|
81432
|
HCPCS
|
Hereditary Comprehensive Cancer Panel
|
10
|
10
|
—
|
—
|
$1,715.00
|
$4,655.00
|
$2,991.50
|
2025-09-10
|
|
74178
|
HCPCS
|
CT--abdomen Pelvis Wo/w IV
|
10
|
10
|
—
|
—
|
$1,660.00
|
$4,506.00
|
$2,895.50
|
2025-09-10
|
|
70543
|
HCPCS
|
MRI Orbits Face Neck W/wo
|
10
|
10
|
—
|
—
|
$1,586.00
|
$4,305.00
|
$2,766.50
|
2025-09-10
|
|
74183
|
HCPCS
|
Abd MRI Wo/w Contrast
|
10
|
10
|
—
|
—
|
$1,584.00
|
$4,301.00
|
$2,763.50
|
2025-09-10
|
|
74177,TC
|
OTHER
|
CT--abdomen Pelvis IV Only
|
10
|
10
|
—
|
—
|
$1,540.00
|
$4,180.00
|
$2,686.00
|
2025-09-10
|
|
74177
|
HCPCS
|
CT--abdomen Pelvis IV And Oral With Contrast
|
10
|
10
|
—
|
—
|
$1,540.00
|
$4,180.00
|
$2,686.00
|
2025-09-10
|
|
70546
|
HCPCS
|
MRA Head Wo/w Contr Cow
|
10
|
10
|
—
|
—
|
$1,503.00
|
$4,078.00
|
$2,621.00
|
2025-09-10
|
|
66982,RT
|
OTHER
|
Complex Cataract Surg Rt
|
10
|
10
|
—
|
—
|
$1,458.00
|
$3,959.00
|
$2,543.50
|
2025-09-10
|
|
66984,RT
|
OTHER
|
Extracap Cataract Remv Rt
|
10
|
10
|
—
|
—
|
$1,458.00
|
$3,959.00
|
$2,543.50
|
2025-09-10
|
|
66982,LT
|
OTHER
|
Complex Cataract Surg Lt
|
10
|
10
|
—
|
—
|
$1,458.00
|
$3,959.00
|
$2,543.50
|
2025-09-10
|
|
66984,LT
|
OTHER
|
Extracap Cataract Remv Lt
|
10
|
10
|
—
|
—
|
$1,458.00
|
$3,959.00
|
$2,543.50
|
2025-09-10
|
|
70553
|
HCPCS
|
Brain Wo/w Contr MRI
|
10
|
10
|
—
|
—
|
$1,444.00
|
$3,919.00
|
$2,518.50
|
2025-09-10
|
|
72158
|
HCPCS
|
L Spine Wo/w Contr MRI
|
10
|
10
|
—
|
—
|
$1,443.00
|
$3,918.00
|
$2,517.50
|
2025-09-10
|
|
72156
|
HCPCS
|
C Spine Wo/w Contr MRI
|
10
|
10
|
—
|
—
|
$1,443.00
|
$3,918.00
|
$2,517.50
|
2025-09-10
|
|
72157
|
HCPCS
|
T Spine Wo/w Contr MRI
|
10
|
10
|
—
|
—
|
$1,430.00
|
$3,882.00
|
$2,494.50
|
2025-09-10
|
|
81229
|
HCPCS
|
Chromosomal Microarray, Postnatal, ClariSure(R) Oligo-snp
|
10
|
10
|
—
|
—
|
$1,428.00
|
$3,875.00
|
$2,490.50
|
2025-09-10
|
|
81162
|
HCPCS
|
Brca1 And Brca2 Comprehensive Analysis
|
20
|
10
|
—
|
—
|
$1,260.00
|
$4,344.00
|
$2,368.50
|
2025-09-10
|
|
66983,RT
|
OTHER
|
Intracap Cataract Remv Rt
|
10
|
10
|
—
|
—
|
$1,337.00
|
$3,629.00
|
$2,332.00
|
2025-09-10
|
|
66983,LT
|
OTHER
|
Intracap Cataract Remv Lt
|
10
|
10
|
—
|
—
|
$1,337.00
|
$3,629.00
|
$2,332.00
|
2025-09-10
|
|
74175
|
HCPCS
|
CTA Abd Wo/w Contrast W/imag
|
10
|
10
|
—
|
—
|
$1,297.00
|
$3,522.00
|
$2,263.00
|
2025-09-10
|
|
73720
|
HCPCS
|
Le Rt Non Jnt Wo/w Contr
|
10
|
10
|
—
|
—
|
$1,268.00
|
$3,441.00
|
$2,211.50
|
2025-09-10
|
|
0350
|
RC
|
CT Chest/abdomen With IV Contrast
|
20
|
10
|
—
|
—
|
$1,125.00
|
$4,069.00
|
$2,149.00
|
2025-09-10
|
|
70336
|
HCPCS
|
Temporomandibular Joints
|
10
|
10
|
—
|
—
|
$1,186.00
|
$3,219.00
|
$2,068.50
|
2025-09-10
|
|
74176
|
HCPCS
|
CT Abd Pelvis W / O Contrast
|
10
|
10
|
—
|
—
|
$1,165.00
|
$3,163.00
|
$2,032.50
|
2025-09-10
|
|
74181
|
HCPCS
|
Abdomen MRI
|
10
|
10
|
—
|
—
|
$1,152.00
|
$3,126.00
|
$2,009.00
|
2025-09-10
|
|
72194
|
HCPCS
|
Pelvis Wo/w Contrast
|
10
|
10
|
—
|
—
|
$1,141.00
|
$3,096.00
|
$1,990.00
|
2025-09-10
|
|
71275
|
HCPCS
|
CTA Chest Wo/w Contr W/image
|
10
|
10
|
—
|
—
|
$1,133.00
|
$3,074.00
|
$1,976.00
|
2025-09-10
|
|
72197
|
HCPCS
|
Pelvis Wo/w Contr MRI
|
10
|
10
|
—
|
—
|
$1,113.00
|
$3,020.00
|
$1,941.00
|
2025-09-10
|
|
71552
|
HCPCS
|
MRI Chest W
|
10
|
10
|
—
|
—
|
$1,102.00
|
$2,992.00
|
$1,923.00
|
2025-09-10
|
|
71552,TC
|
OTHER
|
MRI Chest Wo/w
|
10
|
10
|
—
|
—
|
$1,102.00
|
$2,992.00
|
$1,923.00
|
2025-09-10
|
|
72126
|
HCPCS
|
Cervical Spine With Contrast
|
10
|
10
|
—
|
—
|
$1,101.00
|
$2,990.00
|
$1,921.00
|
2025-09-10
|
|
70496
|
HCPCS
|
CT Angio Head Arteries With Contrast
|
10
|
10
|
—
|
—
|
$1,093.00
|
$2,966.00
|
$1,906.00
|
2025-09-10
|
|
73702
|
HCPCS
|
Lower Extremity Rt Wo/w Contr
|
10
|
10
|
—
|
—
|
$1,083.00
|
$2,939.00
|
$1,889.00
|
2025-09-10
|
|
72132
|
HCPCS
|
CT Lumbar With Contrast
|
10
|
10
|
—
|
—
|
$1,059.00
|
$2,875.00
|
$1,847.50
|
2025-09-10
|
|
73221
|
HCPCS
|
Ue Rt Joint Wo Contrast
|
10
|
10
|
—
|
—
|
$1,045.00
|
$2,836.00
|
$1,822.50
|
2025-09-10
|
|
70488
|
HCPCS
|
Maxillofacial Wo/w Contr
|
10
|
10
|
—
|
—
|
$1,040.00
|
$2,823.00
|
$1,814.50
|
2025-09-10
|
|
70540
|
HCPCS
|
MRI Orbits Face/neck Wo
|
10
|
10
|
—
|
—
|
$1,035.00
|
$2,810.00
|
$1,805.50
|
2025-09-10
|
|
70492
|
HCPCS
|
Neck Wo/w Contrast
|
10
|
10
|
—
|
—
|
$1,033.00
|
$2,803.00
|
$1,801.50
|
2025-09-10
|
|
72149
|
HCPCS
|
L Spine W Contrast MRI
|
10
|
10
|
—
|
—
|
$1,024.00
|
$2,780.00
|
$1,786.50
|
2025-09-10
|
|
71270
|
HCPCS
|
Chest Wo/w Contrast
|
10
|
10
|
—
|
—
|
$1,021.00
|
$2,770.00
|
$1,780.50
|
2025-09-10
|
|
72129
|
HCPCS
|
Thoracic Spine With Contrast
|
10
|
10
|
—
|
—
|
$1,014.00
|
$2,753.00
|
$1,769.00
|
2025-09-10
|
|
94002
|
HCPCS
|
Ventilator Per Day Unit
|
10
|
10
|
—
|
—
|
$1,006.00
|
$2,731.00
|
$1,755.00
|
2025-09-10
|
|
72146
|
HCPCS
|
T Spine Wo Contrast MRI
|
10
|
10
|
—
|
—
|
$994.00
|
$2,697.00
|
$1,733.50
|
2025-09-10
|
|
73701
|
HCPCS
|
Lower Extremity Lt W C
|
10
|
10
|
—
|
—
|
$980.00
|
$2,660.00
|
$1,709.50
|
2025-09-10
|
|
72193
|
HCPCS
|
Pelvis W Contrast
|
10
|
10
|
—
|
—
|
$972.00
|
$2,638.00
|
$1,695.50
|
2025-09-10
|
|
70547
|
HCPCS
|
MRA Neck Wo (carotids)
|
10
|
10
|
—
|
—
|
$968.00
|
$2,627.00
|
$1,688.00
|
2025-09-10
|
|
73220
|
HCPCS
|
Ue Lt Non Jnt Wo/w Contr
|
20
|
10
|
—
|
—
|
$894.00
|
$3,111.00
|
$1,685.50
|
2025-09-10
|
|
73706
|
HCPCS
|
CTA Bilat Leg W/iv
|
30
|
10
|
—
|
—
|
$841.00
|
$3,410.00
|
$1,674.00
|
2025-09-10
|
|
72148
|
HCPCS
|
L Spine Wo Contrast MRI
|
10
|
10
|
—
|
—
|
$948.00
|
$2,573.00
|
$1,653.50
|
2025-09-10
|
|
70470
|
HCPCS
|
Head Wo/w Contrast
|
10
|
10
|
—
|
—
|
$939.00
|
$2,550.00
|
$1,638.50
|
2025-09-10
|
|
73218
|
HCPCS
|
Ue Lt Non Jnt Wo Contr
|
10
|
10
|
—
|
—
|
$933.00
|
$2,534.00
|
$1,628.00
|
2025-09-10
|
|
74170
|
HCPCS
|
Abdomen Wo/w Contrast
|
10
|
10
|
—
|
—
|
$926.00
|
$2,513.00
|
$1,615.00
|
2025-09-10
|
|
70551
|
HCPCS
|
Brain Wo Contrast MRI
|
10
|
10
|
—
|
—
|
$915.00
|
$2,483.00
|
$1,596.00
|
2025-09-10
|
|
72141
|
HCPCS
|
C Spine Wo Contrast MRI
|
10
|
10
|
—
|
—
|
$915.00
|
$2,482.00
|
$1,595.50
|
2025-09-10
|
|
25605
|
HCPCS
|
Closed Treatment Of Distal Radial Fracture
|
20
|
10
|
—
|
—
|
$877.00
|
$2,688.00
|
$1,586.50
|
2025-09-10
|
|
93976
|
HCPCS
|
Renal Doppler US - Limited
|
10
|
10
|
—
|
—
|
$908.00
|
$2,463.00
|
$1,583.50
|
2025-09-10
|
|
73721
|
HCPCS
|
Le Rt Jnt Wo Contr
|
10
|
10
|
—
|
—
|
$905.00
|
$2,456.00
|
$1,578.50
|
2025-09-10
|
|
70491
|
HCPCS
|
Neck Soft Tissue W C
|
10
|
10
|
—
|
—
|
$905.00
|
$2,456.00
|
$1,578.50
|
2025-09-10
|
|
73718
|
HCPCS
|
Le Rt Non Jnt Wo Contrast
|
10
|
10
|
—
|
—
|
$894.00
|
$2,427.00
|
$1,559.50
|
2025-09-10
|
|
72125
|
HCPCS
|
Cervical Spine Without Contrast
|
10
|
10
|
—
|
—
|
$891.00
|
$2,420.00
|
$1,554.50
|
2025-09-10
|
|
74160
|
HCPCS
|
Abdomen With Contrast
|
10
|
10
|
—
|
—
|
$887.00
|
$2,408.00
|
$1,547.50
|
2025-09-10
|
|
71260
|
HCPCS
|
Chest With Contrast
|
10
|
10
|
—
|
—
|
$887.00
|
$2,406.00
|
$1,546.50
|
2025-09-10
|
|
72195
|
HCPCS
|
Pelvis Wo Contrast MRI
|
10
|
10
|
—
|
—
|
$879.00
|
$2,385.00
|
$1,533.00
|
2025-09-10
|
|
70544
|
HCPCS
|
MRA Head Wo Cont Cow
|
10
|
10
|
—
|
—
|
$879.00
|
$2,385.00
|
$1,533.00
|
2025-09-10
|
|
P9021
|
HCPCS
|
Processing And Storage
|
60
|
10
|
—
|
—
|
$307.00
|
$4,988.00
|
$1,532.00
|
2025-09-10
|
|
72128
|
HCPCS
|
Thoracic Spine Without Contrast
|
10
|
10
|
—
|
—
|
$859.00
|
$2,332.00
|
$1,498.50
|
2025-09-10
|
|
73201
|
HCPCS
|
Upper Extremity Rt W C
|
10
|
10
|
—
|
—
|
$859.00
|
$2,330.00
|
$1,498.00
|
2025-09-10
|
|
74185
|
HCPCS
|
MRA Abdomen
|
10
|
10
|
—
|
—
|
$858.00
|
$2,328.00
|
$1,496.50
|
2025-09-10
|
|
71550
|
HCPCS
|
MRI Chest Wo
|
10
|
10
|
—
|
—
|
$845.00
|
$2,294.00
|
$1,474.00
|
2025-09-10
|
|
70460
|
HCPCS
|
Head With Contrast
|
10
|
10
|
—
|
—
|
$834.00
|
$2,263.00
|
$1,454.50
|
2025-09-10
|
|
93306
|
HCPCS
|
Echocardiogram, Complete
|
10
|
10
|
—
|
—
|
$828.00
|
$2,247.00
|
$1,444.00
|
2025-09-10
|
|
72131
|
HCPCS
|
Lumbar Spine Without Contrast
|
10
|
10
|
—
|
—
|
$816.00
|
$2,215.00
|
$1,423.50
|
2025-09-10
|
|
70481
|
HCPCS
|
Orbits W Contrast
|
10
|
10
|
—
|
—
|
$814.00
|
$2,210.00
|
$1,420.00
|
2025-09-10
|
|
73202
|
HCPCS
|
Upper Extremity Lt Wo/w Contr
|
10
|
10
|
—
|
—
|
$787.00
|
$2,137.00
|
$1,373.00
|
2025-09-10
|
|
66985
|
HCPCS
|
Iridectomy
|
10
|
10
|
—
|
—
|
$770.00
|
$2,090.00
|
$1,343.00
|
2025-09-10
|
|
70490
|
HCPCS
|
Neck Soft Tissue Without C
|
10
|
10
|
—
|
—
|
$764.00
|
$2,075.00
|
$1,333.00
|
2025-09-10
|
|
86711
|
HCPCS
|
Stratify Jcv Antibody (with Index) With Reflex To Inhibit -- Quest
|
10
|
10
|
—
|
—
|
$759.00
|
$2,060.00
|
$1,324.00
|
2025-09-10
|
|
70482
|
HCPCS
|
Orbit Wo/w Contrast
|
10
|
10
|
—
|
—
|
$758.00
|
$2,057.00
|
$1,322.00
|
2025-09-10
|
|
70486,TC
|
OTHER
|
CT--sinuses--multisection Coronal Sagittal
|
10
|
10
|
—
|
—
|
$754.00
|
$2,046.00
|
$1,315.00
|
2025-09-10
|
|
94003
|
HCPCS
|
Ventilator Per Day Subseq
|
10
|
10
|
—
|
—
|
$746.00
|
$2,025.00
|
$1,301.50
|
2025-09-10
|
|
70487
|
HCPCS
|
Maxillofacial W Contrast
|
10
|
10
|
—
|
—
|
$746.00
|
$2,024.00
|
$1,300.50
|
2025-09-10
|
|
73700
|
HCPCS
|
Lower Extremity Lt Without C
|
10
|
10
|
—
|
—
|
$735.00
|
$1,995.00
|
$1,282.00
|
2025-09-10
|
|
72192
|
HCPCS
|
Pelvis Without Contrast
|
10
|
10
|
—
|
—
|
$729.00
|
$1,980.00
|
$1,272.00
|
2025-09-10
|
|
59410
|
HCPCS
|
Vag Deliv W/postpart Care
|
10
|
10
|
—
|
—
|
$723.00
|
$1,963.00
|
$1,261.00
|
2025-09-10
|
|
70486
|
HCPCS
|
Maxillofacial Without C
|
10
|
10
|
—
|
—
|
$710.00
|
$1,928.00
|
$1,238.50
|
2025-09-10
|
|
75733
|
HCPCS
|
CT Angio-renal Vessals-w And Wo Contrast
|
10
|
10
|
—
|
—
|
$709.00
|
$1,926.00
|
$1,237.50
|
2025-09-10
|
|
74150
|
HCPCS
|
Abdomen Without Contrast
|
10
|
10
|
—
|
—
|
$706.00
|
$1,916.00
|
$1,231.50
|
2025-09-10
|
|
0110
|
RC
|
Med/surg Room (private)
|
20
|
10
|
—
|
—
|
$666.00
|
$2,154.00
|
$1,225.50
|
2025-09-10
|
|
73200
|
HCPCS
|
Upper Extremity Lt Without C
|
10
|
10
|
—
|
—
|
$698.00
|
$1,895.00
|
$1,218.00
|
2025-09-10
|
|
35207
|
HCPCS
|
Pro Fee Repair Blood Vessel Direct Hand Finger
|
20
|
10
|
—
|
—
|
$649.00
|
$2,212.00
|
$1,215.00
|
2025-09-10
|
|
70480
|
HCPCS
|
Orbit Sella Fossa Ear Without
|
10
|
10
|
—
|
—
|
$696.00
|
$1,890.00
|
$1,214.00
|
2025-09-10
|
|
99291
|
HCPCS
|
Critcare, 1st Hr, Ip Pf
|
20
|
10
|
—
|
—
|
$497.00
|
$3,183.00
|
$1,205.00
|
2025-09-10
|
|
71250
|
HCPCS
|
Chest Without Contrast
|
10
|
10
|
—
|
—
|
$659.00
|
$1,789.00
|
$1,149.50
|
2025-09-10
|
|
45390
|
HCPCS
|
Colonscopy, Flexible; With Endoscopic Mucosal Resection
|
10
|
10
|
—
|
—
|
$648.00
|
$1,759.00
|
$1,130.50
|
2025-09-10
|
|
59409
|
HCPCS
|
Vaginal Delivery Only
|
20
|
10
|
—
|
—
|
$641.00
|
$1,759.00
|
$1,121.00
|
2025-09-10
|
|
71271
|
HCPCS
|
Chest, Low Dose, Without Contrast
|
10
|
10
|
—
|
—
|
$638.00
|
$1,733.00
|
$1,113.50
|
2025-09-10
|
|
70450
|
HCPCS
|
Head Without Contrast
|
10
|
10
|
—
|
—
|
$635.00
|
$1,724.00
|
$1,108.00
|
2025-09-10
|
|
0160
|
RC
|
Administrative Room Day
|
10
|
10
|
—
|
—
|
$630.00
|
$1,710.00
|
$1,099.00
|
2025-09-10
|
|
G0121
|
HCPCS
|
Screening Mcare Avg Risk
|
10
|
10
|
—
|
—
|
$608.00
|
$1,650.00
|
$1,060.50
|
2025-09-10
|
|
82139
|
HCPCS
|
Amino Acid Analysis, Lc/ms, Plasma
|
10
|
10
|
—
|
—
|
$608.00
|
$1,650.00
|
$1,060.50
|
2025-09-10
|
|
G0105
|
HCPCS
|
Screening Mcare High Risk
|
10
|
10
|
—
|
—
|
$608.00
|
$1,650.00
|
$1,060.50
|
2025-09-10
|
|
0123
|
RC
|
Pediatric Room
|
10
|
10
|
—
|
—
|
$596.00
|
$1,618.00
|
$1,039.50
|
2025-09-10
|
|
0129
|
RC
|
Swing Bed
|
10
|
10
|
—
|
—
|
$595.00
|
$1,615.00
|
$1,038.00
|
2025-09-10
|
|
0550
|
RC
|
Swing Bed
|
10
|
10
|
—
|
—
|
$595.00
|
$1,615.00
|
$1,038.00
|
2025-09-10
|
|
49083
|
HCPCS
|
Abdominal Paracentesis With Imaging Guidance
|
20
|
10
|
—
|
—
|
$320.00
|
$3,125.00
|
$1,010.00
|
2025-09-10
|
|
45378
|
HCPCS
|
Colonoscopy
|
10
|
10
|
—
|
—
|
$567.00
|
$1,540.00
|
$989.50
|
2025-09-10
|
|
76800
|
HCPCS
|
S.t. Back
|
10
|
10
|
—
|
—
|
$555.00
|
$1,506.00
|
$968.00
|
2025-09-10
|
|
93880
|
HCPCS
|
Doppler Scan Xcranial Bilat (carotid)
|
10
|
10
|
—
|
—
|
$533.00
|
$1,447.00
|
$930.00
|
2025-09-10
|
|
A0130
|
HCPCS
|
Non-emergency Transportation: Wheelchair Van
|
10
|
10
|
—
|
—
|
$525.00
|
$1,425.00
|
$915.50
|
2025-09-10
|
|
93925
|
HCPCS
|
Bilat Doppler Low Ext Artery
|
10
|
10
|
—
|
—
|
$524.00
|
$1,421.00
|
$913.50
|
2025-09-10
|
|
44360
|
HCPCS
|
Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Not …
|
10
|
10
|
—
|
—
|
$507.00
|
$1,376.00
|
$884.00
|
2025-09-10
|
|
0636
|
RC
|
Hydroxocobalamin 5gm Vial Suv
|
10
|
10
|
—
|
—
|
$506.00
|
$1,372.00
|
$882.00
|
2025-09-10
|
|
93975
|
HCPCS
|
Renal Doppler US - Complete
|
10
|
10
|
—
|
—
|
$505.00
|
$1,370.00
|
$880.50
|
2025-09-10
|
|
93930
|
HCPCS
|
Duplex Scan Ue Arteries/artieral
|
10
|
10
|
—
|
—
|
$497.00
|
$1,349.00
|
$867.00
|
2025-09-10
|
|
46040
|
HCPCS
|
I&d Of Ischiorectal And/or Perirectal Abcess - ProFee
|
20
|
10
|
—
|
—
|
$401.00
|
$1,915.00
|
$852.00
|
2025-09-10
|
|
93970
|
HCPCS
|
Cmpl Bilat Venous Stud US
|
10
|
10
|
—
|
—
|
$475.00
|
$1,288.00
|
$828.00
|
2025-09-10
|
|
36573
|
HCPCS
|
Insertion Of Picc With Imaging, Age 5 Or Older
|
10
|
10
|
—
|
—
|
$473.00
|
$1,282.00
|
$824.50
|
2025-09-10
|
|
81225
|
HCPCS
|
Pharmacogenomics Panel
|
10
|
10
|
—
|
—
|
$473.00
|
$1,282.00
|
$824.50
|
2025-09-10
|
|
45398
|
HCPCS
|
Colonoscopy, Flexible, With Band Ligation (hemorrhoids)
|
20
|
10
|
—
|
—
|
$290.00
|
$2,328.00
|
$823.00
|
2025-09-10
|
|
81270
|
HCPCS
|
Jak2 V617f Cascading Reflex To Exon 9,exon 12,mpl And Csf -- Quest
|
20
|
10
|
—
|
—
|
$272.00
|
$2,422.00
|
$815.50
|
2025-09-10
|
|
46230
|
HCPCS
|
Excision Of Multiple External Papillae Or Tags, Anus
|
20
|
10
|
—
|
—
|
$184.00
|
$2,992.00
|
$800.50
|
2025-09-10
|
|
43870
|
HCPCS
|
Closure Of Gastrostomy, Surgical
|
10
|
10
|
—
|
—
|
$454.00
|
$1,232.00
|
$792.00
|
2025-09-10
|
|
36430
|
HCPCS
|
Blood Administration
|
60
|
10
|
—
|
—
|
$234.00
|
$2,226.00
|
$761.50
|
2025-09-10
|
|
31605
|
HCPCS
|
Tracheostomy, Emergency Procedure, Cricothyroid
|
20
|
10
|
—
|
—
|
$373.00
|
$1,537.00
|
$747.50
|
2025-09-10
|
|
A6024
|
HCPCS
|
Collagen Matrix 5cm X 2cm
|
10
|
10
|
—
|
—
|
$426.00
|
$1,157.00
|
$743.50
|
2025-09-10
|
|
45350
|
HCPCS
|
Sigmoidoscopy, Flexible; With Band Ligation(s)
|
10
|
10
|
—
|
—
|
$426.00
|
$1,155.00
|
$742.50
|
2025-09-10
|
|
13132
|
HCPCS
|
Repair Complex,2.6-7.5 Cm
|
30
|
10
|
—
|
—
|
$316.00
|
$1,866.00
|
$737.00
|
2025-09-10
|
|
90677
|
HCPCS
|
Prevnar 20 Syr
|
10
|
10
|
—
|
—
|
$410.00
|
$1,112.00
|
$714.50
|
2025-09-10
|
|
93308
|
HCPCS
|
Echocardiogram, Limited
|
10
|
10
|
—
|
—
|
$408.00
|
$1,107.00
|
$711.50
|
2025-09-10
|
|
45331
|
HCPCS
|
Flex Sig W/biopsy
|
10
|
10
|
—
|
—
|
$405.00
|
$1,100.00
|
$707.00
|
2025-09-10
|
|
44380
|
HCPCS
|
Ileoscopy, Through Stoma; Diagnostic, Inc Collection Of Specimen(s) By Brushing…
|
10
|
10
|
—
|
—
|
$405.00
|
$1,100.00
|
$707.00
|
2025-09-10
|
|
P9034
|
HCPCS
|
Platelet Phoresis, 1 Unit
|
20
|
10
|
—
|
—
|
$327.00
|
$1,617.00
|
$704.50
|
2025-09-10
|
|
13160
|
HCPCS
|
Closure Wound/exten/compl
|
20
|
10
|
—
|
—
|
$308.00
|
$1,739.00
|
$704.00
|
2025-09-10
|
|
11771
|
HCPCS
|
Exc Pilonidal Cyst Xtensv
|
20
|
10
|
—
|
—
|
$297.00
|
$1,739.00
|
$690.00
|
2025-09-10
|
|
27562
|
HCPCS
|
Closed Txt Patel Disloc
|
20
|
10
|
—
|
—
|
$387.00
|
$1,106.00
|
$685.00
|
2025-09-10
|
|
92950
|
HCPCS
|
Cardiopulmonary Resus
|
20
|
10
|
—
|
—
|
$363.00
|
$1,216.00
|
$676.00
|
2025-09-10
|
|
15100
|
HCPCS
|
Split Graft 1st 100 Sq Cm
|
20
|
10
|
—
|
—
|
$284.00
|
$1,739.00
|
$673.50
|
2025-09-10
|
|
45333
|
HCPCS
|
Flex Sigmoid-remove Polyp
|
10
|
10
|
—
|
—
|
$386.00
|
$1,048.00
|
$673.50
|
2025-09-10
|
|
99285,PF
|
OTHER
|
ER Visit,comp,pro Fee
|
10
|
10
|
—
|
—
|
$385.00
|
$1,045.00
|
$671.50
|
2025-09-10
|
|
43246
|
HCPCS
|
Peg Tube Placement
|
10
|
10
|
—
|
—
|
$385.00
|
$1,045.00
|
$671.50
|
2025-09-10
|
|
59426
|
HCPCS
|
Antepartum Care;7 Or More
|
10
|
10
|
—
|
—
|
$383.00
|
$1,039.00
|
$668.00
|
2025-09-10
|
|
11646
|
HCPCS
|
Excise Lesion >4 Cm
|
20
|
10
|
—
|
—
|
$267.00
|
$1,739.00
|
$653.00
|
2025-09-10
|
|
47000
|
HCPCS
|
Percutaneous Liver Biopsy
|
10
|
10
|
—
|
—
|
$365.00
|
$990.00
|
$636.50
|
2025-09-10
|
|
93926
|
HCPCS
|
Uni Duplex Low Ext Lt Artery
|
10
|
10
|
—
|
—
|
$364.00
|
$989.00
|
$635.50
|
2025-09-10
|
|
36590
|
HCPCS
|
Removal Of Tunneled Central Venous Access Device, With Subcutaneous Port Or Pump…
|
20
|
10
|
—
|
—
|
$105.00
|
$2,660.00
|
$632.00
|
2025-09-10
|
|
87902
|
HCPCS
|
Hcv RNA Ns3 Genotype
|
40
|
10
|
—
|
—
|
$333.00
|
$1,147.00
|
$624.50
|
2025-09-10
|
|
81401
|
HCPCS
|
Huntington Disease Mutation Analysis
|
10
|
10
|
—
|
—
|
$355.00
|
$962.00
|
$618.50
|
2025-09-10
|
|
76805
|
HCPCS
|
OB U/s Gestation
|
10
|
10
|
—
|
—
|
$355.00
|
$962.00
|
$618.50
|
2025-09-10
|
|
11626
|
HCPCS
|
Excise Lesion >4 Cm
|
30
|
10
|
—
|
—
|
$219.00
|
$1,739.00
|
$618.00
|
2025-09-10
|
|
76700
|
HCPCS
|
Complete Abdomen U S
|
10
|
10
|
—
|
—
|
$350.00
|
$949.00
|
$610.00
|
2025-09-10
|
|
26765
|
HCPCS
|
Open Txt Dist Phalang Fx
|
20
|
10
|
—
|
—
|
$213.00
|
$1,739.00
|
$609.50
|
2025-09-10
|
|
V2787
|
HCPCS
|
Alcon Toric Lens
|
10
|
10
|
—
|
—
|
$348.00
|
$945.00
|
$607.50
|
2025-09-10
|
|
33016
|
HCPCS
|
Pericardiocentesis, Including Imaging Guide, When Performed
|
20
|
10
|
—
|
—
|
$133.00
|
$2,290.00
|
$603.00
|
2025-09-10
|
|
43235
|
HCPCS
|
Egd
|
10
|
10
|
—
|
—
|
$345.00
|
$936.00
|
$601.50
|
2025-09-10
|
|
99285
|
HCPCS
|
Emergency Dept Visit High Severity&threat Funcj
|
20
|
10
|
—
|
—
|
$138.00
|
$2,232.00
|
$598.00
|
2025-09-10
|
|
26951
|
HCPCS
|
Amputation, Finger/thumb
|
20
|
10
|
—
|
—
|
$304.00
|
$1,106.00
|
$581.50
|
2025-09-10
|
|
15200
|
HCPCS
|
Full Thck Graft Trnk<20cm
|
20
|
10
|
—
|
—
|
$302.00
|
$1,106.00
|
$579.50
|
2025-09-10
|
|
92960
|
HCPCS
|
Cardioversion, Ext
|
10
|
10
|
—
|
—
|
$330.00
|
$896.00
|
$575.50
|
2025-09-10
|
|
27301
|
HCPCS
|
Incision,deep Abcess
|
20
|
10
|
—
|
—
|
$298.00
|
$1,106.00
|
$574.50
|
2025-09-10
|
|
27550
|
HCPCS
|
Closed Treatment Of Knee Dislocation: Without Anesthesia
|
20
|
10
|
—
|
—
|
$192.00
|
$1,692.00
|
$572.00
|
2025-09-10
|
|
11446
|
HCPCS
|
Excise,lesion,>4 Cm
|
20
|
10
|
—
|
—
|
$183.00
|
$1,739.00
|
$569.50
|
2025-09-10
|
|
36558
|
HCPCS
|
Insert Tunnel Cath >=5yrs
|
20
|
10
|
—
|
—
|
$183.00
|
$1,739.00
|
$568.50
|
2025-09-10
|
|
27786
|
HCPCS
|
Closed Treatment Of Distal Fibular Fracture; Without Manipulation
|
20
|
10
|
—
|
—
|
$286.00
|
$1,154.00
|
$568.50
|
2025-09-10
|
|
45330
|
HCPCS
|
Flex Sig
|
10
|
10
|
—
|
—
|
$324.00
|
$880.00
|
$565.50
|
2025-09-10
|
|
G0104
|
HCPCS
|
Flex Sig Canc Scrn-mcare
|
10
|
10
|
—
|
—
|
$324.00
|
$880.00
|
$565.50
|
2025-09-10
|
|
44388
|
HCPCS
|
Colonscopy Through Stoma
|
10
|
10
|
—
|
—
|
$324.00
|
$880.00
|
$565.50
|
2025-09-10
|
|
94660
|
HCPCS
|
Cpap, Init&mgmt
|
10
|
10
|
—
|
—
|
$321.00
|
$872.00
|
$560.50
|
2025-09-10
|
|
28090
|
HCPCS
|
Excis Lesion Tendon Foot
|
20
|
10
|
—
|
—
|
$177.00
|
$1,739.00
|
$560.50
|
2025-09-10
|
|
93931
|
HCPCS
|
Right Ue Arterial
|
10
|
10
|
—
|
—
|
$319.00
|
$866.00
|
$556.50
|
2025-09-10
|
|
25650
|
HCPCS
|
Fracture And/or Dislocation Procedure On The Forearm And Wrist
|
20
|
10
|
—
|
—
|
$282.00
|
$1,087.00
|
$551.50
|
2025-09-10
|
|
13121
|
HCPCS
|
Repair Comp. 2.6cm-7.5cm
|
30
|
10
|
—
|
—
|
$203.00
|
$1,496.00
|
$550.50
|
2025-09-10
|
|
81220
|
HCPCS
|
Cystic Fibrosis Screen
|
10
|
10
|
—
|
—
|
$315.00
|
$855.00
|
$549.50
|
2025-09-10
|
|
86360
|
HCPCS
|
Cd4/t-helper Cell Profile (lymphocyte Subset Panel 4)
|
10
|
10
|
—
|
—
|
$315.00
|
$855.00
|
$549.50
|
2025-09-10
|
|
11426
|
HCPCS
|
Excise,lesion,4.0 Cm
|
20
|
10
|
—
|
—
|
$165.00
|
$1,739.00
|
$544.00
|
2025-09-10
|
|
27750
|
HCPCS
|
Fracture And/or Disclocation Procedure On The Leg (tibia & Fibula & Ankle Joint)
|
10
|
10
|
—
|
—
|
$308.00
|
$837.00
|
$537.50
|
2025-09-10
|
|
93320
|
HCPCS
|
Doppler Echocardiography, Pulsed Wave And/or Coninuous Wave With Spectral Display:…
|
10
|
10
|
—
|
—
|
$301.00
|
$818.00
|
$525.50
|
2025-09-10
|
|
26755
|
HCPCS
|
Phalangeal Fracture In A Finger Or A Thumb
|
20
|
10
|
—
|
—
|
$234.00
|
$1,255.00
|
$522.50
|
2025-09-10
|
|
87536
|
HCPCS
|
HIV-1 Rna, Quantitative, Real-time Pcr
|
10
|
10
|
—
|
—
|
$299.00
|
$812.00
|
$522.00
|
2025-09-10
|
|
40805
|
HCPCS
|
Remove F/b Mouth Complex
|
20
|
10
|
—
|
—
|
$147.00
|
$1,739.00
|
$520.00
|
2025-09-10
|
|
59160
|
HCPCS
|
Curettage Postpartum
|
20
|
10
|
—
|
—
|
$147.00
|
$1,739.00
|
$520.00
|
2025-09-10
|
|
77074
|
HCPCS
|
Xr--xxx Bones--views Survey
|
10
|
10
|
—
|
—
|
$298.00
|
$808.00
|
$519.00
|
2025-09-10
|
|
76604
|
HCPCS
|
Chest Ultrasound St Non Breast
|
10
|
10
|
—
|
—
|
$297.00
|
$806.00
|
$518.00
|
2025-09-10
|
|
G0438
|
HCPCS
|
Annual Wellness First Mc
|
10
|
10
|
—
|
—
|
$296.00
|
$805.00
|
$517.00
|
2025-09-10
|
|
93971
|
HCPCS
|
Limited Venous Studies US
|
10
|
10
|
—
|
—
|
$295.00
|
$802.00
|
$515.00
|
2025-09-10
|
|
76856
|
HCPCS
|
Pelvis Non OB Ultra Sound
|
10
|
10
|
—
|
—
|
$290.00
|
$788.00
|
$506.50
|
2025-09-10
|
|
11606
|
HCPCS
|
Excise Lesion >4 Cm
|
30
|
10
|
—
|
—
|
$187.00
|
$1,361.00
|
$502.00
|
2025-09-10
|
|
71111
|
HCPCS
|
Xr--ribs.bilateral--views 4
|
10
|
10
|
—
|
—
|
$287.00
|
$778.00
|
$500.00
|
2025-09-10
|
|
76801
|
HCPCS
|
OB U/s 1st Trimester
|
10
|
10
|
—
|
—
|
$286.00
|
$775.00
|
$498.50
|
2025-09-10
|
|
93321
|
HCPCS
|
Doppler Echocardiography, Pulsed Wave And/or Continuous Wave With Spectral Display…
|
10
|
10
|
—
|
—
|
$285.00
|
$773.00
|
$497.00
|
2025-09-10
|
|
20102
|
HCPCS
|
Expl Wound,abd/flank/back
|
20
|
10
|
—
|
—
|
$129.00
|
$1,739.00
|
$496.00
|
2025-09-10
|
|
76536
|
HCPCS
|
S T Neck
|
10
|
10
|
—
|
—
|
$284.00
|
$770.00
|
$495.00
|
2025-09-10
|
|
76830
|
HCPCS
|
Transvaginal Ultra Sound
|
10
|
10
|
—
|
—
|
$282.00
|
$766.00
|
$492.00
|
2025-09-10
|
|
72114
|
HCPCS
|
Xr--spine.lumbar--views 5^w Flexion & W Extension
|
10
|
10
|
—
|
—
|
$280.00
|
$759.00
|
$488.00
|
2025-09-10
|
|
93325
|
HCPCS
|
Doppler Echocardiography Color Flow Velocity Mapping
|
10
|
10
|
—
|
—
|
$279.00
|
$758.00
|
$487.00
|
2025-09-10
|
|
37785
|
HCPCS
|
Ligation Varicose Vein
|
20
|
10
|
—
|
—
|
$122.00
|
$1,739.00
|
$486.00
|
2025-09-10
|
|
86352
|
HCPCS
|
Immune Cell Function
|
10
|
10
|
—
|
—
|
$278.00
|
$753.00
|
$484.50
|
2025-09-10
|
|
11644
|
HCPCS
|
Excise Lesion 3.1-4 Cm
|
20
|
10
|
—
|
—
|
$224.00
|
$1,106.00
|
$482.00
|
2025-09-10
|
|
81332
|
HCPCS
|
Alpha-1 Antitrypsin (aat) Mutation Analysis
|
10
|
10
|
—
|
—
|
$276.00
|
$749.00
|
$481.00
|
2025-09-10
|
|
53020
|
HCPCS
|
Meatotomy, Cutting Meatus
|
20
|
10
|
—
|
—
|
$116.00
|
$1,739.00
|
$477.50
|
2025-09-10
|
|
66821,LT
|
OTHER
|
Yag Laser Lt
|
10
|
10
|
—
|
—
|
$273.00
|
$742.00
|
$476.50
|
2025-09-10
|
|
66821,RT
|
OTHER
|
Yag Laser
|
10
|
10
|
—
|
—
|
$273.00
|
$742.00
|
$476.50
|
2025-09-10
|
|
12042
|
HCPCS
|
Layer Closure 2.6-7.5 Cm
|
30
|
10
|
—
|
—
|
$254.00
|
$866.00
|
$475.50
|
2025-09-10
|
|
12051
|
HCPCS
|
Layer Closure <2.5cm
|
30
|
10
|
—
|
—
|
$250.00
|
$891.00
|
$474.50
|
2025-09-10
|
|
43249
|
HCPCS
|
Egd Balln Dil
|
20
|
10
|
—
|
—
|
$162.00
|
$1,376.00
|
$473.50
|
2025-09-10
|
|
43248
|
HCPCS
|
Egd Dil W/guidewire
|
20
|
10
|
—
|
—
|
$162.00
|
$1,376.00
|
$473.50
|
2025-09-10
|
|
43244
|
HCPCS
|
Egd W/banding Varices
|
20
|
10
|
—
|
—
|
$162.00
|
$1,376.00
|
$473.50
|
2025-09-10
|
|
76870
|
HCPCS
|
Scrotum Ultrasound
|
10
|
10
|
—
|
—
|
$271.00
|
$736.00
|
$473.00
|
2025-09-10
|
|
45385
|
HCPCS
|
Colonoscopy, Flexible; With Removal Of Tumor(s), Polyp(s), Or Other Lesion(s) By…
|
20
|
10
|
—
|
—
|
$102.00
|
$1,815.00
|
$472.50
|
2025-09-10
|
|
45384
|
HCPCS
|
Colonoscopy, Flexible; With Removal Of Tumor(s), Polyp(s), Or Other Lesion(s) By…
|
20
|
10
|
—
|
—
|
$102.00
|
$1,815.00
|
$472.50
|
2025-09-10
|
|
76770
|
HCPCS
|
Abdominal Aorta Ultrasound
|
10
|
10
|
—
|
—
|
$270.00
|
$732.00
|
$470.50
|
2025-09-10
|
|
99235
|
HCPCS
|
Adm/dc Same Day-mod Ip
|
10
|
10
|
—
|
—
|
$267.00
|
$724.00
|
$465.50
|
2025-09-10
|
|
11642
|
HCPCS
|
Excise Mal Lesion 1.1-2
|
15
|
10
|
—
|
—
|
$175.00
|
$475.00
|
$464.00
|
2025-09-10
|
|
99284,PF
|
OTHER
|
ER Visit,detailed,pro Fee
|
10
|
10
|
—
|
—
|
$264.00
|
$716.00
|
$460.50
|
2025-09-10
|
|
46221
|
HCPCS
|
Hemorrhoidectomy Simple
|
10
|
10
|
—
|
—
|
$264.00
|
$715.00
|
$460.00
|
2025-09-10
|
|
41800
|
HCPCS
|
Drainage Of Abscess, Cyst, Heatoma From Dentoalveolar Structures
|
20
|
10
|
—
|
—
|
$262.00
|
$717.00
|
$458.50
|
2025-09-10
|
|
74021
|
HCPCS
|
Xr--abdomen--views 2
|
10
|
10
|
—
|
—
|
$263.00
|
$713.00
|
$458.50
|
2025-09-10
|
|
73521
|
HCPCS
|
Xr--pelvis+hip.bilateral--views
|
10
|
10
|
—
|
—
|
$263.00
|
$713.00
|
$458.50
|
2025-09-10
|
|
J1442
|
HCPCS
|
Neupogen 300 Mg/0.5ml Inj
|
10
|
10
|
—
|
—
|
$262.00
|
$712.00
|
$457.50
|
2025-09-10
|
|
26775
|
HCPCS
|
Clsd Reduct Finger Disloc
|
20
|
10
|
—
|
—
|
$202.00
|
$1,106.00
|
$454.50
|
2025-09-10
|
|
72052
|
HCPCS
|
Xr--spine.cervical--complete, Incl Oblique Flexion Ext Studies
|
10
|
10
|
—
|
—
|
$260.00
|
$705.00
|
$453.00
|
2025-09-10
|
|
36556
|
HCPCS
|
Insert Centrl Venous Cath
|
30
|
10
|
—
|
—
|
$84.00
|
$2,255.00
|
$452.00
|
2025-09-10
|
|
25600
|
HCPCS
|
Closed T/x,radial Fractur
|
30
|
10
|
—
|
—
|
$177.00
|
$1,222.00
|
$450.00
|
2025-09-10
|
|
43251
|
HCPCS
|
Egd, Flexible, Transoral, With Removal Of Tumor(s), Polyp(s) Or Other Lesion(s) …
|
20
|
10
|
—
|
—
|
$162.00
|
$1,247.00
|
$450.00
|
2025-09-10
|
|
12041
|
HCPCS
|
Layer Closure <2.5cm
|
20
|
10
|
—
|
—
|
$231.00
|
$844.00
|
$443.00
|
2025-09-10
|
|
99284
|
HCPCS
|
Emergency Department Visit High/urgent Severity
|
20
|
10
|
—
|
—
|
$113.00
|
$1,567.00
|
$442.50
|
2025-09-10
|
|
23655
|
HCPCS
|
Clos Tx Shldr Disloc,anes
|
20
|
10
|
—
|
—
|
$192.00
|
$1,106.00
|
$442.00
|
2025-09-10
|
|
31500
|
HCPCS
|
Intubation - Ip
|
20
|
10
|
—
|
—
|
$238.00
|
$789.00
|
$441.50
|
2025-09-10
|
|
76857
|
HCPCS
|
Pelvis Non OB Ultra Sound Limited
|
10
|
10
|
—
|
—
|
$251.00
|
$682.00
|
$438.00
|
2025-09-10
|
|
85305
|
HCPCS
|
Protein S Antigen, Total And Free
|
10
|
10
|
—
|
—
|
$251.00
|
$681.00
|
$438.00
|
2025-09-10
|
|
21930
|
HCPCS
|
Excision Tumor Back/flank
|
20
|
10
|
—
|
—
|
$185.00
|
$1,106.00
|
$434.00
|
2025-09-10
|
|
11624
|
HCPCS
|
Excise Lesion 3.1-4 Cm
|
30
|
10
|
—
|
—
|
$183.00
|
$1,106.00
|
$431.50
|
2025-09-10
|
|
31720
|
HCPCS
|
Naso Tracheal Suction
|
10
|
10
|
—
|
—
|
$247.00
|
$670.00
|
$430.50
|
2025-09-10
|
|
76815
|
HCPCS
|
OB Ultra Sound Limited
|
10
|
10
|
—
|
—
|
$245.00
|
$666.00
|
$428.00
|
2025-09-10
|
|
81335
|
HCPCS
|
Thiopurine S-methyltransferase(tpmt) Genotype -- Quest
|
10
|
10
|
—
|
—
|
$245.00
|
$664.00
|
$427.00
|
2025-09-10
|
|
12057
|
HCPCS
|
Layer Closure >30 Cm
|
30
|
10
|
—
|
—
|
$117.00
|
$1,449.00
|
$425.00
|
2025-09-10
|
|
0120
|
RC
|
Med/surg Room (semi-private)
|
50
|
10
|
—
|
—
|
$1.00
|
$2,154.00
|
$424.50
|
2025-09-10
|
|
82671
|
HCPCS
|
Estrogens, Fractionated, Lc/ms/ms
|
10
|
10
|
—
|
—
|
$243.00
|
$660.00
|
$424.00
|
2025-09-10
|
|
27614
|
HCPCS
|
Biopsy Lower Leg Soft Tis
|
10
|
10
|
—
|
—
|
$243.00
|
$660.00
|
$424.00
|
2025-09-10
|
|
82652
|
HCPCS
|
Vitamin D, 1,25-dihydroxy, Lc/ms/ms
|
10
|
10
|
—
|
—
|
$243.00
|
$660.00
|
$424.00
|
2025-09-10
|
|
99292
|
HCPCS
|
Critcare,add 30min,profee
|
20
|
10
|
—
|
—
|
$205.00
|
$910.00
|
$422.50
|
2025-09-10
|
|
12046
|
HCPCS
|
Layer Closure,20.1-30.0 Cm
|
20
|
10
|
—
|
—
|
$152.00
|
$1,171.00
|
$422.00
|
2025-09-10
|
|
87517
|
HCPCS
|
Hepatitis B Virus Dna, Quantitative, Real-time Pcr
|
10
|
10
|
—
|
—
|
$239.00
|
$650.00
|
$417.50
|
2025-09-10
|
|
23650
|
HCPCS
|
Closed Treatment Shoulder Dislocation
|
30
|
10
|
—
|
—
|
$122.00
|
$1,149.00
|
$417.00
|
2025-09-10
|
|
94762
|
HCPCS
|
Overnight Oximetry
|
10
|
10
|
—
|
—
|
$237.00
|
$644.00
|
$414.00
|
2025-09-10
|
|
12056
|
HCPCS
|
Layer Closure 20.1-30 Cm
|
30
|
10
|
—
|
—
|
$117.00
|
$1,378.00
|
$412.00
|
2025-09-10
|
|
59425
|
HCPCS
|
Antepartum Care Only;4-6
|
10
|
10
|
—
|
—
|
$236.00
|
$641.00
|
$412.00
|
2025-09-10
|
|
94618
|
HCPCS
|
Pulmonary Stress Testing (eg, 6-minute Walk Test), Including Measurement Of Hear…
|
10
|
10
|
—
|
—
|
$236.00
|
$640.00
|
$411.50
|
2025-09-10
|
|
45020
|
HCPCS
|
I&d Deep Supralevator Abs
|
20
|
10
|
—
|
—
|
$167.00
|
$1,106.00
|
$411.50
|
2025-09-10
|
|
92977
|
HCPCS
|
Thrombolysis,iv
|
10
|
10
|
—
|
—
|
$233.00
|
$634.00
|
$407.00
|
2025-09-10
|
|
26160
|
HCPCS
|
Exc Les Of Tendon Sheath
|
20
|
10
|
—
|
—
|
$159.00
|
$1,106.00
|
$407.00
|
2025-09-10
|
|
87799
|
HCPCS
|
Adenovirus Dna, Quantitative Real-time Pcr
|
30
|
10
|
—
|
—
|
$213.00
|
$769.00
|
$406.50
|
2025-09-10
|
|
84445
|
HCPCS
|
Tsi
|
10
|
10
|
—
|
—
|
$232.00
|
$630.00
|
$404.50
|
2025-09-10
|
|
72110
|
HCPCS
|
Xr--spine.lumbar--views 5
|
10
|
10
|
—
|
—
|
$232.00
|
$630.00
|
$404.50
|
2025-09-10
|
|
20103
|
HCPCS
|
Explore Penetrating Wound
|
20
|
10
|
—
|
—
|
$148.00
|
$1,106.00
|
$404.00
|
2025-09-10
|
|
59414
|
HCPCS
|
Deliver Placenta Separate
|
10
|
10
|
—
|
—
|
$231.00
|
$627.00
|
$403.00
|
2025-09-10
|
|
45915
|
HCPCS
|
Remove Rectal Obstruction
|
20
|
10
|
—
|
—
|
$146.00
|
$1,106.00
|
$401.50
|
2025-09-10
|
|
76817
|
HCPCS
|
Transvaginal OB U/s
|
10
|
10
|
—
|
—
|
$229.00
|
$620.00
|
$399.00
|
2025-09-10
|
|
11643
|
HCPCS
|
Excise Lesion 2.1-3 Cm
|
20
|
10
|
—
|
—
|
$203.00
|
$791.00
|
$398.00
|
2025-09-10
|
|
45380
|
HCPCS
|
Colonoscopy, Flexible; With Biopsy, Single Or Multiple
|
20
|
10
|
—
|
—
|
$61.00
|
$1,704.00
|
$396.50
|
2025-09-10
|
|
27810
|
HCPCS
|
Closed Treatment Of Bimalleolar Ankle Fracture With Manipulation
|
20
|
10
|
—
|
—
|
$217.00
|
$665.00
|
$392.50
|
2025-09-10
|
|
66761
|
HCPCS
|
Laser Periph Iridotomy Lt
|
10
|
10
|
—
|
—
|
$225.00
|
$610.00
|
$392.00
|
2025-09-10
|
|
65855
|
HCPCS
|
Trabeculoplasty
|
10
|
10
|
—
|
—
|
$225.00
|
$610.00
|
$392.00
|
2025-09-10
|
|
11406
|
HCPCS
|
Excise,lesion,>4.0cm
|
20
|
10
|
—
|
—
|
$138.00
|
$1,106.00
|
$390.50
|
2025-09-10
|
|
74022
|
HCPCS
|
Xr--abdomen--views 3
|
10
|
10
|
—
|
—
|
$223.00
|
$605.00
|
$389.00
|
2025-09-10
|
|
45381
|
HCPCS
|
Colonoscopy, Flexible; With Directed Submucosal Injection(s), Any Substance
|
20
|
10
|
—
|
—
|
$57.00
|
$1,694.00
|
$389.00
|
2025-09-10
|
|
91322
|
HCPCS
|
Spike-vax 2023-2024 (12^)
|
10
|
10
|
—
|
—
|
$223.00
|
$604.00
|
$388.50
|
2025-09-10
|
|
12047
|
HCPCS
|
Layer Closure >30 Cm
|
30
|
10
|
—
|
—
|
$117.00
|
$1,270.00
|
$387.00
|
2025-09-10
|
|
11750
|
HCPCS
|
Excise,nail Part/complete
|
20
|
10
|
—
|
—
|
$138.00
|
$1,087.00
|
$387.00
|
2025-09-10
|
|
76380
|
HCPCS
|
Sinuses Limited Or Follow Up CT
|
10
|
10
|
—
|
—
|
$221.00
|
$600.00
|
$385.50
|
2025-09-10
|
|
27780
|
HCPCS
|
Closed Treatment Of Proximal Fibula Or Shaft Fracture
|
10
|
10
|
—
|
—
|
$221.00
|
$598.00
|
$385.00
|
2025-09-10
|
|
13100
|
HCPCS
|
Repair,complex 1.1-2.5 Cm
|
30
|
10
|
—
|
—
|
$154.00
|
$1,038.00
|
$383.00
|
2025-09-10
|
|
76641
|
HCPCS
|
Breast Rt Ultra Sound
|
10
|
10
|
—
|
—
|
$219.00
|
$595.00
|
$382.00
|
2025-09-10
|
|
70150
|
HCPCS
|
Xr--facial Bones--views 3
|
10
|
10
|
—
|
—
|
$219.00
|
$594.00
|
$381.50
|
2025-09-10
|
|
L0454
|
HCPCS
|
Lower Spine Support Brace - Vista 464 Tlso
|
10
|
10
|
—
|
—
|
$218.00
|
$591.00
|
$380.00
|
2025-09-10
|
|
99236
|
HCPCS
|
Adm/dc Same Day-high Ip
|
20
|
10
|
—
|
—
|
$168.00
|
$901.00
|
$375.50
|
2025-09-10
|
|
11603
|
HCPCS
|
Excise Lesion 2.1-3 Cm
|
30
|
10
|
—
|
—
|
$178.00
|
$835.00
|
$375.50
|
2025-09-10
|
|
70130
|
HCPCS
|
Xr--mastoid.right--views 3
|
10
|
10
|
—
|
—
|
$215.00
|
$584.00
|
$375.50
|
2025-09-10
|
|
87522
|
HCPCS
|
Hepatitis C Virus Rna, Quantitative, Real-time Pcr
|
10
|
10
|
—
|
—
|
$214.00
|
$580.00
|
$372.50
|
2025-09-10
|
|
74250
|
HCPCS
|
Xr--abdomen--views (sitzmark)
|
10
|
10
|
—
|
—
|
$213.00
|
$579.00
|
$371.50
|
2025-09-10
|
|
99395,MP
|
OTHER
|
Scorpio Gold Phys
|
10
|
10
|
—
|
—
|
$212.00
|
$577.00
|
$370.50
|
2025-09-10
|
|
87910
|
HCPCS
|
Cytomegalovirus (cmv) Genotype
|
10
|
10
|
—
|
—
|
$212.00
|
$577.00
|
$370.50
|
2025-09-10
|
|
81256
|
HCPCS
|
Hereditary Hemochromatosis DNA Mutation Analysis
|
20
|
10
|
—
|
—
|
$186.00
|
$749.00
|
$369.00
|
2025-09-10
|
|
72050
|
HCPCS
|
Xr--spine.cervical--views 4 Or 5
|
10
|
10
|
—
|
—
|
$211.00
|
$574.00
|
$368.50
|
2025-09-10
|
|
11444
|
HCPCS
|
Excise,lesion,3.1-4 Cm
|
20
|
10
|
—
|
—
|
$178.00
|
$791.00
|
$367.50
|
2025-09-10
|
|
41008
|
HCPCS
|
Intraoral I&d Of Abscess, Cyst, Or Hematoma Tongue And Mouth
|
10
|
10
|
—
|
—
|
$210.00
|
$570.00
|
$366.50
|
2025-09-10
|
|
12037
|
HCPCS
|
Layer Closure >30.0 Cm
|
30
|
10
|
—
|
—
|
$117.00
|
$1,478.00
|
$366.50
|
2025-09-10
|
|
11012
|
HCPCS
|
Debride Inc Remov Foreign
|
20
|
10
|
—
|
—
|
$175.00
|
$797.00
|
$365.00
|
2025-09-10
|
|
76705
|
HCPCS
|
Limited Abdomen U S
|
20
|
10
|
—
|
—
|
$175.00
|
$782.00
|
$361.50
|
2025-09-10
|
|
11424
|
HCPCS
|
Excise,lesion,3.1-4 Cm
|
20
|
10
|
—
|
—
|
$116.00
|
$1,106.00
|
$361.00
|
2025-09-10
|
|
12055
|
HCPCS
|
Layer Closure 12.6-20 Cm
|
30
|
10
|
—
|
—
|
$117.00
|
$1,326.00
|
$359.00
|
2025-09-10
|
|
13101
|
HCPCS
|
Repair,complex 2.6-7.5 Cm
|
30
|
10
|
—
|
—
|
$112.00
|
$1,115.00
|
$357.50
|
2025-09-10
|
|
11622
|
HCPCS
|
Excise Lesion 1.1-2 Cm
|
30
|
10
|
—
|
—
|
$162.00
|
$844.00
|
$357.00
|
2025-09-10
|
|
42330
|
HCPCS
|
Sialolithotomy Uncomplica
|
20
|
10
|
—
|
—
|
$111.00
|
$1,106.00
|
$353.50
|
2025-09-10
|
|
55250
|
HCPCS
|
Vasectomy
|
10
|
10
|
—
|
—
|
$203.00
|
$550.00
|
$353.50
|
2025-09-10
|
|
L8610
|
HCPCS
|
Ocular Implant
|
10
|
10
|
—
|
—
|
$203.00
|
$550.00
|
$353.50
|
2025-09-10
|
|
46945
|
HCPCS
|
Ligation Of Hemorrhoids
|
10
|
10
|
—
|
—
|
$203.00
|
$550.00
|
$353.50
|
2025-09-10
|
|
81226
|
HCPCS
|
Cytochrome P450 2d6 Genotype -- Quest
|
10
|
10
|
—
|
—
|
$202.00
|
$548.00
|
$352.50
|
2025-09-10
|
|
96365
|
HCPCS
|
Therapeutic 16-60 Min
|
10
|
10
|
—
|
—
|
$202.00
|
$547.00
|
$352.00
|
2025-09-10
|
|
11623
|
HCPCS
|
Excise Lesion 2.1-3 Cm
|
30
|
10
|
—
|
—
|
$153.00
|
$874.00
|
$351.50
|
2025-09-10
|
|
12053
|
HCPCS
|
Layer Closure, 5.1-7.5 Cm
|
30
|
10
|
—
|
—
|
$103.00
|
$1,001.00
|
$350.50
|
2025-09-10
|