[Federal Register: August 9, 2002 (Volume 67, Number 154)] [Proposed Rules] [Page 52141-52190] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr09au02-37] [[pp. 52141-52190]] Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2003 Payment Rates; and Changes to Payment Suspension for Unfiled Cost Reports [[Continued from page 52140]] [[Page 52141]] and we would not expect these procedures to be performed during the same operative session with a higher paying procedure with status indicator ``T.'' Therefore, we propose to continue our current policy of multiple procedure discounting. That is, when two or more APCS with status indicator ``T'' are billed together we propose to pay 100 percent for the highest cost APC and 50 percent for all other APCs with status indicator ``T.'' We propose not to adjust these payments to account for device costs in the APCs. F. Outpatient Billing For Dialysis Currently, hospitals are unable to bill for dialysis treatments furnished to End-Stage Renal Disease (ESRD) patients on an outpatient basis, unless the hospital also has a certified hospital-based ESRD facility. As a result of this policy, there has been an increase in denials by the PROs for inappropriate hospital admissions. When ESRD patients come to the hospital for a medical emergency or for problems with their access sites, they typically miss their regularly scheduled dialysis appointments. If the ESRD patient's usual facility is unable to reschedule the dialysis treatment, the beneficiary has to wait until the next scheduled dialysis appointment. CMS is concerned that by maintaining this policy, beneficiaries may be receiving interrupted care because there will be unnecessary lapses in treatment. The ESRD patient should not be prevented from receiving her or his normal dialysis because he or she experienced another unrelated medical situation. Therefore, we propose to allow payment for dialysis treatments for ESRD patients in the outpatient department of a hospital in specific situations. Payment would be limited to unscheduled dialysis for ESRD patients in exceptional circumstances. Outpatient dialysis for acute patients would not be included in this payment mechanism. We propose to limit this payment to medical situations in which the ESRD patient cannot obtain her or his regularly scheduled dialysis treatment at a certified ESRD facility. Situations that we propose to allow are limited to: (1) dialysis performed following or in connection with a vascular access procedure; (2) dialysis performed following treatment for an unrelated medical emergency. For example, if a patient goes to the emergency room for chest pains and misses a regularly scheduled dialysis treatment that cannot be rescheduled, we would allow the hospital to provide and bill Medicare for the dialysis treatment; and (3) emergency dialysis--Currently, the only mechanism available for payment in this situation is through an inpatient admission. We will maintain our policy that routine treatments in non-ESRD certified hospitals would not be payable under OPPS. We believe it is important to make this change in policy for two reasons: (1) to ensure that hospital outpatient departments are paid for providing this much needed service; and (2) to prevent dialysis patients from receiving interrupted care. Non-ESRD certified hospital outpatient facilities would bill Medicare using a new G code, G0GGG, ``Unscheduled or emergency treatment for dialysis for ESRD patient in the outpatient department of a hospital that does not have a certified ESRD facility.'' We propose that this new code will have status indicator ``S'' and be assigned to APC 0170. Payment would be roughly equivalent to the reimbursement rate for acute dialysis. We propose to implement this change effective January 1, 2003. Effective January 1, 2003, this would be the only way for non-ESRD certified hospital outpatient facilities to bill Medicare and be paid for providing outpatient dialysis to ESRD beneficiaries. CMS will be monitoring the use of this new code to ensure that (1) certified dialysis facilities are not incorrectly using this code; and (2) the same dialysis patient is not repeatedly using this code, which would indicate routine dialysis treatment. When ESRD patients receive outpatient dialysis in non-ESRD certified hospital outpatient facilities, the patient's home facility would be responsible for obtaining and reviewing the patient's medical records to ensure that appropriate care was provided in the hospital and that modifications are made, if necessary, to the patient's plan of care upon her or his return to the facility. This ensures continuity of care for the patient. IX. Summary of and Responses to MedPAC Recommendations The Medicare Payment Advisory Commission (MedPAC) in its March 2002 Report to the Congress: ``Medicare Payment Policy,'' makes a number of recommendations relating to the OPPS. This section provides responses to those recommendations. Recommendation: For calendar year 2003, the Secretary should increase the payment rates for services covered by the OPPS by the rate of increase in the hospital market basket. Response: Section 1833(t)(3)(C)(ii) of the Act requires the Secretary to update the conversion factor annually. Under section 1833(t)(3)(C)(iv) of the Act, the update is equal to the hospital market basket percentage increase applicable under the hospital inpatient PPS, minus one percentage point for the years 2000 and 2002. The Secretary has the authority under section 1833(t)(3)(C)(iv) of the Act to substitute a market basket that is specific to hospital outpatient services. In the September 8, 1998 proposed rule on the OPPS, we indicated that we were considering the option of developing an outpatient-specific market basket and invited comments on possible sources of data suitable for constructing one (63 FR 47579). We received no comments in response to this invitation, and we therefore announced in the April 7, 2000 final rule that we would update the conversion factor by the hospital inpatient market basket increase, minus one percentage point, for the years 2000, 2001, and 2002 (65 FR 18502). (As required by section 401(c) of the BIPA, we made payment adjustments effective April 1, 2001 under a special payment rule that had the effect of providing a full market basket update in 2001.) For 2003, we propose to increase payment rates by the rate of increase in the hospital market basket. Recommendation: The Congress should--Replace hospital-specific payments for pass-through devices with national rates. Give the Secretary authority to consider alternatives to average wholesale price (AWP) when determining payments for pass- through drugs and biologicals. Response: Regarding the pricing of transitional pass-through devices, we share the Commission's concern that the current methodology provides incentives for hospitals to inflate charges for transitional pass-through devices to increase payments. However, we believe that alternative approaches are not necessarily superior. Further, the salience of this problem should be much less in the future. At present, the payment for a transitional pass-through device is set, on a claim-by-claim basis, relative to the hospital's charge for that device. The charge is reduced to a measure of cost by application of a hospital-specific cost-to-charge ratio, and a subtraction is made to reflect the portion of device costs already recognized in the payment for the associated procedure APC. This procedure means that a higher charge by a hospital will result in a higher payment from Medicare. The Commission notes that this method embodies an incentive for hospitals, perhaps prompted by manufacturers, to increase charges as a means of [[Page 52142]] increasing payments. The Commission is concerned that this situation may lead to excessive payments and may bias the charges used to revise, from year to year, relative weights in the OPPS. In fact, the extent to which hospitals raising their charges on devices is problematic depends on the outcomes. In general, we anticipate that hospital charge structures, on average, reflect their costs; this assumption helps support the use of charge data to revise relative weights in hospital prospective payment systems. Accordingly, whether payments to hospitals for transitional pass-through devices might be considered excessive depends on whether hospitals inflate charges beyond the levels appropriate to recover their costs. Whether their behavior leads to biases in charge data depends on whether they set charges on transitional pass-through devices significantly differently than on other services. Moving to a fee schedule for transitional pass-through devices would remove the particular incentive problem that the Commission noted, which we agree would be desirable. However, the establishment of appropriate national rates would then become the focus. In the absence of field data on actual costs, we will be inevitably reliant on information that manufacturers provide. At present, manufacturers are asked for information about prices on applications for pass-through status. Anecdotal information suggests this information is not fully reliable as a measure of what hospitals actually pay. The Commission's report discusses the possibility of CMS setting the rate for a device based on analysis of the manufacturer's costs, including an appropriate rate of return on equity. This approach would confront a number of accounting, legal, and operational difficulties. First, it would take some time to complete the analysis for a new product, which could significantly delay establishment of a rate. The rate that would be used in the meantime, or whether billing would be permitted at all, would be open to question. Second, it appears that large firms with multiple product lines supply most devices, which would make determining the costs of a particular device difficult. This problem would be compounded when multiple enterprises are involved in bringing a product to market, which is not uncommon in the device industry, where invention and initial development may occur in one firm and final development, manufacturing, and marketing in another. Third, the government generally does not have access to manufacturers cost information. While legal authority could be enhanced, manufacturers would face incentives that raise questions about the reliability of information provided, and the need for government accounting and auditing resources would be high. Fourth, as the Commission's report notes, an appropriate rate of return on equity would have to be established. Fifth, devices are now paid, under BIPA, on the basis of categories. As a result, if a manufacturer brings to market a product that fits the description of a category, hospitals can bill for that manufacturer's product without any change in coding or notification of CMS. Consequently, we do not know what specific devices are actually being billed in these categories, or who manufactures them. Whatever rate might be established on the basis of an initial application for a category would presumably be based on the applicant's costs. Later entrants might have significantly different cost structures, but this information would not come into account unless a more elaborate process was implemented to include it. Finally, whether a rate set in this fashion would pay less or more than the current method is unclear. The current method is based on actual experience in the field, and it will reflect, though perhaps somewhat tenuously, whatever competitive market pressures exist. Any method that we use aimed at ensuring a more reliable price could yield a price that is too high, since it will not reflect market activity. Whether a rate set by ex ante analysis of this sort would produce superior results does not appear obvious. The Commission's report also mentions the possibility of using competitive bidding to set rates for transitional pass-through devices. While competitive bidding appears attractive as a means of setting a market-related price, it has not proven an easy process for Medicare to implement. Competitive bidding seems best suited for established products with multiple suppliers. However, transitional pass-through devices are by definition new to the market and will frequently have only one manufacturer, at least at the start of the 2 to 3 year transitional pass-through period. Even in those instances in which this technique would be possible, it involves a fair amount of administrative resources and time, and using it to establish a rate that will be used at the most for 3 years does not appear to be an effective use of resources. Both of the suggestions discussed above reflect procedures that involve relatively high overhead on the part of CMS and of other actors. It is not obvious whether either would produce results that are superior to those derived from the present method. While they would change incentives on hospitals, incentives of manufacturers would still be a source of concern. We agree with the Commission that further investigation would be necessary to determine a feasible alternative to cost-based pass-through payments. In considering the advantages of various approaches, it is important to keep the size of the problem in mind, especially when contemplating procedures for setting rates that would involve substantial administrative resources. As of July 1, 2002, the OPPS pays for 100 categories of devices. As is explained in section III.C of this preamble, we are proposing that 95 categories will lose pass-through status and be retired as of January 1, 2003.\3\ Since the initial categories were established in April 2001, we have added only three categories. While several applications are pending, given the extensiveness of the existing categories, it appears likely that the number of new categories to be established in future years will be small.\4\ The likely volume of claims represented by these new categories is of course speculative, but it also does not seem likely to be large relative to the size of the OPPS system. As discussed below, we developed criteria for the establishment of new categories that were specifically intended to limit future pass-through payments to devices that provide a substantial clinical improvement. --------------------------------------------------------------------------- \3\ In accord with the BBRA amendment that established the pass- through payment methodology, items are only eligible for pass- through payments for 2 to 3 years. After expiration of pass-through status, payments for devices described by these categories will be packaged into APC payments for the procedures with which they are used. \4\ If a new device arrives on the market that would have fit in a category formerly in use but subsequently retired, it will not be eligible for pass-through payment. --------------------------------------------------------------------------- Considering that the identified alternatives do not appear to be manifestly superior to the current system but do involve significantly more administrative resources, and given the anticipated small volume of transitional pass-through devices in the future, we think on balance it would be best to let more experience develop with the current system before making significant changes to the current method. However, we agree that it would be desirable to give the Secretary authority [[Page 52143]] to use alternatives to AWP when determining payments for pass-through drugs and biologicals. At present, total payment for these items is governed by the general rule (section 1842(o) of the Act) for Medicare pricing of drugs, which requires they be paid at 95 percent of AWP. This rule also covers most drugs delivered ``incident to'' physicians' services in physicians' offices and elsewhere. The Congress is at present considering various changes to the AWP as the basis for Medicare payment for drugs, and if a change is adopted to this standard, it may be an appropriate standard for transitional pass- through drugs and biologicals as well. Recommendation: The Secretary should do the following: Ensure additional payments are made only for new or substantially improved technologies that are expensive in relation to the applicable ambulatory payment classification rate. Avoid basing national rates only on reported costs. Ensure that the same broad principles guide payments for new technologies in the inpatient and outpatient payment systems. Response: We agree that additional payments should be limited to items that have the greatest merit and that have high costs not well captured in the existing payment structure. The Commission notes that limiting the number of transitional pass-through items limits the burdens on hospitals and us; reduces the likelihood of exceeding the statutory cap on aggregate pass-through payment, necessitating a uniform reduction in transitional pass-through payments; and limits the redistribution of funds across hospitals that are low versus high users of transitional pass-through items. We agree with these points. On November 2, 2001, we published an interim final rule with comment period in the Federal Register (66 FR 55850 to 55857) that set forth criteria we will use to evaluate whether to establish new categories of devices in the future. These criteria include tests of whether a device is new, whether it represents a substantial medical improvement for Medicare beneficiaries, and whether its costs are high relative to the payments that would otherwise be made. Section 1833(t)(6)(D) of the Act prescribes the method for setting payment for transitional pass-through drugs and devices. The issue of possible alternatives is discussed above. We agree that the same principles should govern payments for new technologies in the inpatient and outpatient prospective payment systems. Criteria governing extra new technology payments in the IPPS were established in a final rule published in the Federal Register (66 FR 46902 to 46925) on September 7, 2001. The criteria have the same general form as those for the OPPS. They differ in some particulars, largely traceable to the difference of the two payment systems. In particular, the IPPS system pays on the basis of an episode of care. As a result, the bundle of payment is generally larger and hospitals are better able to absorb minor cost differences. Considering the impact of new technology on all costs of the episode is also pertinent. Consequently, the criteria for special payment for inpatient new technologies require examination of the net effect on costs of the entire episode (not just the added costs of a new technology), and the relative cost standard we established is somewhat more stringent than for the OPPS. We believe it is premature to judge whether it will make sense to make these criteria even closer in the future, as the Commission's discussion suggests. X. Summary of Proposed Changes for 2003 A. Changes Required by Statute We are proposing the following changes to implement statutory requirements: Add APCs, delete APCs, and modify the composition of some existing APCs. Recalibrate the relative payment weights of the APCs. Update the conversion factor and the wage index. Revise the APC payment amounts to reflect the APC reclassifications, the recalibration of payment weights, and the other required updates and adjustments. Cease transitional pass-through payments for drugs and biologicals (including blood and blood products) and devices (including brachytherapy), that will, on January 1, 2003, have been paid under transitional pass-through methodology for at least 2 years. B. Additional Changes to OPPS and Payment Suspension Provisions We are proposing the following additional changes to the OPPS and Payment Suspension Provisions: Creation of new evaluation and management service codes for outpatient clinic and emergency department encounters for implementation no earlier than January 1, 2004. Changes to the list of services that we do not pay in outpatient departments because we define them as ``inpatient only'' procedures. Changes to our policy of nonpayment for procedures on the ``inpatient only'' list in special cases involving death or transfer before inpatient admission. Changes to our policy governing observation in cases of direct admission to observation. Changes to status indicators for HCPCS codes. Changes to our policies governing dialysis for ESRD patients and regarding partial hospitalization. In addition, we are making changes to payment suspension policies. C. Changes to the Regulations Text A. We propose to make the following changes to our regulations: Amend Sec. 410.43(b) to add clinical social worker services (for the diagnosis and treatment of mental illnesses) that meet the requirements of section 1861(hh)(2) of the Act to the specified professional services that are separately covered and not paid as partial hospitalization services. Amend Sec. 419.66(c)(1) to specify that we must establish a new category for a medical device if it is not described by any category previously in effect as well as an existing category. XI. Summary of Proposed Payment Suspension Provisions In this rule, we propose to revise Sec. 405.371 (c) to specify that we may suspend Medicare payments ``in whole or in part'' if a provider has failed to timely file an acceptable cost report. This provision is consistent with the existing provisions in Sec. 405.371(a) governing the suspension of Medicare payments ``in whole or in part'' under certain conditions. We believe the Medicare program would benefit because immediate complete payment suspension can be disruptive to providers and may negatively affect the care of Medicare patients. XII. 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: [[Page 52144]] 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. This rule does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995. XIII. Response to Public Comments Because of the large number of items of correspondence we normally receive on a proposed rule, we are not able to acknowledge or respond to them individually. However, in preparing the final rule, we will consider all comments concerning the provisions of this proposed rule that we receive by the date and time specified in the DATES section of this preamble and respond to those comments in the preamble to that rule. XIV. Regulatory Impact Analysis The regulatory impact analysis for this proposed rule consists of an impact analysis for the OPPS provisions and a regulatory impact statement for the provision for payment suspension for unfiled cost reports. A. OPPS 1. General We have examined the impacts of this proposed rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review) and the Regulatory Flexibility Act (RFA) (September 16, 1980 Pub. L. 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if 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). We estimate the effects of the provisions that would be implemented by this proposed rule would result in expenditures exceeding $100 million in any 1 year. We estimate the total increase (from changes in the proposed rule as well as enrollment, utilization, and case mix changes) in expenditures under the OPPS for CY 2003 compared to CY 2002 to be approximately $1.372 billion. Therefore, this proposed rule is an economically significant rule under Executive Order 12866, and a major rule under 5 U.S.C. 804(2). The RFA requires agencies to determine whether a rule will have a significant economic impact on a substantial number of small entities. For purposes of the RFA, small entities include small businesses, nonprofit organizations and government agencies. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of $6 to $29 million or less in any 1 year (see 65 FR 69432). For purposes of the RFA we have determined that approximately 37 percent of hospitals and 98 percent of mental health practitioners would be considered small entities according to the Small Business Administration (SBA) size standards. We do not have data available to calculate the percentages of entities in the pharmaceutical preparation manufacturing, biological products, or medical instrument industries. For the pharmaceutical preparation manufacturing industry (NAICS 325412), the size standard is 750 or fewer employees and $67.6 billion in annual sales (1997 business census). For biological products (except diagnostic) (NAICS 325414) $5.7 billion and medical instruments (NAICS 339112), with $18.5 billion in annual sales, the standard is 50 or fewer employees (see the standards web site at http://www.sba.gov/ regulations/siccodes/). Individuals and States are not included in the definition of a small entity. In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This 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 that is located outside of a Metropolitan Statistical Area (MSA) and has fewer than 100 beds (or New England County Metropolitan Area (NECMA)). Section 601(g) of the Social Security Amendments of 1983 (Pub. L. 98-21) designated hospitals in certain New England counties as belonging to the adjacent NECMA. Thus, for purposes of the OPPS, we classify these hospitals as urban hospitals. We believe that the changes in this proposed rule would affect both a substantial number of rural hospitals as well as other classes of hospitals and that the effects on some may be significant. Therefore, we conclude that this proposed rule has a significant impact on a substantial number of small entities. However, the statute provides for small rural hospitals (of less than 100 beds) to be held harmless by the law and to continue to be paid at cost; therefore this proposed rule has no impact on them. Unfunded Mandates Section 202 of the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4) also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in an expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. This proposed rule would not mandate any requirements for State, local, or tribal governments. This proposed rule imposes no unfunded mandates on the private sector. Federalism Executive Order 13132 establishes certain requirements that an agency must meet when it publishes a proposed rule (and subsequent final rule) that imposes substantial direct costs on State and local governments, preempts State law, or otherwise has Federalism implications. We have examined this proposed rule in accordance with Executive Order 13132, Federalism, and have determined that it will not have an impact on the rights, roles, and responsibilities of State, local or tribal governments. The impact analysis (see table 10) shows that payments to governmental hospitals (including State, local and tribal governmental hospitals) would increase by 5 percent under the proposed rule. 2. Changes in this Proposed Rule We are proposing several changes to the OPPS that are required by the statute. We are required under section 1833(t)(3)(C)(ii) of the Act to update annually the conversion factor used to determine the APC payment rates. We are also required under section 1833(t)(9)(A) of the Act to revise, not less often than annually, the wage index and other adjustments. In addition, we must review the clinical integrity of payment groups and weights at least annually. Accordingly, in this proposed rule, we are updating the conversion factor and the wage index adjustment for hospital outpatient services furnished beginning January 1, 2003 as [[Page 52145]] we discuss in sections VI and IV, respectively, of this preamble. We are also proposing revisions to the relative APC payment weights based on claims data from January 1, 2001 through December 31, 2001. Finally, we are proposing to remove 95 devices and more than 200 drugs and biologicals from pass-through payment status. Under this proposed rule, the change to the conversion factor as provided by statute would increase total OPPS payments by 3.5 percent in 2003. The changes to the wage index and to the APC weights (which incorporates the cessation of pass-through payments for many drugs and devices) do not increase OPPS payments because the OPPS is budget neutral. However, the wage index and APC weight changes do change the distribution of payments within the budget neutral system as shown in Table 10 and described in more detail in this section. Alternatives Considered Alternatives to the changes we propose and the reason that we did not choose to propose them are discussed throughout this proposed rule. Below we discuss options we considered when analyzing methodologies to appropriately recognize the costs of former pass-through items. For a more detailed discussion, see section III.C.1 regarding the expiration of pass-through payment for devices and section III.C.2 regarding the expiration of pass-through payment for drugs and biologicals. Payment for Categories of Devices We considered establishing separate APCs for categories of devices and paying for them separately. We did not propose this option because we believe that to the extent possible, hospital payment for procedures and visits should include all of the costs required to provide the procedures and visits. A second option we considered involved (1) packaging some categories of devices into the procedures with which they were billed in 2001 and (2) paying the rest through separate APCs (as discussed in section III.C.). We did not propose this option because we believe that devices are routinely used in the services for which they are needed and therefore are consistently paid at the cost of providing the service. Furthermore, criteria that would provide a basis for some devices to be packaged and for others to be paid separately would have to be developed and approved, thereby further complicating an already complex payment system. Payment for Drugs and Biologicals We considered continuing to make separate payment for all drugs and biologicals through separate APCs. We did not propose to pay separately for all drugs through separate APCs because we believe that, to the extent possible, hospital payment for services should include all of the costs of the services. We believe that drugs should be packaged with the services in which they are furnished except when we determine that there is a valid reason to do otherwise. However, we recognize that (unlike the stability that exists with device usage with the applicable procedures) the use of drugs may vary widely depending upon patient and disease characteristics. Therefore, packaging payment for all drugs may, in some cases, provide inadequate payment for the services furnished. Where a hospital has a disproportionate share of patients who need greater amounts of expensive drugs, underpayment for the drugs needed by these patients could result in cessation of needed services. For the first year that we are ceasing transitional pass- through payment for drugs, we decided to proceed cautiously by proposing to pay separately for drugs when the cost per encounter was more than $150 or when special characteristics existed (for example, orphan drugs, blood products). We also considered packaging the costs of all drugs into the cost of the associated procedures with which they were billed in 2001. We did not package all payment for drugs into the payment for the procedures because, while this packaging is ultimately our goal, we believe, for the reasons indicated above, that we need to proceed cautiously to ensure that we do not inadvertently threaten access to needed care. Conclusion It is clear that the changes in this proposed rule would affect both a substantial number of rural hospitals as well as other classes of hospitals, and the effects on some may be significant. Therefore, the discussion below, in combination with the rest of this proposed rule, constitutes a regulatory impact analysis. The OPPS rates proposed for CY 2003 would have, overall, a positive effect for every category of hospital with the exception of children's hospitals, which are held harmless under the OPPS. The changes in the OPPS proposed for 2003 would result in an overall 3.5 percent increase in Medicare payments to hospitals, exclusive of outlier and transitional pass-through payments and transitional corridor payments. As described in the preamble, budget neutrality adjustments are made to the conversion factor and the weights to assure that the revisions in the wage index, APC groups, and relative weights do not affect aggregate payments. The impact of the wage and recalibration changes does vary somewhat by hospital group. Estimates of these impacts are displayed on Table 10. The overall projected increase in payments for urban hospitals is slightly lower (2.5 percent) than the average increase for all hospitals (3.5 percent) while the increase for rural hospitals is significantly greater (7.6 percent) than the average increase. Rural hospitals gain 2.3 percent from the wage index change, and also gain 1.6 percent from APC changes. A discussion of the distribution of outlier payments that we project under this proposed rule can be found under section D below. Table 11 presents the outlier distribution that we expect to see under this proposed rule. 3. Limitations of Our Analysis The distributional impacts represent the projected effects of the proposed policy changes, as well as statutory changes effective for 2003, on various hospital groups. We estimate the effects of individual policy changes by estimating payments per service while holding all other payment policies constant. We use the best data available but do not attempt to predict behavioral responses to our policy changes. In addition, we do not make adjustments for future changes in variables such as service volume, service mix, or number of encounters. 4. Estimated Impacts of This Proposed Rule on Hospitals The OPPS is a budget neutral payment system under which the increase to the total payments made under OPPS is limited by the increase to the conversion factor set under the methodology in the statute. The impact tables show the redistributive effects of the wage index and APC changes. In some cases, under this proposed rule, hospitals would receive more total payment than in 2002 while in other cases they would receive less total payment than they received in 2002. The impact of this proposed rule would depend on a number of factors, most significant of which are the mix of services furnished by a hospital (for example, how the APCs for the hospital's most frequently furnished services would change) and the impact of the wage index changes on the hospital. Column 4 in Table 10 represents the full impact on each hospital group of all [[Page 52146]] the changes for 2003. Columns 2 and 3 in the table reflect the independent effects of the proposed change in the wage index and the APC reclassification and recalibration changes, respectively. We excluded critical access hospitals (CAHs) from the analysis of the impact of the proposed 2003 OPPS rates that is summarized in Table 10. For that reason, the total number of hospitals included in Table 10 (4,551) is lower than in previous years. CAHs are excluded from the OPPS. In general, the wage index changes favor rural hospitals, particularly the largest in bed size and volume. The only rural hospitals that would experience a negative impact due to wage index changes are those in Puerto Rico, a decrease of 2.8 percent. Conversely, the urban hospitals are generally negatively affected by wage index changes, with the largest decreases occurring in those with 300-499 beds (-0.7 percent) and those in the Middle Atlantic (-1.3 percent), Pacific (-.09 percent) and Puerto Rico Regions (-1.8 percent). However, this effect is somewhat lessened by the distribution of outlier payments as discussed in more detail below. The APC reclassification and recalibration changes also favor rural hospitals and have a negative effect on urban hospitals in excess of 200 beds. Specifically, urban hospitals with 200-299 beds (-0.5 percent decrease), urban hospitals with 300-499 beds (-2.0 percent decrease) and urban hospitals in excess of 500 beds (a -1.9 percent decrease) all show a decrease attributed to APC recalibration. We believe this occurs as a result of our folding 75 percent of estimated pass-through device costs into APC payments in the 2002 OPPS. Specifically, a comparison of the relative payment weights proposed for 2003, as listed in Addendum A, with the final 2002 relative payment weights in the March 1, 2002 final rule shows a decrease in the weights for certain APCs in 2002 that included a fold-in of 75 percent of estimated pass-through device costs. We relied on cost information supplied by device manufacturers in estimating the device costs to be folded in when calculating the median APC costs for the 2002 OPPS, whereas the proposed 2003 relative payment weights are based on actual hospital charges and utilization under the OPPS as reported by hospitals. We believe this downward tendency in the payment weights for APCs that include device costs, based on actual hospital experience, accounts in part for the lower positive effect of the proposed 2003 rates on urban hospitals and on teaching hospitals, which tend to perform a higher number of procedures involving costly new technology devices, in contrast with an increased positive effect in 2003 on rural and non-teaching hospitals, which tend to furnish a higher volume of clinic and preventive services than procedures associated with expensive new technology devices. In both urban and rural areas, hospitals that provide a lower volume of outpatient services are projected to receive a larger increase in payments than higher volume hospitals. In rural areas, hospitals with volumes of fewer than 5000 services are projected to experience a significant increase in payments (8.1 percent). The less favorable impact for the high volume urban hospitals is attributable to both wage index and APC changes. For example, urban hospitals providing more than 42,999 services are projected to gain a combined 1.6 percent due to these changes. Major teaching hospitals are projected to experience a smaller increase in payments (1.7 percent) than the aggregate for all hospitals (3.5 percent) due to negative impacts of the wage index (-0.5 percent) and recalibration (-1.2 percent). Hospitals with less intensive teaching programs are projected to experience an overall increase (2.0 percent) that is smaller than the average for all hospitals. There is little difference in impact among hospitals with that serve low-income patients. Table 10.--Impact of Changes for CY 2003 Hospital Outpatient Prospective Payment System [Percent change in total payment to hospitals (program and beneficiary); does not include the effects of outlier and transitional pass-through payments or of transitional corridor payments.] ---------------------------------------------------------------------------------------------------------------- Number of New wage APC All CY 2003 hospitals index \2\ changes)\3\ changes \4\ \1\ (1) (2) (3) (4) ---------------------------------------------------------------------------------------------------------------- ALL HOSPITALS.............................................. 4,551 0.0 0.0 3.5 NON-TEFRA HOSPITALS........................................ 4,002 0.0 -0.1 3.4 URBAN HOSPS................................................ 2,429 -0.6 -0.5 2.5 LARGE URBAN (GT 1 MILL.)............................... 1,398 -0.7 -0.1 2.6 OTHER URBAN (LE 1 MILL.)............................... 1,031 -0.4 -0.9 2.2 RURAL HOSPS................................................ 1,573 2.3 1.6 7.6 BEDS (URBAN): 0-99 BEDS.............................................. 554 -0.3 3.1 6.4 100-199 BEDS........................................... 882 -0.6 1.4 4.3 200-299 BEDS........................................... 488 -0.6 -0.5 2.3 300-499 BEDS........................................... 364 -0.7 -2.0 0.7 500+ BEDS.............................................. 141 -0.3 -1.9 1.3 BEDS (RURAL): 0-49 BEDS.............................................. 754 0.4 2.9 7.0 50-99 BEDS............................................. 479 1.5 2.3 7.6 100-149 BEDS........................................... 201 2.4 1.5 7.6 150-199 BEDS........................................... 73 5.5 0.1 9.5 200+ BEDS.............................................. 66 3.3 0.0 7.0 VOLUME (URBAN): LT 5,000............................................... 188 0.9 6.5 10.9 5,000-10,999........................................... 305 -0.8 5.1 7.9 11,000-20,999.......................................... 472 -0.7 2.6 5.5 21,000-42,999.......................................... 657 -0.8 0.3 3.0 GT 42,999.............................................. 807 -0.5 -1.4 1.6 VOLUME (RURAL): LT 5,000............................................... 326 0.2 4.2 8.1 5,000-10,999........................................... 446 0.6 4.4 8.7 [[Page 52147]] 11,000-20,999.......................................... 373 1.3 2.7 7.7 21,000-42,999.......................................... 290 1.9 1.4 6.9 GT 42,999.............................................. 138 4.3 -0.2 7.8 REGION (URBAN): NEW ENGLAND............................................ 127 -0.6 0.6 3.4 MIDDLE ATLANTIC........................................ 372 -1.3 0.2 2.3 SOUTH ATLANTIC......................................... 370 -0.2 -0.1 3.2 EAST NORTH CENT........................................ 413 -0.7 -1.4 1.4 EAST SOUTH CENT........................................ 153 -0.6 -1.0 1.9 WEST NORTH CENT........................................ 172 -0.3 -1.6 1.6 WEST SOUTH CENT........................................ 293 0.5 -0.7 3.3 MOUNTAIN............................................... 122 -0.4 -1.1 1.9 PACIFIC................................................ 368 -0.9 0.6 3.1 PUERTO RICO............................................ 39 -1.8 4.7 6.4 REGION (RURAL): NEW ENGLAND............................................ 40 1.6 1.3 6.5 MIDDLE ATLANTIC........................................ 63 2.2 1.3 7.2 SOUTH ATLANTIC......................................... 226 2.6 2.1 8.4 EAST NORTH CENT........................................ 213 1.2 -0.2 4.6 EAST SOUTH CENT........................................ 232 2.3 2.6 8.7 WEST NORTH CENT........................................ 271 2.0 0.9 6.6 WEST SOUTH CENT........................................ 278 1.8 3.2 8.8 MOUNTAIN............................................... 141 4.1 1.3 9.2 PACIFIC................................................ 104 5.6 2.7 12.1 PUERTO RICO............................................ 5 -2.8 10.4 11.1 TEACHING STATUS: NON-TEACHING........................................... 2,935 0.4 1.1 5.0 MINOR.................................................. 782 -0.4 -1.1 2.0 MAJOR.................................................. 284 -0.5 -1.2 1.7 DSH PATIENT PERCENT: 0..................................................... 11 4.9 10.1 19.4 GT 0-0.10.............................................. 982 -0.2 -0.4 3.0 0.10-0.16.............................................. 873 0.7 -0.8 3.4 0.16-0.23.............................................. 767 -0.6 -0.3 2.6 0.23-0.35.............................................. 756 -0.2 0.1 3.4 GE 0.35................................................ 613 -0.1 2.2 5.8 URBAN IME/DSH: IME & DSH.............................................. 982 -0.7 -1.2 1.6 IME/NO DSH............................................. 0 0.0 0.0 0.0 NO IME/DSH............................................. 1,441 -0.4 0.7 3.8 NO IME/NO DSH.......................................... 6 5.4 9.8 19.7 RURAL HOSP. TYPES: NO SPECIAL STATUS...................................... 610 0.7 2.7 7.1 RRC.................................................... 167 4.2 0.2 8.2 SCH/EACH............................................... 507 1.5 2.7 7.8 MDH.................................................... 199 0.8 2.1 6.6 SCH AND RRC............................................ 75 4.0 0.5 8.2 TYPE OF OWNERSHIP: VOLUNTARY.............................................. 2,440 -0.1 -0.4 3.1 PROPRIETARY............................................ 707 -0.6 0.9 3.8 GOVERNMENT............................................. 855 0.7 0.7 5.0 SPECIALTY HOSPITALS: EYE AND EAR............................................ 13 -1.4 11.5 13.7 TRAUMA................................................. 153 -0.3 -1.5 1.6 CANCER................................................. 10 0.5 -3.9 0.2 TEFRA HOSPITALS (NOT INCLUDED ON OTHER LINES): REHAB.................................................. 166 10.3 2.8 16.9 PSYCH.................................................. 198 0.1 15.9 20.1 LTC.................................................... 143 1.3 15.9 20.4 CHILDREN............................................... 42 -1.4 -2.8 -0.9 ---------------------------------------------------------------------------------------------------------------- Note: For CY 2003, under the OPPS transitional corridor policy, the following categories of hospitals are held harmless compared to their 1996 payment margin for these services: cancer and children's hospitals and rural hospitals with 100 or fewer beds. \1\ Some data necessary to classify hospitals by category were missing; thus, the total number of hospitals in each category may not equal the national total. \2\ This column shows the impact of updating the wage index used to calculate payment by applying the proposed FY 2003 hospital inpatient wage index after geographic reclassification by the Medicare Geographic Classification Review Board. The hospital inpatient proposed rule for FY 2003 was published in the Federal Register on May 9, 2002. \3\ This column shows the impact of changes resulting from the reclassification of HCPCS codes among APC groups and the recalibration of APC weights based on 2001 hospital claims data. [[Page 52148]] \4\ This column shows changes in total payment from CY 2002 to CY 2003, excluding outlier and pass-through payments. It incorporates all of the changes reflected in columns 2 and 3. In addition, it shows the impact of the proposed CY 2003 payment update. The sum of the columns may be different from the percentage changes shown here due to rounding. As stated elsewhere in this preamble, we propose to allocate 2 percent of the estimated 2003 expenditures to outlier payments. In Table 11 below, we provide a distribution by percentage of the total projected outlier payments for the categories of hospitals that we show in the impact table (Table 10). We project, based on the mix of services for the hospitals that will be paid under the OPPS in 2003, that most hospitals will receive outlier payments. It appears that, with the exception of some smaller bed hospitals, all Tax Equity & Fiscal Responsibility Act of 1982 (TEFRA) hospitals can be expected to receive outlier payments. This is because TEFRA hospitals provide an atypical mix of specialty services (which account for less than 1 percent of total OPPS payment before consideration of outliers). A greater percentage of non-TEFRA hospitals are not projected to receive outlier payments. The anticipated outlier payments for urban hospitals can be expected to ameliorate the impact of the wage index and APC changes on payments to urban hospitals. Table 11.--Distribution of Outlier Payments for CY 2003 Hospital Outpatient Prospective Payment System ---------------------------------------------------------------------------------------------------------------- Percent of Number of Percent of Number of total hosps total hosps hosps with outlier outliers payments ---------------------------------------------------------------------------------------------------------------- ALL HOSPITALS............................................... 4,551 100.00 4,306 100.00 NON-TEFRA HOSPITALS......................................... 4,002 88.00 3,987 99.40 URBAN HOSPS................................................. 2,429 53.40 2,420 83.20 LARGE URBAN (GT 1 MILL.)................................ 1,398 30.80 1,396 55.20 OTHER URBAN (LE 1 MILL.)................................ 1,031 22.60 1,024 28.00 RURAL HOSPS................................................. 1,573 34.60 1,567 16.00 BEDS (URBAN): 0-99 BEDS............................................... 554 12.20 550 6.80 100-199 BEDS............................................ 882 19.40 877 18.20 200-299 BEDS............................................ 488 10.80 488 16.20 300-499 BEDS............................................ 364 8.00 364 21.00 500+ BEDS............................................... 141 3.00 141 21.00 BEDS (RURAL): 0-49 BEDS............................................... 754 16.60 751 4.20 50-99 BEDS.............................................. 479 10.60 477 5.00 100-149 BEDS............................................ 201 4.40 200 2.60 150-199 BEDS............................................ 73 1.60 73 2.00 200+ BEDS............................................... 66 1.40 66 2.40 VOLUME (URBAN): LT 5,000................................................ 188 4.20 180 1.00 5,000-10,999............................................ 310 6.80 309 2.80 11,000-20,999........................................... 467 10.20 467 7.00 21,000-42,999........................................... 659 14.40 659 15.80 GT 42,999............................................... 805 17.60 805 56.60 VOLUME (RURAL): LT 5,000................................................ 326 7.20 321 1.00 5,000-10,999............................................ 447 9.80 446 2.60 11,000-20,999........................................... 372 8.20 372 3.80 21,000-42,999........................................... 290 6.40 290 4.20 GT 42,999............................................... 138 3.00 138 4.40 REGION (URBAN): NEW ENGLAND............................................. 127 2.80 126 6.20 MIDDLE ATLANTIC......................................... 372 8.20 371 22.80 SOUTH ATLANTIC.......................................... 370 8.20 369 11.00 EAST NORTH CENT......................................... 413 9.00 409 15.60 EAST SOUTH CENT......................................... 153 3.40 152 3.40 WEST NORTH CENT......................................... 172 3.80 172 4.40 WEST SOUTH CENT......................................... 293 6.40 292 8.20 MOUNTAIN................................................ 122 2.60 122 3.00 PACIFIC................................................. 368 8.00 368 8.60 PUERTO RICO............................................. 39 0.80 39 0.20 REGION (RURAL): NEW ENGLAND............................................. 40 0.80 40 1.00 MIDDLE ATLANTIC......................................... 63 1.40 63 1.00 SOUTH ATLANTIC.......................................... 226 5.00 223 3.00 EAST NORTH CENT......................................... 213 4.60 212 3.00 EAST SOUTH CENT......................................... 232 5.00 232 1.60 WEST NORTH CENT......................................... 271 6.00 270 2.40 WEST SOUTH CENT......................................... 278 6.20 278 1.60 MOUNTAIN................................................ 141 3.00 141 1.40 PACIFIC................................................. 104 2.20 103 1.20 PUERTO RICO............................................. 5 0.20 5 0.00 TEACHING STATUS: NON-TEACHING............................................ 2,935 64.40 2,920 39.80 [[Page 52149]] MINOR................................................... 782 17.20 782 27.20 MAJOR................................................... 284 6.20 284 32.20 DSH PATIENT PERCENT: 0....................................................... 11 0.20 10 0.00 GT 0--0.10.............................................. 982 21.60 978 24.80 0.10--0.16.............................................. 873 19.20 873 19.40 0.16--0.23.............................................. 767 16.80 765 17.60 0.23--0.35.............................................. 756 16.60 753 20.00 GE 0.35................................................. 613 13.40 608 17.40 URBAN IME/DSH: IME & DSH............................................... 982 21.60 982 57.20 IME/NO DSH.............................................. 0 0.00 0 0.00 NO IME/DSH.............................................. 1,441 31.60 1,433 26.00 NO IME/NO DSH........................................... 6 0.20 5 0.00 RURAL HOSP. TYPES: NO SPECIAL STATUS....................................... 621 13.60 617 5.20 RRC..................................................... 167 3.60 166 4.00 SCH/EACH................................................ 511 11.20 511 4.40 MDH..................................................... 199 4.40 198 1.00 SCH AND RRC............................................. 75 1.60 75 1.40 TYPE OF OWNERSHIP: VOLUNTARY............................................... 2,440 53.60 2,435 73.60 PROPRIETARY............................................. 707 15.60 702 10.40 GOVERNMENT.............................................. 855 18.80 850 15.20 SPECIALTY HOSPITALS: EYE AND EAR............................................. 13 0.20 13 0.20 TRAUMA.................................................. 153 3.40 153 15.00 CANCER.................................................. 10 0.20 10 3.80 TEFRA HOSPITALS (NOT INCLUDED ON OTHER LINES): REHAB................................................... 166 3.60 113 0.20 PSYCH................................................... 198 4.40 65 0.20 LTC..................................................... 143 3.20 100 0.20 CHILDREN................................................ 42 1.00 41 0.20 ---------------------------------------------------------------------------------------------------------------- 5. Estimated Impacts of This Proposed Rule on Beneficiaries For services for which the beneficiary pays a coinsurance of 20 percent of the payment rate, the beneficiary share of payment would increase for services for which OPPS payments would rise and would decrease for services for which OPPS payments would fall. For example for a mid level office visit (APC 0601), the minimum unadjusted copayment in 2002 was $9.67; under this proposed rule, the minimum unadjusted copayment would be $10.82 because the OPPS payment for the service would increase under this proposed rule. For some services (those services for which a national unadjusted copayment amount is shown in Addendum B), however, the beneficiary copayment is frozen based on historic data and would not change, therefore not presenting any potential impact on beneficiaries. However, in all cases, the statute limits beneficiary liability for copayment for a service to the inpatient hospital deductible for the applicable year. This amount was $812 for 2002, but is not yet determined for 2003. In general, the impact of this proposed rule on beneficiaries would vary based on the service the beneficiary receives and whether the copayment for the service is one that is frozen under the OPPS. B. Payment Suspension for Unfiled Cost Reports Overall Impact We have examined the impacts of this proposed rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 16, 1980, Pub. L. 96- 354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132. (A description of each of these requirements is stated above in section XIV.A.1.) We have determined that the proposed payment suspension provision does not have an economic impact on Medicare payments or other payments to providers. We are proposing to allow the Secretary flexibility in payment suspensions, but we are not altering the final payment determination in any way. With the implementation of the various prospective payment systems, the majority of the payment to providers is based on the PPS methodology and not on the cost report. Suspending all payments because the cost report is not timely filed negatively affects providers. Providing the Secretary with flexibility in payment suspension can lessen the financial impact on providers. For these reasons, we are not preparing analyses for either the RFA or section 1102(b) of the Act because we have determined, and we certify, that this rule would not have a significant economic impact on a substantial number of small entities or a significant impact on the operations of a substantial number of small rural hospitals. Under the requirement for Unfunded Mandates, this proposed rule will not have an economic effect on State, local, or tribal governments, in the aggregate, or on the private sector. Anticipated Effects 1. Effects on providers that file cost reports. The majority of providers that file cost reports comply with the timeliness provisions and will be unaffected by this proposed regulation. [[Page 52150]] In FY 2000, collectively 16 percent of hospitals, skilled nursing facilities, and home health agencies filed late cost reports. Of this 16 percent, 65 percent of those were only 1 day late. Currently, when a provider fails to file an acceptable cost report, the provider is placed on a complete payment suspension. Under this provision, for those providers who do not file timely, an immediate payment suspension less than the total suspension currently required might be imposed if the Secretary deemed it appropriate, which would allow the provider to more easily continue operations while completing and submitting the acceptable cost report. 2. Effects on other providers. The payment suspension provision does not affect other providers. 3. Effects on the Medicare Program. The provision would allow the Secretary to more effectively manage the Medicare program by imposing other than complete payment suspension when it is appropriate to do so. The Medicare program benefits because immediate complete payment suspension can be disruptive to providers and may negatively affect the care of Medicare patients. There are no costs to the Medicare program to doing so, because when the cost report is submitted, the suspended payments are returned to the provider. 4. Effects on Beneficiaries. We have determined that this provision has a potentially positive impact on beneficiaries. Under this proposed provision the Secretary will have the discretion to impose less than 100 percent payment suspension when a provider fails to timely file an acceptable cost report. Doing so will lessen the financial burden on the provider and thereby allow it to provide adequate services to its patient population as it works to complete and file an acceptable cost report. Alternatives Considered We considered not revising existing Sec. 405.371(c) to provide that payment suspension could be ``in whole or in part''. However, we did not choose this option because we believe the Secretary should have the discretion to impose partial payment suspensions when circumstances warrant in order to more effectively manage the Medicare program. Conclusion In conclusion, we have determined that the proposed payment suspension provision does not have an economic impact on Medicare payments. Federalism Since this regulation does not impose any costs on State or local governments, it will not have an effect on State or local governments. State or local governments will have no roles or responsibilities associated with this provision. In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget. List of Subjects 42 CFR Part 405 Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays. 42 CFR Part 410 Health facilities, Health professions, Kidney diseases, Laboratories, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays. 42 CFR Part 419 Hospitals, Medicare, Reporting and recordkeeping requirements. For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services proposes to amend 42 CFR chapter IV as follows: PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Subpart C--Suspension of Payment, Recovery of Overpayments, and Repayment of Scholarships and Loans 1. The authority citation for subpart C continues to read as follows: Authority: Secs. 1102, 1815, 1833, 1842, 1866, 1870, 1871, 1879, and 1892 of the Social Security Act (42 U.S.C. 1302, 1395g, 1395l, 1395u, 1395cc, 1395gg, 1395hh, 1395pp, and 1395ccc) and 31 U.S.C. 3711. 2.Section 405.371(c) is revised to read as follows: Sec. 405.371 Suspension, offset and recoupment of Medicare payments to providers and suppliers of services. * * * * * (c) Suspension of payment in the case of unfiled cost reports. If a provider has failed to timely file an acceptable cost report, payment to the provider is immediately suspended in whole or in part until a cost report is filed and determined by the intermediary to be acceptable. In the case of an unfiled cost report, the provisions of Sec. 405.372 do not apply. (See Sec. 405.372(a)(2) concerning failure to furnish other information.) PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS 1.The authority citation continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh). 2. In 410.43 republish the introductory text of paragraph (b), and add a new paragraph (b)(6) to read as follows: Sec. 410.43 Partial hospitalization services: Conditions and exclusions. * * * * * (b) The following services are separately covered and not paid as partial hospitalization services: * * * * * (6) Clinical social worker services that meet the requirements of section 1861(hh)(2) of the Act. PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES 1. The authority citation continues to read as follows: Authority: Secs. 1102, 1833(t), and 1871 of the Social Security Act (42 U.S.C. 1302, 1395l(t), and 1395hh). Sec. 419.66 [Amended] 2. In Sec. 419.66, paragraph (c)(1) is amended by adding the phrase ``or by any category previously in effect'' after ``categories'' and before ``and'. Catalog of Federal Domestic Assistance Program No. 93.773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program) Dated: July 31, 2002. Thomas A. Scully, Administrator, Centers for Medicare & Medicaid Services. Approved: August 5, 2002. Tommy G. Thompson, Secretary. BILLING CODE 4120-01-P [[Page 52151]] Addendum A.--List of Ambulatory Payment Classifications (APCs) With Status Indicators, Relative Weights, Payment Rates, and Copayment Amounts Calendar Year 2003 ---------------------------------------------------------------------------------------------------------------- National Minimum APC Group title Status indicator Relative Payment unadjusted unadjusted weight rate copayment copayment ---------------------------------------------------------------------------------------------------------------- 0620................ Critical Care........ S 10.25 $533.09 $150.55 $106.62 0656................ Transcatheter T 90.90 $4,927.70 .......... $985.54 Placement of Drug- Eluting Coronary Stents. 0657................ Placement of Tissue S 1.38 $71.77 .......... $14.35 Clips. 0658................ Percutaneous Breast T 5.57 $289.69 .......... $57.94 Biopsies. ---------------------------------------------------------------------------------------------------------------- Addendum A.--List of Ambulatory Payment Classifications (APCs) with Status Indicators, Relative Weights, Payment Rates, and Copayment Amounts Calendar Year 2003 ---------------------------------------------------------------------------------------------------------------- National Minimum APC Group title Status Relative Payment rate unadjusted unadjusted indicator weight copayment copayment ---------------------------------------------------------------------------------------------------------------- 0001............. Level I S 0.43 $22.36 $7.88 $4.47 Photochemotherapy. 0002............. Fine needle Biopsy/ T 0.63 $32.77 $8.52 $6.55 Aspiration. 0003............. Bone Marrow Biopsy/ T 1.24 $64.49 $27.08 $12.90 Aspiration. 0004............. Level I Needle T 1.63 $84.77 $22.04 $16.95 Biopsy/Aspiration Except Bone Marrow. 0005............. Level II Needle T 3.02 $157.07 $69.11 $31.41 Biopsy /Aspiration Except Bone Marrow. 0006............. Level I Incision & T 1.89 $98.30 $25.56 $19.66 Drainage. 0007............. Level II Incision & T 9.44 $490.96 $103.10 $98.19 Drainage. 0008............. Level III Incision T 16.32 $848.79 ............ $169.76 and Drainage. 0009............. Nail Procedures.... T 0.68 $35.37 $8.34 $7.07 0010............. Level I Destruction T 0.70 $36.41 $10.56 $7.28 of Lesion. 0011............. Level II T 1.93 $100.38 $27.88 $20.08 Destruction of Lesion. 0012............. Level I Debridement T 0.76 $39.53 $10.67 $7.91 & Destruction. 0013............. Level II T 1.10 $57.21 $14.30 $11.44 Debridement & Destruction. 0015............. Level III T 1.43 $74.37 $18.59 $14.87 Debridement & Destruction. 0016............. Level IV T 2.57 $133.66 $56.14 $26.73 Debridement & Destruction. 0017............. Level VI T 16.46 $856.07 $227.84 $171.21 Debridement & Destruction. 0018............. Biopsy of Skin/ T 0.92 $47.85 $15.79 $9.57 Puncture of Lesion. 0019............. Level I Excision/ T 3.94 $204.92 $75.82 $40.98 Biopsy. 0020............. Level II Excision/ T 7.36 $382.79 $114.84 $76.56 Biopsy. 0021............. Level III Excision/ T 14.58 $758.29 $227.49 $151.66 Biopsy. 0022............. Level IV Excision/ T 18.10 $941.36 $367.13 $188.27 Biopsy. 0023............. Exploration T 2.38 $123.78 $40.37 $24.76 Penetrating Wound. 0024............. Level I Skin Repair T 2.00 $104.02 $37.45 $20.80 0025............. Level II Skin T 5.89 $306.33 $116.41 $61.27 Repair. 0027............. Level IV Skin T 15.73 $818.10 $343.60 $163.62 Repair. 0028............. Level I Breast T 17.44 $907.04 $303.74 $181.41 Surgery. 0029............. Level II Breast T 29.89 $1,554.55 $632.64 $310.91 Surgery. 0030............. Level III Breast T 40.23 $2,092.32 $763.55 $418.46 Surgery. 0032............. Insertion of T 7.14 $371.34 ............ $74.27 Central Venous/ Arterial Catheter. 0033............. Partial P 4.96 $257.96 ............ $51.59 Hospitalization. 0035............. Placement of T 0.24 $12.48 $3.74 $2.50 Arterial or Central Venous Catheter. 0041............. Level I Arthroscopy T 27.58 $1,434.41 $580.06 $286.88 0042............. Level II T 43.24 $2,248.87 $804.74 $449.77 Arthroscopy. 0043............. Closed Treatment T 1.68 $87.38 ............ $17.48 Fracture Finger/ Toe/Trunk. 0045............. Bone/Joint T 13.47 $700.56 $280.22 $140.11 Manipulation Under Anesthesia. 0046............. Open/Percutaneous T 29.03 $1,509.82 $535.76 $301.96 Treatment Fracture or Dislocation. 0047............. Arthroplasty T 29.59 $1,538.95 $537.03 $307.79 without Prosthesis. 0048............. Arthroplasty with T 36.93 $1,920.69 $633.83 $384.14 Prosthesis. 0049............. Level I T 19.45 $1,011.58 ............ $202.32 Musculoskeletal Procedures Except Hand and Foot. 0050............. Level II T 23.60 $1,227.41 ............ $245.48 Musculoskeletal Procedures Except Hand and Foot. 0051............. Level III T 34.03 $1,769.87 ............ $353.97 Musculoskeletal Procedures Except Hand and Foot. 0052............. Level IV T 42.37 $2,203.62 ............ $440.72 Musculoskeletal Procedures Except Hand and Foot. 0053............. Level I Hand T 14.76 $767.65 $253.49 $153.53 Musculoskeletal Procedures. 0054............. Level II Hand T 23.50 $1,222.21 $472.33 $244.44 Musculoskeletal Procedures. 0055............. Level I Foot T 18.28 $950.72 $355.34 $190.14 Musculoskeletal Procedures. 0056............. Level II Foot T 22.94 $1,193.09 $405.81 $238.62 Musculoskeletal Procedures. 0057............. Bunion Procedures.. T 23.87 $1,241.45 $496.58 $248.29 0058............. Level I Strapping S 1.09 $56.69 $14.74 $11.34 and Cast Application. 0060............. Manipulation S 0.36 $18.72 ............ $3.74 Therapy. [[Page 52152]] 0068............. CPAP Initiation.... S 1.59 $82.69 $45.48 $16.54 0069............. Thoracoscopy....... T 29.51 $1,534.79 $591.64 $306.96 0070............. Thoracentesis/ T 3.30 $171.63 ............ $34.33 Lavage Procedures. 0071............. Level I Endoscopy T 1.01 $52.53 $14.18 $10.51 Upper Airway. 0072............. Level II Endoscopy T 1.66 $86.33 $37.99 $17.27 Upper Airway. 0073............. Level III Endoscopy T 3.63 $188.79 $74.14 $37.76 Upper Airway. 0074............. Level IV Endoscopy T 12.84 $667.80 $295.70 $133.56 Upper Airway. 0075............. Level V Endoscopy T 20.41 $1,061.50 $445.92 $212.30 Upper Airway. 0076............. Endoscopy Lower T 9.30 $483.68 $189.92 $96.74 Airway. 0077............. Level I Pulmonary S 0.26 $13.52 $7.44 $2.70 Treatment. 0078............. Level II Pulmonary S 0.68 $35.37 $15.21 $7.07 Treatment. 0079............. Ventilation S 1.63 $84.77 $16.80 $16.95 Initiation and Management. 0080............. Diagnostic Cardiac T 35.64 $1,853.60 $838.92 $370.72 Catheterization. 0081............. Non-Coronary T 22.69 $1,180.08 ............ $236.02 Angioplasty or Atherectomy. 0082............. Coronary T 75.42 $3,922.52 $1,137.53 $784.50 Atherectomy. 0083............. Coronary T 47.83 $2,487.59 ............ $497.52 Angioplasty and Percutaneous Valvuloplasty. 0084............. Level I S 9.60 $499.29 ............ $99.86 Electrophysiologic Evaluation. 0085............. Level II T 31.77 $1,652.33 $363.51 $330.47 Electrophysiologic Evaluation. 0086............. Ablate Heart T 43.70 $2,272.79 $772.75 $454.56 Dysrhythm Focus. 0087............. Cardiac T 5.81 $302.17 ............ $60.43 Electrophysiologic Recording/Mapping. 0088............. Thrombectomy....... T 33.96 $1,766.23 $678.68 $353.25 0089............. Insertion/ T 108.92 $5,664.82 $1,642.80 $1,132.96 Replacement of Permanent Pacemaker and Electrodes. 0090............. Insertion/ T 77.15 $4,012.49 $1,444.50 $802.50 Replacement of Pacemaker Pulse Generator. 0091............. Level II Vascular T 27.03 $1,405.80 $348.23 $281.16 Ligation. 0092............. Level I Vascular T 24.97 $1,298.66 $505.37 $259.73 Ligation. 0093............. Vascular Repair/ T 26.29 $1,367.32 $277.34 $273.46 Fistula Construction. 0094............. Level I S 2.68 $139.38 $47.39 $27.88 Resuscitation and Cardioversion. 0095............. Cardiac S 0.66 $34.33 $16.73 $6.87 Rehabilitation. 0096............. Non-Invasive S 1.82 $94.66 $48.15 $18.93 Vascular Studies. 0097............. Cardiac and X 0.84 $43.69 $23.80 $8.74 Ambulatory Blood Pressure Monitoring. 0098............. Injection of T 1.90 $98.82 $20.88 $19.76 Sclerosing Solution. 0099............. Electrocardiograms. S 0.38 $19.76 ............ $3.95 0100............. Stress Tests and X 1.34 $69.69 $38.33 $13.94 Continuous ECG. 0101............. Tilt Table S 4.40 $228.84 $105.27 $45.77 Evaluation. 0103............. Miscellaneous T 11.26 $585.62 $210.82 $117.12 Vascular Procedures. 0104............. Transcatheter T 72.72 $3,782.09 ............ $756.42 Placement of Intracoronary Stents. 0105............. Revision/Removal of T 19.14 $995.45 $370.40 $199.09 Pacemakers, AICD, or Vascular. 0106............. Insertion/ T 29.23 $1,520.22 $410.46 $304.04 Replacement/Repair of Pacemaker and/ or Electrodes. 0107............. Insertion of T 181.51 $9,440.15 $2,076.83 $1,888.03 Cardioverter- Defibrillator. 0108............. Insertion/ T 232.69 $12,101.97 ............ $2,420.39 Replacement/Repair of Cardioverter- Defibrillator Leads. 0109............. Removal of T 7.68 $399.43 $131.49 $79.89 Implanted Devices. 0110............. Transfusion........ S 4.04 $210.12 ............ $42.02 0111............. Blood Product S 13.60 $707.32 $198.05 $141.46 Exchange. 0112............. Apheresis, S 39.40 $2,049.15 $612.47 $409.83 Photopheresis, and Plasmapheresis. 0113............. Excision Lymphatic T 19.75 $1,027.18 ............ $205.44 System. 0114............. Thyroid/ T 37.55 $1,952.94 $507.76 $390.59 Lymphadenectomy Procedures. 0115............. Cannula/Access T 23.48 $1,221.17 $439.62 $244.23 Device Procedures. 0116............. Chemotherapy S 0.85 $44.21 ............ $8.84 Administration by Other Technique Except Infusion. 0117............. Chemotherapy S 3.87 $201.27 $52.33 $40.25 Administration by Infusion Only. 0118............. Chemotherapy S 5.68 $295.41 $72.03 $59.08 Administration by Both Infusion and Other Technique. 0119............. Implantation of T 25.88 $1,345.99 ............ $269.20 Devices. 0120............. Infusion Therapy T 1.81 $94.14 $25.42 $18.83 Except Chemotherapy. 0121............. Level I Tube T 2.17 $112.86 $45.14 $22.57 changes and Repositioning. 0122............. Level II Tube T 3.89 $202.32 $46.53 $40.46 changes and Repositioning. 0123............. Bone Marrow S 4.86 $252.76 ............ $50.55 Harvesting and Bone Marrow/Stem Cell Transplant. 0124............. Revision of T 23.47 $1,220.65 ............ $244.13 Implanted Infusion Pump. 0125............. Refilling of T 1.73 $89.98 ............ $18.00 Infusion Pump. 0130............. Level I Laparoscopy T 31.99 $1,663.77 $659.53 $332.75 0131............. Level II T 42.44 $2,207.26 $1,001.89 $441.45 Laparoscopy. 0132............. Level III T 57.95 $3,013.92 $1,239.22 $602.78 Laparoscopy. 0140............. Esophageal Dilation T 5.84 $303.73 $107.24 $60.75 without Endoscopy. [[Page 52153]] 0141............. Upper GI Procedures T 7.82 $406.71 $150.48 $81.34 0142............. Small Intestine T 8.21 $426.99 $152.78 $85.40 Endoscopy. 0143............. Lower GI Endoscopy. T 8.37 $435.32 $186.06 $87.06 0146............. Level I T 3.47 $180.47 $64.40 $36.09 Sigmoidoscopy. 0147............. Level II T 7.30 $379.67 $83.53 $75.93 Sigmoidoscopy. 0148............. Level I Anal/Rectal T 3.61 $187.75 $67.59 $37.55 Procedure. 0149............. Level III Anal/ T 16.91 $879.47 $293.06 $175.89 Rectal Procedure. 0150............. Level IV Anal/ T 22.02 $1,145.24 $437.12 $229.05 Rectal Procedure. 0151............. Endoscopic T 18.23 $948.12 $245.46 $189.62 Retrograde Cholangio- Pancreatography (ERCP). 0152............. Percutaneous T 6.18 $321.42 $80.36 $64.28 Abdominal and Biliary Procedures. 0153............. Peritoneal and T 25.99 $1,351.71 $540.68 $270.34 Abdominal Procedures. 0154............. Hernia/Hydrocele T 26.98 $1,403.20 $491.12 $280.64 Procedures. 0155............. Level II Anal/ T 10.05 $522.69 $188.17 $104.54 Rectal Procedure. 0156............. Level II Urinary T 3.10 $161.23 $48.37 $32.25 and Anal Procedures. 0157............. Colorectal Cancer S 2.73 $141.98 $22.19 $28.40 Screening: Barium Enema. 0158............. Colorectal Cancer T 7.56 $393.19 ............ $98.30 Screening: Colonoscopy. 0159............. Colorectal Cancer S 2.48 $128.98 ............ $32.25 Screening: Flexible Sigmoidoscopy. 0160............. Level I T 6.44 $334.94 $105.06 $66.99 Cystourethroscopy and other Genitourinary Procedures. 0161............. Level II T 16.03 $833.70 $249.36 $166.74 Cystourethroscopy and other Genitourinary Procedures. 0162............. Level III T 21.50 $1,118.19 ............ $223.64 Cystourethroscopy and other Genitourinary Procedures. 0163............. Level IV T 24.77 $1,288.26 ............ $257.65 Cystourethroscopy and other Genitourinary Procedures. 0164............. Level I Urinary and T 1.18 $61.37 $18.41 $12.27 Anal Procedures. 0165............. Level III Urinary T 12.62 $656.35 ............ $131.27 and Anal Procedures. 0166............. Level I Urethral T 15.63 $812.90 $218.73 $162.58 Procedures. 0167............. Level III Urethral T 27.15 $1,412.04 $555.84 $282.41 Procedures. 0168............. Level II Urethral T 24.10 $1,253.42 $405.60 $250.68 Procedures. 0169............. Lithotripsy........ T 46.44 $2,415.30 $1,115.69 $483.06 0170............. Dialysis........... S 4.79 $249.12 ............ $49.82 0179............. Urinary T 81.28 $4,227.29 $1,817.73 $845.46 Incontinence Procedures. 0180............. Circumcision....... T 18.95 $985.57 $304.87 $197.11 0181............. Penile Procedures.. T 29.88 $1,554.03 $621.82 $310.81 0182............. Insertion of Penile T 83.80 $4,358.35 $1,438.26 $871.67 Prosthesis. 0183............. Testes/Epididymis T 22.19 $1,154.08 $448.94 $230.82 Procedures. 0184............. Prostate Biopsy.... T 3.66 $190.35 $95.18 $38.07 0187............. Miscellaneous X 4.19 $217.92 $94.96 $43.58 Placement/ Repositioning. 0188............. Level II Female T 1.12 $58.25 $11.95 $11.65 Reproductive Proc. 0189............. Level III Female T 1.63 $84.77 $18.60 $16.95 Reproductive Proc. 0190............. Surgical T 20.06 $1,043.30 $424.28 $208.66 Hysteroscopy. 0191............. Level I Female T 0.22 $11.44 $3.32 $2.29 Reproductive Proc. 0192............. Level IV Female T 2.94 $152.91 $42.81 $30.58 Reproductive Proc. 0193............. Level V Female T 14.57 $757.77 $171.13 $151.55 Reproductive Proc. 0194............. Level VI Female T 18.88 $981.93 $397.84 $196.39 Reproductive Proc. 0195............. Level VII Female T 24.37 $1,267.46 $483.80 $253.49 Reproductive Proc. 0196............. Dilation and T 16.32 $848.79 $338.23 $169.76 Curettage. 0197............. Infertility T 1.19 $61.89 $24.76 $12.38 Procedures. 0198............. Pregnancy and T 1.33 $69.17 $32.92 $13.83 Neonatal Care Procedures. 0199............. Vaginal Delivery... T 5.69 $295.93 $72.98 $59.19 0200............. Therapeutic T 14.49 $753.61 $307.83 $150.72 Abortion. 0201............. Spontaneous T 15.84 $823.82 $329.65 $164.76 Abortion. 0202............. Level VIII Female T 39.09 $2,033.03 $996.18 $406.61 Reproductive Proc. 0203............. Level IV Nerve T 10.96 $570.02 $256.51 $114.00 Injections. 0204............. Level I Nerve T 2.13 $110.78 $42.10 $22.16 Injections. 0206............. Level II Nerve T 4.89 $254.32 $75.55 $50.86 Injections. 0207............. Level III Nerve T 5.97 $310.49 $123.69 $62.10 Injections. 0208............. Laminotomies and T 39.95 $2,077.76 ............ $415.55 Laminectomies. 0209............. Extended EEG S 12.09 $628.79 $280.58 $125.76 Studies and Sleep Studies, Level II. 0212............. Nervous System T 3.53 $183.59 $84.45 $36.72 Injections. 0213............. Extended EEG S 3.38 $175.79 $70.41 $35.16 Studies and Sleep Studies, Level I. 0214............. Electroencephalogra S 2.37 $123.26 $61.63 $24.65 m. 0215............. Level I Nerve and S 0.60 $31.21 ............ $6.24 Muscle Tests. 0216............. Level III Nerve and S 3.06 $159.15 $71.62 $31.83 Muscle Tests. 0218............. Level II Nerve and S 1.06 $55.13 ............ $11.03 Muscle Tests. 0220............. Level I Nerve T 16.66 $866.47 ............ $173.29 Procedures. 0221............. Level II Nerve T 25.35 $1,318.43 $463.62 $263.69 Procedures. [[Page 52154]] 0222............. Implantation of T 140.56 $7,310.39 ............ $1,462.08 Neurological Device. 0223............. Implantation of T 20.30 $1,055.78 ............ $211.16 Pain Management Device. 0224............. Implantation of T 39.14 $2,035.63 $453.41 $407.13 Reservoir/Pump/ Shunt. 0225............. Implantation of T 44.47 $2,312.84 ............ $462.57 Neurostimulator Electrodes. 0226............. Implantation of T 44.20 $2,298.80 ............ $459.76 Drug Infusion Reservoir. 0227............. Implantation of T 128.03 $6,658.71 ............ $1,331.74 Drug Infusion Device. 0228............. Creation of Lumbar T 55.05 $2,863.10 $696.46 $572.62 Subarachnoid Shunt. 0229............. Transcatherter T 49.00 $2,548.44 $662.59 $509.69 Placement of Intravascular Shunts. 0230............. Level I Eye Tests & S 0.78 $40.57 $15.82 $8.11 Treatments. 0231............. Level III Eye Tests S 2.24 $116.50 $52.43 $23.30 & Treatments. 0232............. Level I Anterior T 4.91 $255.36 $112.36 $51.07 Segment Eye Procedures. 0233............. Level II Anterior T 13.43 $698.48 $266.33 $139.70 Segment Eye Procedures. 0234............. Level III Anterior T 21.45 $1,115.59 $535.48 $223.12 Segment Eye Procedures. 0235............. Level I Posterior T 5.62 $292.29 $81.84 $58.46 Segment Eye Procedures. 0236............. Level II Posterior T 20.62 $1,072.43 ............ $214.49 Segment Eye Procedures. 0237............. Level III Posterior T 35.09 $1,825.00 $818.54 $365.00 Segment Eye Procedures. 0238............. Level I Repair and T 3.04 $158.11 $58.96 $31.62 Plastic Eye Procedures. 0239............. Level II Repair and T 6.91 $359.38 $115.94 $71.88 Plastic Eye Procedures. 0240............. Level III Repair T 16.99 $883.63 $315.31 $176.73 and Plastic Eye Procedures. 0241............. Level IV Repair and T 21.89 $1,138.48 $384.47 $227.70 Plastic Eye Procedures. 0242............. Level V Repair and T 28.87 $1,501.50 $597.36 $300.30 Plastic Eye Procedures. 0243............. Strabismus/Muscle T 20.94 $1,089.07 $431.39 $217.81 Procedures. 0244............. Corneal Transplant. T 38.14 $1,983.62 $851.42 $396.72 0245............. Level I Cataract T 14.39 $748.41 $251.21 $149.68 Procedures without IOL Insert. 0246............. Cataract Procedures T 23.59 $1,226.89 $495.96 $245.38 with IOL Insert. 0247............. Laser Eye T 4.97 $258.48 $108.56 $51.70 Procedures Except Retinal. 0248............. Laser Retinal T 4.44 $230.92 $96.99 $46.18 Procedures. 0249............. Level II Cataract T 27.75 $1,443.25 $524.67 $288.65 Procedures without IOL Insert. 0250............. Nasal Cauterization/ T 1.68 $87.38 $30.58 $17.48 Packing. 0251............. Level I ENT T 1.92 $99.86 ............ $19.97 Procedures. 0252............. Level II ENT T 6.27 $326.10 $114.24 $65.22 Procedures. 0253............. Level III ENT T 14.79 $769.21 $284.61 $153.84 Procedures. 0254............. Level IV ENT T 21.89 $1,138.48 $352.93 $227.70 Procedures. 0256............. Level V ENT T 35.51 $1,846.84 ............ $369.37 Procedures. 0258............. Tonsil and Adenoid T 21.15 $1,099.99 $437.25 $220.00 Procedures. 0259............. Level VI ENT T 291.05 $15,137.22 $7,417.24 $3,027.44 Procedures. 0260............. Level I Plain Film X 0.81 $42.13 $23.17 $8.43 Except Teeth. 0261............. Level II Plain Film X 1.37 $71.25 $34.15 $14.25 Except Teeth Including Bone Density Measurement. 0262............. Plain Film of Teeth X 0.60 $31.21 $10.30 $6.24 0263............. Level I X 1.99 $103.50 $45.54 $20.70 Miscellaneous Radiology Procedures. 0264............. Level II X 2.75 $143.02 $77.23 $28.60 Miscellaneous Radiology Procedures. 0265............. Level I Diagnostic S 1.04 $54.09 $29.75 $10.82 Ultrasound Except Vascular. 0266............. Level II Diagnostic S 1.70 $88.42 $48.63 $17.68 Ultrasound Except Vascular. 0267............. Level III S 2.58 $134.18 $65.52 $26.84 Diagnostic Ultrasound Except Vascular. 0268............. Ultrasound Guidance S 1.48 $76.97 ............ $15.39 Procedures. 0269............. Level III S 3.42 $177.87 $92.49 $35.57 Echocardiogram Except Transesophageal. 0270............. Transesophageal S 5.65 $293.85 $146.79 $58.77 Echocardiogram. 0271............. Mammography........ S 0.69 $35.89 $16.80 $7.18 0272............. Level I Fluoroscopy X 1.38 $71.77 $38.64 $14.35 0274............. Myelography........ S 3.21 $166.95 $80.14 $33.39 0275............. Arthrography....... S 3.09 $160.71 $69.09 $32.14 0276............. Level I Digestive S 1.69 $87.90 $41.72 $17.58 Radiology. 0277............. Level II Digestive S 2.50 $130.02 $60.47 $26.00 Radiology. 0278............. Diagnostic S 2.65 $137.82 $66.07 $27.56 Urography. 0279............. Level II S 8.41 $437.40 $174.57 $87.48 Angiography and Venography except Extremity. 0280............. Level III S 15.51 $806.66 $353.85 $161.33 Angiography and Venography except Extremity. 0281............. Venography of S 5.23 $272.01 $115.16 $54.40 Extremity. 0282............. Miscellaneous S 1.76 $91.54 $44.51 $18.31 Computerized Axial Tomography. 0283............. Computerized Axial S 4.75 $247.04 ............ $49.41 Tomography with Contrast Material. 0284............. Magnetic Resonance S 7.74 $402.55 $201.02 $80.51 Imaging and Magnetic Resonance Angiography with Contrast Material. 0285............. Myocardial Positron S 16.73 $870.11 $374.15 $174.02 Emission Tomography (PET). 0286............. Myocardial Scans... S 6.94 $360.94 $198.52 $72.19 0287............. Complex Venography. S 7.13 $370.82 $114.51 $74.16 0288............. Bone Density:Axial S 1.38 $71.77 ............ $14.35 Skeleton. [[Page 52155]] 0289............. Needle Localization X 1.84 $95.70 $44.80 $19.14 for Breast Biopsy. 0290............. Level I Diagnostic S 2.16 $112.34 $56.17 $22.47 Nuclear Medicine Excluding Myocardial Scans. 0291............. Level II Diagnostic S 4.19 $217.92 $108.96 $43.58 Nuclear Medicine Excluding Myocardial Scans. 0292............. Level III S 4.53 $235.60 $117.80 $47.12 Diagnostic Nuclear Medicine Excluding Myocardial Scans. 0294............. Level II S 4.45 $231.44 $127.29 $46.29 Therapeutic Nuclear Medicine. 0295............. Level I Therapeutic S 3.86 $200.75 $110.41 $40.15 Nuclear Medicine. 0296............. Level I Therapeutic S 2.12 $110.26 $52.92 $22.05 Radiologic Procedures. 0297............. Level II S 7.80 $405.67 $172.51 $81.13 Therapeutic Radiologic Procedures. 0299............. Miscellaneous S 6.20 $322.46 ............ $64.49 Radiation Treatment. 0300............. Level I Radiation S 1.53 $79.57 ............ $15.91 Therapy. 0301............. Level II Radiation S 2.22 $115.46 ............ $23.09 Therapy. 0302............. Level III Radiation S 10.17 $528.93 $200.99 $105.79 Therapy. 0303............. Treatment Device X 2.93 $152.39 $68.58 $30.48 Construction. 0304............. Level I Therapeutic X 1.69 $87.90 $41.52 $17.58 Radiation Treatment Preparation. 0305............. Level II X 3.87 $201.27 $91.38 $40.25 Therapeutic Radiation Treatment Preparation. 0310............. Level III X 14.38 $747.89 $339.05 $149.58 Therapeutic Radiation Treatment Preparation. 0312............. Radioelement S 4.23 $220.00 ............ $44.00 Applications. 0313............. Brachytherapy...... S 13.80 $717.72 ............ $143.54 0314............. Hyperthermic S 4.24 $220.52 $101.77 $44.10 Therapies. 0320............. Electroconvulsive S 4.46 $231.96 $80.06 $46.39 Therapy. 0321............. Biofeedback and S 1.27 $66.05 $21.78 $13.21 Other Training. 0322............. Brief Individual S 1.44 $74.89 $12.40 $14.98 Psychotherapy. 0323............. Extended Individual S 1.95 $101.42 $21.26 $20.28 Psychotherapy. 0324............. Family S 2.71 $140.94 ............ $28.19 Psychotherapy. 0325............. Group Psychotherapy S 1.55 $80.61 $18.27 $16.12 0330............. Dental Procedures.. S 0.64 $33.29 ............ $6.66 0332............. Computerized Axial S 3.62 $188.27 $91.27 $37.65 Tomography and Computerized Angiography without Contrast Material. 0333............. Computerized Axial S 5.69 $295.93 $146.98 $59.19 Tomography and Computerized Angio w/o Contrast Material followed by Contrast. 0335............. Magnetic Resonance S 6.46 $335.98 $151.46 $67.20 Imaging, Miscellaneous. 0336............. Magnetic Resonance S 7.01 $364.58 $176.94 $72.92 Imaging and Magnetic Resonance Angiography without Contrast. 0337............. MRI and Magnetic S 9.86 $512.81 $240.77 $102.56 Resonance Angiography without Contrast Material followed by Contrast Material. 0339............. Observation........ S 7.60 $395.27 ............ $79.05 0340............. Minor Ancillary X 0.66 $34.33 ............ $6.87 Procedures. 0341............. Skin Tests and X 0.16 $8.32 $3.08 $1.66 Miscellaneous Red Blood Cell Tests. 0342............. Level I Pathology.. X 0.23 $11.96 $5.88 $2.39 0343............. Level II Pathology. X 0.47 $24.44 $13.20 $4.89 0344............. Level III Pathology X 0.66 $34.33 $18.54 $6.87 0345............. Level I Transfusion X 0.19 $9.88 $3.06 $1.98 Laboratory Procedures. 0346............. Level II X 0.42 $21.84 $5.46 $4.37 Transfusion Laboratory Procedures. 0347............. Level III X 0.98 $50.97 $12.74 $10.19 Transfusion Laboratory Procedures. 0348............. Fertility X 0.83 $43.17 ............ $8.63 Laboratory Procedures. 0352............. Level I Injections. X 0.14 $7.28 ............ $1.46 0353............. Level II Allergy X 0.43 $22.36 ............ $4.47 Injections. 0354............. Administration of K 0.09 $4.68 ............ ............ Influenza/ Pneumonia Vaccine. 0355............. Level I K 0.24 $12.48 ............ $2.50 Immunizations. 0356............. Level II K 0.69 $35.89 ............ $7.18 Immunizations. 0359............. Level II Injections X 0.83 $43.17 ............ $8.63 0360............. Level I Alimentary X 1.65 $85.81 $42.91 $17.16 Tests. 0361............. Level II Alimentary X 3.55 $184.63 $83.23 $36.93 Tests. 0362............. Level III X 2.83 $147.19 ............ $29.44 Otorhinolaryngolog ic Function Tests. 0363............. Level I X 0.76 $39.53 $14.63 $7.91 Otorhinolaryngolog ic Function Tests. 0364............. Level I Audiometry. X 0.45 $23.40 $9.13 $4.68 0365............. Level II Audiometry X 1.31 $68.13 $20.16 $13.63 0367............. Level I Pulmonary X 0.60 $31.21 $15.61 $6.24 Test. 0368............. Level II Pulmonary X 0.96 $49.93 $24.97 $9.99 Tests. 0369............. Level III Pulmonary X 2.39 $124.30 $41.02 $24.86 Tests. 0370............. Allergy Tests...... X 0.74 $38.49 $11.16 $7.70 0371............. Level I Allergy X 0.50 $26.00 ............ $5.20 Injections. 0372............. Therapeutic X 0.56 $29.13 $10.09 $5.83 Phlebotomy. 0373............. Neuropsychological X 2.37 $123.26 ............ $24.65 Testing. 0374............. Monitoring X 1.20 $62.41 ............ $12.48 Psychiatric Drugs. [[Page 52156]] 0600............. Low Level Clinic V 0.91 $47.33 ............ $9.47 Visits. 0601............. Mid Level Clinic V 1.04 $54.09 ............ $10.82 Visits. 0602............. High Level Clinic V 1.57 $81.65 ............ $16.33 Visits. 0610............. Low Level Emergency V 1.49 $77.49 $19.57 $15.50 Visits. 0611............. Mid Level Emergency V 2.66 $138.34 $36.47 $27.67 Visits. 0612............. High Level V 4.53 $235.60 $54.14 $47.12 Emergency Visits. 0620............. Critical Care...... S 10.25 $533.09 $150.55 $106.62 0656............. Transcatheter T 90.90 $4,927.70 ............ $985.54 Placement of Drug- Eluting Coronary Stents. 0657............. Placement of Tissue S 1.38 $71.77 ............ $14.35 Clips. 0658............. Percutaneous Breast T 5.57 $289.69 ............ $57.94 Biopsies. 0659............. Hyperbaric Oxygen.. S 3.12 $162.27 ............ $32.45 0660............. Level II X 1.65 $85.81 $31.75 $17.16 Otorhinolaryngolog ic Function Tests. 0661............. Level IV Pathology. X 3.46 $179.95 $98.97 $35.99 0662............. CT Angiography..... S 5.96 $309.97 $170.48 $61.99 0663............. Stereoteactic S 63.69 $3,312.45 ............ $662.49 Radiosurgery. 0664............. Proton Beam S 11.03 $573.66 ............ $114.73 Radiation Therapy. 0665............. Bone S 0.73 $37.97 ............ $7.59 Density:Appendicul arSkeleton. 0666............. Myocardial Add-on S 1.59 $82.69 $45.48 $16.54 Scans. 0667............. Nonmyocardial S 18.68 $971.53 ............ $194.31 Positron Emission Tomography (PET). 0668............. Level I Angiography S 5.36 $278.77 $122.66 $55.75 and Venography except Extremity. 0669............. Digital Mammography S 0.95 $49.41 ............ $9.88 0670............. Intravenous and S 14.78 $768.69 $276.73 $153.74 Intracardiac Ultrasound. 0671............. Level II S 1.68 $87.38 $45.44 $17.48 Echocardiogram Except Transesophageal. 0672............. Level IV Posterior T 39.95 $2,077.76 $1,038.88 $415.55 Segment Procedures. 0673............. Level IV Anterior T 27.47 $1,428.69 $685.77 $285.74 Segment Eye Procedures. 0674............. Prostate T 69.25 $3,601.62 ............ $720.32 Cryoablation. 0675............. Prostatic T 51.57 $2,682.10 ............ $536.42 Thermotherapy. 0676............. Level II T 4.62 $240.28 $64.88 $48.06 Transcatheter Thrombolysis. 0677............. Level I T 2.80 $145.63 ............ $29.13 Transcatheter Thrombolysis. 0678............. External T 2.55 $132.62 ............ $26.52 Counterpulsation. 0679............. Level II S 5.70 $296.45 $100.79 $59.29 Resuscitation and Cardioversion. 0680............. Insertion of S 51.95 $2,701.87 ............ $540.37 Patient Activated Event Recorders. 0681............. Knee Arthroplasty.. T 158.14 $8,224.70 $3,289.88 $1,644.94 0682............. Level V Debridement T 6.74 $350.54 $161.25 $70.11 & Destruction. 0683............. Level II S 2.11 $109.74 $39.51 $21.95 Photochemotherapy. 0684............. Prostate T 103.47 $5,381.37 ............ $1,076.27 Brachytherapy. 0685............. Level III Needle T 4.47 $232.48 $102.29 $46.50 Biopsy/Aspiration Except Bone Marrow. 0686............. Level III Skin T 11.30 $587.70 $270.34 $117.54 Repair. 0687............. Revision/Removal of T 19.50 $1,014.18 $466.52 $202.84 Neurostimulator Electrodes. 0688............. Revision/Removal of T 30.58 $1,590.44 $779.32 $318.09 Neurostimulator Pulse Generator Receiver. 0689............. Electronic Analysis S 0.60 $31.21 $12.03 $6.24 of Cardioverter- defibrillators. 0690............. Electronic Analysis S 0.45 $23.40 $10.63 $4.68 of Pacemakers and other Cardiac Devices. 0691............. Electronic Analysis S 3.14 $163.31 $89.02 $32.66 of Programmable Shunts/Pumps. 0692............. Electronic Analysis S 0.85 $44.21 $24.32 $8.84 of Neurostimulator Pulse Generators. 0693............. Level II Breast T 39.30 $2,043.95 $798.17 $408.79 Reconstruction. 0694............. Mohs Surgery....... T 3.90 $202.84 $81.14 $40.57 0695............. Level VII T 19.65 $1,021.98 $266.59 $204.40 Debridement & Destruction. 0697............. Level I S 1.51 $78.53 $40.84 $15.71 Echocardiogram Except Transesophageal. 0698............. Level II Eye Tests S 1.01 $52.53 $20.49 $10.51 & Treatments. 0699............. Level IV Eye Tests T 2.37 $123.26 $55.47 $24.65 & Treatment. 0701............. SR 89 chloride, per K 6.43 $334.42 ............ $66.88 mCi. 0702............. SM 153 lexidronam, K 15.02 $781.18 ............ $156.24 50 mCi. 0706............. New Technology - S ............ $25.00 ............ $5.00 Level I ($0 - $50). 0707............. New Technology - S ............ $75.00 ............ $15.00 Level II ($50 - $100). 0708............. New Technology - S ............ $150.00 ............ $30.00 Level III ($100 - $200). 0709............. New Technology - S ............ $250.00 ............ $50.00 Level IV ($200 - $300). 0710............. New Technology - S ............ $400.00 ............ $80.00 Level V ($300 - $500). 0711............. New Technology - S ............ $625.00 ............ $125.00 Level VI ($500 - $750). 0712............. New Technology - S ............ $875.00 ............ $175.00 Level VII ($750 - $1000). 0713............. New Technology - S ............ $1,125.00 ............ $225.00 Level VIII ($1000 - $1250). 0714............. New Technology - S ............ $1,375.00 ............ $275.00 Level IX ($1250 - $1500). 0715............. New Technology - S ............ $1,625.00 ............ $325.00 Level X ($1500 - $1750). 0716............. New Technology - S ............ $1,875.00 ............ $375.00 Level XI ($1750 - $2000). [[Page 52157]] 0717............. New Technology - S ............ $2,250.00 ............ $450.00 Level XII ($2000 - $2500). 0718............. New Technology - S ............ $2,750.00 ............ $550.00 Level XIII ($2500 - $3000). 0719............. New Technology- S ............ $3,250.00 ............ $650.00 Level XIV ($3000- $3500). 0720............. New Technology - S ............ $4,250.00 ............ $850.00 Level XV ($3500 - $5000). 0721............. New Technology - S ............ $5,500.00 ............ $1,100.00 Level XVI ($5000 - $6000). 0726............. Dexrazoxane hcl K 2.40 $124.82 ............ $24.96 injection, 250 mg. 0728............. Filgrastim 300 mcg K 2.24 $116.50 ............ $23.30 injection. 0730............. Pamidronate K 3.46 $179.95 ............ $35.99 disodium , 30 mg. 0732............. Mesna injection 200 K 0.55 $28.60 ............ $5.72 mg. 0733............. Non esrd epoetin K 0.19 $9.88 ............ $1.98 alpha inj, 1000 u. 0734............. Darbepoetin alfa, 1 G ............ $4.74 ............ $.68 mcg. 0800............. Leuprolide acetate, K 4.15 $215.84 ............ $43.17 3.75 mg. 0802............. Etoposide oral 50 K 0.54 $28.08 ............ $5.62 mg. 0807............. Aldesleukin/single K 6.09 $316.73 ............ $63.35 use vial. 0810............. Goserelin acetate K 5.94 $308.93 ............ $61.79 implant 3.6 mg. 0811............. Carboplatin K 1.58 $82.17 ............ $16.43 injection 50 mg. 0813............. Cisplatin 10 mg K 0.47 $24.44 ............ $4.89 injection. 0820............. Daunorubicin 10 mg. K 2.27 $118.06 ............ $23.61 0821............. Daunorubicin K 3.17 $164.87 ............ $32.97 citrate liposom 10 mg. 0822............. Diethylstilbestrol K 2.21 $114.94 ............ $22.99 injection 250 mg. 0823............. Docetaxel, 20 mg... K 4.01 $208.56 ............ $41.71 0827............. Floxuridine K 2.42 $125.86 ............ $25.17 injection 500 mg. 0828............. Gemcitabine HCL 200 K 1.49 $77.49 ............ $15.50 mg. 0830............. Irinotecan K 1.86 $96.74 ............ $19.35 injection 20 mg. 0831............. Ifosfomide K 2.06 $107.14 ............ $21.43 injection 1 gm. 0832............. Idarubicin hcl K 4.57 $237.68 ............ $47.54 injection 5 mg. 0838............. Interferon gamma 1- K 2.49 $129.50 ............ $25.90 b inj, 3 million u. 0840............. Melphalan hydrochl K 4.09 $212.72 ............ $42.54 50 mg. 0842............. Fludarabine K 3.30 $171.63 ............ $34.33 phosphate inj 50 mg. 0843............. Pegaspargase, singl K 2.38 $123.78 ............ $24.76 dose vial. 0844............. Pentostatin K 21.32 $1,108.83 ............ $221.77 injection, 10 mg. 0849............. Rituximab, 100 mg.. K 5.71 $296.97 ............ $59.39 0852............. Topotecan, 4 mg.... K 7.61 $395.79 ............ $79.16 0855............. Vinorelbine K 1.10 $57.21 ............ $11.44 tartrate, 10 mg. 0856............. Porfimer sodium, 75 K 26.35 $1,370.44 ............ $274.09 mg. 0857............. Bleomycin sulfate K 3.10 $161.23 ............ $32.25 injection 15 u. 0858............. Cladribine, 1mg.... K 0.84 $43.69 ............ $8.74 0861............. Leuprolide acetate K 0.84 $43.69 ............ $8.74 injection 1 mg. 0862............. Mitomycin 5 mg inj. K 1.18 $61.37 ............ $12.27 0863............. Paclitaxel K 2.50 $130.02 ............ $26.00 injection, 30 mg. 0864............. Mitoxantrone hcl, 5 K 3.02 $157.07 ............ $31.41 mg. 0884............. Rho d immune K 0.70 $36.41 ............ $7.28 globulin inj, 1 dose pkg. 0888............. Cyclosporine oral K 0.04 $2.08 ............ $.42 100 mg. 0890............. Lymphocyte immune K 3.64 $189.31 ............ $37.86 globulin 250 mg. 0891............. Tacrolimus oral per K 0.02 $1.04 ............ $.21 1 mg. 0900............. Alglucerase K 0.53 $27.56 ............ $5.51 injection, per 10 u. 0901............. Alpha 1 proteinase K 0.02 $1.04 ............ $.21 inhibitor, 10 mg. 0902............. Botulinum toxin a, K 0.05 $2.60 ............ $.52 per unit. 0903............. Cytomegalovirus imm K 0.34 $17.68 ............ $3.54 IV/vial. 0905............. Immune globulin 500 K 0.45 $23.40 ............ $4.68 mg. 0909............. Interferon beta-1a, K 2.77 $144.06 ............ $28.81 33 mcg. 0916............. Injection K 0.05 $2.60 ............ $.52 imiglucerase /unit. 0925............. Factor viii per iu. K 0.01 $.52 ............ $.10 0926............. Factor VIII K 0.02 $1.04 ............ $.21 (porcine) per iu. 0927............. Factor viii K 0.01 $.52 ............ $.10 recombinant per iu. 0928............. Factor ix complex K 0.01 $.52 ............ $.10 per iu. 0929............. Anti-inhibitor per K 0.01 $.52 ............ $.10 iu. 0930............. Antithrombin iii K 0.01 $.52 ............ $.10 injection per iu. 0931............. Factor IX non- K 0.01 $.52 ............ $.10 recombinant, per iu. 0932............. Factor IX K 0.03 $1.56 ............ $.31 recombinant, per iu. 0949............. Plasma, Pooled K 1.26 $65.53 ............ $13.11 Multiple Donor, Solvent/Detergent T. 0950............. Blood (Whole) For K 1.25 $65.01 ............ $13.00 Transfusion. 0952............. Cryoprecipitate.... K 0.53 $27.56 ............ $5.51 0954............. RBC leukocytes K 1.59 $82.69 ............ $16.54 reduced. 0955............. Plasma, Fresh K 0.71 $36.93 ............ $7.39 Frozen. 0956............. Plasma Protein K 1.94 $100.90 ............ $20.18 Fraction. 0957............. Platelet K 0.67 $34.85 ............ $6.97 Concentrate. 0958............. Platelet Rich K 1.12 $58.25 ............ $11.65 Plasma. 0959............. Red Blood Cells.... K 1.12 $58.25 ............ $11.65 [[Page 52158]] 0960............. Washed Red Blood K 1.42 $73.85 ............ $14.77 Cells. 0961............. Infusion, Albumin K 0.47 $24.44 ............ $4.89 (Human) 5%, 50 ml. 0963............. Albumin (human), K 2.37 $123.26 ............ $24.65 5%, 250 ml. 0964............. Albumin (human), K 0.50 $26.00 ............ $5.20 25%, 20 ml. 0965............. Albumin (human), K 1.25 $65.01 ............ $13.00 25%, 50ml. 0966............. Plasmaprotein K 9.71 $505.01 ............ $101.00 fract,5%,250ml. 0970............. New Technology - T ............ $25.00 ............ $5.00 Level I ($0 - $50). 0971............. New Technology - T ............ $75.00 ............ $15.00 Level II ($50 - $100). 0972............. New Technology - T ............ $150.00 ............ $30.00 Level III ($100 - $200). 0973............. New Technology - T ............ $250.00 ............ $50.00 Level IV ($200 - $300). 0974............. New Technology - T ............ $400.00 ............ $80.00 Level V ($300 - $500). 0975............. New Technology - T ............ $625.00 ............ $125.00 Level VI ($500 - $750). 0976............. New Technology - T ............ $875.00 ............ $175.00 Level VII ($750 - $1000). 0977............. New Technology - T ............ $1,125.00 ............ $225.00 Level VIII ($1000 - $1250). 0978............. New Technology - T ............ $1,375.00 ............ $275.00 Level IX ($1250 - $1500). 0979............. New Technology - T ............ $1,625.00 ............ $325.00 Level X ($1500 - $1750). 0980............. New Technology - T ............ $1,875.00 ............ $375.00 Level XI ($1750 - $2000). 0981............. New Technology - T ............ $2,250.00 ............ $450.00 Level XII ($2000 - $2500). 0982............. New Technology - T ............ $2,750.00 ............ $550.00 Level XIII ($2500 - $3000). 0983............. New Technology- T ............ $3,250.00 ............ $650.00 Level XIV ($3000- $3500). 0984............. New Technology - T ............ $4,250.00 ............ $850.00 Level XV ($3500 - $5000). 0985............. New Technology - T ............ $5,500.00 ............ $1,100.00 Level XVI ($5000 - $6000). 1009............. Cryoprecip reduced K 0.66 $34.33 ............ $6.87 plasma. 1010............. Blood, L/R, CMV-neg K 1.67 $86.86 ............ $17.37 1011............. Platelets, HLA-m, L/ K 6.03 $313.61 ............ $62.72 R, unit. 1013............. Platelet K 0.91 $47.33 ............ $9.47 concentrate, L/R, unit. 1016............. Blood, L/R, froz/ K 1.09 $56.69 ............ $11.34 deglycerol/washed. 1017............. Platelets, aph/ K 4.78 $248.60 ............ $49.72 pher, L/R, CMV- neg, unit. 1018............. Blood, L/R, K 1.90 $98.82 ............ $19.76 irradiated. 1019............. Platelets, aph/ K 6.93 $360.42 ............ $72.08 pher, L/R, irradiated, unit. 1058............. TC 99M oxidronate, G ............ $36.74 ............ $5.26 per vial. 1059............. Cultured K 43.64 $2,269.67 ............ $453.93 chondrocytes implnt. 1064............. I-131 cap, each add G ............ $5.86 ............ $.75 mCi. 1065............. I-131 sol, each add G ............ $15.81 ............ $2.03 mCi. 1084............. Denileukin K 13.94 $725.01 ............ $145.00 diftitox, 300 MCG. 1086............. Temozolomide,oral 5 K 0.05 $2.60 ............ $.52 mg. 1091............. IN 111 K 4.36 $226.76 ............ $45.35 Oxyquinoline, per .5 mCi. 1092............. IN 111 Pentetate, K 4.78 $248.60 ............ $49.72 per 0.5 mCi. 1095............. Technetium TC 99M K 0.25 $13.00 ............ $2.60 Depreotide. 1096............. TC 99M Exametazime, K 3.35 $174.23 ............ $34.85 per dose. 1122............. TC 99M arcitumomab, K 8.33 $433.23 ............ $86.65 per vial. 1167............. Epirubicin hcl, 2 K 0.32 $16.64 ............ $3.33 mg. 1178............. Busulfan IV, 6 mg.. K 0.53 $27.56 ............ $5.51 1203............. Verteporfin for K 16.26 $845.67 ............ $169.13 injection. 1207............. Octreotide acetate K 1.22 $63.45 ............ $12.69 depot 1mg. 1305............. Apligraf........... K 12.47 $648.55 ............ $129.71 1348............. I-131 sol, per 1-6 K 0.19 $9.88 ............ $1.98 mCi. 1409............. Factor viia K 13.53 $703.68 ............ $140.74 recombinant, per 1.2 mg. 1604............. IN 111 capromab K 5.91 $307.37 ............ $61.47 pendetide, per dose. 1605............. Abciximab K 5.82 $302.69 ............ $60.54 injection, 10 mg. 1609............. Rho(D) immune K 0.22 $11.44 ............ $2.29 globulin h, sd, 100 iu. 1611............. Hylan G-F 20 K 2.43 $126.38 ............ $25.28 injection, 16 mg. 1612............. Daclizumab, K 3.77 $196.07 ............ $39.21 parenteral, 25 mg. 1613............. Trastuzumab, 10 mg. K 0.66 $34.33 ............ $6.87 1614............. Valrubicin, 200 mg. K 2.04 $106.10 ............ $21.22 1615............. Basiliximab, 20 mg. K 9.64 $501.37 ............ $100.27 1618............. Vonwillebrandfactrc K 0.01 $.52 ............ $.10 mplx, per iu. 1620............. Technetium tc99m K 2.80 $145.63 ............ $29.13 bicisate. 1625............. Indium 111-in K 4.57 $237.68 ............ $47.54 pentetreotide. 1628............. Chromic phosphate K 1.35 $70.21 ............ $14.04 p32. 1716............. Brachytx seed, Gold K 0.35 $18.20 ............ $3.64 198. 1718............. Brachytx seed, K 0.64 $33.29 ............ $6.66 Iodine 125. 1719............. Brachytxseed, Non- K 0.57 $29.65 ............ $5.93 HDR Ir-192. 1720............. Brachytx seed, K 0.89 $46.29 ............ $9.26 Palladium 103. 1765............. Adhesion barrier... H ............ ............ ............ ............ 1775............. FDG, per dose (4-40 G ............ $475.00 ............ $68.00 mCi/ml). 1783............. Ocular implant, H ............ ............ ............ ............ aqueous drainage assist device. 1888............. Catheter, ablation, H ............ ............ ............ ............ non-cardiac, endovascular (implantable. [[Page 52159]] 1900............. Lead, left H ............ ............ ............ ............ ventricular coronary venous system. 2618............. Probe, cryoablation H ............ ............ ............ ............ 7000............. Amifostine, 500 mg. K 4.46 $231.96 ............ $46.39 7001............. Amphotericin B K 2.05 $106.62 ............ $21.32 lipid complex, 50 mg. 7011............. Oprelvekin K 2.52 $131.06 ............ $26.21 injection, 5 mg. 7024............. Corticorelin ovine K 4.62 $240.28 ............ $48.06 triflutat. 7025............. Digoxin immune FAB K 2.77 $144.06 ............ $28.81 (ovine). 7030............. Hemin, per 1 mg.... K 0.01 $.52 ............ $.10 7031............. Octreotide acetate K 0.90 $46.81 ............ $9.36 injection. 7034............. Somatropin K 0.78 $40.57 ............ $8.11 injection. 7035............. Teniposide, 50 mg.. K 1.24 $64.49 ............ $12.90 7038............. Muromonab-CD3, 5 mg K 4.43 $230.40 ............ $46.08 7041............. Tirofiban K 4.82 $250.68 ............ $50.14 hydrochloride 12.5 mg. 7042............. Capecitabine, oral, K 0.03 $1.56 ............ $.31 150 mg. 7043............. Infliximab K 0.74 $38.49 ............ $7.70 injection 10 mg. 7045............. Trimetrexate K 1.23 $63.97 ............ $12.79 glucoronate. 7046............. Doxorubicin hcl K 4.54 $236.12 ............ $47.22 liposome inj 10 mg. 7049............. Filgrastim 480 mcg K 3.37 $175.27 ............ $35.05 injection. 7051............. Leuprolide acetate G ............ $5,399.80 ............ $773.02 implant, 65 mg. 9002............. Tenecteplase, 50mg/ K 25.46 $1,324.15 ............ $264.83 vial. 9003............. Palivizumab, per K 9.34 $485.76 ............ $97.15 50mg. 9004............. Gemtuzumab K 1.05 $54.61 ............ $10.92 ozogamicin inj,5mg. 9005............. Reteplase injection K 10.84 $563.78 ............ $112.76 9009............. Baclofen refill kit K 0.79 $41.09 ............ $8.22 - per 2000 mcg. 9010............. Baclofen refill kit K 0.95 $49.41 ............ $9.88 - per 4000 mcg. 9012............. Arsenic Trioxide... G ............ $23.75 ............ $3.40 9015............. Mycophenolate G ............ $2.40 ............ $.34 mofetil oral 250 mg. 9016............. Echocardiography G ............ $118.75 ............ $17.00 contrast. 9018............. Botulinum tox B, G ............ $8.79 ............ $1.26 per 100 u. 9019............. Caspofungin G ............ $34.20 ............ $4.90 acetate, 5 mg. 9020............. Sirolimus tablet, 1 K 0.05 $2.60 ............ $.52 mg. 9104............. Anti-thymocycte K 1.97 $102.46 ............ $20.49 globulin rabbit. 9105............. Hep B imm glob, per K 1.58 $82.17 ............ $16.43 1 ml. 9106............. Sirolimus, 1 mg.... K 0.05 $2.60 ............ $.52 9108............. Thyrotropin alfa, K 8.79 $457.16 ............ $91.43 per 1.1 mg. 9109............. Tirofliban hcl, per K 2.32 $120.66 ............ $24.13 6.25 mg. 9110............. Alemtuzumab, per ml G ............ $486.88 ............ $69.70 9111............. Inj, bivalirudin, G ............ $397.81 ............ $56.95 per 250mg vial. 9112............. Perflutren lipid G ............ $148.20 ............ $21.22 micro, per 2ml. 9113............. Inj pantoprazole G ............ $22.80 ............ $3.26 sodium, vial. 9114............. Nesiritide, per 1.5 G ............ $433.20 ............ $62.02 mg vial. 9115............. Inj, zoledronic G ............ $406.78 ............ $58.23 acid, per 2 mg. 9200............. Orcel, per 36 cm2.. G ............ $1,135.25 ............ $162.52 9201............. Dermagraft, per G ............ $577.60 ............ $82.69 37.5 sq cm. 9217............. Leuprolide acetate K 6.30 $327.66 ............ $65.53 suspnsion, 7.5 mg. 9500............. Platelets, K 0.92 $47.85 ............ $9.57 irradiated. 9501............. Platelets, pheresis K 5.10 $265.25 ............ $53.05 9502............. Platelet pheresis K 1.99 $103.50 ............ $20.70 irradiated. 9503............. Fresh frozen K 0.77 $40.05 ............ $8.01 plasma, ea unit. 9504............. RBC deglycerolized. K 1.91 $99.34 ............ $19.87 9505............. RBC irradiated..... K 1.82 $94.66 ............ $18.93 9506............. Granulocytes, K 0.45 $23.40 ............ $4.68 pheresis. ---------------------------------------------------------------------------------------------------------------- -------------------- CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. [[Page 52159]] Addendum B.--Payment Status by HCPCS Code and Related Information Calender Year 2003 -------------------------------------------------------------------------------------------------------------------------------------------------------- National Minimum CPT/HCPCS Status indicator Description APC Relative Payment unadjusted unadjusted weight rate copayment copayment -------------------------------------------------------------------------------------------------------------------------------------------------------- 0002T..................... C Endovas repr abdo ao ............ ............ ............ ............ ............ aneurys. 0003T..................... S Cervicography.............. 0706 ............ $25.00 ............ $5.00 0005T..................... C Perc cath stent/brain cv ............ ............ ............ ............ ............ art. 0006T..................... C Perc cath stent/brain cv ............ ............ ............ ............ ............ art. [[Page 52160]] 0007T..................... C Perc cath stent/brain cv ............ ............ ............ ............ ............ art. 0008T..................... E Upper gi endoscopy w/suture ............ ............ ............ ............ ............ 0009T..................... T Endometrial cryoablation... 0980 ............ $1,875.00 ............ $375.00 00100..................... N Anesth, salivary gland..... ............ ............ ............ ............ ............ 00102..................... N Anesth, repair of cleft lip ............ ............ ............ ............ ............ 00103..................... N Anesth, blepharoplasty..... ............ ............ ............ ............ ............ 00104..................... N Anesth, electroshock....... ............ ............ ............ ............ ............ 0010T..................... A Tb test, gamma interferon.. ............ ............ ............ ............ ............ 00120..................... N Anesth, ear surgery........ ............ ............ ............ ............ ............ 00124..................... N Anesth, ear exam........... ............ ............ ............ ............ ............ 00126..................... N Anesth, tympanotomy........ ............ ............ ............ ............ ............ 0012T..................... T Osteochondral knee 0041 27.58 $1,434.41 $580.06 $286.88 autograft. 0013T..................... T Osteochondral knee 0041 27.58 $1,434.41 $580.06 $286.88 allograft. 00140..................... N Anesth, procedures on eye.. ............ ............ ............ ............ ............ 00142..................... N Anesth, lens surgery....... ............ ............ ............ ............ ............ 00144..................... N Anesth, corneal transplant. ............ ............ ............ ............ ............ 00145..................... N Anesth, vitreoretinal surg. ............ ............ ............ ............ ............ 00147..................... N Anesth, iridectomy......... ............ ............ ............ ............ ............ 00148..................... N Anesth, eye exam........... ............ ............ ............ ............ ............ 0014T..................... T Meniscal transplant, knee.. 0041 27.58 $1,434.41 $580.06 $286.88 00160..................... N Anesth, nose/sinus surgery. ............ ............ ............ ............ ............ 00162..................... N Anesth, nose/sinus surgery. ............ ............ ............ ............ ............ 00164..................... N Anesth, biopsy of nose..... ............ ............ ............ ............ ............ 0016T..................... E Thermotx choroid vasc ............ ............ ............ ............ ............ lesion. 00170..................... N Anesth, procedure on mouth. ............ ............ ............ ............ ............ 00172..................... N Anesth, cleft palate repair ............ ............ ............ ............ ............ 00174..................... C Anesth, pharyngeal surgery. ............ ............ ............ ............ ............ 00176..................... C Anesth, pharyngeal surgery. ............ ............ ............ ............ ............ 0017T..................... E Photocoagulat macular ............ ............ ............ ............ ............ drusen. 0018T..................... S Transcranial magnetic 0215 0.60 $31.21 ............ $6.24 stimul. 00190..................... N Anesth, face/skull bone ............ ............ ............ ............ ............ surg. 00192..................... C Anesth, facial bone surgery ............ ............ ............ ............ ............ 0019T..................... A Extracorp shock wave tx, ms ............ ............ ............ ............ ............ 0020T..................... A Extracorp shock wave tx, ft ............ ............ ............ ............ ............ 00210..................... N Anesth, open head surgery.. ............ ............ ............ ............ ............ 00212..................... N Anesth, skull drainage..... ............ ............ ............ ............ ............ 00214..................... C Anesth, skull drainage..... ............ ............ ............ ............ ............ 00215..................... C Anesth, skull repair/fract. ............ ............ ............ ............ ............ 00216..................... N Anesth, head vessel surgery ............ ............ ............ ............ ............ 00218..................... N Anesth, special head ............ ............ ............ ............ ............ surgery. 0021T..................... C Fetal oximetry, trnsvag/ ............ ............ ............ ............ ............ cerv. 00220..................... N Anesth, intrcrn nerve...... ............ ............ ............ ............ ............ 00222..................... N Anesth, head nerve surgery. ............ ............ ............ ............ ............ 0023T..................... A Phenotype drug test, hiv 1. ............ ............ ............ ............ ............ 0024T..................... C Transcath cardiac reduction ............ ............ ............ ............ ............ 0025T..................... S Ultrasonic pachymetry...... 0230 0.78 $40.57 $15.82 $8.11 0026T..................... A Measure remnant ............ ............ ............ ............ ............ lipoproteins. 00300..................... N Anesth, head/neck/ptrunk... ............ ............ ............ ............ ............ 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, skin, ext/per/ ............ ............ ............ ............ ............ atrunk. 00402..................... N Anesth, surgery of breast.. ............ ............ ............ ............ ............ 00404..................... C Anesth, surgery of breast.. ............ ............ ............ ............ ............ 00406..................... C Anesth, surgery of breast.. ............ ............ ............ ............ ............ 00410..................... N Anesth, correct heart ............ ............ ............ ............ ............ rhythm. 00450..................... N Anesth, surgery of shoulder ............ ............ ............ ............ ............ 00452..................... C Anesth, surgery of shoulder ............ ............ ............ ............ ............ 00454..................... N Anesth, collar bone 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 ............ ............ ............ ............ ............ [[Page 52161]] 00524..................... C Anesth, chest drainage..... ............ ............ ............ ............ ............ 00528..................... N Anesth, chest partition ............ ............ ............ ............ ............ view. 00530..................... N Anesth, pacemaker insertion ............ ............ ............ ............ ............ 00532..................... N Anesth, vascular access.... ............ ............ ............ ............ ............ 00534..................... N Anesth, cardioverter/defib. ............ ............ ............ ............ ............ 00537..................... N Anesth, cardiac electrophys ............ ............ ............ ............ ............ 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. 00550..................... N Anesth, sternal debridement ............ ............ ............ ............ ............ 00560..................... C Anesth, open heart surgery. ............ ............ ............ ............ ............ 00562..................... C Anesth, open heart surgery. ............ ............ ............ ............ ............ 00563..................... N Anesth, heart proc w/pump.. ............ ............ ............ ............ ............ 00566..................... N Anesth, cabg w/o pump...... ............ ............ ............ ............ ............ 00580..................... C Anesth heart/lung ............ ............ ............ ............ ............ transplant. 00600..................... N Anesth, spine, cord surgery ............ ............ ............ ............ ............ 00604..................... C Anesth, sitting procedure.. ............ ............ ............ ............ ............ 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 ............ ............ ............ ............ ............ 00635..................... N Anesth, lumbar puncture.... ............ ............ ............ ............ ............ 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, upper gi visualize. ............ ............ ............ ............ ............ 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, hemorr/excise liver ............ ............ ............ ............ ............ 00794..................... C Anesth, pancreas removal... ............ ............ ............ ............ ............ 00796..................... C Anesth, for liver ............ ............ ............ ............ ............ transplant. 00797..................... N Anesth, surgery for obesity ............ ............ ............ ............ ............ 00800..................... N Anesth, abdominal wall surg ............ ............ ............ ............ ............ 00802..................... C Anesth, fat layer removal.. ............ ............ ............ ............ ............ 00810..................... N Anesth, low intestine scope ............ ............ ............ ............ ............ 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.. ............ ............ ............ ............ ............ 00851..................... N Anesth, tubal ligation..... ............ ............ ............ ............ ............ 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.. ............ ............ ............ ............ ............ 00869..................... N Anesth, vasectomy.......... ............ ............ ............ ............ ............ 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 ............ ............ ............ ............ ............ 00902..................... N Anesth, anorectal surgery.. ............ ............ ............ ............ ............ 00904..................... C Anesth, perineal surgery... ............ ............ ............ ............ ............ [[Page 52162]] 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, surg on vag/urethal ............ ............ ............ ............ ............ 00944..................... C Anesth, vaginal ............ ............ ............ ............ ............ hysterectomy. 00948..................... N Anesth, repair of cervix... ............ ............ ............ ............ ............ 00950..................... N Anesth, vaginal endoscopy.. ............ ............ ............ ............ ............ 00952..................... N Anesth, hysteroscope/graph. ............ ............ ............ ............ ............ 01112..................... N Anesth, bone aspirate/bx... ............ ............ ............ ............ ............ 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. ............ ............ ............ ............ ............ 01210..................... N Anesth, hip joint surgery.. ............ ............ ............ ............ ............ 01212..................... C Anesth, hip disarticulation ............ ............ ............ ............ ............ 01214..................... C Anesth, hip arthroplasty... ............ ............ ............ ............ ............ 01215..................... N Anesth, revise hip repair.. ............ ............ ............ ............ ............ 01220..................... N Anesth, procedure on femur. ............ ............ ............ ............ ............ 01230..................... N Anesth, surgery of femur... ............ ............ ............ ............ ............ 01232..................... C Anesth, amputation of femur ............ ............ ............ ............ ............ 01234..................... C Anesth, radical femur 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 ............ ............ ............ ............ ............ 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, knee arthroplasty.. ............ ............ ............ ............ ............ 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. ............ ............ ............ ............ ............ 01462..................... N Anesth, lower leg procedure ............ ............ ............ ............ ............ 01464..................... N Anesth, ankle arthroscopy.. ............ ............ ............ ............ ............ 01470..................... N Anesth, lower leg surgery.. ............ ............ ............ ............ ............ [[Page 52163]] 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, lwr leg embolectomy ............ ............ ............ ............ ............ 01520..................... N Anesth, lower leg vein surg ............ ............ ............ ............ ............ 01522..................... N Anesth, lower leg vein 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...... ............ ............ ............ ............ ............ 01710..................... N Anesth, elbow area surgery. ............ ............ ............ ............ ............ 01712..................... N Anesth, uppr arm tendon ............ ............ ............ ............ ............ surg. 01714..................... N Anesth, uppr arm tendon ............ ............ ............ ............ ............ surg. 01716..................... N Anesth, biceps tendon ............ ............ ............ ............ ............ repair. 01730..................... N Anesth, uppr arm 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, uppr arm artery ............ ............ ............ ............ ............ surg. 01772..................... N Anesth, uppr arm ............ ............ ............ ............ ............ embolectomy. 01780..................... N Anesth, upper arm vein surg ............ ............ ............ ............ ............ 01782..................... N Anesth, uppr arm vein ............ ............ ............ ............ ............ repair. 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, lwr arm artery surg ............ ............ ............ ............ ............ 01842..................... N Anesth, lwr arm embolectomy ............ ............ ............ ............ ............ 01844..................... N Anesth, vascular shunt surg ............ ............ ............ ............ ............ 01850..................... N Anesth, lower arm vein surg ............ ............ ............ ............ ............ 01852..................... N Anesth, lwr arm vein repair ............ ............ ............ ............ ............ 01860..................... N Anesth, lower arm casting.. ............ ............ ............ ............ ............ 01905..................... N Anes, spine inject, x-ray/ ............ ............ ............ ............ ............ re. 01916..................... N Anesth, dx arteriography... ............ ............ ............ ............ ............ 01920..................... N Anesth, catheterize heart.. ............ ............ ............ ............ ............ 01922..................... N Anesth, cat or MRI scan.... ............ ............ ............ ............ ............ 01924..................... N Anes, ther interven rad, ............ ............ ............ ............ ............ art. 01925..................... N Anes, ther interven rad, ............ ............ ............ ............ ............ car. 01926..................... N Anes, tx interv rad hrt/ ............ ............ ............ ............ ............ cran. 01930..................... N Anes, ther interven rad, ............ ............ ............ ............ ............ vei. 01931..................... N Anes, ther interven rad, ............ ............ ............ ............ ............ tip. 01932..................... N Anes, tx interv rad, th ............ ............ ............ ............ ............ vein. 01933..................... N Anes, tx interv rad, cran v ............ ............ ............ ............ ............ 01951..................... N Anesth, burn, less 4 ............ ............ ............ ............ ............ percent. 01952..................... N Anesth, burn, 4-9 percent.. ............ ............ ............ ............ ............ 01953..................... N Anesth, burn, each 9 ............ ............ ............ ............ ............ percent. [[Page 52164]] 01960..................... N Anesth, vaginal delivery... ............ ............ ............ ............ ............ 01961..................... N Anesth, cs delivery........ ............ ............ ............ ............ ............ 01962..................... N Anesth, emer hysterectomy.. ............ ............ ............ ............ ............ 01963..................... N Anesth, cs hysterectomy.... ............ ............ ............ ............ ............ 01964..................... N Anesth, abortion procedures ............ ............ ............ ............ ............ 01967..................... N Anesth/analg, vag delivery. ............ ............ ............ ............ ............ 01968..................... N Anes/analg cs deliver add- ............ ............ ............ ............ ............ on. 01969..................... N Anesth/analg cs hyst add-on ............ ............ ............ ............ ............ 01990..................... C Support for organ donor.... ............ ............ ............ ............ ............ 01995..................... N Regional anesthesia limb... ............ ............ ............ ............ ............ 01996..................... N Manage daily drug therapy.. ............ ............ ............ ............ ............ 01999..................... N Unlisted anesth procedure.. ............ ............ ............ ............ ............ 10021..................... T Fna w/o image.............. 0002 0.63 $32.77 $8.52 $6.55 10022..................... T Fna w/image................ 0002 0.63 $32.77 $8.52 $6.55 10040..................... T Acne surgery............... 0010 0.70 $36.41 $10.56 $7.28 10060..................... T Drainage of skin abscess... 0006 1.89 $98.30 $25.56 $19.66 10061..................... T Drainage of skin abscess... 0006 1.89 $98.30 $25.56 $19.66 10080..................... T Drainage of pilonidal cyst. 0006 1.89 $98.30 $25.56 $19.66 10081..................... T Drainage of pilonidal cyst. 0007 9.44 $490.96 $103.10 $98.19 10120..................... T Remove foreign body........ 0006 1.89 $98.30 $25.56 $19.66 10121..................... T Remove foreign body........ 0021 14.58 $758.29 $227.49 $151.66 10140..................... T Drainage of hematoma/fluid. 0007 9.44 $490.96 $103.10 $98.19 10160..................... T Puncture drainage of lesion 0018 0.92 $47.85 $15.79 $9.57 10180..................... T Complex drainage, wound.... 0007 9.44 $490.96 $103.10 $98.19 11000..................... T Debride infected skin...... 0015 1.43 $74.37 $18.59 $14.87 11001..................... T Debride infected skin add- 0013 1.10 $57.21 $14.30 $11.44 on. 11010..................... T Debride skin, fx........... 0022 18.10 $941.36 $367.13 $188.27 11011..................... T Debride skin/muscle, fx.... 0022 18.10 $941.36 $367.13 $188.27 11012..................... T Debride skin/muscle/bone, 0022 18.10 $941.36 $367.13 $188.27 fx. 11040..................... T Debride skin, partial...... 0015 1.43 $74.37 $18.59 $14.87 11041..................... T Debride skin, full......... 0015 1.43 $74.37 $18.59 $14.87 11042..................... T Debride skin/tissue........ 0016 2.57 $133.66 $56.14 $26.73 11043..................... T Debride tissue/muscle...... 0016 2.57 $133.66 $56.14 $26.73 11044..................... T Debride tissue/muscle/bone. 0682 6.74 $350.54 $161.25 $70.11 11055..................... T Trim skin lesion........... 0012 0.76 $39.53 $10.67 $7.91 11056..................... T Trim skin lesions, 2 to 4.. 0012 0.76 $39.53 $10.67 $7.91 11057..................... T Trim skin lesions, over 4.. 0012 0.76 $39.53 $10.67 $7.91 11100..................... T Biopsy of skin lesion...... 0018 0.92 $47.85 $15.79 $9.57 11101..................... T Biopsy, skin add-on........ 0018 0.92 $47.85 $15.79 $9.57 11200..................... T Removal of skin tags....... 0013 1.10 $57.21 $14.30 $11.44 11201..................... T Remove skin tags add-on.... 0015 1.43 $74.37 $18.59 $14.87 11300..................... T Shave skin lesion.......... 0012 0.76 $39.53 $10.67 $7.91 11301..................... T Shave skin lesion.......... 0012 0.76 $39.53 $10.67 $7.91 11302..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11303..................... T Shave skin lesion.......... 0015 1.43 $74.37 $18.59 $14.87 11305..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11306..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11307..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11308..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11310..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11311..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11312..................... T Shave skin lesion.......... 0013 1.10 $57.21 $14.30 $11.44 11313..................... T Shave skin lesion.......... 0016 2.57 $133.66 $56.14 $26.73 11400..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11401..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11402..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11403..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11404..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11406..................... T Removal of skin lesion..... 0021 14.58 $758.29 $227.49 $151.66 11420..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11421..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11422..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11423..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11424..................... T Removal of skin lesion..... 0021 14.58 $758.29 $227.49 $151.66 11426..................... T Removal of skin lesion..... 0022 18.10 $941.36 $367.13 $188.27 11440..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 [[Page 52165]] 11441..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11442..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11443..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11444..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11446..................... T Removal of skin lesion..... 0022 18.10 $941.36 $367.13 $188.27 11450..................... T Removal, sweat gland lesion 0022 18.10 $941.36 $367.13 $188.27 11451..................... T Removal, sweat gland lesion 0022 18.10 $941.36 $367.13 $188.27 11462..................... T Removal, sweat gland lesion 0022 18.10 $941.36 $367.13 $188.27 11463..................... T Removal, sweat gland lesion 0022 18.10 $941.36 $367.13 $188.27 11470..................... T Removal, sweat gland lesion 0022 18.10 $941.36 $367.13 $188.27 11471..................... T Removal, sweat gland lesion 0022 18.10 $941.36 $367.13 $188.27 11600..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11601..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11602..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11603..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11604..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11606..................... T Removal of skin lesion..... 0021 14.58 $758.29 $227.49 $151.66 11620..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11621..................... T Removal of skin lesion..... 0019 3.94 $204.92 $75.82 $40.98 11622..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11623..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11624..................... T Removal of skin lesion..... 0021 14.58 $758.29 $227.49 $151.66 11626..................... T Removal of skin lesion..... 0022 18.10 $941.36 $367.13 $188.27 11640..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11641..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11642..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11643..................... T Removal of skin lesion..... 0020 7.36 $382.79 $114.84 $76.56 11644..................... T Removal of skin lesion..... 0021 14.58 $758.29 $227.49 $151.66 11646..................... T Removal of skin lesion..... 0022 18.10 $941.36 $367.13 $188.27 11719..................... T Trim nail(s)............... 0009 0.68 $35.37 $8.34 $7.07 11720..................... T Debride nail, 1-5.......... 0009 0.68 $35.37 $8.34 $7.07 11721..................... T Debride nail, 6 or more.... 0009 0.68 $35.37 $8.34 $7.07 11730..................... T Removal of nail plate...... 0013 1.10 $57.21 $14.30 $11.44 11732..................... T Remove nail plate, add-on.. 0012 0.76 $39.53 $10.67 $7.91 11740..................... T Drain blood from under nail 0009 0.68 $35.37 $8.34 $7.07 11750..................... T Removal of nail bed........ 0019 3.94 $204.92 $75.82 $40.98 11752..................... T Remove nail bed/finger tip. 0022 18.10 $941.36 $367.13 $188.27 11755..................... T Biopsy, nail unit.......... 0019 3.94 $204.92 $75.82 $40.98 11760..................... T Repair of nail bed......... 0024 2.00 $104.02 $37.45 $20.80 11762..................... T Reconstruction of nail bed. 0024 2.00 $104.02 $37.45 $20.80 11765..................... T Excision of nail fold, toe. 0015 1.43 $74.37 $18.59 $14.87 11770..................... T Removal of pilonidal lesion 0022 18.10 $941.36 $367.13 $188.27 11771..................... T Removal of pilonidal lesion 0022 18.10 $941.36 $367.13 $188.27 11772..................... T Removal of pilonidal lesion 0022 18.10 $941.36 $367.13 $188.27 11900..................... T Injection into skin lesions 0012 0.76 $39.53 $10.67 $7.91 11901..................... T Added skin lesions 0012 0.76 $39.53 $10.67 $7.91 injection. 11920..................... T Correct skin color defects. 0024 2.00 $104.02 $37.45 $20.80 11921..................... T Correct skin color defects. 0024 2.00 $104.02 $37.45 $20.80 11922..................... T Correct skin color defects. 0024 2.00 $104.02 $37.45 $20.80 11950..................... T Therapy for contour defects 0024 2.00 $104.02 $37.45 $20.80 11951..................... T Therapy for contour defects 0024 2.00 $104.02 $37.45 $20.80 11952..................... T Therapy for contour defects 0024 2.00 $104.02 $37.45 $20.80 11954..................... T Therapy for contour defects 0024 2.00 $104.02 $37.45 $20.80 11960..................... T Insert tissue expander(s).. 0027 15.73 $818.10 $343.60 $163.62 11970..................... T Replace tissue expander.... 0027 15.73 $818.10 $343.60 $163.62 11971..................... T Remove tissue expander(s).. 0022 18.10 $941.36 $367.13 $188.27 11975..................... E Insert contraceptive cap... ............ ............ ............ ............ ............ 11976..................... T Removal of contraceptive 0019 3.94 $204.92 $75.82 $40.98 cap. 11977..................... E Removal/reinsert contra cap ............ ............ ............ ............ ............ 11980..................... X Implant hormone pellet(s).. 0340 0.66 $34.33 ............ $6.87 11981..................... X Insert drug implant device. 0340 0.66 $34.33 ............ $6.87 11982..................... X Remove drug implant device. 0340 0.66 $34.33 ............ $6.87 11983..................... X Remove/insert drug implant. 0340 0.66 $34.33 ............ $6.87 12001..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12002..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12004..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 [[Page 52166]] 12005..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12006..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12007..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12011..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12013..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12014..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12015..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12016..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12017..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12018..................... T Repair superficial wound(s) 0024 2.00 $104.02 $37.45 $20.80 12020..................... T Closure of split wound..... 0024 2.00 $104.02 $37.45 $20.80 12021..................... T Closure of split wound..... 0024 2.00 $104.02 $37.45 $20.80 12031..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12032..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12034..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12035..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12036..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12037..................... T Layer closure of wound(s).. 0025 5.89 $306.33 $116.41 $61.27 12041..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12042..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12044..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12045..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12046..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12047..................... T Layer closure of wound(s).. 0025 5.89 $306.33 $116.41 $61.27 12051..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12052..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12053..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12054..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12055..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12056..................... T Layer closure of wound(s).. 0024 2.00 $104.02 $37.45 $20.80 12057..................... T Layer closure of wound(s).. 0025 5.89 $306.33 $116.41 $61.27 13100..................... T Repair of wound or lesion.. 0025 5.89 $306.33 $116.41 $61.27 13101..................... T Repair of wound or lesion.. 0025 5.89 $306.33 $116.41 $61.27 13102..................... T Repair wound/lesion add-on. 0024 2.00 $104.02 $37.45 $20.80 13120..................... T Repair of wound or lesion.. 0024 2.00 $104.02 $37.45 $20.80 13121..................... T Repair of wound or lesion.. 0024 2.00 $104.02 $37.45 $20.80 13122..................... T Repair wound/lesion add-on. 0024 2.00 $104.02 $37.45 $20.80 13131..................... T Repair of wound or lesion.. 0024 2.00 $104.02 $37.45 $20.80 13132..................... T Repair of wound or lesion.. 0024 2.00 $104.02 $37.45 $20.80 13133..................... T Repair wound/lesion add-on. 0024 2.00 $104.02 $37.45 $20.80 13150..................... T Repair of wound or lesion.. 0025 5.89 $306.33 $116.41 $61.27 13151..................... T Repair of wound or lesion.. 0024 2.00 $104.02 $37.45 $20.80 13152..................... T Repair of wound or lesion.. 0025 5.89 $306.33 $116.41 $61.27 13153..................... T Repair wound/lesion add-on. 0024 2.00 $104.02 $37.45 $20.80 13160..................... T Late closure of wound...... 0027 15.73 $818.10 $343.60 $163.62 14000..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14001..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14020..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14021..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14040..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14041..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14060..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14061..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14300..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 14350..................... T Skin tissue rearrangement.. 0027 15.73 $818.10 $343.60 $163.62 15000..................... T Skin graft................. 0025 5.89 $306.33 $116.41 $61.27 15001..................... T Skin graft add-on.......... 0025 5.89 $306.33 $116.41 $61.27 15050..................... T Skin pinch graft........... 0025 5.89 $306.33 $116.41 $61.27 15100..................... T Skin split graft........... 0027 15.73 $818.10 $343.60 $163.62 15101..................... T Skin split graft add-on.... 0027 15.73 $818.10 $343.60 $163.62 15120..................... T Skin split graft........... 0027 15.73 $818.10 $343.60 $163.62 15121..................... T Skin split graft add-on.... 0027 15.73 $818.10 $343.60 $163.62 15200..................... T Skin full graft............ 0027 15.73 $818.10 $343.60 $163.62 15201..................... T Skin full graft add-on..... 0025 5.89 $306.33 $116.41 $61.27 15220..................... T Skin full graft............ 0027 15.73 $818.10 $343.60 $163.62 15221..................... T Skin full graft add-on..... 0025 5.89 $306.33 $116.41 $61.27 [[Page 52167]] 15240..................... T Skin full graft............ 0027 15.73 $818.10 $343.60 $163.62 15241..................... T Skin full graft add-on..... 0025 5.89 $306.33 $116.41 $61.27 15260..................... T Skin full graft............ 0027 15.73 $818.10 $343.60 $163.62 15261..................... T Skin full graft add-on..... 0025 5.89 $306.33 $116.41 $61.27 15342..................... T Cultured skin graft, 25 cm. 0025 5.89 $306.33 $116.41 $61.27 15343..................... T Culture skn graft addl 25 0024 2.00 $104.02 $37.45 $20.80 cm. 15350..................... T Skin homograft............. 0686 11.30 $587.70 $270.34 $117.54 15351..................... T Skin homograft add-on...... 0027 15.73 $818.10 $343.60 $163.62 15400..................... T Skin heterograft........... 0025 5.89 $306.33 $116.41 $61.27 15401..................... T Skin heterograft add-on.... 0025 5.89 $306.33 $116.41 $61.27 15570..................... T Form skin pedicle flap..... 0027 15.73 $818.10 $343.60 $163.62 15572..................... T Form skin pedicle flap..... 0027 15.73 $818.10 $343.60 $163.62 15574..................... T Form skin pedicle flap..... 0027 15.73 $818.10 $343.60 $163.62 15576..................... T Form skin pedicle flap..... 0027 15.73 $818.10 $343.60 $163.62 15600..................... T Skin graft................. 0027 15.73 $818.10 $343.60 $163.62 15610..................... T Skin graft................. 0027 15.73 $818.10 $343.60 $163.62 15620..................... T Skin graft................. 0027 15.73 $818.10 $343.60 $163.62 15630..................... T Skin graft................. 0027 15.73 $818.10 $343.60 $163.62 15650..................... T Transfer skin pedicle flap. 0027 15.73 $818.10 $343.60 $163.62 15732..................... T Muscle-skin graft, head/ 0027 15.73 $818.10 $343.60 $163.62 neck. 15734..................... T Muscle-skin graft, trunk... 0027 15.73 $818.10 $343.60 $163.62 15736..................... T Muscle-skin graft, arm..... 0027 15.73 $818.10 $343.60 $163.62 15738..................... T Muscle-skin graft, leg..... 0027 15.73 $818.10 $343.60 $163.62 15740..................... T Island pedicle flap graft.. 0027 15.73 $818.10 $343.60 $163.62 15750..................... T Neurovascular pedicle graft 0027 15.73 $818.10 $343.60 $163.62 15756..................... C Free muscle flap, microvasc ............ ............ ............ ............ ............ 15757..................... C Free skin flap, microvasc.. ............ ............ ............ ............ ............ 15758..................... C Free fascial flap, ............ ............ ............ ............ ............ microvasc. 15760..................... T Composite skin graft....... 0027 15.73 $818.10 $343.60 $163.62 15770..................... T Derma-fat-fascia graft..... 0027 15.73 $818.10 $343.60 $163.62 15775..................... T Hair transplant punch 0025 5.89 $306.33 $116.41 $61.27 grafts. 15776..................... T Hair transplant punch 0025 5.89 $306.33 $116.41 $61.27 grafts. 15780..................... T Abrasion treatment of skin. 0022 18.10 $941.36 $367.13 $188.27 15781..................... T Abrasion treatment of skin. 0022 18.10 $941.36 $367.13 $188.27 15782..................... T Abrasion treatment of skin. 0022 18.10 $941.36 $367.13 $188.27 15783..................... T Abrasion treatment of skin. 0016 2.57 $133.66 $56.14 $26.73 15786..................... T Abrasion, lesion, single... 0013 1.10 $57.21 $14.30 $11.44 15787..................... T Abrasion, lesions, add-on.. 0013 1.10 $57.21 $14.30 $11.44 15788..................... T Chemical peel, face, 0012 0.76 $39.53 $10.67 $7.91 epiderm. 15789..................... T Chemical peel, face, dermal 0015 1.43 $74.37 $18.59 $14.87 15792..................... T Chemical peel, nonfacial... 0012 0.76 $39.53 $10.67 $7.91 15793..................... T Chemical peel, nonfacial... 0013 1.10 $57.21 $14.30 $11.44 15810..................... T Salabrasion................ 0016 2.57 $133.66 $56.14 $26.73 15811..................... T Salabrasion................ 0016 2.57 $133.66 $56.14 $26.73 15819..................... T Plastic surgery, neck...... 0025 5.89 $306.33 $116.41 $61.27 15820..................... T Revision of lower eyelid... 0027 15.73 $818.10 $343.60 $163.62 15821..................... T Revision of lower eyelid... 0027 15.73 $818.10 $343.60 $163.62 15822..................... T Revision of upper eyelid... 0027 15.73 $818.10 $343.60 $163.62 15823..................... T Revision of upper eyelid... 0027 15.73 $818.10 $343.60 $163.62 15824..................... T Removal of forehead 0027 15.73 $818.10 $343.60 $163.62 wrinkles. 15825..................... T Removal of neck wrinkles... 0027 15.73 $818.10 $343.60 $163.62 15826..................... T Removal of brow wrinkles... 0027 15.73 $818.10 $343.60 $163.62 15828..................... T Removal of face wrinkles... 0027 15.73 $818.10 $343.60 $163.62 15829..................... T Removal of skin wrinkles... 0027 15.73 $818.10 $343.60 $163.62 15831..................... T Excise excessive skin 0022 18.10 $941.36 $367.13 $188.27 tissue. 15832..................... T Excise excessive skin 0022 18.10 $941.36 $367.13 $188.27 tissue. 15833..................... T Excise excessive skin 0022 18.10 $941.36 $367.13 $188.27 tissue. 15834..................... T Excise excessive skin 0022 18.10 $941.36 $367.13 $188.27 tissue. 15835..................... T Excise excessive skin 0025 5.89 $306.33 $116.41 $61.27 tissue. 15836..................... T Excise excessive skin 0020 7.36 $382.79 $114.84 $76.56 tissue. 15837..................... T Excise excessive skin 0020 7.36 $382.79 $114.84 $76.56 tissue. 15838..................... T Excise excessive skin 0020 7.36 $382.79 $114.84 $76.56 tissue. 15839..................... T Excise excessive skin 0020 7.36 $382.79 $114.84 $76.56 tissue. 15840..................... T Graft for face nerve palsy. 0027 15.73 $818.10 $343.60 $163.62 15841..................... T Graft for face nerve palsy. 0027 15.73 $818.10 $343.60 $163.62 15842..................... T Flap for face nerve palsy.. 0027 15.73 $818.10 $343.60 $163.62 [[Page 52168]] 15845..................... T Skin and muscle repair, 0027 15.73 $818.10 $343.60 $163.62 face. 15850..................... T Removal of sutures......... 0016 2.57 $133.66 $56.14 $26.73 15851..................... T Removal of sutures......... 0013 1.10 $57.21 $14.30 $11.44 15852..................... X Dressing change,not for 0340 0.66 $34.33 ............ $6.87 burn. 15860..................... S Test for blood flow in 0706 ............ $25.00 ............ $5.00 graft. 15876..................... T Suction assisted lipectomy. 0027 15.73 $818.10 $343.60 $163.62 15877..................... T Suction assisted lipectomy. 0027 15.73 $818.10 $343.60 $163.62 15878..................... T Suction assisted lipectomy. 0027 15.73 $818.10 $343.60 $163.62 15879..................... T Suction assisted lipectomy. 0027 15.73 $818.10 $343.60 $163.62 15920..................... T Removal of tail bone ulcer. 0022 18.10 $941.36 $367.13 $188.27 15922..................... T Removal of tail bone ulcer. 0027 15.73 $818.10 $343.60 $163.62 15931..................... T Remove sacrum pressure sore 0022 18.10 $941.36 $367.13 $188.27 15933..................... T Remove sacrum pressure sore 0022 18.10 $941.36 $367.13 $188.27 15934..................... T Remove sacrum pressure sore 0027 15.73 $818.10 $343.60 $163.62 15935..................... T Remove sacrum pressure sore 0027 15.73 $818.10 $343.60 $163.62 15936..................... T Remove sacrum pressure sore 0027 15.73 $818.10 $343.60 $163.62 15937..................... T Remove sacrum pressure sore 0027 15.73 $818.10 $343.60 $163.62 15940..................... T Remove hip pressure sore... 0022 18.10 $941.36 $367.13 $188.27 15941..................... T Remove hip pressure sore... 0022 18.10 $941.36 $367.13 $188.27 15944..................... T Remove hip pressure sore... 0027 15.73 $818.10 $343.60 $163.62 15945..................... T Remove hip pressure sore... 0027 15.73 $818.10 $343.60 $163.62 15946..................... T Remove hip pressure sore... 0027 15.73 $818.10 $343.60 $163.62 15950..................... T Remove thigh pressure sore. 0022 18.10 $941.36 $367.13 $188.27 15951..................... T Remove thigh pressure sore. 0022 18.10 $941.36 $367.13 $188.27 15952..................... T Remove thigh pressure sore. 0027 15.73 $818.10 $343.60 $163.62 15953..................... T Remove thigh pressure sore. 0027 15.73 $818.10 $343.60 $163.62 15956..................... T Remove thigh pressure sore. 0027 15.73 $818.10 $343.60 $163.62 15958..................... T Remove thigh pressure sore. 0027 15.73 $818.10 $343.60 $163.62 15999..................... T Removal of pressure sore... 0022 18.10 $941.36 $367.13 $188.27 16000..................... T Initial treatment of 0013 1.10 $57.21 $14.30 $11.44 burn(s). 16010..................... T Treatment of burn(s)....... 0016 2.57 $133.66 $56.14 $26.73 16015..................... T Treatment of burn(s)....... 0017 16.46 $856.07 $227.84 $171.21 16020..................... T Treatment of burn(s)....... 0013 1.10 $57.21 $14.30 $11.44 16025..................... T Treatment of burn(s)....... 0013 1.10 $57.21 $14.30 $11.44 16030..................... T Treatment of burn(s)....... 0015 1.43 $74.37 $18.59 $14.87 16035..................... C Incision of burn scab, ............ ............ ............ ............ ............ initi. 16036..................... C Incise burn scab, addl ............ ............ ............ ............ ............ incis. 17000..................... T Detroy benign/premal lesion 0010 0.70 $36.41 $10.56 $7.28 17003..................... T Destroy lesions, 2-14...... 0010 0.70 $36.41 $10.56 $7.28 17004..................... T Destroy lesions, 15 or more 0011 1.93 $100.38 $27.88 $20.08 17106..................... T Destruction of skin lesions 0011 1.93 $100.38 $27.88 $20.08 17107..................... T Destruction of skin lesions 0011 1.93 $100.38 $27.88 $20.08 17108..................... T Destruction of skin lesions 0011 1.93 $100.38 $27.88 $20.08 17110..................... T Destruct lesion, 1-14...... 0010 0.70 $36.41 $10.56 $7.28 17111..................... T Destruct lesion, 15 or more 0011 1.93 $100.38 $27.88 $20.08 17250..................... T Chemical cautery, tissue... 0013 1.10 $57.21 $14.30 $11.44 17260..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17261..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17262..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17263..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17264..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17266..................... T Destruction of skin lesions 0016 2.57 $133.66 $56.14 $26.73 17270..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17271..................... T Destruction of skin lesions 0012 0.76 $39.53 $10.67 $7.91 17272..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17273..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17274..................... T Destruction of skin lesions 0016 2.57 $133.66 $56.14 $26.73 17276..................... T Destruction of skin lesions 0016 2.57 $133.66 $56.14 $26.73 17280..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17281..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17282..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17283..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17284..................... T Destruction of skin lesions 0016 2.57 $133.66 $56.14 $26.73 17286..................... T Destruction of skin lesions 0015 1.43 $74.37 $18.59 $14.87 17304..................... T Chemosurgery of skin lesion 0694 3.90 $202.84 $81.14 $40.57 17305..................... T 2nd stage chemosurgery..... 0694 3.90 $202.84 $81.14 $40.57 [[Page 52169]] 17306..................... T 3rd stage chemosurgery..... 0694 3.90 $202.84 $81.14 $40.57 17307..................... T Followup skin lesion 0694 3.90 $202.84 $81.14 $40.57 therapy. 17310..................... T Extensive skin chemosurgery 0694 3.90 $202.84 $81.14 $40.57 17340..................... T Cryotherapy of skin........ 0012 0.76 $39.53 $10.67 $7.91 17360..................... T Skin peel therapy.......... 0012 0.76 $39.53 $10.67 $7.91 17380..................... T Hair removal by 0012 0.76 $39.53 $10.67 $7.91 electrolysis. 17999..................... T Skin tissue procedure...... 0006 1.89 $98.30 $25.56 $19.66 19000..................... T Drainage of breast lesion.. 0004 1.63 $84.77 $22.04 $16.95 19001..................... T Drain breast lesion add-on. 0004 1.63 $84.77 $22.04 $16.95 19020..................... T Incision of breast lesion.. 0008 16.32 $848.79 ............ $169.76 19030..................... N Injection for breast x-ray. ............ ............ ............ ............ ............ 19100..................... T Bx breast percut w/o image. 0005 3.02 $157.07 $69.11 $31.41 19101..................... T Biopsy of breast, open..... 0028 17.44 $907.04 $303.74 $181.41 19102..................... T Bx breast percut w/image... 0005 3.02 $157.07 $69.11 $31.41 19103..................... T Bx breast percut w/device.. 0658 5.57 $289.69 ............ $57.94 19110..................... T Nipple exploration......... 0028 17.44 $907.04 $303.74 $181.41 19112..................... T Excise breast duct fistula. 0028 17.44 $907.04 $303.74 $181.41 19120..................... T Removal of breast lesion... 0028 17.44 $907.04 $303.74 $181.41 19125..................... T Excision, breast lesion.... 0028 17.44 $907.04 $303.74 $181.41 19126..................... T Excision, addl breast 0028 17.44 $907.04 $303.74 $181.41 lesion. 19140..................... T Removal of breast tissue... 0028 17.44 $907.04 $303.74 $181.41 19160..................... T Removal of breast tissue... 0028 17.44 $907.04 $303.74 $181.41 19162..................... T Remove breast tissue, nodes 0693 39.30 $2,043.95 $798.17 $408.79 19180..................... T Removal of breast.......... 0029 29.89 $1,554.55 $632.64 $310.91 19182..................... T Removal of breast.......... 0029 29.89 $1,554.55 $632.64 $310.91 19200..................... C Removal of breast.......... ............ ............ ............ ............ ............ 19220..................... C Removal of breast.......... ............ ............ ............ ............ ............ 19240..................... T Removal of breast.......... 0030 40.23 $2,092.32 $763.55 $418.46 19260..................... T Removal of chest wall 0021 14.58 $758.29 $227.49 $151.66 lesion. 19271..................... C Revision of chest wall..... ............ ............ ............ ............ ............ 19272..................... C Extensive chest wall ............ ............ ............ ............ ............ surgery. 19290..................... N Place needle wire, breast.. ............ ............ ............ ............ ............ 19291..................... N Place needle wire, breast.. ............ ............ ............ ............ ............ 19295..................... S Place breast clip, percut.. 0657 1.38 $71.77 ............ $14.35 19316..................... T Suspension of breast....... 0029 29.89 $1,554.55 $632.64 $310.91 19318..................... T Reduction of large breast.. 0693 39.30 $2,043.95 $798.17 $408.79 19324..................... T Enlarge breast............. 0693 39.30 $2,043.95 $798.17 $408.79 19325..................... T Enlarge breast with implant 0693 39.30 $2,043.95 $798.17 $408.79 19328..................... T Removal of breast implant.. 0029 29.89 $1,554.55 $632.64 $310.91 19330..................... T Removal of implant material 0029 29.89 $1,554.55 $632.64 $310.91 19340..................... T Immediate breast prosthesis 0030 40.23 $2,092.32 $763.55 $418.46 19342..................... T Delayed breast prosthesis.. 0693 39.30 $2,043.95 $798.17 $408.79 19350..................... T Breast reconstruction...... 0029 29.89 $1,554.55 $632.64 $310.91 19355..................... T Correct inverted nipple(s). 0029 29.89 $1,554.55 $632.64 $310.91 19357..................... T Breast reconstruction...... 0693 39.30 $2,043.95 $798.17 $408.79 19361..................... C Breast reconstruction...... ............ ............ ............ ............ ............ 19364..................... C Breast reconstruction...... ............ ............ ............ ............ ............ 19366..................... T Breast reconstruction...... 0029 29.89 $1,554.55 $632.64 $310.91 19367..................... C Breast reconstruction...... ............ ............ ............ ............ ............ 19368..................... C Breast reconstruction...... ............ ............ ............ ............ ............ 19369..................... C Breast reconstruction...... ............ ............ ............ ............ ............ 19370..................... T Surgery of breast capsule.. 0029 29.89 $1,554.55 $632.64 $310.91 19371..................... T Removal of breast capsule.. 0029 29.89 $1,554.55 $632.64 $310.91 19380..................... T Revise breast 0030 40.23 $2,092.32 $763.55 $418.46 reconstruction. 19396..................... T Design custom breast 0029 29.89 $1,554.55 $632.64 $310.91 implant. 19499..................... T Breast surgery procedure... 0028 17.44 $907.04 $303.74 $181.41 20000..................... T Incision of abscess........ 0006 1.89 $98.30 $25.56 $19.66 20005..................... T Incision of deep abscess... 0049 19.45 $1,011.58 ............ $202.32 20100..................... T Explore wound, neck........ 0023 2.38 $123.78 $40.37 $24.76 20101..................... T Explore wound, chest....... 0027 15.73 $818.10 $343.60 $163.62 20102..................... T Explore wound, abdomen..... 0027 15.73 $818.10 $343.60 $163.62 20103..................... T Explore wound, extremity... 0023 2.38 $123.78 $40.37 $24.76 20150..................... T Excise epiphyseal bar...... 0051 34.03 $1,769.87 ............ $353.97 20200..................... T Muscle biopsy.............. 0021 14.58 $758.29 $227.49 $151.66 20205..................... T Deep muscle biopsy......... 0021 14.58 $758.29 $227.49 $151.66 20206..................... T Needle biopsy, muscle...... 0005 3.02 $157.07 $69.11 $31.41 [[Page 52170]] 20220..................... T Bone biopsy, trocar/needle. 0019 3.94 $204.92 $75.82 $40.98 20225..................... T Bone biopsy, trocar/needle. 0019 3.94 $204.92 $75.82 $40.98 20240..................... T Bone biopsy, excisional.... 0022 18.10 $941.36 $367.13 $188.27 20245..................... T Bone biopsy, excisional.... 0022 18.10 $941.36 $367.13 $188.27 20250..................... T Open bone biopsy........... 0049 19.45 $1,011.58 ............ $202.32 20251..................... T Open bone biopsy........... 0049 19.45 $1,011.58 ............ $202.32 20500..................... T Injection of sinus tract... 0251 1.92 $99.86 ............ $19.97 20501..................... N Inject sinus tract for x- ............ ............ ............ ............ ............ ray. 20520..................... T Removal of foreign body.... 0019 3.94 $204.92 $75.82 $40.98 20525..................... T Removal of foreign body.... 0022 18.10 $941.36 $367.13 $188.27 20526..................... T Ther injection carpal 0204 2.13 $110.78 $42.10 $22.16 tunnel. 20550..................... T Inject tendon/ligament/cyst 0204 2.13 $110.78 $42.10 $22.16 20551..................... T Inject tendon origin/insert 0204 2.13 $110.78 $42.10 $22.16 20552..................... T Inject trigger point, 1 or 0204 2.13 $110.78 $42.10 $22.16 2. 20553..................... T Inject trigger points, > 3. 0204 2.13 $110.78 $42.10 $22.16 20600..................... T Drain/inject, joint/bursa.. 0204 2.13 $110.78 $42.10 $22.16 20605..................... T Drain/inject, joint/bursa.. 0204 2.13 $110.78 $42.10 $22.16 20610..................... T Drain/inject, joint/bursa.. 0204 2.13 $110.78 $42.10 $22.16 20615..................... T Treatment of bone cyst..... 0004 1.63 $84.77 $22.04 $16.95 20650..................... T Insert and remove bone pin. 0049 19.45 $1,011.58 ............ $202.32 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..................... X Removal of fixation device. 0340 0.66 $34.33 ............ $6.87 20670..................... T Removal of support implant. 0021 14.58 $758.29 $227.49 $151.66 20680..................... T Removal of support implant. 0022 18.10 $941.36 $367.13 $188.27 20690..................... T Apply bone fixation device. 0050 23.60 $1,227.41 ............ $245.48 20692..................... T Apply bone fixation device. 0050 23.60 $1,227.41 ............ $245.48 20693..................... T Adjust bone fixation device 0049 19.45 $1,011.58 ............ $202.32 20694..................... T Remove bone fixation device 0049 19.45 $1,011.58 ............ $202.32 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 graft.. 0050 23.60 $1,227.41 ............ $245.48 20902..................... T Removal of bone for graft.. 0050 23.60 $1,227.41 ............ $245.48 20910..................... T Remove cartilage for graft. 0027 15.73 $818.10 $343.60 $163.62 20912..................... T Remove cartilage for graft. 0027 15.73 $818.10 $343.60 $163.62 20920..................... T Removal of fascia for graft 0027 15.73 $818.10 $343.60 $163.62 20922..................... T Removal of fascia for graft 0027 15.73 $818.10 $343.60 $163.62 20924..................... T Removal of tendon for graft 0050 23.60 $1,227.41 ............ $245.48 20926..................... T Removal of tissue for graft 0027 15.73 $818.10 $343.60 $163.62 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...... ............ ............ ............ ............ ............ 20950..................... T Fluid pressure, muscle..... 0006 1.89 $98.30 $25.56 $19.66 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 stimulation 0049 19.45 $1,011.58 ............ $202.32 20979..................... A Us bone stimulation........ ............ ............ ............ ............ ............ 20999..................... T Musculoskeletal surgery.... 0049 19.45 $1,011.58 ............ $202.32 [[Page 52171]] 21010..................... T Incision of jaw joint...... 0254 21.89 $1,138.48 $352.93 $227.70 21015..................... T Resection of facial tumor.. 0253 14.79 $769.21 $284.61 $153.84 21025..................... T Excision of bone, lower jaw 0256 35.51 $1,846.84 ............ $369.37 21026..................... T Excision of facial bone(s). 0256 35.51 $1,846.84 ............ $369.37 21029..................... T Contour of face bone lesion 0256 35.51 $1,846.84 ............ $369.37 21030..................... T Removal of face bone lesion 0254 21.89 $1,138.48 $352.93 $227.70 21031..................... T Remove exostosis, mandible. 0254 21.89 $1,138.48 $352.93 $227.70 21032..................... T Remove exostosis, maxilla.. 0254 21.89 $1,138.48 $352.93 $227.70 21034..................... T Removal of face bone lesion 0256 35.51 $1,846.84 ............ $369.37 21040..................... T Removal of jaw bone lesion. 0254 21.89 $1,138.48 $352.93 $227.70 21041..................... T Removal of jaw bone lesion. 0256 35.51 $1,846.84 ............ $369.37 21044..................... T Removal of jaw bone lesion. 0256 35.51 $1,846.84 ............ $369.37 21045..................... C Extensive jaw surgery...... ............ ............ ............ ............ ............ 21050..................... T Removal of jaw joint....... 0256 35.51 $1,846.84 ............ $369.37 21060..................... T Remove jaw joint cartilage. 0256 35.51 $1,846.84 ............ $369.37 21070..................... T Remove coronoid process.... 0256 35.51 $1,846.84 ............ $369.37 21076..................... T Prepare face/oral 0254 21.89 $1,138.48 $352.93 $227.70 prosthesis. 21077..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21079..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21080..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21081..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21082..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21083..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21084..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21085..................... T Prepare face/oral 0253 14.79 $769.21 $284.61 $153.84 prosthesis. 21086..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21087..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21088..................... T Prepare face/oral 0256 35.51 $1,846.84 ............ $369.37 prosthesis. 21089..................... T Prepare face/oral 0253 14.79 $769.21 $284.61 $153.84 prosthesis. 21100..................... T Maxillofacial fixation..... 0256 35.51 $1,846.84 ............ $369.37 21110..................... T Interdental fixation....... 0252 6.27 $326.10 $114.24 $65.22 21116..................... N Injection, jaw joint x-ray. ............ ............ ............ ............ ............ 21120..................... T Reconstruction of chin..... 0254 21.89 $1,138.48 $352.93 $227.70 21121..................... T Reconstruction of chin..... 0254 21.89 $1,138.48 $352.93 $227.70 21122..................... T Reconstruction of chin..... 0254 21.89 $1,138.48 $352.93 $227.70 21123..................... T Reconstruction of chin..... 0254 21.89 $1,138.48 $352.93 $227.70 21125..................... T Augmentation, lower jaw 0254 21.89 $1,138.48 $352.93 $227.70 bone. 21127..................... T Augmentation, lower jaw 0256 35.51 $1,846.84 ............ $369.37 bone. 21137..................... T Reduction of forehead...... 0254 21.89 $1,138.48 $352.93 $227.70 21138..................... T Reduction of forehead...... 0256 35.51 $1,846.84 ............ $369.37 21139..................... T Reduction of forehead...... 0256 35.51 $1,846.84 ............ $369.37 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 lesion 0254 21.89 $1,138.48 $352.93 $227.70 21182..................... C Reconstruct cranial bone... ............ ............ ............ ............ ............ 21183..................... C Reconstruct cranial bone... ............ ............ ............ ............ ............ 21184..................... C Reconstruct cranial bone... ............ ............ ............ ............ ............ 21188..................... C Reconstruction of midface.. ............ ............ ............ ............ ............ 21193..................... C Reconst lwr jaw w/o graft.. ............ ............ ............ ............ ............ 21194..................... C Reconst lwr jaw w/graft.... ............ ............ ............ ............ ............ 21195..................... C Reconst lwr jaw w/o ............ ............ ............ ............ ............ fixation. 21196..................... C Reconst lwr jaw w/fixation. ............ ............ ............ ............ ............ [[Page 52172]] 21198..................... T Reconstr lwr jaw segment... 0256 35.51 $1,846.84 ............ $369.37 21199..................... T Reconstr lwr jaw w/advance. 0256 35.51 $1,846.84 ............ $369.37 21206..................... T Reconstruct upper jaw bone. 0256 35.51 $1,846.84 ............ $369.37 21208..................... T Augmentation of facial 0256 35.51 $1,846.84 ............ $369.37 bones. 21209..................... T Reduction of facial bones.. 0256 35.51 $1,846.84 ............ $369.37 21210..................... T Face bone graft............ 0256 35.51 $1,846.84 ............ $369.37 21215..................... T Lower jaw bone graft....... 0256 35.51 $1,846.84 ............ $369.37 21230..................... T Rib cartilage graft........ 0256 35.51 $1,846.84 ............ $369.37 21235..................... T Ear cartilage graft........ 0254 21.89 $1,138.48 $352.93 $227.70 21240..................... T Reconstruction of jaw joint 0256 35.51 $1,846.84 ............ $369.37 21242..................... T Reconstruction of jaw joint 0256 35.51 $1,846.84 ............ $369.37 21243..................... T Reconstruction of jaw joint 0256 35.51 $1,846.84 ............ $369.37 21244..................... T Reconstruction of lower jaw 0256 35.51 $1,846.84 ............ $369.37 21245..................... T Reconstruction of jaw...... 0256 35.51 $1,846.84 ............ $369.37 21246..................... T Reconstruction of jaw...... 0256 35.51 $1,846.84 ............ $369.37 21247..................... C Reconstruct lower jaw bone. ............ ............ ............ ............ ............ 21248..................... T Reconstruction of jaw...... 0256 35.51 $1,846.84 ............ $369.37 21249..................... T Reconstruction of jaw...... 0256 35.51 $1,846.84 ............ $369.37 21255..................... C Reconstruct lower jaw bone. ............ ............ ............ ............ ............ 21256..................... C Reconstruction of orbit.... ............ ............ ............ ............ ............ 21260..................... T Revise eye sockets......... 0256 35.51 $1,846.84 ............ $369.37 21261..................... T Revise eye sockets......... 0256 35.51 $1,846.84 ............ $369.37 21263..................... T Revise eye sockets......... 0256 35.51 $1,846.84 ............ $369.37 21267..................... T Revise eye sockets......... 0256 35.51 $1,846.84 ............ $369.37 21268..................... C Revise eye sockets......... ............ ............ ............ ............ ............ 21270..................... T Augmentation, cheek bone... 0256 35.51 $1,846.84 ............ $369.37 21275..................... T Revision, orbitofacial 0256 35.51 $1,846.84 ............ $369.37 bones. 21280..................... T Revision of eyelid......... 0256 35.51 $1,846.84 ............ $369.37 21282..................... T Revision of eyelid......... 0253 14.79 $769.21 $284.61 $153.84 21295..................... T Revision of jaw muscle/bone 0252 6.27 $326.10 $114.24 $65.22 21296..................... T Revision of jaw muscle/bone 0254 21.89 $1,138.48 $352.93 $227.70 21299..................... T Cranio/maxillofacial 0253 14.79 $769.21 $284.61 $153.84 surgery. 21300..................... T Treatment of skull fracture 0253 14.79 $769.21 $284.61 $153.84 21310..................... X Treatment of nose fracture. 0340 0.66 $34.33 ............ $6.87 21315..................... X Treatment of nose fracture. 0340 0.66 $34.33 ............ $6.87 21320..................... X Treatment of nose fracture. 0340 0.66 $34.33 ............ $6.87 21325..................... T Treatment of nose fracture. 0254 21.89 $1,138.48 $352.93 $227.70 21330..................... T Treatment of nose fracture. 0254 21.89 $1,138.48 $352.93 $227.70 21335..................... T Treatment of nose fracture. 0254 21.89 $1,138.48 $352.93 $227.70 21336..................... T Treat nasal septal fracture 0046 29.03 $1,509.82 $535.76 $301.96 21337..................... T Treat nasal septal fracture 0253 14.79 $769.21 $284.61 $153.84 21338..................... T Treat nasoethmoid fracture. 0254 21.89 $1,138.48 $352.93 $227.70 21339..................... T Treat nasoethmoid fracture. 0254 21.89 $1,138.48 $352.93 $227.70 21340..................... T Treatment of nose fracture. 0256 35.51 $1,846.84 ............ $369.37 21343..................... C Treatment of sinus fracture ............ ............ ............ ............ ............ 21344..................... C Treatment of sinus fracture ............ ............ ............ ............ ............ 21345..................... T Treat nose/jaw fracture.... 0254 21.89 $1,138.48 $352.93 $227.70 21346..................... C Treat nose/jaw fracture.... ............ ............ ............ ............ ............ 21347..................... C Treat nose/jaw fracture.... ............ ............ ............ ............ ............ 21348..................... C Treat nose/jaw fracture.... ............ ............ ............ ............ ............ 21355..................... T Treat cheek bone fracture.. 0256 35.51 $1,846.84 ............ $369.37 21356..................... C Treat cheek bone fracture.. ............ ............ ............ ............ ............ 21360..................... C Treat cheek bone fracture.. ............ ............ ............ ............ ............ 21365..................... C Treat cheek bone fracture.. ............ ............ ............ ............ ............ 21366..................... C Treat cheek bone fracture.. ............ ............ ............ ............ ............ 21385..................... C Treat eye socket fracture.. ............ ............ ............ ............ ............ 21386..................... C Treat eye socket fracture.. ............ ............ ............ ............ ............ 21387..................... C Treat eye socket fracture.. ............ ............ ............ ............ ............ 21390..................... T Treat eye socket fracture.. 0256 35.51 $1,846.84 ............ $369.37 21395..................... C Treat eye socket fracture.. ............ ............ ............ ............ ............ 21400..................... T Treat eye socket fracture.. 0252 6.27 $326.10 $114.24 $65.22 21401..................... T Treat eye socket fracture.. 0253 14.79 $769.21 $284.61 $153.84 21406..................... T Treat eye socket fracture.. 0256 35.51 $1,846.84 ............ $369.37 21407..................... T Treat eye socket fracture.. 0256 35.51 $1,846.84 ............ $369.37 21408..................... C Treat eye socket fracture.. ............ ............ ............ ............ ............ 21421..................... T Treat mouth roof fracture.. 0254 21.89 $1,138.48 $352.93 $227.70 [[Page 52173]] 21422..................... C Treat mouth roof fracture.. ............ ............ ............ ............ ............ 21423..................... C Treat mouth roof fracture.. ............ ............ ............ ............ ............ 21431..................... C Treat craniofacial fracture ............ ............ ............ ............ ............ 21432..................... C Treat craniofacial fracture ............ ............ ............ ............ ............ 21433..................... C Treat craniofacial fracture ............ ............ ............ ............ ............ 21435..................... C Treat craniofacial fracture ............ ............ ............ ............ ............ 21436..................... C Treat craniofacial fracture ............ ............ ............ ............ ............ 21440..................... T Treat dental ridge fracture 0254 21.89 $1,138.48 $352.93 $227.70 21445..................... T Treat dental ridge fracture 0254 21.89 $1,138.48 $352.93 $227.70 21450..................... T Treat lower jaw fracture... 0251 1.92 $99.86 ............ $19.97 21451..................... T Treat lower jaw fracture... 0252 6.27 $326.10 $114.24 $65.22 21452..................... T Treat lower jaw fracture... 0253 14.79 $769.21 $284.61 $153.84 21453..................... T Treat lower jaw fracture... 0256 35.51 $1,846.84 ............ $369.37 21454..................... T Treat lower jaw fracture... 0254 21.89 $1,138.48 $352.93 $227.70 21461..................... T Treat lower jaw fracture... 0256 35.51 $1,846.84 ............ $369.37 21462..................... T Treat lower jaw fracture... 0256 35.51 $1,846.84 ............ $369.37 21465..................... T Treat lower jaw fracture... 0256 35.51 $1,846.84 ............ $369.37 21470..................... T Treat lower jaw fracture... 0256 35.51 $1,846.84 ............ $369.37 21480..................... T Reset dislocated jaw....... 0251 1.92 $99.86 ............ $19.97 21485..................... T Reset dislocated jaw....... 0253 14.79 $769.21 $284.61 $153.84 21490..................... T Repair dislocated jaw...... 0256 35.51 $1,846.84 ............ $369.37 21493..................... T Treat hyoid bone fracture.. 0252 6.27 $326.10 $114.24 $65.22 21494..................... T Treat hyoid bone fracture.. 0252 6.27 $326.10 $114.24 $65.22 21495..................... C Treat hyoid bone fracture.. ............ ............ ............ ............ ............ 21497..................... T Interdental wiring......... 0253 14.79 $769.21 $284.61 $153.84 21499..................... T Head surgery procedure..... 0253 14.79 $769.21 $284.61 $153.84 21501..................... T Drain neck/chest lesion.... 0008 16.32 $848.79 ............ $169.76 21502..................... T Drain chest lesion......... 0049 19.45 $1,011.58 ............ $202.32 21510..................... C Drainage of bone lesion.... ............ ............ ............ ............ ............ 21550..................... T Biopsy of neck/chest....... 0021 14.58 $758.29 $227.49 $151.66 21555..................... T Remove lesion, neck/chest.. 0022 18.10 $941.36 $367.13 $188.27 21556..................... T Remove lesion, neck/chest.. 0022 18.10 $941.36 $367.13 $188.27 21557..................... C Remove tumor, neck/chest... ............ ............ ............ ............ ............ 21600..................... T Partial removal of rib..... 0050 23.60 $1,227.41 ............ $245.48 21610..................... T Partial removal of rib..... 0050 23.60 $1,227.41 ............ $245.48 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.... 0049 19.45 $1,011.58 ............ $202.32 21705..................... C Revision of neck muscle/rib ............ ............ ............ ............ ............ 21720..................... T Revision of neck muscle.... 0049 19.45 $1,011.58 ............ $202.32 21725..................... T Revision of neck muscle.... 0006 1.89 $98.30 $25.56 $19.66 21740..................... C Reconstruction of sternum.. ............ ............ ............ ............ ............ 21750..................... C Repair of sternum ............ ............ ............ ............ ............ separation. 21800..................... T Treatment of rib fracture.. 0043 1.68 $87.38 ............ $17.48 21805..................... T Treatment of rib fracture.. 0046 29.03 $1,509.82 $535.76 $301.96 21810..................... C Treatment of rib ............ ............ ............ ............ ............ fracture(s). 21820..................... T Treat sternum fracture..... 0043 1.68 $87.38 ............ $17.48 21825..................... C Treat sternum fracture..... ............ ............ ............ ............ ............ 21899..................... T Neck/chest surgery 0252 6.27 $326.10 $114.24 $65.22 procedure. 21920..................... T Biopsy soft tissue of back. 0020 7.36 $382.79 $114.84 $76.56 21925..................... T Biopsy soft tissue of back. 0022 18.10 $941.36 $367.13 $188.27 21930..................... T Remove lesion, back or 0022 18.10 $941.36 $367.13 $188.27 flank. 21935..................... T Remove tumor, back......... 0022 18.10 $941.36 $367.13 $188.27 22100..................... T Remove part of neck 0208 39.95 $2,077.76 ............ $415.55 vertebra. 22101..................... T Remove part, thorax 0208 39.95 $2,077.76 ............ $415.55 vertebra. 22102..................... T Remove part, lumbar 0208 39.95 $2,077.76 ............ $415.55 vertebra. 22103..................... T Remove extra spine segment. 0208 39.95 $2,077.76 ............ $415.55 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..... ............ ............ ............ ............ ............ [[Page 52174]] 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 0043 1.68 $87.38 ............ $17.48 fracture. 22310..................... T Treat spine fracture....... 0043 1.68 $87.38 ............ $17.48 22315..................... T Treat spine fracture....... 0043 1.68 $87.38 ............ $17.48 22318..................... C Treat odontoid fx w/o graft ............ ............ ............ ............ ............ 22319..................... C Treat odontoid fx w/graft.. ............ ............ ............ ............ ............ 22325..................... C Treat spine fracture....... ............ ............ ............ ............ ............ 22326..................... C Treat neck spine fracture.. ............ ............ ............ ............ ............ 22327..................... C Treat thorax spine fracture ............ ............ ............ ............ ............ 22328..................... C Treat each add spine fx.... ............ ............ ............ ............ ............ 22505..................... T Manipulation of spine...... 0045 13.47 $700.56 $280.22 $140.11 22520..................... T Percut vertebroplasty thor. 0050 23.60 $1,227.41 ............ $245.48 22521..................... T Percut vertebroplasty lumb. 0050 23.60 $1,227.41 ............ $245.48 22522..................... T Percut vertebroplasty addl. 0050 23.60 $1,227.41 ............ $245.48 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 or more...... ............ ............ ............ ............ ............ 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 pelv 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.... 0043 1.68 $87.38 ............ $17.48 22900..................... T Remove abdominal wall 0022 18.10 $941.36 $367.13 $188.27 lesion. 22999..................... T Abdomen surgery procedure.. 0022 18.10 $941.36 $367.13 $188.27 23000..................... T Removal of calcium deposits 0021 14.58 $758.29 $227.49 $151.66 23020..................... T Release shoulder joint..... 0051 34.03 $1,769.87 ............ $353.97 23030..................... T Drain shoulder lesion...... 0008 16.32 $848.79 ............ $169.76 23031..................... T Drain shoulder bursa....... 0008 16.32 $848.79 ............ $169.76 23035..................... T Drain shoulder bone lesion. 0049 19.45 $1,011.58 ............ $202.32 23040..................... T Exploratory shoulder 0050 23.60 $1,227.41 ............ $245.48 surgery. 23044..................... T Exploratory shoulder 0050 23.60 $1,227.41 ............ $245.48 surgery. [[Page 52175]] 23065..................... T Biopsy shoulder tissues.... 0021 14.58 $758.29 $227.49 $151.66 23066..................... T Biopsy shoulder tissues.... 0022 18.10 $941.36 $367.13 $188.27 23075..................... T Removal of shoulder lesion. 0021 14.58 $758.29 $227.49 $151.66 23076..................... T Removal of shoulder lesion. 0022 18.10 $941.36 $367.13 $188.27 23077..................... T Remove tumor of shoulder... 0022 18.10 $941.36 $367.13 $188.27 23100..................... T Biopsy of shoulder joint... 0049 19.45 $1,011.58 ............ $202.32 23101..................... T Shoulder joint surgery..... 0050 23.60 $1,227.41 ............ $245.48 23105..................... T Remove shoulder joint 0050 23.60 $1,227.41 ............ $245.48 lining. 23106..................... T Incision of collarbone 0050 23.60 $1,227.41 ............ $245.48 joint. 23107..................... T Explore treat shoulder 0050 23.60 $1,227.41 ............ $245.48 joint. 23120..................... T Partial removal, collar 0051 34.03 $1,769.87 ............ $353.97 bone. 23125..................... T Removal of collar bone..... 0051 34.03 $1,769.87 ............ $353.97 23130..................... T Remove shoulder bone, part. 0051 34.03 $1,769.87 ............ $353.97 23140..................... T Removal of bone lesion..... 0049 19.45 $1,011.58 ............ $202.32 23145..................... T Removal of bone lesion..... 0050 23.60 $1,227.41 ............ $245.48 23146..................... T Removal of bone lesion..... 0050 23.60 $1,227.41 ............ $245.48 23150..................... T Removal of humerus lesion.. 0050 23.60 $1,227.41 ............ $245.48 23155..................... T Removal of humerus lesion.. 0050 23.60 $1,227.41 ............ $245.48 23156..................... T Removal of humerus lesion.. 0050 23.60 $1,227.41 ............ $245.48 23170..................... T Remove collar bone lesion.. 0050 23.60 $1,227.41 ............ $245.48 23172..................... T Remove shoulder blade 0050 23.60 $1,227.41 ............ $245.48 lesion. 23174..................... T Remove humerus lesion...... 0050 23.60 $1,227.41 ............ $245.48 23180..................... T Remove collar bone lesion.. 0050 23.60 $1,227.41 ............ $245.48 23182..................... T Remove shoulder blade 0050 23.60 $1,227.41 ............ $245.48 lesion. 23184..................... T Remove humerus lesion...... 0050 23.60 $1,227.41 ............ $245.48 23190..................... T Partial removal of scapula. 0050 23.60 $1,227.41 ............ $245.48 23195..................... T Removal of head of humerus. 0050 23.60 $1,227.41 ............ $245.48 23200..................... C Removal of collar bone..... ............ ............ ............ ............ ............ 23210..................... C Removal of shoulder blade.. ............ ............ ............ ............ ............ 23220..................... C Partial removal of humerus. ............ ............ ............ ............ ............ 23221..................... C Partial removal of humerus. ............ ............ ............ ............ ............ 23222..................... C Partial removal of humerus. ............ ............ ............ ............ ............ 23330..................... T Remove shoulder foreign 0020 7.36 $382.79 $114.84 $76.56 body. 23331..................... T Remove shoulder foreign 0022 18.10 $941.36 $367.13 $188.27 body. 23332..................... C Remove shoulder foreign ............ ............ ............ ............ ............ body. 23350..................... N Injection for shoulder x- ............ ............ ............ ............ ............ ray. 23395..................... T Muscle transfer,shoulder/ 0051 34.03 $1,769.87 ............ $353.97 arm. 23397..................... T Muscle transfers........... 0052 42.37 $2,203.62 ............ $440.72 23400..................... T Fixation of shoulder blade. 0050 23.60 $1,227.41 ............ $245.48 23405..................... T Incision of tendon & muscle 0050 23.60 $1,227.41 ............ $245.48 23406..................... T Incise tendon(s) & 0050 23.60 $1,227.41 ............ $245.48 muscle(s). 23410..................... T Repair of tendon(s)........ 0052 42.37 $2,203.62 ............ $440.72 23412..................... T Repair of tendon(s)........ 0052 42.37 $2,203.62 ............ $440.72 23415..................... T Release of shoulder 0051 34.03 $1,769.87 ............ $353.97 ligament. 23420..................... T Repair of shoulder......... 0052 42.37 $2,203.62 ............ $440.72 23430..................... T Repair biceps tendon....... 0052 42.37 $2,203.62 ............ $440.72 23440..................... T Remove/transplant tendon... 0052 42.37 $2,203.62 ............ $440.72 23450..................... T Repair shoulder capsule.... 0052 42.37 $2,203.62 ............ $440.72 23455..................... T Repair shoulder capsule.... 0052 42.37 $2,203.62 ............ $440.72 23460..................... T Repair shoulder capsule.... 0052 42.37 $2,203.62 ............ $440.72 23462..................... T Repair shoulder capsule.... 0052 42.37 $2,203.62 ............ $440.72 23465..................... T Repair shoulder capsule.... 0052 42.37 $2,203.62 ............ $440.72 23466..................... T Repair shoulder capsule.... 0052 42.37 $2,203.62 ............ $440.72 23470..................... T Reconstruct shoulder joint. 0048 36.93 $1,920.69 $633.83 $384.14 23472..................... C Reconstruct shoulder joint. ............ ............ ............ ............ ............ 23480..................... T Revision of collar bone.... 0051 34.03 $1,769.87 ............ $353.97 23485..................... T Revision of collar bone.... 0051 34.03 $1,769.87 ............ $353.97 23490..................... T Reinforce clavicle......... 0051 34.03 $1,769.87 ............ $353.97 23491..................... T Reinforce shoulder bones... 0051 34.03 $1,769.87 ............ $353.97 23500..................... T Treat clavicle fracture.... 0043 1.68 $87.38 ............ $17.48 23505..................... T Treat clavicle fracture.... 0043 1.68 $87.38 ............ $17.48 23515..................... T Treat clavicle fracture.... 0046 29.03 $1,509.82 $535.76 $301.96 23520..................... T Treat clavicle dislocation. 0043 1.68 $87.38 ............ $17.48 23525..................... T Treat clavicle dislocation. 0043 1.68 $87.38 ............ $17.48 23530..................... T Treat clavicle dislocation. 0046 29.03 $1,509.82 $535.76 $301.96 23532..................... T Treat clavicle dislocation. 0046 29.03 $1,509.82 $535.76 $301.96 [[Page 52176]] 23540..................... T Treat clavicle dislocation. 0043 1.68 $87.38 ............ $17.48 23545..................... T Treat clavicle dislocation. 0043 1.68 $87.38 ............ $17.48 23550..................... T Treat clavicle dislocation. 0046 29.03 $1,509.82 $535.76 $301.96 23552..................... T Treat clavicle dislocation. 0046 29.03 $1,509.82 $535.76 $301.96 23570..................... T Treat shoulder blade fx.... 0043 1.68 $87.38 ............ $17.48 23575..................... T Treat shoulder blade fx.... 0043 1.68 $87.38 ............ $17.48 23585..................... T Treat scapula fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 23600..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 23605..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 23615..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 23616..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 23620..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 23625..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 23630..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 23650..................... T Treat shoulder dislocation. 0043 1.68 $87.38 ............ $17.48 23655..................... T Treat shoulder dislocation. 0045 13.47 $700.56 $280.22 $140.11 23660..................... T Treat shoulder dislocation. 0046 29.03 $1,509.82 $535.76 $301.96 23665..................... T Treat dislocation/fracture. 0043 1.68 $87.38 ............ $17.48 23670..................... T Treat dislocation/fracture. 0046 29.03 $1,509.82 $535.76 $301.96 23675..................... T Treat dislocation/fracture. 0043 1.68 $87.38 ............ $17.48 23680..................... T Treat dislocation/fracture. 0046 29.03 $1,509.82 $535.76 $301.96 23700..................... T Fixation of shoulder....... 0045 13.47 $700.56 $280.22 $140.11 23800..................... T Fusion of shoulder joint... 0051 34.03 $1,769.87 ............ $353.97 23802..................... T Fusion of shoulder joint... 0051 34.03 $1,769.87 ............ $353.97 23900..................... C Amputation of arm & girdle. ............ ............ ............ ............ ............ 23920..................... C Amputation at shoulder ............ ............ ............ ............ ............ joint. 23921..................... T Amputation follow-up 0025 5.89 $306.33 $116.41 $61.27 surgery. 23929..................... T Shoulder surgery procedure. 0043 1.68 $87.38 ............ $17.48 23930..................... T Drainage of arm lesion..... 0008 16.32 $848.79 ............ $169.76 23931..................... T Drainage of arm bursa...... 0006 1.89 $98.30 $25.56 $19.66 23935..................... T Drain arm/elbow bone lesion 0049 19.45 $1,011.58 ............ $202.32 24000..................... T Exploratory elbow surgery.. 0050 23.60 $1,227.41 ............ $245.48 24006..................... T Release elbow joint........ 0050 23.60 $1,227.41 ............ $245.48 24065..................... T Biopsy arm/elbow soft 0021 14.58 $758.29 $227.49 $151.66 tissue. 24066..................... T Biopsy arm/elbow soft 0021 14.58 $758.29 $227.49 $151.66 tissue. 24075..................... T Remove arm/elbow lesion.... 0021 14.58 $758.29 $227.49 $151.66 24076..................... T Remove arm/elbow lesion.... 0022 18.10 $941.36 $367.13 $188.27 24077..................... T Remove tumor of arm/elbow.. 0022 18.10 $941.36 $367.13 $188.27 24100..................... T Biopsy elbow joint lining.. 0049 19.45 $1,011.58 ............ $202.32 24101..................... T Explore/treat elbow joint.. 0050 23.60 $1,227.41 ............ $245.48 24102..................... T Remove elbow joint lining.. 0050 23.60 $1,227.41 ............ $245.48 24105..................... T Removal of elbow bursa..... 0049 19.45 $1,011.58 ............ $202.32 24110..................... T Remove humerus lesion...... 0049 19.45 $1,011.58 ............ $202.32 24115..................... T Remove/graft bone lesion... 0050 23.60 $1,227.41 ............ $245.48 24116..................... T Remove/graft bone lesion... 0050 23.60 $1,227.41 ............ $245.48 24120..................... T Remove elbow lesion........ 0049 19.45 $1,011.58 ............ $202.32 24125..................... T Remove/graft bone lesion... 0050 23.60 $1,227.41 ............ $245.48 24126..................... T Remove/graft bone lesion... 0050 23.60 $1,227.41 ............ $245.48 24130..................... T Removal of head of radius.. 0050 23.60 $1,227.41 ............ $245.48 24134..................... T Removal of arm bone lesion. 0050 23.60 $1,227.41 ............ $245.48 24136..................... T Remove radius bone lesion.. 0050 23.60 $1,227.41 ............ $245.48 24138..................... T Remove elbow bone lesion... 0050 23.60 $1,227.41 ............ $245.48 24140..................... T Partial removal of arm bone 0050 23.60 $1,227.41 ............ $245.48 24145..................... T Partial removal of radius.. 0050 23.60 $1,227.41 ............ $245.48 24147..................... T Partial removal of elbow... 0050 23.60 $1,227.41 ............ $245.48 24149..................... C Radical resection of elbow. ............ ............ ............ ............ ............ 24150..................... T Extensive humerus surgery.. 0052 42.37 $2,203.62 ............ $440.72 24151..................... T Extensive humerus surgery.. 0052 42.37 $2,203.62 ............ $440.72 24152..................... T Extensive radius surgery... 0052 42.37 $2,203.62 ............ $440.72 24153..................... T Extensive radius surgery... 0052 42.37 $2,203.62 ............ $440.72 24155..................... T Removal of elbow joint..... 0051 34.03 $1,769.87 ............ $353.97 24160..................... T Remove elbow joint implant. 0050 23.60 $1,227.41 ............ $245.48 24164..................... T Remove radius head implant. 0050 23.60 $1,227.41 ............ $245.48 24200..................... T Removal of arm foreign body 0019 3.94 $204.92 $75.82 $40.98 24201..................... T Removal of arm foreign body 0021 14.58 $758.29 $227.49 $151.66 24220..................... N Injection for elbow x-ray.. ............ ............ ............ ............ ............ [[Page 52177]] 24300..................... T Manipulate elbow w/anesth.. 0045 13.47 $700.56 $280.22 $140.11 24301..................... T Muscle/tendon transfer..... 0050 23.60 $1,227.41 ............ $245.48 24305..................... T Arm tendon lengthening..... 0050 23.60 $1,227.41 ............ $245.48 24310..................... T Revision of arm tendon..... 0049 19.45 $1,011.58 ............ $202.32 24320..................... T Repair of arm tendon....... 0051 34.03 $1,769.87 ............ $353.97 24330..................... T Revision of arm muscles.... 0051 34.03 $1,769.87 ............ $353.97 24331..................... T Revision of arm muscles.... 0051 34.03 $1,769.87 ............ $353.97 24332..................... T Tenolysis, triceps......... 0049 19.45 $1,011.58 ............ $202.32 24340..................... T Repair of biceps tendon.... 0051 34.03 $1,769.87 ............ $353.97 24341..................... T Repair arm tendon/muscle... 0051 34.03 $1,769.87 ............ $353.97 24342..................... T Repair of ruptured tendon.. 0051 34.03 $1,769.87 ............ $353.97 24343..................... T Repr elbow lat ligmnt w/ 0050 23.60 $1,227.41 ............ $245.48 tiss. 24344..................... T Reconstruct elbow lat 0051 34.03 $1,769.87 ............ $353.97 ligmnt. 24345..................... T Repr elbw med ligmnt w/tiss 0050 23.60 $1,227.41 ............ $245.48 24346..................... T Reconstruct elbow med 0051 34.03 $1,769.87 ............ $353.97 ligmnt. 24350..................... T Repair of tennis elbow..... 0050 23.60 $1,227.41 ............ $245.48 24351..................... T Repair of tennis elbow..... 0050 23.60 $1,227.41 ............ $245.48 24352..................... T Repair of tennis elbow..... 0050 23.60 $1,227.41 ............ $245.48 24354..................... T Repair of tennis elbow..... 0050 23.60 $1,227.41 ............ $245.48 24356..................... T Revision of tennis elbow... 0050 23.60 $1,227.41 ............ $245.48 24360..................... T Reconstruct elbow joint.... 0047 29.59 $1,538.95 $537.03 $307.79 24361..................... T Reconstruct elbow joint.... 0048 36.93 $1,920.69 $633.83 $384.14 24362..................... T Reconstruct elbow joint.... 0048 36.93 $1,920.69 $633.83 $384.14 24363..................... T Replace elbow joint........ 0048 36.93 $1,920.69 $633.83 $384.14 24365..................... T Reconstruct head of radius. 0047 29.59 $1,538.95 $537.03 $307.79 24366..................... T Reconstruct head of radius. 0048 36.93 $1,920.69 $633.83 $384.14 24400..................... T Revision of humerus........ 0050 23.60 $1,227.41 ............ $245.48 24410..................... T Revision of humerus........ 0050 23.60 $1,227.41 ............ $245.48 24420..................... T Revision of humerus........ 0051 34.03 $1,769.87 ............ $353.97 24430..................... T Repair of humerus.......... 0051 34.03 $1,769.87 ............ $353.97 24435..................... T Repair humerus with graft.. 0051 34.03 $1,769.87 ............ $353.97 24470..................... T Revision of elbow joint.... 0051 34.03 $1,769.87 ............ $353.97 24495..................... T Decompression of forearm... 0050 23.60 $1,227.41 ............ $245.48 24498..................... T Reinforce humerus.......... 0051 34.03 $1,769.87 ............ $353.97 24500..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24505..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24515..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24516..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24530..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24535..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24538..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24545..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24546..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24560..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24565..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24566..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24575..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24576..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24577..................... T Treat humerus fracture..... 0043 1.68 $87.38 ............ $17.48 24579..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24582..................... T Treat humerus fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 24586..................... T Treat elbow fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 24587..................... T Treat elbow fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 24600..................... T Treat elbow dislocation.... 0043 1.68 $87.38 ............ $17.48 24605..................... T Treat elbow dislocation.... 0045 13.47 $700.56 $280.22 $140.11 24615..................... T Treat elbow dislocation.... 0046 29.03 $1,509.82 $535.76 $301.96 24620..................... T Treat elbow fracture....... 0043 1.68 $87.38 ............ $17.48 24635..................... T Treat elbow fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 24640..................... T Treat elbow dislocation.... 0043 1.68 $87.38 ............ $17.48 24650..................... T Treat radius fracture...... 0043 1.68 $87.38 ............ $17.48 24655..................... T Treat radius fracture...... 0043 1.68 $87.38 ............ $17.48 24665..................... T Treat radius fracture...... 0046 29.03 $1,509.82 $535.76 $301.96 24666..................... T Treat radius fracture...... 0046 29.03 $1,509.82 $535.76 $301.96 24670..................... T Treat ulnar fracture....... 0043 1.68 $87.38 ............ $17.48 24675..................... T Treat ulnar fracture....... 0043 1.68 $87.38 ............ $17.48 24685..................... T Treat ulnar fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 [[Page 52178]] 24800..................... T Fusion of elbow joint...... 0051 34.03 $1,769.87 ............ $353.97 24802..................... T Fusion/graft of elbow joint 0051 34.03 $1,769.87 ............ $353.97 24900..................... C Amputation of upper arm.... ............ ............ ............ ............ ............ 24920..................... C Amputation of upper arm.... ............ ............ ............ ............ ............ 24925..................... T Amputation follow-up 0049 19.45 $1,011.58 ............ $202.32 surgery. 24930..................... C Amputation follow-up ............ ............ ............ ............ ............ surgery. 24931..................... C Amputate upper arm & ............ ............ ............ ............ ............ implant. 24935..................... T Revision of amputation..... 0052 42.37 $2,203.62 ............ $440.72 24940..................... C Revision of upper arm...... ............ ............ ............ ............ ............ 24999..................... T Upper arm/elbow surgery.... 0043 1.68 $87.38 ............ $17.48 25000..................... T Incision of tendon sheath.. 0049 19.45 $1,011.58 ............ $202.32 25001..................... T Incise flexor carpi 0049 19.45 $1,011.58 ............ $202.32 radialis. 25020..................... T Decompress forearm 1 space. 0049 19.45 $1,011.58 ............ $202.32 25023..................... T Decompress forearm 1 space. 0050 23.60 $1,227.41 ............ $245.48 25024..................... T Decompress forearm 2 spaces 0050 23.60 $1,227.41 ............ $245.48 25025..................... T Decompress forarm 2 spaces. 0050 23.60 $1,227.41 ............ $245.48 25028..................... T Drainage of forearm lesion. 0049 19.45 $1,011.58 ............ $202.32 25031..................... T Drainage of forearm bursa.. 0049 19.45 $1,011.58 ............ $202.32 25035..................... T Treat forearm bone lesion.. 0049 19.45 $1,011.58 ............ $202.32 25040..................... T Explore/treat wrist joint.. 0050 23.60 $1,227.41 ............ $245.48 25065..................... T Biopsy forearm soft tissues 0021 14.58 $758.29 $227.49 $151.66 25066..................... T Biopsy forearm soft tissues 0022 18.10 $941.36 $367.13 $188.27 25075..................... T Remove forearm lesion 0021 14.58 $758.29 $227.49 $151.66 subcut. 25076..................... T Remove forearm lesion deep. 0022 18.10 $941.36 $367.13 $188.27 25077..................... T Remove tumor, forearm/wrist 0022 18.10 $941.36 $367.13 $188.27 25085..................... T Incision of wrist capsule.. 0049 19.45 $1,011.58 ............ $202.32 25100..................... T Biopsy of wrist joint...... 0049 19.45 $1,011.58 ............ $202.32 25101..................... T Explore/treat wrist joint.. 0050 23.60 $1,227.41 ............ $245.48 25105..................... T Remove wrist joint lining.. 0050 23.60 $1,227.41 ............ $245.48 25107..................... T Remove wrist joint 0050 23.60 $1,227.41 ............ $245.48 cartilage. 25110..................... T Remove wrist tendon lesion. 0049 19.45 $1,011.58 ............ $202.32 25111..................... T Remove wrist tendon lesion. 0053 14.76 $767.65 $253.49 $153.53 25112..................... T Reremove wrist tendon 0053 14.76 $767.65 $253.49 $153.53 lesion. 25115..................... T Remove wrist/forearm lesion 0049 19.45 $1,011.58 ............ $202.32 25116..................... T Remove wrist/forearm lesion 0049 19.45 $1,011.58 ............ $202.32 25118..................... T Excise wrist tendon sheath. 0050 23.60 $1,227.41 ............ $245.48 25119..................... T Partial removal of ulna.... 0050 23.60 $1,227.41 ............ $245.48 25120..................... T Removal of forearm lesion.. 0050 23.60 $1,227.41 ............ $245.48 25125..................... T Remove/graft forearm lesion 0050 23.60 $1,227.41 ............ $245.48 25126..................... T Remove/graft forearm lesion 0050 23.60 $1,227.41 ............ $245.48 25130..................... T Removal of wrist lesion.... 0050 23.60 $1,227.41 ............ $245.48 25135..................... T Remove & graft wrist lesion 0050 23.60 $1,227.41 ............ $245.48 25136..................... T Remove & graft wrist lesion 0050 23.60 $1,227.41 ............ $245.48 25145..................... T Remove forearm bone lesion. 0050 23.60 $1,227.41 ............ $245.48 25150..................... T Partial removal of ulna.... 0050 23.60 $1,227.41 ............ $245.48 25151..................... T Partial removal of radius.. 0050 23.60 $1,227.41 ............ $245.48 25170..................... T Extensive forearm surgery.. 0052 42.37 $2,203.62 ............ $440.72 25210..................... T Removal of wrist bone...... 0054 23.50 $1,222.21 $472.33 $244.44 25215..................... T Removal of wrist bones..... 0054 23.50 $1,222.21 $472.33 $244.44 25230..................... T Partial removal of radius.. 0050 23.60 $1,227.41 ............ $245.48 25240..................... T Partial removal of ulna.... 0050 23.60 $1,227.41 ............ $245.48 25246..................... N Injection for wrist x-ray.. ............ ............ ............ ............ ............ 25248..................... T Remove forearm foreign body 0049 19.45 $1,011.58 ............ $202.32 25250..................... T Removal of wrist prosthesis 0050 23.60 $1,227.41 ............ $245.48 25251..................... T Removal of wrist prosthesis 0050 23.60 $1,227.41 ............ $245.48 25259..................... T Manipulate wrist w/anesthes 0043 1.68 $87.38 ............ $17.48 25260..................... T Repair forearm tendon/ 0050 23.60 $1,227.41 ............ $245.48 muscle. 25263..................... T Repair forearm tendon/ 0050 23.60 $1,227.41 ............ $245.48 muscle. 25265..................... T Repair forearm tendon/ 0050 23.60 $1,227.41 ............ $245.48 muscle. 25270..................... T Repair forearm tendon/ 0050 23.60 $1,227.41 ............ $245.48 muscle. 25272..................... T Repair forearm tendon/ 0050 23.60 $1,227.41 ............ $245.48 muscle. 25274..................... T Repair forearm tendon/ 0050 23.60 $1,227.41 ............ $245.48 muscle. 25275..................... T Repair forearm tendon 0050 23.60 $1,227.41 ............ $245.48 sheath. 25280..................... T Revise wrist/forearm tendon 0050 23.60 $1,227.41 ............ $245.48 25290..................... T Incise wrist/forearm tendon 0050 23.60 $1,227.41 ............ $245.48 25295..................... T Release wrist/forearm 0049 19.45 $1,011.58 ............ $202.32 tendon. [[Page 52179]] 25300..................... T Fusion of tendons at wrist. 0050 23.60 $1,227.41 ............ $245.48 25301..................... T Fusion of tendons at wrist. 0050 23.60 $1,227.41 ............ $245.48 25310..................... T Transplant forearm tendon.. 0051 34.03 $1,769.87 ............ $353.97 25312..................... T Transplant forearm tendon.. 0051 34.03 $1,769.87 ............ $353.97 25315..................... T Revise palsy hand tendon(s) 0051 34.03 $1,769.87 ............ $353.97 25316..................... T Revise palsy hand tendon(s) 0051 34.03 $1,769.87 ............ $353.97 25320..................... T Repair/revise wrist joint.. 0051 34.03 $1,769.87 ............ $353.97 25332..................... T Revise wrist joint......... 0047 29.59 $1,538.95 $537.03 $307.79 25335..................... T Realignment of hand........ 0051 34.03 $1,769.87 ............ $353.97 25337..................... T Reconstruct ulna/radioulnar 0051 34.03 $1,769.87 ............ $353.97 25350..................... T Revision of radius......... 0051 34.03 $1,769.87 ............ $353.97 25355..................... T Revision of radius......... 0051 34.03 $1,769.87 ............ $353.97 25360..................... T Revision of ulna........... 0050 23.60 $1,227.41 ............ $245.48 25365..................... T Revise radius & ulna....... 0050 23.60 $1,227.41 ............ $245.48 25370..................... T Revise radius or ulna...... 0051 34.03 $1,769.87 ............ $353.97 25375..................... T Revise radius & ulna....... 0051 34.03 $1,769.87 ............ $353.97 25390..................... T Shorten radius or ulna..... 0050 23.60 $1,227.41 ............ $245.48 25391..................... T Lengthen radius or ulna.... 0051 34.03 $1,769.87 ............ $353.97 25392..................... T Shorten radius & ulna...... 0050 23.60 $1,227.41 ............ $245.48 25393..................... T Lengthen radius & ulna..... 0051 34.03 $1,769.87 ............ $353.97 25394..................... T Repair carpal bone, shorten 0053 14.76 $767.65 $253.49 $153.53 25400..................... T Repair radius or ulna...... 0050 23.60 $1,227.41 ............ $245.48 25405..................... T Repair/graft radius or ulna 0050 23.60 $1,227.41 ............ $245.48 25415..................... T Repair radius & ulna....... 0050 23.60 $1,227.41 ............ $245.48 25420..................... T Repair/graft radius & ulna. 0051 34.03 $1,769.87 ............ $353.97 25425..................... T Repair/graft radius or ulna 0051 34.03 $1,769.87 ............ $353.97 25426..................... T Repair/graft radius & ulna. 0051 34.03 $1,769.87 ............ $353.97 25430..................... T Vasc graft into carpal bone 0054 23.50 $1,222.21 $472.33 $244.44 25431..................... T Repair nonunion carpal bone 0054 23.50 $1,222.21 $472.33 $244.44 25440..................... T Repair/graft wrist bone.... 0051 34.03 $1,769.87 ............ $353.97 25441..................... T Reconstruct wrist joint.... 0048 36.93 $1,920.69 $633.83 $384.14 25442..................... T Reconstruct wrist joint.... 0048 36.93 $1,920.69 $633.83 $384.14 25443..................... T Reconstruct wrist joint.... 0048 36.93 $1,920.69 $633.83 $384.14 25444..................... T Reconstruct wrist joint.... 0048 36.93 $1,920.69 $633.83 $384.14 25445..................... T Reconstruct wrist joint.... 0048 36.93 $1,920.69 $633.83 $384.14 25446..................... T Wrist replacement.......... 0048 36.93 $1,920.69 $633.83 $384.14 25447..................... T Repair wrist joint(s)...... 0047 29.59 $1,538.95 $537.03 $307.79 25449..................... T Remove wrist joint implant. 0047 29.59 $1,538.95 $537.03 $307.79 25450..................... T Revision of wrist joint.... 0051 34.03 $1,769.87 ............ $353.97 25455..................... T Revision of wrist joint.... 0051 34.03 $1,769.87 ............ $353.97 25490..................... T Reinforce radius........... 0051 34.03 $1,769.87 ............ $353.97 25491..................... T Reinforce ulna............. 0051 34.03 $1,769.87 ............ $353.97 25492..................... T Reinforce radius and ulna.. 0051 34.03 $1,769.87 ............ $353.97 25500..................... T Treat fracture of radius... 0043 1.68 $87.38 ............ $17.48 25505..................... T Treat fracture of radius... 0043 1.68 $87.38 ............ $17.48 25515..................... T Treat fracture of radius... 0046 29.03 $1,509.82 $535.76 $301.96 25520..................... T Treat fracture of radius... 0043 1.68 $87.38 ............ $17.48 25525..................... T Treat fracture of radius... 0046 29.03 $1,509.82 $535.76 $301.96 25526..................... T Treat fracture of radius... 0046 29.03 $1,509.82 $535.76 $301.96 25530..................... T Treat fracture of ulna..... 0043 1.68 $87.38 ............ $17.48 25535..................... T Treat fracture of ulna..... 0043 1.68 $87.38 ............ $17.48 25545..................... T Treat fracture of ulna..... 0046 29.03 $1,509.82 $535.76 $301.96 25560..................... T Treat fracture radius & 0043 1.68 $87.38 ............ $17.48 ulna. 25565..................... T Treat fracture radius & 0043 1.68 $87.38 ............ $17.48 ulna. 25574..................... T Treat fracture radius & 0046 29.03 $1,509.82 $535.76 $301.96 ulna. 25575..................... T Treat fracture radius/ulna. 0046 29.03 $1,509.82 $535.76 $301.96 25600..................... T Treat fracture radius/ulna. 0043 1.68 $87.38 ............ $17.48 25605..................... T Treat fracture radius/ulna. 0043 1.68 $87.38 ............ $17.48 25611..................... T Treat fracture radius/ulna. 0046 29.03 $1,509.82 $535.76 $301.96 25620..................... T Treat fracture radius/ulna. 0046 29.03 $1,509.82 $535.76 $301.96 25622..................... T Treat wrist bone fracture.. 0043 1.68 $87.38 ............ $17.48 25624..................... T Treat wrist bone fracture.. 0043 1.68 $87.38 ............ $17.48 25628..................... T Treat wrist bone fracture.. 0046 29.03 $1,509.82 $535.76 $301.96 25630..................... T Treat wrist bone fracture.. 0043 1.68 $87.38 ............ $17.48 25635..................... T Treat wrist bone fracture.. 0043 1.68 $87.38 ............ $17.48 25645..................... T Treat wrist bone fracture.. 0046 29.03 $1,509.82 $535.76 $301.96 [[Page 52180]] 25650..................... T Treat wrist bone fracture.. 0043 1.68 $87.38 ............ $17.48 25651..................... T Pin ulnar styloid fracture. 0046 29.03 $1,509.82 $535.76 $301.96 25652..................... T Treat fracture ulnar 0046 29.03 $1,509.82 $535.76 $301.96 styloid. 25660..................... T Treat wrist dislocation.... 0043 1.68 $87.38 ............ $17.48 25670..................... T Treat wrist dislocation.... 0046 29.03 $1,509.82 $535.76 $301.96 25671..................... T Pin radioulnar dislocation. 0046 29.03 $1,509.82 $535.76 $301.96 25675..................... T Treat wrist dislocation.... 0043 1.68 $87.38 ............ $17.48 25676..................... T Treat wrist dislocation.... 0046 29.03 $1,509.82 $535.76 $301.96 25680..................... T Treat wrist fracture....... 0043 1.68 $87.38 ............ $17.48 25685..................... T Treat wrist fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 25690..................... T Treat wrist dislocation.... 0043 1.68 $87.38 ............ $17.48 25695..................... T Treat wrist dislocation.... 0046 29.03 $1,509.82 $535.76 $301.96 25800..................... T Fusion of wrist joint...... 0051 34.03 $1,769.87 ............ $353.97 25805..................... T Fusion/graft of wrist joint 0051 34.03 $1,769.87 ............ $353.97 25810..................... T Fusion/graft of wrist joint 0051 34.03 $1,769.87 ............ $353.97 25820..................... T Fusion of hand bones....... 0053 14.76 $767.65 $253.49 $153.53 25825..................... T Fuse hand bones with graft. 0054 23.50 $1,222.21 $472.33 $244.44 25830..................... T Fusion, radioulnar jnt/ulna 0051 34.03 $1,769.87 ............ $353.97 25900..................... C Amputation of forearm...... ............ ............ ............ ............ ............ 25905..................... C Amputation of forearm...... ............ ............ ............ ............ ............ 25907..................... T Amputation follow-up 0049 19.45 $1,011.58 ............ $202.32 surgery. 25909..................... C Amputation follow-up ............ ............ ............ ............ ............ surgery. 25915..................... C Amputation of forearm...... ............ ............ ............ ............ ............ 25920..................... C Amputate hand at wrist..... ............ ............ ............ ............ ............ 25922..................... T Amputate hand at wrist..... 0049 19.45 $1,011.58 ............ $202.32 25924..................... C Amputation follow-up ............ ............ ............ ............ ............ surgery. 25927..................... C Amputation of hand......... ............ ............ ............ ............ ............ 25929..................... T Amputation follow-up 0027 15.73 $818.10 $343.60 $163.62 surgery. 25931..................... C Amputation follow-up ............ ............ ............ ............ ............ surgery. 25999..................... T Forearm or wrist surgery... 0043 1.68 $87.38 ............ $17.48 26010..................... T Drainage of finger abscess. 0006 1.89 $98.30 $25.56 $19.66 26011..................... T Drainage of finger abscess. 0007 9.44 $490.96 $103.10 $98.19 26020..................... T Drain hand tendon sheath... 0053 14.76 $767.65 $253.49 $153.53 26025..................... T Drainage of palm bursa..... 0053 14.76 $767.65 $253.49 $153.53 26030..................... T Drainage of palm bursa(s).. 0053 14.76 $767.65 $253.49 $153.53 26034..................... T Treat hand bone lesion..... 0053 14.76 $767.65 $253.49 $153.53 26035..................... T Decompress fingers/hand.... 0053 14.76 $767.65 $253.49 $153.53 26037..................... T Decompress fingers/hand.... 0053 14.76 $767.65 $253.49 $153.53 26040..................... T Release palm contracture... 0054 23.50 $1,222.21 $472.33 $244.44 26045..................... T Release palm contracture... 0054 23.50 $1,222.21 $472.33 $244.44 26055..................... T Incise finger tendon sheath 0053 14.76 $767.65 $253.49 $153.53 26060..................... T Incision of finger tendon.. 0053 14.76 $767.65 $253.49 $153.53 26070..................... T Explore/treat hand joint... 0053 14.76 $767.65 $253.49 $153.53 26075..................... T Explore/treat finger joint. 0053 14.76 $767.65 $253.49 $153.53 26080..................... T Explore/treat finger joint. 0053 14.76 $767.65 $253.49 $153.53 26100..................... T Biopsy hand joint lining... 0053 14.76 $767.65 $253.49 $153.53 26105..................... T Biopsy finger joint lining. 0053 14.76 $767.65 $253.49 $153.53 26110..................... T Biopsy finger joint lining. 0053 14.76 $767.65 $253.49 $153.53 26115..................... T Remove hand lesion subcut.. 0022 18.10 $941.36 $367.13 $188.27 26116..................... T Remove hand lesion, deep... 0022 18.10 $941.36 $367.13 $188.27 26117..................... T Remove tumor, hand/finger.. 0022 18.10 $941.36 $367.13 $188.27 26121..................... T Release palm contracture... 0054 23.50 $1,222.21 $472.33 $244.44 26123..................... T Release palm contracture... 0054 23.50 $1,222.21 $472.33 $244.44 26125..................... T Release palm contracture... 0054 23.50 $1,222.21 $472.33 $244.44 26130..................... T Remove wrist joint lining.. 0053 14.76 $767.65 $253.49 $153.53 26135..................... T Revise finger joint, each.. 0054 23.50 $1,222.21 $472.33 $244.44 26140..................... T Revise finger joint, each.. 0053 14.76 $767.65 $253.49 $153.53 26145..................... T Tendon excision, palm/ 0053 14.76 $767.65 $253.49 $153.53 finger. 26160..................... T Remove tendon sheath lesion 0053 14.76 $767.65 $253.49 $153.53 26170..................... T Removal of palm tendon, 0053 14.76 $767.65 $253.49 $153.53 each. 26180..................... T Removal of finger tendon... 0053 14.76 $767.65 $253.49 $153.53 26185..................... T Remove finger bone......... 0053 14.76 $767.65 $253.49 $153.53 26200..................... T Remove hand bone lesion.... 0053 14.76 $767.65 $253.49 $153.53 26205..................... T Remove/graft bone lesion... 0054 23.50 $1,222.21 $472.33 $244.44 26210..................... T Removal of finger lesion... 0053 14.76 $767.65 $253.49 $153.53 26215..................... T Remove/graft finger lesion. 0053 14.76 $767.65 $253.49 $153.53 [[Page 52181]] 26230..................... T Partial removal of hand 0053 14.76 $767.65 $253.49 $153.53 bone. 26235..................... T Partial removal, finger 0053 14.76 $767.65 $253.49 $153.53 bone. 26236..................... T Partial removal, finger 0053 14.76 $767.65 $253.49 $153.53 bone. 26250..................... T Extensive hand surgery..... 0053 14.76 $767.65 $253.49 $153.53 26255..................... T Extensive hand surgery..... 0054 23.50 $1,222.21 $472.33 $244.44 26260..................... T Extensive finger surgery... 0053 14.76 $767.65 $253.49 $153.53 26261..................... T Extensive finger surgery... 0053 14.76 $767.65 $253.49 $153.53 26262..................... T Partial removal of finger.. 0053 14.76 $767.65 $253.49 $153.53 26320..................... T Removal of implant from 0021 14.58 $758.29 $227.49 $151.66 hand. 26340..................... T Manipulate finger w/anesth. 0043 1.68 $87.38 ............ $17.48 26350..................... T Repair finger/hand tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26352..................... T Repair/graft hand tendon... 0054 23.50 $1,222.21 $472.33 $244.44 26356..................... T Repair finger/hand tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26357..................... T Repair finger/hand tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26358..................... T Repair/graft hand tendon... 0054 23.50 $1,222.21 $472.33 $244.44 26370..................... T Repair finger/hand tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26372..................... T Repair/graft hand tendon... 0054 23.50 $1,222.21 $472.33 $244.44 26373..................... T Repair finger/hand tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26390..................... T Revise hand/finger tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26392..................... T Repair/graft hand tendon... 0054 23.50 $1,222.21 $472.33 $244.44 26410..................... T Repair hand tendon......... 0053 14.76 $767.65 $253.49 $153.53 26412..................... T Repair/graft hand tendon... 0054 23.50 $1,222.21 $472.33 $244.44 26415..................... T Excision, hand/finger 0054 23.50 $1,222.21 $472.33 $244.44 tendon. 26416..................... T Graft hand or finger tendon 0054 23.50 $1,222.21 $472.33 $244.44 26418..................... T Repair finger tendon....... 0053 14.76 $767.65 $253.49 $153.53 26420..................... T Repair/graft finger tendon. 0054 23.50 $1,222.21 $472.33 $244.44 26426..................... T Repair finger/hand tendon.. 0054 23.50 $1,222.21 $472.33 $244.44 26428..................... T Repair/graft finger tendon. 0054 23.50 $1,222.21 $472.33 $244.44 26432..................... T Repair finger tendon....... 0053 14.76 $767.65 $253.49 $153.53 26433..................... T Repair finger tendon....... 0053 14.76 $767.65 $253.49 $153.53 26434..................... T Repair/graft finger tendon. 0054 23.50 $1,222.21 $472.33 $244.44 26437..................... T Realignment of tendons..... 0053 14.76 $767.65 $253.49 $153.53 26440..................... T Release palm/finger tendon. 0053 14.76 $767.65 $253.49 $153.53 26442..................... T Release palm & finger 0054 23.50 $1,222.21 $472.33 $244.44 tendon. 26445..................... T Release hand/finger tendon. 0053 14.76 $767.65 $253.49 $153.53 26449..................... T Release forearm/hand tendon 0054 23.50 $1,222.21 $472.33 $244.44 26450..................... T Incision of palm tendon.... 0053 14.76 $767.65 $253.49 $153.53 26455..................... T Incision of finger tendon.. 0053 14.76 $767.65 $253.49 $153.53 26460..................... T Incise hand/finger tendon.. 0053 14.76 $767.65 $253.49 $153.53 26471..................... T Fusion of finger tendons... 0053 14.76 $767.65 $253.49 $153.53 26474..................... T Fusion of finger tendons... 0053 14.76 $767.65 $253.49 $153.53 26476..................... T Tendon lengthening......... 0053 14.76 $767.65 $253.49 $153.53 26477..................... T Tendon shortening.......... 0053 14.76 $767.65 $253.49 $153.53 26478..................... T Lengthening of hand tendon. 0053 14.76 $767.65 $253.49 $153.53 26479..................... T Shortening of hand tendon.. 0053 14.76 $767.65 $253.49 $153.53 26480..................... T Transplant hand tendon..... 0054 23.50 $1,222.21 $472.33 $244.44 26483..................... T Transplant/graft hand 0054 23.50 $1,222.21 $472.33 $244.44 tendon. 26485..................... T Transplant palm tendon..... 0054 23.50 $1,222.21 $472.33 $244.44 26489..................... T Transplant/graft palm 0054 23.50 $1,222.21 $472.33 $244.44 tendon. 26490..................... T Revise thumb tendon........ 0054 23.50 $1,222.21 $472.33 $244.44 26492..................... T Tendon transfer with graft. 0054 23.50 $1,222.21 $472.33 $244.44 26494..................... T Hand tendon/muscle transfer 0054 23.50 $1,222.21 $472.33 $244.44 26496..................... T Revise thumb tendon........ 0054 23.50 $1,222.21 $472.33 $244.44 26497..................... T Finger tendon transfer..... 0054 23.50 $1,222.21 $472.33 $244.44 26498..................... T Finger tendon transfer..... 0054 23.50 $1,222.21 $472.33 $244.44 26499..................... T Revision of finger......... 0054 23.50 $1,222.21 $472.33 $244.44 26500..................... T Hand tendon reconstruction. 0053 14.76 $767.65 $253.49 $153.53 26502..................... T Hand tendon reconstruction. 0054 23.50 $1,222.21 $472.33 $244.44 26504..................... T Hand tendon reconstruction. 0054 23.50 $1,222.21 $472.33 $244.44 26508..................... T Release thumb contracture.. 0053 14.76 $767.65 $253.49 $153.53 26510..................... T Thumb tendon transfer...... 0054 23.50 $1,222.21 $472.33 $244.44 26516..................... T Fusion of knuckle joint.... 0054 23.50 $1,222.21 $472.33 $244.44 26517..................... T Fusion of knuckle joints... 0054 23.50 $1,222.21 $472.33 $244.44 26518..................... T Fusion of knuckle joints... 0054 23.50 $1,222.21 $472.33 $244.44 26520..................... T Release knuckle contracture 0053 14.76 $767.65 $253.49 $153.53 26525..................... T Release finger contracture. 0053 14.76 $767.65 $253.49 $153.53 [[Page 52182]] 26530..................... T Revise knuckle joint....... 0047 29.59 $1,538.95 $537.03 $307.79 26531..................... T Revise knuckle with implant 0048 36.93 $1,920.69 $633.83 $384.14 26535..................... T Revise finger joint........ 0047 29.59 $1,538.95 $537.03 $307.79 26536..................... T Revise/implant finger joint 0048 36.93 $1,920.69 $633.83 $384.14 26540..................... T Repair hand joint.......... 0053 14.76 $767.65 $253.49 $153.53 26541..................... T Repair hand joint with 0054 23.50 $1,222.21 $472.33 $244.44 graft. 26542..................... T Repair hand joint with 0053 14.76 $767.65 $253.49 $153.53 graft. 26545..................... T Reconstruct finger joint... 0054 23.50 $1,222.21 $472.33 $244.44 26546..................... T Repair nonunion hand....... 0054 23.50 $1,222.21 $472.33 $244.44 26548..................... T Reconstruct finger joint... 0054 23.50 $1,222.21 $472.33 $244.44 26550..................... T Construct thumb replacement 0054 23.50 $1,222.21 $472.33 $244.44 26551..................... C Great toe-hand transfer.... ............ ............ ............ ............ ............ 26553..................... C Single transfer, toe-hand.. ............ ............ ............ ............ ............ 26554..................... C Double transfer, toe-hand.. ............ ............ ............ ............ ............ 26555..................... T Positional change of finger 0054 23.50 $1,222.21 $472.33 $244.44 26556..................... C Toe joint transfer......... ............ ............ ............ ............ ............ 26560..................... T Repair of web finger....... 0053 14.76 $767.65 $253.49 $153.53 26561..................... T Repair of web finger....... 0054 23.50 $1,222.21 $472.33 $244.44 26562..................... T Repair of web finger....... 0054 23.50 $1,222.21 $472.33 $244.44 26565..................... T Correct metacarpal flaw.... 0054 23.50 $1,222.21 $472.33 $244.44 26567..................... T Correct finger deformity... 0054 23.50 $1,222.21 $472.33 $244.44 26568..................... T Lengthen metacarpal/finger. 0054 23.50 $1,222.21 $472.33 $244.44 26580..................... T Repair hand deformity...... 0054 23.50 $1,222.21 $472.33 $244.44 26587..................... T Reconstruct extra finger... 0053 14.76 $767.65 $253.49 $153.53 26590..................... T Repair finger deformity.... 0054 23.50 $1,222.21 $472.33 $244.44 26591..................... T Repair muscles of hand..... 0054 23.50 $1,222.21 $472.33 $244.44 26593..................... T Release muscles of hand.... 0053 14.76 $767.65 $253.49 $153.53 26596..................... T Excision constricting 0054 23.50 $1,222.21 $472.33 $244.44 tissue. 26600..................... T Treat metacarpal fracture.. 0043 1.68 $87.38 ............ $17.48 26605..................... T Treat metacarpal fracture.. 0043 1.68 $87.38 ............ $17.48 26607..................... T Treat metacarpal fracture.. 0043 1.68 $87.38 ............ $17.48 26608..................... T Treat metacarpal fracture.. 0046 29.03 $1,509.82 $535.76 $301.96 26615..................... T Treat metacarpal fracture.. 0046 29.03 $1,509.82 $535.76 $301.96 26641..................... T Treat thumb dislocation.... 0043 1.68 $87.38 ............ $17.48 26645..................... T Treat thumb fracture....... 0043 1.68 $87.38 ............ $17.48 26650..................... T Treat thumb fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 26665..................... T Treat thumb fracture....... 0046 29.03 $1,509.82 $535.76 $301.96 26670..................... T Treat hand dislocation..... 0043 1.68 $87.38 ............ $17.48 26675..................... T Treat hand dislocation..... 0043 1.68 $87.38 ............ $17.48 26676..................... T Pin hand dislocation....... 0046 29.03 $1,509.82 $535.76 $301.96 26685..................... T Treat hand dislocation..... 0046 29.03 $1,509.82 $535.76 $301.96 26686..................... T Treat hand dislocation..... 0046 29.03 $1,509.82 $535.76 $301.96 26700..................... T Treat knuckle dislocation.. 0043 1.68 $87.38 ............ $17.48 26705..................... T Treat knuckle dislocation.. 0043 1.68 $87.38 ............ $17.48 26706..................... T Pin knuckle dislocation.... 0043 1.68 $87.38 ............ $17.48 26715..................... T Treat knuckle dislocation.. 0046 29.03 $1,509.82 $535.76 $301.96 26720..................... T Treat finger fracture, each 0043 1.68 $87.38 ............ $17.48 26725..................... T Treat finger fracture, each 0043 1.68 $87.38 ............ $17.48 26727..................... T Treat finger fracture, each 0046 29.03 $1,509.82 $535.76 $301.96 26735..................... T Treat finger fracture, each 0046 29.03 $1,509.82 $535.76 $301.96 26740..................... T Treat finger fracture, each 0043 1.68 $87.38 ............ $17.48 26742..................... T Treat finger fracture, each 0043 1.68 $87.38 ............ $17.48 26746..................... T Treat finger fracture, each 0046 29.03 $1,509.82 $535.76 $301.96 26750..................... T Treat finger fracture, each 0043 1.68 $87.38 ............ $17.48 26755..................... T Treat finger fracture, each 0043 1.68 $87.38 ............ $17.48 26756..................... T Pin finger fracture, each.. 0046 29.03 $1,509.82 $535.76 $301.96 26765..................... T Treat finger fracture, each 0046 29.03 $1,509.82 $535.76 $301.96 26770..................... T Treat finger dislocation... 0043 1.68 $87.38 ............ $17.48 26775..................... T Treat finger dislocation... 0045 13.47 $700.56 $280.22 $140.11 26776..................... T Pin finger dislocation..... 0046 29.03 $1,509.82 $535.76 $301.96 26785..................... T Treat finger dislocation... 0046 29.03 $1,509.82 $535.76 $301.96 26820..................... T Thumb fusion with graft.... 0054 23.50 $1,222.21 $472.33 $244.44 26841..................... T Fusion of thumb............ 0054 23.50 $1,222.21 $472.33 $244.44 26842..................... T Thumb fusion with graft.... 0054 23.50 $1,222.21 $472.33 $244.44 26843..................... T Fusion of hand joint....... 0054 23.50 $1,222.21 $472.33 $244.44 26844..................... T Fusion/graft of hand joint. 0054 23.50 $1,222.21 $472.33 $244.44 [[Page 52183]] 26850..................... T Fusion of knuckle.......... 0054 23.50 $1,222.21 $472.33 $244.44 26852..................... T Fusion of knuckle with 0054 23.50 $1,222.21 $472.33 $244.44 graft. 26860..................... T Fusion of finger joint..... 0054 23.50 $1,222.21 $472.33 $244.44 26861..................... T Fusion of finger jnt, add- 0054 23.50 $1,222.21 $472.33 $244.44 on. 26862..................... T Fusion/graft of finger 0054 23.50 $1,222.21 $472.33 $244.44 joint. 26863..................... T Fuse/graft added joint..... 0054 23.50 $1,222.21 $472.33 $244.44 26910..................... T Amputate metacarpal bone... 0054 23.50 $1,222.21 $472.33 $244.44 26951..................... T Amputation of finger/thumb. 0053 14.76 $767.65 $253.49 $153.53 26952..................... T Amputation of finger/thumb. 0053 14.76 $767.65 $253.49 $153.53 26989..................... T Hand/finger surgery........ 0043 1.68 $87.38 ............ $17.48 26990..................... T Drainage of pelvis lesion.. 0049 19.45 $1,011.58 ............ $202.32 26991..................... T Drainage of pelvis bursa... 0049 19.45 $1,011.58 ............ $202.32 26992..................... C Drainage of bone lesion.... ............ ............ ............ ............ ............ 27000..................... T Incision of hip tendon..... 0049 19.45 $1,011.58 ............ $202.32 27001..................... T Incision of hip tendon..... 0050 23.60 $1,227.41 ............ $245.48 27003..................... T Incision of hip tendon..... 0050 23.60 $1,227.41 ............ $245.48 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 joint... 0051 34.03 $1,769.87 ............ $353.97 27035..................... T Denervation of hip joint... 0052 42.37 $2,203.62 ............ $440.72 27036..................... C Excision of hip joint/ ............ ............ ............ ............ ............ muscle. 27040..................... T Biopsy of soft tissues..... 0021 14.58 $758.29 $227.49 $151.66 27041..................... T Biopsy of soft tissues..... 0022 18.10 $941.36 $367.13 $188.27 27047..................... T Remove hip/pelvis lesion... 0022 18.10 $941.36 $367.13 $188.27 27048..................... T Remove hip/pelvis lesion... 0022 18.10 $941.36 $367.13 $188.27 27049..................... T Remove tumor, hip/pelvis... 0022 18.10 $941.36 $367.13 $188.27 27050..................... T Biopsy of sacroiliac joint. 0049 19.45 $1,011.58 ............ $202.32 27052..................... T Biopsy of hip joint........ 0049 19.45 $1,011.58 ............ $202.32 27054..................... C Removal of hip joint lining ............ ............ ............ ............ ............ 27060..................... T Removal of ischial bursa... 0049 19.45 $1,011.58 ............ $202.32 27062..................... T Remove femur lesion/bursa.. 0049 19.45 $1,011.58 ............ $202.32 27065..................... T Removal of hip bone lesion. 0049 19.45 $1,011.58 ............ $202.32 27066..................... T Removal of hip bone lesion. 0050 23.60 $1,227.41 ............ $245.48 27067..................... T Remove/graft hip bone 0050 23.60 $1,227.41 ............ $245.48 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...... ............ ............ ............ ............ ............ 27077..................... C Extensive hip surgery...... ............ ............ ............ ............ ............ 27078..................... C Extensive hip surgery...... ............ ............ ............ ............ ............ 27079..................... C Extensive hip surgery...... ............ ............ ............ ............ ............ 27080..................... T Removal of tail bone....... 0050 23.60 $1,227.41 ............ $245.48 27086..................... T Remove hip foreign body.... 0020 7.36 $382.79 $114.84 $76.56 27087..................... T Remove hip foreign body.... 0049 19.45 $1,011.58 ............ $202.32 27090..................... C Removal of hip prosthesis.. ............ ............ ............ ............ ............ 27091..................... C Removal of hip prosthesis.. ............ ............ ............ ............ ............ 27093..................... N Injection for hip x-ray.... ............ ............ ............ ............ ............ 27095..................... N Injection for hip x-ray.... ............ ............ ............ ............ ............ 27096..................... N Inject sacroiliac joint.... ............ ............ ............ ............ ............ 27097..................... T Revision of hip tendon..... 0050 23.60 $1,227.41 ............ $245.48 27098..................... T Transfer tendon to pelvis.. 0050 23.60 $1,227.41 ............ $245.48 27100..................... T Transfer of abdominal 0051 34.03 $1,769.87 ............ $353.97 muscle. 27105..................... T Transfer of spinal muscle.. 0051 34.03 $1,769.87 ............ $353.97 27110..................... T Transfer of iliopsoas 0051 34.03 $1,769.87 ............ $353.97 muscle. 27111..................... T Transfer of iliopsoas 0051 34.03 $1,769.87 ............ $353.97 muscle. 27120..................... C Reconstruction of hip ............ ............ ............ ............ ............ socket. 27122..................... C Reconstruction of hip ............ ............ ............ ............ ............ socket. 27125..................... C Partial hip replacement.... ............ ............ ............ ............ ............ 27130..................... C Total hip arthroplasty..... ............ ............ ............ ............ ............ 27132..................... C Total hip arthroplasty..... ............ ............ ............ ............ ............ 27134..................... C Revise hip joint ............ ............ ............ ............ ............ replacement. 27137..................... C Revise hip joint ............ ............ ............ ............ ............ replacement. 27138..................... C Revise hip joint ............ ............ ............ ............ ............ replacement. 27140..................... C Transplant femur ridge..... ............ ............ ............ ............ ............ [[Page 52184]] 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 Treat slipped epiphysis.... ............ ............ ............ ............ ............ 27178..................... C Treat slipped epiphysis.... ............ ............ ............ ............ ............ 27179..................... C Revise head/neck of femur.. ............ ............ ............ ............ ............ 27181..................... C Treat slipped epiphysis.... ............ ............ ............ ............ ............ 27185..................... C Revision of femur epiphysis ............ ............ ............ ............ ............ 27187..................... C Reinforce hip bones........ ............ ............ ............ ............ ............ 27193..................... T Treat pelvic ring fracture. 0043 1.68 $87.38 ............ $17.48 27194..................... T Treat pelvic ring fracture. 0045 13.47 $700.56 $280.22 $140.11 27200..................... T Treat tail bone fracture... 0043 1.68 $87.38 ............ $17.48 27202..................... T Treat tail bone fracture... 0046 29.03 $1,509.82 $535.76 $301.96 27215..................... C Treat pelvic fracture(s)... ............ ............ ............ ............ ............ 27216..................... T Treat pelvic ring fracture. 0050 23.60 $1,227.41 ............ $245.48 27217..................... C Treat pelvic ring fracture. ............ ............ ............ ............ ............ 27218..................... C Treat pelvic ring fracture. ............ ............ ............ ............ ............ 27220..................... T Treat hip socket fracture.. 0043 1.68 $87.38 ............ $17.48 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 thigh fracture....... 0043 1.68 $87.38 ............ $17.48 27232..................... C Treat thigh fracture....... ............ ............ ............ ............ ............ 27235..................... T Treat thigh fracture....... 0050 23.60 $1,227.41 ............ $245.48 27236..................... C Treat thigh fracture....... ............ ............ ............ ............ ............ 27238..................... T Treat thigh fracture....... 0043 1.68 $87.38 ............ $17.48 27240..................... C Treat thigh fracture....... ............ ............ ............ ............ ............ 27244..................... C Treat thigh fracture....... ............ ............ ............ ............ ............ 27245..................... C Treat thigh fracture....... ............ ............ ............ ............ ............ 27246..................... T Treat thigh fracture....... 0043 1.68 $87.38 ............ $17.48 27248..................... C Treat thigh fracture....... ............ ............ ............ ............ ............ 27250..................... T Treat hip dislocation...... 0043 1.68 $87.38 ............ $17.48 27252..................... T Treat hip dislocation...... 0045 13.47 $700.56 $280.22 $140.11 27253..................... C Treat hip dislocation...... ............ ............ ............ ............ ............ 27254..................... C Treat hip dislocation...... ............ ............ ............ ............ ............ 27256..................... T Treat hip dislocation...... 0043 1.68 $87.38 ............ $17.48 27257..................... T Treat hip dislocation...... 0045 13.47 $700.56 $280.22 $140.11 27258..................... C Treat hip dislocation...... ............ ............ ............ ............ ............ 27259..................... C Treat hip dislocation...... ............ ............ ............ ............ ............ 27265..................... T Treat hip dislocation...... 0043 1.68 $87.38 ............ $17.48 27266..................... T Treat hip dislocation...... 0045 13.47 $700.56 $280.22 $140.11 27275..................... T Manipulation of hip joint.. 0045 13.47 $700.56 $280.22 $140.11 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 surgery... 0043 1.68 $87.38 ............ $17.48 27301..................... T Drain thigh/knee lesion.... 0008 16.32 $848.79 ............ $169.76 27303..................... C Drainage of bone lesion.... ............ ............ ............ ............ ............ 27305..................... T Incise thigh tendon & 0049 19.45 $1,011.58 ............ $202.32 fascia. 27306..................... T Incision of thigh tendon... 0049 19.45 $1,011.58 ............ $202.32 27307..................... T Incision of thigh tendons.. 0049 19.45 $1,011.58 ............ $202.32 27310..................... T Exploration of knee joint.. 0050 23.60 $1,227.41 ............ $245.48 27315..................... T Partial removal, thigh 0220 16.66 $866.47 ............ $173.29 nerve. 27320..................... T Partial removal, thigh 0220 16.66 $866.47 ............ $173.29 nerve. 27323..................... T Biopsy, thigh soft tissues. 0021 14.58 $758.29 $227.49 $151.66 [[Page 52185]] 27324..................... T Biopsy, thigh soft tissues. 0022 18.10 $941.36 $367.13 $188.27 27327..................... T Removal of thigh lesion.... 0022 18.10 $941.36 $367.13 $188.27 27328..................... T Removal of thigh lesion.... 0022 18.10 $941.36 $367.13 $188.27 27329..................... T Remove tumor, thigh/knee... 0022 18.10 $941.36 $367.13 $188.27 27330..................... T Biopsy, knee joint lining.. 0050 23.60 $1,227.41 ............ $245.48 27331..................... T Explore/treat knee joint... 0050 23.60 $1,227.41 ............ $245.48 27332..................... T Removal of knee cartilage.. 0050 23.60 $1,227.41 ............ $245.48 27333..................... T Removal of knee cartilage.. 0050 23.60 $1,227.41 ............ $245.48 27334..................... T Remove knee joint lining... 0050 23.60 $1,227.41 ............ $245.48 27335..................... T Remove knee joint lining... 0050 23.60 $1,227.41 ............ $245.48 27340..................... T Removal of kneecap bursa... 0049 19.45 $1,011.58 ............ $202.32 27345..................... T Removal of knee cyst....... 0049 19.45 $1,011.58 ............ $202.32 27347..................... T Remove knee cyst........... 0049 19.45 $1,011.58 ............ $202.32 27350..................... T Removal of kneecap......... 0050 23.60 $1,227.41 ............ $245.48 27355..................... T Remove femur lesion........ 0050 23.60 $1,227.41 ............ $245.48 27356..................... T Remove femur lesion/graft.. 0050 23.60 $1,227.41 ............ $245.48 27357..................... T Remove femur lesion/graft.. 0050 23.60 $1,227.41 ............ $245.48 27358..................... T Remove femur lesion/ 0050 23.60 $1,227.41 ............ $245.48 fixation. 27360..................... T Partial removal, leg 0050 23.60 $1,227.41 ............ $245.48 bone(s). 27365..................... C Extensive leg surgery...... ............ ............ ............ ............ ............ 27370..................... N Injection for knee x-ray... ............ ............ ............ ............ ............ 27372..................... T Removal of foreign body.... 0022 18.10 $941.36 $367.13 $188.27 27380..................... T Repair of kneecap tendon... 0049 19.45 $1,011.58 ............ $202.32 27381..................... T Repair/graft kneecap tendon 0049 19.45 $1,011.58 ............ $202.32 27385..................... T Repair of thigh muscle..... 0049 19.45 $1,011.58 ............ $202.32 27386..................... T Repair/graft of thigh 0049 19.45 $1,011.58 ............ $202.32 muscle. 27390..................... T Incision of thigh tendon... 0049 19.45 $1,011.58 ............ $202.32 27391..................... T Incision of thigh tendons.. 0049 19.45 $1,011.58 ............ $202.32 27392..................... T Incision of thigh tendons.. 0049 19.45 $1,011.58 ............ $202.32 27393..................... T Lengthening of thigh tendon 0050 23.60 $1,227.41 ............ $245.48 27394..................... T Lengthening of thigh 0050 23.60 $1,227.41 ............ $245.48 tendons. 27395..................... T Lengthening of thigh 0051 34.03 $1,769.87 ............ $353.97 tendons. 27396..................... T Transplant of thigh tendon. 0050 23.60 $1,227.41 ............ $245.48 27397..................... T Transplants of thigh 0051 34.03 $1,769.87 ............ $353.97 tendons. 27400..................... T Revise thigh muscles/ 0051 34.03 $1,769.87 ............ $353.97 tendons. 27403..................... T Repair of knee cartilage... 0050 23.60 $1,227.41 ............ $245.48 27405..................... T Repair of knee ligament.... 0051 34.03 $1,769.87 ............ $353.97 27407..................... T Repair of knee ligament.... 0051 34.03 $1,769.87 ............ $353.97 27409..................... T Repair of knee ligaments... 0051 34.03 $1,769.87 ............ $353.97 27418..................... T Repair degenerated kneecap. 0051 34.03 $1,769.87 ............ $353.97 27420..................... T Revision of unstable 0051 34.03 $1,769.87 ............ $353.97 kneecap. 27422..................... T Revision of unstable 0051 34.03 $1,769.87 ............ $353.97 kneecap. 27424..................... T Revision/removal of kneecap 0051 34.03 $1,769.87 ............ $353.97 27425..................... T Lateral retinacular release 0050 23.60 $1,227.41 ............ $245.48 27427..................... T Reconstruction, knee....... 0052 42.37 $2,203.62 ............ $440.72 27428..................... T Reconstruction, knee....... 0052 42.37 $2,203.62 ............ $440.72 27429..................... T Reconstruction, knee....... 0052 42.37 $2,203.62 ............ $440.72 27430..................... T Revision of thigh muscles.. 0051 34.03 $1,769.87 ............ $353.97 27435..................... T Incision of knee joint..... 0051 34.03 $1,769.87 ............ $353.97 27437..................... T Revise kneecap............. 0047 29.59 $1,538.95 $537.03 $307.79 27438..................... T Revise kneecap with implant 0048 36.93 $1,920.69 $633.83 $384.14 27440..................... T Revision of knee joint..... 0047 29.59 $1,538.95 $537.03 $307.79 27441..................... T Revision of knee joint..... 0047 29.59 $1,538.95 $537.03 $307.79 27442..................... T Revision of knee joint..... 0047 29.59 $1,538.95 $537.03 $307.79 27443..................... T Revision of knee joint..... 0047 29.59 $1,538.95 $537.03 $307.79 27445..................... C Revision of knee joint..... ............ ............ ............ ............ ............ 27446..................... T Revision of knee joint..... 0681 158.14 $8,224.70 $3,289.88 $1,644.94 27447..................... C Total knee arthroplasty.... ............ ............ ............ ............ ............ 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.... ............ ............ ............ ............ ............ [[Page 52186]] 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/replace knee joint.. ............ ............ ............ ............ ............ 27487..................... C Revise/replace knee joint.. ............ ............ ............ ............ ............ 27488..................... C Removal of knee prosthesis. ............ ............ ............ ............ ............ 27495..................... C Reinforce thigh............ ............ ............ ............ ............ ............ 27496..................... T Decompression of thigh/knee 0049 19.45 $1,011.58 ............ $202.32 27497..................... T Decompression of thigh/knee 0049 19.45 $1,011.58 ............ $202.32 27498..................... T Decompression of thigh/knee 0049 19.45 $1,011.58 ............ $202.32 27499..................... T Decompression of thigh/knee 0049 19.45 $1,011.58 ............ $202.32 27500..................... T Treatment of thigh fracture 0043 1.68 $87.38 ............ $17.48 27501..................... T Treatment of thigh fracture 0043 1.68 $87.38 ............ $17.48 27502..................... T Treatment of thigh fracture 0043 1.68 $87.38 ............ $17.48 27503..................... T Treatment of thigh fracture 0043 1.68 $87.38 ............ $17.48 27506..................... C Treatment of thigh fracture ............ ............ ............ ............ ............ 27507..................... C Treatment of thigh fracture ............ ............ ............ ............ ............ 27508..................... T Treatment of thigh fracture 0043 1.68 $87.38 ............ $17.48 27509..................... T Treatment of thigh fracture 0046 29.03 $1,509.82 $535.76 $301.96 27510..................... T Treatment of thigh fracture 0043 1.68 $87.38 ............ $17.48 27511..................... C Treatment of thigh fracture ............ ............ ............ ............ ............ 27513..................... C Treatment of thigh fracture ............ ............ ............ ............ ............ 27514..................... C Treatment of thigh fracture ............ ............ ............ ............ ............ 27516..................... T Treat thigh fx growth plate 0043 1.68 $87.38 ............ $17.48 27517..................... T Treat thigh fx growth plate 0043 1.68 $87.38 ............ $17.48 27519..................... C Treat thigh fx growth plate ............ ............ ............ ............ ............ 27520..................... T Treat kneecap fracture..... 0043 1.68 $87.38 ............ $17.48 27524..................... T Treat kneecap fracture..... 0046 29.03 $1,509.82 $535.76 $301.96 27530..................... T Treat knee fracture........ 0043 1.68 $87.38 ............ $17.48 27532..................... T Treat knee fracture........ 0043 1.68 $87.38 ............ $17.48 27535..................... C Treat knee fracture........ ............ ............ ............ ............ ............ 27536..................... C Treat knee fracture........ ............ ............ ............ ............ ............ 27538..................... T Treat knee fracture(s)..... 0043 1.68 $87.38 ............ $17.48 27540..................... C Treat knee fracture........ ............ ............ ............ ............ ............ 27550..................... T Treat knee dislocation..... 0043 1.68 $87.38 ............ $17.48 27552..................... T Treat knee dislocation..... 0045 13.47 $700.56 $280.22 $140.11 27556..................... C Treat knee dislocation..... ............ ............ ............ ............ ............ 27557..................... C Treat knee dislocation..... ............ ............ ............ ............ ............ 27558..................... C Treat knee dislocation..... ............ ............ ............ ............ ............ 27560..................... T Treat kneecap dislocation.. 0043 1.68 $87.38 ............ $17.48 27562..................... T Treat kneecap dislocation.. 0045 13.47 $700.56 $280.22 $140.11 27566..................... T Treat kneecap dislocation.. 0046 29.03 $1,509.82 $535.76 $301.96 27570..................... T Fixation of knee joint..... 0045 13.47 $700.56 $280.22 $140.11 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 0049 19.45 $1,011.58 ............ $202.32 surgery. 27596..................... C Amputation follow-up ............ ............ ............ ............ ............ surgery. 27598..................... C Amputate lower leg at knee. ............ ............ ............ ............ ............ 27599..................... T Leg surgery procedure...... 0043 1.68 $87.38 ............ $17.48 27600..................... T Decompression of lower leg. 0049 19.45 $1,011.58 ............ $202.32 27601..................... T Decompression of lower leg. 0049 19.45 $1,011.58 ............ $202.32 27602..................... T Decompression of lower leg. 0049 19.45 $1,011.58 ............ $202.32 27603..................... T Drain lower leg lesion..... 0008 16.32 $848.79 ............ $169.76 27604..................... T Drain lower leg bursa...... 0049 19.45 $1,011.58 ............ $202.32 27605..................... T Incision of achilles tendon 0055 18.28 $950.72 $355.34 $190.14 27606..................... T Incision of achilles tendon 0049 19.45 $1,011.58 ............ $202.32 27607..................... T Treat lower leg bone lesion 0049 19.45 $1,011.58 ............ $202.32 27610..................... T Explore/treat ankle joint.. 0050 23.60 $1,227.41 ............ $245.48 27612..................... T Exploration of ankle joint. 0050 23.60 $1,227.41 ............ $245.48 27613..................... T Biopsy lower leg soft 0020 7.36 $382.79 $114.84 $76.56 tissue. 27614..................... T Biopsy lower leg soft 0022 18.10 $941.36 $367.13 $188.27 tissue. [[Page 52187]] 27615..................... T Remove tumor, lower leg.... 0046 29.03 $1,509.82 $535.76 $301.96 27618..................... T Remove lower leg lesion.... 0021 14.58 $758.29 $227.49 $151.66 27619..................... T Remove lower leg lesion.... 0022 18.10 $941.36 $367.13 $188.27 27620..................... T Explore/treat ankle joint.. 0050 23.60 $1,227.41 ............ $245.48 27625..................... T Remove ankle joint lining.. 0050 23.60 $1,227.41 ............ $245.48 27626..................... T Remove ankle joint lining.. 0050 23.60 $1,227.41 ............ $245.48 27630..................... T Removal of tendon lesion... 0049 19.45 $1,011.58 ............ $202.32 27635..................... T Remove lower leg bone 0050 23.60 $1,227.41 ............ $245.48 lesion. 27637..................... T Remove/graft leg bone 0050 23.60 $1,227.41 ............ $245.48 lesion. 27638..................... T Remove/graft leg bone 0050 23.60 $1,227.41 ............ $245.48 lesion. 27640..................... T Partial removal of tibia... 0051 34.03 $1,769.87 ............ $353.97 27641..................... T Partial removal of fibula.. 0050 23.60 $1,227.41 ............ $245.48 27645..................... C Extensive lower leg surgery ............ ............ ............ ............ ............ 27646..................... C Extensive lower leg surgery ............ ............ ............ ............ ............ 27647..................... T Extensive ankle/heel 0051 34.03 $1,769.87 ............ $353.97 surgery. 27648..................... N Injection for ankle x-ray.. ............ ............ ............ ............ ............ 27650..................... T Repair achilles tendon..... 0051 34.03 $1,769.87 ............ $353.97 27652..................... T Repair/graft achilles 0051 34.03 $1,769.87 ............ $353.97 tendon. 27654..................... T Repair of achilles tendon.. 0051 34.03 $1,769.87 ............ $353.97 27656..................... T Repair leg fascia defect... 0049 19.45 $1,011.58 ............ $202.32 27658..................... T Repair of leg tendon, each. 0049 19.45 $1,011.58 ............ $202.32 27659..................... T Repair of leg tendon, each. 0049 19.45 $1,011.58 ............ $202.32 27664..................... T Repair of leg tendon, each. 0049 19.45 $1,011.58 ............ $202.32 27665..................... T Repair of leg tendon, each. 0050 23.60 $1,227.41 ............ $245.48 27675..................... T Repair lower leg tendons... 0049 19.45 $1,011.58 ............ $202.32 27676..................... T Repair lower leg tendons... 0050 23.60 $1,227.41 ............ $245.48 27680..................... T Release of lower leg tendon 0050 23.60 $1,227.41 ............ $245.48 27681..................... T Release of lower leg 0050 23.60 $1,227.41 ............ $245.48 tendons. 27685..................... T Revision of lower leg 0050 23.60 $1,227.41 ............ $245.48 tendon. 27686..................... T Revise lower leg tendons... 0050 23.60 $1,227.41 ............ $245.48 27687..................... T Revision of calf tendon.... 0050 23.60 $1,227.41 ............ $245.48 27690..................... T Revise lower leg tendon.... 0051 34.03 $1,769.87 ............ $353.97 27691..................... T Revise lower leg tendon.... 0051 34.03 $1,769.87 ............ $353.97 27692..................... T Revise additional leg 0051 34.03 $1,769.87 ............ $353.97 tendon. 27695..................... T Repair of ankle ligament... 0050 23.60 $1,227.41 ............ $245.48 27696..................... T Repair of ankle ligaments.. 0050 23.60 $1,227.41 ............ $245.48 27698..................... T Repair of ankle ligament... 0050 23.60 $1,227.41 ............ $245.48 27700..................... T Revision of ankle joint.... 0047 29.59 $1,538.95 $537.03 $307.79 27702..................... C Reconstruct ankle joint.... ............ ............ ............ ............ ............ 27703..................... C Reconstruction, ankle joint ............ ............ ............ ............ ............ 27704..................... T Removal of ankle implant... 0049 19.45 $1,011.58 ............ $202.32 27705..................... T Incision of tibia.......... 0051 34.03 $1,769.87 ............ $353.97 27707..................... T Incision of fibula......... 0049 19.45 $1,011.58 ............ $202.32 27709..................... T Incision of tibia & fibula. 0050 23.60 $1,227.41 ............ $245.48 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 epiphysis.. 0050 23.60 $1,227.41 ............ $245.48 27732..................... T Repair of fibula epiphysis. 0050 23.60 $1,227.41 ............ $245.48 27734..................... T Repair lower leg epiphyses. 0050 23.60 $1,227.41 ............ $245.48 27740..................... T Repair of leg epiphyses.... 0050 23.60 $1,227.41 ............ $245.48 27742..................... T Repair of leg epiphyses.... 0051 34.03 $1,769.87 ............ $353.97 27745..................... T Reinforce tibia............ 0051 34.03 $1,769.87 ............ $353.97 27750..................... T Treatment of tibia fracture 0043 1.68 $87.38 ............ $17.48 27752..................... T Treatment of tibia fracture 0043 1.68 $87.38 ............ $17.48 27756..................... T Treatment of tibia fracture 0046 29.03 $1,509.82 $535.76 $301.96 27758..................... T Treatment of tibia fracture 0046 29.03 $1,509.82 $535.76 $301.96 27759..................... T Treatment of tibia fracture 0046 29.03 $1,509.82 $535.76 $301.96 27760..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27762..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27766..................... T Treatment of ankle fracture 0046 29.03 $1,509.82 $535.76 $301.96 27780..................... T Treatment of fibula 0043 1.68 $87.38 ............ $17.48 fracture. [[Page 52188]] 27781..................... T Treatment of fibula 0043 1.68 $87.38 ............ $17.48 fracture. 27784..................... T Treatment of fibula 0046 29.03 $1,509.82 $535.76 $301.96 fracture. 27786..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27788..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27792..................... T Treatment of ankle fracture 0046 29.03 $1,509.82 $535.76 $301.96 27808..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27810..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27814..................... T Treatment of ankle fracture 0046 29.03 $1,509.82 $535.76 $301.96 27816..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27818..................... T Treatment of ankle fracture 0043 1.68 $87.38 ............ $17.48 27822..................... T Treatment of ankle fracture 0046 29.03 $1,509.82 $535.76 $301.96 27823..................... T Treatment of ankle fracture 0046 29.03 $1,509.82 $535.76 $301.96 27824..................... T Treat lower leg fracture... 0043 1.68 $87.38 ............ $17.48 27825..................... T Treat lower leg fracture... 0043 1.68 $87.38 ............ $17.48 27826..................... T Treat lower leg fracture... 0046 29.03 $1,509.82 $535.76 $301.96 27827..................... T Treat lower leg fracture... 0046 29.03 $1,509.82 $535.76 $301.96 27828..................... T Treat lower leg fracture... 0046 29.03 $1,509.82 $535.76 $301.96 27829..................... T Treat lower leg joint...... 0046 29.03 $1,509.82 $535.76 $301.96 27830..................... T Treat lower leg dislocation 0043 1.68 $87.38 ............ $17.48 27831..................... T Treat lower leg dislocation 0043 1.68 $87.38 ............ $17.48 27832..................... T Treat lower leg dislocation 0046 29.03 $1,509.82 $535.76 $301.96 27840..................... T Treat ankle dislocation.... 0043 1.68 $87.38 ............ $17.48 27842..................... T Treat ankle dislocation.... 0045 13.47 $700.56 $280.22 $140.11 27846..................... T Treat ankle dislocation.... 0046 29.03 $1,509.82 $535.76 $301.96 27848..................... T Treat ankle dislocation.... 0046 29.03 $1,509.82 $535.76 $301.96 27860..................... T Fixation of ankle joint.... 0045 13.47 $700.56 $280.22 $140.11 27870..................... T Fusion of ankle joint...... 0051 34.03 $1,769.87 ............ $353.97 27871..................... T Fusion of tibiofibular 0051 34.03 $1,769.87 ............ $353.97 joint. 27880..................... C Amputation of lower leg.... ............ ............ ............ ............ ............ 27881..................... C Amputation of lower leg.... ............ ............ ............ ............ ............ 27882..................... C Amputation of lower leg.... ............ ............ ............ ............ ............ 27884..................... T Amputation follow-up 0049 19.45 $1,011.58 ............ $202.32 surgery. 27886..................... C Amputation follow-up ............ ............ ............ ............ ............ surgery. 27888..................... C Amputation of foot at ankle ............ ............ ............ ............ ............ 27889..................... T Amputation of foot at ankle 0050 23.60 $1,227.41 ............ $245.48 27892..................... T Decompression of leg....... 0049 19.45 $1,011.58 ............ $202.32 27893..................... T Decompression of leg....... 0049 19.45 $1,011.58 ............ $202.32 27894..................... T Decompression of leg....... 0049 19.45 $1,011.58 ............ $202.32 27899..................... T Leg/ankle surgery procedure 0043 1.68 $87.38 ............ $17.48 28001..................... T Drainage of bursa of foot.. 0008 16.32 $848.79 ............ $169.76 28002..................... T Treatment of foot infection 0049 19.45 $1,011.58 ............ $202.32 28003..................... T Treatment of foot infection 0049 19.45 $1,011.58 ............ $202.32 28005..................... T Treat foot bone lesion..... 0055 18.28 $950.72 $355.34 $190.14 28008..................... T Incision of foot fascia.... 0055 18.28 $950.72 $355.34 $190.14 28010..................... T Incision of toe tendon..... 0055 18.28 $950.72 $355.34 $190.14 28011..................... T Incision of toe tendons.... 0055 18.28 $950.72 $355.34 $190.14 28020..................... T Exploration of foot joint.. 0055 18.28 $950.72 $355.34 $190.14 28022..................... T Exploration of foot joint.. 0055 18.28 $950.72 $355.34 $190.14 28024..................... T Exploration of toe joint... 0055 18.28 $950.72 $355.34 $190.14 28030..................... T Removal of foot nerve...... 0220 16.66 $866.47 ............ $173.29 28035..................... T Decompression of tibia 0220 16.66 $866.47 ............ $173.29 nerve. 28043..................... T Excision of foot lesion.... 0021 14.58 $758.29 $227.49 $151.66 28045..................... T Excision of foot lesion.... 0055 18.28 $950.72 $355.34 $190.14 28046..................... T Resection of tumor, foot... 0055 18.28 $950.72 $355.34 $190.14 28050..................... T Biopsy of foot joint lining 0055 18.28 $950.72 $355.34 $190.14 28052..................... T Biopsy of foot joint lining 0055 18.28 $950.72 $355.34 $190.14 28054..................... T Biopsy of toe joint lining. 0055 18.28 $950.72 $355.34 $190.14 28060..................... T Partial removal, foot 0056 22.94 $1,193.09 $405.81 $238.62 fascia. 28062..................... T Removal of foot fascia..... 0056 22.94 $1,193.09 $405.81 $238.62 28070..................... T Removal of foot joint 0056 22.94 $1,193.09 $405.81 $238.62 lining. 28072..................... T Removal of foot joint 0056 22.94 $1,193.09 $405.81 $238.62 lining. 28080..................... T Removal of foot lesion..... 0055 18.28 $950.72 $355.34 $190.14 28086..................... T Excise foot tendon sheath.. 0055 18.28 $950.72 $355.34 $190.14 28088..................... T Excise foot tendon sheath.. 0055 18.28 $950.72 $355.34 $190.14 28090..................... T Removal of foot lesion..... 0055 18.28 $950.72 $355.34 $190.14 28092..................... T Removal of toe lesions..... 0055 18.28 $950.72 $355.34 $190.14 [[Page 52189]] 28100..................... T Removal of ankle/heel 0055 18.28 $950.72 $355.34 $190.14 lesion. 28102..................... T Remove/graft foot lesion... 0056 22.94 $1,193.09 $405.81 $238.62 28103..................... T Remove/graft foot lesion... 0056 22.94 $1,193.09 $405.81 $238.62 28104..................... T Removal of foot lesion..... 0055 18.28 $950.72 $355.34 $190.14 28106..................... T Remove/graft foot lesion... 0056 22.94 $1,193.09 $405.81 $238.62 28107..................... T Remove/graft foot lesion... 0056 22.94 $1,193.09 $405.81 $238.62 28108..................... T Removal of toe lesions..... 0055 18.28 $950.72 $355.34 $190.14 28110..................... T Part removal of metatarsal. 0056 22.94 $1,193.09 $405.81 $238.62 28111..................... T Part removal of metatarsal. 0055 18.28 $950.72 $355.34 $190.14 28112..................... T Part removal of metatarsal. 0055 18.28 $950.72 $355.34 $190.14 28113..................... T Part removal of metatarsal. 0055 18.28 $950.72 $355.34 $190.14 28114..................... T Removal of metatarsal heads 0055 18.28 $950.72 $355.34 $190.14 28116..................... T Revision of foot........... 0055 18.28 $950.72 $355.34 $190.14 28118..................... T Removal of heel bone....... 0055 18.28 $950.72 $355.34 $190.14 28119..................... T Removal of heel spur....... 0055 18.28 $950.72 $355.34 $190.14 28120..................... T Part removal of ankle/heel. 0055 18.28 $950.72 $355.34 $190.14 28122..................... T Partial removal of foot 0055 18.28 $950.72 $355.34 $190.14 bone. 28124..................... T Partial removal of toe..... 0055 18.28 $950.72 $355.34 $190.14 28126..................... T Partial removal of toe..... 0055 18.28 $950.72 $355.34 $190.14 28130..................... T Removal of ankle bone...... 0055 18.28 $950.72 $355.34 $190.14 28140..................... T Removal of metatarsal...... 0055 18.28 $950.72 $355.34 $190.14 28150..................... T Removal of toe............. 0055 18.28 $950.72 $355.34 $190.14 28153..................... T Partial removal of toe..... 0055 18.28 $950.72 $355.34 $190.14 28160..................... T Partial removal of toe..... 0055 18.28 $950.72 $355.34 $190.14 28171..................... T Extensive foot surgery..... 0055 18.28 $950.72 $355.34 $190.14 28173..................... T Extensive foot surgery..... 0055 18.28 $950.72 $355.34 $190.14 28175..................... T Extensive foot surgery..... 0055 18.28 $950.72 $355.34 $190.14 28190..................... T Removal of foot foreign 0019 3.94 $204.92 $75.82 $40.98 body. 28192..................... T Removal of foot foreign 0021 14.58 $758.29 $227.49 $151.66 body. 28193..................... T Removal of foot foreign 0021 14.58 $758.29 $227.49 $151.66 body. 28200..................... T Repair of foot tendon...... 0055 18.28 $950.72 $355.34 $190.14 28202..................... T Repair/graft of foot tendon 0056 22.94 $1,193.09 $405.81 $238.62 28208..................... T Repair of foot tendon...... 0055 18.28 $950.72 $355.34 $190.14 28210..................... T Repair/graft of foot tendon 0055 18.28 $950.72 $355.34 $190.14 28220..................... T Release of foot tendon..... 0055 18.28 $950.72 $355.34 $190.14 28222..................... T Release of foot tendons.... 0055 18.28 $950.72 $355.34 $190.14 28225..................... T Release of foot tendon..... 0055 18.28 $950.72 $355.34 $190.14 28226..................... T Release of foot tendons.... 0055 18.28 $950.72 $355.34 $190.14 28230..................... T Incision of foot tendon(s). 0055 18.28 $950.72 $355.34 $190.14 28232..................... T Incision of toe tendon..... 0055 18.28 $950.72 $355.34 $190.14 28234..................... T Incision of foot tendon.... 0055 18.28 $950.72 $355.34 $190.14 28238..................... T Revision of foot tendon.... 0056 22.94 $1,193.09 $405.81 $238.62 28240..................... T Release of big toe......... 0055 18.28 $950.72 $355.34 $190.14 28250..................... T Revision of foot fascia.... 0056 22.94 $1,193.09 $405.81 $238.62 28260..................... T Release of midfoot joint... 0056 22.94 $1,193.09 $405.81 $238.62 28261..................... T Revision of foot tendon.... 0056 22.94 $1,193.09 $405.81 $238.62 28262..................... T Revision of foot and ankle. 0056 22.94 $1,193.09 $405.81 $238.62 28264..................... T Release of midfoot joint... 0056 22.94 $1,193.09 $405.81 $238.62 28270..................... T Release of foot contracture 0055 18.28 $950.72 $355.34 $190.14 28272..................... T Release of toe joint, each. 0055 18.28 $950.72 $355.34 $190.14 28280..................... T Fusion of toes............. 0055 18.28 $950.72 $355.34 $190.14 28285..................... T Repair of hammertoe........ 0055 18.28 $950.72 $355.34 $190.14 28286..................... T Repair of hammertoe........ 0055 18.28 $950.72 $355.34 $190.14 28288..................... T Partial removal of foot 0056 22.94 $1,193.09 $405.81 $238.62 bone. 28289..................... T Repair hallux rigidus...... 0056 22.94 $1,193.09 $405.81 $238.62 28290..................... T Correction of bunion....... 0056 22.94 $1,193.09 $405.81 $238.62 28292..................... T Correction of bunion....... 0057 23.87 $1,241.45 $496.58 $248.29 28293..................... T Correction of bunion....... 0057 23.87 $1,241.45 $496.58 $248.29 28294..................... T Correction of bunion....... 0056 22.94 $1,193.09 $405.81 $238.62 28296..................... T Correction of bunion....... 0056 22.94 $1,193.09 $405.81 $238.62 28297..................... T Correction of bunion....... 0057 23.87 $1,241.45 $496.58 $248.29 28298..................... T Correction of bunion....... 0056 22.94 $1,193.09 $405.81 $238.62 28299..................... T Correction of bunion....... 0057 23.87 $1,241.45 $496.58 $248.29 28300..................... T Incision of heel bone...... 0056 22.94 $1,193.09 $405.81 $238.62 28302..................... T Incision of ankle bone..... 0056 22.94 $1,193.09 $405.81 $238.62 28304..................... T Incision of midfoot bones.. 0056 22.94 $1,193.09 $405.81 $238.62 [[Continued on page 52191]]
