NJ PIP Fee Schedule Exhibit 7: Hospital Outpatient Surgical Facility Fees

Exhibit 7 prices the facility half of a surgical procedure performed in a hospital outpatient surgical facility. Its 1,263 rows carry a North and a South amount for each code, and that amount is the maximum reimbursable to the facility. The surgeon's own service is priced separately, on Exhibit 1.

1,263 rows · Appendix Exhibit 7 · 135 codes exempt from the multiple procedure reduction · does not apply in an emergency room

The schedule001

Exhibit 7 in full, all 1,263 rows

How to read this table

North, South: The facility fee, chosen by the region where the service was rendered (11:3-29.4(b)).
not listed: The source file leaves the cell empty. 11:3-29.4(a) and 29.4(e) price a service that is not on this schedule, and FAQ Answer 8 confirms the rule puts no restriction on which procedures may be performed in an HOSF. 38 rows are in this state.
X: Not subject to multiple procedure reductions, under 11:3-29.5(d)2. 135 rows.
N1: Packaged item, no separate payment. The item is paid inside another procedure. 105 rows.
AS: Ancillary service, separately payable rather than integral to the surgery. 126 rows.

Anesthesia base units, Category III and HCPCS codes

2 rows

Code	Description	North	South	Flags
0232T	NJX PLATELET PLASMA	$182.27	$156.22	AS
G0289	ARTHRO, LOOSE BODY + CHONDRO	$0.00	$0.00	X N1

Surgery, CPT 10000 to 69999

849 rows

Code	Description	North	South	Flags
10060	DRAIN SKIN ABSCESS	$404.79	$346.94
10061	DRAIN SKIN ABSCESS	$404.79	$346.94
10120	REMOVE FOREIGN BODY	$741.84	$635.83
10121	REMOVE FOREIGN BODY	$4,909.21	$4,207.68
10140	DRAIN HEMATOMA/FLUID	$3,533.67	$3,028.71
10160	PUNCTURE DRAIN LESION	$404.79	$346.94
10180	COMPLEX DRAIN WOUND	$5,485.22	$4,701.38
11000	DEBRIDE INFECTED SKIN	$741.84	$635.83
11001	DEBRIDE INFECTED SKIN, ADDED	$247.20	$211.88
11010	DEBRIDE SKIN, FX	$1,381.84	$1,184.38
11011	DEBRIDE SKIN/MUSCLE, FX	$1,381.84	$1,184.38
11012	DEBRIDE SKIN/MUSCLE/BONE, FX	$1,381.84	$1,184.38
11042	DEBRIDE SKIN/TISSUE	$741.84	$635.83
11043	DEBRIDE TISSUE/MUSCLE	$741.84	$635.83
11044	DEBRIDE TISSUE/MUSCLE/BONE	$2,306.26	$1,976.70
11045	DEBRIDE SUBQ TISSUE ADD-ON	$741.84	$635.83
11046	DEBRIDE MUSCLE/FASCIA ADD-ON	$741.84	$635.83
11047	DEBRIDE BONE ADD-ON	$2,306.26	$1,976.70
11055	TRIM SKIN LESION	$247.20	$211.88
11056	TRIM SKIN LESIONS, 2 TO 4	$247.20	$211.88
11057	TRIM SKIN LESIONS, OVER 4	$247.20	$211.88
11100	BIOPSY SKIN LESION	$406.64	$348.53
11101	BIOPSY SKIN, ADDED	$247.20	$211.88
11200	REMOVE SKIN TAGS	$247.20	$211.88
11300	SHAVE SKIN LESION	$247.20	$211.88
11301	SHAVE SKIN LESION	$247.20	$211.88
11302	SHAVE SKIN LESION	$247.20	$211.88
11305	SHAVE SKIN LESION	$247.20	$211.88
11306	SHAVE SKIN LESION	$247.20	$211.88
11310	SHAVE SKIN LESION	$247.20	$211.88
11311	SHAVE SKIN LESION	$247.20	$211.88
11400	EXCISE TRT-EXT BENIGN+MARG 0.5 < CM	$1,381.84	$1,184.38
11401	EXCISE TRT-EXT BENIGN+MARG 0.6-1 CM	$1,381.84	$1,184.38
11402	EXCISE TRT-EXT BENIGN+MARG 1.1-2 CM	$1,381.84	$1,184.38
11403	EXCISE TRT-EXT BENIGN+MARG 2.1-3 CM	$2,306.26	$1,976.70
11404	EXCISE TRT-EXT BENIGN+MARG 3.1-4 CM	$4,909.21	$4,042.57
11406	EXCISE TRT-EXT BENIGN+MARG > 4.0 CM	$4,909.21	$4,042.57
11420	EXCISE H-F-NECK-SP BENIGN+MARG 0.5 <	$2,306.26	$1,976.70
11421	EXCISE H-F-NECK-SP BENIGN+MARG 0.6-1	$2,306.26	$1,976.70
11422	EXCISE H-F-NECK-SP BENIGN+MARG 1.1-2	$2,306.26	$1,976.70
11423	EXCISE H-F-NECK-SP BENIGN+MARG 2.1-3	$4,909.21	$4,207.68
11424	EXCISE H-F-NECK-SP BENIGN+MARG 3.1-4	$4,909.21	$4,207.68
11426	EXCISE H-F-NECK-SP BENIGN+MARG > 4 CM	$6,489.68	$5,562.30
11440	EXCISE FACE-MM BENIGN+MARG 0.5 < CM	$1,381.84	$1,184.38
11441	EXCISE FACE-MM BENIGN+MARG 0.6-1 CM	$1,381.84	$1,184.38
11442	EXCISE FACE-MM BENIGN+MARG 1.1-2 CM	$2,306.26	$1,976.70
11443	EXCISE FACE-MM BENIGN+MARG 2.1-3 CM	$2,306.26	$1,976.70
11444	EXCISE FACE-MM BENIGN+MARG 3.1-4 CM	$2,306.26	$1,976.70
11719	TRIM NAIL(S)	$117.49	$100.70
11720	DEBRIDE NAIL, 1-5	$247.20	$211.88
11721	DEBRIDE NAIL, 6 OR MORE	$247.20	$211.88
11730	REMOVE NAIL PLATE	$247.20	$211.88
11732	REMOVE NAIL PLATE, ADDED	$247.20	$211.88
11740	DRAIN BLOOD UNDER NAIL	$117.49	$100.70
11750	REMOVE NAIL BED	$1,381.84	$1,184.38
11752	REMOVE NAIL BED/FINGER TIP	$6,489.68	$5,562.30
11760	REPAIR NAIL BED	$361.97	$310.24
11762	RECONSTRUCT NAIL BED	$4,673.83	$4,005.94
11765	EXCISE NAIL FOLD, TOE	$247.20	$211.88
11900	INJECTION INTO SKIN LESIONS	$247.20	$211.88
11901	ADDED SKIN LESIONS INJECTION	$247.20	$211.88
11950	THERAPY FOR CONTOUR DEFECTS	$361.97	$310.24
11951	THERAPY FOR CONTOUR DEFECTS	$361.97	$310.24
11960	INSERT TISSUE EXPANDER(S)	$6,050.71	$5,186.06
11981	INSERT DRUG IMPLANT DEVICE	$182.27	$156.22	AS
11982	REMOVE DRUG IMPLANT DEVICE	$182.27	$156.22	AS
12001	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12002	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12004	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12005	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12006	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12011	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12013	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12014	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12015	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12016	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12017	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12018	REPAIR SUPERFICIAL WOUND(S)	$361.97	$310.24
12020	CLOSE SPLIT WOUND	$1,260.61	$1,080.47
12021	CLOSE SPLIT WOUND	$858.58	$735.89
12031	INTERMED WOUND REPAIR S/TRT/EXT	$361.97	$310.24
12032	INTERMED WOUND REPAIR S/TRT/EXT	$858.58	$735.89
12034	INTERMED WOUND REPAIR S/TRT/EXT	$361.97	$310.24
12035	INTERMED WOUND REPAIR S/TRT/EXT	$361.97	$310.24
12036	INTERMED WOUND REPAIR S/TRT/EXT	$858.58	$735.89
12037	INTERMED WOUND REPAIR S/TRT/EXT	$858.58	$735.89
12041	INTERMED WOUND REPAIR N-HF/GENITAL	$361.97	$310.24
12042	INTERMED WOUND REPAIR N-HG/GENITAL	$361.97	$310.24
12044	INTERMED WOUND REPAIR N-HG/GENITAL	$361.97	$310.24
12045	INTERMED WOUND REPAIR N-HG/GENITAL	$858.58	$735.89
12046	INTERMED WOUND REPAIR N-HG/GENITAL	$858.58	$735.89
12047	INTERMED WOUND REPAIR N-HG/GENITAL	$858.58	$735.89
12051	INTERMED WOUND REPAIR FACE/MM	$858.58	$735.89
12052	INTERMED WOUND REPAIR FACE/MM	$361.97	$310.24
12053	INTERMED WOUND REPAIR FACE/MM	$361.97	$310.24
12054	INTERMED WOUND REPAIR FACE/MM	$361.97	$310.24
12055	INTERMED WOUND REPAIR FACE/MM	$858.58	$735.89
12056	INTERMED WOUND REPAIR FACE/MM	$858.58	$735.89
12057	INTERMED WOUND REPAIR FACE/MM	$858.58	$735.89
13100	REPAIR WOUND OR LESION	$1,260.61	$1,080.47
13101	REPAIR WOUND OR LESION	$1,260.61	$1,080.47
13102	REPAIR WOUND/LESION, ADDED	$1,260.61	$1,080.47
13120	REPAIR WOUND OR LESION	$858.58	$735.89
13121	REPAIR WOUND OR LESION	$858.58	$735.89
13122	REPAIR WOUND/LESION, ADDED	$361.97	$310.24
13131	REPAIR WOUND OR LESION	$858.58	$735.89
13132	REPAIR WOUND OR LESION	$1,260.61	$1,080.47
13133	REPAIR WOUND/LESION, ADDED	$858.58	$735.89
13150	REPAIR WOUND OR LESION	$1,260.61	$1,080.47
13151	REPAIR WOUND OR LESION	$1,260.61	$1,080.47
13152	REPAIR WOUND OR LESION	$1,260.61	$1,080.47
13153	REPAIR WOUND/LESION, ADDED	$858.58	$735.89
13160	LATE CLOSE WOUND	$6,050.71	$5,186.06
14000	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14001	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14020	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14021	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14040	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14041	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14060	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14061	SKIN TISSUE REARRANGEMENT	$4,673.83	$4,005.94
14301	SKIN TISSUE REARRANGEMENT	$6,050.71	$5,186.06
14302	SKIN TISSUE REARRANGE ADDED	$6,050.71	$5,186.06
15002	WOUND PREP, TRUNK/ARM/LEG	$1,260.61	$1,080.47
15003	WOUND PREP, ADDED 100 CM	$1,260.61	$1,080.47
15004	WOUND PREP, F/N/HF/G	$1,260.61	$1,080.47
15005	WOUND PREP, F/N/HF/G, ADDED CM	$1,260.61	$1,080.47
15050	SKIN PINCH GRAFT	$1,260.61	$1,080.47
15100	SKIN SPLIT GRAFT, TRUNK/ARM/LEG	$6,050.71	$5,186.06
15101	SKIN SPLIT GRAFT T/A/L, ADDED	$6,050.71	$5,186.06
15120	SKIN SPLIT A-GRAFT FAC/NECK/HF/G	$6,050.71	$5,186.06
15121	SKIN SPLIT A-GRAFT F/N/HF/G ADDED	$6,050.71	$5,186.06
15130	DERM AUTOGRAFT, TRUNK/ARM/LEG	$4,673.83	$4,005.94
15170	ACELLULAR GRAFT TRUNK/ARMS/LEGS	$1,260.61	$1,080.47
15171	ACELLULAR GRAFT T/ARM/LEG, ADDED	$858.58	$735.89
15175	ACELLULAR GRAFT, F/N/HF/G	$1,260.61	$1,080.47
15220	SKIN FULL GRAFT SCALP/ARM/LEG	$4,673.83	$4,005.94
15221	SKIN FULL GRAFT, ADDED	$1,260.61	$1,080.47
15240	SKIN FULL GRAFT FACE/GENITAL/HF	$4,673.83	$4,005.94
15241	SKIN FULL GRAFT, ADDED	$1,260.61	$1,080.47
15260	SKIN FULL GRAFT EEN & LIPS	$4,673.83	$4,005.94
15330	APPLY ACELLULAR ALLOGRAFT T/ARM/LEG	$1,260.61	$1,080.47
15331	APPLY ACELLULAR GRAFT T/A/L, ADDED	$1,260.61	$1,080.47
15340	APPLY CULT SKIN SUBSTITUTE	$858.58	$735.89
15341	APPLY CULT SKIN SUB, ADDED	$858.58	$735.89
15365	APPLY CULT DERM SUB F/N/HF/G	$858.58	$735.89
15366	APPLY CULT DERM F/HF/G ADDED	$858.58	$735.89
15430	APPLY ACELLULAR XENOGRAFT	$1,260.61	$1,080.47
15431	APPLY ACELLULAR XENOGRAFT ADDED	$1,260.61	$1,080.47
15570	FORM SKIN PEDICLE FLAP	$6,050.71	$5,186.06
15572	FORM SKIN PEDICLE FLAP	$6,050.71	$5,186.06
15574	FORM SKIN PEDICLE FLAP	$6,050.71	$5,186.06
15576	FORM SKIN PEDICLE FLAP	$6,050.71	$5,186.06
15620	SKIN GRAFT	$6,050.71	$5,186.06
15732	MUSCLE-SKIN GRAFT, HEAD/NECK	$6,050.71	$5,186.06
15734	MUSCLE-SKIN GRAFT, TRUNK	$6,050.71	$5,186.06
15736	MUSCLE-SKIN GRAFT, ARM	$6,050.71	$5,186.06
15738	MUSCLE-SKIN GRAFT, LEG	$6,050.71	$5,186.06
15770	DERMA-FAT-FASCIA GRAFT	$6,050.71	$5,186.06
15780	ABRASION TREAT SKIN	$6,489.68	$5,562.30
15781	ABRASION TREAT SKIN	$1,381.84	$1,184.38
15782	ABRASION TREAT SKIN	$1,381.84	$1,184.38
15786	ABRASION, LESION, SING	$247.20	$211.88
15787	ABRASION, LESIONS, ADDED	$247.20	$211.88
15823	REVISE UPPER EYELID	$6,050.71	$5,186.06
15830	EXCISE SKIN ABD	$6,489.68	$5,562.30
15832	EXCISE EXCESSIVE SKIN TISSUE	$6,489.68	$5,562.30
15851	REMOVE SUTURES	$741.84	$635.83
15852	DRESSING CHANGE NOT FOR BURN	$182.27	$156.22	AS
15940	REMOVE HIP PRESSURE SORE	$6,489.68	$5,562.30
15941	REMOVE HIP PRESSURE SORE	$6,489.68	$5,562.30
15944	REMOVE HIP PRESSURE SORE	$6,050.71	$5,186.06
15945	REMOVE HIP PRESSURE SORE	$6,050.71	$5,186.06
15946	REMOVE HIP PRESSURE SORE	$6,050.71	$5,186.06
15950	REMOVE THIGH PRESSURE SORE	$6,489.68	$5,562.30
15951	REMOVE THIGH PRESSURE SORE	$6,489.68	$5,562.30
15952	REMOVE THIGH PRESSURE SORE	$4,673.83	$4,005.94
15953	REMOVE THIGH PRESSURE SORE	$4,673.83	$4,005.94
15956	REMOVE THIGH PRESSURE SORE	$4,673.83	$4,005.94
15958	REMOVE THIGH PRESSURE SORE	$4,673.83	$4,005.94
16000	INITIAL TREAT BURN(S)	$247.20	$211.88
16020	DRESS/DEBRIDE P-THICK BURN, S	$406.64	$348.53
16025	DRESS/DEBRIDE P-THICK BURN, M	$406.64	$348.53
16030	DRESS/DEBRIDE P-THICK BURN, L	$406.64	$348.53
17000	DESTROY PREMALIG LESION	$247.20	$211.88
17003	DESTROY PREMALIG LES, 2-14	$117.49	$100.70
17004	DESTROY PREMALIG LESIONS 15+	$741.84	$635.83
17106	DESTROY SKIN LESIONS	$741.84	$635.83
17107	DESTROY SKIN LESIONS	$741.84	$635.83
17108	DESTROY SKIN LESIONS	$741.84	$635.83
17110	DESTROY B9 LESION, 1-14	$247.20	$211.88
17111	DSTRJ B9 SK TGS/CUTAN VASC 15/>	$406.64	$348.53
17250	CHEM CAUT GRANLTJ TISS PROUD FLESH SINUS/FSTL	$406.64	$348.53
17261	DESTROY SKIN LESIONS	$406.64	$348.53
17262	DESTROY SKIN LESIONS	$406.64	$348.53
19000	DRAIN BREAST LESION	$1,244.88	$1,066.98
19120	REMOVE BREAST LESION	$6,949.27	$5,956.21
19125	EXCISE BREAST LESION	$6,949.27	$5,956.21
19290	PLACE NEEDLE WIRE, BREAST	$0.00	$0.00	N1
20100	EXPLORE WOUND, NECK	$2,150.53	$1,843.22
20101	EXPLORE WOUND, CHEST	$6,050.71	$5,186.06
20102	EXPLORE WOUND, ABDOMEN	$6,050.71	$5,186.06
20103	EXPLORE WOUND, EXTREMITY	$3,533.67	$3,028.71
20520	REMOVE FOREIGN BODY	$6,238.69	$5,347.18
20525	REMOVE FOREIGN BODY	$6,489.68	$5,562.30
20526	THERAPEUTIC INJECTION, CARP TUNNEL	$724.57	$621.03
20550	INJECT TENDON SHEATH/LIGAMENT	$724.57	$621.03
20551	INJECT TENDON ORIGIN/INSERT	$724.57	$621.03
20552	INJECT TRIGGER POINT, 1/2 MUSCLE	$724.57	$621.03
20553	INJECT TRIGGER POINTS, =/> 3	$724.57	$621.03
20600	DRAIN/INJ, JOINT/BURSA	$724.57	$621.03
20605	DRAIN/INJ, JOINT/BURSA	$724.57	$621.03
20610	DRAIN/INJ, JOINT/BURSA	$724.57	$621.03
20612	ASPIRATE/INJECT GANGLION CYST	$724.57	$621.03
20615	TREAT BONE CYST	$1,244.88	$1,066.98
20650	INSERT & REMOVE BONE PIN	$6,238.69	$5,347.18
20660	APPLY, REM FIXATION DEVICE	$1,494.88	$1,281.26
20662	APPLY PELVIS BRACE	$6,238.69	$5,347.18
20663	APPLY THIGH BRACE	$6,238.69	$5,347.18
20665	REMOVE FIXATION DEVICE	$182.27	$156.22	AS
20670	REMOVE SUPPORT IMPLANT	$4,909.21	$4,207.68
20680	REMOVE SUPPORT IMPLANT	$6,489.68	$5,562.30
20690	APPLY BONE FIXATION DEVICE	$8,755.84	$7,504.63
20692	APPLY BONE FIXATION DEVICE	$8,755.84	$7,504.63
20693	ADJUST BONE FIXATION DEVICE	$6,238.69	$5,347.18
20694	REMOVE BONE FIXATION DEVICE	$6,238.69	$5,347.18
20696	COMP MULTIPLANE EXT FIXATION	$8,755.84	$7,504.63
20697	COMP EXT FIXATE STRUT CHANGE	$5,657.91	$4,849.39
20900	REMOVE BONE FOR GRAFT	$8,755.84	$7,504.63
20902	REMOVE BONE FOR GRAFT	$8,755.84	$7,504.63
20910	REMOVE CARTILAGE FOR GRAFT	$6,050.71	$5,186.06
20912	REMOVE CARTILAGE FOR GRAFT	$6,050.71	$5,186.06
20920	REMOVE FASCIA FOR GRAFT	$4,673.83	$4,005.94
20922	REMOVE FASCIA FOR GRAFT	$4,673.83	$4,005.94
20924	REMOVE TENDON FOR GRAFT	$8,755.84	$7,504.63
20926	REMOVE TISSUE FOR GRAFT	$1,260.61	$1,080.47
20950	FLUID PRESSURE, MUSCLE	$404.79	$346.94
20975	ELECTRICAL BONE STIMULATION	$0.00	$0.00	N1
20979	US BONE STIMULATION	$182.27	$156.22	AS
20985	COMPUTER-ASSIST DIR MS PX	$0.00	$0.00	N1
21060	REMOVE JAW JOINT CARTILAGE	$12,135.56	$10,401.38
21070	REMOVE CORONOID PROCESS	$12,135.56	$10,401.38
21073	MANIPULATE TMJ W/ANESTH	$2,150.53	$1,843.22
21085	PREPARE FACE/ORAL PROSTHESIS	$4,708.37	$4,035.54
21110	INTERDENTAL FIXATION	$2,150.53	$1,843.22
21116	INJECTION, JAW JOINT X-RAY	$0.00	$0.00	N1
21209	REDUCE FACIAL BONES	$12,135.56	$10,401.38
21210	FACE BONE GRAFT	$12,135.56	$10,401.38
21240	RECONSTRUCT JAW JOINT	$12,135.56	$10,401.38
21242	RECONSTRUCT JAW JOINT	$12,135.56	$10,401.38
21243	RECONSTRUCT JAW JOINT	$12,135.56	$10,401.38
21244	RECONSTRUCT LOWER JAW	$12,135.56	$10,401.38
21245	RECONSTRUCT JAW	$12,135.56	$10,401.38
21246	RECONSTRUCT JAW	$12,135.56	$10,401.38
21248	RECONSTRUCT JAW	$12,135.56	$10,401.38
21249	RECONSTRUCT JAW	$12,135.56	$10,401.38
21310	TREAT NOSE FX	$307.68	$263.71
21315	TREAT NOSE FX	$4,708.37	$4,035.54
21320	TREAT NOSE FX	$4,708.37	$4,035.54
21325	TREAT NOSE FX	$6,964.52	$5,969.29
21330	TREAT NOSE FX	$6,964.52	$5,969.29
21335	TREAT NOSE FX	$6,964.52	$5,969.29
21356	TREAT CHEEK BONE FX	$6,964.52	$5,969.29
21360	TREAT CHEEK BONE FX	$6,964.52	$5,969.29
21365	TREAT CHEEK BONE FX	$12,135.56	$10,401.38
21385	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21386	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21390	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21395	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21400	TREAT EYE SOCKET FX	$2,150.53	$1,843.22
21401	TREAT EYE SOCKET FX	$4,708.37	$4,035.54
21406	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21407	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21408	TREAT EYE SOCKET FX	$12,135.56	$10,401.38
21450	TREAT LOWER JAW FX	$965.03	$827.13
21451	TREAT LOWER JAW FX	$2,150.53	$1,843.22
21452	TREAT LOWER JAW FX	$4,708.37	$4,035.54
21453	TREAT LOWER JAW FX	$12,135.56	$10,401.38
21454	TREAT LOWER JAW FX	$6,964.52	$5,969.29
21461	TREAT LOWER JAW FX	$12,135.56	$10,401.38
21462	TREAT LOWER JAW FX	$12,135.56	$10,401.38
21465	TREAT LOWER JAW FX	$12,135.56	$10,401.38
21470	TREAT LOWER JAW FX	$12,135.56	$10,401.38
21800	TREAT RIB FX	$428.68	$367.42
21820	TREAT STERNUM FX	$428.68	$367.42
22222	REVISE THORAX SPINE	$13,940.72	$11,948.58
22305	TREAT SPINE PROCESS FX	$428.68	$367.42
22310	TREAT SPINE FX	$1,494.88	$1,281.26
22315	TREAT SPINE FX	$5,657.91	$4,849.39
22505	MANIPULATE SPINE	$4,222.92	$3,619.46
22520	PERCUT VERTEBROPLASTY THORACIC	$8,755.84	$7,504.63
22521	PERCUT VERTEBROPLASTY LUMBAR	$8,755.84	$7,504.63
22522	PERCUT VERTEBROPLASTY ADDED	$8,755.84	$7,504.63
22612	LUMBAR SPINE FUSION	$13,940.72	$11,948.58
22614	SPINE FUSION, EXTRA SEGMENT	$13,940.72	$11,948.58
22851	APPLY SPINE PROSTH DEVICE	$6,238.69	$5,347.18
23120	PARTIAL REMOVE COLLAR BONE	$8,755.84	$7,504.63
23125	REMOVE COLLAR BONE	$8,755.84	$7,504.63
23130	REMOVE SHOULDER BONE, PART	$12,850.12	$11,013.83
23331	REMOVE SHOULDER FOREIGN BODY	$6,489.68	$5,562.30
23350	INJECTION FOR SHOULDER X-RAY	$0.00	$0.00	N1
23405	TX SHO AREA 1 TDN	$8,755.84	$7,504.63
23406	TX SHO AREA MLT TDN THRU SM INC	$8,755.84	$7,504.63
23410	OPEN REPAIR OF ROTATOR CUFF, RECENT	$12,850.12	$11,013.83
23412	OPEN REPAIR OF ROTATOR CUFF, OLD	$12,850.12	$11,013.83
23415	CORACOACROMIAL LIGM RLS +-ACROMP	$12,850.12	$11,013.83
23420	RECONSTRUCTION ROTATOR CUFF, OLD	$12,850.12	$11,013.83
23430	TENODIS LONG TDN BICEPS	$12,850.12	$11,013.83
23440	RESCJ/TRNSPLJ LONG TDN BICEPS	$12,850.12	$11,013.83
23470	RECONSTRUCT SHOULDER JOINT	$19,460.64	$17,581.99
23480	REVISE COLLAR BONE	$12,850.12	$11,013.83
23485	REVISE COLLAR BONE	$24,164.43	$20,711.32
23500	TREAT CLAVICLE FX	$428.68	$367.42
23505	TREAT CLAVICLE FX	$5,657.91	$4,849.39
23515	TREAT CLAVICLE FX	$18,168.29	$15,572.03
23520	TREAT CLAVICLE DISLOCATION	$1,494.88	$1,281.26
23525	TREAT CLAVICLE DISLOCATION	$1,494.88	$1,281.26
23530	TREAT CLAVICLE DISLOCATION	$13,070.23	$11,202.49
23540	TREAT CLAVICLE DISLOCATION	$428.68	$367.42
23545	TREAT CLAVICLE DISLOCATION	$1,494.88	$1,281.26
23550	TREAT CLAVICLE DISLOCATION	$13,070.23	$11,202.49
23552	TREAT CLAVICLE DISLOCATION	$13,070.23	$11,202.49
23570	TREAT SHOULDER BLADE FX	$428.68	$367.42
23600	TREAT HUMERUS FX	$428.68	$367.42
23605	TREAT HUMERUS FX	$5,657.91	$4,849.39
23615	TREAT HUMERUS FX	$18,168.29	$15,572.03
23616	TREAT HUMERUS FX	$18,168.29	$15,572.03
23620	TREAT HUMERUS FX	$428.68	$367.42
23625	TREAT HUMERUS FX	$5,657.91	$4,849.39
23630	TREAT HUMERUS FX	$18,168.29	$15,572.03
23650	TREAT SHOULDER DISLOCATION	$428.68	$367.42
23655	TREAT SHOULDER DISLOCATION	$4,222.92	$3,619.46
23700	FIXATE SHOULDER	$4,222.92	$3,619.46
24220	INJECTION FOR ELBOW X-RAY	$0.00	$0.00	N1
24300	MANIPULATE ELBOW W/ANESTH	$4,222.92	$3,619.46
24305	ARM TENDON LENGTHENING	$8,755.84	$7,504.63
24340	REPAIR BICEPS TENDON	$12,850.12	$11,013.83
24341	REPAIR ARM TENDON/MUSCLE	$12,850.12	$11,013.83
24342	REPAIR RUPTURED TENDON	$12,850.12	$11,013.83
24343	REPAIR ELBOW LAT LIGAMENT W/TISS	$8,755.84	$7,504.63
24500	TREAT HUMERUS FX	$428.68	$367.42
24505	TREAT HUMERUS FX	$428.68	$367.42
24515	TREAT HUMERUS FX	$18,168.29	$15,572.03
24516	TREAT HUMERUS FX	$18,168.29	$15,572.03
24530	TREAT HUMERUS FX	$428.68	$367.42
24535	TREAT HUMERUS FX	$1,494.88	$1,281.26
24545	TREAT HUMERUS FX	$18,168.29	$15,572.03
24546	TREAT HUMERUS FX	$18,168.29	$15,572.03
24560	TREAT HUMERUS FX	$428.68	$367.42
24565	TREAT HUMERUS FX	$428.68	$367.42
24575	TREAT HUMERUS FX	$18,168.29	$15,572.03
24576	TREAT HUMERUS FX	$428.68	$367.42
24577	TREAT HUMERUS FX	$428.68	$367.42
24579	TREAT HUMERUS FX	$18,168.29	$15,572.03
25000	INCISE TENDON SHEATH	$6,238.69	$5,347.18
25001	INCISE FLEXOR CARPI RADIALIS	$6,238.69	$5,347.18
25020	DECOMPRESS FOREARM 1 SPACE	$8,755.84	$7,504.63
25023	DECOMPRESS FOREARM 1 SPACE	$8,755.84	$7,504.63
25024	DECOMPRESS FOREARM 2 SPACES	$8,755.84	$7,504.63
25025	DECOMPRESS FOREARM 2 SPACES	$8,755.84	$7,504.63
25118	EXCISE WRIST TENDON SHEATH	$8,755.84	$7,504.63
25215	REMOVE WRIST BONES	$8,755.84	$7,504.63
25246	INJECTION FOR WRIST X-RAY	$0.00	$0.00	N1
25259	MANIPULATE WRIST W/ANESTH	$5,657.91	$4,849.39
25260	REPAIR FOREARM TENDON/MUSCLE	$8,755.84	$7,504.63
25263	REPAIR FOREARM TENDON/MUSCLE	$8,755.84	$7,504.63
25265	REPAIR FOREARM TENDON/MUSCLE	$8,755.84	$7,504.63
25270	REPAIR FOREARM TENDON/MUSCLE	$8,755.84	$7,504.63
25272	REPAIR FOREARM TENDON/MUSCLE	$8,755.84	$7,504.63
25274	REPAIR FOREARM TENDON/MUSCLE	$8,755.84	$7,504.63
25295	RELEASE WRIST/FOREARM TENDON	$6,238.69	$5,347.18
25500	TREAT FX RADIUS	$428.68	$367.42
25505	TREAT FX RADIUS	$1,494.88	$1,281.26
25515	TREAT FX RADIUS	$13,070.23	$11,202.49
25525	TREAT FX RADIUS	$13,070.23	$11,202.49
25526	TREAT FX RADIUS	$13,070.23	$11,202.49
25530	TREAT FX ULNA	$428.68	$367.42
25535	TREAT FX ULNA	$428.68	$367.42
25545	TREAT FX ULNA	$13,070.23	$11,202.49
25560	TREAT FX RADIUS & ULNA	$428.68	$367.42
25565	TREAT FX RADIUS & ULNA	$1,494.88	$1,281.26
25574	TREAT FX RADIUS & ULNA	$18,168.29	$15,572.03
25575	TREAT FX RADIUS/ULNA	$18,168.29	$15,572.03
25600	TREAT FX RADIUS/ULNA	$428.68	$367.42
25605	TREAT FX RADIUS/ULNA	$1,494.88	$1,281.26
25606	TREAT FX DISTAL RADIAL	$7,210.82	$6,180.39
25607	TREAT FX RADIAL EXTRA-ARTICULAR	$18,168.29	$15,572.03
25608	TREAT FX RADIAL INTRA-ARTICULAR	$18,168.29	$15,572.03
25609	TREAT FX RADIAL 3+ FRAG	$18,168.29	$15,572.03
25622	TREAT WRIST BONE FX	$428.68	$367.42
25624	TREAT WRIST BONE FX	$1,494.88	$1,281.26
25628	TREAT WRIST BONE FX	$13,070.23	$11,202.49
25630	TREAT WRIST BONE FX	$428.68	$367.42
25635	TREAT WRIST BONE FX	$428.68	$367.42
25645	TREAT WRIST BONE FX	$13,070.23	$11,202.49
25650	TREAT WRIST BONE FX	$428.68	$367.42
25652	TREAT FX ULNAR STYLOID	$13,070.23	$11,202.49
25670	TREAT FX ULNAR STYLOID	$7,210.82	$6,180.39
25671	TREAT FX ULNAR STYLOID	$7,210.82	$6,180.39
25676	TREAT WRIST DISLOCATION	$7,210.82	$6,180.39
25680	TREAT WRIST FX	$428.68	$367.42
25685	TREAT WRIST FX	$7,210.82	$6,180.39
26055	INCISE FINGER TENDON SHEATH	$4,660.94	$3,994.89
26116	EXCISE HAND TUMOR DEEP < 1.5 CM	$4,909.21	$4,207.68
26140	REVISE FINGER JOINT, EACH	$4,660.94	$3,994.89
26145	TENDON EXCISE PALM/FINGER	$4,660.94	$3,994.89
26340	MANIPULATE FINGER W/ANESTH	$1,494.88	$1,281.26
26410	REPAIR HAND TENDON	$4,660.94	$3,994.89
26418	REPAIR FINGER TENDON	$4,660.94	$3,994.89
26445	RELEASE HAND/FINGER TENDON	$4,660.94	$3,994.89
26480	TRANSPLANT HAND TENDON	$8,083.67	$6,928.51
26525	RELEASE FINGER CONTRACTURE	$4,660.94	$3,994.89
26540	REPAIR HAND JOINT	$4,660.94	$3,994.89
26600	TREAT METACARPAL FX	$428.68	$367.42
26605	TREAT METACARPAL FX	$428.68	$367.42
26607	TREAT METACARPAL FX	$5,657.91	$4,849.39
26608	TREAT METACARPAL FX	$7,210.82	$6,180.39
26615	TREAT METACARPAL FX	$13,070.23	$11,202.49
26720	TREAT FINGER FX, EACH	$428.68	$367.42
26725	TREAT FINGER FX, EACH	$428.68	$367.42
26727	TREAT FINGER FX, EACH	$7,210.82	$6,180.39
26735	TREAT FINGER FX, EACH	$7,210.82	$6,180.39
26740	TREAT FINGER FX, EACH	$428.68	$367.42
26742	TREAT FINGER FX, EACH	$428.68	$367.42
26746	TREAT FINGER FX, EACH	$7,210.82	$6,180.39
26750	TREAT FINGER FX, EACH	$428.68	$367.42
26755	TREAT FINGER FX, EACH	$428.68	$367.42
27093	INJECTION FOR HIP X-RAY	$0.00	$0.00	N1
27095	INJECTION FOR HIP X-RAY	$0.00	$0.00	N1
27193	TREAT PELVIC RING FX	$428.68	$367.42
27194	TREAT PELVIC RING FX	$4,222.92	$3,619.46
27275	MANIPULATE HIP JOINT	$4,222.92	$3,619.46
27403	REPAIR KNEE CARTILAGE	$8,755.84	$7,504.63
27405	REPAIR KNEE LIGAMENT	$12,850.12	$11,013.83
27420	REVISE UNSTABLE KNEECAP	$12,850.12	$11,013.83
27422	REVISE UNSTABLE KNEECAP	$12,850.12	$11,013.83
27424	REVISION/REMOVE KNEECAP	$12,850.12	$11,013.83
27500	TREAT THIGH FX	$1,494.88	$1,281.26
27501	TREAT THIGH FX	$428.68	$367.42
27502	TREAT THIGH FX	$5,657.91	$4,849.39
27503	TREAT THIGH FX	$428.68	$367.42
27508	TREAT THIGH FX	$428.68	$367.42
27509	TREAT THIGH FX	$7,210.82	$6,180.39
27510	TREAT THIGH FX	$1,494.88	$1,281.26
27520	TREAT KNEECAP FX	$428.68	$367.42
27524	TREAT KNEECAP FX	$13,070.23	$11,202.49
27530	TREAT KNEE FX	$428.68	$367.42
27532	TREAT KNEE FX	$5,657.91	$4,849.39
27538	TREAT KNEE FX(S)	$428.68	$367.42
27570	FIXATE KNEE JOINT	$4,222.92	$3,619.46
27685	REVISE LOWER LEG TENDON	$8,755.84	$7,504.63
27686	REVISE LOWER LEG TENDONS	$8,755.84	$7,504.63
27690	REVISE LOWER LEG TENDON	$12,850.12	$11,013.83
27691	REVISE LOWER LEG TENDON	$12,850.12	$11,013.83
27692	REVISE ADDEDITIONAL LEG TENDON	$12,850.12	$11,013.83
27695	REPAIR ANKLE LIGAMENT	$8,755.84	$7,504.63
27696	REPAIR ANKLE LIGAMENTS	$8,755.84	$7,504.63
27698	REPAIR ANKLE LIGAMENT	$8,755.84	$7,504.63
27750	TREAT TIBIA FX	$428.68	$367.42
27752	TREAT TIBIA FX	$5,657.91	$4,849.39
27758	TREAT TIBIA FX	$13,070.23	$11,202.49
27759	TREAT TIBIA FX	$18,168.29	$15,572.03
27760	CLOSED TREAT MEDIAL ANKLE FX	$428.68	$367.42
27762	CLOSED TREAT MED ANKLE FX W/MANIP	$5,657.91	$4,849.39
27766	OPEN TREAT MEDIAL ANKLE FX	$13,070.23	$11,202.49
27786	TREAT ANKLE FX	$428.68	$367.42
27788	TREAT ANKLE FX	$428.68	$367.42
27792	TREAT ANKLE FX	$13,070.23	$11,202.49
27808	TREAT ANKLE FX	$428.68	$367.42
27810	TREAT ANKLE FX	$428.68	$367.42
27814	TREAT ANKLE FX	$13,070.23	$11,202.49
27816	TREAT ANKLE FX	$428.68	$367.42
27818	TREAT ANKLE FX	$1,494.88	$1,281.26
27822	TREAT ANKLE FX	$13,070.23	$11,202.49
27823	TREAT ANKLE FX	$18,168.29	$15,572.03
27824	TREAT LOWER LEG FX	$428.68	$367.42
27825	TREAT LOWER LEG FX	$5,657.91	$4,849.39
27826	TREAT LOWER LEG FX	$13,070.23	$11,202.49
27827	TREAT LOWER LEG FX	$18,168.29	$15,572.03
27828	TREAT LOWER LEG FX	$18,168.29	$15,572.03
27829	TREAT LOWER LEG JOINT	$13,070.23	$11,202.49
27840	TREAT ANKLE DISLOCATION	$428.68	$367.42
27842	TREAT ANKLE DISLOCATION	$4,222.92	$3,619.46
27846	TREAT ANKLE DISLOCATION	$13,070.23	$11,202.49
27848	TREAT ANKLE DISLOCATION	$13,070.23	$11,202.49
27860	FIXATE ANKLE JOINT	$4,222.92	$3,619.46
28120	PART REMOVE ANKLE/HEEL	$6,135.71	$5,258.91
28122	PARTIAL REMOVE FOOT BONE	$6,135.71	$5,258.91
28400	TREAT HEEL FX	$428.68	$367.42
28405	TREAT HEEL FX	$5,657.91	$4,849.39
28415	TREAT HEEL FX	$18,168.29	$15,572.03
28420	TREAT/GRAFT HEEL FX	$13,070.23	$11,202.49
28430	TREAT ANKLE FX	$428.68	$367.42
28435	TREAT ANKLE FX	$428.68	$367.42
28436	TREAT ANKLE FX	$7,210.82	$6,180.39
28445	TREAT ANKLE FX	$13,070.23	$11,202.49
28470	TREAT METATARSAL FX	$428.68	$367.42
28475	TREAT METATARSAL FX	$428.68	$367.42
28476	TREAT METATARSAL FX	$7,210.82	$6,180.39
28485	TREAT METATARSAL FX	$13,070.23	$11,202.49
28725	FUSE FOOT BONES	$15,005.30	$12,861.03
28730	FUSE FOOT BONES	$15,005.30	$12,861.03
28740	FUSE FOOT BONES	$15,005.30	$12,861.03
28750	FUSE BIG TOE JOINT	$15,005.30	$12,861.03
29065	APPLY LONG ARM CAST	$691.49	$592.68	X
29075	APPLY FOREARM CAST	$691.49	$592.68	X
29085	APPLY HAND/WRIST CAST	$304.17	$260.71	X
29086	APPLY FINGER CAST	$304.17	$260.71	X
29105	APPLY LONG ARM SPLINT	$304.17	$260.71	X
29125	APPLY FOREARM SPLINT	$304.17	$260.71	X
29126	APPLY FOREARM SPLINT	$304.17	$260.71	X
29130	APPLY FINGER SPLINT	$304.17	$260.71	X
29131	APPLY FINGER SPLINT	$304.17	$260.71	X
29200	STRAP CHEST	$304.17	$260.71	X
29240	STRAP SHOULDER	$304.17	$260.71	X
29260	STRAP ELBOW OR WRIST	$304.17	$260.71	X
29280	STRAP HAND OR FINGER	$304.17	$260.71	X
29345	APPLY LONG LEG CAST	$691.49	$592.68	X
29355	APPLY LONG LEG CAST	$691.49	$592.68	X
29365	APPLY LONG LEG CAST	$691.49	$592.68	X
29405	APPLY SHORT LEG CAST	$691.49	$592.68	X
29425	APPLY SHORT LEG CAST	$691.49	$592.68	X
29450	APPLY LEG CAST	$304.17	$260.71	X
29505	APPLY LONG LEG SPLINT	$304.17	$260.71	X
29515	APPLY LOWER LEG SPLINT	$304.17	$260.71	X
29520	STRAP HIP	$304.17	$260.71	X
29530	STRAP KNEE	$304.17	$260.71	X
29540	STRAP ANKLE AND/OR FT	$304.17	$260.71	X
29550	STRAP TOES	$304.17	$260.71	X
29580	APPLY PASTE BOOT	$304.17	$260.71	X
29581	APPLY MULTILAY COMPRESS LWR LEG	$304.17	$260.71	X
29590	APPLY FOOT SPLINT	$304.17	$260.71	X
29700	REMOVE/REVISE CAST	$304.17	$260.71	X
29705	REMOVE/REVISE CAST	$304.17	$260.71	X
29710	REMOVE/REVISE CAST	$691.49	$592.68	X
29740	WEDGE CAST	$304.17	$260.71	X
29800	JAW ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29804	JAW ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29805	SHOULDER ARTHROSCOPY, DIAG	$8,137.61	$6,974.74
29806	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29807	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29819	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29820	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29821	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29822	SHOULDER ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29823	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29824	SHOULDER ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29825	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29826	SHOULDER ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29827	ARTHROSCOPY ROTATOR CUFF REPAIR	$13,154.68	$11,274.87
29828	ARTHROSCOPY BICEPS TENODESIS	$13,154.68	$11,274.87
29830	ELBOW ARTHROSCOPY	$8,137.61	$6,974.74
29834	ELBOW ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29835	ELBOW ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29837	ELBOW ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29840	WRIST ARTHROSCOPY	$8,137.61	$6,974.74
29844	WRIST ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29845	WRIST ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29846	WRIST ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29847	WRIST ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29848	WRIST ENDOSCOPY/SURG	$8,137.61	$6,974.74
29850	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29855	TIBIAL ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29860	HIP ARTHROSCOPY, DIAG	$13,154.68	$11,274.87
29861	HIP ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29862	HIP ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29863	HIP ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29870	KNEE ARTHROSCOPY, DIAG	$8,137.61	$6,974.74
29871	KNEE ARTHROSCOPY/DRAIN	$8,137.61	$6,974.74
29873	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29874	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29875	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29876	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29877	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29879	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29880	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29881	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29882	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29883	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29884	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29886	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29887	KNEE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29888	KNEE ARTHROSCOPY/SURG	$24,164.43	$20,711.32
29889	KNEE ARTHROSCOPY/SURG	$24,164.43	$20,711.32
29891	ANKLE ARTHROSCOPY/SURG	$13,154.68	$11,274.87
29894	ANKLE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29895	ANKLE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29897	ANKLE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29898	ANKLE ARTHROSCOPY/SURG	$8,137.61	$6,974.74
29899	ANKLE ARTHROSCOPY/SURG	$13,154.68	$11,274.87
30100	INTRANASAL BIOPSY	$2,150.53	$1,843.22
30130	EXCISE INFERIOR TURBINATE	$4,708.37	$4,035.54
30140	RESECT INFERIOR TURBINATE	$6,964.52	$5,969.29
30200	INJECTION TREAT NOSE	$2,150.53	$1,843.22
30300	REMOVE NASAL FOREIGN BODY	$182.27	$156.22	AS
30310	REMOVE NASAL FOREIGN BODY	$4,708.37	$4,035.54
30520	REPAIR NASAL SEPTUM	$6,964.52	$5,969.29
30802	ABLATE INF TURBINATE SUBMUCOSAL	$4,708.37	$4,035.54
30901	CONTROL NOSEBLEED	$307.68	$263.71
30903	CONTROL NOSEBLEED	$307.68	$263.71
30905	CONTROL NOSEBLEED	$307.68	$263.71
30930	THERAPEUTIC FX, NASAL INF TURB	$4,708.37	$4,035.54
31000	IRRIGATE MAXILLARY SINUS	$965.03	$827.13
31020	EXPLORE MAXILLARY SINUS	$6,964.52	$5,969.29
31231	NASAL ENDOSCOPY, DIAG	$546.21	$468.15
31237	NASAL/SINUS ENDOSCOPY, SURG	$5,959.12	$5,107.56
31238	NASAL/SINUS ENDOSCOPY, SURG	$5,959.12	$5,107.56
31255	REMOVE ETHMOID SINUS	$8,403.49	$7,202.63
31256	EXPLORE MAXILLARY SINUS	$8,403.49	$7,202.63
31267	ENDOSCOPY, MAXILLARY SINUS	$8,403.49	$7,202.63
31500	INSERT EMERGENCY AIRWAY	$642.80	$550.94	X
31505	DIAGNOSTIC LARYNGOSCOPY	$252.44	$216.37
31515	LARYNGOSCOPY FOR ASPIRATION	$5,959.12	$5,107.56
31525	DIAG LARYNGOSCOPY EXCL NB	$5,959.12	$5,107.56
31575	DIAGNOSTIC LARYNGOSCOPY	$546.21	$468.15
31579	DIAGNOSTIC LARYNGOSCOPY	$1,147.30	$983.35
31600	INCISE WINDPIPE	$6,964.52	$5,969.29
31605	INCISE WINDPIPE	$2,150.53	$1,843.22
31622	DIAG BRONCHOSCOPE/WASH	$2,851.45	$2,443.97
31624	DIAG BRONCHOSCOPE/LAVAGE	$2,851.45	$2,443.97
31645	BRONCHOSCOPY, CLEAR AIRWAYS	$2,851.45	$2,443.97
31646	BRONCHOSCOPY, RECLEAR AIRWAY	$2,851.45	$2,443.97
32405	BIOPSY LUNG OR MEDIASTINUM	$2,643.63	$2,265.85
32551	INSERT CHEST TUBE	$1,510.65	$1,294.77
32601	THORACOSCOPY, DIAGNOSTIC	$9,461.41	$8,109.37
33210	INSERT HEART ELECTRODE	$9,299.39	$8,275.58
33212	INSERT PULSE GENERATOR	$12,451.20	$11,516.42
36000	PLACE NEEDLE IN VEIN	$0.00	$0.00	N1
36005	INJECTION EXT VENOGRAPHY	$0.00	$0.00	N1
36010	PLACE CATHETER IN VEIN	$0.00	$0.00	N1
36011	PLACE CATHETER IN VEIN	$0.00	$0.00	N1
36013	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36014	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36140	ESTABLISH ACCESS TO ARTERY	$0.00	$0.00	N1
36200	PLACE CATHETER IN AORTA	$0.00	$0.00	N1
36215	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36216	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36217	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36218	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36245	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36246	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36247	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36248	PLACE CATHETER IN ARTERY	$0.00	$0.00	N1
36400	BLOOD DRAW < 3 YRS FEM/JUGULAR	$0.00	$0.00	N1
36406	BLOOD DRAW < 3 YRS OTHER VEIN	$0.00	$0.00	N1
36410	NON-ROUTINE BL DRAW > 3 YRS	$0.00	$0.00	N1
36425	VEIN ACCESS CUTDOWN > 1 YR	$72.62	$62.24	AS
36430	BLOOD TRANSFUSION SERVICE	$921.03	$789.41	X
36471	INJECTION THERAPY VEINS	$247.20	$211.88
36513	APHERESIS PLATELETS	$3,363.75	$2,883.07	X
36514	APHERESIS PLASMA	$3,363.75	$2,883.07	X
36515	APHERESIS, ADSORP/REINFUSE	$8,540.97	$7,320.46	X
36555	INSERT NON-TUNNEL CV CATH	$3,087.37	$2,646.18
36556	INSERT NON-TUNNEL CV CATH	$3,087.37	$2,646.18
36558	INSERT TUNNELED CV CATH	$5,241.41	$4,907.68
36569	INSERT PICC CATH	$3,087.37	$2,646.18
36571	INSERT PICVAD CATH	$5,241.41	$4,907.68
36576	REPAIR TUNNELED CV CATH	$3,087.37	$2,646.18
36578	REPLACE TUNNELED CV CATH	$5,241.41	$4,907.68
36580	REPLACE CVAD CATH	$3,087.37	$2,646.18
36584	REPLACE PICC CATH	$3,087.37	$2,646.18
36589	REMOVE TUNNELED CV CATH	$1,718.86	$1,473.23
36592	COLLECT BLOOD PICC	$171.82	$147.27
36593	DECLOT VASCULAR DEVICE	$637.44	$546.35
36598	INJECT W/FLUOR, EVAL CV DEVICE	$637.44	$546.35
36600	WITHDRAW ARTERIAL BLOOD	$72.62	$62.24
36620	INSERT CATHETER, ARTERY	$0.00	$0.00	N1
36625	INSERT CATHETER, ARTERY	$0.00	$0.00	N1
36800	INSERT CANNULA	$8,505.69	$7,354.12
36810	INSERT CANNULA	$8,505.69	$7,354.12
36815	INSERT CANNULA	$8,505.69	$7,354.12
36818	AV FUSE, UPPER ARM, CEPHALIC	$11,329.30	$9,710.33
36833	AV FISTULA REVISION	$11,329.30	$9,710.33
36860	EXTERNAL CANNULA DECLOTTING	$637.44	$546.35
37204	TRANSCATHETER OCCLUSION	$19,232.98	$16,856.39
37609	TEMPORAL ARTERY PROCEDURE	$4,909.21	$4,207.68
37620	REVISE MAJOR VEIN	$11,946.47	$10,239.31
37650	REVISE MAJOR VEIN	$7,454.87	$6,389.56
38200	INJECTION FOR SPLEEN X-RAY	$0.00	$0.00	N1
43235	UPPER GI ENDOSCOPY, DIAGNOSIS	$2,411.81	$2,067.16
43236	UPPER GI SCOPE W/SUBMUCOSA INJECT	$2,411.81	$2,067.16
43239	UPPER GI ENDOSCOPY, BIOPSY	$2,411.81	$2,067.16
43246	PLACE GASTROSTOMY TUBE	$2,411.81	$2,067.16
43248	UPPER GI ENDOSCOPY/GUIDE WIRE	$2,411.81	$2,067.16
43249	ESOPH ENDOSCOPY, DILATION	$2,411.81	$2,067.16
43255	OPERATIVE UPPER GI ENDOSCOPY	$2,411.81	$2,067.16
43259	ENDOSCOPIC ULTRASOUND EXAM	$2,411.81	$2,067.16
43260	ENDO CHOLANGIOPANCREATOGRAPHY	$6,309.66	$5,408.00
43450	DILATE ESOPHAGUS	$1,782.37	$1,527.67
43760	CHANGE GASTROSTOMY TUBE	$637.44	$546.35
43830	PLACE GASTROSTOMY TUBE	$4,529.06	$3,881.86
44500	INTRODUCE GASTROINTESTINAL TUBE	$1,718.86	$1,473.23
46040	INCISE RECTAL ABSCESS	$6,610.91	$5,666.21
46600	DIAGNOSTIC ANOSCOPY	$182.27	$156.22	AS
47000	NEEDLE BIOPSY LIVER	$2,643.63	$2,265.85
49080	PUNCTURE, PERITONEAL CAVITY	$1,510.65	$1,294.77
49320	DIAG LAP SEPARATE PROC	$10,495.79	$8,995.94
49421	INSERT ABDOM DRAIN, PERM	$7,481.94	$6,471.31
49505	PART RPR I/HERNIA INIT REDUCT >5 YR	$8,982.66	$7,699.03
50392	INSERT KIDNEY DRAIN	$4,772.16	$4,090.22
50394	INJECTION FOR KIDNEY X-RAY	$0.00	$0.00	N1
51600	INJECTION FOR BLADDER X-RAY	$0.00	$0.00	N1
51610	INJECTION FOR BLADDER X-RAY	$0.00	$0.00	N1
51700	IRRIGATION BLADDER	$553.11	$474.07
51701	INSERT BLADDER CATHETER	$182.27	$156.22	AS
51702	INSERT TEMP BLADDER CATH	$182.27	$156.22	AS
51703	INSERT BLADDER CATH, COMPLEX	$301.69	$258.58
51705	CHANGE BLADDER TUBE	$553.11	$474.07
51720	TREAT BLADDER LESION	$872.10	$747.48
51725	SIMPLE CYSTOMETROGRAM	$872.10	$747.48
51726	COMPLEX CYSTOMETROGRAM	$872.10	$747.48
51741	ELECTRO-UROFLOWMETRY, FIRST	$301.69	$258.58
51784	ANAL/URINARY MUSCLE STUDY	$301.69	$258.58
51797	INTRAABDOMINAL PRESSURE TEST	$553.11	$474.07
51798	US URINE CAPACITY MEASURE	$182.27	$156.22	AS
52000	CYSTOSCOPY	$2,020.50	$1,731.77
52005	CYSTOSCOPY & URETER CATHETER	$7,150.85	$6,128.99
52204	CYSTOSCOPY W/BIOPSY(S)	$7,150.85	$6,128.99
52281	CYSTOSCOPY & TREAT	$4,772.16	$4,090.22
52310	CYSTOSCOPY & TREAT	$4,772.16	$4,090.22
52332	CYSTOSCOPY & TREAT	$7,150.85	$6,128.99
52351	CYSTOURETERO & OR PYELOSCOPE	$7,150.85	$6,128.99
53600	DILATE URETHRA STRICTURE	$874.07	$749.17
53601	DILATE URETHRA STRICTURE	$301.69	$258.58
53660	DILATE URETHRA	$301.69	$258.58
53661	DILATE URETHRA	$301.69	$258.58
54235	PENILE INJECTION	$872.10	$747.48
57452	EXAM CERVIX W/SCOPE	$443.98	$380.53
57500	BIOPSY CERVIX	$1,783.00	$1,528.21
57511	CRYOCAUTERY CERVIX	$443.98	$380.53
58340	CATHETER FOR HYSTERORRHAPHY	$0.00	$0.00	N1
58558	HYSTEROSCOPY, BIOPSY	$6,268.18	$5,372.45
59000	AMNIOCENTESIS, DIAGNOSTIC	$983.13	$842.64
59025	FETAL NON-STRESS TEST	$443.98	$380.53
59841	ABORTION	$5,615.09	$4,812.69
61790	TREAT TRIGEMINAL NERVE	$5,195.44	$4,453.01
62263	EPIDURAL LYSIS MULT SESSIONS	$2,060.68	$1,766.21
62264	EPIDURAL LYSIS ON SINGLE DAY	$3,474.53	$2,978.02
62270	SPINAL FLUID TAP, DIAGNOSTIC	$1,054.25	$903.60
62273	INJECT EPIDURAL PATCH	$2,060.68	$1,766.21
62280	TREAT SPINAL CORD LESION	$2,060.68	$1,766.21
62281	TREAT SPINAL CORD LESION	$2,060.68	$1,766.21
62282	TREAT SPINAL CANAL LESION	$2,060.68	$1,766.21
62284	INJECTION FOR MYELOGRAM	$0.00	$0.00	N1
62287	PERCUTANEOUS DISKECTOMY	$10,121.96	$8,675.52
62290	INJECT FOR SPINE DISK X-RAY	$0.00	$0.00	N1
62291	INJECT FOR SPINE DISK X-RAY	$0.00	$0.00	N1
62292	INJECTION INTO DISK LESION	$2,060.68	$1,766.21
62310	INJECT SPINE C/T	$2,060.68	$1,766.21
62311	INJECT SPINE L/S (CD)	$2,060.68	$1,766.21
62318	INJECT SPINE W/CATH, C/T	$2,060.68	$1,766.21
62319	INJECT SPINE W/CATH L/S (CD)	$3,474.53	$2,978.02
62350	IMPLANT SPINAL CANAL CATH	$11,382.48	$9,755.92
62355	REMOVE SPINAL CANAL CATHETER	$3,474.53	$2,978.02
62360	INSERT SPINE INFUSION DEVICE	$11,382.48	$9,755.92
62362	IMPLANT SPINE INFUSION PUMP	$22,227.97	$20,941.63
62365	REMOVE SPINE INFUSION DEVICE	$10,121.96	$8,675.52
62367	ANALYZE SPINE INFUSION PUMP	$657.70	$563.72	X
62368	ANALYZE SPINE INFUSION PUMP	$657.70	$563.72	X
63020	NECK SPINE DISK SURG	$13,940.72	$11,948.58
63030	LOW BACK DISK SURG	$13,940.72	$11,948.58
63035	SPINAL DISK SURG, ADDED	$13,940.72	$11,948.58
63040	LAMINOTOMY, SINGLE CERV	$13,940.72	$11,948.58
63042	LAMINOTOMY, SINGLE LUMBAR	$13,940.72	$11,948.58
63045	REMOVE SPINAL LAMINA	$13,940.72	$11,948.58
63046	REMOVE SPINAL LAMINA	$13,940.72	$11,948.58
63047	REMOVE SPINAL LAMINA	$13,940.72	$11,948.58
63048	REMOVE SPINAL LAMINA, ADDED	$13,940.72	$11,948.58
63056	DECOMPRESS SPINAL CORD	$13,940.72	$11,948.58
63057	DECOMPRESS SPINE CORD, ADDED	$13,940.72	$11,948.58
63075	NECK SPINE DISK SURG	$13,940.72	$11,948.58
63076	NECK SPINE DISK SURG	$13,940.72	$11,948.58
63650	IMPLANT NEUROELECTRODES	$17,950.74	$9,545.51	X
63655	IMPLANT NEUROELECTRODES	$13,352.79	$12,138.59	X
63685	INSERT/REDO SPINE N GENERATOR	$23,191.56	$22,061.87	X
63688	REVISE/REMOVE NEURORECEIVER	$7,898.33	$6,769.65
64400	NERVE BLOCK INJ, TRIGEMINAL	$724.57	$621.03
64402	NERVE BLOCK INJ, FACIAL	$724.57	$621.03
64405	NERVE BLOCK INJ, OCCIPITAL	$1,054.25	$903.60
64412	NERVE BLOCK INJ, SPINAL ACCESSORY	$2,060.68	$1,766.21
64413	NERVE BLOCK INJ, CERV PLEXUS	$1,054.25	$903.60
64415	NERVE BLOCK INJ, BRACHIAL PLEXUS	$1,054.25	$903.60
64416	NERVE BLOCK CONT INFUSE, B PLEX	$2,060.68	$1,766.21
64417	NERVE BLOCK INJ, AXILLARY	$1,054.25	$903.60
64418	NERVE BLOCK INJ, SUPRASCAPULAR	$1,054.25	$903.60
64420	NERVE BLOCK INJ, INTERCOSTAL, SING	$1,054.25	$903.60
64421	NERVE BLOCK INJ, INTERCOSTAL, MULT	$2,060.68	$1,766.21
64425	NERVE BLOCK INJ, ILIO-ING/HYPOGI	$1,054.25	$903.60
64430	NERVE BLOCK INJ, PUDENDAL	$2,060.68	$1,766.21
64435	NERVE BLOCK INJ, PARACERV	$1,054.25	$903.60
64445	NERVE BLOCK INJ, SCIATIC, SING	$2,060.68	$1,766.21
64446	NERVE BLOCK INJ, SCIATIC, CONT INF	$2,060.68	$1,766.21
64447	NERVE BLOCK INJ, FEM, SING	$1,054.25	$903.60
64448	NERVE BLOCK INJ, FEM, CONT INF	$2,060.68	$1,766.21
64449	NERVE BLOCK INJ, LUMBAR PLEXUS	$2,060.68	$1,766.21
64450	NERVE BLOCK, OTHER PERIPHERAL	$1,054.25	$903.60
64455	NERVE BLOCK INJ, PLANTAR DIGIT	$724.57	$621.03
64479	INJECT FORAMEN EPIDURAL C/T	$2,060.68	$1,766.21
64480	INJECT FORAMEN EPIDURAL, ADDED	$1,054.25	$903.60
64483	INJECT FORAMEN EPIDURAL L/S	$2,060.68	$1,766.21
64484	INJECT FORAMEN EPIDURAL, ADDED	$1,054.25	$903.60
64490	INJECT PARAVERT F JNT C/T 1 LEV	$2,060.68	$1,766.21
64491	INJECT PARAVERT F JNT C/T 2 LEV	$724.57	$621.03
64492	INJECT PARAVERT F JNT C/T 3 LEV	$724.57	$621.03
64493	INJECT PARAVERT F JNT L/S 1 LEV	$2,060.68	$1,766.21
64494	INJECT PARAVERT F JNT L/S 2 LEV	$724.57	$621.03
64495	INJECT PARAVERT F JNT L/S 3 LEV	$724.57	$621.03
64505	NERVE BLOCK SPHENOPALATINE GANGLIA	$724.57	$621.03
64510	NERVE BLOCK STELLATE GANGLION	$2,060.68	$1,766.21
64517	NERVE BLOCK INJ, HYPOGAS PLXS	$2,060.68	$1,766.21
64520	NERVE BLOCK LUMBAR/THORACIC	$2,060.68	$1,766.21
64555	IMPLANT NEUROELECTRODES	$10,600.82	$9,545.51	X
64561	IMPLANT NEUROELECTRODES	$10,600.82	$9,545.51	X
64565	IMPLANT NEUROELECTRODES	$10,600.82	$9,545.51	X
64600	INJECTION TREAT NERVE	$3,474.53	$2,978.02
64605	INJECTION TREAT NERVE	$5,195.44	$4,453.01
64610	INJECTION TREAT NERVE	$5,195.44	$4,453.01
64612	DESTROY NERVE, FACE MUSCLE	$724.57	$621.03
64613	DESTROY NERVE, NECK MUSCLE	$1,054.25	$903.60
64614	DESTROY NERVE, EXTREMITY MUSC	$1,054.25	$903.60
64620	INJECTION TREAT NERVE	$2,060.68	$1,766.21
64622	DESTROY PARAVERTEBRAL NERVE L/S	$3,474.53	$2,978.02
64623	DESTROY PARAVERT NERVE, ADDED	$2,060.68	$1,766.21
64626	DESTROY PARAVERTEBRAL NERVE C/T	$2,060.68	$1,766.21
64627	DESTROY PARAVERT NERVE, ADDED	$724.57	$621.03
64640	INJECTION TREAT NERVE	$2,060.68	$1,766.21
64680	INJECTION TREAT NERVE	$2,060.68	$1,766.21
64702	REVISE FINGER/TOE NERVE	$5,195.44	$4,453.01
64704	REVISE HAND/FOOT NERVE	$5,195.44	$4,453.01
64708	REVISE ARM/LEG NERVE	$5,195.44	$4,453.01
64712	REVISE SCIATIC NERVE	$5,195.44	$4,453.01
64713	REVISE ARM NERVE(S)	$5,195.44	$4,453.01
64714	REVISE LOW BACK NERVE(S)	$5,195.44	$4,453.01
64716	REVISE CRANIAL NERVE	$5,195.44	$4,453.01
64718	REVISE ULNAR NERVE AT ELBOW	$5,195.44	$4,453.01
64719	REVISE ULNAR NERVE AT WRIST	$5,195.44	$4,453.01
64721	CARPAL TUNNEL SURG	$5,195.44	$4,453.01
65205	REMOVE FOREIGN BODY EYE	$263.33	$225.70	X
65210	REMOVE FOREIGN BODY EYE	$263.33	$225.70	X
65220	REMOVE FOREIGN BODY EYE	$263.33	$225.70	X
65222	REMOVE FOREIGN BODY EYE	$263.33	$225.70	X
65265	REMOVE FOREIGN BODY EYE	$6,362.61	$5,453.39
67412	EXPLORE/TREAT EYE SOCKET	$5,433.49	$4,657.04
69210	REMOVE IMPACTED EAR WAX	$182.27	$156.22	AS
69310	REBUILD OUTER EAR CANAL	$12,135.56	$10,401.38
69320	REBUILD OUTER EAR CANAL	$12,135.56	$10,401.38
69666	REPAIR MIDDLE EAR STRUCTURES	$12,135.56	$10,401.38
69667	REPAIR MIDDLE EAR STRUCTURES	$12,135.56	$10,401.38
69990	MICROSURG, ADDED	$0.00	$0.00	N1

Radiology, CPT 70000 to 79999

374 rows

Code	Description	North	South	Flags
70030	X-RAY EYE FOR FOREIGN BODY	$177.57	$152.20	AS
70100	X-RAY JAW < 4 VIEWS	$177.57	$152.20	AS
70110	X-RAY JAW MINIMUM 4 VIEWS	$177.57	$152.20	AS
70120	X-RAY MASTOIDS < 3 VIEWS/SIDE	$177.57	$152.20	AS
70130	X-RAY MASTOIDS MINIMUM 3 VIEWS/SIDE	$177.57	$152.20	AS
70140	X-RAY FACIAL BONES < 3 VIEWS	$177.57	$152.20	AS
70150	X-RAY FACIAL BONES MINIMUM 3 VIEWS	$177.57	$152.20	AS
70160	X-RAY NASAL BONES MINIMUM 3 VIEWS	$177.57	$152.20	AS
70190	X-RAY OPTIC FORAMINA	$177.57	$152.20	AS
70200	X-RAY ORBITS, MINIMUM 4 VIEWS	$177.57	$152.20	AS
70210	X-RAY SINUSES < 3 VIEWS	$177.57	$152.20	AS
70220	X-RAY SINUSES MINIMUM 3 VIEWS	$177.57	$152.20	AS
70250	X-RAY SKULL < 4 VIEWS	$177.57	$152.20	AS
70260	X-RAY SKULL MINIMUM 4 VIEWS	$299.09	$256.35	AS
70300	X-RAY TEETH SINGLE VIEW	$120.17	$103.00	AS
70310	X-RAY TEETH < FULL MOUTH	$120.17	$103.00	AS
70320	X-RAY TEETH FULL MOUTH	$120.17	$103.00	AS
70328	X-RAY TMJ UNILATERAL	$177.57	$152.20	AS
70330	X-RAY TMJ BILATERAL	$177.57	$152.20	AS
70332	TMJ ARTHOGRAPHY; RAD SUPER & INTERP	$1,084.37	$929.42
70336	MRI TMJ	$1,352.04	$1,158.83
70350	CEPHALOGRAM, ORTHODONTIC	$177.57	$152.20	AS
70355	ORTHOPANTOGRAM	$120.17	$103.00	AS
70360	X-RAY NECK SOFT TISSUE	$177.57	$152.20	AS
70450	CT HEAD/BRAIN W/O DYE	$764.27	$655.06
70460	CT HEAD/BRAIN W/DYE	$1,182.03	$1,013.12
70470	CT HEAD/BRAIN W/O & W/DYE	$1,317.77	$1,129.46
70480	CT ORBIT/EAR/FOSSA W/O DYE	$764.27	$655.06
70481	CT ORBIT/EAR/FOSSA W/DYE	$1,182.03	$1,013.12
70482	CT ORBIT/EAR/FOSSA W/O & W/DYE	$1,317.77	$1,129.46
70486	CT MAXILLOFACIAL W/O DYE	$764.27	$655.06
70487	CT MAXILLOFACIAL W/DYE	$1,182.03	$1,013.12
70488	CT MAXILLOFACIAL W/O & W/DYE	$1,317.77	$1,129.46
70490	CT SOFT TISSUE NECK W/O DYE	$764.27	$655.06
70491	CT SOFT TISSUE NECK W/DYE	$1,182.03	$1,013.12
70492	CT SOFT TISSUE NECK W/O & W/DYE	$1,317.77	$1,129.46
70496	CT ANGIOGRAPHY, HEAD	$1,334.69	$1,143.96
70498	CT ANGIOGRAPHY, NECK	$1,334.69	$1,143.96
70540	MRI ORBIT/FACE/NECK W/O DYE	$1,352.04	$1,158.83
70542	MRI ORBIT/FACE/NECK W/DYE	$1,722.84	$1,476.64
70543	MRI ORBIT/FACE/NECK W/O & W/DYE	$2,103.77	$1,803.14
70544	MR ANGIOGRAPHY HEAD W/O DYE	$1,352.04	$1,158.83
70545	MR ANGIOGRAPHY HEAD W/DYE	$1,722.84	$1,476.64
70546	MR ANGIOGRAPH HEAD W/O & W/DYE	$2,103.77	$1,803.14
70547	MR ANGIOGRAPHY NECK W/O DYE	$1,352.04	$1,158.83
70548	MR ANGIOGRAPHY NECK W/DYE	$1,722.84	$1,476.64
70549	MR ANGIOGRAPH NECK W/O & W/DYE	$2,103.77	$1,803.14
70551	MRI BRAIN W/O DYE	$1,352.04	$1,158.83
70552	MRI BRAIN W/DYE	$1,722.84	$1,476.64
70553	MRI BRAIN W/O & W/DYE	$2,103.77	$1,803.14
70554	FMRI BRAIN BY TECH	$1,352.04	$1,158.83
70555	FMRI BRAIN BY PHYS/PSYCH	$1,352.04	$1,158.83	X
71010	CHEST X-RAY SINGLE VIEW FRONTAL	$177.57	$152.20
71020	CHEST X-RAY 2 VIEWS FRONTAL & LATERAL	$177.57	$152.20
71021	CHEST X-RAY 2 VIEWS W/APICAL LORD PROC	$177.57	$152.20	AS
71022	CHEST X-RAY 2 VIEWS W/OBLIQUE PROJ	$177.57	$152.20	AS
71030	CHEST X-RAY MINIMUM 4 VIEWS	$177.57	$152.20	AS
71035	CHEST X-RAY SPECIAL VIEWS	$177.57	$152.20	AS
71040	CONTRAST X-RAY BRONCHI UNILATERAL	$906.64	$777.08
71090	X-RAY & PACEMAKER INSERT	$0.00	$0.00	N1
71100	X-RAY RIBS 2 VIEWS	$177.57	$152.20	AS
71101	X-RAY RIBS/CHEST MINIMUM 3 VIEWS	$177.57	$152.20	AS
71110	X-RAY RIBS BILATERAL 3 VIEWS	$177.57	$152.20	AS
71111	X-RAY RIBS/CHEST MINIMUM 4 VIEWS	$299.09	$256.35	AS
71120	X-RAY STERNUM MINIMUM 2 VIEWS	$177.57	$152.20	AS
71130	X-RAY STERNOCLAV JOINT MINIMUM 3 VIEWS	$177.57	$152.20	AS
71250	CT THORAX W/O DYE	$764.27	$655.06
71260	CT THORAX W/DYE	$1,182.03	$1,013.12
71270	CT THORAX W/O & W/DYE	$1,317.77	$1,129.46
71275	CT ANGIOGRAPHY, CHEST	$1,334.69	$1,143.96
71550	MRI CHEST W/O DYE	$1,352.04	$1,158.83
71552	MRI CHEST W/O & W/DYE	$2,103.77	$1,803.14
72010	X-RAY SPINE ANTEROPOST & LATERAL	$299.09	$256.35	AS
72020	X-RAY SPINE SINGLE VIEW SPECIFY LEVEL	$177.57	$152.20	AS
72040	X-RAY NECK SPINE CERV 2/3 VIEWS	$177.57	$152.20	AS
72050	X-RAY NECK SPINE CERV MINIMUM 4 VIEWS	$299.09	$256.35	AS
72052	X-RAY NECK SPINE COMPLETE	$299.09	$256.35	AS
72069	X-RAY TRUNK SPINE STANDING	$177.57	$152.20	AS
72070	X-RAY THORACIC SPINE 2 VIEWS	$177.57	$152.20	AS
72072	X-RAY THORACIC SPINE 3 VIEWS	$177.57	$152.20	AS
72074	X-RAY THORACIC SPINE MINIMUM 4 VIEWS	$177.57	$152.20	AS
72080	X-RAY TRUNK SPINE 2 VIEWS	$177.57	$152.20	AS
72090	X-RAY TRUNK SPINE SCOLIOSIS STUDY	$299.09	$256.35	AS
72100	X-RAY LOWER SPINE 2/3 VIEWS	$177.57	$152.20	AS
72110	X-RAY LOWER SPINE MINIMUM 4 VIEWS	$299.09	$256.35	AS
72114	X-RAY LOWER SPINE COMPLETE	$299.09	$256.35	AS
72120	X-RAY LOWER SPINE BENDING MINIMUM 4 VIEWS	$177.57	$152.20	AS
72125	CT NECK SPINE W/O DYE	$764.27	$655.06
72126	CT NECK SPINE W/DYE	$1,182.03	$1,013.12
72127	CT NECK SPINE W/O & W/DYE	$1,317.77	$1,129.46
72128	CT CHEST SPINE W/O DYE	$764.27	$655.06
72129	CT CHEST SPINE W/DYE	$1,182.03	$1,013.12
72130	CT CHEST SPINE W/O & W/DYE	$1,317.77	$1,129.46
72131	CT LUMBAR SPINE W/O DYE	$764.27	$655.06
72132	CT LUMBAR SPINE W/DYE	$1,182.03	$1,013.12
72133	CT LUMBAR SPINE W/O & W/DYE	$1,317.77	$1,129.46
72141	MRI NECK SPINE W/O DYE	$1,352.04	$1,158.83
72142	MRI NECK SPINE W/DYE	$1,722.84	$1,476.64
72146	MRI CHEST SPINE W/O DYE	$1,352.04	$1,158.83
72147	MRI CHEST SPINE W/DYE	$1,722.84	$1,476.64
72148	MRI LUMBAR SPINE W/O DYE	$1,352.04	$1,158.83
72149	MRI LUMBAR SPINE W/DYE	$1,722.84	$1,476.64
72156	MRI NECK SPINE W/O & W/DYE	$2,103.77	$1,803.14
72157	MRI CHEST SPINE W/O & W/DYE	$2,103.77	$1,803.14
72158	MRI LUMBAR SPINE W/O & W/DYE	$2,103.77	$1,803.14
72170	X-RAY PELVIS 1/2 VIEWS	$177.57	$152.20	AS
72190	X-RAY PELVIS MINIMUM 3 VIEWS	$177.57	$152.20	AS
72191	CT ANGIOGRAPH PELVIS W/O & W/DYE	$1,334.69	$1,143.96
72192	CT PELVIS W/O DYE	$764.27	$655.06
72193	CT PELVIS W/DYE	$1,182.03	$1,013.12
72194	CT PELVIS W/O & W/DYE	$1,317.77	$1,129.46
72195	MRI PELVIS W/O DYE	$1,352.04	$1,158.83
72196	MRI PELVIS W/DYE	$1,722.84	$1,476.64
72197	MRI PELVIS W/O & W/DYE	$2,103.77	$1,803.14
72200	X-RAY EXAM SACROILIAC JOINTS	$177.57	$152.20	AS
72202	X-RAY EXAM SACROILIAC JOINTS	$177.57	$152.20	AS
72220	X-RAY TAILBONE	$177.57	$152.20	AS
72240	CONTRAST X-RAY NECK SPINE	$1,967.75	$1,686.56
72255	CONTRAST X-RAY THORAX SPINE	$1,967.75	$1,686.56
72265	CONTRAST X-RAY LOWER SPINE	$1,967.75	$1,686.56
72270	CONTRAST X-RAY SPINE	$1,967.75	$1,686.56
72275	EPIDUROGRAPHY	$0.00	$0.00	N1
72285	X-RAY C/T SPINE DISK	$6,593.09	$5,650.93
72291	PERCUT VERT/SACROPLASTY, FLUOR	$0.00	$0.00	N1
72295	X-RAY LOWER SPINE DISK	$6,593.09	$5,650.93
73000	X-RAY COLLAR BONE	$177.57	$152.20	AS
73010	X-RAY SHOULDER BLADE	$177.57	$152.20	AS
73020	X-RAY SHOULDER 1 VIEW	$177.57	$152.20	AS
73030	X-RAY SHOULDER MINIMUM 2 VIEWS	$177.57	$152.20	AS
73040	CONTRAST X-RAY SHOULDER	$1,084.37	$929.42
73050	X-RAY SHOULDERS	$177.57	$152.20	AS
73060	X-RAY HUMERUS MINIMUM 2 VIEWS	$177.57	$152.20	AS
73070	X-RAY ELBOW 2 VIEWS	$177.57	$152.20	AS
73080	X-RAY ELBOW MINIMUM 3 VIEWS	$177.57	$152.20	AS
73090	X-RAY FOREARM	$177.57	$152.20	AS
73092	X-RAY ARM, INFANT	$177.57	$152.20	AS
73100	X-RAY WRIST 2 VIEWS	$177.57	$152.20	AS
73110	X-RAY WRIST MINIMUM 3 VIEWS	$177.57	$152.20	AS
73115	CONTRAST X-RAY WRIST	$1,084.37	$929.42
73120	X-RAY HAND 2 VIEWS	$177.57	$152.20	AS
73130	X-RAY HAND MINIMUM 3 VIEWS	$177.57	$152.20	AS
73140	X-RAY FINGER(S) MINIMUM 2 VIEWS	$177.57	$152.20	AS
73200	CT UPPER EXTREMITY W/O DYE	$764.27	$655.06
73201	CT UPPER EXTREMITY W/DYE	$1,182.03	$1,013.12
73202	CT UPPER EXTREMITY W/O & W/DYE	$1,317.77	$1,129.46
73206	CT ANGIO UPR EXTREMITY W/O & W/DYE	$1,334.69	$1,143.96
73218	MRI UPPER EXTREMITY W/O DYE	$1,352.04	$1,158.83
73219	MRI UPPER EXTREMITY W/DYE	$1,722.84	$1,476.64
73220	MRI UPPER EXTREMITY W/O & W/DYE	$2,103.77	$1,803.14
73221	MRI JOINT UPPER EXTREMITY W/O DYE	$1,352.04	$1,158.83
73222	MRI JOINT UPPER EXTREMITY W/DYE	$1,722.84	$1,476.64
73223	MRI JOINT UPPER EXTREMITY W/O & W/DYE	$2,103.77	$1,803.14
73500	X-RAY HIP UNILATERAL 1 VIEW	$177.57	$152.20	AS
73510	X-RAY HIP COMPLETE MINIMUM 2 VIEWS	$177.57	$152.20	AS
73520	X-RAY HIPS MINIMUM 2 VIEWS	$177.57	$152.20	AS
73525	X-RAY HIP ARTHROGRAPHY	$1,084.37	$929.42
73530	X-RAY HIP DURING OPERATIVE PROCEDURE	$0.00	$0.00	N1
73540	X-RAY PELVIS & HIPS MINIMUM 2 VIEWS	$177.57	$152.20	AS
73542	X-RAY EXAM, SACROILIAC JOINT	$1,084.37	$929.42
73550	X-RAY THIGH 2 VIEWS	$177.57	$152.20	AS
73560	X-RAY KNEE 1/2 VIEWS	$177.57	$152.20	AS
73562	X-RAY KNEE 3 VIEWS	$177.57	$152.20	AS
73564	X-RAY KNEE, COMPLETE 4/MORE VIEWS	$177.57	$152.20	AS
73565	X-RAY KNEES STANDING ANTEROPOST	$177.57	$152.20	AS
73580	X-RAY KNEE ARTHOGRAPHY	$1,084.37	$929.42
73590	X-RAY TIBIA & FIBULA 2 VIEWS	$177.57	$152.20	AS
73592	X-RAY LEG, INFANT MINIMUM 2 VIEWS	$177.57	$152.20	AS
73600	X-RAY ANKLE 2 VIEWS	$177.57	$152.20	AS
73610	X-RAY ANKLE MINIMUM 3 VIEWS	$177.57	$152.20	AS
73615	CONTRAST X-RAY ANKLE	$1,084.37	$929.42
73620	X-RAY FOOT 2 VIEWS	$177.57	$152.20	AS
73630	X-RAY FOOT MINIMUM 3 VIEWS	$177.57	$152.20	AS
73650	X-RAY HEEL	$177.57	$152.20	AS
73660	X-RAY TOE(S)	$177.57	$152.20	AS
73700	CT LOWER EXTREMITY W/O DYE	$764.27	$655.06
73701	CT LOWER EXTREMITY W/DYE	$1,182.03	$1,013.12
73706	CT ANGIO LWR EXTREMITY W/O & W/DYE	$1,334.69	$1,143.96
73718	MRI LOWER EXTREMITY W/O DYE	$1,352.04	$1,158.83
73719	MRI LOWER EXTREMITY W/DYE	$1,722.84	$1,476.64
73720	MRI LOWER EXTREMITY W/O & W/DYE	$2,103.77	$1,803.14
73721	MRI JOINT LOWER EXTREMITY W/O DYE	$1,352.04	$1,158.83
73722	MRI JOINT LOWER EXTREMITY W/DYE	$1,722.84	$1,476.64
73723	MRI JOINT LWR EXTREMITY W/O & W/DYE	$2,103.77	$1,803.14
74000	X-RAY ABDOMEN SINGLE ANTEROPOST	$177.57	$152.20	AS
74010	X-RAY ABDOMEN ANTEROPOST & ADDED VW	$177.57	$152.20	AS
74020	X-RAY ABDOMEN COMPLETE	$177.57	$152.20	AS
74022	X-RAY EXAM SERIES, ABDOMEN	$299.09	$256.35	AS
74150	CT ABDOMEN W/O DYE	$764.27	$655.06
74160	CT ABDOMEN W/DYE	$1,182.03	$1,013.12
74170	CT ABDOMEN W/O & W/DYE	$1,317.77	$1,129.46
74175	CT ANGIO ABDOM W/O & W/DYE	$1,334.69	$1,143.96
74176	CT ANGIO ABDOM & PELVIS	$764.27	$655.06
74177	CT ANGIO ABDOM & PELVIS W/CONTRAST	$1,182.03	$1,013.12
74178	CT ANGIO ABDOM & PELVIS 1+ REGNS	$1,317.77	$1,129.46
74181	MRI ABDOMEN W/O DYE	$1,352.04	$1,158.83
74183	MRI ABDOMEN W/O & W/DYE	$2,103.77	$1,803.14
74220	CONTRAST X-RAY, ESOPHAGUS	$341.90	$293.04	X
74230	CINE/VIDEO X-RAY, THROAT/ESOPH	$341.90	$293.04	X
74241	X-RAY EXAM, UPPER GI TRACT W/KUB	$341.90	$293.04	X
74246	CONTRAST X-RAY UGI TRACT W/O KUB	$341.90	$293.04	X
74280	CONTRAST X-RAY COLON W/WO GLUCOGEN	$559.77	$479.78	X
74290	CONTRAST X-RAY, GALLBLADDER	$341.90	$293.04	X
74330	X-RAY BILE/PANCREAS ENDOSCOPY	$0.00	$0.00	N1
74400	CONTRAST X-RAY URINARY TRACT	$694.37	$595.14	X
74410	CONTRAST X-RAY URINARY TRACT	$694.37	$595.14	X
74415	CONTRAST X-RAY URINARY TRACT	$694.37	$595.14	X
74420	CONTRAST X-RAY URINARY TRACT	$694.37	$595.14	X
74425	CONTRAST X-RAY URINARY TRACT	$694.37	$595.14
74430	CONTRAST X-RAY BLADDER	$694.37	$595.14
74450	X-RAY URETHRA/BLADDER	$694.37	$595.14
74455	X-RAY URETHRA/BLADDER	$694.37	$595.14
74475	X-RAY CONTROL, CATH INSERT	$4,772.16	$4,090.22
74480	X-RAY CONTROL, CATH INSERT	$4,772.16	$4,090.22
74485	X-RAY GUIDE, GU DILATION	$4,772.16	$4,090.22
75561	CARDIAC MRI FOR MORPH W/DYE	$2,103.77	$1,803.14
75572	CT HEART W/3D IMAGE	$1,012.70	$867.98	X
75574	CT ANGIO HEART W/3D IMAGE	$1,012.70	$867.98	X
75605	CONTRAST X-RAY AORTA	$7,990.03	$6,848.25
75625	CONTRAST X-RAY AORTA	$7,990.03	$6,848.25
75630	X-RAY AORTA, LEG ARTERIES	$7,990.03	$6,848.25
75635	CT ANGIO ABDOMINAL ARTERIES	$1,334.69	$1,143.96
75650	ARTERY X-RAYS HEAD & NECK	$12,970.25	$11,116.79
75665	ARTERY X-RAYS HEAD & NECK	$7,990.03	$6,848.25
75671	ARTERY X-RAYS HEAD & NECK	$12,970.25	$11,116.79
75676	ARTERY X-RAYS NECK UNILATERAL	$7,990.03	$6,848.25
75680	ARTERY X-RAYS NECK BILATERAL	$7,990.03	$6,848.25
75685	ARTERY X-RAYS SPINE	$7,990.03	$6,848.25
75705	ARTERY X-RAYS SPINE	$7,990.03	$6,848.25
75710	ARTERY X-RAYS ARM/LEG	$7,990.03	$6,848.25
75716	ARTERY X-RAYS ARMS/LEGS	$7,990.03	$6,848.25
75722	ARTERY X-RAYS KIDNEY	$7,990.03	$6,848.25
75724	ARTERY X-RAYS KIDNEYS	$7,990.03	$6,848.25
75726	ARTERY X-RAYS ABDOMEN	$7,990.03	$6,848.25
75736	ARTERY X-RAYS PELVIS	$7,990.03	$6,848.25
75743	ARTERY X-RAYS LUNGS	$7,990.03	$6,848.25
75774	ARTERY X-RAY, EACH VESSEL	$0.00	$0.00	N1
75809	NONVASCULAR SHUNT, X-RAY	$299.09	$256.35
75820	VEIN X-RAY ARM/LEG	$2,833.55	$2,428.63
75822	VEIN X-RAY ARMS/LEGS	$2,833.55	$2,428.63
75825	VEIN X-RAY TRUNK	$7,990.03	$6,848.25
75894	X-RAYS, TRANSCATH THERAPY	$0.00	$0.00	N1
75898	F/U ANGIOGRAPHY	$299.09	$256.35
75940	X-RAY PLACE VEIN FILTER	$0.00	$0.00	N1
75960	TRANSCATH IV STENT RS & I	$0.00	$0.00	N1
75961	RETRIEVE BROKEN CATHETER	$0.00	$0.00	N1
75962	REPAIR ARTERIAL BLOCKAGE	$12,095.18	$10,542.37
75964	REPAIR ARTERY BLOCKAGE, EACH	$0.00	$0.00	N1
75978	REPAIR VENOUS BLOCKAGE	$8,317.24	$7,228.17
75984	X-RAY CONTROL CATHETER CHANGE	$0.00	$0.00	N1
75989	ABSCESS DRAIN UNDER X-RAY	$0.00	$0.00	N1
76000	FLUOROSCOPE EXAM	$329.21	$282.16
76001	FLUOROSCOPE EXAM, EXTENSIVE	$0.00	$0.00	N1
76010	X-RAY NOSE TO RECTUM	$177.57	$152.20	AS
76080	X-RAY FISTULA	$906.64	$777.08
76098	X-RAY EXAM, BREAST SPECIMEN	$1,605.07	$1,375.71
76100	X-RAY BODY SECTION	$299.09	$256.35	AS
76102	COMPLEX BODY SECTION X-RAYS	$906.64	$777.08	AS
76120	CINE/VIDEO X-RAYS	$329.21	$282.16	AS
76125	CINE/VIDEO X-RAYS, ADDED	$0.00	$0.00	N1
76376	3D RENDER W/O POST PROCESS	$0.00	$0.00	N1
76377	3D RENDERING W/POST PROCESS	$0.00	$0.00	N1
76380	CAT SCAN F/U STUDY	$447.45	$383.51	X
76506	ECHO EXAM HEAD	$245.43	$210.36	X
76510	OPHTHALMIC US, B & QUANT A	$691.93	$593.05
76511	OPHTHALMIC US, QUANT A ONLY	$379.59	$325.35	X
76512	OPHTHALMIC US, B W/NON-QUANT A	$379.59	$325.35	X
76514	ECHO EXAM EYE, THICKNESS	$72.62	$62.24	AS
76516	ECHO EXAM EYE	$245.43	$210.36	X
76519	ECHO EXAM EYE	$379.59	$325.35	X
76536	US EXAM HEAD & NECK	$379.59	$325.35	X
76604	US EXAM, CHEST	$245.43	$210.36
76645	US EXAM, BREAST(S)	$245.43	$210.36	X
76700	US EXAM, ABDOM, COMPLETE	$379.59	$325.35
76705	ECHO EXAM ABDOMEN	$379.59	$325.35
76770	US EXAM ABDOM BACK WALL, COMP	$379.59	$325.35
76775	US EXAM ABDOM BACK WALL, LIM	$379.59	$325.35
76776	US EXAM K TRANSPLANT W/DOPPLER	$379.59	$325.35
76800	US EXAM, SPINAL CANAL	$379.59	$325.35	X
76801	OBSTET US < 14 WKS, SINGLE FETUS	$379.59	$325.35	X
76805	OBSTET US >/= 14 WKS, SINGLE FETUS	$379.59	$325.35	X
76810	OBSTET US >/= 14 WKS, ADDED FETUS	$379.59	$325.35	X
76811	OBSTET US, DETAILED, SINGLE FETUS	$603.18	$516.98	X
76814	OBSTET US NUCHAL MEAS, ADDED	$245.43	$210.36	X
76815	OBSTET US, LIMITED, FETUS(S)	$245.43	$210.36	X
76816	OBSTET US, F/U, PER FETUS	$245.43	$210.36	X
76817	TRANSVAGINAL US, OBSTETRIC	$245.43	$210.36	X
76818	FETAL BIOPHYS PROFILE W/NST	$379.59	$325.35	X
76819	FETAL BIOPHYS PROFILE W/O NST	$379.59	$325.35	X
76820	UMBILICAL ARTERY ECHO	$245.43	$210.36	X
76821	MIDDLE CEREBRAL ARTERY ECHO	$245.43	$210.36	X
76826	ECHO EXAM FETAL HEART	$1,586.46	$1,359.76	X
76827	ECHO EXAM FETAL HEART	$245.43	$210.36	X
76828	ECHO EXAM FETAL HEART	$245.43	$210.36	X
76830	TRANSVAGINAL US, NON-OB	$379.59	$325.35	X
76856	US EXAM, PELVIC, COMPLETE	$379.59	$325.35
76857	US EXAM, PELVIC, LIMITED	$245.43	$210.36
76870	US EXAM, SCROTUM	$379.59	$325.35
76872	US, TRANSRECTAL	$379.59	$325.35	X
76881	US XTR NON-VASC COMPLETE	$379.59	$325.35	X
76882	US XTR NON-VASC LMTD	$245.43	$210.36	X
76937	US GUIDE VASCULAR ACCESS	$0.00	$0.00	N1
76942	ECHO GUIDE FOR BIOPSY	$0.00	$0.00	N1
76998	US GUIDE, INTRAOP	$0.00	$0.00	N1
77001	FLUOROGUIDE FOR VEIN DEVICE	$0.00	$0.00	N1
77002	NEEDLE LOCALIZATION BY X-RAY	$0.00	$0.00	N1
77003	FLUOROGUIDE FOR SPINE INJECT	$0.00	$0.00	N1
77011	CT SCAN FOR LOCALIZATION	$0.00	$0.00	N1
77012	CT SCAN FOR NEEDLE BIOPSY	$0.00	$0.00	N1
77032	GUIDANCE FOR NEEDLE, BREAST	$0.00	$0.00	N1
77072	X-RAYS FOR BONE AGE	$177.57	$152.20	AS
77073	X-RAYS, BONE LENGTH STUDIES	$177.57	$152.20	AS
77074	X-RAYS, BONE SURVEY, LIMITED	$299.09	$256.35	AS
77075	X-RAYS, BONE SURVEY COMPLETE	$299.09	$256.35	AS
77076	X-RAYS, BONE SURVEY, INFANT	$299.09	$256.35	AS
77077	JOINT SURVEY, SINGLE VIEW	$177.57	$152.20	AS
77080	DIAG BONE DENSITY, AXIAL	$278.03	$238.30	X
77081	DIAG BONE DENSITY/PERIPHERAL	$126.60	$108.51	X
77082	DIAG BONE DENSITY, VERTEBRAL FX	$177.57	$152.20	X
77280	SET RADIATION THERAPY FIELD	$411.92	$353.06	AS
77285	SET RADIATION THERAPY FIELD	$1,070.85	$917.82	AS
77290	SET RADIATION THERAPY FIELD	$1,070.85	$917.82	AS
77295	SET RADIATION THERAPY FIELD	$3,653.77	$3,131.64	AS
77300	RADIATION THERAPY DOSE PLAN	$411.92	$353.06	AS
77305	TELETX ISODOSE PLAN SIMPLE	$411.92	$353.06	AS
77310	TELETX ISODOSE PLAN INTERMED	$411.92	$353.06	AS
77315	TELETX ISODOSE PLAN COMPLEX	$1,070.85	$917.82	AS
77321	SPECIAL TELETX PORT PLAN	$1,070.85	$917.82	AS
77331	SPECIAL RADIATION DOSIMETRY	$411.92	$353.06	AS
77332	RADIATION TREAT AID(S)	$787.38	$674.86	AS
77333	RADIATION TREAT AID(S)	$787.38	$674.86	AS
77334	RADIATION TREAT AID(S)	$787.38	$674.86	AS
77336	RADIATION PHYSICS CONSULT	$411.92	$353.06	AS
77371	SRS, MULTISOURCE	$30,204.85	$25,888.56	X
77403	RADIATION TX SING AREA 6-10MEV	$385.67	$330.55	X
77413	RADIATION TX 3/MORE AREA 6-10MEV	$632.95	$542.50	X
77414	RADIATION TX 3/MORE AREA 11-19MEV	$632.95	$542.50	X
77417	RADIOLOGY PORT FILM(S)	$0.00	$0.00	N1
77470	SPECIAL RADIATION TREAT	$1,532.02	$1,313.09	X
78006	THYROID IMAGING W/UPTAKE	$865.36	$741.70	X
78007	THYROID IMAGE, MULT UPTAKES	$865.36	$741.70	X
78102	BONE MARROW IMAGING, LTD	$1,013.33	$868.52	X
78103	BONE MARROW IMAGING, MULT	$1,013.33	$868.52	X
78215	LIVER & SPLEEN IMAGING	$1,045.30	$895.93	X
78220	LIVER FUNCTION STUDY	$1,045.30	$895.93	X
78223	HEPATOBILIARY IMAGING	$1,045.30	$895.93	X
78232	SALIVARY GLAND FUNCTION EXAM	$943.46	$808.64	X
78300	BONE IMAGING, LIMITED AREA	$964.75	$826.89	X
78305	BONE IMAGING, MULTIPLE AREAS	$964.75	$826.89	X
78306	BONE IMAGING, WHOLE BODY	$964.75	$826.89	X
78315	BONE IMAGING, 3 PHASE	$964.75	$826.89	X
78320	BONE IMAGING (3D)	$964.75	$826.89	X
78445	VASCULAR FLOW IMAGING	$789.90	$677.02	X
78451	HEART MUSCLE IMAGE SPECT, SING	$2,995.98	$2,567.85	X
78452	HEART MUSCLE IMAGE SPECT, MULT	$2,995.98	$2,567.85	X
78469	HEART INFARCT IMAGE (3D)	$1,148.83	$984.67	X
78472	GATED HEART, PLANAR, SING	$1,148.83	$984.67	X
78481	HEART FIRST PASS, SING	$1,148.83	$984.67	X
78494	HEART IMAGE, SPECT	$1,148.83	$984.67	X
78580	LUNG PERFUSION IMAGING	$776.02	$665.13	X
78584	LUNG V/Q IMAGE SINGLE BREATH	$1,261.32	$1,081.07	X
78585	LUNG V/Q IMAGING	$1,261.32	$1,081.07	X
78588	PERFUSION LUNG IMAGE	$1,261.32	$1,081.07	X
78594	VENT IMAGE, MULT PROJ, GAS	$776.02	$665.13	X
78596	LUNG DIFFERENTIAL FUNCTION	$1,261.32	$1,081.07	X
78607	BRAIN IMAGING (3D)	$2,350.85	$2,014.92	X
78707	KID FLOW/FUNCT IMAGE W/O DRUG	$1,267.39	$1,086.28	X
78708	KID FLOW/FUNCT IMAGE W/DRUG	$1,267.39	$1,086.28	X
78709	KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE	$1,267.39	$1,086.28	X
78802	TUMOR IMAGING, WHOLE BODY	$1,872.66	$1,605.05	X
78803	TUMOR IMAGING (3D)	$1,872.66	$1,605.05	X
78805	ABSCESS IMAGING, LTD AREA	$1,872.66	$1,605.05	X
78806	ABSCESS IMAGING, WHOLE BODY	$1,872.66	$1,605.05	X
78815	PET IMAGE W/CT, SKULL-THIGH	$4,108.15	$3,521.09	X
79101	NUCLEAR RX, IV ADMIN	$883.62	$757.35	X

Pathology and laboratory, CPT 80000 to 89999

1 rows

Code	Description	North	South	Flags
88141	CYTOPATH, C/V, INTERPRET	not listed	not listed	N1

Medicine, CPT 90000 to 99999

37 rows

Code	Description	North	South	Flags
92070	FIT CONTACT LENS	not listed	not listed	N1
92504	EAR MICROSCOPY EXAM	not listed	not listed	N1
92547	SUPPLEMENTAL ELECTRICAL TEST	not listed	not listed	N1
92621	AUDITORY FUNCTION, + 15 MIN	not listed	not listed	N1
93314	ECHO TRANSESOPHAGEAL	not listed	not listed	N1
93320	DOPPLER ECHO EXAM, HEART	not listed	not listed	N1
93321	DOPPLER ECHO EXAM, HEART	not listed	not listed	N1
93325	DOPPLER COLOR FLOW, ADDED	not listed	not listed	N1
93463	DRUG ADMIN & HEMODYNMIC MEAS	not listed	not listed	N1
93464	EXERCISE W/HEMODYNAMIC MEAS	not listed	not listed	N1
93563	INJECT CONGENITAL CARD CATH	not listed	not listed	N1
93564	INJECT HEART CONGNTL ART/GRAFT	not listed	not listed	N1
93565	INJECT L VENTR/ATRIAL ANGIO	not listed	not listed	N1
93566	INJECT R VENTR/ATRIAL ANGIO	not listed	not listed	N1
93567	INJECT SUPRVLV AORTOGRAPHY	not listed	not listed	N1
93568	INJECT PULM ART HEART CATH	not listed	not listed	N1
93609	MAP TACHYCARDIA, ADDED	not listed	not listed	N1
93623	STIMULATION, PACING HEART	not listed	not listed	N1
93641	ELECTROPHYSIOLOGY EVAL	not listed	not listed	N1
94760	MEASURE BLOOD OXYGEN LEVEL	not listed	not listed	N1
94761	MEASURE BLOOD OXYGEN LEVEL	not listed	not listed	N1
95873	GUIDE NERVE DESTROY, ELECT STIM	not listed	not listed	N1
95874	GUIDE NERVE DESTROY, NEEDLE EMG	not listed	not listed	N1
95920	INTRAOP NERVE TEST, ADDED	not listed	not listed	N1
95955	EEG DURING SURG	not listed	not listed	N1
95957	EEG DIGITAL ANALYSIS	not listed	not listed	N1
96368	THER/DIAG CONCURRENT INF	not listed	not listed	N1
99143	MOD SEDATION SAME PHYS, < 5 YRS	not listed	not listed	N1
99144	MOD SEDATION BY SAME PHYS, 5 YRS +	not listed	not listed	N1
99145	MOD SEDATION BY SAME PHYS, ADDED	not listed	not listed	N1
99148	MOD SEDATION DIFF PHYS < 5 YRS	not listed	not listed	N1
99149	MOD SEDATION DIFF PHYS 5 YRS +	not listed	not listed	N1
99150	MOD SEDATION DIFF PHYS, ADDED	not listed	not listed	N1
99175	INDUCTION VOMITING	not listed	not listed	N1
99292	CRITICAL CARE, ADDED 30 MIN	not listed	not listed	N1
99354	PROLONGED SERVICE, OFFICE	not listed	not listed	N1
99355	PROLONGED SERVICE, OFFICE	not listed	not listed	N1

Source

The schedule: N.J.A.C. 11:3-29 Appendix, Exhibit 7, published by the New Jersey Department of Banking and Insurance and effective for treatment rendered on or after January 4, 2013. It has not been amended since.
Official files: the Department’s auto medical fee schedule page, the rule text and the Department’s own FAQ.
This page: parsed from the Department’s Excel file, with every row count and every figure cross-checked against the Department’s PDF of the same exhibit. Free to download as one CSV of all seven exhibits, 7,553 rows, no sign-up.

Amounts are the maximum reimbursable under the New Jersey PIP fee schedule, not what a provider billed and not what an insurer paid. N.J.A.C. 11:3-29caps reimbursement at the lesser of the provider’s charge or the scheduled amount, and 11:3-29.6 bars a provider from billing a patient the difference. This page reproduces the schedule; it does not decide whether a service was medically necessary, correctly coded, or covered. Verify any figure against the Department’s own file before relying on it. Current Procedural Terminology (CPT) is copyright 2010 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT® is a trademark of the American Medical Association.

Reading exhibit 7002

What the rule says about this schedule

What is a hospital outpatient surgical facility fee?

It is the money the hospital is paid for hosting the surgery, as distinct from the money the surgeon is paid for performing it. 11:3-29.5(b) makes the Exhibit 7 amount the maximum reimbursable for an outpatient procedure performed in a hospital outpatient surgical facility, and that one amount is meant to cover everything on the facility's side of the case.

11:3-29.5(a)1 through 8 lists what is inside it: operating and recovery rooms, patient preparation and waiting areas, the work of nurses and technical staff, drugs and biologicals, surgical dressings, supplies, splints, casts, appliances and equipment, diagnostic and therapeutic items, administrative and housekeeping services, blood and blood products, anesthesia materials, and implantable DME and prosthetics. A line billed separately for something on that list is being billed twice.

When does Exhibit 7 apply instead of the technical component on Exhibit 1?

FAQ Answer 20 draws the line by why the patient is there. If the patient was admitted to the hospital outpatient facility for a surgical procedure, the Exhibit 7 fee applies. If a physician simply referred the patient to have an imaging study done at the hospital outpatient department, the TC rows on the physicians' column of Exhibit 1 apply instead.

The Department reaches that answer through 11:3-29.4(g), which interprets the fee schedules in accordance with the Medicare Claims Processing Manual, and points specifically at chapter 13, sections 20.2.1 through 20.2.3. X-rays and MRIs carry fees on both schedules, so the choice is not cosmetic: the two numbers are different, and the reason for the visit decides which is right.

Where does Exhibit 7 not apply at all?

In three places, each named by the rule. Exhibit 7 facility fees do not apply to services provided in a hospital emergency room (11:3-29.4(a)2, billed with ER). They do not apply to trauma services at a Level I or Level II trauma hospital (29.4(a)1, billed with TS). And they do not cover physician services, which stay on Exhibit 1.

FAQ Answer 19 adds a fourth boundary that carriers and providers argue about by name. A rehabilitation hospital's outpatient bill meeting the definition of hospital outpatient services does not make the HOSF rate apply to everything done there. Exhibit 7 prices the items in 29.5(a)1 through 8 when they are provided in connection with a surgical service listed on the schedule. Outpatient physical therapy at such a facility is priced under the physicians' fee schedule and the daily maximum, not under Exhibit 7 and not as a usual and customary claim.

How are multiple procedures in one session paid?

11:3-29.5(d) sets its own formula for facilities, separate from the physicians' one. When several procedures happen in the same operative session in an ASC or an HOSF, the facility fee for the highest paying procedure is reimbursed at 100 percent and every additional procedure at 50 percent.

Two details decide real cases. A procedure performed bilaterally in one session is reported as two procedures and is subject to that reduction (29.5(d)1), which is the opposite of how the physicians' column treats a bilateral procedure. And the codes marked X in the flag column are exempt from the reduction entirely, because Medicare exempts them and 29.5(d)2 carries that exemption across. 135 rows on this exhibit are marked X.

Are the North and South columns correct for Exhibit 7?

They are published by the State, and the rule is inconsistent about them. 11:3-29.3(a) defines the North and South regions for Exhibit 1, Exhibit 2 and Exhibit 4, and does not name Exhibit 7. The exhibit carries North and South columns anyway.

What grounds using them is 11:3-29.4(b), which speaks generally of the region determining the proper fee set forth in the schedules, by where the service was rendered, or for elective care given to a New Jersey resident outside the State, by where the insured lives. We publish the columns as the Department published them, and say the inconsistency out loud rather than papering over a gap in the rule.

The other exhibits003

The rest of the New Jersey PIP fee schedule

Exhibit 1

Pricing a whole PIP packet, not one code?

See PIP Engine