rib. 252 19.39 $1,025.49 $509.18 $205.10
21610... T Partial removal of rib. 252 19.39 $1,025.49 $509.18 $205.10
21615... C Removal of rib......... ......... ......... ......... ........... ...........
21616... C Removal of rib and ......... ......... ......... ........... ...........
nerves.
21620... C Partial removal of ......... ......... ......... ........... ...........
sternum.
21627... C Sternal debridement.... ......... ......... ......... ........... ...........
21630... C Extensive sternum ......... ......... ......... ........... ...........
surgery.
21632... C Extensive sternum ......... ......... ......... ........... ...........
surgery.
21700... T Revision of neck muscle 132 6.04 $319.30 $134.24 $63.86
21705... C Revision of neck muscle/ ......... ......... ......... ........... ...........
rib.
21720... T Revision of neck muscle 132 6.04 $319.30 $134.24 $63.86
21725... T Revision of neck muscle 132 6.04 $319.30 $134.24 $63.86
21740... C Reconstruction of ......... ......... ......... ........... ...........
sternum.
21750... C Repair of sternum ......... ......... ......... ........... ...........
separation.
21800... T Treatment of rib 207 1.70 $90.11 $31.64 $18.02
fracture.
21805... T Treatment of rib 216 20.13 $1,064.67 $520.93 $212.93
fracture.
21810... C Treatment of rib ......... ......... ......... ........... ...........
fracture(s).
21820... T Treat sternum fracture. 207 1.70 $90.11 $31.64 $18.02
21825... C Repair sternum fracture ......... ......... ......... ........... ...........
21899... T Neck/chest surgery 207 1.70 $90.11 $31.64 $18.02
procedure.
21920... T Biopsy soft tissue of 161 3.50 $185.12 $75.48 $37.02
back.
21925... T Biopsy soft tissue of 163 10.69 $565.14 $264.65 $113.03
back.
21930... T Remove lesion, back or 163 10.69 $565.14 $264.65 $113.03
flank.
21935... T Remove tumor of back... 163 10.69 $565.14 $264.65 $113.03
22100... C Remove part of neck ......... ......... ......... ........... ...........
vertebra.
22101... C Remove part, thorax ......... ......... ......... ........... ...........
vertebra.
22102... C Remove part, lumbar ......... ......... ......... ........... ...........
vertebra.
22103... C Remove extra spine ......... ......... ......... ........... ...........
segment.
22110... C Remove part of neck ......... ......... ......... ........... ...........
vertebra.
22112... C Remove part, thorax ......... ......... ......... ........... ...........
vertebra.
22114... C Remove part, lumbar ......... ......... ......... ........... ...........
vertebra.
22116... C Remove extra spine ......... ......... ......... ........... ...........
segment.
22210... C Revision of neck spine. ......... ......... ......... ........... ...........
22212... C Revision of thorax ......... ......... ......... ........... ...........
spine.
22214... C Revision of lumbar ......... ......... ......... ........... ...........
spine.
22216... C Revise, extra spine ......... ......... ......... ........... ...........
segment.
22220... C Revision of neck spine. ......... ......... ......... ........... ...........
22222... C Revision of thorax ......... ......... ......... ........... ...........
spine.
22224... C Revision of lumbar ......... ......... ......... ........... ...........
spine.
22226... C Revise, extra spine ......... ......... ......... ........... ...........
segment.
22305... T Treat spine process 207 1.70 $90.11 $31.64 $18.02
fracture.
22310... T Treat spine fracture... 207 1.70 $90.11 $31.64 $18.02
22315... T Treat spine fracture... 207 1.70 $90.11 $31.64 $18.02
22325... C Repair of spine ......... ......... ......... ........... ...........
fracture.
22326... C Repair neck spine ......... ......... ......... ........... ...........
fracture.
22327... C Repair thorax spine ......... ......... ......... ........... ...........
fracture.
[[Page 47633]]
22328... C Repair each add spine ......... ......... ......... ........... ...........
fx.
22505... T Manipulation of spine.. 210 10.46 $553.39 $283.4 $110.68
22548... C Neck spine fusion...... ......... ......... ......... ........... ...........
22554... C Neck spine fusion...... ......... ......... ......... ........... ...........
22556... C Thorax spine fusion.... ......... ......... ......... ........... ...........
22558... C Lumbar spine fusion.... ......... ......... ......... ........... ...........
22585... C Additional spinal ......... ......... ......... ........... ...........
fusion.
22590... C Spine & skull spinal ......... ......... ......... ........... ...........
fusion.
22595... C Neck spinal fusion..... ......... ......... ......... ........... ...........
22600... C Neck spine fusion...... ......... ......... ......... ........... ...........
22610... C Thorax spine fusion.... ......... ......... ......... ........... ...........
22612... C Lumbar spine fusion.... ......... ......... ......... ........... ...........
22614... C Spine fusion, extra ......... ......... ......... ........... ...........
segment.
22630... C Lumbar spine fusion.... ......... ......... ......... ........... ...........
22632... C Spine fusion, extra ......... ......... ......... ........... ...........
segment.
22800... C Fusion of spine........ ......... ......... ......... ........... ...........
22802... C Fusion of spine........ ......... ......... ......... ........... ...........
22804... C Fusion of spine........ ......... ......... ......... ........... ...........
22808... C Fusion of spine........ ......... ......... ......... ........... ...........
22810... C Fusion of spine........ ......... ......... ......... ........... ...........
22812... C Fusion of spine........ ......... ......... ......... ........... ...........
22818... C Kyphectomy, 1-2 ......... ......... ......... ........... ...........
segments.
22819... C Kyphectomy, 3 & more ......... ......... ......... ........... ...........
segment.
22830... C Exploration of spinal ......... ......... ......... ........... ...........
fusion.
22840... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22841... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22842... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22843... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22844... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22845... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22846... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22847... C Insert spine fixation ......... ......... ......... ........... ...........
device.
22848... C Insert pelvic fixation ......... ......... ......... ........... ...........
device.
22849... C Reinsert spinal ......... ......... ......... ........... ...........
fixation.
22850... C Remove spine fixation ......... ......... ......... ........... ...........
device.
22851... C Apply spine prosth ......... ......... ......... ........... ...........
device.
22852... C Remove spine fixation ......... ......... ......... ........... ...........
device.
22855... C Remove spine fixation ......... ......... ......... ........... ...........
device.
22899... T Spine surgery procedure 207 1.70 $90.11 $31.64 $18.02
22900... T Remove abdominal wall 163 10.69 $565.14 $264.65 $113.03
lesion.
22999... T Abdomen surgery 163 10.69 $565.14 $264.65 $113.03
procedure.
23000... T Removal of calcium 162 5.67 $299.71 $125.43 $59.94
deposits.
23020... T Release shoulder joint. 253 26.33 $1,392.78 $699.24 $278.56
23030... T Drain shoulder lesion.. 132 6.04 $319.30 $134.24 $63.86
23031... T Drain shoulder bursa... 132 6.04 $319.30 $134.24 $63.86
23035... C Drain shoulderbone ......... ......... ......... ........... ...........
lesion.
23040... T Exploratory shoulder 252 19.39 $1,025.49 $509.18 $205.10
surgery.
23044... T Exploratory shoulder 252 19.39 $1,025.49 $509.18 $205.10
surgery.
23065... T Biopsy shoulder tissues 161 3.50 $185.12 $75.48 $37.02
23066... T Biopsy shoulder tissues 163 10.69 $565.14 $264.65 $113.03
23075... T Removal of shoulder 162 5.67 $299.71 $125.43 $59.94
lesion.
23076... T Removal of shoulder 163 10.69 $565.14 $264.65 $113.03
lesion.
23077... T Remove tumor of 163 10.69 $565.14 $264.65 $113.03
shoulder.
23100... T Biopsy of shoulder 251 14.26 $754.18 $366.12 $150.84
joint.
23101... T Shoulder joint surgery. 252 19.39 $1,025.49 $509.18 $205.10
23105... T Remove shoulder joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
23106... T Incision of collarbone 252 19.39 $1,025.49 $509.18 $205.10
joint.
23107... T Explore, treat shoulder 252 19.39 $1,025.49 $509.18 $205.10
joint.
23120... T Partial removal, 253 26.33 $1,392.78 $699.24 $278.56
collarbone.
23125... C Removal of collarbone.. ......... ......... ......... ........... ...........
23130... T Partial removal, 253 26.33 $1,392.78 $699.24 $278.56
shoulderbone.
23140... T Removal of bone lesion. 251 14.26 $754.18 $366.12 $150.84
23145... T Removal of bone lesion. 252 19.39 $1,025.49 $509.18 $205.10
23146... T Removal of bone lesion. 252 19.39 $1,025.49 $509.18 $205.10
23150... T Removal of humerus 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23155... T Removal of humerus 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23156... T Removal of humerus 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23170... T Remove collarbone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23172... T Remove shoulder blade 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23174... T Remove humerus lesion.. 252 19.39 $1,025.49 $509.18 $205.10
23180... T Remove collarbone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23182... T Remove shoulderblade 252 19.39 $1,025.49 $509.18 $205.10
lesion.
23184... T Remove humerus lesion.. 252 19.39 $1,025.49 $509.18 $205.10
23190... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10
scapula.
23195... C Removal of head of ......... ......... ......... ........... ...........
humerus.
[[Page 47634]]
23200... C Removal of collarbone.. ......... ......... ......... ........... ...........
23210... C Removal of ......... ......... ......... ........... ...........
shoulderblade.
23220... C Partial removal of ......... ......... ......... ........... ...........
humerus.
23221... C Partial removal of ......... ......... ......... ........... ...........
humerus.
23222... C Partial removal of ......... ......... ......... ........... ...........
humerus.
23330... T Remove shoulder foreign 163 10.69 $565.14 $264.65 $113.03
body.
23331... T Remove shoulder foreign 163 10.69 $565.14 $264.65 $113.03
body.
23332... C Remove shoulder foreign ......... ......... ......... ........... ...........
body.
23350... T Injection for shoulder 347 2.93 $154.75 $62.15 $30.95
x-ray.
23395... C Muscle transfer, ......... ......... ......... ........... ...........
shoulder/arm.
23397... C Muscle transfers....... ......... ......... ......... ........... ...........
23400... C Fixation of ......... ......... ......... ........... ...........
shoulderblade.
23405... T Incision of tendon & 252 19.39 $1,025.49 $509.18 $205.10
muscle.
23406... T Incise tendon(s) & 252 19.39 $1,025.49 $509.18 $205.10
muscle(s).
23410... T Repair of tendon(s).... 254 34.37 $1,817.86 $937.22 $363.57
23412... T Repair of tendon(s).... 254 34.37 $1,817.86 $937.22 $363.57
23415... T Release of shoulder 253 26.33 $1,392.78 $699.24 $278.56
ligament.
23420... T Repair of shoulder..... 254 34.37 $1,817.86 $937.22 $363.57
23430... T Repair biceps tendon... 254 34.37 $1,817.86 $937.22 $363.57
23440... C Removal/transplant ......... ......... ......... ........... ...........
tendon.
23450... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57
23455... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57
23460... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57
23462... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57
23465... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57
23466... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57
23470... C Reconstruct shoulder ......... ......... ......... ........... ...........
joint.
23472... C Reconstruct shoulder ......... ......... ......... ........... ...........
joint.
23480... T Revision of collarbone. 253 26.33 $1,392.78 $699.24 $278.56
23485... T Revision of collarbone. 253 26.33 $1,392.78 $699.24 $278.56
23490... T Reinforce clavicle..... 253 26.33 $1,392.78 $699.24 $278.56
23491... T Reinforce shoulderbones 253 26.33 $1,392.78 $699.24 $278.56
23500... T Treat clavicle fracture 207 1.70 $90.11 $31.64 $18.02
23505... T Treat clavicle fracture 207 1.70 $90.11 $31.64 $18.02
23515... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
23520... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02
dislocation.
23525... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02
dislocation.
23530... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
23532... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
23540... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02
dislocation.
23545... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02
dislocation.
23550... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
23552... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
23570... T Treat shoulderblade 207 1.70 $90.11 $31.64 $18.02
fracture.
23575... T Treat shoulderblade 207 1.70 $90.11 $31.64 $18.02
fracture.
23585... T Repair scapula fracture 216 20.13 $1,064.67 $520.93 $212.93
23600... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
23605... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
23615... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
23616... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
23620... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
23625... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
23630... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
23650... T Treat shoulder 207 1.70 $90.11 $31.64 $18.02
dislocation.
23655... T Treat shoulder 210 10.46 $553.39 $283.40 $110.68
dislocation.
23660... T Repair shoulder 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
23665... T Treat dislocation/ 209 1.94 $102.84 $37.29 $20.57
fracture.
23670... T Repair dislocation/ 216 20.13 $1,064.67 $520.93 $212.93
fracture.
23675... T Treat dislocation/ 209 1.94 $102.84 $37.29 $20.57
fracture.
23680... T Repair dislocation/ 216 20.13 $1,064.67 $520.93 $212.93
fracture.
23700... T Fixation of shoulder... 210 10.46 $553.39 $283.40 $110.68
23800... T Fusion of shoulder 253 26.33 $1,392.78 $699.24 $278.56
joint.
23802... T Fusion of shoulder 253 26.33 $1,392.78 $699.24 $278.56
joint.
23900... C Amputation of arm & ......... ......... ......... ........... ...........
girdle.
23920... C Amputation at shoulder ......... ......... ......... ........... ...........
joint.
23921... T Amputation follow-up 183 11.17 $590.61 $286.57 $118.12
surgery.
23929... T Shoulder surgery 207 1.70 $90.11 $31.64 $18.02
procedure.
23930... T Drainage of arm lesion. 132 6.04 $319.30 $134.24 $63.86
23931... T Drainage of arm bursa.. 132 6.04 $319.30 $134.24 $63.86
23935... T Drain arm/elbow bone 251 14.26 $754.18 $366.12 $150.84
lesion.
24000... T Exploratory elbow 252 19.39 $1,025.49 $509.18 $205.10
surgery.
24006... T Release elbow joint.... 252 19.39 $1,025.49 $509.18 $205.10
24065... T Biopsy arm/elbow soft 161 3.50 $185.12 $75.48 $37.02
tissue.
24066... T Biopsy arm/elbow soft 163 10.69 $565.14 $264.65 $113.03
tissue.
24075... T Remove arm/elbow lesion 162 5.67 $299.71 $125.43 $59.94
[[Page 47635]]
24076... T Remove arm/elbow lesion 163 10.69 $565.14 $264.65 $113.03
24077... T Remove tumor of arm/ 163 10.69 $565.14 $264.65 $113.03
elbow.
24100... T Biopsy elbow joint 251 14.26 $754.18 $366.12 $150.84
lining.
24101... T Explore/treat elbow 252 19.39 $1,025.49 $509.18 $205.10
joint.
24102... T Remove elbow joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
24105... T Removal of elbow bursa. 251 14.26 $754.18 $366.12 $150.84
24110... T Remove humerus lesion.. 251 14.26 $754.18 $366.12 $150.84
24115... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24116... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24120... T Remove elbow lesion.... 251 14.26 $754.18 $366.12 $150.84
24125... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24126... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24130... T Removal of head of 252 19.39 $1,025.49 $509.18 $205.10
radius.
24134... T Removal of arm bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24136... T Remove radius bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24138... T Remove elbow bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
24140... T Partial removal of arm 252 19.39 $1,025.49 $509.18 $205.10
bone.
24145... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10
radius.
24147... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10
elbow.
24149... C Radical resection of ......... ......... ......... ........... ...........
elbow.
24150... C Extensive humerus ......... ......... ......... ........... ...........
surgery.
24151... C Extensive humerus ......... ......... ......... ........... ...........
surgery.
24152... C Extensive radius ......... ......... ......... ........... ...........
surgery.
24153... C Extensive radius ......... ......... ......... ........... ...........
surgery.
24155... T Removal of elbow joint. 253 26.33 $1,392.78 $699.24 $278.56
24160... T Remove elbow joint 252 19.39 $1,025.49 $509.18 $205.10
implant.
24164... T Remove radius head 252 19.39 $1,025.49 $509.18 $205.10
implant.
24200... T Removal of arm foreign 161 3.50 $185.12 $75.48 $37.02
body.
24201... T Removal of arm foreign 163 10.69 $565.14 $264.65 $113.03
body.
24220... T Injection for elbow x- 347 2.93 $154.75 $62.15 $30.95
ray.
24301... T Muscle/tendon transfer. 252 19.39 $1,025.49 $509.18 $205.10
24305... T Arm tendon lengthening. 252 19.39 $1,025.49 $509.18 $205.10
24310... T Revision of arm tendon. 251 14.26 $754.18 $366.12 $150.84
24320... T Repair of arm tendon... 253 26.33 $1,392.78 $699.24 $278.56
24330... T Revision of arm muscles 253 26.33 $1,392.78 $699.24 $278.56
24331... T Revision of arm muscles 253 26.33 $1,392.78 $699.24 $278.56
24340... T Repair of biceps tendon 253 26.33 $1,392.78 $699.24 $278.56
24341... T Repair tendon/muscle 253 26.33 $1,392.78 $699.24 $278.56
arm.
24342... T Repair of ruptured 253 26.33 $1,392.78 $699.24 $278.56
tendon.
24350... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10
24351... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10
24352... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10
24354... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10
24356... T Revision of tennis 252 19.39 $1,025.49 $509.18 $205.10
elbow.
24360... T Reconstruct elbow joint 217 20.48 $1,083.27 $526.81 $216.65
24361... T Reconstruct elbow joint 218 27.50 $1,454.49 $715.52 $290.90
24362... T Reconstruct elbow joint 218 27.50 $1,454.49 $715.52 $290.90
24363... T Replace elbow joint.... 218 27.50 $1,454.49 $715.52 $290.90
24365... T Reconstruct head of 217 20.48 $1,083.27 $526.81 $216.65
radius.
24366... T Reconstruct head of 218 27.50 $1,454.49 $715.52 $290.90
radius.
24400... T Revision of humerus.... 252 19.39 $1,025.49 $509.18 $205.10
24410... T Revision of humerus.... 252 19.39 $1,025.49 $509.18 $205.10
24420... T Revision of humerus.... 253 26.33 $1,392.78 $699.24 $278.56
24430... T Repair of humerus...... 253 26.33 $1,392.78 $699.24 $278.56
24435... T Repair humerus with 253 26.33 $1,392.78 $699.24 $278.56
graft.
24470... T Revision of elbow joint 253 26.33 $1,392.78 $699.24 $278.56
24495... T Decompression of 252 19.39 $1,025.49 $509.18 $205.10
forearm.
24498... T Reinforce humerus...... 253 26.33 $1,392.78 $699.24 $278.56
24500... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24505... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24515... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
24516... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
24530... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24535... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24538... T Treat humerus fracture. 216 20.13 $1,064.67 $520.93 $212.93
24545... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
24546... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
24560... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24565... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24566... T Treat humerus fracture. 216 20.13 $1,064.67 $520.93 $212.93
24575... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
24576... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24577... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57
24579... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93
24582... T Treat humerus fracture. 216 20.13 $1,064.67 $520.93 $212.93
[[Page 47636]]
24586... T Repair elbow fracture.. 216 20.13 $1,064.67 $520.93 $212.93
24587... T Repair elbow fracture.. 216 20.13 $1,064.67 $520.93 $212.93
24600... T Treat elbow dislocation 209 1.94 $102.84 $37.29 $20.57
24605... T Treat elbow dislocation 210 10.46 $553.39 $283.40 $110.68
24615... T Repair elbow 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
24620... T Treat elbow fracture... 209 1.94 $102.84 $37.29 $20.57
24635... T Repair elbow fracture.. 216 20.13 $1,064.67 $520.93 $212.93
24640... T Treat elbow dislocation 209 1.94 $102.84 $37.29 $20.57
24650... T Treat radius fracture.. 209 1.94 $102.84 $37.29 $20.57
24655... T Treat radius fracture.. 209 1.94 $102.84 $37.29 $20.57
24665... T Repair radius fracture. 216 20.13 $1,064.67 $520.93 $212.93
24666... T Repair radius fracture. 216 20.13 $1,064.67 $520.93 $212.93
24670... T Treatment of ulna 209 1.94 $102.84 $37.29 $20.57
fracture.
24675... T Treatment of ulna 209 1.94 $102.84 $37.29 $20.57
fracture.
24685... T Repair ulna fracture... 216 20.13 $1,064.67 $520.93 $212.93
24800... T Fusion of elbow joint.. 253 26.33 $1,392.78 $699.24 $278.56
24802... T Fusion/graft of elbow 253 26.33 $1,392.78 $699.24 $278.56
joint.
24900... C Amputation of upper arm ......... ......... ......... ........... ...........
24920... C Amputation of upper arm ......... ......... ......... ........... ...........
24925... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84
surgery.
24930... C Amputation follow-up ......... ......... ......... ........... ...........
surgery.
24931... C Amputate upper arm & ......... ......... ......... ........... ...........
implant.
24935... C Revision of amputation. ......... ......... ......... ........... ...........
24940... C Revision of upper arm.. ......... ......... ......... ........... ...........
24999... T Upper arm/elbow surgery 209 1.94 $102.84 $37.29 $20.57
25000... T Incision of tendon 251 14.26 $754.18 $366.12 $150.84
sheath.
25020... T Decompression of 251 14.26 $754.18 $366.12 $150.84
forearm.
25023... T Decompression of 252 19.39 $1,025.49 $509.18 $205.10
forearm.
25028... T Drainage of forearm 251 14.26 $754.18 $366.12 $150.84
lesion.
25031... T Drainage of forearm 251 14.26 $754.18 $366.12 $150.84
bursa.
25035... T Treat forearm bone 251 14.26 $754.18 $366.12 $150.84
lesion.
25040... T Explore/treat wrist 252 19.39 $1,025.49 $509.18 $205.10
joint.
25065... T Biopsy forearm soft 161 3.50 $185.12 $75.48 $37.02
tissues.
25066... T Biopsy forearm soft 163 10.69 $565.14 $264.65 $113.03
tissues.
25075... T Removal of forearm 162 5.67 $299.71 $125.43 $59.94
lesion.
25076... T Removal of forearm 163 10.69 $565.14 $264.65 $113.03
lesion.
25077... T Remove tumor, forearm/ 163 10.69 $565.14 $264.65 $113.03
wrist.
25085... T Incision of wrist 251 14.26 $754.18 $366.12 $150.84
capsule.
25100... T Biopsy of wrist joint.. 251 14.26 $754.18 $366.12 $150.84
25101... T Explore/treat wrist 252 19.39 $1,025.49 $509.18 $205.10
joint.
25105... T Remove wrist joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
25107... T Remove wrist joint 252 19.39 $1,025.49 $509.18 $205.10
cartilage.
25110... T Remove wrist tendon 251 14.26 $754.18 $366.12 $150.84
lesion.
25111... T Remove wrist tendon 261 10.54 $557.31 $261.48 $111.46
lesion.
25112... T Remove wrist tendon 261 10.54 $557.31 $261.48 $111.46
lesion.
25115... T Remove wrist/forearm 251 14.26 $754.18 $366.12 $150.84
lesion.
25116... T Remove wrist/forearm 251 14.26 $754.18 $366.12 $150.84
lesion.
25118... T Excise wrist tendon 252 19.39 $1,025.49 $509.18 $205.10
sheath.
25119... T Partial removal of ulna 252 19.39 $1,025.49 $509.18 $205.10
25120... T Removal of forearm 252 19.39 $1,025.49 $509.18 $205.10
lesion.
25125... T Remove/graft forearm 252 19.39 $1,025.49 $509.18 $205.10
lesion.
25126... T Remove/graft forearm 252 19.39 $1,025.49 $509.18 $205.10
lesion.
25130... T Removal of wrist lesion 252 19.39 $1,025.49 $509.18 $205.10
25135... T Remove & graft wrist 252 19.39 $1,025.49 $509.18 $205.10
lesion.
25136... T Remove & graft wrist 252 19.39 $1,025.49 $509.18 $205.10
lesion.
25145... T Remove forearm bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
25150... T Partial removal of ulna 252 19.39 $1,025.49 $509.18 $205.10
25151... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10
radius.
25170... C Extensive forearm ......... ......... ......... ........... ...........
surgery.
25210... T Removal of wrist bone.. 262 18.35 $970.64 $480.93 $194.13
25215... T Removal of wrist bones. 262 18.35 $970.64 $480.93 $194.13
25230... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10
radius.
25240... T Partial removal of ulna 252 19.39 $1,025.49 $509.18 $205.10
25246... T Injection for wrist x- 347 2.93 $154.75 $62.15 $30.95
ray.
25248... T Remove forearm foreign 251 14.26 $754.18 $366.12 $150.84
body.
25250... T Removal of wrist 252 19.39 $1,025.49 $509.18 $205.10
prosthesis.
25251... T Removal of wrist 252 19.39 $1,025.49 $509.18 $205.10
prosthesis.
25260... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10
muscle.
25263... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10
muscle.
25265... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10
muscle.
25270... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10
muscle.
25272... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10
muscle.
25274... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10
muscle.
25280... T Revise wrist/forearm 252 19.39 $1,025.49 $509.18 $205.10
tendon.
25290... T Incise wrist/forearm 252 19.39 $1,025.49 $509.18 $205.10
tendon.
[[Page 47637]]
25295... T Release wrist/forearm 251 14.26 $754.18 $366.12 $150.84
tendon.
25300... T Fusion of tendons at 252 19.39 $1,025.49 $509.18 $205.10
wrist.
25301... T Fusion of tendons at 252 19.39 $1,025.49 $509.18 $205.10
wrist.
25310... T Transplant forearm 253 26.33 $1,392.78 $699.24 $278.56
tendon.
25312... T Transplant forearm 253 26.33 $1,392.78 $699.24 $278.56
tendon.
25315... T Revise palsy hand 253 26.33 $1,392.78 $699.24 $278.56
tendon(s).
25316... T Revise palsy hand 253 26.33 $1,392.78 $699.24 $278.56
tendon(s).
25320... T Repair/revise wrist 253 26.33 $1,392.78 $699.24 $278.56
joint.
25332... T Revise wrist joint..... 217 20.48 $1,083.27 $526.81 $216.65
25335... T Realignment of hand.... 253 26.33 $1,392.78 $699.24 $278.56
25337... T Reconstruct ulna/ 253 26.33 $1,392.78 $699.24 $278.56
radioulnar.
25350... T Revision of radius..... 253 26.33 $1,392.78 $699.24 $278.56
25355... T Revision of radius..... 253 26.33 $1,392.78 $699.24 $278.56
25360... T Revision of ulna....... 252 19.39 $1,025.49 $509.18 $205.10
25365... T Revise radius & ulna... 252 19.39 $1,025.49 $509.18 $205.10
25370... T Revise radius or ulna.. 253 26.33 $1,392.78 $699.24 $278.56
25375... T Revise radius & ulna... 253 26.33 $1,392.78 $699.24 $278.56
25390... C Shorten radius/ulna.... ......... ......... ......... ........... ...........
25391... C Lengthen radius/ulna... ......... ......... ......... ........... ...........
25392... C Shorten radius & ulna.. ......... ......... ......... ........... ...........
25393... C Lengthen radius & ulna. ......... ......... ......... ........... ...........
25400... T Repair radius or ulna.. 252 19.39 $1,025.49 $509.18 $205.10
25405... C Repair/graft radius or ......... ......... ......... ........... ...........
ulna.
25415... T Repair radius & ulna... 252 19.39 $1,025.49 $509.18 $205.10
25420... C Repair/graft radius & ......... ......... ......... ........... ...........
ulna.
25425... T Repair/graft radius or 253 26.33 $1,392.78 $699.24 $278.56
ulna.
25426... T Repair/graft radius & 253 26.33 $1,392.78 $699.24 $278.56
ulna.
25440... T Repair/graft wrist bone 253 26.33 $1,392.78 $699.24 $278.56
25441... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90
25442... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90
25443... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90
25444... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90
25445... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90
25446... T Wrist replacement...... 218 27.50 $1,454.49 $715.52 $290.90
25447... T Repair wrist joint(s).. 217 20.48 $1,083.27 $526.81 $216.65
25449... T Remove wrist joint 217 20.48 $1,083.27 $526.81 $216.65
implant.
25450... T Revision of wrist joint 253 26.33 $1,392.78 $699.24 $278.56
25455... T Revision of wrist joint 253 26.33 $1,392.78 $699.24 $278.56
25490... T Reinforce radius....... 253 26.33 $1,392.78 $699.24 $278.56
25491... T Reinforce ulna......... 253 26.33 $1,392.78 $699.24 $278.56
25492... T Reinforce radius and 253 26.33 $1,392.78 $699.24 $278.56
ulna.
25500... T Treat fracture of 209 1.94 $102.84 $37.29 $20.57
radius.
25505... T Treat fracture of 209 1.94 $102.84 $37.29 $20.57
radius.
25515... T Repair fracture of 216 20.13 $1,064.67 $520.93 $212.93
radius.
25520... T Repair fracture of 209 1.94 $102.84 $37.29 $20.57
radius.
25525... T Repair fracture of 216 20.13 $1,064.67 $520.93 $212.93
radius.
25526... T Repair fracture of 216 20.13 $1,064.67 $520.93 $212.93
radius.
25530... T Treat fracture of ulna. 209 1.94 $102.84 $37.29 $20.57
25535... T Treat fracture of ulna. 209 1.94 $102.84 $37.29 $20.57
25545... T Repair fracture of ulna 216 20.13 $1,064.67 $520.93 $212.93
25560... T Treat fracture radius & 209 1.94 $102.84 $37.29 $20.57
ulna.
25565... T Treat fracture radius & 209 1.94 $102.84 $37.29 $20.57
ulna.
25574... T Treat fracture radius & 216 20.13 $1,064.67 $520.93 $212.93
ulna.
25575... T Repair fracture radius/ 216 20.13 $1,064.67 $520.93 $212.93
ulna.
25600... T Treat fracture radius/ 209 1.94 $102.84 $37.29 $20.57
ulna.
25605... T Treat fracture radius/ 209 1.94 $102.84 $37.29 $20.57
ulna.
25611... T Repair fracture radius/ 216 20.13 $1,064.67 $520.93 $212.93
ulna.
25620... T Repair fracture radius/ 216 20.13 $1,064.67 $520.93 $212.93
ulna.
25622... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57
fracture.
25624... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57
fracture.
25628... T Repair wrist bone 216 20.13 $1,064.67 $520.93 $212.93
fracture.
25630... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57
fracture.
25635... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57
fracture.
25645... T Repair wrist bone 216 20.13 $1,064.67 $520.93 $212.93
fracture.
25650... T Repair wrist bone 209 1.94 $102.84 $37.29 $20.57
fracture.
25660... T Treat wrist dislocation 209 1.94 $102.84 $37.29 $20.57
25670... T Repair wrist 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
25675... T Treat wrist dislocation 209 1.94 $102.84 $37.29 $20.57
25676... T Repair wrist 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
25680... T Treat wrist fracture... 209 1.94 $102.84 $37.29 $20.57
25685... T Repair wrist fracture.. 216 20.13 $1,064.67 $520.93 $212.93
25690... T Treat wrist dislocation 209 1.94 102.84 $37.29 $20.57
25695... T Repair wrist 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
25800... T Fusion of wrist joint.. 253 26.33 $1,392.78 $699.24 $278.56
25805... T Fusion/graft of wrist 253 26.33 $1,392.78 $699.24 $278.56
joint.
[[Page 47638]]
25810... T Fusion/graft of wrist 253 26.33 $1,392.78 $699.24 $278.56
joint.
25820... T Fusion of hand bones... 261 10.54 $557.31 $261.48 $111.46
25825... T Fusion hand bones with 262 18.35 $970.64 $480.93 $194.13
graft.
25830... T Fusion radioulnar jnt/ 253 26.33 $1,392.78 $699.24 $278.56
ulna.
25900... C Amputation of forearm.. ......... ......... ......... ........... ...........
25905... C Amputation of forearm.. ......... ......... ......... ........... ...........
25907... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84
surgery.
25909... C Amputation follow-up ......... ......... ......... ........... ...........
surgery.
25915... C Amputation of forearm.. ......... ......... ......... ........... ...........
25920... C Amputate hand at wrist. ......... ......... ......... ........... ...........
25922... T Amputate hand at wrist. 251 14.26 $754.18 $366.12 $150.84
25924... C Amputation follow-up ......... ......... ......... ........... ...........
surgery.
25927... C Amputation of hand..... ......... ......... ......... ........... ...........
25929... T Amputation follow-up 183 11.17 $590.61 $286.57 $118.12
surgery.
25931... C Amputation follow-up ......... ......... ......... ........... ...........
surgery.
25999... T Forearm or wrist 209 1.94 $102.84 $37.29 $20.57
surgery.
26010... T Drainage of finger 131 1.94 $102.84 $36.61 $20.57
abscess.
26011... T Drainage of finger 131 1.94 $102.84 $36.61 $20.57
abscess.
26020... T Drain hand tendon 261 10.54 $557.31 $261.48 $111.46
sheath.
26025... T Drainage of palm bursa. 261 10.54 $557.31 $261.48 $111.46
26030... T Drainage of palm 261 10.54 $557.31 $261.48 $111.46
bursa(s).
26034... T Treat hand bone lesion. 261 10.54 $557.31 $261.48 $111.46
26035... T Decompress fingers/hand 261 10.54 $557.31 $261.48 $111.46
26037... T Decompress fingers/hand 261 10.54 $557.31 $261.48 $111.46
26040... T Release palm 262 18.35 $970.64 $480.93 $194.13
contracture.
26045... T Release palm 262 18.35 $970.64 $480.93 $194.13
contracture.
26055... T Incise finger tendon 261 10.54 $557.31 $261.48 $111.46
sheath.
26060... T Incision of finger 261 10.54 $557.31 $261.48 $111.46
tendon.
26070... T Explore/treat hand 261 10.54 $557.31 $261.48 $111.46
joint.
26075... T Explore/treat finger 261 10.54 $557.31 $261.48 $111.46
joint.
26080... T Explore/treat finger 261 10.54 $557.31 $261.48 $111.46
joint.
26100... T Biopsy hand joint 261 10.54 $557.31 $261.48 $111.46
lining.
26105... T Biopsy finger joint 261 10.54 $557.31 $261.48 $111.46
lining.
26110... T Biopsy finger joint 261 10.54 $557.31 $261.48 $111.46
lining.
26115... T Removal of hand lesion. 163 10.69 $565.14 $264.65 $113.03
26116... T Removal of hand lesion. 163 10.69 $565.14 $264.65 $113.03
26117... T Remove tumor, hand/ 163 10.69 $565.14 $264.65 $113.03
finger.
26121... T Release palm 262 18.35 $970.64 $480.93 $194.13
contracture.
26123... T Release palm 262 18.35 $970.64 $480.93 $194.13
contracture.
26125... T Release palm 262 18.35 $970.64 $480.93 $194.13
contracture.
26130... T Remove wrist joint 261 10.54 $557.31 $261.48 $111.46
lining.
26135... T Revise finger joint, 262 18.35 $970.64 $480.93 $194.13
each.
26140... T Revise finger joint, 261 10.54 $557.31 $261.48 $111.46
each.
26145... T Tendon excision, palm/ 261 10.54 $557.31 $261.48 $111.46
finger.
26160... T Remove tendon sheath 261 10.54 $557.31 $261.48 $111.46
lesion.
26170... T Removal of palm tendon, 261 10.54 $557.31 $261.48 $111.46
each.
26180... T Removal of finger 261 10.54 $557.31 $261.48 $111.46
tendon.
26185... T Remove finger bone..... 261 10.54 $557.31 $261.48 $111.46
26200... T Remove hand bone lesion 261 10.54 $557.31 $261.48 $111.46
26205... T Remove/graft bone 262 18.35 $970.64 $480.93 $194.13
lesion.
26210... T Removal of finger 261 10.54 $557.31 $261.48 $111.46
lesion.
26215... T Remove/graft finger 261 10.54 $557.31 $261.48 $111.46
lesion.
26230... T Partial removal of hand 261 10.54 $557.31 $261.48 $111.46
bone.
26235... T Partial removal, finger 261 10.54 $557.31 $261.48 $111.46
bone.
26236... T Partial removal, finger 261 10.54 $557.31 $261.48 $111.46
bone.
26250... T Extensive hand surgery. 261 10.54 $557.31 $261.48 $111.46
26255... T Extensive hand surgery. 262 18.35 $970.64 $480.93 $194.13
26260... T Extensive finger 261 10.54 $557.31 $261.48 $111.46
surgery.
26261... T Extensive finger 261 10.54 $557.31 $261.48 $111.46
surgery.
26262... T Partial removal of 261 10.54 $557.31 $261.48 $111.46
finger.
26320... T Removal of implant from 163 10.69 $565.14 $264.65 $113.03
hand.
26350... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26352... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26356... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26357... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26358... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26370... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26372... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26373... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26390... T Revise hand/finger 262 18.35 $970.64 $480.93 $194.13
tendon.
26392... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26410... T Repair hand tendon..... 261 10.54 $557.31 $261.48 $111.46
26412... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26415... T Excision, hand/finger 262 18.35 $970.64 $480.93 $194.13
tendon.
26416... T Graft hand or finger 262 18.35 $970.64 $480.93 $194.13
tendon.
[[Page 47639]]
26418... T Repair finger tendon... 261 10.54 $557.31 $261.48 $111.46
26420... T Repair/graft finger 262 18.35 $970.64 $480.93 $194.13
tendon.
26426... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26428... T Repair/graft finger 262 18.35 $970.64 $480.93 $194.13
tendon.
26432... T Repair finger tendon... 261 10.54 $557.31 $261.48 $111.46
26433... T Repair finger tendon... 261 10.54 $557.31 $261.48 $111.46
26434... T Repair/graft finger 262 18.35 $970.64 $480.93 $194.13
tendon.
26437... T Realignment of tendons. 261 10.54 $557.31 $261.48 $111.46
26440... T Release palm/finger 261 10.54 $557.31 $261.48 $111.46
tendon.
26442... T Release palm & finger 262 18.35 $970.64 $480.93 $194.13
tendon.
26445... T Release hand/finger 261 10.54 $557.31 $261.48 $111.46
tendon.
26449... T Release forearm/hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26450... T Incision of palm tendon 261 10.54 $557.31 $261.48 $111.46
26455... T Incision of finger 261 10.54 $557.31 $261.48 $111.46
tendon.
26460... T Incise hand/finger 261 10.54 $557.31 $261.48 $111.46
tendon.
26471... T Fusion of finger 261 10.54 $557.31 $261.48 $111.46
tendons.
26474... T Fusion of finger 261 10.54 $557.31 $261.48 $111.46
tendons.
26476... T Tendon lengthening..... 261 10.54 $557.31 $261.48 $111.46
26477... T Tendon shortening...... 261 10.54 $557.31 $261.48 $111.46
26478... T Lengthening of hand 261 10.54 $557.31 $261.48 $111.46
tendon.
26479... T Shortening of hand 261 10.54 $557.31 $261.48 $111.46
tendon.
26480... T Transplant hand tendon. 262 18.35 $970.64 $480.93 $194.13
26483... T Transplant/graft hand 262 18.35 $970.64 $480.93 $194.13
tendon.
26485... T Transplant palm tendon. 262 18.35 $970.64 $480.93 $194.13
26489... T Transplant/graft palm 262 18.35 $970.64 $480.93 $194.13
tendon.
26490... T Revise thumb tendon.... 262 18.35 $970.64 $480.93 $194.13
26492... T Tendon transfer with 262 18.35 $970.64 $480.93 $194.13
graft.
26494... T Hand tendon/muscle 262 18.35 $970.64 $480.93 $194.13
transfer.
26496... T Revise thumb tendon.... 262 18.35 $970.64 $480.93 $194.13
26497... T Finger tendon transfer. 262 18.35 $970.64 $480.93 $194.13
26498... T Finger tendon transfer. 262 18.35 $970.64 $480.93 $194.13
26499... T Revision of finger..... 262 18.35 $970.64 $480.93 $194.13
26500... T Hand tendon 261 10.54 $557.31 $261.48 $111.46
reconstruction.
26502... T Hand tendon 262 18.35 $970.64 $480.93 $194.13
reconstruction.
26504... T Hand tendon 262 18.35 $970.64 $480.93 $194.13
reconstruction.
26508... T Release thumb 261 10.54 $557.31 $261.48 $111.46
contracture.
26510... T Thumb tendon transfer.. 262 18.35 $970.64 $480.93 $194.13
26516... T Fusion of knuckle joint 262 18.35 $970.64 $480.93 $194.13
26517... T Fusion of knuckle 262 18.35 $970.64 $480.93 $194.13
joints.
26518... T Fusion of knuckle 262 18.35 $970.64 $480.93 $194.13
joints.
26520... T Release knuckle 261 10.54 $557.31 $261.48 $111.46
contracture.
26525... T Release finger 261 10.54 $557.31 $261.48 $111.46
contracture.
26530... T Revise knuckle joint... 217 20.48 $1,083.27 $526.81 $216.65
26531... T Revise knuckle with 218 27.50 $1,454.49 $715.52 $290.90
implant.
26535... T Revise finger joint.... 217 20.48 $1,083.27 $526.81 $216.65
26536... T Revise/implant finger 218 27.50 $1,454.49 $715.52 $290.90
joint.
26540... T Repair hand joint...... 261 10.54 $557.31 $261.48 $111.46
26541... T Repair hand joint with 262 18.35 $970.64 $480.93 $194.13
graft.
26542... T Repair hand joint with 261 10.54 $557.31 $261.48 $111.46
graft.
26545... T Reconstruct finger 262 18.35 $970.64 $480.93 $194.13
joint.
26546... T Repair non-union hand.. 262 18.35 $970.64 $480.93 $194.13
26548... T Reconstruct finger 262 18.35 $970.64 $480.93 $194.13
joint.
26550... T Construct thumb 262 18.35 $970.64 $480.93 $194.13
replacement.
26551... C Great toe-hand transfer ......... ......... ......... ........... ...........
26553... C Single toe-hand ......... ......... ......... ........... ...........
transfer.
26554... C Double toe-hand ......... ......... ......... ........... ...........
transfer.
26555... T Positional change of 262 18.35 $970.64 $480.93 $194.13
finger.
26556... C Toe joint transfer..... ......... ......... ......... ........... ...........
26560... T Repair of web finger... 261 10.54 $557.31 $261.48 $111.46
26561... T Repair of web finger... 262 18.35 $970.64 $480.93 $194.13
26562... T Repair of web finger... 262 18.35 $970.64 $480.93 $194.13
26565... T Correct metacarpal flaw 262 18.35 $970.64 $480.93 $194.13
26567... T Correct finger 262 18.35 $970.64 $480.93 $194.13
deformity.
26568... T Lengthen metacarpal/ 262 18.35 $970.64 $480.93 $194.13
finger.
26580... T Repair hand deformity.. 262 18.35 $970.64 $480.93 $194.13
26585... T Repair finger deformity 262 18.35 $970.64 $480.93 $194.13
26587... T Reconstruct extra 261 10.54 $557.31 $261.48 $111.46
finger.
26590... T Repair finger deformity 262 18.35 $970.64 $480.93 $194.13
26591... T Repair muscles of hand. 262 18.35 $970.64 $480.93 $194.13
26593... T Release muscles of hand 261 10.54 $557.31 $261.48 $111.46
26596... T Excision constricting 262 18.35 $970.64 $480.93 $194.13
tissue.
26597... T Release of scar 262 18.35 $970.64 $480.93 $194.13
contracture.
26600... T Treat metacarpal 209 1.94 $102.84 $37.29 $20.57
fracture.
26605... T Treat metacarpal 209 1.94 $102.84 $37.29 $20.57
fracture.
26607... T Treat metacarpal 209 1.94 $102.84 $37.29 $20.57
fracture.
[[Page 47640]]
26608... T Treat metacarpal 216 20.13 $1,064.67 $520.93 $212.93
fracture.
26615... T Repair metacarpal 216 20.13 $1,064.67 $520.93 $212.93
fracture.
26641... T Treat thumb dislocation 209 1.94 $102.84 $37.29 $20.57
26645... T Treat thumb fracture... 209 1.94 $102.84 $37.29 $20.57
26650... T Repair thumb fracture.. 216 20.13 $1,064.67 $520.93 $212.93
26665... T Repair thumb fracture.. 216 20.13 $1,064.67 $520.93 $212.93
26670... T Treat hand dislocation. 209 1.94 $102.84 $37.29 $20.57
26675... T Treat hand dislocation. 210 10.46 $553.39 $283.4 $110.68
26676... T Pin hand dislocation... 216 20.13 $1,064.67 $520.93 $212.93
26685... T Repair hand dislocation 216 20.13 $1,064.67 $520.93 $212.93
26686... T Repair hand dislocation 216 20.13 $1,064.67 $520.93 $212.93
26700... T Treat knuckle 207 1.70 $90.11 $31.64 $18.02
dislocation.
26705... T Treat knuckle 210 10.46 $553.39 $283.4 $110.68
dislocation.
26706... T Pin knuckle dislocation 209 1.94 $102.84 $37.29 $20.57
26715... T Repair knuckle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
26720... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02
each.
26725... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02
each.
26727... T Treat finger fracture, 216 20.13 $1,064.67 $520.93 $212.93
each.
26735... T Repair finger fracture, 216 20.13 $1,064.67 $520.93 $212.93
each.
26740... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02
each.
26742... T Treat finger fracture, 209 1.94 $102.84 $37.29 $20.57
each.
26746... T Repair finger fracture, 216 20.13 $1,064.67 $520.93 $212.93
each.
26750... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02
each.
26755... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02
each.
26756... T Pin finger fracture, 216 20.13 $1,064.67 $520.93 $212.93
each.
26765... T Repair finger fracture, 216 20.13 $1,064.67 $520.93 $212.93
each.
26770... T Treat finger 207 1.70 $90.11 $31.64 $18.02
dislocation.
26775... T Treat finger 210 10.46 $553.39 $283.4 $110.68
dislocation.
26776... T Pin finger dislocation. 216 20.13 $1,064.67 $520.93 $212.93
26785... T Repair finger 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
26820... T Thumb fusion with graft 262 18.35 $970.64 $480.93 $194.13
26841... T Fusion of thumb........ 262 18.35 $970.64 $480.93 $194.13
26842... T Thumb fusion with graft 262 18.35 $970.64 $480.93 $194.13
26843... T Fusion of hand joint... 262 18.35 $970.64 $480.93 $194.13
26844... T Fusion/graft of hand 262 18.35 $970.64 $480.93 $194.13
joint.
26850... T Fusion of knuckle...... 262 18.35 $970.64 $480.93 $194.13
26852... T Fusion of knuckle with 262 18.35 $970.64 $480.93 $194.13
graft.
26860... T Fusion of finger joint. 262 18.35 $970.64 $480.93 $194.13
26861... T Fusion of finger joint, 262 18.35 $970.64 $480.93 $194.13
added.
26862... T Fusion/graft of finger 262 18.35 $970.64 $480.93 $194.13
joint.
26863... T Fuse/graft added joint. 262 18.35 $970.64 $480.93 $194.13
26910... T Amputate metacarpal 262 18.35 $970.64 $480.93 $194.13
bone.
26951... T Amputation of finger/ 261 10.54 $557.31 $261.48 $111.46
thumb.
26952... T Amputation of finger/ 261 10.54 $557.31 $261.48 $111.46
thumb.
26989... T Hand/finger surgery.... 207 1.70 $90.11 $31.64 $18.02
26990... T Drainage of pelvis 251 14.26 $754.18 $366.12 $150.84
lesion.
26991... T Drainage of pelvis 251 14.26 $754.18 $366.12 $150.84
bursa.
26992... C Drainage of bone lesion ......... ......... ......... ........... ...........
27000... T Incision of hip tendon. 251 14.26 $754.18 $366.12 $150.84
27001... T Incision of hip tendon. 252 19.39 $1,025.49 $509.18 $205.10
27003... T Incision of hip tendon. 252 19.39 $1,025.49 $509.18 $205.10
27005... C Incision of hip tendon. ......... ......... ......... ........... ...........
27006... C Incision of hip tendons ......... ......... ......... ........... ...........
27025... C Incision of hip/thigh ......... ......... ......... ........... ...........
fascia.
27030... C Drainage of hip joint.. ......... ......... ......... ........... ...........
27033... T Exploration of hip 253 26.33 $1,392.78 $699.24 $278.56
joint.
27035... C Denervation of hip ......... ......... ......... ........... ...........
joint.
27036... C Excision of hip joint/ ......... ......... ......... ........... ...........
muscle.
27040... T Biopsy of soft tissues. 162 5.67 $299.71 $125.43 $59.94
27041... T Biopsy of soft tissues. 163 10.69 $565.14 $264.65 $113.03
27047... T Remove hip/pelvis 163 10.69 $565.14 $264.65 $113.03
lesion.
27048... T Remove hip/pelvis 163 10.69 $565.14 $264.65 $113.03
lesion.
27049... T Remove tumor, hip/ 163 10.69 $565.14 $264.65 $113.03
pelvis.
27050... T Biopsy of sacroiliac 251 14.26 $754.18 $366.12 $150.84
joint.
27052... T Biopsy of hip joint.... 251 14.26 $754.18 $366.12 $150.84
27054... C Removal of hip joint ......... ......... ......... ........... ...........
lining.
27060... T Removal of ischial 251 14.26 $754.18 $366.12 $150.84
bursa.
27062... T Remove femur lesion/ 251 14.26 $754.18 $366.12 $150.84
bursa.
27065... T Removal of hip bone 251 14.26 $754.18 $366.12 $150.84
lesion.
27066... T Removal of hip bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
27067... T Remove/graft hip bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
27070... C Partial removal of hip ......... ......... ......... ........... ...........
bone.
27071... C Partial removal of hip ......... ......... ......... ........... ...........
bone.
27075... C Extensive hip surgery.. ......... ......... ......... ........... ...........
27076... C Extensive hip surgery.. ......... ......... ......... ........... ...........
[[Page 47641]]
27077... C Extensive hip surgery.. ......... ......... ......... ........... ...........
27078... C Extensive hip surgery.. ......... ......... ......... ........... ...........
27079... C Extensive hip surgery.. ......... ......... ......... ........... ...........
27080... T Removal of tail bone... 252 19.39 $1,025.49 $509.18 $205.10
27086... T Remove hip foreign body 251 14.26 $754.18 $366.12 $150.84
27087... T Remove hip foreign body 251 14.26 $754.18 $366.12 $150.84
27090... C Removal of hip ......... ......... ......... ........... ...........
prosthesis.
27091... C Removal of hip ......... ......... ......... ........... ...........
prosthesis.
27093... T Injection for hip x-ray 347 2.93 $154.75 $62.15 $30.95
27095... T Injection for hip x-ray 347 2.93 $154.75 $62.15 $30.95
27097... T Revision of hip tendon. 252 19.39 $1,025.49 $509.18 $205.10
27098... T Transfer tendon to 252 19.39 $1,025.49 $509.18 $205.10
pelvis.
27100... T Transfer of abdominal 253 26.33 $1,392.78 $699.24 $278.56
muscle.
27105... T Transfer of spinal 253 26.33 $1,392.78 $699.24 $278.56
muscle.
27110... T Transfer of iliopsoas 253 26.33 $1,392.78 $699.24 $278.56
muscle.
27111... T Transfer of iliopsoas 253 26.33 $1,392.78 $699.24 $278.56
muscle.
27120... C Reconstruction of hip ......... ......... ......... ........... ...........
socket.
27122... C Reconstruction of hip ......... ......... ......... ........... ...........
socket.
27125... C Partial hip replacement ......... ......... ......... ........... ...........
27130... C Total hip replacement.. ......... ......... ......... ........... ...........
27132... C Total hip replacement.. ......... ......... ......... ........... ...........
27134... C Revise hip joint ......... ......... ......... ........... ...........
replacement.
27137... C Revise hip joint ......... ......... ......... ........... ...........
replacement.
27138... C Revise hip joint ......... ......... ......... ........... ...........
replacement.
27140... C Transplant of femur ......... ......... ......... ........... ...........
ridge.
27146... C Incision of hip bone... ......... ......... ......... ........... ...........
27147... C Revision of hip bone... ......... ......... ......... ........... ...........
27151... C Incision of hip bones.. ......... ......... ......... ........... ...........
27156... C Revision of hip bones.. ......... ......... ......... ........... ...........
27158... C Revision of pelvis..... ......... ......... ......... ........... ...........
27161... C Incision of neck of ......... ......... ......... ........... ...........
femur.
27165... C Incision/fixation of ......... ......... ......... ........... ...........
femur.
27170... C Repair/graft femur head/ ......... ......... ......... ........... ...........
neck.
27175... C Treat slipped epiphysis ......... ......... ......... ........... ...........
27176... C Treat slipped epiphysis ......... ......... ......... ........... ...........
27177... C Repair slipped ......... ......... ......... ........... ...........
epiphysis.
27178... C Repair slipped ......... ......... ......... ........... ...........
epiphysis.
27179... C Revise head/neck of ......... ......... ......... ........... ...........
femur.
27181... C Repair slipped ......... ......... ......... ........... ...........
epiphysis.
27185... C Revision of femur ......... ......... ......... ........... ...........
epiphysis.
27187... C Reinforce hip bones.... ......... ......... ......... ........... ...........
27193... T Treat pelvic ring 209 1.94 $102.84 $37.29 $20.57
fracture.
27194... T Treat pelvic ring 210 10.46 $553.39 $283.4 $110.68
fracture.
27200... T Treat tail bone 207 1.70 $90.11 $31.64 $18.02
fracture.
27202... T Repair tail bone 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27215... C Pelvic fracture(s) ......... ......... ......... ........... ...........
treatment.
27216... C Treat pelvic ring ......... ......... ......... ........... ...........
fracture.
27217... C Treat pelvic ring ......... ......... ......... ........... ...........
fracture.
27218... C Treat pelvic ring ......... ......... ......... ........... ...........
fracture.
27220... T Treat hip socket 209 1.94 $102.84 $37.29 $20.57
fracture.
27222... C Treat hip socket ......... ......... ......... ........... ...........
fracture.
27226... C Treat hip wall fracture ......... ......... ......... ........... ...........
27227... C Treat hip fracture(s).. ......... ......... ......... ........... ...........
27228... C Treat hip fracture(s).. ......... ......... ......... ........... ...........
27230... T Treat fracture of thigh 209 1.94 $102.84 $37.29 $20.57
27232... C Treat fracture of thigh ......... ......... ......... ........... ...........
27235... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27236... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27238... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27240... C Treatment of thigh ......... ......... ......... ........... ...........
fracture.
27244... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27245... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27246... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27248... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27250... T Treat hip dislocation.. 209 1.94 $102.84 $37.29 $20.57
27252... T Treat hip dislocation.. 210 10.46 $553.39 $283.4 $110.68
27253... C Repair of hip ......... ......... ......... ........... ...........
dislocation.
27254... C Repair of hip ......... ......... ......... ........... ...........
dislocation.
27256... T Treatment of hip 209 1.94 $102.84 $37.29 $20.57
dislocation.
27257... T Treatment of hip 210 10.46 $553.39 $283.4 $110.68
dislocation.
27258... C Repair of hip ......... ......... ......... ........... ...........
dislocation.
27259... C Repair of hip ......... ......... ......... ........... ...........
dislocation.
27265... T Treatment of hip 209 1.94 $102.84 $37.29 $20.57
dislocation.
27266... T Treatment of hip 217 20.48 $1,083.27 $526.81 $216.65
dislocation.
27275... T Manipulation of hip 210 10.46 $553.39 $283.4 $110.68
joint.
[[Page 47642]]
27280... C Fusion of sacroiliac ......... ......... ......... ........... ...........
joint.
27282... C Fusion of pubic bones.. ......... ......... ......... ........... ...........
27284... C Fusion of hip joint.... ......... ......... ......... ........... ...........
27286... C Fusion of hip joint.... ......... ......... ......... ........... ...........
27290... C Amputation of leg at ......... ......... ......... ........... ...........
hip.
27295... C Amputation of leg at ......... ......... ......... ........... ...........
hip.
27299... T Pelvis/hip joint 207 1.70 $90.11 $31.64 $18.02
surgery.
27301... T Drain thigh/knee lesion 132 6.04 $319.3 $134.24 $63.86
27303... C Drainage of bone lesion ......... ......... ......... ........... ...........
27305... T Incise thigh tendon & 251 14.26 $754.18 $366.12 $150.84
fascia.
27306... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84
tendon.
27307... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84
tendons.
27310... T Exploration of knee 252 19.39 $1,025.49 $509.18 $205.10
joint.
27315... T Partial removal, thigh 631 12.98 $686.6 $333.8 $137.32
nerve.
27320... T Partial removal, thigh 631 12.98 $686.6 $333.8 $137.32
nerve.
27323... T Biopsy thigh soft 162 5.67 $299.71 $125.43 $59.94
tissues.
27324... T Biopsy thigh soft 163 10.69 $565.14 $264.65 $113.03
tissues.
27327... T Removal of thigh lesion 163 10.69 $565.14 $264.65 $113.03
27328... T Removal of thigh lesion 163 10.69 $565.14 $264.65 $113.03
27329... T Remove tumor, thigh/ 163 10.69 $565.14 $264.65 $113.03
knee.
27330... T Biopsy knee joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
27331... T Explore/treat knee 252 19.39 $1,025.49 $509.18 $205.10
joint.
27332... T Removal of knee 252 19.39 $1,025.49 $509.18 $205.10
cartilage.
27333... T Removal of knee 252 19.39 $1,025.49 $509.18 $205.10
cartilage.
27334... T Remove knee joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
27335... T Remove knee joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
27340... T Removal of kneecap 251 14.26 $754.18 $366.12 $150.84
bursa.
27345... T Removal of knee cyst... 251 14.26 $754.18 $366.12 $150.84
27350... T Removal of kneecap..... 252 19.39 $1,025.49 $509.18 $205.10
27355... T Remove femur lesion.... 252 19.39 $1,025.49 $509.18 $205.10
27356... T Remove femur lesion/ 252 19.39 $1,025.49 $509.18 $205.10
graft.
27357... T Remove femur lesion/ 252 19.39 $1,025.49 $509.18 $205.10
graft.
27358... T Remove femur lesion/ 252 19.39 $1,025.49 $509.18 $205.10
fixation.
27360... T Partial removal leg 252 19.39 $1,025.49 $509.18 $205.10
bone(s).
27365... C Extensive leg surgery.. ......... ......... ......... ........... ...........
27370... T Injection for knee x- 347 2.93 $154.75 $62.15 $30.95
ray.
27372... T Removal of foreign body 163 10.69 $565.14 $264.65 $113.03
27380... T Repair of kneecap 251 14.26 $754.18 $366.12 $150.84
tendon.
27381... T Repair/graft kneecap 251 14.26 $754.18 $366.12 $150.84
tendon.
27385... T Repair of thigh muscle. 251 14.26 $754.18 $366.12 $150.84
27386... T Repair/graft of thigh 251 14.26 $754.18 $366.12 $150.84
muscle.
27390... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84
tendon.
27391... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84
tendons.
27392... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84
tendons.
27393... T Lengthening of thigh 252 19.39 $1,025.49 $509.18 $205.10
tendon.
27394... T Lengthening of thigh 252 19.39 $1,025.49 $509.18 $205.10
tendons.
27395... T Lengthening of thigh 253 26.33 $1,392.78 $699.24 $278.56
tendons.
27396... T Transplant of thigh 252 19.39 $1,025.49 $509.18 $205.10
tendon.
27397... T Transplants of thigh 253 26.33 $1,392.78 $699.24 $278.56
tendons.
27400... T Revise thigh muscles/ 253 26.33 $1,392.78 $699.24 $278.56
tendons.
27403... T Repair of knee 252 19.39 $1,025.49 $509.18 $205.10
cartilage.
27405... T Repair of knee ligament 253 26.33 $1,392.78 $699.24 $278.56
27407... T Repair of knee ligament 253 26.33 $1,392.78 $699.24 $278.56
27409... T Repair of knee 253 26.33 $1,392.78 $699.24 $278.56
ligaments.
27418... T Repair degenerated 253 26.33 $1,392.78 $699.24 $278.56
kneecap.
27420... T Revision of unstable 253 26.33 $1,392.78 $699.24 $278.56
kneecap.
27422... T Revision of unstable 253 26.33 $1,392.78 $699.24 $278.56
kneecap.
27424... T Revision/removal of 253 26.33 $1,392.78 $699.24 $278.56
kneecap.
27425... T Lateral retinacular 252 19.39 $1,025.49 $509.18 $205.10
release.
27427... T Reconstruction, knee... 254 34.37 $1,817.86 $937.22 $363.57
27428... T Reconstruction, knee... 254 34.37 $1,817.86 $937.22 $363.57
27429... T Reconstruction, knee... 254 34.37 $1,817.86 $937.22 $363.57
27430... T Revision of thigh 253 26.33 $1,392.78 $699.24 $278.56
muscles.
27435... T Incision of knee joint. 253 26.33 $1,392.78 $699.24 $278.56
27437... T Revise kneecap......... 217 20.48 $1,083.27 $526.81 $216.65
27438... T Revise kneecap with 218 27.50 $1,454.49 $715.52 $290.90
implant.
27440... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65
27441... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65
27442... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65
27443... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65
27445... C Revision of knee joint. ......... ......... ......... ........... ...........
27446... C Revision of knee joint. ......... ......... ......... ........... ...........
27447... C Total knee replacement. ......... ......... ......... ........... ...........
27448... C Incision of thigh...... ......... ......... ......... ........... ...........
27450... C Incision of thigh...... ......... ......... ......... ........... ...........
[[Page 47643]]
27454... C Realignment of thigh ......... ......... ......... ........... ...........
bone.
27455... C Realignment of knee.... ......... ......... ......... ........... ...........
27457... C Realignment of knee.... ......... ......... ......... ........... ...........
27465... C Shortening of thigh ......... ......... ......... ........... ...........
bone.
27466... C Lengthening of thigh ......... ......... ......... ........... ...........
bone.
27468... C Shorten/lengthen thighs ......... ......... ......... ........... ...........
27470... C Repair of thigh........ ......... ......... ......... ........... ...........
27472... C Repair/graft of thigh.. ......... ......... ......... ........... ...........
27475... C Surgery to stop leg ......... ......... ......... ........... ...........
growth.
27477... C Surgery to stop leg ......... ......... ......... ........... ...........
growth.
27479... C Surgery to stop leg ......... ......... ......... ........... ...........
growth.
27485... C Surgery to stop leg ......... ......... ......... ........... ...........
growth.
27486... C Revise knee joint ......... ......... ......... ........... ...........
replace.
27487... C Revise knee joint ......... ......... ......... ........... ...........
replace.
27488... C Removal of knee ......... ......... ......... ........... ...........
prosthesis.
27495... C Reinforce thigh........ ......... ......... ......... ........... ...........
27496... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84
knee.
27497... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84
knee.
27498... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84
knee.
27499... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84
knee.
27500... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27501... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27502... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27503... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27506... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27507... C Treatment of thigh ......... ......... ......... ........... ...........
fracture.
27508... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27509... T Treatment of thigh 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27510... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57
fracture.
27511... C Treatment of thigh ......... ......... ......... ........... ...........
fracture.
27513... C Treatment of thigh ......... ......... ......... ........... ...........
fracture.
27514... C Repair of thigh ......... ......... ......... ........... ...........
fracture.
27516... T Repair of thigh growth 209 1.94 $102.84 $37.29 $20.57
plate.
27517... T Repair of thigh growth 209 1.94 $102.84 $37.29 $20.57
plate.
27519... C Repair of thigh growth ......... ......... ......... ........... ...........
plate.
27520... T Treat kneecap fracture. 209 1.94 $102.84 $37.29 $20.57
27524... C Repair of kneecap ......... ......... ......... ........... ...........
fracture.
27530... T Treatment of knee 209 1.94 $102.84 $37.29 $20.57
fracture.
27532... T Treatment of knee 209 1.94 $102.84 $37.29 $20.57
fracture.
27535... C Treatment of knee ......... ......... ......... ........... ...........
fracture.
27536... C Repair of knee fracture ......... ......... ......... ........... ...........
27538... T Treat knee fracture(s). 209 1.94 $102.84 $37.29 $20.57
27540... C Repair of knee fracture ......... ......... ......... ........... ...........
27550... T Treat knee dislocation. 209 1.94 $102.84 $37.29 $20.57
27552... T Treat knee dislocation. 210 10.46 $553.39 $283.40 $110.68
27556... T Repair of knee 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
27557... C Repair of knee ......... ......... ......... ........... ...........
dislocation.
27558... C Repair of knee ......... ......... ......... ........... ...........
dislocation.
27560... T Treat kneecap 209 1.94 $102.84 $37.29 $20.57
dislocation.
27562... T Treat kneecap 210 10.46 $553.39 $283.40 $110.68
dislocation.
27566... T Repair kneecap 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
27570... T Fixation of knee joint. 210 10.46 $553.39 $283.40 $110.68
27580... C Fusion of knee......... ......... ......... ......... ........... ...........
27590... C Amputate leg at thigh.. ......... ......... ......... ........... ...........
27591... C Amputate leg at thigh.. ......... ......... ......... ........... ...........
27592... C Amputate leg at thigh.. ......... ......... ......... ........... ...........
27594... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84
surgery.
27596... C Amputation follow-up ......... ......... ......... ........... ...........
surgery.
27598... C Amputate lower leg at ......... ......... ......... ........... ...........
knee.
27599... T Leg surgery procedure.. 209 1.94 $102.84 $37.29 $20.57
27600... T Decompression of lower 251 14.26 $754.18 $366.12 $150.84
leg.
27601... T Decompression of lower 251 14.26 $754.18 $366.12 $150.84
leg.
27602... T Decompression of lower 251 14.26 $754.18 $366.12 $150.84
leg.
27603... T Drain lower leg lesion. 132 6.04 $319.3 $134.24 $63.86
27604... T Drain lower leg bursa.. 251 14.26 $754.18 $366.12 $150.84
27605... T Incision of achilles 271 14.41 $762.01 $368.38 $152.40
tendon.
27606... T Incision of achilles 251 14.26 $754.18 $366.12 $150.84
tendon.
27607... T Treat lower leg bone 251 14.26 $754.18 $366.12 $150.84
lesion.
27610... T Explore/treat ankle 252 19.39 $1,025.49 $509.18 $205.10
joint.
27612... T Exploration of ankle 252 19.39 $1,025.49 $509.18 $205.10
joint.
27613... T Biopsy lower leg soft 161 3.50 $185.12 $75.48 $37.02
tissue.
27614... T Biopsy lower leg soft 163 10.69 $565.14 $264.65 $113.03
tissue.
27615... T Remove tumor, lower leg 216 20.13 $1,064.67 $520.93 $212.93
27618... T Remove lower leg lesion 163 10.69 $565.14 $264.65 $113.03
27619... T Remove lower leg lesion 163 10.69 $565.14 $264.65 $113.03
[[Page 47644]]
27620... T Explore, treat ankle 252 19.39 $1,025.49 $509.18 $205.10
joint.
27625... T Remove ankle joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
27626... T Remove ankle joint 252 19.39 $1,025.49 $509.18 $205.10
lining.
27630... T Removal of tendon 251 14.26 $754.18 $366.12 $150.84
lesion.
27635... T Remove lower leg bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
27637... T Remove/graft leg bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
27638... T Remove/graft leg bone 252 19.39 $1,025.49 $509.18 $205.10
lesion.
27640... T Partial removal of 253 26.33 $1,392.78 $699.24 $278.56
tibia.
27641... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10
fibula.
27645... C Extensive lower leg ......... ......... ......... ........... ...........
surgery.
27646... C Extensive lower leg ......... ......... ......... ........... ...........
surgery.
27647... T Extensive ankle/heel 253 26.33 $1,392.78 $699.24 $278.56
surgery.
27648... T Injection for ankle x- 347 2.93 $154.75 $62.15 $30.95
ray.
27650... T Repair achilles tendon. 253 26.33 $1,392.78 $699.24 $278.56
27652... T Repair/graft achilles 253 26.33 $1,392.78 $699.24 $278.56
tendon.
27654... T Repair of achilles 253 26.33 $1,392.78 $699.24 $278.56
tendon.
27656... T Repair leg fascia 251 14.26 $754.18 $366.12 $150.84
defect.
27658... T Repair of leg tendon, 251 14.26 $754.18 $366.12 $150.84
each.
27659... T Repair of leg tendon, 251 14.26 $754.18 $366.12 $150.84
each.
27664... T Repair of leg tendon, 251 14.26 $754.18 $366.12 $150.84
each.
27665... T Repair of leg tendon, 252 19.39 $1,025.49 $509.18 $205.10
each.
27675... T Repair lower leg 251 14.26 $754.18 $366.12 $150.84
tendons.
27676... T Repair lower leg 252 19.39 $1,025.49 $509.18 $205.10
tendons.
27680... T Release of lower leg 252 19.39 $1,025.49 $509.18 $205.10
tendon.
27681... T Release of lower leg 252 19.39 $1,025.49 $509.18 $205.10
tendons.
27685... T Revision of lower leg 252 19.39 $1,025.49 $509.18 $205.10
tendon.
27686... T Revise lower leg 252 19.39 $1,025.49 $509.18 $205.10
tendons.
27687... T Revision of calf tendon 252 19.39 $1,025.49 $509.18 $205.10
27690... T Revise lower leg tendon 253 26.33 $1,392.78 $699.24 $278.56
27691... T Revise lower leg tendon 253 26.33 $1,392.78 $699.24 $278.56
27692... T Revise additional leg 253 26.33 $1,392.78 $699.24 $278.56
tendon.
27695... T Repair of ankle 252 19.39 $1,025.49 $509.18 $205.10
ligament.
27696... T Repair of ankle 252 19.39 $1,025.49 $509.18 $205.10
ligaments.
27698... T Repair of ankle 252 19.39 $1,025.49 $509.18 $205.10
ligament.
27700... T Revision of ankle joint 217 20.48 $1,083.27 $526.81 $216.65
27702... C Reconstruct ankle joint ......... ......... ......... ........... ...........
27703... C Reconstruction, ankle ......... ......... ......... ........... ...........
joint.
27704... T Removal of ankle 251 14.26 $754.18 $366.12 $150.84
implant.
27705... T Incision of tibia...... 253 26.33 $1,392.78 $699.24 $278.56
27707... T Incision of fibula..... 251 14.26 $754.18 $366.12 $150.84
27709... T Incision of tibia & 252 19.39 $1,025.49 $509.18 $205.10
fibula.
27712... C Realignment of lower ......... ......... ......... ........... ...........
leg.
27715... C Revision of lower leg.. ......... ......... ......... ........... ...........
27720... C Repair of tibia........ ......... ......... ......... ........... ...........
27722... C Repair/graft of tibia.. ......... ......... ......... ........... ...........
27724... C Repair/graft of tibia.. ......... ......... ......... ........... ...........
27725... C Repair of lower leg.... ......... ......... ......... ........... ...........
27727... C Repair of lower leg.... ......... ......... ......... ........... ...........
27730... T Repair of tibia 252 19.39 $1,025.49 $509.18 $205.10
epiphysis.
27732... T Repair of fibula 252 19.39 $1,025.49 $509.18 $205.10
epiphysis.
27734... T Repair lower leg 252 19.39 $1,025.49 $509.18 $205.10
epiphyses.
27740... T Repair of leg epiphyses 252 19.39 $1,025.49 $509.18 $205.10
27742... T Repair of leg epiphyses 253 26.33 $1,392.78 $699.24 $278.56
27745... T Reinforce tibia........ 253 26.33 $1,392.78 $699.24 $278.56
27750... T Treatment of tibia 209 1.94 $102.84 $37.29 $20.57
fracture.
27752... T Treatment of tibia 209 1.94 $102.84 $37.29 $20.57
fracture.
27756... T Repair of tibia 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27758... T Repair of tibia 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27759... T Repair of tibia 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27760... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27762... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27766... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27780... T Treatment of fibula 209 1.94 $102.84 $37.29 $20.57
fracture.
27781... T Treatment of fibula 209 1.94 $102.84 $37.29 $20.57
fracture.
27784... T Repair of fibula 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27786... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27788... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27792... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27808... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27810... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27814... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27816... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27818... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
27822... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27823... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
[[Page 47645]]
27824... T Treat lower leg 209 1.94 $102.84 $37.29 $20.57
fracture.
27825... T Treat lower leg 209 1.94 $102.84 $37.29 $20.57
fracture.
27826... T Treat lower leg 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27827... T Treat lower leg 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27828... T Treat lower leg 216 20.13 $1,064.67 $520.93 $212.93
fracture.
27829... T Treat lower leg joint.. 216 20.13 $1,064.67 $520.93 $212.93
27830... T Treat lower leg 209 1.94 $102.84 $37.29 $20.57
dislocation.
27831... T Treat lower leg 210 10.46 $553.39 $283.40 $110.68
dislocation.
27832... T Repair lower leg 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
27840... T Treat ankle dislocation 209 1.94 $102.84 $37.29 $20.57
27842... T Treat ankle dislocation 210 10.46 $553.39 $283.40 $110.68
27846... T Repair ankle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
27848... T Repair ankle 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
27860... T Fixation of ankle joint 210 10.46 $553.39 $283.40 $110.68
27870... T Fusion of ankle joint.. 253 26.33 $1,392.78 $699.24 $278.56
27871... T Fusion of tibiofibular 253 26.33 $1,392.78 $699.24 $278.56
joint.
27880... C Amputation of lower leg ......... ......... ......... ........... ...........
27881... C Amputation of lower leg ......... ......... ......... ........... ...........
27882... C Amputation of lower leg ......... ......... ......... ........... ...........
27884... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84
surgery.
27886... C Amputation follow-up ......... ......... ......... ........... ...........
surgery.
27888... C Amputation of foot at ......... ......... ......... ........... ...........
ankle.
27889... T Amputation of foot at 252 19.39 $1,025.49 $509.18 $205.10
ankle.
27892... T Decompression of leg... 251 14.26 $754.18 $366.12 $150.84
27893... T Decompression of leg... 251 14.26 $754.18 $366.12 $150.84
27894... T Decompression of leg... 251 14.26 $754.18 $366.12 $150.84
27899... T Leg/ankle surgery 209 1.94 $102.84 $37.29 $20.57
procedure.
28001... T Drainage of bursa of 132 6.04 $319.3 $134.24 $63.86
foot.
28002... T Treatment of foot 251 14.26 $754.18 $366.12 $150.84
infection.
28003... T Treatment of foot 251 14.26 $754.18 $366.12 $150.84
infection.
28005... T Treat foot bone lesion. 271 14.41 $762.01 $368.38 $152.40
28008... T Incision of foot fascia 271 14.41 $762.01 $368.38 $152.40
28010... T Incision of toe tendon. 271 14.41 $762.01 $368.38 $152.40
28011... T Incision of toe tendons 271 14.41 $762.01 $368.38 $152.40
28020... T Exploration of a foot 271 14.41 $762.01 $368.38 $152.40
joint.
28022... T Exploration of a foot 271 14.41 $762.01 $368.38 $152.40
joint.
28024... T Exploration of a toe 271 14.41 $762.01 $368.38 $152.40
joint.
28030... T Removal of foot nerve.. 631 12.98 $686.60 $333.80 $137.32
28035... T Decompression of tibia 631 12.98 $686.60 $333.80 $137.32
nerve.
28043... T Excision of foot lesion 162 5.67 $299.71 $125.43 $59.94
28045... T Excision of foot lesion 271 14.41 $762.01 $368.38 $152.40
28046... T Resection of tumor, 271 14.41 $762.01 $368.38 $152.40
foot.
28050... T Biopsy of foot joint 271 14.41 $762.01 $368.38 $152.40
lining.
28052... T Biopsy of foot joint 271 14.41 $762.01 $368.38 $152.40
lining.
28054... T Biopsy of toe joint 271 14.41 $762.01 $368.38 $152.40
lining.
28060... T Partial removal foot 272 16.56 $875.63 $409.74 $175.13
fascia.
28062... T Removal of foot fascia. 272 16.56 $875.63 $409.74 $175.13
28070... T Removal of foot joint 272 16.56 $875.63 $409.74 $175.13
lining.
28072... T Removal of foot joint 272 16.56 $875.63 $409.74 $175.13
lining.
28080... T Removal of foot lesion. 271 14.41 $762.01 $368.38 $152.40
28086... T Excise foot tendon 271 14.41 $762.01 $368.38 $152.40
sheath.
28088... T Excise foot tendon 271 14.41 $762.01 $368.38 $152.40
sheath.
28090... T Removal of foot lesion. 271 14.41 $762.01 $368.38 $152.40
28092... T Removal of toe lesions. 271 14.41 $762.01 $368.38 $152.40
28100... T Removal of ankle/heel 271 14.41 $762.01 $368.38 $152.40
lesion.
28102... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13
lesion.
28103... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13
lesion.
28104... T Removal of foot lesion. 271 14.41 $762.01 $368.38 $152.40
28106... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13
lesion.
28107... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13
lesion.
28108... T Removal of toe lesions. 271 14.41 $762.01 $368.38 $152.40
28110... T Part removal of 276 19.19 $1,014.71 $500.14 $202.94
metatarsal.
28111... T Part removal of 271 14.41 $762.01 $368.38 $152.40
metatarsal.
28112... T Part removal of 271 14.41 $762.01 $368.38 $152.40
metatarsal.
28113... T Part removal of 271 14.41 $762.01 $368.38 $152.40
metatarsal.
28114... T Removal of metatarsal 271 14.41 $762.01 $368.38 $152.40
heads.
28116... T Revision of foot....... 271 14.41 $762.01 $368.38 $152.40
28118... T Removal of heel bone... 271 14.41 $762.01 $368.38 $152.40
28119... T Removal of heel spur... 271 14.41 $762.01 $368.38 $152.40
28120... T Part removal of ankle/ 271 14.41 $762.01 $368.38 $152.40
heel.
28122... T Partial removal of foot 271 14.41 $762.01 $368.38 $152.40
bone.
28124... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40
28126... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40
28130... T Removal of ankle bone.. 271 14.41 $762.01 $368.38 $152.40
28140... T Removal of metatarsal.. 271 14.41 $762.01 $368.38 $152.40
[[Page 47646]]
28150... T Removal of toe......... 271 14.41 $762.01 $368.38 $152.40
28153... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40
28160... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40
28171... T Extensive foot surgery. 271 14.41 $762.01 $368.38 $152.40
28173... T Extensive foot surgery. 271 14.41 $762.01 $368.38 $152.40
28175... T Extensive foot surgery. 271 14.41 $762.01 $368.38 $152.40
28190... T Removal of foot foreign 161 3.50 $185.12 $75.48 $37.02
body.
28192... T Removal of foot foreign 163 10.69 $565.14 $264.65 $113.03
body.
28193... T Removal of foot foreign 163 10.69 $565.14 $264.65 $113.03
body.
28200... T Repair of foot tendon.. 271 14.41 $762.01 $368.38 $152.40
28202... T Repair/graft of foot 272 16.56 $875.63 $409.74 $175.13
tendon.
28208... T Repair of foot tendon.. 271 14.41 $762.01 $368.38 $152.40
28210... T Repair/graft of foot 271 14.41 $762.01 $368.38 $152.40
tendon.
28220... T Release of foot tendon. 271 14.41 $762.01 $368.38 $152.40
28222... T Release of foot tendons 271 14.41 $762.01 $368.38 $152.40
28225... T Release of foot tendon. 271 14.41 $762.01 $368.38 $152.40
28226... T Release of foot tendons 271 14.41 $762.01 $368.38 $152.40
28230... T Incision of foot 271 14.41 $762.01 $368.38 $152.40
tendon(s).
28232... T Incision of toe tendon. 271 14.41 $762.01 $368.38 $152.40
28234... T Incision of foot tendon 271 14.41 $762.01 $368.38 $152.40
28238... T Revision of foot tendon 272 16.56 $875.63 $409.74 $175.13
28240... T Release of big toe..... 271 14.41 $762.01 $368.38 $152.40
28250... T Revision of foot fascia 272 16.56 $875.63 $409.74 $175.13
28260... T Release of midfoot 272 16.56 $875.63 $409.74 $175.13
joint.
28261... T Revision of foot tendon 272 16.56 $875.63 $409.74 $175.13
28262... T Revision of foot and 272 16.56 $875.63 $409.74 $175.13
ankle.
28264... T Release of midfoot 272 16.56 $875.63 $409.74 $175.13
joint.
28270... T Release of foot 271 14.41 $762.01 $368.38 $152.40
contracture.
28272... T Release of toe joint, 271 14.41 $762.01 $368.38 $152.40
each.
28280... T Fusion of toes......... 271 14.41 $762.01 $368.38 $152.40
28285... T Repair of hammertoe.... 271 14.41 $762.01 $368.38 $152.40
28286... T Repair of hammertoe.... 271 14.41 $762.01 $368.38 $152.40
28288... T Partial removal of foot 272 16.56 $875.63 $409.74 $175.13
bone.
28290... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28292... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28293... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28294... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28296... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28297... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28298... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28299... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94
28300... T Incision of heel bone.. 272 16.56 $875.63 $409.74 $175.13
28302... T Incision of ankle bone. 272 16.56 $875.63 $409.74 $175.13
28304... T Incision of midfoot 272 16.56 $875.63 $409.74 $175.13
bones.
28305... T Incise/graft midfoot 272 16.56 $875.63 $409.74 $175.13
bones.
28306... T Incision of metatarsal. 272 16.56 $875.63 $409.74 $175.13
28307... T Incision of metatarsal. 272 16.56 $875.63 $409.74 $175.13
28308... T Incision of metatarsal. 272 16.56 $875.63 $409.74 $175.13
28309... T Incision of metatarsals 272 16.56 $875.63 $409.74 $175.13
28310... T Revision of big toe.... 271 14.41 $762.01 $368.38 $152.40
28312... T Revision of toe........ 271 14.41 $762.01 $368.38 $152.40
28313... T Repair deformity of toe 271 14.41 $762.01 $368.38 $152.40
28315... T Removal of sesamoid 271 14.41 $762.01 $368.38 $152.40
bone.
28320... T Repair of foot bones... 272 16.56 $875.63 $409.74 $175.13
28322... T Repair of metatarsals.. 272 16.56 $875.63 $409.74 $175.13
28340... T Resect enlarged toe 271 14.41 $762.01 $368.38 $152.40
tissue.
28341... T Resect enlarged toe.... 271 14.41 $762.01 $368.38 $152.40
28344... T Repair extra toe(s).... 272 16.56 $875.63 $409.74 $175.13
28345... T Repair webbed toe(s)... 272 16.56 $875.63 $409.74 $175.13
28360... T Reconstruct cleft foot. 272 16.56 $875.63 $409.74 $175.13
28400... T Treatment of heel 209 1.94 $102.84 $37.29 $20.57
fracture.
28405... T Treatment of heel 209 1.94 $102.84 $37.29 $20.57
fracture.
28406... T Treatment of heel 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28415... T Repair of heel fracture 216 20.13 $1,064.67 $520.93 $212.93
28420... T Repair/graft heel 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28430... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
28435... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57
fracture.
28436... T Treatment of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28445... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28450... T Treat midfoot fracture, 209 1.94 $102.84 $37.29 $20.57
each.
28455... T Treat midfoot fracture, 209 1.94 $102.84 $37.29 $20.57
each.
28456... T Repair midfoot fracture 216 20.13 $1,064.67 $520.93 $212.93
28465... T Repair midfoot 216 20.13 $1,064.67 $520.93 $212.93
fracture, each.
28470... T Treat metatarsal 209 1.94 $102.84 $37.29 $20.57
fracture.
28475... T Treat metatarsal 209 1.94 $102.84 $37.29 $20.57
fracture.
[[Page 47647]]
28476... T Repair metatarsal 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28485... T Repair metatarsal 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28490... T Treat big toe fracture. 207 1.70 $90.11 $31.64 $18.02
28495... T Treat big toe fracture. 207 1.70 $90.11 $31.64 $18.02
28496... T Repair big toe fracture 216 20.13 $1,064.67 $520.93 $212.93
28505... T Repair big toe fracture 216 20.13 $1,064.67 $520.93 $212.93
28510... T Treatment of toe 207 1.70 $90.11 $31.64 $18.02
fracture.
28515... T Treatment of toe 207 1.70 $90.11 $31.64 $18.02
fracture.
28525... T Repair of toe fracture. 216 20.13 $1,064.67 $520.93 $212.93
28530... T Treat sesamoid bone 209 1.94 $102.84 $37.29 $20.57
fracture.
28531... T Treat sesamoid bone 216 20.13 $1,064.67 $520.93 $212.93
fracture.
28540... T Treat foot dislocation. 209 1.94 $102.84 $37.29 $20.57
28545... T Treat foot dislocation. 210 10.46 $553.39 $283.40 $110.68
28546... T Treat foot dislocation. 216 20.13 $1,064.67 $520.93 $212.93
28555... T Repair foot dislocation 216 20.13 $1,064.67 $520.93 $212.93
28570... T Treat foot dislocation. 209 1.94 $102.84 $37.29 $20.57
28575... T Treat foot dislocation. 210 10.46 $553.39 $283.40 $110.68
28576... T Treat foot dislocation. 216 20.13 $1,064.67 $520.93 $212.93
28585... T Repair foot dislocation 216 20.13 $1,064.67 $520.93 $212.93
28600... T Treat foot dislocation. 209 1.94 $102.84 $37.29 $20.57
28605... T Treat foot dislocation. 210 10.46 $553.39 $283.40 $110.68
28606... T Treat foot dislocation. 216 20.13 $1,064.67 $520.93 $212.93
28615... T Repair foot dislocation 216 20.13 $1,064.67 $520.93 $212.93
28630... T Treat toe dislocation.. 207 1.70 $90.11 $31.64 $18.02
28635... T Treat toe dislocation.. 210 10.46 $553.39 $283.40 $110.68
28636... T Treat toe dislocation.. 216 20.13 $1,064.67 $520.93 $212.93
28645... T Repair toe dislocation. 216 20.13 $1,064.67 $520.93 $212.93
28660... T Treat toe dislocation.. 207 1.70 $90.11 $31.64 $18.02
28665... T Treat toe dislocation.. 210 10.46 $553.39 $283.40 $110.68
28666... T Treat toe dislocation.. 216 20.13 $1,064.67 $520.93 $212.93
28675... T Repair of toe 216 20.13 $1,064.67 $520.93 $212.93
dislocation.
28705... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13
28715... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13
28725... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13
28730... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13
28735... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13
28737... T Revision of foot bones. 271 14.41 $762.01 $368.38 $152.40
28740... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13
28750... T Fusion of big toe joint 271 14.41 $762.01 $368.38 $152.40
28755... T Fusion of big toe joint 271 14.41 $762.01 $368.38 $152.40
28760... T Fusion of big toe joint 272 16.56 $875.63 $409.74 $175.13
28800... C Amputation of midfoot.. ......... ......... ......... ........... ...........
28805... C Amputation thru ......... ......... ......... ........... ...........
metatarsal.
28810... T Amputation toe & 271 14.41 $762.01 $368.38 $152.40
metatarsal.
28820... T Amputation of toe...... 271 14.41 $762.01 $368.38 $152.40
28825... T Partial amputation of 271 14.41 $762.01 $368.38 $152.40
toe.
28899... T Foot/toes surgery 207 1.70 $90.11 $31.64 $18.02
procedure.
29000... N Application of body ......... ......... ......... ........... ...........
cast.
29010... N Application of body ......... ......... ......... ........... ...........
cast.
29015... N Application of body ......... ......... ......... ........... ...........
cast.
29020... N Application of body ......... ......... ......... ........... ...........
cast.
29025... N Application of body ......... ......... ......... ........... ...........
cast.
29035... N Application of body ......... ......... ......... ........... ...........
cast.
29040... N Application of body ......... ......... ......... ........... ...........
cast.
29044... N Application of body ......... ......... ......... ........... ...........
cast.
29046... N Application of body ......... ......... ......... ........... ...........
cast.
29049... N Application of figure ......... ......... ......... ........... ...........
eight.
29055... N Application of shoulder ......... ......... ......... ........... ...........
cast.
29058... N Application of shoulder ......... ......... ......... ........... ...........
cast.
29065... N Application of long arm ......... ......... ......... ........... ...........
cast.
29075... N Application of forearm ......... ......... ......... ........... ...........
cast.
29085... N Apply hand/wrist cast.. ......... ......... ......... ........... ...........
29105... N Apply long arm splint.. ......... ......... ......... ........... ...........
29125... N Apply forearm splint... ......... ......... ......... ........... ...........
29126... N Apply forearm splint... ......... ......... ......... ........... ...........
29130... N Application of finger ......... ......... ......... ........... ...........
splint.
29131... N Application of finger ......... ......... ......... ........... ...........
splint.
29200... N Strapping of chest..... ......... ......... ......... ........... ...........
29220... N Strapping of low back.. ......... ......... ......... ........... ...........
29240... N Strapping of shoulder.. ......... ......... ......... ........... ...........
29260... N Strapping of elbow or ......... ......... ......... ........... ...........
wrist.
29280... N Strapping of hand or ......... ......... ......... ........... ...........
finger.
29305... N Application of hip cast ......... ......... ......... ........... ...........
29325... N Application of hip ......... ......... ......... ........... ...........
casts.
29345... N Application of long leg ......... ......... ......... ........... ...........
cast.
[[Page 47648]]
29355... N Application of long leg ......... ......... ......... ........... ...........
cast.
29358... N Apply long leg cast ......... ......... ......... ........... ...........
brace.
29365... N Application of long leg ......... ......... ......... ........... ...........
cast.
29405... N Apply short leg cast... ......... ......... ......... ........... ...........
29425... N Apply short leg cast... ......... ......... ......... ........... ...........
29435... N Apply short leg cast... ......... ......... ......... ........... ...........
29440... N Addition of walker to ......... ......... ......... ........... ...........
cast.
29445... N Apply rigid leg cast... ......... ......... ......... ........... ...........
29450... N Application of leg cast ......... ......... ......... ........... ...........
29505... N Application long leg ......... ......... ......... ........... ...........
splint.
29515... N Application lower leg ......... ......... ......... ........... ...........
splint.
29520... N Strapping of hip....... ......... ......... ......... ........... ...........
29530... N Strapping of knee...... ......... ......... ......... ........... ...........
29540... N Strapping of ankle..... ......... ......... ......... ........... ...........
29550... N Strapping of toes...... ......... ......... ......... ........... ...........
29580... N Application of paste ......... ......... ......... ........... ...........
boot.
29590... N Application of foot ......... ......... ......... ........... ...........
splint.
29700... N Removal/revision of ......... ......... ......... ........... ...........
cast.
29705... N Removal/revision of ......... ......... ......... ........... ...........
cast.
29710... N Removal/revision of ......... ......... ......... ........... ...........
cast.
29715... N Removal/revision of ......... ......... ......... ........... ...........
cast.
29720... N Repair of body cast.... ......... ......... ......... ........... ...........
29730... N Windowing of cast...... ......... ......... ......... ........... ...........
29740... N Wedging of cast........ ......... ......... ......... ........... ...........
29750... N Wedging of clubfoot ......... ......... ......... ........... ...........
cast.
29799... N Casting/strapping ......... ......... ......... ........... ...........
procedure.
29800... T Jaw arthroscopy/surgery 280 22.20 $1,174.36 $581.72 $234.87
29804... T Jaw arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57
29815... T Shoulder arthroscopy... 280 22.20 $1,174.36 $581.72 $234.87
29819... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29820... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29821... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29822... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29823... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29825... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29826... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29830... T Elbow arthroscopy...... 280 22.20 $1,174.36 $581.72 $234.87
29834... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29835... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29836... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29837... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29838... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29840... T Wrist arthroscopy...... 280 22.20 $1,174.36 $581.72 $234.87
29843... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29844... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29845... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29846... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29847... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29848... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29850... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29851... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29855... T Tibial arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29856... T Tibial arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29860... T Hip arthroscopy, dx.... 281 22.65 $1,197.87 $590.31 $239.57
29861... T Hip arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57
29862... T Hip arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57
29863... T Hip arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57
29870... T Knee arthroscopy, 280 22.20 $1,174.36 $581.72 $234.87
diagnostic.
29871... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
drainage.
29874... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29875... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29876... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
surgery.
29877... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29879... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29880... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29881... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29882... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
surgery.
29883... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
surgery.
29884... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29885... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
surgery.
29886... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29887... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
surgery.
29888... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29889... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29891... T Ankle arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29
surgery.
[[Page 47649]]
29892... T Ankle arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06
surgery.
29893... T Scope, plantar 271 14.41 $762.01 $368.38 $152.40
fasciotomy.
29894... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29895... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29897... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29898... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57
surgery.
29909... T Arthroscopy of joint... 280 22.20 $1,174.36 $581.72 $234.87
30000... T Drainage of nose lesion 311 1.43 $75.42 $20.57 $15.08
30020... T Drainage of nose lesion 311 1.43 $75.42 $20.57 $15.08
30100... T Intranasal biopsy...... 311 1.43 $75.42 $20.57 $15.08
30110... T Removal of nose 311 1.43 $75.42 $20.57 $15.08
polyp(s).
30115... T Removal of nose 313 15.81 $836.45 $411.09 $167.29
polyp(s).
30117... T Removal of intranasal 311 1.43 $75.42 $20.57 $15.08
lesion.
30118... T Removal of intranasal 313 15.81 $836.45 $411.09 $167.29
lesion.
30120... T Revision of nose....... 313 15.81 $836.45 $411.09 $167.29
30124... T Removal of nose lesion. 311 1.43 $75.42 $20.57 $15.08
30125... T Removal of nose lesion. 313 15.81 $836.45 $411.09 $167.29
30130... T Removal of turbinate 313 15.81 $836.45 $411.09 $167.29
bones.
30140... T Removal of turbinate 313 15.81 $836.45 $411.09 $167.29
bones.
30150... T Partial removal of nose 313 15.81 $836.45 $411.09 $167.29
30160... T Removal of nose........ 313 15.81 $836.45 $411.09 $167.29
30200... T Injection treatment of 347 2.93 $154.75 $62.15 $30.95
nose.
30210... T Nasal sinus therapy.... 311 1.43 $75.42 $20.57 $15.08
30220... T Insert nasal septal 311 1.43 $75.42 $20.57 $15.08
button.
30300... T Remove nasal foreign 311 1.43 $75.42 $20.57 $15.08
body.
30310... T Remove nasal foreign 313 15.81 $836.45 $411.09 $167.29
body.
30320... T Remove nasal foreign 313 15.81 $836.45 $411.09 $167.29
body.
30400... T Reconstruction of nose. 314 25.65 $1,356.54 $693.37 $271.31
30410... T Reconstruction of nose. 314 25.65 $1,356.54 $693.37 $271.31
30420... T Reconstruction of nose. 314 25.65 $1,356.54 $693.37 $271.31
30430... T Revision of nose....... 313 15.81 $836.45 $411.09 $167.29
30435... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31
30450... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31
30460... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31
30462... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31
30520... T Repair of nasal septum. 313 15.81 $836.45 $411.09 $167.29
30540... T Repair nasal defect.... 313 15.81 $836.45 $411.09 $167.29
30545... T Repair nasal defect.... 314 25.65 $1,356.54 $693.37 $271.31
30560... T Release of nasal 311 1.43 $75.42 $20.57 $15.08
adhesions.
30580... T Repair upper jaw 313 15.81 $836.45 $411.09 $167.29
fistula.
30600... T Repair mouth/nose 313 15.81 $836.45 $411.09 $167.29
fistula.
30620... T Intranasal 313 15.81 $836.45 $411.09 $167.29
reconstruction.
30630... T Repair nasal septum 313 15.81 $836.45 $411.09 $167.29
defect.
30801... T Cauterization inner 312 7.26 $383.95 $178.31 $76.79
nose.
30802... T Cauterization inner 312 7.26 $383.95 $178.31 $76.79
nose.
30901... T Control of nosebleed... 318 2.07 $109.70 $38.65 $21.94
30903... T Control of nosebleed... 318 2.07 109.70 $38.65 $21.94
30905... T Control of nosebleed... 318 2.07 $109.70 $38.65 $21.94
30906... T Repeat control of 318 2.07 $109.70 $38.65 $21.94
nosebleed.
30915... T Ligation nasal sinus 367 17.59 $930.48 $449.06 $186.10
artery.
30920... T Ligation upper jaw 367 17.59 $930.48 $449.06 $186.10
artery.
30930... T Therapy fracture of 312 7.26 $383.95 $178.31 $76.79
nose.
30999... T Nasal surgery procedure 318 2.07 $109.70 $38.65 $21.94
31000... T Irrigation maxillary 311 1.43 $75.42 $20.57 $15.08
sinus.
31002... T Irrigation sphenoid 311 1.43 $75.42 $20.57 $15.08
sinus.
31020... T Exploration maxillary 313 15.81 $836.45 $411.09 $167.29
sinus.
31030... T Exploration maxillary 313 15.81 $836.45 $411.09 $167.29
sinus.
31032... T Explore sinus, remove 313 15.81 $836.45 $411.09 $167.29
polyps.
31040... T Exploration behind 314 25.65 $1,356.54 $693.37 $271.31
upper jaw.
31050... T Exploration sphenoid 313 15.81 $836.45 $411.09 $167.29
sinus.
31051... T Sphenoid sinus surgery. 313 15.81 $836.45 $411.09 $167.29
31070... T Exploration of frontal 313 15.81 $836.45 $411.09 $167.29
sinus.
31075... T Exploration of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31080... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31081... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31084... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31085... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31086... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31087... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31090... T Exploration of sinuses. 314 25.65 $1,356.54 $693.37 $271.31
31200... T Removal of ethmoid 313 15.81 $836.45 $411.09 $167.29
sinus.
31201... T Removal of ethmoid 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31205... T Removal of ethmoid 314 25.65 $1,356.54 $693.37 $271.31
sinus.
31225... C Removal of upper jaw... ......... ......... ......... ........... ...........
31230... C Removal of upper jaw... ......... ......... ......... ........... ...........
[[Page 47650]]
31231... T Nasal endoscopy, dx.... 331 0.69 $36.24 $14.01 $7.25
31233... T Nasal/sinus endoscopy, 332 9.74 $515.19 $244.98 $103.04
dx.
31235... T Nasal/sinus endoscopy, 332 9.74 $515.19 $244.98 $103.04
dx.
31237... T Nasal/sinus endoscopy, 332 9.74 $515.19 $244.98 $103.04
surg.
31238... T Nasal/sinus endoscopy, 332 9.74 $515.19 $244.98 $103.04
surg.
31239... T Nasal/sinus endoscopy, 333 17.24 $911.87 $464.20 $182.37
surg.
31240... T Nasal/sinus endoscopy, 332 9.74 $515.19 $244.98 $103.04
surg.
31254... T Revision of ethmoid 333 17.24 $911.87 $464.20 $182.37
sinus.
31255... T Removal of ethmoid 333 17.24 $911.87 $464.20 $182.37
sinus.
31256... T Exploration maxillary 333 17.24 $911.87 $464.20 $182.37
sinus.
31267... T Endoscopy, maxillary 333 17.24 $911.87 $464.20 $182.37
sinus.
31276... T Sinus surgical 333 17.24 $911.87 $464.20 $182.37
endoscopy.
31287... T Nasal/sinus endoscopy, 333 17.24 $911.87 $464.20 $182.37
surg.
31288... T Nasal/sinus endoscopy, 333 17.24 $911.87 $464.20 $182.37
surg.
31290... C Nasal/sinus endoscopy, ......... ......... ......... ........... ...........
surg.
31291... C Nasal/sinus endoscopy, ......... ......... ......... ........... ...........
surg.
31292... C Nasal/sinus endoscopy, ......... ......... ......... ........... ...........
surg.
31293... C Nasal/sinus endoscopy, ......... ......... ......... ........... ...........
surg.
31294... C Nasal/sinus endoscopy, ......... ......... ......... ........... ...........
surg.
31299... T Sinus surgery procedure 331 0.69 $36.24 $14.01 $7.25
31300... T Removal of larynx 314 25.65 $1,356.54 $693.37 $271.31
lesion.
31320... T Diagnostic incision 313 15.81 $836.45 $411.09 $167.29
larynx.
31360... C Removal of larynx...... ......... ......... ......... ........... ...........
31365... C Removal of larynx...... ......... ......... ......... ........... ...........
31367... C Partial removal of ......... ......... ......... ........... ...........
larynx.
31368... C Partial removal of ......... ......... ......... ........... ...........
larynx.
31370... C Partial removal of ......... ......... ......... ........... ...........
larynx.
31375... C Partial removal of ......... ......... ......... ........... ...........
larynx.
31380... C Partial removal of ......... ......... ......... ........... ...........
larynx.
31382... C Partial removal of ......... ......... ......... ........... ...........
larynx.
31390... C Removal of larynx & ......... ......... ......... ........... ...........
pharynx.
31395... C Reconstruct larynx & ......... ......... ......... ........... ...........
pharynx.
31400... T Revision of larynx..... 314 25.65 $1,356.54 $693.37 $271.31
31420... T Removal of epiglottis.. 314 25.65 $1,356.54 $693.37 $271.31
31500... S Insert emergency airway 947 4.07 $215.48 $109.61 $43.10
31502... T Change of windpipe 470 2.22 $117.53 $54.92 $23.51
airway.
31505... T Diagnostic laryngoscopy 331 0.69 $36.24 $14.01 $7.25
31510... T Laryngoscopy with 332 9.74 $515.19 $244.98 $103.04
biopsy.
31511... T Remove foreign body, 332 9.74 $515.19 $244.98 $103.04
larynx.
31512... T Removal of larynx 332 9.74 $515.19 $244.98 $103.04
lesion.
31513... T Injection into vocal 332 9.74 $515.19 $244.98 $103.04
cord.
31515... T Laryngoscopy for 332 9.74 $515.19 $244.98 $103.04
aspiration.
31520... T Diagnostic laryngoscopy 332 9.74 $515.19 $244.98 $103.04
31525... T Diagnostic laryngoscopy 332 9.74 $515.19 $244.98 $103.04
31526... T Diagnostic laryngoscopy 332 9.74 $515.19 $244.98 $103.04
31527... T Laryngoscopy for 333 17.24 $911.87 $464.20 $182.37
treatment.
31528... T Laryngoscopy and 332 9.74 $515.19 $244.98 $103.04
dilatation.
31529... T Laryngoscopy and 332 9.74 $515.19 $244.98 $103.04
dilatation.
31530... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31531... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31535... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31536... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31540... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31541... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31560... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31561... T Operative laryngoscopy. 333 17.24 $911.87 $464.20 $182.37
31570... T Laryngoscopy with 333 17.24 $911.87 $464.20 $182.37
injection.
31571... T Laryngoscopy with 333 17.24 $911.87 $464.20 $182.37
injection.
31575... T Diagnostic laryngoscopy 331 0.69 $36.24 $14.01 $7.25
31576... T Laryngoscopy with 332 9.74 $515.19 $244.98 $103.04
biopsy.
31577... T Remove foreign body, 332 9.74 $515.19 $244.98 $103.04
larynx.
31578... T Removal of larynx 332 9.74 $515.19 $244.98 $103.04
lesion.
31579... T Diagnostic laryngoscopy 331 0.69 $36.24 $14.01 $7.25
31580... C Revision of larynx..... ......... ......... ......... ........... ...........
31582... C Revision of larynx..... ......... ......... ......... ........... ...........
31584... C Repair of larynx ......... ......... ......... ........... ...........
fracture.
31585... T Repair of larynx 207 1.70 $90.11 $31.64 $18.02
fracture.
31586... T Repair of larynx 209 1.94 $102.84 $37.29 $20.57
fracture.
31587... C Revision of larynx..... ......... ......... ......... ........... ...........
31588... T Revision of larynx..... 314 25.65 $1,356.54 $693.37 $271.31
31590... T Reinnervate larynx..... 314 25.65 $1,356.54 $693.37 $271.31
31595... T Larynx nerve surgery... 313 15.81 $836.45 $411.09 $167.29
31599... T Larynx surgery 207 1.70 $90.11 $31.64 $18.02
procedure.
31600... C Incision of windpipe... ......... ......... ......... ........... ...........
31601... C Incision of windpipe... ......... ......... ......... ........... ...........
[[Page 47651]]
31603... T Incision of windpipe... 311 1.43 $75.42 $20.57 $15.08
31605... T Incision of windpipe... 311 1.43 $75.42 $20.57 $15.08
31610... C Incision of windpipe... ......... ......... ......... ........... ...........
31611... T Surgery/speech 313 15.81 $836.45 $411.09 $167.29
prosthesis.
31612... T Puncture/clear windpipe 312 7.26 $383.95 $178.31 $76.79
31613... T Repair windpipe opening 313 15.81 $836.45 $411.09 $167.29
31614... T Repair windpipe opening 313 15.81 $836.45 $411.09 $167.29
31615... T Visualization of 336 7.44 $393.74 $197.98 $78.75
windpipe.
31622... T Diagnostic bronchoscopy 336 7.44 $393.74 $197.98 $78.75
31625... T Bronchoscopy with 336 7.44 $393.74 $197.98 $78.75
biopsy.
31628... T Bronchoscopy with 336 7.44 $393.74 $197.98 $78.75
biopsy.
31629... T Bronchoscopy with 336 7.44 $393.74 $197.98 $78.75
biopsy.
31630... T Bronchoscopy with 336 7.44 $393.74 $197.98 $78.75
repair.
31631... T Bronchoscopy with 336 7.44 $393.74 $197.98 $78.75
dilation.
31635... T Remove foreign body, 336 7.44 $393.74 $197.98 $78.75
airway.
31640... T Bronchoscopy & remove 336 7.44 $393.74 $197.98 $78.75
lesion.
31641... T Bronchoscopy, treat 336 7.44 $393.74 $197.98 $78.75
blockage.
31645... T Bronchoscopy, clear 336 7.44 $393.74 $197.98 $78.75
airways.
31646... T Bronchoscopy, reclear 336 7.44 $393.74 $197.98 $78.75
airways.
31656... T Bronchoscopy, inject 336 7.44 $393.74 $197.98 $78.75
for xray.
31700... T Insertion of airway 332 9.74 $515.19 $244.98 $103.04
catheter.
31708... T Instill airway contrast 347 2.93 $154.75 $62.15 $30.95
dye.
31710... T Insertion of airway 347 2.93 $154.75 $62.15 $30.95
catheter.
31715... T Injection for bronchus 347 2.93 $154.75 $62.15 $30.95
x-ray.
31717... T Bronchial brush biopsy. 332 9.74 $515.19 $244.98 $103.04
31720... T Clearance of airways... 332 9.74 $515.19 $244.98 $103.04
31725... C Clearance of airways... ......... ......... ......... ........... ...........
31730... T Intro windpipe wire/ 332 9.74 $515.19 $244.98 $103.04
tube.
31750... T Repair of windpipe..... 314 25.65 $1,356.54 $693.37 $271.31
31755... T Repair of windpipe..... 314 25.65 $1,356.54 $693.37 $271.31
31760... C Repair of windpipe..... ......... ......... ......... ........... ...........
31766... C Reconstruction of ......... ......... ......... ........... ...........
windpipe.
31770... C Repair/graft of ......... ......... ......... ........... ...........
bronchus.
31775... C Reconstruct bronchus... ......... ......... ......... ........... ...........
31780... C Reconstruct windpipe... ......... ......... ......... ........... ...........
31781... C Reconstruct windpipe... ......... ......... ......... ........... ...........
31785... C Remove windpipe lesion. ......... ......... ......... ........... ...........
31786... C Remove windpipe lesion. ......... ......... ......... ........... ...........
31800... C Repair of windpipe ......... ......... ......... ........... ...........
injury.
31805... C Repair of windpipe ......... ......... ......... ........... ...........
injury.
31820... T Closure of windpipe 313 15.81 $836.45 $411.09 $167.29
lesion.
31825... T Repair of windpipe 313 15.81 $836.45 $411.09 $167.29
defect.
31830... T Revise windpipe scar... 313 15.81 $836.45 $411.09 $167.29
31899... T Airways surgical 336 7.44 $393.74 $197.98 $78.75
procedure.
32000... T Drainage of chest...... 320 3.17 $167.49 $79.33 $33.50
32002... T Treatment of collapsed 320 3.17 $167.49 $79.33 $33.50
lung.
32005... C Treat lung lining ......... ......... ......... ........... ...........
chemically.
32020... T Insertion of chest tube 320 3.17 $167.49 $79.33 $33.50
32035... C Exploration of chest... ......... ......... ......... ........... ...........
32036... C Exploration of chest... ......... ......... ......... ........... ...........
32095... C Biopsy through chest ......... ......... ......... ........... ...........
wall.
32100... C Exploration/biopsy of ......... ......... ......... ........... ...........
chest.
32110... C Explore/repair chest... ......... ......... ......... ........... ...........
32120... C Re-exploration of chest ......... ......... ......... ........... ...........
32124... C Explore chest, free ......... ......... ......... ........... ...........
adhesions.
32140... C Removal of lung ......... ......... ......... ........... ...........
lesion(s).
32141... C Remove/treat lung ......... ......... ......... ........... ...........
lesions.
32150... C Removal of lung ......... ......... ......... ........... ...........
lesion(s).
32151... C Remove lung foreign ......... ......... ......... ........... ...........
body.
32160... C Open chest heart ......... ......... ......... ........... ...........
massage.
32200... C Open drainage, lung ......... ......... ......... ........... ...........
lesion.
32201... C Percut drainage, lung ......... ......... ......... ........... ...........
lesion.
32215... C Treat chest lining..... ......... ......... ......... ........... ...........
32220... C Release of lung........ ......... ......... ......... ........... ...........
32225... C Partial release of lung ......... ......... ......... ........... ...........
32310... C Removal of chest lining ......... ......... ......... ........... ...........
32320... C Free/remove chest ......... ......... ......... ........... ...........
lining.
32400... T Needle biopsy chest 122 4.87 $257.60 $115.03 $51.52
lining.
32402... C Open biopsy chest ......... ......... ......... ........... ...........
lining.
32405... T Biopsy, lung or 122 4.87 $257.60 $115.03 $51.52
mediastinum.
32420... T Puncture/clear lung.... 320 3.17 $167.49 $79.33 $33.50
32440... C Removal of lung........ ......... ......... ......... ........... ...........
32442... C Sleeve pneumonectomy... ......... ......... ......... ........... ...........
32445... C Removal of lung........ ......... ......... ......... ........... ...........
32480... C Partial removal of lung ......... ......... ......... ........... ...........
[[Page 47652]]
32482... C Bilobectomy............ ......... ......... ......... ........... ...........
32484... C Segmentectomy.......... ......... ......... ......... ........... ...........
32486... C Sleeve lobectomy....... ......... ......... ......... ........... ...........
32488... C Completion ......... ......... ......... ........... ...........
pneumonectomy.
32491... C Lung volume reduction.. ......... ......... ......... ........... ...........
32500... C Partial removal of lung ......... ......... ......... ........... ...........
32501... C Repair bronchus (add- ......... ......... ......... ........... ...........
on).
32520... C Remove lung & revise ......... ......... ......... ........... ...........
chest.
32522... C Remove lung & revise ......... ......... ......... ........... ...........
chest.
32525... C Remove lung & revise ......... ......... ......... ........... ...........
chest.
32540... C Removal of lung lesion. ......... ......... ......... ........... ...........
32601... C Thoracoscopy, ......... ......... ......... ........... ...........
diagnostic.
32602... C Thoracoscopy, ......... ......... ......... ........... ...........
diagnostic.
32603... C Thoracoscopy, ......... ......... ......... ........... ...........
diagnostic.
32604... C Thoracoscopy, ......... ......... ......... ........... ...........
diagnostic.
32605... C Thoracoscopy, ......... ......... ......... ........... ...........
diagnostic.
32606... C Thoracoscopy, ......... ......... ......... ........... ...........
diagnostic.
32650... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32651... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32652... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32653... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32654... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32655... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32656... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32657... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32658... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32659... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32660... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32661... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32662... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32663... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32664... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32665... C Thoracoscopy, surgical. ......... ......... ......... ........... ...........
32800... C Repair lung hernia..... ......... ......... ......... ........... ...........
32810... C Close chest after ......... ......... ......... ........... ...........
drainage.
32815... C Close bronchial fistula ......... ......... ......... ........... ...........
32820... C Reconstruct injured ......... ......... ......... ........... ...........
chest.
32850... C Donor pneumonectomy.... ......... ......... ......... ........... ...........
32851... C Lung transplant, single ......... ......... ......... ........... ...........
32852... C Lung transplant w/ ......... ......... ......... ........... ...........
bypass.
32853... C Lung transplant, double ......... ......... ......... ........... ...........
32854... C Lung transplant w/ ......... ......... ......... ........... ...........
bypass.
32900... C Removal of rib(s)...... ......... ......... ......... ........... ...........
32905... C Revise & repair chest ......... ......... ......... ........... ...........
wall.
32906... C Revise & repair chest ......... ......... ......... ........... ...........
wall.
32940... C Revision of lung....... ......... ......... ......... ........... ...........
32960... T Therapeutic 320 3.17 $167.49 $79.33 $33.50
pneumothorax.
32999... T Chest surgery procedure 320 3.17 $167.49 $79.33 $33.50
33010... T Drainage of heart sac.. 320 3.17 $167.49 $79.33 $33.50
33011... T Repeat drainage of 320 3.17 $167.49 $79.33 $33.50
heart sac.
33015... C Incision of heart sac.. ......... ......... ......... ........... ...........
33020... C Incision of heart sac.. ......... ......... ......... ........... ...........
33025... C Incision of heart sac.. ......... ......... ......... ........... ...........
33030... C Partial removal of ......... ......... ......... ........... ...........
heart sac.
33031... C Partial removal of ......... ......... ......... ........... ...........
heart sac.
33050... C Removal of heart sac ......... ......... ......... ........... ...........
lesion.
33120... C Removal of heart lesion ......... ......... ......... ........... ...........
33130... C Removal of heart lesion ......... ......... ......... ........... ...........
33200... C Insertion of heart ......... ......... ......... ........... ...........
pacemaker.
33201... C Insertion of heart ......... ......... ......... ........... ...........
pacemaker.
33206... C Insertion of heart ......... ......... ......... ........... ...........
pacemaker.
33207... C Insertion of heart ......... ......... ......... ........... ...........
pacemaker.
33208... C Insertion of heart ......... ......... ......... ........... ...........
pacemaker.
33210... C Insertion of heart ......... ......... ......... ........... ...........
electrode.
33211... C Insertion of heart ......... ......... ......... ........... ...........
electrode.
33212... C Insertion of pulse ......... ......... ......... ........... ...........
generator.
33213... C Insertion of pulse ......... ......... ......... ........... ...........
generator.
33214... C Upgrade of pacemaker ......... ......... ......... ........... ...........
system.
33216... C Revision implanted ......... ......... ......... ........... ...........
electrode.
33217... C Insert/revise electrode ......... ......... ......... ........... ...........
33218... C Repair pacemaker ......... ......... ......... ........... ...........
electrodes.
33220... C Repair pacemaker ......... ......... ......... ........... ...........
electrode.
33222... T Pacemaker AICD pocket.. 360 6.09 $322.24 $140.12 $64.45
33223... T Pacemaker AICD pocket.. 360 6.09 $322.24 $140.12 $64.45
33233... C Removal of pacemaker ......... ......... ......... ........... ...........
system.
[[Page 47653]]
33234... C Removal of pacemaker ......... ......... ......... ........... ...........
system.
33235... C Removal pacemaker ......... ......... ......... ........... ...........
electrode.
33236... C Remove electrode/ ......... ......... ......... ........... ...........
thoracotomy.
33237... C Remove electrode/ ......... ......... ......... ........... ...........
thoracotomy.
33238... C Remove electrode/ ......... ......... ......... ........... ...........
thoracotomy.
33240... C Insert/replace pulse ......... ......... ......... ........... ...........
gener.
33241... C Remove pulse generator ......... ......... ......... ........... ...........
only.
33242... C Repair pulse generator/ ......... ......... ......... ........... ...........
leads.
33243... C Remove generator/ ......... ......... ......... ........... ...........
thoracotomy.
33244... C Remove generator....... ......... ......... ......... ........... ...........
33245... C Implant heart ......... ......... ......... ........... ...........
defibrillator.
33246... C Implant heart ......... ......... ......... ........... ...........
defibrillator.
33247... C Insert/replace leads... ......... ......... ......... ........... ...........
33249... C Insert/replace leads/ ......... ......... ......... ........... ...........
gener.
33250... C Ablate heart dysrhythm ......... ......... ......... ........... ...........
focus.
33251... C Ablate heart dysrhythm ......... ......... ......... ........... ...........
focus.
33253... C Reconstruct atria...... ......... ......... ......... ........... ...........
33261... C Ablate heart dysrhythm ......... ......... ......... ........... ...........
focus.
33300... C Repair of heart wound.. ......... ......... ......... ........... ...........
33305... C Repair of heart wound.. ......... ......... ......... ........... ...........
33310... C Exploratory heart ......... ......... ......... ........... ...........
surgery.
33315... C Exploratory heart ......... ......... ......... ........... ...........
surgery.
33320... C Repair major blood ......... ......... ......... ........... ...........
vessel(s).
33321... C Repair major vessel.... ......... ......... ......... ........... ...........
33322... C Repair major blood ......... ......... ......... ........... ...........
vessel(s).
33330... C Insert major vessel ......... ......... ......... ........... ...........
graft.
33332... C Insert major vessel ......... ......... ......... ........... ...........
graft.
33335... C Insert major vessel ......... ......... ......... ........... ...........
graft.
33400... C Repair of aortic valve. ......... ......... ......... ........... ...........
33401... C Valvuloplasty, open.... ......... ......... ......... ........... ...........
33403... C Valvuloplasty, w/cp ......... ......... ......... ........... ...........
bypass.
33404... C Prepare heart-aorta ......... ......... ......... ........... ...........
conduit.
33405... C Replacement of aortic ......... ......... ......... ........... ...........
valve.
33406... C Replacement, aortic ......... ......... ......... ........... ...........
valve.
33411... C Replacement of aortic ......... ......... ......... ........... ...........
valve.
33412... C Replacement of aortic ......... ......... ......... ........... ...........
valve.
33413... C Replacement, aortic ......... ......... ......... ........... ...........
valve.
33414... C Repair, aortic valve... ......... ......... ......... ........... ...........
33415... C Revision, subvalvular ......... ......... ......... ........... ...........
tissue.
33416... C Revise ventricle muscle ......... ......... ......... ........... ...........
33417... C Repair of aortic valve. ......... ......... ......... ........... ...........
33420... C Revision of mitral ......... ......... ......... ........... ...........
valve.
33422... C Revision of mitral ......... ......... ......... ........... ...........
valve.
33425... C Repair of mitral valve. ......... ......... ......... ........... ...........
33426... C Repair of mitral valve. ......... ......... ......... ........... ...........
33427... C Repair of mitral valve. ......... ......... ......... ........... ...........
33430... C Replacement of mitral ......... ......... ......... ........... ...........
valve.
33460... C Revision of tricuspid ......... ......... ......... ........... ...........
valve.
33463... C Valvuloplasty, ......... ......... ......... ........... ...........
tricuspid.
33464... C Valvuloplasty, ......... ......... ......... ........... ...........
tricuspid.
33465... C Replace tricuspid valve ......... ......... ......... ........... ...........
33468... C Revision of tricuspid ......... ......... ......... ........... ...........
valve.
33470... C Revision of pulmonary ......... ......... ......... ........... ...........
valve.
33471... C Valvotomy, pulmonary ......... ......... ......... ........... ...........
valve.
33472... C Revision of pulmonary ......... ......... ......... ........... ...........
valve.
33474... C Revision of pulmonary ......... ......... ......... ........... ...........
valve.
33475... C Replacement, pulmonary ......... ......... ......... ........... ...........
valve.
33476... C Revision of heart ......... ......... ......... ........... ...........
chamber.
33478... C Revision of heart ......... ......... ......... ........... ...........
chamber.
33496... C Repair, prosth valve ......... ......... ......... ........... ...........
clot.
33500... C Repair heart vessel ......... ......... ......... ........... ...........
fistula.
33501... C Repair heart vessel ......... ......... ......... ........... ...........
fistula.
33502... C Coronary artery ......... ......... ......... ........... ...........
correction.
33503... C Coronary artery graft.. ......... ......... ......... ........... ...........
33504... C Coronary artery graft.. ......... ......... ......... ........... ...........
33505... C Repair artery w/tunnel. ......... ......... ......... ........... ...........
33506... C Repair artery, ......... ......... ......... ........... ...........
translocation.
33510... C CABG, vein, single..... ......... ......... ......... ........... ...........
33511... C CABG, vein, two........ ......... ......... ......... ........... ...........
33512... C CABG, vein, three...... ......... ......... ......... ........... ...........
33513... C CABG, vein, four....... ......... ......... ......... ........... ...........
33514... C CABG, vein, five....... ......... ......... ......... ........... ...........
33516... C CABG, vein, six+....... ......... ......... ......... ........... ...........
33517... C CABG, artery-vein, ......... ......... ......... ........... ...........
single.
33518... C CABG, artery-vein, two. ......... ......... ......... ........... ...........
[[Page 47654]]
33519... C CABG, artery-vein, ......... ......... ......... ........... ...........
three.
33521... C CABG, artery-vein, four ......... ......... ......... ........... ...........
33522... C CABG, artery-vein, five ......... ......... ......... ........... ...........
33523... C CABG, artery-vein, six+ ......... ......... ......... ........... ...........
33530... C Coronary artery, bypass/ ......... ......... ......... ........... ...........
reop.
33533... C CABG, arterial, single. ......... ......... ......... ........... ...........
33534... C CABG, arterial, two.... ......... ......... ......... ........... ...........
33535... C CABG, arterial, three.. ......... ......... ......... ........... ...........
33536... C CABG, arterial, four+.. ......... ......... ......... ........... ...........
33542... C Removal of heart lesion ......... ......... ......... ........... ...........
33545... C Repair of heart damage. ......... ......... ......... ........... ...........
33572... C Open coronary ......... ......... ......... ........... ...........
endarterectomy.
33600... C Closure of valve....... ......... ......... ......... ........... ...........
33602... C Closure of valve....... ......... ......... ......... ........... ...........
33606... C Anastomosis/artery- ......... ......... ......... ........... ...........
aorta.
33608... C Repair anomaly w/ ......... ......... ......... ........... ...........
conduit.
33610... C Repair by enlargement.. ......... ......... ......... ........... ...........
33611... C Repair double ventricle ......... ......... ......... ........... ...........
33612... C Repair double ventricle ......... ......... ......... ........... ...........
33615... C Repair (simple fontan). ......... ......... ......... ........... ...........
33617... C Repair by modified ......... ......... ......... ........... ...........
fontan.
33619... C Repair single ventricle ......... ......... ......... ........... ...........
33641... C Repair heart septum ......... ......... ......... ........... ...........
defect.
33645... C Revision of heart veins ......... ......... ......... ........... ...........
33647... C Repair heart septum ......... ......... ......... ........... ...........
defects.
33660... C Repair of heart defects ......... ......... ......... ........... ...........
33665... C Repair of heart defects ......... ......... ......... ........... ...........
33670... C Repair of heart ......... ......... ......... ........... ...........
chambers.
33681... C Repair heart septum ......... ......... ......... ........... ...........
defect.
33684... C Repair heart septum ......... ......... ......... ........... ...........
defect.
33688... C Repair heart septum ......... ......... ......... ........... ...........
defect.
33690... C Reinforce pulmonary ......... ......... ......... ........... ...........
artery.
33692... C Repair of heart defects ......... ......... ......... ........... ...........
33694... C Repair of heart defects ......... ......... ......... ........... ...........
33697... C Repair of heart defects ......... ......... ......... ........... ...........
33702... C Repair of heart defects ......... ......... ......... ........... ...........
33710... C Repair of heart defects ......... ......... ......... ........... ...........
33720... C Repair of heart defect. ......... ......... ......... ........... ...........
33722... C Repair of heart defect. ......... ......... ......... ........... ...........
33730... C Repair heart-vein ......... ......... ......... ........... ...........
defect(s).
33732... C Repair heart-vein ......... ......... ......... ........... ...........
defect.
33735... C Revision of heart ......... ......... ......... ........... ...........
chamber.
33736... C Revision of heart ......... ......... ......... ........... ...........
chamber.
33737... C Revision of heart ......... ......... ......... ........... ...........
chamber.
33750... C Major vessel shunt..... ......... ......... ......... ........... ...........
33755... C Major vessel shunt..... ......... ......... ......... ........... ...........
33762... C Major vessel shunt..... ......... ......... ......... ........... ...........
33764... C Major vessel shunt & ......... ......... ......... ........... ...........
graft.
33766... C Major vessel shunt..... ......... ......... ......... ........... ...........
33767... C Atrial septectomy/ ......... ......... ......... ........... ...........
septostomy.
33770... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33771... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33774... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33775... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33776... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33777... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33778... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33779... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33780... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33781... C Repair great vessels ......... ......... ......... ........... ...........
defect.
33786... C Repair arterial trunk.. ......... ......... ......... ........... ...........
33788... C Revision of pulmonary ......... ......... ......... ........... ...........
artery.
33800... C Aortic suspension...... ......... ......... ......... ........... ...........
33802... C Repair vessel defect... ......... ......... ......... ........... ...........
33803... C Repair vessel defect... ......... ......... ......... ........... ...........
33813... C Repair septal defect... ......... ......... ......... ........... ...........
33814... C Repair septal defect... ......... ......... ......... ........... ...........
33820... C Revise major vessel.... ......... ......... ......... ........... ...........
33822... C Revise major vessel.... ......... ......... ......... ........... ...........
33824... C Revise major vessel.... ......... ......... ......... ........... ...........
33840... C Remove aorta ......... ......... ......... ........... ...........
constriction.
33845... C Remove aorta ......... ......... ......... ........... ...........
constriction.
33851... C Remove aorta ......... ......... ......... ........... ...........
constriction.
33852... C Repair septal defect... ......... ......... ......... ........... ...........
33853... C Repair septal defect... ......... ......... ......... ........... ...........
[[Page 47655]]
33860... C Ascending aorta graft.. ......... ......... ......... ........... ...........
33861... C Ascending aorta graft.. ......... ......... ......... ........... ...........
33863... C Ascending aorta graft.. ......... ......... ......... ........... ...........
33870... C Transverse aortic arch ......... ......... ......... ........... ...........
graft.
33875... C Thoracic aorta graft... ......... ......... ......... ........... ...........
33877... C Thoracoabdominal graft. ......... ......... ......... ........... ...........
33910... C Remove lung artery ......... ......... ......... ........... ...........
emboli.
33915... C Remove lung artery ......... ......... ......... ........... ...........
emboli.
33916... C Surgery of great vessel ......... ......... ......... ........... ...........
33917... C Repair pulmonary artery ......... ......... ......... ........... ...........
33918... C Repair pulmonary ......... ......... ......... ........... ...........
atresia.
33919... C Repair pulmonary ......... ......... ......... ........... ...........
atresia.
33920... C Repair pulmonary ......... ......... ......... ........... ...........
atresia.
33922... C Transect pulmonary ......... ......... ......... ........... ...........
artery.
33924... C Remove pulmonary shunt. ......... ......... ......... ........... ...........
33930... C Removal of donor heart/ ......... ......... ......... ........... ...........
lung.
33935... C Transplantation, heart/ ......... ......... ......... ........... ...........
lung.
33940... C Removal of donor heart. ......... ......... ......... ........... ...........
33945... C Transplantation of ......... ......... ......... ........... ...........
heart.
33960... C External circulation ......... ......... ......... ........... ...........
assist.
33961... C External circulation ......... ......... ......... ........... ...........
assist.
33970... C Aortic circulation ......... ......... ......... ........... ...........
assist.
33971... C Aortic circulation ......... ......... ......... ........... ...........
assist.
33973... C Insert balloon device.. ......... ......... ......... ........... ...........
33974... C Remove intra-aortic ......... ......... ......... ........... ...........
balloon.
33975... C Implant ventricular ......... ......... ......... ........... ...........
device.
33976... C Implant ventricular ......... ......... ......... ........... ...........
device.
33977... C Remove ventricular ......... ......... ......... ........... ...........
device.
33978... C Remove ventricular ......... ......... ......... ........... ...........
device.
33999... T Cardiac surgery 320 3.17 $167.49 $79.33 $33.50
procedure.
34001... C Removal of artery clot. ......... ......... ......... ........... ...........
34051... C Removal of artery clot. ......... ......... ......... ........... ...........
34101... C Removal of artery clot. ......... ......... ......... ........... ...........
34111... C Removal of arm artery ......... ......... ......... ........... ...........
clot.
34151... C Removal of artery clot. ......... ......... ......... ........... ...........
34201... C Removal of artery clot. ......... ......... ......... ........... ...........
34203... C Removal of leg artery ......... ......... ......... ........... ...........
clot.
34401... C Removal of vein clot... ......... ......... ......... ........... ...........
34421... C Removal of vein clot... ......... ......... ......... ........... ...........
34451... C Removal of vein clot... ......... ......... ......... ........... ...........
34471... C Removal of vein clot... ......... ......... ......... ........... ...........
34490... C Removal of vein clot... ......... ......... ......... ........... ...........
34501... C Repair valve, femoral ......... ......... ......... ........... ...........
vein.
34502... C Reconstruct, vena cava. ......... ......... ......... ........... ...........
34510... C Transposition of vein ......... ......... ......... ........... ...........
valve.
34520... C Cross-over vein graft.. ......... ......... ......... ........... ...........
34530... C Leg vein fusion........ ......... ......... ......... ........... ...........
35001... C Repair defect of artery ......... ......... ......... ........... ...........
35002... C Repair artery rupture, ......... ......... ......... ........... ...........
neck.
35005... C Repair defect of artery ......... ......... ......... ........... ...........
35011... C Repair defect of artery ......... ......... ......... ........... ...........
35013... C Repair artery rupture, ......... ......... ......... ........... ...........
arm.
35021... C Repair defect of artery ......... ......... ......... ........... ...........
35022... C Repair artery rupture, ......... ......... ......... ........... ...........
chest.
35045... C Repair defect of arm ......... ......... ......... ........... ...........
artery.
35081... C Repair defect of artery ......... ......... ......... ........... ...........
35082... C Repair artery rupture, ......... ......... ......... ........... ...........
aorta.
35091... C Repair defect of artery ......... ......... ......... ........... ...........
35092... C Repair artery rupture, ......... ......... ......... ........... ...........
aorta.
35102... C Repair defect of artery ......... ......... ......... ........... ...........
35103... C Repair artery rupture, ......... ......... ......... ........... ...........
groin.
35111... C Repair defect of artery ......... ......... ......... ........... ...........
35112... C Repair artery rupture, ......... ......... ......... ........... ...........
spleen.
35121... C Repair defect of artery ......... ......... ......... ........... ...........
35122... C Repair artery rupture, ......... ......... ......... ........... ...........
belly.
35131... C Repair defect of artery ......... ......... ......... ........... ...........
35132... C Repair artery rupture, ......... ......... ......... ........... ...........
groin.
35141... C Repair defect of artery ......... ......... ......... ........... ...........
35142... C Repair artery rupture, ......... ......... ......... ........... ...........
thigh.
35151... C Repair defect of artery ......... ......... ......... ........... ...........
35152... C Repair artery rupture, ......... ......... ......... ........... ...........
knee.
35161... C Repair defect of artery ......... ......... ......... ........... ...........
35162... C Repair artery rupture.. ......... ......... ......... ........... ...........
35180... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35182... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
[[Page 47656]]
35184... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35188... T Repair blood vessel 368 22.83 $1,207.67 $648.85 $241.53
lesion.
35189... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35190... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35201... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35206... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35207... T Repair blood vessel 368 22.83 $1,207.67 $648.85 $241.53
lesion.
35211... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35216... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35221... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35226... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35231... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35236... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35241... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35246... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35251... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35256... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35261... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35266... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35271... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35276... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35281... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35286... C Repair blood vessel ......... ......... ......... ........... ...........
lesion.
35301... C Rechanneling of artery. ......... ......... ......... ........... ...........
35311... C Rechanneling of artery. ......... ......... ......... ........... ...........
35321... C Rechanneling of artery. ......... ......... ......... ........... ...........
35331... C Rechanneling of artery. ......... ......... ......... ........... ...........
35341... C Rechanneling of artery. ......... ......... ......... ........... ...........
35351... C Rechanneling of artery. ......... ......... ......... ........... ...........
35355... C Rechanneling of artery. ......... ......... ......... ........... ...........
35361... C Rechanneling of artery. ......... ......... ......... ........... ...........
35363... C Rechanneling of artery. ......... ......... ......... ........... ...........
35371... C Rechanneling of artery. ......... ......... ......... ........... ...........
35372... C Rechanneling of artery. ......... ......... ......... ........... ...........
35381... C Rechanneling of artery. ......... ......... ......... ........... ...........
35390... C Reoperation, carotid... ......... ......... ......... ........... ...........
35400... C Angioscopy............. ......... ......... ......... ........... ...........
35450... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35452... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35454... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35456... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35458... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35459... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35460... C Repair venous blockage. ......... ......... ......... ........... ...........
35470... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35471... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35472... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35473... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35474... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35475... C Repair arterial ......... ......... ......... ........... ...........
blockage.
35476... C Repair venous blockage. ......... ......... ......... ........... ...........
35480... C Atherectomy, open...... ......... ......... ......... ........... ...........
35481... C Atherectomy, open...... ......... ......... ......... ........... ...........
35482... C Atherectomy, open...... ......... ......... ......... ........... ...........
35483... C Atherectomy, open...... ......... ......... ......... ........... ...........
35484... C Atherectomy, open...... ......... ......... ......... ........... ...........
35485... C Atherectomy, open...... ......... ......... ......... ........... ...........
35490... C Atherectomy, ......... ......... ......... ........... ...........
percutaneous.
35491... C Atherectomy, ......... ......... ......... ........... ...........
percutaneous.
35492... C Atherectomy, ......... ......... ......... ........... ...........
percutaneous.
35493... C Atherectomy, ......... ......... ......... ........... ...........
percutaneous.
35494... C Atherectomy, ......... ......... ......... ........... ...........
percutaneous.
35495... C Atherectomy, ......... ......... ......... ........... ...........
percutaneous.
35501... C Artery bypass graft.... ......... ......... ......... ........... ...........
35506... C Artery bypass graft.... ......... ......... ......... ........... ...........
35507... C Artery bypass graft.... ......... ......... ......... ........... ...........
35508... C Artery bypass graft.... ......... ......... ......... ........... ...........
35509... C Artery bypass graft.... ......... ......... ......... ........... ...........
35511... C Artery bypass graft.... ......... ......... ......... ........... ...........
35515... C Artery bypass graft.... ......... ......... ......... ........... ...........
35516... C Artery bypass graft.... ......... ......... ......... ........... ...........
35518... C Artery bypass graft.... ......... ......... ......... ........... ...........
35521... C Artery bypass graft.... ......... ......... ......... ........... ...........
35526... C Artery bypass graft.... ......... ......... ......... ........... ...........
35531... C Artery bypass graft.... ......... ......... ......... ........... ...........
[[Page 47657]]
35533... C Artery bypass graft.... ......... ......... ......... ........... ...........
35536... C Artery bypass graft.... ......... ......... ......... ........... ...........
35541... C Artery bypass graft.... ......... ......... ......... ........... ...........
35546... C Artery bypass graft.... ......... ......... ......... ........... ...........
35548... C Artery bypass graft.... ......... ......... ......... ........... ...........
35549... C Artery bypass graft.... ......... ......... ......... ........... ...........
35551... C Artery bypass graft.... ......... ......... ......... ........... ...........
35556... C Artery bypass graft.... ......... ......... ......... ........... ...........
35558... C Artery bypass graft.... ......... ......... ......... ........... ...........
35560... C Artery bypass graft.... ......... ......... ......... ........... ...........
35563... C Artery bypass graft.... ......... ......... ......... ........... ...........
35565... C Artery bypass graft.... ......... ......... ......... ........... ...........
35566... C Artery bypass graft.... ......... ......... ......... ........... ...........
35571... C Artery bypass graft.... ......... ......... ......... ........... ...........
35582... C Vein bypass graft...... ......... ......... ......... ........... ...........
35583... C Vein bypass graft...... ......... ......... ......... ........... ...........
35585... C Vein bypass graft...... ......... ......... ......... ........... ...........
35587... C Vein bypass graft...... ......... ......... ......... ........... ...........
35601... C Artery bypass graft.... ......... ......... ......... ........... ...........
35606... C Artery bypass graft.... ......... ......... ......... ........... ...........
35612... C Artery bypass graft.... ......... ......... ......... ........... ...........
35616... C Artery bypass graft.... ......... ......... ......... ........... ...........
35621... C Artery bypass graft.... ......... ......... ......... ........... ...........
35623... C Bypass graft, not vein. ......... ......... ......... ........... ...........
35626... C Artery bypass graft.... ......... ......... ......... ........... ...........
35631... C Artery bypass graft.... ......... ......... ......... ........... ...........
35636... C Artery bypass graft.... ......... ......... ......... ........... ...........
35641... C Artery bypass graft.... ......... ......... ......... ........... ...........
35642... C Artery bypass graft.... ......... ......... ......... ........... ...........
35645... C Artery bypass graft.... ......... ......... ......... ........... ...........
35646... C Artery bypass graft.... ......... ......... ......... ........... ...........
35650... C Artery bypass graft.... ......... ......... ......... ........... ...........
35651... C Artery bypass graft.... ......... ......... ......... ........... ...........
35654... C Artery bypass graft.... ......... ......... ......... ........... ...........
35656... C Artery bypass graft.... ......... ......... ......... ........... ...........
35661... C Artery bypass graft.... ......... ......... ......... ........... ...........
35663... C Artery bypass graft.... ......... ......... ......... ........... ...........
35665... C Artery bypass graft.... ......... ......... ......... ........... ...........
35666... C Artery bypass graft.... ......... ......... ......... ........... ...........
35671... C Artery bypass graft.... ......... ......... ......... ........... ...........
35681... C Artery bypass graft.... ......... ......... ......... ........... ...........
35691... C Arterial transposition. ......... ......... ......... ........... ...........
35693... C Arterial transposition. ......... ......... ......... ........... ...........
35694... C Arterial transposition. ......... ......... ......... ........... ...........
35695... C Arterial transposition. ......... ......... ......... ........... ...........
35700... C Reoperation, bypass ......... ......... ......... ........... ...........
graft.
35701... C Exploration, carotid ......... ......... ......... ........... ...........
artery.
35721... C Exploration, femoral ......... ......... ......... ........... ...........
artery.
35741... C Exploration popliteal ......... ......... ......... ........... ...........
artery.
35761... C Exploration of artery/ ......... ......... ......... ........... ...........
vein.
35800... C Explore neck vessels... ......... ......... ......... ........... ...........
35820... C Explore chest vessels.. ......... ......... ......... ........... ...........
35840... C Explore abdominal ......... ......... ......... ........... ...........
vessels.
35860... C Explore limb vessels... ......... ......... ......... ........... ...........
35870... C Repair vessel graft ......... ......... ......... ........... ...........
defect.
35875... T Removal of clot in 368 22.83 $1,207.67 $648.85 $241.53
graft.
35876... T Removal of clot in 368 22.83 $1,207.67 $648.85 $241.53
graft.
35901... C Excision, graft, neck.. ......... ......... ......... ........... ...........
35903... C Excision, graft, ......... ......... ......... ........... ...........
extremity.
35905... C Excision, graft, thorax ......... ......... ......... ........... ...........
35907... C Excision, graft, ......... ......... ......... ........... ...........
abdomen.
36000... N Place needle in vein... ......... ......... ......... ........... ...........
36005... T Injection, venography.. 347 2.93 $154.75 $62.15 $30.95
36010... T Place catheter in vein. 342 3.20 $169.45 $80.23 $33.89
36011... T Place catheter in vein. 342 3.20 $169.45 $80.23 $33.89
36012... T Place catheter in vein. 342 3.20 $169.45 $80.23 $33.89
36013... T Place catheter in 342 3.20 $169.45 $80.23 $33.89
artery.
36014... T Place catheter in 342 3.20 $169.45 $80.23 $33.89
artery.
36015... T Place catheter in 342 3.20 $169.45 $80.23 $33.89
artery.
36100... T Establish access to 342 3.20 $169.45 $80.23 $33.89
artery.
36120... T Establish access to 342 3.20 $169.45 $80.23 $33.89
artery.
36140... T Establish access to 342 3.20 $169.45 $80.23 $33.89
artery.
36145... N Artery to vein shunt... ......... ......... ......... ........... ...........
36160... T Establish access to 342 3.20 $169.45 $80.23 $33.89
aorta.
36200... T Place catheter in aorta 342 3.20 $169.45 $80.23 $33.89
[[Page 47658]]
36215... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36216... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36217... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36218... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36245... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36246... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36247... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36248... T Place catheter in 343 9.52 $503.44 $224.87 $100.69
artery.
36260... T Insertion of infusion 368 22.83 $1,207.67 $648.85 $241.53
pump.
36261... T Revision of infusion 360 6.09 $322.24 $140.12 $64.45
pump.
36262... T Removal of infusion 360 6.09 $322.24 $140.12 $64.45
pump.
36299... T Vessel injection 360 6.09 $322.24 $140.12 $64.45
procedure.
36400... N Drawing blood.......... ......... ......... ......... ........... ...........
36405... N Drawing blood.......... ......... ......... ......... ........... ...........
36406... N Drawing blood.......... ......... ......... ......... ........... ...........
36410... T Drawing blood.......... 341 0.13 $6.86 $2.94 $1.37
36415... E Drawing blood.......... ......... ......... ......... ........... ...........
36420... T Establish access to 341 0.13 $6.86 $2.94 $1.37
vein.
36425... T Establish access to 341 0.13 $6.86 $2.94 $1.37
vein.
36430... T Blood transfusion 369 4.33 $229.19 $97.18 $45.84
service.
36440... T Blood transfusion 369 4.33 $229.19 $97.18 $45.84
service.
36450... T Exchange transfusion 369 4.33 $229.19 $97.18 $45.84
service.
36455... T Exchange transfusion 369 4.33 $229.19 $97.18 $45.84
service.
36460... T Transfusion service, 369 4.33 $229.19 $97.18 $45.84
fetal.
36468... T Injection(s); spider 339 1.02 $53.87 $19.66 $10.77
veins.
36469... T Injection(s); spider 339 1.02 $53.87 $19.66 $10.77
veins.
36470... T Injection therapy of 339 1.02 $53.87 $19.66 $10.77
vein.
36471... T Injection therapy of 339 1.02 $53.87 $19.66 $10.77
veins.
36481... T Insertion of catheter, 343 9.52 $503.44 $224.87 $100.69
vein.
36488... S Insertion of catheter, 346 4.83 $255.64 $120.23 $51.13
vein.
36489... S Insertion of catheter, 346 4.83 $255.64 $120.23 $51.13
vein.
36490... S Insertion of catheter, 346 4.83 $255.64 $120.23 $51.13
vein.
36491... S Insertion of catheter, 346 4.83 $255.64 $120.23 $51.13
vein.
36493... S Repositioning of cvc... 346 4.83 $255.64 $120.23 $51.13
36500... T Insertion of catheter, 342 3.20 $169.45 $80.23 $33.89
vein.
36510... C Insertion of catheter, ......... ......... ......... ........... ...........
vein.
36520... T Plasma and/or cell 369 4.33 $229.19 $97.18 $45.84
exchange.
36522... T Photopheresis.......... 369 4.33 $229.19 $97.18 $45.84
36530... T Insertion of infusion 368 22.83 $1,207.67 $648.85 $241.53
pump.
36531... T Revision of infusion 360 6.09 $322.24 $140.12 $64.45
pump.
36532... T Removal of infusion 360 6.09 $322.24 $140.12 $64.45
pump.
36533... T Insertion of access 368 22.83 $1,207.67 $648.85 $241.53
port.
36534... T Revision of access port 360 6.09 $322.24 $140.12 $64.45
36535... T Removal of access port. 360 6.09 $322.24 $140.12 $64.45
36600... N Withdrawal of arterial ......... ......... ......... ........... ...........
blood.
36620... T Insertion catheter, 342 3.20 $169.45 $80.23 $33.89
artery.
36625... T Insertion catheter, 342 3.20 $169.45 $80.23 $33.89
artery.
36640... S Insertion catheter, 346 4.83 $255.64 $120.23 $51.13
artery.
36660... C Insertion catheter, ......... ......... ......... ........... ...........
artery.
36680... X Insert needle, bone 906 1.46 $77.38 $42.49 $15.48
cavity.
36800... T Insertion of cannula... 368 22.83 $1,207.67 $648.85 $241.53
36810... T Insertion of cannula... 368 22.83 $1,207.67 $648.85 $241.53
36815... T Insertion of cannula... 368 22.83 $1,207.67 $648.85 $241.53
36821... T Artery-vein fusion..... 368 22.83 $1,207.67 $648.85 $241.53
36822... C Insertion of cannula(s) ......... ......... ......... ........... ...........
36825... T Artery-vein graft...... 368 22.83 $1,207.67 $648.85 $241.53
36830... T Artery-vein graft...... 368 22.83 $1,207.67 $648.85 $241.53
36832... T Revise artery-vein 368 22.83 $1,207.67 $648.85 $241.53
fistula.
36834... C Repair A-V aneurysm.... ......... ......... ......... ........... ...........
36835... T Artery to vein shunt... 368 22.83 $1,207.67 $648.85 $241.53
36860... T Cannula declotting..... 368 22.83 $1,207.67 $648.85 $241.53
36861... T Cannula declotting..... 368 22.83 $1,207.67 $648.85 $241.53
37140... C Revision of circulation ......... ......... ......... ........... ...........
37145... C Revision of circulation ......... ......... ......... ........... ...........
37160... C Revision of circulation ......... ......... ......... ........... ...........
37180... C Revision of circulation ......... ......... ......... ........... ...........
37181... C Splice spleen/kidney ......... ......... ......... ........... ...........
veins.
37195... C Thrombolytic therapy, ......... ......... ......... ........... ...........
stroke.
37200... C Transcatheter biopsy... ......... ......... ......... ........... ...........
37201... C Transcatheter therapy ......... ......... ......... ........... ...........
infuse.
37202... C Transcatheter therapy ......... ......... ......... ........... ...........
infuse.
37203... T Transcatheter retrieval 360 6.09 $322.24 $140.12 $64.45
37204... C Transcatheter occlusion ......... ......... ......... ........... ...........
37205... C Transcatheter stent.... ......... ......... ......... ........... ...........
37206... C Transcatheter stent.... ......... ......... ......... ........... ...........
[[Page 47659]]
37207... C Transcatheter stent.... ......... ......... ......... ........... ...........
37208... C Transcatheter stent.... ......... ......... ......... ........... ...........
37209... C Exchange arterial ......... ......... ......... ........... ...........
catheter.
37250... C Intravascular us....... ......... ......... ......... ........... ...........
37251... C Intravascular us....... ......... ......... ......... ........... ...........
37565... C Ligation of neck vein.. ......... ......... ......... ........... ...........
37600... C Ligation of neck artery ......... ......... ......... ........... ...........
37605... C Ligation of neck artery ......... ......... ......... ........... ...........
37606... C Ligation of neck artery ......... ......... ......... ........... ...........
37607... T Ligation of fistula.... 368 22.83 $1,207.67 $648.85 $241.53
37609... T Temporal artery 162 5.67 $299.71 $125.43 $59.94
procedure.
37615... C Ligation of neck artery ......... ......... ......... ........... ...........
37616... C Ligation of chest ......... ......... ......... ........... ...........
artery.
37617... C Ligation of abdomen ......... ......... ......... ........... ...........
artery.
37618... T Ligation of extremity 367 17.59 $930.48 $449.06 $186.10
artery.
37620... C Revision of major vein. ......... ......... ......... ........... ...........
37650... T Revision of major vein. 367 17.59 $930.48 $449.06 $186.10
37660... C Revision of major vein. ......... ......... ......... ........... ...........
37700... T Revise leg vein........ 367 17.59 $930.48 $449.06 $186.10
37720... T Removal of leg vein.... 367 17.59 $930.48 $449.06 $186.10
37730... T Removal of leg veins... 367 17.59 $930.48 $449.06 $186.10
37735... T Removal of leg veins/ 367 17.59 $930.48 $449.06 $186.10
lesion.
37760... T Revision of leg veins.. 367 17.59 $930.48 $449.06 $186.10
37780... T Revision of leg vein... 367 17.59 $930.48 $449.06 $186.10
37785... T Revise secondary 367 17.59 $930.48 $449.06 $186.10
varicosity.
37788... C Revascularization, ......... ......... ......... ........... ...........
penis.
37790... T Penile venous occlusion 537 28.72 $1,519.13 $864.45 $303.83
37799... T Vascular surgery 162 5.67 $299.71 $125.43 $59.94
procedure.
38100... C Removal of spleen, ......... ......... ......... ........... ...........
total.
38101... C Removal of spleen, ......... ......... ......... ........... ...........
partial.
38102... C Removal of spleen, ......... ......... ......... ........... ...........
total.
38115... C Repair of ruptured ......... ......... ......... ........... ...........
spleen.
38200... T Injection for spleen x- 347 2.93 $154.75 $62.15 $30.95
ray.
38230... T Bone marrow collection. 369 4.33 $229.19 $97.18 $45.84
38231... T Stem cell collection... 369 4.33 $229.19 $97.18 $45.84
38240... C Bone marrow/stem ......... ......... ......... ........... ...........
transplant.
38241... C Bone marrow/stem ......... ......... ......... ........... ...........
transplant.
38300... T Drainage lymph node 132 6.04 $319.3 $134.24 $63.86
lesion.
38305... T Drainage lymph node 132 6.04 $319.3 $134.24 $63.86
lesion.
38308... T Incision of lymph 396 13.28 $702.27 $338.77 $140.45
channels.
38380... C Thoracic duct procedure ......... ......... ......... ........... ...........
38381... C Thoracic duct procedure ......... ......... ......... ........... ...........
38382... C Thoracic duct procedure ......... ......... ......... ........... ...........
38500... T Biopsy/removal, lymph 396 13.28 $702.27 $338.77 $140.45
node(s).
38505... T Needle biopsy, lymph 122 4.87 $257.6 $115.03 $51.52
node(s).
38510... T Biopsy/removal, lymph 396 13.28 $702.27 $338.77 $140.45
node(s).
38520... T Biopsy/removal, lymph 396 13.28 $702.27 $338.77 $140.45
node(s).
38525... T Biopsy/removal, lymph 396 13.28 $702.27 $338.77 $140.45
node(s).
38530... T Biopsy/removal, lymph 396 13.28 $702.27 $338.77 $140.45
node(s).
38542... T Explore deep node(s), 397 18.37 $971.62 $496.97 $194.32
neck.
38550... T Removal neck/armpit 396 13.28 $702.27 $338.77 $140.45
lesion.
38555... T Removal neck/armpit 397 18.37 $971.62 $496.97 $194.32
lesion.
38562... C Removal, pelvic lymph ......... ......... ......... ........... ...........
nodes.
38564... C Removal, abdomen lymph ......... ......... ......... ........... ...........
nodes.
38700... C Removal of lymph nodes, ......... ......... ......... ........... ...........
neck.
38720... C Removal of lymph nodes, ......... ......... ......... ........... ...........
neck.
38724... C Removal of lymph nodes, ......... ......... ......... ........... ...........
neck.
38740... T Remove armpit lymph 397 18.37 $971.62 $496.97 $194.32
nodes.
38745... T Remove armpits lymph 397 18.37 $971.62 $496.97 $194.32
nodes.
38746... C Remove thoracic lymph ......... ......... ......... ........... ...........
nodes.
38747... C Remove abdominal lymph ......... ......... ......... ........... ...........
nodes.
38760... T Remove groin lymph 397 18.37 $971.62 $496.97 $194.32
nodes.
38765... C Remove groin lymph ......... ......... ......... ........... ...........
nodes.
38770... C Remove pelvis lymph ......... ......... ......... ........... ...........
nodes.
38780... C Remove abdomen lymph ......... ......... ......... ........... ...........
nodes.
38790... T Injection for lymphatic 347 2.93 $154.75 $62.15 $30.95
xray.
38794... T Access thoracic lymph 342 3.20 $169.45 $80.23 $33.89
duct.
38999... T Blood/lymph system 132 6.04 $319.30 $134.24 $63.86
procedure.
39000... C Exploration of chest... ......... ......... ......... ........... ...........
39010... C Exploration of chest... ......... ......... ......... ........... ...........
39200... C Removal chest lesion... ......... ......... ......... ........... ...........
39220... C Removal chest lesion... ......... ......... ......... ........... ...........
39400... C Visualization of chest. ......... ......... ......... ........... ...........
39499... C Chest procedure........ ......... ......... ......... ........... ...........
39501... C Repair diaphragm ......... ......... ......... ........... ...........
laceration.
[[Page 47660]]
39502... C Repair paraesophageal ......... ......... ......... ........... ...........
hernia.
39503... C Repair of diaphragm ......... ......... ......... ........... ...........
hernia.
39520... C Repair of diaphragm ......... ......... ......... ........... ...........
hernia.
39530... C Repair of diaphragm ......... ......... ......... ........... ...........
hernia.
39531... C Repair of diaphragm ......... ......... ......... ........... ...........
hernia.
39540... C Repair of diaphragm ......... ......... ......... ........... ...........
hernia.
39541... C Repair of diaphragm ......... ......... ......... ........... ...........
hernia.
39545... C Revision of diaphragm.. ......... ......... ......... ........... ...........
39599... C Diaphragm surgery ......... ......... ......... ........... ...........
procedure.
40490... T Biopsy of lip.......... 311 1.43 $75.42 $20.57 $15.08
40500... T Partial excision of lip 313 15.81 $836.45 $411.09 $167.29
40510... T Partial excision of lip 313 15.81 $836.45 $411.09 $167.29
40520... T Partial excision of lip 313 15.81 $836.45 $411.09 $167.29
40525... T Reconstruct lip with 313 15.81 $836.45 $411.09 $167.29
flap.
40527... T Reconstruct lip with 313 15.81 $836.45 $411.09 $167.29
flap.
40530... T Partial removal of lip. 313 15.81 $836.45 $411.09 $167.29
40650... T Repair lip............. 313 15.81 $836.45 $411.09 $167.29
40652... T Repair lip............. 313 15.81 $836.45 $411.09 $167.29
40654... T Repair lip............. 313 15.81 $836.45 $411.09 $167.29
40700... T Repair cleft lip/nasal. 314 25.65 $1,356.54 $693.37 $271.31
40701... T Repair cleft lip/nasal. 314 25.65 $1,356.54 $693.37 $271.31
40702... T Repair cleft lip/nasal. 314 25.65 $1,356.54 $693.37 $271.31
40720... T Repair cleft lip/nasal. 314 25.65 $1,356.54 $693.37 $271.31
40761... T Repair cleft lip/nasal. 314 25.65 $1,356.54 $693.37 $271.31
40799... T Lip surgery procedure.. 311 1.43 $75.42 $20.57 $15.08
40800... T Drainage of mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
40801... T Drainage of mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
40804... T Removal foreign body, 311 1.43 $75.42 $20.57 $15.08
mouth.
40805... T Removal foreign body, 311 1.43 $75.42 $20.57 $15.08
mouth.
40806... T Incision of lip fold... 311 1.43 $75.42 $20.57 $15.08
40808... T Biopsy of mouth lesion. 311 1.43 $75.42 $20.57 $15.08
40810... T Excision of mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
40812... T Excise/repair mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
40814... T Excise/repair mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
40816... T Excision of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
40818... T Excise oral mucosa for 313 15.81 $836.45 $411.09 $167.29
graft.
40819... T Excise lip or cheek 313 15.81 $836.45 $411.09 $167.29
fold.
40820... T Treatment of mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
40830... T Repair mouth laceration 312 7.26 $383.95 $178.31 $76.79
40831... T Repair mouth laceration 312 7.26 $383.95 $178.31 $76.79
40840... T Reconstruction of mouth 313 15.81 $836.45 $411.09 $167.29
40842... T Reconstruction of mouth 313 15.81 $836.45 $411.09 $167.29
40843... T Reconstruction of mouth 314 25.65 $1,356.54 $693.37 $271.31
40844... T Reconstruction of mouth 314 25.65 $1,356.54 $693.37 $271.31
40845... T Reconstruction of mouth 314 25.65 $1,356.54 $693.37 $271.31
40899... T Mouth surgery procedure 311 1.43 $75.42 $20.57 $15.08
41000... T Drainage of mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
41005... T Drainage of mouth 311 1.43 $75.42 $20.57 $15.08
lesion.
41006... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41007... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41008... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41009... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41010... T Incision of tongue fold 313 15.81 $836.45 $411.09 $167.29
41015... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41016... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41017... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41018... T Drainage of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41100... T Biopsy of tongue....... 311 1.43 $75.42 $20.57 $15.08
41105... T Biopsy of tongue....... 311 1.43 $75.42 $20.57 $15.08
41108... T Biopsy of floor of 311 1.43 $75.42 $20.57 $15.08
mouth.
41110... T Excision of tongue 311 1.43 $75.42 $20.57 $15.08
lesion.
41112... T Excision of tongue 313 15.81 $836.45 $411.09 $167.29
lesion.
41113... T Excision of tongue 313 15.81 $836.45 $411.09 $167.29
lesion.
41114... T Excision of tongue 313 15.81 $836.45 $411.09 $167.29
lesion.
41115... T Excision of tongue fold 311 1.43 $75.42 $20.57 $15.08
41116... T Excision of mouth 313 15.81 $836.45 $411.09 $167.29
lesion.
41120... T Partial removal of 313 15.81 $836.45 $411.09 $167.29
tongue.
41130... C Partial removal of ......... ......... ......... ........... ...........
tongue.
41135... C Tongue and neck surgery ......... ......... ......... ........... ...........
41140... C Removal of tongue...... ......... ......... ......... ........... ...........
41145... C Tongue removal; neck ......... ......... ......... ........... ...........
surgery.
41150... C Tongue, mouth, jaw ......... ......... ......... ........... ...........
surgery.
41153... C Tongue, mouth, neck ......... ......... ......... ........... ...........
surgery.
41155... C Tongue, jaw, & neck ......... ......... ......... ........... ...........
surgery.
41250... T Repair tongue 312 7.26 $383.95 $178.31 $76.79
laceration.
[[Page 47661]]
41251... T Repair tongue 312 7.26 $383.95 $178.31 $76.79
laceration.
41252... T Repair tongue 312 7.26 $383.95 $178.31 $76.79
laceration.
41500... T Fixation of tongue..... 312 7.26 $383.95 $178.31 $76.79
41510... T Tongue to lip surgery.. 312 7.26 $383.95 $178.31 $76.79
41520... T Reconstruction, tongue 313 15.81 $836.45 $411.09 $167.29
fold.
41599... T Tongue and mouth 311 1.43 $75.42 $20.57 $15.08
surgery.
41800... T Drainage of gum lesion. 312 7.26 $383.95 $178.31 $76.79
41805... T Removal foreign body, 311 1.43 $75.42 $20.57 $15.08
gum.
41806... T Removal foreign body, 311 1.43 $75.42 $20.57 $15.08
jawbone.
41820... T Excision, gum, each 311 1.43 $75.42 $20.57 $15.08
quadrant.
41821... T Excision of gum flap... 311 1.43 $75.42 $20.57 $15.08
41822... T Excision of gum lesion. 231 12.02 $635.66 $299.9 $127.13
41823... T Excision of gum lesion. 231 12.02 $635.66 $299.9 $127.13
41825... T Excision of gum lesion. 311 1.43 $75.42 $20.57 $15.08
41826... T Excision of gum lesion. 311 1.43 $75.42 $20.57 $15.08
41827... T Excision of gum lesion. 313 15.81 $836.45 $411.09 $167.29
41828... T Excision of gum lesion. 311 1.43 $75.42 $20.57 $15.08
41830... T Removal of gum tissue.. 311 1.43 $75.42 $20.57 $15.08
41850... T Treatment of gum lesion 311 1.43 $75.42 $20.57 $15.08
41870... T Gum graft.............. 311 1.43 $75.42 $20.57 $15.08
41872... T Repair gum............. 311 1.43 $75.42 $20.57 $15.08
41874... T Repair tooth socket.... 311 1.43 $75.42 $20.57 $15.08
41899... T Dental surgery 311 1.43 $75.42 $20.57 $15.08
procedure.
42000... T Drainage mouth roof 311 1.43 $75.42 $20.57 $15.08
lesion.
42100... T Biopsy roof of mouth... 311 1.43 $75.42 $20.57 $15.08
42104... T Excision lesion, mouth 311 1.43 $75.42 $20.57 $15.08
roof.
42106... T Excision lesion, mouth 311 1.43 $75.42 $20.57 $15.08
roof.
42107... T Excision lesion, mouth 313 15.81 $836.45 $411.09 $167.29
roof.
42120... T Remove palate/lesion... 313 15.81 $836.45 $411.09 $167.29
42140... T Excision of uvula...... 311 1.43 $75.42 $20.57 $15.08
42145... C Repair, palate,pharynx/ ......... ......... ......... ........... ...........
uvula.
42160... T Treatment mouth roof 311 1.43 $75.42 $20.57 $15.08
lesion.
42180... T Repair palate.......... 313 15.81 $836.45 $411.09 $167.29
42182... T Repair palate.......... 313 15.81 $836.45 $411.09 $167.29
42200... T Reconstruct cleft 313 15.81 $836.45 $411.09 $167.29
palate.
42205... T Reconstruct cleft 313 15.81 $836.45 $411.09 $167.29
palate.
42210... T Reconstruct cleft 314 25.65 $1,356.54 $693.37 $271.31
palate.
42215... T Reconstruct cleft 313 15.81 $836.45 $411.09 $167.29
palate.
42220... T Reconstruct cleft 313 15.81 $836.45 $411.09 $167.29
palate.
42225... T Reconstruct cleft 314 25.65 $1,356.54 $693.37 $271.31
palate.
42226... T Lengthening of palate.. 314 25.65 $1,356.54 $693.37 $271.31
42227... T Lengthening of palate.. 314 25.65 $1,356.54 $693.37 $271.31
42235... T Repair palate.......... 313 15.81 $836.45 $411.09 $167.29
42260... T Repair nose to lip 313 15.81 $836.45 $411.09 $167.29
fistula.
42280... T Preparation, palate 311 1.43 $75.42 $20.57 $15.08
mold.
42281... T Insertion, palate 311 1.43 $75.42 $20.57 $15.08
prosthesis.
42299... T Palate/uvula surgery... 311 1.43 $75.42 $20.57 $15.08
42300... T Drainage of salivary 312 7.26 $383.95 $178.31 $76.79
gland.
42305... T Drainage of salivary 312 7.26 $383.95 $178.31 $76.79
gland.
42310... T Drainage of salivary 312 7.26 $383.95 $178.31 $76.79
gland.
42320... T Drainage of salivary 312 7.26 $383.95 $178.31 $76.79
gland.
42325... T Create salivary cyst 313 15.81 $836.45 $411.09 $167.29
drain.
42326... T Create salivary cyst 313 15.81 $836.45 $411.09 $167.29
drain.
42330... T Removal of salivary 311 1.43 $75.42 $20.57 $15.08
stone.
42335... T Removal of salivary 311 1.43 $75.42 $20.57 $15.08
stone.
42340... T Removal of salivary 313 15.81 $836.45 $411.09 $167.29
stone.
42400... T Biopsy of salivary 122 4.87 $257.6 $115.03 $51.52
gland.
42405... T Biopsy of salivary 312 7.26 $383.95 $178.31 $76.79
gland.
42408... T Excision of salivary 313 15.81 $836.45 $411.09 $167.29
cyst.
42409... T Drainage of salivary 313 15.81 $836.45 $411.09 $167.29
cyst.
42410... T Excise parotid gland/ 313 15.81 $836.45 $411.09 $167.29
lesion.
42415... T Excise parotid gland/ 314 25.65 $1,356.54 $693.37 $271.31
lesion.
42420... T Excise parotid gland/ 314 25.65 $1,356.54 $693.37 $271.31
lesion.
42425... T Excise parotid gland/ 314 25.65 $1,356.54 $693.37 $271.31
lesion.
42426... C Excise parotid gland/ ......... ......... ......... ........... ...........
lesion.
42440... T Excision submaxillary 313 15.81 $836.45 $411.09 $167.29
gland.
42450... T Excision sublingual 313 15.81 $836.45 $411.09 $167.29
gland.
42500... T Repair salivary duct... 313 15.81 $836.45 $411.09 $167.29
42505... T Repair salivary duct... 313 15.81 $836.45 $411.09 $167.29
42507... T Parotid duct diversion. 313 15.81 $836.45 $411.09 $167.29
42508... T Parotid duct diversion. 313 15.81 $836.45 $411.09 $167.29
42509... T Parotid duct diversion. 314 25.65 $1,356.54 $693.37 $271.31
42510... T Parotid duct diversion. 313 15.81 $836.45 $411.09 $167.29
42550... T Injection for salivary 347 2.93 $154.75 $62.15 $30.95
x-ray.
42600... T Closure of salivary 313 15.81 $836.45 $411.09 $167.29
fistula.
[[Page 47662]]
42650... T Dilation of salivary 311 1.43 $75.42 $20.57 $15.08
duct.
42660... T Dilation of salivary 311 1.43 $75.42 $20.57 $15.08
duct.
42665... T Ligation of salivary 311 1.43 $75.42 $20.57 $15.08
duct.
42699... T Salivary surgery 311 1.43 $75.42 $20.57 $15.08
procedure.
42700... T Drainage of tonsil 312 7.26 $383.95 $178.31 $76.79
abscess.
42720... T Drainage of throat 312 7.26 $383.95 $178.31 $76.79
abscess.
42725... T Drainage of throat 313 15.81 $836.45 $411.09 $167.29
abscess.
42800... T Biopsy of throat....... 312 7.26 $383.95 $178.31 $76.79
42802... T Biopsy of throat....... 312 7.26 $383.95 $178.31 $76.79
42804... T Biopsy of upper nose/ 312 7.26 $383.95 $178.31 $76.79
throat.
42806... T Biopsy of upper nose/ 312 7.26 $383.95 $178.31 $76.79
throat.
42808... T Excise pharynx lesion.. 312 7.26 $383.95 $178.31 $76.79
42809... T Remove pharynx foreign 151 1.74 $92.07 $35.71 $18.41
body.
42810... T Excision of neck cyst.. 313 15.81 $836.45 $411.09 $167.29
42815... T Excision of neck cyst.. 313 15.81 $836.45 $411.09 $167.29
42820... T Remove tonsils and 319 17.30 $914.81 $480.02 $182.96
adenoids.
42821... T Remove tonsils and 319 17.30 $914.81 $480.02 $182.96
adenoids.
42825... T Removal of tonsils..... 319 17.30 $914.81 $480.02 $182.96
42826... T Removal of tonsils..... 319 17.30 $914.81 $480.02 $182.96
42830... T Removal of adenoids.... 319 17.30 $914.81 $480.02 $182.96
42831... T Removal of adenoids.... 319 17.30 $914.81 $480.02 $182.96
42835... T Removal of adenoids.... 319 17.30 $914.81 $480.02 $182.96
42836... T Removal of adenoids.... 319 17.30 $914.81 $480.02 $182.96
42842... T Extensive surgery of 314 25.65 $1,356.54 $693.37 $271.31
throat.
42844... T Extensive surgery of 314 25.65 $1,356.54 $693.37 $271.31
throat.
42845... C Extensive surgery of ......... ......... ......... ........... ...........
throat.
42860... T Excision of tonsil tags 319 17.30 $914.81 $480.02 $182.96
42870... T Excision of lingual 319 17.30 $914.81 $480.02 $182.96
tonsil.
42890... T Partial removal of 314 25.65 $1,356.54 $693.37 $271.31
pharynx.
42892... T Revision of pharyngeal 314 25.65 $1,356.54 $693.37 $271.31
walls.
42894... C Revision of pharyngeal ......... ......... ......... ........... ...........
walls.
42900... T Repair throat wound.... 313 15.81 $836.45 $411.09 $167.29
42950... T Reconstruction of 313 15.81 $836.45 $411.09 $167.29
throat.
42953... C Repair throat, ......... ......... ......... ........... ...........
esophagus.
42955... T Surgical opening of 313 15.81 $836.45 $411.09 $167.29
throat.
42960... T Control throat bleeding 318 2.07 $109.7 $38.65 $21.94
42961... C Control throat bleeding ......... ......... ......... ........... ...........
42962... T Control throat bleeding 313 15.81 $836.45 $411.09 $167.29
42970... T Control nose/throat 318 2.07 $109.7 $38.65 $21.94
bleeding.
42971... C Control nose/throat ......... ......... ......... ........... ...........
bleeding.
42972... T Control nose/throat 313 15.81 $836.45 $411.09 $167.29
bleeding.
42999... T Throat surgery 318 2.07 $109.7 $38.65 $21.94
procedure.
43020... T Incision of esophagus.. 313 15.81 $836.45 $411.09 $167.29
43030... T Throat muscle surgery.. 313 15.81 $836.45 $411.09 $167.29
43045... C Incision of esophagus.. ......... ......... ......... ........... ...........
43100... C Excision of esophagus ......... ......... ......... ........... ...........
lesion.
43101... C Excision of esophagus ......... ......... ......... ........... ...........
lesion.
43107... C Removal of esophagus... ......... ......... ......... ........... ...........
43108... C Removal of esophagus... ......... ......... ......... ........... ...........
43112... C Removal of esophagus... ......... ......... ......... ........... ...........
43113... C Removal of esophagus... ......... ......... ......... ........... ...........
43116... C Partial removal of ......... ......... ......... ........... ...........
esophagus.
43117... C Partial removal of ......... ......... ......... ........... ...........
esophagus.
43118... C Partial removal of ......... ......... ......... ........... ...........
esophagus.
43121... C Partial removal of ......... ......... ......... ........... ...........
esophagus.
43122... C Parital removal of ......... ......... ......... ........... ...........
esophagus.
43123... C Partial removal of ......... ......... ......... ........... ...........
esophagus.
43124... C Removal of esophagus... ......... ......... ......... ........... ...........
43130... C Removal of esophagus ......... ......... ......... ........... ...........
pouch.
43135... C Removal of esophagus ......... ......... ......... ........... ...........
pouch.
43200... T Esophagus endoscopy.... 417 6.44 $340.85 $181.70 $68.17
43202... T Esophagus endoscopy, 417 6.44 $340.85 $181.70 $68.17
biopsy.
43204... T Esophagus endoscopy & 407 7.06 $373.17 $189.84 $74.63
inject.
43205... T Esophagus endoscopy/ 407 7.06 $373.17 $189.84 $74.63
ligation.
43215... T Esophagus endoscopy.... 407 7.06 $373.17 $189.84 $74.63
43216... T Esophagus endoscopy/ 407 7.06 $373.17 $189.84 $74.63
lesion.
43217... T Esophagus endoscopy.... 407 7.06 $373.17 $189.84 $74.63
43219... T Esophagus endoscopy.... 449 7.80 $412.35 $215.38 $82.47
43220... T Esophagus 407 7.06 $373.17 $189.84 $74.63
endoscopy,dilation.
43226... T Esophagus 407 7.06 $373.17 $189.84 $74.63
endoscopy,dilation.
43227... T Esophagus endoscopy, 407 7.06 $373.17 $189.84 $74.63
repair.
43228... T Esophagus 449 7.80 $412.35 $215.38 $82.47
endoscopy,ablation.
43234... T Upper GI endoscopy, 417 6.44 $340.85 $181.70 $68.17
exam.
43235... T Upper gi 417 6.44 $340.85 $181.70 $68.17
endoscopy,diagnosis.
43239... T Upper GI endoscopy, 417 6.44 $340.85 $181.70 $68.17
biopsy.
[[Page 47663]]
43241... T Upper GI endoscopy with 418 7.59 $401.58 $214.25 $80.32
tube.
43243... T Upper GI endoscopy & 418 7.59 $401.58 $214.25 $80.32
inject..
43244... T Upper GI endoscopy/ 418 7.59 $401.58 $214.25 $80.32
ligation.
43245... T Operative upper GI 418 7.59 $401.58 $214.25 $80.32
endoscopy.
43246... T Place gastrostomy tube. 418 7.59 $401.58 $214.25 $80.32
43247... T Operative upper GI 418 7.59 $401.58 $214.25 $80.32
endoscopy.
43248... T Upper GI endoscopy/ 418 7.59 $401.58 $214.25 $80.32
guidewire.
43249... T Esophagus 418 7.59 $401.58 $214.25 $80.32
endoscopy,dilation.
43250... T Upper GI endoscopy/ 418 7.59 $401.58 $214.25 $80.32
tumor.
43251... T Operative upper GI 418 7.59 $401.58 $214.25 $80.32
endoscopy.
43255... T Operative upper GI 418 7.59 $401.58 $214.25 $80.32
endoscopy.
43258... T Operative upper GI 449 7.80 $412.35 $215.38 $82.47
endoscopy.
43259... T Endoscopic ultrasound 449 7.80 $412.35 $215.38 $82.47
exam.
43260... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43261... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43262... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43263... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43264... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43265... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43267... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43268... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43269... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43271... T Endoscopy,bile duct/ 456 9.78 $517.15 $257.19 $103.43
pancreas.
43272... T Endoscopy,bile duct/ 449 7.80 $412.35 $215.38 $82.47
pancreas.
43300... C Repair of esophagus.... ......... ......... ......... ........... ...........
43305... C Repair esophagus and ......... ......... ......... ........... ...........
fistula.
43310... C Repair of esophagus.... ......... ......... ......... ........... ...........
43312... C Repair esophagus and ......... ......... ......... ........... ...........
fistula.
43320... C Fuse esophagus & ......... ......... ......... ........... ...........
stomach.
43324... C Revise esophagus & ......... ......... ......... ........... ...........
stomach.
43325... C Revise esophagus & ......... ......... ......... ........... ...........
stomach.
43326... C Revise esophagus & ......... ......... ......... ........... ...........
stomach.
43330... C Repair of esophagus.... ......... ......... ......... ........... ...........
43331... C Repair of esophagus.... ......... ......... ......... ........... ...........
43340... C Fuse esophagus & ......... ......... ......... ........... ...........
intestine.
43341... C Fuse esophagus & ......... ......... ......... ........... ...........
intestine.
43350... C Surgical opening, ......... ......... ......... ........... ...........
esophagus.
43351... C Surgical opening, ......... ......... ......... ........... ...........
esophagus.
43352... C Surgical opening, ......... ......... ......... ........... ...........
esophagus.
43360... C Gastrointestinal repair ......... ......... ......... ........... ...........
43361... C Gastrointestinal repair ......... ......... ......... ........... ...........
43400... C Ligate esophagus veins. ......... ......... ......... ........... ...........
43401... C Esophagus surgery for ......... ......... ......... ........... ...........
veins.
43405... C Ligate/staple esophagus ......... ......... ......... ........... ...........
43410... C Repair esophagus wound. ......... ......... ......... ........... ...........
43415... C Repair esophagus wound. ......... ......... ......... ........... ...........
43420... C Repair esophagus ......... ......... ......... ........... ...........
opening.
43425... C Repair esophagus ......... ......... ......... ........... ...........
opening.
43450... T Dilate esophagus....... 406 4.31 $228.21 $108.48 $45.64
43453... T Dilate esophagus....... 406 4.31 $228.21 $108.48 $45.64
43456... T Dilate esophagus....... 406 4.31 $228.21 $108.48 $45.64
43458... T Dilation of esophagus.. 406 4.31 $228.21 $108.48 $45.64
43460... C Pressure treatment ......... ......... ......... ........... ...........
esophagus.
43496... C Free jejunum flap, ......... ......... ......... ........... ...........
microvasc.
43499... T Esophagus surgery 406 4.31 $228.21 $108.48 $45.64
procedure.
43500... C Surgical opening of ......... ......... ......... ........... ...........
stomach.
43501... C Surgical repair of ......... ......... ......... ........... ...........
stomach.
43502... C Surgical repair of ......... ......... ......... ........... ...........
stomach.
43510... C Surgical opening of ......... ......... ......... ........... ...........
stomach.
43520... C Incision of pyloric ......... ......... ......... ........... ...........
muscle.
43600... T Biopsy of stomach...... 417 6.44 $340.85 $181.70 $68.17
43605... C Biopsy of stomach...... ......... ......... ......... ........... ...........
43610... C Excision of stomach ......... ......... ......... ........... ...........
lesion.
43611... C Excision of stomach ......... ......... ......... ........... ...........
lesion.
43620... C Removal of stomach..... ......... ......... ......... ........... ...........
43621... C Removal of stomach..... ......... ......... ......... ........... ...........
43622... C Removal of stomach..... ......... ......... ......... ........... ...........
43631... C Removal of stomach, ......... ......... ......... ........... ...........
partial.
43632... C Removal stomach, ......... ......... ......... ........... ...........
partial.
43633... C Removal stomach, ......... ......... ......... ........... ...........
partial.
43634... C Removal stomach, ......... ......... ......... ........... ...........
partial.
43635... C Partial removal of ......... ......... ......... ........... ...........
stomach.
43638... C Partial removal of ......... ......... ......... ........... ...........
stomach.
43639... C Removal stomach, ......... ......... ......... ........... ...........
partial.
43640... C Vagotomy & pylorus ......... ......... ......... ........... ...........
repair.
[[Page 47664]]
43641... C Vagotomy & pylorus ......... ......... ......... ........... ...........
repair.
43750... T Place gastrostomy tube. 418 7.59 $401.58 $214.25 $80.32
43760... T Change gastrostomy tube 470 2.22 $117.53 $54.92 $23.51
43761... T Reposition gastrostomy 470 2.22 $117.53 $54.92 $23.51
tube.
43800... C Reconstruction of ......... ......... ......... ........... ...........
pylorus.
43810... C Fusion of stomach and ......... ......... ......... ........... ...........
bowel.
43820... C Fusion of stomach and ......... ......... ......... ........... ...........
bowel.
43825... C Fusion of stomach and ......... ......... ......... ........... ...........
bowel.
43830... C Place gastrostomy tube. ......... ......... ......... ........... ...........
43831... C Place gastrostomy tube. ......... ......... ......... ........... ...........
43832... C Place gastrostomy tube. ......... ......... ......... ........... ...........
43840... C Repair of stomach ......... ......... ......... ........... ...........
lesion.
43842... C Gastroplasty for ......... ......... ......... ........... ...........
obesity.
43843... C Gastroplasty for ......... ......... ......... ........... ...........
obesity.
43846... C Gastric bypass for ......... ......... ......... ........... ...........
obesity.
43847... C Gastric bypass for ......... ......... ......... ........... ...........
obesity.
43848... C Revision gastroplasty.. ......... ......... ......... ........... ...........
43850... C Revise stomach-bowel ......... ......... ......... ........... ...........
fusion.
43855... C Revise stomach-bowel ......... ......... ......... ........... ...........
fusion.
43860... C Revise stomach-bowel ......... ......... ......... ........... ...........
fusion.
43865... C Revise stomach-bowel ......... ......... ......... ........... ...........
fusion.
43870... T Repair stomach opening. 182 4.00 $211.56 $84.98 $42.31
43880... C Repair stomach-bowel ......... ......... ......... ........... ...........
fistula.
43999... T Stomach surgery 470 2.22 $117.53 $54.92 $23.51
procedure.
44005... C Freeing of bowel ......... ......... ......... ........... ...........
adhesion.
44010... C Incision of small bowel ......... ......... ......... ........... ...........
44015... C Insert needle catheter, ......... ......... ......... ........... ...........
bowel.
44020... C Exploration of small ......... ......... ......... ........... ...........
bowel.
44021... C Decompress small bowel. ......... ......... ......... ........... ...........
44025... C Incision of large bowel ......... ......... ......... ........... ...........
44050... C Reduce bowel ......... ......... ......... ........... ...........
obstruction.
44055... C Correct malrotation of ......... ......... ......... ........... ...........
bowel.
44100... T Biopsy of bowel........ 417 6.44 $340.85 $181.70 $68.17
44110... C Excision of bowel ......... ......... ......... ........... ...........
lesion(s).
44111... C Excision of bowel ......... ......... ......... ........... ...........
lesion(s).
44120... C Removal of small ......... ......... ......... ........... ...........
intestine.
44121... C Removal of small ......... ......... ......... ........... ...........
intestine.
44125... C Removal of small ......... ......... ......... ........... ...........
intestine.
44130... C Bowel to bowel fusion.. ......... ......... ......... ........... ...........
44139... C Mobilization of colon.. ......... ......... ......... ........... ...........
44140... C Partial removal of ......... ......... ......... ........... ...........
colon.
44141... C Partial removal of ......... ......... ......... ........... ...........
colon.
44143... C Partial removal of ......... ......... ......... ........... ...........
colon.
44144... C Partial removal of ......... ......... ......... ........... ...........
colon.
44145... C Partial removal of ......... ......... ......... ........... ...........
colon.
44146... C Partial removal of ......... ......... ......... ........... ...........
colon.
44147... C Partial removal of ......... ......... ......... ........... ...........
colon.
44150... C Removal of colon....... ......... ......... ......... ........... ...........
44151... C Removal of colon/ ......... ......... ......... ........... ...........
ileostomy.
44152... C Removal of colon/ ......... ......... ......... ........... ...........
ileostomy.
44153... C Removal of colon/ ......... ......... ......... ........... ...........
ileostomy.
44155... C Removal of colon....... ......... ......... ......... ........... ...........
44156... C Removal of colon/ ......... ......... ......... ........... ...........
ileostomy.
44160... C Removal of colon....... ......... ......... ......... ........... ...........
44300... C Open bowel to skin..... ......... ......... ......... ........... ...........
44310... C Ileostomy/jejunostomy.. ......... ......... ......... ........... ...........
44312... T Revision of ileostomy.. 183 11.17 $590.61 $286.57 $118.12
44314... C Revision of ileostomy.. ......... ......... ......... ........... ...........
44316... C Devise bowel pouch..... ......... ......... ......... ........... ...........
44320... C Colostomy.............. ......... ......... ......... ........... ...........
44322... C Colostomy with biopsies ......... ......... ......... ........... ...........
44340... T Revision of colostomy.. 183 11.17 $590.61 $286.57 $118.12
44345... C Revision of colostomy.. ......... ......... ......... ........... ...........
44346... C Revision of colostomy.. ......... ......... ......... ........... ...........
44360... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44361... T Small bowel 419 7.13 $377.09 $164.08 $75.42
endoscopy,biopsy.
44363... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44364... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44365... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44366... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44369... T Small bowel endoscopy.. 449 7.80 $412.35 $215.38 $82.47
44372... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44373... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44376... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44377... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
[[Page 47665]]
44378... T Small bowel endoscopy.. 419 7.13 $377.09 $164.08 $75.42
44380... T Small bowel endoscopy.. 426 6.85 $362.40 $187.81 $72.48
44382... T Small bowel endoscopy.. 426 6.85 $362.40 $187.81 $72.48
44385... T Endoscopy of bowel 426 6.85 $362.40 $187.81 $72.48
pouch.
44386... T Endoscopy, bowel pouch, 426 6.85 $362.40 $187.81 $72.48
biopsy.
44388... T Colon endoscopy........ 426 6.85 $362.40 $187.81 $72.48
44389... T Colonoscopy with biopsy 426 6.85 $362.40 $187.81 $72.48
44390... T Colonoscopy for foreign 427 8.22 $434.88 $224.19 $86.98
body.
44391... T Colonoscopy for 427 8.22 $434.88 $224.19 $86.98
bleeding.
44392... T Colonoscopy & 427 8.22 $434.88 $224.19 $86.98
polypectomy.
44393... T Colonoscopy, lesion 449 7.80 $412.35 $215.38 $82.47
removal.
44394... T Colonoscopy w/snare.... 427 8.22 $434.88 $224.19 $86.98
44500... C Intro, gastrointestinal ......... ......... ......... ........... ...........
tube.
44602... C Suture, small intestine ......... ......... ......... ........... ...........
44603... C Suture, small intestine ......... ......... ......... ........... ...........
44604... C Suture, large intestine ......... ......... ......... ........... ...........
44605... C Repair of bowel lesion. ......... ......... ......... ........... ...........
44615... C Intestinal ......... ......... ......... ........... ...........
stricturoplasty.
44620... C Repair bowel opening... ......... ......... ......... ........... ...........
44625... C Repair bowel opening... ......... ......... ......... ........... ...........
44626... C Repair bowel opening... ......... ......... ......... ........... ...........
44640... C Repair bowel-skin ......... ......... ......... ........... ...........
fistula.
44650... C Repair bowel fistula... ......... ......... ......... ........... ...........
44660... C Repair bowel-bladder ......... ......... ......... ........... ...........
fistula.
44661... C Repair bowel-bladder ......... ......... ......... ........... ...........
fistula.
44680... C Surgical revision, ......... ......... ......... ........... ...........
intestine.
44700... C Suspend bowel w/ ......... ......... ......... ........... ...........
prosthesis.
44799... T Intestine surgery 419 7.13 $377.09 $164.08 $75.42
procedure.
44800... C Excision of bowel pouch ......... ......... ......... ........... ...........
44820... C Excision of mesentery ......... ......... ......... ........... ...........
lesion.
44850... C Repair of mesentery.... ......... ......... ......... ........... ...........
44899... C Bowel surgery procedure ......... ......... ......... ........... ...........
44900... C Drain, app abscess, ......... ......... ......... ........... ...........
open.
44901... C Drain, app abscess, ......... ......... ......... ........... ...........
perc.
44950... C Appendectomy........... ......... ......... ......... ........... ...........
44955... C Appendectomy........... ......... ......... ......... ........... ...........
44960... C Appendectomy........... ......... ......... ......... ........... ...........
45000... T Drainage of pelvic 452 4.83 $255.64 $109.61 $51.13
abscess.
45005... T Drainage of rectal 452 4.83 $255.64 $109.61 $51.13
abscess.
45020... T Drainage of rectal 452 4.83 $255.64 $109.61 $51.13
abscess.
45100... T Biopsy of rectum....... 452 4.83 $255.64 $109.61 $51.13
45108... T Removal of anorectal 453 16.87 $892.28 $445.22 $178.46
lesion.
45110... C Removal of rectum...... ......... ......... ......... ........... ...........
45111... C Partial removal of ......... ......... ......... ........... ...........
rectum.
45112... C Removal of rectum...... ......... ......... ......... ........... ...........
45113... C Partial proctectomy.... ......... ......... ......... ........... ...........
45114... C Partial removal of ......... ......... ......... ........... ...........
rectum.
45116... C Partial removal of ......... ......... ......... ........... ...........
rectum.
45119... C Remove, rectum w/ ......... ......... ......... ........... ...........
reservoir.
45120... C Removal of rectum...... ......... ......... ......... ........... ...........
45121... C Removal of rectum and ......... ......... ......... ........... ...........
colon.
45123... C Partial proctectomy.... ......... ......... ......... ........... ...........
45130... C Excision of rectal ......... ......... ......... ........... ...........
prolapse.
45135... C Excision of rectal ......... ......... ......... ........... ...........
prolapse.
45150... T Excision of rectal 453 16.87 $892.28 $445.22 $178.46
stricture.
45160... T Excision of rectal 453 16.87 $892.28 $445.22 $178.46
lesion.
45170... T Excision of rectal 453 16.87 $892.28 $445.22 $178.46
lesion.
45190... T Destruction, rectal 453 16.87 $892.28 $445.22 $178.46
tumor.
45300... T Proctosigmoidoscopy.... 446 2.59 $137.12 $65.09 $27.42
45303... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45305... T Proctosigmoidoscopy; 446 2.59 $137.12 $65.09 $27.42
biopsy.
45307... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45308... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45309... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45315... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45317... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45320... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45321... T Proctosigmoidoscopy.... 447 6.87 $363.38 $184.87 $72.68
45330... T Sigmoidoscopy, 446 2.59 $137.12 $65.09 $27.42
diagnostic.
45331... T Sigmoidoscopy and 446 2.59 $137.12 $65.09 $27.42
biopsy.
45332... T Sigmoidoscopy.......... 448 5.37 $284.04 $141.25 $56.81
45333... T Sigmoidoscopy & 448 5.37 $284.04 $141.25 $56.81
polypectomy.
45334... T Sigmoidoscopy for 448 5.37 $284.04 $141.25 $56.81
bleeding.
45337... T Sigmoidoscopy, 448 5.37 $284.04 $141.25 $56.81
decompression.
45338... T Sigmoidoscopy.......... 448 5.37 $284.04 $141.25 $56.81
[[Page 47666]]
45339... T Sigmoidoscopy.......... 449 7.80 $412.35 $215.38 $82.47
45355... T Surgical colonoscopy... 427 8.22 $434.88 $224.19 $86.98
45378... T Diagnostic colonoscopy. 426 6.85 $362.40 $187.81 $72.48
45379... T Colonoscopy............ 427 8.22 $434.88 $224.19 $86.98
45380... T Colonoscopy and biopsy. 426 6.85 $362.40 $187.81 $72.48
45382... T Colonoscopy, control 427 8.22 $434.88 $224.19 $86.98
bleeding.
45383... T Colonoscopy, lesion 449 7.80 $412.35 $215.38 $82.47
removal.
45384... T Colonoscopy............ 427 8.22 $434.88 $224.19 $86.98
45385... T Colonoscopy, lesion 427 8.22 $434.88 $224.19 $86.98
removal.
45500... T Repair of rectum....... 453 16.87 $892.28 $445.22 $178.46
45505... T Repair of rectum....... 453 16.87 $892.28 $445.22 $178.46
45520... T Treatment of rectal 339 1.02 $53.87 $19.66 $10.77
prolapse.
45540... C Correct rectal prolapse ......... ......... ......... ........... ...........
45541... C Correct rectal prolapse ......... ......... ......... ........... ...........
45550... C Repair rectum; remove ......... ......... ......... ........... ...........
sigmoid.
45560... T Repair of rectocele.... 453 16.87 $892.28 $445.22 $178.46
45562... C Exploration/repair of ......... ......... ......... ........... ...........
rectum.
45563... C Exploration/repair of ......... ......... ......... ........... ...........
rectum.
45800... C Repair rectumbladder ......... ......... ......... ........... ...........
fistula.
45805... C Repair fistula; ......... ......... ......... ........... ...........
colostomy.
45820... C Repair rectourethral ......... ......... ......... ........... ...........
fistula.
45825... C Repair fistula; ......... ......... ......... ........... ...........
colostomy.
45900... T Reduction of rectal 452 4.83 $255.64 $109.61 $51.13
prolapse.
45905... T Dilation of anal 452 4.83 $255.64 $109.61 $51.13
sphincter.
45910... T Dilation of rectal 452 4.83 $255.64 $109.61 $51.13
narrowing.
45915... T Remove rectal 452 4.83 $255.64 $109.61 $51.13
obstruction.
45999... T Rectum surgery 452 4.83 $255.64 $109.61 $51.13
procedure.
46030... T Removal of rectal 452 4.83 $255.64 $109.61 $51.13
marker.
46040... T Incision of rectal 452 4.83 $255.64 $109.61 $51.13
abscess.
46045... T Incision of rectal 453 16.87 $892.28 $445.22 $178.46
abscess.
46050... T Incision of anal 452 4.83 $255.64 $109.61 $51.13
abscess.
46060... T Incision of rectal 453 16.87 $892.28 $445.22 $178.46
abscess.
46070... T Incision of anal septum 451 2.56 $135.16 $54.24 $27.03
46080... T Incision of anal 452 4.83 $255.64 $109.61 $51.13
sphincter.
46083... T Incise external 451 2.56 $135.16 $54.24 $27.03
hemorrhoid.
46200... T Removal of anal fissure 453 16.87 $892.28 $445.22 $178.46
46210... T Removal of anal crypt.. 452 4.83 $255.64 $109.61 $51.13
46211... T Removal of anal crypts. 453 16.87 $892.28 $445.22 $178.46
46220... T Removal of anal tab.... 451 2.56 $135.16 $54.24 $27.03
46221... T Ligation of 451 2.56 $135.16 $54.24 $27.03
hemorrhoid(s).
46230... T Removal of anal tabs... 451 2.56 $135.16 $54.24 $27.03
46250... T Hemorrhoidectomy....... 453 16.87 $892.28 $445.22 $178.46
46255... T Hemorrhoidectomy....... 453 16.87 $892.28 $445.22 $178.46
46257... T Remove hemorrhoids & 453 16.87 $892.28 $445.22 $178.46
fissure.
46258... T Remove hemorrhoids & 453 16.87 $892.28 $445.22 $178.46
fistula.
46260... T Hemorrhoidectomy....... 453 16.87 $892.28 $445.22 $178.46
46261... T Remove hemorrhoids & 453 16.87 $892.28 $445.22 $178.46
fissure.
46262... T Remove hemorrhoids & 453 16.87 $892.28 $445.22 $178.46
fistula.
46270... T Removal of anal fistula 453 16.87 $892.28 $445.22 $178.46
46275... T Removal of anal fistula 453 16.87 $892.28 $445.22 $178.46
46280... T Removal of anal fistula 453 16.87 $892.28 $445.22 $178.46
46285... T Removal of anal fistula 453 16.87 $892.28 $445.22 $178.46
46288... T Repair anal fistula.... 453 16.87 $892.28 $445.22 $178.46
46320... T Removal of hemorrhoid 451 2.56 $135.16 $54.24 $27.03
clot.
46500... T Injection into 451 2.56 $135.16 $54.24 $27.03
hemorrhoids.
46600... N Diagnostic anoscopy.... ......... ......... ......... ........... ...........
46604... N Anoscopy and dilation.. ......... ......... ......... ........... ...........
46606... T Anoscopy and biopsy.... 436 1.43 $75.42 $24.86 $15.08
46608... T Anoscopy; remove 437 2.91 $153.77 $76.61 $30.75
foreign body.
46610... T Anoscopy; remove lesion 437 2.91 $153.77 $76.61 $30.75
46611... T Anoscopy............... 437 2.91 $153.77 $76.61 $30.75
46612... T Anoscopy; remove 437 2.91 $153.77 $76.61 $30.75
lesions.
46614... T Anoscopy; control 437 2.91 $153.77 $76.61 $30.75
bleeding.
46615... T Anoscopy............... 437 2.91 $153.77 $76.61 $30.75
46700... T Repair of anal 453 16.87 $892.28 $445.22 $178.46
stricture.
46705... C Repair of anal ......... ......... ......... ........... ...........
stricture.
46715... C Repair of anovaginal ......... ......... ......... ........... ...........
fistula.
46716... C Repair of anovaginal ......... ......... ......... ........... ...........
fistula.
46730... C Construction of absent ......... ......... ......... ........... ...........
anus.
46735... C Construction of absent ......... ......... ......... ........... ...........
anus.
46740... C Construction of absent ......... ......... ......... ........... ...........
anus.
46742... C Repair, imperforated ......... ......... ......... ........... ...........
anus.
46744... C Repair, cloacal anomaly ......... ......... ......... ........... ...........
46746... C Repair, cloacal anomaly ......... ......... ......... ........... ...........
46748... C Repair, cloacal anomaly ......... ......... ......... ........... ...........
[[Page 47667]]
46750... T Repair of anal 453 16.87 $892.28 $445.22 $178.46
sphincter.
46751... C Repair of anal ......... ......... ......... ........... ...........
sphincter.
46753... T Reconstruction of anus. 453 16.87 $892.28 $445.22 $178.46
46754... T Removal of suture from 452 4.83 $255.64 $109.61 $51.13
anus.
46760... T Repair of anal 453 16.87 $892.28 $445.22 $178.46
sphincter.
46761... T Repair of anal 453 16.87 $892.28 $445.22 $178.46
sphincter.
46762... T Implant artificial 453 16.87 $892.28 $445.22 $178.46
sphincter.
46900... T Destruction, anal 152 10.43 $551.43 $261.71 $110.29
lesion(s).
46910... T Destruction, anal 152 10.43 $551.43 $261.71 $110.29
lesion(s).
46916... T Cryosurgery, anal 152 10.43 $551.43 $261.71 $110.29
lesion(s).
46917... T Laser surgery, anal 152 10.43 $551.43 $261.71 $110.29
lesion(s).
46922... T Excision of anal 152 10.43 $551.43 $261.71 $110.29
lesion(s).
46924... T Destruction, anal 152 10.43 $551.43 $261.71 $110.29
lesion(s).
46934... T Destruction of 451 2.56 $135.16 $54.24 $27.03
hemorrhoids.
46935... T Destruction of 451 2.56 $135.16 $54.24 $27.03
hemorrhoids.
46936... T Destruction of 451 2.56 $135.16 $54.24 $27.03
hemorrhoids.
46937... T Cryotherapy of rectal 453 16.87 $892.28 $445.22 $178.46
lesion.
46938... T Cryotherapy of rectal 453 16.87 $892.28 $445.22 $178.46
lesion.
46940... T Treatment of anal 451 2.56 $135.16 $54.24 $27.03
fissure.
46942... T Treatment of anal 451 2.56 $135.16 $54.24 $27.03
fissure.
46945... T Ligation of hemorrhoids 451 2.56 $135.16 $54.24 $27.03
46946... T Ligation of hemorrhoids 451 2.56 $135.16 $54.24 $27.03
46999... T Anus surgery procedure. 452 4.83 $255.64 $109.61 $51.13
47000... T Needle biopsy of liver. 122 4.87 $257.60 $115.03 $51.52
47001... C Needle biopsy, liver... ......... ......... ......... ........... ...........
47010... C Open drainage, liver ......... ......... ......... ........... ...........
lesion.
47011... C Percut drain, liver ......... ......... ......... ........... ...........
lesion.
47015... C Inject/aspirate liver ......... ......... ......... ........... ...........
cyst.
47100... C Wedge biopsy of liver.. ......... ......... ......... ........... ...........
47120... C Partial removal of ......... ......... ......... ........... ...........
liver.
47122... C Extensive removal of ......... ......... ......... ........... ...........
liver.
47125... C Partial removal of ......... ......... ......... ........... ...........
liver.
47130... C Partial removal of ......... ......... ......... ........... ...........
liver.
47133... C Removal of donor liver. ......... ......... ......... ........... ...........
47134... C Partial removal, donor ......... ......... ......... ........... ...........
liver.
47135... C Transplantation of ......... ......... ......... ........... ...........
liver.
47136... C Transplantation of ......... ......... ......... ........... ...........
liver.
47300... C Surgery for liver ......... ......... ......... ........... ...........
lesion.
47350... C Repair liver wound..... ......... ......... ......... ........... ...........
47360... C Repair liver wound..... ......... ......... ......... ........... ...........
47361... C Repair liver wound..... ......... ......... ......... ........... ...........
47362... C Repair liver wound..... ......... ......... ......... ........... ...........
47399... T Liver surgery procedure 122 4.87 $257.60 $115.03 $51.52
47400... C Incision of liver duct. ......... ......... ......... ........... ...........
47420... C Incision of bile duct.. ......... ......... ......... ........... ...........
47425... C Incision of bile duct.. ......... ......... ......... ........... ...........
47460... C Incise bile duct ......... ......... ......... ........... ...........
sphincter.
47480... C Incision of gallbladder ......... ......... ......... ........... ...........
47490... C Incision of gallbladder ......... ......... ......... ........... ...........
47500... T Injection for liver x- 347 2.93 $154.75 $62.15 $30.95
rays.
47505... T Injection for liver x- 347 2.93 $154.75 $62.15 $30.95
rays.
47510... T Insert catheter, bile 458 7.24 $382.97 $181.70 $76.59
duct.
47511... T Insert bile duct drain. 458 7.24 $382.97 $181.70 $76.59
47525... T Change bile duct 470 2.22 $117.53 $54.92 $23.51
catheter.
47530... T Revise, reinsert bile 470 2.22 $117.53 $54.92 $23.51
tube.
47550... C Bile duct endoscopy.... ......... ......... ......... ........... ...........
47552... T Biliary endoscopy, thru 458 7.24 $382.97 $181.70 $76.59
skin.
47553... T Biliary endoscopy, thru 458 7.24 $382.97 $181.70 $76.59
skin.
47554... T Biliary endoscopy, thru 458 7.24 $382.97 $181.70 $76.59
skin.
47555... T Biliary endoscopy, thru 458 7.24 $382.97 $181.70 $76.59
skin.
47556... T Biliary endoscopy, thru 458 7.24 $382.97 $181.70 $76.59
skin.
47600... C Removal of gallbladder. ......... ......... ......... ........... ...........
47605... C Removal of gallbladder. ......... ......... ......... ........... ...........
47610... C Removal of gallbladder. ......... ......... ......... ........... ...........
47612... C Removal of gallbladder. ......... ......... ......... ........... ...........
47620... C Removal of gallbladder. ......... ......... ......... ........... ...........
47630... T Remove bile duct stone. 458 7.24 $382.97 $181.70 $76.59
47700... C Exploration of bile ......... ......... ......... ........... ...........
ducts.
47701... C Bile duct revision..... ......... ......... ......... ........... ...........
47711... C Excision of bile duct ......... ......... ......... ........... ...........
tumor.
47712... C Excision of bile duct ......... ......... ......... ........... ...........
tumor.
47715... C Excision of bile duct ......... ......... ......... ........... ...........
cyst.
47716... C Fusion of bile duct ......... ......... ......... ........... ...........
cyst.
47720... C Fuse gallbladder & ......... ......... ......... ........... ...........
bowel.
47721... C Fuse upper gi ......... ......... ......... ........... ...........
structures.
[[Page 47668]]
47740... C Fuse gallbladder & ......... ......... ......... ........... ...........
bowel.
47741... C Fuse gallbladder & ......... ......... ......... ........... ...........
bowel.
47760... C Fuse bile ducts and ......... ......... ......... ........... ...........
bowel.
47765... C Fuse liver ducts & ......... ......... ......... ........... ...........
bowel.
47780... C Fuse bile ducts and ......... ......... ......... ........... ...........
bowel.
47785... C Fuse bile ducts and ......... ......... ......... ........... ...........
bowel.
47800... C Reconstruction of bile ......... ......... ......... ........... ...........
ducts.
47801... C Placement, bile duct ......... ......... ......... ........... ...........
support.
47802... C Fuse liver duct & ......... ......... ......... ........... ...........
intestine.
47900... C Suture bile duct injury ......... ......... ......... ........... ...........
47999... T Bile tract surgery 470 2.22 $117.53 $54.92 $23.51
procedure.
48000... C Drainage of abdomen.... ......... ......... ......... ........... ...........
48001... C Placement of drain, ......... ......... ......... ........... ...........
pancreas.
48005... C Resect/debride pancreas ......... ......... ......... ........... ...........
48020... C Removal of pancreatic ......... ......... ......... ........... ...........
stone.
48100... C Biopsy of pancreas..... ......... ......... ......... ........... ...........
48102... T Needle biopsy, pancreas 122 4.87 $257.60 $115.03 $51.52
48120... C Removal of pancreas ......... ......... ......... ........... ...........
lesion.
48140... C Partial removal of ......... ......... ......... ........... ...........
pancreas.
48145... C Partial removal of ......... ......... ......... ........... ...........
pancreas.
48146... C Pancreatectomy......... ......... ......... ......... ........... ...........
48148... C Removal of pancreatic ......... ......... ......... ........... ...........
duct.
48150... C Partial removal of ......... ......... ......... ........... ...........
pancreas.
48152... C Pancreatectomy......... ......... ......... ......... ........... ...........
48153... C Pancreatectomy......... ......... ......... ......... ........... ...........
48154... C Pancreatectomy......... ......... ......... ......... ........... ...........
48155... C Removal of pancreas.... ......... ......... ......... ........... ...........
48160... E Pancreas removal, ......... ......... ......... ........... ...........
transplant.
48180... C Fuse pancreas and bowel ......... ......... ......... ........... ...........
48400... C Injection, ......... ......... ......... ........... ...........
intraoperative.
48500... C Surgery of pancreas ......... ......... ......... ........... ...........
cyst.
48510... C Drain pancreatic ......... ......... ......... ........... ...........
pseudocyst.
48511... C Drain pancreatic ......... ......... ......... ........... ...........
pseudocyst.
48520... C Fuse pancreas cyst and ......... ......... ......... ........... ...........
bowel.
48540... C Fuse pancreas cyst and ......... ......... ......... ........... ...........
bowel.
48545... C Pancreatorrhaphy....... ......... ......... ......... ........... ...........
48547... C Duodenal exclusion..... ......... ......... ......... ........... ...........
48550... E Donor pancreatectomy... ......... ......... ......... ........... ...........
48554... E Transplantallograft ......... ......... ......... ........... ...........
pancreas.
48556... C Removal, allograft ......... ......... ......... ........... ...........
pancreas.
48999... T Pancreas surgery 122 4.87 $257.60 $115.03 $51.52
procedure.
49000... C Exploration of abdomen. ......... ......... ......... ........... ...........
49002... C Reopening of abdomen... ......... ......... ......... ........... ...........
49010... C Exploration behind ......... ......... ......... ........... ...........
abdomen.
49020... C Drain abdominal abscess ......... ......... ......... ........... ...........
49021... C Drain abdominal abscess ......... ......... ......... ........... ...........
49040... C Open drainage abdom ......... ......... ......... ........... ...........
abscess.
49041... C Percut drain abdom ......... ......... ......... ........... ...........
abscess.
49060... C Open drain retroper ......... ......... ......... ........... ...........
abscess.
49061... C Percutdrain retroper ......... ......... ......... ........... ...........
abscess.
49062... C Drain to peritoneal ......... ......... ......... ........... ...........
cavity.
49080... T Puncture, peritoneal 320 3.17 $167.49 $79.33 $33.50
cavity.
49081... T Removal of abdominal 320 3.17 $167.49 $79.33 $33.50
fluid.
49085... T Remove abdomen foreign 459 18.06 $954.97 $496.52 $190.99
body.
49180... T Biopsy, abdominal mass. 122 4.87 $257.60 $115.03 $51.52
49200... C Removal of abdominal ......... ......... ......... ........... ...........
lesion.
49201... C Removal of abdominal ......... ......... ......... ........... ...........
lesion.
49215... C Excise sacral spine ......... ......... ......... ........... ...........
tumor.
49220... C Multiple surgery, ......... ......... ......... ........... ...........
abdomen.
49250... T Excision of umbilicus.. 459 18.06 $954.97 $496.52 $190.99
49255... C Removal of omentum..... ......... ......... ......... ........... ...........
49400... T Air injection into 347 2.93 $154.75 $62.15 $30.95
abdomen.
49420... T Insert abdominal drain. 459 18.06 $954.97 $496.52 $190.99
49421... T Insert abdominal drain. 459 18.06 $954.97 $496.52 $190.99
49422... T Remove perm cannula/ 470 2.22 $117.53 $54.92 $23.51
catheter.
49423... T Exchange drainage cath. 459 18.06 $954.97 $496.52 $190.99
49424... T Assess cyst, contrast 347 2.93 $154.75 $62.15 $30.95
inj.
49425... C Insert abdomen-venous ......... ......... ......... ........... ...........
drain.
49426... T Revise abdomen-venous 459 18.06 $954.97 $496.52 $190.99
shunt.
49427... T Injection, abdominal 347 2.93 $154.75 $62.15 $30.95
shunt.
49428... C Ligation of shunt...... ......... ......... ......... ........... ...........
49429... T Removal of shunt....... 470 2.22 $117.53 $54.92 $23.51
49495... T Repair inguinal hernia, 466 21.43 $1,133.23 $562.97 $226.65
init.
49496... T Repair inguinal hernia, 466 21.43 $1,133.23 $562.97 $226.65
init.
49500... T Repair inguinal hernia. 466 21.43 $1,133.23 $562.97 $226.65
[[Page 47669]]
49501... T Repair inguinal hernia, 466 21.43 $1,133.23 $562.97 $226.65
init.
49505... T Repair inguinal hernia. 466 21.43 $1,133.23 $562.97 $226.65
49507... T Repair, inguinal hernia 466 21.43 $1,133.23 $562.97 $226.65
49520... T Rerepair inguinal 466 21.43 $1,133.23 $562.97 $226.65
hernia.
49521... T Repair inguinal hernia, 466 21.43 $1,133.23 $562.97 $226.65
rec.
49525... T Repair inguinal hernia. 466 21.43 $1,133.23 $562.97 $226.65
49540... T Repair lumbar hernia... 466 21.43 $1,133.23 $562.97 $226.65
49550... T Repair femoral hernia.. 466 21.43 $1,133.23 $562.97 $226.65
49553... T Repair femoral hernia, 466 21.43 $1,133.23 $562.97 $226.65
init.
49555... T Repair femoral hernia.. 466 21.43 $1,133.23 $562.97 $226.65
49557... T Repair femoral hernia, 466 21.43 $1,133.23 $562.97 $226.65
recur.
49560... T Repair abdominal hernia 466 21.43 $1,133.23 $562.97 $226.65
49561... T Repair incisional 466 21.43 $1,133.23 $562.97 $226.65
hernia.
49565... T Rerepair abdominal 466 21.43 $1,133.23 $562.97 $226.65
hernia.
49566... T Repair incisional 466 21.43 $1,133.23 $562.97 $226.65
hernia.
49568... T Hernia repair w/mesh... 466 21.43 $1,133.23 $562.97 $226.65
49570... T Repair epigastric 466 21.43 $1,133.23 $562.97 $226.65
hernia.
49572... T Repair, epigastric 466 21.43 $1,133.23 $562.97 $226.65
hernia.
49580... T Repair umbilical hernia 466 21.43 $1,133.23 $562.97 $226.65
49582... T Repair umbilical hernia 466 21.43 $1,133.23 $562.97 $226.65
49585... T Repair umbilical hernia 466 21.43 $1,133.23 $562.97 $226.65
49587... T Repair umbilical hernia 466 21.43 $1,133.23 $562.97 $226.65
49590... T Repair abdominal hernia 466 21.43 $1,133.23 $562.97 $226.65
49600... T Repair umbilical lesion 466 21.43 $1,133.23 $562.97 $226.65
49605... C Repair umbilical lesion ......... ......... ......... ........... ...........
49606... C Repair umbilical lesion ......... ......... ......... ........... ...........
49610... C Repair umbilical lesion ......... ......... ......... ........... ...........
49611... C Repair umbilical lesion ......... ......... ......... ........... ...........
49900... C Repair of abdominal ......... ......... ......... ........... ...........
wall.
49905... C Omental flap........... ......... ......... ......... ........... ...........
49906... C Free omental flap, ......... ......... ......... ........... ...........
microvasc.
49999... T Abdomen surgery 470 2.22 $117.53 $54.92 $23.51
procedure.
50010... C Exploration of kidney.. ......... ......... ......... ........... ...........
50020... C Open drain renal ......... ......... ......... ........... ...........
abscess.
50021... C Percut drain renal ......... ......... ......... ........... ...........
abscess.
50040... C Drainage of kidney..... ......... ......... ......... ........... ...........
50045... C Exploration of kidney.. ......... ......... ......... ........... ...........
50060... C Removal of kidney stone ......... ......... ......... ........... ...........
50065... C Incision of kidney..... ......... ......... ......... ........... ...........
50070... C Incision of kidney..... ......... ......... ......... ........... ...........
50075... C Removal of kidney stone ......... ......... ......... ........... ...........
50080... C Removal of kidney stone ......... ......... ......... ........... ...........
50081... C Removal of kidney stone ......... ......... ......... ........... ...........
50100... C Revise kidney blood ......... ......... ......... ........... ...........
vessels.
50120... C Exploration of kidney.. ......... ......... ......... ........... ...........
50125... C Explore and drain ......... ......... ......... ........... ...........
kidney.
50130... C Removal of kidney stone ......... ......... ......... ........... ...........
50135... C Exploration of kidney.. ......... ......... ......... ........... ...........
50200... T Biopsy of kidney....... 122 4.87 $257.60 $115.03 $51.52
50205... C Biopsy of kidney....... ......... ......... ......... ........... ...........
50220... C Removal of kidney...... ......... ......... ......... ........... ...........
50225... C Removal of kidney...... ......... ......... ......... ........... ...........
50230... C Removal of kidney...... ......... ......... ......... ........... ...........
50234... C Removal of kidney & ......... ......... ......... ........... ...........
ureter.
50236... C Removal of kidney & ......... ......... ......... ........... ...........
ureter.
50240... C Partial removal of ......... ......... ......... ........... ...........
kidney.
50280... C Removal of kidney ......... ......... ......... ........... ...........
lesion.
50290... C Removal of kidney ......... ......... ......... ........... ...........
lesion.
50300... C Removal of donor kidney ......... ......... ......... ........... ...........
50320... C Removal of donor kidney ......... ......... ......... ........... ...........
50340... C Removal of kidney...... ......... ......... ......... ........... ...........
50360... C Transplantation of ......... ......... ......... ........... ...........
kidney.
50365... C Transplantation of ......... ......... ......... ........... ...........
kidney.
50370... C Remove transplanted ......... ......... ......... ........... ...........
kidney.
50380... C Reimplantation of ......... ......... ......... ........... ...........
kidney.
50390... T Drainage of kidney 122 4.87 $257.60 $115.03 $51.52
lesion.
50392... T Insert kidney drain.... 347 2.93 $154.75 $62.15 $30.95
50393... T Insert ureteral tube... 347 2.93 $154.75 $62.15 $30.95
50394... T Injection for kidney x- 347 2.93 $154.75 $62.15 $30.95
ray.
50395... T Create passage to 347 2.93 $154.75 $62.15 $30.95
kidney.
50396... T Measure kidney pressure 529 2.50 $132.23 $63.05 $26.45
50398... T Change kidney tube..... 521 5.06 $267.39 $112.10 $53.48
50400... C Revision of kidney/ ......... ......... ......... ........... ...........
ureter.
50405... C Revision of kidney/ ......... ......... ......... ........... ...........
ureter.
50500... C Repair of kidney wound. ......... ......... ......... ........... ...........
[[Page 47670]]
50520... C Close kidney-skin ......... ......... ......... ........... ...........
fistula.
50525... C Repair renal-abdomen ......... ......... ......... ........... ...........
fistula.
50526... C Repair renal-abdomen ......... ......... ......... ........... ...........
fistula.
50540... C Revision of horseshoe ......... ......... ......... ........... ...........
kidney.
50551... T Kidney endoscopy....... 522 10.46 $553.39 $262.39 $110.68
50553... T Kidney endoscopy....... 522 10.46 $553.39 $262.39 $110.68
50555... T Kidney endoscopy & 522 10.46 $553.39 $262.39 $110.68
biopsy.
50557... T Kidney endoscopy & 522 10.46 $553.39 $262.39 $110.68
treatment.
50559... T Renal endoscopy; 522 10.46 $553.39 $262.39 $110.68
radiotracer.
50561... T Kidney endoscopy & 522 10.46 $553.39 $262.39 $110.68
treatment.
50570... C Kidney endoscopy....... ......... ......... ......... ........... ...........
50572... C Kidney endoscopy....... ......... ......... ......... ........... ...........
50574... C Kidney endoscopy & ......... ......... ......... ........... ...........
biopsy.
50575... C Kidney endoscopy....... ......... ......... ......... ........... ...........
50576... C Kidney endoscopy & ......... ......... ......... ........... ...........
treatment.
50578... C Renal endoscopy; ......... ......... ......... ........... ...........
radiotracer.
50580... C Kidney endoscopy & ......... ......... ......... ........... ...........
treatment.
50590... T Fragmenting of kidney 527 51.56 $2,726.80 $1,372.95 $545.36
stone.
50600... C Exploration of ureter.. ......... ......... ......... ........... ...........
50605... C Insert ureteral support ......... ......... ......... ........... ...........
50610... C Removal of ureter stone ......... ......... ......... ........... ...........
50620... C Removal of ureter stone ......... ......... ......... ........... ...........
50630... C Removal of ureter stone ......... ......... ......... ........... ...........
50650... C Removal of ureter...... ......... ......... ......... ........... ...........
50660... C Removal of ureter...... ......... ......... ......... ........... ...........
50684... T Injection for ureter x- 347 2.93 $154.75 $62.15 $30.95
ray.
50686... T Measure ureter pressure 529 2.50 $132.23 $63.05 $26.45
50688... T Change of ureter tube.. 470 2.22 $117.53 $54.92 $23.51
50690... T Injection for ureter x- 347 2.93 $154.75 $62.15 $30.95
ray.
50700... C Revision of ureter..... ......... ......... ......... ........... ...........
50715... C Release of ureter...... ......... ......... ......... ........... ...........
50722... C Release of ureter...... ......... ......... ......... ........... ...........
50725... C Release/revise ureter.. ......... ......... ......... ........... ...........
50727... C Revise ureter.......... ......... ......... ......... ........... ...........
50728... C Revise ureter.......... ......... ......... ......... ........... ...........
50740... C Fusion of ureter & ......... ......... ......... ........... ...........
kidney.
50750... C Fusion of ureter & ......... ......... ......... ........... ...........
kidney.
50760... C Fusion of ureters...... ......... ......... ......... ........... ...........
50770... C Splicing of ureters.... ......... ......... ......... ........... ...........
50780... C Reimplant ureter in ......... ......... ......... ........... ...........
bladder.
50782... C Reimplant ureter in ......... ......... ......... ........... ...........
bladder.
50783... C Reimplant ureter in ......... ......... ......... ........... ...........
bladder.
50785... C Reimplant ureter in ......... ......... ......... ........... ...........
bladder.
50800... C Implant ureter in bowel ......... ......... ......... ........... ...........
50810... C Fusion of ureter & ......... ......... ......... ........... ...........
bowel.
50815... C Urine shunt to bowel... ......... ......... ......... ........... ...........
50820... C Construct bowel bladder ......... ......... ......... ........... ...........
50825... C Construct bowel bladder ......... ......... ......... ........... ...........
50830... C Revise urine flow...... ......... ......... ......... ........... ...........
50840... C Replace ureter by bowel ......... ......... ......... ........... ...........
50845... C Appendico-vesicostomy.. ......... ......... ......... ........... ...........
50860... C Transplant ureter to ......... ......... ......... ........... ...........
skin.
50900... C Repair of ureter....... ......... ......... ......... ........... ...........
50920... C Closure ureter/skin ......... ......... ......... ........... ...........
fistula.
50930... C Closure ureter/bowel ......... ......... ......... ........... ...........
fistula.
50940... C Release of ureter...... ......... ......... ......... ........... ...........
50951... T Endoscopy of ureter.... 523 16.87 $892.28 $447.03 $178.46
50953... T Endoscopy of ureter.... 523 16.87 $892.28 $447.03 $178.46
50955... T Ureter endoscopy & 523 16.87 $892.28 $447.03 $178.46
biopsy.
50957... T Ureter endoscopy & 523 16.87 $892.28 $447.03 $178.46
treatment.
50959... T Ureter endoscopy & 523 16.87 $892.28 $447.03 $178.46
tracer.
50961... T Ureter endoscopy & 523 16.87 $892.28 $447.03 $178.46
treatment.
50970... C Ureter endoscopy....... ......... ......... ......... ........... ...........
50972... C Ureter endoscopy & ......... ......... ......... ........... ...........
catheter.
50974... C Ureter endoscopy & ......... ......... ......... ........... ...........
biopsy.
50976... C Ureter endoscopy & ......... ......... ......... ........... ...........
treatment.
50978... C Ureter endoscopy & ......... ......... ......... ........... ...........
tracer.
50980... C Ureter endoscopy & ......... ......... ......... ........... ...........
treatment.
51000... T Drainage of bladder.... 530 2.52 $133.21 $54.69 $26.64
51005... T Drainage of bladder.... 530 2.52 $133.21 $54.69 $26.64
51010... T Drainage of bladder.... 530 2.52 $133.21 $54.69 $26.64
51020... T Incise & treat bladder. 523 16.87 $892.28 $447.03 $178.46
51030... T Incise & treat bladder. 523 16.87 $892.28 $447.03 $178.46
51040... T Incise & drain bladder. 523 16.87 $892.28 $447.03 $178.46
51045... T Incise bladder, drain 523 16.87 $892.28 $447.03 $178.46
ureter.
[[Page 47671]]
51050... T Removal of bladder 523 16.87 $892.28 $447.03 $178.46
stone.
51060... C Removal of ureter stone ......... ......... ......... ........... ...........
51065... T Removal of ureter stone 523 16.87 $892.28 $447.03 $178.46
51080... T Drainage of bladder 132 6.04 $319.30 $134.24 $63.86
abscess.
51500... T Removal of bladder cyst 466 21.43 $1,133.23 $562.97 $226.65
51520... T Removal of bladder 523 16.87 $892.28 $447.03 $178.46
lesion.
51525... C Removal of bladder ......... ......... ......... ........... ...........
lesion.
51530... C Removal of bladder ......... ......... ......... ........... ...........
lesion.
51535... C Repair of ureter lesion ......... ......... ......... ........... ...........
51550... C Partial removal of ......... ......... ......... ........... ...........
bladder.
51555... C Partial removal of ......... ......... ......... ........... ...........
bladder.
51565... C Revise bladder & ......... ......... ......... ........... ...........
ureter(s).
51570... C Removal of bladder..... ......... ......... ......... ........... ...........
51575... C Removal of bladder & ......... ......... ......... ........... ...........
nodes.
51580... C Remove bladder; revise ......... ......... ......... ........... ...........
tract.
51585... C Removal of bladder & ......... ......... ......... ........... ...........
nodes.
51590... C Remove bladder; revise ......... ......... ......... ........... ...........
tract.
51595... C Remove bladder; revise ......... ......... ......... ........... ...........
tract.
51596... C Remove bladder, create ......... ......... ......... ........... ...........
pouch.
51597... C Removal of pelvic ......... ......... ......... ........... ...........
structures.
51600... T Injection for bladder x- 347 2.93 $154.75 $62.15 $30.95
ray.
51605... T Preparation for bladder 347 2.93 $154.75 $62.15 $30.95
xray.
51610... T Injection for bladder x- 347 2.93 $154.75 $62.15 $30.95
ray.
51700... T Irrigation of bladder.. 530 2.52 $133.21 $54.69 $26.64
51705... T Change of bladder tube. 470 2.22 $117.53 $54.92 $23.51
51710... T Change of bladder tube. 470 2.22 $117.53 $54.92 $23.51
51715... T Endoscopic injection/ 531 18.94 $1,001.98 $527.26 $200.40
implant.
51720... T Treatment of bladder 530 2.52 $133.21 $54.69 $26.64
lesion.
51725... T Simple cystometrogram.. 529 2.50 $132.23 $63.05 $26.45
51726... T Complex cystometrogram. 529 2.50 $132.23 $63.05 $26.45
51736... T Urine flow measurement. 529 2.50 $132.23 $63.05 $26.45
51741... T Electro-uroflowmetry, 529 2.50 $132.23 $63.05 $26.45
first.
51772... T Urethra pressure 529 2.50 $132.23 $63.05 $26.45
profile.
51784... T Anal/urinary muscle 529 2.50 $132.23 $63.05 $26.45
study.
51785... T Anal/urinary muscle 529 2.50 $132.23 $63.05 $26.45
study.
51792... T Urinary reflex study... 529 2.50 $132.23 $63.05 $26.45
51795... T Urine voiding pressure 529 2.50 $132.23 $63.05 $26.45
study.
51797... T Intraabdominal pressure 529 2.50 $132.23 $63.05 $26.45
test.
51800... C Revision of bladder/ ......... ......... ......... ........... ...........
urethra.
51820... C Revision of urinary ......... ......... ......... ........... ...........
tract.
51840... C Attach bladder/urethra. ......... ......... ......... ........... ...........
51841... C Attach bladder/urethra. ......... ......... ......... ........... ...........
51845... C Repair bladder neck.... ......... ......... ......... ........... ...........
51860... C Repair of bladder wound ......... ......... ......... ........... ...........
51865... C Repair of bladder wound ......... ......... ......... ........... ...........
51880... T Repair of bladder 523 16.87 $892.28 $447.03 $178.46
opening.
51900... C Repair bladder/vagina ......... ......... ......... ........... ...........
lesion.
51920... C Close bladder-uterus ......... ......... ......... ........... ...........
fistula.
51925... C Hysterectomy/bladder ......... ......... ......... ........... ...........
repair.
51940... C Correction of bladder ......... ......... ......... ........... ...........
defect.
51960... C Revision of bladder & ......... ......... ......... ........... ...........
bowel.
51980... C Construct bladder ......... ......... ......... ........... ...........
opening.
52000... T Cystoscopy............. 521 5.06 $267.39 $112.10 $53.48
52005... T Cystoscopy & ureter 522 10.46 $553.39 $262.39 $110.68
catheter.
52007... T Cystoscopy and biopsy.. 522 10.46 $553.39 $262.39 $110.68
52010... T Cystoscopy & duct 522 10.46 $553.39 $262.39 $110.68
catheter.
52204... T Cystoscopy............. 522 10.46 $553.39 $262.39 $110.68
52214... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52224... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52234... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52235... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52240... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52250... T Cystoscopy & 523 16.87 $892.28 $447.03 $178.46
radiotracer.
52260... T Cystoscopy & treatment. 522 10.46 $553.39 $262.39 $110.68
52265... T Cystoscopy & treatment. 521 5.06 $267.39 $112.10 $53.48
52270... T Cystoscopy & revise 522 10.46 $553.39 $262.39 $110.68
urethra.
52275... T Cystoscopy & revise 522 10.46 $553.39 $262.39 $110.68
urethra.
52276... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52277... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52281... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52282... T Cystoscopy, implant 523 16.87 $892.28 $447.03 $178.46
stent.
52283... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52285... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52290... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52300... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
[[Page 47672]]
52301... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52305... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52310... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52315... T Cystoscopy and 522 10.46 $553.39 $262.39 $110.68
treatment.
52317... T Remove bladder stone... 523 16.87 $892.28 $447.03 $178.46
52318... T Remove bladder stone... 523 16.87 $892.28 $447.03 $178.46
52320... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52325... T Cystoscopy, stone 523 16.87 $892.28 $447.03 $178.46
removal.
52327... T Cystoscopy, inject 522 10.46 $553.39 $262.39 $110.68
material.
52330... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52332... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52334... T Create passage to 523 16.87 $892.28 $447.03 $178.46
kidney.
52335... T Endoscopy of urinary 523 16.87 $892.28 $447.03 $178.46
tract.
52336... T Cystoscopy, stone 523 16.87 $892.28 $447.03 $178.46
removal.
52337... T Cystoscopy, stone 524 28.89 1,527.95 $833.49 $305.59
removal.
52338... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52339... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52340... T Cystoscopy and 523 16.87 $892.28 $447.03 $178.46
treatment.
52450... T Incision of prostate... 523 16.87 $892.28 $447.03 $178.46
52500... T Revision of bladder 523 16.87 $892.28 $447.03 $178.46
neck.
52510... T Dilation prostatic 522 10.46 $553.39 $262.39 $110.68
urethra.
52601... T Prostatectomy (TURP)... 524 28.89 $1,527.95 $833.49 $305.59
52606... T Control postop bleeding 523 16.87 $892.28 $447.03 $178.46
52612... T Prostatectomy, first 524 28.89 $1,527.95 $833.49 $305.59
stage.
52614... T Prostatectomy, second 524 28.89 $1,527.95 $833.49 $305.59
stage.
52620... T Remove residual 524 28.89 $1,527.95 $833.49 $305.59
prostate.
52630... T Remove prostate 524 28.89 $1,527.95 $833.49 $305.59
regrowth.
52640... T Relieve bladder 523 16.87 $892.28 $447.03 $178.46
contracture.
52647... T Laser surgery of 524 28.89 $1,527.95 $833.49 $305.59
prostate.
52648... T Laser surgery of 524 28.89 $1,527.95 $833.49 $305.59
prostate.
52700... T Drainage of prostate 523 16.87 $892.28 $447.03 $178.46
abscess.
53000... T Incision of urethra.... 531 18.94 $1,001.98 $527.26 $200.40
53010... T Incision of urethra.... 531 18.94 $1,001.98 $527.26 $200.40
53020... T Incision of urethra.... 531 18.94 $1,001.98 $527.26 $200.40
53025... T Incision of urethra.... 531 18.94 $1,001.98 $527.26 $200.40
53040... T Drainage of urethra 531 18.94 $1,001.98 $527.26 $200.40
abscess.
53060... T Drainage of urethra 531 18.94 $1,001.98 $527.26 $200.40
abscess.
53080... T Drainage of urinary 531 18.94 $1,001.98 $527.26 $200.40
leakage.
53085... C Drainage of urinary ......... ......... ......... ........... ...........
leakage.
53200... T Biopsy of urethra...... 531 18.94 $1,001.98 $527.26 $200.40
53210... T Removal of urethra..... 532 25.50 $1,348.71 $602.29 $269.74
53215... T Removal of urethra..... 532 25.50 $1,348.71 $602.29 $269.74
53220... T Treatment of urethra 532 25.50 $1,348.71 $602.29 $269.74
lesion.
53230... T Removal of urethra 532 25.50 $1,348.71 $602.29 $269.74
lesion.
53235... T Removal of urethra 532 25.50 $1,348.71 $602.29 $269.74
lesion.
53240... T Surgery for urethra 532 25.50 $1,348.71 $602.29 $269.74
pouch.
53250... T Removal of urethra 531 18.94 $1,001.98 $527.26 $200.40
gland.
53260... T Treatment of urethra 531 18.94 $1,001.98 $527.26 $200.40
lesion.
53265... T Treatment of urethra 531 18.94 $1,001.98 $527.26 $200.40
lesion.
53270... T Removal of urethra 531 18.94 $1,001.98 $527.26 $200.40
gland.
53275... T Repair of urethra 531 18.94 $1,001.98 $527.26 $200.40
defect.
53400... T Revise urethra, 1st 532 25.50 $1,348.71 $602.29 $269.74
stage.
53405... T Revise urethra, 2nd 532 25.50 $1,348.71 $602.29 $269.74
stage.
53410... T Reconstruction of 532 25.50 $1,348.71 $602.29 $269.74
urethra.
53415... C Reconstruction of ......... ......... ......... ........... ...........
urethra.
53420... T Reconstruct urethra, 532 25.50 $1,348.71 $602.29 $269.74
stage 1.
53425... T Reconstruct urethra, 532 25.50 $1,348.71 $602.29 $269.74
stage 2.
53430... T Reconstruction of 532 25.50 $1,348.71 $602.29 $269.74
urethra.
53440... T Correct bladder 538 45.59 $2,411.41 $1,540.64 $482.28
function.
53442... T Remove perineal 531 18.94 $1,001.98 $527.26 $200.40
prosthesis.
53443... C Reconstruction of ......... ......... ......... ........... ...........
urethra.
53445... T Correct urine flow 538 45.59 $2,411.41 $1,540.64 $482.28
control.
53447... T Remove artificial 532 25.50 $1,348.71 $602.29 $269.74
sphincter.
53449... T Correct artificial 532 25.50 $1,348.71 $602.29 $269.74
sphincter.
53450... T Revision of urethra.... 532 25.50 $1,348.71 $602.29 $269.74
53460... T Revision of urethra.... 532 25.50 $1,348.71 $602.29 $269.74
53502... T Repair of urethra 531 18.94 $1,001.98 $527.26 $200.40
injury.
53505... T Repair of urethra 531 18.94 $1,001.98 $527.26 $200.40
injury.
53510... T Repair of urethra 531 18.94 $1,001.98 $527.26 $200.40
injury.
53515... T Repair of urethra 532 25.50 $1,348.71 $602.29 $269.74
injury.
53520... T Repair of urethra 532 25.50 $1,348.71 $602.29 $269.74
defect.
53600... T Dilate urethra 530 2.52 $133.21 $54.69 $26.64
stricture.
53601... T Dilate urethra 530 2.52 $133.21 $54.69 $26.64
stricture.
53605... T Dilate urethra 522 10.46 $553.39 $262.39 $110.68
stricture.
53620... T Dilate urethra 530 2.52 $133.21 $54.69 $26.64
stricture.
[[Page 47673]]
53621... T Dilate urethra 530 2.52 $133.21 $54.69 $26.64
stricture.
53660... T Dilation of urethra.... 530 2.52 $133.21 $54.69 $26.64
53661... T Dilation of urethra.... 530 2.52 $133.21 $54.69 $26.64
53665... T Dilation of urethra.... 531 18.94 $1,001.98 $527.26 $200.4
53670... N Insert urinary catheter ......... ......... ......... ........... ...........
53675... T Insert urinary catheter 530 2.52 $133.21 $54.69 $26.64
53850... T Prostatic microwave 524 28.89 $1,527.95 $833.49 $305.59
thermotx.
53852... T Prostatic rf thermotx.. 524 28.89 $1,527.95 $833.49 $305.59
53899... T Urology surgery 530 2.52 $133.21 $54.69 $26.64
procedure.
54000... T Slitting of prepuce.... 531 18.94 $1,001.98 $527.26 $200.4
54001... T Slitting of prepuce.... 531 18.94 $1,001.98 $527.26 $200.4
54015... T Drain penis lesion..... 132 6.04 $319.3 $134.24 $63.86
54050... T Destruction, penis 152 10.43 $551.43 $261.71 $110.29
lesion(s).
54055... T Destruction, penis 152 10.43 $551.43 $261.71 $110.29
lesion(s).
54056... T Cryosurgery, penis 152 10.43 $551.43 $261.71 $110.29
lesion(s).
54057... T Laser surg, penis 152 10.43 $551.43 $261.71 $110.29
lesion(s).
54060... T Excision of penis 152 10.43 $551.43 $261.71 $110.29
lesion(s).
54065... T Destruction, penis 152 10.43 $551.43 $261.71 $110.29
lesion(s).
54100... T Biopsy of penis........ 162 5.67 $299.71 $125.43 $59.94
54105... T Biopsy of penis........ 162 5.67 $299.71 $125.43 $59.94
54110... T Treatment of penis 537 28.72 $1,519.13 $864.45 $303.83
lesion.
54111... T Treat penis lesion, 537 28.72 $1,519.13 $864.45 $303.83
graft.
54112... T Treat penis lesion, 537 28.72 $1,519.13 $864.45 $303.83
graft.
54115... T Treatment of penis 132 6.04 $319.3 $134.24 $63.86
lesion.
54120... T Partial removal of 537 28.72 $1,519.13 $864.45 $303.83
penis.
54125... C Removal of penis....... ......... ......... ......... ........... ...........
54130... C Remove penis & nodes... ......... ......... ......... ........... ...........
54135... C Remove penis & nodes... ......... ......... ......... ........... ...........
54150... T Circumcision........... 536 13.17 $696.39 $326.57 $139.28
54152... T Circumcision........... 536 13.17 $696.39 $326.57 $139.28
54160... T Circumcision........... 536 13.17 $696.39 $326.57 $139.28
54161... T Circumcision........... 536 13.17 $696.39 $326.57 $139.28
54200... T Treatment of penis 530 2.52 $133.21 $54.69 $26.64
lesion.
54205... T Treatment of penis 537 28.72 $1,519.13 $864.45 $303.83
lesion.
54220... T Treatment of penis 530 2.52 $133.21 $54.69 $26.64
lesion.
54230... T Prepare penis study.... 347 2.93 $154.75 $62.15 $30.95
54231... T Dynamic cavernosometry. 530 2.52 $133.21 $54.69 $26.64
54235... T Penile injection....... 530 2.52 $133.21 $54.69 $26.64
54240... T Penis study............ 529 2.50 $132.23 $63.05 $26.45
54250... T Penis study............ 529 2.50 $132.23 $63.05 $26.45
54300... T Revision of penis...... 537 28.72 $1,519.13 $864.45 $303.83
54304... T Revision of penis...... 537 28.72 $1,519.13 $864.45 $303.83
54308... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54312... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54316... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54318... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54322... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54324... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54326... T Reconstruction of 537 28.72 $1,519.13 $864.45 $303.83
urethra.
54328... T Revise penis, urethra.. 537 28.72 $1,519.13 $864.45 $303.83
54332... C Revise penis, urethra.. ......... ......... ......... ........... ...........
54336... C Revise penis, urethra.. ......... ......... ......... ........... ...........
54340... T Secondary urethral 537 28.72 $1,519.13 $864.45 $303.83
surgery.
54344... T Secondary urethral 537 28.72 $1,519.13 $864.45 $303.83
surgery.
54348... T Secondary urethral 537 28.72 $1,519.13 $864.45 $303.83
surgery.
54352... T Reconstruct urethra, 537 28.72 $1,519.13 $864.45 $303.83
penis.
54360... T Penis plastic surgery.. 537 28.72 $1,519.13 $864.45 $303.83
54380... T Repair penis........... 537 28.72 $1,519.13 $864.45 $303.83
54385... T Repair penis........... 537 28.72 $1,519.13 $864.45 $303.83
54390... C Repair penis and ......... ......... ......... ........... ...........
bladder.
54400... T Insert semi-rigid 538 45.59 $2,411.41 $1,540.64 $482.28
prosthesis.
54401... T Insert self-contd 538 45.59 $2,411.41 $1,540.64 $482.28
prosthesis.
54402... T Remove penis prosthesis 537 28.72 $1,519.13 $864.45 $303.83
54405... T Insert multi-comp 538 45.59 $2,411.41 $1,540.64 $482.28
prosthesis.
54407... T Remove multi-comp 537 28.72 $1,519.13 $864.45 $303.83
prosthesis.
54409... T Revise penis prosthesis 537 28.72 $1,519.13 $864.45 $303.83
54420... T Revision of penis...... 537 28.72 $1,519.13 $864.45 $303.83
54430... C Revision of penis...... ......... ......... ......... ........... ...........
54435... T Revision of penis...... 537 28.72 $1,519.13 $864.45 $303.83
54440... T Repair of penis........ 537 28.72 $1,519.13 $864.45 $303.83
54450... T Preputial stretching... 530 2.52 $133.21 $54.69 $26.64
54500... T Biopsy of testis....... 122 4.87 $257.6 $115.03 $51.52
54505... T Biopsy of testis....... 546 17.15 $906.97 $453.81 $181.39
54510... T Removal of testis 546 17.15 $906.97 $453.81 $181.39
lesion.
54520... T Removal of testis...... 546 17.15 $906.97 $453.81 $181.39
[[Page 47674]]
54530... T Removal of testis...... 546 17.15 $906.97 $453.81 $181.39
54535... C Extensive testis ......... ......... ......... ........... ...........
surgery.
54550... T Exploration for testis. 546 17.15 $906.97 $453.81 $181.39
54560... C Exploration for testis. ......... ......... ......... ........... ...........
54600... T Reduce testis torsion.. 546 17.15 $906.97 $453.81 $181.39
54620... T Suspension of testis... 546 17.15 $906.97 $453.81 $181.39
54640... T Suspension of testis... 546 17.15 $906.97 $453.81 $181.39
54650... C Orchiopexy (Fowler- ......... ......... ......... ........... ...........
Stephens).
54660... T Revision of testis..... 546 17.15 $906.97 $453.81 $181.39
54670... T Repair testis injury... 546 17.15 $906.97 $453.81 $181.39
54680... T Relocation of 546 17.15 $906.97 $453.81 $181.39
testis(es).
54700... T Drainage of scrotum.... 546 17.15 $906.97 $453.81 $181.39
54800... T Biopsy of epididymis... 122 4.87 $257.6 $115.03 $51.52
54820... T Exploration of 546 17.15 $906.97 $453.81 $181.39
epididymis.
54830... T Remove epididymis 546 17.15 $906.97 $453.81 $181.39
lesion.
54840... T Remove epididymis 546 17.15 $906.97 $453.81 $181.39
lesion.
54860... T Removal of epididymis.. 546 17.15 $906.97 $453.81 $181.39
54861... T Removal of epididymis.. 546 17.15 $906.97 $453.81 $181.39
54900... T Fusion of spermatic 546 17.15 $906.97 $453.81 $181.39
ducts.
54901... T Fusion of spermatic 546 17.15 $906.97 $453.81 $181.39
ducts.
55000... T Drainage of hydrocele.. 121 0.67 $35.26 $21.02 $7.05
55040... T Removal of hydrocele... 466 21.43 $1,133.23 $562.97 $226.65
55041... T Removal of hydroceles.. 466 21.43 $1,133.23 $562.97 $226.65
55060... T Repair of hydrocele.... 546 17.15 $906.97 $453.81 $181.39
55100... T Drainage of scrotum 132 6.04 $319.3 $134.24 $63.86
abscess.
55110... T Explore scrotum........ 546 17.15 $906.97 $453.81 $181.39
55120... T Removal of scrotum 546 17.15 $906.97 $453.81 $181.39
lesion.
55150... T Removal of scrotum..... 546 17.15 $906.97 $453.81 $181.39
55175... T Revision of scrotum.... 546 17.15 $906.97 $453.81 $181.39
55180... T Revision of scrotum.... 546 17.15 $906.97 $453.81 $181.39
55200... T Incision of sperm duct. 546 17.15 $906.97 $453.81 $181.39
55250... T Removal of sperm 546 17.15 $906.97 $453.81 $181.39
duct(s).
55300... T Preparation,sperm duct 347 2.93 $154.75 $62.15 $30.95
x-ray.
55400... T Repair of sperm duct... 546 17.15 $906.97 $453.81 $181.39
55450... T Ligation of sperm duct. 546 17.15 $906.97 $453.81 $181.39
55500... T Removal of hydrocele... 546 17.15 $906.97 $453.81 $181.39
55520... T Removal of sperm cord 546 17.15 $906.97 $453.81 $181.39
lesion.
55530... T Revise spermatic cord 546 17.15 $906.97 $453.81 $181.39
veins.
55535... T Revise spermatic cord 546 17.15 $906.97 $453.81 $181.39
veins.
55540... T Revise hernia & sperm 546 17.15 $906.97 $453.81 $181.39
veins.
55600... C Incise sperm duct pouch ......... ......... ......... ........... ...........
55605... C Incise sperm duct pouch ......... ......... ......... ........... ...........
55650... C Remove sperm duct pouch ......... ......... ......... ........... ...........
55680... T Remove sperm pouch 546 17.15 $906.97 $453.81 $181.39
lesion.
55700... T Biopsy of prostate..... 547 4.39 $232.13 $125.2 $46.43
55705... T Biopsy of prostate..... 547 4.39 $232.13 $125.2 $46.43
55720... T Drainage of prostate 523 16.87 $892.28 $447.03 $178.46
abscess.
55725... T Drainage of prostate 523 16.87 $892.28 $447.03 $178.46
abscess.
55801... C Removal of prostate.... ......... ......... ......... ........... ...........
55810... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55812... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55815... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55821... C Removal of prostate.... ......... ......... ......... ........... ...........
55831... C Removal of prostate.... ......... ......... ......... ........... ...........
55840... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55842... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55845... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55859... T Percut/needle insert, 523 16.87 $892.28 $447.03 $178.46
pros.
55860... C Surgical exposure, ......... ......... ......... ........... ...........
prostate.
55862... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55865... C Extensive prostate ......... ......... ......... ........... ...........
surgery.
55870... T Electroejaculation..... 568 2.50 $132.23 $49.49 $26.45
55899... T Genital surgery 530 2.52 $133.21 $54.69 $26.64
procedure.
55970... E Sex transformation, M ......... ......... ......... ........... ...........
to F.
55980... E Sex transformation, F ......... ......... ......... ........... ...........
to M.
56300... T Laparoscopy; diagnostic 551 24.78 $1,310.51 $711.67 $262.1
56301... T Laparoscopy; tubal 551 24.78 $1,310.51 $711.67 $262.1
cautery.
56302... T Laparoscopy; tubal 551 24.78 $1,310.51 $711.67 $262.1
block.
56303... T Laparoscopy; excise 551 24.78 $1,310.51 $711.67 $262.1
lesions.
56304... T Laparoscopy; lysis..... 551 24.78 $1,310.51 $711.67 $262.1
56305... T Laparoscopy; biopsy.... 551 24.78 $1,310.51 $711.67 $262.1
56306... T Laparoscopy; aspiration 551 24.78 $1,310.51 $711.67 $262.1
56307... T Laparoscopy; remove 552 37.72 $1,995.15 $1,053.16 $399.03
adnexa.
56308... C Laparoscopy; ......... ......... ......... ........... ...........
hysterectomy.
56309... T Laparoscopy; remove 552 37.72 $1,995.15 $1,053.16 $399.03
myoma.
[[Page 47675]]
56310... C Laparoscopic ......... ......... ......... ........... ...........
enterolysis.
56311... T Laparoscopic lymph node 552 37.72 $1,995.15 $1,053.16 $399.03
biop.
56312... T Laparoscopic 552 37.72 $1,995.15 $1,053.16 $399.03
lymphadenectomy.
56313... T Laparoscopic 552 37.72 $1,995.15 $1,053.16 $399.03
lymphadenectomy.
56314... C Lapar; drain lymphocele ......... ......... ......... ........... ...........
56315... C Laparoscopic ......... ......... ......... ........... ...........
appendectomy.
56316... T Laparoscopic hernia 552 37.72 $1,995.15 $1,053.16 $399.03
repair.
56317... T Laparoscopic hernia 552 37.72 $1,995.15 $1,053.16 $399.03
repair.
56318... T Laparoscopic 552 37.72 $1,995.15 $1,053.16 $399.03
orchiectomy.
56320... T Laparoscopy, spermatic 552 37.72 $1,995.15 $1,053.16 $399.03
veins.
56322... C Laparoscopy, vagus ......... ......... ......... ........... ...........
nerves.
56323... C Laparoscopy, vagus ......... ......... ......... ........... ...........
nerves.
56324... C Laparoscopy, ......... ......... ......... ........... ...........
cholecystoenter.
56340... C Laparoscopic ......... ......... ......... ........... ...........
cholecystectomy.
56341... C Laparoscopic ......... ......... ......... ........... ...........
cholecystectomy.
56342... C Laparoscopic ......... ......... ......... ........... ...........
cholecystectomy.
56343... T Laparoscopic 552 37.72 $1,995.15 $1,053.16 $399.03
salpingostomy.
56344... T Laparoscopic 552 37.72 $1,995.15 $1,053.16 $399.03
fimbrioplasty.
56345... C Laparoscopic ......... ......... ......... ........... ...........
splenectomy.
56346... T Laparoscopic 551 24.78 $1,310.51 $711.67 $262.1
gastrostomy.
56347... C Laparoscopic ......... ......... ......... ........... ...........
jejunostomy.
56348... C Laparo; resect ......... ......... ......... ........... ...........
intestine.
56349... C Laparoscopy; ......... ......... ......... ........... ...........
fundoplasty.
56350... T Hysteroscopy; 562 12.76 $674.84 $330.86 $134.97
diagnostic.
56351... T Hysteroscopy; biopsy... 550 16.89 $893.26 $447.93 $178.65
56352... T Hysteroscopy; lysis.... 550 16.89 $893.26 $447.93 $178.65
56353... T Hysteroscopy; resect 550 16.89 $893.26 $447.93 $178.65
septum.
56354... T Hysteroscopy; remove 550 16.89 $893.26 $447.93 $178.65
myoma.
56355... T Hysteroscopy; remove 550 16.89 $893.26 $447.93 $178.65
impact.
56356... T Hysteroscopy; ablation. 550 16.89 $893.26 $447.93 $178.65
56362... T Laparoscopy w/cholangio 552 37.72 $1,995.15 $1,053.16 $399.03
56363... T Laparoscopy w/biopsy... 552 37.72 $1,995.15 $1,053.16 $399.03
56399... T Laparoscopy procedure.. 562 12.76 $674.84 $330.86 $134.97
56405... T I & D of vulva/perineum 561 1.52 $80.32 $24.63 $16.06
56420... T Drainage of gland 561 1.52 $80.32 $24.63 $16.06
abscess.
56440... T Surgery for vulva 562 12.76 $674.84 $330.86 $134.97
lesion.
56441... T Lysis of labial 561 1.52 $80.32 $24.63 $16.06
lesion(s).
56501... T Destruction, vulva 152 10.43 $551.43 $261.71 $110.29
lesion(s).
56515... T Destruction, vulva 152 10.43 $551.43 $261.71 $110.29
lesion(s).
56605... T Biopsy of vulva/ 161 3.50 $385.12 $75.48 $37.02
perineum.
56606... T Biopsy of vulva/ 161 3.50 $185.12 $75.48 $37.02
perineum.
56620... T Partial removal of 563 16.91 $894.24 $464.88 $178.85
vulva.
56625... T Complete removal of 563 16.91 $894.24 $464.88 $178.85
vulva.
56630... C Extensive vulva surgery ......... ......... ......... ........... ...........
56631... C Extensive vulva surgery ......... ......... ......... ........... ...........
56632... C Extensive vulva surgery ......... ......... ......... ........... ...........
56633... C Extensive vulva surgery ......... ......... ......... ........... ...........
56634... C Extensive vulva surgery ......... ......... ......... ........... ...........
56637... C Extensive vulva surgery ......... ......... ......... ........... ...........
56640... C Extensive vulva surgery ......... ......... ......... ........... ...........
56700... T Partial removal of 562 12.76 $674.84 $330.86 $134.97
hymen.
56720... T Incision of hymen...... 562 12.76 $674.84 $330.86 $134.97
56740... T Remove vagina gland 562 12.76 $674.84 $330.86 $134.97
lesion.
56800... T Repair of vagina....... 562 12.76 $674.84 $330.86 $134.97
56805... C Repair clitoris........ ......... ......... ......... ........... ...........
56810... T Repair of perineum..... 562 12.76 $674.84 $330.86 $134.97
57000... T Exploration of vagina.. 562 12.76 $674.84 $330.86 $134.97
57010... T Drainage of pelvic 562 12.76 $674.84 $330.86 $134.97
abscess.
57020... T Drainage of pelvic 562 12.76 $674.84 $330.86 $134.97
fluid.
57061... T Destruction vagina 561 1.52 $80.32 $24.63 $16.06
lesion(s).
57065... T Destruction vagina 562 12.76 $674.84 $330.86 $134.97
lesion(s).
57100... T Biopsy of vagina....... 561 1.52 $80.32 $24.63 $16.06
57105... T Biopsy of vagina....... 562 12.76 $674.84 $330.86 $134.97
57108... C Partial removal of ......... ......... ......... ........... ...........
vagina.
57110... C Removal of vagina...... ......... ......... ......... ........... ...........
57120... C Closure of vagina...... ......... ......... ......... ........... ...........
57130... T Remove vagina lesion... 562 12.76 $674.84 $330.86 $134.97
57135... T Remove vagina lesion... 562 12.76 $674.84 $330.86 $134.97
57150... T Treat vagina infection. 561 1.52 $80.32 $24.63 $16.06
57160... T Insertion of pessary/ 561 1.52 $80.32 $24.63 $16.06
device.
57170... T Fitting of diaphragm/ 561 1.52 $80.32 $24.63 $16.06
cap.
57180... T Treat vaginal bleeding. 561 1.52 $80.32 $24.63 $16.06
57200... T Repair of vagina....... 562 12.76 $674.84 $330.86 $134.97
57210... T Repair vagina/perineum. 562 12.76 $674.84 $330.86 $134.97
57220... T Revision of urethra.... 563 16.91 $894.24 $464.88 $178.85
[[Page 47676]]
57230... T Repair of urethral 562 12.76 $674.84 $330.86 $134.97
lesion.
57240... T Repair bladder & vagina 563 16.91 $894.24 $464.88 $178.85
57250... T Repair rectum & vagina. 563 16.91 $894.24 $464.88 $178.85
57260... T Repair of vagina....... 563 16.91 $894.24 $464.88 $178.85
57265... T Extensive repair of 563 16.91 $894.24 $464.88 $178.85
vagina.
57268... T Repair of bowel bulge.. 563 16.91 $894.24 $464.88 $178.85
57270... C Repair of bowel pouch.. ......... ......... ......... ........... ...........
57280... C Suspension of vagina... ......... ......... ......... ........... ...........
57282... C Repair of vaginal ......... ......... ......... ........... ...........
prolapse.
57284... T Repair paravaginal 563 16.91 $894.24 $464.88 $178.85
defect.
57288... T Repair bladder defect.. 563 16.91 $894.24 $464.88 $178.85
57289... T Repair bladder & vagina 563 16.91 $894.24 $464.88 $178.85
57291... T Construction of vagina. 563 16.91 $894.24 $464.88 $178.85
57292... C Construct vagina with ......... ......... ......... ........... ...........
graft.
57300... T Repair rectum-vagina 563 16.91 $894.24 $464.88 $178.85
fistula.
57305... C Repair rectum-vagina ......... ......... ......... ........... ...........
fistula.
57307... C Fistula repair & ......... ......... ......... ........... ...........
colostomy.
57308... C Fistula repair, ......... ......... ......... ........... ...........
transperine.
57310... C Repair urethrovaginal ......... ......... ......... ........... ...........
lesion.
57311... C Repair urethrovaginal ......... ......... ......... ........... ...........
lesion.
57320... C Repair bladder-vagina ......... ......... ......... ........... ...........
lesion.
57330... C Repair bladder-vagina ......... ......... ......... ........... ...........
lesion.
57335... C Repair vagina.......... ......... ......... ......... ........... ...........
57400... T Dilation of vagina..... 562 12.76 $674.84 $330.86 $134.97
57410... T Pelvic examination..... 562 12.76 $674.84 $330.86 $134.97
57415... T Removal vaginal foreign 562 12.76 $674.84 $330.86 $134.97
body.
57452... T Examination of vagina.. 561 1.52 $80.32 $24.63 $16.06
57454... T Vagina examination & 561 1.52 $80.32 $24.63 $16.06
biopsy.
57460... T Cervix excision........ 562 12.76 $674.84 $330.86 $134.97
57500... T Biopsy of cervix....... 561 1.52 $80.32 $24.63 $16.06
57505... T Endocervical curettage. 561 1.52 $80.32 $24.63 $16.06
57510... T Cauterization of cervix 561 1.52 $80.32 $24.63 $16.06
57511... T Cryocautery of cervix.. 561 1.52 $80.32 $24.63 $16.06
57513... T Laser surgery of cervix 561 1.52 $80.32 $24.63 $16.06
57520... T Conization of cervix... 563 16.91 $894.24 $464.88 $178.85
57522... T Conization of cervix... 563 16.91 $894.24 $464.88 $178.85
57530... T Removal of cervix...... 563 16.91 $894.24 $464.88 $178.85
57531... C Removal of cervix, ......... ......... ......... ........... ...........
radical.
57540... C Removal of residual ......... ......... ......... ........... ...........
cervix.
57545... C Remove cervix, repair ......... ......... ......... ........... ...........
pelvis.
57550... T Removal of residual 563 16.91 $894.24 $464.88 $178.85
cervix.
57555... T Remove cervix, repair 563 16.91 $894.24 $464.88 $178.85
vagina.
57556... T Remove cervix, repair 563 16.91 $894.24 $464.88 $178.85
bowel.
57700... T Revision of cervix..... 562 12.76 $674.84 $330.86 $134.97
57720... T Revision of cervix..... 562 12.76 $674.84 $330.86 $134.97
57800... T Dilation of cervical 561 1.52 $80.32 $24.63 $16.06
canal.
57820... T D&c of residual cervix. 567 13.61 $719.9 $364.09 $143.98
58100... T Biopsy of uterus lining 561 1.52 $80.32 $24.63 $16.06
58120... T Dilation and curettage 567 13.61 $719.9 $364.09 $143.98
(D&C).
58140... C Removal of uterus ......... ......... ......... ........... ...........
lesion.
58145... T Removal of uterus 563 16.91 $894.24 $464.88 $178.85
lesion.
58150... C Total hysterectomy..... ......... ......... ......... ........... ...........
58152... C Total hysterectomy..... ......... ......... ......... ........... ...........
58180... C Partial hysterectomy... ......... ......... ......... ........... ...........
58200... C Extensive hysterectomy. ......... ......... ......... ........... ...........
58210... C Extensive hysterectomy. ......... ......... ......... ........... ...........
58240... C Removal of pelvis ......... ......... ......... ........... ...........
contents.
58260... C Vaginal hysterectomy... ......... ......... ......... ........... ...........
58262... C Vaginal hysterectomy... ......... ......... ......... ........... ...........
58263... C Vaginal hysterectomy... ......... ......... ......... ........... ...........
58267... C Hysterectomy & vagina ......... ......... ......... ........... ...........
repair.
58270... C Hysterectomy & vagina ......... ......... ......... ........... ...........
repair.
58275... C Hysterectomy, revise ......... ......... ......... ........... ...........
vagina.
58280... C Hysterectomy, revise ......... ......... ......... ........... ...........
vagina.
58285... C Extensive hysterectomy. ......... ......... ......... ........... ...........
58300... E Insert intrauterine ......... ......... ......... ........... ...........
device.
58301... T Remove intrauterine 561 1.52 $80.32 $24.63 $16.06
device.
58321... T Artificial insemination 568 2.50 $132.23 $49.49 $26.45
58322... T Artificial insemination 568 2.50 $132.23 $49.49 $26.45
58323... T Sperm washing.......... 568 2.50 $132.23 $49.49 $26.45
58340... T Catheter for 347 2.93 $154.75 $62.15 $30.95
hysterography.
58345... T Reopen fallopian tube.. 562 12.76 $674.84 $330.86 $134.97
58350... T Reopen fallopian tube.. 562 12.76 $674.84 $330.86 $134.97
58400... C Suspension of uterus... ......... ......... ......... ........... ...........
58410... C Suspension of uterus... ......... ......... ......... ........... ...........
[[Page 47677]]
58520... C Repair of ruptured ......... ......... ......... ........... ...........
uterus.
58540... C Revision of uterus..... ......... ......... ......... ........... ...........
58600... C Division of fallopian ......... ......... ......... ........... ...........
tube.
58605... C Division of fallopian ......... ......... ......... ........... ...........
tube.
58611... C Ligate oviduct(s)...... ......... ......... ......... ........... ...........
58615... C Occlude fallopian ......... ......... ......... ........... ...........
tube(s).
58700... C Removal of fallopian ......... ......... ......... ........... ...........
tube.
58720... C Removal of ovary/ ......... ......... ......... ........... ...........
tube(s).
58740... C Revise fallopian ......... ......... ......... ........... ...........
tube(s).
58750... C Repair oviduct......... ......... ......... ......... ........... ...........
58752... C Revise ovarian tube(s). ......... ......... ......... ........... ...........
58760... C Remove tubal ......... ......... ......... ........... ...........
obstruction.
58770... C Create new tubal ......... ......... ......... ........... ...........
opening.
58800... T Drainage of ovarian 563 16.91 $894.24 $464.88 $178.85
cyst(s).
58805... C Drainage of ovarian ......... ......... ......... ........... ...........
cyst(s).
58820... T Open drain ovary 563 16.91 $894.24 $464.88 $178.85
abscess.
58822... C Percut drain ovary ......... ......... ......... ........... ...........
abscess.
58823... C Percut drain pelvic ......... ......... ......... ........... ...........
abscess.
58825... C Transposition, ovary(s) ......... ......... ......... ........... ...........
58900... C Biopsy of ovary(s)..... ......... ......... ......... ........... ...........
58920... C Partial removal of ......... ......... ......... ........... ...........
ovary(s).
58925... C Removal of ovarian ......... ......... ......... ........... ...........
cyst(s).
58940... C Removal of ovary(s).... ......... ......... ......... ........... ...........
58943... C Removal of ovary(s).... ......... ......... ......... ........... ...........
58950... C Resect ovarian ......... ......... ......... ........... ...........
malignancy.
58951... C Resect ovarian ......... ......... ......... ........... ...........
malignancy.
58952... C Resect ovarian ......... ......... ......... ........... ...........
malignancy.
58960... C Exploration of abdomen. ......... ......... ......... ........... ...........
58970... T Retrieval of oocyte.... 562 12.76 $674.84 $330.86 $134.97
58974... T Transfer of embryo..... 568 2.50 $132.23 $49.49 $26.45
58976... T Transfer of embryo..... 568 2.50 $132.23 $49.49 $26.45
58999... T Genital surgery 161 3.50 $185.12 $75.48 $37.02
procedure.
59000... T Amniocentesis.......... 578 1.26 $66.60 $33.90 $13.32
59012... T Fetal cord puncture, 578 1.26 $66.60 $33.90 $13.32
prenatal.
59015... T Chorion biopsy......... 578 1.26 $66.60 $33.90 $13.32
59020... T Fetal contract stress 578 1.26 $66.60 $33.90 $13.32
test.
59025... T Fetal non-stress test.. 578 1.26 $66.60 $33.90 $13.32
59030... T Fetal scalp blood 578 1.26 $66.60 $33.90 $13.32
sample.
59050... T Fetal monitor w/report. 578 1.26 $66.60 $33.90 $13.32
59051... N Fetal monitor/interpret ......... ......... ......... ........... ...........
only.
59100... C Remove uterus lesion... ......... ......... ......... ........... ...........
59120... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59121... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59130... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59135... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59136... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59140... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59150... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59151... C Treat ectopic pregnancy ......... ......... ......... ........... ...........
59160... T D&C after delivery..... 567 13.61 $719.90 $364.09 $143.98
59200... T Insert cervical dilator 561 1.52 $80.32 $24.63 $16.06
59300... T Episiotomy or vaginal 562 12.76 $674.84 $330.86 $134.97
repair.
59320... T Revision of cervix..... 562 12.76 $674.84 $330.86 $134.97
59325... C Revision of cervix..... ......... ......... ......... ........... ...........
59350... C Repair of uterus....... ......... ......... ......... ........... ...........
59400... E Obstetrical care....... ......... ......... ......... ........... ...........
59409... T Obstetrical care....... 580 4.59 $242.90 $146.45 $48.58
59410... E Obstetrical care....... ......... ......... ......... ........... ...........
59412... T Antepartum manipulation 580 4.59 $242.90 $146.45 $48.58
59414... T Deliver placenta....... 580 4.59 $242.90 $146.45 $48.58
59425... E Antepartum care only... ......... ......... ......... ........... ...........
59426... E Antepartum care only... ......... ......... ......... ........... ...........
59430... E Care after delivery.... ......... ......... ......... ........... ...........
59510... E Cesarean delivery...... ......... ......... ......... ........... ...........
59514... C Cesarean delivery only. ......... ......... ......... ........... ...........
59515... E Cesarean delivery...... ......... ......... ......... ........... ...........
59525... C Remove uterus after ......... ......... ......... ........... ...........
cesarean.
59610... E Vbac delivery.......... ......... ......... ......... ........... ...........
59612... T Vbac delivery only..... 580 4.59 $242.90 $146.45 $48.58
59614... E Vbac care after ......... ......... ......... ........... ...........
delivery.
59618... E Attempted vbac delivery ......... ......... ......... ........... ...........
59620... C Attempted vbac delivery ......... ......... ......... ........... ...........
only.
59622... E Attempted vbac after ......... ......... ......... ........... ...........
care.
59812... T Treatment of 587 13.26 $701.29 $347.14 $140.26
miscarriage.
59820... T Care of miscarriage.... 587 13.26 $701.29 $347.14 $140.26
[[Page 47678]]
59821... T Treatment of 587 13.26 $701.29 $347.14 $140.26
miscarriage.
59830... C Treat uterus infection. ......... ......... ......... ........... ...........
59840... T Abortion............... 586 12.50 $661.13 $431.89 $132.23
59841... T Abortion............... 586 12.50 $661.13 $431.89 $132.23
59850... C Abortion............... ......... ......... ......... ........... ...........
59851... C Abortion............... ......... ......... ......... ........... ...........
59852... C Abortion............... ......... ......... ......... ........... ...........
59855... C Abortion............... ......... ......... ......... ........... ...........
59856... C Abortion............... ......... ......... ......... ........... ...........
59857... C Abortion............... ......... ......... ......... ........... ...........
59866... C Abortion............... ......... ......... ......... ........... ...........
59870... T Evacuate mole of uterus 587 13.26 $701.29 $347.14 $140.26
59871... T Remove cerclage suture. 562 12.76 $674.84 $330.86 $134.97
59899... T Maternity care 578 1.26 $66.60 $33.90 $13.32
procedure.
60000... T Drain thyroid/tongue 312 7.26 $383.95 $178.31 $76.79
cyst.
60001... T Aspirate/inject thyroid 121 0.67 $35.26 $21.02 $7.05
cyst.
60100... T Biopsy of thyroid...... 122 4.87 $257.60 $115.03 $51.52
60200... T Remove thyroid lesion.. 397 18.37 $971.62 $496.97 $194.32
60210... T Partial excision 397 18.37 $971.62 $496.97 $194.32
thyroid.
60212... C Partial thyroid ......... ......... ......... ........... ...........
excision.
60220... T Partial removal of 397 18.37 $971.62 $496.97 $194.32
thyroid.
60225... T Partial removal of 397 18.37 $971.62 $496.97 $194.32
thyroid.
60240... T Removal of thyroid..... 397 18.37 $971.62 $496.97 $194.32
60252... C Removal of thyroid..... ......... ......... ......... ........... ...........
60254... C Extensive thyroid ......... ......... ......... ........... ...........
surgery.
60260... C Repeat thyroid surgery. ......... ......... ......... ........... ...........
60270... C Removal of thyroid..... ......... ......... ......... ........... ...........
60271... C Removal of thyroid..... ......... ......... ......... ........... ...........
60280... T Remove thyroid duct 397 18.37 $971.62 $496.97 $194.32
lesion.
60281... T Remove thyroid duct 397 18.37 $971.62 $496.97 $194.32
lesion.
60500... C Explore parathyroid ......... ......... ......... ........... ...........
glands.
60502... C Re-explore parathyroids ......... ......... ......... ........... ...........
60505... C Explore parathyroid ......... ......... ......... ........... ...........
glands.
60512... C Autotransplant, ......... ......... ......... ........... ...........
parathyroid.
60520... C Removal of thymus gland ......... ......... ......... ........... ...........
60521... C Removal thymus gland... ......... ......... ......... ........... ...........
60522... C Removal of thymus gland ......... ......... ......... ........... ...........
60540... C Explore adrenal gland.. ......... ......... ......... ........... ...........
60545... C Explore adrenal gland.. ......... ......... ......... ........... ...........
60600... C Remove carotid body ......... ......... ......... ........... ...........
lesion.
60605... C Remove carotid body ......... ......... ......... ........... ...........
lesion.
60699... T Endocrine surgery 121 0.67 $35.26 $21.02 $7.05
procedure.
61000... T Remove cranial cavity 602 3.33 $176.30 $87.69 $35.26
fluid.
61001... T Remove cranial cavity 602 3.33 $176.30 $87.69 $35.26
fluid.
61020... T Remove brain cavity 602 3.33 $176.30 $87.69 $35.26
fluid.
61026... T Injection into brain 602 3.33 $176.30 $87.69 $35.26
canal.
61050... T Remove brain canal 602 3.33 $176.30 $87.69 $35.26
fluid.
61055... T Injection into brain 602 3.33 $176.30 $87.69 $35.26
canal.
61070... T Brain canal shunt 602 3.33 $176.30 $87.69 $35.26
procedure.
61105... C Drill skull for ......... ......... ......... ........... ...........
examination.
61106... C Drill skull for exam/ ......... ......... ......... ........... ...........
surgery.
61107... C Drill skull for ......... ......... ......... ........... ...........
implantation.
61108... C Drill skull for ......... ......... ......... ........... ...........
drainage.
61120... C Pierce skull for ......... ......... ......... ........... ...........
examination.
61130... C Pierce skull, exam/ ......... ......... ......... ........... ...........
surgery.
61140... C Pierce skull for biopsy ......... ......... ......... ........... ...........
61150... C Pierce skull for ......... ......... ......... ........... ...........
drainage.
61151... C Pierce skull for ......... ......... ......... ........... ...........
drainage.
61154... C Pierce skull, remove ......... ......... ......... ........... ...........
clot.
61156... C Pierce skull for ......... ......... ......... ........... ...........
drainage.
61210... C Pierce skull; implant ......... ......... ......... ........... ...........
device.
61215... T Insert brain-fluid 618 25.56 $1,351.64 $780.60 $270.33
device.
61250... C Pierce skull & explore. ......... ......... ......... ........... ...........
61253... C Pierce skull & explore. ......... ......... ......... ........... ...........
61304... C Open skull for ......... ......... ......... ........... ...........
exploration.
61305... C Open skull for ......... ......... ......... ........... ...........
exploration.
61312... C Open skull for drainage ......... ......... ......... ........... ...........
61313... C Open skull for drainage ......... ......... ......... ........... ...........
61314... C Open skull for drainage ......... ......... ......... ........... ...........
61315... C Open skull for drainage ......... ......... ......... ........... ...........
61320... C Open skull for drainage ......... ......... ......... ........... ...........
61321... C Open skull for drainage ......... ......... ......... ........... ...........
61330... C Decompress eye socket.. ......... ......... ......... ........... ...........
61332... C Explore/biopsy eye ......... ......... ......... ........... ...........
socket.
61333... C Explore orbit; remove ......... ......... ......... ........... ...........
lesion.
[[Page 47679]]
61334... C Explore orbit; remove ......... ......... ......... ........... ...........
object.
61340... C Relieve cranial ......... ......... ......... ........... ...........
pressure.
61343... C Incise skull, pressure ......... ......... ......... ........... ...........
relief.
61345... C Relieve cranial ......... ......... ......... ........... ...........
pressure.
61440... C Incise skull for ......... ......... ......... ........... ...........
surgery.
61450... C Incise skull for ......... ......... ......... ........... ...........
surgery.
61458... C Incise skull for brain ......... ......... ......... ........... ...........
wound.
61460... C Incise skull for ......... ......... ......... ........... ...........
surgery.
61470... C Incise skull for ......... ......... ......... ........... ...........
surgery.
61480... C Incise skull for ......... ......... ......... ........... ...........
surgery.
61490... C Incise skull for ......... ......... ......... ........... ...........
surgery.
61500... C Removal of skull lesion ......... ......... ......... ........... ...........
61501... C Remove infected skull ......... ......... ......... ........... ...........
bone.
61510... C Removal of brain lesion ......... ......... ......... ........... ...........
61512... C Remove brain lining ......... ......... ......... ........... ...........
lesion.
61514... C Removal of brain ......... ......... ......... ........... ...........
abscess.
61516... C Removal of brain lesion ......... ......... ......... ........... ...........
61518... C Removal of brain lesion ......... ......... ......... ........... ...........
61519... C Remove brain lining ......... ......... ......... ........... ...........
lesion.
61520... C Removal of brain lesion ......... ......... ......... ........... ...........
61521... C Removal of brain lesion ......... ......... ......... ........... ...........
61522... C Removal of brain ......... ......... ......... ........... ...........
abscess.
61524... C Removal of brain lesion ......... ......... ......... ........... ...........
61526... C Removal of brain lesion ......... ......... ......... ........... ...........
61530... C Removal of brain lesion ......... ......... ......... ........... ...........
61531... C Implant brain ......... ......... ......... ........... ...........
electrodes.
61533... C Implant brain ......... ......... ......... ........... ...........
electrodes.
61534... C Removal of brain lesion ......... ......... ......... ........... ...........
61535... C Remove brain electrodes ......... ......... ......... ........... ...........
61536... C Removal of brain lesion ......... ......... ......... ........... ...........
61538... C Removal of brain tissue ......... ......... ......... ........... ...........
61539... C Removal of brain tissue ......... ......... ......... ........... ...........
61541... C Incision of brain ......... ......... ......... ........... ...........
tissue.
61542... C Removal of brain tissue ......... ......... ......... ........... ...........
61543... C Removal of brain tissue ......... ......... ......... ........... ...........
61544... C Remove and treat brain ......... ......... ......... ........... ...........
lesion.
61545... C Excision of brain tumor ......... ......... ......... ........... ...........
61546... C Removal of pituitary ......... ......... ......... ........... ...........
gland.
61548... C Removal of pituitary ......... ......... ......... ........... ...........
gland.
61550... C Release of skull seams. ......... ......... ......... ........... ...........
61552... C Release of skull seams. ......... ......... ......... ........... ...........
61556... C Incise skull/sutures... ......... ......... ......... ........... ...........
61557... C Incise skull/sutures... ......... ......... ......... ........... ...........
61558... C Excision of skull/ ......... ......... ......... ........... ...........
sutures.
61559... C Excision of skull/ ......... ......... ......... ........... ...........
sutures.
61563... C Excision of skull tumor ......... ......... ......... ........... ...........
61564... C Excision of skull tumor ......... ......... ......... ........... ...........
61570... C Remove brain foreign ......... ......... ......... ........... ...........
body.
61571... C Incise skull for brain ......... ......... ......... ........... ...........
wound.
61575... C Skull base/brainstem ......... ......... ......... ........... ...........
surgery.
61576... C Skull base/brainstem ......... ......... ......... ........... ...........
surgery.
61580... C Craniofacial approach, ......... ......... ......... ........... ...........
skull.
61581... C Craniofacial approach, ......... ......... ......... ........... ...........
skull.
61582... C Craniofacial approach, ......... ......... ......... ........... ...........
skull.
61583... C Craniofacial approach, ......... ......... ......... ........... ...........
skull.
61584... C Orbitocranial approach/ ......... ......... ......... ........... ...........
skull.
61585... C Orbitocranial approach/ ......... ......... ......... ........... ...........
skull.
61586... C Resect nasopharynx, ......... ......... ......... ........... ...........
skull.
61590... C Infratemporal approach/ ......... ......... ......... ........... ...........
skull.
61591... C Infratemporal approach/ ......... ......... ......... ........... ...........
skull.
61592... C Orbitocranial approach/ ......... ......... ......... ........... ...........
skull.
61595... C Transtemporal approach/ ......... ......... ......... ........... ...........
skull.
61596... C Transcochlear approach/ ......... ......... ......... ........... ...........
skull.
61597... C Transcondylar approach/ ......... ......... ......... ........... ...........
skull.
61598... C Transpetrosal approach/ ......... ......... ......... ........... ...........
skull.
61600... C Resect/excise cranial ......... ......... ......... ........... ...........
lesion.
61601... C Resect/excise cranial ......... ......... ......... ........... ...........
lesion.
61605... C Resect/excise cranial ......... ......... ......... ........... ...........
lesion.
61606... C Resect/excise cranial ......... ......... ......... ........... ...........
lesion.
61607... C Resect/excise cranial ......... ......... ......... ........... ...........
lesion.
61608... C Resect/excise cranial ......... ......... ......... ........... ...........
lesion.
61609... C Transect, artery, sinus ......... ......... ......... ........... ...........
61610... C Transect, artery, sinus ......... ......... ......... ........... ...........
61611... C Transect, artery, sinus ......... ......... ......... ........... ...........
61612... C Transect, artery, sinus ......... ......... ......... ........... ...........
[[Page 47680]]
61613... C Remove aneurysm, sinus. ......... ......... ......... ........... ...........
61615... C Resect/excise lesion, ......... ......... ......... ........... ...........
skull.
61616... C Resect/excise lesion, ......... ......... ......... ........... ...........
skull.
61618... C Repair dura............ ......... ......... ......... ........... ...........
61619... C Repair dura............ ......... ......... ......... ........... ...........
61624... C Occlusion/embolization ......... ......... ......... ........... ...........
cath.
61626... C Occlusion/embolization ......... ......... ......... ........... ...........
cath.
61680... C Intracranial vessel ......... ......... ......... ........... ...........
surgery.
61682... C Intracranial vessel ......... ......... ......... ........... ...........
surgery.
61684... C Intracranial vessel ......... ......... ......... ........... ...........
surgery.
61686... C Intracranial vessel ......... ......... ......... ........... ...........
surgery.
61690... C Intracranial vessel ......... ......... ......... ........... ...........
surgery.
61692... C Intracranial vessel ......... ......... ......... ........... ...........
surgery.
61700... C Inner skull vessel ......... ......... ......... ........... ...........
surgery.
61702... C Inner skull vessel ......... ......... ......... ........... ...........
surgery.
61703... C Clamp neck artery...... ......... ......... ......... ........... ...........
61705... C Revise circulation to ......... ......... ......... ........... ...........
head.
61708... C Revise circulation to ......... ......... ......... ........... ...........
head.
61710... C Revise circulation to ......... ......... ......... ........... ...........
head.
61711... C Fusion of skull ......... ......... ......... ........... ...........
arteries.
61712... C Skull or spine ......... ......... ......... ........... ...........
microsurgery.
61720... C Incise skull/brain ......... ......... ......... ........... ...........
surgery.
61735... C Incise skull/brain ......... ......... ......... ........... ...........
surgery.
61750... C Incise skull; brain ......... ......... ......... ........... ...........
biopsy.
61751... C Brain biopsy with cat ......... ......... ......... ........... ...........
scan.
61760... C Implant brain ......... ......... ......... ........... ...........
electrodes.
61770... C Incise skull for ......... ......... ......... ........... ...........
treatment.
61790... T Treat trigeminal nerve. 631 12.98 $686.60 $333.80 $137.32
61791... C Treat trigeminal tract. ......... ......... ......... ........... ...........
61793... S Focus radiation beam... 757 2.20 $116.55 $52.43 $23.31
61795... C Brain surgery using ......... ......... ......... ........... ...........
computer.
61850... C Implant neuroelectrodes ......... ......... ......... ........... ...........
61855... C Implant neuroelectrodes ......... ......... ......... ........... ...........
61860... C Implant neuroelectrodes ......... ......... ......... ........... ...........
61865... C Implant neuroelectrodes ......... ......... ......... ........... ...........
61870... C Implant neuroelectrodes ......... ......... ......... ........... ...........
61875... C Implant neuroelectrodes ......... ......... ......... ........... ...........
61880... C Revise/remove ......... ......... ......... ........... ...........
neuroelectrode.
61885... T Implant neuroreceiver.. 618 25.56 $1,351.64 $780.60 $270.33
61888... C Revise/remove ......... ......... ......... ........... ...........
neuroreceiver.
62000... C Repair of skull ......... ......... ......... ........... ...........
fracture.
62005... C Repair of skull ......... ......... ......... ........... ...........
fracture.
62010... C Treatment of head ......... ......... ......... ........... ...........
injury.
62100... C Repair brain fluid ......... ......... ......... ........... ...........
leakage.
62115... C Reduction of skull ......... ......... ......... ........... ...........
defect.
62116... C Reduction of skull ......... ......... ......... ........... ...........
defect.
62117... C Reduction of skull ......... ......... ......... ........... ...........
defect.
62120... C Repair skull cavity ......... ......... ......... ........... ...........
lesion.
62121... C Incise skull repair.... ......... ......... ......... ........... ...........
62140... C Repair of skull defect. ......... ......... ......... ........... ...........
62141... C Repair of skull defect. ......... ......... ......... ........... ...........
62142... C Remove skull plate/flap ......... ......... ......... ........... ...........
62143... C Replace skull plate/ ......... ......... ......... ........... ...........
flap.
62145... C Repair of skull and ......... ......... ......... ........... ...........
brain.
62146... C Repair of skull with ......... ......... ......... ........... ...........
graft.
62147... C Repair of skull with ......... ......... ......... ........... ...........
graft.
62180... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62190... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62192... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62194... T Replace/irrigate 602 3.33 $176.30 $87.69 $35.26
catheter.
62200... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62201... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62220... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62223... C Establish brain cavity ......... ......... ......... ........... ...........
shunt.
62225... T Replace/irrigate 602 3.33 $176.30 $87.69 $35.26
catheter.
62230... T Replace/revise brain 617 11.56 $611.18 $287.70 $122.24
shunt.
62256... C Remove brain cavity ......... ......... ......... ........... ...........
shunt.
62258... C Replace brain cavity ......... ......... ......... ........... ...........
shunt.
62268... T Drain spinal cord cyst. 602 3.33 $176.30 $87.69 $35.26
62269... T Needle biopsy spinal 122 4.87 $257.60 $115.03 $51.52
cord.
62270... T Spinal fluid tap, 600 2.63 $139.08 $61.47 $27.82
diagnostic.
62272... T Drain spinal fluid..... 600 2.63 $139.08 $61.47 $27.82
62273... T Treat lumbar spine 602 3.33 $176.30 $87.69 $35.26
lesion.
62274... T Inject spinal 602 3.33 $176.30 $87.69 $35.26
anesthetic.
62275... T Inject spinal 602 3.33 $176.30 $87.69 $35.26
anesthetic.
[[Page 47681]]
62276... T Inject spinal 602 3.33 $176.30 $87.69 $35.26
anesthetic.
62277... T Inject spinal 602 3.33 176.30 $87.69 $35.26
anesthetic.
62278... T Inject spinal 602 3.33 $176.30 $87.69 $35.26
anesthetic.
62279... T Inject spinal 602 3.33 $176.30 $87.69 $35.26
anesthetic.
62280... T Treat spinal cord 602 3.33 $176.30 $87.69 $35.26
lesion.
62281... T Treat spinal cord 602 3.33 $176.30 $87.69 $35.26
lesion.
62282... T Treat spinal canal 602 3.33 $176.30 $87.69 $35.26
lesion.
62284... T Injection for myelogram 347 2.93 $154.75 $62.15 $30.95
62287... T Percutaneous diskectomy 631 12.98 $686.60 $333.80 $137.32
62288... T Injection into spinal 602 3.33 $176.30 $87.69 $35.26
canal.
62289... T Injection into spinal 602 3.33 $176.30 $87.69 $35.26
canal.
62290... T Inject for spine disk x- 347 2.93 $154.75 $62.15 $30.95
ray.
62291... T Inject for spine disk x- 347 2.93 $154.75 $62.15 $30.95
ray.
62292... T Injection into disk 602 3.33 $176.30 $87.69 $35.26
lesion.
62294... T Injection into spinal 602 3.33 $176.30 $87.69 $35.26
artery.
62298... T Injection into spinal 602 3.33 $176.30 $87.69 $35.26
canal.
62350... T Implant spinal catheter 617 11.56 $611.18 $287.70 $122.24
62351... C Implant spinal catheter ......... ......... ......... ........... ...........
62355... T Remove spinal canal 617 11.56 $611.18 $287.70 $122.24
catheter.
62360... T Insert spine infusion 618 25.56 $1,351.64 $780.60 $270.33
device.
62361... T Implant spine infusion 618 25.56 $1,351.64 $780.60 $270.33
pump.
62362... T Implant spine infusion 618 25.56 $1,351.64 $780.60 $270.33
pump.
62365... T Remove spine infusion 617 11.56 $611.18 $287.70 $122.24
device.
62367... X Analyze spine infusion 966 0.39 $20.57 $12.43 $4.11
pump.
62368... X Analyze spine infusion 966 0.39 $20.57 $12.43 $4.11
pump.
63001... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63003... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63005... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63011... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63012... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63015... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63016... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63017... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63020... C Neck spine disk surgery ......... ......... ......... ........... ...........
63030... C Low back disk surgery.. ......... ......... ......... ........... ...........
63035... C Added spinal disk ......... ......... ......... ........... ...........
surgery.
63040... C Neck spine disk surgery ......... ......... ......... ........... ...........
63042... C Low back disk surgery.. ......... ......... ......... ........... ...........
63045... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63046... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63047... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63048... C Removal of spinal ......... ......... ......... ........... ...........
lamina.
63055... C Decompress spinal cord. ......... ......... ......... ........... ...........
63056... C Decompress spinal cord. ......... ......... ......... ........... ...........
63057... C Decompress spinal cord. ......... ......... ......... ........... ...........
63064... C Decompress spinal cord. ......... ......... ......... ........... ...........
63066... C Decompress spinal cord. ......... ......... ......... ........... ...........
63075... C Neck spine disk surgery ......... ......... ......... ........... ...........
63076... C Neck spine disk surgery ......... ......... ......... ........... ...........
63077... C Spine disk surgery, ......... ......... ......... ........... ...........
thorax.
63078... C Spine disk surgery, ......... ......... ......... ........... ...........
thorax.
63081... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63082... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63085... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63086... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63087... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63088... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63090... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63091... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63170... C Incise spinal cord ......... ......... ......... ........... ...........
tract(s).
63172... C Drainage of spinal cyst ......... ......... ......... ........... ...........
63173... C Drainage of spinal cyst ......... ......... ......... ........... ...........
63180... C Revise spinal cord ......... ......... ......... ........... ...........
ligaments.
63182... C Revise spinal cord ......... ......... ......... ........... ...........
ligaments.
63185... C Incise spinal column/ ......... ......... ......... ........... ...........
nerves.
63190... C Incise spinal column/ ......... ......... ......... ........... ...........
nerves.
63191... C Incise spinal column/ ......... ......... ......... ........... ...........
nerves.
63194... C Incise spinal column & ......... ......... ......... ........... ...........
cord.
63195... C Incise spinal column & ......... ......... ......... ........... ...........
cord.
63196... C Incise spinal column & ......... ......... ......... ........... ...........
cord.
63197... C Incise spinal column & ......... ......... ......... ........... ...........
cord.
63198... C Incise spinal column & ......... ......... ......... ........... ...........
cord.
63199... C Incise spinal column & ......... ......... ......... ........... ...........
cord.
63200... C Release of spinal cord. ......... ......... ......... ........... ...........
63250... C Revise spinal cord ......... ......... ......... ........... ...........
vessels.
[[Page 47682]]
63251... C Revise spinal cord ......... ......... ......... ........... ...........
vessels.
63252... C Revise spinal cord ......... ......... ......... ........... ...........
vessels.
63265... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63266... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63267... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63268... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63270... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63271... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63272... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63273... C Excise intraspinal ......... ......... ......... ........... ...........
lesion.
63275... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63276... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63277... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63278... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63280... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63281... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63282... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63283... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63285... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63286... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63287... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63290... C Biopsy/excise spinal ......... ......... ......... ........... ...........
tumor.
63300... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63301... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63302... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63303... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63304... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63305... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63306... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63307... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63308... C Removal of vertebral ......... ......... ......... ........... ...........
body.
63600... T Remove spinal cord 631 12.98 $686.60 $333.80 $137.32
lesion.
63610... T Stimulation of spinal 631 12.98 $686.60 $333.80 $137.32
cord.
63615... T Remove lesion of spinal 631 12.98 $686.60 $333.80 $137.32
cord.
63650... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
63655... C Implant neuroelectrodes ......... ......... ......... ........... ...........
63660... T Revise/remove 617 11.56 $611.18 $287.70 $122.24
neuroelectrode.
63685... T Implant neuroreceiver.. 618 25.56 $1,351.64 $780.60 $270.33
63688... T Revise/remove 617 11.56 $611.18 $287.70 $122.24
neuroreceiver.
63690... X Analysis of 966 0.39 $20.57 $12.43 $4.11
neuroreceiver.
63691... X Analysis of 966 0.39 $20.57 $12.43 $4.11
neuroreceiver.
63700... C Repair of spinal ......... ......... ......... ........... ...........
herniation.
63702... C Repair of spinal ......... ......... ......... ........... ...........
herniation.
63704... C Repair of spinal ......... ......... ......... ........... ...........
herniation.
63706... C Repair of spinal ......... ......... ......... ........... ...........
herniation.
63707... C Repair spinal fluid ......... ......... ......... ........... ...........
leakage.
63709... C Repair spinal fluid ......... ......... ......... ........... ...........
leakage.
63710... C Graft repair of spine ......... ......... ......... ........... ...........
defect.
63740... C Install spinal shunt... ......... ......... ......... ........... ...........
63741... C Install spinal shunt... ......... ......... ......... ........... ...........
63744... T Revision of spinal 617 11.56 $611.18 $287.70 $122.24
shunt.
63746... T Removal of spinal shunt 617 11.56 $611.18 $287.70 $122.24
64400... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64402... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64405... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64408... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64410... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64412... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64413... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64415... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64417... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64418... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64420... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64421... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64425... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64430... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64435... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64440... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64441... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64442... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64443... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64445... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64450... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64505... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64508... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
[[Page 47683]]
64510... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64520... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64530... T Injection for nerve 601 3.11 $164.55 $74.13 $32.91
block.
64550... A Apply neurostimulator.. ......... ......... ......... ........... ...........
64553... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64555... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64560... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64565... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64573... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64575... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64577... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64580... T Implant neuroelectrodes 616 14.43 $762.99 $366.57 $152.60
64585... T Revise/remove 617 11.56 $611.18 $287.70 $122.24
neuroelectrode.
64590... T Implant neuroreceiver.. 618 25.56 $1,351.64 $780.60 $270.33
64595... T Revise/remove 617 11.56 $611.18 $287.70 $122.24
neuroreceiver.
64600... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64605... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64610... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64612... T Destroy nerve, face 601 3.11 $164.55 $74.13 $32.91
muscle.
64613... T Destroy nerve, spine 601 3.11 $164.55 $74.13 $32.91
muscle.
64620... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64622... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64623... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64630... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64640... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64680... T Injection treatment of 601 3.11 $164.55 $74.13 $32.91
nerve.
64702... T Revise finger/toe nerve 631 12.98 $686.60 $333.80 $137.32
64704... T Revise hand/foot nerve. 631 12.98 $686.60 $333.80 $137.32
64708... T Revise arm/leg nerve... 631 12.98 $686.60 $333.80 $137.32
64712... T Revision of sciatic 631 12.98 $686.60 $333.8 $137.32
nerve.
64713... T Revision of arm 631 12.98 $686.60 $333.80 $137.32
nerve(s).
64714... T Revise low back 631 12.98 $686.60 $333.80 $137.32
nerve(s).
64716... T Revision of cranial 631 12.98 $686.60 $333.80 $137.32
nerve.
64718... T Revise ulnar nerve at 631 12.98 $686.60 $333.80 $137.32
elbow.
64719... T Revise ulnar nerve at 631 12.98 $686.60 $333.80 $137.32
wrist.
64721... T Carpal tunnel surgery.. 631 12.98 $686.60 $333.80 $137.32
64722... T Relieve pressure on 631 12.98 $686.60 $333.80 $137.32
nerve(s).
64726... T Release foot/toe nerve. 631 12.98 $686.60 $333.80 $137.32
64727... T Internal nerve revision 631 12.98 $686.60 $333.80 $137.32
64732... T Incision of brow nerve. 631 12.98 $686.60 $333.80 $137.32
64734... T Incision of cheek nerve 631 12.98 $686.60 $333.80 $137.32
64736... T Incision of chin nerve. 631 12.98 $686.60 $333.80 $137.32
64738... T Incision of jaw nerve.. 631 12.98 $686.60 $333.80 $137.32
64740... T Incision of tongue 631 12.98 $686.60 $333.8 $137.32
nerve.
64742... T Incision of facial 631 12.98 $686.60 $333.80 $137.32
nerve.
64744... T Incise nerve, back of 631 12.98 $686.60 $333.80 $137.32
head.
64746... T Incise diaphragm nerve. 631 12.98 $686.60 $333.80 $137.32
64752... C Incision of vagus nerve ......... ......... ......... ........... ...........
64755... C Incision of stomach ......... ......... ......... ........... ...........
nerves.
64760... C Incision of vagus nerve ......... ......... ......... ........... ...........
64761... T Incision of pelvis 631 12.98 $686.60 $333.80 $137.32
nerve.
64763... C Incise hip/thigh nerve. ......... ......... ......... ........... ...........
64766... C Incise hip/thigh nerve. ......... ......... ......... ........... ...........
64771... T Sever cranial nerve.... 631 12.98 $686.60 $333.80 $137.32
64772... T Incision of spinal 631 12.98 $686.60 $333.80 $137.32
nerve.
64774... T Remove skin nerve 631 12.98 $686.60 $333.80 $137.32
lesion.
64776... T Remove digit nerve 631 12.98 $686.60 $333.80 $137.32
lesion.
64778... T Added digit nerve 631 12.98 $686.60 $333.80 $137.32
surgery.
64782... T Remove limb nerve 631 12.98 $686.60 $333.80 $137.32
lesion.
64783... T Added limb nerve 631 12.98 $686.60 $333.80 $137.32
surgery.
64784... T Remove nerve lesion.... 631 12.98 $686.60 $333.80 $137.32
64786... T Remove sciatic nerve 632 18.13 $958.88 $461.04 $191.78
lesion.
64787... T Implant nerve end...... 631 12.98 $686.60 $333.80 $137.32
64788... T Remove skin nerve 631 12.98 $686.60 $333.80 $137.32
lesion.
64790... T Removal of nerve lesion 631 12.98 $686.60 $333.80 $137.32
64792... T Removal of nerve lesion 632 18.13 $958.88 $461.04 $191.78
64795... T Biopsy of nerve........ 631 12.98 $686.60 $333.80 $137.32
64802... C Remove sympathetic ......... ......... ......... ........... ...........
nerves.
64804... C Remove sympathetic ......... ......... ......... ........... ...........
nerves.
64809... C Remove sympathetic ......... ......... ......... ........... ...........
nerves.
64818... C Remove sympathetic ......... ......... ......... ........... ...........
nerves.
64820... C Remove sympathetic ......... ......... ......... ........... ...........
nerves.
64830... T Microrepair of nerve... 631 12.98 $686.60 $333.80 $137.32
64831... T Repair of digit nerve.. 632 18.13 $958.88 $461.04 $191.78
64832... T Repair additional nerve 632 18.13 $958.88 $461.04 $191.78
[[Page 47684]]
64834... T Repair of hand or foot 632 18.13 $958.88 $461.04 $191.78
nerve.
64835... T Repair of hand or foot 632 18.13 $958.88 $461.04 $191.78
nerve.
64836... T Repair of hand or foot 632 18.13 $958.88 $461.04 $191.78
nerve.
64837... T Repair additional nerve 632 18.13 $958.88 $461.04 $191.78
64840... T Repair of leg nerve.... 632 18.13 $958.88 $461.04 $191.78
64856... T Repair/transpose nerve. 632 18.13 $958.88 $461.04 $191.78
64857... T Repair arm/leg nerve... 632 18.13 $958.88 $461.04 $191.78
64858... T Repair sciatic nerve... 632 18.13 $958.88 $461.04 $191.78
64859... T Additional nerve 632 18.13 $958.88 $461.04 $191.78
surgery.
64861... T Repair of arm nerves... 632 18.13 $958.88 $461.04 $191.78
64862... T Repair of low back 632 18.13 $958.88 $461.04 $191.78
nerves.
64864... T Repair of facial nerve. 632 18.13 $958.88 $461.04 $191.78
64865... T Repair of facial nerve. 632 18.13 $958.88 $461.04 $191.78
64866... C Fusion of facial/other ......... ......... ......... ........... ...........
nerve.
64868... C Fusion of facial/other ......... ......... ......... ........... ...........
nerve.
64870... T Fusion of facial/other 632 18.13 $958.88 $461.04 $191.78
nerve.
64872... T Subsequent repair of 632 18.13 $958.88 $461.04 $191.78
nerve.
64874... T Repair & revise nerve.. 632 18.13 $958.88 $461.04 $191.78
64876... T Repair nerve; shorten 632 18.13 $958.88 $461.04 $191.78
bone.
64885... T Nerve graft, head or 632 18.13 $958.88 $461.04 $191.78
neck.
64886... T Nerve graft, head or 632 18.13 $958.88 $461.04 $191.78
neck.
64890... T Nerve graft, hand or 632 18.13 $958.88 $461.04 $191.78
foot.
64891... T Nerve graft, hand or 632 18.13 $958.88 $461.04 $191.78
foot.
64892... T Nerve graft, arm or leg 632 18.13 $958.88 $461.04 $191.78
64893... T Nerve graft, arm or leg 632 18.13 $958.88 $461.04 $191.78
64895... T Nerve graft, hand or 632 18.13 $958.88 $461.04 $191.78
foot.
64896... T Nerve graft, hand or 632 18.13 $958.88 $461.04 $191.78
foot.
64897... T Nerve graft, arm or leg 632 18.13 $958.88 $461.04 $191.78
64898... T Nerve graft, arm or leg 632 18.13 $958.88 $461.04 $191.78
64901... T Additional nerve graft. 632 18.13 $958.88 $461.04 $191.78
64902... T Additional nerve graft. 632 18.13 $958.88 $461.04 $191.78
64905... T Nerve pedicle transfer. 632 18.13 $958.88 $461.04 $191.78
64907... T Nerve pedicle transfer. 632 18.13 $958.88 $461.04 $191.78
64999... T Nervous system surgery. 601 3.11 $164.55 $74.13 $32.91
65091... T Revise eye............. 684 13.48 $713.04 $348.94 $142.61
65093... T Revise eye with implant 684 13.48 $713.04 $348.94 $142.61
65101... T Removal of eye......... 684 13.48 $713.04 $348.94 $142.61
65103... T Remove eye/insert 684 13.48 $713.04 $348.94 $142.61
implant.
65105... T Remove eye/attach 684 13.48 $713.04 $348.94 $142.61
implant.
65110... C Removal of eye......... ......... ......... ......... ........... ...........
65112... C Remove eye, revise ......... ......... ......... ........... ...........
socket.
65114... C Remove eye, revise ......... ......... ......... ........... ...........
socket.
65125... T Revise ocular implant.. 681 1.67 $88.15 $30.51 $17.63
65130... T Insert ocular implant.. 684 13.48 $713.04 $348.94 $142.61
65135... T Insert ocular implant.. 684 13.48 $713.04 $348.94 $142.61
65140... T Attach ocular implant.. 684 13.48 $713.04 $348.94 $142.61
65150... T Revise ocular implant.. 684 13.48 $713.04 $348.94 $142.61
65155... T Reinsert ocular implant 684 13.48 $713.04 $348.94 $142.61
65175... T Removal of ocular 683 10.19 $538.7 $257.87 $107.74
implant.
65205... T Remove foreign body 681 1.67 $88.15 $30.51 $17.63
from eye.
65210... T Remove foreign body 681 1.67 $88.15 $30.51 $17.63
from eye.
65220... T Remove foreign body 681 1.67 $88.15 $30.51 $17.63
from eye.
65222... T Remove foreign body 681 1.67 $88.15 $30.51 $17.63
from eye.
65235... T Remove foreign body 652 16.48 $871.71 $433.69 $174.34
from eye.
65260... T Remove foreign body 676 6.30 $333.01 $140.35 $66.60
from eye.
65265... T Remove foreign body 676 6.30 $333.01 $140.35 $66.60
from eye.
65270... T Repair of eye wound.... 183 11.17 $590.61 $286.57 $118.12
65272... T Repair of eye wound.... 651 7.24 $382.97 $174.70 $76.59
65273... C Repair of eye wound.... ......... ......... ......... ........... ...........
65275... T Repair of eye wound.... 651 7.24 $382.97 $174.70 $76.59
65280... T Repair of eye wound.... 652 16.48 $871.71 $433.69 $174.34
65285... T Repair of eye wound.... 652 16.48 $871.71 $433.69 $174.34
65286... T Repair of eye wound.... 651 7.24 $382.97 $174.70 $76.59
65290... T Repair of eye socket 677 16.26 $859.96 $436.63 $171.99
wound.
65400... T Removal of eye lesion.. 652 16.48 $871.71 $433.69 $174.34
65410... T Biopsy of cornea....... 683 10.19 $538.70 $257.87 $107.74
65420... T Removal of eye lesion.. 651 7.24 $382.97 $174.70 $76.59
65426... T Removal of eye lesion.. 652 16.48 $871.71 $433.69 $174.34
65430... T Corneal smear.......... 681 1.67 $88.15 $30.51 $17.63
65435... T Curette/treat cornea... 681 1.67 $88.15 $30.51 $17.63
65436... T Curette/treat cornea... 651 7.24 $382.97 $174.70 $76.59
65450... T Treatment of corneal 651 7.24 $382.97 $174.70 $76.59
lesion.
65600... T Revision of cornea..... 681 1.67 $88.15 $30.51 $17.63
65710... T Corneal transplant..... 670 29.24 $1,546.56 $847.50 $309.31
65730... T Corneal transplant..... 670 29.24 $1,546.56 $847.50 $309.31
[[Page 47685]]
65750... T Corneal transplant..... 670 29.24 $1,546.56 $847.50 $309.31
65755... T Corneal transplant..... 670 29.24 $1,546.56 $847.50 $309.31
65760... E Revision of cornea..... ......... ......... ......... ........... ...........
65765... E Revision of cornea..... ......... ......... ......... ........... ...........
65767... E Corneal tissue ......... ......... ......... ........... ...........
transplant.
65770... T Revise cornea with 652 16.48 $871.71 $433.69 $174.34
implant.
65771... E Radial keratotomy...... ......... ......... ......... ........... ...........
65772... T Correction of 651 7.24 $382.97 $174.70 $76.59
astigmatism.
65775... T Correction of 652 16.48 $871.71 $433.69 $174.34
astigmatism.
65800... T Drainage of eye........ 683 10.19 $538.70 $257.87 $107.74
65805... T Drainage of eye........ 683 10.19 $538.70 $257.87 $107.74
65810... T Drainage of eye........ 651 7.24 $382.97 $174.70 $76.59
65815... T Drainage of eye........ 651 7.24 $382.97 $174.70 $76.59
65820... T Relieve inner eye 651 7.24 $382.97 $174.70 $76.59
pressure.
65850... T Incision of eye........ 652 16.48 $871.71 $433.69 $174.34
65855... T Laser surgery of eye... 649 4.44 $235.07 $111.64 $47.01
65860... T Incise inner eye 649 4.44 $235.07 $111.64 $47.01
adhesions.
65865... T Incise inner eye 652 16.48 $871.71 $433.69 $174.34
adhesions.
65870... T Incise inner eye 652 16.48 $871.71 $433.69 $174.34
adhesions.
65875... T Incise inner eye 652 16.48 $871.71 $433.69 $174.34
adhesions.
65880... T Incise inner eye 652 16.48 $871.71 $433.69 $174.34
adhesions.
65900... T Remove eye lesion...... 652 16.48 $871.71 $433.69 $174.34
65920... T Remove implant from eye 652 16.48 $871.71 $433.69 $174.34
65930... T Remove blood clot from 652 16.48 $871.71 $433.69 $174.34
eye.
66020... T Injection treatment of 683 10.19 $538.70 $257.87 $107.74
eye.
66030... T Injection treatment of 683 10.19 $538.70 $257.87 $107.74
eye.
66130... T Remove eye lesion...... 651 7.24 $382.97 $174.70 $76.59
66150... T Glaucoma surgery....... 652 16.48 $871.71 $433.69 $174.34
66155... T Glaucoma surgery....... 652 16.48 $871.71 $433.69 $174.34
66160... T Glaucoma surgery....... 652 16.48 $871.71 $433.69 $174.34
66165... T Glaucoma surgery....... 652 16.48 $871.71 $433.69 $174.34
66170... T Glaucoma surgery....... 652 16.48 $871.71 $433.69 $174.34
66172... T Incision of eye........ 652 16.48 $871.71 $433.69 $174.34
66180... T Implant eye shunt...... 652 16.48 $871.71 $433.69 $174.34
66185... T Revise eye shunt....... 652 16.48 $871.71 $433.69 $174.34
66220... T Repair eye lesion...... 676 6.30 $333.01 $140.35 $66.60
66225... T Repair/graft eye lesion 652 16.48 $871.71 $433.69 $174.34
66250... T Follow-up surgery of 652 16.48 $871.71 $433.69 $174.34
eye.
66500... T Incision of iris....... 651 7.24 $382.97 $174.70 $76.59
66505... T Incision of iris....... 651 7.24 $382.97 $174.70 $76.59
66600... T Remove iris and lesion. 651 7.24 $382.97 $174.70 $76.59
66605... T Removal of iris........ 652 16.48 $871.71 $433.69 $174.34
66625... T Removal of iris........ 651 7.24 $382.97 $174.70 $76.59
66630... T Removal of iris........ 651 7.24 $382.97 $174.70 $76.59
66635... T Removal of iris........ 652 16.48 $871.71 $433.69 $174.34
66680... T Repair iris & ciliary 652 16.48 $871.71 $433.69 $174.34
body.
66682... T Repair iris and ciliary 652 16.48 $871.71 $433.69 $174.34
body.
66700... T Destruction, ciliary 651 7.24 $382.97 $174.70 $76.59
body.
66710... T Destruction, ciliary 651 7.24 $382.97 $174.70 $76.59
body.
66720... T Destruction, ciliary 651 7.24 $382.97 $174.70 $76.59
body.
66740... T Destruction, ciliary 652 16.48 $871.71 $433.69 $174.34
body.
66761... T Revision of iris....... 649 4.44 $235.07 $111.64 $47.01
66762... T Revision of iris....... 649 4.44 $235.07 $111.64 $47.01
66770... T Removal of inner eye 649 4.44 $235.07 $111.64 $47.01
lesion.
66820... T Incision, secondary 651 7.24 $382.97 $174.70 $76.59
cataract.
66821... T After cataract laser 649 4.44 $235.07 $111.64 $47.01
surgery.
66825... T Reposition intraocular 651 7.24 $382.97 $174.70 $76.59
lens.
66830... T Removal of lens lesion. 652 16.48 $871.71 $433.69 $174.34
66840... T Removal of lens 667 19.28 $1,019.61 $521.83 $203.92
material.
66850... T Removal of lens 667 19.28 $1,019.61 $521.83 $203.92
material.
66852... T Removal of lens 667 19.28 $1,019.61 $521.83 $203.92
material.
66920... T Extraction of lens..... 667 19.28 $1,019.61 $521.83 $203.92
66930... T Extraction of lens..... 667 19.28 $1,019.61 $521.83 $203.92
66940... T Extraction of lens..... 667 19.28 $1,019.61 $521.83 $203.92
66983... T Remove cataract, insert 668 19.28 $1,019.61 $530.87 $203.92
lens.
66984... T Remove cataract, insert 668 19.28 $1,019.61 $530.87 $203.92
lens.
66985... T Insert lens prosthesis. 668 19.28 $1,019.61 $530.87 $203.92
66986... T Exchange lens 668 19.28 $1,019.61 $530.87 $203.92
prosthesis.
66999... T Eye surgery procedure.. 649 4.44 $235.07 $111.64 $47.01
67005... T Partial removal of eye 676 6.30 $333.01 $140.35 $66.60
fluid.
67010... T Partial removal of eye 676 6.30 $333.01 $140.35 $66.60
fluid.
67015... T Release of eye fluid... 676 6.30 $333.01 $140.35 $66.60
67025... T Replace eye fluid...... 683 10.19 $538.70 $257.87 $107.74
67027... T Implant eye drug system 690 30.54 $1,615.12 $852.02 $323.02
67028... T Injection eye drug..... 682 3.54 $187.08 $81.36 $37.42
[[Page 47686]]
67030... T Incise inner eye 676 6.30 $333.01 $140.35 $66.60
strands.
67031... T Laser surgery, eye 649 4.44 $235.07 $111.64 $47.01
strands.
67036... T Removal of inner eye 690 30.54 $1,615.12 $852.02 $323.02
fluid.
67038... T Strip retinal membrane. 690 30.54 $1,615.12 $852.02 $323.02
67039... T Laser treatment of 690 30.54 $1,615.12 $852.02 $323.02
retina.
67040... T Laser treatment of 690 30.54 $1,615.12 $852.02 $323.02
retina.
67101... T Repair, detached retina 676 6.30 $333.01 $140.35 $66.60
67105... T Repair, detached retina 648 3.94 $208.62 $95.15 $41.72
67107... T Repair detached retina. 690 30.54 $1,615.12 $852.02 $323.02
67108... T Repair detached retina. 690 30.54 $1,615.12 $852.02 $323.02
67110... T Repair detached retina. 676 6.30 $333.01 $140.35 $66.60
67112... T Re-repair detached 690 30.54 $1,615.12 $852.02 $323.02
retina.
67115... T Release, encircling 676 6.30 $333.01 $140.35 $66.60
material.
67120... T Remove eye implant 676 6.30 $333.01 $140.35 $66.60
material.
67121... T Remove eye implant 676 6.30 $333.01 $140.35 $66.60
material.
67141... T Treatment of retina.... 676 6.30 $333.01 $140.35 $66.60
67145... T Treatment of retina.... 648 3.94 $208.62 $95.15 $41.72
67208... T Treatment of retinal 676 6.30 $333.01 $140.35 $66.60
lesion.
67210... T Treatment of retinal 648 3.94 $208.62 $95.15 $41.72
lesion.
67218... T Treatment of retinal 676 6.30 $333.01 $140.35 $66.60
lesion.
67227... T Treatment of retinal 676 6.30 $333.01 $140.35 $66.60
lesion.
67228... T Treatment of retinal 648 3.94 $208.62 $95.15 $41.72
lesion.
67250... T Reinforce eye wall..... 684 13.48 $713.04 $348.94 $142.61
67255... T Reinforce/graft eye 684 13.48 $713.04 $348.94 $142.61
wall.
67299... T Eye surgery procedure.. 649 4.44 $235.07 $111.64 $47.01
67311... T Revise eye muscle...... 677 16.26 $859.96 $436.63 $171.99
67312... T Revise two eye muscles. 677 16.26 $859.96 $436.63 $171.99
67314... T Revise eye muscle...... 677 16.26 $859.96 $436.63 $171.99
67316... T Revise two eye muscles. 677 16.26 $859.96 $436.63 $171.99
67318... T Revise eye muscle(s)... 677 16.26 $859.96 $436.63 $171.99
67320... T Revise eye muscle(s)... 677 16.26 $859.96 $436.63 $171.99
67331... T Eye surgery follow-up.. 677 16.26 $859.96 $436.63 $171.99
67332... T Rerevise eye muscles... 677 16.26 $859.96 $436.63 $171.99
67334... T Revise eye muscle w/ 677 16.26 $859.96 $436.63 $171.99
suture.
67335... T Eye suture during 677 16.26 $859.96 $436.63 $171.99
surgery.
67340... T Revise eye muscle...... 677 16.26 $859.96 $436.63 $171.99
67343... T Release eye tissue..... 677 16.26 $859.96 $436.63 $171.99
67345... T Destroy nerve of eye 681 1.67 $88.15 $30.51 $17.63
muscle.
67350... T Biopsy eye muscle...... 162 5.67 $299.71 $125.43 $59.94
67399... T Eye muscle surgery 162 5.67 $299.71 $125.43 $59.94
procedure.
67400... T Explore/biopsy eye 684 13.48 $713.04 $348.94 $142.61
socket.
67405... T Explore/drain eye 684 13.48 $713.04 $348.94 $142.61
socket.
67412... T Explore/treat eye 684 13.48 $713.04 $348.94 $142.61
socket.
67413... T Explore/treat eye 684 13.48 $713.04 $348.94 $142.61
socket.
67414... C Explore/decompress eye ......... ......... ......... ........... ...........
socke.
67415... T Aspiration orbital 122 $4.87 $257.60 $115.03 $51.52
contents.
67420... T Explore/treat eye 232 23.93 $1,265.45 $639.35 $253.09
socket.
67430... T Explore/treat eye 232 23.93 $1,265.45 $639.35 $253.09
socket.
67440... T Explore/drain eye 232 23.93 $1,265.45 $639.35 $253.09
socket.
67445... C Explore/decompress eye ......... ......... ......... ........... ...........
socke.
67450... T Explore/biopsy eye 232 23.93 $1,265.45 $639.35 $253.09
socket.
67500... T Inject/treat eye socket 681 1.67 $88.15 $30.51 $17.63
67505... T Inject/treat eye socket 681 1.67 $88.15 $30.51 $17.63
67515... T Inject/treat eye socket 681 1.67 $88.15 $30.51 $17.63
67550... T Insert eye socket 684 13.48 $713.04 $348.94 $142.61
implant.
67560... T Revise eye socket 684 13.48 $713.04 $348.94 $142.61
implant.
67570... C Decompress optic nerve. ......... ......... ......... ........... ...........
67599... T Orbit surgery procedure 681 1.67 $88.15 $30.51 $17.63
67700... T Drainage of eyelid 682 3.54 $187.08 $81.36 $37.42
abscess.
67710... T Incision of eyelid..... 682 3.54 $187.08 $81.36 $37.42
67715... T Incision of eyelid fold 683 10.19 $538.76 $257.87 $107.74
67800... T Remove eyelid lesion... 682 3.54 $187.08 $81.36 $37.42
67801... T Remove eyelid lesions.. 682 3.54 $187.08 $81.36 $37.42
67805... T Remove eyelid lesions.. 682 3.54 $187.08 $81.36 $37.42
67808... T Remove eyelid lesion(s) 684 13.48 $713.04 $348.94 $142.61
67810... T Biopsy of eyelid....... 682 3.54 $187.08 $81.36 $37.42
67820... T Revise eyelashes....... 682 3.54 $187.08 $81.36 $37.42
67825... T Revise eyelashes....... 682 3.54 $187.08 $81.36 $37.42
67830... T Revise eyelashes....... 683 10.19 $538.7 $257.87 $107.74
67835... T Revise eyelashes....... 684 13.48 $713.04 $348.94 $142.61
67840... T Remove eyelid lesion... 682 3.54 $187.08 $81.36 $37.42
67850... T Treat eyelid lesion.... 682 3.54 $187.08 $81.36 $37.42
67875... T Closure of eyelid by 682 3.54 $187.08 $81.36 $37.42
suture.
67880... T Revision of eyelid..... 683 10.19 $538.70 $257.87 $107.74
67882... T Revision of eyelid..... 684 13.48 $713.04 $348.94 $142.61
[[Page 47687]]
67900... T Repair brow defect..... 684 13.48 $713.04 $348.94 $142.61
67901... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67902... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67903... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67904... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67906... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67908... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67909... T Revise eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67911... T Revise eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67914... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67915... T Repair eyelid defect... 682 3.54 $187.08 $81.36 $37.42
67916... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67917... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67921... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67922... T Repair eyelid defect... 682 3.54 $187.08 $81.36 $37.42
67923... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67924... T Repair eyelid defect... 684 13.48 $713.04 $348.94 $142.61
67930... T Repair eyelid wound.... 682 3.54 $187.08 $81.36 $37.42
67935... T Repair eyelid wound.... 683 10.19 $538.70 $257.87 $107.74
67938... T Remove eyelid foreign 682 3.54 $187.08 $81.36 $37.42
body.
67950... T Revision of eyelid..... 684 13.48 $713.04 $348.94 $142.61
67961... T Revision of eyelid..... 684 13.48 $713.04 $348.94 $142.61
67966... T Revision of eyelid..... 684 13.48 $713.04 $348.94 $142.61
67971... T Reconstruction of 684 13.48 $713.04 $348.94 $142.61
eyelid.
67973... T Reconstruction of 684 13.48 $713.04 $348.94 $142.61
eyelid.
67974... T Reconstruction of 684 13.48 $713.04 $348.94 $142.61
eyelid.
67975... T Reconstruction of 684 13.48 $713.04 $348.94 $142.61
eyelid.
67999... T Revision of eyelid..... 682 3.54 $187.08 $81.36 $37.42
68020... T Incise/drain eyelid 682 3.54 $187.08 $81.36 $37.42
lining.
68040... T Treatment of eyelid 682 3.54 $187.08 $81.36 $37.42
lesions.
68100... T Biopsy of eyelid lining 162 5.67 $299.71 $125.43 $59.94
68110... T Remove eyelid lining 162 5.67 $299.71 $125.43 $59.94
lesion.
68115... T Remove eyelid lining 162 5.67 $299.71 $125.43 $59.94
lesion.
68130... T Remove eyelid lining 652 16.48 $871.71 $433.69 $174.34
lesion.
68135... T Remove eyelid lining 162 5.67 $299.71 $125.43 $59.94
lesion.
68200... T Treat eyelid by 681 1.67 $88.15 $30.51 $17.63
injection.
68320... T Revise/graft eyelid 684 13.48 $713.04 $348.94 $142.61
lining.
68325... T Revise/graft eyelid 684 13.48 $713.04 $348.94 $142.61
lining.
68326... T Revise/graft eyelid 684 13.48 $713.04 $348.94 $142.61
lining.
68328... T Revise/graft eyelid 684 13.48 $713.04 $348.94 $142.61
lining.
68330... T Revise eyelid lining... 652 16.48 $871.71 $433.69 $174.34
68335... T Revise/graft eyelid 684 13.48 $713.04 $348.94 $142.61
lining.
68340... T Separate eyelid 684 13.48 $713.04 $348.94 $142.61
adhesions.
68360... T Revise eyelid lining... 652 16.48 $871.71 $433.69 $174.34
68362... T Revise eyelid lining... 652 16.48 $871.71 $433.69 $174.34
68399... T Eyelid lining surgery.. 162 5.67 $299.71 $125.43 $59.94
68400... T Incise/drain tear gland 682 3.54 $187.08 $81.36 $37.42
68420... T Incise/drain tear sac.. 682 3.54 $187.08 $81.36 $37.42
68440... T Incise tear duct 682 3.54 $187.08 $81.36 $37.42
opening.
68500... T Removal of tear gland.. 684 13.48 $713.04 $348.94 $142.61
68505... T Partial removal tear 684 13.48 $713.04 $348.94 $142.61
gland.
68510... T Biopsy of tear gland... 683 10.19 $538.70 $257.87 $107.74
68520... T Removal of tear sac.... 684 13.48 $713.04 $348.94 $142.61
68525... T Biopsy of tear sac..... 683 10.19 $538.70 $257.87 $107.74
68530... T Clearance of tear duct. 682 3.54 $187.08 $81.36 $37.42
68540... T Remove tear gland 684 13.48 $713.04 $348.94 $142.61
lesion.
68550... T Remove tear gland 684 13.48 $713.04 $348.94 $142.61
lesion.
68700... T Repair tear ducts...... 684 13.48 $713.04 $348.94 $142.61
68705... T Revise tear duct 682 3.54 $187.08 $81.36 $37.42
opening.
68720... T Create tear sac drain.. 684 13.48 $713.04 $348.94 $142.61
68745... T Create tear duct drain. 684 13.48 $713.04 $348.94 $142.61
68750... T Create tear duct drain. 684 13.48 $713.04 $348.94 $142.61
68760... T Close tear duct opening 682 3.54 $187.08 $81.36 $37.42
68761... T Close tear duct opening 681 1.67 $88.15 $30.51 $17.63
68770... T Close tear system 684 13.48 $713.04 $348.94 $142.61
fistula.
68801... T Dilate tear duct 682 3.54 $187.08 $81.36 $37.42
opening.
68810... T Probe nasolacrimal duct 683 10.19 $538.70 $257.87 $107.74
68811... T Probe nasolacrimal duct 684 13.48 $713.04 $348.94 $142.61
68815... T Probe nasolacrimal duct 684 13.48 $713.04 $348.94 $142.61
68840... T Explore/irrigate tear 682 3.54 $187.08 $81.36 $37.42
ducts.
68850... T Injection for tear sac 347 2.93 $154.75 $62.15 $30.95
x-ray.
68899... T Tear duct system 681 1.67 $88.15 $30.51 $17.63
surgery.
69000... T Drain external ear 131 1.94 $102.84 $36.61 $20.57
lesion.
69005... T Drain external ear 131 1.94 $102.84 $36.61 $20.57
lesion.
69020... T Drain outer ear canal 131 1.94 $102.84 $36.61 $20.57
lesion.
[[Page 47688]]
69090... E Pierce earlobes........ ......... ......... ......... ........... ...........
69100... T Biopsy of external ear. 161 3.50 $185.12 $75.48 $37.02
69105... T Biopsy of external ear 161 3.50 $185.12 $75.48 $37.02
canal.
69110... T Partial removal 163 10.69 $565.14 $264.65 $113.03
external ear.
69120... T Removal of external ear 313 15.81 $836.45 $411.09 $167.29
69140... T Remove ear canal 313 15.81 $836.45 $411.09 $167.29
lesion(s).
69145... T Remove ear canal 163 10.69 $565.14 $264.65 $113.03
lesion(s).
69150... T Extensive ear canal 314 25.65 $1,356.54 $693.37 $271.31
surgery.
69155... C Extensive ear/neck ......... ......... ......... ........... ...........
surgery.
69200... T Clear outer ear canal.. 311 1.43 $75.42 $20.57 $15.08
69205... T Clear outer ear canal.. 163 10.69 $565.14 $264.65 $113.03
69210... T Remove impacted ear wax 311 1.43 $75.42 $20.57 $15.08
69220... T Clean out mastoid 151 1.74 $92.07 $35.71 $18.41
cavity.
69222... T Clean out mastoid 311 1.43 $75.42 $20.57 $15.08
cavity.
69300... T Revise external ear.... 313 15.81 $836.45 $411.09 $167.29
69310... T Rebuild outer ear canal 314 25.65 $1,356.54 $693.37 $271.31
69320... T Rebuild outer ear canal 314 25.65 $1,356.54 $693.37 $271.31
69399... T Outer ear surgery 311 1.43 $75.42 $20.57 $15.08
procedure.
69400... T Inflate middle ear 311 1.43 $75.42 $20.57 $15.08
canal.
69401... N Inflate middle ear ......... ......... ......... ........... ...........
canal.
69405... T Catheterize middle ear 311 1.43 $75.42 $20.57 $15.08
canal.
69410... T Inset middle ear baffle 311 1.43 $75.42 $20.57 $15.08
69420... T Incision of eardrum.... 311 1.43 $75.42 $20.57 $15.08
69421... T Incision of eardrum.... 312 7.26 $383.95 $178.31 $76.79
69424... T Remove ventilating tube 311 1.43 $75.42 $20.57 $15.08
69433... T Create eardrum opening. 312 7.26 $383.95 $178.31 $76.79
69436... T Create eardrum opening. 312 7.26 $383.95 $178.31 $76.79
69440... T Exploration of middle 313 15.81 $836.45 $411.09 $167.29
ear.
69450... T Eardrum revision....... 313 15.81 $836.45 $411.09 $167.29
69501... T Mastoidectomy.......... 314 25.65 $1,356.54 $693.37 $271.31
69502... T Mastoidectomy.......... 314 25.65 $1,356.54 $693.37 $271.31
69505... T Remove mastoid 314 25.65 $1,356.54 $693.37 $271.31
structures.
69511... T Extensive mastoid 314 25.65 $1,356.54 $693.37 $271.31
surgery.
69530... T Extensive mastoid 314 25.65 $1,356.54 $693.37 $271.31
surgery.
69535... C Remove part of temporal ......... ......... ......... ........... ...........
bone.
69540... T Remove ear lesion...... 311 1.43 $75.42 $20.57 $15.08
69550... T Remove ear lesion...... 314 25.65 $1,356.54 $693.37 $271.31
69552... T Remove ear lesion...... 314 25.65 $1,356.54 $693.37 $271.31
69554... C Remove ear lesion...... ......... ......... ......... ........... ...........
69601... T Mastoid surgery 314 25.65 $1,356.54 $693.37 $271.31
revision.
69602... T Mastoid surgery 314 25.65 $1,356.54 $693.37 $271.31
revision.
69603... T Mastoid surgery 314 25.65 $1,356.54 $693.37 $271.31
revision.
69604... T Mastoid surgery 314 25.65 $1,356.54 $693.37 $271.31
revision.
69605... T Mastoid surgery 314 25.65 $1,356.54 $693.37 $271.31
revision.
69610... T Repair of eardrum...... 311 1.43 $75.42 $20.57 $15.08
69620... T Repair of eardrum...... 313 15.81 $836.45 $411.09 $167.29
69631... T Repair eardrum 314 25.65 $1,356.54 $693.37 $271.31
structures.
69632... T Rebuild eardrum 314 25.65 $1,356.54 $693.37 $271.31
structures.
69633... T Rebuild eardrum 314 25.65 $1,356.54 $693.37 $271.31
structures.
69635... T Repair eardrum 314 25.65 $1,356.54 $693.37 $271.31
structures.
69636... T Rebuild eardrum 314 25.65 $1,356.54 $693.37 $271.31
structures.
69637... T Rebuild eardrum 314 25.65 $1,356.54 $693.37 $271.31
structures.
69641... T Revise middle ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69642... T Revise middle ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69643... T Revise middle ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69644... T Revise middle ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69645... T Revise middle ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69646... T Revise middle ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69650... T Release middle ear bone 314 25.65 $1,356.54 $693.37 $271.31
69660... T Revise middle ear bone. 314 25.65 $1,356.54 $693.37 $271.31
69661... T Revise middle ear bone. 314 25.65 $1,356.54 $693.37 $271.31
69662... T Revise middle ear bone. 314 25.65 $1,356.54 $693.37 $271.31
69666... T Repair middle ear 314 25.65 $1,356.54 $693.37 $271.31
structures.
69667... T Repair middle ear 314 25.65 $1,356.54 $693.37 $271.31
structures.
69670... T Remove mastoid air 314 25.65 $1,356.54 $693.37 $271.31
cells.
69676... T Remove middle ear nerve 314 25.65 $1,356.54 $693.37 $271.31
69700... T Close mastoid fistula.. 314 25.65 $1,356.54 $693.37 $271.31
69710... E Implant/replace hearing ......... ......... ......... ........... ...........
aid.
69711... T Remove/repair hearing 314 25.65 $1,356.54 $693.37 $271.31
aid.
69720... T Release facial nerve... 314 25.65 $1,356.54 $693.37 $271.31
69725... T Release facial nerve... 314 25.65 $1,356.54 $693.37 $271.31
69740... T Repair facial nerve.... 314 25.65 $1,356.54 $693.37 $271.31
69745... T Repair facial nerve.... 314 25.65 $1,356.54 $693.37 $271.31
69799... T Middle ear surgery 311 1.43 $75.42 $20.57 $15.08
procedure.
69801... T Incise inner ear....... 314 25.65 $1,356.54 $693.37 $271.31
[[Page 47689]]
69802... T Incise inner ear....... 314 25.65 $1,356.54 $693.37 $271.31
69805... T Explore inner ear...... 314 25.65 $1,356.54 $693.37 $271.31
69806... T Explore inner ear...... 314 25.65 $1,356.54 $693.37 $271.31
69820... T Establish inner ear 314 25.65 $1,356.54 $693.37 $271.31
window.
69840... T Revise inner ear window 314 25.65 $1,356.54 $693.37 $271.31
69905... T Remove inner ear....... 314 25.65 $1,356.54 $693.37 $271.31
69910... T Remove inner ear & 314 25.65 $1,356.54 $693.37 $271.31
mastoid.
69915... T Incise inner ear nerve. 314 25.65 $1,356.54 $693.37 $271.31
69930... T Implant cochlear device 317 ......... ......... ........... ...........
69949... T Inner ear surgery 314 25.65 $1,356.54 $693.37 $271.31
procedure.
69950... C Incise inner ear nerve. ......... ......... ......... ........... ...........
69955... C Release facial nerve... ......... ......... ......... ........... ...........
69960... C Release inner ear canal ......... ......... ......... ........... ...........
69970... C Remove inner ear lesion ......... ......... ......... ........... ...........
69979... C Temporal bone surgery.. ......... ......... ......... ........... ...........
70010... S Contrast x-ray of brain 728 4.07 $215.48 $113.23 $43.10
70015... S Contrast x-ray of brain 728 4.07 $215.48 $113.23 $43.10
70030... X X-ray eye for foreign 700 0.78 $41.14 $22.37 $8.23
body.
70100... X X-ray exam of jaw...... 700 0.78 $41.14 $22.37 $8.23
70110... X X-ray exam of jaw...... 700 0.78 $41.14 $22.37 $8.23
70120... X X-ray exam of mastoids. 700 0.78 $41.14 $22.37 $8.23
70130... X X-ray exam of mastoids. 700 0.78 $41.14 $22.37 $8.23
70134... X X-ray exam of middle 700 0.78 $41.14 $22.37 $8.23
ear.
70140... X X-ray exam of facial 700 0.78 $41.14 $22.37 $8.23
bones.
70150... X X-ray exam of facial 700 0.78 $41.14 $22.37 $8.23
bones.
70160... X X-ray exam of nasal 700 0.78 $41.14 $22.37 $8.23
bones.
70170... X X-ray exam of tear duct 706 1.96 $103.82 $57.63 $20.76
70190... X X-ray exam of eye 700 0.78 $41.14 $22.37 $8.23
sockets.
70200... X X-ray exam of eye 700 0.78 $41.14 $22.37 $8.23
sockets.
70210... X X-ray exam of sinuses.. 700 0.78 $41.14 $22.37 $8.23
70220... X X-ray exam of sinuses.. 700 0.78 $41.14 $22.37 $8.23
70240... X X-ray exam pituitary 700 0.78 $41.14 $22.37 $8.23
saddle.
70250... X X-ray exam of skull.... 700 0.78 $41.14 $22.37 $8.23
70260... X X-ray exam of skull.... 700 0.78 $41.14 $22.37 $8.23
70300... X X-ray exam of teeth.... 700 0.78 $41.14 $22.37 $8.23
70310... X X-ray exam of teeth.... 700 0.78 $41.14 $22.37 $8.23
70320... X Full mouth x-ray of 700 0.78 $41.14 $22.37 $8.23
teeth.
70328... X X-ray exam of jaw joint 700 0.78 $41.14 $22.37 $8.23
70330... X X-ray exam of jaw 700 0.78 $41.14 $22.37 $8.23
joints.
70332... S X-ray exam of jaw joint 730 2.48 $131.25 $72.09 $26.25
70336... S Magnetic image jaw 726 7.96 $421.16 $258.09 $84.23
joint.
70350... X X-ray head for 700 0.78 $41.14 $22.37 $8.23
orthodontia.
70355... X Panoramic x-ray of jaws 700 0.78 $41.14 $22.37 $8.23
70360... X X-ray exam of neck..... 700 0.78 $41.14 $22.37 $8.23
70370... X Throat x-ray & 716 1.59 $84.23 $47.91 $16.85
fluoroscopy.
70371... X Speech evaluation, 716 1.59 $84.23 $47.91 $16.85
complex.
70373... X Contrast x-ray of 706 1.96 $103.82 $57.63 $20.76
larynx.
70380... X X-ray exam of salivary 700 0.78 $41.14 $22.37 $8.23
gland.
70390... X X-ray exam of salivary 706 1.96 $103.82 $57.63 $20.76
duct.
70450... S CAT scan of head or 710 5.06 $267.39 $176.28 $53.48
brain.
70460... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
head.
70470... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
head.
70480... S CAT scan of skull...... 710 5.06 $267.39 $176.28 $53.48
70481... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
skull.
70482... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
skull.
70486... S CAT scan of face, jaw.. 710 5.06 $267.39 $176.28 $53.48
70487... S Contrast CAT scan, face/ 710 5.06 $267.39 $176.28 $53.48
jaw.
70488... S Contrast CAT scans face/ 710 5.06 $267.39 $176.28 $53.48
jaw.
70490... S CAT scan of neck tissue 710 5.06 $267.39 $176.28 $53.48
70491... S Contrast CAT of neck 710 5.06 $267.39 $176.28 $53.48
tissue.
70492... S Contrast CAT of neck 710 5.06 $267.39 $176.28 $53.48
tissue.
70540... S Magnetic image, face, 726 7.96 $421.16 $258.09 $84.23
neck.
70541... S Magnetic image, head 720 6.35 $335.95 $206.11 $67.19
(MRA).
70551... S Magnetic image, brain 726 7.96 $421.16 $258.09 $84.23
(MRI).
70552... S Magnetic image, brain 726 7.96 $421.16 $258.09 $84.23
(MRI).
70553... S Magnetic image, brain.. 726 7.96 $421.16 $258.09 $84.23
71010... X Chest x-ray............ 700 0.78 $41.14 $22.37 $8.23
71015... X X-ray exam of chest.... 700 0.78 $41.14 $22.37 $8.23
71020... X Chest x-ray............ 700 0.78 $41.14 $22.37 $8.23
71021... X Chest x-ray............ 700 0.78 $41.14 $22.37 $8.23
71022... X Chest x-ray............ 700 0.78 $41.14 $22.37 $8.23
71023... X Chest x-ray and 716 1.59 $84.23 $47.91 $16.85
fluoroscopy.
71030... X Chest x-ray............ 700 0.78 $41.14 $22.37 $8.23
71034... X Chest x-ray & 716 1.59 $84.23 $47.91 $16.85
fluoroscopy.
71035... X Chest x-ray............ 700 0.78 $41.14 $22.37 $8.23
[[Page 47690]]
71036... X X-ray guidance for 716 1.59 $84.23 $47.91 $16.85
biopsy.
71038... X X-ray guidance for 716 1.59 $84.23 $47.91 $16.85
biopsy.
71040... X Contrast x-ray of 706 1.96 $103.82 $57.63 $20.76
bronchi.
71060... X Contrast x-ray of 706 1.96 $103.82 $57.63 $20.76
bronchi.
71090... X X-ray & pacemaker 716 1.59 $84.23 $47.91 $16.85
insertion.
71100... X X-ray exam of ribs..... 700 0.78 $41.14 $22.37 $8.23
71101... X X-ray exam of ribs, 700 0.78 $41.14 $22.37 $8.23
chest.
71110... X X-ray exam of ribs..... 700 0.78 $41.14 $22.37 $8.23
71111... X X-ray exam of ribs, 700 0.78 $41.14 $22.37 $8.23
chest.
71120... X X-ray exam of 700 0.78 $41.14 $22.37 $8.23
breastbone.
71130... X X-ray exam of 700 0.78 $41.14 $22.37 $8.23
breastbone.
71250... S Cat scan of chest...... 710 5.06 $267.39 $176.28 $53.48
71260... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
chest.
71270... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
chest.
71550... S Magnetic image, chest.. 726 7.96 $421.16 $258.09 $84.23
71555... E Magnetic imaging/chest ......... ......... ......... ........... ...........
(MRA).
72010... X X-ray exam of spine.... 700 0.78 $41.14 $22.37 $8.23
72020... X X-ray exam of spine.... 700 0.78 $41.14 $22.37 $8.23
72040... X X-ray exam of neck 700 0.78 $41.14 $22.37 $8.23
spine.
72050... X X-ray exam of neck 700 0.78 $41.14 $22.37 $8.23
spine.
72052... X X-ray exam of neck 700 0.78 $41.14 $22.37 $8.23
spine.
72069... X X-ray exam of trunk 700 0.78 $41.14 $22.37 $8.23
spine.
72070... X X-ray exam of thorax 700 0.78 $41.14 $22.37 $8.23
spine.
72072... X X-ray exam of thoracic 700 0.78 $41.14 $22.37 $8.23
spine.
72074... X X-ray exam of thoracic 700 0.78 $41.14 $22.37 $8.23
spine.
72080... X X-ray exam of trunk 700 0.78 $41.14 $22.37 $8.23
spine.
72090... X X-ray exam of trunk 700 0.78 $41.14 $22.37 $8.23
spine.
72100... X X-ray exam of lower 700 0.78 $41.14 $22.37 $8.23
spine.
72110... X X-ray exam of lower 700 0.78 $41.14 $22.37 $8.23
spine.
72114... X X-ray exam of lower 700 0.78 $41.14 $22.37 $8.23
spine.
72120... X X-ray exam of lower 700 0.78 $41.14 $22.37 $8.23
spine.
72125... S CAT scan of neck spine. 710 5.06 $267.39 $176.28 $53.48
72126... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
neck.
72127... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
neck.
72128... S CAT scan of thorax 710 5.06 $267.39 $176.28 $53.48
spine.
72129... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
thorax.
72130... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
thorax.
72131... S CAT scan of lower spine 710 5.06 $267.39 $176.28 $53.48
72132... S Contrast CAT of lower 710 5.06 $267.39 $176.28 $53.48
spine.
72133... S Contrast CAT scans, low 710 5.06 $267.39 $176.28 $53.48
spine.
72141... S Magnetic image, neck 726 7.96 $421.16 $258.09 $84.23
spine.
72142... S Magnetic image, neck 726 7.96 $421.16 $258.09 $84.23
spine.
72146... S Magnetic image, chest 726 7.96 $421.16 $258.09 $84.23
spine.
72147... S Magnetic image, chest 726 7.96 $421.16 $258.09 $84.23
spine.
72148... S Magnetic image, lumbar 726 7.96 $421.16 $258.09 $84.23
spine.
72149... S Magnetic image, lumbar 726 7.96 $421.16 $258.09 $84.23
spine.
72156... S Magnetic image, neck 726 7.96 $421.16 $258.09 $84.23
spine.
72157... S Magnetic image, chest 726 7.96 $421.16 $258.09 $84.23
spine.
72158... S Magnetic image, lumbar 726 7.96 $421.16 $258.09 $84.23
spine.
72159... E Magnetic imaging/spine ......... ......... ......... ........... ...........
(MRA).
72170... X X-ray exam of pelvis... 700 0.78 $41.14 $22.37 $8.23
72190... X X-ray exam of pelvis... 700 0.78 $41.14 $22.37 $8.23
72192... S CAT scan of pelvis..... 710 5.06 $267.39 $176.28 $53.48
72193... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
pelvis.
72194... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
pelvis.
72196... S Magnetic image, pelvis. 726 7.96 $421.16 $258.09 $84.23
72198... E Magnetic imaging/ ......... ......... ......... ........... ...........
pelvis(MRA).
72200... X X-ray exam sacroiliac 700 0.78 $41.14 $22.37 $8.23
joints.
72202... X X-ray exam sacroiliac 700 0.78 $41.14 $22.37 $8.23
joints.
72220... X X-ray exam of tailbone. 700 0.78 $41.14 $22.37 $8.23
72240... S Contrast x-ray of neck 728 4.07 $215.48 $113.23 $43.10
spine.
72255... S Contrast x-ray thorax 728 4.07 $215.48 $113.23 $43.10
spine.
72265... S Contrast x-ray lower 728 4.07 $215.48 $113.23 $43.10
spine.
72270... S Contrast x-ray of spine 728 4.07 $215.48 $113.23 $43.10
72285... S X-ray of neck spine 728 4.07 $215.48 $113.23 $43.10
disk.
72295... S X-ray of lower spine 728 4.07 $215.48 $113.23 $43.10
disk.
73000... X X-ray exam of 700 0.78 $41.14 $22.37 $8.23
collarbone.
73010... X X-ray exam of 700 0.78 $41.14 $22.37 $8.23
shoulderblade.
73020... X X-ray exam of shoulder. 700 0.78 $41.14 $22.37 $8.23
73030... X X-ray exam of shoulder. 700 0.78 $41.14 $22.37 $8.23
73040... S Contrast x-ray of 730 2.48 $131.25 $72.09 $26.25
shoulder.
73050... X X-ray exam of shoulders 700 0.78 $41.14 $22.37 $8.23
73060... X X-ray exam of humerus.. 700 0.78 $41.14 $22.37 $8.23
73070... X X-ray exam of elbow.... 700 0.78 $41.14 $22.37 $8.23
73080... X X-ray exam of elbow.... 700 0.78 $41.14 $22.37 $8.23
[[Page 47691]]
73085... S Contrast x-ray of elbow 730 2.48 $131.25 $72.09 $26.25
73090... X X-ray exam of forearm.. 700 0.78 $41.14 $22.37 $8.23
73092... X X-ray exam of arm, 700 0.78 $41.14 $22.37 $8.23
infant.
73100... X X-ray exam of wrist.... 700 0.78 $41.14 $22.37 $8.23
73110... X X-ray exam of wrist.... 700 0.78 $41.14 $22.37 $8.23
73115... S Contrast x-ray of wrist 730 2.48 $131.25 $72.09 $26.25
73120... X X-ray exam of hand..... 700 0.78 $41.14 $22.37 $8.23
73130... X X-ray exam of hand..... 700 0.78 $41.14 $22.37 $8.23
73140... X X-ray exam of finger(s) 700 0.78 $41.14 $22.37 $8.23
73200... S CAT scan of arm........ 710 5.06 $267.39 $176.28 $53.48
73201... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
arm.
73202... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
arm.
73220... S Magnetic image, arm, 726 7.96 $421.16 $258.09 $84.23
hand.
73221... S Magnetic image, joint 726 7.96 $421.16 $258.09 $84.23
of arm.
73225... E Magnetic imaging/upper ......... ......... ......... ........... ...........
(MRA).
73500... X X-ray exam of hip...... 700 0.78 $41.14 $22.37 $8.23
73510... X X-ray exam of hip...... 700 0.78 $41.14 $22.37 $8.23
73520... X X-ray exam of hips..... 700 0.78 $41.14 $22.37 $8.23
73525... S Contrast x-ray of hip.. 730 2.48 $131.25 $72.09 $26.25
73530... X X-ray exam of hip...... 700 0.78 $41.14 $22.37 $8.23
73540... X X-ray exam of pelvis & 700 0.78 $41.14 $22.37 $8.23
hips.
73550... X X-ray exam of thigh.... 700 0.78 $41.14 $22.37 $8.23
73560... X X-ray exam of knee..... 700 0.78 $41.14 $22.37 $8.23
73562... X X-ray exam of knee..... 700 0.78 $41.14 $22.37 $8.23
73564... X X-ray exam of knee..... 700 0.78 $41.14 $22.37 $8.23
73565... X X-ray exam of knee..... 700 0.78 $41.14 $22.37 $8.23
73580... S Contrast x-ray of knee 730 2.48 $131.25 $72.09 $26.25
joint.
73590... X X-ray exam of lower leg 700 0.78 $41.14 $22.37 $8.23
73592... X X-ray exam of leg, 700 0.78 $41.14 $22.37 $8.23
infant.
73600... X X-ray exam of ankle.... 700 0.78 $41.14 $22.37 $8.23
73610... X X-ray exam of ankle.... 700 0.78 $41.14 $22.37 $8.23
73615... S Contrast x-ray of ankle 730 2.48 $131.25 $72.09 $26.25
73620... X X-ray exam of foot..... 700 0.78 $41.14 $22.37 $8.23
73630... X X-ray exam of foot..... 700 0.78 $41.14 $22.37 $8.23
73650... X X-ray exam of heel..... 700 0.78 $41.14 $22.37 $8.23
73660... X X-ray exam of toe(s)... 700 0.78 $41.14 $22.37 $8.23
73700... S CAT scan of leg........ 710 5.06 $267.39 $176.28 $53.48
73701... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
leg.
73702... S Contrast CAT scans of 710 5.06 $267.39 $176.28 $53.48
leg.
73720... S Magnetic image, leg, 726 7.96 $421.16 $258.09 $84.23
foot.
73721... S Magnetic image, joint 726 7.96 $421.16 $258.09 $84.23
of leg.
73725... E Magnetic imaging/lower ......... ......... ......... ........... ...........
(MRA).
74000... X X-ray exam of abdomen.. 700 0.78 $41.14 $22.37 $8.23
74010... X X-ray exam of abdomen.. 700 0.78 $41.14 $22.37 $8.23
74020... X X-ray exam of abdomen.. 700 0.78 $41.14 $22.37 $8.23
74022... X X-ray exam series, 700 0.78 $41.14 $22.37 $8.23
abdomen.
74150... S CAT scan of abdomen.... 710 5.06 $267.39 $176.28 $53.48
74160... S Contrast CAT scan of 710 5.06 $267.39 $176.28 $53.48
abdomen.
74170... S Contrast CAT scans, 710 5.06 $267.39 $176.28 $53.48
abdomen.
74181... S Magnetic image,abdomen 726 7.96 $421.16 $258.09 $84.23
(MRI).
74185... E Magnetic image/abdomen ......... ......... ......... ........... ...........
(MRA).
74190... X X-ray exam of 706 1.96 $103.82 $57.63 $20.76
peritoneum.
74210... S Contrast xray exam of 736 1.85 $97.95 $54.24 $19.59
throat.
74220... S Contrast xray 736 1.85 $97.95 $54.24 $19.59
exam,esophagus.
74230... S Cinema xray throat/ 736 1.85 $97.95 $54.24 $19.59
esophagus.
74235... S Remove esophagus 738 4.48 $237.03 $133.34 $47.41
obstruction.
74240... S X-ray exam upper GI 736 1.85 $97.95 $54.24 $19.59
tract.
74241... S X-ray exam upper GI 736 1.85 $97.95 $54.24 $19.59
tract.
74245... S X-ray exam upper GI 736 1.85 $97.95 $54.24 $19.59
tract.
74246... S Contrast xray upper GI 736 1.85 $97.95 $54.24 $19.59
tract.
74247... S Contrast xray upper GI 736 1.85 $97.95 $54.24 $19.59
tract.
74249... S Contrast xray upper GI 736 1.85 $97.95 $54.24 $19.59
tract.
74250... S X-ray exam of small 736 1.85 $97.95 $54.24 $19.59
bowel.
74251... S X-ray exam of small 736 1.85 $97.95 $54.24 $19.59
bowel.
74260... S X-ray exam of small 736 1.85 $97.95 $54.24 $19.59
bowel.
74270... S Contrast x-ray exam of 736 1.85 $97.95 $54.24 $19.59
colon.
74280... S Contrast x-ray exam of 736 1.85 $97.95 $54.24 $19.59
colon.
74283... S Contrast x-ray exam of 736 1.85 $97.95 $54.24 $19.59
colon.
74290... S Contrast x-ray, 736 1.85 $97.95 $54.24 $19.59
gallbladder.
74291... S Contrast x-rays, 736 1.85 $97.95 $54.24 $19.59
gallbladder.
74300... C X-ray bile ducts, ......... ......... ......... ........... ...........
pancreas.
74301... C Additional x-rays at ......... ......... ......... ........... ...........
surgery.
74305... X X-ray bile ducts, 706 1.96 $103.82 $57.63 $20.76
pancreas.
74320... X Contrast x-ray of bile 706 1.96 $103.82 $57.63 $20.76
ducts.
74327... S X-ray for bile stone 738 4.48 $237.03 $133.34 $47.41
removal.
[[Page 47692]]
74328... X Xray for bile duct 706 1.96 $103.82 $57.63 $20.76
endoscopy.
74329... X X-ray for pancreas 706 1.96 $103.82 $57.63 $20.76
endoscopy.
74330... X Xray,bile/pancreas 706 1.96 $103.82 $57.63 $20.76
endoscopy.
74340... X X-ray guide for GI tube 716 1.59 $84.23 $47.91 $16.85
74350... X X-ray guide, stomach 706 1.96 $103.82 $57.63 $20.76
tube.
74355... X X-ray guide, intestinal 706 1.96 $103.82 $57.63 $20.76
tube.
74360... S X-ray guide, GI 738 4.48 $237.03 $133.34 $47.41
dilation.
74363... S X-ray, bile duct 738 4.48 $237.03 $133.34 $47.41
dilation.
74400... S Contrast x-ray urinary 737 2.81 $148.88 $86.56 $29.78
tract.
74405... S Contrast x-ray urinary 737 2.81 $148.88 $86.56 $29.78
tract.
74410... S Contrast x-ray urinary 737 2.81 $148.88 $86.56 $29.78
tract.
74415... S Contrast x-ray urinary 737 2.81 $148.88 $86.56 $29.78
tract.
74420... S Contrast x-ray urinary 737 2.81 $148.88 $86.56 $29.78
tract.
74425... S Contrast x-ray urinary 737 2.81 $148.88 $86.56 $29.78
tract.
74430... S Contrast x-ray of 737 2.81 $148.88 $86.56 $29.78
bladder.
74440... S Xray exam male genital 737 2.81 $148.88 $86.56 $29.78
tract.
74445... S X-ray exam of penis.... 737 2.81 $148.88 $86.56 $29.78
74450... S X-ray exam urethra/ 737 2.81 $148.88 $86.56 $29.78
bladder.
74455... S X-ray exam urethra/ 737 2.81 $148.88 $86.56 $29.78
bladder.
74470... X X-ray exam of kidney 706 1.96 $103.82 $57.63 $20.76
lesion.
74475... S Xray control catheter 738 4.48 $237.03 $133.34 $47.41
insert.
74480... S Xray control catheter 738 4.48 $237.03 $133.34 $47.41
insert.
74485... S X-ray guide, GU 738 4.48 $237.03 $133.34 $47.41
dilation.
74710... X X-ray measurement of 700 0.78 $41.14 $22.37 $8.23
pelvis.
74740... X X-ray female genital 706 1.96 $103.82 $57.63 $20.76
tract.
74742... X X-ray fallopian tube... 706 1.96 $103.82 $57.63 $20.76
74775... S X-ray exam of perineum. 737 2.81 $148.88 $86.56 $29.78
75552... S Magnetic image, 726 7.96 $421.16 $258.09 $84.23
myocardium.
75553... S Magnetic image, 726 7.96 $421.16 $258.09 $84.23
myocardium.
75554... S Cardiac MRI/function... 726 7.96 $421.16 $258.09 $84.23
75555... S Cardiac MRI/limited 726 7.96 $421.16 $258.09 $84.23
study.
75556... E Cardiac MRI/flow ......... ......... ......... ........... ...........
mapping.
75600... S Contrast x-ray exam of 739 5.83 $308.53 $168.82 $61.71
aorta.
75605... S Contrast x-ray exam of 739 5.83 $308.53 $168.82 $61.71
aorta.
75625... S Contrast x-ray exam of 739 5.83 $308.53 $168.82 $61.71
aorta.
75630... S X-ray aorta, leg 739 5.83 $308.53 $168.82 $61.71
arteries.
75650... S Artery x-rays, head & 739 5.83 $308.53 $168.82 $61.71
neck.
75658... S X-ray exam of arm 739 5.83 $308.53 $168.82 $61.71
arteries.
75660... S Artery x-rays, head & 739 5.83 $308.53 $168.82 $61.71
neck.
75662... S Artery x-rays, head & 739 5.83 $308.53 $168.82 $61.71
neck.
75665... S Artery x-rays, head & 739 5.83 $308.53 $168.82 $61.71
neck.
75671... S Artery x-rays, head & 739 5.83 $308.53 $168.82 $61.71
neck.
75676... S Artery x-rays, neck.... 739 5.83 $308.53 $168.82 $61.71
75680... S Artery x-rays, neck.... 739 5.83 $308.53 $168.82 $61.71
75685... S Artery x-rays, spine... 739 5.83 $308.53 $168.82 $61.71
75705... S Artery x-rays, spine... 739 5.83 $308.53 $168.82 $61.71
75710... S Artery x-rays, arm/leg. 739 5.83 $308.53 $168.82 $61.71
75716... S Artery x-rays, arms/ 739 5.83 $308.53 $168.82 $61.71
legs.
75722... S Artery x-rays, kidney.. 739 5.83 $308.53 $168.82 $61.71
75724... S Artery x-rays, kidneys. 739 5.83 $308.53 $168.82 $61.71
75726... S Artery x-rays, abdomen. 739 5.83 $308.53 $168.82 $61.71
75731... S Artery x-rays, adrenal 739 5.83 $308.53 $168.82 $61.71
gland.
75733... S Artery x-rays,adrenal 739 5.83 $308.53 $168.82 $61.71
glands.
75736... S Artery x-rays, pelvis.. 739 5.83 $308.53 $168.82 $61.71
75741... S Artery x-rays, lung.... 739 5.83 $308.53 $168.82 $61.71
75743... S Artery x-rays, lungs... 739 5.83 $308.53 $168.82 $61.71
75746... S Artery x-rays, lung.... 739 5.83 $308.53 $168.82 $61.71
75756... S Artery x-rays, chest... 739 5.83 $308.53 $168.82 $61.71
75774... S Artery x-ray, each 739 5.83 $308.53 $168.82 $61.71
vessel.
75790... S Visualize A-V shunt.... 739 5.83 $308.53 $168.82 $61.71
75801... X Lymph vessel x-ray, arm/ 706 1.96 $103.82 $57.63 $20.76
leg.
75803... X Lymph vessel x-ray,arms/ 706 1.96 $103.82 $57.63 $20.76
legs.
75805... X Lymph vessel x-ray, 706 1.96 $103.82 $57.63 $20.76
trunk.
75807... X Lymph vessel x-ray, 706 1.96 $103.82 $57.63 $20.76
trunk.
75809... X Nonvascular shunt, x- 706 1.96 $103.82 $57.63 $20.76
ray.
75810... S Vein x-ray, spleen/ 739 5.83 $308.53 $168.82 $61.71
liver.
75820... S Vein x-ray, arm/leg.... 739 5.83 $308.53 $168.82 $61.71
75822... S Vein x-ray, arms/legs.. 739 5.83 $308.53 $168.82 $61.71
75825... S Vein x-ray, trunk...... 739 5.83 $308.53 $168.82 $61.71
75827... S Vein x-ray, chest...... 739 5.83 $308.53 $168.82 $61.71
75831... S Vein x-ray, kidney..... 739 5.83 $308.53 $168.82 $61.71
75833... S Vein x-ray, kidneys.... 739 5.83 $308.53 $168.82 $61.71
75840... S Vein x-ray, adrenal 739 5.83 $308.53 $168.82 $61.71
gland.
75842... S Vein x-ray, adrenal 739 5.83 $308.53 $168.82 $61.71
glands.
75860... S Vein x-ray, neck....... 739 5.83 $308.53 $168.82 $61.71
[[Page 47693]]
75870... S Vein x-ray, skull...... 739 5.83 $308.53 $168.82 $61.71
75872... S Vein x-ray, skull...... 739 5.83 $308.53 $168.82 $61.71
75880... S Vein x-ray, eye socket. 739 5.83 $308.53 $168.82 $61.71
75885... S Vein x-ray, liver...... 739 5.83 $308.53 $168.82 $61.71
75887... S Vein x-ray, liver...... 739 5.83 $308.53 $168.82 $61.71
75889... S Vein x-ray, liver...... 739 5.83 $308.53 $168.82 $61.71
75891... S Vein x-ray, liver...... 739 5.83 $308.53 $168.82 $61.71
75893... N Venous sampling by ......... ......... ......... ........... ...........
catheter.
75894... C Xrays, transcatheter ......... ......... ......... ........... ...........
therapy.
75896... C Xrays, transcatheter ......... ......... ......... ........... ...........
therapy.
75898... X Follow-up angiogram.... 706 1.96 $103.82 $57.63 $20.76
75900... C Arterial catheter ......... ......... ......... ........... ...........
exchange.
75940... C X-ray placement, vein ......... ......... ......... ........... ...........
filter.
75945... C Intravascular us....... ......... ......... ......... ........... ...........
75946... C Intravascular us....... ......... ......... ......... ........... ...........
75960... C Transcatheter intro, ......... ......... ......... ........... ...........
stent.
75961... C Retrieval, broken ......... ......... ......... ........... ...........
catheter.
75962... C Repair arterial ......... ......... ......... ........... ...........
blockage.
75964... C Repair artery blockage, ......... ......... ......... ........... ...........
each.
75966... C Repair arterial ......... ......... ......... ........... ...........
blockage.
75968... C Repair artery blockage, ......... ......... ......... ........... ...........
each.
75970... C Vascular biopsy........ ......... ......... ......... ........... ...........
75978... C Repair venous blockage. ......... ......... ......... ........... ...........
75980... S Contrast xray exam bile 738 4.48 $237.03 $133.34 $47.41
duct.
75982... S Contrast xray exam bile 738 4.48 $237.03 $133.34 $47.41
duct.
75984... S Xray control catheter 738 4.48 $237.03 $133.34 $47.41
change.
75989... X Abscess drainage under 716 1.59 $84.23 $47.91 $16.85
x-ray.
75992... C Atherectomy, x-ray exam ......... ......... ......... ........... ...........
75993... C Atherectomy, x-ray exam ......... ......... ......... ........... ...........
75994... C Atherectomy, x-ray exam ......... ......... ......... ........... ...........
75995... C Atherectomy, x-ray exam ......... ......... ......... ........... ...........
75996... C Atherectomy, x-ray exam ......... ......... ......... ........... ...........
76000... X Fluoroscope examination 716 1.59 $84.23 $47.91 $16.85
76001... X Fluoroscope exam, 716 1.59 $84.23 $47.91 $16.85
extensive.
76003... X Needle localization by 716 1.59 $84.23 $47.91 $16.85
x-ray.
76010... X X-ray, nose to rectum.. 700 0.78 $41.14 $22.37 $8.23
76020... X X-rays for bone age.... 700 0.78 $41.14 $22.37 $8.23
76040... X X-rays, bone evaluation 700 0.78 $41.14 $22.37 $8.23
76061... X X-rays, bone survey.... 700 0.78 $41.14 $22.37 $8.23
76062... X X-rays, bone survey.... 700 0.78 $41.14 $22.37 $8.23
76065... X X-rays, bone evaluation 700 0.78 $41.14 $22.37 $8.23
76066... X Joint(s) survey, single 700 0.78 $41.14 $22.37 $8.23
film.
76070... E CT scan, bone density ......... ......... ......... ........... ...........
study.
76075... X Dual energy x-ray study 706 1.96 $103.82 $57.63 $20.76
76076... X Dual energy x-ray study 700 0.78 $41.14 $22.37 $8.23
76078... X Photodensitometry...... 700 0.78 $41.14 $22.37 $8.23
76080... X X-ray exam of fistula.. 706 1.96 $103.82 $57.63 $20.76
76086... X X-ray of mammary duct.. 706 1.96 $103.82 $57.63 $20.76
76088... X X-ray of mammary ducts. 706 1.96 $103.82 $57.63 $20.76
76090... S Mammogram, one breast.. 746 0.69 $36.24 $19.44 $7.25
76091... S Mammogram, both breasts 746 0.69 $36.24 $19.44 $7.25
76092... A Mammogram, screening... ......... ......... ......... ........... ...........
76093... S Magnetic image, breast. 726 7.96 $421.16 $258.09 $84.23
76094... S Magnetic image, both 726 7.96 $421.16 $258.09 $84.23
breasts.
76095... X Stereotactic breast 706 1.96 $103.82 $57.63 $20.76
biopsy.
76096... X X-ray of needle wire, 706 1.96 $103.82 $57.63 $20.76
breast.
76098... X X-ray exam, breast 700 0.78 $41.14 $22.37 $8.23
specimen.
76100... X X-ray exam of body 700 0.78 $41.14 $22.37 $8.23
section.
76101... X Complex body section x- 706 1.96 $103.82 $57.63 $20.76
ray.
76102... X Complex body section x- 706 1.96 $103.82 $57.63 $20.76
rays.
76120... X Cinematic x-rays....... 700 0.78 $41.14 $22.37 $8.23
76125... X Cinematic x-rays....... 700 0.78 $41.14 $22.37 $8.23
76140... E X-ray consultation..... ......... ......... ......... ........... ...........
76150... X X-ray exam, dry process 700 0.78 $41.14 $22.37 $8.23
76350... N Special x-ray contrast ......... ......... ......... ........... ...........
study.
76355... S CAT scan for 710 5.06 $267.39 $176.28 $53.48
localization.
76360... S CAT scan for needle 710 5.06 $267.39 $176.28 $53.48
biopsy.
76365... S CAT scan for cyst 710 5.06 $267.39 $176.28 $53.48
aspiration.
76370... S CAT scan for therapy 710 5.06 $267.39 $176.28 $53.48
guide.
76375... S 3d/holograph reconstr 710 5.06 $267.39 $176.28 $53.48
add-on.
76380... S CAT scan follow-up 710 5.06 $267.39 $176.28 $53.48
study.
76390... S Mr spectroscopy........ 726 7.96 $421.16 $258.09 $84.23
76400... S Magnetic image, bone 726 7.96 $421.16 $258.09 $84.23
marrow.
76499... X Radiographic procedure. 700 0.78 $41.14 $22.37 $8.23
76506... S Echo exam of head...... 747 1.65 $87.17 $54.69 $17.43
[[Page 47694]]
76511... S Echo exam of eye....... 747 1.65 $87.17 $54.69 $17.43
76512... S Echo exam of eye....... 747 1.65 $87.17 $54.69 $17.43
76513... S Echo exam of eye, water 747 1.65 $87.17 $54.69 $17.43
bath.
76516... S Echo exam of eye....... 747 1.65 $87.17 $54.69 $17.43
76519... S Echo exam of eye....... 747 1.65 $87.17 $54.69 $17.43
76529... S Echo exam of eye....... 747 1.65 $87.17 $54.69 $17.43
76536... S Echo exam of head and 747 1.65 $87.17 $54.69 $17.43
neck.
76604... S Echo exam of chest..... 747 1.65 $87.17 $54.69 $17.43
76645... S Echo exam of breast.... 747 1.65 $87.17 $54.69 $17.43
76700... S Echo exam of abdomen... 747 1.65 $87.17 $54.69 $17.43
76705... S Echo exam of abdomen... 747 1.65 $87.17 $54.69 $17.43
76770... S Echo exam abdomen back 747 1.65 $87.17 $54.69 $17.43
wall.
76775... S Echo exam abdomen back 747 1.65 $87.17 $54.69 $17.43
wall.
76778... S Echo exam kidney 747 1.65 $87.17 $54.69 $17.43
transplant.
76800... S Echo exam spinal canal. 747 1.65 $87.17 $54.69 $17.43
76805... S Echo exam of pregnant 747 1.65 $87.17 $54.69 $17.43
uterus.
76810... S Echo exam of pregnant 747 1.65 $87.17 $54.69 $17.43
uterus.
76815... S Echo exam of pregnant 747 1.65 $87.17 $54.69 $17.43
uterus.
76816... S Echo exam followup or 747 1.65 $87.17 $54.69 $17.43
repeat.
76818... S Fetal biophysical 747 1.65 $87.17 $54.69 $17.43
profile.
76825... X Echo exam of fetal 957 2.83 $149.86 $117.07 $29.97
heart.
76826... X Echo exam of fetal 957 2.83 $149.86 $117.07 $29.97
heart.
76827... X Echo exam of fetal 957 2.83 $149.86 $117.07 $29.97
heart.
76828... X Echo exam of fetal 957 2.83 $149.86 $117.07 $29.97
heart.
76830... S Echo exam, transvaginal 747 1.65 $87.17 $54.69 $17.43
76831... S Echo exam, uterus...... 747 1.65 $87.17 $54.69 $17.43
76856... S Echo exam of pelvis.... 747 1.65 $87.17 $54.69 $17.43
76857... S Echo exam of pelvis.... 747 1.65 $87.17 $54.69 $17.43
76870... S Echo exam of scrotum... 747 1.65 $87.17 $54.69 $17.43
76872... S Echo exam, transrectal. 747 1.65 $87.17 $54.69 $17.43
76880... S Echo exam of extremity. 747 1.65 $87.17 $54.69 $17.43
76885... S Echo exam, infant hips. 747 1.65 $87.17 $54.69 $17.43
76886... S Echo exam, infant hips. 747 1.65 $87.17 $54.69 $17.43
76930... X Echo guide for heart 749 2.46 $130.27 $76.16 $26.05
sac tap.
76932... X Echo guide for heart 749 2.46 $130.27 $76.16 $26.05
biopsy.
76934... X Echo guide for chest 749 2.46 $130.27 $76.16 $26.05
tap.
76936... X Echo guide for artery 749 2.46 $130.27 $76.16 $26.05
repair.
76938... X Echo exam for drainage. 749 2.46 $130.27 $76.16 $26.05
76941... X Echo guide for 749 2.46 $130.27 $76.16 $26.05
transfusion.
76942... X Echo guide for biopsy.. 749 2.46 $130.27 $76.16 $26.05
76945... X Echo guide, villus 749 2.46 $130.27 $76.16 $26.05
sampling.
76946... X Echo guide for 749 2.46 $130.27 $76.16 $26.05
amniocentesis.
76948... X Echo guide, ova 749 2.46 $130.27 $76.16 $26.05
aspiration.
76950... X Echo guidance 749 2.46 $130.27 $76.16 $26.05
radiotherapy.
76960... X Echo guidance 749 2.46 $130.27 $76.16 $26.05
radiotherapy.
76965... X Echo guidance 749 2.46 $130.27 $76.16 $26.05
radiotherapy.
76970... S Ultrasound exam follow- 747 1.65 $87.17 $54.69 $17.43
up.
76975... S GI endoscopic 747 1.65 $87.17 $54.69 $17.43
ultrasound.
76986... S Echo exam at surgery... 747 1.65 $87.17 $54.69 $17.43
76999... S Echo examination 747 1.65 $87.17 $54.69 $17.43
procedure.
77261... X Radiation therapy 750 0.93 $48.97 $25.54 $9.79
planning.
77262... X Radiation therapy 750 0.93 $48.97 $25.54 $9.79
planning.
77263... X Radiation therapy 750 0.93 $48.97 $25.54 $9.79
planning.
77280... X Set radiation therapy 752 3.56 $188.05 $88.82 $37.61
field.
77285... X Set radiation therapy 752 3.56 $188.05 $88.82 $37.61
field.
77290... X Set radiation therapy 752 3.56 $188.05 $88.82 $37.61
field.
77295... X Set radiation therapy 752 3.56 $188.05 $88.82 $37.61
field.
77299... X Radiation therapy 751 1.07 $56.81 $33.22 $11.36
planning.
77300... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77305... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77310... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77315... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77321... X Radiation therapy port 751 1.07 $56.81 $33.22 $11.36
plan.
77326... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77327... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77328... X Radiation therapy dose 751 1.07 $56.81 $33.22 $11.36
plan.
77331... X Special radiation 751 1.07 $56.81 $33.22 $11.36
dosimetry.
77332... X Radiation treatment 751 1.07 $56.81 $33.22 $11.36
aid(s).
77333... X Radiation treatment 751 1.07 $56.81 $33.22 $11.36
aid(s).
77334... X Radiation treatment 751 1.07 $56.81 $33.22 $11.36
aid(s).
77336... X Radiation physics consu 750 0.93 $48.97 $25.54 $9.79
77370... X Radiation physics 750 0.93 $48.97 $25.54 $9.79
consult.
77399... X External radiation 750 0.93 $48.97 $25.54 $9.79
dosimetry.
77401... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77402... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
[[Page 47695]]
77403... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77404... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77406... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77407... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77408... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77409... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77411... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77412... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77413... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77414... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77416... S Radiation treatment 757 2.20 $116.55 $52.43 $23.31
delivery.
77417... X Radiology port film(s). 700 0.78 $41.14 $22.37 $8.23
77419... E Weekly radiation ......... ......... ......... ........... ...........
therapy.
77420... E Weekly radiation ......... ......... ......... ........... ...........
therapy.
77425... E Weekly radiation ......... ......... ......... ........... ...........
therapy.
77430... E Weekly radiation ......... ......... ......... ........... ...........
therapy.
77431... X Radiation therapy 750 0.93 $48.97 $25.54 $9.79
management.
77432... X Stereotactic radiation 750 0.93 $48.97 $25.54 $9.79
trmt.
77470... S Special radiation 757 2.20 $116.55 $52.43 $23.31
treatment.
77499... N Radiation therapy ......... ......... ......... ........... ...........
management.
77600... S Hyperthermia treatment. 758 3.41 $180.22 $76.84 $36.04
77605... S Hyperthermia treatment. 758 3.41 $180.22 $76.84 $36.04
77610... S Hyperthermia treatment. 758 3.41 $180.22 $76.84 $36.04
77615... S Hyperthermia treatment. 758 3.41 $180.22 $76.84 $36.04
77620... S Hyperthermia treatment. 758 3.41 $180.22 $76.84 $36.04
77750... S Infuse radioactive 759 8.09 $428.02 $160.01 $85.60
materials.
77761... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77762... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77763... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77776... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77777... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77778... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77781... S High intensity 759 8.09 $428.02 $160.01 $85.60
brachytherapy.
77782... S High intensity 759 8.09 $428.02 $160.01 $85.60
brachytherapy.
77783... S High intensity 759 8.09 $428.02 $160.01 $85.60
brachytherapy.
77784... S High intensity 759 8.09 $428.02 $160.01 $85.60
brachytherapy.
77789... S Radioelement 759 8.09 $428.02 $160.01 $85.60
application.
77790... N Radioelement handling.. ......... ......... ......... ........... ...........
77799... S Radium/radioisotope 759 8.09 $428.02 $160.01 $85.60
therapy.
78000... S Thyroid, single uptake. 761 2.06 $108.72 $61.47 $21.74
78001... S Thyroid, multiple 762 1.80 $95.01 $51.53 $19.00
uptakes.
78003... S Thyroid suppress/stimul 762 1.80 $95.01 $51.53 $19.00
78006... S Thyroid, imaging with 771 3.81 $201.77 $116.84 $40.35
uptake.
78007... S Thyroid, image, mult 772 4.28 $226.25 $127.92 $45.25
uptakes.
78010... S Thyroid imaging........ 771 3.81 $201.77 $116.84 $40.35
78011... S Thyroid imaging with 771 3.81 $201.77 $116.84 $40.35
flow.
78015... S Thyroid met imaging.... 771 3.81 $201.77 $116.84 $40.35
78016... S Thyroid met imaging/ 772 4.28 $226.25 $127.92 $45.25
studies.
78017... S Thyroid met imaging, 772 4.28 $226.25 $127.92 $45.25
mult.
78018... S Thyroid, met imaging, 772 4.28 $226.25 $127.92 $45.25
body.
78070... S Parathyroid nuclear 772 4.28 $226.25 $127.92 $45.25
imaging.
78075... S Adrenal nuclear imaging 772 4.28 $226.25 $127.92 $45.25
78099... S Endocrine nuclear 761 2.06 $108.72 $61.47 $21.74
procedure.
78102... S Bone marrow imaging, 771 3.81 $201.77 $116.84 $40.35
ltd.
78103... S Bone marrow imaging, 771 3.81 $201.77 $116.84 $40.35
mult.
78104... S Bone marrow imaging, 771 3.81 $201.77 $116.84 $40.35
body.
78110... S Plasma volume, single.. 761 2.06 $108.72 $61.47 $21.74
78111... S Plasma volume, multiple 761 2.06 $108.72 $61.47 $21.74
78120... S Red cell mass, single.. 761 2.06 $108.72 $61.47 $21.74
78121... S Red cell mass, multiple 762 1.80 $95.01 $51.53 $19.00
78122... S Blood volume........... 762 1.80 $95.01 $51.53 $19.00
78130... S Red cell survival study 762 1.80 $95.01 $51.53 $19.00
78135... S Red cell survival 762 1.80 $95.01 $51.53 $19.00
kinetics.
78140... S Red cell sequestration. 762 1.80 $95.01 $51.53 $19.00
78160... S Plasma iron turnover... 762 1.80 $95.01 $51.53 $19.00
78162... S Iron absorption exam... 762 1.80 $95.01 $51.53 $19.00
78170... S Red cell iron 762 1.80 $95.01 $51.53 $19.00
utilization.
78172... S Total body iron 762 1.80 $95.01 $51.53 $19.00
estimation.
78185... S Spleen imaging......... 771 3.81 $201.77 $116.84 $40.35
78190... S Platelet survival, 762 1.80 $95.01 $51.53 $19.00
kinetics.
78191... S Platelet survival...... 762 1.80 $95.01 $51.53 $19.00
78195... S Lymph system imaging... 772 4.28 $226.25 $127.92 $45.25
78199... S Blood/lymph nuclear 761 2.06 $108.72 $61.47 $21.74
exam.
78201... S Liver imaging.......... 771 3.81 $201.77 $116.84 $40.35
78202... S Liver imaging with flow 771 3.81 $201.77 $116.84 $40.35
[[Page 47696]]
78205... S Liver imaging (3D)..... 781 5.37 $284.04 $145.77 $56.81
78215... S Liver and spleen 771 3.81 $201.77 $116.84 $40.35
imaging.
78216... S Liver & spleen image, 771 3.81 $201.77 $116.84 $40.35
flow.
78220... S Liver function study... 772 4.28 $226.25 $127.92 $45.25
78223... S Hepatobiliary imaging.. 772 4.28 $226.25 $127.92 $45.25
78230... S Salivary gland imaging. 771 3.81 $201.77 $116.84 $40.35
78231... S Serial salivary imaging 771 3.81 $201.77 $116.84 $40.35
78232... S Salivary gland function 772 4.28 $226.25 $127.92 $45.25
exam.
78258... S Esophageal motility 772 4.28 $226.25 $127.92 $45.25
study.
78261... S Gastric mucosa imaging. 771 3.81 $201.77 $116.84 $40.35
78262... S Gastroesophageal reflux 772 4.28 $226.25 $127.92 $45.25
exam.
78264... S Gastric emptying study. 772 4.28 $226.25 $127.92 $45.25
78270... S Vit B-12 absorption 761 2.06 $108.72 $61.47 $21.74
exam.
78271... S Vit B-12 absorp exam, 761 2.06 $108.72 $61.47 $21.74
IF.
78272... S Vit B-12 absorp, 761 2.06 $108.72 $61.47 $21.74
combined.
78278... S Acute GI blood loss 772 4.28 $226.25 $127.92 $45.25
imaging.
78282... S GI protein loss exam... 761 2.06 $108.72 $61.47 $21.74
78290... S Meckel's divert exam... 771 3.81 $201.77 $116.84 $40.35
78291... S Leveen/shunt patency 772 4.28 $226.25 $127.92 $45.25
exam.
78299... S GI nuclear procedure... 761 2.06 $108.72 $61.47 $21.74
78300... S Bone imaging, limited 771 3.81 $201.77 $116.84 $40.35
area.
78305... S Bone imaging, multiple 771 3.81 $201.77 $116.84 $40.35
areas.
78306... S Bone imaging, whole 771 3.81 $201.77 $116.84 $40.35
body.
78315... S Bone imaging, 3 phase.. 772 4.28 $226.25 $127.92 $45.25
78320... S Bone imaging (3D)...... 781 5.37 $284.04 $145.77 $56.81
78350... X Bone mineral, single 700 0.78 $41.14 $22.37 $8.23
photon.
78351... E Bone mineral, dual ......... ......... ......... ........... ...........
photon.
78399... S Musculoskeletal nuclear 771 3.81 $201.77 $116.84 $40.35
exam.
78414... S Non-imaging heart 762 1.80 $95.01 $51.53 $19.00
function.
78428... S Cardiac shunt imaging.. 771 3.81 $201.77 $116.84 $40.35
78445... S Vascular flow imaging.. 771 3.81 $201.77 $116.84 $40.35
78455... S Venous thrombosis study 762 1.80 $95.01 $51.53 $19.00
78457... S Venous thrombosis 771 3.81 $201.77 $116.84 $40.35
imaging.
78458... S Ven thrombosis images, 771 3.81 $201.77 $116.84 $40.35
bilat.
78459... S Heart muscle imaging 760 17.91 $947.13 $419.46 $189.43
(PET).
78460... S Heart muscle blood 771 3.81 $201.77 $116.84 $40.35
single.
78461... S Heart muscle blood 772 4.28 $226.25 $127.92 $45.25
multiple.
78464... S Heart image (3D) single 781 5.37 $284.04 $145.77 $56.81
78465... S Heart image (3D) 782 9.50 $502.46 $275.04 $100.49
multiple.
78466... S Heart infarct image.... 771 3.81 $201.77 $116.84 $40.35
78468... S Heart infarct image, EF 772 4.28 $226.25 $127.92 $45.25
78469... S Heart infarct image 781 5.37 $284.04 $145.77 $56.81
(3D).
78472... S Gated heart, resting... 772 4.28 $226.25 $127.92 $45.25
78473... S Gated heart, multiple.. 772 4.28 $226.25 $127.92 $45.25
78478... S Heart wall motion (add- 771 3.81 $201.77 $116.84 $40.35
on).
78480... S Heart function, (add- 771 3.81 $201.77 $116.84 $40.35
on).
78481... S Heart first pass single 771 3.81 $201.77 $116.84 $40.35
78483... S Heart first pass 772 4.28 $226.25 $127.92 $45.25
multiple.
78491... E Heart image (pet) ......... ......... ......... ........... ...........
single.
78492... E Heart image (pet) ......... ......... ......... ........... ...........
multiple.
78499... S Cardiovascular nuclear 762 1.80 $95.01 $51.53 $19.00
exam.
78580... S Lung perfusion imaging. 771 3.81 $201.77 $116.84 $40.35
78584... S Lung V/Q image single 772 4.28 $226.25 $127.92 $45.25
breath.
78585... S Lung V/Q imaging....... 772 4.28 $226.25 $127.92 $45.25
78586... S Aerosol lung image, 771 3.81 $201.77 $116.84 $40.35
single.
78587... S Aerosol lung image, 771 3.81 $201.77 $116.84 $40.35
multiple.
78591... S Vent image, 1 breath, 1 771 3.81 $201.77 $116.84 $40.35
proj.
78593... S Vent image, 1 proj, gas 771 3.81 $201.77 $116.84 $40.35
78594... S Vent image, mult proj, 772 4.28 $226.25 $127.92 $45.25
gas.
78596... S Lung differential 772 4.28 $226.25 $127.92 $45.25
function.
78599... S Respiratory nuclear 771 3.81 $201.77 $116.84 $40.35
exam.
78600... S Brain imaging, ltd 771 3.81 $201.77 $116.84 $40.35
static.
78601... S Brain ltd imaging & 771 3.81 $201.77 $116.84 $40.35
flow.
78605... S Brain imaging, complete 771 3.81 $201.77 $116.84 $40.35
78606... S Brain imaging comp & 772 4.28 $226.25 $127.92 $45.25
flow.
78607... S Brain imaging (3D)..... 781 5.37 $284.04 $145.77 $56.81
78608... S Brain imaging (PET).... 760 17.91 $947.13 $419.46 $189.43
78609... S Brain imaging (PET).... 760 17.91 $947.13 $419.46 $189.43
78610... S Brain flow imaging only 771 3.81 $201.77 $116.84 $40.35
78615... S Cerebral blood flow 772 4.28 $226.25 $127.92 $45.25
imaging.
78630... S Cerebrospinal fluid 772 4.28 $226.25 $127.92 $45.25
scan.
78635... S CSF ventriculography... 772 4.28 $226.25 $127.92 $45.25
78645... S CSF shunt evaluation... 772 4.28 $226.25 $127.92 $45.25
78647... S Cerebrospinal fluid 781 5.37 $284.04 $145.77 $56.81
scan.
78650... S CSF leakage imaging.... 772 4.28 $226.25 $127.92 $45.25
[[Page 47697]]
78660... S Nuclear exam of tear 771 3.81 $201.77 $116.84 $40.35
flow.
78699... S Nervous system nuclear 771 3.81 $201.77 $116.84 $40.35
exam.
78700... S Kidney imaging, static. 771 3.81 $201.77 $116.84 $40.35
78701... S Kidney imaging with 771 3.81 $201.77 $116.84 $40.35
flow.
78704... S Imaging renogram....... 771 3.81 $201.77 $116.84 $40.35
78707... S Kidney flow & function 771 3.81 $201.77 $116.84 $40.35
image.
78708... S Kidney flow & function 772 4.28 $226.25 $127.92 $45.25
image.
78709... S Kidney flow & function 772 4.28 $226.25 $127.92 $45.25
image.
78710... S Kidney imaging (3D).... 781 5.37 $284.04 $145.77 $56.81
78715... S Renal vascular flow 771 3.81 $201.77 $116.84 $40.35
exam.
78725... S Kidney function study.. 761 2.06 $108.72 $61.47 $21.74
78730... S Urinary bladder 771 3.81 $201.77 $116.84 $40.35
retention.
78740... S Ureteral reflux study.. 772 4.28 $226.25 $127.92 $45.25
78760... S Testicular imaging..... 771 3.81 $201.77 $116.84 $40.35
78761... S Testicular imaging & 771 3.81 $201.77 $116.84 $40.35
flow.
78799... S Genitourinary nuclear 771 3.81 $201.77 $116.84 $40.35
exam.
78800... S Tumor imaging, limited 772 4.28 $226.25 $127.92 $45.25
area.
78801... S Tumor imaging, mult 772 4.28 $226.25 $127.92 $45.25
areas.
78802... S Tumor imaging, whole 772 4.28 $226.25 $127.92 $45.25
body.
78803... S Tumor imaging (3D)..... 782 9.50 $502.46 $275.04 $100.49
78805... S Abscess imaging, ltd 772 4.28 $226.25 $127.92 $45.25
area.
78806... S Abscess imaging, whole 772 4.28 $226.25 $127.92 $45.25
body.
78807... S Nuclear localization/ 782 9.50 $502.46 $275.04 $100.49
abscess.
78810... S Tumor imaging (PET).... 760 17.91 $947.13 $419.46 $189.43
78890... N Nuclear medicine data ......... ......... ......... ........... ...........
proc.
78891... N Nuclear med data proc.. ......... ......... ......... ........... ...........
78990... E Provide diag ......... ......... ......... ........... ...........
radionuclide(s).
78999... S Nuclear diagnostic exam 761 2.06 $108.72 $61.47 $21.74
79000... S Intial hyperthyroid 792 4.80 $253.68 $144.19 $50.74
therapy.
79001... S Repeat hyperthyroid 791 16.26 $859.96 $562.06 $171.99
therapy.
79020... S Thyroid ablation....... 792 4.80 $253.68 $144.19 $50.74
79030... S Thyroid ablation, 792 4.80 $253.68 $144.19 $50.74
carcinoma.
79035... S Thyroid metastatic 792 4.80 $253.68 $144.19 $50.74
therapy.
79100... S Hematopoetic nuclear 791 16.26 $859.96 $562.06 $171.99
therapy.
79200... S Intracavitary nuc 792 4.80 $253.68 $144.19 $50.74
treatment.
79300... S Interstitial nuclear 791 16.26 $859.96 $562.06 $171.99
therapy.
79400... S Nonhemato nuclear 791 16.26 $859.96 $562.06 $171.99
therapy.
79420... S Intravascular nuc 791 16.26 $859.96 $562.06 $171.99
therapy.
79440... S Nuclear joint therapy.. 791 16.26 $859.96 $562.06 $171.99
79900... N Provide ther ......... ......... ......... ........... ...........
radiopharm(s).
79999... S Nuclear medicine 791 16.26 $859.96 $562.06 $171.99
therapy.
80049... A Metabolic panel, basic. ......... ......... ......... ........... ...........
80050... A General health panel... ......... ......... ......... ........... ...........
80051... A Electrolyte panel...... ......... ......... ......... ........... ...........
80054... A Comprehen metabolic ......... ......... ......... ........... ...........
panel.
80055... A Obstetric panel........ ......... ......... ......... ........... ...........
80058... A Hepatic function panel. ......... ......... ......... ........... ...........
80059... A Hepatitis panel........ ......... ......... ......... ........... ...........
80061... A Lipid panel............ ......... ......... ......... ........... ...........
80072... A Arthritis panel........ ......... ......... ......... ........... ...........
80090... A Torch antibody panel... ......... ......... ......... ........... ...........
80091... A Thyroid panel.......... ......... ......... ......... ........... ...........
80092... A Thyroid panel w/TSH.... ......... ......... ......... ........... ...........
80100... A Drug screen............ ......... ......... ......... ........... ...........
80101... A Drug screen............ ......... ......... ......... ........... ...........
80102... A Drug confirmation...... ......... ......... ......... ........... ...........
80103... N Drug analysis, tissue ......... ......... ......... ........... ...........
prep.
80150... A Assay of amikacin...... ......... ......... ......... ........... ...........
80152... A Assay of amitriptyline. ......... ......... ......... ........... ...........
80154... A Assay of ......... ......... ......... ........... ...........
benzodiazepines.
80156... A Assay carbamazepine.... ......... ......... ......... ........... ...........
80158... A Assay of cyclosporine.. ......... ......... ......... ........... ...........
80160... A Assay of desipramine... ......... ......... ......... ........... ...........
80162... A Assay for digoxin...... ......... ......... ......... ........... ...........
80164... A Assay, dipropylacetic ......... ......... ......... ........... ...........
acid.
80166... A Assay of doxepin....... ......... ......... ......... ........... ...........
80168... A Assay of ethosuximide.. ......... ......... ......... ........... ...........
80170... A Gentamicin............. ......... ......... ......... ........... ...........
80172... A Assay for gold......... ......... ......... ......... ........... ...........
80174... A Assay of imipramine.... ......... ......... ......... ........... ...........
80176... A Assay for lidocaine.... ......... ......... ......... ........... ...........
80178... A Assay for lithium...... ......... ......... ......... ........... ...........
80182... A Assay for nortriptyline ......... ......... ......... ........... ...........
80184... A Assay for phenobarbital ......... ......... ......... ........... ...........
80185... A Assay for phenytoin.... ......... ......... ......... ........... ...........
[[Page 47698]]
80186... A Assay for phenytoin, ......... ......... ......... ........... ...........
free.
80188... A Assay for primidone.... ......... ......... ......... ........... ...........
80190... A Assay for procainamide. ......... ......... ......... ........... ...........
80192... A Assay for procainamide. ......... ......... ......... ........... ...........
80194... A Assay for quinidine.... ......... ......... ......... ........... ...........
80196... A Assay for salicylate... ......... ......... ......... ........... ...........
80197... A Assay for tacrolimus... ......... ......... ......... ........... ...........
80198... A Assay for theophylline. ......... ......... ......... ........... ...........
80200... A Assay for tobramycin... ......... ......... ......... ........... ...........
80201... A Assay for topiramate... ......... ......... ......... ........... ...........
80202... A Assay for vancomycin... ......... ......... ......... ........... ...........
80299... A Quantitative assay, ......... ......... ......... ........... ...........
drug.
80400... A Acth stimulation panel. ......... ......... ......... ........... ...........
80402... A Acth stimulation panel. ......... ......... ......... ........... ...........
80406... A Acth stimulation panel. ......... ......... ......... ........... ...........
80408... A Aldosterone suppression ......... ......... ......... ........... ...........
eval.
80410... A Calcitonin stimul panel ......... ......... ......... ........... ...........
80412... A CRH stimulation panel.. ......... ......... ......... ........... ...........
80414... A Testosterone response.. ......... ......... ......... ........... ...........
80415... A Estradiol response ......... ......... ......... ........... ...........
panel.
80416... A Renin stimulation panel ......... ......... ......... ........... ...........
80417... A Renin stimulation panel ......... ......... ......... ........... ...........
80418... A Pituitary evaluation ......... ......... ......... ........... ...........
panel.
80420... A Dexamethasone panel.... ......... ......... ......... ........... ...........
80422... A Glucagon tolerance ......... ......... ......... ........... ...........
panel.
80424... A Glucagon tolerance ......... ......... ......... ........... ...........
panel.
80426... A Gonadotropin hormone ......... ......... ......... ........... ...........
panel.
80428... A Growth hormone panel... ......... ......... ......... ........... ...........
80430... A Growth hormone panel... ......... ......... ......... ........... ...........
80432... A Insulin suppression ......... ......... ......... ........... ...........
panel.
80434... A Insulin tolerance panel ......... ......... ......... ........... ...........
80435... A Insulin tolerance panel ......... ......... ......... ........... ...........
80436... A Metyrapone panel....... ......... ......... ......... ........... ...........
80438... A TRH stimulation panel.. ......... ......... ......... ........... ...........
80439... A TRH stimulation panel.. ......... ......... ......... ........... ...........
80440... A TRH stimulation panel.. ......... ......... ......... ........... ...........
80500... X Lab pathology 882 0.39 $20.57 $11.75 $4.11
consultation.
80502... X Lab pathology 882 0.39 $20.57 $11.75 $4.11
consultation.
81000... A Urinalysis, nonauto, w/ ......... ......... ......... ........... ...........
scope.
81001... A Urinalysis, auto, w/ ......... ......... ......... ........... ...........
scope.
81002... A Urinalysis nonauto w/o ......... ......... ......... ........... ...........
scope.
81003... A Urinalysis, auto, w/o ......... ......... ......... ........... ...........
scope.
81005... A Urinalysis............. ......... ......... ......... ........... ...........
81007... A Urine screen for ......... ......... ......... ........... ...........
bacteria.
81015... A Microscopic exam of ......... ......... ......... ........... ...........
urine.
81020... A Urinalysis, glass test. ......... ......... ......... ........... ...........
81025... A Urine pregnancy test... ......... ......... ......... ........... ...........
81050... A Urinalysis, volume ......... ......... ......... ........... ...........
measure.
81099... A Urinalysis test ......... ......... ......... ........... ...........
procedure.
82000... A Assay blood ......... ......... ......... ........... ...........
acetaldehyde.
82003... A Assay acetaminophen.... ......... ......... ......... ........... ...........
82009... A Test for acetone/ ......... ......... ......... ........... ...........
ketones.
82010... A Acetone assay.......... ......... ......... ......... ........... ...........
82013... A Acetylcholinester- ase ......... ......... ......... ........... ...........
assay.
82024... A ACTH................... ......... ......... ......... ........... ...........
82030... A ADP & AMP.............. ......... ......... ......... ........... ...........
82040... A Assay serum albumin.... ......... ......... ......... ........... ...........
82042... A Assay urine albumin.... ......... ......... ......... ........... ...........
82043... A Microalbumin, ......... ......... ......... ........... ...........
quantitative.
82044... A Microalbumin, semiquant ......... ......... ......... ........... ...........
82055... A Assay ethanol.......... ......... ......... ......... ........... ...........
82075... A Assay breath ethanol... ......... ......... ......... ........... ...........
82085... A Assay of aldolase...... ......... ......... ......... ........... ...........
82088... A Aldosterone............ ......... ......... ......... ........... ...........
82101... A Assay of urine ......... ......... ......... ........... ...........
alkaloids.
82103... A Alpha-1-antitrypsin, ......... ......... ......... ........... ...........
total.
82104... A Alpha-1-antitrypsin, ......... ......... ......... ........... ...........
pheno.
82105... A Alpha-fetoprotein, ......... ......... ......... ........... ...........
serum.
82106... A Alpha-fetoprotein; ......... ......... ......... ........... ...........
amniotic.
82108... A Assay, aluminum........ ......... ......... ......... ........... ...........
82128... A Test for amino acids... ......... ......... ......... ........... ...........
82130... A Amino acids analysis... ......... ......... ......... ........... ...........
82131... A Amino acids............ ......... ......... ......... ........... ...........
82135... A Assay, aminolevulinic ......... ......... ......... ........... ...........
acid.
82140... A Assay of ammonia....... ......... ......... ......... ........... ...........
[[Page 47699]]
82143... A Amniotic fluid scan.... ......... ......... ......... ........... ...........
82145... A Assay of amphetamines.. ......... ......... ......... ........... ...........
82150... A Assay of amylase....... ......... ......... ......... ........... ...........
82154... A Androstanediol ......... ......... ......... ........... ...........
glucuronide.
82157... A Assay of ......... ......... ......... ........... ...........
androstenedione.
82160... A Androsterone assay..... ......... ......... ......... ........... ...........
82163... A Assay of angiotensin II ......... ......... ......... ........... ...........
82164... A Angiotensin I enzyme ......... ......... ......... ........... ...........
test.
82172... A Apolipoprotein......... ......... ......... ......... ........... ...........
82175... A Assay of arsenic....... ......... ......... ......... ........... ...........
82180... A Assay of ascorbic acid. ......... ......... ......... ........... ...........
82190... A Atomic absorption...... ......... ......... ......... ........... ...........
82205... A Assay of barbiturates.. ......... ......... ......... ........... ...........
82232... A Beta-2 protein......... ......... ......... ......... ........... ...........
82239... A Bile acids, total...... ......... ......... ......... ........... ...........
82240... A Bile acids, ......... ......... ......... ........... ...........
cholylglycine.
82250... A Assay bilirubin........ ......... ......... ......... ........... ...........
82251... A Assay bilirubin........ ......... ......... ......... ........... ...........
82252... A Fecal bilirubin test... ......... ......... ......... ........... ...........
82270... A Test feces for blood... ......... ......... ......... ........... ...........
82273... A Test for blood, other ......... ......... ......... ........... ...........
source.
82286... A Assay of bradykinin.... ......... ......... ......... ........... ...........
82300... A Assay cadmium.......... ......... ......... ......... ........... ...........
82306... A Assay of vitamin D..... ......... ......... ......... ........... ...........
82307... A Assay of vitamin D..... ......... ......... ......... ........... ...........
82308... A Assay of calcitonin.... ......... ......... ......... ........... ...........
82310... A Assay calcium.......... ......... ......... ......... ........... ...........
82330... A Assay calcium.......... ......... ......... ......... ........... ...........
82331... A Calcium infusion test.. ......... ......... ......... ........... ...........
82340... A Assay calcium in urine. ......... ......... ......... ........... ...........
82355... A Calculus (stone) ......... ......... ......... ........... ...........
analysis.
82360... A Calculus (stone) assay. ......... ......... ......... ........... ...........
82365... A Calculus (stone) assay. ......... ......... ......... ........... ...........
82370... A X-ray assay, calculus ......... ......... ......... ........... ...........
(stone).
82374... A Assay blood carbon ......... ......... ......... ........... ...........
dioxide.
82375... A Assay blood carbon ......... ......... ......... ........... ...........
monoxide.
82376... A Test for carbon ......... ......... ......... ........... ...........
monoxide.
82378... A Carcinoembryonic ......... ......... ......... ........... ...........
antigen.
82380... A Assay carotene......... ......... ......... ......... ........... ...........
82382... A Assay urine ......... ......... ......... ........... ...........
catecholamines.
82383... A Assay blood ......... ......... ......... ........... ...........
catecholamines.
82384... A Assay three ......... ......... ......... ........... ...........
catecholamines.
82387... A Cathepsin-D............ ......... ......... ......... ........... ...........
82390... A Assay ceruloplasmin.... ......... ......... ......... ........... ...........
82397... A Chemiluminescent assay. ......... ......... ......... ........... ...........
82415... A Assay chloramphenicol.. ......... ......... ......... ........... ...........
82435... A Assay blood chloride... ......... ......... ......... ........... ...........
82436... A Assay urine chloride... ......... ......... ......... ........... ...........
82438... A Assay other fluid ......... ......... ......... ........... ...........
chlorides.
82441... A Test for ......... ......... ......... ........... ...........
chlorohydrocarbons.
82465... A Assay serum cholesterol ......... ......... ......... ........... ...........
82480... A Assay serum ......... ......... ......... ........... ...........
cholinesterase.
82482... A Assay rbc ......... ......... ......... ........... ...........
cholinesterase.
82485... A Assay chondroitin ......... ......... ......... ........... ...........
sulfate.
82486... A Gas/liquid ......... ......... ......... ........... ...........
chromatography.
82487... A Paper chromatography... ......... ......... ......... ........... ...........
82488... A Paper chromatography... ......... ......... ......... ........... ...........
82489... A Thin layer ......... ......... ......... ........... ...........
chromatography.
82491... A Chromotography, ......... ......... ......... ........... ...........
quantitative.
82495... A Assay chromium......... ......... ......... ......... ........... ...........
82507... A Assay citrate.......... ......... ......... ......... ........... ...........
82520... A Assay for cocaine...... ......... ......... ......... ........... ...........
82523... A Collagen crosslinks.... ......... ......... ......... ........... ...........
82525... A Assay copper........... ......... ......... ......... ........... ...........
82528... A Assay corticosterone... ......... ......... ......... ........... ...........
82530... A Cortisol, free......... ......... ......... ......... ........... ...........
82533... A Total cortisol......... ......... ......... ......... ........... ...........
82540... A Assay creatine......... ......... ......... ......... ........... ...........
82550... A Assay CK (CPK)......... ......... ......... ......... ........... ...........
82552... A Assay CPK in blood..... ......... ......... ......... ........... ...........
82553... A Creatine, MB fraction.. ......... ......... ......... ........... ...........
82554... A Creatine, isoforms..... ......... ......... ......... ........... ...........
82565... A Assay creatinine....... ......... ......... ......... ........... ...........
82570... A Assay urine creatinine. ......... ......... ......... ........... ...........
82575... A Creatinine clearance ......... ......... ......... ........... ...........
test.
[[Page 47700]]
82585... A Assay cryofibrinogen... ......... ......... ......... ........... ...........
82595... A Assay cryoglobulin..... ......... ......... ......... ........... ...........
82600... A Assay cyanide.......... ......... ......... ......... ........... ...........
82607... A Vitamin B-12........... ......... ......... ......... ........... ...........
82608... A B-12 binding capacity.. ......... ......... ......... ........... ...........
82615... A Test for urine cystines ......... ......... ......... ........... ...........
82626... A Dehydroepiandrosterone. ......... ......... ......... ........... ...........
82627... A Dehydroepiandrosterone. ......... ......... ......... ........... ...........
82633... A Desoxycorticoster one. ......... ......... ......... ........... ...........
82634... A Deoxycortisol.......... ......... ......... ......... ........... ...........
82638... A Assay dibucaine number. ......... ......... ......... ........... ...........
82646... A Assay of ......... ......... ......... ........... ...........
dihydrocodeinone.
82649... A Assay of dihydromorphin ......... ......... ......... ........... ...........
one.
82651... A Dihydrotestosterone ......... ......... ......... ........... ...........
assay.
82652... A Assay, dihydroxyvitamin ......... ......... ......... ........... ...........
D.
82654... A Assay of dimethadione.. ......... ......... ......... ........... ...........
82664... A Electrophoretic test... ......... ......... ......... ........... ...........
82666... A Epiandrosterone assay.. ......... ......... ......... ........... ...........
82668... A Erythropoietin......... ......... ......... ......... ........... ...........
82670... A Estradiol.............. ......... ......... ......... ........... ...........
82671... A Estrogens assay........ ......... ......... ......... ........... ...........
82672... A Estrogen assay......... ......... ......... ......... ........... ...........
82677... A Estriol................ ......... ......... ......... ........... ...........
82679... A Estrone................ ......... ......... ......... ........... ...........
82690... A Ethchlorvynol.......... ......... ......... ......... ........... ...........
82693... A Ethylene glycol........ ......... ......... ......... ........... ...........
82696... A Etiocholanolone........ ......... ......... ......... ........... ...........
82705... A Fats/lipids, feces, ......... ......... ......... ........... ...........
qualitative.
82710... A Fats/lipids, feces, ......... ......... ......... ........... ...........
quantitative.
82715... A Fecal fat assay........ ......... ......... ......... ........... ...........
82725... A Assay blood fatty acids ......... ......... ......... ........... ...........
82728... A Assay ferritin......... ......... ......... ......... ........... ...........
82735... A Assay fluoride......... ......... ......... ......... ........... ...........
82742... A Assay of flurazepam.... ......... ......... ......... ........... ...........
82746... A Blood folic acid serum. ......... ......... ......... ........... ...........
82747... A Folic acid, RBC........ ......... ......... ......... ........... ...........
82757... A Assay semen fructose... ......... ......... ......... ........... ...........
82759... A RBC galactokinase assay ......... ......... ......... ........... ...........
82760... A Assay galactose........ ......... ......... ......... ........... ...........
82775... A Assay galactose ......... ......... ......... ........... ...........
transferase.
82776... A Galactose transferase ......... ......... ......... ........... ...........
test.
82784... A Assay gammaglobulin IgM ......... ......... ......... ........... ...........
82785... A Assay, gammaglobulin ......... ......... ......... ........... ...........
IgE.
82787... A IgG1, 2, 3 and 4....... ......... ......... ......... ........... ...........
82800... A Blood pH............... ......... ......... ......... ........... ...........
82803... A Blood gases: pH, pO2 & ......... ......... ......... ........... ...........
pCO2.
82805... A Blood gases W/02 ......... ......... ......... ........... ...........
saturation.
82810... A Blood gases, O2 sat ......... ......... ......... ........... ...........
only.
82820... A Hemoglobin-oxygen ......... ......... ......... ........... ...........
affinity.
82926... A Assay gastric acid..... ......... ......... ......... ........... ...........
82928... A Assay gastric acid..... ......... ......... ......... ........... ...........
82938... A Gastrin test........... ......... ......... ......... ........... ...........
82941... A Assay of gastrin....... ......... ......... ......... ........... ...........
82943... A Assay of glucagon...... ......... ......... ......... ........... ...........
82946... A Glucagon tolerance test ......... ......... ......... ........... ...........
82947... A Assay quantitative, ......... ......... ......... ........... ...........
glucose.
82948... A Reagent strip/blood ......... ......... ......... ........... ...........
glucose.
82950... A Glucose test........... ......... ......... ......... ........... ...........
82951... A Glucose tolerance test ......... ......... ......... ........... ...........
(GTT).
82952... A GTT-added samples...... ......... ......... ......... ........... ...........
82953... A Glucose-tolbutamide ......... ......... ......... ........... ...........
test.
82955... A Assay G6PD enzyme...... ......... ......... ......... ........... ...........
82960... A Test for G6PD enzyme... ......... ......... ......... ........... ...........
82962... A Glucose blood test..... ......... ......... ......... ........... ...........
82963... A Glucosidase assay...... ......... ......... ......... ........... ...........
82965... A Assay GDH enzyme....... ......... ......... ......... ........... ...........
82975... A Assay glutamine........ ......... ......... ......... ........... ...........
82977... A Assay of GGT........... ......... ......... ......... ........... ...........
82978... A Glutathione assay...... ......... ......... ......... ........... ...........
82979... A Assay RBC glutathione ......... ......... ......... ........... ...........
enzyme.
82980... A Assay of glutethimide.. ......... ......... ......... ........... ...........
82985... A Glycated protein....... ......... ......... ......... ........... ...........
83001... A Gonadotropin (FSH)..... ......... ......... ......... ........... ...........
83002... A Gonadotropin (LH)...... ......... ......... ......... ........... ...........
83003... A Assay growth hormone ......... ......... ......... ........... ...........
(HGH).
[[Page 47701]]
83008... A Assay guanosine........ ......... ......... ......... ........... ...........
83010... A Quant assay haptoglobin ......... ......... ......... ........... ...........
83012... A Assay haptoglobins..... ......... ......... ......... ........... ...........
83015... A Heavy metal screen..... ......... ......... ......... ........... ...........
83018... A Quantitative screen, ......... ......... ......... ........... ...........
metals.
83019... A Breath isotope test.... ......... ......... ......... ........... ...........
83020... A Assay hemoglobin....... ......... ......... ......... ........... ...........
83026... A Hemoglobin, copper ......... ......... ......... ........... ...........
sulfate.
83030... A Fetal hemoglobin assay. ......... ......... ......... ........... ...........
83033... A Fetal fecal hemoglobin ......... ......... ......... ........... ...........
assay.
83036... A Glycated hemoglobin ......... ......... ......... ........... ...........
test.
83045... A Blood methemoglobin ......... ......... ......... ........... ...........
test.
83050... A Blood methemoglobin ......... ......... ......... ........... ...........
assay.
83051... A Assay plasma hemoglobin ......... ......... ......... ........... ...........
83055... A Blood sulfhemoglobin ......... ......... ......... ........... ...........
test.
83060... A Blood sulfhemoglobin ......... ......... ......... ........... ...........
assay.
83065... A Hemoglobin heat assay.. ......... ......... ......... ........... ...........
83068... A Hemoglobin stability ......... ......... ......... ........... ...........
screen.
83069... A Assay urine hemoglobin. ......... ......... ......... ........... ...........
83070... A Qualt assay hemosiderin ......... ......... ......... ........... ...........
83071... A Quant assay of ......... ......... ......... ........... ...........
hemosiderin.
83088... A Assay histamine........ ......... ......... ......... ........... ...........
83150... A Assay for HVA.......... ......... ......... ......... ........... ...........
83491... A Assay of ......... ......... ......... ........... ...........
corticosteroids.
83497... A Assay 5-HIAA........... ......... ......... ......... ........... ...........
83498... A Assay of progesterone.. ......... ......... ......... ........... ...........
83499... A Assay of progesterone.. ......... ......... ......... ........... ...........
83500... A Assay free ......... ......... ......... ........... ...........
hydroxyproline.
83505... A Assay total ......... ......... ......... ........... ...........
hydroxyproline.
83516... A Immunoassay, non ......... ......... ......... ........... ...........
antibody.
83518... A Immunoassay, dipstick.. ......... ......... ......... ........... ...........
83519... A Immunoassay nonantibody ......... ......... ......... ........... ...........
83520... A Immunoassay, RIA....... ......... ......... ......... ........... ...........
83525... A Assay of insulin....... ......... ......... ......... ........... ...........
83527... A Assay of insulin....... ......... ......... ......... ........... ...........
83528... A Assay intrinsic factor. ......... ......... ......... ........... ...........
83540... A Assay iron............. ......... ......... ......... ........... ...........
83550... A Iron binding test...... ......... ......... ......... ........... ...........
83570... A Assay IDH enzyme....... ......... ......... ......... ........... ...........
83582... A Assay ketogenic ......... ......... ......... ........... ...........
steroids.
83586... A Assay 17-(17- ......... ......... ......... ........... ...........
KS)ketosteroids.
83593... A Fractionation ......... ......... ......... ........... ...........
ketosteroids.
83605... A Lactic acid assay...... ......... ......... ......... ........... ...........
83615... A Lactate (LD) (LDH) ......... ......... ......... ........... ...........
enzyme.
83625... A Assay LDH enzymes...... ......... ......... ......... ........... ...........
83632... A Placental lactogen..... ......... ......... ......... ........... ...........
83633... A Test urine for lactose. ......... ......... ......... ........... ...........
83634... A Assay urine for lactose ......... ......... ......... ........... ...........
83655... A Assay for lead......... ......... ......... ......... ........... ...........
83661... A Assay L/S ratio........ ......... ......... ......... ........... ...........
83662... A L/S ratio, foam ......... ......... ......... ........... ...........
stability.
83670... A Assay LAP enzyme....... ......... ......... ......... ........... ...........
83690... A Assay lipase........... ......... ......... ......... ........... ...........
83715... A Assay blood ......... ......... ......... ........... ...........
lipoproteins.
83717... A Assay blood ......... ......... ......... ........... ...........
lipoproteins.
83718... A Blood lipoprotein assay ......... ......... ......... ........... ...........
83719... A Blood lipoprotein assay ......... ......... ......... ........... ...........
83721... A Blood lipoprotein assay ......... ......... ......... ........... ...........
83727... A LRH hormone assay...... ......... ......... ......... ........... ...........
83735... A Assay magnesium........ ......... ......... ......... ........... ...........
83775... A Assay of md enzyme..... ......... ......... ......... ........... ...........
83785... A Assay of manganese..... ......... ......... ......... ........... ...........
83805... A Assay of meprobamate... ......... ......... ......... ........... ...........
83825... A Assay mercury.......... ......... ......... ......... ........... ...........
83835... A Assay metanephrines.... ......... ......... ......... ........... ...........
83840... A Assay methadone........ ......... ......... ......... ........... ...........
83857... A Assay methemalbumin.... ......... ......... ......... ........... ...........
83858... A Assay methsuximide..... ......... ......... ......... ........... ...........
83864... A Mucopolysaccharides.... ......... ......... ......... ........... ...........
83866... A Mucopolysaccharides ......... ......... ......... ........... ...........
screen.
83872... A Assay synovial fluid ......... ......... ......... ........... ...........
mucin.
83873... A Assay, CSF protein..... ......... ......... ......... ........... ...........
83874... A Myoglobin.............. ......... ......... ......... ........... ...........
83883... A Nephelometry, not ......... ......... ......... ........... ...........
specified.
83885... A Assay for nickel....... ......... ......... ......... ........... ...........
[[Page 47702]]
83887... A Assay nicotine......... ......... ......... ......... ........... ...........
83890... A Molecular diagnostics.. ......... ......... ......... ........... ...........
83892... A Molecular diagnostics.. ......... ......... ......... ........... ...........
83894... A Molecular diagnostics.. ......... ......... ......... ........... ...........
83896... A Molecular diagnostics.. ......... ......... ......... ........... ...........
83898... A Molecular diagnostics.. ......... ......... ......... ........... ...........
83902... A Molecular diagnostics.. ......... ......... ......... ........... ...........
83912... A Genetic examination.... ......... ......... ......... ........... ...........
83915... A Assay nucleotidase..... ......... ......... ......... ........... ...........
83916... A Oligoclonal bands...... ......... ......... ......... ........... ...........
83918... A Assay organic acids.... ......... ......... ......... ........... ...........
83925... A Opiates................ ......... ......... ......... ........... ...........
83930... A Assay blood osmolality. ......... ......... ......... ........... ...........
83935... A Assay urine osmolality. ......... ......... ......... ........... ...........
83937... A Assay for osteocalcin.. ......... ......... ......... ........... ...........
83945... A Assay oxalate.......... ......... ......... ......... ........... ...........
83970... A Assay of parathormone.. ......... ......... ......... ........... ...........
83986... A Assay body fluid ......... ......... ......... ........... ...........
acidity.
83992... A Assay for phencyclidine ......... ......... ......... ........... ...........
84022... A Assay of phenothiazine. ......... ......... ......... ........... ...........
84030... A Assay blood PKU........ ......... ......... ......... ........... ...........
84035... A Assay phenylketones.... ......... ......... ......... ........... ...........
84060... A Assay acid phosphatase. ......... ......... ......... ........... ...........
84061... A Phosphatase, forensic ......... ......... ......... ........... ...........
exam.
84066... A Assay prostate ......... ......... ......... ........... ...........
phosphatase.
84075... A Assay alkaline ......... ......... ......... ........... ...........
phosphatase.
84078... A Assay alkaline ......... ......... ......... ........... ...........
phosphatase.
84080... A Assay alkaline ......... ......... ......... ........... ...........
phosphatases.
84081... A Amniotic fluid enzyme ......... ......... ......... ........... ...........
test.
84085... A Assay RBC PG6D enzyme.. ......... ......... ......... ........... ...........
84087... A Assay phosphohexose ......... ......... ......... ........... ...........
enzymes.
84100... A Assay phosphorus....... ......... ......... ......... ........... ...........
84105... A Assay urine phosphorus. ......... ......... ......... ........... ...........
84106... A Test for ......... ......... ......... ........... ...........
porphobilinogen.
84110... A Assay porphobilinogen.. ......... ......... ......... ........... ...........
84119... A Test urine for ......... ......... ......... ........... ...........
porphyrins.
84120... A Assay urine porphyrins. ......... ......... ......... ........... ...........
84126... A Assay feces porphyrins. ......... ......... ......... ........... ...........
84127... A Porphyrins, feces...... ......... ......... ......... ........... ...........
84132... A Assay serum potassium.. ......... ......... ......... ........... ...........
84133... A Assay urine potassium.. ......... ......... ......... ........... ...........
84134... A Prealbumin............. ......... ......... ......... ........... ...........
84135... A Assay pregnanediol..... ......... ......... ......... ........... ...........
84138... A Assay pregnanetriol.... ......... ......... ......... ........... ...........
84140... A Assay for pregnenolone. ......... ......... ......... ........... ...........
84143... A Assay/17- ......... ......... ......... ........... ...........
hydroxypregnenolone.
84144... A Assay progesterone..... ......... ......... ......... ........... ...........
84146... A Assay for prolactin.... ......... ......... ......... ........... ...........
84150... A Assay of prostaglandin. ......... ......... ......... ........... ...........
84153... A Prostate specific ......... ......... ......... ........... ...........
antigen.
84155... A Assay protein.......... ......... ......... ......... ........... ...........
84160... A Assay serum protein.... ......... ......... ......... ........... ...........
84165... A Assay serum proteins... ......... ......... ......... ........... ...........
84181... A Western blot test...... ......... ......... ......... ........... ...........
84182... A Protein, western blot ......... ......... ......... ........... ...........
test.
84202... A Assay RBC ......... ......... ......... ........... ...........
protoporphyrin.
84203... A Test RBC protoporphyrin ......... ......... ......... ........... ...........
84206... A Assay of proinsulin.... ......... ......... ......... ........... ...........
84207... A Assay vitamin B-6...... ......... ......... ......... ........... ...........
84210... A Assay pyruvate......... ......... ......... ......... ........... ...........
84220... A Assay pyruvate kinase.. ......... ......... ......... ........... ...........
84228... A Assay quinine.......... ......... ......... ......... ........... ...........
84233... A Assay estrogen......... ......... ......... ......... ........... ...........
84234... A Assay progesterone..... ......... ......... ......... ........... ...........
84235... A Assay endocrine hormone ......... ......... ......... ........... ...........
84238... A Assay non-endocrine ......... ......... ......... ........... ...........
receptor.
84244... A Assay of renin......... ......... ......... ......... ........... ...........
84252... A Assay vitamin B-2...... ......... ......... ......... ........... ...........
84255... A Assay selenium......... ......... ......... ......... ........... ...........
84260... A Assay serotonin........ ......... ......... ......... ........... ...........
84270... A Sex hormone globulin ......... ......... ......... ........... ...........
(SHBG).
84275... A Assay sialic acid...... ......... ......... ......... ........... ...........
84285... A Assay silica........... ......... ......... ......... ........... ...........
84295... A Assay serum sodium..... ......... ......... ......... ........... ...........
84300... A Assay urine sodium..... ......... ......... ......... ........... ...........
[[Page 47703]]
84305... A Somatomedin............ ......... ......... ......... ........... ...........
84307... A Somatostatin........... ......... ......... ......... ........... ...........
84311... A Spectrophotometry...... ......... ......... ......... ........... ...........
84315... A Body fluid specific ......... ......... ......... ........... ...........
gravity.
84375... A Chromatogram assay, ......... ......... ......... ........... ...........
sugars.
84392... A Assay urine sulfate.... ......... ......... ......... ........... ...........
84402... A Testosterone........... ......... ......... ......... ........... ...........
84403... A Assay total ......... ......... ......... ........... ...........
testosterone.
84425... A Assay vitamin B-1...... ......... ......... ......... ........... ...........
84430... A Assay thiocyanate...... ......... ......... ......... ........... ...........
84432... A Thyroglobulin.......... ......... ......... ......... ........... ...........
84436... A Assay, total thyroxine. ......... ......... ......... ........... ...........
84437... A Assay neonatal ......... ......... ......... ........... ...........
thyroxine.
84439... A Assay, free thyroxine.. ......... ......... ......... ........... ...........
84442... A Thyroid activity (TBG) ......... ......... ......... ........... ...........
assay.
84443... A Assay thyroid stim ......... ......... ......... ........... ...........
hormone.
84445... A Thyroid immunoglobulins ......... ......... ......... ........... ...........
TSI.
84446... A Assay vitamin E........ ......... ......... ......... ........... ...........
84449... A Assay for transcortin.. ......... ......... ......... ........... ...........
84450... A Transferase (AST) ......... ......... ......... ........... ...........
(SGOT).
84460... A Alanine amino (ALT) ......... ......... ......... ........... ...........
(SGPT).
84466... A Transferrin............ ......... ......... ......... ........... ...........
84478... A Assay triglycerides.... ......... ......... ......... ........... ...........
84479... A Assay thyroid (t-3 or t- ......... ......... ......... ........... ...........
4).
84480... A Assay triiodothyronine ......... ......... ......... ........... ...........
(t-3).
84481... A Free assay (FT-3)...... ......... ......... ......... ........... ...........
84482... A T3 reverse............. ......... ......... ......... ........... ...........
84484... A Troponin, quant........ ......... ......... ......... ........... ...........
84485... A Assay duodenal fluid ......... ......... ......... ........... ...........
trypsin.
84488... A Test feces for trypsin. ......... ......... ......... ........... ...........
84490... A Assay feces for trypsin ......... ......... ......... ........... ...........
84510... A Assay tyrosine......... ......... ......... ......... ........... ...........
84512... A Troponin, qual......... ......... ......... ......... ........... ...........
84520... A Assay urea nitrogen.... ......... ......... ......... ........... ...........
84525... A Urea nitrogen semi- ......... ......... ......... ........... ...........
quant.
84540... A Assay urine urea-N..... ......... ......... ......... ........... ...........
84545... A Urea-N clearance test.. ......... ......... ......... ........... ...........
84550... A Assay blood uric acid.. ......... ......... ......... ........... ...........
84560... A Assay urine uric acid.. ......... ......... ......... ........... ...........
84577... A Assay feces ......... ......... ......... ........... ...........
urobilinogen.
84578... A Test urine urobilinogen ......... ......... ......... ........... ...........
84580... A Assay urine ......... ......... ......... ........... ...........
urobilinogen.
84583... A Assay urine ......... ......... ......... ........... ...........
urobilinogen.
84585... A Assay urine VMA........ ......... ......... ......... ........... ...........
84586... A VIP assay.............. ......... ......... ......... ........... ...........
84588... A Assay vasopressin...... ......... ......... ......... ........... ...........
84590... A Assay vitamin-A........ ......... ......... ......... ........... ...........
84597... A Assay vitamin-K........ ......... ......... ......... ........... ...........
84600... A Assay for volatiles.... ......... ......... ......... ........... ...........
84620... A Xylose tolerance test.. ......... ......... ......... ........... ...........
84630... A Assay zinc............. ......... ......... ......... ........... ...........
84681... A Assay C-peptide........ ......... ......... ......... ........... ...........
84702... A Chorionic gonadotropin ......... ......... ......... ........... ...........
test.
84703... A Chorionic gonadotropin ......... ......... ......... ........... ...........
assay.
84830... A Ovulation tests........ ......... ......... ......... ........... ...........
84999... A Clinical chemistry test ......... ......... ......... ........... ...........
85002... A Bleeding time test..... ......... ......... ......... ........... ...........
85007... A Differential WBC count. ......... ......... ......... ........... ...........
85008... A Nondifferential WBC ......... ......... ......... ........... ...........
count.
85009... A Differential WBC count. ......... ......... ......... ........... ...........
85013... A Hematocrit............. ......... ......... ......... ........... ...........
85014... A Hematocrit............. ......... ......... ......... ........... ...........
85018... A Hemoglobin............. ......... ......... ......... ........... ...........
85021... A Automated hemogram..... ......... ......... ......... ........... ...........
85022... A Automated hemogram..... ......... ......... ......... ........... ...........
85023... A Automated hemogram..... ......... ......... ......... ........... ...........
85024... A Automated hemogram..... ......... ......... ......... ........... ...........
85025... A Automated hemogram..... ......... ......... ......... ........... ...........
85027... A Automated hemogram..... ......... ......... ......... ........... ...........
85029... A Automated hemogram..... ......... ......... ......... ........... ...........
85030... A Automated hemogram..... ......... ......... ......... ........... ...........
85031... A Manual hemogram, ......... ......... ......... ........... ...........
complete cbc.
85041... A Red blood cell (RBC) ......... ......... ......... ........... ...........
count.
85044... A Reticulocyte count..... ......... ......... ......... ........... ...........
85045... A Reticulocyte count..... ......... ......... ......... ........... ...........
[[Page 47704]]
85048... A White blood cell (WBC) ......... ......... ......... ........... ...........
count.
85060... X Blood smear 882 0.39 $20.57 $11.75 $4.11
interpretation.
85095... T Bone marrow aspiration. 121 0.67 $35.26 $21.02 $7.05
85097... X Bone marrow 882 0.39 $20.57 $11.75 $4.11
interpretation.
85102... T Bone marrow biopsy..... 121 0.67 $35.26 $21.02 $7.05
85130... A Chromogenic substrate ......... ......... ......... ........... ...........
assay.
85170... A Blood clot retraction.. ......... ......... ......... ........... ...........
85175... A Blood clot lysis time.. ......... ......... ......... ........... ...........
85210... A Blood clot factor II ......... ......... ......... ........... ...........
test.
85220... A Blood clot factor V ......... ......... ......... ........... ...........
test.
85230... A Blood clot factor VII ......... ......... ......... ........... ...........
test.
85240... A Blood clot factor VIII ......... ......... ......... ........... ...........
test.
85244... A Blood clot factor VIII ......... ......... ......... ........... ...........
test.
85245... A Blood clot factor VIII ......... ......... ......... ........... ...........
test.
85246... A Blood clot factor VIII ......... ......... ......... ........... ...........
test.
85247... A Blood clot factor VIII ......... ......... ......... ........... ...........
test.
85250... A Blood clot factor IX ......... ......... ......... ........... ...........
test.
85260... A Blood clot factor X ......... ......... ......... ........... ...........
test.
85270... A Blood clot factor XI ......... ......... ......... ........... ...........
test.
85280... A Blood clot factor XII ......... ......... ......... ........... ...........
test.
85290... A Blood clot factor XIII ......... ......... ......... ........... ...........
test.
85291... A Blood clot factor XIII ......... ......... ......... ........... ...........
test.
85292... A Blood clot factor assay ......... ......... ......... ........... ...........
85293... A Blood clot factor assay ......... ......... ......... ........... ...........
85300... A Antithrombin III test.. ......... ......... ......... ........... ...........
85301... A Antithrombin III test.. ......... ......... ......... ........... ...........
85302... A Blood clot inhibitor ......... ......... ......... ........... ...........
antigen.
85303... A Blood clot inhibitor ......... ......... ......... ........... ...........
test.
85305... A Blood clot inhibitor ......... ......... ......... ........... ...........
assay.
85306... A Blood clot inhibitor ......... ......... ......... ........... ...........
test.
85335... A Factor inhibitor test.. ......... ......... ......... ........... ...........
85337... A Thrombomodulin......... ......... ......... ......... ........... ...........
85345... A Coagulation time....... ......... ......... ......... ........... ...........
85347... A Coagulation time....... ......... ......... ......... ........... ...........
85348... A Coagulation time....... ......... ......... ......... ........... ...........
85360... A Euglobulin lysis....... ......... ......... ......... ........... ...........
85362... A Fibrin degradation ......... ......... ......... ........... ...........
products.
85366... A Fibrinogen test........ ......... ......... ......... ........... ...........
85370... A Fibrinogen test........ ......... ......... ......... ........... ...........
85378... A Fibrin degradation..... ......... ......... ......... ........... ...........
85379... A Fibrin degradation..... ......... ......... ......... ........... ...........
85384... A Fibrinogen............. ......... ......... ......... ........... ...........
85385... A Fibrinogen............. ......... ......... ......... ........... ...........
85390... A Fibrinolysins screen... ......... ......... ......... ........... ...........
85400... A Fibrinolytic plasmin... ......... ......... ......... ........... ...........
85410... A Fibrinolytic ......... ......... ......... ........... ...........
antiplasmin.
85415... A Fibrinolytic ......... ......... ......... ........... ...........
plasminogen.
85420... A Fibrinolytic ......... ......... ......... ........... ...........
plasminogen.
85421... A Fibrinolytic ......... ......... ......... ........... ...........
plasminogen.
85441... A Heinz bodies; direct... ......... ......... ......... ........... ...........
85445... A Heinz bodies; induced.. ......... ......... ......... ........... ...........
85460... A Hemoglobin, fetal...... ......... ......... ......... ........... ...........
85461... A Hemoglobin, fetal...... ......... ......... ......... ........... ...........
85475... A Hemolysin.............. ......... ......... ......... ........... ...........
85520... A Heparin assay.......... ......... ......... ......... ........... ...........
85525... A Heparin................ ......... ......... ......... ........... ...........
85530... A Heparin-protamine ......... ......... ......... ........... ...........
tolerance.
85535... A Iron stain, blood cells ......... ......... ......... ........... ...........
85540... A Wbc alkaline ......... ......... ......... ........... ...........
phosphatase.
85547... A RBC mechanical ......... ......... ......... ........... ...........
fragility.
85549... A Muramidase............. ......... ......... ......... ........... ...........
85555... A RBC osmotic fragility.. ......... ......... ......... ........... ...........
85557... A RBC osmotic fragility.. ......... ......... ......... ........... ...........
85576... A Blood platelet ......... ......... ......... ........... ...........
aggregation.
85585... A Blood platelet ......... ......... ......... ........... ...........
estimation.
85590... A Platelet manual count.. ......... ......... ......... ........... ...........
85595... A Platelet count, ......... ......... ......... ........... ...........
automated.
85597... A Platelet neutralization ......... ......... ......... ........... ...........
85610... A Prothrombin time....... ......... ......... ......... ........... ...........
85611... A Prothrombin test....... ......... ......... ......... ........... ...........
85612... A Viper venom prothrombin ......... ......... ......... ........... ...........
time.
85613... A Russell viper venom, ......... ......... ......... ........... ...........
diluted.
85635... A Reptilase test......... ......... ......... ......... ........... ...........
85651... A Rbc sed rate, nonauto.. ......... ......... ......... ........... ...........
85652... A Rbc sed rate, auto..... ......... ......... ......... ........... ...........
[[Page 47705]]
85660... A RBC sickle cell test... ......... ......... ......... ........... ...........
85670... A Thrombin time, plasma.. ......... ......... ......... ........... ...........
85675... A Thrombin time, titer... ......... ......... ......... ........... ...........
85705... A Thromboplastin ......... ......... ......... ........... ...........
inhibition.
85730... A Thromboplastin time, ......... ......... ......... ........... ...........
partial.
85732... A Thromboplastin time, ......... ......... ......... ........... ...........
partial.
85810... A Blood viscosity ......... ......... ......... ........... ...........
examination.
85999... A Hematology procedure... ......... ......... ......... ........... ...........
86000... A Agglutinins; febrile... ......... ......... ......... ........... ...........
86003... A Allergen specific IgE.. ......... ......... ......... ........... ...........
86005... A Allergen specific IgE.. ......... ......... ......... ........... ...........
86021... A WBC antibody ......... ......... ......... ........... ...........
identification.
86022... A Platelet antibodies.... ......... ......... ......... ........... ...........
86023... A Immunoglobulin assay... ......... ......... ......... ........... ...........
86038... A Antinuclear antibodies. ......... ......... ......... ........... ...........
86039... A Antinuclear antibodies ......... ......... ......... ........... ...........
(ANA).
86060... A Antistreptolysin O ......... ......... ......... ........... ...........
titer.
86063... A Antistreptolysin O ......... ......... ......... ........... ...........
screen.
86077... X Physician blood bank 882 0.39 $20.57 $11.75 $4.11
service.
86078... X Physician blood bank 882 0.39 $20.57 $11.75 $4.11
service.
86079... X Physician blood bank 882 0.39 $20.57 $11.75 $4.11
service.
86140... A C-reactive protein..... ......... ......... ......... ........... ...........
86147... A Cardiolipin antibody... ......... ......... ......... ........... ...........
86148... A Phospholipid antibody.. ......... ......... ......... ........... ...........
86155... A Chemotaxis assay....... ......... ......... ......... ........... ...........
86156... A Cold agglutinin screen. ......... ......... ......... ........... ...........
86157... A Cold agglutinin, titer. ......... ......... ......... ........... ...........
86160... A Complement, antigen.... ......... ......... ......... ........... ...........
86161... A Complement/function ......... ......... ......... ........... ...........
activity.
86162... A Complement, total ......... ......... ......... ........... ...........
(CH50).
86171... A Complement fixation, ......... ......... ......... ........... ...........
each.
86185... A Counterimmunoelectropho ......... ......... ......... ........... ...........
resis.
86215... A Deoxyribonuclease, ......... ......... ......... ........... ...........
antibody.
86225... A DNA antibody........... ......... ......... ......... ........... ...........
86226... A DNA antibody, single ......... ......... ......... ........... ...........
strand.
86235... A Nuclear antigen ......... ......... ......... ........... ...........
antibody.
86243... A Fc receptor............ ......... ......... ......... ........... ...........
86255... A Fluorescent antibody; ......... ......... ......... ........... ...........
screen.
86256... A Fluorescent antibody; ......... ......... ......... ........... ...........
titer.
86277... A Growth hormone antibody ......... ......... ......... ........... ...........
86280... A Hemagglutination ......... ......... ......... ........... ...........
inhibition.
86308... A Heterophile antibodies. ......... ......... ......... ........... ...........
86309... A Heterophile antibodies. ......... ......... ......... ........... ...........
86310... A Heterophile antibodies. ......... ......... ......... ........... ...........
86316... A Immunoassay, tumor ......... ......... ......... ........... ...........
antigen.
86317... A Immunoassay, infectious ......... ......... ......... ........... ...........
agent.
86318... A Immunoassay, infectious ......... ......... ......... ........... ...........
agent.
86320... A Serum ......... ......... ......... ........... ...........
immunoelectrophoresis.
86325... A Other ......... ......... ......... ........... ...........
immunoelectrophoresis.
86327... A Immunoelectrophoresis ......... ......... ......... ........... ...........
assay.
86329... A Immunodiffusion........ ......... ......... ......... ........... ...........
86331... A Immunodiffusion ......... ......... ......... ........... ...........
ouchterlony.
86332... A Immune complex assay... ......... ......... ......... ........... ...........
86334... A Immunofixation ......... ......... ......... ........... ...........
procedure.
86337... A Insulin antibodies..... ......... ......... ......... ........... ...........
86340... A Intrinsic factor ......... ......... ......... ........... ...........
antibody.
86341... A Islet cell antibody.... ......... ......... ......... ........... ...........
86343... A Leukocyte histamine ......... ......... ......... ........... ...........
release.
86344... A Leukocyte phagocytosis. ......... ......... ......... ........... ...........
86353... A Lymphocyte ......... ......... ......... ........... ...........
transformation.
86359... A T cells, total count... ......... ......... ......... ........... ...........
86360... A T cell absolute count/ ......... ......... ......... ........... ...........
ratio.
86361... A T cell absolute count.. ......... ......... ......... ........... ...........
86376... A Microsomal antibody.... ......... ......... ......... ........... ...........
86378... A Migration inhibitory ......... ......... ......... ........... ...........
factor.
86382... A Neutralization test, ......... ......... ......... ........... ...........
viral.
86384... A Nitroblue tetrazolium ......... ......... ......... ........... ...........
dye.
86403... A Particle agglutination ......... ......... ......... ........... ...........
test.
86406... A Particle agglutination ......... ......... ......... ........... ...........
test.
86430... A Rheumatoid factor test. ......... ......... ......... ........... ...........
86431... A Rheumatoid factor, ......... ......... ......... ........... ...........
quant.
86485... X Skin test, candida..... 861 0.13 $6.86 $3.62 $1.37
86490... X Coccidioidomycosis skin 861 0.13 $6.86 $3.62 $1.37
test.
86510... X Histoplasmosis skin 861 0.13 $6.86 $3.62 $1.37
test.
86580... X TB intradermal test.... 861 0.13 $6.86 $3.62 $1.37
[[Page 47706]]
86585... X TB tine test........... 861 0.13 $6.86 $3.62 $1.37
86586... X Skin test, unlisted.... 861 0.13 $6.86 $3.62 $1.37
86588... A Streptocollus, direct ......... ......... ......... ........... ...........
screen.
86590... A Streptokinase, antibody ......... ......... ......... ........... ...........
86592... A Blood serology, ......... ......... ......... ........... ...........
qualitative.
86593... A Blood serology, ......... ......... ......... ........... ...........
quantitative.
86602... A Antinomyces antibody... ......... ......... ......... ........... ...........
86603... A Adenovirus, antibody... ......... ......... ......... ........... ...........
86606... A Aspergillus antibody... ......... ......... ......... ........... ...........
86609... A Bacterium, antibody.... ......... ......... ......... ........... ...........
86612... A Blastomyces, antibody.. ......... ......... ......... ........... ...........
86615... A Bordetella antibody.... ......... ......... ......... ........... ...........
86617... A Lyme disease antibody.. ......... ......... ......... ........... ...........
86618... A Lyme disease antibody.. ......... ......... ......... ........... ...........
86619... A Borrelia antibody...... ......... ......... ......... ........... ...........
86622... A Brucella, antibody..... ......... ......... ......... ........... ...........
86625... A Campylobacter, antibody ......... ......... ......... ........... ...........
86628... A Candida, antibody...... ......... ......... ......... ........... ...........
86631... A Chlamydia, antibody.... ......... ......... ......... ........... ...........
86632... A Chlamydia, IgM, ......... ......... ......... ........... ...........
antibody.
86635... A Coccidioides, antibody. ......... ......... ......... ........... ...........
86638... A Q fever antibody....... ......... ......... ......... ........... ...........
86641... A Cryptococcus antibody.. ......... ......... ......... ........... ...........
86644... A CMV antibody........... ......... ......... ......... ........... ...........
86645... A CMV antibody, IgM...... ......... ......... ......... ........... ...........
86648... A Diphtheria antibody.... ......... ......... ......... ........... ...........
86651... A Encephalitis antibody.. ......... ......... ......... ........... ...........
86652... A Encephalitis antibody.. ......... ......... ......... ........... ...........
86653... A Encephalitis, antibody. ......... ......... ......... ........... ...........
86654... A Encephalitis, antibody. ......... ......... ......... ........... ...........
86658... A Enterovirus, antibody.. ......... ......... ......... ........... ...........
86663... A Epstein-barr antibody.. ......... ......... ......... ........... ...........
86664... A Epstein-barr antibody.. ......... ......... ......... ........... ...........
86665... A Epstein-barr, antibody. ......... ......... ......... ........... ...........
86668... A Francisella tularensis. ......... ......... ......... ........... ...........
86671... A Fungus, antibody....... ......... ......... ......... ........... ...........
86674... A Giardia lamblia........ ......... ......... ......... ........... ...........
86677... A Helicobacter pylori.... ......... ......... ......... ........... ...........
86682... A Helminth, antibody..... ......... ......... ......... ........... ...........
86684... A Hemophilus influenza... ......... ......... ......... ........... ...........
86687... A HTLV I................. ......... ......... ......... ........... ...........
86688... A HTLV-II................ ......... ......... ......... ........... ...........
86689... A HTLV/HIV confirmatory ......... ......... ......... ........... ...........
test.
86692... A Hepatitis, delta agent. ......... ......... ......... ........... ...........
86694... A Herpes simplex test.... ......... ......... ......... ........... ...........
86695... A Herpes simplex test.... ......... ......... ......... ........... ...........
86698... A Histoplasma............ ......... ......... ......... ........... ...........
86701... A HIV-1.................. ......... ......... ......... ........... ...........
86702... A HIV-2.................. ......... ......... ......... ........... ...........
86703... A HIV-1/HIV-2, single ......... ......... ......... ........... ...........
assay.
86704... A Hep b core ab test, igg ......... ......... ......... ........... ...........
& m.
86705... A Hep b core ab test, igm ......... ......... ......... ........... ...........
86706... A Hepatitis b surface ab ......... ......... ......... ........... ...........
test.
86707... A Hepatitis be ab test... ......... ......... ......... ........... ...........
86708... A Hep a ab test, igg & m. ......... ......... ......... ........... ...........
86709... A Hep a ab test, igm..... ......... ......... ......... ........... ...........
86710... A Influenza virus........ ......... ......... ......... ........... ...........
86713... A Legionella............. ......... ......... ......... ........... ...........
86717... A Leishmania............. ......... ......... ......... ........... ...........
86720... A Leptospira............. ......... ......... ......... ........... ...........
86723... A Listeria monocytogenes. ......... ......... ......... ........... ...........
86727... A Lymph choriomeningitis. ......... ......... ......... ........... ...........
86729... A Lympho venereum........ ......... ......... ......... ........... ...........
86732... A Mucormycosis........... ......... ......... ......... ........... ...........
86735... A Mumps.................. ......... ......... ......... ........... ...........
86738... A Mycoplasma............. ......... ......... ......... ........... ...........
86741... A Neisseria meningitidis. ......... ......... ......... ........... ...........
86744... A Nocardia............... ......... ......... ......... ........... ...........
86747... A Parvovirus............. ......... ......... ......... ........... ...........
86750... A Malaria................ ......... ......... ......... ........... ...........
86753... A Protozoa, not elsewhere ......... ......... ......... ........... ...........
86756... A Respiratory virus...... ......... ......... ......... ........... ...........
86759... A Rotavirus.............. ......... ......... ......... ........... ...........
86762... A Rubella................ ......... ......... ......... ........... ...........
86765... A Rubeola................ ......... ......... ......... ........... ...........
[[Page 47707]]
86768... A Salmonella............. ......... ......... ......... ........... ...........
86771... A Shigella............... ......... ......... ......... ........... ...........
86774... A Tetanus................ ......... ......... ......... ........... ...........
86777... A Toxoplasma............. ......... ......... ......... ........... ...........
86778... A Toxoplasma, IgM........ ......... ......... ......... ........... ...........
86781... A Treponema pallidum ......... ......... ......... ........... ...........
confirm.
86784... A Trichinella............ ......... ......... ......... ........... ...........
86787... A Varicella-zoster....... ......... ......... ......... ........... ...........
86790... A Virus, not specified... ......... ......... ......... ........... ...........
86793... A Yersinia............... ......... ......... ......... ........... ...........
86800... A Thyroglobulin antibody. ......... ......... ......... ........... ...........
86803... A Hepatitis c ab test.... ......... ......... ......... ........... ...........
86804... A Hep c ab test, confirm. ......... ......... ......... ........... ...........
86805... A Lymphocytotoxicity ......... ......... ......... ........... ...........
assay.
86806... A Lymphocytotoxicity ......... ......... ......... ........... ...........
assay.
86807... A Cytotoxic antibody ......... ......... ......... ........... ...........
screening.
86808... A Cytotoxic antibody ......... ......... ......... ........... ...........
screening.
86812... A HLA typing, A, B, or C. ......... ......... ......... ........... ...........
86813... A HLA typing, A, B, or C. ......... ......... ......... ........... ...........
86816... A HLA typing, DR/DQ...... ......... ......... ......... ........... ...........
86817... A HLA typing, DR/DQ...... ......... ......... ......... ........... ...........
86821... A Lymphocyte culture, ......... ......... ......... ........... ...........
mixed.
86822... A Lymphocyte culture, ......... ......... ......... ........... ...........
primed.
86849... A Immunology procedure... ......... ......... ......... ........... ...........
86850... A RBC antibody screen.... ......... ......... ......... ........... ...........
86860... A RBC antibody elution... ......... ......... ......... ........... ...........
86870... A RBC antibody ......... ......... ......... ........... ...........
identification.
86880... A Coombs test............ ......... ......... ......... ........... ...........
86885... A Coombs test............ ......... ......... ......... ........... ...........
86886... A Coombs test............ ......... ......... ......... ........... ...........
86890... A Autologous blood ......... ......... ......... ........... ...........
process.
86891... A Autologous blood, op ......... ......... ......... ........... ...........
salvage.
86900... A Blood typing, ABO...... ......... ......... ......... ........... ...........
86901... A Blood typing, Rh (D)... ......... ......... ......... ........... ...........
86903... A Blood typing, antigen ......... ......... ......... ........... ...........
screen.
86904... A Blood typing, patient ......... ......... ......... ........... ...........
serum.
86905... A Blood typing, RBC ......... ......... ......... ........... ...........
antigens.
86906... A Blood typing, Rh ......... ......... ......... ........... ...........
phenotype.
86910... E Blood typing, paternity ......... ......... ......... ........... ...........
test.
86911... E Blood typing, antigen ......... ......... ......... ........... ...........
system.
86915... A Bone marrow............ ......... ......... ......... ........... ...........
86920... A Compatibility test..... ......... ......... ......... ........... ...........
86921... A Compatibility test..... ......... ......... ......... ........... ...........
86922... A Compatibility test..... ......... ......... ......... ........... ...........
86927... A Plasma, fresh frozen... ......... ......... ......... ........... ...........
86930... A Frozen blood prep...... ......... ......... ......... ........... ...........
86931... A Frozen blood thaw...... ......... ......... ......... ........... ...........
86932... A Frozen blood, freeze/ ......... ......... ......... ........... ...........
thaw.
86940... A Hemolysins/agglutinins ......... ......... ......... ........... ...........
auto.
86941... A Hemolysins/agglutinins. ......... ......... ......... ........... ...........
86945... A Blood product/ ......... ......... ......... ........... ...........
irradiation.
86950... A Leukacyte transfusion.. ......... ......... ......... ........... ...........
86965... A Pooling blood platelets ......... ......... ......... ........... ...........
86970... A RBC pretreatment....... ......... ......... ......... ........... ...........
86971... A RBC pretreatment....... ......... ......... ......... ........... ...........
86972... A RBC pretreatment....... ......... ......... ......... ........... ...........
86975... A RBC pretreatment, serum ......... ......... ......... ........... ...........
86976... A RBC pretreatment, serum ......... ......... ......... ........... ...........
86977... A RBC pretreatment, serum ......... ......... ......... ........... ...........
86978... A RBC pretreatment, serum ......... ......... ......... ........... ...........
86985... A Split blood or products ......... ......... ......... ........... ...........
86999... A Transfusion procedure.. ......... ......... ......... ........... ...........
87001... A Small animal ......... ......... ......... ........... ...........
inoculation.
87003... A Small animal ......... ......... ......... ........... ...........
inoculation.
87015... A Specimen concentration. ......... ......... ......... ........... ...........
87040... A Blood culture for ......... ......... ......... ........... ...........
bacteria.
87045... A Stool culture for ......... ......... ......... ........... ...........
bacteria.
87060... A Nose/throat ......... ......... ......... ........... ...........
culture,bacteria.
87070... A Culture specimen, ......... ......... ......... ........... ...........
bacteria.
87072... A Culture of specimen by ......... ......... ......... ........... ...........
kit.
87075... A Culture specimen, ......... ......... ......... ........... ...........
bacteria.
87076... A Bacteria identification ......... ......... ......... ........... ...........
87081... A Bacteria culture screen ......... ......... ......... ........... ...........
87082... A Culture of specimen by ......... ......... ......... ........... ...........
kit.
87083... A Culture of specimen by ......... ......... ......... ........... ...........
kit.
[[Page 47708]]
87084... A Culture of specimen by ......... ......... ......... ........... ...........
kit.
87085... A Culture of specimen by ......... ......... ......... ........... ...........
kit.
87086... A Urine culture, colony ......... ......... ......... ........... ...........
count.
87087... A Urine bacteria culture. ......... ......... ......... ........... ...........
87088... A Urine bacteria culture. ......... ......... ......... ........... ...........
87101... A Skin fungus culture.... ......... ......... ......... ........... ...........
87102... A Fungus isolation ......... ......... ......... ........... ...........
culture.
87103... A Blood fungus culture... ......... ......... ......... ........... ...........
87106... A Fungus identification.. ......... ......... ......... ........... ...........
87109... A Mycoplasma culture..... ......... ......... ......... ........... ...........
87110... A Culture, chlamydia..... ......... ......... ......... ........... ...........
87116... A Mycobacteria culture... ......... ......... ......... ........... ...........
87117... A Mycobacteria culture... ......... ......... ......... ........... ...........
87118... A Mycobacteria ......... ......... ......... ........... ...........
identification.
87140... A Culture typing, ......... ......... ......... ........... ...........
fluorescent.
87143... A Culture typing, GLC ......... ......... ......... ........... ...........
method.
87145... A Culture typing, phage ......... ......... ......... ........... ...........
method.
87147... A Culture typing, ......... ......... ......... ........... ...........
serologic.
87151... A Culture typing, ......... ......... ......... ........... ...........
serologic.
87155... A Culture typing, ......... ......... ......... ........... ...........
precipitin.
87158... A Culture typing, added ......... ......... ......... ........... ...........
method.
87163... A Special microbiology ......... ......... ......... ........... ...........
culture.
87164... A Dark field examination. ......... ......... ......... ........... ...........
87166... A Dark field examination. ......... ......... ......... ........... ...........
87174... A Endotoxin, bacterial... ......... ......... ......... ........... ...........
87175... A Assay, endotoxin, ......... ......... ......... ........... ...........
bacterial.
87176... A Endotoxin, bacterial... ......... ......... ......... ........... ...........
87177... A Ova and parasites ......... ......... ......... ........... ...........
smears.
87181... A Antibiotic sensitivity, ......... ......... ......... ........... ...........
each.
87184... A Antibiotic sensitivity, ......... ......... ......... ........... ...........
each.
87186... A Antibiotic sensitivity, ......... ......... ......... ........... ...........
MIC.
87187... A Antibiotic sensitivity, ......... ......... ......... ........... ...........
MBC.
87188... A Antibiotic sensitivity, ......... ......... ......... ........... ...........
each.
87190... A TB antibiotic ......... ......... ......... ........... ...........
sensitivity.
87192... A Antibiotic sensitivity, ......... ......... ......... ........... ...........
each.
87197... A Bactericidal level, ......... ......... ......... ........... ...........
serum.
87205... A Smear, stain & ......... ......... ......... ........... ...........
interpret.
87206... A Smear, stain & ......... ......... ......... ........... ...........
interpret.
87207... A Smear, stain & ......... ......... ......... ........... ...........
interpret.
87208... A Smear, stain & ......... ......... ......... ........... ...........
interpret.
87210... A Smear, stain & ......... ......... ......... ........... ...........
interpret.
87211... A Smear, stain & ......... ......... ......... ........... ...........
interpret.
87220... A Tissue exam for fungi.. ......... ......... ......... ........... ...........
87230... A Assay, toxin or ......... ......... ......... ........... ...........
antitoxin.
87250... A Virus inoculation for ......... ......... ......... ........... ...........
test.
87252... A Virus inoculation for ......... ......... ......... ........... ...........
test.
87253... A Virus inoculation for ......... ......... ......... ........... ...........
test.
87260... A Adenovirus ag, dfa..... ......... ......... ......... ........... ...........
87265... A Pertussis ag, dfa...... ......... ......... ......... ........... ...........
87270... A Chylmd trach ag, dfa... ......... ......... ......... ........... ...........
87272... A Cryptosporidum ag, dfa. ......... ......... ......... ........... ...........
87274... A Herpes simplex ag, dfa. ......... ......... ......... ........... ...........
87276... A Influenza ag, dfa...... ......... ......... ......... ........... ...........
87278... A Legion pneumo ag, dfa.. ......... ......... ......... ........... ...........
87280... A Resp syncytial ag, dfa. ......... ......... ......... ........... ...........
87285... A Trepon pallidum ag, dfa ......... ......... ......... ........... ...........
87290... A Varicella ag, dfa...... ......... ......... ......... ........... ...........
87299... A Ag detection nos, dfa.. ......... ......... ......... ........... ...........
87301... A Adenovirus ag, eia..... ......... ......... ......... ........... ...........
87320... A Chylmd trach ag, eia... ......... ......... ......... ........... ...........
87324... A Clostridium ag, eia.... ......... ......... ......... ........... ...........
87328... A Cryptospor ag, eia..... ......... ......... ......... ........... ...........
87332... A Cytomegalovirus ag, eia ......... ......... ......... ........... ...........
87335... A E coli 0157 ag, eia.... ......... ......... ......... ........... ...........
87340... A Hepatitis b surface ag, ......... ......... ......... ........... ...........
eia.
87350... A Hepatitis b ag, eia.... ......... ......... ......... ........... ...........
87380... A Hepatitis delta ag, eia ......... ......... ......... ........... ...........
87385... A Histoplasma capsul ag, ......... ......... ......... ........... ...........
eia.
87390... A Hiv-1 ag, eia.......... ......... ......... ......... ........... ...........
87391... A Hiv-2 ag, eia.......... ......... ......... ......... ........... ...........
87420... A Resp syncytial ag, eia. ......... ......... ......... ........... ...........
87425... A Rotavirus ag, eia...... ......... ......... ......... ........... ...........
87430... A Strep a ag, eia........ ......... ......... ......... ........... ...........
87449... A Ag detect nos, eia, ......... ......... ......... ........... ...........
mult.
87450... A Ag detect nos, eia, ......... ......... ......... ........... ...........
single.
[[Page 47709]]
87470... A Bartonella, dna, dir ......... ......... ......... ........... ...........
probe.
87471... A Bartonella, dna, amp ......... ......... ......... ........... ...........
probe.
87472... A Bartonella, dna, quant. ......... ......... ......... ........... ...........
87475... A Lyme dis, dna, dir ......... ......... ......... ........... ...........
probe.
87476... A Lyme dis, dna, amp ......... ......... ......... ........... ...........
probe.
87477... A Lyme dis, dna, quant... ......... ......... ......... ........... ...........
87480... A Candida, dna, dir probe ......... ......... ......... ........... ...........
87481... A Candida, dna, amp probe ......... ......... ......... ........... ...........
87482... A Candida, dna, quant.... ......... ......... ......... ........... ...........
87485... A Chylmd pneum, dna, dir ......... ......... ......... ........... ...........
probe.
87486... A Chylmd pneum, dna, amp ......... ......... ......... ........... ...........
probe.
87487... A Chylmd pneum, dna, ......... ......... ......... ........... ...........
quant.
87490... A Chylmd trach, dna, dir ......... ......... ......... ........... ...........
probe.
87491... A Chylmd trach, dna, amp ......... ......... ......... ........... ...........
probe.
87492... A Chylmd trach, dna, ......... ......... ......... ........... ...........
quant.
87495... A Cytomeg, dna, dir probe ......... ......... ......... ........... ...........
87496... A Cytomeg, dna, amp probe ......... ......... ......... ........... ...........
87497... A Cytomeg, dna, quant.... ......... ......... ......... ........... ...........
87510... A Gardner vag, dna, dir ......... ......... ......... ........... ...........
probe.
87511... A Gardner vag, dna, amp ......... ......... ......... ........... ...........
probe.
87512... A Gardner vag, dna, quant ......... ......... ......... ........... ...........
87515... A Hepatitis b, dna, dir ......... ......... ......... ........... ...........
probe.
87516... A Hepatitis b, dna, amp ......... ......... ......... ........... ...........
probe.
87517... A Hepatitis b, dna, quant ......... ......... ......... ........... ...........
87520... A Hepatitis c, rna, dir ......... ......... ......... ........... ...........
probe.
87521... A Hepatitis c, rna, amp ......... ......... ......... ........... ...........
probe.
87522... A Hepatitis c, rna, quant ......... ......... ......... ........... ...........
87525... A Hepatitis g, dna, dir ......... ......... ......... ........... ...........
probe.
87526... A Hepatitis g, dna, amp ......... ......... ......... ........... ...........
probe.
87527... A Hepatitis g, dna, quant ......... ......... ......... ........... ...........
87528... A Hsv, dna, dir probe.... ......... ......... ......... ........... ...........
87529... A Hsv, dna, amp probe.... ......... ......... ......... ........... ...........
87530... A Hsv, dna, quant........ ......... ......... ......... ........... ...........
87531... A Hhv-6, dna, dir probe.. ......... ......... ......... ........... ...........
87532... A Hhv-6, dna, amp probe.. ......... ......... ......... ........... ...........
87533... A Hhv-6, dna, quant...... ......... ......... ......... ........... ...........
87534... A Hiv-1, dna, dir probe.. ......... ......... ......... ........... ...........
87535... A Hiv-1, dna, amp probe.. ......... ......... ......... ........... ...........
87536... A Hiv-1, dna, quant...... ......... ......... ......... ........... ...........
87537... A Hiv-2, dna, dir probe.. ......... ......... ......... ........... ...........
87538... A Hiv-2, dna, amp probe.. ......... ......... ......... ........... ...........
87539... A Hiv-2, dna, quant...... ......... ......... ......... ........... ...........
87540... A Legion pneumo, dna, dir ......... ......... ......... ........... ...........
prob.
87541... A Legion pneumo, dna, amp ......... ......... ......... ........... ...........
prob.
87542... A Legion pneumo, dna, ......... ......... ......... ........... ...........
quant.
87550... A Mycobacteria, dna, dir ......... ......... ......... ........... ...........
probe.
87551... A Mycobacteria, dna, amp ......... ......... ......... ........... ...........
probe.
87552... A Mycobacteria, dna, ......... ......... ......... ........... ...........
quant.
87555... A M.tuberculo, dna, dir ......... ......... ......... ........... ...........
probe.
87556... A M.tuberculo, dna, amp ......... ......... ......... ........... ...........
probe.
87557... A M.tuberculo, dna, quant ......... ......... ......... ........... ...........
87560... A M.avium-intra, dna, dir ......... ......... ......... ........... ...........
prob.
87561... A M.avium-intra, dna, amp ......... ......... ......... ........... ...........
prob.
87562... A M.avium-intra, dna, ......... ......... ......... ........... ...........
quant.
87580... A M.pneumon, dna, dir ......... ......... ......... ........... ...........
probe.
87581... A M.pneumon, dna, amp ......... ......... ......... ........... ...........
probe.
87582... A M.pneumon, dna, quant.. ......... ......... ......... ........... ...........
87590... A N.gonorrhoeae, dna, dir ......... ......... ......... ........... ...........
prob.
87591... A N.gonorrhoeae, dna, amp ......... ......... ......... ........... ...........
prob.
87592... A N.gonorrhoeae, dna, ......... ......... ......... ........... ...........
quant.
87620... A Hpv, dna, dir probe.... ......... ......... ......... ........... ...........
87621... A Hpv, dna, amp probe.... ......... ......... ......... ........... ...........
87622... A Hpv, dna, quant........ ......... ......... ......... ........... ...........
87650... A Strep a, dna, dir probe ......... ......... ......... ........... ...........
87651... A Strep a, dna, amp probe ......... ......... ......... ........... ...........
87652... A Strep a, dna, quant.... ......... ......... ......... ........... ...........
87797... A Detect agent nos, dna, ......... ......... ......... ........... ...........
dir.
87798... A Detect agent nos, dna, ......... ......... ......... ........... ...........
amp.
87799... A Detect agent nos, dna, ......... ......... ......... ........... ...........
quant.
87810... A Chylmd trach assay w/ ......... ......... ......... ........... ...........
optic.
87850... A N. gonorrhoeae assay w/ ......... ......... ......... ........... ...........
optic.
87880... A Strep a assay w/optic.. ......... ......... ......... ........... ...........
87899... A Agent nos assay w/optic ......... ......... ......... ........... ...........
87999... A Microbiology procedure. ......... ......... ......... ........... ...........
88000... E Autopsy (necropsy), ......... ......... ......... ........... ...........
gross.
[[Page 47710]]
88005... E Autopsy (necropsy), ......... ......... ......... ........... ...........
gross.
88007... E Autopsy (necropsy), ......... ......... ......... ........... ...........
gross.
88012... E Autopsy (necropsy), ......... ......... ......... ........... ...........
gross.
88014... E Autopsy (necropsy), ......... ......... ......... ........... ...........
gross.
88016... E Autopsy (necropsy), ......... ......... ......... ........... ...........
gross.
88020... E Autopsy (necropsy), ......... ......... ......... ........... ...........
complete.
88025... E Autopsy (necropsy), ......... ......... ......... ........... ...........
complete.
88027... E Autopsy (necropsy), ......... ......... ......... ........... ...........
complete.
88028... E Autopsy (necropsy), ......... ......... ......... ........... ...........
complete.
88029... E Autopsy (necropsy), ......... ......... ......... ........... ...........
complete.
88036... E Limited autopsy........ ......... ......... ......... ........... ...........
88037... E Limited autopsy........ ......... ......... ......... ........... ...........
88040... E Forensic autopsy ......... ......... ......... ........... ...........
(necropsy).
88045... E Coroner's autopsy ......... ......... ......... ........... ...........
(necropsy).
88099... E Necropsy (autopsy) ......... ......... ......... ........... ...........
procedure.
88104... X Cytopathology, fluids.. 882 0.39 $20.57 $11.75 $4.11
88106... X Cytopathology, fluids.. 882 0.39 $20.57 $11.75 $4.11
88107... X Cytopathology, fluids.. 882 0.39 $20.57 $11.75 $4.11
88108... X Cytopath, concentrate 882 0.39 $20.57 $11.75 $4.11
tech.
88125... X Forensic cytopathology. 881 0.20 $10.77 $6.78 $2.15
88130... A Sex chromatin ......... ......... ......... ........... ...........
identification.
88140... A Sex chromatin ......... ......... ......... ........... ...........
identification.
88141... N Cytopath cerv/vag ......... ......... ......... ........... ...........
interpret.
88142... A Cytopath cerv/vag thin ......... ......... ......... ........... ...........
layer.
88150... A Cytopath cerv/vag...... ......... ......... ......... ........... ...........
88152... A Cytopath cerv/vag auto. ......... ......... ......... ........... ...........
88155... A Cytopath cerv/vag index ......... ......... ......... ........... ...........
88156... A Cytopath cerv/vag tbs.. ......... ......... ......... ........... ...........
88158... A Cytopath cerv/vag tbs ......... ......... ......... ........... ...........
auto.
88160... X Cytopath smear, other 882 0.39 $20.57 $11.75 $4.11
source.
88161... X Cytopath smear, other 882 0.39 $20.57 $11.75 $4.11
source.
88162... X Cytopath smear, other 882 0.39 $20.57 $11.75 $4.11
source.
88170... T Fine needle aspiration. 121 0.67 $35.26 $21.02 $7.05
88171... T Fine needle aspiration. 121 0.67 $35.26 $21.02 $7.05
88172... X Evaluation of smear.... 882 0.39 $20.57 $11.75 $4.11
88173... X Interpretation of smear 882 0.39 $20.57 $11.75 $4.11
88180... X Cell marker study...... 882 0.39 $20.57 $11.75 $4.11
88182... X Cell marker study...... 882 0.39 $20.57 $11.75 $4.11
88199... X Cytopathology procedure 881 0.20 $10.77 $6.78 $2.15
88230... A Tissue culture, ......... ......... ......... ........... ...........
lymphocyte.
88233... A Tissue culture, skin/ ......... ......... ......... ........... ...........
biopsy.
88235... A Tissue culture, ......... ......... ......... ........... ...........
placenta.
88237... A Tissue culture, bone ......... ......... ......... ........... ...........
marrow.
88239... A Tissue culture, other.. ......... ......... ......... ........... ...........
88245... A Chromosome analysis.... ......... ......... ......... ........... ...........
88248... A Chromosome analysis.... ......... ......... ......... ........... ...........
88250... A Chromosome analysis.... ......... ......... ......... ........... ...........
88260... A Chromosome analysis: 5 ......... ......... ......... ........... ...........
cells.
88261... A Chromosome analysis: 5 ......... ......... ......... ........... ...........
cells.
88262... A Chromosome count:15-20 ......... ......... ......... ........... ...........
cells.
88263... A Chromosome analysis:45 ......... ......... ......... ........... ...........
cells.
88267... A Chromosome ......... ......... ......... ........... ...........
analysis:placenta.
88269... A Chromosome ......... ......... ......... ........... ...........
analysis:amniotic.
88280... A Chromosome karyotype ......... ......... ......... ........... ...........
study.
88283... A Chromosome banding ......... ......... ......... ........... ...........
study.
88285... A Chromosome count: ......... ......... ......... ........... ...........
additional.
88289... A Chromosome study: ......... ......... ......... ........... ...........
additional.
88299... A Cytogenetic study...... ......... ......... ......... ........... ...........
88300... X Surg path, gross....... 881 0.20 $10.77 $6.78 $2.15
88302... X Tissue exam by 882 0.39 $20.57 $11.75 $4.11
pathologist.
88304... X Tissue exam by 882 0.39 $20.57 $11.75 $4.11
pathologist.
88305... X Tissue exam by 882 0.39 $20.57 $11.75 $4.11
pathologist.
88307... X Tissue exam by 883 0.65 $34.28 $20.34 $6.86
pathologist.
88309... X Tissue exam by 883 0.65 $34.28 $20.34 $6.86
pathologist.
88311... X Decalcify tissue....... 881 0.20 $10.77 $6.78 $2.15
88312... X Special stains......... 882 0.39 $20.57 $11.75 $4.11
88313... X Special stains......... 881 0.20 $10.77 $6.78 $2.15
88314... X Histochemical stain.... 882 0.39 $20.57 $11.75 $4.11
88318... X Chemical histochemistry 882 0.39 $20.57 $11.75 $4.11
88319... X Enzyme histochemistry.. 882 0.39 $20.57 $11.75 $4.11
88321... X Microslide consultation 882 0.39 $20.57 $11.75 $4.11
88323... X Microslide consultation 882 0.39 $20.57 $11.75 $4.11
88325... X Comprehensive review of 882 0.39 $20.57 $11.75 $4.11
data.
88329... X Pathology consult in 882 0.39 $20.57 $11.75 $4.11
surgery.
88331... X Pathology consult in 882 0.39 $20.57 $11.75 $4.11
surgery.
[[Page 47711]]
88332... X Pathology consult in 882 0.39 $20.57 $11.75 $4.11
surgery.
88342... X Immunocytochemistry.... 882 0.39 $20.57 $11.75 $4.11
88346... X Immunofluorescent study 882 0.39 $20.57 $11.75 $4.11
88347... X Immunofluorescent study 882 0.39 $20.57 $11.75 $4.11
88348... X Electron microscopy.... 883 0.65 $34.28 $20.34 $6.86
88349... X Scanning electron 883 0.65 $34.28 $20.34 $6.86
microscopy.
88355... X Analysis, skeletal 883 0.65 $34.28 $20.34 $6.86
muscle.
88356... X Analysis, nerve........ 883 0.65 $34.28 $20.34 $6.86
88358... X Analysis, tumor........ 883 0.65 $34.28 $20.34 $6.86
88362... X Nerve teasing 883 0.65 $34.28 $20.34 $6.86
preparations.
88365... X Tissue hybridization... 883 0.65 $34.28 $20.34 $6.86
88371... A Protein, western blot ......... ......... ......... ........... ...........
tissue.
88372... A Protein analysis w/ ......... ......... ......... ........... ...........
probe.
88399... X Surgical pathology 881 0.20 $10.77 $6.78 $2.15
procedure.
89050... A Body fluid cell count.. ......... ......... ......... ........... ...........
89051... A Body fluid cell count.. ......... ......... ......... ........... ...........
89060... A Exam,synovial fluid ......... ......... ......... ........... ...........
crystals.
89100... X Sample intestinal 928 3.11 $164.55 $83.85 $32.91
contents.
89105... X Sample intestinal 928 3.11 $164.55 $83.85 $32.91
contents.
89125... A Specimen fat stain..... ......... ......... ......... ........... ...........
89130... X Sample stomach contents 928 3.11 $164.55 $83.85 $32.91
89132... X Sample stomach contents 928 3.11 $164.55 $83.85 $32.91
89135... X Sample stomach contents 928 3.11 $164.55 $83.85 $32.91
89136... X Sample stomach contents 928 3.11 $164.55 $83.85 $32.91
89140... X Sample stomach contents 928 3.11 $164.55 $83.85 $32.91
89141... X Sample stomach contents 928 3.11 $164.55 $83.85 $32.91
89160... A Exam feces for meat ......... ......... ......... ........... ...........
fibers.
89190... A Nasal smear for ......... ......... ......... ........... ...........
eosinophils.
89250... A Fertilization of oocyte ......... ......... ......... ........... ...........
89251... A Culture oocyte w/ ......... ......... ......... ........... ...........
embryos.
89252... A Assist oocyte ......... ......... ......... ........... ...........
fertilization.
89253... A Embryo hatching........ ......... ......... ......... ........... ...........
89254... A Oocyte identification.. ......... ......... ......... ........... ...........
89255... A Prepare embryo for ......... ......... ......... ........... ...........
transfer.
89256... A Prepare cryopreserved ......... ......... ......... ........... ...........
embryo.
89257... A Sperm identification... ......... ......... ......... ........... ...........
89258... A Cryopreservation, ......... ......... ......... ........... ...........
embryo.
89259... A Cryopreservation, sperm ......... ......... ......... ........... ...........
89260... A Sperm isolation, simple ......... ......... ......... ........... ...........
89261... A Sperm isolation, ......... ......... ......... ........... ...........
complex.
89300... A Semen analysis......... ......... ......... ......... ........... ...........
89310... A Semen analysis......... ......... ......... ......... ........... ...........
89320... A Semen analysis......... ......... ......... ......... ........... ...........
89325... A Sperm antibody test.... ......... ......... ......... ........... ...........
89329... A Sperm evaluation test.. ......... ......... ......... ........... ...........
89330... A Evaluation, cervical ......... ......... ......... ........... ...........
mucus.
89350... X Sputum specimen 881 0.20 $10.77 $6.78 $2.15
collection.
89355... A Exam feces for starch.. ......... ......... ......... ........... ...........
89360... X Collect sweat for test. 881 0.20 $10.77 $6.78 $2.15
89365... A Water load test........ ......... ......... ......... ........... ...........
89399... X Pathology lab procedure 881 0.20 $10.77 $6.78 $2.15
90700... X DTaP immunization...... 901 0.07 $3.92 $2.49 0.78
90701... X DTP immunization....... 901 0.07 $3.92 $2.49 0.78
90702... X DT immunization........ 901 0.07 $3.92 $2.49 0.78
90703... X Tetanus immunization... 901 0.07 $3.92 $2.49 0.78
90704... X Mumps immunization..... 901 0.07 $3.92 $2.49 0.78
90705... X Measles immunization... 901 0.07 $3.92 $2.49 0.78
90706... X Rubella immunization... 901 0.07 $3.92 $2.49 0.78
90707... X MMR virus immunization. 902 1.78 $94.03 $41.58 $18.81
90708... X Measles-rubella 901 0.07 $3.92 $2.49 0.78
immunization.
90709... X Rubella & mumps 901 0.07 $3.92 $2.49 0.78
immunization.
90710... X Combined vaccine....... 901 0.07 $3.92 $2.49 0.78
90711... X Combined vaccine....... 901 0.07 $3.92 $2.49 0.78
90712... X Oral poliovirus 902 1.78 $94.03 $41.58 $18.81
immunization.
90713... X Poliomyelitis 902 1.78 $94.03 $41.58 $18.81
immunization.
90714... X Typhoid immunization... 901 0.07 $3.92 $2.49 0.78
90716... X Chicken pox vaccine.... 902 1.78 $94.03 $41.58 $18.81
90717... X Yellow fever 902 1.78 $94.03 $41.58 $18.81
immunization.
90718... X Td immunization........ 901 0.07 $3.92 $2.49 0.78
90719... X Diphtheria immunization 901 0.07 $3.92 $2.49 0.78
90720... X DTP/HIB vaccine........ 902 1.78 $94.03 $41.58 $18.81
90721... X Dtap/hib vaccine....... 903 1.17 $61.71 $25.76 $12.34
90724... X Influenza immunization. 901 0.07 $3.92 $2.49 0.78
90725... X Cholera immunization... 901 0.07 $3.92 $2.49 0.78
90726... X Rabies immunization.... 903 1.17 $61.71 $25.76 $12.34
[[Page 47712]]
90727... X Plague immunization.... 903 1.17 $61.71 $25.76 $12.34
90728... X BCG immunization....... 903 1.17 $61.71 $25.76 $12.34
90730... X Hepatitis A vaccine.... 901 0.07 $3.92 $2.49 0.78
90732... X Pneumococcal 901 0.07 $3.92 $2.49 0.78
immunization.
90733... X Meningococcal 902 1.78 $94.03 $41.58 $18.81
immunization.
90735... X Encephalitis virus 903 1.17 $61.71 $25.76 $12.34
vaccine.
90737... X Influenza B 902 1.78 $94.03 $41.58 $18.81
immunization.
90741... X Passive immunization, 902 1.78 $94.03 $41.58 $18.81
ISG.
90742... X Special passive 903 1.17 $61.71 $25.76 $12.34
immunization.
90744... X Hepatitis B vaccine, 902 1.78 $94.03 $41.58 $18.81
under 11.
90745... X Hepatitis B vaccine, 11- 902 1.78 $94.03 $41.58 $18.81
19.
90746... X Hepatitis B vaccine, 902 1.78 $94.03 $41.58 $18.81
over 20.
90747... X Hepatitis B vaccine, 902 1.78 $94.03 $41.58 $18.81
ill pat.
90748... X Hepatitis b/hib vaccine 901 0.07 $3.92 $2.49 0.78
90749... X Immunization procedure. 901 0.07 $3.92 $2.49 0.78
90780... X IV infusion therapy, 1 906 1.46 $77.38 $42.49 $15.48
hour.
90781... X IV infusion, additional 906 1.46 $77.38 $42.49 $15.48
hour.
90782... X Injection (SC)/(IM).... 907 0.85 $45.05 $11.98 $9.01
90783... X Injection (IA)......... 907 0.85 $45.05 $11.98 $9.01
90784... X Injection (IV)......... 907 0.85 $45.05 $11.98 $9.01
90788... X Injection of antibiotic 907 0.85 $45.05 $11.98 $9.01
90799... X Therapeutic/diag 907 0.85 $45.05 $11.98 $9.01
injection.
90801... S Psy dx interview....... 092 1.57 $83.25 $21.92 $16.65
90802... S Intac psy dx interview. 092 1.57 $83.25 $21.92 $16.65
90804... S Psytx, office (20-30).. 091 1.19 $62.69 $15.37 $12.54
90805... S Psytx, office (20-30) w/ 091 1.19 $62.69 $15.37 $12.54
e&m.
90806... S Psytx, office (45-50).. 092 1.57 $83.25 $21.92 $16.65
90807... S Psytx, office (45-50) w/ 092 1.57 $83.25 $21.92 $16.65
e&m.
90808... S Psytx, office (75-80).. 092 1.57 $83.25 $21.92 $16.65
90809... S Psytx, office (75-80) w/ 092 1.57 $83.25 $21.92 $16.65
e&m.
90810... S Intac psytx, office (20- 091 1.19 $62.69 $15.37 $12.54
30).
90811... S Intac psytx, off 20-30 091 1.19 $62.69 $15.37 $12.54
w/e&m.
90812... S Intac psytx, office (45- 092 1.57 $83.25 $21.92 $16.65
50).
90813... S Intac psytx, off 45-50 092 1.57 $83.25 $21.92 $16.65
w/e&m.
90814... S Intac psytx, office (75- 092 1.57 $83.25 $21.92 $16.65
80).
90815... S Intac psytx, off 75-80 092 1.57 $83.25 $21.92 $16.65
w/e&m.
90816... S Psytx, hosp (20-30).... 091 1.19 $62.69 $15.37 $12.54
90817... S Psytx, hosp (20-30) w/ 091 1.19 $62.69 $15.37 $12.54
e&m.
90818... S Psytx, hosp (45-50).... 092 1.57 $83.25 $21.92 $16.65
90819... S Psytx, hosp (45-50) w/ 092 1.57 $83.25 $21.92 $16.65
e&m.
90821... S Psytx, hosp (75-80).... 092 1.57 $83.25 $21.92 $16.65
90822... S Psytx, hosp (75-80) w/ 092 1.57 $83.25 $21.92 $16.65
e&m.
90823... S Intac psytx, hosp (20- 091 1.19 $62.69 $15.37 $12.54
30).
90824... S Intac psytx, hsp 20-30 091 1.19 $62.69 $15.37 $12.54
w/e&m.
90826... S Intac psytx, hosp (45- 092 1.57 $83.25 $21.92 $16.65
50).
90827... S Intac psytx, hsp 45-50 092 1.57 $83.25 $21.92 $16.65
w/e&m.
90828... S Intac psytx, hosp (75- 092 1.57 $83.25 $21.92 $16.65
80).
90829... S Intac psytx, hsp 75-80 092 1.57 $83.25 $21.92 $16.65
w/e&m.
90845... S Psychoanalysis......... 092 1.57 $83.25 $21.92 $16.65
90846... S Family psytx w/o 093 1.54 $81.29 $20.11 $16.26
patient.
90847... S Family psytx w/patient. 093 1.54 $81.29 $20.11 $16.26
90849... S Multiple family group 094 1.24 $65.62 $20.11 $13.12
psytx.
90853... S Group psychotherapy.... 094 1.24 $65.62 $20.11 $13.12
90857... S Intac group psytx...... 094 1.24 $65.62 $20.11 $13.12
90862... X Medication management.. 090 0.85 $45.05 $12.43 $9.01
90865... S Narcosynthesis......... 092 1.57 $83.25 $21.92 $16.65
90870... S Electroconvulsive 919 3.17 $167.49 $80.00 $33.50
therapy.
90871... S Electroconvulsive 919 3.17 $167.49 $80.00 $33.50
therapy.
90875... E Psychophysiological ......... ......... ......... ........... ...........
therapy.
90876... E Psychophysiological ......... ......... ......... ........... ...........
therapy.
90880... S Hypnotherapy........... 092 1.57 $83.25 $21.92 $16.65
90882... E Environmental ......... ......... ......... ........... ...........
manipulation.
90885... N Psy evaluation of ......... ......... ......... ........... ...........
records.
90887... N Consultation with ......... ......... ......... ........... ...........
family.
90889... N Preparation of report.. ......... ......... ......... ........... ...........
90899... S Psychiatric service/ 091 1.19 $62.69 $15.37 $12.54
therapy.
90901... S Biofeedback, any method 920 1.17 $61.71 $29.61 $12.34
90911... S Biofeedback peri/uro/ 920 1.17 $61.71 $29.61 $12.34
rectal.
90918... A ESRD related services, ......... ......... ......... ........... ...........
month.
90919... A ESRD related services, ......... ......... ......... ........... ...........
month.
90920... A ESRD related services, ......... ......... ......... ........... ...........
month.
90921... A ESRD related services, ......... ......... ......... ........... ...........
month.
90922... A ESRD related services, ......... ......... ......... ........... ...........
day.
90923... A Esrd related services, ......... ......... ......... ........... ...........
day.
90924... A Esrd related services, ......... ......... ......... ........... ...........
day.
[[Page 47713]]
90925... A Esrd related services, ......... ......... ......... ........... ...........
day.
90935... S Hemodialysis, one 926 4.28 $226.25 $69.83 $45.25
evaluation.
90937... S Hemodialysis, repeated 926 4.28 $226.25 $69.83 $45.25
eval.
90945... S Dialysis, one 926 4.28 $226.25 $69.83 $45.25
evaluation.
90947... S Dialysis, repeated eval 926 4.28 $226.25 $69.83 $45.25
90989... E Dialysis training/ ......... ......... ......... ........... ...........
complete.
90993... N Dialysis training/ ......... ......... ......... ........... ...........
incomplete.
90997... S Hemoperfusion.......... 926 4.28 $226.25 $69.83 $45.25
90999... S Dialysis procedure..... 926 4.28 $226.25 $69.83 $45.25
91000... X Esophageal intubation.. 928 3.11 $164.55 $83.85 $32.91
91010... X Esophagus motility 928 3.11 $164.55 $83.85 $32.91
study.
91011... X Esophagus motility 928 3.11 $164.55 $83.85 $32.91
study.
91012... X Esophagus motility 928 3.11 $164.55 $83.85 $32.91
study.
91020... X Gastric motility....... 928 3.11 $164.55 $83.85 $32.91
91030... X Acid perfusion of 928 3.11 $164.55 $83.85 $32.91
esophagus.
91032... X Esophagus, acid reflux 928 3.11 $164.55 $83.85 $32.91
test.
91033... X Prolonged acid reflux 928 3.11 $164.55 $83.85 $32.91
test.
91052... X Gastric analysis test.. 928 3.11 $164.55 $83.85 $32.91
91055... X Gastric intubation for 928 3.11 $164.55 $83.85 $32.91
smear.
91060... X Gastric saline load 928 3.11 $164.55 $83.85 $32.91
test.
91065... X Breath hydrogen test... 928 3.11 $164.55 $83.85 $32.91
91100... X Pass intestine bleeding 928 3.11 $164.55 $83.85 $32.91
tube.
91105... X Gastric intubation 928 3.11 $164.55 $83.85 $32.91
treatment.
91122... N Anal pressure record... ......... ......... ......... ........... ...........
91299... X Gastroenterology 928 3.11 $164.55 $83.85 $32.91
procedure.
92002... V Eye exam, new patient.. 913 ......... ......... ........... ...........
92004... V Eye exam, new patient.. 915 ......... ......... ........... ...........
92012... V Eye exam established pt 913 ......... ......... ........... ...........
92014... V Eye exam & treatment... 915 ......... ......... ........... ...........
92015... E Refraction............. ......... ......... ......... ........... ...........
92018... T New eye exam & 676 6.30 $333.01 $140.35 $66.6
treatment.
92019... T Eye exam & treatment... 676 6.30 $333.01 $140.35 $66.6
92020... N Special eye evaluation. ......... ......... ......... ........... ...........
92060... X Special eye evaluation. 930 1.02 $53.87 $22.83 $10.77
92065... X Orthoptic/pleoptic 930 1.02 $53.87 $22.83 $10.77
training.
92070... N Fitting of contact lens ......... ......... ......... ........... ...........
92081... X Visual field 930 1.02 $53.87 $22.83 $10.77
examination(s).
92082... X Visual field 930 1.02 $53.87 $22.83 $10.77
examination(s).
92083... X Visual field 930 1.02 $53.87 $22.83 $10.77
examination(s).
92100... N Serial tonometry ......... ......... ......... ........... ...........
exam(s).
92120... X Tonography & eye 931 0.74 $39.18 $21.47 $7.84
evaluation.
92130... X Water provocation 931 0.74 $39.18 $21.47 $7.84
tonography.
92140... X Glaucoma provocative 930 1.02 $53.87 $22.83 $10.77
tests.
92225... N Special eye exam, ......... ......... ......... ........... ...........
initial.
92226... N Special eye exam, ......... ......... ......... ........... ...........
subsequent.
92230... X Eye exam with photos... 931 0.74 $39.18 $21.47 $7.84
92235... X Eye exam with photos... 932 2.52 $133.21 $65.09 $26.64
92240... X Icg angiography........ 931 0.74 $39.18 $21.47 $7.84
92250... X Eye exam with photos... 931 0.74 $39.18 $21.47 $7.84
92260... N Ophthalmoscopy/ ......... ......... ......... ........... ...........
dynamometry.
92265... X Eye muscle evaluation.. 932 2.52 $133.21 $65.09 $26.64
92270... X Electro-oculography.... 932 2.52 $133.21 $65.09 $26.64
92275... X Electroretinography.... 981 1.46 $77.38 $41.81 $15.48
92283... X Color vision 930 1.02 $53.87 $22.83 $10.77
examination.
92284... X Dark adaptation eye 930 1.02 $53.87 $22.83 $10.77
exam.
92285... X Eye photography........ 930 1.02 $53.87 $22.83 $10.77
92286... X Internal eye 932 2.52 $133.21 $65.09 $26.64
photography.
92287... X Internal eye 932 2.52 $133.21 $65.09 $26.64
photography.
92310... E Contact lens fitting... ......... ......... ......... ........... ...........
92311... X Contact lens fitting... 936 0.52 $27.42 $9.49 $5.48
92312... X Contact lens fitting... 936 0.52 $27.42 $9.49 $5.48
92313... X Contact lens fitting... 936 0.52 $27.42 $9.49 $5.48
92314... E Prescription of contact ......... ......... ......... ........... ...........
lens.
92315... X Prescription of contact 936 0.52 $27.42 $9.49 $5.48
lens.
92316... X Prescription of contact 936 0.52 $27.42 $9.49 $5.48
lens.
92317... X Prescription of contact 936 0.52 $27.42 $9.49 $5.48
lens.
92325... X Modification of contact 936 0.52 $27.42 $9.49 $5.48
lens.
92326... X Replacement of contact 936 0.52 $27.42 $9.49 $5.48
lens.
92330... X Fitting of artificial 936 0.52 $27.42 $9.49 $5.48
eye.
92335... N Fitting of artificial ......... ......... ......... ........... ...........
eye.
92340... E Fitting of spectacles.. ......... ......... ......... ........... ...........
92341... E Fitting of spectacles.. ......... ......... ......... ........... ...........
92342... E Fitting of spectacles.. ......... ......... ......... ........... ...........
92352... X Special spectacles 936 0.52 $27.42 $9.49 $5.48
fitting.
92353... X Special spectacles 936 0.52 $27.42 $9.49 $5.48
fitting.
[[Page 47714]]
92354... X Special spectacles 936 0.52 $27.42 $9.49 $5.48
fitting.
92355... X Special spectacles 936 0.52 $27.42 $9.49 $5.48
fitting.
92358... X Eye prosthesis service. 936 0.52 $27.42 $9.49 $5.48
92370... E Repair & adjust ......... ......... ......... ........... ...........
spectacles.
92371... X Repair & adjust 936 0.52 $27.42 $9.49 $5.48
spectacles.
92390... E Supply of spectacles... ......... ......... ......... ........... ...........
92391... E Supply of contact ......... ......... ......... ........... ...........
lenses.
92392... E Supply of low vision ......... ......... ......... ........... ...........
aids.
92393... E Supply of artificial ......... ......... ......... ........... ...........
eye.
92395... E Supply of spectacles... ......... ......... ......... ........... ...........
92396... E Supply of contact ......... ......... ......... ........... ...........
lenses.
92499... X Eye service or 931 0.74 $39.18 $21.47 $7.84
procedure.
92502... T Ear and throat 311 1.43 $75.42 $20.57 $15.08
examination.
92504... N Ear microscopy ......... ......... ......... ........... ...........
examination.
92506... A Speech & hearing ......... ......... ......... ........... ...........
evaluation.
92507... A Speech/hearing therapy. ......... ......... ......... ........... ...........
92508... A Speech/hearing therapy. ......... ......... ......... ........... ...........
92510... A Rehab for ear implant.. ......... ......... ......... ........... ...........
92511... T Nasopharyngos-......... 331 0.69 $36.24 $14.01 $7.25
copy...................
92512... X Nasal function studies. 940 3.04 $160.63 $51.98 $32.13
92516... X Facial nerve function 940 3.04 $160.63 $51.98 $32.13
test.
92520... X Laryngeal function 940 3.04 $160.63 $51.98 $32.13
studies.
92525... A Oral function ......... ......... ......... ........... ...........
evaluation.
92526... A Oral function therapy.. ......... ......... ......... ........... ...........
92531... N Spontaneous nystagmus ......... ......... ......... ........... ...........
study.
92532... N Positional nystagmus ......... ......... ......... ........... ...........
study.
92533... N Caloric vestibular test ......... ......... ......... ........... ...........
92534... N Optokinetic nystagmus.. ......... ......... ......... ........... ...........
92541... X Spontaneous nystagmus 940 3.04 $160.63 $51.98 $32.13
test.
92542... X Positional nystagmus 940 3.04 $160.63 $51.98 $32.13
test.
92543... X Caloric vestibular test 940 3.04 $160.63 $51.98 $32.13
92544... X Optokinetic nystagmus 940 3.04 $160.63 $51.98 $32.13
test.
92545... X Oscillating tracking 940 3.04 $160.63 $51.98 $32.13
test.
92546... X Sinusoidal rotational 940 3.04 $160.63 $51.98 $32.13
test.
92547... X Supplemental electrical 940 3.04 $160.63 $51.98 $32.13
test.
92548... X Posturography.......... 940 3.04 $160.63 $51.98 $32.13
92551... E Pure tone hearing test, ......... ......... ......... ........... ...........
air.
92552... X Pure tone audiometry, 941 0.74 $39.18 $13.56 $7.84
air.
92553... X Audiometry, air & bone. 941 0.74 $39.18 $13.56 $7.84
92555... X Speech threshold 941 0.74 $39.18 $13.56 $7.84
audiometry.
92556... X Speech audiometry, 941 0.74 $39.18 $13.56 $7.84
complete.
92557... X Comprehensive hearing 942 1.48 $78.36 $22.15 $15.67
test.
92559... E Group audiometric ......... ......... ......... ........... ...........
testing.
92560... E Bekesy audiometry, ......... ......... ......... ........... ...........
screen.
92561... X Bekesy audiometry, 942 1.48 $78.36 $22.15 $15.67
diagnosis.
92562... X Loudness balance test.. 942 1.48 $78.36 $22.15 $15.67
92563... X Tone decay hearing test 942 1.48 $78.36 $22.15 $15.67
92564... X Sisi hearing test...... 942 1.48 $78.36 $22.15 $15.67
92565... X Stenger test, pure tone 942 1.48 $78.36 $22.15 $15.67
92567... X Tympanometry........... 941 0.74 $39.18 $13.56 $7.84
92568... X Acoustic reflex testing 942 1.48 $78.36 $22.15 $15.67
92569... X Acoustic reflex decay 942 1.48 $78.36 $22.15 $15.67
test.
92571... X Filtered speech hearing 942 1.48 $78.36 $22.15 $15.67
test.
92572... X Staggered spondaic word 942 1.48 $78.36 $22.15 $15.67
test.
92573... X Lombard test........... 942 1.48 $78.36 $22.15 $15.67
92575... X Sensorineural acuity 942 1.48 $78.36 $22.15 $15.67
test.
92576... X Synthetic sentence test 942 1.48 $78.36 $22.15 $15.67
92577... X Stenger test, speech... 942 1.48 $78.36 $22.15 $15.67
92579... X Visual audiometry (vra) 942 1.48 $78.36 $22.15 $15.67
92582... X Conditioning play 942 1.48 $78.36 $22.15 $15.67
audiometry.
92583... X Select picture 942 1.48 $78.36 $22.15 $15.67
audiometry.
92584... X Electrocochleography... 940 3.04 $160.63 $51.98 $32.13
92585... X Auditory evoked 982 1.39 $73.46 $38.87 $14.69
potential.
92587... X Evoked auditory test... 940 3.04 $160.63 $51.98 $32.13
92588... X Evoked auditory test... 940 3.04 $160.63 $51.98 $32.13
92589... X Auditory function 942 1.48 $78.36 $22.15 $15.67
test(s).
92590... E Hearing aid exam, one ......... ......... ......... ........... ...........
ear.
92591... E Hearing aid exam, both ......... ......... ......... ........... ...........
ears.
92592... E Hearing aid check, one ......... ......... ......... ........... ...........
ear.
92593... E Hearing aid check, both ......... ......... ......... ........... ...........
ears.
92594... E Electro hearing aid ......... ......... ......... ........... ...........
test, one.
92595... E Electro hearing aid ......... ......... ......... ........... ...........
test, both.
92596... X Ear protector 942 1.48 $78.36 $22.15 $15.67
evaluation.
92597... A Oral speech device eval ......... ......... ......... ........... ...........
[[Page 47715]]
92598... A Modify oral speech ......... ......... ......... ........... ...........
device.
92599... X ENT procedure/service.. 941 0.74 $39.18 $13.56 $7.84
92950... S Heart/lung 947 4.07 $215.48 $109.61 $43.10
resuscitation(CPR.
92953... S Temporary external 947 4.07 $215.48 $109.61 $43.10
pacing.
92960... S Heart electroconversion 947 4.07 $215.48 $109.61 $43.10
92970... C Cardioassist, internal. ......... ......... ......... ........... ...........
92971... C Cardioassist, external. ......... ......... ......... ........... ...........
92975... C Dissolve clot, heart ......... ......... ......... ........... ...........
vessel.
92977... C Dissolve clot, heart ......... ......... ......... ........... ...........
vessel.
92978... C Intravas us, heart (add- ......... ......... ......... ........... ...........
on).
92979... C Intravas us, heart (add- ......... ......... ......... ........... ...........
on).
92980... C Insert intracoronary ......... ......... ......... ........... ...........
stent.
92981... C Insert intracoronary ......... ......... ......... ........... ...........
stent.
92982... C Coronary artery ......... ......... ......... ........... ...........
dilation.
92984... C Coronary artery ......... ......... ......... ........... ...........
dilation.
92986... C Revision of aortic ......... ......... ......... ........... ...........
valve.
92987... C Revision of mitral ......... ......... ......... ........... ...........
valve.
92990... C Revision of pulmonary ......... ......... ......... ........... ...........
valve.
92992... C Revision of heart ......... ......... ......... ........... ...........
chamber.
92993... C Revision of heart ......... ......... ......... ........... ...........
chamber.
92995... C Coronary atherectomy... ......... ......... ......... ........... ...........
92996... C Coronary atherectomy... ......... ......... ......... ........... ...........
92997... C Pul art balloon repair, ......... ......... ......... ........... ...........
perc.
92998... C Pul art balloon repair, ......... ......... ......... ........... ...........
perc.
93000... N Electrocardiogram, ......... ......... ......... ........... ...........
complete.
93005... X Electrocardiogram, 950 0.35 $18.61 $15.82 $3.72
tracing.
93010... N Electrocardiogram ......... ......... ......... ........... ...........
report.
93012... X Transmission of ecg.... 956 1.11 $58.77 $55.82 $11.75
93014... N Report on transmitted ......... ......... ......... ........... ...........
ecg.
93015... N Cardiovascular stress ......... ......... ......... ........... ...........
test.
93016... N Cardiovascular stress ......... ......... ......... ........... ...........
test.
93017... X Cardiovascular stress 949 1.46 $77.38 $62.83 $15.48
test.
93018... N Cardiovascular stress ......... ......... ......... ........... ...........
test.
93024... X Cardiac drug stress 949 1.46 $77.38 $62.83 $15.48
test.
93040... N Rhythm ECG with report. ......... ......... ......... ........... ...........
93041... X Rhythm ECG, tracing.... 950 0.35 $18.61 $15.82 $3.72
93042... N Rhythm ECG, report..... ......... ......... ......... ........... ...........
93224... X ECG monitor/report, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93225... X ECG monitor/record, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93226... X ECG monitor/report, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93227... N ECG monitor/review, 24 ......... ......... ......... ........... ...........
hrs.
93230... X ECG monitor/report, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93231... X Ecg monitor/record, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93232... X ECG monitor/report, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93233... N ECG monitor/review, 24 ......... ......... ......... ........... ...........
hrs.
93235... X ECG monitor/report, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93236... X ECG monitor/report, 24 956 1.11 $58.77 $55.82 $11.75
hrs.
93237... N ECG monitor/review, 24 ......... ......... ......... ........... ...........
hrs.
93268... X ECG record/review...... 956 1.11 $58.77 $55.82 $11.75
93270... X ECG recording.......... 956 1.11 $58.77 $55.82 $11.75
93271... X Ecg/monitoring and 956 1.11 $58.77 $55.82 $11.75
anaylysis.
93272... N Ecg/review,interpret ......... ......... ......... ........... ...........
only.
93278... X ECG/signal-averaged.... 956 1.11 $58.77 $55.82 $11.75
93303... X Echo transthoracic..... 957 2.83 $149.86 $117.07 $29.97
93304... X Echo transthoracic..... 957 2.83 $149.86 $117.07 $29.97
93307... X Echo exam of heart..... 957 2.83 $149.86 $117.07 $29.97
93308... X Echo exam of heart..... 957 2.83 $149.86 $117.07 $29.97
93312... X Echo transesophageal... 957 2.83 $149.86 $117.07 $29.97
93313... X Echo transesophageal... 957 2.83 $149.86 $117.07 $29.97
93314... N Echo transesophageal... ......... ......... ......... ........... ...........
93315... X Echo transesophageal... 957 2.83 $149.86 $117.07 $29.97
93316... X Echo transesophageal... 957 2.83 $149.86 $117.07 $29.97
93317... N Echo transesophageal... ......... ......... ......... ........... ...........
93320... X Doppler echo exam, 957 2.83 $149.86 $117.07 $29.97
heart.
93321... X Doppler echo exam, 957 2.83 $149.86 $117.07 $29.97
heart.
93325... X Doppler color flow..... 957 2.83 $149.86 $117.07 $29.97
93350... X Echo transthoracic..... 957 2.83 $149.86 $117.07 $29.97
93501... T Right heart 958 26.11 $1,381.03 $659.47 $276.21
catheterization.
93503... T Insert/place heart 958 26.11 $1,381.03 $659.47 $276.21
catheter.
93505... T Biopsy of heart lining. 958 26.11 $1,381.03 $659.47 $276.21
93508... T Cath placement, 343 9.52 $503.44 $224.87 $100.69
angiography.
93510... T Left heart 958 26.11 $1,381.03 $659.47 $276.21
catheterization.
93511... T Left heart 958 26.11 $1,381.03 $659.47 $276.21
catheterization.
93514... T Left heart 958 26.11 $1,381.03 $659.47 $276.21
catheterization.
93524... T Left heart 958 26.11 $1,381.03 $659.47 $276.21
catheterization.
[[Page 47716]]
93526... T Rt & Lt heart catheters 958 26.11 $1,381.03 $659.47 $276.21
93527... T Rt & Lt heart catheters 958 26.11 $1,381.03 $659.47 $276.21
93528... T Rt & Lt heart catheters 958 26.11 $1,381.03 $659.47 $276.21
93529... T Rt, Lt heart 958 26.11 $1,381.03 $659.47 $276.21
catheterization.
93530... T Rt heart cath, 958 26.11 $1,381.03 $659.47 $276.21
congenital.
93531... T R & l heart cath, 958 26.11 $1,381.03 $659.47 $276.21
congenital.
93532... T R & l heart cath, 958 26.11 $1,381.03 $659.47 $276.21
congenital.
93533... T R & l heart cath, 958 26.11 $1,381.03 $659.47 $276.21
congenital.
93536... T Insert circulation assi 958 26.11 $1,381.03 $659.47 $276.21
93539... N Injection, cardiac cath ......... ......... ......... ........... ...........
93540... N Injection, cardiac cath ......... ......... ......... ........... ...........
93541... N Injection for lung ......... ......... ......... ........... ...........
angiogram.
93542... N Injection for heart x- ......... ......... ......... ........... ...........
rays.
93543... N Injection for heart x- ......... ......... ......... ........... ...........
rays.
93544... N Injection for ......... ......... ......... ........... ...........
aortography.
93545... N Injection for coronary ......... ......... ......... ........... ...........
xrays.
93555... N Imaging, cardiac cath.. ......... ......... ......... ........... ...........
93556... N Imaging, cardiac cath.. ......... ......... ......... ........... ...........
93561... N Cardiac output ......... ......... ......... ........... ...........
measurement.
93562... N Cardiac output ......... ......... ......... ........... ...........
measurement.
93600... S Bundle of His recording 960 4.24 $224.29 $144.41 $44.86
93602... S Intra-atrial recording. 960 4.24 $224.29 $144.41 $44.86
93603... S Right ventricular 960 4.24 $224.29 $144.41 $44.86
recording.
93607... S Right ventricular 960 4.24 $224.29 $144.41 $44.86
recording.
93609... S Mapping of tachycardia. 960 4.24 $224.29 $144.41 $44.86
93610... S Intra-atrial pacing.... 960 4.24 $224.29 $144.41 $44.86
93612... S Intraventricular pacing 960 4.24 $224.29 $144.41 $44.86
93615... S Esophageal recording... 960 4.24 $224.29 $144.41 $44.86
93616... S Esophageal recording... 960 4.24 $224.29 $144.41 $44.86
93618... S Heart rhythm pacing.... 960 4.24 $224.29 $144.41 $44.86
93619... S Electrophysiology 960 4.24 $224.29 $144.41 $44.86
evaluation.
93620... S Electrophysiology 960 4.24 $224.29 $144.41 $44.86
evaluation.
93621... S Electrophysiology 960 4.24 $224.29 $144.41 $44.86
evaluation.
93622... S Electrophysiology 960 4.24 $224.29 $144.41 $44.86
evaluation.
93623... S Stimulation, pacing 960 4.24 $224.29 $144.41 $44.86
heart.
93624... S Electrophysiologic 960 4.24 $224.29 $144.41 $44.86
study.
93631... S Heart pacing, mapping.. 960 4.24 $224.29 $144.41 $44.86
93640... S Evaluation heart device 960 4.24 $224.29 $144.41 $44.86
93641... S Electrophysiology 960 4.24 $224.29 $144.41 $44.86
evaluation.
93642... S Electrophysiology 960 4.24 $224.29 $144.41 $44.86
evaluation.
93650... S Ablate heart dysrhythm 960 4.24 $224.29 $144.41 $44.86
focus.
93651... S Ablate heart dysrhythm 960 4.24 $224.29 $144.41 $44.86
focus.
93652... S Ablate heart dysrhythm 960 4.24 $224.29 $144.41 $44.86
focus.
93660... S Tilt table evaluation.. 960 4.24 $224.29 $144.41 $44.86
93720... X Total body 967 1.70 $90.11 $57.40 $18.02
plethysmography.
93721... X Plethysmography tracing 967 1.70 $90.11 $57.40 $18.02
93722... N Plethysmography report. ......... ......... ......... ........... ...........
93724... S Analyze pacemaker 960 4.24 $224.29 $144.41 $44.86
system.
93731... X Analyze pacemaker 966 0.39 $20.57 $12.43 $4.11
system.
93732... X Analyze pacemaker 966 0.39 $20.57 $12.43 $4.11
system.
93733... X Telephone analysis, 966 0.39 $20.57 $12.43 $4.11
pacemaker.
93734... X Analyze pacemaker 966 0.39 $20.57 $12.43 $4.11
system.
93735... X Analyze pacemaker 966 0.39 $20.57 $12.43 $4.11
system.
93736... X Telephone analysis, 966 0.39 $20.57 $12.43 $4.11
pacemaker.
93737... X Analyze cardio/ 966 0.39 $20.57 $12.43 $4.11
defibrillator.
93738... X Analyze cardio/ 966 0.39 $20.57 $12.43 $4.11
defibrillator.
93740... X Temperature gradient 967 1.70 $90.11 $57.40 $18.02
studies.
93760... E Cephalic thermogram.... ......... ......... ......... ........... ...........
93762... E Peripheral thermogram.. ......... ......... ......... ........... ...........
93770... N Measure venous pressure ......... ......... ......... ........... ...........
93784... E Ambulatory BP ......... ......... ......... ........... ...........
monitoring.
93786... E Ambulatory BP recording ......... ......... ......... ........... ...........
93788... E Ambulatory BP analysis. ......... ......... ......... ........... ...........
93790... E Review/report BP ......... ......... ......... ........... ...........
recording.
93797... X Cardiac rehab.......... 948 0.81 $43.10 $16.95 $8.62
93798... X Cardiac rehab/monitor.. 948 0.81 $43.10 $16.95 $8.62
93799... X Cardiovascular 967 1.70 $90.11 $57.40 $18.02
procedure.
93875... X Extracranial study..... 968 2.37 $125.37 $79.55 $25.07
93880... X Extracranial study..... 968 2.37 $125.37 $79.55 $25.07
93882... X Extracranial study..... 968 2.37 $125.37 $79.55 $25.07
93886... X Intracranial study..... 968 2.37 $125.37 $79.55 $25.07
93888... X Intracranial study..... 968 2.37 $125.37 $79.55 $25.07
93922... X Extremity study........ 967 1.70 $90.11 $57.40 $18.02
93923... X Extremity study........ 967 1.70 $90.11 $57.40 $18.02
93924... X Extremity study........ 967 1.70 $90.11 $57.40 $18.02
[[Page 47717]]
93925... X Lower extremity study.. 968 2.37 $125.37 $79.55 $25.07
93926... X Lower extremity study.. 968 2.37 $125.37 $79.55 $25.07
93930... X Upper extremity study.. 968 2.37 $125.37 $79.55 $25.07
93931... X Upper extremity study.. 968 2.37 $125.37 $79.55 $25.07
93965... X Extremity study........ 967 1.70 $90.11 $57.40 $18.02
93970... X Extremity study........ 968 2.37 $125.37 $79.55 $25.07
93971... X Extremity study........ 968 2.37 $125.37 $79.55 $25.07
93975... X Vascular study......... 968 2.37 $125.37 $79.55 $25.07
93976... X Vascular study......... 968 2.37 $125.37 $79.55 $25.07
93978... X Vascular study......... 968 2.37 $125.37 $79.55 $25.07
93979... X Vascular study......... 968 2.37 $125.37 $79.55 $25.07
93980... X Penile vascular study.. 968 2.37 $125.37 $79.55 $25.07
93981... X Penile vascular study.. 968 2.37 $125.37 $79.55 $25.07
93990... X Doppler flow testing... 968 2.37 $125.37 $79.55 $25.07
94010... X Breathing capacity test 971 0.78 $41.14 $21.47 $8.23
94060... X Evaluation of wheezing. 971 0.78 $41.14 $21.47 $8.23
94070... S Evaluation of wheezing. 973 1.89 $99.90 $55.82 $19.98
94150... N Vital capacity test.... ......... ......... ......... ........... ...........
94200... X Lung function test (MBC/ 971 0.78 $41.14 $21.47 $8.23
MVV).
94240... X Residual lung capacity. 972 1.02 $53.87 $29.38 $10.77
94250... X Expired gas collection. 971 0.78 $41.14 $21.47 $8.23
94260... X Thoracic gas volume.... 971 0.78 $41.14 $21.47 $8.23
94350... X Lung nitrogen washout 972 1.02 $53.87 $29.38 $10.77
curve.
94360... X Measure airflow 971 0.78 $41.14 $21.47 $8.23
resistance.
94370... X Breath airway closing 972 1.02 $53.87 $29.38 $10.77
volume.
94375... X Respiratory flow volume 971 0.78 $41.14 $21.47 $8.23
loop.
94400... X CO2 breathing response 971 0.78 $41.14 $21.47 $8.23
curve.
94450... X Hypoxia response curve. 971 0.78 $41.14 $21.47 $8.23
94620... S Pulmonary stress 973 1.89 $99.90 $55.82 $19.98
testing.
94640... S Airway inhalation 976 0.44 $23.30 $14.92 $4.66
treatment.
94642... S Aerosol inhalation 976 0.44 $23.30 $14.92 $4.66
treatment.
94650... S Pressure breathing 976 0.44 $23.30 $14.92 $4.66
(IPPB).
94651... S Pressure breathing 976 0.44 $23.30 $14.92 $4.66
(IPPB).
94652... C Pressure breathing ......... ......... ......... ........... ...........
(IPPB).
94656... C Initial ventilator mgmt ......... ......... ......... ........... ...........
94657... S Cont. ventilator....... 976 0.44 $23.30 $14.92 $4.66
94660... S Pos airway pressure, 976 0.44 $23.30 $14.92 $4.66
CPAP.
94662... S Neg pressure 976 0.44 $23.30 $14.92 $4.66
ventilation,cnp.
94664... S Aerosol or vapor 976 0.44 $23.30 $14.92 $4.66
inhalations.
94665... S Aerosol or vapor 976 0.44 $23.30 $14.92 $4.66
inhalations.
94667... S Chest wall manipulation 976 0.44 $23.30 $14.92 $4.66
94668... S Chest wall manipulation 976 0.44 $23.30 $14.92 $4.66
94680... X Exhaled air analysis: 972 1.02 $53.87 $29.38 $10.77
O2.
94681... X Exhaled air analysis: 972 1.02 $53.87 $29.38 $10.77
O2,CO2.
94690... X Exhaled air analysis... 972 1.02 $53.87 $29.38 $10.77
94720... X Monoxide diffusing 972 1.02 $53.87 $29.38 $10.77
capacity.
94725... X Membrane diffusion 972 1.02 $53.87 $29.38 $10.77
capacity.
94750... S Pulmonary compliance 973 1.89 $99.90 $55.82 $19.98
study.
94760... N Measure blood oxygen ......... ......... ......... ........... ...........
level.
94761... N Measure blood oxygen ......... ......... ......... ........... ...........
level.
94762... X Measure blood oxygen 971 0.78 $41.14 $21.47 $8.23
level.
94770... X Exhaled carbon dioxide 971 0.78 $41.14 $21.47 $8.23
test.
94772... S Breath recording, 973 1.89 $99.90 $55.82 $19.98
infant.
94799... X Pulmonary service/ 971 0.78 $41.14 $21.47 $8.23
procedure.
95004... X Allergy skin tests..... 977 0.63 $33.30 $12.66 $6.66
95010... X Sensitivity skin tests. 977 0.63 $33.30 $12.66 $6.66
95015... X Sensitivity skin tests. 977 0.63 $33.30 $12.66 $6.66
95024... X Allergy skin tests..... 977 0.63 $33.30 $12.66 $6.66
95027... X Skin end point 977 0.63 $33.30 $12.66 $6.66
titration.
95028... X Allergy skin tests..... 977 0.63 $33.30 $12.66 $6.66
95044... X Allergy patch tests.... 977 0.63 $33.30 $12.66 $6.66
95052... X Photo patch test....... 977 0.63 $33.30 $12.66 $6.66
95056... X Photosensitivity tests. 977 0.63 $33.30 $12.66 $6.66
95060... X Eye allergy tests...... 977 0.63 $33.30 $12.66 $6.66
95065... X Nose allergy test...... 977 0.63 $33.30 $12.66 $6.66
95070... S Bronchial allergy tests 973 1.89 $99.90 $55.82 $19.98
95071... S Bronchial allergy tests 973 1.89 $99.90 $55.82 $19.98
95075... X Ingestion challenge 928 3.11 $164.55 $83.85 $32.91
test.
95078... X Provocative testing.... 977 0.63 $33.30 $12.66 $6.66
95115... X Immunotherapy, one 978 0.31 $16.65 $3.39 $3.33
injection.
95117... X Immunotherapy 978 0.31 $16.65 $3.39 $3.33
injections.
95120... E Immunotherapy, one ......... ......... ......... ........... ...........
injection.
95125... E Immunotherapy, many ......... ......... ......... ........... ...........
antigens.
95130... E Immunotherapy, insect ......... ......... ......... ........... ...........
venom.
95131... E Immunotherapy, insect ......... ......... ......... ........... ...........
venoms.
[[Page 47718]]
95132... E Immunotherapy, insect ......... ......... ......... ........... ...........
venoms.
95133... E Immunotherapy, insect ......... ......... ......... ........... ...........
venoms.
95134... E Immunotherapy, insect ......... ......... ......... ........... ...........
venoms.
95144... X Antigen therapy 978 0.31 $16.65 $3.39 $3.33
services.
95145... X Antigen therapy 978 0.31 $16.65 $3.39 $3.33
services.
95146... X Antigen therapy 978 0.31 $16.65 $3.39 $3.33
services.
95147... X Antigen therapy 978 0.31 $16.65 $3.39 $3.33
services.
95148... X Antigen therapy 978 0.31 $16.65 $3.39 $3.33
services.
95149... X Antigen therapy 901 0.07 $3.92 $2.49 $.78
services.
95165... X Antigen therapy 978 0.31 $16.65 $3.39 $3.33
services.
95170... X Antigen therapy 901 0.07 $3.92 $2.49 $.78
services.
95180... X Rapid desensitization.. 977 0.63 $33.30 $12.66 $6.66
95199... X Allergy immunology 977 0.63 $33.30 $12.66 $6.66
services.
95805... S Multiple sleep latency 979 10.17 $537.72 $288.83 $107.54
test.
95806... S Sleep study, unattended 979 10.17 $537.72 $288.83 $107.54
95807... S Sleep study, attended.. 979 10.17 $537.72 $288.83 $107.54
95808... S Polysomnography, 1-3... 979 10.17 $537.72 $288.83 $107.54
95810... S Polysomnography, 4 or 979 10.17 $537.72 $288.83 $107.54
more.
95811... S Polysomnography w/cpap. 979 10.17 $537.72 $288.83 $107.54
95812... S Electroencephalogram 979 10.17 $537.72 $288.83 $107.54
(EEG).
95813... S Electroencephalogram 979 10.17 $537.72 $288.83 $107.54
(EEG).
95816... X Electroencephalogram 980 2.15 $113.62 $57.86 $22.72
(EEG).
95819... X Electroencephalogram 980 2.15 $113.62 $57.86 $22.72
(EEG).
95822... X Sleep 980 2.15 $113.62 $57.86 $22.72
electroencephalogram.
95824... X Electroencephalography. 980 2.15 $113.62 $57.86 $22.72
95827... S Night 979 10.17 $537.72 $288.83 $107.54
electroencephalogram.
95829... X Surgery 980 2.15 $113.62 $57.86 $22.72
electrocorticogram.
95830... N Insert electrodes for ......... ......... ......... ........... ...........
EEG.
95831... N Limb muscle testing, ......... ......... ......... ........... ...........
manual.
95832... N Hand muscle testing, ......... ......... ......... ........... ...........
manual.
95833... N Body muscle testing, ......... ......... ......... ........... ...........
manual.
95834... N Body muscle testing, ......... ......... ......... ........... ...........
manual.
95851... N Range of motion ......... ......... ......... ........... ...........
measurements.
95852... N Range of motion ......... ......... ......... ........... ...........
measurements.
95857... X Tensilon test.......... 981 1.46 $77.38 $41.81 $15.48
95858... X Tensilon test & myogram 982 1.39 $73.46 $38.87 $14.69
95860... X Muscle test, one limb.. 982 1.39 $73.46 $38.87 $14.69
95861... X Muscle test, two limbs. 982 1.39 $73.46 $38.87 $14.69
95863... X Muscle test, 3 limbs... 982 1.39 $73.46 $38.87 $14.69
95864... X Muscle test, 4 limbs... 982 1.39 $73.46 $38.87 $14.69
95867... X Muscle test, head or 981 1.46 $77.38 $41.81 $15.48
neck.
95868... X Muscle test, head or 982 1.39 $73.46 $38.87 $14.69
neck.
95869... X Muscle test, thor 981 1.46 $77.38 $41.81 $15.48
paraspinal.
95870... X Muscle test, non- 981 1.46 $77.38 $41.81 $15.48
paraspinal.
95872... X Muscle test, one fiber. 982 1.39 $73.46 $38.87 $14.69
95875... X Limb exercise test..... 982 1.39 $73.46 $38.87 $14.69
95900... X Motor nerve conduction 981 1.46 $77.38 $41.81 $15.48
test.
95903... X Motor nerve conduction 982 1.39 $73.46 $38.87 $14.69
test.
95904... X Sense nerve conduction 982 1.39 $73.46 $38.87 $14.69
test.
95920... C Intraoperative nerve ......... ......... ......... ........... ...........
testing.
95921... X Autonomic nervous func 981 1.46 $77.38 $41.81 $15.48
test.
95922... X Autonomic nervous func 981 1.46 $77.38 $41.81 $15.48
test.
95923... X Autonomic nervous func 981 1.46 $77.38 $41.81 $15.48
test.
95925... X Somatosensory testing.. 982 1.39 $73.46 $38.87 $14.69
95926... X Somatosensory testing.. 981 1.46 $77.38 $41.81 $15.48
95927... X Somatosensory testing.. 981 1.46 $77.38 $41.81 $15.48
95930... X Visual evoked potential 981 1.46 $77.38 $41.81 $15.48
test.
95933... X Blink reflex test...... 981 1.46 $77.38 $41.81 $15.48
95934... X `h' reflex test........ 981 1.46 $77.38 $41.81 $15.48
95936... X `h' reflex test........ 981 1.46 $77.38 $41.81 $15.48
95937... X Neuromuscular junction 981 1.46 $77.38 $41.81 $15.48
test.
95950... X Ambulatory eeg 981 1.46 $77.38 $41.81 $15.48
monitoring.
95951... S EEG monitoring/ 979 10.17 $537.72 $288.83 $107.54
videorecord.
95953... S EEG monitoring/computer 979 10.17 $537.72 $288.83 $107.54
95954... S EEG monitoring/giving 979 10.17 $537.72 $288.83 $107.54
drugs.
95955... X EEG during surgery..... 980 2.15 $113.62 $57.86 $22.72
95956... N EEG monitoring/cable/ ......... ......... ......... ........... ...........
radio.
95957... N EEG digital analysis... ......... ......... ......... ........... ...........
95958... S EEG monitoring/function 979 10.17 $537.72 $288.83 $107.54
test.
95961... C Electrode stimulation, ......... ......... ......... ........... ...........
brain.
95962... C Electrode stimulation, ......... ......... ......... ........... ...........
brain.
95999... N Neurological procedure. ......... ......... ......... ........... ...........
96100... X Psychological testing.. 089 2.54 $134.19 $37.29 $26.84
96105... X Assessment of aphasia.. 089 2.54 $134.19 $37.29 $26.84
96110... X Developmental test, lim 089 2.54 $134.19 $37.29 $26.84
[[Page 47719]]
96111... X Developmental test, 089 2.54 $134.19 $37.29 $26.84
extend.
96115... X Neurobehavior status 089 2.54 $134.19 $37.29 $26.84
exam.
96117... X Neuropsych test battery 089 2.54 $134.19 $37.29 $26.84
96400... S Chemotherapy, (SC)/(IM) 987 0.65 $34.28 $13.33 $6.86
96405... S Intralesional chemo 987 0.65 $34.28 $13.33 $6.86
admin.
96406... S Intralesional chemo 987 0.65 $34.28 $13.33 $6.86
admin.
96408... S Chemotherapy, push 988 4.15 $219.40 $97.63 $43.88
technique.
96410... S Chemotherapy, infusion 988 4.15 $219.40 $97.63 $43.88
method.
96412... S Chemotherapy, infusion 988 4.15 $219.40 $97.63 $43.88
method.
96414... S Chemotherapy, infusion 989 1.72 $91.09 $40.68 $18.22
method.
96420... S Chemotherapy, push 988 4.15 $219.40 $97.63 $43.88
technique.
96422... S Chemotherapy, infusion 988 4.15 $219.40 $97.63 $43.88
method.
96423... S Chemotherapy, infusion 988 4.15 $219.40 $97.63 $43.88
method.
96425... S Chemotherapy, infusion 989 1.72 $91.09 $40.68 $18.22
method.
96440... S Chemotherapy, 989 1.72 $91.09 $40.68 $18.22
intracavitary.
96445... S Chemotherapy, 989 1.72 $91.09 $40.68 $18.22
intracavitary.
96450... S Chemotherapy, into CNS. 989 1.72 $91.09 $40.68 $18.22
96520... E Pump refilling, ......... ......... ......... ........... ...........
maintenance.
96530... E Pump refilling, ......... ......... ......... ........... ...........
maintenance.
96542... S Chemotherapy injection. 989 1.72 $91.09 $40.68 $18.22
96545... N Provide chemotherapy ......... ......... ......... ........... ...........
agent.
96549... S Chemotherapy, 987 0.65 $34.28 $13.33 $6.86
unspecified.
96900... S Ultraviolet light 990 0.43 $22.53 $8.14 $4.51
therapy.
96902... N Trichogram............. ......... ......... ......... ........... ...........
96910... S Photochemotherapy with 990 0.43 $22.53 $8.14 $4.51
UV-B.
96912... S Photochemotherapy with 990 0.43 $22.53 $8.14 $4.51
UV-A.
96913... S Photochemotherapy, UV-A 990 0.43 $22.53 $8.14 $4.51
or B.
96999... S Dermatological 990 0.43 $22.53 $8.14 $4.51
procedure.
97001... A Pt evaluation.......... ......... ......... ......... ........... ...........
97002... A Pt re-evaluation....... ......... ......... ......... ........... ...........
97003... A Ot evaluation.......... ......... ......... ......... ........... ...........
97004... A Ot re-evaluation....... ......... ......... ......... ........... ...........
97010... A Hot or cold packs ......... ......... ......... ........... ...........
therapy.
97012... A Mechanical traction ......... ......... ......... ........... ...........
therapy.
97014... A Electric stimulation ......... ......... ......... ........... ...........
therapy.
97016... A Vasopneumatic device ......... ......... ......... ........... ...........
therapy.
97018... A Paraffin bath therapy.. ......... ......... ......... ........... ...........
97020... A Microwave therapy...... ......... ......... ......... ........... ...........
97022... A Whirlpool therapy...... ......... ......... ......... ........... ...........
97024... A Diathermy treatment.... ......... ......... ......... ........... ...........
97026... A Infrared therapy....... ......... ......... ......... ........... ...........
97028... A Ultraviolet therapy.... ......... ......... ......... ........... ...........
97032... A Electrical stimulation. ......... ......... ......... ........... ...........
97033... A Electric current ......... ......... ......... ........... ...........
therapy.
97034... A Contrast bath therapy.. ......... ......... ......... ........... ...........
97035... A Ultrasound therapy..... ......... ......... ......... ........... ...........
97036... A Hydrotherapy........... ......... ......... ......... ........... ...........
97039... A Physical therapy ......... ......... ......... ........... ...........
treatment.
97110... A Therapeutic exercises.. ......... ......... ......... ........... ...........
97112... A Neuromuscular ......... ......... ......... ........... ...........
reeducation.
97113... A Aquatic therapy/ ......... ......... ......... ........... ...........
exercises.
97116... A Gait training therapy.. ......... ......... ......... ........... ...........
97122... A Manual traction therapy ......... ......... ......... ........... ...........
97124... A Massage therapy........ ......... ......... ......... ........... ...........
97139... A Physical medicine ......... ......... ......... ........... ...........
procedure.
97150... A Group therapeutic ......... ......... ......... ........... ...........
procedures.
97250... S Myofascial release..... 997 0.69 $36.24 $7.25 $7.25
97260... S Regional manipulation.. 997 0.69 $36.24 $7.25 $7.25
97261... S Supplemental 997 0.69 $36.24 $7.25 $7.25
manipulations.
97265... A Joint mobilization..... ......... ......... ......... ........... ...........
97504... A Orthotic training...... ......... ......... ......... ........... ...........
97520... A Prosthetic training.... ......... ......... ......... ........... ...........
97530... A Therapeutic activities. ......... ......... ......... ........... ...........
97535... A Self care mngment ......... ......... ......... ........... ...........
training.
97537... A Community/work ......... ......... ......... ........... ...........
reintegration.
97542... A Wheelchair mngement ......... ......... ......... ........... ...........
training.
97545... A Work hardening......... ......... ......... ......... ........... ...........
97546... A Work hardening......... ......... ......... ......... ........... ...........
97703... A Prosthetic checkout.... ......... ......... ......... ........... ...........
97750... A Physical performance ......... ......... ......... ........... ...........
test.
97770... A Cognitive skills ......... ......... ......... ........... ...........
development.
97780... E Acupuncture w/o stim... ......... ......... ......... ........... ...........
97781... E Acupuncture w/stim..... ......... ......... ......... ........... ...........
97799... A Physical medicine ......... ......... ......... ........... ...........
procedure.
98925... S Osteopathic 997 0.69 $36.24 $7.25 $7.25
manipulation.
[[Page 47720]]
98926... S Osteopathic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98927... S Osteopathic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98928... S Osteopathic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98929... S Osteopathic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98940... S Chiropractic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98941... S Chiropractic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98942... S Chiropractic 997 0.69 $36.24 $7.25 $7.25
manipulation.
98943... E Chiropractic ......... ......... ......... ........... ...........
manipulation.
99000... E Specimen handling...... ......... ......... ......... ........... ...........
99001... N Specimen handling...... ......... ......... ......... ........... ...........
99002... E Device handling........ ......... ......... ......... ........... ...........
99024... N Post-op follow-up visit ......... ......... ......... ........... ...........
99025... N Initial surgical ......... ......... ......... ........... ...........
evaluation.
99050... E Medical services after ......... ......... ......... ........... ...........
hrs.
99052... E Medical services at ......... ......... ......... ........... ...........
night.
99054... E Medical services, ......... ......... ......... ........... ...........
unusual hrs.
99056... E Non-office medical ......... ......... ......... ........... ...........
services.
99058... N Office emergency care.. ......... ......... ......... ........... ...........
99070... E Special supplies....... ......... ......... ......... ........... ...........
99071... E Patient education ......... ......... ......... ........... ...........
materials.
99075... E Medical testimony...... ......... ......... ......... ........... ...........
99078... S Group health education. 921 ......... ......... ........... ...........
99080... E Special reports or ......... ......... ......... ........... ...........
forms.
99082... E Unusual physician ......... ......... ......... ........... ...........
travel.
99090... E Computer data analysis. ......... ......... ......... ........... ...........
99100... N Special anesthesia ......... ......... ......... ........... ...........
service.
99116... N Anesthesia with ......... ......... ......... ........... ...........
hypothermia.
99135... N Special anesthesia ......... ......... ......... ........... ...........
procedure.
99140... N Emergency anesthesia... ......... ......... ......... ........... ...........
99141... N Sedation, iv/im or ......... ......... ......... ........... ...........
inhalant.
99142... N Sedation, oral/rectal/ ......... ......... ......... ........... ...........
nasal.
99175... N Induction of vomiting.. ......... ......... ......... ........... ...........
99183... S Hyperbaric oxygen 969 2.65 $140.06 $141.70 $28.01
therapy.
99185... N Regional hypothermia... ......... ......... ......... ........... ...........
99186... N Total body hypothermia. ......... ......... ......... ........... ...........
99190... C Special pump services.. ......... ......... ......... ........... ...........
99191... C Special pump services.. ......... ......... ......... ........... ...........
99192... C Special pump services.. ......... ......... ......... ........... ...........
99195... X Phlebotomy............. 999 0.43 $22.53 $10.85 $4.51
99199... N Special service or ......... ......... ......... ........... ...........
report.
99201... V Office/outpatient 911 ......... ......... ........... ...........
visit, new.
99202... V Office/outpatient 911 ......... ......... ........... ...........
visit, new.
99203... V Office/outpatient 913 ......... ......... ........... ...........
visit, new.
99204... V Office/outpatient 915 ......... ......... ........... ...........
visit, new.
99205... V Office/outpatient 915 ......... ......... ........... ...........
visit, new.
99211... V Office/outpatient 911 ......... ......... ........... ...........
visit, est.
99212... V Office/outpatient 911 ......... ......... ........... ...........
visit, est.
99213... V Office/outpatient 913 ......... ......... ........... ...........
visit, est.
99214... V Office/outpatient 915 ......... ......... ........... ...........
visit, est.
99215... V Office/outpatient 915 ......... ......... ........... ...........
visit, est.
99217... N Observation care ......... ......... ......... ........... ...........
discharge.
99218... N Observation care....... ......... ......... ......... ........... ...........
99219... N Observation care....... ......... ......... ......... ........... ...........
99220... N Observation care....... ......... ......... ......... ........... ...........
99221... E Initial hospital care.. ......... ......... ......... ........... ...........
99222... E Initial hospital care.. ......... ......... ......... ........... ...........
99223... E Initial hospital care.. ......... ......... ......... ........... ...........
99231... E Subsequent hospital ......... ......... ......... ........... ...........
care.
99232... E Subsequent hospital ......... ......... ......... ........... ...........
care.
99233... E Subsequent hospital ......... ......... ......... ........... ...........
care.
99234... C Observ/hosp same date.. ......... ......... ......... ........... ...........
99235... C Observ/hosp same date.. ......... ......... ......... ........... ...........
99236... C Observ/hosp same date.. ......... ......... ......... ........... ...........
99238... E Hospital discharge day. ......... ......... ......... ........... ...........
99239... E Hospital discharge day. ......... ......... ......... ........... ...........
99241... V Office consultation.... 911 ......... ......... ........... ...........
99242... V Office consultation.... 911 ......... ......... ........... ...........
99243... V Office consultation.... 913 ......... ......... ........... ...........
99244... V Office consultation.... 915 ......... ......... ........... ...........
99245... V Office consultation.... 915 ......... ......... ........... ...........
99251... C Initial inpatient ......... ......... ......... ........... ...........
consult.
99252... C Initial inpatient ......... ......... ......... ........... ...........
consult.
99253... C Initial inpatient ......... ......... ......... ........... ...........
consult.
99254... C Initial inpatient ......... ......... ......... ........... ...........
consult.
99255... C Initial inpatient ......... ......... ......... ........... ...........
consult.
[[Page 47721]]
99261... C Follow-up inpatient ......... ......... ......... ........... ...........
consult.
99262... C Follow-up inpatient ......... ......... ......... ........... ...........
consult.
99263... C Follow-up inpatient ......... ......... ......... ........... ...........
consult.
99271... V Confirmatory 911 ......... ......... ........... ...........
consultation.
99272... V Confirmatory 911 ......... ......... ........... ...........
consultation.
99273... V Confirmatory 913 ......... ......... ........... ...........
consultation.
99274... V Confirmatory 915 ......... ......... ........... ...........
consultation.
99275... V Confirmatory 915 ......... ......... ........... ...........
consultation.
99281... V Emergency dept visit... 951 ......... ......... ........... ...........
99282... V Emergency dept visit... 951 ......... ......... ........... ...........
99283... V Emergency dept visit... 953 ......... ......... ........... ...........
99284... V Emergency dept visit... 955 ......... ......... ........... ...........
99285... V Emergency dept visit... 955 ......... ......... ........... ...........
99288... E Direct advanced life ......... ......... ......... ........... ...........
support.
99291... S Critical care, first 900 7.44 $393.74 $144.87 $78.75
hour.
99292... N Critical care, addl 30 ......... ......... ......... ........... ...........
min.
99295... C Neonatal critical care. ......... ......... ......... ........... ...........
99296... C Neonatal critical care. ......... ......... ......... ........... ...........
99297... C Neonatal critical care. ......... ......... ......... ........... ...........
99301... E Nursing facility care.. ......... ......... ......... ........... ...........
99302... E Nursing facility care.. ......... ......... ......... ........... ...........
99303... E Nursing facility care.. ......... ......... ......... ........... ...........
99311... E Nursing facility care, ......... ......... ......... ........... ...........
subseq.
99312... E Nursing facility care, ......... ......... ......... ........... ...........
subseq.
99313... E Nursing facility care, ......... ......... ......... ........... ...........
subseq.
99315... E Nursing fac discharge ......... ......... ......... ........... ...........
day.
99316... E Nursing fac discharge ......... ......... ......... ........... ...........
day.
99321... N Rest home visit, new ......... ......... ......... ........... ...........
patient.
99322... N Rest home visit, new ......... ......... ......... ........... ...........
patient.
99323... N Rest home visit, new ......... ......... ......... ........... ...........
patient.
99331... N Rest home visit, estab ......... ......... ......... ........... ...........
pat.
99332... N Rest home visit, estab ......... ......... ......... ........... ...........
pat.
99333... N Rest home visit, estab ......... ......... ......... ........... ...........
pat.
99341... N Home visit, new patient ......... ......... ......... ........... ...........
99342... N Home visit, new patient ......... ......... ......... ........... ...........
99343... N Home visit, new patient ......... ......... ......... ........... ...........
99344... N Home visit, new patient ......... ......... ......... ........... ...........
99345... N Home visit, new patient ......... ......... ......... ........... ...........
99347... N Home visit, estab ......... ......... ......... ........... ...........
patient.
99348... N Home visit, estab ......... ......... ......... ........... ...........
patient.
99349... N Home visit, estab ......... ......... ......... ........... ...........
patient.
99350... N Home visit, estab ......... ......... ......... ........... ...........
patient.
99354... N Prolonged service, ......... ......... ......... ........... ...........
office.
99355... N Prolonged service, ......... ......... ......... ........... ...........
office.
99356... C Prolonged service, ......... ......... ......... ........... ...........
inpatient.
99357... C Prolonged service, ......... ......... ......... ........... ...........
inpatient.
99358... N Prolonged serv, w/o ......... ......... ......... ........... ...........
contact.
99359... N Prolonged serv, w/o ......... ......... ......... ........... ...........
contact.
99360... E Physician standby ......... ......... ......... ........... ...........
services.
99361... E Physician/team ......... ......... ......... ........... ...........
conference.
99362... E Physician/team ......... ......... ......... ........... ...........
conference.
99371... E Physician phone ......... ......... ......... ........... ...........
consultation.
99372... E Physician phone ......... ......... ......... ........... ...........
consultation.
99373... E Physician phone ......... ......... ......... ........... ...........
consultation.
99374... E Home health care ......... ......... ......... ........... ...........
supervision.
99375... E Home health care ......... ......... ......... ........... ...........
supervision.
99377... E Hospice care ......... ......... ......... ........... ...........
supervision.
99378... E Hospice care ......... ......... ......... ........... ...........
supervision.
99379... E Nursing fac care ......... ......... ......... ........... ...........
supervision.
99380... E Nursing fac care ......... ......... ......... ........... ...........
supervision.
99381... E Preventive visit, new, ......... ......... ......... ........... ...........
infant.
99382... E Preventive visit, new, ......... ......... ......... ........... ...........
age 1-4.
99383... E Preventive visit, new, ......... ......... ......... ........... ...........
age 5-11.
99384... E Preventive visit, new, ......... ......... ......... ........... ...........
12-17.
99385... E Preventive visit, new, ......... ......... ......... ........... ...........
18-39.
99386... E Preventive visit, new, ......... ......... ......... ........... ...........
40-64.
99387... E Preventive visit, new, ......... ......... ......... ........... ...........
65 & over.
99391... E Preventive visit, est, ......... ......... ......... ........... ...........
infant.
99392... E Preventive visit, est, ......... ......... ......... ........... ...........
age 1-4.
99393... E Preventive visit, est, ......... ......... ......... ........... ...........
age 5-11.
99394... E Preventive visit, est, ......... ......... ......... ........... ...........
12-17.
99395... E Preventive visit, est, ......... ......... ......... ........... ...........
18-39.
99396... E Preventive visit, est, ......... ......... ......... ........... ...........
40-64.
99397... E Preventive visit, est, ......... ......... ......... ........... ...........
65 & over.
99401... E Preventive counseling, ......... ......... ......... ........... ...........
indiv.
[[Page 47722]]
99402... E Preventive counseling, ......... ......... ......... ........... ...........
indiv.
99403... E Preventive counseling, ......... ......... ......... ........... ...........
indiv.
99404... E Preventive counseling, ......... ......... ......... ........... ...........
indiv.
99411... E Preventive counseling, ......... ......... ......... ........... ...........
group.
99412... E Preventive counseling, ......... ......... ......... ........... ...........
group.
99420... E Health risk assessment ......... ......... ......... ........... ...........
test.
99429... E Unlisted preventive ......... ......... ......... ........... ...........
service.
99431... N Initial care, normal ......... ......... ......... ........... ...........
newborn.
99432... N Newborn care not in ......... ......... ......... ........... ...........
hospital.
99433... C Normal newborn care, ......... ......... ......... ........... ...........
hospital.
99435... E Hospital NB discharge ......... ......... ......... ........... ...........
day.
99436... N Attendance, birth...... ......... ......... ......... ........... ...........
99440... S Newborn resuscitation.. 947 4.07 $215.48 $109.61 $43.10
99450... E Life/disability ......... ......... ......... ........... ...........
evaluation.
99455... N Disability examination. ......... ......... ......... ........... ...........
99456... N Disability examination. ......... ......... ......... ........... ...........
99499... N Unlisted E/M service... ......... ......... ......... ........... ...........
A0021... E Outside state ambulance ......... ......... ......... ........... ...........
serv.
A0030... A Air ambulance service.. ......... ......... ......... ........... ...........
A0040... A Helicopter ambulance ......... ......... ......... ........... ...........
service.
A0050... A Water amb service ......... ......... ......... ........... ...........
emergency.
A0080... E Noninterest escort in ......... ......... ......... ........... ...........
non er.
A0090... E Interest escort in non ......... ......... ......... ........... ...........
er.
A0100... E Nonemergency transport ......... ......... ......... ........... ...........
taxi.
A0110... E Nonemergency transport ......... ......... ......... ........... ...........
bus.
A0120... E Noner transport mini- ......... ......... ......... ........... ...........
bus.
A0130... E Noner transport wheelch ......... ......... ......... ........... ...........
van.
A0140... E Nonemergency transport ......... ......... ......... ........... ...........
air.
A0160... E Noner transport case ......... ......... ......... ........... ...........
worker.
A0170... E Noner transport parking ......... ......... ......... ........... ...........
fees.
A0180... E Noner transport lodgng ......... ......... ......... ........... ...........
recip.
A0190... E Noner transport meals ......... ......... ......... ........... ...........
recip.
A0200... E Noner transport lodgng ......... ......... ......... ........... ...........
escrt.
A0210... E Noner transport meals ......... ......... ......... ........... ...........
escort.
A0225... A Neonatal emergency ......... ......... ......... ........... ...........
transport.
A0300... A Ambulance basic non- ......... ......... ......... ........... ...........
emer all.
A0302... A Ambulance basic ......... ......... ......... ........... ...........
emergeny all.
A0304... A Amb adv non-er no serv ......... ......... ......... ........... ...........
all.
A0306... A Amb adv non-er spec ......... ......... ......... ........... ...........
serv all.
A0308... A Amb adv er no spec serv ......... ......... ......... ........... ...........
all.
A0310... A Amb adv er spec serv ......... ......... ......... ........... ...........
all.
A0320... A Amb basic non-er + ......... ......... ......... ........... ...........
supplies.
A0322... A Amb basic emerg + ......... ......... ......... ........... ...........
supplies.
A0324... A Adv non-er serv sep ......... ......... ......... ........... ...........
mileage.
A0326... A Adv non-er no serv sep ......... ......... ......... ........... ...........
mile.
A0328... A Adv er no serv sep ......... ......... ......... ........... ...........
mileage.
A0330... A Adv er spec serv sep ......... ......... ......... ........... ...........
mile.
A0340... A Amb basic non-er + ......... ......... ......... ........... ...........
mileage.
A0342... A Ambul basic emer + ......... ......... ......... ........... ...........
mileage.
A0344... A Amb adv non-er no serv ......... ......... ......... ........... ...........
+mile.
A0346... A Amb adv non-er serv + ......... ......... ......... ........... ...........
mile.
A0348... A Adv emer no spec serv + ......... ......... ......... ........... ...........
mile.
A0350... A Adv emer spec serv + ......... ......... ......... ........... ...........
mileage.
A0360... A Basic non-er sep mile & ......... ......... ......... ........... ...........
supp.
A0362... A Basic emer sep mile & ......... ......... ......... ........... ...........
supply.
A0364... A Adv non-er no serv sep ......... ......... ......... ........... ...........
mi & su.
A0366... A Adv non-er serv sep mil ......... ......... ......... ........... ...........
& supp.
A0368... A Adv er no serv sep mile ......... ......... ......... ........... ...........
& supp.
A0370... A Adv er spec serv sep mi ......... ......... ......... ........... ...........
& supp.
A0380... A Basic life support ......... ......... ......... ........... ...........
mileage.
A0382... A Basic support routine ......... ......... ......... ........... ...........
suppls.
A0384... A Bls defibrillation ......... ......... ......... ........... ...........
supplies.
A0390... A Advanced life support ......... ......... ......... ........... ...........
mileage.
A0392... A Als defibrillation ......... ......... ......... ........... ...........
supplies.
A0394... A Als IV drug therapy ......... ......... ......... ........... ...........
supplies.
A0396... A Als esophageal intub ......... ......... ......... ........... ...........
suppls.
A0398... A Als routine disposble ......... ......... ......... ........... ...........
suppls.
A0420... A Ambulance waiting 1/2 ......... ......... ......... ........... ...........
hr.
A0422... A Ambulance 02 life ......... ......... ......... ........... ...........
sustaining.
A0424... A Extra ambulance ......... ......... ......... ........... ...........
attendant.
A0888... E Noncovered ambulance ......... ......... ......... ........... ...........
mileage.
A0999... A Unlisted ambulance ......... ......... ......... ........... ...........
service.
A4206... A 1 CC sterile syringe & ......... ......... ......... ........... ...........
needle.
A4207... A 2 CC sterile syringe & ......... ......... ......... ........... ...........
needle.
A4208... A 3 CC sterile syringe & ......... ......... ......... ........... ...........
needle.
[[Page 47723]]
A4209... A 5+ CC sterile syringe & ......... ......... ......... ........... ...........
needle.
A4210... E Nonneedle injection ......... ......... ......... ........... ...........
device.
A4211... A Supp for self-adm ......... ......... ......... ........... ...........
injections.
A4212... A Non coring needle or ......... ......... ......... ........... ...........
stylet.
A4213... A 20+ CC syringe only.... ......... ......... ......... ........... ...........
A4214... A 30 CC sterile water/ ......... ......... ......... ........... ...........
saline.
A4215... A Sterile needle......... ......... ......... ......... ........... ...........
A4220... A Infusion pump refill ......... ......... ......... ........... ...........
kit.
A4221... A Maint drug infus cath ......... ......... ......... ........... ...........
per wk.
A4222... A Drug infusion pump ......... ......... ......... ........... ...........
supplies.
A4230... E Infus insulin pump non ......... ......... ......... ........... ...........
needl.
A4231... E Infusion insulin pump ......... ......... ......... ........... ...........
needle.
A4232... E Syringe w/needle ......... ......... ......... ........... ...........
insulin 3cc.
A4244... A Alcohol or peroxide per ......... ......... ......... ........... ...........
pint.
A4245... A Alcohol wipes per box.. ......... ......... ......... ........... ...........
A4246... A Betadine/phisohex ......... ......... ......... ........... ...........
solution.
A4247... A Betadine/iodine swabs/ ......... ......... ......... ........... ...........
wipes.
A4250... E Urine reagent strips/ ......... ......... ......... ........... ...........
tablets.
A4253... A Blood glucose/reagent ......... ......... ......... ........... ...........
strips.
A4254... A Battery for glucose ......... ......... ......... ........... ...........
monitor.
A4255... A Glucose monitor ......... ......... ......... ........... ...........
platforms.
A4256... A Calibrator solution/ ......... ......... ......... ........... ...........
chips.
A4258... A Lancet device each..... ......... ......... ......... ........... ...........
A4259... A Lancets per box........ ......... ......... ......... ........... ...........
A4260... E Levonorgestrel implant. ......... ......... ......... ........... ...........
A4262... N Temporary tear duct ......... ......... ......... ........... ...........
plug.
A4263... A Permanent tear duct ......... ......... ......... ........... ...........
plug.
A4265... A Paraffin............... ......... ......... ......... ........... ...........
A4270... A Disposable endoscope ......... ......... ......... ........... ...........
sheath.
A4300... A Cath impl vasc access ......... ......... ......... ........... ...........
portal.
A4301... A Implantable access syst ......... ......... ......... ........... ...........
perc.
A4305... A Drug delivery system ......... ......... ......... ........... ...........
>=50 ML.
A4306... A Drug delivery system ......... ......... ......... ........... ...........
<=5 ML.
A4310... A Insert tray w/o bag/ ......... ......... ......... ........... ...........
cath.
A4311... A Catheter w/o bag 2-way ......... ......... ......... ........... ...........
latex.
A4312... A Cath w/o bag 2-way ......... ......... ......... ........... ...........
silicone.
A4313... A Catheter w/bag 3-way... ......... ......... ......... ........... ...........
A4314... A Cath w/drainage 2-way ......... ......... ......... ........... ...........
latex.
A4315... A Cath w/drainage 2-way ......... ......... ......... ........... ...........
silcne.
A4316... A Cath w/drainage 3-way.. ......... ......... ......... ........... ...........
A4320... A Irrigation tray........ ......... ......... ......... ........... ...........
A4321... A Cath therapeutic irrig ......... ......... ......... ........... ...........
agent.
A4322... A Irrigation syringe..... ......... ......... ......... ........... ...........
A4323... A Saline irrigation ......... ......... ......... ........... ...........
solution.
A4326... A Male external catheter. ......... ......... ......... ........... ...........
A4327... A Fem urinary collect dev ......... ......... ......... ........... ...........
cup.
A4328... A Fem urinary collect ......... ......... ......... ........... ...........
pouch.
A4329... A External catheter start ......... ......... ......... ........... ...........
set.
A4330... A Stool collection pouch. ......... ......... ......... ........... ...........
A4335... A Incontinence supply.... ......... ......... ......... ........... ...........
A4338... A Indwelling catheter ......... ......... ......... ........... ...........
latex.
A4340... A Indwelling catheter ......... ......... ......... ........... ...........
special.
A4344... A Cath indw foley 2 way ......... ......... ......... ........... ...........
silicn.
A4346... A Cath indw foley 3 way.. ......... ......... ......... ........... ...........
A4347... A Male external catheter. ......... ......... ......... ........... ...........
A4351... A Straight tip urine ......... ......... ......... ........... ...........
catheter.
A4352... A Coude tip urinary ......... ......... ......... ........... ...........
catheter.
A4353... A Intermittent urinary ......... ......... ......... ........... ...........
cath.
A4354... A Cath insertion tray w/ ......... ......... ......... ........... ...........
bag.
A4355... A Bladder irrigation ......... ......... ......... ........... ...........
tubing.
A4356... A Ext ureth clmp or compr ......... ......... ......... ........... ...........
dvc.
A4357... A Bedside drainage bag... ......... ......... ......... ........... ...........
A4358... A Urinary leg bag........ ......... ......... ......... ........... ...........
A4359... A Urinary suspensory w/o ......... ......... ......... ........... ...........
leg b.
A4361... A Ostomy face plate...... ......... ......... ......... ........... ...........
A4362... A Solid skin barrier..... ......... ......... ......... ........... ...........
A4363... A Liquid skin barrier.... ......... ......... ......... ........... ...........
A4364... A Ostomy/cath adhesive... ......... ......... ......... ........... ...........
A4365... A Ostomy adhesive remover ......... ......... ......... ........... ...........
wipe.
A4367... A Ostomy belt............ ......... ......... ......... ........... ...........
A4368... A Ostomy filter.......... ......... ......... ......... ........... ...........
A4397... A Irrigation supply ......... ......... ......... ........... ...........
sleeve.
A4398... A Ostomy irrigation bag.. ......... ......... ......... ........... ...........
A4399... A Ostomy irrig cone/cath ......... ......... ......... ........... ...........
w brs.
A4400... A Ostomy irrigation set.. ......... ......... ......... ........... ...........
[[Page 47724]]
A4402... A Lubricant per ounce.... ......... ......... ......... ........... ...........
A4404... A Ostomy ring each....... ......... ......... ......... ........... ...........
A4421... A Ostomy supply misc..... ......... ......... ......... ........... ...........
A4454... A Tape all types all ......... ......... ......... ........... ...........
sizes.
A4455... A Adhesive remover per ......... ......... ......... ........... ...........
ounce.
A4460... A Elastic compression ......... ......... ......... ........... ...........
bandage.
A4462... A Abdmnl drssng holder/ ......... ......... ......... ........... ...........
binder.
A4465... A Non-elastic extremity ......... ......... ......... ........... ...........
binder.
A4470... A Gravlee jet washer..... ......... ......... ......... ........... ...........
A4480... A Vabra aspirator........ ......... ......... ......... ........... ...........
A4481... A Tracheostoma filter.... ......... ......... ......... ........... ...........
A4490... E Above knee surgical ......... ......... ......... ........... ...........
stocking.
A4495... E Thigh length surg ......... ......... ......... ........... ...........
stocking.
A4500... E Below knee surgical ......... ......... ......... ........... ...........
stocking.
A4510... E Full length surg ......... ......... ......... ........... ...........
stocking.
A4550... E Surgical trays......... ......... ......... ......... ........... ...........
A4554... E Disposable underpads... ......... ......... ......... ........... ...........
A4556... A Electrodes............. ......... ......... ......... ........... ...........
A4557... A Lead wires............. ......... ......... ......... ........... ...........
A4558... A Conductive paste or gel ......... ......... ......... ........... ...........
A4560... A Pessary................ ......... ......... ......... ........... ...........
A4565... A Slings................. ......... ......... ......... ........... ...........
A4570... A Splint................. ......... ......... ......... ........... ...........
A4572... A Rib belt............... ......... ......... ......... ........... ...........
A4575... E Hyperbaric o2 chamber ......... ......... ......... ........... ...........
disps.
A4580... A Cast supplies (plaster) ......... ......... ......... ........... ...........
A4590... A Special casting ......... ......... ......... ........... ...........
material.
A4595... A TENS suppl 2 lead per ......... ......... ......... ........... ...........
month.
A4611... A Heavy duty battery..... ......... ......... ......... ........... ...........
A4612... A Battery cables......... ......... ......... ......... ........... ...........
A4613... A Battery charger........ ......... ......... ......... ........... ...........
A4615... A Cannula nasal.......... ......... ......... ......... ........... ...........
A4616... A Tubing (oxygen) per ......... ......... ......... ........... ...........
foot.
A4617... A Mouth piece............ ......... ......... ......... ........... ...........
A4618... A Breathing circuits..... ......... ......... ......... ........... ...........
A4619... A Face tent.............. ......... ......... ......... ........... ...........
A4620... A Variable concentration ......... ......... ......... ........... ...........
mask.
A4621... A Tracheotomy mask or ......... ......... ......... ........... ...........
collar.
A4622... A Tracheostomy or ......... ......... ......... ........... ...........
larngectomy.
A4623... A Tracheostomy inner ......... ......... ......... ........... ...........
cannula.
A4624... A Tracheal suction tube.. ......... ......... ......... ........... ...........
A4625... A Trach care kit for new ......... ......... ......... ........... ...........
trach.
A4626... A Tracheostomy cleaning ......... ......... ......... ........... ...........
brush.
A4627... E Spacer bag/reservoir... ......... ......... ......... ........... ...........
A4628... A Oropharyngeal suction ......... ......... ......... ........... ...........
cath.
A4629... A Tracheostomy care kit.. ......... ......... ......... ........... ...........
A4630... A Repl bat t.e.n.s. own ......... ......... ......... ........... ...........
by pt.
A4631... A Wheelchair battery..... ......... ......... ......... ........... ...........
A4635... A Underarm crutch pad.... ......... ......... ......... ........... ...........
A4636... A Handgrip for cane etc.. ......... ......... ......... ........... ...........
A4637... A Repl tip cane/crutch/ ......... ......... ......... ........... ...........
walker.
A4640... A Alternating pressure ......... ......... ......... ........... ...........
pad.
A4641... N Diagnostic imaging ......... ......... ......... ........... ...........
agent.
A4642... N Satumomab pendetide per ......... ......... ......... ........... ...........
dose.
A4643... N High dose contrast MRI. ......... ......... ......... ........... ...........
A4644... N Contrast 100-199 MGs ......... ......... ......... ........... ...........
iodine.
A4645... N Contrast 200-299 MGs ......... ......... ......... ........... ...........
iodine.
A4646... N Contrast 300-399 MGs ......... ......... ......... ........... ...........
iodine.
A4647... N Supp-paramagnetic contr ......... ......... ......... ........... ...........
mat.
A4649... A Surgical supplies...... ......... ......... ......... ........... ...........
A4650... A Supp esrd centrifuge... ......... ......... ......... ........... ...........
A4655... A Esrd syringe/needle.... ......... ......... ......... ........... ...........
A4660... A Esrd blood pressure ......... ......... ......... ........... ...........
device.
A4663... A Esrd blood pressure ......... ......... ......... ........... ...........
cuff.
A4670... E Auto blood pressure ......... ......... ......... ........... ...........
monitor.
A4680... A Activated carbon ......... ......... ......... ........... ...........
filters.
A4690... A Dialyzers.............. ......... ......... ......... ........... ...........
A4700... A Standard dialysate ......... ......... ......... ........... ...........
solution.
A4705... A Bicarb dialysate ......... ......... ......... ........... ...........
solution.
A4712... A Sterile water.......... ......... ......... ......... ........... ...........
A4714... A Treated water for ......... ......... ......... ........... ...........
dialysis.
A4730... A Fistula cannulation set ......... ......... ......... ........... ...........
dial.
A4735... A Local/topical ......... ......... ......... ........... ...........
anesthetics.
A4740... A Esrd shunt accessory... ......... ......... ......... ........... ...........
A4750... A Arterial or venous ......... ......... ......... ........... ...........
tubing.
[[Page 47725]]
A4755... A Arterial and venous ......... ......... ......... ........... ...........
tubing.
A4760... A Standard testing ......... ......... ......... ........... ...........
solution.
A4765... A Dialysate concentrate.. ......... ......... ......... ........... ...........
A4770... A Blood testing supplies. ......... ......... ......... ........... ...........
A4771... A Blood clotting time ......... ......... ......... ........... ...........
tube.
A4772... A Dextrostick/glucose ......... ......... ......... ........... ...........
strips.
A4773... A Hemostix............... ......... ......... ......... ........... ...........
A4774... A Ammonia test paper..... ......... ......... ......... ........... ...........
A4780... A Esrd sterilizing agent. ......... ......... ......... ........... ...........
A4790... A Esrd cleansing agents.. ......... ......... ......... ........... ...........
A4800... A Heparin/antidote ......... ......... ......... ........... ...........
dialysis.
A4820... A Supplies hemodialysis ......... ......... ......... ........... ...........
kit.
A4850... A Rubber tipped hemostats ......... ......... ......... ........... ...........
A4860... A Disposable catheter ......... ......... ......... ........... ...........
caps.
A4870... A Plumbing/electrical ......... ......... ......... ........... ...........
work.
A4880... A Water storage tanks.... ......... ......... ......... ........... ...........
A4890... A Contracts/repair/ ......... ......... ......... ........... ...........
maintenance.
A4900... A Capd supply kit........ ......... ......... ......... ........... ...........
A4901... A Capd supply kit........ ......... ......... ......... ........... ...........
A4905... A Ipd supply kit......... ......... ......... ......... ........... ...........
A4910... A Esrd nonmedical ......... ......... ......... ........... ...........
supplies.
A4912... A Gomco drain bottle..... ......... ......... ......... ........... ...........
A4913... A Esrd supply............ ......... ......... ......... ........... ...........
A4914... A Preparation kit........ ......... ......... ......... ........... ...........
A4918... A Venous pressure clamp.. ......... ......... ......... ........... ...........
A4919... A Supp dialysis dialyzer ......... ......... ......... ........... ...........
holde.
A4920... A Harvard pressure clamp. ......... ......... ......... ........... ...........
A4921... A Measuring cylinder..... ......... ......... ......... ........... ...........
A4927... A Gloves................. ......... ......... ......... ........... ...........
A5051... A Pouch clsd w barr ......... ......... ......... ........... ...........
attached.
A5052... A Clsd ostomy pouch w/o ......... ......... ......... ........... ...........
barr.
A5053... A Clsd ostomy pouch ......... ......... ......... ........... ...........
faceplate.
A5054... A Clsd ostomy pouch w/ ......... ......... ......... ........... ...........
flange.
A5055... A Stoma cap.............. ......... ......... ......... ........... ...........
A5061... A Pouch drainable w ......... ......... ......... ........... ...........
barrier at.
A5062... A Drnble ostomy pouch w/o ......... ......... ......... ........... ...........
barr.
A5063... A Drain ostomy pouch w/ ......... ......... ......... ........... ...........
flange.
A5064... E Drain ostomy pouch w/ ......... ......... ......... ........... ...........
fceplte.
A5065... E Drain ostomy pouch on ......... ......... ......... ........... ...........
fcplte.
A5071... A Urinary pouch w/barrier ......... ......... ......... ........... ...........
A5072... A Urinary pouch w/o ......... ......... ......... ........... ...........
barrier.
A5073... A Urinary pouch on barr w/ ......... ......... ......... ........... ...........
flng.
A5074... E Urinary pouch w/ ......... ......... ......... ........... ...........
faceplate.
A5075... E Urinary pouch on ......... ......... ......... ........... ...........
faceplate.
A5081... A Continent stoma plug... ......... ......... ......... ........... ...........
A5082... A Continent stoma ......... ......... ......... ........... ...........
catheter.
A5093... A Ostomy accessory convex ......... ......... ......... ........... ...........
inse.
A5102... A Bedside drain btl w/wo ......... ......... ......... ........... ...........
tube.
A5105... A Urinary suspensory..... ......... ......... ......... ........... ...........
A5112... A Urinary leg bag........ ......... ......... ......... ........... ...........
A5113... A Latex leg strap........ ......... ......... ......... ........... ...........
A5114... A Foam/fabric leg strap.. ......... ......... ......... ........... ...........
A5119... A Skin barrier wipes box ......... ......... ......... ........... ...........
pr 50.
A5121... A Solid skin barrier 6x6. ......... ......... ......... ........... ...........
A5122... A Solid skin barrier 8x8. ......... ......... ......... ........... ...........
A5123... A Skin barrier with ......... ......... ......... ........... ...........
flange.
A5126... A Adhesive disc/foam pad. ......... ......... ......... ........... ...........
A5131... A Appliance cleaner...... ......... ......... ......... ........... ...........
A5149... A Incontinence/ostomy ......... ......... ......... ........... ...........
supply.
A5500... A Diab shoe for density ......... ......... ......... ........... ...........
insert.
A5501... A Diabetic custom molded ......... ......... ......... ........... ...........
shoe.
A5502... A Diabetic shoe density ......... ......... ......... ........... ...........
insert.
A5503... A Diabetic shoe w/roller/ ......... ......... ......... ........... ...........
rockr.
A5504... A Diabetic shoe with ......... ......... ......... ........... ...........
wedge.
A5505... A Diab shoe w/metatarsal ......... ......... ......... ........... ...........
bar.
A5506... A Diabetic shoe w/off set ......... ......... ......... ........... ...........
heel.
A5507... A Modification diabetic ......... ......... ......... ........... ...........
shoe.
A6020... A Collagen dressing cover ......... ......... ......... ........... ...........
ea.
A6025... E Silicone gel sheet, ......... ......... ......... ........... ...........
each.
A6154... A Wound pouch each....... ......... ......... ......... ........... ...........
A6196... A Alginate dressing <=16 ......... ......... ......... ........... ...........
sq in.
A6197... A Alginate drsg >16 <=48 ......... ......... ......... ........... ...........
sq in.
A6198... A Alginate dressing > 48 ......... ......... ......... ........... ...........
sq in.
A6199... A Alginate drsg wound ......... ......... ......... ........... ...........
filler.
A6203... A Composite drsg <= 16 sq ......... ......... ......... ........... ...........
in.
[[Page 47726]]
A6204... A Composite drsg >16<=48 ......... ......... ......... ........... ...........
sq in.
A6205... A Composite drsg > 48 sq ......... ......... ......... ........... ...........
in.
A6206... A Contact layer <= 16 sq ......... ......... ......... ........... ...........
in.
A6207... A Contact layer >16<= 48 ......... ......... ......... ........... ...........
sq in.
A6208... A Contact layer > 48 sq ......... ......... ......... ........... ...........
in.
A6209... A Foam drsg <=16 sq in w/ ......... ......... ......... ........... ...........
o bdr.
A6210... A Foam drg >16<=48 sq in ......... ......... ......... ........... ...........
w/o b.
A6211... A Foam drg > 48 sq in w/o ......... ......... ......... ........... ...........
brdr.
A6212... A Foam drg <=16 sq in w/ ......... ......... ......... ........... ...........
border.
A6213... A Foam drg >16<=48 sq in ......... ......... ......... ........... ...........
w/bdr.
A6214... A Foam drg > 48 sq in w/ ......... ......... ......... ........... ...........
border.
A6215... A Foam dressing wound ......... ......... ......... ........... ...........
filler.
A6216... A Non-sterile gauze<=16 ......... ......... ......... ........... ...........
sq in.
A6217... A Non-sterile ......... ......... ......... ........... ...........
gauze>16<=48 sq.
A6218... A Non-sterile gauze > 48 ......... ......... ......... ........... ...........
sq in.
A6219... A Gauze <= 16 sq in w/ ......... ......... ......... ........... ...........
border.
A6220... A Gauze >16 <=48 sq in w/ ......... ......... ......... ........... ...........
bordr.
A6221... A Gauze > 48 sq in w/ ......... ......... ......... ........... ...........
border.
A6222... A Gauze <=16 in no w/sal ......... ......... ......... ........... ...........
w/o b.
A6223... A Gauze >16<=48 no w/sal ......... ......... ......... ........... ...........
w/o b.
A6224... A Gauze > 48 in no w/sal ......... ......... ......... ........... ...........
w/o b.
A6228... A Gauze <= 16 sq in water/ ......... ......... ......... ........... ...........
sal.
A6229... A Gauze >16<=48 sq in ......... ......... ......... ........... ...........
watr/sal.
A6230... A Gauze > 48 sq in water/ ......... ......... ......... ........... ...........
salne.
A6234... A Hydrocolld drg <=16 w/o ......... ......... ......... ........... ...........
bdr.
A6235... A Hydrocolld drg >16<=48 ......... ......... ......... ........... ...........
w/o b.
A6236... A Hydrocolld drg > 48 in ......... ......... ......... ........... ...........
w/o b.
A6237... A Hydrocolld drg <=16 in ......... ......... ......... ........... ...........
w/bdr.
A6238... A Hydrocolld drg >16<=48 ......... ......... ......... ........... ...........
w/bdr.
A6239... A Hydrocolld drg > 48 in ......... ......... ......... ........... ...........
w/bdr.
A6240... A Hydrocolld drg filler ......... ......... ......... ........... ...........
paste.
A6241... A Hydrocolloid drg filler ......... ......... ......... ........... ...........
dry.
A6242... A Hydrogel drg <=16 in w/ ......... ......... ......... ........... ...........
o bdr.
A6243... A Hydrogel drg >16<=48 w/ ......... ......... ......... ........... ...........
o bdr.
A6244... A Hydrogel drg >48 in w/o ......... ......... ......... ........... ...........
bdr.
A6245... A Hydrogel drg <= 16 in w/ ......... ......... ......... ........... ...........
bdr.
A6246... A Hydrogel drg >16<=48 in ......... ......... ......... ........... ...........
w/b.
A6247... A Hydrogel drg > 48 sq in ......... ......... ......... ........... ...........
w/b.
A6248... A Hydrogel drsg gel ......... ......... ......... ........... ...........
filler.
A6250... A Skin seal protect ......... ......... ......... ........... ...........
moisturizr.
A6251... A Absorpt drg <=16 sq in ......... ......... ......... ........... ...........
w/o b.
A6252... A Absorpt drg >16 <=48 w/ ......... ......... ......... ........... ...........
o bdr.
A6253... A Absorpt drg > 48 sq in ......... ......... ......... ........... ...........
w/o b.
A6254... A Absorpt drg <=16 sq in ......... ......... ......... ........... ...........
w/bdr.
A6255... A Absorpt drg >16<=48 in ......... ......... ......... ........... ...........
w/bdr.
A6256... A Absorpt drg > 48 sq in ......... ......... ......... ........... ...........
w/bdr.
A6257... A Transparent film <= 16 ......... ......... ......... ........... ...........
sq in.
A6258... A Transparent film ......... ......... ......... ........... ...........
>16<=48 in.
A6259... A Transparent film > 48 ......... ......... ......... ........... ...........
sq in.
A6260... A Wound cleanser any type/ ......... ......... ......... ........... ...........
size.
A6261... A Wound filler gel/paste/ ......... ......... ......... ........... ...........
oz.
A6262... A Wound filler dry form/ ......... ......... ......... ........... ...........
gram.
A6263... A Non-sterile elastic ......... ......... ......... ........... ...........
gauze/yd.
A6264... A Non-sterile no elastic ......... ......... ......... ........... ...........
gauze.
A6265... A Tape per 18 sq inches.. ......... ......... ......... ........... ...........
A6266... A Impreg gauze no h20/sal/ ......... ......... ......... ........... ...........
yard.
A6402... A Sterile gauze <= 16 sq ......... ......... ......... ........... ...........
in.
A6403... A Sterile gauze>16 <= 48 ......... ......... ......... ........... ...........
sq in.
A6404... A Sterile gauze > 48 sq ......... ......... ......... ........... ...........
in.
A6405... A Sterile elastic gauze/ ......... ......... ......... ........... ...........
yd.
A6406... A Sterile non-elastic ......... ......... ......... ........... ...........
gauze/yd.
A9150... E Misc/exper non- ......... ......... ......... ........... ...........
prescript dru.
A9160... E Podiatrist non-covered ......... ......... ......... ........... ...........
servi.
A9170... E Chiropractor non- ......... ......... ......... ........... ...........
covered ser.
A9190... E Misc/expe personal ......... ......... ......... ........... ...........
comfort i.
A9270... E Non-covered item or ......... ......... ......... ........... ...........
service.
A9300... E Exercise equipment..... ......... ......... ......... ........... ...........
A9500... N Technetium TC 99m ......... ......... ......... ........... ...........
sestamibi.
A9502... N Technetium TC99M ......... ......... ......... ........... ...........
tetrofosmin.
A9503... N Technetium TC 99m ......... ......... ......... ........... ...........
medronate.
A9505... N Thallous chloride TL ......... ......... ......... ........... ...........
201/mci.
A9600... N Strontium-89 chloride.. ......... ......... ......... ........... ...........
B4034... A Enter feed supkit syr ......... ......... ......... ........... ...........
by day.
B4035... A Enteral feed supp pump ......... ......... ......... ........... ...........
per d.
B4036... A Enteral feed sup kit ......... ......... ......... ........... ...........
grav by.
[[Page 47727]]
B4081... A Enteral ng tubing w/ ......... ......... ......... ........... ...........
stylet.
B4082... A Enteral ng tubing w/o ......... ......... ......... ........... ...........
stylet.
B4083... A Enteral stomach tube ......... ......... ......... ........... ...........
levine.
B4084... A Gastrostomy/jejunostomy ......... ......... ......... ........... ...........
tubi.
B4085... A Gastrostomy tube w/ring ......... ......... ......... ........... ...........
each.
B4150... A Enteral formulae ......... ......... ......... ........... ...........
category i.
B4151... A Enteral formulae ......... ......... ......... ........... ...........
category i-.
B4152... A Enteral formulae ......... ......... ......... ........... ...........
category ii.
B4153... A Enteral formulae ......... ......... ......... ........... ...........
category ii.
B4154... A Enteral formulae ......... ......... ......... ........... ...........
category IV.
B4155... A Enteral formulae ......... ......... ......... ........... ...........
category v.
B4156... A Enteral formulae ......... ......... ......... ........... ...........
category vi.
B4164... A Parenteral 50% dextrose ......... ......... ......... ........... ...........
solu.
B4168... A Parenteral sol amino ......... ......... ......... ........... ...........
acid 3..
B4172... A Parenteral sol amino ......... ......... ......... ........... ...........
acid 5..
B4176... A Parenteral sol amino ......... ......... ......... ........... ...........
acid 7-.
B4178... A Parenteral sol amino ......... ......... ......... ........... ...........
acid >.
B4180... A Parenteral sol carb > ......... ......... ......... ........... ...........
50%.
B4184... A Parenteral sol lipids ......... ......... ......... ........... ...........
10%.
B4186... A Parenteral sol lipids ......... ......... ......... ........... ...........
20%.
B4189... A Parenteral sol amino ......... ......... ......... ........... ...........
acid &.
B4193... A Parenteral sol 52-73 gm ......... ......... ......... ........... ...........
prot.
B4197... A Parenteral sol 74-100 ......... ......... ......... ........... ...........
gm pro.
B4199... A Parenteral sol > 100gm ......... ......... ......... ........... ...........
prote.
B4216... A Parenteral nutrition ......... ......... ......... ........... ...........
additiv.
B4220... A Parenteral supply kit ......... ......... ......... ........... ...........
premix.
B4222... A Parenteral supply kit ......... ......... ......... ........... ...........
homemi.
B4224... A Parenteral ......... ......... ......... ........... ...........
administration ki.
B5000... A Parenteral sol renal- ......... ......... ......... ........... ...........
amirosy.
B5100... A Parenteral sol hepatic- ......... ......... ......... ........... ...........
fream.
B5200... A Parenteral sol stres- ......... ......... ......... ........... ...........
brnch c.
B9000... A Enter infusion pump w/o ......... ......... ......... ........... ...........
alrm.
B9002... A Enteral infusion pump w/ ......... ......... ......... ........... ...........
ala.
B9004... A Parenteral infus pump ......... ......... ......... ........... ...........
portab.
B9006... A Parenteral infus pump ......... ......... ......... ........... ...........
statio.
B9998... A Enteral supp not ......... ......... ......... ........... ...........
otherwise c.
B9999... A Parenteral supp not ......... ......... ......... ........... ...........
othrws c.
D0120... E Periodic oral ......... ......... ......... ........... ...........
evaluation.
D0140... E Limit oral eval problm ......... ......... ......... ........... ...........
focus.
D0150... S Comprehensve oral 031 1.33 $70.52 $14.10 $14.10
evaluation.
D0160... E Extensv oral eval prob ......... ......... ......... ........... ...........
focus.
D0210... E Intraor complete film ......... ......... ......... ........... ...........
series.
D0220... E Intraoral periapical ......... ......... ......... ........... ...........
first f.
D0230... E Intraoral periapical ea ......... ......... ......... ........... ...........
add.
D0240... S Intraoral occlusal film 031 1.33 $70.52 $14.10 $14.10
D0250... S Extraoral first film... 031 1.33 $70.52 $14.10 $14.10
D0260... S Extraoral ea additional 031 1.33 $70.52 $14.10 $14.10
film.
D0270... S Dental bitewing single 031 1.33 $70.52 $14.10 $14.10
film.
D0272... S Dental bitewings two 031 1.33 $70.52 $14.10 $14.10
films.
D0274... S Dental bitewings four 031 1.33 $70.52 $14.10 $14.10
films.
D0290... E Dental film skull/ ......... ......... ......... ........... ...........
facial bon.
D0310... E Dental saliography..... ......... ......... ......... ........... ...........
D0320... E Dental tmj arthrogram ......... ......... ......... ........... ...........
incl i.
D0321... E Dental other tmj films. ......... ......... ......... ........... ...........
D0322... E Dental tomographic ......... ......... ......... ........... ...........
survey.
D0330... E Dental panoramic film.. ......... ......... ......... ........... ...........
D0340... E Dental cephalometric ......... ......... ......... ........... ...........
film.
D0415... E Bacteriologic study.... ......... ......... ......... ........... ...........
D0425... E Caries susceptibility ......... ......... ......... ........... ...........
test.
D0460... S Pulp vitality test..... 031 1.33 $70.52 $14.10 $14.10
D0470... E Diagnostic casts....... ......... ......... ......... ........... ...........
D0471... S Diagnostic photographs. 031 1.33 $70.52 $14.10 $14.10
D0501... S Histopathologic 031 1.33 $70.52 $14.10 $14.10
examinations.
D0502... S Other oral pathology 031 1.33 $70.52 $14.10 $14.10
procedu.
D0999... S Unspecified diagnostic 031 1.33 $70.52 $14.10 $14.10
proce.
D1110... E Dental prophylaxis ......... ......... ......... ........... ...........
adult.
D1120... E Dental prophylaxis ......... ......... ......... ........... ...........
child.
D1201... E Topical fluor w prophy ......... ......... ......... ........... ...........
child.
D1203... E Topical fluor w/o ......... ......... ......... ........... ...........
prophy chi.
D1204... E Topical fluor w/o ......... ......... ......... ........... ...........
prophy adu.
D1205... E Topical fluoride w/ ......... ......... ......... ........... ...........
prophy a.
D1310... E Nutri counsel-control ......... ......... ......... ........... ...........
caries.
D1320... E Tobacco counseling..... ......... ......... ......... ........... ...........
D1330... E Oral hygiene ......... ......... ......... ........... ...........
instruction.
D1351... E Dental sealant per ......... ......... ......... ........... ...........
tooth.
[[Page 47728]]
D1510... S Space maintainer fxd 031 1.33 $70.52 $14.10 $14.10
unilat.
D1515... S Fixed bilat space 031 1.33 $70.52 $14.10 $14.10
maintainer.
D1520... S Remove unilat space 031 1.33 $70.52 $14.10 $14.10
maintain.
D1525... S Remove bilat space 031 1.33 $70.52 $14.10 $14.10
maintain.
D1550... S Recement space 031 1.33 $70.52 $14.10 $14.10
maintainer.
D2110... E Amalgam one surface ......... ......... ......... ........... ...........
primary.
D2120... E Amalgam two surfaces ......... ......... ......... ........... ...........
primary.
D2130... E Amalgam three surfaces ......... ......... ......... ........... ...........
prima.
D2131... E Amalgam four/more surf ......... ......... ......... ........... ...........
prima.
D2140... E Amalgam one surface ......... ......... ......... ........... ...........
permanen.
D2150... E Amalgam two surfaces ......... ......... ......... ........... ...........
permane.
D2160... E Amalgam three surfaces ......... ......... ......... ........... ...........
perma.
D2161... E Amalgam 4 or > surfaces ......... ......... ......... ........... ...........
perm.
D2210... E Silcate cement per ......... ......... ......... ........... ...........
restorat.
D2330... E Resin one surface- ......... ......... ......... ........... ...........
anterior.
D2331... E Resin two surfaces- ......... ......... ......... ........... ...........
anterior.
D2332... E Resin three surfaces- ......... ......... ......... ........... ...........
anterio.
D2335... E Resin 4/> surf or w ......... ......... ......... ........... ...........
incis an.
D2336... E Composite resin crown.. ......... ......... ......... ........... ...........
D2380... E Resin one surf poster ......... ......... ......... ........... ...........
primar.
D2381... E Resin two surf poster ......... ......... ......... ........... ...........
primar.
D2382... E Resin three/more surf ......... ......... ......... ........... ...........
post p.
D2385... E Resin one surf poster ......... ......... ......... ........... ...........
perman.
D2386... E Resin two surf poster ......... ......... ......... ........... ...........
perman.
D2387... E Resin three/more surf ......... ......... ......... ........... ...........
post p.
D2410... E Dental gold foil one ......... ......... ......... ........... ...........
surface.
D2420... E Dental gold foil two ......... ......... ......... ........... ...........
surface.
D2430... E Dental gold foil three ......... ......... ......... ........... ...........
surfa.
D2510... E Dental inlay metalic 1 ......... ......... ......... ........... ...........
surf.
D2520... E Dental inlay metallic 2 ......... ......... ......... ........... ...........
surf.
D2530... E Dental inlay metl 3/ ......... ......... ......... ........... ...........
more sur.
D2543... E Dental onlay metallic 3 ......... ......... ......... ........... ...........
surf.
D2544... E Dental onlay metl 4/ ......... ......... ......... ........... ...........
more sur.
D2610... E Inlay porcelain/ceramic ......... ......... ......... ........... ...........
1 su.
D2620... E Inlay porcelain/ceramic ......... ......... ......... ........... ...........
2 su.
D2630... E Dental onlay porc 3/ ......... ......... ......... ........... ...........
more sur.
D2642... E Dental onlay porcelin 2 ......... ......... ......... ........... ...........
surf.
D2643... E Dental onlay porcelin 3 ......... ......... ......... ........... ...........
surf.
D2644... E Dental onlay porc 4/ ......... ......... ......... ........... ...........
more sur.
D2650... E Inlay composite/resin ......... ......... ......... ........... ...........
one su.
D2651... E Inlay composite/resin ......... ......... ......... ........... ...........
two su.
D2652... E Dental inlay resin 3/ ......... ......... ......... ........... ...........
mre sur.
D2662... E Dental onlay resin 2 ......... ......... ......... ........... ...........
surface.
D2663... E Dental onlay resin 3 ......... ......... ......... ........... ...........
surface.
D2664... E Dental onlay resin 4/ ......... ......... ......... ........... ...........
mre sur.
D2710... E Crown resin laboratory. ......... ......... ......... ........... ...........
D2720... E Crown resin w/ high ......... ......... ......... ........... ...........
noble me.
D2721... E Crown resin w/ base ......... ......... ......... ........... ...........
metal.
D2722... E Crown resin w/ noble ......... ......... ......... ........... ...........
metal.
D2740... E Crown porcelain/ceramic ......... ......... ......... ........... ...........
subs.
D2750... E Crown porcelain w/ h ......... ......... ......... ........... ...........
noble m.
D2751... E Crown porcelain fused ......... ......... ......... ........... ...........
base m.
D2752... E Crown porcelain w/ ......... ......... ......... ........... ...........
noble met.
D2790... E Crown full cast high ......... ......... ......... ........... ...........
noble m.
D2791... E Crown full cast base ......... ......... ......... ........... ...........
metal.
D2792... E Crown full cast noble ......... ......... ......... ........... ...........
metal.
D2810... E Crown 3/4 cast metallic ......... ......... ......... ........... ...........
D2910... E Dental recement inlay.. ......... ......... ......... ........... ...........
D2920... E Dental recement crown.. ......... ......... ......... ........... ...........
D2930... E Prefab stnlss steel ......... ......... ......... ........... ...........
crwn pri.
D2931... E Prefab stnlss steel ......... ......... ......... ........... ...........
crown pe.
D2932... E Prefabricated resin ......... ......... ......... ........... ...........
crown.
D2933... E Prefab stainless steel ......... ......... ......... ........... ...........
crown.
D2940... E Dental sedative filling ......... ......... ......... ........... ...........
D2950... E Core build-up incl any ......... ......... ......... ........... ...........
pins.
D2951... E Tooth pin retention.... ......... ......... ......... ........... ...........
D2952... E Post and core cast + ......... ......... ......... ........... ...........
crown.
D2954... E Prefab post/core + ......... ......... ......... ........... ...........
crown.
D2955... E Post removal........... ......... ......... ......... ........... ...........
D2960... E Laminate labial veneer. ......... ......... ......... ........... ...........
D2961... E Lab labial veneer resin ......... ......... ......... ........... ...........
D2962... E Lab labial veneer ......... ......... ......... ........... ...........
porcelain.
D2970... S Temporary-fractured 031 1.33 $70.52 $14.10 $14.10
tooth.
D2980... E Crown repair........... ......... ......... ......... ........... ...........
D2999... S Dental unspec 031 1.33 $70.52 $14.10 $14.10
restorative pr.
[[Page 47729]]
D3110... E Pulp cap direct........ ......... ......... ......... ........... ...........
D3120... E Pulp cap indirect...... ......... ......... ......... ........... ...........
D3220... E Therapeutic pulpotomy.. ......... ......... ......... ........... ...........
D3230... E Pulpal therapy anterior ......... ......... ......... ........... ...........
prim.
D3240... E Pulpal therapy ......... ......... ......... ........... ...........
posterior pri.
D3310... E Anterior............... ......... ......... ......... ........... ...........
D3320... E Root canal therapy 2 ......... ......... ......... ........... ...........
canals.
D3330... E Root canal therapy 3 ......... ......... ......... ........... ...........
canals.
D3346... E Retreat root canal ......... ......... ......... ........... ...........
anterior.
D3347... E Retreat root canal ......... ......... ......... ........... ...........
bicuspid.
D3348... E Retreat root canal ......... ......... ......... ........... ...........
molar.
D3351... E Apexification/recalc ......... ......... ......... ........... ...........
initial.
D3352... E Apexification/recalc ......... ......... ......... ........... ...........
interim.
D3353... E Apexification/recalc ......... ......... ......... ........... ...........
final.
D3410... E Apicoect/perirad surg ......... ......... ......... ........... ...........
anter.
D3421... E Root surgery bicuspid.. ......... ......... ......... ........... ...........
D3425... E Root surgery molar..... ......... ......... ......... ........... ...........
D3426... E Root surgery ea add ......... ......... ......... ........... ...........
root.
D3430... E Retrograde filling..... ......... ......... ......... ........... ...........
D3450... E Root amputation........ ......... ......... ......... ........... ...........
D3460... S Endodontic endosseous 031 1.33 $70.52 $14.10 $14.10
implan.
D3470... E Intentional ......... ......... ......... ........... ...........
replantation.
D3910... E Isolation-tooth w rubb ......... ......... ......... ........... ...........
dam.
D3920... E Tooth splitting........ ......... ......... ......... ........... ...........
D3950... E Canal prep/fitting of ......... ......... ......... ........... ...........
dowel.
D3960... E Bleaching of discolored ......... ......... ......... ........... ...........
toot.
D3999... S Endodontic procedure... 031 1.33 $70.52 $14.10 $14.10
D4210... E Gingivectomy/plasty per ......... ......... ......... ........... ...........
quad.
D4211... E Gingivectomy/plasty per ......... ......... ......... ........... ...........
toot.
D4220... E Gingival curettage per ......... ......... ......... ........... ...........
quadr.
D4240... E Gingival flap proc w/ ......... ......... ......... ........... ...........
planin.
D4249... E Crown lengthen hard ......... ......... ......... ........... ...........
tissue.
D4250... S Mucogingival surg per 031 1.33 $70.52 $14.10 $14.10
quadra.
D4260... S Osseous surgery per 031 1.33 $70.52 $14.10 $14.10
quadrant.
D4263... S Bone replce graft first 031 1.33 $70.52 $14.10 $14.10
site.
D4264... S Bone replce graft each 031 1.33 $70.52 $14.10 $14.10
add.
D4266... E Guided tiss regen ......... ......... ......... ........... ...........
resorble.
D4267... E Guided tiss regen ......... ......... ......... ........... ...........
nonresorb.
D4270... S Pedicle soft tissue 031 1.33 $70.52 $14.10 $14.10
graft pr.
D4271... S Free soft tissue graft 031 1.33 $70.52 $14.10 $14.10
proc.
D4273... S Subepithelial tissue 031 1.33 $70.52 $14.10 $14.10
graft.
D4274... E Distal/proximal wedge ......... ......... ......... ........... ...........
proc.
D4320... E Provision splnt ......... ......... ......... ........... ...........
intracoronal.
D4321... E Provisional splint ......... ......... ......... ........... ...........
extracoro.
D4341... E Periodontal scaling & ......... ......... ......... ........... ...........
root.
D4355... S Full mouth debridement. 031 1.33 $70.52 $14.10 $14.10
D4381... S Localized chemo 031 1.33 $70.52 $14.10 $14.10
delivery.
D4910... E Periodontal maint ......... ......... ......... ........... ...........
procedures.
D4920... E Unscheduled dressing ......... ......... ......... ........... ...........
change.
D4999... E Unspecified periodontal ......... ......... ......... ........... ...........
proc.
D5110... E Dentures complete ......... ......... ......... ........... ...........
maxillary.
D5120... E Dentures complete ......... ......... ......... ........... ...........
mandible.
D5130... E Dentures immediat ......... ......... ......... ........... ...........
maxillary.
D5140... E Dentures immediat ......... ......... ......... ........... ...........
mandible.
D5211... E Dentures maxill part ......... ......... ......... ........... ...........
resin.
D5212... E Dentures mand part ......... ......... ......... ........... ...........
resin.
D5213... E Dentures maxill part ......... ......... ......... ........... ...........
metal.
D5214... E Dentures mandibl part ......... ......... ......... ........... ...........
metal.
D5281... E Removable partial ......... ......... ......... ........... ...........
denture.
D5410... E Dentures adjust cmplt ......... ......... ......... ........... ...........
maxil.
D5411... E Dentures adjust cmplt ......... ......... ......... ........... ...........
mand.
D5421... E Dentures adjust part ......... ......... ......... ........... ...........
maxill.
D5422... E Dentures adjust part ......... ......... ......... ........... ...........
mandbl.
D5510... E Dentur repr broken ......... ......... ......... ........... ...........
compl bas.
D5520... E Replace denture teeth ......... ......... ......... ........... ...........
complt.
D5610... E Dentures repair resin ......... ......... ......... ........... ...........
base.
D5620... E Rep part denture cast ......... ......... ......... ........... ...........
frame.
D5630... E Rep partial denture ......... ......... ......... ........... ...........
clasp.
D5640... E Replace part denture ......... ......... ......... ........... ...........
teeth.
D5650... E Add tooth to partial ......... ......... ......... ........... ...........
denture.
D5660... E Add clasp to partial ......... ......... ......... ........... ...........
denture.
D5710... E Dentures rebase cmplt ......... ......... ......... ........... ...........
maxil.
D5711... E Dentures rebase cmplt ......... ......... ......... ........... ...........
mand.
D5720... E Dentures rebase part ......... ......... ......... ........... ...........
maxill.
D5721... E Dentures rebase part ......... ......... ......... ........... ...........
mandbl.
[[Page 47730]]
D5730... E Denture reln cmplt ......... ......... ......... ........... ...........
maxil ch.
D5731... E Denture reln cmplt mand ......... ......... ......... ........... ...........
chr.
D5740... E Denture reln part maxil ......... ......... ......... ........... ...........
chr.
D5741... E Denture reln part mand ......... ......... ......... ........... ...........
chr.
D5750... E Denture reln cmplt max ......... ......... ......... ........... ...........
lab.
D5751... E Denture reln cmplt mand ......... ......... ......... ........... ...........
lab.
D5760... E Denture reln part maxil ......... ......... ......... ........... ...........
lab.
D5761... E Denture reln part mand ......... ......... ......... ........... ...........
lab.
D5810... E Denture interm cmplt ......... ......... ......... ........... ...........
maxill.
D5811... E Denture interm cmplt ......... ......... ......... ........... ...........
mandbl.
D5820... E Denture interm part ......... ......... ......... ........... ...........
maxill.
D5821... E Denture interm part ......... ......... ......... ........... ...........
mandbl.
D5850... E Denture tiss conditn ......... ......... ......... ........... ...........
maxill.
D5851... E Denture tiss condtin ......... ......... ......... ........... ...........
mandbl.
D5860... E Overdenture complete... ......... ......... ......... ........... ...........
D5861... E Overdenture partial.... ......... ......... ......... ........... ...........
D5862... E Precision attachment... ......... ......... ......... ........... ...........
D5899... E Removable prosthodontic ......... ......... ......... ........... ...........
proc.
D5911... S Facial moulage 031 1.33 $70.52 $14.10 $14.10
sectional.
D5912... S Facial moulage complete 031 1.33 $70.52 $14.10 $14.10
D5913... E Nasal prosthesis....... ......... ......... ......... ........... ...........
D5914... E Auricular prosthesis... ......... ......... ......... ........... ...........
D5915... E Orbital prosthesis..... ......... ......... ......... ........... ...........
D5916... E Ocular prosthesis...... ......... ......... ......... ........... ...........
D5919... E Facial prosthesis...... ......... ......... ......... ........... ...........
D5922... E Nasal septal prosthesis ......... ......... ......... ........... ...........
D5923... E Ocular prosthesis ......... ......... ......... ........... ...........
interim.
D5924... E Cranial prosthesis..... ......... ......... ......... ........... ...........
D5925... E Facial augmentation ......... ......... ......... ........... ...........
implant.
D5926... E Replacement nasal ......... ......... ......... ........... ...........
prosthesis.
D5927... E Auricular replacement.. ......... ......... ......... ........... ...........
D5928... E Orbital replacement.... ......... ......... ......... ........... ...........
D5929... E Facial replacement..... ......... ......... ......... ........... ...........
D5931... E Surgical obturator..... ......... ......... ......... ........... ...........
D5932... E Postsurgical obturator. ......... ......... ......... ........... ...........
D5933... E Refitting of obturator. ......... ......... ......... ........... ...........
D5934... E Mandibular flange ......... ......... ......... ........... ...........
prosthesis.
D5935... E Mandibular denture ......... ......... ......... ........... ...........
prosth.
D5936... E Temp obturator ......... ......... ......... ........... ...........
prosthesis.
D5937... E Trismus appliance...... ......... ......... ......... ........... ...........
D5951... E Feeding aid............ ......... ......... ......... ........... ...........
D5952... E Pediatric speech aid... ......... ......... ......... ........... ...........
D5953... E Adult speech aid....... ......... ......... ......... ........... ...........
D5954... E Superimposed prosthesis ......... ......... ......... ........... ...........
D5955... E Palatal lift prosthesis ......... ......... ......... ........... ...........
D5958... E Intraoral con def inter ......... ......... ......... ........... ...........
plt.
D5959... E Intraoral con def mod ......... ......... ......... ........... ...........
palat.
D5960... E Modify speech aid ......... ......... ......... ........... ...........
prosthesis.
D5982... E Surgical stent......... ......... ......... ......... ........... ...........
D5983... S Radiation applicator... 031 1.33 $70.52 $14.10 $14.10
D5984... S Radiation shield....... 031 1.33 $70.52 $14.10 $14.10
D5985... S Radiation cone locator. 031 1.33 $70.52 $14.10 $14.10
D5986... E Fluoride applicator.... ......... ......... ......... ........... ...........
D5987... S Commissure splint...... 031 1.33 $70.52 $14.10 $14.10
D5988... E Surgical splint........ ......... ......... ......... ........... ...........
D5999... E Maxillofacial ......... ......... ......... ........... ...........
prosthesis.
D6010... E Odontics endosteal ......... ......... ......... ........... ...........
implant.
D6020... E Odontics abutment ......... ......... ......... ........... ...........
placement.
D6040... E Odontics eposteal ......... ......... ......... ........... ...........
implant.
D6050... E Odontics transosteal ......... ......... ......... ........... ...........
implnt.
D6055... E Implant connecting bar. ......... ......... ......... ........... ...........
D6080... E Implant maintenance.... ......... ......... ......... ........... ...........
D6090... E Repair implant......... ......... ......... ......... ........... ...........
D6095... E Odontics repr abutment. ......... ......... ......... ........... ...........
D6100... E Removal of implant..... ......... ......... ......... ........... ...........
D6199... E Implant procedure...... ......... ......... ......... ........... ...........
D6210... E Prosthodont high noble ......... ......... ......... ........... ...........
metal.
D6211... E Bridge base metal cast. ......... ......... ......... ........... ...........
D6212... E Bridge noble metal cast ......... ......... ......... ........... ...........
D6240... E Bridge porcelain high ......... ......... ......... ........... ...........
noble.
D6241... E Bridge porcelain base ......... ......... ......... ........... ...........
metal.
D6242... E Bridge porcelain nobel ......... ......... ......... ........... ...........
metal.
D6250... E Bridge resin w/high ......... ......... ......... ........... ...........
noble.
D6251... E Bridge resin base metal ......... ......... ......... ........... ...........
D6252... E Bridge resin w/noble ......... ......... ......... ........... ...........
metal.
[[Page 47731]]
D6520... E Dental retainer two ......... ......... ......... ........... ...........
surfaces.
D6530... E Retainer metallic 3+ ......... ......... ......... ........... ...........
surface.
D6543... E Dental retainr onlay 3 ......... ......... ......... ........... ...........
surf.
D6544... E Dental retainr onlay 4/ ......... ......... ......... ........... ...........
more.
D6545... E Dental retainr cast ......... ......... ......... ........... ...........
metl.
D6720... E Retain crown resin w hi ......... ......... ......... ........... ...........
nble.
D6721... E Crown resin w/base ......... ......... ......... ........... ...........
metal.
D6722... E Crown resin w/noble ......... ......... ......... ........... ...........
metal.
D6750... E Crown porcelain high ......... ......... ......... ........... ...........
noble.
D6751... E Crown porcelain base ......... ......... ......... ........... ...........
metal.
D6752... E Crown porcelain noble ......... ......... ......... ........... ...........
metal.
D6780... E Crown 3/4 high noble ......... ......... ......... ........... ...........
metal.
D6790... E Crown full high noble ......... ......... ......... ........... ...........
metal.
D6791... E Crown full base metal ......... ......... ......... ........... ...........
cast.
D6792... E Crown full noble metal ......... ......... ......... ........... ...........
cast.
D6920... S Dental connector bar... 031 1.33 $70.52 $14.10 $14.10
D6930... E Dental recement bridge. ......... ......... ......... ........... ...........
D6940... E Stress breaker......... ......... ......... ......... ........... ...........
D6950... E Precision attachment... ......... ......... ......... ........... ...........
D6970... E Post & core plus ......... ......... ......... ........... ...........
retainer.
D6971... E Cast post bridge ......... ......... ......... ........... ...........
retainer.
D6972... E Prefab post & core plus ......... ......... ......... ........... ...........
reta.
D6973... E Core build up for ......... ......... ......... ........... ...........
retainer.
D6975... E Coping metal........... ......... ......... ......... ........... ...........
D6980... E Bridge repair.......... ......... ......... ......... ........... ...........
D6999... E Fixed prosthodontic ......... ......... ......... ........... ...........
proc.
D7110... S Oral surgery single 031 1.33 $70.52 $14.10 $14.10
tooth.
D7120... S Each add tooth 031 1.33 $70.52 $14.10 $14.10
extraction.
D7130... S Tooth root removal..... 031 1.33 $70.52 $14.10 $14.10
D7210... S Rem imp tooth w mucoper 031 1.33 $70.52 $14.10 $14.10
flp.
D7220... S Impact tooth remov soft 031 1.33 $70.52 $14.10 $14.10
tiss.
D7230... S Impact tooth remov part 031 1.33 $70.52 $14.10 $14.10
bony.
D7240... S Impact tooth remov comp 031 1.33 $70.52 $14.10 $14.10
bony.
D7241... S Impact tooth rem bony w/ 031 1.33 $70.52 $14.10 $14.10
comp.
D7250... S Tooth root removal..... 031 1.33 $70.52 $14.10 $14.10
D7260... S Oral antral fistula 031 1.33 $70.52 $14.10 $14.10
closure.
D7270... E Tooth reimplantation... ......... ......... ......... ........... ...........
D7272... E Tooth transplantation.. ......... ......... ......... ........... ...........
D7280... E Exposure impact tooth ......... ......... ......... ........... ...........
orthod.
D7281... E Exposure tooth aid ......... ......... ......... ........... ...........
eruption.
D7285... E Biopsy of oral tissue ......... ......... ......... ........... ...........
hard.
D7286... E Biopsy of oral tissue ......... ......... ......... ........... ...........
soft.
D7290... E Repositioning of teeth. ......... ......... ......... ........... ...........
D7291... S Transseptal fiberotomy. 031 1.33 $70.52 $14.10 $14.10
D7310... E Alveoplasty w/ ......... ......... ......... ........... ...........
extraction.
D7320... E Alveoplasty w/o ......... ......... ......... ........... ...........
extraction.
D7340... E Vestibuloplasty ridge ......... ......... ......... ........... ...........
extens.
D7350... E Vestibuloplasty exten ......... ......... ......... ........... ...........
graft.
D7410... E Rad exc lesion up to ......... ......... ......... ........... ...........
1.25 cm.
D7420... E Lesion > 1.25 cm....... ......... ......... ......... ........... ...........
D7430... E Exc benign tumor to ......... ......... ......... ........... ...........
1.25 cm.
D7431... E Benign tumor exc > 1.25 ......... ......... ......... ........... ...........
cm.
D7440... E Malig tumor exc to 1.25 ......... ......... ......... ........... ...........
cm.
D7441... E Malig tumor > 1.25 cm.. ......... ......... ......... ........... ...........
D7450... E Rem odontogen cyst to ......... ......... ......... ........... ...........
1.25cm.
D7451... E Rem odontogen cyst > ......... ......... ......... ........... ...........
1.25 cm.
D7460... E Rem nonodonto cyst to ......... ......... ......... ........... ...........
1.25cm.
D7461... E Rem nonodonto cyst > ......... ......... ......... ........... ...........
1.25 cm.
D7465... E Lesion destruction..... ......... ......... ......... ........... ...........
D7470... E Rem exostosis maxilla/ ......... ......... ......... ........... ...........
mandib.
D7480... E Partial ostectomy...... ......... ......... ......... ........... ...........
D7490... E Mandible resection..... ......... ......... ......... ........... ...........
D7510... E I&d absc intraoral soft ......... ......... ......... ........... ...........
tiss.
D7520... E I&d abscess extraoral.. ......... ......... ......... ........... ...........
D7530... E Removal fb skin/areolar ......... ......... ......... ........... ...........
tiss.
D7540... E Removal of fb reaction. ......... ......... ......... ........... ...........
D7550... E Removal of sloughed off ......... ......... ......... ........... ...........
bone.
D7560... E Maxillary sinusotomy... ......... ......... ......... ........... ...........
D7610... E Maxilla open reduct ......... ......... ......... ........... ...........
simple.
D7620... E Clsd reduct simpl ......... ......... ......... ........... ...........
maxilla fx.
D7630... E Open red simpl mandible ......... ......... ......... ........... ...........
fx.
D7640... E Clsd red simpl mandible ......... ......... ......... ........... ...........
fx.
D7650... E Open red simp malar/ ......... ......... ......... ........... ...........
zygom fx.
D7660... E Clsd red simp malar/ ......... ......... ......... ........... ...........
zygom fx.
D7670... E Open red simple ......... ......... ......... ........... ...........
alveolus fx.
[[Page 47732]]
D7680... E Reduct simple facial ......... ......... ......... ........... ...........
bone fx.
D7710... E Maxilla open reduct ......... ......... ......... ........... ...........
compound.
D7720... E Clsd reduct compd ......... ......... ......... ........... ...........
maxilla fx.
D7730... E Open reduct compd ......... ......... ......... ........... ...........
mandble fx.
D7740... E Clsd reduct compd ......... ......... ......... ........... ...........
mandble fx.
D7750... E Open red comp malar/ ......... ......... ......... ........... ...........
zygma fx.
D7760... E Clsd red comp malar/ ......... ......... ......... ........... ...........
zygma fx.
D7770... E Open reduc compd ......... ......... ......... ........... ...........
alveolus fx.
D7780... E Reduct compnd facial ......... ......... ......... ........... ...........
bone fx.
D7810... E Tmj open reduct- ......... ......... ......... ........... ...........
dislocation.
D7820... E Closed tmp manipulation ......... ......... ......... ........... ...........
D7830... E Tmj manipulation under ......... ......... ......... ........... ...........
anest.
D7840... E Removal of tmj condyle. ......... ......... ......... ........... ...........
D7850... E Tmj meniscectomy....... ......... ......... ......... ........... ...........
D7852... E Tmj repair of joint ......... ......... ......... ........... ...........
disc.
D7854... E Tmj excisn of joint ......... ......... ......... ........... ...........
membrane.
D7856... E Tmj cutting of a muscle ......... ......... ......... ........... ...........
D7858... E Tmj reconstruction..... ......... ......... ......... ........... ...........
D7860... E Tmj cutting into joint. ......... ......... ......... ........... ...........
D7865... E Tmj reshaping ......... ......... ......... ........... ...........
components.
D7870... E Tmj aspiration joint ......... ......... ......... ........... ...........
fluid.
D7872... E Tmj diagnostic ......... ......... ......... ........... ...........
arthroscopy.
D7873... E Tmj arthroscopy lysis ......... ......... ......... ........... ...........
adhesn.
D7874... E Tmj arthroscopy disc ......... ......... ......... ........... ...........
reposit.
D7875... E Tmj arthroscopy ......... ......... ......... ........... ...........
synovectomy.
D7876... E Tmj arthroscopy ......... ......... ......... ........... ...........
discectomy.
D7877... E Tmj arthroscopy ......... ......... ......... ........... ...........
debridement.
D7880... E Occlusal orthotic ......... ......... ......... ........... ...........
appliance.
D7899... E Tmj unspecified therapy ......... ......... ......... ........... ...........
D7910... E Dent sutur recent wnd ......... ......... ......... ........... ...........
to 5cm.
D7911... E Dental suture wound to ......... ......... ......... ........... ...........
5 cm.
D7912... E Suture complicate wnd > ......... ......... ......... ........... ...........
5 cm.
D7920... E Dental skin graft...... ......... ......... ......... ........... ...........
D7940... S Reshaping bone 031 1.33 $70.52 $14.10 $14.10
orthognathic.
D7941... E Bone cutting ramus ......... ......... ......... ........... ...........
closed.
D7942... E Bone cutting ramus open ......... ......... ......... ........... ...........
D7943... E Cutting ramus open w/ ......... ......... ......... ........... ...........
graft.
D7944... E Bone cutting segmented. ......... ......... ......... ........... ...........
D7945... E Bone cutting body ......... ......... ......... ........... ...........
mandible.
D7946... E Reconstruction maxilla ......... ......... ......... ........... ...........
total.
D7947... E Reconstruct maxilla ......... ......... ......... ........... ...........
segment.
D7948... E Reconstruct midface no ......... ......... ......... ........... ...........
graft.
D7949... E Reconstruct midface w/ ......... ......... ......... ........... ...........
graft.
D7950... E Mandible graft......... ......... ......... ......... ........... ...........
D7955... E Repair maxillofacial ......... ......... ......... ........... ...........
defects.
D7960... E Frenulectomy/ ......... ......... ......... ........... ...........
frenulotomy.
D7970... E Excision hyperplastic ......... ......... ......... ........... ...........
tissue.
D7971... E Excision pericoronal ......... ......... ......... ........... ...........
gingiva.
D7980... E Sialolithotomy......... ......... ......... ......... ........... ...........
D7981... E Excision of salivary ......... ......... ......... ........... ...........
gland.
D7982... E Sialodochoplasty....... ......... ......... ......... ........... ...........
D7983... E Closure of salivary ......... ......... ......... ........... ...........
fistula.
D7990... E Emergency tracheotomy.. ......... ......... ......... ........... ...........
D7991... E Dental coronoidectomy.. ......... ......... ......... ........... ...........
D7995... E Synthetic graft facial ......... ......... ......... ........... ...........
bones.
D7996... E Implant mandible for ......... ......... ......... ........... ...........
augment.
D7999... E Oral surgery procedure. ......... ......... ......... ........... ...........
D8010... E Limited dental tx ......... ......... ......... ........... ...........
primary.
D8020... E Limited dental tx ......... ......... ......... ........... ...........
transition.
D8030... E Limited dental tx ......... ......... ......... ........... ...........
adolescent.
D8040... E Limited dental tx adult ......... ......... ......... ........... ...........
D8050... E Intercep dental tx ......... ......... ......... ........... ...........
primary.
D8060... E Intercep dental tx ......... ......... ......... ........... ...........
transitn.
D8070... E Compre dental tx ......... ......... ......... ........... ...........
transition.
D8080... E Compre dental tx ......... ......... ......... ........... ...........
adolescent.
D8090... E Compre dental tx adult. ......... ......... ......... ........... ...........
D8210... E Orthodontic rem ......... ......... ......... ........... ...........
appliance tx.
D8220... E Fixed appliance therapy ......... ......... ......... ........... ...........
habt.
D8660... E Preorthodontic tx visit ......... ......... ......... ........... ...........
D8670... E Periodic orthodontc tx ......... ......... ......... ........... ...........
visit.
D8680... E Orthodontic retention.. ......... ......... ......... ........... ...........
D8690... E Orthodontic treatment.. ......... ......... ......... ........... ...........
D8999... E Orthodontic procedure.. ......... ......... ......... ........... ...........
D9110... N Tx dental pain minor ......... ......... ......... ........... ...........
proc.
D9210... E Dent anesthesia w/o ......... ......... ......... ........... ...........
surgery.
[[Page 47733]]
D9211... E Regional block ......... ......... ......... ........... ...........
anesthesia.
D9212... E Trigeminal block ......... ......... ......... ........... ...........
anesthesia.
D9215... E Local anesthesia....... ......... ......... ......... ........... ...........
D9220... E General anesthesia..... ......... ......... ......... ........... ...........
D9221... E General anesthesia ea ......... ......... ......... ........... ...........
ad 15m.
D9230... N Analgesia.............. ......... ......... ......... ........... ...........
D9240... E Intravenous sedation... ......... ......... ......... ........... ...........
D9310... E Dental consultation.... ......... ......... ......... ........... ...........
D9410... E Dental house call...... ......... ......... ......... ........... ...........
D9420... E Hospital call.......... ......... ......... ......... ........... ...........
D9430... E Office visit during ......... ......... ......... ........... ...........
hours.
D9440... E Office visit after ......... ......... ......... ........... ...........
hours.
D9610... E Dent therapeutic drug ......... ......... ......... ........... ...........
inject.
D9630... S Other drugs/medicaments 031 1.33 $70.52 $14.10 $14.10
D9910... E Dent appl desensitizing ......... ......... ......... ........... ...........
med.
D9920... E Behavior management.... ......... ......... ......... ........... ...........
D9930... S Treatment of 031 1.33 $70.52 $14.10 $14.10
complications.
D9940... S Dental occlusal guard.. 031 1.33 $70.52 $14.10 $14.10
D9941... E Fabrication athletic ......... ......... ......... ........... ...........
guard.
D9950... S Occlusion analysis..... 031 1.33 $70.52 $14.10 $14.10
D9951... S Limited occlusal 031 1.33 $70.52 $14.10 $14.10
adjustment.
D9952... S Complete occlusal 031 1.33 $70.52 $14.10 $14.10
adjustment.
D9970... E Enamel microabrasion... ......... ......... ......... ........... ...........
D9999... E Adjunctive procedure... ......... ......... ......... ........... ...........
E0100... A Cane adjust/fixed with ......... ......... ......... ........... ...........
tip.
E0105... A Cane adjust/fixed quad/ ......... ......... ......... ........... ...........
3 pro.
E0110... A Crutch forearm pair.... ......... ......... ......... ........... ...........
E0111... A Crutch forearm each.... ......... ......... ......... ........... ...........
E0112... A Crutch underarm pair ......... ......... ......... ........... ...........
wood.
E0113... A Crutch underarm each ......... ......... ......... ........... ...........
wood.
E0114... A Crutch underarm pair no ......... ......... ......... ........... ...........
wood.
E0116... A Crutch underarm each no ......... ......... ......... ........... ...........
wood.
E0130... A Walker rigid adjust/ ......... ......... ......... ........... ...........
fixed ht.
E0135... A Walker folding adjust/ ......... ......... ......... ........... ...........
fixed.
E0141... A Rigid walker wheeled wo ......... ......... ......... ........... ...........
seat.
E0142... A Walker rigid wheeled ......... ......... ......... ........... ...........
with se.
E0143... A Walker folding wheeled ......... ......... ......... ........... ...........
w/o s.
E0145... A Walker whled seat/ ......... ......... ......... ........... ...........
crutch att.
E0146... A Folding walker wheels w ......... ......... ......... ........... ...........
seat.
E0147... A Walker variable wheel ......... ......... ......... ........... ...........
resist.
E0153... A Forearm crutch platform ......... ......... ......... ........... ...........
atta.
E0154... A Walker platform ......... ......... ......... ........... ...........
attachment.
E0155... A Walker rigd pick-up/ ......... ......... ......... ........... ...........
wheel at.
E0156... A Walker seat attachment. ......... ......... ......... ........... ...........
E0157... A Walker crutch ......... ......... ......... ........... ...........
attachment.
E0158... A Walker leg extensions.. ......... ......... ......... ........... ...........
E0159... A Brake for wheeled ......... ......... ......... ........... ...........
walker.
E0160... A Sitz type bath or ......... ......... ......... ........... ...........
equipment.
E0161... A Sitz bath/equipment w/ ......... ......... ......... ........... ...........
faucet.
E0162... A Sitz bath chair........ ......... ......... ......... ........... ...........
E0163... A Commode chair stationry ......... ......... ......... ........... ...........
fxd.
E0164... A Commode chair mobile ......... ......... ......... ........... ...........
fixed a.
E0165... A Commode chair stationry ......... ......... ......... ........... ...........
det.
E0166... A Commode chair mobile ......... ......... ......... ........... ...........
detach.
E0167... A Commode chair pail or ......... ......... ......... ........... ...........
pan.
E0175... A Commode chair foot rest ......... ......... ......... ........... ...........
E0176... A Air pressre pad/cushion ......... ......... ......... ........... ...........
nonp.
E0177... A Water press pad/cushion ......... ......... ......... ........... ...........
nonp.
E0178... A Gel pressre pad/cushion ......... ......... ......... ........... ...........
nonp.
E0179... A Dry pressre pad/cushion ......... ......... ......... ........... ...........
nonp.
E0180... A Press pad alternating w ......... ......... ......... ........... ...........
pump.
E0181... A Press pad alternating w/ ......... ......... ......... ........... ...........
pum.
E0182... A Pressure pad ......... ......... ......... ........... ...........
alternating pum.
E0184... A Dry pressure mattress.. ......... ......... ......... ........... ...........
E0185... A Gel pressure mattress ......... ......... ......... ........... ...........
pad.
E0186... A Air pressure mattress.. ......... ......... ......... ........... ...........
E0187... A Water pressure mattress ......... ......... ......... ........... ...........
E0188... E Synthetic sheepskin pad ......... ......... ......... ........... ...........
E0189... E Lambswool sheepskin pad ......... ......... ......... ........... ...........
E0191... A Protector heel or elbow ......... ......... ......... ........... ...........
E0192... A Pad wheelchr low press/ ......... ......... ......... ........... ...........
posit.
E0193... A Powered air flotation ......... ......... ......... ........... ...........
bed.
E0194... A Air fluidized bed...... ......... ......... ......... ........... ...........
E0196... A Gel pressure mattress.. ......... ......... ......... ........... ...........
E0197... A Air pressure pad for ......... ......... ......... ........... ...........
mattres.
[[Page 47734]]
E0198... A Water pressure pad for ......... ......... ......... ........... ...........
mattr.
E0199... A Dry pressure pad for ......... ......... ......... ........... ...........
mattres.
E0200... A Heat lamp without stand ......... ......... ......... ........... ...........
E0202... A Phototherapy light w/ ......... ......... ......... ........... ...........
photom.
E0205... A Heat lamp with stand... ......... ......... ......... ........... ...........
E0210... A Electric heat pad ......... ......... ......... ........... ...........
standard.
E0215... A Electric heat pad moist ......... ......... ......... ........... ...........
E0217... A Water circ heat pad w ......... ......... ......... ........... ...........
pump.
E0218... A Water circ cold pad w ......... ......... ......... ........... ...........
pump.
E0220... A Hot water bottle....... ......... ......... ......... ........... ...........
E0225... A Hydrocollator unit..... ......... ......... ......... ........... ...........
E0230... A Ice cap or collar...... ......... ......... ......... ........... ...........
E0235... A Paraffin bath unit ......... ......... ......... ........... ...........
portable.
E0236... A Pump for water ......... ......... ......... ........... ...........
circulating p.
E0238... A Heat pad non-electric ......... ......... ......... ........... ...........
moist.
E0239... A Hydrocollator unit ......... ......... ......... ........... ...........
portable.
E0241... E Bath tub wall rail..... ......... ......... ......... ........... ...........
E0242... E Bath tub rail floor.... ......... ......... ......... ........... ...........
E0243... E Toilet rail............ ......... ......... ......... ........... ...........
E0244... E Toilet seat raised..... ......... ......... ......... ........... ...........
E0245... E Tub stool or bench..... ......... ......... ......... ........... ...........
E0246... A Transfer tub rail ......... ......... ......... ........... ...........
attachment.
E0249... A Pad water circulating ......... ......... ......... ........... ...........
heat u.
E0250... A Hosp bed fixed ht w/ ......... ......... ......... ........... ...........
mattres.
E0251... A Hosp bed fixd ht w/o ......... ......... ......... ........... ...........
mattres.
E0255... A Hospital bed var ht w/ ......... ......... ......... ........... ...........
mattr.
E0256... A Hospital bed var ht w/o ......... ......... ......... ........... ...........
matt.
E0260... A Hosp bed semi-electr w/ ......... ......... ......... ........... ...........
matt.
E0261... A Hosp bed semi-electr w/ ......... ......... ......... ........... ...........
o mat.
E0265... A Hosp bed total electr w/ ......... ......... ......... ........... ...........
mat.
E0266... A Hosp bed total elec w/o ......... ......... ......... ........... ...........
matt.
E0270... A Hospital bed ......... ......... ......... ........... ...........
institutional t.
E0271... A Mattress innerspring... ......... ......... ......... ........... ...........
E0272... A Mattress foam rubber... ......... ......... ......... ........... ...........
E0273... A Bed board.............. ......... ......... ......... ........... ...........
E0274... A Over-bed table......... ......... ......... ......... ........... ...........
E0275... A Bed pan standard....... ......... ......... ......... ........... ...........
E0276... A Bed pan fracture....... ......... ......... ......... ........... ...........
E0277... A Powered pres-redu air ......... ......... ......... ........... ...........
mattrs.
E0280... A Bed cradle............. ......... ......... ......... ........... ...........
E0290... A Hosp bed fx ht w/o ......... ......... ......... ........... ...........
rails w/m.
E0291... A Hosp bed fx ht w/o rail ......... ......... ......... ........... ...........
w/o.
E0292... A Hosp bed var ht w/o ......... ......... ......... ........... ...........
rail w/o.
E0293... A Hosp bed var ht w/o ......... ......... ......... ........... ...........
rail w/.
E0294... A Hosp bed semi-elect w/ ......... ......... ......... ........... ...........
mattr.
E0295... A Hosp bed semi-elect w/o ......... ......... ......... ........... ...........
matt.
E0296... A Hosp bed total elect w/ ......... ......... ......... ........... ...........
matt.
E0297... A Hosp bed total elect w/ ......... ......... ......... ........... ...........
o mat.
E0305... A Rails bed side half ......... ......... ......... ........... ...........
length.
E0310... A Rails bed side full ......... ......... ......... ........... ...........
length.
E0315... A Bed accessory brd/tbl/ ......... ......... ......... ........... ...........
supprt.
E0325... A Urinal male jug-type... ......... ......... ......... ........... ...........
E0326... A Urinal female jug-type. ......... ......... ......... ........... ...........
E0350... A Control unit bowel ......... ......... ......... ........... ...........
system.
E0352... A Disposable pack w/bowel ......... ......... ......... ........... ...........
syst.
E0370... A Air elevator for heel.. ......... ......... ......... ........... ...........
E0371... A Nonpower mattress ......... ......... ......... ........... ...........
overlay.
E0372... A Powered air mattress ......... ......... ......... ........... ...........
overlay.
E0373... A Nonpowered pressure ......... ......... ......... ........... ...........
mattress.
E0424... A Stationary compressed ......... ......... ......... ........... ...........
gas 02.
E0425... A Gas system stationary ......... ......... ......... ........... ...........
compre.
E0430... A Oxygen system gas ......... ......... ......... ........... ...........
portable.
E0431... A Portable gaseous 02.... ......... ......... ......... ........... ...........
E0434... A Portable liquid 02..... ......... ......... ......... ........... ...........
E0435... A Oxygen system liquid ......... ......... ......... ........... ...........
portabl.
E0439... A Stationary liquid 02... ......... ......... ......... ........... ...........
E0440... A Oxygen system liquid ......... ......... ......... ........... ...........
station.
E0441... A Oxygen contents gas per/ ......... ......... ......... ........... ...........
unit.
E0442... A Oxygen contents liq per/ ......... ......... ......... ........... ...........
unit.
E0443... A Port 02 contents gas/ ......... ......... ......... ........... ...........
unit.
E0444... A Port 02 contents liq/ ......... ......... ......... ........... ...........
unit.
E0450... A Volume vent stationary/ ......... ......... ......... ........... ...........
porta.
E0452... A Intermit assis device w ......... ......... ......... ........... ...........
cpap.
E0453... A Ventilator 12 hrs/less ......... ......... ......... ........... ...........
per d.
E0455... A Oxygen tent excl croup/ ......... ......... ......... ........... ...........
ped t.
[[Page 47735]]
E0457... A Chest shell............ ......... ......... ......... ........... ...........
E0459... A Chest wrap............. ......... ......... ......... ........... ...........
E0460... A Neg press vent portabl/ ......... ......... ......... ........... ...........
statn.
E0462... A Rocking bed w/ or w/o ......... ......... ......... ........... ...........
side r.
E0480... A Percussor elect/pneum ......... ......... ......... ........... ...........
home m.
E0500... A Ippb all types......... ......... ......... ......... ........... ...........
E0550... A Humidif extens supple w ......... ......... ......... ........... ...........
ippb.
E0555... A Humidifier for use w/ ......... ......... ......... ........... ...........
regula.
E0560... A Humidifier supplemental ......... ......... ......... ........... ...........
w/ i.
E0565... A Compressor air power ......... ......... ......... ........... ...........
source.
E0570... A Nebulizer with ......... ......... ......... ........... ...........
compression.
E0575... A Nebulizer ultrasonic... ......... ......... ......... ........... ...........
E0580... A Nebulizer for use w/ ......... ......... ......... ........... ...........
regulat.
E0585... A Nebulizer w/ compressor ......... ......... ......... ........... ...........
& he.
E0600... A Suction pump portab hom ......... ......... ......... ........... ...........
modl.
E0601... A Cont airway pressure ......... ......... ......... ........... ...........
device.
E0605... A Vaporizer room type.... ......... ......... ......... ........... ...........
E0606... A Drainage board postural ......... ......... ......... ........... ...........
E0607... A Blood glucose monitor ......... ......... ......... ........... ...........
home.
E0608... A Apnea monitor.......... ......... ......... ......... ........... ...........
E0609... A Blood gluc mon w/ ......... ......... ......... ........... ...........
special fea.
E0610... A Pacemaker monitr ......... ......... ......... ........... ...........
audible/vis.
E0615... A Pacemaker monitr ......... ......... ......... ........... ...........
digital/vis.
E0621... A Patient lift sling or ......... ......... ......... ........... ...........
seat.
E0625... A Patient lift bathroom ......... ......... ......... ........... ...........
or toi.
E0627... A Seat lift incorp lift- ......... ......... ......... ........... ...........
chair.
E0628... A Seat lift for pt furn- ......... ......... ......... ........... ...........
electr.
E0629... A Seat lift for pt furn- ......... ......... ......... ........... ...........
non-el.
E0630... A Patient lift hydraulic. ......... ......... ......... ........... ...........
E0635... A Patient lift electric.. ......... ......... ......... ........... ...........
E0650... A Pneuma compresor non- ......... ......... ......... ........... ...........
segment.
E0651... A Pneum compressor ......... ......... ......... ........... ...........
segmental.
E0652... A Pneum compres w/cal ......... ......... ......... ........... ...........
pressure.
E0655... A Pneumatic appliance ......... ......... ......... ........... ...........
half arm.
E0660... A Pneumatic appliance ......... ......... ......... ........... ...........
full leg.
E0665... A Pneumatic appliance ......... ......... ......... ........... ...........
full arm.
E0666... A Pneumatic appliance ......... ......... ......... ........... ...........
half leg.
E0667... A Seg pneumatic appl full ......... ......... ......... ........... ...........
leg.
E0668... A Seg pneumatic appl full ......... ......... ......... ........... ...........
arm.
E0669... A Seg pneumatic appli ......... ......... ......... ........... ...........
half leg.
E0671... A Pressure pneum appl ......... ......... ......... ........... ...........
full leg.
E0672... A Pressure pneum appl ......... ......... ......... ........... ...........
full arm.
E0673... A Pressure pneum appl ......... ......... ......... ........... ...........
half leg.
E0690... A Ultraviolet cabinet.... ......... ......... ......... ........... ...........
E0700... A Safety equipment....... ......... ......... ......... ........... ...........
E0710... A Restraints any type.... ......... ......... ......... ........... ...........
E0720... A Tens two lead.......... ......... ......... ......... ........... ...........
E0730... A Tens four lead......... ......... ......... ......... ........... ...........
E0731... A Conductive garment for ......... ......... ......... ........... ...........
tens/.
E0740... A Incontinence treatment ......... ......... ......... ........... ...........
systm.
E0744... A Neuromuscular stim for ......... ......... ......... ........... ...........
scoli.
E0745... A Neuromuscular stim for ......... ......... ......... ........... ...........
shock.
E0746... A Electromyograph ......... ......... ......... ........... ...........
biofeedback.
E0747... A Elec osteogen stim not ......... ......... ......... ........... ...........
spine.
E0748... A Elec osteogen stim ......... ......... ......... ........... ...........
spinal.
E0749... A Elec osteogen stim ......... ......... ......... ........... ...........
implanted.
E0751... A Pulse generator or ......... ......... ......... ........... ...........
receiver.
E0753... A Neurostimul electrodes/ ......... ......... ......... ........... ...........
leads.
E0755... A Electronic salivary ......... ......... ......... ........... ...........
reflex s.
E0760... A Osteogen ultrasound ......... ......... ......... ........... ...........
stimltor.
E0776... A Iv pole................ ......... ......... ......... ........... ...........
E0781... A External ambulatory ......... ......... ......... ........... ...........
infus pu.
E0782... A Non-programble infusion ......... ......... ......... ........... ...........
pump.
E0783... A Programmable infusion ......... ......... ......... ........... ...........
pump.
E0784... A Ext amb infusn pump ......... ......... ......... ........... ...........
insulin.
E0791... A Parenteral infusion ......... ......... ......... ........... ...........
pump sta.
E0840... A Tract frame attach ......... ......... ......... ........... ...........
headboard.
E0850... A Traction stand free ......... ......... ......... ........... ...........
standing.
E0855... A Cervical traction ......... ......... ......... ........... ...........
equipment.
E0860... A Tract equip cervical ......... ......... ......... ........... ...........
tract.
E0870... A Tract frame attach ......... ......... ......... ........... ...........
footboard.
E0880... A Trac stand free stand ......... ......... ......... ........... ...........
extrem.
E0890... A Traction frame attach ......... ......... ......... ........... ...........
pelvic.
E0900... A Trac stand free stand ......... ......... ......... ........... ...........
pelvic.
E0910... A Trapeze bar attached to ......... ......... ......... ........... ...........
bed.
[[Page 47736]]
E0920... A Fracture frame attached ......... ......... ......... ........... ...........
to b.
E0930... A Fracture frame free ......... ......... ......... ........... ...........
standing.
E0935... A Exercise device passive ......... ......... ......... ........... ...........
moti.
E0940... A Trapeze bar free ......... ......... ......... ........... ...........
standing.
E0941... A Gravity assisted ......... ......... ......... ........... ...........
traction de.
E0942... A Cervical head harness/ ......... ......... ......... ........... ...........
halter.
E0943... A Cervical pillow........ ......... ......... ......... ........... ...........
E0944... A Pelvic belt/harness/ ......... ......... ......... ........... ...........
boot.
E0945... A Belt/harness extremity. ......... ......... ......... ........... ...........
E0946... A Fracture frame dual w ......... ......... ......... ........... ...........
cross.
E0947... A Fracture frame ......... ......... ......... ........... ...........
attachmnts pe.
E0948... A Fracture frame ......... ......... ......... ........... ...........
attachmnts ce.
E0950... A Tray................... ......... ......... ......... ........... ...........
E0951... A Loop heel.............. ......... ......... ......... ........... ...........
E0952... A Loop tie............... ......... ......... ......... ........... ...........
E0953... A Pneumatic tire......... ......... ......... ......... ........... ...........
E0954... A Wheelchair semi- ......... ......... ......... ........... ...........
pneumatic ca.
E0958... A Whlchr att-conv 1 arm ......... ......... ......... ........... ...........
drive.
E0959... A Amputee adapter........ ......... ......... ......... ........... ...........
E0961... A Wheelchair brake ......... ......... ......... ........... ...........
extension.
E0962... A Wheelchair 1 inch ......... ......... ......... ........... ...........
cushion.
E0963... A Wheelchair 2 inch ......... ......... ......... ........... ...........
cushion.
E0964... A Wheelchair 3 inch ......... ......... ......... ........... ...........
cushion.
E0965... A Wheelchair 4 inch ......... ......... ......... ........... ...........
cushion.
E0966... A Wheelchair head rest ......... ......... ......... ........... ...........
extensi.
E0967... A Wheelchair hand rims... ......... ......... ......... ........... ...........
E0968... A Wheelchair commode seat ......... ......... ......... ........... ...........
E0969... A Wheelchair narrowing ......... ......... ......... ........... ...........
device.
E0970... A Wheelchair no. 2 ......... ......... ......... ........... ...........
footplates.
E0971... A Wheelchair anti-tipping ......... ......... ......... ........... ...........
devi.
E0972... A Transfer board or ......... ......... ......... ........... ...........
device.
E0973... A Wheelchair adjustabl ......... ......... ......... ........... ...........
height.
E0974... A Wheelchair grade-aid... ......... ......... ......... ........... ...........
E0975... A Wheelchair reinforced ......... ......... ......... ........... ...........
seat u.
E0976... A Wheelchair reinforced ......... ......... ......... ........... ...........
back u.
E0977... A Wheelchair wedge ......... ......... ......... ........... ...........
cushion.
E0978... A Wheelchair belt w/ ......... ......... ......... ........... ...........
airplane b.
E0979... A Wheelchair belt with ......... ......... ......... ........... ...........
velcro.
E0980... A Wheelchair safety vest. ......... ......... ......... ........... ...........
E0990... A Whellchair elevating ......... ......... ......... ........... ...........
leg res.
E0991... A Wheelchair upholstry ......... ......... ......... ........... ...........
seat.
E0992... A Wheelchair solid seat ......... ......... ......... ........... ...........
insert.
E0993... A Wheelchair back ......... ......... ......... ........... ...........
upholstery.
E0994... A Wheelchair arm rest.... ......... ......... ......... ........... ...........
E0995... A Wheelchair calf rest... ......... ......... ......... ........... ...........
E0996... A Wheelchair tire solid.. ......... ......... ......... ........... ...........
E0997... A Wheelchair caster w/ a ......... ......... ......... ........... ...........
fork.
E0998... A Wheelchair caster w/o a ......... ......... ......... ........... ...........
fork.
E0999... A Wheelchr pneumatic tire ......... ......... ......... ........... ...........
w/wh.
E1000... A Wheelchair tire ......... ......... ......... ........... ...........
pneumatic ca.
E1001... A Wheelchair wheel....... ......... ......... ......... ........... ...........
E1031... A Rollabout chair with ......... ......... ......... ........... ...........
casters.
E1050... A Whelchr fxd full length ......... ......... ......... ........... ...........
arms.
E1060... A Wheelchair detachable ......... ......... ......... ........... ...........
arms.
E1065... A Wheelchair power ......... ......... ......... ........... ...........
attachment.
E1066... A Wheelchair battery ......... ......... ......... ........... ...........
charger.
E1069... A Wheelchair deep cycle ......... ......... ......... ........... ...........
batter.
E1070... A Wheelchair detachable ......... ......... ......... ........... ...........
foot r.
E1083... A Hemi-wheelchair fixed ......... ......... ......... ........... ...........
arms.
E1084... A Hemi-wheelchair ......... ......... ......... ........... ...........
detachable a.
E1085... A Hemi-wheelchair fixed ......... ......... ......... ........... ...........
arms.
E1086... A Hemi-wheelchair ......... ......... ......... ........... ...........
detachable a.
E1087... A Wheelchair lightwt ......... ......... ......... ........... ...........
fixed arm.
E1088... A Wheelchair lightweight ......... ......... ......... ........... ...........
det a.
E1089... A Wheelchair lightwt ......... ......... ......... ........... ...........
fixed arm.
E1090... A Wheelchair lightweight ......... ......... ......... ........... ...........
det a.
E1091... A Wheelchair youth....... ......... ......... ......... ........... ...........
E1092... A Wheelchair wide w/ leg ......... ......... ......... ........... ...........
rests.
E1093... A Wheelchair wide w/ foot ......... ......... ......... ........... ...........
rest.
E1100... A Whchr s-recl fxd arm ......... ......... ......... ........... ...........
leg res.
E1110... A Wheelchair semi-recl ......... ......... ......... ........... ...........
detach.
E1130... A Whlchr stand fxd arm ft ......... ......... ......... ........... ...........
rest.
E1140... A Wheelchair standard ......... ......... ......... ........... ...........
detach a.
E1150... A Wheelchair standard w/ ......... ......... ......... ........... ...........
leg r.
E1160... A Wheelchair fixed arms.. ......... ......... ......... ........... ...........
[[Page 47737]]
E1170... A Whlchr ampu fxd arm leg ......... ......... ......... ........... ...........
rest.
E1171... A Wheelchair amputee w/o ......... ......... ......... ........... ...........
leg r.
E1172... A Wheelchair amputee ......... ......... ......... ........... ...........
detach ar.
E1180... A Wheelchair amputee w/ ......... ......... ......... ........... ...........
foot r.
E1190... A Wheelchair amputee w/ ......... ......... ......... ........... ...........
leg re.
E1195... A Wheelchair amputee ......... ......... ......... ........... ...........
heavy dut.
E1200... A Wheelchair amputee ......... ......... ......... ........... ...........
fixed arm.
E1210... A Whlchr moto ful arm leg ......... ......... ......... ........... ...........
rest.
E1211... A Wheelchair motorized w/ ......... ......... ......... ........... ...........
det.
E1212... A Wheelchair motorized w ......... ......... ......... ........... ...........
full.
E1213... A Wheelchair motorized w/ ......... ......... ......... ........... ...........
det.
E1220... A Whlchr special size/ ......... ......... ......... ........... ...........
constrc.
E1221... A Wheelchair spec size w ......... ......... ......... ........... ...........
foot.
E1222... A Wheelchair spec size w/ ......... ......... ......... ........... ...........
leg.
E1223... A Wheelchair spec size w ......... ......... ......... ........... ...........
foot.
E1224... A Wheelchair spec size w/ ......... ......... ......... ........... ...........
leg.
E1225... A Wheelchair spec sz semi- ......... ......... ......... ........... ...........
recl.
E1226... A Wheelchair spec sz full- ......... ......... ......... ........... ...........
recl.
E1227... A Wheelchair spec sz spec ......... ......... ......... ........... ...........
ht a.
E1228... A Wheelchair spec sz spec ......... ......... ......... ........... ...........
ht b.
E1230... A Power operated vehicle. ......... ......... ......... ........... ...........
E1240... A Whchr litwt det arm leg ......... ......... ......... ........... ...........
rest.
E1250... A Wheelchair lightwt ......... ......... ......... ........... ...........
fixed arm.
E1260... A Wheelchair lightwt foot ......... ......... ......... ........... ...........
rest.
E1270... A Wheelchair lightweight ......... ......... ......... ........... ...........
leg r.
E1280... A Whchr h-duty det arm ......... ......... ......... ........... ...........
leg res.
E1285... A Wheelchair heavy duty ......... ......... ......... ........... ...........
fixed.
E1290... A Wheelchair hvy duty ......... ......... ......... ........... ...........
detach a.
E1295... A Wheelchair heavy duty ......... ......... ......... ........... ...........
fixed.
E1296... A Wheelchair special seat ......... ......... ......... ........... ...........
heig.
E1297... A Wheelchair special seat ......... ......... ......... ........... ...........
dept.
E1298... A Wheelchair spec seat ......... ......... ......... ........... ...........
depth/w.
E1300... A Whirlpool portable..... ......... ......... ......... ........... ...........
E1310... A Whirlpool non-portable. ......... ......... ......... ........... ...........
E1340... A Repair for DME, per 15 ......... ......... ......... ........... ...........
min.
E1353... A Oxygen supplies ......... ......... ......... ........... ...........
regulator.
E1355... A Oxygen supplies stand/ ......... ......... ......... ........... ...........
rack.
E1372... A Oxy suppl heater for ......... ......... ......... ........... ...........
nebuliz.
E1375... A Oxygen suppl nebulizer ......... ......... ......... ........... ...........
porta.
E1377... A Oxygen concentrator to ......... ......... ......... ........... ...........
244 c.
E1378... A Oxygen concentrator to ......... ......... ......... ........... ...........
488 c.
E1379... A Oxygen concentrator to ......... ......... ......... ........... ...........
732 c.
E1380... A Oxygen concentrator to ......... ......... ......... ........... ...........
976 c.
E1381... A Oxygen concentrat to ......... ......... ......... ........... ...........
1220 cu.
E1382... A Oxygen concentrat to ......... ......... ......... ........... ...........
1464 cu.
E1383... A Oxygen concentrat to ......... ......... ......... ........... ...........
1708 cu.
E1384... A Oxygen concentrat to ......... ......... ......... ........... ...........
1952 cu.
E1385... A Oxygen concentrator > ......... ......... ......... ........... ...........
1952 c.
E1399... A Durable medical ......... ......... ......... ........... ...........
equipment mi.
E1400... A Oxygen concentrator < 2 ......... ......... ......... ........... ...........
lite.
E1401... A Oxygen concentrator 2-3 ......... ......... ......... ........... ...........
lite.
E1402... A Oxygen concentrator 3-4 ......... ......... ......... ........... ...........
lite.
E1403... A Oxygen concentrator 4-5 ......... ......... ......... ........... ...........
lite.
E1404... A Oxygen concentrator > 5 ......... ......... ......... ........... ...........
lite.
E1405... A O2/water vapor enrich w/ ......... ......... ......... ........... ...........
heat.
E1406... A O2/water vapor enrich w/ ......... ......... ......... ........... ...........
o he.
E1510... A Kidney dialysate ......... ......... ......... ........... ...........
delivry sys.
E1520... A Heparin infusion pump ......... ......... ......... ........... ...........
for di.
E1530... A Air bubble detector for ......... ......... ......... ........... ...........
dial.
E1540... A Pressure alarm for ......... ......... ......... ........... ...........
dialysis.
E1550... A Bath conductivity meter ......... ......... ......... ........... ...........
E1560... A Blood leak detector for ......... ......... ......... ........... ...........
dial.
E1570... A Adjustable chair for ......... ......... ......... ........... ...........
esrd pt.
E1575... A Transducer protector/ ......... ......... ......... ........... ...........
fluid b.
E1580... A Unipuncture control ......... ......... ......... ........... ...........
system.
E1590... A Hemodialysis machine... ......... ......... ......... ........... ...........
E1592... A Auto interm peritoneal ......... ......... ......... ........... ...........
dialy.
E1594... A Cycler dialysis machine ......... ......... ......... ........... ...........
E1600... A Deliv/install equip for ......... ......... ......... ........... ...........
dial.
E1610... A Reverse osmosis water ......... ......... ......... ........... ...........
purifi.
E1615... A Deionizer water ......... ......... ......... ........... ...........
purification.
E1620... A Blood pump for dialysis ......... ......... ......... ........... ...........
E1625... A Water softening system. ......... ......... ......... ........... ...........
E1630... A Reciprocating ......... ......... ......... ........... ...........
peritoneal dia.
E1632... A Wearable artificial ......... ......... ......... ........... ...........
kidney.
[[Page 47738]]
E1635... A Compact travel ......... ......... ......... ........... ...........
hemodialyzer.
E1636... A Sorbent cartridges for ......... ......... ......... ........... ...........
dialy.
E1640... A Replacement components ......... ......... ......... ........... ...........
for d.
E1699... A Dialysis equipment ......... ......... ......... ........... ...........
unspecifi.
E1700... A Jaw motion rehab system ......... ......... ......... ........... ...........
E1701... A Repl cushions for jaw ......... ......... ......... ........... ...........
motion.
E1702... A Repl measr scales jaw ......... ......... ......... ........... ...........
motion.
E1800... A Adjust elbow ext/flex ......... ......... ......... ........... ...........
device.
E1805... A Adjust wrist ext/flex ......... ......... ......... ........... ...........
device.
E1810... A Adjust knee ext/flex ......... ......... ......... ........... ...........
device.
E1815... A Adjust ankle ext/flex ......... ......... ......... ........... ...........
device.
E1820... A Soft interface material ......... ......... ......... ........... ...........
E1825... A Adjust finger ext/flex ......... ......... ......... ........... ...........
devc.
E1830... A Adjust toe ext/flex ......... ......... ......... ........... ...........
device.
G0001... N Drawing blood for ......... ......... ......... ........... ...........
specimen.
G0002... N Temporary urinary ......... ......... ......... ........... ...........
catheter.
G0004... X ECG transm phys review 956 1.11 $58.77 $55.82 $11.75
& int.
G0005... X ECG 24 hour recording.. 956 1.11 $58.77 $55.82 $11.75
G0006... X ECG transmission & 956 1.11 $58.77 $55.82 $11.75
analysis.
G0007... N ECG phy review & ......... ......... ......... ........... ...........
interpret.
G0008... X Admin influenza virus 901 0.07 $3.92 $2.49 $0.78
vac.
G0009... X Admin pneumococcal 901 0.07 $3.92 $2.49 $0.78
vaccine.
G0010... X Admin hepatitis b 902 1.78 $94.03 $41.58 $18.81
vaccine.
G0015... X Post symptom ECG 956 1.11 $58.77 $55.82 $11.75
tracing.
G0016... N Post symptom ECG md ......... ......... ......... ........... ...........
review.
G0025... X Collagen skin test kit. 881 0.20 $10.77 $6.78 $2.15
G0026... A Fecal leukocyte ......... ......... ......... ........... ...........
examination.
G0027... A Semen analysis......... ......... ......... ......... ........... ...........
G0030... S PET imaging prev PET 760 17.91 $947.13 $419.46 $189.43
single.
G0031... S PET imaging prev PET 760 17.91 $947.13 $419.46 $189.43
multple.
G0032... S PET follow SPECT 78464 760 17.91 $947.13 $419.46 $189.43
singl.
G0033... S PET follow SPECT 78464 760 17.91 $947.13 $419.46 $189.43
mult.
G0034... S PET follow SPECT 76865 760 17.91 $947.13 $419.46 $189.43
singl.
G0035... S PET follow SPECT 78465 760 17.91 $947.13 $419.46 $189.43
mult.
G0036... S PET follow cornry angio 760 17.91 $947.13 $419.46 $189.43
sing.
G0037... S PET follow cornry angio 760 17.91 $947.13 $419.46 $189.43
mult.
G0038... S PET follow myocard perf 760 17.91 $947.13 $419.46 $189.43
sing.
G0039... S PET follow myocard perf 760 17.91 $947.13 $419.46 $189.43
mult.
G0040... S PET follow stress echo 760 17.91 $947.13 $419.46 $189.43
singl.
G0041... S PET follow stress echo 760 17.91 $947.13 $419.46 $189.43
mult.
G0042... S PET follow ventriculogm 760 17.91 $947.13 $419.46 $189.43
sing.
G0043... S PET follow ventriculogm 760 17.91 $947.13 $419.46 $189.43
mult.
G0044... S PET following rest ECG 760 17.91 $947.13 $419.46 $189.43
singl.
G0045... S PET following rest ECG 760 17.91 $947.13 $419.46 $189.43
mult.
G0046... S PET follow stress ECG 760 17.91 $947.13 $419.46 $189.43
singl.
G0047... S PET follow stress ECG 760 17.91 $947.13 $419.46 $189.43
mult.
G0050... S Residual urine by 747 1.65 $87.17 $54.69 $17.43
ultrasound.
G0101... V CA screen;pelvic/breast 913 ......... ......... ........... ...........
exam.
G0104... T CA screen;flexi 446 2.59 $137.12 $65.09 $27.42
sigmoidscope.
G0105... T Colorectal scrn; hi 426 6.85 $362.40 $187.81 $72.48
risk ind.
G0106... S Colon CA screen;barium 736 1.85 $97.95 $54.24 $19.59
enema.
G0107... A CA screen; fecal blood ......... ......... ......... ........... ...........
test.
G0110... A Nett pulm-rehab educ; ......... ......... ......... ........... ...........
ind.
G0111... A Nett pulm-rehab educ; ......... ......... ......... ........... ...........
group.
G0112... A Nett;nutrition guid, ......... ......... ......... ........... ...........
initial.
G0113... A Nett;nutrition ......... ......... ......... ........... ...........
guid,subseqnt.
G0114... A Nett; psychosocial ......... ......... ......... ........... ...........
consult.
G0115... A Nett; psychological ......... ......... ......... ........... ...........
testing.
G0116... A Nett; psychosocial ......... ......... ......... ........... ...........
counsel.
G0120... S Colon ca scrn; barium 736 1.85 $97.95 $54.24 $19.59
enema.
G0121... E Colon ca scrn; barium ......... ......... ......... ........... ...........
enema.
G0122... E Colon ca scrn; barium ......... ......... ......... ........... ...........
enema.
J0120... N Tetracyclin injection.. ......... ......... ......... ........... ...........
J0150... N Injection adenosine 6 ......... ......... ......... ........... ...........
MG.
J0170... N Adrenalin epinephrin ......... ......... ......... ........... ...........
inject.
J0190... N Inj biperiden lactate/5 ......... ......... ......... ........... ...........
mg.
J0205... N Alglucerase injection.. ......... ......... ......... ........... ...........
J0207... N Amifostine............. ......... ......... ......... ........... ...........
J0210... N Methyldopate hcl ......... ......... ......... ........... ...........
injection.
J0256... N Alpha 1-proteinase 500 ......... ......... ......... ........... ...........
MG.
J0270... E Alprostadil for ......... ......... ......... ........... ...........
injection.
J0280... N Aminophyllin 250 MG inj ......... ......... ......... ........... ...........
J0290... N Ampicillin 500 MG inj.. ......... ......... ......... ........... ...........
J0295... N Ampicillin sodium per ......... ......... ......... ........... ...........
1.5 gm.
J0300... N Amobarbital 125 MG inj. ......... ......... ......... ........... ...........
[[Page 47739]]
J0330... N Succinycholine chloride ......... ......... ......... ........... ...........
inj.
J0340... N Nandrolon ......... ......... ......... ........... ...........
phenpropionate inj.
J0350... N Injection anistreplase ......... ......... ......... ........... ...........
30 u.
J0360... N Hydralazine hcl ......... ......... ......... ........... ...........
injection.
J0380... N Inj metaraminol ......... ......... ......... ........... ...........
bitartrate.
J0390... N Chloroquine injection.. ......... ......... ......... ........... ...........
J0400... N Inj trimethaphan ......... ......... ......... ........... ...........
camsylate.
J0460... N Atropine sulfate ......... ......... ......... ........... ...........
injection.
J0470... N Dimecaprol injection... ......... ......... ......... ........... ...........
J0475... N Baclofen 10 MG ......... ......... ......... ........... ...........
injection.
J0500... N Dicyclomine injection.. ......... ......... ......... ........... ...........
J0510... N Benzquinamide injection ......... ......... ......... ........... ...........
J0515... N Inj benztropine ......... ......... ......... ........... ...........
mesylate.
J0520... N Bethanechol chloride ......... ......... ......... ........... ...........
inject.
J0530... N Penicillin g benzathine ......... ......... ......... ........... ...........
inj.
J0540... N Penicillin g benzathine ......... ......... ......... ........... ...........
inj.
J0550... N Penicillin g benzathine ......... ......... ......... ........... ...........
inj.
J0560... N Penicillin g benzathine ......... ......... ......... ........... ...........
inj.
J0570... N Penicillin g benzathine ......... ......... ......... ........... ...........
inj.
J0580... N Penicillin g benzathine ......... ......... ......... ........... ...........
inj.
J0585... N Botulinum toxin a per ......... ......... ......... ........... ...........
unit.
J0590... N Ethylnorepinephrine hcl ......... ......... ......... ........... ...........
inj.
J0600... N Edetate calcium ......... ......... ......... ........... ...........
disodium inj.
J0610... N Calcium gluconate ......... ......... ......... ........... ...........
injection.
J0620... N Calcium glycer & lact/ ......... ......... ......... ........... ...........
10 ML.
J0630... N Calcitonin salmon ......... ......... ......... ........... ...........
injection.
J0635... N Calcitriol injection... ......... ......... ......... ........... ...........
J0640... X Leucovorin calcium 064 4.17 $220.38 $140.12 $44.08
injection.
J0670... N Inj mepivacaine HCL/10 ......... ......... ......... ........... ...........
ml.
J0690... N Cefazolin sodium ......... ......... ......... ........... ...........
injection.
J0694... N Cefoxitin sodium ......... ......... ......... ........... ...........
injection.
J0695... N Cefonocid sodium ......... ......... ......... ........... ...........
injection.
J0696... N Ceftriaxone sodium ......... ......... ......... ........... ...........
injection.
J0697... N Sterile cefuroxime ......... ......... ......... ........... ...........
injection.
J0698... N Cefotaxime sodium ......... ......... ......... ........... ...........
injection.
J0702... N Betamethasone acet&sod ......... ......... ......... ........... ...........
phosp.
J0704... N Betamethasone sod phosp/ ......... ......... ......... ........... ...........
4 MG.
J0710... N Cephapirin sodium ......... ......... ......... ........... ...........
injection.
J0713... N Inj ceftazidime per 500 ......... ......... ......... ........... ...........
mg.
J0715... N Ceftizoxime sodium / ......... ......... ......... ........... ...........
500 MG.
J0720... N Chloramphenicol sodium ......... ......... ......... ........... ...........
injec.
J0725... N Chorionic gonadotropin/ ......... ......... ......... ........... ...........
1000u.
J0730... N Chlorpheniramin maleate ......... ......... ......... ........... ...........
inj.
J0735... N Clonidine hydrochloride ......... ......... ......... ........... ...........
J0740... N Cidofovir injection.... ......... ......... ......... ........... ...........
J0743... N Cilastatin sodium ......... ......... ......... ........... ...........
injection.
J0745... N Inj codeine phosphate / ......... ......... ......... ........... ...........
30 MG.
J0760... N Colchicine injection... ......... ......... ......... ........... ...........
J0770... N Colistimethate sodium ......... ......... ......... ........... ...........
inj.
J0780... N Prochlorperazine ......... ......... ......... ........... ...........
injection.
J0800... N Corticotropin injection ......... ......... ......... ........... ...........
J0810... N Cortisone injection.... ......... ......... ......... ........... ...........
J0835... N Inj cosyntropin per ......... ......... ......... ........... ...........
0.25 MG.
J0850... N Cytomegalovirus imm IV / ......... ......... ......... ........... ...........
vial.
J0895... N Deferoxamine mesylate ......... ......... ......... ........... ...........
inj.
J0900... N Testosterone enanthate ......... ......... ......... ........... ...........
inj.
J0945... N Brompheniramine maleate ......... ......... ......... ........... ...........
inj.
J0970... N Estradiol valerate ......... ......... ......... ........... ...........
injection.
J1000... N Depo-estradiol ......... ......... ......... ........... ...........
cypionate inj.
J1020... N Methylprednisolone 20 ......... ......... ......... ........... ...........
MG inj.
J1030... N Methylprednisolone 40 ......... ......... ......... ........... ...........
MG inj.
J1040... N Methylprednisolone 80 ......... ......... ......... ........... ...........
MG inj.
J1050... N Medroxyprogesterone inj ......... ......... ......... ........... ...........
J1055... E Medrxyprogester acetate ......... ......... ......... ........... ...........
inj.
J1060... N Testosterone cypionate ......... ......... ......... ........... ...........
1 ML.
J1070... N Testosterone cypionat ......... ......... ......... ........... ...........
100 MG.
J1080... N Testosterone cypionat ......... ......... ......... ........... ...........
200 MG.
J1090... N Testosterone cypionate ......... ......... ......... ........... ...........
50 MG.
J1095... N Inj dexamethasone ......... ......... ......... ........... ...........
acetate.
J1100... N Dexamethosone sodium ......... ......... ......... ........... ...........
phos.
J1110... N Inj dihydroergotamine ......... ......... ......... ........... ...........
mesylt.
J1120... N Acetazolamid sodium ......... ......... ......... ........... ...........
injectio.
J1160... N Digoxin injection...... ......... ......... ......... ........... ...........
J1165... N Phenytoin sodium ......... ......... ......... ........... ...........
injection.
J1170... N Hydromorphone injection ......... ......... ......... ........... ...........
[[Page 47740]]
J1180... N Dyphylline injection... ......... ......... ......... ........... ...........
J1190... N Dexrazoxane HCl ......... ......... ......... ........... ...........
injection.
J1200... N Diphenhydramine hcl ......... ......... ......... ........... ...........
injectio.
J1205... N Chlorothiazide sodium ......... ......... ......... ........... ...........
inj.
J1212... N Dimethyl sulfoxide 50% ......... ......... ......... ........... ...........
50 ML.
J1230... N Methadone injection.... ......... ......... ......... ........... ...........
J1240... N Dimenhydrinate ......... ......... ......... ........... ...........
injection.
J1245... N Dipyridamole injection. ......... ......... ......... ........... ...........
J1250... N Inj dobutamine HCL/250 ......... ......... ......... ........... ...........
mg.
J1320... N Amitriptyline injection ......... ......... ......... ........... ...........
J1325... N Epoprostenol injection. ......... ......... ......... ........... ...........
J1330... N Ergonovine maleate ......... ......... ......... ........... ...........
injection.
J1362... N Erythromycin glucep / ......... ......... ......... ........... ...........
250 MG.
J1364... N Erythro lactobionate / ......... ......... ......... ........... ...........
500 MG.
J1380... N Estradiol valerate 10 ......... ......... ......... ........... ...........
MG inj.
J1390... N Estradiol valerate 20 ......... ......... ......... ........... ...........
MG inj.
J1410... N Inj estrogen conjugate ......... ......... ......... ........... ...........
25 MG.
J1435... N Injection estrone per 1 ......... ......... ......... ........... ...........
MG.
J1436... N Etidronate disodium inj ......... ......... ......... ........... ...........
J1440... N Filgrastim 300 mcg ......... ......... ......... ........... ...........
injeciton.
J1441... N Filgrastim 480 mcg ......... ......... ......... ........... ...........
injection.
J1455... N Foscarnet sodium ......... ......... ......... ........... ...........
injection.
J1460... N Gamma globulin 1 CC inj ......... ......... ......... ........... ...........
J1470... N Gamma globulin 2 CC inj ......... ......... ......... ........... ...........
J1480... N Gamma globulin 3 CC inj ......... ......... ......... ........... ...........
J1490... N Gamma globulin 4 CC inj ......... ......... ......... ........... ...........
J1500... N Gamma globulin 5 CC inj ......... ......... ......... ........... ...........
J1510... N Gamma globulin 6 CC inj ......... ......... ......... ........... ...........
J1520... N Gamma globulin 7 CC inj ......... ......... ......... ........... ...........
J1530... N Gamma globulin 8 CC inj ......... ......... ......... ........... ...........
J1540... N Gamma globulin 9 CC inj ......... ......... ......... ........... ...........
J1550... N Gamma globulin 10 CC ......... ......... ......... ........... ...........
inj.
J1560... N Gamma globulin > 10 CC ......... ......... ......... ........... ...........
inj.
J1561... N Immune globulin 500 mg. ......... ......... ......... ........... ...........
J1562... N Immune globulin 5 gms.. ......... ......... ......... ........... ...........
J1565... N RSV-ivig............... ......... ......... ......... ........... ...........
J1570... N Ganciclovir sodium ......... ......... ......... ........... ...........
injection.
J1580... N Garamycin gentamicin ......... ......... ......... ........... ...........
inj.
J1600... N Gold sodium thiomaleate ......... ......... ......... ........... ...........
inj.
J1610... N Glucagon hydrochloride/ ......... ......... ......... ........... ...........
1 MG.
J1620... N Gonadorelin hydroch/ ......... ......... ......... ........... ...........
100 mcg.
J1626... N Granisetron HCl ......... ......... ......... ........... ...........
injection.
J1630... N Haloperidol injection.. ......... ......... ......... ........... ...........
J1631... N Haloperidol decanoate ......... ......... ......... ........... ...........
inj.
J1642... N Inj heparin sodium per ......... ......... ......... ........... ...........
10 u.
J1644... N Inj heparin sodium per ......... ......... ......... ........... ...........
1000u.
J1645... N Dalteparin sodium...... ......... ......... ......... ........... ...........
J1650... N Inj enoxaparin sodium ......... ......... ......... ........... ...........
30 mg.
J1670... N Tetanus immune globulin ......... ......... ......... ........... ...........
inj.
J1690... N Prednisolone tebutate ......... ......... ......... ........... ...........
inj.
J1700... N Hydrocortisone acetate ......... ......... ......... ........... ...........
inj.
J1710... N Hydrocortisone sodium ......... ......... ......... ........... ...........
ph inj.
J1720... N Hydrocortisone sodium ......... ......... ......... ........... ...........
succ i.
J1730... N Diazoxide injection.... ......... ......... ......... ........... ...........
J1739... N Hydroxyprogesterone cap ......... ......... ......... ........... ...........
125.
J1741... N Hydroxyprogesterone cap ......... ......... ......... ........... ...........
250.
J1742... N Ibutilide fumarate ......... ......... ......... ........... ...........
injection.
J1760... N Iron dextran 2 CC inj.. ......... ......... ......... ........... ...........
J1770... N Iron dextran 5 CC inj.. ......... ......... ......... ........... ...........
J1780... N Iron dextran 10 CC inj. ......... ......... ......... ........... ...........
J1785... N Injection imiglucerase / ......... ......... ......... ........... ...........
unit.
J1790... N Droperidol injection... ......... ......... ......... ........... ...........
J1800... N Propranolol injection.. ......... ......... ......... ........... ...........
J1810... N Droperidol/fentanyl inj ......... ......... ......... ........... ...........
J1820... N Insulin injection...... ......... ......... ......... ........... ...........
J1825... N Interferon beta-1a..... ......... ......... ......... ........... ...........
J1830... N Interferon beta-1b / ......... ......... ......... ........... ...........
.25 MG.
J1840... N Kanamycin sulfate 500 ......... ......... ......... ........... ...........
MG inj.
J1850... N Kanamycin sulfate 75 MG ......... ......... ......... ........... ...........
inj.
J1885... N Ketorolac tromethamine ......... ......... ......... ........... ...........
inj.
J1890... N Cephalothin sodium ......... ......... ......... ........... ...........
injection.
J1910... N Kutapressin injection.. ......... ......... ......... ........... ...........
J1930... N Propiomazine injection. ......... ......... ......... ........... ...........
J1940... N Furosemide injection... ......... ......... ......... ........... ...........
J1950... X Leuprolide acetate / 064 4.17 $220.38 $140.12 $44.08
3.75 MG.
[[Page 47741]]
J1955... N Inj levocarnitine per 1 ......... ......... ......... ........... ...........
gm.
J1960... N Levorphanol tartrate ......... ......... ......... ........... ...........
inj.
J1970... N Methotrimeprazine ......... ......... ......... ........... ...........
injection.
J1980... N Hyoscyamine sulfate inj ......... ......... ......... ........... ...........
J1990... N Chlordiazepoxide ......... ......... ......... ........... ...........
injection.
J2000... N Lidocaine injection.... ......... ......... ......... ........... ...........
J2010... N Lincomycin injection... ......... ......... ......... ........... ...........
J2060... N Lorazepam injection.... ......... ......... ......... ........... ...........
J2150... N Mannitol injection..... ......... ......... ......... ........... ...........
J2175... N Meperidine hydrochl / ......... ......... ......... ........... ...........
100 MG.
J2180... N Meperidine/promethazine ......... ......... ......... ........... ...........
inj.
J2210... N Methylergonovin maleate ......... ......... ......... ........... ...........
inj.
J2240... N Metocurine iodide ......... ......... ......... ........... ...........
injection.
J2250... N Inj midazolam ......... ......... ......... ........... ...........
hydrochloride.
J2260... N Inj milrinone lactate / ......... ......... ......... ........... ...........
5 ML.
J2270... N Morphine sulfate ......... ......... ......... ........... ...........
injection.
J2275... N Morphine sulfate ......... ......... ......... ........... ...........
injection.
J2300... N Inj nalbuphine ......... ......... ......... ........... ...........
hydrochloride.
J2310... N Inj naloxone ......... ......... ......... ........... ...........
hydrochloride.
J2320... N Nandrolone decanoate 50 ......... ......... ......... ........... ...........
MG.
J2321... N Nandrolone decanoate ......... ......... ......... ........... ...........
100 MG.
J2322... N Nandrolone decanoate ......... ......... ......... ........... ...........
200 MG.
J2330... N Thiothixene injection.. ......... ......... ......... ........... ...........
J2350... N Niacinamide/niacin ......... ......... ......... ........... ...........
injection.
J2360... N Orphenadrine injection. ......... ......... ......... ........... ...........
J2370... N Phenylephrine hcl ......... ......... ......... ........... ...........
injection.
J2400... N Chloroprocaine hcl ......... ......... ......... ........... ...........
injection.
J2405... N Ondansetron hcl ......... ......... ......... ........... ...........
injection.
J2410... N Oxymorphone hcl ......... ......... ......... ........... ...........
injection.
J2430... N Pamidronate disodium / ......... ......... ......... ........... ...........
30 MG.
J2440... N Papaverin hcl injection ......... ......... ......... ........... ...........
J2460... N Oxytetracycline ......... ......... ......... ........... ...........
injection.
J2480... N Hydrochlorides of opium ......... ......... ......... ........... ...........
inj.
J2510... N Penicillin g procaine ......... ......... ......... ........... ...........
inj.
J2512... N Inj pentagastrin per 2 ......... ......... ......... ........... ...........
ML.
J2515... N Pentobarbital sodium ......... ......... ......... ........... ...........
inj.
J2540... N Penicillin g potassium ......... ......... ......... ........... ...........
inj.
J2545... A Pentamidine isethionte/ ......... ......... ......... ........... ...........
300mg.
J2550... N Promethazine hcl ......... ......... ......... ........... ...........
injection.
J2560... N Phenobarbital sodium ......... ......... ......... ........... ...........
inj.
J2590... N Oxytocin injection..... ......... ......... ......... ........... ...........
J2597... N Inj desmopressin ......... ......... ......... ........... ...........
acetate.
J2640... N Prednisolone sodium ph ......... ......... ......... ........... ...........
inj.
J2650... N Prednisolone acetate ......... ......... ......... ........... ...........
inj.
J2670... N Totazoline hcl ......... ......... ......... ........... ...........
injection.
J2675... N Inj progesterone per 50 ......... ......... ......... ........... ...........
MG.
J2680... N Fluphenazine decanoate ......... ......... ......... ........... ...........
25 MG.
J2690... N Procainamide hcl ......... ......... ......... ........... ...........
injection.
J2700... N Oxacillin sodium ......... ......... ......... ........... ...........
injeciton.
J2710... N Neostigmine methylslfte ......... ......... ......... ........... ...........
inj.
J2720... N Inj protamine sulfate/ ......... ......... ......... ........... ...........
10 MG.
J2725... N Inj protirelin per 250 ......... ......... ......... ........... ...........
mcg.
J2730... N Pralidoxime chloride ......... ......... ......... ........... ...........
inj.
J2760... N Phentolaine mesylate ......... ......... ......... ........... ...........
inj.
J2765... N Metoclopramide hcl ......... ......... ......... ........... ...........
injection.
J2790... N Rho d immune globulin ......... ......... ......... ........... ...........
inj.
J2800... N Methocarbamol injection ......... ......... ......... ........... ...........
J2810... N Inj theophylline per 40 ......... ......... ......... ........... ...........
MG.
J2820... N Sargramostim injection. ......... ......... ......... ........... ...........
J2860... N Secobarbital sodium inj ......... ......... ......... ........... ...........
J2910... N Aurothioglucose ......... ......... ......... ........... ...........
injeciton.
J2912... N Sodium chloride ......... ......... ......... ........... ...........
injection.
J2920... N Methylprednisolone ......... ......... ......... ........... ...........
injection.
J2930... N Methylprednisolone ......... ......... ......... ........... ...........
injection.
J2950... N Promazine hcl injeciton ......... ......... ......... ........... ...........
J2970... N Methicillin sodium ......... ......... ......... ........... ...........
injection.
J2995... N Inj streptokinase / ......... ......... ......... ........... ...........
250000 IU.
J2996... N Alteplase recombinant ......... ......... ......... ........... ...........
inj.
J3000... N Streptomycin injection. ......... ......... ......... ........... ...........
J3010... N Fentanyl citrate ......... ......... ......... ........... ...........
injeciton.
J3030... N Sumatriptan succinate / ......... ......... ......... ........... ...........
6 MG.
J3070... N Pentazocine hcl ......... ......... ......... ........... ...........
injeciton.
J3080... N Chlorprothixene ......... ......... ......... ........... ...........
injection.
J3105... N Terbutaline sulfate inj ......... ......... ......... ........... ...........
J3120... N Testosterone enanthate ......... ......... ......... ........... ...........
inj.
[[Page 47742]]
J3130... N Testosterone enanthate ......... ......... ......... ........... ...........
inj.
J3140... N Testosterone suspension ......... ......... ......... ........... ...........
inj.
J3150... N Testosteron propionate ......... ......... ......... ........... ...........
inj.
J3230... N Chlorpromazine hcl ......... ......... ......... ........... ...........
injection.
J3240... N Thyrotropin injection.. ......... ......... ......... ........... ...........
J3250... N Trimethobenzamide hcl ......... ......... ......... ........... ...........
inj.
J3260... N Tobramycin sulfate ......... ......... ......... ........... ...........
injection.
J3265... N Injection torsemide 10 ......... ......... ......... ........... ...........
mg/ml.
J3270... N Imipramine hcl ......... ......... ......... ........... ...........
injection.
J3280... N Thiethylperazine ......... ......... ......... ........... ...........
maleate inj.
J3301... N Triamcinolone acetonide ......... ......... ......... ........... ...........
inj.
J3302... N Triamcinolone diacetate ......... ......... ......... ........... ...........
inj.
J3303... N Triamcinolone ......... ......... ......... ........... ...........
hexacetonl inj.
J3305... N Inj trimetrexate ......... ......... ......... ........... ...........
glucoronate.
J3310... N Perphenazine injeciton. ......... ......... ......... ........... ...........
J3320... N Spectinomycn di-hcl inj ......... ......... ......... ........... ...........
J3350... N Urea injection......... ......... ......... ......... ........... ...........
J3360... N Diazepam injection..... ......... ......... ......... ........... ...........
J3364... N Urokinase 5000 IU ......... ......... ......... ........... ...........
injection.
J3365... N Urokinase 250,000 IU ......... ......... ......... ........... ...........
inj.
J3370... E Vancomycin hcl ......... ......... ......... ........... ...........
injeciton.
J3390... N Methoxamine injection.. ......... ......... ......... ........... ...........
J3400... N Triflupromazine hcl inj ......... ......... ......... ........... ...........
J3410... N Hydroxyzine hcl ......... ......... ......... ........... ...........
injeciton.
J3420... N Vitamin b12 injection.. ......... ......... ......... ........... ...........
J3430... N Vitamin k phytonadione ......... ......... ......... ........... ...........
inj.
J3450... N Mephentermine sulfate ......... ......... ......... ........... ...........
inj.
J3470... N Hyaluronidase injection ......... ......... ......... ........... ...........
J3475... N Inj magnesium sulfate.. ......... ......... ......... ........... ...........
J3480... N Inj potassium chloride. ......... ......... ......... ........... ...........
J3490... N Drugs unclassified ......... ......... ......... ........... ...........
injection.
J3520... E Edetate disodium per ......... ......... ......... ........... ...........
150 mg.
J3530... N Nasal vaccine ......... ......... ......... ........... ...........
inhalation.
J3535... E Metered dose inhaler ......... ......... ......... ........... ...........
drug.
J3570... E Laetrile amygdalin vit ......... ......... ......... ........... ...........
B17.
J7030... A Normal saline solution ......... ......... ......... ........... ...........
infus.
J7040... A Normal saline solution ......... ......... ......... ........... ...........
infus.
J7042... A 5% dextrose/normal ......... ......... ......... ........... ...........
saline.
J7050... A Normal saline solution ......... ......... ......... ........... ...........
infus.
J7051... A Sterile saline/water... ......... ......... ......... ........... ...........
J7060... A 5% dextrose/water...... ......... ......... ......... ........... ...........
J7070... A D5w infusion........... ......... ......... ......... ........... ...........
J7100... A Dextran 40 infusion.... ......... ......... ......... ........... ...........
J7110... A Dextran 75 infusion.... ......... ......... ......... ........... ...........
J7120... A Ringers lactate ......... ......... ......... ........... ...........
infusion.
J7130... A Hypertonic saline ......... ......... ......... ........... ...........
solution.
J7190... N Factor viii............ ......... ......... ......... ........... ...........
J7191... N Factor VIII (porcine).. ......... ......... ......... ........... ...........
J7192... N Factor viii recombinant ......... ......... ......... ........... ...........
J7194... N Factor ix complex...... ......... ......... ......... ........... ...........
J7196... N Othr hemophilia clot ......... ......... ......... ........... ...........
factors.
J7197... N Antithrombin iii ......... ......... ......... ........... ...........
injection.
J7300... E Intraut copper ......... ......... ......... ........... ...........
contraceptive.
J7310... N Ganciclovir long act ......... ......... ......... ........... ...........
implant.
J7500... N Azathiop po tab 50mg ......... ......... ......... ........... ...........
100s ea.
J7501... N Azathioprine parenteral ......... ......... ......... ........... ...........
J7503... N Cyclosporine parenteral ......... ......... ......... ........... ...........
J7504... N Lymphocyte immune ......... ......... ......... ........... ...........
globulin.
J7505... N Monoclonal antibodies.. ......... ......... ......... ........... ...........
J7506... N Prednisone oral........ ......... ......... ......... ........... ...........
J7507... N Tacrolimus oral per 1 ......... ......... ......... ........... ...........
MG.
J7508... N Tacrolimus oral per 5 ......... ......... ......... ........... ...........
MG.
J7509... N Methylprednisolone oral ......... ......... ......... ........... ...........
J7510... N Prednisolone oral per 5 ......... ......... ......... ........... ...........
mg.
J7599... N Immunosuppressive drug ......... ......... ......... ........... ...........
noc.
J7610... A Acetylcysteine 10% ......... ......... ......... ........... ...........
injection.
J7615... A Acetylcysteine 20% ......... ......... ......... ........... ...........
injection.
J7620... A Albuterol sulfate .083%/ ......... ......... ......... ........... ...........
ml.
J7625... A Albuterol sulfate .5% ......... ......... ......... ........... ...........
inj.
J7627... A Bitolterolmesylate ......... ......... ......... ........... ...........
inhal sol.
J7630... A Cromolyn sodium ......... ......... ......... ........... ...........
injeciton.
J7640... A Epinephrine injection.. ......... ......... ......... ........... ...........
J7645... A Ipratropium bromide ......... ......... ......... ........... ...........
.02%/ml.
J7650... A Isoetharine hcl .1% inj ......... ......... ......... ........... ...........
J7651... A Isoetharine hcl .125% ......... ......... ......... ........... ...........
inj.
[[Page 47743]]
J7652... A Isoetharine hcl .167% ......... ......... ......... ........... ...........
inj.
J7653... A Isoetharine hcl .2%/ ......... ......... ......... ........... ...........
inj.
J7654... A Isoetharine hcl .25% ......... ......... ......... ........... ...........
inj.
J7655... A Isoetharine hcl 1% inj. ......... ......... ......... ........... ...........
J7660... A Isoproterenol hcl .5% ......... ......... ......... ........... ...........
inj.
J7665... A Isoproterenol hcl 1% ......... ......... ......... ........... ...........
inj.
J7670... A Metaproterenol sulfate ......... ......... ......... ........... ...........
.4%.
J7672... A Metaproterenol sulfate ......... ......... ......... ........... ...........
.6%.
J7675... A Metaproterenol sulfate ......... ......... ......... ........... ...........
5%.
J7699... A Inhalation solution for ......... ......... ......... ........... ...........
DME.
J7799... A Non-inhalation drug for ......... ......... ......... ........... ...........
DME.
J8499... E Oral prescrip drug non ......... ......... ......... ........... ...........
chemo.
J8530... N Cyclophosphamide oral ......... ......... ......... ........... ...........
25 MG.
J8560... N Etoposide oral 50 MG... ......... ......... ......... ........... ...........
J8600... N Melphalan oral 2 MG.... ......... ......... ......... ........... ...........
J8610... X Methotrexate oral 2.5 061 1.04 $54.85 $36.61 $10.97
MG.
J8999... X Oral prescription drug 061 1.04 $54.85 $36.61 $10.97
chemo.
J9000... X Doxorubic hcl 10 MG vl 062 1.69 $89.13 $36.61 $17.83
chemo.
J9015... X Aldesleukin/single use 061 1.04 $54.85 $36.61 $10.97
vial.
J9020... X Asparaginase injection. 062 1.69 $89.13 $36.61 $17.83
J9031... X Bcg live intravesical 063 2.89 $152.79 $110.97 $30.56
vac.
J9040... X Bleomycin sulfate 063 2.89 $152.79 $110.97 $30.56
injection.
J9045... X Carboplatin injection.. 063 2.89 $152.79 $110.97 $30.56
J9050... X Carmus bischl nitro inj 063 2.89 $152.79 $110.97 $30.56
J9060... X Cisplatin 10 MG 062 1.69 $89.13 $36.61 $17.83
injeciton.
J9062... X Cisplatin 50 MG 063 2.89 $152.79 $110.97 $30.56
injeciton.
J9065... X Inj cladribine per 1 MG 062 1.69 $89.13 $36.61 $17.83
J9070... X Cyclophosphamide 100 MG 061 1.04 $54.85 $36.61 $10.97
inj.
J9080... X Cyclophosphamide 200 MG 061 1.04 $54.85 $36.61 $10.97
inj.
J9090... X Cyclophosphamide 500 MG 061 1.04 $54.85 $36.61 $10.97
inj.
J9091... X Cyclophosphamide 1.0 062 1.69 $89.13 $36.61 $17.83
grm inj.
J9092... X Cyclophosphamide 2.0 062 1.69 $89.13 $36.61 $17.83
grm inj.
J9093... X Cyclophosphamide 061 1.04 $54.85 $36.61 $10.97
lyophilized.
J9094... X Cyclophosphamide 061 1.04 $54.85 $36.61 $10.97
lyophilized.
J9095... X Cyclophosphamide 061 1.04 $54.85 $36.61 $10.97
lyophilized.
J9096... X Cyclophosphamide 062 1.69 $89.13 $36.61 $17.83
lyophilized.
J9097... X Cyclophosphamide 062 1.69 $89.13 $36.61 $17.83
lyophilized.
J9100... X Cytarabine hcl 100 MG 061 1.04 $54.85 $36.61 $10.97
inj.
J9110... X Cytarabine hcl 500 MG 061 1.04 $54.85 $36.61 $10.97
inj.
J9120... X Dactinomycin 061 1.04 $54.85 $36.61 $10.97
actinomycin d.
J9130... X Dacarbazine 10 MG inj.. 061 1.04 $54.85 $36.61 $10.97
J9140... X Dacarbazine 200 MG inj. 061 1.04 $54.85 $36.61 $10.97
J9150... X Daunorubicin........... 062 1.69 $89.13 $36.61 $17.83
J9165... X Diethylstilbestrol 061 1.04 $54.85 $36.61 $10.97
injection.
J9170... X Docetaxel.............. 061 1.04 $54.85 $36.61 $10.97
J9181... X Etoposide 10 MG inj.... 061 1.04 $54.85 $36.61 $10.97
J9182... X Etoposide 100 MG inj... 063 2.89 $152.79 $110.97 $30.56
J9185... X Fludarabine phosphate 063 2.89 $152.79 $110.97 $30.56
inj.
J9190... X Fluorouracil injection. 061 1.04 $54.85 $36.61 $10.97
J9200... X Floxuridine injection.. 063 2.89 $152.79 $110.97 $30.56
J9201... X Gemcitabine HCl........ 061 1.04 $54.85 $36.61 $10.97
J9202... X Goserelin acetate 063 2.89 $152.79 $110.97 $30.56
implant.
J9206... X Irinotecan injection... 061 1.04 $54.85 $36.61 $10.97
J9208... X Ifosfomide injection... 063 2.89 $152.79 $110.97 $30.56
J9209... X Mesna injection........ 063 2.89 $152.79 $110.97 $30.56
J9211... X Idarubicin hcl 062 1.69 $89.13 $36.61 $17.83
injeciton.
J9213... X Interferon alfa-2a inj. 062 1.69 $89.13 $36.61 $17.83
J9214... X Interferon alfa-2b inj. 061 1.04 $54.85 $36.61 $10.97
J9215... X Interferon alfa-n3 inj. 061 1.04 $54.85 $36.61 $10.97
J9216... X Interferon gamma 1-b 063 2.89 $152.79 $110.97 $30.56
inj.
J9217... X Leuprolide acetate 064 4.17 $220.38 $140.12 $44.08
suspnsion.
J9218... X Leuprolide acetate 061 1.04 $54.85 $36.61 $10.97
injeciton.
J9230... X Mechlorethamine hcl inj 061 1.04 $54.85 $36.61 $10.97
J9245... X Inj melphalan hydrochl 064 4.17 $220.38 $140.12 $44.08
50 MG.
J9250... X Methotrexate sodium inj 061 1.04 $54.85 $36.61 $10.97
J9260... X Methotrexate sodium inj 061 1.04 $54.85 $36.61 $10.97
J9265... X Paclitaxel injection... 062 1.69 $89.13 $36.61 $17.83
J9266... X Pegaspargase/singl dose 061 1.04 $54.85 $36.61 $10.97
vial.
J9268... X Pentostatin injection.. 062 1.69 $89.13 $36.61 $17.83
J9270... X Plicamycin 063 2.89 $152.79 $110.97 $30.56
(mithramycin) inj.
J9280... X Mitomycin 5 MG inj..... 063 2.89 $152.79 $110.97 $30.56
J9290... X Mitomycin 20 MG inj.... 064 4.17 $220.38 $140.12 $44.08
J9291... X Mitomycin 40 MG inj.... 064 4.17 $220.38 $140.12 $44.08
J9293... X Mitoxantrone hydrochl / 064 4.17 $220.38 $140.12 $44.08
5 MG.
J9320... X Streptozocin injection. 063 2.89 $152.79 $110.97 $30.56
[[Page 47744]]
J9340... X Thiotepa injection..... 063 2.89 $152.79 $110.97 $30.56
J9350... X Topotecan.............. 061 1.04 $54.85 $36.61 $10.97
J9360... X Vinblastine sulfate inj 061 1.04 $54.85 $36.61 $10.97
J9370... X Vincristine sulfate 1 062 1.69 $89.13 $36.61 $17.83
MG inj.
J9375... X Vincristine sulfate 2 063 2.89 $152.79 $110.97 $30.56
MG inj.
J9380... X Vincristine sulfate 5 063 2.89 $152.79 $110.97 $30.56
MG inj.
J9390... X Vinorelbine tartrate/10 061 1.04 $54.85 $36.61 $10.97
mg.
J9600... X Porfimer sodium........ 061 1.04 $54.85 $36.61 $10.97
J9999... X Chemotherapy drug...... 061 1.04 $54.85 $36.61 $10.97
K0001... A Standard wheelchair.... ......... ......... ......... ........... ...........
K0002... A Stnd hemi (low seat) ......... ......... ......... ........... ...........
whlchr.
K0003... A Lightweight wheelchair. ......... ......... ......... ........... ...........
K0004... A High strength ltwt ......... ......... ......... ........... ...........
whlchr.
K0005... A Ultralightweight ......... ......... ......... ........... ...........
wheelchair.
K0006... A Heavy duty wheelchair.. ......... ......... ......... ........... ...........
K0007... A Extra heavy duty ......... ......... ......... ........... ...........
wheelchair.
K0008... A Cstm manual wheelchair/ ......... ......... ......... ........... ...........
base.
K0009... A Other manual wheelchair/ ......... ......... ......... ........... ...........
base.
K0010... A Stnd wt frame power ......... ......... ......... ........... ...........
whlchr.
K0011... A Stnd wt pwr whlchr w ......... ......... ......... ........... ...........
control.
K0012... A Ltwt portbl power ......... ......... ......... ........... ...........
whlchr.
K0013... A Custom power whlchr ......... ......... ......... ........... ...........
base.
K0014... A Other power whlchr base ......... ......... ......... ........... ...........
K0015... A Detach non-adjus hght ......... ......... ......... ........... ...........
armrst.
K0016... A Detach adjust armrst ......... ......... ......... ........... ...........
cmplete.
K0017... A Detach adjust armrest ......... ......... ......... ........... ...........
base.
K0018... A Detach adjust armrst ......... ......... ......... ........... ...........
upper.
K0019... A Arm pad each........... ......... ......... ......... ........... ...........
K0020... A Fixed adjust armrest ......... ......... ......... ........... ...........
pair.
K0021... A Anti-tipping device ......... ......... ......... ........... ...........
each.
K0022... A Reinforced back ......... ......... ......... ........... ...........
upholstery.
K0023... A Planr back insrt foam w/ ......... ......... ......... ........... ...........
strp.
K0024... A Plnr back insrt foam w/ ......... ......... ......... ........... ...........
hrdwr.
K0025... A Hook-on headrest ......... ......... ......... ........... ...........
extension.
K0026... A Back upholst lgtwt ......... ......... ......... ........... ...........
whlchr.
K0027... A Back upholst other ......... ......... ......... ........... ...........
whlchr.
K0028... A Fully reclining back... ......... ......... ......... ........... ...........
K0029... A Reinforced seat ......... ......... ......... ........... ...........
upholstery.
K0030... A Solid plnr seat sngl ......... ......... ......... ........... ...........
dnsfoam.
K0031... A Safety belt/pelvic ......... ......... ......... ........... ...........
strap.
K0032... A Seat uphols lgtwt ......... ......... ......... ........... ...........
whlchr.
K0033... A Seat upholstery other ......... ......... ......... ........... ...........
whlchr.
K0034... A Heel loop each......... ......... ......... ......... ........... ...........
K0035... A Heel loop with ankle ......... ......... ......... ........... ...........
strap.
K0036... A Toe loop each.......... ......... ......... ......... ........... ...........
K0037... A High mount flip-up ......... ......... ......... ........... ...........
footrest.
K0038... A Leg strap each......... ......... ......... ......... ........... ...........
K0039... A Leg strap h style each. ......... ......... ......... ........... ...........
K0040... A Adjustable angle ......... ......... ......... ........... ...........
footplate.
K0041... A Large size footplate ......... ......... ......... ........... ...........
each.
K0042... A Standard size footplate ......... ......... ......... ........... ...........
each.
K0043... A Ftrst lower extension ......... ......... ......... ........... ...........
tube.
K0044... A Ftrst upper hanger ......... ......... ......... ........... ...........
bracket.
K0045... A Footrest complete ......... ......... ......... ........... ...........
assembly.
K0046... A Elevat legrst low ......... ......... ......... ........... ...........
extension.
K0047... A Elevat legrst up hangr ......... ......... ......... ........... ...........
brack.
K0048... A Elevate legrest ......... ......... ......... ........... ...........
complete.
K0049... A Calf pad each.......... ......... ......... ......... ........... ...........
K0050... A Ratchet assembly....... ......... ......... ......... ........... ...........
K0051... A Cam relese assem ftrst/ ......... ......... ......... ........... ...........
lgrst.
K0052... A Swingaway detach ......... ......... ......... ........... ...........
footrest.
K0053... A Elevate footrest ......... ......... ......... ........... ...........
articulate.
K0054... A Seat wdth 10-12/15/17/ ......... ......... ......... ........... ...........
20 wc.
K0055... A Seat dpth 15/17/18 ltwt ......... ......... ......... ........... ...........
wc.
K0056... A Seat ht <17 or <=21 ......... ......... ......... ........... ...........
ltwt wc.
K0057... A Seat wdth 19/20 hvy dty ......... ......... ......... ........... ...........
wc.
K0058... A Seat dpth 17/18 power ......... ......... ......... ........... ...........
wc.
K0059... A Plastic coated handrim ......... ......... ......... ........... ...........
each.
K0060... A Steel handrim each..... ......... ......... ......... ........... ...........
K0061... A Aluminum handrim each.. ......... ......... ......... ........... ...........
K0062... A Handrim 8-10 vert/obliq ......... ......... ......... ........... ...........
proj.
K0063... A Hndrm 12-16 vert/obliq ......... ......... ......... ........... ...........
proj.
K0064... A Zero pressure tube flat ......... ......... ......... ........... ...........
free.
K0065... A Spoke protectors....... ......... ......... ......... ........... ...........
K0066... A Solid tire any size ......... ......... ......... ........... ...........
each.
[[Page 47745]]
K0067... A Pneumatic tire any size ......... ......... ......... ........... ...........
each.
K0068... A Pneumatic tire tube ......... ......... ......... ........... ...........
each.
K0069... A Rear whl complete solid ......... ......... ......... ........... ...........
tire.
K0070... A Rear whl compl pneum ......... ......... ......... ........... ...........
tire.
K0071... A Front castr compl pneum ......... ......... ......... ........... ...........
tire.
K0072... A Frnt cstr cmpl sem- ......... ......... ......... ........... ...........
pneum tir.
K0073... A Caster pin lock each... ......... ......... ......... ........... ...........
K0074... A Pneumatic caster tire ......... ......... ......... ........... ...........
each.
K0075... A Semi-pneumatic caster ......... ......... ......... ........... ...........
tire.
K0076... A Solid caster tire each. ......... ......... ......... ........... ...........
K0077... A Front caster assem ......... ......... ......... ........... ...........
complete.
K0078... A Pneumatic caster tire ......... ......... ......... ........... ...........
tube.
K0079... A Wheel lock extension ......... ......... ......... ........... ...........
pair.
K0080... A Anti-rollback device ......... ......... ......... ........... ...........
pair.
K0081... A Wheel lock assembly ......... ......... ......... ........... ...........
complete.
K0082... A 22 nf deep cycl acid ......... ......... ......... ........... ...........
battery.
K0083... A 22 nf gel cell battery ......... ......... ......... ........... ...........
each.
K0084... A Grp 24 deep cycl acid ......... ......... ......... ........... ...........
battry.
K0085... A Group 24 gel cell ......... ......... ......... ........... ...........
battery.
K0086... A U-1 lead acid battery ......... ......... ......... ........... ...........
each.
K0087... A U-1 gel cell battery ......... ......... ......... ........... ...........
each.
K0088... A Battry chrgr acid/gel ......... ......... ......... ........... ...........
cell.
K0089... A Battery charger dual ......... ......... ......... ........... ...........
mode.
K0090... A Rear tire power ......... ......... ......... ........... ...........
wheelchair.
K0091... A Rear tire tube power ......... ......... ......... ........... ...........
whlchr.
K0092... A Rear assem cmplt powr ......... ......... ......... ........... ...........
whlchr.
K0093... A Rear zero pressure tire ......... ......... ......... ........... ...........
tube.
K0094... A Wheel tire for power ......... ......... ......... ........... ...........
base.
K0095... A Wheel tire tube each ......... ......... ......... ........... ...........
base.
K0096... A Wheel assem powr base ......... ......... ......... ........... ...........
complt.
K0097... A Wheel zero presure tire ......... ......... ......... ........... ...........
tube.
K0098... A Drive belt power ......... ......... ......... ........... ...........
wheelchair.
K0099... A Front caster power ......... ......... ......... ........... ...........
whelchair.
K0100... A Amputee adapter pair... ......... ......... ......... ........... ...........
K0101... A One-arm drive ......... ......... ......... ........... ...........
attachment.
K0102... A Crutch and cane holder. ......... ......... ......... ........... ...........
K0103... A Transfer board < 25''.. ......... ......... ......... ........... ...........
K0104... A Cylinder tank carrier.. ......... ......... ......... ........... ...........
K0105... A Iv hanger.............. ......... ......... ......... ........... ...........
K0106... A Arm trough each........ ......... ......... ......... ........... ...........
K0107... A Wheelchair tray........ ......... ......... ......... ........... ...........
K0108... A Other accessories...... ......... ......... ......... ........... ...........
K0109... A Customize whlchr base ......... ......... ......... ........... ...........
frame.
K0112... A Trunk vest supprt innr ......... ......... ......... ........... ...........
frame.
K0113... A Trunk vest suprt w/o ......... ......... ......... ........... ...........
inr frm.
K0114... A Whlchr back suprt inr ......... ......... ......... ........... ...........
frame.
K0115... A Back module orthotic ......... ......... ......... ........... ...........
system.
K0116... A Back & seat modul ......... ......... ......... ........... ...........
orthot sys.
K0119... N Azathioprine oral tab ......... ......... ......... ........... ...........
50 MG.
K0120... N Azathioprine prentrl ......... ......... ......... ........... ...........
100 MG.
K0121... N Cyclosporine oral 25 MG ......... ......... ......... ........... ...........
K0122... N Cyclosporine prentrl ......... ......... ......... ........... ...........
250 MG.
K0123... N Imun/antitymocyt glob ......... ......... ......... ........... ...........
250 MG.
K0137... A Skin barrier liquid per ......... ......... ......... ........... ...........
oz.
K0138... A Skin barrier paste per ......... ......... ......... ........... ...........
oz.
K0139... A Skin barrier powder per ......... ......... ......... ........... ...........
oz.
K0168... A Disposable nebulizer ......... ......... ......... ........... ...........
set.
K0169... A Disposable nebulizer ......... ......... ......... ........... ...........
small.
K0170... A Non disposable ......... ......... ......... ........... ...........
nebulizer set.
K0171... A Filtered nebulizer set. ......... ......... ......... ........... ...........
K0172... A Disposable nebulizer ......... ......... ......... ........... ...........
unfill.
K0173... A Disposable nebulizer ......... ......... ......... ........... ...........
prefill.
K0174... A Reservoir bottle w ......... ......... ......... ........... ...........
nebulizer.
K0175... A Disposable corrugated ......... ......... ......... ........... ...........
tubing.
K0176... A Non dispos corrugated ......... ......... ......... ........... ...........
tubing.
K0177... A Water collec dev w ......... ......... ......... ........... ...........
nebulizer.
K0178... A Disposbl filter w ......... ......... ......... ........... ...........
compressor.
K0179... A Non-dispos filter w/ ......... ......... ......... ........... ...........
compress.
K0180... A Aerosol mask with ......... ......... ......... ........... ...........
nebulizer.
K0181... A Dome & mouthpiece w/ ......... ......... ......... ........... ...........
nebuliz.
K0182... A Water distilled w/ ......... ......... ......... ........... ...........
nebulizer.
K0183... A Nasal application with ......... ......... ......... ........... ...........
cpap.
K0184... A Nasal pillows/seals ......... ......... ......... ........... ...........
pair.
K0185... A Headgear with cpap ......... ......... ......... ........... ...........
device.
K0186... A Chin strap with cpap ......... ......... ......... ........... ...........
device.
[[Page 47746]]
K0187... A Tubing with cpap device ......... ......... ......... ........... ...........
K0188... A Filter disposable with ......... ......... ......... ........... ...........
cpap.
K0189... A Filter non-disposable w/ ......... ......... ......... ........... ...........
cpap.
K0190... A Disposable canister w/ ......... ......... ......... ........... ...........
pump.
K0191... A Non-disposbl canister w/ ......... ......... ......... ........... ...........
pump.
K0192... A Tubing used w/ suction ......... ......... ......... ........... ...........
pump.
K0193... A Airway pressure dev/w ......... ......... ......... ........... ...........
hmdfer.
K0194... A Assist device w/ ......... ......... ......... ........... ...........
humidifier.
K0195... A Elevating whlchair leg ......... ......... ......... ........... ...........
rests.
K0268... A Humidifier with cpap ......... ......... ......... ........... ...........
device.
K0269... A Aerosol compressor cpap ......... ......... ......... ........... ...........
dev.
K0270... A Ultrasonic generator w ......... ......... ......... ........... ...........
nebul.
K0277... A Skin barrier solid 4x4 ......... ......... ......... ........... ...........
equiv.
K0278... A Skin barrier with ......... ......... ......... ........... ...........
flange.
K0279... A Skin barrier extended ......... ......... ......... ........... ...........
wear.
K0280... A Extension drainage ......... ......... ......... ........... ...........
tubing.
K0281... A Lubricant catheter ......... ......... ......... ........... ...........
insertion.
K0283... A Saline solution ......... ......... ......... ........... ...........
dispenser.
K0284... A External infusion pump ......... ......... ......... ........... ...........
reuse.
K0400... A Skin support attachment ......... ......... ......... ........... ...........
each.
K0401... A Diabetic deluxe shoe... ......... ......... ......... ........... ...........
K0407... A Urinary cath skin ......... ......... ......... ........... ...........
attachment.
K0408... A Urinary cath leg strap. ......... ......... ......... ........... ...........
K0409... A Sterile H2O irrigation ......... ......... ......... ........... ...........
solut.
K0410... A Male ext cath w/adh ......... ......... ......... ........... ...........
coating.
K0411... A Male ext cath w/adh ......... ......... ......... ........... ...........
strip.
K0412... N Mycophenolate mofetil ......... ......... ......... ........... ...........
25o mg.
K0415... N RX antiemetic drg, oral ......... ......... ......... ........... ...........
NOS.
K0416... N Rx antiemetic ......... ......... ......... ........... ...........
drg,rectal NOS.
K0417... A Mech infus pump sht trm ......... ......... ......... ........... ...........
drug.
K0418... N Oral cyclosporin....... ......... ......... ......... ........... ...........
K0419... A Drainable plstic pch w ......... ......... ......... ........... ...........
fcplt.
K0420... A Drainable rubber pch w ......... ......... ......... ........... ...........
fcplt.
K0421... A drainable plstic pch w/ ......... ......... ......... ........... ...........
o fp.
K0422... A Drainable rubber pch w/ ......... ......... ......... ........... ...........
o fp.
K0423... A Urinary plstic pouch w ......... ......... ......... ........... ...........
fcplt.
K0424... A Urinary rubber pouch w ......... ......... ......... ........... ...........
fcplt.
K0425... A Urinary plstic pouch w/ ......... ......... ......... ........... ...........
o fp.
K0426... A Urinary hvy plstc pch w/ ......... ......... ......... ........... ...........
o fp.
K0427... A Urinary rubber pouch w/ ......... ......... ......... ........... ...........
o fp.
K0428... A Ostomy faceplt/silicone ......... ......... ......... ........... ...........
ring.
K0429... A Skin barrier solid ext ......... ......... ......... ........... ...........
wear.
K0430... A Skin barrier w flang ex ......... ......... ......... ........... ...........
wear.
K0431... A Closed pouch w st wear ......... ......... ......... ........... ...........
bar.
K0432... A Drainable pch w ex wear ......... ......... ......... ........... ...........
bar.
K0433... A Drainable pch w st wear ......... ......... ......... ........... ...........
bar.
K0434... A Drainable pch ex wear ......... ......... ......... ........... ...........
convex.
K0435... A Urinary pouch w ex wear ......... ......... ......... ........... ...........
bar.
K0436... A Urinary pouch w st wear ......... ......... ......... ........... ...........
bar.
K0437... A Urine pch w ex wear bar ......... ......... ......... ........... ...........
conv.
K0438... A Ostomy pouch liq ......... ......... ......... ........... ...........
deodorant.
K0439... A Ostomy pouch solid ......... ......... ......... ........... ...........
deodorant.
K0440... A Nasal prosthesis....... ......... ......... ......... ........... ...........
K0441... A Midfacial prosthesis... ......... ......... ......... ........... ...........
K0442... A Orbital prosthesis..... ......... ......... ......... ........... ...........
K0443... A Upper facial prosthesis ......... ......... ......... ........... ...........
K0444... A Hemi-facial prosthesis. ......... ......... ......... ........... ...........
K0445... S Auricular prosthesis... 031 1.33 $70.52 $14.10 $14.10
K0446... A Partial facial ......... ......... ......... ........... ...........
prosthesis.
K0447... A Nasal septal prosthesis ......... ......... ......... ........... ...........
K0448... A Unspec maxillofacial ......... ......... ......... ........... ...........
prosth.
K0449... A Repair maxillofacial ......... ......... ......... ........... ...........
prosth.
K0450... A Liq adhes for facial ......... ......... ......... ........... ...........
prosth.
K0451... A Adhesive remover wipes. ......... ......... ......... ........... ...........
K0452... A Wheelchair bearings.... ......... ......... ......... ........... ...........
K0453... N Amphotericin B......... ......... ......... ......... ........... ...........
K0455... A Pump uninterrupted ......... ......... ......... ........... ...........
infusion.
K0501... A Aerosol compressor for ......... ......... ......... ........... ...........
svneb.
K0503... A Acetylcysteine inh sol ......... ......... ......... ........... ...........
u d.
K0504... A Albuterol inh sol con.. ......... ......... ......... ........... ...........
K0505... A Albuterol inh sol u d.. ......... ......... ......... ........... ...........
K0506... A Atropine inh sol con... ......... ......... ......... ........... ...........
K0507... A Atropine inh sol u d... ......... ......... ......... ........... ...........
K0508... A Bitolterol mes inh sol ......... ......... ......... ........... ...........
con.
K0509... A Bitolterol mes inh sol ......... ......... ......... ........... ...........
u d.
[[Page 47747]]
K0511... A Cromolyn sodium inh sol ......... ......... ......... ........... ...........
u d.
K0512... A Dexamethasone inh sol ......... ......... ......... ........... ...........
con.
K0513... A Dexamethasone inh sol u ......... ......... ......... ........... ...........
d.
K0514... A Dornase alpha inh sol u ......... ......... ......... ........... ...........
d.
K0515... A Glycopyrrolate inh sol ......... ......... ......... ........... ...........
con.
K0516... A Glycopyrrolate inh sol ......... ......... ......... ........... ...........
u d.
K0518... A Ipratropium brom inh ......... ......... ......... ........... ...........
sol u d.
K0519... A Isoetharine HCl inh sol ......... ......... ......... ........... ...........
con.
K0520... A Isoetharine HCl inh sol ......... ......... ......... ........... ...........
u d.
K0521... A IsoproterenolHCl inh ......... ......... ......... ........... ...........
sol con.
K0522... A IsoproterenolHCl inh ......... ......... ......... ........... ...........
sol u d.
K0523... A Metaproterenol inh sol ......... ......... ......... ........... ...........
con.
K0524... A Metaproterenol inh sol ......... ......... ......... ........... ...........
u d.
K0525... A Terbutaline SO4 inh sol ......... ......... ......... ........... ...........
con.
K0526... A Terbutaline SO4 inh sol ......... ......... ......... ........... ...........
u d.
K0527... A Triamcinolone inh sol ......... ......... ......... ........... ...........
con.
K0528... A Triamcinolone inh sol u ......... ......... ......... ........... ...........
d.
K0529... A Sterile H20 or nss w lv ......... ......... ......... ........... ...........
neb.
K0530... A Nebulizer not used w ......... ......... ......... ........... ...........
oxygen.
L0100... A Cerv craniosten helmet ......... ......... ......... ........... ...........
mold.
L0110... A Cerv craniostenosis hel ......... ......... ......... ........... ...........
non-.
L0120... A Cerv flexible non- ......... ......... ......... ........... ...........
adjustable.
L0130... A Flex thermoplastic ......... ......... ......... ........... ...........
collar mo.
L0140... A Cervical semi-rigid ......... ......... ......... ........... ...........
adjustab.
L0150... A Cerv semi-rig adj ......... ......... ......... ........... ...........
molded chn.
L0160... A Cerv semi-rig wire occ/ ......... ......... ......... ........... ...........
mand.
L0170... A Cervical collar molded ......... ......... ......... ........... ...........
to pt.
L0172... A Cerv col thermplas foam ......... ......... ......... ........... ...........
2 pi.
L0174... A Cerv col foam 2 piece w ......... ......... ......... ........... ...........
thor.
L0180... A Cer post col occ/man ......... ......... ......... ........... ...........
sup adj.
L0190... A Cerv collar supp adj ......... ......... ......... ........... ...........
cerv ba.
L0200... A Cerv col supp adj bar & ......... ......... ......... ........... ...........
thor.
L0210... A Thoracic rib belt...... ......... ......... ......... ........... ...........
L0220... A Thor rib belt custom ......... ......... ......... ........... ...........
fabrica.
L0300... A TLSO flex surgical ......... ......... ......... ........... ...........
support.
L0310... A Tlso flexible custom ......... ......... ......... ........... ...........
fabrica.
L0315... A Tlso flex elas rigid ......... ......... ......... ........... ...........
post pa.
L0317... A Tlso flex hypext elas ......... ......... ......... ........... ...........
post p.
L0320... A Tlso a-p contrl w apron ......... ......... ......... ........... ...........
frnt.
L0330... A Tlso ant-pos-lateral ......... ......... ......... ........... ...........
control.
L0340... A Tlso a-p-l-rotary with ......... ......... ......... ........... ...........
apron.
L0350... A Tlso flex compress ......... ......... ......... ........... ...........
jacket cu.
L0360... A Tlso flex compress ......... ......... ......... ........... ...........
jacket mo.
L0370... A Tlso a-p-l-rotary ......... ......... ......... ........... ...........
hyperexten.
L0380... A Tlso a-p-l-rot w/ pos ......... ......... ......... ........... ...........
extens.
L0390... A Tlso a-p-l control ......... ......... ......... ........... ...........
molded.
L0400... A Tlso a-p-l w interface ......... ......... ......... ........... ...........
mater.
L0410... A Tlso a-p-l two piece ......... ......... ......... ........... ...........
constr.
L0420... A Tlso a-p-l 2 piece w ......... ......... ......... ........... ...........
interfa.
L0430... A Tlso a-p-l w interface ......... ......... ......... ........... ...........
custm.
L0440... A Tlso a-p-l overlap frnt ......... ......... ......... ........... ...........
cust.
L0500... A Lso flex surgical ......... ......... ......... ........... ...........
support.
L0510... A Lso flexible custom ......... ......... ......... ........... ...........
fabricat.
L0515... A Lso flex elas w/ rig ......... ......... ......... ........... ...........
post pa.
L0520... A Lso a-p-l control with ......... ......... ......... ........... ...........
apron.
L0530... A Lso ant-pos control w ......... ......... ......... ........... ...........
apron.
L0540... A Lso lumbar flexion a-p- ......... ......... ......... ........... ...........
l.
L0550... A Lso a-p-l control ......... ......... ......... ........... ...........
molded.
L0560... A Lso a-p-l w interface.. ......... ......... ......... ........... ...........
L0565... A Lso a-p-l control ......... ......... ......... ........... ...........
custom.
L0600... A Sacroiliac flex surg ......... ......... ......... ........... ...........
support.
L0610... A Sacroiliac flexible ......... ......... ......... ........... ...........
custm fa.
L0620... A Sacroiliac semi-rig w ......... ......... ......... ........... ...........
apron.
L0700... A Ctlso a-p-l control ......... ......... ......... ........... ...........
molded.
L0710... A Ctlso a-p-l control w/ ......... ......... ......... ........... ...........
inter.
L0810... A Halo cervical into jckt ......... ......... ......... ........... ...........
vest.
L0820... A Halo cervical into body ......... ......... ......... ........... ...........
jack.
L0830... A Halo cerv into ......... ......... ......... ........... ...........
milwaukee typ.
L0860... A Magnetic resonanc image ......... ......... ......... ........... ...........
comp.
L0900... A Torso/ptosis support... ......... ......... ......... ........... ...........
L0910... A Torso & ptosis supp ......... ......... ......... ........... ...........
custm fa.
L0920... A Torso/pendulous abd ......... ......... ......... ........... ...........
support.
L0930... A Pendulous abdomen supp ......... ......... ......... ........... ...........
custm.
L0940... A Torso/postsurgical ......... ......... ......... ........... ...........
support.
L0950... A Post surg support ......... ......... ......... ........... ...........
custom fab.
[[Page 47748]]
L0960... A Post surgical support ......... ......... ......... ........... ...........
pads.
L0970... A Tlso corset front...... ......... ......... ......... ........... ...........
L0972... A Lso corset front....... ......... ......... ......... ........... ...........
L0974... A Tlso full corset....... ......... ......... ......... ........... ...........
L0976... A Lso full corset........ ......... ......... ......... ........... ...........
L0978... A Axillary crutch ......... ......... ......... ........... ...........
extension.
L0980... A Peroneal straps pair... ......... ......... ......... ........... ...........
L0982... A Stocking supp grips set ......... ......... ......... ........... ...........
of f.
L0984... A Protective body sock ......... ......... ......... ........... ...........
each.
L0999... A Add to spinal orthosis ......... ......... ......... ........... ...........
NOS.
L1000... A Ctlso milwauke initial ......... ......... ......... ........... ...........
model.
L1010... A Ctlso axilla sling..... ......... ......... ......... ........... ...........
L1020... A Kyphosis pad........... ......... ......... ......... ........... ...........
L1025... A Kyphosis pad floating.. ......... ......... ......... ........... ...........
L1030... A Lumbar bolster pad..... ......... ......... ......... ........... ...........
L1040... A Lumbar or lumbar rib ......... ......... ......... ........... ...........
pad.
L1050... A Sternal pad............ ......... ......... ......... ........... ...........
L1060... A Thoracic pad........... ......... ......... ......... ........... ...........
L1070... A Trapezius sling........ ......... ......... ......... ........... ...........
L1080... A Outrigger.............. ......... ......... ......... ........... ...........
L1085... A Outrigger bil w/ vert ......... ......... ......... ........... ...........
extens.
L1090... A Lumbar sling........... ......... ......... ......... ........... ...........
L1100... A Ring flange plastic/ ......... ......... ......... ........... ...........
leather.
L1110... A Ring flange plas/ ......... ......... ......... ........... ...........
leather mol.
L1120... A Covers for upright each ......... ......... ......... ........... ...........
L1200... A Furnsh initial orthosis ......... ......... ......... ........... ...........
only.
L1210... A Lateral thoracic ......... ......... ......... ........... ...........
extension.
L1220... A Anterior thoracic ......... ......... ......... ........... ...........
extension.
L1230... A Milwaukee type ......... ......... ......... ........... ...........
superstructur.
L1240... A Lumbar derotation pad.. ......... ......... ......... ........... ...........
L1250... A Anterior asis pad...... ......... ......... ......... ........... ...........
L1260... A Anterior thoracic ......... ......... ......... ........... ...........
derotation.
L1270... A Abdominal pad.......... ......... ......... ......... ........... ...........
L1280... A Rib gusset (elastic) ......... ......... ......... ........... ...........
each.
L1290... A Lateral trochanteric ......... ......... ......... ........... ...........
pad.
L1300... A Body jacket mold to ......... ......... ......... ........... ...........
patient.
L1310... A Post-operative body ......... ......... ......... ........... ...........
jacket.
L1499... A Spinal orthosis NOS.... ......... ......... ......... ........... ...........
L1500... A Thkao mobility frame... ......... ......... ......... ........... ...........
L1510... A Thkao standing frame... ......... ......... ......... ........... ...........
L1520... A Thkao swivel walker.... ......... ......... ......... ........... ...........
L1600... A Abduct hip flex frejka ......... ......... ......... ........... ...........
w cvr.
L1610... A Abduct hip flex frejka ......... ......... ......... ........... ...........
covr.
L1620... A Abduct hip flex pavlik ......... ......... ......... ........... ...........
harne.
L1630... A Abduct control hip semi- ......... ......... ......... ........... ...........
flex.
L1640... A Pelv band/spread bar ......... ......... ......... ........... ...........
thigh c.
L1650... A HO abduction hip ......... ......... ......... ........... ...........
adjustable.
L1660... A HO abduction static ......... ......... ......... ........... ...........
plastic.
L1680... A Pelvic & hip control ......... ......... ......... ........... ...........
thigh c.
L1685... A Post-op hip abduct ......... ......... ......... ........... ...........
custom fa.
L1686... A HO post-op hip ......... ......... ......... ........... ...........
abduction.
L1700... A Leg perthes orth ......... ......... ......... ........... ...........
toronto typ.
L1710... A Legg perthes orth ......... ......... ......... ........... ...........
newington.
L1720... A Legg perthes orthosis ......... ......... ......... ........... ...........
trilat.
L1730... A Legg perthes orth ......... ......... ......... ........... ...........
scottish r.
L1750... A Legg perthes sling..... ......... ......... ......... ........... ...........
L1755... A Legg perthes patten ......... ......... ......... ........... ...........
bottom t.
L1800... A Knee orthoses elas w ......... ......... ......... ........... ...........
stays.
L1810... A Ko elastic with joints. ......... ......... ......... ........... ...........
L1815... A Elastic with condylar ......... ......... ......... ........... ...........
pads.
L1820... A Ko elas w/ condyle pads ......... ......... ......... ........... ...........
& jo.
L1825... A Ko elastic knee cap.... ......... ......... ......... ........... ...........
L1830... A Ko immobilizer canvas ......... ......... ......... ........... ...........
longit.
L1832... A KO adj jnt pos rigid ......... ......... ......... ........... ...........
support.
L1834... A Ko w/0 joint rigid ......... ......... ......... ........... ...........
molded to.
L1840... A Ko derot ant cruciate ......... ......... ......... ........... ...........
custom.
L1843... A KO single upright ......... ......... ......... ........... ...........
custom fit.
L1844... A Ko w/adj jt rot cntrl ......... ......... ......... ........... ...........
molded.
L1845... A Ko w/ adj flex/ext ......... ......... ......... ........... ...........
rotat cus.
L1846... A Ko w adj flex/ext rotat ......... ......... ......... ........... ...........
mold.
L1850... A Ko swedish type........ ......... ......... ......... ........... ...........
L1855... A Ko plas doub upright ......... ......... ......... ........... ...........
jnt mol.
L1858... A Ko polycentric ......... ......... ......... ........... ...........
pneumatic pad.
L1860... A Ko supracondylar socket ......... ......... ......... ........... ...........
mold.
L1870... A Ko doub upright lacers ......... ......... ......... ........... ...........
molde.
[[Page 47749]]
L1880... A Ko doub upright cuffs/ ......... ......... ......... ........... ...........
lacers.
L1885... A Knee upright w/ ......... ......... ......... ........... ...........
resistance.
L1900... A Afo sprng wir drsflx ......... ......... ......... ........... ...........
calf bd.
L1902... A Afo ankle gauntlet..... ......... ......... ......... ........... ...........
L1904... A Afo molded ankle ......... ......... ......... ........... ...........
gauntlet.
L1906... A Afo multiligamentus ......... ......... ......... ........... ...........
ankle su.
L1910... A Afo sing bar clasp ......... ......... ......... ........... ...........
attach sh.
L1920... A Afo sing upright w/ ......... ......... ......... ........... ...........
adjust s.
L1930... A Afo plastic............ ......... ......... ......... ........... ...........
L1940... A Afo molded to patient ......... ......... ......... ........... ...........
plasti.
L1945... A Afo molded plas rig ant ......... ......... ......... ........... ...........
tib.
L1950... A Afo spiral molded to pt ......... ......... ......... ........... ...........
plas.
L1960... A Afo pos solid ank ......... ......... ......... ........... ...........
plastic mo.
L1970... A Afo plastic molded w/ ......... ......... ......... ........... ...........
ankle j.
L1980... A Afo sing solid stirrup ......... ......... ......... ........... ...........
calf.
L1990... A Afo doub solid stirrup ......... ......... ......... ........... ...........
calf.
L2000... A Kafo sing fre stirr thi/ ......... ......... ......... ........... ...........
calf.
L2010... A Kafo sng solid stirrup ......... ......... ......... ........... ...........
w/o j.
L2020... A Kafo dbl solid stirrup ......... ......... ......... ........... ...........
band/.
L2030... A Kafo dbl solid stirrup ......... ......... ......... ........... ...........
w/o j.
L2035... A KAFO plastic pediatric ......... ......... ......... ........... ...........
size.
L2036... A Kafo plas doub free ......... ......... ......... ........... ...........
knee mol.
L2037... A Kafo plas sing free ......... ......... ......... ........... ...........
knee mol.
L2038... A Kafo w/o joint multi- ......... ......... ......... ........... ...........
axis an.
L2039... A KAFO, plstic, medlat ......... ......... ......... ........... ...........
rotat con.
L2040... A Hkafo torsion bil rot ......... ......... ......... ........... ...........
straps.
L2050... A Hkafo torsion cable hip ......... ......... ......... ........... ...........
pelv.
L2060... A Hkafo torsion ball ......... ......... ......... ........... ...........
bearing j.
L2070... A Hkafo torsion unilat ......... ......... ......... ........... ...........
rot str.
L2080... A Hkafo unilat torsion ......... ......... ......... ........... ...........
cable.
L2090... A Hkafo unilat torsion ......... ......... ......... ........... ...........
ball br.
L2102... A Afo tibial fx cast ......... ......... ......... ........... ...........
plstr mol.
L2104... A Afo tib fx cast ......... ......... ......... ........... ...........
synthetic mo.
L2106... A Afo tib fx cast plaster ......... ......... ......... ........... ...........
mold.
L2108... A Afo tib fx cast molded ......... ......... ......... ........... ...........
to pt.
L2112... A Afo tibial fracture ......... ......... ......... ........... ...........
soft.
L2114... A Afo tib fx semi-rigid.. ......... ......... ......... ........... ...........
L2116... A Afo tibial fracture ......... ......... ......... ........... ...........
rigid.
L2122... A Kafo fem fx cast ......... ......... ......... ........... ...........
plaster mol.
L2124... A Kafo fem fx cast ......... ......... ......... ........... ...........
synthet mol.
L2126... A Kafo fem fx cast ......... ......... ......... ........... ...........
thermoplas.
L2128... A Kafo fem fx cast molded ......... ......... ......... ........... ...........
to p.
L2132... A Kafo femoral fx cast ......... ......... ......... ........... ...........
soft.
L2134... A Kafo fem fx cast semi- ......... ......... ......... ........... ...........
rigid.
L2136... A Kafo femoral fx cast ......... ......... ......... ........... ...........
rigid.
L2180... A Plas shoe insert w ank ......... ......... ......... ........... ...........
joint.
L2182... A Drop lock knee......... ......... ......... ......... ........... ...........
L2184... A Limited motion knee ......... ......... ......... ........... ...........
joint.
L2186... A Adj motion knee jnt ......... ......... ......... ........... ...........
lerman t.
L2188... A Quadrilateral brim..... ......... ......... ......... ........... ...........
L2190... A Waist belt............. ......... ......... ......... ........... ...........
L2192... A Pelvic band & belt ......... ......... ......... ........... ...........
thigh fla.
L2200... A Limited ankle motion ea ......... ......... ......... ........... ...........
jnt.
L2210... A Dorsiflexion assist ......... ......... ......... ........... ...........
each joi.
L2220... A Dorsi & plantar flex ......... ......... ......... ........... ...........
ass/res.
L2230... A Split flat caliper ......... ......... ......... ........... ...........
stirr & p.
L2240... A Round caliper and plate ......... ......... ......... ........... ...........
atta.
L2250... A Foot plate molded ......... ......... ......... ........... ...........
stirrup at.
L2260... A Reinforced solid ......... ......... ......... ........... ...........
stirrup.
L2265... A Long tongue stirrup.... ......... ......... ......... ........... ...........
L2270... A Varus/valgus strap ......... ......... ......... ........... ...........
padded/li.
L2275... A Plastic mod low ext pad/ ......... ......... ......... ........... ...........
line.
L2280... A Molded inner boot...... ......... ......... ......... ........... ...........
L2300... A Abduction bar jointed ......... ......... ......... ........... ...........
adjust.
L2310... A Abduction bar-straight. ......... ......... ......... ........... ...........
L2320... A Non-molded lacer....... ......... ......... ......... ........... ...........
L2330... A Lacer molded to patient ......... ......... ......... ........... ...........
mode.
L2335... A Anterior swing band.... ......... ......... ......... ........... ...........
L2340... A Pre-tibial shell molded ......... ......... ......... ........... ...........
to p.
L2350... A Prosthetic type socket ......... ......... ......... ........... ...........
molde.
L2360... A Extended steel shank... ......... ......... ......... ........... ...........
L2370... A Patten bottom.......... ......... ......... ......... ........... ...........
L2375... A Torsion ank & half ......... ......... ......... ........... ...........
solid sti.
L2380... A Torsion straight knee ......... ......... ......... ........... ...........
joint.
L2385... A Straight knee joint ......... ......... ......... ........... ...........
heavy du.
[[Page 47750]]
L2390... A Offset knee joint each. ......... ......... ......... ........... ...........
L2395... A Offset knee joint heavy ......... ......... ......... ........... ...........
duty.
L2397... A Suspension sleeve lower ......... ......... ......... ........... ...........
ext.
L2405... A Knee joint drop lock ea ......... ......... ......... ........... ...........
jnt.
L2415... A Knee joint cam lock ......... ......... ......... ........... ...........
each joi.
L2425... A Knee disc/dial lock/adj ......... ......... ......... ........... ...........
flex.
L2430... A Knee jnt ratchet lock ......... ......... ......... ........... ...........
ea jnt.
L2435... A Knee joint polycentric ......... ......... ......... ........... ...........
joint.
L2492... A Knee lift loop drop ......... ......... ......... ........... ...........
lock rin.
L2500... A Thi/glut/ischia wgt ......... ......... ......... ........... ...........
bearing.
L2510... A Th/wght bear quad-lat ......... ......... ......... ........... ...........
brim m.
L2520... A Th/wght bear quad-lat ......... ......... ......... ........... ...........
brim c.
L2525... A Th/wght bear nar m-l ......... ......... ......... ........... ...........
brim mo.
L2526... A Th/wght bear nar m-l ......... ......... ......... ........... ...........
brim cu.
L2530... A Thigh/wght bear lacer ......... ......... ......... ........... ...........
non-mo.
L2540... A Thigh/wght bear lacer ......... ......... ......... ........... ...........
molded.
L2550... A Thigh/wght bear high ......... ......... ......... ........... ...........
roll cu.
L2570... A Hip clevis type 2 posit ......... ......... ......... ........... ...........
jnt.
L2580... A Pelvic control pelvic ......... ......... ......... ........... ...........
sling.
L2600... A Hip clevis/thrust ......... ......... ......... ........... ...........
bearing fr.
L2610... A Hip clevis/thrust ......... ......... ......... ........... ...........
bearing lo.
L2620... A Pelvic control hip ......... ......... ......... ........... ...........
heavy dut.
L2622... A Hip joint adjustable ......... ......... ......... ........... ...........
flexion.
L2624... A Hip adj flex ext abduct ......... ......... ......... ........... ...........
cont.
L2627... A Plastic mold recipro ......... ......... ......... ........... ...........
hip & c.
L2628... A Metal frame recipro hip ......... ......... ......... ........... ...........
& ca.
L2630... A Pelvic control band & ......... ......... ......... ........... ...........
belt u.
L2640... A Pelvic control band & ......... ......... ......... ........... ...........
belt b.
L2650... A Pelv & thor control ......... ......... ......... ........... ...........
gluteal.
L2660... A Thoracic control ......... ......... ......... ........... ...........
thoracic ba.
L2670... A Thorac cont paraspinal ......... ......... ......... ........... ...........
uprig.
L2680... A Thorac cont lat support ......... ......... ......... ........... ...........
upri.
L2750... A Plating chrome/nickel ......... ......... ......... ........... ...........
pr bar.
L2755... A Carbon graphite ......... ......... ......... ........... ...........
lamination.
L2760... A Extension per extension ......... ......... ......... ........... ...........
per.
L2770... A Low ext orthosis per ......... ......... ......... ........... ...........
bar/jnt.
L2780... A Non-corrosive finish... ......... ......... ......... ........... ...........
L2785... A Drop lock retainer each ......... ......... ......... ........... ...........
L2795... A Knee control full ......... ......... ......... ........... ...........
kneecap.
L2800... A Knee cap medial or ......... ......... ......... ........... ...........
lateral p.
L2810... A Knee control condylar ......... ......... ......... ........... ...........
pad.
L2820... A Soft interface below ......... ......... ......... ........... ...........
knee se.
L2830... A Soft interface above ......... ......... ......... ........... ...........
knee se.
L2840... A Tibial length sock fx ......... ......... ......... ........... ...........
or equ.
L2850... A Femoral lgth sock fx or ......... ......... ......... ........... ...........
equa.
L2860... A Torsion mechanism knee/ ......... ......... ......... ........... ...........
ankle.
L2999... A Lower extremity ......... ......... ......... ........... ...........
orthosis NOS.
L3000... A Ft insert ucb berkeley ......... ......... ......... ........... ...........
shell.
L3001... A Foot insert remov ......... ......... ......... ........... ...........
molded spe.
L3002... A Foot insert plastazote ......... ......... ......... ........... ...........
or eq.
L3003... A Foot insert silicone ......... ......... ......... ........... ...........
gel eac.
L3010... A Foot longitudinal arch ......... ......... ......... ........... ...........
suppo.
L3020... A Foot longitud/ ......... ......... ......... ........... ...........
metatarsal sup.
L3030... A Foot arch support remov ......... ......... ......... ........... ...........
prem.
L3040... A Ft arch suprt premold ......... ......... ......... ........... ...........
longit.
L3050... A Foot arch supp premold ......... ......... ......... ........... ...........
metat.
L3060... A Foot arch supp longitud/ ......... ......... ......... ........... ...........
meta.
L3070... A Arch suprt att to sho ......... ......... ......... ........... ...........
longit.
L3080... A Arch supp att to shoe ......... ......... ......... ........... ...........
metata.
L3090... A Arch supp att to shoe ......... ......... ......... ........... ...........
long/m.
L3100... A Hallus-valgus nght ......... ......... ......... ........... ...........
dynamic s.
L3140... A Abduction rotation bar ......... ......... ......... ........... ...........
shoe.
L3150... A Abduct rotation bar w/o ......... ......... ......... ........... ...........
shoe.
L3160... A Shoe styled positioning ......... ......... ......... ........... ...........
dev.
L3170... A Foot plastic heel ......... ......... ......... ........... ...........
stabilizer.
L3201... A Oxford w supinat/pronat ......... ......... ......... ........... ...........
inf.
L3202... A Oxford w/ supinat/ ......... ......... ......... ........... ...........
pronator c.
L3203... A Oxford w/ supinator/ ......... ......... ......... ........... ...........
pronator.
L3204... A Hightop w/ supp/ ......... ......... ......... ........... ...........
pronator inf.
L3206... A Hightop w/ supp/ ......... ......... ......... ........... ...........
pronator chi.
L3207... A Hightop w/ supp/ ......... ......... ......... ........... ...........
pronator jun.
L3208... A Surgical boot each ......... ......... ......... ........... ...........
infant.
L3209... A Surgical boot each ......... ......... ......... ........... ...........
child.
L3211... A Surgical boot each ......... ......... ......... ........... ...........
junior.
L3212... A Benesch boot pair ......... ......... ......... ........... ...........
infant.
[[Page 47751]]
L3213... A Benesch boot pair child ......... ......... ......... ........... ...........
L3214... A Benesch boot pair ......... ......... ......... ........... ...........
junior.
L3215... A Orthopedic ftwear ......... ......... ......... ........... ...........
ladies oxf.
L3216... A Orthoped ladies shoes ......... ......... ......... ........... ...........
dpth i.
L3217... A Ladies shoes hightop ......... ......... ......... ........... ...........
depth i.
L3218... A Ladies surgical boot ......... ......... ......... ........... ...........
each.
L3219... A Orthopedic mens shoes ......... ......... ......... ........... ...........
oxford.
L3221... A Orthopedic mens shoes ......... ......... ......... ........... ...........
dpth i.
L3222... A Mens shoes hightop ......... ......... ......... ........... ...........
depth inl.
L3223... A Mens surgical boot each ......... ......... ......... ........... ...........
L3224... A Woman's shoe oxford ......... ......... ......... ........... ...........
brace.
L3225... A Man's shoe oxford brace ......... ......... ......... ........... ...........
L3230... A Custom shoes depth ......... ......... ......... ........... ...........
inlay.
L3250... A Custom mold shoe remov ......... ......... ......... ........... ...........
prost.
L3251... A Shoe molded to pt ......... ......... ......... ........... ...........
silicone s.
L3252... A Shoe molded plastazote ......... ......... ......... ........... ...........
cust.
L3253... A Shoe molded plastazote ......... ......... ......... ........... ...........
cust.
L3254... A Orth foot non-stndard ......... ......... ......... ........... ...........
size/w.
L3255... A Orth foot non-standard ......... ......... ......... ........... ...........
size/.
L3257... A Orth foot add charge ......... ......... ......... ........... ...........
split s.
L3260... A Ambulatory surgical ......... ......... ......... ........... ...........
boot eac.
L3265... A Plastazote sandal each. ......... ......... ......... ........... ...........
L3300... A Sho lift taper to ......... ......... ......... ........... ...........
metatarsal.
L3310... A Shoe lift elev heel/ ......... ......... ......... ........... ...........
sole neo.
L3320... A Shoe lift elev heel/ ......... ......... ......... ........... ...........
sole cor.
L3330... A Lifts elevation metal ......... ......... ......... ........... ...........
extens.
L3332... A Shoe lifts tapered to ......... ......... ......... ........... ...........
one-ha.
L3334... A Shoe lifts elevation ......... ......... ......... ........... ...........
heel /i.
L3340... A Shoe wedge sach........ ......... ......... ......... ........... ...........
L3350... A Shoe heel wedge........ ......... ......... ......... ........... ...........
L3360... A Shoe sole wedge outside ......... ......... ......... ........... ...........
sole.
L3370... A Shoe sole wedge between ......... ......... ......... ........... ...........
sole.
L3380... A Shoe clubfoot wedge.... ......... ......... ......... ........... ...........
L3390... A Shoe outflare wedge.... ......... ......... ......... ........... ...........
L3400... A Shoe metatarsal bar ......... ......... ......... ........... ...........
wedge ro.
L3410... A Shoe metatarsal bar ......... ......... ......... ........... ...........
between.
L3420... A Full sole/heel wedge ......... ......... ......... ........... ...........
btween.
L3430... A Sho heel count plast ......... ......... ......... ........... ...........
reinfor.
L3440... A Heel leather reinforced ......... ......... ......... ........... ...........
L3450... A Shoe heel sach cushion ......... ......... ......... ........... ...........
type.
L3455... A Shoe heel new leather ......... ......... ......... ........... ...........
standa.
L3460... A Shoe heel new rubber ......... ......... ......... ........... ...........
standar.
L3465... A Shoe heel thomas with ......... ......... ......... ........... ...........
wedge.
L3470... A Shoe heel thomas extend ......... ......... ......... ........... ...........
to b.
L3480... A Shoe heel pad & depress ......... ......... ......... ........... ...........
for.
L3485... A Shoe heel pad removable ......... ......... ......... ........... ...........
for.
L3500... A Shoe misc add insole ......... ......... ......... ........... ...........
leather.
L3510... A Shoe misc addition ......... ......... ......... ........... ...........
insole ru.
L3520... A Shoe insole felt cver w/ ......... ......... ......... ........... ...........
lea.
L3530... A Shoe misc additions ......... ......... ......... ........... ...........
sole hal.
L3540... A Shoe misc additions ......... ......... ......... ........... ...........
sole ful.
L3550... A Shoe misc add toe tap ......... ......... ......... ........... ...........
standa.
L3560... A Shoe misc add toe tap ......... ......... ......... ........... ...........
horses.
L3570... A Shoe special extension ......... ......... ......... ........... ...........
to in.
L3580... A Shoe convert instep ......... ......... ......... ........... ...........
velcro c.
L3590... A Shoe convert firm to ......... ......... ......... ........... ...........
soft cn.
L3595... A Shoe misc additions ......... ......... ......... ........... ...........
march ba.
L3600... A Trans shoe calip plate ......... ......... ......... ........... ...........
exist.
L3610... A Trans shoe caliper ......... ......... ......... ........... ...........
plate new.
L3620... A Trans shoe solid ......... ......... ......... ........... ...........
stirrup exi.
L3630... A Trans shoe solid ......... ......... ......... ........... ...........
stirrup new.
L3640... A Shoe dennis browne ......... ......... ......... ........... ...........
splint bo.
L3649... A Unlist proc orth shoe ......... ......... ......... ........... ...........
modif/.
L3650... A Shlder fig 8 abduct ......... ......... ......... ........... ...........
restrain.
L3660... A Abduct restrainer ......... ......... ......... ........... ...........
canvas & web.
L3670... A Acromio/clavicular ......... ......... ......... ........... ...........
canvas & we.
L3700... A Elbow orthoses elas w ......... ......... ......... ........... ...........
stays.
L3710... A Elbow elastic with ......... ......... ......... ........... ...........
metal joi.
L3720... A Forearm/arm cuffs free ......... ......... ......... ........... ...........
motio.
L3730... A Forearm/arm cuffs ext/ ......... ......... ......... ........... ...........
flex a.
L3740... A Cuffs adj lock w/ ......... ......... ......... ........... ...........
active con.
L3800... A Whfo short opponen no ......... ......... ......... ........... ...........
attach.
L3805... A Whfo long opponens no ......... ......... ......... ........... ...........
attach.
L3810... A Whfo thumb abduction ......... ......... ......... ........... ...........
bar.
L3815... A Whfo second m.p. ......... ......... ......... ........... ...........
abduction a.
[[Page 47752]]
L3820... A Whfo ip ext asst w/ mp ......... ......... ......... ........... ...........
ext s.
L3825... A Whfo m.p. extension ......... ......... ......... ........... ...........
stop.
L3830... A Whfo m.p. extension ......... ......... ......... ........... ...........
assist.
L3835... A Whfo m.p. spring ......... ......... ......... ........... ...........
extension a.
L3840... A Whfo spring swivel ......... ......... ......... ........... ...........
thumb.
L3845... A Whfo thumb ip ext ass w/ ......... ......... ......... ........... ...........
mp.
L3850... A Action wrist w/ ......... ......... ......... ........... ...........
dorsiflex as.
L3855... A Whfo adj m.p. flexion ......... ......... ......... ........... ...........
contro.
L3860... A Whfo adj m.p. flex ctrl ......... ......... ......... ........... ...........
& i.
L3890... A Torsion mechanism wrist/ ......... ......... ......... ........... ...........
elbo.
L3900... A Hinge extension/flex ......... ......... ......... ........... ...........
wrist/f.
L3901... A Hinge ext/flex wrist ......... ......... ......... ........... ...........
finger.
L3902... A Whfo ext power compress ......... ......... ......... ........... ...........
gas.
L3904... A Whfo electric custom ......... ......... ......... ........... ...........
fitted.
L3906... A Wrist gauntlet molded ......... ......... ......... ........... ...........
to pt.
L3907... A Whfo wrst gauntlt thmb ......... ......... ......... ........... ...........
spica.
L3908... A Wrist cock-up non- ......... ......... ......... ........... ...........
molded.
L3910... A Whfo swanson design.... ......... ......... ......... ........... ...........
L3912... A Flex glove w/elastic ......... ......... ......... ........... ...........
finger.
L3914... A WHO wrist extension ......... ......... ......... ........... ...........
cock-up.
L3916... A Whfo wrist extens w/ ......... ......... ......... ........... ...........
outrigg.
L3918... A HFO knuckle bender..... ......... ......... ......... ........... ...........
L3920... A Knuckle bender with ......... ......... ......... ........... ...........
outrigge.
L3922... A Knuckle bend 2 seg to ......... ......... ......... ........... ...........
flex j.
L3924... A Oppenheimer............ ......... ......... ......... ........... ...........
L3926... A Thomas suspension...... ......... ......... ......... ........... ...........
L3928... A Finger extension w/ ......... ......... ......... ........... ...........
clock sp.
L3930... A Finger extension with ......... ......... ......... ........... ...........
wrist.
L3932... A Safety pin spring wire. ......... ......... ......... ........... ...........
L3934... A Safety pin modified.... ......... ......... ......... ........... ...........
L3936... A Palmer................. ......... ......... ......... ........... ...........
L3938... A Dorsal wrist........... ......... ......... ......... ........... ...........
L3940... A Dorsal wrist w/ ......... ......... ......... ........... ...........
outrigger at.
L3942... A Reverse knuckle bender. ......... ......... ......... ........... ...........
L3944... A Reverse knuckle bend w/ ......... ......... ......... ........... ...........
outr.
L3946... A HFO composite elastic.. ......... ......... ......... ........... ...........
L3948... A Finger knuckle bender.. ......... ......... ......... ........... ...........
L3950... A Oppenheimer w/ knuckle ......... ......... ......... ........... ...........
bend.
L3952... A Oppenheimer w/ rev ......... ......... ......... ........... ...........
knuckle 2.
L3954... A Spreading hand......... ......... ......... ......... ........... ...........
L3956... A Add joint upper ext ......... ......... ......... ........... ...........
orthosis.
L3960... A Sewho airplan desig ......... ......... ......... ........... ...........
abdu pos.
L3962... A Sewho erbs palsey ......... ......... ......... ........... ...........
design abd.
L3963... A Molded w/ articulating ......... ......... ......... ........... ...........
elbow.
L3964... A Seo mobile arm sup att ......... ......... ......... ........... ...........
to wc.
L3965... A Arm supp att to wc ......... ......... ......... ........... ...........
rancho ty.
L3966... A Mobile arm supports ......... ......... ......... ........... ...........
reclinin.
L3968... A Friction dampening arm ......... ......... ......... ........... ...........
supp.
L3969... A Monosuspension arm/hand ......... ......... ......... ........... ...........
supp.
L3970... A Elevat proximal arm ......... ......... ......... ........... ...........
support.
L3972... A Offset/lat rocker arm w/ ......... ......... ......... ........... ...........
ela.
L3974... A Mobile arm support ......... ......... ......... ........... ...........
supinator.
L3980... A Upp ext fx orthosis ......... ......... ......... ........... ...........
humeral.
L3982... A Upper ext fx orthosis ......... ......... ......... ........... ...........
rad/ul.
L3984... A Upper ext fx orthosis ......... ......... ......... ........... ...........
wrist.
L3985... A Forearm hand fx orth w/ ......... ......... ......... ........... ...........
wr h.
L3986... A Humeral rad/ulna wrist ......... ......... ......... ........... ...........
fx or.
L3995... A Sock fracture or equal ......... ......... ......... ........... ...........
each.
L3999... A Upper limb orthosis NOS ......... ......... ......... ........... ...........
L4000... A Repl girdle milwaukee ......... ......... ......... ........... ...........
orth.
L4010... A Replace trilateral ......... ......... ......... ........... ...........
socket br.
L4020... A Replace quadlat socket ......... ......... ......... ........... ...........
brim.
L4030... A Replace socket brim ......... ......... ......... ........... ...........
cust fit.
L4040... A Replace molded thigh ......... ......... ......... ........... ...........
lacer.
L4045... A Replace non-molded ......... ......... ......... ........... ...........
thigh lac.
L4050... A Replace molded calf ......... ......... ......... ........... ...........
lacer.
L4055... A Replace non-molded calf ......... ......... ......... ........... ...........
lace.
L4060... A Replace high roll cuff. ......... ......... ......... ........... ...........
L4070... A Replace prox & dist ......... ......... ......... ........... ...........
upright.
L4080... A Repl met band kafo-afo ......... ......... ......... ........... ...........
prox.
L4090... A Repl met band kafo-afo ......... ......... ......... ........... ...........
calf/.
L4100... A Repl leath cuff kafo ......... ......... ......... ........... ...........
prox th.
L4110... A Repl leath cuff kafo- ......... ......... ......... ........... ...........
afo cal.
L4130... A Replace pretibial shell ......... ......... ......... ........... ...........
L4205... A Ortho dvc repair per 15 ......... ......... ......... ........... ...........
min.
[[Page 47753]]
L4210... A Orth dev repair/repl ......... ......... ......... ........... ...........
minor p.
L4310... A Mult-podus/eq orth prep ......... ......... ......... ........... ...........
mgmt.
L4320... A Low ext mgmt sys ft pos ......... ......... ......... ........... ...........
afo.
L4350... A Pneumatic ankle cntrl ......... ......... ......... ........... ...........
splint.
L4360... A Pneumatic walking ......... ......... ......... ........... ...........
splint.
L4370... A Pneumatic full leg ......... ......... ......... ........... ...........
splint.
L4380... A Pneumatic knee splint.. ......... ......... ......... ........... ...........
L4390... A Replace multi-podus ......... ......... ......... ........... ...........
splint.
L4392... A Replace ankle contrac ......... ......... ......... ........... ...........
splint.
L4394... A Replace foot drop ......... ......... ......... ........... ...........
splint.
L4396... A Ankle contracture ......... ......... ......... ........... ...........
splint.
L4398... A Foot drop splint ......... ......... ......... ........... ...........
recumbent.
L5000... A Sho insert w arch toe ......... ......... ......... ........... ...........
filler.
L5010... A Mold socket ank hgt w/ ......... ......... ......... ........... ...........
toe f.
L5020... A Tibial tubercle hgt w/ ......... ......... ......... ........... ...........
toe f.
L5050... A Ank symes mold sckt ......... ......... ......... ........... ...........
sach ft.
L5060... A Symes met fr leath ......... ......... ......... ........... ...........
socket ar.
L5100... A Molded socket shin sach ......... ......... ......... ........... ...........
foot.
L5105... A Plast socket jts/thgh ......... ......... ......... ........... ...........
lacer.
L5150... A Mold sckt ext knee shin ......... ......... ......... ........... ...........
sach.
L5160... A Mold socket bent knee ......... ......... ......... ........... ...........
shin s.
L5200... A Kne sing axis fric shin ......... ......... ......... ........... ...........
sach.
L5210... A No knee/ankle joints w/ ......... ......... ......... ........... ...........
ft b.
L5220... A No knee joint with ......... ......... ......... ........... ...........
artic ali.
L5230... A Fem focal defic ......... ......... ......... ........... ...........
constant fri.
L5250... A Hip canad sing axi cons ......... ......... ......... ........... ...........
fric.
L5270... A Tilt table locking hip ......... ......... ......... ........... ...........
sing.
L5280... A Hemipelvect canad sing ......... ......... ......... ........... ...........
axis.
L5300... A Bk sach soft cover & ......... ......... ......... ........... ...........
finish.
L5310... A Knee disart sach soft ......... ......... ......... ........... ...........
cv/fin.
L5320... A Ak open end sach soft ......... ......... ......... ........... ...........
cv/fin.
L5330... A Hip canadian sach sft ......... ......... ......... ........... ...........
cv/fin.
L5340... A Hemipelvectomy canad cv/ ......... ......... ......... ........... ...........
fin.
L5400... A Postop dress & 1 cast ......... ......... ......... ........... ...........
chg bk.
L5410... A Postop dsg bk ea add ......... ......... ......... ........... ...........
cast ch.
L5420... A Postop dsg & 1 cast chg ......... ......... ......... ........... ...........
ak/d.
L5430... A Postop dsg ak ea add ......... ......... ......... ........... ...........
cast ch.
L5450... A Postop app non-wgt bear ......... ......... ......... ........... ...........
dsg.
L5460... A Postop app non-wgt bear ......... ......... ......... ........... ...........
dsg.
L5500... A Init bk ptb plaster ......... ......... ......... ........... ...........
direct.
L5505... A Init ak ischal plstr ......... ......... ......... ........... ...........
direct.
L5510... A Prep BK ptb plaster ......... ......... ......... ........... ...........
molded.
L5520... A Prep BK ptb thermopls ......... ......... ......... ........... ...........
direct.
L5530... A Prep BK ptb thermopls ......... ......... ......... ........... ...........
molded.
L5535... A Prep BK ptb open end ......... ......... ......... ........... ...........
socket.
L5540... A Prep BK ptb laminated ......... ......... ......... ........... ...........
socket.
L5560... A Prep AK ischial plast ......... ......... ......... ........... ...........
molded.
L5570... A Prep AK ischial direct ......... ......... ......... ........... ...........
form.
L5580... A Prep AK ischial thermo ......... ......... ......... ........... ...........
mold.
L5585... A Prep AK ischial open ......... ......... ......... ........... ...........
end.
L5590... A Prep AK ischial ......... ......... ......... ........... ...........
laminated.
L5595... A Hip disartic sach ......... ......... ......... ........... ...........
thermopls.
L5600... A Hip disart sach laminat ......... ......... ......... ........... ...........
mold.
L5610... A Above knee hydracadence ......... ......... ......... ........... ...........
L5611... A Ak 4 bar link w/fric ......... ......... ......... ........... ...........
swing.
L5613... A Ak 4 bar ling w/hydraul ......... ......... ......... ........... ...........
swig.
L5614... A 4-bar link above knee w/ ......... ......... ......... ........... ...........
swng.
L5616... A Ak univ multiplex sys ......... ......... ......... ........... ...........
frict.
L5617... A AK/BK self-aligning ......... ......... ......... ........... ...........
unit ea.
L5618... A Test socket symes...... ......... ......... ......... ........... ...........
L5620... A Test socket below knee. ......... ......... ......... ........... ...........
L5622... A Test socket knee ......... ......... ......... ........... ...........
disarticula.
L5624... A Test socket above knee. ......... ......... ......... ........... ...........
L5626... A Test socket hip ......... ......... ......... ........... ...........
disarticulat.
L5628... A Test socket ......... ......... ......... ........... ...........
hemipelvectomy.
L5629... A Below knee acrylic ......... ......... ......... ........... ...........
socket.
L5630... A Syme typ expandabl wall ......... ......... ......... ........... ...........
sckt.
L5631... A Ak/knee disartic ......... ......... ......... ........... ...........
acrylic soc.
L5632... A Symes type ptb brim ......... ......... ......... ........... ...........
design s.
L5634... A Symes type poster ......... ......... ......... ........... ...........
opening so.
L5636... A Symes type medial ......... ......... ......... ........... ...........
opening so.
L5637... A Below knee total ......... ......... ......... ........... ...........
contact.
L5638... A Below knee leather ......... ......... ......... ........... ...........
socket.
L5639... A Below knee wood socket. ......... ......... ......... ........... ...........
L5640... A Knee disarticulat ......... ......... ......... ........... ...........
leather so.
[[Page 47754]]
L5642... A Above knee leather ......... ......... ......... ........... ...........
socket.
L5643... A Hip flex inner socket ......... ......... ......... ........... ...........
ext fr.
L5644... A Above knee wood socket. ......... ......... ......... ........... ...........
L5645... A Ak flexibl inner socket ......... ......... ......... ........... ...........
ext.
L5646... A Below knee air cushion ......... ......... ......... ........... ...........
socke.
L5647... A Below knee suction ......... ......... ......... ........... ...........
socket.
L5648... A Above knee air cushion ......... ......... ......... ........... ...........
socke.
L5649... A Isch containmt/narrow m- ......... ......... ......... ........... ...........
l so.
L5650... A Tot contact ak/knee ......... ......... ......... ........... ...........
disart s.
L5651... A Ak flex inner socket ......... ......... ......... ........... ...........
ext fra.
L5652... A Suction susp ak/knee ......... ......... ......... ........... ...........
disart.
L5653... A Knee disart expand wall ......... ......... ......... ........... ...........
sock.
L5654... A Socket insert symes.... ......... ......... ......... ........... ...........
L5655... A Socket insert below ......... ......... ......... ........... ...........
knee.
L5656... A Socket insert knee ......... ......... ......... ........... ...........
articulat.
L5658... A Socket insert above ......... ......... ......... ........... ...........
knee.
L5660... A Sock insrt syme ......... ......... ......... ........... ...........
silicone gel.
L5661... A Multi-durometer symes.. ......... ......... ......... ........... ...........
L5662... A Socket insert bk ......... ......... ......... ........... ...........
silicone ge.
L5663... A Sock knee disartic ......... ......... ......... ........... ...........
silicone.
L5664... A Socket insert ak ......... ......... ......... ........... ...........
silicone ge.
L5665... A Multi-durometer below ......... ......... ......... ........... ...........
knee.
L5666... A Below knee cuff ......... ......... ......... ........... ...........
suspension.
L5667... A Socket insert w lock ......... ......... ......... ........... ...........
lower.
L5668... A Socket insert w/o lock ......... ......... ......... ........... ...........
lower.
L5669... A Below knee socket w/o ......... ......... ......... ........... ...........
lock.
L5670... A Bk molded supracondylar ......... ......... ......... ........... ...........
susp.
L5672... A Bk removable medial ......... ......... ......... ........... ...........
brim sus.
L5674... A Bk latex sleeve ......... ......... ......... ........... ...........
suspension/e.
L5675... A Bk latex sleeve susp/eq ......... ......... ......... ........... ...........
hvy.
L5676... A Bk knee joints single ......... ......... ......... ........... ...........
axis p.
L5677... A Bk knee joints ......... ......... ......... ........... ...........
polycentric p.
L5678... A Bk joint covers pair... ......... ......... ......... ........... ...........
L5680... A Bk thigh lacer non- ......... ......... ......... ........... ...........
molded.
L5682... A Bk thigh lacer glut/ ......... ......... ......... ........... ...........
ischia m.
L5684... A Bk fork strap.......... ......... ......... ......... ........... ...........
L5686... A Bk back check.......... ......... ......... ......... ........... ...........
L5688... A Bk waist belt webbing.. ......... ......... ......... ........... ...........
L5690... A Bk waist belt padded ......... ......... ......... ........... ...........
and lin.
L5692... A Ak pelvic control belt ......... ......... ......... ........... ...........
light.
L5694... A Ak pelvic control belt ......... ......... ......... ........... ...........
pad/l.
L5695... A Ak sleeve susp neoprene/ ......... ......... ......... ........... ...........
equa.
L5696... A Ak/knee disartic pelvic ......... ......... ......... ........... ...........
join.
L5697... A Ak/knee disartic pelvic ......... ......... ......... ........... ...........
band.
L5698... A Ak/knee disartic ......... ......... ......... ........... ...........
silesian ba.
L5699... A Shoulder harness....... ......... ......... ......... ........... ...........
L5700... A Replace socket below ......... ......... ......... ........... ...........
knee.
L5701... A Replace socket above ......... ......... ......... ........... ...........
knee.
L5702... A Replace socket hip..... ......... ......... ......... ........... ...........
L5704... A Custom shape covr below ......... ......... ......... ........... ...........
knee.
L5705... A Custm shape cover above ......... ......... ......... ........... ...........
knee.
L5706... A Custm shape cvr knee ......... ......... ......... ........... ...........
disart.
L5707... A Custm shape cover hip ......... ......... ......... ........... ...........
disart.
L5710... A Kne-shin exo sng axi ......... ......... ......... ........... ...........
mnl loc.
L5711... A Knee-shin exo mnl lock ......... ......... ......... ........... ...........
ultra.
L5712... A Knee-shin exo frict swg ......... ......... ......... ........... ...........
& st.
L5714... A Knee-shin exo variable ......... ......... ......... ........... ...........
frict.
L5716... A Knee-shin exo mech ......... ......... ......... ........... ...........
stance ph.
L5718... A Knee-shin exo frct swg ......... ......... ......... ........... ...........
& sta.
L5722... A Knee-shin pneum swg ......... ......... ......... ........... ...........
frct exo.
L5724... A Knee-shin exo fluid ......... ......... ......... ........... ...........
swing ph.
L5726... A Knee-shin ext jnts fld ......... ......... ......... ........... ...........
swg e.
L5728... A Knee-shin fluid swg & ......... ......... ......... ........... ...........
stance.
L5780... A Knee-shin pneum/hydra ......... ......... ......... ........... ...........
pneum.
L5785... A Exoskeletal bk ultralt ......... ......... ......... ........... ...........
mater.
L5790... A Exoskeletal ak ultra- ......... ......... ......... ........... ...........
light m.
L5795... A Exoskel hip ultra-light ......... ......... ......... ........... ...........
mate.
L5810... A Endoskel knee-shin mnl ......... ......... ......... ........... ...........
lock.
L5811... A Endo knee-shin mnl lck ......... ......... ......... ........... ...........
ultra.
L5812... A Endo knee-shin frct swg ......... ......... ......... ........... ...........
& st.
L5814... A Endo knee-shin hydral ......... ......... ......... ........... ...........
swg ph.
L5816... A Endo knee-shin polyc ......... ......... ......... ........... ...........
mch sta.
L5818... A Endo knee-shin frct swg ......... ......... ......... ........... ...........
& st.
L5822... A Endo knee-shin pneum ......... ......... ......... ........... ...........
swg frc.
L5824... A Endo knee-shin fluid ......... ......... ......... ........... ...........
swing p.
[[Page 47755]]
L5826... A Pediatric knee joint... ......... ......... ......... ........... ...........
L5828... A Endo knee-shin fluid ......... ......... ......... ........... ...........
swg/sta.
L5830... A Endo knee-shin pneum/ ......... ......... ......... ........... ...........
swg pha.
L5840... A Multi-axial knee/shin ......... ......... ......... ........... ...........
system.
L5845... A Knee-shin sys stance ......... ......... ......... ........... ...........
flexion.
L5846... A Knee-shin sys ......... ......... ......... ........... ...........
microprocessor.
L5850... A Endo ak/hip knee extens ......... ......... ......... ........... ...........
assi.
L5855... A Mech hip extension ......... ......... ......... ........... ...........
assist.
L5910... A Endo below knee ......... ......... ......... ........... ...........
alignable sy.
L5920... A Endo ak/hip alignable ......... ......... ......... ........... ...........
system.
L5925... A Above knee manual lock. ......... ......... ......... ........... ...........
L5930... A High activity knee ......... ......... ......... ........... ...........
frame.
L5940... A Endo bk ultra-light ......... ......... ......... ........... ...........
material.
L5950... A Endo ak ultra-light ......... ......... ......... ........... ...........
material.
L5960... A Endo hip ultra-light ......... ......... ......... ........... ...........
materia.
L5962... A Below knee flex cover ......... ......... ......... ........... ...........
system.
L5964... A Above knee flex cover ......... ......... ......... ........... ...........
system.
L5966... A Hip flexible cover ......... ......... ......... ........... ...........
system.
L5970... A Foot external keel sach ......... ......... ......... ........... ...........
foot.
L5972... A Flexible keel foot..... ......... ......... ......... ........... ...........
L5974... A Foot single axis ankle/ ......... ......... ......... ........... ...........
foot.
L5976... A Energy storing foot.... ......... ......... ......... ........... ...........
L5978... A Ft prosth multiaxial ......... ......... ......... ........... ...........
ankl/ft.
L5979... A Multi-axial ankle/ft ......... ......... ......... ........... ...........
prosth.
L5980... A Flex foot system....... ......... ......... ......... ........... ...........
L5981... A Flex-walk sys low ext ......... ......... ......... ........... ...........
prosth.
L5982... A Exoskeletal axial ......... ......... ......... ........... ...........
rotation u.
L5984... A Endoskeletal axial ......... ......... ......... ........... ...........
rotation.
L5985... A Lwr ext dynamic prosth ......... ......... ......... ........... ...........
pylon.
L5986... A Multi-axial rotation ......... ......... ......... ........... ...........
unit.
L5987... A Shank ft w vert load ......... ......... ......... ........... ...........
pylon.
L5999... A Lowr extremity prosthes ......... ......... ......... ........... ...........
NOS.
L6000... A Par hand robin-aids ......... ......... ......... ........... ...........
thum rem.
L6010... A Hand robin-aids little/ ......... ......... ......... ........... ...........
ring.
L6020... A Part hand robin-aids no ......... ......... ......... ........... ...........
fing.
L6050... A Wrst MLd sck flx hng ......... ......... ......... ........... ...........
tri pad.
L6055... A Wrst mold sock w/exp ......... ......... ......... ........... ...........
interfa.
L6100... A Elb mold sock flex ......... ......... ......... ........... ...........
hinge pad.
L6110... A Elbow mold sock ......... ......... ......... ........... ...........
suspension t.
L6120... A Elbow mold doub splt ......... ......... ......... ........... ...........
soc ste.
L6130... A Elbow stump activated ......... ......... ......... ........... ...........
lock h.
L6200... A Elbow mold outsid lock ......... ......... ......... ........... ...........
hinge.
L6205... A Elbow molded w/ expand ......... ......... ......... ........... ...........
inter.
L6250... A Elbow inter loc elbow ......... ......... ......... ........... ...........
forarm.
L6300... A Shlder disart int lock ......... ......... ......... ........... ...........
elbow.
L6310... A Shoulder passive restor ......... ......... ......... ........... ...........
comp.
L6320... A Shoulder passive restor ......... ......... ......... ........... ...........
cap.
L6350... A Thoracic intern lock ......... ......... ......... ........... ...........
elbow.
L6360... A Thoracic passive restor ......... ......... ......... ........... ...........
comp.
L6370... A Thoracic passive restor ......... ......... ......... ........... ...........
cap.
L6380... A Postop dsg cast chg ......... ......... ......... ........... ...........
wrst/elb.
L6382... A Postop dsg cast chg elb ......... ......... ......... ........... ...........
dis/.
L6384... A Postop dsg cast chg ......... ......... ......... ........... ...........
shlder/t.
L6386... A Postop ea cast chg & ......... ......... ......... ........... ...........
realign.
L6388... A Postop applicat rigid ......... ......... ......... ........... ...........
dsg on.
L6400... A Below elbow prosth tiss ......... ......... ......... ........... ...........
shap.
L6450... A Elb disart prosth tiss ......... ......... ......... ........... ...........
shap.
L6500... A Above elbow prosth tiss ......... ......... ......... ........... ...........
shap.
L6550... A Shldr disar prosth tiss ......... ......... ......... ........... ...........
shap.
L6570... A Scap thorac prosth tiss ......... ......... ......... ........... ...........
shap.
L6580... A Wrist/elbow bowden ......... ......... ......... ........... ...........
cable mol.
L6582... A Wrist/elbow bowden cbl ......... ......... ......... ........... ...........
dir f.
L6584... A Elbow fair lead cable ......... ......... ......... ........... ...........
molded.
L6586... A Elbow fair lead cable ......... ......... ......... ........... ...........
dir fo.
L6588... A Shdr fair lead cable ......... ......... ......... ........... ...........
molded.
L6590... A Shdr fair lead cable ......... ......... ......... ........... ...........
direct.
L6600... A Polycentric hinge pair. ......... ......... ......... ........... ...........
L6605... A Single pivot hinge pair ......... ......... ......... ........... ...........
L6610... A Flexible metal hinge ......... ......... ......... ........... ...........
pair.
L6615... A Disconnect locking ......... ......... ......... ........... ...........
wrist uni.
L6616... A Disconnect insert ......... ......... ......... ........... ...........
locking wr.
L6620... A Flexion-friction wrist ......... ......... ......... ........... ...........
unit.
L6623... A Spring-ass rot wrst w/ ......... ......... ......... ........... ...........
latch.
L6625... A Rotation wrst w/ cable ......... ......... ......... ........... ...........
lock.
L6628... A Quick disconn hook ......... ......... ......... ........... ...........
adapter o.
[[Page 47756]]
L6629... A Lamination collar w/ ......... ......... ......... ........... ...........
couplin.
L6630... A Stainless steel any ......... ......... ......... ........... ...........
wrist.
L6632... A Latex suspension sleeve ......... ......... ......... ........... ...........
each.
L6635... A Lift assist for elbow.. ......... ......... ......... ........... ...........
L6637... A Nudge control elbow ......... ......... ......... ........... ...........
lock.
L6640... A Shoulder abduction ......... ......... ......... ........... ...........
joint pai.
L6641... A Excursion amplifier ......... ......... ......... ........... ...........
pulley t.
L6642... A Excursion amplifier ......... ......... ......... ........... ...........
lever ty.
L6645... A Shoulder flexion- ......... ......... ......... ........... ...........
abduction j.
L6650... A Shoulder universal ......... ......... ......... ........... ...........
joint.
L6655... A Standard control cable ......... ......... ......... ........... ...........
extra.
L6660... A Heavy duty control ......... ......... ......... ........... ...........
cable.
L6665... A Teflon or equal cable ......... ......... ......... ........... ...........
lining.
L6670... A Hook to hand cable ......... ......... ......... ........... ...........
adapter.
L6672... A Harness chest/shlder ......... ......... ......... ........... ...........
saddle.
L6675... A Harness figure of 8 ......... ......... ......... ........... ...........
sing con.
L6676... A Harness figure of 8 ......... ......... ......... ........... ...........
dual con.
L6680... A Test sock wrist disart/ ......... ......... ......... ........... ...........
bel e.
L6682... A Test sock elbw disart/ ......... ......... ......... ........... ...........
above.
L6684... A Test socket shldr ......... ......... ......... ........... ...........
disart/tho.
L6686... A Suction socket......... ......... ......... ......... ........... ...........
L6687... A Frame typ socket bel ......... ......... ......... ........... ...........
elbow/w.
L6688... A Frame typ sock above ......... ......... ......... ........... ...........
elb/dis.
L6689... A Frame typ socket ......... ......... ......... ........... ...........
shoulder di.
L6690... A Frame typ sock ......... ......... ......... ........... ...........
interscap-tho.
L6691... A Removable insert each.. ......... ......... ......... ........... ...........
L6692... A Silicone gel insert or ......... ......... ......... ........... ...........
equal.
L6700... A Terminal device model ......... ......... ......... ........... ...........
#3.
L6705... A Terminal device model ......... ......... ......... ........... ...........
#5.
L6710... A Terminal device model ......... ......... ......... ........... ...........
#5x.
L6715... A Terminal device model ......... ......... ......... ........... ...........
#5xa.
L6720... A Terminal device model ......... ......... ......... ........... ...........
#6.
L6725... A Terminal device model ......... ......... ......... ........... ...........
#7.
L6730... A Terminal device model ......... ......... ......... ........... ...........
#7lo.
L6735... A Terminal device model ......... ......... ......... ........... ...........
#8.
L6740... A Terminal device model ......... ......... ......... ........... ...........
#8x.
L6745... A Terminal device model ......... ......... ......... ........... ...........
#88x.
L6750... A Terminal device model ......... ......... ......... ........... ...........
#10p.
L6755... A Terminal device model ......... ......... ......... ........... ...........
#10x.
L6765... A Terminal device model ......... ......... ......... ........... ...........
#12p.
L6770... A Terminal device model ......... ......... ......... ........... ...........
#99x.
L6775... A Terminal device ......... ......... ......... ........... ...........
model#555.
L6780... A Terminal device model ......... ......... ......... ........... ...........
#ss555.
L6790... A Hooks-accu hook or ......... ......... ......... ........... ...........
equal.
L6795... A Hooks-2 load or equal.. ......... ......... ......... ........... ...........
L6800... A Hooks-aprl vc or equal. ......... ......... ......... ........... ...........
L6805... A Modifier wrist flexion ......... ......... ......... ........... ...........
unit.
L6806... A Trs grip vc or equal... ......... ......... ......... ........... ...........
L6807... A Term device grip1/2 or ......... ......... ......... ........... ...........
equal.
L6808... A Term device infant or ......... ......... ......... ........... ...........
child.
L6809... A Trs super sport passive ......... ......... ......... ........... ...........
L6810... A Pincher tool otto bock ......... ......... ......... ........... ...........
or eq.
L6825... A Hands dorrance vo...... ......... ......... ......... ........... ...........
L6830... A Hand aprl vc........... ......... ......... ......... ........... ...........
L6835... A Hand sierra vo......... ......... ......... ......... ........... ...........
L6840... A Hand becker imperial... ......... ......... ......... ........... ...........
L6845... A Hand becker lock grip.. ......... ......... ......... ........... ...........
L6850... A Term dvc-hand becker ......... ......... ......... ........... ...........
plylite.
L6855... A Hand robin-aids vo..... ......... ......... ......... ........... ...........
L6860... A Hand robin-aids vo soft ......... ......... ......... ........... ...........
L6865... A Hand passive hand...... ......... ......... ......... ........... ...........
L6867... A Hand detroit infant ......... ......... ......... ........... ...........
hand.
L6868... A Passive inf hand ......... ......... ......... ........... ...........
steeper/hos.
L6870... A Hand child mitt........ ......... ......... ......... ........... ...........
L6872... A Hand nyu child hand.... ......... ......... ......... ........... ...........
L6873... A Hand mech inf steeper ......... ......... ......... ........... ...........
or equ.
L6875... A Hand bock vc........... ......... ......... ......... ........... ...........
L6880... A Hand bock vo........... ......... ......... ......... ........... ...........
L6890... A Production glove....... ......... ......... ......... ........... ...........
L6895... A Custom glove........... ......... ......... ......... ........... ...........
L6900... A Hand restorat thumb/1 ......... ......... ......... ........... ...........
finger.
L6905... A Hand restoration ......... ......... ......... ........... ...........
multiple fi.
L6910... A Hand restoration no ......... ......... ......... ........... ...........
fingers.
L6915... A Hand restoration ......... ......... ......... ........... ...........
replacmnt g.
L6920... A Wrist disarticul switch ......... ......... ......... ........... ...........
ctrl.
[[Page 47757]]
L6925... A Wrist disart ......... ......... ......... ........... ...........
myoelectronic c.
L6930... A Below elbow switch ......... ......... ......... ........... ...........
control.
L6935... A Below elbow ......... ......... ......... ........... ...........
myoelectronic ct.
L6940... A Elbow disarticulation ......... ......... ......... ........... ...........
switch.
L6945... A Elbow disart ......... ......... ......... ........... ...........
myoelectronic c.
L6950... A Above elbow switch ......... ......... ......... ........... ...........
control.
L6955... A Above elbow ......... ......... ......... ........... ...........
myoelectronic ct.
L6960... A Shldr disartic switch ......... ......... ......... ........... ...........
contro.
L6965... A Shldr disartic ......... ......... ......... ........... ...........
myoelectronic.
L6970... A Interscapular-thor ......... ......... ......... ........... ...........
switch ct.
L6975... A Interscap-thor ......... ......... ......... ........... ...........
myoelectronic.
L7010... A Hand otto back steeper/ ......... ......... ......... ........... ...........
eq sw.
L7015... A Hand sys teknik village ......... ......... ......... ........... ...........
swit.
L7020... A Electronic greifer ......... ......... ......... ........... ...........
switch ct.
L7025... A Electron hand ......... ......... ......... ........... ...........
myoelectronic.
L7030... A Hand sys teknik vill ......... ......... ......... ........... ...........
myoelec.
L7035... A Electron greifer ......... ......... ......... ........... ...........
myoelectro.
L7040... A Prehensile actuator ......... ......... ......... ........... ...........
hosmer s.
L7045... A Electron hook child ......... ......... ......... ........... ...........
michigan.
L7170... A Electronic elbow hosmer ......... ......... ......... ........... ...........
swit.
L7180... A Electronic elbow utah ......... ......... ......... ........... ...........
myoele.
L7185... A Electron elbow ......... ......... ......... ........... ...........
adolescent sw.
L7186... A Electron elbow child ......... ......... ......... ........... ...........
switch.
L7190... A Elbow adolescent ......... ......... ......... ........... ...........
myoelectron.
L7191... A Elbow child ......... ......... ......... ........... ...........
myoelectronic ct.
L7260... A Electron wrist rotator ......... ......... ......... ........... ...........
otto.
L7261... A Electron wrist rotator ......... ......... ......... ........... ...........
utah.
L7266... A Servo control steeper ......... ......... ......... ........... ...........
or equ.
L7272... A Analogue control unb or ......... ......... ......... ........... ...........
equa.
L7274... A Proportional ctl 12 ......... ......... ......... ........... ...........
volt uta.
L7360... A Six volt bat otto bock/ ......... ......... ......... ........... ...........
eq ea.
L7362... A Battery chrgr six volt ......... ......... ......... ........... ...........
otto.
L7364... A Twelve volt battery ......... ......... ......... ........... ...........
utah/equ.
L7366... A Battery chrgr 12 volt ......... ......... ......... ........... ...........
utah/e.
L7499... A Upper extremity ......... ......... ......... ........... ...........
prosthes NOS.
L7500... A Prosthetic dvc repair ......... ......... ......... ........... ...........
hourly.
L7510... A Prosthetic device ......... ......... ......... ........... ...........
repair rep.
L7520... A Repair prosthesis per ......... ......... ......... ........... ...........
15 min.
L7900... A Vacuum erection system. ......... ......... ......... ........... ...........
L8000... A Mastectomy bra......... ......... ......... ......... ........... ...........
L8010... A Mastectomy sleeve...... ......... ......... ......... ........... ...........
L8020... A Mastectomy form........ ......... ......... ......... ........... ...........
L8030... A Breast prosthesis ......... ......... ......... ........... ...........
silicone/e.
L8039... A Breast prosthesis NOS.. ......... ......... ......... ........... ...........
L8100... A Elas suprt stock bk med ......... ......... ......... ........... ...........
wgt.
L8110... A Elastic supp stocking ......... ......... ......... ........... ...........
bk hvy.
L8120... A Elastic supp stockng bk ......... ......... ......... ........... ...........
surg.
L8130... A Elastic supp stocking ......... ......... ......... ........... ...........
ak med.
L8140... A Elastic supp stocking ......... ......... ......... ........... ...........
ak hvy.
L8150... A Elastic supp stockng ak ......... ......... ......... ........... ...........
surg.
L8160... A Supp stocking full lgth ......... ......... ......... ........... ...........
med.
L8170... A Supp stocking full lgth ......... ......... ......... ........... ...........
hvy.
L8180... A Supp stocking heavy ......... ......... ......... ........... ...........
surg wei.
L8190... A Elas stocking leotards ......... ......... ......... ........... ...........
med w.
L8200... A Elas stocking leotards ......... ......... ......... ........... ...........
surg.
L8210... A Elastic stocking custom ......... ......... ......... ........... ...........
made.
L8220... A Elastic stocking ......... ......... ......... ........... ...........
lymphedema.
L8230... A Elastic stocking garter ......... ......... ......... ........... ...........
belt.
L8239... A Elastic support NOS.... ......... ......... ......... ........... ...........
L8300... A Truss single w/ ......... ......... ......... ........... ...........
standard pad.
L8310... A Truss double w/ ......... ......... ......... ........... ...........
standard pad.
L8320... A Truss addition to std ......... ......... ......... ........... ...........
pad wa.
L8330... A Truss add to std pad ......... ......... ......... ........... ...........
scrotal.
L8400... A Sheath below knee...... ......... ......... ......... ........... ...........
L8410... A Sheath above knee...... ......... ......... ......... ........... ...........
L8415... A Sheath upper limb...... ......... ......... ......... ........... ...........
L8417... A Pros sheath/sock w gel ......... ......... ......... ........... ...........
cushn.
L8420... A Sock wool below knee... ......... ......... ......... ........... ...........
L8430... A Sock wool above knee... ......... ......... ......... ........... ...........
L8435... A Sock wool upper limb... ......... ......... ......... ........... ...........
L8440... A Shrinker below knee.... ......... ......... ......... ........... ...........
L8460... A Shrinker above knee.... ......... ......... ......... ........... ...........
L8465... A Shrinker upper limb.... ......... ......... ......... ........... ...........
L8470... A Stump sock single below ......... ......... ......... ........... ...........
knee.
L8480... A Stump sock single above ......... ......... ......... ........... ...........
knee.
[[Page 47758]]
L8485... A Stump sock fitting uppr ......... ......... ......... ........... ...........
limb.
L8490... A Air seal suction reten ......... ......... ......... ........... ...........
systm.
L8499... A Unlisted misc ......... ......... ......... ........... ...........
prosthetic ser.
L8500... A Artificial larynx...... ......... ......... ......... ........... ...........
L8501... A Tracheostomy speaking ......... ......... ......... ........... ...........
valve.
L8600... A Implant breast silicone/ ......... ......... ......... ........... ...........
eq.
L8603... A Collagen imp urinary ......... ......... ......... ........... ...........
2.5 CC.
L8610... A Ocular implant......... ......... ......... ......... ........... ...........
L8612... A Aqueous shunt ......... ......... ......... ........... ...........
prosthesis.
L8613... A Ossicular implant...... ......... ......... ......... ........... ...........
L8614... A Cochlear device/system. ......... ......... ......... ........... ...........
L8619... A Replace cochlear ......... ......... ......... ........... ...........
processor.
L8630... A Metacarpophalangeal ......... ......... ......... ........... ...........
implant.
L8641... A Metatarsal joint ......... ......... ......... ........... ...........
implant.
L8642... A Hallux implant......... ......... ......... ......... ........... ...........
L8658... A Interphalangeal joint ......... ......... ......... ........... ...........
implnt.
L8670... A Vascular graft, ......... ......... ......... ........... ...........
synthetic.
L8699... A Prosthetic implant NOS. ......... ......... ......... ........... ...........
M0064... X Visit for drug 090 0.85 $45.05 $12.43 $9.01
monitoring.
M0075... E Cellular therapy....... ......... ......... ......... ........... ...........
M0076... E Prolotherapy........... ......... ......... ......... ........... ...........
M0100... E Intragastric ......... ......... ......... ........... ...........
hypothermia.
M0101... E Foot care hygienic/pm.. ......... ......... ......... ........... ...........
M0300... E IV chelation therapy... ......... ......... ......... ........... ...........
M0301... E Fabric wrapping of ......... ......... ......... ........... ...........
aneurysm.
M0302... E Assessment of cardiac ......... ......... ......... ........... ...........
output.
P2028... A Cephalin floculation ......... ......... ......... ........... ...........
test.
P2029... A Congo red blood test... ......... ......... ......... ........... ...........
P2031... E Hair analysis.......... ......... ......... ......... ........... ...........
P2033... A Blood thymol turbidity. ......... ......... ......... ........... ...........
P2038... A Blood mucoprotein...... ......... ......... ......... ........... ...........
P3000... A Screen pap by tech w md ......... ......... ......... ........... ...........
supv.
P3001... A Screening pap smear by ......... ......... ......... ........... ...........
phys.
P7001... E Culture bacterial urine ......... ......... ......... ........... ...........
P9010... N Whole blood for ......... ......... ......... ........... ...........
transfusion.
P9011... N Blood split unit....... ......... ......... ......... ........... ...........
P9012... N Cryoprecipitate each ......... ......... ......... ........... ...........
unit.
P9013... N Unit/s blood fibrinogen ......... ......... ......... ........... ...........
P9014... N Gamma globulin 1 ML.... ......... ......... ......... ........... ...........
P9015... N Rh immune globulin 1 ML ......... ......... ......... ........... ...........
P9016... N Leukocyte poor blood, ......... ......... ......... ........... ...........
unit.
P9017... N One donor fresh frozn ......... ......... ......... ........... ...........
plasma.
P9018... N Plasma protein fract, ......... ......... ......... ........... ...........
unit.
P9019... N Platelet concentrate ......... ......... ......... ........... ...........
unit.
P9020... N Platelet rich plasma ......... ......... ......... ........... ...........
unit.
P9021... N Red blood cells unit... ......... ......... ......... ........... ...........
P9022... N Washed red blood cells ......... ......... ......... ........... ...........
unit.
P9603... N One-way allow prorated ......... ......... ......... ........... ...........
miles.
P9604... N One-way allow prorated ......... ......... ......... ........... ...........
trip.
P9610... E Urine specimen collect ......... ......... ......... ........... ...........
singl.
P9615... E Urine specimen collect ......... ......... ......... ........... ...........
mult.
Q0034... X Admin of influenza 901 0.07 $3.92 $2.49 $.78
vaccine.
Q0035... X Cardiokymography....... 950 0.35 $18.61 $15.82 $3.72
Q0068... T Extracorpeal 369 4.33 $229.19 $97.18 $45.84
plasmapheresis.
Q0081... X Infusion ther other 906 1.46 $77.38 $42.49 $15.48
than che.
Q0082... X Activity therapy w/ ......... ......... ......... ........... ...........
partial h.
Q0083... S Chemo by other than 987 0.65 $34.28 $13.33 $6.86
infusion.
Q0084... S Chemotherapy by 989 1.72 $91.09 $40.68 $18.22
infusion.
Q0085... S Chemo by both infusion 989 1.72 $91.09 $40.68 $18.22
and o.
Q0086... A Physical therapy ......... ......... ......... ........... ...........
evaluation/.
Q0091... T Obtaining screen pap 561 1.52 $80.32 $24.63 $16.06
smear.
Q0092... N Set up port xray ......... ......... ......... ........... ...........
equipment.
Q0111... A Wet mounts/ w ......... ......... ......... ........... ...........
preparations.
Q0112... A Potassium hydroxide ......... ......... ......... ........... ...........
preps.
Q0113... A Pinworm examinations... ......... ......... ......... ........... ...........
Q0114... A Fern test.............. ......... ......... ......... ........... ...........
Q0115... A Post-coital mucous exam ......... ......... ......... ........... ...........
Q0132... A Dispensing fee DME neb ......... ......... ......... ........... ...........
drug.
Q0136... N Non esrd epoetin alpha ......... ......... ......... ........... ...........
inj.
Q0144... E Azithromycin dihydrate, ......... ......... ......... ........... ...........
oral.
Q0156... N Human albumin 5%....... ......... ......... ......... ........... ...........
Q0157... N Human albumin 25%...... ......... ......... ......... ........... ...........
Q9920... A Epoetin with hct <= 20. ......... ......... ......... ........... ...........
Q9921... A Epoetin with hct = 21.. ......... ......... ......... ........... ...........
Q9922... A Epoetin with hct = 22.. ......... ......... ......... ........... ...........
[[Page 47759]]
Q9923... A Epoetin with hct = 23.. ......... ......... ......... ........... ...........
Q9924... A Epoetin with hct = 24.. ......... ......... ......... ........... ...........
Q9925... A Epoetin with hct = 25.. ......... ......... ......... ........... ...........
Q9926... A Epoetin with hct = 26.. ......... ......... ......... ........... ...........
Q9927... A Epoetin with hct = 27.. ......... ......... ......... ........... ...........
Q9928... A Epoetin with hct = 28.. ......... ......... ......... ........... ...........
Q9929... A Epoetin with hct = 29.. ......... ......... ......... ........... ...........
Q9930... A Epoetin with hct = 30.. ......... ......... ......... ........... ...........
Q9931... A Epoetin with hct = 31.. ......... ......... ......... ........... ...........
Q9932... A Epoetin with hct = 32.. ......... ......... ......... ........... ...........
Q9933... A Epoetin with hct = 33.. ......... ......... ......... ........... ...........
Q9934... A Epoetin with hct = 34.. ......... ......... ......... ........... ...........
Q9935... A Epoetin with hct = 35.. ......... ......... ......... ........... ...........
Q9936... A Epoetin with hct = 36.. ......... ......... ......... ........... ...........
Q9937... A Epoetin with hct = 37.. ......... ......... ......... ........... ...........
Q9938... A Epoetin with hct = 38.. ......... ......... ......... ........... ...........
Q9939... A Epoetin with hct = 39.. ......... ......... ......... ........... ...........
Q9940... A Epoetin with hct >= 40. ......... ......... ......... ........... ...........
R0070... N Transport portable x- ......... ......... ......... ........... ...........
ray.
R0075... N Transport port x-ray ......... ......... ......... ........... ...........
multipl.
R0076... N Transport portable EKG. ......... ......... ......... ........... ...........
V2020... A Vision svcs frames ......... ......... ......... ........... ...........
purchases.
V2025... E Eyeglasses delux frames ......... ......... ......... ........... ...........
V2100... A Lens spher single plano ......... ......... ......... ........... ...........
4.00.
V2101... A Single visn sphere 4.12- ......... ......... ......... ........... ...........
7.00.
V2102... A Singl visn sphere 7.12- ......... ......... ......... ........... ...........
20.00.
V2103... A Spherocylindr 4.00d/12- ......... ......... ......... ........... ...........
2.00d.
V2104... A Spherocylindr 4.00d/ ......... ......... ......... ........... ...........
2.12-4d.
V2105... A Spherocylinder 4.00d/ ......... ......... ......... ........... ...........
4.25-6d.
V2106... A Spherocylinder 4.00d/ ......... ......... ......... ........... ...........
>6.00d.
V2107... A Spherocylinder 4.25d/12- ......... ......... ......... ........... ...........
2d.
V2108... A Spherocylinder 4.25d/ ......... ......... ......... ........... ...........
2.12-4d.
V2109... A Spherocylinder 4.25d/ ......... ......... ......... ........... ...........
4.25-6d.
V2110... A Spherocylinder 4.25d/ ......... ......... ......... ........... ...........
over 6d.
V2111... A Spherocylindr 7.25d/.25- ......... ......... ......... ........... ...........
2.25.
V2112... A Spherocylindr 7.25d/ ......... ......... ......... ........... ...........
2.25-4d.
V2113... A Spherocylindr 7.25d/ ......... ......... ......... ........... ...........
4.25-6d.
V2114... A Spherocylinder over ......... ......... ......... ........... ...........
12.00d.
V2115... A Lens lenticular bifocal ......... ......... ......... ........... ...........
V2116... A Nonaspheric lens ......... ......... ......... ........... ...........
bifocal.
V2117... A Aspheric lens bifocal.. ......... ......... ......... ........... ...........
V2118... A Lens aniseikonic single ......... ......... ......... ........... ...........
V2199... A Lens single vision not ......... ......... ......... ........... ...........
oth c.
V2200... A Lens spher bifoc plano ......... ......... ......... ........... ...........
4.00d.
V2201... A Lens sphere bifocal ......... ......... ......... ........... ...........
4.12-7.0.
V2202... A Lens sphere bifocal ......... ......... ......... ........... ...........
7.12-20.
V2203... A Lens sphcyl bifocal ......... ......... ......... ........... ...........
4.00d/.1.
V2204... A Lens sphcy bifocal ......... ......... ......... ........... ...........
4.00d/2.1.
V2205... A Lens sphcy bifocal ......... ......... ......... ........... ...........
4.00d/4.2.
V2206... A Lens sphcy bifocal ......... ......... ......... ........... ...........
4.00d/ove.
V2207... A Lens sphcy bifocal 4.25- ......... ......... ......... ........... ...........
7d/.
V2208... A Lens sphcy bifocal 4.25- ......... ......... ......... ........... ...........
7/2.
V2209... A Lens sphcy bifocal 4.25- ......... ......... ......... ........... ...........
7/4.
V2210... A Lens sphcy bifocal 4.25- ......... ......... ......... ........... ...........
7/ov.
V2211... A Lens sphcy bifo 7.25-12/ ......... ......... ......... ........... ...........
.25-.
V2212... A Lens sphcyl bifo 7.25- ......... ......... ......... ........... ...........
12/2.2.
V2213... A Lens sphcyl bifo 7.25- ......... ......... ......... ........... ...........
12/4.2.
V2214... A Lens sphcyl bifocal ......... ......... ......... ........... ...........
over 12.
V2215... A Lens lenticular bifocal ......... ......... ......... ........... ...........
V2216... A Lens lenticular ......... ......... ......... ........... ...........
nonaspheric.
V2217... A Lens lenticular ......... ......... ......... ........... ...........
aspheric bif.
V2218... A Lens aniseikonic ......... ......... ......... ........... ...........
bifocal.
V2219... A Lens bifocal seg width ......... ......... ......... ........... ...........
over.
V2220... A Lens bifocal add over ......... ......... ......... ........... ...........
3.25d.
V2299... A Lens bifocal speciality ......... ......... ......... ........... ...........
V2300... A Lens sphere trifocal ......... ......... ......... ........... ...........
4.00d.
V2301... A Lens sphere trifocal ......... ......... ......... ........... ...........
4.12-7.
V2302... A Lens sphere trifocal ......... ......... ......... ........... ...........
7.12-20.
V2303... A Lens sphcy trifocal 4.0/ ......... ......... ......... ........... ...........
.12-.
V2304... A Lens sphcy trifocal 4.0/ ......... ......... ......... ........... ...........
2.25.
V2305... A Lens sphcy trifocal 4.0/ ......... ......... ......... ........... ...........
4.25.
V2306... A Lens sphcyl trifocal ......... ......... ......... ........... ...........
4.00/>6.
V2307... A Lens sphcy trifocal ......... ......... ......... ........... ...........
4.25-7/.
V2308... A Lens sphc trifocal 4.25- ......... ......... ......... ........... ...........
7/2.
V2309... A Lens sphc trifocal 4.25- ......... ......... ......... ........... ...........
7/4.
[[Page 47760]]
V2310... A Lens sphc trifocal 4.25- ......... ......... ......... ........... ...........
7/>6.
V2311... A Lens sphc trifo 7.25-12/ ......... ......... ......... ........... ...........
.25-.
V2312... A Lens sphc trifo 7.25-12/ ......... ......... ......... ........... ...........
2.25.
V2313... A Lens sphc trifo 7.25-12/ ......... ......... ......... ........... ...........
4.25.
V2314... A Lens sphcyl trifocal ......... ......... ......... ........... ...........
over 12.
V2315... A Lens lenticular ......... ......... ......... ........... ...........
trifocal.
V2316... A Lens lenticular ......... ......... ......... ........... ...........
nonaspheric.
V2317... A Lens lenticular ......... ......... ......... ........... ...........
aspheric tri.
V2318... A Lens aniseikonic ......... ......... ......... ........... ...........
trifocal.
V2319... A Lens trifocal seg width ......... ......... ......... ........... ...........
> 28.
V2320... A Lens trifocal add over ......... ......... ......... ........... ...........
3.25d.
V2399... A Lens trifocal ......... ......... ......... ........... ...........
speciality.
V2410... A Lens variab asphericity ......... ......... ......... ........... ...........
sing.
V2430... A Lens variable ......... ......... ......... ........... ...........
asphericity bi.
V2499... A Variable asphericity ......... ......... ......... ........... ...........
lens.
V2500... A Contact lens pmma ......... ......... ......... ........... ...........
spherical.
V2501... A Cntct lens pmma-toric/ ......... ......... ......... ........... ...........
prism.
V2502... A Contact lens pmma ......... ......... ......... ........... ...........
bifocal.
V2503... A Cntct lens pmma color ......... ......... ......... ........... ...........
vision.
V2510... A Cntct gas permeable ......... ......... ......... ........... ...........
sphericl.
V2511... A Cntct toric prism ......... ......... ......... ........... ...........
ballast.
V2512... A Cntct lens gas permbl ......... ......... ......... ........... ...........
bifocl.
V2513... A Contact lens extended ......... ......... ......... ........... ...........
wear.
V2520... A Contact lens ......... ......... ......... ........... ...........
hydrophilic.
V2521... A Cntct lens hydrophilic ......... ......... ......... ........... ...........
toric.
V2522... A Cntct lens hydrophil ......... ......... ......... ........... ...........
bifocl.
V2523... A Cntct lens hydrophil ......... ......... ......... ........... ...........
extend.
V2530... A Contact lens gas ......... ......... ......... ........... ...........
impermeable.
V2531... A Contact lens gas ......... ......... ......... ........... ...........
permeable.
V2599... A Contact lens/es other ......... ......... ......... ........... ...........
type.
V2600... A Hand held low vision ......... ......... ......... ........... ...........
aids.
V2610... A Single lens spectacle ......... ......... ......... ........... ...........
mount.
V2615... A Telescop/othr compound ......... ......... ......... ........... ...........
lens.
V2623... A Plastic eye prosth ......... ......... ......... ........... ...........
custom.
V2624... A Polishing artifical eye ......... ......... ......... ........... ...........
V2625... A Enlargemnt of eye ......... ......... ......... ........... ...........
prosthesis.
V2626... A Reduction of eye ......... ......... ......... ........... ...........
prosthesis.
V2627... A Scleral cover shell.... ......... ......... ......... ........... ...........
V2628... A Fabrication & fitting.. ......... ......... ......... ........... ...........
V2629... A Prosthetic eye other ......... ......... ......... ........... ...........
type.
V2630... N Anter chamber intraocul ......... ......... ......... ........... ...........
lens.
V2631... N Iris support intraoclr ......... ......... ......... ........... ...........
lens.
V2632... N Post chmbr intraocular ......... ......... ......... ........... ...........
lens.
V2700... A Balance lens........... ......... ......... ......... ........... ...........
V2710... A Glass/plastic slab off ......... ......... ......... ........... ...........
prism.
V2715... A Prism lens/es.......... ......... ......... ......... ........... ...........
V2718... A Fresnell prism press-on ......... ......... ......... ........... ...........
lens.
V2730... A Special base curve..... ......... ......... ......... ........... ...........
V2740... A Rose tint plastic...... ......... ......... ......... ........... ...........
V2741... A Non-rose tint plastic.. ......... ......... ......... ........... ...........
V2742... A Rose tint glass........ ......... ......... ......... ........... ...........
V2743... A Non-rose tint glass.... ......... ......... ......... ........... ...........
V2744... A Tint photochromatic ......... ......... ......... ........... ...........
lens/es.
V2750... A Anti-reflective coating ......... ......... ......... ........... ...........
V2755... A UV lens/es............. ......... ......... ......... ........... ...........
V2760... A Scratch resistant ......... ......... ......... ........... ...........
coating.
V2770... A Occluder lens/es....... ......... ......... ......... ........... ...........
V2780... A Oversize lens/es....... ......... ......... ......... ........... ...........
V2781... A Progressive lens per ......... ......... ......... ........... ...........
lens.
V2785... N Corneal tissue ......... ......... ......... ........... ...........
processing.
V2799... A Miscellaneous vision ......... ......... ......... ........... ...........
service.
V5008... E Hearing screening...... ......... ......... ......... ........... ...........
V5010... E Assessment for hearing ......... ......... ......... ........... ...........
aid.
V5011... E Hearing aid fitting/ ......... ......... ......... ........... ...........
checking.
V5014... E Hearing aid repair/ ......... ......... ......... ........... ...........
modifying.
V5020... E Conformity evaluation.. ......... ......... ......... ........... ...........
V5030... E Body-worn hearing aid ......... ......... ......... ........... ...........
air.
V5040... E Body-worn hearing aid ......... ......... ......... ........... ...........
bone.
V5050... E Body-worn hearing aid ......... ......... ......... ........... ...........
in ear.
V5060... E Behind ear hearing aid. ......... ......... ......... ........... ...........
V5070... E Glasses air conduction. ......... ......... ......... ........... ...........
V5080... E Glasses bone conduction ......... ......... ......... ........... ...........
V5090... E Hearing aid dispensing ......... ......... ......... ........... ...........
fee.
V5100... E Body-worn bilat hearing ......... ......... ......... ........... ...........
aid.
V5110... E Hearing aid dispensing ......... ......... ......... ........... ...........
fee.
[[Page 47761]]
V5120... E Body-worn binaur ......... ......... ......... ........... ...........
hearing aid.
V5130... E In ear binaural hearing ......... ......... ......... ........... ...........
aid.
V5140... E Behind ear binaur ......... ......... ......... ........... ...........
hearing ai.
V5150... E Glasses binaural ......... ......... ......... ........... ...........
hearing aid.
V5160... E Dispensing fee binaural ......... ......... ......... ........... ...........
V5170... E Within ear cros hearing ......... ......... ......... ........... ...........
aid.
V5180... E Behind ear cros hearing ......... ......... ......... ........... ...........
aid.
V5190... E Glasses cros hearing ......... ......... ......... ........... ...........
aid.
V5200... E Cros hearing aid ......... ......... ......... ........... ...........
dispens fee.
V5210... E In ear bicros hearing ......... ......... ......... ........... ...........
aid.
V5220... E Behind ear bicros ......... ......... ......... ........... ...........
hearing ai.
V5230... E Glasses bicros hearing ......... ......... ......... ........... ...........
aid.
V5240... E Dispensing fee bicros.. ......... ......... ......... ........... ...........
V5299... A Hearing service........ ......... ......... ......... ........... ...........
V5336... E Repair communication ......... ......... ......... ........... ...........
device.
V5362... A Speech screening....... ......... ......... ......... ........... ...........
V5363... A Language screening..... ......... ......... ......... ........... ...........
V5364... A Dysphagia screening.... ......... ......... ......... ........... ...........
----------------------------------------------------------------------------------------------------------------
Addendum C.--Proposed Hospital Outpatient Payment for Procedures by APC
----------------------------------------------------------------------------------------------------------------
Proposed National Minimum
APC CPT \1\/ HCPCS Description Status indicator Relative payment unadjusted unadjusted
HCPCS weight rate coinsurance coinsurance
----------\2\---------------------------------------------------------------------------------------------------
031.. Dental procedures S 1.34 $67.90 $13.58 $13.58
031.. D0150 Comprehensive oral
evaluation
031.. D0240 Intraoral occlusal
film
031.. D0250 Extraoral first film
031.. D0260 Extraoral ea
additional film
031.. D0270 Dental bitewing
single film
031.. D0272 Dental bitewings two
films
031.. D0274 Dental bitewings
four films
031.. D0460 Pulp vitality test
031.. D0471 Diagnostic
photographs
031.. D0501 Histopathologic
examinations
031.. D0502 Other oral pathology
procedure
031.. D0999 Unspecified
diagnostic
procedure
031.. D1510 Space maintainer fxd
unilat
031.. D1515 Fixed bilat space
maintainer
031.. D1520 Remove unilat space
maintain
031.. D1525 Remove bilat space
maintain
031.. D1550 Recement space
maintainer
031.. D2970 Temporary- fractured
tooth
031.. D2999 Dental unspec
restorative pr
031.. D3460 Endodontic
endosseous implan
031.. D3999 Endodontic procedure
031.. D4250 Mucogingival surg
per quadra
031.. D4260 Osseous surgery per
quadrant
031.. D4263 Bone replce graft
first site
031.. D4264 Bone replce graft
each add
031.. D4270 Pedicle soft tissue
graft pr
031.. D4271 Free soft tissue
graft proc
031.. D4273 Subepithelial tissue
graft
031.. D4355 Full mouth
debridement
031.. D4381 Localized chemo
delivery
031.. D5911 Facial moulage
sectional
031.. D5912 Facial moulage
complete
031.. D5983 Radiation applicator
031.. D5984 Radiation shield
031.. D5985 Radiation cone
locator
031.. D5987 Commissure splint
031.. D6920 Dental connector bar
031.. D7110 Oral surgery single
tooth
031.. D7120 Each add tooth
extraction
031.. D7130 Tooth root removal
031.. D7210 Rem imp tooth w
mucoper flp
031.. D7220 Impact tooth remov
soft tiss
031.. D7230 Impact tooth remov
part bony
031.. D7240 Impact tooth remov
comp bony
031.. D7241 Impact tooth rem
bony w/comp
031.. D7250 Tooth root removal
031.. D7260 Oral antral fistula
closure
031.. D7291 Transseptal
fiberotomy
[[Page 47762]]
031.. D7940 Reshaping bone
orthognathic
031.. D9630 Other drugs/
medicaments
031.. D9930 Treatment of
complications
031.. D9940 Dental occlusal
guard
031.. D9950 Occlusion analysis
031.. D9951 Limited occlusal
adjustment
031.. D9952 Complete occlusal
adjustment
031.. K0445 Auricular prosthesis
061.. Level I Chemotherapeutic X 1.04 $52.70 $36.61 $10.54
agents
061.. J8610 Methotrexate oral
2.5 MG
061.. J8999 Oral prescription
drug chemo
061.. J9015 Aldesleukin/single
use vial
061.. J9070 Cyclophosphamide 100
MG inj
061.. J9080 Cyclophosphamide 200
MG inj
061.. J9090 Cyclophosphamide 500
MG inj
061.. J9093 Cyclophosphamide
lyophilized
061.. J9094 Cyclophosphamide
lyophilized
061.. J9095 Cyclophosphamide
lyophilized
061.. J9100 Cytarabine hcl 100
MG inj
061.. J9110 Cytarabine hcl 500
MG inj
061.. J9120 Dactinomycin
actinomycin d
061.. J9130 Dacarbazine 10 MG
inj
061.. J9140 Dacarbazine 200 MG
inj
061.. J9165 Diethylstilbestrol
injection
061.. J9170 Docetaxel
061.. J9181 Etoposide 10 MG inj
061.. J9190 Fluorouracil
injection
061.. J9201 Gemcitabine HCl
061.. J9206 Irinotecan injection
061.. J9214 Interferon alfa-2b
inj
061.. J9215 Interferon alfa-n3
inj
061.. J9218 Leuprolide acetate
injection
061.. J9230 Mechlorethamine hcl
inj
061.. J9250 Methotrexate sodium
inj
061.. J9260 Methotrexate sodium
inj
061.. J9266 Pegaspargase/singl
dose vial
061.. J9350 Topotecan
061.. J9360 Vinblastine sulfate
inj
061.. J9390 Vinorelbine tartrate/
10 mg
061.. J9600 Porfimer sodium
061.. J9999 Chemotherapy drug
062.. Level II Chemotherapeutic X 1.69 $85.63 $36.61 $17.13
agents
062.. J9000 Doxorubic hcl 10 MG
vl chemo
062.. J9020 Asparaginase
injection
062.. J9060 Cisplatin 10 MG
injection
062.. J9065 Inj cladribine per 1
MG
062.. J9091 Cyclophosphamide 1.0
grm inj
062.. J9092 Cyclophosphamide 2.0
grm inj
062.. J9096 Cyclophosphamide
lyophilized
062.. J9097 Cyclophosphamide
lyophilized
062.. J9150 Daunorubicin
062.. J9211 Idarubicin hcl
injection
062.. J9213 Interferon alfa-2a
inj
062.. J9265 Paclitaxel injection
062.. J9268 Pentostatin
injection
062.. J9370 Vincristine sulfate
1 MG inj
063.. Level III Chemotherapeutic X 2.89 $146.43 $110.97 $29.29
agents
063.. J9031 Bcg live
intravesical vac
063.. J9040 Bleomycin sulfate
injection
063.. J9045 Carboplatin
injection
063.. J9050 Carmus bischl nitro
inj
063.. J9062 Cisplatin 50 MG
injection
063.. J9182 Etoposide 100 MG inj
063.. J9185 Fludarabine
phosphate inj
063.. J9200 Floxuridine
injection
063.. J9202 Goserelin acetate
implant
063.. J9208 Ifosfomide injection
063.. J9209 Mesna injection
063.. J9216 Interferon gamma 1-b
inj
063.. J9270 Plicamycin
(mithramycin) inj
063.. J9280 Mitomycin 5 MG inj
063.. J9320 Streptozocin
injection
063.. J9340 Thiotepa injection
063.. J9375 Vincristine sulfate
2 MG inj
[[Page 47763]]
063.. J9380 Vincristine sulfate
5 MG inj
064.. Level IV Chemotherapeutic X 4.17 $211.29 $140.12 $42.26
agents
064.. J0640 Leucovorin calcium
injection
064.. J9217 Leuprolide acetate
suspnsion
064.. J9245 Inj melphalan
hydrochl 50 MG
064.. J9290 Mitomycin 20 MG inj
064.. J9291 Mitomycin 40 MG inj
064.. J9293 Mitoxantrone
hydrochl / 5 MG
089.. Neuropsychological Testing X 2.54 $128.7 $37.29 $25.74
089.. 96100 PSYCHOLOGICAL TESTING (INCLUDES PSYCHODIAGNOSTIC ASSESSMENT OF PERSONALITY, PSYCHOPATHOLOGY,
EMOTIONALITY, INTELLECTUAL ABILITIES, EG, WAIS-R, RORSCHACH, MMPI) WITH INTERPRETATION AND
REPORT, PER HOUR
089.. 96105 ASSESSMENT OF APHASIA (INCLUDES ASSESSMENT OF EXPRESSIVE AND RECEPTIVE SPEECH AND LANGUAGE
FUNCTION, LANGUAGE COMPREHENSION, SPEECH PRODUCTION ABILITY, READING, SPELLING, WRITING, EG,
BY BOSTON DIAGNOSTIC APHASIA EXAMINATION) WITH INTERPRETATION AND REPORT
089.. 96110 DEVELOPMENTAL TESTING; LIMITED (EG, DEVELOPMENTAL SCREENING TEST II, EARLY LANGUAGE MILESTONE
SCREEN), WITH INTERPRETATION AND REPORT
089.. 96111 DEVELOPMENTAL TESTING; EXTENDED (INCLUDES ASSESSMENT OF MOTOR, LANGUAGE, SOCIAL, ADAPTIVE AND/
OR COGNITIVE FUNCTIONING BY STANDARDIZED DEVELOPMENTAL INSTRUMENTS, EG, BAYLEY SCALES OF
INFANT DEVELOPMENT) WITH INTERPRETATION AND REPORT, PER HOUR
089.. 96115 NEUROBEHAVIORAL STATUS EXAM (CLINICAL ASSESSMENT OF THINKING, REASONING AND JUDGMENT, EG,
ACQUIRED KNOWLEDGE, ATTENTION, MEMORY, VISUAL SPATIAL ABILITIES, LANGUAGE FUNCTIONS, PLANNING)
WITH INTERPRETATION AND REPORT, PER HOUR
089.. 96117 NEUROPSYCHOLOGICAL TESTING BATTERY (EG, HALSTEAD-REITAN, LURIA, WAIS-R) WITH INTERPRETATION AND
REPORT, PER HOUR
090.. Monitoring psychiatric drugs X 0.85 $43.07 $12.43 $8.61
090.. 90862 PHARMACOLOGIC MANAGEMENT, INCLUDING PRESCRIPTION, USE, AND REVIEW OF MEDICATION WITH NO MORE
THAN MINIMAL MEDICAL PSYCHOTHERAPY
090.. M0064 Visit for drug monitoring
091.. Brief Individual Psychotherapy S 1.09 $55.23 $14.01 $11.05
091.. 90804 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE
OR OUTPATIENT FACILITY, APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT;
091.. 90805 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE
OR OUTPATIENT FACILITY, APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH
MEDICAL EVALUATION AND MANAGEMENT SERVICES
091.. 90810 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIPMENT, PHYSICAL DEVICES, LANGUAGE
INTERPRETER, OR OTHER MECHANISMS OF NON-VERBAL COMMUNICATION, IN AN OFFICE OR OUTPATIENT
FACILITY, APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT;
091.. 90811 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIPMENT, PHYSICAL DEVICES, LANGUAGE
INTERPRETER, OR OTHER MECHANISMS OF NON-VERBAL COMMUNICATION, IN AN OFFICE OR OUTPATIENT
FACILITY, APPROXIMATELY 20 TO 30 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH M
091.. 90899 UNLISTED PSYCHIATRIC SERVICE OR PROCEDURE
092.. Extended Individual S 1.57 $79.55 $21.92 $15.91
Psychotherapy
092.. 90801 PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAMINATION
092.. 90802 INTERACTIVE PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAMINATION USING PLAY EQUIPMENT, PHYSICAL
DEVICES, LANGUAGE INTERPRETER, OR OTHER MECHANISMS OF COMMUNICATION
092.. 90806 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE
OR OUTPATIENT FACILITY, APPROXIMATELY 45 TO 50 MINUTES FACE-TO-FACE WITH THE PATIENT;
092.. 90807 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE
OR OUTPATIENT FACILITY, APPROXIMATELY 45 TO 50 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH
MEDICAL EVALUATION AND MANAGEMENT SERVICES
092.. 90808 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE
OR OUTPATIENT FACILITY, APPROXIMATELY 75 TO 80 MINUTES FACE-TO-FACE WITH THE PATIENT;
092.. 90809 INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, BEHAVIOR MODIFYING AND/OR SUPPORTIVE, IN AN OFFICE
OR OUTPATIENT FACILITY, APPROXIMATELY 75 TO 80 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH
MEDICAL EVALUATION AND MANAGEMENT SERVICES
092.. 90812 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIPMENT, PHYSICAL DEVICES, LANGUAGE
INTERPRETER, OR OTHER MECHANISMS OF NON-VERBAL COMMUNICATION, IN AN OFFICE OR OUTPATIENT
FACILITY, APPROXIMATELY 45 TO 50 MINUTES FACE-TO-FACE WITH THE PATIENT;
092.. 90813 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIPMENT, PHYSICAL DEVICES, LANGUAGE
INTERPRETER, OR OTHER MECHANISMS OF NON-VERBAL COMMUNICATION, IN AN OFFICE OR OUTPATIENT
FACILITY, APPROXIMATELY 45 TO 50 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH M
092.. 90814 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIPMENT, PHYSICAL DEVICES, LANGUAGE
INTERPRETER, OR OTHER MECHANISMS OF NON-VERBAL COMMUNICATION, IN AN OFFICE OR OUTPATIENT
FACILITY, APPROXIMATELY 75 TO 80 MINUTES FACE-TO-FACE WITH THE PATIENT;
092.. 90815 INDIVIDUAL PSYCHOTHERAPY, INTERACTIVE, USING PLAY EQUIPMENT, PHYSICAL DEVICES, LANGUAGE
INTERPRETER, OR OTHER MECHANISMS OF NON-VERBAL COMMUNICATION, IN AN OFFICE OR OUTPATIENT
FACILITY, APPROXIMATELY 75 TO 80 MINUTES FACE-TO-FACE WITH THE PATIENT; WITH M
092.. 90845 PSYCHOANALYSIS
092.. 90865 NARCOSYNTHESIS FOR PSYCHIATRIC DIAGNOSTIC AND THERAPEUTIC PURPOSES (EG, SODIUM AMOBARBITAL
(AMYTAL) INTERVIEW
092.. 90880 HYPNOTHERAPY
093.. Family Psychotherapy
S 1.54 $78.03 $20.11 $15.61
[[Page 47764]]
093.. 90846 FAMILY PSYCHOTHERAPY (WITHOUT THE PATIENT PRESENT)
093.. 90847 FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTHERAPY) (WITH PATIENT PRESENT)
094.. Group Psychotherapy S 1.24 $62.83 $20.11 $12.57
094.. 90849 MULTIPLE-FAMILY GROUP PSYCHOTHERAPY
094.. 90853 GROUP PSYCHOTHERAPY (OTHER THAN OF A MULTIPLE-FAMILY GROUP)
094.. 90857 INTERACTIVE GROUP PSYCHOTHERAPY
121.. Level I needle biopsy/ T 0.67 $33.95 $20.91 $6.79
aspiration
121.. 17999 UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE
121.. 19000 PUNCTURE ASPIRATION OF CYST OF BREAST;
121.. 19001 PUNCTURE ASPIRATION OF CYST OF BREAST; EACH ADDITIONAL CYST
121.. 20615 ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYST
121.. 55000 PUNCTURE ASPIRATION OF HYDROCELE, TUNICA VAGINALIS, WITH OR WITHOUT INJECTION OF MEDICATION
121.. 60001 ASPIRATION AND/OR INJECTION, THYROID CYST
121.. 60699 UNLISTED PROCEDURE, ENDOCRINE SYSTEM
121.. 85095 BONE MARROW; ASPIRATION ONLY
121.. 85102 BONE MARROW BIOPSY, NEEDLE OR TROCAR
121.. 88170 FINE NEEDLE ASPIRATION WITH OR WITHOUT PREPARATION OF SMEARS; SUPERFICIAL TISSUE (EG, THYROID,
BREAST, PROSTATE
121.. 88171 FINE NEEDLE ASPIRATION WITH OR WITHOUT PREPARATION OF SMEARS; DEEP TISSUE UNDER RADIOLOGIC
GUIDANCE
122.. Level II needle biopsy/ T 4.87 $246.76 $115.03 $49.35
aspiration
122.. 19100 BIOPSY OF BREAST; NEEDLE CORE (SEPARATE PROCEDURE)
122.. 20206 BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE
122.. 32400 BIOPSY, PLEURA; PERCUTANEOUS NEEDLE
122.. 32405 BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE
122.. 38505 BIOPSY OR EXCISION OF LYMPH NODE(S); BY NEEDLE, SUPERFICIAL (EG, CERVICAL, INGUINAL, AXILLARY)
122.. 42400 BIOPSY OF SALIVARY GLAND; NEEDLE
122.. 47000 BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS
122.. 47399 UNLISTED PROCEDURE, LIVER
122.. 48102 BIOPSY OF PANCREAS, PERCUTANEOUS NEEDLE
122.. 48999 UNLISTED PROCEDURE, PANCREAS
122.. 49180 BIOPSY, ABDOMINAL OR RETROPERITONEAL MASS, PERCUTANEOUS NEEDLE
122.. 50200 RENAL BIOPSY; PERCUTANEOUS, BY TROCAR OR NEEDLE
122.. 50390 ASPIRATION AND/OR INJECTION OF RENAL CYST OR PELVIS BY NEEDLE, PERCUTANEOUS
122.. 54500 BIOPSY OF TESTIS, NEEDLE (SEPARATE PROCEDURE)
122.. 54800 BIOPSY OF EPIDIDYMIS, NEEDLE
122.. 60100 BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE
122.. 62269 BIOPSY OF SPINAL CORD, PERCUTANEOUS NEEDLE
122.. 67415 FINE NEEDLE ASPIRATION OF ORBITAL CONTENTS
131.. Level I incision & drainage T 1.94 $98.30 $36.61 $19.66
131.. 10040 ACNE SURGERY (EG, MARSUPIALIZATION, OPENING OR REMOVAL OF MULTIPLE MILIA, COMEDONES, CYSTS,
PUSTULES)
131.. 10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR
SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA); SIMPLE OR SINGLE
131.. 10061 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR
SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA); COMPLICATED OR MULTIPLE
131.. 10080 INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE
131.. 10081 INCISION AND DRAINAGE OF PILONIDAL CYST; COMPLICATED
131.. 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE
131.. 10140 INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION
131.. 10160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST
131.. 10180 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION
131.. 11976 REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSULES
131.. 20000 INCISION OF SOFT TISSUE ABSCESS (EG, SECONDARY TO OSTEOMYELITIS); SUPERFICIAL
131.. 26010 DRAINAGE OF FINGER ABSCESS; SIMPLE
131.. 26011 DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON)
131.. 69000 DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; SIMPLE
131.. 69005 DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED
131.. 69020 DRAINAGE EXTERNAL AUDITORY CANAL, ABSCESS
132.. Level II incision & drainage T 6.04 $306.04 $134.13 $61.21
132.. 19020 MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP
132.. 20950 MONITORING OF INTERSTITIAL FLUID PRESSURE (INCLUDES INSERTION OF DEVICE, EG, WICK CATHETER
TECHNIQUE, NEEDLE MANOMETER TECHNIQUE) IN DETECTION OF MUSCLE COMPARTMENT SYNDROME
132.. 21501 INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX;
132.. 21700 DIVISION OF SCALENUS ANTICUS; WITHOUT RESECTION OF CERVICAL RIB
132.. 21720 DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, OPEN OPERATION; WITHOUT CAST APPLICATION
132.. 21725 DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, OPEN OPERATION; WITH CAST APPLICATION
132.. 23030 INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR HEMATOMA
132.. 23031 INCISION AND DRAINAGE, SHOULDER AREA; INFECTED BURSA
132.. 23930 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESS OR HEMATOMA
132.. 23931 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; INFECTED BURSA
132.. 27301 INCISION AND DRAINAGE OF DEEP ABSCESS, INFECTED BURSA, OR HEMATOMA, THIGH OR KNEE REGION
132.. 27603 INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS OR HEMATOMA
132.. 28001 INCISION AND DRAINAGE, INFECTED BURSA, FOOT
132.. 38300 DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; SIMPLE
[[Page 47765]]
132.. 38305 DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; EXTENSIVE
132.. 38999 UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM
132.. 51080 DRAINAGE OF PERIVESICAL OR PREVESICAL SPACE ABSCESS
132.. 54015 INCISION AND DRAINAGE OF PENIS, DEEP
132.. 54115 REMOVAL FOREIGN BODY FROM DEEP PENILE TISSUE (EG, PLASTIC IMPLANT)
132.. 55100 DRAINAGE OF SCROTAL WALL ABSCESS
137.. Nail procedures T 0.46 $23.31 $4.66 $4.66
137.. 11719 TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER
137.. 11720 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVE
137.. 11721 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MORE
137.. 11740 EVACUATION OF SUBUNGUAL HEMATOMA
137.. 11755 BIOPSY OF NAIL UNIT, ANY METHOD (EG, PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL AND LATERAL NAIL
FOLDS) (SEPARATE PROCEDURE)
141.. Level I Destruction of lesion T 0.59 $29.90 $9.49 $5.98
141.. 17000 DESTRUCTION BY ANY METHOD, INCLUDING LASER, WITH OR WITHOUT SURGICAL CURETTEMENT, ALL BENIGN OR
PREMALIGNANT LESIONS (EG, ACTINIC KERATOSES) OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR
PROLIFERATIVE LESIONS, INCLUDING LOCAL ANESTHESIA; FIRST LESION
141.. 17003 DESTRUCTION BY ANY METHOD, INCLUDING LASER, WITH OR WITHOUT SURGICAL CURETTEMENT, ALL BENIGN OR
PREMALIGNANT LESIONS (EG, ACTINIC KERATOSES) OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR
PROLIFERATIVE LESIONS, INCLUDING LOCAL ANESTHESIA; SECOND THROUGH 14 LE
141.. 17106 DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, LASER TECHNIQUE); LESS THAN 10 SQ
CM
141.. 17110 DESTRUCTION BY ANY METHOD OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; UP TO 14 LESIONS
142.. Level II Destruction of lesion T 3.77 $191.02 $73.00 $38.20
142.. 17004 DESTRUCTION BY ANY METHOD, INCLUDING LASER, WITH OR WITHOUT SURGICAL CURETTEMENT, ALL BENIGN OR
PREMALIGNANT LESIONS (EG, ACTINIC KERATOSES) OTHER THAN SKIN TAGS OR CUTANEOUS VASCULAR
PROLIFERATIVE LESIONS, INCLUDING LOCAL ANESTHESIA; 15 OR MORE LESIONS
142.. 17107 DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, LASER TECHNIQUE); 10.0-50.0 SQ CM
142.. 17108 DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS (EG, LASER TECHNIQUE); OVER 50.0 SQ CM
142.. 17111 DESTRUCTION BY ANY METHOD OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; 15 OR MORE LESIONS
151.. Level I debridement/ T 1.74 $88.16 $35.71 $17.63
destruction
151.. 11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE
151.. 11001 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; EACH ADDITIONAL 10% OF THE BODY SURFACE
151.. 11040 DEBRIDEMENT; SKIN, PARTIAL THICKNESS
151.. 11041 DEBRIDEMENT; SKIN, FULL THICKNESS
151.. 11042 DEBRIDEMENT; SKIN, AND SUBCUTANEOUS TISSUE
151.. 11055 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION
151.. 11056 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); TWO TO FOUR LESIONS
151.. 11057 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN FOUR LESIONS
151.. 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 LESIONS
151.. 11201 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; EACH ADDITIONAL TEN LESIONS
151.. 11300 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5
CM OR LESS
151.. 11301 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6
TO 1.0 CM
151.. 11302 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1
TO 2.0 CM
151.. 11303 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER OVER
2.0 CM
151.. 11305 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA;
LESION DIAMETER 0.5 CM OR LESS
151.. 11306 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA;
LESION DIAMETER 0.6 TO 1.0 CM
151.. 11307 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA;
LESION DIAMETER 1.1 TO 2.0 CM
151.. 11308 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA;
LESION DIAMETER OVER 2.0 CM
151.. 11310 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS
MEMBRANE; LESION DIAMETER 0.5 CM OR LESS
151.. 11311 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS
MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM
151.. 11312 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS
MEMBRANE; LESION DIAMETER 1.1 TO 2.0 CM
151.. 11313 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS
MEMBRANE; LESION DIAMETER OVER 2.0 CM
151.. 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE
151.. 11731 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SECOND NAIL PLATE
151.. 11732 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH ADDITIONAL NAIL PLATE
151.. 11765 WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWN TOENAIL)
151.. 11900 INJECTION, INTRALESIONAL; UP TO AND INCLUDING SEVEN LESIONS
151.. 11901 INJECTION, INTRALESIONAL; MORE THAN SEVEN LESIONS
151.. 15783 DERMABRASION; SUPERFICIAL, ANY SITE, (EG, TATTOO REMOVAL)
151.. 15786 ABRASION; SINGLE LESION (EG, KERATOSIS, SCAR)
151.. 15787 ABRASION; EACH ADDITIONAL FOUR LESIONS OR LESS
151.. 15788 CHEMICAL PEEL, FACIAL; EPIDERMAL
151.. 15789 CHEMICAL PEEL, FACIAL; DERMAL
151.. 15792 CHEMICAL PEEL, NONFACIAL; EPIDERMAL
151.. 15793 CHEMICAL PEEL, NONFACIAL; DERMAL
[[Page 47766]]
151.. 15810 SALABRASION; 20 SQ CM OR LESS
151.. 15850 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAME SURGEON
151.. 15851 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), OTHER SURGEON
151.. 15852 DRESSING CHANGE (FOR OTHER THAN BURNS) UNDER ANESTHESIA (OTHER THAN LOCAL)
151.. 16000 INITIAL TREATMENT, FIRST DEGREE BURN, WHEN NO MORE THAN LOCAL TREATMENT IS REQUIRED
151.. 16020 DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, OFFICE OR HOSPITAL,
SMALL
151.. 16025 DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, MEDIUM (EG, WHOLE FACE
OR WHOLE EXTREMITY)
151.. 16030 DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; WITHOUT ANESTHESIA, LARGE (EG, MORE THAN
ONE EXTREMITY)
151.. 17250 CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA)
151.. 17260 DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS
151.. 17261 DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM
151.. 17262 DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM
151.. 17263 DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM
151.. 17264 DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM
151.. 17266 DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 4.0 CM
151.. 17270 DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER
0.5 CM OR LESS
151.. 17271 DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER
0.6 TO 1.0 CM
151.. 17272 DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER
1.1 TO 2.0 CM
151.. 17273 DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER
2.1 TO 3.0 CM
151.. 17274 DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER
3.1 TO 4.0 CM
151.. 17276 DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER
OVER 4.0 CM
151.. 17280 DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE;
LESION DIAMETER 0.5 CM OR LESS
151.. 17281 DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE;
LESION DIAMETER 0.6 TO 1.0 CM
151.. 17282 DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE;
LESION DIAMETER 1.1 TO 2.0 CM
151.. 17283 DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE;
LESION DIAMETER 2.1 TO 3.0 CM
151.. 17284 DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE;
LESION DIAMETER 3.1 TO 4.0 CM
151.. 17286 DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE;
LESION DIAMETER OVER 4.0 CM
151.. 17340 CRYOTHERAPY (CO2 SLUSH, LIQUID N2) FOR ACNE
151.. 17360 CHEMICAL EXFOLIATION FOR ACNE (EG, ACNE PASTE, ACID)
151.. 17380 ELECTROLYSIS EPILATION, EACH 1/2 HOUR
151.. 42809 REMOVAL OF FOREIGN BODY FROM PHARYNX
151.. 69220 DEBRIDEMENT, MASTOIDECTOMY CAVITY, SIMPLE (EG, ROUTINE CLEANING)
152.. Level II debridement/ T 10.43 $528.48 $261.71 $105.7
destruction
152.. 16010 DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; UNDER ANESTHESIA, SMALL
152.. 16015 DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT; UNDER ANESTHESIA, MEDIUM OR LARGE, OR WITH
MAJOR DEBRIDEMENT
152.. 46900 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; CHEMICAL
152.. 46910 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; ELECTRODESICCATION
152.. 46916 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; CRYOSURGERY
152.. 46917 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; LASER SURGERY
152.. 46922 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; SURGICAL EXCISION
152.. 46924 DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), EXTENSIVE, ANY METHOD
152.. 54050 DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; CHEMICAL
152.. 54055 DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; ELECTRODESICCATION
152.. 54056 DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; CRYOSURGERY
152.. 54057 DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; LASER SURGERY
152.. 54060 DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), SIMPLE; SURGICAL EXCISION
152.. 54065 DESTRUCTION OF LESION(S), PENIS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC
VESICLE), EXTENSIVE, ANY METHOD
152.. 56501 DESTRUCTION OF LESION(S), VULVA; SIMPLE, ANY METHOD
152.. 56515 DESTRUCTION OF LESION(S), VULVA; EXTENSIVE, ANY METHOD
161.. Level I excision/biopsy T 3.50 $177.34 $75.48 $35.47
161.. 11100 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS
OTHERWISE LISTED (SEPARATE PROCEDURE); SINGLE LESION
161.. 11101 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS
OTHERWISE LISTED (SEPARATE PROCEDURE); EACH SEPARATE/ADDITIONAL LESION
[[Page 47767]]
161.. 11400 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION
DIAMETER 0.5 CM OR LESS
161.. 11401 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION
DIAMETER 0.6 TO 1.0 CM
161.. 11402 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION
DIAMETER 1.1 TO 2.0 CM
161.. 11403 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION
DIAMETER 2.1 TO 3.0 CM
161.. 11420 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 0.5 CM OR LESS
161.. 11421 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM
161.. 11422 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM
161.. 11423 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM
161.. 11440 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS,
MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS
161.. 11441 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS,
MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM
161.. 11442 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS,
MUCOUS MEMBRANE; LESION DIAMETER 1.1 TO 2.0 CM
161.. 11443 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS,
MUCOUS MEMBRANE; LESION DIAMETER 2.1 TO 3.0 CM
161.. 11600 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION DIAMETER 0.5 CM OR LESS
161.. 11601 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM
161.. 11602 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM
161.. 11603 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM
161.. 11620 EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS
161.. 11621 EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM
161.. 11622 EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM
161.. 11623 EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM
161.. 11640 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 0.5 CM OR LESS
161.. 11641 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 0.6 TO 1.0 CM
161.. 11642 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 1.1 TO 2.0 CM
161.. 11643 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 2.1 TO 3.0 CM
161.. 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR
PERMANENT REMOVAL;
161.. 20520 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE
161.. 21550 BIOPSY, SOFT TISSUE OF NECK OR THORAX
161.. 21920 BIOPSY, SOFT TISSUE OF BACK OR FLANK; SUPERFICIAL
161.. 23065 BIOPSY, SOFT TISSUE OF SHOULDER AREA; SUPERFICIAL
161.. 24065 BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; SUPERFICIAL
161.. 24200 REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA; SUBCUTANEOUS
161.. 25065 BIOPSY, SOFT TISSUE OF FOREARM AND/OR WRIST; SUPERFICIAL
161.. 27613 BIOPSY, SOFT TISSUE OF LEG OR ANKLE AREA; SUPERFICIAL
161.. 28190 REMOVAL OF FOREIGN BODY, FOOT; SUBCUTANEOUS
161.. 56605 BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); ONE LESION
161.. 56606 BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION
161.. 58999 UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)
161.. 69100 BIOPSY EXTERNAL EAR
161.. 69105 BIOPSY EXTERNAL AUDITORY CANAL
162.. Level II excision/biopsy T 5.67 $287.30 $125.43 $57.46
162.. 11043 DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, AND MUSCLE
162.. 11044 DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, MUSCLE, AND BONE
162.. 11404 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION
DIAMETER 3.1 TO 4.0 CM
162.. 11424 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM
162.. 11444 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS,
MUCOUS MEMBRANE; LESION DIAMETER 3.1 TO 4.0 CM
162.. 11604 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM
162.. 11770 EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE
162.. 16035 ESCHAROTOMY
162.. 16040 EXCISION BURN WOUND, WITHOUT SKIN GRAFTING, EMPLOYING ALLOPLASTIC DRESSING (EG, SYNTHETIC
MESH), ANY ANATOMIC SITE; UP TO ONE PERCENT TOTAL BODY SURFACE AREA
162.. 16041 EXCISION BURN WOUND, WITHOUT SKIN GRAFTING, EMPLOYING ALLOPLASTIC DRESSING (EG, SYNTHETIC
MESH), ANY ANATOMIC SITE; GREATER THAN ONE PERCENT AND UP TO NINE PERCENT TOTAL BODY SURFACE
AREA
162.. 16042 EXCISION BURN WOUND, WITHOUT SKIN GRAFTING, EMPLOYING ALLOPLASTIC DRESSING (EG, SYNTHETIC
MESH), ANY ANATOMIC SITE; EACH ADDITIONAL NINE PERCENT TOTAL BODY SURFACE AREA, OR PART
THEREOF
162.. 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; FI
162.. 17305 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; SE
[[Page 47768]]
162.. 17306 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; TH
162.. 17307 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; AD
162.. 17310 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; MO
162.. 20200 BIOPSY, MUSCLE; SUPERFICIAL
162.. 20205 BIOPSY, MUSCLE; DEEP
162.. 20220 BIOPSY, BONE, TROCAR, OR NEEDLE; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS)
162.. 20225 BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (VERTEBRAL BODY, FEMUR)
162.. 20670 REMOVAL OF IMPLANT; SUPERFICIAL, (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)
162.. 23000 REMOVAL OF SUBDELTOID (OR INTRATENDINOUS) CALCAREOUS DEPOSITS, OPEN METHOD
162.. 23075 EXCISION, TUMOR, SHOULDER AREA; SUBCUTANEOUS
162.. 24075 EXCISION, TUMOR, UPPER ARM OR ELBOW AREA; SUBCUTANEOUS
162.. 25075 EXCISION, TUMOR, FOREARM AND/OR WRIST AREA; SUBCUTANEOUS
162.. 27040 BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA; SUPERFICIAL
162.. 27323 BIOPSY, SOFT TISSUE OF THIGH OR KNEE AREA; SUPERFICIAL
162.. 28043 EXCISION, TUMOR, FOOT; SUBCUTANEOUS
162.. 37609 LIGATION OR BIOPSY, TEMPORAL ARTERY
162.. 37799 UNLISTED PROCEDURE, VASCULAR SURGERY
162.. 54100 BIOPSY OF PENIS; CUTANEOUS (SEPARATE PROCEDURE)
162.. 54105 BIOPSY OF PENIS; DEEP STRUCTURES
162.. 67350 BIOPSY OF EXTRAOCULAR MUSCLE
162.. 67399 UNLISTED PROCEDURE, OCULAR MUSCLE
162.. 68100 BIOPSY OF CONJUNCTIVA
162.. 68110 EXCISION OF LESION, CONJUNCTIVA; UP TO 1 CM
162.. 68115 EXCISION OF LESION, CONJUNCTIVA; OVER 1 CM
162.. 68135 DESTRUCTION OF LESION, CONJUNCTIVA
162.. 68399 UNLISTED PROCEDURE, CONJUNCTIVA
163.. Level III excision/biopsy T 10.69 $541.66 $264.65 $108.33
163.. 10121 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED
163.. 11010 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED WITH OPEN FRACTURE(S) AND/OR
DISLOCATION(S); SKIN AND SUBCUTANEOUS TISSUES
163.. 11011 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED WITH OPEN FRACTURE(S) AND/OR
DISLOCATION(S); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, AND MUSCLE
163.. 11012 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED WITH OPEN FRACTURE(S) AND/OR
DISLOCATION(S); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, MUSCLE, AND BONE
163.. 11406 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION
DIAMETER OVER
163.. 11426 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER OVER 4.0 CM
163.. 11446 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS,
MUCOUS MEMBRANE; LESION DIAMETER OVER 4.0 CM
163.. 11450 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH SIMPLE OR
INTERMEDIATE REPAIR
163.. 11451 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, AXILLARY; WITH COMPLEX REPAIR
163.. 11462 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH SIMPLE OR
INTERMEDIATE REPAIR
163.. 11463 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, INGUINAL; WITH COMPLEX REPAIR
163.. 11470 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, PERIANAL, PERINEAL, OR UMBILICAL;
WITH SIMPLE OR INTERMEDIATE REPAIR
163.. 11471 EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENITIS, PERIANAL, PERINEAL, OR UMBILICAL;
WITH COMPLEX REPAIR
163.. 11606 EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION DIAMETER OVER 4.0 CM
163.. 11624 EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM
163.. 11626 EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 4.0 CM
163.. 11644 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 3.1 TO 4.0 CM
163.. 11646 EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER OVER 4.0 CM
163.. 11752 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR
PERMANENT REMOVAL; WITH AMPUTATION OF TUFT OF DISTAL PHALANX
163.. 11771 EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
163.. 11772 EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED
163.. 11971 REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF PROSTHESIS
163.. 15780 DERMABRASION; TOTAL FACE (EG, FOR ACNE SCARRING, FINE WRINKLING, RHYTIDS, GENERAL KERATOSIS)
163.. 15781 DERMABRASION; SEGMENTAL, FACE
163.. 15782 DERMABRASION; REGIONAL, OTHER THAN FACE
163.. 15811 SALABRASION; OVER 20 SQ CM
163.. 15838 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); SUBMENTAL FAT PAD
163.. 15920 EXCISION, COCCYGEAL PRESSURE ULCER, WITH COCCYGECTOMY; WITH PRIMARY SUTURE
163.. 15931 EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTURE;
163.. 15933 EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTURE; WITH OSTECTOMY
163.. 15940 EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUTURE;
163.. 15941 EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUTURE; WITH OSTECTOMY (ISCHIECTOMY)
163.. 15950 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMARY SUTURE;
163.. 15951 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMARY SUTURE; WITH OSTECTOMY
163.. 15999 UNLISTED PROCEDURE, EXCISION PRESSURE ULCER
[[Page 47769]]
163.. 20240 BIOPSY, EXCISIONAL; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS, TROCHANTER OF
FEMUR)
163.. 20245 BIOPSY, EXCISIONAL; DEEP (EG, HUMERUS, ISCHIUM, FEMUR)
163.. 20525 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR COMPLICATED
163.. 20680 REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METAL BAND, NAIL, ROD OR PLATE)
163.. 21555 EXCISION TUMOR, SOFT TISSUE OF NECK OR THORAX; SUBCUTANEOUS
163.. 21556 EXCISION TUMOR, SOFT TISSUE OF NECK OR THORAX; DEEP, SUBFASCIAL, INTRAMUSCULAR
163.. 21925 BIOPSY, SOFT TISSUE OF BACK OR FLANK; DEEP
163.. 21930 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK
163.. 21935 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF BACK OR FLANK
163.. 22900 EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL (EG, DESMOID)
163.. 22999 UNLISTED PROCEDURE, ABDOMEN, MUSCULOSKELETAL SYSTEM
163.. 23066 BIOPSY, SOFT TISSUE OF SHOULDER AREA; DEEP
163.. 23076 EXCISION, TUMOR, SHOULDER AREA; DEEP, SUBFASCIAL, OR INTRAMUSCULAR
163.. 23077 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF SHOULDER AREA
163.. 23330 REMOVAL OF FOREIGN BODY, SHOULDER; SUBCUTANEOUS
163.. 23331 REMOVAL OF FOREIGN BODY, SHOULDER; DEEP (EG, NEER PROSTHESIS REMOVAL)
163.. 24066 BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; DEEP
163.. 24076 EXCISION, TUMOR, UPPER ARM OR ELBOW AREA; DEEP, SUBFASCIAL OR INTRAMUSCULAR
163.. 24077 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF UPPER ARM OR ELBOW AREA
163.. 24201 REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA; DEEP
163.. 25066 BIOPSY, SOFT TISSUE OF FOREARM AND/OR WRIST; DEEP
163.. 25076 EXCISION, TUMOR, FOREARM AND/OR WRIST AREA; DEEP, SUBFASCIAL OR INTRAMUSCULAR
163.. 25077 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOREARM AND/OR WRIST AREA
163.. 26115 EXCISION, TUMOR OR VASCULAR MALFORMATION, HAND OR FINGER; SUBCUTANEOUS
163.. 26116 EXCISION, TUMOR OR VASCULAR MALFORMATION, HAND OR FINGER; DEEP, SUBFASCIAL, INTRAMUSCULAR
163.. 26117 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF HAND OR FINGER
163.. 26320 REMOVAL OF IMPLANT FROM FINGER OR HAND
163.. 27041 BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA; DEEP
163.. 27047 EXCISION, TUMOR, PELVIS AND HIP AREA; SUBCUTANEOUS
163.. 27048 EXCISION, TUMOR, PELVIS AND HIP AREA; DEEP, SUBFASCIAL, INTRAMUSCULAR
163.. 27049 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF PELVIS AND HIP AREA
163.. 27324 BIOPSY, SOFT TISSUE OF THIGH OR KNEE AREA; DEEP
163.. 27327 EXCISION, TUMOR, THIGH OR KNEE AREA; SUBCUTANEOUS
163.. 27328 EXCISION, TUMOR, THIGH OR KNEE AREA; DEEP, SUBFASCIAL, OR INTRAMUSCULAR
163.. 27329 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF THIGH OR KNEE AREA
163.. 27372 REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA
163.. 27614 BIOPSY, SOFT TISSUE OF LEG OR ANKLE AREA; DEEP
163.. 27618 EXCISION, TUMOR, LEG OR ANKLE AREA; SUBCUTANEOUS
163.. 27619 EXCISION, TUMOR, LEG OR ANKLE AREA; DEEP, SUBFASCIAL OR INTRAMUSCULAR
163.. 28192 REMOVAL OF FOREIGN BODY, FOOT; DEEP
163.. 28193 REMOVAL OF FOREIGN BODY, FOOT; COMPLICATED
163.. 69110 EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR
163.. 69145 EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL
163.. 69205 REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA
181.. Level I skin repair T 2.19 $110.97 $43.84 $22.19
181.. 11760 REPAIR OF NAIL BED
181.. 11762 RECONSTRUCTION OF NAIL BED WITH GRAFT
181.. 11920 TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS OF
SKIN, INCLUDING MICROPIGMENTATION; 6.0 SQ CM OR LESS
181.. 11921 TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS OF
SKIN, INCLUDING MICROPIGMENTATION; 6.1 TO 20.0 SQ CM
181.. 11922 TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE OPAQUE PIGMENTS TO CORRECT COLOR DEFECTS OF
SKIN, INCLUDING MICROPIGMENTATION; EACH ADDITIONAL 20.0 SQ CM
181.. 11950 SUBCUTANEOUS INJECTION OF ''FILLING'' MATERIAL (EG, COLLAGEN); 1 CC OR LESS
181.. 11951 SUBCUTANEOUS INJECTION OF ''FILLING'' MATERIAL (EG, COLLAGEN); 1.1 TO 5.0 CC
181.. 11952 SUBCUTANEOUS INJECTION OF ''FILLING'' MATERIAL (EG, COLLAGEN); 5.1 TO 10.0 CC
181.. 11954 SUBCUTANEOUS INJECTION OF ''FILLING'' MATERIAL (EG, COLLAGEN); OVER 10.0 CC
181.. 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
181.. 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
181.. 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
181.. 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
181.. 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
181.. 12007 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR
EXTREMITIES (INCLUDING HANDS AND FEET); OVER 30.0 CM
181.. 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
2.5 CM OR LESS
181.. 12013 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
2.6 CM TO 5.0 CM
181.. 12014 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
5.1 CM TO 7.5 CM
181.. 12015 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
7.6 CM TO 12.5 CM
181.. 12016 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
12.6 CM TO 20.0 CM
[[Page 47770]]
181.. 12017 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
20.1 CM TO 30.0 CM
181.. 12018 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES;
OVER 30.0 CM
181.. 12020 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE
181.. 12021 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; WITH PACKING
181.. 12031 LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
2.5 CM OR LESS
181.. 12032 LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
2.6 CM TO 7.5 CM
181.. 12034 LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
7.6 CM TO 12.5 CM
181.. 12035 LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
12.6 CM TO 20.0 CM
181.. 12036 LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
20.1 CM TO 30.0 CM
181.. 12041 LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.5 CM OR LESS
181.. 12042 LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO 7.5 CM
181.. 12044 LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6 CM TO 12.5 CM
181.. 12045 LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 12.6 CM TO 20.0 CM
181.. 12046 LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 20.1 CM TO 30.0 CM
181.. 12051 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR
LESS
181.. 12052 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.6 CM TO
5.0 CM
181.. 12053 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 5.1 CM TO
7.5 CM
181.. 12054 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 7.6 CM TO
12.5 CM
181.. 12055 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 12.6 CM TO
20.0 CM
181.. 12056 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 20.1 CM TO
30.0 CM
181.. 20500 INJECTION OF SINUS TRACT; THERAPEUTIC (SEPARATE PROCEDURE)
182.. Level II skin repair T 4. $202.68 $84.98 $40.54
182.. 13100 REPAIR, COMPLEX, TRUNK; 1.1 CM TO 2.5 CM
182.. 13101 REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM
182.. 13120 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM
182.. 13121 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM
182.. 13131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET;
1.1 CM TO 2.5 CM
182.. 13132 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET;
2.6 CM TO 7.5 CM
182.. 13150 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.0 CM OR LESS
182.. 13151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM
182.. 13152 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM
182.. 13160 SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED
182.. 13300 REPAIR, UNUSUAL, COMPLICATED, OVER 7.5 CM, ANY AREA
182.. 43870 CLOSURE OF GASTROSTOMY, SURGICAL
183.. Level III skin repair T 11.17 $565.98 $286.46 $113.20
183.. 11960 INSERTION OF TISSUE EXPANDER(S) FOR OTHER THAN BREAST, INCLUDING SUBSEQUENT EXPANSION
183.. 11970 REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROSTHESIS
183.. 12037 LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET);
OVER 30.0 CM
183.. 12047 LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; OVER 30.0 CM
183.. 12057 LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; OVER 30.0
CM
183.. 14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS
183.. 14001 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM
183.. 14020 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/ OR LEGS; DEFECT 10 SQ CM OR LESS
183.. 14021 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/ OR LEGS; DEFECT 10.1 SQ CM TO 30.0
SQ CM
183.. 14040 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE,
GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS
183.. 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
183.. 14060 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 SQ CM OR
LESS
183.. 14061 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM
TO 30.0 SQ CM
183.. 14300 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE THAN 30 SQ CM, UNUSUAL OR COMPLICATED, ANY AREA
183.. 14350 FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION OF RECIPIENT SITE
183.. 15000 EXCISIONAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION OF ESSENTIALLY INTACT SKIN
(INCLUDING SUBCUTANEOUS TISSUES), SCAR, OR OTHER LESION PRIOR TO REPAIR WITH FREE SKIN GRAFT
(LIST AS SEPARATE SERVICE IN ADDITION TO SKIN GRAFT)
183.. 15050 PINCH GRAFT, SINGLE OR MULTIPLE, TO COVER SMALL ULCER, TIP OF DIGIT, OR OTHER MINIMAL OPEN AREA
(EXCEPT ON FACE), UP TO DEFECT SIZE 2 CM DIAMETER
183.. 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)
183.. 15101 SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/OR FEET (EXCEPT MULTIPLE DIGITS); EACH
ADDITIONAL 100 SQ CM, OR EACH ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN, OR PART
THEREOF
183.. 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)
183.. 15121 SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, AND/OR MULTIPLE DIGITS; EACH
ADDITIONAL 100 SQ CM, OR EACH ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN, OR PART
THEREOF
183.. 15200 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; 20 SQ CM OR LESS
183.. 15201 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; EACH ADDITIONAL 20
SQ CM
183.. 15220 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/OR LEGS;
20 SQ CM OR LESS
183.. 15221 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/OR LEGS;
EACH ADDITIONAL 20 SQ CM
183.. 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
[[Page 47771]]
183.. 15241 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN,
MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; EACH ADDITIONAL 20 SQ CM
183.. 15260 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR
LIPS; 20 SQ CM OR LESS
183.. 15261 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR
LIPS; EACH ADDITIONAL 20 SQ CM
183.. 15350 APPLICATION OF ALLOGRAFT, SKIN
183.. 15400 APPLICATION OF XENOGRAFT, SKIN
183.. 15570 FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; TRUNK
183.. 15572 FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; SCALP, ARMS, OR LEGS
183.. 15574 FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; FOREHEAD, CHEEKS, CHIN, MOUTH,
NECK, AXILLAE, GENITALIA, HANDS OR FEET
183.. 15576 FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; EYELIDS, NOSE, EARS, LIPS, OR
INTRAORAL
183.. 15580 CROSS FINGER FLAP, INCLUDING FREE GRAFT TO DONOR SITE
183.. 15600 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT TRUNK
183.. 15610 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT SCALP, ARMS, OR LEGS
183.. 15620 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT FOREHEAD, CHEEKS, CHIN, NECK,
AXILLAE, GENITALIA, HANDS (EXCEPT 15625), OR FEET
183.. 15625 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); SECTION PEDICLE OF CROSS FINGER FLAP
183.. 15630 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT EYELIDS, NOSE, EARS, OR LIPS
183.. 15650 TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (EG, ABDOMEN TO WRIST, ``WALKING'' TUBE), ANY
LOCATION
183.. 15775 PUNCH GRAFT FOR HAIR TRANSPLANT; 1 TO 15 PUNCH GRAFTS
183.. 15776 PUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN 15 PUNCH GRAFTS
183.. 15819 CERVICOPLASTY
183.. 15820 BLEPHAROPLASTY, LOWER EYELID
183.. 15821 BLEPHAROPLASTY, LOWER EYELID; WITH EXTENSIVE HERNIATED FAT PAD
183.. 15822 BLEPHAROPLASTY, UPPER EYELID
183.. 15823 BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID
183.. 15825 RHYTIDECTOMY; NECK WITH PLATYSMAL TIGHTENING (PLATYSMAL FLAP, ``P-FLAP'')
183.. 15829 RHYTIDECTOMY; SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM (SMAS) FLAP
183.. 15835 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); BUTTOCK
183.. 20910 CARTILAGE GRAFT; COSTOCHONDRAL
183.. 20912 CARTILAGE GRAFT; NASAL SEPTUM
183.. 20920 FASCIA LATA GRAFT; BY STRIPPER
183.. 20922 FASCIA LATA GRAFT; BY INCISION AND AREA EXPOSURE, COMPLEX OR SHEET
183.. 20926 TISSUE GRAFTS, OTHER (EG, PARATENON, FAT, DERMIS)
183.. 23921 DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR SCAR REVISION
183.. 25929 TRANSMETACARPAL AMPUTATION; SECONDARY CLOSURE OR SCAR REVISION
183.. 44312 REVISION OF ILEOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE)
183.. 44340 REVISION OF COLOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE)
183.. 65270 REPAIR OF LACERATION; CONJUNCTIVA, WITH OR WITHOUT NONPERFORATING LACERATION SCLERA, DIRECT
CLOSURE
184.. Level IV skin repair T 15.17 $768.66 $396.40 $153.73
184.. 15732 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; HEAD AND NECK (EG, TEMPORALIS, MASSETER,
STERNOCLEIDOMASTOID, LEVATOR SCAPULAE)
184.. 15734 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; TRUNK
184.. 15736 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPER EXTREMITY
184.. 15738 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY
184.. 15740 FLAP; ISLAND PEDICLE
184.. 15750 FLAP; NEUROVASCULAR PEDICLE
184.. 15760 GRAFT; COMPOSITE (EG, FULL THICKNESS OF EXTERNAL EAR OR NASAL ALA), INCLUDING PRIMARY CLOSURE,
DONOR AREA
184.. 15770 GRAFT; DERMA-FAT-FASCIA
184.. 15824 RHYTIDECTOMY; FOREHEAD
184.. 15826 RHYTIDECTOMY; GLABELLAR FROWN LINES
184.. 15828 RHYTIDECTOMY; CHEEK, CHIN, AND NECK
184.. 15831 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); ABDOMEN
(ABDOMINOPLASTY)
184.. 15832 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); THIGH
184.. 15833 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); LEG
184.. 15834 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); HIP
184.. 15836 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); ARM
184.. 15837 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); FOREARM OR HAND
184.. 15839 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDING LIPECTOMY); OTHER AREA
184.. 15840 GRAFT FOR FACIAL NERVE PARALYSIS; FREE FASCIA GRAFT (INCLUDING OBTAINING FASCIA)
184.. 15841 GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAFT (INCLUDING OBTAINING GRAFT)
184.. 15842 GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAFT BY MICROSURGICAL TECHNIQUE
184.. 15845 GRAFT FOR FACIAL NERVE PARALYSIS; REGIONAL MUSCLE TRANSFER
184.. 15876 SUCTION ASSISTED LIPECTOMY; HEAD AND NECK
184.. 15877 SUCTION ASSISTED LIPECTOMY; TRUNK
184.. 15878 SUCTION ASSISTED LIPECTOMY; UPPER EXTREMITY
184.. 15879 SUCTION ASSISTED LIPECTOMY; LOWER EXTREMITY
184.. 15922 EXCISION, COCCYGEAL PRESSURE ULCER, WITH COCCYGECTOMY; WITH FLAP CLOSURE
184.. 15934 EXCISION, SACRAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE
184.. 15935 EXCISION, SACRAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
184.. 15936 EXCISION, SACRAL PRESSURE ULCER, WITH MUSCLE OR MYOCUTANEOUS FLAP CLOSURE
184.. 15937 EXCISION, SACRAL PRESSURE ULCER, WITH MUSCLE OR MYOCUTANEOUS FLAP CLOSURE; WITH OSTECTOMY
184.. 15944 EXCISION, ISCHIAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE
[[Page 47772]]
184.. 15945 EXCISION, ISCHIAL PRESSURE ULCER, WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
184.. 15946 EXCISION, ISCHIAL PRESSURE ULCER, WITH OSTECTOMY, WITH MUSCLE OR MYOCUTANEOUS FLAP CLOSURE
184.. 15952 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH SKIN FLAP CLOSURE
184.. 15953 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
184.. 15956 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH MUSCLE OR MYOCUTANEOUS FLAP CLOSURE
184.. 15958 EXCISION, TROCHANTERIC PRESSURE ULCER, WITH MUSCLE OR MYOCUTANEOUS FLAP CLOSURE; WITH OSTECTOMY
197.. Incision/excision breast T 12.13 $614.62 $310.75 $122.92
197.. 19101 BIOPSY OF BREAST; INCISIONAL
197.. 19110 NIPPLE EXPLORATION, WITH OR WITHOUT EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPILLOMA
LACTIFEROUS DUCT
197.. 19112 EXCISION OF LACTIFEROUS DUCT FISTULA
197.. 19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR ABERRANT BREAST TISSUE, DUCT
LESION, NIPPLE OR AREOLAR LESION (EXCEPT 19140), MALE OR FEMALE, ONE OR MORE LESIONS
197.. 19125 EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER; SINGLE
LESION
197.. 19126 EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER; EACH
ADDITIONAL LESION SEPARATELY IDENTIFIED BY A RADIOLOGICAL MARKER
197.. 19140 MASTECTOMY FOR GYNECOMASTIA
197.. 19290 PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST
197.. 19291 PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST; EACH ADDITIONAL LESION
197.. 19396 PREPARATION OF MOULAGE FOR CUSTOM BREAST IMPLANT
197.. 19499 UNLISTED PROCEDURE, BREAST
198.. Breast reconstruction/ T 19.17 $971.33 $530.20 $194.27
mastectomy
198.. 19160 MASTECTOMY, PARTIAL;
198.. 19162 MASTECTOMY, PARTIAL; WITH AXILLARY LYMPHADENECTOMY
198.. 19180 MASTECTOMY, SIMPLE, COMPLETE
198.. 19182 MASTECTOMY, SUBCUTANEOUS
198.. 19316 MASTOPEXY
198.. 19318 REDUCTION MAMMAPLASTY
198.. 19324 MAMMAPLASTY, AUGMENTATION; WITHOUT PROSTHETIC IMPLANT
198.. 19325 MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT
198.. 19328 REMOVAL OF INTACT MAMMARY IMPLANT
198.. 19330 REMOVAL OF MAMMARY IMPLANT MATERIAL
198.. 19340 IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION
198.. 19342 DELAYED INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION
198.. 19350 NIPPLE/AREOLA RECONSTRUCTION
198.. 19355 CORRECTION OF INVERTED NIPPLES
198.. 19357 BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH TISSUE EXPANDER, INCLUDING SUBSEQUENT
EXPANSION
198.. 19366 BREAST RECONSTRUCTION WITH OTHER TECHNIQUE
198.. 19370 OPEN PERIPROSTHETIC CAPSULOTOMY, BREAST
198.. 19371 PERIPROSTHETIC CAPSULECTOMY, BREAST
198.. 19380 REVISION OF RECONSTRUCTED BREAST
200.. Arthrocentesis & Ligament/ T 1.89 $95.77 $39.10 $19.15
Tendon Injection
200.. 20550 INJECTION, TENDON SHEATH, LIGAMENT, TRIGGER POINTS OR GANGLION CYST
200.. 20600 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL JOINT, BURSA OR GANGLION CYST (EG, FINGERS,
TOES)
200.. 20605 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTERMEDIATE JOINT, BURSA OR GANGLION CYST (EG,
TEMPOROMANDIBULAR, ACROMIOCLAVICULAR, WRIST, ELBOW OR ANKLE, OLECRANON BURSA)
200.. 20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, KNEE
JOINT, SUBACROMIAL BURSA)
207.. Closed treatment fracture T 1.70 $86.14 $31.64 $17.23
finger/toe/trunk
207.. 21800 CLOSED TREATMENT OF RIB FRACTURE, UNCOMPLICATED, EACH
207.. 21820 CLOSED TREATMENT OF STERNUM FRACTURE
207.. 21899 UNLISTED PROCEDURE, NECK OR THORAX
207.. 22305 CLOSED TREATMENT OF VERTEBRAL PROCESS FRACTURE(S)
207.. 22310 CLOSED TREATMENT OF VERTEBRAL BODY FRACTURE(S), WITHOUT MANIPULATION, REQUIRING AND INCLUDING
CASTING OR BRACING
207.. 22315 CLOSED TREATMENT OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S) REQUIRING CASTING OR BRACING,
WITH AND INCLUDING CASTING AND/OR BRACING, WITH OR WITHOUT ANESTHESIA, BY MANIPULATION OR
TRACTION
207.. 22899 UNLISTED PROCEDURE, SPINE
207.. 23500 CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITHOUT MANIPULATION
207.. 23505 CLOSED TREATMENT OF CLAVICULAR FRACTURE; WITH MANIPULATION
207.. 23520 CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITHOUT MANIPULATION
207.. 23525 WITH MANIPULATION
207.. 23540 CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION; WITHOUT MANIPULATION
207.. 23545 CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLOCATION; WITH MANIPULATION
207.. 23570 CLOSED TREATMENT OF SCAPULAR FRACTURE; WITHOUT MANIPULATION
207.. 23575 CLOSED TREATMENT OF SCAPULAR FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION
(WITH OR WITHOUT SHOULDER JOINT INVOLVEMENT)
207.. 23650 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; WITHOUT ANESTHESIA
207.. 23929 UNLISTED PROCEDURE, SHOULDER
207.. 26700 CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; WITHOUT
ANESTHESIA
207.. 26720 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB;
WITHOUT MANIPULATION, EACH
207.. 26725 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB;
WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION, EACH
[[Page 47773]]
207.. 26740 CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT;
WITHOUT MANIPULATION, EACH
207.. 26750 CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITHOUT MANIPULATION, EACH
207.. 26755 CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITH MANIPULATION, EACH
207.. 26770 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; WITHOUT
ANESTHESIA
207.. 26989 UNLISTED PROCEDURE, HANDS OR FINGERS
207.. 27200 CLOSED TREATMENT OF COCCYGEAL FRACTURE
207.. 27299 UNLISTED PROCEDURE, PELVIS OR HIP JOINT
207.. 28490 CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES; WITHOUT MANIPULATION
207.. 28495 CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES; WITH MANIPULATION
207.. 28510 CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITHOUT MANIPULATION,
EACH
207.. 28515 CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE; WITH MANIPULATION,
EACH
207.. 28630 CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA
207.. 28660 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; WITHOUT ANESTHESIA
207.. 28899 UNLISTED PROCEDURE, FOOT OR TOES
207.. 31585 TREATMENT OF CLOSED LARYNGEAL FRACTURE; WITHOUT MANIPULATION
207.. 31599 UNLISTED PROCEDURE, LARYNX
209.. Closed treatment fracture/ T 1.94 $98.30 $37.29 $19.66
dislocation/except finger/toe/
trunk
209.. 23600 CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITHOUT
MANIPULATION
209.. 23605 CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITH MANIPULATION,
WITH OR WITHOUT SKELETAL TRACTION
209.. 23620 CLOSED TREATMENT OF GREATER TUBEROSITY FRACTURE; WITHOUT MANIPULATION
209.. 23625 CLOSED TREATMENT OF GREATER TUBEROSITY FRACTURE; WITH MANIPULATION
209.. 23665 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER TUBEROSITY, WITH
MANIPULATION
209.. 23675 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH SURGICAL OR ANATOMICAL NECK FRACTURE, WITH
MANIPULATION
209.. 24500 CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUT MANIPULATION
209.. 24505 CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETAL
TRACTION
209.. 24530 CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT
INTERCONDYLAR EXTENSION; WITHOUT MANIPULATION
209.. 24535 CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT
INTERCONDYLAR EXTENSION; WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION
209.. 24560 CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL; WITHOUT MANIPULATION
209.. 24565 CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL; WITH MANIPULATION
209.. 24576 CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL; WITHOUT MANIPULATION
209.. 24577 CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL; WITH MANIPULATION
209.. 24600 TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA
209.. 24620 CLOSED TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF
ULNA WITH DISLOCATION OF RADIAL HEAD), WITH MANIPULATION
209.. 24640 CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, ``NURSEMAID ELBOW'', WITH MANIPULATION
209.. 24650 CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT MANIPULATION
209.. 24655 CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITH MANIPULATION
209.. 24670 CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (OLECRANON PROCESS); WITHOUT MANIPULATION
209.. 24675 CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (OLECRANON PROCESS); WITH MANIPULATION
209.. 24999 UNLISTED PROCEDURE, HUMERUS OR ELBOW
209.. 25500 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITHOUT MANIPULATION
209.. 25505 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATION
209.. 25520 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE, WITH DISLOCATION OF DISTAL RADIO-ULNAR JOINT
(GALEAZZI FRACTURE/DISLOCATION)
209.. 25530 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITHOUT MANIPULATION
209.. 25535 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITH MANIPULATION
209.. 25560 CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITHOUT MANIPULATION
209.. 25565 CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITH MANIPULATION
209.. 25600 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION,
WITH OR WITHOUT FRACTURE OF ULNAR STYLOID; WITHOUT MANIPULATION
209.. 25605 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION,
WITH OR WITHOUT FRACTURE OF ULNAR STYLOID; WITH MANIPULATION
209.. 25622 CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITHOUT MANIPULATION
209.. 25624 CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITH MANIPULATION
209.. 25630 CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHOID (NAVICULAR)); WITHOUT
MANIPULATION, EACH BONE
209.. 25635 CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHOID (NAVICULAR)); WITH
MANIPULATION, EACH BONE
209.. 25650 CLOSED TREATMENT OF ULNAR STYLOID FRACTURE
209.. 25660 CLOSED TREATMENT OF RADIOCARPAL OR INTERCARPAL DISLOCATION, ONE OR MORE BONES, WITH
MANIPULATION
209.. 25675 CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION WITH MANIPULATION
209.. 25680 CLOSED TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF FRACTURE DISLOCATION, WITH MANIPULATION
209.. 25690 CLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION
209.. 25999 UNLISTED PROCEDURE, FOREARM OR WRIST
209.. 26600 CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MANIPULATION, EACH BONE
209.. 26605 CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH MANIPULATION, EACH BONE
209.. 26607 CLOSED TREATMENT OF METACARPAL FRACTURE, WITH MANIPULATION, WITH INTERNAL OR EXTERNAL FIXATION,
EACH BONE
209.. 26641 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, WITH MANIPULATION
209.. 26645 CLOSED TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), WITH
MANIPULATION
209.. 26670 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE), SINGLE,
WITH MANIPULATION; WITHOUT ANESTHESIA
[[Page 47774]]
209.. 26706 PERCUTANEOUS SKELETAL FIXATION OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION
209.. 26742 CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT;
WITH MANIPULATION, EACH
209.. 27193 CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION, DIASTASIS OR SUBLUXATION; WITHOUT
MANIPULATION
209.. 27220 CLOSED TREATMENT OF ACETABULUM (HIP SOCKET) FRACTURE(S); WITHOUT MANIPULATION
209.. 27230 CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK; WITHOUT MANIPULATION
209.. 27238 CLOSED TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE;
WITHOUT MANIPULATION
209.. 27246 CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE, WITHOUT MANIPULATION
209.. 27250 CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUT ANESTHESIA
209.. 27256 TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL),
BY ABDUCTION, SPLINT OR TRACTION; WITHOUT ANESTHESIA, WITHOUT MANIPULATION
209.. 27265 CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; WITHOUT ANESTHESIA
209.. 27500 CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHOUT MANIPULATION
209.. 27501 CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE WITH OR WITHOUT
INTERCONDYLAR EXTENSION, WITHOUT MANIPULATION
209.. 27502 CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL
TRACTION
209.. 27503 CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE WITH OR WITHOUT
INTERCONDYLAR EXTENSION, WITH MANIPULATION, WITH OR WITHOUT SKIN OR SKELETAL TRACTION
209.. 27508 CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITHOUT
MANIPULATION
209.. 27510 CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITH MANIPULATION
209.. 27516 CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION; WITHOUT MANIPULATION
209.. 27517 CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION; WITH MANIPULATION, WITH OR WITHOUT
SKIN OR SKELETAL TRACTION
209.. 27520 CLOSED TREATMENT OF PATELLAR FRACTURE, WITHOUT MANIPULATION
209.. 27530 CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITHOUT MANIPULATION
209.. 27532 CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITH OR WITHOUT MANIPULATION, WITH
SKELETAL TRACTION
209.. 27538 CLOSED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF KNEE, WITH OR
WITHOUT MANIPULATION
209.. 27550 CLOSED TREATMENT OF KNEE DISLOCATION; WITHOUT ANESTHESIA
209.. 27560 CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA
209.. 27599 UNLISTED PROCEDURE, FEMUR OR KNEE
209.. 27750 CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITHOUT
MANIPULATION
209.. 27752 CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITH
MANIPULATION, WITH OR WITHOUT SKELETAL TRACTION
209.. 27760 CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITHOUT MANIPULATION
209.. 27762 CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKIN OR
SKELETAL TRACTION
209.. 27780 CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITHOUT MANIPULATION
209.. 27781 CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITH MANIPULATION
209.. 27786 CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITHOUT MANIPULATION
209.. 27788 CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITH MANIPULATION
209.. 27808 CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, (INCLUDING POTTS); WITHOUT MANIPULATION
209.. 27810 CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, (INCLUDING POTTS); WITH MANIPULATION
209.. 27816 CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHOUT MANIPULATION
209.. 27818 CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITH MANIPULATION
209.. 27824 CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, PILON OR
TIBIAL PLAFOND), WITH OR WITHOUT ANESTHESIA; WITHOUT MANIPULATION
209.. 27825 CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, PILON OR
TIBIAL PLAFOND), WITH OR WITHOUT ANESTHESIA; WITH SKELETAL TRACTION AND/OR REQUIRING
MANIPULATION
209.. 27830 CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION; WITHOUT ANESTHESIA
209.. 27840 CLOSED TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA
209.. 27899 UNLISTED PROCEDURE, LEG OR ANKLE
209.. 28400 CLOSED TREATMENT OF CALCANEAL FRACTURE; WITHOUT MANIPULATION
209.. 28405 CLOSED TREATMENT OF CALCANEAL FRACTURE; WITH MANIPULATION
209.. 28430 CLOSED TREATMENT OF TALUS FRACTURE; WITHOUT MANIPULATION
209.. 28435 CLOSED TREATMENT OF TALUS FRACTURE; WITH MANIPULATION
209.. 28450 TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITHOUT MANIPULATION, EACH
209.. 28455 TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS); WITH MANIPULATION, EACH
209.. 28470 CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION, EACH
209.. 28475 CLOSED TREATMENT OF METATARSAL FRACTURE; WITH MANIPULATION, EACH
209.. 28530 CLOSED TREATMENT OF SESAMOID FRACTURE
209.. 28540 CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL; WITHOUT ANESTHESIA
209.. 28570 CLOSED TREATMENT OF TALOTARSAL JOINT DISLOCATION; WITHOUT ANESTHESIA
209.. 28600 CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION; WITHOUT ANESTHESIA
209.. 31586 TREATMENT OF CLOSED LARYNGEAL FRACTURE; WITH CLOSED MANIPULATIVE REDUCTION
210.. Bone/joint manipulation under T 10.46 $530.00 $283.40 $106.00
anesthesia
210.. 22505 MANIPULATION OF SPINE REQUIRING ANESTHESIA, ANY REGION
210.. 23655 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA
210.. 23700 MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPARATUS
(DISLOCATION EXCLUDED)
210.. 24605 TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA
210.. 26675 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE), SINGLE,
WITH MANIPULATION; REQUIRING ANESTHESIA
210.. 26705 CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; REQUIRING
ANESTHESIA
210.. 26775 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; REQUIRING
ANESTHESIA
[[Page 47775]]
210.. 27194 CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION, DIASTASIS OR SUBLUXATION; WITH
MANIPULATION, REQUIRING MORE THAN LOCAL ANESTHESIA
210.. 27252 CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; REQUIRING ANESTHESIA
210.. 27257 TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL),
BY ABDUCTION, SPLINT OR TRACTION; WITH MANIPULATION, REQUIRING ANESTHESIA
210.. 27275 MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHESIA
210.. 27552 CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA
210.. 27562 CLOSED TREATMENT OF PATELLAR DISLOCATION; REQUIRING ANESTHESIA
210.. 27570 MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION OR OTHER
FIXATION DEVICES)
210.. 27831 CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION; REQUIRING ANESTHESIA
210.. 27842 CLOSED TREATMENT OF ANKLE DISLOCATION; REQUIRING ANESTHESIA, WITH OR WITHOUT PERCUTANEOUS
SKELETAL FIXATION
210.. 27860 MANIPULATION OF ANKLE UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION OR OTHER
FIXATION APPARATUS)
210.. 28545 CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL; REQUIRING ANESTHESIA
210.. 28575 CLOSED TREATMENT OF TALOTARSAL JOINT DISLOCATION; REQUIRING ANESTHESIA
210.. 28605 CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION; REQUIRING ANESTHESIA
210.. 28635 CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION; REQUIRING ANESTHESIA
210.. 28665 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION; REQUIRING ANESTHESIA
216.. Open/percutaneous treatment T 20.13 $1,019.98 $520.82 $204.00
fracture or dislocation
216.. 21336 OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT STABILIZATION
216.. 21805 OPEN TREATMENT OF RIB FRACTURE WITHOUT FIXATION, EACH
216.. 23515 OPEN TREATMENT OF CLAVICULAR FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 23530 OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;
216.. 23532 OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES
OBTAINING GRAFT)
216.. 23550 OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;
216.. 23552 OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES
OBTAINING GRAFT)
216.. 23585 OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR ACROMION) WITH OR WITHOUT INTERNAL
FIXATION
216.. 23615 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR WITHOUT
INTERNAL OR EXTERNAL FIXATION, WITH OR WITHOUT REPAIR OF TUBEROSITY(-IES);
216.. 23616 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, WITH OR WITHOUT
INTERNAL OR EXTERNAL FIXATION, WITH OR WITHOUT REPAIR OF TUBEROSITY(-IES); WITH PROXIMAL
HUMERAL PROSTHETIC REPLACEMENT
216.. 23630 OPEN TREATMENT OF GREATER TUBEROSITY FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 23660 OPEN TREATMENT OF ACUTE SHOULDER DISLOCATION
216.. 23670 OPEN TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER TUBEROSITY, WITH OR WITHOUT
INTERNAL OR EXTERNAL FIXATION
216.. 23680 OPEN TREATMENT OF SHOULDER DISLOCATION, WITH SURGICAL OR ANATOMICAL NECK FRACTURE, WITH OR
WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 24515 OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE
216.. 24516 OPEN TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR
WITHOUT CERCLAGE AND/OR LOCKING SCREWS
216.. 24538 PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR
WITHOUT INTERCONDYLAR EXTENSION
216.. 24545 OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION; WITHOUT INTERCONDYLAR EXTENSION
216.. 24546 OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION; WITH INTERCONDYLAR EXTENSION
216.. 24566 PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH
MANIPULATION
216.. 24575 OPEN TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION
216.. 24579 OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION
216.. 24582 PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH
MANIPULATION
216.. 24586 OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL
HUMERUS AND PROXIMAL ULNA AND/ OR PROXIMAL RADIUS);
216.. 24587 OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL
HUMERUS AND PROXIMAL ULNA AND/ OR PROXIMAL RADIUS); WITH IMPLANT ARTHROPLASTY
216.. 24615 OPEN TREATMENT OF ACUTE OR CHRONIC ELBOW DISLOCATION
216.. 24635 OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF
ULNA WITH DISLOCATION OF RADIAL HEAD), WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 24665 OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, WITH OR WITHOUT INTERNAL FIXATION OR RADIAL
HEAD EXCISION;
216.. 24666 OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, WITH OR WITHOUT INTERNAL FIXATION OR RADIAL
HEAD EXCISION; WITH RADIAL HEAD PROSTHETIC REPLACEMENT
216.. 24685 OPEN TREATMENT OF ULNAR FRACTURE PROXIMAL END (OLECRANON PROCESS), WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION
216.. 25515 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 25525 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTERNAL AND/ OR EXTERNAL FIXATION AND CLOSED
TREATMENT OF DISLOCATION OF DISTAL RADIO-ULNAR JOINT (GALEAZZI FRACTURE/DISLOCATION), WITH OR
WITHOUT PERCUTANEOUS SKELETAL FIXATION
216.. 25526 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTERNAL AND/ OR EXTERNAL FIXATION AND OPEN
TREATMENT, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION OF DISTAL RADIO-ULNAR JOINT (GALEAZZI
FRACTURE/DISLOCATION), INCLUDES REPAIR OF TRIANGULAR CARTILAGE
216.. 25545 OPEN TREATMENT OF ULNAR SHAFT FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 25574 OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FIXATION; OF
RADIUS OR ULNA
[[Page 47776]]
216.. 25575 OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FIXATION; OF
RADIUS AND ULNA
216.. 25611 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR
EPIPHYSEAL SEPARATION, WITH OR WITHOUT FRACTURE OF ULNAR STYLOID, REQUIRING MANIPULATION, WITH
OR WITHOUT EXTERNAL FIXATION
216.. 25620 OPEN TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION,
WITH OR WITHOUT FRACTURE OF ULNAR STYLOID, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 25628 OPEN TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION
216.. 25645 OPEN TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHOID (NAVICULAR)), EACH BONE
216.. 25670 OPEN TREATMENT OF RADIOCARPAL OR INTERCARPAL DISLOCATION, ONE OR MORE BONES
216.. 25676 OPEN TREATMENT OF DISTAL RADIOULNAR DISLOCATION, ACUTE OR CHRONIC
216.. 25685 OPEN TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF FRACTURE DISLOCATION
216.. 25695 OPEN TREATMENT OF LUNATE DISLOCATION
216.. 26608 PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE
216.. 26615 OPEN TREATMENT OF METACARPAL FRACTURE, SINGLE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION,
EACH BONE
216.. 26650 PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT
FRACTURE), WITH MANIPULATION, WITH OR WITHOUT EXTERNAL FIXATION
216.. 26665 OPEN TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), WITH OR
WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 26676 PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT
FRACTURE), SINGLE, WITH MANIPULATION
216.. 26685 OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE); SINGLE,
WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 26686 OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE); COMPLEX,
MULTIPLE OR DELAYED REDUCTION
216.. 26715 OPEN TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION
216.. 26727 PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE
PHALANX, FINGER OR THUMB, WITH MANIPULATION, EACH
216.. 26735 OPEN TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB, WITH
OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH
216.. 26746 OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT,
WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH
216.. 26756 PERCUTANEOUS SKELETAL FIXATION OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, EACH
216.. 26765 OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION, EACH
216.. 26776 PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION
216.. 26785 OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION, SINGLE
216.. 27202 OPEN TREATMENT OF COCCYGEAL FRACTURE
216.. 27509 PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, OR
SUPRACONDYLAR OR TRANSCONDYLAR, WITH OR WITHOUT INTERCONDYLAR EXTENSION, OR DISTAL FEMORAL
EPIPHYSEAL SEPARATION
216.. 27556 OPEN TREATMENT OF KNEE DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITHOUT
PRIMARY LIGAMENTOUS REPAIR OR AUGMENTATION/RECONSTRUCTION
216.. 27566 OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUT PARTIAL OR TOTAL PATELLECTOMY
216.. 27615 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF LEG OR ANKLE AREA
216.. 27756 PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG,
PINS OR SCREWS)
216.. 27758 OPEN TREATMENT OF TIBIAL SHAFT FRACTURE, (WITH OR WITHOUT FIBULAR FRACTURE) WITH PLATE/SCREWS,
WITH OR WITHOUT CERCLAGE
216.. 27759 OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY
IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE
216.. 27766 OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 27784 OPEN TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION
216.. 27792 OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION
216.. 27814 OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 27822 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION,
MEDIAL AND/OR LATERAL MALLEOLUS; WITHOUT FIXATION OF POSTERIOR LIP
216.. 27823 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION,
MEDIAL AND/OR LATERAL MALLEOLUS; WITH FIXATION OF POSTERIOR LIP
216.. 27826 OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/ PORTION OF DISTAL TIBIA (EG,
PILON OR TIBIAL PLAFOND), WITH INTERNAL OR EXTERNAL FIXATION; OF FIBULA ONLY
216.. 27827 OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/ PORTION OF DISTAL TIBIA (EG,
PILON OR TIBIAL PLAFOND), WITH INTERNAL OR EXTERNAL FIXATION; OF TIBIA ONLY
216.. 27828 OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/ PORTION OF DISTAL TIBIA (EG,
PILON OR TIBIAL PLAFOND), WITH INTERNAL OR EXTERNAL FIXATION; OF BOTH TIBIA AND FIBULA
216.. 27829 OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, WITH OR WITHOUT INTERNAL
OR EXTERNAL FIXATION
216.. 27832 OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION, OR WITH EXCISION OF PROXIMAL FIBULA
216.. 27846 OPEN TREATMENT OF ANKLE DISLOCATION, WITH OR WITHOUT PERCUTANEOUS SKELETAL FIXATION; WITHOUT
REPAIR OR INTERNAL FIXATION
216.. 27848 OPEN TREATMENT OF ANKLE DISLOCATION, WITH OR WITHOUT PERCUTANEOUS SKELETAL FIXATION; WITH
REPAIR OR INTERNAL OR EXTERNAL FIXATION
216.. 28406 PERCUTANEOUS SKELETAL FIXATION OF CALCANEAL FRACTURE, WITH MANIPULATION
216.. 28415 OPEN TREATMENT OF CALCANEAL FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION;
216.. 28420 OPEN TREATMENT OF CALCANEAL FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION; WITH
PRIMARY ILIAC OR OTHER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT)
216.. 28436 PERCUTANEOUS SKELETAL FIXATION OF TALUS FRACTURE, WITH MANIPULATION
216.. 28445 OPEN TREATMENT OF TALUS FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 28456 PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), WITH
MANIPULATION, EACH
[[Page 47777]]
216.. 28465 OPEN TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), WITH OR WITHOUT INTERNAL
OR EXTERNAL FIXATION, EACH
216.. 28476 PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH MANIPULATION, EACH
216.. 28485 OPEN TREATMENT OF METATARSAL FRACTURE, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION, EACH
216.. 28496 PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH MANIPULATION
216.. 28505 OPEN TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH OR WITHOUT INTERNAL OR
EXTERNAL FIXATION
216.. 28525 OPEN TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE, WITH OR WITHOUT
INTERNAL OR EXTERNAL FIXATION, EACH
216.. 28531 OPEN TREATMENT OF SESAMOID FRACTURE, WITH OR WITHOUT INTERNAL FIXATION
216.. 28546 PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL, WITH
MANIPULATION
216.. 28555 OPEN TREATMENT OF TARSAL BONE DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 28576 PERCUTANEOUS SKELETAL FIXATION OF TALOTARSAL JOINT DISLOCATION, WITH MANIPULATION
216.. 28585 OPEN TREATMENT OF TALOTARSAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL FIXATION
216.. 28606 PERCUTANEOUS SKELETAL FIXATION OF TARSOMETATARSAL JOINT DISLOCATION, WITH MANIPULATION
216.. 28615 OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION
216.. 28636 PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANGEAL JOINT DISLOCATION, WITH MANIPULATION
216.. 28645 OPEN TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION
216.. 28666 PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL JOINT DISLOCATION, WITH MANIPULATION
216.. 28675 OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, WITH OR WITHOUT INTERNAL OR EXTERNAL
FIXATION
217.. Arthroplasty T 20.48 $1,037.71 $526.81 $207.54
217.. 24360 ARTHROPLASTY, ELBOW; WITH MEMBRANE
217.. 24365 ARTHROPLASTY, RADIAL HEAD;
217.. 25332 ARTHROPLASTY, WRIST, WITH OR WITHOUT INTERPOSITION, WITH OR WITHOUT EXTERNAL OR INTERNAL
FIXATION
217.. 25447 INTERPOSITION ARTHROPLASTY, INTERCARPAL OR CARPOMETACARPAL JOINTS
217.. 25449 REVISION OF ARTHROPLASTY, INCLUDING REMOVAL OF IMPLANT, WRIST JOINT
217.. 26530 ARTHROPLASTY, METACARPOPHALANGEAL JOINT; SINGLE, EACH
217.. 26535 ARTHROPLASTY INTERPHALANGEAL JOINT; SINGLE, EACH
217.. 27266 CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; REQUIRING REGIONAL OR GENERAL ANESTHESIA
217.. 27437 ARTHROPLASTY, PATELLA; WITHOUT PROSTHESIS
217.. 27440 ARTHROPLASTY, KNEE, TIBIAL PLATEAU;
217.. 27441 ARTHROPLASTY, KNEE, TIBIAL PLATEAU; WITH DEBRIDEMENT AND PARTIAL SYNOVECTOMY
217.. 27442 ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLATEAUS;
217.. 27443 ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLATEAUS; WITH DEBRIDEMENT AND PARTIAL
SYNOVECTOMY
217.. 27700 ARTHROPLASTY, ANKLE;
218.. Arthroplasty with prosthesis T 27.49 $1,392.90 $715.52 $278.58
218.. 21243 ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH PROSTHETIC JOINT REPLACEMENT
218.. 24361 ARTHROPLASTY, ELBOW; WITH DISTAL HUMERAL PROSTHETIC REPLACEMENT
218.. 24362 ARTHROPLASTY, ELBOW; WITH IMPLANT AND FASCIA LATA LIGAMENT RECONSTRUCTION
218.. 24363 ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (``TOTAL
ELBOW'')
218.. 24366 ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT
218.. 25441 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL RADIUS
218.. 25442 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL ULNA
218.. 25443 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; SCAPHOID (NAVICULAR)
218.. 25444 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; LUNATE
218.. 25445 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; TRAPEZIUM
218.. 25446 ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL RADIUS AND PARTIAL OR ENTIRE CARPUS (``TOTAL
WRIST'')
218.. 26531 ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, SINGLE, EACH
218.. 26536 ARTHROPLASTY INTERPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, SINGLE, EACH
218.. 27438 ARTHROPLASTY, PATELLA; WITH PROSTHESIS
226.. Maxillofacial prostheses T 1.59 $80.56 $21.92 $16.11
226.. 21076 IMPRESSION AND CUSTOM PREPARATION; SURGICAL OBTURATOR PROSTHESIS
226.. 21077 IMPRESSION AND CUSTOM PREPARATION; ORBITAL PROSTHESIS
226.. 21079 IMPRESSION AND CUSTOM PREPARATION; INTERIM OBTURATOR PROSTHESIS
226.. 21080 IMPRESSION AND CUSTOM PREPARATION; DEFINITIVE OBTURATOR PROSTHESIS
226.. 21081 IMPRESSION AND CUSTOM PREPARATION; MANDIBULAR RESECTION PROSTHESIS
226.. 21082 IMPRESSION AND CUSTOM PREPARATION; PALATAL AUGMENTATION PROSTHESIS
226.. 21083 IMPRESSION AND CUSTOM PREPARATION; PALATAL LIFT PROSTHESIS
226.. 21084 IMPRESSION AND CUSTOM PREPARATION; SPEECH AID PROSTHESIS
226.. 21086 IMPRESSION AND CUSTOM PREPARATION; AURICULAR PROSTHESIS
226.. 21087 IMPRESSION AND CUSTOM PREPARATION; NASAL PROSTHESIS
226.. 21088 IMPRESSION AND CUSTOM PREPARATION; FACIAL PROSTHESIS
226.. 21089 UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE
231.. Level I skull and facial bone T 12.02 $609.05 $299.9 $121.81
procedures
231.. 21015 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FACE OR SCALP
231.. 21025 EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); MANDIBLE
231.. 21026 EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); FACIAL BONE(S)
231.. 21029 REMOVAL BY CONTOURING OF BENIGN TUMOR OF FACIAL BONE (EG, FIBROUS DYSPLASIA)
231.. 21030 EXCISION OF BENIGN TUMOR OR CYST OF FACIAL BONE OTHER THAN MANDIBLE
231.. 21031 EXCISION OF TORUS MANDIBULARIS
231.. 21032 EXCISION OF MAXILLARY TORUS PALATINUS
231.. 21040 EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMPLE
231.. 21041 EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; COMPLEX
231.. 21100 APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACIAL FIXATION, INCLUDES REMOVAL (SEPARATE
PROCEDURE)
[[Page 47778]]
231.. 21110 APPLICATION OF INTERDENTAL FIXATION DEVICE FOR CONDITIONS OTHER THAN FRACTURE OR DISLOCATION,
INCLUDES
231.. 21120 GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, PROSTHETIC MATERIAL)
231.. 21125 AUGMENTATION, MANDIBULAR BODY OR ANGLE; PROSTHETIC MATERIAL
231.. 21280 MEDIAL CANTHOPEXY (SEPARATE PROCEDURE)
231.. 21282 LATERAL CANTHOPEXY
231.. 21295 REDUCTION OF MASSETER MUSCLE AND BONE (EG, FOR TREATMENT OF BENIGN MASSETERIC HYPERTROPHY);
EXTRAORAL APPROACH
231.. 21296 REDUCTION OF MASSETER MUSCLE AND BONE (EG, FOR TREATMENT OF BENIGN MASSETERIC HYPERTROPHY);
INTRAORAL APPROACH
231.. 21299 UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE
231.. 21300 CLOSED TREATMENT OF SKULL FRACTURE WITHOUT OPERATION
231.. 21310 CLOSED TREATMENT OF NASAL BONE FRACTURE WITHOUT MANIPULATION
231.. 21315 CLOSED TREATMENT OF NASAL BONE FRACTURE; WITHOUT STABILIZATION
231.. 21320 CLOSED TREATMENT OF NASAL BONE FRACTURE; WITH STABILIZATION
231.. 21325 OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED
231.. 21337 CLOSED TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT STABILIZATION
231.. 21355 PERCUTANEOUS TREATMENT OF FRACTURE OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD,
WITH MANIPULATION
231.. 21400 CLOSED TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOWOUT''; WITHOUT MANIPULATION
231.. 21401 CLOSED TREATMENT OF FRACTURE OF ORBIT, EXCEPT ``BLOWOUT''; WITH MANIPULATION
231.. 21440 CLOSED TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR RIDGE FRACTURE (SEPARATE PROCEDURE)
231.. 21451 CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITH MANIPULATION
231.. 21480 CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT
231.. 21485 CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; COMPLICATED (EG, RECURRENT REQUIRING
INTERMAXILLARY FIXATION OR SPLINTING), INITIAL OR SUBSEQUENT
231.. 21493 CLOSED TREATMENT OF HYOID FRACTURE; WITHOUT MANIPULATION
231.. 21494 CLOSED TREATMENT OF HYOID FRACTURE; WITH MANIPULATION
231.. 21497 INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE
231.. 21499 UNLISTED MUSCULOSKELETAL PROCEDURE, HEAD
231.. 41822 EXCISION OF FIBROUS TUBEROSITIES, DENTOALVEOLAR STRUCTURES
231.. 41823 EXCISION OF OSSEOUS TUBEROSITIES, DENTOALVEOLAR STRUCTURES
232.. Level II skull and facial bone T 23.93 $1,212.52 $639.35 $242.50
procedures
232.. 21010 ARTHROTOMY, TEMPOROMANDIBULAR JOINT
232.. 21034 EXCISION OF MALIGNANT TUMOR OF FACIAL BONE OTHER THAN MANDIBLE
232.. 21044 EXCISION OF MALIGNANT TUMOR OF MANDIBLE
232.. 21050 CONDYLECTOMY, TEMPOROMANDIBULAR JOINT (SEPARATE PROCEDURE)
232.. 21060 MENISCECTOMY, PARTIAL OR COMPLETE, TEMPOROMANDIBULAR JOINT (SEPARATE PROCEDURE)
232.. 21070 CORONOIDECTOMY (SEPARATE PROCEDURE)
232.. 21121 GENIOPLASTY; SLIDING OSTEOTOMY, SINGLE PIECE
232.. 21122 GENIOPLASTY; SLIDING OSTEOTOMIES, TWO OR MORE OSTEOTOMIES (EG, WEDGE EXCISION OR BONE WEDGE
REVERSAL FOR ASYMMETRICAL CHIN)
232.. 21123 GENIOPLASTY; SLIDING, AUGMENTATION WITH INTERPOSITIONAL BONE GRAFTS (INCLUDES OBTAINING
AUTOGRAFTS)
232.. 21127 AUGMENTATION, MANDIBULAR BODY OR ANGLE; WITH BONE GRAFT, ONLAY OR INTERPOSITIONAL (INCLUDES
OBTAINING AUTOGRAFT)
232.. 21181 RECONSTRUCTION BY CONTOURING OF BENIGN TUMOR OF CRANIAL BONES (EG, FIBROUS DYSPLASIA),
EXTRACRANIAL
232.. 21206 OSTEOTOMY, MAXILLA, SEGMENTAL (EG, WASSMUND OR SCHUCHARD)
232.. 21208 OSTEOPLASTY, FACIAL BONES; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, OR PROSTHETIC IMPLANT)
232.. 21209 OSTEOPLASTY, FACIAL BONES; REDUCTION
232.. 21210 GRAFT, BONE; NASAL, MAXILLARY OR MALAR AREAS (INCLUDES OBTAINING GRAFT)
232.. 21215 GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)
232.. 21230 GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, NOSE OR EAR (INCLUDES OBTAINING GRAFT)
232.. 21235 GRAFT; EAR CARTILAGE, AUTOGENOUS, TO NOSE OR EAR (INCLUDES OBTAINING GRAFT)
232.. 21240 ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUT AUTOGRAFT (INCLUDES OBTAINING GRAFT)
232.. 21242 ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH ALLOGRAFT
232.. 21244 RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSOSTEAL BONE PLATE (EG, MANDIBULAR STAPLE BONE
PLATE)
232.. 21245 RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; PARTIAL
232.. 21246 RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; COMPLETE
232.. 21248 RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL IMPLANT (EG, BLADE, CYLINDER); PARTIAL
232.. 21249 RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL IMPLANT (EG, BLADE, CYLINDER); COMPLETE
232.. 21260 PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM, WITH BONE GRAFTS; EXTRACRANIAL APPROACH
232.. 21267 ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UNILATERAL, WITH BONE GRAFTS; EXTRACRANIAL
APPROACH
232.. 21270 MALAR AUGMENTATION, PROSTHETIC MATERIAL
232.. 21275 SECONDARY REVISION OF ORBITOCRANIOFACIAL RECONSTRUCTION
232.. 21330 OPEN TREATMENT OF NASAL FRACTURE; COMPLICATED, WITH INTERNAL AND/OR EXTERNAL SKELETAL FIXATION
232.. 21335 OPEN TREATMENT OF NASAL FRACTURE; WITH CONCOMITANT OPEN TREATMENT OF FRACTURED SEPTUM
232.. 21338 OPEN TREATMENT OF NASOETHMOID FRACTURE; WITHOUT EXTERNAL FIXATION
232.. 21339 OPEN TREATMENT OF NASOETHMOID FRACTURE; WITH EXTERNAL FIXATION
232.. 21340 PERCUTANEOUS TREATMENT OF NASOETHMOID COMPLEX FRACTURE, WITH SPLINT, WIRE OR HEADCAP FIXATION,
INCLUDING REPAIR OF CANTHAL LIGAMENTS AND/OR THE NASOLACRIMAL APPARATUS
232.. 21343 OPEN TREATMENT OF DEPRESSED FRONTAL SINUS FRACTURE
232.. 21345 CLOSED TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE), WITH INTERDENTAL WIRE
FIXATION OR FIXATION OF DENTURE OR SPLINT
232.. 21421 CLOSED TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE), WITH INTERDENTAL WIRE
FIXATION OR FIXATION OF DENTURE OR SPLINT
232.. 21445 OPEN TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR RIDGE FRACTURE (SEPARATE PROCEDURE)
[[Page 47779]]
232.. 21450 CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITHOUT MANIPULATION
232.. 21452 PERCUTANEOUS TREATMENT OF MANDIBULAR FRACTURE, WITH EXTERNAL FIXATION
232.. 21453 CLOSED TREATMENT OF MANDIBULAR FRACTURE WITH INTERDENTAL FIXATION
232.. 21454 OPEN TREATMENT OF MANDIBULAR FRACTURE WITH EXTERNAL FIXATION
232.. 21461 OPEN TREATMENT OF MANDIBULAR FRACTURE; WITHOUT INTERDENTAL FIXATION
232.. 21462 OPEN TREATMENT OF MANDIBULAR FRACTURE; WITH INTERDENTAL FIXATION
232.. 21465 OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE
232.. 21490 OPEN TREATMENT OF TEMPOROMANDIBULAR DISLOCATION
232.. 67420 ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH REMOVAL OF LESION
232.. 67430 ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH REMOVAL OF FOREIGN
BODY
232.. 67440 ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); WITH DRAINAGE
232.. 67450 ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); FOR EXPLORATION, WITH OR
WITHOUT BIOPSY
251.. Level I musculoskeletal T 14.26 $722.55 $366.12 $144.51
procedures
251.. 20005 INCISION OF SOFT TISSUE ABSCESS (EG, SECONDARY TO OSTEOMYELITIS); DEEP OR COMPLICATED
251.. 20250 BIOPSY, VERTEBRAL BODY, OPEN; THORACIC
251.. 20251 BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL
251.. 20650 INSERTION OF WIRE OR PIN WITH APPLICATION OF SKELETAL TRACTION, INCLUDING REMOVAL (SEPARATE
PROCEDURE)
251.. 20693 ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM REQUIRING ANESTHESIA (EG, NEW PIN(S) OR
WIRE(S) AND/OR NEW RING(S) OR BAR(S))
251.. 20694 REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM
251.. 20975 ELECTRICAL STIMULATION TO AID BONE HEALING; INVASIVE (OPERATIVE)
251.. 23100 ARTHROTOMY WITH BIOPSY, GLENOHUMERAL JOINT
251.. 23140 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA;
251.. 23935 INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HUMERUS OR
ELBOW
251.. 24100 ARTHROTOMY, ELBOW; WITH SYNOVIAL BIOPSY ONLY
251.. 24105 EXCISION, OLECRANON BURSA
251.. 24110 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS;
251.. 24120 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON
PROCESS;
251.. 24310 TENOTOMY, OPEN, ELBOW TO SHOULDER, SINGLE, EACH
251.. 24925 AMPUTATION, ARM THROUGH HUMERUS; SECONDARY CLOSURE OR SCAR REVISION
251.. 25000 TENDON SHEATH INCISION; AT RADIAL STYLOID (EG, FOR DEQUERVAIN'S DISEASE)
251.. 25020 DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST; FLEXOR OR EXTENSOR COMPARTMENT
251.. 25028 INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA
251.. 25031 INCISION AND DRAINAGE, FOREARM AND/OR WRIST; INFECTED BURSA
251.. 25035 INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), FOREARM
AND/OR WRIST
251.. 25085 CAPSULOTOMY, WRIST (EG, FOR CONTRACTURE)
251.. 25100 ARTHROTOMY, WRIST JOINT; WITH BIOPSY
251.. 25110 EXCISION, LESION OF TENDON SHEATH, FOREARM AND/OR WRIST
251.. 25115 RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (EG, TENOSYNOVITIS,
FUNGUS, TBC, OR OTHER GRANULOMAS, RHEUMATOID ARTHRITIS); FLEXORS
251.. 25116 RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (EG, TENOSYNOVITIS,
FUNGUS, TBC, OR OTHER GRANULOMAS, RHEUMATOID ARTHRITIS); EXTENSORS, WITH OR WITHOUT
TRANSPOSITION OF DORSAL RETINACULUM
251.. 25248 EXPLORATION WITH REMOVAL OF DEEP FOREIGN BODY, FOREARM OR WRIST
251.. 25295 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON
251.. 25907 AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; SECONDARY CLOSURE OR SCAR REVISION
251.. 25922 DISARTICULATION THROUGH WRIST; SECONDARY CLOSURE OR SCAR REVISION
251.. 26990 INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; DEEP ABSCESS OR HEMATOMA
251.. 26991 INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; INFECTED BURSA
251.. 27000 TENOTOMY, ADDUCTOR OF HIP, SUBCUTANEOUS, CLOSED (SEPARATE PROCEDURE)
251.. 27050 ARTHROTOMY, WITH BIOPSY; SACROILIAC JOINT
251.. 27052 ARTHROTOMY, WITH BIOPSY; HIP JOINT
251.. 27060 EXCISION; ISCHIAL BURSA
251.. 27062 EXCISION; TROCHANTERIC BURSA OR CALCIFICATION
251.. 27065 EXCISION OF BONE CYST OR BENIGN TUMOR; SUPERFICIAL (WING OF ILIUM, SYMPHYSIS PUBIS, OR GREATER
TROCHANTER OF FEMUR) WITH OR WITHOUT AUTOGRAFT
251.. 27086 REMOVAL OF FOREIGN BODY, PELVIS OR HIP; SUBCUTANEOUS TISSUE
251.. 27087 REMOVAL OF FOREIGN BODY, PELVIS OR HIP; DEEP
251.. 27305 FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN
251.. 27306 TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTRING, (SEPARATE PROCEDURE); SINGLE
251.. 27307 TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTRING, (SEPARATE PROCEDURE); MULTIPLE
251.. 27340 EXCISION, PREPATELLAR BURSA
251.. 27345 EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (BAKER'S CYST)
251.. 27380 SUTURE OF INFRAPATELLAR TENDON; PRIMARY
251.. 27381 SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON GRAFT
251.. 27385 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; PRIMARY
251.. 27386 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL
OR TENDON GRAFT
251.. 27390 TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE
251.. 27391 TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE, ONE LEG
251.. 27392 TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE, BILATERAL
251.. 27496 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE COMPARTMENT (FLEXOR OR EXTENSOR OR ADDUCTOR);
251.. 27497 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE COMPARTMENT (FLEXOR OR EXTENSOR OR ADDUCTOR);
WITH DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE
251.. 27498 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE COMPARTMENTS;
[[Page 47780]]
251.. 27499 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE COMPARTMENTS; WITH DEBRIDEMENT OF
NONVIABLE MUSCLE AND/OR NERVE
251.. 27594 AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; SECONDARY CLOSURE OR SCAR REVISION
251.. 27600 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL COMPARTMENTS ONLY
251.. 27601 DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR COMPARTMENT(S) ONLY
251.. 27602 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S)
251.. 27604 INCISION AND DRAINAGE, LEG OR ANKLE; INFECTED BURSA
251.. 27606 TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS (SEPARATE PROCEDURE); GENERAL ANESTHESIA
251.. 27607 INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), LEG OR
ANKLE
251.. 27630 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST OR GANGLION), LEG AND/OR ANKLE
251.. 27656 REPAIR, FASCIAL DEFECT OF LEG
251.. 27658 REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; PRIMARY, WITHOUT GRAFT, SINGLE, EACH
251.. 27659 REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; SECONDARY WITH OR WITHOUT GRAFT, SINGLE TENDON, EACH
251.. 27664 REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; PRIMARY, WITHOUT GRAFT, SINGLE, EACH
251.. 27675 REPAIR FOR DISLOCATING PERONEAL TENDONS; WITHOUT FIBULAR OSTEOTOMY
251.. 27704 REMOVAL OF ANKLE IMPLANT
251.. 27707 OSTEOTOMY; FIBULA
251.. 27884 AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; SECONDARY CLOSURE OR SCAR REVISION
251.. 27892 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL COMPARTMENTS ONLY, WITH DEBRIDEMENT OF
NONVIABLE MUSCLE AND/OR NERVE
251.. 27893 DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR COMPARTMENT(S) ONLY, WITH DEBRIDEMENT OF NONVIABLE
MUSCLE AND/OR NERVE
251.. 27894 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S), WITH
DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE
251.. 28002 DEEP DISSECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT, WITH OR WITHOUT TENDON SHEATH
INVOLVEMENT; SINGLE BURSAL SPACE, SPECIFY
251.. 28003 DEEP DISSECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT, WITH OR WITHOUT TENDON SHEATH
INVOLVEMENT; MULTIPLE AREAS
252.. Level II Musculoskeletal T 19.39 $982.48 $509.18 $196.5
Procedures
252.. 20690 APPLICATION OF A UNIPLANE (PINS OR WIRES IN ONE PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM
252.. 20692 APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN ONE PLANE), UNILATERAL, EXTERNAL
FIXATION SYSTEM (EG, ILIZAROV, MONTICELLI TYPE)
252.. 20900 BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)
252.. 20902 BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE
252.. 20924 TENDON GRAFT, FROM A DISTANCE (EG, PALMARIS, TOE EXTENSOR, PLANTARIS)
252.. 21502 INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX; WITH PARTIAL
RIB OSTECTOMY
252.. 21600 EXCISION OF RIB, PARTIAL
252.. 21610 COSTOTRANSVERSECTOMY (SEPARATE PROCEDURE)
252.. 23040 ARTHROTOMY, GLENOHUMERAL JOINT, FOR INFECTION, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF
FOREIGN BODY
252.. 23044 ARTHROTOMY, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT, FOR INFECTION, WITH EXPLORATION,
DRAINAGE, OR REMOVAL OF FOREIGN BODY
252.. 23101 ARTHROTOMY WITH BIOPSY, OR WITH EXCISION OF TORN CARTILAGE, ACROMIOCLAVICULAR, STERNOCLAVICULAR
JOINT
252.. 23105 ARTHROTOMY WITH SYNOVECTOMY; GLENOHUMERAL JOINT
252.. 23106 ARTHROTOMY WITH SYNOVECTOMY; STERNOCLAVICULAR JOINT
252.. 23107 ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOOSE OR
FOREIGN BODY
252.. 23145 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA; WITH AUTOGRAFT
(INCLUDES OBTAINING GRAFT)
252.. 23146 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA; WITH ALLOGRAFT
252.. 23150 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS;
252.. 23155 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS; WITH AUTOGRAFT
(INCLUDES OBTAINING GRAFT)
252.. 23156 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS; WITH ALLOGRAFT
252.. 23170 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), CLAVICLE
252.. 23172 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), SCAPULA
252.. 23174 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HUMERAL HEAD TO SURGICAL NECK
252.. 23180 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), CLAVICLE
252.. 23182 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), SCAPULA
252.. 23184 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), PROXIMAL HUMERUS
252.. 23190 OSTECTOMY OF SCAPULA, PARTIAL (EG, SUPERIOR MEDIAL ANGLE)
252.. 23405 TENOMYOTOMY, SHOULDER AREA; SINGLE
252.. 23406 TENOMYOTOMY, SHOULDER AREA; MULTIPLE THROUGH SAME INCISION
252.. 24000 ARTHROTOMY, ELBOW, FOR INFECTION, WITH EXPLORATION, DRAINAGE OR REMOVAL OF FOREIGN BODY
252.. 24006 ARTHROTOMY OF THE ELBOW, WITH CAPSULAR EXCISION FOR CAPSULAR RELEASE (SEPARATE PROCEDURE)
252.. 24101 ARTHROTOMY, ELBOW; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF
LOOSE OR FOREIGN BODY
252.. 24102 ARTHROTOMY, ELBOW; WITH SYNOVECTOMY
252.. 24115 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING
GRAFT)
252.. 24116 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; WITH ALLOGRAFT
252.. 24125 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON
PROCESS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
252.. 24126 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON
PROCESS; WITH ALLOGRAFT
252.. 24130 EXCISION, RADIAL HEAD
252.. 24134 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), SHAFT OR DISTAL HUMERUS
[[Page 47781]]
252.. 24136 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), RADIAL HEAD OR NECK
252.. 24138 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), OLECRANON PROCESS
252.. 24140 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), HUMERUS
252.. 24145 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), RADIAL HEAD OR NECK
252.. 24147 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), OLECRANON PROCESS
252.. 24160 IMPLANT REMOVAL; ELBOW JOINT
252.. 24164 IMPLANT REMOVAL; RADIAL HEAD
252.. 24301 MUSCLE OR TENDON TRANSFER, ANY TYPE, UPPER ARM OR ELBOW, SINGLE (EXCLUDING 24320-24331)
252.. 24305 TENDON LENGTHENING, UPPER ARM OR ELBOW, SINGLE, EACH
252.. 24350 FASCIOTOMY, LATERAL OR MEDIAL (EG, ``TENNIS ELBOW'' OR EPICONDYLITIS);
252.. 24351 FASCIOTOMY, LATERAL OR MEDIAL (EG, ``TENNIS ELBOW'' OR EPICONDYLITIS); WITH EXTENSOR ORIGIN
DETACHMENT
252.. 24352 FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'' OR EPICONDYLITIS); WITH ANNULAR LIGAMENT
RESECTION
252.. 24354 FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'' OR EPICONDYLITIS); WITH STRIPPING
252.. 24356 FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'' OR EPICONDYLITIS); WITH PARTIAL OSTECTOMY
252.. 24400 OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXATION
252.. 24410 MULTIPLE OSTEOTOMIES WITH REALIGNMENT ON INTRAMEDULLARY ROD, HUMERAL SHAFT (SOFIELD TYPE
PROCEDURE)
252.. 24495 DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL ARTERY EXPLORATION
252.. 25023 DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST; WITH DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR
NERVE
252.. 25040 ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN
BODY
252.. 25101 ARTHROTOMY, WRIST JOINT; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT
REMOVAL OF LOOSE OR FOREIGN BODY
252.. 25105 ARTHROTOMY, WRIST JOINT; WITH SYNOVECTOMY
252.. 25107 ARTHROTOMY, DISTAL RADIOULNAR JOINT FOR REPAIR OF TRIANGULAR CARTILAGE COMPLEX
252.. 25118 SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COMPARTMENT;
252.. 25119 SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COMPARTMENT; WITH RESECTION OF DISTAL ULNA
252.. 25120 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK OF
RADIUS AND OLECRANON PROCESS);
252.. 25125 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK OF
RADIUS AND OLECRANON PROCESS); WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
252.. 25126 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK OF
RADIUS AND OLECRANON PROCESS); WITH ALLOGRAFT
252.. 25130 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES;
252.. 25135 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES; WITH AUTOGRAFT (INCLUDES
OBTAINING GRAFT)
252.. 25136 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES; WITH ALLOGRAFT
252.. 25145 SEQUESTRECTOMY (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), FOREARM AND/OR WRIST
252.. 25150 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS); ULNA
252.. 25151 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS); RADIUS
252.. 25230 RADIAL STYLOIDECTOMY (SEPARATE PROCEDURE)
252.. 25240 EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPE OR MATCHED RESECTION)
252.. 25250 REMOVAL OF WRIST PROSTHESIS; (SEPARATE PROCEDURE)
252.. 25251 REMOVAL OF WRIST PROSTHESIS; COMPLICATED, INCLUDING ''TOTAL WRIST''
252.. 25260 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE
252.. 25263 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; SECONDARY, SINGLE, EACH TENDON OR
MUSCLE
252.. 25265 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; SECONDARY, WITH FREE GRAFT (INCLUDES
OBTAINING GRAFT), EACH TENDON OR MUSCLE
252.. 25270 REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR
MUSCLE
252.. 25272 REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; SECONDARY, SINGLE, EACH TENDON OR
MUSCLE
252.. 25274 REPAIR, TENDON OR MUSCLE, EXTENSOR, SECONDARY, WITH TENDON GRAFT (INCLUDES OBTAINING GRAFT),
FOREARM AND/OR WRIST, EACH TENDON OR MUSCLE
252.. 25280 LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH
TENDON
252.. 25290 TENOTOMY, OPEN, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON
252.. 25300 TENODESIS AT WRIST; FLEXORS OF FINGERS
252.. 25301 TENODESIS AT WRIST; EXTENSORS OF FINGERS
252.. 25360 OSTEOTOMY; ULNA
252.. 25365 OSTEOTOMY; RADIUS AND ULNA
252.. 25400 REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)
252.. 25415 REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)
252.. 27001 TENOTOMY, ADDUCTOR OF HIP, SUBCUTANEOUS, OPEN
252.. 27003 TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN, WITH OBTURATOR NEURECTOMY
252.. 27066 EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP, WITH OR WITHOUT AUTOGRAFT
252.. 27067 EXCISION OF BONE CYST OR BENIGN TUMOR; WITH AUTOGRAFT REQUIRING SEPARATE INCISION
252.. 27080 COCCYGECTOMY, PRIMARY
252.. 27097 HAMSTRING RECESSION, PROXIMAL
252.. 27098 ADDUCTOR TRANSFER TO ISCHIUM
252.. 27310 ARTHROTOMY, KNEE, FOR INFECTION, WITH EXPLORATION, DRAINAGE OR REMOVAL OF FOREIGN BODY
252.. 27330 ARTHROTOMY, KNEE; WITH SYNOVIAL BIOPSY ONLY
252.. 27331 ARTHROTOMY, KNEE; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF
LOOSE OR FOREIGN BODIES
252.. 27332 ARTHROTOMY, KNEE, WITH EXCISION OF SEMILUNAR CARTILAGE (MENISCECTOMY); MEDIAL OR LATERAL
252.. 27333 ARTHROTOMY, KNEE, WITH EXCISION OF SEMILUNAR CARTILAGE (MENISCECTOMY); MEDIAL AND LATERAL
252.. 27334 ARTHROTOMY, KNEE, WITH SYNOVECTOMY; ANTERIOR OR POSTERIOR
252.. 27335 ARTHROTOMY, KNEE, WITH SYNOVECTOMY; ANTERIOR AND POSTERIOR INCLUDING POPLITEAL AREA
252.. 27350 PATELLECTOMY OR HEMIPATELLECTOMY
[[Page 47782]]
252.. 27355 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR;
252.. 27356 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH ALLOGRAFT
252.. 27357 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH AUTOGRAFT (INCLUDES OBTAINING
GRAFT)
252.. 27358 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH INTERNAL FIXATION (LIST IN
ADDITION TO 27355, 27356, OR 27357)
252.. 27360 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS), FEMUR, PROXIMAL TIBIA AND/ OR FIBULA
252.. 27393 LENGTHENING OF HAMSTRING TENDON; SINGLE
252.. 27394 LENGTHENING OF HAMSTRING TENDON; MULTIPLE, ONE LEG
252.. 27396 TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE
252.. 27403 ARTHROTOMY WITH OPEN MENISCUS REPAIR
252.. 27425 LATERAL RETINACULAR RELEASE (ANY METHOD)
252.. 27610 ARTHROTOMY, ANKLE, FOR INFECTION, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY
252.. 27612 ARTHROTOMY, ANKLE, POSTERIOR CAPSULAR RELEASE, WITH OR WITHOUT ACHILLES TENDON LENGTHENING
252.. 27620 ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF
LOOSE OR FOREIGN BODY
252.. 27625 ARTHROTOMY, ANKLE, WITH SYNOVECTOMY;
252.. 27626 ARTHROTOMY, ANKLE, WITH SYNOVECTOMY; INCLUDING TENOSYNOVECTOMY
252.. 27635 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA;
252.. 27637 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; WITH AUTOGRAFT (INCLUDES
OBTAINING GRAFT)
252.. 27638 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; WITH ALLOGRAFT
252.. 27641 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS OR EXOSTOSIS); FIBULA
252.. 27665 REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; SECONDARY WITH OR WITHOUT GRAFT, SINGLE TENDON,
EACH
252.. 27676 REPAIR FOR DISLOCATING PERONEAL TENDONS; WITH FIBULAR OSTEOTOMY
252.. 27680 TENOLYSIS, INCLUDING TIBIA, FIBULA, AND ANKLE FLEXOR; SINGLE
252.. 27681 TENOLYSIS, INCLUDING TIBIA, FIBULA, AND ANKLE FLEXOR; MULTIPLE (THROUGH SAME INCISION), EACH
252.. 27685 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SINGLE (SEPARATE PROCEDURE)
252.. 27686 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; MULTIPLE (THROUGH SAME INCISION), EACH
252.. 27687 GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)
252.. 27695 SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT, ANKLE; COLLATERAL
252.. 27696 SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT, ANKLE; BOTH COLLATERAL LIGAMENTS
252.. 27698 SUTURE, SECONDARY REPAIR, TORN, RUPTURED OR SEVERED LIGAMENT, ANKLE, COLLATERAL (EG, WATSON-
JONES PROCEDURE)
252.. 27709 OSTEOTOMY; TIBIA AND FIBULA
252.. 27730 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL TIBIA
252.. 27732 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL FIBULA
252.. 27734 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL TIBIA AND FIBULA
252.. 27740 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, COMBINED, PROXIMAL AND DISTAL TIBIA AND
FIBULA;
252.. 27889 ANKLE DISARTICULATION
253.. Level III Musculoskeletal T 26.33 $1,334.13 $699.24 $266.83
Procedures
253.. 23020 CAPSULAR CONTRACTURE RELEASE (SEVER TYPE PROCEDURE)
253.. 23120 CLAVICULECTOMY; PARTIAL
253.. 23130 ACROMIOPLASTY OR ACROMIONECTOMY, PARTIAL
253.. 23415 CORACOACROMIAL LIGAMENT RELEASE, WITH OR WITHOUT ACROMIOPLASTY
253.. 23480 OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION;
253.. 23485 OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION; WITH BONE GRAFT FOR NONUNION OR
MALUNION (INCLUDES OBTAINING GRAFT AND/OR NECESSARY FIXATION)
253.. 23490 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT
METHYLMETHACRYLATE; CLAVICLE
253.. 23491 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT
METHYLMETHACRYLATE; PROXIMAL HUMERUS AND HUMERAL HEAD
253.. 23800 ARTHRODESIS, SHOULDER JOINT; WITH OR WITHOUT LOCAL BONE GRAFT
253.. 23802 ARTHRODESIS, SHOULDER JOINT; WITH PRIMARY AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)
253.. 24155 RESECTION OF ELBOW JOINT (ARTHRECTOMY)
253.. 24320 TENOPLASTY, WITH MUSCLE TRANSFER, WITH OR WITHOUT FREE GRAFT, ELBOW TO SHOULDER, SINGLE (SEDDON-
BROOKES TYPE PROCEDURE)
253.. 24330 FLEXOR-PLASTY, ELBOW (EG, STEINDLER TYPE ADVANCEMENT);
253.. 24331 FLEXOR-PLASTY, ELBOW (EG, STEINDLER TYPE ADVANCEMENT); WITH EXTENSOR ADVANCEMENT
253.. 24340 TENODESIS OF BICEPS TENDON AT ELBOW (SEPARATE PROCEDURE)
253.. 24341 REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECONDARY
(EXCLUDES ROTATOR CUFF)
253.. 24342 REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT
253.. 24420 OSTEOPLASTY, HUMERUS (EG, SHORTENING OR LENGTHENING) (EXCLUDING 64876)
253.. 24430 REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)
253.. 24435 REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING
GRAFT)
253.. 24470 HEMIEPIPHYSEAL ARREST (EG, FOR CUBITUS VARUS OR VALGUS, DISTAL HUMERUS)
253.. 24498 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING), WITH OR WITHOUT
METHYLMETHACRYLATE, HUMERUS
253.. 24800 ARTHRODESIS, ELBOW JOINT; WITH OR WITHOUT LOCAL AUTOGRAFT OR ALLOGRAFT
253.. 24802 ARTHRODESIS, ELBOW JOINT; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT OTHER THAN LOCALLY OBTAINED)
253.. 25310 TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; EACH
TENDON
253.. 25312 TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; WITH
TENDON GRAFT(S) (INCLUDES OBTAINING GRAFT), EACH TENDON
253.. 25315 FLEXOR ORIGIN SLIDE (EG, FOR CEREBRAL PALSY, VOLKMANN CONTRACTURE), FOREARM AND/OR WRIST;
253.. 25316 FLEXOR ORIGIN SLIDE (EG, FOR CEREBRAL PALSY, VOLKMANN CONTRACTURE), FOREARM AND/OR WRIST; WITH
TENDON(S) TRANSFER
253.. 25320 CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, ANY METHOD (EG, CAPSULODESIS, LIGAMENT REPAIR, TENDON
TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR CARPAL
INSTABILITY
[[Page 47783]]
253.. 25335 CENTRALIZATION OF WRIST ON ULNA (EG, RADIAL CLUB HAND)
253.. 25337 RECONSTRUCTION FOR STABILIZATION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT, SECONDARY
BY SOFT TISSUE STABILIZATION (EG, TENDON TRANSFER, TENDON GRAFT OR WEAVE, OR TENODESIS) WITH
OR WITHOUT OPEN REDUCTION OF DISTAL RADIOULNAR JOINT
253.. 25350 OSTEOTOMY, RADIUS; DISTAL THIRD
253.. 25355 OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD
253.. 25370 MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE); RADIUS
OR ULNA
253.. 25375 MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE); RADIUS
AND ULNA
253.. 25425 REPAIR OF DEFECT WITH AUTOGRAFT; RADIUS OR ULNA
253.. 25426 REPAIR OF DEFECT WITH AUTOGRAFT; RADIUS AND ULNA
253.. 25440 REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, WITH OR WITHOUT RADIAL STYLOIDECTOMY (INCLUDES
OBTAINING GRAFT AND NECESSARY FIXATION)
253.. 25450 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL RADIUS OR ULNA
253.. 25455 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL RADIUS AND ULNA
253.. 25490 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT
METHYLMETHACRYLATE; RADIUS
253.. 25491 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT
METHYLMETHACRYLATE; ULNA
253.. 25492 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT
METHYLMETHACRYLATE; RADIUS AND VLNA
253.. 25800 ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR ULNOCARPAL FUSION); WITHOUT BONE GRAFT
253.. 25805 ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR ULNOCARPAL FUSION); WITH SLIDING GRAFT
253.. 25810 ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR ULNOCARPAL FUSION); WITH ILIAC OR OTHER
AUTOGRAFT (INCLUDES OBTAINING GRAFT)
253.. 25830 DISTAL RADIOULNAR JOINT ARTHRODESIS AND SEGMENTAL RESECTION OF ULNA (EG, SAUVE-KAPANDJI
PROCEDURE), WITH OR WITHOUT BONE GRAFT
253.. 27033 ARTHROTOMY, HIP, WITH EXPLORATION OR REMOVAL OF LOOSE OR FOREIGN BODY
253.. 27100 TRANSFER EXTERNAL OBLIQUE MUSCLE TO GREATER TROCHANTER INCLUDING FASCIAL OR TENDON EXTENSION
(GRAFT)
253.. 27105 TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASCIAL OR TENDON EXTENSION GRAFT)
253.. 27110 TRANSFER ILIOPSOAS; TO GREATER TROCHANTER
253.. 27111 TRANSFER ILIOPSOAS; TO FEMORAL NECK
253.. 27395 LENGTHENING OF HAMSTRING TENDON; MULTIPLE, BILATERAL
253.. 27397 TRANSPLANT, HAMSTRING TENDON TO PATELLA; MULTIPLE
253.. 27400 TENDON OR MUSCLE TRANSFER, HAMSTRINGS TO FEMUR (EGGERS TYPE PROCEDURE)
253.. 27405 REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL
253.. 27407 REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; CRUCIATE
253.. 27409 REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL AND CRUCIATE LIGAMENTS
253.. 27418 ANTERIOR TIBIAL TUBERCLEPLASTY (EG, FOR CHONDROMALACIA PATELLAE)
253.. 27420 RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA; (HAUSER TYPE PROCEDURE)
253.. 27422 RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA; WITH EXTENSOR REALIGNMENT AND/OR MUSCLE
ADVANCEMENT OR RELEASE (CAMPBELL, GOLDWAITE TYPE PROCEDURE)
253.. 27424 RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA; WITH PATELLECTOMY
253.. 27430 QUADRICEPSPLASTY (BENNETT OR THOMPSON TYPE)
253.. 27435 CAPSULOTOMY, KNEE, POSTERIOR CAPSULAR RELEASE
253.. 27640 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS OR EXOSTOSIS); TIBIA
253.. 27647 RADICAL RESECTION OF TUMOR, BONE; TALUS OR CALCANEUS
253.. 27650 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;
253.. 27652 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON; WITH GRAFT (INCLUDES OBTAINING
GRAFT)
253.. 27654 REPAIR, SECONDARY, RUPTURED ACHILLES TENDON, WITH OR WITHOUT GRAFT
253.. 27690 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); SUPERFICIAL
(EG, ANTERIOR TIBIAL EXTENSORS INTO MIDFOOT)
253.. 27691 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); DEEP (EG,
ANTERIOR TIBIAL OR POSTERIOR TIBIAL THROUGH INTEROSSEOUS SPACE, FLEXOR DIGITORUM LONGUS,
FLEXOR HALLUCIS LONGUS, OR PERONEAL TENDON TO MIDFOOT OR HINDFOOT)
253.. 27692 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); EACH ADDITIONAL
TENDON
253.. 27705 OSTEOTOMY; TIBIA
253.. 27742 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, COMBINED, PROXIMAL AND DISTAL TIBIA AND
FIBULA; AND DISTAL FEMUR
253.. 27745 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT
METHYLMETHACRYLATE, TIBIA
253.. 27870 ARTHRODESIS, ANKLE, ANY METHOD
253.. 27871 ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL
254.. Level IV Musculoskeletal T 34.37 $1,741.51 $937.11 $348.30
Procedures
254.. 23410 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF); ACUTE
254.. 23412 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF); CHRONIC
254.. 23420 REPAIR OF COMPLETE SHOULDER (ROTATOR) CUFF AVULSION, CHRONIC (INCLUDES ACROMIOPLASTY)
254.. 23430 TENODESIS OF LONG TENDON OF BICEPS
254.. 23450 CAPSULORRHAPHY, ANTERIOR; PUTTI-PLATT PROCEDURE OR MAGNUSON TYPE OPERATION
254.. 23455 CAPSULORRHAPHY, ANTERIOR; BANKART TYPE OPERATION WITH OR WITHOUT STAPLING
254.. 23460 CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH BONE BLOCK
254.. 23462 CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH CORACOID PROCESS TRANSFER
254.. 23465 CAPSULORRHAPHY FOR RECURRENT DISLOCATION, POSTERIOR, WITH OR WITHOUT BONE BLOCK
254.. 23466 CAPSULORRHAPHY WITH ANY TYPE MULTI-DIRECTIONAL INSTABILITY
254.. 27427 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; EXTRA-ARTICULAR
254.. 27428 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)
254.. 27429 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN) AND EXTRA-ARTICULAR
261.. Level I Hand Musculoskeletal T 10.54 $534.06 $261.48 $106.81
Procedures
261.. 25111 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY
[[Page 47784]]
261.. 25112 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); RECURRENT
261.. 25820 INTERCARPAL FUSION; WITHOUT BONE GRAFT
261.. 26020 DRAINAGE OF TENDON SHEATH, ONE DIGIT AND/OR PALM
261.. 26025 DRAINAGE OF PALMAR BURSA; SINGLE, ULNAR OR RADIAL
261.. 26030 DRAINAGE OF PALMAR BURSA; MULTIPLE OR COMPLICATED
261.. 26034 INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HAND OR
FINGER
261.. 26035 DECOMPRESSION FINGERS AND/OR HAND, INJECTION INJURY (EG, GREASE GUN)
261.. 26037 DECOMPRESSIVE FASCIOTOMY, HAND (EXCLUDES 26035)
261.. 26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER)
261.. 26060 TENOTOMY, PERCUTANEOUS, SINGLE, EACH DIGIT
261.. 26070 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY; CARPOMETACARPAL JOINT
261.. 26075 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY; METACARPOPHALANGEAL JOINT
261.. 26080 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY; INTERPHALANGEAL JOINT, EACH
261.. 26100 ARTHROTOMY WITH SYNOVIAL BIOPSY; CARPOMETACARPAL JOINT
261.. 26105 ARTHROTOMY WITH SYNOVIAL BIOPSY; METACARPOPHALANGEAL JOINT
261.. 26110 ARTHROTOMY WITH SYNOVIAL BIOPSY; INTERPHALANGEAL JOINT, EACH
261.. 26130 SYNOVECTOMY, CARPOMETACARPAL JOINT
261.. 26140 SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, INCLUDING EXTENSOR RECONSTRUCTION, EACH
INTERPHALANGEAL
261.. 26145 SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOMY), FLEXOR, PALM OR FINGER, SINGLE, EACH
DIGIT
261.. 26160 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST, MUCOUS CYST, OR GANGLION), HAND OR
FINGER
261.. 26170 EXCISION OF TENDON, PALM, FLEXOR, SINGLE (SEPARATE PROCEDURE), EACH
261.. 26180 EXCISION OF TENDON, FINGER, FLEXOR (SEPARATE PROCEDURE)
261.. 26185 SESAMOIDECTOMY, THUMB OR FINGER (SEPARATE PROCEDURE)
261.. 26200 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF METACARPAL;
261.. 26210 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL, MIDDLE, OR DISTAL PHALANX OF
FINGER;
261.. 26215 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL, MIDDLE, OR DISTAL PHALANX OF
FINGER; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
261.. 26230 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS); METACARPAL
261.. 26235 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER
261.. 26236 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS); DISTAL PHALANX OF FINGER
261.. 26250 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPAL;
261.. 26260 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL OR MIDDLE PHALANX OF FINGER;
261.. 26261 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL OR MIDDLE PHALANX OF FINGER; WITH AUTOGRAFT
(INCLUDES OBTAINING GRAFT)
261.. 26262 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, DISTAL PHALANX OF FINGER
261.. 26410 EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH
TENDON
261.. 26418 EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT,
EACH TENDON
261.. 26432 EXTENSOR TENDON REPAIR, DISTAL INSERTION (``MALLET FINGER''), CLOSED, SPLINTING WITH OR WITHOUT
PERCUTANEOUS PINNING
261.. 26433 EXTENSOR TENDON REPAIR, DISTAL INSERTION (``MALLET FINGER''), OPEN, PRIMARY OR SECONDARY
REPAIR; WITHOUT GRAFT
261.. 26437 EXTENSOR TENDON REALIGNMENT, HAND
261.. 26440 TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM OR FINGER, SINGLE, EACH TENDON
261.. 26445 TENOLYSIS, EXTENSOR TENDON, DORSUM OF HAND OR FINGER; EACH TENDON
261.. 26450 TENOTOMY, FLEXOR, SINGLE, PALM, OPEN, EACH
261.. 26455 TENOTOMY, FLEXOR, SINGLE, FINGER, OPEN, EACH
261.. 26460 TENOTOMY, EXTENSOR, HAND OR FINGER, SINGLE, OPEN, EACH
261.. 26471 TENODESIS; FOR PROXIMAL INTERPHALANGEAL JOINT STABILIZATION
261.. 26474 TENODESIS; FOR DISTAL JOINT STABILIZATION
261.. 26476 TENDON LENGTHENING, EXTENSOR, HAND OR FINGER, SINGLE, EACH
261.. 26477 TENDON SHORTENING, EXTENSOR, HAND OR FINGER, SINGLE, EACH
261.. 26478 TENDON LENGTHENING, FLEXOR, HAND OR FINGER, SINGLE, EACH
261.. 26479 TENDON SHORTENING, FLEXOR, HAND OR FINGER, SINGLE, EACH
261.. 26500 TENDON PULLEY RECONSTRUCTION; WITH LOCAL TISSUES (SEPARATE PROCEDURE)
261.. 26508 THENAR MUSCLE RELEASE FOR THUMB CONTRACTURE
261.. 26520 CAPSULECTOMY OR CAPSULOTOMY FOR CONTRACTURE; METACARPOPHALANGEAL JOINT, SINGLE, EACH
261.. 26525 CAPSULECTOMY OR CAPSULOTOMY FOR CONTRACTURE; INTERPHALANGEAL JOINT, SINGLE, EACH
261.. 26540 REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT
261.. 26542 RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHALANGEAL JOINT, SINGLE; WITH LOCAL TISSUE (EG,
ADDUCTOR ADVANCEMENT)
261.. 26560 REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; WITH SKIN FLAPS
261.. 26587 RECONSTRUCTION OF SUPERNUMERARY DIGIT, SOFT TISSUE AND BONE
261.. 26593 RELEASE, INTRINSIC MUSCLES OF HAND (SPECIFY)
261.. 26951 AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING
NEURECTOMIES; WITH DIRECT CLOSURE
261.. 26952 AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING
NEURECTOMIES; WITH LOCAL ADVANCEMENT FLAPS (V-Y, HOOD)
262.. Level II Hand Musculoskeletal T 18.35 $929.78 $480.82 $185.96
Procedures
262.. 25210 CARPECTOMY; ONE BONE
262.. 25215 CARPECTOMY; ALL BONES OF PROXIMAL ROW
262.. 25825 INTERCARPAL FUSION; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
262.. 26040 FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; PERCUTANEOUS
262.. 26045 FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; OPEN, PARTIAL
262.. 26121 FASCIECTOMY, PALM ONLY, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN
GRAFTING (INCLUDES OBTAINING GRAFT)
[[Page 47785]]
262.. 26123 FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL
JOINT, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES
OBTAINING GRAFT);
262.. 26125 FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL
JOINT, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES
OBTAINING GRAFT); EACH ADDITIONAL DIGIT (LIST SEPARATELY IN ADDITION
262.. 26135 SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING INTRINSIC RELEASE AND EXTENSOR HOOD
RECONSTRUCTION, EACH DIGIT
262.. 26205 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF METACARPAL; WITH AUTOGRAFT (INCLUDES
OBTAINING GRAFT)
262.. 26255 RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPAL; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)
262.. 26350 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, NOT IN ''NO MAN'S LAND''; PRIMARY OR SECONDARY
WITHOUT FREE GRAFT, EACH TENDON
262.. 26352 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, NOT IN ''NO MAN'S LAND''; SECONDARY WITH FREE
GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON
262.. 26356 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN ''NO MAN'S LAND''; PRIMARY, EACH TENDON
262.. 26357 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN ''NO MAN'S LAND''; SECONDARY, EACH TENDON
262.. 26358 FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN ''NO MAN'S LAND''; SECONDARY WITH FREE GRAFT
(INCLUDES OBTAINING GRAFT), EACH TENDON
262.. 26370 PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTACT SUBLIMIS; PRIMARY
262.. 26372 PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTACT SUBLIMIS; SECONDARY WITH FREE GRAFT
(INCLUDES OBTAINING GRAFT)
262.. 26373 PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTACT SUBLIMIS; SECONDARY WITHOUT FREE GRAFT
262.. 26390 FLEXOR TENDON EXCISION, IMPLANTATION OF PLASTIC TUBE OR ROD FOR DELAYED TENDON GRAFT, HAND OR
FINGER
262.. 26392 REMOVAL OF TUBE OR ROD AND INSERTION OF FLEXOR TENDON GRAFT (INCLUDES OBTAINING GRAFT), HAND OR
FINGER
262.. 26412 EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PRIMARY OR SECONDARY; WITH FREE GRAFT (INCLUDES
OBTAINING GRAFT), EACH TENDON
262.. 26415 EXTENSOR TENDON EXCISION, IMPLANTATION OF PLASTIC TUBE OR ROD FOR DELAYED EXTENSOR TENDON
GRAFT, HAND OR FINGER
262.. 26416 REMOVAL OF TUBE OR ROD AND INSERTION OF EXTENSOR TENDON GRAFT (INCLUDES OBTAINING GRAFT), HAND
OR FINGER
262.. 26420 EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE, PRIMARY OR SECONDARY; WITH FREE GRAFT
(INCLUDES OBTAINING GRAFT) EACH TENDON
262.. 26426 EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECONDARY (BOUTONNIERE DEFORMITY); USING LOCAL
TISSUES
262.. 26428 EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECONDARY (BOUTONNIERE DEFORMITY); WITH FREE GRAFT
(INCLUDES OBTAINING GRAFT)
262.. 26434 EXTENSOR TENDON REPAIR, DISTAL INSERTION (''MALLET FINGER''), OPEN, PRIMARY OR SECONDARY
REPAIR; WITH FREE GRAFT (INCLUDES OBTAINING GRAFT)
262.. 26442 TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM AND FINGER, EACH TENDON
262.. 26449 TENOLYSIS, COMPLEX, EXTENSOR TENDON, DORSUM OF HAND OR FINGER, INCLUDING HAND AND FOREARM
262.. 26480 TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL AREA OR DORSUM OF HAND, SINGLE; WITHOUT FREE
GRAFT, EACH
262.. 26483 TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL AREA OR DORSUM OF HAND, SINGLE; WITH FREE TENDON
GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON
262.. 26485 TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EACH TENDON; WITHOUT FREE TENDON GRAFT
262.. 26489 TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EACH TENDON; WITH FREE TENDON GRAFT (INCLUDES
OBTAINING GRAFT), EACH TENDON
262.. 26490 OPPONENSPLASTY; SUBLIMIS TENDON TRANSFER TYPE
262.. 26492 OPPONENSPLASTY; TENDON TRANSFER WITH GRAFT (INCLUDES OBTAINING GRAFT)
262.. 26494 OPPONENSPLASTY; HYPOTHENAR MUSCLE TRANSFER
262.. 26496 OPPONENSPLASTY; OTHER METHODS
262.. 26497 TENDON TRANSFER TO RESTORE INTRINSIC FUNCTION; RING AND SMALL FINGER
262.. 26498 TENDON TRANSFER TO RESTORE INTRINSIC FUNCTION; ALL FOUR FINGERS
262.. 26499 CORRECTION CLAW FINGER, OTHER METHODS
262.. 26502 TENDON PULLEY RECONSTRUCTION; WITH TENDON OR FASCIAL GRAFT (INCLUDES OBTAINING GRAFT) (SEPARATE
PROCEDURE)
262.. 26504 TENDON PULLEY RECONSTRUCTION; WITH TENDON PROSTHESIS (SEPARATE PROCEDURE)
262.. 26510 CROSS INTRINSIC TRANSFER
262.. 26516 CAPSULODESIS FOR M-P JOINT STABILIZATION; SINGLE DIGIT
262.. 26517 CAPSULODESIS FOR M-P JOINT STABILIZATION; TWO DIGITS
262.. 26518 CAPSULODESIS FOR M-P JOINT STABILIZATION; THREE OR FOUR DIGITS
262.. 26541 RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHALANGEAL JOINT, SINGLE; WITH TENDON OR FASCIAL
GRAFT (INCLUDES OBTAINING GRAFT)
262.. 26545 RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGEAL JOINT, SINGLE, INCLUDING GRAFT, EACH JOINT
262.. 26546 REPAIR NON-UNION, METACARPAL OR PHALANX, (INCLUDES OBTAINING BONE GRAFT WITH OR WITHOUT
EXTERNAL OR INTERNAL FIXATION)
262.. 26548 REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE, INTERPHALANGEAL JOINT
262.. 26550 POLLICIZATION OF A DIGIT
262.. 26555 POSITIONAL CHANGE OF OTHER FINGER
262.. 26561 REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; WITH SKIN FLAPS AND GRAFTS
262.. 26562 REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; COMPLEX (EG, INVOLVING BONE, NAILS)
262.. 26565 OSTEOTOMY FOR CORRECTION OF DEFORMITY; METACARPAL
262.. 26567 OSTEOTOMY FOR CORRECTION OF DEFORMITY; PHALANX OF FINGER
262.. 26568 OSTEOPLASTY FOR LENGTHENING OF METACARPAL OR PHALANX
262.. 26580 REPAIR CLEFT HAND
262.. 26585 REPAIR BIFID DIGIT
262.. 26590 REPAIR MACRODACTYLIA
262.. 26591 REPAIR, INTRINSIC MUSCLES OF HAND (SPECIFY)
262.. 26596 EXCISION OF CONSTRICTING RING OF FINGER, WITH MULTIPLE Z-PLASTIES
262.. 26597 RELEASE OF SCAR CONTRACTURE, FLEXOR OR EXTENSOR, WITH SKIN GRAFTS, REARRANGEMENT FLAPS, OR Z-
PLASTIES, HAND AND/OR FINGER
[[Page 47786]]
262.. 26820 FUSION IN OPPOSITION, THUMB, WITH AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)
262.. 26841 ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR WITHOUT INTERNAL FIXATION;
262.. 26842 ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT
(INCLUDES OBTAINING GRAFT)
262.. 26843 ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER THAN THUMB;
262.. 26844 ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER THAN THUMB; WITH AUTOGRAFT (INCLUDES
OBTAINING GRAFT)
262.. 26850 ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;
262.. 26852 ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT
(INCLUDES OBTAINING GRAFT)
262.. 26860 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;
262.. 26861 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; EACH ADDITIONAL
INTERPHALANGEAL JOINT
262.. 26862 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES
OBTAINING GRAFT)
262.. 26863 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES
OBTAINING GRAFT), EACH ADDITIONAL JOINT
262.. 26910 AMPUTATION, METACARPAL, WITH FINGER OR THUMB (RAY AMPUTATION), SINGLE, WITH OR WITHOUT
INTEROSSEOUS TRANSFER
271.. Level I Foot Musculoskeletal T 14.41 $730.15 $368.38 $146.03
Procedures
271.. 27605 TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS (SEPARATE PROCEDURE); *LOCAL ANESTHESIA
271.. 28005 INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), FOOT
271.. 28008 FASCIOTOMY, FOOT AND/OR TOE
271.. 28010 TENOTOMY, SUBCUTANEOUS, TOE; SINGLE
271.. 28011 TENOTOMY, SUBCUTANEOUS, TOE; MULTIPLE
271.. 28020 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERTARSAL OR
TARSOMETATARSAL JOINT
271.. 28022 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY;
METATARSOPHALANGEAL JOINT
271.. 28024 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERPHALANGEAL
JOINT
271.. 28045 EXCISION, TUMOR, FOOT; DEEP, SUBFASCIAL, INTRAMUSCULAR
271.. 28046 RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM), SOFT TISSUE OF FOOT
271.. 28050 ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERTARSAL OR TARSOMETATARSAL JOINT
271.. 28052 ARTHROTOMY FOR SYNOVIAL BIOPSY; METATARSOPHALANGEAL JOINT
271.. 28054 ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JOINT
271.. 28080 EXCISION OF INTERDIGITAL (MORTON) NEUROMA, SINGLE, EACH
271.. 28086 SYNOVECTOMY, TENDON SHEATH, FOOT; FLEXOR
271.. 28088 SYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSOR
271.. 28090 EXCISION OF LESION OF TENDON OR FIBROUS SHEATH OR CAPSULE (INCLUDING SYNOVECTOMY) (CYST OR
GANGLION); FOOT
271.. 28092 EXCISION OF LESION OF TENDON OR FIBROUS SHEATH OR CAPSULE (INCLUDING SYNOVECTOMY) (CYST OR
GANGLION); TOES
271.. 28100 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS;
271.. 28104 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL BONES, EXCEPT TALUS OR
CALCANEUS;
271.. 28108 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, PHALANGES OF FOOT
271.. 28111 OSTECTOMY, COMPLETE EXCISION; FIRST METATARSAL HEAD
271.. 28112 OSTECTOMY, COMPLETE EXCISION; OTHER METATARSAL HEAD (SECOND, THIRD OR FOURTH)
271.. 28113 OSTECTOMY, COMPLETE EXCISION; FIFTH METATARSAL HEAD
271.. 28114 OSTECTOMY, COMPLETE EXCISION; ALL METATARSAL HEADS, WITH PARTIAL PROXIMAL PHALANGECTOMY,
EXCLUDING FIRST METATARSAL (CLAYTON TYPE PROCEDURE)
271.. 28116 OSTECTOMY, EXCISION OF TARSAL COALITION
271.. 28118 OSTECTOMY, CALCANEUS;
271.. 28119 OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PLANTAR FASCIAL RELEASE
271.. 28120 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) OF BONE (EG,
FOR OSTEOMYELITIS OR TALAR BOSSING), TALUS OR CALCANEUS
271.. 28122 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS OR TARSAL BOSSING), TARSAL OR METATARSAL BONE, EXCEPT TALUS OR CALCANEUS
271.. 28124 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (EG, FOR
OSTEOMYELITIS OR DORSAL BOSSING), PHALANX OF TOE
271.. 28126 RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, SINGLE TOE, EACH
271.. 28130 TALECTOMY (ASTRAGALECTOMY)
271.. 28140 METATARSECTOMY
271.. 28150 PHALANGECTOMY OF TOE, SINGLE, EACH
271.. 28153 RESECTION, HEAD OF PHALANX, TOE
271.. 28160 HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, SINGLE, EACH
271.. 28171 RADICAL RESECTION OF TUMOR, BONE; TARSAL (EXCEPT TALUS OR CALCANEUS)
271.. 28173 RADICAL RESECTION OF TUMOR, BONE; METATARSAL
271.. 28175 RADICAL RESECTION OF TUMOR, BONE; PHALANX OF TOE
271.. 28200 REPAIR OR SUTURE OF TENDON, FOOT, FLEXOR, SINGLE; PRIMARY OR SECONDARY, WITHOUT FREE GRAFT,
EACH TENDON
271.. 28208 REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE; PRIMARY OR SECONDARY, EACH TENDON
271.. 28210 REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE; SECONDARY WITH FREE GRAFT, EACH TENDON
(INCLUDES OBTAINING GRAFT)
271.. 28220 TENOLYSIS, FLEXOR, FOOT; SINGLE
271.. 28222 TENOLYSIS, FLEXOR, FOOT; MULTIPLE (THROUGH SAME INCISION)
271.. 28225 TENOLYSIS, EXTENSOR, FOOT; SINGLE
271.. 28226 TENOLYSIS, EXTENSOR, FOOT; MULTIPLE (THROUGH SAME INCISION)
271.. 28230 TENOTOMY, OPEN, FLEXOR; FOOT, SINGLE OR MULTIPLE (SEPARATE PROCEDURE)
271.. 28232 TENOTOMY, OPEN, FLEXOR; TOE, SINGLE (SEPARATE PROCEDURE)
271.. 28234 TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE
271.. 28240 TENOTOMY, LENGTHENING, OR RELEASE, ABDUCTOR HALLUCIS MUSCLE
271.. 28270 CAPSULOTOMY; METATARSOPHALANGEAL JOINT, WITH OR WITHOUT TENORRHAPHY, SINGLE, EACH JOINT
(SEPARATE PROCEDURE)
[[Page 47787]]
271.. 28272 CAPSULOTOMY; INTERPHALANGEAL JOINT, SINGLE, EACH JOINT (SEPARATE PROCEDURE)
271.. 28280 WEBBING OPERATION (CREATE SYNDACTYLISM OF TOES) (KELIKIAN TYPE PROCEDURE)
271.. 28285 HAMMERTOE OPERATION, ONE TOE (EG, INTERPHALANGEAL FUSION, FILLETING, PHALANGECTOMY)
271.. 28286 COCK-UP FIFTH TOE OPERATION WITH PLASTIC SKIN CLOSURE (RUIZ-MORA TYPE PROCEDURE)
271.. 28310 OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; PROXIMAL PHALANX, FIRST TOE
(SEPARATE PROCEDURE)
271.. 28312 OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; OTHER PHALANGES, ANY TOE
271.. 28313 RECONSTRUCTION, ANGULAR DEFORMITY OF TOE (OVERLAPPING SECOND TOE, FIFTH TOE, CURLY TOES), SOFT
TISSUE PROCEDURES ONLY
271.. 28315 SESAMOIDECTOMY, FIRST TOE (SEPARATE PROCEDURE)
271.. 28340 RECONSTRUCTION, TOE, MACRODACTYLY; SOFT TISSUE RESECTION
271.. 28341 RECONSTRUCTION, TOE, MACRODACTYLY; REQUIRING BONE RESECTION
271.. 28737 ARTHRODESIS, MIDTARSAL NAVICULAR-CUNEIFORM, WITH TENDON LENGTHENING AND ADVANCEMENT (MILLER
TYPE PROCEDURE)
271.. 28750 ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT
271.. 28755 ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT
271.. 28810 AMPUTATION, METATARSAL, WITH TOE, SINGLE
271.. 28820 AMPUTATION, TOE; METATARSOPHALANGEAL JOINT
271.. 28825 AMPUTATION, TOE; INTERPHALANGEAL JOINT
271.. 29893 ENDOSCOPIC PLANTAR FASCIOTOMY
272.. Level II Foot Musculoskeletal T 16.56 $839.09 $409.74 $167.82
Procedures
272.. 28060 FASCIECTOMY, EXCISION OF PLANTAR FASCIA; PARTIAL (SEPARATE PROCEDURE)
272.. 28062 FASCIECTOMY, EXCISION OF PLANTAR FASCIA; RADICAL (SEPARATE PROCEDURE)
272.. 28070 SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT, EACH
272.. 28072 SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH
272.. 28102 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS; WITH ILIAC OR OTHER
AUTOGRAFT (INCLUDES OBTAINING GRAFT)
272.. 28103 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS; WITH ALLOGRAFT
272.. 28106 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL BONES, EXCEPT TALUS OR
CALCANEUS; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)
272.. 28107 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TARSAL OR METATARSAL BONES, EXCEPT TALUS OR
CALCANEUS; WITH ALLOGRAFT
272.. 28202 REPAIR OR SUTURE OF TENDON, FOOT, FLEXOR, SINGLE; SECONDARY WITH FREE GRAFT, EACH TENDON
(INCLUDES OBTAINING GRAFT)
272.. 28238 ADVANCEMENT OF POSTERIOR TIBIAL TENDON WITH EXCISION OF ACCESSORY NAVICULAR BONE (KIDNER TYPE
PROCEDURE)
272.. 28250 DIVISION OF PLANTAR FASCIA AND MUSCLE (''STEINDLER STRIPPING'') (SEPARATE PROCEDURE)
272.. 28260 CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY (SEPARATE PROCEDURE)
272.. 28261 CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING
272.. 28262 CAPSULOTOMY, MIDFOOT; EXTENSIVE, INCLUDING POSTERIOR TALOTIBIAL CAPSULOTOMY AND TENDON(S)
LENGTHENING AS FOR RESISTANT CLUBFOOT DEFORMITY
272.. 28264 CAPSULOTOMY, MIDTARSAL (HEYMAN TYPE PROCEDURE)
272.. 28288 OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, SINGLE, METATARSAL HEAD, FIRST THROUGH FIFTH,
EACH METATARSAL HEAD
272.. 28300 OSTEOTOMY; CALCANEUS (DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATION
272.. 28302 OSTEOTOMY; TALUS
272.. 28304 OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS OR TALUS;
272.. 28305 OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS OR TALUS; WITH AUTOGRAFT (INCLUDES OBTAINING
GRAFT) (FOWLER TYPE)
272.. 28306 OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, WITH OR WITHOUT LENGTHENING, FOR SHORTENING OR
ANGULAR CORRECTION; FIRST METATARSAL
272.. 28307 OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, WITH OR WITHOUT LENGTHENING, FOR SHORTENING OR
ANGULAR CORRECTION; FIRST METATARSAL WITH AUTOGRAFT
272.. 28308 OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, WITH OR WITHOUT LENGTHENING, FOR SHORTENING OR
ANGULAR CORRECTION; OTHER THAN FIRST METATARSAL
272.. 28309 OSTEOTOMY, METATARSALS, MULTIPLE, FOR CAVUS FOOT (SWANSON TYPE PROCEDURE)
272.. 28320 REPAIR OF NONUNION OR MALUNION; TARSAL BONES (EG, CALCANEUS, TALUS)
272.. 28322 REPAIR OF NONUNION OR MALUNION; METATARSAL, WITH OR WITHOUT BONE GRAFT (INCLUDES OBTAINING
GRAFT)
272.. 28344 RECONSTRUCTION, TOE(S); POLYDACTYLY
272.. 28345 RECONSTRUCTION, TOE(S); SYNDACTYLY, WITH OR WITHOUT SKIN GRAFT(S), EACH WEB
272.. 28360 RECONSTRUCTION, CLEFT FOOT
272.. 28705 PANTALAR ARTHRODESIS
272.. 28715 TRIPLE ARTHRODESIS
272.. 28725 SUBTALAR ARTHRODESIS
272.. 28730 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE;
272.. 28735 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE; WITH OSTEOTOMY AS FOR
FLATFOOT CORRECTION
272.. 28740 ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT
272.. 28760 ARTHRODESIS, GREAT TOE, INTERPHALANGEAL JOINT, WITH EXTENSOR HALLUCIS LONGUS TRANSFER TO FIRST
METATARSAL NECK (JONES TYPE PROCEDURE)
276.. Bunion Procedures T 19.19 $972.35 $500.14 $194.47
276.. 28110 OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD (BUNIONETTE) (SEPARATE PROCEDURE)
276.. 28290 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; SIMPLE EXOSTECTOMY (SILVER
TYPE PROCEDURE)
276.. 28292 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; KELLER, MCBRIDE, OR MAYO
TYPE PROCEDURE
276.. 28293 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; RESECTION OF JOINT WITH
IMPLANT
[[Page 47788]]
276.. 28294 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; WITH TENDON TRANSPLANTS
(JOPLIN TYPE PROCEDURE)
276.. 28296 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; WITH METATARSAL OSTEOTOMY
(EG, MITCHELL, CHEVRON, OR CONCENTRIC TYPE PROCEDURES)
276.. 28297 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; LAPIDUS TYPE PROCEDURE
276.. 28298 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; BY PHALANX OSTEOTOMY
276.. 28299 HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT SESAMOIDECTOMY; BY OTHER METHODS (EG, DOUBLE
OSTEOTOMY)
280.. Diagnostic Arthroscopy T 22.2 $1,124.86 $581.72 $224.97
280.. 29800 ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE
PROCEDURE)
280.. 29815 ARTHROSCOPY, SHOULDER, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
280.. 29830 ARTHROSCOPY, ELBOW, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
280.. 29840 ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
280.. 29870 ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
280.. 29909 UNLISTED PROCEDURE, ARTHROSCOPY
281.. Level I Surgical Arthroscopy T 22.65 $1,147.66 $590.20 $229.53
281.. 29804 ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICAL
281.. 29819 ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
281.. 29820 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL
281.. 29821 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE
281.. 29822 ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED
281.. 29823 ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, EXTENSIVE
281.. 29825 ARTHROSCOPY, SHOULDER, SURGICAL; WITH LYSIS AND RESECTION OF ADHESIONS, WITH OR WITHOUT
MANIPULATION
281.. 29826 ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY,
WITH OR WITHOUT CORACOACROMIAL RELEASE
281.. 29834 ARTHROSCOPY, ELBOW, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
281.. 29835 ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, PARTIAL
281.. 29836 ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, COMPLETE
281.. 29837 ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, LIMITED
281.. 29838 ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, EXTENSIVE
281.. 29843 ARTHROSCOPY, WRIST, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE
281.. 29844 ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, PARTIAL
281.. 29845 ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, COMPLETE
281.. 29846 ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT
DEBRIDEMENT
281.. 29847 ARTHROSCOPY, WRIST, SURGICAL; INTERNAL FIXATION FOR FRACTURE OR INSTABILITY
281.. 29848 ARTHROSCOPY, WRIST, SURGICAL; WITH RELEASE OF TRANSVERSE CARPAL LIGAMENT
281.. 29860 ARTHROSCOPY, HIP, DIAGNOSTIC WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
281.. 29861 ARTHROSCOPY, HIP, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
281.. 29862 ARTHROSCOPY, HIP, SURGICAL; WITH DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY),
ABRASION ARTHROPLASTY, AND/OR RESECTION OF LABRUM
281.. 29863 ARTHROSCOPY, HIP, SURGICAL; WITH SYNOVECTOMY
281.. 29874 ARTHROSCOPY, KNEE, SURGICAL; FOR REMOVAL OF LOOSE BODY OR FOREIGN BODY (EG, OSTEOCHONDRITIS
DISSECANS FRAGMENTATION, CHONDRAL FRAGMENTATION)
281.. 29875 ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (EG, PLICA OR SHELF RESECTION) (SEPARATE
PROCEDURE)
281.. 29877 ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY)
281.. 29879 ARTHROSCOPY, KNEE, SURGICAL; ABRASION ARTHROPLASTY (INCLUDES CHONDROPLASTY WHERE NECESSARY) OR
MULTIPLE DRILLING
281.. 29880 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL
SHAVING)
281.. 29881 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL
SHAVING)
281.. 29884 ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITH OR WITHOUT MANIPULATION (SEPARATE
PROCEDURE)
281.. 29886 ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACT OSTEOCHONDRITIS DISSECANS LESION
281.. 29894 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; WITH REMOVAL OF LOOSE BODY OR
FOREIGN BODY
281.. 29895 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; SYNOVECTOMY, PARTIAL
281.. 29897 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED
281.. 29898 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, EXTENSIVE
282.. Level II Surgical Arthroscopy T 23.94 $1,213.03 $614.04 $242.61
282.. 29871 ARTHROSCOPY, KNEE, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE
282.. 29876 ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, MAJOR, TWO OR MORE COMPARTMENTS (EG, MEDIAL OR
LATERAL)
282.. 29882 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL OR LATERAL)
282.. 29883 ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL AND LATERAL)
282.. 29885 ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR OSTEOCHONDRITIS DISSECANS WITH BONE GRAFTING, WITH OR
WITHOUT INTERNAL FIXATION (INCLUDING DEBRIDEMENT OF BASE OF LESION)
282.. 29887 ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACT OSTEOCHONDRITIS DISSECANS LESION WITH INTERNAL
FIXATION
282.. 29891 ARTHROSCOPY, ANKLE, SURGICAL; EXCISION OF OSTEOCHONDRAL DEFECT OF TALUS AND/OR TIBIA, INCLUDING
DRILLING OF THE DEFECT
286.. Arthroscopically-Aided T 26.76 $1,355.91 $802.41 $271.18
Procedures
286.. 29850 ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE
KNEE, WITH OR WITHOUT MANIPULATION; WITHOUT INTERNAL OR EXTERNAL FIXATION (INCLUDES
ARTHROSCOPY)
286.. 29851 ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE
KNEE, WITH OR WITHOUT MANIPULATION; WITH INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)
286.. 29855 ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, WITH OR
WITHOUT INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)
286.. 29856 ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR
WITHOUT INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)
[[Page 47789]]
286.. 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION
286.. 29889 ARTHROSCOPICALLY AIDED POSTERIOR CRUCIATE LIGAMENT REPAIR/ AUGMENTATION OR RECONSTRUCTION
286.. 29892 ARTHROSCOPICALLY AIDED REPAIR OF LARGE OSTEOCHONDRITIS DISSECANS LESION, TALAR DOME FRACTURE,
OR TIBIAL PLAFOND FRACTURE, WITH OR WITHOUT INTERNAL FIXATION (INCLUDES ARTHROSCOPY)
311.. Level I ENT Procedures T 1.43 $72.46 $20.57 $14.49
311.. 30000 DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPROACH
311.. 30020 DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM
311.. 30100 BIOPSY, INTRANASAL
311.. 30110 EXCISION, NASAL POLYP(S), SIMPLE
311.. 30117 EXCISION OR DESTRUCTION, ANY METHOD (INCLUDING LASER), INTRANASAL LESION; INTERNAL APPROACH
311.. 30124 EXCISION DERMOID CYST, NOSE; SIMPLE, SKIN, SUBCUTANEOUS
311.. 30210 DISPLACEMENT THERAPY (PROETZ TYPE)
311.. 30220 INSERTION, NASAL SEPTAL PROSTHESIS (BUTTON)
311.. 30300 REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROCEDURE
311.. 30560 LYSIS INTRANASAL SYNECHIA
311.. 31000 LAVAGE BY CANNULATION; MAXILLARY SINUS (ANTRUM PUNCTURE OR NATURAL OSTIUM)
311.. 31002 LAVAGE BY CANNULATION; SPHENOID SINUS
311.. 31603 TRACHEOSTOMY, EMERGENCY PROCEDURE; TRANSTRACHEAL
311.. 31605 TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID MEMBRANE
311.. 40490 BIOPSY OF LIP
311.. 40799 UNLISTED PROCEDURE, LIPS
311.. 40800 DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; SIMPLE
311.. 40801 DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; COMPLICATED
311.. 40804 REMOVAL OF EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH; SIMPLE
311.. 40805 REMOVAL OF EMBEDDED FOREIGN BODY, VESTIBULE OF MOUTH; COMPLICATED
311.. 40806 INCISION OF LABIAL FRENUM (FRENOTOMY)
311.. 40808 BIOPSY, VESTIBULE OF MOUTH
311.. 40810 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITHOUT REPAIR
311.. 40812 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH SIMPLE REPAIR
311.. 40820 DESTRUCTION OF LESION OR SCAR OF VESTIBULE OF MOUTH BY PHYSICAL METHODS (EG, LASER, THERMAL,
CRYO, CHEMICAL)
311.. 40899 UNLISTED PROCEDURE, VESTIBULE OF MOUTH
311.. 41000 INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH;
LINGUAL
311.. 41005 INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH;
SUBLINGUAL, SUPERFICIAL
311.. 41100 BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS
311.. 41105 BIOPSY OF TONGUE; POSTERIOR ONE-THIRD
311.. 41108 BIOPSY OF FLOOR OF MOUTH
311.. 41110 EXCISION OF LESION OF TONGUE WITHOUT CLOSURE
311.. 41115 EXCISION OF LINGUAL FRENUM (FRENECTOMY)
311.. 41599 UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH
311.. 41805 REMOVAL OF EMBEDDED FOREIGN BODY FROM DENTOALVEOLAR STRUCTURES; SOFT TISSUES
311.. 41806 REMOVAL OF EMBEDDED FOREIGN BODY FROM DENTOALVEOLAR STRUCTURES; BONE
311.. 41820 GINGIVECTOMY, EXCISION GINGIVA, EACH QUADRANT
311.. 41821 OPERCULECTOMY, EXCISION PERICORONAL TISSUES
311.. 41825 EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITHOUT REPAIR
311.. 41826 EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH SIMPLE REPAIR
311.. 41828 EXCISION OF HYPERPLASTIC ALVEOLAR MUCOSA, EACH QUADRANT (SPECIFY)
311.. 41830 ALVEOLECTOMY, INCLUDING CURETTAGE OF OSTEITIS OR SEQUESTRECTOMY
311.. 41850 DESTRUCTION OF LESION (EXCEPT EXCISION), DENTOALVEOLAR STRUCTURES
311.. 41870 PERIODONTAL MUCOSAL GRAFTING
311.. 41872 GINGIVOPLASTY, EACH QUADRANT (SPECIFY)
311.. 41874 ALVEOLOPLASTY, EACH QUADRANT (SPECIFY)
311.. 41899 UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES
311.. 42000 DRAINAGE OF ABSCESS OF PALATE, UVULA
311.. 42100 BIOPSY OF PALATE, UVULA
311.. 42104 EXCISION, LESION OF PALATE, UVULA; WITHOUT CLOSURE
311.. 42106 EXCISION, LESION OF PALATE, UVULA; WITH SIMPLE PRIMARY CLOSURE
311.. 42140 UVULECTOMY, EXCISION OF UVULA
311.. 42160 DESTRUCTION OF LESION, PALATE OR UVULA (THERMAL, CRYO OR CHEMICAL)
311.. 42280 MAXILLARY IMPRESSION FOR PALATAL PROSTHESIS
311.. 42281 INSERTION OF PIN-RETAINED PALATAL PROSTHESIS
311.. 42299 UNLISTED PROCEDURE, PALATE, UVULA
311.. 42330 SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL
311.. 42335 SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), COMPLICATED, INTRAORAL
311.. 42650 DILATION SALIVARY DUCT
311.. 42660 DILATION AND CATHETERIZATION OF SALIVARY DUCT, WITH OR WITHOUT INJECTION
311.. 42665 LIGATION SALIVARY DUCT, INTRAORAL
311.. 42699 UNLISTED PROCEDURE, SALIVARY GLANDS OR DUCTS
311.. 69200 REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITHOUT GENERAL ANESTHESIA
311.. 69210 REMOVAL IMPACTED CERUMEN (SEPARATE PROCEDURE), ONE OR BOTH EARS
311.. 69222 DEBRIDEMENT, MASTOIDECTOMY CAVITY, COMPLEX (EG, WITH ANESTHESIA OR MORE THAN ROUTINE CLEANING)
311.. 69399 UNLISTED PROCEDURE, EXTERNAL EAR
311.. 69400 EUSTACHIAN TUBE INFLATION, TRANSNASAL; WITH CATHETERIZATION
311.. 69405 EUSTACHIAN TUBE CATHETERIZATION, TRANSTYMPANIC
311.. 69410 FOCAL APPLICATION OF PHASE CONTROL SUBSTANCE, MIDDLE EAR (BAFFLE TECHNIQUE)
[[Page 47790]]
311.. 69420 MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBE INFLATION
311.. 69424 VENTILATING TUBE REMOVAL WHEN ORIGINALLY INSERTED BY ANOTHER PHYSICIAN
311.. 69540 EXCISION AURAL POLYP
311.. 69610 TYMPANIC MEMBRANE REPAIR, WITH OR WITHOUT SITE PREPARATION OR PERFORATION FOR CLOSURE, WITH OR
WITHOUT PATCH
311.. 69799 UNLISTED PROCEDURE, MIDDLE EAR
311.. 92502 OTOLARYNGOLOGIC EXAMINATION UNDER GENERAL ANESTHESIA
312.. Level II ENT Procedures T 7.26 $367.86 $178.31 $73.57
312.. 30801 CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD,
(SEPARATE PROCEDURE); SUPERFICIAL
312.. 30802 CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD,
(SEPARATE PROCEDURE); INTRAMURAL
312.. 30930 FRACTURE NASAL TURBINATE(S), THERAPEUTIC
312.. 31612 TRACHEAL PUNCTURE, PERCUTANEOUS WITH TRANSTRACHEAL ASPIRATION AND/OR INJECTION
12... 40830 CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS
312.. 40831 CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX
312.. 41250 REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO-THIRDS OF TONGUE
312.. 41251 REPAIR OF LACERATION 2.5 CM OR LESS; POSTERIOR ONE-THIRD OF TONGUE
312.. 41252 REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX
312.. 41500 FIXATION OF TONGUE, MECHANICAL, OTHER THAN SUTURE (EG, K-WIRE)
312.. 41510 SUTURE OF TONGUE TO LIP FOR MICROGNATHIA (DOUGLAS TYPE PROCEDURE)
312.. 41800 DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES
312.. 42300 DRAINAGE OF ABSCESS; PAROTID, SIMPLE
312.. 42305 DRAINAGE OF ABSCESS; PAROTID, COMPLICATED
312.. 42310 DRAINAGE OF ABSCESS; SUBMAXILLARY OR SUBLINGUAL, INTRAORAL
312.. 42320 DRAINAGE OF ABSCESS; SUBMAXILLARY, EXTERNAL
312.. 42405 BIOPSY OF SALIVARY GLAND; INCISIONAL
312.. 42700 INCISION AND DRAINAGE ABSCESS; PERITONSILLAR
312.. 42720 INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR PARAPHARYNGEAL, INTRAORAL APPROACH
312.. 42800 BIOPSY; OROPHARYNX
312.. 42802 BIOPSY; HYPOPHARYNX
312.. 42804 BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE
312.. 42806 BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LESION
312.. 42808 EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY METHOD
312.. 60000 INCISION AND DRAINAGE OF THYROGLOSSAL CYST, INFECTED
312.. 69421 MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBE INFLATION REQUIRING GENERAL ANESTHESIA
312.. 69433 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), LOCAL OR TOPICAL ANESTHESIA
312.. 69436 TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE), GENERAL ANESTHESIA
313.. Level III ENT Procedures T 15.81 $801.08 $411.09 $160.22
313.. 30115 EXCISION, NASAL POLYP(S), EXTENSIVE
313.. 30118 EXCISION OR DESTRUCTION, ANY METHOD (INCLUDING LASER), INTRANASAL LESION; EXTERNAL APPROACH
(LATERAL RHINOTOMY)
313.. 30120 EXCISION OR SURGICAL PLANING OF SKIN OF NOSE FOR RHINOPHYMA
313.. 30125 EXCISION DERMOID CYST, NOSE; COMPLEX, UNDER BONE OR CARTILAGE
313.. 30130 EXCISION TURBINATE, PARTIAL OR COMPLETE
313.. 30140 SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE
313.. 30150 RHINECTOMY; PARTIAL
313.. 30160 RHINECTOMY; TOTAL
313.. 30310 REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERAL ANESTHESIA
313.. 30320 REMOVAL FOREIGN BODY, INTRANASAL; BY LATERAL RHINOTOMY
313.. 30430 RHINOPLASTY, SECONDARY; MINOR REVISION (SMALL AMOUNT OF NASAL TIP WORK)
313.. 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION, WITH OR WITHOUT CARTILAGE SCORING, CONTOURING OR
REPLACEMENT WITH GRAFT
313.. 30540 REPAIR CHOANAL ATRESIA; INTRANASAL
313.. 30580 REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED)
313.. 30600 REPAIR FISTULA; ORONASAL
313.. 30620 SEPTAL OR OTHER INTRANASAL DERMATOPLASTY (DOES NOT INCLUDE OBTAINING GRAFT)
313.. 30630 REPAIR NASAL SEPTAL PERFORATIONS
313.. 31020 SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL
313.. 31030 SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC) WITHOUT REMOVAL OF ANTROCHOANAL
POLYPS
313.. 31032 SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL-LUC) WITH REMOVAL OF ANTROCHOANAL POLYPS
313.. 31050 SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY;
313.. 31051 SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY; WITH MUCOSAL STRIPPING OR REMOVAL OF POLYP(S)
313.. 31070 SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE (TREPHINE OPERATION)
313.. 31200 ETHMOIDECTOMY; INTRANASAL, ANTERIOR
313.. 31320 LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); DIAGNOSTIC
313.. 31595 SECTION RECURRENT LARYNGEAL NERVE, THERAPEUTIC (SEPARATE PROCEDURE), UNILATERAL
313.. 31611 CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBSEQUENT INSERTION OF AN ALARYNGEAL SPEECH
PROSTHESIS (EG, VOICE BUTTON, BLOM-SINGER PROSTHESIS)
313.. 31613 TRACHEOSTOMA REVISION; SIMPLE, WITHOUT FLAP ROTATION
313.. 31614 TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION
313.. 31820 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT PLASTIC REPAIR
313.. 31825 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTIC REPAIR
313.. 31830 REVISION OF TRACHEOSTOMY SCAR
313.. 40500 VERMILIONECTOMY (LIP SHAVE), WITH MUCOSAL ADVANCEMENT
[[Page 47791]]
313.. 40510 EXCISION OF LIP; TRANSVERSE WEDGE EXCISION WITH PRIMARY CLOSURE
313.. 40520 EXCISION OF LIP; V-EXCISION WITH PRIMARY DIRECT LINEAR CLOSURE
313.. 40525 EXCISION OF LIP; FULL THICKNESS, RECONSTRUCTION WITH LOCAL FLAP (EG, ESTLANDER OR FAN)
313.. 40527 EXCISION OF LIP; FULL THICKNESS, RECONSTRUCTION WITH CROSS LIP FLAP (ABBE-ESTLANDER)
313.. 40530 RESECTION OF LIP, MORE THAN ONE-FOURTH, WITHOUT RECONSTRUCTION
313.. 40650 REPAIR LIP, FULL THICKNESS; VERMILION ONLY
313.. 40652 REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HEIGHT
313.. 40654 REPAIR LIP, FULL THICKNESS; OVER ONE-HALF VERTICAL HEIGHT, OR COMPLEX
313.. 40814 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH COMPLEX REPAIR
313.. 40816 EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; COMPLEX, WITH EXCISION OF
UNDERLYING MUSCLE
313.. 40818 EXCISION OF MUCOSA OF VESTIBULE OF MOUTH AS DONOR GRAFT
313.. 40819 EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY, FRENULECTOMY, FRENECTOMY)
313.. 40840 VESTIBULOPLASTY; ANTERIOR
313.. 40842 VESTIBULOPLASTY; POSTERIOR, UNILATERAL
313.. 41006 INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH;
SUBLINGUAL, DEEP, SUPRAMYLOHYOID
313.. 41007 INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH;
SUBMENTAL SPACE
313.. 41008 INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH;
SUBMANDIBULAR
313.. 41009 INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH;
MASTICATOR SPACE
313.. 41010 INCISION OF LINGUAL FRENUM (FRENOTOMY)
313.. 41015 EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBLINGUAL
313.. 41016 EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBMENTAL
313.. 41017 EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBMANDIBULAR
313.. 41018 EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; MASTICATOR
SPACE
313.. 41112 EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIOR TWO-THIRDS
313.. 41113 EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERIOR ONE-THIRD
313.. 41114 EXCISION OF LESION OF TONGUE WITH CLOSURE; WITH LOCAL TONGUE FLAP
313.. 41116 EXCISION, LESION OF FLOOR OF MOUTH
313.. 41120 GLOSSECTOMY; LESS THAN ONE-HALF TONGUE
313.. 41520 FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITH Z-PLASTY)
313.. 41827 EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH COMPLEX
REPAIR
313.. 42107 EXCISION, LESION OF PALATE, UVULA; WITH LOCAL FLAP CLOSURE
313.. 42120 RESECTION OF PALATE OR EXTENSIVE RESECTION OF LESION
313.. 42180 REPAIR, LACERATION OF PALATE; UP TO 2 CM
313.. 42182 REPAIR, LACERATION OF PALATE; OVER 2 CM OR COMPLEX
313.. 42200 PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PALATE ONLY
313.. 42205 PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALVEOLAR RIDGE; SOFT TISSUE ONLY
313.. 42215 PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION
313.. 42220 PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENING PROCEDURE
313.. 42235 REPAIR OF ANTERIOR PALATE, INCLUDING VOMER FLAP
313.. 42260 REPAIR OF NASOLABIAL FISTULA
313.. 42325 FISTULIZATION OF SUBLINGUAL SALIVARY CYST (RANULA);
313.. 42326 FISTULIZATION OF SUBLINGUAL SALIVARY CYST (RANULA); WITH PROSTHESIS
313.. 42340 SIALOLITHOTOMY; PAROTID, EXTRAORAL OR COMPLICATED INTRAORAL
313.. 42408 EXCISION OF SUBLINGUAL SALIVARY CYST (RANULA)
313.. 42409 MARSUPIALIZATION OF SUBLINGUAL SALIVARY CYST (RANULA)
313.. 42410 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE, WITHOUT NERVE DISSECTION
313.. 42440 EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND
313.. 42450 EXCISION OF SUBLINGUAL GLAND
313.. 42500 PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; PRIMARY OR SIMPLE
313.. 42505 PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; SECONDARY OR COMPLICATED
313.. 42507 PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE);
313.. 42508 PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); WITH EXCISION OF ONE SUBMANDIBULAR
GLAND
313.. 42510 PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); WITH LIGATION OF BOTH SUBMANDIBULAR
(WHARTON'S) DUCTS
313.. 42600 CLOSURE SALIVARY FISTULA
313.. 42725 INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR PARAPHARYNGEAL, EXTERNAL APPROACH
313.. 42810 EXCISION BRANCHIAL CLEFT CYST OR VESTIGE, CONFINED TO SKIN AND SUBCUTANEOUS TISSUES
313.. 42815 EXCISION BRANCHIAL CLEFT CYST, VESTIGE, OR FISTULA, EXTENDING BENEATH SUBCUTANEOUS TISSUES AND/
OR INTO PHARYNX
313.. 42900 SUTURE PHARYNX FOR WOUND OR INJURY
313.. 42950 PHARYNGOPLASTY (PLASTIC OR RECONSTRUCTIVE OPERATION ON PHARYNX)
313.. 42955 PHARYNGOSTOMY (FISTULIZATION OF PHARYNX, EXTERNAL FOR FEEDING)
313.. 42962 CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); WITH SECONDARY
SURGICAL INTERVENTION
313.. 42972 CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTADENOIDECTOMY); WITH
SECONDARY SURGICAL INTERVENTION
313.. 43020 ESOPHAGOTOMY, CERVICAL APPROACH, WITH REMOVAL OF FOREIGN BODY
313.. 43030 CRICOPHARYNGEAL MYOTOMY
313.. 69120 EXCISION EXTERNAL EAR; COMPLETE AMPUTATION
313.. 69140 EXCISION EXOSTOSIS(ES), EXTERNAL AUDITORY CANAL
313.. 69300 OTOPLASTY, PROTRUDING EAR, WITH OR WITHOUT SIZE REDUCTION
313.. 69440 MIDDLE EAR EXPLORATION THROUGH POSTAURICULAR OR EAR CANAL INCISION
313.. 69450 TYMPANOLYSIS, TRANSCANAL
313.. 69620 MYRINGOPLASTY (SURGERY CONFINED TO DRUMHEAD AND DONOR AREA)
314.. Level IV ENT Procedures T 25.65 $1,299.67 $693.37 $259.93
314.. 30400 RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES AND/OR ELEVATION OF NASAL TIP
[[Page 47792]]
314.. 30410 RHINOPLASTY, PRIMARY; COMPLETE, EXTERNAL PARTS INCLUDING BONY PYRAMID, LATERAL AND ALAR
CARTILAGES, AND/OR ELEVATION OF NASAL TIP
314.. 30420 RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL REPAIR
314.. 30435 RHINOPLASTY, SECONDARY; INTERMEDIATE REVISION (BONY WORK WITH OSTEOTOMIES)
314.. 30450 RHINOPLASTY, SECONDARY; MAJOR REVISION (NASAL TIP WORK AND OSTEOTOMIES)
314.. 30460 RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITAL CLEFT LIP AND/OR PALATE, INCLUDING
COLUMELLAR LENGTHENING; TIP ONLY
314.. 30462 RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITAL CLEFT LIP AND/OR PALATE, INCLUDING
COLUMELLAR LENGTHENING; TIP, SEPTUM, OSTEOTOMIES
314.. 30545 REPAIR CHOANAL ATRESIA; TRANSPALATINE
314.. 31040 PTERYGOMAXILLARY FOSSA SURGERY, ANY APPROACH
314.. 31075 SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL (FOR MUCOCELE OR OSTEOMA, LYNCH TYPE)
314.. 31080 SINUSOTOMY FRONTAL; OBLITERATIVE WITHOUT OSTEOPLASTIC FLAP, BROW INCISION (INCLUDES ABLATION)
314.. 31081 SINUSOTOMY FRONTAL; OBLITERATIVE, WITHOUT OSTEOPLASTIC FLAP, CORONAL INCISION (INCLUDES
ABLATION)
314.. 31084 SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTIC FLAP, BROW INCISION
314.. 31085 SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTIC FLAP, CORONAL INCISION
314.. 31086 SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLASTIC FLAP, BROW INCISION
314.. 31087 SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLASTIC FLAP, CORONAL INCISION
314.. 31090 SINUSOTOMY COMBINED, THREE OR MORE SINUSES (UNILATERAL)
314.. 31201 ETHMOIDECTOMY; INTRANASAL, TOTAL
314.. 31205 ETHMOIDECTOMY; EXTRANASAL, TOTAL
314.. 31300 LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMOVAL OF TUMOR OR LARYNGOCELE, CORDECTOMY
314.. 31400 ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROACH
314.. 31420 EPIGLOTTIDECTOMY
314.. 31588 LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (EG, FOR BURNS, RECONSTRUCTION AFTER PARTIAL
LARYNGECTOMY)
314.. 31590 LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE
314.. 31750 TRACHEOPLASTY; CERVICAL
314.. 31755 TRACHEOPLASTY; TRACHEOPHARYNGEAL FISTULIZATION, EACH STAGE
314.. 40700 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY, PARTIAL OR COMPLETE, UNILATERAL
314.. 40701 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY BILATERAL, ONE STAGE PROCEDURE
314.. 40702 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY BILATERAL, ONE OF TWO STAGES
314.. 40720 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; SECONDARY, BY RECREATION OF DEFECT AND RECLOSURE
314.. 40761 PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; WITH CROSS LIP PEDICLE FLAP (ABBE-ESTLANDER TYPE),
INCLUDING SECTIONING AND INSERTING OF PEDICLE
314.. 40843 VESTIBULOPLASTY; POSTERIOR, BILATERAL
314.. 40844 VESTIBULOPLASTY; ENTIRE ARCH
314.. 40845 VESTIBULOPLASTY; COMPLEX (INCLUDING RIDGE EXTENSION, MUSCLE REPOSITIONING)
314.. 42210 PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALVEOLAR RIDGE; WITH BONE GRAFT TO ALVEOLAR
RIDGE (INCLUDES OBTAINING GRAFT)
314.. 42225 PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGEAL FLAP
314.. 42226 LENGTHENING OF PALATE, AND PHARYNGEAL FLAP
314.. 42227 LENGTHENING OF PALATE, WITH ISLAND FLAP
314.. 42415 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE, WITH DISSECTION AND PRESERVATION OF
FACIAL NERVE
314.. 42420 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, WITH DISSECTION AND PRESERVATION OF FACIAL
NERVE
314.. 42425 EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, EN BLOC REMOVAL WITH SACRIFICE OF FACIAL
NERVE
314.. 42509 PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); WITH EXCISION OF BOTH SUBMANDIBULAR
GLANDS
314.. 42842 RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; WITHOUT CLOSURE
314.. 42844 RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; CLOSURE WITH LOCAL
FLAP (EG, TONGUE, BUCCAL)
314.. 42890 LIMITED PHARYNGECTOMY
314.. 42892 RESECTION OF LATERAL PHARYNGEAL WALL OR PYRIFORM SINUS, DIRECT CLOSURE BY ADVANCEMENT OF
LATERAL AND POSTERIOR PHARYNGEAL WALLS
314.. 69150 RADICAL EXCISION EXTERNAL AUDITORY CANAL LESION; WITHOUT NECK DISSECTION
314.. 69310 RECONSTRUCTION OF EXTERNAL AUDITORY CANAL (MEATOPLASTY) (EG, FOR STENOSIS DUE TO TRAUMA,
INFECTION) (SEPARATE PROCEDURE)
314.. 69320 RECONSTRUCTION EXTERNAL AUDITORY CANAL FOR CONGENITAL ATRESIA, SINGLE STAGE
314.. 69501 TRANSMASTOID ANTROTOMY (''SIMPLE'' MASTOIDECTOMY)
314.. 69502 MASTOIDECTOMY; COMPLETE
314.. 69505 MASTOIDECTOMY; MODIFIED RADICAL
314.. 69511 MASTOIDECTOMY; RADICAL
314.. 69530 PETROUS APICECTOMY INCLUDING RADICAL MASTOIDECTOMY
314.. 69550 EXCISION AURAL GLOMUS TUMOR; TRANSCANAL
314.. 69552 EXCISION AURAL GLOMUS TUMOR; TRANSMASTOID
314.. 69601 REVISION MASTOIDECTOMY; RESULTING IN COMPLETE MASTOIDECTOMY
314.. 69602 REVISION MASTOIDECTOMY; RESULTING IN MODIFIED RADICAL MASTOIDECTOMY
314.. 69603 REVISION MASTOIDECTOMY; RESULTING IN RADICAL MASTOIDECTOMY
314.. 69604 REVISION MASTOIDECTOMY; RESULTING IN TYMPANOPLASTY
314.. 69605 REVISION MASTOIDECTOMY; WITH APICECTOMY
314.. 69631 TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR
SURGERY), INITIAL OR REVISION; WITHOUT OSSICULAR CHAIN RECONSTRUCTION
314.. 69632 TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR
SURGERY), INITIAL OR REVISION; WITH OSSICULAR CHAIN RECONSTRUCTION (EG, POSTFENESTRATION)
314.. 69633 TYMPANOPLASTY WITHOUT MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/OR MIDDLE EAR
SURGERY), INITIAL OR REVISION; WITH OSSICULAR CHAIN RECONSTRUCTION AND SYNTHETIC PROSTHESIS
(EG, PARTIAL OSSICULAR REPLACEMENT PROSTHESIS (PORP), TOTAL OSSICULAR REPL
[[Page 47793]]
314.. 69635 TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR
SURGERY, AND/OR TYMPANIC MEMBRANE REPAIR); WITHOUT OSSICULAR CHAIN RECONSTRUCTION
314.. 69636 TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR
SURGERY, AND/OR TYMPANIC MEMBRANE REPAIR); WITH OSSICULAR CHAIN RECONSTRUCTION
314.. 69637 TYMPANOPLASTY WITH ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR
SURGERY, AND/OR TYMPANIC MEMBRANE REPAIR); WITH OSSICULAR CHAIN RECONSTRUCTION AND SYNTHETIC
PROSTHESIS (EG, PARTIAL OSSICULAR REPLACEMENT PROSTHESIS (PORP), TOTAL
314.. 69641 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE
REPAIR); WITHOUT OSSICULAR CHAIN RECONSTRUCTION
314.. 69642 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE
REPAIR); WITH OSSICULAR CHAIN RECONSTRUCTION
314.. 69643 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE
REPAIR); WITH INTACT OR RECONSTRUCTED WALL, WITHOUT OSSICULAR CHAIN RECONSTRUCTION
314.. 69644 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE
REPAIR); WITH INTACT OR RECONSTRUCTED CANAL WALL, WITH OSSICULAR CHAIN RECONSTRUCTION
314.. 69645 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE
REPAIR); RADICAL OR COMPLETE, WITHOUT OSSICULAR CHAIN RECONSTRUCTION
314.. 69646 TYMPANOPLASTY WITH MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE
REPAIR); RADICAL OR COMPLETE, WITH OSSICULAR CHAIN RECONSTRUCTION
314.. 69650 STAPES MOBILIZATION
314.. 69660 STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OF OSSICULAR CONTINUITY, WITH OR WITHOUT USE
OF FOREIGN MATERIAL;
314.. 69661 STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OF OSSICULAR CONTINUITY, WITH OR WITHOUT USE
OF FOREIGN MATERIAL; WITH FOOTPLATE DRILL OUT
314.. 69662 REVISION OF STAPEDECTOMY OR STAPEDOTOMY
314.. 69666 REPAIR OVAL WINDOW FISTULA
314.. 69667 REPAIR ROUND WINDOW FISTULA
314.. 69670 MASTOID OBLITERATION (SEPARATE PROCEDURE)
314.. 69676 TYMPANIC NEURECTOMY
314.. 69700 CLOSURE POSTAURICULAR FISTULA, MASTOID (SEPARATE PROCEDURE)
314.. 69711 REMOVAL OR REPAIR OF ELECTROMAGNETIC BONE CONDUCTION HEARING DEVICE IN TEMPORAL BONE
314.. 69720 DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; LATERAL TO GENICULATE GANGLION
314.. 69725 DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; INCLUDING MEDIAL TO GENICULATE GANGLION
314.. 69740 SUTURE FACIAL NERVE, INTRATEMPORAL, WITH OR WITHOUT GRAFT OR DECOMPRESSION; LATERAL TO
GENICULATE GANGLION
314.. 69745 SUTURE FACIAL NERVE, INTRATEMPORAL, WITH OR WITHOUT GRAFT OR DECOMPRESSION; INCLUDING MEDIAL TO
GENICULATE GANGLION
314.. 69801 LABYRINTHOTOMY, WITH OR WITHOUT CRYOSURGERY INCLUDING OTHER NONEXCISIONAL DESTRUCTIVE
PROCEDURES OR PERFUSION OF VESTIBULOACTIVE DRUGS (SINGLE OR MULTIPLE PERFUSIONS); TRANSCANAL
314.. 69802 LABYRINTHOTOMY, WITH OR WITHOUT CRYOSURGERY INCLUDING OTHER NONEXCISIONAL DESTRUCTIVE
PROCEDURES OR PERFUSION OF VESTIBULOACTIVE DRUGS (SINGLE OR MULTIPLE PERFUSIONS); WITH
MASTOIDECTOMY
314.. 69805 ENDOLYMPHATIC SAC OPERATION; WITHOUT SHUNT
314.. 69806 ENDOLYMPHATIC SAC OPERATION; WITH SHUNT
314.. 69820 FENESTRATION SEMICIRCULAR CANAL
314.. 69840 REVISION FENESTRATION OPERATION
314.. 69905 LABYRINTHECTOMY; TRANSCANAL
314.. 69910 LABYRINTHECTOMY; WITH MASTOIDECTOMY
314.. 69915 VESTIBULAR NERVE SECTION, TRANSLABYRINTHINE APPROACH
314.. 69949 UNLISTED PROCEDURE, INNER EAR
317.. Implantation of Cochlear T
Device
317.. 69930 COCHLEAR DEVICE IMPLANTATION, WITH OR WITHOUT MASTOIDECTOMY
318.. Nasal Cauterization/Packing T 2.07 $104.89 $38.65 $20.98
318.. 30901 CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD
318.. 30903 CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX (EXTENSIVE CAUTERY AND/OR PACKING) ANY METHOD
318.. 30905 CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERIZATION, ANY
METHOD; INITIAL
318.. 30906 CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERIZATION, ANY
METHOD;
318.. 30999 UNLISTED PROCEDURE, NOSE
318.. 42960 CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); SIMPLE
318.. 42970 CONTROL OF NASOPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POSTADENOIDECTOMY); SIMPLE,
WITH POSTERIOR NASAL PACKS, WITH OR WITHOUT ANTERIOR PACKS AND/OR CAUTERIZATION
318.. 42999 UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS
319.. Tonsil/Adenoid Procedures T 17.30 $876.58 $480.02 $175.32
319.. 42820 TONSILLECTOMY AND ADENOIDECTOMY; UNDER AGE 12
319.. 42821 TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER
319.. 42825 TONSILLECTOMY, PRIMARY OR SECONDARY; UNDER AGE 12
319.. 42826 TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVER
319.. 42830 ADENOIDECTOMY, PRIMARY; UNDER AGE 12
319.. 42831 ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER
319.. 42835 ADENOIDECTOMY, SECONDARY; UNDER AGE 12
319.. 42836 ADENOIDECTOMY, SECONDARY; AGE 12 OR OVER
319.. 42860 EXCISION OF TONSIL TAGS
319.. 42870 EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD (SEPARATE PROCEDURE)
320.. Thoracentesis/Lavage T 3.17 $160.62 $79.33 $32.12
Procedures
320.. 32000 THORACENTESIS, PUNCTURE OF PLEURAL CAVITY FOR ASPIRATION, INITIAL OR SUBSEQUENT
[[Page 47794]]
320.. 32002 THORACENTESIS WITH INSERTION OF TUBE WITH OR WITHOUT WATER SEAL (EG, FOR PNEUMOTHORAX)
(SEPARATE
320.. 32020 TUBE THORACOSTOMY WITH OR WITHOUT WATER SEAL (EG, FOR ABSCESS, HEMOTHORAX, EMPYEMA) (SEPARATE
PROCEDURE)
320.. 32420 PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION
320.. 32960 PNEUMOTHORAX, THERAPEUTIC, INTRAPLEURAL INJECTION OF AIR
320.. 32999 UNLISTED PROCEDURE, LUNGS AND PLEURA
320.. 33010 PERICARDIOCENTESIS; INITIAL
320.. 33011 PERICARDIOCENTESIS; SUBSEQUENT
320.. 33999 UNLISTED PROCEDURE, CARDIAC SURGERY
320.. 49080 PERITONEOCENTESIS, ABDOMINAL PARACENTESIS, OR PERITONEAL LAVAGE (DIAGNOSTIC OR THERAPEUTIC);
INITIAL
320.. 49081 PERITONEOCENTESIS, ABDOMINAL PARACENTESIS, OR PERITONEAL LAVAGE (DIAGNOSTIC OR THERAPEUTIC);
SUBSEQUENT
331.. Level I Endoscopy Upper Airway T 0.69 $34.96 $14.01 $6.99
331.. 31231 NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
331.. 31299 UNLISTED PROCEDURE, ACCESSORY SINUSES
331.. 31505 LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); DIAGNOSTIC
331.. 31575 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC
331.. 31579 LARYNGOSCOPY, FLEXIBLE OR RIGID FIBEROPTIC, WITH STROBOSCOPY
331.. 92511 NASOPHARYNGOSCOPY WITH ENDOSCOPE (SEPARATE PROCEDURE)
332.. Level II Endoscopy Upper T 9.74 $493.52 $244.98 $98.70
Airway
332.. 31233 NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY SINUSOSCOPY (VIA INFERIOR MEATUS OR CANINE
FOSSA PUNCTURE)
332.. 31235 NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SINUSOSCOPY (VIA PUNCTURE OF SPHENOIDAL FACE OR
CANNULATION OF OSTIUM)
332.. 31237 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH BIOPSY, POLYPECTOMY OR DEBRIDEMENT (SEPARATE PROCEDURE)
332.. 31238 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF EPISTAXIS
332.. 31240 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSA RESECTION
332.. 31510 LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH BIOPSY
332.. 31511 LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH REMOVAL OF FOREIGN BODY
332.. 31512 LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH REMOVAL OF LESION
332.. 31513 LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH VOCAL CORD INJECTION
332.. 31515 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; FOR ASPIRATION
332.. 31520 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, NEWBORN
332.. 31525 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, EXCEPT NEWBORN
332.. 31526 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, WITH OPERATING MICROSCOPE
332.. 31528 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATATION, INITIAL
332.. 31529 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATATION, SUBSEQUENT
332.. 31576 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH BIOPSY
332.. 31577 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF FOREIGN BODY
332.. 31578 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF LESION
332.. 31700 CATHETERIZATION, TRANSGLOTTIC (SEPARATE PROCEDURE)
332.. 31717 CATHETERIZATION WITH BRONCHIAL BRUSH BIOPSY
332.. 31720 CATHETER ASPIRATION (SEPARATE PROCEDURE); NASOTRACHEAL
332.. 31730 TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDLE WIRE DILATOR/ STENT OR INDWELLING TUBE FOR
OXYGEN
333.. Level III Endoscopy Upper T 17.24 $873.54 $464.20 $174.71
Airway
333.. 31239 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH DACRYOCYSTORHINOSTOMY
333.. 31254 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, PARTIAL (ANTERIOR)
333.. 31255 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR)
333.. 31256 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY;
333.. 31267 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM
MAXILLARY SINUS
333.. 31276 NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXPLORATION, WITH OR WITHOUT REMOVAL OF
TISSUE FROM FRONTAL SINUS
333.. 31287 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY;
333.. 31288 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; WITH REMOVAL OF TISSUE FROM THE SPHENOID
SINUS
333.. 31527 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH INSERTION OF OBTURATOR
333.. 31530 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL;
333.. 31531 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH FOREIGN BODY REMOVAL; WITH OPERATING MICROSCOPE
333.. 31535 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY;
333.. 31536 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE
333.. 31540 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR
EPIGLOTTIS;
333.. 31541 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR
EPIGLOTTIS; WITH OPERATING MICROSCOPE
333.. 31560 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY;
333.. 31561 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY; WITH OPERATING MICROSCOPE
333.. 31570 LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC;
333.. 31571 LARYNGOSCOPY, DIRECT, WITH INJECTION INTO VOCAL CORD(S), THERAPEUTIC; WITH OPERATING MICROSCOPE
336.. Endoscopy Lower Airway T 7.44 $376.98 $197.98 $75.40
336.. 31615 TRACHEOBRONCHOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCISION
336.. 31622 BRONCHOSCOPY; DIAGNOSTIC, (FLEXIBLE OR RIGID), WITH OR WITHOUT CELL WASHING OR BRUSHING
336.. 31625 BRONCHOSCOPY; WITH BIOPSY
336.. 31628 BRONCHOSCOPY; WITH TRANSBRONCHIAL LUNG BIOPSY, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE
336.. 31629 BRONCHOSCOPY; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY
336.. 31630 BRONCHOSCOPY; WITH TRACHEAL OR BRONCHIAL DILATION OR CLOSED REDUCTION OF FRACTURE
336.. 31631 BRONCHOSCOPY; WITH TRACHEAL DILATION AND PLACEMENT OF TRACHEAL STENT
336.. 31635 BRONCHOSCOPY; WITH REMOVAL OF FOREIGN BODY
336.. 31640 BRONCHOSCOPY; WITH EXCISION OF TUMOR
[[Page 47795]]
336.. 31641 BRONCHOSCOPY; WITH DESTRUCTION OF TUMOR OR RELIEF OF STENOSIS BY ANY METHOD OTHER THAN EXCISION
(EG, LASER)
336.. 31645 BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, INITIAL (EG, DRAINAGE OF
LUNG ABSCESS)
336.. 31646 BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, SUBSEQUENT
336.. 31656 BRONCHOSCOPY; WITH INJECTION OF CONTRAST MATERIAL FOR SEGMENTAL BRONCHOGRAPHY (FIBERSCOPE ONLY)
336.. 31899 UNLISTED PROCEDURE, TRACHEA, BRONCHI
339.. Injection of Sclerosing T 1.02 $51.68 $19.66 $10.34
Solution
339.. 36468 SINGLE OR MULTIPLE INJECTIONS OF SCLEROSING SOLUTIONS, SPIDER VEINS (TELANGIECTASIA); LIMB OR
TRUNK
339.. 36469 SINGLE OR MULTIPLE INJECTIONS OF SCLEROSING SOLUTIONS, SPIDER VEINS (TELANGIECTASIA); FACE
339.. 36470 INJECTION OF SCLEROSING SOLUTION; SINGLE VEIN
339.. 36471 INJECTION OF SCLEROSING SOLUTION; MULTIPLE VEINS, SAME LEG
339.. 45520 PERIRECTAL INJECTION OF SCLEROSING SOLUTION FOR PROLAPSE
341.. Level I Needle and Catheter T .13 $6.59 $2.94 $1.32
Placement
341.. 36410 VENIPUNCTURE, CHILD OVER AGE 3 YEARS OR ADULT, NECESSITATING PHYSICIAN'S SKILL (SEPARATE
PROCEDURE), FOR DIAGNOSTIC OR THERAPEUTIC PURPOSES. NOT TO BE USED FOR ROUTINE VENIPUNCTURE.
341.. 36420 VENIPUNCTURE, CUTDOWN; UNDER AGE 1 YEAR
341.. 36425 VENIPUNCTURE, CUTDOWN; AGE 1 OR OVER
342.. Level II Needle and Catheter T 3.20 $162.14 $80.23 $32.43
Placement
342.. 36010 INTRODUCTION OF CATHETER, SUPERIOR OR INFERIOR VENA CAVA
342.. 36011 SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM; FIRST ORDER BRANCH (EG, RENAL VEIN, JUGULAR VEIN)
342.. 36012 SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM; SECOND ORDER, OR MORE SELECTIVE, BRANCH (EG, LEFT
ADRENAL VEIN, PETROSAL SINUS)
342.. 36013 INTRODUCTION OF CATHETER, RIGHT HEART OR MAIN PULMONARY ARTERY
342.. 36014 SELECTIVE CATHETER PLACEMENT, LEFT OR RIGHT PULMONARY ARTERY
342.. 36015 SELECTIVE CATHETER PLACEMENT, SEGMENTAL OR SUBSEGMENTAL PULMONARY ARTERY
342.. 36100 INTRODUCTION OF NEEDLE OR INTRACATHETER, CAROTID OR VERTEBRAL ARTERY
342.. 36120 INTRODUCTION OF NEEDLE OR INTRACATHETER; RETROGRADE BRACHIAL ARTERY
342.. 36140 INTRODUCTION OF NEEDLE OR INTRACATHETER; EXTREMITY ARTERY
342.. 36160 INTRODUCTION OF NEEDLE OR INTRACATHETER, AORTIC, TRANSLUMBAR
342.. 36200 INTRODUCTION OF CATHETER, AORTA
342.. 36500 VENOUS CATHETERIZATION FOR SELECTIVE ORGAN BLOOD SAMPLING
342.. 36620 ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION (SEPARATE
PROCEDURE); PERCUTANEOUS
342.. 36625 ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION (SEPARATE
PROCEDURE); CUTDOWN
342.. 38794 CANNULATION, THORACIC DUCT
343.. Level III Needle and Catheter T 9.52 $482.37 $224.87 $96.47
Placement
343.. 36215 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRST ORDER THORACIC OR BRACHIOCEPHALIC
BRANCH, WITHIN A VASCULAR FAMILY
343.. 36216 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL SECOND ORDER THORACIC OR BRACHIOCEPHALIC
BRANCH, WITHIN A VASCULAR FAMILY
343.. 36217 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE THORACIC
OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY
343.. 36218 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; ADDITIONAL SECOND ORDER, THIRD ORDER, AND
BEYOND, THORACIC OR BRACHIOCEPHALIC BRANCH, WITHIN A VASCULAR FAMILY (USE IN ADDITION TO 36216
OR 36217 AS APPROPRIATE)
343.. 36245 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRST ORDER ABDOMINAL, PELVIC, OR LOWER
EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY
343.. 36246 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL SECOND ORDER ABDOMINAL, PELVIC, OR LOWER
EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY
343.. 36247 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE ABDOMINAL,
PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY
343.. 36248 SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; ADDITIONAL SECOND ORDER, THIRD ORDER, AND
BEYOND, ABDOMINAL, PELVIC, OR LOWER EXTREMITY ARTERY BRANCH, WITHIN A VASCULAR FAMILY (USE IN
ADDITION TO 36246 OR 36247 AS APPROPRIATE)
343.. 36481 PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY METHOD
343.. 93508 CATHETER PLACEMENT IN CORONARY ARTERY(S), ARTERIAL CORONARY CONDUIT(S), AND/OR VENOUS CORONARY
BYPASS GRAFT(S) FOR CORONARY ANGIOGRAPHY WITHOUT CONCOMITANT LEFT HEART CATHETERIZATION
346.. Placement Transvenous Caths/ T 4.83 $244.73 $120.23 $48.95
Cutdown
346.. 36488 PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL
VENOUS PRESSURE, HYPERALIMENTATION, HEMODIALYSIS, OR CHEMOTHERAPY); PERCUTANEOUS, AGE 2 YEARS
OR UNDER
346.. 36489 PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL
VENOUS PRESSURE, HYPERALIMENTATION, HEMODIALYSIS, OR CHEMOTHERAPY); PERCUTANEOUS, OVER AGE 2
346.. 36490 PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL
VENOUS PRESSURE, HYPERALIMENTATION, HEMODIALYSIS, OR CHEMOTHERAPY); CUTDOWN, AGE 2 YEARS OR
UNDER
346.. 36491 PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (EG, FOR CENTRAL
VENOUS PRESSURE, HYPERALIMENTATION, HEMODIALYSIS, OR CHEMOTHERAPY); CUTDOWN, OVER AGE 2
346.. 36493 REPOSITIONING OF PREVIOUSLY PLACED CENTRAL VENOUS CATHETER UNDER FLUOROSCOPIC GUIDANCE
346.. 36640 ARTERIAL CATHETERIZATION FOR PROLONGED INFUSION THERAPY (CHEMOTHERAPY), CUTDOWN
347.. Injection Procedures for T 2.93 $148.46 $62.15 $29.69
Interventional Radiology
347.. 19030 INJECTION PROCEDURE ONLY FOR MAMMARY DUCTOGRAM OR GALACTOGRAM
347.. 20501 INJECTION OF SINUS TRACT; DIAGNOSTIC (SINOGRAM)
347.. 21116 INJECTION PROCEDURE FOR TEMPOROMANDIBULAR JOINT ARTHROGRAPHY
[[Page 47796]]
347.. 23350 INJECTION PROCEDURE FOR SHOULDER ARTHROGRAPHY
347.. 24220 INJECTION PROCEDURE FOR ELBOW ARTHROGRAPHY
347.. 25246 INJECTION PROCEDURE FOR WRIST ARTHROGRAPHY
347.. 27093 INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITHOUT ANESTHESIA
347.. 27095 INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITH ANESTHESIA
347.. 27370 INJECTION PROCEDURE FOR KNEE ARTHROGRAPHY
347.. 27648 INJECTION PROCEDURE FOR ANKLE ARTHROGRAPHY
347.. 30200 INJECTION INTO TURBINATE(S), THERAPEUTIC
347.. 31708 INSTILLATION OF CONTRAST MATERIAL FOR LARYNGOGRAPHY OR BRONCHOGRAPHY, WITHOUT CATHETERIZATION
347.. 31710 CATHETERIZATION FOR BRONCHOGRAPHY, WITH OR WITHOUT INSTILLATION OF CONTRAST MATERIAL
347.. 31715 TRANSTRACHEAL INJECTION FOR BRONCHOGRAPHY
347.. 36005 INJECTION PROCEDURE FOR CONTRAST VENOGRAPHY (INCLUDING INTRODUCTION OF NEEDLE OR INTRACATHETER)
347.. 38200 INJECTION PROCEDURE FOR SPLENOPORTOGRAPHY
347.. 38790 INJECTION PROCEDURE FOR LYMPHANGIOGRAPHY
347.. 42550 INJECTION PROCEDURE FOR SIALOGRAPHY
347.. 47500 INJECTION PROCEDURE FOR PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY
347.. 47505 INJECTION PROCEDURE FOR CHOLANGIOGRAPHY THROUGH AN EXISTING CATHETER (EG, PERCUTANEOUS
TRANSHEPATIC OR T-TUBE)
347.. 49400 INJECTION OF AIR OR CONTRAST INTO PERITONEAL CAVITY (SEPARATE PROCEDURE)
347.. 49424 CONTRAST INJECTION FOR ASSESSMENT OF ABSCESS OR CYST VIA PREVIOUSLY PLACED CATHETER (SEPARATE
PROCEDURE)
347.. 49427 INJECTION PROCEDURE (EG, CONTRAST MEDIA) FOR EVALUATION OF PREVIOUSLY PLACED PERITONEAL-VENOUS
SHUNT
347.. 50392 INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION,
PERCUTANEOUS
347.. 50393 INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR
INJECTION, PERCUTANEOUS
347.. 50394 INJECTION PROCEDURE FOR PYELOGRAPHY (AS NEPHROSTOGRAM, PYELOSTOGRAM, ANTEGRADE
PYELOURETEROGRAMS) THROUGH NEPHROSTOMY OR PYELOSTOMY TUBE, OR INDWELLING URETERAL CATHETER
347.. 50395 INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER WITH DILATION TO ESTABLISH NEPHROSTOMY
TRACT, PERCUTANEOUS
347.. 50684 INJECTION PROCEDURE FOR URETEROGRAPHY OR URETEROPYELOGRAPHY THROUGH URETEROSTOMY OR INDWELLING
URETERAL CATHETER
347.. 50690 INJECTION PROCEDURE FOR VISUALIZATION OF ILEAL CONDUIT AND/OR URETEROPYELOGRAPHY, EXCLUSIVE OF
RADIOLOGIC SERVICE
347.. 51600 INJECTION PROCEDURE FOR CYSTOGRAPHY OR VOIDING URETHROCYSTOGRAPHY
347.. 51605 INJECTION PROCEDURE AND PLACEMENT OF CHAIN FOR CONTRAST AND/OR CHAIN URETHROCYSTOGRAPHY
347.. 51610 INJECTION PROCEDURE FOR RETROGRADE URETHROCYSTOGRAPHY
347.. 54230 INJECTION PROCEDURE FOR CORPORA CAVERNOSOGRAPHY
347.. 55300 VASOTOMY FOR VASOGRAMS, SEMINAL VESICULOGRAMS, OR EPIDIDYMOGRAMS, UNILATERAL OR BILATERAL
347.. 58340 CATHETERIZATION AND INTRODUCTION OF SALINE OR CONTRAST MATERIAL FOR HYSTEROSONOGRAPHY OR
HYSTEROSALPINGOGRAPHY
347.. 62284 INJECTION PROCEDURE FOR MYELOGRAPHY AND/OR COMPUTERIZED AXIAL TOMOGRAPHY, SPINAL (OTHER THAN C1-
C2 AND POSTERIOR FOSSA)
347.. 62290 INJECTION PROCEDURE FOR DISKOGRAPHY, EACH LEVEL; LUMBAR
347.. 62291 INJECTION PROCEDURE FOR DISKOGRAPHY, EACH LEVEL; CERVICAL
347.. 68850 INJECTION OF CONTRAST MEDIUM FOR DACRYOCYSTOGRAPHY
360.. Removal/Revision, Pacemaker/ T 6.09 $308.58 $140.12 $61.72
Vascular Device
360.. 33222 REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKER
360.. 33223 REVISION OR RELOCATION OF SKIN POCKET FOR IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
360.. 36261 REVISION OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP
360.. 36262 REMOVAL OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP
360.. 36299 UNLISTED PROCEDURE, VASCULAR INJECTION
360.. 36531 REVISION OF IMPLANTABLE INTRAVENOUS INFUSION PUMP
360.. 36532 REMOVAL OF IMPLANTABLE INTRAVENOUS INFUSION PUMP
360.. 36534 REVISION OF IMPLANTABLE VENOUS ACCESS PORT AND/OR SUBCUTANEOUS RESERVOIR
419.. 44377 SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM;
WITH BIOPSY, SINGLE OR MULTIPLE
419.. 44378 SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM;
WITH CONTROL OF BLEEDING, ANY METHOD
419.. 44799 UNLISTED PROCEDURE, INTESTINE
426.. Diagnostic Lower GI Endoscopy T 6.85 $347.09 $187.81 $69.42
426.. 44380 ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR
WASHING (SEPARATE PROCEDURE)
426.. 44382 ILEOSCOPY, THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
426.. 44385 ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL OR PELVIC) POUCH; DIAGNOSTIC, WITH OR
WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)
426.. 44386 ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL OR PELVIC) POUCH; WITH BIOPSY, SINGLE OR
MULTIPLE
426.. 44388 COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR
WASHING (SEPARATE PROCEDURE)
426.. 44389 COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
426.. 45378 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF
SPECIMEN(S) BY BRUSHING OR WASHING, WITH OR WITHOUT COLON DECOMPRESSION (SEPARATE PROCEDURE)
426.. 45380 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH BIOPSY, SINGLE OR MULTIPLE
426.. G0105 Colorectal Ca screening, pt at high risk
427.. Therapeutic Lower GI Endoscopy T 8.22 $416.5 $224.19 $83.3
427.. 44390 COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF FOREIGN BODY
[[Page 47797]]
427.. 44391 COLONOSCOPY THROUGH STOMA; WITH CONTROL OF BLEEDING, ANY METHOD
427.. 44392 COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY
FORCEPS OR BIPOLAR CAUTERY
427.. 44394 COLONOSCOPY THROUGH STOMA; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE
TECHNIQUE
427.. 45355 COLONOSCOPY, RIGID OR FLEXIBLE, TRANSABDOMINAL VIA COLOTOMY, SINGLE OR MULTIPLE
427.. 45379 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF FOREIGN BODY
427.. 45382 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH CONTROL OF BLEEDING, ANY METHOD
427.. 45384 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR
OTHER LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY
427.. 45385 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR
OTHER LESION(S) BY SNARE TECHNIQUE
437.. Therapeutic Anoscopy T 2.91 $147.45 $76.61 $29.49
437.. 46608 ANOSCOPY; WITH REMOVAL OF FOREIGN BODY
437.. 46610 ANOSCOPY; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY HOT BIOPSY FORCEPS OR BIPOLAR
CAUTERY
437.. 46611 ANOSCOPY; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY SNARE TECHNIQUE
437.. 46612 ANOSCOPY; WITH REMOVAL OF MULTIPLE TUMORS, POLYPS, OR OTHER LESIONS BY HOT BIOPSY FORCEPS,
BIPOLAR CAUTERY OR SNARE TECHNIQUE
437.. 46614 ANOSCOPY; WITH CONTROL OF BLEEDING, ANY METHOD
437.. 46615 ANOSCOPY; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY
HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
446.. Diagnostic Sigmoidoscopy T 2.59 $131.23 $65.09 $26.25
446.. 45300 PROCTOSIGMOIDOSCOPY, RIGID; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING
OR WASHING (SEPARATE PROCEDURE)
446.. 45305 PROCTOSIGMOIDOSCOPY, RIGID; WITH BIOPSY, SINGLE OR MULTIPLE
446.. 45330 SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR
WASHING (SEPARATE PROCEDURE)
446.. 45331 SIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
446.. G0104 Colorectal Ca screening
447.. Therapeutic T 6.87 $348.10 $184.76 $69.62
Proctosigmoidoscopy
447.. 45303 PROCTOSIGMOIDOSCOPY, RIGID; WITH DILATION, ANY METHOD
447.. 45307 PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF FOREIGN BODY
447.. 45308 PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY HOT BIOPSY
FORCEPS OR BIPOLAR CAUTERY
447.. 45309 PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY SNARE
TECHNIQUE
447.. 45315 PROCTOSIGMOIDOSCOPY, RIGID; WITH REMOVAL OF MULTIPLE TUMORS, POLYPS, OR OTHER LESIONS BY HOT
BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
447.. 45317 PROCTOSIGMOIDOSCOPY, RIGID; WITH CONTROL OF BLEEDING, ANY METHOD
447.. 45320 PROCTOSIGMOIDOSCOPY, RIGID; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT
AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE (EG, LASER)
447.. 45321 PROCTOSIGMOIDOSCOPY, RIGID; WITH DECOMPRESSION OF VOLVULUS
448.. Therapeutic Flexible T 5.37 $272.09 $141.25 $54.42
Sigmoidoscopy
448.. 45332 SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY
448.. 45333 SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY
FORCEPS OR BIPOLAR CAUTERY
448.. 45334 SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD
448.. 45337 SIGMOIDOSCOPY, FLEXIBLE; WITH DECOMPRESSION OF VOLVULUS, ANY METHOD
448.. 45338 SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE
TECHNIQUE
449.. Complex GI Endoscopy T 7.8 $395.22 $215.38 $79.04
449.. 43219 ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH INSERTION OF PLASTIC TUBE OR STENT
449.. 43228 ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S), NOT
AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
449.. 43258 UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR
JEJUNUM AS APPROPRIATE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE
TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
449.. 43259 UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR
JEJUNUM AS APPROPRIATE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION
449.. 43272 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ABLATION OF TUMOR(S), POLYP(S), OR
OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE
TECHNIQUE
449.. 44369 SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM;
WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY
FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
449.. 44393 COLONOSCOPY THROUGH STOMA; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE
TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
449.. 45339 SIGMOIDOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE
TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
449.. 45383 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH ABLATION OF TUMOR(S), POLYP(S), OR
OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE
TECHNIQUE
451.. Level I Anal/Rectal Procedures T 2.56 $129.71 $54.24 $25.94
451.. 46070 INCISION, ANAL SEPTUM (INFANT)
451.. 46083 INCISION OF THROMBOSED HEMORRHOID, EXTERNAL
451.. 46220 PAPILLECTOMY OR EXCISION OF SINGLE TAG, ANUS (SEPARATE PROCEDURE)
[[Page 47798]]
451.. 46221 HEMORRHOIDECTOMY, BY SIMPLE LIGATURE (EG, RUBBER BAND)
451.. 46230 EXCISION OF EXTERNAL HEMORRHOID TAGS AND/OR MULTIPLE PAPILLAE
451.. 46320 ENUCLEATION OR EXCISION OF EXTERNAL THROMBOTIC HEMORRHOID
451.. 46500 INJECTION OF SCLEROSING SOLUTION, HEMORRHOIDS
451.. 46934 DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL
451.. 46935 DESTRUCTION OF HEMORRHOIDS, ANY METHOD; EXTERNAL
451.. 46936 DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL AND EXTERNAL
451.. 46940 CURETTAGE OR CAUTERIZATION OF ANAL FISSURE, INCLUDING DILATION OF ANAL SPHINCTER (SEPARATE
PROCEDURE); INITIAL
451.. 46942 CURETTAGE OR CAUTERIZATION OF ANAL FISSURE, INCLUDING DILATION OF ANAL SPHINCTER (SEPARATE
PROCEDURE); SUBSEQUENT
451.. 46945 LIGATION OF INTERNAL HEMORRHOIDS; SINGLE PROCEDURE
451.. 46946 LIGATION OF INTERNAL HEMORRHOIDS; MULTIPLE PROCEDURES
452.. Level II Anal/Rectal T 4.82 $244.23 $109.61 $48.85
Procedures
452.. 45000 TRANSRECTAL DRAINAGE OF PELVIC ABSCESS
452.. 45005 INCISION AND DRAINAGE OF SUBMUCOSAL ABSCESS, RECTUM
452.. 45020 INCISION AND DRAINAGE OF DEEP SUPRALEVATOR, PELVIRECTAL, OR RETRORECTAL ABSCESS
452.. 45100 BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)
452.. 45900 REDUCTION OF PROCIDENTIA (SEPARATE PROCEDURE) UNDER ANESTHESIA
452.. 45905 DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE) UNDER ANESTHESIA OTHER THAN LOCAL
452.. 45910 DILATION OF RECTAL STRICTURE (SEPARATE PROCEDURE) UNDER ANESTHESIA OTHER THAN LOCAL
452.. 45915 REMOVAL OF FECAL IMPACTION OR FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA
452.. 45999 UNLISTED PROCEDURE, RECTUM
452.. 46030 REMOVAL OF ANAL SETON, OTHER MARKER
452.. 46040 INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL ABSCESS (SEPARATE PROCEDURE)
452.. 46050 INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL
452.. 46080 SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER (SEPARATE PROCEDURE)
452.. 46210 CRYPTECTOMY; SINGLE
452.. 46754 REMOVAL OF THIERSCH WIRE OR SUTURE, ANAL CANAL
452.. 46999 UNLISTED PROCEDURE, ANUS
453.. Level III Anal/Rectal T 16.87 $854.79 $445.22 $170.96
Procedures
453.. 45108 ANORECTAL MYOMECTOMY
453.. 45150 DIVISION OF STRICTURE OF RECTUM
453.. 45160 EXCISION OF RECTAL TUMOR BY PROCTOTOMY, TRANSSACRAL OR TRANSCOCCYGEAL APPROACH
453.. 45170 EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH
453.. 45190 DESTRUCTION OF RECTAL TUMOR, ANY METHOD (EG, ELECTRODESICCATION) TRANSANAL APPROACH
453.. 45500 PROCTOPLASTY; FOR STENOSIS
453.. 45505 PROCTOPLASTY; FOR PROLAPSE OF MUCOUS MEMBRANE
453.. 45560 REPAIR OF RECTOCELE (SEPARATE PROCEDURE)
453.. 46045 INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULAR, OR SUBMUCOSAL ABSCESS, TRANSANAL, UNDER
ANESTHESIA
453.. 46060 INCISION AND DRAINAGE OF ISCHIORECTAL OR INTRAMURAL ABSCESS, WITH FISTULECTOMY OR FISTULOTOMY,
SUBMUSCULAR, WITH OR WITHOUT PLACEMENT OF SETON
453.. 46200 FISSURECTOMY, WITH OR WITHOUT SPHINCTEROTOMY
453.. 46211 CRYPTECTOMY; MULTIPLE (SEPARATE PROCEDURE)
453.. 46250 HEMORRHOIDECTOMY, EXTERNAL, COMPLETE
453.. 46255 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE;
453.. 46257 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE; WITH FISSURECTOMY
453.. 46258 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE; WITH FISTULECTOMY, WITH OR WITHOUT
FISSURECTOMY
453.. 46260 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE;
453.. 46261 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE; WITH FISSURECTOMY
453.. 46262 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE; WITH FISTULECTOMY, WITH OR
WITHOUT FISSURECTOMY
453.. 46270 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS
453.. 46275 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBMUSCULAR
453.. 46280 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); COMPLEX OR MULTIPLE, WITH OR
WITHOUT PLACEMENT OF SETON
453.. 46285 SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SECOND STAGE
453.. 46288 CLOSURE OF ANAL FISTULA WITH RECTAL ADVANCEMENT FLAP
453.. 46700 ANOPLASTY, PLASTIC OPERATION FOR STRICTURE; ADULT
453.. 46750 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE; ADULT
453.. 46753 GRAFT (THIERSCH OPERATION) FOR RECTAL INCONTINENCE AND/OR PROLAPSE
453.. 46760 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; MUSCLE TRANSPLANT
453.. 46761 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; LEVATOR MUSCLE IMBRICATION (PARK POSTERIOR
ANAL REPAIR)
453.. 46762 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; IMPLANTATION ARTIFICIAL SPHINCTER
453.. 46937 CRYOSURGERY OF RECTAL TUMOR; BENIGN
453.. 46938 CRYOSURGERY OF RECTAL TUMOR; MALIGNANT
456.. Endoscopic Retrograde T 9.78 $495.55 $257.19 $99.11
Cholangiopancreatography
(ERCP)
456.. 43260 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); DIAGNOSTIC, WITH OR WITHOUT COLLECTION
OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)
456.. 43261 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH BIOPSY, SINGLE OR MULTIPLE
456.. 43262 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH SPHINCTEROTOMY/PAPILLOTOMY
456.. 43263 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH PRESSURE MEASUREMENT OF SPHINCTER
OF ODDI (PANCREATIC DUCT OR COMMON BILE DUCT)
456.. 43264 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE REMOVAL OF
STONE(S) FROM BILIARY AND/OR PANCREATIC DUCTS
[[Page 47799]]
456.. 43265 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE DESTRUCTION,
LITHOTRIPSY OF STONE(S), ANY METHOD
456.. 43267 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE INSERTION OF
NASOBILIARY OR NASOPANCREATIC DRAINAGE TUBE
456.. 43268 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE INSERTION OF
TUBE OR STENT INTO BILE OR PANCREATIC DUCT
456.. 43269 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE REMOVAL OF
FOREIGN BODY AND/OR CHANGE OF TUBE OR STENT
456.. 43271 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ENDOSCOPIC RETROGRADE BALLOON
DILATION OF AMPULLA, BILIARY AND/OR PANCREATIC DUCT(S)
458.. Percutaneous Biliary T 7.23 $366.34 $181.59 $73.27
Endoscopic Procedures
458.. 47510 INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC CATHETER FOR BILIARY DRAINAGE
458.. 47511 INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC STENT FOR INTERNAL AND EXTERNAL BILIARY DRAINAGE
458.. 47552 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; DIAGNOSTIC, WITH OR WITHOUT
COLLECTION OF SPECIMEN(S) BY BRUSHING AND/OR WASHING (SEPARATE PROCEDURE)
458.. 47553 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH BIOPSY, SINGLE OR MULTIPLE
458.. 47554 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH REMOVAL OF STONE(S)
458.. 47555 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH DILATION OF BILIARY DUCT
STRICTURE(S) WITHOUT STENT
458.. 47556 BILIARY ENDOSCOPY, PERCUTANEOUS VIA T-TUBE OR OTHER TRACT; WITH DILATION OF BILIARY DUCT
STRICTURE(S) WITH STENT
458.. 47630 BILIARY DUCT STONE EXTRACTION, PERCUTANEOUS VIA T-TUBE TRACT, BASKET, OR SNARE (EG, BURHENNE
TECHNIQUE)
459.. Peritoneal and Abdominal T 18.06 $915.09 $496.52 $183.02
Procedures
459.. 49085 REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY
459.. 49250 UMBILECTOMY, OMPHALECTOMY, EXCISION OF UMBILICUS (SEPARATE PROCEDURE)
459.. 49420 INSERTION OF INTRAPERITONEAL CANNULA OR CATHETER FOR DRAINAGE OR DIALYSIS; TEMPORARY
459.. 49421 INSERTION OF INTRAPERITONEAL CANNULA OR CATHETER FOR DRAINAGE OR DIALYSIS; PERMANENT
459.. 49423 EXCHANGE OF PREVIOUSLY PLACED ABSCESS OR CYST DRAINAGE CATHETER UNDER RADIOLOGICAL GUIDANCE
(SEPARATE PROCEDURE)
459.. 49426 REVISION OF PERITONEAL-VENOUS SHUNT
466.. Hernia/Hydrocele Procedures T 21.43 $1,085.85 $562.97 $217.17
466.. 49495 REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, WITH OR WITHOUT HYDROCELECTOMY; REDUCIBLE
466.. 49496 REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, WITH OR WITHOUT HYDROCELECTOMY;
INCARCERATED OR STRANGULATED
466.. 49500 REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, WITH OR WITHOUT HYDROCELECTOMY;
REDUCIBLE
466.. 49501 REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, WITH OR WITHOUT HYDROCELECTOMY;
INCARCERATED OR STRANGULATED
466.. 49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE
466.. 49507 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER; INCARCERATED OR STRANGULATED
466.. 49520 REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; REDUCIBLE
466.. 49521 REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED
466.. 49525 REPAIR INGUINAL HERNIA, SLIDING, ANY AGE
466.. 49540 REPAIR LUMBAR HERNIA
466.. 49550 REPAIR INITIAL FEMORAL HERNIA, ANY AGE, REDUCIBLE;
466.. 49553 REPAIR INITIAL FEMORAL HERNIA, ANY AGE, REDUCIBLE; INCARCERATED OR STRANGULATED
466.. 49555 REPAIR RECURRENT FEMORAL HERNIA; REDUCIBLE
466.. 49557 REPAIR RECURRENT FEMORAL HERNIA; INCARCERATED OR STRANGULATED
466.. 49560 REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; REDUCIBLE
466.. 49561 REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED
466.. 49565 REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; REDUCIBLE
466.. 49566 REPAIR RECURRENT INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED
466.. 49568 IMPLANTATION OF MESH OR OTHER PROSTHESIS FOR INCISIONAL OR VENTRAL HERNIA REPAIR (LIST
SEPARATELY IN ADDITION TO CODE FOR THE INCISIONAL OR VENTRAL HERNIA REPAIR)
466.. 49570 REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); REDUCIBLE (SEPARATE PROCEDURE)
466.. 49572 REPAIR EPIGASTRIC HERNIA (EG, PREPERITONEAL FAT); INCARCERATED OR STRANGULATED
466.. 49580 REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; REDUCIBLE
466.. 49582 REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; INCARCERATED OR STRANGULATED
466.. 49585 REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE
466.. 49587 REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; INCARCERATED OR STRANGULATED
466.. 49590 REPAIR SPIGELIAN HERNIA
466.. 49600 REPAIR OF SMALL OMPHALOCELE, WITH PRIMARY CLOSURE
466.. 51500 EXCISION OF URACHAL CYST OR SINUS, WITH OR WITHOUT UMBILICAL HERNIA REPAIR
466.. 55040 EXCISION OF HYDROCELE; UNILATERAL
466.. 55041 EXCISION OF HYDROCELE; BILATERAL
470.. Tube Procedures T 2.22 $112.49 $54.92 $22.50
470.. 31502 TRACHEOTOMY TUBE CHANGE PRIOR TO ESTABLISHMENT OF FISTULA TRACT
470.. 43760 CHANGE OF GASTROSTOMY TUBE
470.. 43761 REPOSITIONING OF THE GASTRIC FEEDING TUBE THROUGH THE DUODENUM FOR ENTERIC NUTRITION
470.. 43999 UNLISTED PROCEDURE, STOMACH
470.. 47525 CHANGE OF PERCUTANEOUS BILIARY DRAINAGE CATHETER
470.. 47530 REVISION AND/OR REINSERTION OF TRANSHEPATIC TUBE
470.. 47999 UNLISTED PROCEDURE, BILIARY TRACT
470.. 49422 REMOVAL OF PERMANENT INTRAPERITONEAL CANNULA OR CATHETER
470.. 49429 REMOVAL OF PERITONEAL-VENOUS SHUNT
[[Page 47800]]
470.. 49999 UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM
470.. 50688 CHANGE OF URETEROSTOMY TUBE
470.. 51705 CHANGE OF CYSTOSTOMY TUBE; SIMPLE
470.. 51710 CHANGE OF CYSTOSTOMY TUBE; COMPLICATED
521.. Level I Cystourethroscopy and T 5.06 $256.39 $112.10 $51.28
other Genitourinary Procedures
521.. 50398 CHANGE OF NEPHROSTOMY OR PYELOSTOMY TUBE
521.. 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE)
521.. 52265 CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL CYSTITIS; LOCAL ANESTHESIA
522.. Level II Cystourethroscopy and T 10.46 $530.00 $262.39 $106.00
other Genitourinary Procedures
522.. 50551 RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;
522.. 50553 RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH URETERAL
CATHETERIZATION, WITH OR WITHOUT DILATION OF URETER
522.. 50555 RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH BIOPSY
522.. 50557 RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH FULGURATION AND/OR
INCISION, WITH OR WITHOUT BIOPSY
522.. 50559 RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH INSERTION OF
RADIOACTIVE SUBSTANCE WITH OR WITHOUT BIOPSY AND/OR FULGURATION
522.. 50561 RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH REMOVAL OF FOREIGN
BODY OR CALCULUS
522.. 52005 CYSTOURETHROSCOPY, WITH URETERAL CATHETERIZATION, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR
URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;
522.. 52007 CYSTOURETHROSCOPY, WITH URETERAL CATHETERIZATION, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR
URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH BRUSH BIOPSY OF URETER AND/OR RENAL
PELVIS
522.. 52010 CYSTOURETHROSCOPY, WITH EJACULATORY DUCT CATHETERIZATION, WITH OR WITHOUT IRRIGATION,
INSTILLATION, OR DUCT RADIOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE
522.. 52204 CYSTOURETHROSCOPY, WITH BIOPSY
522.. 52214 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OF TRIGONE,
BLADDER NECK, PROSTATIC FOSSA, URETHRA, OR PERIURETHRAL GLANDS
522.. 52224 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OR TREATMENT OF
MINOR (LESS THAN 0.5 CM) LESION(S) WITH OR WITHOUT BIOPSY
522.. 52260 CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL CYSTITIS; GENERAL OR CONDUCTION
(SPINAL) ANESTHESIA
522.. 52270 CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; FEMALE
522.. 52275 CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; MALE
522.. 52276 CYSTOURETHROSCOPY WITH DIRECT VISION INTERNAL URETHROTOMY
522.. 52281 CYSTOURETHROSCOPY, WITH CALIBRATION AND/OR DILATION OF URETHRAL STRICTURE OR STENOSIS, WITH OR
WITHOUT MEATOTOMY, WITH OR WITHOUT INJECTION PROCEDURE FOR CYSTOGRAPHY, MALE OR FEMALE
522.. 52283 CYSTOURETHROSCOPY, WITH STEROID INJECTION INTO STRICTURE
522.. 52285 CYSTOURETHROSCOPY FOR TREATMENT OF THE FEMALE URETHRAL SYNDROME WITH 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
522.. 52290 CYSTOURETHROSCOPY; WITH URETERAL MEATOTOMY, UNILATERAL OR BILATERAL
522.. 52300 CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ORTHOTOPIC URETEROCELE(S), UNILATERAL OR
BILATERAL
522.. 52301 CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ECTOPIC URETEROCELE(S), UNILATERAL OR
BILATERAL
522.. 52305 CYSTOURETHROSCOPY; WITH INCISION OR RESECTION OF ORIFICE OF BLADDER DIVERTICULUM, SINGLE OR
MULTIPLE
522.. 52310 CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URETHRA OR
BLADDER (SEPARATE PROCEDURE); SIMPLE
522.. 52315 CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URETHRA OR
BLADDER (SEPARATE PROCEDURE); COMPLICATED
522.. 52327 CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH SUBURETERIC INJECTION OF IMPLANT
MATERIAL
522.. 52510 TRANSURETHRAL BALLOON DILATION OF THE PROSTATIC URETHRA, ANY METHOD
522.. 53605 DILATION OF URETHRAL STRICTURE OR VESICAL NECK BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE,
GENERAL OR CONDUCTION (SPINAL) ANESTHESIA
523.. Level III Cystourethroscopy T 16.87 $854.79 $447.03 $170.96
and other Genitourinary
Procedures
523.. 50951 URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION,
OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;
523.. 50953 URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION,
OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH URETERAL CATHETERIZATION, WITH OR
WITHOUT DILATION OF URETER
523.. 50955 URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION,
OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH BIOPSY
523.. 50957 URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION,
OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH FULGURATION AND/OR INCISION, WITH
OR WITHOUT BIOPSY
523.. 50959 URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION,
OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH INSERTION OF RADIOACTIVE
SUBSTANCE, WITH OR WITHOUT BIOPSY AND/OR FULGURATION (NOT INCLUDING PROVIS)
523.. 50961 URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION,
OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH REMOVAL OF FOREIGN BODY OR
CALCULUS
523.. 51020 CYSTOTOMY OR CYSTOSTOMY; WITH FULGURATION AND/OR INSERTION OF RADIOACTIVE MATERIAL
523.. 51030 CYSTOTOMY OR CYSTOSTOMY; WITH CRYOSURGICAL DESTRUCTION OF INTRAVESICAL LESION
[[Page 47801]]
523.. 51040 CYSTOSTOMY, CYSTOTOMY WITH DRAINAGE
523.. 51045 CYSTOTOMY, WITH INSERTION OF URETERAL CATHETER OR STENT (SEPARATE PROCEDURE)
523.. 51050 CYSTOLITHOTOMY, CYSTOTOMY WITH REMOVAL OF CALCULUS, WITHOUT VESICAL NECK RESECTION
523.. 51065 CYSTOTOMY, WITH STONE BASKET EXTRACTION AND/OR ULTRASONIC OR ELECTROHYDRAULIC FRAGMENTATION OF
URETERAL CALCULUS
523.. 51520 CYSTOTOMY; FOR SIMPLE EXCISION OF VESICAL NECK (SEPARATE PROCEDURE)
523.. 51880 CLOSURE OF CYSTOSTOMY (SEPARATE PROCEDURE)
523.. 52234 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION
OF; SMALL BLADDER TUMOR(S) (0.5 TO 2.0 CM)
523.. 52235 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION
OF; MEDIUM BLADDER TUMOR(S) (2.0 TO 5.0 CM)
523.. 52240 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION
OF; LARGE BLADDER TUMOR(S)
523.. 52250 CYSTOURETHROSCOPY WITH INSERTION OF RADIOACTIVE SUBSTANCE, WITH OR WITHOUT BIOPSY OR
FULGURATION
523.. 52277 CYSTOURETHROSCOPY, WITH RESECTION OF EXTERNAL SPHINCTER (SPHINCTEROTOMY)
523.. 52282 CYSTOURETHROSCOPY, WITH INSERTION OF URETHRAL STENT
523.. 52317 LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF
FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM)
523.. 52318 LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF
FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM)
523.. 52320 CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH REMOVAL OF URETERAL CALCULUS
523.. 52325 CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH FRAGMENTATION OF URETERAL CALCULUS
(EG, ULTRASONIC OR ELECTRO-HYDRAULIC TECHNIQUE)
523.. 52330 CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH MANIPULATION, WITHOUT REMOVAL OF
URETERAL CALCULUS
523.. 52332 CYSTOURETHROSCOPY, WITH INSERTION OF INDWELLING URETERAL STENT (EG, GIBBONS OR DOUBLE-J TYPE)
523.. 52334 CYSTOURETHROSCOPY WITH INSERTION OF URETERAL GUIDE WIRE THROUGH KIDNEY TO ESTABLISH A
PERCUTANEOUS NEPHROSTOMY, RETROGRADE
523.. 52335 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR
PYELOURETERAL JUNCTION BY ANY METHOD);
523.. 52336 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR
PYELOURETERAL JUNCTION BY ANY METHOD); WITH REMOVAL OR MANIPULATION OF CALCULUS (URETERAL
CATHETERIZATION IS INCLUDED)
523.. 52338 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR
PYELOURETERAL JUNCTION BY ANY METHOD); WITH BIOPSY AND/OR FULGURATION OF LESION
523.. 52339 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR
PYELOURETERAL JUNCTION BY ANY METHOD); WITH RESECTION OF TUMOR
523.. 52340 CYSTOURETHROSCOPY WITH INCISION, FULGURATION, OR RESECTION OF CONGENITAL POSTERIOR URETHRAL
VALVES, OR CONGENITAL OBSTRUCTIVE HYPERTROPHIC MUCOSAL FOLDS
523.. 52450 TRANSURETHRAL INCISION OF PROSTATE
523.. 52500 TRANSURETHRAL RESECTION OF BLADDER NECK (SEPARATE PROCEDURE)
523.. 52606 TRANSURETHRAL FULGURATION FOR POSTOPERATIVE BLEEDING OCCURRING AFTER THE USUAL FOLLOW-UP TIME
523.. 52640 TRANSURETHRAL RESECTION; OF POSTOPERATIVE BLADDER NECK CONTRACTURE
523.. 52700 TRANSURETHRAL DRAINAGE OF PROSTATIC ABSCESS
523.. 55720 PROSTATOTOMY, EXTERNAL DRAINAGE OF PROSTATIC ABSCESS, ANY APPROACH; SIMPLE
523.. 55725 PROSTATOTOMY, EXTERNAL DRAINAGE OF PROSTATIC ABSCESS, ANY APPROACH; COMPLICATED
523.. 55859 TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT
APPLICATION, WITH OR WITHOUT CYSTOSCOPY
524.. Level IV Cystourethroscopy and T 28.89 $1,463.84 $833.38 $292.77
other Genitourinary Procedures
524.. 52337 CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR
PYELOURETERAL JUNCTION BY ANY METHOD); WITH LITHOTRIPSY (URETERAL CATHETERIZATION IS INCLUDED)
524.. 52601 TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE
BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR
DILATION, AND INTERNAL URETHROTOMY ARE INCLUDED)
524.. 52612 TRANSURETHRAL RESECTION OF PROSTATE; FIRST STAGE OF TWO-STAGE RESECTION (PARTIAL RESECTION)
524.. 52614 TRANSURETHRAL RESECTION OF PROSTATE; SECOND STAGE OF TWO-STAGE RESECTION (RESECTION COMPLETED)
524.. 52620 TRANSURETHRAL RESECTION; OF RESIDUAL OBSTRUCTIVE TISSUE AFTER 90 DAYS POSTOPERATIVE
524.. 52630 TRANSURETHRAL RESECTION; OF REGROWTH OF OBSTRUCTIVE TISSUE LONGER THAN ONE YEAR POSTOPERATIVE
524.. 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)
524.. 52648 CONTACT LASER VAPORIZATION WITH OR WITHOUT TRANSURETHRAL RESECTION OF PROSTATE, INCLUDING
CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL
CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY ARE INCLUDED)
524.. 53850 TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY MICROWAVE THERMOTHERAPY
524.. 53852 TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY RADIOFREQUENCY THERMOTHERAPY
527.. Lithotripsy T 51.56 $2,612.52 $1,372.95 $522.5
527.. 50590 LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE
529.. Simple Urinary Studies and T 2.5 $126.67 $63.05 $25.33
Procedures
529.. 50396 MANOMETRIC STUDIES THROUGH NEPHROSTOMY OR PYELOSTOMY TUBE, OR INDWELLING URETERAL CATHETER
529.. 50686 MANOMETRIC STUDIES THROUGH URETEROSTOMY OR INDWELLING URETERAL CATHETER
529.. 51725 SIMPLE CYSTOMETROGRAM (CMG) (EG, SPINAL MANOMETER)
529.. 51726 COMPLEX CYSTOMETROGRAM (EG, CALIBRATED ELECTRONIC EQUIPMENT)
529.. 51736 SIMPLE UROFLOWMETRY (UFR) (EG, STOP-WATCH FLOW RATE, MECHANICAL UROFLOWMETER)
[[Page 47802]]
529.. 51741 COMPLEX UROFLOWMETRY (EG, CALIBRATED ELECTRONIC EQUIPMENT)
529.. 51772 URETHRAL PRESSURE PROFILE STUDIES (UPP) (URETHRAL CLOSURE PRESSURE PROFILE), ANY TECHNIQUE
529.. 51784 ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL SPHINCTER, OTHER THAN NEEDLE, ANY TECHNIQUE
529.. 51785 NEEDLE ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL SPHINCTER, ANY TECHNIQUE
529.. 51792 STIMULUS EVOKED RESPONSE (EG, MEASUREMENT OF BULBOCAVERNOSUS REFLEX LATENCY TIME)
529.. 51795 VOIDING PRESSURE STUDIES (VP); BLADDER VOIDING PRESSURE, ANY TECHNIQUE
529.. 51797 VOIDING PRESSURE STUDIES (VP); INTRA-ABDOMINAL VOIDING PRESSURE (AP) (RECTAL, GASTRIC,
INTRAPERITONEAL)
529.. 54240 PENILE PLETHYSMOGRAPHY
529.. 54250 NOCTURNAL PENILE TUMESCENCE AND/OR RIGIDITY TEST
530.. Genitourinary Procedures T 2.52 $127.69 $54.69 $25.54
530.. 51000 ASPIRATION OF BLADDER BY NEEDLE
530.. 51005 ASPIRATION OF BLADDER; BY TROCAR OR INTRACATHETER
530.. 51010 ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER
530.. 51700 BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION
530.. 51720 BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING DETENTION TIME)
530.. 53600 DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE; INITIAL
530.. 53601 DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE; SUBSEQUENT
530.. 53620 DILATION OF URETHRAL STRICTURE BY PASSAGE OF FILIFORM AND FOLLOWER, MALE; INITIAL
530.. 53621 DILATION OF URETHRAL STRICTURE BY PASSAGE OF FILIFORM AND FOLLOWER, MALE; SUBSEQUENT
530.. 53660 DILATION OF FEMALE URETHRA INCLUDING SUPPOSITORY AND/OR INSTILLATION; INITIAL
530.. 53661 DILATION OF FEMALE URETHRA INCLUDING SUPPOSITORY AND/OR INSTILLATION; SUBSEQUENT
530.. 53675 CATHETERIZATION, URETHRA; COMPLICATED (MAY INCLUDE DIFFICULT REMOVAL OF BALLOON CATHETER)
530.. 53899 UNLISTED PROCEDURE, URINARY SYSTEM
530.. 54200 INJECTION PROCEDURE FOR PEYRONIE DISEASE;
530.. 54220 IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM
530.. 54231 DYNAMIC CAVERNOSOMETRY, INCLUDING INTRACAVERNOSAL INJECTION OF VASOACTIVE DRUGS (EG,
PAPAVERINE, PHENTOLAMINE)
530.. 54235 INJECTION OF CORPORA CAVERNOSA WITH PHARMACOLOGIC AGENT(S) (EG, PAPAVERINE, PHENTOLAMINE)
530.. 54450 FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIAL ADHESIONS AND STRETCHING
530.. 55899 UNLISTED PROCEDURE, MALE GENITAL SYSTEM
531.. Level I Urethral Procedures T 18.94 $959.68 $527.26 $191.94
531.. 51715 ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSAL TISSUES OF THE URETHRA AND/OR
BLADDER NECK
531.. 53000 URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE PROCEDURE); PENDULOUS URETHRA
531.. 53010 URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE PROCEDURE); PERINEAL URETHRA, EXTERNAL
531.. 53020 MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE); EXCEPT INFANT
531.. 53025 MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE); INFANT
531.. 53040 DRAINAGE OF DEEP PERIURETHRAL ABSCESS
531.. 53060 DRAINAGE OF SKENE'S GLAND ABSCESS OR CYST
531.. 53080 DRAINAGE OF PERINEAL URINARY EXTRAVASATION; UNCOMPLICATED (SEPARATE PROCEDURE)
531.. 53200 BIOPSY OF URETHRA
531.. 53250 EXCISION OF BULBOURETHRAL GLAND (COWPER'S GLAND)
531.. 53260 EXCISION OR FULGURATION; URETHRAL POLYP(S), DISTAL URETHRA
531.. 53265 EXCISION OR FULGURATION; URETHRAL CARUNCLE
531.. 53270 EXCISION OR FULGURATION; SKENE'S GLANDS
531.. 53275 EXCISION OR FULGURATION; URETHRAL PROLAPSE
531.. 53442 REMOVAL OF PERINEAL PROSTHESIS INTRODUCED FOR CONTINENCE
531.. 53502 URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY, FEMALE
531.. 53505 URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PENILE
531.. 53510 URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PERINEAL
531.. 53665 DILATION OF FEMALE URETHRA, GENERAL OR CONDUCTION (SPINAL) ANESTHESIA
531.. 54000 SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); NEWBORN
531.. 54001 SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN
532.. Level II Urethral Procedures T 25.5 $1,292.07 $602.18 $258.41
532.. 53210 URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; FEMALE
532.. 53215 URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; MALE
532.. 53220 EXCISION OR FULGURATION OF CARCINOMA OF URETHRA
532.. 53230 EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE); FEMALE
532.. 53235 EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE); MALE
532.. 53240 MARSUPIALIZATION OF URETHRAL DIVERTICULUM, MALE OR FEMALE
532.. 53400 URETHROPLASTY; FIRST STAGE, FOR FISTULA, DIVERTICULUM, OR STRICTURE (EG, JOHANNSEN TYPE)
532.. 53405 URETHROPLASTY; SECOND STAGE (FORMATION OF URETHRA), INCLUDING URINARY DIVERSION
532.. 53410 URETHROPLASTY, ONE-STAGE RECONSTRUCTION OF MALE ANTERIOR URETHRA
532.. 53420 URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA; FIRST
STAGE
532.. 53425 URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA; SECOND
STAGE
532.. 53430 URETHROPLASTY, RECONSTRUCTION OF FEMALE URETHRA
532.. 53447 REMOVAL, REPAIR, OR REPLACEMENT OF INFLATABLE SPHINCTER INCLUDING PUMP AND/OR RESERVOIR AND/OR
CUFF
532.. 53449 SURGICAL CORRECTION OF HYDRAULIC ABNORMALITY OF INFLATABLE SPHINCTER DEVICE
532.. 53450 URETHROMEATOPLASTY, WITH MUCOSAL ADVANCEMENT
532.. 53460 URETHROMEATOPLASTY, WITH PARTIAL EXCISION OF DISTAL URETHRAL SEGMENT (RICHARDSON TYPE
PROCEDURE)
532.. 53515 URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PROSTATOMEMBRANOUS
532.. 53520 CLOSURE OF URETHROSTOMY OR URETHROCUTANEOUS FISTULA, MALE (SEPARATE PROCEDURE)
536.. Circumcision T 13.17 $667.32 $326.57 $133.46
536.. 54150 CIRCUMCISION, USING CLAMP OR OTHER DEVICE; NEWBORN
[[Page 47803]]
536.. 54152 CIRCUMCISION, USING CLAMP OR OTHER DEVICE; EXCEPT NEWBORN
536.. 54160 CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE OR DORSAL SLIT; NEWBORN
536.. 54161 CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE OR DORSAL SLIT; EXCEPT NEWBORN
537.. Penile Procedures T 28.72 $1,455.23 $864.34 $291.05
537.. 37790 PENILE VENOUS OCCLUSIVE PROCEDURE
537.. 54110 EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE);
537.. 54111 EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); WITH GRAFT TO 5 CM IN LENGTH
537.. 54112 EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); WITH GRAFT GREATER THAN 5 CM IN LENGTH
537.. 54120 AMPUTATION OF PENIS; PARTIAL
537.. 54205 INJECTION PROCEDURE FOR PEYRONIE DISEASE; WITH SURGICAL EXPOSURE OF PLAQUE
537.. 54300 PLASTIC OPERATION OF PENIS FOR STRAIGHTENING OF CHORDEE (EG, HYPOSPADIAS), WITH OR WITHOUT
MOBILIZATION OF URETHRA
537.. 54304 PLASTIC OPERATION ON PENIS FOR CORRECTION OF CHORDEE OR FOR FIRST STAGE HYPOSPADIAS REPAIR WITH
OR WITHOUT TRANSPLANTATION OF PREPUCE AND/OR SKIN FLAPS
537.. 54308 URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION); LESS THAN 3 CM
537.. 54312 URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION); GREATER THAN 3
CM
537.. 54316 URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION) WITH FREE SKIN
GRAFT OBTAINED FROM SITE OTHER THAN GENITALIA
537.. 54318 URETHROPLASTY FOR THIRD STAGE HYPOSPADIAS REPAIR TO RELEASE PENIS FROM SCROTUM (EG, THIRD STAGE
CECIL
537.. 54322 ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH SIMPLE
MEATAL ADVANCEMENT (EG, MAGPI, V-FLAP)
537.. 54324 ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH
URETHROPLASTY BY LOCAL SKIN FLAPS (EG, FLIP-FLAP, PREPUCIAL FLAP)
537.. 54326 ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH
URETHROPLASTY BY LOCAL SKIN FLAPS AND MOBILIZATION OF URETHRA
537.. 54328 ONE STAGE DISTAL HYPOSPADIAS REPAIR (WITH OR WITHOUT CHORDEE OR CIRCUMCISION); WITH EXTENSIVE
DISSECTION TO CORRECT CHORDEE AND URETHROPLASTY WITH LOCAL SKIN FLAPS, SKIN GRAFT PATCH, AND/
OR ISLAND FLAP
537.. 54340 REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); BY CLOSURE,
INCISION, OR EXCISION,
537.. 54344 REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); REQUIRING
MOBILIZATION OF SKIN FLAPS AND URETHROPLASTY WITH FLAP OR PATCH GRAFT
537.. 54348 REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); REQUIRING EXTENSIVE
DISSECTION AND URETHROPLASTY WITH FLAP, PATCH OR TUBED GRAFT (INCLUDES URINARY DIVERSION)
537.. 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
537.. 54360 PLASTIC OPERATION ON PENIS TO CORRECT ANGULATION
537.. 54380 PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO EXTERNAL SPHINCTER;
537.. 54385 PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO EXTERNAL SPHINCTER; WITH INCONTINENCE
537.. 54402 REMOVAL OR REPLACEMENT OF NON-INFLATABLE (SEMI-RIGID) OR INFLATABLE (SELF-CONTAINED) PENILE
PROSTHESIS
537.. 54407 REMOVAL, REPAIR, OR REPLACEMENT OF INFLATABLE (MULTI-COMPONENT) PENILE PROSTHESIS, INCLUDING
PUMP AND/OR RESERVOIR AND/OR CYLINDERS
537.. 54409 SURGICAL CORRECTION OF HYDRAULIC ABNORMALITY OF INFLATABLE (MULTI-COMPONENT) PROSTHESIS
INCLUDING PUMP AND/OR RESERVOIR AND/OR CYLINDERS
537.. 54420 CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT (PRIAPISM OPERATION), UNILATERAL OR BILATERAL
537.. 54435 CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION (EG, BIOPSY NEEDLE, WINTER PROCEDURE, RONGEUR, OR
PUNCH) FOR PRIAPISM
537.. 54440 PLASTIC OPERATION OF PENIS FOR INJURY
538.. Insertion of Penile Prosthesis T 45.59 $2,310.02 $1,540.64 $462.00
538.. 53440 OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE, WITH OR WITHOUT INTRODUCTION OF
PROSTHESIS
538.. 53445 OPERATION FOR CORRECTION OF URINARY INCONTINENCE WITH PLACEMENT OF INFLATABLE URETHRAL OR
BLADDER NECK SPHINCTER, INCLUDING PLACEMENT OF PUMP AND/OR RESERVOIR
538.. 54400 INSERTION OF PENILE PROSTHESIS; NON-INFLATABLE (SEMI-RIGID)
538.. 54401 INSERTION OF PENILE PROSTHESIS; INFLATABLE (SELF-CONTAINED)
538.. 54405 INSERTION OF INFLATABLE (MULTI-COMPONENT) PENILE PROSTHESIS, INCLUDING PLACEMENT OF PUMP,
CYLINDERS, AND/OR RESERVOIR
546.. Testes/Epididymis Procedures T 17.14 $868.47 $453.81 $173.69
546.. 54505 BIOPSY OF TESTIS, INCISIONAL (SEPARATE PROCEDURE)
546.. 54510 EXCISION OF LOCAL LESION OF TESTIS
546.. 54520 ORCHIECTOMY, SIMPLE (INCLUDING SUBCAPSULAR), WITH OR WITHOUT TESTICULAR PROSTHESIS, SCROTAL OR
INGUINAL APPROACH
546.. 54530 ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH
546.. 54550 EXPLORATION FOR UNDESCENDED TESTIS (INGUINAL OR SCROTAL AREA)
546.. 54600 REDUCTION OF TORSION OF TESTIS, SURGICAL, WITH OR WITHOUT FIXATION OF CONTRALATERAL TESTIS
546.. 54620 FIXATION OF CONTRALATERAL TESTIS (SEPARATE PROCEDURE)
546.. 54640 ORCHIOPEXY, INGUINAL APPROACH, WITH OR WITHOUT HERNIA REPAIR
546.. 54660 INSERTION OF TESTICULAR PROSTHESIS (SEPARATE PROCEDURE)
546.. 54670 SUTURE OR REPAIR OF TESTICULAR INJURY
546.. 54680 TRANSPLANTATION OF TESTIS(ES) TO THIGH (BECAUSE OF SCROTAL DESTRUCTION)
546.. 54700 INCISION AND DRAINAGE OF EPIDIDYMIS, TESTIS AND/OR SCROTAL SPACE (EG, ABSCESS OR HEMATOMA)
546.. 54820 EXPLORATION OF EPIDIDYMIS, WITH OR WITHOUT BIOPSY
546.. 54830 EXCISION OF LOCAL LESION OF EPIDIDYMIS
546.. 54840 EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY
546.. 54860 EPIDIDYMECTOMY; UNILATERAL
546.. 54861 EPIDIDYMECTOMY; BILATERAL
[[Page 47804]]
546.. 54900 EPIDIDYMOVASOSTOMY, ANASTOMOSIS OF EPIDIDYMIS TO VAS DEFERENS; UNILATERAL
546.. 54901 EPIDIDYMOVASOSTOMY, ANASTOMOSIS OF EPIDIDYMIS TO VAS DEFERENS; BILATERAL
546.. 55060 REPAIR OF TUNICA VAGINALIS HYDROCELE (BOTTLE TYPE)
546.. 55110 SCROTAL EXPLORATION
546.. 55120 REMOVAL OF FOREIGN BODY IN SCROTUM
546.. 55150 RESECTION OF SCROTUM
546.. 55175 SCROTOPLASTY; SIMPLE
546.. 55180 SCROTOPLASTY; COMPLICATED
546.. 55200 VASOTOMY, CANNULIZATION WITH OR WITHOUT INCISION OF VAS, UNILATERAL OR BILATERAL (SEPARATE
PROCEDURE)
546.. 55250 VASECTOMY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE), INCLUDING POSTOPERATIVE SEMEN
EXAMINATION(S)
546.. 55400 VASOVASOSTOMY, VASOVASORRHAPHY
546.. 55450 LIGATION (PERCUTANEOUS) OF VAS DEFERENS, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
546.. 55500 EXCISION OF HYDROCELE OF SPERMATIC CORD, UNILATERAL (SEPARATE PROCEDURE)
546.. 55520 EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE)
546.. 55530 EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR VARICOCELE; (SEPARATE PROCEDURE)
546.. 55535 EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR VARICOCELE; ABDOMINAL APPROACH
546.. 55540 EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR VARICOCELE; WITH HERNIA REPAIR
546.. 55680 EXCISION OF MULLERIAN DUCT CYST
547.. Prostate Biopsy T 4.39 $222.44 $125.2 $44.49
547.. 55700 BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
547.. 55705 BIOPSY, PROSTATE; INCISIONAL, ANY APPROACH
550.. Surgical Hysteroscopy T 16.89 $855.81 $447.93 $171.16
550.. 56351 HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR
WITHOUT D & C
550.. 56352 HYSTEROSCOPY, SURGICAL; WITH LYSIS OF INTRAUTERINE ADHESIONS (ANY METHOD)
550.. 56353 HYSTEROSCOPY, SURGICAL; WITH DIVISION OR RESECTION OF INTRAUTERINE SEPTUM (ANY METHOD)
550.. 56354 HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA
550.. 56355 HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF IMPACTED FOREIGN BODY
550.. 56356 HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION (ANY METHOD)
551.. Level I Laparoscopy T 24.78 $1,255.59 $711.67 $251.12
551.. 56300 LAPAROSCOPY (PERITONEOSCOPY), DIAGNOSTIC; (SEPARATE PROCEDURE)
551.. 56301 LAPAROSCOPY, SURGICAL; WITH FULGURATION OF OVIDUCTS (WITH OR WITHOUT TRANSECTION)
551.. 56302 LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY DEVICE (EG, BAND, CLIP, OR FALOPE RING)
551.. 56303 LAPAROSCOPY, SURGICAL; WITH FULGURATION OR EXCISION OF LESIONS OF THE OVARY, PELVIC VISCERA, OR
PERITONEAL SURFACE BY ANY METHOD
551.. 56304 LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) (SEPARATE
PROCEDURE)
551.. 56305 LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)
551.. 56306 LAPAROSCOPY, SURGICAL; WITH ASPIRATION (SINGLE OR MULTIPLE)
551.. 56346 LAPAROSCOPY, SURGICAL; GASTROSTOMY, TEMPORARY (TUBE OR RUBBER OR PLASTIC) (SEPARATE PROCEDURE)
552.. Level II Laparoscopy T 37.71 $1,910.75 $1,053.16 $382.15
552.. 56307 LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR TOTAL OOPHORECTOMY AND/OR
SALPINGECTOMY)
552.. 56309 LAPAROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA (SINGLE OR MULTIPLE)
552.. 56311 LAPAROSCOPY, SURGICAL; WITH RETROPERITONEAL LYMPH NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE
552.. 56312 LAPAROSCOPY, SURGICAL; WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY
552.. 56313 LAPAROSCOPY, SURGICAL; WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PERI-AORTIC LYMPH NODE
SAMPLING (BIOPSY), SINGLE OR MULTIPLE
552.. 56316 LAPAROSCOPY, SURGICAL; REPAIR OF INITIAL INGUINAL HERNIA
552.. 56317 LAPAROSCOPY, SURGICAL; REPAIR OF RECURRENT INGUINAL HERNIA
552.. 56318 LAPAROSCOPY, SURGICAL; ORCHIECTOMY
552.. 56320 LAPAROSCOPY, SURGICAL; WITH LIGATION OF SPERMATIC VEINS FOR VARICOCELE
552.. 56343 LAPAROSCOPY, SURGICAL; WITH SALPINGOSTOMY (SALPINGONEOSTOMY)
552.. 56344 LAPAROSCOPY, SURGICAL; WITH FIMBRIOPLASTY
552.. 56362 LAPAROSCOPY WITH GUIDED TRANSHEPATIC CHOLANGIOGRAPHY; WITHOUT BIOPSY
552.. 56363 LAPAROSCOPY WITH GUIDED TRANSHEPATIC CHOLANGIOGRAPHY; WITH BIOPSY
561.. Level I Female Reproductive T 1.52 $77.02 $24.63 $15.4
Procedures
561.. 56405 INCISION AND DRAINAGE OF VULVA OR PERINEAL ABSCESS
561.. 56420 INCISION AND DRAINAGE OF BARTHOLIN'S GLAND ABSCESS
561.. 56441 LYSIS OF LABIAL ADHESIONS
561.. 57061 DESTRUCTION OF VAGINAL LESION(S); SIMPLE, ANY METHOD
561.. 57100 BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE)
561.. 57150 IRRIGATION OF VAGINA AND/OR APPLICATION OF MEDICAMENT FOR TREATMENT OF BACTERIAL, PARASITIC, OR
FUNGOID DISEASE
561.. 57160 FITTING AND INSERTION OF PESSARY OR OTHER INTRAVAGINAL SUPPORT DEVICE
561.. 57170 DIAPHRAGM OR CERVICAL CAP FITTING WITH INSTRUCTIONS
561.. 57180 INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONTANEOUS OR TRAUMATIC NONOBSTETRICAL
VAGINAL HEMORRHAGE (SEPARATE PROCEDURE)
561.. 57452 COLPOSCOPY (VAGINOSCOPY); (SEPARATE PROCEDURE)
561.. 57454 COLPOSCOPY (VAGINOSCOPY); WITH BIOPSY(S) OF THE CERVIX AND/OR ENDOCERVICAL CURETTAGE
561.. 57500 BIOPSY, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE
PROCEDURE)
561.. 57505 ENDOCERVICAL CURETTAGE (NOT DONE AS PART OF A DILATION AND CURETTAGE)
561.. 57510 CAUTERIZATION OF CERVIX; ELECTRO OR THERMAL
561.. 57511 CAUTERIZATION OF CERVIX; CRYOCAUTERY, INITIAL OR REPEAT
561.. 57513 CAUTERIZATION OF CERVIX; LASER ABLATION
[[Page 47805]]
561.. 57800 DILATION OF CERVICAL CANAL, INSTRUMENTAL (SEPARATE PROCEDURE)
561.. 58100 ENDOMETRIAL SAMPLING (BIOPSY) WITH OR WITHOUT ENDOCERVICAL SAMPLING (BIOPSY), WITHOUT CERVICAL
DILATION, ANY METHOD (SEPARATE PROCEDURE)
561.. 58301 REMOVAL OF INTRAUTERINE DEVICE (IUD)
561.. 59200 INSERTION OF CERVICAL DILATOR (EG, LAMINARIA, PROSTAGLANDIN) (SEPARATE PROCEDURE)
562.. Level II Female Reproductive T 12.76 $646.54 $330.75 $129.31
Procedures
562.. 56350 HYSTEROSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE)
562.. 56399 UNLISTED PROCEDURE, LAPAROSCOPY, HYSTEROSCOPY
562.. 56440 MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST
562.. 56700 PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING
562.. 56720 HYMENOTOMY, SIMPLE INCISION
562.. 56740 EXCISION OF BARTHOLIN'S GLAND OR CYST
562.. 56800 PLASTIC REPAIR OF INTROITUS
562.. 56810 PERINEOPLASTY, REPAIR OF PERINEUM, NONOBSTETRICAL (SEPARATE PROCEDURE)
562.. 57000 COLPOTOMY; WITH EXPLORATION
562.. 57010 COLPOTOMY; WITH DRAINAGE OF PELVIC ABSCESS
562.. 57020 COLPOCENTESIS (SEPARATE PROCEDURE)
562.. 57065 DESTRUCTION OF VAGINAL LESION(S); EXTENSIVE, ANY METHOD
562.. 57105 BIOPSY OF VAGINAL MUCOSA; EXTENSIVE, REQUIRING SUTURE (INCLUDING CYSTS)
562.. 57130 EXCISION OF VAGINAL SEPTUM
562.. 57135 EXCISION OF VAGINAL CYST OR TUMOR
562.. 57200 COLPORRHAPHY, SUTURE OF INJURY OF VAGINA (NONOBSTETRICAL)
562.. 57210 COLPOPERINEORRHAPHY, SUTURE OF INJURY OF VAGINA AND/OR PERINEUM (NONOBSTETRICAL)
562.. 57230 PLASTIC REPAIR OF URETHROCELE
562.. 57400 DILATION OF VAGINA UNDER ANESTHESIA
562.. 57410 PELVIC EXAMINATION UNDER ANESTHESIA
562.. 57415 REMOVAL OF IMPACTED VAGINAL FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA
562.. 57460 COLPOSCOPY (VAGINOSCOPY); WITH LOOP ELECTRODE EXCISION PROCEDURE OF THE CERVIX
562.. 57700 CERCLAGE OF UTERINE CERVIX, NONOBSTETRICAL
562.. 57720 TRACHELORRHAPHY, PLASTIC REPAIR OF UTERINE CERVIX, VAGINAL APPROACH
562.. 58345 TRANSCERVICAL INTRODUCTION OF FALLOPIAN TUBE CATHETER FOR DIAGNOSIS AND/OR RE-ESTABLISHING
PATENCY (ANY METHOD), WITH OR WITHOUT HYSTEROSALPINGOGRAPHY
562.. 58350 CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIALS
562.. 58970 FOLLICLE PUNCTURE FOR OOCYTE RETRIEVAL, ANY METHOD
562.. 59300 EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING PHYSICIAN
562.. 59320 CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL
562.. 59871 REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA (OTHER THAN LOCAL)
563.. Level III Female Reproductive T 16.90 $856.31 $464.88 $171.26
Procedures
563.. 56620 VULVECTOMY SIMPLE; PARTIAL
563.. 56625 VULVECTOMY SIMPLE; COMPLETE
563.. 57220 PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL APPROACH (EG, KELLY URETHRAL PLICATION)
563.. 57240 ANTERIOR COLPORRHAPHY, REPAIR OF CYSTOCELE WITH OR WITHOUT REPAIR OF URETHROCELE
563.. 57250 POSTERIOR COLPORRHAPHY, REPAIR OF RECTOCELE WITH OR WITHOUT PERINEORRHAPHY
563.. 57260 COMBINED ANTEROPOSTERIOR COLPORRHAPHY;
563.. 57265 COMBINED ANTEROPOSTERIOR COLPORRHAPHY; WITH ENTEROCELE REPAIR
563.. 57268 REPAIR OF ENTEROCELE, VAGINAL APPROACH (SEPARATE PROCEDURE)
563.. 57284 PARAVAGINAL DEFECT REPAIR (INCLUDING REPAIR OF CYSTOCELE, STRESS URINARY INCONTINENCE, AND/OR
INCOMPLETE VAGINAL PROLAPSE)
563.. 57288 SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SYNTHETIC)
563.. 57289 PEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHY
563.. 57291 CONSTRUCTION OF ARTIFICIAL VAGINA; WITHOUT GRAFT
563.. 57300 CLOSURE OF RECTOVAGINAL FISTULA; VAGINAL OR TRANSANAL APPROACH
563.. 57520 CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION, WITH OR WITHOUT DILATION AND CURETTAGE, WITH
OR WITHOUT REPAIR; COLD KNIFE OR LASER
563.. 57522 CONIZATION OF CERVIX, WITH OR WITHOUT FULGURATION, WITH OR WITHOUT DILATION AND CURETTAGE, WITH
OR WITHOUT REPAIR; LOOP ELECTRODE EXCISION
563.. 57530 TRACHELECTOMY (CERVICECTOMY), AMPUTATION OF CERVIX (SEPARATE PROCEDURE)
563.. 57550 EXCISION OF CERVICAL STUMP, VAGINAL APPROACH;
563.. 57555 EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITH ANTERIOR AND/OR POSTERIOR REPAIR
563.. 57556 EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITH REPAIR OF ENTEROCELE
563.. 58145 MYOMECTOMY, EXCISION OF FIBROID TUMOR OF UTERUS, SINGLE OR MULTIPLE (SEPARATE PROCEDURE);
VAGINAL APPROACH
563.. 58800 DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL, (SEPARATE PROCEDURE); VAGINAL APPROACH
563.. 58820 DRAINAGE OF OVARIAN ABSCESS; VAGINAL APPROACH, OPEN
567.. D & C T 13.61 $689.61 $364.09 $137.92
567.. 57820 DILATION AND CURETTAGE OF CERVICAL STUMP
567.. 58120 DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)
567.. 59160 CURRETTAGE, POSTPARTUM
568.. Infertility Procedures T 2.49 $126.17 $49.49 $25.23
568.. 55870 ELECTROEJACULATION
568.. 58321 ARTIFICIAL INSEMINATION; INTRA-CERVICAL
568.. 58322 ARTIFICIAL INSEMINATION; INTRA-UTERINE
568.. 58323 SPERM WASHING FOR ARTIFICIAL INSEMINATION
568.. 58974 EMBRYO TRANSFER, INTRAUTERINE
[[Page 47806]]
568.. 58976 GAMETE, ZYGOTE, OR EMBRYO INTRAFALLOPIAN TRANSFER, ANY METHOD
578.. Pregnancy and Neonatal Care T 1.26 $63.84 $33.9 $12.77
Procedures
578.. 59000 AMNIOCENTESIS, ANY METHOD
578.. 59012 CORDOCENTESIS (INTRAUTERINE), ANY METHOD
578.. 59015 CHORIONIC VILLUS SAMPLING, ANY METHOD
578.. 59020 FETAL CONTRACTION STRESS TEST
578.. 59025 FETAL NON-STRESS TEST
578.. 59030 FETAL SCALP BLOOD SAMPLING
578.. 59050 FETAL MONITORING DURING LABOR BY CONSULTING PHYSICIAN (IE, NON-ATTENDING PHYSICIAN) WITH
WRITTEN REPORT; SUPERVISION AND INTERPRETATION
578.. 59899 UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY
580.. Vaginal Delivery T 4.59 $232.57 $146.34 $46.51
580.. 59409 VAGINAL DELIVERY ONLY (WITH OR WITHOUT EPISIOTOMY AND/OR FORCEPS);
580.. 59412 EXTERNAL CEPHALIC VERSION, WITH OR WITHOUT TOCOLYSIS (LIST IN ADDITION TO CODE(S) FOR DELIVERY)
580.. 59414 DELIVERY OF PLACENTA (SEPARATE PROCEDURE)
580.. 59612 VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN DELIVERY (WITH OR WITHOUT EPISIOTOMY AND/OR
FORCEPS);
586.. Therapeutic Abortion T 12.5 $633.37 $431.89 $126.67
586.. 59840 INDUCED ABORTION, BY DILATION AND CURETTAGE
586.. 59841 INDUCED ABORTION, BY DILATION AND EVACUATION
587.. Spontaneous Abortion T 13.25 $671.37 $347.02 $134.27
587.. 59812 TREATMENT OF INCOMPLETE ABORTION, ANY TRIMESTER, COMPLETED SURGICALLY
587.. 59820 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER
587.. 59821 TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER
587.. 59870 UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE
600.. Spinal Tap T 2.63 $133.26 $61.47 $26.65
600.. 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC
600.. 62272 SPINAL PUNCTURE, THERAPEUTIC, FOR DRAINAGE OF SPINAL FLUID (BY NEEDLE OR CATHETER)
601.. Level I Nervous System T 3.11 $157.58 $74.13 $31.52
Injections
601.. 64400 INJECTION, ANESTHETIC AGENT; TRIGEMINAL NERVE, ANY DIVISION OR BRANCH
601.. 64402 INJECTION, ANESTHETIC AGENT; FACIAL NERVE
601.. 64405 INJECTION, ANESTHETIC AGENT; GREATER OCCIPITAL NERVE
601.. 64408 INJECTION, ANESTHETIC AGENT; VAGUS NERVE
601.. 64410 INJECTION, ANESTHETIC AGENT; PHRENIC NERVE
601.. 64412 INJECTION, ANESTHETIC AGENT; SPINAL ACCESSORY NERVE
601.. 64413 INJECTION, ANESTHETIC AGENT; CERVICAL PLEXUS
601.. 64415 INJECTION, ANESTHETIC AGENT; BRACHIAL PLEXUS
601.. 64417 INJECTION, ANESTHETIC AGENT; AXILLARY NERVE
601.. 64418 INJECTION, ANESTHETIC AGENT; SUPRASCAPULAR NERVE
601.. 64420 INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVE, SINGLE
601.. 64421 INJECTION, ANESTHETIC AGENT; INTERCOSTAL NERVES, MULTIPLE, REGIONAL BLOCK
601.. 64425 INJECTION, ANESTHETIC AGENT; ILIOINGUINAL, ILIOHYPOGASTRIC NERVES
601.. 64430 INJECTION, ANESTHETIC AGENT; PUDENDAL NERVE
601.. 64435 INJECTION, ANESTHETIC AGENT; PARACERVICAL (UTERINE) NERVE
601.. 64440 INJECTION, ANESTHETIC AGENT; PARAVERTEBRAL NERVE (THORACIC, LUMBAR, SACRAL, COCCYGEAL), SINGLE
VERTEBRAL LEVEL
601.. 64441 INJECTION, ANESTHETIC AGENT; PARAVERTEBRAL NERVES, MULTIPLE LEVELS (EG, REGIONAL BLOCK)
601.. 64442 INJECTION, ANESTHETIC AGENT; PARAVERTEBRAL FACET JOINT NERVE, LUMBAR, SINGLE LEVEL
601.. 64443 INJECTION, ANESTHETIC AGENT; PARAVERTEBRAL FACET JOINT NERVE, LUMBAR, EACH ADDITIONAL LEVEL
601.. 64445 INJECTION, ANESTHETIC AGENT; SCIATIC NERVE
601.. 64450 INJECTION, ANESTHETIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH
601.. 64505 INJECTION, ANESTHETIC AGENT; SPHENOPALATINE GANGLION
601.. 64508 INJECTION, ANESTHETIC AGENT; CAROTID SINUS (SEPARATE PROCEDURE)
601.. 64510 INJECTION, ANESTHETIC AGENT; STELLATE GANGLION (CERVICAL SYMPATHETIC)
601.. 64520 INJECTION, ANESTHETIC AGENT; LUMBAR OR THORACIC (PARAVERTEBRAL SYMPATHETIC)
601.. 64530 INJECTION, ANESTHETIC AGENT; CELIAC PLEXUS, WITH OR WITHOUT RADIOLOGIC MONITORING
601.. 64600 DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE; SUPRAORBITAL, INFRAORBITAL, MENTAL, OR
INFERIOR ALVEOLAR BRANCH
601.. 64605 DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE; SECOND AND THIRD DIVISION BRANCHES AT
FORAMEN OVALE
601.. 64610 DESTRUCTION BY NEUROLYTIC AGENT, TRIGEMINAL NERVE; SECOND AND THIRD DIVISION BRANCHES AT
FORAMEN OVALE UNDER RADIOLOGIC MONITORING
601.. 64612 DESTRUCTION BY NEUROLYTIC AGENT (CHEMODENERVATION OF MUSCLE ENDPLATE); MUSCLES ENERVATED BY
FACIAL NERVE (EG, FOR BLEPHAROSPASM, HEMIFACIAL SPASM)
601.. 64613 DESTRUCTION BY NEUROLYTIC AGENT (CHEMODENERVATION OF MUSCLE ENDPLATE); CERVICAL SPINAL MUSCLES
(EG, FOR SPASMODIC TORTICOLLIS)
601.. 64620 DESTRUCTION BY NEUROLYTIC AGENT; INTERCOSTAL NERVE
601.. 64622 DESTRUCTION BY NEUROLYTIC AGENT; PARAVERTEBRAL FACET JOINT NERVE, LUMBAR, SINGLE LEVEL
601.. 64623 DESTRUCTION BY NEUROLYTIC AGENT; PARAVERTEBRAL FACET JOINT NERVE, LUMBAR, EACH ADDITIONAL LEVEL
601.. 64630 DESTRUCTION BY NEUROLYTIC AGENT; PUDENDAL NERVE
601.. 64640 DESTRUCTION BY NEUROLYTIC AGENT; OTHER PERIPHERAL NERVE OR BRANCH
601.. 64680 DESTRUCTION BY NEUROLYTIC AGENT, CELIAC PLEXUS, WITH OR WITHOUT RADIOLOGIC MONITORING
601.. 64999 UNLISTED PROCEDURE, NERVOUS SYSTEM
602.. Level II Nervous System T 3.33 $168.73 $87.69 $33.75
Injections
[[Page 47807]]
602.. 61000 SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT, UNILATERAL OR BILATERAL; INITIAL
602.. 61001 SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT, UNILATERAL OR BILATERAL; SUBSEQUENT TAPS
602.. 61020 VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, FONTANELLE, SUTURE, OR IMPLANTED VENTRICULAR
CATHETER/RESERVOIR; WITHOUT INJECTION
602.. 61026 VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, FONTANELLE, SUTURE, OR IMPLANTED VENTRICULAR
CATHETER/RESERVOIR; WITH INJECTION OF DRUG OR OTHER SUBSTANCE FOR DIAGNOSIS OR TREATMENT
602.. 61050 CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCTURE; WITHOUT INJECTION (SEPARATE PROCEDURE)
602.. 61055 CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCTURE; WITH INJECTION OF DRUG OR OTHER SUBSTANCE FOR
DIAGNOSIS OR TREATMENT (EG, C1-C2)
602.. 61070 PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION OR INJECTION PROCEDURE
602.. 62194 REPLACEMENT OR IRRIGATION, SUBARACHNOID/SUBDURAL CATHETER
602.. 62225 REPLACEMENT OR IRRIGATION, VENTRICULAR CATHETER
602.. 62268 PERCUTANEOUS ASPIRATION, SPINAL CORD CYST OR SYRINX
602.. 62273 INJECTION, LUMBAR EPIDURAL, OF BLOOD OR CLOT PATCH
602.. 62274 INJECTION OF DIAGNOSTIC OR THERAPEUTIC ANESTHETIC OR ANTISPASMODIC SUBSTANCE (INCLUDING
NARCOTICS); SUBARACHNOID OR SUBDURAL, SINGLE
602.. 62275 INJECTION OF DIAGNOSTIC OR THERAPEUTIC ANESTHETIC OR ANTISPASMODIC SUBSTANCE (INCLUDING
NARCOTICS); EPIDURAL, CERVICAL OR THORACIC, SINGLE
602.. 62276 INJECTION OF DIAGNOSTIC OR THERAPEUTIC ANESTHETIC OR ANTISPASMODIC SUBSTANCE (INCLUDING
NARCOTICS); SUBARACHNOID OR SUBDURAL, DIFFERENTIAL
602.. 62277 INJECTION OF DIAGNOSTIC OR THERAPEUTIC ANESTHETIC OR ANTISPASMODIC SUBSTANCE (INCLUDING
NARCOTICS); SUBARACHNOID OR SUBDURAL, CONTINUOUS
602.. 62278 INJECTION OF DIAGNOSTIC OR THERAPEUTIC ANESTHETIC OR ANTISPASMODIC SUBSTANCE (INCLUDING
NARCOTICS); EPIDURAL, LUMBAR OR CAUDAL, SINGLE
602.. 62279 INJECTION OF DIAGNOSTIC OR THERAPEUTIC ANESTHETIC OR ANTISPASMODIC SUBSTANCE (INCLUDING
NARCOTICS); EPIDURAL, LUMBAR OR CAUDAL, CONTINUOUS
602.. 62280 INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, ICED SALINE SOLUTIONS); SUBARACHNOID
602.. 62281 INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, ICED SALINE SOLUTIONS); EPIDURAL,
CERVICAL OR THORACIC
602.. 62282 INJECTION OF NEUROLYTIC SUBSTANCE (EG, ALCOHOL, PHENOL, ICED SALINE SOLUTIONS); EPIDURAL,
LUMBAR OR CAUDAL
602.. 62288 INJECTION OF SUBSTANCE OTHER THAN ANESTHETIC, ANTISPASMODIC, CONTRAST, OR NEUROLYTIC SOLUTIONS;
SUBARACHNOID (SEPARATE PROCEDURE)
602.. 62289 INJECTION OF SUBSTANCE OTHER THAN ANESTHETIC, ANTISPASMODIC, CONTRAST, OR NEUROLYTIC SOLUTIONS;
LUMBAR OR CAUDAL EPIDURAL (SEPARATE PROCEDURE)
602.. 62292 INJECTION PROCEDURE FOR CHEMONUCLEOLYSIS, INCLUDING DISKOGRAPHY, INTERVERTEBRAL DISK, SINGLE OR
MULTIPLE LEVELS, LUMBAR
602.. 62294 INJECTION PROCEDURE, ARTERIAL, FOR OCCLUSION OF ARTERIOVENOUS MALFORMATION, SPINAL
602.. 62298 INJECTION OF SUBSTANCE OTHER THAN ANESTHETIC, CONTRAST, OR NEUROLYTIC SOLUTIONS, EPIDURAL,
CERVICAL OR THORACIC (SEPARATE PROCEDURE)
616.. Implantation of T 14.43 $731.16 $366.57 $146.23
Neurostimulator Electrodes
616.. 63650 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; EPIDURAL
616.. 64553 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; CRANIAL NERVE
616.. 64555 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; PERIPHERAL NERVE
616.. 64560 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; AUTONOMIC NERVE
616.. 64565 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; NEUROMUSCULAR
616.. 64573 INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; CRANIAL NERVE
616.. 64575 INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; PERIPHERAL NERVE
616.. 64577 INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; AUTONOMIC NERVE
616.. 64580 INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; NEUROMUSCULAR
617.. Revision/Removal Neurological T 11.56 $585.74 $287.59 $117.15
Device
617.. 62230 REPLACEMENT OR REVISION OF CSF SHUNT, OBSTRUCTED VALVE, OR DISTAL CATHETER IN SHUNT SYSTEM
617.. 62350 IMPLANTATION, REVISION OR REPOSITIONING OF INTRATHECAL OR EPIDURAL CATHETER, FOR IMPLANTABLE
RESERVOIR OR IMPLANTABLE INFUSION PUMP; WITHOUT LAMINECTOMY
617.. 62355 REMOVAL OF PREVIOUSLY IMPLANTED INTRATHECAL OR EPIDURAL CATHETER
617.. 62365 REMOVAL OF SUBCUTANEOUS RESERVOIR OR PUMP, PREVIOUSLY IMPLANTED FOR INTRATHECAL OR EPIDURAL
INFUSION
617.. 63660 REVISION OR REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODES
617.. 63688 REVISION OR REMOVAL OF IMPLANTED SPINAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
617.. 63744 REPLACEMENT, IRRIGATION OR REVISION OF LUMBOSUBARACHNOID SHUNT
617.. 63746 REMOVAL OF ENTIRE LUMBOSUBARACHNOID SHUNT SYSTEM WITHOUT REPLACEMENT
617.. 64585 REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR ELECTRODES
617.. 64595 REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
618.. Implantation of Neurological T 25.56 $1,295.11 $780.49 $259.02
Device
618.. 61215 INSERTION OF SUBCUTANEOUS RESERVOIR, PUMP OR CONTINUOUS INFUSION SYSTEM FOR CONNECTION TO
VENTRICULAR CATHETER
618.. 61885 INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER,
DIRECT OR INDUCTIVE COUPLING
618.. 62360 IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; SUBCUTANEOUS
RESERVOIR
618.. 62361 IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; NON-
PROGRAMMABLE PUMP
618.. 62362 IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; PROGRAMMABLE
PUMP, INCLUDING PREPARATION OF PUMP, WITH OR WITHOUT PROGRAMMING
618.. 63685 INCISION AND SUBCUTANEOUS PLACEMENT OF SPINAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER,
DIRECT OR INDUCTIVE COUPLING
618.. 64590 INCISION AND SUBCUTANEOUS PLACEMENT OF PERIPHERAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER,
DIRECT OR INDUCTIVE COUPLING
[[Page 47808]]
631.. Level I Nerve Procedures T 12.98 $657.69 $333.8 $131.54
631.. 27315 NEURECTOMY, HAMSTRING MUSCLE
631.. 27320 NEURECTOMY, POPLITEAL (GASTROCNEMIUS)
631.. 28030 NEURECTOMY OF INTRINSIC MUSCULATURE OF FOOT
631.. 28035 TARSAL TUNNEL RELEASE (POSTERIOR TIBIAL NERVE DECOMPRESSION)
631.. 61790 CREATION OF LESION BY STEREOTACTIC METHOD, PERCUTANEOUS, BY NEUROLYTIC AGENT (EG, ALCOHOL,
THERMAL, ELECTRICAL, RADIOFREQUENCY); GASSERIAN GANGLION
631.. 62287 ASPIRATION PROCEDURE, PERCUTANEOUS, OF NUCLEUS PULPOSUS OF INTERVERTEBRAL DISK, ANY METHOD,
SINGLE OR MULTIPLE LEVELS, LUMBAR
631.. 63600 CREATION OF LESION OF SPINAL CORD BY STEREOTACTIC METHOD, PERCUTANEOUS, ANY MODALITY (INCLUDING
STIMULATION AND/OR RECORDING)
631.. 63610 STEREOTACTIC STIMULATION OF SPINAL CORD, PERCUTANEOUS, SEPARATE PROCEDURE NOT FOLLOWED BY OTHER
SURGERY
631.. 63615 STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION, SPINAL CORD
631.. 64702 NEUROPLASTY; DIGITAL, ONE OR BOTH, SAME DIGIT
631.. 64704 NEUROPLASTY; NERVE OF HAND OR FOOT
631.. 64708 NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; OTHER THAN SPECIFIED
631.. 64712 NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; SCIATIC NERVE
631.. 64713 NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; BRACHIAL PLEXUS
631.. 64714 NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; LUMBAR PLEXUS
631.. 64716 NEUROPLASTY AND/OR TRANSPOSITION; CRANIAL NERVE (SPECIFY)
631.. 64718 NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW
631.. 64719 NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT WRIST
631.. 64721 NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL
631.. 64722 DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY)
631.. 64726 DECOMPRESSION; PLANTAR DIGITAL NERVE
631.. 64727 INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE
FOR NEUROPLASTY) (NEUROPLASTY INCLUDES EXTERNAL NEUROLYSIS)
631.. 64732 TRANSECTION OR AVULSION OF; SUPRAORBITAL NERVE
631.. 64734 TRANSECTION OR AVULSION OF; INFRAORBITAL NERVE
631.. 64736 TRANSECTION OR AVULSION OF; MENTAL NERVE
631.. 64738 TRANSECTION OR AVULSION OF; INFERIOR ALVEOLAR NERVE BY OSTEOTOMY
631.. 64740 TRANSECTION OR AVULSION OF; LINGUAL NERVE
631.. 64742 TRANSECTION OR AVULSION OF; FACIAL NERVE, DIFFERENTIAL OR COMPLETE
631.. 64744 TRANSECTION OR AVULSION OF; GREATER OCCIPITAL NERVE
631.. 64746 TRANSECTION OR AVULSION OF; PHRENIC NERVE
631.. 64761 TRANSECTION OR AVULSION OF; PUDENDAL NERVE
631.. 64771 TRANSECTION OR AVULSION OF OTHER CRANIAL NERVE, EXTRADURAL
631.. 64772 TRANSECTION OR AVULSION OF OTHER SPINAL NERVE, EXTRADURAL
631.. 64774 EXCISION OF NEUROMA; CUTANEOUS NERVE, SURGICALLY IDENTIFIABLE
631.. 64776 EXCISION OF NEUROMA; DIGITAL NERVE, ONE OR BOTH, SAME DIGIT
631.. 64778 EXCISION OF NEUROMA; DIGITAL NERVE, EACH ADDITIONAL DIGIT (LIST SEPARATELY BY THIS NUMBER)
631.. 64782 EXCISION OF NEUROMA; HAND OR FOOT, EXCEPT DIGITAL NERVE
631.. 64783 EXCISION OF NEUROMA; HAND OR FOOT, EACH ADDITIONAL NERVE, EXCEPT SAME DIGIT (LIST SEPARATELY BY
THIS NUMBER)
631.. 64784 EXCISION OF NEUROMA; MAJOR PERIPHERAL NERVE, EXCEPT SCIATIC
631.. 64787 IMPLANTATION OF NERVE END INTO BONE OR MUSCLE (LIST SEPARATELY IN ADDITION TO NEUROMA EXCISION)
631.. 64788 EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS NERVE
631.. 64790 EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERAL NERVE
631.. 64795 BIOPSY OF NERVE
631.. 64830 MICRODISSECTION AND/OR MICROREPAIR OF NERVE (LIST SEPARATELY IN ADDITION TO CODE FOR NERVE
REPAIR)
632.. Level II Nerve Procedures T 18.13 $918.64 $461.04 $183.73
632.. 64786 EXCISION OF NEUROMA; SCIATIC NERVE
632.. 64792 EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; EXTENSIVE (INCLUDING MALIGNANT TYPE)
632.. 64831 SUTURE OF DIGITAL NERVE, HAND OR FOOT; ONE NERVE
632.. 64832 SUTURE OF DIGITAL NERVE, HAND OR FOOT; EACH ADDITIONAL DIGITAL NERVE
632.. 64834 SUTURE OF ONE NERVE, HAND OR FOOT; COMMON SENSORY NERVE
632.. 64835 SUTURE OF ONE NERVE, HAND OR FOOT; MEDIAN MOTOR THENAR
632.. 64836 SUTURE OF ONE NERVE, HAND OR FOOT; ULNAR MOTOR
632.. 64837 SUTURE OF EACH ADDITIONAL NERVE, HAND OR FOOT
632.. 64840 SUTURE OF POSTERIOR TIBIAL NERVE
632.. 64856 SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT SCIATIC; INCLUDING TRANSPOSITION
632.. 64857 SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT SCIATIC; WITHOUT TRANSPOSITION
632.. 64858 SUTURE OF SCIATIC NERVE
632.. 64859 SUTURE OF EACH ADDITIONAL MAJOR PERIPHERAL NERVE
632.. 64861 SUTURE OF; BRACHIAL PLEXUS
632.. 64862 SUTURE OF; LUMBAR PLEXUS
632.. 64864 SUTURE OF FACIAL NERVE; EXTRACRANIAL
632.. 64865 SUTURE OF FACIAL NERVE; INFRATEMPORAL, WITH OR WITHOUT GRAFTING
632.. 64870 ANASTOMOSIS; FACIAL-PHRENIC
632.. 64872 SUTURE OF NERVE; REQUIRING SECONDARY OR DELAYED SUTURE (LIST SEPARATELY IN ADDITION TO CODE FOR
PRIMARY NEURORRHAPHY)
632.. 64874 SUTURE OF NERVE; REQUIRING EXTENSIVE MOBILIZATION, OR TRANSPOSITION OF NERVE (LIST SEPARATELY
IN ADDITION TO CODE FOR NERVE SUTURE)
632.. 64876 SUTURE OF NERVE; REQUIRING SHORTENING OF BONE OF EXTREMITY (LIST SEPARATELY IN ADDITION TO CODE
FOR NERVE SUTURE)
632.. 64885 NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; UP TO 4 CM IN LENGTH
[[Page 47809]]
632.. 64886 NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; MORE THAN 4 CM LENGTH
632.. 64890 NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, HAND OR FOOT; UP TO 4 CM LENGTH
632.. 64891 NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, HAND OR FOOT; MORE THAN 4 CM LENGTH
632.. 64892 NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARM OR LEG; UP TO 4 CM LENGTH
632.. 64893 NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, ARM OR LEG; MORE THAN 4 CM LENGTH
632.. 64895 NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), HAND OR FOOT; UP TO 4 CM
LENGTH
632.. 64896 NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), HAND OR FOOT; MORE THAN 4 CM
LENGTH
632.. 64897 NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), ARM OR LEG; UP TO 4 CM LENGTH
632.. 64898 NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), ARM OR LEG; MORE THAN 4 CM
LENGTH
632.. 64901 NERVE GRAFT, EACH ADDITIONAL NERVE; SINGLE STRAND
632.. 64902 NERVE GRAFT, EACH ADDITIONAL NERVE; MULTIPLE STRANDS (CABLE)
632.. 64905 NERVE PEDICLE TRANSFER; FIRST STAGE
632.. 64907 NERVE PEDICLE TRANSFER; SECOND STAGE
648.. Laser Retinal Procedures T 3.94 $199.64 $95.15 $39.93
648.. 67105 REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; PHOTOCOAGULATION, WITH OR WITHOUT DRAINAGE
OF SUBRETINAL FLUID
648.. 67145 PROPHYLAXIS OF RETINAL DETACHMENT (EG, RETINAL BREAK, LATTICE DEGENERATION) WITHOUT DRAINAGE,
ONE OR MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)
648.. 67210 DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS), ONE
OR MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)
648.. 67228 DESTRUCTION OF EXTENSIVE OR PROGRESSIVE RETINOPATHY (EG, DIABETIC RETINOPATHY), ONE OR MORE
SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)
649.. Laser Eye Procedures except T 4.44 $224.97 $111.64 $44.99
Retinal
649.. 65855 TRABECULOPLASTY BY LASER SURGERY, ONE OR MORE SESSIONS (DEFINED TREATMENT SERIES)
649.. 65860 SEVERING ADHESIONS OF ANTERIOR SEGMENT, LASER TECHNIQUE (SEPARATE PROCEDURE)
649.. 66761 IRIDOTOMY/IRIDECTOMY BY LASER SURGERY (EG, FOR GLAUCOMA) (ONE OR MORE SESSIONS)
649.. 66762 IRIDOPLASTY BY PHOTOCOAGULATION (ONE OR MORE SESSIONS) (EG, FOR IMPROVEMENT OF VISION, FOR
WIDENING OF ANTERIOR CHAMBER ANGLE)
649.. 66770 DESTRUCTION OF CYST OR LESION IRIS OR CILIARY BODY (NONEXCISIONAL PROCEDURE)
649.. 66821 DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR
HYALOID); LASER SURGERY (EG, YAG LASER) (ONE OR MORE STAGES)
649.. 66999 UNLISTED PROCEDURE, ANTERIOR SEGMENT OF EYE
649.. 67031 SEVERING OF VITREOUS STRANDS, VITREOUS FACE ADHESIONS, SHEETS, MEMBRANES OR OPACITIES, LASER
SURGERY (ONE OR MORE STAGES)
649.. 67299 UNLISTED PROCEDURE, POSTERIOR SEGMENT
651.. Level I Anterior Segment Eye T 7.24 $366.85 $174.7 $73.37
Procedures
651.. 65272 REPAIR OF LACERATION; CONJUNCTIVA, BY MOBILIZATION AND REARRANGEMENT, WITHOUT HOSPITALIZATION
651.. 65275 REPAIR OF LACERATION; CORNEA, NONPERFORATING, WITH OR WITHOUT REMOVAL FOREIGN BODY
651.. 65286 REPAIR OF LACERATION; APPLICATION OF TISSUE GLUE, WOUNDS OF CORNEA AND/OR SCLERA
651.. 65420 EXCISION OR TRANSPOSITION OF PTERYGIUM; WITHOUT GRAFT
651.. 65436 REMOVAL OF CORNEAL EPITHELIUM; WITH APPLICATION OF CHELATING AGENT (EG, EDTA)
651.. 65450 DESTRUCTION OF LESION OF CORNEA BY CRYOTHERAPY, PHOTOCOAGULATION OR THERMOCAUTERIZATION
651.. 65772 CORNEAL RELAXING INCISION FOR CORRECTION OF SURGICALLY INDUCED ASTIGMATISM
651.. 65810 PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH REMOVAL OF VITREOUS AND/OR
DISCISSION OF ANTERIOR HYALOID MEMBRANE, WITH OR WITHOUT AIR INJECTION
651.. 65815 PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH REMOVAL OF BLOOD, WITH OR
WITHOUT IRRIGATION AND/OR AIR INJECTION
651.. 65820 GONIOTOMY
651.. 66130 EXCISION OF LESION, SCLERA
651.. 66500 IRIDOTOMY BY STAB INCISION (SEPARATE PROCEDURE); EXCEPT TRANSFIXION
651.. 66505 IRIDOTOMY BY STAB INCISION (SEPARATE PROCEDURE); WITH TRANSFIXION AS FOR IRIS BOMBE
651.. 66600 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; FOR REMOVAL OF LESION
651.. 66625 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; PERIPHERAL FOR GLAUCOMA (SEPARATE PROCEDURE)
651.. 66630 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; SECTOR FOR GLAUCOMA (SEPARATE PROCEDURE)
651.. 66700 CILIARY BODY DESTRUCTION; DIATHERMY
651.. 66710 CILIARY BODY DESTRUCTION; CYCLOPHOTOCOAGULATION
651.. 66720 CILIARY BODY DESTRUCTION; CRYOTHERAPY
651.. 66820 DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR
HYALOID); STAB INCISION TECHNIQUE (ZIEGLER OR WHEELER KNIFE)
651.. 66825 REPOSITIONING OF INTRAOCULAR LENS PROSTHESIS, REQUIRING AN INCISION (SEPARATE PROCEDURE)
652.. Level II Anterior Segment Eye T 16.48 $835.03 $433.69 $167.01
Procedures
652.. 65235 REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM ANTERIOR CHAMBER OR LENS
652.. 65280 REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, NOT INVOLVING UVEAL TISSUE
652.. 65285 REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, WITH REPOSITION OR RESECTION OF UVEAL
TISSUE
652.. 65400 EXCISION OF LESION, CORNEA (KERATECTOMY, LAMELLAR, PARTIAL), EXCEPT PTERYGIUM
652.. 65426 EXCISION OR TRANSPOSITION OF PTERYGIUM; WITH GRAFT
652.. 65770 KERATOPROSTHESIS
652.. 65775 CORNEAL WEDGE RESECTION FOR CORRECTION OF SURGICALLY INDUCED ASTIGMATISM
652.. 65850 TRABECULOTOMY AB EXTERNO
652.. 65865 SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
OF AIR OR LIQUID) (SEPARATE PROCEDURE); GONIOSYNECHIAE
652.. 65870 SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
OF AIR OR LIQUID) (SEPARATE PROCEDURE); ANTERIOR SYNECHIAE, EXCEPT GONIOSYNECHIAE
[[Page 47810]]
652.. 65875 SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
OF AIR OR LIQUID) (SEPARATE PROCEDURE); POSTERIOR SYNECHIAE
652.. 65880 SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE, INCISIONAL TECHNIQUE (WITH OR WITHOUT INJECTION
OF AIR OR LIQUID) (SEPARATE PROCEDURE); CORNEOVITREAL ADHESIONS
652.. 65900 REMOVAL OF EPITHELIAL DOWNGROWTH, ANTERIOR CHAMBER EYE
652.. 65920 REMOVAL OF IMPLANTED MATERIAL, ANTERIOR SEGMENT EYE
652.. 65930 REMOVAL OF BLOOD CLOT, ANTERIOR SEGMENT EYE
652.. 66150 FISTULIZATION OF SCLERA FOR GLAUCOMA; TREPHINATION WITH IRIDECTOMY
652.. 66155 FISTULIZATION OF SCLERA FOR GLAUCOMA; THERMOCAUTERIZATION WITH IRIDECTOMY
652.. 66160 FISTULIZATION OF SCLERA FOR GLAUCOMA; SCLERECTOMY WITH PUNCH OR SCISSORS, WITH IRIDECTOMY
652.. 66165 FISTULIZATION OF SCLERA FOR GLAUCOMA; IRIDENCLEISIS OR IRIDOTASIS
652.. 66170 FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO IN ABSENCE OF PREVIOUS SURGERY
652.. 66172 FISTULIZATION OF SCLERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO WITH SCARRING FROM PREVIOUS
OCULAR SURGERY OR TRAUMA (INCLUDES INJECTION OF ANTIFIBROTIC AGENTS)
652.. 66180 AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR (EG, MOLTENO, SCHOCKET, DENVER-KRUPIN)
652.. 66185 REVISION OF AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR
652.. 66225 REPAIR OF SCLERAL STAPHYLOMA; WITH GRAFT
652.. 66250 REVISION OR REPAIR OF OPERATIVE WOUND OF ANTERIOR SEGMENT, ANY TYPE, EARLY OR LATE, MAJOR OR
MINOR PROCEDURE
652.. 66605 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; WITH CYCLECTOMY
652.. 66635 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; OPTICAL (SEPARATE PROCEDURE)
652.. 66680 REPAIR OF IRIS, CILIARY BODY (AS FOR IRIDODIALYSIS)
652.. 66682 SUTURE OF IRIS, CILIARY BODY (SEPARATE PROCEDURE) WITH RETRIEVAL OF SUTURE THROUGH SMALL
INCISION (EG, MCCANNEL SUTURE)
652.. 66740 CILIARY BODY DESTRUCTION; CYCLODIALYSIS
652.. 66830 REMOVAL OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR
HYALOID) WITH CORNEO-SCLERAL SECTION, WITH OR WITHOUT IRIDECTOMY (IRIDOCAPSULOTOMY,
IRIDOCAPSULECTOMY)
652.. 68130 EXCISION OF LESION, CONJUNCTIVA; WITH ADJACENT SCLERA
652.. 68330 REPAIR OF SYMBLEPHARON; CONJUNCTIVOPLASTY, WITHOUT GRAFT
652.. 68360 CONJUNCTIVAL FLAP; BRIDGE OR PARTIAL (SEPARATE PROCEDURE)
652.. 68362 CONJUNCTIVAL FLAP; TOTAL (SUCH AS GUNDERSON THIN FLAP OR PURSE STRING FLAP)
667.. Cataract Procedures T 15.33 $776.40 $521.72 $155.28
667.. 66840 REMOVAL OF LENS MATERIAL; ASPIRATION TECHNIQUE, ONE OR MORE STAGES
667.. 66850 REMOVAL OF LENS MATERIAL; PHACOFRAGMENTATION TECHNIQUE (MECHANICAL OR ULTRASONIC) (EG,
PHACOEMULSIFICATION), WITH ASPIRATION
667.. 66852 REMOVAL OF LENS MATERIAL; PARS PLANA APPROACH, WITH OR WITHOUT VITRECTOMY
667.. 66920 REMOVAL OF LENS MATERIAL; INTRACAPSULAR
667.. 66930 REMOVAL OF LENS MATERIAL; INTRACAPSULAR, FOR DISLOCATED LENS
667.. 66940 REMOVAL OF LENS MATERIAL; EXTRACAPSULAR (OTHER THAN 66840, 66850, 66852)
668.. Cataract Procedures with IOL T 19.28 $976.91 $530.87 $195.38
Insert
668.. 66983 INTRACAPSULAR CATARACT EXTRACTION WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (ONE STAGE
PROCEDURE)
668.. 66984 EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (ONE STAGE
PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR
PHACOEMULSIFICATION)
668.. 66985 INSERTION OF INTRAOCULAR LENS PROSTHESIS (SECONDARY IMPLANT), NOT ASSOCIATED WITH CONCURRENT
CATARACT REMOVAL
668.. 66986 EXCHANGE OF INTRAOCULAR LENS
670.. Corneal Transplant T 29.23 $1,481.07 $847.5 $296.21
670.. 65710 KERATOPLASTY (CORNEAL TRANSPLANT); LAMELLAR
670.. 65730 KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (EXCEPT IN APHAKIA)
670.. 65750 KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN APHAKIA)
670.. 65755 KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN PSEUDOPHAKIA)
676.. Posterior Segment Eye T 6.3 $319.22 $140.35 $63.84
Procedures
676.. 65260 REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM POSTERIOR SEGMENT, MAGNETIC EXTRACTION, ANTERIOR OR
POSTERIOR ROUTE
676.. 65265 REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM POSTERIOR SEGMENT, NONMAGNETIC EXTRACTION
676.. 66220 REPAIR OF SCLERAL STAPHYLOMA; WITHOUT GRAFT
676.. 67005 REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUE OR LIMBAL INCISION); PARTIAL REMOVAL
676.. 67010 REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUE OR LIMBAL INCISION); SUBTOTAL
REMOVAL WITH MECHANICAL VITRECTOMY
676.. 67015 ASPIRATION OR RELEASE OF VITREOUS, SUBRETINAL OR CHOROIDAL FLUID, PARS PLANA APPROACH
(POSTERIOR SCLEROTOMY)
676.. 67030 DISCISSION OF VITREOUS STRANDS (WITHOUT REMOVAL), PARS PLANA APPROACH
676.. 67101 REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; CRYOTHERAPY OR DIATHERMY, WITH OR WITHOUT
DRAINAGE OF SUBRETINAL FLUID
676.. 67110 REPAIR OF RETINAL DETACHMENT; BY INJECTION OF AIR OR OTHER GAS (EG, PNEUMATIC RETINOPEXY)
676.. 67115 RELEASE OF ENCIRCLING MATERIAL (POSTERIOR SEGMENT)
676.. 67120 REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT; EXTRAOCULAR
676.. 67121 REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT; INTRAOCULAR
676.. 67141 PROPHYLAXIS OF RETINAL DETACHMENT (EG, RETINAL BREAK, LATTICE DEGENERATION) WITHOUT DRAINAGE,
ONE OR MORE SESSIONS; CRYOTHERAPY, DIATHERMY
676.. 67208 DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS), ONE
OR MORE SESSIONS; CRYOTHERAPY, DIATHERMY
676.. 67218 DESTRUCTION OF LOCALIZED LESION OF RETINA (EG, MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS), ONE
OR MORE SESSIONS; RADIATION BY IMPLANTATION OF SOURCE (INCLUDES REMOVAL OF SOURCE)
[[Page 47811]]
676.. 67227 DESTRUCTION OF EXTENSIVE OR PROGRESSIVE RETINOPATHY (EG, DIABETIC RETINOPATHY), ONE OR MORE
SESSIONS; CRYOTHERAPY, DIATHERMY
676.. 92018 OPHTHALMOLOGICAL EXAMINATION AND EVALUATION, UNDER GENERAL ANESTHESIA, WITH OR WITHOUT
MANIPULATION OF GLOBE FOR PASSIVE RANGE OF MOTION OR OTHER MANIPULATION TO FACILITATE
DIAGNOSTIC EXAMINATION; COMPLETE
676.. 92019 OPHTHALMOLOGICAL EXAMINATION AND EVALUATION, UNDER GENERAL ANESTHESIA, WITH OR WITHOUT
MANIPULATION OF GLOBE FOR PASSIVE RANGE OF MOTION OR OTHER MANIPULATION TO FACILITATE
DIAGNOSTIC EXAMINATION; LIMITED
677.. Strabismus/Muscle Procedures T 16.26 $823.89 $436.63 $164.78
677.. 65290 REPAIR OF WOUND, EXTRAOCULAR MUSCLE, TENDON AND/OR TENON'S CAPSULE
677.. 67311 STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); ONE
HORIZONTAL MUSCLE
677.. 67312 STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); TWO
HORIZONTAL MUSCLES
677.. 67314 STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); ONE
VERTICAL MUSCLE (EXCLUDING SUPERIOR OBLIQUE)
677.. 67316 STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); TWO
OR MORE VERTICAL MUSCLES (EXCLUDING SUPERIOR OBLIQUE)
677.. 67318 STRABISMUS SURGERY, ANY PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON), SUPERIOR OBLIQUE MUSCLE
677.. 67320 TRANSPOSITION PROCEDURE (EG, FOR PARETIC EXTRAOCULAR MUSCLE), ANY EXTRAOCULAR MUSCLE (SPECIFY)
677.. 67331 STRABISMUS SURGERY ON PATIENT WITH PREVIOUS EYE SURGERY OR INJURY THAT DID NOT INVOLVE THE
EXTRAOCULAR MUSCLES
677.. 67332 STRABISMUS SURGERY ON PATIENT WITH SCARRING OF EXTRAOCULAR MUSCLES (EG, PRIOR OCULAR INJURY,
STRABISMUS OR RETINAL DETACHMENT SURGERY) OR RESTRICTIVE MYOPATHY (EG, DYSTHYROID
OPHTHALMOPATHY)
677.. 67334 STRABISMUS SURGERY BY POSTERIOR FIXATION SUTURE TECHNIQUE, WITH OR WITHOUT MUSCLE RECESSION
677.. 67335 PLACEMENT OF ADJUSTABLE SUTURE(S) DURING STRABISMUS SURGERY, INCLUDING POSTOPERATIVE
ADJUSTMENT(S) OF SUTURE(S) (REPORT IN ADDITION TO CODE FOR SPECIFIC STRABISMUS SURGERY)
677.. 67340 STRABISMUS SURGERY INVOLVING EXPLORATION AND/OR REPAIR OF DETACHED EXTRAOCULAR MUSCLE(S)
677.. 67343 RELEASE OF EXTENSIVE SCAR TISSUE WITHOUT DETACHING EXTRAOCULAR MUSCLE (SEPARATE PROCEDURE)
681.. Level I Eye Procedures T 1.67 $84.62 $30.51 $16.92
681.. 65125 MODIFICATION OF OCULAR IMPLANT WITH PLACEMENT OR REPLACEMENT OF PEGS (EG, DRILLING RECEPTACLE
FOR PROSTHESIS APPENDAGE) (SEPARATE PROCEDURE)
681.. 65205 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL SUPERFICIAL
681.. 65210 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL EMBEDDED (INCLUDES CONCRETIONS),
SUBCONJUNCTIVAL, OR SCLERAL NONPERFORATING
681.. 65220 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITHOUT SLIT LAMP
681.. 65222 REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEAL, WITH SLIT LAMP
681.. 65430 SCRAPING OF CORNEA, DIAGNOSTIC, FOR SMEAR AND/OR CULTURE
681.. 65435 REMOVAL OF CORNEAL EPITHELIUM; WITH OR WITHOUT CHEMOCAUTERIZATION (ABRASION, CURETTAGE)
681.. 65600 MULTIPLE PUNCTURES OF ANTERIOR CORNEA (EG, FOR CORNEAL EROSION, TATTOO)
681.. 67345 CHEMODENERVATION OF EXTRAOCULAR MUSCLE
681.. 67500 RETROBULBAR INJECTION; MEDICATION (SEPARATE PROCEDURE, DOES NOT INCLUDE SUPPLY OF MEDICATION)
681.. 67505 RETROBULBAR INJECTION; ALCOHOL
681.. 67515 INJECTION OF THERAPEUTIC AGENT INTO TENON'S CAPSULE
681.. 67599 UNLISTED PROCEDURE, ORBIT
681.. 68200 SUBCONJUNCTIVAL INJECTION
681.. 68761 CLOSURE OF THE LACRIMAL PUNCTUM; BY PLUG, EACH
681.. 68899 UNLISTED PROCEDURE, LACRIMAL SYSTEM
682.. Level II Eye Procedures T 3.54 $179.37 $81.36 $35.87
682.. 67028 INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT (SEPARATE PROCEDURE)
682.. 67700 BLEPHAROTOMY, DRAINAGE OF ABSCESS, EYELID
682.. 67710 SEVERING OF TARSORRHAPHY
682.. 67800 EXCISION OF CHALAZION; SINGLE
682.. 67801 EXCISION OF CHALAZION; MULTIPLE, SAME LID
682.. 67805 EXCISION OF CHALAZION; MULTIPLE, DIFFERENT LIDS
682.. 67810 BIOPSY OF EYELID
682.. 67820 CORRECTION OF TRICHIASIS; EPILATION, BY FORCEPS ONLY
682.. 67825 CORRECTION OF TRICHIASIS; EPILATION BY OTHER THAN FORCEPS (EG, BY ELECTROSURGERY, CRYOTHERAPY,
LASER SURGERY
682.. 67840 EXCISION OF LESION OF EYELID (EXCEPT CHALAZION) WITHOUT CLOSURE OR WITH SIMPLE DIRECT CLOSURE
682.. 67850 DESTRUCTION OF LESION OF LID MARGIN (UP TO 1 CM)
682.. 67875 TEMPORARY CLOSURE OF EYELIDS BY SUTURE (EG, FROST SUTURE)
682.. 67915 REPAIR OF ECTROPION; THERMOCAUTERIZATION
682.. 67922 REPAIR OF ENTROPION; THERMOCAUTERIZATION
682.. 67930 SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN, TARSUS, AND/OR PALPEBRAL CONJUNCTIVA
DIRECT CLOSURE; PARTIAL THICKNESS
682.. 67938 REMOVAL OF EMBEDDED FOREIGN BODY, EYELID
682.. 67999 UNLISTED PROCEDURE, EYELIDS
682.. 68020 INCISION OF CONJUNCTIVA, DRAINAGE OF CYST
682.. 68040 EXPRESSION OF CONJUNCTIVAL FOLLICLES (EG, FOR TRACHOMA)
682.. 68400 INCISION, DRAINAGE OF LACRIMAL GLAND
682.. 68420 INCISION, DRAINAGE OF LACRIMAL SAC (DACRYOCYSTOTOMY OR DACRYOCYSTOSTOMY)
682.. 68440 SNIP INCISION OF LACRIMAL PUNCTUM
682.. 68530 REMOVAL OF FOREIGN BODY OR DACRYOLITH, LACRIMAL PASSAGES
682.. 68705 CORRECTION OF EVERTED PUNCTUM, CAUTERY
682.. 68760 CLOSURE OF THE LACRIMAL PUNCTUM; BY THERMOCAUTERIZATION, LIGATION, OR LASER SURGERY
682.. 68801 DILATION OF LACRIMAL PUNCTUM, WITH OR WITHOUT IRRIGATION
[[Page 47812]]
682.. 68840 PROBING OF LACRIMAL CANALICULI, WITH OR WITHOUT IRRIGATION
683.. Level III Eye Procedures T 10.19 $516.32 $257.87 $103.26
683.. 65175 REMOVAL OF OCULAR IMPLANT
683.. 65410 BIOPSY OF CORNEA
683.. 65800 PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH DIAGNOSTIC ASPIRATION OF
AQUEOUS
683.. 65805 PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH THERAPEUTIC RELEASE OF
AQUEOUS
683.. 66020 INJECTION, ANTERIOR CHAMBER (SEPARATE PROCEDURE); AIR OR LIQUID
683.. 66030 INJECTION, ANTERIOR CHAMBER (SEPARATE PROCEDURE); MEDICATION
683.. 67025 INJECTION OF VITREOUS SUBSTITUTE, PARS PLANA OR LIMBAL APPROACH, (FLUID-GAS EXCHANGE), WITH OR
WITHOUT ASPIRATION (SEPARATE PROCEDURE)
683.. 67715 CANTHOTOMY (SEPARATE PROCEDURE)
683.. 67830 CORRECTION OF TRICHIASIS; INCISION OF LID MARGIN
683.. 67880 CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIAN TARSORRHAPHY, OR CANTHORRHAPHY
683.. 67935 SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN, TARSUS, AND/OR PALPEBRAL CONJUNCTIVA
DIRECT CLOSURE; FULL THICKNESS
683.. 68510 BIOPSY OF LACRIMAL GLAND
683.. 68525 BIOPSY OF LACRIMAL SAC
683.. 68810 PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION;
684.. Level IV Eye Procedures T 13.48 $683.02 $348.94 $136.6
684.. 65091 EVISCERATION OF OCULAR CONTENTS; WITHOUT IMPLANT
684.. 65093 EVISCERATION OF OCULAR CONTENTS; WITH IMPLANT
684.. 65101 ENUCLEATION OF EYE; WITHOUT IMPLANT
684.. 65103 ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES NOT ATTACHED TO IMPLANT
684.. 65105 ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES ATTACHED TO IMPLANT
684.. 65130 INSERTION OF OCULAR IMPLANT SECONDARY; AFTER EVISCERATION, IN SCLERAL SHELL
684.. 65135 INSERTION OF OCULAR IMPLANT SECONDARY; AFTER ENUCLEATION, MUSCLES NOT ATTACHED TO IMPLANT
684.. 65140 INSERTION OF OCULAR IMPLANT SECONDARY; AFTER ENUCLEATION, MUSCLES ATTACHED TO IMPLANT
684.. 65150 REINSERTION OF OCULAR IMPLANT; WITH OR WITHOUT CONJUNCTIVAL GRAFT
684.. 65155 REINSERTION OF OCULAR IMPLANT; WITH USE OF FOREIGN MATERIAL FOR REINFORCEMENT AND/OR ATTACHMENT
OF MUSCLES TO IMPLANT
684.. 67250 SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITHOUT GRAFT
684.. 67255 SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITH GRAFT
684.. 67400 ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); FOR EXPLORATION, WITH OR
WITHOUT BIOPSY
684.. 67405 ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH DRAINAGE ONLY
684.. 67412 ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH REMOVAL OF LESION
684.. 67413 ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); WITH REMOVAL OF FOREIGN
BODY
684.. 67550 ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); INSERTION
684.. 67560 ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); REMOVAL OR REVISION
684.. 67808 EXCISION OF CHALAZION; UNDER GENERAL ANESTHESIA AND/OR REQUIRING HOSPITALIZATION, SINGLE OR
MULTIPLE
684.. 67835 CORRECTION OF TRICHIASIS; INCISION OF LID MARGIN, WITH FREE MUCOUS MEMBRANE GRAFT
684.. 67882 CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIAN TARSORRHAPHY, OR CANTHORRHAPHY; WITH
TRANSPOSITION OF TARSAL PLATE
684.. 67900 REPAIR OF BROW PTOSIS (SUPRACILIARY, MID-FOREHEAD OR CORONAL APPROACH)
684.. 67901 REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITH SUTURE OR OTHER MATERIAL
684.. 67902 REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING
FASCIA)
684.. 67903 REPAIR OF BLEPHAROPTOSIS; (TARSO)LEVATOR RESECTION OR ADVANCEMENT, INTERNAL APPROACH
684.. 67904 REPAIR OF BLEPHAROPTOSIS; (TARSO)LEVATOR RESECTION OR ADVANCEMENT, EXTERNAL APPROACH
684.. 67906 REPAIR OF BLEPHAROPTOSIS; SUPERIOR RECTUS TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING
FASCIA)
684.. 67908 REPAIR OF BLEPHAROPTOSIS; CONJUNCTIVO-TARSO-MULLER'S MUSCLE-LEVATOR RESECTION (EG, FASANELLA-
SERVAT TYPE)
684.. 67909 REDUCTION OF OVERCORRECTION OF PTOSIS
684.. 67911 CORRECTION OF LID RETRACTION
684.. 67914 REPAIR OF ECTROPION; SUTURE
684.. 67916 REPAIR OF ECTROPION; BLEPHAROPLASTY, EXCISION TARSAL WEDGE
684.. 67917 REPAIR OF ECTROPION; BLEPHAROPLASTY, EXTENSIVE (EG, KUHNT-SZYMANOWSKI OR TARSAL STRIP
OPERATIONS)
684.. 67921 REPAIR OF ENTROPION; SUTURE
684.. 67923 REPAIR OF ENTROPION; BLEPHAROPLASTY, EXCISION TARSAL WEDGE
684.. 67924 REPAIR OF ENTROPION; BLEPHAROPLASTY, EXTENSIVE (EG, WHEELER OPERATION)
684.. 67950 CANTHOPLASTY (RECONSTRUCTION OF CANTHUS)
684.. 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
684.. 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
684.. 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
684.. 67973 RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
EYELID; TOTAL EYELID, LOWER, ONE STAGE OR FIRST STAGE
684.. 67974 RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
EYELID; TOTAL EYELID, UPPER, ONE STAGE OR FIRST STAGE
684.. 67975 RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING
EYELID; SECOND STAGE
684.. 68320 CONJUNCTIVOPLASTY; WITH CONJUNCTIVAL GRAFT OR EXTENSIVE REARRANGEMENT
[[Page 47813]]
684.. 68325 CONJUNCTIVOPLASTY; WITH BUCCAL MUCOUS MEMBRANE GRAFT (INCLUDES OBTAINING GRAFT)
684.. 68326 CONJUNCTIVOPLASTY, RECONSTRUCTION CUL-DE-SAC; WITH CONJUNCTIVAL GRAFT OR EXTENSIVE
REARRANGEMENT
684.. 68328 CONJUNCTIVOPLASTY, RECONSTRUCTION CUL-DE-SAC; WITH BUCCAL MUCOUS MEMBRANE GRAFT (INCLUDES
OBTAINING GRAFT)
684.. 68335 REPAIR OF SYMBLEPHARON; WITH FREE GRAFT CONJUNCTIVA OR BUCCAL MUCOUS MEMBRANE (INCLUDES
OBTAINING GRAFT)
684.. 68340 REPAIR OF SYMBLEPHARON; DIVISION OF SYMBLEPHARON, WITH OR WITHOUT INSERTION OF CONFORMER OR
CONTACT LENS
684.. 68500 EXCISION OF LACRIMAL GLAND (DACRYOADENECTOMY), EXCEPT FOR TUMOR; TOTAL
684.. 68505 EXCISION OF LACRIMAL GLAND (DACRYOADENECTOMY), EXCEPT FOR TUMOR; PARTIAL
684.. 68520 EXCISION OF LACRIMAL SAC (DACRYOCYSTECTOMY)
684.. 68540 EXCISION OF LACRIMAL GLAND TUMOR; FRONTAL APPROACH
684.. 68550 EXCISION OF LACRIMAL GLAND TUMOR; INVOLVING OSTEOTOMY
684.. 68700 PLASTIC REPAIR OF CANALICULI
684.. 68720 DACRYOCYSTORHINOSTOMY (FISTULIZATION OF LACRIMAL SAC TO NASAL CAVITY)
684.. 68745 CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO NASAL CAVITY); WITHOUT TUBE
684.. 68750 CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO NASAL CAVITY); WITH INSERTION OF TUBE OR
STENT
684.. 68770 CLOSURE OF LACRIMAL FISTULA (SEPARATE PROCEDURE)
684.. 68811 PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION; REQUIRING GENERAL ANESTHESIA
684.. 68815 PROBING OF NASOLACRIMAL DUCT, WITH OR WITHOUT IRRIGATION; WITH INSERTION OF TUBE OR STENT
690.. Vitrectomy T 30.54 $1,547.45 $852.02 $309.49
690.. 67027 IMPLANTATION OR REPLACEMENT OF INTRAVITREAL DRUG DELIVERY SYSTEM (EG, GANCICLOVIR IMPLANT),
INCLUDES CONCOMITANT REMOVAL OF VITREOUS
690.. 67036 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH;
690.. 67038 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH EPIRETINAL MEMBRANE STRIPPING
690.. 67039 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH FOCAL ENDOLASER PHOTOCOAGULATION
690.. 67040 VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH ENDOLASER PANRETINAL PHOTOCOAGULATION
690.. 67107 REPAIR OF RETINAL DETACHMENT; SCLERAL BUCKLING (SUCH AS LAMELLAR SCLERAL DISSECTION,
IMBRICATION OR ENCIRCLING PROCEDURE), WITH OR WITHOUT IMPLANT, WITH OR WITHOUT CRYOTHERAPY,
PHOTOCOAGULATION, AND DRAINAGE OF SUBRETINAL FLUID
690.. 67108 REPAIR OF RETINAL DETACHMENT; WITH VITRECTOMY, ANY METHOD, WITH OR WITHOUT AIR OR GAS
TAMPONADE, FOCAL ENDOLASER PHOTOCOAGULATION, CRYOTHERAPY, DRAINAGE OF SUBRETINAL FLUID,
SCLERAL BUCKLING, AND/OR REMOVAL OF LENS BY SAME TECHNIQUE
690.. 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
700.. Plain Film X 0.78 $39.52 $22.37 $7.90
700.. 70030 RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY
700.. 70100 RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS
700.. 70110 RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS
700.. 70120 RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE
700.. 70130 RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE
700.. 70134 RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE
700.. 70140 RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS
700.. 70150 RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS
700.. 70160 RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS
700.. 70190 RADIOLOGIC EXAMINATION; OPTIC FORAMINA
700.. 70200 RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS
700.. 70210 RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS
700.. 70220 RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS
700.. 70240 RADIOLOGIC EXAMINATION, SELLA TURCICA
700.. 70250 RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO
700.. 70260 RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS, WITH OR WITHOUT STEREO
700.. 70300 RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW
700.. 70310 RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL MOUTH
700.. 70320 RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH
700.. 70328 RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL
700.. 70330 RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; BILATERAL
700.. 70350 CEPHALOGRAM, ORTHODONTIC
700.. 70355 ORTHOPANTOGRAM
700.. 70360 RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE
700.. 70380 RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS
700.. 71010 RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL
700.. 71015 RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL
700.. 71020 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
700.. 71021 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH APICAL LORDOTIC PROCEDURE
700.. 71022 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH OBLIQUE PROJECTIONS
700.. 71030 RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;
700.. 71035 RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL DECUBITUS, BUCKY STUDIES)
700.. 71100 RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS
700.. 71101 RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE
VIEWS
700.. 71110 RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS
700.. 71111 RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF FOUR VIEWS
700.. 71120 RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS
700.. 71130 RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM OF THREE VIEWS
700.. 72010 RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY, ANTEROPOSTERIOR AND LATERAL
700.. 72020 RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL
700.. 72040 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND LATERAL
[[Page 47814]]
700.. 72050 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS
700.. 72052 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING OBLIQUE AND FLEXION AND/OR
EXTENSION STUDIES
700.. 72069 RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS)
700.. 72070 RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL
700.. 72072 RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL, INCLUDING SWIMMER'S VIEW
OF THE CERVICOTHORACIC JUNCTION
700.. 72074 RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING OBLIQUES, MINIMUM OF FOUR VIEWS
700.. 72080 RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR AND LATERAL
700.. 72090 RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE AND ERECT STUDIES
700.. 72100 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL
700.. 72110 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH OBLIQUE VIEWS
700.. 72114 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING BENDING VIEWS
700.. 72120 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY, MINIMUM OF FOUR VIEWS
700.. 72170 RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY
700.. 72190 RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS
700.. 72200 RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS
700.. 72202 RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS
700.. 72220 RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS
700.. 73000 RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE
700.. 73010 RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE
700.. 73020 RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW
700.. 73030 RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS
700.. 73050 RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH OR WITHOUT WEIGHTED
DISTRACTION
700.. 73060 RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS
700.. 73070 RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73080 RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS
700.. 73090 RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73092 RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS
700.. 73100 RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73110 RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS
700.. 73120 RADIOLOGIC EXAMINATION, HAND; TWO VIEWS
700.. 73130 RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS
700.. 73140 RADIOLOGIC EXAMINATION, FINGER(S), MINIMUM OF TWO VIEWS
700.. 73500 RADIOLOGIC EXAMINATION, HIP, UNILATERAL; ONE VIEW
700.. 73510 RADIOLOGIC EXAMINATION, HIP, UNILATERAL; COMPLETE, MINIMUM OF TWO VIEWS
700.. 73520 RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF EACH HIP, INCLUDING
ANTEROPOSTERIOR VIEW OF PELVIS
700.. 73530 RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE
700.. 73540 RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF TWO VIEWS
700.. 73550 RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73560 RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73562 RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE
VIEWS
700.. 73564 RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/
OR STANDING VIEWS
700.. 73565 RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING, ANTEROPOSTERIOR
700.. 73590 RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73592 RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO VIEWS
700.. 73600 RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73610 RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS
700.. 73620 RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS
700.. 73630 RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS
700.. 73650 RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS
700.. 73660 RADIOLOGIC EXAMINATION; TOE(S), MINIMUM OF TWO VIEWS
700.. 74000 RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW
700.. 74010 RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL OBLIQUE AND CONE VIEWS
700.. 74020 RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS AND/OR ERECT VIEWS
700.. 74022 RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES, INCLUDING SUPINE, ERECT, AND/
OR DECUBITUS VIEWS, UPRIGHT PA CHEST
700.. 74710 PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION
700.. 76010 RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY, SINGLE FILM, CHILD
700.. 76020 BONE AGE STUDIES
700.. 76040 BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)
700.. 76061 RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES)
700.. 76062 RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON)
700.. 76065 RADIOLOGIC EXAMINATION, OSSEOUS SURVEY, INFANT
700.. 76066 JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY)
700.. 76076 DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR
SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL)
700.. 76078 RADIOGRAPHIC ABSORPTIOMETRY (PHOTODENSITOMETRY), ONE OR MORE SITES
700.. 76098 RADIOLOGICAL EXAMINATION, SURGICAL SPECIMEN
700.. 76100 RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG, TOMOGRAPHY), OTHER THAN WITH UROGRAPHY
700.. 76120 CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED
700.. 76125 CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION
700.. 76150 XERORADIOGRAPHY
700.. 76499 UNLISTED DIAGNOSTIC RADIOLOGIC PROCEDURE
700.. 77417 THERAPEUTIC RADIOLOGY PORT FILM(S)
700.. 78350 BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES; SINGLE PHOTON ABSORPTIOMETRY
[[Page 47815]]
706.. Miscellaneous Radiological X 1.96 $99.31 $57.63 $19.86
Procedures
706.. 70170 DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 70373 LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 70390 SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 71040 BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 71060 BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 74190 PERITONEOGRAM (EG, AFTER INJECTION OF AIR OR CONTRAST), RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 74305 CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 74320 CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 74328 ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 74329 ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 74330 COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL
SUPERVISION AND INTERPRETATION
706.. 74350 PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 74355 PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 74470 RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST VISUALIZATION, RADIOLOGICAL
SUPERVISION AND INTERPRETATION
706.. 74740 HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 74742 TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 75801 LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 75803 LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 75805 LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 75807 LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 75809 SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING NONVASCULAR SHUNT (EG, LEVEEN
SHUNT, VENTRICULOPERITONEAL SHUNT), RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 75898 ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR TRANSCATHETER THERAPY, EMBOLIZATION
OR INFUSION
706.. 76075 DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES; AXIAL SKELETON
(EG, HIPS, PELVIS, SPINE)
706.. 76080 RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 76086 MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 76088 MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
706.. 76095 STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 76096 PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
706.. 76101 RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID
POLYTOMOGRAPHY), OTHER THAN WITH UROGRAPHY; UNILATERAL
706.. 76102 RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY SECTION (EG, MASTOID
POLYTOMOGRAPHY), OTHER THAN WITH UROGRAPHY; BILATERAL
710.. Computerized Axial Tomography S 5.06 $256.39 $176.28 $51.28
710.. 70450 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL
710.. 70460 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S)
710.. 70470 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 70480 COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR;
WITHOUT CONTRAST MATERIAL
710.. 70481 COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR;
WITH CONTRAST MATERIAL(S)
710.. 70482 COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR;
WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS
710.. 70486 COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL
710.. 70487 COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH CONTRAST MATERIAL(S)
710.. 70488 COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY
CONTRAST MATERIAL(S) AND FURTHER SECTIONS
710.. 70490 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL
710.. 70491 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S)
710.. 70492 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 71250 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL
710.. 71260 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)
710.. 71270 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 72125 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL
710.. 72126 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST MATERIAL
710.. 72127 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 72128 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL
710.. 72129 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL
710.. 72130 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 72131 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL
710.. 72132 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST MATERIAL
710.. 72133 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 72192 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL
710.. 72193 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)
[[Page 47816]]
710.. 72194 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 73200 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL
710.. 73201 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST MATERIAL(S)
710.. 73202 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 73700 COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL
710.. 73701 COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST MATERIAL(S)
710.. 73702 COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 74150 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL
710.. 74160 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S)
710.. 74170 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST
MATERIAL(S) AND FURTHER SECTIONS
710.. 76355 COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION
710.. 76360 COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
710.. 76365 COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
710.. 76370 COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS
710.. 76375 CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR HOLOGRAPHIC RECONSTRUCTION OF
COMPUTERIZED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, OR OTHER TOMOGRAPHIC MODALITY
710.. 76380 COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY
716.. Fluoroscopy X 1.59 $80.56 $47.91 $16.11
716.. 70370 RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY AND/OR MAGNIFICATION TECHNIQUE
716.. 70371 COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR VIDEO RECORDING
716.. 71023 RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL; WITH FLUOROSCOPY
716.. 71034 RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS; WITH FLUOROSCOPY
716.. 71036 NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS, FLUOROSCOPIC LOCALIZATION
ONLY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
716.. 71038 FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHING
716.. 71090 INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
716.. 74340 INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT), INCLUDING MULTIPLE
FLUOROSCOPIES AND FILMS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
716.. 75989 RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR SPECIMEN COLLECTION (IE,
FLUOROSCOPY, ULTRASOUND, OR COMPUTED TOMOGRAPHY), WITH PLACEMENT OF INDWELLING CATHETER,
RADIOLOGICAL SUPERVISION AND INTERPRETATION
716.. 76000 FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME, OTHER THAN 71023 OR 71034 (EG,
CARDIAC FLUOROSCOPY)
716.. 76001 FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-RADIOLOGIC PHYSICIAN (EG,
NEPHROSTOLITHOTOMY, ERCP, BRONCHOSCOPY, TRANSBRONCHIAL BIOPSY)
716.. 76003 FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE ASPIRATION
720.. Magnetic Resonance Angiography S 6.34 $321.24 206.11 $64.25
720.. 70541 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD AND/OR NECK, WITH OR WITHOUT CONTRAST MATERIAL(S)
726.. Magnetic Resonance Imaging S 7.96 $403.33 $258.09 $80.67
726.. 70336 MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT
726.. 70540 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK
726.. 70551 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST
MATERIAL
726.. 70552 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITH CONTRAST
MATERIAL(S)
726.. 70553 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES
726.. 71550 MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR EVALUATION OF HILAR AND MEDIASTINAL
LYMPHADENOPATHY)
726.. 72141 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST
MATERIAL
726.. 72142 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITH CONTRAST
MATERIAL(S)
726.. 72146 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST
MATERIAL
726.. 72147 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITH CONTRAST
MATERIAL(S)
726.. 72148 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST
MATERIAL
726.. 72149 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITH CONTRAST
MATERIAL(S)
726.. 72156 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL,
FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; CERVICAL
726.. 72157 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL,
FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; THORACIC
726.. 72158 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL,
FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; LUMBAR
726.. 72196 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS
726.. 73220 MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT
726.. 73221 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY
726.. 73720 MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER THAN JOINT
726.. 73721 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY
726.. 74181 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN
726.. 75552 CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY; WITHOUT CONTRAST MATERIAL
726.. 75553 CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY; WITH CONTRAST MATERIAL
726.. 75554 CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR WITHOUT MORPHOLOGY; COMPLETE STUDY
726.. 75555 CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR WITHOUT MORPHOLOGY; LIMITED STUDY
726.. 76093 MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH CONTRAST MATERIAL(S); UNILATERAL
726.. 76094 MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH CONTRAST MATERIAL(S); BILATERAL
[[Page 47817]]
726.. 76390 MAGNETIC RESONANCE SPECTROSCOPY
726.. 76400 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY
728.. Myelography S 4.07 $206.22 $113.23 $41.24
728.. 70010 MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 70015 CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 72240 MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 72255 MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 72265 MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 72270 MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 72285 DISKOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
728.. 72295 DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. Arthography S 2.48 $125.66 $72.09 $25.13
730.. 70332 TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. 73040 RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. 73085 RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. 73115 RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. 73525 RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. 73580 RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
730.. 73615 RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
736.. Digestive Radiology S 1.85 $93.74 $54.24 $18.75
736.. 74210 RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS
736.. 74220 RADIOLOGIC EXAMINATION; ESOPHAGUS
736.. 74230 SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH CINERADIOGRAPHY AND/OR VIDEO
736.. 74240 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT
KUB
736.. 74241 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITH KUB
736.. 74245 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL BOWEL, INCLUDES MULTIPLE
SERIAL FILMS
736.. 74246 RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH
DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH OR WITHOUT DELAYED FILMS,
WITHOUT KUB
736.. 74247 RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH
DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH OR WITHOUT DELAYED FILMS,
WITH KUB
736.. 74249 RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR CONTRAST, WITH SPECIFIC HIGH
DENSITY BARIUM, EFFERVESCENT AGENT, WITH OR WITHOUT GLUCAGON; WITH SMALL BOWEL FOLLOW-THROUGH
736.. 74250 RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS;
736.. 74251 RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL FILMS; VIA ENTEROCLYSIS TUBE
736.. 74260 DUODENOGRAPHY, HYPOTONIC
736.. 74270 RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA, WITH OR WITHOUT KUB
736.. 74280 RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH DENSITY BARIUM, WITH OR WITHOUT
GLUCAGON
736.. 74283 THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF INTUSSUSCEPTION OR OTHER INTRALUMINAL
OBSTRUCTION (EG, MECONIUM ILEUS)
736.. 74290 CHOLECYSTOGRAPHY, ORAL CONTRAST;
736.. 74291 CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT EXAMINATION OR MULTIPLE DAY EXAMINATION
736.. G0106 Colorectal Ca screening
736.. G0120 Colorectal Ca screening
737.. Diagnostic Urography S 2.81 $142.38 $86.56 $28.48
737.. 74400 UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY;
737.. 74405 UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH OR WITHOUT TOMOGRAPHY; WITH
SPECIAL HYPERTENSIVE CONTRAST CONCENTRATION AND/OR CLEARANCE STUDIES
737.. 74410 UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE;
737.. 74415 UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH NEPHROTOMOGRAPHY
737.. 74420 UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB
737.. 74425 UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM, LOOPOGRAM), RADIOLOGICAL SUPERVISION AND
737.. 74430 CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
737.. 74440 VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
737.. 74445 CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
737.. 74450 URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
737.. 74455 URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND INTERPRETATION
737.. 74775 PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF ANOMALIES)
738.. Therapeutic Radiologic S 4.48 $227.00 $133.23 $45.4
Procedures
738.. 74235 REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON CATHETER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION
738.. 74327 POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T-TUBE TRACT, BASKET, OR SNARE (EG,
BURHENNE TECHNIQUE), RADIOLOGICAL SUPERVISION AND INTERPRETATION
738.. 74360 INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG, ESOPHAGUS), RADIOLOGICAL
SUPERVISION AND INTERPRETATION
738.. 74363 PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT STRICTURE WITH OR WITHOUT PLACEMENT OF
STENT, RADIOLOGICAL SUPERVISION AND INTERPRETATION
738.. 74475 INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION,
PERCUTANEOUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
738.. 74480 INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR
INJECTION, PERCUTANEOUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
738.. 74485 DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL SUPERVISION AND INTERPRETATION
738.. 75980 PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISION
AND INTERPRETATION
[[Page 47818]]
738.. 75982 PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED INTERNAL AND EXTERNAL BILIARY DRAINAGE
OR OF A DRAINAGE STENT FOR INTERNAL BILIARY DRAINAGE IN PATIENTS WITH AN INOPERABLE MECHANICAL
BILIARY OBSTRUCTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION
738.. 75984 CHANGE OF PERCUTANEOUS TUBE OR DRAINAGE CATHETER WITH CONTRAST MONITORING (EG, GASTROINTESTINAL
SYSTEM, GENITOURINARY SYSTEM, ABSCESS), RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. Diagnostic Angiography and S 5.83 $295.40 $168.71 $59.08
Venography
739.. 75600 AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75605 AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75625 AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75630 AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER EXTREMITY, CATHETER, BY SERIALOGRAPHY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75650 ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75658 ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75660 ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75662 ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75665 ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75671 ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75676 ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75680 ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75685 ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75705 ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75710 ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75716 ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75722 ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION
AND INTERPRETATION
739.. 75724 ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH AORTOGRAM), RADIOLOGICAL SUPERVISION
AND INTERPRETATION
739.. 75726 ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR WITHOUT FLUSH AORTOGRAM),
RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75731 ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75733 ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75736 ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75741 ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75743 ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75746 ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS INJECTION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION
739.. 75756 ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75774 ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC EXAMINATION, RADIOLOGICAL
SUPERVISION AND INTERPRETATION
739.. 75790 ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75810 SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75820 VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75822 VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75825 VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75827 VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75831 VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75833 VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75840 VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75842 VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75860 VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75870 VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75872 VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75880 VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION
739.. 75885 PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75887 PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION
739.. 75889 HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
739.. 75891 HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC EVALUATION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION
746.. Mammography S 0.69 $34.96 $19.44 $6.99
746.. 76090 MAMMOGRAPHY; UNILATERAL
746.. 76091 MAMMOGRAPHY; BILATERAL
747.. Diagnostic Ultrasound Except S 1.65 $83.60 $54.69 $16.72
Vascular
747.. 76506 ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION (GRAY SCALE) (FOR
DETERMINATION OF VENTRICULAR SIZE, DELINEATION OF CEREBRAL CONTENTS AND DETECTION OF FLUID
MASSES OR OTHER INTRACRANIAL ABNORMALITIES), INCLUDING A-MODE ENCEPHALOGRAPH
747.. 76511 OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH AMPLITUDE QUANTIFICATION
747.. 76512 OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN (WITH OR WITHOUT SIMULTANEOUS A-
SCAN)
747.. 76513 OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; IMMERSION (WATER BATH) B-SCAN
747.. 76516 OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN;
747.. 76519 OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH INTRAOCULAR LENS POWER CALCULATION
747.. 76529 OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION
[[Page 47819]]
747.. 76536 ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR
REAL TIME WITH IMAGE DOCUMENTATION
747.. 76604 ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME WITH IMAGE DOCUMENTATION
747.. 76645 ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR REAL TIME WITH IMAGE
DOCUMENTATION
747.. 76700 ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
747.. 76705 ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE
ORGAN, QUADRANT, FOLLOW-UP)
747.. 76770 ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE
747.. 76775 ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED
747.. 76778 ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION, WITH OR
WITHOUT DUPLEX DOPPLER STUDIES
747.. 76800 ECHOGRAPHY, SPINAL CANAL AND CONTENTS
747.. 76805 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
(COMPLETE FETAL AND MATERNAL EVALUATION)
747.. 76810 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
(COMPLETE FETAL AND MATERNAL EVALUATION), MULTIPLE GESTATION, AFTER THE FIRST TRIMESTER
747.. 76815 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (FETAL
SIZE, HEART BEAT, PLACENTAL LOCATION, FETAL POSITION, OR EMERGENCY IN THE DELIVERY ROOM)
747.. 76816 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; FOLLOW-UP OR
REPEAT
747.. 76818 FETAL BIOPHYSICAL PROFILE
747.. 76830 ECHOGRAPHY, TRANSVAGINAL
747.. 76831 HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER
747.. 76856 ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE
747.. 76857 ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR
FOLLOW-UP (EG, FOR FOLLICLES)
747.. 76870 ECHOGRAPHY, SCROTUM AND CONTENTS
747.. 76872 ECHOGRAPHY, TRANSRECTAL
747.. 76880 ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION
747.. 76885 ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; DYNAMIC (EG, REQUIRING
MANIPULATION)
747.. 76886 ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION; LIMITED, STATIC (EG, NOT
REQUIRING MANIPULATION
747.. 76970 ULTRASOUND STUDY FOLLOW-UP (SPECIFY)
747.. 76975 GASTROINTESTINAL ENDOSCOPIC ULTRASOUND, RADIOLOGICAL SUPERVISION AND INTERPRETATION
747.. 76986 ECHOGRAPHY, INTRAOPERATIVE
747.. 76999 UNLISTED ULTRASOUND PROCEDURE
747.. G0050 POST-VOIDAL RESIDUAL URINE/BLADDER CAPACITY
749.. Guidance under Ultrasound X 2.44 $123.63 $76.16 $24.73
749.. 76930 ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
749.. 76932 ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
749.. 76934 ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL PARACENTESIS, RADIOLOGICAL SUPERVISION AND
INTERPRETATION
749.. 76936 ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEUDO-ANEURYSM OR ARTERIOVENOUS FISTULAE
(INCLUDES DIAGNOSTIC ULTRASOUND EVALUATION, COMPRESSION OF LESION AND IMAGING)
749.. 76938 ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION) OR RENAL PELVIS ASPIRATION, RADIOLOGICAL
SUPERVISION AND INTERPRETATION
749.. 76941 ULTRASONIC GUIDANCE FOR INTRAUTERINE FETAL TRANSFUSION OR CORDOCENTESIS, RADIOLOGICAL
SUPERVISION AND INTERPRETATION
749.. 76942 ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION AND INTERPRETATION
749.. 76945 ULTRASONIC GUIDANCE FOR CHORIONIC VILLUS SAMPLING, RADIOLOGICAL SUPERVISION AND INTERPRETATION
749.. 76946 ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION
749.. 76948 ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL SUPERVISION AND INTERPRETATION
749.. 76950 ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN
749.. 76960 ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS, EXCEPT FOR B-SCAN ECHOGRAPHY
749.. 76965 ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENT APPLICATION
750.. Therapeutic Radiation X 0.91 $46.11 $25.54 $9.22
Treatment Planning
750.. 77261 THERAPEUTIC RADIOLOGY TREATMENT PLANNING; SIMPLE
750.. 77262 THERAPEUTIC RADIOLOGY TREATMENT PLANNING; INTERMEDIATE
750.. 77263 THERAPEUTIC RADIOLOGY TREATMENT PLANNING; COMPLEX
750.. 77336 CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF THERAPEUTIC RADIOLOGIST
INCLUDING CONTINUING QUALITY ASSURANCE REPORTED PER WEEK OF THERAPY
750.. 77370 SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION
750.. 77399 UNLISTED PROCEDURE, MEDICAL RADIATION PHYSICS, DOSIMETRY AND TREATMENT DEVICES
750.. 77431 RADIATION THERAPY MANAGEMENT WITH COMPLETE COURSE OF THERAPY CONSISTING OF ONE OR TWO FRACTIONS
ONLY
750.. 77432 STEREOTACTIC RADIATION TREATMENT MANAGEMENT OF CEREBRAL LESION(S) (COMPLETE COURSE OF TREATMENT
CONSISTING OF ONE SESSION)
751.. Level I Therapeutic Radiation X 1.15 $58.27 $33.22 $11.65
Treatment Preparation
751.. 77299 UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY CLINICAL TREATMENT PLANNING
751.. 77300 BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE, TDF, NSD, GAP CALCULATION, OFF
AXIS FACTOR, TISSUE INHOMOGENEITY FACTORS, AS REQUIRED DURING COURSE OF TREATMENT, ONLY WHEN
PRESCRIBED BY THE TREATING PHYSICIAN
751.. 77305 TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); SIMPLE (ONE OR TWO PARALLEL
OPPOSED UNMODIFIED PORTS DIRECTED TO A SINGLE AREA OF INTEREST)
[[Page 47820]]
751.. 77310 TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); INTERMEDIATE (THREE OR MORE
TREATMENT PORTS DIRECTED TO A SINGLE AREA OF INTEREST)
751.. 77315 TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER CALCULATED); COMPLEX (MANTLE OR INVERTED Y,
TANGENTIAL PORTS, THE USE OF WEDGES, COMPENSATORS, COMPLEX BLOCKING, ROTATIONAL BEAM, OR
SPECIAL BEAM CONSIDERATIONS)
751.. 77321 SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMIBODY, TOTAL BODY
751.. 77326 BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE FROM SINGLE PLANE, ONE TO FOUR
SOURCES/ RIBBON APPLICATION, REMOTE AFTERLOADING BRACHYTHERAPY, 1 TO 8 SOURCES)
751.. 77327 BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE DOSAGE CALCULATIONS, APPLICATION
INVOLVING 5 TO 10 SOURCES/RIBBONS, REMOTE AFTERLOADING BRACHYTHERAPY, 9 TO 12 SOURCES)
751.. 77328 BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE PLAN, VOLUME IMPLANT
CALCULATIONS, OVER 10 SOURCES/RIBBONS USED, SPECIAL SPATIAL RECONSTRUCTION, REMOTE
AFTERLOADING BRACHYTHERAPY, OVER 12 SOURCES)
751.. 77331 SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN PRESCRIBED BY THE TREATING
PHYSICIAN
751.. 77332 TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK, SIMPLE BOLUS)
751.. 77333 TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE (MULTIPLE BLOCKS, STENTS, BITE BLOCKS,
SPECIAL BOLUS)
751.. 77334 TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR BLOCKS, SPECIAL SHIELDS,
COMPENSATORS, WEDGES, MOLDS OR CASTS)
752.. Level II Therapeutic Radiation X 3.54 $179.37 $88.82 $35.87
Treatment
752.. 77280 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE
752.. 77285 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE
752.. 77290 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX
752.. 77295 THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; THREE-DIMENSIONAL
757.. Radiation Therapy S 2.30 $116.54 $52.43 $23.31
757.. 61793 STEREOTACTIC RADIOSURGERY (PARTICLE BEAM, GAMMA RAY OR LINEAR ACCELERATOR), ONE OR MORE
SESSIONS
757.. 77401 RADIATION TREATMENT DELIVERY, SUPERFICIAL AND/OR ORTHO VOLTAGE
757.. 77402 RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS,
SIMPLE BLOCKS OR NO BLOCKS; UP TO 5 MEV
757.. 77403 RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS,
SIMPLE BLOCKS OR NO BLOCKS; 6-10 MEV
757.. 77404 RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS,
SIMPLE BLOCKS OR NO BLOCKS; 11-19 MEV
757.. 77406 RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT OR PARALLEL OPPOSED PORTS,
SIMPLE BLOCKS OR NO BLOCKS; 20 MEV OR GREATER
757.. 77407 RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE
TREATMENT AREA, USE OF MULTIPLE BLOCKS; UP TO 5 MEV
757.. 77408 RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE
TREATMENT AREA, USE OF MULTIPLE BLOCKS; 6-10 MEV
757.. 77409 RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE
TREATMENT AREA, USE OF MULTIPLE BLOCKS; 11-19 MEV
757.. 77411 RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS, THREE OR MORE PORTS ON A SINGLE
TREATMENT AREA, USE OF MULTIPLE BLOCKS; 20 MEV OR GREATER
757.. 77412 RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING,
TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, ELECTRON
OR NEUTRONS); UP TO 5 MEV
757.. 77413 RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING,
TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, ELECTRON
OR NEUTRONS); 6-10 MEV
757.. 77414 RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING,
TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, ELECTRON
OR NEUTRONS); 11-19 MEV
757.. 77416 RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT AREAS, CUSTOM BLOCKING,
TANGENTIAL PORTS, WEDGES, ROTATIONAL BEAM, COMPENSATORS, SPECIAL PARTICLE BEAM (EG, ELECTRON
OR NEUTRONS); 20 MEV OR GREATER
757.. 77470 SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY IRRADIATION, PER ORAL,
VAGINAL CONE IRRADIATION
758.. Hyperthermic Therapies S 3.41 $172.78 $76.84 $34.56
758.. 77600 HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A DEPTH OF 4 CM OR LESS)
758.. 77605 HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS GREATER THAN 4 CM)
758.. 77610 HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER INTERSTITIAL APPLICATORS
758.. 77615 HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5 INTERSTITIAL APPLICATORS
758.. 77620 HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S)
759.. Brachytherapy and Complex S 7.98 $404.34 $160.01 $80.87
Radioelement Applications
759.. 77750 INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION
759.. 77761 INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE
759.. 77762 INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE
759.. 77763 INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX
759.. 77776 INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLE
759.. 77777 INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE
759.. 77778 INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX
759.. 77781 REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE POSITIONS OR CATHETERS
759.. 77782 REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE POSITIONS OR CATHETERS
759.. 77783 REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE POSITIONS OR CATHETERS
759.. 77784 REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12 SOURCE POSITIONS OR CATHETERS
759.. 77789 SURFACE APPLICATION OF RADIOELEMENT
759.. 77799 UNLISTED PROCEDURE, CLINICAL BRACHYTHERAPY
760.. PET Scans S 17.26 $874.55 $419.46 $174.91
760.. 78459 MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC EVALUATION
[[Page 47821]]
760.. 78608 BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); METABOLIC EVALUATION
760.. 78609 BRAIN IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); PERFUSION EVALUATION
760.. 78810 TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC EVALUATION
760.. G0030 PET imaging prev PET single
760.. G0031 PET imaging prev PET multple
760.. G0032 PET follow SPECT 78464 singl
760.. G0033 PET follow SPECT 78464 mult
760.. G0034 PET follow SPECT 76865 singl
760.. G0035 PET follow SPECT 78465 mult
760.. G0036 PET follow cornry angio sing
760.. G0037 PET follow cornry angio mult
760.. G0038 PET follow myocard perf sing
760.. G0039 PET follow myocard perf mult
760.. G0040 PET follow stress echo singl
760.. G0041 PET follow stress echo mult
760.. G0042 PET follow ventriculogm sing
760.. G0043 PET follow ventriculogm mult
760.. G0044 PET following rest ECG singl
760.. G0045 PET following rest ECG mult
760.. G0046 PET follow stress ECG singl
760.. G0047 PET follow stress ECG mult
761.. Standard Non-Imaging Nuclear S 2.04 $103.37 $61.47 $20.67
Medicine
761.. 78000 THYROID UPTAKE; SINGLE DETERMINATION
761.. 78099 UNLISTED ENDOCRINE PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
761.. 78110 PLASMA VOLUME, RADIOPHARMACEUTICAL VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); SINGLE
SAMPLING
761.. 78111 PLASMA VOLUME, RADIOPHARMACEUTICAL VOLUME-DILUTION TECHNIQUE (SEPARATE PROCEDURE); MULTIPLE
SAMPLINGS
761.. 78120 RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE SAMPLING
761.. 78199 UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC PROCEDURE, DIAGNOSTIC NUCLEAR
MEDICINE
761.. 78270 VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC FACTOR
761.. 78271 VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC FACTOR
761.. 78272 VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT INTRINSIC FACTOR
761.. 78282 GASTROINTESTINAL PROTEIN LOSS
761.. 78299 UNLISTED GASTROINTESTINAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
761.. 78725 KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION
761.. 78999 UNLISTED MISCELLANEOUS PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
762.. Complex Non-Imaging Nuclear S 1.78 $90.19 $51.53 $18.04
Medicine
762.. 78001 THYROID UPTAKE; MULTIPLE DETERMINATIONS
762.. 78003 THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT INCLUDING INITIAL UPTAKE STUDIES)
762.. 78121 RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE SAMPLINGS
762.. 78122 WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE MEASUREMENT OF PLASMA VOLUME AND RED CELL
VOLUME (RADIOPHARMACEUTICAL VOLUME-DILUTION TECHNIQUE)
762.. 78130 RED CELL SURVIVAL STUDY;
762.. 78135 RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG, SPLENIC AND/OR HEPATIC
SEQUESTRATION)
762.. 78140 LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG, SPLENIC AND/OR HEPATIC)
762.. 78160 PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE
762.. 78162 RADIOIRON ORAL ABSORPTION
762.. 78170 RADIOIRON RED CELL UTILIZATION
762.. 78172 CHELATABLE IRON FOR ESTIMATION OF TOTAL BODY IRON
762.. 78190 KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL ORGAN/TISSUE LOCALIZATION
762.. 78191 PLATELET SURVIVAL STUDY
762.. 78414 DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG, EJECTION FRACTION WITH PROBE
TECHNIQUE) WITH OR WITHOUT PHARMACOLOGIC INTERVENTION OR EXERCISE, SINGLE OR MULTIPLE
DETERMINATIONS
762.. 78455 VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN)
762.. 78499 UNLISTED CARDIOVASCULAR PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
771.. Standard Planar Nuclear S 3.78 $191.53 $116.84 $38.31
Medicine
771.. 78006 THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION
771.. 78010 THYROID IMAGING; ONLY
771.. 78011 THYROID IMAGING; WITH VASCULAR FLOW
771.. 78015 THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND CHEST ONLY)
771.. 78102 BONE MARROW IMAGING; LIMITED AREA
771.. 78103 BONE MARROW IMAGING; MULTIPLE AREAS
771.. 78104 BONE MARROW IMAGING; WHOLE BODY
771.. 78185 SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW
771.. 78201 LIVER IMAGING; STATIC ONLY
771.. 78202 LIVER IMAGING; WITH VASCULAR FLOW
771.. 78215 LIVER AND SPLEEN IMAGING; STATIC ONLY
771.. 78216 LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW
771.. 78230 SALIVARY GLAND IMAGING;
771.. 78231 SALIVARY GLAND IMAGING; WITH SERIAL IMAGES
771.. 78261 GASTRIC MUCOSA IMAGING
771.. 78290 BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL'S LOCALIZATION, VOLVULUS)
771.. 78300 BONE AND/OR JOINT IMAGING; LIMITED AREA
771.. 78305 BONE AND/OR JOINT IMAGING; MULTIPLE AREAS
771.. 78306 BONE AND/OR JOINT IMAGING; WHOLE BODY
[[Page 47822]]
771.. 78399 UNLISTED MUSCULOSKELETAL PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
771.. 78428 CARDIAC SHUNT DETECTION
771.. 78445 NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY)
771.. 78457 VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); UNILATERAL
771.. 78458 VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL
771.. 78460 MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR STRESS (EXERCISE AND/OR
PHARMACOLOGIC), WITH OR WITHOUT QUANTIFICATION
771.. 78466 MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR QUANTITATIVE
771.. 78478 MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR QUANTITATIVE STUDY (LIST SEPARATELY
IN ADDITION TO CODE FOR PRIMARY PROCEDURE) (USE ONLY FOR CODES 78460, 78461, 78464, 78465)
771.. 78480 MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST SEPARATELY IN ADDITION TO CODE FOR
PRIMARY PROCEDURE) (USE ONLY FOR CODES 78460, 78461, 78464, 78465)
771.. 78481 CARDIAC BLOOD POOL IMAGING, (PLANAR), FIRST PASS TECHNIQUE; SINGLE STUDY, AT REST OR WITH
STRESS (EXERCISE AND/OR PHARMACOLOGIC), WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR
WITHOUT QUANTIFICATION
771.. 78580 PULMONARY PERFUSION IMAGING, PARTICULATE
771.. 78586 PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION
771.. 78587 PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG, ANTERIOR, POSTERIOR, LATERAL
VIEWS)
771.. 78591 PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE PROJECTION
771.. 78593 PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE
BREATH; SINGLE PROJECTION
771.. 78599 UNLISTED RESPIRATORY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
771.. 78600 BRAIN IMAGING, LIMITED PROCEDURE; STATIC
771.. 78601 BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW
771.. 78605 BRAIN IMAGING, COMPLETE STUDY; STATIC
771.. 78610 BRAIN IMAGING, VASCULAR FLOW ONLY
771.. 78660 RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY
771.. 78699 UNLISTED NERVOUS SYSTEM PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
771.. 78700 KIDNEY IMAGING; STATIC ONLY
771.. 78701 KIDNEY IMAGING; WITH VASCULAR FLOW
771.. 78704 KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM)
771.. 78707 KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY WITHOUT PHARMACOLOGICAL
INTERVENTION
771.. 78715 KIDNEY VASCULAR FLOW ONLY
771.. 78730 URINARY BLADDER RESIDUAL STUDY
771.. 78760 TESTICULAR IMAGING;
771.. 78761 TESTICULAR IMAGING; WITH VASCULAR FLOW
771.. 78799 UNLISTED GENITOURINARY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE
772.. Complex Planar Nuclear S 4.22 $213.83 $127.92 $42.77
Medicine
772.. 78007 THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS
772.. 78016 THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG, URINARY RECOVERY)
772.. 78017 THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREAS
772.. 78018 THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY
772.. 78070 PARATHYROID IMAGING
772.. 78075 ADRENAL IMAGING, CORTEX AND/OR MEDULLA
772.. 78195 LYMPHATICS AND LYMPH GLANDS IMAGING
772.. 78220 LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES
772.. 78223 HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH OR WITHOUT PHARMACOLOGIC
INTERVENTION, WITH OR WITHOUT QUANTITATIVE MEASUREMENT OF GALLBLADDER FUNCTION
772.. 78232 SALIVARY GLAND FUNCTION STUDY
772.. 78258 ESOPHAGEAL MOTILITY
772.. 78262 GASTROESOPHAGEAL REFLUX STUDY
772.. 78264 GASTRIC EMPTYING STUDY
772.. 78278 ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING
772.. 78291 PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER SHUNT)
772.. 78315 BONE AND/OR JOINT IMAGING; THREE PHASE STUDY
772.. 78461 MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES, (PLANAR) AT REST AND/OR STRESS (EXERCISE AND/OR
PHARMACOLOGIC), AND REDISTRIBUTION AND/OR REST INJECTION, WITH OR WITHOUT QUANTIFICATION
772.. 78468 MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY FIRST PASS TECHNIQUE
772.. 78472 CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT REST OR STRESS (EXERCISE AND/OR
PHARMACOLOGIC), WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR WITHOUT ADDITIONAL
QUANTITATIVE PROCESSING
772.. 78473 MULTIPLE STUDIES, WALL MOTION STUDY PLUS EJECTION FRACTION, AT REST AND STRESS (EXERCISE AND/OR
PHARMACOLOGIC), WITH OR WITHOUT ADDITIONAL QUANTIFICATION
772.. 78483 CARDIAC BLOOD POOL IMAGING, (PLANAR), FIRST PASS TECHNIQUE; MULTIPLE STUDIES, AT REST AND WITH
STRESS (EXERCISE AND/OR PHARMACOLOGIC), WALL MOTION STUDY PLUS EJECTION FRACTION, WITH OR
WITHOUT QUANTIFICATION
772.. 78584 PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE BREATH
772.. 78585 PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; REBREATHING AND WASHOUT, WITH OR
WITHOUT SINGLE BREATH
772.. 78594 PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND WASHOUT WITH OR WITHOUT SINGLE
BREATH; MULTIPLE PROJECTIONS (EG, ANTERIOR, POSTERIOR, LATERAL VIEWS)
772.. 78596 PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION (VENTILATION/PERFUSION) STUDY
772.. 78606 BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW
772.. 78615 CEREBRAL BLOOD FLOW
772.. 78630 CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); CISTERNOGRAPHY
772.. 78635 CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); VENTRICULOGRAPHY
772.. 78645 CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); SHUNT EVALUATION
772.. 78650 CSF LEAKAGE DETECTION AND LOCALIZATION
[[Page 47823]]
772.. 78708 KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY, WITH PHARMACOLOGICAL INTERVENTION
(EG, ANGIOTENSIN CONVERTING ENZYME INHIBITOR AND/OR DIURETIC)
772.. 78709 KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; MULTIPLE STUDIES, WITH AND WITHOUT
PHARMACOLOGICAL INTERVENTION (EG, ANGIOTENSIN CONVERTING ENZYME INHIBITOR AND/OR DIURETIC)
772.. 78740 URETERAL REFLUX STUDY (RADIOPHARMACEUTICAL VOIDING CYSTOGRAM)
772.. 78800 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; LIMITED AREA
772.. 78801 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; MULTIPLE AREAS
772.. 78802 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; WHOLE BODY
772.. 78805 RADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; LIMITED AREA
772.. 78806 RADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; WHOLE BODY
781.. Standard SPECT Nuclear S 5.26 $266.52 $145.77 $53.30
Medicine
781.. 78205 LIVER IMAGING (SPECT)
781.. 78320 BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)
781.. 78464 MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY AT REST OR STRESS (EXERCISE AND/
OR PHARMACOLOGIC), WITH OR WITHOUT QUANTIFICATION
781.. 78469 MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH OR WITHOUT QUANTIFICATION
781.. 78607 BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT)
781.. 78647 CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF MATERIAL); TOMOGRAPHIC (SPECT)
781.. 78710 KIDNEY IMAGING, TOMOGRAPHIC (SPECT)
782.. Complex SPECT Nuclear Medicine S 9.28 $470.21 $275.04 $94.04
782.. 78465 MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE STUDIES, AT REST AND/OR STRESS
(EXERCISE AND/OR PHARMACOLOGIC) AND REDISTRIBUTION AND/OR REST INJECTION, WITH OR WITHOUT
QUANTIFICATION
782.. 78803 RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR; TOMOGRAPHIC (SPECT)
782.. 78807 RADIOPHARMACEUTICAL LOCALIZATION OF ABSCESS; TOMOGRAPHIC (SPECT)
791.. Standard Therapeutic Nuclear S 15.83 $802.10 $562.06 $160.42
Medicine
791.. 79001 RADIOPHARMACEUTICAL THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY
791.. 79100 RADIOPHARMACEUTICAL THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH TREATMENT
791.. 79300 INTERSTITIAL RADIOACTIVE COLLOID THERAPY
791.. 79400 RADIOPHARMACEUTICAL THERAPY, NONTHYROID, NONHEMATOLOGIC
791.. 79420 INTRAVASCULAR RADIOPHARMACEUTICAL THERAPY, PARTICULATE
791.. 79440 INTRA-ARTICULAR RADIOPHARMACEUTICAL THERAPY
791.. 79999 UNLISTED RADIOPHARMACEUTICAL THERAPEUTIC PROCEDURE
792.. Complex Therapeutic Nuclear S 4.80 $243.21 $144.19 $48.64
Medicine
792.. 79000 RADIOPHARMACEUTICAL THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING EVALUATION OF PATIENT
792.. 79020 RADIOPHARMACEUTICAL THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC DISEASE), INCLUDING
EVALUATION OF PATIENT
792.. 79030 RADIOPHARMACEUTICAL ABLATION OF GLAND FOR THYROID CARCINOMA
792.. 79035 RADIOPHARMACEUTICAL THERAPY FOR METASTASES OF THYROID CARCINOMA
792.. 79200 INTRACAVITARY RADIOACTIVE COLLOID THERAPY
861.. Immunology Tests X 0.13 $6.59 $3.62 $1.32
861.. 86485 SKIN TEST; CANDIDA
861.. 86490 SKIN TEST; COCCIDIOIDOMYCOSIS
861.. 86510 SKIN TEST; HISTOPLASMOSIS
861.. 86580 SKIN TEST; TUBERCULOSIS, INTRADERMAL
861.. 86585 SKIN TEST; TUBERCULOSIS, TINE TEST
861.. 86586 SKIN TEST; UNLISTED ANTIGEN, EACH
881.. Level I Pathology X 0.20 $10.13 $6.78 $2.03
881.. 88125 CYTOPATHOLOGY, FORENSIC (EG, SPERM)
881.. 88199 UNLISTED CYTOPATHOLOGY PROCEDURE
881.. 88300 LEVEL I - SURGICAL PATHOLOGY, GROSS EXAMINATION ONLY
881.. 88311 DECALCIFICATION PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY
EXAMINATION)
881.. 88313 SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION); GROUP
II, ALL OTHER, (EG, IRON, TRICHROME), EXCEPT IMMUNOCYTOCHEMISTRY AND IMMUNOPEROXIDASE STAINS,
EACH
881.. 88399 UNLISTED SURGICAL PATHOLOGY PROCEDURE
881.. 89350 SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE (SEPARATE PROCEDURE)
881.. 89360 SWEAT COLLECTION BY IONTOPHORESIS
881.. 89399 UNLISTED MISCELLANEOUS PATHOLOGY TEST
881.. G0025 Collagen skin test kit
882.. Level II Pathology X 0.39 $19.76 $11.75 $3.95
882.. 80500 CLINICAL PATHOLOGY CONSULTATION; LIMITED, WITHOUT REVIEW OF PATIENT'S HISTORY AND MEDICAL
RECORDS
882.. 80502 CLINICAL PATHOLOGY CONSULTATION; COMPREHENSIVE, FOR A COMPLEX DIAGNOSTIC PROBLEM, WITH REVIEW
OF PATIENT'S HISTORY AND MEDICAL RECORDS
882.. 85060 BLOOD SMEAR, PERIPHERAL, INTERPRETATION BY PHYSICIAN WITH WRITTEN REPORT
882.. 85097 BONE MARROW; SMEAR INTERPRETATION ONLY, WITH OR WITHOUT DIFFERENTIAL CELL COUNT
882.. 86077 BLOOD BANK PHYSICIAN SERVICES; DIFFICULT CROSS MATCH AND/OR EVALUATION OF IRREGULAR
ANTIBODY(S), INTERPRETATION AND WRITTEN REPORT
882.. 86078 BLOOD BANK PHYSICIAN SERVICES; INVESTIGATION OF TRANSFUSION REACTION INCLUDING SUSPICION OF
TRANSMISSIBLE DISEASE, INTERPRETATION AND WRITTEN REPORT
882.. 86079 BLOOD BANK PHYSICIAN SERVICES; AUTHORIZATION FOR DEVIATION FROM STANDARD BLOOD BANKING
PROCEDURES (EG, USE OF OUTDATED BLOOD, TRANSFUSION OF RH INCOMPATIBLE UNITS), WITH WRITTEN
REPORT
882.. 88104 CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SMEARS WITH
INTERPRETATION
[[Page 47824]]
882.. 88106 CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; FILTER METHOD ONLY
WITH INTERPRETATION
882.. 88107 CYTOPATHOLOGY, FLUIDS, WASHINGS OR BRUSHINGS, EXCEPT CERVICAL OR VAGINAL; SMEARS AND FILTER
PREPARATION WITH INTERPRETATION
882.. 88108 CYTOPATHOLOGY, CONCENTRATION TECHNIQUE, SMEARS AND INTERPRETATION (EG, SACCOMANNO TECHNIQUE)
882.. 88160 CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; SCREENING AND INTERPRETATION
882.. 88161 CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; PREPARATION, SCREENING AND INTERPRETATION
882.. 88162 CYTOPATHOLOGY, SMEARS, ANY OTHER SOURCE; EXTENDED STUDY INVOLVING OVER 5 SLIDES AND/OR MULTIPLE
STAINS
882.. 88172 EVALUATION OF FINE NEEDLE ASPIRATE WITH OR WITHOUT PREPARATION OF SMEARS; IMMEDIATE
CYTOHISTOLOGIC STUDY TO DETERMINE ADEQUACY OF SPECIMEN(S)
882.. 88173 EVALUATION OF FINE NEEDLE ASPIRATE WITH OR WITHOUT PREPARATION OF SMEARS; INTERPRETATION AND
REPORT
882.. 88180 FLOW CYTOMETRY; EACH CELL SURFACE MARKER
882.. 88182 FLOW CYTOMETRY; CELL CYCLE OR DNA ANALYSIS
882.. 88302 LEVEL II - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION
882.. 88304 LEVEL III - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION
882.. 88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION
882.. 88312 SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION); GROUP
I FOR MICROORGANISMS (EG, GRIDLEY, ACID FAST, METHENAMINE SILVER), EACH
882.. 88314 SPECIAL STAINS (LIST SEPARATELY IN ADDITION TO CODE FOR SURGICAL PATHOLOGY EXAMINATION);
HISTOCHEMICAL STAINING WITH FROZEN SECTION(S)
882.. 88318 DETERMINATIVE HISTOCHEMISTRY TO IDENTIFY CHEMICAL COMPONENTS (EG, COPPER, ZINC)
882.. 88319 DETERMINATIVE HISTOCHEMISTRY OR CYTOCHEMISTRY TO IDENTIFY ENZYME CONSTITUENTS, EACH
882.. 88321 CONSULTATION AND REPORT ON REFERRED SLIDES PREPARED ELSEWHERE
882.. 88323 CONSULTATION AND REPORT ON REFERRED MATERIAL REQUIRING PREPARATION OF SLIDES
882.. 88325 CONSULTATION, COMPREHENSIVE, WITH REVIEW OF RECORDS AND SPECIMENS, WITH REPORT ON REFERRED
MATERIAL
882.. 88329 PATHOLOGY CONSULTATION DURING SURGERY;
882.. 88331 PATHOLOGY CONSULTATION DURING SURGERY; WITH FROZEN SECTION(S), SINGLE SPECIMEN
882.. 88332 PATHOLOGY CONSULTATION DURING SURGERY; EACH ADDITIONAL TISSUE BLOCK WITH FROZEN SECTION(S)
882.. 88342 IMMUNOCYTOCHEMISTRY (INCLUDING TISSUE IMMUNOPEROXIDASE), EACH ANTIBODY
882.. 88346 IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; DIRECT METHOD
882.. 88347 IMMUNOFLUORESCENT STUDY, EACH ANTIBODY; INDIRECT METHOD
883.. Level III Pathology X 0.65 $32.94 $20.34 $6.59
883.. 88307 LEVEL V - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION
883.. 88309 LEVEL VI - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION
883.. 88348 ELECTRON MICROSCOPY; DIAGNOSTIC
883.. 88349 ELECTRON MICROSCOPY; SCANNING
883.. 88355 MORPHOMETRIC ANALYSIS; SKELETAL MUSCLE
883.. 88356 MORPHOMETRIC ANALYSIS; NERVE
883.. 88358 MORPHOMETRIC ANALYSIS; TUMOR
883.. 88362 NERVE TEASING PREPARATIONS
883.. 88365 TISSUE IN SITU HYBRIDIZATION, INTERPRETATION AND REPORT
900.. Critical Care V 7.44 $376.98 $144.87 $75.40
900.. 99291 CRITICAL CARE, EVALUATION AND MANAGEMENT OF THE UNSTABLE CRITICALLY ILL OR UNSTABLE CRITICALLY
INJURED PATIENT, REQUIRING THE CONSTANT ATTENDANCE OF THE PHYSICIAN; FIRST HOUR
901.. Level I Immunization X 0.07 $3.55 $2.49 $0.71
901.. 90700 IMMUNIZATION, ACTIVE; DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE (DTAP)
901.. 90701 IMMUNIZATION, ACTIVE; DIPHTHERIA AND TETANUS TOXOIDS AND PERTUSSIS VACCINE (DTP)
901.. 90702 IMMUNIZATION, ACTIVE; DIPHTHERIA AND TETANUS TOXOIDS (DT)
901.. 90703 IMMUNIZATION, ACTIVE; TETANUS TOXOID
901.. 90704 IMMUNIZATION, ACTIVE; MUMPS VIRUS VACCINE, LIVE
901.. 90705 IMMUNIZATION, ACTIVE; MEASLES VIRUS VACCINE, LIVE, ATTENUATED
901.. 90706 IMMUNIZATION, ACTIVE; RUBELLA VIRUS VACCINE, LIVE
901.. 90708 IMMUNIZATION, ACTIVE; MEASLES AND RUBELLA VIRUS VACCINE, LIVE
901.. 90709 IMMUNIZATION, ACTIVE; RUBELLA AND MUMPS VIRUS VACCINE, LIVE
901.. 90710 IMMUNIZATION, ACTIVE; MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE
901.. 90711 IMMUNIZATION, ACTIVE; DIPHTHERIA, TETANUS TOXOIDS, AND PERTUSSIS (DTP) AND INJECTABLE
POLIOMYELITIS VACCINE
901.. 90714 IMMUNIZATION, ACTIVE; TYPHOID VACCINE
901.. 90718 IMMUNIZATION, ACTIVE; TETANUS AND DIPHTHERIA TOXOIDS ABSORBED, FOR ADULT USE (TD)
901.. 90719 IMMUNIZATION, ACTIVE; DIPHTHERIA TOXOID
901.. 90724 IMMUNIZATION, ACTIVE; INFLUENZA VIRUS VACCINE
901.. 90725 IMMUNIZATION, ACTIVE; CHOLERA VACCINE
901.. 90730 IMMUNIZATION, ACTIVE; HEPATITIS A VACCINE
901.. 90732 IMMUNIZATION, ACTIVE; PNEUMOCOCCAL VACCINE, POLYVALENT
901.. 90748 IMMUNIZATION, ACTIVE, HEPATITIS B AND HEMOPHILUS INFLUENZA B (HIB) VACCINE
901.. 90749 UNLISTED IMMUNIZATION PROCEDURE
901.. 95149 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY
(SPECIFY NUMBER OF DOSES); FIVE SINGLE STINGING INSECT VENOMS
901.. 95170 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY;
WHOLE BODY EXTRACT OF BITING INSECT OR OTHER ARTHROPOD (SPECIFY NUMBER OF DOSES)
901.. G0008 INFLUENZA VACCINE
901.. G0009 PNEUMOCOCCAL VACCINE
901.. Q0034 INFLUENZA VACCINE
902.. Level II Immunization X 1.78 $90.19 $41.47 $18.04
[[Page 47825]]
902.. 90707 IMMUNIZATION, ACTIVE; MEASLES, MUMPS AND RUBELLA VIRUS VACCINE, LIVE
902.. 90712 IMMUNIZATION, ACTIVE; POLIOVIRUS VACCINE, LIVE, ORAL (ANY TYPE(S))
902.. 90713 IMMUNIZATION, ACTIVE; POLIOMYELITIS VACCINE
902.. 90716 IMMUNIZATION, ACTIVE; VARICELLA (CHICKEN POX) VACCINE
902.. 90717 IMMUNIZATION, ACTIVE; YELLOW FEVER VACCINE
902.. 90720 IMMUNIZATION, ACTIVE; DIPHTHERIA, TETANUS TOXOIDS, AND PERTUSSIS (DTP) AND HEMOPHILUS INFLUENZA
B (HIB) VACCINE
902.. 90733 IMMUNIZATION, ACTIVE; MENINGOCOCCAL POLYSACCHARIDE VACCINE (ANY GROUP(S))
902.. 90737 IMMUNIZATION, ACTIVE; HEMOPHILUS INFLUENZA B
902.. 90741 IMMUNIZATION, PASSIVE; IMMUNE SERUM GLOBULIN, HUMAN (ISG)
902.. 90744 IMMUNIZATION, ACTIVE, HEPATITIS B VACCINE; NEWBORN TO 11 YEARS
902.. 90745 IMMUNIZATION, ACTIVE, HEPATITIS B VACCINE; 11-19 YEARS
902.. 90746 IMMUNIZATION, ACTIVE, HEPATITIS B VACCINE; 20 YEARS AND ABOVE
902.. 90747 IMMUNIZATION, ACTIVE, HEPATITIS B VACCINE; DIALYSIS OR IMMUNOSUPPRESSED PATIENT, ANY AGE
902.. G0010 HEPATITIS B VACCINE
903.. Level III Immunization X 1.16 $58.78 $25.65 $11.76
903.. 90721 IMMUNIZATION, ACTIVE; DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE (DTAP) AND
HEMOPHILUS INFLUENZA B (HIB) VACCINE
903.. 90726 IMMUNIZATION, ACTIVE; RABIES VACCINE
903.. 90727 IMMUNIZATION, ACTIVE; PLAGUE VACCINE
903.. 90728 IMMUNIZATION, ACTIVE; BCG VACCINE
903.. 90735 IMMUNIZATION, ACTIVE; ENCEPHALITIS VIRUS VACCINE
903.. 90742 IMMUNIZATION, PASSIVE; SPECIFIC HYPERIMMUNE SERUM GLOBULIN (EG, HEPATITIS B, MEASLES,
PERTUSSIS, RABIES, RHO(D), TETANUS, VACCINIA, VARICELLA-ZOSTER)
906.. Infusion Therapy except X 1.46 $73.98 $42.49 $14.80
Chemotherapy
906.. 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION
906.. 90780 IV INFUSION FOR THERAPY/DIAGNOSIS, ADMINISTERED BY PHYSICIAN OR UNDER DIRECT SUPERVISION OF
PHYSICIAN; UP TO ONE HOUR
906.. 90781 IV INFUSION FOR THERAPY/DIAGNOSIS, ADMINISTERED BY PHYSICIAN OR UNDER DIRECT SUPERVISION OF
PHYSICIAN; EACH ADDITIONAL HOUR, UP TO EIGHT (8) HOURS
906.. Q0081 INFUSION THERAPY
907.. Intramuscular Injections X 0.85 $43.07 $11.98 $8.61
907.. 90782 THERAPEUTIC OR DIAGNOSTIC INJECTION (SPECIFY MATERIAL INJECTED); SUBCUTANEOUS OR INTRAMUSCULAR
907.. 90783 THERAPEUTIC OR DIAGNOSTIC INJECTION (SPECIFY MATERIAL INJECTED); INTRA-ARTERIAL
907.. 90784 THERAPEUTIC OR DIAGNOSTIC INJECTION (SPECIFY MATERIAL INJECTED); INTRAVENOUS
907.. 90788 INTRAMUSCULAR INJECTION OF ANTIBIOTIC (SPECIFY)
907.. 90799 UNLISTED THERAPEUTIC OR DIAGNOSTIC INJECTION
919.. Electroconvulsive Therapy S 3.17 $160.62 $80.00 $32.12
919.. 90870 ELECTROCONVULSIVE THERAPY (INCLUDES NECESSARY MONITORING); SINGLE SEIZURE
919.. 90871 ELECTROCONVULSIVE THERAPY (INCLUDES NECESSARY MONITORING); MULTIPLE SEIZURES, PER DAY
920.. Biofeedback and other Training S 1.17 $59.28 $29.61 $11.86
920.. 90901 BIOFEEDBACK TRAINING BY ANY MODALITY
920.. 90911 BIOFEEDBACK TRAINING, PERINEAL MUSCLES, ANORECTAL OR URETHRAL SPHINCTER, INCLUDING EMG AND/OR
MANOMETRY
921.. Diabetes Education S
921.. 99078 PHYSICIAN EDUCATIONAL SERVICES RENDERED TO PATIENTS IN A GROUP SETTING (EG, PRENATAL, OBESITY,
OR DIABETIC INSTRUCTIONS)
926.. Dialysis for other than ESRD S 4.28 $216.87 $69.83 $43.37
patients
926.. 90935 HEMODIALYSIS PROCEDURE WITH SINGLE PHYSICIAN EVALUATION
926.. 90937 HEMODIALYSIS PROCEDURE REQUIRING REPEATED EVALUATION(S) WITH OR WITHOUT SUBSTANTIAL REVISION OF
DIALYSIS PRESCRIPTION
926.. 90945 DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS (EG, PERITONEAL, HEMOFILTRATION), WITH SINGLE
PHYSICIAN EVALUATION
926.. 90947 DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS (EG, PERITONEAL, HEMOFILTRATION) REQUIRING REPEATED
EVALUATIONS, WITH OR WITHOUT SUBSTANTIAL REVISION OF DIALYSIS PRESCRIPTION
926.. 90997 HEMOPERFUSION (EG, WITH ACTIVATED CHARCOAL OR RESIN)
926.. 90999 UNLISTED DIALYSIS PROCEDURE, INPATIENT OR OUTPATIENT
928.. Alimentary Tests X 3.11 $157.58 $83.85 $31.52
928.. 89100 DUODENAL INTUBATION AND ASPIRATION; SINGLE SPECIMEN (EG, SIMPLE BILE STUDY OR AFFERENT LOOP
CULTURE) PLUS APPROPRIATE TEST PROCEDURE
928.. 89105 DUODENAL INTUBATION AND ASPIRATION; COLLECTION OF MULTIPLE FRACTIONAL SPECIMENS WITH PANCREATIC
OR GALLBLADDER STIMULATION, SINGLE OR DOUBLE LUMEN TUBE
928.. 89130 GASTRIC INTUBATION AND ASPIRATION, DIAGNOSTIC, EACH SPECIMEN, FOR CHEMICAL ANALYSES OR
CYTOPATHOLOGY;
928.. 89132 GASTRIC INTUBATION AND ASPIRATION, DIAGNOSTIC, EACH SPECIMEN, AFTER STIMULATION
928.. 89135 GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); ONE
HOUR
928.. 89136 GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); TWO
HOURS
928.. 89140 GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); TWO
HOURS INCLUDING GASTRIC STIMULATION (EG, HISTALOG, PENTAGASTRIN)
928.. 89141 GASTRIC INTUBATION, ASPIRATION, AND FRACTIONAL COLLECTIONS (EG, GASTRIC SECRETORY STUDY); THREE
HOURS, INCLUDING GASTRIC STIMULATION
928.. 91000 ESOPHAGEAL INTUBATION AND COLLECTION OF WASHINGS FOR CYTOLOGY, INCLUDING PREPARATION OF
SPECIMENS (SEPARATE PROCEDURE)
928.. 91010 ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY;
[[Page 47826]]
928.. 91011 ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY;
WITH MECHOLYL OR SIMILAR STIMULANT
928.. 91012 ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY;
WITH ACID PERFUSION STUDIES
928.. 91020 GASTRIC MOTILITY (MANOMETRIC) STUDIES
928.. 91030 ESOPHAGUS, ACID PERFUSION (BERNSTEIN) TEST FOR ESOPHAGITIS
928.. 91032 ESOPHAGUS, ACID REFLUX TEST, WITH INTRALUMINAL PH ELECTRODE FOR DETECTION OF GASTROESOPHAGEAL
REFLUX;
928.. 91033 ESOPHAGUS, ACID REFLUX TEST, WITH INTRALUMINAL PH ELECTRODE FOR DETECTION OF GASTROESOPHAGEAL
REFLUX; PROLONGED RECORDING
928.. 91052 GASTRIC ANALYSIS TEST WITH INJECTION OF STIMULANT OF GASTRIC SECRETION (EG, HISTAMINE, INSULIN,
PENTAGASTRIN, CALCIUM AND SECRETIN)
928.. 91055 GASTRIC INTUBATION, WASHINGS, AND PREPARING SLIDES FOR CYTOLOGY (SEPARATE PROCEDURE)
928.. 91060 GASTRIC SALINE LOAD TEST
928.. 91065 BREATH HYDROGEN TEST (EG, FOR DETECTION OF LACTASE DEFICIENCY)
928.. 91100 INTESTINAL BLEEDING TUBE, PASSAGE, POSITIONING AND MONITORING
928.. 91105 GASTRIC INTUBATION, AND ASPIRATION OR LAVAGE FOR TREATMENT (EG, FOR INGESTED POISONS)
928.. 91299 UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE
928.. 95075 INGESTION CHALLENGE TEST (SEQUENTIAL AND INCREMENTAL INGESTION OF TEST ITEMS, EG, FOOD, DRUG OR
OTHER SUBSTANCE SUCH AS METABISULFITE)
930.. Minor Eye Examinations X 1.02 $51.68 $22.83 $10.34
930.. 92060 SENSORIMOTOR EXAMINATION WITH MULTIPLE MEASUREMENTS OF OCULAR DEVIATION (EG, RESTRICTIVE OR
PARETIC MUSCLE WITH DIPLOPIA) WITH INTERPRETATION AND REPORT (SEPARATE PROCEDURE)
930.. 92065 ORTHOPTIC AND/OR PLEOPTIC TRAINING, WITH CONTINUING MEDICAL DIRECTION AND EVALUATION
930.. 92081 VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; LIMITED
EXAMINATION (EG, TANGENT SCREEN, AUTOPLOT, ARC PERIMETER, OR SINGLE STIMULUS LEVEL AUTOMATED
TEST, SUCH AS OCTOPUS 3 OR 7 EQUIVALENT)
930.. 92082 VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; INTERMEDIATE
EXAMINATION (EG, AT LEAST 2 ISOPTERS ON GOLDMANN PERIMETER, OR SEMIQUANTITATIVE, AUTOMATED
SUPRATHRESHOLD SCREENING PROGRAM, HUMPHREY SUPRATHRESHOLD AUTOMATIC
930.. 92083 VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; EXTENDED
EXAMINATION (EG, GOLDMANN VISUAL FIELDS WITH AT LEAST 3 ISOPTERS PLOTTED AND STATIC
DETERMINATION WITHIN THE CENTRAL 30!, OR QUANTITATIVE, AUTOMATED THRESHOLD PERI
930.. 92140 PROVOCATIVE TESTS FOR GLAUCOMA, WITH INTERPRETATION AND REPORT, WITHOUT TONOGRAPHY
930.. 92283 COLOR VISION EXAMINATION, EXTENDED, EG, ANOMALOSCOPE OR EQUIVALENT
930.. 92284 DARK ADAPTATION EXAMINATION WITH INTERPRETATION AND REPORT
930.. 92285 EXTERNAL OCULAR PHOTOGRAPHY WITH INTERPRETATION AND REPORT FOR DOCUMENTATION OF MEDICAL
PROGRESS (EG, CLOSE-UP PHOTOGRAPHY, SLIT LAMP PHOTOGRAPHY, GONIOPHOTOGRAPHY, STEREO-
PHOTOGRAPHY)
931.. Level I Eye Tests X 0.74 $37.5 $21.47 $7.50
931.. 92120 TONOGRAPHY WITH INTERPRETATION AND REPORT, RECORDING INDENTATION TONOMETER METHOD OR PERILIMBAL
SUCTION METHOD
931.. 92130 TONOGRAPHY WITH WATER PROVOCATION
931.. 92230 FLUORESCEIN ANGIOSCOPY WITH INTERPRETATION AND REPORT
931.. 92240 INDOCYANINE-GREEN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT
931.. 92250 FUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORT
931.. 92499 UNLISTED OPHTHALMOLOGICAL SERVICE OR PROCEDURE
932.. Level II Eye Tests X 2.52 $127.69 $65.09 $25.54
932.. 92235 FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT
932.. 92265 NEEDLE OCULOELECTROMYOGRAPHY, ONE OR MORE EXTRAOCULAR MUSCLES, ONE OR BOTH EYES, WITH
INTERPRETATION AND REPORT
932.. 92270 ELECTRO-OCULOGRAPHY WITH INTERPRETATION AND REPORT
932.. 92286 SPECIAL ANTERIOR SEGMENT PHOTOGRAPHY WITH INTERPRETATION AND REPORT; WITH SPECULAR ENDOTHELIAL
MICROSCOPY AND CELL COUNT
932.. 92287 SPECIAL ANTERIOR SEGMENT PHOTOGRAPHY WITH INTERPRETATION AND REPORT; WITH FLUORESCEIN
ANGIOGRAPHY
936.. Fitting of Vision Aids X 0.52 $26.35 $9.49 $5.27
936.. 92311 PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH
MEDICAL SUPERVISION OF ADAPTATION; CORNEAL LENS FOR APHAKIA, ONE EYE
936.. 92312 PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH
MEDICAL SUPERVISION OF ADAPTATION; CORNEAL LENS FOR APHAKIA, BOTH EYES
936.. 92313 PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF AND FITTING OF CONTACT LENS, WITH
MEDICAL SUPERVISION OF ADAPTATION; CORNEOSCLERAL LENS
936.. 92315 PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
OF ADAPTATION AND DIRECTION OF FITTING BY INDEPENDENT TECHNICIAN; CORNEAL LENS FOR APHAKIA,
ONE EYE
936.. 92316 PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
OF ADAPTATION AND DIRECTION OF FITTING BY INDEPENDENT TECHNICIAN; CORNEAL LENS FOR APHAKIA,
BOTH EYES
936.. 92317 PRESCRIPTION OF OPTICAL AND PHYSICAL CHARACTERISTICS OF CONTACT LENS, WITH MEDICAL SUPERVISION
OF ADAPTATION AND DIRECTION OF FITTING BY INDEPENDENT TECHNICIAN; CORNEOSCLERAL LENS
936.. 92325 MODIFICATION OF CONTACT LENS (SEPARATE PROCEDURE), WITH MEDICAL SUPERVISION OF ADAPTATION
936.. 92326 REPLACEMENT OF CONTACT LENS
936.. 92330 PRESCRIPTION, FITTING, AND SUPPLY OF OCULAR PROSTHESIS (ARTIFICIAL EYE), WITH MEDICAL
SUPERVISION OF ADAPTATION
936.. 92352 FITTING OF SPECTACLE PROSTHESIS FOR APHAKIA; MONOFOCAL
936.. 92353 FITTING OF SPECTACLE PROSTHESIS FOR APHAKIA; MULTIFOCAL
936.. 92354 FITTING OF SPECTACLE MOUNTED LOW VISION AID; SINGLE ELEMENT SYSTEM
936.. 92355 FITTING OF SPECTACLE MOUNTED LOW VISION AID; TELESCOPIC OR OTHER COMPOUND LENS SYSTEM
[[Page 47827]]
936.. 92358 PROSTHESIS SERVICE FOR APHAKIA, TEMPORARY (DISPOSABLE OR LOAN, INCLUDING MATERIALS)
936.. 92371 REPAIR AND REFITTING SPECTACLES; SPECTACLE PROSTHESIS FOR APHAKIA
940.. Otorhinolaryngologic Function X 3.04 $154.04 $51.98 $30.81
Tests
940.. 92512 NASAL FUNCTION STUDIES (EG, RHINOMANOMETRY)
940.. 92516 FACIAL NERVE FUNCTION STUDIES (EG, ELECTRONEURONOGRAPHY)
940.. 92520 LARYNGEAL FUNCTION STUDIES
940.. 92541 SPONTANEOUS NYSTAGMUS TEST, INCLUDING GAZE AND FIXATION NYSTAGMUS, WITH RECORDING
940.. 92542 POSITIONAL NYSTAGMUS TEST, MINIMUM OF 4 POSITIONS, WITH RECORDING
940.. 92543 CALORIC VESTIBULAR TEST, EACH IRRIGATION (BINAURAL, BITHERMAL STIMULATION CONSTITUTES FOUR
TESTS), WITH
940.. 92544 OPTOKINETIC NYSTAGMUS TEST, BIDIRECTIONAL, FOVEAL OR PERIPHERAL STIMULATION, WITH RECORDING
940.. 92545 OSCILLATING TRACKING TEST, WITH RECORDING
940.. 92546 SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING
940.. 92547 USE OF VERTICAL ELECTRODES IN ANY OR ALL OF ABOVE TESTS COUNTS AS ONE ADDITIONAL TEST
940.. 92548 COMPUTERIZED DYNAMIC POSTUROGRAPHY
940.. 92584 ELECTROCOCHLEOGRAPHY
940.. 92587 EVOKED OTOACOUSTIC EMISSIONS; LIMITED (SINGLE STIMULUS LEVEL, EITHER TRANSIENT OR DISTORTION
PRODUCTS)
940.. 92588 EVOKED OTOACOUSTIC EMISSIONS; COMPREHENSIVE OR DIAGNOSTIC EVALUATION (COMPARISON OF TRANSIENT
AND/OR DISTORTION PRODUCT OTOACOUSTIC EMISSIONS AT MULTIPLE LEVELS AND FREQUENCIES)
941.. Level I Audiometry X 0.74 $37.50 $13.56 $7.50
941.. 92552 PURE TONE AUDIOMETRY (THRESHOLD); AIR ONLY
941.. 92553 PURE TONE AUDIOMETRY (THRESHOLD); AIR AND BONE
941.. 92555 SPEECH AUDIOMETRY THRESHOLD;
941.. 92556 SPEECH AUDIOMETRY THRESHOLD; WITH SPEECH RECOGNITION
941.. 92567 TYMPANOMETRY (IMPEDANCE TESTING)
941.. 92599 UNLISTED OTORHINOLARYNGOLOGICAL SERVICE OR PROCEDURE
942.. Level II Audiometry X 1.48 $74.99 $22.15 $15.00
942.. 92557 COMPREHENSIVE AUDIOMETRY THRESHOLD EVALUATION AND SPEECH RECOGNITION (92553 AND 92556 COMBINED)
942.. 92561 BEKESY AUDIOMETRY; DIAGNOSTIC
942.. 92562 LOUDNESS BALANCE TEST, ALTERNATE BINAURAL OR MONAURAL
942.. 92563 TONE DECAY TEST
942.. 92564 SHORT INCREMENT SENSITIVITY INDEX (SISI)
942.. 92565 STENGER TEST, PURE TONE
942.. 92568 ACOUSTIC REFLEX TESTING
942.. 92569 ACOUSTIC REFLEX DECAY TEST
942.. 92571 FILTERED SPEECH TEST
942.. 92572 STAGGERED SPONDAIC WORD TEST
942.. 92573 LOMBARD TEST
942.. 92575 SENSORINEURAL ACUITY LEVEL TEST
942.. 92576 SYNTHETIC SENTENCE IDENTIFICATION TEST
942.. 92577 STENGER TEST, SPEECH
942.. 92579 VISUAL REINFORCEMENT AUDIOMETRY (VRA)
942.. 92582 CONDITIONING PLAY AUDIOMETRY
942.. 92583 SELECT PICTURE AUDIOMETRY
942.. 92589 CENTRAL AUDITORY FUNCTION TEST(S) (SPECIFY)
942.. 92596 EAR PROTECTOR ATTENUATION MEASUREMENTS
947.. Resuscitation and S 4.07 $206.22 $109.61 $41.24
Cardioversion
947.. 31500 INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE
947.. 92950 CARDIOPULMONARY RESUSCITATION (EG, IN CARDIAC ARREST)
947.. 92953 TEMPORARY TRANSCUTANEOUS PACING
947.. 92960 CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA, EXTERNAL
947.. 99440 NEWBORN RESUSCITATION: PROVISION OF POSITIVE PRESSURE VENTILATION AND/OR CHEST COMPRESSIONS IN
THE PRESENCE OF ACUTE INADEQUATE VENTILATION AND/OR CARDIAC OUTPUT
948.. Cardiac Rehabilitation X 0.81 $41.04 $16.95 $8.21
948.. 93797 PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITHOUT CONTINUOUS ECG MONITORING
(PER SESSION)
948.. 93798 PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION; WITH CONTINUOUS ECG MONITORING (PER
SESSION)
949.. Cardiovascular Stress Test X 1.46 $73.98 $62.83 $14.80
949.. 93017 CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE, CONTINOUS
ELECTROCARDIOGRAPHIC MONITORING, AND/OR PHARMACOLOGICAL STRESS; TRACING ONLY, WITHOUT
INTERPRETATION AND REPORT
949.. 93024 ERGONOVINE PROVOCATION TEST
950.. Electrocardiogram (ECG) X 0.35 $17.73 $15.82 $3.55
950.. 93005 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND
REPORT
950.. 93041 RHYTHM ECG, ONE TO THREE LEADS; TRACING ONLY WITHOUT INTERPRETATION AND REPORT
950.. Q0035 CARDIOKYMOGRAPHY
956.. Continuous ECG and Blood X 1.11 $56.24 $55.82 $11.25
Pressure Monitoring
956.. 93012 TELEPHONIC TRANSMISSION OF POST-SYMPTOM ELECTROCARDIOGRAM RHYTHM STRIP(S), PER 30 DAY PERIOD OF
TIME; TRACING ONLY
956.. 93224 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORDING AND
STORAGE, WITH VISUAL SUPERIMPOSITION SCANNING; INCLUDES RECORDING, SCANNING ANALYSIS WITH
REPORT, PHYSICIAN REVIEW AND INTERPRETATION
[[Page 47828]]
956.. 93225 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORDING AND
STORAGE, WITH VISUAL SUPERIMPOSITION SCANNING; RECORDING (INCLUDES HOOK-UP, RECORDING, AND
DISCONNECTION)
956.. 93226 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORDING AND
STORAGE, WITH VISUAL SUPERIMPOSITION SCANNING; SCANNING ANALYSIS WITH REPORT
956.. 93230 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORDING AND
STORAGE WITHOUT SUPERIMPOSITION SCANNING UTILIZING A DEVICE CAPABLE OF PRODUCING A FULL
MINIATURIZED PRINTOUT; INCLUDES RECORDING, MICROPROCESSOR-BASED ANALYSIS
956.. 93231 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORDING AND
STORAGE WITHOUT SUPERIMPOSITION SCANNING UTILIZING A DEVICE CAPABLE OF PRODUCING A FULL
MINIATURIZED PRINTOUT; RECORDING (INCLUDES HOOK-UP, RECORDING, AND DISCO
956.. 93232 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS ORIGINAL ECG WAVEFORM RECORDING AND
STORAGE WITHOUT SUPERIMPOSITION SCANNING UTILIZING A DEVICE CAPABLE OF PRODUCING A FULL
MINIATURIZED PRINTOUT; MICROPROCESSOR-BASED ANALYSIS WITH REPORT
956.. 93235 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS COMPUTERIZED MONITORING AND NON-
CONTINUOUS RECORDING, AND REAL-TIME DATA ANALYSIS UTILIZING A DEVICE CAPABLE OF PRODUCING
INTERMITTENT FULL-SIZED WAVEFORM TRACINGS, POSSIBLY PATIENT ACTIVATED; INC
956.. 93236 ELECTROCARDIOGRAPHIC MONITORING FOR 24 HOURS BY CONTINUOUS COMPUTERIZED MONITORING AND NON-
CONTINUOUS RECORDING, AND REAL-TIME DATA ANALYSIS UTILIZING A DEVICE CAPABLE OF PRODUCING
INTERMITTENT FULL-SIZED WAVEFORM TRACINGS, POSSIBLY PATIENT ACTIVATED; MON
956.. 93268 PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, PER 30 DAY
PERIOD OF TIME; INCLUDES TRANSMISSION, PHYSICIAN REVIEW AND INTERPRETATION
956.. 93270 PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, PER 30 DAY
PERIOD OF TIME; RECORDING (INCLUDES HOOK-UP, RECORDING, AND DISCONNECTION)
956.. 93271 PATIENT DEMAND SINGLE OR MULTIPLE EVENT RECORDING WITH PRESYMPTOM MEMORY LOOP, PER 30 DAY
PERIOD OF TIME; MONITORING, RECEIPT OF TRANSMISSIONS, AND ANALYSIS
956.. 93278 SIGNAL-AVERAGED ELECTROCARDIOGRAPHY (SAECG), WITH OR WITHOUT ECG
956.. G0004 ECG TRANSM PHYS REVIEW & INt
956.. G0005 ECG 24 HOUR RECORDING
956.. G0006 ECG TRANSMISSION & ANALYSIS
956.. G0015 POST SYMPTOM ECG TRACING
957.. Echocardiography S 2.83 $143.39 $117.07 $28.68
957.. 76825 ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D), WITH
OR WITHOUT M-MODE RECORDING;
957.. 76826 ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH IMAGE DOCUMENTATION (2D), WITH
OR WITHOUT M-MODE RECORDING; FOLLOW-UP OR REPEAT STUDY
957.. 76827 DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH
SPECTRAL DISPLAY; COMPLETE
957.. 76828 DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED WAVE AND/OR CONTINUOUS WAVE WITH
SPECTRAL DISPLAY; FOLLOW-UP OR REPEAT STUDY
957.. 93303 TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE
957.. 93304 TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY
957.. 93307 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE
RECORDING; COMPLETE
957.. 93308 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE
RECORDING; FOLLOW-UP OR LIMITED STUDY
957.. 93312 ECHOCARDIOGRAPHY, TRANSESOPHAGEAL, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-
MODE RECORDING); INCLUDING PROBE PLACEMENT, IMAGE ACQUISITION, INTERPRETATION AND REPORT
957.. 93313 ECHOCARDIOGRAPHY, TRANSESOPHAGEAL, REAL TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-
MODE RECORDING); PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY
957.. 93315 TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; INCLUDING PROBE PLACEMENT,
IMAGE ACQUISITION, INTERPRETATION AND REPORT
957.. 93316 TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; PLACEMENT OF TRANSESOPHAGEAL
PROBE ONLY
957.. 93320 DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST
SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING 93303, 93304, 93307, 93308,
93312, 93314, 93315, 93317, 93350); COMPLETE
957.. 93321 DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST
SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING 93303, 93304, 93307, 93308,
93312, 93314, 93315, 93317, 93350); FOLLOW-UP OR LIMITED STUDY
957.. 93325 DOPPLER COLOR FLOW VELOCITY MAPPING (LIST SEPARATELY IN ADDITION TO CODE FOR ECHOCARDIOGRAPHY
76825, 76826, 76827, 76828, 93303, 93304, 93307, 93308, 93312, 93314, 93315, 93317, 93320,
93321, 93350)
957.. 93350 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), WITH OR WITHOUT M-
MODE RECORDING, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE
AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPOR
958.. Diagnostic Cardiac T 26.11 $1,322.98 $659.47 $264.60
Catheterization
958.. 93501 RIGHT HEART CATHETERIZATION
958.. 93503 INSERTION AND PLACEMENT OF FLOW DIRECTED CATHETER (EG, SWAN-GANZ) FOR MONITORING PURPOSES
958.. 93505 ENDOMYOCARDIAL BIOPSY
958.. 93510 LEFT HEART CATHETERIZATION, RETROGRADE, FROM THE BRACHIAL ARTERY, AXILLARY ARTERY OR FEMORAL
ARTERY; PERCUTANEOUS
958.. 93511 LEFT HEART CATHETERIZATION, RETROGRADE, FROM THE BRACHIAL ARTERY, AXILLARY ARTERY OR FEMORAL
ARTERY; BY CUTDOWN
958.. 93514 LEFT HEART CATHETERIZATION BY LEFT VENTRICULAR PUNCTURE
958.. 93524 COMBINED TRANSSEPTAL AND RETROGRADE LEFT HEART CATHETERIZATION
958.. 93526 COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION
[[Page 47829]]
958.. 93527 COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT
SEPTUM (WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION)
958.. 93528 COMBINED RIGHT HEART CATHETERIZATION WITH LEFT VENTRICULAR PUNCTURE (WITH OR WITHOUT RETROGRADE
LEFT HEART CATHETERIZATION)
958.. 93529 COMBINED RIGHT HEART CATHETERIZATION AND LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL
OPENING (WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION)
958.. 93530 RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES
958.. 93531 COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL
CARDIAC ANOMALIES
958.. 93532 COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT
SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES
958.. 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
958.. 93536 PERCUTANEOUS INSERTION OF INTRA-AORTIC BALLOON CATHETER
960.. Cardiac Electrophysiologic S 4.24 $214.84 $144.41 $42.97
Tests/Procedures
960.. 93600 BUNDLE OF HIS RECORDING
960.. 93602 INTRA-ATRIAL RECORDING
960.. 93603 RIGHT VENTRICULAR RECORDING
960.. 93607 LEFT VENTRICULAR RECORDING
960.. 93609 INTRAVENTRICULAR AND/OR INTRA-ATRIAL MAPPING OF TACHYCARDIA SITE(S) WITH CATHETER MANIPULATION
TO RECORD FROM MULTIPLE SITES TO IDENTIFY ORIGIN OF TACHYCARDIA
960.. 93610 INTRA-ATRIAL PACING
960.. 93612 INTRAVENTRICULAR PACING
960.. 93615 ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM WITH OR WITHOUT VENTRICULAR ELECTROGRAM(S);
960.. 93616 ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM WITH OR WITHOUT VENTRICULAR ELECTROGRAM(S); WITH
PACING
960.. 93618 INDUCTION OF ARRHYTHMIA BY ELECTRICAL PACING
960.. 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 OR ATTEMPTED INDUCTI
960.. 93620 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; WITH INDUCTION OR ATTEMPTED INDUCTION
960.. 93621 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; WITH LEFT ATRIAL RECORDINGS FROM CORON
960.. 93622 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; WITH LEFT VENTRICULAR RECORDINGS, WITH
960.. 93623 PROGRAMMED STIMULATION AND PACING AFTER INTRAVENOUS DRUG INFUSION (USE THIS CODE WITH 93620,
93621, 93622)
960.. 93624 ELECTROPHYSIOLOGIC FOLLOW-UP STUDY WITH PACING AND RECORDING TO TEST EFFECTIVENESS OF THERAPY,
INCLUDING INDUCTION OR ATTEMPTED INDUCTION OF ARRHYTHMIA
960.. 93631 INTRA-OPERATIVE EPICARDIAL AND ENDOCARDIAL PACING AND MAPPING TO LOCALIZE THE SITE OF
TACHYCARDIA OR ZONE OF SLOW CONDUCTION FOR SURGICAL CORRECTION
960.. 93640 ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER-DEFIBRILLATOR LEADS (INCLUDES DEFIBRILLATION
THRESHOLD TESTING AND SENSING FUNCTION) AT TIME OF INITIAL IMPLANTATION OR REPLACEMENT;
960.. 93641 ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER-DEFIBRILLATOR LEADS (INCLUDES DEFIBRILLATION
THRESHOLD TESTING AND SENSING FUNCTION) AT TIME OF INITIAL IMPLANTATION OR REPLACEMENT; WITH
TESTING OF CARDIOVERTER-DEFIBRILLATOR PULSE GENERATOR
960.. 93642 ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER-DEFIBRILLATOR (INCLUDES DEFIBRILLATION THRESHOLD
EVALUATION, INDUCTION OF ARRHYTHMIA, EVALUATION OF SENSING AND PACING FOR ARRHYTHMIA
TERMINATION, AND PROGRAMMING OR REPROGRAMMING OF SENSING OR THERAPEUTIC PAR
960.. 93650 INTRACARDIAC CATHETER ABLATION OF ATRIOVENTRICULAR NODE FUNCTION, ATRIOVENTRICULAR CONDUCTION
FOR CREATION OF COMPLETE HEART BLOCK, WITH OR WITHOUT TEMPORARY PACEMAKER PLACEMENT
960.. 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
960.. 93652 INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR TREATMENT OF VENTRICULAR
TACHYCARDIA
960.. 93660 EVALUATION OF CARDIOVASCULAR FUNCTION WITH TILT TABLE EVALUATION, WITH CONTINUOUS ECG
MONITORING AND INTERMITTENT BLOOD PRESSURE MONITORING, WITH OR WITHOUT PHARMACOLOGICAL
INTERVENTION
960.. 93724 ELECTRONIC ANALYSIS OF ANTITACHYCARDIA PACEMAKER SYSTEM (INCLUDES ELECTROCARDIOGRAPHIC
RECORDING, PROGRAMMING OF DEVICE, INDUCTION AND TERMINATION OF TACHYCARDIA VIA IMPLANTED
PACEMAKER, AND INTERPRETATION OF RECORDINGS)
966.. Electronic Analysis of X 0.39 $19.76 $12.43 $3.95
Pacemakers/other devices
966.. 62367 ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION
(INCLUDES EVALUATION OF RESERVOIR STATUS, ALARM STATUS, DRUG PRESCRIPTION STATUS); WITHOUT
REPROGRAMMING
966.. 62368 ELECTRONIC ANALYSIS OF PROGRAMMABLE, IMPLANTED PUMP FOR INTRATHECAL OR EPIDURAL DRUG INFUSION
(INCLUDES EVALUATION OF RESERVOIR STATUS, ALARM STATUS, DRUG PRESCRIPTION STATUS); WITH
REPROGRAMMING
966.. 63690 ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (MAY INCLUDE RATE,
PULSE AMPLITUDE AND DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE
SELECTABILITY, OUTPUT MODULATION, CYCLING, IMPEDANCE AND PATIENT COMPLIANCE MEAS
966.. 63691 ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM (MAY INCLUDE RATE,
PULSE AMPLITUDE AND DURATION, CONFIGURATION OF WAVE FORM, BATTERY STATUS, ELECTRODE
SELECTABILITY, OUTPUT MODULATION, CYCLING, IMPEDANCE AND PATIENT COMPLIANCE MEAS
[[Page 47830]]
966.. 93731 ELECTRONIC ANALYSIS OF DUAL-CHAMBER PACEMAKER SYSTEM (INCLUDES EVALUATION OF PROGRAMMABLE
PARAMETERS AT REST AND DURING ACTIVITY WHERE APPLICABLE, USING ELECTROCARDIOGRAPHIC RECORDING
AND INTERPRETATION OF RECORDINGS AT REST AND DURING EXERCISE, ANALYSIS
966.. 93732 ELECTRONIC ANALYSIS OF DUAL-CHAMBER PACEMAKER SYSTEM (INCLUDES EVALUATION OF PROGRAMMABLE
PARAMETERS AT REST AND DURING ACTIVITY WHERE APPLICABLE, USING ELECTROCARDIOGRAPHIC RECORDING
AND INTERPRETATION OF RECORDINGS AT REST AND DURING EXERCISE, ANALYSIS
966.. 93733 ELECTRONIC ANALYSIS OF DUAL CHAMBER INTERNAL PACEMAKER SYSTEM (MAY INCLUDE RATE, PULSE
AMPLITUDE AND DURATION, CONFIGURATION OF WAVE FORM, AND/OR TESTING OF SENSORY FUNCTION OF
PACEMAKER), TELEPHONIC ANALYSIS
966.. 93734 ELECTRONIC ANALYSIS OF SINGLE CHAMBER PACEMAKER SYSTEM (INCLUDES EVALUATION OF PROGRAMMABLE
PARAMETERS AT REST AND DURING ACTIVITY WHERE APPLICABLE, USING ELECTROCARDIOGRAPHIC RECORDING
AND INTERPRETATION OF RECORDINGS AT REST AND DURING EXERCISE, ANALYSI
966.. 93735 ELECTRONIC ANALYSIS OF SINGLE CHAMBER PACEMAKER SYSTEM (INCLUDES EVALUATION OF PROGRAMMABLE
PARAMETERS AT REST AND DURING ACTIVITY WHERE APPLICABLE, USING ELECTROCARDIOGRAPHIC RECORDING
AND INTERPRETATION OF RECORDINGS AT REST AND DURING EXERCISE, ANALYSI
966.. 93736 ELECTRONIC ANALYSIS OF SINGLE CHAMBER INTERNAL PACEMAKER SYSTEM (MAY INCLUDE RATE, PULSE
AMPLITUDE AND DURATION, CONFIGURATION OF WAVE FORM, AND/OR TESTING OF SENSORY FUNCTION OF
PACEMAKER), TELEPHONIC ANALYSIS
966.. 93737 ELECTRONIC ANALYSIS OF CARDIOVERTER/DEFIBRILLATOR ONLY (INTERROGATION, EVALUATION OF PULSE
GENERATOR STATUS); WITHOUT REPROGRAMMING
966.. 93738 ELECTRONIC ANALYSIS OF CARDIOVERTER/DEFIBRILLATOR ONLY (INTERROGATION, EVALUATION OF PULSE
GENERATOR STATUS); WITH REPROGRAMMING
967.. Non-Invasive Vascular Studies X 1.70 $86.14 $57.40 $17.23
967.. 93720 PLETHYSMOGRAPHY, TOTAL BODY; WITH INTERPRETATION AND REPORT
967.. 93721 PLETHYSMOGRAPHY, TOTAL BODY; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT
967.. 93740 TEMPERATURE GRADIENT STUDIES
967.. 93799 UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE
967.. 93922 NON-INVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, SINGLE LEVEL, BILATERAL
(EG, ANKLE/BRACHIAL INDICES, DOPPLER WAVEFORM ANALYSIS, VOLUME PLETHYSMOGRAPHY, TRANSCUTANEOUS
OXYGEN TENSION MEASUREMENT)
967.. 93923 NON-INVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, MULTIPLE LEVELS OR WITH
PROVOCATIVE FUNCTIONAL MANEUVERS, COMPLETE BILATERAL STUDY (EG, SEGMENTAL BLOOD PRESSURE
MEASUREMENTS, SEGMENTAL DOPPLER WAVEFORM ANALYSIS, SEGMENTAL VOLUME PLE
967.. 93924 NON-INVASIVE PHYSIOLOGIC STUDIES OF LOWER EXTREMITY ARTERIES, AT REST AND FOLLOWING TREADMILL
STRESS TESTING, COMPLETE BILATERAL STUDY
967.. 93965 NON-INVASIVE PHYSIOLOGIC STUDIES OF EXTREMITY VEINS, COMPLETE BILATERAL STUDY (EG, DOPPLER
WAVEFORM ANALYSIS WITH RESPONSES TO COMPRESSION AND OTHER MANEUVERS, PHLEBORHEOGRAPHY,
IMPEDANCE PLETHYSMOGRAPHY)
968.. Vascular Ultrasound X 2.37 $120.09 $79.55 $24.02
968.. 93875 NON-INVASIVE PHYSIOLOGIC STUDIES OF EXTRACRANIAL ARTERIES, COMPLETE BILATERAL STUDY (EG,
PERIORBITAL FLOW DIRECTION WITH ARTERIAL COMPRESSION, OCULAR PNEUMOPLETHYSMOGRAPHY, DOPPLER
ULTRASOUND SPECTRAL ANALYSIS)
968.. 93880 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY
968.. 93882 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; UNILATERAL OR LIMITED STUDY
968.. 93886 TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; COMPLETE STUDY
968.. 93888 TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; LIMITED STUDY
968.. 93925 DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY
968.. 93926 DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY
968.. 93930 DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY
968.. 93931 DUPLEX SCAN OF UPPER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; UNILATERAL OR LIMITED STUDY
968.. 93970 DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMPLETE
BILATERAL STUDY
968.. 93971 DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS;
UNILATERAL OR LIMITED STUDY
968.. 93975 DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR
RETROPERITONEAL ORGANS; COMPLETE STUDY
968.. 93976 DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMINAL, PELVIC, SCROTAL CONTENTS AND/OR
RETROPERITONEAL ORGANS; LIMITED STUDY
968.. 93978 DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; COMPLETE STUDY
968.. 93979 DUPLEX SCAN OF AORTA, INFERIOR VENA CAVA, ILIAC VASCULATURE, OR BYPASS GRAFTS; UNILATERAL OR
LIMITED STUDY
968.. 93980 DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; COMPLETE STUDY
968.. 93981 DUPLEX SCAN OF ARTERIAL INFLOW AND VENOUS OUTFLOW OF PENILE VESSELS; FOLLOW-UP OR LIMITED STUDY
968.. 93990 DUPLEX SCAN OF HEMODIALYSIS ACCESS (INCLUDING ARTERIAL INFLOW, BODY OF ACCESS AND VENOUS
OUTFLOW)
969.. Hyperbaric Oxygen S 2.65 $134.27 $141.70 $26.85
969.. 99183 PHYSICIAN ATTENDANCE AND SUPERVISION OF HYPERBARIC OXYGEN THERAPY, PER SESSION
971.. Level I Pulmonary Tests X 0.78 $39.52 $21.47 $7.90
971.. 94010 SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE
MEASUREMENT(S), WITH OR WITHOUT MAXIMAL VOLUNTARY VENTILATION
971.. 94060 BRONCHOSPASM EVALUATION: SPIROMETRY AS IN 94010, BEFORE AND AFTER BRONCHODILATOR (AEROSOL OR
PARENTERAL) OR EXERCISE
971.. 94200 MAXIMUM BREATHING CAPACITY, MAXIMAL VOLUNTARY VENTILATION
971.. 94250 EXPIRED GAS COLLECTION, QUANTITATIVE, SINGLE PROCEDURE (SEPARATE PROCEDURE)
971.. 94260 THORACIC GAS VOLUME
971.. 94360 DETERMINATION OF RESISTANCE TO AIRFLOW, OSCILLATORY OR PLETHYSMOGRAPHIC METHODS
971.. 94375 RESPIRATORY FLOW VOLUME LOOP
971.. 94400 BREATHING RESPONSE TO CO2 (CO2 RESPONSE CURVE)
971.. 94450 BREATHING RESPONSE TO HYPOXIA (HYPOXIA RESPONSE CURVE)
[[Page 47831]]
971.. 94762 NONINVASIVE EAR OR PULSE OXIMETRY FOR OXYGEN SATURATION; BY CONTINUOUS OVERNIGHT MONITORING
(SEPARATE PROCEDURE)
971.. 94770 CARBON DIOXIDE, EXPIRED GAS DETERMINATION BY INFRARED ANALYZER
971.. 94799 UNLISTED PULMONARY SERVICE OR PROCEDURE
972.. Level II Pulmonary Tests X 1.02 $51.68 $29.38 $10.34
972.. 94240 FUNCTIONAL RESIDUAL CAPACITY OR RESIDUAL VOLUME: HELIUM METHOD, NITROGEN OPEN CIRCUIT METHOD,
OR OTHER METHOD
972.. 94350 DETERMINATION OF MALDISTRIBUTION OF INSPIRED GAS: MULTIPLE BREATH NITROGEN WASHOUT CURVE
INCLUDING ALVEOLAR NITROGEN OR HELIUM EQUILIBRATION TIME
972.. 94370 DETERMINATION OF AIRWAY CLOSING VOLUME, SINGLE BREATH TESTS
972.. 94680 OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST AND EXERCISE, DIRECT, SIMPLE
972.. 94681 OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; INCLUDING CO2 OUTPUT, PERCENTAGE OXYGEN EXTRACTED
972.. 94690 OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; REST, INDIRECT (SEPARATE PROCEDURE)
972.. 94720 CARBON MONOXIDE DIFFUSING CAPACITY, ANY METHOD
972.. 94725 MEMBRANE DIFFUSION CAPACITY
973.. Level III Pulmonary Tests S 1.89 $95.77 $55.82 $19.15
973.. 94070 PROLONGED POSTEXPOSURE EVALUATION OF BRONCHOSPASM WITH MULTIPLE SPIROMETRIC DETERMINATIONS
AFTER ANTIGEN, COLD AIR, METHACHOLINE OR OTHER CHEMICAL AGENT, WITH SPIROMETRY AS IN 94010
973.. 94620 PULMONARY STRESS TESTING, SIMPLE OR COMPLEX
973.. 94750 PULMONARY COMPLIANCE STUDY, ANY METHOD
973.. 94772 CIRCADIAN RESPIRATORY PATTERN RECORDING (PEDIATRIC PNEUMOGRAM), 12 TO 24 HOUR CONTINUOUS
RECORDING, INFANT
973.. 95070 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH
HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS
973.. 95071 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH
ANTIGENS OR GASES, SPECIFY
976.. Pulmonary Therapy S 0.44 $22.29 $14.92 $4.46
976.. 94640 NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION
976.. 94642 AEROSOL INHALATION OF PENTAMIDINE FOR PNEUMOCYSTIS CARINII PNEUMONIA TREATMENT OR PROPHYLAXIS
976.. 94650 INTERMITTENT POSITIVE PRESSURE BREATHING (IPPB) TREATMENT, AIR OR OXYGEN, WITH OR WITHOUT
NEBULIZED MEDICATION; INITIAL DEMONSTRATION AND/OR EVALUATION
976.. 94651 INTERMITTENT POSITIVE PRESSURE BREATHING (IPPB) TREATMENT, AIR OR OXYGEN, WITH OR WITHOUT
NEBULIZED MEDICATION; SUBSEQUENT
976.. 94657 VENTILATION ASSIST AND MANAGEMENT, INITIATION OF PRESSURE OR VOLUME PRESET VENTILATORS FOR
ASSISTED OR CONTROLLED BREATHING; SUBSEQUENT DAYS
976.. 94660 CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION (CPAP), INITIATION AND MANAGEMENT
976.. 94662 CONTINUOUS NEGATIVE PRESSURE VENTILATION (CNP), INITIATION AND MANAGEMENT
976.. 94664 AEROSOL OR VAPOR INHALATIONS FOR SPUTUM MOBILIZATION, BRONCHODILATION, OR SPUTUM INDUCTION FOR
DIAGNOSTIC PURPOSES; INITIAL DEMONSTRATION AND/OR EVALUATION
976.. 94665 AEROSOL OR VAPOR INHALATIONS FOR SPUTUM MOBILIZATION, BRONCHODILATION, OR SPUTUM INDUCTION FOR
DIAGNOSTIC PURPOSES; SUBSEQUENT
977.. Allergy Tests X 0.63 $31.92 $12.66 $6.38
977.. 95004 PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE
REACTION, SPECIFY NUMBER OF TESTS
977.. 95010 PERCUTANEOUS TESTS (SCRATCH, PUNCTURE, PRICK) SEQUENTIAL AND INCREMENTAL, WITH DRUGS,
BIOLOGICALS OR VENOMS, IMMEDIATE TYPE REACTION, SPECIFY NUMBER OF TESTS
977.. 95015 INTRACUTANEOUS (INTRADERMAL) TESTS, SEQUENTIAL AND INCREMENTAL, WITH DRUGS, BIOLOGICALS, OR
VENOMS, IMMEDIATE TYPE REACTION, SPECIFY NUMBER OF TESTS
977.. 95024 INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS, IMMEDIATE TYPE REACTION, SPECIFY
NUMBER OF TESTS
977.. 95027 SKIN END POINT TITRATION
977.. 95028 INTRACUTANEOUS (INTRADERMAL) TESTS WITH ALLERGENIC EXTRACTS, DELAYED TYPE REACTION, INCLUDING
READING, SPECIFY NUMBER OF TESTS
977.. 95044 PATCH OR APPLICATION TEST(S) (SPECIFY NUMBER OF TESTS)
977.. 95052 PHOTO PATCH TEST(S) (SPECIFY NUMBER OF TESTS)
977.. 95056 PHOTO TESTS
977.. 95060 OPHTHALMIC MUCOUS MEMBRANE TESTS
977.. 95065 DIRECT NASAL MUCOUS MEMBRANE TEST
977.. 95078 PROVOCATIVE TESTING (EG, RINKEL TEST)
977.. 95180 RAPID DESENSITIZATION PROCEDURE, EACH HOUR (EG, INSULIN, PENICILLIN, HORSE SERUM)
977.. 95199 UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SERVICE OR PROCEDURE
978.. Allergy Injections X 0.31 $15.71 $3.39 $3.14
978.. 95115 PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC
EXTRACTS; SINGLE INJECTION
978.. 95117 PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY NOT INCLUDING PROVISION OF ALLERGENIC
EXTRACTS; TWO OR MORE INJECTIONS
978.. 95144 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY,
SINGLE OR MULTIPLE ANTIGENS, SINGLE DOSE VIALS (SPECIFY NUMBER OF VIALS)
978.. 95145 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY
(SPECIFY NUMBER OF DOSES); SINGLE STINGING INSECT VENOM
978.. 95146 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY
(SPECIFY NUMBER OF DOSES); TWO SINGLE STINGING INSECT VENOMS
978.. 95147 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY
(SPECIFY NUMBER OF DOSES); THREE SINGLE STINGING INSECT VENOMS
[[Page 47832]]
978.. 95148 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY
(SPECIFY NUMBER OF DOSES); FOUR SINGLE STINGING INSECT VENOMS
978.. 95165 PROFESSIONAL SERVICES FOR THE SUPERVISION AND PROVISION OF ANTIGENS FOR ALLERGEN IMMUNOTHERAPY;
SINGLE OR MULTIPLE ANTIGENS (SPECIFY NUMBER OF DOSES)
979.. Extended EEG Studies and Sleep S 10.17 $515.31 $288.83 $103.06
Studies
979.. 95805 MULTIPLE SLEEP LATENCY OR MAINTENANCE OF WAKEFULNESS TESTING, RECORDING, ANALYSIS AND
INTERPRETATION OF PHYSIOLOGICAL MEASUREMENTS OF SLEEP DURING MULTIPLE TRIALS TO ASSESS
SLEEPINESS
979.. 95806 SLEEP STUDY, SIMULTANEOUS RECORDING OF VENTILATION, RESPIRATORY EFFORT, ECG OR HEART RATE, AND
OXYGEN SATURATION, UNATTENDED BY A TECHNOLOGIST
979.. 95807 SLEEP STUDY, SIMULTANEOUS RECORDING OF VENTILATION, RESPIRATORY EFFORT, ECG OR HEART RATE, AND
OXYGEN SATURATION, ATTENDED BY A TECHNOLOGIST
979.. 95808 POLYSOMNOGRAPHY; SLEEP STAGING WITH 1-3 ADDITIONAL PARAMETERS OF SLEEP, ATTENDED BY A
TECHNOLOGIST
979.. 95810 POLYSOMNOGRAPHY; OF SLEEP, ATTENDED BY A TECHNOLOGIST SLEEP STAGING WITH 4 OR MORE ADDITIONAL
PARAMETERS OF SLEEP, ATTENDED BY A TECHNOLOGIST
979.. 95811 POLYSOMNOGRAPHY; OF SLEEP, ATTENDED BY A TECHNOLOGIST SLEEP STAGING WITH 4 OR MORE ADDITIONAL
PARAMETERS OF SLEEP, WITH INITIATION OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY OR BILEVEL
VENTILATION, ATTENDED BY A TECHNOLOGIST
979.. 95812 ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; UP TO ONE HOUR
979.. 95813 ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; GREATER THAN ONE HOUR
979.. 95827 ELECTROENCEPHALOGRAM (EEG); ALL NIGHT SLEEP ONLY
979.. 95951 MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BY CABLE OR RADIO, 16 OR MORE CHANNEL
TELEMETRY, COMBINED ELECTROENCEPHALOGRAPHIC (EEG) AND VIDEO RECORDING AND INTERPRETATION (EG,
FOR PRESURGICAL LOCALIZATION), EACH 24 HOURS
979.. 95953 MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BY COMPUTERIZED PORTABLE 16 OR MORE
CHANNEL EEG, ELECTROENCEPHALOGRAPHIC (EEG) RECORDING AND INTERPRETATION, EACH 24 HOURS
979.. 95954 PHARMACOLOGICAL OR PHYSICAL ACTIVATION REQUIRING PHYSICIAN ATTENDANCE DURING EEG RECORDING OF
ACTIVATION PHASE (EG, THIOPENTAL ACTIVATION TEST)
979.. 95956 MONITORING FOR LOCALIZATION OF CEREBRAL SEIZURE FOCUS BY CABLE OR RADIO, 16 OR MORE CHANNEL
TELEMETRY, ELECTROENCEPHALOGRAPHIC (EEG) RECORDING AND INTERPRETATION, EACH 24 HOURS
979.. 95958 WADA ACTIVATION TEST FOR HEMISPHERIC FUNCTION, INCLUDING ELECTROENCEPHALOGRAPHIC (EEG)
MONITORING
980.. Electroencephalogram S 2.15 $108.94 $57.86 $21.79
980.. 92275 ELECTRORETINOGRAPHY WITH INTERPRETATION AND REPORT
980.. 95857 TENSILON TEST FOR MYASTHENIA GRAVIS;
980.. 95867 NEEDLE ELECTROMYOGRAPHY, CRANIAL NERVE SUPPLIED MUSCLES, UNILATERAL
980.. 95869 NEEDLE ELECTROMYOGRAPHY; THORACIC PARASPINAL MUSCLES
980.. 95870 NEEDLE ELECTROMYOGRAPHY; OTHER THAN PARASPINAL (EG, ABDOMEN, THORAX)
980.. 95900 NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY, EACH NERVE, ANY/ALL SITE(S) ALONG THE
NERVE; MOTOR, WITHOUT F-WAVE STUDY
980.. 95921 TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; CARDIOVAGAL INNERVATION (PARASYMPATHETIC
FUNCTION), INCLUDING TWO OR MORE OF THE FOLLOWING: HEART RATE RESPONSE TO DEEP BREATHING WITH
RECORDED R-R INTERVAL, VALSALVA RATIO, AND 30:15 RATIO
980.. 95922 TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; VASOMOTOR ADRENERGIC INNERVATION (SYMPATHETIC
ADRENERGIC FUNCTION), INCLUDING BEAT-TO-BEAT BLOOD PRESSURE AND R-R INTERVAL CHANGES DURING
VALSALVA MANEUVER AND AT LEAST FIVE MINUTES OF PASSIVE TILT
980.. 95923 TESTING OF AUTONOMIC NERVOUS SYSTEM FUNCTION; SUDOMOTOR, INCLUDING ONE OR MORE OF THE
FOLLOWING: QUANTITATIVE SUDOMOTOR AXON REFLEX TEST (QSART), SILASTIC SWEAT IMPRINT,
THERMOREGULATORY SWEAT TEST, AND CHANGES IN SYMPATHETIC SKIN POTENTIAL
980.. 95926 SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR
SKIN SITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM; IN LOWER LIMBS
980.. 95927 SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR
SKIN SITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM; IN THE TRUNK OR HEAD
980.. 95930 VISUAL EVOKED POTENTIAL (VEP) TESTING CENTRAL NERVOUS SYSTEM, CHECKERBOARD OR FLASH
980.. 95933 ORBICULARIS OCULI (BLINK) REFLEX, BY ELECTRODIAGNOSTIC TESTING
980.. 95934 H-REFLEX, AMPLITUDE AND LATENCY STUDY; RECORD GASTROCNEMIUS/SOLEUS MUSCLE
980.. 95936 H-REFLEX, AMPLITUDE AND LATENCY STUDY; RECORD MUSCLE OTHER THAN GASTROCNEMIUS/SOLEUS MUSCLE
980.. 95937 NEUROMUSCULAR JUNCTION TESTING (REPETITIVE STIMULATION, PAIRED STIMULI), EACH NERVE, ANY ONE
METHOD
980.. 95950 MONITORING FOR IDENTIFICATION AND LATERALIZATION OF CEREBRAL SEIZURE FOCUS,
ELECTROENCEPHALOGRAPHIC (EG, 8 CHANNEL EEG) RECORDING AND INTERPRETATION, EACH 24 HOURS
981.. Level I Nerve and Muscle Tests X 1.46 $73.98 $41.81 $14.80
981.. 92585 AUDITORY EVOKED POTENTIALS FOR EVOKED RESPONSE AUDIOMETRY AND/OR TESTING OF THE CENTRAL NERVOUS
SYSTEM
981.. 95858 TENSILON TEST FOR MYASTHENIA GRAVIS; WITH ELECTROMYOGRAPHIC RECORDING
981.. 95860 NEEDLE ELECTROMYOGRAPHY, ONE EXTREMITY WITH OR WITHOUT RELATED PARASPINAL AREAS
981.. 95861 NEEDLE ELECTROMYOGRAPHY, TWO EXTREMITIES WITH OR WITHOUT RELATED PARASPINAL AREAS
981.. 95863 NEEDLE ELECTROMYOGRAPHY, THREE EXTREMITIES WITH OR WITHOUT RELATED PARASPINAL AREAS
981.. 95864 NEEDLE ELECTROMYOGRAPHY, FOUR EXTREMITIES WITH OR WITHOUT RELATED PARASPINAL AREAS
981.. 95868 NEEDLE ELECTROMYOGRAPHY, CRANIAL NERVE SUPPLIED MUSCLES, BILATERAL
981.. 95872 NEEDLE ELECTROMYOGRAPHY USING SINGLE FIBER ELECTRODE, WITH QUANTITATIVE MEASUREMENT OF JITTER,
BLOCKING AND/OR FIBER DENSITY, ANY/ALL SITES OF EACH MUSCLE STUDIED
981.. 95875 ISCHEMIC LIMB EXERCISE WITH NEEDLE ELECTROMYOGRAPHY, WITH LACTIC ACID DETERMINATION
981.. 95903 NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY, EACH NERVE, ANY/ALL SITE(S) ALONG THE
NERVE; MOTOR, WITH F-WAVE STUDY
981.. 95904 NERVE CONDUCTION, AMPLITUDE AND LATENCY/VELOCITY STUDY, EACH NERVE, ANY/ALL SITE(S) ALONG THE
NERVE; SENSORY
981.. 95920 INTRAOPERATIVE NEUROPHYSIOLOGY TESTING, PER HOUR
[[Page 47833]]
981.. 95925 SHORT-LATENCY SOMATOSENSORY EVOKED POTENTIAL STUDY, STIMULATION OF ANY/ALL PERIPHERAL NERVES OR
SKIN SITES, RECORDING FROM THE CENTRAL NERVOUS SYSTEM; IN UPPER LIMBS
982.. Level II Nerve and Muscle X 1.39 $70.43 $38.87 $14.09
Tests
982.. 92585 Auditory evoked potential
982.. 95858 Tensilon test & myogram
982.. 95860 Muscle test, one limb
982.. 95861 Muscle test, two limbs
982.. 95863 Muscle test, 3 limbs
982.. 95864 Muscle test, 4 limbs
982.. 95868 Muscle test, head or neck
982.. 95872 Muscle test, one fiber
982.. 95875 Limb exercise test
982.. 95925 Somatosensory testing
987.. Subcutaneous or Intramuscular S .65 $32.94 $13.33 $6.59
Chemotherapy
987.. 96400 CHEMOTHERAPY ADMINISTRATION, SUBCUTANEOUS OR INTRAMUSCULAR, WITH OR WITHOUT LOCAL ANESTHESIA
987.. 96405 CHEMOTHERAPY ADMINISTRATION, INTRALESIONAL; UP TO AND INCLUDING 7 LESIONS
987.. 96406 CHEMOTHERAPY ADMINISTRATION, INTRALESIONAL; MORE THAN 7 LESIONS
987.. 96549 UNLISTED CHEMOTHERAPY PROCEDURE
987.. Q0083 Chemo other than infusion
988.. Chemotherapy except by S 4.15 $210.28 $97.52 $42.06
Extended Infusion
988.. 96408 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; PUSH TECHNIQUE
988.. 96410 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; INFUSION TECHNIQUE, UP TO ONE HOUR
988.. 96412 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; INFUSION TECHNIQUE, ONE TO 8 HOURS, EACH ADDITIONAL
HOUR
988.. 96420 CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; PUSH TECHNIQUE
988.. 96422 CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; INFUSION TECHNIQUE, UP TO ONE HOUR
988.. 96423 CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; INFUSION TECHNIQUE, ONE TO 8 HOURS, EACH
ADDITIONAL HOUR
989.. Chemotherapy by Extended S 1.72 $87.15 $40.68 $17.43
Infusion
989.. 96414 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS; INFUSION TECHNIQUE, INITIATION OF PROLONGED INFUSION
(MORE THAN 8 HOURS), REQUIRING THE USE OF A PORTABLE OR IMPLANTABLE PUMP
989.. 96425 CHEMOTHERAPY ADMINISTRATION, INTRA-ARTERIAL; INFUSION TECHNIQUE, INITIATION OF PROLONGED
INFUSION (MORE THAN 8 HOURS), REQUIRING THE USE OF A PORTABLE OR IMPLANTABLE PUMP
989.. 96440 CHEMOTHERAPY ADMINISTRATION INTO PLEURAL CAVITY, REQUIRING AND INCLUDING THORACENTESIS
989.. 96445 CHEMOTHERAPY ADMINISTRATION INTO PERITONEAL CAVITY, REQUIRING AND INCLUDING PERITONEOCENTESIS
989.. 96450 CHEMOTHERAPY ADMINISTRATION, INTO CNS (EG, INTRATHECAL), REQUIRING AND INCLUDING LUMBAR
PUNCTURE
989.. 96542 CHEMOTHERAPY INJECTION, SUBARACHNOID OR INTRAVENTRICULAR VIA SUBCUTANEOUS RESERVOIR, SINGLE OR
MULTIPLE AGENTS
989.. Q0084 Chemo, infusion only
989.. Q0085 Chemo, infusion and other technique
990.. Photochemotherapy S .43 $21.79 $8.14 $4.36
990.. 96900 ACTINOTHERAPY (ULTRAVIOLET LIGHT)
990.. 96910 PHOTOCHEMOTHERAPY; TAR AND ULTRAVIOLET B (GOECKERMAN TREATMENT) OR PETROLATUM AND ULTRAVIOLET B
990.. 96912 PHOTOCHEMOTHERAPY; PSORALENS AND ULTRAVIOLET A (PUVA)
990.. 96913 PHOTOCHEMOTHERAPY (GOECKERMAN AND/OR PUVA) FOR SEVERE PHOTORESPONSIVE DERMATOSES REQUIRING AT
LEAST FOUR TO EIGHT HOURS OF CARE UNDER DIRECT SUPERVISION OF THE PHYSICIAN (INCLUDES
APPLICATION OF MEDICATION AND DRESSINGS)
990.. 96999 UNLISTED SPECIAL DERMATOLOGICAL SERVICE OR PROCEDURE
997.. Manipulation Therapy S .69 $34.96 $7.23 $6.99
997.. 97250 MYOFASCIAL RELEASE/SOFT TISSUE MOBILIZATION, ONE OR MORE REGIONS
997.. 97260 MANIPULATION (CERVICAL, THORACIC, LUMBOSACRAL, SACROILIAC, HAND, WRIST) (SEPARATE PROCEDURE),
PERFORMED BY PHYSICIAN; ONE AREA
997.. 97261 MANIPULATION (CERVICAL, THORACIC, LUMBOSACRAL, SACROILIAC, HAND, WRIST) (SEPARATE PROCEDURE),
PERFORMED BY PHYSICIAN; EACH ADDITIONAL AREA
997.. 98925 OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); ONE TO TWO BODY REGIONS INVOLVED
997.. 98926 OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); THREE TO FOUR BODY REGIONS INVOLVED
997.. 98927 OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); FIVE TO SIX BODY REGIONS INVOLVED
997.. 98928 OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); SEVEN TO EIGHT BODY REGIONS INVOLVED
997.. 98929 OSTEOPATHIC MANIPULATIVE TREATMENT (OMT); NINE TO TEN BODY REGIONS INVOLVED
997.. 98940 CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, ONE TO TWO REGIONS
997.. 98941 CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, THREE TO FOUR REGIONS
997.. 98942 CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, FIVE REGIONS
999.. Therapeutic Phlebotomy X .43 $21.79 $10.85 $4.36
999.. 99195 PHLEBOTOMY, THERAPEUTIC (SEPARATE PROCEDURE)
----------------------------------------------------------------------------------------------------------------
[[Page 47834]]
Addendum D.--Summary of Medical APCs
----------------------------------------------------------------------------------------------------------------
CPT \1\
APC HCPCS Description
--------------------------------------------------------------------------\2\-----------------------------------
911 Low Level Clinic Visits
99201 Office/outpatient visit, new
99202 Office/outpatient visit, new
99211 Office/outpatient visit, est
99212 Office/outpatient visit, est
99241 Office consultation
99242 Office consultation
99271 Confirmatory consultation
99272 Confirmatory consultation
G0101 Cancer Screening Exam, Women
913 Mid Level Clinic Visits
92002 Eye exam, new patient
92012 Eye exam established pt
99203 Office/outpatient visit, new
99213 Office/outpatient visit, est
99243 Office consultation
99273 Confirmatory consultation
915 High Level Clinic Visits
92004 Eye exam, new patient
92014 Eye exam & treatment
92506 Speech & hearing evaluation
99204 Office/outpatient visit, new
99205 Office/outpatient visit, new
99214 Office/outpatient visit, est
99215 Office/outpatient visit, est
99244 Office consultation
99245 Office consultation
99274 Confirmatory consultation
99275 Confirmatory consultation
951 Low Level Emergency Visits
99281 Emergency dept visit
99282 Emergency dept visit
953 Mid Level Emergency Visits
99283 Emergency dept visit
955 High Level Emergency Visits
99284 Emergency dept visit
99285 Emergency dept visit
----------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1997 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved.
Note: Medical visit APCs are created by combining level of visit from Addendum D with reason for visit from
Addendum E. Thus a midlevel clinic visit (99203) for an eye disorder groups to APC 91368.
Addendum E.--Major Diagnostic Categories (MDCs)
------------------------------------------------------------------------
MDC Description
------------------------------------------------------------------------
11... Well care and administrative
18... Skin and breast diseases
24... Musculoskeletal diseases
31... Ear, nose, mouth and throat diseases
33... Respiratory system diseases
36... Cardiovascular system diseases
41... Digestive system diseases
53... Kidney, urinary tract and male genital diseases
56... Female genital system diseases
57... Pregnancy and Neonatal Care
63... Nervous System Diseases
68... Eye Diseases
72... Trauma and poisoning
78... Major signs, symptoms and findings
82... Endocrine, nutritional and metabolic diseases
86... Immunologic and hematologic diseases
88... Malignancy
91... Psychiatric Disorders
97... Infectious disease
99... Unknown cause of mortality
------------------------------------------------------------------------
Addendum F.--ICD-9 Codes With Major Diagnostic Categories (MDCs) for
Payment of Medical Visits Under the Hospital Outpatient PPS
------------------------------------------------------------------------
ICD-9 ICD-9 Description MDC
------------------------------------------------------------------------
0010.... CHOLERA D/T VIB CHOLERAE............................ 41
0011.... CHOLERA D/T VIB EL TOR.............................. 41
0019.... CHOLERA NOS......................................... 41
[[Page 47835]]
0020.... TYPHOID FEVER....................................... 97
0021.... PARATYPHOID FEVER A................................. 97
0022.... PARATYPHOID FEVER B................................. 97
0023.... PARATYPHOID FEVER C................................. 97
0029.... PARATYPHOID FEVER NOS............................... 97
0030.... SALMONELLA ENTERITIS................................ 41
0031.... SALMONELLA SEPTICEMIA............................... 97
00320... LOCAL SALMONELLA INF NOS............................ 97
00321... SALMONELLA MENINGITIS............................... 97
00322... SALMONELLA PNEUMONIA................................ 33
00323... SALMONELLA ARTHRITIS................................ 24
00324... SALMONELLA OSTEOMYELITIS............................ 24
00329... LOCAL SALMONELLA INF NEC............................ 97
0038.... SALMONELLA INFECTION NEC............................ 97
0039.... SALMONELLA INFECTION NOS............................ 97
0040.... SHIGELLA DYSENTERIAE................................ 41
0041.... SHIGELLA FLEXNERI................................... 41
0042.... SHIGELLA BOYDII..................................... 41
0043.... SHIGELLA SONNEI..................................... 41
0048.... SHIGELLA INFECTION NEC.............................. 41
0049.... SHIGELLOSIS NOS..................................... 41
0050.... STAPH FOOD POISONING................................ 41
0051.... BOTULISM............................................ 97
0052.... FOOD POIS D/T C. PERFRIN............................ 41
0053.... FOOD POIS: CLOSTRID NEC............................. 41
0054.... FOOD POIS: V. PARAHAEM.............................. 41
00581... FOOD POISN D/T V. VULNIF............................ 41
00589... BACT FOOD POISONING NEC............................. 41
0059.... FOOD POISONING NOS.................................. 41
0060.... AC AMEBIASIS W/O ABSCESS............................ 41
0061.... CHR AMEBIASIS W/O ABSCES............................ 41
0062.... AMEBIC NONDYSENT COLITIS............................ 41
0063.... AMEBIC LIVER ABSCESS................................ 41
0064.... AMEBIC LUNG ABSCESS................................. 33
0065.... AMEBIC BRAIN ABSCESS................................ 97
0066.... AMEBIC SKIN ULCERATION.............................. 18
0068.... AMEBIC INFECTION NEC................................ 97
0069.... AMEBIASIS NOS....................................... 97
0070.... BALANTIDIASIS....................................... 41
0071.... GIARDIASIS.......................................... 41
0072.... COCCIDIOSIS......................................... 41
0073.... INTEST TRICHOMONIASIS............................... 41
0078.... PROTOZOAL INTEST DIS NEC............................ 41
0079.... PROTOZOAL INTEST DIS NOS............................ 41
00800... INTEST INFEC E COLI NOS............................. 41
00801... INT INF E COLI ENTRPATH............................. 41
00802... INT INF E COLI ENTRTOXGN............................ 41
00803... INT INF E COLI ENTRNVSV............................. 41
00804... INT INF E COLI ENTRHMRG............................. 41
00809... INT INF E COLI SPCF NEC............................. 41
0081.... ARIZONA ENTERITIS................................... 41
0082.... AEROBACTER ENTERITIS................................ 41
0083.... PROTEUS ENTERITIS................................... 41
00841... STAPHYLOCOCC ENTERITIS.............................. 41
00842... PSEUDOMONAS ENTERITIS............................... 41
00843... INT INFEC CAMPYLOBACTER............................. 41
00844... INT INF YRSNIA ENTRCLTCA............................ 41
00845... INT INF CLSTRDIUM DFCILE............................ 41
00846... INTES INFEC OTH ANEROBES............................ 41
00847... INT INF OTH GRM NEG BCTR............................ 41
00849... BACTERIAL ENTERITIS NEC............................. 41
0085.... BACTERIAL ENTERITIS NOS............................. 41
00861... INTES INFEC ROTAVIRUS............................... 41
00862... INTES INFEC ADENOVIRUS.............................. 41
00863... INT INF NORWALK VIRUS............................... 41
00864... INT INF OTH SML RND VRUS............................ 41
00865... INTES INFEC CALCIVIRUS.............................. 41
00866... INTES INFEC ASTROVIRUS.............................. 41
00867... INT INF ENTEROVIRUS NEC............................. 41
00869... OTHER VIRAL INTES INFEC............................. 41
0088.... VIRAL ENTERITIS NOS................................. 41
0090.... INFECTIOUS ENTERITIS NOS............................ 41
0091.... ENTERITIS OF INFECT ORIG............................ 41
0092.... INFECTIOUS DIARRHEA NOS............................. 41
0093.... DIARRHEA OF INFECT ORIG............................. 41
01000... PRIM TB COMPLEX-UNSPEC.............................. 33
[[Page 47836]]
01001... PRIM TB COMPLEX-NO EXAM............................. 33
01002... PRIM TB COMPLEX-EXM UNKN............................ 33
01003... PRIM TB COMPLEX-MICRO DX............................ 33
01004... PRIM TB COMPLEX-CULT DX............................. 33
01005... PRIM TB COMPLEX-HISTO DX............................ 33
01006... PRIM TB COMPLEX-OTH TEST............................ 33
01010... PRIM TB PLEURISY-UNSPEC............................. 33
01011... PRIM TB PLEURISY-NO EXAM............................ 33
01012... PRIM TB PLEUR-EXAM UNKN............................. 33
01013... PRIM TB PLEURIS-MICRO DX............................ 33
01014... PRIM TB PLEURISY-CULT DX............................ 33
01015... PRIM TB PLEURIS-HISTO DX............................ 33
01016... PRIM TB PLEURIS-OTH TEST............................ 33
01080... PRIM PROG TB NEC-UNSPEC............................. 33
01081... PRIM PROG TB NEC-NO EXAM............................ 33
01082... PRIM PR TB NEC-EXAM UNKN............................ 33
01083... PRIM PRG TB NEC-MICRO DX............................ 33
01084... PRIM PROG TB NEC-CULT DX............................ 33
01085... PRIM PRG TB NEC-HISTO DX............................ 33
01086... PRIM PRG TB NEC-OTH TEST............................ 33
01090... PRIMARY TB NOS-UNSPEC............................... 33
01091... PRIMARY TB NOS-NO EXAM.............................. 33
01092... PRIMARY TB NOS-EXAM UNKN............................ 33
01093... PRIMARY TB NOS-MICRO DX............................. 33
01094... PRIMARY TB NOS-CULT DX.............................. 33
01095... PRIMARY TB NOS-HISTO DX............................. 33
01096... PRIMARY TB NOS-OTH TEST............................. 33
01100... TB LUNG INFILTR-UNSPEC.............................. 33
01101... TB LUNG INFILTR-NO EXAM............................. 33
01102... TB LUNG INFILTR-EXM UNKN............................ 33
01103... TB LUNG INFILTR-MICRO DX............................ 33
01104... TB LUNG INFILTR-CULT DX............................. 33
01105... TB LUNG INFILTR-HISTO DX............................ 33
01106... TB LUNG INFILTR-OTH TEST............................ 33
01110... TB LUNG NODULAR-UNSPEC.............................. 33
01111... TB LUNG NODULAR-NO EXAM............................. 33
01112... TB LUNG NODUL-EXAM UNKN............................. 33
01113... TB LUNG NODULAR-MICRO DX............................ 33
01114... TB LUNG NODULAR-CULT DX............................. 33
01115... TB LUNG NODULAR-HISTO DX............................ 33
01116... TB LUNG NODULAR-OTH TEST............................ 33
01120... TB LUNG W CAVITY-UNSPEC............................. 33
01121... TB LUNG W CAVITY-NO EXAM............................ 33
01122... TB LUNG CAVITY-EXAM UNKN............................ 33
01123... TB LUNG W CAVIT-MICRO DX............................ 33
01124... TB LUNG W CAVITY-CULT DX............................ 33
01125... TB LUNG W CAVIT-HISTO DX............................ 33
01126... TB LUNG W CAVIT-OTH TEST............................ 33
01130... TB OF BRONCHUS-UNSPEC............................... 33
01131... TB OF BRONCHUS-NO EXAM.............................. 33
01132... TB OF BRONCHUS-EXAM UNKN............................ 33
01133... TB OF BRONCHUS-MICRO DX............................. 33
01134... TB OF BRONCHUS-CULT DX.............................. 33
01135... TB OF BRONCHUS-HISTO DX............................. 33
01136... TB OF BRONCHUS-OTH TEST............................. 33
01140... TB LUNG FIBROSIS-UNSPEC............................. 33
01141... TB LUNG FIBROSIS-NO EXAM............................ 33
01142... TB LUNG FIBROS-EXAM UNKN............................ 33
01143... TB LUNG FIBROS-MICRO DX............................. 33
01144... TB LUNG FIBROSIS-CULT DX............................ 33
01145... TB LUNG FIBROS-HISTO DX............................. 33
01146... TB LUNG FIBROS-OTH TEST............................. 33
01150... TB BRONCHIECTASIS-UNSPEC............................ 33
01151... TB BRONCHIECT-NO EXAM............................... 33
01152... TB BRONCHIECT-EXAM UNKN............................. 33
01153... TB BRONCHIECT-MICRO DX.............................. 33
01154... TB BRONCHIECT-CULT DX............................... 33
01155... TB BRONCHIECT-HISTO DX.............................. 33
01156... TB BRONCHIECT-OTH TEST.............................. 33
01160... TB PNEUMONIA-UNSPEC................................. 33
01161... TB PNEUMONIA-NO EXAM................................ 33
01162... TB PNEUMONIA-EXAM UNKN.............................. 33
01163... TB PNEUMONIA-MICRO DX............................... 33
01164... TB PNEUMONIA-CULT DX................................ 33
01165... TB PNEUMONIA-HISTO DX............................... 33
01166... TB PNEUMONIA-OTH TEST............................... 33
[[Page 47837]]
01170... TB PNEUMOTHORAX-UNSPEC.............................. 33
01171... TB PNEUMOTHORAX-NO EXAM............................. 33
01172... TB PNEUMOTHORX-EXAM UNKN............................ 33
01173... TB PNEUMOTHORAX-MICRO DX............................ 33
01174... TB PNEUMOTHORAX-CULT DX............................. 33
01175... TB PNEUMOTHORAX-HISTO DX............................ 33
01176... TB PNEUMOTHORAX-OTH TEST............................ 33
01180... PULMONARY TB NEC-UNSPEC............................. 33
01181... PULMONARY TB NEC-NO EXAM............................ 33
01182... PULMON TB NEC-EXAM UNKN............................. 33
01183... PULMON TB NEC-MICRO DX.............................. 33
01184... PULMON TB NEC-CULT DX............................... 33
01185... PULMON TB NEC-HISTO DX.............................. 33
01186... PULMON TB NEC-OTH TEST.............................. 33
01190... PULMONARY TB NOS-UNSPEC............................. 33
01191... PULMONARY TB NOS-NO EXAM............................ 33
01192... PULMON TB NOS-EXAM UNKN............................. 33
01193... PULMON TB NOS-MICRO DX.............................. 33
01194... PULMON TB NOS-CULT DX............................... 33
01195... PULMON TB NOS-HISTO DX.............................. 33
01196... PULMON TB NOS-OTH TEST.............................. 33
01200... TB PLEURISY-UNSPEC.................................. 33
01201... TB PLEURISY-NO EXAM................................. 33
01202... TB PLEURISY-EXAM UNKN............................... 33
01203... TB PLEURISY-MICRO DX................................ 33
01204... TB PLEURISY-CULT DX................................. 33
01205... TB PLEURISY-HISTOLOG DX............................. 33
01206... TB PLEURISY-OTH TEST................................ 33
01210... TB THORACIC NODES-UNSPEC............................ 33
01211... TB THORAX NODE-NO EXAM.............................. 33
01212... TB THORAX NODE-EXAM UNKN............................ 33
01213... TB THORAX NODE-MICRO DX............................. 33
01214... TB THORAX NODE-CULT DX.............................. 33
01215... TB THORAX NODE-HISTO DX............................. 33
01216... TB THORAX NODE-OTH TEST............................. 33
01220... ISOL TRACHEAL TB-UNSPEC............................. 31
01221... ISOL TRACHEAL TB-NO EXAM............................ 31
01222... ISOL TRACH TB-EXAM UNKN............................. 31
01223... ISOLAT TRACH TB-MICRO DX............................ 31
01224... ISOL TRACHEAL TB-CULT DX............................ 31
01225... ISOLAT TRACH TB-HISTO DX............................ 31
01226... ISOLAT TRACH TB-OTH TEST............................ 31
01230... TB LARYNGITIS-UNSPEC................................ 31
01231... TB LARYNGITIS-NO EXAM............................... 31
01232... TB LARYNGITIS-EXAM UNKN............................. 31
01233... TB LARYNGITIS-MICRO DX.............................. 31
01234... TB LARYNGITIS-CULT DX............................... 31
01235... TB LARYNGITIS-HISTO DX.............................. 31
01236... TB LARYNGITIS-OTH TEST.............................. 31
01280... RESP TB NEC-UNSPEC.................................. 33
01281... RESP TB NEC-NO EXAM................................. 33
01282... RESP TB NEC-EXAM UNKN............................... 33
01283... RESP TB NEC-MICRO DX................................ 33
01284... RESP TB NEC-CULT DX................................. 33
01285... RESP TB NEC-HISTO DX................................ 33
01286... RESP TB NEC-OTH TEST................................ 33
01300... TB MENINGITIS-UNSPEC................................ 63
01301... TB MENINGITIS-NO EXAM............................... 63
01302... TB MENINGITIS-EXAM UNKN............................. 63
01303... TB MENINGITIS-MICRO DX.............................. 63
01304... TB MENINGITIS-CULT DX............................... 63
01305... TB MENINGITIS-HISTO DX.............................. 63
01306... TB MENINGITIS-OTH TEST.............................. 63
01310... TUBRCLMA MENINGES-UNSPEC............................ 63
01311... TUBRCLMA MENING-NO EXAM............................. 63
01312... TUBRCLMA MENIN-EXAM UNKN............................ 63
01313... TUBRCLMA MENING-MICRO DX............................ 63
01314... TUBRCLMA MENING-CULT DX............................. 63
01315... TUBRCLMA MENING-HISTO DX............................ 63
01316... TUBRCLMA MENING-OTH TEST............................ 63
01320... TUBERCULOMA BRAIN-UNSPEC............................ 63
01321... TUBRCLOMA BRAIN-NO EXAM............................. 63
01322... TUBRCLMA BRAIN-EXAM UNKN............................ 63
01323... TUBRCLOMA BRAIN-MICRO DX............................ 63
01324... TUBRCLOMA BRAIN-CULT DX............................. 63
01325... TUBRCLOMA BRAIN-HISTO DX............................ 63
[[Page 47838]]
01326... TUBRCLOMA BRAIN-OTH TEST............................ 63
01330... TB BRAIN ABSCESS-UNSPEC............................. 63
01331... TB BRAIN ABSCESS-NO EXAM............................ 63
01332... TB BRAIN ABSC-EXAM UNKN............................. 63
01333... TB BRAIN ABSC-MICRO DX.............................. 63
01334... TB BRAIN ABSCESS-CULT DX............................ 63
01335... TB BRAIN ABSC-HISTO DX.............................. 63
01336... TB BRAIN ABSC-OTH TEST.............................. 63
01340... TUBRCLMA SP CORD-UNSPEC............................. 63
01341... TUBRCLMA SP CORD-NO EXAM............................ 63
01342... TUBRCLMA SP CD-EXAM UNKN............................ 63
01343... TUBRCLMA SP CRD-MICRO DX............................ 63
01344... TUBRCLMA SP CORD-CULT DX............................ 63
01345... TUBRCLMA SP CRD-HISTO DX............................ 63
01346... TUBRCLMA SP CRD-OTH TEST............................ 63
01350... TB SP CRD ABSCESS-UNSPEC............................ 63
01351... TB SP CRD ABSC-NO EXAM.............................. 63
01352... TB SP CRD ABSC-EXAM UNKN............................ 63
01353... TB SP CRD ABSC-MICRO DX............................. 63
01354... TB SP CRD ABSC-CULT DX.............................. 63
01355... TB SP CRD ABSC-HISTO DX............................. 63
01356... TB SP CRD ABSC-OTH TEST............................. 63
01360... TB ENCEPHALITIS-UNSPEC.............................. 63
01361... TB ENCEPHALITIS-NO EXAM............................. 63
01362... TB ENCEPHALIT-EXAM UNKN............................. 63
01363... TB ENCEPHALITIS-MICRO DX............................ 63
01364... TB ENCEPHALITIS-CULT DX............................. 63
01365... TB ENCEPHALITIS-HISTO DX............................ 63
01366... TB ENCEPHALITIS-OTH TEST............................ 63
01380... CNS TB NEC-UNSPEC................................... 63
01381... CNS TB NEC-NO EXAM.................................. 63
01382... CNS TB NEC-EXAM UNKN................................ 63
01383... CNS TB NEC-MICRO DX................................. 63
01384... CNS TB NEC-CULT DX.................................. 63
01385... CNS TB NEC-HISTO DX................................. 63
01386... CNS TB NEC-OTH TEST................................. 63
01390... CNS TB NOS-UNSPEC................................... 63
01391... CNS TB NOS-NO EXAM.................................. 63
01392... CNS TB NOS-EXAM UNKN................................ 63
01393... CNS TB NOS-MICRO DX................................. 63
01394... CNS TB NOS-CULT DX.................................. 63
01395... CNS TB NOS-HISTO DX................................. 63
01396... CNS TB NOS-OTH TEST................................. 63
01400... TB PERITONITIS-UNSPEC............................... 41
01401... TB PERITONITIS-NO EXAM.............................. 41
01402... TB PERITONITIS-EXAM UNKN............................ 41
01403... TB PERITONITIS-MICRO DX............................. 41
01404... TB PERITONITIS-CULT DX.............................. 41
01405... TB PERITONITIS-HISTO DX............................. 41
01406... TB PERITONITIS-OTH TEST............................. 41
01480... INTESTINAL TB NEC-UNSPEC............................ 41
01481... INTESTIN TB NEC-NO EXAM............................. 41
01482... INTEST TB NEC-EXAM UNKN............................. 41
01483... INTESTIN TB NEC-MICRO DX............................ 41
01484... INTESTIN TB NEC-CULT DX............................. 41
01485... INTESTIN TB NEC-HISTO DX............................ 41
01486... INTESTIN TB NEC-OTH TEST............................ 41
01500... TB OF VERTEBRA-UNSPEC............................... 24
01501... TB OF VERTEBRA-NO EXAM.............................. 24
01502... TB OF VERTEBRA-EXAM UNKN............................ 24
01503... TB OF VERTEBRA-MICRO DX............................. 24
01504... TB OF VERTEBRA-CULT DX.............................. 24
01505... TB OF VERTEBRA-HISTO DX............................. 24
01506... TB OF VERTEBRA-OTH TEST............................. 24
01510... TB OF HIP-UNSPEC.................................... 24
01511... TB OF HIP-NO EXAM................................... 24
01512... TB OF HIP-EXAM UNKN................................. 24
01513... TB OF HIP-MICRO DX.................................. 24
01514... TB OF HIP-CULT DX................................... 24
01515... TB OF HIP-HISTO DX.................................. 24
01516... TB OF HIP-OTH TEST.................................. 24
01520... TB OF KNEE-UNSPEC................................... 24
01521... TB OF KNEE-NO EXAM.................................. 24
01522... TB OF KNEE-EXAM UNKN................................ 24
01523... TB OF KNEE-MICRO DX................................. 24
01524... TB OF KNEE-CULT DX.................................. 24
[[Page 47839]]
01525... TB OF KNEE-HISTO DX................................. 24
01526... TB OF KNEE-OTH TEST................................. 24
01550... TB OF LIMB BONES-UNSPEC............................. 24
01551... TB LIMB BONES-NO EXAM............................... 24
01552... TB LIMB BONES-EXAM UNKN............................. 24
01553... TB LIMB BONES-MICRO DX.............................. 24
01554... TB LIMB BONES-CULT DX............................... 24
01555... TB LIMB BONES-HISTO DX.............................. 24
01556... TB LIMB BONES-OTH TEST.............................. 24
01560... TB OF MASTOID-UNSPEC................................ 31
01561... TB OF MASTOID-NO EXAM............................... 31
01562... TB OF MASTOID-EXAM UNKN............................. 31
01563... TB OF MASTOID-MICRO DX.............................. 31
01564... TB OF MASTOID-CULT DX............................... 31
01565... TB OF MASTOID-HISTO DX.............................. 31
01566... TB OF MASTOID-OTH TEST.............................. 31
01570... TB OF BONE NEC-UNSPEC............................... 24
01571... TB OF BONE NEC-NO EXAM.............................. 24
01572... TB OF BONE NEC-EXAM UNKN............................ 24
01573... TB OF BONE NEC-MICRO DX............................. 24
01574... TB OF BONE NEC-CULT DX.............................. 24
01575... TB OF BONE NEC-HISTO DX............................. 24
01576... TB OF BONE NEC-OTH TEST............................. 24
01580... TB OF JOINT NEC-UNSPEC.............................. 24
01581... TB OF JOINT NEC-NO EXAM............................. 24
01582... TB JOINT NEC-EXAM UNKN.............................. 24
01583... TB OF JOINT NEC-MICRO DX............................ 24
01584... TB OF JOINT NEC-CULT DX............................. 24
01585... TB OF JOINT NEC-HISTO DX............................ 24
01586... TB OF JOINT NEC-OTH TEST............................ 24
01590... TB BONE/JOINT NOS-UNSPEC............................ 24
01591... TB BONE/JT NOS-NO EXAM.............................. 24
01592... TB BONE/JT NOS-EXAM UNKN............................ 24
01593... TB BONE/JT NOS-MICRO DX............................. 24
01594... TB BONE/JT NOS-CULT DX.............................. 24
01595... TB BONE/JT NOS-HISTO DX............................. 24
01596... TB BONE/JT NOS-OTH TEST............................. 24
01600... TB OF KIDNEY-UNSPEC................................. 53
01601... TB OF KIDNEY-NO EXAM................................ 53
01602... TB OF KIDNEY-EXAM UNKN.............................. 53
01603... TB OF KIDNEY-MICRO DX............................... 53
01604... TB OF KIDNEY-CULT DX................................ 53
01605... TB OF KIDNEY-HISTO DX............................... 53
01606... TB OF KIDNEY-OTH TEST............................... 53
01610... TB OF BLADDER-UNSPEC................................ 53
01611... TB OF BLADDER-NO EXAM............................... 53
01612... TB OF BLADDER-EXAM UNKN............................. 53
01613... TB OF BLADDER-MICRO DX.............................. 53
01614... TB OF BLADDER-CULT DX............................... 53
01615... TB OF BLADDER-HISTO DX.............................. 53
01616... TB OF BLADDER-OTH TEST.............................. 53
01620... TB OF URETER-UNSPEC................................. 53
01621... TB OF URETER-NO EXAM................................ 53
01622... TB OF URETER-EXAM UNKN.............................. 53
01623... TB OF URETER-MICRO DX............................... 53
01624... TB OF URETER-CULT DX................................ 53
01625... TB OF URETER-HISTO DX............................... 53
01626... TB OF URETER-OTH TEST............................... 53
01630... TB URINARY NEC-UNSPEC............................... 53
01631... TB URINARY NEC-NO EXAM.............................. 53
01632... TB URINARY NEC-EXAM UNKN............................ 53
01633... TB URINARY NEC-MICRO DX............................. 53
01634... TB URINARY NEC-CULT DX.............................. 53
01635... TB URINARY NEC-HISTO DX............................. 53
01636... TB URINARY NEC-OTH TEST............................. 53
01640... TB EPIDIDYMIS-UNSPEC................................ 53
01641... TB EPIDIDYMIS-NO EXAM............................... 53
01642... TB EPIDIDYMIS-EXAM UNKN............................. 53
01643... TB EPIDIDYMIS-MICRO DX.............................. 53
01644... TB EPIDIDYMIS-CULT DX............................... 53
01645... TB EPIDIDYMIS-HISTO DX.............................. 53
01646... TB EPIDIDYMIS-OTH TEST.............................. 53
01650... TB MALE GENIT NEC-UNSPEC............................ 53
01651... TB MALE GEN NEC-NO EXAM............................. 53
01652... TB MALE GEN NEC-EX UNKN............................. 53
01653... TB MALE GEN NEC-MICRO DX............................ 53
[[Page 47840]]
01654... TB MALE GEN NEC-CULT DX............................. 53
01655... TB MALE GEN NEC-HISTO DX............................ 53
01656... TB MALE GEN NEC-OTH TEST............................ 53
01660... TB OVARY & TUBE-UNSPEC.............................. 56
01661... TB OVARY & TUBE-NO EXAM............................. 56
01662... TB OVARY/TUBE-EXAM UNKN............................. 56
01663... TB OVARY & TUBE-MICRO DX............................ 56
01664... TB OVARY & TUBE-CULT DX............................. 56
01665... TB OVARY & TUBE-HISTO DX............................ 56
01666... TB OVARY & TUBE-OTH TEST............................ 56
01670... TB FEMALE GEN NEC-UNSPEC............................ 56
01671... TB FEM GEN NEC-NO EXAM.............................. 56
01672... TB FEM GEN NEC-EXAM UNKN............................ 56
01673... TB FEM GEN NEC-MICRO DX............................. 56
01674... TB FEM GEN NEC-CULT DX.............................. 56
01675... TB FEM GEN NEC-HISTO DX............................. 56
01676... TB FEM GEN NEC-OTH TEST............................. 56
01690... GU TB NOS-UNSPEC.................................... 53
01691... GU TB NOS-NO EXAM................................... 53
01692... GU TB NOS-EXAM UNKN................................. 53
01693... GU TB NOS-MICRO DX.................................. 53
01694... GU TB NOS-CULT DX................................... 53
01695... GU TB NOS-HISTO DX.................................. 53
01696... GU TB NOS-OTH TEST.................................. 53
01700... TB SKIN/SUBCUTAN-UNSPEC............................. 18
01701... TB SKIN/SUBCUT-NO EXAM.............................. 18
01702... TB SKIN/SUBCUT-EXAM UNKN............................ 18
01703... TB SKIN/SUBCUT-MICRO DX............................. 18
01704... TB SKIN/SUBCUT-CULT DX.............................. 18
01705... TB SKIN/SUBCUT-HISTO DX............................. 18
01706... TB SKIN/SUBCUT-OTH TEST............................. 18
01710... ERYTHEMA NODOS TB-UNSPEC............................ 18
01711... ERYTHEM NODOS TB-NO EXAM............................ 18
01712... ERYTHEM NOD TB-EXAM UNKN............................ 18
01713... ERYTHEM NOD TB-MICRO DX............................. 18
01714... ERYTHEM NODOS TB-CULT DX............................ 18
01715... ERYTHEM NOD TB-HISTO DX............................. 18
01716... ERYTHEM NOD TB-OTH TEST............................. 18
01720... TB PERIPH LYMPH-UNSPEC.............................. 86
01721... TB PERIPH LYMPH-NO EXAM............................. 86
01722... TB PERIPH LYMPH-EXAM UNK............................ 86
01723... TB PERIPH LYMPH-MICRO DX............................ 86
01724... TB PERIPH LYMPH-CULT DX............................. 86
01725... TB PERIPH LYMPH-HISTO DX............................ 86
01726... TB PERIPH LYMPH-OTH TEST............................ 86
01730... TB OF EYE-UNSPEC.................................... 68
01731... TB OF EYE-NO EXAM................................... 68
01732... TB OF EYE-EXAM UNKN................................. 68
01733... TB OF EYE-MICRO DX.................................. 68
01734... TB OF EYE-CULT DX................................... 68
01735... TB OF EYE-HISTO DX.................................. 68
01736... TB OF EYE-OTH TEST.................................. 68
01740... TB OF EAR-UNSPEC.................................... 31
01741... TB OF EAR-NO EXAM................................... 31
01742... TB OF EAR-EXAM UNKN................................. 31
01743... TB OF EAR-MICRO DX.................................. 31
01744... TB OF EAR-CULT DX................................... 31
01745... TB OF EAR-HISTO DX.................................. 31
01746... TB OF EAR-OTH TEST.................................. 31
01750... TB OF THYROID-UNSPEC................................ 82
01751... TB OF THYROID-NO EXAM............................... 82
01752... TB OF THYROID-EXAM UNKN............................. 82
01753... TB OF THYROID-MICRO DX.............................. 82
01754... TB OF THYROID-CULT DX............................... 82
01755... TB OF THYROID-HISTO DX.............................. 82
01756... TB OF THYROID-OTH TEST.............................. 82
01760... TB OF ADRENAL-UNSPEC................................ 82
01761... TB OF ADRENAL-NO EXAM............................... 82
01762... TB OF ADRENAL-EXAM UNKN............................. 82
01763... TB OF ADRENAL-MICRO DX.............................. 82
01764... TB OF ADRENAL-CULT DX............................... 82
01765... TB OF ADRENAL-HISTO DX.............................. 82
01766... TB OF ADRENAL-OTH TEST.............................. 82
01770... TB OF SPLEEN-UNSPEC................................. 86
01771... TB OF SPLEEN-NO EXAM................................ 86
01772... TB OF SPLEEN-EXAM UNKN.............................. 86
[[Page 47841]]
01773... TB OF SPLEEN-MICRO DX............................... 86
01774... TB OF SPLEEN-CULT DX................................ 86
01775... TB OF SPLEEN-HISTO DX............................... 86
01776... TB OF SPLEEN-OTH TEST............................... 86
01780... TB ESOPHAGUS-UNSPEC................................. 41
01781... TB ESOPHAGUS-NO EXAM................................ 41
01782... TB ESOPHAGUS-EXAM UNKN.............................. 41
01783... TB ESOPHAGUS-MICRO DX............................... 41
01784... TB ESOPHAGUS-CULT DX................................ 41
01785... TB ESOPHAGUS-HISTO DX............................... 41
01786... TB ESOPHAGUS-OTH TEST............................... 41
01790... TB OF ORGAN NEC-UNSPEC.............................. 97
01791... TB OF ORGAN NEC-NO EXAM............................. 97
01792... TB ORGAN NEC-EXAM UNKN.............................. 97
01793... TB OF ORGAN NEC-MICRO DX............................ 97
01794... TB OF ORGAN NEC-CULT DX............................. 97
01795... TB OF ORGAN NEC-HISTO DX............................ 97
01796... TB OF ORGAN NEC-OTH TEST............................ 97
01800... ACUTE MILIARY TB-UNSPEC............................. 97
01801... ACUTE MILIARY TB-NO EXAM............................ 97
01802... AC MILIARY TB-EXAM UNKN............................. 97
01803... AC MILIARY TB-MICRO DX.............................. 97
01804... ACUTE MILIARY TB-CULT DX............................ 97
01805... AC MILIARY TB-HISTO DX.............................. 97
01806... AC MILIARY TB-OTH TEST.............................. 97
01880... MILIARY TB NEC-UNSPEC............................... 97
01881... MILIARY TB NEC-NO EXAM.............................. 97
01882... MILIARY TB NEC-EXAM UNKN............................ 97
01883... MILIARY TB NEC-MICRO DX............................. 97
01884... MILIARY TB NEC-CULT DX.............................. 97
01885... MILIARY TB NEC-HISTO DX............................. 97
01886... MILIARY TB NEC-OTH TEST............................. 97
01890... MILIARY TB NOS-UNSPEC............................... 97
01891... MILIARY TB NOS-NO EXAM.............................. 97
01892... MILIARY TB NOS-EXAM UNKN............................ 97
01893... MILIARY TB NOS-MICRO DX............................. 97
01894... MILIARY TB NOS-CULT DX.............................. 97
01895... MILIARY TB NOS-HISTO DX............................. 97
01896... MILIARY TB NOS-OTH TEST............................. 97
0200.... BUBONIC PLAGUE...................................... 97
0201.... CELLULOCUTANEOUS PLAGUE............................. 97
0202.... SEPTICEMIC PLAGUE................................... 97
0203.... PRIMARY PNEUMONIC PLAGUE............................ 33
0204.... SECONDARY PNEUMON PLAGUE............................ 33
0205.... PNEUMONIC PLAGUE NOS................................ 33
0208.... OTHER TYPES OF PLAGUE............................... 97
0209.... PLAGUE NOS.......................................... 97
0210.... ULCEROGLANDUL TULAREMIA............................. 97
0211.... ENTERIC TULAREMIA................................... 41
0212.... PULMONARY TULAREMIA................................. 33
0213.... OCULOGLANDULAR TULAREMIA............................ 97
0218.... TULAREMIA NEC....................................... 97
0219.... TULAREMIA NOS....................................... 97
0220.... CUTANEOUS ANTHRAX................................... 18
0221.... PULMONARY ANTHRAX................................... 33
0222.... GASTROINTESTINAL ANTHRAX............................ 41
0223.... ANTHRAX SEPTICEMIA.................................. 97
0228.... OTHER ANTHRAX MANIFEST.............................. 97
0229.... ANTHRAX NOS......................................... 97
0230.... BRUCELLA MELITENSIS................................. 97
0231.... BRUCELLA ABORTUS.................................... 97
0232.... BRUCELLA SUIS....................................... 97
0233.... BRUCELLA CANIS...................................... 97
0238.... BRUCELLOSIS NEC..................................... 97
0239.... BRUCELLOSIS NOS..................................... 97
024..... GLANDERS............................................ 97
025..... MELIOIDOSIS......................................... 97
0260.... SPIRILLARY FEVER.................................... 97
0261.... STREPTOBACILLARY FEVER.............................. 97
0269.... RAT-BITE FEVER NOS.................................. 97
0270.... LISTERIOSIS......................................... 97
0271.... ERYSIPELOTHRIX INFECTION............................ 97
0272.... PASTEURELLOSIS...................................... 97
0278.... ZOONOTIC BACT DIS NEC............................... 97
0279.... ZOONOTIC BACT DIS NOS............................... 97
0300.... LEPROMATOUS LEPROSY................................. 97
[[Page 47842]]
0301.... TUBERCULOID LEPROSY................................. 97
0302.... INDETERMINATE LEPROSY............................... 97
0303.... BORDERLINE LEPROSY.................................. 97
0308.... LEPROSY NEC......................................... 97
0309.... LEPROSY NOS......................................... 97
0310.... PULMONARY MYCOBACTERIA.............................. 33
0311.... CUTANEOUS MYCOBACTERIA.............................. 18
0318.... MYCOBACTERIAL DIS NEC............................... 97
0319.... MYCOBACTERIAL DIS NOS............................... 97
0320.... FAUCIAL DIPHTHERIA.................................. 31
0321.... NASOPHARYNX DIPHTHERIA.............................. 31
0322.... ANT NASAL DIPHTHERIA................................ 31
0323.... LARYNGEAL DIPHTHERIA................................ 31
03281... CONJUNCTIVAL DIPHTHERIA............................. 68
03282... DIPHTHERITIC MYOCARDITIS............................ 36
03283... DIPHTHERITIC PERITONITIS............................ 41
03284... DIPHTHERITIC CYSTITIS............................... 53
03285... CUTANEOUS DIPHTHERIA................................ 18
03289... DIPHTHERIA NEC...................................... 97
0329.... DIPHTHERIA NOS...................................... 97
0330.... BORDETELLA PERTUSSIS................................ 33
0331.... BORDETELLA PARAPERTUSSIS............................ 33
0338.... WHOOPING COUGH NEC.................................. 33
0339.... WHOOPING COUGH NOS.................................. 33
0340.... STREP SORE THROAT................................... 31
0341.... SCARLET FEVER....................................... 97
035..... ERYSIPELAS.......................................... 18
0360.... MENINGOCOCCAL MENINGITIS............................ 63
0361.... MENINGOCOCC ENCEPHALITIS............................ 63
0362.... MENINGOCOCCEMIA..................................... 97
0363.... MENINGOCOCC ADRENAL SYND............................ 97
03640... MENINGOCOCC CARDITIS NOS............................ 36
03641... MENINGOCOCC PERICARDITIS............................ 36
03642... MENINGOCOCC ENDOCARDITIS............................ 36
03643... MENINGOCOCC MYOCARDITIS............................. 36
03681... MENINGOCOCC OPTIC NEURIT............................ 68
03682... MENINGOCOCC ARTHROPATHY............................. 24
03689... MENINGOCOCCAL INFECT NEC............................ 97
0369.... MENINGOCOCCAL INFECT NOS............................ 97
037..... TETANUS............................................. 97
0380.... STREPTOCOCCAL SEPTICEMIA............................ 97
0382.... PNEUMOCOCCAL SEPTICEMIA............................. 97
0383.... ANAEROBIC SEPTICEMIA................................ 97
03840... GRAM-NEG SEPTICEMIA NOS............................. 97
03841... H. INFLUENAE SEPTICEMIA............................. 97
03842... E COLI SEPTICEMIA................................... 97
03843... PSEUDOMONAS SEPTICEMIA.............................. 97
03844... SERRATIA SEPTICEMIA................................. 97
03849... GRAM-NEG SEPTICEMIA NEC............................. 97
0388.... SEPTICEMIA NEC...................................... 97
0389.... SEPTICEMIA NOS...................................... 97
0390.... CUTANEOUS ACTINOMYCOSIS............................. 18
0391.... PULMONARY ACTINOMYCOSIS............................. 33
0392.... ABDOMINAL ACTINOMYCOSIS............................. 41
0393.... CERVICOFAC ACTINOMYCOSIS............................ 18
0394.... MADURA FOOT......................................... 18
0398.... ACTINOMYCOSIS NEC................................... 97
0399.... ACTINOMYCOSIS NOS................................... 97
0400.... GAS GANGRENE........................................ 97
0401.... RHINOSCLEROMA....................................... 97
0402.... WHIPPLE'S DISEASE................................... 41
0403.... NECROBACILLOSIS..................................... 97
04081... TROPICAL PYOMYOSITIS................................ 24
04089... BACTERIAL DISEASES NEC.............................. 97
04100... STREPTOCOCCUS UNSPECF............................... 97
04101... STREPTOCOCCUS GROUP A............................... 97
04102... STREPTOCOCCUS GROUP B............................... 97
04103... STREPTOCOCCUS GROUP C............................... 97
04104... STREPTOCOCCUS GROUP D............................... 97
04105... STREPTOCOCCUS GROUP G............................... 97
04109... OTHER STREPTOCOCCUS................................. 97
04110... STAPHYLOCOCCUS UNSPCFIED............................ 97
04111... STAPHYLOCOCCUS AUREUS............................... 97
04119... OTHER STAPHYLOCOCCUS................................ 97
0412.... PNEUMOCOCCUS INFECT NOS............................. 97
0413.... KLEBSIELLA INFECT NOS............................... 97
[[Page 47843]]
0414.... E. COLI INFECT NOS.................................. 97
0415.... H. INFLUENZAE INFECT NOS............................ 97
0416.... PROTEUS INFECTION NOS............................... 97
0417.... PSEUDOMONAS INFECT NOS.............................. 97
04181... MYCOPLASMA.......................................... 97
04182... BACILLUS FRAGILIS................................... 97
04183... CLOSTRIDIUM PERFRINGENS............................. 97
04184... OTHER ANAEROBES..................................... 97
04185... OTH GRAM NEGATV BACTERIA............................ 97
04186... HELICOBACTER PYLORI................................. 41
04189... OTH SPECF BACTERIA.................................. 97
0419.... BACTERIAL INFECTION NOS............................. 97
042..... HUMAN IMMUNO VIRUS DIS.............................. 86
04500... AC BULBAR POLIO-TYPE NOS............................ 63
04501... AC BULBAR POLIO-TYPE 1.............................. 63
04502... AC BULBAR POLIO-TYPE 2.............................. 63
04503... AC BULBAR POLIO-TYPE 3.............................. 63
04510... PARAL POLIO NEC-TYPE NOS............................ 63
04511... PARAL POLIO NEC-TYPE 1.............................. 63
04512... PARAL POLIO NEC-TYPE 2.............................. 63
04513... PARAL POLIO NEC-TYPE 3.............................. 63
04520... NONPARALY POLIO-TYPE NOS............................ 63
04521... NONPARALYT POLIO-TYPE 1............................. 63
04522... NONPARALYT POLIO-TYPE 2............................. 63
04523... NONPARALYT POLIO-TYPE 3............................. 63
04590... AC POLIO NOS-TYPE NOS............................... 63
04591... AC POLIO NOS-TYPE 1................................. 63
04592... AC POLIO NOS-TYPE 2................................. 63
04593... AC POLIO NOS-TYPE 3................................. 63
0460.... KURU................................................ 63
0461.... JAKOB-CREUTZFELDT DIS............................... 63
0462.... SUBAC SCLEROS PANENCEPH............................. 63
0463.... PROG MULTIFOC LEUKOENCEP............................ 63
0468.... CNS SLOW VIRUS INFEC NEC............................ 63
0469.... CNS SLOW VIRUS INFEC NOS............................ 63
0470.... COXSACKIE VIRUS MENING.............................. 63
0471.... ECHO VIRUS MENINGITIS............................... 63
0478.... VIRAL MENINGITIS NEC................................ 63
0479.... VIRAL MENINGITIS NOS................................ 63
048..... OTH ENTEROVIRAL CNS DIS............................. 97
0490.... LYMPHOCYTIC CHORIOMENING............................ 63
0491.... ADENOVIRAL MENINGITIS............................... 63
0498.... VIRAL ENCEPHALITIS NEC.............................. 63
0499.... VIRAL ENCEPHALITIS NOS.............................. 63
0500.... VARIOLA MAJOR....................................... 97
0501.... ALASTRIM............................................ 97
0502.... MODIFIED SMALLPOX................................... 97
0509.... SMALLPOX NOS........................................ 97
0510.... COWPOX.............................................. 97
0511.... PSEUDOCOWPOX........................................ 18
0512.... CONTAGIOUS PUSTULAR DERM............................ 18
0519.... PARAVACCINIA NOS.................................... 97
0520.... POSTVARICELLA ENCEPHALIT............................ 63
0521.... VARICELLA PNEUMONITIS............................... 33
0527.... VARICELLA COMPLICAT NEC............................. 97
0528.... VARICELLA COMPLICAT NOS............................. 97
0529.... VARICELLA UNCOMPLICATED............................. 97
0530.... HERPES ZOSTER MENINGITIS............................ 63
05310... H ZOSTER NERV SYST NOS.............................. 63
05311... GENICULATE HERPES ZOSTER............................ 63
05312... POSTHERPES TRIGEM NEURAL............................ 63
05313... POSTHERPES POLYNEUROPATH............................ 63
05319... H ZOSTER NERV SYST NEC.............................. 63
05320... HERPES ZOSTER OF EYELID............................. 68
05321... H ZOSTER KERATOCONJUNCT............................. 68
05322... H ZOSTER IRIDOCYCLITIS.............................. 68
05329... HERPES ZOSTER OF EYE NEC............................ 68
05371... H ZOSTER OTITIS EXTERNA............................. 31
05379... H ZOSTER COMPLICATED NEC............................ 97
0538.... H ZOSTER COMPLICATED NOS............................ 97
0539.... HERPES ZOSTER NOS................................... 18
0540.... ECZEMA HERPETICUM................................... 18
05410... GENITAL HERPES NOS.................................. 97
05411... HERPETIC VULVOVAGINITIS............................. 97
05412... HERPETIC ULCER OF VULVA............................. 97
05413... HERPETIC INFECT OF PENIS............................ 97
[[Page 47844]]
05419... GENITAL HERPES NEC.................................. 97
0542.... HERPETIC GINGIVOSTOMAT.............................. 31
0543.... HERPETIC ENCEPHALITIS............................... 63
05440... HERPES SIMPLEX EYE NOS.............................. 68
05441... HERPES SIMPLEX OF EYELID............................ 68
05442... DENDRITIC KERATITIS................................. 68
05443... H SIMPLEX KERATITIS................................. 68
05444... H SIMPLEX IRIDOCYCLITIS............................. 68
05449... HERPES SIMPLEX EYE NEC.............................. 68
0545.... HERPETIC SEPTICEMIA................................. 97
0546.... HERPETIC WHITLOW.................................... 18
05471... VISCERAL HERPES SIMPLEX............................. 41
05472... H SIMPLEX MENINGITIS................................ 63
05473... H SIMPLEX OTITIS EXTERNA............................ 31
05479... H SIMPLEX COMPLICAT NEC............................. 97
0548.... H SIMPLEX COMPLICAT NOS............................. 97
0549.... HERPES SIMPLEX NOS.................................. 18
0550.... POSTMEASLES ENCEPHALITIS............................ 63
0551.... POSTMEASLES PNEUMONIA............................... 33
0552.... POSTMEASLES OTITIS MEDIA............................ 31
05571... MEASLES KERATITIS................................... 68
05579... MEASLES COMPLICATION NEC............................ 97
0558.... MEASLES COMPLICATION NOS............................ 97
0559.... MEASLES UNCOMPLICATED............................... 97
05600... RUBELLA NERVE COMPL NOS............................. 63
05601... RUBELLA ENCEPHALITIS................................ 63
05609... RUBELLA NERVE COMPL NEC............................. 63
05671... ARTHRITIS DUE TO RUBELLA............................ 24
05679... RUBELLA COMPLICATION NEC............................ 97
0568.... RUBELLA COMPLICATION NOS............................ 97
0569.... RUBELLA UNCOMPLICATED............................... 97
0570.... ERYTHEMA INFECTIOSUM................................ 97
0578.... VIRAL EXANTHEMATA NEC............................... 97
0579.... VIRAL EXANTHEMATA NOS............................... 97
0600.... SYLVATIC YELLOW FEVER............................... 97
0601.... URBAN YELLOW FEVER.................................. 97
0609.... YELLOW FEVER NOS.................................... 97
061..... DENGUE.............................................. 97
0620.... JAPANESE ENCEPHALITIS............................... 63
0621.... WEST EQUINE ENCEPHALITIS............................ 63
0622.... EAST EQUINE ENCEPHALITIS............................ 63
0623.... ST LOUIS ENCEPHALITIS............................... 63
0624.... AUSTRALIAN ENCEPHALITIS............................. 63
0625.... CALIFORNIA ENCEPHALITIS............................. 97
0628.... MOSQUIT-BORNE ENCEPH NEC............................ 97
0629.... MOSQUIT-BORNE ENCEPH NOS............................ 97
0630.... RUSSIA SPR-SUMMER ENCEPH............................ 97
0631.... LOUPING ILL......................................... 97
0632.... CENT EUROPE ENCEPHALITIS............................ 63
0638.... TICK-BORNE ENCEPH NEC............................... 97
0639.... TICK-BORNE ENCEPH NOS............................... 97
064..... VIR ENCEPH ARTHROPOD NEC............................ 63
0650.... CRIMEAN HEMORRHAGIC FEV............................. 97
0651.... OMSK HEMORRHAGIC FEVER.............................. 97
0652.... KYASANUR FOREST DISEASE............................. 97
0653.... TICK-BORNE HEM FEVER NEC............................ 97
0654.... MOSQUITO-BORNE HEM FEVER............................ 97
0658.... ARTHROPOD HEM FEVER NEC............................. 97
0659.... ARTHROPOD HEM FEVER NOS............................. 97
0660.... PHLEBOTOMUS FEVER................................... 97
0661.... TICK-BORNE FEVER.................................... 97
0662.... VENEZUELAN EQUINE FEVER............................. 63
0663.... MOSQUITO-BORNE FEVER NEC............................ 97
0668.... ARTHROPOD VIRUS NEC................................. 97
0669.... ARTHROPOD VIRUS NOS................................. 97
0700.... HEPATITIS A WITH COMA............................... 78
0701.... HEPATITIS A W/O COMA................................ 41
07020... HPT B ACTE COMA WO DLTA............................. 78
07021... HPT B ACTE COMA W DLTA.............................. 78
07022... HPT B CHRN COMA WO DLTA............................. 78
07023... HPT B CHRN COMA W DLTA.............................. 78
07030... HPT B ACTE WO CM WO DLTA............................ 41
07031... HPT B ACTE WO CM W DLTA............................. 41
07032... HPT B CHRN WO CM WO DLTA............................ 41
07033... HPT B CHRN WO CM W DLTA............................. 41
07041... HPT C ACUTE W HEPAT COMA............................ 78
[[Page 47845]]
07042... HPT DLT WO B W HPT COMA............................. 78
07043... HPT E W HEPAT COMA.................................. 78
07044... CHRNC HPT C W HEPAT COMA............................ 78
07049... OTH VRL HEPAT W HPT COMA............................ 78
07051... HPT C ACUTE WO HPAT COMA............................ 41
07052... HPT DLT WO B WO HPT COMA............................ 41
07053... HPT E WO HEPAT COMA................................. 41
07054... CHRNC HPT C WO HPAT COMA............................ 41
07059... OTH VRL HPAT WO HPT COMA............................ 41
0706.... VIRAL HEPAT NOS W COMA.............................. 78
0709.... VIRAL HEPAT NOS W/O COMA............................ 41
071..... RABIES.............................................. 63
0720.... MUMPS ORCHITIS...................................... 53
0721.... MUMPS MENINGITIS.................................... 63
0722.... MUMPS ENCEPHALITIS.................................. 63
0723.... MUMPS PANCREATITIS.................................. 41
07271... MUMPS HEPATITIS..................................... 41
07272... MUMPS POLYNEUROPATHY................................ 63
07279... MUMPS COMPLICATION NEC.............................. 97
0728.... MUMPS COMPLICATION NOS.............................. 97
0729.... MUMPS UNCOMPLICATED................................. 97
0730.... ORNITHOSIS PNEUMONIA................................ 33
0737.... ORNITHOSIS COMPLICAT NEC............................ 97
0738.... ORNITHOSIS COMPLICAT NOS............................ 97
0739.... ORNITHOSIS NOS...................................... 97
0740.... HERPANGINA.......................................... 31
0741.... EPIDEMIC PLEURODYNIA................................ 33
07420... COXSACKIE CARDITIS NOS.............................. 36
07421... COXSACKIE PERICARDITIS.............................. 36
07422... COXSACKIE ENDOCARDITIS.............................. 36
07423... COXSACKIE MYOCARDITIS............................... 36
0743.... HAND, FOOT & MOUTH DIS.............................. 97
0748.... COXSACKIE VIRUS NEC................................. 97
075..... INFECTIOUS MONONUCLEOSIS............................ 97
0760.... TRACHOMA, INITIAL STAGE............................. 68
0761.... TRACHOMA, ACTIVE STAGE.............................. 68
0769.... TRACHOMA NOS........................................ 68
0770.... INCLUSION CONJUNCTIVITIS............................ 68
0771.... EPIDEM KERATOCONJUNCTIV............................. 68
0772.... PHARYNGOCONJUNCT FEVER.............................. 68
0773.... ADENOVIRAL CONJUNCT NEC............................. 68
0774.... EPIDEM HEM CONJUNCTIVIT............................. 68
0778.... VIRAL CONJUNCTIVITIS NEC............................ 68
07798... UNSP DS CONJUC CHLAMYDIA............................ 97
07799... UNSP DS CONJUC VIRUSES.............................. 97
0780.... MOLLUSCUM CONTAGIOSUM............................... 18
07810... VIRAL WARTS NOS..................................... 97
07811... CONDYLOMA ACUMINATUM................................ 97
07819... OTH SPECFD VIRAL WARTS.............................. 97
0782.... SWEATING FEVER...................................... 97
0783.... CAT-SCRATCH DISEASE................................. 97
0784.... FOOT & MOUTH DISEASE................................ 97
0785.... CYTOMEGALOVIRAL DISEASE............................. 97
0786.... HEM NEPHROSONEPHRITIS............................... 53
0787.... ARENAVIRAL HEM FEVER................................ 97
07881... EPIDEMIC VERTIGO.................................... 31
07882... EPIDEMIC VOMITING SYND.............................. 41
07888... OTH SPEC DIS CHLAMYDIAE............................. 97
07889... OTH SPEC DIS VIRUSES................................ 97
0790.... ADENOVIRUS INFECT NOS............................... 97
0791.... ECHO VIRUS INFECT NOS............................... 97
0792.... COXSACKIE VIRUS INF NOS............................. 97
0793.... RHINOVIRUS INFECT NOS............................... 97
0794.... HUMAN PAPILLOMA VIRUS............................... 97
07950... RETROVIRUS, UNSPECIFIED............................. 86
07951... HTLV-1 INFECTION OTH DIS............................ 86
07952... HTLV-II INFECTN OTH DIS............................. 86
07953... HIV-2 INFECTION OTH DIS............................. 86
07959... OTH SPECFIED RETROVIRUS............................. 86
07981... HANTAVIRUS INFECTION................................ 97
07988... OTH SPCF CHLAMYDIAL INFC............................ 97
07989... OTH SPECF VIRAL INFECTN............................. 97
07998... CHLAMYDIAL INFECTION NOS............................ 97
07999... VIRAL INFECTION NOS................................. 97
080..... LOUSE-BORNE TYPHUS.................................. 97
0810.... MURINE TYPHUS....................................... 97
[[Page 47846]]
0811.... BRILL'S DISEASE..................................... 97
0812.... SCRUB TYPHUS........................................ 97
0819.... TYPHUS NOS.......................................... 97
0820.... SPOTTED FEVERS...................................... 97
0821.... BOUTONNEUSE FEVER................................... 97
0822.... NORTH ASIAN TICK FEVER.............................. 97
0823.... QUEENSLAND TICK TYPHUS.............................. 97
0828.... TICK-BORNE RICKETTS NEC............................. 97
0829.... TICK-BORNE RICKETTS NOS............................. 97
0830.... Q FEVER............................................. 97
0831.... TRENCH FEVER........................................ 97
0832.... RICKETTSIALPOX...................................... 97
0838.... RICKETTSIOSES NEC................................... 97
0839.... RICKETTSIOSIS NOS................................... 97
0840.... FALCIPARUM MALARIA.................................. 97
0841.... VIVAX MALARIA....................................... 97
0842.... QUARTAN MALARIA..................................... 97
0843.... OVALE MALARIA....................................... 97
0844.... MALARIA NEC......................................... 97
0845.... MIXED MALARIA....................................... 97
0846.... MALARIA NOS......................................... 97
0847.... INDUCED MALARIA..................................... 97
0848.... BLACKWATER FEVER.................................... 97
0849.... MALARIA COMPLICATED NEC............................. 97
0850.... VISCERAL LEISHMANIASIS.............................. 97
0851.... CUTAN LEISHMANIAS URBAN............................. 18
0852.... CUTAN LEISHMANIAS ASIAN............................. 18
0853.... CUTAN LEISHMANIAS ETHIOP............................ 18
0854.... CUTAN LEISHMANIAS AMER.............................. 18
0855.... MUCOCUTAN LEISHMANIASIS............................. 18
0859.... LEISHMANIASIS NOS................................... 97
0860.... CHAGAS DISEASE OF HEART............................. 36
0861.... CHAGAS DIS OF OTH ORGAN............................. 97
0862.... CHAGAS DISEASE NOS.................................. 97
0863.... GAMBIAN TRYPANOSOMIASIS............................. 97
0864.... RHODESIAN TRYPANOSOMIAS............................. 97
0865.... AFRICAN TRYPANOSOMA NOS............................. 97
0869.... TRYPANOSOMIASIS NOS................................. 97
0870.... LOUSE-BORNE RELAPS FEVER............................ 97
0871.... TICK-BORNE RELAPS FEVER............................. 97
0879.... RELAPSING FEVER NOS................................. 97
0880.... BARTONELLOSIS....................................... 97
08881... LYME DISEASE........................................ 97
08882... BABESIOSIS.......................................... 97
08889... OTH ARTHROPOD-BORNE DIS............................. 97
0889.... ARTHROPOD-BORNE DIS NOS............................. 97
0900.... EARLY CONG SYPH SYMPTOM............................. 97
0901.... EARLY CONGEN SYPH LATENT............................ 97
0902.... EARLY CONGEN SYPH NOS............................... 97
0903.... SYPHILITIC KERATITIS................................ 68
09040... JUVENILE NEUROSYPH NOS.............................. 63
09041... CONGEN SYPH ENCEPHALITIS............................ 63
09042... CONGEN SYPH MENINGITIS.............................. 63
09049... JUVENILE NEUROSYPH NEC.............................. 63
0905.... LATE CONGEN SYPH SYMPTOM............................ 97
0906.... LATE CONGEN SYPH LATENT............................. 97
0907.... LATE CONGEN SYPH NOS................................ 97
0909.... CONGENITAL SYPHILIS NOS............................. 97
0910.... PRIMARY GENITAL SYPHILIS............................ 97
0911.... PRIMARY ANAL SYPHILIS............................... 41
0912.... PRIMARY SYPHILIS NEC................................ 97
0913.... SECONDARY SYPH SKIN................................. 18
0914.... SYPHILITIC ADENOPATHY............................... 97
09150... SYPHILITIC UVEITIS NOS.............................. 68
09151... SYPHILIT CHORIORETINITIS............................ 68
09152... SYPHILITIC IRIDOCYCLITIS............................ 68
09161... SYPHILITIC PERIOSTITIS.............................. 24
09162... SYPHILITIC HEPATITIS................................ 41
09169... SECOND SYPH VISCERA NEC............................. 41
0917.... SECOND SYPHILIS RELAPSE............................. 97
09181... ACUTE SYPHIL MENINGITIS............................. 63
09182... SYPHILITIC ALOPECIA................................. 18
09189... SECONDARY SYPHILIS NEC.............................. 97
0919.... SECONDARY SYPHILIS NOS.............................. 97
0920.... EARLY SYPH LATENT RELAPS............................ 97
0929.... EARLY SYPHIL LATENT NOS............................. 97
[[Page 47847]]
0930.... AORTIC ANEURYSM, SYPHIL............................. 36
0931.... SYPHILITIC AORTITIS................................. 36
09320... SYPHIL ENDOCARDITIS NOS............................. 36
09321... SYPHILITIC MITRAL VALVE............................. 36
09322... SYPHILITIC AORTIC VALVE............................. 36
09323... SYPHIL TRICUSPID VALVE.............................. 36
09324... SYPHIL PULMONARY VALVE.............................. 36
09381... SYPHILITIC PERICARDITIS............................. 36
09382... SYPHILITIC MYOCARDITIS.............................. 36
09389... CARDIOVASCULAR SYPH NEC............................. 36
0939.... CARDIOVASCULAR SYPH NOS............................. 36
0940.... TABES DORSALIS...................................... 63
0941.... GENERAL PARESIS..................................... 63
0942.... SYPHILITIC MENINGITIS............................... 63
0943.... ASYMPTOMAT NEUROSYPHILIS............................ 63
09481... SYPHILITIC ENCEPHALITIS............................. 63
09482... SYPHILITIC PARKINSONISM............................. 63
09483... SYPH DISSEM RETINITIS............................... 68
09484... SYPHILITIC OPTIC ATROPHY............................ 68
09485... SYPH RETROBULB NEURITIS............................. 63
09486... SYPHIL ACOUSTIC NEURITIS............................ 31
09487... SYPH RUPT CEREB ANEURYSM............................ 63
09489... NEUROSYPHILIS NEC................................... 63
0949.... NEUROSYPHILIS NOS................................... 63
0950.... SYPHILITIC EPISCLERITIS............................. 68
0951.... SYPHILIS OF LUNG.................................... 33
0952.... SYPHILITIC PERITONITIS.............................. 41
0953.... SYPHILIS OF LIVER................................... 41
0954.... SYPHILIS OF KIDNEY.................................. 53
0955.... SYPHILIS OF BONE.................................... 24
0956.... SYPHILIS OF MUSCLE.................................. 24
0957.... SYPHILIS OF TENDON/BURSA............................ 24
0958.... LATE SYMPT SYPHILIS NEC............................. 97
0959.... LATE SYMPT SYPHILIS NOS............................. 97
096..... LATE SYPHILIS LATENT................................ 97
0970.... LATE SYPHILIS NOS................................... 97
0971.... LATENT SYPHILIS NOS................................. 97
0979.... SYPHILIS NOS........................................ 97
0980.... ACUTE GC INFECT LOWER GU............................ 97
09810... GC (ACUTE) UPPER GU NOS............................. 97
09811... GC CYSTITIS (ACUTE)................................. 53
09812... GC PROSTATITIS (ACUTE).............................. 53
09813... GC ORCHITIS (ACUTE)................................. 97
09814... GC SEM VESICULIT (ACUTE)............................ 97
09815... GC CERVICITIS (ACUTE)............................... 97
09816... GC ENDOMETRITIS (ACUTE)............................. 97
09817... ACUTE GC SALPINGITIS................................ 97
09819... GC (ACUTE) UPPER GU NEC............................. 97
0982.... CHR GC INFECT LOWER GU.............................. 97
09830... CHR GC UPPER GU NOS................................. 53
09831... GC CYSTITIS, CHRONIC................................ 53
09832... GC PROSTATITIS, CHRONIC............................. 53
09833... GC ORCHITIS, CHRONIC................................ 97
09834... GC SEM VESICULITIS, CHR............................. 97
09835... GC CERVICITIS, CHRONIC.............................. 97
09836... GC ENDOMETRITIS, CHRONIC............................ 97
09837... GC SALPINGITIS (CHRONIC)............................ 97
09839... CHR GC UPPER GU NEC................................. 97
09840... GONOCOCCAL CONJUNCTIVIT............................. 68
09841... GONOCOCCAL IRIDOCYCLITIS............................ 68
09842... GONOCOCCAL ENDOPHTHALMIA............................ 68
09843... GONOCOCCAL KERATITIS................................ 68
09849... GONOCOCCAL EYE NEC.................................. 68
09850... GONOCOCCAL ARTHRITIS................................ 24
09851... GONOCOCCAL SYNOVITIS................................ 24
09852... GONOCOCCAL BURSITIS................................. 24
09853... GONOCOCCAL SPONDYLITIS.............................. 24
09859... GC INFECT JOINT NEC................................. 24
0986.... GONOCOCCAL INFEC PHARYNX............................ 31
0987.... GC INFECT ANUS & RECTUM............................. 97
09881... GONOCOCCAL KERATOSIS................................ 68
09882... GONOCOCCAL MENINGITIS............................... 63
09883... GONOCOCCAL PERICARDITIS............................. 36
09884... GONOCOCCAL ENDOCARDITIS............................. 36
09885... GONOCOCCAL HEART DIS NEC............................ 36
09886... GONOCOCCAL PERITONITIS.............................. 41
[[Page 47848]]
09889... GONOCOCCAL INF SITE NEC............................. 97
0990.... CHANCROID........................................... 97
0991.... LYMPHOGRANULOMA VENEREUM............................ 97
0992.... GRANULOMA INGUINALE................................. 97
0993.... REITER'S DISEASE.................................... 24
09940... UNSPCF NONGNCCL URETHRTS............................ 97
09941... CHLMYD TRACHOMATIS URETH............................ 97
09949... NONGC URTH OTH SPF ORGSM............................ 97
09950... OTH VD CHLM TRCH UNSP ST............................ 97
09951... OTH VD CHLM TRCH PHARYNX............................ 97
09952... OTH VD CHLM TRCH ANS RCT............................ 97
09953... OTH VD CHLM TRCH LOWR GU............................ 97
09954... OTH VD CHLM TRCH OTH GU............................. 97
09955... OT VD CHLM TRCH UNSPF GU............................ 97
09956... OT VD CHLM TRCH PRTONEUM............................ 97
09959... OTH VD CHLM TRCH SPCF ST............................ 97
0998.... VENEREAL DISEASE NEC................................ 97
0999.... VENEREAL DISEASE NOS................................ 97
1000.... LEPTOSPIROS ICTEROHEM............................... 97
10081... LEPTOSPIRAL MENINGITIS.............................. 63
10089... LEPTOSPIRAL INFECT NEC.............................. 63
1009.... LEPTOSPIROSIS NOS................................... 97
101..... VINCENT'S ANGINA.................................... 31
1020.... INITIAL LESIONS YAWS................................ 18
1021.... MULTIPLE PAPILLOMATA................................ 18
1022.... EARLY SKIN YAWS NEC................................. 18
1023.... HYPERKERATOSIS OF YAWS.............................. 18
1024.... GUMMATA AND ULCERS, YAWS............................ 18
1025.... GANGOSA............................................. 31
1026.... YAWS OF BONE & JOINT................................ 24
1027.... YAWS MANIFESTATIONS NEC............................. 97
1028.... LATENT YAWS......................................... 97
1029.... YAWS NOS............................................ 97
1030.... PINTA PRIMARY LESIONS............................... 18
1031.... PINTA INTERMED LESIONS.............................. 18
1032.... PINTA LATE LESIONS.................................. 97
1033.... PINTA MIXED LESIONS................................. 18
1039.... PINTA NOS........................................... 97
1040.... NONVENEREAL ENDEMIC SYPH............................ 97
1048.... SPIROCHETAL INFECT NEC.............................. 97
1049.... SPIROCHETAL INFECT NOS.............................. 97
1100.... DERMATOPHYT SCALP/BEARD............................. 18
1101.... DERMATOPHYTOSIS OF NAIL............................. 18
1102.... DERMATOPHYTOSIS OF HAND............................. 18
1103.... DERMATOPHYTOSIS OF GROIN............................ 18
1104.... DERMATOPHYTOSIS OF FOOT............................. 18
1105.... DERMATOPHYTOSIS OF BODY............................. 18
1106.... DEEP DERMATOPHYTOSIS................................ 18
1108.... DERMATOPHYTOSIS SITE NEC............................ 18
1109.... DERMATOPHYTOSIS SITE NOS............................ 18
1110.... PITYRIASIS VERSICOLOR............................... 18
1111.... TINEA NIGRA......................................... 18
1112.... TINEA BLANCA........................................ 18
1113.... BLACK PIEDRA........................................ 18
1118.... DERMATOMYCOSES NEC.................................. 18
1119.... DERMATOMYCOSIS NOS.................................. 18
1120.... THRUSH.............................................. 31
1121.... CANDIDAL VULVOVAGINITIS............................. 97
1122.... CANDIDIAS UROGENITAL NEC............................ 97
1123.... CUTANEOUS CANDIDIASIS............................... 18
1124.... CANDIDIASIS OF LUNG................................. 33
1125.... DISSEMINATED CANDIDIASIS............................ 97
11281... CANDIDAL ENDOCARDITIS............................... 36
11282... CANDIDAL OTITIS EXTERNA............................. 31
11283... CANDIDAL MENINGITIS................................. 63
11284... CANDIDAL ESOPHAGITIS................................ 97
11285... CANDIDAL ENTERITIS.................................. 97
11289... CANDIDIASIS SITE NEC................................ 97
1129.... CANDIDIASIS SITE NOS................................ 18
1140.... PRIMARY COCCIDIOIDOMYCOS............................ 33
1141.... PRIM CUTAN COCCIDIOID............................... 18
1142.... COCCIDIOIDAL MENINGITIS............................. 63
1143.... PROGRESS COCCIDIOID NEC............................. 97
1144.... CH PL COCCIDIOIDOMYCOSIS............................ 97
1145.... PL COCIDIOIDOMYCOSIS NOS............................ 97
1149.... COCCIDIOIDOMYCOSIS NOS.............................. 97
[[Page 47849]]
11500... HISTOPLASMA CAPSULAT NOS............................ 97
11501... HISTOPLASM CAPSUL MENING............................ 63
11502... HISTOPLASM CAPSUL RETINA............................ 68
11503... HISTOPLASM CAPS PERICARD............................ 36
11504... HISTOPLASM CAPS ENDOCARD............................ 36
11505... HISTOPLASM CAPS PNEUMON............................. 33
11509... HISTOPLASMA CAPSULAT NEC............................ 97
11510... HISTOPLASMA DUBOISII NOS............................ 97
11511... HISTOPLASM DUBOIS MENING............................ 63
11512... HISTOPLASM DUBOIS RETINA............................ 68
11513... HISTOPLASM DUB PERICARD............................. 36
11514... HISTOPLASM DUB ENDOCARD............................. 36
11515... HISTOPLASM DUB PNEUMONIA............................ 33
11519... HISTOPLASMA DUBOISII NEC............................ 97
11590... HISTOPLASMOSIS NOS.................................. 97
11591... HISTOPLASMOSIS MENINGIT............................. 63
11592... HISTOPLASMOSIS RETINITIS............................ 68
11593... HISTOPLASMOSIS PERICARD............................. 36
11594... HISTOPLASMOSIS ENDOCARD............................. 36
11595... HISTOPLASMOSIS PNEUMONIA............................ 33
11599... HISTOPLASMOSIS NEC.................................. 97
1160.... BLASTOMYCOSIS....................................... 97
1161.... PARACOCCIDIOIDOMYCOSIS.............................. 97
1162.... LOBOMYCOSIS......................................... 97
1170.... RHINOSPORIDIOSIS.................................... 97
1171.... SPOROTRICHOSIS...................................... 97
1172.... CHROMOBLASTOMYCOSIS................................. 97
1173.... ASPERGILLOSIS....................................... 97
1174.... MYCOTIC MYCETOMAS................................... 97
1175.... CRYPTOCOCCOSIS...................................... 97
1176.... ALLESCHERIOSIS...................................... 97
1177.... ZYGOMYCOSIS......................................... 97
1178.... DEMATIACIOUS FUNGI INF.............................. 97
1179.... MYCOSES NEC & NOS................................... 18
118..... OPPORTUNISTIC MYCOSES............................... 97
1200.... SCHISTOSOMA HAEMATOBIUM............................. 53
1201.... SCHISTOSOMA MANSONI................................. 41
1202.... SCHISTOSOMA JAPONICUM............................... 97
1203.... CUTANEOUS SCHISTOSOMA............................... 18
1208.... SCHISTOSOMIASIS NEC................................. 97
1209.... SCHISTOSOMIASIS NOS................................. 97
1210.... OPISTHORCHIASIS..................................... 41
1211.... CLONORCHIASIS....................................... 41
1212.... PARAGONIMIASIS...................................... 33
1213.... FASCIOLIASIS........................................ 41
1214.... FASCIOLOPSIASIS..................................... 41
1215.... METAGONIMIASIS...................................... 97
1216.... HETEROPHYIASIS...................................... 97
1218.... TREMATODE INFECTION NEC............................. 97
1219.... TREMATODE INFECTION NOS............................. 97
1220.... ECHINOCOCC GRANUL LIVER............................. 41
1221.... ECHINOCOCC GRANUL LUNG.............................. 33
1222.... ECHINOCOCC GRAN THYROID............................. 82
1223.... ECHINOCOCC GRANUL NEC............................... 97
1224.... ECHINOCOCC GRANUL NOS............................... 97
1225.... ECHINOCOC MULTILOC LIVER............................ 41
1226.... ECHINOCOCC MULTILOC NEC............................. 97
1227.... ECHINOCOCC MULTILOC NOS............................. 97
1228.... ECHINOCOCCOSIS NOS LIVER............................ 41
1229.... ECHINOCOCCOSIS NEC/NOS.............................. 97
1230.... TAENIA SOLIUM INTESTINE............................. 41
1231.... CYSTICERCOSIS....................................... 41
1232.... TAENIA SAGINATA INFECT.............................. 41
1233.... TAENIASIS NOS....................................... 41
1234.... DIPHYLLOBOTHRIAS INTEST............................. 41
1235.... SPARGANOSIS......................................... 41
1236.... HYMENOLEPIASIS...................................... 41
1238.... CESTODE INFECTION NEC............................... 41
1239.... CESTODE INFECTION NOS............................... 41
124..... TRICHINOSIS......................................... 97
1250.... BANCROFTIAN FILARIASIS.............................. 97
1251.... MALAYAN FILARIASIS.................................. 97
1252.... LOIASIS............................................. 97
1253.... ONCHOCERCIASIS...................................... 97
1254.... DIPETALONEMIASIS.................................... 97
1255.... MANSONELLA OZZARDI INFEC............................ 97
[[Page 47850]]
1256.... FILARIASIS NEC...................................... 97
1257.... DRACONTIASIS........................................ 97
1259.... FILARIASIS NOS...................................... 97
1260.... ANCYLOSTOMA DUODENALE............................... 41
1261.... NECATOR AMERICANUS.................................. 41
1262.... ANCYLOSTOMA BRAZILIENSE............................. 41
1263.... ANCYLOSTOMA CEYLANICUM.............................. 41
1268.... ANCYLOSTOMA NEC..................................... 41
1269.... ANCYLOSTOMIASIS NOS................................. 41
1270.... ASCARIASIS.......................................... 41
1271.... ANISAKIASIS......................................... 41
1272.... STRONGYLOIDIASIS.................................... 41
1273.... TRICHURIASIS........................................ 41
1274.... ENTEROBIASIS........................................ 41
1275.... CAPILLARIASIS....................................... 41
1276.... TRICHOSTRONGYLIASIS................................. 41
1277.... INTEST HELMINTHIASIS NEC............................ 41
1278.... MIXED INTESTINE HELMINTH............................ 97
1279.... INTEST HELMINTHIASIS NOS............................ 41
1280.... TOXOCARIASIS........................................ 97
1281.... GNATHOSTOMIASIS..................................... 97
1288.... HELMINTHIASIS NEC................................... 97
1289.... HELMINTHIASIS NOS................................... 97
129..... INTESTIN PARASITISM NOS............................. 41
1300.... TOXOPLASM MENINGOENCEPH............................. 63
1301.... TOXOPLASM CONJUNCTIVITIS............................ 68
1302.... TOXOPLASM CHORIORETINIT............................. 68
1303.... TOXOPLASMA MYOCARDITIS.............................. 36
1304.... TOXOPLASMA PNEUMONITIS.............................. 33
1305.... TOXOPLASMA HEPATITIS................................ 41
1307.... TOXOPLASMOSIS SITE NEC.............................. 97
1308.... MULTISYSTEM TOXOPLASMOS............................. 97
1309.... TOXOPLASMOSIS NOS................................... 97
13100... UROGENITAL TRICHOMON NOS............................ 97
13101... TRICHOMONAL VAGINITIS............................... 97
13102... TRICHOMONAL URETHRITIS.............................. 97
13103... TRICHOMONAL PROSTATITIS............................. 97
13109... UROGENITAL TRICHOMON NEC............................ 97
1318.... TRICHOMONIASIS NEC.................................. 97
1319.... TRICHOMONIASIS NOS.................................. 97
1320.... PEDICULUS CAPITIS................................... 18
1321.... PEDICULUS CORPORIS.................................. 18
1322.... PHTHIRUS PUBIS...................................... 18
1323.... MIXED PEDICUL & PHTHIRUS............................ 18
1329.... PEDICULOSIS NOS..................................... 18
1330.... SCABIES............................................. 18
1338.... ACARIASIS NEC....................................... 18
1339.... ACARIASIS NOS....................................... 18
1340.... MYIASIS............................................. 18
1341.... ARTHROPOD INFEST NEC................................ 18
1342.... HIRUDINIASIS........................................ 18
1348.... INFESTATION NEC..................................... 18
1349.... INFESTATION NOS..................................... 18
135..... SARCOIDOSIS......................................... 33
1360.... AINHUM.............................................. 97
1361.... BEHCET'S SYNDROME................................... 24
1362.... FREE-LIVING AMEBA INFECT............................ 97
1363.... PNEUMOCYSTOSIS...................................... 33
1364.... PSOROSPERMIASIS..................................... 97
1365.... SARCOSPORIDIOSIS.................................... 97
1368.... INFECT/PARASITE DIS NEC............................. 97
1369.... INFECT/PARASITE DIS NOS............................. 97
1370.... LATE EFFECT TB, RESP/NOS............................ 33
1371.... LATE EFFECT CNS TB.................................. 63
1372.... LATE EFFECT GU TB................................... 53
1373.... LATE EFF BONE & JOINT TB............................ 24
1374.... LATE EFFECT TB NEC.................................. 97
138..... LATE EFFECT ACUTE POLIO............................. 63
1390.... LATE EFF VIRAL ENCEPHAL............................. 63
1391.... LATE EFFECT OF TRACHOMA............................. 68
1398.... LATE EFF INFECT DIS NEC............................. 97
1400.... MAL NEO UPPER VERMILION............................. 88
1401.... MAL NEO LOWER VERMILION............................. 88
1403.... MAL NEO UPPER LIP, INNER............................ 88
1404.... MAL NEO LOWER LIP, INNER............................ 88
1405.... MAL NEO LIP, INNER NOS.............................. 88
[[Page 47851]]
1406.... MAL NEO LIP, COMMISSURE............................. 88
1408.... MAL NEO LIP NEC..................................... 88
1409.... MAL NEO LIP/VERMIL NOS.............................. 88
1410.... MAL NEO TONGUE BASE................................. 88
1411.... MAL NEO DORSAL TONGUE............................... 88
1412.... MAL NEO TIP/LAT TONGUE.............................. 88
1413.... MAL NEO VENTRAL TONGUE.............................. 88
1414.... MAL NEO ANT 2/3 TONGUE.............................. 88
1415.... MAL NEO TONGUE JUNCTION............................. 88
1416.... MAL NEO LINGUAL TONSIL.............................. 88
1418.... MALIG NEO TONGUE NEC................................ 88
1419.... MALIG NEO TONGUE NOS................................ 88
1420.... MALIG NEO PAROTID................................... 88
1421.... MALIG NEO SUBMANDIBULAR............................. 88
1422.... MALIG NEO SUBLINGUAL................................ 88
1428.... MAL NEO MAJ SALIVARY NEC............................ 88
1429.... MAL NEO SALIVARY NOS................................ 88
1430.... MALIG NEO UPPER GUM................................. 88
1431.... MALIG NEO LOWER GUM................................. 88
1438.... MALIG NEO GUM NEC................................... 88
1439.... MALIG NEO GUM NOS................................... 88
1440.... MAL NEO ANT FLOOR MOUTH............................. 88
1441.... MAL NEO LAT FLOOR MOUTH............................. 88
1448.... MAL NEO MOUTH FLOOR NEC............................. 88
1449.... MAL NEO MOUTH FLOOR NOS............................. 88
1450.... MAL NEO CHEEK MUCOSA................................ 88
1451.... MAL NEO MOUTH VESTIBULE............................. 88
1452.... MALIG NEO HARD PALATE............................... 88
1453.... MALIG NEO SOFT PALATE............................... 88
1454.... MALIGNANT NEOPLASM UVULA............................ 88
1455.... MALIGNANT NEO PALATE NOS............................ 88
1456.... MALIG NEO RETROMOLAR................................ 88
1458.... MALIG NEOPLASM MOUTH NEC............................ 88
1459.... MALIG NEOPLASM MOUTH NOS............................ 88
1460.... MALIGNANT NEOPL TONSIL.............................. 88
1461.... MAL NEO TONSILLAR FOSSA............................. 88
1462.... MAL NEO TONSIL PILLARS.............................. 88
1463.... MALIGN NEOPL VALLECULA.............................. 88
1464.... MAL NEO ANT EPIGLOTTIS.............................. 88
1465.... MAL NEO EPIGLOTTIS JUNCT............................ 88
1466.... MAL NEO LAT OROPHARYNX.............................. 88
1467.... MAL NEO POST OROPHARYNX............................. 88
1468.... MAL NEO OROPHARYNX NEC.............................. 88
1469.... MALIG NEO OROPHARYNX NOS............................ 88
1470.... MAL NEO SUPER NASOPHARYN............................ 88
1471.... MAL NEO POST NASOPHARYNX............................ 88
1472.... MAL NEO LAT NASOPHARYNX............................. 88
1473.... MAL NEO ANT NASOPHARYNX............................. 88
1478.... MAL NEO NASOPHARYNX NEC............................. 88
1479.... MAL NEO NASOPHARYNX NOS............................. 88
1480.... MAL NEO POSTCRICOID................................. 88
1481.... MAL NEO PYRIFORM SINUS.............................. 88
1482.... MAL NEO ARYEPIGLOTT FOLD............................ 88
1483.... MAL NEO POST HYPOPHARYNX............................ 88
1488.... MAL NEO HYPOPHARYNX NEC............................. 88
1489.... MAL NEO HYPOPHARYNX NOS............................. 88
1490.... MAL NEO PHARYNX NOS................................. 88
1491.... MAL NEO WALDEYER'S RING............................. 88
1498.... MAL NEO ORAL/PHARYNX NEC............................ 88
1499.... MAL NEO OROPHRYN ILL-DEF............................ 88
1500.... MAL NEO CERVICAL ESOPHAG............................ 88
1501.... MAL NEO THORACIC ESOPHAG............................ 88
1502.... MAL NEO ABDOMIN ESOPHAG............................. 88
1503.... MAL NEO UPPER 3RD ESOPH............................. 88
1504.... MAL NEO MIDDLE 3RD ESOPH............................ 88
1505.... MAL NEO LOWER 3RD ESOPH............................. 88
1508.... MAL NEO ESOPHAGUS NEC............................... 88
1509.... MAL NEO ESOPHAGUS NOS............................... 88
1510.... MAL NEO STOMACH CARDIA.............................. 88
1511.... MALIGNANT NEO PYLORUS............................... 88
1512.... MAL NEO PYLORIC ANTRUM.............................. 88
1513.... MAL NEO STOMACH FUNDUS.............................. 88
1514.... MAL NEO STOMACH BODY................................ 88
1515.... MAL NEO STOM LESSER CURV............................ 88
1516.... MAL NEO STOM GREAT CURV............................. 88
1518.... MALIG NEOPL STOMACH NEC............................. 88
[[Page 47852]]
1519.... MALIG NEOPL STOMACH NOS............................. 88
1520.... MALIGNANT NEOPL DUODENUM............................ 88
1521.... MALIGNANT NEOPL JEJUNUM............................. 88
1522.... MALIGNANT NEOPLASM ILEUM............................ 88
1523.... MAL NEO MECKEL'S DIVERT............................. 88
1528.... MAL NEO SMALL BOWEL NEC............................. 88
1529.... MAL NEO SMALL BOWEL NOS............................. 88
1530.... MAL NEO HEPATIC FLEXURE............................. 88
1531.... MAL NEO TRANSVERSE COLON............................ 88
1532.... MAL NEO DESCEND COLON............................... 88
1533.... MAL NEO SIGMOID COLON............................... 88
1534.... MALIGNANT NEOPLASM CECUM............................ 88
1535.... MALIGNANT NEO APPENDIX.............................. 88
1536.... MALIG NEO ASCEND COLON.............................. 88
1537.... MAL NEO SPLENIC FLEXURE............................. 88
1538.... MALIGNANT NEO COLON NEC............................. 88
1539.... MALIGNANT NEO COLON NOS............................. 88
1540.... MAL NEO RECTOSIGMOID JCT............................ 88
1541.... MALIGNANT NEOPL RECTUM.............................. 88
1542.... MALIG NEOPL ANAL CANAL.............................. 88
1543.... MALIGNANT NEO ANUS NOS.............................. 88
1548.... MAL NEO RECTUM/ANUS NEC............................. 88
1550.... MAL NEO LIVER, PRIMARY.............................. 88
1551.... MAL NEO INTRAHEPAT DUCTS............................ 88
1552.... MALIGNANT NEO LIVER NOS............................. 88
1560.... MALIG NEO GALLBLADDER............................... 88
1561.... MAL NEO EXTRAHEPAT DUCTS............................ 88
1562.... MAL NEO AMPULLA OF VATER............................ 88
1568.... MALIG NEO BILIARY NEC............................... 88
1569.... MALIG NEO BILIARY NOS............................... 88
1570.... MAL NEO PANCREAS HEAD............................... 88
1571.... MAL NEO PANCREAS BODY............................... 88
1572.... MAL NEO PANCREAS TAIL............................... 88
1573.... MAL NEO PANCREATIC DUCT............................. 88
1574.... MAL NEO ISLET LANGERHANS............................ 88
1578.... MALIG NEO PANCREAS NEC.............................. 88
1579.... MALIG NEO PANCREAS NOS.............................. 88
1580.... MAL NEO RETROPERITONEUM............................. 88
1588.... MAL NEO PERITONEUM NEC.............................. 88
1589.... MAL NEO PERITONEUM NOS.............................. 88
1590.... MALIG NEO INTESTINE NOS............................. 88
1591.... MALIGNANT NEO SPLEEN NEC............................ 88
1598.... MAL NEO GI/INTRA-ABD NEC............................ 88
1599.... MAL NEO GI TRACT ILL-DEF............................ 88
1600.... MAL NEO NASAL CAVITIES.............................. 88
1601.... MALIG NEO MIDDLE EAR................................ 88
1602.... MAL NEO MAXILLARY SINUS............................. 88
1603.... MAL NEO ETHMOIDAL SINUS............................. 88
1604.... MALIG NEO FRONTAL SINUS............................. 88
1605.... MAL NEO SPHENOID SINUS.............................. 88
1608.... MAL NEO ACCESS SINUS NEC............................ 88
1609.... MAL NEO ACCESS SINUS NOS............................ 88
1610.... MALIGNANT NEO GLOTTIS............................... 88
1611.... MALIG NEO SUPRAGLOTTIS.............................. 88
1612.... MALIG NEO SUBGLOTTIS................................ 88
1613.... MAL NEO CARTILAGE LARYNX............................ 88
1618.... MALIGNANT NEO LARYNX NEC............................ 88
1619.... MALIGNANT NEO LARYNX NOS............................ 88
1620.... MALIGNANT NEO TRACHEA............................... 88
1622.... MALIG NEO MAIN BRONCHUS............................. 88
1623.... MAL NEO UPPER LOBE LUNG............................. 88
1624.... MAL NEO MIDDLE LOBE LUNG............................ 88
1625.... MAL NEO LOWER LOBE LUNG............................. 88
1628.... MAL NEO BRONCH/LUNG NEC............................. 88
1629.... MAL NEO BRONCH/LUNG NOS............................. 88
1630.... MAL NEO PARIETAL PLEURA............................. 88
1631.... MAL NEO VISCERAL PLEURA............................. 88
1638.... MALIG NEOPL PLEURA NEC.............................. 88
1639.... MALIG NEOPL PLEURA NOS.............................. 88
1640.... MALIGNANT NEOPL THYMUS.............................. 88
1641.... MALIGNANT NEOPL HEART............................... 88
1642.... MAL NEO ANT MEDIASTINUM............................. 88
1643.... MAL NEO POST MEDIASTINUM............................ 88
1648.... MAL NEO MEDIASTINUM NEC............................. 88
1649.... MAL NEO MEDIASTINUM NOS............................. 88
1650.... MAL NEO UPPER RESP NOS.............................. 88
[[Page 47853]]
1658.... MAL NEO THORAX/RESP NEC............................. 88
1659.... MAL NEO RESP SYSTEM NOS............................. 88
1700.... MAL NEO SKULL/FACE BONE............................. 88
1701.... MALIGNANT NEO MANDIBLE.............................. 88
1702.... MALIG NEO VERTEBRAE................................. 88
1703.... MAL NEO RIBS/STERN/CLAV............................. 88
1704.... MAL NEO LONG BONES ARM.............................. 88
1705.... MAL NEO BONES WRIST/HAND............................ 88
1706.... MAL NEO PELVIC GIRDLE............................... 88
1707.... MAL NEO LONG BONES LEG.............................. 88
1708.... MAL NEO BONES ANKLE/FOOT............................ 88
1709.... MALIG NEOPL BONE NOS................................ 88
1710.... MAL NEO SOFT TISSUE HEAD............................ 88
1712.... MAL NEO SOFT TISSUE ARM............................. 88
1713.... MAL NEO SOFT TISSUE LEG............................. 88
1714.... MAL NEO SOFT TIS THORAX............................. 88
1715.... MAL NEO SOFT TIS ABDOMEN............................ 88
1716.... MAL NEO SOFT TIS PELVIS............................. 88
1717.... MAL NEOPL TRUNK NOS................................. 88
1718.... MAL NEO SOFT TISSUE NEC............................. 88
1719.... MAL NEO SOFT TISSUE NOS............................. 88
1720.... MALIG MELANOMA LIP.................................. 88
1721.... MALIG MELANOMA EYELID............................... 88
1722.... MALIG MELANOMA EAR.................................. 88
1723.... MAL MELANOM FACE NEC/NOS............................ 88
1724.... MAL MELANOMA SCALP/NECK............................. 88
1725.... MALIG MELANOMA TRUNK................................ 88
1726.... MALIG MELANOMA ARM.................................. 88
1727.... MALIG MELANOMA LEG.................................. 88
1728.... MALIG MELANOMA SKIN NEC............................. 88
1729.... MALIG MELANOMA SKIN NOS............................. 88
1730.... MALIG NEO SKIN LIP.................................. 88
1731.... MALIG NEO SKIN EYELID............................... 88
1732.... MALIG NEO SKIN EAR.................................. 88
1733.... MAL NEO SKIN FACE NEC............................... 88
1734.... MAL NEO SCALP/SKIN NECK............................. 88
1735.... MALIG NEO SKIN TRUNK................................ 88
1736.... MALIG NEO SKIN ARM.................................. 88
1737.... MALIG NEO SKIN LEG.................................. 88
1738.... MALIG NEO SKIN NEC.................................. 88
1739.... MALIG NEO SKIN NOS.................................. 88
1740.... MALIG NEO NIPPLE.................................... 88
1741.... MAL NEO BREAST-CENTRAL.............................. 88
1742.... MAL NEO BREAST UP-INNER............................. 88
1743.... MAL NEO BREAST LOW-INNER............................ 88
1744.... MAL NEO BREAST UP-OUTER............................. 88
1745.... MAL NEO BREAST LOW-OUTER............................ 88
1746.... MAL NEO BREAST-AXILLARY............................. 88
1748.... MALIGN NEOPL BREAST NEC............................. 88
1749.... MALIGN NEOPL BREAST NOS............................. 88
1750.... MAL NEO MALE NIPPLE................................. 88
1759.... MAL NEO MALE BREAST NEC............................. 88
1760.... SKIN - KAPOSI'S SARCOMA............................. 86
1761.... SFT TISUE - KPSI'S SRCMA............................ 86
1762.... PALATE - KPSI's SARCOMA............................. 86
1763.... GI SITES - KPSI'S SRCOMA............................ 86
1764.... LUNG - KAPOSI'S SARCOMA............................. 86
1765.... LYM NDS - KPSI'S SARCOMA............................ 86
1768.... SPF STS - KPSI'S SARCOMA............................ 86
1769.... KAPOSI'S SARCOMA NOS................................ 86
179..... MALIG NEOPL UTERUS NOS.............................. 88
1800.... MALIG NEO ENDOCERVIX................................ 88
1801.... MALIG NEO EXOCERVIX................................. 88
1808.... MALIG NEO CERVIX NEC................................ 88
1809.... MAL NEO CERVIX UTERI NOS............................ 88
181..... MALIGNANT NEOPL PLACENTA............................ 88
1820.... MALIG NEO CORPUS UTERI.............................. 88
1821.... MAL NEO UTERINE ISTHMUS............................. 88
1828.... MAL NEO BODY UTERUS NEC............................. 88
1830.... MALIGN NEOPL OVARY.................................. 88
1832.... MAL NEO FALLOPIAN TUBE.............................. 88
1833.... MAL NEO BROAD LIGAMENT.............................. 88
1834.... MALIG NEO PARAMETRIUM............................... 88
1835.... MAL NEO ROUND LIGAMENT.............................. 88
1838.... MAL NEO ADNEXA NEC.................................. 88
1839.... MAL NEO ADNEXA NOS.................................. 88
[[Page 47854]]
1840.... MALIGN NEOPL VAGINA................................. 88
1841.... MAL NEO LABIA MAJORA................................ 88
1842.... MAL NEO LABIA MINORA................................ 88
1843.... MALIGN NEOPL CLITORIS............................... 88
1844.... MALIGN NEOPL VULVA NOS.............................. 88
1848.... MAL NEO FEMALE GENIT NEC............................ 88
1849.... MAL NEO FEMALE GENIT NOS............................ 88
185..... MALIGN NEOPL PROSTATE............................... 88
1860.... MAL NEO UNDESCEND TESTIS............................ 88
1869.... MALIG NEO TESTIS NEC................................ 88
1871.... MALIGN NEOPL PREPUCE................................ 88
1872.... MALIG NEO GLANS PENIS............................... 88
1873.... MALIG NEO PENIS BODY................................ 88
1874.... MALIG NEO PENIS NOS................................. 88
1875.... MALIG NEO EPIDIDYMIS................................ 88
1876.... MAL NEO SPERMATIC CORD.............................. 88
1877.... MALIGN NEOPL SCROTUM................................ 88
1878.... MAL NEO MALE GENITAL NEC............................ 88
1879.... MAL NEO MALE GENITAL NOS............................ 88
1880.... MAL NEO BLADDER-TRIGONE............................. 88
1881.... MAL NEO BLADDER-DOME................................ 88
1882.... MAL NEO BLADDER-LATERAL............................. 88
1883.... MAL NEO BLADDER-ANTERIOR............................ 88
1884.... MAL NEO BLADDER-POST................................ 88
1885.... MAL NEO BLADDER NECK................................ 88
1886.... MAL NEO URETERIC ORIFICE............................ 88
1887.... MALIG NEO URACHUS................................... 88
1888.... MALIG NEO BLADDER NEC............................... 88
1889.... MALIG NEO BLADDER NOS............................... 88
1890.... MALIG NEOPL KIDNEY.................................. 88
1891.... MALIG NEO RENAL PELVIS.............................. 88
1892.... MALIGN NEOPL URETER................................. 88
1893.... MALIGN NEOPL URETHRA................................ 88
1894.... MAL NEO PARAURETHRAL................................ 88
1898.... MAL NEO URINARY NEC................................. 88
1899.... MAL NEO URINARY NOS................................. 88
1900.... MALIGN NEOPL EYEBALL................................ 88
1901.... MALIGN NEOPL ORBIT.................................. 88
1902.... MAL NEO LACRIMAL GLAND.............................. 88
1903.... MAL NEO CONJUNCTIVA................................. 88
1904.... MALIGN NEOPL CORNEA................................. 88
1905.... MALIGN NEOPL RETINA................................. 88
1906.... MALIGN NEOPL CHOROID................................ 88
1907.... MAL NEO LACRIMAL DUCT............................... 88
1908.... MALIGN NEOPL EYE NEC................................ 88
1909.... MALIGN NEOPL EYE NOS................................ 88
1910.... MALIGN NEOPL CEREBRUM............................... 88
1911.... MALIG NEO FRONTAL LOBE.............................. 88
1912.... MAL NEO TEMPORAL LOBE............................... 88
1913.... MAL NEO PARIETAL LOBE............................... 88
1914.... MAL NEO OCCIPITAL LOBE.............................. 88
1915.... MAL NEO CEREB VENTRICLE............................. 88
1916.... MAL NEO CEREBELLUM NOS.............................. 88
1917.... MAL NEO BRAIN STEM.................................. 88
1918.... MALIG NEO BRAIN NEC................................. 88
1919.... MALIG NEO BRAIN NOS................................. 88
1920.... MAL NEO CRANIAL NERVES.............................. 88
1921.... MAL NEO CEREBRAL MENING............................. 88
1922.... MAL NEO SPINAL CORD................................. 88
1923.... MAL NEO SPINAL MENINGES............................. 88
1928.... MAL NEO NERVOUS SYST NEC............................ 88
1929.... MAL NEO NERVOUS SYST NOS............................ 88
193..... MALIGN NEOPL THYROID................................ 88
1940.... MALIGN NEOPL ADRENAL................................ 88
1941.... MALIG NEO PARATHYROID............................... 88
1943.... MALIG NEO PITUITARY................................. 88
1944.... MALIGN NEO PINEAL GLAND............................. 88
1945.... MAL NEO CAROTID BODY................................ 88
1946.... MAL NEO PARAGANGLIA NEC............................. 88
1948.... MAL NEO ENDOCRINE NEC............................... 88
1949.... MAL NEO ENDOCRINE NOS............................... 88
1950.... MAL NEO HEAD/FACE/NECK.............................. 88
1951.... MALIGN NEOPL THORAX................................. 88
1952.... MALIG NEO ABDOMEN................................... 88
1953.... MALIGN NEOPL PELVIS................................. 88
1954.... MALIGN NEOPL ARM.................................... 88
[[Page 47855]]
1955.... MALIGN NEOPL LEG.................................... 88
1958.... MALIG NEO SITE NEC.................................. 88
1960.... MAL NEO LYMPH-HEAD/NECK............................. 88
1961.... MAL NEO LYMPH-INTRATHOR............................. 88
1962.... MAL NEO LYMPH INTRA-ABD............................. 88
1963.... MAL NEO LYMPH-AXILLA/ARM............................ 88
1965.... MAL NEO LYMPH-INGUIN/LEG............................ 88
1966.... MAL NEO LYMPH-INTRAPELV............................. 88
1968.... MAL NEO LYMPH NODE-MULT............................. 88
1969.... MAL NEO LYMPH NODE NOS.............................. 88
1970.... SECONDARY MALIG NEO LUNG............................ 88
1971.... SEC MAL NEO MEDIASTINUM............................. 88
1972.... SECOND MALIG NEO PLEURA............................. 88
1973.... SEC MALIG NEO RESP NEC.............................. 88
1974.... SEC MALIG NEO SM BOWEL.............................. 88
1975.... SEC MALIG NEO LG BOWEL.............................. 88
1976.... SEC MAL NEO PERITONEUM.............................. 88
1977.... SECOND MALIG NEO LIVER.............................. 88
1978.... SEC MAL NEO GI NEC.................................. 88
1980.... SECOND MALIG NEO KIDNEY............................. 88
1981.... SEC MALIG NEO URIN NEC.............................. 88
1982.... SECONDARY MALIG NEO SKIN............................ 88
1983.... SEC MAL NEO BRAIN/SPINE............................. 88
1984.... SEC MALIG NEO NERVE NEC............................. 88
1985.... SECONDARY MALIG NEO BONE............................ 88
1986.... SECOND MALIG NEO OVARY.............................. 88
1987.... SECOND MALIG NEO ADRENAL............................ 88
19881... SECOND MALIG NEO BREAST............................. 88
19882... SECOND MALIG NEO GENITAL............................ 88
19889... SECONDARY MALIG NEO NEC............................. 88
1990.... MALIG NEO DISSEMINATED.............................. 88
1991.... MALIGNANT NEOPLASM NOS.............................. 88
20000... RETCLSRC UNSP XTRNDL ORG............................ 88
20001... RETICULOSARCOMA HEAD................................ 88
20002... RETICULOSARCOMA THORAX.............................. 88
20003... RETICULOSARCOMA ABDOM............................... 88
20004... RETICULOSARCOMA AXILLA.............................. 88
20005... RETICULOSARCOMA INGUIN.............................. 88
20006... RETICULOSARCOMA PELVIC.............................. 88
20007... RETICULOSARCOMA SPLEEN.............................. 88
20008... RETICULOSARCOMA MULT................................ 88
20010... LYMPHSRC UNSP XTRNDL ORG............................ 88
20011... LYMPHOSARCOMA HEAD.................................. 88
20012... LYMPHOSARCOMA THORAX................................ 88
20013... LYMPHOSARCOMA ABDOM................................. 88
20014... LYMPHOSARCOMA AXILLA................................ 88
20015... LYMPHOSARCOMA INGUIN................................ 88
20016... LYMPHOSARCOMA PELVIC................................ 88
20017... LYMPHOSARCOMA SPLEEN................................ 88
20018... LYMPHOSARCOMA MULT.................................. 88
20020... BRKT TMR UNSP XTRNDL ORG............................ 88
20021... BURKITT'S TUMOR HEAD................................ 88
20022... BURKITT'S TUMOR THORAX.............................. 88
20023... BURKITT'S TUMOR ABDOM............................... 88
20024... BURKITT'S TUMOR AXILLA.............................. 88
20025... BURKITT'S TUMOR INGUIN.............................. 88
20026... BURKITT'S TUMOR PELVIC.............................. 88
20027... BURKITT'S TUMOR SPLEEN.............................. 88
20028... BURKITT'S TUMOR MULT................................ 88
20080... OTH VARN UNSP XTRNDL ORG............................ 88
20081... MIXED LYMPHOSARC HEAD............................... 88
20082... MIXED LYMPHOSARC THORAX............................. 88
20083... MIXED LYMPHOSARC ABDOM.............................. 88
20084... MIXED LYMPHOSARC AXILLA............................. 88
20085... MIXED LYMPHOSARC INGUIN............................. 88
20086... MIXED LYMPHOSARC PELVIC............................. 88
20087... MIXED LYMPHOSARC SPLEEN............................. 88
20088... MIXED LYMPHOSARC MULT............................... 88
20100... HDGK PRG UNSP XTRNDL ORG............................ 88
20101... HODGKINS PARAGRAN HEAD.............................. 88
20102... HODGKINS PARAGRAN THORAX............................ 88
20103... HODGKINS PARAGRAN ABDOM............................. 88
20104... HODGKINS PARAGRAN AXILLA............................ 88
20105... HODGKINS PARAGRAN INGUIN............................ 88
20106... HODGKINS PARAGRAN PELVIC............................ 88
20107... HODGKINS PARAGRAN SPLEEN............................ 88
[[Page 47856]]
20108... HODGKINS PARAGRAN MULT.............................. 88
20110... HDGK GRN UNSP XTRNDL ORG............................ 88
20111... HODGKINS GRANULOM HEAD.............................. 88
20112... HODGKINS GRANULOM THORAX............................ 88
20113... HODGKINS GRANULOM ABDOM............................. 88
20114... HODGKINS GRANULOM AXILLA............................ 88
20115... HODGKINS GRANULOM INGUIN............................ 88
20116... HODGKINS GRANULOM PELVIC............................ 88
20117... HODGKINS GRANULOM SPLEEN............................ 88
20118... HODGKINS GRANULOM MULT.............................. 88
20120... HDGK SRC UNSP XTRNDL ORG............................ 88
20121... HODGKINS SARCOMA HEAD............................... 88
20122... HODGKINS SARCOMA THORAX............................. 88
20123... HODGKINS SARCOMA ABDOM.............................. 88
20124... HODGKINS SARCOMA AXILLA............................. 88
20125... HODGKINS SARCOMA INGUIN............................. 88
20126... HODGKINS SARCOMA PELVIC............................. 88
20127... HODGKINS SARCOMA SPLEEN............................. 88
20128... HODGKINS SARCOMA MULT............................... 88
20140... LYM-HST UNSP XTRNDL ORGN............................ 88
20141... HODG LYMPH-HISTIO HEAD.............................. 88
20142... HODG LYMPH-HISTIO THORAX............................ 88
20143... HODG LYMPH-HISTIO ABDOM............................. 88
20144... HODG LYMPH-HISTIO AXILLA............................ 88
20145... HODG LYMPH-HISTIO INGUIN............................ 88
20146... HODG LYMPH-HISTIO PELVIC............................ 88
20147... HODG LYMPH-HISTIO SPLEEN............................ 88
20148... HODG LYMPH-HISTIO MULT.............................. 88
20150... NDR SCLR UNSP XTRNDL ORG............................ 88
20151... HODG NODUL SCLERO HEAD.............................. 88
20152... HODG NODUL SCLERO THORAX............................ 88
20153... HODG NODUL SCLERO ABDOM............................. 88
20154... HODG NODUL SCLERO AXILLA............................ 88
20155... HODG NODUL SCLERO INGUIN............................ 88
20156... HODG NODUL SCLERO PELVIC............................ 88
20157... HODG NODUL SCLERO SPLEEN............................ 88
20158... HODG NODUL SCLERO MULT.............................. 88
20160... MXD CELR UNSP XTRNDL ORG............................ 88
20161... HODGKINS MIX CELL HEAD.............................. 88
20162... HODGKINS MIX CELL THORAX............................ 88
20163... HODGKINS MIX CELL ABDOM............................. 88
20164... HODGKINS MIX CELL AXILLA............................ 88
20165... HODGKINS MIX CELL INGUIN............................ 88
20166... HODGKINS MIX CELL PELVIC............................ 88
20167... HODGKINS MIX CELL SPLEEN............................ 88
20168... HODGKINS MIX CELL MULT.............................. 88
20170... LYM DPLT UNSP XTRNDL ORG............................ 88
20171... HODG LYMPH DEPLET HEAD.............................. 88
20172... HODG LYMPH DEPLET THORAX............................ 88
20173... HODG LYMPH DEPLET ABDOM............................. 88
20174... HODG LYMPH DEPLET AXILLA............................ 88
20175... HODG LYMPH DEPLET INGUIN............................ 88
20176... HODG LYMPH DEPLET PELVIC............................ 88
20177... HODG LYMPH DEPLET SPLEEN............................ 88
20178... HODG LYMPH DEPLET MULT.............................. 88
20190... HDGK DIS UNSP XTRNDL ORG............................ 88
20191... HODGKINS DIS NOS HEAD............................... 88
20192... HODGKINS DIS NOS THORAX............................. 88
20193... HODGKINS DIS NOS ABDOM.............................. 88
20194... HODGKINS DIS NOS AXILLA............................. 88
20195... HODGKINS DIS NOS INGUIN............................. 88
20196... HODGKINS DIS NOS PELVIC............................. 88
20197... HODGKINS DIS NOS SPLEEN............................. 88
20198... HODGKINS DIS NOS MULT............................... 88
20200... NDLR LYM UNSP XTRNDL ORG............................ 88
20201... NODULAR LYMPHOMA HEAD............................... 88
20202... NODULAR LYMPHOMA THORAX............................. 88
20203... NODULAR LYMPHOMA ABDOM.............................. 88
20204... NODULAR LYMPHOMA AXILLA............................. 88
20205... NODULAR LYMPHOMA INGUIN............................. 88
20206... NODULAR LYMPHOMA PELVIC............................. 88
20207... NODULAR LYMPHOMA SPLEEN............................. 88
20208... NODULAR LYMPHOMA MULT............................... 88
20210... MYCS FNG UNSP XTRNDL ORG............................ 88
20211... MYCOSIS FUNGOIDES HEAD.............................. 88
20212... MYCOSIS FUNGOIDES THORAX............................ 88
[[Page 47857]]
20213... MYCOSIS FUNGOIDES ABDOM............................. 88
20214... MYCOSIS FUNGOIDES AXILLA............................ 88
20215... MYCOSIS FUNGOIDES INGUIN............................ 88
20216... MYCOSIS FUNGOIDES PELVIC............................ 88
20217... MYCOSIS FUNGOIDES SPLEEN............................ 88
20218... MYCOSIS FUNGOIDES MULT.............................. 88
20220... SZRY DIS UNSP XTRNDL ORG............................ 88
20221... SEZARY'S DISEASE HEAD............................... 88
20222... SEZARY'S DISEASE THORAX............................. 88
20223... SEZARY'S DISEASE ABDOM.............................. 88
20224... SEZARY'S DISEASE AXILLA............................. 88
20225... SEZARY'S DISEASE INGUIN............................. 88
20226... SEZARY'S DISEASE PELVIC............................. 88
20227... SEZARY'S DISEASE SPLEEN............................. 88
20228... SEZARY'S DISEASE MULT............................... 88
20230... MLG HIST UNSP XTRNDL ORG............................ 88
20231... MAL HISTIOCYTOSIS HEAD.............................. 88
20232... MAL HISTIOCYTOSIS THORAX............................ 88
20233... MAL HISTIOCYTOSIS ABDOM............................. 88
20234... MAL HISTIOCYTOSIS AXILLA............................ 88
20235... MAL HISTIOCYTOSIS INGUIN............................ 88
20236... MAL HISTIOCYTOSIS PELVIC............................ 88
20237... MAL HISTIOCYTOSIS SPLEEN............................ 88
20238... MAL HISTIOCYTOSIS MULT.............................. 88
20240... LK RTCTL UNSP XTRNDL ORG............................ 88
20241... HAIRY-CELL LEUKEM HEAD.............................. 88
20242... HAIRY-CELL LEUKEM THORAX............................ 88
20243... HAIRY-CELL LEUKEM ABDOM............................. 88
20244... HAIRY-CELL LEUKEM AXILLA............................ 88
20245... HAIRY-CELL LEUKEM INGUIN............................ 88
20246... HAIRY-CELL LEUKEM PELVIC............................ 88
20247... HAIRY-CELL LEUKEM SPLEEN............................ 88
20248... HAIRY-CELL LEUKEM MULT.............................. 88
20250... LTR-SIWE UNSP XTRNDL ORG............................ 88
20251... LETTERER-SIWE DIS HEAD.............................. 88
20252... LETTERER-SIWE DIS THORAX............................ 88
20253... LETTERER-SIWE DIS ABDOM............................. 88
20254... LETTERER-SIWE DIS AXILLA............................ 88
20255... LETTERER-SIWE DIS INGUIN............................ 88
20256... LETTERER-SIWE DIS PELVIC............................ 88
20257... LETTERER-SIWE DIS SPLEEN............................ 88
20258... LETTERER-SIWE DIS MULT.............................. 88
20260... MLG MAST UNSP XTRNDL ORG............................ 88
20261... MAL MASTOCYTOSIS HEAD............................... 88
20262... MAL MASTOCYTOSIS THORAX............................. 88
20263... MAL MASTOCYTOSIS ABDOM.............................. 88
20264... MAL MASTOCYTOSIS AXILLA............................. 88
20265... MAL MASTOCYTOSIS INGUIN............................. 88
20266... MAL MASTOCYTOSIS PELVIC............................. 88
20267... MAL MASTOCYTOSIS SPLEEN............................. 88
20268... MAL MASTOCYTOSIS MULT............................... 88
20280... OTH LYMP UNSP XTRNDL ORG............................ 88
20281... LYMPHOMAS NEC HEAD.................................. 88
20282... LYMPHOMAS NEC THORAX................................ 88
20283... LYMPHOMAS NEC ABDOM................................. 88
20284... LYMPHOMAS NEC AXILLA................................ 88
20285... LYMPHOMAS NEC INGUIN................................ 88
20286... LYMPHOMAS NEC PELVIC................................ 88
20287... LYMPHOMAS NEC SPLEEN................................ 88
20288... LYMPHOMAS NEC MULT.................................. 88
20290... UNSP LYM UNSP XTRNDL ORG............................ 88
20291... LYMPHOID MAL NEC HEAD............................... 88
20292... LYMPHOID MAL NEC THORAX............................. 88
20293... LYMPHOID MAL NEC ABDOM.............................. 88
20294... LYMPHOID MAL NEC AXILLA............................. 88
20295... LYMPHOID MAL NEC INGUIN............................. 88
20296... LYMPHOID MAL NEC PELVIC............................. 88
20297... LYMPHOID MAL NEC SPLEEN............................. 88
20298... LYMPHOID MAL NEC MULT............................... 88
20300... MULT MYELM W/O REMISSION............................ 88
20301... MULT MYELM W REMISSION.............................. 88
20310... PLSM CELL LEUK W/O RMSON............................ 88
20311... PLSM CELL LEUK W RMSON.............................. 88
20380... OTH IMNPRFL NPL W/O RMSN............................ 88
20381... OTH IMNPRFL NPL W RMSN.............................. 88
20400... ACT LYM LEUK W/O RMSION............................. 88
[[Page 47858]]
20401... ACT LYM LEUK W RMSION............................... 88
20410... CHR LYM LEUK W/O RMSION............................. 88
20411... CHR LYM LEUK W RMSION............................... 88
20420... SBAC LYM LEUK W/O RMSION............................ 88
20421... SBAC LYM LEUK W RMSION.............................. 88
20480... OTH LYM LEUK W/O RMSION............................. 88
20481... OTH LYM LEUK W RMSION............................... 88
20490... UNS LYM LEUK W/O RMSION............................. 88
20491... UNS LYM LEUK W RMSION............................... 88
20500... ACT MYL LEUK W/O RMSION............................. 88
20501... ACT MYL LEUK W RMSION............................... 88
20510... CHR MYL LEUK W/O RMSION............................. 88
20511... CHR MYL LEUK W RMSION............................... 88
20520... SBAC MYL LEUK W/O RMSION............................ 88
20521... SBAC MYL LEUK W RMSION.............................. 88
20530... MYL SRCOMA W/O RMSION............................... 88
20531... MYL SRCOMA W RMSION................................. 88
20580... OTH MYL LEUK W/O RMSION............................. 88
20581... OTH MYL LEUK W RMSION............................... 88
20590... UNS MYL LEUK W/O RMSION............................. 88
20591... UNS MYL LEUK W RMSION............................... 88
20600... ACT MONO LEUK W/O RMSION............................ 88
20601... ACT MONO LEUK W RMSION.............................. 88
20610... CHR MONO LEUK W/O RMSION............................ 88
20611... CHR MONO LEUK W RMSION.............................. 88
20620... SBAC MONO LEUK W/O RMSON............................ 88
20621... SBAC MONO LEUK W RMSION............................. 88
20680... OTH MONO LEUK W/O RMSION............................ 88
20681... OTH MONO LEUK W RMSION.............................. 88
20690... UNS MONO LEUK W/O RMSION............................ 88
20691... UNS MONO LEUK W RMSION.............................. 88
20700... ACT ERTH/ERYLK W/O RMSON............................ 88
20701... ACT ERTH/ERYLK W RMSON.............................. 88
2071.... CHRONIC ERYTHREMIA*................................. 88
20710... CHR ERYTHRM W/O REMISION............................ 88
20711... CHR ERYTHRM W REMISION.............................. 88
2072.... MEGAKARYOCYTIC LEUKEMIA*............................ 88
20720... MGKRYCYT LEUK W/O RMSION............................ 88
20721... MGKRYCYT LEUK W RMSION.............................. 88
2078.... SPECIFIED LEUKEMIA NEC*............................. 88
20780... OTH SPF LEUK W/O REMSION............................ 88
20781... OTH SPF LEUK W REMSION.............................. 88
2080.... ACT LEUK UNS CL W/O RMSN*........................... 88
20800... ACT LEUK UNS CL W/O RMSN............................ 88
20801... ACT LEUK UNS CL W RMSON............................. 88
2081.... CHRONIC LEUKEMIA NOS*............................... 88
20810... CHR LEUK UNS CL W/O RMSN............................ 88
20811... CHR LEUK UNS CL W RMSON............................. 88
2082.... SUBACUTE LEUKEMIA NOS*.............................. 88
20820... SBAC LEUK UNS CL W/O RMS............................ 88
20821... SBAC LEUK UNS CL W RMSON............................ 88
2088.... LEUKEMIA-UNSPEC CELL NEC*........................... 88
20880... OTH LEUK UNS CL W/O RMSN............................ 88
20881... OTH LEUK UNS CL W RMSON............................. 88
2089.... LEUKEMIA-UNSPEC CELL NOS*........................... 88
20890... LEUKEMIA NOS W/O REMSION............................ 88
20891... LEUKEMIA NOS W REMISSION............................ 88
2100.... BENIGN NEOPLASM LIP................................. 31
2101.... BENIGN NEOPLASM TONGUE.............................. 31
2102.... BEN NEO MAJOR SALIVARY.............................. 31
2103.... BENIGN NEO MOUTH FLOOR.............................. 31
2104.... BENIGN NEO MOUTH NEC/NOS............................ 31
2105.... BENIGN NEOPLASM TONSIL.............................. 31
2106.... BENIGN NEO OROPHARYN NEC............................ 31
2107.... BENIGN NEO NASOPHARYNX.............................. 31
2108.... BENIGN NEO HYPOPHARYNX.............................. 31
2109.... BENIGN NEO PHARYNX NOS.............................. 31
2110.... BENIGN NEO ESOPHAGUS................................ 41
2111.... BENIGN NEOPLASM STOMACH............................. 41
2112.... BENIGN NEOPLASM SM BOWEL............................ 41
2113.... BENIGN NEOPLASM LG BOWEL............................ 41
2114.... BENIGN NEOPL RECTUM/ANUS............................ 41
2115.... BEN NEO LIVER/BILE DUCTS............................ 41
2116.... BENIGN NEOPLASM PANCREAS............................ 41
2117.... BEN NEO ISLETS LANGERHAN............................ 82
2118.... BEN NEO PERITONEUM.................................. 41
[[Page 47859]]
2119.... BEN NEO GI TRACT NEC/NOS............................ 41
2120.... BEN NEO NASAL CAV/SINUS............................. 31
2121.... BENIGN NEO LARYNX................................... 31
2122.... BENIGN NEO TRACHEA.................................. 33
2123.... BENIGN NEO BRONCHUS/LUNG............................ 33
2124.... BENIGN NEOPLASM PLEURA.............................. 33
2125.... BENIGN NEO MEDIASTINUM.............................. 33
2126.... BENIGN NEOPLASM THYMUS.............................. 86
2127.... BENIGN NEOPLASM HEART............................... 36
2128.... BENIGN NEO RESP SYS NEC............................. 33
2129.... BENIGN NEO RESP SYS NOS............................. 33
2130.... BEN NEO SKULL/FACE BONE............................. 24
2131.... BEN NEO LOWER JAW BONE.............................. 31
2132.... BENIGN NEO VERTEBRAE................................ 24
2133.... BEN NEO RIBS/STERN/CLAV............................. 33
2134.... BEN NEO LONG BONES ARM.............................. 24
2135.... BEN NEO BONES WRIST/HAND............................ 24
2136.... BENIGN NEO PELVIC GIRDLE............................ 24
2137.... BEN NEO LONG BONES LEG.............................. 24
2138.... BEN NEO BONES ANKLE/FOOT............................ 24
2139.... BENIGN NEO BONE NOS................................. 24
2140.... LIPOMA SKIN FACE.................................... 18
2141.... LIPOMA SKIN NEC..................................... 18
2142.... LIPOMA INTRATHORACIC................................ 33
2143.... LIPOMA INTRA-ABDOMINAL.............................. 41
2144.... LIPOMA SPERMATIC CORD............................... 53
2148.... LIPOMA NEC.......................................... 18
2149.... LIPOMA NOS.......................................... 18
2150.... BEN NEO SOFT TISSUE HEAD............................ 18
2152.... BEN NEO SOFT TISSUE ARM............................. 18
2153.... BEN NEO SOFT TISSUE LEG............................. 18
2154.... BEN NEO SOFT TIS THORAX............................. 18
2155.... BEN NEO SOFT TIS ABDOMEN............................ 18
2156.... BEN NEO SOFT TIS PELVIS............................. 18
2157.... BENIGN NEO TRUNK NOS................................ 18
2158.... BEN NEO SOFT TISSUE NEC............................. 18
2159.... BEN NEO SOFT TISSUE NOS............................. 18
2160.... BENIGN NEO SKIN LIP................................. 18
2161.... BENIGN NEO SKIN EYELID.............................. 68
2162.... BENIGN NEO SKIN EAR................................. 18
2163.... BENIGN NEO SKIN FACE NEC............................ 18
2164.... BEN NEO SCALP/SKIN NECK............................. 18
2165.... BENIGN NEO SKIN TRUNK............................... 18
2166.... BENIGN NEO SKIN ARM................................. 18
2167.... BENIGN NEO SKIN LEG................................. 18
2168.... BENIGN NEOPLASM SKIN NEC............................ 18
2169.... BENIGN NEOPLASM SKIN NOS............................ 18
217..... BENIGN NEOPLASM BREAST.............................. 18
2180.... SUBMUCOUS LEIOMYOMA................................. 56
2181.... INTRAMURAL LEIOMYOMA................................ 56
2182.... SUBSEROUS LEIOMYOMA................................. 56
2189.... UTERINE LEIOMYOMA NOS............................... 56
2190.... BENIGN NEO CERVIX UTERI............................. 56
2191.... BENIGN NEO CORPUS UTERI............................. 56
2198.... BENIGN NEO UTERUS NEC............................... 56
2199.... BENIGN NEO UTERUS NOS............................... 56
220..... BENIGN NEOPLASM OVARY............................... 56
2210.... BEN NEO FALLOPIAN TUBE.............................. 56
2211.... BENIGN NEOPLASM VAGINA.............................. 56
2212.... BENIGN NEOPLASM VULVA............................... 56
2218.... BEN NEO FEM GENITAL NEC............................. 56
2219.... BEN NEO FEM GENITAL NOS............................. 56
2220.... BENIGN NEOPLASM TESTIS.............................. 53
2221.... BENIGN NEOPLASM PENIS............................... 53
2222.... BENIGN NEOPLASM PROSTATE............................ 53
2223.... BENIGN NEO EPIDIDYMIS............................... 53
2224.... BENIGN NEOPLASM SCROTUM............................. 53
2228.... BEN NEO MALE GENITAL NEC............................ 53
2229.... BEN NEO MALE GENITAL NOS............................ 53
2230.... BENIGN NEOPLASM KIDNEY.............................. 53
2231.... BENIGN NEO RENAL PELVIS............................. 53
2232.... BENIGN NEOPLASM URETER.............................. 53
2233.... BENIGN NEOPLASM BLADDER............................. 53
22381... BENIGN NEOPLASM URETHRA............................. 53
22389... BENIGN NEO URINARY NEC.............................. 53
2239.... BENIGN NEO URINARY NOS.............................. 53
[[Page 47860]]
2240.... BENIGN NEOPLASM EYEBALL............................. 68
2241.... BENIGN NEOPLASM ORBIT............................... 68
2242.... BEN NEO LACRIMAL GLAND.............................. 68
2243.... BENIGN NEO CONJUNCTIVA.............................. 68
2244.... BENIGN NEOPLASM CORNEA.............................. 68
2245.... BENIGN NEOPLASM RETINA.............................. 68
2246.... BENIGN NEOPLASM CHOROID............................. 68
2247.... BEN NEO LACRIMAL DUCT............................... 68
2248.... BENIGN NEOPLASM EYE NEC............................. 68
2249.... BENIGN NEOPLASM EYE NOS............................. 68
2250.... BENIGN NEOPLASM BRAIN............................... 63
2251.... BENIGN NEO CRANIAL NERVE............................ 63
2252.... BEN NEO CEREBR MENINGES............................. 63
2253.... BENIGN NEO SPINAL CORD.............................. 63
2254.... BEN NEO SPINAL MENINGES............................. 63
2258.... BENIGN NEO NERV SYS NEC............................. 63
2259.... BENIGN NEO NERV SYS NOS............................. 63
226..... BENIGN NEOPLASM THYROID............................. 82
2270.... BENIGN NEOPLASM ADRENAL............................. 82
2271.... BENIGN NEO PARATHYROID.............................. 82
2273.... BENIGN NEO PITUITARY................................ 82
2274.... BEN NEOPL PINEAL GLAND.............................. 63
2275.... BENIGN NEO CAROTID BODY............................. 63
2276.... BEN NEO PARAGANGLIA NEC............................. 63
2278.... BENIGN NEO ENDOCRINE NEC............................ 82
2279.... BENIGN NEO ENDOCRINE NOS............................ 82
22800... HEMANGIOMA NOS...................................... 36
22801... HEMANGIOMA SKIN..................................... 18
22802... HEMANGIOMA INTRACRANIAL............................. 63
22803... HEMANGIOMA RETINA................................... 68
22804... HEMANGIOMA INTRA-ABDOM.............................. 41
22809... HEMANGIOMA NEC...................................... 36
2281.... LYMPHANGIOMA, ANY SITE.............................. 86
2290.... BENIGN NEO LYMPH NODES.............................. 86
2298.... BENIGN NEOPLASM NEC................................. 18
2299.... BENIGN NEOPLASM NOS................................. 18
2300.... CA IN SITU ORAL CAV/PHAR............................ 88
2301.... CA IN SITU ESOPHAGUS................................ 88
2302.... CA IN SITU STOMACH.................................. 88
2303.... CA IN SITU COLON.................................... 88
2304.... CA IN SITU RECTUM................................... 88
2305.... CA IN SITU ANAL CANAL............................... 88
2306.... CA IN SITU ANUS NOS................................. 88
2307.... CA IN SITU BOWEL NEC/NOS............................ 88
2308.... CA IN SITU LIVER/BILIARY............................ 88
2309.... CA IN SITU GI NEC/NOS............................... 88
2310.... CA IN SITU LARYNX................................... 88
2311.... CA IN SITU TRACHEA.................................. 88
2312.... CA IN SITU BRONCHUS/LUNG............................ 88
2318.... CA IN SITU RESP SYS NEC............................. 88
2319.... CA IN SITU RESP SYS NOS............................. 88
2320.... CA IN SITU SKIN LIP................................. 88
2321.... CA IN SITU EYELID................................... 88
2322.... CA IN SITU SKIN EAR................................. 88
2323.... CA IN SITU SKIN FACE NEC............................ 88
2324.... CA IN SITU SCALP.................................... 88
2325.... CA IN SITU SKIN TRUNK............................... 88
2326.... CA IN SITU SKIN ARM................................. 88
2327.... CA IN SITU SKIN LEG................................. 88
2328.... CA IN SITU SKIN NEC................................. 88
2329.... CA IN SITU SKIN NOS................................. 88
2330.... CA IN SITU BREAST................................... 88
2331.... CA IN SITU CERVIX UTERI............................. 88
2332.... CA IN SITU UTERUS NEC............................... 88
2333.... CA IN SITU FEM GEN NEC.............................. 88
2334.... CA IN SITU PROSTATE................................. 88
2335.... CA IN SITU PENIS.................................... 88
2336.... CA IN SITU MALE GEN NEC............................. 88
2337.... CA IN SITU BLADDER.................................. 88
2339.... CA IN SITU URINARY NEC.............................. 88
2340.... CA IN SITU EYE...................................... 88
2348.... CA IN SITU NEC...................................... 88
2349.... CA IN SITU NOS...................................... 88
2350.... UNC BEHAV NEO SALIVARY.............................. 88
2351.... UNC BEHAV NEO ORAL/PHAR............................. 88
2352.... UNC BEHAV NEO INTESTINE............................. 88
[[Page 47861]]
2353.... UNC BEHAV NEO LIVER................................. 88
2354.... UNC BEHAV NEO PERITONEUM............................ 88
2355.... UNC BEHAV NEO GI NEC................................ 88
2356.... UNC BEHAV NEO LARYNX................................ 88
2357.... UNC BEHAV NEO LUNG.................................. 88
2358.... UNC BEHAV NEO PLEURA................................ 88
2359.... UNC BEHAV NEO RESP NEC.............................. 88
2360.... UNCERT BEHAV NEO UTERUS............................. 88
2361.... UNC BEHAV NEO PLACENTA.............................. 88
2362.... UNC BEHAV NEO OVARY................................. 88
2363.... UNC BEHAV NEO FEMALE NEC............................ 88
2364.... UNC BEHAV NEO TESTIS................................ 88
2365.... UNC BEHAV NEO PROSTATE.............................. 88
2366.... UNC BEHAV NEO MALE NEC.............................. 88
2367.... UNC BEHAV NEO BLADDER............................... 88
23690... UNC BEHAV NEO URINAR NOS............................ 88
23691... UNC BEHAV NEO KIDNEY................................ 88
23699... UNC BEHAV NEO URINAR NEC............................ 88
2370.... UNC BEHAV NEO PITUITARY............................. 88
2371.... UNC BEHAV NEO PINEAL................................ 88
2372.... UNC BEHAV NEO ADRENAL............................... 88
2373.... UNC BEHAV NEO PARAGANG.............................. 88
2374.... UNCER NEO ENDOCRINE NEC............................. 88
2375.... UNC BEH NEO BRAIN/SPINAL............................ 88
2376.... UNC BEHAV NEO MENINGES.............................. 88
2377.... NEUROFIBROMATOSIS*.................................. 88
23770... NEUROFIBROMATOSIS NOS............................... 63
23771... NEUROFIBROMATOSIS TYPE I............................ 63
23772... NEUROFIBROMATOSIS TYP II............................ 63
2379.... UNC BEH NEO NERV SYS NEC............................ 88
2380.... UNC BEHAV NEO BONE.................................. 88
2381.... UNC BEHAV NEO SOFT TISSU............................ 88
2382.... UNC BEHAV NEO SKIN.................................. 88
2383.... UNC BEHAV NEO BREAST................................ 88
2384.... POLYCYTHEMIA VERA................................... 88
2385.... MASTOCYTOMA NOS..................................... 88
2386.... PLASMACYTOMA NOS.................................... 88
2387.... LYMPHOPROLIFERAT DIS NOS............................ 88
2388.... UNCERT BEHAVIOR NEO NEC............................. 88
2389.... UNCERT BEHAVIOR NEO NOS............................. 88
2390.... DIGESTIVE NEOPLASM NOS.............................. 88
2391.... RESPIRATORY NEOPLASM NOS............................ 88
2392.... BONE/SKIN NEOPLASM NOS.............................. 88
2393.... BREAST NEOPLASM NOS................................. 88
2394.... BLADDER NEOPLASM NOS................................ 88
2395.... OTHER GU NEOPLASM NOS............................... 88
2396.... BRAIN NEOPLASM NOS.................................. 88
2397.... ENDOCRINE/NERV NEO NOS.............................. 88
2398.... NEOPLASM NOS, SITE NEC.............................. 88
2399.... NEOPLASM NOS........................................ 88
2400.... SIMPLE GOITER....................................... 82
2409.... GOITER NOS.......................................... 82
2410.... NONTOX UNINODULAR GOITER............................ 82
2411.... NONTOX MULTINODUL GOITER............................ 82
2419.... NONTOX NODUL GOITER NOS............................. 82
24200... TOX DIF GOITER NO CRISIS............................ 82
24201... TOX DIF GOITER W CRISIS............................. 78
24210... TOX UNINOD GOIT NO CRIS............................. 82
24211... TOX UNINOD GOIT W CRISIS............................ 78
24220... TOX MULTNOD GOIT NO CRIS............................ 82
24221... TOX MULTNOD GOIT W CRIS............................. 78
24230... TOX NOD GOITER NO CRISIS............................ 82
24231... TOX NOD GOITER W CRISIS............................. 78
24240... THYROTOX-ECT NOD NO CRIS............................ 82
24241... THYROTOX-ECT NOD W CRIS............................. 78
24280... THYRTOX ORIG NEC NO CRIS............................ 82
24281... THYROTOX ORIG NEC W CRIS............................ 78
24290... THYROTOX NOS NO CRISIS.............................. 82
24291... THYROTOX NOS W CRISIS............................... 78
243..... CONGENITAL HYPOTHYROIDSM............................ 82
2440.... POSTSURGICAL HYPOTHYROID............................ 82
2441.... POSTABLAT HYPOTHYR NEC.............................. 82
2442.... IODINE HYPOTHYROIDISM............................... 82
2443.... IATROGEN HYPOTHYROID NEC............................ 82
2448.... ACQUIRED HYPOTHYROID NEC............................ 82
2449.... HYPOTHYROIDISM NOS.................................. 82
[[Page 47862]]
2450.... ACUTE THYROIDITIS................................... 82
2451.... SUBACUTE THYROIDITIS................................ 82
2452.... CHR LYMPHOCYT THYROIDIT............................. 82
2453.... CHR FIBROUS THYROIDITIS............................. 82
2454.... IATROGENIC THYROIDITIS.............................. 82
2458.... CHR THYROIDITIS NEC/NOS............................. 82
2459.... THYROIDITIS NOS..................................... 82
2460.... DIS THYROCALCITON SECRET............................ 82
2461.... DYSHORMONOGENIC GOITER.............................. 82
2462.... CYST OF THYROID..................................... 82
2463.... HEMORR/INFARC THYROID............................... 82
2468.... DISORDERS OF THYROID NEC............................ 82
2469.... DISORDER OF THYROID NOS............................. 82
25000... DMII WO CMP NT ST UNCNTR............................ 82
25001... DMI WO CMP NT ST UNCNTRL............................ 82
25002... DMII WO CMP UNCNTRLD................................ 82
25003... DMI WO CMP UNCNTRLD................................. 82
25010... DMII KETO NT ST UNCNTRLD............................ 78
25011... DMI KETO NT ST UNCNTRLD............................. 78
25012... DMII KETOACD UNCONTROLD............................. 78
25013... DMI KETOACD UNCONTROLD.............................. 78
25020... DMII HPRSM NT ST UNCNTRL............................ 78
25021... DMI HPRSM NT ST UNCNTRLD............................ 78
25022... DMII HPROSMLR UNCONTROLD............................ 78
25023... DMI HPROSMLR UNCONTROLD............................. 78
25030... DMII O CM NT ST UNCNTRLD............................ 78
25031... DMI O CM NT ST UNCNTRLD............................. 78
25032... DMII OTH COMA UNCONTROLD............................ 78
25033... DMI OTH COMA UNCONTROLD............................. 78
25040... DMII RENL NT ST UNCNTRLD............................ 53
25041... DMI RENL NT ST UNCNTRLD............................. 53
25042... DMII RENAL UNCNTRLD................................. 82
25043... DMI RENAL UNCNTRLD.................................. 82
25050... DMII OPHTH NT ST UNCNTRL............................ 68
25051... DMI OPHTH NT ST UNCNTRLD............................ 68
25052... DMII OPHTH UNCNTRLD................................. 82
25053... DMI OPHTH UNCNTRLD.................................. 82
25060... DMII NEURO NT ST UNCNTRL............................ 63
25061... DMI NEURO NT ST UNCNTRLD............................ 63
25062... DMII NEURO UNCNTRLD................................. 82
25063... DMI NEURO UNCNTRLD.................................. 82
25070... DMII CIRC NT ST UNCNTRLD............................ 82
25071... DMI CIRC NT ST UNCNTRLD............................. 82
25072... DMII CIRC UNCNTRLD.................................. 82
25073... DMI CIRC UNCNTRLD................................... 82
25080... DMII OTH NT ST UNCNTRLD............................. 82
25081... DMI OTH NT ST UNCNTRLD.............................. 82
25082... DMII OTH UNCNTRLD................................... 82
25083... DMI OTH UNCNTRLD.................................... 82
25090... DMII UNSPF NT ST UNCNTRL............................ 82
25091... DMI UNSPF NT ST UNCNTRLD............................ 82
25092... DMII UNSPF UNCNTRLD................................. 82
25093... DMI UNSPF UNCNTRLD.................................. 82
2510.... HYPOGLYCEMIC COMA................................... 78
2511.... OTH SPCF HYPOGLYCEMIA............................... 82
2512.... HYPOGLYCEMIA NOS.................................... 82
2513.... POSTSURG HYPOINSULINEMIA............................ 82
2514.... ABN SECRETION GLUCAGON.............................. 82
2515.... ABNORM SECRETION GASTRIN............................ 41
2518.... PANCREATIC DISORDER NEC............................. 82
2519.... PANCREATIC DISORDER NOS............................. 82
2520.... HYPERPARATHYROIDISM................................. 82
2521.... HYPOPARATHYROIDISM.................................. 82
2528.... PARATHYROID DISORDER NEC............................ 82
2529.... PARATHYROID DISORDER NOS............................ 82
2530.... ACROMEGALY AND GIGANTISM............................ 82
2531.... ANT PITUIT HYPERFUNC NEC............................ 82
2532.... PANHYPOPITUITARISM.................................. 82
2533.... PITUITARY DWARFISM.................................. 82
2534.... ANTER PITUITARY DIS NEC............................. 82
2535.... DIABETES INSIPIDUS.................................. 82
2536.... NEUROHYPOPHYSIS DIS NEC............................. 82
2537.... IATROGENIC PITUITARY DIS............................ 82
2538.... PITUITARY DISORDER NEC.............................. 82
2539.... PITUITARY DISORDER NOS.............................. 82
2540.... PERSIST HYPERPLAS THYMUS............................ 86
[[Page 47863]]
2541.... ABSCESS OF THYMUS................................... 86
2548.... DISEASES OF THYMUS NEC.............................. 86
2549.... DISEASE OF THYMUS NOS............................... 86
2550.... CUSHING'S SYNDROME.................................. 82
2551.... HYPERALDOSTERONISM.................................. 82
2552.... ADRENOGENITAL DISORDERS............................. 82
2553.... CORTICOADREN OVERACT NEC............................ 82
2554.... CORTICOADRENAL INSUFFIC............................. 82
2555.... ADRENAL HYPOFUNCTION NEC............................ 82
2556.... MEDULLOADRENAL HYPERFUNC............................ 82
2558.... ADRENAL DISORDER NEC................................ 82
2559.... ADRENAL DISORDER NOS................................ 82
2560.... HYPERESTROGENISM.................................... 56
2561.... OVARIAN HYPERFUNC NEC............................... 56
2562.... POSTABLATIV OVARIAN FAIL............................ 56
2563.... OVARIAN FAILURE NEC................................. 56
2564.... POLYCYSTIC OVARIES.................................. 56
2568.... OVARIAN DYSFUNCTION NEC............................. 56
2569.... OVARIAN DYSFUNCTION NOS............................. 56
2570.... TESTICULAR HYPERFUNCTION............................ 82
2571.... POSTABLAT TESTIC HYPOFUN............................ 82
2572.... TESTICULAR HYPOFUNC NEC............................. 82
2578.... TESTICULAR DYSFUNCT NEC............................. 82
2579.... TESTICULAR DYSFUNCT NOS............................. 82
2580.... WERMER'S SYNDROME................................... 82
2581.... COMB ENDOCR DYSFUNCT NEC............................ 82
2588.... POLYGLANDUL DYSFUNC NEC............................. 82
2589.... POLYGLANDUL DYSFUNC NOS............................. 82
2590.... DELAY SEXUAL DEVELOP NEC............................ 82
2591.... SEXUAL PRECOCITY NEC................................ 82
2592.... CARCINOID SYNDROME.................................. 82
2593.... ECTOPIC HORMONE SECR NEC............................ 82
2594.... DWARFISM NEC........................................ 82
2598.... ENDOCRINE DISORDERS NEC............................. 82
2599.... ENDOCRINE DISORDER NOS.............................. 82
260..... KWASHIORKOR......................................... 82
261..... NUTRITIONAL MARASMUS................................ 82
262..... OTH SEVERE MALNUTRITION............................. 82
2630.... MALNUTRITION MOD DEGREE............................. 82
2631.... MALNUTRITION MILD DEGREE............................ 82
2632.... ARREST DEVEL D/T MALNUTR............................ 82
2638.... PROTEIN-CAL MALNUTR NEC............................. 82
2639.... PROTEIN-CAL MALNUTR NOS............................. 82
2640.... VIT A CONJUNCTIV XEROSIS............................ 68
2641.... VIT A BITOT'S SPOT.................................. 68
2642.... VIT A CORNEAL XEROSIS............................... 68
2643.... VIT A CORNEA ULCER/XEROS............................ 68
2644.... VIT A KERATOMALACIA................................. 68
2645.... VIT A NIGHT BLINDNESS............................... 68
2646.... VIT A DEF W CORNEAL SCAR............................ 68
2647.... VIT A OCULAR DEFIC NEC.............................. 68
2648.... VITAMIN A DEFICIENCY NEC............................ 82
2649.... VITAMIN A DEFICIENCY NOS............................ 82
2650.... BERIBERI............................................ 82
2651.... THIAMINE DEFIC NEC/NOS.............................. 82
2652.... PELLAGRA............................................ 82
2660.... ARIBOFLAVINOSIS..................................... 82
2661.... VITAMIN B6 DEFICIENCY............................... 82
2662.... B-COMPLEX DEFIC NEC................................. 82
2669.... VITAMIN B DEFICIENCY NOS............................ 82
267..... ASCORBIC ACID DEFICIENCY............................ 82
2680.... RICKETS, ACTIVE..................................... 24
2681.... RICKETS, LATE EFFECT................................ 24
2682.... OSTEOMALACIA NOS.................................... 24
2689.... VITAMIN D DEFICIENCY NOS............................ 82
2690.... DEFICIENCY OF VITAMIN K............................. 82
2691.... VITAMIN DEFICIENCY NEC.............................. 82
2692.... VITAMIN DEFICIENCY NOS.............................. 82
2693.... MINERAL DEFICIENCY NEC.............................. 82
2698.... NUTRITION DEFICIENCY NEC............................ 82
2699.... NUTRITION DEFICIENCY NOS............................ 82
2700.... AMINO-ACID TRANSPORT DIS............................ 82
2701.... PHENYLKETONURIA-PKU................................. 82
2702.... AROM AMIN-ACID METAB NEC............................ 82
2703.... BRAN-CHAIN AMIN-ACID DIS............................ 82
2704.... SULPH AMINO-ACID MET DIS............................ 82
[[Page 47864]]
2705.... DIS HISTIDINE METABOLISM............................ 82
2706.... DIS UREA CYCLE METABOL.............................. 82
2707.... STRAIG AMIN-ACID MET NEC............................ 82
2708.... DIS AMINO-ACID METAB NEC............................ 82
2709.... DIS AMINO-ACID METAB NOS............................ 82
2710.... GLYCOGENOSIS........................................ 82
2711.... GALACTOSEMIA........................................ 82
2712.... HERED FRUCTOSE INTOLERAN............................ 41
2713.... DISACCHARIDASE DEF/MALAB............................ 41
2714.... RENAL GLYCOSURIA.................................... 82
2718.... DIS CARBOHYDR METAB NEC............................. 82
2719.... DIS CARBOHYDR METAB NOS............................. 82
2720.... PURE HYPERCHOLESTEROLEM............................. 82
2721.... PURE HYPERGLYCERIDEMIA.............................. 82
2722.... MIXED HYPERLIPIDEMIA................................ 82
2723.... HYPERCHYLOMICRONEMIA................................ 82
2724.... HYPERLIPIDEMIA NEC/NOS.............................. 82
2725.... LIPOPROTEIN DEFICIENCIES............................ 82
2726.... LIPODYSTROPHY....................................... 82
2727.... LIPIDOSES........................................... 82
2728.... LIPOID METABOL DIS NEC.............................. 82
2729.... LIPOID METABOL DIS NOS.............................. 82
2730.... POLYCLON HYPERGAMMAGLOBU............................ 86
2731.... MONOCLON PARAPROTEINEMIA............................ 86
2732.... PARAPROTEINEMIA NEC................................. 88
2733.... MACROGLOBULINEMIA................................... 88
2738.... DIS PLAS PROTEIN MET NEC............................ 88
2739.... DIS PLAS PROTEIN MET NOS............................ 88
2740.... GOUTY ARTHROPATHY................................... 24
27410... GOUTY NEPHROPATHY NOS............................... 53
27411... URIC ACID NEPHROLITHIAS............................. 53
27419... GOUTY NEPHROPATHY NEC............................... 53
27481... GOUTY TOPHI OF EAR.................................. 24
27482... GOUTY TOPHI SITE NEC................................ 24
27489... GOUT W MANIFESTATION NEC............................ 24
2749.... GOUT NOS............................................ 24
2750.... DIS IRON METABOLISM................................. 82
2751.... DIS COPPER METABOLISM............................... 82
2752.... DIS MAGNESIUM METABOLISM............................ 82
2753.... DIS PHOSPHORUS METABOL.............................. 82
2754.... DIS CALCIUM METABOLISM*............................. 82
2758.... DIS MINERAL METABOL NEC............................. 82
2759.... DIS MINERAL METABOL NOS............................. 82
2760.... HYPEROSMOLALITY..................................... 82
2761.... HYPOSMOLALITY....................................... 82
2762.... ACIDOSIS............................................ 82
2763.... ALKALOSIS........................................... 82
2764.... MIXED ACID-BASE BAL DIS............................. 82
2765.... HYPOVOLEMIA......................................... 82
2766.... FLUID OVERLOAD...................................... 82
2767.... HYPERPOTASSEMIA..................................... 82
2768.... HYPOPOTASSEMIA...................................... 82
2769.... ELECTROLYT/FLUID DIS NEC............................ 82
27700... CYSTIC FIBROS W/O ILEUS............................. 82
27701... CYSTIC FIBROSIS W ILEUS............................. 57
2771.... DIS PORPHYRIN METABOLISM............................ 82
2772.... PURINE/PYRIMID DIS NEC.............................. 82
2773.... AMYLOIDOSIS......................................... 86
2774.... DIS BILIRUBIN EXCRETION............................. 41
2775.... MUCOPOLYSACCHARIDOSIS............................... 82
2776.... DEFIC CIRCUL ENZYME NEC............................. 82
2778.... METABOLISM DISORDER NEC............................. 82
2779.... METABOLISM DISORDER NOS............................. 82
2780.... OBESITY*............................................ 82
27800... OBESITY NOS......................................... 82
27801... MORBID OBESITY...................................... 82
2781.... LOCALIZED ADIPOSITY................................. 82
2782.... HYPERVITAMINOSIS A.................................. 82
2783.... HYPERCAROTINEMIA.................................... 82
2784.... HYPERVITAMINOSIS D.................................. 82
2788.... OTHER HYPERALIMENTATION............................. 82
27900... HYPOGAMMAGLOBULINEM NOS............................. 86
27901... SELECTIVE IGA IMMUNODEF............................. 86
27902... SELECTIVE IGM IMMUNODEF............................. 86
27903... SELECTIVE IG DEFIC NEC.............................. 86
27904... CONG HYPOGAMMAGLOBULINEM............................ 86
[[Page 47865]]
27905... IMMUNODEFIC W HYPER-IGM............................. 86
27906... COMMON VARIABL IMMUNODEF............................ 86
27909... HUMORAL IMMUNITY DEF NEC............................ 86
27910... IMMUNDEF T-CELL DEF NOS............................. 86
27911... DIGEORGE'S SYNDROME................................. 86
27912... WISKOTT-ALDRICH SYNDROME............................ 86
27913... NEZELOF'S SYNDROME.................................. 86
27919... DEFIC CELL IMMUNITY NOS............................. 86
2792.... COMBINED IMMUNITY DEFIC............................. 86
2793.... IMMUNITY DEFICIENCY NOS............................. 86
2794.... AUTOIMMUNE DISEASE NEC.............................. 24
2798.... IMMUNE MECHANISM DIS NEC............................ 86
2799.... IMMUNE MECHANISM DIS NOS............................ 86
2800.... CHR BLOOD LOSS ANEMIA............................... 86
2801.... IRON DEF ANEMIA DIETARY............................. 86
2808.... IRON DEFIC ANEMIA NEC............................... 86
2809.... IRON DEFIC ANEMIA NOS............................... 86
2810.... PERNICIOUS ANEMIA................................... 86
2811.... B12 DEFIC ANEMIA NEC................................ 86
2812.... FOLATE-DEFICIENCY ANEMIA............................ 86
2813.... MEGALOBLASTIC ANEMIA NEC............................ 86
2814.... PROTEIN DEFIC ANEMIA................................ 86
2818.... NUTRITIONAL ANEMIA NEC.............................. 86
2819.... DEFICIENCY ANEMIA NOS............................... 86
2820.... HEREDITARY SPHEROCYTOSIS............................ 86
2821.... HEREDIT ELLIPTOCYTOSIS.............................. 86
2822.... GLUTATHIONE DIS ANEMIA.............................. 86
2823.... ENZYME DEFIC ANEMIA NEC............................. 86
2824.... THALASSEMIAS........................................ 86
2825.... SICKLE-CELL TRAIT................................... 86
28260... SICKLE-CELL ANEMIA NOS.............................. 86
28261... HB-S DISEASE W/O CRISIS............................. 86
28262... HB-S DISEASE WITH CRISIS............................ 86
28263... SICKLE-CELL/HB-C DISEASE............................ 86
28269... SICKLE-CELL ANEMIA NEC.............................. 86
2827.... HEMOGLOBINOPATHIES NEC.............................. 86
2828.... HERED HEMOLYTIC ANEM NEC............................ 86
2829.... HERED HEMOLYTIC ANEM NOS............................ 86
2830.... AUTOIMMUN HEMOLYTIC ANEM............................ 86
2831.... NONAUTOIMMU HEMOLYT ANEM*........................... 86
28310... NONAUTO HEM ANEMIA NOS.............................. 86
28311... HEMOLYTIC UREMIC SYND............................... 86
28319... OTH NONAUTO HEM ANEMIA.............................. 86
2832.... HEMOLYTIC HEMOGLOBINURIA............................ 86
2839.... ACQ HEMOLYTIC ANEMIA NOS............................ 86
2840.... CONGEN APLASTIC ANEMIA.............................. 86
2848.... APLASTIC ANEMIAS NEC................................ 86
2849.... APLASTIC ANEMIA NOS................................. 86
2850.... SIDEROBLASTIC ANEMIA................................ 86
2851.... AC POSTHEMORRHAG ANEMIA............................. 86
2858.... ANEMIA NEC.......................................... 86
2859.... ANEMIA NOS.......................................... 86
2860.... CONG FACTOR VIII DIORD.............................. 86
2861.... CONG FACTOR IX DISORDER............................. 86
2862.... CONG FACTOR XI DISORDER............................. 86
2863.... CONG DEF CLOT FACTOR NEC............................ 86
2864.... VON WILLEBRAND'S DISEASE............................ 86
2865.... CIRCULATING ANTICOAG DIS............................ 86
2866.... DEFIBRINATION SYNDROME.............................. 86
2867.... ACQ COAGUL FACTOR DEFIC............................. 86
2869.... COAGULAT DEFECT NEC/NOS............................. 86
2870.... ALLERGIC PURPURA.................................... 86
2871.... THROMBOCYTOPATHY.................................... 86
2872.... PURPURA NOS......................................... 86
2873.... PRIMARY THROMBOCYTOPENIA............................ 86
2874.... SECOND THROMBOCYTOPENIA............................. 86
2875.... THROMBOCYTOPENIA NOS................................ 86
2878.... HEMORRHAGIC COND NEC................................ 86
2879.... HEMORRHAGIC COND NOS................................ 86
2880.... AGRANULOCYTOSIS..................................... 86
2881.... FUNCTION DIS NEUTROPHILS............................ 86
2882.... GENETIC ANOMALY LEUKOCYT............................ 86
2883.... EOSINOPHILIA........................................ 86
2888.... WBC DISEASE NEC..................................... 86
2889.... WBC DISEASE NOS..................................... 86
2890.... SECONDARY POLYCYTHEMIA.............................. 86
[[Page 47866]]
2891.... CHRONIC LYMPHADENITIS............................... 86
2892.... MESENTERIC LYMPHADENITIS............................ 41
2893.... LYMPHADENITIS NOS................................... 86
2894.... HYPERSPLENISM....................................... 86
28950... SPLEEN DISEASE NOS.................................. 86
28951... CHR CONGEST SPLENOMEGALY............................ 86
28959... SPLEEN DISEASE NEC.................................. 86
2896.... FAMILIAL POLYCYTHEMIA............................... 86
2897.... METHEMOGLOBINEMIA................................... 86
2898.... BLOOD DISEASES NEC.................................. 86
2899.... BLOOD DISEASE NOS................................... 86
*2900... SENILE DEMENTIA UNCOMP.............................. ........
29010... PRESENILE DEMENTIA.................................. 91
29011... PRESENILE DELIRIUM.................................. 91
29012... PRESENILE DELUSION.................................. 91
29013... PRESENILE DEPRESSION................................ 91
29020... SENILE DELUSION..................................... 91
29021... SENILE DEPRESSIVE................................... 91
2903.... SENILE DELIRIUM..................................... 91
29040... ARTERIOSCLER DEMENT NOS............................. 91
29041... ARTERIOSCLER DELIRIUM............................... 91
29042... ARTERIOSCLER DELUSION............................... 91
29043... ARTERIOSCLER DEPRESSIVE............................. 91
2908.... SENILE PSYCHOSIS NEC................................ 91
2909.... SENILE PSYCHOT COND NOS............................. 91
2910.... DELIRIUM TREMENS.................................... 91
2911.... ALCOHOL AMNESTIC SYND............................... 91
2912.... ALCOHOLIC DEMENTIA NEC.............................. 91
2913.... ALCOHOL HALLUCINOSIS................................ 91
2914.... PATHOLOGIC ALCOHOL INTOX............................ 91
2915.... ALCOHOLIC JEALOUSY.................................. 91
2918.... ALCOHOLIC PSYCHOSIS NEC*............................ 91
2919.... ALCOHOLIC PSYCHOSIS NOS............................. 91
2920.... DRUG WITHDRAWAL SYNDROME............................ 91
29211... DRUG PARANOID STATE................................. 91
29212... DRUG HALLUCINOSIS................................... 91
2922.... PATHOLOGIC DRUG INTOX............................... 91
29281... DRUG-INDUCED DELIRIUM............................... 91
29282... DRUG-INDUCED DEMENTIA............................... 91
29283... DRUG AMNESTIC SYNDROME.............................. 91
29284... DRUG DEPRESSIVE SYNDROME............................ 91
29289... DRUG MENTAL DISORDER NEC............................ 91
2929.... DRUG MENTAL DISORDER NOS............................ 91
2930.... ACUTE DELIRIUM...................................... 91
2931.... SUBACUTE DELIRIUM................................... 91
29381... ORGANIC DELUSIONAL SYND............................. 91
29382... ORGANIC HALLUCINOSIS SYN............................ 91
29383... ORGANIC AFFECTIVE SYND.............................. 91
29389... TRANSIENT ORG MENTAL NEC............................ 91
2939.... TRANSIENT ORG MENTAL NOS............................ 91
2940.... AMNESTIC SYNDROME................................... 91
2941.... DEMENTIA IN OTH DISEASES............................ 91
2948.... ORGANIC BRAIN SYND NEC.............................. 91
2949.... ORGANIC BRAIN SYND NOS.............................. 91
29500... SIMPL SCHIZOPHREN-UNSPEC............................ 91
29501... SIMPL SCHIZOPHREN-SUBCHR............................ 91
29502... SIMPLE SCHIZOPHREN-CHR.............................. 91
29503... SIMP SCHIZ-SUBCHR/EXACER............................ 91
29504... SIMPL SCHIZO-CHR/EXACERB............................ 91
29505... SIMPL SCHIZOPHREN-REMISS............................ 91
29510... HEBEPHRENIA-UNSPEC.................................. 91
29511... HEBEPHRENIA-SUBCHRONIC.............................. 91
29512... HEBEPHRENIA-CHRONIC................................. 91
29513... HEBEPHREN-SUBCHR/EXACERB............................ 91
29514... HEBEPHRENIA-CHR/EXACERB............................. 91
29515... HEBEPHRENIA-REMISSION............................... 91
29520... CATATONIA-UNSPEC.................................... 91
29521... CATATONIA-SUBCHRONIC................................ 91
29522... CATATONIA-CHRONIC................................... 91
29523... CATATONIA-SUBCHR/EXACERB............................ 91
29524... CATATONIA-CHR/EXACERB............................... 91
29525... CATATONIA-REMISSION................................. 91
29530... PARANOID SCHIZO-UNSPEC.............................. 91
29531... PARANOID SCHIZO-SUBCHR.............................. 91
29532... PARANOID SCHIZO-CHRONIC............................. 91
29533... PARAN SCHIZO-SUBCHR/EXAC............................ 91
[[Page 47867]]
29534... PARAN SCHIZO-CHR/EXACERB............................ 91
29535... PARANOID SCHIZO-REMISS.............................. 91
29540... AC SCHIZOPHRENIA-UNSPEC............................. 91
29541... AC SCHIZOPHRENIA-SUBCHR............................. 91
29542... AC SCHIZOPHRENIA-CHR................................ 91
29543... AC SCHIZO-SUBCHR/EXACERB............................ 91
29544... AC SCHIZOPHR-CHR/EXACERB............................ 91
29545... AC SCHIZOPHRENIA-REMISS............................. 91
29550... LATENT SCHIZOPHREN-UNSP............................. 91
29551... LAT SCHIZOPHREN-SUBCHR.............................. 91
29552... LATENT SCHIZOPHREN-CHR.............................. 91
29553... LAT SCHIZO-SUBCHR/EXACER............................ 91
29554... LATENT SCHIZO-CHR/EXACER............................ 91
29555... LAT SCHIZOPHREN-REMISS.............................. 91
29560... RESID SCHIZOPHREN-UNSP.............................. 91
29561... RESID SCHIZOPHREN-SUBCHR............................ 91
29562... RESIDUAL SCHIZOPHREN-CHR............................ 91
29563... RESID SCHIZO-SUBCHR/EXAC............................ 91
29564... RESID SCHIZO-CHR/EXACERB............................ 91
29565... RESID SCHIZOPHREN-REMISS............................ 91
29570... SCHIZOAFFECTIVE-UNSPEC.............................. 91
29571... SCHIZOAFFECTIVE-SUBCHR.............................. 91
29572... SCHIZOAFFECTIVE-CHRONIC............................. 91
29573... SCHIZOAFF-SUBCHR/EXACER............................. 91
29574... SCHIZOAFFECT-CHR/EXACER............................. 91
29575... SCHIZOAFFECTIVE-REMISS.............................. 91
29580... SCHIZOPHRENIA NEC-UNSPEC............................ 91
29581... SCHIZOPHRENIA NEC-SUBCHR............................ 91
29582... SCHIZOPHRENIA NEC-CHR............................... 91
29583... SCHIZO NEC-SUBCHR/EXACER............................ 91
29584... SCHIZO NEC-CHR/EXACERB.............................. 91
29585... SCHIZOPHRENIA NEC-REMISS............................ 91
29590... SCHIZOPHRENIA NOS-UNSPEC............................ 91
29591... SCHIZOPHRENIA NOS-SUBCHR............................ 91
29592... SCHIZOPHRENIA NOS-CHR............................... 91
29593... SCHIZO NOS-SUBCHR/EXACER............................ 91
29594... SCHIZO NOS-CHR/EXACERB.............................. 91
29595... SCHIZOPHRENIA NOS-REMISS............................ 91
29600... MANIC DISORDER-UNSPEC............................... 91
29601... MANIC DISORDER-MILD................................. 91
29602... MANIC DISORDER-MOD.................................. 91
29603... MANIC DISORDER-SEVERE............................... 91
29604... MANIC DIS-SEVERE W PSYCH............................ 91
29605... MANIC DIS-PARTIAL REMISS............................ 91
29606... MANIC DIS-FULL REMISSION............................ 91
29610... RECUR MANIC DIS-UNSPEC.............................. 91
29611... RECUR MANIC DIS-MILD................................ 91
29612... RECUR MANIC DIS-MOD................................. 91
29613... RECUR MANIC DIS-SEVERE.............................. 91
29614... RECUR MANIC-SEV W PSYCHO............................ 91
29615... RECUR MANIC-PART REMISS............................. 91
29616... RECUR MANIC-FULL REMISS............................. 91
29620... DEPRESS PSYCHOSIS-UNSPEC............................ 91
29621... DEPRESS PSYCHOSIS-MILD.............................. 91
29622... DEPRESSIVE PSYCHOSIS-MOD............................ 91
29623... DEPRESS PSYCHOSIS-SEVERE............................ 91
29624... DEPR PSYCHOS-SEV W PSYCH............................ 91
29625... DEPR PSYCHOS-PART REMISS............................ 91
29626... DEPR PSYCHOS-FULL REMISS............................ 91
29630... RECURR DEPR PSYCHOS-UNSP............................ 91
29631... RECURR DEPR PSYCHOS-MILD............................ 91
29632... RECURR DEPR PSYCHOS-MOD............................. 91
29633... RECUR DEPR PSYCH-SEVERE............................. 91
29634... REC DEPR PSYCH-PSYCHOTIC............................ 91
29635... RECUR DEPR PSYC-PART REM............................ 91
29636... RECUR DEPR PSYC-FULL REM............................ 91
29640... BIPOL AFF, MANIC-UNSPEC............................. 91
29641... BIPOLAR AFF, MANIC-MILD............................. 91
29642... BIPOLAR AFFEC, MANIC-MOD............................ 91
29643... BIPOL AFF, MANIC-SEVERE............................. 91
29644... BIPOL MANIC-SEV W PSYCH............................. 91
29645... BIPOL AFF MANIC-PART REM............................ 91
29646... BIPOL AFF MANIC-FULL REM............................ 91
29650... BIPOLAR AFF, DEPR-UNSPEC............................ 91
29651... BIPOLAR AFFEC, DEPR-MILD............................ 91
29652... BIPOLAR AFFEC, DEPR-MOD............................. 91
[[Page 47868]]
29653... BIPOL AFF, DEPR-SEVERE.............................. 91
29654... BIPOL DEPR-SEV W PSYCH.............................. 91
29655... BIPOL AFF DEPR-PART REM............................. 91
29656... BIPOL AFF DEPR-FULL REM............................. 91
29660... BIPOL AFF, MIXED-UNSPEC............................. 91
29661... BIPOLAR AFF, MIXED-MILD............................. 91
29662... BIPOLAR AFFEC, MIXED-MOD............................ 91
29663... BIPOL AFF, MIXED-SEVERE............................. 91
29664... BIPOL MIXED-SEV W PSYCH............................. 91
29665... BIPOL AFF, MIX-PART REM............................. 91
29666... BIPOL AFF, MIX-FULL REM............................. 91
2967.... BIPOLAR AFFECTIVE NOS............................... 91
29680... MANIC-DEPRESSIVE NOS................................ 91
29681... ATYPICAL MANIC DISORDER............................. 91
29682... ATYPICAL DEPRESSIVE DIS............................. 91
29689... MANIC-DEPRESSIVE NEC................................ 91
29690... AFFECTIVE PSYCHOSIS NOS............................. 91
29699... AFFECTIVE PSYCHOSES NEC............................. 91
2970.... PARANOID STATE, SIMPLE.............................. 91
2971.... PARANOIA............................................ 91
2972.... PARAPHRENIA......................................... 91
2973.... SHARED PARANOID DISORDER............................ 91
2978.... PARANOID STATES NEC................................. 91
2979.... PARANOID STATE NOS.................................. 91
2980.... REACT DEPRESS PSYCHOSIS............................. 91
2981.... EXCITATIV TYPE PSYCHOSIS............................ 91
2982.... REACTIVE CONFUSION.................................. 91
2983.... ACUTE PARANOID REACTION............................. 91
2984.... PSYCHOGEN PARANOID PSYCH............................ 91
2988.... REACT PSYCHOSIS NEC/NOS............................. 91
2989.... PSYCHOSIS NOS....................................... 91
29900... INFANTILE AUTISM-ACTIVE............................. 91
29901... INFANTILE AUTISM-RESID.............................. 91
29910... DISINTEGR PSYCH-ACTIVE.............................. 91
29911... DISINTEGR PSYCH-RESIDUAL............................ 91
29980... CHILD PSYCHOS NEC-ACTIVE............................ 91
29981... CHILD PSYCHOS NEC-RESID............................. 91
29990... CHILD PSYCHOS NOS-ACTIVE............................ 91
29991... CHILD PSYCHOS NOS-RESID............................. 91
30000... ANXIETY STATE NOS................................... 91
30001... PANIC DISORDER...................................... 91
30002... GENERALIZED ANXIETY DIS............................. 91
30009... ANXIETY STATE NEC................................... 91
30010... HYSTERIA NOS........................................ 91
30011... CONVERSION DISORDER................................. 91
30012... PSYCHOGENIC AMNESIA................................. 91
30013... PSYCHOGENIC FUGUE................................... 91
30014... MULTIPLE PERSONALITY................................ 91
30015... DISSOCIATIVE REACT NOS.............................. 91
30016... FACTITIOUS ILL W SYMPTOM............................ 91
30019... FACTITIOUS ILL NEC/NOS.............................. 91
30020... PHOBIA NOS.......................................... 91
30021... AGORAPHOBIA WITH PANIC.............................. 91
30022... AGORAPHOBIA W/O PANIC............................... 91
30023... SOCIAL PHOBIA....................................... 91
30029... ISOLATED PHOBIAS NEC................................ 91
3003.... OBSESSIVE-COMPULSIVE DIS............................ 91
3004.... NEUROTIC DEPRESSION................................. 91
3005.... NEURASTHENIA........................................ 91
3006.... DEPERSONALIZATION SYND.............................. 91
3007.... HYPOCHONDRIASIS..................................... 91
30081... SOMATIZATION DISORDER............................... 91
30089... NEUROTIC DISORDERS NEC.............................. 91
3009.... NEUROTIC DISORDER NOS............................... 91
3010.... PARANOID PERSONALITY................................ 91
30110... AFFECTIV PERSONALITY NOS............................ 91
30111... CHRONIC HYPOMANIC PERSON............................ 91
30112... CHR DEPRESSIVE PERSON............................... 91
30113... CYCLOTHYMIC DISORDER................................ 91
30120... SCHIZOID PERSONALITY NOS............................ 91
30121... INTROVERTED PERSONALITY............................. 91
30122... SCHIZOTYPAL PERSONALITY............................. 91
3013.... EXPLOSIVE PERSONALITY............................... 91
3014.... COMPULSIVE PERSONALITY.............................. 91
30150... HISTRIONIC PERSON NOS............................... 91
30151... CHR FACTITIOUS ILLNESS.............................. 91
[[Page 47869]]
30159... HISTRIONIC PERSON NEC............................... 91
3016.... DEPENDENT PERSONALITY............................... 91
3017.... ANTISOCIAL PERSONALITY.............................. 91
30181... NARCISSISTIC PERSONALITY............................ 91
30182... AVOIDANT PERSONALITY................................ 91
30183... BORDERLINE PERSONALITY.............................. 91
30184... PASSIVE-AGGRESSIV PERSON............................ 91
30189... PERSONALITY DISORDER NEC............................ 91
3019.... PERSONALITY DISORDER NOS............................ 91
3020.... EGO-DYSTONIC HOMOSEXLTY............................. 91
3021.... ZOOPHILIA........................................... 91
3022.... PEDOPHILIA.......................................... 91
3023.... TRANSVESTISM........................................ 91
3024.... EXHIBITIONISM....................................... 91
30250... TRANS-SEXUALISM NOS................................. 91
30251... TRANS-SEXUALISM, ASEXUAL............................ 91
30252... TRANS-SEXUAL, HOMOSEXUAL............................ 91
30253... TRANS-SEX, HETEROSEXUAL............................. 91
3026.... PSYCHOSEX IDENTITY DIS.............................. 91
30270... PSYCHOSEXUAL DYSFUNC NOS............................ 91
30271... INHIBITED SEXUAL DESIRE............................. 91
30272... INHIBITED SEX EXCITEMENT............................ 91
30273... INHIBITED FEMALE ORGASM............................. 91
30274... INHIBITED MALE ORGASM............................... 91
30275... PREMATURE EJACULATION............................... 91
30276... FUNCTIONAL DYSPAREUNIA.............................. 91
30279... PSYCHOSEXUAL DYSFUNC NEC............................ 91
30281... FETISHISM........................................... 91
30282... VOYEURISM........................................... 91
30283... SEXUAL MASOCHISM.................................... 91
30284... SEXUAL SADISM....................................... 91
30285... GEND IDEN DIS, ADOL/ADULT........................... 91
30289... PSYCHOSEXUAL DIS NEC................................ 91
3029.... PSYCHOSEXUAL DIS NOS................................ 91
30300... AC ALCOHOL INTOX-UNSPEC............................. 91
30301... AC ALCOHOL INTOX-CONTIN............................. 91
30302... AC ALCOHOL INTOX-EPISOD............................. 91
30303... AC ALCOHOL INTOX-REMISS............................. 91
30390... ALCOH DEP NEC/NOS-UNSPEC............................ 91
30391... ALCOH DEP NEC/NOS-CONTIN............................ 91
30392... ALCOH DEP NEC/NOS-EPISOD............................ 91
30393... ALCOH DEP NEC/NOS-REMISS............................ 91
30400... OPIOID DEPENDENCE-UNSPEC............................ 91
30401... OPIOID DEPENDENCE-CONTIN............................ 91
30402... OPIOID DEPENDENCE-EPISOD............................ 91
30403... OPIOID DEPENDENCE-REMISS............................ 91
30410... BARBITURAT DEPEND-UNSPEC............................ 91
30411... BARBITURAT DEPEND-CONTIN............................ 91
30412... BARBITURAT DEPEND-EPISOD............................ 91
30413... BARBITURAT DEPEND-REMISS............................ 91
30420... COCAINE DEPEND-UNSPEC............................... 91
30421... COCAINE DEPEND-CONTIN............................... 91
30422... COCAINE DEPEND-EPISODIC............................. 91
30423... COCAINE DEPEND-REMISS............................... 91
30430... CANNABIS DEPEND-UNSPEC.............................. 91
30431... CANNABIS DEPEND-CONTIN.............................. 91
30432... CANNABIS DEPEND-EPISODIC............................ 91
30433... CANNABIS DEPEND-REMISS.............................. 91
30440... AMPHETAMIN DEPEND-UNSPEC............................ 91
30441... AMPHETAMIN DEPEND-CONTIN............................ 91
30442... AMPHETAMIN DEPEND-EPISOD............................ 91
30443... AMPHETAMIN DEPEND-REMISS............................ 91
30450... HALLUCINOGEN DEP-UNSPEC............................. 91
30451... HALLUCINOGEN DEP-CONTIN............................. 91
30452... HALLUCINOGEN DEP-EPISOD............................. 91
30453... HALLUCINOGEN DEP-REMISS............................. 91
30460... DRUG DEPEND NEC-UNSPEC.............................. 91
30461... DRUG DEPEND NEC-CONTIN.............................. 91
30462... DRUG DEPEND NEC-EPISODIC............................ 91
30463... DRUG DEPEND NEC-IN REM.............................. 91
30470... OPIOID/OTHER DEP-UNSPEC............................. 91
30471... OPIOID/OTHER DEP-CONTIN............................. 91
30472... OPIOID/OTHER DEP-EPISOD............................. 91
30473... OPIOID/OTHER DEP-REMISS............................. 91
30480... COMB DRUG DEP NEC-UNSPEC............................ 91
30481... COMB DRUG DEP NEC-CONTIN............................ 91
[[Page 47870]]
30482... COMB DRUG DEP NEC-EPISOD............................ 91
30483... COMB DRUG DEP NEC-REMISS............................ 91
30490... DRUG DEPEND NOS-UNSPEC.............................. 91
30491... DRUG DEPEND NOS-CONTIN.............................. 91
30492... DRUG DEPEND NOS-EPISODIC............................ 91
30493... DRUG DEPEND NOS-REMISS.............................. 91
30500... ALCOHOL ABUSE-UNSPEC................................ 91
30501... ALCOHOL ABUSE-CONTINUOUS............................ 91
30502... ALCOHOL ABUSE-EPISODIC.............................. 91
30503... ALCOHOL ABUSE-IN REMISS............................. 91
3051.... TOBACCO USE DISORDER................................ 11
30510... TOBACCO USE DISORDER................................ 11
30511... TOBACCO USE DISORDER................................ 11
30512... TOBACCO USE DISORDER................................ 11
30513... TOBACCO USE DISORDER................................ 11
30520... CANNABIS ABUSE-UNSPEC............................... 91
30521... CANNABIS ABUSE-CONTIN............................... 91
30522... CANNABIS ABUSE-EPISODIC............................. 91
30523... CANNABIS ABUSE-IN REMISS............................ 91
30530... HALLUCINOG ABUSE-UNSPEC............................. 91
30531... HALLUCINOG ABUSE-CONTIN............................. 91
30532... HALLUCINOG ABUSE-EPISOD............................. 91
30533... HALLUCINOG ABUSE-REMISS............................. 91
30540... BARBITURATE ABUSE-UNSPEC............................ 91
30541... BARBITURATE ABUSE-CONTIN............................ 91
30542... BARBITURATE ABUSE-EPISOD............................ 91
30543... BARBITURATE ABUSE-REMISS............................ 91
30550... OPIOID ABUSE-UNSPEC................................. 91
30551... OPIOID ABUSE-CONTINUOUS............................. 91
30552... OPIOID ABUSE-EPISODIC............................... 91
30553... OPIOID ABUSE-IN REMISS.............................. 91
30560... COCAINE ABUSE-UNSPEC................................ 91
30561... COCAINE ABUSE-CONTINUOUS............................ 91
30562... COCAINE ABUSE-EPISODIC.............................. 91
30563... COCAINE ABUSE-IN REMISS............................. 91
30570... AMPHETAMINE ABUSE-UNSPEC............................ 91
30571... AMPHETAMINE ABUSE-CONTIN............................ 91
30572... AMPHETAMINE ABUSE-EPISOD............................ 91
30573... AMPHETAMINE ABUSE-REMISS............................ 91
30580... ANTIDEPRESS ABUSE-UNSPEC............................ 91
30581... ANTIDEPRESS ABUSE-CONTIN............................ 91
30582... ANTIDEPRESS ABUSE-EPISOD............................ 91
30583... ANTIDEPRESS ABUSE-REMISS............................ 91
30590... DRUG ABUSE NEC-UNSPEC............................... 91
30591... DRUG ABUSE NEC-CONTIN............................... 91
30592... DRUG ABUSE NEC-EPISODIC............................. 91
30593... DRUG ABUSE NEC-IN REMISS............................ 91
3060.... PSYCHOGEN MUSCULSKEL DIS............................ 24
3061.... PSYCHOGENIC RESPIR DIS.............................. 33
3062.... PSYCHOGEN CARDIOVASC DIS............................ 36
3063.... PSYCHOGENIC SKIN DISEASE............................ 18
3064.... PSYCHOGENIC GI DISEASE.............................. 41
30650... PSYCHOGENIC GU DIS NOS.............................. 53
30651... PSYCHOGENIC VAGINISMUS.............................. 56
30652... PSYCHOGENIC DYSMENORRHEA............................ 56
30653... PSYCHOGENIC DYSURIA................................. 53
30659... PSYCHOGENIC GU DIS NEC.............................. 53
3066.... PSYCHOGEN ENDOCRINE DIS............................. 82
3067.... PSYCHOGENIC SENSORY DIS............................. 91
3068.... PSYCHOGENIC DISORDER NEC............................ 91
3069.... PSYCHOGENIC DISORDER NOS............................ 91
3070.... STAMMERING & STUTTERING............................. 91
3071.... ANOREXIA NERVOSA.................................... 91
30720... TIC DISORDER NOS.................................... 63
30721... TRANSIENT TIC, CHILDHOOD............................ 63
30722... CHRONIC MOTOR TIC DIS............................... 63
30723... GILLES TOURETTE DISORDER............................ 63
3073.... STEREOTYPED MOVEMENTS............................... 91
30740... NONORGANIC SLEEP DIS NOS............................ 91
30741... TRANSIENT INSOMNIA.................................. 91
30742... PERSISTENT INSOMNIA................................. 91
30743... TRANSIENT HYPERSOMNIA............................... 91
30744... PERSISTENT HYPERSOMNIA.............................. 91
30745... DISRUPT SLEEP-WAKE CYCLE............................ 91
30746... SOMNAMBULISM/NGHT TERROR............................ 91
30747... SLEEP STAGE DYSFUNC NEC............................. 91
[[Page 47871]]
30748... REPETIT SLEEP INTRUSION............................. 91
30749... NONORGANIC SLEEP DIS NEC............................ 91
30750... EATING DISORDER NOS................................. 91
30751... BULIMIA............................................. 91
30752... PICA................................................ 91
30753... PSYCHOGENIC RUMINATION.............................. 91
30754... PSYCHOGENIC VOMITING................................ 91
30759... EATING DISORDER NEC................................. 91
3076.... ENURESIS............................................ 91
3077.... ENCOPRESIS.......................................... 91
30780... PSYCHOGENIC PAIN NOS................................ 91
30781... TENSION HEADACHE.................................... 63
30789... PSYCHOGENIC PAIN NEC................................ 91
3079.... SPECIAL SYMPTOM NEC/NOS............................. 91
3080.... STRESS REACT, EMOTIONAL............................. 91
3081.... STRESS REACTION, FUGUE.............................. 91
3082.... STRESS REACT, PSYCHOMOT............................. 91
3083.... ACUTE STRESS REACT NEC.............................. 91
3084.... STRESS REACT, MIXED DIS............................. 91
3089.... ACUTE STRESS REACT NOS.............................. 91
3090.... BRIEF DEPRESSIVE REACT.............................. 91
3091.... PROLONG DEPRESSIVE REACT............................ 91
30921... SEPARATION ANXIETY.................................. 91
30922... EMANCIPATION DISORDER............................... 91
30923... ACADEMIC/WORK INHIBITION............................ 91
30924... ADJ REACT-ANXIOUS MOOD.............................. 91
30928... ADJ REACT-MIXED EMOTION............................. 91
30929... ADJ REACT-EMOTION NEC............................... 91
3093.... ADJUST REACT-CONDUCT DIS............................ 91
3094.... ADJ REACT-EMOTION/CONDUC............................ 91
30981... PROLONG POSTTRAUM STRESS............................ 91
30982... ADJUST REACT-PHYS SYMPT............................. 91
30983... ADJUST REACT-WITHDRAWAL............................. 91
30989... ADJUSTMENT REACTION NEC............................. 91
3099.... ADJUSTMENT REACTION NOS............................. 91
3100.... FRONTAL LOBE SYNDROME............................... 91
3101.... ORGANIC PERSONALITY SYND............................ 91
3102.... POSTCONCUSSION SYNDROME............................. 63
3108.... NONPSYCHOT BRAIN SYN NEC............................ 91
3109.... NONPSYCHOT BRAIN SYN NOS............................ 91
311..... DEPRESSIVE DISORDER NEC............................. 91
31200... UNSOCIAL AGGRESS-UNSPEC............................. 91
31201... UNSOCIAL AGGRESSION-MILD............................ 91
31202... UNSOCIAL AGGRESSION-MOD............................. 91
31203... UNSOCIAL AGGRESS-SEVERE............................. 91
31210... UNSOCIAL UNAGGRESS-UNSP............................. 91
31211... UNSOCIAL UNAGGRESS-MILD............................. 91
31212... UNSOCIAL UNAGGRESS-MOD.............................. 91
31213... UNSOCIAL UNAGGR-SEVERE.............................. 91
31220... SOCIAL CONDUCT DIS-UNSP............................. 91
31221... SOCIAL CONDUCT DIS-MILD............................. 91
31222... SOCIAL CONDUCT DIS-MOD.............................. 91
31223... SOCIAL CONDUCT DIS-SEV.............................. 91
31230... IMPULSE CONTROL DIS NOS............................. 91
31231... PATHOLOGICAL GAMBLING............................... 91
31232... KLEPTOMANIA......................................... 91
31233... PYROMANIA........................................... 91
31234... INTERMITT EXPLOSIVE DIS............................. 91
31235... ISOLATED EXPLOSIVE DIS.............................. 91
31239... IMPULSE CONTROL DIS NEC............................. 91
3124.... MIX DIS CONDUCT/EMOTION............................. 91
3128.... OTHER CONDUCT DISTURB*.............................. 91
31281... CNDCT DSRDR CHLDHD ONST............................. 63
31282... CNDCT DSRDR ADLSCNT ONST............................ 63
31289... OTHER CONDUCT DISORDER.............................. 63
3129.... CONDUCT DISTURBANCE NOS............................. 91
3130.... OVERANXIOUS DISORDER................................ 91
3131.... MISERY & UNHAPPINESS DIS............................ 91
31321... SHYNESS DISORDER-CHILD.............................. 91
31322... INTROVERTED DIS-CHILD............................... 91
31323... ELECTIVE MUTISM..................................... 91
3133.... RELATIONSHIP PROBLEMS............................... 91
31381... OPPOSITIONAL DISORDER............................... 91
31382... IDENTITY DISORDER................................... 91
31383... ACADEMIC UNDERACHIEVMENT............................ 91
31389... EMOTIONAL DIS CHILD NEC............................. 91
[[Page 47872]]
3139.... EMOTIONAL DIS CHILD NOS............................. 91
31400... ATTN DEFIC NONHYPERACT.............................. 91
31401... ATTN DEFICIT W HYPERACT............................. 91
3141.... HYPERKINET W DEVEL DELAY............................ 91
3142.... HYPERKINETIC CONDUCT DIS............................ 91
3148.... OTHER HYPERKINETIC SYND............................. 91
3149.... HYPERKINETIC SYND NOS............................... 91
31500... READING DISORDER NOS................................ 91
31501... ALEXIA.............................................. 91
31502... DEVELOPMENTAL DYSLEXIA.............................. 91
31509... READING DISORDER NEC................................ 91
3151.... ARITHMETICAL DISORDER............................... 91
3152.... OTH LEARNING DIFFICULTY............................. 91
31531... DEVELOPMENT LANGUAGE DIS............................ 91
31539... SPEECH/LANGUAGE DIS NEC............................. 91
3154.... COORDINATION DISORDER............................... 91
3155.... MIXED DEVELOPMENT DIS............................... 91
3158.... DEVELOPMENT DELAYS NEC.............................. 91
3159.... DEVELOPMENT DELAY NOS............................... 91
316..... PSYCHIC FACTOR W OTH DIS............................ 91
317..... MILD MENTAL RETARDATION............................. 91
3180.... MOD MENTAL RETARDATION.............................. 91
3181.... SEVERE MENTAL RETARDAT.............................. 91
3182.... PROFOUND MENTAL RETARDAT............................ 91
319..... MENTAL RETARDATION NOS.............................. 91
3200.... HEMOPHILUS MENINGITIS............................... 63
3201.... PNEUMOCOCCAL MENINGITIS............................. 63
3202.... STREPTOCOCCAL MENINGITIS............................ 63
3203.... STAPHYLOCOCC MENINGITIS............................. 63
3207.... MENING IN OTH BACT DIS.............................. 63
3208.... BACTERIAL MENINGITIS NEC*........................... 63
32081... ANAEROBIC MENINGITIS................................ 63
32082... MNINGTS GRAM-NEG BCT NEC............................ 63
32089... MENINGITIS OTH SPCF BACT............................ 63
3209.... BACTERIAL MENINGITIS NOS............................ 63
3210.... CRYPTOCOCCAL MENINGITIS............................. 63
3211.... MENING IN OTH FUNGAL DIS............................ 63
3212.... MENING IN OTH VIRAL DIS............................. 63
3213.... TRYPANOSOMIASIS MENINGIT............................ 63
3214.... MENINGIT D/T SARCOIDOSIS............................ 63
3218.... MENING IN OTH NONBAC DIS............................ 63
3220.... NONPYOGENIC MENINGITIS.............................. 63
3221.... EOSINOPHILIC MENINGITIS............................. 63
3222.... CHRONIC MENINGITIS.................................. 63
3229.... MENINGITIS NOS...................................... 63
3230.... ENCEPHALIT IN VIRAL DIS............................. 63
3231.... RICKETTSIAL ENCEPHALITIS............................ 63
3232.... PROTOZOAL ENCEPHALITIS.............................. 63
3234.... OTH ENCEPHALIT D/T INFEC............................ 63
3235.... POSTIMMUNIZAT ENCEPHALIT............................ 63
3236.... POSTINFECT ENCEPHALITIS............................. 63
3237.... TOXIC ENCEPHALITIS.................................. 63
3238.... ENCEPHALITIS NEC.................................... 63
3239.... ENCEPHALITIS NOS.................................... 63
3240.... INTRACRANIAL ABSCESS................................ 63
3241.... INTRASPINAL ABSCESS................................. 63
3249.... CNS ABSCESS NOS..................................... 63
325..... PHLEBITIS INTRCRAN SINUS............................ 63
326..... LATE EFF CNS ABSCESS................................ 63
3300.... LEUKODYSTROPHY...................................... 63
3301.... CEREBRAL LIPIDOSES.................................. 63
3302.... CEREB DEGEN IN LIPIDOSIS............................ 63
3303.... CERB DEG CHLD IN OTH DIS............................ 63
3308.... CEREB DEGEN IN CHILD NEC............................ 63
3309.... CEREB DEGEN IN CHILD NOS............................ 63
3310.... ALZHEIMER'S DISEASE................................. 91
3311.... PICK'S DISEASE...................................... 91
3312.... SENILE DEGENERAT BRAIN.............................. 91
3313.... COMMUNICAT HYDROCEPHALUS............................ 63
3314.... OBSTRUCTIV HYDROCEPHALUS............................ 63
3317.... CEREB DEGEN IN OTH DIS.............................. 63
33181... REYE'S SYNDROME..................................... 63
33189... CEREB DEGENERATION NEC.............................. 63
3319.... CEREB DEGENERATION NOS.............................. 63
3320.... PARALYSIS AGITANS................................... 63
3321.... SECONDARY PARKINSONISM.............................. 63
[[Page 47873]]
3330.... DEGEN BASAL GANGLIA NEC............................. 63
3331.... TREMOR NEC.......................................... 63
3332.... MYOCLONUS........................................... 63
3333.... TICS OF ORGANIC ORIGIN.............................. 63
3334.... HUNTINGTON'S CHOREA................................. 63
3335.... CHOREA NEC.......................................... 63
3336.... IDIOPAT TORSION DYSTONIA............................ 63
3337.... SYMPTOM TORSION DYSTONIA............................ 63
33381... BLEPHAROSPASM....................................... 68
33382... OROFACIAL DYSKINESIA................................ 63
33383... SPASMODIC TORTICOLLIS............................... 63
33384... ORGANIC WRITERS' CRAMP.............................. 63
33389... FRAGM TORSION DYSTON NEC............................ 63
33390... EXTRAPYRAMIDAL DIS NOS.............................. 63
33391... STIFF-MAN SYNDROME.................................. 63
33392... NEUROLEPTIC MALGNT SYND............................. 63
33393... BNIGN SHUDDERING ATTACKS............................ 63
33399... EXTRAPYRAMIDAL DIS NEC.............................. 63
3340.... FRIEDREICH'S ATAXIA................................. 63
3341.... HERED SPASTIC PARAPLEGIA............................ 63
3342.... PRIMARY CEREBELLAR DEGEN............................ 63
3343.... CEREBELLAR ATAXIA NEC............................... 63
3344.... CEREBEL ATAX IN OTH DIS............................. 63
3348.... SPINOCEREBELLAR DIS NEC............................. 63
3349.... SPINOCEREBELLAR DIS NOS............................. 63
3350.... WERDNIG-HOFFMANN DISEASE............................ 63
33510... SPINAL MUSCL ATROPHY NOS............................ 63
33511... KUGELBERG-WELANDER DIS.............................. 63
33519... SPINAL MUSCL ATROPHY NEC............................ 63
33520... AMYOTROPHIC SCLEROSIS............................... 63
33521... PROG MUSCULAR ATROPHY............................... 63
33522... PROGRESSIVE BULBAR PALSY............................ 63
33523... PSEUDOBULBAR PALSY.................................. 63
33524... PRIM LATERAL SCLEROSIS.............................. 63
33529... MOTOR NEURON DISEASE NEC............................ 63
3358.... ANT HORN CELL DIS NEC............................... 63
3359.... ANT HORN CELL DIS NOS............................... 63
3360.... SYRINGOMYELIA....................................... 63
3361.... VASCULAR MYELOPATHIES............................... 63
3362.... COMB DEG CORD IN OTH DIS............................ 63
3363.... MYELOPATHY IN OTH DIS............................... 63
3368.... MYELOPATHY NEC...................................... 63
3369.... SPINAL CORD DISEASE NOS............................. 63
3370.... IDIOPATH AUTO NEUROPATHY............................ 63
3371.... AUT NEUROPTHY IN OTH DIS............................ 63
33720... UNSP RFLX SYMPTH DYSTRPH............................ 63
33721... RFLX SYM DYSTRPH UP LIMB............................ 63
33722... RFLX SYM DYSTRPH LWR LMB............................ 63
33729... RFLX SYM DYSTRPH OTH ST............................. 63
3379.... AUTONOMIC NERVE DIS NEC............................. 63
340..... MULTIPLE SCLEROSIS.................................. 63
3410.... NEUROMYELITIS OPTICA................................ 63
3411.... SCHILDER'S DISEASE.................................. 63
3418.... CNS DEMYELINATION NEC............................... 63
3419.... CNS DEMYELINATION NOS............................... 63
3420.... FLACCID HEMIPLEGIA*................................. 63
34200... FLCCD HMIPLGA UNSPF SIDE............................ 63
34201... FLCCD HMIPLGA DOMNT SIDE............................ 63
34202... FLCCD HMIPLG NONDMNT SDE............................ 63
3421.... SPASTIC HEMIPLEGIA*................................. 63
34210... SPSTC HMIPLGA UNSPF SIDE............................ 63
34211... SPSTC HMIPLGA DOMNT SIDE............................ 63
34212... SPSTC HMIPLG NONDMNT SDE............................ 63
34280... OT SP HMIPLGA UNSPF SIDE............................ 63
34281... OT SP HMIPLGA DOMNT SIDE............................ 63
34282... OT SP HMIPLG NONDMNT SDE............................ 63
3429.... HEMIPLEGIA NOS*..................................... 63
34290... UNSP HEMIPLGA UNSPF SIDE............................ 63
34291... UNSP HEMIPLGA DOMNT SIDE............................ 63
34292... UNSP HMIPLGA NONDMNT SDE............................ 63
3430.... CONGENITAL DIPLEGIA................................. 63
3431.... CONGENITAL HEMIPLEGIA............................... 63
3432.... CONGENITAL QUADRIPLEGIA............................. 63
3433.... CONGENITAL MONOPLEGIA............................... 63
3434.... INFANTILE HEMIPLEGIA................................ 63
3438.... CEREBRAL PALSY NEC.................................. 63
[[Page 47874]]
3439.... CEREBRAL PALSY NOS.................................. 63
3440.... QUADRIPLEGIA NOS*................................... 63
34400... QUADRIPLEGIA, UNSPECIFD............................. 63
34401... QUADRPLG C1-C4, COMPLETE............................ 63
34402... QUADRPLG C1-C4, INCOMPLT............................ 63
34403... QUADRPLG C5-C7, COMPLETE............................ 63
34404... QUADRPLG C5-C7, INCOMPLT............................ 63
34409... OTHER QUADRIPLEGIA.................................. 63
3441.... PARAPLEGIA NOS...................................... 63
3442.... DIPLEGIA OF UPPER LIMBS............................. 63
3443.... MONOPLEGIA OF LOWER LIMB*........................... 63
34430... MONPLGA LWR LMB UNSP SDE............................ 63
34431... MONPLGA LWR LMB DMNT SDE............................ 63
34432... MNPLG LWR LMB NONDMNT SD............................ 63
3444.... MONOPLEGIA OF UPPER LIMB*........................... 63
34440... MONPLGA UPR LMB UNSP SDE............................ 63
34441... MONPLGA UPR LMB DMNT SDE............................ 63
34442... MNPLG UPR LMB NONDMNT SD............................ 63
3445.... MONOPLEGIA NOS...................................... 63
34460... CAUDA EQUINA SYND NOS............................... 63
34461... NEUROGENIC BLADDER.................................. 53
3448.... PARALYTIC SYNDROMES NEC*............................ 63
34481... LOCKED-IN STATE..................................... 78
34489... OTH SPCF PARALYTIC SYND............................. 63
3449.... PARALYSIS NOS....................................... 63
34500... GEN NONCV EP W/O INTR EP............................ 63
34501... GEN NONCONV EP W INTR EP............................ 63
34510... GEN CNV EPIL W/O INTR EP............................ 63
34511... GEN CNV EPIL W INTR EPIL............................ 63
3452.... PETIT MAL STATUS.................................... 78
3453.... GRAND MAL STATUS.................................... 78
34540... PSYMOTR EPIL W/O INT EPI............................ 63
34541... PSYMOTR EPIL W INTR EPIL............................ 63
34550... PART EPIL W/O INTR EPIL............................. 63
34551... PART EPIL W INTR EPIL............................... 63
34560... INF SPASM W/O INTR EPIL............................. 63
34561... INF SPASM W INTRACT EPIL............................ 63
34570... EPIL PAR CONT W/O INT EP............................ 63
34571... EPIL PAR CONT W INTR EPI............................ 63
34580... EPILEP NEC W/O INTR EPIL............................ 63
34581... EPILEPSY NEC W INTR EPIL............................ 63
34590... EPILEP NOS W/O INTR EPIL............................ 63
34591... EPILEPSY NOS W INTR EPIL............................ 63
3460.... CLASSICAL MIGRAINE*................................. 63
34600... CLSC MIGRNE WO NTRC MGRN............................ 63
34601... CLSC MGRN W NTRC MGR STD............................ 63
3461.... COMMON MIGRAINE*.................................... 63
34610... COMN MIGRNE WO NTRC MGRN............................ 63
34611... COMN MGRN W NTRC MGR STD............................ 63
3462.... VARIANTS OF MIGRAINE*............................... 63
34620... VRNT MIGRNE WO NTRC MGRN............................ 63
34621... VRNT MGRN W NTRC MGR STD............................ 63
3468.... MIGRAINE NEC*....................................... 63
34680... OTHR MIGRNE WO NTRC MGRN............................ 63
34681... OTHR MGRN W NTRC MGR STD............................ 63
3469.... MIGRAINE NOS*....................................... 63
34690... MIGRNE UNSP WO NTRC MGRN............................ 63
34691... MGRN UNSP W NTRC MGR STD............................ 63
347..... CATAPLEXY AND NARCOLEPSY............................ 63
3480.... CEREBRAL CYSTS...................................... 63
3481.... ANOXIC BRAIN DAMAGE................................. 63
3482.... PSEUDOTUMOR CEREBRI................................. 63
3483.... ENCEPHALOPATHY NOS.................................. 63
3484.... COMPRESSION OF BRAIN................................ 63
3485.... CEREBRAL EDEMA...................................... 63
3488.... BRAIN CONDITIONS NEC................................ 63
3489.... BRAIN CONDITION NOS................................. 63
3490.... LUMBAR PUNCTURE REACTION............................ 63
3491.... COMPLICATION CNS DEVICE............................. 63
3492.... DISORDER OF MENINGES NEC............................ 63
34981... CEREBROSPINAL RHINORRHEA............................ 63
34982... TOXIC ENCEPHALOPATHY................................ 63
34989... CNS DISORDER NEC.................................... 63
3499.... CNS DISORDER NOS.................................... 63
3501.... TRIGEMINAL NEURALGIA................................ 63
3502.... ATYPICAL FACE PAIN.................................. 63
[[Page 47875]]
3508.... TRIGEMINAL NERVE DIS NEC............................ 63
3509.... TRIGEMINAL NERVE DIS NOS............................ 63
3510.... BELL'S PALSY........................................ 63
3511.... GENICULATE GANGLIONITIS............................. 63
3518.... FACIAL NERVE DIS NEC................................ 63
3519.... FACIAL NERVE DIS NOS................................ 63
3520.... OLFACTORY NERVE DISORDER............................ 63
3521.... GLOSSOPHARYNG NEURALGIA............................. 63
3522.... GLOSSOPHAR NERVE DIS NEC............................ 63
3523.... PNEUMOGASTRIC NERVE DIS............................. 63
3524.... ACCESSORY NERVE DISORDER............................ 63
3525.... HYPOGLOSSAL NERVE DIS............................... 63
3526.... MULT CRANIAL NERVE PALSY............................ 63
3529.... CRANIAL NERVE DIS NOS............................... 63
3530.... BRACHIAL PLEXUS LESIONS............................. 63
3531.... LUMBOSACRAL PLEX LESION............................. 63
3532.... CERVICAL ROOT LESION NEC............................ 63
3533.... THORACIC ROOT LESION NEC............................ 63
3534.... LUMBSACRAL ROOT LES NEC............................. 63
3535.... NEURALGIC AMYOTROPHY................................ 63
3536.... PHANTOM LIMB (SYNDROME)............................. 63
3538.... NERV ROOT/PLEXUS DIS NEC............................ 63
3539.... NERV ROOT/PLEXUS DIS NOS............................ 63
3540.... CARPAL TUNNEL SYNDROME.............................. 63
3541.... MEDIAN NERVE LESION NEC............................. 63
3542.... ULNAR NERVE LESION.................................. 63
3543.... RADIAL NERVE LESION................................. 63
3544.... CAUSALGIA UPPER LIMB................................ 63
3545.... MONONEURITIS MULTIPLEX.............................. 63
3548.... MONONEURITIS ARM NEC................................ 63
3549.... MONONEURITIS ARM NOS................................ 63
3550.... SCIATIC NERVE LESION................................ 63
3551.... MERALGIA PARESTHETICA............................... 63
3552.... FEMORAL NERVE LESION NEC............................ 63
3553.... LAT POPLITEAL NERVE LES............................. 63
3554.... MED POPLITEAL NERVE LES............................. 63
3555.... TARSAL TUNNEL SYNDROME.............................. 63
3556.... PLANTAR NERVE LESION................................ 63
3557.... MONONEURITIS LEG NEC*............................... 63
35571... CAUSALGIA LOWER LIMB................................ 63
35579... OTH MONONEUR LOWER LIMB............................. 63
3558.... MONONEURITIS LEG NOS................................ 63
3559.... MONONEURITIS NOS.................................... 63
3560.... HERED PERIPH NEUROPATHY............................. 63
3561.... PERONEAL MUSCLE ATROPHY............................. 63
3562.... HERED SENSORY NEUROPATHY............................ 63
3563.... REFSUM'S DISEASE.................................... 63
3564.... IDIO PROG POLYNEUROPATHY............................ 63
3568.... IDIO PERIPH NEURPTHY NEC............................ 63
3569.... IDIO PERIPH NEURPTHY NOS............................ 63
3570.... AC INFECT POLYNEURITIS.............................. 63
3571.... NEURPTHY IN COL VASC DIS............................ 63
3572.... NEUROPATHY IN DIABETES.............................. 63
3573.... NEUROPATHY IN MALIG DIS............................. 63
3574.... NEUROPATHY IN OTHER DIS............................. 63
3575.... ALCOHOLIC POLYNEUROPATHY............................ 63
3576.... NEUROPATHY DUE TO DRUGS............................. 63
3577.... NEURPTHY TOXIC AGENT NEC............................ 63
3578.... INFLAM/TOX NEUROPTHY NEC............................ 63
3579.... INFLAM/TOX NEUROPTHY NOS............................ 63
3580.... MYASTHENIA GRAVIS................................... 63
3581.... MYASTHENIA IN OTH DIS............................... 63
3582.... TOXIC MYONEURAL DISORDER............................ 63
3588.... MYONEURAL DISORDERS NEC............................. 63
3589.... MYONEURAL DISORDERS NOS............................. 63
3590.... CONG HERED MUSC DYSTRPHY............................ 63
3591.... HERED PROG MUSC DYSTRPHY............................ 63
3592.... MYOTONIC DISORDERS.................................. 63
3593.... FAMIL PERIODIC PARALYSIS............................ 63
3594.... TOXIC MYOPATHY...................................... 63
3595.... MYOPATHY IN ENDOCRIN DIS............................ 63
3596.... INFL MYOPATHY IN OTH DIS............................ 63
3598.... MYOPATHY NEC........................................ 63
3599.... MYOPATHY NOS........................................ 63
36000... PURULENT ENDOPHTHALM NOS............................ 68
36001... ACUTE ENDOPHTHALMITIS............................... 68
[[Page 47876]]
36002... PANOPHTHALMITIS..................................... 68
36003... CHRONIC ENDOPHTHALMITIS............................. 68
36004... VITREOUS ABSCESS.................................... 68
36011... SYMPATHETIC UVEITIS................................. 68
36012... PANUVEITIS.......................................... 68
36013... PARASITIC ENDOPHTHAL NOS............................ 68
36014... OPHTHALMIA NODOSA................................... 68
36019... ENDOPHTHALMITIS NEC................................. 68
36020... DEGENERAT GLOBE DIS NOS............................. 68
36021... PROGRESSIVE HIGH MYOPIA............................. 68
36023... SIDEROSIS........................................... 68
36024... OTHER METALLOSIS, EYE............................... 68
36029... DEGENERATIVE GLOBE NEC.............................. 68
36030... HYPOTONY NOS, EYE................................... 68
36031... PRIMARY HYPOTONY.................................... 68
36032... HYPOTONY DUE TO FISTULA............................. 68
36033... HYPOTONY W EYE DIS NEC.............................. 68
36034... FLAT ANTERIOR CHAMBER............................... 68
36040... DEGENERATION OF EYE NOS............................. 68
36041... BLIND HYPOTENSIVE EYE............................... 68
36042... BLIND HYPERTENSIVE EYE.............................. 68
36043... HEMOPHTHALMOS....................................... 68
36044... LEUCOCORIA.......................................... 68
36050... OLD MAGNET FB, EYE NOS.............................. 68
36051... OLD MAGNET FB, ANT CHAMB............................ 68
36052... OLD MAGNET FB, IRIS................................. 68
36053... OLD MAGNET FB, LENS................................. 68
36054... OLD MAGNET FB, VITREOUS............................. 68
36055... OLD MAGNET FB, POST WALL............................ 68
36059... OLD MAGNET FB, EYE NEC.............................. 68
36060... INTRAOCULAR FB NOS.................................. 68
36061... FB IN ANTERIOR CHAMBER.............................. 68
36062... FB IN IRIS OR CILIARY............................... 68
36063... FOREIGN BODY IN LENS................................ 68
36064... FOREIGN BODY IN VITREOUS............................ 68
36065... FB IN POSTERIOR WALL................................ 68
36069... INTRAOCULAR FB NEC.................................. 68
36081... LUXATION OF GLOBE................................... 68
36089... DISORDER OF GLOBE NEC............................... 68
3609.... DISORDER OF GLOBE NOS............................... 68
36100... DETACHMNT W DEFECT NOS.............................. 68
36101... PART DETACH-SINGL DEFEC............................. 68
36102... PART DETACH-MULT DEFECT............................. 68
36103... PART DETACH-GIANT TEAR.............................. 68
36104... PART DETACH-DIALYSIS................................ 68
36105... RECENT DETACHMENT, TOTAL............................ 68
36106... OLD DETACHMENT, PARTIAL............................. 68
36107... OLD DETACHMENT, TOTAL............................... 68
36110... RETINOSCHISIS NOS................................... 68
36111... FLAT RETINOSCHISIS.................................. 68
36112... BULLOUS RETINOSCHISIS............................... 68
36113... PRIMARY RETINAL CYSTS............................... 68
36114... SECONDARY RETINAL CYSTS............................. 68
36119... RETINOSHISIS OR CYST NEC............................ 68
3612.... SEROUS RETINA DETACHMENT............................ 68
36130... RETINAL DEFECT NOS.................................. 68
36131... ROUND HOLE OF RETINA................................ 68
36132... HORSESHOE TEAR OF RETINA............................ 68
36133... MULT DEFECTS OF RETINA.............................. 68
36181... RETINAL TRACTION DETACH............................. 68
36189... RETINAL DETACHMENT NEC.............................. 68
3619.... RETINAL DETACHMENT NOS.............................. 68
36201... DIABETIC RETINOPATHY NOS............................ 68
36202... PROLIF DIAB RETINOPATHY............................. 68
36210... BACKGRND RETINOPATHY NOS............................ 68
36211... HYPERTENSIVE RETINOPATHY............................ 68
36212... EXUDATIVE RETINOPATHY............................... 68
36213... RETINAL VASCULAR CHANGES............................ 68
36214... RETINA MICROANEURYSM NOS............................ 68
36215... RETINAL TELANGIECTASIA.............................. 68
36216... RETINAL NEOVASCULAR NOS............................. 68
36217... RETINAL VARICES..................................... 68
36218... RETINAL VASCULITIS.................................. 68
36221... RETROLENTAL FIBROPLASIA............................. 68
36229... PROLIF RETINOPATHY NEC.............................. 68
36230... RETINAL VASC OCCLUS NOS............................. 68
[[Page 47877]]
36231... CENT RETINA ARTERY OCCLU............................ 68
36232... ARTERIAL BRANCH OCCLUS.............................. 68
36233... PART ARTERIAL OCCLUSION............................. 68
36234... TRANSIENT ARTERIAL OCCLU............................ 68
36235... CENT RETINAL VEIN OCCLUS............................ 68
36236... VENOUS TRIBUTARY OCCLUS............................. 68
36237... RETINA VENOUS ENGORGEMNT............................ 68
36240... RETINA LAYER SEPARAT NOS............................ 68
36241... CENT SEROUS RETINOPATHY............................. 68
36242... SEROUS DETACH PIGM EPITH............................ 68
36243... HEM DETACH PIGMNT EPITH............................. 68
36250... MACULAR DEGENERATION NOS............................ 68
36251... NONEXUDAT MACULAR DEGEN............................. 68
36252... EXUDATIVE MACULAR DEGEN............................. 68
36253... CYSTOID MACULAR DEGEN............................... 68
36254... MACULAR CYST OR HOLE................................ 68
36255... TOXIC MACULOPATHY................................... 68
36256... MACULAR PUCKERING................................... 68
36257... DRUSEN (DEGENERATIVE)............................... 68
36260... PERIPH RETINA DEGEN NOS............................. 68
36261... PAVING STONE DEGENERAT.............................. 68
36262... MICROCYSTOID DEGENERAT.............................. 68
36263... LATTICE DEGENERATION................................ 68
36264... SENILE RETICULAR DEGEN.............................. 68
36265... SECONDRY PIGMENT DEGEN.............................. 68
36266... SEC VITREORETINA DEGEN.............................. 68
36270... HERED RETIN DYSTRPHY NOS............................ 68
36271... RET DYSTRPH IN LIPIDOSES............................ 68
36272... RET DYSTRPH IN SYST DIS............................. 68
36273... VITREORETINAL DYSTROPHY............................. 68
36274... PIGMENT RETINA DYSTROPHY............................ 68
36275... SENSORY RETINA DYSTROPHY............................ 68
36276... VITELLIFORM DYSTROPHY............................... 68
36277... BRUCH MEMBRANE DYSTROPHY............................ 68
36281... RETINAL HEMORRHAGE.................................. 68
36282... RETINA EXUDATES/DEPOSITS............................ 68
36283... RETINAL EDEMA....................................... 68
36284... RETINAL ISCHEMIA.................................... 68
36285... RETINAL NERV FIBER DEFEC............................ 68
36289... RETINAL DISORDERS NEC............................... 68
3629.... RETINAL DISORDER NOS................................ 68
36300... FOCAL CHORIORETINIT NOS............................. 68
36301... JUXTAPAP FOC CHOROIDITIS............................ 68
36303... FOC CHOROIDITIS POST NEC............................ 68
36304... PERIPH FOCAL CHOROIDITIS............................ 68
36305... JUXTAPAP FOCAL RETINITIS............................ 68
36306... MACULAR FOCAL RETINITIS............................. 68
36307... FOC RETINITIS POST NEC.............................. 68
36308... PERIPH FOCAL RETINITIS.............................. 68
36310... DISSEM CHORIORETINIT NOS............................ 68
36311... DISSEM CHOROIDITIS, POST............................ 68
36312... PERIPH DISEM CHOROIDITIS............................ 68
36313... GEN DISSEM CHOROIDITIS.............................. 68
36314... METASTAT DISSEM RETINIT............................. 68
36315... PIGMENT EPITHELIOPATHY.............................. 68
36320... CHORIORETINITIS NOS................................. 68
36321... PARS PLANITIS....................................... 68
36322... HARADA'S DISEASE.................................... 68
36330... CHORIORETINAL SCAR NOS.............................. 68
36331... SOLAR RETINOPATHY................................... 68
36332... MACULAR SCARS NEC................................... 68
36333... POSTERIOR POLE SCAR NEC............................. 68
36334... PERIPHERAL RETINAL SCARS............................ 68
36335... DISSEMINATED RETINA SCAR............................ 68
36340... CHOROIDAL DEGEN NOS................................. 68
36341... SENILE ATROPHY, CHOROID............................. 68
36342... DIFUS SEC ATROPH CHOROID............................ 68
36343... ANGIOID STREAKS, CHOROID............................ 68
36350... HERED CHOROID ATROPH NOS............................ 68
36351... PRT CIRCMPAP CHOROID DYS............................ 68
36352... TOT CIRCMPAP CHOROID DYS............................ 68
36353... PART CENT CHOROID DYSTR............................. 68
36354... TOT CENT CHOROID ATROPHY............................ 68
36355... CHOROIDEREMIA....................................... 68
36356... PRT GEN CHOROID DYST NEC............................ 68
36357... TOT GEN CHOROID DYST NEC............................ 68
[[Page 47878]]
36361... CHOROIDAL HEMORRHAGE NOS............................ 68
36362... EXPULSIVE CHOROID HEMORR............................ 68
36363... CHOROIDAL RUPTURE................................... 68
36370... CHOROIDAL DETACHMENT NOS............................ 68
36371... SEROUS CHOROID DETACHMNT............................ 68
36372... HEMORR CHOROID DETACHMNT............................ 68
3638.... DISORDERS OF CHOROID NEC............................ 68
3639.... CHOROIDAL DISORDER NOS.............................. 68
36400... ACUTE IRIDOCYCLITIS NOS............................. 68
36401... PRIMARY IRIDOCYCLITIS............................... 68
36402... RECURRENT IRIDOCYCLITIS............................. 68
36403... SECONDRY IRITIS, INFECT............................. 68
36404... SECOND IRITIS, NONINFEC............................. 68
36405... HYPOPYON............................................ 68
36410... CHR IRIDOCYCLITIS NOS............................... 68
36411... CHR IRIDOCYL IN OTH DIS............................. 68
36421... FUCH HETROCHROM CYCLITIS............................ 68
36422... GLAUCOMATOCYCLIT CRISES............................. 68
36423... LENS-INDUCED IRIDOCYCLIT............................ 68
36424... VOGT-KOYANAGI SYNDROME.............................. 68
3643.... IRIDOCYCLITIS NOS................................... 68
36441... HYPHEMA............................................. 68
36442... RUBEOSIS IRIDIS..................................... 68
36451... PROGRESSIVE IRIS ATROPHY............................ 68
36452... IRIDOSCHISIS........................................ 68
36453... PIGMENT IRIS DEGENERAT.............................. 68
36454... PUPILLARY MARGIN DEGEN.............................. 68
36455... MIOTIC CYST PUPIL MARGIN............................ 68
36456... DEGEN CHAMBER ANGLE................................. 68
36457... DEGEN CILIARY BODY.................................. 68
36459... IRIS ATROPHY NEC.................................... 68
36460... IDIOPATHIC CYSTS.................................... 68
36461... IMPLANTATION CYSTS.................................. 68
36462... EXUD CYST IRIS/ANT CHAMB............................ 68
36463... PRIMARY CYST PARS PLANA............................. 68
36464... EXUDAT CYST PARS PLANA.............................. 68
36470... ADHESIONS OF IRIS NOS............................... 68
36471... POSTERIOR SYNECHIAE................................. 68
36472... ANTERIOR SYNECHIAE.................................. 68
36473... GONIOSYNECHIAE...................................... 68
36474... PUPILLARY MEMBRANES................................. 68
36475... PUPILLARY ABNORMALITIES............................. 68
36476... IRIDODIALYSIS....................................... 68
36477... RECESSION, CHAMBER ANGLE............................ 68
3648.... IRIS/CILIARY DIS NEC................................ 68
3649.... IRIS/CILIARY DIS NOS................................ 68
36500... PREGLAUCOMA NOS..................................... 68
36501... OPN ANGL W BORDERLN FIND............................ 68
36502... ANATOMICAL NARROW ANGLE............................. 68
36503... STEROID RESPONDERS.................................. 68
36504... OCULAR HYPERTENSION................................. 68
36510... OPEN-ANGLE GLAUCOMA NOS............................. 68
36511... PRIM OPEN ANGLE GLAUCOMA............................ 68
36512... LOW TENSION GLAUCOMA................................ 68
36513... PIGMENTARY GLAUCOMA................................. 68
36514... GLAUCOMA OF CHILDHOOD............................... 68
36515... RESIDUAL OPN ANG GLAUCMA............................ 68
36520... PRIM ANGL-CLOS GLAUC NOS............................ 68
36521... INTERMIT ANGL-CLOS GLAUC............................ 68
36522... ACUTE ANGL-CLOS GLAUCOMA............................ 68
36523... CHR ANGLE-CLOS GLAUCOMA............................. 68
36524... RESIDUAL ANGL-CLOS GLAUC............................ 68
36531... GLAUC STAGE-STER INDUCED............................ 68
36532... GLAUC RESID-STER INDUCED............................ 68
36541... GLAUC W CHAMB ANGLE ANOM............................ 68
36542... GLAUCOMA W IRIS ANOMALY............................. 68
36543... GLAUC W ANT SEG ANOM NEC............................ 68
36544... GLAUCOMA W SYSTEMIC SYND............................ 68
36551... PHACOLYTIC GLAUCOMA................................. 68
36552... PSEUDOEXFOLIAT GLAUCOMA............................. 68
36559... GLAUCOMA W LENS DIS NEC............................. 68
36560... GLAUC W OCULAR DIS NOS.............................. 68
36561... GLAUC W PUPILLARY BLOCK............................. 68
36562... GLAUCOMA W OCULAR INFLAM............................ 68
36563... GLAUCOMA W VASCULAR DIS............................. 68
36564... GLAUCOMA W TUMOR OR CYST............................ 68
[[Page 47879]]
36565... GLAUCOMA W OCULAR TRAUMA............................ 68
36581... HYPERSECRETION GLAUCOMA............................. 68
36582... GLAUC W INC EPISCL PRESS............................ 68
36589... GLAUCOMA NEC........................................ 68
3659.... GLAUCOMA NOS........................................ 68
36600... NONSENILE CATARACT NOS.............................. 68
36601... ANT SUBCAPS POL CATARACT............................ 68
36602... POST SUBCAPS POL CATARCT............................ 68
36603... CORTICAL CATARACT................................... 68
36604... NUCLEAR CATARACT.................................... 68
36609... NONSENILE CATARACT NEC.............................. 68
36610... SENILE CATARACT NOS................................. 68
36611... PSEUDOEXFOL LENS CAPSULE............................ 68
36612... INCIPIENT CATARACT.................................. 68
36613... ANT SUBCAPS SENILE CATAR............................ 68
36614... POST SUBCAP SENILE CATAR............................ 68
36615... CORTICAL SENILE CATARACT............................ 68
36616... SENILE NUCLEAR CATARACT............................. 68
36617... MATURE CATARACT..................................... 68
36618... HYPERMATURE CATARACT................................ 68
36619... SENILE CATARACT NEC................................. 68
36620... TRAUMATIC CATARACT NOS.............................. 68
36621... LOCAL TRAUMATIC OPACITY............................. 68
36622... TOTAL TRAUMATIC CATARACT............................ 68
36623... PART RESOLV TRAUM CATAR............................. 68
36630... CATARACTA COMPLICATA NOS............................ 68
36631... GLAUCOMATOUS FLECKS................................. 68
36632... CATARACT IN INFLAM DIS.............................. 68
36633... CATARACT W NEOVASCULIZAT............................ 68
36634... CATARACT IN DEGEN DIS............................... 68
36641... DIABETIC CATARACT................................... 68
36642... TETANIC CATARACT.................................... 68
36643... MYOTONIC CATARACT................................... 68
36644... CATARACT W SYNDROME NEC............................. 68
36645... TOXIC CATARACT...................................... 68
36646... CATARACT W RADIATION................................ 68
36650... AFTER-CATARACT NOS.................................. 68
36651... SOEMMERING'S RING................................... 68
36652... AFTER-CATARACT NEC.................................. 68
36653... AFTR-CATAR OBSCUR VISION............................ 68
3668.... CATARACT NEC........................................ 68
3669.... CATARACT NOS........................................ 68
3670.... HYPERMETROPIA....................................... 68
3671.... MYOPIA.............................................. 68
36720... ASTIGMATISM NOS..................................... 68
36721... REGULAR ASTIGMATISM................................. 68
36722... IRREGULAR ASTIGMATISM............................... 68
36731... ANISOMETROPIA....................................... 68
36732... ANISEIKONIA......................................... 68
3674.... PRESBYOPIA.......................................... 68
36751... PARESIS OF ACCOMMODATION............................ 68
36752... TOT INTERN OPHTHALMOPLEG............................ 68
36753... SPASM OF ACCOMMODATION.............................. 68
36781... TRANSIENT REFRACT CHANGE............................ 68
36789... REFRACTION DISORDER NEC............................. 68
3679.... REFRACTION DISORDER NOS............................. 68
36800... AMBLYOPIA NOS....................................... 68
36801... STRABISMIC AMBLYOPIA................................ 68
36802... DEPRIVATION AMBLYOPIA............................... 68
36803... REFRACTIVE AMBLYOPIA................................ 68
36810... SUBJ VISUAL DISTURB NOS............................. 68
36811... SUDDEN VISUAL LOSS.................................. 68
36812... TRANSIENT VISUAL LOSS............................... 68
36813... VISUAL DISCOMFORT................................... 68
36814... DISTORTION OF SHAPE/SIZE............................ 68
36815... VISUAL DISTORTIONS NEC.............................. 68
36816... PSYCHOPHYSIC VISUAL DIST............................ 68
3682.... DIPLOPIA............................................ 68
36830... BINOCULAR VISION DIS NOS............................ 68
36831... BINOCULAR VIS SUPPRESS.............................. 68
36832... VISUAL PERCEPT W/O FUSN............................. 68
36833... FUSION W DEF STEREOPSIS............................. 68
36834... ABN RETINA CORRESPOND............................... 68
36840... VISUAL FIELD DEFECT NOS............................. 68
36841... CENTRAL SCOTOMA..................................... 68
36842... SCOTOMA OF BLIND SPOT............................... 68
[[Page 47880]]
36843... SECTOR OR ARCUATE DEFECT............................ 68
36844... VISUAL FIELD DEFECT NEC............................. 68
36845... GEN VISUAL CONTRACTION.............................. 68
36846... HOMONYMOUS HEMIANOPSIA.............................. 68
36847... HETERONYMOUS HEMIANOPSIA............................ 68
36851... PROTAN DEFECT....................................... 68
36852... DEUTAN DEFECT....................................... 68
36853... TRITAN DEFECT....................................... 68
36854... ACHROMATOPSIA....................................... 68
36855... ACQ COLOR DEFICIENCY................................ 68
36859... COLOR DEFICIENCY NEC................................ 68
36860... NIGHT BLINDNESS NOS................................. 68
36861... CONGEN NIGHT BLINDNESS.............................. 68
36862... ACQUIRED NIGHT BLINDNESS............................ 68
36863... ABN DARK ADAPTAT CURVE.............................. 68
36869... NIGHT BLINDNESS NEC................................. 68
3688.... VISUAL DISTURBANCES NEC............................. 68
3689.... VISUAL DISTURBANCE NOS.............................. 68
36900... BOTH EYES BLIND-WHO DEF............................. 68
36901... TOT IMPAIRMENT-BOTH EYES............................ 68
36902... ONE EYE-NEAR TOT/OTH-NOS............................ 68
36903... ONE EYE-NEAR TOT/OTH-TOT............................ 68
36904... NEAR-TOT IMPAIR-BOTH EYE............................ 68
36905... ONE EYE-PROFOUND/OTH-NOS............................ 68
36906... ONE EYE-PROFOUND/OTH-TOT............................ 68
36907... ONE EYE-PRFND/OTH-NR TOT............................ 68
36908... PROFOUND IMPAIR BOTH EYE............................ 68
36910... BLINDNESS/LOW VISION................................ 68
36911... 1 EYE-SEV/OTH-BLIND NOS............................. 68
36912... ONE EYE-SEVERE/OTH-TOTAL............................ 68
36913... ONE EYE-SEV/OTH-NEAR TOT............................ 68
36914... ONE EYE-SEV/OTH-PRFND............................... 68
36915... ONE EYE-MOD/OTH-BLIND............................... 68
36916... ONE EYE-MODERATE/OTH-TOT............................ 68
36917... ONE EYE-MOD/OTH-NEAR TOT............................ 68
36918... ONE EYE-MOD/OTH-PROFOUND............................ 68
36920... LOW VISION, 2 EYES NOS.............................. 68
36921... ONE EYE-SEVERE/OTH-NOS.............................. 68
36922... SEVERE IMPAIR-BOTH EYES............................. 68
36923... ONE EYE-MODERATE/OTH-NOS............................ 68
36924... ONE EYE-MODERATE/OTH-SEV............................ 68
36925... MODERATE IMPAIR-BOTH EYE............................ 68
3693.... BLINDNESS NOS, BOTH EYES............................ 68
3694.... LEGAL BLINDNESS-USA DEF............................. 68
36960... BLINDNESS, ONE EYE.................................. 68
36961... ONE EYE-TOTAL/OTH-UNKNWN............................ 68
36962... ONE EYE-TOT/OTH-NEAR NOR............................ 68
36963... ONE EYE-TOTAL/OTH-NORMAL............................ 68
36964... ONE EYE-NEAR TOT/OTH-NOS............................ 68
36965... NEAR-TOT IMP/NEAR-NORMAL............................ 68
36966... NEAR-TOTAL IMPAIR/NORMAL............................ 68
36967... ONE EYE-PRFOUND/OTH-UNKN............................ 68
36968... PROFND IMPAIR/NEAR NORM............................. 68
36969... PROFOUND IMPAIR/NORMAL.............................. 68
36970... LOW VISION, ONE EYE................................. 68
36971... ONE EYE-SEVERE/OTH-UNKNW............................ 68
36972... ONE EYE-SEV/OTH-NR NORM............................. 68
36973... ONE EYE-SEVERE/OTH-NORM............................. 68
36974... ONE EYE-MOD/OTHER-UNKNWN............................ 68
36975... ONE EYE-MOD/OTH-NR NORM............................. 68
36976... ONE EYE-MOD/OTH NORMAL.............................. 68
3698.... VISUAL LOSS, ONE EYE NOS............................ 68
3699.... VISUAL LOSS NOS..................................... 68
37000... CORNEAL ULCER NOS................................... 68
37001... MARGINAL CORNEAL ULCER.............................. 68
37002... RING CORNEAL ULCER.................................. 68
37003... CENTRAL CORNEAL ULCER............................... 68
37004... HYPOPYON ULCER...................................... 68
37005... MYCOTIC CORNEAL ULCER............................... 68
37006... PERFORATED CORNEAL ULCER............................ 68
37007... MOOREN'S ULCER...................................... 68
37020... SUPERFIC KERATITIS NOS.............................. 68
37021... PUNCTATE KERATITIS.................................. 68
37022... MACULAR KERATITIS................................... 68
37023... FILAMENTARY KERATITIS............................... 68
37024... PHOTOKERATITIS...................................... 68
[[Page 47881]]
37031... PHLYCTEN KERATOCONJUNCT............................. 68
37032... LIMBAR KERATOCONJUNCTIV............................. 68
37033... KERATOCONJUNCTIVIT SICCA............................ 68
37034... EXPSURE KERATOCONJUNCTIV............................ 68
37035... NEUROTROPH KERATOCONJUNC............................ 68
37040... KERATOCONJUNCTIVITIS NOS............................ 68
37044... KERATITIS IN EXANTHEMA.............................. 68
37049... KERATOCONJUNCTIVITIS NEC............................ 68
37050... INTERSTIT KERATITIS NOS............................. 68
37052... DIFFUS INTERSTIT KERATIT............................ 68
37054... SCLEROSING KERATITIS................................ 68
37055... CORNEAL ABSCESS..................................... 68
37059... INTERSTIT KERATITIS NEC............................. 68
37060... CORNEA NEOVASCULARIZ NOS............................ 68
37061... LOCAL VASCULARIZA CORNEA............................ 68
37062... CORNEAL PANNUS...................................... 68
37063... DEEP VASCULARIZA CORNEA............................. 68
37064... CORNEAL GHOST VESSELS............................... 68
3708.... KERATITIS NEC....................................... 68
3709.... KERATITIS NOS....................................... 68
37100... CORNEAL OPACITY NOS................................. 68
37101... MINOR OPACITY OF CORNEA............................. 68
37102... PERIPH OPACITY OF CORNEA............................ 68
37103... CENTRAL OPACITY, CORNEA............................. 68
37104... ADHERENT LEUCOMA.................................... 68
37105... PHTHISICAL CORNEA................................... 68
37110... CORNEAL DEPOSIT NOS................................. 68
37111... ANT CORNEA PIGMENTATION............................. 68
37112... STROMAL CORNEA PIGMENT.............................. 68
37113... POST CORNEA PIGMENTATION............................ 68
37114... KAYSER-FLEISCHER RING............................... 68
37115... OTH DEPOSIT W METAB DIS............................. 68
37116... ARGENTOUS CORNEA DEPOSIT............................ 68
37120... CORNEAL EDEMA NOS................................... 68
37121... IDIOPATHIC CORNEAL EDEMA............................ 68
37122... SECONDARY CORNEAL EDEMA............................. 68
37123... BULLOUS KERATOPATHY................................. 68
37124... EDEMA D/T CONTACT LENS.............................. 68
37130... CORNEA MEMB CHANGE NOS.............................. 68
37131... FOLD OF BOWMAN MEMBRANE............................. 68
37132... FOLD IN DESCEMET MEMBRAN............................ 68
37133... RUPTURE DESCEMET MEMBRAN............................ 68
37140... CORNEAL DEGENERATION NOS............................ 68
37141... SENILE CORNEAL CHANGES.............................. 68
37142... RECURRENT CORNEA EROSION............................ 68
37143... BAND-SHAPED KERATOPATHY............................. 68
37144... CALCER CORNEA DEGEN NEC............................. 68
37145... KERATOMALACIA NOS................................... 68
37146... NODULAR CORNEA DEGEN................................ 68
37148... PERIPHERAL CORNEA DEGEN............................. 68
37149... CORNEA DEGENERATION NEC............................. 68
37150... CORNEAL DYSTROPHY NOS............................... 68
37151... JUV EPITH CORNEA DYSTRPH............................ 68
37152... ANT CORNEA DYSTROPHY NEC............................ 68
37153... GRANULAR CORNEA DYSTRPHY............................ 68
37154... LATTICE CORNEA DYSTROPHY............................ 68
37155... MACULAR CORNEA DYSTROPHY............................ 68
37156... STROM CORNEA DYSTRPH NEC............................ 68
37157... ENDOTHEL CORNEA DYSTRPHY............................ 68
37158... POST CORNEA DYSTRPHY NEC............................ 68
37160... KERATOCONUS NOS..................................... 68
37161... KERATOCONUS, STABLE................................. 68
37162... KERATOCONUS, AC HYDROPS............................. 68
37170... CORNEAL DEFORMITY NOS............................... 68
37171... CORNEAL ECTASIA..................................... 68
37172... DESCEMETOCELE....................................... 68
37173... CORNEAL STAPHYLOMA.................................. 68
37181... CORNEAL ANESTHESIA.................................. 68
37182... CORNEAL DSDR CONTCT LENS............................ 68
37189... CORNEAL DISORDER NEC................................ 68
3719.... CORNEAL DISORDER NOS................................ 68
37200... ACUTE CONJUNCTIVITIS NOS............................ 68
37201... SEROUS CONJUNCTIVITIS............................... 68
37202... AC FOLLIC CONJUNCTIVITIS............................ 68
37203... MUCOPUR CONJUNCTIVIT NEC............................ 68
37204... PSEUDOMEMB CONJUNCTIVIT............................. 68
[[Page 47882]]
37205... AC ATOPIC CONJUNCTIVITIS............................ 68
37210... CHR CONJUNCTIVITIS NOS.............................. 68
37211... SIMPL CHR CONJUNCTIVITIS............................ 68
37212... CHR FOLLIC CONJUNCTIVIT............................. 68
37213... VERNAL CONJUNCTIVITIS............................... 68
37214... CHR ALLRG CONJUNCTIV NEC............................ 68
37215... PARASITIC CONJUNCTIVITIS............................ 68
37220... BLEPHAROCONJUNCTIVIT NOS............................ 68
37221... ANGULAR BLEPHAROCONJUNCT............................ 68
37222... CONTACT BLEPHAROCONJUNCT............................ 68
37230... CONJUNCTIVITIS NOS.................................. 68
37231... ROSACEA CONJUNCTIVITIS.............................. 68
37233... MUCOCUTAN DIS CONJUNCTIV............................ 68
37239... CONJUNCTIVITIS NEC.................................. 68
37240... PTERYGIUM NOS....................................... 68
37241... PERIPH STATION PTERYGIUM............................ 68
37242... PERIPH PROGESS PTERYGIUM............................ 68
37243... CENTRAL PTERYGIUM................................... 68
37244... DOUBLE PTERYGIUM.................................... 68
37245... RECURRENT PTERYGIUM................................. 68
37250... CONJUNCTIVAL DEGEN NOS.............................. 68
37251... PINGUECULA.......................................... 68
37252... PSEUDOPTERYGIUM..................................... 68
37253... CONJUNCTIVAL XEROSIS................................ 68
37254... CONJUNCTIVAL CONCRETIONS............................ 68
37255... CONJUNCTIVA PIGMENTATION............................ 68
37256... CONJUNCTIVAL DEPOSITS............................... 68
37261... GRANULOMA OF CONJUNCTIVA............................ 68
37262... LOCAL CONJUNCTIVA ADHES............................. 68
37263... SYMBLEPHARON........................................ 68
37264... SCARRING OF CONJUNCTIVA............................. 68
37271... HYPEREMIA OF CONJUNCTIVA............................ 68
37272... CONJUNCTIVAL HEMORRHAGE............................. 68
37273... CONJUNCTIVAL EDEMA.................................. 68
37274... CONJUNCTIVA VASC ANOMALY............................ 68
37275... CONJUNCTIVAL CYSTS.................................. 68
3728.... CONJUNCTIVA DISORDER NEC............................ 68
3729.... CONJUNCTIVA DISORDER NOS............................ 68
37300... BLEPHARITIS NOS..................................... 68
37301... ULCERATIVE BLEPHARITIS.............................. 68
37302... SQUAMOUS BLEPHARITIS................................ 68
37311... HORDEOLUM EXTERNUM.................................. 68
37312... HORDEOLUM INTERNUM.................................. 68
37313... ABSCESS OF EYELID................................... 68
3732.... CHALAZION........................................... 68
37331... ECZEM DERMATITIS EYELID............................. 68
37332... CONTACT DERMATIT EYELID............................. 68
37333... XERODERMA OF EYELID................................. 68
37334... DISC LUP ERYTHEMATOS LID............................ 68
3734.... INFECT DERM LID W DEFORM............................ 68
3735.... INFEC DERMATITIS LID NEC............................ 68
3736.... PARASITIC INFEST EYELID............................. 68
3738.... INFLAMMATION EYELID NEC............................. 68
3739.... INFLAMMATION EYELID NOS............................. 68
37400... ENTROPION NOS....................................... 68
37401... SENILE ENTROPION.................................... 68
37402... MECHANICAL ENTROPION................................ 68
37403... SPASTIC ENTROPION................................... 68
37404... CICATRICIAL ENTROPION............................... 68
37405... TRICHIASIS W/O ENTROPION............................ 68
37410... ECTROPION NOS....................................... 68
37411... SENILE ECTROPION.................................... 68
37412... MECHANICAL ECTROPION................................ 68
37413... SPASTIC ECTROPION................................... 68
37414... CICATRICIAL ECTROPION............................... 68
37420... LAGOPHTHALMOS NOS................................... 68
37421... PARALYTIC LAGOPHTHALMOS............................. 68
37422... MECHANICAL LAGOPHTHALMOS............................ 68
37423... CICATRICIAL LAGOPHTHALM............................. 68
37430... PTOSIS OF EYELID NOS................................ 68
37431... PARALYTIC PTOSIS.................................... 68
37432... MYOGENIC PTOSIS..................................... 68
37433... MECHANICAL PTOSIS................................... 68
37434... BLEPHAROCHALASIS.................................... 68
37441... LID RETRACTION OR LAG............................... 68
37443... ABNORM INNERVATION SYND............................. 68
[[Page 47883]]
37444... SENSORY DISORDERS, LID.............................. 68
37445... SENSORMOTR DISOR LID NEC............................ 68
37446... BLEPHAROPHIMOSIS.................................... 68
37450... DEGEN DISORDER NOS, LID............................. 68
37451... XANTHELASMA......................................... 18
37452... HYPERPIGMENTATION LID............................... 68
37453... HYPOPIGMENTATION LID................................ 68
37454... HYPERTRICHOSIS OF EYELID............................ 68
37455... HYPOTRICHOSIS OF EYELID............................. 68
37456... DEGEN DIS EYELID NEC................................ 68
37481... HEMORRHAGE OF EYELID................................ 68
37482... EDEMA OF EYELID..................................... 68
37483... ELEPHANTIASIS OF EYELID............................. 68
37484... CYSTS OF EYELIDS.................................... 68
37485... VASCULAR ANOMALY, EYELID............................ 68
37486... OLD FOREIGN BODY, EYELID............................ 68
37487... DERMATOCHALASIS..................................... 68
37489... DISORDERS OF EYELID NEC............................. 68
3749.... DISORDER OF EYELID NOS.............................. 68
37500... DACRYOADENITIS NOS.................................. 68
37501... ACUTE DACRYOADENITIS................................ 68
37502... CHRONIC DACRYOADENITIS.............................. 68
37503... CH ENLARGMNT LACRIM GLND............................ 68
37511... DACRYOPS............................................ 68
37512... LACRIMAL GLAND CYST NEC............................. 68
37513... PRIMARY LACRIMAL ATROPHY............................ 68
37514... SECONDARY LACRIM ATROPHY............................ 68
37515... TEAR FILM INSUFFIC NOS.............................. 68
37516... LACRIMAL GLAND DISLOCAT............................. 68
37520... EPIPHORA NOS........................................ 68
37521... EPIPHORA D/T EXCESS TEAR............................ 68
37522... EPIPHORA D/T INSUF DRAIN............................ 68
37530... DACRYOCYSTITIS NOS.................................. 68
37531... ACUTE CANALICULITIS................................. 68
37532... ACUTE DACRYOCYSTITIS................................ 68
37533... PHLEGMON DACRYOCYSTITIS............................. 68
37541... CHRONIC CANALICULITIS............................... 68
37542... CHRONIC DACRYOCYSTITIS.............................. 68
37543... LACRIMAL MUCOCELE................................... 68
37551... LACRIML PUNCTUM EVERSION............................ 68
37552... LACRIML PUNCTUM STENOSIS............................ 68
37553... LACRIM CANALIC STENOSIS............................. 68
37554... LACRIMAL SAC STENOSIS............................... 68
37555... NEONATAL NASOLACRML OBST............................ 68
37556... ACQ NASOLACRML STENOSIS............................. 68
37557... DACRYOLITH.......................................... 68
37561... LACRIMAL FISTULA.................................... 68
37569... LACRIM PASSGE CHANGE NEC............................ 68
37581... LACRIM PASSAGE GRANULOMA............................ 68
37589... LACRIMAL SYST DIS NEC............................... 68
3759.... LACRIMAL SYST DIS NOS............................... 68
37600... ACUTE INFLAM NOS, ORBIT............................. 68
37601... ORBITAL CELLULITIS.................................. 68
37602... ORBITAL PERIOSTITIS................................. 68
37603... ORBITAL OSTEOMYELITIS............................... 68
37604... ORBITAL TENONITIS................................... 68
37610... CHR INFLAM NOS, ORBIT............................... 68
37611... ORBITAL GRANULOMA................................... 68
37612... ORBITAL MYOSITIS.................................... 68
37613... PARASITE INFEST, ORBIT.............................. 68
37621... THYROTOXIC EXOPHTHALMOS............................. 68
37622... EXOPHTHALM OPHTHALMOPLEG............................ 68
37630... EXOPHTHALMOS NOS.................................... 68
37631... CONSTANT EXOPHTHALMOS............................... 68
37632... ORBITAL HEMORRHAGE.................................. 68
37633... ORBITAL EDEMA....................................... 68
37634... INTERMITTNT EXOPHTHALMOS............................ 68
37635... PULSATING EXOPHTHALMOS.............................. 68
37636... LATERAL GLOBE DISPLACMNT............................ 68
37640... DEFORMITY OF ORBIT NOS.............................. 68
37641... HYPERTELORISM OF ORBIT.............................. 68
37642... EXOSTOSIS OF ORBIT.................................. 68
37643... ORBT DEFORM D/T BONE DIS............................ 68
37644... CRANIOFACIAL-ORBIT DEFOR............................ 68
37645... ATROPHY OF ORBIT.................................... 68
37646... ENLARGEMENT OF ORBIT................................ 68
[[Page 47884]]
37647... ORBIT DEFORM D/T TRAUMA............................. 68
37650... ENOPHTHALMOS NOS.................................... 68
37651... ENOPHTH D/T ORBIT ATRPHY............................ 68
37652... ENOPHTHALMOS D/T TRAUMA............................. 68
3766.... OLD FOREIGN BODY, ORBIT............................. 68
37681... ORBITAL CYSTS....................................... 68
37682... EXTRAOCUL MUSCL MYOPATHY............................ 68
37689... ORBITAL DISORDERS NEC............................... 68
3769.... ORBITAL DISORDER NOS................................ 68
37700... PAPILLEDEMA NOS..................................... 68
37701... PAPILLEDEMA W INCR PRESS............................ 68
37702... PAPILLEDEMA W DECR PRESS............................ 68
37703... PAPILLEDEMA W RETINA DIS............................ 68
37704... FOSTER-KENNEDY SYNDROME............................. 63
37710... OPTIC ATROPHY NOS................................... 63
37711... PRIMARY OPTIC ATROPHY............................... 63
37712... POSTINFLAM OPTIC ATROPHY............................ 63
37713... OPTIC ATRPH W RETIN DYST............................ 63
37714... CUPPING OF OPTIC DISC............................... 63
37715... PARTIAL OPTIC ATROPHY............................... 63
37716... HEREDITARY OPTIC ATROPHY............................ 63
37721... DRUSEN OF OPTIC DISC................................ 68
37722... CRATER-LIKE HOLE OP DISC............................ 68
37723... COLOBOMA OF OPTIC DISC.............................. 68
37724... PSEUDOPAPILLEDEMA................................... 78
37730... OPTIC NEURITIS NOS.................................. 68
37731... OPTIC PAPILLITIS.................................... 68
37732... RETROBULBAR NEURITIS................................ 68
37733... NUTRITION OPTC NEUROPTHY............................ 68
37734... TOXIC OPTIC NEUROPATHY.............................. 68
37739... OPTIC NEURITIS NEC.................................. 68
37741... ISCHEMIC OPTIC NEUROPTHY............................ 68
37742... OPTIC NERVE SHEATH HEMOR............................ 68
37749... OPTIC NERVE DISORDER NEC............................ 68
37751... OPT CHIASM W PITUIT DIS............................. 63
37752... OPT CHIASM DIS/NEOPL NEC............................ 63
37753... OPT CHIASM W VASCUL DIS............................. 63
37754... OP CHIASM DIS W INFL DIS............................ 63
37761... VIS PATH DIS W NEOPLASMS............................ 63
37762... VIS PATH DIS W VASC DIS............................. 63
37763... VIS PATH DIS W INFL DIS............................. 63
37771... VIS CORTX DIS W NEOPLASM............................ 63
37772... VIS CORTX DIS W VASC DIS............................ 63
37773... VIS CORTEX DIS W INFLAM............................. 63
37775... CORTICAL BLINDNESS.................................. 63
3779.... OPTIC NERVE DISORDER NOS............................ 63
37800... ESOTROPIA NOS....................................... 68
37801... MONOCULAR ESOTROPIA................................. 68
37802... MONOC ESOTROP W A PATTRN............................ 68
37803... MONOC ESOTROP W V PATTRN............................ 68
37804... MONOC ESOTROP W X/Y PAT............................. 68
37805... ALTERNATING ESOTROPIA............................... 68
37806... ALT ESOTROPIA W A PATTRN............................ 68
37807... ALT ESOTROPIA W V PATTRN............................ 68
37808... ALT ESOTROP W X/Y PATTRN............................ 68
37810... EXOTROPIA NOS....................................... 68
37811... MONOCULAR EXOTROPIA................................. 68
37812... MONOC EXOTROP W A PATTRN............................ 68
37813... MONOC EXOTROP W V PATTRN............................ 68
37814... MONOC EXOTROP W X/Y PAT............................. 68
37815... ALTERNATING EXOTROPIA............................... 68
37816... ALT EXOTROPIA W A PATTRN............................ 68
37817... ALT EXOTROPIA W V PATTRN............................ 68
37818... ALT EXOTROP W X/Y PATTRN............................ 68
37820... INTERMIT HETEROTROP NOS............................. 68
37821... INTERMIT MONOC ESOTROPIA............................ 68
37822... INTERMIT ALTRN ESOTROPIA............................ 68
37823... INTERMIT MONOC EXOTROPIA............................ 68
37824... INTERMIT ALTRN EXOTROPIA............................ 68
37830... HETEROTROPIA NOS.................................... 68
37831... HYPERTROPIA......................................... 68
37832... HYPOTROPIA.......................................... 68
37833... CYCLOTROPIA......................................... 68
37834... MONOFIXATION SYNDROME............................... 68
37835... ACCOMMODATIVE ESOTROPIA............................. 68
37840... HETEROPHORIA NOS.................................... 68
[[Page 47885]]
37841... ESOPHORIA........................................... 68
37842... EXOPHORIA........................................... 68
37843... VERTICAL HETEROPHORIA............................... 68
37844... CYCLOPHORIA......................................... 68
37845... ALTERNATING HYPERPHORIA............................. 68
37850... PARALYTIC STRABISMUS NOS............................ 68
37851... PARTIAL THIRD NERV PALSY............................ 68
37852... TOTAL THIRD NERVE PALSY............................. 68
37853... FOURTH NERVE PALSY.................................. 68
37854... SIXTH NERVE PALSY................................... 68
37855... EXTERNAL OPHTHALMOPLEGIA............................ 68
37856... TOTAL OPHTHALMOPLEGIA............................... 68
37860... MECHANICAL STRABISM NOS............................. 68
37861... BROWN'S SHEATH SYNDROME............................. 68
37862... MECH STRAB D/T MUSCL DIS............................ 68
37863... MECH STRAB W OTH CONDITN............................ 68
37871... DUANE'S SYNDROME.................................... 68
37872... PROG EXT OPHTHALMOPLEGIA............................ 68
37873... NEUROMUSCLE DIS STRABISM............................ 68
37881... PALSY OF CONJUGATE GAZE............................. 68
37882... SPASM OF CONJUGATE GAZE............................. 68
37883... CONVERGENC INSUFFICIENCY............................ 68
37884... CONVERGENCE EXCESS.................................. 68
37885... ANOMALIES OF DIVERGENCE............................. 68
37886... INTERNUCL OPHTHALMOPLEG............................. 63
37887... SKEW DEVIATION, EYE................................. 68
3789.... EYE MOVEMNT DISORDER NOS............................ 68
37900... SCLERITIS NOS....................................... 68
37901... EPISCLERIT PERIODIC FUGX............................ 68
37902... NODULAR EPISCLERITIS................................ 68
37903... ANTERIOR SCLERITIS.................................. 68
37904... SCLEROMALACIA PERFORANS............................. 68
37905... SCLERITIS W CORNEA INVOL............................ 68
37906... BRAWNY SCLERITIS.................................... 68
37907... POSTERIOR SCLERITIS................................. 68
37909... SCLERITIS NEC....................................... 68
37911... SCLERAL ECTASIA..................................... 68
37912... STAPHYLOMA POSTICUM................................. 68
37913... EQUATORIAL STAPHYLOMA............................... 68
37914... LOCAL ANTERIOR STAPHYLMA............................ 68
37915... RING STAPHYLOMA..................................... 68
37916... SCLERAL DEGEN DIS NEC............................... 68
37919... DISORDER OF SCLERA NEC.............................. 68
37921... VITREOUS DEGENERATION............................... 68
37922... CRYSTAL DEPOSIT VITREOUS............................ 68
37923... VITREOUS HEMORRHAGE................................. 68
37924... VITREOUS OPACITIES NEC.............................. 68
37925... VITREOUS MEMBRANES.................................. 68
37926... VITREOUS PROLAPSE................................... 68
37929... VITREOUS DISORDERS NEC.............................. 68
37931... APHAKIA............................................. 68
37932... SUBLUXATION OF LENS................................. 68
37933... ANT DISLOCATION OF LENS............................. 68
37934... POST DISLOCATION OF LENS............................ 68
37939... DISORDERS OF LENS NEC............................... 68
37940... ABN PUPIL FUNCTION NOS.............................. 68
37941... ANISOCORIA.......................................... 68
37942... MIOSIS NOT D/T MIOTICS.............................. 68
37943... MYDRIASIS NOT D/T MYDRTC............................ 68
37945... ARGYLL ROBERTSON PUPIL.............................. 68
37946... TONIC PUPILLARY REACTION............................ 68
37949... PUPIL FUNCT ANOMALY NEC............................. 68
37950... NYSTAGMUS NOS....................................... 68
37951... CONGENITAL NYSTAGMUS................................ 68
37952... LATENT NYSTAGMUS.................................... 68
37953... VISUAL DEPRIVATN NYSTAGM............................ 68
37954... NYSTAGMS W VESTIBULR DIS............................ 68
37955... DISSOCIATED NYSTAGMUS............................... 68
37956... NYSTAGMUS NEC....................................... 68
37957... SACCADIC EYE MOVMNT DEF............................. 68
37958... SMOOTH PURSUIT MVMNT DEF............................ 68
37959... IRREGULAR EYE MVMNTS NEC............................ 68
3798.... EYE DISORDERS NEC................................... 68
37990... EYE DISORDER NOS.................................... 68
37991... PAIN IN OR AROUND EYE............................... 68
37992... SWELLING OR MASS OF EYE............................. 68
[[Page 47886]]
37993... REDNESS/DISCHARGE OF EYE............................ 68
37999... ILL-DEFINED EYE DIS NEC............................. 68
38000... PERICHONDRITIS PINNA NOS............................ 31
38001... AC PERICHONDRITIS PINNA............................. 24
38002... CHR PERICHONDRITIS PINNA............................ 24
38010... INFEC OTITIS EXTERNA NOS............................ 31
38011... ACUTE INFECTION OF PINNA............................ 31
38012... ACUTE SWIMMERS' EAR................................. 31
38013... AC INFECT EXTERN EAR NEC............................ 31
38014... MALIGNANT OTITIS EXTERNA............................ 31
38015... CHR MYCOT OTITIS EXTERNA............................ 31
38016... CHR INF OTIT EXTERNA NEC............................ 31
38021... CHOLESTEATOMA EXTERN EAR............................ 31
38022... ACUTE OTITIS EXTERNA NEC............................ 31
38023... CHR OTITIS EXTERNA NEC.............................. 31
38030... DISORDER OF PINNA NOS............................... 31
38031... HEMATOMA AURICLE/PINNA.............................. 31
38032... ACQ DEFORM AURICLE/PINNA............................ 31
38039... NONINFECT DIS PINNA NEC............................. 31
3804.... IMPACTED CERUMEN.................................... 31
38050... ACQ STENOS EAR CANAL NOS............................ 31
38051... STENOSIS EAR D/T TRAUMA............................. 31
38052... STENOSIS EAR D/T SURGERY............................ 31
38053... STENOSIS EAR D/T INFLAM............................. 31
38081... EXOSTOSIS EXT EAR CANAL............................. 31
38089... DIS EXTERNAL EAR NEC................................ 31
3809.... DIS EXTERNAL EAR NOS................................ 31
38100... AC NONSUP OTITIS MED NOS............................ 31
38101... AC SEROUS OTITIS MEDIA.............................. 31
38102... AC MUCOID OTITIS MEDIA.............................. 31
38103... AC SANGUIN OTITIS MEDIA............................. 31
38104... AC ALLERGIC SEROUS OM............................... 31
38105... AC ALLERGIC MUCOID OM............................... 31
38106... AC ALLERG SANGUINOUS OM............................. 31
38110... CHR SEROUS OM SIMP/NOS.............................. 31
38119... CHR SEROUS OM NEC................................... 31
38120... CHR MUCOID OM SIMP/NOS.............................. 31
38129... CHR MUCOID OM NEC................................... 31
3813.... CHR NONSUP OM NOS/NEC............................... 31
3814.... NONSUPP OTITIS MEDIA NOS............................ 31
38150... EUSTACHIAN SALPING NOS.............................. 31
38151... AC EUSTACHIAN SALPING............................... 31
38152... CHR EUSTACHIAN SALPING.............................. 31
38160... OBSTR EUSTACH TUBE NOS.............................. 31
38161... OSSEOUS EUSTACHIAN OBSTR............................ 31
38162... INTRINSIC EUSTACH OBSTR............................. 31
38163... EXTRINSIC EUSTACH OBSTR............................. 31
3817.... PATULOUS EUSTACHIAN TUBE............................ 31
38181... DYSFUNCT EUSTACHIAN TUBE............................ 31
38189... EUSTACHIAN TUBE DIS NEC............................. 31
3819.... EUSTACHIAN TUBE DIS NOS............................. 31
38200... AC SUPP OTITIS MEDIA NOS............................ 31
38201... AC SUPP OM W DRUM RUPT.............................. 31
38202... AC SUPP OM IN OTH DIS............................... 31
3821.... CHR TUBOTYMPAN SUPPUR OM............................ 31
3822.... CHR ATTICOANTRAL SUP OM............................. 31
3823.... CHR SUP OTITIS MEDIA NOS............................ 31
3824.... SUPPUR OTITIS MEDIA NOS............................. 31
3829.... OTITIS MEDIA NOS.................................... 31
38300... AC MASTOIDITIS W/O COMPL............................ 31
38301... SUBPERI MASTOID ABSCESS............................. 31
38302... AC MASTOIDITIS-COMPL NEC............................ 31
3831.... CHRONIC MASTOIDITIS................................. 31
38320... PETROSITIS NOS...................................... 31
38321... ACUTE PETROSITIS.................................... 31
38322... CHRONIC PETROSITIS.................................. 31
38330... POSTMASTOID COMPL NOS............................... 31
38331... POSTMASTOID MUCOSAL CYST............................ 31
38332... POSTMASTOID CHOLESTEATMA............................ 31
38333... POSTMASTOID GRANULATIONS............................ 31
38381... POSTAURICULAR FISTULA............................... 31
38389... DISORDERS OF MASTOID NEC............................ 31
3839.... MASTOIDITIS NOS..................................... 31
38400... ACUTE MYRINGITIS NOS................................ 31
38401... BULLOUS MYRINGITIS.................................. 31
38409... ACUTE MYRINGITIS NEC................................ 31
[[Page 47887]]
3841.... CHRONIC MYRINGITIS.................................. 31
38420... PERFORAT TYMPAN MEMB NOS............................ 31
38421... CENT PERF TYMPANIC MEMB............................. 31
38422... ATTIC PERF TYMPANIC MEMB............................ 31
38423... MARGINAL PERF TYMP NEC.............................. 31
38424... MULT PERF TYMPANIC MEMB............................. 31
38425... TOTAL PERF TYMPANIC MEMB............................ 31
38481... ATROPHIC FLACCID TYMPAN............................. 31
38482... ATROPHIC NONFLACCID TYMP............................ 31
3849.... DIS TYMPANIC MEMB NOS............................... 31
38500... TYMPANOSCLEROSIS NOS................................ 31
38501... TYMPANOSCL-TYMPANIC MEMB............................ 31
38502... TYMPNOSCLER-TYMP/OSSICLE............................ 31
38503... TYMPANOSCLER-ALL PARTS.............................. 31
38509... TYMPNSCLR-OTH SITE COMB............................. 31
38510... ADHESIVE MID EAR DIS NOS............................ 31
38511... ADHESION TYMPANUM-INCUS............................. 31
38512... ADHESION TYMPANUM-STAPES............................ 31
38513... ADHESION TYMP-PROMONTOR............................. 31
38519... ADHESIVE MID EAR DIS NEC............................ 31
38521... ANKYLOSIS MALLEUS................................... 31
38522... ANKYLOSIS EAR OSSICL NEC............................ 31
38523... DISLOCATION EAR OSSICLE............................. 31
38524... PARTIAL LOSS EAR OSSICLE............................ 31
38530... CHOLESTEATOMA NOS................................... 31
38531... CHOLESTEATOMA OF ATTIC.............................. 31
38532... CHOLESTEATOMA MIDDLE EAR............................ 31
38533... CHOLESTMA MID EAR/MSTOID............................ 31
38535... DIFFUSE CHOLESTEATOSIS.............................. 31
38582... CHOLESTERIN GRANULOMA............................... 31
38583... FOREIGN BODY MIDDLE EAR............................. 31
38589... DIS MID EAR/MASTOID NEC............................. 31
3859.... DIS MID EAR/MASTOID NOS............................. 31
38600... MENIERE'S DISEASE NOS............................... 31
38601... MENIERE DIS COCHLVESTIB............................. 31
38602... MENIERE DIS COCHLEAR................................ 31
38603... MENIERE DIS VESTIBULAR.............................. 31
38604... INACTIVE MENIERE'S DIS.............................. 31
38610... PERIPHERAL VERTIGO NOS.............................. 31
38611... BENIGN PARXYSMAL VERTIGO............................ 31
38612... VESTIBULAR NEURONITIS............................... 31
38619... PERIPHERAL VERTIGO NEC.............................. 31
3862.... CENTRAL ORIGIN VERTIGO.............................. 31
38630... LABYRINTHITIS NOS................................... 31
38631... SEROUS LABYRINTHITIS................................ 31
38632... CIRCUMSCRI LABYRINTHITIS............................ 31
38633... SUPPURATIV LABYRINTHITIS............................ 31
38634... TOXIC LABYRINTHITIS................................. 31
38635... VIRAL LABYRINTHITIS................................. 31
38640... LABYRINTHINE FISTULA NOS............................ 31
38641... ROUND WINDOW FISTULA................................ 31
38642... OVAL WINDOW FISTULA................................. 31
38643... SEMICIRCUL CANAL FISTULA............................ 31
38648... LABYRINTH FISTULA COMB.............................. 31
38650... LABYRINTHINE DYSFUNC NOS............................ 31
38651... HYPRACT LABYRINTH UNILAT............................ 31
38652... HYPERACT LABYRINTH BILAT............................ 31
38653... HYPOACT LABYRINTH UNILAT............................ 31
38654... HYPOACT LABYRINTH BILAT............................. 31
38655... LOSS LABYRN REACT UNILAT............................ 31
38656... LOSS LABYRIN REACT BILAT............................ 31
38658... LABYRINTHINE DYSFUNC NEC............................ 31
3868.... DISORDERS LABYRINTH NEC............................. 31
3869.... VERTIGINOUS SYND NOS................................ 31
3870.... OTOSCLER-OVAL WND NONOBL............................ 31
3871.... OTOSCLER-OVAL WNDW OBLIT............................ 31
3872.... COCHLEAR OTOSCLEROSIS............................... 31
3878.... OTOSCLEROSIS NEC.................................... 31
3879.... OTOSCLEROSIS NOS.................................... 31
38800... DEGEN/VASCUL DIS EAR NOS............................ 31
38801... PRESBYACUSIS........................................ 31
38802... TRANS ISCHEMIC DEAFNESS............................. 31
38810... NOISE EFFECT-EAR/NOS................................ 31
38811... ACOUSTIC TRAUMA..................................... 31
38812... HEARING LOSS D/T NOISE.............................. 31
3882.... SUDDEN HEARING LOSS NOS............................. 31
[[Page 47888]]
38830... TINNITUS NOS........................................ 31
38831... SUBJECTIVE TINNITUS................................. 31
38832... OBJECTIVE TINNITUS.................................. 31
38840... ABN AUDITORY PERCEPT NOS............................ 31
38841... DIPLACUSIS.......................................... 31
38842... HYPERACUSIS......................................... 31
38843... IMPAIRM AUDITORY DISCRIM............................ 31
38844... AUDITORY RECRUITMENT................................ 31
3885.... ACOUSTIC NERVE DISORDERS............................ 31
38860... OTORRHEA NOS........................................ 31
38861... CEREBROSP FLUID OTORRHEA............................ 63
38869... OTORRHEA NEC........................................ 31
38870... OTALGIA NOS......................................... 31
38871... OTOGENIC PAIN....................................... 31
38872... REFERRED PAIN OF EAR................................ 31
3888.... DISORDERS OF EAR NEC................................ 31
3889.... DISORDER OF EAR NOS................................. 31
38900... CONDUCT HEARING LOSS NOS............................ 31
38901... CONDUC HEAR LOSS EXT EAR............................ 31
38902... CONDUCT HEAR LOSS TYMPAN............................ 31
38903... CONDUC HEAR LOSS MID EAR............................ 31
38904... COND HEAR LOSS INNER EAR............................ 31
38908... COND HEAR LOSS COMB TYPE............................ 31
38910... SENSORNEUR HEAR LOSS NOS............................ 31
38911... SENSORY HEARING LOSS................................ 31
38912... NEURAL HEARING LOSS................................. 31
38914... CENTRAL HEARING LOSS................................ 31
38918... SENSORNEUR LOSS COMB TYP............................ 31
3892.... MIXED HEARING LOSS.................................. 31
3897.... DEAF MUTISM NEC..................................... 31
3898.... HEARING LOSS NEC.................................... 31
3899.... HEARING LOSS NOS.................................... 31
390..... RHEUM FEV W/O HRT INVOLV............................ 24
3910.... ACUTE RHEUMATIC PERICARD............................ 36
3911.... ACUTE RHEUMATIC ENDOCARD............................ 36
3912.... AC RHEUMATIC MYOCARDITIS............................ 36
3918.... AC RHEUMAT HRT DIS NEC.............................. 36
3919.... AC RHEUMAT HRT DIS NOS.............................. 36
3920.... RHEUM CHOREA W HRT INVOL............................ 36
3929.... RHEUMATIC CHOREA NOS................................ 36
393..... CHR RHEUMATIC PERICARD.............................. 36
3940.... MITRAL STENOSIS..................................... 36
3941.... RHEUMATIC MITRAL INSUFF............................. 36
3942.... MITRAL STENOSIS W INSUFF............................ 36
3949.... MITRAL VALVE DIS NEC/NOS............................ 36
3950.... RHEUMAT AORTIC STENOSIS............................. 36
3951.... RHEUMATIC AORTIC INSUFF............................. 36
3952.... RHEUM AORTIC STEN/INSUFF............................ 36
3959.... RHEUM AORTIC DIS NEC/NOS............................ 36
3960.... MITRAL/AORTIC STENOSIS.............................. 36
3961.... MITRAL STENOS/AORT INSUF............................ 36
3962.... MITRAL INSUF/AORT STENOS............................ 36
3963.... MITRAL/AORTIC VAL INSUFF............................ 36
3968.... MITR/AORTIC MULT INVOLV............................. 36
3969.... MITRAL/AORTIC V DIS NOS............................. 36
3970.... TRICUSPID VALVE DISEASE............................. 36
3971.... RHEUM PULMON VALVE DIS.............................. 36
3979.... RHEUM ENDOCARDITIS NOS.............................. 36
3980.... RHEUMATIC MYOCARDITIS............................... 36
39890... RHEUMATIC HEART DIS NOS............................. 36
39891... RHEUMATIC HEART FAILURE............................. 36
39899... RHEUMATIC HEART DIS NEC............................. 36
4010.... MALIGNANT HYPERTENSION.............................. 36
4011.... BENIGN HYPERTENSION................................. 36
4019.... HYPERTENSION NOS.................................... 36
40200... MAL HYPERTEN HRT DIS NOS............................ 36
40201... MAL HYPERT HRT DIS W CHF............................ 36
40210... BEN HYPERTEN HRT DIS NOS............................ 36
40211... BENIGN HYP HRT DIS W CHF............................ 36
40290... HYPERTENSIVE HRT DIS NOS............................ 36
40291... HYPERTEN HEART DIS W CHF............................ 36
40300... MAL HYP REN W/O REN FAIL............................ 36
40301... MAL HYP REN W RENAL FAIL............................ 53
40310... BEN HYP REN W/O REN FAIL............................ 36
40311... BEN HYP RENAL W REN FAIL............................ 53
40390... HYP REN NOS W/O REN FAIL............................ 36
[[Page 47889]]
40391... HYP RENAL NOS W REN FAIL............................ 53
40400... MAL HY HT/REN W/O CHF/RF............................ 36
40401... MAL HYPER HRT/REN W CHF............................. 36
40402... MAL HY HT/REN W REN FAIL............................ 53
40403... MAL HYP HRT/REN W CHF&RF............................ 36
40410... BEN HY HT/REN W/O CHF/RF............................ 36
40411... BEN HYPER HRT/REN W CHF............................. 36
40412... BEN HY HT/REN W REN FAIL............................ 53
40413... BEN HYP HRT/REN W CHF&RF............................ 36
40490... HY HT/REN NOS W/O CHF/RF............................ 36
40491... HYPER HRT/REN NOS W CHF............................. 36
40492... HY HT/REN NOS W REN FAIL............................ 53
40493... HYP HT/REN NOS W CHF&RF............................. 36
40501... MAL RENOVASC HYPERTENS.............................. 36
40509... MAL SECOND HYPERTEN NEC............................. 36
40511... BENIGN RENOVASC HYPERTEN............................ 36
40519... BENIGN SECOND HYPERT NEC............................ 36
40591... RENOVASC HYPERTENSION............................... 36
40599... SECOND HYPERTENSION NEC............................. 36
41000... AMI ANTEROLATERAL, UNSPEC........................... 36
41001... AMI ANTEROLATERAL, INIT............................. 36
41002... AMI ANTEROLATERAL, SUBSEQ........................... 36
41010... AMI ANTERIOR WALL, UNSPEC........................... 36
41011... AMI ANTERIOR WALL, INIT............................. 36
41012... AMI ANTERIOR WALL, SUBSEQ........................... 36
41020... AMI INFEROLATERAL, UNSPEC........................... 36
41021... AMI INFEROLATERAL, INIT............................. 36
41022... AMI INFEROLATERAL, SUBSEQ........................... 36
41030... AMI INFEROPOST, UNSPEC.............................. 36
41031... AMI INFEROPOST, INITIAL............................. 36
41032... AMI INFEROPOST, SUBSEQ.............................. 36
41040... AMI INFERIOR WALL, UNSPEC........................... 36
41041... AMI INFERIOR WALL, INIT............................. 36
41042... AMI INFERIOR WALL, SUBSEQ........................... 36
41050... AMI LATERAL NEC, UNSPEC............................. 36
41051... AMI LATERAL NEC, INITIAL............................ 36
41052... AMI LATERAL NEC, SUBSEQ............................. 36
41060... TRUE POST INFARCT, UNSPEC........................... 36
41061... TRUE POST INFARCT, INIT............................. 36
41062... TRUE POST INFARCT, SUBSEQ........................... 36
41070... SUBENDO INFARCT, UNSPEC............................. 36
41071... SUBENDO INFARCT, INITIAL............................ 36
41072... SUBENDO INFARCT, SUBSEQ............................. 36
41080... AMI NEC, UNSPECIFIED................................ 36
41081... AMI NEC, INITIAL.................................... 36
41082... AMI NEC, SUBSEQUENT................................. 36
41090... AMI NOS, UNSPECIFIED................................ 36
41091... AMI NOS, INITIAL.................................... 36
41092... AMI NOS, SUBSEQUENT................................. 36
4110.... POST MI SYNDROME.................................... 36
4111.... INTERMED CORONARY SYND.............................. 36
41181... CORONARY OCCLSN W/O MI.............................. 36
41189... AC ISCHEMIC HRT DIS NEC............................. 36
412..... OLD MYOCARDIAL INFARCT.............................. 36
4130.... ANGINA DECUBITUS.................................... 36
4131.... PRINZMETAL ANGINA................................... 36
4139.... ANGINA PECTORIS NEC/NOS............................. 36
41400... COR ATH UNSP VSL NTV/GFT............................ 36
41401... CRNRY ATHRSCL NATVE VSSL............................ 36
41402... CRN ATH ATLG VN BPS GRFT............................ 36
41403... CRN ATH NONATLG BLG GRFT............................ 36
41410... ANEURYSM, HEART (WALL).............................. 36
41411... CORONARY VESSEL ANEURYSM............................ 36
41419... ANEURYSM OF HEART NEC............................... 36
4148.... CHR ISCHEMIC HRT DIS NEC............................ 36
4149.... CHR ISCHEMIC HRT DIS NOS............................ 36
4150.... ACUTE COR PULMONALE................................. 36
41511... IATROGEN PULM EMB/INFARC............................ 33
41519... PULM EMBOL/INFARCT NEC.............................. 33
4160.... PRIM PULM HYPERTENSION.............................. 36
4161.... KYPHOSCOLIOTIC HEART DIS............................ 36
4168.... CHR PULMON HEART DIS NEC............................ 36
4169.... CHR PULMON HEART DIS NOS............................ 36
4170.... ARTERIOVEN FISTU PUL VES............................ 36
4171.... PULMON ARTERY ANEURYSM.............................. 36
4178.... PULMON CIRCULAT DIS NEC............................. 36
[[Page 47890]]
4179.... PULMON CIRCULAT DIS NOS............................. 36
4200.... AC PERICARDIT IN OTH DIS............................ 36
42090... ACUTE PERICARDITIS NOS.............................. 36
42091... AC IDIOPATH PERICARDITIS............................ 36
42099... ACUTE PERICARDITIS NEC.............................. 36
4210.... AC/SUBAC BACT ENDOCARD.............................. 36
4211.... AC ENDOCARDIT IN OTH DIS............................ 36
4219.... AC/SUBAC ENDOCARDIT NOS............................. 36
4220.... AC MYOCARDIT IN OTH DIS............................. 36
42290... ACUTE MYOCARDITIS NOS............................... 36
42291... IDIOPATHIC MYOCARDITIS.............................. 36
42292... SEPTIC MYOCARDITIS.................................. 36
42293... TOXIC MYOCARDITIS................................... 36
42299... ACUTE MYOCARDITIS NEC............................... 36
4230.... HEMOPERICARDIUM..................................... 36
4231.... ADHESIVE PERICARDITIS............................... 36
4232.... CONSTRICTIV PERICARDITIS............................ 36
4238.... PERICARDIAL DISEASE NEC............................. 36
4239.... PERICARDIAL DISEASE NOS............................. 36
4240.... MITRAL VALVE DISORDER............................... 36
4241.... AORTIC VALVE DISORDER............................... 36
4242.... NONRHEUM TRICUSP VAL DIS............................ 36
4243.... PULMONARY VALVE DISORDER............................ 36
42490... ENDOCARDITIS NOS.................................... 36
42491... ENDOCARDITIS IN OTH DIS............................. 36
42499... ENDOCARDITIS NEC.................................... 36
4250.... ENDOMYOCARDIAL FIBROSIS............................. 36
4251.... HYPERTR OBSTR CARDIOMYOP............................ 36
4252.... OBSC AFRIC CARDIOMYOPATH............................ 36
4253.... ENDOCARD FIBROELASTOSIS............................. 36
4254.... PRIM CARDIOMYOPATHY NEC............................. 36
4255.... ALCOHOLIC CARDIOMYOPATHY............................ 36
4257.... METABOLIC CARDIOMYOPATHY............................ 36
4258.... CARDIOMYOPATH IN OTH DIS............................ 36
4259.... SECOND CARDIOMYOPATH NOS............................ 36
4260.... ATRIOVENT BLOCK COMPLETE............................ 36
42610... ATRIOVENT BLOCK NOS................................. 36
42611... ATRIOVENT BLOCK-1ST DEGR............................ 36
42612... ATRIOVEN BLOCK-MOBITZ II............................ 36
42613... AV BLOCK-2ND DEGREE NEC............................. 36
4262.... LEFT BB HEMIBLOCK................................... 36
4263.... LEFT BB BLOCK NEC................................... 36
4264.... RT BUNDLE BRANCH BLOCK.............................. 36
42650... BUNDLE BRANCH BLOCK NOS............................. 36
42651... RT BBB/LFT POST FASC BLK............................ 36
42652... RT BBB/LFT ANT FASC BLK............................. 36
42653... BILAT BB BLOCK NEC.................................. 36
42654... TRIFASCICULAR BLOCK................................. 36
4266.... OTHER HEART BLOCK................................... 36
4267.... ANOMALOUS AV EXCITATION............................. 36
42681... LOWN-GANONG-LEVINE SYND............................. 36
42689... CONDUCTION DISORDER NEC............................. 36
4269.... CONDUCTION DISORDER NOS............................. 36
4270.... PAROX ATRIAL TACHYCARDIA............................ 36
4271.... PAROX VENTRIC TACHYCARD............................. 78
4272.... PAROX TACHYCARDIA NOS............................... 36
42731... ATRIAL FIBRILLATION................................. 36
42732... ATRIAL FLUTTER...................................... 36
42741... VENTRICULAR FIBRILLATION............................ 78
42742... VENTRICULAR FLUTTER................................. 78
4275.... CARDIAC ARREST...................................... 78
42760... PREMATURE BEATS NOS................................. 36
42761... ATRIAL PREMATURE BEATS.............................. 36
42769... PREMATURE BEATS NEC................................. 36
42781... SINOATRIAL NODE DYSFUNCT............................ 36
42789... CARDIAC DYSRHYTHMIAS NEC............................ 36
4279.... CARDIAC DYSRHYTHMIA NOS............................. 36
4280.... CONGESTIVE HEART FAILURE............................ 36
4281.... LEFT HEART FAILURE.................................. 36
4289.... HEART FAILURE NOS................................... 36
4290.... MYOCARDITIS NOS..................................... 36
4291.... MYOCARDIAL DEGENERATION............................. 36
4292.... ASCVD............................................... 36
4293.... CARDIOMEGALY........................................ 36
4294.... HRT DIS POSTCARDIAC SURG............................ 36
4295.... CHORDAE TENDINAE RUPTURE............................ 36
[[Page 47891]]
4296.... PAPILLARY MUSCLE RUPTURE............................ 36
42971... ACQ CARDIAC SEPTL DEFECT............................ 36
42979... OTHER SEQUELAE OF MI NEC............................ 36
42981... PAPILLARY MUSCLE DIS NEC............................ 36
42982... HYPERKINETIC HEART DIS.............................. 36
42989... ILL-DEFINED HRT DIS NEC............................. 36
4299.... HEART DISEASE NOS................................... 36
430..... SUBARACHNOID HEMORRHAGE............................. 63
431..... INTRACEREBRAL HEMORRHAGE............................ 63
4320.... NONTRAUM EXTRADURAL HEM............................. 63
4321.... SUBDURAL HEMORRHAGE................................. 63
4329.... INTRACRANIAL HEMORR NOS............................. 63
43300... OCL BSLR ART WO INFRCT.............................. 63
43301... OCL BSLR ART W INFRCT............................... 63
43310... OCL CRTD ART WO INFRCT.............................. 63
43311... OCL CRTD ART W INFRCT............................... 63
43320... OCL VRTB ART WO INFRCT.............................. 63
43321... OCL VRTB ART W INFRCT............................... 63
43330... OCL MLT BI ART WO INFRCT............................ 63
43331... OCL MLT BI ART W INFRCT............................. 63
43380... OCL SPCF ART WO INFRCT.............................. 63
43381... OCL SPCF ART W INFRCT............................... 63
43390... OCL ART NOS WO INFRCT............................... 63
43391... OCL ART NOS W INFRCT................................ 63
43400... CRBL THRMBS WO INFRCT............................... 63
43401... CRBL THRMBS W INFRCT................................ 63
43410... CRBL EMBLSM WO INFRCT............................... 63
43411... CRBL EMBLSM W INFRCT................................ 63
43490... CRBL ART OC NOS WO INFRC............................ 63
43491... CRBL ART OCL NOS W INFRC............................ 63
4350.... BASILAR ARTERY SYNDROME............................. 63
4351.... VERTEBRAL ARTERY SYNDROM............................ 63
4352.... SUBCLAVIAN STEAL SYNDROM............................ 63
4353.... VERTBROBASLR ARTERY SYND............................ 63
4358.... TRANS CEREB ISCHEMIA NEC............................ 63
4359.... TRANS CEREB ISCHEMIA NOS............................ 63
436..... CVA................................................. 63
4370.... CEREBRAL ATHEROSCLEROSIS............................ 63
4371.... AC CEREBROVASC INSUF NOS............................ 63
4372.... HYPERTENS ENCEPHALOPATHY............................ 63
4373.... NONRUPT CEREBRAL ANEURYM............................ 63
4374.... CEREBRAL ARTERITIS.................................. 63
4375.... MOYAMOYA DISEASE.................................... 63
4376.... NONPYOGEN THROMBOS SINUS............................ 63
4377.... TRANSIENT GLOBAL AMNESIA............................ 11
4378.... CEREBROVASC DISEASE NEC............................. 63
4379.... CEREBROVASC DISEASE NOS............................. 63
4400.... AORTIC ATHEROSCLEROSIS.............................. 36
4401.... RENAL ARTERY ATHEROSCLER............................ 53
44020... ATHSCL EXTRM NTV ART NOS............................ 36
44021... ATH EXT NTV AT W CLAUDCT............................ 36
44022... ATH EXT NTV AT W RST PN............................. 36
44023... ATH EXT NTV ART ULCRTION............................ 36
44024... ATH EXT NTV ART GNGRENE............................. 36
44029... ATHRSC EXTRM NTV ART OTH............................ 36
44030... ATHSCL EXTRM BPS GFT NOS............................ 36
44031... ATH EXT AUTOLOGS BPS GFT............................ 36
44032... ATH EXT NONAUTLG BPS GFT............................ 36
4408.... ATHEROSCLEROSIS NEC................................. 36
4409.... ATHEROSCLEROSIS NOS................................. 36
44100... DSCT OF AORTA UNSP SITE............................. 78
44101... DSCT OF THORACIC AORTA.............................. 78
44102... DSCT OF ABDOMINAL AORTA............................. 78
44103... DSCT OF THORACOABD AORTA............................ 78
4411.... RUPTUR THORACIC ANEURYSM............................ 78
4412.... THORACIC AORTIC ANEURYSM............................ 36
4413.... RUPT ABD AORTIC ANEURYSM............................ 78
4414.... ABDOM AORTIC ANEURYSM............................... 36
4415.... RUPT AORTIC ANEURYSM NOS............................ 78
4416.... THORACOABD ANEURYSM RUPT............................ 78
4417.... THRACABD ANURYSM WO RUPT............................ 36
4419.... AORTIC ANEURYSM NOS................................. 36
4420.... UPPER EXTREMITY ANEURYSM............................ 36
4421.... RENAL ARTERY ANEURYSM............................... 53
4422.... ILIAC ARTERY ANEURYSM............................... 36
4423.... LOWER EXTREMITY ANEURYSM............................ 36
[[Page 47892]]
44281... ANEURYSM OF NECK.................................... 36
44282... SUBCLAVIAN ANEURYSM................................. 36
44283... SPLENIC ARTERY ANEURYSM............................. 36
44284... VISCERAL ANEURYSM NEC............................... 36
44289... ANEURYSM NEC........................................ 36
4429.... ANEURYSM NOS........................................ 36
4430.... RAYNAUD'S SYNDROME.................................. 86
4431.... THROMBOANGIIT OBLITERANS............................ 36
44381... ANGIOPATHY IN OTHER DIS............................. 36
44389... PERIPH VASCULAR DIS NEC............................. 36
4439.... PERIPH VASCULAR DIS NOS............................. 36
4440.... ABD AORTIC EMBOLISM................................. 36
4441.... THORACIC AORTIC EMBOLISM............................ 36
44421... UPPER EXTREMITY EMBOLISM............................ 36
44422... LOWER EXTREMITY EMBOLISM............................ 36
44481... ILIAC ARTERY EMBOLISM............................... 36
44489... ARTERIAL EMBOLISM NEC............................... 36
4449.... ARTERIAL EMBOLISM NOS............................... 36
4460.... POLYARTERITIS NODOSA................................ 86
4461.... MUCOCUTAN LYMPH NODE SYN............................ 86
4462.... HYPERSENSITIV ANGIITIS*............................. 86
44620... HYPERSENSIT ANGIITIS NOS............................ 86
44621... GOODPASTURE'S SYNDROME.............................. 86
44629... HYPERSENSIT ANGIITIS NEC............................ 86
4463.... LETHAL MIDLINE GRANULOMA............................ 86
4464.... WEGENER'S GRANULOMATOSIS............................ 86
4465.... GIANT CELL ARTERITIS................................ 86
4466.... THROMBOT MICROANGIOPATHY............................ 86
4467.... TAKAYASU'S DISEASE.................................. 86
4470.... ACQ ARTERIOVEN FISTULA.............................. 36
4471.... STRICTURE OF ARTERY................................. 36
4472.... RUPTURE OF ARTERY................................... 78
4473.... RENAL ARTERY HYPERPLASIA............................ 53
4474.... CELIAC ART COMPRESS SYN............................. 41
4475.... NECROSIS OF ARTERY.................................. 36
4476.... ARTERITIS NOS....................................... 24
4478.... ARTERIAL DISEASE NEC................................ 36
4479.... ARTERIAL DISEASE NOS................................ 36
4480.... HEREDIT HEMORR TELANGIEC............................ 36
4481.... NEVUS, NON-NEOPLASTIC............................... 18
4489.... CAPILLARY DIS NEC/NOS............................... 36
4510.... SUPERFIC PHLEBITIS-LEG.............................. 36
45111... FEMORAL VEIN PHLEBITIS.............................. 36
45119... DEEP PHLEBITIS-LEG NEC.............................. 36
4512.... THROMBOPHLEBITIS LEG NOS............................ 36
45181... ILIAC THROMBOPHLEBITIS.............................. 36
45182... PHLBTS SPRFC VN UP EXTRM............................ 36
45183... PHLBTS DEEP VN UP EXTRM............................. 36
45184... PHLBTS VN NOS UP EXTRM.............................. 36
45189... THROMBOPHLEBITIS NEC................................ 36
4519.... THROMBOPHLEBITIS NOS................................ 36
452..... PORTAL VEIN THROMBOSIS.............................. 41
4530.... BUDD-CHIARI SYNDROME................................ 41
4531.... THROMBOPHLEBITIS MIGRANS............................ 36
4532.... VENA CAVA THROMBOSIS................................ 36
4533.... RENAL VEIN THROMBOSIS............................... 53
4538.... VENOUS THROMBOSIS NEC............................... 36
4539.... VENOUS THROMBOSIS NOS............................... 36
4540.... LEG VARICOSITY W ULCER.............................. 36
4541.... LEG VARICOSITY W INFLAM............................. 36
4542.... VARICOS LEG ULCER/INFLAM............................ 36
4549.... VARICOSE VEIN OF LEG NOS............................ 36
4550.... INT HEMORRHOID W/O COMPL............................ 41
4551.... INT THROMBOS HEMORRHOID............................. 41
4552.... INT HEMRRHOID W COMP NEC............................ 41
4553.... EXT HEMORRHOID W/O COMPL............................ 41
4554.... EXT THROMBOS HEMORRHOID............................. 41
4555.... EXT HEMRRHOID W COMP NEC............................ 41
4556.... HEMORRHOIDS NOS..................................... 41
4557.... THROMBOS HEMORRHOIDS NOS............................ 41
4558.... HEMRRHOID NOS W COMP NEC............................ 41
4559.... RESIDUAL HEMORRHOID TAGS............................ 41
4560.... ESOPHAG VARICES W BLEED............................. 41
4561.... ESOPH VARICES W/O BLEED............................. 41
45620... BLEED ESOPH VAR OTH DIS............................. 41
45621... ESOPH VARICE OTH DIS NOS............................ 41
[[Page 47893]]
4563.... SUBLINGUAL VARICES.................................. 36
4564.... SCROTAL VARICES..................................... 53
4565.... PELVIC VARICES...................................... 53
4566.... VULVAL VARICES...................................... 56
4568.... VARICES OF OTHER SITES.............................. 36
4570.... POSTMASTECT LYMPHEDEMA.............................. 18
4571.... OTHER LYMPHEDEMA.................................... 18
4572.... LYMPHANGITIS........................................ 18
4578.... NONINFECT LYMPH DIS NEC............................. 86
4579.... NONINFECT LYMPH DIS NOS............................. 86
4580.... ORTHOSTATIC HYPOTENSION............................. 36
4581.... CHRONIC HYPOTENSION................................. 36
4582.... IATROGENIC HYPOTENSION.............................. 82
4589.... HYPOTENSION NOS..................................... 36
4590.... HEMORRHAGE NOS...................................... 11
4591.... POSTPHLEBITIC SYNDROME.............................. 36
4592.... COMPRESSION OF VEIN................................. 36
45981... VENOUS INSUFFICIENCY NOS............................ 36
45989... CIRCULATORY DISEASE NEC............................. 36
4599.... CIRCULATORY DISEASE NOS............................. 36
460..... ACUTE NASOPHARYNGITIS............................... 31
4610.... AC MAXILLARY SINUSITIS.............................. 31
4611.... AC FRONTAL SINUSITIS................................ 31
4612.... AC ETHMOIDAL SINUSITIS.............................. 31
4613.... AC SPHENOIDAL SINUSITIS............................. 31
4618.... OTHER ACUTE SINUSITIS............................... 31
4619.... ACUTE SINUSITIS NOS................................. 31
462..... ACUTE PHARYNGITIS................................... 31
463..... ACUTE TONSILLITIS................................... 31
4640.... ACUTE LARYNGITIS.................................... 31
46410... AC TRACHEITIS NO OBSTRUC............................ 31
46411... AC TRACHEITIS W OBSTRUCT............................ 31
46420... AC LARYNGOTRACH NO OBSTR............................ 31
46421... AC LARYNGOTRACH W OBSTR............................. 31
46430... AC EPIGLOTTITIS NO OBSTR............................ 31
46431... AC EPIGLOTTITIS W OBSTR............................. 78
4644.... CROUP............................................... 31
4650.... ACUTE LARYNGOPHARYNGITIS............................ 31
4658.... ACUTE URI MULT SITES NEC............................ 31
4659.... ACUTE URI NOS....................................... 31
4660.... ACUTE BRONCHITIS.................................... 33
470..... DEVIATED NASAL SEPTUM............................... 31
4710.... POLYP OF NASAL CAVITY............................... 31
4711.... POLYPOID SINUS DEGEN................................ 31
4718.... NASAL SINUS POLYP NEC............................... 31
4719.... NASAL POLYP NOS..................................... 31
4720.... CHRONIC RHINITIS.................................... 31
4721.... CHRONIC PHARYNGITIS................................. 31
4722.... CHRONIC NASOPHARYNGITIS............................. 31
4730.... CHR MAXILLARY SINUSITIS............................. 31
4731.... CHR FRONTAL SINUSITIS............................... 31
4732.... CHR ETHMOIDAL SINUSITIS............................. 31
4733.... CHR SPHENOIDAL SINUSITIS............................ 31
4738.... CHRONIC SINUSITIS NEC............................... 31
4739.... CHRONIC SINUSITIS NOS............................... 31
4740.... CHRONIC TONSILLITIS*................................ 31
47410... HYPERTROPHY T AND A................................. 31
47411... HYPERTROPHY TONSILS................................. 31
47412... HYPERTROPHY ADENOIDS................................ 31
4742.... ADENOID VEGETATIONS................................. 31
4748.... CHR T & A DIS NEC................................... 31
4749.... CHR T & A DIS NOS................................... 31
475..... PERITONSILLAR ABSCESS............................... 31
4760.... CHRONIC LARYNGITIS.................................. 31
4761.... CHR LARYNGOTRACHEITIS............................... 31
4770.... RHINITIS DUE TO POLLEN.............................. 31
4778.... ALLERGIC RHINITIS NEC............................... 31
4779.... ALLERGIC RHINITIS NOS............................... 31
4780.... HYPERTRPH NASAL TURBINAT............................ 31
4781.... NASAL & SINUS DIS NEC............................... 31
47820... DISEASE OF PHARYNX NOS.............................. 31
47821... CELLULITIS OF PHARYNX............................... 31
47822... PARAPHARYNGEAL ABSCESS.............................. 31
47824... RETROPHARYNGEAL ABSCESS............................. 31
47825... EDEMA PHARYNX/NASOPHARYX............................ 31
47826... CYST PHARYNX/NASOPHARYNX............................ 31
[[Page 47894]]
47829... DISEASE OF PHARYNX NEC.............................. 31
47830... VOCAL CORD PARALYSIS NOS............................ 31
47831... VOCAL PARAL UNILAT PART............................. 31
47832... VOCAL PARAL UNILAT TOTAL............................ 31
47833... VOCAL PARAL BILAT PART.............................. 31
47834... VOCAL PARAL BILAT TOTAL............................. 31
4784.... VOCAL CORD/LARYNX POLYP............................. 31
4785.... VOCAL CORD DISEASE NEC.............................. 31
4786.... EDEMA OF LARYNX..................................... 31
47870... DISEASE OF LARYNX NOS............................... 31
47871... LARYNGEAL CELLULITIS................................ 31
47874... STENOSIS OF LARYNX.................................. 31
47875... LARYNGEAL SPASM..................................... 31
47879... DISEASE OF LARYNX NEC............................... 31
4788.... URT HYPERSENS REACT NOS............................. 31
4789.... UPPER RESP DIS NEC/NOS.............................. 31
4800.... ADENOVIRAL PNEUMONIA................................ 33
4801.... RESP SYNCYT VIRAL PNEUM............................. 33
4802.... PARINFLUENZA VIRAL PNEUM............................ 33
4808.... VIRAL PNEUMONIA NEC................................. 33
4809.... VIRAL PNEUMONIA NOS................................. 33
481..... PNEUMOCOCCAL PNEUMONIA.............................. 33
4820.... K. PNEUMONIAE PNEUMONIA............................. 33
4821.... PSEUDOMONAL PNEUMONIA............................... 33
4822.... H. INFLUENZAE PNEUMONIA............................. 33
48230... STREPTOCOCCAL PNEUMN NOS............................ 33
48231... PNEUMONIA STRPTOCOCCUS A............................ 33
48232... PNEUMONIA STRPTOCOCCUS B............................ 33
48239... PNEUMONIA OTH STREP................................. 33
4824.... STAPHYLOCOCCAL PNEUMONIA............................ 33
48281... PNEUMONIA ANAEROBES................................. 33
48282... PNEUMONIA E COLI.................................... 33
48283... PNEUMO OTH GRM-NEG BACT............................. 33
48289... PNEUMONIA OTH SPCF BACT............................. 33
4829.... BACTERIAL PNEUMONIA NOS............................. 33
4830.... PNEU MYCPLSM PNEUMONIAE............................. 33
4838.... PNEUMON OTH SPEC ORGNSM............................. 33
4841.... PNEUM W CYTOMEG INCL DIS............................ 33
4843.... PNEUMONIA IN WHOOP COUGH............................ 33
4845.... PNEUMONIA IN ANTHRAX................................ 33
4846.... PNEUM IN ASPERGILLOSIS.............................. 33
4847.... PNEUM IN OTH SYS MYCOSES............................ 33
4848.... PNEUM IN INFECT DIS NEC............................. 33
485..... BRONCHOPNEUMONIA ORG NOS............................ 33
486..... PNEUMONIA, ORGANISM NOS............................. 33
4870.... INFLUENZA WITH PNEUMONIA............................ 33
4871.... FLU W RESP MANIFEST NEC............................. 31
4878.... FLU W MANIFESTATION NEC............................. 31
490..... BRONCHITIS NOS...................................... 33
4910.... SIMPLE CHR BRONCHITIS............................... 33
4911.... MUCOPURUL CHR BRONCHITIS............................ 33
4912.... OBSTRUCT CHR BRONCHITIS*............................ 33
49120... OBS CHR BRNC W/O ACT EXA............................ 33
49121... OBS CHR BRNC W ACT EXA.............................. 33
4918.... CHRONIC BRONCHITIS NEC.............................. 33
4919.... CHRONIC BRONCHITIS NOS.............................. 33
4920.... EMPHYSEMATOUS BLEB.................................. 33
4928.... EMPHYSEMA NEC....................................... 33
49300... EXT ASTHMA W/O STAT ASTH............................ 33
49301... EXT ASTHMA W STATUS ASTH............................ 78
49310... INT ASTHMA W/O STAT ASTH............................ 33
49311... INT ASTHMA W STATUS ASTH............................ 78
49320... CH OB ASTH W/O STAT ASTH............................ 33
49321... CH OB ASTHMA W STAT ASTH............................ 78
49390... ASTHMA W/O STATUS ASTHM............................. 33
49391... ASTHMA W STATUS ASTHMAT............................. 78
494..... BRONCHIECTASIS...................................... 33
4950.... FARMERS' LUNG....................................... 33
4951.... BAGASSOSIS.......................................... 33
4952.... BIRD-FANCIERS' LUNG................................. 33
4953.... SUBEROSIS........................................... 33
4954.... MALT WORKERS' LUNG.................................. 33
4955.... MUSHROOM WORKERS' LUNG.............................. 33
4956.... MAPL BARK-STRIPPRS' LUNG............................ 33
4957.... ``VENTILATION'' PNEUMONIT........................... 33
4958.... ALLERG ALVEOL/PNEUM NEC............................. 33
[[Page 47895]]
4959.... ALLERG ALVEOL/PNEUM NOS............................. 33
496..... CHR AIRWAY OBSTRUCT NEC............................. 33
500..... COAL WORKERS' PNEUMOCON............................. 33
501..... ASBESTOSIS.......................................... 33
502..... SILICA PNEUMOCON NEC................................ 33
503..... INORG DUST PNEUMOCON NEC............................ 33
504..... DUST PNEUMONOPATHY NEC.............................. 33
505..... PNEUMOCONIOSIS NOS.................................. 33
5060.... FUM/VAPOR BRONC/PNEUMON............................. 33
5061.... FUM/VAPOR AC PULM EDEMA............................. 33
5062.... FUM/VAPOR UP RESP INFLAM............................ 33
5063.... FUM/VAP AC RESP COND NEC............................ 33
5064.... FUM/VAPOR CHR RESP COND............................. 33
5069.... FUM/VAPOR RESP COND NOS............................. 33
5070.... FOOD/VOMIT PNEUMONITIS.............................. 33
5071.... OIL/ESSENCE PNEUMONITIS............................. 33
5078.... SOLID/LIQ PNEUMONIT NEC............................. 33
5080.... AC PUL MANIF D/T RADIAT............................. 33
5081.... CHR PUL MANIF D/T RADIAT............................ 33
5088.... RESP COND: EXT AGENT NEC............................ 33
5089.... RESP COND: EXT AGENT NOS............................ 33
5100.... EMPYEMA WITH FISTULA................................ 33
5109.... EMPYEMA W/O FISTULA................................. 33
5110.... PLEURISY W/O EFFUS OR TB............................ 33
5111.... BACT PLEUR/EFFUS NOT TB............................. 33
5118.... PLEURAL EFFUS NEC NOT TB............................ 33
5119.... PLEURAL EFFUSION NOS................................ 33
5120.... SPONT TENS PNEUMOTHORAX............................. 33
5121.... IATROGENIC PNEUMOTHORAX............................. 78
5128.... SPONT PNEUMOTHORAX NEC.............................. 33
5130.... ABSCESS OF LUNG..................................... 33
5131.... ABSCESS OF MEDIASTINUM.............................. 33
514..... PULM CONGEST/HYPOSTASIS............................. 33
515..... POSTINFLAM PULM FIBROSIS............................ 33
5160.... PUL ALVEOLAR PROTEINOSIS............................ 33
5161.... IDIO PULM HEMOSIDEROSIS............................. 33
5162.... PULM ALVEOLAR MICROLITH............................. 33
5163.... IDIO FIBROS ALVEOLITIS.............................. 33
5168.... ALVEOL PNEUMONOPATHY NEC............................ 33
5169.... ALVEOL PNEUMONOPATHY NOS............................ 33
5171.... RHEUMATIC PNEUMONIA................................. 33
5172.... SYST SCLEROSIS LUNG DIS............................. 33
5178.... LUNG INVOLV IN OTH DIS.............................. 33
5180.... PULMONARY COLLAPSE.................................. 33
5181.... INTERSTITIAL EMPHYSEMA.............................. 33
5182.... COMPENSATORY EMPHYSEMA.............................. 33
5183.... PULMONARY EOSINOPHILIA.............................. 33
5184.... ACUTE LUNG EDEMA NOS................................ 33
5185.... POST TRAUM PULM INSUFFIC............................ 33
51881... RESPIRATORY FAILURE................................. 33
51882... OTHER PULMONARY INSUFF.............................. 33
51889... OTHER LUNG DISEASE NEC.............................. 33
5190.... TRACHEOSTOMY COMPLIC................................ 33
5191.... TRACHEA/BRONCHUS DIS NEC............................ 33
5192.... MEDIASTINITIS....................................... 33
5193.... MEDIASTINUM DISEASE NEC............................. 33
5194.... DISORDERS OF DIAPHRAGM.............................. 33
5198.... RESP SYSTEM DISEASE NEC............................. 11
5199.... RESP SYSTEM DISEASE NOS............................. 11
5200.... ANODONTIA........................................... 31
5201.... SUPERNUMERARY TEETH................................. 31
5202.... ABNORMAL TOOTH SIZE/FORM............................ 31
5203.... MOTTLED TEETH....................................... 31
5204.... TOOTH FORMATION DISTURB............................. 31
5205.... HEREDIT TOOTH STRUCT NEC............................ 31
5206.... TOOTH ERUPTION DISTURB.............................. 31
5207.... TEETHING SYNDROME................................... 31
5208.... TOOTH DEVEL/ERUP DIS NEC............................ 31
5209.... TOOTH DEVEL/ERUP DIS NOS............................ 31
5210.... DENTAL CARIES....................................... 31
5211.... EXCESS ATTRITION-TEETH.............................. 31
5212.... ABRASION OF TEETH................................... 31
5213.... EROSION OF TEETH.................................... 31
5214.... RESORPTION OF TEETH................................. 31
5215.... HYPERCEMENTOSIS..................................... 31
5216.... ANKYLOSIS OF TEETH.................................. 31
[[Page 47896]]
5217.... POSTERUPT COLOR CHANGE.............................. 31
5218.... HARD TISS DIS TEETH NEC............................. 31
5219.... HARD TISS DIS TEETH NOS............................. 31
5220.... PULPITIS............................................ 31
5221.... NECROSIS OF TOOTH PULP.............................. 31
5222.... TOOTH PULP DEGENERATION............................. 31
5223.... ABN HARD TISS-TOOTH PULP............................ 31
5224.... AC APICAL PERIODONTITIS............................. 31
5225.... PERIAPICAL ABSCESS.................................. 31
5226.... CHR APICAL PERIODONTITIS............................ 31
5227.... PERIAPICAL ABSC W SINUS............................. 31
5228.... RADICULAR CYST...................................... 31
5229.... PULP/PERIAPICAL DIS NEC............................. 31
5230.... ACUTE GINGIVITIS.................................... 31
5231.... CHRONIC GINGIVITIS.................................. 31
5232.... GINGIVAL RECESSION.................................. 31
5233.... ACUTE PERIODONTITIS................................. 31
5234.... CHRONIC PERIODONTITIS............................... 31
5235.... PERIODONTOSIS....................................... 31
5236.... ACCRETIONS ON TEETH................................. 31
5238.... PERIODONTAL DISEASE NEC............................. 31
5239.... GINGIV/PERIODONT DIS NOS............................ 31
52400... UNSPCF ANOMALY JAW SIZE............................. 31
52401... MAXILLARY HYPERPLASIA............................... 31
52402... MANDIBULAR HYPERPLASIA.............................. 31
52403... MAXILLARY HYPOPLASIA................................ 31
52404... MANDIBULAR HYPOPLASIA............................... 31
52405... MACROGENIA.......................................... 31
52406... MICROGENIA.......................................... 31
52409... OTH SPCF ANMLY JAW SIZE............................. 31
52410... UNSPCF ANM JAW CRANL BSE............................ 31
52411... MAXILLARY ASYMMETRY................................. 31
52412... OTHER JAW ASYMMETRY................................. 31
52419... SPCFD ANOM JAW CRANL BSE............................ 31
5242.... DENTAL ARCH ANOMALY................................. 31
5243.... TOOTH POSITION ANOMALY.............................. 31
5244.... MALOCCLUSION NOS.................................... 31
5245.... ABN DENTOFACIAL FUNCTION............................ 31
52460... TMJ DISORDERS NOS................................... 24
52461... ADHESNS/ANKYLOSIS--TMJ.............................. 24
52462... ARTHRALGIA TMJ...................................... 24
52463... ARTICULAR DISC DISORDER............................. 24
52469... OTHER SPECF TMJ DISORDRS............................ 24
52470... UNSPF DENT ALVELR ANMALY............................ 31
52471... ALVEOLAR MAXIL HYPRPLSIA............................ 31
52472... ALVEOLAR MANDIB HYPRPLAS............................ 31
52473... ALVEOLAR MAXIL HYPOPLSIA............................ 31
52474... ALVEOLAR MANDB HYPOPLSIA............................ 31
52479... OTH SPCF ALVEOLAR ANMALY............................ 31
5248.... DENTOFACIAL ANOMALY NEC............................. 31
5249.... DENTOFACIAL ANOMALY NOS............................. 31
5250.... EXFOLIATION OF TEETH................................ 31
5251.... LOSS OF TEETH, ACQUIRED............................. 31
5252.... ATROPHY ALVEOLAR RIDGE.............................. 31
5253.... RETAINED DENTAL ROOT................................ 31
5258.... DENTAL DISORDER NEC................................. 31
5259.... DENTAL DISORDER NOS................................. 31
5260.... DEVEL ODONTOGENIC CYSTS............................. 31
5261.... FISSURAL CYSTS OF JAW............................... 31
5262.... CYSTS OF JAWS NEC................................... 31
5263.... CENT GIANT CELL GRANULOM............................ 31
5264.... INFLAMMATION OF JAW................................. 31
5265.... ALVEOLITIS OF JAW................................... 31
52681... EXOSTOSIS OF JAW.................................... 31
52689... JAW DISEASE NEC..................................... 31
5269.... JAW DISEASE NOS..................................... 31
5270.... SALIVARY GLAND ATROPHY.............................. 31
5271.... SALIVARY GLND HYPRTROPHY............................ 31
5272.... SIALOADENITIS....................................... 31
5273.... SALIVARY GLAND ABSCESS.............................. 31
5274.... SALIVARY GLAND FISTULA.............................. 31
5275.... SIALOLITHIASIS...................................... 31
5276.... SALIVARY GLAND MUCOCELE............................. 31
5277.... SALIVARY SECRETION DIS.............................. 31
5278.... SALIVARY GLAND DIS NEC.............................. 31
5279.... SALIVARY GLAND DIS NOS.............................. 31
[[Page 47897]]
5280.... STOMATITIS.......................................... 31
5281.... CANCRUM ORIS........................................ 31
5282.... ORAL APHTHAE........................................ 31
5283.... CELLULITIS/ABSCESS MOUTH............................ 31
5284.... ORAL SOFT TISSUE CYST............................... 31
5285.... DISEASES OF LIPS.................................... 31
5286.... LEUKOPLAKIA ORAL MUCOSA............................. 31
5287.... ORAL EPITHELIUM DIS NEC............................. 31
5288.... ORAL SUBMUCOSAL FIBROSIS............................ 31
5289.... ORAL SOFT TISSUE DIS NEC............................ 31
5290.... GLOSSITIS........................................... 31
5291.... GEOGRAPHIC TONGUE................................... 31
5292.... MED RHOMBOID GLOSSITIS.............................. 31
5293.... HYPERTROPH TONGUE PAPILL............................ 31
5294.... ATROPHY TONGUE PAPILLAE............................. 31
5295.... PLICATED TONGUE..................................... 31
5296.... GLOSSODYNIA......................................... 31
5298.... TONGUE DISORDER NEC................................. 31
5299.... TONGUE DISORDER NOS................................. 31
5300.... ACHALASIA & CARDIOSPASM............................. 41
53010... ESOPHAGITIS, UNSPECIFIED............................ 41
53011... REFLUX ESOPHAGITIS.................................. 41
53019... OTHER ESOPHAGITIS................................... 41
5302.... ULCER OF ESOPHAGUS.................................. 41
5303.... ESOPHAGEAL STRICTURE................................ 41
5304.... PERFORATION OF ESOPHAGUS............................ 41
5305.... DYSKINESIA OF ESOPHAGUS............................. 41
5306.... ACQ ESOPHAG DIVERTICULUM............................ 41
5307.... MALLORY-WEISS SYNDROME.............................. 41
53081... ESOPHAGEAL REFLUX................................... 41
53082... ESOPHAGEAL HEMORRHAGE............................... 41
53083... ESOPHAGEAL LEUKOPLAKIA.............................. 41
53084... TRACHEOESOPHAGEAL FSTULA............................ 41
53089... OTHER DSRDERS ESOPHAGUS............................. 41
5309.... ESOPHAGEAL DISORDER NOS............................. 41
53100... AC STOMACH ULCER W HEM.............................. 41
53101... AC STOMAC ULC W HEM-OBST............................ 41
53110... AC STOMACH ULCER W PERF............................. 78
53111... AC STOM ULC W PERF-OBST............................. 78
53120... AC STOMAC ULC W HEM/PERF............................ 78
53121... AC STOM ULC HEM/PERF-OBS............................ 78
53130... ACUTE STOMACH ULCER NOS............................. 41
53131... AC STOMACH ULC NOS-OBSTR............................ 41
53140... CHR STOMACH ULC W HEM............................... 41
53141... CHR STOM ULC W HEM-OBSTR............................ 41
53150... CHR STOMACH ULCER W PERF............................ 78
53151... CHR STOM ULC W PERF-OBST............................ 78
53160... CHR STOMACH ULC HEM/PERF............................ 78
53161... CHR STOM ULC HEM/PERF-OB............................ 78
53170... CHR STOMACH ULCER NOS............................... 41
53171... CHR STOMACH ULC NOS-OBST............................ 41
53190... STOMACH ULCER NOS................................... 41
53191... STOMACH ULCER NOS-OBSTR............................. 41
53200... AC DUODENAL ULCER W HEM............................. 41
53201... AC DUODEN ULC W HEM-OBST............................ 41
53210... AC DUODENAL ULCER W PERF............................ 78
53211... AC DUODEN ULC PERF-OBSTR............................ 78
53220... AC DUODEN ULC W HEM/PERF............................ 78
53221... AC DUOD ULC HEM/PERF-OBS............................ 78
53230... ACUTE DUODENAL ULCER NOS............................ 41
53231... AC DUODENAL ULC NOS-OBST............................ 41
53240... CHR DUODEN ULCER W HEM.............................. 41
53241... CHR DUODEN ULC HEM-OBSTR............................ 41
53250... CHR DUODEN ULCER W PERF............................. 78
53251... CHR DUODEN ULC PERF-OBST............................ 78
53260... CHR DUODEN ULC HEM/PERF............................. 78
53261... CHR DUOD ULC HEM/PERF-OB............................ 78
53270... CHR DUODENAL ULCER NOS.............................. 41
53271... CHR DUODEN ULC NOS-OBSTR............................ 41
53290... DUODENAL ULCER NOS.................................. 41
53291... DUODENAL ULCER NOS-OBSTR............................ 41
53300... AC PEPTIC ULCER W HEMORR............................ 41
53301... AC PEPTIC ULC W HEM-OBST............................ 41
53310... AC PEPTIC ULCER W PERFOR............................ 78
53311... AC PEPTIC ULC W PERF-OBS............................ 78
53320... AC PEPTIC ULC W HEM/PERF............................ 78
[[Page 47898]]
53321... AC PEPT ULC HEM/PERF-OBS............................ 78
53330... ACUTE PEPTIC ULCER NOS.............................. 41
53331... AC PEPTIC ULCER NOS-OBST............................ 41
53340... CHR PEPTIC ULCER W HEM.............................. 41
53341... CHR PEPTIC ULC W HEM-OBS............................ 41
53350... CHR PEPTIC ULCER W PERF............................. 78
53351... CHR PEPTIC ULC PERF-OBST............................ 78
53360... CHR PEPT ULC W HEM/PERF............................. 78
53361... CHR PEPT ULC HEM/PERF-OB............................ 78
53370... CHRONIC PEPTIC ULCER NOS............................ 41
53371... CHR PEPTIC ULCER NOS-OBS............................ 41
53390... PEPTIC ULCER NOS.................................... 41
53391... PEPTIC ULCER NOS-OBSTRUC............................ 41
53400... AC MARGINAL ULCER W HEM............................. 41
53401... AC MARGIN ULC W HEM-OBST............................ 41
53410... AC MARGINAL ULCER W PERF............................ 78
53411... AC MARGIN ULC W PERF-OBS............................ 78
53420... AC MARGIN ULC W HEM/PERF............................ 78
53421... AC MARG ULC HEM/PERF-OBS............................ 78
53430... AC MARGINAL ULCER NOS............................... 41
53431... AC MARGINAL ULC NOS-OBST............................ 41
53440... CHR MARGINAL ULCER W HEM............................ 41
53441... CHR MARGIN ULC W HEM-OBS............................ 41
53450... CHR MARGINAL ULC W PERF............................. 78
53451... CHR MARGIN ULC PERF-OBST............................ 78
53460... CHR MARGIN ULC HEM/PERF............................. 78
53461... CHR MARG ULC HEM/PERF-OB............................ 78
53470... CHR MARGINAL ULCER NOS.............................. 41
53471... CHR MARGINAL ULC NOS-OBS............................ 41
53490... GASTROJEJUNAL ULCER NOS............................. 41
53491... GASTROJEJUN ULC NOS-OBST............................ 41
53500... ACUTE GASTRTIS W/O HMRHG............................ 41
53501... ACUTE GASTRITIS W HMRHG............................. 41
53510... ATRPH GASTRTIS W/O HMRHG............................ 41
53511... ATRPH GASTRITIS W HMRHG............................. 41
53520... GSTR MCSL HYPRT W/O HMRG............................ 41
53521... GSTR MCSL HYPRT W HMRG.............................. 41
53530... ALCHL GASTRTIS W/O HMRHG............................ 41
53531... ALCHL GSTRITIS W HMRHG.............................. 41
53540... OTH SPF GSTRT W/O HMRHG............................. 41
53541... OTH SPF GASTRT W HMRHG.............................. 41
53550... GSTR/DDNTS NOS W/O HMRHG............................ 41
53551... GSTR/DDNTS NOS W HMRHG.............................. 41
53560... DUODENITIS W/O HMRHG................................ 41
53561... DUODENITIS W HMRHG.................................. 41
5360.... ACHLORHYDRIA........................................ 41
5361.... AC DILATION OF STOMACH.............................. 41
5362.... PERSISTENT VOMITING................................. 41
5363.... GASTROPARESIS....................................... 41
5368.... STOMACH FUNCTION DIS NEC............................ 41
5369.... STOMACH FUNCTION DIS NOS............................ 41
5370.... ACQ PYLORIC STENOSIS................................ 41
5371.... GASTRIC DIVERTICULUM................................ 41
5372.... CHRONIC DUODENAL ILEUS.............................. 41
5373.... DUODENAL OBSTRUCTION NEC............................ 41
5374.... GASTRIC/DUODENAL FISTULA............................ 41
5375.... GASTROPTOSIS........................................ 41
5376.... HOURGLASS STRICTURE STOM............................ 41
53781... PYLOROSPASM......................................... 41
53782... ANGIO STM/DUDN W/O HMRHG............................ 41
53783... ANGIO STM/DUDN W HMRHG.............................. 41
53789... GASTRODUODENAL DIS NEC.............................. 41
5379.... GASTRODUODENAL DIS NOS.............................. 41
5400.... AC APPEND W PERITONITIS............................. 41
5401.... ABSCESS OF APPENDIX................................. 41
5409.... ACUTE APPENDICITIS NOS.............................. 41
541..... APPENDICITIS NOS.................................... 41
542..... OTHER APPENDICITIS.................................. 41
5430.... HYPERPLASIA OF APPENDIX............................. 41
5439.... DISEASES OF APPENDIX NEC............................ 41
55000... UNILAT ING HERNIA W GANG............................ 41
55001... RECUR UNIL ING HERN-GANG............................ 41
55002... BILAT ING HERNIA W GANG............................. 41
55003... RECUR BIL ING HERN-GANG............................. 41
55010... UNILAT ING HERNIA W OBST............................ 41
55011... RECUR UNIL ING HERN-OBST............................ 41
[[Page 47899]]
55012... BILAT ING HERNIA W OBST............................. 41
55013... RECUR BIL ING HERN-OBSTR............................ 41
55090... UNILAT INGUINAL HERNIA.............................. 41
55091... RECUR UNILAT INGUIN HERN............................ 41
55092... BILAT INGUINAL HERNIA............................... 41
55093... RECUR BILAT INGUIN HERN............................. 41
55100... UNIL FEMORAL HERN W GANG............................ 41
55101... REC UNIL FEM HERN W GANG............................ 41
55102... BILAT FEM HERN W GANG............................... 41
55103... RECUR BIL FEM HERN-GANG............................. 41
5511.... UMBILICAL HERNIA W GANGR............................ 41
55120... GANGR VENTRAL HERNIA NOS............................ 41
55121... GANGR INCISIONAL HERNIA............................. 41
55129... GANG VENTRAL HERNIA NEC............................. 41
5513.... DIAPHRAGM HERNIA W GANGR............................ 78
5518.... HERNIA, SITE NEC W GANGR............................ 78
5519.... HERNIA, SITE NOS W GANGR............................ 78
55200... UNIL FEMORAL HERN W OBST............................ 41
55201... REC UNIL FEM HERN W OBST............................ 41
55202... BIL FEMORAL HERN W OBSTR............................ 41
55203... REC BIL FEM HERN W OBSTR............................ 41
5521.... UMBILICAL HERNIA W OBSTR............................ 41
55220... OBSTR VENTRAL HERNIA NOS............................ 41
55221... OBSTR INCISIONAL HERNIA............................. 41
55229... OBSTR VENTRAL HERNIA NEC............................ 41
5523.... DIAPHRAGM HERNIA W OBSTR............................ 41
5528.... HERNIA, SITE NEC W OBSTR............................ 41
5529.... HERNIA, SITE NOS W OBSTR............................ 41
55300... UNILAT FEMORAL HERNIA............................... 41
55301... RECUR UNIL FEMORAL HERN............................. 41
55302... BILATERAL FEMORAL HERNIA............................ 41
55303... RECUR BILAT FEMORAL HERN............................ 41
5531.... UMBILICAL HERNIA.................................... 41
55320... VENTRAL HERNIA NOS.................................. 41
55321... INCISIONAL HERNIA................................... 41
55329... VENTRAL HERNIA NEC.................................. 41
5533.... DIAPHRAGMATIC HERNIA................................ 41
5538.... HERNIA NEC.......................................... 41
5539.... HERNIA NOS.......................................... 41
5550.... REG ENTERITIS, SM INTEST............................ 41
5551.... REG ENTERITIS, LG INTEST............................ 41
5552.... REG ENTERIT SM/LG INTEST............................ 41
5559.... REGIONAL ENTERITIS NOS.............................. 41
5560.... ULCERATIVE ENTEROCOLITIS............................ 41
5561.... ULCERATIVE ILEOCOLITIS.............................. 41
5562.... ULCERATIVE PROCTITIS................................ 41
5563.... ULCERTVE PRCTOSIGMOIDTIS............................ 41
5564.... PSEUDOPOLYPOSIS COLON............................... 41
5565.... LFTSDED ULCERTVE COLITIS............................ 41
5566.... UNIVRSL ULCERTVE COLITIS............................ 41
5568.... OTHER ULCERATIVE COLITIS............................ 41
5569.... ULCERATVE COLITIS UNSPCF............................ 41
5570.... AC VASC INSUFF INTESTINE............................ 41
5571.... CHR VASC INSUFF INTEST.............................. 41
5579.... VASC INSUFF INTEST NOS.............................. 41
5581.... RADIATION GASTROENTERIT............................. 41
5582.... TOXIC GASTROENTERITIS............................... 41
5589.... NONINF GASTROENTERIT NEC............................ 41
5600.... INTUSSUSCEPTION..................................... 41
5601.... PARALYTIC ILEUS..................................... 41
5602.... VOLVULUS OF INTESTINE............................... 41
56030... IMPACTION INTESTINE NOS............................. 41
56031... GALLSTONE ILEUS..................................... 41
56039... IMPACTION INTESTINE NEC............................. 41
56081... INTESTINAL ADHES W OBSTR............................ 41
56089... INTESTINAL OBSTRUCT NEC............................. 41
5609.... INTESTINAL OBSTRUCT NOS............................. 41
56200... DVRTCLO SML INT W/O HMRG............................ 41
56201... DVRTCLI SML INT W/O HMRG............................ 41
56202... DVRTCLO SML INT W HMRHG............................. 41
56203... DVRTCLI SML INT W HMRHG............................. 41
56210... DVRTCLO COLON W/O HMRHG............................. 41
56211... DVRTCLI COLON W/O HMRHG............................. 41
56212... DVRTCLO COLON W HMRHG............................... 41
56213... DVRTCLI COLON W HMRHG............................... 41
5640.... CONSTIPATION........................................ 41
[[Page 47900]]
5641.... IRRITABLE COLON..................................... 41
5642.... POSTGASTRIC SURGERY SYND............................ 41
5643.... VOMITING POST-GI SURGERY............................ 41
5644.... POSTOP GI FUNCT DIS NEC............................. 41
5645.... FUNCTIONAL DIARRHEA................................. 41
5646.... ANAL SPASM.......................................... 41
5647.... MEGACOLON NEC....................................... 41
5648.... FUNCT DIS INTESTINE NEC............................. 41
5649.... FUNCT DIS INTESTINE NOS............................. 41
5650.... ANAL FISSURE........................................ 41
5651.... ANAL FISTULA........................................ 41
566..... ANAL & RECTAL ABSCESS............................... 41
5670.... PERITONITIS IN INFEC DIS............................ 41
5671.... PNEUMOCOCCAL PERITONITIS............................ 41
5672.... SUPPURAT PERITONITIS NEC............................ 41
5678.... PERITONITIS NEC..................................... 41
5679.... PERITONITIS NOS..................................... 41
5680.... PERITONEAL ADHESIONS................................ 41
56881... HEMOPERITONEUM...................................... 78
56882... PERITONEAL EFFUSION................................. 41
56889... PERITONEAL DISORDER NEC............................. 41
5689.... PERITONEAL DISORDER NOS............................. 41
5690.... ANAL & RECTAL POLYP................................. 41
5691.... RECTAL PROLAPSE..................................... 41
5692.... RECTAL & ANAL STENOSIS.............................. 41
5693.... RECTAL & ANAL HEMORRHAGE............................ 41
56941... RECTAL & ANAL ULCER................................. 41
56942... ANAL OR RECTAL PAIN................................. 41
56949... RECTAL & ANAL DIS NEC............................... 41
5695.... INTESTINAL ABSCESS.................................. 41
56960... COLSTOMY/ENTER COMP NOS............................. 41
56961... COLOSTY/ENTEROST INFECTN............................ 41
56969... COLSTMY/ENTEROS COMP NEC............................ 41
56981... INTESTINAL FISTULA.................................. 41
56982... ULCERATION OF INTESTINE............................. 41
56983... PERFORATION OF INTESTINE............................ 41
56984... ANGIO INTES W/O HMRHG............................... 41
56985... ANGIO INTES W HMRHG................................. 41
56989... INTESTINAL DISORDERS NEC............................ 41
5699.... INTESTINAL DISORDER NOS............................. 41
570..... ACUTE NECROSIS OF LIVER............................. 41
5710.... ALCOHOLIC FATTY LIVER............................... 41
5711.... AC ALCOHOLIC HEPATITIS.............................. 41
5712.... ALCOHOL CIRRHOSIS LIVER............................. 41
5713.... ALCOHOL LIVER DAMAGE NOS............................ 41
57140... CHRONIC HEPATITIS NOS............................... 41
57141... CHR PERSISTENT HEPATITIS............................ 41
57149... CHRONIC HEPATITIS NEC............................... 41
5715.... CIRRHOSIS OF LIVER NOS.............................. 41
5716.... BILIARY CIRRHOSIS................................... 41
5718.... CHRONIC LIVER DIS NEC............................... 41
5719.... CHRONIC LIVER DIS NOS............................... 41
5720.... ABSCESS OF LIVER.................................... 41
5721.... PORTAL PYEMIA....................................... 41
5722.... HEPATIC COMA........................................ 78
5723.... PORTAL HYPERTENSION................................. 41
5724.... HEPATORENAL SYNDROME................................ 41
5728.... OTH SEQUELA, CHR LIV DIS............................ 41
5730.... CHR PASSIV CONGEST LIVER............................ 41
5731.... HEPATITIS IN VIRAL DIS.............................. 41
5732.... HEPATITIS IN OTH INF DIS............................ 41
5733.... HEPATITIS NOS....................................... 41
5734.... HEPATIC INFARCTION.................................. 41
5738.... LIVER DISORDERS NEC................................. 41
5739.... LIVER DISORDER NOS.................................. 41
57400... CHOLELITH W AC CHOLECYST............................ 41
57401... CHOLELITH/AC GB INF-OBST............................ 41
57410... CHOLELITH W CHOLECYS NEC............................ 41
57411... CHOLELITH/GB INF NEC-OBS............................ 41
57420... CHOLELITHIASIS NOS.................................. 41
57421... CHOLELITHIAS NOS W OBSTR............................ 41
57430... CHOLEDOCHOLITH/AC GB INF............................ 41
57431... CHOLEDOCHLITH/AC GB-OBST............................ 41
57440... CHOLEDOCHLITH/GB INF NEC............................ 41
57441... CHOLEDOCHLITH/GB NEC-OBS............................ 41
57450... CHOLEDOCHOLITHIASIS NOS............................. 41
[[Page 47901]]
57451... CHOLEDOCHLITH NOS W OBST............................ 41
5750.... ACUTE CHOLECYSTITIS................................. 41
5752.... OBSTRUCTION GALLBLADDER............................. 41
5753.... HYDROPS OF GALLBLADDER.............................. 41
5754.... PERFORATION GALLBLADDER............................. 41
5755.... FISTULA OF GALLBLADDER.............................. 41
5756.... GB CHOLESTEROLOSIS.................................. 41
5758.... DIS OF GALLBLADDER NEC.............................. 41
5759.... DIS OF GALLBLADDER NOS.............................. 41
5760.... POSTCHOLECYSTECTOMY SYND............................ 41
5761.... CHOLANGITIS......................................... 41
5762.... OBSTRUCTION OF BILE DUCT............................ 41
5763.... PERFORATION OF BILE DUCT............................ 41
5764.... FISTULA OF BILE DUCT................................ 41
5765.... SPASM SPHINCTER OF ODDI............................. 41
5768.... DIS OF BILIARY TRACT NEC............................ 41
5769.... DIS OF BILIARY TRACT NOS............................ 41
5770.... ACUTE PANCREATITIS.................................. 41
5771.... CHRONIC PANCREATITIS................................ 41
5772.... PANCREAT CYST/PSEUDOCYST............................ 41
5778.... PANCREATIC DISEASE NEC.............................. 41
5779.... PANCREATIC DISEASE NOS.............................. 41
5780.... HEMATEMESIS......................................... 41
5781.... BLOOD IN STOOL...................................... 41
5789.... GASTROINTEST HEMORR NOS............................. 41
5790.... CELIAC DISEASE...................................... 41
5791.... TROPICAL SPRUE...................................... 41
5792.... BLIND LOOP SYNDROME................................. 41
5793.... INTEST POSTOP NONABSORB............................. 41
5794.... PANCREATIC STEATORRHEA.............................. 41
5798.... INTEST MALABSORPTION NEC............................ 41
5799.... INTEST MALABSORPTION NOS............................ 41
5800.... AC PROLIFERAT NEPHRITIS............................. 53
5804.... AC RAPIDLY PROGR NEPHRIT............................ 53
58081... AC NEPHRITIS IN OTH DIS............................. 53
58089... ACUTE NEPHRITIS NEC................................. 53
5809.... ACUTE NEPHRITIS NOS................................. 53
5810.... NEPHROTIC SYN, PROLIFER............................. 53
5811.... EPIMEMBRANOUS NEPHRITIS............................. 53
5812.... MEMBRANOPROLIF NEPHROSIS............................ 53
5813.... MINIMAL CHANGE NEPHROSIS............................ 53
58181... NEPHROTIC SYN IN OTH DIS............................ 53
58189... NEPHROTIC SYNDROME NEC.............................. 53
5819.... NEPHROTIC SYNDROME NOS.............................. 53
5820.... CHR PROLIFERAT NEPHRITIS............................ 53
5821.... CHR MEMBRANOUS NEPHRITIS............................ 53
5822.... CHR MEMBRANOPROLIF NEPHR............................ 53
5824.... CHR RAPID PROGR NEPHRIT............................. 53
58281... CHR NEPHRITIS IN OTH DIS............................ 53
58289... CHRONIC NEPHRITIS NEC............................... 53
5829.... CHRONIC NEPHRITIS NOS............................... 53
5830.... PROLIFERAT NEPHRITIS NOS............................ 53
5831.... MEMBRANOUS NEPHRITIS NOS............................ 53
5832.... MEMBRANOPROLIF NEPHR NOS............................ 53
5834.... RAPIDLY PROG NEPHRIT NOS............................ 53
5836.... RENAL CORT NECROSIS NOS............................. 53
5837.... NEPHR NOS/MEDULL NECROS............................. 53
58381... NEPHRITIS NOS IN OTH DIS............................ 53
58389... NEPHRITIS NEC....................................... 53
5839.... NEPHRITIS NOS....................................... 53
5845.... LOWER NEPHRON NEPHROSIS............................. 53
5846.... AC RENAL FAIL, CORT NECR............................ 53
5847.... AC REN FAIL, MEDULL NECR............................ 53
5848.... AC RENAL FAILURE NEC................................ 53
5849.... ACUTE RENAL FAILURE NOS............................. 53
585..... CHRONIC RENAL FAILURE............................... 53
586..... RENAL FAILURE NOS................................... 53
587..... RENAL SCLEROSIS NOS................................. 53
5880.... RENAL OSTEODYSTROPHY................................ 53
5881.... NEPHROGEN DIABETES INSIP............................ 53
5888.... IMPAIRED RENAL FUNCT NEC............................ 53
5889.... IMPAIRED RENAL FUNCT NOS............................ 53
5890.... UNILATERAL SMALL KIDNEY............................. 53
5891.... BILATERAL SMALL KIDNEYS............................. 53
5899.... SMALL KIDNEY NOS.................................... 53
59000... CHR PYELONEPHRITIS NOS.............................. 53
[[Page 47902]]
59001... CHR PYELONEPH W MED NECR............................ 53
59010... AC PYELONEPHRITIS NOS............................... 53
59011... AC PYELONEPHR W MED NECR............................ 53
5902.... RENAL/PERIRENAL ABSCESS............................. 53
5903.... PYELOURETERITIS CYSTICA............................. 53
59080... PYELONEPHRITIS NOS.................................. 53
59081... PYELONEPHRIT IN OTH DIS............................. 53
5909.... INFECTION OF KIDNEY NOS............................. 53
591..... HYDRONEPHROSIS...................................... 53
5920.... CALCULUS OF KIDNEY.................................. 53
5921.... CALCULUS OF URETER.................................. 53
5929.... URINARY CALCULUS NOS................................ 53
5930.... NEPHROPTOSIS........................................ 53
5931.... HYPERTROPHY OF KIDNEY............................... 53
5932.... CYST OF KIDNEY, ACQUIRED............................ 53
5933.... STRICTURE OF URETER................................. 53
5934.... URETERIC OBSTRUCTION NEC............................ 53
5935.... HYDROURETER......................................... 53
5936.... POSTURAL PROTEINURIA................................ 53
59370... VESCOURETRL RFLUX UNSPCF............................ 53
59371... VSCURT RFLX NPHT UNILTRL............................ 53
59372... VSCOURTL RFLX NPHT BLTRL............................ 53
59373... VSCOURTL RFLX W NPHT NOS............................ 53
59381... RENAL VASCULAR DISORDER............................. 53
59382... URETERAL FISTULA.................................... 53
59389... RENAL & URETERAL DIS NEC............................ 53
5939.... RENAL & URETERAL DIS NOS............................ 53
5940.... BLAD DIVERTICULUM CALCUL............................ 53
5941.... BLADDER CALCULUS NEC................................ 53
5942.... URETHRAL CALCULUS................................... 53
5948.... LOWER URIN CALCUL NEC............................... 53
5949.... LOWER URIN CALCUL NOS............................... 53
5950.... ACUTE CYSTITIS...................................... 53
5951.... CHR INTERSTIT CYSTITIS.............................. 53
5952.... CHRONIC CYSTITIS NEC................................ 53
5953.... TRIGONITIS.......................................... 53
5954.... CYSTITIS IN OTH DIS................................. 53
59581... CYSTITIS CYSTICA.................................... 53
59582... IRRADIATION CYSTITIS................................ 53
59589... CYSTITIS NEC........................................ 53
5959.... CYSTITIS NOS........................................ 53
5960.... BLADDER NECK OBSTRUCTION............................ 53
5961.... INTESTINOVESICAL FISTULA............................ 53
5962.... VESICAL FISTULA NEC................................. 53
5963.... DIVERTICULUM OF BLADDER............................. 53
5964.... ATONY OF BLADDER.................................... 53
59651... HYPERTONICITY OF BLADDER............................ 53
59652... LOW BLADDER COMPLIANCE.............................. 53
59653... PARALYSIS OF BLADDER................................ 53
59654... NEUROGENIC BLADDER NOS.............................. 53
59655... DETRUSR SPHINC DYSSNRGIA............................ 53
59659... OTH FUNC DSDR BLADDER............................... 53
5966.... BLADDER RUPT, NONTRAUM.............................. 53
5967.... BLADDER WALL HEMORRHAGE............................. 53
5968.... BLADDER DISORDER NEC................................ 53
5969.... BLADDER DISORDER NOS................................ 53
5970.... URETHRAL ABSCESS.................................... 53
59780... URETHRITIS NOS...................................... 53
59781... URETHRAL SYNDROME NOS............................... 53
59789... URETHRITIS NEC...................................... 53
59800... URETHR STRICT:INFECT NOS............................ 53
59801... URETH STRICT:OTH INFECT............................. 53
5981.... TRAUM URETHRAL STRICTURE............................ 53
5982.... POSTOP URETHRAL STRICTUR............................ 53
5988.... URETHRAL STRICTURE NEC.............................. 53
5989.... URETHRAL STRICTURE NOS.............................. 53
5990.... URIN TRACT INFECTION NOS............................ 53
5991.... URETHRAL FISTULA.................................... 53
5992.... URETHRAL DIVERTICULUM............................... 53
5993.... URETHRAL CARUNCLE................................... 53
5994.... URETHRAL FALSE PASSAGE.............................. 53
5995.... PROLAPSE URETHRAL MUCOSA............................ 53
5996.... URINARY OBSTRUCTION NOS............................. 53
5997.... HEMATURIA........................................... 53
5998.... URINARY TRACT DIS NEC*.............................. 53
59981... URETHRAL HYPERMOBILITY.............................. 53
[[Page 47903]]
59982... INTRINSC SPHNCTR DFICNCY............................ 53
59983... URETHRAL INSTABILITY................................ 53
59984... OTH SPCF DSDR URETHRA............................... 53
59989... OTH SPCF DSDR URNRY TRCT............................ 53
5999.... URINARY TRACT DIS NOS............................... 53
600..... HYPERPLASIA OF PROSTATE............................. 53
6010.... ACUTE PROSTATITIS................................... 53
6011.... CHRONIC PROSTATITIS................................. 53
6012.... ABSCESS OF PROSTATE................................. 53
6013.... PROSTATOCYSTITIS.................................... 53
6014.... PROSTATITIS IN OTH DIS.............................. 53
6018.... PROSTATIC INFLAM DIS NEC............................ 53
6019.... PROSTATITIS NOS..................................... 53
6020.... CALCULUS OF PROSTATE................................ 53
6021.... PROSTATIC CONGEST/HEMORR............................ 53
6022.... ATROPHY OF PROSTATE................................. 53
6028.... PROSTATIC DISORDERS NEC............................. 53
6029.... PROSTATIC DISORDER NOS.............................. 53
6030.... ENCYSTED HYDROCELE.................................. 53
6031.... INFECTED HYDROCELE.................................. 53
6038.... HYDROCELE NEC....................................... 53
6039.... HYDROCELE NOS....................................... 53
6040.... ORCHITIS WITH ABSCESS............................... 53
60490... ORCHITIS/EPIDIDYMIT NOS............................. 53
60491... ORCHITIS IN OTH DISEASE............................. 53
60499... ORCHITIS/EPIDIDYMIT NEC............................. 53
605..... REDUN PREPUCE & PHIMOSIS............................ 53
6060.... AZOOSPERMIA......................................... 53
6061.... OLIGOSPERMIA........................................ 53
6068.... MALE INFERTILITY NEC................................ 53
6069.... MALE INFERTILITY NOS................................ 53
6070.... LEUKOPLAKIA OF PENIS................................ 53
6071.... BALANOPOSTHITIS..................................... 53
6072.... INFLAM DIS, PENIS NEC............................... 53
6073.... PRIAPISM............................................ 53
60781... BALANITIS XEROTICA OBLIT............................ 53
60782... VASCULAR DISORDER, PENIS............................ 53
60783... EDEMA OF PENIS...................................... 53
60784... IMPOTENCE, ORGANIC ORIGN............................ 53
60789... DISORDER OF PENIS NEC............................... 53
6079.... DISORDER OF PENIS NOS............................... 53
6080.... SEMINAL VESICULITIS................................. 97
6081.... SPERMATOCELE........................................ 53
6082.... TORSION OF TESTIS................................... 53
6083.... ATROPHY OF TESTIS................................... 53
6084.... MALE GEN INFLAM DIS NEC............................. 53
60881... MALE GEN DIS IN OTH DIS............................. 53
60883... MALE GEN VASCUL DIS NEC............................. 53
60884... CHYLOCELE, TUNIC VAGINAL............................ 53
60885... STRICTURE, MALE GEN ORGN............................ 53
60886... EDEMA, MALE GENITAL ORGN............................ 53
60889... MALE GENITAL DIS NEC................................ 53
6089.... MALE GENITAL DIS NOS................................ 53
6100.... SOLITARY CYST OF BREAST............................. 18
6101.... DIFFUS CYSTIC MASTOPATHY............................ 18
6102.... FIBROADENOSIS OF BREAST............................. 18
6103.... FIBROSCLEROSIS OF BREAST............................ 18
6104.... MAMMARY DUCT ECTASIA................................ 18
6108.... BENIGN MAMM DYSPLAS NEC............................. 18
6109.... BENIGN MAMM DYSPLAS NOS............................. 18
6110.... INFLAM DISEASE OF BREAST............................ 18
6111.... HYPERTROPHY OF BREAST............................... 18
6112.... FISSURE OF NIPPLE................................... 18
6113.... FAT NECROSIS OF BREAST.............................. 18
6114.... ATROPHY OF BREAST................................... 18
6115.... GALACTOCELE......................................... 18
6116.... GALACTORRHEA-NONOBSTET.............................. 18
61171... MASTODYNIA.......................................... 18
61172... LUMP OR MASS IN BREAST.............................. 18
61179... SYMPTOMS IN BREAST NEC.............................. 18
6118.... BREAST DISORDERS NEC................................ 18
6119.... BREAST DISORDER NOS................................. 18
6140.... AC SALPINGO-OOPHORITIS.............................. 97
6141.... CHR SALPINGO-OOPHORITIS............................. 97
6142.... SALPINGO-OOPHORITIS NOS............................. 97
6143.... ACUTE PARAMETRITIS.................................. 56
[[Page 47904]]
6144.... CHRONIC PARAMETRITIS................................ 56
6145.... AC PELV PERITONITIS-FEM............................. 56
6146.... FEM PELVIC PERITON ADHES............................ 56
6147.... CHR PELV PERITON NEC-FEM............................ 56
6148.... FEM PELV INFLAM DIS NEC............................. 97
6149.... FEM PELV INFLAM DIS NOS............................. 97
6150.... AC UTERINE INFLAMMATION............................. 56
6151.... CHR UTERINE INFLAMMATION............................ 56
6159.... UTERINE INFLAM DIS NOS.............................. 56
6160.... CERVICITIS.......................................... 97
61610... VAGINITIS NOS....................................... 97
61611... VAGINITIS IN OTH DISEASE............................ 97
6162.... BARTHOLIN'S GLAND CYST.............................. 56
6163.... BARTHOLIN'S GLND ABSCESS............................ 56
6164.... ABSCESS OF VULVA NEC................................ 56
61650... ULCERATION OF VULVA NOS............................. 56
61651... VULVAR ULCER IN OTH DIS............................. 56
6168.... FEMALE GEN INFLAM NEC............................... 56
6169.... FEMALE GEN INFLAM NOS............................... 56
6170.... UTERINE ENDOMETRIOSIS............................... 56
6171.... OVARIAN ENDOMETRIOSIS............................... 56
6172.... TUBAL ENDOMETRIOSIS................................. 56
6173.... PELV PERIT ENDOMETRIOSIS............................ 56
6174.... VAGINAL ENDOMETRIOSIS............................... 56
6175.... INTESTINAL ENDOMETRIOSIS............................ 41
6176.... ENDOMETRIOSIS IN SCAR............................... 18
6178.... ENDOMETRIOSIS NEC................................... 56
6179.... ENDOMETRIOSIS NOS................................... 56
6180.... PROLAPSE OF VAGINAL WALL............................ 56
6181.... UTERINE PROLAPSE.................................... 56
6182.... UTEROVAG PROLAPS-INCOMPL............................ 56
6183.... UTEROVAG PROLAPS-COMPLET............................ 56
6184.... UTERVAGINAL PROLAPSE NOS............................ 56
6185.... POSTOP VAGINAL PROLAPSE............................. 56
6186.... VAGINAL ENTEROCELE.................................. 56
6187.... OLD LACER PELVIC MUSCLE............................. 56
6188.... GENITAL PROLAPSE NEC................................ 56
6189.... GENITAL PROLAPSE NOS................................ 56
6190.... URIN-GENITAL FISTUL, FEM............................ 56
6191.... DIGEST-GENIT FISTUL, FEM............................ 41
6192.... GENITAL-SKIN FISTUL, FEM............................ 56
6198.... FEM GENITAL FISTULA NEC............................. 56
6199.... FEM GENITAL FISTULA NOS............................. 56
6200.... FOLLICULAR CYST OF OVARY............................ 56
6201.... CORPUS LUTEUM CYST.................................. 56
6202.... OVARIAN CYST NEC/NOS................................ 56
6203.... ACQ ATROPHY OVARY & TUBE............................ 56
6204.... PROLAPSE OF OVARY & TUBE............................ 56
6205.... TORSION OF OVARY OR TUBE............................ 56
6206.... BROAD LIGAMENT LACER SYN............................ 56
6207.... BROAD LIGAMENT HEMATOMA............................. 56
6208.... NONINFL DIS OVA/ADNX NEC............................ 56
6209.... NONINFL DIS OVA/ADNX NOS............................ 56
6210.... POLYP OF CORPUS UTERI............................... 56
6211.... CHR UTERINE SUBINVOLUTN............................. 56
6212.... HYPERTROPHY OF UTERUS............................... 56
6213.... ENDOMETRIAL HYPERPLASIA............................. 56
6214.... HEMATOMETRA......................................... 56
6215.... INTRAUTERINE SYNECHIAE.............................. 56
6216.... MALPOSITION OF UTERUS............................... 56
6217.... CHR INVERSION OF UTERUS............................. 56
6218.... DISORDERS OF UTERUS NEC............................. 56
6219.... DISORDER OF UTERUS NOS.............................. 56
6220.... EROSION/ECTROPION CERVIX............................ 56
6221.... DYSPLASIA OF CERVIX................................. 56
6222.... LEUKOPLAKIA OF CERVIX............................... 56
6223.... OLD LACERATION OF CERVIX............................ 56
6224.... STRICTURE OF CERVIX................................. 56
6225.... INCOMPETENCE OF CERVIX.............................. 56
6226.... HYPERTROPHIC ELONG CERVX............................ 56
6227.... MUCOUS POLYP OF CERVIX.............................. 56
6228.... NONINFLAM DIS CERVIX NEC............................ 56
6229.... NONINFLAM DIS CERVIX NOS............................ 56
6230.... DYSPLASIA OF VAGINA................................. 56
6231.... LEUKOPLAKIA OF VAGINA............................... 56
6232.... STRICTURE OF VAGINA................................. 56
[[Page 47905]]
6233.... TIGHT HYMENAL RING.................................. 56
6234.... OLD VAGINAL LACERATION.............................. 56
6235.... NONINFECT VAG LEUKORRHEA............................ 56
6236.... VAGINAL HEMATOMA.................................... 56
6237.... POLYP OF VAGINA..................................... 56
6238.... NONINFLAM DIS VAGINA NEC............................ 56
6239.... NONINFLAM DIS VAGINA NOS............................ 56
6240.... DYSTROPHY OF VULVA.................................. 56
6241.... ATROPHY OF VULVA.................................... 56
6242.... HYPERTROPHY OF CLITORIS............................. 56
6243.... HYPERTROPHY OF LABIA................................ 56
6244.... OLD LACERATION OF VULVA............................. 56
6245.... HEMATOMA OF VULVA................................... 56
6246.... POLYP OF LABIA AND VULVA............................ 56
6248.... NONINFLAM DIS VULVA NEC............................. 56
6249.... NONINFLAM DIS VULVA NOS............................. 56
6250.... DYSPAREUNIA......................................... 56
6251.... VAGINISMUS.......................................... 56
6252.... MITTELSCHMERZ....................................... 56
6253.... DYSMENORRHEA........................................ 56
6254.... PREMENSTRUAL TENSION................................ 56
6255.... PELVIC CONGESTION SYND.............................. 56
6256.... FEM STRESS INCONTINENCE............................. 56
6258.... FEM GENITAL SYMPTOMS NEC............................ 56
6259.... FEM GENITAL SYMPTOMS NOS............................ 56
6260.... ABSENCE OF MENSTRUATION............................. 56
6261.... SCANTY MENSTRUATION................................. 56
6262.... EXCESSIVE MENSTRUATION.............................. 56
6263.... PUBERTAL MENORRHAGIA................................ 56
6264.... IRREGULAR MENSTRUATION.............................. 56
6265.... OVULATION BLEEDING.................................. 56
6266.... METRORRHAGIA........................................ 56
6267.... POSTCOITAL BLEEDING................................. 56
6268.... MENSTRUAL DISORDER NEC.............................. 56
6269.... MENSTRUAL DISORDER NOS.............................. 56
6270.... PREMENOPAUSE MENORRHAGIA............................ 56
6271.... POSTMENOPAUSAL BLEEDING............................. 56
6272.... FEMALE CLIMACTERIC STATE............................ 56
6273.... ATROPHIC VAGINITIS.................................. 56
6274.... ARTIFIC MENOPAUSE STATES............................ 56
6278.... MENOPAUSAL DISORDER NEC............................. 56
6279.... MENOPAUSAL DISORDER NOS............................. 56
6280.... INFERTILITY-ANOVULATION............................. 56
6281.... INFERTIL-PITUITARY ORIG............................. 56
6282.... INFERTILITY-TUBAL ORIGIN............................ 56
6283.... INFERTILITY-UTERINE ORIG............................ 56
6284.... INFERTIL-CERVICAL ORIG.............................. 56
6288.... FEMALE INFERTILITY NEC.............................. 56
6289.... FEMALE INFERTILITY NOS.............................. 56
6290.... HEMATOCELE, FEMALE NEC.............................. 56
6291.... HYDROCELE CANAL NUCK-FEM............................ 56
6298.... FEMALE GENITAL DIS NEC.............................. 56
6299.... FEMALE GENITAL DIS NOS.............................. 56
630..... HYDATIDIFORM MOLE................................... 57
631..... OTH ABN PROD CONCEPTION............................. 57
632..... MISSED ABORTION..................................... 57
6330.... ABDOMINAL PREGNANCY................................. 57
6331.... TUBAL PREGNANCY..................................... 57
6332.... OVARIAN PREGNANCY................................... 57
6338.... ECTOPIC PREGNANCY NEC............................... 57
6339.... ECTOPIC PREGNANCY NOS............................... 57
63400... SPON ABOR W PEL INF-UNSP............................ 57
63401... SPON ABOR W PELV INF-INC............................ 57
63402... SPON ABOR W PEL INF-COMP............................ 57
63410... SPON ABORT W HEMORR-UNSP............................ 57
63411... SPON ABORT W HEMORR-INC............................. 57
63412... SPON ABORT W HEMORR-COMP............................ 57
63420... SPON AB W PEL DAMAG-UNSP............................ 57
63421... SPON AB W PELV DAMAG-INC............................ 57
63422... SPON AB W PEL DAMAG-COMP............................ 57
63430... SPON AB W REN FAIL-UNSP............................. 57
63431... SPON AB W REN FAIL-INC.............................. 57
63432... SPON AB W REN FAIL-COMP............................. 57
63440... SPON AB W METAB DIS-UNSP............................ 57
63441... SPON AB W METAB DIS-INC............................. 57
63442... SPON AB W METAB DIS-COMP............................ 57
[[Page 47906]]
63450... SPON ABORT W SHOCK-UNSP............................. 57
63451... SPON ABORT W SHOCK-INC.............................. 57
63452... SPON ABORT W SHOCK-COMP............................. 57
63460... SPON ABORT W EMBOL-UNSP............................. 57
63461... SPON ABORT W EMBOL-INC.............................. 57
63462... SPON ABORT W EMBOL-COMP............................. 57
63470... SPON AB W COMPL NEC-UNSP............................ 57
63471... SPON AB W COMPL NEC-INC............................. 57
63472... SPON AB W COMPL NEC-COMP............................ 57
63480... SPON AB W COMPL NOS-UNSP............................ 57
63481... SPON AB W COMPL NOS-INC............................. 57
63482... SPON AB W COMPL NOS-COMP............................ 57
63490... SPON ABORT UNCOMPL-UNSP............................. 57
63491... SPON ABORT UNCOMPL-INC.............................. 57
63492... SPON ABORT UNCOMPL-COMP............................. 57
63500... LEG ABOR W PELV INF-UNSP............................ 57
63501... LEG ABOR W PELV INF-INC............................. 57
63502... LEG ABOR W PELV INF-COMP............................ 57
63510... LEGAL ABOR W HEMORR-UNSP............................ 57
63511... LEGAL ABORT W HEMORR-INC............................ 57
63512... LEGAL ABOR W HEMORR-COMP............................ 57
63520... LEG AB W PELV DAMAG-UNSP............................ 57
63521... LEG AB W PELV DAMAG-INC............................. 57
63522... LEG AB W PELV DAMAG-COMP............................ 57
63530... LEG ABOR W REN FAIL-UNSP............................ 57
63531... LEG ABOR W REN FAIL-INC............................. 57
63532... LEG ABOR W REN FAIL-COMP............................ 57
63540... LEG AB W METAB DIS-UNSP............................. 57
63541... LEG AB W METAB DIS-INC.............................. 57
63542... LEG AB W METAB DIS-COMP............................. 57
63550... LEGAL ABORT W SHOCK-UNSP............................ 57
63551... LEGAL ABORT W SHOCK-INC............................. 57
63552... LEGAL ABORT W SHOCK-COMP............................ 57
63560... LEGAL ABORT W EMBOL-UNSP............................ 57
63561... LEGAL ABORT W EMBOL-INC............................. 57
63562... LEGAL ABORT W EMBOL-COMP............................ 57
63570... LEG AB W COMPL NEC-UNSP............................. 57
63571... LEG AB W COMPL NEC-INC.............................. 57
63572... LEG AB W COMPL NEC-COMP............................. 57
63580... LEG AB W COMPL NOS-UNSP............................. 57
63581... LEG AB W COMPL NOS-INC.............................. 57
63582... LEG AB W COMPL NOS-COMP............................. 57
63590... LEGAL ABORT UNCOMPL-UNSP............................ 57
63591... LEGAL ABORT UNCOMPL-INC............................. 57
63592... LEGAL ABORT UNCOMPL-COMP............................ 57
63600... ILLEG AB W PELV INF-UNSP............................ 57
63601... ILLEG AB W PELV INF-INC............................. 57
63602... ILLEG AB W PELV INF-COMP............................ 57
63610... ILLEG AB W HEMORR-UNSPEC............................ 57
63611... ILLEG AB W HEMORR-INC............................... 57
63612... ILLEG AB W HEMORR-COMP.............................. 57
63620... ILLEG AB W PEL DAMG-UNSP............................ 57
63621... ILLEG AB W PEL DAMAG-INC............................ 57
63622... ILLEG AB W PEL DAMG-COMP............................ 57
63630... ILLEG AB W REN FAIL-UNSP............................ 57
63631... ILLEG AB W REN FAIL-INC............................. 57
63632... ILLEG AB W REN FAIL-COMP............................ 57
63640... ILLEG AB W MET DIS-UNSP............................. 57
63641... ILLEG AB W METAB DIS-INC............................ 57
63642... ILLEG AB W MET DIS-COMP............................. 57
63650... ILLEG ABORT W SHOCK-UNSP............................ 57
63651... ILLEG ABORT W SHOCK-INC............................. 57
63652... ILLEG ABORT W SHOCK-COMP............................ 57
63660... ILLEG AB W EMBOLISM-UNSP............................ 57
63661... ILLEG AB W EMBOLISM-INC............................. 57
63662... ILLEG AB W EMBOLISM-COMP............................ 57
63670... ILLG AB W COMPL NEC-UNSP............................ 57
63671... ILLEG AB W COMPL NEC-INC............................ 57
63672... ILLG AB W COMPL NEC-COMP............................ 57
63680... ILLG AB W COMPL NOS-UNSP............................ 57
63681... ILLEG AB W COMPL NOS-INC............................ 57
63682... ILLG AB W COMPL NOS-COMP............................ 57
63690... ILLEG ABORT UNCOMPL-UNSP............................ 57
63691... ILLEG ABORT UNCOMPL-INC............................. 57
63692... ILLEG ABORT UNCOMPL-COMP............................ 57
63700... ABORT NOS W PEL INF-UNSP............................ 57
[[Page 47907]]
63701... ABORT NOS W PEL INF-INC............................. 57
63702... ABORT NOS W PEL INF-COMP............................ 57
63710... ABORT NOS W HEMORR-UNSP............................. 57
63711... ABORT NOS W HEMORR-INC.............................. 57
63712... ABORT NOS W HEMORR-COMP............................. 57
63720... AB NOS W PELV DAMAG-UNSP............................ 57
63721... AB NOS W PELV DAMAG-INC............................. 57
63722... AB NOS W PELV DAMAG-COMP............................ 57
63730... AB NOS W RENAL FAIL-UNSP............................ 57
63731... AB NOS W RENAL FAIL-INC............................. 57
63732... AB NOS W RENAL FAIL-COMP............................ 57
63740... AB NOS W METAB DIS-UNSP............................. 57
63741... AB NOS W METAB DIS-INC.............................. 57
63742... AB NOS W METAB DIS-COMP............................. 57
63750... ABORT NOS W SHOCK-UNSP.............................. 57
63751... ABORT NOS W SHOCK-INC............................... 57
63752... ABORT NOS W SHOCK-COMP.............................. 57
63760... AB NOS W EMBOLISM-UNSP.............................. 57
63761... AB NOS W EMBOLISM-INC............................... 57
63762... AB NOS W EMBOLISM-COMP.............................. 57
63770... AB NOS W COMPL NEC-UNSP............................. 57
63771... AB NOS W COMPL NEC-INC.............................. 57
63772... AB NOS W COMPL NEC-COMP............................. 57
63780... AB NOS W COMPL NOS-UNSP............................. 57
63781... AB NOS W COMPL NOS-INC.............................. 57
63782... AB NOS W COMPL NOS-COMP............................. 57
63790... AB NOS UNCOMPLICAT-UNSP............................. 57
63791... AB NOS UNCOMPLICAT-INC.............................. 57
63792... AB NOS UNCOMPLICAT-COMP............................. 57
6380.... ATTEM ABORT W PELVIC INF............................ 57
6381.... ATTEM ABORT W HEMORRHAGE............................ 57
6382.... ATTEM ABORT W PELV DAMAG............................ 57
6383.... ATTEM ABORT W RENAL FAIL............................ 57
6384.... ATTEM ABOR W METABOL DIS............................ 57
6385.... ATTEM ABORTION W SHOCK.............................. 57
6386.... ATTEMP ABORT W EMBOLISM............................. 57
6387.... ATTEMP ABORT W COMPL NEC............................ 57
6388.... ATTEMP ABORT W COMPL NOS............................ 57
6389.... ATTEMPTED ABORT UNCOMPL............................. 57
6390.... POSTABORTION GU INFECT.............................. 57
6391.... POSTABORTION HEMORRHAGE............................. 57
6392.... POSTABORT PELVIC DAMAGE............................. 57
6393.... POSTABORT RENAL FAILURE............................. 57
6394.... POSTABORT METABOLIC DIS............................. 57
6395.... POSTABORTION SHOCK.................................. 57
6396.... POSTABORTION EMBOLISM............................... 57
6398.... POSTABORTION COMPL NEC.............................. 57
6399.... POSTABORTION COMPL NOS.............................. 57
64000... THREATENED ABORT-UNSPEC............................. 57
*64001.. THREATENED ABORT-DELIVER............................ ........
64003... THREATEN ABORT-ANTEPART............................. 57
64080... HEM EARLY PREG NEC-UNSP............................. 57
*64081.. HEM EARLY PREG NEC-DELIV............................ ........
64083... HEM EARLY PG NEC-ANTEPAR............................ 57
64090... HEMORR EARLY PREG-UNSPEC............................ 57
*64091.. HEM EARLY PREG-DELIVERED............................ ........
64093... HEM EARLY PREG-ANTEPART............................. 57
64100... PLACENTA PREVIA-UNSPEC.............................. 57
*64101.. PLACENTA PREVIA-DELIVER............................. ........
64103... PLACENTA PREVIA-ANTEPART............................ 57
64110... PLACENTA PREV HEM-UNSPEC............................ 57
*64111.. PLACENTA PREV HEM-DELIV............................. ........
64113... PLACEN PREV HEM-ANTEPART............................ 57
64120... PREM SEPAR PLACEN-UNSPEC............................ 57
64121... PREM SEPAR PLACEN-DELIV............................. 57
64123... PREM SEPAR PLAC-ANTEPART............................ 57
64130... COAG DEF HEMORR-UNSPEC.............................. 57
64131... COAG DEF HEMORR-DELIVER............................. 57
64133... COAG DEF HEMORR-ANTEPART............................ 57
64180... ANTEPART HEM NEC-UNSPEC............................. 57
*64181.. ANTEPARTUM HEM NEC-DELIV............................ ........
64183... ANTEPART HEM NEC-ANTEPAR............................ 57
64190... ANTEPART HEM NOS-UNSPEC............................. 57
*64191.. ANTEPARTUM HEM NOS-DELIV............................ ........
64193... ANTEPART HEM NOS-ANTEPAR............................ 57
64200... ESSEN HYPERTEN PREG-UNSP............................ 57
[[Page 47908]]
*64201.. ESSEN HYPERTEN-DELIVERED............................ ........
*64202.. ESSEN HYPERTEN-DEL W P/P............................ ........
64203... ESSEN HYPERTEN-ANTEPART............................. 57
64204... ESSEN HYPERTEN-POSTPART............................. 57
64210... RENAL HYPERTEN PREG-UNSP............................ 57
*64211.. RENAL HYPERTEN PG-DELIV............................. ........
*64212.. RENAL HYPERTEN-DEL P/P.............................. ........
64213... RENAL HYPERTEN-ANTEPART............................. 57
64214... RENAL HYPERTEN-POSTPART............................. 57
64220... OLD HYPERTEN PREG-UNSPEC............................ 57
*64221.. OLD HYPERTEN NEC-DELIVER............................ ........
*64222.. OLD HYPERTEN-DELIV W P/P............................ ........
64223... OLD HYPERTEN NEC-ANTEPAR............................ 57
64224... OLD HYPERTEN NEC-POSTPAR............................ 57
64230... TRANS HYPERTEN PREG-UNSP............................ 57
*64231.. TRANS HYPERTEN-DELIVERED............................ ........
*64232.. TRANS HYPERTEN-DEL W P/P............................ ........
64233... TRANS HYPERTEN-ANTEPART............................. 57
64234... TRANS HYPERTEN-POSTPART............................. 57
64240... MILD/NOS PREECLAMP-UNSP............................. 57
*64241.. MILD/NOS PREECLAMP-DELIV............................ ........
*64242.. MILD PREECLAMP-DEL W P/P............................ ........
64243... MILD/NOS PREECLAMP-ANTEP............................ 57
64244... MILD/NOS PREECLAMP-P/P.............................. 57
64250... SEVERE PREECLAMP-UNSPEC............................. 57
*64251.. SEVERE PREECLAMP-DELIVER............................ ........
*64252.. SEV PREECLAMP-DEL W P/P............................. ........
64253... SEV PREECLAMP-ANTEPARTUM............................ 57
64254... SEV PREECLAMP-POSTPARTUM............................ 57
64260... ECLAMPSIA-UNSPECIFIED............................... 57
*64261.. ECLAMPSIA-DELIVERED................................. ........
*64262.. ECLAMPSIA-DELIV W P/P............................... ........
64263... ECLAMPSIA-ANTEPARTUM................................ 57
64264... ECLAMPSIA-POSTPARTUM................................ 57
64270... TOX W OLD HYPERTEN-UNSP............................. 57
*64271.. TOX W OLD HYPERTEN-DELIV............................ ........
*64272.. TOX W OLD HYP-DEL W P/P............................. ........
64273... TOX W OLD HYPER-ANTEPART............................ 57
64274... TOX W OLD HYPER-POSTPART............................ 57
64290... HYPERTEN PREG NOS-UNSPEC............................ 57
*64291.. HYPERTENS NOS-DELIVERED............................. ........
*64292.. HYPERTENS NOS-DEL W P/P............................. ........
64293... HYPERTENS NOS-ANTEPARTUM............................ 57
64294... HYPERTENS NOS-POSTPARTUM............................ 57
64300... MILD HYPEREM GRAV-UNSPEC............................ 57
*64301.. MILD HYPEREM GRAV-DELIV............................. ........
64303... MILD HYPEREMESIS-ANTEPAR............................ 57
64310... HYPEREM W METAB DIS-UNSP............................ 57
*64311.. HYPEREM W METAB DIS-DEL............................. ........
64313... HYPEREM W METAB-ANTEPART............................ 57
64320... LATE VOMIT OF PREG-UNSP............................. 57
*64321.. LATE VOMIT OF PREG-DELIV............................ ........
64323... LATE VOMIT PREG-ANTEPART............................ 57
64380... VOMIT COMPL PREG-UNSPEC............................. 57
*64381.. VOMIT COMPL PREG-DELIVER............................ ........
*64383.. VOMIT COMPL PREG-ANTEPAR............................ 57
64390... VOMIT OF PREG NOS-UNSPEC............................ 57
*64391.. VOMIT OF PREG NOS-DELIV............................. ........
*64393.. VOMIT OF PG NOS-ANTEPART............................ 57
64400... THREAT PREM LABOR-UNSPEC............................ 57
64403... THRT PREM LABOR-ANTEPART............................ 57
*64410.. THREAT LABOR NEC-UNSPEC............................. 57
64413... THREAT LABOR NEC-ANTEPAR............................ 57
64420... EARLY ONSET DELIV-UNSPEC............................ 57
*64421.. EARLY ONSET DELIVERY-DEL............................ ........
64500... PROLONGED PREG-UNSPEC............................... 57
*64501.. PROLONGED PREG-DELIVERED............................ ........
64503... PROLONGED PREG-ANTEPART............................. 57
64600... PAPYRACEOUS FETUS-UNSPEC............................ 57
*64601.. PAPYRACEOUS FETUS-DELIV............................. ........
64603... PAPYRACEOUS FET-ANTEPAR............................. 57
64610... EDEMA IN PREG-UNSPEC................................ 57
*64611.. EDEMA IN PREG-DELIVERED............................. ........
*64612.. EDEMA IN PREG-DEL W P/P............................. ........
64613... EDEMA IN PREG-ANTEPARTUM............................ 57
64614... EDEMA IN PREG-POSTPARTUM............................ 57
[[Page 47909]]
64620... RENAL DIS PREG NOS-UNSP............................. 57
*64621.. RENAL DIS NOS-DELIVERED............................. ........
*64622.. RENAL DIS NOS-DEL W P/P............................. ........
*64623.. RENAL DIS NOS-ANTEPARTUM............................ 57
64624... RENAL DIS NOS-POSTPARTUM............................ 57
64630... HABITUAL ABORTER-UNSPEC............................. 57
*64631.. HABITUAL ABORTER-DELIVER............................ ........
64633... HABITUAL ABORT-ANTEPART............................. 57
64640... NEURITIS OF PREG-UNSPEC............................. 57
*64641.. NEURITIS-DELIVERED.................................. ........
*64642.. NEURITIS-DELIVERED W P/P............................ ........
64643... NEURITIS OF PREG-ANTEPAR............................ 57
64644... NEURITIS OF PREG-POSTPAR............................ 57
64650... BACTERIURIA PREG-UNSPEC............................. 57
*64651.. ASYM BACTERIURIA-DELIVER............................ ........
*64652.. ASY BACTERURIA-DEL W P/P............................ ........
64653... ASY BACTERIURIA-ANTEPART............................ 57
64654... ASY BACTERIURIA-POSTPART............................ 57
64660... GU INFECT IN PREG-UNSPEC............................ 57
*64661.. GU INFECTION-DELIVERED.............................. ........
*64662.. GU INFECTION-DELIV W P/P............................ ........
64663... GU INFECTION-ANTEPARTUM............................. 57
64664... GU INFECTION-POSTPARTUM............................. 57
64670... LIVER DIS IN PREG-UNSPEC............................ 57
*64671.. LIVER DISORDER-DELIVERED............................ ........
64673... LIVER DISORDER-ANTEPART............................. 57
64680... PREG COMPL NEC-UNSPEC............................... 57
*64681.. PREG COMPL NEC-DELIVERED............................ ........
*64682.. PREG COMPL NEC-DEL W P/P............................ ........
64683... PREG COMPL NEC-ANTEPART............................. 57
64684... PREG COMPL NEC-POSTPART............................. 57
64690... PREG COMPL NOS-UNSPEC............................... 57
*64691.. PREG COMPL NOS-DELIVERED............................ ........
64693... PREG COMPL NOS-ANTEPART............................. 57
64700... SYPHILIS IN PREG-UNSPEC............................. 57
*64701.. SYPHILIS-DELIVERED.................................. ........
*64702.. SYPHILIS-DELIVERED W P/P............................ ........
64703... SYPHILIS-ANTEPARTUM................................. 57
64704... SYPHILIS-POSTPARTUM................................. 57
64710... GONORRHEA IN PREG-UNSPEC............................ 57
*64711.. GONORRHEA-DELIVERED................................. ........
*64712.. GONORRHEA-DELIVER W P/P............................. ........
64713... GONORRHEA-ANTEPARTUM................................ 57
64714... GONORRHEA-POSTPARTUM................................ 57
64720... OTHER VD IN PREG-UNSPEC............................. 57
*64721.. OTHER VD-DELIVERED.................................. ........
*64722.. OTHER VD-DELIVERED W P/P............................ ........
64723... OTHER VD-ANTEPARTUM................................. 57
64724... OTHER VD-POSTPARTUM................................. 57
64730... TB IN PREG-UNSPECIFIED.............................. 57
*64731.. TUBERCULOSIS-DELIVERED.............................. ........
*64732.. TUBERCULOSIS-DELIV W P/P............................ ........
64733... TUBERCULOSIS-ANTEPARTUM............................. 57
64734... TUBERCULOSIS-POSTPARTUM............................. 57
64740... MALARIA IN PREG-UNSPEC.............................. 57
*64741.. MALARIA-DELIVERED................................... ........
*64742.. MALARIA-DELIVERED W P/P............................. ........
64743... MALARIA-ANTEPARTUM.................................. 57
64744... MALARIA-POSTPARTUM.................................. 57
64750... RUBELLA IN PREG-UNSPEC.............................. 57
*64751.. RUBELLA-DELIVERED................................... ........
*64752.. RUBELLA-DELIVERED W P/P............................. ........
64753... RUBELLA-ANTEPARTUM.................................. 57
64754... RUBELLA-POSTPARTUM.................................. 57
64760... OTH VIRUS IN PREG-UNSPEC............................ 57
*64761.. OTH VIRAL DIS-DELIVERED............................. ........
*64762.. OTH VIRAL DIS-DEL W P/P............................. ........
64763... OTH VIRAL DIS-ANTEPARTUM............................ 57
64764... OTH VIRAL DIS-POSTPARTUM............................ 57
64780... INF DIS IN PREG NEC-UNSP............................ 57
*64781.. INFECT DIS NEC-DELIVERED............................ ........
*64782.. INFECT DIS NEC-DEL W P/P............................ ........
64783... INFECT DIS NEC-ANTEPART............................. 57
64784... INFECT DIS NEC-POSTPART............................. 57
64790... INFECT IN PREG NOS-UNSP............................. 57
*64791.. INFECT NOS-DELIVERED................................ ........
[[Page 47910]]
*64792.. INFECT NOS-DELIVER W P/P............................ ........
64793... INFECT NOS-ANTEPARTUM............................... 57
64794... INFECT NOS-POSTPARTUM............................... 57
64800... DIABETES IN PREG-UNSPEC............................. 57
*64801.. DIABETES-DELIVERED.................................. ........
*64802.. DIABETES-DELIVERED W P/P............................ ........
64803... DIABETES-ANTEPARTUM................................. 57
64804... DIABETES-POSTPARTUM................................. 57
64810... THYROID DYSFUN PREG-UNSP............................ 57
*64811.. THYROID DYSFUNC-DELIVER............................. ........
*64812.. THYROID DYSFUN-DEL W P/P............................ ........
64813... THYROID DYSFUNC-ANTEPART............................ 57
64814... THYROID DYSFUNC-POSTPART............................ 57
64820... ANEMIA IN PREG-UNSPEC............................... 57
*64821.. ANEMIA-DELIVERED.................................... ........
*64822.. ANEMIA-DELIVERED W P/P.............................. ........
64823... ANEMIA-ANTEPARTUM................................... 57
64824... ANEMIA-POSTPARTUM................................... 57
64830... DRUG DEPEND PREG-UNSPEC............................. 57
*64831.. DRUG DEPENDENCE-DELIVER............................. ........
*64832.. DRUG DEPENDEN-DEL W P/P............................. ........
64833... DRUG DEPENDENCE-ANTEPART............................ 57
64834... DRUG DEPENDENCE-POSTPART............................ 57
64840... MENTAL DIS PREG-UNSPEC.............................. 57
*64841.. MENTAL DISORDER-DELIVER............................. ........
*64842.. MENTAL DIS-DELIV W P/P.............................. ........
64843... MENTAL DISORDER-ANTEPART............................ 57
64844... MENTAL DISORDER-POSTPART............................ 57
64850... CONGEN CV DIS PREG-UNSP............................. 57
*64851.. CONGEN CV DIS-DELIVERED............................. ........
*64852.. CONGEN CV DIS-DEL W P/P............................. ........
64853... CONGEN CV DIS-ANTEPARTUM............................ 57
64854... CONGEN CV DIS-POSTPARTUM............................ 57
64860... CV DIS NEC PREG-UNSPEC.............................. 57
*64861.. CV DIS NEC PREG-DELIVER............................. ........
*64862.. CV DIS NEC-DELIVER W P/P............................ ........
64863... CV DIS NEC-ANTEPARTUM............................... 57
64864... CV DIS NEC-POSTPARTUM............................... 57
64870... BONE DISORD IN PREG-UNSP............................ 57
*64871.. BONE DISORDER-DELIVERED............................. ........
*64872.. BONE DISORDER-DEL W P/P............................. ........
64873... BONE DISORDER-ANTEPARTUM............................ 57
64874... BONE DISORDER-POSTPARTUM............................ 57
64880... ABN GLUCOSE IN PREG-UNSP............................ 57
*64881.. ABN GLUCOSE TOLER-DELIV............................. ........
*64882.. ABN GLUCOSE-DELIV W P/P............................. ........
64883... ABN GLUCOSE-ANTEPARTUM.............................. 57
64884... ABN GLUCOSE-POSTPARTUM.............................. 57
64890... OTH CURR COND PREG-UNSP............................. 57
*64891.. OTH CURR COND-DELIVERED............................. ........
*64892.. OTH CURR COND-DEL W P/P............................. ........
64893... OTH CURR COND-ANTEPARTUM............................ 57
64894... OTH CURR COND-POSTPARTUM............................ 57
*650.... NORMAL DELIVERY..................................... ........
65100... TWIN PREGNANCY-UNSPEC............................... 57
*65101.. TWIN PREGNANCY-DELIVERED............................ ........
65103... TWIN PREGNANCY-ANTEPART............................. 57
65110... TRIPLET PREGNANCY-UNSPEC............................ 57
*65111.. TRIPLET PREGNANCY-DELIV............................. ........
65113... TRIPLET PREG-ANTEPARTUM............................. 57
65120... QUADRUPLET PREG-UNSPEC.............................. 57
*65121.. QUADRUPLET PREG-DELIVER............................. ........
65123... QUADRUPLET PREG-ANTEPART............................ 57
65130... TWINS W FETAL LOSS-UNSP............................. 57
*65131.. TWINS W FETAL LOSS-DEL.............................. ........
65133... TWINS W FETAL LOSS-ANTE............................. 57
65140... TRIPLETS W FET LOSS-UNSP............................ 57
*65141.. TRIPLETS W FET LOSS-DEL............................. ........
65143... TRIPLETS W FET LOSS-ANTE............................ 57
65150... QUADS W FETAL LOSS-UNSP............................. 57
*65151.. QUADS W FETAL LOSS-DEL.............................. ........
65153... QUADS W FETAL LOSS-ANTE............................. 57
65160... MULT GES W FET LOSS-UNSP............................ 57
*65161.. MULT GES W FET LOSS-DEL............................. ........
65163... MULT GES W FET LOSS-ANTE............................ 57
65180... MULTI GESTAT NEC-UNSPEC............................. 57
[[Page 47911]]
*65181.. MULTI GESTAT NEC-DELIVER............................ ........
65183... MULTI GEST NEC-ANTEPART............................. 57
65190... MULTI GESTAT NOS-UNSPEC............................. 57
*65191.. MULT GESTATION NOS-DELIV............................ ........
65193... MULTI GEST NOS-ANTEPART............................. 57
65200... UNSTABLE LIE-UNSPECIFIED............................ 57
*65201.. UNSTABLE LIE-DELIVERED.............................. ........
65203... UNSTABLE LIE-ANTEPARTUM............................. 57
65210... CEPHALIC VERS NOS-UNSPEC............................ 57
*65211.. CEPHALIC VERS NOS-DELIV............................. ........
65213... CEPHAL VERS NOS-ANTEPART............................ 57
65220... BREECH PRESENTAT-UNSPEC............................. 57
*65221.. BREECH PRESENTAT-DELIVER............................ ........
65223... BREECH PRESENT-ANTEPART............................. 57
65230... TRANSV/OBLIQ LIE-UNSPEC............................. 57
*65231.. TRANSVER/OBLIQ LIE-DELIV............................ ........
65233... TRANSV/OBLIQ LIE-ANTEPAR............................ 57
65240... FACE/BROW PRESENT-UNSPEC............................ 57
*65241.. FACE/BROW PRESENT-DELIV............................. ........
65243... FACE/BROW PRES-ANTEPART............................. 57
65250... HIGH HEAD AT TERM-UNSPEC............................ 57
*65251.. HIGH HEAD AT TERM-DELIV............................. ........
65253... HIGH HEAD TERM-ANTEPART............................. 57
65260... MULT GEST MALPRESEN-UNSP............................ 57
*65261.. MULT GEST MALPRES-DELIV............................. ........
65263... MULT GES MALPRES-ANTEPAR............................ 57
65270... PROLAPSED ARM-UNSPEC................................ 57
*65271.. PROLAPSED ARM-DELIVERED............................. ........
65273... PROLAPSED ARM-ANTEPART.............................. 57
65280... MALPOSITION NEC-UNSPEC.............................. 57
*65281.. MALPOSITION NEC-DELIVER............................. ........
65283... MALPOSITION NEC-ANTEPART............................ 57
65290... MALPOSITION NOS-UNSPEC.............................. 57
*65291.. MALPOSITION NOS-DELIVER............................. ........
65293... MALPOSITION NOS-ANTEPART............................ 57
65300... PELVIC DEFORM NOS-UNSPEC............................ 57
*65301.. PELVIC DEFORM NOS-DELIV............................. ........
65303... PELV DEFORM NOS-ANTEPART............................ 57
65310... CONTRACT PELV NOS-UNSPEC............................ 57
*65311.. CONTRACT PELV NOS-DELIV............................. ........
65313... CONTRAC PELV NOS-ANTEPAR............................ 57
65320... INLET CONTRACTION-UNSPEC............................ 57
*65321.. INLET CONTRACTION-DELIV............................. ........
65323... INLET CONTRACT-ANTEPART............................. 57
65330... OUTLET CONTRACTION-UNSP............................. 57
*65331.. OUTLET CONTRACTION-DELIV............................ ........
65333... OUTLET CONTRACT-ANTEPART............................ 57
65340... FETOPELV DISPROP-UNSPEC............................. 57
*65341.. FETOPELV DISPROPOR-DELIV............................ ........
65343... FETOPEL DISPROP-ANTEPART............................ 57
65350... FETAL DISPROP NOS-UNSPEC............................ 57
*65351.. FETAL DISPROP NOS-DELIV............................. ........
65353... FETAL DISPRO NOS-ANTEPAR............................ 57
65360... HYDROCEPHAL FETUS-UNSPEC............................ 57
*65361.. HYDROCEPH FETUS-DELIVER............................. ........
65363... HYDROCEPH FETUS-ANTEPART............................ 57
65370... OTH ABN FET DISPROP-UNSP............................ 57
*65371.. OTH ABN FET DISPRO-DELIV............................ ........
65373... OTH ABN FET DISPRO-ANTEP............................ 57
65380... DISPROPORTION NEC-UNSPEC............................ 57
*65381.. DISPROPORTION NEC-DELIV............................. ........
65383... DISPROPOR NEC-ANTEPARTUM............................ 57
*65390.. DISPROPORTION NOS-UNSPEC............................ ........
*65391.. DISPROPORTION NOS-DELIV............................. ........
65393... DISPROPOR NOS-ANTEPARTUM............................ 57
65400... CONG ABN UTER PREG-UNSP............................. 57
*65401.. CONGEN ABN UTERUS-DELIV............................. ........
*65402.. CONG ABN UTER-DEL W P/P............................. ........
65403... CONGEN ABN UTER-ANTEPART............................ 57
65404... CONGEN ABN UTER-POSTPART............................ 57
65410... UTER TUMOR IN PREG-UNSP............................. 57
*65411.. UTERINE TUMOR-DELIVERED............................. ........
*65412.. UTERINE TUMOR-DEL W P/P............................. ........
65413... UTERINE TUMOR-ANTEPARTUM............................ 57
65414... UTERINE TUMOR-POSTPARTUM............................ 57
65420... PREV C-DELIVERY UNSPEC.............................. 57
[[Page 47912]]
*65421.. PREV C-DELIVERY-DELIVRD............................. ........
65423... PREV C-DELIVERY-ANTEPART............................ 57
65430... RETROVERT UTERUS-UNSPEC............................. 57
*65431.. RETROVERT UTERUS-DELIVER............................ ........
*65432.. RETROVERT UTER-DEL W P/P............................ ........
65433... RETROVERT UTER-ANTEPART............................. 57
65434... RETROVERT UTER-POSTPART............................. 57
65440... ABN GRAV UTERUS NEC-UNSP............................ 57
*65441.. ABN UTERUS NEC-DELIVERED............................ ........
*65442.. ABN UTERUS NEC-DEL W P/P............................ ........
65443... ABN UTERUS NEC-ANTEPART............................. 57
65444... ABN UTERUS NEC-POSTPART............................. 57
65450... CERV INCOMPET PREG-UNSP............................. 57
*65451.. CERVICAL INCOMPET-DELIV............................. ........
*65452.. CERV INCOMPET-DEL W P/P............................. ........
65453... CERV INCOMPET-ANTEPARTUM............................ 57
65454... CERV INCOMPET-POSTPARTUM............................ 57
65460... ABN CERVIX NEC PREG-UNSP............................ 57
*65461.. ABN CERVIX NEC-DELIVERED............................ ........
*65462.. ABN CERVIX NEC-DEL W P/P............................ ........
65463... ABN CERVIX NEC-ANTEPART............................. 57
65464... ABN CERVIX NEC-POSTPART............................. 57
65470... ABN VAGINA IN PREG-UNSP............................. 57
*65471.. ABNORM VAGINA-DELIVERED............................. ........
*65472.. ABNORM VAGINA-DEL W P/P............................. ........
65473... ABNORM VAGINA-ANTEPARTUM............................ 57
65474... ABNORM VAGINA-POSTPARTUM............................ 57
65480... ABN VULVA IN PREG-UNSPEC............................ 57
*65481.. ABNORMAL VULVA-DELIVERED............................ ........
*65482.. ABNORMAL VULVA-DEL W P/P............................ ........
65483... ABNORMAL VULVA-ANTEPART............................. 57
65484... ABNORMAL VULVA-POSTPART............................. 57
65490... ABN PEL NEC IN PREG-UNSP............................ 57
*65491.. ABN PELV ORG NEC-DELIVER............................ ........
*65492.. ABN PELV NEC-DELIV W P/P............................ ........
65493... ABN PELV ORG NEC-ANTEPAR............................ 57
65494... ABN PELV ORG NEC-POSTPAR............................ 57
65500... FETAL CNS MALFORM-UNSPEC............................ 57
*65501.. FETAL CNS MALFORM-DELIV............................. ........
65503... FETAL CNS MALFOR-ANTEPAR............................ 57
65510... FETAL CHROMOS ABN-UNSPEC............................ 57
*65511.. FETAL CHROMOSO ABN-DELIV............................ ........
65513... FET CHROMO ABN-ANTEPART............................. 57
65520... FAMIL HEREDIT DIS-UNSPEC............................ 57
*65521.. FAMIL HEREDIT DIS-DELIV............................. ........
65523... FAMIL HERED DIS-ANTEPART............................ 57
65530... FET DAMG D/T VIRUS-UNSP............................. 57
*65531.. FET DAMG D/T VIRUS-DELIV............................ ........
65533... FET DAMG D/T VIRUS-ANTEP............................ 57
65540... FET DAMG D/T DIS-UNSPEC............................. 57
*65541.. FET DAMG D/T DIS-DELIVER............................ ........
65543... FET DAMG D/T DIS-ANTEPAR............................ 57
65550... FETAL DAMG D/T DRUG-UNSP............................ 57
*65551.. FET DAMAG D/T DRUG-DELIV............................ ........
65553... FET DAMG D/T DRUG-ANTEPA............................ 57
65560... RADIAT FETAL DAMAG-UNSP............................. 57
*65561.. RADIAT FETAL DAMAG-DELIV............................ ........
65563... RADIAT FET DAMAG-ANTEPAR............................ 57
65580... FETAL ABNORM NEC-UNSPEC............................. 57
*65581.. FETAL ABNORM NEC-DELIVER............................ ........
65583... FETAL ABNORM NEC-ANTEPAR............................ 57
65590... FETAL ABNORM NOS-UNSPEC............................. 57
*65591.. FETAL ABNORM NOS-DELIVER............................ ........
65593... FETAL ABNORM NOS-ANTEPAR............................ 57
65600... FETAL-MATERNAL HEM-UNSP............................. 57
*65601.. FETAL-MATERNAL HEM-DELIV............................ ........
65603... FETAL-MATERN HEM-ANTEPAR............................ 57
65610... RH ISOIMMUNIZATION-UNSP............................. 57
*65611.. RH ISOIMMUNIZAT-DELIVER............................. ........
65613... RH ISOIMMUNIZAT-ANTEPART............................ 57
65620... ABO ISOIMMUNIZATION-UNSP............................ 57
*65621.. ABO ISOIMMUNIZAT-DELIVER............................ ........
65623... ABO ISOIMMUNIZAT-ANTEPAR............................ 57
65630... FETAL DISTRESS-UNSPEC............................... 57
*65631.. FETAL DISTRESS-DELIVERED............................ ........
65633... FETAL DISTRESS-ANTEPART............................. 57
[[Page 47913]]
65640... INTRAUTERINE DEATH-UNSP............................. 57
*65641.. INTRAUTER DEATH-DELIVER............................. ........
65643... INTRAUTER DEATH-ANTEPART............................ 57
65650... POOR FETAL GROWTH-UNSPEC............................ 57
*65651.. POOR FETAL GROWTH-DELIV............................. ........
65653... POOR FETAL GRTH-ANTEPART............................ 57
65660... EXCESS FETAL GRTH-UNSPEC............................ 57
*65661.. EXCESS FETAL GRTH-DELIV............................. ........
65663... EXCESS FET GRTH-ANTEPART............................ 57
65670... OTH PLACENT COND-UNSPEC............................. 57
*65671.. OTH PLACENT COND-DELIVER............................ ........
65673... OTH PLACENT COND-ANTEPAR............................ 57
65680... FET/PLAC PROB NEC-UNSPEC............................ 57
*65681.. FET/PLAC PROB NEC-DELIV............................. ........
65683... FET/PLAC PROB NEC-ANTEPA............................ 57
65690... FET/PLAC PROB NOS-UNSPEC............................ 57
*65691.. FET/PLAC PROB NOS-DELIV............................. ........
65693... FET/PLAC PROB NOS-ANTEPA............................ 57
65700... POLYHYDRAMNIOS-UNSPEC............................... 57
*65701.. POLYHYDRAMNIOS-DELIVERED............................ ........
65703... POLYHYDRAMNIOS-ANTEPART............................. 57
65800... OLIGOHYDRAMNIOS-UNSPEC.............................. 57
*65801.. OLIGOHYDRAMNIOS-DELIVER............................. ........
65803... OLIGOHYDRAMNIOS-ANTEPAR............................. 57
65810... PREM RUPT MEMBRAN-UNSPEC............................ 57
*65811.. PREM RUPT MEMBRAN-DELIV............................. ........
65813... PREM RUPT MEMB-ANTEPART............................. 57
65820... PROLONG RUPT MEMB-UNSPEC............................ 57
65821... PROLONG RUPT MEMB-DELIV............................. 57
65823... PROLONG RUP MEMB-ANTEPAR............................ 57
65830... ARTIFIC RUPT MEMBR-UNSP............................. 57
*65831.. ARTIFIC RUPT MEMBR-DELIV............................ ........
65833... ARTIF RUPT MEMB-ANTEPART............................ 57
65840... AMNIOTIC INFECTION-UNSP............................. 57
*65841.. AMNIOTIC INFECTION-DELIV............................ ........
65843... AMNIOTIC INFECT-ANTEPART............................ 57
65880... AMNIOTIC PROB NEC-UNSPEC............................ 57
*65881.. AMNIOTIC PROB NEC-DELIV............................. ........
65883... AMNION PROB NEC-ANTEPART............................ 57
65890... AMNIOTIC PROB NOS-UNSPEC............................ 57
65891... AMNIOTIC PROB NOS-DELIV............................. 57
65893... AMNION PROB NOS-ANTEPART............................ 57
65900... FAIL MECHAN INDUCT-UNSP............................. 57
*65901.. FAIL MECH INDUCT-DELIVER............................ ........
65903... FAIL MECH INDUCT-ANTEPAR............................ 57
65910... FAIL INDUCTION NOS-UNSP............................. 57
*65911.. FAIL INDUCTION NOS-DELIV............................ ........
65913... FAIL INDUCT NOS-ANTEPART............................ 57
65920... PYREXIA IN LABOR-UNSPEC............................. 57
*65921.. PYREXIA IN LABOR-DELIVER............................ ........
65923... PYREXIA IN LABOR-ANTEPAR............................ 57
65930... SEPTICEMIA IN LABOR-UNSP............................ 57
*65931.. SEPTICEM IN LABOR-DELIV............................. ........
65933... SEPTICEM IN LABOR-ANTEPA............................ 57
65940... GRAND MULTIPARITY-UNSPEC............................ 57
*65941.. GRAND MULTIPARITY-DELIV............................. ........
65943... GRAND MULTIPARITY-ANTEPA............................ 57
65950... ELDERLY PRIMIGRAVID-UNSP............................ 57
*65951.. ELDERLY PRIMIGRAVIDA-DEL............................ ........
65953... ELDER PRIMIGRAVID-ANTEPA............................ 57
65960... OTH ADVNCD MTRNL AGE UNS............................ 57
*65961.. OTH ADVNCD MTRNL AGE DEL............................ ........
65963... OTH ADVNCD MTRNL AGE ANT............................ 57
65980... COMPLIC LABOR NEC-UNSP.............................. 57
*65981.. COMPLIC LABOR NEC-DELIV............................. ........
65983... COMPL LABOR NEC-ANTEPART............................ 57
65990... COMPLIC LABOR NOS-UNSP.............................. 57
*65991.. COMPLIC LABOR NOS-DELIV............................. ........
65993... COMPL LABOR NOS-ANTEPART............................ 57
66000... OBSTRUCT/FET MALPOS-UNSP............................ 57
*66001.. OBSTRUC/FET MALPOS-DELIV............................ ........
66003... OBSTRUC/FET MALPOS-ANTEP............................ 57
66010... BONY PELV OBSTRUC-UNSPEC............................ 57
*66011.. BONY PELV OBSTRUCT-DELIV............................ ........
66013... BONY PELV OBSTRUC-ANTEPA............................ 57
66020... ABN PELV TISS OBSTR-UNSP............................ 57
[[Page 47914]]
66021... ABN PELV TIS OBSTR-DELIV............................ 57
66023... ABN PELV TIS OBSTR-ANTEP............................ 57
66030... PERSIST OCCIPITPOST-UNSP............................ 57
*66031.. PERSIST OCCIPTPOST-DELIV............................ ........
66033... PERSIST OCCIPTPOST-ANTEP............................ 57
66040... SHOULDER DYSTOCIA-UNSPEC............................ 57
*66041.. SHOULDER DYSTOCIA-DELIV............................. ........
66043... SHOULDER DYSTOCIA-ANTEPA............................ 57
66050... LOCKED TWINS-UNSPECIFIED............................ 57
*66051.. LOCKED TWINS-DELIVERED.............................. ........
66053... LOCKED TWINS-ANTEPARTUM............................. 57
66060... FAIL TRIAL LAB NOS-UNSP............................. 57
*66061.. FAIL TRIAL LAB NOS-DELIV............................ ........
66063... FAIL TRIAL LAB NOS-ANTEP............................ 57
66070... FAILED FORCEP NOS-UNSPEC............................ 57
*66071.. FAILED FORCEPS NOS-DELIV............................ ........
66073... FAIL FORCEPS NOS-ANTEPAR............................ 57
66080... OBSTRUC LABOR NEC-UNSPEC............................ 57
*66081.. OBSTRUCT LABOR NEC-DELIV............................ ........
66083... OBSTRUC LABOR NEC-ANTEPA............................ 57
66090... OBSTRUC LABOR NOS-UNSPEC............................ 57
*66091.. OBSTRUCT LABOR NOS-DELIV............................ ........
66093... OBSTRUC LABOR NOS-ANTEPA............................ 57
66100... PRIM UTERINE INERT-UNSP............................. 57
*66101.. PRIM UTERINE INERT-DELIV............................ ........
66103... PRIM UTER INERT-ANTEPART............................ 57
66110... SEC UTERINE INERT-UNSPEC............................ 57
*66111.. SEC UTERINE INERT-DELIV............................. ........
66113... SEC UTERINE INERT-ANTEPA............................ 57
66120... UTERINE INERTIA NEC-UNSP............................ 57
*66121.. UTERINE INERT NEC-DELIV............................. ........
66123... UTERINE INERT NEC-ANTEPA............................ 57
66130... PRECIPITATE LABOR-UNSPEC............................ 57
*66131.. PRECIPITATE LABOR-DELIV............................. ........
66133... PRECIPITATE LABOR-ANTEPA............................ 57
66140... UTER DYSTOCIA NOS-UNSPEC............................ 57
*66141.. UTER DYSTOCIA NOS-DELIV............................. ........
66143... UTER DYSTOCIA NOS-ANTEPA............................ 57
66190... ABNORMAL LABOR NOS-UNSP............................. 57
*66191.. ABNORMAL LABOR NOS-DELIV............................ ........
66193... ABNORM LABOR NOS-ANTEPAR............................ 57
66200... PROLONGED 1ST STAGE-UNSP............................ 57
*66201.. PROLONG 1ST STAGE-DELIV............................. ........
66203... PROLONG 1ST STAGE-ANTEPA............................ 57
66210... PROLONGED LABOR NOS-UNSP............................ 57
*66211.. PROLONG LABOR NOS-DELIV............................. ........
66213... PROLONG LABOR NOS-ANTEPA............................ 57
66220... PROLONGED 2ND STAGE-UNSP............................ 57
*66221.. PROLONG 2ND STAGE-DELIV............................. ........
66223... PROLONG 2ND STAGE-ANTEPA............................ 57
66230... DELAY DEL 2ND TWIN-UNSP............................. 57
*66231.. DELAY DEL 2ND TWIN-DELIV............................ ........
66233... DELAY DEL 2 TWIN-ANTEPAR............................ 57
66300... CORD PROLAPSE-UNSPEC................................ 57
*66301.. CORD PROLAPSE-DELIVERED............................. ........
66303... CORD PROLAPSE-ANTEPARTUM............................ 57
66310... CORD AROUND NECK-UNSPEC............................. 57
*66311.. CORD AROUND NECK-DELIVER............................ ........
66313... CORD AROUND NECK-ANTEPAR............................ 57
66320... CORD COMPRESS NEC-UNSPEC............................ 57
*66321.. CORD COMPRESS NEC-DELIV............................. ........
66323... CORD COMPRES NEC-ANTEPAR............................ 57
66330... CORD ENTANGLE NEC-UNSPEC............................ 57
*66331.. CORD ENTANGLE NEC-DELIV............................. ........
66333... CORD ENTANGL NEC-ANTEPAR............................ 57
66340... SHORT CORD-UNSPECIFIED.............................. 57
*66341.. SHORT CORD-DELIVERED................................ ........
66343... SHORT CORD-ANTEPARTUM............................... 57
66350... VASA PREVIA-UNSPECIFIED............................. 57
*66351.. VASA PREVIA-DELIVERED............................... ........
66353... VASA PREVIA-ANTEPARTUM.............................. 57
66360... VASC LESION CORD-UNSPEC............................. 57
*66361.. VASC LESION CORD-DELIVER............................ ........
66363... VASC LESION CORD-ANTEPAR............................ 57
66380... CORD COMPLICAT NEC-UNSP............................. 57
*66381.. CORD COMPLICAT NEC-DELIV............................ ........
[[Page 47915]]
66383... CORD COMPL NEC-ANTEPART............................. 57
66390... CORD COMPLICAT NOS-UNSP............................. 57
*66391.. CORD COMPLICAT NOS-DELIV............................ ........
66393... CORD COMPL NOS-ANTEPART............................. 57
66400... DEL W 1 DEG LACERAT-UNSP............................ 57
*66401.. DEL W 1 DEG LACERAT-DEL............................. ........
66404... DEL W 1 DEG LAC-POSTPART............................ 57
66410... DEL W 2 DEG LACERAT-UNSP............................ 57
*66411.. DEL W 2 DEG LACERAT-DEL............................. ........
66414... DEL W 2 DEG LAC-POSTPART............................ 57
66420... DEL W 3 DEG LACERAT-UNSP............................ 57
*66421.. DEL W 3 DEG LACERAT-DEL............................. ........
66424... DEL W 3 DEG LAC-POSTPART............................ 57
66430... DEL W 4 DEG LACERAT-UNSP............................ 57
*66431.. DEL W 4 DEG LACERAT-DEL............................. ........
66434... DEL W 4 DEG LAC-POSTPART............................ 57
66440... OB PERINEAL LAC NOS-UNSP............................ 57
*66441.. OB PERINEAL LAC NOS-DEL............................. ........
66444... PERINEAL LAC NOS-POSTPAR............................ 57
66450... OB PERINEAL HEMATOM-UNSP............................ 57
*66451.. OB PERINEAL HEMATOMA-DEL............................ ........
66454... PERIN HEMATOMA-POSTPART............................. 57
66480... OB PERIN TRAUM NEC-UNSP............................. 57
*66481.. OB PERINEAL TRAU NEC-DEL............................ ........
66484... PERIN TRAUM NEC-POSTPART............................ 57
66490... OB PERIN TRAUM NOS-UNSP............................. 57
*66491.. OB PERINEAL TRAU NOS-DEL............................ ........
66494... PERIN TRAUM NOS-POSTPART............................ 57
66500... PRELABOR RUPT UTER-UNSP............................. 57
*66501.. PRELABOR RUPT UTERUS-DEL............................ ........
66503... PRELAB RUPT UTER-ANTEPAR............................ 57
66510... RUPTURE UTERUS NOS-UNSP............................. 57
*66511.. RUPTURE UTERUS NOS-DELIV............................ ........
66520... INVERSION OF UTERUS-UNSP............................ 57
*66522.. INVERS UTERUS-DEL W P/P............................. ........
66524... INVERS UTERUS-POSTPART.............................. 57
66530... LACERAT OF CERVIX-UNSPEC............................ 57
*66531.. LACERAT OF CERVIX-DELIV............................. ........
66534... LACER OF CERVIX-POSTPART............................ 57
66540... HIGH VAGINAL LACER-UNSP............................. 57
*66541.. HIGH VAGINAL LACER-DELIV............................ ........
66544... HIGH VAGINAL LAC-POSTPAR............................ 57
66550... OB INJ PELV ORG NEC-UNSP............................ 57
*66551.. OB INJ PELV ORG NEC-DEL............................. ........
66554... INJ PELV ORG NEC-POSTPAR............................ 57
66560... DAMAGE TO PELVIC JT-UNSP............................ 57
*66561.. DAMAGE TO PELVIC JT-DEL............................. ........
66564... DAMAGE PELVIC JT-POSTPAR............................ 57
66570... OB PELVIC HEMATOMA-UNSP............................. 57
*66571.. OB PELVIC HEMATOMA-DELIV............................ ........
*66572.. PELVIC HEMATOM-DEL W PP............................. ........
66574... PELVIC HEMATOMA-POSTPART............................ 57
66580... OB TRAUMA NEC-UNSPEC................................ 57
*66581.. OB TRAUMA NEC-DELIVERED............................. ........
*66582.. OB TRAUMA NEC-DEL W P/P............................. ........
66583... OB TRAUMA NEC-ANTEPARTUM............................ 57
66584... OB TRAUMA NEC-POSTPARTUM............................ 57
66590... OB TRAUMA NOS-UNSPEC................................ 57
*66591.. OB TRAUMA NOS-DELIVERED............................. ........
*66592.. OB TRAUMA NOS-DEL W P/P............................. ........
66593... OB TRAUMA NOS-ANTEPARTUM............................ 57
66594... OB TRAUMA NOS-POSTPARTUM............................ 57
66600... THIRD-STAGE HEM-UNSPEC.............................. 57
*66602.. THRD-STAGE HEM-DEL W P/P............................ ........
66604... THIRD-STAGE HEM-POSTPART............................ 57
66610... POSTPARTUM HEM NEC-UNSP............................. 57
*66612.. POSTPA HEM NEC-DEL W P/P............................ ........
66614... POSTPART HEM NEC-POSTPAR............................ 57
66620... DELAY P/PART HEM-UNSPEC............................. 57
*66622.. DELAY P/P HEM-DEL W P/P............................. ........
66624... DELAY P/PART HEM-POSTPAR............................ 57
66630... POSTPART COAGUL DEF-UNSP............................ 57
*66632.. P/P COAG DEF-DEL W P/P.............................. ........
66634... POSTPART COAG DEF-POSTPA............................ 57
66700... RETAIN PLACENTA NOS-UNSP............................ 57
*66702.. RETND PLAC NOS-DEL W P/P............................ ........
[[Page 47916]]
66704... RETAIN PLAC NOS-POSTPART............................ 57
66710... RETAIN PROD CONCEPT-UNSP............................ 57
*66712.. RET PROD CONC-DEL W P/P............................. ........
66714... RET PROD CONCEPT-POSTPAR............................ 57
66800... PULM COMPL IN DEL-UNSPEC............................ 57
*66801.. PULM COMPL IN DEL-DELIV............................. ........
*66802.. PULM COMPLIC-DEL W P/P.............................. ........
66803... PULM COMPLICAT-ANTEPART............................. 57
66804... PULM COMPLICAT-POSTPART............................. 57
66810... HEART COMPL IN DEL-UNSP............................. 57
*66811.. HEART COMPL IN DEL-DELIV............................ ........
*66812.. HEART COMPL-DEL W P/P............................... ........
66813... HEART COMPLIC-ANTEPART.............................. 57
66814... HEART COMPLIC-POSTPART.............................. 57
66820... CNS COMPL LABOR/DEL-UNSP............................ 57
*66821.. CNS COMPL LAB/DEL-DELIV............................. ........
*66822.. CNS COMPLIC-DEL W P/P............................... ........
66823... CNS COMPL IN DEL-ANTEPAR............................ 57
66824... CNS COMPL IN DEL-POSTPAR............................ 57
66880... ANESTH COMP DEL NEC-UNSP............................ 57
*66881.. ANESTH COMPL NEC-DELIVER............................ ........
*66882.. ANESTH COMPL NEC-DEL P/P............................ ........
66883... ANESTH COMPL ANTEPARTUM............................. 57
66884... ANESTH COMPL-POSTPARTUM............................. 57
66890... ANESTH COMP DEL NOS-UNSP............................ 57
*66891.. ANESTH COMPL NOS-DELIVER............................ ........
*66892.. ANESTH COMPL NOS-DEL P/P............................ ........
66893... ANESTH COMPL-ANTEPARTUM............................. 57
66894... ANESTH COMPL-POSTPARTUM............................. 57
66900... MATERNAL DISTRESS-UNSPEC............................ 57
*66901.. MATERNAL DISTRESS-DELIV............................. ........
*66902.. MATERN DISTRES-DEL W P/P............................ ........
66903... MATERN DISTRESS-ANTEPAR............................. 57
66904... MATERN DISTRESS-POSTPART............................ 57
66910... OBSTETRIC SHOCK-UNSPEC.............................. 57
*66911.. OBSTETRIC SHOCK-DELIVER............................. ........
*66912.. OBSTET SHOCK-DELIV W P/P............................ ........
66913... OBSTETRIC SHOCK-ANTEPAR............................. 57
66914... OBSTETRIC SHOCK-POSTPART............................ 57
66920... MATERN HYPOTENS SYN-UNSP............................ 57
*66921.. MATERN HYPOTEN SYN-DELIV............................ ........
*66922.. MATERN HYPOTEN-DEL W P/P............................ ........
66923... MATERN HYPOTENS-ANTEPAR............................. 57
66924... MATERN HYPOTENS-POSTPART............................ 57
66930... AC REN FAIL W DELIV-UNSP............................ 57
*66932.. AC REN FAIL-DELIV W P/P............................. ........
66934... AC RENAL FAILURE-POSTPAR............................ 57
66940... OTH OB SURG COMPL-UNSPEC............................ 57
*66941.. OTH OB COMPL-DELIVERED.............................. ........
*66942.. OTH OB COMPL-DELIV W P/P............................ ........
66943... COMPLC OB SURG ANTEPRTM............................. 56
66944... OTH OB SURG COMPL-POSTPA............................ 57
66950... FORCEP DELIV NOS-UNSPEC............................. 57
*66951.. FORCEP DELIV NOS-DELIVER............................ ........
66960... BREECH EXTR NOS-UNSPEC.............................. 57
*66961.. BREECH EXTR NOS-DELIVER............................. ........
66970... CESAREAN DELIV NOS-UNSP............................. 57
*66971.. CESAREAN DELIVERY NOS............................... ........
*66980.. COMPL LAB/DELIV NEC-UNSP............................ ........
*66981.. COMP LAB/DELIV NEC-DELIV............................ ........
*66982.. COMPL DEL NEC-DEL W P/P............................. ........
66983... COMPL DELIV NEC-ANTEPAR............................. 57
66984... COMPL DELIV NEC-POSTPART............................ 57
66990... COMPL LAB/DELIV NOS-UNSP............................ 57
*66991.. COMP LAB/DELIV NOS-DELIV............................ ........
*66992.. COMPL DEL NOS-DEL W P/P............................. ........
66993... COMPL DELIV NOS-ANTEPAR............................. 57
66994... COMPL DELIV NOS-POSTPART............................ 57
67000... MAJOR PUERP INFECT-UNSP............................. 57
*67002.. MAJOR PUERP INF-DEL P/P............................. ........
67004... MAJOR PUERP INF-POSTPART............................ 57
67100... VARIC VEIN LEG PREG-UNSP............................ 57
*67101.. VARICOSE VEIN LEG-DELIV............................. ........
*67102.. VARIC VEIN LEG-DEL W P/P............................ ........
67103... VARIC VEIN LEG-ANTEPART............................. 57
67104... VARIC VEIN LEG-POSTPART............................. 57
[[Page 47917]]
67110... VARIC VULVA PREG-UNSPEC............................. 57
*67111.. VARICOSE VULVA-DELIVERED............................ ........
*67112.. VARICOSE VULVA-DEL W P/P............................ ........
67113... VARICOSE VULVA-ANTEPART............................. 57
67114... VARICOSE VULVA-POSTPART............................. 57
67120... THROMBOPHLEB PREG-UNSPEC............................ 57
*67121.. THROMBOPHLEBITIS-DELIVER............................ ........
*67122.. THROMBOPHLEB-DELIV W P/P............................ ........
67123... THROMBOPHLEBIT-ANTEPART............................. 57
67124... THROMBOPHLEBIT-POSTPART............................. 57
67130... DEEP THROMB ANTEPAR-UNSP............................ 57
*67131.. DEEP THROM ANTEPAR-DELIV............................ ........
67133... DEEP VEIN THROMB-ANTEPAR............................ 57
67140... DEEP THROMB POSTPAR-UNSP............................ 57
*67142.. THROMB POSTPAR-DEL W P/P............................ ........
67144... DEEP VEIN THROMB-POSTPAR............................ 57
67150... THROMBOSIS NEC PREG-UNSP............................ 57
*67151.. THROMBOSIS NEC-DELIVERED............................ ........
*67152.. THROMB NEC-DELIV W P/P.............................. ........
67153... THROMBOSIS NEC-ANTEPART............................. 57
67154... THROMBOSIS NEC-POSTPART............................. 57
67180... VEN COMPL PREG NEC-UNSP............................. 57
*67181.. VENOUS COMPL NEC-DELIVER............................ ........
*67182.. VEN COMP NEC-DELIV W P/P............................ ........
67183... VENOUS COMPL NEC-ANTEPAR............................ 57
67184... VENOUS COMPL NEC-POSTPAR............................ 57
67190... VEN COMPL PREG NOS-UNSP............................. 57
*67191.. VENOUS COMPL NOS-DELIVER............................ ........
*67192.. VEN COMP NOS-DELIV W P/P............................ ........
67193... VENOUS COMPL NOS-ANTEPAR............................ 57
67194... VENOUS COMPL NOS-POSTPAR............................ 57
67200... PUERPERAL PYREXIA-UNSPEC............................ 57
*67202.. PUERP PYREXIA-DEL W P/P............................. ........
67204... PUERP PYREXIA-POSTPARTUM............................ 57
67300... OB AIR EMBOLISM-UNSPEC.............................. 57
*67301.. OB AIR EMBOLISM-DELIVER............................. ........
*67302.. OB AIR EMBOL-DELIV W P/P............................ ........
67303... OB AIR EMBOLISM-ANTEPART............................ 57
67304... OB AIR EMBOLISM-POSTPART............................ 57
67310... AMNIOTIC EMBOLISM-UNSPEC............................ 57
*67311.. AMNIOTIC EMBOLISM-DELIV............................. ........
*67312.. AMNIOT EMBOL-DELIV W P/P............................ ........
67313... AMNIOTIC EMBOL-ANTEPART............................. 57
67314... AMNIOTIC EMBOL-POSTPART............................. 57
67320... OB PULM EMBOL NOS-UNSPEC............................ 57
*67321.. PULM EMBOL NOS-DELIVERED............................ ........
*67322.. PULM EMBOL NOS-DEL W P/P............................ ........
67323... PULM EMBOL NOS-ANTEPART............................. 57
67324... PULM EMBOL NOS-POSTPART............................. 57
67330... OB PYEMIC EMBOL-UNSPEC.............................. 57
*67331.. OB PYEMIC EMBOL-DELIVER............................. ........
*67332.. OB PYEM EMBOL-DEL W P/P............................. ........
67333... OB PYEMIC EMBOL-ANTEPART............................ 57
67334... OB PYEMIC EMBOL-POSTPART............................ 57
67380... OB PULMON EMBOL NEC-UNSP............................ 57
*67381.. PULMON EMBOL NEC-DELIVER............................ ........
*67382.. PULM EMBOL NEC-DEL W P/P............................ ........
67383... PULMON EMBOL NEC-ANTEPAR............................ 57
67384... PULMON EMBOL NEC-POSTPAR............................ 57
67400... PUERP CEREBVASC DIS-UNSP............................ 57
*67401.. PUERP CEREBVAS DIS-DELIV............................ ........
*67402.. CEREBVAS DIS-DELIV W P/P............................ ........
67403... CEREBROVASC DIS-ANTEPART............................ 57
67404... CEREBROVASC DIS-POSTPART............................ 57
67410... DISRUPT C-SECT WND-UNSP............................. 57
*67412.. DISRUPT C-SECT-DEL W P/P............................ ........
67414... DISRUPT C-SECT-POSTPART............................. 57
67420... DISRUPT PERINEUM-UNSPEC............................. 57
*67422.. DISRUPT PERIN-DEL W P/P............................. ........
67424... DISRUPT PERINEUM-POSTPAR............................ 57
67430... OB SURG COMPL NEC-UNSPEC............................ 57
*67432.. OB SURG COMPL-DEL W P/P............................. ........
67434... OB SURG COMP NEC-POSTPAR............................ 57
67440... PLACENTAL POLYP-UNSPEC.............................. 57
67442... PLACENT POLYP-DEL W P/P............................. ........
67444... PLACENTAL POLYP-POSTPART............................ 57
[[Page 47918]]
67480... PUERP COMPL NEC-UNSPEC.............................. 57
*67482.. PUERP COMP NEC-DEL W P/P............................ ........
67484... PUERP COMPL NEC-POSTPART............................ 57
67490... PUERP COMPL NOS-UNSPEC.............................. 57
*67492.. PUERP COMP NOS-DEL W P/P............................ ........
67494... PUERP COMPL NOS-POSTPART............................ 57
67500... INFECT NIPPLE PREG-UNSP............................. 57
67501... INFECT NIPPLE-DELIVERED............................. 57
67502... INFECT NIPPLE-DEL W P/P............................. 57
67503... INFECT NIPPLE-ANTEPARTUM............................ 57
67504... INFECT NIPPLE-POSTPARTUM............................ 57
67510... BREAST ABSCESS PREG-UNSP............................ 57
67511... BREAST ABSCESS-DELIVERED............................ 57
67512... BREAST ABSCESS-DEL W P/P............................ 57
67513... BREAST ABSCESS-ANTEPART............................. 57
67514... BREAST ABSCESS-POSTPART............................. 57
67520... MASTITIS IN PREG-UNSPEC............................. 57
67521... MASTITIS-DELIVERED.................................. 57
67522... MASTITIS-DELIV W P/P................................ 57
67523... MASTITIS-ANTEPARTUM................................. 57
67524... MASTITIS-POSTPARTUM................................. 57
67580... BREAST INF PREG NEC-UNSP............................ 57
67581... BREAST INFECT NEC-DELIV............................. 57
67582... BREAST INF NEC-DEL W P/P............................ 57
67583... BREAST INF NEC-ANTEPART............................. 57
67584... BREAST INF NEC-POSTPART............................. 57
67590... BREAST INF PREG NOS-UNSP............................ 57
67591... BREAST INFECT NOS-DELIV............................. 57
67592... BREAST INF NOS-DEL W P/P............................ 57
67593... BREAST INF NOS-ANTEPART............................. 57
67594... BREAST INF NOS-POSTPART............................. 57
67600... RETRACT NIPPLE PREG-UNSP............................ 57
67601... RETRACTED NIPPLE-DELIVER............................ 57
67602... RETRACT NIPPLE-DEL W P/P............................ 57
67603... RETRACT NIPPLE-ANTEPART............................. 57
67604... RETRACT NIPPLE-POSTPART............................. 57
67610... CRACKED NIPPLE PREG-UNSP............................ 57
67611... CRACKED NIPPLE-DELIVERED............................ 57
67612... CRACKED NIPPLE-DEL W P/P............................ 57
67613... CRACKED NIPPLE-ANTEPART............................. 57
67614... CRACKED NIPPLE-POSTPART............................. 57
67620... BREAST ENGORGE-UNSPEC............................... 57
67621... BREAST ENGORGE-DELIVERED............................ 57
67622... BREAST ENGORGE-DEL W P/P............................ 57
67623... BREAST ENGORGE-ANTEPART............................. 57
67624... BREAST ENGORGE-POSTPART............................. 57
67630... BREAST DIS PREG NEC-UNSP............................ 57
67631... BREAST DIS NEC-DELIVERED............................ 57
67632... BREAST DIS NEC-DEL W P/P............................ 57
67633... BREAST DIS NEC-ANTEPART............................. 57
67634... BREAST DIS NEC-POSTPART............................. 57
67640... LACTATION FAIL-UNSPEC............................... 57
67641... LACTATION FAIL-DELIVERED............................ 57
67642... LACTATION FAIL-DEL W P/P............................ 57
67643... LACTATION FAIL-ANTEPART............................. 57
67644... LACTATION FAIL-POSTPART............................. 57
67650... SUPPR LACTATION-UNSPEC.............................. 57
67651... SUPPR LACTATION-DELIVER............................. 57
67652... SUPPR LACTAT-DEL W P/P.............................. 57
67653... SUPPR LACTATION-ANTEPAR............................. 57
67654... SUPPR LACTATION-POSTPART............................ 57
67660... GALACTORRHEA PREG-UNSPEC............................ 57
67661... GALACTORRHEA-DELIVERED.............................. 57
67662... GALACTORRHEA-DEL W P/P.............................. 57
67663... GALACTORRHEA-ANTEPARTUM............................. 57
67664... GALACTORRHEA-POSTPARTUM............................. 57
67680... LACTATION DIS NEC-UNSPEC............................ 57
67681... LACTATION DIS NEC-DELIV............................. 57
67682... LACTAT DIS NEC-DEL W P/P............................ 57
67683... LACTAT DIS NEC-ANTEPART............................. 57
67684... LACTAT DIS NEC-POSTPART............................. 57
67690... LACTATION DIS NOS-UNSPEC............................ 57
67691... LACTATION DIS NOS-DELIV............................. 57
67692... LACTAT DIS NOS-DEL W P/P............................ 57
67693... LACTAT DIS NOS-ANTEPART............................. 57
67694... LACTAT DIS NOS-POSTPART............................. 57
[[Page 47919]]
677..... LATE EFFCT CMPLCATN PREG............................ 11
6800.... CARBUNCLE OF FACE................................... 18
6801.... CARBUNCLE OF NECK................................... 18
6802.... CARBUNCLE OF TRUNK.................................. 18
6803.... CARBUNCLE OF ARM.................................... 18
6804.... CARBUNCLE OF HAND................................... 18
6805.... CARBUNCLE OF BUTTOCK................................ 18
6806.... CARBUNCLE OF LEG.................................... 18
6807.... CARBUNCLE OF FOOT................................... 18
6808.... CARBUNCLE, SITE NEC................................. 18
6809.... CARBUNCLE NOS....................................... 18
68100... CELLULITIS, FINGER NOS.............................. 18
68101... FELON............................................... 18
68102... ONYCHIA OF FINGER................................... 18
68110... CELLULITIS, TOE NOS................................. 18
68111... ONYCHIA OF TOE...................................... 18
6819.... CELLULITIS OF DIGIT NOS............................. 18
6820.... CELLULITIS OF FACE.................................. 18
6821.... CELLULITIS OF NECK.................................. 18
6822.... CELLULITIS OF TRUNK................................. 18
6823.... CELLULITIS OF ARM................................... 18
6824.... CELLULITIS OF HAND.................................. 18
6825.... CELLULITIS OF BUTTOCK............................... 18
6826.... CELLULITIS OF LEG................................... 18
6827.... CELLULITIS OF FOOT.................................. 18
6828.... CELLULITIS, SITE NEC................................ 18
6829.... CELLULITIS NOS...................................... 18
683..... ACUTE LYMPHADENITIS................................. 86
684..... IMPETIGO............................................ 18
6850.... PILONIDAL CYST W ABSCESS............................ 18
6851.... PILONIDAL CYST W/O ABSC............................. 18
6861.... PYOGENIC GRANULOMA.................................. 18
6868.... LOCAL SKIN INFECTION NEC............................ 18
6869.... LOCAL SKIN INFECTION NOS............................ 18
69010... SEBRRHEIC DERMATITIS NOS............................ 18
69011... SEBORRHEA CAPITIS................................... 18
69012... SBRHEIC INFANTL DRMTITIS............................ 18
69018... SEBRRHEIC DERMATITIS NEC............................ 18
6908.... ERYTHMTSQUAMOUS DERM NEC............................ 18
6910.... DIAPER OR NAPKIN RASH............................... 18
6918.... OTHER ATOPIC DERMATITIS............................. 18
6920.... DETERGENT DERMATITIS................................ 18
6921.... OIL & GREASE DERMATITIS............................. 18
6922.... SOLVENT DERMATITIS.................................. 18
6923.... TOPICAL MED DERMATITIS.............................. 18
6924.... CHEMICAL DERMATITIS NEC............................. 18
6925.... TOPICAL FOOD DERMATITIS............................. 18
6926.... DERMATITIS DUE TO PLANT............................. 18
69270... SOLAR DERMATITIS NOS................................ 18
69271... SUNBURN............................................. 18
69272... ACT DRMTITIS SOLAR RDIAT............................ 18
69273... ACTNC RETIC ACTNC GRNLMA............................ 18
69274... OTH CHR DRMTIT SOLAR RAD............................ 18
69279... OTH DERMATITIS SOLAR RAD............................ 18
69281... COSMETIC DERMATITIS................................. 18
69282... DERMATITIS OTH RADIATION............................ 18
69283... DERMATITIS METALS................................... 18
69289... DERMATITIS NEC...................................... 18
6929.... DERMATITIS NOS...................................... 18
6930.... DRUG DERMATITIS NOS................................. 18
6931.... DERMAT D/T FOOD INGEST.............................. 18
6938.... DERMAT D/T INT AGENT NEC............................ 18
6939.... DERMAT D/T INT AGENT NOS............................ 18
6940.... DERMATITIS HERPETIFORMIS............................ 18
6941.... SUBCORNEAL PUST DERMATOS............................ 68
6942.... JUVEN DERMAT HERPETIFORM............................ 18
6943.... IMPETIGO HERPETIFORMIS.............................. 18
6944.... PEMPHIGUS........................................... 18
6945.... PEMPHIGOID.......................................... 18
69460... BN MUCOUS MEMB PEMPH NOS............................ 18
69461... OCULAR PEMPHIGUS.................................... 68
6948.... BULLOUS DERMATOSES NEC.............................. 18
6949.... BULLOUS DERMATOSES NOS.............................. 18
6950.... TOXIC ERYTHEMA...................................... 18
6951.... ERYTHEMA MULTIFORME................................. 18
6952.... ERYTHEMA NODOSUM.................................... 18
[[Page 47920]]
6953.... ROSACEA............................................. 18
6954.... LUPUS ERYTHEMATOSUS................................. 18
69581... RITTER'S DISEASE.................................... 18
69589... ERYTHEMATOUS COND NEC............................... 18
6959.... ERYTHEMATOUS COND NOS............................... 18
6960.... PSORIATIC ARTHROPATHY............................... 24
6961.... OTHER PSORIASIS..................................... 18
6962.... PARAPSORIASIS....................................... 18
6963.... PITYRIASIS ROSEA.................................... 18
6964.... PITYRIASIS RUBRA PILARIS............................ 18
6965.... PITYRIASIS NEC & NOS................................ 18
6968.... PSORIAS RELATED DIS NEC............................. 18
6970.... LICHEN PLANUS....................................... 18
6971.... LICHEN NITIDUS...................................... 18
6978.... LICHEN NEC.......................................... 18
6979.... LICHEN NOS.......................................... 18
6980.... PRURITUS ANI........................................ 18
6981.... PRURITUS OF GENITALIA............................... 53
6982.... PRURIGO............................................. 18
6983.... LICHENIFICATION..................................... 18
6984.... DERMATITIS FACTITIA................................. 18
6988.... PRURITIC CONDITIONS NEC............................. 18
6989.... PRURITIC DISORDER NOS............................... 18
700..... CORNS AND CALLOSITIES............................... 18
7010.... CIRCUMSCRIBE SCLERODERMA............................ 18
7011.... KERATODERMA, ACQUIRED............................... 18
7012.... ACQ ACANTHOSIS NIGRICANS............................ 18
7013.... STRIAE ATROPHICAE................................... 18
7014.... KELOID SCAR......................................... 18
7015.... ABNORMAL GRANULATION NEC............................ 18
7018.... SKIN HYPERTRO/ATROPH NEC............................ 18
7019.... SKIN HYPERTRO/ATROPH NOS............................ 18
7020.... ACTINIC KERATOSIS................................... 18
70211... INFLAMED SBRHEIC KERATOS............................ 18
70219... OTHER SBORHEIC KERATOSIS............................ 18
7028.... OTHER SPECF DERMATOSES.............................. 18
7030.... INGROWING NAIL...................................... 18
7038.... DISEASES OF NAIL NEC................................ 18
7039.... DISEASE OF NAIL NOS................................. 18
70400... ALOPECIA NOS........................................ 18
70401... ALOPECIA AREATA..................................... 18
70402... TELOGEN EFFLUVIUM................................... 18
70409... ALOPECIA NEC........................................ 18
7041.... HIRSUTISM........................................... 18
7042.... ABNORMALITIES OF HAIR............................... 18
7043.... VARIATIONS IN HAIR COLOR............................ 18
7048.... HAIR DISEASES NEC................................... 18
7049.... HAIR DISEASE NOS.................................... 18
7050.... ANHIDROSIS.......................................... 18
7051.... PRICKLY HEAT........................................ 18
70581... DYSHIDROSIS......................................... 18
70582... FOX-FORDYCE DISEASE................................. 18
70583... HIDRADENITIS........................................ 18
70589... SWEAT GLAND DISORDER NEC............................ 18
7059.... SWEAT GLAND DISORDER NOS............................ 18
7060.... ACNE VARIOLIFORMIS.................................. 18
7061.... ACNE NEC............................................ 18
7062.... SEBACEOUS CYST...................................... 18
7063.... SEBORRHEA........................................... 18
7068.... SEBACEOUS GLAND DIS NEC............................. 18
7069.... SEBACEOUS GLAND DIS NOS............................. 18
7070.... DECUBITUS ULCER..................................... 18
7071.... CHRONIC ULCER OF LEG................................ 18
7078.... CHRONIC SKIN ULCER NEC.............................. 18
7079.... CHRONIC SKIN ULCER NOS.............................. 18
7080.... ALLERGIC URTICARIA.................................. 18
7081.... IDIOPATHIC URTICARIA................................ 18
7082.... URTICARIA FROM COLD/HEAT............................ 18
7083.... DERMATOGRAPHIC URTICARIA............................ 18
7084.... VIBRATORY URTICARIA................................. 18
7085.... CHOLINERGIC URTICARIA............................... 18
7088.... URTICARIA NEC....................................... 18
7089.... URTICARIA NOS....................................... 18
70900... DYSCHROMIA, UNSPECIFIED............................. 18
70901... VITILIGO............................................ 18
70909... OTHER DYSCHROMIA.................................... 18
[[Page 47921]]
7091.... VASCULAR DISORD OF SKIN............................. 18
7092.... SCAR & FIBROSIS OF SKIN............................. 18
7093.... DEGENERATIVE SKIN DISORD............................ 18
7094.... FOREIGN BODY GRANUL-SKIN............................ 18
7098.... SKIN DISORDERS NEC.................................. 18
7099.... SKIN DISORDER NOS................................... 18
7100.... SYST LUPUS ERYTHEMATOSUS............................ 86
7101.... SYSTEMIC SCLEROSIS.................................. 86
7102.... SICCA SYNDROME...................................... 86
7103.... DERMATOMYOSITIS..................................... 86
7104.... POLYMYOSITIS........................................ 86
7105.... EOSINOPHILIA MYALGIA SND............................ 24
7108.... DIFF CONNECT TIS DIS NEC............................ 24
7109.... DIFF CONNECT TIS DIS NOS............................ 24
71100... PYOGEN ARTHRITIS-UNSPEC............................. 24
71101... PYOGEN ARTHRITIS-SHLDER............................. 24
71102... PYOGEN ARTHRITIS-UP/ARM............................. 24
71103... PYOGEN ARTHRITIS-FOREARM............................ 24
71104... PYOGEN ARTHRITIS-HAND............................... 24
71105... PYOGEN ARTHRITIS-PELVIS............................. 24
71106... PYOGEN ARTHRITIS-L/LEG.............................. 24
71107... PYOGEN ARTHRITIS-ANKLE.............................. 24
71108... PYOGEN ARTHRITIS NEC................................ 24
71109... PYOGEN ARTHRITIS-MULT............................... 24
71110... REITER ARTHRITIS-UNSPEC............................. 24
71111... REITER ARTHRITIS-SHLDER............................. 24
71112... REITER ARTHRITIS-UP/ARM............................. 24
71113... REITER ARTHRITIS-FOREARM............................ 24
71114... REITER ARTHRITIS-HAND............................... 24
71115... REITER ARTHRITIS-PELVIS............................. 24
71116... REITER ARTHRITIS-L/LEG.............................. 24
71117... REITER ARTHRITIS-ANKLE.............................. 24
71118... REITER ARTHRITIS NEC................................ 24
71119... REITER ARTHRITIS-MULT............................... 24
71120... BEHCET ARTHRITIS-UNSPEC............................. 24
71121... BEHCET ARTHRITIS-SHLDER............................. 24
71122... BEHCET ARTHRITIS-UP/ARM............................. 24
71123... BEHCET ARTHRITIS-FOREARM............................ 24
71124... BEHCET ARTHRITIS-HAND............................... 24
71125... BEHCET ARTHRITIS-PELVIS............................. 24
71126... BEHCET ARTHRITIS-L/LEG.............................. 24
71127... BEHCET ARTHRITIS-ANKLE.............................. 24
71128... BEHCET ARTHRITIS NEC................................ 24
71129... BEHCET ARTHRITIS-MULT............................... 24
71130... DYSENTER ARTHRIT-UNSPEC............................. 24
71131... DYSENTER ARTHRIT-SHLDER............................. 24
71132... DYSENTER ARTHRIT-UP/ARM............................. 24
71133... DYSENTER ARTHRIT-FOREARM............................ 24
71134... DYSENTER ARTHRIT-HAND............................... 24
71135... DYSENTER ARTHRIT-PELVIS............................. 24
71136... DYSENTER ARTHRIT-L/LEG.............................. 24
71137... DYSENTER ARTHRIT-ANKLE.............................. 24
71138... DYSENTER ARTHRIT NEC................................ 24
71139... DYSENTER ARTHRIT-MULT............................... 24
71140... BACT ARTHRITIS-UNSPEC............................... 24
71141... BACT ARTHRITIS-SHLDER............................... 24
71142... BACT ARTHRITIS-UP/ARM............................... 24
71143... BACT ARTHRITIS-FOREARM.............................. 24
71144... BACT ARTHRITIS-HAND................................. 24
71145... BACT ARTHRITIS-PELVIS............................... 24
71146... BACT ARTHRITIS-L/LEG................................ 24
71147... BACT ARTHRITIS-ANKLE................................ 24
71148... BACT ARTHRITIS NEC.................................. 24
71149... BACT ARTHRITIS-MULT................................. 24
71150... VIRAL ARTHRITIS-UNSPEC.............................. 24
71151... VIRAL ARTHRITIS-SHLDER.............................. 24
71152... VIRAL ARTHRITIS-UP/ARM.............................. 24
71153... VIRAL ARTHRITIS-FOREARM............................. 24
71154... VIRAL ARTHRITIS-HAND................................ 24
71155... VIRAL ARTHRITIS-PELVIS.............................. 24
71156... VIRAL ARTHRITIS-L/LEG............................... 24
71157... VIRAL ARTHRITIS-ANKLE............................... 24
71158... VIRAL ARTHRITIS NEC................................. 24
71159... VIRAL ARTHRITIS-MULT................................ 24
71160... MYCOTIC ARTHRITIS-UNSPEC............................ 24
71161... MYCOTIC ARTHRITIS-SHLDER............................ 24
[[Page 47922]]
71162... MYCOTIC ARTHRITIS-UP/ARM............................ 24
71163... MYCOTIC ARTHRIT-FOREARM............................. 24
71164... MYCOTIC ARTHRITIS-HAND.............................. 24
71165... MYCOTIC ARTHRITIS-PELVIS............................ 24
71166... MYCOTIC ARTHRITIS-L/LEG............................. 24
71167... MYCOTIC ARTHRITIS-ANKLE............................. 24
71168... MYCOTIC ARTHRITIS NEC............................... 24
71169... MYCOTIC ARTHRITIS-MULT.............................. 24
71170... HELMINTH ARTHRIT-UNSPEC............................. 24
71171... HELMINTH ARTHRIT-SHLDER............................. 24
71172... HELMINTH ARTHRIT-UP/ARM............................. 24
71173... HELMINTH ARTHRIT-FOREARM............................ 24
71174... HELMINTH ARTHRIT-HAND............................... 24
71175... HELMINTH ARTHRIT-PELVIS............................. 24
71176... HELMINTH ARTHRIT-L/LEG.............................. 24
71177... HELMINTH ARTHRIT-ANKLE.............................. 24
71178... HELMINTH ARTHRIT NEC................................ 24
71179... HELMINTH ARTHRIT-MULT............................... 24
71180... INF ARTHRITIS NEC-UNSPEC............................ 24
71181... INF ARTHRITIS NEC-SHLDER............................ 24
71182... INF ARTHRITIS NEC-UP/ARM............................ 24
71183... INF ARTHRIT NEC-FOREARM............................. 24
71184... INF ARTHRITIS NEC-HAND.............................. 24
71185... INF ARTHRITIS NEC-PELVIS............................ 24
71186... INF ARTHRITIS NEC-L/LEG............................. 24
71187... INF ARTHRITIS NEC-ANKLE............................. 24
71188... INF ARTHRIT NEC-OTH SITE............................ 24
71189... INF ARTHRITIS NEC-MULT.............................. 24
71190... INF ARTHRITIS NOS-UNSPEC............................ 24
71191... INF ARTHRITIS NOS-SHLDER............................ 24
71192... INF ARTHRITIS NOS-UP/ARM............................ 24
71193... INF ARTHRIT NOS-FOREARM............................. 24
71194... INF ARTHRIT NOS-HAND................................ 24
71195... INF ARTHRIT NOS-PELVIS.............................. 24
71196... INF ARTHRIT NOS-L/LEG............................... 24
71197... INF ARTHRIT NOS-ANKLE............................... 24
71198... INF ARTHRIT NOS-OTH SITE............................ 24
71199... INF ARTHRITIS NOS-MULT.............................. 24
71210... DICALC PHOS CRYST-UNSPEC............................ 24
71211... DICALC PHOS CRYST-SHLDER............................ 24
71212... DICALC PHOS CRYST-UP/ARM............................ 24
71213... DICALC PHOS CRYS-FOREARM............................ 24
71214... DICALC PHOS CRYST-HAND.............................. 24
71215... DICALC PHOS CRYST-PELVIS............................ 24
71216... DICALC PHOS CRYST-L/LEG............................. 24
71217... DICALC PHOS CRYST-ANKLE............................. 24
71218... DICALC PHOS CRY-SITE NEC............................ 24
71219... DICALC PHOS CRYST-MULT.............................. 24
71220... PYROPHOSPH CRYST-UNSPEC............................. 24
71221... PYROPHOSPH CRYST-SHLDER............................. 24
71222... PYROPHOSPH CRYST-UP/ARM............................. 24
71223... PYROPHOSPH CRYST-FOREARM............................ 24
71224... PYROPHOSPH CRYST-HAND............................... 24
71225... PYROPHOSPH CRYST-PELVIS............................. 24
71226... PYROPHOSPH CRYST-L/LEG.............................. 24
71227... PYROPHOSPH CRYST-ANKLE.............................. 24
71228... PYROPHOS CRYST-SITE NEC............................. 24
71229... PYROPHOS CRYST-MULT................................. 24
71230... CHONDROCALCIN NOS-UNSPEC............................ 24
71231... CHONDROCALCIN NOS-SHLDER............................ 24
71232... CHONDROCALCIN NOS-UP/ARM............................ 24
71233... CHONDROCALC NOS-FOREARM............................. 24
71234... CHONDROCALCIN NOS-HAND.............................. 24
71235... CHONDROCALCIN NOS-PELVIS............................ 24
71236... CHONDROCALCIN NOS-L/LEG............................. 24
71237... CHONDROCALCIN NOS-ANKLE............................. 24
71238... CHONDROCALC NOS-OTH SITE............................ 24
71239... CHONDROCALCIN NOS-MULT.............................. 24
71280... CRYST ARTHROP NEC-UNSPEC............................ 24
71281... CRYST ARTHROP NEC-SHLDER............................ 24
71282... CRYST ARTHROP NEC-UP/ARM............................ 24
71283... CRYS ARTHROP NEC-FOREARM............................ 24
71284... CRYST ARTHROP NEC-HAND.............................. 24
71285... CRYST ARTHROP NEC-PELVIS............................ 24
71286... CRYST ARTHROP NEC-L/LEG............................. 24
71287... CRYST ARTHROP NEC-ANKLE............................. 24
[[Page 47923]]
71288... CRY ARTHROP NEC-OTH SITE............................ 24
71289... CRYST ARTHROP NEC-MULT.............................. 24
71290... CRYST ARTHROP NOS-UNSPEC............................ 24
71291... CRYST ARTHROP NOS-SHLDR............................. 24
71292... CRYST ARTHROP NOS-UP/ARM............................ 24
71293... CRYS ARTHROP NOS-FOREARM............................ 24
71294... CRYST ARTHROP NOS-HAND.............................. 24
71295... CRYST ARTHROP NOS-PELVIS............................ 24
71296... CRYST ARTHROP NOS-L/LEG............................. 24
71297... CRYST ARTHROP NOS-ANKLE............................. 24
71298... CRY ARTHROP NOS-OTH SITE............................ 24
71299... CRYST ARTHROP NOS-MULT.............................. 24
7130.... ARTHROP W ENDOCR/MET DIS............................ 24
7131.... ARTHROP W NONINF GI DIS............................. 24
7132.... ARTHROPATH W HEMATOL DIS............................ 24
7133.... ARTHROPATHY W SKIN DIS.............................. 24
7134.... ARTHROPATHY W RESP DIS.............................. 24
7135.... ARTHROPATHY W NERVE DIS............................. 24
7136.... ARTHROP W HYPERSEN REACT............................ 24
7137.... ARTHROP W SYSTEM DIS NEC............................ 24
7138.... ARTHROP W OTH DIS NEC............................... 24
7140.... RHEUMATOID ARTHRITIS................................ 24
7141.... FELTY'S SYNDROME.................................... 24
7142.... SYST RHEUM ARTHRITIS NEC............................ 24
71430... JUV RHEUM ARTHRITIS NOS............................. 24
71431... POLYART JUV RHEUM ARTHR............................. 24
71432... PAUCIART JUV RHEUM ARTHR............................ 24
71433... MONOART JUV RHEUM ARTHR............................. 24
7144.... CHR POSTRHEUM ARTHRITIS............................. 24
71481... RHEUMATOID LUNG..................................... 33
71489... INFLAMM POLYARTHROP NEC............................. 24
7149.... INFLAMM POLYARTHROP NOS............................. 24
71500... GENERAL OSTEOARTHROSIS.............................. 24
71504... GEN OSTEOARTHROS-HAND............................... 24
71509... GENERAL OSTEOARTHROSIS.............................. 24
71510... LOC PRIM OSTEOART-UNSPEC............................ 24
71511... LOC PRIM OSTEOART-SHLDER............................ 24
71512... LOC PRIM OSTEOART-UP/ARM............................ 24
71513... LOC PRIM OSTEOART-FORARM............................ 24
71514... LOC PRIM OSTEOARTH-HAND............................. 24
71515... LOC PRIM OSTEOART-PELVIS............................ 24
71516... LOC PRIM OSTEOART-L/LEG............................. 24
71517... LOC PRIM OSTEOARTH-ANKLE............................ 24
71518... LOC PRIM OSTEOARTHR NEC............................. 24
71520... LOC 2ND OSTEOARTH-UNSPEC............................ 24
71521... LOC 2ND OSTEOARTH-SHLDER............................ 24
71522... LOC 2ND OSTEOARTH-UP/ARM............................ 24
71523... LOC 2ND OSTEOART-FOREARM............................ 24
71524... LOC 2ND OSTEOARTHRO-HAND............................ 24
71525... LOC 2ND OSTEOARTH-PELVIS............................ 24
71526... LOC 2ND OSTEOARTHR-L/LEG............................ 24
71527... LOC 2ND OSTEOARTHR-ANKLE............................ 24
71528... LOC 2ND OSTEOARTHROS NEC............................ 24
71530... LOC OSTEOARTH NOS-UNSPEC............................ 24
71531... LOC OSTEOARTH NOS-SHLDER............................ 24
71532... LOC OSTEOARTH NOS-UP/ARM............................ 24
71533... LOC OSTEOART NOS-FOREARM............................ 24
71534... LOC OSTEOARTH NOS-HAND.............................. 24
71535... LOC OSTEOARTH NOS-PELVIS............................ 24
71536... LOC OSTEOARTH NOS-L/LEG............................. 24
71537... LOC OSTEOARTH NOS-ANKLE............................. 24
71538... LOC OSTEOAR NOS-SITE NEC............................ 24
71580... OSTEOARTHROSIS-MULT SITE............................ 24
71589... OSTEOARTHROSIS-MULT SITE............................ 24
71590... OSTEOARTHROS NOS-UNSPEC............................. 24
71591... OSTEOARTHROS NOS-SHLDER............................. 24
71592... OSTEOARTHROS NOS-UP/ARM............................. 24
71593... OSTEOARTHROS NOS-FOREARM............................ 24
71594... OSTEOARTHROS NOS-HAND............................... 24
71595... OSTEOARTHROS NOS-PELVIS............................. 24
71596... OSTEOARTHROS NOS-L/LEG.............................. 24
71597... OSTEOARTHROS NOS-ANKLE.............................. 24
71598... OSTEOARTHRO NOS-OTH SITE............................ 24
71600... KASCHIN-BECK DIS-UNSPEC............................. 24
71601... KASCHIN-BECK DIS-SHLDER............................. 24
71602... KASCHIN-BECK DIS-UP/ARM............................. 24
[[Page 47924]]
71603... KASCHIN-BECK DIS-FOREARM............................ 24
71604... KASCHIN-BECK DIS-HAND............................... 24
71605... KASCHIN-BECK DIS-PELVIS............................. 24
71606... KASCHIN-BECK DIS-L/LEG.............................. 24
71607... KASCHIN-BECK DIS-ANKLE.............................. 24
71608... KASCHIN-BECK DIS NEC................................ 24
71609... KASCHIN-BECK DIS-MULT............................... 24
71610... TRAUM ARTHROPATHY-UNSPEC............................ 24
71611... TRAUM ARTHROPATHY-SHLDER............................ 24
71612... TRAUM ARTHROPATHY-UP/ARM............................ 24
71613... TRAUM ARTHROPATH-FOREARM............................ 24
71614... TRAUM ARTHROPATHY-HAND.............................. 24
71615... TRAUM ARTHROPATHY-PELVIS............................ 24
71616... TRAUM ARTHROPATHY-L/LEG............................. 24
71617... TRAUM ARTHROPATHY-ANKLE............................. 24
71618... TRAUM ARTHROPATHY NEC............................... 24
71619... TRAUM ARTHROPATHY-MULT.............................. 24
71620... ALLERG ARTHRITIS-UNSPEC............................. 24
71621... ALLERG ARTHRITIS-SHLDER............................. 24
71622... ALLERG ARTHRITIS-UP/ARM............................. 24
71623... ALLERG ARTHRITIS-FOREARM............................ 24
71624... ALLERG ARTHRITIS-HAND............................... 24
71625... ALLERG ARTHRITIS-PELVIS............................. 24
71626... ALLERG ARTHRITIS-L/LEG.............................. 24
71627... ALLERG ARTHRITIS-ANKLE.............................. 24
71628... ALLERG ARTHRITIS NEC................................ 24
71629... ALLERG ARTHRITIS-MULT............................... 24
71630... CLIMACT ARTHRITIS-UNSPEC............................ 24
71631... CLIMACT ARTHRITIS-SHLDER............................ 24
71632... CLIMACT ARTHRITIS-UP/ARM............................ 24
71633... CLIMACT ARTHRIT-FOREARM............................. 24
71634... CLIMACT ARTHRITIS-HAND.............................. 24
71635... CLIMACT ARTHRITIS-PELVIS............................ 24
71636... CLIMACT ARTHRITIS-L/LEG............................. 24
71637... CLIMACT ARTHRITIS-ANKLE............................. 24
71638... CLIMACT ARTHRITIS NEC............................... 24
71639... CLIMACT ARTHRITIS-MULT.............................. 24
71640... TRANS ARTHROPATHY-UNSPEC............................ 24
71641... TRANS ARTHROPATHY-SHLDER............................ 24
71642... TRANS ARTHROPATHY-UP/ARM............................ 24
71643... TRANS ARTHROPATH-FOREARM............................ 24
71644... TRANS ARTHROPATHY-HAND.............................. 24
71645... TRANS ARTHROPATHY-PELVIS............................ 24
71646... TRANS ARTHROPATHY-L/LEG............................. 24
71647... TRANS ARTHROPATHY-ANKLE............................. 24
71648... TRANS ARTHROPATHY NEC............................... 24
71649... TRANS ARTHROPATHY-MULT.............................. 24
71650... POLYARTHRITIS NOS-UNSPEC............................ 24
71651... POLYARTHRITIS NOS-SHLDER............................ 24
71652... POLYARTHRITIS NOS-UP/ARM............................ 24
71653... POLYARTHRIT NOS-FOREARM............................. 24
71654... POLYARTHRITIS NOS-HAND.............................. 24
71655... POLYARTHRITIS NOS-PELVIS............................ 24
71656... POLYARTHRITIS NOS-L/LEG............................. 24
71657... POLYARTHRITIS NOS-ANKLE............................. 24
71658... POLYARTHRIT NOS-OTH SITE............................ 24
71659... POLYARTHRITIS NOS-MULT.............................. 24
71660... MONOARTHRITIS NOS-UNSPEC............................ 24
71661... MONOARTHRITIS NOS-SHLDER............................ 24
71662... MONOARTHRITIS NOS-UP/ARM............................ 24
71663... MONOARTHRIT NOS-FOREARM............................. 24
71664... MONOARTHRITIS NOS-HAND.............................. 24
71665... MONOARTHRITIS NOS-PELVIS............................ 24
71666... MONOARTHRITIS NOS-L/LEG............................. 24
71667... MONOARTHRITIS NOS-ANKLE............................. 24
71668... MONOARTHRIT NOS-OTH SITE............................ 24
71680... ARTHROPATHY NEC-UNSPEC.............................. 24
71681... ARTHROPATHY NEC-SHLDER.............................. 24
71682... ARTHROPATHY NEC-UP/ARM.............................. 24
71683... ARTHROPATHY NEC-FOREARM............................. 24
71684... ARTHROPATHY NEC-HAND................................ 24
71685... ARTHROPATHY NEC-PELVIS.............................. 24
71686... ARTHROPATHY NEC-L/LEG............................... 24
71687... ARTHROPATHY NEC-ANKLE............................... 24
71688... ARTHROPATHY NEC-OTH SITE............................ 24
71689... ARTHROPATHY NEC-MULT................................ 24
[[Page 47925]]
71690... ARTHROPATHY NOS-UNSPEC.............................. 24
71691... ARTHROPATHY NOS-SHLDER.............................. 24
71692... ARTHROPATHY NOS-UP/ARM.............................. 24
71693... ARTHROPATHY NOS-FOREARM............................. 24
71694... ARTHROPATHY NOS-HAND................................ 24
71695... ARTHROPATHY NOS-PELVIS.............................. 24
71696... ARTHROPATHY NOS-L/LEG............................... 24
71697... ARTHROPATHY NOS-ANKLE............................... 24
71698... ARTHROPATHY NOS-OTH SITE............................ 24
71699... ARTHROPATHY NOS-MULT................................ 24
7170.... OLD BUCKET TEAR MED MEN............................. 24
7171.... DERANG ANT MED MENISCUS............................. 24
7172.... DERANG POST MED MENISCUS............................ 24
7173.... DERANG MED MENISCUS NEC............................. 24
71740... DERANG LAT MENISCUS NOS............................. 24
71741... OLD BUCKET TEAR LAT MEN............................. 24
71742... DERANGE ANT LAT MENISCUS............................ 24
71743... DERANG POST LAT MENISCUS............................ 24
71749... DERANG LAT MENISCUS NEC............................. 24
7175.... DERANGEMENT MENISCUS NEC............................ 24
7176.... LOOSE BODY IN KNEE.................................. 24
7177.... CHONDROMALACIA PATELLAE............................. 24
71781... OLD DISRUPT LAT COLLAT.............................. 24
71782... OLD DISRUPT MED COLLAT.............................. 24
71783... OLD DISRUPT ANT CRUCIATE............................ 24
71784... OLD DISRUPT POST CRUCIAT............................ 24
71785... OLD DISRUPT KNEE LIG NEC............................ 24
71789... INT DERANGEMENT KNEE NEC............................ 24
7179.... INT DERANGEMENT KNEE NOS............................ 24
71800... ARTIC CARTIL DIS-UNSPEC............................. 24
71801... ARTIC CARTIL DIS-SHLDER............................. 24
71802... ARTIC CARTIL DIS-UP/ARM............................. 24
71803... ARTIC CARTIL DIS-FOREARM............................ 24
71804... ARTIC CARTIL DIS-HAND............................... 24
71805... ARTIC CARTIL DIS-PELVIS............................. 24
71807... ARTIC CARTIL DIS-ANKLE.............................. 24
71808... ARTIC CARTIL DIS-JT NEC............................. 24
71809... ARTIC CARTIL DIS-MULT JT............................ 24
71810... LOOSE BODY-UNSPEC................................... 24
71811... LOOSE BODY-SHLDER................................... 24
71812... LOOSE BODY-UP/ARM................................... 24
71813... LOOSE BODY-FOREARM.................................. 24
71814... LOOSE BODY-HAND..................................... 24
71815... LOOSE BODY-PELVIS................................... 24
71817... LOOSE BODY-ANKLE.................................... 24
71818... LOOSE BODY-JOINT NEC................................ 24
71819... LOOSE BODY-MULT JOINTS.............................. 24
71820... PATHOL DISLOCAT-UNSPEC.............................. 24
71821... PATHOL DISLOCAT-SHLDER.............................. 24
71822... PATHOL DISLOCAT-UP/ARM.............................. 24
71823... PATHOL DISLOCAT-FOREARM............................. 24
71824... PATHOL DISLOCAT-HAND................................ 24
71825... PATHOL DISLOCAT-PELVIS.............................. 24
71826... PATHOL DISLOCAT-L/LEG............................... 24
71827... PATHOL DISLOCAT-ANKLE............................... 24
71828... PATHOL DISLOCAT-JT NEC.............................. 24
71829... PATHOL DISLOCAT-MULT JTS............................ 24
71830... RECUR DISLOCAT-UNSPEC............................... 24
71831... RECUR DISLOCAT-SHLDER............................... 24
71832... RECUR DISLOCAT-UP/ARM............................... 24
71833... RECUR DISLOCAT-FOREARM.............................. 24
71834... RECUR DISLOCAT-HAND................................. 24
71835... RECUR DISLOCAT-PELVIS............................... 24
71836... RECUR DISLOCAT-L/LEG................................ 24
71837... RECUR DISLOCAT-ANKLE................................ 24
71838... RECUR DISLOCAT-JT NEC............................... 24
71839... RECUR DISLOCAT-MULT JTS............................. 24
71840... JT CONTRACTURE-UNSPEC............................... 24
71841... JT CONTRACTURE-SHLDER............................... 24
71842... JT CONTRACTURE-UP/ARM............................... 24
71843... JT CONTRACTURE-FOREARM.............................. 24
71844... JT CONTRACTURE-HAND................................. 24
71845... JT CONTRACTURE-PELVIS............................... 24
71846... JT CONTRACTURE-L/LEG................................ 24
71847... JT CONTRACTURE-ANKLE................................ 24
71848... JT CONTRACTURE-JT NEC............................... 24
[[Page 47926]]
71849... JT CONTRACTURE-MULT JTS............................. 24
71850... ANKYLOSIS-UNSPEC.................................... 24
71851... ANKYLOSIS-SHOULDER.................................. 24
71852... ANKYLOSIS-UPPER/ARM................................. 24
71853... ANKYLOSIS-FOREARM................................... 24
71854... ANKYLOSIS-HAND...................................... 24
71855... ANKYLOSIS-PELVIS.................................... 24
71856... ANKYLOSIS-LOWER/LEG................................. 24
71857... ANKYLOSIS-ANKLE..................................... 24
71858... ANKYLOSIS-JOINT NEC................................. 24
71859... ANKYLOSIS-MULT JOINTS............................... 24
71860... PROTRUSIO ACETAB-UNSPEC............................. 24
71865... PROTRUSIO ACETABULI NOS............................. 24
71880... JT DERANGMNT NEC-UNSP JT............................ 24
71881... JT DERANGMENT NEC-SHLDER............................ 24
71882... JT DERANGMENT NEC-UP/ARM............................ 24
71883... JT DERANGMNT NEC-FOREARM............................ 24
71884... JT DERANGEMENT NEC-HAND............................. 24
71885... JT DERANGMENT NEC-PELVIS............................ 24
71886... JT DERANGEMENT NEC-L/LEG............................ 24
71887... JT DERANGEMENT NEC-ANKLE............................ 24
71888... JT DERANGMENT NEC-OTH JT............................ 24
71889... JT DERANGEMENT NEC-MULT............................. 24
71890... JT DERANGMNT NOS-UNSP JT............................ 24
71891... JT DERANGMENT NOS-SHLDER............................ 24
71892... JT DERANGMENT NOS-UP/ARM............................ 24
71893... JT DERANGMNT NOS-FOREARM............................ 24
71894... JT DERANGEMENT NOS-HAND............................. 24
71895... JT DERANGMENT NOS-PELVIS............................ 24
71897... JT DERANGEMENT NOS-ANKLE............................ 24
71898... JT DERANGMENT NOS-OTH JT............................ 24
71899... JT DERANGEMENT NOS-MULT............................. 24
71900... JOINT EFFUSION-UNSPEC............................... 24
71901... JOINT EFFUSION-SHLDER............................... 24
71902... JOINT EFFUSION-UP/ARM............................... 24
71903... JOINT EFFUSION-FOREARM.............................. 24
71904... JOINT EFFUSION-HAND................................. 24
71905... JOINT EFFUSION-PELVIS............................... 24
71906... JOINT EFFUSION-L/LEG................................ 24
71907... JOINT EFFUSION-ANKLE................................ 24
71908... JOINT EFFUSION-JT NEC............................... 24
71909... JOINT EFFUSION-MULT JTS............................. 24
71910... HEMARTHROSIS-UNSPEC................................. 24
71911... HEMARTHROSIS-SHLDER................................. 24
71912... HEMARTHROSIS-UP/ARM................................. 24
71913... HEMARTHROSIS-FOREARM................................ 24
71914... HEMARTHROSIS-HAND................................... 24
71915... HEMARTHROSIS-PELVIS................................. 24
71916... HEMARTHROSIS-L/LEG.................................. 24
71917... HEMARTHROSIS-ANKLE.................................. 24
71918... HEMARTHROSIS-JT NEC................................. 24
71919... HEMARTHROSIS-MULT JTS............................... 24
71920... VILLONOD SYNOVIT-UNSPEC............................. 24
71921... VILLONOD SYNOVIT-SHLDER............................. 24
71922... VILLONOD SYNOVIT-UP/ARM............................. 24
71923... VILLONOD SYNOVIT-FOREARM............................ 24
71924... VILLONOD SYNOVIT-HAND............................... 24
71925... VILLONOD SYNOVIT-PELVIS............................. 24
71926... VILLONOD SYNOVIT-L/LEG.............................. 24
71927... VILLONOD SYNOVIT-ANKLE.............................. 24
71928... VILLONOD SYNOVIT-JT NEC............................. 24
71929... VILLONOD SYNOVIT-MULT JT............................ 24
71930... PALINDROM RHEUM-UNSPEC.............................. 24
71931... PALINDROM RHEUM-SHLDER.............................. 24
71932... PALINDROM RHEUM-UP/ARM.............................. 24
71933... PALINDROM RHEUM-FOREARM............................. 24
71934... PALINDROM RHEUM-HAND................................ 24
71935... PALINDROM RHEUM-PELVIS.............................. 24
71936... PALINDROM RHEUM-L/LEG............................... 24
71937... PALINDROM RHEUM-ANKLE............................... 24
71938... PALINDROM RHEUM-JT NEC.............................. 24
71939... PALINDROM RHEUM-MULT JTS............................ 24
71940... JOINT PAIN-UNSPEC................................... 24
71941... JOINT PAIN-SHLDER................................... 24
71942... JOINT PAIN-UP/ARM................................... 24
71943... JOINT PAIN-FOREARM.................................. 24
[[Page 47927]]
71944... JOINT PAIN-HAND..................................... 24
71945... JOINT PAIN-PELVIS................................... 24
71946... JOINT PAIN-L/LEG.................................... 24
71947... JOINT PAIN-ANKLE.................................... 24
71948... JOINT PAIN-JT NEC................................... 24
71949... JOINT PAIN-MULT JTS................................. 24
71950... JT STIFFNESS NEC-UNSPEC............................. 24
71951... JT STIFFNESS NEC-SHLDER............................. 24
71952... JT STIFFNESS NEC-UP/ARM............................. 24
71953... JT STIFFNES NEC-FOREARM............................. 24
71954... JT STIFFNESS NEC-HAND............................... 24
71955... JT STIFFNESS NEC-PELVIS............................. 24
71956... JT STIFFNESS NEC-L/LEG.............................. 24
71957... JT STIFFNESS NEC-ANKLE.............................. 24
71958... JT STIFFNESS NEC-OTH JT............................. 24
71959... JT STIFFNESS NEC-MULT JT............................ 24
71960... JOINT SYMPT NEC-UNSP JT............................. 24
71961... JOINT SYMPTOM NEC-SHLDER............................ 24
71962... JOINT SYMPTOM NEC-UP/ARM............................ 24
71963... JOINT SYMPT NEC-FOREARM............................. 24
71964... JOINT SYMPTOM NEC-HAND.............................. 24
71965... JOINT SYMPTOM NEC-PELVIS............................ 24
71966... JOINT SYMPTOM NEC-L/LEG............................. 24
71967... JOINT SYMPTOM NEC-ANKLE............................. 24
71968... JOINT SYMPTOM NEC-OTH JT............................ 24
71969... JOINT SYMPT NEC-MULT JTS............................ 24
71970... DIFFICULT WALK-UNSPEC............................... 24
71975... DIFFICULT WALK-PELVIS............................... 24
71976... DIFFICULT WALK-LO/LEG............................... 24
71977... DIFFICULT WALK-FOOT................................. 24
71978... DIFFICULT WALK NEC.................................. 24
71979... DIFFICULT WALK-MULT................................. 24
71980... JOINT DIS NEC-UNSPEC................................ 24
71981... JOINT DIS NEC-SHLDER................................ 24
71982... JOINT DIS NEC-UP/ARM................................ 24
71983... JOINT DIS NEC-FOREARM............................... 24
71984... JOINT DIS NEC-HAND.................................. 24
71985... JOINT DIS NEC-PELVIS................................ 24
71986... JOINT DIS NEC-L/LEG................................. 24
71987... JOINT DIS NEC-ANKLE................................. 24
71988... JOINT DIS NEC-OTH JT................................ 24
71989... JOINT DIS NEC-MULT JTS.............................. 24
71990... JOINT DIS NOS-UNSPEC JT............................. 24
71991... JOINT DIS NOS-SHLDER................................ 24
71992... JOINT DIS NOS-UP/ARM................................ 24
71993... JOINT DIS NOS-FOREARM............................... 24
71994... JOINT DIS NOS-HAND.................................. 24
71995... JOINT DIS NOS-PELVIS................................ 24
71996... JOINT DIS NOS-L/LEG................................. 24
71997... JOINT DIS NOS-ANKLE................................. 24
71998... JOINT DIS NOS-OTH JT................................ 24
71999... JOINT DIS NOS-MULT JTS.............................. 24
7200.... ANKYLOSING SPONDYLITIS.............................. 24
7201.... SPINAL ENTHESOPATHY................................. 24
7202.... SACROILIITIS NEC.................................... 24
72081... SPONDYLOPATHY IN OTH DIS............................ 24
72089... INFLAM SPONDYLOPATHY NEC............................ 24
7209.... INFLAM SPONDYLOPATHY NOS............................ 24
7210.... CERVICAL SPONDYLOSIS................................ 24
7211.... CERV SPONDYL W MYELOPATH............................ 24
7212.... THORACIC SPONDYLOSIS................................ 24
7213.... LUMBOSACRAL SPONDYLOSIS............................. 24
72141... SPOND COMPR THOR SP CORD............................ 24
72142... SPOND COMPR LUMB SP CORD............................ 24
7215.... KISSING SPINE....................................... 24
7216.... ANKYL VERT HYPEROSTOSIS............................. 24
7217.... TRAUMATIC SPONDYLOPATHY............................. 24
7218.... SPINAL DISORDERS NEC................................ 24
72190... SPONDYLOS NOS W/O MYELOP............................ 24
72191... SPONDYLOSIS NOS W MYELOP............................ 24
7220.... CERVICAL DISC DISPLACMNT............................ 24
72210... LUMBAR DISC DISPLACEMENT............................ 24
72211... THORACIC DISC DISPLACMNT............................ 24
7222.... DISC DISPLACEMENT NOS............................... 24
72230... SCHMORL'S NODES NOS................................. 24
72231... SCHMORLS NODE-THORACIC.............................. 24
[[Page 47928]]
72232... SCHMORLS NODE-LUMBAR................................ 24
72239... SCHMORLS NODE-REGION NEC............................ 24
7224.... CERVICAL DISC DEGEN................................. 24
72251... THORACIC DISC DEGEN................................. 24
72252... LUMB/LUMBOSAC DISC DEGEN............................ 24
7226.... DISC DEGENERATION NOS............................... 24
72270... DISC DIS W MYELOPATH NOS............................ 24
72271... CERV DISC DIS W MYELOPAT............................ 24
72272... THOR DISC DIS W MYELOPAT............................ 24
72273... LUMB DISC DIS W MYELOPAT............................ 24
72280... POSTLAMINECTOMY SYND NOS............................ 24
72281... POSTLAMINECT SYND-CERV.............................. 24
72282... POSTLAMINECT SYND-THORAC............................ 24
72283... POSTLAMINECT SYND-LUMBAR............................ 24
72290... DISC DIS NEC/NOS-UNSPEC............................. 24
72291... DISC DIS NEC/NOS-CERV............................... 24
72292... DISC DIS NEC/NOS-THORAC............................. 24
72293... DISC DIS NEC/NOS-LUMBAR............................. 24
7230.... CERVICAL SPINAL STENOSIS............................ 24
7231.... CERVICALGIA......................................... 24
7232.... CERVICOCRANIAL SYNDROME............................. 63
7233.... CERVICOBRACHIAL SYNDROME............................ 63
7234.... BRACHIAL NEURITIS NOS............................... 63
7235.... TORTICOLLIS NOS..................................... 24
7236.... PANNICULITIS OF NECK................................ 18
7237.... OSSIFICATION CERV LIG............................... 24
7238.... CERVICAL SYNDROME NEC............................... 24
7239.... NECK DISORDER/SYMPT NOS............................. 24
72400... SPINAL STENOSIS NOS................................. 24
72401... SPINAL STENOSIS-THORACIC............................ 24
72402... SPINAL STENOSIS-LUMBAR.............................. 24
72409... SPINAL STENOSIS-OTH SITE............................ 24
7241.... PAIN IN THORACIC SPINE.............................. 24
7242.... LUMBAGO............................................. 24
7243.... SCIATICA............................................ 24
7244.... LUMBOSACRAL NEURITIS NOS............................ 24
7245.... BACKACHE NOS........................................ 24
7246.... DISORDERS OF SACRUM................................. 24
72470... DISORDER OF COCCYX NOS.............................. 24
72471... HYPERMOBILITY OF COCCYX............................. 24
72479... DISORDER OF COCCYX NEC.............................. 24
7248.... OTHER BACK SYMPTOMS................................. 24
7249.... BACK DISORDER NOS................................... 24
725..... POLYMYALGIA RHEUMATICA.............................. 24
7260.... ADHESIVE CAPSULIT SHLDER............................ 24
72610... ROTATOR CUFF SYND NOS............................... 24
72611... CALCIF TENDINITIS SHLDER............................ 24
72612... BICIPITAL TENOSYNOVITIS............................. 24
72619... ROTATOR CUFF DIS NEC................................ 24
7262.... SHOULDER REGION DIS NEC............................. 24
72630... ELBOW ENTHESOPATHY NOS.............................. 24
72631... MEDIAL EPICONDYLITIS................................ 24
72632... LATERAL EPICONDYLITIS............................... 24
72633... OLECRANON BURSITIS.................................. 24
72639... ELBOW ENTHESOPATHY NEC.............................. 24
7264.... ENTHESOPATHY OF WRIST............................... 24
7265.... ENTHESOPATHY OF HIP................................. 24
72660... ENTHESOPATHY OF KNEE NOS............................ 24
72661... PES ANSERINUS TENDINITIS............................ 24
72662... TIBIAL COLL LIG BURSITIS............................ 24
72663... FIBULA COLL LIG BURSITIS............................ 24
72664... PATELLAR TENDINITIS................................. 24
72665... PREPATELLAR BURSITIS................................ 24
72669... ENTHESOPATHY OF KNEE NEC............................ 24
72670... ANKLE ENTHESOPATHY NOS.............................. 24
72671... ACHILLES TENDINITIS................................. 24
72672... TIBIALIS TENDINITIS................................. 24
72673... CALCANEAL SPUR...................................... 24
72679... ANKLE ENTHESOPATHY NEC.............................. 24
7268.... PERIPH ENTHESOPATHY NEC............................. 24
72690... ENTHESOPATHY, SITE NOS.............................. 24
72691... EXOSTOSIS, SITE NOS................................. 24
72700... SYNOVITIS NOS....................................... 24
72701... SYNOVITIS IN OTH DIS................................ 24
72702... GIANT CELL TUMOR TENDON............................. 24
72703... TRIGGER FINGER...................................... 24
[[Page 47929]]
72704... RADIAL STYLOID TENOSYNOV............................ 24
72705... TENOSYNOV HAND/WRIST NEC............................ 24
72706... TENOSYNOVITIS FOOT/ANKLE............................ 24
72709... SYNOVITIS NEC....................................... 24
7271.... BUNION.............................................. 24
7272.... OCCUPATIONAL BURSITIS............................... 24
7273.... BURSITIS NEC........................................ 24
72740... SYNOVIAL CYST NOS................................... 24
72741... GANGLION OF JOINT................................... 24
72742... GANGLION OF TENDON.................................. 24
72743... GANGLION NOS........................................ 24
72749... BURSAL CYST NEC..................................... 24
72750... RUPTURE OF SYNOVIUM NOS............................. 24
72751... POPLITEAL SYNOVIAL CYST............................. 24
72759... RUPTURE OF SYNOVIUM NEC............................. 24
72760... NONTRAUM TENDON RUPT NOS............................ 24
72761... ROTATOR CUFF RUPTURE................................ 24
72762... BICEPS TENDON RUPTURE............................... 24
72763... RUPT EXTEN TENDON HAND.............................. 24
72764... RUPT FLEXOR TENDON HAND............................. 24
72765... RUPTURE QUADRICEP TENDON............................ 24
72766... RUPTURE PATELLAR TENDON............................. 24
72767... RUPTURE ACHILLES TENDON............................. 24
72768... RUPTURE TENDON FOOT NEC............................. 24
72769... NONTRAUM TENDON RUPT NEC............................ 24
72781... CONTRACTURE OF TENDON............................... 24
72782... CALCIUM DEPOSIT TENDON.............................. 24
72789... SYNOV/TEND/BURSA DIS NEC............................ 24
7279.... SYNOV/TEND/BURSA DIS NOS............................ 24
7280.... INFECTIVE MYOSITIS.................................. 24
72810... MUSCULAR CALCIFICAT NOS............................. 24
72811... PROG MYOSITIS OSSIFICANS............................ 24
72812... TRAUM MYOSITIS OSSIFICAN............................ 24
72813... POSTOP HETEROTOPIC CALC............................. 24
72819... MUSCULAR CALCIFICAT NEC............................. 24
7282.... MUSC DISUSE ATROPHY NEC............................. 24
7283.... MUSCLE DISORDERS NEC................................ 24
7284.... LAXITY OF LIGAMENT.................................. 24
7285.... HYPERMOBILITY SYNDROME.............................. 24
7286.... CONTRACTED PALMAR FASCIA............................ 24
72871... PLANTAR FIBROMATOSIS................................ 24
72879... FIBROMATOSES NEC.................................... 24
72881... INTERSTITIAL MYOSITIS............................... 24
72882... FB GRANULOMA OF MUSCLE.............................. 24
72883... NONTRAUM MUSCLE RUPTURE............................. 24
72884... DIASTASIS OF MUSCLE................................. 24
72885... SPASM OF MUSCLE..................................... 24
72886... NECROTIZING FASCIITIS............................... 97
72889... MUSCLE/LIGAMENT DIS NEC............................. 24
7289.... MUSCLE/LIGAMENT DIS NOS............................. 24
7290.... RHEUMATISM NOS...................................... 24
7291.... MYALGIA AND MYOSITIS NOS............................ 24
7292.... NEURALGIA/NEURITIS NOS.............................. 63
72930... PANNICULITIS, UNSP SITE............................. 18
72931... HYPERTROPHY OF FAT PAD.............................. 18
72939... PANNICULITIS, SITE NEC.............................. 18
7294.... FASCIITIS NOS....................................... 24
7295.... PAIN IN LIMB........................................ 24
7296.... OLD FB IN SOFT TISSUE............................... 72
72981... SWELLING OF LIMB.................................... 24
72982... CRAMP IN LIMB....................................... 24
72989... MUSCSKEL SYMPT LIMB NEC............................. 24
7299.... SOFT TISSUE DIS NEC/NOS............................. 24
73000... AC OSTEOMYELITIS-UNSPEC............................. 24
73001... AC OSTEOMYELITIS-SHLDER............................. 24
73002... AC OSTEOMYELITIS-UP/ARM............................. 24
73003... AC OSTEOMYELITIS-FOREARM............................ 24
73004... AC OSTEOMYELITIS-HAND............................... 24
73005... AC OSTEOMYELITIS-PELVIS............................. 24
73006... AC OSTEOMYELITIS-L/LEG.............................. 24
73007... AC OSTEOMYELITIS-ANKLE.............................. 24
73008... AC OSTEOMYELITIS NEC................................ 24
73009... AC OSTEOMYELITIS-MULT............................... 24
73010... CHR OSTEOMYELITIS-UNSP.............................. 24
73011... CHR OSTEOMYELIT-SHLDER.............................. 24
73012... CHR OSTEOMYELIT-UP/ARM.............................. 24
[[Page 47930]]
73013... CHR OSTEOMYELIT-FOREARM............................. 24
73014... CHR OSTEOMYELIT-HAND................................ 24
73015... CHR OSTEOMYELIT-PELVIS.............................. 24
73016... CHR OSTEOMYELIT-L/LEG............................... 24
73017... CHR OSTEOMYELIT-ANKLE............................... 24
73018... CHR OSTEOMYELIT NEC................................. 24
73019... CHR OSTEOMYELIT-MULT................................ 24
73020... OSTEOMYELITIS NOS-UNSPEC............................ 24
73021... OSTEOMYELITIS NOS-SHLDER............................ 24
73022... OSTEOMYELITIS NOS-UP/ARM............................ 24
73023... OSTEOMYELIT NOS-FOREARM............................. 24
73024... OSTEOMYELITIS NOS-HAND.............................. 24
73025... OSTEOMYELITIS NOS-PELVIS............................ 24
73026... OSTEOMYELITIS NOS-L/LEG............................. 24
73027... OSTEOMYELITIS NOS-ANKLE............................. 24
73028... OSTEOMYELIT NOS-OTH SITE............................ 24
73029... OSTEOMYELITIS NOS-MULT.............................. 24
73030... PERIOSTITIS-UNSPEC.................................. 24
73031... PERIOSTITIS-SHLDER.................................. 24
73032... PERIOSTITIS-UP/ARM.................................. 24
73033... PERIOSTITIS-FOREARM................................. 24
73034... PERIOSTITIS-HAND.................................... 24
73035... PERIOSTITIS-PELVIS.................................. 24
73036... PERIOSTITIS-L/LEG................................... 24
73037... PERIOSTITIS-ANKLE................................... 24
73038... PERIOSTITIS NEC..................................... 24
73039... PERIOSTITIS-MULT.................................... 24
73070... POLIO OSTEOPATHY-UNSPEC............................. 24
73071... POLIO OSTEOPATHY-SHLDER............................. 24
73072... POLIO OSTEOPATHY-UP/ARM............................. 24
73073... POLIO OSTEOPATHY-FOREARM............................ 24
73074... POLIO OSTEOPATHY-HAND............................... 24
73075... POLIO OSTEOPATHY-PELVIS............................. 24
73076... POLIO OSTEOPATHY-L/LEG.............................. 24
73077... POLIO OSTEOPATHY-ANKLE.............................. 24
73078... POLIO OSTEOPATHY NEC................................ 24
73079... POLIO OSTEOPATHY-MULT............................... 24
73080... BONE INFECT NEC-UNSPEC.............................. 24
73081... BONE INFECT NEC-SHLDER.............................. 24
73082... BONE INFECT NEC-UP/ARM.............................. 24
73083... BONE INFECT NEC-FOREARM............................. 24
73084... BONE INFECT NEC-HAND................................ 24
73085... BONE INFECT NEC-PELVIS.............................. 24
73086... BONE INFECT NEC-L/LEG............................... 24
73087... BONE INFECT NEC-ANKLE............................... 24
73088... BONE INFECT NEC-OTH SITE............................ 24
73089... BONE INFECT NEC-MULT................................ 24
73090... BONE INFEC NOS-UNSP SITE............................ 24
73091... BONE INFECT NOS-SHLDER.............................. 24
73092... BONE INFECT NOS-UP/ARM.............................. 24
73093... BONE INFECT NOS-FOREARM............................. 24
73094... BONE INFECT NOS-HAND................................ 24
73095... BONE INFECT NOS-PELVIS.............................. 24
73096... BONE INFECT NOS-L/LEG............................... 24
73097... BONE INFECT NOS-ANKLE............................... 24
73098... BONE INFECT NOS-OTH SITE............................ 24
73099... BONE INFECT NOS-MULT................................ 24
7310.... OSTEITIS DEFORMANS NOS.............................. 24
7311.... OSTEITIS DEF IN OTH DIS............................. 24
7312.... HYPERTROPH OSTEOARTHROP............................. 24
7318.... BONE INVOLV IN OTH DIS.............................. 24
7320.... JUV OSTEOCHONDROS SPINE............................. 24
7321.... JUV OSTEOCHONDROS PELVIS............................ 24
7322.... FEMORAL EPIPHYSIOLYSIS.............................. 24
7323.... JUV OSTEOCHONDROSIS ARM............................. 24
7324.... JUV OSTEOCHONDROSIS LEG............................. 24
7325.... JUV OSTEOCHONDROSIS FOOT............................ 24
7326.... JUV OSTEOCHONDROSIS NEC............................. 24
7327.... OSTEOCHONDRIT DISSECANS............................. 24
7328.... OSTEOCHONDROPATHY NEC............................... 24
7329.... OSTEOCHONDROPATHY NOS............................... 24
73300... OSTEOPOROSIS NOS.................................... 24
73301... SENILE OSTEOPOROSIS................................. 24
73302... IDIOPATHIC OSTEOPOROSIS............................. 24
73303... DISUSE OSTEOPOROSIS................................. 24
73309... OSTEOPOROSIS NEC.................................... 24
[[Page 47931]]
73310... PATH FX UNSPECIFIED SITE............................ 72
73311... PATH FX HUMERUS..................................... 72
73312... PATH FX DSTL RADIUS ULNA............................ 72
73313... PATH FX VERTEBRAE................................... 72
73314... PATH FX NECK OF FEMUR............................... 72
73315... PATH FX OTH SPCF PRT FMR............................ 72
73316... PATH FX TIBIA FIBULA................................ 72
73319... PATH FX OTH SPECIF SITE............................. 72
73320... CYST OF BONE NOS.................................... 24
73321... SOLITARY BONE CYST.................................. 24
73322... ANEURYSMAL BONE CYST................................ 24
73329... BONE CYST NEC....................................... 24
7333.... HYPEROSTOSIS OF SKULL............................... 24
73340... ASEPT NECROSIS BONE NOS............................. 24
73341... ASEPTIC NECROSIS HUMERUS............................ 24
73342... ASEPTIC NECROSIS FEMUR.............................. 24
73343... ASEPT NECRO FEMUR CONDYL............................ 24
73344... ASEPTIC NECROSIS TALUS.............................. 24
73349... ASEPT NECROSIS BONE NEC............................. 24
7335.... OSTEITIS CONDENSANS................................. 24
7336.... TIETZE'S DISEASE.................................... 33
7337.... ALGONEURODYSTROPHY.................................. 24
73381... MALUNION OF FRACTURE................................ 72
73382... NONUNION OF FRACTURE................................ 72
74742... PART ANOM PULM VEN CONN............................. 36
74749... GREAT VEIN ANOMALY NEC.............................. 36
7475.... UMBILICAL ARTERY ABSENCE............................ 36
74760... UNSP PRPHERL VASC ANOMAL............................ 36
74761... GSTRONTEST VESL ANOMALY............................. 36
74762... RENAL VESSEL ANOMALY................................ 36
74763... UPR LIMB VESSEL ANOMALY............................. 36
74764... LWR LIMB VESSEL ANOMALY............................. 36
74769... OTH SPCF PRPH VSCL ANOML............................ 36
74781... CEREBROVASCULAR ANOMALY............................. 11
74782... SPINAL VESSEL ANOMALY............................... 36
74789... CIRCULATORY ANOMALY NEC............................. 36
7479.... CIRCULATORY ANOMALY NOS............................. 11
7480.... CHOANAL ATRESIA..................................... 31
7481.... NOSE ANOMALY NEC.................................... 31
7482.... LARYNGEAL WEB....................................... 31
7483.... LARYNGOTRACH ANOMALY NEC............................ 31
7484.... CONGENITAL CYSTIC LUNG.............................. 33
7485.... AGENESIS OF LUNG.................................... 33
74860... LUNG ANOMALY NOS.................................... 33
74861... CONGEN BRONCHIECTASIS............................... 33
74869... LUNG ANOMALY NEC.................................... 33
7488.... RESPIRATORY ANOMALY NEC............................. 11
7489.... RESPIRATORY ANOMALY NOS............................. 11
74900... CLEFT PALATE NOS.................................... 31
74901... UNILAT CLEFT PALATE-COMP............................ 31
74902... UNILAT CLEFT PALATE-INC............................. 31
74903... BILAT CLEFT PALATE-COMPL............................ 31
74904... BILAT CLEFT PALATE-INC.............................. 31
74910... CLEFT LIP NOS....................................... 31
74911... UNILAT CLEFT LIP-COMPL.............................. 31
74912... UNILAT CLEFT LIP-IMCOMPL............................ 31
74913... BILAT CLEFT LIP-COMPLETE............................ 31
74914... BILAT CLEFT LIP-INCOMPL............................. 31
74920... CLEFT PALATE & LIP NOS.............................. 31
74921... UNIL CLEFT PALAT/LIP-COM............................ 31
74922... UNIL CLEFT PALAT/LIP-INC............................ 31
74923... BILAT CLFT PALAT/LIP-COM............................ 31
74924... BILAT CLFT PALAT/LIP-INC............................ 31
74925... CLEFT PALATE & LIP NEC.............................. 31
7500.... TONGUE TIE.......................................... 31
75010... TONGUE ANOMALY NOS.................................. 31
75011... AGLOSSIA............................................ 31
75012... CONG ADHESIONS OF TONGUE............................ 31
75013... CONG FISSURE OF TONGUE.............................. 31
75015... CONG MACROGLOSSIA................................... 31
75016... MICROGLOSSIA........................................ 31
75019... TONGUE ANOMALY NEC.................................. 31
75021... SALIVARY GLAND ABSENCE.............................. 31
75022... ACCESSORY SALIVARY GLAND............................ 31
75023... CONG ATRESIA, SALIV DUCT............................ 31
75024... CONG SALIVARY FISTULA............................... 31
[[Page 47932]]
75025... CONGENITAL LIP FISTULA.............................. 31
75026... MOUTH ANOMALY NEC................................... 11
75027... DIVERTICULUM OF PHARYNX............................. 31
75029... PHARYNGEAL ANOMALY NEC.............................. 11
7503.... CONG ESOPH FISTULA/ATRES............................ 41
7504.... ESOPHAGEAL ANOMALY NEC.............................. 41
7505.... CONG PYLORIC STENOSIS............................... 41
7506.... CONGENITAL HIATUS HERNIA............................ 41
7507.... GASTRIC ANOMALY NEC................................. 41
7508.... UPPER GI ANOMALY NEC................................ 41
7509.... UPPER GI ANOMALY NOS................................ 41
7510.... MECKEL'S DIVERTICULUM............................... 41
7511.... ATRESIA SMALL INTESTINE............................. 41
7512.... ATRESIA LARGE INTESTINE............................. 41
7513.... HIRSCHSPRUNG'S DISEASE.............................. 41
7514.... INTESTINAL FIXATION ANOM............................ 41
7515.... INTESTINAL ANOMALY NEC.............................. 41
75160... BILIARY & LIVER ANOM NOS............................ 41
75161... BILIARY ATRESIA..................................... 41
75162... CONG CYSTIC LIVER DIS............................... 41
75169... BILIARY & LIVER ANOM NEC............................ 41
7517.... PANCREAS ANOMALIES.................................. 41
7518.... ANOM DIGESTIVE SYST NEC............................. 41
7519.... ANOM DIGESTIVE SYST NOS............................. 41
7520.... ANOMALIES OF OVARIES................................ 56
75210... TUBAL/BROAD LIG ANOM NOS............................ 56
75211... EMBRYONIC CYST OF ADNEXA............................ 56
75219... TUBAL/BROAD LIG ANOM NEC............................ 56
7522.... DOUBLING OF UTERUS.................................. 56
7523.... UTERINE ANOMALY NEC................................. 56
75240... CERVIX/FEM GEN ANOM NOS............................. 56
75241... EMBRYON CYST FEM GEN NEC............................ 56
75242... IMPERFORATE HYMEN................................... 56
75249... CERVIX/FEM GEN ANOM NEC............................. 56
7527.... INDETERMINATE SEX................................... 53
7528.... GENITAL ORGAN ANOM NEC.............................. 53
7529.... GENITAL ORGAN ANOM NOS.............................. 53
7530.... RENAL AGENESIS...................................... 53
75310... CYSTIC KIDNEY DISEAS NOS............................ 53
75311... CONGENITAL RENAL CYST............................... 53
75312... POLYCYSTIC KIDNEY NOS............................... 53
75313... POLYCYST KID-AUTOSOM DOM............................ 53
75314... POLYCYST KID-AUTOSOM REC............................ 53
75315... RENAL DYSPLASIA..................................... 53
75316... MEDULLARY CYSTIC KIDNEY............................. 53
75317... MEDULLARY SPONGE KIDNEY............................. 53
75319... CYSTIC KIDNEY DISEAS NEC............................ 53
7533.... KIDNEY ANOMALY NEC.................................. 53
7534.... URETERAL ANOMALY NEC................................ 53
7535.... BLADDER EXSTROPHY................................... 53
7536.... CONGEN URETHRAL STENOSIS............................ 53
7537.... ANOMALIES OF URACHUS................................ 53
7538.... CYSTOURETHRAL ANOM NEC.............................. 53
7539.... URINARY ANOMALY NOS................................. 53
7540.... CONG SKULL/FACE/JAW DEF............................. 24
7541.... CONGENITAL TORTICOLLIS.............................. 24
7542.... CONG POSTURAL DEFORMITY............................. 24
75430... CONG HIP DISLOC, UNILAT............................. 24
75431... CONGEN HIP DISLOC, BILAT............................ 24
75432... CONG HIP SUBLUX, UNILAT............................. 24
75433... CONG HIP SUBLUX, BILAT.............................. 24
75435... CONG HIP DISLOC W SUBLUX............................ 24
75440... CONG GENU RECURVATUM................................ 24
75441... CONG KNEE DISLOCATION............................... 24
75442... CONGEN BOWING OF FEMUR.............................. 24
75443... CONG BOWING TIBIA/FIBULA............................ 24
75444... CONG BOWING LEG NOS................................. 24
75450... TALIPES VARUS....................................... 24
75451... TALIPES EQUINOVARUS................................. 24
75452... METATARSUS PRIMUS VARUS............................. 24
75453... METATARSUS VARUS.................................... 24
75459... CONG VARUS FOOT DEF NEC............................. 24
75460... TALIPES VALGUS...................................... 24
75461... CONGENITAL PES PLANUS............................... 24
75462... TALIPES CALCANEOVALGUS.............................. 24
75469... CONG VALGUS FOOT DEF NEC............................ 24
[[Page 47933]]
75470... TALIPES NOS......................................... 24
75471... TALIPES CAVUS....................................... 24
75479... CONG FOOT DEFORM NEC................................ 24
75481... PECTUS EXCAVATUM.................................... 11
75482... PECTUS CARINATUM.................................... 11
75489... NONTERATOGENIC ANOM NEC............................. 24
75500... POLYDACTYLY NOS..................................... 24
75501... POLYDACTYLY, FINGERS................................ 24
75502... POLYDACTYLY, TOES................................... 24
75510... SYNDACTYLY, MULTIPLE/NOS............................ 24
75511... SYNDACTYL FING-NO FUSION............................ 24
75512... SYNDACTYL FING W FUSION............................. 24
75513... SYNDACTYL TOE-NO FUSION............................. 24
75514... SYNDACTYL TOE W FUSION.............................. 24
75520... REDUC DEFORM UP LIMB NOS............................ 24
75521... TRANSVERSE DEFIC ARM................................ 24
75522... LONGITUD DEFIC ARM NEC.............................. 24
75523... COMBIN LONGIT DEFIC ARM............................. 24
75524... LONGITUDIN DEFIC HUMERUS............................ 24
75525... LONGITUD DEFIC RADIOULNA............................ 24
75526... LONGITUD DEFIC RADIUS............................... 24
75527... LONGITUDINAL DEFIC ULNA............................. 24
75528... LONGITUDINAL DEFIC HAND............................. 24
75529... LONGITUD DEFIC PHALANGES............................ 24
75530... REDUCTION DEFORM LEG NOS............................ 24
75531... TRANSVERSE DEFIC LEG................................ 24
75532... LONGITUDIN DEFIC LEG NEC............................ 24
75533... COMB LONGITUDIN DEF LEG............................. 24
75534... LONGITUDINAL DEFIC FEMUR............................ 24
75535... TIBIOFIBULA LONGIT DEFIC............................ 24
75536... LONGITUDINAL DEFIC TIBIA............................ 24
75537... LONGITUDIN DEFIC FIBULA............................. 24
75538... LONGITUDINAL DEFIC FOOT............................. 24
75539... LONGITUD DEFIC PHALANGES............................ 24
7554.... REDUCT DEFORM LIMB NOS.............................. 24
75550... UPPER LIMB ANOMALY NOS.............................. 24
75551... CONG DEFORMITY-CLAVICLE............................. 24
75552... CONG ELEVATION-SCAPULA.............................. 24
75553... RADIOULNAR SYNOSTOSIS............................... 24
75554... MADELUNG'S DEFORMITY................................ 24
75555... ACROCEPHALOSYNDACTYLY............................... 24
75556... ACCESSORY CARPAL BONES.............................. 24
75557... MACRODACTYLIA (FINGERS)............................. 24
75558... CONGENITAL CLEFT HAND............................... 24
75559... UPPER LIMB ANOMALY NEC.............................. 24
75560... LOWER LIMB ANOMALY NOS.............................. 24
75561... CONGENITAL COXA VALGA............................... 24
75562... CONGENITAL COXA VARA................................ 24
75563... CONG HIP DEFORMITY NEC.............................. 24
75564... CONG KNEE DEFORMITY................................. 24
75565... MACRODACTYLIA OF TOES............................... 24
75566... ANOMALIES OF TOES NEC............................... 24
75567... ANOMALIES OF FOOT NEC............................... 24
75569... LOWER LIMB ANOMALY NEC.............................. 24
7558.... CONGEN LIMB ANOMALY NEC............................. 24
7559.... CONGEN LIMB ANOMALY NOS............................. 24
7560.... ANOMAL SKULL/FACE BONES............................. 24
75610... ANOMALY OF SPINE NOS................................ 24
75611... LUMBOSACR SPONDYLOLYSIS............................. 24
75612... SPONDYLOLISTHESIS................................... 24
75613... CONG ABSENCE OF VERTEBRA............................ 24
75614... HEMIVERTEBRA........................................ 24
75615... CONGEN FUSION OF SPINE.............................. 24
75616... KLIPPEL-FEIL SYNDROME............................... 24
75617... SPINA BIFIDA OCCULTA................................ 63
75619... ANOMALY OF SPINE NEC................................ 24
7562.... CERVICAL RIB........................................ 24
7563.... RIB & STERNUM ANOMAL NEC............................ 11
7564.... CHONDRODYSTROPHY.................................... 24
75650... OSTEODYSTROPHY NOS.................................. 24
75651... OSTEOGENESIS IMPERFECTA............................. 24
75652... OSTEOPETROSIS....................................... 24
75653... OSTEOPOIKILOSIS..................................... 24
75654... POLYOSTOTIC FIBROS DYSPL............................ 24
75655... CHONDROECTODERM DYSPLAS............................. 24
75656... MULT EPIPHYSEAL DYSPLAS............................. 24
[[Page 47934]]
75659... OSTEODYSTROPHY NEC.................................. 24
7566.... ANOMALIES OF DIAPHRAGM.............................. 11
75681... ABSENCE OF MUSCLE/TENDON............................ 24
75682... ACCESSORY MUSCLE.................................... 24
75683... EHLERS-DANLOS SYNDROME.............................. 24
75689... SOFT TISSUE ANOMALY NEC............................. 24
7569.... MUSCULOSKEL ANOM NEC/NOS............................ 24
7570.... HEREDITARY EDEMA OF LEGS............................ 18
7571.... ICHTHYOSIS CONGENITA................................ 18
7572.... DERMATOGLYPHIC ANOMALIES............................ 18
75731... CONG ECTODERMAL DYSPLAS............................. 18
75732... VASCULAR HAMARTOMAS................................. 18
75733... CONG SKIN PIGMENT ANOMAL............................ 18
75739... SKIN ANOMALY NEC.................................... 18
7574.... HAIR ANOMALIES NEC.................................. 18
7575.... NAIL ANOMALIES NEC.................................. 18
7576.... BREAST ANOMALIES NEC................................ 18
7578.... OTH INTEGUMENT ANOMALIES............................ 18
7579.... INTEGUMENT ANOMALY NOS.............................. 18
7580.... DOWN'S SYNDROME..................................... 91
7581.... PATAU'S SYNDROME.................................... 91
7582.... EDWARDS' SYNDROME................................... 91
7583.... AUTOSOMAL DELETION SYND............................. 91
7584.... BALANCE AUTOSOM TRANSLOC............................ 11
7585.... AUTOSOMAL ANOMALIES NEC............................. 11
7586.... GONADAL DYSGENESIS.................................. 53
7587.... KLINEFELTER'S SYNDROME.............................. 53
7589.... CHROMOSOME ANOMALY NOS.............................. 57
7590.... ANOMALIES OF SPLEEN................................. 86
7591.... ADRENAL GLAND ANOMALY............................... 82
7592.... ENDOCRINE ANOMALY NEC............................... 82
7593.... SITUS INVERSUS...................................... 41
7594.... CONJOINED TWINS..................................... 57
7595.... TUBEROUS SCLEROSIS.................................. 63
7596.... HAMARTOSES NEC...................................... 18
7597.... MULT CONGEN ANOMAL NEC.............................. 57
75981... PRADER-WILLI SYNDROME............................... 57
75982... MARFAN SYNDROME..................................... 57
75983... FRAGILE X SYNDROME.................................. 82
75989... SPECFIED CONG ANOMAL NEC............................ 57
7599.... CONGENITAL ANOMALY NOS.............................. 57
7600.... MATERN HYPERTEN AFF NB.............................. 57
7601.... MATERN URINE DIS AFF NB............................. 57
7602.... MATERNAL INFEC AFF NB............................... 57
7603.... MATERN CARDIORESP AFF NB............................ 57
7604.... MATERN NUTRIT DIS AFF NB............................ 57
7605.... MATERNAL INJURY AFF NB.............................. 57
7606.... SURG OP ON MOTHER AFF NB............................ 57
76070... NOXIOUS SUBST NOS AFF NB............................ 57
76071... MATERNAL ALCOHOL AFF NB............................. 57
76072... MATERNAL NARCOTIC AFF NB............................ 57
76073... MATERNAL HALLUCIN AFF NB............................ 57
76074... MATERNAL ANTI-INF AFF NB............................ 57
76075... COCAINE - NXS INFL FETUS............................ 57
76076... FTS/NB AFCTD MTRNL DES.............................. 56
76079... NOXIOUS SUBST NEC AFF NB............................ 57
7608.... MATERNAL COND NEC AFF NB............................ 57
7609.... MATERNAL COND NOS AFF NB............................ 57
7610.... INCOMPETNT CERVIX AFF NB............................ 57
7611.... PREMAT RUPT MEMB AFF NB............................. 57
7612.... OLIGOHYDRAMNIOS AFF NB.............................. 57
7613.... POLYHYDRAMNIOS AFF NB............................... 57
7614.... ECTOPIC PREGNANCY AFF NB............................ 57
7615.... MULT PREGNANCY AFF NB............................... 57
7616.... MATERNAL DEATH AFF NB............................... 57
7617.... ANTEPART MALPRES AFF NB............................. 57
7618.... MATERN COMPL NEC AFF NB............................. 57
7619.... MATERN COMPL NOS AFF NB............................. 57
7620.... PLACENTA PREVIA AFF NB.............................. 57
7621.... PLACENTA HEM NEC AFF NB............................. 57
7622.... ABN PLAC NEC/NOS AFF NB............................. 57
7623.... PLACENT TRANSFUSION SYN............................. 57
7624.... PROLAPSED CORD AFF NB............................... 57
7625.... OTH UMBIL CORD COMPRESS............................. 57
7626.... UMBIL COND NEC AFF NB............................... 57
7627.... CHORIOAMNIONITIS AFF NB............................. 57
[[Page 47935]]
7628.... ABN AMNION NEC AFF NB............................... 57
7629.... ABN AMNION NOS AFF NB............................... 57
7630.... BREECH DEL/EXTRAC AFF NB............................ 57
7631.... MALPOS/DISPRO NEC AFF NB............................ 57
7632.... FORCEPS DELIVERY AFF NB............................. 57
7633.... VACUUM EXTRAC DEL AFF NB............................ 57
7634.... CESAREAN DELIVERY AFF NB............................ 57
7635.... MAT ANESTH/ANALG AFF NB............................. 57
7636.... PRECIPITATE DEL AFF NB.............................. 57
7637.... ABN UTERINE CONTR AFF NB............................ 57
7638.... COMPL DELIV NEC AFF NB.............................. 57
7639.... COMPL DELIV NOS AFF NB.............................. 57
76400... LIGHT-FOR-DATES WTNOS............................... 57
76401... LIGHT-FOR-DATES <500G............................... 57
76402... LT-FOR-DATES 500-749G............................... 57
76403... LT-FOR-DATES 750-999G............................... 57
76404... LT-FOR-DATES 1000-1249G............................. 57
76405... LT-FOR-DATES 1250-1499G............................. 57
76406... LT-FOR-DATES 1500-1749G............................. 57
76407... LT-FOR-DATES 1750-1999G............................. 57
76408... LT-FOR-DATES 2000-2499G............................. 57
76409... LT-FOR-DATES 2500+G................................. 57
76410... LT-FOR-DATE W/MAL WTNOS............................. 57
76411... LT-FOR-DATE W/MAL <500G............................. 57
76412... LT-DATE W/MAL 500-749G.............................. 57
76413... LT-DATE W/MAL 750-999G.............................. 57
76414... LT-DATE W/MAL 1000-1249G............................ 57
76415... LT-DATE W/MAL 1250-1499G............................ 57
76416... LT-DATE W/MAL 1500-1749G............................ 57
76417... LT-DATE W/MAL 1750-1999G............................ 57
76418... LT-DATE W/MAL 2000-2499G............................ 57
76419... LT-FOR-DATE W/MAL 2500+G............................ 57
76420... FETAL MALNUTRITION WTNOS............................ 57
76421... FETAL MALNUTRITION <500G............................ 57
76422... FETAL MALNUTR 500-749G.............................. 57
76423... FETAL MAL 750-999G.................................. 57
76424... FETAL MAL 1000-1249G................................ 57
76425... FETAL MAL 1250-1499G................................ 57
76426... FETAL MAL 1500-1749G................................ 57
76427... FETAL MALNUTR 1750-1999G............................ 57
76428... FETAL MALNUTR 2000-2499G............................ 57
76429... FETAL MALNUTR 2500+G................................ 57
76490... FET GROWTH RETARD WTNOS............................. 57
76491... FET GROWTH RETARD <500G............................. 57
76492... FET GROWTH RET 500-749G............................. 57
76493... FET GROWTH RET 750-999G............................. 57
76494... FET GRWTH RET 1000-1249G............................ 57
76495... FET GRWTH RET 1250-1499G............................ 57
76496... FET GRWTH RET 1500-1749G............................ 57
76497... FET GRWTH RET 1750-1999G............................ 57
76498... FET GRWTH RET 2000-2499G............................ 57
76499... FET GROWTH RET 2500+G............................... 57
76500... EXTREME IMMATUR WTNOS............................... 57
76501... EXTREME IMMATUR <500G............................... 57
76502... EXTREME IMMATUR 500-749G............................ 57
76503... EXTREME IMMATUR 750-999G............................ 57
76504... EXTREME IMMAT 1000-1249G............................ 57
76505... EXTREME IMMAT 1250-1499G............................ 57
76506... EXTREME IMMAT 1500-1749G............................ 57
76507... EXTREME IMMAT 1750-1999G............................ 57
76508... EXTREME IMMAT 2000-2499G............................ 57
76509... EXTREME IMMAT 2500+G................................ 57
76510... PRETERM INFANT NEC WTNOS............................ 57
76511... PRETERM NEC <500G................................... 57
76512... PRETERM NEC 500-749G................................ 57
76513... PRETERM NEC 750-999G................................ 57
76514... PRETERM NEC 1000-1249G.............................. 57
76515... PRETERM NEC 1250-1499G.............................. 57
76516... PRETERM NEC 1500-1749G.............................. 57
76517... PRETERM NEC 1750-1999G.............................. 57
76518... PRETERM NEC 2000-2499G.............................. 57
76519... PRETERM NEC 2500+G.................................. 57
7660.... EXCEPTIONALLY LARGE BABY............................ 57
7661.... HEAVY-FOR-DATE INFAN NEC............................ 57
7662.... POST-TERM INFANT NOS................................ 57
7670.... CEREBRAL HEM AT BIRTH............................... 57
[[Page 47936]]
7671.... SCALP INJURY AT BIRTH............................... 57
7672.... CLAVICLE FX AT BIRTH................................ 57
7673.... BONE INJURY NEC AT BIRTH............................ 57
7674.... SPINAL CORD INJ AT BIRTH............................ 57
7675.... FACIAL NERVE INJ-BIRTH.............................. 57
7676.... BRACH PLEXUS INJ-BIRTH.............................. 57
7677.... NERVE INJ NEC AT BIRTH.............................. 57
7678.... BIRTH TRAUMA NEC.................................... 57
7679.... BIRTH TRAUMA NOS.................................... 57
7680.... FETAL DEATH-ANOXIA NOS.............................. 57
7681.... FET DEATH-ANOXIA DUR LAB............................ 57
7682.... FET DISTRESS BEFOR LABOR............................ 57
7683.... FETAL DISTRESS DUR LABOR............................ 57
7684.... FETAL DISTRESS NOS.................................. 57
7685.... SEVERE BIRTH ASPHYXIA............................... 57
7686.... MILD/MOD BIRTH ASPHYXIA............................. 57
7689.... BIRTH ASPHYXIA NOS.................................. 57
769..... RESPIRATORY DISTRESS SYN............................ 57
7700.... CONGENITAL PNEUMONIA................................ 57
7701.... MECONIUM ASPIRATN SYNDRM............................ 57
7702.... NB INTERSTIT EMPHYSEMA.............................. 57
7703.... NB PULMONARY HEMORRHAGE............................. 57
7704.... PRIMARY ATELECTASIS................................. 57
7705.... NB ATELECTASIS NEC/NOS.............................. 57
7706.... NB TRANSITORY TACHYPNEA............................. 57
7707.... PERINATAL CHR RESP DIS.............................. 57
7708.... POST-BIRTH RESP PROB NEC............................ 57
7709.... NB RESPIRATORY COND NOS............................. 57
7710.... CONGENITAL RUBELLA.................................. 57
7711.... CONG CYTOMEGALOVIRUS INF............................ 57
7712.... CONGENITAL INFEC NEC................................ 57
7713.... TETANUS NEONATORUM.................................. 57
7714.... OMPHALITIS OF NEWBORN............................... 57
7715.... NEONATAL INFEC MASTITIS............................. 57
7716.... NEONATAL CONJUNCTIVITIS............................. 57
7717.... NEONATAL CANDIDA INFECT............................. 57
7718.... PERINATAL INFECTION NEC............................. 57
7720.... FETAL BLOOD LOSS NEC................................ 57
7721.... NB INTRAVENTRICULAR HEM............................. 57
7722.... NB SUBARACHNOID HEMORR.............................. 57
7723.... POST-BIRTH UMBIL HEMORR............................. 57
7724.... NB GI HEMORRHAGE.................................... 57
7725.... NB ADRENAL HEMORRHAGE............................... 57
7726.... NB CUTANEOUS HEMORRHAGE............................. 57
7728.... NEONATAL HEMORRHAGE NEC............................. 57
7729.... NEONATAL HEMORRHAGE NOS............................. 57
7730.... NB HEMOLYT DIS:RH ISOIMM............................ 57
7731.... NB HEMOLYT DIS-ABO ISOIM............................ 57
7732.... NB HEMOLYT DIS-ISOIM NEC............................ 57
7733.... HYDROPS FETALIS:ISOIMM.............................. 57
7734.... NB KERNICTERUS:ISOIMMUN............................. 57
7735.... NB LATE ANEMIA:ISOIMMUN............................. 57
7740.... PERINAT JAUND-HERED ANEM............................ 57
7741.... PERINAT JAUND:HEMOLYSIS............................. 57
7742.... NEONAT JAUND PRETERM DEL............................ 57
77430... DELAY CONJUGAT JAUND NOS............................ 57
77431... NEONAT JAUND IN OTH DIS............................. 57
77439... DELAY CONJUGAT JAUND NEC............................ 57
7744.... FETAL/NEONATAL HEPATITIS............................ 57
7745.... PERINATAL JAUNDICE NEC.............................. 57
7746.... FETAL/NEONATAL JAUND NOS............................ 57
7747.... NB KERNICTERUS...................................... 57
7750.... INFANT DIABET MOTHER SYN............................ 57
7751.... NEONAT DIABETES MELLITUS............................ 57
7752.... NEONAT MYASTHENIA GRAVIS............................ 57
7753.... NEONATAL THYROTOXICOSIS............................. 57
7754.... HYPOCALCEM/HYPOMAGNES NB............................ 57
7755.... NEONATAL DEHYDRATION................................ 57
7756.... NEONATAL HYPOGLYCEMIA............................... 57
7757.... LATE METAB ACIDOSIS NB.............................. 57
7758.... TRANSIENT MET DIS NB NEC............................ 57
7759.... TRANSIENT MET DIS NB NOS............................ 57
7760.... NB HEMORRHAGIC DISEASE.............................. 57
7761.... NEONATAL THROMBOCYTOPEN............................. 57
7762.... DISSEM INTRAVASC COAG NB............................ 57
7763.... OTH NEONATAL COAG DIS............................... 57
[[Page 47937]]
7764.... POLYCYTHEMIA NEONATORUM............................. 57
7765.... CONGENITAL ANEMIA................................... 57
7766.... ANEMIA OF PREMATURITY............................... 57
7767.... NEONATAL NEUTROPENIA................................ 57
7768.... TRANSIENT HEMAT DIS NEC............................. 57
7769.... NB HEMATOLOGICAL DIS NOS............................ 57
7771.... MECONIUM OBSTRUCTION................................ 57
7772.... INTEST OBST-INSPISS MILK............................ 57
7773.... SWALLOWED BLOOD SYNDROME............................ 57
7774.... TRANSITORY ILEUS OF NB.............................. 57
7775.... NECROT ENTEROCOLITIS NB............................. 57
7776.... PERINATAL INTEST PERFOR............................. 57
7778.... PERINAT GI SYS DIS NEC.............................. 57
7779.... PERINAT GI SYS DIS NOS.............................. 57
7780.... HYDROPS FETALIS NO ISOIM............................ 57
7781.... SCLEREMA NEONATORUM................................. 57
7782.... NB COLD INJURY SYNDROME............................. 57
7783.... NB HYPOTHERMIA NEC.................................. 57
7784.... NB TEMP REGULAT DIS NEC............................. 57
7785.... EDEMA OF NEWBORN NEC/NOS............................ 57
7786.... CONGENITAL HYDROCELE................................ 57
7787.... NB BREAST ENGORGEMENT............................... 57
7788.... NB INTEGUMENT COND NEC.............................. 57
7789.... NB INTEGUMENT COND NOS.............................. 57
7790.... CONVULSIONS IN NEWBORN.............................. 57
7791.... NB CEREB IRRIT NEC/NOS.............................. 57
7792.... CNS DYSFUNCTION SYN NB.............................. 57
7793.... NB FEEDING PROBLEMS................................. 57
7794.... NB DRUG REACTION/INTOXIC............................ 57
7795.... NB DRUG WITHDRAWAL SYNDR............................ 57
*7796... TERMINATION OF PREGNANCY............................ ........
7798.... PERINATAL CONDITION NEC............................. 57
7799.... PERINATAL CONDITION NOS............................. 57
78001... COMA................................................ 78
78002... TRANS ALTER AWARENESS............................... 63
78003... PERSISTENT VEGTV STATE.............................. 78
78009... OTHER ALTER CONSCIOUSNES............................ 63
7801.... HALLUCINATIONS...................................... 91
7802.... SYNCOPE AND COLLAPSE................................ 63
7804.... DIZZINESS AND GIDDINESS............................. 11
78050... SLEEP DISTURBANCE NOS............................... 91
78051... INSOMNIA W SLEEP APNEA.............................. 63
78052... INSOMNIA NEC........................................ 91
78053... HYPERSOMNI W SLEEP APNEA............................ 63
78054... HYPERSOMNIA NEC..................................... 91
78055... IRREG SLEEP-WAKE RHY NOS............................ 91
78056... SLEEP STAGE DYSFUNCTIONS............................ 91
78057... OTH UNSPCF SLEEP APNEA.............................. 91
78059... SLEEP DISTURBANCES NEC.............................. 91
7806.... FEVER............................................... 97
7807.... MALAISE AND FATIGUE................................. 11
7808.... HYPERHIDROSIS....................................... 99
7809.... GENERAL SYMPTOMS NEC................................ 11
7810.... ABN INVOLUN MOVEMENT NEC............................ 63
7811.... SMELL & TASTE DISTURB............................... 63
7812.... ABNORMALITY OF GAIT................................. 63
7813.... LACK OF COORDINATION................................ 11
7814.... TRANSIENT LIMB PARALYSIS............................ 63
7815.... CLUBBING OF FINGERS................................. 33
7816.... MENINGISMUS......................................... 78
7817.... TETANY.............................................. 82
7818.... NEUROLOGIC NEGLECT SYNDR............................ 63
7819.... NERV/MUSCULSKEL SYM NEC............................. 11
7820.... SKIN SENSATION DISTURB.............................. 11
7821.... NONSPECIF SKIN ERUPT NEC............................ 18
7822.... LOCAL SUPRFICIAL SWELLNG............................ 11
7823.... EDEMA............................................... 11
7824.... JAUNDICE NOS........................................ 41
7825.... CYANOSIS............................................ 36
78261... PALLOR.............................................. 11
78262... FLUSHING............................................ 11
7827.... SPONTANEOUS ECCHYMOSES.............................. 86
7828.... CHANGES IN SKIN TEXTURE............................. 11
7829.... INTEGUMENT TISS SYMP NEC............................ 11
7830.... ANOREXIA............................................ 41
7831.... ABNORMAL WEIGHT GAIN................................ 82
[[Page 47938]]
7832.... ABNORMAL LOSS OF WEIGHT............................. 82
7833.... FEEDING PROBLEM..................................... 41
7834.... LACK NORM PHYSIOL DEVEL............................. 82
7835.... POLYDIPSIA.......................................... 82
7836.... POLYPHAGIA.......................................... 82
7839.... NUTR/METAB/DEVEL SYM NEC............................ 82
7840.... HEADACHE............................................ 63
7841.... THROAT PAIN......................................... 11
7842.... SWELLING IN HEAD & NECK............................. 11
7843.... APHASIA............................................. 63
78440... VOICE DISTURBANCE NOS............................... 11
78441... APHONIA............................................. 11
78449... VOICE DISTURBANCE NEC............................... 11
7845.... SPEECH DISTURBANCE NEC.............................. 11
78460... SYMBOLIC DYSFUNCTION NOS............................ 91
78461... ALEXIA AND DYSLEXIA................................. 91
78469... SYMBOLIC DYSFUNCTION NEC............................ 91
7847.... EPISTAXIS........................................... 31
7848.... HEMORRHAGE FROM THROAT.............................. 41
7849.... SYMP INVOL HEAD/NECK NEC............................ 11
7850.... TACHYCARDIA NOS..................................... 36
7851.... PALPITATIONS........................................ 36
7852.... CARDIAC MURMURS NEC................................. 36
7853.... ABNORM HEART SOUNDS NEC............................. 36
7854.... GANGRENE............................................ 36
78550... SHOCK NOS........................................... 78
78551... CARDIOGENIC SHOCK................................... 78
78559... SHOCK W/O TRAUMA NEC................................ 97
7856.... ENLARGEMENT LYMPH NODES............................. 86
7859.... CARDIOVAS SYS SYMP NEC.............................. 36
78600... RESPIRATORY ABNORM NOS.............................. 33
78601... HYPERVENTILATION.................................... 11
78602... ORTHOPNEA........................................... 36
78609... RESPIRATORY ABNORM NEC.............................. 33
7861.... STRIDOR............................................. 33
7862.... COUGH............................................... 31
7863.... HEMOPTYSIS.......................................... 33
7864.... ABNORMAL SPUTUM..................................... 11
78650... CHEST PAIN NOS...................................... 36
78651... PRECORDIAL PAIN..................................... 36
78652... PAINFUL RESPIRATION................................. 36
78659... CHEST PAIN NEC...................................... 36
7866.... CHEST SWELLING/MASS/LUMP............................ 24
7867.... ABNORMAL CHEST SOUNDS............................... 11
7868.... HICCOUGH............................................ 11
7869.... RESP SYS/CHEST SYMP NEC............................. 11
7870.... NAUSEA AND VOMITING*................................ 41
78701... NAUSEA WITH VOMITING................................ 41
78702... NAUSEA ALONE........................................ 41
78703... VOMITING ALONE...................................... 41
7871.... HEARTBURN........................................... 41
7872.... DYSPHAGIA........................................... 41
7873.... FLATUL/ERUCTAT/GAS PAIN............................. 41
7874.... VISIBLE PERISTALSIS................................. 41
7875.... ABNORMAL BOWEL SOUNDS............................... 41
7876.... INCONTINENCE OF FECES............................... 41
7877.... ABNORMAL FECES...................................... 41
78791... DIARRHEA............................................ 41
78799... DIGESTVE SYST SYMPTM NEC............................ 41
7880.... RENAL COLIC......................................... 53
7881.... DYSURIA............................................. 53
78820... RETENTION URINE NOS................................. 53
78821... INCMPLET BLDDER EMPTYING............................ 53
78829... OTH SPCF RETENTION URINE............................ 53
7883.... INCONTINENCE OF URINE*.............................. 53
78830... URINARY INCONTINENCE NOS............................ 53
78831... URGE INCONTINENCE................................... 53
78832... STRESS INCONTINENCE MALE............................ 53
78833... MIXED INCONTINENCE.................................. 53
78834... INCONTNCE WO SENSR AWARE............................ 53
78835... POST-VOID DRIBBLING................................. 53
78836... NOCTURNAL ENURESIS.................................. 53
78837... CONTINUOUS LEAKAGE.................................. 53
78839... OTH URINRY INCONTINENCE............................. 53
78841... URINARY FREQUENCY................................... 53
78842... POLYURIA............................................ 53
[[Page 47939]]
78843... NOCTURIA............................................ 53
7885.... OLIGURIA & ANURIA................................... 53
78861... SPLITTING URINARY STREAM............................ 53
78862... SLOWING URINARY STREAM.............................. 53
78869... OTH ABNORMALT URINATION............................. 53
7887.... URETHRAL DISCHARGE.................................. 97
7888.... EXTRAVASATION OF URINE.............................. 53
7889.... URINARY SYS SYMPTOM NEC............................. 53
78900... ABDMNAL PAIN UNSPCF SITE............................ 41
78901... ABDMNAL PAIN RT UPR QUAD............................ 41
78902... ABDMNAL PAIN LFT UP QUAD............................ 41
78903... ABDMNAL PAIN RT LWR QUAD............................ 41
78904... ABDMNAL PAIN LT LWR QUAD............................ 41
78905... ABDMNAL PAIN PERIUMBILIC............................ 41
78906... ABDMNAL PAIN EPIGASTRIC............................. 41
78907... ABDMNAL PAIN GENERALIZED............................ 41
78909... ABDMNAL PAIN OTH SPCF ST............................ 41
7891.... HEPATOMEGALY........................................ 41
7892.... SPLENOMEGALY........................................ 86
78930... ABDMNAL MASS UNSPCF SITE............................ 41
78931... ABDMNAL MASS RT UPR QUAD............................ 41
78932... ABDMNAL MASS LFT UP QUAD............................ 41
78933... ABDMNAL MASS RT LWR QUAD............................ 41
78934... ABDMNAL MASS LT LWR QUAD............................ 41
78935... ABDMNAL MASS PERIUMBILIC............................ 41
78936... ABDMNAL MASS EPIGASTRIC............................. 41
78937... ABDMNAL MASS GENERALIZED............................ 41
78939... ABDMNAL MASS OTH SPCF ST............................ 41
78940... ABDMNAL RGDT UNSPCF SITE............................ 41
78941... ABDMNAL RGDT RT UPR QUAD............................ 41
78942... ABDMNAL RGDT LFT UP QUAD............................ 41
78943... ABDMNAL RGDT RT LWR QUAD............................ 41
78944... ABDMNAL RGDT LT LWR QUAD............................ 41
78945... ABDMNAL RGDT PERIUMBILIC............................ 41
78946... ABDMNAL RGDT EPIGASTRIC............................. 41
78947... ABDMNAL RGDT GENERALIZED............................ 41
78949... ABDMNAL RGDT OTH SPCF ST............................ 41
7895.... ASCITES............................................. 41
78960... ABDMNAL TNDR UNSPCF SITE............................ 41
78961... ABDMNAL TNDR RT UPR QUAD............................ 41
78962... ABDMNAL TNDR LFT UP QUAD............................ 41
78963... ABDMNAL TNDR RT LWR QUAD............................ 41
78964... ABDMNAL TNDR LT LWR QUAD............................ 41
78965... ABDMNAL TNDR PERIUMBILIC............................ 41
78966... ABDMNAL TNDR EPIGASTRIC............................. 41
78967... ABDMNAL TNDR GENERALIZED............................ 41
78969... ABDMNAL TNDR OTH SPCF ST............................ 41
7899.... ABDOMEN/PELVIS SYMP NEC............................. 11
7900.... ABNORM RED BLOOD CELL............................... 86
7901.... ELEVATED SEDIMENT RATE.............................. 11
7902.... ABN GLUCOSE TOLERAN TEST............................ 11
7903.... EXCESS BLOOD-ALCOHOL LEV............................ 91
7904.... ELEV TRANSAMINASE/LDH............................... 11
7905.... ABN SERUM ENZY LEVEL NEC............................ 11
7906.... ABN BLOOD CHEMISTRY NEC............................. 11
7907.... BACTEREMIA.......................................... 97
7908.... VIREMIA NOS......................................... 97
79091... ABNRML ART BLOOD GASES.............................. 11
79092... ABNRML COAGULTION PRFILE............................ 11
79093... ELVTD PRSTATE SPCF ANTGN............................ 11
79099... OTH NSPCF FINDING BLOOD............................. 11
7910.... PROTEINURIA......................................... 53
7911.... CHYLURIA............................................ 78
7912.... HEMOGLOBINURIA...................................... 53
7913.... MYOGLOBINURIA....................................... 53
7914.... BILIURIA............................................ 53
7915.... GLYCOSURIA.......................................... 53
7916.... ACETONURIA.......................................... 53
7917.... OTH CELLS/CASTS IN URINE............................ 53
7919.... ABN URINE FINDINGS NEC.............................. 53
7920.... ABN FND-CEREBROSPINAL FL............................ 11
7921.... ABN FIND-STOOL CONTENTS............................. 11
7922.... ABN FINDINGS-SEMEN.................................. 53
7923.... ABN FIND-AMNIOTIC FLUID............................. 57
7924.... ABN FINDINGS-SALIVA................................. 11
7929.... ABN FIND-BODY SUBST NEC............................. 11
[[Page 47940]]
7930.... ABN FINDING-SKULL & HEAD............................ 11
7931.... ABN FINDINGS-LUNG FIELD............................. 11
7932.... ABN FD-INTRATHOR ORG NEC............................ 11
7933.... ABN FIND-BILIARY TRACT.............................. 41
7934.... ABN FINDINGS-GI TRACT............................... 11
7935.... ABN FINDINGS-GU ORGANS.............................. 53
7936.... ABN FIND-ABDOMINAL AREA............................. 11
7937.... ABN FIND-MUSCULOSKEL SYS............................ 11
7938.... ABNORMAL FINDINGS-BREAST............................ 18
7939.... ABN FIND-BODY STRUCT NEC............................ 11
79400... ABN CNS FUNCT STUDY NOS............................. 11
79401... ABNORM ECHOENCEPHALOGRAM............................ 11
79402... ABN ELECTROENCEPHALOGRAM............................ 11
79409... ABN CNS FUNCT STUDY NEC............................. 11
79410... ABN STIMUL RESPONSE NOS............................. 11
79411... ABN RETINAL FUNCT STUDY............................. 68
79412... ABNORM ELECTRO-OCULOGRAM............................ 68
79413... ABNORMAL VEP........................................ 68
79414... ABN OCULOMOTOR STUDIES.............................. 68
79415... ABN AUDITORY FUNCT STUDY............................ 31
79416... ABN VESTIBULAR FUNC STUD............................ 11
79417... ABNORM ELECTROMYOGRAM............................... 24
79419... ABN PERIPH NERV STUD NEC............................ 11
7942.... ABN PULMONARY FUNC STUDY............................ 11
79430... ABN CARDIOVASC STUDY NOS............................ 11
79431... ABNORM ELECTROCARDIOGRAM............................ 11
79439... ABN CARDIOVASC STUDY NEC............................ 11
7944.... ABN KIDNEY FUNCT STUDY.............................. 53
7945.... ABN THYROID FUNCT STUDY............................. 82
7946.... ABN ENDOCRINE STUDY NEC............................. 82
7947.... ABN BASAL METABOL STUDY............................. 82
7948.... ABN LIVER FUNCTION STUDY............................ 41
7949.... ABN FUNCTION STUDY NEC.............................. 53
7950.... ABN PAP SMEAR-CERVIX................................ 56
7951.... ABN PAP SMEAR-OTH SITE.............................. 56
7952.... ABN CHROMOSOMAL ANALYSIS............................ 57
7953.... POSITIVE CULTURE FINDING............................ 97
7954.... ABN HISTOLOGIC FIND NEC............................. 11
7955.... TUBERCULIN TEST REACTION............................ 11
7956.... FALSE POS SERO TEST-SYPH............................ 11
79571... NONSPCF SERLGC EVDNC HIV............................ 86
79579... OTH UNSPCF NSPF IMUN FND............................ 86
7960.... ABN TOXICOLOGIC FINDING............................. 11
7961.... ABNORMAL REFLEX..................................... 11
7962.... ELEV BL PRES W/O HYPERTN............................ 36
7963.... LOW BLOOD PRESS READING............................. 36
7964.... ABN CLINICAL FINDING NEC............................ 11
7969.... ABNORMAL FINDINGS NEC............................... 11
797..... SENILITY W/O PSYCHOSIS.............................. 91
7980.... SUDDEN INFANT DEATH SYND............................ 99
7981.... INSTANTANEOUS DEATH................................. 99
7982.... DEATH WITHIN 24 HR SYMPT............................ 99
7989.... UNATTENDED DEATH.................................... 99
7990.... ASPHYXIA............................................ 78
7991.... RESPIRATORY ARREST.................................. 78
7992.... NERVOUSNESS......................................... 91
7993.... DEBILITY NOS........................................ 11
7994.... CACHEXIA............................................ 41
7998.... ILL-DEFINE CONDITION NEC............................ 11
7999.... UNKN CAUSE MORB/MORT NEC............................ 11
80000... CLOSED SKULL VAULT FX............................... 72
80001... CL SKULL VLT FX W/O COMA............................ 72
80002... CL SKULL VLT FX-BRF COMA............................ 72
80003... CL SKULL VLT FX-MOD COMA............................ 72
80004... CL SKL VLT FX-PROLN COMA............................ 72
80005... CL SKUL VLT FX-DEEP COMA............................ 72
80006... CL SKULL VLT FX-COMA NOS............................ 72
80009... CL SKL VLT FX-CONCUS NOS............................ 72
80010... CL SKL VLT FX/CEREBR LAC............................ 72
80011... CL SKULL VLT FX W/O COMA............................ 72
80012... CL SKULL VLT FX-BRF COMA............................ 72
80013... CL SKULL VLT FX-MOD COMA............................ 72
80014... CL SKL VLT FX-PROLN COMA............................ 72
80015... CL SKUL VLT FX-DEEP COMA............................ 72
80016... CL SKULL VLT FX-COMA NOS............................ 72
80019... CL SKL VLT FX-CONCUS NOS............................ 72
[[Page 47941]]
80020... CL SKL VLT FX/MENING HEM............................ 72
80021... CL SKULL VLT FX W/O COMA............................ 72
80022... CL SKULL VLT FX-BRF COMA............................ 72
80023... CL SKULL VLT FX-MOD COMA............................ 72
80024... CL SKL VLT FX-PROLN COMA............................ 72
80025... CL SKUL VLT FX-DEEP COMA............................ 72
80026... CL SKULL VLT FX-COMA NOS............................ 72
80029... CL SKL VLT FX-CONCUS NOS............................ 72
80030... CL SKULL VLT FX/HEM NEC............................. 72
80031... CL SKULL VLT FX W/O COMA............................ 72
80032... CL SKULL VLT FX-BRF COMA............................ 72
80033... CL SKULL VLT FX-MOD COMA............................ 72
80034... CL SKL VLT FX-PROLN COMA............................ 72
80035... CL SKUL VLT FX-DEEP COMA............................ 72
80036... CL SKULL VLT FX-COMA NOS............................ 72
80039... CL SKL VLT FX-CONCUS NOS............................ 72
80040... CL SKL VLT FX/BR INJ NEC............................ 72
80041... CL SKULL VLT FX W/O COMA............................ 72
80042... CL SKULL VLT FX-BRF COMA............................ 72
80043... CL SKULL VLT FX-MOD COMA............................ 72
80044... CL SKL VLT FX-PROLN COMA............................ 72
80045... CL SKUL VLT FX-DEEP COMA............................ 72
80046... CL SKULL VLT FX-COMA NOS............................ 72
80049... CL SKL VLT FX-CONCUS NOS............................ 72
80050... OPN SKULL VAULT FRACTURE............................ 72
80051... OPN SKUL VLT FX W/O COMA............................ 72
80052... OPN SKUL VLT FX-BRF COMA............................ 72
80053... OPN SKUL VLT FX-MOD COMA............................ 72
80054... OPN SKL VLT FX-PROLN COM............................ 72
80055... OPN SKL VLT FX-DEEP COMA............................ 72
80056... OPN SKUL VLT FX-COMA NOS............................ 72
80059... OP SKL VLT FX-CONCUS NOS............................ 72
80060... OPN SKL VLT FX/CEREB LAC............................ 72
80061... OPN SKUL VLT FX W/O COMA............................ 72
80062... OPN SKUL VLT FX-BRF COMA............................ 72
80063... OPN SKUL VLT FX-MOD COMA............................ 72
80064... OPN SKL VLT FX-PROLN COM............................ 72
80065... OPN SKL VLT FX-DEEP COMA............................ 72
80066... OPN SKUL VLT FX-COMA NOS............................ 72
80069... OP SKL VLT FX-CONCUS NOS............................ 72
80070... OPN SKL VLT FX/MENIN HEM............................ 72
80071... OPN SKUL VLT FX W/O COMA............................ 72
80072... OPN SKUL VLT FX-BRF COMA............................ 72
80073... OPN SKUL VLT FX-MOD COMA............................ 72
80074... OPN SKL VLT FX-PROLN COM............................ 72
80075... OPN SKL VLT FX-DEEP COMA............................ 72
80076... OPN SKUL VLT FX-COMA NOS............................ 72
80079... OP SKL VLT FX-CONCUS NOS............................ 72
80080... OPN SKULL VLT FX/HEM NEC............................ 72
80081... OPN SKUL VLT FX W/O COMA............................ 72
80082... OPN SKUL VLT FX-BRF COMA............................ 72
80083... OPN SKUL VLT FX-MOD COMA............................ 72
80084... OPN SKL VLT FX-PROLN COM............................ 72
80085... OPN SKL VLT FX-DEEP COMA............................ 72
80086... OPN SKUL VLT FX-COMA NOS............................ 72
80089... OP SKL VLT FX-CONCUS NOS............................ 72
80090... OP SKL VLT FX/BR INJ NEC............................ 72
80091... OPN SKUL VLT FX W/O COMA............................ 72
80092... OPN SKUL VLT FX-BRF COMA............................ 72
80093... OPN SKUL VLT FX-MOD COMA............................ 72
80094... OPN SKL VLT FX-PROLN COM............................ 72
80095... OP SKUL VLT FX-DEEP COMA............................ 72
80096... OPN SKUL VLT FX-COMA NOS............................ 72
80099... OP SKL VLT FX-CONCUS NOS............................ 72
80100... CLOS SKULL BASE FRACTURE............................ 72
80101... CL SKUL BASE FX W/O COMA............................ 72
80102... CL SKUL BASE FX-BRF COMA............................ 72
80103... CL SKUL BASE FX-MOD COMA............................ 72
80104... CL SKL BASE FX-PROL COMA............................ 72
80105... CL SKL BASE FX-DEEP COMA............................ 72
80106... CL SKUL BASE FX-COMA NOS............................ 72
80109... CL SKULL BASE FX-CONCUSS............................ 72
80110... CL SKL BASE FX/CEREB LAC............................ 72
80111... CL SKUL BASE FX W/O COMA............................ 72
80112... CL SKUL BASE FX-BRF COMA............................ 72
80113... CL SKUL BASE FX-MOD COMA............................ 72
[[Page 47942]]
80114... CL SKL BASE FX-PROL COMA............................ 72
80115... CL SKL BASE FX-DEEP COMA............................ 72
80116... CL SKUL BASE FX-COMA NOS............................ 72
80119... CL SKULL BASE FX-CONCUSS............................ 72
80120... CL SKL BASE FX/MENIN HEM............................ 72
80121... CL SKUL BASE FX W/O COMA............................ 72
80122... CL SKUL BASE FX/BRF COMA............................ 72
80123... CL SKUL BASE FX-MOD COMA............................ 72
80124... CL SKL BASE FX-PROL COMA............................ 72
80125... CL SKL BASE FX-DEEP COMA............................ 72
80126... CL SKUL BASE FX-COMA NOS............................ 72
80129... CL SKULL BASE FX-CONCUSS............................ 72
80130... CL SKULL BASE FX/HEM NEC............................ 72
80131... CL SKUL BASE FX W/O COMA............................ 72
80132... CL SKUL BASE FX-BRF COMA............................ 72
80133... CL SKUL BASE FX-MOD COMA............................ 72
80134... CL SKL BASE FX-PROL COMA............................ 72
80135... CL SKL BASE FX-DEEP COMA............................ 72
80136... CL SKUL BASE FX-COMA NOS............................ 72
80139... CL SKULL BASE FX-CONCUSS............................ 72
80140... CL SK BASE FX/BR INJ NEC............................ 72
80141... CL SKUL BASE FX W/O COMA............................ 72
80142... CL SKUL BASE FX-BRF COMA............................ 72
80143... CL SKUL BASE FX-MOD COMA............................ 72
80144... CL SKL BASE FX-PROL COMA............................ 72
80145... CL SKL BASE FX-DEEP COMA............................ 72
80146... CL SKUL BASE FX-COMA NOS............................ 72
80149... CL SKULL BASE FX-CONCUSS............................ 72
80150... OPEN SKULL BASE FRACTURE............................ 72
80151... OPN SKL BASE FX W/O COMA............................ 72
80152... OPN SKL BASE FX-BRF COMA............................ 72
80153... OPN SKL BASE FX-MOD COMA............................ 72
80154... OP SKL BASE FX-PROL COMA............................ 72
80155... OP SKL BASE FX-DEEP COMA............................ 72
80156... OPN SKL BASE FX-COMA NOS............................ 72
80159... OPN SKUL BASE FX-CONCUSS............................ 72
80160... OP SKL BASE FX/CEREB LAC............................ 72
80161... OPN SKL BASE FX W/O COMA............................ 72
80162... OPN SKL BASE FX-BRF COMA............................ 72
80163... OPN SKL BASE FX-MOD COMA............................ 72
80164... OP SKL BASE FX-PROL COMA............................ 72
80165... OP SKL BASE FX-DEEP COMA............................ 72
80166... OPN SKL BASE FX-COMA NOS............................ 72
80169... OPN SKUL BASE FX-CONCUSS............................ 72
80170... OP SKL BASE FX/MENIN HEM............................ 72
80171... OPN SKL BASE FX W/O COMA............................ 72
80172... OPN SKL BASE FX-BRF COMA............................ 72
80173... OPN SKL BASE FX-MOD COMA............................ 72
80174... OP SKL BASE FX-PROL COMA............................ 72
80175... OP SKL BASE FX-DEEP COMA............................ 72
80176... OPN SKL BASE FX-COMA NOS............................ 72
80179... OPN SKUL BASE FX-CONCUSS............................ 72
80180... OPN SKUL BASE FX/HEM NEC............................ 72
80181... OPN SKL BASE FX W/O COMA............................ 72
80182... OPN SKL BASE FX-BRF COMA............................ 72
80183... OPN SKL BASE FX-MOD COMA............................ 72
80184... OP SKL BASE FX-PROL COMA............................ 72
80185... OP SKL BASE FX-DEEP COMA............................ 72
80186... OPN SKL BASE FX-COMA NOS............................ 72
80189... OPN SKUL BASE FX-CONCUSS............................ 72
80190... OP SK BASE FX/BR INJ NEC............................ 72
80191... OP SKUL BASE FX W/O COMA............................ 72
80192... OPN SKL BASE FX-BRF COMA............................ 72
80193... OPN SKL BASE FX-MOD COMA............................ 72
80194... OP SKL BASE FX-PROL COMA............................ 72
80195... OP SKL BASE FX-DEEP COMA............................ 72
80196... OPN SKL BASE FX-COMA NOS............................ 72
80199... OPN SKUL BASE FX-CONCUSS............................ 72
8020.... NASAL BONE FX-CLOSED................................ 72
8021.... NASAL BONE FX-OPEN.................................. 72
80220... MANDIBLE FX NOS-CLOSED.............................. 72
80221... FX CONDYL PROC MANDIB-CL............................ 72
80222... SUBCONDYLAR FX MANDIB-CL............................ 72
80223... FX CORON PROC MANDIB-CL............................. 72
80224... FX RAMUS NOS-CLOSED................................. 72
80225... FX ANGLE OF JAW-CLOSED.............................. 72
[[Page 47943]]
80226... FX SYMPHY MANDIB BODY-CL............................ 72
80227... FX ALVEOLAR BORD MAND-CL............................ 72
80228... FX MANDIBLE BODY NEC-CL............................. 72
80229... MULT FX MANDIBLE-CLOSED............................. 72
80230... MANDIBLE FX NOS-OPEN................................ 72
80231... FX CONDYL PROC MAND-OPEN............................ 72
80232... SUBCONDYL FX MANDIB-OPEN............................ 72
80233... FX CORON PROC MANDIB-OPN............................ 72
80234... FX RAMUS NOS-OPEN................................... 72
80235... FX ANGLE OF JAW-OPEN................................ 72
80236... FX SYMPHY MANDIB BDY-OPN............................ 72
80237... FX ALV BORD MAND BDY-OPN............................ 72
80238... FX MANDIBLE BODY NEC-OPN............................ 72
80239... MULT FX MANDIBLE-OPEN............................... 72
8024.... FX MALAR/MAXILLARY-CLOSE............................ 72
8025.... FX MALAR/MAXILLARY-OPEN............................. 72
8026.... FX ORBITAL FLOOR-CLOSED............................. 72
8027.... FX ORBITAL FLOOR-OPEN............................... 72
8028.... FX FACIAL BONE NEC-CLOSE............................ 72
8029.... FX FACIAL BONE NEC-OPEN............................. 72
80300... CLOSE SKULL FRACTURE NEC............................ 72
80301... CL SKULL FX NEC W/O COMA............................ 72
80302... CL SKULL FX NEC-BRF COMA............................ 72
80303... CL SKULL FX NEC-MOD COMA............................ 72
80304... CL SKL FX NEC-PROLN COMA............................ 72
80305... CL SKUL FX NEC-DEEP COMA............................ 72
80306... CL SKULL FX NEC-COMA NOS............................ 72
80309... CL SKULL FX NEC-CONCUSS............................. 72
80310... CL SKL FX NEC/CEREBR LAC............................ 72
80311... CL SKULL FX NEC W/O COMA............................ 72
80312... CL SKULL FX NEC-BRF COMA............................ 72
80313... CL SKULL FX NEC-MOD COMA............................ 72
80314... CL SKL FX NEC-PROLN COMA............................ 72
80315... CL SKUL FX NEC-DEEP COMA............................ 72
80316... CL SKULL FX NEC-COMA NOS............................ 72
80319... CL SKULL FX NEC-CONCUSS............................. 72
80320... CL SKL FX NEC/MENING HEM............................ 72
80321... CL SKULL FX NEC W/O COMA............................ 72
80322... CL SKULL FX NEC-BRF COMA............................ 72
80323... CL SKULL FX NEC-MOD COMA............................ 72
80324... CL SKL FX NEC-PROLN COMA............................ 72
80325... CL SKUL FX NEC-DEEP COMA............................ 72
80326... CL SKULL FX NEC-COMA NOS............................ 72
80329... CL SKULL FX NEC-CONCUSS............................. 72
80330... CL SKULL FX NEC/HEM NEC............................. 72
80331... CL SKULL FX NEC W/O COMA............................ 72
80332... CL SKULL FX NEC-BRF COMA............................ 72
80333... CL SKULL FX NEC-MOD COMA............................ 72
80334... CL SKL FX NEC-PROLN COMA............................ 72
80335... CL SKUL FX NEC-DEEP COMA............................ 72
80336... CL SKULL FX NEC-COMA NOS............................ 72
80339... CL SKULL FX NEC-CONCUSS............................. 72
80340... CL SKL FX NEC/BR INJ NEC............................ 72
80341... CL SKULL FX NEC W/O COMA............................ 72
80342... CL SKULL FX NEC-BRF COMA............................ 72
80343... CL SKULL FX NEC-MOD COMA............................ 72
80344... CL SKL FX NEC-PROLN COMA............................ 72
80345... CL SKUL FX NEC-DEEP COMA............................ 72
80346... CL SKULL FX NEC-COMA NOS............................ 72
80349... CL SKULL FX NEC-CONCUSS............................. 72
80350... OPEN SKULL FRACTURE NEC............................. 72
80351... OPN SKUL FX NEC W/O COMA............................ 72
80352... OPN SKUL FX NEC-BRF COMA............................ 72
80353... OPN SKUL FX NEC-MOD COMA............................ 72
80354... OPN SKL FX NEC-PROL COMA............................ 72
80355... OPN SKL FX NEC-DEEP COMA............................ 72
80356... OPN SKUL FX NEC-COMA NOS............................ 72
80359... OPN SKULL FX NEC-CONCUSS............................ 72
80360... OPN SKL FX NEC/CEREB LAC............................ 72
80361... OPN SKUL FX NEC W/O COMA............................ 72
80362... OPN SKUL FX NEC-BRF COMA............................ 72
80363... OPN SKUL FX NEC-MOD COMA............................ 72
80364... OPN SKL FX NEC-PROLN COM............................ 72
80365... OPN SKL FX NEC-DEEP COMA............................ 72
80366... OPN SKUL FX NEC-COMA NOS............................ 72
80369... OPN SKULL FX NEC-CONCUSS............................ 72
[[Page 47944]]
80370... OPN SKL FX NEC/MENIN HEM............................ 72
80371... OPN SKUL FX NEC W/O COMA............................ 72
80372... OPN SKUL FX NEC-BRF COMA............................ 72
80373... OPN SKUL FX NEC-MOD COMA............................ 72
80374... OPN SKL FX NEC-PROL COMA............................ 72
80375... OPN SKL FX NEC-DEEP COMA............................ 72
80376... OPN SKUL FX NEC-COMA NOS............................ 72
80379... OPN SKULL FX NEC-CONCUSS............................ 72
80380... OPN SKULL FX NEC/HEM NEC............................ 72
80381... OPN SKUL FX NEC W/O COMA............................ 72
80382... OPN SKUL FX NEC-BRF COMA............................ 72
80383... OPN SKUL FX NEC-MOD COMA............................ 72
80384... OPN SKL FX NEC-PROL COMA............................ 72
80385... OPN SKL FX NEC-DEEP COMA............................ 72
80386... OPN SKUL FX NEC-COMA NOS............................ 72
80389... OPN SKULL FX NEC-CONCUSS............................ 72
80390... OP SKL FX NEC/BR INJ NEC............................ 72
80391... OPN SKUL FX NEC W/O COMA............................ 72
80392... OPN SKUL FX NEC-BRF COMA............................ 72
80393... OPN SKUL FX NEC-MOD COMA............................ 72
80394... OPN SKL FX NEC-PROL COMA............................ 72
80395... OPN SKL FX NEC-DEEP COMA............................ 72
80396... OPN SKUL FX NEC-COMA NOS............................ 72
80399... OPN SKULL FX NEC-CONCUSS............................ 72
80400... CL SKUL FX W OTH BONE FX............................ 72
80401... CL SKL W OTH FX W/O COMA............................ 72
80402... CL SKL W OTH FX-BRF COMA............................ 72
80403... CL SKL W OTH FX-MOD COMA............................ 72
80404... CL SKL/OTH FX-PROLN COMA............................ 72
80405... CL SKUL/OTH FX-DEEP COMA............................ 72
80406... CL SKL W OTH FX-COMA NOS............................ 72
80409... CL SKUL W OTH FX-CONCUSS............................ 72
80410... CL SK W OTH FX/CEREB LAC............................ 72
80411... CL SKL W OTH FX W/O COMA............................ 72
80412... CL SKL W OTH FX-BRF COMA............................ 72
80413... CL SKL W OTH FX-MOD COMA............................ 72
80414... CL SKL/OTH FX-PROLN COMA............................ 72
80415... CL SKUL/OTH FX-DEEP COMA............................ 72
80416... CL SKL W OTH FX-COMA NOS............................ 72
80419... CL SKUL W OTH FX-CONCUSS............................ 72
80420... CL SKL/OTH FX/MENING HEM............................ 72
80421... CL SKL W OTH FX W/O COMA............................ 72
80422... CL SKL W OTH FX-BRF COMA............................ 72
80423... CL SKL W OTH FX-MOD COMA............................ 72
80424... CL SKL/OTH FX-PROLN COMA............................ 72
80425... CL SKUL/OTH FX-DEEP COMA............................ 72
80426... CL SKL W OTH FX-COMA NOS............................ 72
80429... CL SKUL W OTH FX-CONCUSS............................ 72
80430... CL SKUL W OTH FX/HEM NEC............................ 72
80431... CL SKL W OTH FX W/O COMA............................ 72
80432... CL SKL W OTH FX-BRF COMA............................ 72
80433... CL SKL W OTH FX-MOD COMA............................ 72
80434... CL SKL/OTH FX-PROLN COMA............................ 72
80435... CL SKUL/OTH FX-DEEP COMA............................ 72
80436... CL SKL W OTH FX-COMA NOS............................ 72
80439... CL SKUL W OTH FX-CONCUSS............................ 72
80440... CL SKL/OTH FX/BR INJ NEC............................ 72
80441... CL SKL W OTH FX W/O COMA............................ 72
80442... CL SKL W OTH FX-BRF COMA............................ 72
80443... CL SKL W OTH FX-MOD COMA............................ 72
80444... CL SKL/OTH FX-PROLN COMA............................ 72
80445... CL SKUL/OTH FX-DEEP COMA............................ 72
80446... CL SKL W OTH FX-COMA NOS............................ 72
80449... CL SKUL W OTH FX-CONCUSS............................ 72
80450... OPN SKULL FX/OTH BONE FX............................ 72
80451... OPN SKUL/OTH FX W/O COMA............................ 72
80452... OPN SKUL/OTH FX-BRF COMA............................ 72
80453... OPN SKUL/OTH FX-MOD COMA............................ 72
80454... OPN SKL/OTH FX-PROL COMA............................ 72
80455... OPN SKL/OTH FX-DEEP COMA............................ 72
80456... OPN SKUL/OTH FX-COMA NOS............................ 72
80459... OPN SKULL/OTH FX-CONCUSS............................ 72
80460... OPN SKL/OTH FX/CEREB LAC............................ 72
80461... OPN SKUL/OTH FX W/O COMA............................ 72
80462... OPN SKUL/OTH FX-BRF COMA............................ 72
80463... OPN SKUL/OTH FX-MOD COMA............................ 72
[[Page 47945]]
80464... OPN SKL/OTH FX-PROL COMA............................ 72
80465... OPN SKL/OTH FX-DEEP COMA............................ 72
80466... OPN SKUL/OTH FX-COMA NOS............................ 72
80469... OPN SKULL/OTH FX-CONCUSS............................ 72
80470... OPN SKL/OTH FX/MENIN HEM............................ 72
80471... OPN SKUL/OTH FX W/O COMA............................ 72
80472... OPN SKUL/OTH FX-BRF COMA............................ 72
80473... OPN SKUL/OTH FX-MOD COMA............................ 72
80474... OPN SKL/OTH FX-PROL COMA............................ 72
80475... OPN SKL/OTH FX-DEEP COMA............................ 72
80476... OPN SKUL/OTH FX-COMA NOS............................ 72
80479... OPN SKULL/OTH FX-CONCUSS............................ 72
80480... OPN SKL W OTH FX/HEM NEC............................ 72
80481... OPN SKUL/OTH FX W/O COMA............................ 72
80482... OPN SKUL/OTH FX-BRF COMA............................ 72
80483... OPN SKUL/OTH FX-MOD COMA............................ 72
80484... OPN SKL/OTH FX-PROL COMA............................ 72
80485... OPN SKL/OTH FX-DEEP COMA............................ 72
80486... OPN SKUL/OTH FX-COMA NOS............................ 72
80489... OPN SKULL/OTH FX-CONCUSS............................ 72
80490... OP SKL/OTH FX/BR INJ NEC............................ 72
80491... OPN SKUL/OTH FX W/O COMA............................ 72
80492... OPN SKUL/OTH FX-BRF COMA............................ 72
80493... OPN SKUL/OTH FX-MOD COMA............................ 72
80494... OPN SKL/OTH FX-PROL COMA............................ 72
80495... OPN SKL/OTH FX-DEEP COMA............................ 72
80496... OPN SKUL/OTH FX-COMA NOS............................ 72
80499... OPN SKULL/OTH FX-CONCUSS............................ 72
80500... FX CERVICAL VERT NOS-CL............................. 72
80501... FX C1 VERTEBRA-CLOSED............................... 72
80502... FX C2 VERTEBRA-CLOSED............................... 72
80503... FX C3 VERTEBRA-CLOSED............................... 72
80504... FX C4 VERTEBRA-CLOSED............................... 72
80505... FX C5 VERTEBRA-CLOSED............................... 72
80506... FX C6 VERTEBRA-CLOSED............................... 72
80507... FX C7 VERTEBRA-CLOSED............................... 72
80508... FX MULT CERVICAL VERT-CL............................ 72
80510... FX CERVICAL VERT NOS-OPN............................ 72
80511... FX C1 VERTEBRA-OPEN................................. 72
80512... FX C2 VERTEBRA-OPEN................................. 72
80513... FX C3 VERTEBRA-OPEN................................. 72
80514... FX C4 VERTEBRA-OPEN................................. 72
80515... FX C5 VERTEBRA-OPEN................................. 72
80516... FX C6 VERTEBRA-OPEN................................. 72
80517... FX C7 VERTEBRA-OPEN................................. 72
80518... FX MLT CERVICAL VERT-OPN............................ 72
8052.... FX DORSAL VERTEBRA-CLOSE............................ 72
8053.... FX DORSAL VERTEBRA-OPEN............................. 72
8054.... FX LUMBAR VERTEBRA-CLOSE............................ 72
8055.... FX LUMBAR VERTEBRA-OPEN............................. 72
8056.... FX SACRUM/COCCYX-CLOSED............................. 24
8057.... FX SACRUM/COCCYX-OPEN............................... 24
8058.... VERTEBRAL FX NOS-CLOSED............................. 72
8059.... VERTEBRAL FX NOS-OPEN............................... 72
80600... C1-C4 FX-CL/CORD INJ NOS............................ 72
80601... C1-C4 FX-CL/COM CORD LES............................ 72
80602... C1-C4 FX-CL/ANT CORD SYN............................ 72
80603... C1-C4 FX-CL/CEN CORD SYN............................ 72
80604... C1-C4 FX-CL/CORD INJ NEC............................ 72
80605... C5-C7 FX-CL/CORD INJ NOS............................ 72
80606... C5-C7 FX-CL/COM CORD LES............................ 72
80607... C5-C7 FX-CL/ANT CORD SYN............................ 72
80608... C5-C7 FX-CL/CEN CORD SYN............................ 72
80609... C5-C7 FX-CL/CORD INJ NEC............................ 72
80610... C1-C4 FX-OP/CORD INJ NOS............................ 72
80611... C1-C4 FX-OP/COM CORD LES............................ 72
80612... C1-C4 FX-OP/ANT CORD SYN............................ 72
80613... C1-C4 FX-OP/CEN CORD SYN............................ 72
80614... C1-C4 FX-OP/CORD INJ NEC............................ 72
0615.... C5-C7 FX-OP/CORD INJ NOS............................ 72
80616... C5-C7 FX-OP/COM CORD LES............................ 72
80617... C5-C7 FX-OP/ANT CORD SYN............................ 72
80618... C5-C7 FX-OP/CEN CORD SYN............................ 72
80619... C5-C7 FX-OP/CORD INJ NEC............................ 72
80620... T1-T6 FX-CL/CORD INJ NOS............................ 72
80621... T1-T6 FX-CL/COM CORD LES............................ 72
[[Page 47946]]
80622... T1-T6 FX-CL/ANT CORD SYN............................ 72
80623... T1-T6 FX-CL/CEN CORD SYN............................ 72
80624... T1-T6 FX-CL/CORD INJ NEC............................ 72
80625... T7-T12 FX-CL/CRD INJ NOS............................ 72
80626... T7-T12 FX-CL/COM CRD LES............................ 72
80627... T7-T12 FX-CL/ANT CRD SYN............................ 72
80628... T7-T12 FX-CL/CEN CRD SYN............................ 72
80629... T7-T12 FX-CL/CRD INJ NEC............................ 72
80630... T1-T6 FX-OP/CORD INJ NOS............................ 72
80631... T1-T6 FX-OP/COM CORD LES............................ 72
80632... T1-T6 FX-OP/ANT CORD SYN............................ 72
80633... T1-T6 FX-OP/CEN CORD SYN............................ 72
80634... T1-T6 FX-OP/CORD INJ NEC............................ 72
80635... T7-T12 FX-OP/CRD INJ NOS............................ 72
80636... T7-T12 FX-OP/COM CRD LES............................ 72
80637... T7-T12 FX-OP/ANT CRD SYN............................ 72
80638... T7-T12 FX-OP/CEN CRD SYN............................ 72
80639... T7-T12 FX-OP/CRD INJ NEC............................ 72
8064.... CL LUMBAR FX W CORD INJ............................. 72
8065.... OPN LUMBAR FX W CORD INJ............................ 72
80660... FX SACRUM-CL/CRD INJ NOS............................ 72
80661... FX SACR-CL/CAUDA EQU LES............................ 72
80662... FX SACR-CL/CAUDA INJ NEC............................ 72
80669... FX SACRUM-CL/CRD INJ NEC............................ 72
80670... FX SACRUM-OP/CRD INJ NOS............................ 72
80671... FX SACR-OP/CAUDA EQU LES............................ 72
80672... FX SACR-OP/CAUDA INJ NEC............................ 72
80679... FX SACRUM-OP/CRD INJ NEC............................ 72
8068.... VERT FX NOS-CL W CRD INJ............................ 72
8069.... VERT FX NOS-OP W CRD INJ............................ 72
80700... FRACTURE RIB NOS-CLOSED............................. 72
80701... FRACTURE ONE RIB-CLOSED............................. 72
80702... FRACTURE TWO RIBS-CLOSED............................ 72
80703... FRACTURE THREE RIBS-CLOS............................ 72
80704... FRACTURE FOUR RIBS-CLOSE............................ 72
80705... FRACTURE FIVE RIBS-CLOSE............................ 72
80706... FRACTURE SIX RIBS-CLOSED............................ 72
80707... FRACTURE SEVEN RIBS-CLOS............................ 72
80708... FX EIGHT/MORE RIB-CLOSED............................ 72
80709... FX MULT RIBS NOS-CLOSED............................. 72
80710... FRACTURE RIB NOS-OPEN............................... 72
80711... FRACTURE ONE RIB-OPEN............................... 72
80712... FRACTURE TWO RIBS-OPEN.............................. 72
80713... FRACTURE THREE RIBS-OPEN............................ 72
80714... FRACTURE FOUR RIBS-OPEN............................. 72
80715... FRACTURE FIVE RIBS-OPEN............................. 72
80716... FRACTURE SIX RIBS-OPEN.............................. 72
80717... FRACTURE SEVEN RIBS-OPEN............................ 72
80718... FX EIGHT/MORE RIBS-OPEN............................. 72
80719... FX MULT RIBS NOS-OPEN............................... 72
8072.... FRACTURE OF STERNUM-CLOS............................ 72
8073.... FRACTURE OF STERNUM-OPEN............................ 72
8074.... FLAIL CHEST......................................... 72
8075.... FX LARYNX/TRACHEA-CLOSED............................ 72
8076.... FX LARYNX/TRACHEA-OPEN.............................. 72
8080.... FRACTURE ACETABULUM-CLOS............................ 72
8081.... FRACTURE ACETABULUM-OPEN............................ 72
8082.... FRACTURE OF PUBIS-CLOSED............................ 72
8083.... FRACTURE OF PUBIS-OPEN.............................. 72
80841... FRACTURE OF ILIUM-CLOSED............................ 72
80842... FRACTURE ISCHIUM-CLOSED............................. 72
80843... PELV FX-CLOS/PELV DISRUP............................ 72
80849... PELVIC FRACTURE NEC-CLOS............................ 72
80851... FRACTURE OF ILIUM-OPEN.............................. 72
80852... FRACTURE OF ISCHIUM-OPEN............................ 72
80853... PELV FX-OPEN/PELV DISRUP............................ 72
80859... PELVIC FRACTURE NEC-OPEN............................ 72
8088.... PELVIC FRACTURE NOS-CLOS............................ 72
8089.... PELVIC FRACTURE NOS-OPEN............................ 72
8090.... FRACTURE TRUNK BONE-CLOS............................ 72
8091.... FRACTURE TRUNK BONE-OPEN............................ 72
81000... FX CLAVICLE NOS-CLOSED.............................. 72
81001... FX CLAVICL, STERN END-CL............................ 72
81002... FX CLAVICLE SHAFT-CLOSED............................ 72
81003... FX CLAVICL, ACROM END-CL............................ 72
81010... FX CLAVICLE NOS-OPEN................................ 72
[[Page 47947]]
81011... FX CLAVIC, STERN END-OPN............................ 72
81012... FX CLAVICLE SHAFT-OPEN.............................. 72
81013... FX CLAVIC, ACROM END-OPN............................ 72
81100... FX SCAPULA NOS-CLOSED............................... 72
81101... FX SCAPUL, ACROM PROC-CL............................ 72
81102... FX SCAPUL, CORAC PROC-CL............................ 72
81103... FX SCAP, GLEN CAV/NCK-CL............................ 72
81109... FX SCAPULA NEC-CLOSED............................... 72
81110... FX SCAPULA NOS-OPEN................................. 72
81111... FX SCAPUL, ACROM PROC-OP............................ 72
81112... FX SCAPUL, CORAC PROC-OP............................ 72
81113... FX SCAP, GLEN CAV/NCK-OP............................ 72
81119... FX SCAPULA NEC-OPEN................................. 72
81200... FX UP END HUMERUS NOS-CL............................ 72
81201... FX SURG NCK HUMERUS-CLOS............................ 72
81202... FX ANATOM NCK HUMERUS-CL............................ 72
81203... FX GR TUBEROS HUMERUS-CL............................ 72
81209... FX UPPER HUMERUS NEC-CL............................. 72
81210... FX UPPER HUMERUS NOS-OPN............................ 72
81211... FX SURG NECK HUMERUS-OPN............................ 72
81212... FX ANAT NECK HUMERUS-OPN............................ 72
81213... FX GR TUBEROS HUMER-OPEN............................ 72
81219... FX UPPER HUMERUS NEC-OPN............................ 72
81220... FX HUMERUS NOS-CLOSED............................... 72
81221... FX HUMERUS SHAFT-CLOSED............................. 72
81230... FX HUMERUS NOS-OPEN................................. 72
81231... FX HUMERUS SHAFT-OPEN............................... 72
81240... FX LOWER HUMERUS NOS-CL............................. 72
81241... SUPRCONDYL FX HUMERUS-CL............................ 72
81242... FX HUMER, LAT CONDYL-CL............................. 72
81243... FX HUMER, MED CONDYL-CL............................. 72
81244... FX HUMER, CONDYL NOS-CL............................. 72
81249... FX LOWER HUMERUS NEC-CL............................. 72
81250... FX LOWER HUMER NOS-OPEN............................. 72
81251... SUPRACONDYL FX HUMER-OPN............................ 72
81252... FX HUMER, LAT CONDYL-OPN............................ 72
81253... FX HUMER, MED CONDYL-OPN............................ 72
81254... FX HUMER, CONDYL NOS-OPN............................ 72
81259... FX LOWER HUMER NEC-OPEN............................. 72
81300... FX UPPER FOREARM NOS-CL............................. 72
81301... FX OLECRAN PROC ULNA-CL............................. 72
81302... FX CORONOID PROC ULNA-CL............................ 72
81303... MONTEGGIA'S FX-CLOSED............................... 72
81304... FX UPPER ULNA NEC/NOS-CL............................ 72
81305... FX RADIUS HEAD-CLOSED............................... 72
81306... FX RADIUS NECK-CLOSED............................... 72
81307... FX UP RADIUS NEC/NOS-CL............................. 72
81308... FX UP RADIUS W ULNA-CLOS............................ 72
81310... FX UPPER FOREARM NOS-OPN............................ 72
81311... FX OLECRAN PROC ULNA-OPN............................ 72
81312... FX CORONOID PRO ULNA-OPN............................ 72
81313... MONTEGGIA'S FX-OPEN................................. 72
81314... FX UP ULNA NEC/NOS-OPEN............................. 72
81315... FX RADIUS HEAD-OPEN................................. 72
81316... FX RADIUS NECK-OPEN................................. 72
81317... FX UP RADIUS NEC/NOS-OPN............................ 72
81318... FX UP RADIUS W ULNA-OPEN............................ 72
81320... FX SHAFT FOREARM NOS-CL............................. 72
81321... FX RADIUS SHAFT-CLOSED.............................. 72
81322... FX ULNA SHAFT-CLOSED................................ 72
81323... FX SHAFT RAD W ULNA-CLOS............................ 72
81330... FX SHAFT FOREARM NOS-OPN............................ 72
81331... FX RADIUS SHAFT-OPEN................................ 72
81332... FX ULNA SHAFT-OPEN.................................. 72
81333... FX SHAFT RAD W ULNA-OPEN............................ 72
81340... FX LOWER FOREARM NOS-CL............................. 72
81341... COLLES' FRACTURE-CLOSED............................. 72
81342... FX DISTAL RADIUS NEC-CL............................. 72
81343... FX DISTAL ULNA-CLOSED............................... 72
81344... FX LOW RADIUS W ULNA-CL............................. 72
81350... FX LOWER FOREARM NOS-OPN............................ 72
81351... COLLES' FRACTURE-OPEN............................... 72
81352... FX DISTAL RADIUS NEC-OPN............................ 72
81353... FX DISTAL ULNA-OPEN................................. 72
81354... FX LOW RADIUS W ULNA-OPN............................ 72
81380... FX FOREARM NOS-CLOSED............................... 72
[[Page 47948]]
81381... FX RADIUS NOS-CLOSED................................ 72
81382... FRACTURE ULNA NOS-CLOSED............................ 72
81383... FX RADIUS W ULNA NOS-CL............................. 72
81390... FX FOREARM NOS-OPEN................................. 72
81391... FRACTURE RADIUS NOS-OPEN............................ 72
81392... FRACTURE ULNA NOS-OPEN.............................. 72
81393... FX RADIUS W ULNA NOS-OPN............................ 72
81400... FX CARPAL BONE NOS-CLOSE............................ 72
81401... FX NAVICULAR, WRIST-CLOS............................ 72
81402... FX LUNATE, WRIST-CLOSED............................. 72
81403... FX TRIQUETRAL, WRIST-CL............................. 72
81404... FX PISIFORM-CLOSED.................................. 72
81405... FX TRAPEZIUM BONE-CLOSED............................ 72
81406... FX TRAPEZOID BONE-CLOSED............................ 72
81407... FX CAPITATE BONE-CLOSED............................. 72
81408... FX HAMATE BONE-CLOSED............................... 72
81409... FX CARPAL BONE NEC-CLOSE............................ 72
81410... FX CARPAL BONE NOS-OPEN............................. 72
81411... FX NAVICULAR, WRIST-OPEN............................ 72
81412... FX LUNATE, WRIST-OPEN............................... 72
81413... FX TRIQUETRAL, WRIST-OPN............................ 72
81414... FX PISIFORM-OPEN.................................... 72
81415... FX TRAPEZIUM BONE-OPEN.............................. 72
81416... FX TRAPEZOID BONE-OPEN.............................. 72
81417... FX CAPITATE BONE-OPEN............................... 72
81418... FX HAMATE BONE-OPEN................................. 72
81419... FX CARPAL BONE NEC-OPEN............................. 72
81500... FX METACARPAL NOS-CLOSED............................ 72
81501... FX 1ST METACARP BASE-CL............................. 72
81502... FX METACARP BASE NEC-CL............................. 72
81503... FX METACARPAL SHAFT-CLOS............................ 72
81504... FX METACARPAL NECK-CLOSE............................ 72
81509... MULT FX METACARPUS-CLOSE............................ 72
81510... FX METACARPAL NOS-OPEN.............................. 72
81511... FX 1ST METACARP BASE-OPN............................ 72
81512... FX METACARP BASE NEC-OPN............................ 72
81513... FX METACARPAL SHAFT-OPEN............................ 72
81514... FX METACARPAL NECK-OPEN............................. 72
81519... MULT FX METACARPUS-OPEN............................. 72
81600... FX PHALANX, HAND NOS-CL............................. 72
81601... FX MID/PRX PHAL, HAND-CL............................ 72
81602... FX DIST PHALANX, HAND-CL............................ 72
81603... FX MULT PHALAN, HAND-CL............................. 72
81610... FX PHALANX, HAND NOS-OPN............................ 72
81611... FX MID/PRX PHAL, HAND-OP............................ 72
81612... FX DISTAL PHAL, HAND-OPN............................ 72
81613... FX MULT PHALAN, HAND-OPN............................ 72
8170.... MULTIPLE FX HAND-CLOSED............................. 72
8171.... MULTIPLE FX HAND-OPEN............................... 72
8180.... FX ARM MULT/NOS-CLOSED.............................. 72
8181.... FX ARM MULT/NOS-OPEN................................ 72
8190.... FX ARMS W RIB/STERNUM-CL............................ 72
8191.... FX ARMS W RIB/STERN-OPEN............................ 72
82000... FX FEMUR INTRCAPS NOS-CL............................ 72
82001... FX UP FEMUR EPIPHY-CLOS............................. 72
82002... FX FEMUR, MIDCERVIC-CLOS............................ 72
82003... FX BASE FEMORAL NCK-CLOS............................ 72
82009... FX FEMUR INTRCAPS NEC-CL............................ 72
82010... FX FEMUR INTRCAP NOS-OPN............................ 72
82011... FX UP FEMUR EPIPHY-OPEN............................. 72
82012... FX FEMUR, MIDCERVIC-OPEN............................ 72
82013... FX BASE FEMORAL NCK-OPEN............................ 72
82019... FX FEMUR INTRCAP NEC-OPN............................ 72
82020... TROCHANTERIC FX NOS-CLOS............................ 72
82021... INTERTROCHANTERIC FX-CL............................. 72
82022... SUBTROCHANTERIC FX-CLOSE............................ 72
82030... TROCHANTERIC FX NOS-OPEN............................ 72
82031... INTERTROCHANTERIC FX-OPN............................ 72
82032... SUBTROCHANTERIC FX-OPEN............................. 72
8208.... FX NECK OF FEMUR NOS-CL............................. 72
8209.... FX NECK OF FEMUR NOS-OPN............................ 72
82100... FX FEMUR NOS-CLOSED................................. 72
82101... FX FEMUR SHAFT-CLOSED............................... 72
82110... FX FEMUR NOS-OPEN................................... 72
82111... FX FEMUR SHAFT-OPEN................................. 72
82120... FX LOW END FEMUR NOS-CL............................. 72
[[Page 47949]]
82121... FX FEMORAL CONDYLE-CLOSE............................ 72
82122... FX LOW FEMUR EPIPHY-CLOS............................ 72
82123... SUPRACONDYL FX FEMUR-CL............................. 72
82129... FX LOW END FEMUR NEC-CL............................. 72
82130... FX LOW END FEMUR NOS-OPN............................ 72
82131... FX FEMORAL CONDYLE-OPEN............................. 72
82132... FX LOW FEMUR EPIPHY-OPEN............................ 72
82133... SUPRACONDYL FX FEMUR-OPN............................ 72
82139... FX LOW END FEMUR NEC-OPN............................ 72
8220.... FRACTURE PATELLA-CLOSED............................. 72
8221.... FRACTURE PATELLA-OPEN............................... 72
82300... FX UPPER END TIBIA-CLOSE............................ 72
82301... FX UPPER END FIBULA-CLOS............................ 72
82302... FX UP TIBIA W FIBULA-CL............................. 72
82310... FX UPPER END TIBIA-OPEN............................. 72
82311... FX UPPER END FIBULA-OPEN............................ 72
82312... FX UP TIBIA W FIBULA-OPN............................ 72
82320... FX SHAFT TIBIA-CLOSED............................... 72
82321... FX SHAFT FIBULA-CLOSED.............................. 72
82322... FX SHAFT FIB W TIB-CLOS............................. 72
82330... FX TIBIA SHAFT-OPEN................................. 72
82331... FX FIBULA SHAFT-OPEN................................ 72
82332... FX SHAFT TIBIA W FIB-OPN............................ 72
82380... FX TIBIA NOS-CLOSED................................. 72
82381... FX FIBULA NOS-CLOSED................................ 72
82382... FX TIBIA W FIBULA NOS-CL............................ 72
82390... FX TIBIA NOS-OPEN................................... 72
82391... FX FIBULA NOS-OPEN.................................. 72
82392... FX TIBIA W FIB NOS-OPEN............................. 72
8240.... FX MEDIAL MALLEOLUS-CLOS............................ 72
8241.... FX MEDIAL MALLEOLUS-OPEN............................ 72
8242.... FX LATERAL MALLEOLUS-CL............................. 72
8243.... FX LATERAL MALLEOLUS-OPN............................ 72
8244.... FX BIMALLEOLAR-CLOSED............................... 72
8245.... FX BIMALLEOLAR-OPEN................................. 72
8246.... FX TRIMALLEOLAR-CLOSED.............................. 72
8247.... FX TRIMALLEOLAR-OPEN................................ 72
8248.... FX ANKLE NOS-CLOSED................................. 72
8249.... FX ANKLE NOS-OPEN................................... 72
8250.... FRACTURE CALCANEUS-CLOSE............................ 72
8251.... FRACTURE CALCANEUS-OPEN............................. 72
82520... FX FOOT BONE NOS-CLOSED............................. 72
82521... FX ASTRAGALUS-CLOSED................................ 72
82522... FX NAVICULAR, FOOT-CLOS............................. 72
82523... FX CUBOID-CLOSED.................................... 72
82524... FX CUNEIFORM, FOOT-CLOS............................. 72
82525... FX METATARSAL-CLOSED................................ 72
82529... FX FOOT BONE NEC-CLOSED............................. 72
82530... FX FOOT BONE NOS-OPEN............................... 72
82531... FX ASTRAGALUS-OPEN.................................. 72
82532... FX NAVICULAR, FOOT-OPEN............................. 72
82533... FX CUBOID-OPEN...................................... 72
82534... FX CUNEIFORM, FOOT-OPEN............................. 72
82535... FX METATARSAL-OPEN.................................. 72
82539... FX FOOT BONE NEC-OPEN............................... 72
8260.... FX PHALANX, FOOT-CLOSED............................. 72
8261.... FX PHALANX, FOOT-OPEN............................... 72
8270.... FX LOWER LIMB NEC-CLOSED............................ 72
8271.... FX LOWER LIMB NEC-OPEN.............................. 72
8280.... FX LEGS W ARM/RIB-CLOSED............................ 72
8281.... FX LEGS W ARM/RIB-OPEN.............................. 72
8290.... FRACTURE NOS-CLOSED................................. 72
8291.... FRACTURE NOS-OPEN................................... 72
8300.... DISLOCATION JAW-CLOSED.............................. 72
8301.... DISLOCATION JAW-OPEN................................ 72
83100... DISLOC SHOULDER NOS-CLOS............................ 72
83101... ANT DISLOC HUMERUS-CLOSE............................ 72
83102... POST DISLOC HUMERUS-CLOS............................ 72
83103... INFER DISLOC HUMERUS-CL............................. 72
83104... DISLOC ACROMIOCLAVIC-CL............................. 72
83109... DISLOC SHOULDER NEC-CLOS............................ 72
83110... DISLOC SHOULDER NOS-OPEN............................ 72
83111... ANT DISLOC HUMERUS-OPEN............................. 72
83112... POST DISLOC HUMERUS-OPEN............................ 72
83113... INFER DISLOC HUMERUS-OPN............................ 72
83114... DISLOC ACROMIOCLAVIC-OPN............................ 72
[[Page 47950]]
83119... DISLOC SHOULDER NEC-OPEN............................ 72
83200... DISLOCAT ELBOW NOS-CLOSE............................ 72
83201... ANT DISLOC ELBOW-CLOSED............................. 72
83202... POST DISLOC ELBOW-CLOSED............................ 72
83203... MED DISLOC ELBOW-CLOSED............................. 72
83204... LAT DISLOC ELBOW-CLOSED............................. 72
83209... DISLOCAT ELBOW NEC-CLOSE............................ 72
83210... DISLOCAT ELBOW NOS-OPEN............................. 72
83211... ANT DISLOC ELBOW-OPEN............................... 72
83212... POST DISLOC ELBOW-OPEN.............................. 72
83213... MED DISLOC ELBOW-OPEN............................... 72
83214... LAT DISLOCAT ELBOW-OPEN............................. 72
83219... DISLOCAT ELBOW NEC-OPEN............................. 72
83300... DISLOC WRIST NOS-CLOSED............................. 72
83301... DISLOC DIST RADIOULN-CL............................. 72
83302... DISLOC RADIOCARPAL-CLOS............................. 72
83303... DISLOCA MIDCARPAL-CLOSED............................ 72
83304... DISLOC CARPOMETACARP-CL............................. 72
83305... DISLOC METACARPAL-CLOSED............................ 72
83309... DISLOC WRIST NEC-CLOSED............................. 72
83310... DISLOCAT WRIST NOS-OPEN............................. 72
83311... DISLOC DIST RADIOULN-OPN............................ 72
83312... DISLOC RADIOCARPAL-OPEN............................. 72
83313... DISLOCAT MIDCARPAL-OPEN............................. 72
83314... DISLOC CARPOMETACARP-OPN............................ 72
83315... DISLOCAT METACARPAL-OPEN............................ 72
83319... DISLOCAT WRIST NEC-OPEN............................. 72
83400... DISL FINGER NOS-CLOSED.............................. 72
83401... DISLOC METACARPOPHALN-CL............................ 72
83402... DISL INTERPHALN HAND-CL............................. 72
83410... DISLOC FINGER NOS-OPEN.............................. 72
83411... DISL METACARPOPHALAN-OPN............................ 72
83412... DISL INTERPHALN HAND-OPN............................ 72
83500... DISLOCAT HIP NOS-CLOSED............................. 72
83501... POSTERIOR DISLOC HIP-CL............................. 72
83502... OBTURATOR DISLOC HIP-CL............................. 72
83503... ANT DISLOC HIP NEC-CLOS............................. 72
83510... DISLOCATION HIP NOS-OPEN............................ 72
83511... POSTERIOR DISLOC HIP-OPN............................ 72
83512... OBTURATOR DISLOC HIP-OPN............................ 72
83513... ANT DISLOC HIP NEC-OPEN............................. 72
8360.... TEAR MED MENISC KNEE-CUR............................ 72
8361.... TEAR LAT MENISC KNEE-CUR............................ 72
8362.... TEAR MENISCUS NEC-CURREN............................ 72
8363.... DISLOCAT PATELLA-CLOSED............................. 72
8364.... DISLOCATION PATELLA-OPEN............................ 72
83650... DISLOCAT KNEE NOS-CLOSED............................ 72
83651... ANT DISLOC PROX TIBIA-CL............................ 72
83652... POST DISL PROX TIBIA-CL............................. 72
83653... MED DISLOC PROX TIBIA-CL............................ 72
83654... LAT DISLOC PROX TIBIA-CL............................ 72
83659... DISLOCAT KNEE NEC-CLOSED............................ 72
83660... DISLOCAT KNEE NOS-OPEN.............................. 72
83661... ANT DISL PROX TIBIA-OPEN............................ 72
83662... POST DISL PROX TIBIA-OPN............................ 72
83663... MED DISL PROX TIBIA-OPEN............................ 72
83664... LAT DISL PROX TIBIA-OPEN............................ 72
83669... DISLOCAT KNEE NEC-OPEN.............................. 72
8370.... DISLOCATION ANKLE-CLOSED............................ 72
8371.... DISLOCATION ANKLE-OPEN.............................. 72
83800... DISLOCAT FOOT NOS-CLOSED............................ 72
83801... DISLOC TARSAL NOS-CLOSED............................ 72
83802... DISLOC MIDTARSAL-CLOSED............................. 72
83803... DISLOC TARSOMETATARS-CL............................. 72
83804... DISLOC METATARSAL NOS-CL............................ 72
83805... DISL METATARSOPHALANG-CL............................ 72
83806... DISL INTERPHALAN FOOT-CL............................ 72
83809... DISLOCAT FOOT NEC-CLOSED............................ 72
83810... DISLOCAT FOOT NOS-OPEN.............................. 72
83811... DISLOC TARSAL NOS-OPEN.............................. 72
83812... DISLOC MIDTARSAL-OPEN............................... 72
83813... DISL TARSOMETATARSAL-OPN............................ 72
83814... DISL METATARSAL NOS-OPEN............................ 72
83815... DISLOC METATARSOPHAL-OPN............................ 72
83816... DIS INTERPHALAN FOOT-OPN............................ 72
83819... DISLOCAT FOOT NEC-OPEN.............................. 72
[[Page 47951]]
83900... DISLOC CERV VERT NOS-CL............................. 72
83901... DISLOC 1ST CERV VERT-CL............................. 72
83902... DISLOC 2ND CERV VERT-CL............................. 72
83903... DISLOC 3RD CERV VERT-CL............................. 72
83904... DISLOC 4TH CERV VERT-CL............................. 72
83905... DISLOC 5TH CERV VERT-CL............................. 72
83906... DISLOC 6TH CERV VERT-CL............................. 72
83907... DISLOC 7TH CERV VERT-CL............................. 72
83908... DISLOC MULT CERV VERT-CL............................ 72
83910... DISLOC CERV VERT NOS-OPN............................ 72
83911... DISLOC LST CERV VERT-OPN............................ 72
83912... DISLOC 2ND CERV VERT-OPN............................ 72
83913... DISLOC 3RD CERV VERT-OPN............................ 72
83914... DISLOC 4TH CERV VERT-OPN............................ 72
83915... DISLOC 5TH CERV VERT-OPN............................ 72
83916... DISLOC 6TH CERV VERT-OPN............................ 72
83917... DISLOC 7TH CERV VERT-OPN............................ 72
83918... DISLOC MLT CERV VERT-OPN............................ 72
83920... DISLOCAT LUMBAR VERT-CL............................. 72
83921... DISLOC THORACIC VERT-CL............................. 72
83930... DISLOCAT LUMBAR VERT-OPN............................ 72
83931... DISLOC THORACIC VERT-OPN............................ 72
83940... DISLOCAT VERTEBRA NOS-CL............................ 72
83941... DISLOCAT COCCYX-CLOSED.............................. 72
83942... DISLOCAT SACRUM-CLOSED.............................. 72
83949... DISLOCAT VERTEBRA NEC-CL............................ 72
83950... DISLOC VERTEBRA NOS-OPEN............................ 72
83951... DISLOCAT COCCYX-OPEN................................ 72
83952... DISLOCAT SACRUM-OPEN................................ 72
83959... DISLOC VERTEBRA NEC-OPEN............................ 72
83961... DISLOCAT STERNUM-CLOSED............................. 72
83969... DISLOCAT SITE NEC-CLOSED............................ 72
83971... DISLOCATION STERNUM-OPEN............................ 72
83979... DISLOCAT SITE NEC-OPEN.............................. 72
8398.... DISLOCATION NEC-CLOSED.............................. 72
8399.... DISLOCATION NEC-OPEN................................ 72
8400.... SPRAIN ACROMIOCLAVICULAR............................ 72
8401.... SPRAIN CORACOCLAVICULAR............................. 72
8402.... SPRAIN CORACOHUMERAL................................ 72
8403.... SPRAIN INFRASPINATUS................................ 72
8404.... SPRAIN ROTATOR CUFF................................. 72
8405.... SPRAIN SUBSCAPULARIS................................ 72
8406.... SPRAIN SUPRASPINATUS................................ 72
8408.... SPRAIN SHOULDER/ARM NEC............................. 72
8409.... SPRAIN SHOULDER/ARM NOS............................. 72
8410.... SPRAIN RADIAL COLLAT LIG............................ 72
8411.... SPRAIN ULNAR COLLAT LIG............................. 72
8412.... SPRAIN RADIOHUMERAL................................. 72
8413.... SPRAIN ULNOHUMERAL.................................. 72
8418.... SPRAIN ELBOW/FOREARM NEC............................ 72
8419.... SPRAIN ELBOW/FOREARM NOS............................ 72
84200... SPRAIN OF WRIST NOS................................. 72
84201... SPRAIN CARPAL....................................... 72
84202... SPRAIN RADIOCARPAL.................................. 72
84209... SPRAIN OF WRIST NEC................................. 72
84210... SPRAIN OF HAND NOS.................................. 72
84211... SPRAIN CARPOMETACARPAL.............................. 72
84212... SPRAIN METACARPOPHALANG............................. 72
84213... SPRAIN INTERPHALANGEAL.............................. 72
84219... SPRAIN OF HAND NEC.................................. 72
8430.... SPRAIN ILIOFEMORAL.................................. 72
8431.... SPRAIN ISCHIOCAPSULAR............................... 72
8438.... SPRAIN HIP & THIGH NEC.............................. 72
8439.... SPRAIN HIP & THIGH NOS.............................. 72
8440.... SPRAIN LATERAL COLL LIG............................. 72
8441.... SPRAIN MEDIAL COLLAT LIG............................ 72
8442.... SPRAIN CRUCIATE LIG KNEE............................ 72
8443.... SPRAIN SUPER TIBIOFIBULA............................ 72
8448.... SPRAIN OF KNEE & LEG NEC............................ 72
8449.... SPRAIN OF KNEE & LEG NOS............................ 72
84500... SPRAIN OF ANKLE NOS................................. 72
84501... SPRAIN OF ANKLE DELTOID............................. 72
84502... SPRAIN CALCANEOFIBULAR.............................. 72
84503... SPRAIN DISTAL TIBIOFIBUL............................ 72
84509... SPRAIN OF ANKLE NEC................................. 72
84510... SPRAIN OF FOOT NOS.................................. 72
[[Page 47952]]
84511... SPRAIN TARSOMETATARSAL.............................. 72
84512... SPRAIN METATARSOPHALANG............................. 72
84513... SPRAIN INTERPHALANG TOE............................. 72
84519... SPRAIN OF FOOT NEC.................................. 72
8460.... SPRAIN LUMBOSACRAL.................................. 72
8461.... SPRAIN SACROILIAC................................... 72
8462.... SPRAIN SACROSPINATUS................................ 72
8463.... SPRAIN SACROTUBEROUS................................ 72
8468.... SPRAIN SACROILIAC NEC............................... 72
8469.... SPRAIN SACROILIAC NOS............................... 72
8470.... SPRAIN OF NECK...................................... 72
8471.... SPRAIN THORACIC REGION.............................. 72
8472.... SPRAIN LUMBAR REGION................................ 72
8473.... SPRAIN OF SACRUM.................................... 72
8474.... SPRAIN OF COCCYX.................................... 72
8479.... SPRAIN OF BACK NOS.................................. 72
8480.... SPRAIN OF NASAL SEPTUM.............................. 72
8481.... SPRAIN OF JAW....................................... 72
8482.... SPRAIN OF THYROID REGION............................ 72
8483.... SPRAIN OF RIBS...................................... 72
84840... SPRAIN OF STERNUM NOS............................... 72
84841... SPRAIN STERNOCLAVICULAR............................. 72
84842... SPRAIN CHONDROSTERNAL............................... 72
84849... SPRAIN OF STERNUM NEC............................... 72
8485.... SPRAIN OF PELVIS.................................... 72
8488.... SPRAIN NEC.......................................... 72
8489.... SPRAIN NOS.......................................... 72
8500.... CONCUSSION W/O COMA................................. 72
8501.... CONCUSSION-BRIEF COMA............................... 72
8502.... CONCUSSION-MODERATE COMA............................ 72
8503.... CONCUSSION-PROLONG COMA............................. 72
8504.... CONCUSSION-DEEP COMA................................ 72
8505.... CONCUSSION W COMA NOS............................... 72
8509.... CONCUSSION NOS...................................... 72
85100... CEREBRAL CORTX CONTUSION............................ 72
85101... CORTEX CONTUSION-NO COMA............................ 72
85102... CORTEX CONTUS-BRIEF COMA............................ 72
85103... CORTEX CONTUS-MOD COMA.............................. 72
85104... CORTX CONTUS-PROLNG COMA............................ 72
85105... CORTEX CONTUS-DEEP COMA............................. 72
85106... CORTEX CONTUS-COMA NOS.............................. 72
85109... CORTEX CONTUS-CONCUS NOS............................ 72
85110... CORTEX CONTUSION/OPN WND............................ 72
85111... OPN CORTX CONTUS-NO COMA............................ 72
85112... OPN CORT CONTUS-BRF COMA............................ 72
85113... OPN CORT CONTUS-MOD COMA............................ 72
85114... OPN CORT CONTU-PROL COMA............................ 72
85115... OPN CORT CONTU-DEEP COMA............................ 72
85116... OPN CORT CONTUS-COMA NOS............................ 72
85119... OPN CORTX CONTUS-CONCUSS............................ 72
85120... CEREBRAL CORTEX LACERAT............................. 72
85121... CORTEX LACERAT W/O COMA............................. 72
85122... CORTEX LACERA-BRIEF COMA............................ 72
85123... CORTEX LACERAT-MOD COMA............................. 72
85124... CORTEX LACERAT-PROL COMA............................ 72
85125... CORTEX LACERAT-DEEP COMA............................ 72
85126... CORTEX LACERAT-COMA NOS............................. 72
85129... CORTEX LACERAT-CONCUSS.............................. 72
85130... CORTEX LACER W OPN WOUND............................ 72
85131... OPN CORTEX LACER-NO COMA............................ 72
85132... OPN CORTX LAC-BRIEF COMA............................ 72
85133... OPN CORTX LACER-MOD COMA............................ 72
85134... OPN CORTX LAC-PROLN COMA............................ 72
85135... OPN CORTEX LAC-DEEP COMA............................ 72
85136... OPN CORTX LACER-COMA NOS............................ 72
85139... OPN CORTX LACER-CONCUSS............................. 72
85140... CEREBEL/BRAIN STM CONTUS............................ 72
85141... CEREBELL CONTUS W/O COMA............................ 72
85142... CEREBELL CONTUS-BRF COMA............................ 72
85143... CEREBELL CONTUS-MOD COMA............................ 72
85144... CEREBEL CONTUS-PROL COMA............................ 72
85145... CEREBEL CONTUS-DEEP COMA............................ 72
85146... CEREBELL CONTUS-COMA NOS............................ 72
85149... CEREBELL CONTUS-CONCUSS............................. 72
85150... CEREBEL CONTUS W OPN WND............................ 72
85151... OPN CEREBE CONT W/O COMA............................ 72
[[Page 47953]]
85152... OPN CEREBE CONT-BRF COMA............................ 72
85153... OPN CEREBE CONT-MOD COMA............................ 72
85154... OPN CEREBE CONT-PROL COM............................ 72
85155... OPN CEREBE CONT-DEEP COM............................ 72
85156... OPN CEREBE CONT-COMA NOS............................ 72
85159... OPN CEREBEL CONT-CONCUSS............................ 72
85160... CEREBEL/BRAIN STEM LACER............................ 72
85161... CEREBEL LACERAT W/O COMA............................ 72
85162... CEREBEL LACER-BRIEF COMA............................ 72
85163... CEREBEL LACERAT-MOD COMA............................ 72
85164... CEREBEL LACER-PROLN COMA............................ 72
85165... CEREBELL LACER-DEEP COMA............................ 72
85166... CEREBEL LACERAT-COMA NOS............................ 72
85169... CEREBEL LACER-CONCUSSION............................ 72
85170... CEREBEL LACER W OPEN WND............................ 72
85171... OPN CEREBEL LAC W/O COMA............................ 72
85172... OPN CEREBEL LAC-BRF COMA............................ 72
85173... OPN CEREBEL LAC-MOD COMA............................ 72
85174... OPN CEREBE LAC-PROL COMA............................ 72
85175... OPN CEREBE LAC-DEEP COMA............................ 72
85176... OPN CEREBEL LAC-COMA NOS............................ 72
85179... OPN CEREBELL LAC-CONCUSS............................ 72
85180... BRAIN LACERATION NEC................................ 72
85181... BRAIN LACER NEC W/O COMA............................ 72
85182... BRAIN LAC NEC-BRIEF COMA............................ 72
85183... BRAIN LACER NEC-MOD COMA............................ 72
85184... BRAIN LAC NEC-PROLN COMA............................ 72
85185... BRAIN LAC NEC-DEEP COMA............................. 72
85186... BRAIN LACER NEC-COMA NOS............................ 72
85189... BRAIN LACER NEC-CONCUSS............................. 72
85190... BRAIN LAC NEC W OPEN WND............................ 72
85191... OPN BRAIN LACER W/O COMA............................ 72
85192... OPN BRAIN LAC-BRIEF COMA............................ 72
85193... OPN BRAIN LACER-MOD COMA............................ 72
85194... OPN BRAIN LAC-PROLN COMA............................ 72
85195... OPEN BRAIN LAC-DEEP COMA............................ 72
85196... OPN BRAIN LACER-COMA NOS............................ 72
85199... OPEN BRAIN LACER-CONCUSS............................ 72
85200... TRAUM SUBARACHNOID HEM.............................. 72
85201... SUBARACHNOID HEM-NO COMA............................ 72
85202... SUBARACH HEM-BRIEF COMA............................. 72
85203... SUBARACH HEM-MOD COMA............................... 72
85204... SUBARACH HEM-PROLNG COMA............................ 72
85205... SUBARACH HEM-DEEP COMA.............................. 72
85206... SUBARACH HEM-COMA NOS............................... 72
85209... SUBARACH HEM-CONCUSSION............................. 72
85210... SUBARACH HEM W OPN WOUND............................ 72
85211... OPN SUBARACH HEM-NO COMA............................ 72
85212... OP SUBARACH HEM-BRF COMA............................ 72
85213... OP SUBARACH HEM-MOD COMA............................ 72
85214... OP SUBARACH HEM-PROL COM............................ 72
85215... OP SUBARACH HEM-DEEP COM............................ 72
85216... OP SUBARACH HEM-COMA NOS............................ 72
85219... OPN SUBARACH HEM-CONCUSS............................ 72
85220... TRAUMATIC SUBDURAL HEM.............................. 72
85221... SUBDURAL HEM W/O COMA............................... 72
85222... SUBDURAL HEM-BRIEF COMA............................. 72
85223... SUBDURAL HEMORR-MOD COMA............................ 72
85224... SUBDURAL HEM-PROLNG COMA............................ 72
85225... SUBDURAL HEM-DEEP COMA.............................. 72
85226... SUBDURAL HEMORR-COMA NOS............................ 72
85229... SUBDURAL HEM-CONCUSSION............................. 72
85230... SUBDURAL HEM W OPN WOUND............................ 72
85231... OPEN SUBDUR HEM W/O COMA............................ 72
85232... OPN SUBDUR HEM-BRF COMA............................. 72
85233... OPN SUBDUR HEM-MOD COMA............................. 72
85234... OPN SUBDUR HEM-PROL COMA............................ 72
85235... OPN SUBDUR HEM-DEEP COMA............................ 72
85236... OPN SUBDUR HEM-COMA NOS............................. 72
85239... OPN SUBDUR HEM-CONCUSS.............................. 72
85240... TRAUMATIC EXTRADURAL HEM............................ 72
85241... EXTRADURAL HEM W/O COMA............................. 72
85242... EXTRADUR HEM-BRIEF COMA............................. 72
85243... EXTRADURAL HEM-MOD COMA............................. 72
85244... EXTRADUR HEM-PROLN COMA............................. 72
85245... EXTRADURAL HEM-DEEP COMA............................ 72
[[Page 47954]]
85246... EXTRADURAL HEM-COMA NOS............................. 72
85249... EXTADURAL HEM-CONCUSS............................... 72
85250... EXTRADURAL HEM W OPN WND............................ 72
85251... EXTRADURAL HEMOR-NO COMA............................ 72
85252... EXTRADUR HEM-BRIEF COMA............................. 72
85253... EXTRADURAL HEM-MOD COMA............................. 72
85254... EXTRADUR HEM-PROLN COMA............................. 72
85255... EXTRADUR HEM-DEEP COMA.............................. 72
85256... EXTRADURAL HEM-COMA NOS............................. 72
85259... EXTRADURAL HEM-CONCUSS.............................. 72
85300... TRAUMATIC BRAIN HEM NEC............................. 72
85301... BRAIN HEM NEC W/O COMA.............................. 72
85302... BRAIN HEM NEC-BRIEF COMA............................ 72
85303... BRAIN HEM NEC-MOD COMA.............................. 72
85304... BRAIN HEM NEC-PROLN COMA............................ 72
85305... BRAIN HEM NEC-DEEP COMA............................. 72
85306... BRAIN HEM NEC-COMA NOS.............................. 72
85309... BRAIN HEM NEC-CONCUSSION............................ 72
85310... BRAIN HEM NEC W OPN WND............................. 72
85311... BRAIN HEM OPN W/O COMA.............................. 72
85312... BRAIN HEM OPN-BRF COMA.............................. 72
85313... BRAIN HEM OPEN-MOD COMA............................. 72
85314... BRAIN HEM OPN-PROLN COMA............................ 72
85315... BRAIN HEM OPEN-DEEP COMA............................ 72
85316... BRAIN HEM OPEN-COMA NOS............................. 72
85319... BRAIN HEM OPN-CONCUSSION............................ 72
85400... BRAIN INJURY NEC.................................... 72
85401... BRAIN INJURY NEC-NO COMA............................ 72
85402... BRAIN INJ NEC-BRIEF COMA............................ 72
85403... BRAIN INJ NEC-MOD COMA.............................. 72
85404... BRAIN INJ NEC-PROLN COMA............................ 72
85405... BRAIN INJ NEC-DEEP COMA............................. 72
85406... BRAIN INJ NEC-COMA NOS.............................. 72
85409... BRAIN INJ NEC-CONCUSSION............................ 72
85410... BRAIN INJURY W OPN WND.............................. 72
85411... OPN BRAIN INJ W/O COMA.............................. 72
85412... OPN BRAIN INJ-BRIEF COMA............................ 72
85413... OPN BRAIN INJ-MOD COMA.............................. 72
85414... OPN BRAIN INJ-PROLN COMA............................ 72
85415... OPN BRAIN INJ-DEEP COMA............................. 72
85416... OPEN BRAIN INJ-COMA NOS............................. 72
85419... OPN BRAIN INJ-CONCUSSION............................ 72
8600.... TRAUM PNEUMOTHORAX-CLOSE............................ 72
8601.... TRAUM PNEUMOTHORAX-OPEN............................. 72
8602.... TRAUM HEMOTHORAX-CLOSED............................. 72
8603.... TRAUM HEMOTHORAX-OPEN............................... 72
8604.... TRAUM PNEUMOHEMOTHOR-CL............................. 72
8605.... TRAUM PNEUMOHEMOTHOR-OPN............................ 72
86100... HEART INJURY NOS-CLOSED............................. 72
86101... HEART CONTUSION-CLOSED.............................. 72
86102... HEART LACERATION-CLOSED............................. 72
86103... HEART CHAMBER LACERAT-CL............................ 72
86110... HEART INJURY NOS-OPEN............................... 72
86111... HEART CONTUSION-OPEN................................ 72
86112... HEART LACERATION-OPEN............................... 72
86113... HEART CHAMBER LACER-OPN............................. 72
86120... LUNG INJURY NOS-CLOSED.............................. 72
86121... LUNG CONTUSION-CLOSED............................... 72
86122... LUNG LACERATION-CLOSED.............................. 72
86130... LUNG INJURY NOS-OPEN................................ 72
86131... LUNG CONTUSION-OPEN................................. 72
86132... LUNG LACERATION-OPEN................................ 72
8620.... DIAPHRAGM INJURY-CLOSED............................. 72
8621.... DIAPHRAGM INJURY-OPEN............................... 72
86221... BRONCHUS INJURY-CLOSED.............................. 72
86222... ESOPHAGUS INJURY-CLOSED............................. 72
86229... INTRATHORACIC INJ NEC-CL............................ 72
86231... BRONCHUS INJURY-OPEN................................ 72
86232... ESOPHAGUS INJURY-OPEN............................... 72
86239... INTRATHORAC INJ NEC-OPEN............................ 72
8628.... INTRATHORACIC INJ NOS-CL............................ 72
8629.... INTRATHORAC INJ NOS-OPEN............................ 72
8630.... STOMACH INJURY-CLOSED............................... 72
8631.... STOMACH INJURY-OPEN................................. 72
86320... SMALL INTEST INJ NOS-CL............................. 72
86321... DUODENUM INJURY-CLOSED.............................. 72
[[Page 47955]]
86329... SMALL INTEST INJ NEC-CL............................. 72
86330... SMALL INTEST INJ NOS-OPN............................ 72
86331... DUODENUM INJURY-OPEN................................ 72
86339... SMALL INTEST INJ NEC-OPN............................ 72
86340... COLON INJURY NOS-CLOSED............................. 72
86341... ASCENDING COLON INJ-CLOS............................ 72
86342... TRANSVERSE COLON INJ-CL............................. 72
86343... DESCENDING COLON INJ-CL............................. 72
86344... SIGMOID COLON INJ-CLOSED............................ 72
86345... RECTUM INJURY-CLOSED................................ 72
86346... COLON INJ MULT SITE-CLOS............................ 72
86349... COLON INJURY NEC-CLOSED............................. 72
86350... COLON INJURY NOS-OPEN............................... 72
86351... ASCENDING COLON INJ-OPEN............................ 72
86352... TRANSVERSE COLON INJ-OPN............................ 72
86353... DESCENDING COLON INJ-OPN............................ 72
86354... SIGMOID COLON INJ-OPEN.............................. 72
86355... RECTUM INJURY-OPEN.................................. 72
86356... COLON INJ MULT SITE-OPEN............................ 72
86359... COLON INJURY NEC-OPEN............................... 72
86380... GI INJURY NOS-CLOSED................................ 72
86381... PANCREAS, HEAD INJ-CLOSE............................ 72
86382... PANCREAS, BODY INJ-CLOSE............................ 72
86383... PANCREAS, TAIL INJ-CLOSE............................ 72
86384... PANCREAS INJURY NOS-CLOS............................ 72
86385... APPENDIX INJURY-CLOSED.............................. 72
86389... GI INJURY NEC-CLOSED................................ 72
86390... GI INJURY NOS-OPEN.................................. 72
86391... PANCREAS, HEAD INJ-OPEN............................. 72
86392... PANCREAS, BODY INJ-OPEN............................. 72
86393... PANCREAS, TAIL INJ-OPEN............................. 72
86394... PANCREAS INJURY NOS-OPEN............................ 72
86395... APPENDIX INJURY-OPEN................................ 72
86399... GI INJURY NEC-OPEN.................................. 72
86400... LIVER INJURY NOS-CLOSED............................. 72
86401... LIVER HEMATOMA/CONTUSION............................ 72
86402... LIVER LACERATION, MINOR............................. 72
86403... LIVER LACERATION, MOD............................... 72
86404... LIVER LACERATION, MAJOR............................. 72
86405... LIVER LACERAT UNSPCF CLS............................ 72
86409... LIVER INJURY NEC-CLOSED............................. 72
86410... LIVER INJURY NOS-OPEN............................... 72
86411... LIVER HEMATOM/CONTUS-OPN............................ 72
86412... LIVER LACERAT, MINOR-OPN............................ 72
86413... LIVER LACERAT, MOD-OPEN............................. 72
86414... LIVER LACERAT, MAJOR-OPN............................ 72
86415... LIVER LACERAT UNSPCF OPN............................ 72
86419... LIVER INJURY NEC-OPEN............................... 72
86500... SPLEEN INJURY NOS-CLOSED............................ 72
86501... SPLEEN HEMATOMA-CLOSED.............................. 72
86502... SPLEEN CAPSULAR TEAR................................ 72
86503... SPLEEN PARENCHYMA LACER............................. 72
86504... SPLEEN DISRUPTION-CLOS.............................. 72
86509... SPLEEN INJURY NEC-CLOSED............................ 72
86510... SPLEEN INJURY NOS-OPEN.............................. 72
86511... SPLEEN HEMATOMA-OPEN................................ 72
86512... SPLEEN CAPSULAR TEAR-OPN............................ 72
86513... SPLEEN PARNCHYM LAC-OPN............................. 72
86514... SPLEEN DISRUPTION-OPEN.............................. 72
86519... SPLEEN INJURY NEC-OPEN.............................. 72
86600... KIDNEY INJURY NOS-CLOSED............................ 72
86601... KIDNEY HEMATOMA-CLOSED.............................. 72
86602... KIDNEY LACERATION-CLOSED............................ 72
86603... KIDNEY DISRUPTION-CLOSED............................ 72
86610... KIDNEY INJURY NOS-OPEN.............................. 72
86611... KIDNEY HEMATOMA-OPEN................................ 72
86612... KIDNEY LACERATION-OPEN.............................. 72
86613... KIDNEY DISRUPTION-OPEN.............................. 72
8670.... BLADDER/URETHRA INJ-CLOS............................ 72
8671.... BLADDER/URETHRA INJ-OPEN............................ 72
8672.... URETER INJURY-CLOSED................................ 72
8673.... URETER INJURY-OPEN.................................. 72
8674.... UTERUS INJURY-CLOSED................................ 72
8675.... UTERUS INJURY-OPEN.................................. 72
8676.... PELVIC ORGAN INJ NEC-CL............................. 72
8677.... PELVIC ORGAN INJ NEC-OPN............................ 72
[[Page 47956]]
8678.... PELVIC ORGAN INJ NOS-CL............................. 72
8679.... PELVIC ORGAN INJ NOS-OPN............................ 72
86800... INTRA-ABDOM INJ NOS-CLOS............................ 72
86801... ADRENAL GLAND INJURY-CL............................. 72
86802... BILIARY TRACT INJURY-CL............................. 72
86803... PERITONEUM INJURY-CLOSED............................ 72
86804... RETROPERITONEUM INJ-CL.............................. 72
86809... INTRA-ABDOM INJ NEC-CLOS............................ 72
86810... INTRA-ABDOM INJ NOS-OPEN............................ 72
86811... ADRENAL GLAND INJURY-OPN............................ 72
86812... BILIARY TRACT INJURY-OPN............................ 72
86813... PERITONEUM INJURY-OPEN.............................. 72
86814... RETROPERITONEUM INJ-OPEN............................ 72
86819... INTRA-ABDOM INJ NEC-OPEN............................ 72
8690.... INTERNAL INJ NOS-CLOSED............................. 72
8691.... INTERNAL INJURY NOS-OPEN............................ 72
8700.... LAC EYELID SKN/PERIOCULR............................ 72
8701.... FULL-THICKNES LAC EYELID............................ 72
8702.... LAC EYELID INV LACRM PAS............................ 72
8703.... PENETR WND ORBIT W/O FB............................. 72
8704.... PENETRAT WND ORBIT W FB............................. 72
8708.... OPN WND OCULAR ADNEX NEC............................ 72
8709.... OPN WND OCULAR ADNEX NOS............................ 72
8710.... OCULAR LAC W/O PROLAPSE............................. 72
8711.... OCULAR LACERA W PROLAPSE............................ 72
8712.... RUPTURE EYE W TISSU LOSS............................ 72
8713.... AVULSION OF EYE..................................... 72
8714.... LACERATION OF EYE NOS............................... 72
8715.... PENETRAT MAGNET FB EYE.............................. 72
8716.... PENETRAT FB NEC EYE................................. 72
8717.... OCULAR PENETRATION NOS.............................. 72
8719.... OPN WOUND OF EYEBALL NOS............................ 72
87200... OPN WOUND EXTERN EAR NOS............................ 72
87201... OPEN WOUND OF AURICLE............................... 72
87202... OPN WOUND AUDITORY CANAL............................ 72
87210... OPN WND EX EAR NOS-COMPL............................ 72
87211... OPEN WOUND AURICLE-COMPL............................ 72
87212... OPEN WND AUD CANAL-COMPL............................ 72
87261... OPEN WOUND OF EAR DRUM.............................. 72
87262... OPEN WOUND OF OSSICLES.............................. 72
87263... OPEN WND EUSTACHIAN TUBE............................ 72
87264... OPEN WOUND OF COCHLEA............................... 72
87269... OPEN WOUND OF EAR NEC............................... 72
87271... OPEN WND EAR DRUM-COMPL............................. 72
87272... OPEN WND OSSICLES-COMPL............................. 72
87273... OPN WND EUSTACH TB-COMPL............................ 72
87274... OPEN WOUND COCHLEA-COMPL............................ 72
87279... OPEN WOUND EAR NEC-COMPL............................ 72
8728.... OPEN WOUND OF EAR NOS............................... 72
8729.... OPEN WOUND EAR NOS-COMPL............................ 72
8730.... OPEN WOUND OF SCALP................................. 72
8731.... OPEN WOUND SCALP-COMPL.............................. 72
87320... OPEN WOUND OF NOSE NOS.............................. 72
87321... OPEN WOUND NASAL SEPTUM............................. 72
87322... OPEN WOUND NASAL CAVITY............................. 72
87323... OPEN WOUND NASAL SINUS.............................. 72
87329... MULT OPEN WOUND NOSE................................ 72
87330... OPEN WND NOSE NOS-COMPL............................. 72
87331... OPN WND NAS SEPTUM-COMPL............................ 72
87332... OPEN WND NASAL CAV-COMPL............................ 72
87333... OPEN WND NAS SINUS-COMPL............................ 72
87339... MULT OPEN WND NOSE-COMPL............................ 72
87340... OPEN WOUND OF FACE NOS.............................. 72
87341... OPEN WOUND OF CHEEK................................. 72
87342... OPEN WOUND OF FOREHEAD.............................. 72
87343... OPEN WOUND OF LIP................................... 72
87344... OPEN WOUND OF JAW................................... 72
87349... OPEN WOUND OF FACE NEC.............................. 72
87350... OPEN WND FACE NOS-COMPL............................. 72
87351... OPEN WOUND CHEEK-COMPL.............................. 72
87352... OPEN WND FOREHEAD-COMPL............................. 72
87353... OPEN WOUND LIP-COMPLICAT............................ 72
87354... OPEN WOUND JAW-COMPLICAT............................ 72
87359... OPEN WND FACE NEC-COMPL............................. 72
87360... OPEN WOUND OF MOUTH NOS............................. 72
87361... OPEN WOUND BUCCAL MUCOSA............................ 72
[[Page 47957]]
87362... OPEN WOUND OF GUM................................... 72
87363... BROKEN TOOTH........................................ 31
87364... OPN WND TONGUE/MOUTH FLR............................ 72
87365... OPEN WOUND OF PALATE................................ 72
87369... OPEN WOUND MOUTH NEC................................ 72
87370... OPEN WND MOUTH NOS-COMPL............................ 72
87371... OPN WND BUC MUCOSA-COMPL............................ 72
87372... OPEN WOUND GUM-COMPL................................ 72
87373... BROKEN TOOTH-COMPLICATED............................ 31
87374... OPEN WOUND TONGUE-COMPL............................. 72
87375... OPEN WOUND PALATE-COMPL............................. 72
87379... OPEN WND MOUTH NOS-COMPL............................ 72
8738.... OPEN WOUND OF HEAD NEC.............................. 72
8739.... OPEN WND HEAD NEC-COMPL............................. 72
87400... OPN WND LARYNX W TRACHEA............................ 72
87401... OPEN WOUND OF LARYNX................................ 72
87402... OPEN WOUND OF TRACHEA............................... 72
87410... OPN WND LARY W TRAC-COMP............................ 72
87411... OPEN WOUND LARYNX-COMPL............................. 72
87412... OPEN WOUND TRACHEA-COMPL............................ 72
8742.... OPEN WOUND THYROID GLAND............................ 72
8743.... OPEN WOUND THYROID-COMPL............................ 72
8744.... OPEN WOUND OF PHARYNX............................... 72
8745.... OPEN WOUND PHARYNX-COMPL............................ 72
8748.... OPEN WOUND OF NECK NEC.............................. 72
8749.... OPN WOUND NECK NEC-COMPL............................ 72
8750.... OPEN WOUND OF CHEST................................. 72
8751.... OPEN WOUND CHEST-COMPL.............................. 72
8760.... OPEN WOUND OF BACK.................................. 72
8761.... OPEN WOUND BACK-COMPL............................... 72
8770.... OPEN WOUND OF BUTTOCK............................... 72
8771.... OPEN WOUND BUTTOCK-COMPL............................ 72
8780.... OPEN WOUND OF PENIS................................. 72
8781.... OPEN WOUND PENIS-COMPL.............................. 72
8782.... OPN WOUND SCROTUM/TESTES............................ 72
8783.... OPN WND SCROT/TEST-COMPL............................ 72
8784.... OPEN WOUND OF VULVA................................. 72
8785.... OPEN WOUND VULVA-COMPL.............................. 72
8786.... OPEN WOUND OF VAGINA................................ 72
8787.... OPEN WOUND VAGINA-COMPL............................. 72
8788.... OPEN WOUND GENITAL NEC.............................. 72
8789.... OPN WND GENITAL NEC-COMP............................ 72
8790.... OPEN WOUND OF BREAST................................ 72
8791.... OPEN WOUND BREAST-COMPL............................. 72
8792.... OPN WND ANTERIOR ABDOMEN............................ 72
8793.... OPN WND ANT ABDOMEN-COMP............................ 72
8794.... OPN WND LATERAL ABDOMEN............................. 72
8795.... OPN WND LAT ABDOMEN-COMP............................ 72
8796.... OPEN WOUND OF TRUNK NEC............................. 72
8797.... OPEN WND TRUNK NEC-COMPL............................ 72
8798.... OPEN WOUND SITE NOS................................. 72
8799.... OPN WOUND SITE NOS-COMPL............................ 72
88000... OPEN WOUND OF SHOULDER.............................. 72
88001... OPEN WOUND OF SCAPULA............................... 72
88002... OPEN WOUND OF AXILLA................................ 72
88003... OPEN WOUND OF UPPER ARM............................. 72
88009... MULT OPEN WOUND SHOULDER............................ 72
88010... OPEN WND SHOULDER-COMPL............................. 72
88011... OPEN WOUND SCAPULA-COMPL............................ 72
88012... OPEN WOUND AXILLA-COMPL............................. 72
88013... OPEN WND UPPER ARM-COMPL............................ 72
88019... MULT OPN WND SHOULD-COMP............................ 72
88020... OPN WND SHOULDR W TENDON............................ 72
88021... OPN WND SCAPULA W TENDON............................ 72
88022... OPEN WND AXILLA W TENDON............................ 72
88023... OPEN WND UP ARM W TENDON............................ 72
88029... MLT OPN WND SHLDR W TEND............................ 72
88100... OPEN WOUND OF FOREARM............................... 72
88101... OPEN WOUND OF ELBOW................................. 72
88102... OPEN WOUND OF WRIST................................. 72
88110... OPEN WOUND FOREARM-COMPL............................ 72
88111... OPEN WOUND ELBOW-COMPLIC............................ 72
88112... OPEN WOUND WRIST-COMPLIC............................ 72
88120... OPEN WND FOREARM W TENDN............................ 72
88121... OPN WOUND ELBOW W TENDON............................ 72
88122... OPN WOUND WRIST W TENDON............................ 72
[[Page 47958]]
8820.... OPEN WOUND OF HAND.................................. 72
8821.... OPN WOUND HAND-COMPLICAT............................ 72
8822.... OPEN WOUND HAND W TENDON............................ 72
8830.... OPEN WOUND OF FINGER................................ 72
8831.... OPEN WOUND FINGER-COMPL............................. 72
8832.... OPEN WND FINGER W TENDON............................ 72
8840.... OPEN WOUND ARM MULT/NOS............................. 72
8841.... OPEN WOUND ARM NOS-COMPL............................ 72
8842.... OPN WND ARM NOS W TENDON............................ 72
8850.... AMPUTATION THUMB.................................... 72
8851.... AMPUTATION THUMB-COMPL.............................. 72
8860.... AMPUTATION FINGER................................... 72
8861.... AMPUTATION FINGER-COMPL............................. 72
8870.... AMPUT BELOW ELB, UNILAT............................. 72
8871.... AMP BELOW ELB, UNIL-COMP............................ 72
8872.... AMPUT ABV ELBOW, UNILAT............................. 72
8873.... AMPUT ABV ELB, UNIL-COMP............................ 72
8874.... AMPUTAT ARM, UNILAT NOS............................. 72
8875.... AMPUT ARM, UNIL NOS-COMP............................ 72
8876.... AMPUTATION ARM, BILAT............................... 72
8877.... AMPUTAT ARM, BILAT-COMPL............................ 72
8900.... OPEN WOUND OF HIP/THIGH............................. 72
8901.... OPEN WND HIP/THIGH-COMPL............................ 72
8902.... OPN WND HIP/THIGH W TEND............................ 72
8910.... OPEN WND KNEE/LEG/ANKLE............................. 72
8911.... OPEN WND KNEE/LEG-COMPL............................. 72
8912.... OPN WND KNEE/LEG W TENDN............................ 72
8920.... OPEN WOUND OF FOOT.................................. 72
8921.... OPEN WOUND FOOT-COMPL............................... 72
8922.... OPEN WOUND FOOT W TENDON............................ 72
8930.... OPEN WOUND OF TOE................................... 72
8931.... OPEN WOUND TOE-COMPL................................ 72
8932.... OPEN WOUND TOE W TENDON............................. 72
8940.... OPEN WOUND OF LEG NEC............................... 72
8941.... OPEN WOUND LEG NEC-COMPL............................ 72
8942.... OPN WND LEG NEC W TENDON............................ 72
8950.... AMPUTATION TOE...................................... 72
8951.... AMPUTATION TOE-COMPLICAT............................ 72
8960.... AMPUTATION FOOT, UNILAT............................. 72
8961.... AMPUT FOOT, UNILAT-COMPL............................ 72
8962.... AMPUTATION FOOT, BILAT.............................. 72
8963.... AMPUTAT FOOT, BILAT-COMP............................ 72
8970.... AMPUT BELOW KNEE, UNILAT............................ 72
8971.... AMPUTAT BK, UNILAT-COMPL............................ 72
8972.... AMPUT ABOVE KNEE, UNILAT............................ 72
8973.... AMPUT ABV KN, UNIL-COMPL............................ 72
8974.... AMPUTAT LEG, UNILAT NOS............................. 72
8975.... AMPUT LEG, UNIL NOS-COMP............................ 72
8976.... AMPUTATION LEG, BILAT............................... 72
8977.... AMPUTAT LEG, BILAT-COMPL............................ 72
90000... INJUR CAROTID ARTERY NOS............................ 72
90001... INJ COMMON CAROTID ARTER............................ 72
90002... INJ EXTERNAL CAROTID ART............................ 72
90003... INJ INTERNAL CAROTID ART............................ 72
9001.... INJ INTERNL JUGULAR VEIN............................ 72
90081... INJ EXTERN JUGULAR VEIN............................. 72
90082... INJ MLT HEAD/NECK VESSEL............................ 72
90089... INJ HEAD/NECK VESSEL NEC............................ 72
9009.... INJ HEAD/NECK VESSEL NOS............................ 72
9010.... INJURY THORACIC AORTA............................... 72
9011.... INJ INNOMIN/SUBCLAV ART............................. 72
9012.... INJ SUPERIOR VENA CAVA.............................. 72
9013.... INJ INNOMIN/SUBCLAV VEIN............................ 72
90140... INJ PULMONARY VESSEL NOS............................ 72
90141... INJURY PULMONARY ARTERY............................. 72
90142... INJURY PULMONARY VEIN............................... 72
90181... INJ INTERCOSTAL ART/VEIN............................ 72
90182... INJ INT MAMMARY ART/VEIN............................ 72
90183... INJ MULT THORACIC VESSEL............................ 72
90189... INJ THORACIC VESSEL NEC............................. 72
9019.... INJ THORACIC VESSEL NOS............................. 72
9020.... INJURY ABDOMINAL AORTA.............................. 72
90210... INJ INFER VENA CAVA NOS............................. 72
90211... INJURY HEPATIC VEINS................................ 72
90219... INJ INFER VENA CAVA NEC............................. 72
90220... INJ CELIAC/MESEN ART NOS............................ 72
[[Page 47959]]
90221... INJURY GASTRIC ARTERY............................... 72
90222... INJURY HEPATIC ARTERY............................... 72
90223... INJURY SPLENIC ARTERY............................... 72
90224... INJURY CELIAC AXIS NEC.............................. 72
90225... INJ SUPER MESENTERIC ART............................ 72
90226... INJ BRNCH SUP MESENT ART............................ 72
90227... INJ INFER MESENTERIC ART............................ 72
90229... INJ MESENTERIC VESS NEC............................. 72
90231... INJ SUPERIOR MESENT VEIN............................ 72
90232... INJ INFERIOR MESENT VEIN............................ 72
90233... INJURY PORTAL VEIN.................................. 72
90234... INJURY SPLENIC VEIN................................. 72
90239... INJ PORT/SPLEN VESS NEC............................. 72
90240... INJURY RENAL VESSEL NOS............................. 72
90241... INJURY RENAL ARTERY................................. 72
90242... INJURY RENAL VEIN................................... 72
90249... INJURY RENAL VESSEL NEC............................. 72
90250... INJURY ILIAC VESSEL NOS............................. 72
90251... INJ HYPOGASTRIC ARTERY.............................. 72
90252... INJURY HYPOGASTRIC VEIN............................. 72
90253... INJURY ILIAC ARTERY................................. 72
90254... INJURY ILIAC VEIN................................... 72
90255... INJURY UTERINE ARTERY............................... 72
90256... INJURY UTERINE VEIN................................. 72
90259... INJURY ILIAC VESSEL NEC............................. 72
90281... INJURY OVARIAN ARTERY............................... 72
90282... INJURY OVARIAN VEIN................................. 72
90287... INJ MULT ABD/PELV VESSEL............................ 72
90289... INJ ABDOMINAL VESSEL NEC............................ 72
9029.... INJ ABDOMINAL VESSEL NOS............................ 72
90300... INJ AXILLARY VESSEL NOS............................. 72
90301... INJURY AXILLARY ARTERY.............................. 72
90302... INJURY AXILLARY VEIN................................ 72
9031.... INJURY BRACHIAL VESSELS............................. 72
9032.... INJURY RADIAL VESSELS............................... 72
9033.... INJURY ULNAR VESSELS................................ 72
9034.... INJURY PALMAR ARTERY................................ 72
9035.... INJURY FINGER VESSELS............................... 72
9038.... INJURY ARM VESSELS NEC.............................. 72
9039.... INJURY ARM VESSEL NOS............................... 72
9040.... INJ COMMON FEMORAL ARTER............................ 72
9041.... INJ SUPERFIC FEMORAL ART............................ 72
9042.... INJURY FEMORAL VEIN................................. 72
9043.... INJURY SAPHENOUS VEIN............................... 72
90440... INJ POPLITEAL VESSEL NOS............................ 72
90441... INJURY POPLITEAL ARTERY............................. 72
90442... INJURY POPLITEAL VEIN............................... 72
90450... INJURY TIBIAL VESSEL NOS............................ 72
90451... INJ ANTER TIBIAL ARTERY............................. 72
90452... INJ ANTERIOR TIBIAL VEIN............................ 72
90453... INJ POST TIBIAL ARTERY.............................. 72
90454... INJ POST TIBIAL VEIN................................ 72
9046.... INJ DEEP PLANTAR VESSEL............................. 72
9047.... INJURY LEG VESSELS NEC.............................. 72
9048.... INJURY LEG VESSEL NOS............................... 72
9049.... BLOOD VESSEL INJURY NOS............................. 72
9050.... LATE EFFEC SKULL/FACE FX............................ 72
9051.... LATE EFF SPINE/TRUNK FX............................. 72
9052.... LATE EFFECT ARM FX.................................. 72
9053.... LATE EFF FEMORAL NECK FX............................ 72
9054.... LATE EFFECT LEG FX.................................. 72
9055.... LATE EFFECT FRACTURE NEC............................ 72
9056.... LATE EFFECT DISLOCATION............................. 72
9057.... LATE EFFEC SPRAIN/STRAIN............................ 72
9058.... LATE EFFEC TENDON INJURY............................ 72
9059.... LATE EFF TRAUMAT AMPUTAT............................ 72
9060.... LT EFF OPN WND HEAD/TRNK............................ 72
9061.... LATE EFF OPEN WND EXTREM............................ 72
9062.... LATE EFF SUPERFICIAL INJ............................ 72
9063.... LATE EFFECT OF CONTUSION............................ 72
9064.... LATE EFFECT OF CRUSHING............................. 72
9065.... LATE EFF HEAD/NECK BURN............................. 72
9066.... LATE EFF WRIST/HAND BURN............................ 72
9067.... LATE EFF BURN EXTREM NEC............................ 72
9068.... LATE EFFECT OF BURNS NEC............................ 72
9069.... LATE EFFECT OF BURN NOS............................. 72
[[Page 47960]]
9070.... LT EFF INTRACRANIAL INJ............................. 72
9071.... LATE EFF CRAN NERVE INJ............................. 72
9072.... LATE EFF SPINAL CORD INJ............................ 72
9073.... LT EFF NERV INJ TRNK NEC............................ 72
9074.... LT EFF NERV INJ SHLD/ARM............................ 72
9075.... LT EFF NERV INJ PELV/LEG............................ 72
9079.... LATE EFF NERVE INJ NEC.............................. 72
9080.... LATE EFF INT INJUR CHEST............................ 72
9081.... LATE EFF INT INJ ABDOMEN............................ 72
9082.... LATE EFF INT INJURY NEC............................. 72
9083.... LATE EFF INJ PERIPH VESS............................ 72
9084.... LT EFF INJ THOR/ABD VESS............................ 72
9085.... LATE EFF FB IN ORIFICE.............................. 72
9086.... LATE EFF COMPLIC TRAUMA............................. 72
9089.... LATE EFFECT INJURY NOS.............................. 72
9090.... LATE EFF DRUG POISONING............................. 72
9091.... LATE EFF NONMED SUBSTANC............................ 72
9092.... LATE EFFECT OF RADIATION............................ 72
9093.... LATE EFF SURG/MED COMPL............................. 11
9094.... LATE EFF CERT EXT CAUSE............................. 72
9095.... LTE EFCT ADVRS EFCT DRUG............................ 11
9099.... LATE EFF EXTER CAUSE NEC............................ 72
9100.... ABRASION HEAD....................................... 72
9101.... ABRASION HEAD-INFECTED.............................. 72
9102.... BLISTER HEAD........................................ 72
9103.... BLISTER HEAD-INFECTED............................... 72
9104.... INSECT BITE HEAD.................................... 72
9105.... INSECT BITE HEAD-INFECT............................. 72
9106.... FOREIGN BODY HEAD................................... 72
9107.... FOREIGN BODY HEAD-INFECT............................ 72
9108.... SUPERFIC INJ HEAD NEC............................... 72
9109.... SUPERF INJ HEAD NEC-INF............................. 72
9110.... ABRASION TRUNK...................................... 72
9111.... ABRASION TRUNK-INFECTED............................. 72
9112.... BLISTER TRUNK....................................... 72
9113.... BLISTER TRUNK-INFECTED.............................. 72
9114.... INSECT BITE TRUNK................................... 72
9115.... INSECT BITE TRUNK-INFEC............................. 72
9116.... FOREIGN BODY TRUNK.................................. 72
9117.... FOREIGN BODY TRUNK-INFEC............................ 72
9118.... SUPERFIC INJ TRUNK NEC.............................. 72
9119.... SUPERF INJ TRNK NEC-INF............................. 72
9120.... ABRASION SHOULDER/ARM............................... 72
9121.... ABRASION SHLDR/ARM-INFEC............................ 72
9122.... BLISTER SHOULDER & ARM.............................. 72
9123.... BLISTER SHOULDER/ARM-INF............................ 72
9124.... INSECT BITE SHOULDER/ARM............................ 72
9125.... INSECT BITE SHLD/ARM-INF............................ 72
9126.... FOREIGN BODY SHOULDR/ARM............................ 72
9127.... FB SHOULDER/ARM-INFECT.............................. 72
9128.... SUPERF INJ SHLDR/ARM NEC............................ 72
9129.... SUPERF INJ SHLDR NEC-INF............................ 72
9130.... ABRASION FOREARM.................................... 72
9131.... ABRASION FOREARM-INFECT............................. 72
9132.... BLISTER FOREARM..................................... 72
9133.... BLISTER FOREARM-INFECTED............................ 72
9134.... INSECT BITE FOREARM................................. 72
9135.... INSECT BITE FOREARM-INF............................. 72
9136.... FOREIGN BODY FOREARM................................ 72
9137.... FOREIGN BODY FOREARM-INF............................ 72
9138.... SUPERF INJ FOREARM NEC.............................. 72
9139.... SUPRF INJ FORARM NEC-INF............................ 72
9140.... ABRASION HAND....................................... 72
9141.... ABRASION HAND-INFECTED.............................. 72
9142.... BLISTER HAND........................................ 72
9143.... BLISTER HAND-INFECTED............................... 72
9144.... INSECT BITE HAND.................................... 72
9145.... INSECT BITE HAND-INFECT............................. 72
9146.... FOREIGN BODY HAND................................... 72
9147.... FOREIGN BODY HAND-INFECT............................ 72
9148.... SUPERFICIAL INJ HAND NEC............................ 72
9149.... SUPERF INJ HAND NEC-INF............................. 72
9150.... ABRASION FINGER..................................... 72
9151.... ABRASION FINGER-INFECTED............................ 72
9152.... BLISTER FINGER...................................... 72
9153.... BLISTER FINGER-INFECTED............................. 72
[[Page 47961]]
9154.... INSECT BITE FINGER.................................. 72
9155.... INSECT BITE FINGER-INFEC............................ 72
9156.... FOREIGN BODY FINGER................................. 72
9157.... FOREIGN BODY FINGER-INF............................. 72
9158.... SUPERFIC INJ FINGER-NEC............................. 72
9159.... SUPRF INJ FINGER NEC-INF............................ 72
9160.... ABRASION HIP & LEG.................................. 72
9161.... ABRASION HIP/LEG-INFECT............................. 72
9162.... BLISTER HIP & LEG................................... 72
9163.... BLISTER HIP & LEG-INFECT............................ 72
9164.... INSECT BITE HIP & LEG............................... 72
9165.... INSECT BITE HIP/LEG-INF............................. 72
9166.... FOREIGN BODY HIP/LEG................................ 72
9167.... FOREIGN BDY HIP/LEG-INF............................. 72
9168.... SUPERFIC INJ HIP/LEG NEC............................ 72
9169.... SUPERF INJ LEG NEC-INFEC............................ 72
9170.... ABRASION FOOT & TOE................................. 72
9171.... ABRASION FOOT/TOE-INFEC............................. 72
9172.... BLISTER FOOT & TOE.................................. 72
9173.... BLISTER FOOT & TOE-INFEC............................ 72
9174.... INSECT BITE FOOT/TOE................................ 72
9175.... INSECT BITE FOOT/TOE-INF............................ 72
9176.... FOREIGN BODY FOOT & TOE............................. 72
9177.... FOREIGN BDY FOOT/TOE-INF............................ 72
9178.... SUPERF INJ FOOT/TOE NEC............................. 72
9179.... SUPERF INJ FOOT NEC-INF............................. 72
9180.... SUPERFIC INJ PERIOCULAR............................. 68
9181.... SUPERFICIAL INJ CORNEA.............................. 68
9182.... SUPERFIC INJ CONJUNCTIVA............................ 68
9189.... SUPERFICIAL INJ EYE NEC............................. 68
9190.... ABRASION NEC........................................ 72
9191.... ABRASION NEC-INFECTED............................... 72
9192.... BLISTER NEC......................................... 72
9193.... BLISTER NEC-INFECTED................................ 72
9194.... INSECT BITE NEC..................................... 72
9195.... INSECT BITE NEC-INFECTED............................ 72
9196.... SUPERFIC FOREIGN BDY NEC............................ 72
9197.... SUPERFICIAL FB NEC-INFEC............................ 72
9198.... SUPERFICIAL INJURY NEC.............................. 72
9199.... SUPERFIC INJ NEC-INFECT............................. 72
920..... CONTUSION FACE/SCALP/NCK............................ 72
9210.... BLACK EYE NOS....................................... 72
9211.... CONTUSION PERIOCULAR................................ 72
9212.... CONTUSION ORBITAL TISSUE............................ 72
9213.... CONTUSION OF EYEBALL................................ 72
9219.... CONTUSION OF EYE NOS................................ 68
9220.... CONTUSION OF BREAST................................. 72
9221.... CONTUSION OF CHEST WALL............................. 72
9222.... CONTUSION ABDOMINAL WALL............................ 72
9224.... CONTUSION GENITAL ORGANS............................ 72
9228.... MULTIPLE CONTUSION TRUNK............................ 72
9229.... CONTUSION TRUNK NOS................................. 72
92300... CONTUSION SHOULDER REG.............................. 72
92301... CONTUSION SCAPUL REGION............................. 72
92302... CONTUSION AXILLARY REG.............................. 72
92303... CONTUSION OF UPPER ARM.............................. 72
92309... CONTUSION SHOULDER & ARM............................ 72
92310... CONTUSION OF FOREARM................................ 72
92311... CONTUSION OF ELBOW.................................. 72
92320... CONTUSION OF HAND(S)................................ 72
92321... CONTUSION OF WRIST.................................. 72
9233.... CONTUSION OF FINGER................................. 72
9238.... MULTIPLE CONTUSION ARM.............................. 72
9239.... CONTUSION UPPER LIMB NOS............................ 72
92400... CONTUSION OF THIGH.................................. 72
92401... CONTUSION OF HIP.................................... 72
92410... CONTUSION OF LOWER LEG.............................. 72
92411... CONTUSION OF KNEE................................... 72
92420... CONTUSION OF FOOT................................... 72
92421... CONTUSION OF ANKLE.................................. 72
9243.... CONTUSION OF TOE.................................... 72
9244.... MULTIPLE CONTUSION LEG.............................. 72
9245.... CONTUSION LEG NOS................................... 72
9248.... MULTIPLE CONTUSIONS NEC............................. 72
9249.... CONTUSION NOS....................................... 72
9251.... CRUSH INJ FACE SCALP................................ 72
[[Page 47962]]
9252.... CRUSH INJ NECK...................................... 72
9260.... CRUSH INJ EXT GENITALIA............................. 72
92611... CRUSHING INJURY BACK................................ 72
92612... CRUSHING INJURY BUTTOCK............................. 72
92619... CRUSHING INJ TRUNK NEC.............................. 72
9268.... MULT CRUSHING INJ TRUNK............................. 72
9269.... CRUSHING INJ TRUNK NOS.............................. 72
92700... CRUSH INJ SHOULDER REG.............................. 72
92701... CRUSH INJ SCAPUL REGION............................. 72
92702... CRUSH INJ AXILLARY REG.............................. 72
92703... CRUSHING INJ UPPER ARM.............................. 72
92709... CRUSH INJ SHOULDER & ARM............................ 72
92710... CRUSHING INJURY FOREARM............................. 72
92711... CRUSHING INJURY ELBOW............................... 72
92720... CRUSHING INJURY OF HAND............................. 72
92721... CRUSHING INJURY OF WRIST............................ 72
9273.... CRUSHING INJURY FINGER.............................. 72
9278.... MULT CRUSHING INJURY ARM............................ 72
9279.... CRUSHING INJURY ARM NOS............................. 72
92800... CRUSHING INJURY THIGH............................... 72
92801... CRUSHING INJURY HIP................................. 72
92810... CRUSHING INJ LOWER LEG.............................. 72
92811... CRUSHING INJURY KNEE................................ 72
92820... CRUSHING INJURY FOOT................................ 72
92821... CRUSHING INJURY ANKLE............................... 72
9283.... CRUSHING INJURY TOE................................. 72
9288.... MULT CRUSHING INJURY LEG............................ 72
9289.... CRUSHING INJURY LEG NOS............................. 72
9290.... CRUSH INJ MULT SITE NEC............................. 72
9299.... CRUSHING INJURY NOS................................. 72
9300.... CORNEAL FOREIGN BODY................................ 68
9301.... FB IN CONJUNCTIVAL SAC.............................. 72
9302.... FB IN LACRIMAL PUNCTUM.............................. 72
9308.... FOREIGN BDY EXT EYE NEC............................. 68
9309.... FOREIGN BDY EXT EYE NOS............................. 68
931..... FOREIGN BODY IN EAR................................. 72
932..... FOREIGN BODY IN NOSE................................ 72
9330.... FOREIGN BODY IN PHARYNX............................. 72
9331.... FOREIGN BODY IN LARYNX.............................. 72
9340.... FOREIGN BODY IN TRACHEA............................. 72
9341.... FOREIGN BODY BRONCHUS............................... 72
9348.... FB TRACH/BRONCH/LUNG NEC............................ 72
9349.... FB RESPIRATORY TREE NOS............................. 72
9350.... FOREIGN BODY IN MOUTH............................... 72
9351.... FOREIGN BODY ESOPHAGUS.............................. 72
9352.... FOREIGN BODY IN STOMACH............................. 72
936..... FB IN INTESTINE & COLON............................. 72
937..... FOREIGN BODY ANUS/RECTUM............................ 72
938..... FOREIGN BODY GI NOS................................. 72
9390.... FB BLADDER & URETHRA................................ 72
9391.... FOREIGN BODY UTERUS................................. 56
9392.... FOREIGN BDY VULVA/VAGINA............................ 72
9393.... FOREIGN BODY PENIS.................................. 72
9399.... FOREIGN BDY GU TRACT NOS............................ 72
9400.... CHEMICAL BURN PERIOCULAR............................ 72
9401.... BURN PERIOCULAR AREA NEC............................ 72
9402.... ALKAL BURN CORNEA/CONJUN............................ 72
9403.... ACID BURN CORNEA/CONJUNC............................ 72
9404.... BURN CORNEA/CONJUNCT NEC............................ 72
9405.... BURN W EYEBALL DESTRUCT............................. 72
9409.... BURN EYE & ADNEXA NOS............................... 72
94100... BURN NOS HEAD-UNSPEC................................ 72
94101... BURN NOS EAR........................................ 72
94102... BURN NOS EYE........................................ 72
94103... BURN NOS LIP........................................ 72
94104... BURN NOS CHIN....................................... 72
94105... BURN NOS NOSE....................................... 72
94106... BURN NOS SCALP...................................... 72
94107... BURN NOS FACE NEC................................... 72
94108... BURN NOS NECK....................................... 72
94109... BURN NOS HEAD-MULT.................................. 72
94110... 1ST DEG BURN HEAD NOS............................... 72
94111... 1ST DEG BURN EAR.................................... 72
94112... 1ST DEG BURN EYE.................................... 72
94113... 1ST DEG BURN LIP.................................... 72
94114... 1ST DEG BURN CHIN................................... 72
[[Page 47963]]
94115... 1ST DEG BURN NOSE................................... 72
94116... 1ST DEG BURN SCALP.................................. 72
94117... 1ST DEG BURN FACE NEC............................... 72
94118... 1ST DEG BURN NECK................................... 72
94119... 1ST DEG BURN HEAD-MULT.............................. 72
94120... 2ND DEG BURN HEAD NOS............................... 72
94121... 2ND DEG BURN EAR.................................... 72
94122... 2ND DEG BURN EYE.................................... 72
94123... 2ND DEG BURN LIP.................................... 72
94124... 2ND DEG BURN CHIN................................... 72
94125... 2ND DEG BURN NOSE................................... 72
94126... 2ND DEG BURN SCALP.................................. 72
94127... 2ND DEG BURN FACE NEC............................... 72
94128... 2ND DEG BURN NECK................................... 72
94129... 2ND DEG BURN HEAD-MULT.............................. 72
94130... 3RD DEG BURN HEAD NOS............................... 72
94131... 3RD DEG BURN EAR.................................... 72
94132... 3RD DEG BURN EYE.................................... 72
94133... 3RD DEG BURN LIP.................................... 72
94134... 3RD DEG BURN CHIN................................... 72
94135... 3RD DEG BURN NOSE................................... 72
94136... 3RD DEG BURN SCALP.................................. 72
94137... 3RD DEG BURN FACE NEC............................... 72
94138... 3RD DEG BURN NECK................................... 72
94139... 3RD DEG BURN HEAD-MULT.............................. 72
94140... DEEP 3 DEG BURN HEAD NOS............................ 72
94141... DEEP 3RD DEG BURN EAR............................... 72
94142... DEEP 3RD DEG BURN EYE............................... 72
94143... DEEP 3RD DEG BURN LIP............................... 72
94144... DEEP 3RD DEG BURN CHIN.............................. 72
94145... DEEP 3RD DEG BURN NOSE.............................. 72
94146... DEEP 3RD DEG BURN SCALP............................. 72
94147... DEEP 3RD BURN FACE NEC.............................. 72
94148... DEEP 3RD DEG BURN NECK.............................. 72
94149... DEEP 3 DEG BRN HEAD-MULT............................ 72
94150... 3RD BURN W LOSS-HEAD NOS............................ 72
94151... 3RD DEG BURN W LOSS-EAR............................. 72
94152... 3RD DEG BURN W LOSS-EYE............................. 72
94153... 3RD DEG BURN W LOSS-LIP............................. 72
94154... 3RD DEG BURN W LOSS-CHIN............................ 72
94155... 3RD DEG BURN W LOSS-NOSE............................ 72
94156... 3RD DEG BRN W LOSS-SCALP............................ 72
94157... 3RD BURN W LOSS-FACE NEC............................ 72
94158... 3RD DEG BURN W LOSS-NECK............................ 72
94159... 3RD BRN W LOSS-HEAD MULT............................ 72
94200... BURN NOS TRUNK-UNSPEC............................... 72
94201... BURN NOS BREAST..................................... 72
94202... BURN NOS CHEST WALL................................. 72
94203... BURN NOS ABDOMINAL WALL............................. 72
94204... BURN NOS BACK....................................... 72
94205... BURN NOS GENITALIA.................................. 72
94209... BURN NOS TRUNK NEC.................................. 72
94210... 1ST DEG BURN TRUNK NOS.............................. 72
94211... 1ST DEG BURN BREAST................................. 72
94212... 1ST DEG BURN CHEST WALL............................. 72
94213... 1ST DEG BURN ABDOMN WALL............................ 72
94214... 1ST DEG BURN BACK................................... 72
94215... 1ST DEG BURN GENITALIA.............................. 72
94219... 1ST DEG BURN TRUNK NEC.............................. 72
94220... 2ND DEG BURN TRUNK NOS.............................. 72
94221... 2ND DEG BURN BREAST................................. 72
94222... 2ND DEG BURN CHEST WALL............................. 72
94223... 2ND DEG BURN ABDOMN WALL............................ 72
94224... 2ND DEG BURN BACK................................... 72
94225... 2ND DEG BURN GENITALIA.............................. 72
94229... 2ND DEG BURN TRUNK NEC.............................. 72
94230... 3RD DEG BURN TRUNK NOS.............................. 72
94231... 3RD DEG BURN BREAST................................. 72
94232... 3RD DEG BURN CHEST WALL............................. 72
94233... 3RD DEG BURN ABDOMN WALL............................ 72
94234... 3RD DEG BURN BACK................................... 72
94235... 3RD DEG BURN GENITALIA.............................. 72
94239... 3RD DEG BURN TRUNK NEC.............................. 72
94240... DEEP 3RD BURN TRUNK NOS............................. 72
94241... DEEP 3RD DEG BURN BREAST............................ 72
94242... DEEP 3RD BURN CHEST WALL............................ 72
[[Page 47964]]
94243... DEEP 3RD BURN ABDOM WALL............................ 72
94244... DEEP 3RD DEG BURN BACK.............................. 72
94245... DEEP 3RD BURN GENITALIA............................. 72
94249... DEEP 3RD BURN TRUNK NEC............................. 72
94250... 3RD BRN W LOSS-TRUNK NOS............................ 72
94251... 3RD BURN W LOSS-BREAST.............................. 72
94252... 3RD BRN W LOSS-CHEST WLL............................ 72
94253... 3RD BRN W LOSS-ABDOM WLL............................ 72
94254... 3RD DEG BURN W LOSS-BACK............................ 72
94255... 3RD BRN W LOSS-GENITALIA............................ 72
94259... 3RD BRN W LOSS-TRUNK NEC............................ 72
94300... BURN NOS ARM-UNSPEC................................. 72
94301... BURN NOS FOREARM.................................... 72
94302... BURN NOS ELBOW...................................... 72
94303... BURN NOS UPPER ARM.................................. 72
94304... BURN NOS AXILLA..................................... 72
94305... BURN NOS SHOULDER................................... 72
94306... BURN NOS SCAPULA.................................... 72
94309... BURN NOS ARM-MULTIPLE............................... 72
94310... 1ST DEG BURN ARM NOS................................ 72
94311... 1ST DEG BURN FOREARM................................ 72
94312... 1ST DEG BURN ELBOW.................................. 72
94313... 1ST DEG BURN UPPER ARM.............................. 72
94314... 1ST DEG BURN AXILLA................................. 72
94315... 1ST DEG BURN SHOULDER............................... 72
94316... 1ST DEG BURN SCAPULA................................ 72
94319... 1ST DEG BURN ARM-MULT............................... 72
94320... 2ND DEG BURN ARM NOS................................ 72
94321... 2ND DEG BURN FOREARM................................ 72
94322... 2ND DEG BURN ELBOW.................................. 72
94323... 2ND DEG BURN UPPER ARM.............................. 72
94324... 2ND DEG BURN AXILLA................................. 72
94325... 2ND DEG BURN SHOULDER............................... 72
94326... 2ND DEG BURN SCAPULA................................ 72
94329... 2ND DEG BURN ARM-MULT............................... 72
94330... 3RD DEG BURN ARM NOS................................ 72
94331... 3RD DEG BURN FOREARM................................ 72
94332... 3RD DEG BURN ELBOW.................................. 72
94333... 3RD DEG BURN UPPER ARM.............................. 72
94334... 3RD DEG BURN AXILLA................................. 72
94335... 3RD DEG BURN SHOULDER............................... 72
94336... 3RD DEG BURN SCAPULA................................ 72
94339... 3RD DEG BURN ARM-MULT............................... 72
94340... DEEP 3 DEG BURN ARM NOS............................. 72
94341... DEEP 3 DEG BURN FOREARM............................. 72
94342... DEEP 3 DEG BURN ELBOW............................... 72
94343... DEEP 3 DEG BRN UPPER ARM............................ 72
94344... DEEP 3 DEG BURN AXILLA.............................. 72
94345... DEEP 3 DEG BURN SHOULDER............................ 72
94346... DEEP 3 DEG BURN SCAPULA............................. 72
94349... DEEP 3 DEG BURN ARM-MULT............................ 72
94350... 3RD BURN W LOSS-ARM NOS............................. 72
94351... 3RD BURN W LOSS-FOREARM............................. 72
94352... 3RD BURN W LOSS-ELBOW............................... 72
94353... 3RD BRN W LOSS-UPPER ARM............................ 72
94354... 3RD BURN W LOSS-AXILLA.............................. 72
94355... 3RD BURN W LOSS-SHOULDER............................ 72
94356... 3RD BURN W LOSS-SCAPULA............................. 72
94359... 3RD BURN W LOSS ARM-MULT............................ 72
94400... BURN NOS HAND-UNSPEC................................ 72
94401... BURN NOS FINGER..................................... 72
94402... BURN NOS THUMB...................................... 72
94403... BURN NOS MULT FINGERS............................... 72
94404... BURN NOS FINGER W THUMB............................. 72
94405... BURN NOS PALM....................................... 72
94406... BURN NOS BACK OF HAND............................... 72
94407... BURN NOS WRIST...................................... 72
94408... BURN NOS HAND-MULTIPLE.............................. 72
94410... 1ST DEG BURN HAND NOS............................... 72
94411... 1ST DEG BURN FINGER................................. 72
94412... 1ST DEG BURN THUMB.................................. 72
94413... 1ST DEG BURN MULT FINGER............................ 72
94414... 1 DEG BURN FINGR W THUMB............................ 72
94415... 1ST DEG BURN PALM................................... 72
94416... 1 DEG BURN BACK OF HAND............................. 72
94417... 1ST DEG BURN WRIST.................................. 72
[[Page 47965]]
94418... 1ST DEG BURN HAND-MULT.............................. 72
94420... 2ND DEG BURN HAND NOS............................... 72
94421... 2ND DEG BURN FINGER................................. 72
94422... 2ND DEG BURN THUMB.................................. 72
94423... 2ND DEG BURN MULT FINGER............................ 72
94424... 2 DEG BURN FINGR W THUMB............................ 72
94425... 2ND DEG BURN PALM................................... 72
94426... 2 DEG BURN BACK OF HAND............................. 72
94427... 2ND DEG BURN WRIST.................................. 72
94428... 2ND DEG BURN HAND-MULT.............................. 72
94430... 3RD DEG BURN HAND NOS............................... 72
94431... 3RD DEG BURN FINGER................................. 72
94432... 3RD DEG BURN THUMB.................................. 72
94433... 3RD DEG BURN MULT FINGER............................ 72
94434... 3 DEG BURN FINGR W THUMB............................ 72
94435... 3RD DEG BURN PALM................................... 72
94436... 3 DEG BURN BACK OF HAND............................. 72
94437... 3RD DEG BURN WRIST.................................. 72
94438... 3RD DEG BURN HAND-MULT.............................. 72
94440... DEEP 3 DEG BRN HAND NOS............................. 72
94441... DEEP 3 DEG BURN FINGER.............................. 72
94442... DEEP 3 DEG BURN THUMB............................... 72
94443... DEEP 3RD BRN MULT FINGER............................ 72
94444... DEEP 3RD BRN FNGR W THMB............................ 72
94445... DEEP 3 DEG BURN PALM................................ 72
94446... DEEP 3RD BRN BACK OF HND............................ 72
94447... DEEP 3 DEG BURN WRIST............................... 72
94448... DEEP 3 DEG BRN HAND-MULT............................ 72
94450... 3RD BRN W LOSS-HAND NOS............................. 72
94451... 3RD BURN W LOSS-FINGER.............................. 72
94452... 3RD BURN W LOSS-THUMB............................... 72
94453... 3RD BRN W LOSS-MULT FNGR............................ 72
94454... 3RD BRN W LOSS-FNGR/THMB............................ 72
94455... 3RD BURN W LOSS-PALM................................ 72
94456... 3RD BRN W LOSS-BK OF HND............................ 72
94457... 3RD BURN W LOSS-WRIST............................... 72
94458... 3RD BRN W LOSS HAND-MULT............................ 72
94500... BURN NOS LEG-UNSPEC................................. 72
94501... BURN NOS TOE........................................ 72
94502... BURN NOS FOOT....................................... 72
94503... BURN NOS ANKLE...................................... 72
94504... BURN NOS LOWER LEG.................................. 72
94505... BURN NOS KNEE....................................... 72
94506... BURN NOS THIGH...................................... 72
94509... BURN NOS LEG-MULTIPLE............................... 72
94510... 1ST DEG BURN LEG NOS................................ 72
94511... 1ST DEG BURN TOE.................................... 72
94512... 1ST DEG BURN FOOT................................... 72
94513... 1ST DEG BURN ANKLE.................................. 72
94514... 1ST DEG BURN LOWER LEG.............................. 72
94515... 1ST DEG BURN KNEE................................... 72
94516... 1ST DEG BURN THIGH.................................. 72
94519... 1ST DEG BURN LEG-MULT............................... 72
94520... 2ND DEG BURN LEG NOS................................ 72
94521... 2ND DEG BURN TOE.................................... 72
94522... 2ND DEG BURN FOOT................................... 72
94523... 2ND DEG BURN ANKLE.................................. 72
94524... 2ND DEG BURN LOWER LEG.............................. 72
94525... 2ND DEG BURN KNEE................................... 72
94526... 2ND DEG BURN THIGH.................................. 72
94529... 2ND DEG BURN LEG-MULT............................... 72
94530... 3RD DEG BURN LEG NOS................................ 72
94531... 3RD DEG BURN TOE.................................... 72
94532... 3RD DEG BURN FOOT................................... 72
94533... 3RD DEG BURN ANKLE.................................. 72
94534... 3RD DEG BURN LOW LEG................................ 72
94535... 3RD DEG BURN KNEE................................... 72
94536... 3RD DEG BURN THIGH.................................. 72
94539... 3RD DEG BURN LEG-MULT............................... 72
94540... DEEP 3RD DEG BRN LEG NOS............................ 72
94541... DEEP 3RD DEG BURN TOE............................... 72
94542... DEEP 3RD DEG BURN FOOT.............................. 72
94543... DEEP 3RD DEG BURN ANKLE............................. 72
94544... DEEP 3RD DEG BRN LOW LEG............................ 72
94545... DEEP 3RD DEG BURN KNEE.............................. 72
94546... DEEP 3RD DEG BURN THIGH............................. 72
[[Page 47966]]
94549... DEEP 3 DEG BURN LEG-MULT............................ 72
94550... 3 DEG BRN W LOSS-LEG NOS............................ 72
94551... 3 DEG BURN W LOSS-TOE............................... 72
94552... 3 DEG BURN W LOSS-FOOT.............................. 72
94553... 3 DEG BURN W LOSS-ANKLE............................. 72
94554... 3 DEG BRN W LOSS-LOW LEG............................ 72
94555... 3 DEG BURN W LOSS-KNEE.............................. 72
94556... 3 DEG BURN W LOSS-THIGH............................. 72
94559... 3 DEG BRN W LOSS LEG-MLT............................ 72
9460.... BURN NOS MULTIPLE SITE.............................. 72
9461.... 1ST DEG BURN MULT SITE.............................. 72
9462.... 2ND DEG BURN MULT SITE.............................. 72
9463.... 3RD DEG BURN MULT SITE.............................. 72
9464.... DEEP 3 DEG BRN MULT SITE............................ 72
9465.... 3RD BRN W LOSS-MULT SITE............................ 72
9470.... BURN OF MOUTH & PHARYNX............................. 72
9471.... BURN LARYNX/TRACHEA/LUNG............................ 72
9472.... BURN OF ESOPHAGUS................................... 72
9473.... BURN OF GI TRACT.................................... 72
9474.... BURN OF VAGINA & UTERUS............................. 72
9478.... BURN INTERNAL ORGAN NEC............................. 72
9479.... BURN INTERNAL ORGAN NOS............................. 72
94800... BDY BRN < 10%/3D DEG NOS............................ 72
94810... 10-19% BDY BRN/3 DEG NOS............................ 72
94811... 10-19% BDY BRN/10-19% 3D............................ 72
94820... 20-29% BDY BRN/3 DEG NOS............................ 72
94821... 20-29% BDY BRN/10-19% 3D............................ 72
94822... 20-29% BDY BRN/20-29% 3D............................ 72
94830... 30-39% BDY BRN/3 DEG NOS............................ 72
94831... 30-39% BDY BRN/10-19% 3D............................ 72
94832... 30-39% BDY BRN/20-29% 3D............................ 72
94833... 30-39% BDY BRN/30-39% 3D............................ 72
94840... 40-49% BDY BRN/3 DEG NOS............................ 72
94841... 40-49% BDY BRN/10-19% 3D............................ 72
94842... 40-49% BDY BRN/20-29% 3D............................ 72
94843... 40-49% BDY BRN/30-39% 3D............................ 72
94844... 40-49% BDY BRN/40-49% 3D............................ 72
94850... 50-59% BDY BRN/3 DEG NOS............................ 72
94851... 50-59% BDY BRN/10-19% 3D............................ 72
94852... 50-59% BDY BRN/20-29% 3D............................ 72
94853... 50-59% BDY BRN/30-39% 3D............................ 72
94854... 50-59% BDY BRN/40-49% 3D............................ 72
94855... 50-59% BDY BRN/50-59% 3D............................ 72
94860... 60-69% BDY BRN/3 DEG NOS............................ 72
94861... 60-69% BDY BRN/10-19% 3D............................ 72
94862... 60-69% BDY BRN/20-29% 3D............................ 72
94863... 60-69% BDY BRN/30-39% 3D............................ 72
94864... 60-69% BDY BRN/40-49% 3D............................ 72
94865... 60-69% BDY BRN/50-59% 3D............................ 72
94866... 60-69% BDY BRN/60-69% 3D............................ 72
94870... 70-79% BDY BRN/3 DEG NOS............................ 72
94871... 70-79% BDY BRN/10-19% 3D............................ 72
94872... 70-79% BDY BRN/20-29% 3D............................ 72
94873... 70-79% BDY BRN/30-39% 3D............................ 72
94874... 70-79% BDY BRN/40-49% 3D............................ 72
94875... 70-79% BDY BRN/50-59% 3D............................ 72
94876... 70-79% BDY BRN/60-69% 3D............................ 72
94877... 70-79% BDY BRN/70-79% 3D............................ 72
94880... 80-89% BDY BRN/3 DEG NOS............................ 72
94881... 80-89% BDY BRN/10-19% 3D............................ 72
94882... 80-89% BDY BRN/20-29% 3D............................ 72
94883... 80-89% BDY BRN/30-39% 3D............................ 72
94884... 80-89% BDY BRN/40-49% 3D............................ 72
94885... 80-89% BDY BRN/50-59% 3D............................ 72
94886... 80-89% BDY BRN/60-69% 3D............................ 72
94887... 80-89% BDY BRN/70-79% 3D............................ 72
94888... 80-89% BDY BRN/80-89% 3D............................ 72
94890... 90% + BDY BRN/3D DEG NOS............................ 72
94891... 90% + BDY BRN/10-19% 3RD............................ 72
94892... 90% + BDY BRN/20-29% 3RD............................ 72
94893... 90% + BDY BRN/30-39% 3RD............................ 72
94894... 90% + BDY BRN/40-49% 3RD............................ 72
94895... 90% + BDY BRN/50-59% 3RD............................ 72
94896... 90% + BDY BRN/60-69% 3RD............................ 72
94897... 90% + BDY BRN/70-79% 3RD............................ 72
94898... 90% + BDY BRN/80-89% 3RD............................ 72
[[Page 47967]]
94899... 90% + BDY BRN/90% + 3RD............................. 72
9490.... BURN NOS............................................ 72
9491.... 1ST DEGREE BURN NOS................................. 72
9492.... 2ND DEGREE BURN NOS................................. 72
9493.... 3RD DEGREE BURN NOS................................. 72
9494.... DEEP 3RD DEG BURN NOS............................... 72
9495.... 3RD BURN W LOSS-SITE NOS............................ 72
9500.... OPTIC NERVE INJURY.................................. 72
9501.... INJURY TO OPTIC CHIASM.............................. 72
9502.... INJURY TO OPTIC PATHWAYS............................ 72
9503.... INJURY TO VISUAL CORTEX............................. 72
9509.... INJ OPTIC NERV/PATH NOS............................. 72
9510.... INJURY OCULOMOTOR NERVE............................. 72
9511.... INJURY TROCHLEAR NERVE.............................. 72
9512.... INJURY TRIGEMINAL NERVE............................. 72
9513.... INJURY ABDUCENS NERVE............................... 72
9514.... INJURY TO FACIAL NERVE.............................. 72
9515.... INJURY TO ACOUSTIC NERVE............................ 72
9516.... INJURY ACCESSORY NERVE.............................. 72
9517.... INJURY HYPOGLOSSAL NERVE............................ 72
9518.... INJURY CRANIAL NERVE NEC............................ 72
9519.... INJURY CRANIAL NERVE NOS............................ 72
95200... C1-C4 SPIN CORD INJ NOS............................. 72
95201... COMPLETE LES CORD/C1-C4............................. 72
95202... ANTERIOR CORD SYND/C1-C4............................ 72
95203... CENTRAL CORD SYND/C1-C4............................. 72
95204... C1-C4 SPIN CORD INJ NEC............................. 72
95205... C5-C7 SPIN CORD INJ NOS............................. 72
95206... COMPLETE LES CORD/C5-C7............................. 72
95207... ANTERIOR CORD SYND/C5-C7............................ 72
95208... CENTRAL CORD SYND/C5-C7............................. 72
95209... C5-C7 SPIN CORD INJ NEC............................. 72
95210... T1-T6 SPIN CORD INJ NOS............................. 72
95211... COMPLETE LES CORD/T1-T6............................. 72
95212... ANTERIOR CORD SYND/T1-T6............................ 72
95213... CENTRAL CORD SYND/T1-T6............................. 72
95214... T1-T6 SPIN CORD INJ NEC............................. 72
95215... T7-T12 SPIN CORD INJ NOS............................ 72
95216... COMPLETE LES CORD/T7-T12............................ 72
95217... ANTERIOR CORD SYN/T7-T12............................ 72
95218... CENTRAL CORD SYN/T7-T12............................. 72
95219... T7-T12 SPIN CORD INJ NEC............................ 72
9522.... LUMBAR SPINAL CORD INJUR............................ 72
9523.... SACRAL SPINAL CORD INJUR............................ 72
9524.... CAUDA EQUINA INJURY................................. 72
9528.... SPIN CORD INJ-MULT SITE............................. 72
9529.... SPINAL CORD INJURY NOS.............................. 72
9530.... CERVICAL ROOT INJURY................................ 72
9531.... DORSAL ROOT INJURY.................................. 72
9532.... LUMBAR ROOT INJURY.................................. 72
9533.... SACRAL ROOT INJURY.................................. 72
9534.... BRACHIAL PLEXUS INJURY.............................. 72
9535.... LUMBOSACRAL PLEX INJURY............................. 72
9538.... MULT NERVE ROOT/PLEX INJ............................ 72
9539.... INJ NERVE ROOT/PLEX NOS............................. 72
9540.... INJ CERV SYMPATH NERVE.............................. 72
9541.... INJ SYMPATH NERVE NEC............................... 72
9548.... INJURY TRUNK NERVE NEC.............................. 72
9549.... INJURY TRUNK NERVE NOS.............................. 72
9550.... INJURY AXILLARY NERVE............................... 72
9551.... INJURY MEDIAN NERVE................................. 72
9552.... INJURY ULNAR NERVE.................................. 72
9553.... INJURY RADIAL NERVE................................. 72
9554.... INJ MUSCULOCUTAN NERVE.............................. 72
9555.... INJ CUTAN SENSO NERV/ARM............................ 72
9556.... INJURY DIGITAL NERVE................................ 72
9557.... INJ NERVE SHLDR/ARM NEC............................. 72
9558.... INJ MULT NERVE SHLDR/ARM............................ 72
9559.... INJ NERVE SHLDR/ARM NOS............................. 72
9560.... INJURY SCIATIC NERVE................................ 72
9561.... INJURY FEMORAL NERVE................................ 72
9562.... INJ POSTERIOR TIB NERVE............................. 72
9563.... INJURY PERONEAL NERVE............................... 72
9564.... INJ CUTAN SENSO NERV/LEG............................ 72
9565.... INJ NERVE PELV/LEG NEC.............................. 72
9568.... INJ MULT NERVE PELV/LEG............................. 72
[[Page 47968]]
9569.... INJ NERVE PELV/LEG NOS.............................. 72
9570.... INJ SUPERF NERV HEAD/NCK............................ 72
9571.... INJURY TO NERVE NEC................................. 72
9578.... INJURY TO MULT NERVES............................... 72
9579.... INJURY TO NERVE NOS................................. 72
9580.... AIR EMBOLISM........................................ 72
9581.... FAT EMBOLISM........................................ 72
9582.... SECONDARY/RECUR HEMORR.............................. 72
9583.... POSTTRAUM WND INFEC NEC............................. 97
9584.... TRAUMATIC SHOCK..................................... 72
9585.... TRAUMATIC ANURIA.................................... 72
9586.... VOLKMANN'S ISCH CONTRACT............................ 72
9587.... TRAUM SUBCUTAN EMPHYSEMA............................ 11
9588.... EARLY COMPLIC TRAUMA NEC............................ 11
9591.... TRUNK INJURY NOS.................................... 11
9592.... SHLDR/UPPER ARM INJ NOS............................. 11
9593.... ELB/FOREARM/WRST INJ NOS............................ 11
9594.... HAND INJURY NOS..................................... 11
9595.... FINGER INJURY NOS................................... 11
9596.... HIP & THIGH INJURY NOS.............................. 11
9597.... LOWER LEG INJURY NOS................................ 11
9598.... INJURY MLT SITE/SITE NEC............................ 11
9599.... INJURY-SITE NOS..................................... 11
9600.... POISONING-PENICILLINS............................... 72
9601.... POIS-ANTIFUNGAL ANTIBIOT............................ 72
9602.... POISON-CHLORAMPHENICOL.............................. 72
9603.... POIS-ERYTHROMYC/MACROLID............................ 72
9604.... POISONING-TETRACYCLINE.............................. 72
9605.... POIS-CEPHALOSPORIN GROUP............................ 72
9606.... POIS-ANTIMYCOBAC ANTIBIO............................ 72
9607.... POIS-ANTINEOP ANTIBIOTIC............................ 72
9608.... POISONING-ANTIBIOTIC NEC............................ 72
9609.... POISONING-ANTIBIOTIC NOS............................ 72
9610.... POISONING-SULFONAMIDES.............................. 72
9611.... POIS-ARSENIC ANTI-INFEC............................. 72
9612.... POIS-HEAV MET ANTI-INFEC............................ 72
9613.... POIS-QUINOLINE/HYDROXYQU............................ 72
9614.... POISONING-ANTIMALARIALS............................. 72
9615.... POIS-ANTIPROTOZ DRUG NEC............................ 72
9616.... POISONING-ANTHELMINTICS............................. 72
9617.... POISONING-ANTIVIRAL DRUG............................ 72
9618.... POIS-ANTIMYCOBAC DRG NEC............................ 72
9619.... POIS-ANTI-INFECT NEC/NOS............................ 72
9620.... POIS-CORTICOSTEROIDS................................ 72
9621.... POISONING-ANDROGENS................................. 72
9622.... POISONING-OVARIAN HORMON............................ 72
9623.... POISON-INSULIN/ANTIDIAB............................. 72
9624.... POIS-ANT PITUITARY HORM............................. 72
9625.... POIS-POST PITUITARY HORM............................ 72
9626.... POISONING-PARATHYROIDS.............................. 72
9627.... POISONING-THYROID/DERIV............................. 72
9628.... POISON-ANTITHYROID AGENT............................ 72
9629.... POISONING HORMON NEC/NOS............................ 72
9630.... POIS-ANTIALLRG/ANTIEMET............................. 72
9631.... POIS-ANTINEOPL/IMMUNOSUP............................ 72
9632.... POISONING-ACIDIFYING AGT............................ 72
9633.... POISONING-ALKALIZING AGT............................ 72
9634.... POISONING-ENZYMES NEC............................... 72
9635.... POISONING-VITAMINS NEC.............................. 72
9638.... POISONING-SYSTEM AGT NEC............................ 72
9639.... POISONING-SYSTEM AGT NOS............................ 72
9640.... POISONING-IRON/COMPOUNDS............................ 72
9641.... POISON-LIVER/ANTIANEMICS............................ 72
9642.... POISONING-ANTICOAGULANTS............................ 72
9643.... POISONING-VITAMIN K................................. 72
9644.... POISON-FIBRINOLYSIS AGNT............................ 72
9645.... POISONING-COAGULANTS................................ 72
9646.... POISONING-GAMMA GLOBULIN............................ 72
9647.... POISONING-BLOOD PRODUCT............................. 72
9648.... POISONING-BLOOD AGT NEC............................. 72
9649.... POISONING-BLOOD AGT NOS............................. 72
96500... POISONING-OPIUM NOS................................. 72
96501... POISONING-HEROIN.................................... 72
96502... POISONING-METHADONE................................. 72
96509... POISONING-OPIATES NEC............................... 72
9651.... POISONING-SALICYLATES............................... 72
[[Page 47969]]
9654.... POIS-AROM ANALGESICS NEC............................ 72
9655.... POISONING-PYRAZOLE DERIV............................ 72
9656.... POISONING-ANTIRHEUMATICS............................ 72
9657.... POIS-NO-NARC ANALGES NEC............................ 72
9658.... POIS-ANALGES/ANTIPYR NEC............................ 72
9659.... POIS-ANALGES/ANTIPYR NOS............................ 72
9660.... POISON-OXAZOLIDINE DERIV............................ 72
9661.... POISON-HYDANTOIN DERIVAT............................ 72
9662.... POISONING-SUCCINIMIDES.............................. 72
9663.... POIS-ANTICONVUL NEC/NOS............................. 72
9664.... POIS-ANTI-PARKINSON DRUG............................ 72
9670.... POISONING-BARBITURATES.............................. 72
9671.... POISONING-CHLORAL HYDRAT............................ 72
9672.... POISONING-PARALDEHYDE............................... 72
9673.... POISONING-BROMINE COMPND............................ 72
9674.... POISONING-METHAQUALONE.............................. 72
9675.... POISONING-GLUTETHIMIDE.............................. 72
9676.... POISON-MIX SEDATIVE NEC............................. 72
9678.... POIS-SEDATIVE/HYPNOT NEC............................ 72
9679.... POIS-SEDATIVE/HYPNOT NOS............................ 72
9680.... POIS-CNS MUSCLE DEPRESS............................. 72
9681.... POISONING-HALOTHANE................................. 72
9682.... POISON-GAS ANESTHET NEC............................. 72
9683.... POISON-INTRAVEN ANESTHET............................ 72
9684.... POIS-GEN ANESTH NEC/NOS............................. 72
9685.... POIS-TOPIC/INFILT ANESTH............................ 72
9686.... POIS-NERVE/PLEX-BLK ANES............................ 72
9687.... POISON-SPINAL ANESTHETIC............................ 72
9689.... POIS-LOCAL ANEST NEC/NOS............................ 72
9690.... POISONING-ANTIDEPRESSANT............................ 72
9691.... POIS-PHENOTHIAZINE TRANQ............................ 72
9692.... POIS-BUTYROPHENONE TRANQ............................ 72
9693.... POISON-ANTIPSYCHOTIC NEC............................ 72
9694.... POIS-BENZODIAZEPINE TRAN............................ 72
9695.... POISON-TRANQUILIZER NEC............................. 72
9696.... POISONING-HALLUCINOGENS............................. 72
9697.... POISON-PSYCHOSTIMULANTS............................. 72
9698.... POISON-PSYCHOTROPIC NEC............................. 72
9699.... POISON-PSYCHOTROPIC NOS............................. 72
9700.... POISONING-ANALEPTICS................................ 72
9701.... POISON-OPIATE ANTAGONIST............................ 72
9708.... POIS-CNS STIMULANTS NEC............................. 72
9709.... POIS-CNS STIMULANT NOS.............................. 72
9710.... POIS-PARASYMPATHOMIMETIC............................ 72
9711.... POIS-PARASYMPATHOLYTICS............................. 72
9712.... POISON-SYMPATHOMIMETICS............................. 72
9713.... POISONING-SYMPATHOLYTICS............................ 72
9719.... POIS-AUTONOMIC AGENT NOS............................ 72
9720.... POIS-CARD RHYTHM REGULAT............................ 72
9721.... POISONING-CARDIOTONICS.............................. 72
9722.... POISONING-ANTILIPEMICS.............................. 72
9723.... POIS-GANGLION BLOCK AGT............................. 72
9724.... POIS-CORONARY VASODILAT............................. 72
9725.... POISON-VASODILATOR NEC.............................. 72
9726.... POIS-ANTIHYPERTEN AGENT............................. 72
9727.... POISON-ANTIVARICOSE DRUG............................ 72
9728.... POISON-CAPILLARY ACT AGT............................ 72
9729.... POIS-CARDIOVASC AGT NEC............................. 72
9730.... POIS-ANTACID/ANTIGASTRIC............................ 72
9731.... POIS-IRRITANT CATHARTICS............................ 72
9732.... POIS-EMOLLIENT CATHARTIC............................ 72
9733.... POISONING-CATHARTIC NEC............................. 72
9734.... POISONING-DIGESTANTS................................ 72
9735.... POISONING-ANTIDIARRH AGT............................ 72
9736.... POISONING-EMETICS................................... 72
9738.... POISONING-GI AGENTS NEC............................. 72
9739.... POISONING-GI AGENT NOS.............................. 72
9740.... POIS-MERCURIAL DIURETICS............................ 72
9741.... POIS-PURINE DIURETICS............................... 72
9742.... POIS-H2CO3 ANHYDRA INHIB............................ 72
9743.... POISONING-SALURETICS................................ 72
9744.... POISONING-DIURETICS NEC............................. 72
9745.... POIS-ELECTRO/CAL/WAT AGT............................ 72
9746.... POISON-MINERAL SALTS NEC............................ 72
9747.... POIS-URIC ACID METABOL.............................. 72
9750.... POISONING-OXYTOCIC AGENT............................ 72
[[Page 47970]]
9751.... POIS-SMOOTH MUSCLE RELAX............................ 72
9752.... POIS-SKELET MUSCLE RELAX............................ 72
9753.... POISON-MUSCLE AGENT NEC............................. 72
9754.... POISONING-ANTITUSSIVES.............................. 72
9755.... POISONING-EXPECTORANTS.............................. 72
9756.... POIS-ANTI-COLD DRUGS................................ 72
9757.... POISONING-ANTIASTHMATICS............................ 72
9758.... POIS-RESPIR DRUG NEC/NOS............................ 72
9760.... POIS-LOCAL ANTI-INFECT.............................. 72
9761.... POISONING-ANTIPRURITICS............................. 72
9762.... POIS-LOC ASTRING/DETERG............................. 72
9763.... POIS-EMOL/DEMUL/PROTECT............................. 72
9764.... POISON-HAIR/SCALP PREP.............................. 72
9765.... POIS-EYE ANTI-INFEC/DRUG............................ 72
9766.... POISON-ENT PREPARATION.............................. 72
9767.... POIS-TOPICAL DENTAL DRUG............................ 72
9768.... POIS-SKIN/MEMBR AGNT NEC............................ 72
9769.... POIS-SKIN/MEMBR AGNT NOS............................ 72
9770.... POISONING-DIETETICS................................. 72
9771.... POISON-LIPOTROPIC DRUGS............................. 72
9772.... POISONING-ANTIDOTES NEC............................. 72
9773.... POISON-ALCOHOL DETERRENT............................ 72
9774.... POIS-PHARMACEUT EXCIPIEN............................ 72
9778.... POISON-MEDICINAL AGT NEC............................ 72
9779.... POISON-MEDICINAL AGT NOS............................ 72
9780.... POISONING-BCG VACCINE............................... 72
9781.... POIS-TYPH/PARATYPH VACC............................. 72
9782.... POISONING-CHOLERA VACCIN............................ 72
9783.... POISONING-PLAGUE VACCINE............................ 72
9784.... POISONING-TETANUS VACCIN............................ 72
9785.... POIS-DIPHTHERIA VACCINE............................. 72
9786.... POIS-PERTUSSIS VACCINE.............................. 72
9788.... POIS-BACT VACCIN NEC/NOS............................ 72
9789.... POIS-MIX BACTER VACCINES............................ 72
9790.... POISON-SMALLPOX VACCINE............................. 72
9791.... POISON-RABIES VACCINE............................... 72
9792.... POISON-TYPHUS VACCINE............................... 72
9793.... POIS-YELLOW FEVER VACCIN............................ 72
9794.... POISONING-MEASLES VACCIN............................ 72
9795.... POIS-POLIOMYELIT VACCINE............................ 72
9796.... POIS-VIRAL/RICK VACC NEC............................ 72
9797.... POISONING-MIXED VACCINE............................. 72
9799.... POIS-VACCINE/BIOLOG NEC............................. 72
9800.... TOXIC EFF ETHYL ALCOHOL............................. 72
9801.... TOXIC EFF METHYL ALCOHOL............................ 72
9802.... TOXIC EFF ISOPROPYL ALC............................. 72
9803.... TOXIC EFFECT FUSEL OIL.............................. 72
9808.... TOXIC EFFECT ALCOHOL NEC............................ 72
9809.... TOXIC EFFECT ALCOHOL NOS............................ 72
981..... TOXIC EFF PETROLEUM PROD............................ 72
9820.... TOXIC EFFECT BENZENE................................ 72
9821.... TOXIC EFF CARBON TETRACH............................ 72
9822.... TOXIC EFF CARBON DISULFI............................ 72
9823.... TX EF CL-HYDCARB SLV NEC............................ 72
9824.... TOXIC EFFECT NITROGLYCOL............................ 72
9828.... TOXIC EFF NONPETROL SOLV............................ 72
9830.... TOX EFF CORROSIVE AROMAT............................ 72
9831.... TOXIC EFFECT ACIDS.................................. 72
9832.... TOXIC EFF CAUSTIC ALKALI............................ 72
9839.... TOXIC EFFECT CAUSTIC NOS............................ 72
9840.... TX EFF INORG LEAD COMPND............................ 72
9841.... TOX EFF ORG LEAD COMPND............................. 72
9848.... TOX EFF LEAD COMPND NEC............................. 72
9849.... TOX EFF LEAD COMPND NOS............................. 72
9850.... TOXIC EFFECT MERCURY................................ 72
9851.... TOXIC EFFECT ARSENIC................................ 72
9852.... TOXIC EFFECT MANGANESE.............................. 72
9853.... TOXIC EFFECT BERYLLIUM.............................. 72
9854.... TOXIC EFFECT ANTIMONY............................... 72
9855.... TOXIC EFFECT CADMIUM................................ 72
9856.... TOXIC EFFECT CHROMIUM............................... 72
9858.... TOXIC EFFECT METALS NEC............................. 72
9859.... TOXIC EFFECT METAL NOS.............................. 72
986..... TOX EFF CARBON MONOXIDE............................. 72
9870.... TOXIC EFF LIQ PETROL GAS............................ 72
9871.... TOX EF HYDROCARB GAS NEC............................ 72
[[Page 47971]]
9872.... TOXIC EFF NITROGEN OXIDE............................ 72
9873.... TOXIC EFF SULFUR DIOXIDE............................ 72
9874.... TOXIC EFFECT FREON.................................. 72
9875.... TOX EFF LACRIMOGENIC GAS............................ 72
9876.... TOXIC EFF CHLORINE GAS.............................. 72
9877.... TOX EFF HYDROCYAN ACD GS............................ 72
9878.... TOXIC EFF GAS/VAPOR NEC............................. 72
9879.... TOXIC EFF GAS/VAPOR NOS............................. 72
9880.... TOXIC EFF FISH/SHELLFISH............................ 72
9881.... TOXIC EFFECT MUSHROOMS.............................. 72
9882.... TOX EFF BERRY/PLANT NEC............................. 72
9888.... TOX EFF NOXIOUS FOOD NEC............................ 72
9889.... TOX EFF NOXIOUS FOOD NOS............................ 72
9890.... TOXIC EFFECT CYANIDES............................... 72
9891.... TOXIC EFFECT STRYCHNINE............................. 72
9892.... TOX EFF CHLOR HYDROCARB............................. 72
9893.... TOX EFF ORGANPHOS/CARBAM............................ 72
9894.... TOXIC EFF PESTICIDES NEC............................ 72
9895.... TOXIC EFFECT VENOM.................................. 72
9896.... TOXIC EFF SOAP/DETERGENT............................ 72
9897.... TOX EFF AFLATOX/MYCOTOX............................. 72
98981... TOXIC EFFECT OF ASBESTOS............................ 72
98982... TOXIC EFFECT OF LATEX............................... 72
98983... TOXIC EFFECT OF SILICONE............................ 72
98984... TOXIC EFFECT OF TOBACCO............................. 72
98989... TOX EFF NONMED SUBST NEC............................ 72
9899.... TOX EFF NONMED SUBST NOS............................ 72
990..... EFFECTS RADIATION NOS............................... 72
9910.... FROSTBITE OF FACE................................... 72
9911.... FROSTBITE OF HAND................................... 72
9912.... FROSTBITE OF FOOT................................... 72
9913.... FROSTBITE NEC/NOS................................... 72
9914.... IMMERSION FOOT...................................... 72
9915.... CHILBLAINS.......................................... 72
9916.... HYPOTHERMIA......................................... 72
9918.... EFFECT REDUCED TEMP NEC............................. 72
9919.... EFFECT REDUCED TEMP NOS............................. 72
9920.... HEAT STROKE & SUNSTROKE............................. 72
9921.... HEAT SYNCOPE........................................ 72
9922.... HEAT CRAMPS......................................... 72
9923.... HEAT EXHAUST-ANHYDROTIC............................. 72
9924.... HEAT EXHAUST-SALT DEPLE............................. 72
9925.... HEAT EXHAUSTION NOS................................. 72
9926.... HEAT FATIGUE, TRANSIENT............................. 72
9927.... HEAT EDEMA.......................................... 72
9928.... HEAT EFFECT NEC..................................... 72
9929.... HEAT EFFECT NOS..................................... 72
9930.... BAROTRAUMA, OTITIC.................................. 31
9931.... BAROTRAUMA, SINUS................................... 31
9932.... EFF HIGH ALTITUD NEC/NOS............................ 72
9933.... CAISSON DISEASE..................................... 72
9934.... EFF AIR PRESS BY EXPLOS............................. 72
9938.... EFFECT AIR PRESSURE NEC............................. 72
9939.... EFFECT AIR PRESSURE NOS............................. 72
9940.... EFFECTS OF LIGHTNING................................ 72
9941.... DROWNING/NONFATAL SUBMER............................ 72
9942.... EFFECTS OF HUNGER................................... 72
9943.... EFFECTS OF THIRST................................... 72
9944.... EXHAUSTION-EXPOSURE................................. 72
9945.... EXHAUSTION-EXCESS EXERT............................. 72
9946.... MOTION SICKNESS..................................... 11
9947.... ASPHYXIATION/STRANGULAT............................. 72
9948.... EFFECTS ELECTRIC CURRENT............................ 72
9949.... EFFECT EXTERNAL CAUS NEC............................ 72
9950.... ANAPHYLACTIC SHOCK.................................. 78
9951.... ANGIONEUROTIC EDEMA................................. 72
9952.... ADV EFF MED/BIOL SUB NOS............................ 72
9953.... ALLERGY, UNSPECIFIED................................ 18
9954.... SHOCK DUE TO ANESTHESIA............................. 72
99560... ANPHYLCT SHK FOOD NOS............................... 78
99561... ANPHYLCT SHK PEANUTS................................ 78
99562... ANPHYLCT SHK CRSTACNS............................... 78
99563... ANPHYLCT SHK FRTS VEG............................... 78
99564... ANPHYLCT SHK TR NTS SEED............................ 78
99565... ANPHYLCT SHK FISH................................... 78
99566... ANPHYLCT SHK FOOD ADDTV............................. 78
[[Page 47972]]
99567... ANPHYLCT SHK MILK PROD.............................. 78
99568... ANPHYLCT SHK EGGS................................... 78
99569... ANPHYLCT SHK OT SPF FOOD............................ 78
99581... ADULT PHYSICAL ABUSE................................ 91
99589... ADVERSE EFFECT NEC.................................. 63
99600... MALFUNC CARD DEV/GRF NOS............................ 36
99601... MALFUNC CARDIAC PACEMAKE............................ 36
99602... MALFUNC PROSTH HRT VALVE............................ 36
99603... MALFUNC CORON BYPASS GRF............................ 36
99604... MCH CMP AUTM MPLNT DFBRL............................ 36
99609... MALFUNC CARD DEV/GRF NEC............................ 36
9961.... MALFUNC VASC DEVICE/GRAF............................ 36
9962.... MALFUN NEURO DEVICE/GRAF............................ 63
99630... MALFUNC GU DEV/GRAFT NOS............................ 53
99631... MALFUNC URETHRAL CATH............................... 53
99632... MALFUNCTION IUD..................................... 56
99639... MALFUNC GU DEV/GRAFT NEC............................ 53
9964.... MALF INT ORTHPED DEV/GRF............................ 24
99651... CORNEAL GRFT MALFUNCTION............................ 68
99652... OTH TISSUE GRAFT MALFUNC............................ 72
99653... LENS PROSTHESIS MALFUNC............................. 68
99654... BREAST PROSTH MALFUNC............................... 18
99659... MALFUNC OTH DEVICE/GRAFT............................ 72
99660... REACTION-UNSP DEVIC/GRFT............................ 72
99661... REACT-CARDIAC DEV/GRAFT............................. 36
99662... REACT-OTH VASC DEV/GRAFT............................ 36
99663... REACT-NERV SYS DEV/GRAFT............................ 63
99664... REACT-INDWELL URIN CATH............................. 53
99665... REACT-OTH GENITOURIN DEV............................ 53
99666... REACT-INTER JOINT PROST............................. 24
99667... REACT-OTH INT ORTHO DEV............................. 24
99669... REACT-INT PROS DEVIC NEC............................ 72
99670... COMP-UNSP DEVICE/GRAFT.............................. 72
99671... COMP-HEART VALVE PROSTH............................. 36
99672... COMP-OTH CARDIAC DEVICE............................. 36
99673... COMP-REN DIALYS DEV/GRFT............................ 36
99674... COMP-OTH VASC DEV/GRAFT............................. 36
99675... COMP-NERV SYS DEV/GRAFT............................. 63
99676... COMP-GENITOURIN DEV/GRFT............................ 53
99677... COMP-INTERNAL JOINT PROS............................ 24
99678... COMP-OTH INT ORTHO DEVIC............................ 24
99679... COMP-INT PROST DEVIC NEC............................ 72
99680... COMP ORGAN TRANSPLNT NOS............................ 72
99681... COMPL KIDNEY TRANSPLANT............................. 53
99682... COMPL LIVER TRANSPLANT.............................. 41
99683... COMPL HEART TRANSPLANT.............................. 36
99684... COMPL LUNG TRANSPLANT............................... 33
99685... COMPL MARROW TRANSPLANT............................. 86
99686... COMPL PANCREAS TRANSPLNT............................ 41
99689... COMP OTH ORGAN TRANSPLNT............................ 72
99690... COMP REATTACH EXTREM NOS............................ 24
99691... COMPL REATTACHED FOREARM............................ 24
99692... COMPL REATTACHED HAND............................... 24
99693... COMPL REATTACHED FINGER............................. 24
99694... COMPL REATTACHED ARM NEC............................ 24
99695... COMPL REATTACHED FOOT............................... 24
99696... COMPL REATTACHED LEG NEC............................ 24
99699... COMPL REATTACH PART NEC............................. 24
99700... NERVOUS SYST COMPLC NOS............................. 63
99701... SURG COMPLICATION - CNS............................. 63
99702... IATROGEN CV INFARC/HMRHG............................ 63
99709... SURG COMP NERV SYSTM NEC............................ 63
9971.... SURG COMPL-HEART.................................... 36
9972.... SURG COMP-PERI VASC SYST............................ 36
9973.... SURG COMPLIC-RESPIR SYST............................ 33
9974.... SURG COMP-DIGESTV SYSTEM............................ 41
9975.... SURG COMPL-URINARY TRACT............................ 53
99760... AMPUTAT STUMP COMPL NOS............................. 24
99761... NEUROMA AMPUTATION STUMP............................ 24
99762... INFECTION AMPUTAT STUMP............................. 24
99769... AMPUTAT STUMP COMPL NEC............................. 24
99791... SURG COMP - HYPERTENSION............................ 36
99799... SURG COMPL-BODY SYST NEC............................ 11
9980.... POSTOPERATIVE SHOCK................................. 72
9982.... ACCIDENTAL OP LACERATION............................ 72
9983.... POSTOP WOUND DISRUPTION............................. 11
[[Page 47973]]
9984.... FB LEFT DURING PROCEDURE............................ 72
9985.... POSTOPERATIVE INFECTION*............................ 97
9986.... PERSIST POSTOP FISTULA.............................. 72
9987.... POSTOP FORGN SUBST REACT............................ 72
99881... EMPHYSEMA RSULT FRM PROC............................ 33
99882... CTRCT FRGMT FRM CTR SURG............................ 68
99889... OTH SPCF CMPLC PROCD NEC............................ 11
9989.... SURGICAL COMPLICAT NOS.............................. 11
9990.... GENERALIZED VACCINIA................................ 97
9991.... AIR EMBOL COMP MED CARE............................. 33
9992.... VASC COMP MED CARE NEC.............................. 36
9993.... INFEC COMPL MED CARE NEC............................ 97
9994.... ANAPHYLACTIC SHOCK-SERUM............................ 78
9995.... SERUM REACTION NEC.................................. 86
9996.... ABO INCOMPATIBILITY REAC............................ 86
9997.... RH INCOMPATIBILITY REACT............................ 86
9998.... TRANSFUSION REACTION NEC............................ 86
9999.... COMPLIC MED CARE NEC/NOS............................ 11
*E8000.. RR COLLISION NOS-EMPLOY............................. ........
*E8001.. RR COLL NOS-PASSENGER............................... ........
*E8002.. RR COLL NOS-PEDESTRIAN.............................. ........
*E8003.. RR COLL NOS-PED CYCLIST............................. ........
*E8008.. RR COLL NOS-PERSON NEC.............................. ........
*E8009.. RR COLL NOS-PERSON NOS.............................. ........
*E8010.. RR COLL W OTH OBJ-EMPLOY............................ ........
*E8011.. RR COLL W OTH OBJ-PASNGR............................ ........
*E8012.. RR COLL W OTH OBJ-PEDEST............................ ........
*E8013.. RR COLL W OTH OBJ-CYCL.............................. ........
*E8018.. RR COL W OTH OBJ-PER NEC............................ ........
*E8019.. RR COL W OTH OBJ-PER NOS............................ ........
*E8020.. RR ACC W DERAIL-EMPLOYEE............................ ........
*E8021.. RR ACC W DERAIL-PASSENG............................. ........
*E8022.. RR ACC W DERAIL-PEDEST.............................. ........
*E8023.. RR ACC W DERAIL-PED CYCL............................ ........
*E8028.. RR ACC W DERAIL-PERS NEC............................ ........
*E8029.. RR ACC W DERAIL-PERS NOS............................ ........
*E8030.. RR ACC W EXPLOSION-EMPL............................. ........
*E8031.. RR ACC W EXPLOS-PASNGR.............................. ........
*E8032.. RR ACC W EXPLOS-PEDEST.............................. ........
*E8033.. RR ACC W EXPLOS-PED CYCL............................ ........
*E8038.. RR ACC W EXPLOS-PERS NEC............................ ........
*E8039.. RR ACC W EXPLOS-PERS NOS............................ ........
*E8040.. FALL ON/FROM TRAIN-EMPL............................. ........
*E8041.. FALL FROM TRAIN-PASSENGR............................ ........
*E8042.. FALL FROM TRAIN-PEDEST.............................. ........
*E8043.. FALL FROM TRAIN-PED CYCL............................ ........
*E8048.. FALL FROM TRAIN-PERS NEC............................ ........
*E8049.. FALL FROM TRAIN-PERS NOS............................ ........
*E8050.. HIT BY TRAIN-EMPLOYEE............................... ........
*E8051.. HIT BY TRAIN-PASSENGER.............................. ........
*E8052.. HIT BY TRAIN-PEDESTRIAN............................. ........
*E8053.. HIT BY TRAIN-PED CYCLIST............................ ........
*E8058.. HIT BY TRAIN-PERSON NEC............................. ........
*E8059.. HIT BY TRAIN-PERSON NOS............................. ........
*E8060.. RR ACC NEC-EMPLOYEE................................. ........
*E8061.. RR ACC NEC-PASSENGER................................ ........
*E8062.. RR ACC NEC-PEDESTRIAN............................... ........
*E8063.. RR ACC NEC-PED CYCLIST.............................. ........
*E8068.. RR ACC NEC-PERSON NEC............................... ........
*E8069.. RR ACC NEC-PERSON NOS............................... ........
*E8070.. RR ACCIDENT NOS-EMPLOYEE............................ ........
*E8071.. RR ACC NOS-PASSENGER................................ ........
*E8072.. RR ACC NOS-PEDESTRIAN............................... ........
*E8073.. RR ACC NOS-PED CYCLIST.............................. ........
*E8078.. RR ACC NOS-PERSON NEC............................... ........
*E8079.. RR ACC NOS-PERSON NOS............................... ........
*E8100.. MV-TRAIN COLL-DRIVER................................ ........
*E8101.. MV-TRAIN COLL-PASNGR................................ ........
*E8102.. MV-TRAIN COLL-MOTORCYCL............................. ........
*E8103.. MV-TRAIN COLL-MCYCL PSGR............................ ........
*E8104.. MV-TRAIN COLL-ST CAR................................ ........
*E8105.. MV-TRAIN COLL-ANIM RID.............................. ........
*E8106.. MV-TRAIN COLL-PED CYCL.............................. ........
*E8107.. MV-TRAIN COLL-PEDEST................................ ........
*E8108.. MV-TRAIN COLL-PERS NEC.............................. ........
*E8109.. MV-TRAIN COLL-PERS NOS.............................. ........
[[Page 47974]]
*E8110.. REENTRANT MV COLL-DRIVER............................ ........
*E8111.. REENTRANT MV COLL-PASNGR............................ ........
*E8112.. REENTRANT COLL-MOTCYCL.............................. ........
*E8113.. REENTRANT COLL-MCYC PSGR............................ ........
*E8114.. REENTRANT COLL-ST CAR............................... ........
*E8115.. REENTRANT COLL-ANIM RID............................. ........
*E8116.. REENTRANT COLL-PED CYCL............................. ........
*E8117.. REENTRANT COLL-PEDEST............................... ........
*E8118.. REENTRANT COLL-PERS NEC............................. ........
*E8119.. REENTRANT COLL-PERS NOS............................. ........
*E8120.. MV COLLISION NOS-DRIVER............................. ........
*E8121.. MV COLLISION NOS-PASNGR............................. ........
*E8122.. MV COLLIS NOS-MOTORCYCL............................. ........
*E8123.. MV COLL NOS-MCYCL PSNGR............................. ........
*E8124.. MV COLLISION NOS-ST CAR............................. ........
*E8125.. MV COLL NOS-ANIM RID................................ ........
*E8126.. MV COLL NOS-PED CYCL................................ ........
*E8127.. MV COLLISION NOS-PEDEST............................. ........
*E8128.. MV COLLIS NOS-PERS NEC.............................. ........
*E8129.. MV COLLIS NOS-PERS NOS.............................. ........
*E8130.. MV-OTH VEH COLL-DRIVER.............................. ........
*E8131.. MV-OTH VEH COLL-PASNGR.............................. ........
*E8132.. MV-OTH VEH COLL-MOTCYCL............................. ........
*E8133.. MV-OTH VEH COLL-MCYC PSG............................ ........
*E8134.. MV-OTH VEH COLL-ST CAR.............................. ........
*E8135.. MV-OTH VEH COLL-ANIM RID............................ ........
*E8136.. MV-OTH VEH COLL-PED CYCL............................ ........
*E8137.. MV-OTH VEH COLL-PEDEST.............................. ........
*E8138.. MV-OTH VEH COLL-PERS NEC............................ ........
*E8139.. MV-OTH VEH COLL-PERS NOS............................ ........
*E8140.. MV COLL W PEDEST-DRIVER............................. ........
*E8141.. MV COLL W PEDEST-PASNGR............................. ........
*E8142.. MV COLL W PEDEST-MOTCYCL............................ ........
*E8143.. MV COLL W PED-MCYCL PSGR............................ ........
*E8144.. MV COLL W PEDEST-ST CAR............................. ........
*E8145.. MV COLL W PED-ANIM RID.............................. ........
*E8146.. MV COLL W PED-PED CYCL.............................. ........
*E8147.. MV COLL W PEDEST-PEDEST............................. ........
*E8148.. MV COLL W PEDES-PERS NEC............................ ........
*E8149.. MV COLL W PEDES-PERS NOS............................ ........
*E8150.. MV COLL W OTH OBJ-DRIVER............................ ........
*E8151.. MV COLL W OTH OBJ-PASNGR............................ ........
*E8152.. MV COLL W OTH OBJ-MOCYCL............................ ........
*E8153.. MV COLL W OBJ-MCYCL PSGR............................ ........
*E8154.. MV COLL W OBJ-ST CAR................................ ........
*E8155.. MV COLL W OBJ-ANIM RIDER............................ ........
*E8156.. MV COLL W OBJ-PED CYCL.............................. ........
*E8157.. MV COLL W OBJ-PEDEST................................ ........
*E8158.. MV COLL W OBJ-PERS NEC.............................. ........
*E8159.. MV COLL W OBJ-PERS NOS.............................. ........
*E8160.. LOSS CONTROL MV ACC-DRIV............................ ........
*E8161.. LOSS CONTROL MV ACC-PSGR............................ ........
*E8162.. LOSS CONTROL MV-MOCYCL.............................. ........
*E8163.. LOSS CONTROL MV-MCYC PSG............................ ........
*E8164.. LOSS CONT MV ACC-ST CAR............................. ........
*E8165.. LOSS CONT MV-ANIM RIDER............................. ........
*E8166.. LOSS CONTROL MV-PED CYCL............................ ........
*E8167.. LOSS CONTROL MV-PEDEST.............................. ........
*E8168.. LOSS CONTROL MV-PERS NEC............................ ........
*E8169.. LOSS CONTROL MV-PERS NOS............................ ........
*E8170.. MV ACC BOARD/ALIGHT-DRIV............................ ........
*E8171.. MV ACC BOARD/ALIGHT-PSGR............................ ........
*E8172.. MV BOARD/ALIGHT-MOTCYCL............................. ........
*E8173.. MV BRD/ALIGHT-MCYCL PSGR............................ ........
*E8174.. MV ACC BRD/ALIGHT-ST CAR............................ ........
*E8175.. MV BRD/ALIGHT-ANIM RIDER............................ ........
*E8176.. MV BRD/ALIGHT-PED CYCL.............................. ........
*E8177.. MV BRD/ALIGHT-PEDESTRIAN............................ ........
*E8178.. MV BOARD/ALIGHT-PERS NEC............................ ........
*E8179.. MV BOARD/ALIGHT-PERS NOS............................ ........
*E8180.. MV TRAFF ACC NEC-DRIVER............................. ........
*E8181.. MV TRAFF ACC NEC-PASNGR............................. ........
*E8182.. MV TRAFF ACC NEC-MOCYCL............................. ........
*E8183.. MV TRAFF ACC-MCYCL PSGR............................. ........
*E8184.. MV TRAFF ACC NEC-ST CAR............................. ........
*E8185.. MV TRAFF ACC-ANIM RIDER............................. ........
[[Page 47975]]
*E8186.. MV TRAFF ACC-PED CYC................................ ........
*E8187.. MV TRAFF ACC NEC-PEDEST............................. ........
*E8188.. MV TRAFF ACC-PERS NEC............................... ........
*E8189.. MV TRAFF ACC-PERS NOS............................... ........
*E8190.. TRAFFIC ACC NOS-DRIVER.............................. ........
*E8191.. TRAFFIC ACC NOS-PASNGR.............................. ........
*E8192.. TRAFFIC ACC NOS-MOTCYCL............................. ........
*E8193.. TRAFF ACC NOS-MCYCL PSGR............................ ........
*E8194.. TRAFFIC ACC NOS-ST CAR.............................. ........
*E8195.. TRAFF ACC NOS-ANIM RIDER............................ ........
*E8196.. TRAFFIC ACC NOS-PED CYCL............................ ........
*E8197.. TRAFFIC ACC NOS-PEDEST.............................. ........
*E8198.. TRAFFIC ACC NOS-PERS NEC............................ ........
*E8199.. TRAFFIC ACC NOS-PERS NOS............................ ........
*E8200.. SNOW VEH ACC-DRIVER................................. ........
*E8201.. SNOW VEH ACC-PASNGR................................. ........
*E8202.. SNOW VEH ACC-MOTORCYCL.............................. ........
*E8203.. SNOW VEH ACC-MCYCL PSGR............................. ........
*E8204.. SNOW VEH ACC-ST CAR................................. ........
*E8205.. SNOW VEH ACC-ANIM RIDER............................. ........
*E8206.. SNOW VEH ACC-PED CYCL............................... ........
*E8207.. SNOW VEH ACC-PEDEST................................. ........
*E8208.. SNOW VEH ACC-PERS NEC............................... ........
*E8209.. SNOW VEH ACC-PERS NOS............................... ........
*E8210.. OTH OFF-ROAD MV ACC-DRIV............................ ........
*E8211.. OTH OFF-ROAD MV ACC-PSGR............................ ........
*E8212.. OTH OFF-ROAD MV-MOCYCL.............................. ........
*E8213.. OTH OFF-ROAD MV-MCYC PSG............................ ........
*E8214.. OTH OFF-ROAD MV-ST CAR.............................. ........
*E8215.. OTH OFF-ROAD MV-ANIM RID............................ ........
*E8216.. OTH OFF-ROAD MV-PED CYCL............................ ........
*E8217.. OTH OFF-ROAD MV-PEDEST.............................. ........
*E8218.. OTH OFF-ROAD MV-PERS NEC............................ ........
*E8219.. OTH OFF-ROAD MV-PERS NOS............................ ........
*E8220.. OTH COLL W MOV OBJ-DRIV............................. ........
*E8221.. OTH COLL W MOV OBJ-PSGR............................. ........
*E8222.. OTH COLL MOV OBJ-MOCYCL............................. ........
*E8223.. OTH COLL MOV OBJ-CYC PSG............................ ........
*E8224.. OTH COLL MOV OBJ-ST CAR............................. ........
*E8225.. OTH COLL MOV OBJ-RIDER.............................. ........
*E8226.. OTH COLL MOV OBJ-PED CYC............................ ........
*E8227.. OTH COLL MOV OBJ-PEDEST............................. ........
*E8228.. OTH COLL MOV OBJ-PER NEC............................ ........
*E8229.. OTH COLL MOV OBJ-PER NOS............................ ........
*E8230.. OTH COLL STNDNG OBJ-DRIV............................ ........
*E8231.. OTH COLL STNDNG OBJ-PSGR............................ ........
*E8232.. OTH COLL STND OBJ-MOCYCL............................ ........
*E8233.. OTH COLL STN OBJ-CYC PSG............................ ........
*E8234.. OTH COLL STND OBJ-ST CAR............................ ........
*E8235.. OTH COLL STND OBJ-RIDER............................. ........
*E8236.. OTH COLL STN OBJ-PED CYC............................ ........
*E8237.. OTH COLL STND OBJ-PEDEST............................ ........
*E8238.. OTH COLL STN OBJ-PER NEC............................ ........
*E8239.. OTH COL-STND-OBJ-PER NOS............................ ........
*E8240.. N-TRAF BOARD/ALIGHT-DRIV............................ ........
*E8241.. N-TRAF BOARD/ALIGHT-PSGR............................ ........
*E8242.. N-TRAF BRD/ALIGHT-MOCYCL............................ ........
*E8243.. N-TRAF BRD/ALIT-MCYC PSG............................ ........
*E8244.. N-TRAF BRD/ALIT-ST CAR.............................. ........
*E8245.. N-TRAF BRD/ALIT-ANIM RID............................ ........
*E8246.. N-TRAF BRD/ALIT-PED CYCL............................ ........
*E8247.. N-TRAF BRD/ALIT-PEDEST.............................. ........
*E8248.. N-TRAF BRD/ALIT-PERS NEC............................ ........
*E8249.. N-TRAF BRD/ALIT-PERS NOS............................ ........
*E8250.. MV N-TRAFF ACC NEC-DRIV............................. ........
*E8251.. MV N-TRAFF NEC/NOS-PSGR............................. ........
*E8252.. MV N-TRAF ACC NEC-MOCYCL............................ ........
*E8253.. MV N-TRAFF NEC-MCYC PSGR............................ ........
*E8254.. MV N-TRAFF NEC-ST CAR............................... ........
*E8255.. MV N-TRAF NEC-ANIM RIDER............................ ........
*E8256.. MV N-TRAFF NEC-PED CYCL............................. ........
*E8257.. MV N-TRAFF NEC-PEDEST............................... ........
*E8258.. MV N-TRAFF NEC-PERS NEC............................. ........
*E8259.. MV N-TRAFF NEC-PERS NOS............................. ........
*E8260.. PEDAL CYCLE ACC-PEDEST.............................. ........
*E8261.. PED CYCL ACC-PED CYCLIST............................ ........
[[Page 47976]]
*E8262.. PED CYCLE ACC-ANIM RIDER............................ ........
*E8263.. PED CYC ACC-OCC ANIM VEH............................ ........
*E8264.. PED CYCLE ACC-OCC ST CAR............................ ........
*E8268.. PED CYCLE ACC-PERS NEC.............................. ........
*E8269.. PED CYCLE ACC-PERS NOS.............................. ........
*E8270.. ANIMAL DRAWN VEH-PEDEST............................. ........
*E8272.. ANIM DRAWN VEH-ANIM RID............................. ........
*E8273.. ANIMAL DRAWN VEH-OCCUPAN............................ ........
*E8274.. ANIM DRAWN-OCC ST CAR............................... ........
*E8278.. ANIM DRAWN VEH-PERS NEC............................. ........
*E8279.. ANIM DRAWN VEH-PERS NOS............................. ........
*E8280.. RIDDEN ANIMAL ACC-PEDEST............................ ........
*E8282.. RIDDEN ANIMAL ACC-RIDER............................. ........
*E8284.. RIDDEN ANIMAL ACC-ST CAR............................ ........
*E8288.. RIDDEN ANIM ACC-PERS NEC............................ ........
*E8289.. RIDDEN ANIM ACC-PERS NOS............................ ........
*E8290.. OTH ROAD VEH ACC-PEDEST............................. ........
*E8294.. OTH RD VEH ACC-ST CAR............................... ........
*E8298.. OTH RD VEH ACC-PERS NEC............................. ........
*E8299.. OTH RD VEH ACC-PERS NOS............................. ........
*E8300.. BOAT ACC W SUBMERS-UNPOW............................ ........
*E8301.. BOAT ACC W SUBMERS-POWER............................ ........
*E8302.. BOAT ACC W SUBMERS-CREW............................. ........
*E8303.. BOAT ACC W SUBMERS-PSGR............................. ........
*E8304.. BOAT SUBMERS-WATER SKIER............................ ........
*E8305.. BOAT SUBMERS-SWIMMER................................ ........
*E8306.. BOAT SUBMERS-DOCKERS................................ ........
*E8308.. BOAT SUBMERS-PERS NEC............................... ........
*E8309.. BOAT SUBMERS-PERS NOS............................... ........
*E8310.. BOAT ACC INJ NEC-UNPOWER............................ ........
*E8311.. BOAT ACC INJ NEC-POWER.............................. ........
*E8312.. BOAT ACC INJ NEC-CREW............................... ........
*E8313.. BOAT ACC INJ NEC-PASSENG............................ ........
*E8314.. BOAT ACC INJ NEC-SKIER.............................. ........
*E8315.. BOAT ACC INJ NEC-SWIM............................... ........
*E8316.. BOAT ACC INJ NEC-DOCKER............................. ........
*E8318.. BOAT INJ NEC-PERSON NEC............................. ........
*E8319.. BOAT INJ NEC-PERSON NOS............................. ........
*E8320.. SUBMERS NEC-UNPOW BOAT.............................. ........
*E8321.. SUBMERS NEC-POWER BOAT.............................. ........
*E8322.. SUBMERS NEC-CREW.................................... ........
*E8323.. SUBMERS NEC-PASSENGER............................... ........
*E8324.. SUBMERS NEC-WATER SKIER............................. ........
*E8325.. SUBMERS NEC-SWIMMER................................. ........
*E8326.. SUBMERS NEC-DOCKER.................................. ........
*E8328.. SUBMERS NEC-PERSON NEC.............................. ........
*E8329.. SUBMERS NEC-PERSON NOS.............................. ........
*E8330.. W/CRAFT STAIR FALL-UNPOW............................ ........
*E8331.. W/CRAFT STAIR FALL-POWER............................ ........
*E8332.. WTRCRAFT STAIR FALL-CREW............................ ........
*E8333.. WTRCRAFT STAIR FALL-PSGR............................ ........
*E8334.. W/CRAFT STAIR FALL-SKIER............................ ........
*E8335.. W/CRAFT STAIR FALL-SWIM............................. ........
*E8336.. W/CRF STAIR FALL-DOCKER............................. ........
*E8338.. W/CRF STAIR FALL-PER NEC............................ ........
*E8339.. W/CRF STAIR FALL-PER NOS............................ ........
*E8340.. W/CRAFT FALL NEC-UNPOW.............................. ........
*E8341.. W/CRAFT FALL NEC-POWER.............................. ........
*E8342.. WATERCRAFT FALL NEC-CREW............................ ........
*E8343.. WTRCRAFT FALL NEC-PASNGR............................ ........
*E8344.. W/CRAFT FALL NEC-SKIER.............................. ........
*E8345.. W/CRAFT FALL NEC-SWIM............................... ........
*E8346.. WTRCRAFT FALL NEC-DOCKER............................ ........
*E8348.. W/CRFT FALL NEC-PERS NEC............................ ........
*E8349.. W/CRFT FALL NEC-PERS NOS............................ ........
*E8350.. W/CRAFT FALL NOS-UNPOW.............................. ........
*E8351.. W/CRAFT FALL NOS-POWER.............................. ........
*E8352.. WTRCRAFT FALL NOS-CREW.............................. ........
*E8353.. WTRCRAFT FALL NOS-PASNGR............................ ........
*E8354.. W/CRAFT FALL NOS-SKIER.............................. ........
*E8355.. W/CRAFT FALL NOS-SWIM............................... ........
*E8356.. WTRCRAFT FALL NOS-DOCKER............................ ........
*E8358.. W/CRFT FALL NOS-PERS NEC............................ ........
*E8359.. W/CRFT FALL NOS-PERS NOS............................ ........
*E8360.. MACHINE ACC-UNPOW BOAT.............................. ........
*E8361.. MACH ACC-OCC POWER BOAT............................. ........
[[Page 47977]]
*E8362.. MACHINERY ACCIDENT-CREW............................. ........
*E8363.. MACHINERY ACC-PASNGR................................ ........
*E8364.. MACHINE ACCIDENT-SKIER.............................. ........
*E8365.. MACHINE ACCIDENT-SWIM............................... ........
*E8366.. MACHINERY ACC-DOCKER................................ ........
*E8368.. MACHINERY ACC-PERS NEC.............................. ........
*E8369.. MACHINERY ACC-PERS NOS.............................. ........
*E8370.. EXPLOSION-OCC UNPOW BOAT............................ ........
*E8371.. EXPLOSION-OCC POWER BOAT............................ ........
*E8372.. WATERCRAFT EXPLOS-CREW.............................. ........
*E8373.. WATERCRAFT EXPLOS-PASNGR............................ ........
*E8374.. WATERCRAFT EXPLOS-SKIER............................. ........
*E8375.. WATERCRAFT EXPLOS-SWIM.............................. ........
*E8376.. WATERCRAFT EXPLOS-DOCKER............................ ........
*E8378.. WATERCRAFT EXPL-PERS NEC............................ ........
*E8379.. WATERCRAFT EXPL-PERS NOS............................ ........
*E8380.. WATERCRAFT ACC NEC-UNPOW............................ ........
*E8381.. WATERCRAFT ACC NEC-POWER............................ ........
*E8382.. WATERCRAFT ACC NEC-CREW............................. ........
*E8383.. WATERCRFT ACC NEC-PASNGR............................ ........
*E8384.. WATERCRAFT ACC NEC-SKIER............................ ........
*E8385.. WATRCRFT ACC NEC-SWIMMER............................ ........
*E8386.. WATERCRFT ACC NEC-DOCKER............................ ........
*E8388.. WTRCRFT ACC NEC-PERS NEC............................ ........
*E8389.. WTRCRFT ACC NEC-PERS NOS............................ ........
*E8400.. TK OFF/LAND-SPCRFT.................................. ........
*E8401.. TK OFF/LAND-MILIT CRAFT............................. ........
*E8402.. TK OFF/LAND-CREW AIRCRFT............................ ........
*E8403.. TK OFF/LAND-PSNG AIRCRFT............................ ........
*E8404.. TK OFF/LAND-COMM CRF NEC............................ ........
*E8405.. TK OFF/LAND-AIRCRAFT NEC............................ ........
*E8406.. TK OFF/LAND-UNP AIRCRFT............................. ........
*E8407.. TK OFF/LAND-PARACHUTIST............................. ........
*E8408.. TK OFF/LAND-GROUND CREW............................. ........
*E8409.. TK OFF/LAND-PERS NEC................................ ........
*E8410.. POW AIRCRAFT ACC-SPCRFT............................. ........
*E8411.. POWER AIRCRAFT ACC-MILIT............................ ........
*E8412.. POWER AIRCRAFT ACC-CREW............................. ........
*E8413.. POWER AIRCRAFT ACC-PSNGR............................ ........
*E8414.. AIRCRAF ACC-OCC COMM NEC............................ ........
*E8415.. OTH POWERED AIRCRAFT ACC............................ ........
*E8416.. POW AIRC ACC-UNP AIRCR.............................. ........
*E8417.. AIRCRAFT ACC-PARACHUTIST............................ ........
*E8418.. AIRCRAFT ACC-GROUND CREW............................ ........
*E8419.. AIRCRFT ACC NOS-PERS NEC............................ ........
*E8426.. UNPOWER AIRCRAFT ACC-OCC............................ ........
*E8427.. UNPOW AIRCRF ACC-CHUTIST............................ ........
*E8428.. UNPOW AIRCRF ACC-GR CREW............................ ........
*E8429.. UNPOW AIRCRF ACC-PER NEC............................ ........
*E8430.. FALL-OCC SPACECRAFT................................. ........
*E8431.. FALL-MILIT AIRCRAFT OCCP............................ ........
*E8432.. FALL-CREW COMM AIRCRAFT............................. ........
*E8433.. FALL-PSNG COMM AIRCRAFT............................. ........
*E8434.. FALL-OCC COMM AIRCRF NEC............................ ........
*E8435.. FALL-OCCUP OTH AIRCRAFT............................. ........
*E8436.. FALL-OCC UNPOWER AIRCRAF............................ ........
*E8437.. FALL-PARACHUTIST.................................... ........
*E8438.. AIRCRFT FALL-GROUND CREW............................ ........
*E8439.. AIRCRAFT FALL-PERSON NEC............................ ........
*E8440.. AIRCRFT ACC NEC-SPCRFT.............................. ........
*E8441.. AIRCRFT ACC NEC-MILITARY............................ ........
*E8442.. AIRCRFT ACC NEC-CREW................................ ........
*E8443.. AIRCRFT ACC NEC-PASNGR.............................. ........
*E8444.. AIRCRFT ACC NEC-COMM NEC............................ ........
*E8445.. AIRCRFT ACC NEC-OCCP NEC............................ ........
*E8446.. AIRCR ACC NEC-UNP AIRCR............................. ........
*E8447.. AIRCRFT ACC-PARACHUTIST............................. ........
*E8448.. AIRCRFT ACC NEC-GRD CREW............................ ........
*E8449.. AIRCRFT ACC NEC-PERS NEC............................ ........
*E8450.. SPACECRAFT ACC-OCCUPANT............................. ........
*E8458.. SPACECRAFT ACC-GRND CREW............................ ........
*E8459.. SPACECRAFT ACC-PERS NEC............................. ........
*E846... INDUS VEH ACC ON PREMISE............................ ........
*E847... CABL CAR ACC NOT ON RAIL............................ ........
*E848... OTH VEHICLE ACC NEC................................. ........
*E8490.. ACCIDENT IN HOME.................................... ........
[[Page 47978]]
*E8491.. ACCIDENT ON FARM.................................... ........
*E8492.. ACCIDENT IN MINE/QUARRY............................. ........
*E8493.. ACC ON INDUSTR PREMISES............................. ........
*E8494.. ACCID IN RECREATION AREA............................ ........
*E8495.. ACCID ON STREET/HIGHWAY............................. ........
*E8496.. ACCIDENT IN PUBLIC BLDG............................. ........
*E8497.. ACCID IN RESIDENT INSTIT............................ ........
*E8498.. ACCIDENT IN PLACE NEC............................... ........
*E8499.. ACCIDENT IN PLACE NOS............................... ........
*E8500.. ACC POISON-HEROIN................................... ........
*E8501.. ACC POISON-METHADONE................................ ........
*E8502.. ACC POISON-OPIATES NEC.............................. ........
*E8503.. ACC POISON-SALICYLATES.............................. ........
*E8504.. ACC POISON-AROM ANALGESC............................ ........
*E8505.. ACC POISON-PYRAZOLE DERV............................ ........
*E8506.. ACC POISON-ANTIRHEUMATIC............................ ........
*E8507.. ACC POISON-NONNARC ANALG............................ ........
*E8508.. ACC POISON-ANALGESIC NEC............................ ........
*E8509.. ACC POISON-ANALGESIC NOS............................ ........
*E851... ACC POISON-BARBITURATES............................. ........
*E8520.. ACC POISN-CHLORL HYDRATE............................ ........
*E8521.. ACC POISON-PARALDEHYDE.............................. ........
*E8522.. ACC POISON-BROMINE CMPND............................ ........
*E8523.. ACC POISON-METHAQUALONE............................. ........
*E8524.. ACC POISON-GLUTETHIMIDE............................. ........
*E8525.. ACC POISON-MIX SEDTV NEC............................ ........
*E8528.. ACC POISON-SEDATIVES NEC............................ ........
*E8529.. ACC POISON-SEDATIVES NOS............................ ........
*E8530.. ACC POIS-PHENTHIAZ TRANQ............................ ........
*E8531.. ACC POIS-BUTYRPHEN TRANQ............................ ........
*E8532.. ACC POISN-BENZDIAZ TRANQ............................ ........
*E8538.. ACC POISN-TRANQUILZR NEC............................ ........
*E8539.. ACC POISN-TRANQUILZR NOS............................ ........
*E8540.. ACC POISON-ANTIDEPRESSNT............................ ........
*E8541.. ACC POISON-HALLUCINOGENS............................ ........
*E8542.. ACC POISN-PSYCHSTIMULANT............................ ........
*E8543.. ACC POISON-CNS STIMULANT............................ ........
*E8548.. ACC POISN PSYCHOTROP NEC............................ ........
*E8550.. ACC POISN-ANTICONVULSANT............................ ........
*E8551.. ACC POISN-CNS DEPRES NEC............................ ........
*E8552.. ACC POISN-LOCAL ANESTHET............................ ........
*E8553.. ACC POISON-CHOLINERGICS............................. ........
*E8554.. ACC POISN-ANTICHOLINERG............................. ........
*E8555.. ACC POISON-ADRENERGICS.............................. ........
*E8556.. ACC POISN-SYMPATHOLYTICS............................ ........
*E8558.. ACC POISON-CNS DRUG NEC............................. ........
*E8559.. ACC POISON-CNS DRUG NOS............................. ........
*E856... ACC POISON-ANTIBIOTICS.............................. ........
*E857... ACC POIS-OTH ANTI-INFECT............................ ........
*E8580.. ACC POISON-HORMONES................................. ........
*E8581.. ACC POISN-SYSTEMIC AGENT............................ ........
*E8582.. ACC POISON-BLOOD AGENT.............................. ........
*E8583.. ACC POISN-CARDIOVASC AGT............................ ........
*E8584.. ACC POISON-GI AGENT................................. ........
*E8585.. ACC POISN-METABOL AGNT.............................. ........
*E8586.. ACC POISN-MUSCL/RESP AGT............................ ........
*E8587.. ACC POISN-SKIN/EENT AGNT............................ ........
*E8588.. ACC POISONING-DRUG NEC.............................. ........
*E8589.. ACC POISONING-DRUG NOS.............................. ........
*E8600.. ACC POISN-ALCOHOL BEVRAG............................ ........
*E8601.. ACC POISON-ETHYL ALCOHOL............................ ........
*E8602.. ACC POISN-METHYL ALCOHOL............................ ........
*E8603.. ACC POISN-ISOPROPYL ALC............................. ........
*E8604.. ACC POISON-FUSEL OIL................................ ........
*E8608.. ACC POISON-ALCOHOL NEC.............................. ........
*E8609.. ACC POISON-ALCOHOL NOS.............................. ........
*E8610.. ACC POIS-SYNTH DETERGENT............................ ........
*E8611.. ACC POISON-SOAP PRODUCTS............................ ........
*E8612.. ACC POISON-POLISHES................................. ........
*E8613.. ACC POISON-CLEANSER NEC............................. ........
*E8614.. ACC POISON-DISINFECTANTS............................ ........
*E8615.. ACC POISON-LEAD PAINTS.............................. ........
*E8616.. ACC POISON-PAINTS NEC............................... ........
*E8619.. ACC POISON-CLEANSER NOS............................. ........
*E8620.. ACC POISN-PETROL SOLVENT............................ ........
*E8621.. ACC POISN-PETROLEUM FUEL............................ ........
[[Page 47979]]
*E8622.. ACC POIS-LUBRICATING OIL............................ ........
*E8623.. ACC POIS-PETROLEUM SOLID............................ ........
*E8624.. ACC POISN-SOLVENTS NEC.............................. ........
*E8629.. ACC POISN-SOLVENT NOS............................... ........
*E8630.. ACC POIS-CHLORINE PESTIC............................ ........
*E8631.. ACC POIS-PHOSPH PESTICID............................ ........
*E8632.. ACC POISON-CARBAMATES............................... ........
*E8633.. ACC POISN-MIXED PESTICID............................ ........
*E8634.. ACC POISON-PESTICIDE NEC............................ ........
*E8635.. ACC POISON-HERBICIDES............................... ........
*E8636.. ACC POISON-FUNGICIDES............................... ........
*E8637.. ACC POISON-RODENTICIDES............................. ........
*E8638.. ACC POISON-FUMIGANTS................................ ........
*E8639.. ACC POIS-AGRCULT NEC/NOS............................ ........
*E8640.. ACC POIS-CORROSIV AROMAT............................ ........
*E8641.. ACC POISON-ACIDS.................................... ........
*E8642.. ACC POISN-CAUSTIC ALKALI............................ ........
*E8643.. ACC POISON-CAUSTIC NEC.............................. ........
*E8644.. ACC POISON-CAUSTIC NOS.............................. ........
*E8650.. ACC POISON-MEAT..................................... ........
*E8651.. ACC POISON-SHELLFISH................................ ........
*E8652.. ACC POISON-FISH NEC................................. ........
*E8653.. ACC POISON-BERRIES/SEEDS............................ ........
*E8654.. ACC POISON-PLANTS NEC............................... ........
*E8655.. ACC POISON-MUSHROOMS................................ ........
*E8658.. ACC POISON-FOOD NEC................................. ........
*E8659.. ACC POISN-FOOD/PLANT NOS............................ ........
*E8660.. ACC POISONING-LEAD.................................. ........
*E8661.. ACC POISONING-MERCURY............................... ........
*E8662.. ACC POISONING-ANTIMONY.............................. ........
*E8663.. ACC POISONING-ARSENIC............................... ........
*E8664.. ACC POISON-METALS NEC............................... ........
*E8665.. ACC POISON-PLANT FOOD............................... ........
*E8666.. ACC POISON-GLUES.................................... ........
*E8667.. ACC POISON-COSMETICS................................ ........
*E8668.. ACC POIS-SOLID/LIQ NEC.............................. ........
*E8669.. ACC POIS-SOLID/LIQ NOS.............................. ........
*E867... ACC POISON-PIPED GAS................................ ........
*E8680.. ACC POIS-LIQ PETROL GAS............................. ........
*E8681.. ACC POIS-UTL GAS NEC/NOS............................ ........
*E8682.. ACC POISON-EXHAUST GAS.............................. ........
*E8683.. ACC POIS-CO/DOMESTC FUEL............................ ........
*E8688.. ACC POIS-CARBN MONOX NEC............................ ........
*E8689.. ACC POIS-CARBN MONOX NOS............................ ........
*E8690.. ACC POISN-NITROGEN OXIDE............................ ........
*E8691.. ACC POISN-SULFUR DIOXIDE............................ ........
*E8692.. ACC POISON-FREON.................................... ........
*E8693.. ACC POISON-TEAR GAS................................. ........
*E8694.. SCNDHND TBCCO SMOKE................................. ........
*E8698.. ACC POISON-GAS/VAPOR NEC............................ ........
*E8699.. ACC POISON-GAS/VAPOR NOS............................ ........
*E8700.. ACC CUT/HEM IN SURGERY.............................. ........
*E8701.. ACC CUT/HEM IN INFUSION............................. ........
*E8702.. ACC CUT/HEM-PERFUSN NEC............................. ........
*E8703.. ACC CUT/HEM IN INJECTION............................ ........
*E8704.. ACC CUT/HEM W SCOPE EXAM............................ ........
*E8705.. ACC CUT/HEM W CATHETERIZ............................ ........
*E8706.. ACC CUT/HEM W HEART CATH............................ ........
*E8707.. ACC CUT/HEM W ENEMA................................. ........
*E8708.. ACC CUT IN MED CARE NEC............................. ........
*E8709.. ACC CUT IN MED CARE NOS............................. ........
*E8710.. POST-SURGICAL FORGN BODY............................ ........
*E8711.. POSTINFUSION FOREIGN BDY............................ ........
*E8712.. POSTPERFUSION FORGN BODY............................ ........
*E8713.. POSTINJECTION FORGN BODY............................ ........
*E8714.. POSTENDOSCOPY FORGN BODY............................ ........
*E8715.. POSTCATHETER FORGN BODY............................. ........
*E8716.. FB POST HEART CATHETER.............................. ........
*E8717.. FB POST-CATHETER REMOVAL............................ ........
*E8718.. POST-OP FOREIGN BODY NEC............................ ........
*E8719.. POST-OP FOREIGN BODY NOS............................ ........
*E8720.. FAILURE STERILE SURGERY............................. ........
*E8721.. FAILURE STERILE INFUSION............................ ........
*E8722.. FAIL STERILE PERFUSN NEC............................ ........
*E8723.. FAIL STERILE INJECTION.............................. ........
*E8724.. FAIL STERILE ENDOSCOPY.............................. ........
[[Page 47980]]
*E8725.. FAIL STERILE CATHETER............................... ........
*E8726.. FAIL STERILE HEART CATH............................. ........
*E8728.. FAIL STERILE PROCED NEC............................. ........
*E8729.. FAIL STERILE PROCED NOS............................. ........
*E8730.. EXCESS FLUID IN INFUSION............................ ........
*E8731.. INCOR DILUT INFUSN FLUID............................ ........
*E8732.. THERAP RADIATION OVERDOS............................ ........
*E8733.. INADV RADIAT EXP-MEDICAL............................ ........
*E8734.. DOSAG FAIL-SHOCK THERAPY............................ ........
*E8735.. WRNG TEMP IN APPLIC/PACK............................ ........
*E8736.. NONADMIN NECESS MEDICINE............................ ........
*E8738.. FAILURE IN DOSAGE NEC............................... ........
*E8739.. FAILURE IN DOSAGE NOS............................... ........
*E8740.. INSTRMNT FAIL IN SURGERY............................ ........
*E8741.. INSTRUMNT FAIL-INFUSION............................. ........
*E8742.. INSTRMNT FAIL-PERFUS NEC............................ ........
*E8743.. INSTRUMNT FAIL-ENDOSCOPY............................ ........
*E8744.. INSTRMNT FAIL-CATHETERIZ............................ ........
*E8745.. INSTRMNT FAIL-HEART CATH............................ ........
*E8748.. INSTRMNT FAIL-PROCED NEC............................ ........
*E8749.. INSTRMNT FAIL-PROCED NOS............................ ........
*E8750.. CONTAMINATED TRANSFUSION............................ ........
*E8751.. CONTAMINATED INJECTION.............................. ........
*E8752.. CONTAMINATED DRUG NEC............................... ........
*E8758.. CONTAMINATION NEC................................... ........
*E8759.. CONTAMINATION NOS................................... ........
*E8760.. MISMATCH BLOOD-TRANSFUSN............................ ........
*E8761.. WRONG FLUID IN INFUSION............................. ........
*E8762.. FAILURE IN SUTURE................................... ........
*E8763.. MISPLACED ENDOTRACH TUBE............................ ........
*E8764.. FAIL INTROD/REMOVE TUBE............................. ........
*E8765.. PERFORMANCE-INAPPROP OP............................. ........
*E8768.. MEDICAL MISADVENTURE NEC............................ ........
*E8769.. MEDICAL MISADVENTURE NOS............................ ........
*E8780.. ABN REACT-ORG TRANSPLANT............................ ........
*E8781.. ABN REACT-ARTIF IMPLANT............................. ........
*E8782.. ABN REACT-ANASTOM/GRAFT............................. ........
*E8783.. ABN REACT-EXTERNAL STOMA............................ ........
*E8784.. ABN REACT-PLAST SURG NEC............................ ........
*E8785.. ABN REACT-LIMB AMPUTAT.............................. ........
*E8786.. ABN REAC-ORGAN REM NEC.............................. ........
*E8788.. ABN REACT-SURG PROC NEC............................. ........
*E8789.. ABN REACT-SURG PROC NOS............................. ........
*E8790.. ABN REACT-CARDIAC CATH.............................. ........
*E8791.. ABN REACT-RENAL DIALYSIS............................ ........
*E8792.. ABN REACT-RADIOTHERAPY.............................. ........
*E8793.. ABN REACT-SHOCK THERAPY............................. ........
*E8794.. ABN REACT-FLUID ASPIRAT............................. ........
*E8795.. ABN REACT-GASTRIC SOUND............................. ........
*E8796.. ABN REACT-URINARY CATH.............................. ........
*E8797.. ABN REACT-BLOOD SAMPLING............................ ........
*E8798.. ABN REACT-PROCEDURE NEC............................. ........
*E8799.. ABN REACT-PROCEDURE NOS............................. ........
*E8800.. FALL ON ESCALATOR................................... ........
*E8801.. FALL ON SIDEWALK CURB............................... ........
*E8809.. FALL ON STAIR/STEP NEC.............................. ........
*E8810.. FALL FROM LADDER.................................... ........
*E8811.. FALL FROM SCAFFOLDING............................... ........
*E882... FALL FROM BUILDING.................................. ........
*E8830.. DIVING ACCIDENT..................................... ........
*E8831.. FALL INTO WELL...................................... ........
*E8832.. FALL INTO STORM DRAIN............................... ........
*E8839.. FALL INTO OTHER HOLE................................ ........
*E8840.. FALL FROM PLAYGRND EQUIP............................ ........
*E8841.. FALL FROM CLIFF..................................... ........
*E8842.. FALL FROM CHAIR..................................... ........
*E8843.. FALL FROM WHEELCHAIR................................ ........
*E8844.. FALL FROM BED....................................... ........
*E8845.. FALL FROM FURNITURE NEC............................. ........
*E8846.. FALL FROM COMMODE................................... ........
*E8849.. FALL-1 LEVEL TO OTH NEC............................. ........
*E885... FALL ON LEVEL-TRIPPING.............................. ........
*E8860.. FALL IN SPORTS...................................... ........
*E8869.. FALL ON LEVEL NEC/NOS............................... ........
*E887... FRACTURE, CAUSE NOS................................. ........
*E888... FALL NEC & NOS...................................... ........
[[Page 47981]]
*E8900.. PRIVAT DWELL FIRE-EXPLOS............................ ........
*E8901.. PRIV DWEL FIRE-PVC FUMES............................ ........
*E8902.. PRIV DWEL FIRE-FUMES NOS............................ ........
*E8903.. PRIV DWEL FIRE-BURNING.............................. ........
*E8908.. PRIV DWEL FIRE-ACCID NEC............................ ........
*E8909.. PRIV DWEL FIRE-ACCID NOS............................ ........
*E8910.. FIRE IN BLDG-EXPLOSION.............................. ........
*E8911.. FIRE IN BLDG-PVC FUMES.............................. ........
*E8912.. FIRE IN BLDG-FUMES NOS.............................. ........
*E8913.. FIRE IN BLDG-BURNING................................ ........
*E8918.. FIRE IN BLDG-ACCID NEC.............................. ........
*E8919.. FIRE IN BLDG-ACCID NOS.............................. ........
*E892... FIRE NOT IN BUILDING................................ ........
*E8930.. CLOTHING FIRE-PRIV DWELL............................ ........
*E8931.. CLOTHING FIRE-BLDG NEC.............................. ........
*E8932.. CLOTHING FIRE NOT IN BLD............................ ........
*E8938.. CLOTHING FIRE NEC................................... ........
*E8939.. CLOTHING FIRE NOS................................... ........
*E894... FIRE-HIGHLY INFLAM MATER............................ ........
*E895... BURN ACC IN PRIVAT DWELL............................ ........
*E896... BURN ACC IN BLDG NEC................................ ........
*E897... BURN ACC NOT IN BLDG................................ ........
*E8980.. BURNING BEDCLOTHES.................................. ........
*E8981.. FIRE ACCIDENT NEC................................... ........
*E899... FIRE ACCIDENT NOS................................... ........
*E9000.. EXCESSIVE HEAT: WEATHER............................. ........
*E9001.. EXCESSIVE HEAT, MAN-MADE............................ ........
*E9009.. EXCESSIVE HEAT NOS.................................. ........
*E9010.. EXCESSIVE COLD: WEATHER............................. ........
*E9011.. EXCESSIVE COLD, MAN-MADE............................ ........
*E9018.. EXCESSIVE COLD NEC.................................. ........
*E9019.. EXCESSIVE COLD NOS.................................. ........
*E9020.. HIGH ALTITUDE RESIDENCE............................. ........
*E9021.. AIR PRESS CHNGE: AIRCRFT............................ ........
*E9022.. AIR PRESS CHANGE: DIVING............................ ........
*E9028.. AIR PRESSURE CHANGE NEC............................. ........
*E9029.. AIR PRESSURE CHANGE NOS............................. ........
*E903... TRAVEL AND MOTION................................... ........
*E9040.. ABANDONMENT/LACK OF CARE............................ ........
*E9041.. LACK OF FOOD........................................ ........
*E9042.. LACK OF WATER....................................... ........
*E9043.. EXPOSURE NEC........................................ ........
*E9049.. PRIVATION NOS....................................... ........
*E9050.. VENOMOUS SNAKE BITE................................. ........
*E9051.. VENOMOUS SPIDER BITE................................ ........
*E9052.. SCORPION STING...................................... ........
*E9053.. HORNET/WASP/BEE STING............................... ........
*E9054.. CENTIPEDE BITE...................................... ........
*E9055.. VENOMOUS ARTHROPODS NEC............................. ........
*E9056.. VENOM SEA ANIMALS/PLANTS............................ ........
*E9057.. POISONING BY OTHER PLANT............................ ........
*E9058.. VENOMOUS BITE/STING NEC............................. ........
*E9059.. VENOMOUS BITE/STING NOS............................. ........
*E9060.. DOG BITE............................................ ........
*E9061.. RAT BITE............................................ ........
*E9062.. NONVENOMOUS SNAKE BITE.............................. ........
*E9063.. ANIMAL BITE NEC..................................... ........
*E9064.. NONVENOM ARTHROPOD BITE............................. ........
*E9065.. ANIMAL BITE NOS..................................... ........
*E9068.. INJ NEC CAUSED BY ANIMAL............................ ........
*E9069.. INJ NOS CAUSED BY ANIMAL............................ ........
*E907... ACC DUE TO LIGHTNING................................ ........
*E908... CATACLYSMIC STORM/FLOOD*............................ ........
*E9080.. ACCIDENT D/T HURRICANE.............................. ........
*E9081.. ACCIDENT D/T TORNADO................................ ........
*E9082.. ACCIDENT D/T FLOODS................................. ........
*E9083.. ACC D/T SNOW BLIZZARD............................... ........
*E9084.. ACCIDENT D/T DUST STORM............................. ........
*E9088.. ACCIDENT D/T STORM NEC.............................. ........
*E9089.. ACC D/T STORM/FLOOD NOS............................. ........
*E909... ACC D/T AVALANCH/EARTHQU*........................... ........
*E9090.. ACC D/T EARTHQUAKES................................. ........
*E9091.. ACC D/T VOLCANIC ERUPT.............................. ........
*E9092.. ACC D/T AVALANCHE................................... ........
*E9093.. ACC D/T DAM COLLAPSE................................ ........
*E9094.. ACC D/T TIDALWAVE NOS............................... ........
[[Page 47982]]
*E9098.. ACC D/T ERUPTIONS NEC............................... ........
*E9099.. ACC D/T ERUPTIONS NOS............................... ........
*E9100.. WATER-SKIING ACCIDENT............................... ........
*E9101.. SKIN/SCUBA DIVING ACC............................... ........
*E9102.. SWIMMING ACCIDENT NOS............................... ........
*E9103.. SWIMMING/DIVING ACC NEC............................. ........
*E9104.. DROWNING IN BATHTUB................................. ........
*E9108.. ACCIDENTAL DROWNING NEC............................. ........
*E9109.. ACCIDENTAL DROWNING NOS............................. ........
*E911... RESP OBSTR-FOOD INHAL............................... ........
*E912... RESP OBSTR-INHAL OBJ NEC............................ ........
*E9130.. SUFFOCAT IN BED/CRADLE.............................. ........
*E9131.. SUFFOCATION-PLASTIC BAG............................. ........
*E9132.. SUFFOCATION-LACK OF AIR............................. ........
*E9133.. CAVE-IN NOS......................................... ........
*E9138.. SUFFOCATION NEC..................................... ........
*E9139.. SUFFOCATION NOS..................................... ........
*E914... FB ENTERING EYE..................................... ........
*E915... FB ENTERING OTH ORIFICE............................. ........
*E916... STRUCK BY FALLING OBJECT............................ ........
*E9170.. STRUCK IN SPORTS.................................... ........
*E9171.. CROWD ACCIDENT...................................... ........
*E9172.. STRUCK IN RUNNING WATER............................. ........
*E9179.. STRUCK BY OBJ/PERSON NEC............................ ........
*E918... CAUGHT BETWEEN OBJECTS.............................. ........
*E9190.. MACHINE ACCID-AGRICULT.............................. ........
*E9191.. MACHINE ACCID-MINING................................ ........
*E9192.. LIFTING MACHINE ACCIDENT............................ ........
*E9193.. METALWORKING MACHINE ACC............................ ........
*E9194.. WOODWORKING MACHINE ACC............................. ........
*E9195.. PRIME MOVER MACHINE ACC............................. ........
*E9196.. TRANSMISSION MACHINE ACC............................ ........
*E9197.. EARTH MOVING MACHINE ACC............................ ........
*E9198.. MACHINERY ACCIDENT NEC.............................. ........
*E9199.. MACHINERY ACCIDENT NOS.............................. ........
*E9200.. ACC-POWERED LAWN MOWER.............................. ........
*E9201.. ACC-POWER HAND TOOL NEC............................. ........
*E9202.. ACC-POWER HOUSE APPLIANC............................ ........
*E9203.. KNIFE/SWORD/DAGGER ACC.............................. ........
*E9204.. ACCID-OTHER HAND TOOLS.............................. ........
*E9205.. ACC-HYPODERMIC NEEDLE............................... ........
*E9208.. ACC-CUTTING INSTRUM NEC............................. ........
*E9209.. ACC-CUTTING INSTRUM NOS............................. ........
*E9210.. BOILER EXPLOSION.................................... ........
*E9211.. GAS CYLINDER EXPLOSION.............................. ........
*E9218.. PRESS VESSEL EXPLOS NEC............................. ........
*E9219.. PRESS VESSEL EXPLOS NOS............................. ........
*E9220.. HANDGUN ACCIDENT.................................... ........
*E9221.. SHOTGUN ACCIDENT.................................... ........
*E9222.. HUNTING RIFLE ACCIDENT.............................. ........
*E9223.. MILITARY FIREARM ACCID.............................. ........
*E9228.. FIREARM ACCIDENT NEC................................ ........
*E9229.. FIREARM ACCIDENT NOS................................ ........
*E9230.. FIREWORKS ACCIDENT.................................. ........
*E9231.. BLASTING MATERIALS ACCID............................ ........
*E9232.. EXPLOSIVE GASES ACCIDENT............................ ........
*E9238.. EXPLOSIVES ACCIDENT NEC............................. ........
*E9239.. EXPLOSIVES ACCIDENT NOS............................. ........
*E9240.. ACC-HOT LIQUID & STEAM.............................. ........
*E9241.. ACCID-CAUSTIC SUBSTANCE............................. ........
*E9242.. ACC-HOT TAP WATER................................... ........
*E9248.. HOT SUBSTANCE ACCID NEC............................. ........
*E9249.. HOT SUBSTANCE ACCID NOS............................. ........
*E9250.. DOMESTIC WIRING ACCIDENT............................ ........
*E9251.. ELECTR POWER GENERAT ACC............................ ........
*E9252.. INDUST WIRING/MACHIN ACC............................ ........
*E9258.. ELECTRIC CURRENT ACC NEC............................ ........
*E9259.. ELECTRIC CURRENT ACC NOS............................ ........
*E9260.. RADIOFREQ RADIAT EXPOSUR............................ ........
*E9261.. INFRA-RED APPL RAD EXOS............................. ........
*E9262.. VIS/ULTRAVIOL LGHT EXPOS............................ ........
*E9263.. X-RAY/GAMMA RAY EXPOSURE............................ ........
*E9264.. LASER EXPOSURE...................................... ........
*E9265.. RADIOACT ISOTOPE EXPOSUR............................ ........
*E9268.. RADIATION EXPOSURE NEC.............................. ........
*E9269.. RADIATION EXPOSURE NOS.............................. ........
[[Page 47983]]
*E927... ACCID FROM OVEREXERTION............................. ........
*E9280.. ACC D/T WEIGHTLESS ENVIR............................ ........
*E9281.. EXPOSURE TO NOISE................................... ........
*E9282.. EXPOSURE TO VIBRATION............................... ........
*E9288.. ACCIDENT NEC........................................ ........
*E9289.. ACCIDENT NOS........................................ ........
*E9290.. LATE EFF MOTOR VEHIC ACC............................ ........
*E9291.. LATE EFF TRANSPORT ACC.............................. ........
*E9292.. LATE EFF ACC POISONING.............................. ........
*E9293.. LATE EFF ACCIDENTAL FALL............................ ........
*E9294.. LATE EFF FIRE ACC................................... ........
*E9295.. LATE EFF ENVIRONMENT ACC............................ ........
*E9298.. LATE EFF ACCIDENT NEC............................... ........
*E9299.. LATE EFF ACCIDENT NOS............................... ........
*E9300.. ADV EFF PENICILLINS................................. ........
*E9301.. ADV EFF ANTIFUNG ANTBIOT............................ ........
*E9302.. ADV EFF CHLORAMPHENICOL............................. ........
*E9303.. ADV EFF ERYTHROMYCIN................................ ........
*E9304.. ADV EFF TETRACYCLINE................................ ........
*E9305.. ADV EFF CEPHALOSPORIN............................... ........
*E9306.. ADV EFF ANTMYCOB ANTBIOT............................ ........
*E9307.. ADV EFF ANTINEOP ANTBIOT............................ ........
*E9308.. ADV EFF ANTIBIOTICS NEC............................. ........
*E9309.. ADV EFF ANTIBIOTIC NOS.............................. ........
*E9310.. ADV EFF SULFONAMIDES................................ ........
*E9311.. ADV EFF ARSENIC ANTI-INF............................ ........
*E9312.. ADV EFF METAL ANTI-INF.............................. ........
*E9313.. ADV EFF QUINOLINE................................... ........
*E9314.. ADV EFF ANTIMALARIALS............................... ........
*E9315.. ADV EFF ANTPROTAZOAL NEC............................ ........
*E9316.. ADV EFF ANTHELMINTICS............................... ........
*E9317.. ADV EFF ANTIVIRAL DRUGS............................. ........
*E9318.. ADV EFF ANTIMYCOBAC NEC............................. ........
*E9319.. ADV EFF ANTINFCT NEC/NOS............................ ........
*E9320.. ADV EFF CORTICOSTEROIDS............................. ........
*E9321.. ADV EFF ANDROGENS................................... ........
*E9322.. ADV EFF OVARIAN HORMONES............................ ........
*E9323.. ADV EFF INSULIN/ANTIDIAB............................ ........
*E9324.. ADV EFF ANT PITUITARY............................... ........
*E9325.. ADV EFF POST PITUITARY.............................. ........
*E9326.. ADV EFF PARATHYROID................................. ........
*E9327.. ADV EFF THYROID & DERIV............................. ........
*E9328.. ADV EFF ANTITHYROID AGNT............................ ........
*E9329.. ADV EFF HORMONES NEC/NOS............................ ........
*E9330.. ADV EFF ANALLRG/ANTEMET............................. ........
*E9331.. ADV EFF ANTINEOPLASTIC.............................. ........
*E9332.. ADV EFF ACIDIFYING AGENT............................ ........
*E9333.. ADV EFF ALKALIZING AGENT............................ ........
*E9334.. ADV EFF ENZYMES NEC................................. ........
*E9335.. ADV EFF VITAMINS NEC................................ ........
*E9338.. ADV EFF SYSTEMIC AGT NEC............................ ........
*E9339.. ADV EFF SYSTEMIC AGT NOS............................ ........
*E9340.. ADV EFF IRON & COMPOUNDS............................ ........
*E9341.. ADV EFF LIVER/ANTIANEMIC............................ ........
*E9342.. ADV EFF ANTICOAGULANTS.............................. ........
*E9343.. ADV EFF VITAMIN K................................... ........
*E9344.. ADV EFF FIBRINOLYSIS AGT............................ ........
*E9345.. ADV EFF COAGULANTS.................................. ........
*E9346.. ADV EFF GAMMA GLOBULIN.............................. ........
*E9347.. ADV EFF BLOOD PRODUCTS.............................. ........
*E9348.. ADV EFF BLOOD AGENT NEC............................. ........
*E9349.. ADV EFF BLOOD AGENT NOS............................. ........
*E9350.. ADV EFF HEROIN...................................... ........
*E9351.. ADV EFF METHADONE................................... ........
*E9352.. ADV EFF OPIATES..................................... ........
*E9353.. ADV EFF SALICYLATES................................. ........
*E9354.. ADV EFF AROM ANALGSC NEC............................ ........
*E9355.. ADV EFF PYRAZOLE DERIV.............................. ........
*E9356.. ADV EFF ANTIRHEUMATICS.............................. ........
*E9357.. ADV EFF NON-NARC ANALGSC............................ ........
*E9358.. ADV EFF ANALGESICS NEC.............................. ........
*E9359.. ADV EFF ANALGESIC NOS............................... ........
*E9360.. ADV EFF OXAZOLIDIN DERIV............................ ........
*E9361.. ADV EFF HYDANTOIN DERIV............................. ........
*E9362.. ADV EFF SUCCINIMIDES................................ ........
*E9363.. ADV EFF ANTCONVL NEC/NOS............................ ........
[[Page 47984]]
*E9364.. ADV EFF ANTI-PARKINSON.............................. ........
*E9370.. ADV EFF BARBITURATES................................ ........
*E9371.. ADV EFF CHLORAL HYDRATE............................. ........
*E9372.. ADV EFF PARALDEHYDE................................. ........
*E9373.. ADV EFF BROMINE COMPNDS............................. ........
*E9374.. ADV EFF METHAQUALONE................................ ........
*E9375.. ADV EFF GLUTETHIMIDE................................ ........
*E9376.. ADV EFF MIX SEDATIVE................................ ........
*E9378.. ADV EFF SEDAT/HYPNOT NEC............................ ........
*E9379.. ADV EFF SEDAT/HYPNOT NOS............................ ........
*E9380.. ADV EFF CNS MUSCL DEPRES............................ ........
*E9381.. ADV EFF HALOTHANE................................... ........
*E9382.. ADV EFF GAS ANESTHET NEC............................ ........
*E9383.. ADV EFF INTRAVEN ANESTH............................. ........
*E9384.. ADV EFF GEN ANES NEC/NOS............................ ........
*E9385.. ADV EFF TOPIC/INFIL ANES............................ ........
*E9386.. ADV EFF NERVE-BLOCK ANES............................ ........
*E9387.. ADV EFF SPINAL ANESTHET............................. ........
*E9389.. ADV EFF LOC ANES NEC/NOS............................ ........
*E9390.. ADV EFF ANTIDEPRESSANTS............................. ........
*E9391.. ADV EFF PHENOTHIAZ TRANQ............................ ........
*E9392.. ADV EFF BUTYROPHEN TRANQ............................ ........
*E9393.. ADV EFF ANTIPSYCHOTC NEC............................ ........
*E9394.. ADV EFF BENZODIAZ TRANQ............................. ........
*E9395.. ADV EFF TRANQUILIZER NEC............................ ........
*E9396.. ADV EFF HALLUCINOGENS............................... ........
*E9397.. ADV EFF PSYCHOSTIMULANTS............................ ........
*E9398.. ADV EFF PSYCHOTROPIC NEC............................ ........
*E9399.. ADV EFF PSYCHOTROPIC NOS............................ ........
*E9400.. ADV EFF ANALEPTICS.................................. ........
*E9401.. ADV EFF OPIAT ANTAGONIST............................ ........
*E9408.. ADV EFF CNS STIMULNT NEC............................ ........
*E9409.. ADV EFF CNS STIMULNT NOS............................ ........
*E9410.. ADV EFF CHOLINERGICS................................ ........
*E9411.. ADV EFF PARASYMPATHOLYTC............................ ........
*E9412.. ADV EFF SYMPATHOMIMETICS............................ ........
*E9413.. ADV EFF SYMPATHOLYTICS.............................. ........
*E9419.. ADV EFF AUTONOM AGNT NOS............................ ........
*E9420.. ADV EFF CARD RHYTH REGUL............................ ........
*E9421.. ADV EFF CARDIOTONICS................................ ........
*E9422.. ADV EFF ANTILIPEMICS................................ ........
*E9423.. ADV EFF GANGLION-BLOCK.............................. ........
*E9424.. ADV EFF CORONARY VASODIL............................ ........
*E9425.. ADV EFF VASODILATORS NEC............................ ........
*E9426.. ADV EFF ANTIHYPERTEN AGT............................ ........
*E9427.. ADV EFF ANTIVARICOSE................................ ........
*E9428.. ADV EFF CAPILLARY-ACT............................... ........
*E9429.. ADV EFF CARDIOVASC NEC.............................. ........
*E9430.. ADV EFF ANTACIDS.................................... ........
*E9431.. ADV EFF IRRIT CATHARTIC............................. ........
*E9432.. ADV EFF EMOLL CATHARTICS............................ ........
*E9433.. ADV EFF CATHARTICS NEC.............................. ........
*E9434.. ADV EFF DIGESTANTS.................................. ........
*E9435.. ADV EFF ANTIDIARRHEA AGT............................ ........
*E9436.. ADV EFF EMETICS..................................... ........
*E9438.. ADV EFF GI AGENT NEC................................ ........
*E9439.. ADV EFF GI AGENT NOS................................ ........
*E9440.. ADV EFF MERCURY DIURETIC............................ ........
*E9441.. ADV EFF PURINE DIURETICS............................ ........
*E9442.. ADV EFF ACETAZOLAMIDE............................... ........
*E9443.. ADV EFF SALURETICS.................................. ........
*E9444.. ADV EFF DIURETICS NEC............................... ........
*E9445.. ADV EFF ELECTROLYTE AGNT............................ ........
*E9446.. ADV EFF MINERAL SALT NEC............................ ........
*E9447.. ADV EFF URIC ACID METAB............................. ........
*E9450.. ADV EFF OXYTOCIC AGENTS............................. ........
*E9451.. ADV EFF SMOOTH MUSC RELX............................ ........
*E9452.. ADV EFF SKELET MUSC RELX............................ ........
*E9453.. ADV EFF MUSC AGT NEC/NOS............................ ........
*E9454.. ADV EFF ANTITUSSIVES................................ ........
*E9455.. ADV EFF EXPECTORANTS................................ ........
*E9456.. ADV EFF ANTI-COMMON COLD............................ ........
*E9457.. ADV EFF ANTIASTHMATICS.............................. ........
*E9458.. ADV EFF RESP DRG NEC/NOS............................ ........
*E9460.. ADV EFF LOC ANTI-INFECTV............................ ........
*E9461.. ADV EFF ANTIPRURITICS............................... ........
[[Page 47985]]
*E9462.. ADV EFF LOCAL ASTRINGENT............................ ........
*E9463.. ADV EFF EMOLLIENT/DEMULC............................ ........
*E9464.. ADV EFF HAIR/SCALP PREP............................. ........
*E9465.. ADV EFF EYE ANTI-INF/DRG............................ ........
*E9466.. ADV EFF ENT ANTI-INF/DRG............................ ........
*E9467.. ADV EFF TOPIC DENTAL DRG............................ ........
*E9468.. ADV EFF SKIN AGENT NEC.............................. ........
*E9469.. ADV EFF SKIN AGENT NOS.............................. ........
*E9470.. ADV EFF DIETETICS................................... ........
*E9471.. ADV EFF LIPOTROPIC DRUGS............................ ........
*E9472.. ADV EFF ANTIDOTES NEC............................... ........
*E9473.. ADV EFF ALCOHOL DETER............................... ........
*E9474.. ADV EFF PHARMACEUT EXCIP............................ ........
*E9478.. ADV EFF MEDICINAL NEC............................... ........
*E9479.. ADV EFF MEDICINAL NOS............................... ........
*E9480.. ADV EFF BCG VACCINE................................. ........
*E9481.. ADV EFF TYPHOID VACCINE............................. ........
*E9482.. ADV EFF CHOLERA VACCINE............................. ........
*E9483.. ADV EFF PLAGUE VACCINE.............................. ........
*E9484.. ADV EFF TETANUS VACCINE............................. ........
*E9485.. ADV EFF DIPHTHER VACCINE............................ ........
*E9486.. ADV EFF PERTUSSIS VACCIN............................ ........
*E9488.. ADV EFF BACT VAC NEC/NOS............................ ........
*E9489.. ADV EFF MIX BACT VACCINE............................ ........
*E9490.. ADV EFF SMALLPOX VACCINE............................ ........
*E9491.. ADV EFF RABIES VACCINE.............................. ........
*E9492.. ADV EFF TYPHUS VACCINE.............................. ........
*E9493.. ADV EFF YELLOW FEVER VAC............................ ........
*E9494.. ADV EFF MEASLES VACCINE............................. ........
*E9495.. ADV EFF POLIO VACCINE............................... ........
*E9496.. ADV EFF VIRAL VACC NEC.............................. ........
*E9497.. ADV EFF MIXED VIRAL-BACT............................ ........
*E9499.. ADV EFF BIOLOGIC NEC/NOS............................ ........
*E9500.. POISON-ANALGESICS................................... ........
*E9501.. POISON-BARBITURATES................................. ........
*E9502.. POISON-SEDAT/HYPNOTIC............................... ........
*E9503.. POISON-PSYCHOTROPIC AGT............................. ........
*E9504.. POISON-DRUG/MEDICIN NEC............................. ........
*E9505.. POISON-DRUG/MEDICIN NOS............................. ........
*E9506.. POISON-AGRICULT AGENT............................... ........
*E9507.. POISON-CORROSIV/CAUSTIC............................. ........
*E9508.. POISON-ARSENIC...................................... ........
*E9509.. POISON-SOLID/LIQUID NEC............................. ........
*E9510.. POISON-PIPED GAS.................................... ........
*E9511.. POISON-GAS IN CONTAINER............................. ........
*E9518.. POISON-UTILITY GAS NEC.............................. ........
*E9520.. POISON-EXHAUST GAS.................................. ........
*E9521.. POISON-CO NEC....................................... ........
*E9528.. POISON-GAS/VAPOR NEC................................ ........
*E9529.. POISON-GAS/VAPOR NOS................................ ........
*E9530.. INJURY-HANGING...................................... ........
*E9531.. INJURY-SUFF W PLAS BAG.............................. ........
*E9538.. INJURY-STRANG/SUFF NEC.............................. ........
*E9539.. INJURY-STRANG/SUFF NOS.............................. ........
*E954... INJURY-SUBMERSION................................... ........
*E9550.. INJURY-HANDGUN...................................... ........
*E9551.. INJURY-SHOTGUN...................................... ........
*E9552.. INJURY-HUNTING RIFLE................................ ........
*E9553.. INJURY-MILITARY FIREARM............................. ........
*E9554.. INJURY-FIREARM NEC.................................. ........
*E9555.. INJURY-EXPLOSIVES................................... ........
*E9559.. INJURY-FIREARM/EXPL NOS............................. ........
*E956... INJURY-CUT INSTRUMENT............................... ........
*E9570.. INJURY-JUMP FM RESIDENCE............................ ........
*E9571.. INJURY-JUMP FM STRUC NEC............................ ........
*E9572.. INJURY-JUMP FM NATUR SIT............................ ........
*E9579.. INJURY-JUMP NEC..................................... ........
*E9580.. INJURY-MOVING OBJECT................................ ........
*E9581.. INJURY-BURN, FIRE................................... ........
*E9582.. INJURY-SCALD........................................ ........
*E9583.. INJURY-EXTREME COLD................................. ........
*E9584.. INJURY-ELECTROCUTION................................ ........
*E9585.. INJURY-MOTOR VEH CRASH.............................. ........
*E9586.. INJURY-AIRCRAFT CRASH............................... ........
*E9587.. INJURY-CAUSTIC SUBSTANCE............................ ........
*E9588.. INJURY-NEC.......................................... ........
[[Page 47986]]
*E9589.. INJURY-NOS.......................................... ........
*E959... LATE EFF OF SELF-INJURY............................. ........
*E9600.. UNARMED FIGHT OR BRAWL.............................. ........
*E9601.. RAPE................................................ ........
*E961... ASSAULT-CORROSIV/CAUST.............................. ........
*E9620.. ASSAULT-POIS W MEDIC AGT............................ ........
*E9621.. ASSAULT-POIS W SOLID/LIQ............................ ........
*E9622.. ASSAULT-POIS W GAS/VAPOR............................ ........
*E9629.. ASSAULT-POISONING NOS............................... ........
*E963... ASSAULT-HANGING/STRANGUL............................ ........
*E964... ASSAULT-SUBMERSION.................................. ........
*E9650.. ASSAULT-HANDGUN..................................... ........
*E9651.. ASSAULT-SHOTGUN..................................... ........
*E9652.. ASSAULT-HUNTING RIFLE............................... ........
*E9653.. ASSAULT-MILITARY WEAPON............................. ........
*E9654.. ASSAULT-FIREARM NEC................................. ........
*E9655.. ASSAULT-ANTIPERSON BOMB............................. ........
*E9656.. ASSAULT-GASOLINE BOMB............................... ........
*E9657.. ASSAULT-LETTER BOMB................................. ........
*E9658.. ASSAULT-EXPLOSIVE NEC............................... ........
*E9659.. ASSAULT-EXPLOSIVE NOS............................... ........
*E966... ASSAULT-CUTTING INSTR............................... ........
*E9670.. BATTER BY FATHER/STEPFTH............................ ........
*E9671.. CHILD ABUSE BY PERS NEC............................. ........
*E9679.. CHILD ABUSE NOS..................................... ........
*E9680.. ASSAULT-FIRE........................................ ........
*E9681.. ASSLT-PUSH FROM HI PLACE............................ ........
*E9682.. ASSAULT-STRIKING W OBJ.............................. ........
*E9683.. ASSAULT-HOT LIQUID.................................. ........
*E9684.. ASSAULT-CRIMINAL NEGLECT............................ ........
*E9685.. ASSLT-TRANSPORT VEHICLE............................. ........
*E9688.. ASSAULT NEC......................................... ........
*E9689.. ASSAULT NOS......................................... ........
*E969... LATE EFFECT ASSAULT................................. ........
*E970... LEGAL INTERVENT-FIREARM............................. ........
*E971... LEGAL INTERVENT-EXPLOSIV............................ ........
*E972... LEGAL INTERVENT-GAS................................. ........
*E973... LEGAL INTERVEN-BLUNT OBJ............................ ........
*E974... LEGAL INTERVEN-CUT INSTR............................ ........
*E975... LEGAL INTERVENTION NEC.............................. ........
*E976... LEGAL INTERVENTION NOS.............................. ........
*E977... LATE EFF-LEGAL INTERVENT............................ ........
*E978... LEGAL EXECUTION..................................... ........
*E9800.. UNDETERM POIS-ANALGESICS............................ ........
*E9801.. UNDETERM POIS-BARBITURAT............................ ........
*E9802.. UNDET POIS-SED/HYPN NEC............................. ........
*E9803.. UNDETERM POIS-PSYCHOTROP............................ ........
*E9804.. UNDET POIS-MED AGNT NEC............................. ........
*E9805.. UNDET POIS-MED AGNT NOS............................. ........
*E9806.. UNDET POIS-CORROS/CAUST............................. ........
*E9807.. UNDET POIS-AGRICULT AGNT............................ ........
*E9808.. UNDETER POIS-ARSENIC................................ ........
*E9809.. UNDETER POIS-SOL/LIQ NEC............................ ........
*E9810.. UNDETER POIS-PIPED GAS.............................. ........
*E9811.. UNDET POIS-CONTAINER GAS............................ ........
*E9818.. UNDET POIS-UTIL GAS NEC............................. ........
*E9820.. UNDETER POIS-EXHAUST GAS............................ ........
*E9821.. UNDETERMIN POISON-CO NEC............................ ........
*E9828.. UNDET POIS-GAS/VAPOR NEC............................ ........
*E9829.. UNDET POIS-GAS/VAPOR NOS............................ ........
*E9830.. UNDETERMIN CIRC-HANGING............................. ........
*E9831.. UNDET CIRC-SUF PLAST BAG............................ ........
*E9838.. UNDET CIRC-SUFFOCATE NEC............................ ........
*E9839.. UNDET CIRC-SUFFOCATE NOS............................ ........
*E984... UNDETERM CIRC-SUBMERSION............................ ........
*E9850.. UNDETERMIN CIRC-HANDGUN............................. ........
*E9851.. UNDETERMIN CIRC-SHOTGUN............................. ........
*E9852.. UNDET CIRC-HUNTING RIFLE............................ ........
*E9853.. UNDET CIRC-MILITARY ARMS............................ ........
*E9854.. UNDETER CIRC-FIREARM NEC............................ ........
*E9855.. UNDETERM CIRC-EXPLOSIVE............................. ........
*E986... UNDET CIRC-CUT INSTRUMNT............................ ........
*E9870.. UNDET CIRC-FALL RESIDENC............................ ........
*E9871.. UNDET FALL STRUCTURE NEC............................ ........
*E9872.. UNDET FALL NATURAL SITE............................. ........
*E9879.. UNDET CIRC-FALL SITE NOS............................ ........
[[Page 47987]]
*E9880.. UNDETERM CIRC-MOVING OBJ............................ ........
*E9881.. UNDETERM CIRC-BURN, FIRE............................ ........
*E9882.. UNDETERM CIRC-SCALD................................. ........
*E9883.. UNDETERM CIRC-EXTRM COLD............................ ........
*E9884.. UNDETERM CIRC-ELECTROCUT............................ ........
*E9885.. UNDET CIRC-MOT VEH CRASH............................ ........
*E9886.. UNDET CIRC-AIRCRFT CRASH............................ ........
*E9887.. UNDET CIRC-CAUSTIC SUBST............................ ........
*E9888.. UNDETERMIN CIRCUMST NEC............................. ........
*E9889.. UNDETERMIN CIRCUMST NOS............................. ........
*E989... LATE EFF INJ-UNDET CIRC............................. ........
*E9900.. WAR INJ:GASOLINE BOMB............................... ........
*E9909.. WAR INJURY:FIRE NEC................................. ........
*E9910.. WAR INJ:RUBBER BULLET............................... ........
*E9911.. WAR INJURY:PELLETS.................................. ........
*E9912.. WAR INJURY:BULLET NEC............................... ........
*E9913.. WAR INJ:ANTIPERSON BOMB............................. ........
*E9919.. WAR INJ:FRAGMENTS NEC............................... ........
*E992... WAR INJ:MARINE EXPLOS............................... ........
*E993... WAR INJURY:EXPLOS NEC............................... ........
*E994... WAR INJ:AIRCRFT DESTRUC............................. ........
*E995... WAR INJUR-CONVEN WAR NEC............................ ........
*E996... WAR INJ:NUCLEAR WEAPONS............................. ........
*E9970.. WAR INJURY:LASERS................................... ........
*E9971.. WAR INJURY:BIOL WARFARE............................. ........
*E9972.. WAR INJURY:GAS/FUM/CHEM............................. ........
*E9978.. WAR INJ-UNCONVEN WAR NEC............................ ........
*E9979.. WAR INJ-UNCONVEN WAR NOS............................ ........
*E998... WAR INJ:POST WAR OPERAT............................. ........
*E999... LATE EFF OF WAR INJURY.............................. ........
V010.... CHOLERA CONTACT..................................... 11
V011.... TUBERCULOSIS CONTACT................................ 11
V012.... POLIOMYELITIS CONTACT............................... 11
V013.... SMALLPOX CONTACT.................................... 11
V014.... RUBELLA CONTACT..................................... 11
V015.... RABIES CONTACT...................................... 11
V016.... VENEREAL DIS CONTACT................................ 11
V017.... VIRAL DIS CONTACT NEC............................... 11
V018.... COMMUNIC DIS CONTACT NEC............................ 11
V019.... COMMUNIC DIS CONTACT NOS............................ 11
V020.... CHOLERA CARRIER..................................... 11
V021.... TYPHOID CARRIER..................................... 11
V022.... AMEBIASIS CARRIER................................... 11
V023.... GI PATHOGEN CARRIER NEC............................. 11
V024.... DIPHTHERIA CARRIER.................................. 11
V025.... BACTERIA DIS CARRIER NEC............................ 11
V026.... VIRAL HEPATITIS CARRIER*............................ 11
V027.... GONORRHEA CARRIER................................... 11
V028.... VENEREAL DIS CARRIER NEC............................ 11
V029.... CARRIER NEC......................................... 11
V030.... VACCIN FOR CHOLERA.................................. 11
V031.... VACC-TYPHOID-PARATYPHOID............................ 11
V032.... VACCIN FOR TUBERCULOSIS............................. 11
V033.... VACCIN FOR PLAGUE................................... 11
V034.... VACCIN FOR TULAREMIA................................ 11
V035.... VACCIN FOR DIPHTHERIA............................... 11
V036.... VACCIN FOR PERTUSSIS................................ 11
V037.... TETANUS TOXOID INOCULAT............................. 11
V0381... ND VAC HMOPHLUS INFLNZ B............................ 11
V0382... ND VAC STRPTCS PNEUMNI B............................ 11
V0389... ND OTHER SPECF VACNATION............................ 11
V039.... VACCIN FOR BACT DIS NOS............................. 11
V040.... VACCIN FOR POLIOMYELITIS............................ 11
V041.... VACCIN FOR SMALLPOX................................. 11
V042.... VACCIN FOR MEASLES.................................. 11
V043.... VACCIN FOR RUBELLA.................................. 11
V044.... VACCIN FOR YELLOW FEVER............................. 11
V045.... VACCIN FOR RABIES................................... 11
V046.... VACCIN FOR MUMPS.................................... 11
V047.... VACCIN FOR COMMON COLD.............................. 11
V048.... VACCIN FOR INFLUENZA................................ 11
V050.... ARBOVIRUS ENCEPH VACCIN............................. 11
V051.... VACC ARBOVIRAL DIS NEC.............................. 11
V052.... VACCIN FOR LEISHMANIASIS............................ 11
V053.... NEED PRPHYL VC VRL HEPAT............................ 11
V054.... NEED PRPHYL VC VARICELLA............................ 11
[[Page 47988]]
V058.... VACCIN FOR DISEASE NEC.............................. 11
V059.... VACCIN FOR SINGL DIS NOS............................ 11
V060.... VACCIN FOR CHOLERA + TAB............................ 11
V061.... VACCIN FOR DTP...................................... 11
V062.... VACCIN FOR DTP + TAB................................ 11
V063.... VACCIN FOR DTP + POLIO.............................. 11
V064.... VAC-MEASLE-MUMPS-RUBELLA............................ 11
V065.... ND VAC TETANUS-DIPHTHRIA............................ 11
V066.... ND VAC STRP PNUMN/INFLNZ............................ 11
V068.... VAC-DIS COMBINATIONS NEC............................ 11
V069.... VAC-DIS COMBINATIONS NOS............................ 11
V070.... PROPHYLACTIC ISOLATION.............................. 11
V071.... DESENSITIZA TO ALLERGENS............................ 11
V072.... PROPHYLACT IMMUNOTHERAPY............................ 11
V0731... PROPHYLAC FLUORIDE ADMIN............................ 11
V0739... OTHER PROPHYLAC CHEMOTHR............................ 11
V074.... NEED PSTMNPASL HRMN RPLC............................ 11
V078.... PROPHYLACTIC MEASURE NEC............................ 11
V079.... PROPHYLACTIC MEASURE NOS............................ 11
V08..... ASYMP HIV INFECTN STATUS............................ 86
V090.... INF MCRG RSTN PNCLLINS.............................. 97
V091.... INF MCRG RSTN B-LACTAM.............................. 97
V092.... INF MCRG RSTN MACROLIDES............................ 97
V093.... INF MCRG RSTN TTRCYCLN.............................. 97
V094.... INF MCRG RSTN AMNGLCSDS............................. 97
V0950... INF MCR RST QN FLR NT ML............................ 97
V0951... INF MCRG RSTN QN FLRQ ML............................ 97
V096.... INF MCRG RSTN SULFNMIDES............................ 97
V0970... INF MCR RST OTH AG NT ML............................ 97
V0971... INF MCRG RSTN OTH AG MLT............................ 97
V0980... INF MCR RST OT DRG NT ML............................ 97
V0981... INF MCRG RSTN OTH DRG ML............................ 97
V0990... INFC MCRG DRGRST NT MULT............................ 97
V0991... INFC MCRG DRGRST MULT............................... 97
V1000... HX OF GI MALIGNANCY NOS............................. 11
V1001... HX OF TONGUE MALIGNANCY............................. 11
V1002... HX-ORAL/PHARYNX MALG NEC............................ 11
V1003... HX-ESOPHAGEAL MALIGNANCY............................ 11
V1004... HX OF GASTRIC MALIGNANCY............................ 11
V1005... HX OF COLONIC MALIGNANCY............................ 11
V1006... HX-RECTAL & ANAL MALIGN............................. 11
V1007... HX OF LIVER MALIGNANCY.............................. 11
V1009... HX OF GI MALIGNANCY NEC............................. 11
V1011... HX-BRONCHOGENIC MALIGNAN............................ 11
V1012... HX-TRACHEAL MALIGNANCY.............................. 11
V1020... HX-RESP ORG MALIGNAN NOS............................ 11
V1021... HX-LARYNGEAL MALIGNANCY............................. 11
V1022... HX-NOSE/EAR/SINUS MALIG............................. 11
V1029... HX-INTRATHORACIC MAL NEC............................ 11
V103.... HX OF BREAST MALIGNANCY............................. 11
V1040... HX-FEMALE GENIT MALG NOS............................ 11
V1041... HX-CERVICAL MALIGNANCY.............................. 11
V1042... HX-UTERUS MALIGNANCY NEC............................ 11
V1043... HX OF OVARIAN MALIGNANCY............................ 11
V1044... HX-FEMALE GENIT MALG NEC............................ 11
V1045... HX-MALE GENIT MALIG NOS............................. 11
V1046... HX-PROSTATIC MALIGNANCY............................. 11
V1047... HX-TESTICULAR MALIGNANCY............................ 11
V1049... HX-MALE GENIT MALIG NEC............................. 11
V1050... HX-URINARY MALIGNAN NOS............................. 11
V1051... HX OF BLADDER MALIGNANCY............................ 11
V1052... HX OF KIDNEY MALIGNANCY............................. 11
V1059... HX-URINARY MALIGNAN NEC............................. 11
V1060... HX OF LEUKEMIA NOS.................................. 11
V1061... HX OF LYMPHOID LEUKEMIA............................. 11
V1062... HX OF MYELOID LEUKEMIA.............................. 11
V1063... HX OF MONOCYTIC LEUKEMIA............................ 11
V1069... HX OF LEUKEMIA NEC.................................. 11
V1071... HX-LYMPHOSARCOMA.................................... 11
V1072... HX-HODGKIN'S DISEASE................................ 11
V1079... HX-LYMPHATIC MALIGN NEC............................. 11
V1081... HX OF BONE MALIGNANCY............................... 11
V1082... HX-MALIG SKIN MELANOMA.............................. 11
V1083... HX-SKIN MALIGNANCY NEC.............................. 11
V1084... HX OF EYE MALIGNANCY................................ 11
V1085... HX OF BRAIN MALIGNANCY.............................. 11
[[Page 47989]]
V1086... HX-MALIGN NERVE SYST NEC............................ 11
V1087... HX OF THYROID MALIGNANCY............................ 11
V1088... HX-ENDOCRINE MALIGN NEC............................. 11
V1089... HX OF MALIGNANCY NEC................................ 11
V109.... HX OF MALIGNANCY NOS................................ 11
V110.... HX OF SCHIZOPHRENIA................................. 11
V111.... HX OF AFFECTIVE DISORDER............................ 11
V112.... HX OF NEUROSIS...................................... 11
V113.... HX OF ALCOHOLISM.................................... 11
V118.... HX-MENTAL DISORDER NEC.............................. 11
V119.... HX-MENTAL DISORDER NOS.............................. 11
V1200... PRSNL HST UNSP NFCT PRST............................ 11
V1201... PRSNL HST TUBERCULOSIS.............................. 11
V1202... PRSNL HST POLIOMYELITIS............................. 11
V1203... PERSONAL HISTRY MALARIA............................. 11
V1209... PRSNL HST OTH NFCT PARST............................ 11
V121.... HX-NUTRITION DEFICIENCY............................. 11
V122.... HX-ENDOCR/META/IMMUN DIS............................ 11
V123.... HX-BLOOD DISEASES................................... 11
V1250... HX-CIRCULATORY DIS NOS.............................. 11
V1251... HX-VEN THROMBOSIS/EMBOLS............................ 11
V1252... HX-THROMBOPHLEBITIS................................. 11
V1259... HX-CIRCULATORY DIS NEC.............................. 11
V126.... HX-RESPIRATORY SYS DIS.............................. 11
V1270... PRSNL HST UNSPC DGSTV DS............................ 11
V1271... PRSNL HST PEPTIC ULCR DS............................ 11
V1272... PRSNL HST COLONIC POLYPS............................ 11
V1279... PRSNL HST OT SPF DGST DS............................ 11
V1300... PRSNL HST URNR DSRD UNSP............................ 11
V1301... PRSNL HST URNR DSRD CALC............................ 11
V1309... PRSN HST OT SPF URN DSRD............................ 11
V131.... HX-TROPHOBLASTIC DISEASE............................ 11
V132.... HX-GENITAL/OBSTETRIC DIS............................ 11
V133.... HX-SKIN/SUBCUTAN TIS DIS............................ 11
V134.... HX OF ARTHRITIS..................................... 11
V135.... HX-MUSCULOSKELET DIS NEC............................ 11
V136.... HX-CONGENITAL MALFORM............................... 11
V137.... HX-PERINATAL PROBLEMS............................... 11
V138.... HX OF DISEASES NEC.................................. 11
V139.... HX OF DISEASE NOS................................... 11
V140.... HX-PENICILLIN ALLERGY............................... 11
V141.... HX-ANTIBIOT ALLERGY NEC............................. 11
V142.... HX-SULFONAMIDES ALLERGY............................. 11
V143.... HX-ANTI-INFECT ALLERGY.............................. 11
V144.... HX-ANESTHETIC ALLERGY............................... 11
V145.... HX-NARCOTIC ALLERGY................................. 11
V146.... HX-ANALGESIC ALLERGY................................ 11
V147.... HX-VACCINE ALLERGY.................................. 11
V148.... HX-DRUG ALLERGY NEC................................. 11
V149.... HX-DRUG ALLERGY NOS................................. 11
V150.... HX OF ALLERGY NEC................................... 11
V151.... HX-MAJOR CARDIOVASC SURG............................ 11
V152.... HX-MAJOR ORGAN SURG NEC............................. 11
V153.... HX OF IRRADIATION................................... 11
V155.... HX OF INJURY........................................ 11
V156.... HX OF POISONING..................................... 11
V157.... HX OF CONTRACEPTION................................. 11
V1581... HX OF PAST NONCOMPLIANCE............................ 11
V1582... HISTORY OF TOBACCO USE.............................. 11
V1584... HX-EXPOSURE ASBESTOS................................ 11
V1585... HX-EXPS HAZRD BODY FLUID............................ 11
V1586... HX-EXPOSURE TO LEAD................................. 11
V1589... HX-HEALTH HAZARDS NEC............................... 11
V159.... HX-HEALTH HAZARD NOS................................ 11
V160.... FAMILY HX-GI MALIGNANCY............................. 11
V161.... FM HX-TRACH/BRONCHOG MAL............................ 11
V162.... FAM HX-INTRATHORACIC MAL............................ 11
V163.... FAMILY HX-BREAST MALIG.............................. 11
V165.... FAMILY HX-URINARY MALIG............................. 11
V166.... FAMILY HX-LEUKEMIA.................................. 11
V167.... FAM HX-LYMPH NEOPLAS NEC............................ 11
V168.... FAMILY HX-MALIGNANCY NEC............................ 11
V169.... FAMILY HX-MALIGNANCY NOS............................ 11
V170.... FAM HX-PSYCHIATRIC COND............................. 11
V171.... FAMILY HX-STROKE.................................... 11
V172.... FAM HX-NEUROLOG DIS NEC............................. 11
[[Page 47990]]
V173.... FAM HX-ISCHEM HEART DIS............................. 11
V174.... FAM HX-CARDIOVAS DIS NEC............................ 11
V175.... FAMILY HX-ASTHMA.................................... 11
V176.... FAM HX-CHR RESP COND NEC............................ 11
V177.... FAMILY HX-ARTHRITIS................................. 11
V178.... FAM HX-MUSCLOSKL DIS NEC............................ 11
V180.... FAM HX-DIABETES MELLITUS............................ 11
V181.... FM HX-ENDO/METAB DIS NEC............................ 11
V182.... FAMILY HX-ANEMIA.................................... 11
V183.... FAM HX-BLOOD DISORD NEC............................. 11
V184.... FAM HX-MENTAL RETARDAT.............................. 11
V185.... FAMILY HX-GI DISORDERS.............................. 11
V186.... FAMILY HX-KIDNEY DISEASE............................ 11
V187.... FAMILY HX-GU DISEASE NEC............................ 11
V188.... FM HX-INFECT/PARASIT DIS............................ 11
V190.... FAMILY HX-BLINDNESS................................. 11
V191.... FAMILY HX-EYE DISORD NEC............................ 11
V192.... FAMILY HX-DEAFNESS.................................. 11
V193.... FAMILY HX-EAR DISORD NEC............................ 11
V194.... FAMILY HX-SKIN CONDITION............................ 11
V195.... FAM HX-CONGEN ANOMALIES............................. 11
V196.... FAMILY HX-ALLERGIC DIS.............................. 11
V197.... CONSANGUINITY....................................... 11
V198.... FAMILY HX-CONDITION NEC............................. 11
V200.... FOUNDLING HEALTH CARE............................... 11
V201.... CARE OF HEALTHY CHLD NEC............................ 11
V202.... ROUTIN CHILD HEALTH EXAM............................ 11
V210.... RAPID CHILDHOOD GROWTH.............................. 11
V211.... PUBERTY............................................. 11
V212.... ADOLESCENCE GROWTH NEC.............................. 11
V218.... CONSTIT STATE IN DEV NEC............................ 11
V219.... CONSTIT STATE IN DEV NOS............................ 11
V220.... SUPERVIS NORMAL 1ST PREG............................ 57
V221.... SUPERVIS OTH NORMAL PREG............................ 57
*V222... PREG STATE, INCIDENTAL.............................. ........
V230.... PREG W HX OF INFERTILITY............................ 57
V231.... PREG W HX-TROPHOBLAS DIS............................ 57
V232.... PREG W HX OF ABORTION............................... 57
V233.... GRAND MULTIPARITY................................... 57
V234.... PREG W POOR OBSTETRIC HX............................ 57
V235.... PREG W POOR REPRODUCT HX............................ 57
V237.... INSUFFICNT PRENATAL CARE............................ 57
V238.... SUPRV HIGH-RISK PREG NEC............................ 57
V239.... SUPRV HIGH-RISK PREG NOS............................ 57
V240.... POSTPART CARE AFTER DEL............................. 57
V241.... POSTPART CARE-LACTATION............................. 57
V242.... ROUT POSTPART FOLLOW-UP............................. 57
V2501... PRESCRIP-ORAL CONTRACEPT............................ 11
V2502... INITIATE CONTRACEPT NEC............................. 11
V2509... CONTRACEPTIVE MANGMT NEC............................ 11
V251.... INSERTION OF IUD.................................... 11
V252.... STERILIZATION....................................... 11
V253.... MENSTRUAL EXTRACTION................................ 56
V2540... CONTRACEPT SURVEILL NOS............................. 11
V2541... CONTRACEPT PILL SURVEILL............................ 11
V2542... IUD SURVEILLANCE.................................... 11
V2543... SRVL MPLNT SBDRM CNTRCEP............................ 11
V2549... CONTRACEPT SURVEILL NEC............................. 11
V255.... NSRT MPLNT SBDRM CNTRCEP............................ 11
V258.... CONTRACEPTIVE MANGMT NEC............................ 11
V259.... CONTRACEPTIVE MANGMT NOS............................ 11
V260.... TUBOPLASTY OR VASOPLASTY............................ 11
V261.... ARTIFICIAL INSEMINATION............................. 11
V262.... PROCREATIVE MGMT-INVEST............................. 11
V263.... GENETIC COUNSELING.................................. 11
V264.... PROCREATIVE MGMT-COUNSEL............................ 11
V268.... PROCREATIVE MANGMT NEC.............................. 11
V269.... PROCREATIVE MANGMT NOS.............................. 11
*V270... DELIVER-SINGLE LIVEBORN............................. ........
*V271... DELIVER-SINGLE STILLBORN............................ ........
*V272... DELIVER-TWINS, BOTH LIVE............................ ........
*V273... DEL-TWINS, 1 NB, 1 SB............................... ........
*V274... DELIVER-TWINS, BOTH SB.............................. ........
*V275... DEL-MULT BIRTH, ALL LIVE............................ ........
*V276... DEL-MULT BRTH, SOME LIVE............................ ........
*V277... DEL-MULT BIRTH, ALL SB.............................. ........
[[Page 47991]]
*V279... OUTCOME OF DELIVERY NOS............................. ........
V280.... SCREENING-CHROMOSOM ANOM............................ 57
V281.... SCREEN-ALPHAFETOPROTEIN............................. 57
V282.... SCREEN BY AMNIOCENT NEC............................. 57
V283.... SCREEN-FETAL MALFORM................................ 57
V284.... SCREEN-FETAL RETARDATION............................ 57
V285.... SCREEN-ISOIMMUNIZATION.............................. 57
V288.... ANTENATAL SCREENING NEC............................. 57
V289.... ANTENATAL SCREENING NOS............................. 57
V290.... NB OBSRV SUSPCT INFECT.............................. 11
V291.... NB OBSRV SUSPCT NEURLGCL............................ 11
V292.... OBSRV NB SUSPC RESP COND............................ 11
V298.... NB OBSRV OTH SUSPCT COND............................ 11
V299.... NB OBSRV UNSP SUSPCT CND............................ 11
V3000... SINGLE LB IN-HOSP W/O CS............................ 57
V3001... SINGLE LB IN-HOSP W CS.............................. 57
V301.... SINGL LIVEBRN-BEFORE ADM............................ 57
V302.... SINGLE LIVEBORN-NONHOSP............................. 57
V3100... TWIN-MATE LB-HOSP W/O CS............................ 57
V3101... TWIN-MATE LB-IN HOS W CS............................ 57
V311.... TWIN, MATE LB-BEFORE ADM............................ 57
V312.... TWIN, MATE LB-NONHOSP............................... 57
V3200... TWIN-MATE SB-HOSP W/O CS............................ 57
V3201... TWIN-MATE SB-HOSP W CS.............................. 57
V321.... TWIN, MATE SB-BEFORE ADM............................ 57
V322.... TWIN, MATE SB-NONHOSP............................... 57
V3300... TWIN-NOS-IN HOSP W/O CS............................. 57
V3301... TWIN-NOS-IN HOSP W CS............................... 57
V331.... TWIN NOS-BEFORE ADMISSN............................. 57
V332.... TWIN NOS-NONHOSP.................................... 57
V3400... OTH MULT LB-HOSP W/O CS............................. 57
V3401... OTH MULT LB-IN HOSP W CS............................ 57
V341.... OTH MULT NB-BEFORE ADM.............................. 57
V342.... OTH MULTIPLE NB-NONHOSP............................. 57
V3500... OTH MULT SB-HOSP W/O CS............................. 57
V3501... OTH MULT SB-IN HOSP W CS............................ 57
V351.... OTH MULT SB-BEFORE ADM.............................. 57
V352.... OTH MULTIPLE SB-NONHOSP............................. 57
V3600... MULT LB/SB-IN HOS W/O CS............................ 57
V3601... MULT LB/SB-IN HOSP W CS............................. 57
V361.... MULT NB/SB-BEFORE ADM............................... 57
V362.... MULTIPLE NB/SB-NONHOSP.............................. 57
V3700... MULT BRTH NOS-HOS W/O CS............................ 57
V3701... MULT BIRTH NOS-HOSP W CS............................ 57
V371.... MULT BRTH NOS-BEFORE ADM............................ 57
V372.... MULT BIRTH NOS-NONHOSP.............................. 57
V3900... LIVEBORN NOS-HOSP W/O CS............................ 57
V3901... LIVEBORN NOS-HOSP W CS.............................. 57
V391.... LIVEBORN NOS-BEFORE ADM............................. 57
V392.... LIVEBORN NOS-NONHOSP................................ 57
V400.... PROBLEMS WITH LEARNING.............................. 91
V401.... PROB WITH COMMUNICATION............................. 91
V402.... MENTAL PROBLEMS NEC................................. 91
V403.... BEHAVIORAL PROBLEMS NEC............................. 91
V409.... MENTAL/BEHAVIOR PROB NOS............................ 91
V410.... PROBLEMS WITH SIGHT................................. 11
V411.... EYE PROBLEMS NEC.................................... 11
V412.... PROBLEMS WITH HEARING............................... 11
V413.... EAR PROBLEMS NEC.................................... 11
V414.... VOICE PRODUCTION PROBLEM............................ 11
V415.... SMELL AND TASTE PROBLEM............................. 11
V416.... PROBLEM W SWALLOWING................................ 11
V417.... SEXUAL FUNCTION PROBLEM............................. 91
V418.... PROBL W SPECIAL FUNC NEC............................ 91
V419.... PROBL W SPECIAL FUNC NOS............................ 91
V420.... KIDNEY TRANSPLANT STATUS............................ 53
V421.... HEART TRANSPLANT STATUS............................. 36
V422.... HEART VALVE TRANSPLANT.............................. 36
V423.... SKIN TRANSPLANT STATUS.............................. 18
V424.... BONE TRANSPLANT STATUS.............................. 24
V425.... CORNEA TRANSPLANT STATUS............................ 68
V426.... LUNG TRANSPLANT STATUS.............................. 33
V427.... LIVER TRANSPLANT STATUS............................. 41
V429.... TRANSPLANT STATUS NOS............................... 11
V430.... EYE REPLACEMENT NEC................................. 68
V431.... LENS REPLACEMENT NEC................................ 11
[[Page 47992]]
V432.... HEART REPLACEMENT NEC............................... 36
V433.... HEART VALVE REPLAC NEC.............................. 36
V434.... BLOOD VESSEL REPLAC NEC............................. 36
V435.... BLADDER REPLACEMENT NEC............................. 53
V4360... JOINT REPLACED UNSPCF............................... 11
V4361... JOINT REPLACED SHOULDER............................. 11
V4362... JOINT REPLACED ELBOW................................ 11
V4363... JOINT REPLACED WRIST................................ 11
V4364... JOINT REPLACED HIP.................................. 11
V4365... JOINT REPLACED KNEE................................. 11
V4366... JOINT REPLACED ANKLE................................ 11
V4369... OTH SPCF JOINT REPLACED............................. 11
V437.... LIMB REPLACEMENT NEC................................ 24
V4381... LARYNX REPLACEMENT.................................. 11
V4382... BREAST REPLACEMENT.................................. 11
V4389... ORGAN/TISS REPLACMNT NEC............................ 11
V440.... TRACHEOSTOMY STATUS................................. 11
V441.... GASTROSTOMY STATUS.................................. 11
V442.... ILEOSTOMY STATUS.................................... 11
V443.... COLOSTOMY STATUS.................................... 11
V444.... ENTEROSTOMY STATUS NEC.............................. 11
V445.... CYSTOSTOMY STATUS................................... 11
V446.... URINOSTOMY STATUS NEC............................... 11
V447.... ARTIFICIAL VAGINA STATUS............................ 11
V448.... ARTIF OPEN STATUS NEC............................... 11
V449.... ARTIF OPEN STATUS NOS............................... 11
V4500... STATUS CARDC DVCE UNSPCF............................ 11
V4501... STATUS CARDIAC PACEMAKER............................ 11
V4502... STATUS AUTM CRD DFBRLTR............................. 11
V4509... STATUS OTH SPCF CRDC DVC............................ 11
V451.... RENAL DIALYSIS STATUS............................... 11
V452.... VENTRICULAR SHUNT STATUS............................ 11
V453.... INTESTINAL BYPASS STATUS............................ 11
V454.... ARTHRODESIS STATUS.................................. 11
V4551... PRSC NTRUTR CNTRCPTV DVC............................ 11
V4552... PRSC SBDRML CNTRCP MPLNT............................ 11
V4559... PRSC OTHER CNTRCPTV DVC............................. 11
V4581... AORTOCORONARY BYPASS................................ 11
V4582... STATUS-POST PTCA.................................... 11
V4583... BREAST IMPL REMOV STATUS............................ 11
V4589... POSTSURGICAL STATES NEC............................. 11
V460.... DEPENDENCE ON ASPIRATOR............................. 33
V461.... DEPENDENCE ON RESPIRATOR............................ 33
V468.... MACHINE DEPENDENCE NEC.............................. 11
V469.... MACHINE DEPENDENCE NOS.............................. 11
V470.... INTERN ORGAN DEFICIENCY............................. 11
V471.... MECH PROB W INTERNAL ORG............................ 11
V472.... CARDIORESPIRAT PROBL NEC............................ 11
V473.... DIGESTIVE PROBLEMS NEC.............................. 11
V474.... URINARY PROBLEMS NEC................................ 11
V475.... GENITAL PROBLEMS NEC................................ 11
V479.... PROBL W INTERNAL ORG NOS............................ 11
V480.... DEFICIENCIES OF HEAD................................ 11
V481.... DEFICIENCIES NECK/TRUNK............................. 11
V482.... MECHANICAL PROB W HEAD.............................. 11
V483.... MECH PROB W NECK & TRUNK............................ 11
V484.... SENSORY PROBLEM W HEAD.............................. 11
V485.... SENSOR PROB W NECK/TRUNK............................ 11
V486.... DISFIGUREMENTS OF HEAD.............................. 11
V487.... DISFIGUREMENT NECK/TRUNK............................ 11
V488.... PROB-HEAD/NECK/TRUNK NEC............................ 11
V489.... PROB-HEAD/NECK/TRUNK NOS............................ 11
V490.... DEFICIENCIES OF LIMBS............................... 11
V491.... MECHANICAL PROB W LIMBS............................. 11
V492.... MOTOR PROBLEMS W LIMBS.............................. 11
V493.... SENSORY PROBLEMS W LIMBS............................ 11
V494.... DISFIGUREMENTS OF LIMBS............................. 11
V495.... LIMB PROBLEMS NEC................................... 11
V4960... STATUS AMPUT UP LMB NOS............................. 11
V4961... STATUS AMPUT THUMB.................................. 11
V4962... STATUS AMPUT OTH FINGERS............................ 11
V4963... STATUS AMPUT HAND................................... 11
V4964... STATUS AMPUT WRIST.................................. 11
V4965... STATUS AMPUT BELOW ELBOW............................ 11
V4966... STATUS AMPUT ABOVE ELBOW............................ 11
V4967... STATUS AMPUT SHOULDER............................... 11
[[Page 47993]]
V4970... STATUS AMPUT LWR LMB NOS............................ 11
V4971... STATUS AMPUT GREAT TOE.............................. 11
V4972... STATUS AMPUT OTHR TOE(S)............................ 11
V4973... STATUS AMPUT FOOT................................... 11
V4974... STATUS AMPUT ANKLE.................................. 11
V4975... STATUS AMPUT BELOW KNEE............................. 11
V4976... STATUS AMPUT ABOVE KNEE............................. 11
V4977... STATUS AMPUT HIP.................................... 11
V498.... PROBL INFLU HEALTH NEC.............................. 11
V499.... PROBL INFLU HEALTH NOS.............................. 11
V500.... HAIR TRANSPLANT..................................... 11
V501.... PLASTIC SURGERY NEC................................. 11
V502.... ROUTINE CIRCUMCISION................................ 11
V503.... EAR PIERCING........................................ 11
V5041... PRPHYLCT ORGN RMVL BRST............................. 11
V5042... PRPHYLCT ORGN RMVL OVARY............................ 11
V5049... PRPHYLCT ORGN RMVL OTHER............................ 11
V508.... ELECTIVE SURGERY NEC................................ 11
V509.... ELECTIVE SURGERY NOS................................ 11
V51..... AFTERCARE W PLASTIC SURG............................ 18
V520.... FITTING ARTIFICIAL ARM.............................. 24
V521.... FITTING ARTIFICIAL LEG.............................. 24
V522.... FITTING ARTIFICIAL EYE.............................. 11
V523.... FITTING DENTAL PROSTHES............................. 31
V524.... FIT/ADJ BREAST PROS/IMPL............................ 18
V528.... FITTING PROSTHESIS NEC.............................. 24
V529.... FITTING PROSTHESIS NOS.............................. 24
V531.... FIT CONTACT LENS/GLASSES............................ 68
V532.... ADJUSTMENT HEARING AID.............................. 31
V533.... ADJUST CARDIAC PACEMAKER*........................... 36
V5331... FTNG CARDIAC PACEMAKER.............................. 11
V5332... FTNG AUTMTC DFIBRILLATOR............................ 11
V5339... FTNG OTH CARDIAC DEVICE............................. 11
V534.... FIT ORTHODONTIC DEVICE.............................. 31
V535.... FIT/ADJ INTES APPL NEC.............................. 41
V536.... FITTING URINARY DEVICES............................. 53
V537.... FIT ORTHOPEDIC DEVICES.............................. 24
V538.... ADJUSTMENT OF WHEELCHAIR............................ 24
V539.... ADJUSTMNT DEVICE NEC/NOS............................ 24
V540.... REMOVAL INT FIXATION DEV............................ 11
V548.... ORTHOPEDIC AFTERCARE NEC............................ 24
V549.... ORTHOPEDIC AFTERCARE NOS............................ 24
V550.... ATTEN TO TRACHEOSTOMY............................... 31
V551.... ATTEN TO GASTROSTOMY................................ 41
V552.... ATTEN TO ILEOSTOMY.................................. 41
V553.... ATTEN TO COLOSTOMY.................................. 41
V554.... ATTEN TO ENTEROSTOMY NEC............................ 41
V555.... ATTEN TO CYSTOSTOMY................................. 53
V556.... ATTEN TO URINOSTOMY NEC............................. 53
V557.... ATTEN ARTIFICIAL VAGINA............................. 56
V558.... ATTN TO ARTIF OPEN NEC.............................. 11
V559.... ATTN TO ARTIF OPEN NOS.............................. 11
V560.... RENAL DIALYSIS ENCOUNTER............................ 11
V561.... FIT/ADJ DIALYSIS CATHETR............................ ........
V568.... DIALYSIS ENCOUNTER, NEC............................. 53
V570.... BREATHING EXERCISES................................. 11
V571.... PHYSICAL THERAPY NEC................................ 11
V5721... ENCNTR OCCUPATNAL THRPY............................. 11
V5722... ENCNTR VOCATIONAL THRPY............................. 11
V573.... SPEECH THERAPY...................................... 11
V574.... ORTHOPTIC TRAINING.................................. 11
V5781... ORTHOTIC TRAINING................................... 24
V5789... REHABILITATION PROC NEC............................. 11
V579.... REHABILITATION PROC NOS............................. 11
V580.... RADIOTHERAPY ENCOUNTER.............................. 11
V581.... CHEMOTHERAPY ENCOUNTER.............................. 11
V582.... BLOOD TRANSFUSION, NO DX............................ 11
V583.... ATTEN-SURG DRESSNG/SUTUR............................ 11
V584.... POSTSURG AFTERCARE NEC*............................. 11
V5841... ENCNTR PLND PO WND CLSR............................. 11
V5849... POSTOP OTH SPECFD AFTRCR............................ 11
V585.... ORTHODONTICS AFTERCARE.............................. 31
V5861... LONG-TERM USE ANTICOAGUL............................ 36
V5869... LONG-TERM USE MEDS NEC.............................. 11
V5881... FIT/ADJ VASCULAR CATHETR............................ 11
*V5882.. FIT/ADJ NON-VSC CATH NEC............................ ........
[[Page 47994]]
V5889... OTHER SPECFIED AFTERCARE............................ 11
V589.... AFTERCARE NOS....................................... 11
V5901... BLOOD DONOR-WHOLE BLOOD............................. 11
V5902... BLOOD DONOR-STEM CELLS.............................. 11
V5909... BLOOD DONOR NEC..................................... 11
V591.... SKIN DONOR.......................................... 11
V592.... BONE DONOR.......................................... 11
V593.... BONE MARROW DONOR................................... 11
V594.... KIDNEY DONOR........................................ 11
V595.... CORNEA DONOR........................................ 11
V596.... LIVER DONOR......................................... 11
V598.... ORG OR TISSUE DONOR NEC............................. 11
V599.... ORG OR TISSUE DONOR NOS............................. 11
V600.... LACK OF HOUSING..................................... 91
V601.... INADEQUATE HOUSING.................................. 91
V602.... ECONOMIC PROBLEM.................................... 91
V603.... PERSON LIVING ALONE................................. 91
V604.... NO FAMILY ABLE TO CARE.............................. 91
V605.... HOLIDAY RELIEF CARE................................. 91
V606.... PERSON IN RESIDENT INST............................. 91
V608.... HOUSING/ECONO CIRCUM NEC............................ 91
V609.... HOUSING/ECONO CIRCUM NOS............................ 91
V610.... FAMILY DISRUPTION................................... 91
V6120... CNSL PRNT-CHLD PROB NOS............................. 91
V6121... CNSL VICTIM CHILD ABUSE............................. 91
V6129... PARENT-CHILD PROBLEM NEC............................ 91
V613.... PROBLEM W AGED PARENT............................... 91
V6141... ALCOHOLISM IN FAMILY................................ 91
V6149... FAMILY HEALTH PROBL NEC............................. 91
V615.... MULTIPARITY......................................... 56
V616.... ILLEGITIMATE PREGNANCY.............................. 91
V617.... UNWANTED PREGNANCY NEC.............................. 91
V618.... FAMILY CIRCUMSTANCES NEC............................ 91
V619.... FAMILY CIRCUMSTANCE NOS............................. 91
V620.... UNEMPLOYMENT........................................ 91
V621.... ADVERSE EFF-WORK ENVIRON............................ 91
V622.... OCCUP CIRCUMSTANCES NEC............................. 91
V623.... EDUCATIONAL CIRCUMSTANCE............................ 91
V624.... SOCIAL MALADJUSTMENT................................ 91
V625.... LEGAL CIRCUMSTANCES................................. 91
V626.... REFUSAL OF TREATMENT................................ 91
V6281... INTERPERSONAL PROBL NEC............................. 91
V6282... BEREAVEMENT, UNCOMPLICAT............................ 91
V6289... PSYCHOLOGICAL STRESS NEC............................ 91
V629.... PSYCHOSOCIAL CIRCUM NOS............................. 91
V630.... HOME REMOTE FROM HOSPITL............................ 91
V631.... NO MEDICAL SERV IN HOME............................. 91
V632.... WAIT ADM TO OTH FACILITY............................ 91
V638.... NO MED FACILITIES NEC............................... 91
V639.... NO MED FACILITIES NOS............................... 91
V640.... NO VACCIN/CONTRAINDICAT............................. 11
V641.... NO PROC/CONTRAINDICATION............................ 11
V642.... NO PROC/PATIENT DECISION............................ 11
V643.... NO PROC FOR REASONS NEC............................. 11
V650.... HEALTHY PERSON W SICK............................... 11
V651.... PERSON CONSULT FOR ANOTH............................ 91
V652.... PERSON FEIGNING ILLNESS............................. 91
V653.... DIETARY SURVEIL/COUNSEL............................. 82
V6540... COUNSELING NOS...................................... 91
V6541... EXERCISE COUNSELING................................. 11
V6542... COUNSLNG SBSTN USE ABUSE............................ 91
V6543... COUNSELING INJRY PREVENT............................ 11
V6544... HIV COUNSELING...................................... 86
V6545... CONSLN OT SEX TRNSMT DIS............................ 97
V6549... OTHER SPECFD COUNSELING............................. 11
V655.... PERSN W FEARED COMPLAINT............................ 91
V658.... REASON FOR CONSULT NEC.............................. 91
V659.... REASON FOR CONSULT NOS.............................. 91
V660.... SURGICAL CONVALESCENCE.............................. 11
V661.... RADIOTHERAPY CONVALESCEN............................ 11
V662.... CHEMOTHERAPY CONVALESCEN............................ 11
V663.... MENTAL DIS CONVALESCENCE............................ 11
V664.... FRACTURE TREATMNT CONVAL............................ 11
V665.... CONVALESCENCE NEC................................... 11
V666.... COMB TREATMENT CONVALES............................. 11
V669.... CONVALESCENCE NOS................................... 11
[[Page 47995]]
V670.... SURGERY FOLLOW-UP................................... 11
V671.... RADIOTHERAPY FOLLOW-UP.............................. 11
V672.... CHEMOTHERAPY FOLLOW-UP.............................. 11
V673.... PSYCHIATRIC FOLLOW-UP............................... 91
V674.... FU EXAM TREATD HEALED FX............................ 11
V6751... HIGH-RISK RX NEC EXAM............................... 11
V6759... FOLLOW-UP EXAM NEC.................................. 11
V676.... COMB TREATMENT FOLLOW-UP............................ 11
V679.... FOLLOW-UP EXAM NOS.................................. 11
V680.... ISSUE MEDICAL CERTIFICAT............................ 91
V681.... ISSUE REPEAT PRESCRIPT.............................. 11
V682.... REQUEST EXPERT EVIDENCE............................. 11
V6881... REFERRAL-NO EXAM/TREAT.............................. 11
V6889... ADMINISTRTVE ENCOUNT NEC............................ 11
V689.... ADMINISTRTVE ENCOUNT NOS............................ 11
V690.... LACK OF PHYSICAL EXERCSE............................ 11
V691.... INAPPRT DIET EAT HABITS............................. 11
V692.... HIGH-RISK SEXUAL BEHAVR............................. 97
V693.... GAMBLING AND BETTING................................ 91
V698.... OTH PRBLMS RLTD LFSTYLE............................. 91
V699.... PRBLM RLTD LFSTYLE NOS.............................. 91
V700.... ROUTINE MEDICAL EXAM................................ 11
V701.... PSYCH EXAM-AUTHORITY REQ............................ 91
V702.... GEN PSYCHIATRIC EXAM NEC............................ 91
V703.... MED EXAM NEC-ADMIN PURP............................. 11
V704.... EXAM-MEDICOLEGAL REASONS............................ 11
V705.... HEALTH EXAM-GROUP SURVEY............................ 11
V706.... HEALTH EXAM-POP SURVEY.............................. 11
V707.... EXAM-CLINICAL RESEARCH.............................. 11
V708.... GENERAL MEDICAL EXAM NEC............................ 11
V709.... GENERAL MEDICAL EXAM NOS............................ 11
V7101... OBSV-ADULT ANTISOC BEHAV............................ 91
V7102... OBSV-ADOLESC ANTISOC BEH............................ 91
V7109... OBSERV-MENTAL COND NEC.............................. 91
V711.... OBSV-SUSPCT MAL NEOPLASM............................ 88
V712.... OBSERV-SUSPECT TB................................... 11
V713.... OBSERV-WORK ACCIDENT................................ 11
V714.... OBSERV-ACCIDENT NEC................................. 11
V715.... OBSERV FOLLOWING RAPE............................... 91
V716.... OBSERV-INFLICTED INJ NEC............................ 11
V717.... OBS-SUSP CARDIOVASC DIS............................. 11
V718.... OBSERV-SUSPECT COND NEC............................. 11
V719.... OBSERV-SUSPECT COND NOS............................. 11
V720.... EYE & VISION EXAMINATION............................ 68
V721.... EAR & HEARING EXAM.................................. 31
V722.... DENTAL EXAMINATION.................................. 31
V723.... GYNECOLOGIC EXAMINATION............................. 56
V724.... PREG EXAM-PREG UNCONFIRM............................ 56
V725.... RADIOLOGICAL EXAM NEC............................... 11
V726.... LABORATORY EXAMINATION.............................. 11
V727.... SKIN/SENSITIZATION TESTS............................ 11
V7281... PREOP CARDIOVSCLR EXAM.............................. 11
V7282... PREOP RESPIRATORY EXAM.............................. 11
V7283... OTH SPCF PREOP EXAM................................. 11
V7284... PREOP EXAM UNSPCF................................... 11
V7285... OTH SPECIFIED EXAM.................................. 11
V729.... EXAMINATION NOS..................................... 11
V730.... SCREENING-POLIOMYELITIS............................. 11
V731.... SCREENING FOR SMALLPOX.............................. 11
V732.... SCREENING FOR MEASLES............................... 11
V733.... SCREENING FOR RUBELLA............................... 11
V734.... SCREENING-YELLOW FEVER.............................. 11
V735.... SCREENING-ARBOVIRUS DIS............................. 11
V736.... SCREENING FOR TRACHOMA.............................. 11
V7388... SCRN OTH SPCF CHLMYD DIS............................ 11
V7389... SCRN OTH SPCF VIRAL DIS............................. 11
V7398... SCRN UNSPCF CHLMYD DIS.............................. 11
V7399... SCRN UNSPCF VIRAL DIS............................... 11
V740.... SCREENING FOR CHOLERA............................... 11
V741.... SCREENING-PULMONARY TB.............................. 11
V742.... SCREENING FOR LEPROSY............................... 11
V743.... SCREENING FOR DIPHTHERIA............................ 11
V744.... SCREEN-BACT CONJUNCTIVIT............................ 11
V745.... SCREEN FOR VENERAL DIS.............................. 11
V746.... SCREENING FOR YAWS.................................. 11
V748.... SCREEN-BACTERIAL DIS NEC............................ 11
[[Page 47996]]
V749.... SCREEN-BACTERIAL DIS NOS............................ 11
V750.... SCREEN-RICKETTSIAL DIS.............................. 11
V751.... SCREENING FOR MALARIA............................... 11
V752.... SCREEN FOR LEISHMANIASIS............................ 11
V753.... SCREEN-TRYPANOSOMIASIS.............................. 11
V754.... SCREEN-MYCOTIC INFECT............................... 11
V755.... SCREEN-SCHISTOSOMIASIS.............................. 11
V756.... SCREEN FOR FILARIASIS............................... 11
V757.... SCREEN FOR HELMINTHIASIS............................ 11
V758.... SCREEN-PARASITIC DIS NEC............................ 11
V759.... SCREEN FOR INFEC DIS NOS............................ 11
V760.... SCREEN MAL NEOP-RESP ORG............................ 11
V762.... SCREEN MAL NEOP-CERVIX.............................. 11
V763.... SCREEN MAL NEOP-BLADDER............................. 11
V7641... SCREEN MAL NEOP-RECTUM.............................. 11
V7642... SCREEN MAL NEOP-ORAL CAV............................ 11
V7643... SCREEN MAL NEOP-SKIN................................ 11
V7649... SCREEN MAL NEOP-SITE NEC............................ 11
V768.... SCREEN-NEOPLASM NEC................................. 11
V769.... SCREEN-NEOPLASM NOS................................. 11
V770.... SCREEN-THYROID DISORDER............................. 11
V771.... SCREEN-DIABETES MELLITUS............................ 11
V772.... SCREEN FOR MALNUTRITION............................. 11
V773.... SCREEN-PHENYLKETONURIA.............................. 11
V774.... SCREEN FOR GALACTOSEMIA............................. 11
V775.... SCREENING FOR GOUT.................................. 11
V776.... SCREEN-CYSTIC FIBROSIS.............................. 11
V777.... SCREEN-INBORN ERR METAB............................. 11
V778.... SCREENING FOR OBESITY............................... 11
V779.... SCREEN-ENDOC/NUT/MET NEC............................ 11
V780.... SCREEN-IRON DEFIC ANEMIA............................ 11
V781.... SCREEN-DEFIC ANEMIA NEC............................. 11
V782.... SCREEN-SICKLE CELL DIS.............................. 11
V783.... SCRN-HEMOGLOBINOPATH NEC............................ 11
V788.... SCREEN-BLOOD DIS NEC................................ 11
V789.... SCREEN-BLOOD DIS NOS................................ 11
V790.... SCREENING FOR DEPRESSION............................ 11
V791.... SCREENING FOR ALCOHOLISM............................ 11
V792.... SCREEN-MENTAL RETARDAT.............................. 11
V793.... SCREEN-DEVELOPMENT PROB............................. 11
V798.... SCREEN-MENTAL DIS NEC............................... 11
V799.... SCREEN-MENTAL DIS NOS............................... 11
V800.... SCREEN-NEUROLOGICAL COND............................ 11
V801.... SCREENING FOR GLAUCOMA.............................. 11
V802.... SCREENING-EYE COND NEC.............................. 11
V803.... SCREENING FOR EAR DIS............................... 11
V810.... SCRN-ISCHEMIC HEART DIS............................. 11
V811.... SCREEN FOR HYPERTENSION............................. 11
V812.... SCREEN-CARDIOVASC NEC............................... 11
V813.... SCREEN-BRONCH/EMPHYSEMA............................. 11
V814.... SCREEN-RESPIR COND NEC.............................. 11
V815.... SCREEN FOR NEPHROPATHY.............................. 11
V816.... SCREEN FOR GU COND NEC.............................. 11
V820.... SCREEN FOR SKIN COND................................ 11
V821.... SCREEN-RHEUMATOID ARTHR............................. 11
V822.... SCREEN-RHEUMAT DIS NEC.............................. 11
V823.... SCREEN-CONG HIP DISLOCAT............................ 11
V824.... POSTNAT SCREEN-CHROM ABN............................ 11
V825.... SCREEN-CONTAMINATION NEC............................ 11
V826.... MULTIPHASIC SCREENING............................... 11
V828.... SCREEN FOR CONDITION NEC............................ 11
V829.... SCREEN FOR CONDITION NOS............................ 11
------------------------------------------------------------------------
Addendum G.--CPT Codes Which Would be Paid Only as Inpatient Procedures
------------------------------------------------------------------------
CPT \1\/
HCPCS HOPD status indicator Description
---\2\------------------------------------------------------------------
15756... C Free muscle flap, microvasc
15757... C Free skin flap, microvasc
15758... C Free fascial flap, microvasc
19200... C Removal of breast
19220... C Removal of breast
19240... C Removal of breast
19260... C Removal of chest wall lesion
19271... C Revision of chest wall
19272... C Extensive chest wall surgery
19361... C Breast reconstruction
19364... C Breast reconstruction
19367... C Breast reconstruction
[[Page 47997]]
19368... C Breast reconstruction
19369... C Breast reconstruction
20100... C Explore wound, neck
20101... C Explore wound, chest
20102... C Explore wound, abdomen
20103... C Explore wound, extremity
20150... C Excise epiphyseal bar
20660... C Apply,remove fixation device
20661... C Application of head brace
20662... C Application of pelvis brace
20663... C Application of thigh brace
20664... C Halo brace application
20802... C Replantation, arm, complete
20805... C Replant forearm, complete
20808... C Replantation, hand, complete
20816... C Replantation digit, complete
20822... C Replantation digit, complete
20824... C Replantation thumb, complete
20827... C Replantation thumb, complete
20838... C Replantation, foot, complete
20930... C Spinal bone allograft
20931... C Spinal bone allograft
20936... C Spinal bone autograft
20937... C Spinal bone autograft
20938... C Spinal bone autograft
20955... C Fibula bone graft, microvasc
20956... C Iliac bone graft, microvasc
20957... C Mt bone graft, microvasc
20962... C Other bone graft, microvasc
20969... C Bone/skin graft, microvasc
20970... C Bone/skin graft, iliac crest
20972... C Bone-skin graft, metatarsal
20973... C Bone-skin graft, great toe
21045... C Extensive jaw surgery
21137... C Reduction of forehead
21138... C Reduction of forehead
21139... C Reduction of forehead
21141... C Reconstruct midface, lefort
21142... C Reconstruct midface, lefort
21143... C Reconstruct midface, lefort
21145... C Reconstruct midface, lefort
21146... C Reconstruct midface, lefort
21147... C Reconstruct midface, lefort
21150... C Reconstruct midface, lefort
21151... C Reconstruct midface, lefort
21154... C Reconstruct midface, lefort
21155... C Reconstruct midface, lefort
21159... C Reconstruct midface, lefort
21160... C Reconstruct midface, lefort
21172... C Reconstruct orbit/forehead
21175... C Reconstruct orbit/forehead
21179... C Reconstruct entire forehead
21180... C Reconstruct entire forehead
21182... C Reconstruct cranial bone
21183... C Reconstruct cranial bone
21184... C Reconstruct cranial bone
21188... C Reconstruction of midface
21193... C Reconstruct lower jaw bone
21194... C Reconstruct lower jaw bone
21195... C Reconstruct lower jaw bone
21196... C Reconstruct lower jaw bone
21198... C Reconstruct lower jaw bone
21247... C Reconstruct lower jaw bone
21255... C Reconstruct lower jaw bone
21256... C Reconstruction of orbit
21261... C Revise eye sockets
21263... C Revise eye sockets
21268... C Revise eye sockets
21344... C Repair of sinus fracture
21346... C Repair of nose/jaw fracture
21347... C Repair of nose/jaw fracture
21348... C Repair of nose/jaw fracture
21356... C Repair cheek bone fracture
21360... C Repair cheek bone fracture
21365... C Repair cheek bone fracture
21366... C Repair cheek bone fracture
21385... C Repair eye socket fracture
21386... C Repair eye socket fracture
21387... C Repair eye socket fracture
21390... C Repair eye socket fracture
21395... C Repair eye socket fracture
21406... C Repair eye socket fracture
21407... C Repair eye socket fracture
21408... C Repair eye socket fracture
21422... C Repair mouth roof fracture
21423... C Repair mouth roof fracture
21431... C Treat craniofacial fracture
21432... C Repair craniofacial fracture
21433... C Repair craniofacial fracture
21435... C Repair craniofacial fracture
21436... C Repair craniofacial fracture
21470... C Repair lower jaw fracture
21495... C Repair hyoid bone fracture
21510... C Drainage of bone lesion
21557... C Remove tumor, neck or chest
21615... C Removal of rib
21616... C Removal of rib and nerves
21620... C Partial removal of sternum
21627... C Sternal debridement
21630... C Extensive sternum surgery
21632... C Extensive sternum surgery
21705... C Revision of neck muscle/rib
21740... C Reconstruction of sternum
21750... C Repair of sternum separation
21810... C Treatment of rib fracture(s)
21825... C Repair sternum fracture
22100... C Remove part of neck vertebra
22101... C Remove part, thorax vertebra
22102... C Remove part, lumbar vertebra
22103... C Remove extra spine segment
22110... C Remove part of neck vertebra
22112... C Remove part, thorax vertebra
22114... C Remove part, lumbar vertebra
22116... C Remove extra spine segment
22210... C Revision of neck spine
22212... C Revision of thorax spine
22214... C Revision of lumbar spine
22216... C Revise, extra spine segment
22220... C Revision of neck spine
22222... C Revision of thorax spine
22224... C Revision of lumbar spine
22226... C Revise, extra spine segment
22325... C Repair of spine fracture
22326... C Repair neck spine fracture
22327... C Repair thorax spine fracture
22328... C Repair each add spine fx
22548... C Neck spine fusion
22554... C Neck spine fusion
22556... C Thorax spine fusion
22558... C Lumbar spine fusion
22585... C Additional spinal fusion
22590... C Spine & skull spinal fusion
22595... C Neck spinal fusion
22600... C Neck spine fusion
22610... C Thorax spine fusion
22612... C Lumbar spine fusion
22614... C Spine fusion, extra segment
22630... C Lumbar spine fusion
22632... C Spine fusion, extra segment
22800... C Fusion of spine
22802... C Fusion of spine
22804... C Fusion of spine
22808... C Fusion of spine
22810... C Fusion of spine
22812... C Fusion of spine
22818... C Kyphectomy, 1-2 segments
22819... C Kyphectomy, 3 & more segments
22830... C Exploration of spinal fusion
22840... C Insert spine fixation device
22841... C Insert spine fixation device
22842... C Insert spine fixation device
22843... C Insert spine fixation device
22844... C Insert spine fixation device
22845... C Insert spine fixation device
22846... C Insert spine fixation device
22847... C Insert spine fixation device
22848... C Insert pelvic fixation device
22849... C Reinsert spinal fixation
22850... C Remove spine fixation device
22851... C Apply spine prosth device
22852... C Remove spine fixation device
22855... C Remove spine fixation device
23035... C Drain shoulder bone lesion
23125... C Removal of collarbone
23195... C Removal of head of humerus
23200... C Removal of collar bone
23210... C Removal of shoulderblade
23220... C Partial removal of humerus
23221... C Partial removal of humerus
23222... C Partial removal of humerus
23332... C Remove shoulder foreign body
23395... C Muscle transfer, shoulder/arm
23397... C Muscle transfers
23400... C Fixation of shoulder blade
23440... C Removal/transplant tendon
23470... C Reconstruct shoulder joint
23472... C Reconstruct shoulder joint
23900... C Amputation of arm & girdle
23920... C Amputation at shoulder joint
24149... C Radical resection of elbow
24150... C Extensive humerus surgery
24151... C Extensive humerus surgery
24152... C Extensive radius surgery
24153... C Extensive radius surgery
24900... C Amputation of upper arm
24920... C Amputation of upper arm
24930... C Amputation follow-up surgery
24931... C Amputate upper arm & implant
24935... C Revision of amputation
24940... C Revision of upper arm
25170... C Extensive forearm surgery
25390... C Shorten radius/ulna
25391... C Lengthen radius/ulna
25392... C Shorten radius & ulna
25393... C Lengthen radius & ulna
25405... C Repair/graft radius or ulna
25420... C Repair/graft radius & ulna
25900... C Amputation of forearm
25905... C Amputation of forearm
25909... C Amputation follow-up surgery
25915... C Amputation of forearm
25920... C Amputate hand at wrist
25924... C Amputation follow-up surgery
25927... C Amputation of hand
25931... C Amputation follow-up surgery
26551... C Great toe-hand transfer
26553... C Single toe-hand transfer
26554... C Double toe-hand transfer
26556... C Toe joint transfer
26992... C Drainage of bone lesion
27005... C Incision of hip tendon
27006... C Incision of hip tendons
27025... C Incision of hip/thigh fascia
27030... C Drainage of hip joint
27035... C Denervation of hip joint
27036... C Excision of hip joint/muscle
[[Page 47998]]
27054... C Removal of hip joint lining
27070... C Partial removal of hip bone
27071... C Partial removal of hip bone
27075... C Extensive hip surgery
27076... C Extensive hip surgery
27077... C Extensive hip surgery
27078... C Extensive hip surgery
27079... C Extensive hip surgery
27090... C Removal of hip prosthesis
27091... C Removal of hip prosthesis
27120... C Reconstruction of hip socket
27122... C Reconstruction of hip socket
27125... C Partial hip replacement
27130... C Total hip replacement
27132... C Total hip replacement
27134... C Revise hip joint replacement
27137... C Revise hip joint replacement
27138... C Revise hip joint replacement
27140... C Transplant of femur ridge
27146... C Incision of hip bone
27147... C Revision of hip bone
27151... C Incision of hip bones
27156... C Revision of hip bones
27158... C Revision of pelvis
27161... C Incision of neck of femur
27165... C Incision/fixation of femur
27170... C Repair/graft femur head/neck
27175... C Treat slipped epiphysis
27176... C Treat slipped epiphysis
27177... C Repair slipped epiphysis
27178... C Repair slipped epiphysis
27179... C Revise head/neck of femur
27181... C Repair slipped epiphysis
27185... C Revision of femur epiphysis
27187... C Reinforce hip bones
27215... C Pelvic fracture(s) treatment
27216... C Treat pelvic ring fracture
27217... C Treat pelvic ring fracture
27218... C Treat pelvic ring fracture
27222... C Treat hip socket fracture
27226... C Treat hip wall fracture
27227... C Treat hip fracture(s)
27228... C Treat hip fracture(s)
27232... C Treat fracture of thigh
27235... C Repair of thigh fracture
27236... C Repair of thigh fracture
27240... C Treatment of thigh fracture
27244... C Repair of thigh fracture
27245... C Repair of thigh fracture
27248... C Repair of thigh fracture
27253... C Repair of hip dislocation
27254... C Repair of hip dislocation
27258... C Repair of hip dislocation
27259... C Repair of hip dislocation
27280... C Fusion of sacroiliac joint
27282... C Fusion of pubic bones
27284... C Fusion of hip joint
27286... C Fusion of hip joint
27290... C Amputation of leg at hip
27295... C Amputation of leg at hip
27303... C Drainage of bone lesion
27365... C Extensive leg surgery
27445... C Revision of knee joint
27446... C Revision of knee joint
27447... C Total knee replacement
27448... C Incision of thigh
27450... C Incision of thigh
27454... C Realignment of thigh bone
27455... C Realignment of knee
27457... C Realignment of knee
27465... C Shortening of thigh bone
27466... C Lengthening of thigh bone
27468... C Shorten/lengthen thighs
27470... C Repair of thigh
27472... C Repair/graft of thigh
27475... C Surgery to stop leg growth
27477... C Surgery to stop leg growth
27479... C Surgery to stop leg growth
27485... C Surgery to stop leg growth
27486... C Revise knee joint replace
27487... C Revise knee joint replace
27488... C Removal of knee prosthesis
27495... C Reinforce thigh
27506... C Repair of thigh fracture
27507... C Treatment of thigh fracture
27511... C Treatment of thigh fracture
27513... C Treatment of thigh fracture
27514... C Repair of thigh fracture
27519... C Repair of thigh growth plate
27524... C Repair of kneecap fracture
27535... C Treatment of knee fracture
27536... C Repair of knee fracture
27540... C Repair of knee fracture
27557... C Repair of knee dislocation
27558... C Repair of knee dislocation
27580... C Fusion of knee
27590... C Amputate leg at thigh
27591... C Amputate leg at thigh
27592... C Amputate leg at thigh
27596... C Amputation follow-up surgery
27598... C Amputate lower leg at knee
27645... C Extensive lower leg surgery
27646... C Extensive lower leg surgery
27702... C Reconstruct ankle joint
27703... C Reconstruction, ankle joint
27712... C Realignment of lower leg
27715... C Revision of lower leg
27720... C Repair of tibia
27722... C Repair/graft of tibia
27724... C Repair/graft of tibia
27725... C Repair of lower leg
27727... C Repair of lower leg
27880... C Amputation of lower leg
27881... C Amputation of lower leg
27882... C Amputation of lower leg
27886... C Amputation follow-up surgery
27888... C Amputation of foot at ankle
28800... C Amputation of midfoot
28805... C Amputation thru metatarsal
31225... C Removal of upper jaw
31230... C Removal of upper jaw
31290... C Nasal/sinus endoscopy, surg
31291... C Nasal/sinus endoscopy, surg
31292... C Nasal/sinus endoscopy, surg
31293... C Nasal/sinus endoscopy, surg
31294... C Nasal/sinus endoscopy, surg
31360... C Removal of larynx
31365... C Removal of larynx
31367... C Partial removal of larynx
31368... C Partial removal of larynx
31370... C Partial removal of larynx
31375... C Partial removal of larynx
31380... C Partial removal of larynx
31382... C Partial removal of larynx
31390... C Removal of larynx & pharynx
31395... C Reconstruct larynx & pharynx
31580... C Revision of larynx
31582... C Revision of larynx
31584... C Repair of larynx fracture
31587... C Revision of larynx
31600... C Incision of windpipe
31601... C Incision of windpipe
31610... C Incision of windpipe
31725... C Clearance of airways
31760... C Repair of windpipe
31766... C Reconstruction of windpipe
31770... C Repair/graft of bronchus
31775... C Reconstruct bronchus
31780... C Reconstruct windpipe
31781... C Reconstruct windpipe
31785... C Remove windpipe lesion
31786... C Remove windpipe lesion
31800... C Repair of windpipe injury
31805... C Repair of windpipe injury
32005... C Treat lung lining chemically
32035... C Exploration of chest
32036... C Exploration of chest
32095... C Biopsy through chest wall
32100... C Exploration/biopsy of chest
32110... C Explore/repair chest
32120... C Re-exploration of chest
32124... C Explore chest, free adhesions
32140... C Removal of lung lesion(s)
32141... C Remove/treat lung lesions
32150... C Removal of lung lesion(s)
32151... C Remove lung foreign body
32160... C Open chest heart massage
32200... C Open drainage, lung lesion
32201... C Percut drainage, lung lesion
32215... C Treat chest lining
32220... C Release of lung
32225... C Partial release of lung
32310... C Removal of chest lining
32320... C Free/remove chest lining
32402... C Open biopsy chest lining
32440... C Removal of lung
32442... C Sleeve pneumonectomy
32445... C Removal of lung
32480... C Partial removal of lung
32482... C Bilobectomy
32484... C Segmentectomy
32486... C Sleeve lobectomy
32488... C Completion pneumonectomy
32491... C Lung volume reduction
32500... C Partial removal of lung
32501... C Repair bronchus (add-on)
32520... C Remove lung & revise chest
32522... C Remove lung & revise chest
32525... C Remove lung & revise chest
32540... C Removal of lung lesion
32601... C Thoracoscopy, diagnostic
32602... C Thoracoscopy, diagnostic
32603... C Thoracoscopy, diagnostic
32604... C Thoracoscopy, diagnostic
32605... C Thoracoscopy, diagnostic
32606... C Thoracoscopy, diagnostic
32650... C Thoracoscopy, surgical
32651... C Thoracoscopy, surgical
32652... C Thoracoscopy, surgical
32653... C Thoracoscopy, surgical
32654... C Thoracoscopy, surgical
32655... C Thoracoscopy, surgical
32656... C Thoracoscopy, surgical
32657... C Thoracoscopy, surgical
32658... C Thoracoscopy, surgical
32659... C Thoracoscopy, surgical
32660... C Thoracoscopy, surgical
32661... C Thoracoscopy, surgical
32662... C Thoracoscopy, surgical
32663... C Thoracoscopy, surgical
32664... C Thoracoscopy, surgical
32665... C Thoracoscopy, surgical
32800... C Repair lung hernia
32810... C Close chest after drainage
32815... C Close bronchial fistula
32820... C Reconstruct injured chest
32850... C Donor pneumonectomy
32851... C Lung transplant, single
32852... C Lung transplant w/bypass
[[Page 47999]]
32853... C Lung transplant, double
32854... C Lung transplant w/bypass
32900... C Removal of rib(s)
32905... C Revise & repair chest wall
32906... C Revise & repair chest wall
32940... C Revision of lung
33015... C Incision of heart sac
33020... C Incision of heart sac
33025... C Incision of heart sac
33030... C Partial removal of heart sac
33031... C Partial removal of heart sac
33050... C Removal of heart sac lesion
33120... C Removal of heart lesion
33130... C Removal of heart lesion
33200... C Insertion of heart pacemaker
33201... C Insertion of heart pacemaker
33206... C Insertion of heart pacemaker
33207... C Insertion of heart pacemaker
33208... C Insertion of heart pacemaker
33210... C Insertion of heart electrode
33211... C Insertion of heart electrode
33212... C Insertion of pulse generator
33213... C Insertion of pulse generator
33214... C Upgrade of pacemaker system
33216... C Revision implanted electrode
33217... C Insert/revise electrode
33218... C Repair pacemaker electrodes
33220... C Repair pacemaker electrode
33233... C Removal of pacemaker system
33234... C Removal of pacemaker system
33235... C Removal pacemaker electrode
33236... C Remove electrode/thoracotomy
33237... C Remove electrode/thoracotomy
33238... C Remove electrode/thoracotomy
33240... C Insert/replace pulse gener
33241... C Remove pulse generator only
33242... C Repair pulse generator/leads
33243... C Remove generator/thoracotomy
33244... C Remove generator
33245... C Implant heart defibrillator
33246... C Implant heart defibrillator
33247... C Insert/replace leads
33249... C Insert/replace leads/gener
33250... C Ablate heart dysrhythm focus
33251... C Ablate heart dysrhythm focus
33253... C Reconstruct atria
33261... C Ablate heart dysrhythm focus
33300... C Repair of heart wound
33305... C Repair of heart wound
33310... C Exploratory heart surgery
33315... C Exploratory heart surgery
33320... C Repair major blood vessel(s)
33321... C Repair major vessel
33322... C Repair major blood vessel(s)
33330... C Insert major vessel graft
33332... C Insert major vessel graft
33335... C Insert major vessel graft
33400... C Repair of aortic valve
33401... C Valvuloplasty, open
33403... C Valvuloplasty, w/cp bypass
33404... C Prepare heart-aorta conduit
33405... C Replacement of aortic valve
33406... C Replacement, aortic valve
33411... C Replacement of aortic valve
33412... C Replacement of aortic valve
33413... C Replacement, aortic valve
33414... C Repair, aortic valve
33415... C Revision, subvalvular tissue
33416... C Revise ventricle muscle
33417... C Repair of aortic valve
33420... C Revision of mitral valve
33422... C Revision of mitral valve
33425... C Repair of mitral valve
33426... C Repair of mitral valve
33427... C Repair of mitral valve
33430... C Replacement of mitral valve
33460... C Revision of tricuspid valve
33463... C Valvuloplasty, tricuspid
33464... C Valvuloplasty, tricuspid
33465... C Replace tricuspid valve
33468... C Revision of tricuspid valve
33470... C Revision of pulmonary valve
33471... C Valvotomy, pulmonary valve
33472... C Revision of pulmonary valve
33474... C Revision of pulmonary valve
33475... C Replacement, pulmonary valve
33476... C Revision of heart chamber
33478... C Revision of heart chamber
33496... C Repair, prosth valve clot
33500... C Repair heart vessel fistula
33501... C Repair heart vessel fistula
33502... C Coronary artery correction
33503... C Coronary artery graft
33504... C Coronary artery graft
33505... C Repair artery w/tunnel
33506... C Repair artery, translocation
33510... C CABG, vein, single
33511... C CABG, vein, two
33512... C CABG, vein, three
33513... C CABG, vein, four
33514... C CABG, vein, five
33516... C CABG, vein, six+
33517... C CABG, artery-vein, single
33518... C CABG, artery-vein, two
33519... C CABG, artery-vein, three
33521... C CABG, artery-vein, four
33522... C CABG, artery-vein, five
33523... C CABG, artery-vein, six+
33530... C Coronary artery, bypass/reop
33533... C CABG, arterial, single
33534... C CABG, arterial, two
33535... C CABG, arterial, three
33536... C CABG, arterial, four+
33542... C Removal of heart lesion
33545... C Repair of heart damage
33572... C Open coronary endarterectomy
33600... C Closure of valve
33602... C Closure of valve
33606... C Anastomosis/artery-aorta
33608... C Repair anomaly w/conduit
33610... C Repair by enlargement
33611... C Repair double ventricle
33612... C Repair double ventricle
33615... C Repair (simple fontan)
33617... C Repair by modified fontan
33619... C Repair single ventricle
33641... C Repair heart septum defect
33645... C Revision of heart veins
33647... C Repair heart septum defects
33660... C Repair of heart defects
33665... C Repair of heart defects
33670... C Repair of heart chambers
33681... C Repair heart septum defect
33684... C Repair heart septum defect
33688... C Repair heart septum defect
33690... C Reinforce pulmonary artery
33692... C Repair of heart defects
33694... C Repair of heart defects
33697... C Repair of heart defects
33702... C Repair of heart defects
33710... C Repair of heart defects
33720... C Repair of heart defect
33722... C Repair of heart defect
33730... C Repair heart-vein defect(s)
33732... C Repair heart-vein defect
33735... C Revision of heart chamber
33736... C Revision of heart chamber
33737... C Revision of heart chamber
33750... C Major vessel shunt
33755... C Major vessel shunt
33762... C Major vessel shunt
33764... C Major vessel shunt & graft
33766... C Major vessel shunt
33767... C Atrial septectomy/septostomy
33770... C Repair great vessels defect
33771... C Repair great vessels defect
33774... C Repair great vessels defect
33775... C Repair great vessels defect
33776... C Repair great vessels defect
33777... C Repair great vessels defect
33778... C Repair great vessels defect
33779... C Repair great vessels defect
33780... C Repair great vessels defect
33781... C Repair great vessels defect
33786... C Repair arterial trunk
33788... C Revision of pulmonary artery
33800... C Aortic suspension
33802... C Repair vessel defect
33803... C Repair vessel defect
33813... C Repair septal defect
33814... C Repair septal defect
33820... C Revise major vessel
33822... C Revise major vessel
33824... C Revise major vessel
33840... C Remove aorta constriction
33845... C Remove aorta constriction
33851... C Remove aorta constriction
33852... C Repair septal defect
33853... C Repair septal defect
33860... C Ascending aorta graft
33861... C Ascending aorta graft
33863... C Ascending aorta graft
33870... C Transverse aortic arch graft
33875... C Thoracic aorta graft
33877... C Thoracoabdominal graft
33910... C Remove lung artery emboli
33915... C Remove lung artery emboli
33916... C Surgery of great vessel
33917... C Repair pulmonary artery
33918... C Repair pulmonary atresia
33919... C Repair pulmonary atresia
33920... C Repair pulmonary atresia
33922... C Transect pulmonary artery
33924... C Remove pulmonary shunt
33930... C Removal of donor heart/lung
33935... C Transplantation, heart/lung
33940... C Removal of donor heart
33945... C Transplantation of heart
33960... C External circulation assist
33961... C External circulation assist
33970... C Aortic circulation assist
33971... C Aortic circulation assist
33973... C Insert balloon device
33974... C Remove intra-aortic balloon
33975... C Implant ventricular device
33976... C Implant ventricular device
33977... C Remove ventricular device
33978... C Remove ventricular device
34001... C Removal of artery clot
34051... C Removal of artery clot
[[Page 48000]]
34101... C Removal of artery clot
34111... C Removal of arm artery clot
34151... C Removal of artery clot
34201... C Removal of artery clot
34203... C Removal of leg artery clot
34401... C Removal of vein clot
34421... C Removal of vein clot
34451... C Removal of vein clot
34471... C Removal of vein clot
34490... C Removal of vein clot
34501... C Repair valve, femoral vein
34502... C Reconstruct, vena cava
34510... C Transposition of vein valve
34520... C Cross-over vein graft
34530... C Leg vein fusion
35001... C Repair defect of artery
35002... C Repair artery rupture, neck
35005... C Repair defect of artery
35011... C Repair defect of artery
35013... C Repair artery rupture, arm
35021... C Repair defect of artery
35022... C Repair artery rupture, chest
35045... C Repair defect of arm artery
35081... C Repair defect of artery
35082... C Repair artery rupture, aorta
35091... C Repair defect of artery
35092... C Repair artery rupture, aorta
35102... C Repair defect of artery
35103... C Repair artery rupture, groin
35111... C Repair defect of artery
35112... C Repair artery rupture,spleen
35121... C Repair defect of artery
35122... C Repair artery rupture, belly
35131... C Repair defect of artery
35132... C Repair artery rupture, groin
35141... C Repair defect of artery
35142... C Repair artery rupture, thigh
35151... C Repair defect of artery
35152... C Repair artery rupture, knee
35161... C Repair defect of artery
35162... C Repair artery rupture
35180... C Repair blood vessel lesion
35182... C Repair blood vessel lesion
35184... C Repair blood vessel lesion
35189... C Repair blood vessel lesion
35190... C Repair blood vessel lesion
35201... C Repair blood vessel lesion
35206... C Repair blood vessel lesion
35211... C Repair blood vessel lesion
35216... C Repair blood vessel lesion
35221... C Repair blood vessel lesion
35226... C Repair blood vessel lesion
35231... C Repair blood vessel lesion
35236... C Repair blood vessel lesion
35241... C Repair blood vessel lesion
35246... C Repair blood vessel lesion
35251... C Repair blood vessel lesion
35256... C Repair blood vessel lesion
35261... C Repair blood vessel lesion
35266... C Repair blood vessel lesion
35271... C Repair blood vessel lesion
35276... C Repair blood vessel lesion
35281... C Repair blood vessel lesion
35286... C Repair blood vessel lesion
35301... C Rechanneling of artery
35311... C Rechanneling of artery
35321... C Rechanneling of artery
35331... C Rechanneling of artery
35341... C Rechanneling of artery
35351... C Rechanneling of artery
35355... C Rechanneling of artery
35361... C Rechanneling of artery
35363... C Rechanneling of artery
35371... C Rechanneling of artery
35372... C Rechanneling of artery
35381... C Rechanneling of artery
35390... C Reoperation, carotid
35400... C Angioscopy
35450... C Repair arterial blockage
35452... C Repair arterial blockage
35454... C Repair arterial blockage
35456... C Repair arterial blockage
35458... C Repair arterial blockage
35459... C Repair arterial blockage
35460... C Repair venous blockage
35470... C Repair arterial blockage
35471... C Repair arterial blockage
35472... C Repair arterial blockage
35473... C Repair arterial blockage
35474... C Repair arterial blockage
35475... C Repair arterial blockage
35476... C Repair venous blockage
35480... C Atherectomy, open
35481... C Atherectomy, open
35482... C Atherectomy, open
35483... C Atherectomy, open
35484... C Atherectomy, open
35485... C Atherectomy, open
35490... C Atherectomy, percutaneous
35491... C Atherectomy, percutaneous
35492... C Atherectomy, percutaneous
35493... C Atherectomy, percutaneous
35494... C Atherectomy, percutaneous
35495... C Atherectomy, percutaneous
35501... C Artery bypass graft
35506... C Artery bypass graft
35507... C Artery bypass graft
35508... C Artery bypass graft
35509... C Artery bypass graft
35511... C Artery bypass graft
35515... C Artery bypass graft
35516... C Artery bypass graft
35518... C Artery bypass graft
35521... C Artery bypass graft
35526... C Artery bypass graft
35531... C Artery bypass graft
35533... C Artery bypass graft
35536... C Artery bypass graft
35541... C Artery bypass graft
35546... C Artery bypass graft
35548... C Artery bypass graft
35549... C Artery bypass graft
35551... C Artery bypass graft
35556... C Artery bypass graft
35558... C Artery bypass graft
35560... C Artery bypass graft
35563... C Artery bypass graft
35565... C Artery bypass graft
35566... C Artery bypass graft
35571... C Artery bypass graft
35582... C Vein bypass graft
35583... C Vein bypass graft
35585... C Vein bypass graft
35587... C Vein bypass graft
35601... C Artery bypass graft
35606... C Artery bypass graft
35612... C Artery bypass graft
35616... C Artery bypass graft
35621... C Artery bypass graft
35623... C Bypass graft, not vein
35626... C Artery bypass graft
35631... C Artery bypass graft
35636... C Artery bypass graft
35641... C Artery bypass graft
35642... C Artery bypass graft
35645... C Artery bypass graft
35646... C Artery bypass graft
35650... C Artery bypass graft
35651... C Artery bypass graft
35654... C Artery bypass graft
35656... C Artery bypass graft
35661... C Artery bypass graft
35663... C Artery bypass graft
35665... C Artery bypass graft
35666... C Artery bypass graft
35671... C Artery bypass graft
35681... C Artery bypass graft
35691... C Arterial transposition
35693... C Arterial transposition
35694... C Arterial transposition
35695... C Arterial transposition
35700... C Reoperation, bypass graft
35701... C Exploration, carotid artery
35721... C Exploration, femoral artery
35741... C Exploration popliteal artery
35761... C Exploration of artery/vein
35800... C Explore neck vessels
35820... C Explore chest vessels
35840... C Explore abdominal vessels
35860... C Explore limb vessels
35870... C Repair vessel graft defect
35901... C Excision, graft, neck
35903... C Excision, graft, extremity
35905... C Excision, graft, thorax
35907... C Excision, graft, abdomen
36510... C Insertion of catheter, vein
36660... C Insertion catheter, artery
36822... C Insertion of cannula(s)
36834... C Repair A-V aneurysm
37140... C Revision of circulation
37145... C Revision of circulation
37160... C Revision of circulation
37180... C Revision of circulation
37181... C Splice spleen/kidney veins
37195... C Thrombolytic therapy, stroke
37200... C Transcatheter biopsy
37201... C Transcatheter therapy infuse
37202... C Transcatheter therapy infuse
37204... C Transcatheter occlusion
37205... C Transcatheter stent
37206... C Transcatheter stent
37207... C Transcatheter stent
37208... C Transcatheter stent
37209... C Exchange arterial catheter
37250... C Intravascular us
37251... C Intravascular us
37565... C Ligation of neck vein
37600... C Ligation of neck artery
37605... C Ligation of neck artery
37606... C Ligation of neck artery
37615... C Ligation of neck artery
37616... C Ligation of chest artery
37617... C Ligation of abdomen artery
37620... C Revision of major vein
37660... C Revision of major vein
37788... C Revascularization, penis
38100... C Removal of spleen, total
38101... C Removal of spleen, partial
38102... C Removal of spleen, total
38115... C Repair of ruptured spleen
38240... C Bone marrow/stem transplant
38241... C Bone marrow/stem transplant
38380... C Thoracic duct procedure
38381... C Thoracic duct procedure
38382... C Thoracic duct procedure
38562... C Removal, pelvic lymph nodes
38564... C Removal, abdomen lymph nodes
38700... C Removal of lymph nodes, neck
[[Page 48001]]
38720... C Removal of lymph nodes, neck
38724... C Removal of lymph nodes, neck
38746... C Remove thoracic lymph nodes
38747... C Remove abdominal lymph nodes
38765... C Remove groin lymph nodes
38770... C Remove pelvis lymph nodes
38780... C Remove abdomen lymph nodes
39000... C Exploration of chest
39010... C Exploration of chest
39200... C Removal chest lesion
39220... C Removal chest lesion
39400... C Visualization of chest
39499... C Chest procedure
39501... C Repair diaphragm laceration
39502... C Repair paraesophageal hernia
39503... C Repair of diaphragm hernia
39520... C Repair of diaphragm hernia
39530... C Repair of diaphragm hernia
39531... C Repair of diaphragm hernia
39540... C Repair of diaphragm hernia
39541... C Repair of diaphragm hernia
39545... C Revision of diaphragm
39599... C Diaphragm surgery procedure
41130... C Partial removal of tongue
41135... C Tongue and neck surgery
41140... C Removal of tongue
41145... C Tongue removal; neck surgery
41150... C Tongue, mouth, jaw surgery
41153... C Tongue, mouth, neck surgery
41155... C Tongue, jaw, & neck surgery
42145... C Repair, palate,pharynx/uvula
42426... C Excise parotid gland/lesion
42845... C Extensive surgery of throat
42894... C Revision of pharyngeal walls
42953... C Repair throat, esophagus
42961... C Control throat bleeding
42971... C Control nose/throat bleeding
43045... C Incision of esophagus
43100... C Excision of esophagus lesion
43101... C Excision of esophagus lesion
43107... C Removal of esophagus
43108... C Removal of esophagus
43112... C Removal of esophagus
43113... C Removal of esophagus
43116... C Partial removal of esophagus
43117... C Partial removal of esophagus
43118... C Partial removal of esophagus
43121... C Partial removal of esophagus
43122... C Parital removal of esophagus
43123... C Partial removal of esophagus
43124... C Removal of esophagus
43130... C Removal of esophagus pouch
43135... C Removal of esophagus pouch
43300... C Repair of esophagus
43305... C Repair esophagus and fistula
43310... C Repair of esophagus
43312... C Repair esophagus and fistula
43320... C Fuse esophagus & stomach
43324... C Revise esophagus & stomach
43325... C Revise esophagus & stomach
43326... C Revise esophagus & stomach
43330... C Repair of esophagus
43331... C Repair of esophagus
43340... C Fuse esophagus & intestine
43341... C Fuse esophagus & intestine
43350... C Surgical opening, esophagus
43351... C Surgical opening, esophagus
43352... C Surgical opening, esophagus
43360... C Gastrointestinal repair
43361... C Gastrointestinal repair
43400... C Ligate esophagus veins
43401... C Esophagus surgery for veins
43405... C Ligate/staple esophagus
43410... C Repair esophagus wound
43415... C Repair esophagus wound
43420... C Repair esophagus opening
43425... C Repair esophagus opening
43460... C Pressure treatment esophagus
43496... C Free jejunum flap, microvasc
43500... C Surgical opening of stomach
43501... C Surgical repair of stomach
43502... C Surgical repair of stomach
43510... C Surgical opening of stomach
43520... C Incision of pyloric muscle
43605... C Biopsy of stomach
43610... C Excision of stomach lesion
43611... C Excision of stomach lesion
43620... C Removal of stomach
43621... C Removal of stomach
43622... C Removal of stomach
43631... C Removal of stomach, partial
43632... C Removal stomach, partial
43633... C Removal stomach, partial
43634... C Removal stomach, partial
43635... C Partial removal of stomach
43638... C Partial removal of stomach
43639... C Removal stomach, partial
43640... C Vagotomy & pylorus repair
43641... C Vagotomy & pylorus repair
43800... C Reconstruction of pylorus
43810... C Fusion of stomach and bowel
43820... C Fusion of stomach and bowel
43825... C Fusion of stomach and bowel
43830... C Place gastrostomy tube
43831... C Place gastrostomy tube
43832... C Place gastrostomy tube
43840... C Repair of stomach lesion
43842... C Gastroplasty for obesity
43843... C Gastroplasty for obesity
43846... C Gastric bypass for obesity
43847... C Gastric bypass for obesity
43848... C Revision gastroplasty
43850... C Revise stomach-bowel fusion
43855... C Revise stomach-bowel fusion
43860... C Revise stomach-bowel fusion
43865... C Revise stomach-bowel fusion
43880... C Repair stomach-bowel fistula
44005... C Freeing of bowel adhesion
44010... C Incision of small bowel
44015... C Insert needle catheter,bowel
44020... C Exploration of small bowel
44021... C Decompress small bowel
44025... C Incision of large bowel
44050... C Reduce bowel obstruction
44055... C Correct malrotation of bowel
44110... C Excision of bowel lesion(s)
44111... C Excision of bowel lesion(s)
44120... C Removal of small intestine
44121... C Removal of small intestine
44125... C Removal of small intestine
44130... C Bowel to bowel fusion
44139... C Mobilization of colon
44140... C Partial removal of colon
44141... C Partial removal of colon
44143... C Partial removal of colon
44144... C Partial removal of colon
44145... C Partial removal of colon
44146... C Partial removal of colon
44147... C Partial removal of colon
44150... C Removal of colon
44151... C Removal of colon/ileostomy
44152... C Removal of colon/ileostomy
44153... C Removal of colon/ileostomy
44155... C Removal of colon
44156... C Removal of colon/ileostomy
44160... C Removal of colon
44300... C Open bowel to skin
44310... C Ileostomy/jejunostomy
44314... C Revision of ileostomy
44316... C Devise bowel pouch
44320... C Colostomy
44322... C Colostomy with biopsies
44345... C Revision of colostomy
44346... C Revision of colostomy
44500... C Intro, gastrointestinal tube
44602... C Suture, small intestine
44603... C Suture, small intestine
44604... C Suture, large intestine
44605... C Repair of bowel lesion
44615... C Intestinal stricturoplasty
44620... C Repair bowel opening
44625... C Repair bowel opening
44626... C Repair bowel opening
44640... C Repair bowel-skin fistula
44650... C Repair bowel fistula
44660... C Repair bowel-bladder fistula
44661... C Repair bowel-bladder fistula
44680... C Surgical revision, intestine
44700... C Suspend bowel w/prosthesis
44800... C Excision of bowel pouch
44820... C Excision of mesentery lesion
44850... C Repair of mesentery
44899... C Bowel surgery procedure
44900... C Drain, app abscess, open
44901... C Drain, app abscess, perc
44950... C Appendectomy
44955... C Appendectomy
44960... C Appendectomy
45110... C Removal of rectum
45111... C Partial removal of rectum
45112... C Removal of rectum
45113... C Partial proctectomy
45114... C Partial removal of rectum
45116... C Partial removal of rectum
45119... C Remove, rectum w/reservoir
45120... C Removal of rectum
45121... C Removal of rectum and colon
45123... C Partial proctectomy
45130... C Excision of rectal prolapse
45135... C Excision of rectal prolapse
45540... C Correct rectal prolapse
45541... C Correct rectal prolapse
45550... C Repair rectum; remove sigmoid
45562... C Exploration/repair of rectum
45563... C Exploration/repair of rectum
45800... C Repair rectumbladder fistula
45805... C Repair fistula; colostomy
45820... C Repair rectourethral fistula
45825... C Repair fistula; colostomy
46705... C Repair of anal stricture
46715... C Repair of anovaginal fistula
46716... C Repair of anovaginal fistula
46730... C Construction of absent anus
46735... C Construction of absent anus
46740... C Construction of absent anus
46742... C Repair, imperforated anus
46744... C Repair, cloacal anomaly
46746... C Repair, cloacal anomaly
46748... C Repair, cloacal anomaly
46751... C Repair of anal sphincter
47001... C Needle biopsy, liver
47010... C Open drainage, liver lesion
47011... C Percut drain, liver lesion
[[Page 48002]]
47015... C Inject/aspirate liver cyst
47100... C Wedge biopsy of liver
47120... C Partial removal of liver
47122... C Extensive removal of liver
47125... C Partial removal of liver
47130... C Partial removal of liver
47133... C Removal of donor liver
47134... C Partial removal, donor liver
47135... C Transplantation of liver
47136... C Transplantation of liver
47300... C Surgery for liver lesion
47350... C Repair liver wound
47360... C Repair liver wound
47361... C Repair liver wound
47362... C Repair liver wound
47400... C Incision of liver duct
47420... C Incision of bile duct
47425... C Incision of bile duct
47460... C Incise bile duct sphincter
47480... C Incision of gallbladder
47490... C Incision of gallbladder
47550... C Bile duct endoscopy
47600... C Removal of gallbladder
47605... C Removal of gallbladder
47610... C Removal of gallbladder
47612... C Removal of gallbladder
47620... C Removal of gallbladder
47700... C Exploration of bile ducts
47701... C Bile duct revision
47711... C Excision of bile duct tumor
47712... C Excision of bile duct tumor
47715... C Excision of bile duct cyst
47716... C Fusion of bile duct cyst
47720... C Fuse gallbladder & bowel
47721... C Fuse upper gi structures
47740... C Fuse gallbladder & bowel
47741... C Fuse gallbladder & bowel
47760... C Fuse bile ducts and bowel
47765... C Fuse liver ducts & bowel
47780... C Fuse bile ducts and bowel
47785... C Fuse bile ducts and bowel
47800... C Reconstruction of bile ducts
47801... C Placement, bile duct support
47802... C Fuse liver duct & intestine
47900... C Suture bile duct injury
48000... C Drainage of abdomen
48001... C Placement of drain, pancreas
48005... C Resect/debride pancreas
48020... C Removal of pancreatic stone
48100... C Biopsy of pancreas
48120... C Removal of pancreas lesion
48140... C Partial removal of pancreas
48145... C Partial removal of pancreas
48146... C Pancreatectomy
48148... C Removal of pancreatic duct
48150... C Partial removal of pancreas
48152... C Pancreatectomy
48153... C Pancreatectomy
48154... C Pancreatectomy
48155... C Removal of pancreas
48180... C Fuse pancreas and bowel
48400... C Injection, intraoperative
48500... C Surgery of pancreas cyst
48510... C Drain pancreatic pseudocyst
48511... C Drain pancreatic pseudocyst
48520... C Fuse pancreas cyst and bowel
48540... C Fuse pancreas cyst and bowel
48545... C Pancreatorrhaphy
48547... C Duodenal exclusion
48556... C Removal, allograft pancreas
49000... C Exploration of abdomen
49002... C Reopening of abdomen
49010... C Exploration behind abdomen
49020... C Drain abdominal abscess
49021... C Drain abdominal abscess
49040... C Open drainage abdom abscess
49041... C Percut drain abdom abscess
49060... C Open drain retroper abscess
49061... C Percutdrain retroper abscess
49062... C Drain to peritoneal cavity
49200... C Removal of abdominal lesion
49201... C Removal of abdominal lesion
49215... C Excise sacral spine tumor
49220... C Multiple surgery, abdomen
49255... C Removal of omentum
49425... C Insert abdomen-venous drain
49428... C Ligation of shunt
49605... C Repair umbilical lesion
49606... C Repair umbilical lesion
49610... C Repair umbilical lesion
49611... C Repair umbilical lesion
49900... C Repair of abdominal wall
49905... C Omental flap
49906... C Free omental flap, microvasc
50010... C Exploration of kidney
50020... C Open drain renal abscess
50021... C Percut drain renal abscess
50040... C Drainage of kidney
50045... C Exploration of kidney
50060... C Removal of kidney stone
50065... C Incision of kidney
50070... C Incision of kidney
50075... C Removal of kidney stone
50080... C Removal of kidney stone
50081... C Removal of kidney stone
50100... C Revise kidney blood vessels
50120... C Exploration of kidney
50125... C Explore and drain kidney
50130... C Removal of kidney stone
50135... C Exploration of kidney
50205... C Biopsy of kidney
50220... C Removal of kidney
50225... C Removal of kidney
50230... C Removal of kidney
50234... C Removal of kidney & ureter
50236... C Removal of kidney & ureter
50240... C Partial removal of kidney
50280... C Removal of kidney lesion
50290... C Removal of kidney lesion
50300... C Removal of donor kidney
50320... C Removal of donor kidney
50340... C Removal of kidney
50360... C Transplantation of kidney
50365... C Transplantation of kidney
50370... C Remove transplanted kidney
50380... C Reimplantation of kidney
50400... C Revision of kidney/ureter
50405... C Revision of kidney/ureter
50500... C Repair of kidney wound
50520... C Close kidney-skin fistula
50525... C Repair renal-abdomen fistula
50526... C Repair renal-abdomen fistula
50540... C Revision of horseshoe kidney
50570... C Kidney endoscopy
50572... C Kidney endoscopy
50574... C Kidney endoscopy & biopsy
50575... C Kidney endoscopy
50576... C Kidney endoscopy & treatment
50578... C Renal endoscopy; radiotracer
50580... C Kidney endoscopy & treatment
50600... C Exploration of ureter
50605... C Insert ureteral support
50610... C Removal of ureter stone
50620... C Removal of ureter stone
50630... C Removal of ureter stone
50650... C Removal of ureter
50660... C Removal of ureter
50700... C Revision of ureter
50715... C Release of ureter
50722... C Release of ureter
50725... C Release/revise ureter
50727... C Revise ureter
50728... C Revise ureter
50740... C Fusion of ureter & kidney
50750... C Fusion of ureter & kidney
50760... C Fusion of ureters
50770... C Splicing of ureters
50780... C Reimplant ureter in bladder
50782... C Reimplant ureter in bladder
50783... C Reimplant ureter in bladder
50785... C Reimplant ureter in bladder
50800... C Implant ureter in bowel
50810... C Fusion of ureter & bowel
50815... C Urine shunt to bowel
50820... C Construct bowel bladder
50825... C Construct bowel bladder
50830... C Revise urine flow
50840... C Replace ureter by bowel
50845... C Appendico-vesicostomy
50860... C Transplant ureter to skin
50900... C Repair of ureter
50920... C Closure ureter/skin fistula
50930... C Closure ureter/bowel fistula
50940... C Release of ureter
50970... C Ureter endoscopy
50972... C Ureter endoscopy & catheter
50974... C Ureter endoscopy & biopsy
50976... C Ureter endoscopy & treatment
50978... C Ureter endoscopy & tracer
50980... C Ureter endoscopy & treatment
51060... C Removal of ureter stone
51525... C Removal of bladder lesion
51530... C Removal of bladder lesion
51535... C Repair of ureter lesion
51550... C Partial removal of bladder
51555... C Partial removal of bladder
51565... C Revise bladder & ureter(s)
51570... C Removal of bladder
51575... C Removal of bladder & nodes
51580... C Remove bladder; revise tract
51585... C Removal of bladder & nodes
51590... C Remove bladder; revise tract
51595... C Remove bladder; revise tract
51596... C Remove bladder, create pouch
51597... C Removal of pelvic structures
51800... C Revision of bladder/urethra
51820... C Revision of urinary tract
51840... C Attach bladder/urethra
51841... C Attach bladder/urethra
51845... C Repair bladder neck
51860... C Repair of bladder wound
51865... C Repair of bladder wound
51900... C Repair bladder/vagina lesion
51920... C Close bladder-uterus fistula
51925... C Hysterectomy/bladder repair
51940... C Correction of bladder defect
51960... C Revision of bladder & bowel
51980... C Construct bladder opening
53085... C Drainage of urinary leakage
53415... C Reconstruction of urethra
53443... C Reconstruction of urethra
54125... C Removal of penis
54130... C Remove penis & nodes
54135... C Remove penis & nodes
54332... C Revise penis, urethra
[[Page 48003]]
54336... C Revise penis, urethra
54390... C Repair penis and bladder
54430... C Revision of penis
54535... C Extensive testis surgery
54560... C Exploration for testis
54650... C Orchiopexy (Fowler-Stephens)
55600... C Incise sperm duct pouch
55605... C Incise sperm duct pouch
55650... C Remove sperm duct pouch
55801... C Removal of prostate
55810... C Extensive prostate surgery
55812... C Extensive prostate surgery
55815... C Extensive prostate surgery
55821... C Removal of prostate
55831... C Removal of prostate
55840... C Extensive prostate surgery
55842... C Extensive prostate surgery
55845... C Extensive prostate surgery
55860... C Surgical exposure, prostate
55862... C Extensive prostate surgery
55865... C Extensive prostate surgery
56308... C Laparoscopy; hysterectomy
56310... C Laparoscopic enterolysis
56314... C Lapar; drain lymphocele
56315... C Laparoscopic appendectomy
56322... C Laparoscopy, vagus nerves
56323... C Laparoscopy, vagus nerves
56324... C Laparoscopy, cholecystoenter
56340... C Laparoscopic cholecystectomy
56341... C Laparoscopic cholecystectomy
56342... C Laparoscopic cholecystectomy
56345... C Laparoscopic splenectomy
56347... C Laparoscopic jejunostomy
56348... C Laparo; resect intestine
56349... C Laparoscopy; fundoplasty
56630... C Extensive vulva surgery
56631... C Extensive vulva surgery
56632... C Extensive vulva surgery
56633... C Extensive vulva surgery
56634... C Extensive vulva surgery
56637... C Extensive vulva surgery
56640... C Extensive vulva surgery
56805... C Repair clitoris
57108... C Partial removal of vagina
57110... C Removal of vagina
57120... C Closure of vagina
57270... C Repair of bowel pouch
57280... C Suspension of vagina
57282... C Repair of vaginal prolapse
57292... C Construct vagina with graft
57305... C Repair rectum-vagina fistula
57307... C Fistula repair & colostomy
57308... C Fistula repair, transperine
57310... C Repair urethrovaginal lesion
57311... C Repair urethrovaginal lesion
57320... C Repair bladder-vagina lesion
57330... C Repair bladder-vagina lesion
57335... C Repair vagina
57531... C Removal of cervix, radical
57540... C Removal of residual cervix
57545... C Remove cervix, repair pelvis
58140... C Removal of uterus lesion
58150... C Total hysterectomy
58152... C Total hysterectomy
58180... C Partial hysterectomy
58200... C Extensive hysterectomy
58210... C Extensive hysterectomy
58240... C Removal of pelvis contents
58260... C Vaginal hysterectomy
58262... C Vaginal hysterectomy
58263... C Vaginal hysterectomy
58267... C Hysterectomy & vagina repair
58270... C Hysterectomy & vagina repair
58275... C Hysterectomy, revise vagina
58280... C Hysterectomy, revise vagina
58285... C Extensive hysterectomy
58400... C Suspension of uterus
58410... C Suspension of uterus
58520... C Repair of ruptured uterus
58540... C Revision of uterus
58600... C Division of fallopian tube
58605... C Division of fallopian tube
58611... C Ligate oviduct(s)
58615... C Occlude fallopian tube(s)
58700... C Removal of fallopian tube
58720... C Removal of ovary/tube(s)
58740... C Revise fallopian tube(s)
58750... C Repair oviduct
58752... C Revise ovarian tube(s)
58760... C Remove tubal obstruction
58770... C Create new tubal opening
58805... C Drainage of ovarian cyst(s)
58822... C Percut drain ovary abscess
58823... C Percut drain pelvic abscess
58825... C Transposition, ovary(s)
58900... C Biopsy of ovary(s)
58920... C Partial removal of ovary(s)
58925... C Removal of ovarian cyst(s)
58940... C Removal of ovary(s)
58943... C Removal of ovary(s)
58950... C Resect ovarian malignancy
58951... C Resect ovarian malignancy
58952... C Resect ovarian malignancy
58960... C Exploration of abdomen
59100... C Remove uterus lesion
59120... C Treat ectopic pregnancy
59121... C Treat ectopic pregnancy
59130... C Treat ectopic pregnancy
59135... C Treat ectopic pregnancy
59136... C Treat ectopic pregnancy
59140... C Treat ectopic pregnancy
59150... C Treat ectopic pregnancy
59151... C Treat ectopic pregnancy
59325... C Revision of cervix
59350... C Repair of uterus
59514... C Cesarean delivery only
59525... C Remove uterus after cesarean
59620... C Attempted vbac delivery only
59830... C Treat uterus infection
59850... C Abortion
59851... C Abortion
59852... C Abortion
59855... C Abortion
59856... C Abortion
59857... C Abortion
59866... C Abortion
60212... C Parital thyroid excision
60252... C Removal of thyroid
60254... C Extensive thyroid surgery
60260... C Repeat thyroid surgery
60270... C Removal of thyroid
60271... C Removal of thyroid
60500... C Explore parathyroid glands
60502... C Re-explore parathyroids
60505... C Explore parathyroid glands
60512... C Autotransplant, parathyroid
60520... C Removal of thymus gland
60521... C Removal thymus gland
60522... C Removal of thymus gland
60540... C Explore adrenal gland
60545... C Explore adrenal gland
60600... C Remove carotid body lesion
60605... C Remove carotid body lesion
61105... C Drill skull for examination
61106... C Drill skull for exam/surgery
61107... C Drill skull for implantation
61108... C Drill skull for drainage
61120... C Pierce skull for examination
61130... C Pierce skull, exam/surgery
61140... C Pierce skull for biopsy
61150... C Pierce skull for drainage
61151... C Pierce skull for drainage
61154... C Pierce skull, remove clot
61156... C Pierce skull for drainage
61210... C Pierce skull; implant device
61250... C Pierce skull & explore
61253... C Pierce skull & explore
61304... C Open skull for exploration
61305... C Open skull for exploration
61312... C Open skull for drainage
61313... C Open skull for drainage
61314... C Open skull for drainage
61315... C Open skull for drainage
61320... C Open skull for drainage
61321... C Open skull for drainage
61330... C Decompress eye socket
61332... C Explore/biopsy eye socket
61333... C Explore orbit; remove lesion
61334... C Explore orbit; remove object
61340... C Relieve cranial pressure
61343... C Incise skull, pressure relief
61345... C Relieve cranial pressure
61440... C Incise skull for surgery
61450... C Incise skull for surgery
61458... C Incise skull for brain wound
61460... C Incise skull for surgery
61470... C Incise skull for surgery
61480... C Incise skull for surgery
61490... C Incise skull for surgery
61500... C Removal of skull lesion
61501... C Remove infected skull bone
61510... C Removal of brain lesion
61512... C Remove brain lining lesion
61514... C Removal of brain abscess
61516... C Removal of brain lesion
61518... C Removal of brain lesion
61519... C Remove brain lining lesion
61520... C Removal of brain lesion
61521... C Removal of brain lesion
61522... C Removal of brain abscess
61524... C Removal of brain lesion
61526... C Removal of brain lesion
61530... C Removal of brain lesion
61531... C Implant brain electrodes
61533... C Implant brain electrodes
61534... C Removal of brain lesion
61535... C Remove brain electrodes
61536... C Removal of brain lesion
61538... C Removal of brain tissue
61539... C Removal of brain tissue
61541... C Incision of brain tissue
61542... C Removal of brain tissue
61543... C Removal of brain tissue
61544... C Remove & treat brain lesion
61545... C Excision of brain tumor
61546... C Removal of pituitary gland
61548... C Removal of pituitary gland
61550... C Release of skull seams
61552... C Release of skull seams
61556... C Incise skull/sutures
61557... C Incise skull/sutures
61558... C Excision of skull/sutures
61559... C Excision of skull/sutures
61563... C Excision of skull tumor
61564... C Excision of skull tumor
61570... C Remove brain foreign body
61571... C Incise skull for brain wound
61575... C Skull base/brainstem surgery
61576... C Skull base/brainstem surgery
[[Page 48004]]
61580... C Craniofacial approach, skull
61581... C Craniofacial approach, skull
61582... C Craniofacial approach, skull
61583... C Craniofacial approach, skull
61584... C Orbitocranial approach/skull
61585... C Orbitocranial approach/skull
61586... C Resect nasopharynx, skull
61590... C Infratemporal approach/skull
61591... C Infratemporal approach/skull
61592... C Orbitocranial approach/skull
61595... C Transtemporal approach/skull
61596... C Transcochlear approach/skull
61597... C Transcondylar approach/skull
61598... C Transpetrosal approach/skull
61600... C Resect/excise cranial lesion
61601... C Resect/excise cranial lesion
61605... C Resect/excise cranial lesion
61606... C Resect/excise cranial lesion
61607... C Resect/excise cranial lesion
61608... C Resect/excise cranial lesion
61609... C Transect, artery, sinus
61610... C Transect, artery, sinus
61611... C Transect, artery, sinus
61612... C Transect, artery, sinus
61613... C Remove aneurysm, sinus
61615... C Resect/excise lesion, skull
61616... C Resect/excise lesion, skull
61618... C Repair dura
61619... C Repair dura
61624... C Occlusion/embolization cath
61626... C Occlusion/embolization cath
61680... C Intracranial vessel surgery
61682... C Intracranial vessel surgery
61684... C Intracranial vessel surgery
61686... C Intracranial vessel surgery
61690... C Intracranial vessel surgery
61692... C Intracranial vessel surgery
61700... C Inner skull vessel surgery
61702... C Inner skull vessel surgery
61703... C Clamp neck artery
61705... C Revise circulation to head
61708... C Revise circulation to head
61710... C Revise circulation to head
61711... C Fusion of skull arteries
61712... C Skull or spine microsurgery
61720... C Incise skull/brain surgery
61735... C Incise skull/brain surgery
61750... C Incise skull; brain biopsy
61751... C Brain biopsy with cat scan
61760... C Implant brain electrodes
61770... C Incise skull for treatment
61791... C Treat trigeminal tract
61795... C Brain surgery using computer
61850... C Implant neuroelectrodes
61855... C Implant neuroelectrodes
61860... C Implant neuroelectrodes
61865... C Implant neuroelectrodes
61870... C Implant neuroelectrodes
61875... C Implant neuroelectrodes
61880... C Revise/remove neuroelectrode
61888... C Revise/remove neuroreceiver
62000... C Repair of skull fracture
62005... C Repair of skull fracture
62010... C Treatment of head injury
62100... C Repair brain fluid leakage
62115... C Reduction of skull defect
62116... C Reduction of skull defect
62117... C Reduction of skull defect
62120... C Repair skull cavity lesion
62121... C Incise skull repair
62140... C Repair of skull defect
62141... C Repair of skull defect
62142... C Remove skull plate/flap
62143... C Replace skull plate/flap
62145... C Repair of skull & brain
62146... C Repair of skull with graft
62147... C Repair of skull with graft
62180... C Establish brain cavity shunt
62190... C Establish brain cavity shunt
62192... C Establish brain cavity shunt
62200... C Establish brain cavity shunt
62201... C Establish brain cavity shunt
62220... C Establish brain cavity shunt
62223... C Establish brain cavity shunt
62256... C Remove brain cavity shunt
62258... C Replace brain cavity shunt
62351... C Implant spinal catheter
63001... C Removal of spinal lamina
63003... C Removal of spinal lamina
63005... C Removal of spinal lamina
63011... C Removal of spinal lamina
63012... C Removal of spinal lamina
63015... C Removal of spinal lamina
63016... C Removal of spinal lamina
63017... C Removal of spinal lamina
63020... C Neck spine disk surgery
63030... C Low back disk surgery
63035... C Added spinal disk surgery
63040... C Neck spine disk surgery
63042... C Low back disk surgery
63045... C Removal of spinal lamina
63046... C Removal of spinal lamina
63047... C Removal of spinal lamina
63048... C Removal of spinal lamina
63055... C Decompress spinal cord
63056... C Decompress spinal cord
63057... C Decompress spinal cord
63064... C Decompress spinal cord
63066... C Decompress spinal cord
63075... C Neck spine disk surgery
63076... C Neck spine disk surgery
63077... C Spine disk surgery, thorax
63078... C Spine disk surgery, thorax
63081... C Removal of vertebral body
63082... C Removal of vertebral body
63085... C Removal of vertebral body
63086... C Removal of vertebral body
63087... C Removal of vertebral body
63088... C Removal of vertebral body
63090... C Removal of vertebral body
63091... C Removal of vertebral body
63170... C Incise spinal cord tract(s)
63172... C Drainage of spinal cyst
63173... C Drainage of spinal cyst
63180... C Revise spinal cord ligaments
63182... C Revise spinal cord ligaments
63185... C Incise spinal column/nerves
63190... C Incise spinal column/nerves
63191... C Incise spinal column/nerves
63194... C Incise spinal column & cord
63195... C Incise spinal column & cord
63196... C Incise spinal column & cord
63197... C Incise spinal column & cord
63198... C Incise spinal column & cord
63199... C Incise spinal column & cord
63200... C Release of spinal cord
63250... C Revise spinal cord vessels
63251... C Revise spinal cord vessels
63252... C Revise spinal cord vessels
63265... C Excise intraspinal lesion
63266... C Excise intraspinal lesion
63267... C Excise intraspinal lesion
63268... C Excise intraspinal lesion
63270... C Excise intraspinal lesion
63271... C Excise intraspinal lesion
63272... C Excise intraspinal lesion
63273... C Excise intraspinal lesion
63275... C Biopsy/excise spinal tumor
63276... C Biopsy/excise spinal tumor
63277... C Biopsy/excise spinal tumor
63278... C Biopsy/excise spinal tumor
63280... C Biopsy/excise spinal tumor
63281... C Biopsy/excise spinal tumor
63282... C Biopsy/excise spinal tumor
63283... C Biopsy/excise spinal tumor
63285... C Biopsy/excise spinal tumor
63286... C Biopsy/excise spinal tumor
63287... C Biopsy/excise spinal tumor
63290... C Biopsy/excise spinal tumor
63300... C Removal of vertebral body
63301... C Removal of vertebral body
63302... C Removal of vertebral body
63303... C Removal of vertebral body
63304... C Removal of vertebral body
63305... C Removal of vertebral body
63306... C Removal of vertebral body
63307... C Removal of vertebral body
63308... C Removal of vertebral body
63655... C Implant neuroelectrodes
63700... C Repair of spinal herniation
63702... C Repair of spinal herniation
63704... C Repair of spinal herniation
63706... C Repair of spinal herniation
63707... C Repair spinal fluid leakage
63709... C Repair spinal fluid leakage
63710... C Graft repair of spine defect
63740... C Install spinal shunt
63741... C Install spinal shunt
64752... C Incision of vagus nerve
64755... C Incision of stomach nerves
64760... C Incision of vagus nerve
64763... C Incise hip/thigh nerve
64766... C Incise hip/thigh nerve
64802... C Remove sympathetic nerves
64804... C Remove sympathetic nerves
64809... C Remove sympathetic nerves
64818... C Remove sympathetic nerves
64820... C Remove sympathetic nerves
64866... C Fusion of facial/other nerve
64868... C Fusion of facial/other nerve
65110... C Removal of eye
65112... C Remove eye, revise socket
65114... C Remove eye, revise socket
65273... C Repair of eye wound
67414... C Explore/decompress eye socke
67445... C Explore/decompress eye socke
67570... C Decompress optic nerve
69155... C Extensive ear/neck surgery
69535... C Remove part of temporal bone
69554... C Remove ear lesion
69950... C Incise inner ear nerve
69955... C Release facial nerve
69960... C Release inner ear canal
69970... C Remove inner ear lesion
69979... C Temporal bone surgery
74300... C X-ray bile ducts, pancreas
74301... C Additional x-rays at surgery
75894... C Xrays, transcatheter therapy
75896... C Xrays, transcatheter therapy
75900... C Arterial catheter exchange
75940... C X-ray placement, vein filter
75945... C Intravascular us
75946... C Intravascular us
75960... C Transcatheter intro, stent
75961... C Retrieval, broken catheter
75962... C Repair arterial blockage
75964... C Repair artery blockage, each
[[Page 48005]]
75966... C Repair arterial blockage
75968... C Repair artery blockage, each
75970... C Vascular biopsy
75978... C Repair venous blockage
75992... C Atherectomy, x-ray exam
75993... C Atherectomy, x-ray exam
75994... C Atherectomy, x-ray exam
75995... C Atherectomy, x-ray exam
75996... C Atherectomy, x-ray exam
92970... C Cardioassist, internal
92971... C Cardioassist, external
92975... C Dissolve clot, heart vessel
92977... C Dissolve clot, heart vessel
92978... C Intravas us, heart (add-on)
92979... C Intravas us, heart (add-on)
92980... C Insert intracoronary stent
92981... C Insert intracoronary stent
92982... C Coronary artery dilation
92984... C Coronary artery dilation
92986... C Revision of aortic valve
92987... C Revision of mitral valve
92990... C Revision of pulmonary valve
92992... C Revision of heart chamber
92993... C Revision of heart chamber
92995... C Coronary atherectomy
92996... C Coronary atherectomy
92997... C Pul art balloon repair, perc
92998... C Pul art balloon repair, perc
94652... C Pressure breathing (IPPB)
94656... C Initial ventilator mgmt
95920... C Intraoperative nerve testing
95961... C Electrode stimulation, brain
95962... C Electrode stimulation, brain
99190... C Special pump services
99191... C Special pump services
99192... C Special pump services
99234... C Observ/hosp same date
99235... C Observ/hosp same date
99236... C Observ/hosp same date
99251... C Initial inpatient consult
99252... C Initial inpatient consult
99253... C Initial inpatient consult
99254... C Initial inpatient consult
99255... C Initial inpatient consult
99261... C Follow-up inpatient consult
99262... C Follow-up inpatient consult
99263... C Follow-up inpatient consult
99295... C Neonatal critical care
99296... C Neonatal critical care
99297... C Neonatal critical care
99356... C Prolonged service, inpatient
99357... C Prolonged service, inpatient
99433... C Normal newborn care,hospital
------------------------------------------------------------------------
Addendum H.--Status Indicators; How Various Services are Treated under Outpatient PPS
----------------------------------------------------------------------------------------------------------------
Indicator Service Status
----------------------------------------------------------------------------------------------------------------
A............................ Pulmonary Rehabilitation Clinical Not paid under PPS
Trial.
C............................ Inpatient Procedures............. Admit Patient; Bill as Inpatient
A............................ Durable Medical Equipment, DMEPOS Fee Schedule
Prosthetics and Orthotics.
E............................ Non-covered Items and Services... Non-paid
A............................ Physical, Occupational and Speech Rehabilitation Fee Schedule
Therapy.
A............................ Ambulance........................ Ambulance Fee Schedule
A............................ EPO for ESRD patients............ National Rate
A............................ Clinical Diagnostic Laboratory Laboratory Fee Schedule
Services.
A............................ Physician Services for ESRD Not paid under PPS
patients.
A............................ Screening Mammography............ National Rate
N............................ Incidental Services, packaged Packaged
into APC Rate.
P............................ Partial Hospitalization.......... Paid per diem APC
S............................ Significant Procedure, not Paid
discounted when multiple.
T............................ Procedure, multiple discount Paid
applies.
V............................ Visit to Clinic or Emergency Paid
Department.
X............................ Ancillary Service................ Paid
----------------------------------------------------------------------------------------------------------------
Addendum I.--Service Mix Indices by Hospital
------------------------------------------------------------------------
Hospital SMI
------------------------------------------------------------------------
010001.......................................................... 2.17
010004.......................................................... 1.18
010005.......................................................... 1.37
010006.......................................................... 1.95
010007.......................................................... 1.07
010008.......................................................... 1.16
010009.......................................................... 1.18
010010.......................................................... 1.40
010011.......................................................... 1.64
010012.......................................................... 1.32
010015.......................................................... 1.40
010016.......................................................... 2.19
010018.......................................................... 4.13
010019.......................................................... 1.91
010021.......................................................... 1.24
010022.......................................................... 1.30
010023.......................................................... 2.49
010024.......................................................... 1.95
010025.......................................................... 1.38
010027.......................................................... 0.76
010029.......................................................... 1.97
010031.......................................................... 1.32
010032.......................................................... 0.83
010033.......................................................... 1.17
010034.......................................................... 1.48
010035.......................................................... 2.18
010036.......................................................... 1.16
010038.......................................................... 2.60
010039.......................................................... 1.40
010040.......................................................... 2.15
010043.......................................................... 1.31
010044.......................................................... 1.38
010045.......................................................... 1.25
010046.......................................................... 1.43
010047.......................................................... 0.97
010049.......................................................... 1.93
010050.......................................................... 1.14
010051.......................................................... 1.06
010052.......................................................... 0.89
010053.......................................................... 1.37
010054.......................................................... 1.30
010055.......................................................... 2.14
010056.......................................................... 1.66
010058.......................................................... 0.57
010059.......................................................... 1.22
010061.......................................................... 1.66
010062.......................................................... 1.14
010064.......................................................... 1.95
010065.......................................................... 1.52
010066.......................................................... 0.77
010068.......................................................... 0.97
010069.......................................................... 1.56
010072.......................................................... 1.49
010073.......................................................... 1.32
010078.......................................................... 1.65
010079.......................................................... 1.59
010080.......................................................... 0.75
010081.......................................................... 1.86
010083.......................................................... 1.37
010084.......................................................... 3.64
010087.......................................................... 1.89
010089.......................................................... 1.67
010090.......................................................... 1.80
010091.......................................................... 1.02
010092.......................................................... 1.67
010094.......................................................... 1.23
010095.......................................................... 0.91
010097.......................................................... 1.23
010098.......................................................... 1.05
010099.......................................................... 1.32
010100.......................................................... 1.67
010101.......................................................... 1.42
010102.......................................................... 0.85
010103.......................................................... 1.63
010104.......................................................... 1.75
010108.......................................................... 1.18
010109.......................................................... 1.33
010110.......................................................... 0.82
010112.......................................................... 1.15
010113.......................................................... 1.97
010114.......................................................... 1.52
[[Page 48006]]
010115.......................................................... 0.94
010117.......................................................... 0.80
010118.......................................................... 1.77
010119.......................................................... 1.56
010120.......................................................... 1.24
010123.......................................................... 1.62
010124.......................................................... 2.29
010125.......................................................... 0.91
010126.......................................................... 1.80
010127.......................................................... 1.88
010128.......................................................... 0.91
010129.......................................................... 1.10
010130.......................................................... 1.13
010131.......................................................... 1.88
010134.......................................................... 1.02
010137.......................................................... 0.97
010138.......................................................... 0.86
010139.......................................................... 2.05
010143.......................................................... 1.42
010144.......................................................... 2.30
010145.......................................................... 1.16
010146.......................................................... 1.76
010148.......................................................... 1.30
010149.......................................................... 1.70
010150.......................................................... 1.60
010152.......................................................... 1.49
010155.......................................................... 1.00
012005.......................................................... 1.01
013025.......................................................... 1.08
013027.......................................................... 0.80
013028.......................................................... 0.66
013029.......................................................... 1.07
013030.......................................................... 0.40
013300.......................................................... 0.87
014000.......................................................... 0.86
014002.......................................................... 0.85
014003.......................................................... 0.83
020001.......................................................... 2.09
020002.......................................................... 1.79
020004.......................................................... 1.27
020005.......................................................... 0.69
020006.......................................................... 1.37
020007.......................................................... 0.58
020008.......................................................... 1.36
020009.......................................................... 0.71
020010.......................................................... 0.38
020011.......................................................... 0.68
020012.......................................................... 2.31
020013.......................................................... 1.41
020014.......................................................... 1.05
020017.......................................................... 2.01
020024.......................................................... 1.21
020025.......................................................... 0.68
024001.......................................................... 0.97
030001.......................................................... 1.79
030002.......................................................... 1.72
030003.......................................................... 1.36
030004.......................................................... 0.58
030006.......................................................... 1.90
030007.......................................................... 1.72
030008.......................................................... 2.23
030009.......................................................... 0.94
030010.......................................................... 1.69
030011.......................................................... 2.18
030012.......................................................... 1.24
030013.......................................................... 1.74
030014.......................................................... 1.81
030016.......................................................... 1.26
030017.......................................................... 2.04
030018.......................................................... 2.22
030019.......................................................... 1.67
030022.......................................................... 1.17
030023.......................................................... 1.69
030024.......................................................... 2.35
030025.......................................................... 1.07
030027.......................................................... 0.94
030030.......................................................... 2.01
030033.......................................................... 1.38
030034.......................................................... 0.77
030035.......................................................... 2.11
030036.......................................................... 1.65
030037.......................................................... 2.92
030038.......................................................... 2.39
030040.......................................................... 1.22
030041.......................................................... 0.85
030043.......................................................... 1.66
030044.......................................................... 1.34
030047.......................................................... 1.01
030049.......................................................... 0.50
030054.......................................................... 0.57
030055.......................................................... 1.65
030059.......................................................... 1.77
030060.......................................................... 1.43
030061.......................................................... 1.44
030062.......................................................... 1.32
030064.......................................................... 1.67
030065.......................................................... 2.01
030067.......................................................... 1.01
030068.......................................................... 1.71
030069.......................................................... 2.11
030080.......................................................... 1.67
030083.......................................................... 1.52
030085.......................................................... 1.78
030086.......................................................... 1.52
030087.......................................................... 3.31
030088.......................................................... 1.58
030089.......................................................... 1.83
030092.......................................................... 1.84
030093.......................................................... 1.16
030094.......................................................... 1.42
030095.......................................................... 1.99
033025.......................................................... 1.10
033026.......................................................... 1.27
033028.......................................................... 1.06
034004.......................................................... 0.89
034008.......................................................... 0.92
034009.......................................................... 0.87
034010.......................................................... 0.87
034013.......................................................... 0.92
034015.......................................................... 0.87
034019.......................................................... 0.87
040001.......................................................... 1.28
040002.......................................................... 1.32
040003.......................................................... 1.12
040004.......................................................... 2.28
040005.......................................................... 1.32
040007.......................................................... 3.03
040008.......................................................... 0.82
040010.......................................................... 2.01
040011.......................................................... 0.98
040014.......................................................... 1.96
040015.......................................................... 1.00
040016.......................................................... 1.43
040017.......................................................... 1.71
040018.......................................................... 1.55
040019.......................................................... 1.59
040020.......................................................... 1.88
040021.......................................................... 2.05
040022.......................................................... 1.39
040024.......................................................... 1.10
040025.......................................................... 1.03
040026.......................................................... 1.75
040027.......................................................... 2.26
040028.......................................................... 1.09
040029.......................................................... 2.25
040030.......................................................... 0.89
040032.......................................................... 0.63
040035.......................................................... 0.75
040036.......................................................... 2.40
040037.......................................................... 1.04
040039.......................................................... 1.54
040040.......................................................... 0.87
040041.......................................................... 2.17
040042.......................................................... 1.31
040044.......................................................... 0.90
040045.......................................................... 1.17
040047.......................................................... 1.14
040048.......................................................... 1.69
040050.......................................................... 1.28
040051.......................................................... 1.14
040053.......................................................... 1.01
040054.......................................................... 1.68
040055.......................................................... 1.97
040058.......................................................... 1.26
040060.......................................................... 0.80
040062.......................................................... 1.75
040064.......................................................... 0.75
040066.......................................................... 2.43
040067.......................................................... 0.73
040069.......................................................... 1.84
040070.......................................................... 1.19
040071.......................................................... 1.30
040072.......................................................... 1.26
040074.......................................................... 1.65
040075.......................................................... 1.08
040076.......................................................... 1.13
040077.......................................................... 1.05
040078.......................................................... 2.58
040080.......................................................... 1.19
040081.......................................................... 0.62
040082.......................................................... 1.05
040084.......................................................... 1.68
040085.......................................................... 1.19
040088.......................................................... 1.98
040090.......................................................... 0.75
040091.......................................................... 1.19
040093.......................................................... 0.79
040100.......................................................... 1.19
040105.......................................................... 0.79
040106.......................................................... 1.28
040107.......................................................... 1.23
040109.......................................................... 1.10
040114.......................................................... 4.13
040116.......................................................... 2.11
040118.......................................................... 2.05
040119.......................................................... 1.78
040124.......................................................... 1.44
040126.......................................................... 1.58
040132.......................................................... 0.55
043026.......................................................... 1.00
043027.......................................................... 0.59
043028.......................................................... 0.84
043029.......................................................... 1.09
043031.......................................................... 0.57
043032.......................................................... 2.32
043300.......................................................... 1.25
044004.......................................................... 0.86
044005.......................................................... 0.88
044006.......................................................... 0.99
044010.......................................................... 1.02
044011.......................................................... 1.22
044012.......................................................... 0.87
050002.......................................................... 1.32
050006.......................................................... 1.90
050007.......................................................... 1.51
050008.......................................................... 1.66
050009.......................................................... 2.00
050013.......................................................... 1.37
050014.......................................................... 1.64
050015.......................................................... 1.65
050016.......................................................... 1.33
050017.......................................................... 3.14
050018.......................................................... 1.71
050021.......................................................... 1.89
050022.......................................................... 1.82
050024.......................................................... 1.27
050025.......................................................... 1.51
050026.......................................................... 1.47
[[Page 48007]]
050028.......................................................... 1.74
050029.......................................................... 1.52
050030.......................................................... 1.19
050032.......................................................... 1.83
050033.......................................................... 1.48
050036.......................................................... 1.87
050038.......................................................... 0.97
050039.......................................................... 1.59
050042.......................................................... 1.90
050043.......................................................... 1.96
050045.......................................................... 2.02
050046.......................................................... 1.29
050047.......................................................... 2.10
050051.......................................................... 1.00
050054.......................................................... 1.05
050055.......................................................... 1.00
050056.......................................................... 2.22
050057.......................................................... 1.79
050058.......................................................... 1.75
050060.......................................................... 1.35
050061.......................................................... 3.66
050063.......................................................... 1.75
050065.......................................................... 1.82
050066.......................................................... 1.58
050067.......................................................... 1.28
050068.......................................................... 1.58
050069.......................................................... 1.74
050077.......................................................... 1.69
050078.......................................................... 1.44
050079.......................................................... 1.44
050080.......................................................... 1.28
050081.......................................................... 0.76
050082.......................................................... 1.83
050084.......................................................... 1.62
050088.......................................................... 0.88
050089.......................................................... 1.28
050090.......................................................... 1.74
050091.......................................................... 2.15
050092.......................................................... 1.12
050093.......................................................... 2.09
050095.......................................................... 2.30
050096.......................................................... 1.07
050097.......................................................... 2.60
050099.......................................................... 1.51
050100.......................................................... 1.55
050101.......................................................... 1.84
050102.......................................................... 1.20
050103.......................................................... 1.80
050104.......................................................... 1.28
050107.......................................................... 1.81
050108.......................................................... 1.89
050109.......................................................... 1.63
050110.......................................................... 2.15
050111.......................................................... 4.65
050112.......................................................... 1.70
050113.......................................................... 0.86
050114.......................................................... 1.16
050115.......................................................... 1.17
050116.......................................................... 1.84
050117.......................................................... 1.85
050118.......................................................... 1.57
050121.......................................................... 2.17
050122.......................................................... 1.88
050124.......................................................... 1.35
050125.......................................................... 2.05
050126.......................................................... 1.96
050127.......................................................... 1.21
050128.......................................................... 1.51
050129.......................................................... 1.99
050131.......................................................... 1.59
050132.......................................................... 1.46
050133.......................................................... 1.50
050135.......................................................... 1.02
050136.......................................................... 1.65
050137.......................................................... 1.40
050138.......................................................... 6.45
050139.......................................................... 5.33
050140.......................................................... 2.13
050144.......................................................... 1.48
050145.......................................................... 1.65
050147.......................................................... 0.87
050148.......................................................... 1.44
050149.......................................................... 1.31
050150.......................................................... 1.63
050152.......................................................... 1.47
050153.......................................................... 1.61
050155.......................................................... 1.55
050158.......................................................... 2.29
050159.......................................................... 0.92
050167.......................................................... 0.91
050168.......................................................... 2.16
050169.......................................................... 1.74
050170.......................................................... 1.58
050172.......................................................... 1.15
050173.......................................................... 1.94
050174.......................................................... 2.40
050175.......................................................... 2.19
050177.......................................................... 1.24
050179.......................................................... 1.57
050180.......................................................... 1.38
050183.......................................................... 0.85
050186.......................................................... 1.01
050188.......................................................... 2.43
050189.......................................................... 1.39
050191.......................................................... 1.67
050192.......................................................... 1.03
050193.......................................................... 1.02
050194.......................................................... 1.62
050195.......................................................... 1.64
050196.......................................................... 1.47
050197.......................................................... 1.72
050204.......................................................... 2.12
050205.......................................................... 1.23
050207.......................................................... 2.14
050208.......................................................... 1.82
050211.......................................................... 1.70
050213.......................................................... 0.87
050214.......................................................... 1.49
050215.......................................................... 1.99
050217.......................................................... 1.50
050219.......................................................... 1.30
050222.......................................................... 1.71
050224.......................................................... 1.77
050225.......................................................... 1.36
050226.......................................................... 1.82
050228.......................................................... 0.83
050230.......................................................... 1.83
050231.......................................................... 3.90
050232.......................................................... 1.83
050233.......................................................... 1.56
050234.......................................................... 1.11
050235.......................................................... 1.81
050236.......................................................... 1.43
050238.......................................................... 1.29
050239.......................................................... 1.61
050240.......................................................... 1.79
050241.......................................................... 1.47
050242.......................................................... 1.55
050243.......................................................... 1.35
050245.......................................................... 0.80
050248.......................................................... 0.94
050251.......................................................... 1.29
050253.......................................................... 0.87
050254.......................................................... 2.05
050256.......................................................... 1.00
050257.......................................................... 0.99
050260.......................................................... 0.73
050261.......................................................... 1.33
050262.......................................................... 1.51
050264.......................................................... 1.57
050267.......................................................... 1.76
050270.......................................................... 1.79
050272.......................................................... 1.00
050274.......................................................... 0.97
050276.......................................................... 0.82
050277.......................................................... 0.95
050278.......................................................... 1.65
050279.......................................................... 1.47
050280.......................................................... 1.77
050281.......................................................... 2.70
050282.......................................................... 1.50
050283.......................................................... 0.80
050286.......................................................... 0.66
050289.......................................................... 1.71
050290.......................................................... 1.53
050291.......................................................... 1.11
050292.......................................................... 0.96
050293.......................................................... 1.01
050295.......................................................... 1.82
050296.......................................................... 1.42
050298.......................................................... 1.38
050299.......................................................... 2.41
050300.......................................................... 1.97
050301.......................................................... 1.85
050302.......................................................... 2.08
050305.......................................................... 1.24
050307.......................................................... 1.90
050308.......................................................... 1.59
050309.......................................................... 1.86
050310.......................................................... 2.15
050312.......................................................... 1.61
050313.......................................................... 1.91
050315.......................................................... 0.79
050317.......................................................... 1.14
050320.......................................................... 0.82
050324.......................................................... 2.00
050325.......................................................... 1.13
050327.......................................................... 1.41
050328.......................................................... 2.07
050329.......................................................... 0.95
050331.......................................................... 1.37
050333.......................................................... 0.66
050334.......................................................... 2.40
050335.......................................................... 0.87
050336.......................................................... 1.52
050337.......................................................... 1.14
050342.......................................................... 1.35
050343.......................................................... 2.06
050348.......................................................... 1.07
050349.......................................................... 0.79
050350.......................................................... 1.29
050351.......................................................... 2.19
050352.......................................................... 1.43
050353.......................................................... 1.85
050355.......................................................... 0.70
050357.......................................................... 1.43
050359.......................................................... 1.99
050360.......................................................... 1.91
050366.......................................................... 1.30
050367.......................................................... 1.24
050369.......................................................... 1.65
050377.......................................................... 0.63
050378.......................................................... 1.36
050379.......................................................... 1.01
050380.......................................................... 2.26
050382.......................................................... 1.93
050385.......................................................... 1.50
050388.......................................................... 0.70
050390.......................................................... 1.65
050391.......................................................... 1.74
050392.......................................................... 1.11
050393.......................................................... 2.05
050394.......................................................... 2.34
050396.......................................................... 2.78
050397.......................................................... 0.89
050401.......................................................... 1.47
050404.......................................................... 0.97
050406.......................................................... 0.85
[[Page 48008]]
050407.......................................................... 1.88
050410.......................................................... 0.67
050411.......................................................... 3.99
050414.......................................................... 1.85
050417.......................................................... 1.81
050418.......................................................... 0.88
050419.......................................................... 1.63
050420.......................................................... 1.18
050421.......................................................... 1.64
050423.......................................................... 1.31
050424.......................................................... 2.03
050426.......................................................... 2.03
050427.......................................................... 0.54
050430.......................................................... 0.92
050431.......................................................... 2.44
050432.......................................................... 1.91
050433.......................................................... 0.99
050434.......................................................... 0.87
050435.......................................................... 1.52
050436.......................................................... 1.04
050438.......................................................... 1.44
050440.......................................................... 0.94
050441.......................................................... 1.43
050443.......................................................... 0.92
050444.......................................................... 1.74
050446.......................................................... 0.93
050447.......................................................... 1.14
050448.......................................................... 2.02
050449.......................................................... 2.24
050454.......................................................... 1.18
050455.......................................................... 2.27
050456.......................................................... 3.32
050457.......................................................... 1.34
050459.......................................................... 1.62
050464.......................................................... 2.06
050468.......................................................... 1.25
050469.......................................................... 1.07
050470.......................................................... 1.37
050471.......................................................... 2.08
050476.......................................................... 1.66
050477.......................................................... 2.95
050478.......................................................... 1.03
050481.......................................................... 2.09
050482.......................................................... 0.68
050483.......................................................... 1.07
050485.......................................................... 2.20
050486.......................................................... 1.97
050488.......................................................... 1.39
050491.......................................................... 1.64
050492.......................................................... 1.50
050494.......................................................... 2.02
050496.......................................................... 1.71
050497.......................................................... 0.69
050498.......................................................... 1.60
050502.......................................................... 2.55
050503.......................................................... 2.26
050506.......................................................... 1.59
050515.......................................................... 9.08
050516.......................................................... 2.17
050517.......................................................... 1.62
050522.......................................................... 1.91
050523.......................................................... 1.38
050526.......................................................... 0.94
050528.......................................................... 1.34
050531.......................................................... 3.15
050534.......................................................... 1.59
050535.......................................................... 1.82
050537.......................................................... 1.75
050539.......................................................... 1.29
050542.......................................................... 1.40
050543.......................................................... 1.13
050545.......................................................... 0.69
050546.......................................................... 0.66
050547.......................................................... 0.76
050548.......................................................... 0.74
050549.......................................................... 1.90
050550.......................................................... 2.12
050551.......................................................... 1.73
050552.......................................................... 0.84
050557.......................................................... 1.41
050559.......................................................... 1.43
050560.......................................................... 2.06
050561.......................................................... 2.70
050564.......................................................... 1.37
050565.......................................................... 1.22
050566.......................................................... 1.01
050567.......................................................... 1.57
050568.......................................................... 1.73
050569.......................................................... 1.58
050570.......................................................... 1.70
050571.......................................................... 1.96
050573.......................................................... 1.69
050577.......................................................... 2.79
050578.......................................................... 0.73
050579.......................................................... 1.68
050580.......................................................... 1.49
050581.......................................................... 1.60
050583.......................................................... 2.12
050584.......................................................... 1.30
050585.......................................................... 1.59
050586.......................................................... 1.91
050588.......................................................... 1.69
050589.......................................................... 1.89
050590.......................................................... 2.07
050591.......................................................... 2.43
050592.......................................................... 1.91
050593.......................................................... 1.34
050594.......................................................... 1.76
050597.......................................................... 1.82
050598.......................................................... 2.19
050599.......................................................... 1.07
050601.......................................................... 2.01
050603.......................................................... 1.16
050607.......................................................... 0.80
050608.......................................................... 1.17
050609.......................................................... 1.29
050613.......................................................... 0.56
050615.......................................................... 2.57
050616.......................................................... 1.75
050618.......................................................... 0.63
050624.......................................................... 1.63
050625.......................................................... 1.96
050630.......................................................... 1.57
050633.......................................................... 1.63
050636.......................................................... 1.58
050638.......................................................... 0.95
050641.......................................................... 1.75
050644.......................................................... 1.85
050661.......................................................... 0.87
050662.......................................................... 0.77
050663.......................................................... 1.40
050666.......................................................... 0.75
050667.......................................................... 0.76
050668.......................................................... 0.73
050675.......................................................... 1.66
050676.......................................................... 0.62
050677.......................................................... 1.36
050678.......................................................... 1.54
050680.......................................................... 1.00
050682.......................................................... 0.77
050684.......................................................... 1.39
050685.......................................................... 1.72
050686.......................................................... 1.98
050688.......................................................... 1.10
050689.......................................................... 1.57
050693.......................................................... 1.61
050694.......................................................... 1.42
050695.......................................................... 1.12
050696.......................................................... 2.25
050697.......................................................... 2.81
050699.......................................................... 0.94
050700.......................................................... 1.65
050701.......................................................... 1.31
050702.......................................................... 0.67
050704.......................................................... 0.90
050707.......................................................... 14.19
050708.......................................................... 10.17
050709.......................................................... 2.00
052031.......................................................... 0.57
053026.......................................................... 1.10
053027.......................................................... 0.70
053028.......................................................... 0.78
053029.......................................................... 0.96
053030.......................................................... 0.71
053031.......................................................... 0.90
053032.......................................................... 0.60
053033.......................................................... 0.93
053034.......................................................... 1.10
053035.......................................................... 1.06
053036.......................................................... 0.83
053037.......................................................... 1.02
053300.......................................................... 0.98
053301.......................................................... 1.27
053302.......................................................... 1.00
053304.......................................................... 0.81
053305.......................................................... 0.65
054001.......................................................... 0.87
054003.......................................................... 0.87
054009.......................................................... 0.88
054012.......................................................... 0.73
054028.......................................................... 0.91
054032.......................................................... 0.64
054050.......................................................... 1.09
054052.......................................................... 0.81
054053.......................................................... 0.99
054055.......................................................... 0.83
054060.......................................................... 0.87
054064.......................................................... 0.83
054065.......................................................... 0.70
054069.......................................................... 0.67
054074.......................................................... 0.87
054075.......................................................... 0.87
054077.......................................................... 0.87
054078.......................................................... 0.89
054085.......................................................... 0.87
054087.......................................................... 0.78
054091.......................................................... 0.83
054093.......................................................... 0.88
054094.......................................................... 0.88
054095.......................................................... 0.87
054096.......................................................... 0.88
054097.......................................................... 0.77
054098.......................................................... 0.87
054099.......................................................... 0.87
054104.......................................................... 0.88
054105.......................................................... 0.87
054106.......................................................... 0.87
054108.......................................................... 0.88
054110.......................................................... 0.87
054111.......................................................... 0.76
054113.......................................................... 0.87
054115.......................................................... 0.87
054116.......................................................... 0.88
054117.......................................................... 0.87
054119.......................................................... 0.87
054122.......................................................... 0.84
054123.......................................................... 0.90
054125.......................................................... 0.99
054126.......................................................... 0.84
054130.......................................................... 0.71
054131.......................................................... 0.96
054133.......................................................... 0.85
054139.......................................................... 0.74
060001.......................................................... 1.99
060003.......................................................... 1.61
060004.......................................................... 1.07
060006.......................................................... 1.40
060007.......................................................... 1.23
[[Page 48009]]
060008.......................................................... 1.36
060009.......................................................... 1.52
060010.......................................................... 1.62
060011.......................................................... 0.87
060012.......................................................... 1.19
060013.......................................................... 1.25
060014.......................................................... 1.69
060015.......................................................... 1.18
060016.......................................................... 1.38
060018.......................................................... 1.61
060020.......................................................... 1.40
060022.......................................................... 1.18
060023.......................................................... 1.77
060024.......................................................... 1.08
060027.......................................................... 1.45
060028.......................................................... 1.69
060029.......................................................... 0.76
060030.......................................................... 1.94
060031.......................................................... 1.60
060032.......................................................... 1.84
060033.......................................................... 1.07
060034.......................................................... 1.44
060036.......................................................... 1.30
060037.......................................................... 0.93
060038.......................................................... 0.89
060041.......................................................... 0.71
060042.......................................................... 1.10
060043.......................................................... 0.85
060044.......................................................... 1.42
060046.......................................................... 1.98
060047.......................................................... 0.61
060049.......................................................... 1.82
060050.......................................................... 1.25
060052.......................................................... 1.09
060053.......................................................... 1.12
060054.......................................................... 1.94
060056.......................................................... 0.86
060057.......................................................... 1.36
060058.......................................................... 0.90
060060.......................................................... 1.12
060062.......................................................... 0.97
060063.......................................................... 0.59
060064.......................................................... 2.03
060065.......................................................... 1.79
060068.......................................................... 0.85
060070.......................................................... 1.04
060071.......................................................... 1.40
060073.......................................................... 1.14
060075.......................................................... 2.15
060076.......................................................... 1.29
060085.......................................................... 0.67
060087.......................................................... 1.53
060088.......................................................... 1.00
060090.......................................................... 0.98
060096.......................................................... 1.69
060100.......................................................... 1.39
060103.......................................................... 2.74
060104.......................................................... 1.65
062009.......................................................... 0.56
062011.......................................................... 1.54
063026.......................................................... 0.66
063027.......................................................... 1.04
063029.......................................................... 1.68
063030.......................................................... 1.60
063301.......................................................... 0.93
063302.......................................................... 0.84
064007.......................................................... 0.87
064009.......................................................... 0.84
064010.......................................................... 1.03
064012.......................................................... 0.87
064016.......................................................... 0.90
070001.......................................................... 1.94
070002.......................................................... 1.78
070003.......................................................... 1.57
070004.......................................................... 1.60
070005.......................................................... 1.17
070006.......................................................... 1.53
070007.......................................................... 1.85
070008.......................................................... 1.32
070009.......................................................... 1.98
070010.......................................................... 1.61
070011.......................................................... 1.43
070012.......................................................... 1.47
070015.......................................................... 1.40
070016.......................................................... 1.40
070017.......................................................... 1.81
070018.......................................................... 1.58
070019.......................................................... 2.00
070020.......................................................... 1.45
070021.......................................................... 1.68
070022.......................................................... 1.67
070024.......................................................... 1.59
070025.......................................................... 1.83
070026.......................................................... 1.49
070027.......................................................... 1.35
070028.......................................................... 1.48
070029.......................................................... 1.55
070030.......................................................... 1.74
070031.......................................................... 1.25
070033.......................................................... 1.27
070034.......................................................... 1.72
070035.......................................................... 1.57
070036.......................................................... 1.39
070039.......................................................... 0.71
072003.......................................................... 3.24
072004.......................................................... 0.59
074000.......................................................... 0.88
074007.......................................................... 0.87
074008.......................................................... 1.05
074012.......................................................... 0.85
080001.......................................................... 2.01
080002.......................................................... 1.54
080003.......................................................... 1.89
080004.......................................................... 1.72
080005.......................................................... 2.03
080006.......................................................... 2.09
080007.......................................................... 1.48
083300.......................................................... 3.49
084002.......................................................... 0.85
090001.......................................................... 2.44
090002.......................................................... 1.64
090003.......................................................... 1.28
090004.......................................................... 1.64
090005.......................................................... 3.11
090006.......................................................... 1.65
090007.......................................................... 0.98
090008.......................................................... 1.67
090010.......................................................... 3.66
090011.......................................................... 2.05
090015.......................................................... 0.45
093025.......................................................... 0.72
093300.......................................................... 1.30
094004.......................................................... 0.83
100001.......................................................... 1.06
100002.......................................................... 1.64
100004.......................................................... 1.02
100006.......................................................... 1.46
100007.......................................................... 2.13
100008.......................................................... 2.17
100009.......................................................... 1.70
100010.......................................................... 1.72
100012.......................................................... 1.78
100014.......................................................... 1.50
100015.......................................................... 1.87
100017.......................................................... 1.69
100018.......................................................... 1.33
100019.......................................................... 2.56
100020.......................................................... 2.02
100022.......................................................... 0.97
100023.......................................................... 1.98
100024.......................................................... 2.03
100025.......................................................... 1.48
100026.......................................................... 1.75
100027.......................................................... 1.01
100028.......................................................... 2.09
100029.......................................................... 1.41
100030.......................................................... 1.98
100032.......................................................... 1.36
100034.......................................................... 1.52
100035.......................................................... 1.72
100038.......................................................... 1.35
100039.......................................................... 2.01
100040.......................................................... 2.03
100043.......................................................... 1.52
100044.......................................................... 1.71
100045.......................................................... 1.54
100046.......................................................... 1.49
100047.......................................................... 1.26
100048.......................................................... 1.07
100049.......................................................... 1.78
100050.......................................................... 1.69
100051.......................................................... 1.51
100052.......................................................... 2.11
100053.......................................................... 1.82
100054.......................................................... 1.38
100055.......................................................... 1.74
100056.......................................................... 2.29
100057.......................................................... 2.09
100060.......................................................... 1.86
100061.......................................................... 1.71
100062.......................................................... 1.99
100063.......................................................... 1.72
100067.......................................................... 1.72
100068.......................................................... 1.44
100069.......................................................... 1.78
100070.......................................................... 1.59
100071.......................................................... 1.31
100072.......................................................... 1.32
100073.......................................................... 1.26
100075.......................................................... 1.48
100076.......................................................... 1.70
100077.......................................................... 2.49
100078.......................................................... 0.75
100080.......................................................... 1.72
100081.......................................................... 1.10
100082.......................................................... 1.63
100084.......................................................... 1.49
100085.......................................................... 1.16
100086.......................................................... 1.65
100087.......................................................... 2.28
100088.......................................................... 2.12
100090.......................................................... 1.93
100092.......................................................... 1.75
100093.......................................................... 1.85
100098.......................................................... 0.79
100099.......................................................... 1.92
100102.......................................................... 1.22
100103.......................................................... 0.73
100105.......................................................... 1.68
100106.......................................................... 1.55
100107.......................................................... 1.38
100108.......................................................... 1.16
100109.......................................................... 1.78
100110.......................................................... 1.45
100112.......................................................... 0.66
100113.......................................................... 1.90
100114.......................................................... 1.70
100117.......................................................... 2.13
100118.......................................................... 1.37
100121.......................................................... 1.75
100122.......................................................... 1.98
100124.......................................................... 1.45
100125.......................................................... 1.53
100126.......................................................... 1.53
100127.......................................................... 2.01
100128.......................................................... 1.83
100129.......................................................... 2.14
100130.......................................................... 1.43
[[Page 48010]]
100131.......................................................... 1.86
100132.......................................................... 1.62
100134.......................................................... 0.90
100135.......................................................... 2.75
100137.......................................................... 1.45
100138.......................................................... 0.74
100139.......................................................... 0.94
100140.......................................................... 1.56
100142.......................................................... 1.47
100144.......................................................... 2.03
100145.......................................................... 1.58
100146.......................................................... 0.98
100147.......................................................... 0.82
100150.......................................................... 1.46
100151.......................................................... 2.14
100154.......................................................... 2.20
100156.......................................................... 1.32
100157.......................................................... 2.28
100159.......................................................... 0.92
100160.......................................................... 1.32
100161.......................................................... 1.33
100162.......................................................... 1.50
100165.......................................................... 1.51
100166.......................................................... 1.31
100167.......................................................... 3.04
100168.......................................................... 1.86
100169.......................................................... 1.82
100170.......................................................... 1.83
100172.......................................................... 0.97
100173.......................................................... 2.15
100174.......................................................... 1.46
100175.......................................................... 1.00
100176.......................................................... 1.67
100177.......................................................... 2.17
100179.......................................................... 2.60
100180.......................................................... 1.43
100181.......................................................... 2.56
100183.......................................................... 1.79
100187.......................................................... 1.84
100189.......................................................... 1.64
100191.......................................................... 1.77
100199.......................................................... 1.74
100200.......................................................... 2.55
100203.......................................................... 1.35
100204.......................................................... 1.76
100206.......................................................... 2.07
100208.......................................................... 1.27
100209.......................................................... 1.49
100210.......................................................... 1.37
100211.......................................................... 1.37
100212.......................................................... 1.65
100213.......................................................... 1.07
100217.......................................................... 2.28
100220.......................................................... 1.93
100221.......................................................... 1.55
100222.......................................................... 0.88
100223.......................................................... 1.50
100224.......................................................... 1.67
100225.......................................................... 1.63
100226.......................................................... 1.36
100228.......................................................... 2.07
100229.......................................................... 1.31
100230.......................................................... 1.16
100231.......................................................... 1.51
100232.......................................................... 1.33
100234.......................................................... 1.48
100235.......................................................... 1.49
100236.......................................................... 1.45
100237.......................................................... 1.83
100238.......................................................... 1.91
100239.......................................................... 1.86
100240.......................................................... 3.25
100241.......................................................... 1.33
100242.......................................................... 1.47
100243.......................................................... 1.28
100244.......................................................... 1.72
100246.......................................................... 2.06
100248.......................................................... 1.63
100249.......................................................... 1.80
100252.......................................................... 1.73
100253.......................................................... 1.80
100254.......................................................... 1.34
100255.......................................................... 2.19
100256.......................................................... 1.73
100258.......................................................... 1.84
100259.......................................................... 1.87
100260.......................................................... 2.23
100262.......................................................... 2.19
100263.......................................................... 1.74
100264.......................................................... 1.44
100265.......................................................... 1.46
100266.......................................................... 1.68
100267.......................................................... 1.86
100268.......................................................... 1.68
100269.......................................................... 2.11
100270.......................................................... 0.71
100271.......................................................... 1.26
100275.......................................................... 1.48
100276.......................................................... 2.14
100277.......................................................... 0.65
100279.......................................................... 1.38
100280.......................................................... 1.22
100281.......................................................... 1.39
100282.......................................................... 1.05
102006.......................................................... 0.68
102007.......................................................... 0.68
102008.......................................................... 0.70
102009.......................................................... 0.69
102013.......................................................... 2.55
103026.......................................................... 1.00
103027.......................................................... 1.16
103028.......................................................... 1.00
103030.......................................................... 0.65
103031.......................................................... 0.83
103032.......................................................... 1.25
103033.......................................................... 0.98
103034.......................................................... 0.97
103036.......................................................... 2.58
103037.......................................................... 1.10
103039.......................................................... 1.00
103300.......................................................... 7.82
103301.......................................................... 1.80
104001.......................................................... 0.46
104002.......................................................... 0.39
104005.......................................................... 0.90
104007.......................................................... 0.48
104008.......................................................... 0.92
104015.......................................................... 0.79
104016.......................................................... 0.85
104017.......................................................... 0.87
104018.......................................................... 0.84
104024.......................................................... 0.94
104026.......................................................... 0.78
104029.......................................................... 0.87
104034.......................................................... 0.87
104036.......................................................... 0.83
104037.......................................................... 0.87
104038.......................................................... 0.87
104040.......................................................... 0.84
104041.......................................................... 0.84
104045.......................................................... 0.74
104046.......................................................... 0.88
104047.......................................................... 0.84
104052.......................................................... 0.86
104054.......................................................... 0.87
104056.......................................................... 0.87
104057.......................................................... 0.87
104060.......................................................... 0.88
110001.......................................................... 1.79
110002.......................................................... 1.20
110003.......................................................... 1.68
110004.......................................................... 1.67
110005.......................................................... 1.63
110006.......................................................... 2.18
110007.......................................................... 1.70
110008.......................................................... 1.51
110009.......................................................... 0.79
110010.......................................................... 2.18
110011.......................................................... 1.69
110013.......................................................... 1.06
110014.......................................................... 1.34
110015.......................................................... 1.16
110016.......................................................... 2.15
110017.......................................................... 0.87
110018.......................................................... 1.44
110020.......................................................... 2.09
110023.......................................................... 1.74
110024.......................................................... 2.23
110025.......................................................... 2.03
110026.......................................................... 1.20
110027.......................................................... 0.96
110028.......................................................... 1.98
110029.......................................................... 1.30
110030.......................................................... 1.69
110031.......................................................... 2.13
110032.......................................................... 1.80
110033.......................................................... 2.46
110034.......................................................... 0.96
110035.......................................................... 1.85
110037.......................................................... 1.10
110038.......................................................... 1.50
110039.......................................................... 1.99
110040.......................................................... 1.68
110041.......................................................... 1.64
110042.......................................................... 1.39
110043.......................................................... 2.40
110044.......................................................... 1.77
110045.......................................................... 1.93
110046.......................................................... 1.89
110048.......................................................... 0.97
110049.......................................................... 0.82
110050.......................................................... 1.04
110051.......................................................... 1.23
110052.......................................................... 0.70
110054.......................................................... 1.63
110056.......................................................... 0.86
110059.......................................................... 1.69
110061.......................................................... 0.77
110062.......................................................... 0.63
110063.......................................................... 1.28
110064.......................................................... 1.33
110065.......................................................... 0.73
110066.......................................................... 1.77
110069.......................................................... 2.30
110070.......................................................... 1.18
110071.......................................................... 0.78
110072.......................................................... 0.99
110073.......................................................... 1.47
110074.......................................................... 1.92
110075.......................................................... 1.43
110076.......................................................... 1.93
110078.......................................................... 1.94
110079.......................................................... 0.80
110080.......................................................... 1.62
110082.......................................................... 2.52
110083.......................................................... 2.25
110086.......................................................... 1.24
110087.......................................................... 1.83
110088.......................................................... 0.61
110089.......................................................... 1.66
110091.......................................................... 2.11
110092.......................................................... 1.14
110093.......................................................... 0.54
110094.......................................................... 0.65
110095.......................................................... 1.69
110096.......................................................... 1.12
110097.......................................................... 0.86
110098.......................................................... 0.90
[[Page 48011]]
110100.......................................................... 0.81
110101.......................................................... 0.94
110103.......................................................... 0.80
110104.......................................................... 1.47
110105.......................................................... 2.14
110107.......................................................... 1.34
110108.......................................................... 0.53
110109.......................................................... 0.97
110111.......................................................... 1.25
110112.......................................................... 0.89
110113.......................................................... 0.94
110114.......................................................... 1.18
110115.......................................................... 1.85
110118.......................................................... 0.49
110120.......................................................... 0.76
110121.......................................................... 2.61
110122.......................................................... 1.77
110124.......................................................... 1.47
110125.......................................................... 2.34
110127.......................................................... 0.94
110128.......................................................... 1.67
110129.......................................................... 1.88
110130.......................................................... 1.03
110132.......................................................... 1.22
110134.......................................................... 0.76
110135.......................................................... 2.17
110136.......................................................... 0.73
110140.......................................................... 1.50
110141.......................................................... 0.74
110142.......................................................... 0.98
110143.......................................................... 1.96
110144.......................................................... 1.16
110146.......................................................... 1.38
110149.......................................................... 1.01
110150.......................................................... 1.84
110152.......................................................... 1.07
110153.......................................................... 1.97
110155.......................................................... 0.97
110156.......................................................... 1.40
110161.......................................................... 2.31
110163.......................................................... 2.66
110164.......................................................... 2.06
110165.......................................................... 1.75
110166.......................................................... 1.76
110168.......................................................... 2.11
110169.......................................................... 4.16
110171.......................................................... 1.46
110172.......................................................... 2.42
110174.......................................................... 1.22
110176.......................................................... 1.81
110177.......................................................... 2.02
110178.......................................................... 5.17
110179.......................................................... 1.57
110181.......................................................... 0.88
110183.......................................................... 1.25
110184.......................................................... 1.38
110185.......................................................... 1.00
110186.......................................................... 2.20
110187.......................................................... 1.44
110188.......................................................... 1.69
110189.......................................................... 1.46
110190.......................................................... 1.07
110191.......................................................... 2.22
110192.......................................................... 1.58
110193.......................................................... 1.86
110194.......................................................... 0.88
110195.......................................................... 0.93
110198.......................................................... 2.26
110200.......................................................... 2.96
110201.......................................................... 1.64
110203.......................................................... 0.92
110205.......................................................... 1.12
110207.......................................................... 0.90
110208.......................................................... 1.02
110209.......................................................... 0.87
112000.......................................................... 0.74
112003.......................................................... 1.11
112004.......................................................... 0.55
113026.......................................................... 0.88
113027.......................................................... 1.00
113300.......................................................... 1.92
114000.......................................................... 0.87
114002.......................................................... 0.90
114003.......................................................... 0.87
114008.......................................................... 0.87
114010.......................................................... 0.95
114012.......................................................... 0.87
114015.......................................................... 0.73
114016.......................................................... 0.87
114017.......................................................... 0.87
114020.......................................................... 0.87
114022.......................................................... 0.87
114023.......................................................... 1.07
114024.......................................................... 0.89
114025.......................................................... 0.88
114030.......................................................... 0.99
114031.......................................................... 0.87
114032.......................................................... 0.93
114033.......................................................... 0.86
114034.......................................................... 0.87
120001.......................................................... 1.96
120002.......................................................... 1.75
120003.......................................................... 1.36
120004.......................................................... 1.42
120005.......................................................... 2.13
120006.......................................................... 1.51
120007.......................................................... 2.14
120009.......................................................... 0.77
120010.......................................................... 1.83
120012.......................................................... 0.86
120014.......................................................... 1.93
120018.......................................................... 0.50
120019.......................................................... 1.67
120022.......................................................... 0.91
120024.......................................................... 0.55
120025.......................................................... 0.54
120026.......................................................... 1.90
120027.......................................................... 1.30
122001.......................................................... 0.55
123025.......................................................... 0.98
123300.......................................................... 1.31
124001.......................................................... 0.87
130001.......................................................... 1.01
130002.......................................................... 1.74
130003.......................................................... 1.89
130005.......................................................... 3.16
130006.......................................................... 1.41
130007.......................................................... 2.35
130008.......................................................... 1.14
130009.......................................................... 1.62
130010.......................................................... 0.61
130011.......................................................... 2.22
130012.......................................................... 1.01
130013.......................................................... 1.74
130014.......................................................... 3.11
130015.......................................................... 0.83
130016.......................................................... 1.29
130017.......................................................... 1.35
130018.......................................................... 1.34
130019.......................................................... 1.49
130021.......................................................... 0.71
130022.......................................................... 2.96
130024.......................................................... 1.71
130025.......................................................... 1.44
130026.......................................................... 4.85
130027.......................................................... 1.11
130028.......................................................... 2.66
130029.......................................................... 1.22
130030.......................................................... 0.59
130031.......................................................... 1.59
130034.......................................................... 1.10
130035.......................................................... 1.22
130036.......................................................... 2.54
130037.......................................................... 1.41
130043.......................................................... 1.22
130044.......................................................... 0.97
130045.......................................................... 1.41
130048.......................................................... 0.73
130049.......................................................... 2.21
130054.......................................................... 0.41
130056.......................................................... 0.52
130060.......................................................... 2.39
130061.......................................................... 1.14
133025.......................................................... 0.98
134002.......................................................... 0.86
134003.......................................................... 0.87
134009.......................................................... 0.89
140001.......................................................... 1.59
140002.......................................................... 1.55
140003.......................................................... 0.97
140004.......................................................... 1.72
140005.......................................................... 0.91
140007.......................................................... 1.70
140008.......................................................... 1.74
140010.......................................................... 1.53
140011.......................................................... 1.20
140012.......................................................... 1.37
140013.......................................................... 1.73
140014.......................................................... 1.60
140015.......................................................... 1.51
140016.......................................................... 1.22
140018.......................................................... 1.27
140019.......................................................... 1.03
140024.......................................................... 1.12
140025.......................................................... 1.03
140026.......................................................... 1.38
140027.......................................................... 1.23
140029.......................................................... 1.37
140030.......................................................... 1.91
140031.......................................................... 1.01
140032.......................................................... 1.49
140033.......................................................... 1.74
140034.......................................................... 1.41
140035.......................................................... 1.12
140036.......................................................... 1.63
140037.......................................................... 1.11
140038.......................................................... 0.93
140040.......................................................... 1.53
140041.......................................................... 1.22
140042.......................................................... 1.03
140043.......................................................... 1.96
140045.......................................................... 0.98
140046.......................................................... 1.49
140047.......................................................... 0.81
140048.......................................................... 1.32
140049.......................................................... 1.34
140051.......................................................... 1.65
140052.......................................................... 1.64
140053.......................................................... 2.10
140054.......................................................... 1.49
140055.......................................................... 0.97
140058.......................................................... 1.43
140059.......................................................... 1.52
140061.......................................................... 1.13
140062.......................................................... 1.49
140063.......................................................... 1.34
140064.......................................................... 1.88
140065.......................................................... 1.59
140066.......................................................... 1.06
140067.......................................................... 1.69
140068.......................................................... 1.16
140069.......................................................... 1.02
140070.......................................................... 1.20
140074.......................................................... 0.80
140075.......................................................... 1.74
140077.......................................................... 1.09
140079.......................................................... 1.60
140080.......................................................... 1.47
[[Page 48012]]
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140082.......................................................... 1.27
140083.......................................................... 0.97
140084.......................................................... 2.00
140086.......................................................... 1.36
140087.......................................................... 1.46
140088.......................................................... 1.07
140089.......................................................... 1.85
140090.......................................................... 1.74
140091.......................................................... 3.74
140093.......................................................... 1.60
140094.......................................................... 1.49
140095.......................................................... 1.23
140097.......................................................... 0.94
140100.......................................................... 1.86
140101.......................................................... 1.27
140102.......................................................... 1.24
140103.......................................................... 1.02
140105.......................................................... 1.69
140107.......................................................... 0.93
140108.......................................................... 1.87
140109.......................................................... 1.07
140110.......................................................... 1.37
140112.......................................................... 1.18
140113.......................................................... 1.41
140114.......................................................... 1.63
140115.......................................................... 1.42
140116.......................................................... 1.76
140117.......................................................... 1.85
140118.......................................................... 1.95
140119.......................................................... 1.80
140120.......................................................... 1.33
140121.......................................................... 1.50
140122.......................................................... 1.64
140125.......................................................... 1.34
140127.......................................................... 2.76
140128.......................................................... 1.05
140129.......................................................... 1.30
140130.......................................................... 1.67
140132.......................................................... 1.97
140133.......................................................... 1.22
140135.......................................................... 1.66
140137.......................................................... 0.82
140138.......................................................... 1.23
140139.......................................................... 1.07
140140.......................................................... 1.33
140141.......................................................... 1.17
140143.......................................................... 1.51
140144.......................................................... 1.01
140145.......................................................... 1.27
140146.......................................................... 1.33
140147.......................................................... 1.34
140148.......................................................... 1.95
140150.......................................................... 1.06
140151.......................................................... 0.92
140152.......................................................... 1.13
140155.......................................................... 1.65
140158.......................................................... 1.12
140160.......................................................... 2.20
140161.......................................................... 1.64
140162.......................................................... 1.50
140164.......................................................... 1.96
140165.......................................................... 1.45
140166.......................................................... 1.23
140167.......................................................... 1.62
140168.......................................................... 1.32
140170.......................................................... 1.01
140171.......................................................... 0.94
140172.......................................................... 1.02
140173.......................................................... 0.82
140174.......................................................... 1.54
140176.......................................................... 1.84
140177.......................................................... 1.32
140179.......................................................... 1.69
140180.......................................................... 1.34
140181.......................................................... 1.31
140182.......................................................... 1.07
140184.......................................................... 1.18
140185.......................................................... 1.69
140186.......................................................... 1.38
140187.......................................................... 1.32
140188.......................................................... 0.88
140189.......................................................... 1.08
140190.......................................................... 1.09
140191.......................................................... 1.21
140193.......................................................... 1.54
140197.......................................................... 1.13
140199.......................................................... 1.24
140200.......................................................... 1.17
140202.......................................................... 1.75
140203.......................................................... 1.71
140205.......................................................... 2.25
140206.......................................................... 1.54
140207.......................................................... 1.64
140208.......................................................... 1.45
140209.......................................................... 1.75
140210.......................................................... 1.30
140211.......................................................... 1.62
140212.......................................................... 0.83
140213.......................................................... 1.41
140215.......................................................... 0.83
140217.......................................................... 1.36
140218.......................................................... 1.20
140220.......................................................... 1.26
140223.......................................................... 2.05
140224.......................................................... 1.55
140228.......................................................... 1.54
140230.......................................................... 0.69
140231.......................................................... 1.57
140233.......................................................... 1.68
140234.......................................................... 1.61
140236.......................................................... 0.85
140239.......................................................... 1.86
140240.......................................................... 1.33
140242.......................................................... 1.87
140245.......................................................... 1.16
140246.......................................................... 1.08
140250.......................................................... 1.10
140251.......................................................... 2.01
140252.......................................................... 1.48
140253.......................................................... 1.85
140258.......................................................... 1.56
140271.......................................................... 0.88
140275.......................................................... 1.61
140276.......................................................... 1.63
140280.......................................................... 1.52
140281.......................................................... 1.81
140285.......................................................... 1.32
140286.......................................................... 1.49
140288.......................................................... 1.39
140289.......................................................... 1.52
140290.......................................................... 2.00
140291.......................................................... 1.60
140292.......................................................... 1.54
140294.......................................................... 1.55
140297.......................................................... 1.05
140300.......................................................... 0.85
142006.......................................................... 0.45
142009.......................................................... 3.19
143025.......................................................... 0.86
143026.......................................................... 0.82
143027.......................................................... 0.97
143300.......................................................... 1.06
144005.......................................................... 0.95
144009.......................................................... 0.83
144019.......................................................... 0.63
144025.......................................................... 0.87
144026.......................................................... 0.87
144029.......................................................... 0.83
144030.......................................................... 0.88
144031.......................................................... 0.92
144033.......................................................... 0.67
144034.......................................................... 0.87
144035.......................................................... 0.70
144036.......................................................... 0.87
150001.......................................................... 1.61
150002.......................................................... 1.43
150003.......................................................... 1.66
150004.......................................................... 1.39
150005.......................................................... 1.71
150006.......................................................... 1.92
150007.......................................................... 1.45
150008.......................................................... 1.65
150009.......................................................... 1.94
150010.......................................................... 1.77
150011.......................................................... 1.22
150012.......................................................... 2.09
150013.......................................................... 1.33
150014.......................................................... 1.49
150015.......................................................... 1.86
150018.......................................................... 1.79
150019.......................................................... 1.31
150020.......................................................... 1.63
150022.......................................................... 1.83
150023.......................................................... 1.53
150024.......................................................... 0.87
150026.......................................................... 1.68
150027.......................................................... 1.05
150029.......................................................... 2.35
150030.......................................................... 1.66
150031.......................................................... 1.09
150033.......................................................... 1.60
150034.......................................................... 1.72
150036.......................................................... 1.17
150037.......................................................... 1.71
150038.......................................................... 1.11
150039.......................................................... 1.50
150042.......................................................... 1.94
150043.......................................................... 1.21
150044.......................................................... 1.60
150045.......................................................... 1.05
150046.......................................................... 1.76
150047.......................................................... 1.24
150049.......................................................... 1.19
150050.......................................................... 1.33
150051.......................................................... 1.48
150052.......................................................... 1.40
150053.......................................................... 1.45
150054.......................................................... 1.11
150056.......................................................... 1.94
150057.......................................................... 2.23
150058.......................................................... 1.77
150059.......................................................... 1.45
150060.......................................................... 0.96
150061.......................................................... 1.55
150062.......................................................... 1.22
150063.......................................................... 1.01
150064.......................................................... 1.23
150065.......................................................... 1.50
150066.......................................................... 1.04
150067.......................................................... 1.34
150069.......................................................... 1.92
150070.......................................................... 1.15
150071.......................................................... 1.01
150072.......................................................... 1.32
150073.......................................................... 1.14
150074.......................................................... 1.67
150075.......................................................... 1.54
150076.......................................................... 1.45
150078.......................................................... 1.20
150079.......................................................... 1.08
150084.......................................................... 2.25
150089.......................................................... 1.72
150090.......................................................... 1.23
150091.......................................................... 1.20
150092.......................................................... 1.20
150094.......................................................... 1.41
150095.......................................................... 1.42
[[Page 48013]]
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150097.......................................................... 1.54
150098.......................................................... 1.19
150099.......................................................... 1.55
150101.......................................................... 1.40
150102.......................................................... 1.08
150103.......................................................... 0.99
150104.......................................................... 1.30
150105.......................................................... 1.19
150106.......................................................... 1.13
150109.......................................................... 2.13
150110.......................................................... 1.04
150111.......................................................... 1.06
150112.......................................................... 2.02
150113.......................................................... 1.59
150114.......................................................... 1.11
150115.......................................................... 2.08
150122.......................................................... 1.50
150123.......................................................... 0.82
150124.......................................................... 1.12
150125.......................................................... 1.62
150126.......................................................... 1.68
150127.......................................................... 0.82
150128.......................................................... 1.69
150129.......................................................... 1.59
150130.......................................................... 0.69
150132.......................................................... 1.73
150133.......................................................... 1.56
150134.......................................................... 1.14
150136.......................................................... 1.54
152007.......................................................... 0.40
152009.......................................................... 0.65
153025.......................................................... 1.30
153027.......................................................... 1.28
153029.......................................................... 0.87
153030.......................................................... 1.06
154009.......................................................... 1.02
154011.......................................................... 1.10
154013.......................................................... 0.93
154014.......................................................... 0.89
154026.......................................................... 0.93
154027.......................................................... 1.01
154028.......................................................... 0.89
154031.......................................................... 0.92
154032.......................................................... 1.07
154035.......................................................... 0.99
154036.......................................................... 0.78
154037.......................................................... 0.93
154038.......................................................... 0.92
154042.......................................................... 0.99
160001.......................................................... 1.86
160002.......................................................... 2.59
160003.......................................................... 1.15
160005.......................................................... 1.83
160007.......................................................... 0.76
160008.......................................................... 1.41
160009.......................................................... 1.01
160012.......................................................... 0.99
160013.......................................................... 1.50
160014.......................................................... 1.94
160016.......................................................... 1.77
160018.......................................................... 1.11
160020.......................................................... 1.14
160021.......................................................... 1.75
160023.......................................................... 1.50
160024.......................................................... 2.22
160026.......................................................... 1.26
160027.......................................................... 1.30
160028.......................................................... 1.42
160029.......................................................... 2.17
160030.......................................................... 2.48
160031.......................................................... 1.04
160032.......................................................... 1.53
160033.......................................................... 2.49
160034.......................................................... 1.58
160035.......................................................... 0.68
160036.......................................................... 1.83
160037.......................................................... 1.48
160039.......................................................... 1.55
160040.......................................................... 1.93
160041.......................................................... 0.99
160043.......................................................... 1.21
160044.......................................................... 1.78
160045.......................................................... 1.77
160046.......................................................... 1.83
160047.......................................................... 1.49
160048.......................................................... 1.01
160049.......................................................... 0.74
160050.......................................................... 1.60
160051.......................................................... 2.00
160052.......................................................... 1.25
160054.......................................................... 1.08
160055.......................................................... 1.26
160056.......................................................... 1.13
160057.......................................................... 1.88
160058.......................................................... 1.21
160060.......................................................... 1.24
160061.......................................................... 1.23
160062.......................................................... 1.09
160063.......................................................... 1.20
160064.......................................................... 3.23
160065.......................................................... 1.09
160066.......................................................... 1.68
160067.......................................................... 1.71
160068.......................................................... 1.47
160069.......................................................... 1.99
160070.......................................................... 1.20
160072.......................................................... 1.42
160073.......................................................... 0.85
160074.......................................................... 0.98
160075.......................................................... 1.08
160076.......................................................... 1.45
160077.......................................................... 1.08
160079.......................................................... 4.24
160080.......................................................... 1.87
160081.......................................................... 1.81
160082.......................................................... 2.11
160083.......................................................... 2.02
160085.......................................................... 1.01
160086.......................................................... 0.88
160088.......................................................... 1.24
160089.......................................................... 1.76
160090.......................................................... 1.12
160091.......................................................... 1.11
160092.......................................................... 1.24
160093.......................................................... 0.88
160094.......................................................... 1.41
160095.......................................................... 1.21
160097.......................................................... 1.19
160098.......................................................... 1.01
160099.......................................................... 1.09
160101.......................................................... 0.81
160102.......................................................... 2.26
160103.......................................................... 0.84
160104.......................................................... 1.48
160106.......................................................... 1.80
160107.......................................................... 1.18
160108.......................................................... 1.50
160109.......................................................... 1.04
160110.......................................................... 1.40
160111.......................................................... 1.08
160112.......................................................... 1.94
160113.......................................................... 0.87
160114.......................................................... 1.70
160115.......................................................... 1.35
160116.......................................................... 1.29
160117.......................................................... 1.96
160118.......................................................... 1.15
160120.......................................................... 0.60
160122.......................................................... 1.26
160124.......................................................... 1.42
160126.......................................................... 1.34
160129.......................................................... 1.50
160130.......................................................... 1.11
160131.......................................................... 1.01
160134.......................................................... 0.78
160135.......................................................... 2.27
160138.......................................................... 1.07
160140.......................................................... 1.12
160142.......................................................... 0.86
160143.......................................................... 1.18
160145.......................................................... 1.07
160146.......................................................... 2.30
160147.......................................................... 1.32
160151.......................................................... 1.13
160152.......................................................... 1.09
160153.......................................................... 1.92
164002.......................................................... 1.50
164003.......................................................... 0.55
170001.......................................................... 3.46
170004.......................................................... 1.09
170006.......................................................... 1.76
170008.......................................................... 4.11
170009.......................................................... 1.24
170010.......................................................... 1.50
170012.......................................................... 2.13
170013.......................................................... 2.22
170014.......................................................... 1.45
170015.......................................................... 1.20
170016.......................................................... 1.74
170017.......................................................... 1.87
170018.......................................................... 0.91
170019.......................................................... 1.59
170020.......................................................... 2.78
170022.......................................................... 1.64
170023.......................................................... 4.37
170024.......................................................... 1.11
170025.......................................................... 1.09
170026.......................................................... 1.87
170027.......................................................... 1.94
170030.......................................................... 0.97
170031.......................................................... 1.18
170032.......................................................... 0.91
170033.......................................................... 2.77
170034.......................................................... 1.32
170035.......................................................... 0.94
170036.......................................................... 0.68
170037.......................................................... 2.66
170038.......................................................... 0.68
170039.......................................................... 0.88
170040.......................................................... 1.73
170041.......................................................... 1.10
170043.......................................................... 0.67
170044.......................................................... 1.02
170045.......................................................... 2.01
170049.......................................................... 2.05
170051.......................................................... 0.69
170052.......................................................... 0.96
170053.......................................................... 0.68
170054.......................................................... 0.95
170055.......................................................... 0.89
170056.......................................................... 0.66
170057.......................................................... 1.15
170058.......................................................... 2.03
170060.......................................................... 1.24
170061.......................................................... 1.30
170063.......................................................... 0.91
170064.......................................................... 1.04
170066.......................................................... 0.70
170067.......................................................... 1.30
170068.......................................................... 3.21
170070.......................................................... 1.46
170072.......................................................... 0.79
170073.......................................................... 0.79
170074.......................................................... 1.39
170075.......................................................... 0.68
170076.......................................................... 1.36
170077.......................................................... 1.25
[[Page 48014]]
170079.......................................................... 0.97
170080.......................................................... 1.00
170081.......................................................... 0.97
170082.......................................................... 1.22
170084.......................................................... 0.96
170085.......................................................... 1.09
170086.......................................................... 3.87
170088.......................................................... 0.80
170089.......................................................... 0.78
170090.......................................................... 0.75
170092.......................................................... 0.90
170093.......................................................... 0.96
170094.......................................................... 0.95
170095.......................................................... 1.45
170097.......................................................... 1.17
170098.......................................................... 2.04
170099.......................................................... 1.52
170100.......................................................... 0.48
170101.......................................................... 0.93
170102.......................................................... 1.64
170103.......................................................... 2.21
170104.......................................................... 2.49
170105.......................................................... 1.25
170106.......................................................... 0.69
170109.......................................................... 1.09
170110.......................................................... 1.13
170112.......................................................... 0.78
170113.......................................................... 1.24
170114.......................................................... 1.55
170115.......................................................... 1.16
170116.......................................................... 1.58
170117.......................................................... 0.61
170119.......................................................... 0.91
170120.......................................................... 1.91
170122.......................................................... 1.84
170123.......................................................... 2.08
170124.......................................................... 1.58
170126.......................................................... 0.71
170128.......................................................... 1.27
170131.......................................................... 1.23
170133.......................................................... 8.93
170134.......................................................... 0.95
170137.......................................................... 1.88
170139.......................................................... 0.54
170142.......................................................... 2.10
170143.......................................................... 1.98
170144.......................................................... 2.15
170145.......................................................... 3.14
170146.......................................................... 1.47
170147.......................................................... 0.99
170148.......................................................... 1.87
170150.......................................................... 1.96
170151.......................................................... 1.23
170152.......................................................... 0.84
170160.......................................................... 0.91
170164.......................................................... 1.11
170166.......................................................... 0.85
170168.......................................................... 0.81
170171.......................................................... 0.92
170175.......................................................... 2.07
170176.......................................................... 2.23
170182.......................................................... 2.39
171304.......................................................... 0.55
171305.......................................................... 0.25
172004.......................................................... 0.52
173025.......................................................... 0.92
173026.......................................................... 1.13
173027.......................................................... 1.39
173028.......................................................... 1.31
174003.......................................................... 1.04
174006.......................................................... 0.58
174012.......................................................... 0.87
174014.......................................................... 1.08
174015.......................................................... 0.86
174016.......................................................... 0.98
174018.......................................................... 0.88
180001.......................................................... 1.55
180004.......................................................... 1.47
180005.......................................................... 1.38
180006.......................................................... 0.81
180007.......................................................... 2.08
180009.......................................................... 1.91
180010.......................................................... 2.00
180011.......................................................... 1.61
180012.......................................................... 2.05
180013.......................................................... 1.84
180014.......................................................... 2.28
180015.......................................................... 1.36
180016.......................................................... 1.56
180017.......................................................... 1.73
180018.......................................................... 1.84
180019.......................................................... 2.09
180021.......................................................... 1.44
180023.......................................................... 1.17
180024.......................................................... 1.41
180025.......................................................... 1.90
180026.......................................................... 1.32
180027.......................................................... 1.97
180030.......................................................... 1.02
180031.......................................................... 0.96
180032.......................................................... 0.86
180033.......................................................... 1.17
180034.......................................................... 1.28
180035.......................................................... 1.57
180036.......................................................... 1.89
180037.......................................................... 1.79
180038.......................................................... 1.35
180040.......................................................... 2.44
180041.......................................................... 1.25
180042.......................................................... 1.35
180043.......................................................... 1.04
180044.......................................................... 1.58
180045.......................................................... 1.77
180046.......................................................... 1.53
180047.......................................................... 1.06
180048.......................................................... 1.79
180049.......................................................... 1.54
180051.......................................................... 1.93
180053.......................................................... 1.34
180054.......................................................... 1.58
180055.......................................................... 2.20
180056.......................................................... 1.65
180058.......................................................... 0.89
180059.......................................................... 1.06
180060.......................................................... 0.55
180063.......................................................... 0.89
180064.......................................................... 1.83
180065.......................................................... 0.81
180066.......................................................... 1.80
180067.......................................................... 1.70
180070.......................................................... 1.31
180072.......................................................... 1.54
180075.......................................................... 1.14
180078.......................................................... 1.33
180079.......................................................... 1.13
180080.......................................................... 2.64
180087.......................................................... 2.13
180088.......................................................... 2.47
180092.......................................................... 1.45
180093.......................................................... 1.89
180094.......................................................... 1.01
180095.......................................................... 1.17
180099.......................................................... 1.18
180101.......................................................... 1.10
180102.......................................................... 2.26
180103.......................................................... 1.89
180104.......................................................... 2.18
180105.......................................................... 1.08
180106.......................................................... 0.94
180108.......................................................... 0.85
180115.......................................................... 1.05
180116.......................................................... 1.57
180117.......................................................... 1.65
180118.......................................................... 1.01
180120.......................................................... 1.03
180121.......................................................... 1.56
180122.......................................................... 1.08
180123.......................................................... 1.82
180124.......................................................... 2.10
180126.......................................................... 1.02
180127.......................................................... 1.79
180128.......................................................... 1.58
180129.......................................................... 1.05
180130.......................................................... 2.45
180132.......................................................... 1.90
180133.......................................................... 1.57
180134.......................................................... 1.10
180136.......................................................... 3.09
180137.......................................................... 1.26
180138.......................................................... 1.56
180139.......................................................... 1.29
180140.......................................................... 0.76
183026.......................................................... 0.71
183027.......................................................... 0.94
183028.......................................................... 0.94
183029.......................................................... 0.37
184000.......................................................... 0.97
184002.......................................................... 0.54
184007.......................................................... 0.87
184008.......................................................... 1.77
184009.......................................................... 0.89
184011.......................................................... 0.90
184015.......................................................... 0.58
184016.......................................................... 0.87
190002.......................................................... 1.76
190003.......................................................... 1.31
190004.......................................................... 1.85
190007.......................................................... 1.13
190008.......................................................... 1.93
190013.......................................................... 1.52
190014.......................................................... 1.54
190015.......................................................... 1.47
190017.......................................................... 1.17
190018.......................................................... 1.33
190019.......................................................... 1.55
190020.......................................................... 1.59
190025.......................................................... 1.27
190026.......................................................... 1.50
190027.......................................................... 1.39
190029.......................................................... 1.12
190033.......................................................... 0.71
190034.......................................................... 1.07
190035.......................................................... 1.77
190036.......................................................... 2.07
190037.......................................................... 0.69
190039.......................................................... 1.30
190040.......................................................... 1.94
190041.......................................................... 1.62
190043.......................................................... 0.48
190044.......................................................... 1.38
190045.......................................................... 1.44
190046.......................................................... 1.19
190048.......................................................... 0.84
190049.......................................................... 1.65
190050.......................................................... 1.41
190053.......................................................... 1.19
190054.......................................................... 1.46
190059.......................................................... 1.10
190060.......................................................... 1.70
190064.......................................................... 2.05
190065.......................................................... 1.40
190071.......................................................... 0.99
190077.......................................................... 0.58
190078.......................................................... 1.81
190079.......................................................... 1.14
190081.......................................................... 0.70
190083.......................................................... 0.87
190086.......................................................... 1.98
[[Page 48015]]
190088.......................................................... 1.12
190089.......................................................... 0.98
190090.......................................................... 1.16
190092.......................................................... 1.37
190095.......................................................... 1.18
190098.......................................................... 1.05
190099.......................................................... 0.91
190102.......................................................... 2.37
190103.......................................................... 0.64
190106.......................................................... 1.16
190109.......................................................... 1.03
190110.......................................................... 1.03
190111.......................................................... 1.93
190112.......................................................... 2.34
190113.......................................................... 1.92
190114.......................................................... 0.99
190115.......................................................... 3.87
190116.......................................................... 1.61
190118.......................................................... 1.14
190120.......................................................... 0.90
190124.......................................................... 1.74
190125.......................................................... 1.51
190128.......................................................... 1.55
190130.......................................................... 0.96
190131.......................................................... 1.04
190133.......................................................... 0.92
190134.......................................................... 0.76
190135.......................................................... 1.81
190136.......................................................... 0.66
190138.......................................................... 5.44
190140.......................................................... 1.22
190142.......................................................... 0.67
190144.......................................................... 1.96
190145.......................................................... 0.95
190146.......................................................... 1.30
190147.......................................................... 1.09
190148.......................................................... 0.73
190149.......................................................... 1.02
190151.......................................................... 1.27
190152.......................................................... 1.81
190155.......................................................... 0.92
190156.......................................................... 0.64
190158.......................................................... 1.34
190160.......................................................... 1.79
190162.......................................................... 1.18
190164.......................................................... 2.12
190167.......................................................... 1.08
190170.......................................................... 0.74
190173.......................................................... 1.39
190175.......................................................... 1.34
190176.......................................................... 1.15
190177.......................................................... 2.05
190178.......................................................... 0.74
190182.......................................................... 2.60
190184.......................................................... 0.76
190185.......................................................... 1.59
190186.......................................................... 0.70
190189.......................................................... 0.62
190190.......................................................... 1.14
190191.......................................................... 1.41
190196.......................................................... 1.97
190197.......................................................... 1.71
190200.......................................................... 1.62
190201.......................................................... 1.49
190202.......................................................... 1.66
190203.......................................................... 1.94
190204.......................................................... 1.60
190205.......................................................... 1.77
190206.......................................................... 1.40
190207.......................................................... 2.12
190208.......................................................... 0.72
190218.......................................................... 1.79
190231.......................................................... 3.50
192004.......................................................... 0.83
192005.......................................................... 0.84
192006.......................................................... 1.19
192008.......................................................... 0.69
192016.......................................................... 3.00
193027.......................................................... 1.10
193028.......................................................... 1.15
193034.......................................................... 0.80
193038.......................................................... 1.02
193041.......................................................... 0.54
193044.......................................................... 1.63
193300.......................................................... 0.94
194000.......................................................... 1.52
194004.......................................................... 0.83
194014.......................................................... 0.88
194018.......................................................... 0.87
194019.......................................................... 0.73
194020.......................................................... 0.25
194021.......................................................... 0.77
194022.......................................................... 0.72
194023.......................................................... 0.77
194024.......................................................... 1.12
194027.......................................................... 0.82
194029.......................................................... 0.87
194031.......................................................... 0.91
194044.......................................................... 0.86
194058.......................................................... 0.87
200001.......................................................... 1.86
200002.......................................................... 1.40
200003.......................................................... 1.19
200006.......................................................... 0.83
200007.......................................................... 1.15
200008.......................................................... 1.81
200009.......................................................... 1.54
200012.......................................................... 1.32
200013.......................................................... 1.34
200015.......................................................... 1.44
200016.......................................................... 1.20
200017.......................................................... 2.09
200018.......................................................... 1.43
200019.......................................................... 1.47
200020.......................................................... 1.45
200021.......................................................... 1.86
200023.......................................................... 0.74
200024.......................................................... 1.69
200025.......................................................... 1.55
200026.......................................................... 1.22
200027.......................................................... 1.72
200028.......................................................... 1.17
200031.......................................................... 1.22
200032.......................................................... 1.35
200033.......................................................... 1.44
200034.......................................................... 1.84
200037.......................................................... 1.30
200038.......................................................... 1.53
200039.......................................................... 1.59
200040.......................................................... 1.69
200041.......................................................... 1.47
200043.......................................................... 0.84
200050.......................................................... 1.86
200051.......................................................... 1.71
200052.......................................................... 1.16
200055.......................................................... 0.96
200062.......................................................... 0.94
200063.......................................................... 2.11
200066.......................................................... 1.38
203025.......................................................... 0.94
204005.......................................................... 0.97
204006.......................................................... 0.87
204007.......................................................... 0.49
213027.......................................................... 1.00
213028.......................................................... 3.29
214000.......................................................... 0.87
214003.......................................................... 0.90
214013.......................................................... 0.87
214015.......................................................... 0.83
214017.......................................................... 0.92
220001.......................................................... 1.47
220003.......................................................... 1.33
220004.......................................................... 1.42
220006.......................................................... 1.58
220008.......................................................... 1.28
220010.......................................................... 2.11
220011.......................................................... 1.11
220015.......................................................... 1.44
220016.......................................................... 1.36
220017.......................................................... 1.49
220019.......................................................... 1.54
220020.......................................................... 1.20
220021.......................................................... 1.39
220023.......................................................... 1.35
220024.......................................................... 1.57
220025.......................................................... 1.72
220028.......................................................... 1.32
220029.......................................................... 1.37
220030.......................................................... 1.00
220031.......................................................... 1.23
220033.......................................................... 1.41
220035.......................................................... 1.51
220036.......................................................... 1.34
220038.......................................................... 1.34
220041.......................................................... 1.44
220042.......................................................... 1.41
220046.......................................................... 1.76
220049.......................................................... 1.91
220050.......................................................... 1.43
220051.......................................................... 1.80
220052.......................................................... 1.45
220053.......................................................... 1.41
220055.......................................................... 1.70
220057.......................................................... 1.47
220058.......................................................... 1.25
220060.......................................................... 1.45
220062.......................................................... 0.92
220063.......................................................... 1.65
220064.......................................................... 1.49
220065.......................................................... 1.24
220066.......................................................... 1.70
220067.......................................................... 1.44
220068.......................................................... 0.85
220070.......................................................... 1.21
220071.......................................................... 1.29
220073.......................................................... 1.37
220074.......................................................... 1.34
220075.......................................................... 1.85
220076.......................................................... 1.30
220077.......................................................... 1.46
220079.......................................................... 1.18
220080.......................................................... 1.35
220081.......................................................... 2.37
220082.......................................................... 1.52
220083.......................................................... 1.63
220084.......................................................... 1.85
220086.......................................................... 1.38
220088.......................................................... 1.44
220089.......................................................... 1.39
220090.......................................................... 1.30
220092.......................................................... 1.36
220094.......................................................... 1.34
220095.......................................................... 1.31
220098.......................................................... 1.49
220100.......................................................... 1.35
220101.......................................................... 1.46
220104.......................................................... 1.01
220105.......................................................... 1.39
220106.......................................................... 1.45
220107.......................................................... 1.50
220108.......................................................... 1.76
220111.......................................................... 1.69
220116.......................................................... 1.19
220119.......................................................... 1.29
220123.......................................................... 1.94
220126.......................................................... 1.54
220128.......................................................... 1.33
220135.......................................................... 1.30
[[Page 48016]]
220153.......................................................... 0.58
220154.......................................................... 1.12
220163.......................................................... 1.16
220171.......................................................... 1.19
222000.......................................................... 0.87
222002.......................................................... 0.71
222006.......................................................... 1.00
222008.......................................................... 0.64
222023.......................................................... 0.86
222024.......................................................... 1.89
222026.......................................................... 0.79
222027.......................................................... 0.64
222029.......................................................... 0.75
222035.......................................................... 0.82
222043.......................................................... 0.55
222044.......................................................... 1.06
222045.......................................................... 3.55
223026.......................................................... 0.79
223027.......................................................... 0.90
223028.......................................................... 1.40
223029.......................................................... 0.74
223030.......................................................... 0.98
223302.......................................................... 1.52
224007.......................................................... 0.92
224013.......................................................... 0.97
224018.......................................................... 0.89
224021.......................................................... 0.89
224022.......................................................... 0.96
224023.......................................................... 0.46
224029.......................................................... 0.86
224034.......................................................... 0.95
224035.......................................................... 1.00
230001.......................................................... 1.47
230002.......................................................... 2.51
230003.......................................................... 1.26
230004.......................................................... 1.78
230005.......................................................... 1.49
230006.......................................................... 1.28
230007.......................................................... 1.78
230012.......................................................... 0.78
230013.......................................................... 1.37
230015.......................................................... 1.42
230017.......................................................... 1.83
230019.......................................................... 1.92
230020.......................................................... 2.00
230021.......................................................... 1.92
230022.......................................................... 1.70
230024.......................................................... 1.81
230027.......................................................... 1.15
230029.......................................................... 1.78
230030.......................................................... 1.90
230031.......................................................... 1.49
230032.......................................................... 2.24
230034.......................................................... 1.35
230035.......................................................... 1.44
230036.......................................................... 1.67
230037.......................................................... 1.56
230038.......................................................... 2.19
230040.......................................................... 1.53
230041.......................................................... 1.71
230042.......................................................... 1.24
230046.......................................................... 1.34
230047.......................................................... 1.99
230053.......................................................... 0.96
230054.......................................................... 1.81
230055.......................................................... 1.38
230056.......................................................... 1.15
230058.......................................................... 1.64
230059.......................................................... 2.18
230060.......................................................... 1.51
230062.......................................................... 1.07
230063.......................................................... 1.54
230065.......................................................... 1.90
230066.......................................................... 1.70
230068.......................................................... 1.71
230069.......................................................... 1.27
230070.......................................................... 2.18
230071.......................................................... 7.65
230072.......................................................... 1.47
230075.......................................................... 1.75
230076.......................................................... 3.06
230077.......................................................... 2.07
230078.......................................................... 1.39
230080.......................................................... 1.87
230081.......................................................... 1.68
230082.......................................................... 1.20
230085.......................................................... 2.54
230086.......................................................... 1.11
230087.......................................................... 1.49
230089.......................................................... 1.65
230092.......................................................... 1.51
230093.......................................................... 1.78
230095.......................................................... 1.72
230096.......................................................... 1.52
230097.......................................................... 2.13
230099.......................................................... 1.46
230100.......................................................... 1.27
230101.......................................................... 1.47
230103.......................................................... 1.38
230104.......................................................... 1.52
230105.......................................................... 2.40
230106.......................................................... 1.26
230107.......................................................... 0.91
230108.......................................................... 1.60
230110.......................................................... 1.73
230111.......................................................... 1.17
230113.......................................................... 0.81
230114.......................................................... 5.22
230115.......................................................... 1.11
230116.......................................................... 1.29
230117.......................................................... 1.67
230118.......................................................... 1.55
230119.......................................................... 1.44
230120.......................................................... 1.61
230121.......................................................... 1.75
230122.......................................................... 2.20
230124.......................................................... 1.31
230125.......................................................... 1.19
230128.......................................................... 1.62
230129.......................................................... 1.63
230130.......................................................... 2.06
230132.......................................................... 1.49
230133.......................................................... 1.48
230134.......................................................... 1.63
230135.......................................................... 1.52
230137.......................................................... 1.52
230141.......................................................... 1.56
230142.......................................................... 1.31
230143.......................................................... 1.63
230144.......................................................... 1.68
230145.......................................................... 1.55
230146.......................................................... 1.30
230147.......................................................... 1.26
230149.......................................................... 1.06
230151.......................................................... 1.31
230153.......................................................... 1.37
230154.......................................................... 0.97
230155.......................................................... 1.08
230156.......................................................... 1.52
230157.......................................................... 1.89
230159.......................................................... 1.95
230162.......................................................... 0.76
230165.......................................................... 2.29
230167.......................................................... 1.77
230169.......................................................... 1.80
230171.......................................................... 1.00
230172.......................................................... 1.21
230174.......................................................... 1.44
230175.......................................................... 0.83
230176.......................................................... 1.98
230178.......................................................... 1.16
230180.......................................................... 1.27
230184.......................................................... 3.32
230186.......................................................... 1.14
230188.......................................................... 1.49
230189.......................................................... 0.87
230190.......................................................... 0.81
230191.......................................................... 1.28
230193.......................................................... 1.40
230194.......................................................... 0.77
230195.......................................................... 1.92
230197.......................................................... 2.26
230199.......................................................... 1.41
230201.......................................................... 1.62
230204.......................................................... 1.54
230205.......................................................... 1.56
230207.......................................................... 1.33
230208.......................................................... 1.41
230211.......................................................... 0.63
230212.......................................................... 1.34
230213.......................................................... 0.90
230216.......................................................... 1.34
230217.......................................................... 1.43
230219.......................................................... 1.22
230221.......................................................... 1.32
230222.......................................................... 1.85
230223.......................................................... 1.88
230227.......................................................... 1.86
230230.......................................................... 1.90
230232.......................................................... 0.74
230235.......................................................... 1.34
230236.......................................................... 1.93
230239.......................................................... 1.53
230241.......................................................... 1.51
230244.......................................................... 1.80
230253.......................................................... 1.49
230254.......................................................... 1.85
230257.......................................................... 3.48
230259.......................................................... 1.76
230264.......................................................... 2.51
230269.......................................................... 1.97
230270.......................................................... 2.14
230273.......................................................... 1.30
230275.......................................................... 1.19
230276.......................................................... 0.72
230277.......................................................... 1.59
230278.......................................................... 1.19
230279.......................................................... 0.90
230280.......................................................... 1.39
233025.......................................................... 0.89
233026.......................................................... 0.79
233027.......................................................... 0.92
233028.......................................................... 1.02
233300.......................................................... 2.34
234006.......................................................... 1.00
234011.......................................................... 0.92
234021.......................................................... 0.71
234023.......................................................... 0.96
234029.......................................................... 0.88
234030.......................................................... 1.86
240001.......................................................... 2.47
240002.......................................................... 1.93
240004.......................................................... 0.93
240005.......................................................... 0.74
240006.......................................................... 1.80
240007.......................................................... 1.63
240008.......................................................... 1.94
240009.......................................................... 0.99
240010.......................................................... 2.46
240011.......................................................... 2.02
240013.......................................................... 1.40
240014.......................................................... 1.40
240016.......................................................... 1.95
240017.......................................................... 2.36
240018.......................................................... 2.14
240019.......................................................... 1.84
240020.......................................................... 1.25
240021.......................................................... 1.27
[[Page 48017]]
240022.......................................................... 1.34
240023.......................................................... 1.35
240025.......................................................... 1.23
240027.......................................................... 1.94
240028.......................................................... 1.28
240029.......................................................... 1.86
240030.......................................................... 2.15
240031.......................................................... 1.28
240036.......................................................... 1.67
240037.......................................................... 1.16
240038.......................................................... 1.95
240040.......................................................... 1.51
240041.......................................................... 1.38
240043.......................................................... 2.18
240044.......................................................... 1.64
240045.......................................................... 1.77
240047.......................................................... 2.26
240048.......................................................... 2.67
240049.......................................................... 1.24
240050.......................................................... 1.79
240051.......................................................... 1.75
240052.......................................................... 1.46
240053.......................................................... 2.00
240056.......................................................... 2.27
240057.......................................................... 1.55
240058.......................................................... 1.01
240059.......................................................... 2.57
240061.......................................................... 4.46
240063.......................................................... 1.85
240064.......................................................... 2.03
240065.......................................................... 1.13
240066.......................................................... 2.49
240069.......................................................... 2.04
240071.......................................................... 1.73
240072.......................................................... 1.77
240073.......................................................... 1.05
240075.......................................................... 1.69
240076.......................................................... 1.69
240077.......................................................... 1.50
240078.......................................................... 2.33
240079.......................................................... 0.99
240080.......................................................... 1.36
240082.......................................................... 1.19
240083.......................................................... 1.40
240084.......................................................... 1.54
240085.......................................................... 0.88
240086.......................................................... 1.32
240087.......................................................... 1.24
240088.......................................................... 1.28
240089.......................................................... 0.91
240090.......................................................... 2.46
240093.......................................................... 1.69
240094.......................................................... 1.12
240096.......................................................... 0.90
240097.......................................................... 3.54
240098.......................................................... 1.21
240099.......................................................... 1.17
240100.......................................................... 1.99
240101.......................................................... 1.25
240102.......................................................... 0.96
240103.......................................................... 1.07
240104.......................................................... 1.64
240105.......................................................... 0.74
240106.......................................................... 0.98
240107.......................................................... 1.22
240108.......................................................... 1.58
240109.......................................................... 1.21
240110.......................................................... 1.50
240111.......................................................... 1.44
240112.......................................................... 1.29
240114.......................................................... 1.11
240115.......................................................... 1.86
240116.......................................................... 1.25
240117.......................................................... 0.88
240119.......................................................... 0.75
240121.......................................................... 1.42
240122.......................................................... 1.00
240123.......................................................... 1.29
240124.......................................................... 1.40
240125.......................................................... 1.17
240127.......................................................... 1.02
240128.......................................................... 2.03
240129.......................................................... 1.41
240130.......................................................... 1.68
240132.......................................................... 1.77
240133.......................................................... 2.16
240135.......................................................... 0.55
240137.......................................................... 2.27
240138.......................................................... 0.98
240139.......................................................... 1.39
240141.......................................................... 1.52
240142.......................................................... 1.16
240143.......................................................... 1.24
240144.......................................................... 1.74
240145.......................................................... 0.93
240146.......................................................... 1.44
240148.......................................................... 0.93
240150.......................................................... 0.78
240152.......................................................... 1.65
240153.......................................................... 1.16
240154.......................................................... 1.13
240155.......................................................... 1.48
240157.......................................................... 1.80
240160.......................................................... 1.39
240161.......................................................... 0.99
240162.......................................................... 1.47
240163.......................................................... 1.20
240166.......................................................... 2.19
240169.......................................................... 1.46
240170.......................................................... 1.11
240171.......................................................... 1.72
240172.......................................................... 1.14
240173.......................................................... 1.58
240179.......................................................... 0.98
240184.......................................................... 1.24
240187.......................................................... 2.12
240193.......................................................... 1.36
240196.......................................................... 9.90
240200.......................................................... 0.61
240207.......................................................... 1.76
240210.......................................................... 1.90
240211.......................................................... 0.68
242004.......................................................... 0.77
243300.......................................................... 0.93
243302.......................................................... 6.10
244009.......................................................... 2.18
250001.......................................................... 1.60
250002.......................................................... 1.01
250003.......................................................... 0.68
250004.......................................................... 1.91
250005.......................................................... 0.71
250006.......................................................... 1.39
250007.......................................................... 1.33
250008.......................................................... 0.68
250009.......................................................... 2.02
250010.......................................................... 0.91
250012.......................................................... 0.85
250015.......................................................... 1.43
250017.......................................................... 0.84
250018.......................................................... 0.44
250019.......................................................... 1.59
250020.......................................................... 0.87
250021.......................................................... 0.53
250023.......................................................... 0.47
250024.......................................................... 0.59
250025.......................................................... 1.29
250027.......................................................... 1.13
250029.......................................................... 0.99
250030.......................................................... 0.74
250031.......................................................... 2.64
250032.......................................................... 1.28
250033.......................................................... 1.04
250034.......................................................... 2.16
250035.......................................................... 1.09
250036.......................................................... 1.21
250037.......................................................... 0.98
250038.......................................................... 0.83
250039.......................................................... 0.68
250040.......................................................... 1.66
250042.......................................................... 1.50
250043.......................................................... 1.13
250044.......................................................... 1.23
250045.......................................................... 1.10
250047.......................................................... 0.61
250048.......................................................... 2.62
250049.......................................................... 0.80
250050.......................................................... 1.38
250051.......................................................... 0.75
250057.......................................................... 1.64
250058.......................................................... 1.91
250059.......................................................... 1.35
250060.......................................................... 0.68
250061.......................................................... 0.93
250063.......................................................... 0.88
250065.......................................................... 0.92
250066.......................................................... 0.75
250067.......................................................... 0.92
250068.......................................................... 1.01
250069.......................................................... 2.29
250071.......................................................... 0.78
250072.......................................................... 1.58
250076.......................................................... 0.46
250077.......................................................... 0.91
250078.......................................................... 1.77
250079.......................................................... 0.81
250081.......................................................... 2.72
250082.......................................................... 1.70
250083.......................................................... 0.86
250084.......................................................... 1.93
250085.......................................................... 0.96
250088.......................................................... 1.12
250089.......................................................... 1.05
250093.......................................................... 1.16
250094.......................................................... 2.41
250095.......................................................... 1.56
250096.......................................................... 1.33
250097.......................................................... 1.88
250098.......................................................... 0.73
250099.......................................................... 2.48
250100.......................................................... 1.57
250101.......................................................... 0.73
250102.......................................................... 1.84
250104.......................................................... 2.12
250105.......................................................... 0.86
250107.......................................................... 0.79
250109.......................................................... 0.75
250112.......................................................... 0.85
250117.......................................................... 0.86
250119.......................................................... 1.04
250120.......................................................... 1.42
250122.......................................................... 1.74
250123.......................................................... 1.90
250124.......................................................... 0.83
250125.......................................................... 1.53
250126.......................................................... 0.83
250128.......................................................... 1.14
250131.......................................................... 0.93
250134.......................................................... 0.63
250136.......................................................... 2.86
250138.......................................................... 2.95
250141.......................................................... 1.97
250144.......................................................... 0.55
250145.......................................................... 0.85
250146.......................................................... 0.81
250148.......................................................... 1.26
250149.......................................................... 0.80
252003.......................................................... 0.32
253025.......................................................... 1.39
[[Page 48018]]
254001.......................................................... 0.81
254002.......................................................... 0.80
254006.......................................................... 0.94
260001.......................................................... 1.38
260002.......................................................... 1.40
260003.......................................................... 1.05
260004.......................................................... 0.88
260005.......................................................... 1.66
260006.......................................................... 1.88
260007.......................................................... 1.83
260008.......................................................... 0.82
260009.......................................................... 1.81
260011.......................................................... 1.67
260012.......................................................... 1.14
260013.......................................................... 1.37
260014.......................................................... 1.86
260015.......................................................... 1.41
260017.......................................................... 1.84
260018.......................................................... 0.69
260019.......................................................... 1.11
260020.......................................................... 2.06
260021.......................................................... 1.44
260022.......................................................... 1.43
260023.......................................................... 1.77
260024.......................................................... 1.06
260025.......................................................... 2.36
260027.......................................................... 1.54
260029.......................................................... 1.33
260030.......................................................... 0.75
260031.......................................................... 1.66
260032.......................................................... 1.73
260034.......................................................... 1.13
260035.......................................................... 0.87
260036.......................................................... 1.26
260039.......................................................... 0.91
260040.......................................................... 1.50
260042.......................................................... 1.10
260044.......................................................... 1.10
260047.......................................................... 1.37
260048.......................................................... 1.43
260050.......................................................... 1.51
260052.......................................................... 1.62
260053.......................................................... 1.26
260054.......................................................... 1.57
260055.......................................................... 0.95
260057.......................................................... 1.30
260059.......................................................... 1.16
260061.......................................................... 1.57
260062.......................................................... 1.52
260063.......................................................... 1.31
260064.......................................................... 1.66
260065.......................................................... 1.34
260066.......................................................... 1.25
260067.......................................................... 0.80
260068.......................................................... 1.63
260070.......................................................... 0.94
260073.......................................................... 0.97
260074.......................................................... 1.16
260077.......................................................... 2.07
260078.......................................................... 1.49
260079.......................................................... 0.91
260080.......................................................... 1.18
260081.......................................................... 1.66
260082.......................................................... 1.00
260085.......................................................... 1.73
260086.......................................................... 1.17
260091.......................................................... 2.45
260094.......................................................... 1.63
260095.......................................................... 1.42
260096.......................................................... 1.53
260097.......................................................... 2.58
260100.......................................................... 1.09
260102.......................................................... 0.79
260103.......................................................... 1.20
260104.......................................................... 1.54
260105.......................................................... 1.75
260107.......................................................... 2.14
260108.......................................................... 1.39
260109.......................................................... 1.20
260110.......................................................... 1.85
260113.......................................................... 1.47
260115.......................................................... 1.07
260116.......................................................... 1.68
260119.......................................................... 1.64
260120.......................................................... 1.62
260122.......................................................... 1.18
260123.......................................................... 0.90
260127.......................................................... 0.99
260128.......................................................... 0.88
260129.......................................................... 1.28
260131.......................................................... 1.27
260134.......................................................... 1.52
260137.......................................................... 2.07
260138.......................................................... 1.71
260141.......................................................... 1.25
260142.......................................................... 1.96
260143.......................................................... 0.82
260147.......................................................... 0.96
260148.......................................................... 0.92
260158.......................................................... 1.11
260159.......................................................... 1.50
260160.......................................................... 0.95
260162.......................................................... 1.90
260163.......................................................... 1.08
260164.......................................................... 1.19
260166.......................................................... 1.39
260172.......................................................... 1.20
260173.......................................................... 0.79
260175.......................................................... 1.79
260176.......................................................... 1.68
260177.......................................................... 1.92
260178.......................................................... 2.47
260179.......................................................... 1.50
260180.......................................................... 1.46
260183.......................................................... 2.01
260186.......................................................... 1.55
260188.......................................................... 1.53
260189.......................................................... 0.57
260190.......................................................... 1.81
260191.......................................................... 1.68
260193.......................................................... 1.97
260195.......................................................... 1.26
260197.......................................................... 1.77
260198.......................................................... 1.52
260200.......................................................... 1.27
262001.......................................................... 0.66
262011.......................................................... 0.58
263025.......................................................... 1.28
263026.......................................................... 1.15
263300.......................................................... 2.18
263301.......................................................... 1.21
263302.......................................................... 1.23
264005.......................................................... 0.83
264007.......................................................... 0.82
264008.......................................................... 0.82
264010.......................................................... 0.65
264011.......................................................... 1.18
264013.......................................................... 0.87
264015.......................................................... 0.91
264016.......................................................... 2.03
264017.......................................................... 1.17
264021.......................................................... 0.69
264024.......................................................... 0.87
264025.......................................................... 0.78
264026.......................................................... 0.87
270002.......................................................... 1.64
270003.......................................................... 1.63
270004.......................................................... 1.74
270006.......................................................... 0.43
270007.......................................................... 0.70
270009.......................................................... 0.97
270011.......................................................... 1.46
270012.......................................................... 2.09
270013.......................................................... 1.84
270014.......................................................... 2.23
270016.......................................................... 0.77
270017.......................................................... 1.27
270019.......................................................... 0.73
270021.......................................................... 1.21
270023.......................................................... 2.07
270024.......................................................... 0.63
270026.......................................................... 1.43
270027.......................................................... 0.93
270028.......................................................... 1.70
270029.......................................................... 1.26
270032.......................................................... 2.60
270033.......................................................... 0.61
270035.......................................................... 1.00
270036.......................................................... 0.85
270039.......................................................... 1.20
270040.......................................................... 1.45
270041.......................................................... 0.89
270044.......................................................... 1.42
270046.......................................................... 0.77
270048.......................................................... 1.75
270049.......................................................... 1.27
270050.......................................................... 1.18
270051.......................................................... 1.78
270052.......................................................... 0.67
270053.......................................................... 0.60
270057.......................................................... 1.54
270058.......................................................... 0.85
270059.......................................................... 0.49
270060.......................................................... 0.61
270063.......................................................... 0.77
270068.......................................................... 1.19
270072.......................................................... 0.43
270073.......................................................... 0.72
270079.......................................................... 1.16
270080.......................................................... 1.30
270081.......................................................... 0.65
270082.......................................................... 0.70
270083.......................................................... 0.89
270084.......................................................... 1.09
271225.......................................................... 0.49
271226.......................................................... 0.69
271227.......................................................... 0.50
271228.......................................................... 0.57
271229.......................................................... 0.67
271230.......................................................... 0.56
271231.......................................................... 0.67
271232.......................................................... 0.60
271233.......................................................... 0.61
280001.......................................................... 1.33
280003.......................................................... 2.35
280005.......................................................... 1.63
280009.......................................................... 2.17
280010.......................................................... 0.77
280011.......................................................... 1.58
280012.......................................................... 1.24
280013.......................................................... 1.41
280014.......................................................... 1.15
280015.......................................................... 1.48
280017.......................................................... 1.18
280018.......................................................... 1.13
280020.......................................................... 1.31
280021.......................................................... 1.75
280022.......................................................... 0.95
280023.......................................................... 1.19
280024.......................................................... 0.92
280025.......................................................... 0.75
280026.......................................................... 0.97
280028.......................................................... 2.02
280029.......................................................... 0.84
280030.......................................................... 1.72
280031.......................................................... 1.45
280032.......................................................... 1.81
280033.......................................................... 0.98
[[Page 48019]]
280034.......................................................... 1.65
280035.......................................................... 1.17
280037.......................................................... 1.01
280038.......................................................... 1.28
280039.......................................................... 1.56
280040.......................................................... 2.07
280041.......................................................... 0.95
280042.......................................................... 0.79
280043.......................................................... 2.09
280045.......................................................... 1.15
280046.......................................................... 1.06
280047.......................................................... 1.68
280048.......................................................... 1.22
280049.......................................................... 0.89
280050.......................................................... 1.16
280051.......................................................... 1.45
280052.......................................................... 1.44
280054.......................................................... 1.15
280055.......................................................... 0.84
280056.......................................................... 0.96
280057.......................................................... 1.45
280058.......................................................... 2.18
280060.......................................................... 1.30
280061.......................................................... 2.55
280062.......................................................... 2.96
280064.......................................................... 1.28
280065.......................................................... 1.88
280066.......................................................... 1.26
280068.......................................................... 0.87
280070.......................................................... 1.30
280073.......................................................... 1.10
280074.......................................................... 1.85
280075.......................................................... 2.00
280076.......................................................... 1.60
280077.......................................................... 2.48
280079.......................................................... 0.82
280080.......................................................... 1.19
280081.......................................................... 1.58
280082.......................................................... 0.87
280083.......................................................... 1.34
280084.......................................................... 1.01
280085.......................................................... 1.66
280088.......................................................... 2.74
280089.......................................................... 1.45
280090.......................................................... 0.72
280091.......................................................... 3.55
280092.......................................................... 0.98
280094.......................................................... 1.36
280097.......................................................... 1.08
280098.......................................................... 0.71
280101.......................................................... 0.73
280102.......................................................... 1.00
280104.......................................................... 1.38
280105.......................................................... 1.67
280106.......................................................... 1.22
280107.......................................................... 1.16
280108.......................................................... 5.55
280109.......................................................... 0.77
280110.......................................................... 1.50
280111.......................................................... 1.21
280114.......................................................... 0.89
280115.......................................................... 2.12
280117.......................................................... 1.72
280118.......................................................... 1.01
283025.......................................................... 0.66
283301.......................................................... 1.10
284007.......................................................... 1.47
290001.......................................................... 1.46
290002.......................................................... 0.51
290003.......................................................... 1.81
290005.......................................................... 2.49
290006.......................................................... 1.10
290007.......................................................... 1.00
290008.......................................................... 1.34
290009.......................................................... 1.40
290010.......................................................... 1.10
290011.......................................................... 0.79
290012.......................................................... 1.49
290013.......................................................... 0.59
290014.......................................................... 1.16
290015.......................................................... 0.88
290016.......................................................... 1.11
290019.......................................................... 1.56
290020.......................................................... 0.59
290021.......................................................... 1.46
290022.......................................................... 1.97
290027.......................................................... 0.84
290032.......................................................... 1.28
290038.......................................................... 1.08
292002.......................................................... 0.76
293027.......................................................... 0.96
294003.......................................................... 0.73
294004.......................................................... 0.78
294005.......................................................... 0.89
300001.......................................................... 1.67
300003.......................................................... 1.26
300005.......................................................... 1.56
300006.......................................................... 1.26
300007.......................................................... 1.57
300008.......................................................... 1.76
300009.......................................................... 1.23
300010.......................................................... 1.01
300011.......................................................... 1.75
300012.......................................................... 1.39
300013.......................................................... 1.07
300014.......................................................... 1.51
300015.......................................................... 1.57
300016.......................................................... 1.29
300017.......................................................... 1.43
300018.......................................................... 1.63
300019.......................................................... 1.64
300021.......................................................... 1.18
300022.......................................................... 1.75
300023.......................................................... 1.29
300024.......................................................... 1.46
300028.......................................................... 1.23
300029.......................................................... 2.12
300033.......................................................... 0.98
300034.......................................................... 1.66
303026.......................................................... 1.26
303027.......................................................... 1.00
304000.......................................................... 0.55
304001.......................................................... 7.13
304003.......................................................... 0.87
310001.......................................................... 1.58
310002.......................................................... 1.44
310005.......................................................... 1.62
310006.......................................................... 1.84
310008.......................................................... 2.66
310009.......................................................... 1.69
310010.......................................................... 1.36
310011.......................................................... 2.11
310012.......................................................... 2.19
310013.......................................................... 1.53
310014.......................................................... 1.69
310015.......................................................... 1.58
310016.......................................................... 1.81
310017.......................................................... 2.03
310018.......................................................... 1.76
310019.......................................................... 1.84
310020.......................................................... 1.87
310021.......................................................... 1.60
310022.......................................................... 1.72
310024.......................................................... 2.26
310025.......................................................... 1.84
310026.......................................................... 1.64
310027.......................................................... 1.62
310028.......................................................... 1.67
310029.......................................................... 2.82
310031.......................................................... 1.35
310032.......................................................... 1.65
310034.......................................................... 2.02
310036.......................................................... 1.44
310037.......................................................... 1.64
310039.......................................................... 2.07
310041.......................................................... 1.66
310042.......................................................... 1.68
310043.......................................................... 1.86
310044.......................................................... 1.53
310045.......................................................... 1.87
310047.......................................................... 2.07
310048.......................................................... 1.87
310050.......................................................... 1.25
310051.......................................................... 1.99
310052.......................................................... 1.53
310054.......................................................... 1.63
310056.......................................................... 1.12
310057.......................................................... 1.66
310058.......................................................... 0.83
310060.......................................................... 2.12
310061.......................................................... 1.95
310062.......................................................... 1.24
310063.......................................................... 1.90
310064.......................................................... 1.78
310067.......................................................... 1.73
310069.......................................................... 1.69
310070.......................................................... 1.96
310072.......................................................... 2.01
310073.......................................................... 1.63
310074.......................................................... 0.97
310076.......................................................... 1.38
310077.......................................................... 1.79
310078.......................................................... 1.45
310081.......................................................... 1.90
310083.......................................................... 1.00
310084.......................................................... 1.44
310086.......................................................... 1.58
310087.......................................................... 1.49
310088.......................................................... 1.28
310090.......................................................... 2.02
310091.......................................................... 2.12
310092.......................................................... 1.63
310093.......................................................... 1.61
310096.......................................................... 1.97
310105.......................................................... 1.06
310108.......................................................... 1.74
310111.......................................................... 1.49
310112.......................................................... 1.91
310113.......................................................... 1.77
310115.......................................................... 1.30
310116.......................................................... 1.65
310118.......................................................... 1.48
310120.......................................................... 1.25
312014.......................................................... 0.70
313025.......................................................... 0.95
313026.......................................................... 0.91
313027.......................................................... 0.99
313029.......................................................... 1.05
313030.......................................................... 0.78
313300.......................................................... 0.90
314001.......................................................... 1.00
314010.......................................................... 0.88
314011.......................................................... 0.89
314012.......................................................... 1.07
314021.......................................................... 0.91
314022.......................................................... 0.87
320001.......................................................... 0.97
320002.......................................................... 1.15
320003.......................................................... 1.52
320004.......................................................... 1.64
320005.......................................................... 1.85
320006.......................................................... 1.73
320009.......................................................... 1.59
320011.......................................................... 1.16
320012.......................................................... 1.48
320013.......................................................... 1.35
320014.......................................................... 1.02
320016.......................................................... 1.91
[[Page 48020]]
320017.......................................................... 1.31
320018.......................................................... 2.01
320019.......................................................... 0.80
320021.......................................................... 1.21
320022.......................................................... 1.76
320023.......................................................... 0.81
320030.......................................................... 1.17
320031.......................................................... 0.74
320032.......................................................... 0.91
320033.......................................................... 1.53
320035.......................................................... 0.72
320037.......................................................... 1.40
320038.......................................................... 1.46
320046.......................................................... 1.20
320048.......................................................... 0.91
320063.......................................................... 1.46
320065.......................................................... 1.32
320067.......................................................... 0.77
320068.......................................................... 0.91
320069.......................................................... 1.25
320074.......................................................... 1.31
320079.......................................................... 1.47
322002.......................................................... 1.31
322003.......................................................... 0.52
323025.......................................................... 0.92
323026.......................................................... 0.74
323027.......................................................... 0.92
323028.......................................................... 1.09
323029.......................................................... 0.87
324003.......................................................... 0.88
324004.......................................................... 0.87
324007.......................................................... 0.97
324008.......................................................... 0.98
324010.......................................................... 1.10
330001.......................................................... 1.68
330002.......................................................... 1.49
330003.......................................................... 1.56
330004.......................................................... 1.59
330005.......................................................... 1.62
330006.......................................................... 1.50
330007.......................................................... 1.54
330008.......................................................... 1.46
330010.......................................................... 1.38
330011.......................................................... 1.13
330012.......................................................... 1.47
330013.......................................................... 1.91
330014.......................................................... 1.26
330016.......................................................... 1.28
330020.......................................................... 0.84
330023.......................................................... 1.68
330024.......................................................... 1.55
330025.......................................................... 1.25
330027.......................................................... 0.61
330028.......................................................... 1.15
330029.......................................................... 1.05
330030.......................................................... 1.58
330033.......................................................... 1.02
330034.......................................................... 0.71
330036.......................................................... 1.57
330037.......................................................... 1.58
330038.......................................................... 1.23
330039.......................................................... 0.72
330041.......................................................... 2.14
330043.......................................................... 1.30
330044.......................................................... 1.61
330045.......................................................... 2.04
330046.......................................................... 1.31
330047.......................................................... 1.51
330048.......................................................... 1.78
330049.......................................................... 1.62
330053.......................................................... 1.20
330055.......................................................... 1.71
330056.......................................................... 1.29
330057.......................................................... 1.64
330058.......................................................... 1.40
330059.......................................................... 1.44
330061.......................................................... 2.02
330062.......................................................... 0.92
330064.......................................................... 1.55
330065.......................................................... 1.65
330066.......................................................... 1.43
330067.......................................................... 1.75
330072.......................................................... 1.25
330073.......................................................... 1.30
330074.......................................................... 1.88
330075.......................................................... 1.32
330078.......................................................... 1.32
330079.......................................................... 1.38
330084.......................................................... 1.35
330085.......................................................... 1.19
330086.......................................................... 1.28
330088.......................................................... 1.15
330090.......................................................... 1.59
330091.......................................................... 1.53
330092.......................................................... 0.88
330094.......................................................... 1.27
330095.......................................................... 1.62
330096.......................................................... 1.49
330097.......................................................... 1.15
330100.......................................................... 3.05
330101.......................................................... 1.52
330102.......................................................... 1.90
330103.......................................................... 1.90
330104.......................................................... 1.44
330106.......................................................... 1.88
330107.......................................................... 1.75
330108.......................................................... 1.49
330111.......................................................... 1.34
330114.......................................................... 0.59
330115.......................................................... 1.59
330116.......................................................... 1.23
330118.......................................................... 1.68
330119.......................................................... 1.86
330121.......................................................... 0.87
330122.......................................................... 1.79
330125.......................................................... 1.31
330126.......................................................... 1.64
330132.......................................................... 0.98
330133.......................................................... 1.96
330135.......................................................... 1.56
330136.......................................................... 0.84
330140.......................................................... 1.72
330141.......................................................... 1.59
330144.......................................................... 1.48
330148.......................................................... 1.09
330151.......................................................... 1.30
330152.......................................................... 1.71
330153.......................................................... 1.51
330157.......................................................... 1.28
330158.......................................................... 1.69
330159.......................................................... 1.59
330160.......................................................... 1.40
330161.......................................................... 0.87
330162.......................................................... 2.57
330163.......................................................... 1.68
330164.......................................................... 1.28
330166.......................................................... 1.34
330167.......................................................... 2.53
330169.......................................................... 1.43
330171.......................................................... 1.48
330175.......................................................... 1.33
330177.......................................................... 1.24
330179.......................................................... 0.84
330180.......................................................... 1.26
330181.......................................................... 1.54
330182.......................................................... 2.51
330183.......................................................... 1.28
330184.......................................................... 1.53
330185.......................................................... 1.11
330188.......................................................... 1.66
330189.......................................................... 5.26
330191.......................................................... 1.48
330193.......................................................... 1.70
330194.......................................................... 1.31
330195.......................................................... 1.49
330197.......................................................... 1.45
330198.......................................................... 1.68
330203.......................................................... 2.34
330205.......................................................... 1.39
330208.......................................................... 1.62
330209.......................................................... 1.54
330211.......................................................... 1.34
330212.......................................................... 1.64
330213.......................................................... 1.09
330214.......................................................... 1.82
330215.......................................................... 1.69
330218.......................................................... 1.16
330219.......................................................... 1.23
330221.......................................................... 1.36
330222.......................................................... 1.76
330223.......................................................... 1.29
330224.......................................................... 1.68
330225.......................................................... 1.51
330226.......................................................... 1.50
330229.......................................................... 1.40
330230.......................................................... 1.59
330232.......................................................... 1.38
330233.......................................................... 1.27
330235.......................................................... 1.96
330236.......................................................... 1.37
330238.......................................................... 1.53
330239.......................................................... 1.45
330241.......................................................... 1.63
330242.......................................................... 1.70
330245.......................................................... 1.49
330246.......................................................... 1.67
330247.......................................................... 3.47
330249.......................................................... 1.30
330250.......................................................... 1.51
330252.......................................................... 0.76
330254.......................................................... 1.34
330258.......................................................... 0.96
330259.......................................................... 1.52
330261.......................................................... 1.46
330263.......................................................... 1.76
330264.......................................................... 1.62
330265.......................................................... 1.10
330267.......................................................... 1.43
330268.......................................................... 0.96
330270.......................................................... 1.34
330273.......................................................... 1.63
330275.......................................................... 1.29
330276.......................................................... 1.21
330277.......................................................... 1.72
330279.......................................................... 1.84
330285.......................................................... 1.38
330286.......................................................... 1.62
330288.......................................................... 0.67
330290.......................................................... 1.25
330293.......................................................... 1.10
330304.......................................................... 1.79
330306.......................................................... 1.18
330307.......................................................... 1.80
330308.......................................................... 1.98
330314.......................................................... 1.81
330316.......................................................... 2.02
330327.......................................................... 1.13
330331.......................................................... 1.65
330332.......................................................... 2.55
330333.......................................................... 1.80
330336.......................................................... 1.40
330338.......................................................... 1.79
330339.......................................................... 2.41
330340.......................................................... 1.65
330350.......................................................... 1.42
330353.......................................................... 1.89
330357.......................................................... 1.29
330359.......................................................... 0.65
[[Page 48021]]
330372.......................................................... 1.88
330381.......................................................... 1.26
330386.......................................................... 1.30
330389.......................................................... 1.37
330390.......................................................... 0.94
330393.......................................................... 1.81
330394.......................................................... 1.59
330395.......................................................... 1.55
330397.......................................................... 0.96
330398.......................................................... 2.02
330399.......................................................... 0.88
332012.......................................................... 0.83
332021.......................................................... 0.53
332022.......................................................... 0.77
333025.......................................................... 0.77
333027.......................................................... 0.80
333028.......................................................... 0.72
333300.......................................................... 1.34
334002.......................................................... 0.87
334022.......................................................... 0.89
334023.......................................................... 1.10
334027.......................................................... 0.75
334048.......................................................... 1.30
334049.......................................................... 0.86
334055.......................................................... 0.83
340001.......................................................... 1.24
340002.......................................................... 2.20
340003.......................................................... 1.37
340004.......................................................... 1.79
340005.......................................................... 1.28
340006.......................................................... 0.92
340007.......................................................... 1.18
340008.......................................................... 1.44
340009.......................................................... 11.22
340010.......................................................... 1.92
340011.......................................................... 1.10
340012.......................................................... 1.45
340013.......................................................... 1.29
340014.......................................................... 0.99
340015.......................................................... 1.80
340016.......................................................... 1.99
340017.......................................................... 1.77
340018.......................................................... 1.40
340019.......................................................... 1.06
340020.......................................................... 1.31
340021.......................................................... 1.63
340022.......................................................... 1.20
340023.......................................................... 1.19
340024.......................................................... 1.41
340025.......................................................... 1.78
340027.......................................................... 1.94
340028.......................................................... 1.49
340030.......................................................... 1.51
340031.......................................................... 1.22
340032.......................................................... 1.67
340035.......................................................... 1.51
340036.......................................................... 1.05
340037.......................................................... 1.16
340038.......................................................... 2.00
340039.......................................................... 1.70
340040.......................................................... 1.99
340041.......................................................... 1.27
340042.......................................................... 1.29
340044.......................................................... 1.03
340045.......................................................... 0.69
340047.......................................................... 1.56
340049.......................................................... 4.05
340050.......................................................... 2.52
340051.......................................................... 1.76
340052.......................................................... 1.21
340053.......................................................... 2.01
340054.......................................................... 1.46
340055.......................................................... 1.23
340060.......................................................... 1.43
340061.......................................................... 1.19
340063.......................................................... 0.85
340064.......................................................... 1.36
340065.......................................................... 1.21
340067.......................................................... 1.46
340068.......................................................... 1.62
340069.......................................................... 1.54
340070.......................................................... 1.62
340071.......................................................... 1.21
340072.......................................................... 1.47
340073.......................................................... 1.93
340075.......................................................... 1.27
340080.......................................................... 1.07
340084.......................................................... 0.91
340085.......................................................... 1.49
340087.......................................................... 1.16
340088.......................................................... 1.73
340089.......................................................... 0.95
340090.......................................................... 1.30
340091.......................................................... 1.97
340093.......................................................... 1.10
340094.......................................................... 2.16
340096.......................................................... 1.65
340097.......................................................... 1.61
340098.......................................................... 1.74
340099.......................................................... 1.19
340100.......................................................... 0.55
340101.......................................................... 1.49
340104.......................................................... 1.12
340105.......................................................... 2.59
340106.......................................................... 1.25
340107.......................................................... 1.87
340109.......................................................... 2.34
340111.......................................................... 1.41
340112.......................................................... 1.15
340113.......................................................... 1.55
340114.......................................................... 1.32
340115.......................................................... 1.50
340116.......................................................... 1.75
340119.......................................................... 1.39
340120.......................................................... 1.17
340121.......................................................... 1.35
340123.......................................................... 1.38
340124.......................................................... 1.22
340125.......................................................... 2.53
340126.......................................................... 1.71
340127.......................................................... 1.20
340129.......................................................... 1.60
340130.......................................................... 1.69
340131.......................................................... 1.74
340132.......................................................... 1.29
340133.......................................................... 0.94
340141.......................................................... 1.78
340142.......................................................... 1.33
340143.......................................................... 1.72
340144.......................................................... 1.88
340145.......................................................... 1.56
340146.......................................................... 0.80
340147.......................................................... 1.96
340148.......................................................... 2.81
340151.......................................................... 1.53
340153.......................................................... 2.63
340155.......................................................... 1.59
340158.......................................................... 1.75
340159.......................................................... 0.93
340160.......................................................... 1.50
340162.......................................................... 1.08
340164.......................................................... 1.23
340166.......................................................... 1.28
340171.......................................................... 1.65
342003.......................................................... 1.01
342012.......................................................... 0.55
343025.......................................................... 1.00
344005.......................................................... 0.87
344006.......................................................... 0.87
344010.......................................................... 0.68
344011.......................................................... 1.01
344014.......................................................... 1.08
344015.......................................................... 0.87
344016.......................................................... 0.72
344019.......................................................... 0.87
350001.......................................................... 0.71
350002.......................................................... 2.20
350003.......................................................... 1.45
350004.......................................................... 2.27
350005.......................................................... 1.22
350006.......................................................... 1.32
350007.......................................................... 1.37
350008.......................................................... 1.11
350009.......................................................... 1.85
350010.......................................................... 1.32
350011.......................................................... 1.84
350012.......................................................... 1.09
350013.......................................................... 1.12
350014.......................................................... 1.20
350015.......................................................... 2.07
350016.......................................................... 0.69
350017.......................................................... 1.48
350018.......................................................... 1.45
350019.......................................................... 2.12
350020.......................................................... 0.83
350021.......................................................... 1.08
350023.......................................................... 1.43
350024.......................................................... 1.19
350025.......................................................... 0.90
350027.......................................................... 0.68
350029.......................................................... 0.88
350030.......................................................... 1.44
350033.......................................................... 1.32
350034.......................................................... 1.21
350035.......................................................... 0.56
350038.......................................................... 1.80
350039.......................................................... 1.23
350041.......................................................... 0.93
350042.......................................................... 1.75
350043.......................................................... 1.74
350044.......................................................... 1.10
350047.......................................................... 1.11
350049.......................................................... 1.43
350050.......................................................... 0.91
350051.......................................................... 1.04
350053.......................................................... 0.86
350055.......................................................... 0.81
350056.......................................................... 1.24
350058.......................................................... 1.02
350060.......................................................... 0.54
350061.......................................................... 1.54
360001.......................................................... 1.79
360002.......................................................... 1.50
360003.......................................................... 1.29
360006.......................................................... 2.02
360007.......................................................... 1.28
360008.......................................................... 1.36
360009.......................................................... 1.56
360010.......................................................... 1.64
360011.......................................................... 1.33
360012.......................................................... 1.89
360013.......................................................... 1.36
360014.......................................................... 1.63
360016.......................................................... 1.27
360017.......................................................... 2.64
360018.......................................................... 1.57
360019.......................................................... 1.38
360020.......................................................... 1.41
360021.......................................................... 3.45
360024.......................................................... 1.47
360025.......................................................... 1.10
360026.......................................................... 1.38
360027.......................................................... 1.68
360028.......................................................... 2.30
360029.......................................................... 1.62
360030.......................................................... 1.48
360031.......................................................... 1.34
360032.......................................................... 1.62
[[Page 48022]]
360034.......................................................... 0.96
360035.......................................................... 1.31
360036.......................................................... 1.55
360037.......................................................... 1.35
360038.......................................................... 1.43
360039.......................................................... 1.36
360040.......................................................... 1.24
360041.......................................................... 1.46
360042.......................................................... 1.24
360044.......................................................... 1.56
360045.......................................................... 1.24
360046.......................................................... 1.51
360047.......................................................... 0.97
360048.......................................................... 1.57
360049.......................................................... 1.60
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360054.......................................................... 1.69
360055.......................................................... 1.66
360056.......................................................... 1.67
360057.......................................................... 1.10
360058.......................................................... 1.19
360059.......................................................... 1.11
360062.......................................................... 1.69
360063.......................................................... 1.09
360064.......................................................... 2.07
360065.......................................................... 1.42
360066.......................................................... 1.64
360067.......................................................... 1.06
360068.......................................................... 1.53
360069.......................................................... 1.18
360070.......................................................... 1.23
360071.......................................................... 1.40
360072.......................................................... 1.47
360074.......................................................... 1.46
360075.......................................................... 1.50
360076.......................................................... 1.68
360077.......................................................... 1.61
360078.......................................................... 1.46
360079.......................................................... 1.80
360080.......................................................... 1.36
360081.......................................................... 1.53
360082.......................................................... 1.83
360083.......................................................... 1.53
360084.......................................................... 1.70
360085.......................................................... 1.93
360086.......................................................... 1.45
360087.......................................................... 1.48
360088.......................................................... 1.21
360089.......................................................... 1.34
360090.......................................................... 2.29
360091.......................................................... 1.47
360092.......................................................... 1.15
360093.......................................................... 1.93
360094.......................................................... 1.29
360095.......................................................... 1.59
360096.......................................................... 1.41
360098.......................................................... 1.88
360099.......................................................... 1.23
360100.......................................................... 1.62
360101.......................................................... 1.92
360102.......................................................... 1.87
360103.......................................................... 1.39
360106.......................................................... 1.05
360107.......................................................... 1.21
360108.......................................................... 1.11
360109.......................................................... 1.32
360112.......................................................... 1.66
360113.......................................................... 1.58
360114.......................................................... 1.30
360115.......................................................... 1.47
360116.......................................................... 1.07
360118.......................................................... 1.40
360121.......................................................... 1.94
360123.......................................................... 1.42
360125.......................................................... 1.13
360126.......................................................... 1.25
360127.......................................................... 1.49
360128.......................................................... 1.04
360129.......................................................... 1.04
360130.......................................................... 1.36
360131.......................................................... 1.46
360132.......................................................... 1.67
360133.......................................................... 1.66
360134.......................................................... 1.63
360136.......................................................... 1.06
360137.......................................................... 1.52
360140.......................................................... 1.02
360141.......................................................... 1.82
360142.......................................................... 1.23
360143.......................................................... 1.50
360144.......................................................... 1.68
360145.......................................................... 1.63
360147.......................................................... 1.54
360148.......................................................... 1.36
360149.......................................................... 1.73
360150.......................................................... 1.77
360151.......................................................... 1.71
360152.......................................................... 1.71
360153.......................................................... 1.10
360154.......................................................... 1.00
360155.......................................................... 1.65
360156.......................................................... 1.42
360159.......................................................... 1.46
360161.......................................................... 1.53
360162.......................................................... 1.42
360163.......................................................... 1.85
360164.......................................................... 1.06
360165.......................................................... 1.00
360166.......................................................... 1.13
360170.......................................................... 1.30
360172.......................................................... 1.72
360174.......................................................... 1.67
360175.......................................................... 1.68
360176.......................................................... 1.14
360177.......................................................... 0.96
360178.......................................................... 1.37
360179.......................................................... 1.51
360180.......................................................... 1.80
360184.......................................................... 0.88
360185.......................................................... 1.41
360186.......................................................... 0.97
360187.......................................................... 1.64
360188.......................................................... 1.03
360189.......................................................... 1.44
360192.......................................................... 1.44
360193.......................................................... 1.52
360194.......................................................... 1.34
360195.......................................................... 1.77
360197.......................................................... 1.19
360200.......................................................... 1.00
360203.......................................................... 1.50
360204.......................................................... 1.26
360210.......................................................... 1.58
360211.......................................................... 1.46
360212.......................................................... 1.50
360213.......................................................... 1.32
360218.......................................................... 1.42
360230.......................................................... 1.87
360231.......................................................... 0.87
360234.......................................................... 1.31
360236.......................................................... 1.58
360239.......................................................... 1.64
360241.......................................................... 0.81
360243.......................................................... 0.87
360244.......................................................... 0.87
360245.......................................................... 0.89
362004.......................................................... 1.18
362007.......................................................... 0.33
362009.......................................................... 0.94
362014.......................................................... 3.41
362015.......................................................... 0.99
363300.......................................................... 1.21
363303.......................................................... 1.31
363305.......................................................... 1.22
363306.......................................................... 0.86
364003.......................................................... 0.92
364017.......................................................... 0.85
364026.......................................................... 0.88
364029.......................................................... 0.93
364032.......................................................... 1.09
364038.......................................................... 1.10
370001.......................................................... 1.82
370002.......................................................... 1.98
370004.......................................................... 1.78
370005.......................................................... 0.92
370006.......................................................... 1.53
370007.......................................................... 1.43
370008.......................................................... 1.77
370011.......................................................... 1.12
370012.......................................................... 0.86
370013.......................................................... 1.89
370014.......................................................... 1.59
370015.......................................................... 1.18
370016.......................................................... 1.85
370017.......................................................... 1.20
370018.......................................................... 2.00
370019.......................................................... 1.45
370020.......................................................... 1.40
370021.......................................................... 0.86
370022.......................................................... 2.88
370023.......................................................... 1.43
370025.......................................................... 1.63
370026.......................................................... 1.88
370028.......................................................... 2.09
370029.......................................................... 1.59
370030.......................................................... 1.20
370032.......................................................... 2.50
370033.......................................................... 1.71
370034.......................................................... 1.60
370035.......................................................... 1.26
370036.......................................................... 0.53
370037.......................................................... 2.76
370038.......................................................... 0.96
370039.......................................................... 1.29
370040.......................................................... 2.17
370041.......................................................... 1.09
370042.......................................................... 0.91
370043.......................................................... 0.81
370045.......................................................... 0.98
370046.......................................................... 1.48
370047.......................................................... 1.81
370048.......................................................... 1.13
370049.......................................................... 2.04
370051.......................................................... 0.77
370054.......................................................... 1.70
370056.......................................................... 1.81
370057.......................................................... 1.23
370059.......................................................... 0.65
370060.......................................................... 1.04
370063.......................................................... 0.91
370064.......................................................... 1.03
370065.......................................................... 1.63
370071.......................................................... 0.89
370072.......................................................... 0.88
370076.......................................................... 1.46
370077.......................................................... 1.37
370078.......................................................... 2.17
370079.......................................................... 1.24
370080.......................................................... 1.02
370082.......................................................... 0.89
370083.......................................................... 1.54
370084.......................................................... 1.13
370085.......................................................... 1.07
370086.......................................................... 1.54
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370100.......................................................... 0.88
370103.......................................................... 1.08
370105.......................................................... 2.87
370106.......................................................... 2.52
370108.......................................................... 1.02
370112.......................................................... 0.99
370113.......................................................... 1.21
370114.......................................................... 1.91
370121.......................................................... 1.82
370122.......................................................... 0.63
370123.......................................................... 1.81
370125.......................................................... 1.27
370126.......................................................... 0.84
370131.......................................................... 0.85
370133.......................................................... 1.16
370138.......................................................... 1.50
370139.......................................................... 1.03
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370141.......................................................... 1.14
370146.......................................................... 0.87
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370149.......................................................... 1.84
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370154.......................................................... 1.56
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370158.......................................................... 1.38
370159.......................................................... 1.35
370163.......................................................... 0.80
370165.......................................................... 0.99
370166.......................................................... 1.31
370169.......................................................... 1.50
370176.......................................................... 1.65
370177.......................................................... 1.07
370178.......................................................... 1.33
370179.......................................................... 0.90
370183.......................................................... 1.38
370186.......................................................... 1.45
370190.......................................................... 1.66
370192.......................................................... 2.00
372004.......................................................... 0.51
373025.......................................................... 0.97
373026.......................................................... 0.84
374003.......................................................... 0.71
374006.......................................................... 0.79
374008.......................................................... 1.09
374010.......................................................... 0.98
374012.......................................................... 0.88
374013.......................................................... 0.85
374017.......................................................... 0.90
374018.......................................................... 0.68
374019.......................................................... 0.95
374020.......................................................... 0.85
380001.......................................................... 2.38
380002.......................................................... 2.39
380003.......................................................... 2.52
380004.......................................................... 3.35
380005.......................................................... 2.55
380006.......................................................... 1.64
380007.......................................................... 2.26
380008.......................................................... 1.37
380009.......................................................... 1.48
380010.......................................................... 1.45
380011.......................................................... 1.95
380013.......................................................... 1.08
380014.......................................................... 2.43
380017.......................................................... 3.10
380018.......................................................... 1.40
380019.......................................................... 1.26
380020.......................................................... 3.28
380021.......................................................... 2.64
380022.......................................................... 2.06
380023.......................................................... 1.47
380025.......................................................... 2.38
380026.......................................................... 1.62
380027.......................................................... 1.58
380029.......................................................... 1.88
380031.......................................................... 1.02
380033.......................................................... 1.81
380035.......................................................... 2.25
380036.......................................................... 1.39
380037.......................................................... 1.74
380038.......................................................... 2.14
380039.......................................................... 1.64
380040.......................................................... 1.76
380042.......................................................... 1.52
380047.......................................................... 2.34
380048.......................................................... 0.72
380050.......................................................... 1.43
380051.......................................................... 1.77
380052.......................................................... 2.78
380056.......................................................... 1.24
380060.......................................................... 1.75
380061.......................................................... 2.66
380062.......................................................... 0.62
380063.......................................................... 1.77
380064.......................................................... 1.51
380065.......................................................... 0.96
380066.......................................................... 2.44
380068.......................................................... 1.03
380069.......................................................... 0.88
380070.......................................................... 1.04
380071.......................................................... 2.13
380072.......................................................... 1.31
380075.......................................................... 1.51
380078.......................................................... 1.14
380081.......................................................... 0.77
380082.......................................................... 2.32
380083.......................................................... 1.63
380084.......................................................... 1.58
380087.......................................................... 0.95
380088.......................................................... 1.55
380089.......................................................... 2.58
380090.......................................................... 1.93
384006.......................................................... 0.90
390001.......................................................... 1.79
390002.......................................................... 1.62
390003.......................................................... 1.11
390004.......................................................... 1.68
390005.......................................................... 1.48
390006.......................................................... 1.17
390007.......................................................... 2.39
390008.......................................................... 1.36
390009.......................................................... 1.68
390010.......................................................... 1.63
390011.......................................................... 1.57
390012.......................................................... 1.81
390013.......................................................... 1.93
390015.......................................................... 1.15
390016.......................................................... 1.43
390017.......................................................... 1.44
390018.......................................................... 1.86
390019.......................................................... 1.37
390022.......................................................... 1.85
390023.......................................................... 1.12
390024.......................................................... 1.99
390025.......................................................... 0.72
390026.......................................................... 1.36
390028.......................................................... 1.98
390029.......................................................... 1.72
390030.......................................................... 1.45
390031.......................................................... 1.55
390032.......................................................... 1.45
390035.......................................................... 1.67
390036.......................................................... 1.75
390037.......................................................... 1.76
390039.......................................................... 1.53
390040.......................................................... 1.13
390041.......................................................... 1.81
390042.......................................................... 1.62
390043.......................................................... 1.89
390044.......................................................... 1.76
390045.......................................................... 1.51
390046.......................................................... 1.31
390047.......................................................... 1.65
390048.......................................................... 1.55
390049.......................................................... 1.82
390050.......................................................... 2.01
390051.......................................................... 1.78
390052.......................................................... 1.65
390054.......................................................... 1.35
390055.......................................................... 1.76
390056.......................................................... 1.41
390057.......................................................... 1.67
390058.......................................................... 2.05
390060.......................................................... 1.16
390061.......................................................... 1.56
390062.......................................................... 1.87
390063.......................................................... 2.32
390065.......................................................... 1.63
390066.......................................................... 1.44
390067.......................................................... 1.84
390068.......................................................... 1.27
390069.......................................................... 1.51
390070.......................................................... 2.11
390071.......................................................... 1.61
390072.......................................................... 1.42
390073.......................................................... 1.70
390074.......................................................... 1.74
390075.......................................................... 1.53
390076.......................................................... 1.51
390078.......................................................... 1.74
390079.......................................................... 2.09
390080.......................................................... 1.57
390081.......................................................... 2.02
390083.......................................................... 1.19
390084.......................................................... 1.26
390086.......................................................... 1.57
390088.......................................................... 1.27
390090.......................................................... 1.91
390091.......................................................... 1.44
390093.......................................................... 1.31
390095.......................................................... 1.52
390096.......................................................... 1.46
390097.......................................................... 1.57
390100.......................................................... 1.70
390101.......................................................... 1.24
390102.......................................................... 1.81
390103.......................................................... 1.39
390104.......................................................... 1.26
390106.......................................................... 1.31
390107.......................................................... 1.66
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390114.......................................................... 1.64
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390118.......................................................... 1.85
390119.......................................................... 1.71
390121.......................................................... 1.59
390122.......................................................... 1.47
390123.......................................................... 2.69
390125.......................................................... 1.55
390126.......................................................... 1.77
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390184.......................................................... 1.13
390185.......................................................... 1.87
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390191.......................................................... 1.91
390192.......................................................... 1.44
390193.......................................................... 1.86
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390197.......................................................... 2.04
390198.......................................................... 1.58
390199.......................................................... 1.12
390200.......................................................... 1.05
390201.......................................................... 1.53
390203.......................................................... 1.75
390204.......................................................... 1.64
390205.......................................................... 1.61
390206.......................................................... 1.43
390209.......................................................... 1.34
390211.......................................................... 1.73
390213.......................................................... 0.70
390215.......................................................... 1.74
390217.......................................................... 1.41
390219.......................................................... 1.21
390220.......................................................... 2.63
390222.......................................................... 1.86
390223.......................................................... 0.85
390224.......................................................... 1.13
390225.......................................................... 1.43
390226.......................................................... 1.54
390228.......................................................... 1.53
390231.......................................................... 1.35
390233.......................................................... 1.41
390235.......................................................... 1.09
390236.......................................................... 1.42
390237.......................................................... 1.45
390238.......................................................... 3.25
390242.......................................................... 1.66
390244.......................................................... 0.64
390245.......................................................... 1.34
390246.......................................................... 1.66
390247.......................................................... 0.66
390249.......................................................... 0.72
390256.......................................................... 1.26
390258.......................................................... 1.64
390260.......................................................... 2.34
390262.......................................................... 1.79
390263.......................................................... 1.87
390265.......................................................... 1.06
390266.......................................................... 1.65
390267.......................................................... 1.78
390268.......................................................... 1.70
390270.......................................................... 1.69
390277.......................................................... 0.67
390279.......................................................... 1.54
392024.......................................................... 1.04
392025.......................................................... 1.08
392026.......................................................... 0.75
393025.......................................................... 0.75
393026.......................................................... 1.05
393027.......................................................... 1.41
393031.......................................................... 1.11
393032.......................................................... 0.85
393035.......................................................... 0.67
393037.......................................................... 0.87
393038.......................................................... 1.12
393039.......................................................... 0.93
393040.......................................................... 2.28
393041.......................................................... 1.47
393042.......................................................... 0.92
393043.......................................................... 0.62
393046.......................................................... 0.83
393301.......................................................... 1.27
393302.......................................................... 1.02
394006.......................................................... 0.79
394007.......................................................... 0.48
394008.......................................................... 1.88
394020.......................................................... 0.83
394023.......................................................... 0.77
394027.......................................................... 0.81
394034.......................................................... 0.85
394040.......................................................... 0.78
394041.......................................................... 0.83
394045.......................................................... 0.90
400001.......................................................... 1.10
400002.......................................................... 3.18
400003.......................................................... 0.97
400004.......................................................... 1.33
400005.......................................................... 1.12
400006.......................................................... 1.58
400007.......................................................... 0.76
400009.......................................................... 1.26
400010.......................................................... 0.76
400011.......................................................... 1.43
400012.......................................................... 0.74
400013.......................................................... 0.89
400014.......................................................... 3.08
400016.......................................................... 1.70
400017.......................................................... 1.31
400018.......................................................... 0.90
400019.......................................................... 2.15
400021.......................................................... 1.36
400022.......................................................... 1.25
400026.......................................................... 0.61
400027.......................................................... 0.58
400028.......................................................... 1.08
400029.......................................................... 0.73
400032.......................................................... 0.75
400094.......................................................... 0.74
400098.......................................................... 0.89
400102.......................................................... 1.52
400106.......................................................... 0.99
400109.......................................................... 1.29
400111.......................................................... 0.92
400112.......................................................... 0.70
400113.......................................................... 1.34
400114.......................................................... 0.95
400115.......................................................... 0.77
400117.......................................................... 1.34
400118.......................................................... 1.14
400120.......................................................... 1.44
400121.......................................................... 0.50
400122.......................................................... 0.65
400123.......................................................... 2.61
400124.......................................................... 6.42
404002.......................................................... 1.66
410001.......................................................... 1.45
410004.......................................................... 1.61
410005.......................................................... 2.08
410006.......................................................... 1.53
410007.......................................................... 1.72
410008.......................................................... 2.13
410009.......................................................... 2.11
410010.......................................................... 1.54
410011.......................................................... 1.94
410012.......................................................... 1.59
410013.......................................................... 1.81
413025.......................................................... 0.74
414000.......................................................... 1.33
420002.......................................................... 3.24
420004.......................................................... 2.85
420005.......................................................... 2.33
420006.......................................................... 0.86
420007.......................................................... 1.69
420009.......................................................... 1.66
420010.......................................................... 1.55
420011.......................................................... 1.18
420014.......................................................... 0.97
420015.......................................................... 1.61
420016.......................................................... 1.37
420018.......................................................... 1.37
420019.......................................................... 1.88
420020.......................................................... 2.01
420023.......................................................... 2.55
420026.......................................................... 2.05
420027.......................................................... 1.82
420030.......................................................... 1.60
420031.......................................................... 0.91
420033.......................................................... 1.52
420036.......................................................... 2.26
420037.......................................................... 1.41
420038.......................................................... 1.37
420039.......................................................... 1.18
420042.......................................................... 1.17
420043.......................................................... 1.29
420048.......................................................... 1.97
420049.......................................................... 1.93
420051.......................................................... 1.67
420053.......................................................... 1.66
420054.......................................................... 1.21
420055.......................................................... 1.18
420056.......................................................... 1.52
420057.......................................................... 1.16
420059.......................................................... 1.07
420061.......................................................... 1.12
420062.......................................................... 1.73
420064.......................................................... 1.02
420065.......................................................... 1.82
420066.......................................................... 1.27
420067.......................................................... 3.32
420068.......................................................... 1.63
420069.......................................................... 1.19
420070.......................................................... 2.73
420071.......................................................... 1.64
420072.......................................................... 0.83
420073.......................................................... 1.92
420074.......................................................... 0.95
420075.......................................................... 1.39
420078.......................................................... 1.85
420079.......................................................... 1.17
420080.......................................................... 2.72
420081.......................................................... 0.61
[[Page 48025]]
420082.......................................................... 1.81
420083.......................................................... 3.22
420085.......................................................... 2.37
420086.......................................................... 2.02
420087.......................................................... 1.99
420088.......................................................... 1.80
420089.......................................................... 2.68
420091.......................................................... 2.25
423025.......................................................... 1.90
423026.......................................................... 1.11
424006.......................................................... 0.87
424007.......................................................... 0.72
424008.......................................................... 0.88
424009.......................................................... 0.71
424010.......................................................... 0.88
430004.......................................................... 1.41
430005.......................................................... 1.88
430007.......................................................... 2.02
430008.......................................................... 1.54
430010.......................................................... 1.68
430011.......................................................... 2.90
430012.......................................................... 2.09
430013.......................................................... 1.87
430014.......................................................... 1.96
430015.......................................................... 3.56
430016.......................................................... 1.73
430018.......................................................... 0.99
430022.......................................................... 0.75
430023.......................................................... 1.01
430024.......................................................... 0.87
430026.......................................................... 0.95
430027.......................................................... 2.50
430028.......................................................... 1.47
430029.......................................................... 1.47
430031.......................................................... 1.06
430033.......................................................... 1.06
430034.......................................................... 0.94
430036.......................................................... 1.17
430037.......................................................... 2.29
430038.......................................................... 1.49
430040.......................................................... 2.17
430041.......................................................... 0.95
430043.......................................................... 1.53
430044.......................................................... 1.02
430047.......................................................... 1.12
430048.......................................................... 1.57
430049.......................................................... 0.75
430051.......................................................... 0.68
430054.......................................................... 1.45
430056.......................................................... 1.29
430057.......................................................... 1.28
430060.......................................................... 0.62
430062.......................................................... 1.23
430064.......................................................... 0.96
430065.......................................................... 0.83
430066.......................................................... 0.93
430073.......................................................... 1.13
430076.......................................................... 0.74
430077.......................................................... 1.90
430079.......................................................... 0.68
430087.......................................................... 0.73
434004.......................................................... 0.95
440001.......................................................... 1.36
440002.......................................................... 2.61
440003.......................................................... 1.62
440006.......................................................... 1.93
440007.......................................................... 0.72
440008.......................................................... 1.35
440009.......................................................... 2.00
440010.......................................................... 1.16
440011.......................................................... 1.53
440012.......................................................... 1.26
440014.......................................................... 1.03
440015.......................................................... 2.17
440016.......................................................... 1.29
440017.......................................................... 1.59
440018.......................................................... 1.04
440019.......................................................... 1.54
440020.......................................................... 1.26
440022.......................................................... 1.03
440023.......................................................... 1.05
440024.......................................................... 1.75
440025.......................................................... 1.42
440026.......................................................... 0.88
440029.......................................................... 1.98
440030.......................................................... 1.74
440031.......................................................... 1.44
440032.......................................................... 0.99
440033.......................................................... 1.22
440034.......................................................... 1.61
440035.......................................................... 1.63
440039.......................................................... 1.45
440040.......................................................... 1.04
440041.......................................................... 0.76
440046.......................................................... 1.52
440047.......................................................... 1.09
440048.......................................................... 2.09
440049.......................................................... 1.66
440050.......................................................... 1.22
440051.......................................................... 1.04
440052.......................................................... 1.02
440053.......................................................... 1.89
440054.......................................................... 1.29
440056.......................................................... 1.12
440057.......................................................... 1.21
440058.......................................................... 1.97
440059.......................................................... 1.63
440060.......................................................... 1.01
440061.......................................................... 1.36
440063.......................................................... 1.59
440064.......................................................... 1.02
440065.......................................................... 1.53
440067.......................................................... 1.46
440068.......................................................... 1.45
440070.......................................................... 1.08
440071.......................................................... 1.63
440072.......................................................... 1.78
440073.......................................................... 1.68
440078.......................................................... 1.04
440081.......................................................... 1.32
440082.......................................................... 1.87
440083.......................................................... 0.79
440084.......................................................... 0.96
440090.......................................................... 0.99
440091.......................................................... 1.79
440100.......................................................... 1.07
440102.......................................................... 1.17
440103.......................................................... 1.50
440104.......................................................... 1.60
440105.......................................................... 3.75
440109.......................................................... 1.05
440110.......................................................... 1.24
440111.......................................................... 0.87
440114.......................................................... 1.25
440115.......................................................... 1.26
440120.......................................................... 2.21
440125.......................................................... 1.87
440130.......................................................... 1.95
440131.......................................................... 1.80
440132.......................................................... 1.41
440133.......................................................... 2.08
440135.......................................................... 1.28
440137.......................................................... 1.29
440141.......................................................... 0.73
440142.......................................................... 0.95
440143.......................................................... 1.07
440144.......................................................... 2.32
440145.......................................................... 0.84
440147.......................................................... 4.16
440148.......................................................... 1.30
440149.......................................................... 0.98
440150.......................................................... 2.08
440151.......................................................... 1.31
440152.......................................................... 1.04
440153.......................................................... 1.27
440156.......................................................... 2.55
440157.......................................................... 1.10
440159.......................................................... 1.24
440161.......................................................... 2.26
440162.......................................................... 0.74
440166.......................................................... 1.81
440168.......................................................... 1.27
440173.......................................................... 2.57
440174.......................................................... 1.25
440175.......................................................... 1.48
440176.......................................................... 1.74
440178.......................................................... 1.26
440180.......................................................... 1.16
440181.......................................................... 1.25
440182.......................................................... 1.24
440183.......................................................... 2.93
440184.......................................................... 2.01
440185.......................................................... 1.39
440186.......................................................... 1.27
440187.......................................................... 1.25
440189.......................................................... 2.18
440192.......................................................... 1.07
440193.......................................................... 1.93
440194.......................................................... 1.39
440197.......................................................... 1.71
440200.......................................................... 1.34
440203.......................................................... 1.26
440205.......................................................... 0.92
440206.......................................................... 1.19
442007.......................................................... 0.68
443025.......................................................... 1.05
443026.......................................................... 1.03
443028.......................................................... 1.05
443029.......................................................... 2.01
444003.......................................................... 0.74
444004.......................................................... 0.88
444006.......................................................... 0.89
444010.......................................................... 0.82
444011.......................................................... 0.98
444012.......................................................... 0.94
444017.......................................................... 0.79
444018.......................................................... 0.83
450002.......................................................... 1.37
450004.......................................................... 1.02
450005.......................................................... 1.31
450007.......................................................... 1.80
450008.......................................................... 1.18
450010.......................................................... 1.39
450011.......................................................... 1.44
450014.......................................................... 0.96
450015.......................................................... 0.84
450016.......................................................... 1.80
450018.......................................................... 0.99
450020.......................................................... 1.20
450021.......................................................... 1.24
450023.......................................................... 1.72
450024.......................................................... 1.04
450025.......................................................... 1.49
450028.......................................................... 1.69
450029.......................................................... 1.15
450031.......................................................... 1.27
450032.......................................................... 1.07
450033.......................................................... 1.14
450034.......................................................... 1.59
450035.......................................................... 1.90
450037.......................................................... 1.47
450039.......................................................... 0.74
450040.......................................................... 1.37
450042.......................................................... 1.49
450044.......................................................... 1.46
450046.......................................................... 1.63
450047.......................................................... 1.22
450050.......................................................... 0.80
[[Page 48026]]
450051.......................................................... 1.46
450052.......................................................... 0.80
450053.......................................................... 0.92
450054.......................................................... 1.36
450055.......................................................... 1.00
450056.......................................................... 2.46
450058.......................................................... 1.43
450059.......................................................... 1.65
450063.......................................................... 0.64
450064.......................................................... 1.51
450065.......................................................... 0.74
450068.......................................................... 1.32
450072.......................................................... 1.43
450073.......................................................... 0.88
450078.......................................................... 0.73
450079.......................................................... 1.57
450080.......................................................... 1.86
450081.......................................................... 0.94
450082.......................................................... 0.99
450083.......................................................... 1.67
450085.......................................................... 0.93
450087.......................................................... 1.32
450090.......................................................... 1.47
450092.......................................................... 1.03
450094.......................................................... 2.09
450096.......................................................... 1.59
450097.......................................................... 2.23
450098.......................................................... 0.77
450099.......................................................... 1.43
450101.......................................................... 1.39
450102.......................................................... 1.75
450104.......................................................... 1.30
450107.......................................................... 1.79
450108.......................................................... 0.78
450109.......................................................... 0.94
450110.......................................................... 1.07
450111.......................................................... 1.51
450112.......................................................... 1.74
450113.......................................................... 1.67
450118.......................................................... 2.42
450119.......................................................... 1.55
450121.......................................................... 1.59
450123.......................................................... 0.96
450124.......................................................... 1.26
450126.......................................................... 1.30
450128.......................................................... 1.33
450130.......................................................... 1.72
450131.......................................................... 1.14
450132.......................................................... 1.38
450133.......................................................... 1.41
450135.......................................................... 1.30
450137.......................................................... 1.19
450140.......................................................... 0.82
450142.......................................................... 1.40
450143.......................................................... 0.90
450144.......................................................... 0.80
450145.......................................................... 0.70
450146.......................................................... 0.70
450147.......................................................... 1.34
450148.......................................................... 1.22
450149.......................................................... 1.22
450150.......................................................... 0.74
450151.......................................................... 0.90
450152.......................................................... 1.36
450153.......................................................... 1.40
450154.......................................................... 1.10
450155.......................................................... 0.94
450157.......................................................... 0.75
450160.......................................................... 1.08
450162.......................................................... 1.32
450163.......................................................... 1.06
450164.......................................................... 0.75
450165.......................................................... 1.04
450166.......................................................... 0.60
450169.......................................................... 0.66
450170.......................................................... 0.77
450176.......................................................... 1.50
450177.......................................................... 1.22
450178.......................................................... 0.79
450181.......................................................... 0.82
450184.......................................................... 1.43
450185.......................................................... 0.86
450187.......................................................... 1.27
450188.......................................................... 0.97
450190.......................................................... 2.27
450191.......................................................... 1.41
450192.......................................................... 1.17
450193.......................................................... 2.81
450194.......................................................... 1.26
450196.......................................................... 1.57
450200.......................................................... 1.34
450201.......................................................... 1.38
450203.......................................................... 1.10
450209.......................................................... 1.12
450210.......................................................... 0.93
450211.......................................................... 1.61
450214.......................................................... 1.87
450217.......................................................... 0.67
450219.......................................................... 1.28
450221.......................................................... 0.75
450222.......................................................... 1.63
450224.......................................................... 1.28
450229.......................................................... 1.67
450231.......................................................... 1.43
450234.......................................................... 0.82
450235.......................................................... 1.09
450236.......................................................... 1.59
450237.......................................................... 1.07
450239.......................................................... 0.83
450241.......................................................... 0.81
450243.......................................................... 0.74
450246.......................................................... 0.87
450249.......................................................... 0.87
450250.......................................................... 0.83
450253.......................................................... 1.21
450258.......................................................... 0.70
450259.......................................................... 1.80
450264.......................................................... 0.59
450269.......................................................... 0.79
450270.......................................................... 0.77
450271.......................................................... 0.83
450272.......................................................... 1.57
450276.......................................................... 0.75
450278.......................................................... 0.84
450280.......................................................... 1.16
450283.......................................................... 0.87
450286.......................................................... 0.68
450288.......................................................... 0.91
450289.......................................................... 0.73
450292.......................................................... 0.98
450293.......................................................... 1.03
450296.......................................................... 1.38
450299.......................................................... 1.91
450303.......................................................... 0.67
450306.......................................................... 1.14
450307.......................................................... 0.68
450309.......................................................... 0.86
450315.......................................................... 1.51
450320.......................................................... 1.41
450321.......................................................... 0.73
450322.......................................................... 0.73
450324.......................................................... 1.27
450327.......................................................... 0.63
450330.......................................................... 1.08
450334.......................................................... 0.66
450337.......................................................... 0.82
450340.......................................................... 1.59
450341.......................................................... 1.25
450346.......................................................... 1.33
450347.......................................................... 1.24
450348.......................................................... 0.76
450351.......................................................... 1.70
450352.......................................................... 1.18
450353.......................................................... 1.02
450355.......................................................... 0.77
450358.......................................................... 1.60
450362.......................................................... 1.27
450369.......................................................... 0.89
450370.......................................................... 1.74
450371.......................................................... 0.93
450372.......................................................... 1.36
450373.......................................................... 0.83
450374.......................................................... 0.67
450376.......................................................... 1.64
450378.......................................................... 1.08
450379.......................................................... 1.35
450381.......................................................... 0.79
450388.......................................................... 2.25
450389.......................................................... 1.49
450393.......................................................... 1.11
450395.......................................................... 0.97
450399.......................................................... 0.66
450400.......................................................... 1.05
450403.......................................................... 1.52
450411.......................................................... 0.91
450417.......................................................... 1.01
450418.......................................................... 1.39
450419.......................................................... 1.01
450422.......................................................... 9.97
450423.......................................................... 1.94
450424.......................................................... 1.76
450429.......................................................... 0.65
450431.......................................................... 1.41
450438.......................................................... 1.10
450446.......................................................... 0.89
450447.......................................................... 1.93
450451.......................................................... 0.79
450457.......................................................... 1.67
450460.......................................................... 1.05
450462.......................................................... 1.17
450464.......................................................... 0.81
450465.......................................................... 1.61
450467.......................................................... 0.95
450469.......................................................... 1.31
450473.......................................................... 0.77
450475.......................................................... 1.24
450484.......................................................... 1.77
450488.......................................................... 1.04
450489.......................................................... 0.64
450497.......................................................... 0.90
450498.......................................................... 1.18
450508.......................................................... 1.26
450514.......................................................... 1.83
450517.......................................................... 0.83
450518.......................................................... 2.02
450523.......................................................... 2.60
450530.......................................................... 1.42
450534.......................................................... 0.71
450535.......................................................... 1.55
450537.......................................................... 1.30
450538.......................................................... 1.15
450539.......................................................... 1.38
450544.......................................................... 1.25
450545.......................................................... 2.33
450547.......................................................... 0.87
450550.......................................................... 1.42
450551.......................................................... 1.40
450558.......................................................... 1.52
450559.......................................................... 0.85
450561.......................................................... 1.38
450563.......................................................... 1.29
450565.......................................................... 1.09
450570.......................................................... 0.93
450571.......................................................... 1.65
450573.......................................................... 0.89
450574.......................................................... 0.57
450575.......................................................... 0.68
450578.......................................................... 0.65
[[Page 48027]]
450580.......................................................... 1.13
450583.......................................................... 0.69
450584.......................................................... 1.00
450586.......................................................... 0.89
450587.......................................................... 1.45
450591.......................................................... 1.31
450596.......................................................... 1.39
450597.......................................................... 0.97
450603.......................................................... 0.70
450604.......................................................... 1.32
450605.......................................................... 1.09
450609.......................................................... 0.74
450610.......................................................... 1.48
450614.......................................................... 0.83
450615.......................................................... 0.77
450617.......................................................... 1.33
450620.......................................................... 0.91
450623.......................................................... 1.31
450626.......................................................... 0.89
450628.......................................................... 0.70
450630.......................................................... 1.39
450631.......................................................... 1.59
450632.......................................................... 0.54
450633.......................................................... 1.56
450634.......................................................... 1.96
450638.......................................................... 2.14
450639.......................................................... 1.42
450641.......................................................... 0.95
450643.......................................................... 1.42
450644.......................................................... 1.81
450646.......................................................... 1.79
450647.......................................................... 1.60
450648.......................................................... 0.94
450649.......................................................... 0.82
450651.......................................................... 1.42
450652.......................................................... 0.68
450653.......................................................... 1.78
450654.......................................................... 0.79
450656.......................................................... 1.58
450658.......................................................... 1.00
450659.......................................................... 2.15
450661.......................................................... 2.36
450662.......................................................... 1.22
450665.......................................................... 0.86
450666.......................................................... 1.39
450668.......................................................... 1.93
450669.......................................................... 1.42
450670.......................................................... 1.64
450672.......................................................... 1.81
450673.......................................................... 0.73
450674.......................................................... 3.52
450675.......................................................... 1.48
450677.......................................................... 1.30
450678.......................................................... 1.51
450683.......................................................... 1.16
450684.......................................................... 1.38
450686.......................................................... 1.46
450688.......................................................... 1.41
450690.......................................................... 0.99
450691.......................................................... 1.19
450694.......................................................... 1.27
450696.......................................................... 6.04
450697.......................................................... 1.28
450698.......................................................... 0.67
450700.......................................................... 0.84
450702.......................................................... 1.53
450703.......................................................... 1.10
450704.......................................................... 1.33
450705.......................................................... 1.17
450706.......................................................... 1.42
450709.......................................................... 2.71
450711.......................................................... 1.87
450712.......................................................... 0.88
450713.......................................................... 1.67
450715.......................................................... 0.98
450716.......................................................... 1.76
450717.......................................................... 1.71
450718.......................................................... 1.60
450723.......................................................... 1.31
450724.......................................................... 1.95
450725.......................................................... 1.36
450727.......................................................... 1.06
450728.......................................................... 0.68
450730.......................................................... 1.45
450733.......................................................... 1.59
450735.......................................................... 0.44
450742.......................................................... 1.55
450743.......................................................... 1.60
450746.......................................................... 0.75
450747.......................................................... 1.74
450749.......................................................... 0.74
450750.......................................................... 0.91
450751.......................................................... 1.65
450754.......................................................... 1.07
450755.......................................................... 1.16
450757.......................................................... 0.67
450758.......................................................... 0.90
450760.......................................................... 1.75
450761.......................................................... 0.73
450763.......................................................... 1.30
450766.......................................................... 1.75
450769.......................................................... 0.74
450770.......................................................... 0.90
450771.......................................................... 1.37
450774.......................................................... 3.69
450775.......................................................... 1.81
450776.......................................................... 0.81
450777.......................................................... 0.85
450779.......................................................... 1.20
450780.......................................................... 3.40
450785.......................................................... 10.47
450788.......................................................... 1.26
450795.......................................................... 0.62
450796.......................................................... 10.29
450797.......................................................... 5.76
450798.......................................................... 0.35
450801.......................................................... 1.84
450802.......................................................... 1.60
450803.......................................................... 0.85
450804.......................................................... 3.50
450809.......................................................... 1.95
452013.......................................................... 0.64
452015.......................................................... 0.55
452016.......................................................... 0.55
452019.......................................................... 1.11
452022.......................................................... 1.00
452028.......................................................... 0.32
452033.......................................................... 0.65
452036.......................................................... 0.52
452037.......................................................... 1.39
452038.......................................................... 0.87
452039.......................................................... 0.69
452042.......................................................... 0.31
452043.......................................................... 0.71
452045.......................................................... 1.03
453025.......................................................... 0.88
453028.......................................................... 0.54
453029.......................................................... 1.25
453031.......................................................... 1.04
453032.......................................................... 0.52
453033.......................................................... 0.75
453034.......................................................... 0.67
453035.......................................................... 1.50
453036.......................................................... 1.40
453037.......................................................... 0.81
453038.......................................................... 0.83
453040.......................................................... 0.83
453041.......................................................... 0.59
453042.......................................................... 0.79
453044.......................................................... 0.90
453047.......................................................... 0.78
453048.......................................................... 0.82
453052.......................................................... 0.98
453053.......................................................... 0.98
453054.......................................................... 1.08
453055.......................................................... 0.70
453056.......................................................... 1.05
453057.......................................................... 0.90
453059.......................................................... 0.98
453065.......................................................... 2.22
453072.......................................................... 0.61
453300.......................................................... 0.77
453302.......................................................... 0.98
453304.......................................................... 0.93
453305.......................................................... 0.71
454000.......................................................... 0.67
454006.......................................................... 0.59
454008.......................................................... 0.47
454009.......................................................... 0.60
454011.......................................................... 0.54
454012.......................................................... 0.77
454014.......................................................... 0.81
454018.......................................................... 0.89
454026.......................................................... 0.94
454028.......................................................... 0.87
454029.......................................................... 1.31
454030.......................................................... 0.86
454031.......................................................... 0.91
454032.......................................................... 0.88
454037.......................................................... 0.87
454038.......................................................... 0.87
454040.......................................................... 0.83
454042.......................................................... 0.81
454043.......................................................... 0.86
454045.......................................................... 0.88
454046.......................................................... 0.87
454050.......................................................... 0.87
454051.......................................................... 0.87
454056.......................................................... 1.08
454057.......................................................... 0.89
454058.......................................................... 0.87
454060.......................................................... 0.88
454063.......................................................... 0.85
454064.......................................................... 0.87
454065.......................................................... 0.89
454066.......................................................... 0.87
454069.......................................................... 0.96
454072.......................................................... 0.87
454073.......................................................... 0.99
454078.......................................................... 0.79
454083.......................................................... 0.89
454084.......................................................... 0.59
454086.......................................................... 0.96
454089.......................................................... 0.88
460001.......................................................... 1.97
460003.......................................................... 2.18
460004.......................................................... 1.73
460005.......................................................... 1.82
460006.......................................................... 2.28
460007.......................................................... 1.93
460008.......................................................... 1.45
460009.......................................................... 1.82
460010.......................................................... 1.64
460011.......................................................... 1.42
460013.......................................................... 2.16
460014.......................................................... 1.00
460015.......................................................... 1.88
460016.......................................................... 0.97
460017.......................................................... 2.21
460018.......................................................... 1.11
460019.......................................................... 1.13
460020.......................................................... 1.22
460021.......................................................... 1.65
460022.......................................................... 0.82
460023.......................................................... 1.97
460024.......................................................... 0.70
460025.......................................................... 0.49
460026.......................................................... 1.21
[[Page 48028]]
460027.......................................................... 0.97
460029.......................................................... 1.22
460030.......................................................... 1.62
460032.......................................................... 0.90
460033.......................................................... 1.28
460035.......................................................... 0.85
460036.......................................................... 1.20
460037.......................................................... 1.41
460039.......................................................... 0.93
460041.......................................................... 1.69
460042.......................................................... 1.59
460044.......................................................... 1.37
460046.......................................................... 7.81
460047.......................................................... 1.46
460049.......................................................... 7.48
460050.......................................................... 2.50
463025.......................................................... 1.08
463301.......................................................... 1.56
464003.......................................................... 0.87
464007.......................................................... 7.13
464009.......................................................... 0.85
464010.......................................................... 0.87
470001.......................................................... 1.35
470003.......................................................... 1.86
470004.......................................................... 1.06
470005.......................................................... 1.47
470006.......................................................... 1.59
470008.......................................................... 1.34
470010.......................................................... 1.23
470011.......................................................... 1.51
470012.......................................................... 1.99
470015.......................................................... 1.18
470018.......................................................... 1.39
470020.......................................................... 0.78
470023.......................................................... 1.49
470024.......................................................... 1.33
474001.......................................................... 0.72
480001.......................................................... 1.19
480002.......................................................... 1.30
490001.......................................................... 1.29
490002.......................................................... 1.14
490003.......................................................... 10.75
490004.......................................................... 1.69
490005.......................................................... 1.77
490006.......................................................... 1.28
490007.......................................................... 1.74
490009.......................................................... 1.36
490011.......................................................... 1.92
490012.......................................................... 1.02
490013.......................................................... 1.87
490014.......................................................... 2.11
490015.......................................................... 1.98
490017.......................................................... 2.14
490018.......................................................... 1.81
490019.......................................................... 1.46
490020.......................................................... 2.42
490021.......................................................... 2.69
490022.......................................................... 1.61
490023.......................................................... 1.59
490024.......................................................... 1.61
490027.......................................................... 1.31
490030.......................................................... 1.73
490031.......................................................... 1.54
490032.......................................................... 1.29
490033.......................................................... 1.15
490035.......................................................... 1.53
490037.......................................................... 1.63
490038.......................................................... 1.58
490040.......................................................... 2.07
490041.......................................................... 2.03
490042.......................................................... 1.75
490043.......................................................... 1.34
490044.......................................................... 1.62
490045.......................................................... 1.58
490046.......................................................... 2.03
490047.......................................................... 0.96
490048.......................................................... 1.75
490050.......................................................... 1.86
490052.......................................................... 1.97
490053.......................................................... 2.23
490054.......................................................... 1.41
490057.......................................................... 1.82
490059.......................................................... 2.24
490060.......................................................... 1.62
490063.......................................................... 2.18
490066.......................................................... 1.89
490067.......................................................... 1.90
490069.......................................................... 1.11
490071.......................................................... 2.06
490073.......................................................... 2.81
490074.......................................................... 2.72
490075.......................................................... 1.83
490077.......................................................... 1.67
490079.......................................................... 1.49
490083.......................................................... 9.68
490084.......................................................... 1.84
490085.......................................................... 1.48
490088.......................................................... 1.64
490089.......................................................... 1.04
490090.......................................................... 1.74
490091.......................................................... 1.84
490092.......................................................... 1.45
490093.......................................................... 1.76
490094.......................................................... 1.43
490095.......................................................... 1.31
490097.......................................................... 1.24
490098.......................................................... 1.45
490099.......................................................... 0.74
490100.......................................................... 2.66
490101.......................................................... 2.21
490107.......................................................... 2.28
490110.......................................................... 2.29
490111.......................................................... 1.53
490112.......................................................... 1.76
490113.......................................................... 1.76
490114.......................................................... 1.12
490115.......................................................... 1.51
490116.......................................................... 1.57
490117.......................................................... 0.88
490118.......................................................... 2.01
490119.......................................................... 1.95
490120.......................................................... 1.62
490122.......................................................... 2.03
490123.......................................................... 1.41
490124.......................................................... 1.50
490126.......................................................... 1.64
490127.......................................................... 0.93
490130.......................................................... 1.61
490131.......................................................... 1.39
492001.......................................................... 0.21
493025.......................................................... 0.87
493026.......................................................... 0.71
493027.......................................................... 1.21
493028.......................................................... 0.71
493301.......................................................... 1.21
494001.......................................................... 0.87
494002.......................................................... 1.04
494011.......................................................... 0.82
494012.......................................................... 0.83
494016.......................................................... 0.73
494018.......................................................... 0.88
494020.......................................................... 0.87
494022.......................................................... 0.69
494023.......................................................... 0.78
494025.......................................................... 0.82
494026.......................................................... 0.78
494028.......................................................... 0.87
500001.......................................................... 1.86
500002.......................................................... 1.31
500003.......................................................... 1.61
500005.......................................................... 1.95
500007.......................................................... 2.03
500008.......................................................... 1.18
500011.......................................................... 1.59
500012.......................................................... 2.00
500014.......................................................... 1.85
500015.......................................................... 1.31
500016.......................................................... 1.41
500019.......................................................... 2.04
500021.......................................................... 1.42
500023.......................................................... 1.39
500024.......................................................... 2.58
500025.......................................................... 1.31
500026.......................................................... 1.53
500027.......................................................... 1.87
500028.......................................................... 0.85
500029.......................................................... 0.72
500030.......................................................... 1.75
500031.......................................................... 1.29
500033.......................................................... 1.59
500036.......................................................... 1.80
500037.......................................................... 1.07
500039.......................................................... 1.93
500041.......................................................... 1.53
500042.......................................................... 2.22
500043.......................................................... 1.06
500044.......................................................... 1.72
500045.......................................................... 1.73
500048.......................................................... 1.17
500049.......................................................... 2.08
500050.......................................................... 1.84
500051.......................................................... 1.97
500053.......................................................... 1.48
500054.......................................................... 1.86
500055.......................................................... 1.33
500057.......................................................... 1.81
500058.......................................................... 1.96
500059.......................................................... 1.66
500060.......................................................... 1.30
500061.......................................................... 0.75
500062.......................................................... 0.59
500064.......................................................... 0.87
500065.......................................................... 1.76
500068.......................................................... 0.76
500069.......................................................... 0.92
500071.......................................................... 1.47
500072.......................................................... 1.74
500073.......................................................... 0.98
500074.......................................................... 1.51
500077.......................................................... 1.51
500079.......................................................... 1.17
500080.......................................................... 0.82
500084.......................................................... 1.43
500085.......................................................... 1.12
500086.......................................................... 1.34
500088.......................................................... 1.94
500089.......................................................... 1.19
500090.......................................................... 0.49
500092.......................................................... 1.10
500094.......................................................... 0.59
500096.......................................................... 1.26
500097.......................................................... 0.83
500098.......................................................... 0.98
500101.......................................................... 0.85
500102.......................................................... 1.00
500104.......................................................... 1.34
500106.......................................................... 0.79
500107.......................................................... 1.21
500108.......................................................... 1.72
500110.......................................................... 1.77
500118.......................................................... 1.62
500119.......................................................... 1.22
500122.......................................................... 1.43
500123.......................................................... 0.61
500124.......................................................... 1.52
500125.......................................................... 0.99
500129.......................................................... 1.44
500132.......................................................... 1.05
[[Page 48029]]
500138.......................................................... 0.90
500139.......................................................... 1.62
500141.......................................................... 1.81
500146.......................................................... 1.69
502002.......................................................... 2.34
503025.......................................................... 0.99
503300.......................................................... 4.72
504002.......................................................... 0.75
504008.......................................................... 0.83
510001.......................................................... 1.62
510002.......................................................... 1.70
510004.......................................................... 0.77
510005.......................................................... 1.11
510006.......................................................... 1.86
510007.......................................................... 1.31
510008.......................................................... 1.52
510012.......................................................... 1.28
510013.......................................................... 1.17
510015.......................................................... 0.76
510016.......................................................... 0.73
510018.......................................................... 1.18
510020.......................................................... 0.88
510022.......................................................... 1.68
510023.......................................................... 1.56
510024.......................................................... 1.97
510026.......................................................... 1.12
510027.......................................................... 0.99
510028.......................................................... 1.04
510029.......................................................... 1.57
510030.......................................................... 1.50
510031.......................................................... 2.16
510033.......................................................... 1.48
510038.......................................................... 1.13
510039.......................................................... 1.54
510043.......................................................... 0.64
510046.......................................................... 1.05
510047.......................................................... 2.11
510048.......................................................... 0.95
510050.......................................................... 1.57
510053.......................................................... 1.03
510055.......................................................... 1.49
510058.......................................................... 1.66
510059.......................................................... 5.37
510060.......................................................... 1.13
510063.......................................................... 0.74
510065.......................................................... 0.80
510066.......................................................... 1.43
510067.......................................................... 1.52
510068.......................................................... 1.26
510070.......................................................... 2.03
510071.......................................................... 1.73
510072.......................................................... 1.04
510077.......................................................... 1.03
510081.......................................................... 0.71
510082.......................................................... 1.13
510084.......................................................... 1.27
510085.......................................................... 1.37
510086.......................................................... 0.91
511300.......................................................... 1.04
511301.......................................................... 0.58
513026.......................................................... 0.62
513027.......................................................... 0.98
513028.......................................................... 1.10
513030.......................................................... 1.04
514001.......................................................... 0.96
514007.......................................................... 1.22
514008.......................................................... 1.29
520002.......................................................... 2.63
520003.......................................................... 1.59
520004.......................................................... 2.63
520006.......................................................... 4.45
520007.......................................................... 1.27
520008.......................................................... 1.79
520009.......................................................... 1.27
520010.......................................................... 1.51
520011.......................................................... 2.38
520013.......................................................... 1.76
520014.......................................................... 1.82
520015.......................................................... 2.06
520016.......................................................... 3.42
520017.......................................................... 1.46
520018.......................................................... 1.52
520019.......................................................... 1.65
520021.......................................................... 2.27
520024.......................................................... 1.40
520025.......................................................... 1.38
520026.......................................................... 1.75
520028.......................................................... 2.46
520029.......................................................... 0.89
520030.......................................................... 3.47
520031.......................................................... 2.68
520032.......................................................... 1.67
520033.......................................................... 2.40
520034.......................................................... 1.80
520035.......................................................... 3.33
520037.......................................................... 2.04
520038.......................................................... 2.45
520039.......................................................... 2.16
520040.......................................................... 1.31
520041.......................................................... 2.16
520042.......................................................... 1.28
520044.......................................................... 2.12
520045.......................................................... 1.37
520047.......................................................... 1.63
520048.......................................................... 1.62
520049.......................................................... 2.96
520051.......................................................... 1.85
520053.......................................................... 1.23
520054.......................................................... 1.19
520057.......................................................... 5.86
520058.......................................................... 1.96
520059.......................................................... 1.92
520060.......................................................... 1.19
520062.......................................................... 2.43
520063.......................................................... 3.44
520064.......................................................... 1.32
520066.......................................................... 2.82
520068.......................................................... 1.13
520069.......................................................... 1.39
520070.......................................................... 1.81
520071.......................................................... 1.66
520074.......................................................... 1.21
520075.......................................................... 1.68
520076.......................................................... 2.23
520077.......................................................... 0.97
520078.......................................................... 2.01
520082.......................................................... 2.49
520083.......................................................... 1.40
520084.......................................................... 2.38
520087.......................................................... 1.74
520088.......................................................... 1.61
520089.......................................................... 4.31
520090.......................................................... 1.38
520091.......................................................... 3.18
520092.......................................................... 1.51
520094.......................................................... 1.25
520095.......................................................... 4.22
520096.......................................................... 1.92
520097.......................................................... 1.73
520098.......................................................... 1.16
520100.......................................................... 1.94
520101.......................................................... 1.13
520102.......................................................... 1.82
520103.......................................................... 1.73
520107.......................................................... 1.51
520109.......................................................... 1.73
520110.......................................................... 1.36
520111.......................................................... 2.22
520112.......................................................... 2.23
520113.......................................................... 2.82
520114.......................................................... 1.27
520115.......................................................... 1.25
520116.......................................................... 1.69
520117.......................................................... 1.51
520118.......................................................... 0.72
520120.......................................................... 0.77
520121.......................................................... 1.32
520122.......................................................... 0.97
520123.......................................................... 1.07
520124.......................................................... 1.31
520130.......................................................... 2.21
520131.......................................................... 1.43
520132.......................................................... 1.65
520134.......................................................... 1.16
520135.......................................................... 1.31
520136.......................................................... 1.37
520138.......................................................... 1.74
520139.......................................................... 3.15
520140.......................................................... 1.64
520141.......................................................... 1.42
520142.......................................................... 0.90
520144.......................................................... 3.38
520145.......................................................... 1.01
520146.......................................................... 1.97
520148.......................................................... 1.52
520149.......................................................... 0.80
520151.......................................................... 2.91
520152.......................................................... 1.99
520153.......................................................... 1.23
520154.......................................................... 1.95
520156.......................................................... 1.55
520157.......................................................... 1.12
520159.......................................................... 0.99
520160.......................................................... 1.73
520161.......................................................... 1.60
520170.......................................................... 2.11
520171.......................................................... 1.19
520173.......................................................... 2.77
520177.......................................................... 2.17
520178.......................................................... 1.73
523025.......................................................... 0.95
523300.......................................................... 2.03
524000.......................................................... 0.94
524001.......................................................... 0.79
524003.......................................................... 0.85
524017.......................................................... 0.35
524018.......................................................... 0.79
524034.......................................................... 0.87
524035.......................................................... 0.87
524038.......................................................... 0.98
524040.......................................................... 1.03
530002.......................................................... 1.40
530003.......................................................... 0.88
530004.......................................................... 1.06
530005.......................................................... 1.23
530006.......................................................... 1.40
530007.......................................................... 1.24
530008.......................................................... 1.34
530009.......................................................... 1.45
530010.......................................................... 1.95
530011.......................................................... 1.41
530012.......................................................... 1.58
530014.......................................................... 1.54
530015.......................................................... 1.59
530016.......................................................... 1.27
530017.......................................................... 1.64
530018.......................................................... 1.18
530019.......................................................... 1.15
530022.......................................................... 1.15
530023.......................................................... 1.07
530025.......................................................... 1.41
530026.......................................................... 1.00
530027.......................................................... 1.03
530029.......................................................... 0.75
530031.......................................................... 0.67
530032.......................................................... 1.52
532002.......................................................... 0.05
534003.......................................................... 0.87
[[Page 48030]]
650001.......................................................... 1.28
------------------------------------------------------------------------
Addendum J.--Wage Index for Urban Areas
------------------------------------------------------------------------
Wage
Urban area (Constituent counties) index
------------------------------------------------------------------------
0040 Abilene, TX.............................................. 0.8081
Taylor, TX
0060 Aguadilla, PR............................................ 0.4772
Aguada, PR
Aguadilla, PR
Moca, PR
0080 Akron, OH................................................ 1.0011
Portage, OH
Summit, OH
0120 Albany, GA............................................... 0.8098
Dougherty, GA
Lee, GA
0160 \2\ Albany-Schenectady-Troy, NY......................... 0.8640
Albany, NY
Montgomery, NY
Rensselaer, NY
Saratoga, NY
Schenectady, NY
Schoharie, NY
0200 Albuquerque, NM.......................................... 0.8813
Bernalillo, NM
Sandoval, NM
Valencia, NM
0220 Alexandria, LA........................................... 0.8598
Rapides, LA
0240 Allentown-Bethlehem-Easton, PA........................... 1.0219
Carbon, PA
Lehigh, PA
Northampton, PA
0280 Altoona, PA.............................................. 0.9398
Blair, PA
0320 Amarillo, TX............................................. 0.8483
Potter, TX
Randall, TX
0380 Anchorage, AK............................................ 1.3088
Anchorage, AK
0440 Ann Arbor, MI............................................ 1.1127I
Lenawee, MI
Livingston, MI
Washtenaw, MI
0450 Anniston, AL............................................. 0.8731
Calhoun, AL
0460 Appleton-Oshkosh-Neenah, WI.............................. 0.8899
Calumet, WI
Outagamie, WI
Winnebago, WI
0470 Arecibo, PR.............................................. 0.4915
Arecibo, PR
Camuy, PR
Hatillo, PR
0480 Asheville, NC............................................ 0.9016
Buncombe, NC
Madison, NC
0500 Athens, GA............................................... 0.8746
Clarke, GA
Madison, GA
Oconee, GA
0520 \1\ Atlanta, GA.......................................... 1.0024
Barrow, GA
Bartow, GA
Carroll, GA
Cherokee, GA
Clayton, GA
Cobb, GA
Coweta, GA
DeKalb, GA
Douglas, GA
Fayette, GA
Forsyth, GA
Fulton, GA
Gwinnett, GA
Henry, GA
Newton, GA
------------------------------------------------------------------------
Addendum J.--Wage Index for Urban Areas
------------------------------------------------------------------------
Wage
Urban area (Constituent counties) index
------------------------------------------------------------------------
Paulding, GA
Pickens, GA
Rockdale, GA
Spalding, GA
Walton, GA
0560 Atlantic-Cape May, NJ.................................... 1.0442
Atlantic, NJ
Cape May, NJ
0600 Augusta-Aiken, GA-SC..................................... 0.9309
Columbia, GA
McDuffie, GA
Richmond, GA
Aiken, SC
Edgefield, SC
0640 \1\ Austin-San Marcos, TX................................ 0.8158
Bastrop, TX
Caldwell, TX
Hays, TX
Travis, TX
Williamson, TX
0680 \2\ Bakersfield, CA...................................... 0.9976
Kern, CA
0720 \1\ Baltimore, MD........................................ 0.9760
Anne Arundel, MD
Baltimore, MD
Baltimore City, MD
Carroll, MD
Harford, MD
Howard, MD
Queen Anne's, MD
0733 \2\ Bangor, ME........................................... 0.8538
Penobscot, ME 0.8538
0743 Barnstable-Yarmouth, MA.................................. 1.5644
Barnstable, MA
0760 Baton Rouge, LA.......................................... 0.8940
Ascension, LA
East Baton Rouge, LA
Livingston, LA
West Baton Rouge, LA
0840 Beaumont-Port Arthur, TX................................. 0.8660
Hardin, TX
Jefferson, TX
Orange, TX
0860 Bellingham, WA........................................... 1.1475
Whatcom, WA
0870 \2\ Benton Harbor, MI.................................... 0.8988
Berrien, MI
0875 \1\ Bergen-Passaic, NJ................................... 1.1845
Bergen, NJ
Passaic, NJ
0880 Billings, MT............................................. 0.9220
Yellowstone, MT
0920 Biloxi-Gulfport-Pascagoula, MS........................... 0.8291
Hancock, MS
Harrison, MS
Jackson, MS
0960 Binghamton, NY........................................... 0.9103
Broome, NY
Tioga, NY
1000 Birmingham, AL........................................... 0.9150
Blount, AL
Jefferson, AL
St. Clair, AL
Shelby, AL
1010 Bismarck, ND............................................. 0.8015
Burleigh, ND
Morton, ND
1020 Bloomington, IN.......................................... 0.9041
Monroe, IN
1040 Bloomington-Normal, IL................................... 0.8926
McLean, IL
1080 Boise City, ID........................................... 0.9267
Ada, ID
Canyon, ID
1123 \1\ \2\ Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH
(Massachusetts Hospitals) 1.0917
Bristol, MA
Essex, MA
Middlesex, MA
Norfolk, MA
Plymouth, MA
Suffolk, MA
Worcester, MA
Hillsborough, NH
Merrimack, NH
Rockingham, NH
Strafford, NH
1123 \1\ Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (New
Hampshire Hospitals).......................................... 1.0885
Bristol, MA
Essex, MA
Middlesex, MA
Norfolk, MA
Plymouth, MA
Suffolk, MA
Worcester, MA
Hillsborough, NH
Merrimack, NH
Rockingham, NH
Strafford, NH
1125 Boulder-Longmont, CO..................................... 1.0122
Boulder, CO
1145 Brazoria, TX............................................. 0.8895
Brazoria, TX
1150 Bremerton, WA............................................ 1.1148
Kitsap, WA
1240 Brownsville-Harlingen-San Benito, TX..................... 0.8291
Cameron, TX
1260 Bryan-College Station, TX................................ 0.7962
Brazos, TX
1280 \1\ Buffalo-Niagara Falls, NY............................ 0.9592
Erie, NY
Niagara, NY
1303 Burlington, VT........................................... 0.9612
Chittenden, VT
Franklin, VT
Grand Isle, VT
1310 Caguas, PR............................................... 0.4445
Caguas, PR
Cayey, PR
Cidra, PR
Gurabo, PR
San Lorenzo, PR
1320 Canton-Massillon, OH..................................... 0.8895
Carroll, OH
Stark, OH
1350 Casper, WY............................................... 0.9227
Natrona, WY
1360 Cedar Rapids, IA......................................... 0.8888
Linn, IA
1400 Champaign-Urbana, IL..................................... 0.8844
Champaign, IL
1440 Charleston-North Charleston, SC.......................... 0.8931
[[Page 48031]]
Berkeley, SC
Charleston, SC
Dorchester, SC
1480 Charleston, WV........................................... 0.9042
Kanawha, WV
Putnam, WV
1520 \1\Charlotte-Gastonia-Rock Hill, NC-SC................... 0.9568
Cabarrus, NC
Gaston, NC
Lincoln, NC
Mecklenburg, NC
Rowan, NC
Stanly, NC
Union, NC
York, SC
1540 Charlottesville, VA...................................... 1.0359
Albemarle, VA
Charlottesville City, VA
Fluvanna, VA
Greene, VA
1560 Chattanooga, TN-GA....................................... 0.9123
Catoosa, GA
Dade, GA
Walker, GA
Hamilton, TN
Marion, TN
1580 Cheyenne, WY............................................. 0.9354
Laramie, WY
1600 \1\ Chicago, IL.......................................... 1.0507
Cook, IL
DeKalb, IL
DuPage, IL
Grundy, IL
Kane, IL
Kendall, IL
Lake, IL
McHenry, IL
Will, IL
1620 Chico-Paradise, CA....................................... 1.0231
Butte, CA
1640 \1\ Cincinnati, OH-KY-IN................................. 0.9465
Dearborn, IN
Ohio, IN
Boone, KY
Campbell, KY
Gallatin, KY
Grant, KY
Kenton, KY
Pendleton, KY
Brown, OH
Clermont, OH
Hamilton, OH
Warren, OH
1660 Clarksville-Hopkinsville, TN-KY.......................... 0.8204
Christian, KY
Montgomery, TN
1680 \1\Cleveland-Lorain-Elyria, OH........................... 0.9970
Ashtabula, OH
Cuyahoga, OH
Geauga, OH
Lake, OH
Lorain, OH
Medina, OH
1720 Colorado Springs, CO..................................... 0.9469
El Paso, CO
1740 Columbia, MO............................................. 0.9678
Boone, MO
1760 Columbia, SC............................................. 0.9368
Lexington, SC
Richland, SC
1800 Columbus, GA-AL.......................................... 0.8573
Russell, AL
Chattahoochee, GA
Harris, GA
Muscogee, GA
1840 \1\ Columbus, OH......................................... 0.9929
Delaware, OH
Fairfield, OH
Franklin, OH
Licking, OH
Madison, OH
Pickaway, OH
1880 Corpus Christi, TX....................................... 0.8112
Nueces, TX
San Patricio, TX
1900 \2\ Cumberland, MD-WV (Maryland Hospitals)............... 0.8627
Allegany, MD
Mineral, WV
1900 Cumberland, MD-WV (West Virginia Hospital)............... 0.8407
Allegany, MD
Mineral, WV
1920 \1\ Dallas, TX........................................... 0.9149
Collin, TX
Dallas, TX
Denton, TX
Ellis, TX
Henderson, TX
Hunt, TX
Kaufman, TX
Rockwall, TX
1950 Danville, VA............................................. 0.9121
Danville City, VA
Pittsylvania, VA
1960 Davenport-Moline-Rock Island, IA-IL...................... 0.8496
Scott, IA
Henry, IL
Rock Island, IL
2000 Dayton-Springfield, OH................................... 0.9670
Clark, OH
Greene, OH
Miami, OH
Montgomery, OH
2020 Daytona Beach, FL........................................ 0.9211
Flagler, FL
Volusia, FL
2030 Decatur, AL.............................................. 0.8302
Lawrence, AL
Morgan, AL
2040 Decatur, IL.............................................. 0.8140
Macon, IL
2080 \1\ Denver, CO........................................... 1.0532
Adams, CO
Arapahoe, CO
Denver, CO
Douglas, CO
Jefferson, CO
2120 Des Moines, IA........................................... 0.8576
Dallas, IA
Polk, IA
Warren, IA
2160 \1\ Detroit, MI.......................................... 1.0601
Lapeer, MI
Macomb, MI
Monroe, MI
Oakland, MI
St. Clair, MI
Wayne, MI
2180 Dothan, AL............................................... 0.7827
Dale, AL
Houston, AL
2190 Dover, DE................................................ 0.9441
Kent, DE
2200 Dubuque, IA.............................................. 0.8292
Dubuque, IA
2240 Duluth-Superior, MN-WI................................... 1.0133
St. Louis, MN
Douglas, WI
2281 Dutchess County, NY...................................... 0.9860
Dutchess, NY
2290 Eau Claire, WI........................................... 0.8755
Chippewa, WI
Eau Claire, WI
2320 El Paso, TX.............................................. 0.8978
El Paso, TX
2330 Elkhart-Goshen, IN....................................... 0.9168
Elkhart, IN
2335 \2\ Elmira, NY........................................... 0.8640
Chemung, NY
2340 Enid, OK................................................. 0.8050
Garfield, OK
2360 Erie, PA................................................. 0.9343
Erie, PA
2400 Eugene-Springfield, OR................................... 1.1288
Lane, OR
2440 Evansville-Henderson, IN-KY.............................. 0.8505
Posey, IN
Vanderburgh, IN
Warrick, IN
Henderson, KY
2520 Fargo-Moorhead, ND-MN (North Dakota Hospitals)........... 0.7905
Clay, MN
Cass, ND
2520 \2\ Fargo-Moorhead, ND-MN (Minnesota Hospitals).......... 0.8665
Clay, MN
Cass, ND
2560 Fayetteville, NC......................................... 0.8460
Cumberland, NC
2580 Fayetteville-Springdale-Rogers, AR....................... 0.8686
Benton, AR
Washington, AR
2620 Flagstaff, AZ-UT......................................... 0.9602
Coconino, AZ
Kane, UT
2640 Flint, MI................................................ 1.1106
Genesee, MI
2650 Florence, AL............................................. 0.7740
Colbert, AL
Lauderdale, AL
2655 Florence, SC............................................. 0.8368
Florence, SC
2670 Fort Collins-Loveland, CO................................ 1.0383
Larimer, CO
2680 \1\ Ft. Lauderdale, FL................................... 1.0534
Broward, FL
2700 Fort Myers-Cape Coral, FL................................ 0.9017
Lee, FL
2710 Fort Pierce-Port St. Lucie, FL........................... 0.9847
Martin, FL
St. Lucie, FL
2720 Fort Smith, AR-OK........................................ 0.7687
Crawford, AR
Sebastian, AR
Sequoyah, OK
2750 2Fort Walton Beach, FL................................... 0.8947
Okaloosa, FL
2760 Fort Wayne, IN........................................... 0.8896
Adams, IN
Allen, IN
De Kalb, IN
Huntington, IN
Wells, IN
Whitley, IN
2800 \1\ Forth Worth-Arlington, TX............................ 0.9192
Hood, TX
Johnson, TX
Parker, TX
Tarrant, TX
2840 Fresno, CA............................................... 1.0491
Fresno, CA
Madera, CA
[[Page 48032]]
2880 Gadsden, AL.............................................. 0.8854
Etowah, AL
2900 Gainesville, FL.......................................... 0.9542
Alachua, FL
2920 Galveston-Texas City, TX................................. 0.9549
Galveston, TX
2960 Gary, IN................................................. 0.9542
Lake, IN
Porter, IN
2975 \2\ Glens Falls, NY...................................... 0.8640
Warren, NY
Washington, NY
2980 Goldsboro, NC............................................ 0.8523
Wayne, NC
2985 Grand Forks, ND-MN....................................... 0.8996
Polk, MN
Grand Forks, ND
2995 Grand Junction, CO....................................... 0.9110
Mesa, CO
3000 \1\ Grand Rapids-Muskegon-Holland, MI.................... 1.0018
Allegan, MI
Kent, MI
Muskegon, MI
Ottawa, MI
3040 Great Falls, MT.......................................... 0.9362
Cascade, MT
3060 Greeley, CO.............................................. 0.9856
Weld, CO
3080 Green Bay, WI............................................ 0.9323
Brown, WI
3120 \1\ Greensboro-Winston-Salem-High Point, NC.............. 0.9418
Alamance, NC
Davidson, NC
Davie, NC
Forsyth, NC
Guilford, NC
Randolph, NC
Stokes, NC
Yadkin, NC
3150 Greenville, NC........................................... 0.9034
Pitt, NC
3160 Greenville-Spartanburg-Anderson, SC...................... 0.9318
Anderson, SC
Cherokee, SC
Greenville, SC
Pickens, SC
Spartanburg, SC
3180 Hagerstown, MD........................................... 1.0268
Washington, MD
3200 Hamilton-Middletown, OH.................................. 0.9292
Butler, OH
3240 Harrisburg-Lebanon-Carlisle, PA.......................... 0.9572
Cumberland, PA
Dauphin, PA
Lebanon, PA
Perry, PA
3283 \1\ \2\ Hartford, CT..................................... 1.2175
Hartford, CT
Litchfield, CT
Middlesex, CT
Tolland, CT
3285 \2\ Hattiesburg, MS...................................... 0.7359
Forrest, MS
Lamar, MS
3290 Hickory-Morganton-Lenoir, NC............................. 0.8687
Alexander, NC
Burke, NC
Caldwell, NC
Catawba, NC
3320 Honolulu, HI............................................. 1.1628
Honolulu, HI
3350 Houma, LA................................................ 0.8266
Lafourche, LA
Terrebonne, LA
3360 \1\Houston, TX........................................... 1.0017
Chambers, TX
Fort Bend, TX
Harris, TX
Liberty, TX
Montgomery, TX
Waller, TX
3400 Huntington-Ashland, WV-KY-OH............................. 0.9728
Boyd, KY
Carter, KY
Greenup, KY
Lawrence, OH
Cabell, WV
Wayne, WV
3440 Huntsville, AL........................................... 0.8428
Limestone, AL
Madison, AL
3480 \1\Indianapolis, IN...................................... 0.9901
Boone, IN
Hamilton, IN
Hancock, IN
Hendricks, IN
Johnson, IN
Madison, IN
Marion, IN
Morgan, IN
Shelby, IN
3500 Iowa City, IA............................................ 0.9561
Johnson, IA
3520 Jackson, MI.............................................. 0.9302
Jackson, MI
3560 Jackson, MS.............................................. 0.8279
Hinds, MS
Madison, MS
Rankin, MS
3580 Jackson, TN.............................................. 0.8632
Madison, TN
Chester, TN
3600 \1\ \2\ Jacksonville, FL................................. 0.8947
Clay, FL
Duval, FL
Nassau, FL
St. Johns, FL
3605 \2\ Jacksonville, NC..................................... 0.8162
Onslow, NC
3610 \2\ Jamestown, NY........................................ 0.8640
Chautauqua, NY
3620 Janesville-Beloit, WI.................................... 0.9128
Rock, WI
3640 Jersey City, NJ.......................................... 1.1372
Hudson, NJ
3660 Johnson City-Kingsport-Bristol, TN-VA.................... 0.8847
Carter, TN
Hawkins, TN
Sullivan, TN
Unicoi, TN
Washington, TN
Bristol City, VA
Scott, VA
Washington, VA
3680 Johnstown, PA............................................ 0.8671
Cambria, PA
Somerset, PA
3700 Jonesboro, AR............................................ 0.7643
Craighead, AR
3710 Joplin, MO............................................... 0.7933
Jasper, MO
Newton, MO
3720 Kalamazoo-Battlecreek, MI................................ 1.2009
Calhoun, MI
Kalamazoo, MI
Van Buren, MI
3740 Kankakee, IL............................................. 0.9175
Kankakee, IL
3760 \1\ Kansas City, KS-MO................................... 0.9672
Johnson, KS
Leavenworth, KS
Miami, KS
Wyandotte, KS
Cass, MO
Clay, MO
Clinton, MO
Jackson, MO
Lafayette, MO
Platte, MO
Ray, MO
3800 Kenosha, WI.............................................. 0.9206
Kenosha, WI
3810 Killeen-Temple, TX....................................... 1.0180
Bell, TX
Coryell, TX
3840 Knoxville, TN............................................ 0.8569
Anderson, TN
Blount, TN
Knox, TN
Loudon, TN
Sevier, TN
Union, TN
3850 Kokomo, IN............................................... 0.9350
Howard, IN
Tipton, IN
3870 La Crosse, WI-MN......................................... 0.8989
Houston, MN
La Crosse, WI
3880 Lafayette, LA............................................ 0.8363
Acadia, LA
Lafayette, LA
St. Landry, LA
St. Martin, LA
3920 Lafayette, IN............................................ 0.8984
Clinton, IN
Tippecanoe, IN
3960 Lake Charles, LA......................................... 0.7738
Calcasieu, LA
3980 Lakeland-Winter Haven, FL................................ 0.8947
Polk, FL
4000 Lancaster, PA............................................ 0.9646
Lancaster, PA
4040 Lansing-East Lansing, MI................................. 1.0130
Clinton, MI
Eaton, MI
Ingham, MI
4080 \2\ Laredo, TX........................................... 0.7404
Webb, TX
4100 Las Cruces, NM........................................... 0.9045
Dona Ana, NM
4120 \1\ Las Vegas, NV-AZ..................................... 1.1349
Mohave, AZ
Clark, NV
Nye, NV
4150 Lawrence, KS............................................. 0.8728
Douglas, KS
4200 Lawton, OK............................................... 0.8770
Comanche, OK
4243 Lewiston-Auburn, ME...................................... 0.9226
Androscoggin, ME
4280 Lexington, KY............................................ 0.8579
Bourbon, KY
Clark, KY
Fayette, KY
Jessamine, KY
Madison, KY
Scott, KY
Woodford, KY
4320 Lima, OH................................................. 0.8885
Allen, OH
Auglaize, OH
[[Page 48033]]
4360 Lincoln, NE.............................................. 0.9082
Lancaster, NE
4400 Little Rock-North Little Rock, AR........................ 0.8598
Faulkner, AR
Lonoke, AR
Pulaski, AR
Saline, AR
4420 Longview-Marshall, TX.................................... 0.8583
Gregg, TX
Harrison, TX
Upshur, TX
4480 \1\ Los Angeles-Long Beach, CA........................... 1.2124
Los Angeles, CA
4520 Louisville, KY-IN........................................ 0.9212
Clark, IN
Floyd, IN
Harrison, IN
Scott, IN
Bullitt, KY
Jefferson, KY
Oldham, KY
4600 Lubbock, TX.............................................. 0.8460
Lubbock, TX
4640 Lynchburg, VA............................................ 0.8680
Amherst, VA
Bedford, VA
Bedford City, VA
Campbell, VA
Lynchburg City, VA
4680 Macon, GA................................................ 0.9109
Bibb, GA
Houston, GA
Jones, GA
Peach, GA
Twiggs, GA
4720 Madison, WI.............................................. 1.0103
Dane, WI
4800 Mansfield, OH............................................ 0.8606
Crawford, OH
Richland, OH
4840 Mayaguez, PR............................................. 0.4360
Anasco, PR
Cabo Rojo, PR
Hormigueros, PR
Mayaguez, PR
Sabana Grande, PR
San German, PR
4880 McAllen-Edinburg-Mission, TX............................. 0.8541
Hidalgo, TX
4890 Medford-Ashland, OR...................................... 1.0109
Jackson, OR
4900 Melbourne-Titusville-Palm Bay, FL........................ 0.9289
Brevard, Fl
4920 \1\ Memphis, TN-AR-MS.................................... 0.8423
Crittenden, AR
DeSoto, MS
Fayette, TN
Shelby, TN
Tipton, TN
4940 Merced, CA............................................... 1.0304
Merced, CA
5000 \1\ Miami, FL............................................ 0.9427
Dade, FL
5015 \1\ Middlesex-Somerset-Hunterdon, NJ..................... 1.0871
Hunterdon, NJ
Middlesex, NJ
Somerset, NJ
5080 \1\ Milwaukee-Waukesha, WI............................... 0.9470
Milwaukee, WI
Ozaukee, WI
Washington, WI
Waukesha, WI
5120 \1\ Minneapolis-St. Paul, MN-WI.......................... 1.0956
Anoka, MN
Carver, MN
Chisago, MN
Dakota, MN
Hennepin, MN
Isanti, MN
Ramsey, MN
Scott, MN
Sherburne, MN
Washington, MN
Wright, MN
Pierce, WI
St. Croix, WI
5160 Mobile, AL............................................... 0.7942
Baldwin, AL
Mobile, AL
5170 Modesto, CA.............................................. 1.0406
Stanislaus, CA
5190 \1\ Monmouth-Ocean, NJ................................... 1.1285
Monmouth, NJ
Ocean, NJ
5200 Monroe, LA............................................... 0.8288
Ouachita, LA
5240 Montgomery, AL........................................... 0.7919
Autauga, AL
Elmore, AL
Montgomery, AL
5280 Muncie, IN............................................... 0.9493
Delaware, IN
5330 \2\ Myrtle Beach, SC..................................... 0.8110
Horry, SC
5345 Naples, FL............................................... 1.0205
Collier, FL
5360 \1\Nashville, TN......................................... 0.9336
Cheatham, TN
Davidson, TN
Dickson, TN
Robertson, TN
Rutherford TN
Sumner, TN
Williamson, TN
Wilson, TN
5380 \1\ Nassau-Suffolk, NY................................... 1.3123
Nassau, NY
Suffolk, NY
5483 \1\ \2\ New Haven-Bridgeport-Stamford-Waterbury-Danbury,
CT............................................................ 1.2175
Fairfield, CT
New Haven, CT
5523 \2\ New London-Norwich, CT............................... 1.2175
New London, CT
5560 \1\ New Orleans, LA...................................... 0.9397
Jefferson, LA
Orleans, LA
Plaquemines, LA
St. Bernard, LA
St. Charles, LA
St. James, LA
St. John The Baptist, LA
St. Tammany, LA
5600 \1\ New York, NY......................................... 1.4537
Bronx, NY
Kings, NY
New York, NY
Putnam, NY
Queens, NY
Richmond, NY
Rockland, NY
Westchester, NY
5640 \1\ Newark, NJ........................................... 1.0899
Essex, NJ
Morris, NJ
Sussex, NJ
Union, NJ
Warren, NJ
5660 Newburgh, NY-PA.......................................... 1.1226
Orange, NY
Pike, PA
5720 \1\ Norfolk-Virginia Beach-Newport News, VA-NC........... 0.8235
Currituck, NC
Chesapeake City, VA
Gloucester, VA
Hampton City, VA
Isle of Wight, VA
James City, VA
Mathews, VA
Newport News City, VA
Norfolk City, VA
Poquoson City, VA
Portsmouth City, VA
Suffolk City, VA
Virginia Beach City, VA
Williamsburg City, VA
York, VA
5775 \1\ Oakland, CA.......................................... 1.5309
Alameda, CA
Contra Costa, CA
5790 Ocala, FL................................................ 0.9229
Marion, FL
5800 Odessa-Midland, TX....................................... 0.7773
Ector, TX
Midland, TX
5880 \1\ Oklahoma City, OK.................................... 0.8764
Canadian, OK
Cleveland, OK
Logan, OK
McClain, OK
Oklahoma, OK
Pottawatomie, OK
5910 Olympia, WA.............................................. 1.1605
Thurston, WA
5920 Omaha, NE-IA............................................. 0.9938
Pottawattamie, IA
Cass, NE
Douglas, NE
Sarpy, NE
Washington, NE
5945 \1\ Orange County, CA.................................... 1.1153
Orange, CA
5960 \1\ Orlando, FL.......................................... 0.9933
Lake, FL
Orange, FL
Osceola, FL
Seminole, FL
5990 \2\ Owensboro, KY........................................ 0.7902
Daviess, KY
6015 \2\ Panama City, FL...................................... 0.8947
Bay, FL
6020 Parkersburg-Marietta, WV-OH (West Virginia Hospitals).... 0.8118
Washington, OH
Wood, WV
6020 \2\ Parkersburg-Marietta, WV-OH (Ohio Hospitals)......... 0.8576
Washington, OH
Wood, WV
6080 \2\ Pensacola, FL........................................ 0.8947
Escambia, FL
Santa Rosa, FL
6120 Peoria-Pekin, IL......................................... 0.8157
Peoria, IL
Tazewell, IL
Woodford, IL
6160 \1\ Philadelphia, PA-NJ.................................. 1.1427
Burlington, NJ
Camden, NJ
Gloucester, NJ
Salem, NJ
Bucks, PA
Chester, PA
[[Page 48034]]
Delaware, PA
Montgomery, PA
Philadelphia, PA
6200 \1\ Phoenix-Mesa, AZ..................................... 0.9759
Maricopa, AZ
Pinal, AZ
6240 Pine Bluff, AR........................................... 0.8003
Jefferson, AR
6280 \1\ Pittsburgh, PA....................................... 0.9896
Allegheny, PA
Beaver, PA
Butler, PA
Fayette, PA
Washington, PA
Westmoreland, PA
6323 \2\ Pittsfield, MA....................................... 1.0917
Berkshire, MA
6340 Pocatello, ID............................................ 0.8760
Bannock, ID
6360 Ponce, PR................................................ 0.4740
Guayanilla, PR
Juana Diaz, PR
Penuelas, PR
Ponce, PR
Villalba, PR
Yauco, PR
6403 Portland, ME............................................. 0.9537
Cumberland, ME
Sagadahoc, ME
York, ME
6440 \1\ Portland-Vancouver, OR-WA............................ 1.1274
Clackamas, OR
Columbia, OR
Multnomah, OR
Washington, OR
Yamhill, OR
Clark, WA
6483 \1\ Providence-Warwick-Pawtucket, RI..................... 1.0888
Bristol, RI
Kent, RI
Newport, RI
Providence, RI
Washington, RI
6520 Provo-Orem, UT........................................... 0.9910
Utah, UT
6560 Pueblo, CO............................................... 0.8785
Pueblo, CO
6580 Punta Gorda, FL.......................................... 0.8994
Charlotte, FL
6600 Racine, WI............................................... 0.9207
Racine, WI
6640 \1\ Raleigh-Durham-Chapel Hill, NC....................... 0.9909
Chatham, NC
Durham, NC
Franklin, NC
Johnston, NC
Orange, NC
Wake, NC
6660 Rapid City, SD........................................... 0.8277
Pennington, SD
6680 Reading, PA.............................................. 0.9282
Berks, PA
6690 Redding, CA.............................................. 1.2017
Shasta, CA
6720 Reno, NV................................................. 1.0169
Washoe, NV
6740 \2\ Richland-Kennewick-Pasco, WA......................... 1.0577
Benton, WA
Franklin, WA
6760 Richmond-Petersburg, VA.................................. 0.9257
Charles City County, VA
Chesterfield, VA
Colonial Heights City, VA
Dinwiddie, VA
Goochland, VA
Hanover, VA
Henrico, VA
Hopewell City, VA
New Kent, VA
Petersburg City, VA
Powhatan, VA
Prince George, VA
Richmond City, VA
6780 \1\ Riverside-San Bernardino, CA......................... 1.0151
Riverside, CA
San Bernardino, CA
6800 Roanoke, VA.............................................. 0.8581
Botetourt, VA
Roanoke, VA
Roanoke City, VA
Salem City, VA
6820 Rochester, MN............................................ 1.1797
Olmsted, MN
6840 \1\ Rochester, NY........................................ 0.9678
Genesee, NY
Livingston, NY
Monroe, NY
Ontario, NY
Orleans, NY
Wayne, NY
6880 Rockford, IL............................................. 0.8703
Boone, IL
Ogle, IL
Winnebago, IL
6895 Rocky Mount, NC.......................................... 0.8214
Edgecombe, NC
Nash, NC
6920 \1\ Sacramento, CA....................................... 1.1952
El Dorado, CA
Placer, CA
Sacramento, CA
6960 Saginaw-Bay City-Midland, MI............................. 0.9567
Bay, MI
Midland, MI
Saginaw, MI
6980 St. Cloud, MN............................................ 0.9667
Benton, MN
Stearns, MN
7000 St. Joseph, MO........................................... 0.9972
Andrew, MO
Buchanan, MO
7040 \1\ St. Louis, MO-IL..................................... 0.9063
Clinton, IL
Jersey, IL
Madison, IL
Monroe, IL
St. Clair, IL
Franklin, MO
Jefferson, MO
Lincoln, MO
St. Charles, MO
St. Louis, MO
St. Louis City, MO
Warren, MO
7080 Salem, OR................................................ 0.9987
Marion, OR
Polk, OR
7120 Salinas, CA.............................................. 1.5270
Monterey, CA
7160 \1\ Salt Lake City-Ogden, UT............................. 0.9458
Davis, UT
Salt Lake, UT
Weber, UT
7200 San Angelo, TX........................................... 0.7512
Tom Green, TX
7240 \1\ San Antonio, TX...................................... 0.7744
Bexar, TX
Comal, TX
Guadalupe, TX
Wilson, TX
7320 \1\ San Diego, CA........................................ 1.2388
San Diego, CA
7360 \1\ San Francisco, CA.................................... 1.362
Marin, CA
San Francisco, CA
San Mateo, CA
7400 \1\ San Jose, CA......................................... 1.3783
Santa Clara, CA
7440 \1\San Juan-Bayamon, PR.................................. 0.4521
Aguas Buenas, PR
Barceloneta, PR
Bayamon, PR
Canovanas, PR
Carolina, PR
Catano, PR
Ceiba, PR
Comerio, PR
Corozal, PR
Dorado, PR
Fajardo, PR
Florida, PR
Guaynabo, PR
Humacao, PR
Juncos, PR
Los Piedras, PR
Loiza, PR
Luguillo, PR
Manati, PR
Morovis, PR
Naguabo, PR
Naranjito, PR
Rio Grande, PR
San Juan, PR
Toa Alta, PR
Toa Baja, PR
Trujillo Alto, PR
Vega Alta, PR
Vega Baja, PR
Yabucoa, PR
7460 San Luis Obispo-Atascadero-Paso Robles, CA............... 1.0825
San Luis Obispo, CA
7480 Santa Barbara-Santa Maria-Lompoc, CA..................... 1.1233
Santa Barbara, CA
7485 Santa Cruz-Watsonville, CA............................... 1.4099
Santa Cruz, CA
7490 Santa Fe, NM............................................. 0.9525
Los Alamos, NM
Santa Fe, NM
7500 Santa Rosa, CA........................................... 1.3167
Sonoma, CA
7510 Sarasota-Bradenton, FL................................... 0.9567
Manatee, FL
Sarasota, FL
7520 Savannah, GA............................................. 0.8776
Bryan, GA
Chatham, GA
Effingham, GA
7560 \2\ Scranton--Wilkes-Barre--Hazleton, PA................. .8615
Columbia, PA
Lackawanna, PA
Luzerne, PA
Wyoming, PA
7600 \1\ Seattle-Bellevue-Everett, WA......................... 1.1634
Island, WA
King, WA
Snohomish, WA
7610 Sharon, PA............................................... 0.8948
Mercer, PA
7620 \2\ Sheboygan, WI........................................ 0.8557
Sheboygan, WI
7640 Sherman-Denison, TX...................................... 0.8229
Grayson, TX
[[Page 48035]]
7680 Shreveport-Bossier City, LA.............................. 0.9436
Bossier, LA
Caddo, LA
Webster, LA
7720 Sioux City, IA-NE........................................ 0.8530
Woodbury, IA
Dakota, NE
7760 Sioux Falls, SD.......................................... 0.8988
Lincoln, SD
Minnehaha, SD
7800 South Bend, IN........................................... 0.9939
St. Joseph, IN
7840 Spokane, WA.............................................. 1.1020
Spokane, WA
7880 Springfield, IL.......................................... 0.8793
Menard, IL
Sangamon, IL
7920 Springfield, MO.......................................... 0.8151
Christian, MO
Greene, MO
Webster, MO
g1 Springfield, MA............................................ 1.0917
8003 Hampden, MA..............................................
Hampshire, MA
8050 State College, PA........................................ 0.9528
Centre, PA
8080 \2\ Steubenville-Weirton, OH-WV (Ohio Hospitals)......... 0.8576
Jefferson, OH
Brooke, WV
Hancock, WV
8080 Steubenville-Weirton, OH-WV (West Virginia Hospitals).... 0.8476
Jefferson, OH
Brooke, WV
Hancock, WV
8120 Stockton-Lodi, CA........................................ 1.1157
San Joaquin, CA
8140 Sumter, SC............................................... 0.8195
Sumter, SC
8160 Syracuse, NY............................................. 0.9410
Cayuga, NY
Madison, NY
Onondaga, NY
Oswego, NY
8200 \2\ Tacoma, WA........................................... 1.0577
Pierce, WA
8240 \2\ Tallahassee, FL...................................... 0.8947
Gadsden, FL
Leon, FL
8280 \1\ Tampa-St. Petersburg-Clearwater, FL.................. 0.9179
Hernando, FL
Hillsborough, FL
Pasco, FL
Pinellas, FL
8320 Terre Haute, IN.......................................... 0.9063
Clay, IN
Vermillion, IN
Vigo, IN
8360 Texarkana, AR-Texarkana, TX.............................. 0.7538
Miller, AR
Bowie, TX
8400 Toledo, OH............................................... 1.0132
Fulton, OH
Lucas, OH
Wood, OH
8440 Topeka, KS............................................... 0.9894
Shawnee, KS
8480 Trenton, NJ.............................................. 1.0399
Mercer, NJ
8520 Tucson, AZ............................................... 0.9104
Pima, AZ
8560 Tulsa, OK................................................ 0.8520
Creek, OK
Osage, OK
Rogers, OK
Tulsa, OK
Wagoner, OK
8600 Tuscaloosa, AL........................................... 0.7706
Tuscaloosa, AL
8640 Tyler, TX................................................ 0.8792
Smith, TX
8680 \2\ Utica-Rome, NY....................................... 0.8640
Herkimer, NY
Oneida, NY
8720 Vallejo-Fairfield-Napa, CA............................... 1.3458
Napa, CA
Solano, CA
8735 Ventura, CA.............................................. 1.0764
Ventura, CA
8750 Victoria, TX............................................. 0.8451
Victoria, TX
8760 Vineland-Millville-Bridgeton, NJ......................... 1.0460
Cumberland, NJ
8780 Visalia-Tulare-Porterville, CA........................... 1.0168
Tulare, CA
8800 Waco, TX................................................. 0.8027
McLennan, TX
8840 \1\ Washington, DC-MD-VA-WV.............................. 1.0863
District of Columbia, DC
Calvert, MD
Charles, MD
Frederick, MD
Montgomery, MD
Prince Georges, MD
Alexandria City, VA
Arlington, VA
Clarke, VA
Culpeper, VA
Fairfax, VA
Fairfax City, VA
Falls Church City, VA
Fauquier, VA
Fredericksburg City, VA
King George, VA
Loudoun, VA
Manassas City, VA
Manassas Park City, VA
Prince William, VA
Spotsylvania, VA
Stafford, VA
Warren, VA
Berkeley, WV
Jefferson, WV
8920 Waterloo-Cedar Falls, IA................................. 0.8402
Black Hawk, IA
8940 Wausau, WI............................................... 0.9814
Marathon, WI
8960 West Palm Beach-Boca Raton, FL........................... 1.0288
Palm Beach, FL
9000 \2\ Wheeling, WV-OH (West Virginia Hospitals)............ 0.7938
Belmont, OH
Marshall, WV
Ohio, WV
9000 \2\ Wheeling, WV-OH (Ohio Hospitals)..................... 0.8576
Belmont, OH
Marshall, WV
Ohio, WV
9040 Wichita, KS.............................................. 0.8990
Butler, KS
Harvey, KS
Sedgwick, KS
9080 Wichita Falls, TX........................................ 0.7864
Archer, TX
Wichita, TX
9140 \2\ Williamsport, PA..................................... 0.8615
Lycoming, PA
9160 Wilmington-Newark, DE-MD................................. 1.1968
New Castle, DE
Cecil, MD
9200 Wilmington, NC........................................... 0.9427
New Hanover, NC
Brunswick, NC
9260 \2\ Yakima, WA........................................... 1.0577
Yakima, WA
9270 Yolo, CA................................................. 1.0702
Yolo, CA
9280 York, PA................................................. 0.9509
York, PA
9320 Youngstown-Warren, OH.................................... 0.9897
Columbiana, OH
Mahoning, OH
Trumbull, OH
9340 Yuba City, CA............................................ 1.0957
Sutter, CA
Yuba, CA
9360 Yuma, AZ................................................. 1.0143
Yuma, AZ
------------------------------------------------------------------------
\1\ Large Urban Area
\2\ Hospitals geographically located in the area are assigned the
statewide rural wage index for FY 1999.
Addendum K.--Wage Index for Rural Areas
------------------------------------------------------------------------
Wage
Nonurban area index
------------------------------------------------------------------------
Alabama........................................................ 0.7385
Alaska......................................................... 1.2534
Arizona........................................................ 0.8082
Arkansas....................................................... 0.7274
California..................................................... 0.9976
Colorado....................................................... 0.8454
Connecticut.................................................... 1.2175
Delaware....................................................... 0.8590
Florida........................................................ 0.8947
Georgia........................................................ 0.7933
Hawaii......................................................... 1.1011
Idaho.......................................................... 0.8548
Illinois....................................................... 0.7985
Indiana........................................................ 0.8429
Iowa........................................................... 0.7846
Kansas......................................................... 0.7334
Kentucky....................................................... 0.7902
Louisiana...................................................... 0.7517
Maine.......................................................... 0.8538
Maryland....................................................... 0.8627
Massachusetts.................................................. 1.0917
Michigan....................................................... 0.8988
Minnesota...................................................... 0.8665
Mississippi.................................................... 0.7359
Missouri....................................................... 0.7510
Montana........................................................ 0.8645
Nebraska....................................................... 0.7683
Nevada......................................................... 0.9267
New Hampshire.................................................. 1.0324
New Jersey..................................................... (\1\)
New Mexico..................................................... 0.7927
New York....................................................... 0.8640
North Carolina................................................. 0.8162
North Dakota................................................... 0.7471
Ohio........................................................... 0.8576
Oklahoma....................................................... 0.7207
Oregon......................................................... 0.9957
Pennsylvania................................................... 0.8615
Puerto Rico.................................................... 0.4083
Rhode Island................................................... (\1\)
South Carolina................................................. 0.8110
South Dakota................................................... 0.7564
Tennessee...................................................... 0.7483
Texas.......................................................... 0.7404
[[Page 48036]]
Utah........................................................... 0.8851
Vermont........................................................ 0.9489
Virginia....................................................... 0.7890
Washington..................................................... 1.0577
West Virginia.................................................. 0.7938
Wisconsin...................................................... 0.8557
Wyoming........................................................ 0.8763
------------------------------------------------------------------------
\1\ All counties within the State are classified as urban.
Addendum L.--Wage Index for Hospitals That Are Reclassified
------------------------------------------------------------------------
Wage
Area index
------------------------------------------------------------------------
Abilene, TX.................................................... 0.8081
Albany, GA..................................................... 0.7933
Albuquerque, NM................................................ 0.8813
Alexandria, LA................................................. 0.8598
Allentown-Bethlehem-Easton, PA................................. 1.0219
Amarillo, TX................................................... 0.8483
Anchorage, AK.................................................. 1.3088
Asheville, NC.................................................. 0.9016
Atlanta, GA.................................................... 1.0024
Augusta-Aiken, GA-SC........................................... 0.9309
Baltimore, MD.................................................. 0.9760
Barnstable-Yarmouth, MA........................................ 1.4646
Baton Rouge, LA................................................ 0.8940
Benton Harbor, MI.............................................. 0.8988
Bergen-Passaic, NJ............................................. 1.1845
Billings, MT................................................... 0.9220
Binghamton, NY................................................. 0.8989
Birmingham, AL................................................. 0.9150
Bismarck, ND................................................... 0.7838
Boise City, ID................................................. 0.9267
Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH............... 1.0885
Brazoria, TX................................................... 0.8895
Bryan-College Station, TX...................................... 0.7962
Buffalo-Niagara Falls, NY...................................... 0.9592
Burlington, VT................................................. 0.9612
Caguas, PR..................................................... 0.4445
Canton-Massillon, OH........................................... 0.8895
Casper, WY..................................................... 0.9227
Champaign-Urbana, IL........................................... 0.8844
Charleston-North Charleston, SC................................ 0.8931
Charleston, WV................................................. 0.8819
Charlotte-Gastonia-Rock Hill, NC-SC............................ 0.9568
Charlottesville, VA............................................ 0.9803
Chattanooga, TN-GA............................................. 0.8885
Chicago, IL.................................................... 1.0507
Cincinnati, OH-KY-IN........................................... 0.9465
Clarksville-Hopkinsville, TN-KY................................ 0.8204
Cleveland-Lorain-Elyria, OH.................................... 0.9970
Columbia, MO................................................... 0.9331
Columbus, GA-AL................................................ 0.8573
Columbus, OH................................................... 0.9929
Corpus Christi, TX............................................. 0.8112
Dallas, TX..................................................... 0.9149
Danville, VA................................................... 0.8779
Davenport-Moline-Rock Island, IA-IL............................ 0.8496
Dayton-Springfield, OH......................................... 0.9670
Denver, CO..................................................... 1.0532
Des Moines, IA................................................. 0.8576
Duluth-Superior, MN-WI......................................... 1.0133
Dutchess County, NY............................................ 0.9860
Elkhart-Goshen, IN............................................. 0.9168
Eugene-Springfield, OR......................................... 1.1141
Evansville-Henderson, IN-KY.................................... 0.8505
Fargo-Moorhead, ND-MN (Minnesota Hospital)..................... 0.8665
Fargo-Moorhead, ND-MN (South Dakota Hospital).................. 0.7905
Fayetteville, NC............................................... 0.8460
Flagstaff, AZ-UT............................................... 0.9602
Flint, MI...................................................... 1.1106
Fort Collins-Loveland, CO...................................... 1.0383
Ft. Lauderdale, FL............................................. 1.0534
Fort Pierce-Port St. Lucie, FL................................. 0.9847
Fort Smith, AR-OK.............................................. 0.7582
Fort Walton Beach, FL.......................................... 0.8694
Forth Worth-Arlington, TX...................................... 0.9192
Gadsden, AL.................................................... 0.8854
Gainesville, FL................................................ 0.9542
Goldsboro, NC.................................................. 0.8366
Grand Forks, ND-MN............................................. 0.8996
Grand Junction, CO............................................. 0.9110
Grand Rapids-Muskegon-Holland, MI.............................. 0.9908
Great Falls, MT................................................ 0.9362
Greeley, CO.................................................... 0.9663
Green Bay, WI.................................................. 0.9323
Greenville, NC................................................. 0.8844
Greenville-Spartanburg-Anderson, SC............................ 0.9318
Harrisburg-Lebanon-Carlisle, PA................................ 0.9572
Hartford, CT................................................... 1.1152
Hattiesburg, MS................................................ 0.7359
Hickory-Morganton-Lenoir, NC................................... 0.8687
Honolulu, HI................................................... 1.1628
Houston, TX.................................................... 1.0017
Huntington-Ashland, WV-KY-OH................................... 0.9353
Huntsville, AL................................................. 0.8269
Indianapolis, IN............................................... 0.9901
Iowa City, IA.................................................. 0.9441
Jackson, MS.................................................... 0.8279
Jackson, TN.................................................... 0.8632
Jacksonville, FL............................................... 0.8915
Johnson City-Kingsport-Bristol, TN-VA.......................... 0.8847
Jonesboro, AR.................................................. 0.7643
Joplin, MO..................................................... 0.7710
Kalamazoo-Battlecreek, MI...................................... 1.1713
Kansas City, KS-MO............................................. 0.9672
Knoxville, TN.................................................. 0.8569
Lafayette, LA.................................................. 0.8363
Lansing-East Lansing, MI....................................... 1.0025
Las Cruces, NM................................................. 0.9045
Las Vegas, NV-AZ............................................... 1.1349
Lexington, KY.................................................. 0.8579
Lima, OH....................................................... 0.8715
Lincoln, NE.................................................... 0.8900
Little Rock-North Little Rock, AR.............................. 0.8598
Los Angeles-Long Beach, CA..................................... 1.2124
Louisville, KY-IN.............................................. 0.9212
Macon, GA...................................................... 0.8886
Madison, WI.................................................... 1.0103
Mansfield, OH.................................................. 0.8606
Memphis, TN-AR-MS.............................................. 0.8423
Merced, CA..................................................... 1.0304
Milwaukee-Waukesha, WI......................................... 0.9289
Minneapolis-St. Paul, MN-WI.................................... 1.0956
Modesto, CA.................................................... 1.0406
Monroe, LA..................................................... 0.8148
Montgomery, AL................................................. 0.7919
Myrtle Beach, SC............................................... 0.8162
Nashville, TN.................................................. 0.9336
New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT............ 1.2175
New London-Norwich, CT......................................... 1.1738
New Orleans, LA................................................ 0.9397
New York, NY................................................... 1.4537
Newark, NJ..................................................... 1.0899
Newburgh, NY-PA................................................ 1.1356
Oakland, CA.................................................... 1.5309
Odessa-Midland, TX............................................. 0.7773
Oklahoma City, OK.............................................. 0.8764
Omaha, NE-IA................................................... 0.9938
Orange County, CA.............................................. 1.1153
Orlando, FL.................................................... 0.9933
Peoria-Pekin, IL............................................... 0.8157
Philadelphia, PA-NJ............................................ 1.1427
Pittsburgh, PA................................................. 0.9740
Pocatello, ID (Idaho Hospital)................................. 0.8760
Pocatello, ID (Wyoming Hospitals).............................. 0.8763
Portland, ME................................................... 0.9537
Portland-Vancouver, OR-WA...................................... 1.1274
Provo-Orem, UT................................................. 0.9910
Raleigh-Durham-Chapel Hill, NC................................. 0.9909
Rapid City, SD................................................. 0.8277
Reno, NV....................................................... 1.0169
Rochester, MN.................................................. 1.1797
Rockford, IL................................................... 0.8703
Sacramento, CA................................................. 1.1952
Saginaw-Bay City-Midland, MI................................... 0.9567
St. Cloud, MN.................................................. 0.9667
St. Louis, MO-IL............................................... 0.9063
Salt Lake City-Ogden, UT....................................... 0.9458
San Diego, CA.................................................. 1.2388
Santa Fe, NM................................................... 0.9414
Santa Rosa, CA................................................. 1.3003
Seattle-Bellevue-Everett, WA................................... 1.1634
Sharon, PA..................................................... 0.8835
Sherman-Denison, TX............................................ 0.8061
Sioux City, IA-NE.............................................. 0.8530
Sioux Falls, SD................................................ 0.8885
South Bend, IN................................................. 0.9939
Spokane, WA.................................................... 1.0819
Springfield, IL................................................ 0.8793
Springfield, MO................................................ 0.8151
State College, PA.............................................. 0.8845
Syracuse, NY................................................... 0.9410
Tallahassee, FL................................................ 0.8566
Tampa-St. Petersburg-Clearwater, FL............................ 0.9179
Texarkana, AR-Texarkana, TX.................................... 0.7538
Topeka, KS..................................................... 0.9667
Tucson, AZ..................................................... 0.9104
Tulsa, OK...................................................... 0.8418
Tuscaloosa, AL................................................. 0.7706
Tyler, TX...................................................... 0.8792
Vallejo-Fairfield-Napa, CA..................................... 1.3458
Victoria, TX................................................... 0.8451
Washington, DC-MD-VA-WV........................................ 1.0863
Waterloo-Cedar Falls, IA....................................... 0.8402
Wausau, WI..................................................... 0.9501
Wichita, KS.................................................... 0.8853
Wichita Falls, TX.............................................. 0.7695
Rural Alabama.................................................. 0.7385
Rural Illinois................................................. 0.7985
Rural Louisiana................................................ 0.7517
Rural Massachusetts............................................ 1.0481
Rural Michigan................................................. 0.8988
Rural Minnesota................................................ 0.8665
Rural Missouri................................................. 0.7510
Rural Nevada................................................... 0.8855
Rural New Mexico............................................... 0.7927
Rural Oregon................................................... 0.9957
Rural Washington............................................... 1.0577
Rural Wyoming.................................................. 0.8763
------------------------------------------------------------------------
[FR Doc. 98-23383 Filed 9-4-98; 8:45 am]
BILLING CODE 4120-01-P