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					                    2007 NH MEDICAID FEE SCHEDULE - COVERED PROCEDURES (THAT ARE NOT MANUALLY PRICED)
                                                                                                                                     PRICING
                                                                                                                                     BEGIN        PRICING
 PROC    TOS MOD 1 MOD 2 MOD 3 MOD 4   PROCEDURE DESCRIPTION                                               PA IND   PAC FEE          DTE          END DTE
00100   7                              ANESTH. FOR PROCEDURES ON SALIVARY GLANDS,INCLUDING BIOPSY          N        3       $13.45     6/1/1994    12/31/2299
00102   7                              ANESTH. PLASTIC REPAIR CLEFT LIP                                    N        3       $13.45     6/1/1994    12/31/2299
00103   7                              ANESTHESIA FOR RECONSTRUCTIVE PROCEDURES OF EYELID                  N        3       $13.45     1/1/1999    12/31/2299
00104   7                              ANESTH. ELECTROCONVULSIVE THERAPY                                   N        3       $13.45     6/1/1994    12/31/2299
00120   7                              ANESTHESIA FOR PROCEDURES ON EXTERNAL,MIDDLE,AND INNER EAR INC.BI   N        3       $13.45     1/1/1999    12/31/2299
00124   7                              ANESTH. OTOSCOPY                                                    N        3       $13.45     6/1/1994    12/31/2299
00126   7                              ANESTH. TYMPANOTOMY                                                 N        3       $13.45     6/1/1994    12/31/2299
00140   7                              ANESTHESIA FOR PROCEDURES ON EYE;NOT OTHERWISE SPECIFIED            N        3       $13.45     1/1/2000    12/31/2299
00142   7                              ANESTH. LENS SURGERY                                                N        3       $13.45     6/1/1994    12/31/2299
00144   7                              ANESTHESIA FOR PROCEDURES ON EYE                                    N        3       $13.45     6/1/1994    12/31/2299
00145   7                              ANESTHESIA FOR PROCEDURES ON EYE;VITREORETINAL SURGERY              N        3       $13.45     6/1/1994    12/31/2299
00147   7                              IRIDECTOMY - ANESTHESIA                                             N        3       $13.45     1/1/1999    12/31/2299
00148   7                              ANESTH. OPHTHALMOSCOPY                                              N        3       $13.45     6/1/1994    12/31/2299
00160   7                              ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES;NOC         N        3       $13.45     1/1/1999    12/31/2299
00162   7                              ANESTH. RADICAL SURGERY-NOSE                                        N        3       $13.45     6/1/1994    12/31/2299
00164   7                              ANESTH. BIOPSY SOFT TISSUE-NOSE                                     N        3       $13.45     6/1/1994    12/31/2299
00170   7                              ANESTH. INTRAORAL NOC                                               N        3       $13.45     6/1/1994    12/31/2299
00172   7                              ANESTH. REPAIR OF CLEFT PALATE                                      N        3       $13.45     6/1/1994    12/31/2299
00174   7                              ANESTH. EXISION OF RETROPHARYNGEAL TUMOR                            N        3       $13.45     6/1/1994    12/31/2299
00176   7                              ANESTH. RADICAL SURGERY-INTRAORAL                                   N        3       $13.45     6/1/1994    12/31/2299
00190   7                              ANESTH. PROCS. ON FACIAL BONES OR SKULL;NOC                         N        3       $13.45     6/1/1994    12/31/2299
00192   7                              ANESTH. RADICAL SURGERY-FACIAL BONES                                N        3       $13.45     6/1/1994    12/31/2299
00210   7                              ANESTHESIA FOR INTRACRANIAL PROCEDURES;NOT OTHERWISE SPECIFIED      N        3       $13.45     1/1/1999    12/31/2299
00212   7                              ANESTH. SUBDURAL TAPS-INTERCRANIAL                                  N        3       $13.45     6/1/1994    12/31/2299
00214   7                              ANESTH. BURR HOLES-INTERCRANIAL                                     N        3       $13.45     6/1/1994    12/31/2299
00215   7                              ELEVATION OF DEPRESSED SKULL FRACTURE, EXTRADURAL(SIMPLE OR COMP.   N        3       $13.45     1/1/1999    12/31/2299
00216   7                              ANESTH. VASCULAR PROCS-INTERCRANIAL                                 N        3       $13.45     6/1/1994    12/31/2299
00218   7                              ANESTH. INTERCRANIAL PROCS. IN SITTING POSITION                     N        3       $13.45     6/1/1994    12/31/2299
00220   7                              SPINAL FLUID SHUNTING PROCEDURES                                    N        3       $13.45     1/1/1999    12/31/2299
00222   7                              ANESTH. ELECTROCOAGULATION OF INTRACRANIAL NERVE                    N        3       $13.45     6/1/1994    12/31/2299
00300   7                              ANESTH. INTEGUMENTARY SYST.-NECK, ALL PROCS.                        N        3       $13.45     6/1/1994    12/31/2299
00320   7                              ANESTH. ALL PROCS.ESOPHAGUS,THYR,LARY,TRACH,LYMPH 1YR OLDER         N        3       $13.45     6/1/1994    12/31/2299
00322   7                              ANESTH. NEEDLE BIOPSY-THYROID                                       N        3       $13.45     6/1/1994    12/31/2299
00326   7                              ANESTH. FOR ALL PROCS ON LARYNX AND TRACH IN CHILD LESS 1YR         N        3       $13.45     1/1/2003    12/31/2299
00350   7                              ANESTH. PROCS. ON MAJOR VESSELS-NECK NOC                            N        3       $13.45     6/1/1994    12/31/2299
00352   7                              ANESTH. SIMPLE LIGATION-NECK VESSEL                                 N        3       $13.45     6/1/1994    12/31/2299
00400   7                              ANESTH. INTEG. SYST. ANTERIOR CHEST NOC                             N        3       $13.45     6/1/1994    12/31/2299
00402   7                              ANESTH. RECONSTRUCTIVE PROCS. BREAST                                N        3       $13.45     6/1/1994    12/31/2299
00404   7                              ANESTH. RADICAL, MODIFIED PROCS. BREAST                             N        3       $13.45     6/1/1994    12/31/2299
00406   7                              ANESTH. RADICAL,MODIFIED PROCS. BREAST W NODE DIS.                  N        3       $13.45     6/1/1994    12/31/2299
00410   7                              ELECTRICAL CONVERSION OF ARRHYTHMIAS                                N        3       $13.45     1/1/2000    12/31/2299
00450   7                              ANESTH. PROCS. ON CLAVICLE-SCAPULA NOC                              N        3       $13.45     6/1/1994    12/31/2299
00452   7                              ANESTH. RADICAL SURGERY-CLAVICLE-SCAPULA                            N        3       $13.45     6/1/1994    12/31/2299
00454   7                              ANESTH. BIOPSY OF CLAVICLE                                          N        3       $13.45     6/1/1994    12/31/2299




                                                                                                                                                                1
00470   7   ANESTHESIA FOR PARTIAL RIB RESECTION;NOT OTHERWISE SPECIFIED        N   3   $13.45   6/1/1994   12/31/2299
00472   7   ANESTH. THORACOPLASTY (ANY TYPE)                                    N   3   $13.45   6/1/1994   12/31/2299
00474   7   ANESTH. RADICAL PROCS. RIBS                                         N   3   $13.45   6/1/1994   12/31/2299
00500   7   ANESTH. ESOPHAGUS-ALL PROCS.                                        N   3   $13.45   6/1/1994   12/31/2299
00520   7   ANESTH CLOSED CHST PROC (INC ESOPHAG,BROCHO,DIAG THORACOSCOPY)      N   3   $13.45   6/1/1994   12/31/2299
00522   7   ANESTH. NEEDLE BIOPSY-PLEURA                                        N   3   $13.45   6/1/1994   12/31/2299
00524   7   ANESTH. PNEUMOCENTESIS                                              N   3   $13.45   6/1/1994   12/31/2299
00528   7   ANESTH. MEDIASTINOSCOPY AND DIAGNOSTIC THORACOSCOPY                 N   3   $13.45   6/1/1994   12/31/2299
00529   7   MEDIASTINOSCOPY AND DIAGNOSTIC THORACOSCOPY NOT UTILIZING ONE LUN   N   3   $13.45   1/1/2004   12/31/2299
00530   7   ANESTHESIA FOR PERMANENT TRANSVENOUS PACEMAKER INSERTION            N   3   $13.45   6/1/1994   12/31/2299
00532   7   ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION                 N   3   $13.45   6/1/1994   12/31/2299
00534   7   ANESTHESIA FOR TRANSVENOUS INSERTION OR REPLACEMENT OF PACING       N   3   $13.45   6/1/1994   12/31/2299
00537   7   ANESTHESIA FOR CARDIAC ELECTOPHSIO PROC INCLUDING RADIOFREQUENCY    N   3   $13.45   1/1/2001   12/31/2299
00539   7   ANESTH FOR TRACH. BRONC RECONSTRUCTION                              N   3   $13.45   1/1/2003   12/31/2299
00540   7   ANESTH THRCTMY PROC, LUNGS,PLEURA,DIAPHRAGM & MEDIASTINUM           N   3   $13.45   6/1/1994   12/31/2299
00541   7   ANEST THORAC , LUNGS,PLEURA, DIAPHGRAGM UTIL. ONE LUNG VENT         N   3   $13.45   1/1/2003   12/31/2299
00542   7   ANESTH. DECORTICATION-LUNG,PLEURA ETC.                              N   3   $13.45   6/1/1994   12/31/2299
00546   7   ANESTH. PULM/NARY RESECTION W THORACOPLASTY                         N   3   $13.45   6/1/1994   12/31/2299
00548   7   ANESTH. INTRATHORACIC REP. TRACHEA-BRONCHI TRAUMA                   N   3   $13.45   6/1/1994   12/31/2299
00550   7   ANESTHESIA FOR STERNAL DEBRIDEMENT                                  N   3   $13.45   1/1/2002   12/31/2299
00560   7   ANESTH. PROCS. HEART,PERICARD,GRT VESLS WO PUMP OX                  N   3   $13.45   6/1/1994   12/31/2299
00561   7   ANES FOR PROCS ON HEART, PERICARDIL SAC AND GREAT VESSELS OF CHES   N   3   $13.45   1/1/2005   12/31/2299
00562   7   ANESTH. PROCS. HEART,PERICARD,GRT VESLS W PUMP OXY                  N   3   $13.45   6/1/1994   12/31/2299
00563   7   ANESTHESIA PROCEDURES ON HEART,PERICARDIUM,AND GREAT VESS...        N   3   $13.45   1/1/2001   12/31/2291
00566   7   ANESTHESIA FOR DIRECT CORONARY ARTERY BYPASS GRAFTING W/O P OXY     N   3   $13.45   1/1/2001   12/31/2291
00580   7   ANESTH. HEART OR HEART/LUNG TRANSPLANT                              N   3   $13.45   6/1/1994   12/31/2299
00600   7   ANESTH. PROCS. CERVICAL SPINE &CORD NOC                             N   3   $13.45   6/1/1994   12/31/2299
00604   7   ANESTH. FOR PROCEDURES ON CERVICAL SPINE AND CORD/SITTING POSITIO   N   3   $13.45   6/1/1994   12/31/2299
00620   7   ANESTH. PROCS. THORACIC SPINE & CORD NOC                            N   3   $13.45   6/1/1994   12/31/2299
00622   7   ANESTH. THORACOLUMBAR SYMPATHECTOMY                                 N   3   $13.45   6/1/1994   12/31/2299
00625   7   ANES SPINE TRANTHOR W/O VENT                                        N   3   $13.45   1/1/2007   12/31/2299
00626   7   ANES. SPINE TRANSTHOR W/VENT                                        N   3   $13.45   1/1/2007   12/31/2299
00630   7   ANESTH. PROCS. IN LUMBAR REGION NOC                                 N   3   $13.45   6/1/1994   12/31/2299
00632   7   ANESTH. LUMBAR SYMPATHECTOMY                                        N   3   $13.45   6/1/1994   12/31/2299
00634   7   ANESTH. LUMBAR CHEMONUCLEOLYSIS                                     N   3   $13.45   6/1/1994   12/31/2299
00635   7   ANESTHESIA FOR PROCEDURES IN LUMBAR REGION;DIAG OR THERAPEUTIC      N   3   $13.45   1/1/2001   12/31/2291
00640   7   ANES FOR MAN OF SPINE OR CLOSED PROC ON CERV, THORAC, LUMBAR        N   3   $13.45   1/1/2003   12/31/2299
00670   7   ANESTH. EXTENSIVE SPINE & CORD PROCS.                               N   3   $13.45   6/1/1994   12/31/2299
00700   7   ANESTH. PROCS. UPPER ANTERIOR ABDOMINAL WALL NOC                    N   3   $13.45   6/1/1994   12/31/2299
00702   7   ANESTH. PERCUTANEOUS LIVER BIOPSY                                   N   3   $13.45   6/1/1994   12/31/2299
00730   7   ANESTH. PROCS. UPPER POSTERIOR ABDOMINAL WALL                       N   3   $13.45   6/1/1994   12/31/2299
00740   7   ANESTH. UPPER GASTROINTESTINAL ENDOSCOPIC PROCS.                    N   3   $13.45   6/1/1994   12/31/2299
00750   7   ANESTH. HERNIA REPAIRS UPPER ABDOMEN NOC                            N   3   $13.45   6/1/1994   12/31/2299
00752   7   ANESTH. LUMBAR/VENTRAL HERNIAS-WOUND DEHISCENCE                     N   3   $13.45   6/1/1994   12/31/2299
00754   7   ANESTH. OMPHALOCELE                                                 N   3   $13.45   6/1/1994   12/31/2299
00756   7   ANESTH. TRANSABDOMINAL REPAIR-DIAPHRAGMATIC HERNIA                  N   3   $13.45   6/1/1994   12/31/2299
00770   7   ANESTH. PROCS. MAJOR ABDOMINAL BLOOD VESSELS                        N   3   $13.45   6/1/1994   12/31/2299
0077T   7   IMPLANTING AND SECURING CEREBRAL THERMAL PERFUSION PROBE            N   3   $13.45   1/1/2005   12/31/2299
0078T   7   ENDOVASCULAR REPAIR OF ABDOMINAL AORTIC ANEURYSM, PSEUDOANEURYSM    N   3   $13.45   1/1/2005   12/31/2299
00790   3   ANEST FR INTRPTNL PROCS UPP ABD INC BWL SHNT NOS                    N   3    $6.25   1/1/1984   12/31/2299
00790   7   ANESTH. INTRAPERITONEAL PROCS. UPPER ABDOMEN NOC                    N   3   $13.45   6/1/1994   12/31/2299




                                                                                                                         2
00792   7   ANESTH. PARTIAL HEPATECTOMY-NOT LIVER BIOPSY                       N   3   $13.45   6/1/1994   12/31/2299
00794   7   ANESTH. PANCREATECTOMY-PARTIAL OR TOTAL                            N   3   $13.45   6/1/1994   12/31/2299
00796   7   ANESTH. LIVER TRANSPLANT                                           N   3   $13.45   6/1/1994   12/31/2299
00797   7   ANESTHESIA, GATRIC RESTRICTIVE PROC FOR MORBID OBESITY             N   3   $13.45   1/1/2002   12/31/2299
00800   7   ANESTH. PROCS. LOWER ANTERIOR ABDOMINAL WALL NOC                   N   3   $13.45   6/1/1994   12/31/2299
00802   7   ANESTH. PANNICULECTOMY                                             N   3   $13.45   6/1/1994   12/31/2299
00806   7   ANESTH. LAPAROSCOPIC PROC.                                         N   3   $13.45   6/2/1994   12/31/2299
0080T   7   ENDOVASCULAR REPAIR OR ABDOMINAL AORTIC ANEURYSM, PSEUDOANEURYSM   N   3   $13.45   1/1/2005   12/31/2299
00810   7   ANESTH. INTESTINAL ENDOSCOPIC PROCS.                               N   3   $13.45   6/1/1994   12/31/2299
0081T   7   PLACEMENT OF VISCERAL EXT PROSTHESIS FOR ENDORVASCULAR REPIRT OF   N   3   $13.45   1/1/2005   12/31/2299
00820   7   ANESTH.PROCS. LOWER POSTERIOR ABDOMINAL WALL                       N   3   $13.45   6/1/1994   12/31/2299
00830   7   ANESTHESIA HERNIA REPAIR LOW ABDOMEN NOC                           N   3   $13.45   6/1/1994   12/31/2299
00832   7   ANESTH. VENTRAL & INCISIONAL HERNIAS                               N   3   $13.45   6/1/1994   12/31/2299
00834   7   ANES FOR HERNIA REPAIRS IN THE LOWER ABDOMEN UNDER 1 YR            N   3   $13.45   1/1/2003   12/31/2299
00836   7   ANES FOR HERNIA REPAIRS IN LOWER AB LESS THAN 37 WEEKS             N   3   $13.45   1/1/2003   12/31/2299
00840   7   ANESTH. INTRAPERITONEAL PROCS. LOWER ABDOMEN NOC                   N   3   $13.45   6/1/1994   12/31/2299
00842   7   ANESTH. AMNIOCENTESIS                                              N   3   $13.45   6/1/1994   12/31/2299
00844   7   ANESTH. ABDOMINOPERINEAL RESECTION                                 N   3   $13.45   6/1/1994   12/31/2299
00846   7   ANESTH. RADICAL HYSTERECTOMY                                       N   3   $13.45   6/1/1994   12/31/2299
00848   7   ANESTH. PELVIC EXENTERATION                                        N   3   $13.45   6/1/1994   12/31/2299
00850   7   ANESTH. CESAREAN SECTION                                           N   3   $13.45   6/1/1994   12/31/2299
00851   7   ANESTHESIA FOR INTRAPRAPERIONEAL PRCEDURES IN LOWER ABDOMEN        N   3   $13.45   1/2/2002   12/31/2299
00855   7   ANESTH. CESAREAN HYSTERECTOMY                                      N   3   $13.45   6/1/1994   12/31/2299
00857   7   ANESTH. CONTINUOUS LUMBAR ANALGSIA-LABOR/C'SECTION                 N   3   $13.45   6/1/1994   12/31/2299
00860   7   ANESTH. EXTRAPERIT. PROCS. LWR.ABD.-URINARY NOC                    N   3   $13.45   6/1/1994   12/31/2299
00862   7   ANESTH. RENAL PROCS. INCLU. UPR 1/3 URETER                         N   3   $13.45   6/1/1994   12/31/2299
00864   7   ANESTH. TOTAL CYSTECTOMY                                           N   3   $13.45   6/1/1994   12/31/2299
00865   7   ANESTHESIA EXTRA PERITONEAL PROC LOW ABDMN,INC URIN TRCT,F         N   3   $13.45   1/1/1996   12/31/2299
00866   7   ANESTH. ADRENALECTOMY                                              N   3   $13.45   6/1/1994   12/31/2299
00868   7   ANESTH. RENAL TRANSPLANT (RECIPIENT)                               N   3   $13.45   6/1/1994   12/31/2299
00870   7   ANESTH. CYSTOLITOTOMY                                              N   3   $13.45   6/1/1994   12/31/2299
00872   7   ANESTH. LITHOTRIPSY EXTRACORPOREAL SHOCK WAVE                      N   3   $13.45   6/1/1994   12/31/2299
00873   7   ANESTHESIA FOR LITHOTRIPSY, EXTRACORPOREAL SHOCK W                 N   3   $13.45   6/1/1994   12/31/2299
00880   7   ANESTH. PROCS. MAJOR LOWER ABDOMINAL VESSELS NOC                   N   3   $13.45   6/1/1994   12/31/2299
00882   7   ANESTH. INFERIOR VENA CAVA LIGATION                                N   3   $13.45   6/1/1994   12/31/2299
00902   7   ANESTH. ANORECTAL PROC.                                            N   3   $13.45   6/1/1994   12/31/2299
00904   7   ANESTH. RADICAL PERINEAL PROC.                                     N   3   $13.45   6/1/1994   12/31/2299
00906   7   ANESTH. VULVECTOMY                                                 N   3   $13.45   6/1/1994   12/31/2299
00908   7   ANESTH. PERINEAL PROSTATECTOMY                                     N   3   $13.45   6/1/1994   12/31/2299
00910   7   ANESTH. TRANSURETHRAL PROC. NOC                                    N   3   $13.45   6/1/1994   12/31/2299
00912   7   ANESTH. TRANSURETHRAL RESECTION-BLADDER TUMORS                     N   3   $13.45   6/1/1994   12/31/2299
00914   7   ANESTH. TRANSURETHRAL RESCTION-PROSTATE                            N   3   $13.45   6/1/1994   12/31/2299
00916   7   ANESTH. POST-TRANSURETHRAL RESECTION BLEEDING                      N   3   $13.45   6/1/1994   12/31/2299
00918   7   ANESTHESIA FOR TRANSURETHRAL PROCEDURES (INCLUDING                 N   3   $13.45   6/1/1994   12/31/2299
00920   7   ANESTH. PROCS. MALE EXTERNAL GENITALIA NOC                         N   3   $13.45   6/1/1994   12/31/2299
00921   7   ANES FOR PROC ON MALE GENITALIA,VASTECTOMY UNI/BILAT               N   3   $13.45   1/1/2003   12/31/2299
00922   7   ANESTH. SEMINAL VESICLES                                           N   3   $13.45   6/1/1994   12/31/2299
00924   7   ANESTH. UNDESCENDED TESTIS UNI/BILATERAL                           N   3   $13.45   6/1/1994   12/31/2299
00926   7   ANESTH. RADICAL ORCHIECTOMY-INGUINAL                               N   3   $13.45   6/1/1994   12/31/2299
00928   7   ANESTH. RADICAL ORCHIECTOMY-ABDOMINAL                              N   3   $13.45   6/1/1994   12/31/2299
00930   7   ANESTH. ORCHIOPEXY UNI/BILATERAL                                   N   3   $13.45   6/1/1994   12/31/2299




                                                                                                                        3
00932   7   ANESTH. COMPLETE AMPUTATION-PENIS                                  N   3   $13.45   6/1/1994   12/31/2299
00934   7   ANESTH. RADICAL AMPUT. PENIS W BILAT LYMPHADONCTMY                 N   3   $13.45   6/1/1994   12/31/2299
00936   7   ANESTH. RADICAL AMPUT. PENIS W BI.ING&ILIAC LYMPH.                 N   3   $13.45   6/1/1994   12/31/2299
00938   7   ANESTH. INSERTION-PENILE PROSTHESIS                                N   3   $13.45   6/1/1994   12/31/2299
00940   7   ANESTH. VAGINAL PROCS. NOC                                         N   3   $13.45   6/1/1994   12/31/2299
00942   7   ANESTH. FOR VAGINAL PROCEDURES INCLUDING BIOPSY OF LABIA, VAGINA   N   3   $13.45   6/1/1994   12/31/2299
00944   7   ANESTH. VAGINAL HYSTERECTOMY                                       N   3   $13.45   6/1/1994   12/31/2299
00948   7   ANESTH. CERVICAL CERCLAGE                                          N   3   $13.45   6/1/1994   12/31/2299
00950   7   ANESTH. CULDOSCOPY                                                 N   3   $13.45   6/1/1994   12/31/2299
00952   7   ANESTH. HYSTEROSCOPY AND/OR HYSTEROSALPINGOGRAPHY                  N   3   $13.45   6/1/1994   12/31/2299
01112   7   ANESTHESIA FOR BONE MARROW ASPIRATION AND/OR BIOPSY ANT OR POST    N   3   $13.45   1/1/2001   12/31/2291
01120   7   ANESTHESIA FOR PROCEDURES ON BONY PELVIS                           N   3   $13.45   6/1/1994   12/31/2299
01130   7   ANESTH. BODY CAST APPLICATION/REVISION                             N   3   $13.45   6/1/1994   12/31/2299
01140   7   ANESTH. INTERPELVIABDOMINAL AMPUT. (HIND QUARTER)                  N   3   $13.45   6/1/1994   12/31/2299
01150   7   ANESTH. RADICAL PROCS. PELVIC TUMOR X HIND QTR AMP                 N   3   $13.45   6/1/1994   12/31/2299
01160   7   ANESTH. CLOSED PROCS. SYMPHYSIS PUBIS/SACRO JOINT                  N   3   $13.45   6/1/1994   12/31/2299
01170   7   ANESTH. OPEN PROCS. SYMPHYSIS PUBIS/SACRO JOINT                    N   3   $13.45   6/1/1994   12/31/2299
01180   7   ANESTH. OBTURATOR NEURECTOMY EXTRAPELVIC                           N   3   $13.45   6/1/1994   12/31/2299
01190   7   ANESTH. OBTURATOR NEURECTOMY INTRAPELVIC                           N   3   $13.45   6/1/1994   12/31/2299
01200   7   ANESTH. CLOSED PROCS. HIP JOINT                                    N   3   $13.45   6/1/1994   12/31/2299
01202   7   ANESTHESIA FOR ARTHROSCOPIC PROC OF HIP JOINT                      N   3   $13.45   1/1/2003   12/31/2299
01210   7   ANESTH. OPEN PROCS. HIP JOINT NOC                                  N   3   $13.45   6/1/1994   12/31/2299
01212   7   ANESTH. HIP DISARTICULATION                                        N   3   $13.45   6/1/1994   12/31/2299
01214   7   ANESTH. TOTAL HIP REPLACEMENT/REVISION                             N   3   $13.45   6/1/1994   12/31/2299
01215   7   ANESTHESIA FOR OPEN PROCEDURES INVOLVONG HIP JOINT;REV TOT HIP     N   3   $13.45   1/1/2001   12/31/2291
01220   7   ANESTH. ALL CLOSED PROCS. UPPER 2/3 FEMUR                          N   3   $13.45   6/1/1994   12/31/2299
01230   7   ANESTH. OPEN PROCS. UPPER 2/3 FEMUR NOC                            N   3   $13.45   6/1/1994   12/31/2299
01232   7   ANESTH. AMPUTATION UPPER 2/3 FEMUR                                 N   3   $13.45   6/1/1994   12/31/2299
01234   7   ANESTH. RADICAL RESECTION UPPER 2/3 FEMUR                          N   3   $13.45   6/1/1994   12/31/2299
01250   7   ANESTH. ALL PROCS. NERVES,MUSC,TENDS,FASCIA UP LEG                 N   3   $13.45   6/1/1994   12/31/2299
01260   7   ANESTH. ALL PROCS. VEINS UPPER LEG INC. EXPLOR.                    N   3   $13.45   6/1/1994   12/31/2299
01270   7   ANESTH. PROCS. ARTERIES UPPER LEG INCL.BYPASS NOC                  N   3   $13.45   6/1/1994   12/31/2299
01272   7   ANESTH. FEMORAL ARTERY LIGATION                                    N   3   $13.45   6/1/1994   12/31/2299
01274   7   ANESTH. FEMORAL ARTERY EMBOLECTOMY                                 N   3   $13.45   6/1/1994   12/31/2299
01320   7   ANESTH. ALL PROCS. NERVE,MUSCLE ETC. KNEE/POPLIT.                  N   3   $13.45   6/1/1994   12/31/2299
01340   7   ANESTH. ALL CLOSED PROCS. LOWER 1/3 FEMUR                          N   3   $13.45   6/1/1994   12/31/2299
01360   7   ANESTH. ALL OPEN PROCS. LOWER 1/3 FEMUR                            N   3   $13.45   6/1/1994   12/31/2299
01380   7   ANESTH. ALL CLOSED PROCS. KNEE JOINT                               N   3   $13.45   6/1/1994   12/31/2299
01382   7   ANESTH. ARTHROSCOPIC PROCS. KNEE JOINT                             N   3   $13.45   6/1/1994   12/31/2299
01390   7   ANESTH. ALL CLOSED PROCS. UPR END TIBIA,FIB/PATELL                 N   3   $13.45   6/1/1994   12/31/2299
01392   7   ANESTH. ALL OPEN PROCS. UPR TIBIA,FIB/PATELLA                      N   3   $13.45   6/1/1994   12/31/2299
01400   7   ANESTH. OPEN PROCS. KNEE JOINT NOC                                 N   3   $13.45   6/1/1994   12/31/2299
01402   7   ANESTH. TOTAL KNEE REPLACEMENT                                     N   3   $13.45   6/1/1994   12/31/2299
01404   7   ANESTH. DISARTICULATION KNEE                                       N   3   $13.45   6/1/1994   12/31/2299
01420   7   ANESTH. ALL CAST APPLIC,REMOVE,REPAIR KNEE                         N   3   $13.45   6/1/1994   12/31/2299
01430   7   ANESTH. PROCS. VEINS KNEE/POPLITEAL AREA NOC                       N   3   $13.45   6/1/1994   12/31/2299
01432   7   ANESTH. ARTERIOVENOUS FISTULA KNEE/POPLITEAL                       N   3   $13.45   6/1/1994   12/31/2299
01440   7   ANESTH. PROCS. ARTERIES KNEE/POPLITEAL NOC                         N   3   $13.45   6/1/1994   12/31/2299
01442   7   ANESTH. POPLITEAL THROMBOENDARTERECTOMY W/WO GRAFT                 N   3   $13.45   6/1/1994   12/31/2299
01444   7   ANESTH. POPLITEAL EXCISION,GRAFT/REP. OCCLUS/ANEUR                 N   3   $13.45   6/1/1994   12/31/2299
01462   7   ANESTH. ALL CLOSED PROCS. LOWER LEG,ANKLE,FOOT                     N   3   $13.45   6/1/1994   12/31/2299




                                                                                                                        4
01464   7   ANESTH. ARTHROSCOPIC PROCS. ANKLE JOINT              N   3   $13.45   6/1/1994   12/31/2299
01470   7   ANESTH. PROCS. NERVE,MUSCLE ETC. LWR LEG,ANK,FTNOC   N   3   $13.45   6/1/1994   12/31/2299
01472   7   ANESTH. REPAIR RUPTURED ACHILLES TEND. W/WO GRAFT    N   3   $13.45   6/1/1994   12/31/2299
01474   7   ANESTH. GASTROCNEMIUS RECESSION                      N   3   $13.45   6/1/1994   12/31/2299
01480   7   ANESTH. OPEN PROCS. BONES LWR LEG,ANKLE,FOOT NOC     N   3   $13.45   6/1/1994   12/31/2299
01482   7   ANESTH. RADICAL RESECTION LWR LEG,ANKLE,FOOT         N   3   $13.45   6/1/1994   12/31/2299
01484   7   ANESTH. OSTEOTOMY/OSTEOPLASTY TIBIA/FIBULA           N   3   $13.45   6/1/1994   12/31/2299
01486   7   ANESTH. TOTAL ANKLE REPLACEMENT                      N   3   $13.45   6/1/1994   12/31/2299
01490   7   ANESTH. LOWER LEG CAST APPLICATION,REMOVAL,REPAIR    N   3   $13.45   6/1/1994   12/31/2299
01500   7   ANSETH. PROCS. ARTERIES LOWER LEG INCL BYPASS NOC    N   3   $13.45   6/1/1994   12/31/2299
01502   7   ANESTH. EMBOLECTOMY LOWER LEG DIRECT/CATHETER        N   3   $13.45   6/1/1994   12/31/2299
01520   7   ANESTH. PROCS. VEINS LOWER NOC                       N   3   $13.45   6/1/1994   12/31/2299
01522   7   ANESTH. VENOUS THROMBECTOMY LOWER LEG DIRECT/CATH.   N   3   $13.45   6/1/1994   12/31/2299
01610   7   ANESTH. ALL PROCS. NERVE,MUSCLE,TEND,ETC SHLD/AXIL   N   3   $13.45   6/1/1994   12/31/2299
01620   7   ANESTH. ALL CLOSED PROCS. HUMER,STERNO/ACRCLAV/SHL   N   3   $13.45   6/1/1994   12/31/2299
01622   7   ANESTH. ARTHROSCOPIC PROCS. SHOULDER JOINT           N   3   $13.45   6/1/1994   12/31/2299
01630   7   ANESTH. OPEN PROCS. HUMER,STERN/ACROCLAV/SHLDR NOC   N   3   $13.45   6/1/1994   12/31/2299
01632   7   ANESTH. RADICAL RESECTION HUMER.CLAVICLE,SHLDR       N   3   $13.45   6/1/1994   12/31/2299
01634   7   ANESTH. SHOULDER DISARTICULATION                     N   3   $13.45   6/1/1994   12/31/2299
01636   7   ANESTH. INTERTHORACOSCAPULAR AMPUT. FOREQUARTER      N   3   $13.45   6/1/1994   12/31/2299
01638   7   ANESTH. TOTAL SHOULDER REPLACEMENT                   N   3   $13.45   6/1/1994   12/31/2299
01650   7   ANETH. PROCS. ARTERIES SHOULDER-AXILLA NOC           N   3   $13.45   6/1/1994   12/31/2299
01652   7   ANESTH. AXILLARY-BRACHIAL ANEURYSM                   N   3   $13.45   6/1/1994   12/31/2299
01654   7   ANESTH. BYPASS GRAFT SHOULDER/AXILLA                 N   3   $13.45   6/1/1994   12/31/2299
01656   7   ANESTH. AXILLARY-FEMORAL BYPASS GRAFT                N   3   $13.45   6/1/1994   12/31/2299
01670   7   ANESTH. ALL PROCS. VEINS SHOULDER/AXILLA             N   3   $13.45   6/1/1994   12/31/2299
01680   7   ANESTH. CAST APPLICATION, REMOVE, REPAIR SHLDR NOC   N   3   $13.45   6/1/1994   12/31/2299
01682   7   ANESTH. SHOULDER SPICA                               N   3   $13.45   6/1/1994   12/31/2299
01710   7   ANESTH. PROCS. NERVE,MUSC,TEND ETC. UPR ARM-ELBNOC   N   3   $13.45   6/1/1994   12/31/2299
01712   7   ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TEND   N   3   $13.45   6/1/1994   12/31/2299
01714   7   ANESTH. TENOPLASTY ELBOW TO SHOULDER                 N   3   $13.45   6/1/1994   12/31/2299
01716   7   ANESTH. TENODESIS RUPTURE LONG TENDON BICEPS         N   3   $13.45   6/1/1994   12/31/2299
01730   7   ANESTH. ALL CLOSED PROCS. HUMEROUS-ELBOW             N   3   $13.45   6/1/1994   12/31/2299
01732   7   ANESTH. ARTHROSCOPIC PROCS. ELBOW JOINT              N   3   $13.45   6/1/1994   12/31/2299
01740   7   ANESTH. OPEN PROCS. HUMERUS-ELBOW NOC                N   3   $13.45   6/1/1994   12/31/2299
01742   7   ANESTH. OSTEOTOMY HUMERUS                            N   3   $13.45   6/1/1994   12/31/2299
01744   7   ANESTH. REPAIR NONUNION/MALUNION HUMERUS             N   3   $13.45   6/1/1994   12/31/2299
01756   7   ANESTH. RADICAL PROCS. HUMERUS-ELBOW                 N   3   $13.45   6/1/1994   12/31/2299
01758   7   ANESTH. EXCISION CYST/TUMOR HUMERUS                  N   3   $13.45   6/1/1994   12/31/2299
01760   7   ANESTH. TOTAL ELBOW REPLACEMENT                      N   3   $13.45   6/1/1994   12/31/2299
01770   7   ANESTH. PROCS. ARTERIES UPPER ARM/ELBOW NOC          N   3   $13.45   6/1/1994   12/31/2299
01772   7   ANESTH. EMBOLECTOMY UPPER ARM/ELBOW                  N   3   $13.45   6/1/1994   12/31/2299
01780   7   ANESTH. PROCS. VEINS UPPER ARM/ELBOW NOC             N   3   $13.45   6/1/1994   12/31/2299
01782   7   ANESTH. PHLEBORRAPHY UPPER ARM/ELBOW                 N   3   $13.45   6/1/1994   12/31/2299
01810   7   ANESTH. ALL PROCS. NERVE,MUSCLE ETC F'ARM,WRST,HND   N   3   $13.45   6/1/1994   12/31/2299
01820   7   ANES CLSD PROCDS RAD ULN WRST HND BNS                N   3   $13.45   6/1/1994   12/31/2299
01829   7   ANES DIAG ARTHROSCOPIC PROC ON WRIST                 N   3   $13.45   1/1/2003   12/31/2299
01830   7   ANESTH. OPEN PROCS. RAD,ULNA,WRIST,HAND BONES NOC    N   3   $13.45   6/1/1994   12/31/2299
01832   7   ANESTH. TOTAL WRIST REPLACEMENT                      N   3   $13.45   6/1/1994   12/31/2299
01840   7   ANESTH. PROCS. ARTERIES F'ARM,WRIST,HAND NOC         N   3   $13.45   6/1/1994   12/31/2299
01842   7   ANESTH. EMBOLECTOMY F'ARM,WRIST,HAND                 N   3   $13.45   6/1/1994   12/31/2299




                                                                                                          5
01844   7   ANESTH. VASCULAR SHUNT/SHUNT REVISION ANY TYPE                     N   3   $13.45   6/1/1994   12/31/2299
01850   7   ANESTH. PROCS. VEINS F'ARM,WRIST,HAND NOC                          N   3   $13.45   6/1/1994   12/31/2299
01852   7   ANESTH. PHLEBORRAPHY F'ARM,WRIST,HAND                              N   3   $13.45   6/1/1994   12/31/2299
01860   7   ANESTH. CAST APPLIC,REMOVE,REP-F'ARM,WRIST,HAND                    N   3   $13.45   6/1/1994   12/31/2299
01905   7   ANESTH FOR MYELOGRAPHY, DISKOGRAPHY, VERTROPLASTY                  N   3   $13.45   1/1/2002   12/31/2299
01916   7   ANESTH. ARTERIOGRAMS,NEEDLE-CAROTID/VERTEBRAL                      N   3   $13.45   6/1/1994   12/31/2299
01920   7   ANESTH. CARDIAC CATH.INCL.CORON.ARTER-VENT-OGRAPHY                 N   3   $13.45   6/1/1994   12/31/2299
01922   7   ANESTHESIA FOR COMP AX TOMO SCANNING                               N   3   $13.45   6/1/1994   12/31/2299
01924   7   ANESTHESIA FOR THERAPEUTIC INTER RADIOLOGIC PROCEDURES             N   3   $13.45   1/2/2002   12/31/2299
01925   7   ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES    N   3   $13.45   1/1/2002   12/31/2299
01926   7   ANESTHSIA FOR THERAPEUTIC INTERVENTIONAL READILOGI PROCEDURES      N   3   $13.45   1/1/2003   12/31/2299
01930   7   ANESSTHESIA FOR THERAPEUTIC INTERVENTION RADIOLOGIC PROCEDURES     N   3   $13.45   1/2/2002   12/31/2299
01931   7   ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES    N   3   $13.45   1/2/2002   12/31/2299
01932   7   ANESTHESIA FOR THERAPEUTIC INTERVENTIONL RADIOLOGIC PROCEDURES     N   3   $13.45   1/2/2002   12/31/2299
01933   7   ANESTHESIA FOR THERAPEUATIC INTERVENTIONAL READOLOGIC PROCEDURES   N   3   $13.45   1/2/2002   12/31/2299
01951   7   ANESTHESIA FOR SECOND AND THIRD DEGREE BURN EXCIS OR DEBRIDEME     N   3   $13.45   1/1/2001   12/31/2291
01952   7   ANESTHESIA FOR SECOND AND THIRD DEGREE BURN EXCIS.OR DEBRIDEM.     N   3   $13.45   1/1/2001   12/31/2299
01953   2   ANESTHESIA FOR SECOND AND THIRD DEGREE BURRN EXCIS.OR DEBRIDEM     N   3   $13.45   1/1/2001   12/31/2299
01958   7   ANESTHESIA FOR EXTERNAL CEPHALIC,VERSION PROCEDURE                 N   3   $13.45   1/1/2004   12/31/2299
01960   7   ANESTHESIA FOR VAGINAL DELIVERY ONLY                               N   3   $13.45   1/1/2002   12/31/2299
01961   7   ANESTHESIA FOR, CESAREAN DELIVERY ONLY                             N   3   $13.45   1/2/2002   12/31/2299
01962   7   ANESTHESIA FOR URGENT HYSTERECTOMY FOLLOWING DELIVERY              N   3   $13.45   1/1/2002   12/31/2299
01963   7   ANESTHESIA FOR CESAREAN HYSTERECTOMY W/O LABOR ANALG/ANESTH CARE   N   3   $13.45   1/2/2002   12/31/2299
01965   7   ANESTHESIA FOR INCOMPLETE OR MISSED ABORTION PROC.                 N   3   $13.45   1/1/2006   12/31/2299
01966   7   ANESTHESIA FOR INDUCED ABORTION PROC.                              N   3   $13.45   1/1/2006   12/31/2299
01967   7   NEURAXIAL LABOR ANALGESIA/ANESTH FOR PLNND DELIVERY                N   3   $13.45   1/1/2002   12/31/2299
01968   7   CESAREAN DELIVERY FOLLOWING NEURAXIAL LABOR ANALGESIA/ANESTH       N   3   $13.45   1/1/2002   12/31/2299
01969   7   CESAREAN HYSTERECTOMY FOLLOWING NEURAXIAL LABOR ANALGESIA/ANESTH   N   3   $13.45   1/1/2002   12/31/2299
01990   7   ANESTH. PHYSIO. SUPPORT ORGAN HARVEST-BRAIN DEAD                   N   3   $13.45   6/1/1994   12/31/2299
01991   7   ANEST DIAG/THER NERVE BLOCKS/INJ O/T PRONE POSITION                N   3   $13.45   1/1/2003   12/31/2299
01992   7   ANES DIAG/THER NERVE BLOCKS /INJ PRONE POSITION                    N   3   $13.45   1/1/2003   12/31/2299
01996   1   DAILY MNGMNT OF EPIDURAL OR SUBARACHNOID DRUG ADMINISTRATION       N   3   $15.00   1/1/1984   12/31/2299
01996   7   DAILY MANAGEMENT OF EPIDURAL OR SUBARACHNOID DRUG                  N   3   $13.45   6/1/1994   12/31/2299
01999   7   UNLISTED ANESTH PROCEDURE(S)                                       N   3   $13.45   6/1/1994   12/31/2299
10021   1   FINE NEEDLE ASPRIATION WITHOUT IMAGING GUIDANCE                    N   3   $51.81   1/1/2002   12/31/2299
10021   2   FINE NEEDLE ASPIRATION, W/O IMAGING GUIDANCE                       N   3   $10.88   1/1/2002     1/9/2200
10022   2   FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE                      N   3   $54.47   1/1/2002   12/31/2299
10040   2   ACNE SURGERY(COMEDONES, CYSTS PUSTULES)                            N   3   $41.00   1/1/1995   12/31/2299
10040   7   ACNE SURGERY(COMEDONES, CYSTS PUSTULES                             N   3   $13.45   6/1/1994   12/31/2299
10060   2   I&D ABCESS(CARBUNCLE,HIDRADENITIS)SIMPLE                           N   3   $39.00   1/1/1995   12/31/2299
10060   7   I&D ABCESS(CARBUNCLE,HIDRADENITIS)SIMPLE                           N   3   $13.45   6/1/1994   12/31/2299
10061   2   INCISION AND DRAINAGE OF ABSCESS;COMPLICATED                       N   3   $67.68   1/2/1996   12/31/2299
10061   7   INCISION AND DRAINAGE OF ABSCESS;COMPLICATED                       N   3   $13.45   6/1/1994   12/31/2299
10080   2   INCISION AND DRAINAGE OF PILONIDAL CYST;SIMPLE                     N   3   $18.50   1/1/1971   12/31/2299
10080   7   INCISION AND DRAINAGE OF PILONIDAL CYST;SIMPLE                     N   3   $13.45   6/1/1994   12/31/2299
10081   2   INCISION AND DRAINAGE OF PILONIDAL CYST;COMPLICATE                 N   3   $75.00   1/1/1984   12/31/2299
10081   7   INCISION AND DRAINAGE OF PILONIDAL CYST;COMPLICATE                 N   3   $13.45   6/1/1994   12/31/2299
10120   2   INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS                 N   3   $12.50   1/1/1971   12/31/2299
10120   7   INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS                 N   3   $13.45   6/1/1994   12/31/2299
10121   2   I&D OF FOREIGN BODY COMPLICATED                                    N   3   $57.00   1/2/1992   12/31/2299
10121   7   I&D OF FOREIGN BODY COMPLICATED                                    N   3   $13.45   6/1/1994   12/31/2299




                                                                                                                        6
10121   F   I&D OF FOREIGN BODY COMPLICATED                                     N   3   $306.00   3/1/2004   12/31/2299
10138   7   ANESTH. ALL CLOSED PROCS. KNEE JOINT                                N   3    $13.45   6/1/1994   12/31/2299
10140   2   INCISION AND DRAINAGE OF HEMATOMA;SIMPLE                            N   3     $9.00   1/1/1971   12/31/2299
10140   7   INCISION AND DRAINAGE OF HEMATOMA;SIMPLE                            N   3    $13.45   6/1/1994   12/31/2299
10160   2   PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, O                  N   3     $7.00   1/1/1973   12/31/2299
10160   7   PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, O                  N   3    $13.45   6/1/1994   12/31/2299
10180   2   INCISION DRAINAGE COMPLX POST OP WND INFECTION                      N   3    $84.00   1/2/1996   12/31/2299
10180   7   INCISION DRAINAGE COMPLX POST OP WND INFECTION                      N   3    $13.45   6/1/1994   12/31/2299
10180   F   INCISION DRAINAGE COMPLX POST OP WND INFECTION                      N   3   $306.00   3/1/2004   12/31/2299
11000   2   DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN                N   3    $33.00   1/1/1995   12/31/2299
11001   2   DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN                N   3     $5.00   1/1/1973   12/31/2299
11001   7   DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SK                  N   3    $13.45   6/1/1994   12/31/2299
11004   2   DEBRIDEMENT OF SKIN SUBCUTANEOUS TISSUE MUSCLE AND FASCIA FOR NEC   N   3   $340.04   1/1/2005   12/31/2299
11004   7   DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCEL AND FASCIA FOR N   N   3    $13.45   1/1/2005   12/31/2299
11005   2   DEBRIDEMENT OF SKIN SUBCUTANEOUS TISSUE MUSCEL AND FASCIA FOR NEC   N   3   $463.31   1/1/2005   12/31/2299
11005   7   DEBRIDEMENT OF SKIN SUBCUTANEOUS TSSUE MUSCEL AND FASCAI FOR NEC    N   3    $13.45   1/1/2005   12/31/2299
11006   2   DEBRIDEMENT OF SKIN SUBCUTANEOUS TISSUE MUSCLE AND FASCAI FOR NEC   N   3   $427.63   1/1/2005   12/31/2299
11006   7   DEBRIDEMENT OF SKIN SUBCUTANEOUS TISSUE MUSCLE AND FASCIA FOR NEC   N   3    $13.45   1/1/2005   12/31/2299
11008   2   REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR NECROT   N   3   $174.02   1/1/2005   12/31/2299
11008   7   REMOVAL OF PROS MATERIAL OR MESH, ABDOMINAL WALL FOR NECROTIZING    N   3    $13.45   1/1/2005   12/31/2299
11010   2   DEBRIDE SKIN,REMOVAL OF FOREIGN MATERIAL ASSOC.W/OPEN FRACTURE(S)   N   3   $207.67   1/1/1997   12/31/2299
11010   7   DEBRIDE SKIN ASSOC W/OPEN FRACTURES AND/OR DISLOCATION(S)           N   3    $13.45   1/1/1997   12/31/2299
11010   F   DEBRIDE SKIN,REMOVAL OF FOREIGN MATERIAL ASSOC.W/OPEN FRACTURE(S)   N   3   $306.00   3/1/2004   12/31/2299
11011   2   DEBRIDE SKIN/MUSCLE, FX                                             N   3   $247.49   1/1/1997   12/31/2299
11011   7   DEBRIDE SKIN/MUSCLE, FX                                             N   3    $13.45   1/1/1997   12/31/2299
11011   F   DEBRIDE SKIN/MUSCLE, FX                                             N   3   $306.00   3/1/2004   12/31/2299
11012   2   DEBRIDE SKIN/MUSCLE/BONE, FX                                        N   3   $343.98   1/1/1997   12/31/2299
11012   7   DEBRIDE SKIN/MUSCLE/BONE, FX                                        N   3    $13.45   1/1/1997   12/31/2299
11012   F   DEBRIDE SKIN/MUSCLE/BONE, FX                                        N   3   $306.00   3/1/2004   12/31/2299
11040   2   DEBRIDEMENT; SKIN; PARTIAL THICKNESS                                N   3    $25.00   1/2/1992   12/31/2299
11040   7   DEBRIDEMENT; SKIN, PARTIAL THICKNESS                                N   3    $13.45   6/1/1994   12/31/2299
11041   2   DEBRIDEMENT; SKIN FULL THICKNESS                                    N   3    $20.00   1/2/1994   12/31/2299
11041   7   DEBRIDMENT SKIN                                                     N   3    $13.45   6/1/1994   12/31/2299
11042   2   DEBRIDEMENT; SKIN AND SUBCUTANEOUS TISSUE                           N   3    $25.00   1/1/1984   12/31/2299
11042   7   DEBRID SKIN SUCUT                                                   N   3    $13.45   6/1/1994   12/31/2299
11042   F   DEBRIDEMENT; SKIN AND SUBCUTANEOUS TISSUE                           N   3   $306.00   3/1/2004   12/31/2299
11043   2   DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, AND MUSCLE                  N   3   $137.74   1/1/2003   12/31/2299
11043   7   DEBRIDEMENT SKIN SUBCU AND MUSCLE                                   N   3    $13.45   6/1/1994   12/31/2299
11043   F   DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, AND MUSCLE                  N   3   $306.00   3/1/2004   12/31/2299
11044   2   DEBRIED SKIN SUBCU. TISSUE, MUSCLE & BONE                           N   3    $40.00   1/1/1988   12/31/2299
11044   7   DEBRIDEMENT SK SUBCU MUSCL BONE                                     N   3    $13.45   6/1/1994   12/31/2299
11044   F   DEBRIED SKIN SUBCU. TISSUE, MUSCLE & BONE                           N   3   $306.00   3/1/2004   12/31/2299
11055   2   PARING/CUTTING OF BENIGN HYPERKERATOTI C LESION(CORN/CALLUS)SINGL   N   3     $9.92   1/1/1999   12/31/2299
11055   7   PARING/CUTTING BENIGN HYPERKERATOTI C LESION(CORN/CALLUS SINGLE     N   3    $13.45   1/1/1998   12/31/2299
11056   2   PARING/CUTTING BENIGN HYPERKERATOTI C LESION(CORN/CALLUS 2-4LEASI   N   3    $14.12   1/1/1998   12/31/2299
11056   7   PARING/CUTTING BENIGN HYPERKERATOTI C LESION CORN/CALLUS 2-4        N   3    $13.45   1/1/1998   12/31/2299
11057   2   PARING/CUTTIN BENIGN HYPERKERATOTI C LESIONS CORN/CALLUS OVER 4     N   3    $15.17   1/1/1998   12/31/2299
11057   7   PARING/CUTTIN BENIGN HYPERKERATOTI C LESION(CORN/CALLUS OVER 4      N   3    $13.45   1/1/1998   12/31/2299
11100   2   BIOPSY SUBCU. SKIN /MUCOUS MEMBRANE W/SIMPLE CLOS.                  N   3    $15.00   1/1/1971   12/31/2299
11100   7   BIOPSY SUBCU. SKIN OR MUCOUS MEMBRANE W/ SIM. CLOS                  N   3    $13.45   6/1/1994   12/31/2299
11101   2   BIOP. SUBCU/MUCOUS MEMB. SIMPLE CLOS. EA. ADD. LESION               N   3     $5.00   1/1/1985   12/31/2299




                                                                                                                          7
11101   7   BIOPSY SUBCU./MUCOUS MEMB. SIMPLE CLOS EA. ADD LES                  N   3    $13.45   6/1/1994   12/31/2299
11200   2   EXC. SKIN TAGS ANY AREA UPTO 15                                     N   3    $25.00   1/1/1988   12/31/2299
11200   7   EXC SKIN TAGS ANY AREA UPTO 15                                      N   3    $13.45   6/1/1994   12/31/2299
11201   2   REMOVAL OF SKIN TAGS,MULTIPLE FIBROCUTANEOUS TAGS EA.ADD.10 LESIO   N   3    $14.40   1/2/1992   12/31/2299
11201   7   EXC SKIN TAGS EA ADD. 10TAGS                                        N   3    $13.45   6/1/1994   12/31/2299
11300   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SNGL .5CM                    N   3    $22.00   1/2/1992   12/31/2299
11301   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $34.00   1/1/1993   12/31/2299
11302   2   SHAVING OF EPIDERMAL OR LESION 1.1 CM -2.0 CM                       N   3    $40.00   1/2/1992   12/31/2299
11303   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $52.54   1/1/1993   12/31/2299
11305   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $28.44   1/1/1993   12/31/2299
11306   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $36.04   1/2/1994   12/31/2299
11307   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $40.46   1/1/1993   12/31/2299
11308   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $69.26   1/1/1993   12/31/2299
11310   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $30.24   1/1/1993   12/31/2299
11311   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $37.72   1/1/1993   12/31/2299
11312   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $55.16   1/1/1993   12/31/2299
11313   2   SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESI                  N   3    $91.39   1/1/1993   12/31/2299
11400   2   EXC BENIGN LES. INC MARGINS XCEPT SKIN TAG < .5CM TRUNK ARMS LE     N   3    $25.00   1/2/1992   12/31/2299
11400   7   EXC BENIGN LESION UPTO .5CM TRUNK ARMS OR LEGS                      N   3    $13.45   6/1/1994   12/31/2299
11401   2   EXC BENIGN LESION INC MARGINS .5 TO 1.CM TRUNK ARMS OR LEGS         N   3    $22.50   1/1/1971   12/31/2299
11401   7   EXC BENIGN LESION INC MARGINS .5 TO 1.CM TRUNK ARMS OR LEGS.        N   3    $13.45   6/1/1994   12/31/2299
11402   2   EXC LESION BENIGN INC MARGINS 1.CM TO2.CM TRUNK ARMS OR LEGS        N   3    $28.00   1/1/1971   12/31/2299
11402   7   EXC LESION BENIGN INC MARGINS 1CM TO 2.CM TRUNK ARMS OR LEGS        N   3    $13.45   6/1/1994   12/31/2299
11403   2   EXC BENIGN LESION INC MARGINS 2.CM TO 3.CM TRUNK ARMS OF LEGS       N   3    $32.00   1/1/1985   12/31/2299
11403   7   EXC BENIGN LESION INC MARGINS 2.CM TO 3.CM TRUNK ARMS OR LEGS       N   3    $13.45   6/1/1994   12/31/2299
11404   2   EXC BENIGN LESION INC MARGINS 3.CM TO 4.CM TRUNK ARMS OR LEGS       N   3    $35.00   1/1/1985   12/31/2299
11404   7   EXC BENIGN LESION INC MARGINS 3.CM TO 4.CM TRUNK ARMS OR LEGS       N   3    $13.45   6/1/1994   12/31/2299
11404   F   EXC BENIGN LESION 3.CM TO 4.CM TRUNK ARMS OR LEGS                   N   3   $225.80   3/1/2004   12/31/2299
11406   2   EXC BENIGN LESION INC MARGINS OVER 4CM TRUNK ARMS OR LEGS           N   3   $120.00   1/2/1996   12/31/2299
11406   7   EXC BENIGN LESION INC MARGINS OVER 4CM TRUNK ARMS OR LEGS           N   3    $13.45   6/1/1994   12/31/2299
11406   F   EXC BENIGN LESION OVER 4CM TRUNK ARMS OR LEGS                       N   3   $306.00   3/1/2004   12/31/2299
11420   2   EXC BENIGN LESION INC MARGINS UP TO .5CM SCALP NECK HAND FEET       N   3    $15.00   1/1/1971   12/31/2299
11420   7   EXC BENIGN LESION INC MARGINS UP TO .5CM SCALP NECK HANDS FEET      N   3    $13.45   6/1/1994   12/31/2299
11421   2   EXC BEN. LESION INC MARGINS .5-1CM SCALP NECK HAND FEET GENITALI    N   3    $60.00   1/2/1994   12/31/2299
11421   7   EXC BEN. LES. INC MARGINS .5-1CM SCALP NECK HANDS FEET GENITAL      N   3    $13.45   6/1/1994   12/31/2299
11422   2   EXC BEN LESION INC MARGINS 1CM-2CM SCALP NECK HAND FEET GENITA      N   3    $37.50   1/1/1973   12/31/2299
11422   7   EXC BEN. LESION INC MARGINS 1CM TO 2CM SCALP NECK HAND FEET         N   3    $13.45   6/1/1994   12/31/2299
11423   2   EXC BENIGN LES INC MARGINS .2.-3.CM SCALP NECK HAND FEET GENITA     N   3    $42.00   1/1/1985   12/31/2299
11423   7   EXC BENIGN LES. INC MARGINS 2.-3.CM SCALP NECK HAND FEET GENIT      N   3    $13.45   6/1/1994   12/31/2299
11424   2   EXC BENIGN LES INC MARGINS 3.1-4.0 CM SCALP NECK HAND FEET GENIT    N   3    $96.00   1/2/1994   12/31/2299
11424   7   EXC BENIGN LES. INC MARGINS 3.1-4.0CM SCALP NECK HAND FEET GENIT    N   3    $13.45   6/1/1994   12/31/2299
11424   F   EXC BENIGN LES. 3.-4.CM SCALP NECK HAND FEET                        N   3   $306.00   3/1/2004   12/31/2299
11426   2   EXC BEN LESION INC MARGINS 4CM/OVER SCALP NECK HAND FEET GEN.       N   3    $90.00   1/2/1991   12/31/2299
11426   7   EXC BENIGN LES. INC MARGINS OVER 4CM SCALP NECK HND FOOT GENIT      N   3    $13.45   6/1/1994   12/31/2299
11426   F   EXC BEN LESION 4CM/OVER SCALP NECK HAND FEET GEN.                   N   3   $306.00   3/1/2004   12/31/2299
11440   2   EXC BENIGN LES INC MARGINS TO .5CM FACE EAR ELIDS NOSE LIPS MUCO    N   3    $30.00   1/1/1975   12/31/2299
11440   7   EXCISION, OTHER BENIGN LESION INC MARGINS FACE,EARS,EYELIDS,N       N   3    $13.45   6/1/1994   12/31/2299
11441   2   EXCISION, OTHER BENIGN LESION INC MARGINS;FACE,EARS,EYELIDS,NO      N   3    $60.00   1/2/1996   12/31/2299
11441   7   EXCISION, OTHER BENIGN LESION INC MARGINS ;FACE,EARS,EYELIDS,NO     N   3    $13.45   6/1/1994   12/31/2299
11442   2   EXCISION, OTHER BENIGN LESION INC MARGINS;FACE,EARS,EYELIDS,NO      N   3    $65.00   1/2/1994   12/31/2299
11442   7   EXCISION, OTHER BENIGN LESION INC MARGINS;FACE,EARS,EYELIDS,NO      N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                          8
11443   2   EXCISION, OTHER BENIGN LESION INC MARGINS ;FACE,EARS,EYELIDS,NO     N   3    $55.00   1/1/1985   12/31/2299
11443   7   EXCISION, OTHER BENIGN LESION INC MARGINS;FACE,EARS,EYELIDS,NO      N   3    $13.45   6/1/1994   12/31/2299
11444   2   EXCISION, OTHER BENIGN LESION INC MARGINS;FACE,EARS,EYELIDS,NO      N   3   $120.00   1/2/1995   12/31/2299
11444   7   EXCISION, OTHER BENIGN LESION INC MARGINS;FACE,EARS,EYELIDS,NO      N   3    $13.45   6/1/1994   12/31/2299
11444   F   EXCISION, OTHER BENIGN LESION;FACE,EARS,EYELIDS,NO                  N   3   $225.80   3/1/2004   12/31/2299
11446   2   EXE BENIGN LESION INC MARGINS OVER 4. CM FACE EYELID LIPS ECT       N   3   $100.00   1/1/1984   12/31/2299
11446   7   EXE BENIGN LESION INC MARGINS OVER 4. CM FACE EYELID LIPS ECT       N   3    $13.45   6/1/1994   12/31/2299
11446   F   EXE BENIGN LESION OVER 4. CM FACE EYELID LIPS ECT                   N   3   $306.00   3/1/2004   12/31/2299
11450   2   EXC SUBCU TISSUE-HIDRADINITIS AXILLARY PRIME CLOS                   N   3   $135.00   1/2/1997   12/31/2299
11450   7   EXC SUBCU TISSUE-HIDRADINITIS AXILLARY PRIME CLOS                   N   3    $13.45   6/1/1994   12/31/2299
11450   F   EXC SUBCU TISSUE-HIDRADINITIS AXILLARY PRIME CLOS                   N   3   $306.00   3/1/2004   12/31/2299
11451   2   EXC SUBCU TISSUE-HIDRADENITIS AXILLARY OTHER CLO                    N   3   $130.00   1/2/1992   12/31/2299
11451   7   EXC SUBCU TISSUE-HIDRADENITIS AXILLARY OTHER CLO                    N   3    $13.45   6/1/1994   12/31/2299
11451   F   EXC SUBCU TISSUE-HIDRADENITIS AXILLARY OTHER CLO                    N   3   $306.00   3/1/2004   12/31/2299
11462   2   EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENTIS, INGUINA   N   3   $112.00   1/2/1998   12/31/2299
11462   7   EXC SUBCU TISSUE-HIDRADENITIS INGUNIAL PRIME CLO                    N   3    $13.45   6/1/1994   12/31/2299
11462   F   EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR HIDRADENTIS, INGUINA   N   3   $306.00   3/1/2004   12/31/2299
11463   7   EXC SUBCU TISSUE-HIDRADINITIS INGUNIAL-OTHER CLOS                   N   3    $13.45   6/1/1994   12/31/2299
11463   F   EXC SUBCU TISSUE -HIDRADINITIS INGUNIAL-OTHER CLOS                  N   3   $306.00   3/1/2004   12/31/2299
11470   2   EXC SUBCU TISSUE-HIDRADENITIS PERIANAL/UMBILICAL                    N   3    $65.00   1/1/1984   12/31/2299
11470   7   EXC SUBCU TISSUE-HIDRADENITIS PERIANAL/UMBILICAL                    N   3    $13.45   6/1/1994   12/31/2299
11470   F   EXC SUBCU TISSUE-HIDRADENITIS PERIANAL/UMBILICAL                    N   3   $306.00   3/1/2004   12/31/2299
11471   7   EXC SUBCU TISSUE-HIDRADENITIS PERIANAL/UMBILICAL                    N   3    $13.45   6/1/1994   12/31/2299
11471   F   EXC SUBCU TISSUE-HIDRADENITIS PERIANAL/UMBILICAL                    N   3   $306.00   3/1/2004   12/31/2299
11600   2   EXCISION, MALIGNANT LESION INC MARGINS- TRUNK, ARMS, OR LEGS;       N   3    $30.00   1/1/1973   12/31/2299
11600   7   EXCISION, MALIGNANT LESION INC MARGINS TRUNK, ARMS, OR LEGS;        N   3    $13.45   6/1/1994   12/31/2299
11601   2   EXCISION MALIG LESION INC MARGINS TRUNK ARMS OR LEGS DIAM.6-1CM     N   3    $40.00   1/1/1973   12/31/2299
11601   7   EXCISION, MALIGNANT LESION INC MARGINS -TRUNK, ARMS, OR LEGS;       N   3    $13.45   6/1/1994   12/31/2299
11602   2   EXCISION, MALIGNANT LESION INC MARGINS- TRUNK, ARMS, OR LEGS;       N   3    $50.00   1/1/1973   12/31/2299
11602   7   EXCISION, MALIG LESION INC MARGINS TRUNK, ARMS, OR LEGS;            N   3    $13.45   6/1/1994   12/31/2299
11603   2   EXCISION, MALIGNANT LESION INC MARGINS- TRUNK, ARMS, OR LEGS;       N   3    $60.00   1/1/1984   12/31/2299
11603   7   EXCISION, MALIGNANT LESION INC MARGINS - TRUNK, ARMS, OR LEGS;      N   3    $13.45   6/1/1994   12/31/2299
11604   2   EXCISION, MALIGNANT LESION INC MARGINS -TRUNK, ARMS, OR LEGS;       N   3    $65.00   1/1/1984   12/31/2299
11604   7   EXCISION, MALIGNANT LESION INC MARGINS - TRUNK, ARMS, OR LEGS;      N   3    $13.45   6/1/1994   12/31/2299
11604   F   EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS;                   N   3   $306.00   3/1/2004   12/31/2299
11606   2   EXCISION, MALIGNANT LESION INC MARGINS - TRUNK, ARMS, OR LEGS;      N   3    $90.00   1/1/1984   12/31/2299
11606   7   EXCISION, MALIGNANT LESION INC MARGINS -TRUNK, ARMS, OR LEGS;       N   3    $13.45   6/1/1994   12/31/2299
11606   F   EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS;                   N   3   $306.00   3/1/2004   12/31/2299
11620   2   EXCISION, MALIG LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GENI   N   3    $50.00   1/1/1971   12/31/2299
11620   7   EXCISION, MALIG LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GENI   N   3    $13.45   6/1/1994   12/31/2299
11621   2   EXCISION, MALIG LESION INC MARGINS -SCALP, NECK, HANDS, FEET,GENI   N   3    $75.00   1/1/1971   12/31/2299
11621   7   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3    $13.45   6/1/1994   12/31/2299
11622   2   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3   $100.00   1/1/1973   12/31/2299
11622   7   EXCISION, MALIGN LESION INC MARGINS-SCALP, NECK, HANDS, FEET,GEN    N   3    $13.45   6/1/1994   12/31/2299
11623   2   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3   $110.00   1/1/1984   12/31/2299
11623   7   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3    $13.45   6/1/1994   12/31/2299
11624   2   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3   $120.00   1/1/1984   12/31/2299
11624   7   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3    $13.45   6/1/1994   12/31/2299
11624   F   EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FE                  N   3   $306.00   3/1/2004   12/31/2299
11626   2   EXCISION, MALIGN LESION INC MARGINS- SCALP, NECK, HANDS, FEET,GEN   N   3   $150.00   1/1/1984   12/31/2299
11626   7   EXCISION, MALIGN LESION INCMARGINS- SCALP, NECK, HANDS, FEET,GEN    N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                          9
11626   F   EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FE                  N   3   $306.00    3/1/2004   12/31/2299
11640   2   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $75.00    1/1/1973   12/31/2299
11640   7   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $13.45    6/1/1994   12/31/2299
11641   2   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,L    N   3   $100.00    1/1/1973   12/31/2299
11641   7   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $13.45    6/1/1994   12/31/2299
11642   2   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3   $125.00    1/1/1971   12/31/2299
11642   7   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $13.45    6/1/1994   12/31/2299
11643   2   EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, N                  N   3   $130.00    1/1/1984   12/31/2299
11643   7   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $13.45    6/1/1994   12/31/2299
11643   8   EXCISION, MALIG LESION INC MARGINS- FACE, EARS, EYELIDS,NOSE,LI     N   3    $26.00    1/1/1984   12/31/2299
11644   2   EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, N                  N   3   $130.00    1/1/1984   12/31/2299
11644   7   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $13.45    6/1/1994   12/31/2299
11644   8   EXCISION, MALIGN LESION INC MARGINS-FACE, EARS, EYELIDS, NOSE,LI    N   3    $26.00    1/1/1989   12/31/2299
11644   F   EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, N                  N   3   $306.00    3/1/2004   12/31/2299
11646   2   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3   $175.00    1/1/1984   12/31/2299
11646   7   EXCISION, MALIGN LESION INC MARGINS- FACE, EARS, EYELIDS, NOSE,LI   N   3    $13.45    6/1/1994   12/31/2299
11646   F   EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, N                  N   3   $306.00    3/1/2004   12/31/2299
11700   7   DEBRIDEMENT OF NAILS, MANUAL; FIVE OR LESS                          N   3    $13.45    6/1/1994   12/31/2299
11701   7   DEBRIDEMENT OF NAILS, MANUAL; EACH ADDITIONAL, FIV                  N   3    $13.45    6/1/1994   12/31/2299
11710   2   DEBRIDEMENT OF NAILS, ELECTRIC GRINDER; FIVE OR LE                  N   3    $14.25   10/1/1989   12/31/2299
11710   3   DEBRIDEMENT OF NAILS; ELECTRIC GRINDER; FIVE OR LS                  N   3    $14.25   3/12/1991   12/31/2299
11711   2   DEBRIDEMENT OF NAILS, ELECTRIC GRINDER; EACH ADDIT                  N   3    $10.00    1/1/1992   12/31/2299
11719   2   TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER                         N   3     $6.50    1/1/1998   12/31/2299
11719   7   TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER                         N   3    $13.45    1/1/1998   12/31/2299
11720   2   DEBRIDMENT NAILS ONE TO FIVE ANY METHOD                             N   3    $15.93    1/1/1997   12/31/2299
11721   2   DEBRIDMENT NAILS ANY METHOD SIX OR MORE                             N   3    $26.87    1/1/1997   12/31/2299
11730   2   AVULSION OF NAIL PLATE, PART OR COMP SIMPLE                         N   3    $22.00    1/2/1993   12/31/2299
11730   7   AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPL                  N   3    $13.45    6/1/1994   12/31/2299
11732   2   AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE;EACH ADDITION   N   3     $6.00    1/1/1984   12/31/2299
11732   7   AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPL                  N   3    $13.45    6/1/1994   12/31/2299
11740   2   EVACUATION OF SUBUNGUAL HEMATOMA                                    N   3     $7.00    1/1/1984   12/31/2299
11740   7   EVACUATION OF SUBUNGUAL HEMATOMA                                    N   3    $13.45    6/1/1994   12/31/2299
11750   2   EXC OF NAIL & NAIL MATRIX PART OR COMPL                             N   3    $90.00    1/2/1995   12/31/2299
11750   7   EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPL                  N   3    $13.45    6/1/1994   12/31/2299
11752   2   WITH AMPUTATION OF TUFT OF DISTAL PHALANX                           N   3    $65.00    1/1/1984   12/31/2299
11752   7   WITH AMPUTATION OF TUFT OF DISTAL PHALANX                           N   3    $13.45    6/1/1994   12/31/2299
11755   2   BIOPSY OF NAIL UNIT, ANY METHOD (EG, PLATE, BED, M                  N   3    $49.64    1/1/1994   12/31/2299
11760   2   RECONSTRUCTION OF NAIL BED;SIMPLE                                   N   3    $20.00    1/1/1984   12/31/2299
11760   7   RECONSTRUCTION OF NAIL BED;SIMPLE                                   N   3    $13.45    6/1/1994   12/31/2299
11762   2   RECONSTRUCTION OF NAIL BED;COMPLICATED                              N   3   $132.00    1/1/1997   12/31/2299
11762   7   RECONSTRUCTION OF NAIL BED;COMPLICATED                              N   3    $13.45    6/1/1994   12/31/2299
11765   2   WDGE EXCISN OF SKIN OF NAIL FLD (INGRN TOENAIL)                     N   3    $25.00    1/1/1984   12/31/2299
11765   7   WDGE EXCISN OF SKIN OF NAIL FLD (INGRN TOENAIL)                     N   3    $13.45    6/1/1994   12/31/2299
11770   2   EXCISION OF PILONIDAL CYST OR SINUS;SIMPLE                          N   3    $50.00    1/1/1979   12/31/2299
11770   7   EXCISION OF PILONIDAL CYST OR SINUS;SIMPLE                          N   3    $13.45    6/1/1994   12/31/2299
11770   F   EXCISION OF PILONIDAL CYST OR SINUS;SIMPLE                          N   3   $351.00    3/1/2004   12/31/2299
11771   2   EXCISION OF PILONIDAL CYST OR SINUS;EXTENSIVE                       N   3   $100.00    1/1/1988   12/31/2299
11771   7   EXCISION OF PILONIDAL CYST OR SINUS;EXTENSIVE                       N   3    $13.45    6/1/1994   12/31/2299
11771   F   EXCISION OF PILONIDAL CYST OR SINUS;EXTENSIVE                       N   3   $351.00    3/1/2004   12/31/2299
11772   2   EXCISION OF PILONIDAL CYST OR SINUS;COMPLICATED                     N   3   $100.00    1/1/1984   12/31/2299
11772   7   EXCISION OF PILONIDAL CYST OR SINUS;COMPLICATED                     N   3    $13.45    6/1/1994   12/31/2299




                                                                                                                       10
11772   F   EXCISION OF PILONIDAL CYST OR SINUS;COMPLICATED                     N   3   $351.00   3/1/2004   12/31/2299
11900   2   INJECTION, INTRALESIONAL; UP TO AND INCLUDING SEVE                  N   3    $10.00   1/1/1971   12/31/2299
11900   7   INJECTION, INTRALESIONAL; UP TO AND INCLUDING SEVE                  N   3    $13.45   6/1/1994   12/31/2299
11901   2   INJECTION, INTRALESIONAL; MORE THAN SEVEN LESIONS                   N   3    $21.00   1/2/1992   12/31/2299
11901   7   INJECTION, INTRALESIONAL; MORE THAN SEVEN LESIONS                   N   3    $13.45   6/1/1994   12/31/2299
11920   2   TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE O                  N   3    $72.18   1/1/2004   12/31/2299
11921   2   TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE O                  N   3    $87.60   1/1/2002   12/31/2299
11922   2   TATTOOING, INTRADERMAL INTRODUCTION OF INSOLUBLE O                  N   3    $18.77   1/1/2002   12/31/2299
11960   2   INSRTN/TISSUE EXPNDRS, FOR OTHER THAN BREAST, INCL SUBS EXPAN       N   3   $309.00   7/1/1994   12/31/2299
11960   7   INSERTION OF TISSUE EXPANDER                                        N   3    $13.45   6/1/1994   12/31/2299
11960   F   INSERTION OF TISSUE EXPANDER                                        N   3   $306.00   3/1/2004   12/31/2299
11970   2   REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROS                  N   3   $318.00   1/2/1992   12/31/2299
11970   7   REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROS                  N   3    $13.45   6/1/1994   12/31/2299
11970   F   REPLACEMENT OF TISSUE EXPANDER WITH PERMANENT PROS                  N   3   $351.00   3/1/2004   12/31/2299
11971   2   REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF                  N   3   $189.50   1/1/2004   12/31/2299
11971   7   REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF                  N   3    $13.45   6/1/1994   12/31/2299
11971   F   REMOVAL OF TISSUE EXPANDER(S) WITHOUT INSERTION OF                  N   3   $225.80   3/1/2004   12/31/2299
11975   2   INSERTION OR REINSERTION, IMPLANTABLE CONTRACEPTIV                  N   3    $50.00   9/1/1992   12/31/2299
11975   7   INSERTION OR REINSERTION, IMPLANTABLE CONTRACEPTIV                  N   3    $13.45   6/1/1994   12/31/2299
11976   2   REMOVAL WITHOUT REINSERTION, IMPLANTABLE CONTRACEP                  N   3    $50.00   1/1/1992   12/31/2299
11976   7   REMOVAL WITHOUT REINSERTION, IMPLANTABLE CONTRACEP                  N   3    $13.45   6/1/1994   12/31/2299
11977   2   REMOVAL WITH REINSERTION, IMPLANTABLE CONTRACEPTIV                  N   3   $100.00   9/1/1999   12/31/2299
11980   2   SUBCUTANEOUS HORMONE PELLET IMPLANT (ESTRADIOL&/OR TESTOSTERONE)    N   3    $68.15   1/1/2000   12/31/2299
11981   2   INSERTION, NON BIODEGRADABLE DRUG DELIVERY IMPLANT                  N   3    $69.55   1/1/2002   12/31/2299
11982   2   REMOVAL NON BIODEGRADABLE DRUG DELIVERY IMPLANT                     N   3    $79.19   1/1/2002   12/31/2299
11983   2   REMOVAL WITH REINSERTION, NON BIODEGRADABLE DRUG DELIVERY IMPLANT   N   3   $127.90   1/1/2002   12/31/2299
12001   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $25.00   1/2/1992   12/31/2299
12001   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $13.45   6/1/1994   12/31/2299
12002   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $36.75   1/2/1992   12/31/2299
12002   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $13.45   6/1/1994   12/31/2299
12004   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $30.00   1/1/1971   12/31/2299
12004   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $13.45   6/1/1994   12/31/2299
12005   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $45.00   1/1/1984   12/31/2299
12005   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $13.45   6/1/1994   12/31/2299
12005   F   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3   $306.00   3/1/2004   12/31/2299
12006   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $60.00   1/1/1984   12/31/2299
12006   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $13.45   6/1/1994   12/31/2299
12006   F   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3   $306.00   3/1/2004   12/31/2299
12007   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3   $154.68   1/1/2004   12/31/2299
12007   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3    $13.45   6/1/1994   12/31/2299
12007   F   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK                  N   3   $306.00   3/1/2004   12/31/2299
12011   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $16.00   8/1/1979   12/31/2299
12011   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $13.45   6/1/1994   12/31/2299
12013   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $25.00   1/1/1984   12/31/2299
12014   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $35.00   1/1/1984   12/31/2299
12014   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $13.45   6/1/1994   12/31/2299
12015   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $45.00   1/1/1984   12/31/2299
12015   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $13.45   6/1/1994   12/31/2299
12016   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $50.00   1/1/1984   12/31/2299
12016   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3    $13.45   6/1/1994   12/31/2299
12016   F   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,                  N   3   $306.00   3/1/2004   12/31/2299




                                                                                                                      11
12017   2   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,   N   3   $100.00   1/1/1984   12/31/2299
12017   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,   N   3    $13.45   6/1/1994   12/31/2299
12017   F   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,   N   3   $306.00   3/1/2004   12/31/2299
12018   7   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,   N   3    $13.45   6/1/1994   12/31/2299
12018   F   SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS,   N   3   $306.00   3/1/2004   12/31/2299
12020   2   TREATMENT OF SUPERFICIAL WOUND DEHISCENCE            N   3    $68.40   1/2/1992   12/31/2299
12020   7   TREATMENT OF SUPERFICIAL WOUND DEHISCENCE            N   3    $13.45   6/1/1994   12/31/2299
12020   F   TREATMENT OF SUPERFICIAL WOUND DEHISCENCE            N   3   $225.80   3/1/2004   12/31/2299
12021   2   TREATMENT OF SUPERFICIAL WOUND DEHISCENCE            N   3    $82.12   1/1/2004   12/31/2299
12021   7   TREATMENT OF SUPERFICIAL WOUND DEHISCENCE            N   3    $13.45   6/1/1994   12/31/2299
12021   F   TREATMENT OF SUPERFICIAL WOUND DEHISCENCE            N   3   $225.80   3/1/2004   12/31/2299
12031   2   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $20.00   1/1/1984   12/31/2299
12031   7   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $13.45   6/1/1994   12/31/2299
12032   2   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $27.00   1/1/1984   12/31/2299
12032   7   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $13.45   6/1/1994   12/31/2299
12034   2   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $35.00   1/1/1984   12/31/2299
12034   7   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $13.45   6/1/1994   12/31/2299
12034   F   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3   $306.00   3/1/2004   12/31/2299
12035   2   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $45.00   1/1/1984   12/31/2299
12035   7   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $13.45   6/1/1994   12/31/2299
12035   F   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3   $306.00   3/1/2004   12/31/2299
12036   2   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $60.00   1/1/1984   12/31/2299
12036   7   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $13.45   6/1/1994   12/31/2299
12036   F   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3   $306.00   3/1/2004   12/31/2299
12037   2   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3   $222.10   1/1/2004   12/31/2299
12037   7   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3    $13.45   6/1/1994   12/31/2299
12037   F   LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK A   N   3   $306.00   3/1/2004   12/31/2299
12041   2   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $20.00   1/1/1984   12/31/2299
12041   7   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $13.45   6/1/1994   12/31/2299
12042   2   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $78.00   1/2/1997   12/31/2299
12042   7   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $13.45   6/1/1994   12/31/2299
12044   2   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $45.00   1/1/1984   12/31/2299
12044   7   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $13.45   6/1/1994   12/31/2299
12044   F   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3   $306.00   3/1/2004   12/31/2299
12045   2   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $55.00   1/1/1984   12/31/2299
12045   7   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $13.45   6/1/1994   12/31/2299
12045   F   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3   $306.00   3/1/2004   12/31/2299
12046   2   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $70.00   1/1/1984   12/31/2299
12046   7   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $13.45   6/1/1994   12/31/2299
12046   F   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3   $306.00   3/1/2004   12/31/2299
12047   7   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3    $13.45   6/1/1994   12/31/2299
12047   F   LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/O   N   3   $306.00   3/1/2004   12/31/2299
12051   2   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3    $66.00   7/1/1994   12/31/2299
12051   7   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3    $13.45   6/1/1994   12/31/2299
12052   2   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3    $84.00   7/1/1994   12/31/2299
12052   7   LAYER CLOSURE FACIAL WOUND 2.5CM TO 5.0CM            N   3    $13.45   6/1/1994   12/31/2299
12053   2   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3    $55.00   1/1/1984   12/31/2299
12053   7   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3    $13.45   6/1/1994   12/31/2299
12054   2   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3   $156.00   1/2/1994   12/31/2299
12054   7   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3    $13.45   6/1/1994   12/31/2299
12054   F   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO   N   3   $306.00   3/1/2004   12/31/2299




                                                                                                       12
12055   2   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3    $90.00   1/1/1984   12/31/2299
12055   7   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3    $13.45   6/1/1994   12/31/2299
12055   F   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3   $306.00   3/1/2004   12/31/2299
12056   2   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3   $100.00   1/1/1984   12/31/2299
12056   7   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3    $13.45   6/1/1994   12/31/2299
12056   F   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3   $306.00   3/1/2004   12/31/2299
12057   7   LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NO                  N   3    $13.45   6/1/1994   12/31/2299
13100   2   COMPLEX REPAIR OF WOUND SKIN GRAFTS 1.0-2.5CM                       N   3   $100.00   1/1/1984   12/31/2299
13100   7   COMPLEX REPAIR OF WOUND SKIN GRAFTS 1.0-2.5CM                       N   3    $13.45   6/1/1994   12/31/2299
13100   F   COMPLEX REPAIR OF WOUND SKIN GRAFTS 1.0-2.5CM                       N   3   $306.00   3/1/2004   12/31/2299
13101   2   CMPLX REPR WOUND TRUNK 2.5 TO 7.5 CM                                N   3   $150.00   1/1/1984   12/31/2299
13101   7   COMPLEX REPAIR OF WOUND SKIN GRAFT 1.0-2.5CM                        N   3    $13.45   6/1/1994   12/31/2299
13101   F   CMPLX REPR WOUND TRUNK 2.5 TO 7.5 CM                                N   3   $351.00   3/1/2004   12/31/2299
13102   2   REPAIR COMPLEX TRUNK EA ADD -5CM (LIST IN ADD TO PRIMARY PROC)      N   3    $44.81   1/1/2000   12/31/2299
13120   2   COMPLEX REPAIR SCALP ARMS LEGS 1.0 TO 2.5 CM                        N   3   $125.00   1/1/1984   12/31/2299
13120   7   COMPLEX REPAIR SCALP ARMS LEGS 1.0 TO 2.5CM                         N   3    $13.45   6/1/1994   12/31/2299
13120   F   COMPLEX REPAIR SCALP ARMS LEGS 1.0 TO 2.5 CM                        N   3   $306.00   3/1/2004   12/31/2299
13121   2   COMPLEX REPAIR SCALP ARMS LEGS 2.5 CM TO 7.5CM                      N   3   $225.00   1/1/1984   12/31/2299
13121   7   COMPLEX REPAIR SCALP ARMS LEGS 2.5CM TO 7.5CM                       N   3    $13.45   6/1/1994   12/31/2299
13121   F   COMPLEX REPAIR SCALP ARMS LEGS 2.5 CM TO 7.5CM                      N   3   $351.00   3/1/2004   12/31/2299
13122   2   REPAIR COMPLEX SCALP ARMS &/OR LEGS EA ADD -5CM (LIST ADD TO PROC   N   3    $52.09   1/1/2000   12/31/2299
13131   2   COMPLEX REPAIR FACE NECK HAND FEET GEN 1CM TO 2.5                   N   3   $114.00   8/1/1991   12/31/2299
13131   7   COMPLEX REPAIR FACE NECK HAND FEET GEN 1CM TO 2.5                   N   3    $13.45   6/1/1994   12/31/2299
13131   F   COMPLEX REPAIR FACE NECK HAND FEET GEN 1CM TO 2.5                   N   3   $306.00   3/1/2004   12/31/2299
13132   2   COMPLEX REPAIR FACE NECK HAND FEET GEN 2.5CM-7.5CM                  N   3   $220.00   1/2/1995   12/31/2299
13132   7   COMPLEX REPAIR FACE NECK HAND FEET GEN 2.5CM-7.5CM                  N   3    $13.45   6/1/1994   12/31/2299
13132   F   COMPLEX REPAIR FACE NECK HAND FEET GEN 2.5CM-7.5CM                  N   3   $351.00   3/1/2004   12/31/2299
13133   2   REPAIR COMPLEX FOREHEAD/CHEECKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA   N   3    $76.98   1/1/2000   12/31/2299
13150   2   COMPLEX REPAIR FACE UP TO 1.0 CM                                    N   3   $150.00   1/1/1984   12/31/2299
13150   7   COMPLEX REPAIR FACE UP TO 1.0 CM                                    N   3    $13.45   6/1/1994   12/31/2299
13150   F   COMPLEX REPAIR FACE UP TO 1.0 CM                                    N   3   $351.00   3/1/2004   12/31/2299
13151   2   REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS;                   N   3   $175.00   1/2/1996   12/31/2299
13151   7   REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS;                   N   3    $13.45   6/1/1994   12/31/2299
13151   F   REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS;                   N   3   $351.00   3/1/2004   12/31/2299
13152   2   REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS;                   N   3   $300.00   1/1/1984   12/31/2299
13152   7   REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS;                   N   3    $13.45   6/1/1994   12/31/2299
13152   F   REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS;                   N   3   $351.00   3/1/2004   12/31/2299
13153   2   REPAIR COMPLEX EYELIDS/NOSE/EARS/&OR LIPS EA ADD -5CM ADD TO PRIM   N   3    $84.73   1/1/2000   12/31/2299
13160   2   SECNDRY CLSUR;SRGCL WOUND/DEHISCE EXTNSV/CMPLICTED                  N   3   $100.00   1/1/1984   12/31/2299
13160   7   SECNDRY CLSUR;SRGCL WOUND/DEHISCE EXTNSV/CMPLICTED                  N   3    $13.45   6/1/1994   12/31/2299
13160   8   SECNDRY CLSUR;SRGCL WOUND/DEHISCE EXTNSV/CMPLICTED                  N   3    $20.00   1/1/1984   12/31/2299
13160   F   SECNDRY CLSUR;SRGCL WOUND/DEHISCE EXTNSV/CMPLICTED                  N   3   $306.00   3/1/2004   12/31/2299
14000   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3   $100.00   1/1/1973   12/31/2299
14000   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3    $13.45   6/1/1994   12/31/2299
14000   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3   $306.00   3/1/2004   12/31/2299
14001   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3   $150.00   1/1/1973   12/31/2299
14001   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3    $13.45   6/1/1994   12/31/2299
14001   8   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3    $30.00   1/1/1973   12/31/2299
14001   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;                   N   3   $351.00   3/1/2004   12/31/2299
14020   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3   $150.00   1/1/1973   12/31/2299
14020   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      13
14020   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3   $351.00   3/1/2004   12/31/2299
14021   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3   $200.00   1/1/1973   12/31/2299
14021   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3    $13.45   6/1/1994   12/31/2299
14021   8   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3    $40.00   1/1/1973   12/31/2299
14021   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP,                   N   3   $351.00   3/1/2004   12/31/2299
14040   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD,CHEEKS,CHIN     N   3   $348.00   1/2/1997   12/31/2299
14040   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEA                  N   3    $13.45   6/1/1994   12/31/2299
14040   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD,CHEEKS,CHIN     N   3   $306.00   3/1/2004   12/31/2299
14041   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEA                  N   3   $250.00   1/1/1979   12/31/2299
14041   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEA                  N   3    $13.45   6/1/1994   12/31/2299
14041   8   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEA                  N   3    $50.00   1/1/1973   12/31/2299
14041   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEA                  N   3   $351.00   3/1/2004   12/31/2299
14060   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3   $250.00   1/1/1973   12/31/2299
14060   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3    $13.45   6/1/1994   12/31/2299
14060   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3   $351.00   3/1/2004   12/31/2299
14061   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3   $350.00   1/1/1973   12/31/2299
14061   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3    $13.45   6/1/1994   12/31/2299
14061   8   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3    $70.00   1/1/1973   12/31/2299
14061   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS                  N   3   $351.00   3/1/2004   12/31/2299
14300   2   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE TH                  N   3   $490.00   7/1/1994   12/31/2299
14300   7   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE TH                  N   3    $13.45   6/1/1994   12/31/2299
14300   F   ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE TH                  N   3   $432.00   3/1/2004   12/31/2299
14350   2   FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION                  N   3   $396.00   1/2/1995   12/31/2299
14350   7   FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION                  N   3    $13.45   6/1/1994   12/31/2299
14350   8   FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION                  N   3    $79.00   1/2/1995   12/31/2299
14350   F   FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION                  N   3   $351.00   3/1/2004   12/31/2299
15002   2   WND PREP, SH/INF, TRK/ARM/LG                                        N   3   $115.94   1/1/2007   12/31/2299
15002   7   WND PREP, SH/INF, TRK/ARM/LG                                        N   3    $13.45   1/1/2007   12/31/2299
15003   2   WND PREP, SH/INF ADDL 100 CM                                        N   3    $23.67   1/1/2007   12/31/2299
15003   7   WND PREP, CH/INF ADDL 100 MG                                        N   3    $13.45   1/1/2007   12/31/2299
15004   2   WND PREP CH/INF F/N/HF/G                                            N   3   $143.44   1/1/2007   12/31/2299
15004   7   WND PREP CH/INF F/N/HF/G                                            N   3    $13.45   1/1/2007   12/31/2299
15005   2   WND PREP. F/N/HF/G, ADDL CM                                         N   3    $47.35   1/1/2007   12/31/2299
15005   7   WND PREP. F/N/HF/G, ADDL CM                                         N   3    $13.45   1/1/2007   12/31/2299
15040   2   HARVEST OF SKIN FOR TISSUE CULTURED SKIN AUTOGRAFT 100 SQ CM OR L   N   3   $150.20   1/1/2006   12/31/2299
15040   7   HARVEST OF SKIN FOR TISSUE CULTURED SKIN AUTOGRAFT 100 SQ CM OR L   N   3    $13.45   1/1/2006   12/31/2299
15040   8   HARVEST OF SKIN FOR TISSUE CLUTURED SKIN AUTOGRAFT 100 SQ CM OR L   N   3    $30.04   1/1/2006   12/31/2299
15050   2   PINCH GRAFT, SINGLE OR MULTIPLE, TO COVER SMALL UL                  N   3    $38.00   8/1/1979   12/31/2299
15050   7   PINCH GRAFT, SINGLE OR MULTIPLE, TO COVER SMALL UL                  N   3    $13.45   6/1/1994   12/31/2299
15050   F   PINCH GRAFT, SINGLE OR MULTIPLE, TO COVER SMALL UL                  N   3   $306.00   3/1/2004   12/31/2299
15100   2   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3   $315.00   1/2/1997   12/31/2299
15100   7   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3    $13.45   6/1/1994   12/31/2299
15100   8   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3    $63.00   1/2/1997   12/31/2299
15100   F   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3   $306.00   3/1/2004   12/31/2299
15101   2   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3    $86.00   1/2/1997   12/31/2299
15101   7   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3    $13.45   6/1/1994   12/31/2299
15101   F   SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/                  N   3   $351.00   3/1/2004   12/31/2299
15110   2   EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, FIRST 100 SQ CM OR LESS     N   3   $471.52   1/1/2006   12/31/2299
15110   7   EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, FIRST 100 SQ CM OR LESS     N   3    $13.45   1/1/2006   12/31/2299
15111   2   EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, EACH ADDITIONAL 100 SQ CM   N   3    $74.23   1/1/2006   12/31/2299
15111   7   EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR OR EAC   N   3    $13.45   1/1/2006   12/31/2299




                                                                                                                      14
15111   8   EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR OR EAC   N   3    $14.85   1/1/2006   12/31/2299
15115   2   EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORB   N   3   $400.75   1/1/2006   12/31/2299
15115   7   EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORB   N   3    $13.45   1/1/2006   12/31/2299
15115   8   EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORB   N   3    $80.15   1/1/2006   12/31/2299
15116   2   EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORB   N   3    $96.23   1/1/2006   12/31/2299
15116   7   EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORB   N   3    $13.45   1/1/2006   12/31/2299
15116   8   EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORB   N   3    $19.25   1/1/2006   12/31/2299
15120   2   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, GENITALIA,HANDSD     N   3   $400.00   1/2/1995   12/31/2299
15120   7   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, GEN                  N   3    $13.45   6/1/1994   12/31/2299
15120   8   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, GEN                  N   3    $80.00   1/2/1995   12/31/2299
15120   F   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, GENITALIA,HANDSD     N   3   $306.00   3/1/2004   12/31/2299
15121   2   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS,ORBITS,GENITALIA,HA   N   3    $50.00   1/1/1973   12/31/2299
15121   7   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, GEN                  N   3    $13.45   6/1/1994   12/31/2299
15121   F   SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS,ORBITS,GENITALIA,HA   N   3   $351.00   3/1/2004   12/31/2299
15130   2   DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, FIRST 100 SQ CM OR LESS        N   3   $313.61   1/1/2006   12/31/2299
15131   2   DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, O   N   3    $60.71   1/1/2006   12/31/2299
15131   7   DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, O   N   3    $13.45   1/1/2006   12/31/2299
15131   8   DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, O   N   3    $12.14   1/1/2006   12/31/2299
15135   2   DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS   N   3   $473.76   1/1/2006   12/31/2299
15135   7   DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS   N   3    $13.45   1/1/2006   12/31/2299
15135   8   DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS   N   3    $94.75   1/1/2006   12/31/2299
15136   2   DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS   N   3    $56.49   1/1/2006   12/31/2299
15136   7   DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS   N   3    $13.45   1/1/2006   12/31/2299
15136   8   DERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS   N   3    $11.30   1/1/2006   12/31/2299
15150   2   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3   $391.42   1/1/2006   12/31/2299
15150   7   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $13.45   1/1/2006   12/31/2299
15150   8   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $78.28   1/1/2006   12/31/2299
15151   2   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; ADDITIONA   N   3    $78.34   1/1/2006   12/31/2299
15151   7   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; ADDITIONA   N   3    $13.45   1/1/2006   12/31/2299
15151   8   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; ADDITIONA   N   3    $15.67   1/1/2006   12/31/2299
15152   2   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $96.20   1/1/2006   12/31/2299
15152   7   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $13.45   1/1/2006   12/31/2299
15152   8   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $19.24   1/1/2006   12/31/2299
15155   2   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH,   N   3   $375.43   1/1/2006   12/31/2299
15155   7   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH,   N   3    $13.45   1/1/2006   12/31/2299
15155   8   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH,   N   3    $74.49   1/1/2006   12/31/2299
15156   2   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH,   N   3   $101.83   1/1/2006   12/31/2299
15156   7   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH    N   3    $13.45   1/1/2006   12/31/2299
15156   8   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH    N   3    $20.37   1/1/2006   12/31/2299
15157   2   TISSUE CULTURED EPIDERMAL AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH,   N   3   $112.78   1/1/2006   12/31/2299
15157   7   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $13.45   1/1/2006   12/31/2299
15157   8   TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 25    N   3    $22.56   1/1/2006   12/31/2299
15170   2   ACELLULAR DERMAL REPLACEMENT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM    N   3   $205.38   1/1/2006   12/31/2299
15170   7   ACELLULAR DERMAL REPLACEMENT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM    N   3    $13.45   1/1/2006   12/31/2299
15170   8   ACELLULAR DERMAL REPLACEMENT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM    N   3    $41.08   1/1/2006   12/31/2299
15171   2   ACELLULAR DERMAL REPLACEMTN, TRUNK, ARMS, LEGS; EACH ADDITIONAL 1   N   3    $52.69   1/1/2006   12/31/2299
15171   7   ACELLULAR DERMAL REPLACEMENT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM    N   3    $13.45   1/1/2006   12/31/2299
15171   8   ACELLULAR DERMAL REPLACEMENT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM    N   3    $10.54   1/1/2006   12/31/2299
15175   2   ACELLULAR DERMAL REPLACEMENT, FACE, SCALP, EYELIDS, MOUTH, NECK,    N   3   $289.98   1/1/2006   12/31/2299
15175   7   ACELLULAR DERMAL REPLACEMENT, FACE, SCALP, EYELIDS, MOUTH, NECK,    N   3    $13.45   1/1/2006   12/31/2299
15175   8   ACELLULAR DERMAL REPLACEMENT, FACE, SCALP, EYELIDS, MOUTH, NECK,    N   3    $58.00   1/1/2006    1/31/2299




                                                                                                                      15
15176   2   ACELLULAR DERMAL REPLACEMENT, FACE, SCALP EYELIDS, MOUTH, NECK, E   N   3    $83.86   1/1/2006   12/31/2299
15176   7   ACELLULAR DERMAL REPLACEMENT, FACE, SCALP, EYELIDS, MOUTH, NECK,    N   3    $13.45   1/1/2006   12/31/2299
15176   8   ACELLULAR DERMAL REPLACEMENT, FACE, SCALP, EYELIDS, MOUTH, NECK,    N   3    $16.77   1/1/2006   12/31/2299
15200   2   FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSU                  N   3   $100.00   1/1/1973   12/31/2299
15200   7   FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSU                  N   3    $13.45   6/1/1994   12/31/2299
15200   F   FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSU                  N   3   $351.00   3/1/2004   12/31/2299
15201   2   FULL THICKNESS GRAFT,FREE,INCLUDING DIRECT CLOSURE DONOR SITE,TRU   N   3    $50.00   1/1/1973   12/31/2299
15201   7   FULL THICKNESS GRAFT,FREE,INCLUDING DIRECT CLOSURE                  N   3    $13.45   6/1/1994   12/31/2299
15201   F   FULL THICKNESS GRAFT,FREE,INCLUDING DIRECT CLOSURE DONOR SITE,TRU   N   3   $306.00   3/1/2004   12/31/2299
15220   2   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3   $150.00   1/1/1973   12/31/2299
15220   7   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3    $13.45   6/1/1994   12/31/2299
15220   F   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3   $306.00   3/1/2004   12/31/2299
15221   2   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF DONOR SITE       N   3    $75.00   1/1/1973   12/31/2299
15221   7   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3    $13.45   6/1/1994   12/31/2299
15221   F   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF DONOR SITE       N   3   $306.00   3/1/2004   12/31/2299
15240   2   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3   $200.00   1/1/1979   12/31/2299
15240   7   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3    $13.45   6/1/1994   12/31/2299
15240   F   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3   $351.00   3/1/2004   12/31/2299
15241   2   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF DONOR SITE       N   3   $100.00   1/1/1973   12/31/2299
15241   7   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3    $13.45   6/1/1994   12/31/2299
15241   F   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF DONOR SITE       N   3   $351.00   3/1/2004   12/31/2299
15260   2   FULL THICKNESS GRAFT, FREE, INCLUDING DIR CLOSURE                   N   3   $346.00   1/2/1993   12/31/2299
15260   7   FULL THICKNESS GRAFT, FREE, INCLUDING DIR CLOSURE                   N   3    $13.45   6/1/1994   12/31/2299
15260   F   FULL THICKNESS GRAFT, FREE, INCLUDING DIR CLOSURE                   N   3   $306.00   3/1/2004   12/31/2299
15261   2   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF DONOR SITE,NOS   N   3   $125.00   1/1/1973   12/31/2299
15261   7   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF                  N   3    $13.45   6/1/1994   12/31/2299
15261   F   FULL THICKNESS GRAFT,FREE,INCLUDING DIR CLOSURE OF DONOR SITE,NOS   N   3   $306.00   3/1/2004   12/31/2299
15300   2   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOUSRE, TRUNK, ARMS, LEGS; FI   N   3   $168.19   1/1/2006   12/31/2299
15300   7   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOUSRE, TRUNK, ARMS, LEGS; FI   N   3    $13.45   1/1/2006   12/31/2299
15300   8   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOUSRE, TRUNK, ARMS, LEGS; FI   N   3    $33.64   1/1/2006   12/31/2299
15301   2   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, TRUNK, ARMS, LEGS; FI   N   3    $35.05   1/1/2006   12/31/2299
15301   7   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, TRUNK, ARMS, LEGS; FI   N   3    $13.45   1/1/2006   12/31/2299
15301   8   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, TRUNK, ARMS, LEGS; FI   N   3     $7.01   1/1/2006   12/31/2299
15320   2   ALLOGRAFT SKIN FOR TEMPOARY WOUND CLOSURE, FACE, SCALP, EYELIDS,    N   3   $194.80   1/1/2006   12/31/2299
15320   7   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, FACE, SCALP, EYELIDS,   N   3    $13.45   1/1/2006   12/31/2299
15320   8   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, FACE, SCALP, EYELIDS,   N   3    $38.96   1/1/2006   12/31/2299
15321   2   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, FACE, SCALP, EYELIDS,   N   3    $52.24   1/1/2006   12/31/2299
15321   7   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, FACE, SCALP, EYELIDS,   N   3    $13.45   1/1/2006   12/31/2299
15321   8   ALLOGRAFT SKIN FOR TEMPORARY WOUND CLOSURE, FACE, SCALP, EYELIDS,   N   3    $10.45   1/1/2006   12/31/2299
15330   2   ACELLULAR ALLOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS     N   3   $167.96   1/1/2006   12/31/2299
15330   7   ACELLULAR ALLOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS     N   3    $13.45   1/1/2006   12/31/2299
15330   8   ACELLULAR ALLOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS     N   3    $33.59   1/1/2006   12/31/2299
15331   2   ACELLULAR DERMAL ALLOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL      N   3    $34.82   1/1/2006   12/31/2299
15331   7   ACELLULAR DERMAL ALLOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 10   N   3    $13.45   1/1/2006   12/31/2299
15331   8   ACELLULAR DERMAL ALLOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 10   N   3     $6.96   1/1/2006   12/31/2299
15335   2   ACELLULAR DERMAL ALLOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EA   N   3   $186.50   1/1/2006   12/31/2299
15335   7   ACELLULAR DERMAL ALLOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EA   N   3    $13.45   1/1/2006   12/31/2299
15335   8   ACELLULAR DERMAL ALLOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EA   N   3    $37.30   1/1/2006   12/31/2299
15336   2   ACELLULAR DERMAL ALLOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EA   N   3    $50.51   1/1/2006   12/31/2299
15336   7   ACELLULAR DERMAL ALLOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EA   N   3    $13.45   1/1/2006   12/31/2299
15340   2   TISSUE CULTURED ALLOGENIC SKIN SUBSTITUTE; FIRST 25 SQ CM OR LESS   N   3   $297.54   1/1/2006   12/31/2299




                                                                                                                      16
15340   7   TISSUE CULTURED ALLOGENIC SKIN SUBSTITUTE; FIRST 25 SQ CM OR LESS   N   3    $13.45   1/1/2006   12/31/2299
15340   8   TISSUE CULTURED ALLOGENIC SKIN SUBSTITUTE; FIRST 25 SQ CM OR LESS   N   3    $59.51   1/1/2006   12/31/2299
15341   2   TISSUE CULTURED ALLOGENIC SKIN SUBSTITUTE; EACH ADDITIONAL 25 SQ    N   3    $25.68   1/1/2006   12/31/2299
15341   7   TISSUE CULTURED ALLOGENIC SKIN SUBSTITUTE; EACH ADDITIONAL 25 SQ    N   3    $13.45   1/1/2006   12/31/2299
15341   8   TISSUE CULTURED ALLOGENIC SKIN SUBSTITUTE; EACH ADDITIONAL 25 SQ    N   3     $5.14   1/1/2006   12/31/2299
15360   2   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE; TRUNK, ARMS, LEGS;    N   3   $192.67   1/1/2006   12/31/2299
15360   7   TISSUE CULTURED ALLOGENIC DERMAL SUBSTITUTE; TRUNK, ARMS, LEGS, F   N   3    $13.45   1/1/2006   12/31/2299
15360   8   TISSUE CULTURED ALLOGENIC DERMAL SUBSTITUTE; TRUNK, ARMS, LEGS, F   N   3    $38.33   1/1/2006   12/31/2299
15361   2   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE; EACH ADDITIONAL 100   N   3    $40.75   1/1/2006   12/31/2299
15361   7   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE; EACH ADDITIONAL 100   N   3    $13.45   1/1/2006   12/31/2299
15361   8   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE; EACH ADDITIONAL 100   N   3     $8.19   1/1/2006   12/31/2299
15365   2   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELID   N   3   $201.14   1/1/2006   12/31/2299
15365   7   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELID   N   3    $13.45   1/1/2006   12/31/2299
15365   8   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELID   N   3    $40.23   1/1/2006   12/31/2299
15366   2   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELID   N   3    $50.56   1/1/2006   12/31/2299
15366   7   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELID   N   3    $13.45   1/1/2006   12/31/2299
15366   8   TISSUE CULTURED ALLOGENEIC DERMAL SUBSTITUTE, FACE, SCALP, EYELID   N   3    $10.11   1/1/2006   12/31/2299
15400   2   APPLICATION OF XENOGRAFT (HETEROGRAFT), SKIN 100 SQ CM OR LESS      N   3    $40.00   1/1/1984   12/31/2299
15400   7   APPLICATION OF XENOGRAFT (HETEROGRAFT), SKIN                        N   3    $13.45   6/1/1994   12/31/2299
15400   F   APPLICATION OF XENOGRAFT (HETEROGRAFT), SKIN 100 SQ CM OR LESS      N   3   $306.00   3/1/2004   12/31/2299
15401   2   APPLICATION OF XENOGRAFT SKIN 100 SQCM                              N   3    $34.90   1/1/1999   12/31/2299
15401   F   APPLICATION OF XENOGRAFT SKIN 100 SQCM                              N   3   $306.00   3/1/2004   12/31/2299
15420   2   XENOGRAFT SKIN (DERMAL), FOR TEMPORARY WOUND CLOSURE, FACE, SCALP   N   3   $215.09   1/1/2006   12/31/2299
15420   7   XENOGRAFT SKIN (DERMAL), FOR TEMPORARY WOUND CLOSURE, FACE, SCALP   N   3    $13.45   1/1/2006   12/31/2299
15420   8   XENOGRAFT SKIN (DERMAL), FOR TEMPORARY WOUND CLOSURE, FACE, SCALP   N   3    $43.02   1/1/2006   12/31/2299
15421   2   XENOGRAFT SKIN (DERMAL) FOR TEMPORARY WOUND CLOSURE, FACE, SCALP,   N   3    $66.28   1/1/2006   12/31/2299
15421   7   XENOGRAFT SKIN (DERMAL) FOR TEMPORARY WOUND CLOSURE, FACE, SCALP,   N   3    $13.45   1/1/2006   12/31/2299
15421   8   XENOGRAFT SKIN (DERMAL) FOR TEMPORARY WOUND CLOSURE, FACE, SCALP,   N   3    $13.26   1/1/2006   12/31/2299
15430   2   ACELLULAR XENOGRAFT IMPLANT; FIRST 100 SQ CM OR LESS, OR ONE PERC   N   3   $292.57   1/1/2006   12/31/2299
15430   7   ACELLULAR XENOGRAFT IMPLANT; FIRST 100 SQ CM OR LESS, OR ONE PERC   N   3    $13.45   1/1/2006   12/31/2299
15430   8   ACELLULAR XENOGRAFT IMPLANT; FIRST 100 SQ CM OR LESS, OR ONE PERC   N   3    $58.51   1/1/2006   12/31/2299
15431   2   ACELLULAR XENOGRAFT IMPLANT; EACH ADDITIONAL 100 SQ CM, OR EACH A   N   3    $23.56   1/1/2006   12/31/2299
15431   7   ACELLULAR XENOGRAFT IMPLANT; EACH ADDITIONAL 100 SQ CM, OR EACH A   N   3    $13.45   1/1/2006   12/31/2299
15431   8   ACELLULAR XENOGRAFT IMPLANT; EACH ADDITIONAL 100 SQ CM, OR EACH A   N   3     $4.71   1/1/2006   12/31/2299
15570   2   FLAPS (SKIN AND/OR DEEP TISSUES)                                    N   3   $309.00   1/2/1992   12/31/2299
15570   7   FLAPS (SKIN AND/OR DEEP TISSUES)                                    N   3    $13.45   6/1/1994   12/31/2299
15570   F   FLAPS (SKIN AND/OR DEEP TISSUES)                                    N   3   $351.00   3/1/2004   12/31/2299
15572   2   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3   $422.32   1/1/2005   12/31/2299
15572   7   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3    $13.45   6/1/1994   12/31/2299
15572   F   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3   $351.00   3/1/2004   12/31/2299
15574   7   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3    $13.45   6/1/1994   12/31/2299
15574   F   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3   $351.00   3/1/2004   12/31/2299
15576   2   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3   $404.78   1/1/2002   12/31/2299
15576   7   FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITH                  N   3    $13.45   6/1/1994   12/31/2299
15600   2   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3   $115.50   1/1/1973   12/31/2299
15600   7   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3    $13.45   6/1/1994   12/31/2299
15600   F   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3   $351.00   3/1/2004   12/31/2299
15610   2   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3   $125.00   1/1/1973   12/31/2299
15610   7   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3    $13.45   6/1/1994   12/31/2299
15610   F   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3   $351.00   3/1/2004   12/31/2299
15620   2   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA                  N   3   $150.00   1/1/1973   12/31/2299




                                                                                                                      17
15620   7   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA          N   3      $13.45   6/1/1994   12/31/2299
15620   F   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA          N   3    $432.00    3/1/2004   12/31/2299
15630   2   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA          N   3    $150.00    1/1/1973   12/31/2299
15630   7   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA          N   3      $13.45   6/1/1994   12/31/2299
15630   F   INTERMEDIATE ''DELAY'' OF ANY FLAP, PRIMARY ''DELA          N   3    $351.00    3/1/2004   12/31/2299
15650   2   TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (EG,AB          N   3    $225.00    1/1/1984   12/31/2299
15650   7   TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (EG,AB          N   3      $13.45   6/1/1994   12/31/2299
15650   F   TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (EG,AB          N   3    $495.00    3/1/2004   12/31/2299
15731   2   FOREHEAD FLAP W/VASC PEDICLE                                N   3    $507.01    1/1/2007   12/31/2299
15731   7   FOREHEAD FLAP W/VASC PEDICLE                                N   3      $13.45   1/1/2007   12/31/2299
15731   8   FOREHEAD FLAP W/VASC PEDICLE                                N   3    $101.00    1/1/2007   12/31/2299
15732   2   MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP               N   3    $704.27    1/1/2002   12/31/2299
15732   7   MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP               N   3      $13.45   6/1/1994   12/31/2299
15732   8   MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP               N   3    $132.45    1/1/2004   12/31/2299
15732   F   MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP               N   3    $351.00    3/1/2004   12/31/2299
15734   2   MUSCLE, MYOCUT OR FASC FLAP ; TRUNK                         N   3    $400.00    1/1/1985   12/31/2299
15734   7   MUSCLE, MYOCUT OR FASC FLAP ; TRUNK                         N   3      $13.45   6/1/1994   12/31/2299
15734   8   MUSCLE, MYOCUT OR FASC FLAP ; TRUNK                         N   3      $80.00   1/1/1985   12/31/2299
15734   F   MUSCLE, MYOCUT OR FASC FLAP ; TRUNK                         N   3    $351.00    3/1/2004   12/31/2299
15736   7   MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP               N   3      $13.45   6/1/1994   12/31/2299
15738   2   MUSCLE MYOCUTANEOUS OF FSCCTNS FLAP LOWER EXTRMTY           N   3    $300.00    1/1/1984   12/31/2299
15738   7   MUSCLE MYOCUTANEOUS OF FSCCTNS FLAP LOWER EXTRMTY           N   3      $13.45   6/1/1994   12/31/2299
15738   8   MUSCLE MYOCUTANEOUS OF FSCCTNS FLAP LOWER EXTRMTY           N   3      $60.00   1/1/1984   12/31/2299
15738   F   MUSCLE MYOCUTANEOUS OF FSCCTNS FLAP LOWER EXTRMTY           N   3    $351.00    3/1/2004   12/31/2299
15740   2   GRAFT; ISLAND PEDICLE FLAP                                  N   3    $300.00    1/1/1973   12/31/2299
15740   7   GRAFT; ISLAND PEDICLE FLAP                                  N   3      $13.45   6/1/1994   12/31/2299
15740   F   GRAFT; ISLAND PEDICLE FLAP                                  N   3    $306.00    3/1/2004   12/31/2299
15750   2   GRAFT; NEUROVASCULAR PEDICLE FLAP                           N   3    $250.00    1/1/1973   12/31/2299
15750   7   GRAFT; NEUROVASCULAR PEDICLE FLAP                           N   3      $13.45   6/1/1994   12/31/2299
15750   8   GRAFT; NEUROVASCULAR PEDICLE FLAP                           N   3      $50.00   1/1/1973   12/31/2299
15750   F   GRAFT; NEUROVASCULAR PEDICLE FLAP                           N   3    $306.00    3/1/2004   12/31/2299
15755   2   FREE FLAP(MICROVASCULAR TRANSFER)                           N   3   $1,200.00   1/2/1992   12/31/2299
15755   7   FREE FLAP(MICROVASCULAR TRANSFER)                           N   3      $13.45   6/1/1994   12/31/2299
15755   8   FREE FLAP(MIRCOVASCULAR TRANSFER)                           N   3    $240.00    1/2/1992   12/31/2299
15756   2   FREE MUSCLE/MYOCUTANEOUS FLAP W MICROVASCULAR ANASTOMOSIS   N   3   $1,500.00   1/2/1998   12/31/2299
15756   7   FREE MUSCLE/MYOCUTANEOUS FLAP WMICROVASCULAR ANASTOMOSIS    N   3      $13.45   1/1/1997   12/31/2299
15756   8   FREE MUSCLE/MYOCUTANEOUS FLAP WMICROVASCULAR ANASTOMOSIS    N   3    $300.00    1/2/1998   12/31/2299
15757   2   FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS                  N   3   $1,624.52   1/1/1997   12/31/2299
15757   7   FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS                  N   3      $13.45   1/1/1997   12/31/2299
15757   8   FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS                  N   3    $324.90    1/1/1997   12/31/2299
15758   2   FREE FASCIAL FLAP W/ MICROVASCULAR ANASTOMOSIS              N   3   $1,624.52   1/1/1997   12/31/2299
15758   7   FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS               N   3      $13.45   1/1/1997   12/31/2299
15758   8   FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS               N   3    $324.90    1/1/1997   12/31/2299
15760   2   GRAFT; COMPOSITE, INCLUDING PRIMARY CLOSURE, DONOR          Y   3    $396.00    1/2/1997   12/31/2299
15760   7   GRAFT; COMPOSITE, INCLUDING PRIMARY CLOSURE, DONOR          Y   3      $13.45   6/1/1994   12/31/2299
15760   F   GRAFT; COMPOSITE, INCLUDING PRIMARY CLOSURE, DONOR          N   3    $306.00    3/1/2004   12/31/2299
15770   2   GRAFT; DERMA-FAT-FASCIA                                     N   3    $300.00    1/1/1973   12/31/2299
15770   7   GRAFT; DERMA-FAT-FASCIA                                     N   3      $13.45   6/1/1994   12/31/2299
15770   8   GRAFT; DERMA-FAT-FASCIA                                     N   3      $60.00   1/1/1984   12/31/2299
15770   F   GRAFT; DERMA-FAT-FASCIA                                     N   3    $351.00    3/1/2004   12/31/2299
15775   7   PUNCH GRAFT FOR HAIR TRANSPLANT; 1 TO 15                    N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                18
15776   7   PUNCH GRAFT FOR HAIR TRANSPLANT; MORE THAN 15                       N   3    $13.45   6/1/1994 12/31/2299
15780   2   DERMABRASION;TOTAL FACE (EG,FOR ACNE SCARRING,FINE WRINKLING,RHYT   N   3   $183.00 12/11/1998 12/31/2299
15780   7   ABRASION OF SKIN FOR REMOVAL OF SCARS, TATTOOS, OR                  N   3    $13.45   6/1/1994 12/31/2299
15781   7   ABRASION OF SKIN FOR REMOVAL OF SCARS,TATTOOS,KERA                  N   3    $13.45   6/1/1994 12/31/2299
15782   7   REMOVAL OF SCAR REGIONAL OTHER THAN FACIAL AREA                     N   3    $13.45   6/1/1994 12/31/2299
15783   7   DERMABRASION                                                        N   3    $13.45   6/1/1994 12/31/2299
15785   7   ABRASION OF SKIN FOR REMOVAL OF SCARS, TATTOOS, AC                  N   3    $13.45   6/1/1994 12/31/2299
15786   7   ABRASION; SINGLE LESION (EG,KERATOSIS,SCAR)                         N   3    $13.45   6/1/1994 12/31/2299
15787   7   ABRASION; EACH ADDITIONAL FOUR LESIONS OR LESS                      N   3    $13.45   6/1/1994 12/31/2299
15800   7   ABRASION OF SKIN, TOTAL FACE, COMBINED WITH SUPERF                  N   3    $13.45   6/1/1994 12/31/2299
15820   7   BLEPHAROPLASTY, LOWER EYELID;                                       N   3    $13.45   6/1/1994 12/31/2299
15821   7   BLEPHAROPLASTY, LOWER EYELID; WITH EXTENSIVE HERNI                  N   3    $13.45   6/1/1994 12/31/2299
15822   7   BLEPHAROPLASTY, UPPER EYELID;                                       N   3    $13.45   6/1/1994 12/31/2299
15822   F   BLEPHAROPLASTY, UPPER EYELID;                                       N   3   $351.00   3/1/2004 12/31/2299
15823   2   BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN                   Y   3   $360.00   1/2/1996 12/31/2299
15823   7   BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN                   N   3    $13.45   6/1/1994 12/31/2299
15823   8   BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN                   N   3    $72.00   1/2/1996 12/31/2299
15823   F   BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN                   N   3   $495.00   3/1/2004 12/31/2299
15830   2   EXC SKIN ABD                                                        Y   3   $606.09   1/1/2007 12/31/2299
15830   7   EXC SKIN ABD                                                        Y   3    $13.45   1/1/2007 12/31/2299
15830   8   EXC SKIN ABD                                                        Y   3   $180.00   1/1/2007 12/31/2299
15839   2   EXCISION, EXCESSIVE SKIN                                            N   3   $392.98   1/1/2004 12/31/2299
15839   7   ANESTHESIOLOGIST EXCISION EXCESS TISSUE & SKIN OTH                  N   3    $13.45   6/1/1994 12/31/2299
15839   8   ASSIST AT SURGERY EXC. EXCESSIVE SKIN & TISSUE                      N   3    $83.25   1/1/2005 12/31/2299
15840   2   GRAFT FOR FACIAL NERVE PARALSIS INC OBTAIN GRAFT                    N   3   $600.00   1/1/1984 12/31/2299
15840   7   GRAFT FOR FACIAL NERVE PARALYSIS; FREE FASCIA GRAF                  N   3    $13.45   6/1/1994 12/31/2299
15840   F   GRAFT FOR FACIAL NERVE PARALSIS INC OBTAIN GRAFT                    N   3   $432.00   3/1/2004 12/31/2299
15841   2   GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAF                  N   3   $625.00   1/1/1984 12/31/2299
15841   7   GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAF                  N   3    $13.45   6/1/1994 12/31/2299
15841   F   GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAF                  N   3   $432.00   3/1/2004 12/31/2299
15842   7   GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAF                  N   3    $13.45   6/1/1994 12/31/2299
15845   2   GRAFT FOR FACIAL NERVE PARALYSIS; REGIONAL MUSCLE                   N   3   $650.00   1/1/1984 12/31/2299
15845   7   GRAFT FOR FACIAL NERVE PARALYSIS; REGIONAL MUSCLE                   N   3    $13.45   6/1/1994 12/31/2299
15845   F   GRAFT FOR FACIAL NERVE PARALYSIS; REGIONAL MUSCLE                   N   3   $432.00   3/1/2004 12/31/2299
15847   7   EXC SKIN ABD ADD-ON                                                 Y   3    $13.45   1/1/2007 12/31/2299
15850   2   REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LO                  N   3    $20.00   2/2/1992 12/31/2299
15850   7   REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LO                  N   3    $13.45   6/1/1994 12/31/2299
15851   2   REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LO                  N   3    $10.00   1/1/1984 12/31/2299
15851   7   REMOVAL OF SUTURES UNDER ANES OTHER THAN LOCAL                      N   3    $13.45   6/1/1994 12/31/2299
15852   2   DRESSING CHANGE-OTHER THAN BURNS-W/ANESTHESIA                       N   3    $30.00   1/1/1984 12/31/2299
15852   7   DRESSING CHANGE OTHER THAN BURNS-W/ANESTHESIA                       N   3    $13.45   6/1/1994 12/31/2299
15860   2   IV INJ OF AGENT TO TEST BLOOD FLOW IN FLAP-GRAFT                    N   3    $15.00   1/1/1984 12/31/2299
15875   7   SUCTION ASSISTED LIPECTOMY, ANY SITE(S)                             N   3    $13.45   6/1/1994 12/31/2299
15876   7   SUCTION ASSISTED LIPECTOMY                                          N   3    $13.45   6/1/1994 12/31/2299
15876   F   SUCTION ASSISTED LIPECTOMY                                          N   3   $351.00   3/1/2004 12/31/2299
15877   7   SUCTION ASSISTED LIPECTOMY                                          N   3    $13.45   6/1/1994 12/31/2299
15877   F   SUCTION ASSISTED LIPECTOMY                                          N   3   $351.00   3/1/2004 12/31/2299
15878   7   SUCTION ASSISTED LIPECTOMY                                          N   3    $13.45   6/1/1994 12/31/2299
15878   F   SUCTION ASSISTED LIPECTOMY                                          N   3   $351.00   3/1/2004 12/31/2299
15879   7   SUCTION ASSISTED LIPECTOMY                                          N   3    $13.45   6/1/1994 12/31/2299
15879   F   SUCTION ASSISTED LIPECTOMY                                          N   3   $351.00   3/1/2004 12/31/2299




                                                                                                                    19
15920   2   EXC COCCYGEAL PRESSURE ULCER W/COCCYGECTOMY                         N   3   $175.00   1/1/1984   12/31/2299
15920   7   EXC COCCYGEAL PRESSURE ULCER W/COCCYGECTOMY                         N   3    $13.45   6/1/1994   12/31/2299
15920   F   EXC COCCYGEAL PRESSURE ULCER W/COCCYGECTOMY                         N   3   $351.00   3/1/2004   12/31/2299
15922   2   EXC COCCYGEAL ULCER W/COCCYGECTOMY SKIN FLAP CL                     N   3   $250.00   1/1/1984   12/31/2299
15922   7   EXC COCCYGEAL ULCER W/COCCYGECTOMY SKIN FLAP CL                     N   3    $13.45   6/1/1994   12/31/2299
15922   F   EXC COCCYGEAL ULCER W/COCCYGECTOMY SKIN FLAP CL                     N   3   $432.00   3/1/2004   12/31/2299
15931   2   REMOV PRESUR ULCER                                                  N   3   $369.12   1/1/2004   12/31/2299
15931   7   EXCISION, SACRAL PRESSURE ULCER, WITH PRIMARY SUTU                  N   3    $13.45   6/1/1994   12/31/2299
15931   F   REMOV PRESUR ULCER                                                  N   3   $351.00   3/1/2004   12/31/2299
15932   7   EXCISION, SACRAL DECUBITUS ULCER; WITH OSTECTOMY                    N   3    $13.45   6/1/1994   12/31/2299
15933   2   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3   $175.00   1/1/1984   12/31/2299
15933   7   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3    $13.45   6/1/1994   12/31/2299
15933   F   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3   $351.00   3/1/2004   12/31/2299
15934   2   EXCISION, SACRAL PRESSURE ULCER, WITH LOCAL OR REG                  N   3   $480.00   1/2/1994   12/31/2299
15934   7   EXCISION, SACRAL PRESSURE ULCER, WITH LOCAL OR REG                  N   3    $13.45   6/1/1994   12/31/2299
15934   8   EXCISION, SACRAL PRESSURE ULCER, WITH LOCAL OR REG                  N   3    $96.00   1/2/1994   12/31/2299
15934   F   EXCISION, SACRAL PRESSURE ULCER, WITH LOCAL OR REG                  N   3   $351.00   3/1/2004   12/31/2299
15935   2   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3   $250.00   1/1/1984   12/31/2299
15935   7   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3    $13.45   6/1/1994   12/31/2299
15935   F   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3   $432.00   3/1/2004   12/31/2299
15936   2   EXCISION, SACRAL PRESSURE ULCER,IN PREPARATION FOR MUSCLE OR MYOC   N   3   $175.00   1/1/1984   12/31/2299
15936   7   EXCISION, SACRAL PRESSURE ULCER, WITH OTHER FLAP C                  N   3    $13.45   6/1/1994   12/31/2299
15936   F   EXCISION, SACRAL PRESSURE ULCER,IN PREPARATION FOR MUSCLE OR MYOC   N   3   $432.00   3/1/2004   12/31/2299
15937   2   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3   $250.00   1/1/1984   12/31/2299
15937   7   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3    $13.45   6/1/1994   12/31/2299
15937   F   EXC SACRAL PRESSURE ULCER WITH OSTECTOMY                            N   3   $432.00   3/1/2004   12/31/2299
15940   2   EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUT                  N   3    $75.00   1/1/1984   12/31/2299
15940   7   EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUT                  N   3    $13.45   6/1/1994   12/31/2299
15940   8   EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUT                  N   3    $76.83   1/1/2005   12/31/2299
15940   F   EXCISION, ISCHIAL PRESSURE ULCER, WITH PRIMARY SUT                  N   3   $351.00   3/1/2004   12/31/2299
15941   2   EXCISION, ISCHIAL DECUBITUS ULCER; WITH OSTECTOMY                   N   3   $150.00   1/1/1984   12/31/2299
15941   7   EXCISION, ISCHIAL DECUBITUS ULCER; WITH OSTECTOMY                   N   3    $13.45   6/1/1994   12/31/2299
15941   F   EXCISION, ISCHIAL DECUBITUS ULCER; WITH OSTECTOMY                   N   3   $351.00   3/1/2004   12/31/2299
15942   7   EXCISION, ISCHIAL DECUBITUS ULCER; SKIN AND MUSCLE                  N   3    $13.45   6/1/1994   12/31/2299
15943   7   EXCISION, ISCHIAL DECUBITUS ULCER; SKIN AND MUSCLE                  N   3    $13.45   6/1/1994   12/31/2299
15944   2   EXCISION, ISCHIAL PRESSURE ULCER, WITH LOCAL OR RE                  N   3   $150.00   1/1/1984   12/31/2299
15944   7   EXCISION, ISCHIAL PRESSURE ULCER, WITH LOCAL OR RE                  N   3    $13.45   6/1/1994   12/31/2299
15944   F   EXCISION, ISCHIAL PRESSURE ULCER, WITH LOCAL OR RE                  N   3   $351.00   3/1/2004   12/31/2299
15945   2   EXCISION, ISCHIAL PRESSURE ULCER, WITH LOCAL OR RE                  N   3   $225.00   1/1/1984   12/31/2299
15945   7   EXCISION, ISCHIAL PRESSURE ULCER, WITH LOCAL OR RE                  N   3    $13.45   6/1/1994   12/31/2299
15945   F   EXCISION, ISCHIAL PRESSURE ULCER, WITH LOCAL OR RE                  N   3   $432.00   3/1/2004   12/31/2299
15946   2   EXCIS.ISCHIAL PRESSURE ULCER WITH OSTECTOMY IN PREPARATION FOR MU   N   3   $325.00   1/1/1984   12/31/2299
15946   7   EXCIS, ISCHIAL PRESSURE ULCER,W/OSTECTOMY,W/MUSCLE                  N   3    $13.45   6/1/1994   12/31/2299
15946   8   EXCIS, ISCHIAL PRESSURE ULCER,W/OSTECTOMY,W/MUSCLE                  N   3    $65.00   1/1/1984   12/31/2299
15946   F   EXCIS.ISCHIAL PRESSURE ULCER WITH OSTECTOMY IN PREPARATION FOR MU   N   3   $432.00   3/1/2004   12/31/2299
15950   2   EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMAR                  N   3    $75.00   1/1/1984   12/31/2299
15950   7   EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMAR                  N   3    $13.45   6/1/1994   12/31/2299
15950   F   EXCISION, TROCHANTERIC PRESSURE ULCER, WITH PRIMAR                  N   3   $351.00   3/1/2004   12/31/2299
15951   2   EXC TROCHANTERIC PRESSURE ULCER W/OSTECTOMY                         N   3   $150.00   1/1/1984   12/31/2299
15951   7   EXC TROCHANTERIC PRESSURE ULCER W/OSTECTOMY                         N   3    $13.45   6/1/1994   12/31/2299
15951   F   EXC TROCHANTERIC PRESSURE ULCER W/OSTECTOMY                         N   3   $432.00   3/1/2004   12/31/2299




                                                                                                                      20
15952   2   EXC TROCHANTERIC PRESSURE ULCER W/SKIN FLAP CLOSE                   N   3   $432.00   1/2/1994   12/31/2299
15952   7   EXC TROCHANTERIC PRESSURE ULCER W/SKIN FLAP CLOSE                   N   3    $13.45   6/1/1994   12/31/2299
15952   F   EXC TROCHANTERIC PRESSURE ULCER W/SKIN FLAP CLOSE                   N   3   $351.00   3/1/2004   12/31/2299
15953   2   EXCISION, TROCHANTERIC PRESSURE ULCER, W/ LOCAL RO                  N   3   $225.00   1/1/1984   12/31/2299
15953   7   EXCISION, TROCHANTERIC PRESSURE ULCER, W/ LOCAL RO                  N   3    $13.45   6/1/1994   12/31/2299
15953   F   EXCISION, TROCHANTERIC PRESSURE ULCER, W/ LOCAL RO                  N   3   $432.00   3/1/2004   12/31/2299
15956   2   EXCIS, TROCHANTERIC PRESSURE ULCER, W/MUSCLE OR MYOCUTANEOUS FLAP   N   3   $300.00   1/1/1984   12/31/2299
15956   7   EXCIS, TROCHANTERIC PRESSURE ULCER, W/MUSCLE OR MY                  N   3    $13.45   6/1/1994   12/31/2299
15956   F   EXCIS, TROCHANTERIC PRESSURE ULCER, W/MUSCLE OR MYOCUTANEOUS FLAP   N   3   $351.00   3/1/2004   12/31/2299
15958   2   EXC TROCHANERIC PRESSURE ULCER W/OSTECTOMY                          N   3   $350.00   1/1/1984   12/31/2299
15958   7   EXC TROCHANERIC PRESSURE ULCER W/OSTECTOMY                          N   3    $13.45   6/1/1994   12/31/2299
15958   8   EXC TROCHANERIC PRESSURE ULCER W/OSTECTOMY                          N   3    $70.00   1/1/1984   12/31/2299
15958   F   EXC TROCHANERIC PRESSURE ULCER W/OSTECTOMY                          N   3   $432.00   3/1/2004   12/31/2299
15999   7   EXC PRESSURE ULCER NOC                                              N   3    $13.45   6/1/1994   12/31/2299
16000   2   INITIAL TREATMENT FIRST DEGREE BURN LOCAL                           N   3    $10.00   8/1/1979   12/31/2299
16020   2   DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUEN                  N   3    $21.00   1/2/1996   12/31/2299
16025   2   DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUEN                  N   3    $40.00   1/1/1984   12/31/2299
16030   2   DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUEN                  N   3    $50.00   1/1/1984   12/31/2299
16035   2   ESCHAROTOMY                                                         N   3   $121.66   1/1/2003   12/31/2299
16035   7   ESCHAROTOMY;INITIAL INCISION                                        N   3    $13.45   6/1/1994   12/31/2299
16036   2   ESCHAROTOMY;EACH ADD.INCISION                                       N   3    $52.94   1/1/2001   12/31/2299
17000   2   DESTRUCTION BY ANY METHOD,INCLUDING LASER,BENIGN OR PREMALIG.LESI   N   3    $21.42   3/1/2004   12/31/2299
17003   2   DESTR.ANY METH.BENIGN/PREMALIGNANT LESIONS/W/LOCAL ANES.2-14LESIO   N   3     $6.16   1/1/1998   12/31/2299
17003   7   DESTR.BENIGN/PREMALIGNANT LESIONS W/LOCAL ANESTHESIA 2-14 LESIONS   N   3    $13.45   1/1/1998   12/31/2299
17004   2   DESTRUCTION BY ANY METHOD, INCLUDING LASER, WITH OR WITHOUT SURGI   N   3   $111.10   1/1/1998   12/31/2299
17004   7   DESTR.BENIGN/PREMALIGNANT LESIONS INCLU.LOCAL ANESTHESIA;15ORMORE   N   3    $13.45   1/1/1998   12/31/2299
17106   2   DESTRUT CUTANEOUS VASCULAR PROLIF LESIONS;< 10SQCM                  N   3   $150.00   1/1/1996   12/31/2299
17107   2   DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS/LASER TEC   N   3   $300.00   1/1/1996   12/31/2299
17107   7   DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LE                  N   3    $13.45   6/1/1994   12/31/2299
17108   2   DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS/LASER       N   3   $570.00   1/1/1996   12/31/2299
17108   7   DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE LE                  N   3    $13.45   6/1/1994   12/31/2299
17110   2   DESTROY ANY METHOD UP TO 15 WARTS MILIA ECT                         N   3    $13.45   3/1/2004   12/31/2299
17110   7   DEST ANY METHD FLT WARTS OR MOLLUS CONT UP TO 15                    N   3    $13.45   6/1/1994   12/31/2299
17111   2   DESTR,ANY METHOD,FLAT WARTS,MOLLUSCUM,CONTAGIOSUM,MILA 15 OR MORE   N   3    $33.07   1/1/1998   12/31/2299
17111   7   DESTRUC.ANY METHOD FLAT WARTS,MOLLUSCUM,CONTAGIOSUM,MILIA;15ORMOR   N   3    $13.45   1/1/1998   12/31/2299
17250   2   CHEMICAL CAUTERIZATION OF A WOUND                                   N   3    $18.00   1/1/1996   12/31/2299
17250   7   CHEMICAL CAUTERIZATION OF A WOUND                                   N   3    $13.45   6/1/1994   12/31/2299
17260   2   DESTRUCTION, MALIGNANT LESIONS                                      N   3    $39.90   1/1/2003   12/31/2299
17260   7   DESTRUCTION, MALIGNANT LESIONS                                      N   3    $13.45   6/1/1994   12/31/2299
17261   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $45.00   1/2/1992   12/31/2299
17261   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $13.45   6/1/1994   12/31/2299
17262   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $67.79   1/1/2004   12/31/2299
17262   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $13.45   6/1/1994   12/31/2299
17263   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $97.19   1/2/1994   12/31/2299
17263   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $13.45   6/1/1994   12/31/2299
17264   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $13.45   6/1/1994   12/31/2299
17266   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK,                   N   3    $13.45   6/1/1994   12/31/2299
17270   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                   N   3    $64.46   1/1/2002   12/31/2299
17270   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                   N   3    $13.45   6/1/1994   12/31/2299
17271   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                   N   3    $60.00   1/2/1995   12/31/2299
17271   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      21
17271   8   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                 N   3    $12.00   1/2/1995   12/31/2299
17272   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                 N   3    $74.99   1/1/2002   12/31/2299
17272   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                 N   3    $13.45   6/1/1994   12/31/2299
17273   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                 N   3    $13.45   6/1/1994   12/31/2299
17274   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                 N   3    $13.45   6/1/1994   12/31/2299
17276   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP,                 N   3    $13.45   6/1/1994   12/31/2299
17280   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $57.60   1/1/2002   12/31/2299
17280   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $13.45   6/1/1994   12/31/2299
17281   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $72.00   1/2/1994   12/31/2299
17281   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $13.45   6/1/1994   12/31/2299
17282   2   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3   $170.00   1/2/1995   12/31/2299
17282   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $13.45   6/1/1994   12/31/2299
17282   8   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $34.00   1/2/1995   12/31/2299
17283   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $13.45   6/1/1994   12/31/2299
17284   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $13.45   6/1/1994   12/31/2299
17286   7   DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, E                N   3    $13.45   6/1/1994   12/31/2299
17300   2   CHEMOSURGERY INCLUD REMOVE LESION & MICROSC DELINE                N   3   $125.00   1/1/1973   12/31/2299
17300   7   CHEMOSURGERY INCLUD REMOVE LESION & MICROSC DELINE                N   3    $13.45   6/1/1994   12/31/2299
17301   2   CHEMOSURGERY INCLUD REMOVE LESION & MICROSC DELINE                N   3    $40.00   1/1/1973   12/31/2299
17301   7   CHEMOSURGERY INCLUD REMOVE LESION & MICROSC DELINE                N   3    $13.45   6/1/1994   12/31/2299
17302   7   CHEMOSURGERY (MOHS TYPE TECHNIQUE), MALIGNANCIES O                N   3    $13.45   6/1/1994   12/31/2299
17311   2   MOHS, 1 STAGE, H/N/HF/G                                           N   3   $193.20   1/1/2007   12/31/2299
17311   7   MOHS, 1 STAGE, H/N/HF/G                                           N   3    $13.45   1/1/2007   12/31/2299
17312   2   MOHS ADDL STAGE                                                   N   3   $102.83   1/1/2007   12/31/2299
17312   7   MOHS ADDL STAGE                                                   N   3    $13.45   1/1/2007   12/31/2299
17313   2   MOHS, 1 STAGE, 1/A/L                                              N   3   $173.18   1/1/2007   12/31/2299
17313   7   MOHS, 1 STAGE, 1/A/L                                              N   3    $13.45   1/1/2007   12/31/2299
17314   2   MOHS, ADDL STAGE, T/A/L                                           N   3    $95.08   1/1/2007   12/31/2299
17314   7   MOHS, ADDL STAGE, T/A/L                                           N   3    $13.45   1/1/2007   12/31/2299
17315   2   MOHS SURG, ADDL BLOCK                                             N   3    $26.90   1/1/2007   12/31/2299
17315   7   MOHS SURG, ADDL BLOCK                                             N   3    $13.45   1/1/2007   12/31/2299
17340   2   CRYOTHERAPY (CO2 SLUSH, LIQUID N2)                                N   3    $12.00   1/2/1992   12/31/2299
17360   2   CHEMICAL EXFOLIATION FOR ACNE                                     N   3     $8.00   1/1/1984   12/31/2299
17999   7   UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBC                N   3    $13.45   6/1/1994   12/31/2299
19000   2   PUNCTURE ASPIRATION OF CYSTS OF BREST-1ST CYST                    N   3    $10.50   1/1/1971   12/31/2299
19001   2   PUNCTURE ASPIRATION OF CYST OF BREAST;EACH ADDITIONAL CYST        N   3     $5.00   1/1/1984   12/31/2299
19001   7   PUNCTURE ASPIRATION BREST CYST-EA ADD CYST                        N   3    $13.45   6/1/1994   12/31/2299
19020   2   MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS,                N   3    $30.00   8/1/1979   12/31/2299
19020   7   MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS,                N   3    $13.45   6/1/1994   12/31/2299
19020   F   MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS,                N   3   $306.00   3/1/2004   12/31/2299
19030   2   INJECTION PROCEDURE ONLY FOR MAMMARY DUCTOGRAM OR                 N   3    $15.00   1/1/1984   12/31/2299
19100   2   BIOPSY OF BREAST; NEEDLE                                          N   3    $42.00   1/2/1995   12/31/2299
19100   7   ANESTHESIA FOR BIOPSY OF BREAST PERCUTANEOUS,NEEDLE CORE          N   3    $13.45   1/2/1995   12/31/2299
19100   F   BIOPSY OF BREAST; NEEDLE                                          N   3   $225.80   3/1/2004   12/31/2299
19101   2   BIOPSY OF BREAST; INCISIONAL                                      N   3    $75.00   1/1/1971   12/31/2299
19101   7   BIOPSY OF BREAST; OPEN INCISIONAL                                 N   3    $13.45   6/1/1994   12/31/2299
19101   F   BIOPSY OF BREAST; INCISIONAL                                      N   3   $306.00   3/1/2004   12/31/2299
19102   2   BIOPSY OF BREAST;PERCUT.NEEDLE CORE,USING IMAGING GUIDANCE        N   3   $155.20   1/1/2001   12/31/2299
19102   F   BIOPSY OF BREAST;PERCUT.NEEDLE CORE,USING IMAGING GUIDANCE        N   3   $306.00   3/1/2004   12/31/2299
19103   2   BIOPSY OF BREAST;PERCUT.AUTOM.VAC.ASSISTED OR ROTAT.BIOPSY DEVI   N   3   $311.94   1/1/2001   12/31/2299
19103   F   BIOPSY OF BREAST;PERCUT.AUTOM.VAC.ASSISTED OR ROTAT.BIOPSY DEVI   N   3   $306.00   3/1/2004   12/31/2299




                                                                                                                    22
19105   2   CRYOSURG ABLATE FA, EACH                                            N   3    $98.54   1/1/2007   12/31/2299
19105   7   CRYOSURG ABLATE FA, EACH                                            N   3    $13.45   1/1/2007   12/31/2299
19110   2   NIPPLE EXPLORATION,W OR W/OUT EXCISION                              N   3    $75.00   1/1/1984   12/31/2299
19110   7   NIPPLE EXPLORATION,W OR W/O EXCISION                                N   3    $13.45   6/1/1994   12/31/2299
19110   F   NIPPLE EXPLORATION,W OR W/OUT EXCISION                              N   3   $306.00   3/1/2004   12/31/2299
19112   2   EXCISION OF LACTIFEROUS DUCT FISTULA                                N   3   $120.00   1/2/1992   12/31/2299
19112   7   EXCISION OF LACTIFEROUS DUCT FISTULA                                N   3    $13.45   6/1/1994   12/31/2299
19112   F   EXCISION OF LACTIFEROUS DUCT FISTULA                                N   3   $351.00   3/1/2004   12/31/2299
19120   2   EXCISION OF CYST, FIBROADENOMA OR OTHER BENIGN OR MALIGNANT TUMOR   N   3   $100.00   1/1/1971   12/31/2299
19120   7   EXCISION OF CYST, FIBROADENOMA OR OTHER BENIGN OR MALIGNANT TUMOR   N   3    $13.45   6/1/1994   12/31/2299
19120   F   EXCISION OF CYST, FIBROADENOMA OR OTHER BENIGN OR MALIGNANT TUMOR   N   3   $351.00   3/1/2004   12/31/2299
19125   2   EXCISION OF BREAST LESION IDENTIFIED BY PRE-OPERATATIVE PLACEMENT   N   3   $190.37   1/1/1994   12/31/2299
19125   7   EXCISION OF BREAST LESION INDENTIFIED BY PRE-OPERATIVE PLACEMENT    N   3    $13.45   7/1/1994   12/31/2299
19125   F   EXCISION OF BREAST LESION IDENTIFIED BY PRE-OPERATATIVE PLACEMENT   N   3   $351.00   3/1/2004   12/31/2299
19126   2   EXCISION OF BREAST LESION IDENTIFIED BY PRE-OPERATIVE PLACEMENT O   N   3    $95.36   1/1/1994   12/31/2299
19126   7   EXCISION OF BREAST LESION IDENTIFIED BY PRE-OPERAT                  N   3    $13.45   7/1/1994   12/31/2299
19126   F   EXCISION OF BREAST LESION IDENTIFIED BY PRE-OPERATIVE PLACEMENT O   N   3   $351.00   3/1/2004   12/31/2299
19141   7   MASTECTOMY FOR GYNECOMASTIA THROUGH CIRCUMAREOLAR                   N   3    $13.45   6/1/1994   12/31/2299
19260   2   EXCISION OF CHEST WALL TUMOR INCLUDING RIBS                         N   3   $300.00   1/1/1984   12/31/2299
19260   7   EXCISION OF CHEST WALL TUMOR INCLUDING RIBS                         N   3    $13.45   6/1/1994   12/31/2299
19271   2   EXC CHEST WALL TUMOR W/PLASTIC RECONSTRUCT                          N   3   $350.00   1/1/1984   12/31/2299
19271   7   EXC CHEST WALL TUMOR W/PLASTIC RECONSTRUCT                          N   3    $13.45   6/1/1994   12/31/2299
19271   8   EXC CHEST WALL TUMOR W/PLASTIC RECONSTRUCT                          N   3    $70.00   1/1/1984   12/31/2299
19272   2   EXC CHEST WALL TUMOR W/MEDIAL LYMPH AND RECONST                     N   3   $400.00   1/1/1984   12/31/2299
19272   7   EXC CHEST WALL TUMOR W/MEDIAL LYMPH AND RECONST                     N   3    $13.45   6/1/1994   12/31/2299
19290   2   PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE                  N   3    $32.64   1/1/1993   12/31/2299
19290   7   INTRODUCTION                                                        N   3    $13.45   6/1/1994   12/31/2299
19290   F   PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE                  N   3   $225.80   3/1/2004   12/31/2299
19291   2   PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE BREAST;EACH      N   3    $18.08   1/1/1993   12/31/2299
19291   7   PREOP PLACEMENT OF NEEDLE LOCALIZATION WIRE,BREAST                  N   3    $13.45   6/1/1994   12/31/2299
19291   F   PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE BREAST;EACH      N   3   $225.80   3/1/2004   12/31/2299
19295   2   IMAGE GUIDED PLACEMENT,METAL.CLIP,PERCUTDURING BREAST BIOPSY        N   3    $62.04   1/1/2001   12/31/2299
19296   6   PLACEMENT OF RADIOTHERAPY AFTERLOADING BALLOON CATHETER INTO THE    N   3   $126.05   1/1/2005   12/31/2299
19297   6   PLACEMENT OF RADIOTHERAPY AFTERLOADING BALLOON CATH                 N   3    $57.73   1/1/2005   12/31/2299
19298   6   PLACEMENT OF RADIOTHERAPY AFTERLOADING BRACHYTHERAPY                N   3   $202.03   1/1/2005   12/31/2299
19300   2   REMOVAL OF BREAST MATERIAL                                          Y   3   $190.70   1/1/2007   12/31/2299
19300   7   REMOVAL OF BREAST MATERIAL                                          Y   3    $13.45   1/1/2007   12/31/2299
19301   2   PARTICAL MASTECTOMY                                                 N   3   $207.70   1/1/2007   12/31/2299
19301   7   PARTICAL MASTECTOMY                                                 N   3    $13.45   1/1/2007   12/31/2299
19301   8   PARTICAL MASTECTOMY                                                 N   3    $41.00   1/1/2007   12/31/2299
19302   2   P-MASTECTOMY W/IN REMOVAL                                           N   3   $440.11   1/1/2007   12/31/2299
19302   7   P-MASTECTOMY W/IN REMOVAL                                           N   3    $13.45   1/1/2007   12/31/2299
19302   8   P-MASTECTOMY W/IN REMOVAL                                           N   3    $88.00   1/1/2007   12/31/2299
19303   2   MAST, SIMPLE, COMPLETE                                              N   3   $444.69   1/1/2007   12/31/2299
19303   7   MAST, SIMPLE, COMPLETE                                              N   3    $13.45   1/1/2007   12/31/2299
19303   8   MAST, SIMPLE, COMPLETE                                              N   3    $88.00   1/1/2007   12/31/2299
19304   2   MAST. SUBQ                                                          N   3   $276.14   1/1/2007   12/31/2299
19304   7   MAST. SUBQ                                                          N   3    $13.45   1/1/2007   12/31/2299
19304   8   MAST. SUBQ                                                          N   3    $55.00   1/1/2007   12/31/2299
19305   2   MAST. RADICAL                                                       N   3   $544.88   1/1/2007   12/31/2299
19305   7   MAST. RADICAL                                                       N   3    $13.45   1/1/2007   12/31/2299




                                                                                                                      23
19305   8   MAST. RADICAL                                          N   3    $108.00    1/1/2007   12/31/2299
19306   2   MAST. RAD. URBAN TYPE                                  N   3    $566.65    1/1/2007   12/31/2299
19306   7   MAST. RAD. URBAN TYPE                                  N   3      $13.45   1/1/2007   12/31/2299
19306   8   MAST. RAD. URBAN TYPE                                  N   3    $113.00    1/1/2007   12/31/2299
19307   2   MAST. MOD RAD                                          N   3    $569.78    1/1/2007   12/31/2299
19307   7   MAST. MOD RAD                                          N   3      $13.45   1/1/2007   12/31/2299
19307   8   MAST. MOD RAD                                          N   3    $113.00    1/1/2007   12/31/2299
19316   2   MASTOPEXY                                              N   3    $540.00    1/2/1998   12/31/2299
19316   F   MASTOPEXY                                              N   3    $432.00    3/1/2004   12/31/2299
19318   2   REDUCTION MAMMAPLASTY                                  Y   3    $708.00    1/2/1998   12/31/2299
19318   7   REDUCTION MAMMAPLASTY                                  N   3      $13.45   6/1/1994   12/31/2299
19318   8   REDUCTION MAMMAPLASTY                                  Y   3    $142.00    1/2/1998   12/31/2299
19318   F   REDUCTION MAMMAPLASTY                                  N   3    $432.00    3/1/2004   12/31/2299
19325   F   MAMMAPLASTY, AUGMENTATION; WITH PROSTHETIC IMPLANT     N   3    $495.00    3/1/2004   12/31/2299
19328   2   REMOVAL OF INTACT MAMMARY IMPLANT                      Y   3    $258.65    1/1/2004   12/31/2299
19328   7   REMOVAL OF INTACT MAMMARY IMPLANT                      Y   3      $13.45   6/1/1994   12/31/2299
19328   F   REMOVAL OF INTACT MAMMARY IMPLANT                      N   3    $225.80    3/1/2004   12/31/2299
19330   2   REMOVAL OF BREAST IMPLANT MATERIAL                     N   3    $273.00    1/2/1995   12/31/2299
19330   7   REMOVAL OF BREAST IMPLANT MATERIAL                     N   3      $13.45   6/1/1994   12/31/2299
19330   8   REMOVAL OF BREAST IMPLANT MATERIAL                     N   3      $55.00   1/2/1995   12/31/2299
19330   F   REMOVAL OF BREAST IMPLANT MATERIAL                     N   3    $225.80    3/1/2004   12/31/2299
19331   7   REMOVAL OF MAMMARY IMPLANT MATERIAL; BILATERAL         N   3      $13.45   6/1/1994   12/31/2299
19340   2   MASTOPEXY/MASTECTOMY ORRECONSTRUCT W/IMPLANT           Y   3    $229.79    1/1/2004   12/31/2299
19340   7   MASTOPEXY/MASTECTOMY OR RECONSTRUCT W/IMPLANT          Y   3      $13.45   6/1/1994   12/31/2299
19340   F   MASTOPEXY/MASTECTOMY ORRECONSTRUCT W/IMPLANT           N   3    $306.00    3/1/2004   12/31/2299
19342   2   DELAYED INSERT OF IMPLANT POST MASTOPEXY ECT           Y   3    $510.00    1/2/1998   12/31/2299
19342   7   DELAYED INSERT OF IMPLANT POST MASTOPEXY ECT           Y   3      $13.45   6/1/1994   12/31/2299
19342   F   DELAYED INSERT OF IMPLANT POST MASTOPEXY ECT           N   3    $351.00    3/1/2004   12/31/2299
19350   2   NIPPLE/AREOLA RECONSTRUCTION                           Y   3    $468.22    1/1/2004   12/31/2299
19350   7   NIPPLE/AREOLA RECONSTRUCTION                           Y   3      $13.45   6/1/1994   12/31/2299
19350   F   NIPPLE/AREOLA RECONSTRUCTION                           N   3    $432.00    3/1/2004   12/31/2299
19355   7   CORRECTION OF INVERTED NIPPLES                         N   3      $13.45   6/1/1994   12/31/2299
19355   F   CORRECTION OF INVERTED NIPPLES                         N   3    $432.00    3/1/2004   12/31/2299
19357   2   BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH      N   3    $720.00    1/2/1994   12/31/2299
19357   7   BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH      N   3      $13.45   6/1/1994   12/31/2299
19357   F   BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH      N   3    $495.00    3/1/2004   12/31/2299
19361   2   BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP,      Y   3    $966.00    1/2/1994   12/31/2299
19361   7   BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP,      N   3      $13.45   6/1/1994   12/31/2299
19361   8   BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP,      Y   3    $193.00    1/2/1994   12/31/2299
19364   2   BREAST RECONSTRUCTION WITH FREE FLAP                   Y   3   $1,038.00   1/2/1998   12/31/2299
19364   7   BREAST RECONSTRUCTION WITH FREE FLAP                   Y   3      $13.45   6/1/1994   12/31/2299
19364   8   BREAST RECONSTRUCTION WITH FREE FLAP                   Y   3    $208.00    1/2/1998   12/31/2299
19366   2   BREAST RECONSTRUCTION WITH OTHER TECHNIQUE             Y   3    $912.00    1/2/1994   12/31/2299
19366   7   BREAST RECONSTRUCTION WITH OTHER TECHNIQUE             Y   3      $13.45   6/1/1994   12/31/2299
19366   8   BREAST RECONSTRUCTION WITH OTHER TECHNIQUE             Y   3    $182.00    1/2/1994   12/31/2299
19366   F   BREAST RECONSTRUCTION WITH OTHER TECHNIQUE             N   3    $495.00    3/1/2004   12/31/2299
19367   2   BREAST RECONSTRUCTION WITH TRAM; SINGLE PEDICLE        Y   3   $1,127.00   1/1/1995   12/31/2299
19368   2   BREAST RECONSTRUCTION WITH MICROVASCULAR ANASTOMOSIS   Y   3   $1,275.00   1/1/1995   12/31/2299
19369   2   BREAST RECONSTRUCTION WITH TRAM - DOUBLE PEDICLE       Y   3   $1,218.00   1/1/1995   12/31/2299
19371   2   PERIPROSTHETIC CAPSULOTOMY, BREAST                     N   3    $422.00    1/2/1995   12/31/2299
19371   8   PERIPROSTHETIC CAPSULOTOMY, BREAST                     N   3      $84.00   1/2/1995   12/31/2299




                                                                                                           24
19371   F   PERIPROSTHETIC CAPSULOTOMY, BREAST                                  N   3   $432.00   3/1/2004   12/31/2299
19380   2   REVISION OF RECONSTRUCTED BREAST                                    Y   3   $450.00   1/2/1996   12/31/2299
19380   7   REVISION OF RECONSTRUCTED BREAST                                    Y   3    $13.45   1/2/1995   12/31/2299
19380   8   REVISION OF RECONSTRUCTED BREAST                                    Y   3    $90.00   1/2/1996   12/31/2299
19380   F   REVISION OF RECONSTRUCTED BREAST                                    N   3   $495.00   3/1/2004   12/31/2299
19499   7   UNLISTED PROCEDURE, BREAST                                          N   3    $13.45   6/1/1994   12/31/2299
20000   2   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTEOMYELITIS;SUPER   N   3    $10.00   1/1/1971   12/31/2299
20000   7   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTE                  N   3    $13.45   6/1/1994   12/31/2299
20005   2   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTE                  N   3    $50.00   1/1/1984   12/31/2299
20005   7   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTE                  N   3    $13.45   6/1/1994   12/31/2299
20005   F   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTE                  N   3   $306.00   3/1/2004   12/31/2299
20010   2   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTE                  N   3    $50.00   1/1/1984   12/31/2299
20010   7   INCISION OF SOFT TISSUE ABSCESS, SECONDARY TO OSTE                  N   3    $13.45   6/1/1994   12/31/2299
20100   8   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE) NECK          N   3    $76.31   1/1/1996   12/31/2299
20101   2   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE) CHEST         N   3   $120.59   1/1/1996   12/31/2299
20101   8   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE) CHEST         N   3    $24.12   1/1/1996   12/31/2299
20102   2   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE)ABD/FLNK/BCK   N   3   $147.69   1/1/1996   12/31/2299
20102   7   ANESTHESIA,EXPLORATION OF PENETRATING WOUND(SEPARATE PROC)ABD/FLN   N   3    $13.45   1/1/1998   12/31/2299
20102   8   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE)ABD/FLNK/BCK   N   3    $29.54   1/1/1996   12/31/2299
20103   2   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE)EXTREMITY      N   3   $198.73   1/1/1996   12/31/2299
20103   8   EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE)EXTREMITY      N   3    $39.75   1/1/1996   12/31/2299
20150   2   EXCISISION EPIPHYSEAL BAR W/OR W/O AUTOGENEOUS SOFT TISSUE GRAFT    N   3   $650.26   1/1/1997   12/31/2299
20150   7   EXCISE EPIPHYSEAL BAR W/ OR W/O AUTOGENOUS SOFT TISSUE              N   3    $13.45   1/1/1997   12/31/2299
20150   8   EXCISE EPIPHYSEAR BAR, W/ OR W/O AUTOGENOUS SOFT TISSUE GRAFT       N   3   $130.06   1/1/1997   12/31/2299
20200   2   BIOPSY, MUSCLE; SUPERFICIAL                                         N   3    $40.00   1/1/1979   12/31/2299
20200   7   BIOPSY, MUSCLE; SUPERFICIAL                                         N   3    $13.45   6/1/1994   12/31/2299
20200   F   BIOPSY, MUSCLE; SUPERFICIAL                                         N   3   $306.00   3/1/2004   12/31/2299
20205   2   BIOPSY, MUSCLE; DEEP                                                N   3    $75.00   1/1/1984   12/31/2299
20205   7   BIOPSY, MUSCLE; DEEP                                                N   3    $13.45   6/1/1994   12/31/2299
20205   F   BIOPSY, MUSCLE; DEEP                                                N   3   $351.00   3/1/2004   12/31/2299
20206   2   BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE                                 N   3    $25.00   1/1/1984   12/31/2299
20206   7   BIOPSY, MUSCLE                                                      N   3    $13.45   6/1/1994   12/31/2299
20206   F   BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE                                 N   3   $225.80   3/1/2004   12/31/2299
20220   2   BIOPSY, BONE, TROCAR OR NEEDLE; SUPERFICIAL                         N   3    $30.00   1/1/1973   12/31/2299
20220   7   BIOPSY, BONE, TROCAR OR NEEDLE; SUPERFICIAL                         N   3    $13.45   6/1/1994   12/31/2299
20220   F   BIOPSY, BONE, TROCAR OR NEEDLE; SUPERFICIAL                         N   3   $225.80   3/1/2004   12/31/2299
20225   2   BIOPSY, BONE, TROCAR OR NEEDLE; DEEP                                N   3   $100.00   1/1/1973   12/31/2299
20225   7   BIOPSY, BONE, TROCAR OR NEEDLE; DEEP                                N   3    $13.45   6/1/1994   12/31/2299
20225   F   BIOPSY, BONE, TROCAR OR NEEDLE; DEEP                                N   3   $306.00   3/1/2004   12/31/2299
20240   2   BIOPSY, BONE EXCISIONAL;SUPERFICIAL                                 N   3    $75.00   1/1/1971   12/31/2299
20240   7   BIOPSY, EXCISIONAL; SUPERFICIAL                                     N   3    $13.45   6/1/1994   12/31/2299
20240   F   BIOPSY, BONE EXCISIONAL;SUPERFICIAL                                 N   3   $306.00   3/1/2004   12/31/2299
20245   2   BIOPSY, EXCISIONAL; DEEP                                            N   3   $125.00   1/1/1973   12/31/2299
20245   7   BIOPSY, EXCISIONAL; DEEP                                            N   3    $13.45   6/1/1994   12/31/2299
20245   F   BIOPSY, EXCISIONAL; DEEP                                            N   3   $351.00   3/1/2004   12/31/2299
20250   2   BIOPSY, VERTEBRAL BODY, OPEN; THORACIC                              N   3   $125.00   1/1/1984   12/31/2299
20250   7   BIOPSY, VERTEBRAL BODY, OPEN; THORACIC                              N   3    $13.45   6/1/1994   12/31/2299
20250   F   BIOPSY, VERTEBRAL BODY, OPEN; THORACIC                              N   3   $351.00   3/1/2004   12/31/2299
20251   2   BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL                    N   3   $150.00   1/1/1984   12/31/2299
20251   7   BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL                    N   3    $13.45   6/1/1994   12/31/2299
20251   8   BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL                    N   3    $46.50   1/1/2003   12/31/2299




                                                                                                                      25
20251   F   BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL                    N   3   $351.00    3/1/2004   12/31/2299
20500   2   INJECTION OF SINUS TRACT; THERAPEUTIC                               N   3    $10.00    1/1/1973   12/31/2299
20501   2   INJECTION OF SINUS TRACT; DIAGNOSTIC                                N   3    $21.00    1/2/1994   12/31/2299
20520   2   REMOVAL OF FOREIGN BODY IN MUSCLE; SIMPLE                           N   3    $30.00    1/1/1979   12/31/2299
20520   7   REMOVAL OF FOREIGN BODY IN MUSCLE; SIMPLE                           N   3    $13.45    6/1/1994   12/31/2299
20525   2   REMOVAL OF FOREIGN BODY IN MUSCLE; DEEP OR COMPLIC                  N   3    $75.00    1/1/1984   12/31/2299
20525   7   REMOVAL OF FOREIGN BODY IN MUSCLE; DEEP OR COMPLIC                  N   3    $13.45    6/1/1994   12/31/2299
20525   F   REMOVAL OF FOREIGN BODY IN MUSCLE; DEEP OR COMPLIC                  N   3   $351.00    3/1/2004   12/31/2299
20526   1   INJECTION, THERAPEUTIC (EG, LOCAL ANESTHETIC CORTICOSTEROID CARPA   N   3    $36.94    1/1/2002   12/31/2299
20526   2   INJECTION,THERAPEUTIC(EG LOCAL ANESTH,CORTICOS,CARPEL TUNNEL        N   3    $39.05    1/1/2002   12/31/2299
20550   2   INJECTION, TENDON SHEATH, LIGAMENT, TRIGGER POINTS OR GANGION CYS   N   3    $38.51    1/1/2002   12/31/2299
20550   3   INJECTION,TENDON SHEATH, LIGAMEN, TRIGGER POINTS                    N   3    $10.00   4/30/1991   12/31/2299
20550   7   INJECTION, TENDON SHEATH, LIGAMENT, TRIGGER POINTS                  N   3    $13.45    6/1/1994   12/31/2299
20551   1   INJECTION, TENDON ORIGIN/INSERTION                                  N   3    $36.94    1/1/2002   12/31/2299
20551   2   INJECTN,THERAPETC,EG LOCAL ANESTH CORTESTEROID,SNGL TENDON          N   3    $33.33    1/1/2002   12/31/2299
20551   7   INJECTN,THERPETC(EG LOCL ANEST,CORTICOSTERIOD,SNGL TENDON           N   3    $13.45    1/1/2002   12/31/2299
20552   2   INJECTION SINGLE OR MULTIPLE TRIGGER POINT(S) ONE OR TWO MUSCLE     N   3    $36.94    1/1/2002   12/31/2299
20552   7   INJECTN, SNGL OR MULT TRIGGER PNTS, 1 OR 2 MUSCLES                  N   3    $13.45    1/1/2002   12/31/2299
20553   2   INJECTION: SINGLE OR MULTIPLE TRIGGER POINT THRE OR MORE MUSCLE     N   3    $36.94    1/1/2002   12/31/2299
20553   7   INJECTION,SINGLE OR MULTIPLE TRIGGER POINT 3 OR MORE MUSCLES        N   3    $13.45    1/1/2002   12/31/2299
20600   2   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL                  N   3    $13.00    1/2/1994   12/31/2299
20600   7   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL                  N   3    $13.45    6/1/1994   12/31/2299
20605   2   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTER                  N   3    $15.00    1/1/1979   12/31/2299
20605   7   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTER                  N   3    $13.45    6/1/1994   12/31/2299
20610   2   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR                  N   3    $22.00    1/2/1996   12/31/2299
20610   3   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION;MAJOR                   N   3    $18.00   1/31/1991   12/31/2299
20610   7   ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR                  N   3    $13.45    6/1/1994   12/31/2299
20612   2   ASPIRATION &/OR INJ GANGLION CYST(S) ANY LOCATION                   N   3    $33.83    1/1/2003   12/31/2299
20615   2   ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYS                  N   3    $30.00    1/1/1984   12/31/2299
20615   7   ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYS                  N   3    $13.45    6/1/1994   12/31/2299
20650   2   INSERTION OF WIRE OR PIN FOR SKELETAL TRACTION, IN                  N   3   $107.33    1/1/1999   12/31/2299
20650   7   INSERTION OF WIRE OR PIN FOR SKELETAL TRACTION, IN                  N   3    $13.45    6/1/1994   12/31/2299
20650   F   INSERTION OF WIRE OR PIN FOR SKELETAL TRACTION, IN                  N   3   $351.00    3/1/2004   12/31/2299
20660   2   APPLICATION OF TONGS OR CALIPER, INCLUDING REMOVAL                  N   3    $75.00    1/1/1973   12/31/2299
20660   7   APPLICATION OF TONGS OR CALIPER, INCLUDING REMOVAL                  N   3    $13.45    6/1/1994   12/31/2299
20661   2   APPLICATION OF HALO; CRANIAL                                        N   3    $50.00    1/1/1984   12/31/2299
20661   7   APPLICATION OF HALO; CRANIAL                                        N   3    $13.45    6/1/1994   12/31/2299
20662   2   APPLICATION OF HALO; PELVIC                                         N   3    $50.00    1/1/1984   12/31/2299
20662   7   APPLICATION OF HALO; PELVIC                                         N   3    $13.45    6/1/1994   12/31/2299
20663   2   APPLICATION OF HALO; FEMORAL                                        N   3    $50.00    1/1/1984   12/31/2299
20663   7   APPLICATION OF HALO; FEMORAL                                        N   3    $13.45    6/1/1994   12/31/2299
20664   2   APPLY HALO,INCL.REMOVAL,CRANIAL,6OR MORE PINS(PEDI;W/GEN.ANESTH     N   3   $261.50    1/1/1998   12/31/2299
20664   7   APPLY HALO,INC.REMOVAL,CRANIAL,6 OR MORE PINS;PEDIATRIC,W/GENANES   N   3    $13.45    1/1/1998   12/31/2299
20664   8   APPLY HALO,INC.REMOVAL,CRANIAL,6OR MORE PINS,PEDIATRIC.W/GENANEST   N   3    $52.30    1/1/1998   12/31/2299
20665   2   REMOVAL OF TONGS OR HALO APPLIED BY ANOTHER PHYSIC                  N   3    $10.00    8/1/1979   12/31/2299
20665   7   REMOVAL OF TONGS OR HALO APPLIED BY ANOTHER PHYSIC                  N   3    $13.45    6/1/1994   12/31/2299
20670   2   REMOVAL OF IMPLANT; SUPERFICIAL,(EG.BURIED WIRE, PIN OR ROD)        N   3    $54.00    1/2/1998   12/31/2299
20670   7   REMOVAL OF IMPLANT; SUPERFICIAL                                     N   3    $13.45    6/1/1994   12/31/2299
20670   F   REMOVAL OF IMPLANT; SUPERFICIAL,(EG.BURIED WIRE, PIN OR ROD)        N   3   $225.80    3/1/2004   12/31/2299
20680   2   REMOVAL OF IMPLANT; DEEP                                            N   3   $150.00    1/3/1992   12/31/2299
20680   7   REMOVAL OF IMPLANT; DEEP                                            N   3    $13.45    6/1/1994   12/31/2299




                                                                                                                       26
20680   8   REMOVAL OF IMPLANT; DEEP                             N   3    $33.00   1/2/1994   12/31/2299
20680   F   REMOVAL OF IMPLANT; DEEP                             N   3   $351.00   3/1/2004   12/31/2299
20690   2   APPLICATION OF EXTERNAL FIXATION SYSTEM (EG,HOFFMA   N   3    $65.00   1/1/1984   12/31/2299
20690   7   APPLICATION OF EXTERNAL FIXATION SYSTEM (EG,HOFFMA   N   3    $13.45   6/1/1994   12/31/2299
20690   8   APPLICATION OF EXTERNAL FIXATION SYS - HOFFMAN       N   3    $13.00   1/1/1984   12/31/2299
20690   F   APPLICATION OF EXTERNAL FIXATION SYSTEM (EG,HOFFMA   N   3   $306.00   3/1/2004   12/31/2299
20692   2   APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE   N   3   $254.10   1/2/1992   12/31/2299
20692   7   APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE   N   3    $13.45   6/1/1994   12/31/2299
20692   8   APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE   N   3    $50.00   1/1/1992   12/31/2299
20692   F   APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE   N   3   $351.00   3/1/2004   12/31/2299
20693   2   ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM   N   3   $160.00   1/1/1984   12/31/2299
20693   7   ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM   N   3    $13.45   6/1/1994   12/31/2299
20693   F   ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM   N   3   $351.00   3/1/2004   12/31/2299
20694   2   REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SY   N   3   $150.60   1/2/1992   12/31/2299
20694   7   REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SY   N   3    $13.45   6/1/1994   12/31/2299
20694   8   REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SY   N   3    $30.00   1/1/1992   12/31/2299
20694   F   REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SY   N   3   $225.80   3/1/2004   12/31/2299
20750   7   REPAIR                                               N   3    $13.45   6/1/1994   12/31/2299
20802   7   REPLANTATION, ARM; COMPLETE                          N   3    $13.45   6/1/1994   12/31/2299
20804   7   REIMPLANTATION, ARM; INCOMPLETE                      N   3    $13.45   6/1/1994   12/31/2299
20805   7   REPLANTATION, FOREARM (INCLUDES RADIUS AND ULNA TO   N   3    $13.45   6/1/1994   12/31/2299
20806   7   REPLANTATION, FOREARM (INCLUDES RADIUS AND ULNA TO   N   3    $13.45   6/1/1994   12/31/2299
20808   7   REPLANTATION, HAND; COMPLETE                         N   3    $13.45   6/1/1994   12/31/2299
20812   7   REIMPLANTATION, HAND; INCOMPLETE                     N   3    $13.45   6/1/1994   12/31/2299
20816   2   REPLANTATION, DIGIT; COMPLETE                        N   3   $700.00   1/1/1984   12/31/2299
20816   7   REPLANTATION, DIGIT; COMPLETE                        N   3    $13.45   6/1/1994   12/31/2299
20820   2   REIMPLANTATION, DIGIT; INCOMPLETE                    N   3   $700.00   1/1/1984   12/31/2299
20820   7   REIMPLANTATION, DIGIT; INCOMPLETE                    N   3    $13.45   6/1/1994   12/31/2299
20822   7   REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES DIS   N   3    $13.45   6/1/1994   12/31/2299
20823   7   REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES DIS   N   3    $13.45   6/1/1994   12/31/2299
20824   7   REPLANTATION, THUMB (INCLUDES CARPOMETACARPAL JOIN   N   3    $13.45   6/1/1994   12/31/2299
20826   7   REPLANTATION, THUMB (INCLUDES CARPOMETACARPAL JOIN   N   3    $13.45   6/1/1994   12/31/2299
20827   7   REPLANTATION, THUMB (INCLUDES DISTAL TIP TO MP JOI   N   3    $13.45   6/1/1994   12/31/2299
20828   7   REPLANTATION, THUMB (INCLUDES DISTAL TIP TO MP JOI   N   3    $13.45   6/1/1994   12/31/2299
20832   7   REPLANTATION, LEG; COMPLETE                          N   3    $13.45   6/1/1994   12/31/2299
20834   7   REPLANTATION, LEG; INCOMPLETE (NONVIABLE EXTREMITY   N   3    $13.45   6/1/1994   12/31/2299
20838   7   REPLANTATION, FOOT; COMPLETE                         N   3    $13.45   6/1/1994   12/31/2299
20840   7   REPLANTATION, FOOT; INCOMPLETE (NONVIABLE EXTREMIT   N   3    $13.45   6/1/1994   12/31/2299
20900   2   BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL           N   3    $60.00   1/1/1973   12/31/2299
20900   7   BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL           N   3    $13.45   6/1/1994   12/31/2299
20900   8   BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL           N   3     $7.20   1/1/1984   12/31/2299
20900   F   BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL           N   3   $351.00   3/1/2004   12/31/2299
20902   2   BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE           N   3   $290.00   1/2/1994   12/31/2299
20902   7   BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE           N   3    $13.45   6/1/1994   12/31/2299
20902   8   BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE           N   3    $24.00   1/1/1984   12/31/2299
20902   F   BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE           N   3   $432.00   3/1/2004   12/31/2299
20910   2   CARTILAGE GRAFT; COSTOCHONDRAL                       N   3   $120.00   1/1/1973   12/31/2299
20910   7   CARTILAGE GRAFT; COSTOCHONDRAL                       N   3    $13.45   6/1/1994   12/31/2299
20910   F   CARTILAGE GRAFT; COSTOCHONDRAL                       N   3   $351.00   3/1/2004   12/31/2299
20912   2   CARTILAGE GRAFT; NASAL SEPTUM                        N   3    $75.00   1/1/1984   12/31/2299
20912   7   CARTILAGE GRAFT; NASAL SEPTUM                        N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       27
20912   F   CARTILAGE GRAFT; NASAL SEPTUM                                       N   3    $351.00    3/1/2004   12/31/2299
20920   2   FASCIA LATA GRAFT; BY STRIPPER                                      N   3      $65.00   1/1/1984   12/31/2299
20920   7   FASCIA LATA GRAFT; BY STRIPPER                                      N   3      $13.45   6/1/1994   12/31/2299
20920   F   FASCIA LATA GRAFT; BY STRIPPER                                      N   3    $432.00    3/1/2004   12/31/2299
20922   2   FASCIA LATA GRAFT; BY INCISION AND AREA EXPOSURE,                   N   3    $150.00    1/1/1984   12/31/2299
20922   7   FASCIA LATA GRAFT; BY INCISION AND AREA EXPOSURE,                   N   3      $13.45   6/1/1994   12/31/2299
20922   F   FASCIA LATA GRAFT; BY INCISION AND AREA EXPOSURE,                   N   3    $351.00    3/1/2004   12/31/2299
20924   2   TENDON GRAFT, FROM A DISTANCE                                       N   3    $150.00    1/1/1984   12/31/2299
20924   7   TENDON GRAFT, FROM A DISTANCE                                       N   3      $13.45   6/1/1994   12/31/2299
20924   8   TENDON GRAFT, FROM A DISTANCE                                       N   3      $59.94   1/1/2003   12/31/2299
20924   F   TENDON GRAFT, FROM A DISTANCE                                       N   3    $432.00    3/1/2004   12/31/2299
20926   2   TISSUE GRAFTS, OTHER                                                N   3    $198.00    1/2/1995   12/31/2299
20926   7   TISSUE GRAFTS, OTHER                                                N   3      $13.45   6/1/1994   12/31/2299
20926   F   TISSUE GRAFTS, OTHER                                                N   3    $432.00    3/1/2004   12/31/2299
20930   2   ALLOGRAFT FOR SPINE SURGERY ONLY; MORSELIZED                        N   3    $120.00    1/1/1997   12/31/2299
20930   8   ALLOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL                        N   3      $24.00   1/1/1997   12/31/2299
20931   2   ALLOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL                        N   3      $93.84   1/1/1996   12/31/2299
20931   8   ALLOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL                        N   3      $18.77   1/1/1996   12/31/2299
20936   2   AUTOGRAFT FOR SPINE SURGERY ONLY; OBTAINED FROM SAME INCISION       N   3    $100.00    1/1/1997   12/31/2299
20936   8   AUTOGRAFT FOR SPINE SURGERY ONLY; OBTAINED FROM SAME INCISION       N   3      $20.00   1/1/1997   12/31/2299
20937   2   AUTOGRAFT FOR SPINE SURGERY ONLY; MORSELIZED                        N   3    $144.67    1/1/1996   12/31/2299
20937   8   AUTOGRAFT FOR SPINE SURGERY ONLY; MORSELIZED                        N   3      $28.93   1/1/1996   12/31/2299
20938   2   AUTOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL                        N   3    $156.47    1/1/1996   12/31/2299
20938   8   AUTOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL                        N   3      $31.29   1/1/1996   12/31/2299
20950   2   MONITORING OF INTERSTITIAL FLUID PRESS (EG WICK CA                  N   3      $40.00   1/1/1984   12/31/2299
20950   7   MONITORING OF INTERSTITIAL FLUID PRESS (EG WICK CA                  N   3      $13.45   6/1/1994   12/31/2299
20955   2   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; FIBULA                   N   3   $1,879.66   1/1/1997   12/31/2299
20955   7   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; FIBULA                   N   3      $13.45   6/1/1994   12/31/2299
20955   8   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; FIBULA                   N   3    $375.94    1/1/1997   12/31/2299
20956   2   BONE GRAFT W/MICROVASCULAR ANASTOMOSIS; ILIAC CREST                 N   3   $1,625.83   1/1/1997   12/31/2299
20956   7   BONE GRAFT W/MICROVASCULAR ANASTOMOSIS; ILIAC CREST                 N   3      $13.45   1/1/1997   12/31/2299
20956   8   BONE GRAFT W/MICROVASCULAR ANASTOMOSIS; ILIAC CREST                 N   3    $325.16    1/1/1997   12/31/2299
20957   2   BONE GRAFT W/MICROVASCULAR ANASTOMOSIS; METATARSAL                  N   3   $1,684.37   1/1/1997   12/31/2299
20957   7   BONE GRAFT W/MICROVASCULAR ANASTOMOSIS; METATARSAL                  N   3      $13.45   1/1/1997   12/31/2299
20957   8   BONE GRAFT W/MICROVASCULAR ANASTOMOSIS; METATARSAL                  N   3    $336.88    1/1/1997   12/31/2299
20960   7   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; RIB                      N   3      $13.45   6/1/1994   12/31/2299
20962   2   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS;OTHER THAN FIBULA,ILIAC   N   3   $1,625.83   1/1/1997   12/31/2299
20962   7   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS; OTHER B                  N   3      $13.45   6/1/1994   12/31/2299
20962   8   BONE GRAFT WITH MICROVASCULAR ANASTOMOSIS;OTHER THAN FIBULA,ILIAC   N   3    $325.16    1/1/1997   12/31/2299
20969   2   FREE OSTEOCUTANEOUS FLAP W/MICROVASCULAR ANAST;OTH                  N   3   $2,104.63   1/1/1997   12/31/2299
20969   7   FREE OSTEOCUTANEOUS FLAP W/MICROVASCULAR ANAST;OTH                  N   3      $13.45   6/1/1994   12/31/2299
20969   8   FREE OSTEOCUTANEOUS FLAP W/MICROVASCULAR ANAST;OTH                  N   3    $420.92    1/1/1997   12/31/2299
20970   2   FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTOMOSIS;ILIAC CRE   N   3   $2,061.71   1/1/1997   12/31/2299
20970   7   FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTO                  N   3      $13.45   6/1/1994   12/31/2299
20970   8   FREE OSTEOCUTANEOUS FLAP WITH MICROVASCULAR ANASTO                  N   3    $412.34    1/1/1997   12/31/2299
20971   7   FREE OSTEOCUTANEOUS FLAP W/MICROVASCULAR ANASTOMOS                  N   3      $13.45   6/1/1994   12/31/2299
20972   7   FREE OSTEOCUTANEOUS FLAP W/MICROVASCULAR ANASTOMOS                  N   3      $13.45   6/1/1994   12/31/2299
20973   7   FREE OSTEOCUTANEOUS FLAP W/MICRO ANASTOM GR TOE                     N   3      $13.45   6/1/1994   12/31/2299
20975   2   ELECTRICAL STIMULATION TO AID BONE HEALING; INVASI                  N   3    $175.00    1/1/1997   12/31/2299
20975   F   ELECTRICAL STIMULATION TO AID BONE HEALING; INVASI                  N   3    $306.00    3/1/2004   12/31/2299
20979   2   LOW INTENSITY ULTRASOUND STIMULATION TO AID BONE HEALING NONINVAS   N   3       $9.59   1/1/2000   12/31/2299




                                                                                                                        28
20982   4   ABLATION BONE TUMOR(S) EG OSTEOID OSTEOMA METASTASIS RADIOFREQUEN   N   3   $1,426.46   1/1/2004   12/31/2299
20999   7   UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERA                  N   3      $13.45   6/1/1994   12/31/2299
21010   2   ARTHROTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                     N   3    $275.00    1/1/1984   12/31/2299
21010   7   ARTHROTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                     N   3      $13.45   6/1/1994   12/31/2299
21010   F   ARTHROTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                     N   3    $306.00    3/1/2004   12/31/2299
21015   2   (SKULL, FACIAL BONES AND TEMPOROMANDIBULAR JOINT)                   N   3    $287.71    1/1/2003   12/31/2299
21015   7   (SKULL, FACIAL BONES AND TEMPOROMANDIBULAR JOINT)                   N   3      $13.45   6/1/1994   12/31/2299
21015   F   (SKULL, FACIAL BONES AND TEMPOROMANDIBULAR JOINT)                   N   3    $351.00    3/1/2004   12/31/2299
21025   2   EXCISN BONE (FOR OSTEMYLITIS/BONE ABSCESS); MANDIB                  N   3    $150.00    1/1/1984   12/31/2299
21025   7   EXCISN BONE (FOR OSTEMYLITIS/BONE ABSCESS); MANDIB                  N   3      $13.45   6/1/1994   12/31/2299
21025   8   EXCISN BONE (FOR OSTEMYLITIS/BONE ABSCESS); MANDIB                  N   3      $30.00   1/1/1984   12/31/2299
21025   F   EXCISN BONE (FOR OSTEMYLITIS/BONE ABSCESS); MANDIB                  N   3    $306.00    3/1/2004   12/31/2299
21026   7   EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE AB                  N   3      $13.45   6/1/1994   12/31/2299
21026   F   EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE AB                  N   3    $306.00    3/1/2004   12/31/2299
21029   7   REMOVAL BY CONTOURING OF BENIGN TUMOR OF FACIAL BO                  N   3      $13.45   6/1/1994   12/31/2299
21029   F   REMOVAL BY CONTOURING OF BENIGN TUMOR OF FACIAL BO                  N   3    $306.00    3/1/2004   12/31/2299
21030   2   EXCISION OF BENIGN TUMOR OR CYST OF FACIAL BONE OT                  N   3    $125.00    1/1/1984   12/31/2299
21030   7   EXCISION OF BENIGN TUMOR OR CYST OF FACIAL BONE OT                  N   3      $13.45   6/1/1994   12/31/2299
21031   2   EXCISION OF TORUS MANDIRULARIS                                      N   3    $100.00    1/1/1984   12/31/2299
21031   7   EXCISION OF TORUS MANDIBULARIS                                      N   3      $13.45   6/1/1994   12/31/2299
21032   7   EXCISION OF MAXILLARY TORUS PALATINUS                               N   3      $13.45   6/1/1994   12/31/2299
21034   2   EXCISION OF MALIGNANT TUMOR OF FACIAL BONE OTHER T                  N   3    $225.00    1/1/1984   12/31/2299
21034   7   EXCISION OF MALIGNANT TUMOR OF FACIAL BONE OTHER T                  N   3      $13.45   6/1/1994   12/31/2299
21034   F   EXCISION OF MALIGNANT TUMOR OF FACIAL BONE OTHER T                  N   3    $351.00    3/1/2004   12/31/2299
21040   2   EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMP                  N   3    $125.00    1/1/1973   12/31/2299
21040   7   EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMP                  N   3      $13.45   6/1/1994   12/31/2299
21040   F   EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMP                  N   3    $306.00    3/1/2004   12/31/2299
21041   7   EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; COMP                  N   3      $13.45   6/1/1994   12/31/2299
21044   2   EXCISION OF MALIGNANT TUMOR OF MANDIBLE;                            N   3    $300.00    1/1/1984   12/31/2299
21044   7   EXCISION OF MALIGNANT TUMOR OF MANDIBLE;                            N   3      $13.45   6/1/1994   12/31/2299
21044   F   EXCISION OF MALIGNANT TUMOR OF MANDIBLE;                            N   3    $306.00    3/1/2004   12/31/2299
21045   2   EXCISION OF MALIGNANT TUMOR OF MANDIBLE; RADICAL R                  N   3    $450.00    1/1/1984   12/31/2299
21045   7   EXCISION OF MALIGNANT TUMOR OF MANDIBLE; RADICAL R                  N   3      $13.45   6/1/1994   12/31/2299
21046   2   EXCISION BENIGN TUMOR/CYST MANDIBLE INTRA ORAL OSTEOTOMY            N   3    $538.18    1/1/2003   12/31/2299
21047   2   EXCIS BENIGN TUMOR/CYST MANDIBLE EXTRA ORAL OSTEOTOMY               N   3    $660.28    1/1/2003   12/31/2299
21048   2   EXC BENIGN TUMOR/CYST MAXILLA INTRA ORAL OSTEOTOMY                  N   3    $553.84    1/1/2003   12/31/2299
21049   2   EXCIS BENIGN TUMOR/CYST MAXILLA EXTRA ORAL OSTEOTOMY                N   3    $627.22    1/1/2003   12/31/2299
21050   2   ARTHRECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                    N   3    $450.00    1/1/1973   12/31/2299
21050   7   ARTHRECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                    N   3      $13.45   6/1/1994   12/31/2299
21050   8   ARTHRECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                    N   3      $90.00   1/1/1973   12/31/2299
21050   F   ARTHRECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                    N   3    $351.00    3/1/2004   12/31/2299
21060   2   MENISCECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                   N   3    $450.00    1/1/1973   12/31/2299
21060   7   MENISCECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                   N   3      $13.45   6/1/1994   12/31/2299
21060   8   MENISCECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                   N   3      $90.00   1/1/1973   12/31/2299
21060   F   MENISCECTOMY, TEMPOROMANDIBULAR JOINT; UNILATERAL                   N   3    $306.00    3/1/2004   12/31/2299
21070   2   CORONOIDECTOMY (SEPARATE PROCEDURE); UNILATERAL                     N   3    $400.00    1/1/1984   12/31/2299
21070   7   CORONOIDECTOMY (SEPARATE PROCEDURE); UNILATERAL                     N   3      $13.45   6/1/1994   12/31/2299
21070   F   CORONOIDECTOMY (SEPARATE PROCEDURE); UNILATERAL                     N   3    $351.00    3/1/2004   12/31/2299
21076   2   IMPRESSION & CUSTOM PREPARATION;SURGICAL OBTURATOR PROSTHESIS       N   3    $758.03    1/1/1996   12/31/2299
21077   2   IMPRESSION & CUSTOM PREPARATION ORBITAL PROSTHESE                   N   3   $1,906.46   1/1/1996   12/31/2299
21079   2   IMPRESSION AND CUSTOM PREPARATION;INTERIM OBTURATOR PROSTHESIS      N   3   $1,225.31   1/1/1997   12/31/2299




                                                                                                                        29
21079   7   (SKULL, FACIAL BONES AND TEMPOROMANDIBULAR JOINT)                   N   3      $13.45   6/1/1994   12/31/2299
21079   8   IMPRESSION AND CUSTOM PREPARATION;INTERIM OBTURATOR PROSTHESIS      N   3    $245.06    1/1/1997   12/31/2299
21080   2   IMPRESSION AND CUSTOM PREPARATION;DEFINITIVE OBTRUATOR PROSTHESIS   N   3   $1,376.51   1/1/1997   12/31/2299
21080   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21080   8   IMPRESSION AND CUSTOM PREPARATION;DEFINITIVE OBTURATOR PROSTHESIS   N   3    $275.30    1/1/1997   12/31/2299
21081   2   IMPRESSION AND CUSTOM PREPARATION;MANDIBULAR RESECTION PROSTHESIS   N   3   $1,254.34   1/1/1997   12/31/2299
21081   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21081   8   IMPRESSION AND CUSTOM PREPARATION;MANDIBULAR RESECTION PROSTHESIS   N   3    $250.86    1/1/1997   12/31/2299
21082   2   IMPRESSION AND CUSTOM PREPARATION;PALATAL AUGMENTATION PROSTHESIS   N   3   $1,144.20   1/1/1997   12/31/2299
21082   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21082   8   IMPRESSION AND CUSTOM PREPARATION;PALATAL AUGMENTATION PROSTHESIS   N   3    $228.84    1/1/1997   12/31/2299
21083   2   IMPRESSION AND CUSTOM PREPARATION;PALATAL LIFT PROSTHESIS           N   3   $1,058.54   1/1/1997   12/31/2299
21083   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21083   8   IMPRESSION AND CUSTOM PREPARATION;PALATAL LIFT PROSTHESIS           N   3    $211.70    1/1/1997   12/31/2299
21085   2   IMPRESSION AND CUSTOM PREPARATION;ORAL SURGICAL SPLINT              N   3    $315.57    1/1/2002   12/31/2299
21085   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21086   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21087   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21088   7   IMPRESSION AND CUSTOM PREPARATION;                                  N   3      $13.45   6/1/1994   12/31/2299
21089   7   UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE                         N   3      $13.45   6/1/1994   12/31/2299
21100   2   APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACI                  N   3      $50.00   1/1/1973   12/31/2299
21100   7   APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACI                  N   3      $13.45   6/1/1994   12/31/2299
21100   F   APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACI                  N   3    $306.00    3/1/2004   12/31/2299
21110   2   APPLICATION OF INTERDENTAL FIXATION DEVICE FOR CON                  N   3      $50.00   1/1/1984   12/31/2299
21110   7   APPLICATION OF INTERDENTAL FIXATION DEVICE FOR CON                  N   3      $13.45   6/1/1994   12/31/2299
21116   2   INJECTION PROC. FOR TEMPOROMANDIBULAR ARTHROTOMGRA                  N   3      $20.00   1/1/1984   12/31/2299
21120   7   (SKULL, FACIAL BONES AND TEMPOROMANDIBULAR JOINT)                   N   3      $13.45   6/1/1994   12/31/2299
21121   7   GENIOPLASTY;                                                        N   3      $13.45   6/1/1994   12/31/2299
21122   7   GENIOPLASTY;                                                        N   3      $13.45   6/1/1994   12/31/2299
21122   F   GENIOPLASTY;                                                        N   3    $495.00    3/1/2004   12/31/2299
21123   7   GENIOPLASTY;                                                        N   3      $13.45   6/1/1994   12/31/2299
21123   F   GENIOPLASTY;                                                        N   3    $495.00    3/1/2004   12/31/2299
21125   7   AUGMENTATION, MANDIBULAR BODY OR ANGLE;                             N   3      $13.45   6/1/1994   12/31/2299
21127   7   AUGMENTATION, MANDIBULAR BODY OR ANGLE;                             N   3      $13.45   6/1/1994   12/31/2299
21127   F   AUGMENTATION, MANDIBULAR BODY OR ANGLE;                             N   3    $495.00    3/1/2004   12/31/2299
21137   7   REDUCTION FOREHEAD;                                                 N   3      $13.45   6/1/1994   12/31/2299
21138   7   REDUCTION FOREHEAD;                                                 N   3      $13.45   6/1/1994   12/31/2299
21139   7   REDUCTION FOREHEAD;                                                 N   3      $13.45   6/1/1994   12/31/2299
21141   2   RECONSTRUCTION MIDFACE; WITHOUT BONE GRAFT                          N   3    $809.86    1/1/1996   12/31/2299
21141   7   RECONSTRUCTION MIDFACE;WITHOUT BONE GRAFT                           N   3      $13.45   1/1/1996   12/31/2299
21141   8   RECONSTRUCTION MIDFACE; WITHOUT BONE GRAFT                          N   3    $161.97    1/1/1996   12/31/2299
21142   2   RECONSTRUCTION MIDFACE; TWO PIECES; WITHOUT BONE GRAFT              N   3    $839.82    1/1/1996   12/31/2299
21142   8   RECONSTRUCITON MIDFACE; TWO PIECES; WITHOUT BONE GRAFT              N   3    $167.96    1/1/1996   12/31/2299
21143   2   RECONSTRUCITON MIDFACE; 3 OR MORE PIECES, WITHOUT BONE GRAFT        N   3    $872.98    1/1/1996   12/31/2299
21143   8   RECONSTRUCTION MIDFACE; 3 OR MORE PIECES; WITHOUT BONE GRAFT        N   3    $174.60    1/1/1996   12/31/2299
21144   7   RECONSTRUCTION MIDFACE, LEFORT I;                                   N   3      $13.45   6/1/1994   12/31/2299
21145   7   RECONSTRUCTION MIDFACE, LEFORT I;                                   N   3      $13.45   6/1/1994   12/31/2299
21146   7   RECONSTRUCTION MIDFACE, LEFORT I;                                   N   3      $13.45   6/1/1994   12/31/2299
21147   7   RECONSTRUCTION MIDFACE, LEFORT I;                                   N   3      $13.45   6/1/1994   12/31/2299
21150   7   RECONSTRUCTION MIDFACE, LEFORT II;                                  N   3      $13.45   6/1/1994   12/31/2299
21151   7   RECONSTRUCTION MIDFACE, LEFORT II;                                  N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                        30
21154   7   RECONSTRUCTION MIDFACE, LEFORT III (EXTRACRANIAL),                  N   3      $13.45   6/1/1994   12/31/2299
21155   7   RECONSTRUCTION MIDFACE, LEFORT III (EXTRACRANIAL),                  N   3      $13.45   6/1/1994   12/31/2299
21159   7   RECONSTRUCTION MIDFACE, LEFORT III (EXTRA AND INTR                  N   3      $13.45   6/1/1994   12/31/2299
21160   7   RECONSTRUCTION MIDFACE, LEFORT III (EXTRA AND INTR                  N   3      $13.45   6/1/1994   12/31/2299
21172   7   RECONSTRUCTION SUPERIOR-LATERAL ORBITAL RIM AND LO                  N   3      $13.45   6/1/1994   12/31/2299
21175   2   RECONSTRUCTION,BIFRONTAL,SUPERIOR-LATERAL ORBITAL RIMS AND LOWER    N   3   $1,380.00   1/2/1994   12/31/2299
21175   7   RECON,BI-FRONTAL,SUP-LAT ORB RIMS AND LOW FRHEAD                    N   3      $13.45   6/1/1994   12/31/2299
21175   8   RECONSTRUCTION,BIFRONTAL,SUPERIOR-LATERAL ORBITAL RIMS AND LOWER    N   3    $276.00    1/2/1994   12/31/2299
21179   2   RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND                  N   3    $924.00    1/2/1994   12/31/2299
21179   7   RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND                  N   3      $13.45   6/1/1994   12/31/2299
21180   7   RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND                  N   3      $13.45   6/1/1994   12/31/2299
21181   7   REMOVAL BY CONTOURING OF BENIGN TUMOR OF CRANIAL B                  N   3      $13.45   6/1/1994   12/31/2299
21181   F   REMOVAL BY CONTOURING OF BENIGN TUMOR OF CRANIAL B                  N   3    $495.00    3/1/2004   12/31/2299
21182   2   RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, N                  N   3   $1,226.19   1/1/2002   12/31/2299
21182   7   RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, N                  N   3      $13.45   6/1/1994   12/31/2299
21183   7   RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, N                  N   3      $13.45   6/1/1994   12/31/2299
21184   7   RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, N                  N   3      $13.45   6/1/1994   12/31/2299
21188   7   RECONSTRUCTION MIDFACE, OSTEOTOMIES (OTHER THAN LE                  N   3      $13.45   6/1/1994   12/31/2299
21193   2   RECONSTRUCTION OF MANDIBULAR RAMI,HORIZ/VERT,C/L OSTETMY W/O GRFT   N   3    $550.00    1/1/1996   12/31/2299
21193   7   RECONSTRUCTION OF MANDIBULAR RAMUS, HORIZONTAL, VERTICAL            N   3      $13.45   6/1/1994   12/31/2299
21194   7   RECONSTRUCTION OF MANDIBULAR RAMUS, HORIZONTAL, VERTICAL,C          N   3      $13.45   6/1/1994   12/31/2299
21195   7   RECONSTRUCTION OF MANDIBULAR RAMUS, SAGITTAL SPLIT                  N   3      $13.45   6/1/1994   12/31/2299
21196   2   RECONSTRUCTION OF MANDIBULAR RAMUS, SAGITTAL SPLIT                  N   3    $788.15    1/1/2002   12/31/2299
21196   7   RECONSTRUCTION OF MANDIBULAR RAMUS, SAGITTAL SPLIT                  N   3      $13.45   6/1/1994   12/31/2299
21198   2   OSTEOTOMY, MANDIBLE, SEGMENTAL                                      N   3    $649.52    1/1/2005   12/31/2299
21198   7   OSTEOTOMY, MANDIBLE, SEGMENTAL                                      N   3      $13.45   6/1/1994   12/31/2299
21199   2   OSTEOTOMY MANDIBLE SEGMENT.W/GENIOGLOSSESADVANCEMENT                N   3    $633.05    1/1/2001   12/31/2299
21206   2   OSTEOPLASTY FOR PROGNATHISM, MICROGNATHISM, OR APE                  N   3    $425.00    1/1/1984   12/31/2299
21206   7   OSTEOPLASTY FOR PROGNATHISM, MICROGNATHISM, OR APE                  N   3      $13.45   6/1/1994   12/31/2299
21206   F   OSTEOPLASTY FOR PROGNATHISM, MICROGNATHISM, OR APE                  N   3    $495.00    3/1/2004   12/31/2299
21208   2   OSTEOPLASTY, FACIAL BONES                                           N   3    $418.04    1/1/2003   12/31/2299
21208   7   OSTEOPLASTY, FACIAL BONES                                           N   3      $13.45   6/1/1994   12/31/2299
21208   F   OSTEOPLASTY, FACIAL BONES                                           N   3    $495.00    3/1/2004   12/31/2299
21209   7   OSTEOPLASTY, FACIAL BONES                                           N   3      $13.45   6/1/1994   12/31/2299
21209   F   OSTEOPLASTY, FACIAL BONES                                           N   3    $495.00    3/1/2004   12/31/2299
21210   2   GRAFT, BONE; NASAL, MAXILLARY AND MALAR AREAS                       N   3    $300.00    1/1/1984   12/31/2299
21210   7   GRAFT, BONE; NASAL, MAXILLARY AND MALAR AREAS                       N   3      $13.45   6/1/1994   12/31/2299
21210   F   GRAFT, BONE; NASAL, MAXILLARY AND MALAR AREAS                       N   3    $495.00    3/1/2004   12/31/2299
21215   2   GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)                    N   3    $300.00    1/1/1984   12/31/2299
21215   7   GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)                    N   3      $13.45   6/1/1994   12/31/2299
21215   F   GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)                    N   3    $495.00    3/1/2004   12/31/2299
21230   2   GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, N                  N   3    $450.00    1/1/1973   12/31/2299
21230   7   GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, N                  N   3      $13.45   6/1/1994   12/31/2299
21230   8   GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, N                  N   3      $90.00   1/1/1973   12/31/2299
21230   F   GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, N                  N   3    $495.00    3/1/2004   12/31/2299
21235   2   GRAFT; EAR CARTILAGE TO NOSE OR EAR                                 N   3    $372.00    1/2/1997   12/31/2299
21235   7   GRAFT; EAR CARTILAGE TO NOSE OR EAR                                 N   3      $13.45   6/1/1994   12/31/2299
21235   8   GRAFT; EAR CARTILAGE TO NOSE OR EAR                                 N   3      $74.00   1/2/1997   12/31/2299
21235   F   GRAFT; EAR CARTILAGE TO NOSE OR EAR                                 N   3    $495.00    3/1/2004   12/31/2299
21240   2   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT                               N   3    $250.00    8/1/1979   12/31/2299
21240   7   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT                               N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                        31
21240   8   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT                N   3    $50.00   8/1/1979   12/31/2299
21240   F   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT                N   3   $432.00   3/1/2004   12/31/2299
21241   2   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT; BILATERAL     N   3   $450.00   1/1/1984   12/31/2299
21241   7   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT; BILATERAL     N   3    $13.45   6/1/1994   12/31/2299
21242   2   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, W/ALLOPLAST   N   3   $300.00   1/1/1984   12/31/2299
21242   7   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, W/ALLOPLAST   N   3    $13.45   6/1/1994   12/31/2299
21242   F   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, W/ALLOPLAST   N   3   $495.00   3/1/2004   12/31/2299
21243   7   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH PROSTH   N   3    $13.45   6/1/1994   12/31/2299
21243   F   ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH PROSTH   N   3   $495.00   3/1/2004   12/31/2299
21244   2   RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSO   N   3   $520.12   1/1/2004   12/31/2299
21244   7   RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSO   N   3    $13.45   6/1/1994   12/31/2299
21244   F   RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSO   N   3   $495.00   3/1/2004   12/31/2299
21245   7   RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTE   N   3    $13.45   6/1/1994   12/31/2299
21245   F   RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTE   N   3   $495.00   3/1/2004   12/31/2299
21246   7   RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTE   N   3    $13.45   6/1/1994   12/31/2299
21246   F   RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTE   N   3   $495.00   3/1/2004   12/31/2299
21247   7   RECONSTRUCTION OF MANDIBULAR CONDYLE WITH BONE AND   N   3    $13.45   6/1/1994   12/31/2299
21248   7   RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL I   N   3    $13.45   6/1/1994   12/31/2299
21248   F   RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL I   N   3   $495.00   3/1/2004   12/31/2299
21249   7   RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL I   N   3    $13.45   6/1/1994   12/31/2299
21249   F   RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL I   N   3   $495.00   3/1/2004   12/31/2299
21255   7   RECONSTRUCTION OF ZYGOMATIC ARCH AND GLENOID FOSSA   N   3    $13.45   6/1/1994   12/31/2299
21256   2   RECONSTRUCTION OF ORBIT WITH OSTEOTOMIES (EXTRACRA   N   3   $800.00   1/2/1994   12/31/2299
21256   7   RECONSTRUCTION OF ORBIT WITH OSTEOTOMIES (EXTRACRA   N   3    $13.45   6/1/1994   12/31/2299
21260   2   PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM,   N   3   $500.00   1/1/1984   12/31/2299
21260   7   PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM,   N   3    $13.45   6/1/1994   12/31/2299
21261   7   ORBITAL HYPERTELORISM CORRECTION (PERIORBITAL) OST   N   3    $13.45   6/1/1994   12/31/2299
21263   7   ORBITAL HYPERTELORISM CORRECTION (PERIORBITAL) OST   N   3    $13.45   6/1/1994   12/31/2299
21267   7   ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UN   N   3    $13.45   6/1/1994   12/31/2299
21267   F   ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UN   N   3   $495.00   3/1/2004   12/31/2299
21268   7   ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UN   N   3    $13.45   6/1/1994   12/31/2299
21270   7   RECONSTRUCTION FOR TREACHER COLLINS SYNDROME (PERI   N   3    $13.45   6/1/1994   12/31/2299
21270   F   RECONSTRUCTION FOR TREACHER COLLINS SYNDROME (PERI   N   3   $495.00   3/1/2004   12/31/2299
21275   2   SECONDARY REVISION OF ORBITOCRANIOFACIAL RECONSTRU   N   3   $477.56   1/1/2004   12/31/2299
21275   7   SECONDARY REVISION OF ORBITOCRANIOFACIAL RECONSTRU   N   3    $13.45   6/1/1994   12/31/2299
21275   F   SECONDARY REVISION OF ORBITOCRANIOFACIAL RECONSTRU   N   3   $495.00   3/1/2004   12/31/2299
21280   7   MEDIAL CANTHOPLASTY                                  N   3    $13.45   6/1/1994   12/31/2299
21280   F   MEDIAL CANTHOPLASTY                                  N   3   $495.00   3/1/2004   12/31/2299
21282   2   LATERAL CANTHOPEXY                                   N   3   $185.11   1/1/2003   12/31/2299
21282   7   LATERAL CANTHOPEXY                                   N   3    $13.45   6/1/1994   12/31/2299
21282   F   LATERAL CANTHOPEXY                                   N   3   $495.00   3/1/2004   12/31/2299
21295   7   REDUCT OF MASSETER MUSCLE(EG, TREAT OF BENIGN MASS   N   3    $13.45   6/1/1994   12/31/2299
21295   F   REDUCT OF MASSETER MUSCLE(EG, TREAT OF BENIGN MASS   N   3   $225.80   3/1/2004   12/31/2299
21296   7   REDUCT OF MASSETER MUSCLE(EG, TREAT OF BENIGN MASS   N   3    $13.45   6/1/1994   12/31/2299
21296   F   REDUCT OF MASSETER MUSCLE(EG, TREAT OF BENIGN MASS   N   3   $225.80   3/1/2004   12/31/2299
21299   7   UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE    N   3    $13.45   6/1/1994   12/31/2299
21310   2   TREATMENT OF CLOSED OR OPEN NASAL FRACTURE WITHOUT   N   3    $15.00   1/1/1973   12/31/2299
21310   7   TREATMENT OF CLOSED OR OPEN NASAL FRACTURE WITHOUT   N   3    $13.45   6/1/1994   12/31/2299
21310   F   TREATMENT OF CLOSED OR OPEN NASAL FRACTURE WITHOUT   N   3   $306.00   3/1/2004   12/31/2299
21315   2   MANIPULATIVE TREATMENT, NASAL BONE FRACTURE, WITHO   N   3    $37.75   8/1/1979   12/31/2299
21315   7   MANIPULATIVE TREATMENT, NASAL BONE FRACTURE, WITHO   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       32
21315   F   MANIPULATIVE TREATMENT, NASAL BONE FRACTURE, WITHO   N   3   $306.00   3/1/2004   12/31/2299
21320   2   MANIPULATIVE TREATMENT, NASAL BONE FRACTURE, WITH    N   3   $118.00   1/2/1997   12/31/2299
21320   7   MANIPULATIVE TREATMENT, NASAL BONE FRACTURE, WITH    N   3    $13.45   6/1/1994   12/31/2299
21320   F   MANIPULATIVE TREATMENT, NASAL BONE FRACTURE, WITH    N   3   $306.00   3/1/2004   12/31/2299
21325   2   OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED      N   3   $100.00   1/1/1973   12/31/2299
21325   7   OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED      N   3    $13.45   6/1/1994   12/31/2299
21325   F   OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED      N   3   $432.00   3/1/2004   12/31/2299
21330   2   OPEN TREATMENT OF NASAL FRACTURE;COMPLICATED,WITH    N   3   $237.50   1/1/1973   12/31/2299
21330   7   OPEN TREATMENT OF NASAL FRACTURE;COMPLICATED,WITH    N   3    $13.45   6/1/1994   12/31/2299
21330   F   OPEN TREATMENT OF NASAL FRACTURE;COMPLICATED,WITH    N   3   $495.00   3/1/2004   12/31/2299
21334   7   OPEN TRTMNT OF COMPLICATED (EF, COMMINUTED OR INVO   N   3    $13.45   6/1/1994   12/31/2299
21335   2   OPEN TREATMENT OF NASAL FRACTURE;WITH CONCOMITANT    N   3   $325.00   1/1/1984   12/31/2299
21335   7   OPEN TREATMENT OF NASAL FRACTURE;WITH CONCOMITANT    N   3    $13.45   6/1/1994   12/31/2299
21335   F   OPEN TREATMENT OF NASAL FRACTURE;WITH CONCOMITANT    N   3   $495.00   3/1/2004   12/31/2299
21336   2   OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR W   N   3   $177.13   1/1/1993   12/31/2299
21336   7   OPEN TRTMNT OF NASAL SEPTAL FRACTURE, W OR W/O STA   N   3    $13.45   6/1/1994   12/31/2299
21336   F   OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR W   N   3   $432.00   3/1/2004   12/31/2299
21337   2   TREATMENT OF CLOSED NASAL SEPTAL FRACTURE            N   3    $50.00   1/1/1984   12/31/2299
21337   7   TREATMENT OF CLOSED NASAL SEPTAL FRACTURE            N   3    $13.45   6/1/1994   12/31/2299
21337   F   TREATMENT OF CLOSED NASAL SEPTAL FRACTURE            N   3   $306.00   3/1/2004   12/31/2299
21338   2   OPEN TREATMENT OF NASOETHMOID FRACTURE W/O EXTERNA   N   3   $125.00   1/1/1984   12/31/2299
21338   7   OPEN TREATMENT OF NASOETHMOID FRACTURE W/O EXTERNA   N   3    $13.45   6/1/1994   12/31/2299
21338   F   OPEN TREATMENT OF NASOETHMOID FRACTURE W/O EXTERNA   N   3   $432.00   3/1/2004   12/31/2299
21339   2   OPEN TREATMENT OF NASOETHMOID FRACTURE WITH EXTERN   N   3   $200.00   1/1/1984   12/31/2299
21339   7   OPEN TREATMENT OF NASOETHMOID FRACTURE WITH EXTERN   N   3    $13.45   6/1/1994   12/31/2299
21339   F   OPEN TREATMENT OF NASOETHMOID FRACTURE WITH EXTERN   N   3   $495.00   3/1/2004   12/31/2299
21340   2   TREATMENT OF CLOSED/OPEN NASOETHMOID COMPLEX FRACT   N   3   $250.00   1/1/1984   12/31/2299
21340   7   TREATMENT OF CLOSED/OPEN NASOETHMOID COMPLEX FRACT   N   3    $13.45   6/1/1994   12/31/2299
21340   F   TREATMENT OF CLOSED/OPEN NASOETHMOID COMPLEX FRACT   N   3   $432.00   3/1/2004   12/31/2299
21343   2   OPEN TREATMENT OF CLOSED OR OPEN DEPRESSED FRONTAL   N   3   $540.00   1/2/1995   12/31/2299
21343   7   OPEN TREATMENT OF CLOSED OR OPEN DEPRESSED FRONTAL   N   3    $13.45   6/1/1994   12/31/2299
21344   2   OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR I   N   3   $543.06   1/1/1993   12/31/2299
21345   2   TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFOR   N   3   $402.00   1/2/1995   12/31/2299
21345   7   TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFOR   N   3    $13.45   6/1/1994   12/31/2299
21345   F   TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFOR   N   3   $495.00   3/1/2004   12/31/2299
21346   2   OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (   N   3   $300.00   1/1/1973   12/31/2299
21346   7   OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (   N   3    $13.45   6/1/1994   12/31/2299
21346   8   OPEN TREAT NASOMAX FRAC LEFORT II TYPE W INT FIX     N   3    $60.00   1/1/1973   12/31/2299
21347   2   OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (   N   3   $650.00   1/1/1984   12/31/2299
21347   7   OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (   N   3    $13.45   6/1/1994   12/31/2299
21348   2   OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (   N   3   $272.92   1/1/1993   12/31/2299
21348   7   OPEN TRTMENT OF NASOMAZILLARY COMPLEX FRACTURE       N   3    $13.45   6/1/1994   12/31/2299
21355   2   MANIPULATIVE TREATMENT OF CLOSED OR OPEN FRACTURE    N   3    $30.00   1/1/1973   12/31/2299
21355   7   MANIPULATIVE TREATMENT OF CLOSED OR OPEN FRACTURE    N   3    $13.45   6/1/1994   12/31/2299
21355   F   MANIPULATIVE TREATMENT OF CLOSED OR OPEN FRACTURE    N   3   $351.00   3/1/2004   12/31/2299
21356   2   OPEN TREATMENT OF DEPRESSED ZYGOMATIC ARCH FRACTUR   N   3   $184.45   1/1/1993   12/31/2299
21356   7   OPEN TRTMENT OF DERESSED ZYGOMATIC ARCH FRACTURE     N   3    $13.45   6/1/1994   12/31/2299
21360   2   OPEN TREATMENT OF CLOSED OR OPEN DEPRESSED MALAR F   N   3   $348.00   1/2/1995   12/31/2299
21360   7   OPEN TREATMENT OF CLOSED OR OPEN DEPRESSED MALAR F   N   3    $13.45   6/1/1994   12/31/2299
21360   8   OPEN TREATMENT OF CLOSED OR OPEN DEPRESSED MALAR F   N   3    $35.00   1/1/1984   12/31/2299
21365   2   OPEN TREATMENT OF CLOSED OR OPEN COMPLICATED; MULT   N   3   $325.00   1/1/1973   12/31/2299




                                                                                                       33
21365   7   OPEN TREATMENT OF CLOSED OR OPEN COMPLICATED; MULT   N   3    $13.45    6/1/1994   12/31/2299
21366   2   OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR I   N   3   $343.49    1/1/1993   12/31/2299
21366   7   OPEN TRTMNT OF COMPLICATED (EG, COMINUTED OR INVOL   N   3    $13.45    6/1/1994   12/31/2299
21380   7   TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTURE WI   N   3    $13.45    6/1/1994   12/31/2299
21385   2   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3   $300.00    1/1/1973   12/31/2299
21385   7   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $13.45    6/1/1994   12/31/2299
21385   8   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $60.00    1/1/1973   12/31/2299
21386   2   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3   $200.00    1/1/1984   12/31/2299
21386   7   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $13.45    6/1/1994   12/31/2299
21387   2   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3   $350.00    1/1/1984   12/31/2299
21387   7   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $13.45    6/1/1994   12/31/2299
21390   2   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3   $350.00    1/1/1973   12/31/2299
21390   7   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $13.45    6/1/1994   12/31/2299
21390   8   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $70.00    1/1/1973   12/31/2299
21395   2   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3   $450.00    1/1/1973   12/31/2299
21395   7   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $13.45    6/1/1994   12/31/2299
21395   8   OPEN TREATMENT OF ORBITAL FLOOR ''BLOWOUT'' FRACTU   N   3    $90.00    1/1/1973   12/31/2299
21400   2   TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOWOUT''   N   3    $50.00    1/1/1984   12/31/2299
21400   F   TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOWOUT''   N   3   $306.00    3/1/2004   12/31/2299
21401   2   TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOWOUT''   N   3   $100.00    1/1/1984   12/31/2299
21401   7   TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOWOUT''   N   3    $13.45    6/1/1994   12/31/2299
21401   F   TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOWOUT''   N   3   $351.00    3/1/2004   12/31/2299
21406   2   OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOW   N   3   $140.00    1/1/1984   12/31/2299
21406   7   OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOW   N   3    $13.45    6/1/1994   12/31/2299
21407   2   OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOW   N   3   $390.00    1/2/1995   12/31/2299
21407   7   OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOW   N   3    $13.45    6/1/1994   12/31/2299
21408   2   OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ''BLOW   N   3   $351.53    1/1/1993   12/31/2299
21408   7   OPEN TRTMNT OF FRACTURE OF ORBIT,EXCEPT BLOWOUT      N   3    $13.45    6/1/1994   12/31/2299
21421   2   TREATMENT OF PALATAL OR ALVEOLAR RIDGE FRACTURES (   N   3   $200.00    1/1/1984   12/31/2299
21421   7   TREATMENT OF PALATAL OR ALVEOLAR RIDGE FRACTURES (   N   3    $13.45    6/1/1994   12/31/2299
21421   8   TREATMENT OF PALATAL OR ALVEOLAR RIDGE FRACTURES (   N   3    $40.00   8/13/1991   12/31/2299
21421   F   TREATMENT OF PALATAL OR ALVEOLAR RIDGE FRACTURES (   N   3   $432.00    3/1/2004   12/31/2299
21422   2   TREATMENT OF PALATAL OR ALVEOLAR RIDGE FRACTURES (   N   3   $400.00    1/1/1984   12/31/2299
21422   7   TREATMENT OF PALATAL OR ALVEOLAR RIDGE FRACTURES (   N   3    $13.45    6/1/1994   12/31/2299
21423   2   OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (L   N   3   $392.49    1/1/1993   12/31/2299
21423   7   OPEN TRTMNT OF PALATAL OR MAZILLARY FRACTURE I TYP   N   3    $13.45    6/1/1994   12/31/2299
21431   2   TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III T   N   3   $200.00    1/1/1984   12/31/2299
21431   7   TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III T   N   3    $13.45    6/1/1994   12/31/2299
21432   2   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3   $600.00    1/1/1984   12/31/2299
21432   7   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3    $13.45    6/1/1994   12/31/2299
21433   2   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3   $600.00    1/1/1984   12/31/2299
21433   7   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3    $13.45    6/1/1994   12/31/2299
21435   2   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3   $625.00    1/1/1984   12/31/2299
21435   7   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3    $13.45    6/1/1994   12/31/2299
21436   2   OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT    N   3   $810.95    1/1/1993   12/31/2299
21436   7   OPEN TRTMNT OF CRANIOFACIL SEPARATION LEFORT 3 TYP   N   3    $13.45    6/1/1994   12/31/2299
21440   2   MANIPULATIVE TREATMENT OF ALVEOLAR RIDGE FRACTURE    N   3   $158.65    1/1/2003   12/31/2299
21440   7   MANIPULATIVE TREATMENT OF ALVEOLAR RIDGE FRACTURE    N   3    $13.45    6/1/1994   12/31/2299
21440   F   MANIPULATIVE TREATMENT OF ALVEOLAR RIDGE FRACTURE    N   3   $351.00    3/1/2004   12/31/2299
21445   7   OPEN TREATMENT OF ALVEOLAR RIDGE FRACTURE (SEPARAT   N   3    $13.45    6/1/1994   12/31/2299
21445   F   OPEN TREATMENT OF ALVEOLAR RIDGE FRACTURE (SEPARAT   N   3   $432.00    3/1/2004   12/31/2299




                                                                                                        34
21450   2   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3    $75.00   1/1/1984   12/31/2299
21450   7   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3    $13.45   6/1/1994   12/31/2299
21450   F   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3   $351.00   3/1/2004   12/31/2299
21451   2   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3   $150.00   1/1/1984   12/31/2299
21451   7   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3    $13.45   6/1/1994   12/31/2299
21451   8   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3    $30.00   1/1/1984   12/31/2299
21451   F   TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTURE;WI                  N   3   $432.00   3/1/2004   12/31/2299
21452   2   TREATMENT OF OPEN MANDIBULAR FRACTURE W/O MANIPULA                  N   3    $75.00   1/1/1984   12/31/2299
21452   7   TREATMENT OF OPEN MANDIBULAR FRACTURE W/O MANIPULA                  N   3    $13.45   6/1/1994   12/31/2299
21452   F   TREATMENT OF OPEN MANDIBULAR FRACTURE W/O MANIPULA                  N   3   $306.00   3/1/2004   12/31/2299
21453   2   CLOSED TREATMENT OF MANDIBULAR FRACTURE WITH INTERDENTAL FIXATION   N   3   $300.00   1/2/1997   12/31/2299
21453   7   WITH MANIPULATION                                                   N   3    $13.45   6/1/1994   12/31/2299
21453   F   CLOSED TREATMENT OF MANDIBULAR FRACTURE WITH INTERDENTAL FIXATION   N   3   $351.00   3/1/2004   12/31/2299
21454   2   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3   $150.00   1/1/1984   12/31/2299
21454   7   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3    $13.45   6/1/1994   12/31/2299
21454   8   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3    $30.00   1/1/1984   12/31/2299
21454   F   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3   $495.00   3/1/2004   12/31/2299
21461   2   OPEN TRTM OF CLOSED OR OPEN MANDIBULAR FX                           N   3   $400.00   1/1/1984   12/31/2299
21461   7   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3    $13.45   6/1/1994   12/31/2299
21461   F   OPEN TRTM OF CLOSED OR OPEN MANDIBULAR FX                           N   3   $432.00   3/1/2004   12/31/2299
21462   2   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3   $400.00   1/1/1973   12/31/2299
21462   7   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3    $13.45   6/1/1994   12/31/2299
21462   F   OPEN TREATMENT OF CLOSED OR OPEN MANDIBULAR FRACTU                  N   3   $495.00   3/1/2004   12/31/2299
21465   2   OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE                      N   3   $400.00   1/1/1984   12/31/2299
21465   7   OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE                      N   3    $13.45   6/1/1994   12/31/2299
21465   F   OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE                      N   3   $432.00   3/1/2004   12/31/2299
21470   2   OPEN TREATMENT OF COMPLICATED CLOSED OR OPEN MANDI                  N   3   $275.00   1/1/1984   12/31/2299
21470   7   OPEN REDUCTION OF COMPLICATED CLOSED OR OPEN MANDI                  N   3    $13.45   6/1/1994   12/31/2299
21480   2   UNCOMPLICATED TREATMENT OF TEMPOROMANDIBULAR DISLO                  N   3    $30.00   8/1/1979   12/31/2299
21480   7   UNCOMPLICATED TREATMENT OF TEMPOROMANDIBULAR DISLO                  N   3    $13.45   6/1/1994   12/31/2299
21480   F   UNCOMPLICATED TREATMENT OF TEMPOROMANDIBULAR DISLO                  N   3   $225.80   3/1/2004   12/31/2299
21485   2   COMPLICATED MANIPULATIVE TREATMENT OF TEMPOROMANDI                  N   3    $50.00   1/1/1984   12/31/2299
21485   7   COMPLICATED MANIPULATIVE TREATMENT OF TEMPOROMANDI                  N   3    $13.45   6/1/1994   12/31/2299
21485   F   COMPLICATED MANIPULATIVE TREATMENT OF TEMPOROMANDI                  N   3   $306.00   3/1/2004   12/31/2299
21490   2   OPEN TREATMENT OF TEMPOROMANDIBULAR DISLOCATION                     N   3   $200.00   8/1/1979   12/31/2299
21490   7   OPEN TREATMENT OF TEMPOROMANDIBULAR DISLOCATION                     N   3    $13.45   6/1/1994   12/31/2299
21490   F   OPEN TREATMENT OF TEMPOROMANDIBULAR DISLOCATION                     N   3   $351.00   3/1/2004   12/31/2299
21495   2   OPEN TREATMENT OF CLOSED OR OPEN HYOID FRACTURE                     N   3   $150.00   1/1/1984   12/31/2299
21495   7   OPEN TREATMENT OF CLOSED OR OPEN HYOID FRACTURE                     N   3    $13.45   6/1/1994   12/31/2299
21497   2   INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE               N   3   $150.00   1/1/1984   12/31/2299
21497   7   INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACT                  N   3    $13.45   6/1/1994   12/31/2299
21497   F   INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE               N   3   $306.00   3/1/2004   12/31/2299
21499   7   UNLISTED PROCEDURE, HEAD                                            N   3    $13.45   6/1/1994   12/31/2299
21501   2   INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA;                    N   3    $50.00   1/1/1984   12/31/2299
21501   7   INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA;                    N   3    $13.45   6/1/1994   12/31/2299
21501   F   INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA;                    N   3   $306.00   3/1/2004   12/31/2299
21502   2   INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA; W                  N   3   $150.00   1/1/1973   12/31/2299
21502   7   INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA; W                  N   3    $13.45   6/1/1994   12/31/2299
21502   F   INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA; W                  N   3   $306.00   3/1/2004   12/31/2299
21510   2   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS                  N   3   $150.00   1/1/1984   12/31/2299
21510   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      35
21511   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299
21550   2   EXCISIONAL BIOPSY, SOFT TISSUES                      N   3    $50.00   1/1/1984   12/31/2299
21550   7   EXCISIONAL BIOPSY, SOFT TISSUES                      N   3    $13.45   6/1/1994   12/31/2299
21555   2   EXCISION BENIGN TUMOR; SUBCUTANEOUS                  N   3   $150.00   2/2/1995   12/31/2299
21555   7   EXCISION BENIGN TUMOR                                N   3    $13.45   6/1/1994   12/31/2299
21555   F   EXCISION BENIGN TUMOR; SUBCUTANEOUS                  N   3   $306.00   3/1/2004   12/31/2299
21556   2   EXCISION BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUSC   N   3   $150.00   1/1/1984   12/31/2299
21556   7   EXCISION BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUSC   N   3    $13.45   6/1/1994   12/31/2299
21556   F   EXCISION BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUSC   N   3   $306.00   3/1/2004   12/31/2299
21557   2   RAD RESEC TUMOR (MALIGN NEOPLSM) SFT TISS NCK THOR   N   3   $432.00   1/2/1994   12/31/2299
21557   7   RAD RESEC TUMOR (MALIGN NEOPLSM) SFR TISS NCK THOR   N   3    $13.45   6/1/1994   12/31/2299
21600   2   EXCISION OF RIB, PARTIAL                             N   3   $150.00   1/1/1973   12/31/2299
21600   7   EXCISION OF RIB, PARTIAL                             N   3    $13.45   6/1/1994   12/31/2299
21600   F   EXCISION OF RIB, PARTIAL                             N   3   $306.00   3/1/2004   12/31/2299
21610   2   COSTOTRANSVERSECTOMY (SEPARATE PROCEDURE)            N   3   $150.00   8/1/1979   12/31/2299
21610   7   COSTOTRANSVERSECTOMY (SEPARATE PROCEDURE)            N   3    $13.45   6/1/1994   12/31/2299
21610   8   COSTOTRANSVERSECTOMY (SEPARATE PROCEDURE)            N   3    $30.00   8/1/1979   12/31/2299
21610   F   COSTOTRANSVERSECTOMY (SEPARATE PROCEDURE)            N   3   $306.00   3/1/2004   12/31/2299
21615   2   EXCISION FIRST AND/OR CERVICAL RIB FOR OUTLET COMP   N   3   $325.00   1/1/1984   12/31/2299
21615   7   EXCISION FIRST AND/OR CERVICAL RIB FOR OUTLET COMP   N   3    $13.45   6/1/1994   12/31/2299
21615   8   EXCISION FIRST AND/OR CERVICAL RIB FOR OUTLET COMP   N   3    $65.00   1/1/1984   12/31/2299
21616   2   EXCISION FIRST AND/OR CERVICAL RIB FOR OUTLET COMP   N   3   $375.00   1/1/1984   12/31/2299
21616   7   EXCISION FIRST AND/OR CERVICAL RIB FOR OUTLET COMP   N   3    $13.45   6/1/1994   12/31/2299
21620   2   OSTECTOMY OF STERNUM, PARTIAL                        N   3   $200.00   7/1/1988   12/31/2299
21620   7   OSTECTOMY OF STERNUM, PARTIAL                        N   3    $13.45   6/1/1994   12/31/2299
21627   2   STERNAL DEBRIDEMENT                                  N   3   $100.00   7/1/1988   12/31/2299
21627   7   ANESTHESIA,STERNAL DEBRIDEMENT                       N   3    $13.45   1/2/1996   12/31/2299
21630   7   RADICAL RESECTION OF STERNUM; FOR TUMOR              N   3    $13.45   6/1/1994   12/31/2299
21632   7   RADICAL RESECTION OF STERNUM FOR TUMOR; WITH MEDIA   N   3    $13.45   6/1/1994   12/31/2299
21685   2   HYOID MYOTOMY AND SUSPENSION                         N   3   $553.67   1/1/2004   12/31/2299
21700   2   DIVISION OF SCALENUS ANTICUS; WITHOUT RESECTION OF   N   3   $250.00   1/1/1973   12/31/2299
21700   7   DIVISION OF SCALENUS ANTICUS; WITHOUT RESECTION OF   N   3    $13.45   6/1/1994   12/31/2299
21700   8   DIVISION OF SCALENUS ANTICUS; WITHOUT RESECTION OF   N   3    $50.00   1/1/1973   12/31/2299
21700   F   DIVISION OF SCALENUS ANTICUS; WITHOUT RESECTION OF   N   3   $306.00   3/1/2004   12/31/2299
21705   2   DIVISION OF SCALENUS ANTICUS; WITH RESECTION OF CE   N   3   $300.00   8/1/1979   12/31/2299
21705   7   DIVISION OF SCALENUS ANTICUS; WITH RESECTION OF CE   N   3    $13.45   6/1/1994   12/31/2299
21705   8   DIVISION OF SCALENUS ANTICUS; WITH RESECTION OF CE   N   3    $60.00   1/1/1973   12/31/2299
21720   2   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3   $200.00   1/1/1973   12/31/2299
21720   7   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3    $13.45   6/1/1994   12/31/2299
21720   8   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3    $40.00   1/1/1984   12/31/2299
21720   F   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3   $351.00   3/1/2004   12/31/2299
21725   2   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3   $225.00   1/1/1973   12/31/2299
21725   7   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3    $13.45   6/1/1994   12/31/2299
21725   F   DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, O   N   3   $351.00   3/1/2004   12/31/2299
21740   2   RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARIN   N   3   $650.00   1/1/1973   12/31/2299
21740   7   RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARIN   N   3    $13.45   6/1/1994   12/31/2299
21740   8   RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARIN   N   3   $130.00   1/1/1973   12/31/2299
21750   2   CLOSURE OF STERNOTOMY SEPARATION WITH OR WITHOUT D   N   3   $352.00   1/2/1992   12/31/2299
21750   7   CLOSURE OF STERNOTOMY SEPARATION WITH OR WITHOUT D   N   3    $13.45   6/1/1994   12/31/2299
21750   8   CLOSURE OF STERNOTOMY SEPARATION WITH OR WITHOUT D   N   3    $82.95   1/1/2004   12/31/2299
21800   2   TREATMENT OF RIB FRACTURE; CLOSED, UNCOMPLICATED,    N   3    $22.00   1/1/1971   12/31/2299




                                                                                                       36
21800   F   TREATMENT OF RIB FRACTURE; CLOSED, UNCOMPLICATED,                   N   3   $225.80   3/1/2004   12/31/2299
21805   2   TREATMENT OF RIB FRACTURE; OPEN OR COMPLICATED, EA                  N   3    $35.00   1/1/1984   12/31/2299
21805   7   TREATMENT OF RIB FRACTURE; OPEN OR COMPLICATED, EA                  N   3    $13.45   6/1/1994   12/31/2299
21805   F   TREATMENT OF RIB FRACTURE; OPEN OR COMPLICATED, EA                  N   3   $306.00   3/1/2004   12/31/2299
21810   2   TREATMENT OF RIB FRACTURE; CLOSED OR OPEN REQUIRIN                  N   3   $100.00   1/1/1984   12/31/2299
21810   7   TREATMENT OF RIB FRACTURE; CLOSED OR OPEN REQUIRIN                  N   3    $13.45   6/1/1994   12/31/2299
21820   2   TREATMENT OF STERNUM FRACTURE; CLOSED                               N   3    $25.00   1/1/1984   12/31/2299
21820   F   TREATMENT OF STERNUM FRACTURE; CLOSED                               N   3   $225.80   3/1/2004   12/31/2299
21825   2   TREATMENT OF STERNUM FRACTURE; OPEN                                 N   3   $100.00   1/1/1984   12/31/2299
21825   7   TREATMENT OF STERNUM FRACTURE; OPEN                                 N   3    $13.45   6/1/1994   12/31/2299
21899   7   UNLISTED PROCEDURE, NECK OR THORAX                                  N   3    $13.45   6/1/1994   12/31/2299
21920   2   BPSY SFT TISSUE BACK OR FLANK SUPERFICIAL                           N   3    $50.00   7/1/1988   12/31/2299
21925   2   BIOPSY SFT TISSUE BACK FLANK DEEP                                   N   3   $150.00   7/1/1988   12/31/2299
21925   F   BIOPSY SFT TISSUE BACK FLANK DEEP                                   N   3   $306.00   3/1/2004   12/31/2299
21930   2   EXCISION TUMOR SFT TISSUE BACK FLANK                                N   3   $240.00   1/2/1996   12/31/2299
21930   7   EXCISION TUMOR SOFT TISSUE BACK FLANK                               N   3    $13.45   6/1/1994   12/31/2299
21930   F   EXCISION TUMOR SFT TISSUE BACK FLANK                                N   3   $306.00   3/1/2004   12/31/2299
21935   2   RADICAL RESECT TUMOR (MAL NEOP) SFT TISS BCK FLANK                  N   3   $720.67   1/1/2002   12/31/2299
21935   F   RADICAL RESECT TUMOR (MAL NEOP) SFT TISS BCK FLANK                  N   3   $351.00   3/1/2004   12/31/2299
22010   2   DELETED BY HCFA USE 21920                                           N   3   $473.85   1/1/2006   12/31/2299
22100   2   PART EXCSN OF POST VERTEBRL CMPNT FOR BONY LESION, 1 VRTBRT SGMNT   N   3   $200.00   1/1/1996   12/31/2299
22100   7   PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS                   N   3    $13.45   6/1/1994   12/31/2299
22101   2   PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS                   N   3   $200.00   1/1/1984   12/31/2299
22101   7   PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS                   N   3    $13.45   6/1/1994   12/31/2299
22102   2   PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS                   N   3   $200.00   1/1/1984   12/31/2299
22102   7   PARTIAL RESECTION OF VERTEBRAL COMPONENT, SPINOUS                   N   3    $13.45   6/1/1994   12/31/2299
22103   2   PARTIAL EXCISION OF POSTERIOR VERTEBRAL CMPONENT; EA ADDL SEGMENT   N   3   $121.33   1/1/1996   12/31/2299
22103   8   PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT,EA ADDL SEGMENT   N   3    $27.27   1/1/1996   12/31/2299
22105   7   PARTIAL RESECTION OF VERTEBRAL COMPONENT FOR TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
22106   7   PARTIAL RESECTION OF VERTEBRAL COMPONENT FOR TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
22107   7   PARTIAL RESECTION OF VERTEBRAL COMPONENT FOR TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
22110   2   PART EXCISION OF VRTRBRL BONDY FOR BONY LESION, W/O DECOMPRESSION   N   3   $300.00   1/1/1996   12/31/2299
22110   7   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION);CERV                  N   3    $13.45   6/1/1994   12/31/2299
22111   2   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION)WITH                   N   3   $300.00   1/1/1984   12/31/2299
22111   7   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION)WITH                   N   3    $13.45   6/1/1994   12/31/2299
22112   2   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); THO                  N   3   $300.00   1/1/1984   12/31/2299
22112   7   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); THO                  N   3    $13.45   6/1/1994   12/31/2299
22113   2   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); WIT                  N   3   $300.00   1/1/1984   12/31/2299
22113   7   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); WIT                  N   3    $13.45   6/1/1994   12/31/2299
22114   2   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); LUM                  N   3   $300.00   1/1/1984   12/31/2299
22114   7   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); LUM                  N   3    $13.45   6/1/1994   12/31/2299
22115   2   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); WIT                  N   3   $300.00   1/1/1984   12/31/2299
22115   7   PARTIAL EXCISION OF VERTEBRAE (CRATERIZATION); WIT                  N   3    $13.45   6/1/1994   12/31/2299
22116   2   PARTIAL EXCISION OF VERTEBRAL BODY;EA ADDL VERTEBRAL SEGMENT        N   3   $120.12   1/1/1996   12/31/2299
22116   8   PARTIAL EXCISION OF VERTEBRAL BODY; EA ADDL VERTEBRAL SEGMENT       N   3    $24.02   1/1/1996   12/31/2299
22135   7   (CERVICAL, THORACIC, AND LUMBAR SPINE)                              N   3    $13.45   6/1/1994   12/31/2299
22140   7   RECONSTRUCT SPINE W/BONE GRAFT SINGLE VERTEBRA                      N   3    $13.45   6/1/1994   12/31/2299
22141   7   RECONSTRUCT SPINE W/BONE GRAFT SINGLE VERTEBRA                      N   3    $13.45   6/1/1994   12/31/2299
22142   7   RECONSTRUCT SPINE W/BONE GRAFT OR METHYL LUMBAR                     N   3    $13.45   6/1/1994   12/31/2299
22148   7   HARVEST BONE AUTOGRAFT-RECONSTRUCT VERTEBRA                         N   3    $13.45   6/1/1994   12/31/2299
22206   7   OSTEOTOMY OF SPINE FOR CORRECTION FIXED DEFORMITY;                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      37
22207   7   OSTEOTOMY OF SPINE FOR CORRECTION FIXED DEFORMITY;                  N   3    $13.45   6/1/1994   12/31/2299
22210   2   OSTOTMY SPN POSTERIOR/OLATERAL, 1 VRTRBRL SGMT, CERVICAL            N   3   $800.00   1/1/1996   12/31/2299
22210   7   OSTEOTOMY CERV SPINE POST APPRCH SINGLE SEGMENT                     N   3    $13.45   6/1/1994   12/31/2299
22210   8   OSTEOTOMY CERV SPINE POST APPRCH SINGLE SEGMENT                     N   3   $160.00   7/1/1988   12/31/2299
22212   2   OSTOTMY SPN POST APRCH FOR CORR DFMTY SNGL SEC THO                  N   3   $800.00   7/1/1988   12/31/2299
22212   7   OSTEOTOMY THOR SPINE POST APPRCH SINGLE SEGMENT                     N   3    $13.45   6/1/1994   12/31/2299
22212   8   OSTEOTOMY THOR SPINE POST APPRCH SINGLE SEGMENT                     N   3   $160.00   7/1/1988   12/31/2299
22214   2   OSTOTMY SPN POST APRCH FOR CORR DFMTY SNCL SEC LUM                  N   3   $800.00   7/1/1988   12/31/2299
22214   7   OSTEOTOMY LUMB SPINE POST APPRCH SINGLE SEGMENT                     N   3    $13.45   6/1/1994   12/31/2299
22214   8   OSTEOTOMY LUMB SPINE POST APPRCH SINGLE SEGMENT                     N   3   $160.00   7/1/1988   12/31/2299
22216   2   OSTEOTOMY OF SPINE; VERTEBRAL SEGMENT; EA. ADD'L SEGMENT            N   3   $294.37   1/1/1996   12/31/2299
22216   8   OSTEOTOMY OF SPINE; VERTEBRAL SEGMENT; EA. ADD'L SEGMENT            N   3    $58.87   1/1/1996   12/31/2299
22220   2   OSTOTMY SPN,INCL DSKCTMY, ANTER APPRCH, 1 VRTRBRL SGMT, CERVICAL    N   3   $800.00   1/1/1996   12/31/2299
22220   7   OSTEOTOMY CERV SPINE ANT APPRCH SINGLE SEGMENT                      N   3    $13.45   6/1/1994   12/31/2299
22220   8   OSTEOTOMY CERV SPINE ANT APPRCH SINGLE SEGMENT                      N   3   $160.00   7/1/1988   12/31/2299
22222   2   OSTOTMY SPN ANTR APRCH FOR CORR DFMTY SNGL SEC THO                  N   3   $800.00   7/1/1988   12/31/2299
22222   7   OSTEOTOMY THOR SPINE ANT APPROACH SINGLE SEGMENT                    N   3    $13.45   6/1/1994   12/31/2299
22222   8   OSTEOTOMY THOR SPINE ANT APPROACH SINGLE SEGMENT                    N   3   $160.00   7/1/1988   12/31/2299
22224   2   OSTOTMY SPN ANTR APRCH FOR CORR DFMTY SNGL SEC LUM                  N   3   $800.00   7/1/1988   12/31/2299
22224   7   OSTEOTOMY OF LUMB SPINE ANT APPRCH SINGLE SEGMENT                   N   3    $13.45   6/1/1994   12/31/2299
22224   8   OSTEOTOMY OF LUMBAR SPINE ONE SEGMNT ANT APPROACH                   N   3   $160.00   7/1/1988   12/31/2299
22226   2   OSTEOTOMY OF SPINE; EA. ADD'L SEGMENT                               N   3   $294.37   1/1/1996   12/31/2299
22226   8   OSTEOTOMY OF SPINE; EA. ADD'L SEGMENT                               N   3    $58.87   1/1/1996   12/31/2299
22230   2   OSTOTMY SPN FOR CRCTN DEFOR EACH ADDNTL SEG                         N   3   $200.00   7/1/1988   12/31/2299
22250   7   PROPHYLACTIC TREATMENT (PLATING AND/OR WIRING) WIT                  N   3    $13.45   6/1/1994   12/31/2299
22251   7   PROPHYLACTIC TREATMENT (PLATING AND/OR WIRING) WIT                  N   3    $13.45   6/1/1994   12/31/2299
22305   2   TREATMENT OF VERTEBRAL PROCESS FRACTURE, EACH                       N   3   $100.00   1/1/1984   12/31/2299
22305   7   TREATMENT OF VERTEBRAL PROCESS FRACTURE, EACH                       N   3    $13.45   6/1/1994   12/31/2299
22305   F   TREATMENT OF VERTEBRAL PROCESS FRACTURE, EACH                       N   3   $225.80   3/1/2004   12/31/2299
22310   2   CLOSED TRTMNT OF VRTRBRL FRACTURE, NO MANIP, INC. CAST/BRACE        N   3   $100.00   1/1/1996   12/31/2299
22310   7   TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR DISLOC                  N   3    $13.45   6/1/1994   12/31/2299
22310   F   CLOSED TRTMNT OF VRTRBRL FRACTURE, NO MANIP, INC. CAST/BRACE        N   3   $225.80   3/1/2004   12/31/2299
22315   2   CLOSED TRTMT OF VRTRBRL FRCTR/DISLOC W/ CAST/BRAC W/-W/O ANSTHSIA   N   3   $175.00   1/1/1996   12/31/2299
22315   7   TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR DISLOC                  N   3    $13.45   6/1/1994   12/31/2299
22315   F   CLOSED TRTMT OF VRTRBRL FRCTR/DISLOC W/ CAST/BRAC W/-W/O ANSTHSIA   N   3   $306.00   3/1/2004   12/31/2299
22318   2   OPEN TX/REDUC ODONTOID FRAC/DISLOC ANT APPROACH INC PLACE INT FIX   N   3   $882.27   1/1/2000   12/31/2299
22318   7   OPEN TX/REDUC ODONTOID FRAC/DISLOC ANT APPROACH INCL PLACE INT FI   N   3    $13.45   1/1/2000   12/31/2299
22318   8   OPEN TX/REDUC ODONTOID FRAC/DISLOC ANT APPROACH INCL PLACE INT FI   N   3   $176.45   1/1/2000   12/31/2299
22319   2   OPEN TX/REDUC ODONTOID FRAC/DISLOC ANT APPROACH INCL INT FIX W/GR   N   3   $996.92   1/1/2000   12/31/2299
22319   7   OPEN TX/REDUC ODONTOID FRAC/DISLOC ANT APPROACH INCL INT FIX W/GR   N   3    $13.45   1/1/2000   12/31/2299
22319   8   OPEN TX/REDUC ODONTOID FRAC/DISLOC ANT APPROACH INCL INT FIX W/GR   N   3   $199.38   1/1/2000   12/31/2299
22325   2   OPEN TRTMNT OF VRTRBRL FRACT/DISLOC, POST APPRCH, 1 VERT/SGMNT      N   3   $600.00   1/1/1996   12/31/2299
22325   7   OPEN TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR                    N   3    $13.45   6/1/1994   12/31/2299
22325   8   OPEN TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR                    N   3   $120.00   1/1/1973   12/31/2299
22326   2   OPEN TRTMNT OF VRTRBRL FRACT/DISLOC,POST APPRCH, 1 VRT/SGMT THORA   N   3   $600.00   1/1/1996   12/31/2299
22326   7   OPEN TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR                    N   3    $13.45   6/1/1994   12/31/2299
22326   8   OPEN TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR                    N   3   $120.00   1/1/1984   12/31/2299
22327   2   OPEN TRTMNT OF VERT FRACT/DISLOC, POST APPRCH 1 VRT/SGMT CERVICAL   N   3   $600.00   1/1/1996   12/31/2299
22327   7   OPEN TREATMENT OF VERTEBRAL BODY FRACTURE AND/OR                    N   3    $13.45   6/1/1994   12/31/2299
22328   2   OPEN TREATMENT OF VERTEBRAL FRACTURES; EA. ADD'L FRACTURED VERTBR   N   3   $239.01   1/1/1996   12/31/2299
22328   8   OPEN TREATMENT OF VERTEBRAL FRACTURES; EA. ADD'L FRACTURED VERTEB   N   3    $47.80   1/1/1996   12/31/2299




                                                                                                                      38
22330   7   OPEN TREATMENT AND FUSION, CERVICAL SPINE; POSTERI                  N   3    $13.45   6/1/1994   12/31/2299
22330   8   OPEN TREATMENT AND FUSION, CERVICAL SPINE; POSTERI                  N   3   $140.00   1/1/1973   12/31/2299
22335   7   OPEN TREATMENT AND FUSION, CERVICAL SPINE; POSTERI                  N   3    $13.45   6/1/1994   12/31/2299
22335   8   OPEN TREATMENT AND FUSION, CERVICAL SPINE; POSTERI                  N   3   $155.00   1/1/1973   12/31/2299
22345   7   OPEN TREATMENT AND FUSION, CERVICAL SPINE; ANTERIO                  N   3    $13.45   6/1/1994   12/31/2299
22345   8   OPEN TREATMENT AND FUSION, CERVICAL SPINE; ANTERIO                  N   3   $150.00   1/1/1973   12/31/2299
22355   7   OPEN TREATMENT AND FUSION, POSTERIOR,WITH LOCAL BO                  N   3    $13.45   6/1/1994   12/31/2299
22355   8   OPEN TREATMENT AND FUSION, POSTERIOR,WITH LOCAL BO                  N   3   $130.00   1/1/1973   12/31/2299
22356   7   OPEN TREATMENT AND FUSION, POSTERIOR,WITH LOCAL BO                  N   3    $13.45   6/1/1994   12/31/2299
22360   7   OPEN TREATMENT & FUSION,POSTERIOR,WITH ILIAC OR OT                  N   3    $13.45   6/1/1994   12/31/2299
22360   8   OPEN TREATMENT & FUSION,POSTERIOR,WITH ILIAC OR OT                  N   3   $180.00   1/1/1984   12/31/2299
22361   7   OPEN TREATMENT & FUSION,POSTERIOR WITH ILIAC OR OT                  N   3    $13.45   6/1/1994   12/31/2299
22361   8   OPEN TREATMENT & FUSION,POSTERIOR WITH ILIAC OR OT                  N   3   $150.00   1/1/1973   12/31/2299
22370   7   OPEN TREATMENT & FUSION,POSTEROLATERAL OR ANTEROLA                  N   3    $13.45   6/1/1994   12/31/2299
22371   7   OPEN TREATMENT & FUSION,POSTEROLATERAL OR ANTEROLA                  N   3    $13.45   6/1/1994   12/31/2299
22379   7   HARRINGTON ROD TECHNIQUE                                            N   3    $13.45   6/1/1994   12/31/2299
22505   2   MANIPULATION OF SPINE REQUIRING ANESTHESIA, ANY RE                  N   3    $40.00   3/1/1987   12/31/2299
22505   7   MANIPULATION OF SPINE REQUIRING ANESTHESIA, ANY RE                  N   3    $13.45   6/1/1994   12/31/2299
22505   F   MANIPULATION OF SPINE REQUIRING ANESTHESIA, ANY RE                  N   3   $306.00   3/1/2004   12/31/2299
22520   2   PERCUT.VERTEBRO.ONE VERTEB.BODY UNILATERAL OR BILAT.INJ.THORACIC    N   3   $314.22   1/1/2001   12/31/2299
22521   2   PERCUT.VERTEB.ONE VERTEB.BODY UNILAT.OR BILAT.INJ.LUMB.             N   3   $294.80   1/1/2001   12/31/2299
22522   2   PERCUT.VERTEB.ONE VERTEB.BODY UNILAT.OR BILAT.INJECTION             N   3   $102.73   1/1/2001   12/31/2299
22523   2   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUTING CAVITY CERATION (F   N   3   $355.27   1/1/2006   12/31/2299
22523   7   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUTING CAVITY CERATION (F   N   3    $13.45   1/1/2006   12/31/2299
22523   8   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUTING CAVITY CERATION (F   N   3    $71.05   1/1/2006   12/31/2299
22524   2   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (F   N   3   $340.47   1/1/2006   12/31/2299
22524   7   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (F   N   3    $13.45   1/1/2006   12/31/2299
22524   8   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (F   N   3    $68.09   1/1/2006   12/31/2299
22525   2   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (F   N   3   $162.58   1/1/2006   12/31/2299
22525   7   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (F   N   3    $13.45   1/1/2006   12/31/2299
22525   8   PERCUTANEOUS VERTEBRAL AUGMENTATION, INCLUDING CAVITY CREATION (F   N   3    $32.52   1/1/2006   12/31/2299
22526   2   IDET.SINGLE LEVEL                                                   N   3   $185.08   1/1/2007   12/31/2299
22526   7   MAST. MOD RAD                                                       N   3    $13.45   1/1/2007   12/31/2299
22527   2   IDET. 1 OR MORE LEVELS                                              N   3    $84.98   1/1/2007   12/31/2299
22527   7   IDET. 1 OR MORE LEVELS                                              N   3    $13.45   1/1/2007   12/31/2299
22532   2   ARTHRODESIS LATERAL EXTRACAVITARY TECHNIQUE INCLUDING MINI          N   3   $968.93   1/1/2004   12/31/2299
22533   2   ARTHRODESIS LATERAL EXTRACAVITARY TECHNIQUE                         N   3   $904.28   1/1/2004   12/31/2299
22534   2   ARTHRODESIS, LATERAL EXTRACAVITARY TECHNIQUE INCLUDING MINIMAL DI   N   3   $227.68   1/1/2004   12/31/2299
22546   8   OPEN TREATMENT OF HUMERAL SUPRACONDYLAR WITH INTERCONDYLAR EXTENS   N   3   $114.00   1/2/1994   12/31/2299
22548   2   ARTHRDS, ANTR TRNSRL/EXTRLRL TECH, CLIVUS C1-C2 W/-W/O EXCISION     N   3   $700.00   1/1/1996   12/31/2299
22548   7   ARTHRDSIS ANT TROR OR XTRORL C1-C2 W BN GFT W WO O                  N   3    $13.45   6/1/1994   12/31/2299
22548   8   ARTHRDSIS ANT TROR OR XTRORL C1-C2 W BN GFT W WO O                  N   3   $140.00   1/1/1984   12/31/2299
22550   7   ARTHRODESIS WITH DISKECTOMY, CERVICAL,POSTERIOR;LO                  N   3    $13.45   6/1/1994   12/31/2299
22550   8   ARTHRODESIS WITH DISKECTOMY, CERVICAL,POSTERIOR;LO                  N   3   $140.00   1/1/1973   12/31/2299
22552   7   ARTHRODESIS WITH DISKECTOMY, CERVICAL,POSTERIOR;WI                  N   3    $13.45   6/1/1994   12/31/2299
22552   8   ARTHRODESIS WITH DISKECTOMY, CERVICAL,POSTERIOR,WI                  N   3   $160.00   1/1/1973   12/31/2299
22554   2   ARTHRDS,ANTER INTRBDY TECH, MIN DSKCTMY TO PREP INTRSPC, CERVICAL   N   3   $700.00   1/1/1996   12/31/2299
22554   7   ARTRODIS ANT BODY TECH CERV BLOW C-2 W BNE GRAFT                    N   3    $13.45   6/1/1994   12/31/2299
22554   8   ARTRODIS ANT BODY TECH CERV BLOW C-2 W BNE GRAFT                    N   3   $240.00   1/1/1984   12/31/2299
22555   7   ARTHRODESIS WITH DISKECTOMY, CERVICAL, ANTERIOR,WI                  N   3    $13.45   6/1/1994   12/31/2299
22555   8   ARTHRODESIS WITH DISKECTOMY, CERVICAL, ANTERIOR,WI                  N   3   $140.00   1/1/1974   12/31/2299




                                                                                                                      39
22556   2   ARTHRDSIS,ANTER INTER TECH, MIN DISKCTMY TO PREP INTRSPC, THRACIC   N   3    $600.00    1/1/1996   12/31/2299
22556   7   ARTHRODESIS, THORACIC, WITH LOCAL BONE RIB                          N   3      $13.45   6/1/1994   12/31/2299
22558   2   ARTHRDES, ANT INTER TECH,MIN DSKCTMY TO PREP INTRSPC, LUMBAR        N   3    $600.00    1/1/1996   12/31/2299
22558   7   ARTHRODESIS, LUMBAR, WITH BONE GRAFT                                N   3      $13.45   6/1/1994   12/31/2299
22558   8   ARTHRODESIS, LUMBAR WITH BONE GRAFT                                 N   3    $120.00    1/2/1993   12/31/2299
22560   7   ARTHRODESIS WITH DISKECTOMY, LUMBAR OR THORACIC,PO                  N   3      $13.45   6/1/1994   12/31/2299
22560   8   ARTHRODESIS WITH DISKECTOMY, LUMBAR OR THORACIC,PO                  N   3    $130.00    1/1/1973   12/31/2299
22561   7   ARTHRODESIS WITH DISKECTOMY, LUMBAR OR THORACIC;WI                  N   3      $13.45   6/1/1994   12/31/2299
22561   8   ARTHRODESIS WITH DISKECTOMY, LUMBAR OR THORACIC;WI                  N   3    $140.00    8/1/1979   12/31/2299
22565   7   ARTHRODESIS WITH DISKECTOMY, LOWER LUMBAR SPINE, A                  N   3      $13.45   6/1/1994   12/31/2299
22565   8   ARTHRODESIS WITH DISKECTOMY, LOWER LUMBAR SPINE, A                  N   3    $113.00    8/1/1979   12/31/2299
22585   2   ARTHRDES, ANT INTER TECH, MIN DSKCTMY TO PREP INTRSPC, EA INTRSPC   N   3      $75.00   1/1/1996   12/31/2299
22585   7   ARTHRODESIS EACH ADDT'L INTRSPACE IN ADD TO SNG LE                  N   3      $13.45   6/1/1994   12/31/2299
22585   8   ARTHRODESIS EA ADDT'L INTRSPACE IN ADD TO SNGLE LE                  N   3      $15.00   1/1/1984   12/31/2299
22590   2   ARTHRDSIS, POST TECHNIQUE, CRANIOCERVICAL (OCCIPUT C-2_)            N   3    $700.00    1/1/1996   12/31/2299
22590   7   ARTHRDSIS POST TEC CRNOCRVCL OCC-C2 W BNE GRFT FIX                  N   3      $13.45   6/1/1994   12/31/2299
22590   8   ARTHRDSIS POST TEC CRNOCRVCL OCC - C2 W BN GFT FIX                  N   3    $140.00    1/1/1984   12/31/2299
22595   2   ARTHODESIS, POSTERIOR TECHNIQUE, ATLAS-AXIS (C1-C2)                 N   3    $700.00    1/1/1997   12/31/2299
22595   7   ARTHORDESIS POST TECH ATLASAXIS W/BONE GRAFT                        N   3      $13.45   6/1/1994   12/31/2299
22595   8   ARTHRODESIS,POSTERIOR TECHNIQUE, CRANIOCERVICAL (OCCIPUT-C-2)       N   3    $221.00    1/2/1994   12/31/2299
22600   2   ARTHDSIS, POSTERIOR/OLATERAL TECH, 1 LEVEL, CERVICAL BELOW C2 SEG   N   3    $700.00    1/1/1996   12/31/2299
22600   7   CERVICAL FUSION, POSTERIOR APPROACH, BELOW C1 LEVE                  N   3      $13.45   6/1/1994   12/31/2299
22600   8   CERVICAL FUSION, POSTERIOR APPROACH, BELOW C1 LEVE                  N   3    $120.00    1/1/1973   12/31/2299
22605   2   CERVICAL FUSION, POSTERIOR APPROACH, BELOW C1 LEVE                  N   3    $700.00    1/1/1973   12/31/2299
22605   7   CERVICAL FUSION, POSTERIOR APPROACH, BELOW C1 LEVE                  N   3      $13.45   6/1/1994   12/31/2299
22605   8   CERVICAL FUSION, POSTERIOR APPROACH, BELOW C1 LEVE                  N   3    $140.00    1/1/1973   12/31/2299
22610   2   ARTHODES, POSTERIOR/OLATERAL TECH, 1 LEVEL THORACIC                 N   3    $800.00    1/1/1996   12/31/2299
22610   7   ARTHRODESIS,POST TECHNQ,W/LOCAL BONE ALLOGRFT;THOR                  N   3      $13.45   6/1/1994   12/31/2299
22612   2   ARTHODES, POSTERIOR/OLATERAL TECH, 1 LEVEL, LUMBAR                  N   3   $1,260.00   1/1/1996   12/31/2299
22612   7   ARTHRODESIS LUMBAR SPINE                                            N   3      $13.45   6/1/1994   12/31/2299
22612   8   ARTRDSIS POST POSTLAT TECH W BNE GRFT FIXAT LUMBAR                  N   3    $252.00    1/2/1992   12/31/2299
22614   2   ARTHRODESIS; SINGLE LEVEL; EA. ADDL VERTEBRAL SEGMENT               N   3    $324.00    1/2/1996   12/31/2299
22614   8   ARTHRODESIS; SINGLE LEVEL; EA. ADD'L VERTEBRAL SEGMENT              N   3      $64.80   1/1/1996   12/31/2299
22615   7   CERVICAL FUSION, ANTERIOR APPROACH (C3-T1) WITH IL                  N   3      $13.45   6/1/1994   12/31/2299
22615   8   CERVICAL FUSION, ANTERIOR APPROACH (C3-T1) WITH IL                  N   3    $140.00    1/1/1973   12/31/2299
22617   2   ATLAS-AXIS FUSION (C1-C2 OR C3) WITH ILIAC OR OTHE                  N   3       $0.00   7/1/1988   12/31/2299
22617   7   ATLAS-AXIS FUSION (C1-C2 OR C3) WITH ILIAC OR OTHE                  N   3      $13.45   6/1/1994   12/31/2299
22617   8   ATLAS-AXIS FUSION (C1-C2 OR C3) WITH ILIAC OR OTHE                  N   3    $140.00    1/1/1984   12/31/2299
22620   2   CERVICOCRANIAL FUSION (OCCIPUT THROUGH C2) WITH IL                  N   3    $700.00    1/1/1984   12/31/2299
22620   7   CERVICOCRANIAL FUSION (OCCIPUT THROUGH C2) WITH IL                  N   3      $13.45   6/1/1994   12/31/2299
22625   7   ARTHORDESIS,POSTERIOR,POST OR LAT TRANS PROC TECH                   N   3      $13.45   6/1/1994   12/31/2299
22630   2   ARTHODESIS, POSTERIOR INTERBODY TECHNIQUE, 1 INTERSPACE, LUMBAR     N   3   $1,020.00   1/1/1996   12/31/2299
22630   7   ARTRODIS POST INT TECH W BONE OR INT FIX LUMBAR                     N   3      $13.45   6/1/1994   12/31/2299
22630   8   ARTRODIS POST INT TECH W BONE OR INT FIX LUMBAR                     N   3    $204.00    1/2/1995   12/31/2299
22632   2   ARTHRODESIS; EA. ADD'L INTERSPACE                                   N   3    $271.18    1/1/1996   12/31/2299
22632   8   ARTHRODESIS; EA. ADD'L INTERSPACE                                   N   3      $54.24   1/1/1996   12/31/2299
22640   7   THORACIC OR LUMBAR FUSION, POSTERIOR OR POSTEROLAT                  N   3      $13.45   6/1/1994   12/31/2299
22640   8   THORACIC OR LUMBAR FUSION, POSTERIOR OR POSTEROLAT                  N   3    $120.00    1/1/1973   12/31/2299
22645   7   THORACIC OR LUMBAR FUSION, POSTERIOR OR POSTEROLAT                  N   3      $13.45   6/1/1994   12/31/2299
22645   8   THORACIC OR LUMBAR FUSION, POSTERIOR OR POSTEROLAT                  N   3    $140.00    1/1/1973   12/31/2299
22655   7   THORACIC OR LUMBAR FUSION;POSTERIOR,WITH ILIAC OR                   N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                        40
22655   8   THORACIC OR LUMBAR FUSION;POSTERIOR,WITH ILIAC OR                   N   3    $160.00    1/1/1973   12/31/2299
22670   7   THORACIC OR LUMBAR FUSION;LATERAL,WITH ILIAC OR OT                  N   3      $13.45   6/1/1994   12/31/2299
22670   8   THORACIC OR LUMBAR FUSION;LATERAL,WITH ILIAC OR OT                  N   3    $160.00    1/1/1973   12/31/2299
22680   7   THORACIC OR LUMBAR FUSION;ANTEROLATERAL OR ANTERIO                  N   3      $13.45   6/1/1994   12/31/2299
22680   8   THORACIC OR LUMBAR FUSION;ANTEROLATERAL OR ANTERIO                  N   3    $160.00    1/1/1973   12/31/2299
22700   7   LUMBAR SPINE FUSION; ANTERIOR INTERBODY FUSION                      N   3      $13.45   6/1/1994   12/31/2299
22700   8   LUMBAR SPINE FUSION; ANTERIOR INTERBODY FUSION                      N   3    $120.00    1/1/1973   12/31/2299
22720   7   LUMBAR SPINE FUSION; POSTERIOR, HARRINGTON OR KNOD                  N   3      $13.45   6/1/1994   12/31/2299
22720   8   LUMBAR SPINE FUSION; POSTERIOR, HARRINGTON OR KNOD                  N   3    $150.00    1/1/1973   12/31/2299
22730   7   ARTHRODESIS, PRIMARY OR REPAIR OF PSEUDARTHROSIS;                   N   3      $13.45   6/1/1994   12/31/2299
22730   8   ARTHRODESIS, PRIMARY OR REPAIR OF PSEUDARTHROSIS;                   N   3      $30.00   1/1/1973   12/31/2299
22735   7   ARTHRODESIS, PRIMARY OR REPAIR OF PSEUDARTHROSIS;                   N   3      $13.45   6/1/1994   12/31/2299
22800   2   ARTHRDES, POST FOR SPINE DEFORM, W/-W/O CAST,UP TO 6 VERT SEGMENT   N   3    $807.00    1/1/1996   12/31/2299
22800   7   ARTHRODESIS,PRIMARY FOR SCOLIOSIS(W-W/O POSTOP CAS                  N   3      $13.45   6/1/1994   12/31/2299
22800   8   ARTHRODESIS,PRIMARY FOR SCOLIOSIS(W-W/O POSTOP CAS                  N   3    $170.00    1/1/1984   12/31/2299
22801   7   ARTHRODESIS, PRIMARY FOR SCOLIOSIS, 6 OR LESS VERT                  N   3      $13.45   6/1/1994   12/31/2299
22801   8   ARTHRODESIS, PRIMARY FOR SCOLIOSIS, 6 OR LESS VERT                  N   3    $185.00    1/1/1973   12/31/2299
22802   2   ARTHODESIS, POSTERIOR FOR SPINE DEFORM, 2/-W/O CAST,4-7 SEGMENTS    N   3   $1,308.00   1/1/1996   12/31/2299
22802   7   ARTHRODESIS,PRIMARY FOR SCOLIOSIS(W-W/O POSTOP CAS                  N   3      $13.45   6/1/1994   12/31/2299
22802   8   ARTHRODESIS,PRIMARY FOR SCOLIOSIS(W-W/O POSTOP CAS                  N   3    $300.00    1/2/1994   12/31/2299
22803   7   ARTHRODESIS, PRIMARY FOR SCOLIOSIS, 7 OR MORE VERT                  N   3      $13.45   6/1/1994   12/31/2299
22804   2   ARTHRODESIS; 13 OR MORE VERTEBRAL SEGMENTS                          N   3   $1,666.68   1/1/1996   12/31/2299
22804   7   ARTHRODESIS; 13 OR MORE VERTEBRAL SEGMENTS                          N   3      $13.45   1/1/1996   12/31/2299
22804   8   ARTHRODESIS; 13 OR MORE VERTEBRAL SEGMENTS                          N   3    $333.34    1/1/1996   12/31/2299
22808   2   ARTHRODESIS; ANTERIOR; 2 TO 3 VERTEBRAL SEGMENTS                    N   3   $1,141.25   1/1/1996   12/31/2299
22808   7   ANESTHESIA, ARTHRODESIS;ANTERIOR;2TO3 VERTEBRAL SEGMENTS            N   3      $13.45   1/1/1996   12/31/2299
22808   8   ARTHRODESIS; ANTERIOR; 2 TO 3 VERTEBRAL SEGMENTS                    N   3    $228.25    1/1/1996   12/31/2299
22810   2   ARTHRODESIS ANT/SPINE DEFORM W/WO CAST 4-7 VERT                     N   3   $1,032.00   1/2/1993   12/31/2299
22810   7   ARTHRODESIS ANT/SPINE DEFORM W/WO CAST 4-7 VERT                     N   3      $13.45   6/1/1994   12/31/2299
22810   8   ARTHRODESIS ANT/SPINE DEFORM W/WO CAST 4-7 VERT                     N   3    $180.00    1/1/1984   12/31/2299
22812   2   ARTHRODES, ANTERIOR, SPINE DEFORM, W/-W/O CAST, 8+ VERT SEGMENTS    N   3    $900.00    1/1/1996   12/31/2299
22812   7   ARTRODS FOR SP DEF ANT W WO CAST GRAFT 8 OR MOR VR                  N   3      $13.45   6/1/1994   12/31/2299
22812   8   ARTRODS FOR SP DEF ANT W WO CAST GRAFT 8 OR MOR VR                  N   3    $180.00    1/1/1984   12/31/2299
22818   2   KYPECTOMY,CIRCUMF.EXPOS.SPINE&RESEC.VERTEBRAL SEG. 1 OR 2 SEGMENT   N   3   $1,380.80   1/1/1998   12/31/2299
22818   7   KYPHECTOMY,CIRCUM.EXPOSURE OF SPINE/RESEC.VERTEBRAL SEG.1OR2 SEGM   N   3      $13.45   1/1/1998   12/31/2299
22818   8   KYPHECTOMY,CIRCUM.EXPOS. SPINE&RESEC.VERTREBRAL SEG. 1 OR 2 SEGME   N   3    $276.16    1/1/1998   12/31/2299
22819   2   KYPHECTOMY,CIRCUM.EXPOS.SPINE&RESEC.VERTEBRAL SEG.3 OR MORE         N   3   $1,472.74   1/1/1998   12/31/2299
22819   7   KYPHECTOMY,CIRCUM.EXPOS.SPINE&RESEC.VERTEBRAL SEGMENTS 3OR MORE     N   3      $13.45   1/1/1998   12/31/2299
22819   8   KYPHECTOMY,CIRCUM.EXPOS.SPINE&RESEC.VERTEBRAL SEGMENTS 3 OR MORE    N   3    $294.54    1/1/1998   12/31/2299
22830   2   EXPLORATION OF SPINAL FUSION                                        N   3    $630.00    1/2/1995   12/31/2299
22830   7   EXPLORATION OF SPINAL FUSION                                        N   3      $13.45   6/1/1994   12/31/2299
22830   8   EXPLORATION OF SPINAL FUSION                                        N   3    $126.00    1/2/1995   12/31/2299
22840   2   POSTERIOR NON SEGMENT INSTRMNTAT.(1 HARRINGTON ROD TECHNIQUE)       N   3    $738.00    1/1/1996   12/31/2299
22840   7   POSTERIOR INSTRUMENTATION; (EG,HARRINGTON ROD TECH                  N   3      $13.45   6/1/1994   12/31/2299
22840   8   POSTERIOR INSTRUMENTATION; (EG,HARRINGTON ROD TECH                  N   3    $100.00    1/1/1973   12/31/2299
22841   2   INTERNAL SPINAL FIXATION BY WIRING OF SPINOUS PROCESSES             N   3    $500.00    1/1/1997   12/31/2299
22841   8   INTERNAL SPINAL FIXATION BY WIRING OF SPINOUS PROCESSES             N   3    $100.00    1/1/1997   12/31/2299
22842   2   PEDICLE FIXATION, 2 RODS W/MULT HOOK&SUBLAM WIRE,3-6 VERT SEGMENT   N   3    $810.00    1/1/1996   12/31/2299
22842   7   POSTERIOR INSTMNTATION SE6 WIRING E6 LUQUE TECHN                    N   3      $13.45   6/1/1994   12/31/2299
22842   8   SEGMENTAL WIRING EG LUQUETECH LIST SPTLY                            N   3    $162.00    1/2/1992   12/31/2299
22843   2   PSOTERIOR SEGMENTAL INSTRUMENTATION 3-6 VERTEBRAL SEGMENTS          N   3    $464.75    1/1/1996   12/31/2299




                                                                                                                        41
22843   8   POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VERTEBRAL SEGMENTS          N   3    $92.95   1/1/1996   12/31/2299
22844   2   POSTERIOR SEGMENTAL INSTRUMENTATION 13 OR MORE VERTEBRAL SEGMENTS   N   3   $567.92   1/1/1996   12/31/2299
22844   8   POSTERIOR SEGMENTAL INSTRUMENTATION - 13+ VERTEBRAL SEGMENTS        N   3   $113.58   1/1/1996   12/31/2299
22845   2   ANTERIOR INSTRUMENTATION; 3 VERTEBRAL SEGMENTS                      N   3   $600.00   1/1/1996   12/31/2299
22845   7   ANTERIOR INSTRUMENTATION; (EG, DWYER INSTRUMENTATI                  N   3    $13.45   6/1/1994   12/31/2299
22845   8   ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS                 N   3   $147.00   1/2/1994   12/31/2299
22846   2   ANTERIOR INSTRUMENTATION; 4-7 VERTEBRAL SEGMENTS                    N   3   $429.14   1/1/1996   12/31/2299
22846   8   ANTERIOR INSTRUMENTATION; 4-7 VERTEBRAL SEGMENTS                    N   3    $85.83   1/1/1996   12/31/2299
22847   2   ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL SEGMENTS              N   3   $476.78   1/1/1996   12/31/2299
22847   8   ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL SEGMENTS              N   3    $95.36   1/1/1996   12/31/2299
22848   2   PELVIC FIXATION OTHER THAN SACRUM                                   N   3   $310.97   1/1/1996   12/31/2299
22848   8   PELVIC FIXATION OTHER THAN SACRUM                                   N   3    $62.19   1/1/1996   12/31/2299
22849   2   REINSERTION OF SPINAL FIXATION DEVICE                               N   3   $654.00   1/2/1995   12/31/2299
22849   7   REINSERTION OF SPINAL FIXATION DEVICE                               N   3    $13.45   6/1/1994   12/31/2299
22849   8   REINSERTION OF SPINAL FIXATION DEVICE                               N   3   $131.00   1/2/1995   12/31/2299
22850   2   REMOVAL OF POSTERIOR INSTRUMENTATION (EG, HARRINGT                  N   3   $300.00   1/1/1984   12/31/2299
22850   7   REMOVAL OF POSTERIOR INSTRUMENTATION (EG, HARRINGT                  N   3    $13.45   6/1/1994   12/31/2299
22850   8   REMOVAL OF POSTERIOR INSTRUMENTATION (EG, HARRINGT                  N   3    $91.00   1/2/1994   12/31/2299
22851   2   APPLICATION OF PROSTHETIC DEVICE TO VERTEBRAL DEFECT OR INTERSPAC   N   3   $347.82   1/1/1996   12/31/2299
22851   8   APPLICATION OF PROSTHETIC DEVICE TO VERTEBRAL DEFECT OR INTERSPAC   N   3    $69.56   1/1/1996   12/31/2299
22852   2   RMVL POST SEG INSTRUMENTATION                                       N   3   $486.00   1/2/1995   12/31/2299
22852   7   RMVL POST SEG INSTRUMENTATION                                       N   3    $13.45   6/1/1994   12/31/2299
22852   8   RMVL POST SEG INSTRUMENTATION                                       N   3    $97.00   1/2/1995   12/31/2299
22855   2   REMOVAL OF ANTERIOR INSTRUMENTATION (EG, DWYER DEV                  N   3   $300.00   1/1/1984   12/31/2299
22855   7   REMOVAL OF ANTERIOR INSTRUMENTATION (EG, DWYER DEV                  N   3    $13.45   6/1/1994   12/31/2299
22855   8   REMOVAL OF ANTERIOR INSTRUMENTATION (EG, DWYER DEV                  N   3   $128.49   1/1/2005   12/31/2299
22857   2   LUMBAR ARTIF DISKECTOMY                                             N   3   $779.76   1/1/2007   12/31/2299
22857   7   LUMBAR ARTIF DISKECTOMY                                             N   3    $13.45   1/1/2007   12/31/2299
22857   8   LUMBAR ARTIF DISKECTOMY                                             N   3   $155.00   1/1/2007   12/31/2299
22862   2   REVISE LUMBAR ARTIF DISC                                            N   3   $948.85   1/1/2007   12/31/2299
22862   7   LUMBAR ARTIF DISKECTOMY                                             N   3   $189.00   1/1/2007   12/31/2299
22862   8   LUMBAR ARTIF DISKECTOMY                                             N   3   $189.00   1/1/2007   12/31/2299
22865   2   REVISION INCL REP OF TOT DISC ARTHROPLASTY (ART DISK)               N   3   $924.07   1/1/2007   12/31/2299
22865   7   REVISION INCL REP OF TOT DISC ARTHROPLASTY (ART DISK)               N   3    $13.45   1/1/2007   12/31/2299
22865   8   REVISION INCL REP OF TOT DISC ARTHROPLASTY (ART DISK)               N   3   $184.00   1/1/2007   12/31/2299
22899   7   UNLISTED PROCEDURE, SPINE                                           N   3    $13.45   6/1/1994   12/31/2299
22900   2   EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL                          N   3   $125.00   1/1/1984   12/31/2299
22900   7   EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL                          N   3    $13.45   6/1/1994   12/31/2299
22900   8   EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL                          N   3    $25.00   1/1/1984   12/31/2299
22900   F   EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL                          N   3   $432.00   3/1/2004   12/31/2299
22910   2   ABDOMINAL FASCIAL TRANSPLANTS, BILATERAL                            N   3   $500.00   1/1/1973   12/31/2299
22910   7   ABDOMINAL FASCIAL TRANSPLANTS, BILATERAL                            N   3    $13.45   6/1/1994   12/31/2299
22910   8   ABDOMINAL FASCIAL TRANSPLANTS, BILATERAL                            N   3   $100.00   1/1/1973   12/31/2299
22999   7   UNLISTED PROCEDURE, ABDOMEN, MUSCULOSKELETAL SYSTE                  N   3    $13.45   6/1/1994   12/31/2299
23000   2   REMOVAL OF SUBDELTOID (OR INTRATENDINOUS) CALCAREOUS DEPOSITS       N   3   $150.00   1/1/1973   12/31/2299
23000   7   REMOVAL OF SUBDELTOID (OR INTRATENDINOUS) CALCAREO                  N   3    $13.45   6/1/1994   12/31/2299
23000   F   REMOVAL OF SUBDELTOID (OR INTRATENDINOUS) CALCAREOUS DEPOSITS       N   3   $306.00   3/1/2004   12/31/2299
23020   2   CAPSULAR CONTRACTURE RELEASE (SEVER TYPE) FOR ERB'                  N   3   $275.00   1/1/1973   12/31/2299
23020   7   CAPSULAR CONTRACTURE RELEASE (SEVER TYPE) FOR ERB'                  N   3    $13.45   6/1/1994   12/31/2299
23020   8   CAPSULAR CONTRACTURE RELEASE (SEVER TYPE) FOR ERB'                  N   3    $55.00   1/1/1973   12/31/2299
23020   F   CAPSULAR CONTRACTURE RELEASE (SEVER TYPE) FOR ERB'                  N   3   $306.00   3/1/2004   12/31/2299




                                                                                                                      42
23030   7   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA                     N   3    $13.45   6/1/1994   12/31/2299
23030   F   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA                     N   3   $225.80   3/1/2004   12/31/2299
23031   2   INCISION AND DRAINAGE; INFECTED BURSA                               N   3    $20.00   1/1/1984   12/31/2299
23031   7   INCISION AND DRAINAGE; INFECTED BURSA                               N   3    $13.45   6/1/1994   12/31/2299
23031   F   INCISION AND DRAINAGE; INFECTED BURSA                               N   3   $351.00   3/1/2004   12/31/2299
23035   2   INCISION,BONE CORTEX (EG SEVER TYPE PROCEDURE                       N   3   $150.00   1/1/1984   12/31/2299
23035   7   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3    $13.45   6/1/1994   12/31/2299
23035   F   INCISION,BONE CORTEX (EG SEVER TYPE PROCEDURE                       N   3   $351.00   3/1/2004   12/31/2299
23036   2   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3   $175.00   1/1/1984   12/31/2299
23036   7   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3    $13.45   6/1/1994   12/31/2299
23040   2   ARTHROTOMY GLENOHUMERAL JOINT, INCLUDING EXPLORATION, DRAINAGE OR   N   3   $275.00   1/1/1973   12/31/2299
23040   7   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL O                  N   3    $13.45   6/1/1994   12/31/2299
23040   8   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL O                  N   3    $50.00   1/1/1973   12/31/2299
23040   F   ARTHROTOMY GLENOHUMERAL JOINT, INCLUDING EXPLORATION, DRAINAGE OR   N   3   $351.00   3/1/2004   12/31/2299
23042   2   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL O                  N   3   $300.00   1/1/1984   12/31/2299
23042   7   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL O                  N   3    $13.45   6/1/1994   12/31/2299
23044   2   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL OF FOREIGN BODY    N   3   $150.00   1/1/1984   12/31/2299
23044   7   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL O                  N   3    $13.45   6/1/1994   12/31/2299
23044   F   ARTHROTOMY WITH EXPLORATION, DRAINAGE OR REMOVAL OF FOREIGN BODY    N   3   $432.00   3/1/2004   12/31/2299
23065   2   BIOPSY, SOFT TISSUES; SUPERFICIAL                                   N   3    $50.00   1/1/1984   12/31/2299
23066   2   BIOPSY, SOFT TISSUES; DEEP                                          N   3   $150.00   1/1/1984   12/31/2299
23066   F   BIOPSY, SOFT TISSUES; DEEP                                          N   3   $306.00   3/1/2004   12/31/2299
23075   2   EXCISION,SOFT TISSUE TUMOR,SHOULDER AREA SUBCUTANEOUS               N   3    $50.00   1/1/1984   12/31/2299
23075   F   EXCISION,SOFT TISSUE TUMOR,SHOULDER AREA SUBCUTANEOUS               N   3   $306.00   3/1/2004   12/31/2299
23076   2   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM                  N   3   $150.00   1/1/1984   12/31/2299
23076   7   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM                  N   3    $13.45   6/1/1994   12/31/2299
23076   F   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM                  N   3   $306.00   3/1/2004   12/31/2299
23077   2   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM                  N   3   $707.29   1/1/2002   12/31/2299
23077   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM                  N   3    $13.45   6/1/1994   12/31/2299
23077   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM                  N   3   $351.00   3/1/2004   12/31/2299
23100   2   ARTHROTOMY GLENOHUMERAL JOINT, INCLUDING BIOPSY                     N   3   $275.00   1/1/1973   12/31/2299
23100   7   ARTHROTOMY FOR BIOPSY, GLENOHUMERAL JOINT                           N   3    $13.45   6/1/1994   12/31/2299
23100   F   ARTHROTOMY GLENOHUMERAL JOINT, INCLUDING BIOPSY                     N   3   $306.00   3/1/2004   12/31/2299
23101   2   ARTHROTOMY ACROMIOCLAVICULAR JOINT OR STERNOCLAVICULAR JOINT        N   3   $275.00   1/1/1984   12/31/2299
23101   7   ARTHROTOMY FOR BIOPSY OR FOR EXCISION OF TORN CART                  N   3    $13.45   6/1/1994   12/31/2299
23101   F   ARTHROTOMY ACROMIOCLAVICULAR JOINT OR STERNOCLAVICULAR JOINT        N   3   $495.00   3/1/2004   12/31/2299
23105   2   ARTHROTOMY;GLENOHUMERAL JOINT, WITH SYNOVECTOMY,WITH OR W/OUT BIO   N   3   $400.00   8/1/1979   12/31/2299
23105   7   ARTHROTOMY FOR SYNOVECTOMY; GLENOHUMERAL JOINT                      N   3    $13.45   6/1/1994   12/31/2299
23105   8   ARTHROTOMY FOR SYNOVECTOMY; GLENOHUMERAL JOINT                      N   3    $80.00   8/1/1979   12/31/2299
23105   F   ARTHROTOMY;GLENOHUMERAL JOINT, WITH SYNOVECTOMY,WITH OR W/OUT BIO   N   3   $432.00   3/1/2004   12/31/2299
23106   2   ARTHROTOMY STERNOCLAVICULAR JOINT,WITH SYNOVECTOMY,W/WO BIOPSY      N   3   $275.00   1/1/1984   12/31/2299
23106   7   ARTHROTOMY FOR SYNOVECTOMY; ACROMIOCLAVICULAR, STE                  N   3    $13.45   6/1/1994   12/31/2299
23106   F   ARTHROTOMY STERNOCLAVICULAR JOINT,WITH SYNOVECTOMY,W/WO BIOPSY      N   3   $432.00   3/1/2004   12/31/2299
23107   7   ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORA                  N   3    $13.45   6/1/1994   12/31/2299
23107   F   ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORA                  N   3   $432.00   3/1/2004   12/31/2299
23110   2   EXCISION, SUBACROMIAL (SUBDELTOID) BURSA                            N   3   $150.00   1/1/1973   12/31/2299
23110   7   EXCISION, SUBACROMIAL (SUBDELTOID) BURSA                            N   3    $13.45   6/1/1994   12/31/2299
23120   2   CLAVICULECTOMY; PARTIAL                                             N   3   $228.00   1/2/1992   12/31/2299
23120   7   CLAVICULECTOMY; PARTIAL                                             N   3    $13.45   6/1/1994   12/31/2299
23120   8   CLAVICULECTOMY; PARTIAL                                             N   3    $55.00   1/2/1994   12/31/2299
23120   F   CLAVICULECTOMY; PARTIAL                                             N   3   $495.00   3/1/2004   12/31/2299




                                                                                                                      43
23125   2   CLAVICULECTOMY; TOTAL                                               N   3   $215.00   8/1/1979   12/31/2299
23125   7   CLAVICULECTOMY; TOTAL                                               N   3    $13.45   6/1/1994   12/31/2299
23125   8   CLAVICULECTOMY; TOTAL                                               N   3    $43.00   8/1/1979   12/31/2299
23125   F   CLAVICULECTOMY; TOTAL                                               N   3   $495.00   3/1/2004   12/31/2299
23130   2   ACROMIOPLASTY OR ACROMIONECTOMY,PARTIAL,W/WO CORACOACROMIAL LIGAM   N   3   $215.00   8/1/1979   12/31/2299
23130   7   ACROMIONECTOMY, PARTIAL OR TOTAL                                    N   3    $13.45   6/1/1994   12/31/2299
23130   8   ACROMIONECTOMY, PARTIAL OR TOTAL                                    N   3    $42.50   1/1/1973   12/31/2299
23130   F   ACROMIOPLASTY OR ACROMIONECTOMY,PARTIAL,W/WO CORACOACROMIAL LIGAM   N   3   $495.00   3/1/2004   12/31/2299
23140   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $150.00   1/1/1973   12/31/2299
23140   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
23140   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $432.00   3/1/2004   12/31/2299
23145   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $225.00   1/1/1973   12/31/2299
23145   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
23145   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3    $45.00   1/1/1973   12/31/2299
23145   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $495.00   3/1/2004   12/31/2299
23146   2   EXCISION OR CURETTAGE OF BONE CYST;WITH HOMOGENOUS                  N   3   $175.00   1/1/1984   12/31/2299
23146   7   EXCISION OR CURETTAGE OF BONE CYST;WITH HOMOGENOUS                  N   3    $13.45   6/1/1994   12/31/2299
23146   F   EXCISION OR CURETTAGE OF BONE CYST;WITH HOMOGENOUS                  N   3   $495.00   3/1/2004   12/31/2299
23150   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $426.54   1/1/2000   12/31/2299
23150   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
23150   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3    $85.30   1/1/2000   12/31/2299
23150   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $432.00   3/1/2004   12/31/2299
23155   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $195.00   1/1/1984   12/31/2299
23155   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3    $13.45   6/1/1994   12/31/2299
23155   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                  N   3   $495.00   3/1/2004   12/31/2299
23156   2   EXCISION OR CURETTAGE OF BONE CYST;WITH HOMOGENOUS                  N   3   $200.00   1/1/1984   12/31/2299
23156   7   EXCISION OR CURETTAGE OF BONE CYST;WITH HOMOGENOUS                  N   3    $13.45   6/1/1994   12/31/2299
23156   F   EXCISION OR CURETTAGE OF BONE CYST;WITH HOMOGENOUS                  N   3   $495.00   3/1/2004   12/31/2299
23170   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3   $125.00   1/1/1984   12/31/2299
23170   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3    $13.45   6/1/1994   12/31/2299
23170   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3   $306.00   3/1/2004   12/31/2299
23171   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3   $150.00   1/1/1984   12/31/2299
23171   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3    $13.45   6/1/1994   12/31/2299
23172   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3   $125.00   1/1/1984   12/31/2299
23172   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3    $13.45   6/1/1994   12/31/2299
23172   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3   $306.00   3/1/2004   12/31/2299
23173   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3   $150.00   1/1/1984   12/31/2299
23173   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                   N   3    $13.45   6/1/1994   12/31/2299
23174   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,H                  N   3   $300.00   1/1/1984   12/31/2299
23174   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,H                  N   3    $13.45   6/1/1994   12/31/2299
23174   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,H                  N   3   $306.00   3/1/2004   12/31/2299
23175   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,H                  N   3   $350.00   1/1/1984   12/31/2299
23175   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,H                  N   3    $13.45   6/1/1994   12/31/2299
23180   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZATION OR DIAPHSE   N   3   $125.00   1/1/1984   12/31/2299
23180   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $13.45   6/1/1994   12/31/2299
23180   8   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $25.00   1/1/1984   12/31/2299
23180   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZATION OR DIAPHSE   N   3   $432.00   3/1/2004   12/31/2299
23181   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3   $150.00   1/1/1984   12/31/2299
23181   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $13.45   6/1/1994   12/31/2299
23182   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZATION OR DIAPHYS   N   3   $125.00   1/1/1984   12/31/2299
23182   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      44
23182   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZATION OR DIAPHYS   N   3   $432.00   3/1/2004   12/31/2299
23183   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3   $150.00   1/1/1984   12/31/2299
23183   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $13.45   6/1/1994   12/31/2299
23184   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3   $125.00   1/1/1973   12/31/2299
23184   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $13.45   6/1/1994   12/31/2299
23184   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3   $432.00   3/1/2004   12/31/2299
23185   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3   $150.00   1/1/1984   12/31/2299
23185   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                  N   3    $13.45   6/1/1994   12/31/2299
23190   2   OSTECTOMY OF SCAPULA, PARTIAL                                       N   3   $175.00   1/1/1973   12/31/2299
23190   7   OSTECTOMY OF SCAPULA, PARTIAL                                       N   3    $13.45   6/1/1994   12/31/2299
23190   F   OSTECTOMY OF SCAPULA, PARTIAL                                       N   3   $432.00   3/1/2004   12/31/2299
23195   2   RESECTION HUMERAL HEAD                                              N   3   $275.00   1/1/1984   12/31/2299
23195   7   RESECTION HUMERAL HEAD                                              N   3    $13.45   6/1/1994   12/31/2299
23195   F   RESECTION HUMERAL HEAD                                              N   3   $495.00   3/1/2004   12/31/2299
23200   2   RADICAL RESECTION FOR TUMOR; CLAVICLE                               N   3   $400.00   1/1/1984   12/31/2299
23200   7   RADICAL RESECTION FOR TUMOR; CLAVICLE                               N   3    $13.45   6/1/1994   12/31/2299
23210   2   RADICAL RESECTION FOR TUMOR; SCAPULA                                N   3   $450.00   1/1/1984   12/31/2299
23210   7   RADICAL RESECTION FOR TUMOR; SCAPULA                                N   3    $13.45   6/1/1994   12/31/2299
23220   2   RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS;                      N   3   $450.00   1/1/1984   12/31/2299
23220   7   RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS;                      N   3    $13.45   6/1/1994   12/31/2299
23221   2   RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS; WIT                  N   3   $550.00   1/1/1984   12/31/2299
23221   7   RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS; WIT                  N   3    $13.45   6/1/1994   12/31/2299
23222   2   RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS; WIT                  N   3   $600.00   1/1/1984   12/31/2299
23222   7   RADICAL RESECTION FOR TUMOR, PROXIMAL HUMERUS; WIT                  N   3    $13.45   6/1/1994   12/31/2299
23330   2   REMOVAL OF FOREIGN BODY; SUBCUTANEOUS                               N   3    $50.00   1/1/1984   12/31/2299
23330   F   REMOVAL OF FOREIGN BODY; SUBCUTANEOUS                               N   3   $225.80   3/1/2004   12/31/2299
23331   2   REMOVAL OF FOREIGN BODY; DEEP PROSTHETIC REMOVAL                    N   3   $275.00   1/1/1973   12/31/2299
23331   7   REMOVAL OF FOREIGN BODY; DEEP PROSTHETIC REMOVAL                    N   3    $13.45   6/1/1994   12/31/2299
23331   8   REMOVAL OF FOREIGN BODY; DEEP PROSTHETIC REMOVAL                    N   3    $55.00   1/1/1973   12/31/2299
23331   F   REMOVAL OF FOREIGN BODY; DEEP PROSTHETIC REMOVAL                    N   3   $225.80   3/1/2004   12/31/2299
23332   2   REMOVAL OF FOREIGN BODY; COMPLICATED, INCLUDING "T                  N   3   $300.00   1/1/1984   12/31/2299
23332   7   REMOVAL OF FOREIGN BODY; COMPLICATED, INCLUDING "T                  N   3    $13.45   6/1/1994   12/31/2299
23350   2   INJECTION PROCEDURE FOR SHOULDER ARTHROGRAPHY                       N   3    $26.00   1/2/1994   12/31/2299
23350   7   INJECTION PROCEDURE FOR SHOULDER ARTHROGRAPHY                       N   3    $13.45   6/1/1994   12/31/2299
23395   2   MUSCLE TRANSFER, ANY TYPE FOR PARALYSIS OF SHOULDE                  N   3   $400.00   1/1/1984   12/31/2299
23395   7   MUSCLE TRANSFER, ANY TYPE FOR PARALYSIS OF SHOULDE                  N   3    $13.45   6/1/1994   12/31/2299
23395   F   MUSCLE TRANSFER, ANY TYPE FOR PARALYSIS OF SHOULDE                  N   3   $495.00   3/1/2004   12/31/2299
23397   2   MUSCLE TRANSFER, ANY TYPE FOR PARALYSIS OF SHOULDE                  N   3   $550.00   1/1/1984   12/31/2299
23397   7   MUSCLE TRANSFER, ANY TYPE FOR PARALYSIS OF SHOULDE                  N   3    $13.45   6/1/1994   12/31/2299
23397   F   MUSCLE TRANSFER, ANY TYPE FOR PARALYSIS OF SHOULDE                  N   3   $495.00   3/1/2004   12/31/2299
23400   2   SCAPULOPEXY                                                         N   3   $475.00   1/1/1984   12/31/2299
23400   7   SCAPULOPEXY                                                         N   3    $13.45   6/1/1994   12/31/2299
23400   F   SCAPULOPEXY                                                         N   3   $495.00   3/1/2004   12/31/2299
23405   2   TENOMYOTOMY; SINGLE                                                 N   3   $100.00   1/1/1984   12/31/2299
23405   7   TENOMYOTOMY; SINGLE                                                 N   3    $13.45   6/1/1994   12/31/2299
23405   F   TENOMYOTOMY; SINGLE                                                 N   3   $306.00   3/1/2004   12/31/2299
23406   2   TENOMYOTOMY; MULTIPLE THROUGH SAME INCISION                         N   3   $150.00   1/1/1984   12/31/2299
23406   7   TENOMYOTOMY; MULTIPLE THROUGH SAME INCISION                         N   3    $13.45   6/1/1994   12/31/2299
23406   F   TENOMYOTOMY; MULTIPLE THROUGH SAME INCISION                         N   3   $306.00   3/1/2004   12/31/2299
23410   2   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO                  N   3   $350.00   1/1/1973   12/31/2299
23410   7   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      45
23410   8   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO   N   3    $70.00   1/1/1973   12/31/2299
23410   F   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO   N   3   $495.00   3/1/2004   12/31/2299
23412   2   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO   N   3   $690.00   1/2/1995   12/31/2299
23412   7   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO   N   3    $13.45   6/1/1994   12/31/2299
23412   8   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO   N   3   $138.00   1/2/1995   12/31/2299
23412   F   REPAIR OF RUPTURED SUPRASPINATUS TENDON OR MUSCULO   N   3   $495.00   3/1/2004   12/31/2299
23415   2   CORACOACROMIAL LIGAMENT RELEASE FOR CHRONIC RUPTUR   N   3   $150.00   1/1/1984   12/31/2299
23415   7   CORACOACROMIAL LIGAMENT RELEASE FOR CHRONIC RUPTUR   N   3    $13.45   6/1/1994   12/31/2299
23415   8   CORACOACROMIAL LIGAMENT RELEASE FOR CHRONIC RUPTUR   N   3    $30.00   1/1/1984   12/31/2299
23415   F   CORACOACROMIAL LIGAMENT RELEASE FOR CHRONIC RUPTUR   N   3   $495.00   3/1/2004   12/31/2299
23420   2   REPAIR OF COMPLETE SHOULDER CUFF AVULSION, CHRONIC   N   3   $702.00   1/2/1997   12/31/2299
23420   7   REPAIR OF COMPLETE SHOULDER CUFF AVULSION, CHRONIC   N   3    $13.45   6/1/1994   12/31/2299
23420   8   REPAIR OF COMPLETE SHOULDER CUFF AVULSION, CHRONIC   N   3   $140.00   1/2/1997   12/31/2299
23420   F   REPAIR OF COMPLETE SHOULDER CUFF AVULSION, CHRONIC   N   3   $495.00   3/1/2004   12/31/2299
23430   2   TENODESIS FOR RUPTURE OF LONG TENDON OF BICEPS       N   3   $300.00   1/1/1973   12/31/2299
23430   7   TENODESIS FOR RUPTURE OF LONG TENDON OF BICEPS       N   3    $13.45   6/1/1994   12/31/2299
23430   8   TENODESIS FOR RUPTURE OF LONG TENDON OF BICEPS       N   3    $60.00   1/1/1973   12/31/2299
23430   F   TENODESIS FOR RUPTURE OF LONG TENDON OF BICEPS       N   3   $432.00   3/1/2004   12/31/2299
23440   2   RESECTION OR TRANSPLANTATION OF LONG TENDON OF BIC   N   3   $300.00   1/1/1984   12/31/2299
23440   7   RESECTION OR TRANSPLANTATION OF LONG TENDON OF BIC   N   3    $13.45   6/1/1994   12/31/2299
23440   F   RESECTION OR TRANSPLANTATION OF LONG TENDON OF BIC   N   3   $432.00   3/1/2004   12/31/2299
23450   2   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $425.00   6/1/1988   12/31/2299
23450   7   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3    $13.45   6/1/1994   12/31/2299
23450   8   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3    $70.00   1/1/1971   12/31/2299
23450   F   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $495.00   3/1/2004   12/31/2299
23455   2   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $475.00   1/1/1973   12/31/2299
23455   7   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3    $13.45   6/1/1994   12/31/2299
23455   8   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3    $95.00   1/1/1973   12/31/2299
23455   F   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $495.00   3/1/2004   12/31/2299
23460   2   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $500.00   1/1/1973   12/31/2299
23460   7   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3    $13.45   6/1/1994   12/31/2299
23460   8   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $100.00   1/1/1973   12/31/2299
23460   F   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $495.00   3/1/2004   12/31/2299
23462   2   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $450.00   1/1/1984   12/31/2299
23462   7   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3    $13.45   6/1/1994   12/31/2299
23462   F   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, ANTERIOR   N   3   $495.00   3/1/2004   12/31/2299
23465   2   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, POSTERIO   N   3   $747.78   1/2/1997   12/31/2299
23465   7   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, POSTERIO   N   3    $13.45   6/1/1994   12/31/2299
23465   8   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, POSTERIO   N   3   $150.00   1/2/1997   12/31/2299
23465   F   CAPSULORRHAPHY FOR RECURRENT DISLOCATION, POSTERIO   N   3   $495.00   3/1/2004   12/31/2299
23466   2   CAPSULORRHAPHY FOR RECURRENT DISLOCATION WITH ANY    N   3   $600.00   1/1/1992   12/31/2299
23466   7   CAPSULORRHAPHY FOR RECURRENT DISLOCATION WITH ANY    N   3    $13.45   6/1/1994   12/31/2299
23466   8   CAPSULORRHAPHY FOR RECURRENT DISLOCATION WITH ANY    N   3   $120.00   1/1/1992   12/31/2299
23466   F   CAPSULORRHAPHY FOR RECURRENT DISLOCATION WITH ANY    N   3   $495.00   3/1/2004   12/31/2299
23470   2   ARTHROPLASTY WITH PROXIMAL HUMERAL IMPLANT           N   3   $500.00   1/1/1984   12/31/2299
23470   7   ARTHROPLASTY WITH PROXIMAL HUMERAL IMPLANT           N   3    $13.45   6/1/1994   12/31/2299
23470   8   ARTHROPLASTY WITH PROXIMAL HUMERAL IMPLANT           N   3   $100.00   1/1/1984   12/31/2299
23472   2   ARTHROPLASTY WITH GLENOID AND PROXIMAL HUMERAL REP   N   3   $500.00   1/1/1973   12/31/2299
23472   7   ARTHROPLASTY WITH GLENOID AND PROXIMAL HUMERAL REP   N   3    $13.45   6/1/1994   12/31/2299
23472   8   ARTHROPLASTY WITH GLENOID AND PROXIMAL HUMERAL REP   N   3   $100.00   1/1/1973   12/31/2299
23480   2   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3   $250.00   1/1/1973   12/31/2299




                                                                                                       46
23480   7   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3    $13.45   6/1/1994   12/31/2299
23480   8   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3    $50.00   1/1/1973   12/31/2299
23480   F   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3   $432.00   3/1/2004   12/31/2299
23485   2   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3   $325.00   1/1/1973   12/31/2299
23485   7   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3    $13.45   6/1/1994   12/31/2299
23485   8   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3    $65.00   1/1/1973   12/31/2299
23485   F   OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXA   N   3   $495.00   3/1/2004   12/31/2299
23490   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3    $13.45   6/1/1994   12/31/2299
23490   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3   $351.00   3/1/2004   12/31/2299
23491   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3    $13.45   6/1/1994   12/31/2299
23491   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3   $351.00   3/1/2004   12/31/2299
23500   2   TREATMENT OF CLOSED CLAVICULAR FRACTURE; WITHOUT M   N   3    $25.00   1/1/1971   12/31/2299
23500   7   TREATMENT OF CLOSED CLAVICULAR FRACTURE; WITHOUT M   N   3    $13.45   6/1/1994   12/31/2299
23500   F   TREATMENT OF CLOSED CLAVICULAR FRACTURE; WITHOUT M   N   3   $225.80   3/1/2004   12/31/2299
23505   2   TREATMENT OF CLOSED CLAVICULAR FRACTURE;WITH MANIP   N   3    $40.00   1/1/1971   12/31/2299
23505   7   TREATMENT OF CLOSED CLAVICULAR FRACTURE;WITH MANIP   N   3    $13.45   6/1/1994   12/31/2299
23505   F   TREATMENT OF CLOSED CLAVICULAR FRACTURE;WITH MANIP   N   3   $225.80   3/1/2004   12/31/2299
23515   2   OPEN TREATMENT OF CLOSED OR OPEN CLAVICULAR WITH O   N   3   $150.00   1/1/1973   12/31/2299
23515   7   OPEN TREATMENT OF CLOSED OR OPEN CLAVICULAR WITH O   N   3    $13.45   6/1/1994   12/31/2299
23515   8   OPEN TREATMENT OF CLOSED OR OPEN CLAVICULAR WITH O   N   3    $30.00   1/1/1973   12/31/2299
23515   F   OPEN TREATMENT OF CLOSED OR OPEN CLAVICULAR WITH O   N   3   $351.00   3/1/2004   12/31/2299
23520   2   TREATMENT OF CLOSED STERNOCLAVICULAR DISLOCATION;    N   3    $50.00   1/1/1984   12/31/2299
23520   7   TREATMENT OF CLOSED STERNOCLAVICULAR DISLOCATION;    N   3    $13.45   6/1/1994   12/31/2299
23520   F   TREATMENT OF CLOSED STERNOCLAVICULAR DISLOCATION;    N   3   $225.80   3/1/2004   12/31/2299
23525   2   TREATMENT OF CLOSED STERNOCLAVICULAR DISLOCATION;    N   3    $70.00   1/1/1973   12/31/2299
23525   7   TREATMENT OF CLOSED STERNOCLAVICULAR DISLOCATION;    N   3    $13.45   6/1/1994   12/31/2299
23525   F   TREATMENT OF CLOSED STERNOCLAVICULAR DISLOCATION;    N   3   $225.80   3/1/2004   12/31/2299
23530   2   OPEN TREATMENT OF CLOSED OR OPEN STERNOCLAVICULAR    N   3   $250.00   1/1/1973   12/31/2299
23530   7   OPEN TREATMENT OF CLOSED OR OPEN STERNOCLAVICULAR    N   3    $13.45   6/1/1994   12/31/2299
23530   F   OPEN TREATMENT OF CLOSED OR OPEN STERNOCLAVICULAR    N   3   $351.00   3/1/2004   12/31/2299
23532   2   OPEN TREATMENT OF CLOSED OR OPEN STERNOCLAVICULAR    N   3   $275.00   1/1/1984   12/31/2299
23532   7   OPEN TREATMENT OF CLOSED OR OPEN STERNOCLAVICULAR    N   3    $13.45   6/1/1994   12/31/2299
23532   F   OPEN TREATMENT OF CLOSED OR OPEN STERNOCLAVICULAR    N   3   $432.00   3/1/2004   12/31/2299
23540   2   TREATMENT OF CLOSED ACROMIOCLAVICULAR DISLOCATION;   N   3    $45.00   1/1/1984   12/31/2299
23540   7   TREATMENT OF CLOSED ACROMIOCLAVICULAR DISLOCATION;   N   3    $13.45   6/1/1994   12/31/2299
23540   F   TREATMENT OF CLOSED ACROMIOCLAVICULAR DISLOCATION;   N   3   $225.80   3/1/2004   12/31/2299
23545   2   TREATMENT OF CLOSED ACROMIOCLAVICULAR DISLOCATION;   N   3    $60.00   1/1/1973   12/31/2299
23545   7   TREATMENT OF CLOSED ACROMIOCLAVICULAR DISLOCATION;   N   3    $13.45   6/1/1994   12/31/2299
23545   F   TREATMENT OF CLOSED ACROMIOCLAVICULAR DISLOCATION;   N   3   $225.80   3/1/2004   12/31/2299
23550   2   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3   $300.00   1/1/1973   12/31/2299
23550   7   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3    $13.45   6/1/1994   12/31/2299
23550   8   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3    $60.00   1/1/1973   12/31/2299
23550   F   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3   $351.00   3/1/2004   12/31/2299
23552   2   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3   $325.00   1/1/1984   12/31/2299
23552   7   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3    $13.45   6/1/1994   12/31/2299
23552   F   OPEN TREATMENT OF CLOSED OR OPEN ACROMIOCLAVICULAR   N   3   $432.00   3/1/2004   12/31/2299
23570   2   TREATMENT OF CLOSED SCAPULAR FRACTURE; WITHOUT MAN   N   3    $20.00   1/1/1973   12/31/2299
23570   7   TREATMENT OF CLOSED SCAPULAR FRACTURE; WITHOUT MAN   N   3    $13.45   6/1/1994   12/31/2299
23570   F   TREATMENT OF CLOSED SCAPULAR FRACTURE; WITHOUT MAN   N   3   $225.80   3/1/2004   12/31/2299
23575   2   TREATMENT OF CLOSED SCAPULAR FRACTURE; WITH MANIPU   N   3    $56.00   1/1/1971   12/31/2299
23575   7   TREATMENT OF CLOSED SCAPULAR FRACTURE; WITH MANIPU   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       47
23575   F   TREATMENT OF CLOSED SCAPULAR FRACTURE; WITH MANIPU   N   3   $225.80   3/1/2004   12/31/2299
23585   2   OPEN TREATMENT OF CLOSED OR OPEN SCAPULAR FRACTURE   N   3   $300.00   8/1/1979   12/31/2299
23585   7   OPEN TREATMENT OF CLOSED OR OPEN SCAPULAR FRACTURE   N   3    $13.45   6/1/1994   12/31/2299
23585   8   OPEN TREATMENT OF CLOSED OR OPEN SCAPULAR FRACTURE   N   3    $60.00   8/1/1979   12/31/2299
23585   F   OPEN TREATMENT OF CLOSED OR OPEN SCAPULAR FRACTURE   N   3   $351.00   3/1/2004   12/31/2299
23600   2   TREATMENT OF CLOSED HUMERAL (SURGICAL OR ANATOMICA   N   3   $150.00   1/2/1995   12/31/2299
23600   7   TREATMENT OF CLOSED HUMERAL (SURGICAL OR ANATOMICA   N   3    $13.45   6/1/1994   12/31/2299
23600   F   TREATMENT OF CLOSED HUMERAL (SURGICAL OR ANATOMICA   N   3   $225.80   3/1/2004   12/31/2299
23605   2   TREATMENT OF CLOSED HUMERAL (SURGICAL OR ANATOMICA   N   3   $125.00   1/1/1973   12/31/2299
23605   7   TREATMENT OF CLOSED HUMERAL (SURGICAL OR ANATOMICA   N   3    $13.45   6/1/1994   12/31/2299
23605   F   TREATMENT OF CLOSED HUMERAL (SURGICAL OR ANATOMICA   N   3   $306.00   3/1/2004   12/31/2299
23615   2   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL FRACTURE,   N   3   $350.00   8/1/1979   12/31/2299
23615   7   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL FRACTURE,   N   3    $13.45   6/1/1994   12/31/2299
23615   8   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL FRACTURE,   N   3    $70.00   8/1/1979   12/31/2299
23615   F   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL FRACTURE,   N   3   $432.00   3/1/2004   12/31/2299
23616   2   OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR AN   N   3   $860.92   1/1/1993   12/31/2299
23616   7   OPEN TRTMNT OF PROXIMAL HUMERAL (SURGICAL OR ANATO   N   3    $13.45   6/1/1994   12/31/2299
23616   F   OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR AN   N   3   $432.00   3/1/2004   12/31/2299
23620   2   TREATMENT OF CLOSED GREATER TUBEROSITY FRACTURE; W   N   3   $138.00   1/2/1995   12/31/2299
23620   F   TREATMENT OF CLOSED GREATER TUBEROSITY FRACTURE; W   N   3   $225.80   3/1/2004   12/31/2299
23625   2   TREATMENT OF CLOSED GREATER TUBEROSITY FRACTURE; W   N   3   $100.00   8/1/1979   12/31/2299
23625   7   TREATMENT OF CLOSED GREATER TUBEROSITY FRACTURE; W   N   3    $13.45   6/1/1994   12/31/2299
23625   F   TREATMENT OF CLOSED GREATER TUBEROSITY FRACTURE; W   N   3   $306.00   3/1/2004   12/31/2299
23630   2   OPEN TREAT OF CLOSED OR OPEN GREATER TUBEROSITY FR   N   3   $250.00   8/1/1979   12/31/2299
23630   7   OPEN TREAT OF CLOSED OR OPEN GREATER TUBEROSITY FR   N   3    $13.45   6/1/1994   12/31/2299
23630   F   OPEN TREAT OF CLOSED OR OPEN GREATER TUBEROSITY FR   N   3   $495.00   3/1/2004   12/31/2299
23650   2   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH MAN   N   3    $30.00   8/1/1979   12/31/2299
23650   F   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH MAN   N   3   $225.80   3/1/2004   12/31/2299
23655   2   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH MAN   N   3    $40.00   8/1/1979   12/31/2299
23655   7   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH MAN   N   3    $13.45   6/1/1994   12/31/2299
23655   F   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH MAN   N   3   $225.80   3/1/2004   12/31/2299
23660   2   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3   $350.00   1/1/1973   12/31/2299
23660   7   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3    $13.45   6/1/1994   12/31/2299
23660   8   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3    $70.00   1/1/1973   12/31/2299
23660   F   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3   $351.00   3/1/2004   12/31/2299
23665   2   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH FRA   N   3    $75.00   1/1/1984   12/31/2299
23665   7   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH FRA   N   3    $13.45   6/1/1994   12/31/2299
23665   F   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH FRA   N   3   $306.00   3/1/2004   12/31/2299
23670   2   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3   $300.00   1/1/1973   12/31/2299
23670   7   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3    $13.45   6/1/1994   12/31/2299
23670   8   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3    $60.00   1/1/1973   12/31/2299
23670   F   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3   $351.00   3/1/2004   12/31/2299
23675   2   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH SUR   N   3   $100.00   1/1/1973   12/31/2299
23675   7   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH SUR   N   3    $13.45   6/1/1994   12/31/2299
23675   F   TREATMENT OF CLOSED SHOULDER DISLOCATION, WITH SUR   N   3   $306.00   3/1/2004   12/31/2299
23680   2   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3   $350.00   1/1/1973   12/31/2299
23680   7   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3    $13.45   6/1/1994   12/31/2299
23680   8   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3    $70.00   1/1/1973   12/31/2299
23680   F   OPEN TREATMENT OF CLOSED OR OPEN SHOULDER DISLOCAT   N   3   $351.00   3/1/2004   12/31/2299
23700   2   MANIPULATION UNDER ANESTHESIA, INCLUDING APPLICATI   N   3   $120.00   1/2/1996   12/31/2299
23700   7   MANIPULATION UNDER ANESTHESIA, INCLUDING APPLICATI   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       48
23700   F   MANIPULATION UNDER ANESTHESIA, INCLUDING APPLICATI   N   3   $225.80   3/1/2004   12/31/2299
23800   2   ARTHRODESIS, SHOULDER JOINT; WITH OR WITHOUT LOCAL   N   3   $500.00   1/1/1973   12/31/2299
23800   7   ARTHRODESIS, SHOULDER JOINT; WITH OR WITHOUT LOCAL   N   3    $13.45   6/1/1994   12/31/2299
23800   8   ARTHRODESIS, SHOULDER JOINT; WITH OR WITHOUT LOCAL   N   3   $100.00   1/1/1973   12/31/2299
23800   F   ARTHRODESIS, SHOULDER JOINT; WITH OR WITHOUT LOCAL   N   3   $432.00   3/1/2004   12/31/2299
23802   2   ARTHRODESIS, SHOULDER JOINT; WITH PRIMARY AUTOGENO   N   3   $400.00   1/1/1984   12/31/2299
23802   7   ARTHRODESIS, SHOULDER JOINT; WITH PRIMARY AUTOGENO   N   3    $13.45   6/1/1994   12/31/2299
23802   F   ARTHRODESIS, SHOULDER JOINT; WITH PRIMARY AUTOGENO   N   3   $495.00   3/1/2004   12/31/2299
23900   2   INTERTHORACOSCAPULAR AMPUTATION (FOREQUARTER)        N   3   $600.00   1/1/1973   12/31/2299
23900   7   INTERTHORACOSCAPULAR AMPUTATION (FOREQUARTER)        N   3    $13.45   6/1/1994   12/31/2299
23900   8   INTERTHORACOSCAPULAR AMPUTATION (FOREQUARTER)        N   3   $120.00   1/1/1973   12/31/2299
23920   2   DISARTICULATION OF SHOULDER;                         N   3   $450.00   1/1/1973   12/31/2299
23920   7   DISARTICULATION OF SHOULDER;                         N   3    $13.45   6/1/1994   12/31/2299
23920   8   DISARTICULATION OF SHOULDER;                         N   3    $90.00   1/1/1973   12/31/2299
23921   2   DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR    N   3    $80.00   1/1/1984   12/31/2299
23921   7   DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR    N   3    $13.45   6/1/1994   12/31/2299
23921   F   DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR    N   3   $351.00   3/1/2004   12/31/2299
23929   7   UNLISTED PROCEDURE, SHOULDER                         N   3    $13.45   6/1/1994   12/31/2299
23930   2   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA      N   3    $50.00   1/1/1984   12/31/2299
23930   7   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA      N   3    $13.45   6/1/1994   12/31/2299
23930   F   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA      N   3   $225.80   3/1/2004   12/31/2299
23931   2   INCISION AND DRAINAGE; INFECTED BURSA                N   3    $25.00   1/1/1984   12/31/2299
23931   7   INCISION AND DRAINAGE; INFECTED BURSA                N   3    $13.45   6/1/1994   12/31/2299
23931   F   INCISION AND DRAINAGE; INFECTED BURSA                N   3   $306.00   3/1/2004   12/31/2299
23935   2   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY   N   3   $100.00   1/1/1984   12/31/2299
23935   7   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY   N   3    $13.45   6/1/1994   12/31/2299
23935   F   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY   N   3   $306.00   3/1/2004   12/31/2299
23936   2   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY   N   3   $100.00   1/1/1984   12/31/2299
23936   7   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY   N   3    $13.45   6/1/1994   12/31/2299
24000   2   ARTHROTOMY, ELBOW, WITH EXPLORATION, DRAINAGE OR R   N   3   $217.00   8/1/1979   12/31/2299
24000   7   ARTHROTOMY, ELBOW, WITH EXPLORATION, DRAINAGE OR R   N   3    $13.45   6/1/1994   12/31/2299
24000   8   ARTHROTOMY, ELBOW, WITH EXPLORATION, DRAINAGE OR R   N   3    $40.00   1/1/1973   12/31/2299
24000   F   ARTHROTOMY, ELBOW, WITH EXPLORATION, DRAINAGE OR R   N   3   $432.00   3/1/2004   12/31/2299
24001   2   ARTHROTOMY,ELBOW,WITH EXPLORATION,DRAINAGE OR REMO   N   3   $240.00   1/1/1984   12/31/2299
24001   7   ARTHROTOMY,ELBOW,WITH EXPLORATION,DRAINAGE OR REMO   N   3    $13.45   6/1/1994   12/31/2299
24006   2   ARTHROTOMY OF THE ELBOW, WITH CAPSULAR EXCISION FO   N   3   $423.52   1/1/2001   12/31/2299
24006   7   ARTHROTOMY OF ELBOW WITH CAPSULAR EXICISN FOR CAPS   N   3    $13.45   6/1/1994   12/31/2299
24065   2   BIOPSY, SOFT TISSUES; SUPERFICIAL                    N   3    $50.00   1/1/1984   12/31/2299
24065   7   BIOPSY, SOFT TISSUES; SUPERFICIAL                    N   3    $13.45   6/1/1994   12/31/2299
24066   2   BIOPSY, SOFT TISSUES; DEEP                           N   3   $150.00   1/1/1984   12/31/2299
24066   7   BIOPSY, SOFT TISSUES; DEEP                           N   3    $13.45   6/1/1994   12/31/2299
24066   F   BIOPSY, SOFT TISSUES; DEEP                           N   3   $306.00   3/1/2004   12/31/2299
24075   2   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3    $50.00   1/1/1984   12/31/2299
24075   7   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3    $13.45   6/1/1994   12/31/2299
24075   F   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3   $306.00   3/1/2004   12/31/2299
24076   2   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM   N   3   $150.00   1/1/1984   12/31/2299
24076   7   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM   N   3    $13.45   6/1/1994   12/31/2299
24076   F   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM   N   3   $306.00   3/1/2004   12/31/2299
24077   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3    $13.45   6/1/1994   12/31/2299
24077   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $351.00   3/1/2004   12/31/2299
24100   2   ARTHROTOMY, ELBOW; FOR SYNOVIAL BIOPSY ONLY          N   3   $250.00   1/1/1973   12/31/2299




                                                                                                       49
24100   7   ARTHROTOMY, ELBOW; FOR SYNOVIAL BIOPSY ONLY          N   3    $13.45   6/1/1994   12/31/2299
24100   F   ARTHROTOMY, ELBOW; FOR SYNOVIAL BIOPSY ONLY          N   3   $225.80   3/1/2004   12/31/2299
24101   2   ARTHROTOMY, ELBOW;WITH JOINT EXPLO, WITH OR W/OUT    N   3   $400.00   1/1/1984   12/31/2299
24101   7   ARTHROTOMY, ELBOW;WITH JOINT EXPLO,WITH OR W/OUT B   N   3    $13.45   6/1/1994   12/31/2299
24101   8   ARTHROTOMY, ELBOW;WITH JOINT EXPLO,WITH OR W/OUT B   N   3    $80.00   1/1/1984   12/31/2299
24101   F   ARTHROTOMY, ELBOW;WITH JOINT EXPLO, WITH OR W/OUT    N   3   $432.00   3/1/2004   12/31/2299
24102   2   ARTHROTOMY, ELBOW; FOR SYNOVECTOMY                   N   3   $350.00   1/1/1973   12/31/2299
24102   7   ARTHROTOMY, ELBOW; FOR SYNOVECTOMY                   N   3    $13.45   6/1/1994   12/31/2299
24102   8   ARTHROTOMY, ELBOW; FOR SYNOVECTOMY                   N   3    $70.00   1/1/1973   12/31/2299
24102   F   ARTHROTOMY, ELBOW; FOR SYNOVECTOMY                   N   3   $432.00   3/1/2004   12/31/2299
24105   2   EXCISION, OLECRANON BURSA                            N   3   $120.00   1/1/1973   12/31/2299
24105   7   EXCISION, OLECRANON BURSA                            N   3    $13.45   6/1/1994   12/31/2299
24105   F   EXCISION, OLECRANON BURSA                            N   3   $351.00   3/1/2004   12/31/2299
24110   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $237.50   1/1/1973   12/31/2299
24110   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
24110   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $47.50   1/1/1973   12/31/2299
24110   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $306.00   3/1/2004   12/31/2299
24115   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $312.50   1/1/1973   12/31/2299
24115   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
24115   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $62.50   1/1/1973   12/31/2299
24115   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $351.00   3/1/2004   12/31/2299
24116   2   EX OR CURETTAGE OF BONE CYST OR BENIGN TUMOR;WITH    N   3   $275.00   1/1/1984   12/31/2299
24116   7   EX OR CURETTAGE OF BONE CYST OR BENIGN TUMOR;WITH    N   3    $13.45   6/1/1994   12/31/2299
24116   F   EX OR CURETTAGE OF BONE CYST OR BENIGN TUMOR;WITH    N   3   $351.00   3/1/2004   12/31/2299
24120   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $200.00   1/1/1973   12/31/2299
24120   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
24120   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $40.00   1/1/1973   12/31/2299
24120   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $351.00   3/1/2004   12/31/2299
24125   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $250.00   1/1/1973   12/31/2299
24125   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
24125   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $50.00   1/1/1973   12/31/2299
24125   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $351.00   3/1/2004   12/31/2299
24126   2   EX OR CURETTAGE OF BONE CYST OR BENIGN TUMOR;WITH    N   3   $230.00   1/1/1984   12/31/2299
24126   7   EX OR CURETTAGE OF BONE CYST OR BENIGN TUMOR;WITH    N   3    $13.45   6/1/1994   12/31/2299
24126   F   EX OR CURETTAGE OF BONE CYST OR BENIGN TUMOR;WITH    N   3   $351.00   3/1/2004   12/31/2299
24130   2   EXCISION, RADIAL HEAD                                N   3   $175.00   1/1/1973   12/31/2299
24130   7   EXCISION, RADIAL HEAD                                N   3    $13.45   6/1/1994   12/31/2299
24130   8   EXCISION, RADIAL HEAD                                N   3    $35.00   1/1/1973   12/31/2299
24130   F   EXCISION, RADIAL HEAD                                N   3   $351.00   3/1/2004   12/31/2299
24134   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3   $125.00   1/1/1984   12/31/2299
24134   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3    $13.45   6/1/1994   12/31/2299
24134   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3   $306.00   3/1/2004   12/31/2299
24135   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;    N   3   $150.00   1/1/1984   12/31/2299
24135   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;    N   3    $13.45   6/1/1994   12/31/2299
24136   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3   $125.00   1/1/1984   12/31/2299
24136   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3    $13.45   6/1/1994   12/31/2299
24136   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3   $306.00   3/1/2004   12/31/2299
24137   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;    N   3   $150.00   1/1/1984   12/31/2299
24137   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;    N   3    $13.45   6/1/1994   12/31/2299
24138   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3   $125.00   1/1/1984   12/31/2299
24138   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,    N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       50
24138   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS,                 N   3   $306.00   3/1/2004   12/31/2299
24139   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;W                N   3   $150.00   1/1/1984   12/31/2299
24139   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;                 N   3    $13.45   6/1/1994   12/31/2299
24140   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $175.00   1/1/1973   12/31/2299
24140   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3    $13.45   6/1/1994   12/31/2299
24140   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $351.00   3/1/2004   12/31/2299
24144   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $190.00   1/1/1984   12/31/2299
24144   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3    $13.45   6/1/1994   12/31/2299
24145   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $120.00   1/1/1984   12/31/2299
24145   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3    $13.45   6/1/1994   12/31/2299
24145   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $351.00   3/1/2004   12/31/2299
24146   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $135.00   1/1/1984   12/31/2299
24146   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3    $13.45   6/1/1994   12/31/2299
24147   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $175.00   1/1/1984   12/31/2299
24147   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3    $13.45   6/1/1994   12/31/2299
24147   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $306.00   3/1/2004   12/31/2299
24148   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3   $200.00   1/1/1984   12/31/2299
24148   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                N   3    $13.45   6/1/1994   12/31/2299
24149   2   RADICAL RESECTION OF CAPSULE/SOFT TISSUE/HETEROTOPIC BONE ELBOW   N   3   $662.83   1/1/1997   12/31/2299
24149   7   RADICAL RESECTION OF ELBOW                                        N   3    $13.45   1/1/1997   12/31/2299
24149   8   RADICAL RESECTION OF ELBOW                                        N   3   $132.56   1/1/1997   12/31/2299
24150   2   RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMER                N   3   $475.00   1/1/1984   12/31/2299
24150   7   RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMER                N   3    $13.45   6/1/1994   12/31/2299
24151   2   RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMER                N   3   $525.00   1/1/1984   12/31/2299
24151   7   RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMER                N   3    $13.45   6/1/1994   12/31/2299
24152   2   RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK;                 N   3   $475.00   1/1/1984   12/31/2299
24152   7   RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK;                 N   3    $13.45   6/1/1994   12/31/2299
24153   2   RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK;W                N   3   $525.00   1/1/1984   12/31/2299
24153   7   RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK;W                N   3    $13.45   6/1/1994   12/31/2299
24155   2   RESECTION OF ELBOW JOINT (ARTHRECTOMY)                            N   3   $400.00   1/1/1984   12/31/2299
24155   7   RESECTION OF ELBOW JOINT (ARTHRECTOMY)                            N   3    $13.45   6/1/1994   12/31/2299
24155   F   RESECTION OF ELBOW JOINT (ARTHRECTOMY)                            N   3   $351.00   3/1/2004   12/31/2299
24160   2   IMPLANT REMOVAL; ELBOW JOINT                                      N   3   $250.00   1/1/1984   12/31/2299
24160   7   IMPLANT REMOVAL; ELBOW JOINT                                      N   3    $13.45   6/1/1994   12/31/2299
24160   F   IMPLANT REMOVAL; ELBOW JOINT                                      N   3   $306.00   3/1/2004   12/31/2299
24164   2   IMPLANT REMOVAL; RADIAL HEAD                                      N   3   $175.00   1/1/1984   12/31/2299
24164   7   IMPLANT REMOVAL; RADIAL HEAD                                      N   3    $13.45   6/1/1994   12/31/2299
24164   F   IMPLANT REMOVAL; RADIAL HEAD                                      N   3   $351.00   3/1/2004   12/31/2299
24200   2   REMOVAL OF FOREIGN BODY; SUBCUTANEOUS                             N   3    $42.00   1/2/1994   12/31/2299
24201   2   REMOVAL OF FOREIGN BODY; DEEP                                     N   3   $125.00   1/1/1984   12/31/2299
24201   7   REMOVAL OF FOREIGN BODY; DEEP                                     N   3    $13.45   6/1/1994   12/31/2299
24201   F   REMOVAL OF FOREIGN BODY; DEEP                                     N   3   $306.00   3/1/2004   12/31/2299
24220   2   INJECTION PROCEDURE FOR ELBOW ARTHROGRAPHY                        N   3    $20.00   1/1/1984   12/31/2299
24300   2   MANIPULATION, ELBOW UNDER ANESTHESIA                              N   3   $211.77   1/1/2002   12/31/2299
24301   2   MUSCLE OR TENDON TRANSFER, ANY TYPE, SINGLE                       N   3   $200.00   1/1/1984   12/31/2299
24301   7   MUSCLE OR TENDON TRANSFER, ANY TYPE, SINGLE                       N   3    $13.45   6/1/1994   12/31/2299
24301   F   MUSCLE OR TENDON TRANSFER, ANY TYPE, SINGLE                       N   3   $432.00   3/1/2004   12/31/2299
24305   2   TENDON LENGTHENING; SINGLE, EACH                                  N   3   $240.00   1/2/1994   12/31/2299
24305   7   TENDON LENGTHENING; SINGLE, EACH                                  N   3    $13.45   6/1/1994   12/31/2299
24305   F   TENDON LENGTHENING; SINGLE, EACH                                  N   3   $432.00   3/1/2004   12/31/2299
24310   2   TENOTOMY, OPEN, ELBOW TO SHOULDER; SINGLE, EACH                   N   3   $125.00   1/1/1973   12/31/2299




                                                                                                                    51
24310   7   TENOTOMY, OPEN, ELBOW TO SHOULDER; SINGLE, EACH                     N   3    $13.45    6/1/1994   12/31/2299
24310   F   TENOTOMY, OPEN, ELBOW TO SHOULDER; SINGLE, EACH                     N   3   $351.00    3/1/2004   12/31/2299
24320   2   TENOPLASTY, WITH MUSCLE TRANSFER, WITH OR WITHOUT                   N   3   $300.00    1/1/1984   12/31/2299
24320   7   TENOPLASTY, WITH MUSCLE TRANSFER, WITH OR WITHOUT                   N   3    $13.45    6/1/1994   12/31/2299
24320   F   TENOPLASTY, WITH MUSCLE TRANSFER, WITH OR WITHOUT                   N   3   $351.00    3/1/2004   12/31/2299
24330   2   FLEXOR-PLASTY, ELBOW, (EG, STEINDLER TYPE ADVANCEM                  N   3   $200.00    1/1/1973   12/31/2299
24330   7   FLEXOR-PLASTY, ELBOW, (EG, STEINDLER TYPE ADVANCEM                  N   3    $13.45    6/1/1994   12/31/2299
24330   F   FLEXOR-PLASTY, ELBOW, (EG, STEINDLER TYPE ADVANCEM                  N   3   $351.00    3/1/2004   12/31/2299
24331   2   FLEXOR-PLASTY, ELBOW, (EG, STEINDLER TYPE ADVANCEM                  N   3   $270.00    1/1/1984   12/31/2299
24331   7   FLEXOR-PLASTY, ELBOW, (EG, STEINDLER TYPE ADVANCEM                  N   3    $13.45    6/1/1994   12/31/2299
24331   F   FLEXOR-PLASTY, ELBOW, (EG, STEINDLER TYPE ADVANCEM                  N   3   $351.00    3/1/2004   12/31/2299
24332   2   TENOLYSIS, TRICEPS                                                  N   3   $290.35   11/1/2002   12/31/2299
24340   2   TENODESIS FOR RUPTURE OF BICEPS TENDON AT ELBOW                     N   3   $350.00    1/1/1973   12/31/2299
24340   7   TENODESIS FOR RUPTURE OF BICEPS TENDON AT ELBOW                     N   3    $13.45    6/1/1994   12/31/2299
24340   F   TENODESIS FOR RUPTURE OF BICEPS TENDON AT ELBOW                     N   3   $351.00    3/1/2004   12/31/2299
24341   2   REPAIR,TENDON/MUSCLE,UPPER ARM/ELBOW,EA.TENDON/MUSCLE PRIM OR SEC   N   3   $366.50    1/1/1997   12/31/2299
24341   7   REPAIR TENDON/MUSCLE ARM                                            N   3    $13.45    1/1/1997   12/31/2299
24341   8   REPAIR TENDON/MUSCLE ARM                                            N   3    $73.30    1/1/1997   12/31/2299
24341   F   REPAIR,TENDON/MUSCLE,UPPER ARM/ELBOW,EA.TENDON/MUSCLE PRIM OR SEC   N   3   $351.00    3/1/2004   12/31/2299
24342   2   REINSERTION OF RUPTURED BICEPS TENDON, DISTAL, WIT                  N   3   $420.00    1/2/1992   12/31/2299
24342   7   REINSERTION OF RUPTURED BICEPS TENDON, DISTAL, WIT                  N   3    $13.45    6/1/1994   12/31/2299
24342   F   REINSERTION OF RUPTURED BICEPS TENDON, DISTAL, WIT                  N   3   $351.00    3/1/2004   12/31/2299
24343   1   REPAIR LATERAL COLLATERAL                                           N   3   $383.88    1/1/2002   12/31/2299
24343   2   REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW W/LOCAL TISSUE            N   3   $383.88    1/1/2002   12/31/2299
24344   2   RECONSTRUCTION LATERAL COLLATERAL LIGAMENT, ELBOW, W/TENDON GRAFT   N   3   $577.93    1/1/2002   12/31/2299
24344   8   RECONSTRUCTION LATERAL COLLATERAL LIGAMENT, ELBOW WITH TENDON       N   3   $577.93    1/1/2002   12/31/2299
24345   2   REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE         N   3   $383.88    1/1/2002   12/31/2299
24345   F   REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE         N   3   $306.00    3/1/2004   12/31/2299
24346   2   RECON MEDIAL COLLAT LIGAMENT, ELBOW W/ TENDON GRAFT                 N   3   $577.93    1/1/2002   12/31/2299
24346   7   OPEN TRTMNT OF HUMERAL SUPRACONDYLAR OR TRANSCOND                   N   3    $13.45    6/1/1994   12/31/2299
24350   2   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $150.00    1/1/1973   12/31/2299
24350   7   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3    $13.45    6/1/1994   12/31/2299
24350   F   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $351.00    3/1/2004   12/31/2299
24351   2   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $150.00    1/1/1984   12/31/2299
24351   7   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3    $13.45    6/1/1994   12/31/2299
24351   F   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $351.00    3/1/2004   12/31/2299
24352   2   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $180.00    1/1/1984   12/31/2299
24352   7   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3    $13.45    6/1/1994   12/31/2299
24352   F   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $351.00    3/1/2004   12/31/2299
24354   2   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $180.00    1/1/1984   12/31/2299
24354   7   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3    $13.45    6/1/1994   12/31/2299
24354   F   FASCIOTOMY, LATERAL OR MEDIAL (EG, ''TENNIS ELBOW'                  N   3   $351.00    3/1/2004   12/31/2299
24356   2   FASCIOTOMY LAT OR MED W PART OSTECTOMY                              N   3   $200.00    1/1/1984   12/31/2299
24356   7   FASCIOTOMY LAT OR MED W PART OSTECTOMY                              N   3    $13.45    6/1/1994   12/31/2299
24356   8   FASCIOTOMY LAT OR MED W PART OSTECTOMY                              N   3    $40.00    1/1/1984   12/31/2299
24356   F   FASCIOTOMY LAT OR MED W PART OSTECTOMY                              N   3   $351.00    3/1/2004   12/31/2299
24360   2   ARTHROPLASTY, ELBOW; WITH MEMBRANE                                  N   3   $325.00    1/1/1984   12/31/2299
24360   7   ARTHROPLASTY, ELBOW; WITH MEMBRANE                                  N   3    $13.45    6/1/1994   12/31/2299
24360   8   ARTHROPLASTY, ELBOW; WITH MEMBRANE                                  N   3    $65.00    1/1/1990   12/31/2299
24360   F   ARTHROPLASTY, ELBOW; WITH MEMBRANE                                  N   3   $495.00    3/1/2004   12/31/2299
24361   2   ARTHROPLASTY ELBOW W DISTAL HUMERAL PROSTH REPLACE                  N   3   $350.00    1/1/1984   12/31/2299




                                                                                                                       52
24361   7   ARTHROPLASTY ELBOW W DISTAL HUMERAL PROSTH REPLACE   N   3    $13.45   6/1/1994   12/31/2299
24361   F   ARTHROPLASTY ELBOW W DISTAL HUMERAL PROSTH REPLACE   N   3   $495.00   3/1/2004   12/31/2299
24362   2   ARTHROPLASTY, ELBOW; WITH IMPLANT AND FASCIA LATA    N   3   $425.00   1/1/1984   12/31/2299
24362   7   ARTHROPLASTY, ELBOW; WITH IMPLANT AND FASCIA LATA    N   3    $13.45   6/1/1994   12/31/2299
24362   F   ARTHROPLASTY, ELBOW; WITH IMPLANT AND FASCIA LATA    N   3   $495.00   3/1/2004   12/31/2299
24363   2   ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXI   N   3   $450.00   1/1/1973   12/31/2299
24363   7   ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXI   N   3    $13.45   6/1/1994   12/31/2299
24363   8   ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXI   N   3    $90.00   1/1/1973   12/31/2299
24363   F   ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXI   N   3   $495.00   3/1/2004   12/31/2299
24365   2   ARTHROPLASTY, RADIAL HEAD;                           N   3   $235.00   1/1/1984   12/31/2299
24365   7   ARTHROPLASTY, RADIAL HEAD;                           N   3    $13.45   6/1/1994   12/31/2299
24365   F   ARTHROPLASTY, RADIAL HEAD;                           N   3   $495.00   3/1/2004   12/31/2299
24366   2   ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT              N   3   $235.00   1/1/1984   12/31/2299
24366   7   ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT              N   3    $13.45   6/1/1994   12/31/2299
24366   8   ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT              N   3    $81.24   1/1/2004   12/31/2299
24366   F   ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT              N   3   $495.00   3/1/2004   12/31/2299
24400   2   OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXAT   N   3   $300.00   1/1/1973   12/31/2299
24400   7   OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXAT   N   3    $13.45   6/1/1994   12/31/2299
24400   8   OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXAT   N   3    $60.00   1/1/1973   12/31/2299
24400   F   OSTEOTOMY, HUMERUS, WITH OR WITHOUT INTERNAL FIXAT   N   3   $432.00   3/1/2004   12/31/2299
24410   2   MULTIPLE OSTEOTOMIES WITH REALIGNMENT ON INTRAMEDU   N   3   $350.00   1/1/1973   12/31/2299
24410   7   MULTIPLE OSTEOTOMIES WITH REALIGNMENT ON INTRAMEDU   N   3    $13.45   6/1/1994   12/31/2299
24410   8   MULTIPLE OSTEOTOMIES WITH REALIGNMENT ON INTRAMEDU   N   3    $70.00   1/1/1973   12/31/2299
24410   F   MULTIPLE OSTEOTOMIES WITH REALIGNMENT ON INTRAMEDU   N   3   $432.00   3/1/2004   12/31/2299
24420   2   OSTEOPLASTY, HUMERUS (EG, SHORTENING OR LENGTHENIN   N   3   $420.00   1/1/1973   12/31/2299
24420   7   OSTEOPLASTY, HUMERUS (EG, SHORTENING OR LENGTHENIN   N   3    $13.45   6/1/1994   12/31/2299
24420   8   OSTEOPLASTY, HUMERUS (EG, SHORTENING OR LENGTHENIN   N   3    $84.00   1/1/1973   12/31/2299
24420   F   OSTEOPLASTY, HUMERUS (EG, SHORTENING OR LENGTHENIN   N   3   $351.00   3/1/2004   12/31/2299
24430   2   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT G   N   3   $425.00   1/1/1973   12/31/2299
24430   7   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT G   N   3    $13.45   6/1/1994   12/31/2299
24430   8   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT G   N   3    $85.00   1/1/1973   12/31/2299
24430   F   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT G   N   3   $351.00   3/1/2004   12/31/2299
24435   2   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIA   N   3   $500.00   1/1/1973   12/31/2299
24435   7   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIA   N   3    $13.45   6/1/1994   12/31/2299
24435   8   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIA   N   3   $100.00   1/1/1973   12/31/2299
24435   F   REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIA   N   3   $432.00   3/1/2004   12/31/2299
24470   2   HEMIEPIPHYSEAL ARREST (EG, FOR CUBITUS VARUS OR VA   N   3   $175.00   1/1/1973   12/31/2299
24470   7   HEMIEPIPHYSEAL ARREST (EG, FOR CUBITUS VARUS OR VA   N   3    $13.45   6/1/1994   12/31/2299
24470   F   HEMIEPIPHYSEAL ARREST (EG, FOR CUBITUS VARUS OR VA   N   3   $351.00   3/1/2004   12/31/2299
24495   2   DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL A   N   3   $175.00   1/1/1984   12/31/2299
24495   7   DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL A   N   3    $13.45   6/1/1994   12/31/2299
24495   8   DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL A   N   3    $35.00   1/2/1984   12/31/2299
24495   F   DECOMPRESSION FASCIOTOMY, FOREARM, WITH BRACHIAL A   N   3   $306.00   3/1/2004   12/31/2299
24498   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3    $13.45   6/1/1994   12/31/2299
24498   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3   $351.00   3/1/2004   12/31/2299
24500   2   TREATMENT OF CLOSED HUMERAL SHAFT FRACTURE; WITHOU   N   3    $75.00   1/1/1971   12/31/2299
24500   7   TREATMENT OF CLOSED HUMERAL SHAFT FRACTURE; WITHOU   N   3    $13.45   6/1/1994   12/31/2299
24500   F   TREATMENT OF CLOSED HUMERAL SHAFT FRACTURE; WITHOU   N   3   $225.80   3/1/2004   12/31/2299
24505   2   TREATMENT OF CLOSED HUMERAL SHAFT FRACTURE; WITH M   N   3   $125.00   1/1/1984   12/31/2299
24505   7   TREATMENT OF CLOSED HUMERAL SHAFT FRACTURE; WITH M   N   3    $13.45   6/1/1994   12/31/2299
24505   F   TREATMENT OF CLOSED HUMERAL SHAFT FRACTURE; WITH M   N   3   $225.80   3/1/2004   12/31/2299




                                                                                                       53
24515   2   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL SHAFT FRA                  N   3   $275.00   1/1/1971   12/31/2299
24515   7   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL SHAFT FRA                  N   3    $13.45   6/1/1994   12/31/2299
24515   8   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL SHAFT FRA                  N   3    $50.00   1/1/1971   12/31/2299
24515   F   OPEN TREATMENT OF CLOSED OR OPEN HUMERAL SHAFT FRA                  N   3   $432.00   3/1/2004   12/31/2299
24516   2   OPEN TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INS                  N   3   $525.85   1/1/2003   12/31/2299
24516   7   OPEN TRTMNT OF HUMERAL SHAFT FRACT, WITH INSERTION                  N   3    $13.45   6/1/1994   12/31/2299
24516   8   OPEN TRTMNT OF HUMERAL SHAFT FRACT, WITH INSERTION                  N   3   $108.76   1/1/2003   12/31/2299
24530   2   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3   $150.00   1/1/1997   12/31/2299
24530   7   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3    $13.45   6/1/1994   12/31/2299
24530   F   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3   $225.80   3/1/2004   12/31/2299
24535   2   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3   $125.00   1/1/1973   12/31/2299
24535   7   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3    $13.45   6/1/1994   12/31/2299
24535   F   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3   $225.80   3/1/2004   12/31/2299
24538   2   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3   $342.00   1/2/1992   12/31/2299
24538   7   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3    $13.45   6/1/1994   12/31/2299
24538   8   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3    $84.00   1/2/1994   12/31/2299
24538   F   TREATMENT OF CLOSED SUPRACONDYLAR OR TRANSCONDYLAR                  N   3   $306.00   3/1/2004   12/31/2299
24545   2   OPEN TREATMENT OF CLOSED OR OPEN SUPRACONDYLAR FRA                  N   3   $250.00   1/1/1973   12/31/2299
24545   7   OPEN TREATMENT OF CLOSED OR OPEN SUPRACONDYLAR FRA                  N   3    $13.45   6/1/1994   12/31/2299
24545   8   OPEN TREATMENT OF CLOSED OR OPEN SUPRACONDYLAR FRA                  N   3    $50.00   1/1/1973   12/31/2299
24545   F   OPEN TREATMENT OF CLOSED OR OPEN SUPRACONDYLAR FRA                  N   3   $432.00   3/1/2004   12/31/2299
24546   2   OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCO                  N   3   $576.00   1/2/1994   12/31/2299
24546   8   OPEN TREATMENT OF HUMERAL SUUPRACONDYLAR OR TRANSCO                 N   3   $115.00   1/2/1994   12/31/2299
24546   F   OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCO                  N   3   $495.00   3/1/2004   12/31/2299
24560   2   TREATMENT OF CLOSED EPICONDYLAR FRACTURE, MEDIAL O                  N   3    $25.00   1/1/1971   12/31/2299
24560   7   TREATMENT OF CLOSED EPICONDYLAR FRACTURE, MEDIAL O                  N   3    $13.45   6/1/1994   12/31/2299
24560   F   TREATMENT OF CLOSED EPICONDYLAR FRACTURE, MEDIAL O                  N   3   $225.80   3/1/2004   12/31/2299
24565   2   TREATMENT OF CLOSED EPICONDYLAR FRACTURE, MEDIAL O                  N   3    $94.00   1/1/1971   12/31/2299
24565   7   TREATMENT OF CLOSED EPICONDYLAR FRACTURE, MEDIAL O                  N   3    $13.45   6/1/1994   12/31/2299
24565   F   TREATMENT OF CLOSED EPICONDYLAR FRACTURE, MEDIAL O                  N   3   $306.00   3/1/2004   12/31/2299
24566   2   PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDY                  N   3   $255.25   1/1/1994   12/31/2299
24566   7   ANESTHESIA, PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDYLAR   N   3    $13.45   1/1/1994   12/31/2299
24566   F   PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDY                  N   3   $306.00   3/1/2004   12/31/2299
24575   2   OPEN TREATMENT OF CLOSED OR OPEN EPICONDYLAR FRACT                  N   3   $175.00   8/1/1979   12/31/2299
24575   7   OPEN TREATMENT OF CLOSED OR OPEN EPICONDYLAR FRACT                  N   3    $13.45   6/1/1994   12/31/2299
24575   8   OPEN TREATMENT OF CLOSED OR OPEN EPICONDYLAR FRACT                  N   3    $37.50   1/1/1973   12/31/2299
24575   F   OPEN TREATMENT OF CLOSED OR OPEN EPICONDYLAR FRACT                  N   3   $351.00   3/1/2004   12/31/2299
24576   2   TREATMENT OF CLOSED CONDYLAR FRACTURE, MEDIAL OR L                  N   3    $40.00   1/1/1984   12/31/2299
24576   F   TREATMENT OF CLOSED CONDYLAR FRACTURE, MEDIAL OR L                  N   3   $225.80   3/1/2004   12/31/2299
24577   2   TREATMENT OF CLOSED CONDYLAR FRACTURE, MEDIAL OR L                  N   3    $80.00   1/1/1984   12/31/2299
24577   7   TREATMENT OF CLOSED CONDYLAR FRACTURE, MEDIAL OR L                  N   3    $13.45   6/1/1994   12/31/2299
24577   F   TREATMENT OF CLOSED CONDYLAR FRACTURE, MEDIAL OR L                  N   3   $225.80   3/1/2004   12/31/2299
24579   2   OPEN TREATMENT OF CLOSED OR OPEN CONDYLAR FRACTURE                  N   3   $325.00   1/2/1992   12/31/2299
24579   7   OPEN TREATMENT OF CLOSED OR OPEN CONDYLAR FRACTURE                  N   3    $13.45   6/1/1994   12/31/2299
24579   8   OPEN TREATMENT OF CLOSED OR OPEN CONDYLAR FRACTURE                  N   3    $35.00   1/1/1984   12/31/2299
24579   F   OPEN TREATMENT OF CLOSED OR OPEN CONDYLAR FRACTURE                  N   3   $351.00   3/1/2004   12/31/2299
24582   2   PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR                  N   3   $316.99   1/1/1994   12/31/2299
24582   F   PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR                  N   3   $306.00   3/1/2004   12/31/2299
24586   2   OPEN TREATMENT OF CLOSED OR OPEN COMMINUTED ELBOW                   N   3   $350.00   1/1/1984   12/31/2299
24586   7   OPEN TREATMENT OF CLOSED OR OPEN COMMINUTED ELBOW                   N   3    $13.45   6/1/1994   12/31/2299
24586   F   OPEN TREATMENT OF CLOSED OR OPEN COMMINUTED ELBOW                   N   3   $432.00   3/1/2004   12/31/2299




                                                                                                                      54
24587   2   OPEN TREATMENT OF CLOSED OR OPEN COMMINUTED ELBOW    N   3   $365.00   1/1/1984   12/31/2299
24587   7   OPEN TREATMENT OF CLOSED OR OPEN COMMINUTED ELBOW    N   3    $13.45   6/1/1994   12/31/2299
24587   F   OPEN TREATMENT OF CLOSED OR OPEN COMMINUTED ELBOW    N   3   $495.00   3/1/2004   12/31/2299
24600   2   TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANE   N   3    $90.00   1/2/1993   12/31/2299
24600   F   TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANE   N   3   $225.80   3/1/2004   12/31/2299
24605   2   TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING A   N   3    $50.00   8/1/1979   12/31/2299
24605   7   TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING A   N   3    $13.45   6/1/1994   12/31/2299
24605   F   TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING A   N   3   $306.00   3/1/2004   12/31/2299
24615   2   OPEN TREATMENT OF CLOSED OR OPEN ELBOW DISLOCATION   N   3   $300.00   8/1/1979   12/31/2299
24615   7   OPEN TREATMENT OF CLOSED OR OPEN ELBOW DISLOCATION   N   3    $13.45   6/1/1994   12/31/2299
24615   8   OPEN TREATMENT OF CLOSED OR OPEN ELBOW DISLOCATION   N   3    $60.00   8/1/1979   12/31/2299
24615   F   OPEN TREATMENT OF CLOSED OR OPEN ELBOW DISLOCATION   N   3   $351.00   3/1/2004   12/31/2299
24620   2   TREATMENT OF CLOSED MONTEGGIA TYPE OF FRACTURE DIS   N   3   $270.00   1/2/1996   12/31/2299
24620   7   TREAT OF CLOSED MONTEGGIA TYPE OF FRACTURE,DISLOC    N   3    $13.45   6/1/1994   12/31/2299
24620   F   TREATMENT OF CLOSED MONTEGGIA TYPE OF FRACTURE DIS   N   3   $306.00   3/1/2004   12/31/2299
24635   2   OPEN TREATMENT OF CLOSED OR OPEN MONTEGGIA TYPE OF   N   3   $462.00   1/2/1992   12/31/2299
24635   7   OPEN TREATMENT OF CLOSED OR OPEN MONTEGGIA TYPE OF   N   3    $13.45   6/1/1994   12/31/2299
24635   8   OPEN TREATMENT OF CLOSED OR OPEN MONTEGGIA TYPE OF   N   3    $60.00   1/1/1973   12/31/2299
24635   F   OPEN TREATMENT OF CLOSED OR OPEN MONTEGGIA TYPE OF   N   3   $351.00   3/1/2004   12/31/2299
24640   2   TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, "NU   N   3    $20.00   8/1/1979   12/31/2299
24640   7   TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, "NU   N   3    $13.45   6/1/1994   12/31/2299
24650   2   TREATMENT OF CLOSED RADIAL HEAD OR NECK FRACTURE;    N   3    $50.00   1/1/1973   12/31/2299
24650   7   TREATMENT OF CLOSED RADIAL HEAD OR NECK FRACTURE;    N   3    $13.45   6/1/1994   12/31/2299
24655   2   TREATMENT OF CLOSED RADIAL HEAD OR NECK FRACTURE;    N   3    $75.00   1/1/1971   12/31/2299
24655   7   TREATMENT OF CLOSED RADIAL HEAD OR NECK FRACTURE;    N   3    $13.45   6/1/1994   12/31/2299
24655   F   TREATMENT OF CLOSED RADIAL HEAD OR NECK FRACTURE;    N   3   $225.80   3/1/2004   12/31/2299
24665   2   OPEN TREAT OF CLOSED OR OPEN RADIAL HEAD OR NECK F   N   3   $200.00   1/1/1973   12/31/2299
24665   7   OPEN TREAT OF CLOSED OR OPEN RADIAL HEAD OR NECK F   N   3    $13.45   6/1/1994   12/31/2299
24665   8   OPEN TREAT OF CLOSED OR OPEN RADIAL HEAD OR NECK F   N   3    $40.00   1/1/1973   12/31/2299
24665   F   OPEN TREAT OF CLOSED OR OPEN RADIAL HEAD OR NECK F   N   3   $432.00   3/1/2004   12/31/2299
24666   2   OPEN TREAT OF CLOSED OR OPEN RAD HD OR NECK FRAC W   N   3   $300.00   1/1/1984   12/31/2299
24666   7   OPEN TREAT OF CLOSED OR OPEN RAD HD OR NECK FRAC W   N   3    $13.45   6/1/1994   12/31/2299
24666   8   OPEN TREAT OF CLOSED OR OPEN RAD HD OR NECK FRAC W   N   3    $60.00   1/1/1984   12/31/2299
24666   F   OPEN TREAT OF CLOSED OR OPEN RAD HD OR NECK FRAC W   N   3   $432.00   3/1/2004   12/31/2299
24670   2   TREATMENT OF CLOSED ULNAR FRACTURE, PROXIMAL END (   N   3    $20.00   1/1/1971   12/31/2299
24670   7   TREATMENT OF CLOSED ULNAR FRACTURE, PROXIMAL END (   N   3    $13.45   6/1/1994   12/31/2299
24670   F   TREATMENT OF CLOSED ULNAR FRACTURE, PROXIMAL END (   N   3   $225.80   3/1/2004   12/31/2299
24675   2   TREATMENT OF CLOSED ULNAR FRACTURE, PROXIMAL END (   N   3    $75.00   1/1/1974   12/31/2299
24675   7   TREATMENT OF CLOSED ULNAR FRACTURE, PROXIMAL END (   N   3    $13.45   6/1/1994   12/31/2299
24675   F   TREATMENT OF CLOSED ULNAR FRACTURE, PROXIMAL END (   N   3   $225.80   3/1/2004   12/31/2299
24685   2   OPEN TREAT. OF CLOS OR OPEN ULNAR FRAC, PROX END (   N   3   $125.00   1/1/1973   12/31/2299
24685   7   OPEN TREAT. OF CLOS OR OPEN ULNAR FRAC, PROX END (   N   3    $13.45   6/1/1994   12/31/2299
24685   8   OPEN TREAT. OF CLOS OR OPEN ULNAR FRAC, PROX END (   N   3    $25.00   1/1/1973   12/31/2299
24685   F   OPEN TREAT. OF CLOS OR OPEN ULNAR FRAC, PROX END (   N   3   $351.00   3/1/2004   12/31/2299
24700   2   MANIPULATION UNDER GENERAL ANESTHESIA (INCLUDES AP   N   3    $25.00   1/1/1973   12/31/2299
24700   7   MANIPULATION UNDER GENERAL ANESTHESIA (INCLUDES AP   N   3    $13.45   6/1/1994   12/31/2299
24800   2   ARTHRODESIS, ELBOW JOINT; WITH OR W/O LOCAL OR HOM   N   3   $400.00   1/1/1973   12/31/2299
24800   7   ARTHRODESIS, ELBOW JOINT; WITH OR W/O LOCAL OR HOM   N   3    $13.45   6/1/1994   12/31/2299
24800   8   ARTHRODESIS, ELBOW JOINT; WITH OR W/O LOCAL OR HOM   N   3    $80.00   1/1/1973   12/31/2299
24800   F   ARTHRODESIS, ELBOW JOINT; WITH OR W/O LOCAL OR HOM   N   3   $432.00   3/1/2004   12/31/2299
24802   2   ARTHRODESIS, ELBOW JOINT; W/ PRIMARY AUTOGENOUS BO   N   3   $400.00   1/1/1984   12/31/2299




                                                                                                       55
24802   7   ARTHRODESIS, ELBOW JOINT; W/ PRIMARY AUTOGENOUS BO                  N   3    $13.45   6/1/1994   12/31/2299
24802   F   ARTHRODESIS, ELBOW JOINT; W/ PRIMARY AUTOGENOUS BO                  N   3   $495.00   3/1/2004   12/31/2299
24813   2   PLACEM.OF FEMOR.PROSTHET.GRAFT DURING ENDOVASCULAR AORT.ANEUR.      N   3   $161.41   1/1/2001   12/31/2299
24900   2   AMPUTATION, ARM THROUGH HUMERUS; WITH PRIMARY CLOS                  N   3   $250.00   1/1/1973   12/31/2299
24900   7   AMPUTATION, ARM THROUGH HUMERUS; WITH PRIMARY CLOS                  N   3    $13.45   6/1/1994   12/31/2299
24900   8   AMPUTATION, ARM THROUGH HUMERUS; WITH PRIMARY CLOS                  N   3    $50.00   1/1/1973   12/31/2299
24920   2   AMPUTATION, ARM THROUGH HUMERUS; OPEN, FLAP OR CIR                  N   3   $225.00   1/1/1973   12/31/2299
24920   7   AMPUTATION, ARM THROUGH HUMERUS; OPEN, FLAP OR CIR                  N   3    $13.45   6/1/1994   12/31/2299
24920   8   AMPUTATION, ARM THROUGH HUMERUS; OPEN, FLAP OR CIR                  N   3    $45.00   1/1/1973   12/31/2299
24925   2   AMPUTATION, ARM THROUGH HUMERUS; SECONDARY CLOSURE                  N   3    $75.00   1/1/1973   12/31/2299
24925   7   AMPUTATION, ARM THROUGH HUMERUS; SECONDARY CLOSURE                  N   3    $13.45   6/1/1994   12/31/2299
24925   F   AMPUTATION, ARM THROUGH HUMERUS; SECONDARY CLOSURE                  N   3   $351.00   3/1/2004   12/31/2299
24930   2   AMPUTATION, ARM THROUGH HUMERUS; REAMPUTATION                       N   3   $175.00   8/1/1979   12/31/2299
24930   7   AMPUTATION, ARM THROUGH HUMERUS; REAMPUTATION                       N   3    $13.45   6/1/1994   12/31/2299
24931   2   AMPUTATION, ARM                                                     N   3   $300.00   1/1/1984   12/31/2299
24931   7   AMPUTATION, ARM THROUGH HUMERUS; WITH IMPLANT                       N   3    $13.45   6/1/1994   12/31/2299
24935   2   STUMP ELONGATION                                                    N   3   $300.00   1/1/1984   12/31/2299
24935   7   STUMP ELONGATION                                                    N   3    $13.45   6/1/1994   12/31/2299
24940   2   CINEPLASTY, UPPER EXTREMITY, COMPLETE PROCEDURE                     N   3   $325.00   1/1/1984   12/31/2299
24940   7   CINEPLASTY, UPPER EXTREMITY, COMPLETE PROCEDURE                     N   3    $13.45   6/1/1994   12/31/2299
24999   7   UNLISTED PROCEDURE, HUMERUS OR ELBOW                                N   3    $13.45   6/1/1994   12/31/2299
25000   2   TENDON SHEATH INCISION; AT RADIAL STYLOID FOR DEQU                  N   3   $110.00   1/1/1973   12/31/2299
25000   7   TENDON SHEATH INCISION; AT RADIAL STYLOID FOR DEQU                  N   3    $13.45   6/1/1994   12/31/2299
25000   F   TENDON SHEATH INCISION; AT RADIAL STYLOID FOR DEQU                  N   3   $351.00   3/1/2004   12/31/2299
25001   2   INCISE FELXOR RARPI RADIALIS                                        N   3   $176.65   1/1/2002   12/31/2299
25020   2   DECOMPRESSION FASCIOTOMY, FLEXOR AND/OR EXTENSOR C                  N   3   $105.00   1/1/1984   12/31/2299
25020   7   DECOMPRESSION FASCIOTOMY, FLEXOR AND/OR EXTENSOR C                  N   3    $13.45   6/1/1994   12/31/2299
25020   8   DECOMPRESSION FASCIOTOMY, FLEXOR AND/OR EXTENSOR C                  N   3    $50.00   1/2/1994   12/31/2299
25020   F   DECOMPRESSION FASCIOTOMY, FLEXOR AND/OR EXTENSOR C                  N   3   $351.00   3/1/2004   12/31/2299
25023   7   DECOMP FASCIOTOMY, FLEX AND/OR EXTENS COMPART W/DE                  N   3    $13.45   6/1/1994   12/31/2299
25024   2   DECOMPRESSION FACIOTOMY FOREARM AND/OR WRIST FLEXOR AND EXTENSOR    N   3   $407.72   1/1/2002   12/31/2299
25024   F   DECOMPRESSION FACIOTOMY FOREARM AND/OR WRIST FLEXOR AND EXTENSOR    N   3   $351.00   3/1/2004   12/31/2299
25025   2   DECOMPRESSION FASCIOTOMY FOREARM AND/OR WRIST, FLEXOR AND EXTENSO   N   3   $658.01   1/1/2003   12/31/2299
25028   2   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA                     N   3   $100.00   1/1/1984   12/31/2299
25028   7   I&D DEEP ABCESS OR HEMATOMA FOREAM OR WRIST                         N   3    $13.45   6/1/1994   12/31/2299
25028   F   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA                     N   3   $225.80   3/1/2004   12/31/2299
25031   7   I&D INFECTED BURSA-FOREARM OR WRIST                                 N   3    $13.45   6/1/1994   12/31/2299
25031   F   INCISION AND DRAINAGE; INFECTED BURSA                               N   3   $306.00   3/1/2004   12/31/2299
25035   2   INCISION, DEEP, WITH OPENING OF CORTEX (EG, FOR OS                  N   3   $100.00   1/1/1984   12/31/2299
25035   7   INCISION, DEEP, WITH OPENING OF CORTEX (EG, FOR OS                  N   3    $13.45   6/1/1994   12/31/2299
25035   8   INCISION, DEEP, WITH OPENING OF CORTEX (EG, FOR OS                  N   3    $20.00   1/1/1984   12/31/2299
25035   F   INCISION, DEEP, WITH OPENING OF CORTEX (EG, FOR OS                  N   3   $306.00   3/1/2004   12/31/2299
25036   2   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3   $100.00   1/1/1984   12/31/2299
25036   7   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3    $13.45   6/1/1994   12/31/2299
25040   2   ARTHROTOMY W/EXPLOR, DRAIN, OR REM OF LOOS OR FORE                  N   3   $125.00   1/1/1973   12/31/2299
25040   7   ARTHROTOMY W/EXPLOR, DRAIN, OR REM OF LOOS OR FORE                  N   3    $13.45   6/1/1994   12/31/2299
25040   F   ARTHROTOMY W/EXPLOR, DRAIN, OR REM OF LOOS OR FORE                  N   3   $495.00   3/1/2004   12/31/2299
25041   2   ARTHROTOMY WITH EXPLORATION, DRAINAGE, OR REMOVAL                   N   3   $125.00   1/1/1984   12/31/2299
25041   7   ARTHROTOMY WITH EXPLORATION, DRAINAGE, OR REMOVAL                   N   3    $13.45   6/1/1994   12/31/2299
25065   2   BIOPSY, SOFT TISSUES; SUPERFICIAL                                   N   3    $50.00   1/1/1984   12/31/2299
25065   7   ANESTHESIA, BIOPSY, SOFT TISSUES, SUPERFICIAL                       N   3    $13.45   1/2/1995   12/31/2299




                                                                                                                      56
25066   2   BIOPSY, SOFT TISSUES; DEEP                           N   3   $150.00   1/1/1984   12/31/2299
25066   7   BIOPSY FOREARM OR WRIST DEEP                         N   3    $13.45   6/1/1994   12/31/2299
25066   F   BIOPSY, SOFT TISSUES; DEEP                           N   3   $306.00   3/1/2004   12/31/2299
25075   2   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3    $50.00   1/1/1984   12/31/2299
25075   7   ANESTH FOR EXCISION BENIGN SUBCUTAN TUMOR WRST/ARM   N   3    $13.45   6/1/1994   12/31/2299
25075   F   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3   $306.00   3/1/2004   12/31/2299
25076   2   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM   N   3   $150.00   1/1/1984   12/31/2299
25076   7   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM   N   3    $13.45   6/1/1994   12/31/2299
25076   F   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL OR INTRAM   N   3   $351.00   3/1/2004   12/31/2299
25077   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3    $13.45   6/1/1994   12/31/2299
25077   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $351.00   3/1/2004   12/31/2299
25085   2   CAPSULOTOMY, WRIST (EG, FOR CONTRACTURE)             N   3   $125.00   1/1/1984   12/31/2299
25085   7   CAPSULOTOMY, WRIST (EG, FOR CONTRACTURE)             N   3    $13.45   6/1/1994   12/31/2299
25085   8   CAPSULOTOMY, WRIST (EG, FOR CONTRACTURE)             N   3    $73.21   1/1/2003   12/31/2299
25085   F   CAPSULOTOMY, WRIST (EG, FOR CONTRACTURE)             N   3   $351.00   3/1/2004   12/31/2299
25100   2   ARTHROTOMY, WRIST JOINT; FOR BIOPSY                  N   3   $125.00   1/1/1973   12/31/2299
25100   7   ARTHROTOMY, WRIST JOINT; FOR BIOPSY                  N   3    $13.45   6/1/1994   12/31/2299
25100   F   ARTHROTOMY, WRIST JOINT; FOR BIOPSY                  N   3   $306.00   3/1/2004   12/31/2299
25101   2   ARTHROTOMY, WRIST JOINT; W/EXPLO, W/ OR W/O BIOPSY   N   3   $125.00   1/1/1984   12/31/2299
25101   7   ARTHROTOMY, WRIST JOINT; W/EXPLO, W/ OR W/O BIOPSY   N   3    $13.45   6/1/1994   12/31/2299
25101   F   ARTHROTOMY, WRIST JOINT; W/EXPLO, W/ OR W/O BIOPSY   N   3   $351.00   3/1/2004   12/31/2299
25105   2   ARTHROTOMY, WRIST JOINT; FOR SYNOVECTOMY             N   3   $150.00   8/1/1979   12/31/2299
25105   7   ARTHROTOMY, WRIST JOINT; FOR SYNOVECTOMY             N   3    $13.45   6/1/1994   12/31/2299
25105   F   ARTHROTOMY, WRIST JOINT; FOR SYNOVECTOMY             N   3   $432.00   3/1/2004   12/31/2299
25107   2   ARTHROTOMY, DISTAL RADIOULNAR JOINT FOR EXCISION T   N   3   $125.00   1/1/1984   12/31/2299
25107   7   ARTHROTOMY, DISTAL RADIOULNAR JOINT FOR EXCISION T   N   3    $13.45   6/1/1994   12/31/2299
25107   F   ARTHROTOMY, DISTAL RADIOULNAR JOINT FOR EXCISION T   N   3   $351.00   3/1/2004   12/31/2299
25109   2   EXCISE TENDON FOREARM/WRIST                          N   3   $267.04   1/1/2007   12/31/2299
25109   7   EXCISE TENDON FOREARM/WRIST                          N   3    $13.45   1/1/2007   12/31/2299
25109   8   EXCISE TENDON FOREARM/WRIST                          N   3    $53.00   1/1/2007   12/31/2299
25110   2   EXCISION, LESION OF TENDON SHEATH                    N   3    $85.00   8/1/1979   12/31/2299
25110   7   EXCISION, LESION OF TENDON SHEATH                    N   3    $13.45   6/1/1994   12/31/2299
25110   F   EXCISION, LESION OF TENDON SHEATH                    N   3   $351.00   3/1/2004   12/31/2299
25111   2   EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRI   N   3   $125.00   8/1/1979   12/31/2299
25111   7   EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRI   N   3    $13.45   6/1/1994   12/31/2299
25111   F   EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRI   N   3   $351.00   3/1/2004   12/31/2299
25112   2   EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); REC   N   3    $85.00   1/1/1984   12/31/2299
25112   7   EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); REC   N   3    $13.45   6/1/1994   12/31/2299
25112   F   EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); REC   N   3   $432.00   3/1/2004   12/31/2299
25115   2   RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FO   N   3   $250.00   1/1/1973   12/31/2299
25115   7   RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FO   N   3    $13.45   6/1/1994   12/31/2299
25115   F   RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FO   N   3   $432.00   3/1/2004   12/31/2299
25116   2   RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FO   N   3   $250.00   1/1/1984   12/31/2299
25116   7   RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FO   N   3    $13.45   6/1/1994   12/31/2299
25116   F   RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FO   N   3   $432.00   3/1/2004   12/31/2299
25118   2   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE   N   3   $140.00   1/1/1971   12/31/2299
25118   7   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE   N   3    $13.45   6/1/1994   12/31/2299
25118   8   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE   N   3    $28.00   8/1/1979   12/31/2299
25118   F   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE   N   3   $306.00   3/1/2004   12/31/2299
25119   2   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE   N   3   $125.00   1/1/1984   12/31/2299
25119   7   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       57
25119   F   SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE                 N   3    $351.00    3/1/2004   12/31/2299
25120   2   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $175.00    1/1/1973   12/31/2299
25120   7   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $13.45   6/1/1994   12/31/2299
25120   8   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $35.00   1/1/1973   12/31/2299
25120   F   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $351.00    3/1/2004   12/31/2299
25125   2   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $250.00    1/1/1973   12/31/2299
25125   7   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $13.45   6/1/1994   12/31/2299
25125   8   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $50.00   1/1/1973   12/31/2299
25125   F   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $351.00    3/1/2004   12/31/2299
25126   2   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $225.00    1/1/1984   12/31/2299
25126   7   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $13.45   6/1/1994   12/31/2299
25126   F   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $351.00    3/1/2004   12/31/2299
25130   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                 N   3    $150.00    1/1/1973   12/31/2299
25130   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                 N   3      $13.45   6/1/1994   12/31/2299
25130   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR                 N   3    $351.00    3/1/2004   12/31/2299
25135   2   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $175.00    1/1/1973   12/31/2299
25135   7   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $13.45   6/1/1994   12/31/2299
25135   8   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $35.00   1/1/1973   12/31/2299
25135   F   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $351.00    3/1/2004   12/31/2299
25136   2   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $135.00    1/1/1984   12/31/2299
25136   7   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3      $13.45   6/1/1994   12/31/2299
25136   F   EXCIS OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF                 N   3    $351.00    3/1/2004   12/31/2299
25145   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;                  N   3    $125.00    1/1/1984   12/31/2299
25145   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;                  N   3      $13.45   6/1/1994   12/31/2299
25145   F   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;                  N   3    $306.00    3/1/2004   12/31/2299
25146   2   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;                  N   3    $125.00    1/1/1984   12/31/2299
25146   7   SEQUESTRECTOMY FOR OSTEOMYELITIS OR BONE ABSCESS;                  N   3      $13.45   6/1/1994   12/31/2299
25150   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                 N   3    $125.00    1/1/1973   12/31/2299
25150   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                 N   3      $13.45   6/1/1994   12/31/2299
25150   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                 N   3    $306.00    3/1/2004   12/31/2299
25151   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                 N   3    $125.00    1/1/1984   12/31/2299
25151   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                 N   3      $13.45   6/1/1994   12/31/2299
25151   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA                 N   3    $306.00    3/1/2004   12/31/2299
25153   2   PARTIAL EXCIS OF BONE (CRATERIZ, SAUCERIZ OR DIAPH                 N   3    $125.00    1/1/1984   12/31/2299
25153   7   PARTIAL EXCIS OF BONE (CRATERIZ, SAUCERIZ OR DIAPH                 N   3      $13.45   6/1/1994   12/31/2299
25170   7   RADICAL RESECTION FOR TUMOR, RADIUS OR ULNA                        N   3      $13.45   6/1/1994   12/31/2299
25175   2   RECONSTRUCTION,BIFRONTAL,SUPERIOR-LATERAL ORBITAL RIMS AND LOWER   N   3   $1,380.00   1/2/1994   12/31/2299
25210   2   CARPECTOMY; ONE BONE                                               N   3    $175.00    1/1/1973   12/31/2299
25210   7   CARPECTOMY; ONE BONE                                               N   3      $13.45   6/1/1994   12/31/2299
25210   8   CARPECTOMY; ONE BONE                                               N   3      $35.00   1/1/1984   12/31/2299
25210   F   CARPECTOMY; ONE BONE                                               N   3    $351.00    3/1/2004   12/31/2299
25215   2   CARPECTOMY; ALL BONES OR PROXIMAL ROW                              N   3    $250.00    1/1/1973   12/31/2299
25215   7   CARPECTOMY; ALL BONES OR PROXIMAL ROW                              N   3      $13.45   6/1/1994   12/31/2299
25215   8   CARPECTOMY; ALL BONES OR PROXIMAL ROW                              N   3      $50.00   1/1/1973   12/31/2299
25215   F   CARPECTOMY; ALL BONES OR PROXIMAL ROW                              N   3    $432.00    3/1/2004   12/31/2299
25230   2   RADIAL STYLOIDECTOMY (SEPARATE PROCEDURE)                          N   3    $125.00    1/1/1973   12/31/2299
25230   7   RADIAL STYLOIDECTOMY (SEPARATE PROCEDURE)                          N   3      $13.45   6/1/1994   12/31/2299
25230   F   RADIAL STYLOIDECTOMY (SEPARATE PROCEDURE)                          N   3    $432.00    3/1/2004   12/31/2299
25240   2   EXCISION DISTAL ULNA (DARRACH TYPE PROCEDURE)                      N   3    $150.00    1/1/1999   12/31/2299
25240   7   EXCISION DISTAL ULNA (DARRACH TYPE PROCEDURE)                      N   3      $13.45   6/1/1994   12/31/2299
25240   F   EXCISION DISTAL ULNA (DARRACH TYPE PROCEDURE)                      N   3    $432.00    3/1/2004   12/31/2299




                                                                                                                       58
25246   2   INJECTION PROCEDURE FOR WRIST ARTHROGRAPHY                          N   3    $41.00   1/1/1994   12/31/2299
25248   2   EXPLORATION FOR REMOVAL OF DEEP FOREIGN BODY                        N   3   $125.00   1/1/1984   12/31/2299
25248   7   EXPLORATION FOR REMOVAL OF DEEP FOREIGN BODY                        N   3    $13.45   6/1/1994   12/31/2299
25248   F   EXPLORATION FOR REMOVAL OF DEEP FOREIGN BODY                        N   3   $306.00   3/1/2004   12/31/2299
25250   2   REMOVAL OF WRIST PROSTHESIS; (SEPARATE PROCEDURE)                   N   3   $200.00   1/1/1984   12/31/2299
25250   7   REMOVAL OF WRIST PROSTHESIS; (SEPARATE PROCEDURE)                   N   3    $13.45   6/1/1994   12/31/2299
25250   F   REMOVAL OF WRIST PROSTHESIS; (SEPARATE PROCEDURE)                   N   3   $225.80   3/1/2004   12/31/2299
25251   2   COMPLICATED, INCLUDING "TOTAL WRIST"                                N   3   $250.00   1/1/1984   12/31/2299
25251   7   COMPLICATED, INCLUDING "TOTAL WRIST"                                N   3    $13.45   6/1/1994   12/31/2299
25251   F   COMPLICATED, INCLUDING TOTAL WRIST                                  N   3   $225.80   3/1/2004   12/31/2299
25259   2   MANIPULATION, WRIST, UNDER ANESTHESIA                               N   3   $209.31   1/2/2002   12/31/2299
25260   2   REPAIR, TENDON OR MUSCLE, FLEXOR; PRIMARY, SINGLE,                  N   3   $300.00   1/2/1997   12/31/2299
25260   7   REPAIR, TENDON OR MUSCLE, FLEXOR; PRIMARY, SINGLE,                  N   3    $13.45   6/1/1994   12/31/2299
25260   8   REPAIR, TENDON OR MUSCLE, FLEXOR; PRIMARY, SINGLE,                  N   3    $60.00   1/2/1996   12/31/2299
25260   F   REPAIR, TENDON OR MUSCLE, FLEXOR; PRIMARY, SINGLE,                  N   3   $432.00   3/1/2004   12/31/2299
25263   2   REPAIR TENDON OR MUSCLE FLEXOR; SECONDARY, SINGL                    N   3   $175.00   1/2/1984   12/31/2299
25263   7   REPAIR TENDON OR MUSCLE, FLEXOR; SECONDARY, SINGL                   N   3    $13.45   6/1/1994   12/31/2299
25263   F   REPAIR TENDON OR MUSCLE FLEXOR; SECONDARY, SINGL                    N   3   $306.00   3/1/2004   12/31/2299
25265   2   REPAIR, TENDON OR MUSCLE, FLEXOR; SECONDARY, W/FRE                  N   3   $225.00   1/1/1984   12/31/2299
25265   7   REPAIR, TENDON OR MUSCLE, FLEXOR; SECONDARY, W/FRE                  N   3    $13.45   6/1/1994   12/31/2299
25265   F   REPAIR, TENDON OR MUSCLE, FLEXOR; SECONDARY, W/FRE                  N   3   $351.00   3/1/2004   12/31/2299
25270   2   REPAIR, TENDON OR MUSCLE, EXTENSOR; PRIMARY, SINGLE,EACH TENDON O   N   3   $120.00   1/1/1997   12/31/2299
25270   7   REPAIR, TENDON OR MUSCLE, EXTENSOR; PRIMARY, SINGL                  N   3    $13.45   6/1/1994   12/31/2299
25270   8   REPAIR, TENDON OR MUSCLE, EXTENSOR; PRIMARY, SINGL                  N   3    $24.00   1/1/1984   12/31/2299
25270   F   REPAIR, TENDON OR MUSCLE, EXTENSOR; PRIMARY, SINGLE,EACH TENDON O   N   3   $432.00   3/1/2004   12/31/2299
25272   2   REPAIR, TENDON OR MUSCLE, EXTENSOR; SECONDARY, SIN                  N   3   $145.00   1/1/1984   12/31/2299
25272   7   REPAIR, TENDON OR MUSCLE, EXTENSOR; SECONDARY, SIN                  N   3    $13.45   6/1/1994   12/31/2299
25272   F   REPAIR, TENDON OR MUSCLE, EXTENSOR; SECONDARY, SIN                  N   3   $351.00   3/1/2004   12/31/2299
25274   2   REPAIR, TENDON OR MUSCLE, EXTENSOR, SECONDARY, W/                   N   3   $595.64   1/1/2002   12/31/2299
25274   7   REPAIR, TENDON OR MUSCLE, EXTENSOR, SECONDARY, W/                   N   3    $13.45   6/1/1994   12/31/2299
25274   F   REPAIR, TENDON OR MUSCLE, EXTENSOR, SECONDARY, W/                   N   3   $432.00   3/1/2004   12/31/2299
25275   2   REPAIR, TENDOR SHEATH, EXTENSOR, FOREARM AND/OR WRIST WITH FREE     N   3   $370.37   1/1/2002   12/31/2299
25275   F   REPAIR, TENDOR SHEATH, EXTENSOR, FOREARM AND/OR WRIST WITH FREE     N   3   $432.00   3/1/2004   12/31/2299
25280   2   LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TE                  N   3   $150.00   1/1/1984   12/31/2299
25280   7   LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TE                  N   3    $13.45   6/1/1994   12/31/2299
25280   8   LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TE                  N   3    $30.00   1/1/1984   12/31/2299
25280   F   LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TE                  N   3   $432.00   3/1/2004   12/31/2299
25290   2   TENOTOMY, OPEN, SINGLE, FLEXOR OR EXTENSOR TENDON,                  N   3   $105.00   1/1/1984   12/31/2299
25290   7   TENOTOMY, OPEN, SINGLE, FLEXOR OR EXTENSOR TENDON,                  N   3    $13.45   6/1/1994   12/31/2299
25290   F   TENOTOMY, OPEN, SINGLE, FLEXOR OR EXTENSOR TENDON,                  N   3   $351.00   3/1/2004   12/31/2299
25295   2   TENOLYSIS, SINGLE FLEXOR OR EXTENSOR TENDON, EACH                   N   3   $125.00   1/1/1997   12/31/2299
25295   7   TENOLYSIS, SINGLE FLEXOR OR EXTENSOR TENDON, EACH                   N   3    $13.45   6/1/1994   12/31/2299
25295   F   TENOLYSIS, SINGLE FLEXOR OR EXTENSOR TENDON, EACH                   N   3   $351.00   3/1/2004   12/31/2299
25300   2   TENODESIS AT WRIST; FLEXORS OF FINGERS                              N   3   $200.00   1/1/1997   12/31/2299
25300   7   TENODESIS AT WRIST; FLEXORS OF FINGERS                              N   3    $13.45   6/1/1994   12/31/2299
25300   F   TENODESIS AT WRIST; FLEXORS OF FINGERS                              N   3   $351.00   3/1/2004   12/31/2299
25301   2   TENODESIS AT WRIST; EXTENSORS OF FINGERS                            N   3   $175.00   1/1/1984   12/31/2299
25301   7   TENODESIS AT WRIST; EXTENSORS OF FINGERS                            N   3    $13.45   6/1/1994   12/31/2299
25301   F   TENODESIS AT WRIST; EXTENSORS OF FINGERS                            N   3   $351.00   3/1/2004   12/31/2299
25310   2   TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTE                  N   3   $420.00   1/2/1996   12/31/2299
25310   7   TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTE                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      59
25310   8   TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTE                  N   3    $84.00   1/2/1996   12/31/2299
25310   F   TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTE                  N   3   $351.00   3/1/2004   12/31/2299
25312   2   TENDON TRANSPLANT OR TRANSFER, FLEXOR OR EXTENSOR,                  N   3   $200.00   1/1/1984   12/31/2299
25312   7   TENDON TRANSPLANT OR TRANSFER, FLEXOR OR EXTENSOR,                  N   3    $13.45   6/1/1994   12/31/2299
25312   F   TENDON TRANSPLANT OR TRANSFER, FLEXOR OR EXTENSOR,                  N   3   $432.00   3/1/2004   12/31/2299
25315   2   FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY;                             N   3   $200.00   1/1/1984   12/31/2299
25315   7   FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY;                             N   3    $13.45   6/1/1994   12/31/2299
25315   F   FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY;                             N   3   $351.00   3/1/2004   12/31/2299
25316   2   FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY; WITH TENDO                  N   3   $200.00   1/1/1984   12/31/2299
25316   7   FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY; WITH TENDO                  N   3    $13.45   6/1/1994   12/31/2299
25316   F   FLEXOR ORIGIN SLIDE FOR CEREBRAL PALSY; WITH TENDO                  N   3   $351.00   3/1/2004   12/31/2299
25320   2   CAPSULORRHAPHY OR RECONSTRUCTION, CAPSULECTOMY, WR                  N   3   $280.00   1/1/1984   12/31/2299
25320   7   CAPSULORRHAPHY OR RECONSTRUCTION, CAPSULECTOMY, WR                  N   3    $13.45   6/1/1994   12/31/2299
25320   F   CAPSULORRHAPHY OR RECONSTRUCTION, CAPSULECTOMY, WR                  N   3   $351.00   3/1/2004   12/31/2299
25330   2   ARTHROPLASTY, WRIST;                                                N   3   $225.00   1/1/1984   12/31/2299
25330   7   ARTHROPLASTY, WRIST;                                                N   3    $13.45   6/1/1994   12/31/2299
25331   2   ARTHROPLASTY, WRIST; WITH IMPLANT                                   N   3   $275.00   1/1/1984   12/31/2299
25331   7   ARTHROPLASTY, WRIST; WITH IMPLANT                                   N   3    $13.45   6/1/1994   12/31/2299
25331   8   ARTHROPLASTY, WRIST; WITH IMPLANT                                   N   3    $40.00   1/1/1973   12/31/2299
25332   2   ARTHROPLASTY, WRIST;W OR W/O INTERPOSITION,W OR W/O INTERNAL FX     N   3   $530.99   1/1/1997   12/31/2299
25332   7   ARTHROPLASTY, WRIST; PSEUDARTHROSIS TYPE WITH INTE                  N   3    $13.45   6/1/1994   12/31/2299
25332   8   ARTHROPLASTY, WRIST;W OR W/O INTERPOSITION,W OR W/O EXT/INT FX      N   3   $106.20   1/1/1997   12/31/2299
25332   F   ARTHROPLASTY, WRIST;W OR W/O INTERPOSITION,W OR W/O INTERNAL FX     N   3   $495.00   3/1/2004   12/31/2299
25335   7   TRANSPOSITION & REALIGNMENT OF HAND OVER ULNA W OR                  N   3    $13.45   6/1/1994   12/31/2299
25335   F   TRANSPOSITION & REALIGNMENT OF HAND OVER ULNA W OR                  N   3   $351.00   3/1/2004   12/31/2299
25337   2   RECONSTRUCTION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT   N   3   $444.00   1/1/1995   12/31/2299
25337   7   ANESTHESIA,RECONSTRUCTION OF UNSTABLE DISTAL ULNA OR DISTAL RADIO   N   3    $13.45   1/1/1999   12/31/2299
25337   F   RECONSTRUCTION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT   N   3   $495.00   3/1/2004   12/31/2299
25350   2   OSTEOTOMY, RADIUS; DISTAL THIRD                                     N   3   $250.00   1/1/1973   12/31/2299
25350   7   OSTEOTOMY, RADIUS; DISTAL THIRD                                     N   3    $13.45   6/1/1994   12/31/2299
25350   8   OSTEOTOMY, RADIUS; DISTAL THIRD                                     N   3    $50.00   1/1/1973   12/31/2299
25350   F   OSTEOTOMY, RADIUS; DISTAL THIRD                                     N   3   $351.00   3/1/2004   12/31/2299
25355   2   OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD                         N   3   $300.00   1/1/1973   12/31/2299
25355   7   OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD                         N   3    $13.45   6/1/1994   12/31/2299
25355   8   OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD                         N   3    $60.00   1/1/1973   12/31/2299
25355   F   OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD                         N   3   $351.00   3/1/2004   12/31/2299
25360   2   OSTEOTOMY; ULNA                                                     N   3   $250.00   1/1/1997   12/31/2299
25360   7   OSTEOTOMY; ULNA                                                     N   3    $13.45   6/1/1994   12/31/2299
25360   8   OSTEOTOMY; ULNA                                                     N   3    $50.00   1/1/1973   12/31/2299
25360   F   OSTEOTOMY; ULNA                                                     N   3   $351.00   3/1/2004   12/31/2299
25365   2   OSTEOTOMY; RADIUS AND ULNA                                          N   3   $450.00   1/1/1997   12/31/2299
25365   7   OSTEOTOMY; RADIUS AND ULNA                                          N   3    $13.45   6/1/1994   12/31/2299
25365   8   OSTEOTOMY; RADIUS AND ULNA                                          N   3    $90.00   1/1/1973   12/31/2299
25365   F   OSTEOTOMY; RADIUS AND ULNA                                          N   3   $351.00   3/1/2004   12/31/2299
25370   2   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3   $300.00   1/1/1997   12/31/2299
25370   7   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3    $13.45   6/1/1994   12/31/2299
25370   8   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3    $60.00   1/1/1973   12/31/2299
25370   F   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3   $351.00   3/1/2004   12/31/2299
25375   2   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3   $350.00   1/1/1997   12/31/2299
25375   7   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3    $13.45   6/1/1994   12/31/2299
25375   8   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3    $70.00   1/1/1973   12/31/2299




                                                                                                                      60
25375   F   MULTIPLE OSTEOTOMIES, WITH REALIGNMENT ON INTRAMED                  N   3   $432.00   3/1/2004   12/31/2299
25390   2   OSTEOPLASTY, RADIUS OR ULNA; SHORTENING                             N   3   $300.00   1/1/1984   12/31/2299
25390   7   OSTEOPLASTY, RADIUS OR ULNA; SHORTENING                             N   3    $13.45   6/1/1994   12/31/2299
25390   8   OSTEOPLASTY, RADIUS OR ULNA; SHORTENING                             N   3    $94.00   1/2/1994   12/31/2299
25390   F   OSTEOPLASTY, RADIUS OR ULNA; SHORTENING                             N   3   $351.00   3/1/2004   12/31/2299
25391   2   OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING WITH AUTO                  N   3   $268.00   1/1/1997   12/31/2299
25391   7   OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING WITH AUTO                  N   3    $13.45   6/1/1994   12/31/2299
25391   8   OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING WITH AUTO                  N   3    $54.00   1/1/1973   12/31/2299
25391   F   OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING WITH AUTO                  N   3   $432.00   3/1/2004   12/31/2299
25392   2   OSTEOPLASTY, RADIUS AND ULNA; SHORTENING                            N   3   $360.00   1/1/1984   12/31/2299
25392   7   OSTEOPLASTY, RADIUS AND ULNA; SHORTENING                            N   3    $13.45   6/1/1994   12/31/2299
25392   F   OSTEOPLASTY, RADIUS AND ULNA; SHORTENING                            N   3   $351.00   3/1/2004   12/31/2299
25393   2   OSTEOPLASTY, RADIUS AND ULNA; LENGTHENING WITH AUT                  N   3   $400.00   1/1/1984   12/31/2299
25393   7   OSTEOPLASTY, RADIUS AND ULNA; LENGTHENING WITH AUT                  N   3    $13.45   6/1/1994   12/31/2299
25393   F   OSTEOPLASTY, RADIUS AND ULNA; LENGTHENING WITH AUT                  N   3   $432.00   3/1/2004   12/31/2299
25394   2   OSTEOPLASTY, CARPLA BONE SHORTENING                                 N   3   $431.92   1/1/2002   12/31/2299
25400   2   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3   $350.00   1/1/1997   12/31/2299
25400   7   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3    $13.45   6/1/1994   12/31/2299
25400   8   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3    $70.00   1/1/1973   12/31/2299
25400   F   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3   $351.00   3/1/2004   12/31/2299
25405   2   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3   $382.00   1/1/1997   12/31/2299
25405   7   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3    $13.45   6/1/1994   12/31/2299
25405   8   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3    $85.00   1/1/1973   12/31/2299
25405   F   REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/                  N   3   $432.00   3/1/2004   12/31/2299
25415   2   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3   $500.00   1/1/1997   12/31/2299
25415   7   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3    $13.45   6/1/1994   12/31/2299
25415   8   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3   $100.00   1/1/1973   12/31/2299
25415   F   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3   $351.00   3/1/2004   12/31/2299
25420   2   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3   $575.00   1/1/1997   12/31/2299
25420   7   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3    $13.45   6/1/1994   12/31/2299
25420   8   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3   $115.00   1/1/1973   12/31/2299
25420   F   REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W                  N   3   $432.00   3/1/2004   12/31/2299
25425   2   REPAIR OF DEFECT WITH AUTOGENOUS BONE GRAFT; RADIU                  N   3   $425.00   1/1/1984   12/31/2299
25425   7   REPAIR OF DEFECT WITH AUTOGENOUS BONE GRAFT; RADIU                  N   3    $13.45   6/1/1994   12/31/2299
25425   F   REPAIR OF DEFECT WITH AUTOGENOUS BONE GRAFT; RADIU                  N   3   $351.00   3/1/2004   12/31/2299
25426   2   REPAIR OF DEFECT WITH AUTOGENOUS BONE GRAFT; RADIU                  N   3   $500.00   1/1/1984   12/31/2299
25426   7   REPAIR OF DEFECT WITH AUTOGENOUS BONE GRAFT; RADIU                  N   3    $13.45   6/1/1994   12/31/2299
25426   F   REPAIR OF DEFECT WITH AUTOGENOUS BONE GRAFT; RADIU                  N   3   $432.00   3/1/2004   12/31/2299
25430   2   INSERTION OF VASCULAR DEDICLE INTO CARPAL BONE EG HARII PROCEDURE   N   3   $383.07   1/1/2002   12/31/2299
25431   2   REPAIR ON NONUNION OF CARPAL BONE (EXCL CARPARL SCAPHOID (NAVIC)    N   3   $377.23   1/2/2002   12/31/2299
25440   2   REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, W O                  N   3   $350.00   1/1/1997   12/31/2299
25440   7   REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, W O                  N   3    $13.45   6/1/1994   12/31/2299
25440   8   REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, W O                  N   3    $70.00   1/1/1973   12/31/2299
25440   F   REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, W O                  N   3   $432.00   3/1/2004   12/31/2299
25441   2   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL R                  N   3   $200.00   1/1/1984   12/31/2299
25441   7   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL R                  N   3    $13.45   6/1/1994   12/31/2299
25441   F   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL R                  N   3   $495.00   3/1/2004   12/31/2299
25442   2   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL U                  N   3   $225.00   1/1/1984   12/31/2299
25442   7   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL U                  N   3    $13.45   6/1/1994   12/31/2299
25442   F   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL U                  N   3   $495.00   3/1/2004   12/31/2299
25443   2   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; SCAPHOID                  N   3   $260.00   1/1/1984   12/31/2299




                                                                                                                      61
25443   7   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; SCAPHOID                N   3    $13.45   6/1/1994   12/31/2299
25443   F   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; SCAPHOID                N   3   $495.00   3/1/2004   12/31/2299
25444   2   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; LUNATE                  N   3   $260.00   1/1/1984   12/31/2299
25444   7   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; LUNATE                  N   3    $13.45   6/1/1994   12/31/2299
25444   F   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; LUNATE                  N   3   $495.00   3/1/2004   12/31/2299
25445   2   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; TRAPEZIU                N   3   $260.00   1/1/1984   12/31/2299
25445   7   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; TRAPEZIU                N   3    $13.45   6/1/1994   12/31/2299
25445   F   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; TRAPEZIU                N   3   $495.00   3/1/2004   12/31/2299
25446   2   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL R                N   3   $600.00   1/1/1984   12/31/2299
25446   7   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL R                N   3    $13.45   6/1/1994   12/31/2299
25446   F   ARTHROPLASTY WITH PROSTHETIC REPLACEMENT; DISTAL R                N   3   $495.00   3/1/2004   12/31/2299
25447   2   INTERPOSITION ARTHROPLASTY: INTERCARP/CARPOMETACAR                N   3   $225.00   1/1/1984   12/31/2299
25447   7   INTERPOSITION ARTHROPLASTY: INTERCARP/CARPOMETACAR                N   3    $13.45   6/1/1994   12/31/2299
25447   8   INTERPOSITION ARTHROPLASTY: INTERCARP/CARPOMETACAR                N   3    $45.00   1/1/1984   12/31/2299
25447   F   INTERPOSITION ARTHROPLASTY: INTERCARP/CARPOMETACAR                N   3   $495.00   3/1/2004   12/31/2299
25449   2   ARTHROPLASTY WITH REMOVAL OF IMPLANT                              N   3   $240.00   1/1/1984   12/31/2299
25449   7   ARTHROPLASTY WITH REMOVAL OF IMPLANT                              N   3    $13.45   6/1/1994   12/31/2299
25449   F   ARTHROPLASTY WITH REMOVAL OF IMPLANT                              N   3   $495.00   3/1/2004   12/31/2299
25450   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3   $150.00   1/1/1997   12/31/2299
25450   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3    $13.45   6/1/1994   12/31/2299
25450   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3    $75.00   1/2/1994   12/31/2299
25450   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3   $351.00   3/1/2004   12/31/2299
25455   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3   $200.00   1/1/1997   12/31/2299
25455   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3    $13.45   6/1/1994   12/31/2299
25455   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3    $40.00   1/1/1973   12/31/2299
25455   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D                N   3   $351.00   3/1/2004   12/31/2299
25490   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING                 N   3    $13.45   6/1/1994   12/31/2299
25490   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING                 N   3   $351.00   3/1/2004   12/31/2299
25491   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING                 N   3    $13.45   6/1/1994   12/31/2299
25491   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING                 N   3   $351.00   3/1/2004   12/31/2299
25492   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING                 N   3    $13.45   6/1/1994   12/31/2299
25492   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING                 N   3   $351.00   3/1/2004   12/31/2299
25500   2   TREATMENT OF CLOSED RADIAL SHAFT FRACTURE; WITHOUT                N   3    $25.00   1/1/1997   12/31/2299
25500   7   TREATMENT OF CLOSED RADIAL SHAFT FRACTURE; WITHOUT                N   3    $13.45   6/1/1994   12/31/2299
25505   2   TREATMENT OF CLOSED RADIAL SHAFT FRACTURE; WITH MANIPULATION      N   3   $100.00   1/1/1997   12/31/2299
25505   7   TREATMENT OF CLOSED RADIAL SHAFT FRACTURE; WITH MA                N   3    $13.45   6/1/1994   12/31/2299
25505   F   TREATMENT OF CLOSED RADIAL SHAFT FRACTURE; WITH MANIPULATION      N   3   $225.80   3/1/2004   12/31/2299
25515   2   OPEN TREATMENT OF CLOSED OR OPEN RADIAL SHAFT FRACTURE            N   3   $200.00   1/1/1997   12/31/2299
25515   7   OPEN TREATMENT OF CLOSED OR OPEN RADIAL SHAFT FRAC                N   3    $13.45   6/1/1994   12/31/2299
25515   8   OPEN TREATMENT OF CLOSED OR OPEN RADIAL SHAFT FRAC                N   3    $40.00   1/1/1973   12/31/2299
25515   F   OPEN TREATMENT OF CLOSED OR OPEN RADIAL SHAFT FRACTURE            N   3   $351.00   3/1/2004   12/31/2299
25520   2   CLOSED TREATMENT OF RADIAL SHAFT FRACTURE, WITH DISLOCATION       N   3   $238.73   1/1/1993   12/31/2299
25520   7   CLOSED TRTMNT OF RADIAL SHAFT FRACTURE WITH DISLOC                N   3    $13.45   6/1/1994   12/31/2299
25520   F   CLOSED TREATMENT OF RADIAL SHAFT FRACTURE, WITH DISLOCATION       N   3   $225.80   3/1/2004   12/31/2299
25525   2   OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTERNAL/EXTERNAL   N   3   $464.02   1/1/1993   12/31/2299
25525   7   OPEN TRTMT RAD SHAFT FX W/INTERNAL PERC SKEL                      N   3    $13.45   6/1/1994   12/31/2299
25525   F   OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTERNAL/EXTERNAL   N   3   $432.00   3/1/2004   12/31/2299
25526   2   OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTE                N   3   $493.38   1/1/1993   12/31/2299
25526   7   OPEN TRTMT RAD SHAFT FX W/INTERNAL CART                           N   3    $13.45   6/1/1994   12/31/2299
25526   F   OPEN TREATMENT OF RADIAL SHAFT FRACTURE, WITH INTE                N   3   $495.00   3/1/2004   12/31/2299
25530   2   TREATMENT OF CLOSED ULNAR SHAFT FRACTURE; WITHOUT MANIPULATION    N   3    $25.00   1/1/1997   12/31/2299




                                                                                                                    62
25530   7   TREATMENT OF CLOSED ULNAR SHAFT FRACTURE; WITHOUT                   N   3      $13.45   6/1/1994   12/31/2299
25535   2   TREATMENT OF CLOSED ULNAR SHAFT FRACTURE; WITH MANIPULATION         N   3      $80.00   1/1/1997   12/31/2299
25535   7   TREATMENT OF CLOSED ULNAR SHAFT FRACTURE; WITH MAN                  N   3      $13.45   6/1/1994   12/31/2299
25535   F   TREATMENT OF CLOSED ULNAR SHAFT FRACTURE; WITH MANIPULATION         N   3    $225.80    3/1/2004   12/31/2299
25537   2   BYPASS GRAFT, WITH VEIN, AORTOILIAC                                 N   3   $1,203.53   1/1/2007   12/31/2299
25537   7   BYPASS GRAFT, WITH VEIN, AORTOILIAC                                 N   3      $13.45   1/1/2007   12/31/2299
25545   2   OPEN TREATMENT OF CLOSED OR OPEN ULNAR SHAFT FRACTURE               N   3    $200.00    1/1/1997   12/31/2299
25545   7   OPEN TREATMENT OF CLOSED OR OPEN ULNAR SHAFT FRACT                  N   3      $13.45   6/1/1994   12/31/2299
25545   8   OPEN TREATMENT OF CLOSED OR OPEN ULNAR SHAFT FRACT                  N   3      $40.00   1/1/1973   12/31/2299
25545   F   OPEN TREATMENT OF CLOSED OR OPEN ULNAR SHAFT FRACTURE               N   3    $351.00    3/1/2004   12/31/2299
25560   2   TREATMENT OF CLOSED RADIAL AND ULNAR SHAFT FRACTURE                 N   3    $115.00    1/2/1996   12/31/2299
25560   7   TREATMENT OF CLOSED RADIAL AND ULNAR SHAFT FRACTUR                  N   3      $13.45   6/1/1994   12/31/2299
25565   2   TRTMT OF CLOSED RADIAL & ULNAR SHAFT FX                             N   3    $235.00    1/2/1998   12/31/2299
25565   7   TREATMENT OF CLOSED RADIAL AND ULNAR SHAFT FRACTUR                  N   3      $13.45   6/1/1994   12/31/2299
25565   8   TREATMENT OF CLOSED RADIAL AND ULNAR SHAFT FRACTUR                  N   3      $58.06   1/1/2004   12/31/2299
25565   F   TRTMT OF CLOSED RADIAL & ULNAR SHAFT FX                             N   3    $306.00    3/1/2004   12/31/2299
25574   2   OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES                  N   3    $346.94    1/1/1993   12/31/2299
25574   7   OPEN TRTMT OF RADIAL AND ULNAR SHAFT FRACT W/INTER                  N   3      $13.45   6/1/1994   12/31/2299
25574   8   OPEN TRTMT OF RADIAL AND ULNAR SHAFT FRACT W/INTER                  N   3      $72.48   1/1/2003   12/31/2299
25574   F   OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES                  N   3    $351.00    3/1/2004   12/31/2299
25575   2   OPEN TREATMENT OF CLOSED OR OPEN RADIAL AND ULNAR                   N   3    $270.00    1/1/1997   12/31/2299
25575   7   OPEN TREATMENT OF CLOSED OR OPEN RADIAL AND ULNAR                   N   3      $13.45   6/1/1994   12/31/2299
25575   8   OPEN TREATMENT OF CLOSED OR OPEN RADIAL AND ULNAR                   N   3      $60.00   1/1/1973   12/31/2299
25575   F   OPEN TREATMENT OF CLOSED OR OPEN RADIAL AND ULNAR                   N   3    $351.00    3/1/2004   12/31/2299
25600   2   CLOSED TREATMENT OF DISTAL RADIAL FRACTURE LEG (EG COLLES OR SMIT   N   3    $104.00    1/2/1996   12/31/2299
25600   7   TRT OF CLOSED DISTAL RADIAL FRAC (COLLES/SMITH) OR                  N   3      $13.45   6/1/1994   12/31/2299
25605   2   TRT OF CLOSED DISTAL RADIAL FRAC (COLLES/SMITH) OR                  N   3    $243.00    1/2/1996   12/31/2299
25605   7   TRT OF CLOSED DISTAL RADIAL FRAC (COLLES/SMITH) OR                  N   3      $13.45   6/1/1994   12/31/2299
25605   8   TRT OF CLOSED DISTAL RADIAL FRAC (COLLES/SMITH) OR                  N   3      $62.26   1/1/2004   12/31/2299
25605   F   TRT OF CLOSED DISTAL RADIAL FRAC (COLLES/SMITH) OR                  N   3    $351.00    3/1/2004   12/31/2299
25606   2   TREAT FX DISTAL RADIAL                                              N   3    $366.47    1/1/2007   12/31/2299
25607   8   TREAT FX DISTAL RADIAL                                              N   3      $73.00   1/1/2007   12/31/2299
25608   2   TREAT FX RAD INTRA-ARTICUL                                          N   3    $418.83    1/1/2007   12/31/2299
25608   7   TREAT FX RAD INTRA-ARTICUL                                          N   3      $13.45   1/1/2007   12/31/2299
25608   8   TREAT FX RAD INTRA-ARTICUL                                          N   3      $83.00   1/1/2007   12/31/2299
25609   2   TREAT FX RADIAL 3+ FRAG                                             N   3    $533.69    1/1/2007   12/31/2299
25609   7   TREAT FX RADIAL 3+ FRAG                                             N   3      $13.45   1/1/2007   12/31/2299
25609   8   TREAT FX RADIAL 3+ FRAG                                             N   3    $106.00    1/1/2007   12/31/2299
25622   2   TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FR                  N   3    $201.00    1/2/1996   12/31/2299
25622   7   TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FR                  N   3      $13.45   6/1/1994   12/31/2299
25624   2   TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FRACTURE WITH MAN   N   3    $100.00    1/1/1997   12/31/2299
25624   7   TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FR                  N   3      $13.45   6/1/1994   12/31/2299
25624   F   TREATMENT OF CLOSED CARPAL SCAPHOID (NAVICULAR) FRACTURE WITH MAN   N   3    $306.00    3/1/2004   12/31/2299
25628   2   OPEN TREATMENT OF CLOSED OR OPEN CARPAL SCAPHOID FRACTURE           N   3    $150.00    1/1/1997   12/31/2299
25628   7   OPEN TREATMENT OF CLOSED OR OPEN CARPAL SCAPHOID F                  N   3      $13.45   6/1/1994   12/31/2299
25628   8   OPEN TREATMENT OF CLOSED OR OPEN CARPAL SCAPHOID F                  N   3      $30.00   1/1/1973   12/31/2299
25628   F   OPEN TREATMENT OF CLOSED OR OPEN CARPAL SCAPHOID FRACTURE           N   3    $351.00    3/1/2004   12/31/2299
25630   2   TREATMENT OF CLOSED CARPAL BONE FRACTURE (EXCLUDING CARPAL SCAPHO   N   3      $25.00   1/1/1997   12/31/2299
25630   7   TREATMENT OF CLOSED CARPAL BONE FRACTURE (EXCLUDIN                  N   3      $13.45   6/1/1994   12/31/2299
25635   2   TREATMENT OF CLOSED CARPAL BONE FRACTURE WITH MANIPULATION EACH B   N   3    $100.00    1/1/1997   12/31/2299
25635   7   TREATMENT OF CLOSED CARPAL BONE FRACTURE (EXCLUDIN                  N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                        63
25635   F   TREATMENT OF CLOSED CARPAL BONE FRACTURE WITH MANIPULATION EACH B   N   3   $225.80   3/1/2004   12/31/2299
25645   2   OPEN TREATMENT OF CLOSED OR OPEN CARPAL BONE FRACTURE EXCLUDING     N   3   $142.00   1/1/1997   12/31/2299
25645   7   OPEN TREATMENT OF CLOSED OR OPEN CARPAL BONE FRAC                   N   3    $13.45   6/1/1994   12/31/2299
25645   8   OPEN TREATMENT OF CLOSED OR OPEN CARPAL BONE FRAC                   N   3    $30.00   1/1/1973   12/31/2299
25645   F   OPEN TREATMENT OF CLOSED OR OPEN CARPAL BONE FRACTURE EXCLUDING     N   3   $351.00   3/1/2004   12/31/2299
25650   2   TREATMENT OF CLOSED ULNAR STYLOID FRACTURE                          N   3    $50.00   1/1/1984   12/31/2299
25650   7   TREATMENT OF CLOSED ULNAR STYLOID FRACTURE                          N   3    $13.45   6/1/1994   12/31/2299
25651   2   PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE            N   3   $226.07   1/1/2002   12/31/2299
25660   2   TREATMENT OF CLOSED RADIOCARPAL OR INTERCARPAL DISLOCATION          N   3    $30.00   1/1/1997   12/31/2299
25660   7   TREATMENT OF CLOSED RADIOCARPAL OR INTERCARPAL DIS                  N   3    $13.45   6/1/1994   12/31/2299
25660   F   TREATMENT OF CLOSED RADIOCARPAL OR INTERCARPAL DISLOCATION          N   3   $225.80   3/1/2004   12/31/2299
25670   7   OPEN TREATMENT OF CLOSED OR OPEN RADIOCARPAL OR IN                  N   3    $13.45   6/1/1994   12/31/2299
25670   F   OPEN TREATMENT OF CLOSED OR OPEN RADIOCARPAL OR INTERCARPAL         N   3   $351.00   3/1/2004   12/31/2299
25675   2   TREATMENT OF CLOSED DISTAL RADIOULNAR DISLOCATION                   N   3   $100.00   1/1/1984   12/31/2299
25675   7   TREATMENT OF CLOSED DISTAL RADIOULNAR DISLOCATION                   N   3    $13.45   6/1/1994   12/31/2299
25675   F   TREATMENT OF CLOSED DISTAL RADIOULNAR DISLOCATION                   N   3   $225.80   3/1/2004   12/31/2299
25676   2   OPEN TREATMENT OF CLOSED OR OPEN DISTAL RADIOULNAR DISLOCATION      N   3   $200.00   1/1/1997   12/31/2299
25676   7   OPEN TREATMENT OF CLOSED OR OPEN DISTAL RADIOULNAR                  N   3    $13.45   6/1/1994   12/31/2299
25676   8   OPEN TREATMENT OF CLOSED OR OPEN DISTAL RADIOULNAR                  N   3    $40.00   8/1/1979   12/31/2299
25676   F   OPEN TREATMENT OF CLOSED OR OPEN DISTAL RADIOULNAR DISLOCATION      N   3   $306.00   3/1/2004   12/31/2299
25680   2   TREATMENT OF CLOSED TRANS-SCAPHOPERILUNAR TYPE OF                   N   3   $150.00   1/1/1973   12/31/2299
25680   7   TREATMENT OF CLOSED TRANS-SCAPHOPERILUNAR TYPE OF                   N   3    $13.45   6/1/1994   12/31/2299
25680   F   TREATMENT OF CLOSED TRANS-SCAPHOPERILUNAR TYPE OF                   N   3   $306.00   3/1/2004   12/31/2299
25685   2   OPEN TREATMENT OF CLOSED OR OPEN TRANS-SCAPHOPERIL                  N   3   $250.00   1/1/1973   12/31/2299
25685   7   OPEN TREATMENT OF CLOSED OR OPEN TRANS-SCAPHOPERIL                  N   3    $13.45   6/1/1994   12/31/2299
25685   8   OPEN TREATMENT OF CLOSED OR OPEN TRANS-SCAPHOPERIL                  N   3    $50.00   1/1/1973   12/31/2299
25685   F   OPEN TREATMENT OF CLOSED OR OPEN TRANS-SCAPHOPERIL                  N   3   $351.00   3/1/2004   12/31/2299
25690   2   TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION                  N   3   $130.00   1/1/1984   12/31/2299
25690   7   TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION                  N   3    $13.45   6/1/1994   12/31/2299
25690   F   TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION                  N   3   $225.80   3/1/2004   12/31/2299
25695   2   OPEN TREATMENT OF LUNATE DISLOCATION                                N   3   $200.00   1/1/1984   12/31/2299
25695   7   OPEN TREATMENT OF LUNATE DISLOCATION                                N   3    $13.45   6/1/1994   12/31/2299
25695   F   OPEN TREATMENT OF LUNATE DISLOCATION                                N   3   $306.00   3/1/2004   12/31/2299
25700   2   MANIPULATION OF JOINT UNDER GENERAL ANESTHESIA                      N   3    $25.00   1/1/1973   12/31/2299
25700   7   MANIPULATION OF JOINT UNDER GENERAL ANESTHESIA                      N   3    $13.45   6/1/1994   12/31/2299
25800   2   ARTHRODESIS, WRIST JOINT; WITHOUT BONE GRAFT                        N   3   $300.00   1/1/1984   12/31/2299
25800   7   ARTHRODESIS, WRIST JOINT; WITHOUT BONE GRAFT                        N   3    $13.45   6/1/1994   12/31/2299
25800   F   ARTHRODESIS, WRIST JOINT; WITHOUT BONE GRAFT                        N   3   $432.00   3/1/2004   12/31/2299
25805   2   ARTHRODESIS, WRIST JOINT; WITH SLIDING GRAFT                        N   3   $300.00   1/1/1973   12/31/2299
25805   7   ARTHRODESIS, WRIST JOINT; WITH SLIDING GRAFT                        N   3    $13.45   6/1/1994   12/31/2299
25805   8   ARTHRODESIS, WRIST JOINT; WITH SLIDING GRAFT                        N   3    $60.00   1/1/1973   12/31/2299
25805   F   ARTHRODESIS, WRIST JOINT; WITH SLIDING GRAFT                        N   3   $495.00   3/1/2004   12/31/2299
25810   2   ARTHRODESIS, WRIST JOINT; W/ ILIAC OR OTHER AUTOGE                  N   3   $400.00   1/1/1999   12/31/2299
25810   7   ARTHRODESIS, WRIST JOINT; W/ ILIAC OR OTHER AUTOGE                  N   3    $13.45   6/1/1994   12/31/2299
25810   8   ARTHRODESIS, WRIST JOINT; W/ ILIAC OR OTHER AUTOGE                  N   3    $80.00   1/1/1973   12/31/2299
25810   F   ARTHRODESIS, WRIST JOINT; W/ ILIAC OR OTHER AUTOGE                  N   3   $495.00   3/1/2004   12/31/2299
25811   7   ANESTHESIA,APPLICATION OF PROSTHETIC DEVICE TO VERTEBRAL DEFECT     N   3    $13.45   1/1/1998   12/31/2299
25820   7   INTERCARPAL FUSION                                                  N   3    $13.45   6/1/1994   12/31/2299
25820   F   INTERCARPAL FUSION                                                  N   3   $432.00   3/1/2004   12/31/2299
25825   2   INTERCARPAL FUSION W GRFT                                           N   3   $250.00   1/1/1984   12/31/2299
25825   7   INTERCARPAL FUSION W GRFT                                           N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      64
25825   8   INTERCARPAL FUSION;W/OUT BONE GRAFT                                 N   3    $50.00   1/1/1984   12/31/2299
25825   F   INTERCARPAL FUSION W GRFT                                           N   3   $495.00   3/1/2004   12/31/2299
25830   2   DISTAL RADIOULNAR JOINT ARTHRODESIS & SEGMENTAL RESECTION OF ULNA   N   3   $594.15   1/1/2004   12/31/2299
25830   F   DISTAL RADIOULNAR JOINT ARTHRODESIS & SEGMENTAL RESECTION OF ULNA   N   3   $495.00   3/1/2004   12/31/2299
25900   2   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA;                       N   3   $225.00   1/1/1973   12/31/2299
25900   7   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA;                       N   3    $13.45   6/1/1994   12/31/2299
25900   8   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA;                       N   3    $45.00   1/1/1973   12/31/2299
25905   2   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; OPEN                  N   3   $200.00   1/1/1973   12/31/2299
25905   7   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; OPEN                  N   3    $13.45   6/1/1994   12/31/2299
25905   8   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; OPEN                  N   3    $40.00   1/1/1973   12/31/2299
25907   2   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; SECO                  N   3    $75.00   1/1/1973   12/31/2299
25907   7   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; SECO                  N   3    $13.45   6/1/1994   12/31/2299
25907   F   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; SECO                  N   3   $351.00   3/1/2004   12/31/2299
25909   2   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; REAM                  N   3   $150.00   8/1/1975   12/31/2299
25909   7   AMPUTATION, FOREARM, THROUGH RADIUS AND ULNA; REAM                  N   3    $13.45   6/1/1994   12/31/2299
25915   2   KRUKENBERG PROCEDURE                                                N   3   $250.00   1/1/1984   12/31/2299
25915   7   KRUKENBERG PROCEDURE                                                N   3    $13.45   6/1/1994   12/31/2299
25920   2   DISARTICULATION THROUGH WRIST;                                      N   3   $200.00   1/1/1973   12/31/2299
25920   7   DISARTICULATION THROUGH WRIST;                                      N   3    $13.45   6/1/1994   12/31/2299
25920   8   DISARTICULATION THROUGH WRIST;                                      N   3    $40.00   1/1/1973   12/31/2299
25922   2   DISARTICULATION THROUGH WRIST; SECONDARY CLOSURE O                  N   3   $100.00   1/1/1984   12/31/2299
25922   7   DISARTICULATION THROUGH WRIST; SECONDARY CLOSURE O                  N   3    $13.45   6/1/1994   12/31/2299
25922   F   DISARTICULATION THROUGH WRIST; SECONDARY CLOSURE O                  N   3   $351.00   3/1/2004   12/31/2299
25924   2   DISARTICULATION THROUGH WRIST; REAMPUTATION                         N   3   $200.00   1/1/1984   12/31/2299
25924   7   DISARTICULATION THROUGH WRIST; REAMPUTATION                         N   3    $13.45   6/1/1994   12/31/2299
25927   2   TRANSMETACARPAL AMPUTATION;                                         N   3   $250.00   1/1/1973   12/31/2299
25927   7   TRANSMETACARPAL AMPUTATION;                                         N   3    $13.45   6/1/1994   12/31/2299
25929   2   TRANSMETACARPAL AMPUTATION; SECONDARY CLOSURE OR S                  N   3    $85.00   1/1/1984   12/31/2299
25929   7   TRANSMETACARPAL AMPUTATION; SECONDARY CLOSURE OR S                  N   3    $13.45   6/1/1994   12/31/2299
25929   F   TRANSMETACARPAL AMPUTATION; SECONDARY CLOSURE OR S                  N   3   $351.00   3/1/2004   12/31/2299
25931   2   TRANSMETACARPAL AMPUTATION; REAMPUTATION                            N   3   $250.00   1/1/1984   12/31/2299
25931   7   TRANSMETACARPAL AMPUTATION; REAMPUTATION                            N   3    $13.45   6/1/1994   12/31/2299
25999   7   UNLISTED PROCEDURE, FOREARM OR WRIST                                N   3    $13.45   6/1/1994   12/31/2299
26010   2   DRAINAGE OF FINGER ABSCESS; SIMPLE                                  N   3    $18.00   1/1/1973   12/31/2299
26010   7   DRAINAGE OF FINGER ABSCESS; SIMPLE                                  N   3    $13.45   6/1/1994   12/31/2299
26011   2   DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON                  N   3    $50.00   8/1/1979   12/31/2299
26011   7   DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON                  N   3    $13.45   6/1/1994   12/31/2299
26011   8   DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON                  N   3    $41.55   1/1/2003   12/31/2299
26011   F   DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON                  N   3   $225.80   3/1/2004   12/31/2299
26020   2   DRAINAGE OF TENDON SHEATH, ONE DIGIT AND/OR PALM                    N   3   $125.00   8/1/1979   12/31/2299
26020   7   DRAINAGE OF TENDON SHEATH, ONE DIGIT AND/OR PALM                    N   3    $13.45   6/1/1994   12/31/2299
26020   F   DRAINAGE OF TENDON SHEATH, ONE DIGIT AND/OR PALM                    N   3   $306.00   3/1/2004   12/31/2299
26025   2   DRAINAGE OF PALMAR BURSA; SINGLE, ULNAR OR RADIAL                   N   3   $125.00   1/1/1973   12/31/2299
26025   7   DRAINAGE OF PALMAR BURSA; SINGLE, ULNAR OR RADIAL                   N   3    $13.45   6/1/1994   12/31/2299
26025   F   DRAINAGE OF PALMAR BURSA; SINGLE, ULNAR OR RADIAL                   N   3   $225.80   3/1/2004   12/31/2299
26030   2   DRAINAGE OF PALMAR BURSA; MULTIPLE OR COMPLICATED                   N   3   $170.00   1/1/1984   12/31/2299
26030   7   DRAINAGE OF PALMAR BURSA; MULTIPLE OR COMPLICATED                   N   3    $13.45   6/1/1994   12/31/2299
26030   F   DRAINAGE OF PALMAR BURSA; MULTIPLE OR COMPLICATED                   N   3   $306.00   3/1/2004   12/31/2299
26032   2   DRAINAGE OF PALMAR BURSA; WITH SUCTION IRRIGATION                   N   3   $140.00   1/1/1984   12/31/2299
26034   2   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3   $125.00   1/1/1984   12/31/2299
26034   7   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                      65
26034   8   INCISION,DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                   N   3    $25.00   1/1/1984   12/31/2299
26034   F   INCISION, DEEP, WITH OPENING OF CORTEX FOR OSTEOMY                  N   3   $306.00   3/1/2004   12/31/2299
26035   2   DECOMPRESSION FINGERS AND/OR HAND, INJECTION INJUR                  N   3   $384.61   1/1/2003   12/31/2299
26035   7   DECOMPRESSION FINGERS AND/OR HAND, INJECTION INJUR                  N   3    $13.45   6/1/1994   12/31/2299
26037   2   DECOMPRESSIVE FASCIOTOMY, HAND (EXCLUDES 26035)                     N   3   $301.79   1/1/2003   12/31/2299
26037   7   DECOMPRESSIVE FASCIOTOMY, HAND (EXCLUDES 26035)                     N   3    $13.45   6/1/1994   12/31/2299
26040   2   FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; C                  N   3    $75.00   8/1/1979   12/31/2299
26040   7   FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; C                  N   3    $13.45   6/1/1994   12/31/2299
26040   F   FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; C                  N   3   $432.00   3/1/2004   12/31/2299
26045   2   FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; O                  N   3   $125.00   1/1/1973   12/31/2299
26045   7   FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; O                  N   3    $13.45   6/1/1994   12/31/2299
26045   F   FASCIOTOMY, PALMAR, FOR DUPUYTREN'S CONTRACTURE; O                  N   3   $351.00   3/1/2004   12/31/2299
26055   2   TENDON SHEATH INCISION FOR TRIGGER FINGER                           N   3   $100.00   1/2/1973   12/31/2299
26055   7   TENDON SHEATH INCISION FOR TRIGGER FINGER                           N   3    $13.45   6/1/1994   12/31/2299
26055   8   TENDON SHEATH INCISION FOR TRIGGER FINGER                           N   3    $56.19   1/1/2004   12/31/2299
26055   F   TENDON SHEATH INCISION FOR TRIGGER FINGER                           N   3   $306.00   3/1/2004   12/31/2299
26060   2   TENOTOMY, SUBCUTANEOUS, SINGLE, EACH DIGIT                          N   3    $10.00   1/1/1973   12/31/2299
26060   7   TENOTOMY, SUBCUTANEOUS, SINGLE, EACH DIGIT                          N   3    $13.45   6/1/1994   12/31/2299
26060   F   TENOTOMY, SUBCUTANEOUS, SINGLE, EACH DIGIT                          N   3   $306.00   3/1/2004   12/31/2299
26070   2   ARTHROTOMY WITH EXPLOR, DRAIN OR REMOVAL OF LOOSE                   N   3   $125.00   1/1/1973   12/31/2299
26070   7   ARTHROTOMY WITH EXPLOR, DRAIN OR REMOVAL OF LOOSE                   N   3    $13.45   6/1/1994   12/31/2299
26070   F   ARTHROTOMY WITH EXPLOR, DRAIN OR REMOVAL OF LOOSE                   N   3   $306.00   3/1/2004   12/31/2299
26075   2   ARTHROTOMY W/EXPLOR, DRAIN OR REMOV OF LOOSE OR FO                  N   3   $125.00   1/1/1973   12/31/2299
26075   7   ARTHROTOMY W/EXPLOR, DRAIN OR REMOV OF LOOSE OR FO                  N   3    $13.45   6/1/1994   12/31/2299
26075   F   ARTHROTOMY W/EXPLOR, DRAIN OR REMOV OF LOOSE OR FO                  N   3   $432.00   3/1/2004   12/31/2299
26080   2   ARTHROTOMY W/EXPLOR, DRAIN OR REMOV OF LOOSE OR FO                  N   3   $100.00   1/1/1973   12/31/2299
26080   7   ARTHROTOMY W/EXPLOR, DRAIN OR REMOV OF LOOSE OR FO                  N   3    $13.45   6/1/1994   12/31/2299
26080   F   ARTHROTOMY W/EXPLOR, DRAIN OR REMOV OF LOOSE OR FO                  N   3   $432.00   3/1/2004   12/31/2299
26100   2   ARTHROTOMY FOR SYNOVIAL BIOPSY; CARPOMETACARPAL JO                  N   3   $125.00   1/1/1973   12/31/2299
26100   7   ARTHROTOMY FOR SYNOVIAL BIOPSY; CARPOMETACARPAL JO                  N   3    $13.45   6/1/1994   12/31/2299
26100   F   ARTHROTOMY FOR SYNOVIAL BIOPSY; CARPOMETACARPAL JO                  N   3   $306.00   3/1/2004   12/31/2299
26105   2   ARTHROTOMY FOR SYNOVIAL BIOPSY; METACARPOPHALANGEA                  N   3   $125.00   1/1/1973   12/31/2299
26105   7   ARTHROTOMY FOR SYNOVIAL BIOPSY; METACARPOPHALANGEA                  N   3    $13.45   6/1/1994   12/31/2299
26105   F   ARTHROTOMY FOR SYNOVIAL BIOPSY; METACARPOPHALANGEA                  N   3   $225.80   3/1/2004   12/31/2299
26110   2   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JO                  N   3   $100.00   1/1/1973   12/31/2299
26110   7   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JO                  N   3    $13.45   6/1/1994   12/31/2299
26110   F   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JO                  N   3   $225.80   3/1/2004   12/31/2299
26115   2   EXCISION OF BENIGN TUMOR; SUBCUTANEOUS                              N   3    $50.00   1/1/1984   12/31/2299
26115   F   EXCISION OF BENIGN TUMOR; SUBCUTANEOUS                              N   3   $306.00   3/1/2004   12/31/2299
26116   2   .XCISION OF BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAM                  N   3   $150.00   1/1/1984   12/31/2299
26116   7   EXCISION OF BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAM                  N   3    $13.45   6/1/1994   12/31/2299
26116   F   .XCISION OF BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAM                  N   3   $306.00   3/1/2004   12/31/2299
26117   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM                  N   3    $13.45   6/1/1994   12/31/2299
26117   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM                  N   3   $351.00   3/1/2004   12/31/2299
26121   2   FASCIECTOMY, PALM ONLY, W OR W/O Z/PLASTY, OTHER TISSUE REARRANGE   N   3   $438.55   1/1/1997   12/31/2299
26121   7   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH                  N   3    $13.45   6/1/1994   12/31/2299
26121   8   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH                  N   3    $87.72   1/1/1997   12/31/2299
26121   F   FASCIECTOMY, PALM ONLY, W OR W/O Z/PLASTY, OTHER TISSUE REARRANGE   N   3   $432.00   3/1/2004   12/31/2299
26123   2   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH                  N   3   $540.00   1/2/1994   12/31/2299
26123   7   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH                  N   3    $13.45   6/1/1994   12/31/2299
26123   F   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH                  N   3   $432.00   3/1/2004   12/31/2299




                                                                                                                      66
26125   2   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH     N   3   $176.68   1/1/2005   12/31/2299
26125   7   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH     N   3    $13.45   6/1/1994   12/31/2299
26125   F   FASCIECTOMY, PALMAR, WITH OR WITHOUT Z-PLASTY, OTH     N   3   $432.00   3/1/2004   12/31/2299
26130   2   SYNOVECTOMY, CARPOMETACARPAL JOINT                     N   3   $125.00   1/1/1973   12/31/2299
26130   7   SYNOVECTOMY, CARPOMETACARPAL JOINT                     N   3    $13.45   6/1/1994   12/31/2299
26130   F   SYNOVECTOMY, CARPOMETACARPAL JOINT                     N   3   $351.00   3/1/2004   12/31/2299
26135   2   SYNOVECTOMY METACARPOPHALANGEAL JOINT INCLUD INTRI     N   3   $125.00   1/1/1973   12/31/2299
26135   7   SYNOVECTOMY METACARPOPHALANGEAL JOINT INCLUD INTRI     N   3    $13.45   6/1/1994   12/31/2299
26135   F   SYNOVECTOMY METACARPOPHALANGEAL JOINT INCLUD INTRI     N   3   $432.00   3/1/2004   12/31/2299
26140   2   SYNOVECTOMY PROXIMAL INTERPHALANGEAL JOINT, INCLUD     N   3   $100.00   1/1/1973   12/31/2299
26140   7   SYNOVECTOMY PROXIMAL INTERPHALANGEAL JOINT, INCLUD     N   3    $13.45   6/1/1994   12/31/2299
26140   F   SYNOVECTOMY PROXIMAL INTERPHALANGEAL JOINT, INCLUD     N   3   $306.00   3/1/2004   12/31/2299
26145   2   SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOM     N   3   $130.00   1/1/1971   12/31/2299
26145   7   SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOM     N   3    $13.45   6/1/1994   12/31/2299
26145   8   SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOM     N   3    $59.55   1/1/2004   12/31/2299
26145   F   SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOM     N   3   $351.00   3/1/2004   12/31/2299
26160   2   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG     N   3    $55.00   8/1/1979   12/31/2299
26160   7   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG     N   3    $13.45   6/1/1994   12/31/2299
26160   F   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG     N   3   $351.00   3/1/2004   12/31/2299
26170   2   EXCISION OF TENDON, PALM, FLEXOR, SINGLE (SEPARATE     N   3   $100.00   8/1/1979   12/31/2299
26170   7   EXCISION OF TENDON, PALM, FLEXOR, SINGLE (SEPARATE     N   3    $13.45   6/1/1994   12/31/2299
26170   F   EXCISION OF TENDON, PALM, FLEXOR, SINGLE (SEPARATE     N   3   $351.00   3/1/2004   12/31/2299
26180   2   EXCISION OF TENDON, FINGER, FLEXOR (SEPARATE PROC)     N   3    $75.00   1/1/1976   12/31/2299
26180   7   EXCISION OF TENDON, FINGER, FLEXOR (SEPARATE PROC)     N   3    $13.45   6/1/1994   12/31/2299
26180   F   EXCISION OF TENDON, FINGER, FLEXOR (SEPARATE PROC)     N   3   $351.00   3/1/2004   12/31/2299
26185   2   SESAMOIDECTOMY,THUMB OR FINGER (SEPARATE PROCEDURE)    N   3   $228.31   1/1/1997   12/31/2299
26185   7   SESAMOIDECTOMY,THUMB OR FINGER (SEPARATE PROCEDURE)    N   3    $13.45   1/1/1997   12/31/2299
26185   8   SESAMOIDECTOMY, THUMB OR FINGER (SEPARATE PROCEDURE)   N   3    $45.66   1/1/1997   12/31/2299
26185   F   SESAMOIDECTOMY,THUMB OR FINGER (SEPARATE PROCEDURE)    N   3   $432.00   3/1/2004   12/31/2299
26200   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR     N   3   $150.00   1/1/1973   12/31/2299
26200   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR     N   3    $13.45   6/1/1994   12/31/2299
26200   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR     N   3   $306.00   3/1/2004   12/31/2299
26205   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR     N   3   $175.00   1/1/1973   12/31/2299
26205   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR     N   3    $13.45   6/1/1994   12/31/2299
26205   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR     N   3   $351.00   3/1/2004   12/31/2299
26206   2   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF ME     N   3   $115.00   1/1/1984   12/31/2299
26206   7   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF ME     N   3    $13.45   6/1/1994   12/31/2299
26210   2   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3   $125.00   1/1/1973   12/31/2299
26210   7   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3    $13.45   6/1/1994   12/31/2299
26210   F   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3   $306.00   3/1/2004   12/31/2299
26215   2   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3   $150.00   1/1/1984   12/31/2299
26215   7   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3    $13.45   6/1/1994   12/31/2299
26215   F   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3   $351.00   3/1/2004   12/31/2299
26216   2   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3   $110.00   1/1/1984   12/31/2299
26216   7   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF PR     N   3    $13.45   6/1/1994   12/31/2299
26230   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA     N   3   $150.00   1/1/1973   12/31/2299
26230   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA     N   3    $13.45   6/1/1994   12/31/2299
26230   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA     N   3   $495.00   3/1/2004   12/31/2299
26235   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA     N   3   $125.00   1/1/1973   12/31/2299
26235   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA     N   3    $13.45   6/1/1994   12/31/2299
26235   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA     N   3   $351.00   3/1/2004   12/31/2299




                                                                                                         67
26236   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA        N   3    $85.00   1/1/1984   12/31/2299
26236   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA        N   3    $13.45   6/1/1994   12/31/2299
26236   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA        N   3   $351.00   3/1/2004   12/31/2299
26250   2   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPA        N   3   $150.00   1/1/1984   12/31/2299
26250   7   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPA        N   3    $13.45   6/1/1994   12/31/2299
26250   F   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPA        N   3   $351.00   3/1/2004   12/31/2299
26255   2   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPA        N   3   $200.00   1/1/1984   12/31/2299
26255   7   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPA        N   3    $13.45   6/1/1994   12/31/2299
26255   F   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPA        N   3   $351.00   3/1/2004   12/31/2299
26260   2   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3   $150.00   1/1/1984   12/31/2299
26260   7   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3    $13.45   6/1/1994   12/31/2299
26260   F   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3   $351.00   3/1/2004   12/31/2299
26261   2   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3   $190.00   1/1/1984   12/31/2299
26261   7   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3    $13.45   6/1/1994   12/31/2299
26261   8   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3     $0.00   1/1/1973   12/31/2299
26261   F   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL         N   3   $351.00   3/1/2004   12/31/2299
26262   2   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, DISTAL PH        N   3   $180.00   1/1/1984   12/31/2299
26262   7   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, DISTAL PH        N   3    $13.45   6/1/1994   12/31/2299
26262   F   RADICAL RESECTION (OSTECTOMY) FOR TUMOR, DISTAL PH        N   3   $306.00   3/1/2004   12/31/2299
26320   2   REMOVAL OF IMPLANT FROM FINGER OR HAND                    N   3   $140.00   1/1/1984   12/31/2299
26320   7   REMOVAL OF IMPLANT FROM FINGER OR HAND                    N   3    $13.45   6/1/1994   12/31/2299
26320   F   REMOVAL OF IMPLANT FROM FINGER OR HAND                    N   3   $306.00   3/1/2004   12/31/2299
26340   2   MANIPULATION, FINGER JOINT, UNDER ANESTHESIA EACH JOINT   N   3   $160.61   1/2/2002   12/31/2299
26350   2   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3   $175.00   1/1/2004   12/31/2299
26350   7   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3    $13.45   6/1/1994   12/31/2299
26350   8   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3    $35.00   1/1/1984   12/31/2299
26350   F   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3   $225.80   3/1/2004   12/31/2299
26352   2   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3   $260.00   1/1/1984   12/31/2299
26352   7   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3    $13.45   6/1/1994   12/31/2299
26352   F   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, NOT IN NO         N   3   $432.00   3/1/2004   12/31/2299
26356   2   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, IN NO MAN'        N   3   $300.00   1/2/1992   12/31/2299
26356   7   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, IN NO MAN'        N   3    $13.45   6/1/1994   12/31/2299
26356   8   FLEXOR TENDON REPAIR OR ADUANCE, SINGL, IN HO MAN'        N   3    $35.00   1/1/1984   12/31/2299
26356   F   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, IN NO MAN'        N   3   $432.00   3/1/2004   12/31/2299
26357   7   FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN           N   3    $13.45   6/1/1994   12/31/2299
26357   F   FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN           N   3   $432.00   3/1/2004   12/31/2299
26358   2   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, IN NO MAN'        N   3   $250.00   1/1/1984   12/31/2299
26358   7   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, IN NO MAN'        N   3    $13.45   6/1/1994   12/31/2299
26358   F   FLEXOR TENDON REPAIR OR ADVANCE, SINGL, IN NO MAN'        N   3   $432.00   3/1/2004   12/31/2299
26370   2   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3   $175.00   1/1/1984   12/31/2299
26370   7   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3    $13.45   6/1/1994   12/31/2299
26370   8   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3    $35.00   1/1/1984   12/31/2299
26370   F   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3   $432.00   3/1/2004   12/31/2299
26372   2   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3   $150.00   1/1/1984   12/31/2299
26372   7   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3    $13.45   6/1/1994   12/31/2299
26372   F   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3   $432.00   3/1/2004   12/31/2299
26373   2   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3   $125.00   1/1/1984   12/31/2299
26373   7   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3    $13.45   6/1/1994   12/31/2299
26373   F   PROFUNDUS TENDON REPAIR OR ADVANCEMENT, WITH INTAC        N   3   $351.00   3/1/2004   12/31/2299
26390   2   FLEXOR TENDON EXCISION, IMPLANTATION OF PLASTIC TU        N   3   $200.00   8/1/1979   12/31/2299
26390   7   FLEXOR TENDON EXCISION, IMPLANTATION OF PLASTIC TU        N   3    $13.45   6/1/1994   12/31/2299




                                                                                                            68
26390   F   FLEXOR TENDON EXCISION, IMPLANTATION OF PLASTIC TU   N   3   $432.00   3/1/2004   12/31/2299
26392   2   REMOVAL OF TUBE OR ROD AND INSERTION OF TENDON GRA   N   3   $250.00   8/1/1979   12/31/2299
26392   7   REMOVAL OF TUBE OR ROD AND INSERTION OF TENDON GRA   N   3    $13.45   6/1/1994   12/31/2299
26392   F   REMOVAL OF TUBE OR ROD AND INSERTION OF TENDON GRA   N   3   $351.00   3/1/2004   12/31/2299
26410   2   EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PR   N   3   $150.00   1/2/1992   12/31/2299
26410   7   EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PR   N   3    $13.45   6/1/1994   12/31/2299
26410   F   EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PR   N   3   $351.00   3/1/2004   12/31/2299
26412   2   EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PR   N   3    $90.00   8/1/1979   12/31/2299
26412   7   EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PR   N   3    $13.45   6/1/1994   12/31/2299
26412   F   EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PR   N   3   $351.00   3/1/2004   12/31/2299
26415   2   EXTENSOR TENDON EXCISION, IMPLANTATION OF PLASTIC    N   3   $598.21   1/1/2002   12/31/2299
26415   7   EXTENSOR TENDON EXCISION, IMPLANTATION OF PLASTIC    N   3    $13.45   6/1/1994   12/31/2299
26415   F   EXTENSOR TENDON EXCISION, IMPLANTATION OF PLASTIC    N   3   $432.00   3/1/2004   12/31/2299
26416   2   REMOVAL OF TUBE OR ROD AND INSERTION OF EXTENSOR T   N   3   $646.10   1/1/2002   12/31/2299
26416   7   REMOVAL OF TUBE OR ROD AND INSERTION OF EXTENSOR T   N   3    $13.45   6/1/1994   12/31/2299
26416   F   REMOVAL OF TUBE OR ROD AND INSERTION OF EXTENSOR T   N   3   $351.00   3/1/2004   12/31/2299
26418   2   EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,    N   3    $50.00   8/1/1979   12/31/2299
26418   7   EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,    N   3    $13.45   6/1/1994   12/31/2299
26418   F   EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,    N   3   $432.00   3/1/2004   12/31/2299
26420   2   EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,    N   3   $175.00   8/1/1979   12/31/2299
26420   7   EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,    N   3    $13.45   6/1/1994   12/31/2299
26420   F   EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,    N   3   $432.00   3/1/2004   12/31/2299
26426   2   EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECON   N   3   $200.00   1/1/1984   12/31/2299
26426   7   EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECON   N   3    $13.45   6/1/1994   12/31/2299
26426   F   EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECON   N   3   $351.00   3/1/2004   12/31/2299
26428   2   EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECON   N   3   $270.00   1/1/1984   12/31/2299
26428   7   EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECON   N   3    $13.45   6/1/1994   12/31/2299
26428   F   EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECON   N   3   $351.00   3/1/2004   12/31/2299
26432   2   EXTENSOR TENDON REPAIR, DISTAL INSERTION (''MALLET   N   3    $70.00   1/1/1984   12/31/2299
26432   7   EXTENSOR TENDON REPAIR, DISTAL INSERTION (''MALLET   N   3    $13.45   6/1/1994   12/31/2299
26432   F   EXTENSOR TENDON REPAIR, DISTAL INSERTION (''MALLET   N   3   $351.00   3/1/2004   12/31/2299
26433   2   EXTENSOR TENDON REPAIR, OPEN, PRIMARY OR SECONDARY   N   3   $100.00   1/1/1984   12/31/2299
26433   7   EXTENSOR TENDON REPAIR, OPEN, PRIMARY OR SECONDARY   N   3    $13.45   6/1/1994   12/31/2299
26433   F   EXTENSOR TENDON REPAIR, OPEN, PRIMARY OR SECONDARY   N   3   $351.00   3/1/2004   12/31/2299
26434   2   EXTENSOR TENDON REPAIR, OPEN, PRIMARY OR SECONDARY   N   3   $125.00   1/2/1984   12/31/2299
26434   7   EXTENSOR TENDON REPAIR, OPEN, PRIMARY OR SECONDARY   N   3    $13.45   6/1/1994   12/31/2299
26434   F   EXTENSOR TENDON REPAIR, OPEN, PRIMARY OR SECONDARY   N   3   $351.00   3/1/2004   12/31/2299
26437   2   EXTENSOR TENDON REALIGNMENT, HAND                    N   3   $424.19   1/1/2004   12/31/2299
26437   7   EXTENSOR TENDON REALIGNMENT, HAND                    N   3    $13.45   6/1/1994   12/31/2299
26437   F   EXTENSOR TENDON REALIGNMENT, HAND                    N   3   $351.00   3/1/2004   12/31/2299
26440   2   TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM OR FINGER,    N   3   $150.00   1/1/2005   12/31/2299
26440   7   TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM OR FINGER,    N   3    $13.45   6/1/1994   12/31/2299
26440   F   TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM OR FINGER,    N   3   $351.00   3/1/2004   12/31/2299
26442   2   TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM AND FINGER,   N   3   $225.00   1/1/1984   12/31/2299
26442   7   TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM AND FINGER,   N   3    $13.45   6/1/1994   12/31/2299
26442   F   TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM AND FINGER,   N   3   $351.00   3/1/2004   12/31/2299
26445   2   TENOLYSIS, EXTENSOR TENDON, DORSUM OF HAND OR FING   N   3   $115.00   1/1/1984   12/31/2299
26445   7   TENOLYSIS, EXTENSOR TENDON, DORSUM OF HAND OR FING   N   3    $13.45   6/1/1994   12/31/2299
26445   F   TENOLYSIS, EXTENSOR TENDON, DORSUM OF HAND OR FING   N   3   $351.00   3/1/2004   12/31/2299
26449   2   TENOLYSIS, COMPLEX, EXTENSOR TENDON, DORSUM OF HAN   N   3   $250.00   1/1/1984   12/31/2299
26449   7   TENOLYSIS, COMPLEX, EXTENSOR TENDON, DORSUM OF HAN   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       69
26449   F   TENOLYSIS, COMPLEX, EXTENSOR TENDON, DORSUM OF HAN   N   3   $351.00   3/1/2004   12/31/2299
26450   2   TENOTOMY, FLEXOR, SINGLE, PALM, OPEN, EACH           N   3   $100.00   1/1/1973   12/31/2299
26450   7   TENOTOMY, FLEXOR, SINGLE, PALM, OPEN, EACH           N   3    $13.45   6/1/1994   12/31/2299
26450   F   TENOTOMY, FLEXOR, SINGLE, PALM, OPEN, EACH           N   3   $351.00   3/1/2004   12/31/2299
26455   2   TENOTOMY, FLEXOR, SINGLE, FINGER, OPEN, EACH         N   3   $100.00   8/1/1979   12/31/2299
26455   7   TENOTOMY, FLEXOR, SINGLE, FINGER, OPEN, EACH         N   3    $13.45   6/1/1994   12/31/2299
26455   F   TENOTOMY, FLEXOR, SINGLE, FINGER, OPEN, EACH         N   3   $351.00   3/1/2004   12/31/2299
26460   2   TENOTOMY, EXTENSOR, HAND OR FINGER, SINGLE, EACH     N   3    $80.00   1/1/1984   12/31/2299
26460   7   TENOTOMY, EXTENSOR, HAND OR FINGER, SINGLE, EACH     N   3    $13.45   6/1/1994   12/31/2299
26460   8   TENOTOMY, EXTENSOR, HAND OR FINGER, SINGLE, EACH     N   3    $48.00   1/1/1984   12/31/2299
26460   F   TENOTOMY, EXTENSOR, HAND OR FINGER, SINGLE, EACH     N   3   $351.00   3/1/2004   12/31/2299
26471   2   TENODESIS; FOR PROXIMAL INTERPHALANGEAL JOINT STAB   N   3   $175.00   1/1/1973   12/31/2299
26471   7   TENODESIS; FOR PROXIMAL INTERPHALANGEAL JOINT STAB   N   3    $13.45   6/1/1994   12/31/2299
26471   F   TENODESIS; FOR PROXIMAL INTERPHALANGEAL JOINT STAB   N   3   $306.00   3/1/2004   12/31/2299
26474   2   TENODESIS; FOR DISTAL JOINT STABILIZATION            N   3   $150.00   1/1/1984   12/31/2299
26474   7   TENODESIS; FOR DISTAL JOINT STABILIZATION            N   3    $13.45   6/1/1994   12/31/2299
26474   F   TENODESIS; FOR DISTAL JOINT STABILIZATION            N   3   $306.00   3/1/2004   12/31/2299
26476   2   TENDON LENGTHENING, EXTENSOR, SINGLE, EACH           N   3    $75.00   1/1/1984   12/31/2299
26476   7   TENDON LENGTHENING, EXTENSOR, SINGLE, EACH           N   3    $13.45   6/1/1994   12/31/2299
26476   F   TENDON LENGTHENING, EXTENSOR, SINGLE, EACH           N   3   $225.80   3/1/2004   12/31/2299
26477   2   TENDON SHORTENING, EXTENSOR, SINGLE, EACH            N   3    $75.00   1/1/1984   12/31/2299
26477   7   TENDON SHORTENING, EXTENSOR, SINGLE, EACH            N   3    $13.45   6/1/1994   12/31/2299
26477   F   TENDON SHORTENING, EXTENSOR, SINGLE, EACH            N   3   $225.80   3/1/2004   12/31/2299
26478   2   TENDON LENGTHENING,FLEXOR,HAND/FINGER,SINGLE,EACH    N   3   $200.00   1/1/1984   12/31/2299
26478   7   TENDON LENGTHENING,FLEXOR,HAND/FINGER,SINGLE,EACH    N   3    $13.45   6/1/1994   12/31/2299
26478   F   TENDON LENGTHENING,FLEXOR,HAND/FINGER,SINGLE,EACH    N   3   $225.80   3/1/2004   12/31/2299
26479   7   TENDON SHORTENING, FLEXOR, HAND OR FINGER, SINGLE,   N   3    $13.45   6/1/1994   12/31/2299
26479   F   TENDON SHORTENING, FLEXOR, HAND OR FINGER, SINGLE,   N   3   $225.80   3/1/2004   12/31/2299
26480   2   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3   $240.00   1/1/1984   12/31/2299
26480   7   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3    $13.45   6/1/1994   12/31/2299
26480   8   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3    $48.00   1/1/1984   12/31/2299
26480   F   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3   $351.00   3/1/2004   12/31/2299
26483   2   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3   $315.00   1/1/1984   12/31/2299
26483   7   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3    $13.45   6/1/1994   12/31/2299
26483   F   TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL ARE   N   3   $351.00   3/1/2004   12/31/2299
26485   2   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3   $300.00   1/1/1984   12/31/2299
26485   7   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3    $13.45   6/1/1994   12/31/2299
26485   8   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3    $60.00   1/1/1984   12/31/2299
26485   F   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3   $306.00   3/1/2004   12/31/2299
26489   2   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3   $375.00   1/1/1984   12/31/2299
26489   7   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3    $13.45   6/1/1994   12/31/2299
26489   F   TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EA    N   3   $351.00   3/1/2004   12/31/2299
26490   2   OPPONENS PLASTY; SUBLIMIS TENDON TRANSFER TYPE       N   3   $237.50   1/1/1973   12/31/2299
26490   7   OPPONENS PLASTY; SUBLIMIS TENDON TRANSFER TYPE       N   3    $13.45   6/1/1994   12/31/2299
26490   F   OPPONENS PLASTY; SUBLIMIS TENDON TRANSFER TYPE       N   3   $351.00   3/1/2004   12/31/2299
26492   2   OPPONENS PLASTY; TENDON TRANSFER WITH GRAFT (INCL    N   3   $275.00   1/1/1973   12/31/2299
26492   7   OPPONENS PLASTY; TENDON TRANSFER WITH GRAFT (INCL    N   3    $13.45   6/1/1994   12/31/2299
26492   8   OPPONENS PLASTY; TENDON TRANSFER WITH GRAFT (INCL    N   3    $55.00   1/1/1973   12/31/2299
26492   F   OPPONENS PLASTY; TENDON TRANSFER WITH GRAFT (INCL    N   3   $351.00   3/1/2004   12/31/2299
26494   2   OPPONENS PLASTY; HYPOTHENAR MUSCLE TRANSFER          N   3   $340.00   1/1/1984   12/31/2299
26494   7   OPPONENS PLASTY; HYPOTHENAR MUSCLE TRANSFER          N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       70
26494   F   OPPONENS PLASTY; HYPOTHENAR MUSCLE TRANSFER          N   3   $351.00   3/1/2004   12/31/2299
26496   2   OPPONENS PLASTY; OTHER METHODS                       N   3   $300.00   1/1/1973   12/31/2299
26496   7   OPPONENS PLASTY; OTHER METHODS                       N   3    $13.45   6/1/1994   12/31/2299
26496   8   OPPONENS PLASTY; OTHER METHODS                       N   3    $60.00   1/1/1973   12/31/2299
26496   F   OPPONENS PLASTY; OTHER METHODS                       N   3   $351.00   3/1/2004   12/31/2299
26497   7   SUBLIMIS TRANSFER TO CORRECT CLAW FINGER; IV AND V   N   3    $13.45   6/1/1994   12/31/2299
26497   F   SUBLIMIS TRANSFER TO CORRECT CLAW FINGER; IV AND V   N   3   $351.00   3/1/2004   12/31/2299
26498   7   SUBLIMIS TRANSFER TO CORRECT CLAW FINGER; II, III,   N   3    $13.45   6/1/1994   12/31/2299
26498   F   SUBLIMIS TRANSFER TO CORRECT CLAW FINGER; II, III,   N   3   $432.00   3/1/2004   12/31/2299
26499   7   CORRECTION CLAW FINGER, OTHER METHODS                N   3    $13.45   6/1/1994   12/31/2299
26499   F   CORRECTION CLAW FINGER, OTHER METHODS                N   3   $351.00   3/1/2004   12/31/2299
26500   2   TENDON PULLEY RECONSTRUCTION; WITH LOCAL TISSUES (   N   3   $150.00   1/1/1973   12/31/2299
26500   7   TENDON PULLEY RECONSTRUCTION; WITH LOCAL TISSUES (   N   3    $13.45   6/1/1994   12/31/2299
26500   F   TENDON PULLEY RECONSTRUCTION; WITH LOCAL TISSUES (   N   3   $432.00   3/1/2004   12/31/2299
26502   2   TENDON PULLEY RECONSTRUCTION; WITH TENDON OR FASCI   N   3   $200.00   1/1/1973   12/31/2299
26502   7   TENDON PULLEY RECONSTRUCTION; WITH TENDON OR FASCI   N   3    $13.45   6/1/1994   12/31/2299
26502   F   TENDON PULLEY RECONSTRUCTION; WITH TENDON OR FASCI   N   3   $432.00   3/1/2004   12/31/2299
26508   2   THENAR MUSCLE RELEASE FOR THUMB CONTRACTURE          N   3   $225.00   1/1/1984   12/31/2299
26508   7   THENAR MUSCLE RELEASE FOR THUMB CONTRACTURE          N   3    $13.45   6/1/1994   12/31/2299
26508   F   THENAR MUSCLE RELEASE FOR THUMB CONTRACTURE          N   3   $351.00   3/1/2004   12/31/2299
26510   2   CROSS INTRINSIC TRANSFER                             N   3   $446.23   1/1/2002   12/31/2299
26510   7   CROSS INTRINSIC TRANSFER                             N   3    $13.45   6/1/1994   12/31/2299
26510   F   CROSS INTRINSIC TRANSFER                             N   3   $351.00   3/1/2004   12/31/2299
26516   2   CAPSULODESIS FOR M-P JOINT STABILIZATION; SINGLE D   N   3   $200.00   1/1/1973   12/31/2299
26516   7   CAPSULODESIS FOR M-P JOINT STABILIZATION; SINGLE D   N   3    $13.45   6/1/1994   12/31/2299
26516   F   CAPSULODESIS FOR M-P JOINT STABILIZATION; SINGLE D   N   3   $225.80   3/1/2004   12/31/2299
26517   2   CAPSULODESIS FOR M-P JOINT STABILIZATION; TWO DIGI   N   3   $285.00   1/1/1984   12/31/2299
26517   7   CAPSULODESIS FOR M-P JOINT STABILIZATION; TWO DIGI   N   3    $13.45   6/1/1994   12/31/2299
26517   F   CAPSULODESIS FOR M-P JOINT STABILIZATION; TWO DIGI   N   3   $351.00   3/1/2004   12/31/2299
26518   2   CAPSULODESIS FOR M-P JOINT STABILIZATION; THREE OR   N   3   $340.00   1/1/1984   12/31/2299
26518   7   CAPSULODESIS FOR M-P JOINT STABILIZATION; THREE OR   N   3    $13.45   6/1/1994   12/31/2299
26518   F   CAPSULODESIS FOR M-P JOINT STABILIZATION; THREE OR   N   3   $351.00   3/1/2004   12/31/2299
26520   2   CAPSULECTOMY FOR CONTRACTURE; METACARPOPHALANGEAL    N   3   $175.00   1/1/1973   12/31/2299
26520   7   CAPSULECTOMY FOR CONTRACTURE; METACARPOPHALANGEAL    N   3    $13.45   6/1/1994   12/31/2299
26520   F   CAPSULECTOMY FOR CONTRACTURE; METACARPOPHALANGEAL    N   3   $351.00   3/1/2004   12/31/2299
26525   2   CAPSULECTOMY FOR CONTRACTURE; INTERPHALANGEAL JOIN   N   3   $175.00   1/1/1973   12/31/2299
26525   7   CAPSULECTOMY FOR CONTRACTURE; INTERPHALANGEAL JOIN   N   3    $13.45   6/1/1994   12/31/2299
26525   F   CAPSULECTOMY FOR CONTRACTURE; INTERPHALANGEAL JOIN   N   3   $351.00   3/1/2004   12/31/2299
26530   2   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; SINGLE, E   N   3   $268.92   1/1/1998   12/31/2299
26530   7   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; SINGLE, E   N   3    $13.45   6/1/1994   12/31/2299
26530   8   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; SINGLE, E   N   3    $53.76   1/1/1998   12/31/2299
26530   F   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; SINGLE, E   N   3   $351.00   3/1/2004   12/31/2299
26531   2   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROS   N   3   $225.00   1/1/1973   12/31/2299
26531   7   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROS   N   3    $13.45   6/1/1994   12/31/2299
26531   F   ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROS   N   3   $495.00   3/1/2004   12/31/2299
26535   2   ARTHROPLASTY INTERPHALANGEAL JOINT; SINGLE, EACH     N   3   $200.00   1/1/1973   12/31/2299
26535   7   ARTHROPLASTY INTERPHALANGEAL JOINT; SINGLE, EACH     N   3    $13.45   6/1/1994   12/31/2299
26535   F   ARTHROPLASTY INTERPHALANGEAL JOINT; SINGLE, EACH     N   3   $495.00   3/1/2004   12/31/2299
26536   2   ARTHROPLASTY INTERPHALANGEAL JOINT; WITH PROSTHETI   N   3   $250.00   8/1/1979   12/31/2299
26536   7   ARTHROPLASTY INTERPHALANGEAL JOINT; WITH PROSTHETI   N   3    $13.45   6/1/1994   12/31/2299
26536   F   ARTHROPLASTY INTERPHALANGEAL JOINT; WITH PROSTHETI   N   3   $495.00   3/1/2004   12/31/2299




                                                                                                       71
26540   2   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3    $250.00    1/1/1973   12/31/2299
26540   7   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3      $13.45   6/1/1994   12/31/2299
26540   8   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3      $50.00   1/7/1992   12/31/2299
26540   F   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3    $432.00    3/1/2004   12/31/2299
26541   2   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3    $320.00    1/1/1984   12/31/2299
26541   7   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3      $13.45   6/1/1994   12/31/2299
26541   8   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3      $64.00   1/1/1984   12/31/2299
26541   F   RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHAL                  N   3    $495.00    3/1/2004   12/31/2299
26542   7   PRIMARY REPAIR OF COLLATERAL LIGAMENT, METACARPOPH                  N   3      $13.45   6/1/1994   12/31/2299
26542   F   PRIMARY REPAIR OF COLLATERAL LIGAMENT, METACARPOPH                  N   3    $432.00    3/1/2004   12/31/2299
26545   2   RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGE                  N   3    $200.00    1/1/1973   12/31/2299
26545   7   RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGE                  N   3      $13.45   6/1/1994   12/31/2299
26545   F   RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGE                  N   3    $432.00    3/1/2004   12/31/2299
26546   2   REPAIR NON-UNIONMETACARPAL OR PHALANX                               N   3    $425.29    1/1/1997   12/31/2299
26546   7   REPAIR NON-UNIION,METACARPAL OR PHALANX,W OR W/O EXTER OR INTER     N   3      $13.45   1/1/1997   12/31/2299
26546   8   REPAIR NON-UNION,METACARPAL/PHALANX W OR W/O EXTER/INTERN FIXATIO   N   3      $85.06   1/1/1997   12/31/2299
26546   F   REPAIR NON-UNIONMETACARPAL OR PHALANX                               N   3    $432.00    3/1/2004   12/31/2299
26548   2   REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE,                     N   3    $523.58    1/1/2003   12/31/2299
26548   7   REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE,                     N   3      $13.45   6/1/1994   12/31/2299
26548   F   REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE,                     N   3    $432.00    3/1/2004   12/31/2299
26550   2   POLLICIZATION OF A DIGIT                                            N   3    $275.00    1/1/1984   12/31/2299
26550   7   POLLICIZATION OF A DIGIT                                            N   3      $13.45   6/1/1994   12/31/2299
26550   F   POLLICIZATION OF A DIGIT                                            N   3    $306.00    3/1/2004   12/31/2299
26551   2   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS; GREAT TOE         N   3   $2,216.03   1/1/1997   12/31/2299
26551   7   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;GREAT TOE WRAP     N   3      $13.45   1/1/1997   12/31/2299
26551   8   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;GREAT TOE WRAP     N   3    $443.20    1/1/1997   12/31/2299
26552   7   RECONSTRUCTION THUMB WITH TOE                                       N   3      $13.45   6/1/1994   12/31/2299
26553   2   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;SINGLE TOE         N   3   $2,200.63   1/1/1997   12/31/2299
26553   7   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;OTHER THAN GRTOE   N   3      $13.45   1/1/1997   12/31/2299
26553   8   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;OTHER THAN GRTOE   N   3    $440.12    1/1/1997   12/31/2299
26554   2   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;DOUBLE TOE         N   3   $2,625.67   1/1/1997   12/31/2299
26554   7   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS;DOUBLE             N   3      $13.45   1/1/1997   12/31/2299
26554   8   TOE-TO-HAND TRANSFER W/MICROVASCULAR ANASTOMOSIS; DOUBLE            N   3    $525.14    1/1/1997   12/31/2299
26555   2   POSITIONAL CHANGE OF OTHER FINGER                                   N   3    $250.00    1/1/1984   12/31/2299
26555   7   POSITIONAL CHANGE OF OTHER FINGER                                   N   3      $13.45   6/1/1994   12/31/2299
26555   F   POSITIONAL CHANGE OF OTHER FINGER                                   N   3    $351.00    3/1/2004   12/31/2299
26556   2   FREE TOE JOINT TRANSFER W/MICROVASCULAR ANASTOMOSIS                 N   3   $2,238.08   1/1/1997   12/31/2299
26556   7   FREE TOE JOINT TRANSFER W/MICROVASCULAR ANASTOMOSIS                 N   3      $13.45   1/1/1997   12/31/2299
26556   8   FREE TOE JOINT TRANSFER W/MICROVASCULAR ANASTOMOSIS                 N   3    $447.62    1/1/1997   12/31/2299
26557   7   TOE TO FINGER TRANSFER; FIRST STAGE                                 N   3      $13.45   6/1/1994   12/31/2299
26558   7   TOE TO FINGER TRANSFER; EACH DELAY                                  N   3      $13.45   6/1/1994   12/31/2299
26559   7   TOE TO FINGER TRANSFER; SECOND STAGE                                N   3      $13.45   6/1/1994   12/31/2299
26560   2   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3    $237.50    1/1/1973   12/31/2299
26560   7   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3      $13.45   6/1/1994   12/31/2299
26560   F   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3    $306.00    3/1/2004   12/31/2299
26561   2   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3    $300.00    1/1/1973   12/31/2299
26561   7   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3      $13.45   6/1/1994   12/31/2299
26561   8   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3      $60.00   1/1/1973   12/31/2299
26561   F   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3    $351.00    3/1/2004   12/31/2299
26562   2   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3    $325.00    1/1/1984   12/31/2299
26562   7   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                        72
26562   F   REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;                   N   3   $432.00   3/1/2004   12/31/2299
26565   2   OSTEOTOMY FOR CORRECTION OF DEFORMITY; METACARPAL                   N   3   $200.00   1/1/1973   12/31/2299
26565   7   OSTEOTOMY FOR CORRECTION OF DEFORMITY; METACARPAL                   N   3    $13.45   6/1/1994   12/31/2299
26565   F   OSTEOTOMY FOR CORRECTION OF DEFORMITY; METACARPAL                   N   3   $495.00   3/1/2004   12/31/2299
26567   2   OSTEOTOMY FOR CORRECTION OF DEFORMITY; PHALANX                      N   3   $125.00   1/1/1973   12/31/2299
26567   7   OSTEOTOMY FOR CORRECTION OF DEFORMITY; PHALANX                      N   3    $13.45   6/1/1994   12/31/2299
26567   F   OSTEOTOMY FOR CORRECTION OF DEFORMITY; PHALANX                      N   3   $495.00   3/1/2004   12/31/2299
26568   7   OSTEOPLASTY FOR LENGTHENING OF METACARPAL OR PHALA                  N   3    $13.45   6/1/1994   12/31/2299
26568   F   OSTEOPLASTY FOR LENGTHENING OF METACARPAL OR PHALA                  N   3   $351.00   3/1/2004   12/31/2299
26580   7   REPAIR CLEFT HAND                                                   N   3    $13.45   6/1/1994   12/31/2299
26585   7   REPAIR BIFID DIGIT                                                  N   3    $13.45   6/1/1994   12/31/2299
26587   2   RECONSTRUCTION OF SUPERNUMERARY DIGIT, SOFT TISSUE                  N   3   $600.00   1/3/1994   12/31/2299
26587   7   RECONSTRUCTION OF SUPERNUMERARY DIGIT, SOFT TISSUE                  N   3    $13.45   6/1/1994   12/31/2299
26587   F   RECONSTRUCTION OF SUPERNUMERARY DIGIT, SOFT TISSUE                  N   3   $495.00   3/1/2004   12/31/2299
26590   2   REPAIR MACRODACTYLIA                                                N   3   $735.34   1/1/2002   12/31/2299
26590   7   REPAIR MACRODACTYLIA                                                N   3    $13.45   6/1/1994   12/31/2299
26590   F   REPAIR MACRODACTYLIA                                                N   3   $495.00   3/1/2004   12/31/2299
26591   2   REPAIR, INTRINSIC MUSCLES OF HAND (SPECIFY)                         N   3   $367.86   1/1/2003   12/31/2299
26591   7   REPAIR, INTRINSIC MUSCLES OF HAND (SPECIFY)                         N   3    $13.45   6/1/1994   12/31/2299
26591   F   REPAIR, INTRINSIC MUSCLES OF HAND (SPECIFY)                         N   3   $351.00   3/1/2004   12/31/2299
26593   2   RELEASE INTRINSIC MUSCLES OF HAND SPECIFY                           N   3   $150.00   1/1/1984   12/31/2299
26593   F   RELEASE INTRINSIC MUSCLES OF HAND SPECIFY                           N   3   $351.00   3/1/2004   12/31/2299
26596   7   EXCISION OF CONSTRICTING RING OF FINGER,                            N   3    $13.45   6/1/1994   12/31/2299
26596   F   EXCISION OF CONSTRICTING RING OF FINGER,                            N   3   $306.00   3/1/2004   12/31/2299
26600   2   CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MAN.EACH   N   3    $64.80   1/2/1996   12/31/2299
26600   7   TREATMENT OF CLOSED METACARPAL FRACTURE, SINGLE; W                  N   3    $13.45   6/1/1994   12/31/2299
26605   2   TREATMENT OF CLOSED METACARPAL FRACTURE, SINGLE; W                  N   3    $94.00   1/2/1992   12/31/2299
26605   7   TREATMENT OF CLOSED METACARPAL FRACTURE, SINGLE; W                  N   3    $13.45   6/1/1994   12/31/2299
26605   F   TREATMENT OF CLOSED METACARPAL FRACTURE, SINGLE; W                  N   3   $306.00   3/1/2004   12/31/2299
26607   2   TREATMENT OF CLOSED METACARPAL FRACTURE, SINGLE; W                  N   3   $150.00   1/1/1984   12/31/2299
26607   7   TRTMT OF CLOSED METACARPIFX SINGLE W/MANIP EACH BN                  N   3    $13.45   6/1/1994   12/31/2299
26607   F   TREATMENT OF CLOSED METACARPAL FRACTURE, SINGLE; W                  N   3   $306.00   3/1/2004   12/31/2299
26608   2   PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACT                  N   3   $174.24   1/1/1993   12/31/2299
26608   7   PERCUTANEOUS SKELETAL FIXATION OF METACAPRAL FRACTURE               N   3    $13.45   1/1/1993   12/31/2299
26608   8   ASSIST.,PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE       N   3    $34.84   1/1/1993   12/31/2299
26608   F   PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACT                  N   3   $432.00   3/1/2004   12/31/2299
26615   2   OPEN TREATMENT OF CLOSED OR OPEN METACARPAL FRACT.                  N   3   $175.00   1/1/1973   12/31/2299
26615   7   OPEN TREATMENT OF CLOSED OR OPEN METACARPAL FRACT.                  N   3    $13.45   6/1/1994   12/31/2299
26615   F   OPEN TREATMENT OF CLOSED OR OPEN METACARPAL FRACT.                  N   3   $432.00   3/1/2004   12/31/2299
26641   2   TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, W                  N   3    $85.00   1/1/1984   12/31/2299
26641   7   TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, W                  N   3    $13.45   6/1/1994   12/31/2299
26645   2   TREATMENT OF CLOSED CARPOMETACARPAL FRACTURE DISLO                  N   3   $100.00   1/1/1976   12/31/2299
26645   7   TREATMENT OF CLOSED CARPOMETACARPAL FRACTURE DISLO                  N   3    $13.45   6/1/1994   12/31/2299
26645   F   TREATMENT OF CLOSED CARPOMETACARPAL FRACTURE DISLO                  N   3   $225.80   3/1/2004   12/31/2299
26650   2   TREATMENT OF CLOSED CARPOMETACARPAL FRACT. DISLOC.                  N   3   $150.00   1/1/1973   12/31/2299
26650   7   TREATMENT OF CLOSED CARPOMETACARPAL FRACT. DISLOC.                  N   3    $13.45   6/1/1994   12/31/2299
26650   F   TREATMENT OF CLOSED CARPOMETACARPAL FRACT. DISLOC.                  N   3   $306.00   3/1/2004   12/31/2299
26665   2   OPEN TREATMENT OF CLOSED OR OPEN CARPOMETACARPAL F                  N   3   $250.00   1/1/1973   12/31/2299
26665   7   OPEN TREATMENT OF CLOSED OR OPEN CARPOMETACARPAL F                  N   3    $13.45   6/1/1994   12/31/2299
26665   8   OPEN TREATMENT OF CLOSED OR OPEN CARPOMETACARPAL F                  N   3    $50.00   1/1/1973   12/31/2299
26665   F   OPEN TREATMENT OF CLOSED OR OPEN CARPOMETACARPAL F                  N   3   $432.00   3/1/2004   12/31/2299




                                                                                                                      73
26670   2   TREAT. OF CLOSED CARPOMETACARPAL DISLOC OTHER THAN   N   3    $18.00   1/1/1973   12/31/2299
26675   2   TREAT. OF CLOSED CARPOMETACARPAL DISLOC OTHER THAN   N   3    $25.00   8/1/1979   12/31/2299
26675   7   TREAT. OF CLOSED CARPOMETACARPAL DISLOC OTHER THAN   N   3    $13.45   6/1/1994   12/31/2299
26675   F   TREAT. OF CLOSED CARPOMETACARPAL DISLOC OTHER THAN   N   3   $306.00   3/1/2004   12/31/2299
26676   2   TREATMENT OF CLOSED CARPOMETACARPAL DISLOCATION,     N   3   $231.00   1/2/1994   12/31/2299
26676   7   TREATMENT OF CLOSED CARPOMETACARPAL DISLOCATION,     N   3    $13.45   6/1/1994   12/31/2299
26676   F   TREATMENT OF CLOSED CARPOMETACARPAL DISLOCATION,     N   3   $306.00   3/1/2004   12/31/2299
26685   2   OPEN TREAT OF CLSD OR OPEN CARPOMETACARPAL DISLOC    N   3   $150.00   1/1/1973   12/31/2299
26685   7   OPEN TREAT OF CLSD OR OPEN CARPOMETACARPAL DISLOC    N   3    $13.45   6/1/1994   12/31/2299
26685   F   OPEN TREAT OF CLSD OR OPEN CARPOMETACARPAL DISLOC    N   3   $351.00   3/1/2004   12/31/2299
26686   2   OPEN TREAT OF CLSD OR OPEN CARPOMETACARPAL DISLOC    N   3    $90.00   1/1/1984   12/31/2299
26686   7   OPEN TREAT OF CLSD OR OPEN CARPOMETACARPAL DISLOC    N   3    $13.45   6/1/1994   12/31/2299
26686   F   OPEN TREAT OF CLSD OR OPEN CARPOMETACARPAL DISLOC    N   3   $351.00   3/1/2004   12/31/2299
26700   2   TREAT OF CLOSED METACARPOPHALANGEAL DISLOC, SINGLE   N   3    $18.00   1/1/1971   12/31/2299
26705   2   TREAT OF CLOSED METACARPOPHALANGEAL DISLOC, SINGLE   N   3    $25.00   8/1/1979   12/31/2299
26705   7   TREAT OF CLOSED METACARPOPHALANGEAL DISLOC, SINGLE   N   3    $13.45   6/1/1994   12/31/2299
26705   F   TREAT OF CLOSED METACARPOPHALANGEAL DISLOC, SINGLE   N   3   $306.00   3/1/2004   12/31/2299
26706   7   TREATMENT OF CLOSED METACARPOPHALANGEAL DISLOCATIO   N   3    $13.45   6/1/1994   12/31/2299
26706   F   TREATMENT OF CLOSED METACARPOPHALANGEAL DISLOCATIO   N   3   $306.00   3/1/2004   12/31/2299
26715   2   OPEN TREAT OF CLOSED OR OPEN METACARPOPHALANGEAL D   N   3   $150.00   1/1/1973   12/31/2299
26715   7   OPEN TREAT OF CLOSED OR OPEN METACARPOPHALANGEAL D   N   3    $13.45   6/1/1994   12/31/2299
26715   F   OPEN TREAT OF CLOSED OR OPEN METACARPOPHALANGEAL D   N   3   $432.00   3/1/2004   12/31/2299
26720   2   TREAT OF CLOSED PHALANGEAL SHAFT FRACTURE, PROXIMA   N   3    $54.00   1/2/1995   12/31/2299
26725   2   TREAT OF CLOSED PHALANGEAL SHAFT FRACTURE, PROXIMA   N   3   $118.00   1/1/1997   12/31/2299
26725   7   TREAT OF CLOSED PHALANGEAL SHAFT FRACTURE, PROXIMA   N   3    $13.45   6/1/1994   12/31/2299
26727   2   TREAT OF UNSTABLE PHALANGEAL SHAFT FRACT, PROX OR    N   3    $50.00   1/2/1984   12/31/2299
26727   7   TREAT OF UNSTABLE PHALANGEAL SHAFT FRACT, PROX OR    N   3    $13.45   6/1/1994   12/31/2299
26727   F   TREAT OF UNSTABLE PHALANGEAL SHAFT FRACT, PROX OR    N   3   $495.00   3/1/2004   12/31/2299
26735   2   OPEN TREAT OF CLOSED OR OPEN PHALANGEAL SHAFT FRAC   N   3   $100.00   1/1/1973   12/31/2299
26735   7   OPEN TREAT OF CLOSED OR OPEN PHALANGEAL SHAFT FRAC   N   3    $13.45   6/1/1994   12/31/2299
26735   F   OPEN TREAT OF CLOSED OR OPEN PHALANGEAL SHAFT FRAC   N   3   $432.00   3/1/2004   12/31/2299
26740   2   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3    $40.00   1/1/1984   12/31/2299
26740   7   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3    $13.45   6/1/1994   12/31/2299
26742   2   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3    $50.00   1/2/1984   12/31/2299
26742   7   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3    $13.45   6/1/1994   12/31/2299
26742   F   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3   $306.00   3/1/2004   12/31/2299
26743   2   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3    $70.00   1/1/1984   12/31/2299
26743   7   TREAT OF CLOSED ARTICULAR FX, INVOLV METACARPOPHAL   N   3    $13.45   6/1/1994   12/31/2299
26746   2   OPEN TREAT OF CLOSED OR OPEN ARTICULAR FX, INVOLV    N   3    $70.00   1/1/1984   12/31/2299
26746   7   OPEN TREAT OF CLOSED OR OPEN ARTICULAR FX, INVOLV    N   3    $13.45   6/1/1994   12/31/2299
26746   F   OPEN TREAT OF CLOSED OR OPEN ARTICULAR FX, INVOLV    N   3   $495.00   3/1/2004   12/31/2299
26750   2   TREAT OF CLOSED DISTAL PHALANGEAL FX, FINGER OR TH   N   3    $15.00   1/1/1971   12/31/2299
26755   2   TREAT OF CLOSED DISTAL PHALANGEAL FX, FINGER OR TH   N   3    $25.00   1/1/1973   12/31/2299
26755   7   TREAT OF CLOSED DISTAL PHALANGEAL FX, FINGER OR TH   N   3    $13.45   6/1/1994   12/31/2299
26756   2   TREATMENT OF CLOSED DISTAL PHALANGEAL FRACTURE,      N   3   $299.57   1/1/2003   12/31/2299
26756   7   TREATMENT OF CLOSED DISTAL PHALANGEAL FRACTURE,      N   3    $13.45   6/1/1994   12/31/2299
26756   F   TREATMENT OF CLOSED DISTAL PHALANGEAL FRACTURE,      N   3   $306.00   3/1/2004   12/31/2299
26765   2   OPEN TREATMENT OF CLOSED OR OPEN DISTAL PHALANGEAL   N   3    $60.00   1/1/1973   12/31/2299
26765   7   OPEN TREATMENT OF CLOSED OR OPEN DISTAL PHALANGEAL   N   3    $13.45   6/1/1994   12/31/2299
26765   F   OPEN TREATMENT OF CLOSED OR OPEN DISTAL PHALANGEAL   N   3   $432.00   3/1/2004   12/31/2299
26770   2   TREAT OF CLOSED INTERPHALANGEAL JOINT DISLOC, SING   N   3    $18.00   1/1/1971   12/31/2299




                                                                                                       74
26775   2   TREAT OF CLOSED INTERPHALANGEAL JOINT DISLOC, SING   N   3    $30.00   1/1/1973   12/31/2299
26775   7   TREAT OF CLOSED INTERPHALANGEAL JOINT DISLOC, SING   N   3    $13.45   6/1/1994   12/31/2299
26776   2   RX CLSED PHALANG DISLOC-SINGLE W/MANIP W/ANESTHES    N   3    $50.00   1/1/1984   12/31/2299
26776   7   RX CLSD PHALANG DISLOC-SINGLE W/MANIP W/ANESTHESIA   N   3    $13.45   6/1/1994   12/31/2299
26776   F   RX CLSED PHALANG DISLOC-SINGLE W/MANIP W/ANESTHES    N   3   $306.00   3/1/2004   12/31/2299
26785   2   OPEN TREATMENT OF CLOSED OR OPEN INTERPHALANGEAL J   N   3    $60.00   1/1/1973   12/31/2299
26785   7   OPEN TREATMENT OF CLOSED OR OPEN INTERPHALANGEAL J   N   3    $13.45   6/1/1994   12/31/2299
26785   F   OPEN TREATMENT OF CLOSED OR OPEN INTERPHALANGEAL J   N   3   $306.00   3/1/2004   12/31/2299
26803   7   PERCUTANEOUS SKELETAL FIXATION OF METCARPAL FX EAC   N   3    $13.45   6/1/1994   12/31/2299
26820   2   FUSION IN OPPOSITION, THUMB, WITH AUTOGENOUS GRAFT   N   3   $275.00   1/1/1984   12/31/2299
26820   7   FUSION IN OPPOSITION, THUMB, WITH AUTOGENOUS GRAFT   N   3    $13.45   6/1/1994   12/31/2299
26820   F   FUSION IN OPPOSITION, THUMB, WITH AUTOGENOUS GRAFT   N   3   $495.00   3/1/2004   12/31/2299
26841   2   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR   N   3   $200.00   1/1/1973   12/31/2299
26841   7   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR   N   3    $13.45   6/1/1994   12/31/2299
26841   8   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR   N   3    $40.00   1/2/1992   12/31/2299
26841   F   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, WITH OR   N   3   $432.00   3/1/2004   12/31/2299
26842   2   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, W/ OR W   N   3   $250.00   1/1/1973   12/31/2299
26842   7   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, W/ OR W   N   3    $13.45   6/1/1994   12/31/2299
26842   8   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, W/ OR W   N   3    $50.00   1/1/1973   12/31/2299
26842   F   ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, W/ OR W   N   3   $432.00   3/1/2004   12/31/2299
26843   2   ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER    N   3   $200.00   1/1/1984   12/31/2299
26843   7   ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER    N   3    $13.45   6/1/1994   12/31/2299
26843   F   ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER    N   3   $351.00   3/1/2004   12/31/2299
26844   2   ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER    N   3   $270.00   1/1/1984   12/31/2299
26844   7   ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER    N   3    $13.45   6/1/1994   12/31/2299
26844   F   ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER    N   3   $351.00   3/1/2004   12/31/2299
26850   2   ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR W/   N   3   $175.00   1/1/1973   12/31/2299
26850   7   ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR W/   N   3    $13.45   6/1/1994   12/31/2299
26850   F   ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR W/   N   3   $432.00   3/1/2004   12/31/2299
26852   2   ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR W/   N   3   $200.00   1/1/1973   12/31/2299
26852   7   ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR W/   N   3    $13.45   6/1/1994   12/31/2299
26852   F   ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR W/   N   3   $432.00   3/1/2004   12/31/2299
26860   2   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $180.00   1/2/1992   12/31/2299
26860   7   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3    $13.45   6/1/1994   12/31/2299
26860   8   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3    $45.00   1/2/1994   12/31/2299
26860   F   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $351.00   3/1/2004   12/31/2299
26861   2   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3    $80.00   1/1/1984   12/31/2299
26861   7   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3    $13.45   6/1/1994   12/31/2299
26861   F   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $306.00   3/1/2004   12/31/2299
26862   2   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $150.00   1/1/1973   12/31/2299
26862   7   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3    $13.45   6/1/1994   12/31/2299
26862   F   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $432.00   3/1/2004   12/31/2299
26863   2   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $100.00   1/1/1984   12/31/2299
26863   7   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3    $13.45   6/1/1994   12/31/2299
26863   F   ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR W/O IN   N   3   $351.00   3/1/2004   12/31/2299
26910   2   AMPUTATION, METACARPAL, W/ FINGER OR THUMB (RAY AM   N   3   $150.00   1/1/1971   12/31/2299
26910   7   AMPUTATION, METACARPAL, W/ FINGER OR THUMB (RAY AM   N   3    $13.45   6/1/1994   12/31/2299
26910   F   AMPUTATION, METACARPAL, W/ FINGER OR THUMB (RAY AM   N   3   $351.00   3/1/2004   12/31/2299
26951   2   AMPUTAT, FINGER OR THUMB, PRIM OR SECOND, ANY JT O   N   3   $144.00   8/1/1991   12/31/2299
26951   7   AMPUTAT, FINGER OR THUMB, PRIM OR SECOND, ANY JT O   N   3    $13.45   6/1/1994   12/31/2299
26951   F   AMPUTAT, FINGER OR THUMB, PRIM OR SECOND, ANY JT O   N   3   $306.00   3/1/2004   12/31/2299




                                                                                                       75
26952   2   AMPUTAT, FINGER OR THUMB, PRIM OR SECOND, ANY JT/P             N   3   $125.00   1/1/1984   12/31/2299
26952   7   AMPUTAT, FINGER OR THUMB, PRIM OR SECOND, ANY JT/P             N   3    $13.45   6/1/1994   12/31/2299
26952   F   AMPUTAT, FINGER OR THUMB, PRIM OR SECOND, ANY JT/P             N   3   $432.00   3/1/2004   12/31/2299
26989   7   UNLISTED PROCEDURE, HANDS OR FINGERS                           N   3    $13.45   6/1/1994   12/31/2299
26990   2   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA                N   3   $100.00   1/1/1984   12/31/2299
26990   7   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA.               N   3    $13.45   6/1/1994   12/31/2299
26990   F   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA                N   3   $225.80   3/1/2004   12/31/2299
26991   2   INCISION AND DRAINAGE; INFECTED BURSA                          N   3    $20.00   1/1/1984   12/31/2299
26991   7   INCISION AND DRAINAGE; INFECTED BURSA                          N   3    $13.45   6/1/1994   12/31/2299
26991   F   INCISION AND DRAINAGE; INFECTED BURSA                          N   3   $225.80   3/1/2004   12/31/2299
26992   2   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS             N   3   $150.00   1/1/1984   12/31/2299
26992   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS             N   3    $13.45   6/1/1994   12/31/2299
26995   7   INCISION, DEEP, W/OPENING OF BONE CORTEX FOR OSTEO             N   3    $13.45   6/1/1994   12/31/2299
27000   2   TENOTOMY, ADDUCTOR, SUBCUTANEOUS, CLOSED (SEPARATE             N   3    $25.00   1/1/1973   12/31/2299
27000   7   TENOTOMY, ADDUCTOR, SUBCUTANEOUS, CLOSED (SEPARATE             N   3    $13.45   6/1/1994   12/31/2299
27000   F   TENOTOMY, ADDUCTOR, SUBCUTANEOUS, CLOSED (SEPARATE             N   3   $306.00   3/1/2004   12/31/2299
27001   2   TENOTOMY, ADDUCTOR, SUBCUTRANEOUS, OPEN;UNILATERAL             N   3   $216.00   1/2/1992   12/31/2299
27001   7   TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN; UNILATERAL             N   3    $13.45   6/1/1994   12/31/2299
27001   8   TENOTOMY,ADDUCTOR,SUBCUTANEOUS,OPEN;UNILATERAL                 N   3     $3.00   1/1/1984   12/31/2299
27001   F   TENOTOMY, ADDUCTOR, SUBCUTRANEOUS, OPEN;UNILATERAL             N   3   $351.00   3/1/2004   12/31/2299
27003   2   TENOTOMY, ADDUCOR, SUBCT OPEN; W/OBTURATORY                    N   3   $150.00   1/1/1984   12/31/2299
27003   7   TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN; W/OBTURATO             N   3    $13.45   6/1/1994   12/31/2299
27003   8   TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN; W/OBTURATO             N   3    $30.00   1/1/1984   12/31/2299
27003   F   TENOTOMY, ADDUCOR, SUBCT OPEN; W/OBTURATORY                    N   3   $351.00   3/1/2004   12/31/2299
27005   2   TENOTOMY, ILIOPSOAS, OPEN (SEPARATE PROCEDURE)                 N   3   $150.00   1/1/1973   12/31/2299
27005   7   TENOTOMY, ILIOPSOAS, OPEN (SEPARATE PROCEDURE)                 N   3    $13.45   6/1/1994   12/31/2299
27005   8   TENOTOMY, ILIOPSOAS, OPEN (SEPARATE PROCEDURE)                 N   3    $30.00   1/1/1984   12/31/2299
27006   2   TENOTOMY, ABDUCTORS, OPEN (SEPARATE PROCEDURE)                 N   3   $150.00   1/1/1984   12/31/2299
27006   7   TENOTOMY, ABDUCTORS, OPEN (SEPARATE PROCEDURE)                 N   3    $13.45   6/1/1994   12/31/2299
27025   2   OBER-YOUNT FASCIOTOMY, COMBINED W/ SPICA CAST,PINS             N   3   $250.00   1/1/1973   12/31/2299
27025   7   OBER-YOUNT FASCIOTOMY, COMBINED W/ SPICA CAST,PINS             N   3    $13.45   6/1/1994   12/31/2299
27025   8   OBER-YOUNT FASCIOTOMY, COMBINED W/ SPICA CAST,PINS             N   3    $50.00   1/1/1973   12/31/2299
27030   2   ARTHROTOMY, HIP, FOR DRAINAGE;                                 N   3   $350.00   1/1/1973   12/31/2299
27030   7   ARTHROTOMY, HIP, FOR DRAINAGE;                                 N   3    $13.45   6/1/1994   12/31/2299
27030   8   ARTHROTOMY, HIP, FOR DRAINAGE;                                 N   3    $70.00   1/1/1973   12/31/2299
27031   7   ARTHROTOMY, HIP, FOR DRAINAGE; WITH SUCTION IRRIGA             N   3    $13.45   6/1/1994   12/31/2299
27033   2   ARTHROTOMY, HIP, FOR EXPLORATION OR REMOVAL OF LOO             N   3   $350.00   1/1/1984   12/31/2299
27033   7   ARTHROTOMY, HIP, FOR EXPLORATION OR REMOVAL OF LOO             N   3    $13.45   6/1/1994   12/31/2299
27033   F   ARTHROTOMY, HIP, FOR EXPLORATION OR REMOVAL OF LOO             N   3   $351.00   3/1/2004   12/31/2299
27035   2   HIP JOINT DENERVATION, INTRA/EXTRAPELVIC INTRA-ART             N   3   $425.00   1/1/1984   12/31/2299
27035   7   HIP JOINT DENERVATION, INTRA/EXTRAPELVIC INTRA-ART             N   3    $13.45   6/1/1994   12/31/2299
27035   F   HIP JOINT DENERVATION, INTRA/EXTRAPELVIC INTRA-ART             N   3   $432.00   3/1/2004   12/31/2299
27036   2   CAPSULECTOMY OR CAPSULOTOMY OF HIP;W OR W/O EXCISION OF BONE   N   3   $600.00   1/1/1997   12/31/2299
27036   7   CAPSULECTOMY OR CAPSULOTOME OF HIP W OR W/O EXCISION OF BONE   N   3    $13.45   1/1/1997   12/31/2299
27036   8   CAPSULECTOMY OR CAPSULOTOMY OF HIP,W OR W/O EXCISION OF BONE   N   3   $120.00   1/1/1997   12/31/2299
27040   2   BIOPSY, SOFT TISSUES; SUPERFICIAL                              N   3    $30.00   1/1/1984   12/31/2299
27040   F   BIOPSY, SOFT TISSUES; SUPERFICIAL                              N   3   $225.80   3/1/2004   12/31/2299
27041   2   BIOPSY, SOFT TISSUES; DEEP                                     N   3   $100.00   1/1/1984   12/31/2299
27041   F   BIOPSY, SOFT TISSUES; DEEP                                     N   3   $306.00   3/1/2004   12/31/2299
27047   2   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                           N   3    $50.00   1/1/1984   12/31/2299
27047   F   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                           N   3   $306.00   3/1/2004   12/31/2299




                                                                                                                 76
27048   2   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3   $150.00   1/1/1984   12/31/2299
27048   7   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3    $13.45   6/1/1994   12/31/2299
27048   F   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3   $351.00   3/1/2004   12/31/2299
27049   2   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $456.00   1/2/1992   12/31/2299
27049   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3    $13.45   6/1/1994   12/31/2299
27049   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $351.00   3/1/2004   12/31/2299
27050   2   ARTHROTOMY, FOR BIOPSY; SACROILIAC JOINT             N   3   $150.00   1/1/1973   12/31/2299
27050   7   ARTHROTOMY, FOR BIOPSY; SACROILIAC JOINT             N   3    $13.45   6/1/1994   12/31/2299
27050   8   ARTHROTOMY, FOR BIOPSY; SACROILIAC JOINT             N   3    $30.00   1/1/1984   12/31/2299
27050   F   ARTHROTOMY, FOR BIOPSY; SACROILIAC JOINT             N   3   $351.00   3/1/2004   12/31/2299
27052   2   ARTHROTOMY, FOR BIOPSY; HIP JOINT                    N   3   $350.00   1/1/1973   12/31/2299
27052   7   ARTHROTOMY, FOR BIOPSY; HIP JOINT                    N   3    $13.45   6/1/1994   12/31/2299
27052   8   ARTHROTOMY, FOR BIOPSY; HIP JOINT                    N   3    $70.00   1/1/1973   12/31/2299
27052   F   ARTHROTOMY, FOR BIOPSY; HIP JOINT                    N   3   $351.00   3/1/2004   12/31/2299
27054   2   ARTHROTOMY FOR SYNOVECTOMY, HIP JOINT                N   3   $500.00   1/1/1973   12/31/2299
27054   7   ARTHROTOMY FOR SYNOVECTOMY, HIP JOINT                N   3    $13.45   6/1/1994   12/31/2299
27054   8   ARTHROTOMY FOR SYNOVECTOMY, HIP JOINT                N   3   $100.00   1/1/1973   12/31/2299
27060   2   EXCISION; ISCHIAL BURSA                              N   3   $125.00   1/1/1973   12/31/2299
27060   7   EXCISION; ISCHIAL BURSA                              N   3    $13.45   6/1/1994   12/31/2299
27060   F   EXCISION; ISCHIAL BURSA                              N   3   $495.00   3/1/2004   12/31/2299
27062   2   EXCISION; TROCHANTERIC BURSA OR CALCIFICATION        N   3   $100.00   1/1/1973   12/31/2299
27062   7   EXCISION; TROCHANGERIC BURSA OR CALCIFICATION        N   3    $13.45   6/1/1994   12/31/2299
27062   F   EXCISION; TROCHANTERIC BURSA OR CALCIFICATION        N   3   $495.00   3/1/2004   12/31/2299
27065   2   EXCISION OF BONE CYST OR BENIGN TUMOR; SUPERFICIAL   N   3   $125.00   1/1/1973   12/31/2299
27065   7   EXCISION OF BONE CYST OR BENIGN TUMOR; SUPERFICIAL   N   3    $13.45   6/1/1994   12/31/2299
27065   F   EXCISION OF BONE CYST OR BENIGN TUMOR; SUPERFICIAL   N   3   $495.00   3/1/2004   12/31/2299
27066   2   EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP W OR W   N   3   $237.50   1/1/1973   12/31/2299
27066   7   EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP W OR W   N   3    $13.45   6/1/1994   12/31/2299
27066   8   EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP W OR W   N   3    $47.50   1/1/1973   12/31/2299
27066   F   EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP W OR W   N   3   $495.00   3/1/2004   12/31/2299
27067   2   EXCISION OF BONE CYST OR BENIGN TUMOR; WITH BONE G   N   3   $275.00   1/1/1984   12/31/2299
27067   7   EXCISION OF BONE CYST OR BENIGN TUMOR; WITH BONE G   N   3    $13.45   6/1/1994   12/31/2299
27067   F   EXCISION OF BONE CYST OR BENIGN TUMOR; WITH BONE G   N   3   $495.00   3/1/2004   12/31/2299
27070   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3   $150.00   1/1/1973   12/31/2299
27070   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3    $13.45   6/1/1994   12/31/2299
27071   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3   $300.00   1/1/1973   12/31/2299
27071   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3    $13.45   6/1/1994   12/31/2299
27071   8   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3    $60.00   1/1/1973   12/31/2299
27075   2   RADICAL RESECT FOR TUMOR OR INFECT; WING OF ILIUM,   N   3   $600.00   1/1/1984   12/31/2299
27075   7   RADICAL RESECT FOR TUMOR OR INFECT; WING OF ILIUM,   N   3    $13.45   6/1/1994   12/31/2299
27075   8   RADICAL RESECT FOR TUMOR OR INFECT; WING OF ILIUM,   N   3   $273.08   1/1/2003   12/31/2299
27076   2   RADICAL RESECT FOR TUMOR OR INFECT; ILIUM,ACETA,PU   N   3   $700.00   1/1/1984   12/31/2299
27076   7   RADICAL RESECT FOR TUMOR OR INFECT; ILIUM,ACETA,PU   N   3    $13.45   6/1/1994   12/31/2299
27077   2   RADICAL RESECTION FOR TUMOR OR INFECTION; INNOMINA   N   3   $650.00   1/1/1984   12/31/2299
27077   7   RADICAL RESECTION FOR TUMOR OR INFECTION; INNOMINA   N   3    $13.45   6/1/1994   12/31/2299
27078   2   RADICAL RESECT FOR TUMOR OR INFECT; ISCHIAL TUBERO   N   3   $600.00   1/1/1984   12/31/2299
27078   7   RADICAL RESECT FOR TUMOR OR INFECT; ISCHIAL TUBERO   N   3    $13.45   6/1/1994   12/31/2299
27079   2   RADICAL RESEC FOR TUMOR OR INFECT; ISCH. TUBEROSIT   N   3   $650.00   1/1/1984   12/31/2299
27079   7   RADICAL RESEC FOR TUMOR OR INFECT; ISCH. TUBEROSIT   N   3    $13.45   6/1/1994   12/31/2299
27080   2   COCCYGECTOMY, PRIMARY                                N   3   $150.00   1/1/1973   12/31/2299
27080   7   COCCYGECTOMY, PRIMARY                                N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       77
27080   8   COCCYGECTOMY, PRIMARY                                              N   3    $30.00   1/1/1984 12/31/2299
27080   F   COCCYGECTOMY, PRIMARY                                              N   3   $306.00   3/1/2004 12/31/2299
27086   2   REMOVAL OF FOREIGN BODY; SUBCUTANEOUS TISSUE                       N   3    $50.00   1/1/1984 12/31/2299
27086   F   REMOVAL OF FOREIGN BODY; SUBCUTANEOUS TISSUE                       N   3   $225.80   3/1/2004 12/31/2299
27087   2   REMOVAL OF FOREIGN BODY; DEEP                                      N   3   $150.00   1/1/1984 12/31/2299
27087   7   REMOVAL OF FOREIGN BODY; DEEP                                      N   3    $13.45   6/1/1994 12/31/2299
27087   F   REMOVAL OF FOREIGN BODY; DEEP                                      N   3   $351.00   3/1/2004 12/31/2299
27088   2   REMOVAL OF FOREIGN BODY; DEEP, COMPLICATED                         N   3   $175.00   1/1/1984 12/31/2299
27088   7   REMOVAL OF FOREIGN BODY; DEEP, COMPLICATED                         N   3    $13.45   6/1/1994 12/31/2299
27090   2   REMOVAL OF HIP PROSTHESIS; (SEPARATE PROCEDURE)                    N   3   $350.00   1/1/1973 12/31/2299
27090   7   REMOVAL OF HIP PROSTHESIS; (SEPARATE PROCEDURE)                    N   3    $13.45   6/1/1994 12/31/2299
27090   8   REMOVAL OF HIP PROSTHESIS; (SEPARATE PROCEDURE)                    N   3    $70.00   1/1/1973 12/31/2299
27091   2   REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING                  N   3   $959.57 12/11/1998 12/31/2299
27091   7   REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING                  N   3    $13.45   6/1/1994 12/31/2299
27091   8   REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING                  N   3   $192.00 12/11/1998 12/31/2299
27093   2   INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITHOUT                  N   3    $25.00   8/1/1979 12/31/2299
27095   2   INJECTION PROCEDURE FOR HIP ARTHROGRAPHY; WITH ANE                 N   3    $25.00   1/1/1995 12/31/2299
27095   7   INJECTION PROCD FOR HIP ARTHROGRAPHY W ANESTHESIA                  N   3    $13.45   6/1/1994 12/31/2299
27096   2   INJ PROC FOR SACROILIAC JOINT ARTHROGRAPHY &/ ANESTHESIA/STEROID   N   3   $251.90   1/1/2000 12/31/2299
27097   2   HAMSTRING RECESSION, PROXIMAL                                      N   3   $175.00   1/1/1984 12/31/2299
27097   7   HAMSTRING RECESSION, PROXIMAL                                      N   3    $13.45   6/1/1994 12/31/2299
27097   8   HAMSTRING RECESSION, PROXIMAL                                      N   3    $78.44   1/1/2003 12/31/2299
27097   F   HAMSTRING RECESSION, PROXIMAL                                      N   3   $351.00   3/1/2004 12/31/2299
27098   2   ADDUCTOR TRANSFER TO ISCHIUM                                       N   3   $225.00   1/1/1984 12/31/2299
27098   7   ADDUCTOR TRANSFER TO ISCHIUM                                       N   3    $13.45   6/1/1994 12/31/2299
27098   F   ADDUCTOR TRANSFER TO ISCHIUM                                       N   3   $351.00   3/1/2004 12/31/2299
27100   2   TRANSF EXTERN. OBLIQUE MUSCLE TO GREATER TROCHANTE                 N   3   $375.00   1/1/1973 12/31/2299
27100   7   TRANSF EXTERN. OBLIQUE MUSCLE TO GREATER TROCHANTE                 N   3    $13.45   6/1/1994 12/31/2299
27100   8   TRANSF EXTERN. OBLIQUE MUSCLE TO GREATER TROCHANTE                 N   3    $75.00   1/1/1973 12/31/2299
27100   F   TRANSF EXTERN. OBLIQUE MUSCLE TO GREATER TROCHANTE                 N   3   $432.00   3/1/2004 12/31/2299
27105   2   TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASC O                 N   3   $400.00   1/1/1973 12/31/2299
27105   7   TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASC O                 N   3    $13.45   6/1/1994 12/31/2299
27105   8   TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASC O                 N   3    $80.00   1/1/1973 12/31/2299
27105   F   TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASC O                 N   3   $432.00   3/1/2004 12/31/2299
27110   2   TRANSFER ILIOPSOAS; TO GREATER TROCHANTER                          N   3   $450.00   1/1/1973 12/31/2299
27110   7   TRANSFER ILIOPSOAS; TO GREATER TROCHANTER                          N   3    $13.45   6/1/1994 12/31/2299
27110   8   TRANSFER ILIOPSOAS; TO GREATER TROCHANTER                          N   3    $90.00   1/1/1973 12/31/2299
27110   F   TRANSFER ILIOPSOAS; TO GREATER TROCHANTER                          N   3   $432.00   3/1/2004 12/31/2299
27111   2   TRANSFER ILIOPSOAS; TO FEMORAL NECK                                N   3   $450.00   1/1/1984 12/31/2299
27111   7   TRANSFER ILIOPSOAS; TO FEMORAL NECK                                N   3    $13.45   6/1/1994 12/31/2299
27111   8   TRANSFER ILIOPSOAS; TO FEMORAL NECK                                N   3    $90.00   1/1/1984 12/31/2299
27111   F   TRANSFER ILIOPSOAS; TO FEMORAL NECK                                N   3   $432.00   3/1/2004 12/31/2299
27115   2   MUSCLE RELEASE, COMPLETE (HANGING HIP OPERATION)                   N   3   $500.00   8/1/1979 12/31/2299
27115   7   MUSCLE RELEASE, COMPLETE (HANGING HIP OPERATION)                   N   3    $13.45   6/1/1994 12/31/2299
27115   8   MUSCLE RELEASE, COMPLETE (HANGING HIP OPERATION)                   N   3   $100.00   1/1/1984 12/31/2299
27120   2   ACETABULOPLASTY; (WHITMAN OR COLONNA TYPE PROCEDUR                 N   3   $600.00   1/1/1973 12/31/2299
27120   7   ACETABULOPLASTY; (WHITMAN OR COLONNA TYPE PROCEDUR                 N   3    $13.45   6/1/1994 12/31/2299
27120   8   ACETABULOPLASTY; (WHITMAN OR COLONNA TYPE PROCEDUR                 N   3   $120.00   1/1/1973 12/31/2299
27122   2   ACETABULOPLASTY; RESECTION FEMORAL HEAD (GIRDLESTO                 N   3   $500.00   1/1/1973 12/31/2299
27122   7   ACETABULOPLASTY; RESECTION FEMORAL HEAD (GIRDLESTO                 N   3    $13.45   6/1/1994 12/31/2299
27122   8   ACETABULOPLASTY; RESECTION FEMORAL HEAD (GIRDLESTO                 N   3   $100.00   1/1/1973 12/31/2299




                                                                                                                   78
27125   2   ARTHROPLASTY; PROSTHESIS                             N   3    $600.00    1/1/1984   12/31/2299
27125   7   ARTHROPLASTY; PROSTHESIS                             N   3      $13.45   6/1/1994   12/31/2299
27125   8   ARTHROPLASTY; PROSTHESIS                             N   3    $120.00    1/1/1984   12/31/2299
27130   2   ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROS   N   3    $850.00    1/1/1973   12/31/2299
27130   7   ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROS   N   3      $13.45   6/1/1994   12/31/2299
27130   8   ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROS   N   3    $170.00    1/1/1973   12/31/2299
27132   2   CNVERSN PREV HIP SURG TO TOTAL HIP REPLACEMENT       N   3    $950.00    1/1/1984   12/31/2299
27132   7   CONVERSN PREV HIP SURG TO TOTAL HIP REPLACEMENT      N   3      $13.45   6/1/1994   12/31/2299
27132   8   CNVERSN PREV HIP SURG TO TOTAL HIP REPLACEMENT       N   3    $190.00    1/1/1984   12/31/2299
27134   2   REVISION OF TOTAL HIP ARTROPLAST BTH COMPNTS         N   3    $875.00    1/1/1984   12/31/2299
27134   7   REVISION OF TOTAL HIP ARTROPLAST BTH COMPONTS        N   3      $13.45   6/1/1994   12/31/2299
27134   8   RVSION TTL HIP ARTHRPLSTY BTH CMPNTS                 N   3    $175.00    1/1/1984   12/31/2299
27137   2   REVISION OF TOTAL HIP ARTHROPLASTY                   N   3   $1,164.00   1/2/1995   12/31/2299
27137   7   REVISION OF TOTAL HIP ARTHROPLASTY                   N   3      $13.45   6/1/1994   12/31/2299
27137   8   REVISION OF TOTAL HIP ARTHROPLASTY                   N   3    $233.00    1/2/1995   12/31/2299
27138   2   REVISION OF TOTAL HIP ARTHROPLASTY                   N   3    $931.84    1/1/2003   12/31/2299
27138   7   REVISION OF TOTAL HIP ARTHROPLASTY                   N   3      $13.45   6/1/1994   12/31/2299
27138   8   REVISION OF TOTAL HIP ARTHROPLASTY                   N   3    $186.37    1/1/2003   12/31/2299
27140   2   OSTEOTOMY AND TRANSFER OF GREATER TROCHANTER (SEPA   N   3    $300.00    1/1/1973   12/31/2299
27140   7   OSTEOTOMY AND TRANSFER OF GREATER TROCHANTER (SEPA   N   3      $13.45   6/1/1994   12/31/2299
27140   8   OSTEOTOMY AND TRANSFER OF GREATER TROCHANTER (SEPA   N   3      $60.00   1/1/1973   12/31/2299
27146   2   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $534.00    1/2/1992   12/31/2299
27146   7   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3      $13.45   6/1/1994   12/31/2299
27146   8   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3      $95.00   1/1/1973   12/31/2299
27147   2   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $650.00    1/1/1973   12/31/2299
27147   7   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3      $13.45   6/1/1994   12/31/2299
27147   8   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $130.00    1/1/1973   12/31/2299
27151   2   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $600.00    1/1/1973   12/31/2299
27151   7   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3      $13.45   6/1/1994   12/31/2299
27151   8   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $120.00    1/1/1973   12/31/2299
27156   2   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $500.00    1/1/1984   12/31/2299
27156   7   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3      $13.45   6/1/1994   12/31/2299
27156   8   OSTEOTOMY, ILIAC OR ACETABULAR OR INNOMINATE BONE;   N   3    $199.82    1/1/2004   12/31/2299
27158   2   OSTEOTOMY, PELVIS, BILATERAL FOR CONGENITAL MALFOR   N   3    $600.00    1/1/1991   12/31/2299
27158   7   OSTEOTOMY, PELVIS, BILATERAL FOR CONGENITAL MALFOR   N   3      $13.45   6/1/1994   12/31/2299
27161   2   OSTEOTOMY, FEMORAL NECK (SEPARATE PROCEDURE)         N   3    $400.00    1/1/1973   12/31/2299
27161   7   OSTEOTOMY, FEMORAL NECK (SEPARATE PROCEDURE)         N   3      $13.45   6/1/1994   12/31/2299
27161   8   OSTEOTOMY, FEMORAL NECK (SEPARATE PROCEDURE)         N   3      $80.00   1/1/1973   12/31/2299
27165   2   OSTEOTOMY, INTERTROCHANTERIC OR SUBTROCHANTERIC IN   N   3    $726.00    1/2/1992   12/31/2299
27165   7   OSTEOTOMY, INTERTROCHANTERIC OR SUBTROCHANTERIC IN   N   3      $13.45   6/1/1994   12/31/2299
27165   8   OSTEOTOMY, INTERTROCHANTERIC OR SUBTROCHANTERIC IN   N   3    $120.00    1/1/1973   12/31/2299
27170   2   BONE GRAFT FOR NONUNION, FEMORAL HEAD, NECK, INTER   N   3    $600.00    1/1/1973   12/31/2299
27170   7   BONE GRAFT FOR NONUNION, FEMORAL HEAD, NECK, INTER   N   3      $13.45   6/1/1994   12/31/2299
27170   8   BONE GRAFT FOR NONUNION, FEMORAL HEAD, NECK, INTER   N   3    $120.00    1/1/1973   12/31/2299
27175   2   TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY TRACTIO   N   3    $400.00    1/1/1984   12/31/2299
27175   7   TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY TRACTIO   N   3      $13.45   6/1/1994   12/31/2299
27176   2   TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE    N   3    $515.00    1/2/1984   12/31/2299
27176   7   TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE    N   3      $13.45   6/1/1994   12/31/2299
27176   8   TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE    N   3      $25.00   1/1/1984   12/31/2299
27177   2   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; SINGL   N   3    $550.00    1/1/1984   12/31/2299
27177   7   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; SINGL   N   3      $13.45   6/1/1994   12/31/2299




                                                                                                         79
27177   8   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; SINGL   N   3   $110.00   1/1/1984   12/31/2299
27178   2   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; CLOSE   N   3   $550.00   1/1/1984   12/31/2299
27178   7   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; CLOSE   N   3    $13.45   6/1/1994   12/31/2299
27179   2   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEO   N   3   $400.00   8/1/1979   12/31/2299
27179   7   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEO   N   3    $13.45   6/1/1994   12/31/2299
27179   8   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEO   N   3    $80.00   8/1/1979   12/31/2299
27181   2   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEO   N   3   $600.00   1/1/1971   12/31/2299
27181   7   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEO   N   3    $13.45   6/1/1994   12/31/2299
27181   8   OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEO   N   3   $120.00   1/1/1973   12/31/2299
27185   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, G   N   3   $125.00   1/1/1973   12/31/2299
27185   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, G   N   3    $13.45   6/1/1994   12/31/2299
27185   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, G   N   3    $25.00   1/1/1973   12/31/2299
27187   2   PROPH TRTMT W/WO METHYL METHAC, FEMOR NCK/PROX FEM   N   3   $500.00   1/1/1984   12/31/2299
27187   7   PROPH TRTMT W/WO METHYL METHAC/FEMOR NCK/PROX FEM    N   3    $13.45   6/1/1994   12/31/2299
27187   8   PROPH TRTMT W/WO METHYL METHAC, FEMOR NCK/PROX FEM   N   3   $100.00   1/1/1984   12/31/2299
27191   7   TREATMENT OF CLOSED SACRAL FRACTURE; WITH MANIPULA   N   3    $13.45   6/1/1994   12/31/2299
27193   2   CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCAT   N   3   $140.14   1/1/1993   12/31/2299
27193   7   FRACTURES AND/OR DISLOCATIONS                        N   3    $13.45   6/1/1994   12/31/2299
27193   F   CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCAT   N   3   $225.80   3/1/2004   12/31/2299
27194   2   CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCAT   N   3   $248.48   1/1/1993   12/31/2299
27194   7   CLOSED TRTMT OF PELVIC RING FX DISLOCATION DIASTAS   N   3    $13.45   6/1/1994   12/31/2299
27194   F   CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCAT   N   3   $306.00   3/1/2004   12/31/2299
27200   7   TREATMENT OF CLOSED COCCYGEAL FRACTURE               N   3    $13.45   6/1/1994   12/31/2299
27202   7   OPEN TREATMENT OF CLOSED OR OPEN COCCYGEAL FRACTUR   N   3    $13.45   6/1/1994   12/31/2299
27202   F   OPEN TREATMENT OF CLOSED OR OPEN COCCYGEAL FRACTUR   N   3   $306.00   3/1/2004   12/31/2299
27211   7   TREATMENT OF CLOSED ILIAC, PUBIC OR ISCHIAL FRACTU   N   3    $13.45   6/1/1994   12/31/2299
27215   2   OPEN TREATMENT OF ILIAC SPINE(S), TUBEROSITY AVULS   N   3   $495.79   1/1/1993   12/31/2299
27215   7   OPEN TRTMT OF ILIAC SPINE TUBEROSITY AVULSION OR I   N   3    $13.45   6/1/1994   12/31/2299
27216   2   PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC   N   3   $344.44   1/1/1993   12/31/2299
27216   7   PERCUTANEOUS SKLTL FIXATION OF POSTERIOR PELVIC FX   N   3    $13.45   6/1/1994   12/31/2299
27217   2   OPEN TREATMENT OF ANTERIOR RING FRACTURE AND/OR DI   N   3   $531.77   1/1/1993   12/31/2299
27217   7   OPEN TRTMT ANTERIOR RING FX AND/OR DISLOCATION       N   3    $13.45   6/1/1994   12/31/2299
27218   2   OPEN TREATMENT OF POSTERIOR RING FRACTURE AND/OR D   N   3   $603.35   1/1/1993   12/31/2299
27218   7   OPEN TRTNT OF POSTERIOR RING FX AND/OR DISLOCATION   N   3    $13.45   6/1/1994   12/31/2299
27220   2   TREATMENT OF CLOSED ACETABULUM (HIP SOCKET) FX(S)    N   3   $268.18   1/1/2002   12/31/2299
27220   7   TREATMENT OF CLOSED ACETABULUM (HIP SOCKET) FX(S)    N   3    $13.45   6/1/1994   12/31/2299
27222   2   TREATMENT OF CLOSED ACETABULUM (HIP SOCKET) FX(S)    N   3   $200.00   1/1/1973   12/31/2299
27222   7   TREATMENT OF CLOSED ACETABULUM (HIP SOCKET) FX(S)    N   3    $13.45   6/1/1994   12/31/2299
27226   2   OPEN TREATMENT OF POSTERIOR OR ANTERIOR ACETABULAR   N   3   $594.38   1/1/1993   12/31/2299
27226   7   OPEN TRTMT OF POSTERIOR OR ANTERIOR ACETABULAR FX    N   3    $13.45   6/1/1994   12/31/2299
27227   2   OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVING   N   3   $711.81   1/1/1993   12/31/2299
27227   7   OPEN TRTMT OF ACETABULAR FX INVOLV ANTERIOR 1 COLU   N   3    $13.45   6/1/1994   12/31/2299
27228   2   OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVING   N   3   $757.01   1/1/1993   12/31/2299
27228   7   OPEN TRTMT OF ACETABULAR FX INVOLV ANTERIOR 2 COLU   N   3    $13.45   6/1/1994   12/31/2299
27230   2   TREATMENT OF CLOSED FEMORAL FRACTURE, PROXIMAL END   N   3    $50.00   1/1/1984   12/31/2299
27230   7   TREATMENT OF CLOSED FEMORAL FRACTURE, PROXIMAL END   N   3    $13.45   6/1/1994   12/31/2299
27230   F   TREATMENT OF CLOSED FEMORAL FRACTURE, PROXIMAL END   N   3   $225.80   3/1/2004   12/31/2299
27232   2   TREATMENT OF CLOSED FEMORAL FRACTURE, PROXIMAL END   N   3   $240.00   1/1/1973   12/31/2299
27232   7   TREATMENT OF CLOSED FEMORAL FRACTURE, PROXIMAL END   N   3    $13.45   6/1/1994   12/31/2299
27235   2   TREAT OF CLOSED OR OPEN FEMORAL FX, PROXIMAL END,    N   3   $500.00   1/1/1984   12/31/2299
27235   7   TREAT OF CLOSED OR OPEN FEMORAL FX, PROXIMAL END,    N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       80
27235   8   TREAT OF CLOSED OR OPEN FEMORAL FX, PROXIMAL END,                   N   3   $100.00   1/1/1984 12/31/2299
27236   2   OPEN TREAT OF CLOSED OR OPEN FEMORAL FX, PROXIMAL                   N   3   $500.00   1/1/1973 12/31/2299
27236   7   OPEN TREAT OF CLOSED OR OPEN FEMORAL FX, PROXIMAL                   N   3    $13.45   6/1/1994 12/31/2299
27236   8   OPEN TREAT OF CLOSED OR OPEN FEMORAL FX, PROXIMAL                   N   3   $100.00   1/1/1971 12/31/2299
27238   7   TREAT OF CLOSED INTERTROCHANTERIC OR PERTROCHANTER                  N   3    $13.45   6/1/1994 12/31/2299
27238   F   TREAT OF CLOSED INTERTROCHANTERIC OR PERTROCHANTER                  N   3   $225.80   3/1/2004 12/31/2299
27240   2   TREAT OF CLOSED INTERTROCHANTERIC OR PERTROCHANTER                  N   3   $245.00   1/1/1973 12/31/2299
27240   7   TREAT OF CLOSED INTERTROCHANTERIC OR PERTROCHANTER                  N   3    $13.45   6/1/1994 12/31/2299
27244   2   OPEN TREAT OF CLOSED OR OPEN INTERTRO OR PERTROCHANTERIC FEM. FX.   N   3   $772.00   1/1/1994 12/31/2299
27244   7   OPEN TREAT OF CLOSED OR OPEN INTERTRO OR PERTROCHA                  N   3    $13.45   6/1/1994 12/31/2299
27244   8   OPEN TREAT OF CLOSED OR OPEN INTERTRO OR PERTROCHA                  N   3   $154.00   1/1/1994 12/31/2299
27245   2   OPEN TREATMENT OF INTERTROCHANTERIC, PERTROCHANTER                  N   3   $689.75   1/1/1993 12/31/2299
27245   7   OPEN TRTMT OF INTEROCHANTERIC PERTOCHAN OR SUBTROC                  N   3    $13.45   6/1/1994 12/31/2299
27245   8   OPEN TRTMT OF INTEROCHANTERIC PERTOCHAN OR SUBTROC                  N   3   $175.00   1/2/1994 12/31/2299
27246   2   TREATMENT OF CLOSED GREATER TROCHANTERIC FRACTURE,                  N   3   $204.00   1/2/1994 12/31/2299
27246   7   TREATMENT OF CLOSED GREATER TROCHANTERIC FRACTURE,                  N   3    $13.45   6/1/1994 12/31/2299
27246   F   TREATMENT OF CLOSED GREATER TROCHANTERIC FRACTURE,                  N   3   $225.80   3/1/2004 12/31/2299
27248   2   OPEN TREAT OF CLOSED OR OPEN GREATER TROCHANTERIC                   N   3   $175.00   1/1/1973 12/31/2299
27248   7   OPEN TREAT OF CLOSED OR OPEN GREATER TROCHANTERIC                   N   3    $13.45   6/1/1994 12/31/2299
27248   8   OPEN TREAT OF CLOSED OR OPEN GREATER TROCHANTERIC                   N   3    $25.00   1/1/1973 12/31/2299
27250   2   TREATMENT OF CLOSED HIP DISLOCATION, TRAUMATIC; W/                  N   3    $75.00   1/1/1976 12/31/2299
27250   F   TREATMENT OF CLOSED HIP DISLOCATION, TRAUMATIC; W/                  N   3   $225.80   3/1/2004 12/31/2299
27252   2   TREATMENT OF CLOSED HIP DISLOCATION, TRAUMATIC; RE                  N   3   $340.87   1/1/1999 12/31/2299
27252   7   TREATMENT OF CLOSED HIP DISLOCATION, TRAUMATIC; RE                  N   3    $13.45   6/1/1994 12/31/2299
27252   F   TREATMENT OF CLOSED HIP DISLOCATION, TRAUMATIC; RE                  N   3   $306.00   3/1/2004 12/31/2299
27253   2   OPEN TREAT OF CLOSED OR OPEN HIP DISLOC, TRAUMATIC                  N   3   $300.00   1/1/1990 12/31/2299
27253   7   OPEN TREAT OF CLOSED OR OPEN HIP DISLOC, TRAUMATIC                  N   3    $13.45   6/1/1994 12/31/2299
27253   8   OPEN TREAT OF CLOSED OR OPEN HIP DISLOC, TRAUMATIC                  N   3    $60.00   1/1/1990 12/31/2299
27254   2   OPEN TREAT OF CLOS/OPEN HIP DISLOC, TRAUMATIC, W A                  N   3   $425.00   1/1/1973 12/31/2299
27254   7   OPEN TREAT OF CLOS/OPEN HIP DISLOC, TRAUMATIC, W A                  N   3    $13.45   6/1/1994 12/31/2299
27254   8   OPEN TREAT OF CLOS/OPEN HIP DISLOC, TRAUMATIC, W A                  N   3    $85.00   1/1/1973 12/31/2299
27256   2   TREAT OF CONGENITAL HIP DISLOCATION, BY ABDUCTION,                  N   3   $130.00   8/1/1979 12/31/2299
27256   7   TREAT OF CONGENITAL HIP DISLOCATION, BY ABDUCTION,                  N   3    $13.45   6/1/1994 12/31/2299
27257   2   TREAT OF CONGENI. HIP DISLOC, BY ABDUCTION, SPLINT                  N   3   $130.00   1/1/1995 12/31/2299
27257   7   TREAT OF CONGENI. HIP DISLOC, BY ABDUCTION, SPLINT                  N   3    $13.45   6/1/1994 12/31/2299
27257   8   TREAT OF CONGENI. HIP DISLOC, BY ABDUCTION, SPLINT                  N   3    $26.00   1/1/1991 12/31/2299
27257   F   TREAT OF CONGENI. HIP DISLOC, BY ABDUCTION, SPLINT                  N   3   $351.00   3/1/2004 12/31/2299
27258   2   OPEN TREAT OF CONGENITAL HIP DISLOC; REPLAC OF FEM                  N   3   $425.00   1/1/1973 12/31/2299
27258   7   OPEN TREAT OF CONGENITAL HIP DISLOC; REPLAC OF FEM                  N   3    $13.45   6/1/1994 12/31/2299
27258   8   OPEN TREAT OF CONGENITAL HIP DISLOC; REPLAC OF FEM                  N   3    $85.00   1/1/1973 12/31/2299
27259   2   OPEN TREAT OF CONGENI. HIP DISLOC; REPLAC OF FEMOR                  N   3   $880.25   1/1/2004 12/31/2299
27259   7   OPEN TREAT OF CONGENI. HIP DISLOC; REPLAC OF FEMOR                  N   3    $13.45   6/1/1994 12/31/2299
27265   2   TREATMENT OF ATRAUMATIC HIP DISLOCATION (EG, POST-                  N   3   $238.17   1/1/2002 12/31/2299
27265   7   TREATMENT OF ATRAUMATIC HIP DISLOCATION (EG, POST-                  N   3    $13.45   6/1/1994 12/31/2299
27266   2   TREATMENT OF ATRAUMATIC HIP DISLOC;REQ GEN ANES                     N   3    $60.00   1/1/1984 12/31/2299
27266   7   TREATMENT OF ATRAUMATIC HIP DISLOC;REQ GEN ANES                     N   3    $13.45   6/1/1994 12/31/2299
27266   8   TRTMNT OF ATRAUMATIC HIP DISCLOCATN;REQ GEN ANES                    N   3    $40.00 11/14/1990 12/31/2299
27266   F   TREATMENT OF ATRAUMATIC HIP DISLOC;REQ GEN ANES                     N   3   $306.00   3/1/2004 12/31/2299
27275   2   MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHE                  N   3    $50.00   8/1/1979 12/31/2299
27275   7   MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHE                  N   3    $13.45   6/1/1994 12/31/2299
27275   F   MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHE                  N   3   $306.00   3/1/2004 12/31/2299




                                                                                                                    81
27280   2   ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAINING   N   3   $350.00   1/1/1973   12/31/2299
27280   7   ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAINING   N   3    $13.45   6/1/1994   12/31/2299
27280   8   ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAINING   N   3    $70.00   1/1/1973   12/31/2299
27281   7   ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAINING   N   3    $13.45   6/1/1994   12/31/2299
27282   7   ARTHRODESIS, SYMPHYSIS PUBIS (INCLUDING OBTAINING    N   3    $13.45   6/1/1994   12/31/2299
27284   2   ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);   N   3   $600.00   1/1/1973   12/31/2299
27284   7   ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);   N   3    $13.45   6/1/1994   12/31/2299
27284   8   ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);   N   3   $120.00   1/1/1973   12/31/2299
27286   2   ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);   N   3   $650.00   1/1/1973   12/31/2299
27286   7   ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);   N   3    $13.45   6/1/1994   12/31/2299
27286   8   ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);   N   3   $130.00   1/1/1973   12/31/2299
27290   2   INTERPELVIABDOMINAL AMPUTATION (HIND QUARTER AMPUT   N   3   $725.00   1/1/1973   12/31/2299
27290   7   INTERPELVIABDOMINAL AMPUTATION (HIND QUARTER AMPUT   N   3    $13.45   6/1/1994   12/31/2299
27290   8   INTERPELVIABDOMINAL AMPUTATION (HIND QUARTER AMPUT   N   3   $145.00   1/1/1973   12/31/2299
27295   2   DISARTICULATION OF HIP                               N   3   $600.00   1/1/1973   12/31/2299
27295   7   DISARTICULATION OF HIP                               N   3    $13.45   6/1/1994   12/31/2299
27295   8   DISARTICULATION OF HIP                               N   3   $120.00   1/1/1973   12/31/2299
27299   7   UNLISTED PROCEDURE, PELVIS OR HIP JOINT              N   3    $13.45   6/1/1994   12/31/2299
27301   2   INCIS & DRAINAGE DEEP ABSCESS,INF BURSA/HEMATOMA     N   3   $289.03   9/1/2005   12/31/2299
27301   7   INCISION AND DRAINAGE OF DEEP ABSCESS, INFECTED BU   N   3    $13.45   6/1/1994   12/31/2299
27301   F   INCIS & DRAINAGE DEEP ABSCESS,INF BURSA/HEMATOMA     N   3   $351.00   3/1/2004   12/31/2299
27303   2   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3   $100.00   1/1/1984   12/31/2299
27303   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299
27303   8   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $20.00   1/1/1984   12/31/2299
27304   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299
27305   2   FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN              N   3   $150.00   1/1/1973   12/31/2299
27305   7   FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN              N   3    $13.45   6/1/1994   12/31/2299
27305   8   FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN              N   3    $30.00   1/1/1984   12/31/2299
27305   F   FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN              N   3   $306.00   3/1/2004   12/31/2299
27306   2   TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTR   N   3    $60.00   1/1/1973   12/31/2299
27306   7   TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTR   N   3    $13.45   6/1/1994   12/31/2299
27306   F   TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTR   N   3   $351.00   3/1/2004   12/31/2299
27307   2   TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTR   N   3    $50.00   8/1/1979   12/31/2299
27307   7   TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTR   N   3    $13.45   6/1/1994   12/31/2299
27307   F   TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR HAMSTR   N   3   $351.00   3/1/2004   12/31/2299
27310   2   ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE OR RE   N   3   $238.00   8/1/1979   12/31/2299
27310   7   ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE OR RE   N   3    $13.45   6/1/1994   12/31/2299
27310   8   ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE OR RE   N   3    $48.00   8/1/1979   12/31/2299
27310   F   ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE OR RE   N   3   $432.00   3/1/2004   12/31/2299
27311   7   ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE OR RE   N   3    $13.45   6/1/1994   12/31/2299
27323   2   BIOPSY, SOFT TISSUES                                 N   3   $102.65   1/1/2004   12/31/2299
27323   7   BIOPSY, SOFT TISSUES; SUPERFICIAL                    N   3    $13.45   6/1/1994   12/31/2299
27323   F   BIOPSY, SOFT TISSUES                                 N   3   $225.80   3/1/2004   12/31/2299
27324   2   BIOPSY, SOFT TISSUES; DEEP                           N   3   $263.02   1/1/2003   12/31/2299
27324   7   BIOPSY, SOFT TISSUES; DEEP                           N   3    $13.45   6/1/1994   12/31/2299
27324   F   BIOPSY, SOFT TISSUES; DEEP                           N   3   $225.80   3/1/2004   12/31/2299
27325   2   NEURECTORMY HAMSTRING                                N   3   $269.81   1/1/2007   12/31/2299
27325   7   NEURECTORMY HAMSTRING                                N   3    $13.45   1/1/2007   12/31/2299
27325   8   NEURECTORMY HAMSTRING                                N   3    $53.00   1/1/2007   12/31/2299
27326   2   NEURECTOMY, POPLITEAL                                N   3   $256.12   1/1/2007   12/31/2299
27326   7   NEURECTOMY, POPLITEAL                                N   3    $13.45   1/1/2006   12/31/2299




                                                                                                       82
27326   8   NEURECTOMY, POPLITEAL                                          N   3    $51.00   1/1/2007   12/31/2299
27327   2   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                           N   3   $149.00   1/2/1992   12/31/2299
27327   7   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                           N   3    $13.45   6/1/1994   12/31/2299
27327   F   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                           N   3   $306.00   3/1/2004   12/31/2299
27328   2   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, OR INTRA             N   3   $204.00   1/2/1994   12/31/2299
27328   7   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, OR INTRA             N   3    $13.45   6/1/1994   12/31/2299
27328   8   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, OR INTRA             N   3    $58.39   1/1/2003   12/31/2299
27328   F   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, OR INTRA             N   3   $351.00   3/1/2004   12/31/2299
27329   2   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM             N   3   $633.25   1/1/2003   12/31/2299
27329   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM             N   3    $13.45   6/1/1994   12/31/2299
27329   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM             N   3   $432.00   3/1/2004   12/31/2299
27330   2   ARTHROTOMY, KNEE; FOR SYNOVIAL BIOPSY ONLY                     N   3   $300.00   1/1/1973   12/31/2299
27330   7   ARTHROTOMY, KNEE; FOR SYNOVIAL BIOPSY ONLY                     N   3    $13.45   6/1/1994   12/31/2299
27330   F   ARTHROTOMY, KNEE; FOR SYNOVIAL BIOPSY ONLY                     N   3   $432.00   3/1/2004   12/31/2299
27331   2   ARTHROTOMY, KNEE; W/ JOINT EXPLOR, W OR W/O BIOPSY             N   3   $250.00   1/1/1984   12/31/2299
27331   7   ARTHROTOMY KNEE; W/ JOINT EXPLOR, W OR W/O BIOPSY              N   3    $13.45   6/1/1994   12/31/2299
27331   8   ARTHROTOMY, KNEE; W/ JOINT EXPLOR, W OR W/O BIOPSY             N   3    $50.00   1/1/1984   12/31/2299
27331   F   ARTHROTOMY, KNEE; W/ JOINT EXPLOR, W OR W/O BIOPSY             N   3   $432.00   3/1/2004   12/31/2299
27332   2   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3   $280.00   1/1/1971   12/31/2299
27332   7   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3    $13.45   6/1/1994   12/31/2299
27332   8   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3    $56.00   8/1/1979   12/31/2299
27332   F   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3   $432.00   3/1/2004   12/31/2299
27333   2   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3   $300.00   1/1/1984   12/31/2299
27333   7   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3    $13.45   6/1/1994   12/31/2299
27333   8   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3    $60.00   1/1/1984   12/31/2299
27333   F   ARTHROTOMY, KNEE, FOR EXCISION OF SEMILUNAR CARTIL             N   3   $432.00   3/1/2004   12/31/2299
27334   2   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR OR POS             N   3   $125.00   1/1/1971   12/31/2299
27334   7   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR OR POS             N   3    $13.45   6/1/1994   12/31/2299
27334   8   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR OR POS             N   3    $75.00   1/1/1973   12/31/2299
27334   F   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR OR POS             N   3   $432.00   3/1/2004   12/31/2299
27335   2   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR AND PO             N   3   $450.00   1/2/1992   12/31/2299
27335   7   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR AND PO             N   3    $13.45   6/1/1994   12/31/2299
27335   F   ARTHROTOMY, KNEE, FOR SYNOVECTOMY; ANTERIOR AND PO             N   3   $432.00   3/1/2004   12/31/2299
27340   2   EXCISION, PREPATELLAR BURSA                                    N   3   $125.00   1/1/1973   12/31/2299
27340   7   EXCISION, PREPATELLAR BURSA                                    N   3    $13.45   6/1/1994   12/31/2299
27340   F   EXCISION, PREPATELLAR BURSA                                    N   3   $351.00   3/1/2004   12/31/2299
27345   2   EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (BAKE             N   3   $282.00   1/2/1993   12/31/2299
27345   7   EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (BAKE             N   3    $13.45   6/1/1994   12/31/2299
27345   8   EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (BAKE             N   3    $35.00   1/1/1973   12/31/2299
27345   F   EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (BAKE             N   3   $432.00   3/1/2004   12/31/2299
27347   2   EXCISION OF LESION OF MENISCUS OR CAPSULE CYST GANGLION KNEE   N   3   $187.15   1/1/1999   12/31/2299
27347   7   EXCISION OF LESION OF MENISCUS OR CYST GANGLION OF KNEE        N   3   $187.15   1/1/1999   12/31/2299
27347   8   EXCISION OF LESION OF MENISCUS OR CYST, GANGLION OF KNEE       N   3   $187.15   1/1/1999   12/31/2299
27347   F   EXCISION OF LESION OF MENISCUS OR CAPSULE CYST GANGLION KNEE   N   3   $432.00   3/1/2004   12/31/2299
27350   2   PATELLECTOMY OR HEMIPATELLECTOMY                               N   3   $300.00   1/1/1974   12/31/2299
27350   7   PATELLECTOMY OR HEMIPATELLECTOMY                               N   3    $13.45   6/1/1994   12/31/2299
27350   8   PATELLECTOMY OR HEMIPATELLECTOMY                               N   3    $60.00   1/1/1984   12/31/2299
27350   F   PATELLECTOMY OR HEMIPATELLECTOMY                               N   3   $432.00   3/1/2004   12/31/2299
27355   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR             N   3   $378.00   7/1/1996   12/31/2299
27355   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR             N   3    $13.45   6/1/1994   12/31/2299
27355   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR             N   3    $55.00   1/1/1973   12/31/2299




                                                                                                                 83
27355   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $351.00   3/1/2004   12/31/2299
27356   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
27356   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $432.00   3/1/2004   12/31/2299
27357   2   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF FE   N   3   $438.00   1/2/1994   12/31/2299
27357   7   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF FE   N   3    $13.45   6/1/1994   12/31/2299
27357   8   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF FE   N   3    $70.00   1/1/1973   12/31/2299
27357   F   EXCIS OR CURETT OF BONE CYST OR BENIGN TUMOR OF FE   N   3   $495.00   3/1/2004   12/31/2299
27358   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
27358   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $495.00   3/1/2004   12/31/2299
27360   2   PARTIAL EXCIS (CRATERIZ, SAUCERIZ OR DIAPHYSECTOMY   N   3   $250.00   1/1/1971   12/31/2299
27360   7   PARTIAL EXCIS (CRATERIZ, SAUCERIZ OR DIAPHYSECTOMY   N   3    $13.45   6/1/1994   12/31/2299
27360   8   PARTIAL EXCIS (CRATERIZ, SAUCERIZ OR DIAPHYSECTOMY   N   3    $50.00   8/1/1979   12/31/2299
27360   F   PARTIAL EXCIS (CRATERIZ, SAUCERIZ OR DIAPHYSECTOMY   N   3   $495.00   3/1/2004   12/31/2299
27361   7   PART EXCIS (CRATERIZ,SAUCERIZ OR DIAPHYS) OF BONE,   N   3    $13.45   6/1/1994   12/31/2299
27365   2   RADICAL RESECTION FOR TUMOR (BONE OR SOFT TISSUE)    N   3   $702.00   1/2/1994   12/31/2299
27365   7   RADICAL RESECTION FOR TUMOR (BONE OR SOFT TISSUE)    N   3    $13.45   6/1/1994   12/31/2299
27370   2   INJECTION PROCEDURE FOR KNEE ARTHROGRAPHY            N   3    $31.00   1/2/1994   12/31/2299
27370   7   INJECTION PROCEDURE FOR KNEE ARTHROGRAPHY            N   3    $13.45   6/1/1994   12/31/2299
27372   2   REMOVAL FOREIGN BODY, DEEP                           N   3   $278.23   1/1/2004   12/31/2299
27372   7   REMOVAL FOREIGN BODY, DEEP                           N   3    $13.45   6/1/1994   12/31/2299
27372   F   REMOVAL FOREIGN BODY, DEEP                           N   3   $495.00   3/1/2004   12/31/2299
27380   2   SUTURE OF INFRAPATELLAR TENDON; PRIMARY              N   3   $275.00   1/1/1973   12/31/2299
27380   7   SUTURE OF INFRAPATELLAR TENDON; PRIMARY              N   3    $13.45   6/1/1994   12/31/2299
27380   8   SUTURE OF INFRAPATELLAR TENDON; PRIMARY              N   3    $70.28   1/1/2004   12/31/2299
27380   F   SUTURE OF INFRAPATELLAR TENDON; PRIMARY              N   3   $225.80   3/1/2004   12/31/2299
27381   2   SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTR   N   3   $275.00   1/1/1984   12/31/2299
27381   7   SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTR   N   3    $13.45   6/1/1994   12/31/2299
27381   F   SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTR   N   3   $351.00   3/1/2004   12/31/2299
27385   2   SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;    N   3   $325.00   1/1/1973   12/31/2299
27385   7   SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;    N   3    $13.45   6/1/1994   12/31/2299
27385   8   SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;    N   3    $65.00   8/1/1979   12/31/2299
27385   F   SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;    N   3   $351.00   3/1/2004   12/31/2299
27386   7   SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;    N   3    $13.45   6/1/1994   12/31/2299
27386   F   SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;    N   3   $351.00   3/1/2004   12/31/2299
27390   2   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE       N   3   $150.00   1/1/1973   12/31/2299
27390   7   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE       N   3    $13.45   6/1/1994   12/31/2299
27390   F   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE       N   3   $225.80   3/1/2004   12/31/2299
27391   2   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3   $200.00   1/1/1973   12/31/2299
27391   7   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3    $13.45   6/1/1994   12/31/2299
27391   F   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3   $306.00   3/1/2004   12/31/2299
27392   2   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3   $250.00   1/1/1984   12/31/2299
27392   7   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3    $13.45   6/1/1994   12/31/2299
27392   8   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3    $90.74   1/1/2003   12/31/2299
27392   F   TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,    N   3   $351.00   3/1/2004   12/31/2299
27393   2   LENGTHENING OF HAMSTRING TENDON; SINGLE              N   3   $175.00   1/1/1980   12/31/2299
27393   7   LENGTHENING OF HAMSTRING TENDON; SINGLE              N   3    $13.45   6/1/1994   12/31/2299
27393   8   LENGTHENING OF HAMSTRING TENDON; SINGLE              N   3    $35.00   1/1/1984   12/31/2299
27393   F   LENGTHENING OF HAMSTRING TENDON; SINGLE              N   3   $306.00   3/1/2004   12/31/2299
27394   2   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, ONE LEG   N   3   $250.00   1/1/1984   12/31/2299
27394   7   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, ONE LEG   N   3    $13.45   6/1/1994   12/31/2299
27394   8   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, ONE LEG   N   3    $50.00   1/1/1984   12/31/2299




                                                                                                       84
27394   F   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, ONE LEG   N   3   $351.00   3/1/2004   12/31/2299
27395   2   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, BILATER   N   3   $400.00   1/1/1984   12/31/2299
27395   7   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, BILATER   N   3    $13.45   6/1/1994   12/31/2299
27395   8   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, BILATER   N   3    $80.00   1/1/1984   12/31/2299
27395   F   LENGTHENING OF HAMSTRING TENDON; MULTIPLE, BILATER   N   3   $351.00   3/1/2004   12/31/2299
27396   2   TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE      N   3   $275.00   1/1/1984   12/31/2299
27396   7   TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE      N   3    $13.45   6/1/1994   12/31/2299
27396   8   TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE      N   3    $55.00   1/1/1984   12/31/2299
27396   F   TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE      N   3   $351.00   3/1/2004   12/31/2299
27397   7   TRANSPLANT, HAMSTRING TENDON TO PATELLA; MULTIPLE    N   3    $13.45   6/1/1994   12/31/2299
27397   F   TRANSPLANT, HAMSTRING TENDON TO PATELLA; MULTIPLE    N   3   $351.00   3/1/2004   12/31/2299
27400   2   TENDON OR MUSCLE TRANSFER, HAMSTRINGS TO FEMUR (EG   N   3   $350.00   1/1/1984   12/31/2299
27400   7   TENDON OR MUSCLE TRANSFER, HAMSTRINGS TO FEMUR (EG   N   3    $13.45   6/1/1994   12/31/2299
27400   8   TENDON OR MUSCLE TRANSFER, HAMSTRINGS TO FEMUR (EG   N   3    $70.00   1/1/1984   12/31/2299
27400   F   TENDON OR MUSCLE TRANSFER, HAMSTRINGS TO FEMUR (EG   N   3   $351.00   3/1/2004   12/31/2299
27403   2   ARTHROTOMY W OPEN MEISCUSREPR                        N   3   $250.00   1/1/1984   12/31/2299
27403   7   ARTHROTOMY W OPEN MEISCUSREPR                        N   3    $13.45   6/1/1994   12/31/2299
27403   8   ARTHROTOMY W OPEN MEISCUSREPR                        N   3    $50.00   1/1/1984   12/31/2299
27403   F   ARTHROTOMY W OPEN MEISCUSREPR                        N   3   $432.00   3/1/2004   12/31/2299
27405   2   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3   $280.00   1/1/1973   12/31/2299
27405   7   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3    $13.45   6/1/1994   12/31/2299
27405   8   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3    $55.00   1/1/1973   12/31/2299
27405   F   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3   $432.00   3/1/2004   12/31/2299
27407   2   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3   $400.00   1/1/1973   12/31/2299
27407   7   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3    $13.45   6/1/1994   12/31/2299
27407   8   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3    $80.00   1/1/1973   12/31/2299
27407   F   SUTURE, PRIM, TORN, RUPT OR SEVERED LIGAMENT, W OR   N   3   $432.00   3/1/2004   12/31/2299
27409   2   SUTUR, PRIM, TORN, RUPT OR SEVERED LIG, W OR W/O M   N   3   $450.00   1/1/1973   12/31/2299
27409   7   SUTUR, PRIM, TORN, RUPT OR SEVERED LIG, W OR W/O M   N   3    $13.45   6/1/1994   12/31/2299
27409   8   SUTUR, PRIM, TORN, RUPT OR SEVERED LIG, W OR W/O M   N   3    $90.00   1/1/1973   12/31/2299
27409   F   SUTUR, PRIM, TORN, RUPT OR SEVERED LIG, W OR W/O M   N   3   $432.00   3/1/2004   12/31/2299
27412   2   AUTOLOGOUS CHONDROCYTE                               Y   3   $967.25   1/1/2005   12/31/2299
27412   7   AUTOLOGOUS CHONDROCYTE                               Y   3    $13.45   1/1/2005   12/31/2299
27415   2   OSTEOCHONDRAL ALLOGRAFT, KNEE OPEN                   Y   3   $806.83   1/1/2005   12/31/2299
27415   7   OSTEOCHONDRAL ALLOGRAFT, KNEE OPEN                   Y   3    $13.45   6/1/1994   12/31/2299
27418   2   ANTERIOR TIBIAL TUBERCLE PLASTY FOR CHONDROMALACIA   N   3   $600.00   1/2/1995   12/31/2299
27418   7   ANTERIOR TIBIAL TUBERCLE PLASTY FOR CHONDROMALACIA   N   3    $13.45   6/1/1994   12/31/2299
27418   8   ANTERIOR TIBIAL TUBERCLE PLASTY FOR CHONDROMALACIA   N   3   $120.00   1/2/1995   12/31/2299
27418   F   ANTERIOR TIBIAL TUBERCLE PLASTY FOR CHONDROMALACIA   N   3   $351.00   3/1/2004   12/31/2299
27420   2   RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3   $375.00   8/1/1979   12/31/2299
27420   7   RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3    $13.45   6/1/1994   12/31/2299
27420   8   RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3    $75.00   8/1/1979   12/31/2299
27420   F   RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3   $351.00   3/1/2004   12/31/2299
27422   2   RECONST FOR RECUR DISLOC PATELLA; W/EXTENSOR REALI   N   3   $500.00   1/1/1984   12/31/2299
27422   7   RECONST FOR RECUR DISLOC PATELLA; W/EXTENSOR REALI   N   3    $13.45   6/1/1994   12/31/2299
27422   8   RECONST FOR RECUR DISLOC PATELLA; W/EXTENSOR REALI   N   3   $100.00   1/1/1984   12/31/2299
27422   F   RECONST FOR RECUR DISLOC PATELLA; W/EXTENSOR REALI   N   3   $495.00   3/1/2004   12/31/2299
27424   2   [21~NSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3   $437.90   1/1/2004   12/31/2299
27424   7   RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3    $13.45   6/1/1994   12/31/2299
27424   8   RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3    $87.58   1/1/2004   12/31/2299
27424   F   [21~NSTRUCTION FOR RECURRENT DISLOCATING PATELLA;    N   3   $351.00   3/1/2004   12/31/2299




                                                                                                       85
27425   2   LATERAL RETINACULAR RELEASE (ANY METHOD)             N   3    $250.00    1/1/1984   12/31/2299
27425   7   LATERAL RETINACULAR RELEASE (ANY METHOD)             N   3      $13.45   6/1/1994   12/31/2299
27425   F   LATERAL RETINACULAR RELEASE (ANY METHOD)             N   3    $495.00    3/1/2004   12/31/2299
27427   2   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION) KNEE EXT   N   3    $468.00    1/2/1992   12/31/2299
27427   7   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION) KNEE EXT   N   3      $13.45   6/1/1994   12/31/2299
27427   8   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION) KNEE EXT   N   3      $70.00   1/1/1984   12/31/2299
27427   F   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION) KNEE EXT   N   3    $351.00    3/1/2004   12/31/2299
27428   2   RECONSTRUC (AUGMENT) KNEE INTRA ARTIC (OPEN)         N   3    $450.00    1/1/1986   12/31/2299
27428   7   RECONSRUC (AUGMENT) KNEE INTRA ARTIC (OPEN)          N   3      $13.45   6/1/1994   12/31/2299
27428   8   RECONSTRUCTION (AUG) KNEE INTRA-ARTICULAR OPEN       N   3      $90.00   1/1/1984   12/31/2299
27428   F   RECONSTRUC (AUGMENT) KNEE INTRA ARTIC (OPEN)         N   3    $432.00    3/1/2004   12/31/2299
27429   2   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE      N   3    $660.00    1/2/1995   12/31/2299
27429   7   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE      N   3      $13.45   6/1/1994   12/31/2299
27429   8   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE      N   3    $132.00    1/2/1995   12/31/2299
27429   F   LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE      N   3    $432.00    3/1/2004   12/31/2299
27430   2   QUADRICEPS PLASTY (BENNETT OR THOMPSON TYPE)         N   3    $375.00    1/1/1973   12/31/2299
27430   7   QUADRICEPS PLASTY (BENNETT OR THOMPSON TYPE)         N   3      $13.45   6/1/1994   12/31/2299
27430   8   QUADRICEPS PLASTY (BENNETT OR THOMPSON TYPE)         N   3      $75.00   1/1/1973   12/31/2299
27430   F   QUADRICEPS PLASTY (BENNETT OR THOMPSON TYPE)         N   3    $432.00    3/1/2004   12/31/2299
27435   2   CAPSULOTOMY, KNEE, POSTERIOR CAPSULAR RELEASE        N   3    $350.00    1/1/1973   12/31/2299
27435   7   CAPSULOTOMY, KNEE, POSTERIOR CAPSULAR RELEASE        N   3      $13.45   6/1/1994   12/31/2299
27435   8   CAPSULOTOMY, KNEE, POSTERIOR CAPSULAR RELEASE        N   3      $70.00   1/1/1973   12/31/2299
27435   F   CAPSULOTOMY, KNEE, POSTERIOR CAPSULAR RELEASE        N   3    $432.00    3/1/2004   12/31/2299
27437   7   ARTHROPLASTY, PATELLA; WITHOUT PROSTHESIS            N   3      $13.45   6/1/1994   12/31/2299
27437   F   ARTHROPLASTY, PATELLA; WITHOUT PROSTHESIS            N   3    $432.00    3/1/2004   12/31/2299
27438   7   ARTHROPLASTY, PATELLA, WITH PROSTHESIS               N   3      $13.45   6/1/1994   12/31/2299
27438   F   ARTHROPLASTY, PATELLA, WITH PROSTHESIS               N   3    $495.00    3/1/2004   12/31/2299
27440   2   ARTHROPLASTY, KNEE, TIBIAL PLATEAU;                  N   3    $500.00    1/1/1973   12/31/2299
27440   7   ARTHROPLASTY, KNEE, TIBIAL PLATEAU;                  N   3      $13.45   6/1/1994   12/31/2299
27440   8   ARTHROPLASTY, KNEE, TIBIAL PLATEAU;                  N   3    $100.00    1/1/1973   12/31/2299
27441   7   ARTHROPLASTY, KNEE, TIBIAL PLATEAU; WITH DEBRIDEME   N   3      $13.45   6/1/1994   12/31/2299
27441   F   ARTHROPLASTY, KNEE, TIBIAL PLATEAU; WITH DEBRIDEME   N   3    $495.00    3/1/2004   12/31/2299
27442   2   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3    $600.00    1/1/1973   12/31/2299
27442   7   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3      $13.45   6/1/1994   12/31/2299
27442   8   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3    $120.00    1/1/1973   12/31/2299
27442   F   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3    $495.00    3/1/2004   12/31/2299
27443   2   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3    $650.00    1/1/1984   12/31/2299
27443   7   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3      $13.45   6/1/1994   12/31/2299
27443   8   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3    $130.00    1/1/1984   12/31/2299
27443   F   ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA   N   3    $495.00    3/1/2004   12/31/2299
27444   7   ARTHROPLASTY, KNEE, TOTAL; FASCIAL                   N   3      $13.45   6/1/1994   12/31/2299
27445   2   ARTHROPLASTY, KNEE, TOTAL; PROSTHETIC (EG, WALLDIU   N   3    $700.00    1/1/1984   12/31/2299
27445   7   ARTHROPLASTY, KNEE, TOTAL; PROSTHETIC (EG, WALLDIU   N   3      $13.45   6/1/1994   12/31/2299
27445   8   ARTHROPLASTY, KNEE, TOTAL; PROSTHETIC (EG, WALLDIU   N   3    $140.00    1/1/1984   12/31/2299
27446   2   ARTHROPLASTY, KNEE, TOTAL, CONDYLE AND PLATEAU ("T   N   3    $936.00    1/2/1996   12/31/2299
27446   7   ARTHROPLASTY, KNEE, TOTAL, CONDYLE AND PLATEAU ("T   N   3      $13.45   6/1/1994   12/31/2299
27446   8   ARTHROPLASTY, KNEE, TOTAL, CONDYLE AND PLATEAU ("T   N   3    $187.00    1/2/1996   12/31/2299
27447   2   ARTHROPLASTY, KNEE, TOTAL, CONDYLE AND PLATEAU ("T   N   3   $1,188.00   1/1/1997   12/31/2299
27447   7   ARTHROPLASTY, KNEE, TOTAL, CONDYLE AND PLATEAU ("T   N   3      $13.45   6/1/1994   12/31/2299
27447   8   ARTHROPLASTY, KNEE, TOTAL, CONDYLE AND PLATEAU ("T   N   3    $238.00    1/1/1997   12/31/2299
27448   2   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITHOUT    N   3    $475.00    1/1/1973   12/31/2299




                                                                                                         86
27448   7   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITHOUT    N   3    $13.45   6/1/1994   12/31/2299
27448   8   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITHOUT    N   3    $95.00   1/1/1973   12/31/2299
27449   7   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITHOUT    N   3    $13.45   6/1/1994   12/31/2299
27450   2   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITH FIX   N   3   $500.00   1/1/1984   12/31/2299
27450   7   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITH FIX   N   3    $13.45   6/1/1994   12/31/2299
27450   8   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITH FIX   N   3   $100.00   1/1/1984   12/31/2299
27452   7   OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR, WITH FIX   N   3    $13.45   6/1/1994   12/31/2299
27454   2   OSTEOTOMY, MULTIPLE, FEMORAL SHAFT, WITH REALIGNME   N   3   $500.00   1/1/1973   12/31/2299
27454   7   OSTEOTOMY, MULTIPLE, FEMORAL SHAFT, WITH REALIGNME   N   3    $13.45   6/1/1994   12/31/2299
27454   8   OSTEOTOMY, MULTIPLE, FEMORAL SHAFT, WITH REALIGNME   N   3   $100.00   1/1/1973   12/31/2299
27455   2   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3   $492.00   1/2/1992   12/31/2299
27455   7   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3    $13.45   6/1/1994   12/31/2299
27455   8   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3    $60.00   1/1/1973   12/31/2299
27457   2   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3   $690.00   1/2/1996   12/31/2299
27457   7   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3    $13.45   6/1/1994   12/31/2299
27457   8   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3   $138.00   1/2/1996   12/31/2299
27460   2   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3   $450.00   1/1/1973   12/31/2299
27460   7   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3    $13.45   6/1/1994   12/31/2299
27460   8   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3    $90.00   1/1/1973   12/31/2299
27462   7   OSTEO,PROX TIB,INCL FIBUL EXCIS/OSTEO(INCL COR. GE   N   3    $13.45   6/1/1994   12/31/2299
27465   2   OSTEOPLASTY, FEMUR; SHORTENING                       N   3   $645.57   1/1/2002   12/31/2299
27465   7   OSTEOPLASTY, FEMUR; SHORTENING                       N   3    $13.45   6/1/1994   12/31/2299
27465   8   OSTEOPLASTY, FEMUR; SHORTENING                       N   3   $118.63   1/1/2004   12/31/2299
27466   2   OSTEOPLASTY, FEMUR; LENGTHENING                      N   3   $685.17   1/1/2004   12/31/2299
27466   7   OSTEOPLASTY, FEMUR; LENGTHENING                      N   3    $13.45   6/1/1994   12/31/2299
27468   7   OSTEOPLASTY, FEMUR; COMBINED, LENGTHENING/SHORTENI   N   3    $13.45   6/1/1994   12/31/2299
27470   2   REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEA   N   3   $500.00   1/1/1973   12/31/2299
27470   7   REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEA   N   3    $13.45   6/1/1994   12/31/2299
27470   8   REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEA   N   3   $100.00   1/1/1973   12/31/2299
27472   2   REPAIR,NONUNION/MALUNION,FEMUR, DISTAL TO HD & NEC   N   3   $600.00   1/2/1992   12/31/2299
27472   7   REPAIR,NONUNION/MALUNION,FEMUR, DISTAL TO HD & NEC   N   3    $13.45   6/1/1994   12/31/2299
27472   8   REPAIR,NONUNION/MALUNION,FEMUR, DISTAL TO HD & NEC   N   3   $110.00   8/1/1979   12/31/2299
27475   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $350.00   1/1/1999   12/31/2299
27475   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $13.45   6/1/1994   12/31/2299
27475   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $70.00   1/1/1999   12/31/2299
27477   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; T   N   3   $300.00   1/1/1973   12/31/2299
27477   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; T   N   3    $13.45   6/1/1994   12/31/2299
27477   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; T   N   3    $60.00   8/1/1979   12/31/2299
27479   2   EPIPHY ARREST BY EPIPHYSIODESIS OR STAPLING; COMBI   N   3   $475.00   8/1/1979   12/31/2299
27479   7   EPIPHY ARREST BY EPIPHYSIODESIS OR STAPLING; COMBI   N   3    $13.45   6/1/1994   12/31/2299
27479   8   EPIPHY ARREST BY EPIPHYSIODESIS OR STAPLING; COMBI   N   3    $95.00   8/1/1979   12/31/2299
27485   2   ARREST, HEMIEPIPHYSEAL, DISTAL FEMUR OR PROXIMAL L   N   3   $275.00   1/1/1973   12/31/2299
27485   7   ARREST, HEMIEPIPHYSEAL, DISTAL FEMUR OR PROXIMAL L   N   3    $13.45   6/1/1994   12/31/2299
27485   8   ARREST, HEMIEPIPHYSEAL, DISTAL FEMUR OR PROXIMAL L   N   3    $55.00   1/1/1973   12/31/2299
27486   2   REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHO   N   3   $732.82   1/1/2003   12/31/2299
27486   7   REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHO   N   3    $13.45   6/1/1994   12/31/2299
27486   8   REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHO   N   3   $160.66   1/1/2004   12/31/2299
27487   2   SECONDARY RECONSTRUCTION FOR REVISION OF TOTAL KNE   N   3   $700.00   1/1/1984   12/31/2299
27487   7   SECONDARY RECONSTRUCTION FOR REVISION OF TOTAL KNE   N   3    $13.45   6/1/1994   12/31/2299
27487   8   SECONDARY RECONSTRUCTION FOR REVISION OF TOTAL KNE   N   3   $140.00   1/1/1984   12/31/2299
27488   2   REMOVAL OF KNEE PROSTHESIS, INCLUDING "TOTAL KNEE"   N   3   $678.00   1/2/1992   12/31/2299




                                                                                                       87
27488   7   REMOVAL OF KNEE PROSTHESIS, INCLUDING "TOTAL KNEE"   N   3    $13.45   6/1/1994   12/31/2299
27488   8   REMOVAL OF KNEE PROSTHESIS, INCLUDING "TOTAL KNEE"   N   3    $50.00   1/1/1992   12/31/2299
27495   2   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3   $852.00   1/2/1995   12/31/2299
27495   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3    $13.45   6/1/1994   12/31/2299
27495   8   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3   $170.00   1/2/1995   12/31/2299
27496   2   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE C   N   3   $188.39   1/1/1993   12/31/2299
27496   7   DECOMPRESSION FASCIOTOMY THIGH AND/OR KNEE 1 COMPT   N   3    $13.45   6/1/1994   12/31/2299
27496   F   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE C   N   3   $495.00   3/1/2004   12/31/2299
27497   2   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE C   N   3   $230.63   1/1/1993   12/31/2299
27497   7   DECOMP FASCIOTOMY THIGH/KNEE 1COMPT W/DEBRIDEMENT    N   3    $13.45   6/1/1994   12/31/2299
27497   F   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE C   N   3   $351.00   3/1/2004   12/31/2299
27498   2   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTI   N   3   $262.94   1/1/1993   12/31/2299
27498   7   DECOMPRESSION FASCITOMY THIGH/KNEE MULTIPLE COMPAR   N   3    $13.45   6/1/1994   12/31/2299
27498   F   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTI   N   3   $351.00   3/1/2004   12/31/2299
27499   2   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTI   N   3   $302.99   1/1/1993   12/31/2299
27499   7   DECOMP FASCIOTOMY THIGH/KNEE MULTIP COMPT W/DEBRID   N   3    $13.45   6/1/1994   12/31/2299
27499   F   DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTI   N   3   $351.00   3/1/2004   12/31/2299
27500   2   TREATMENT OF CLOSED FEMORAL SHAFT FX (INCLUD SUPRA   N   3   $216.60   1/2/1992   12/31/2299
27500   7   TREATMENT OF CLOSED FEMORAL SHAFT FX (INCLUD SUPRA   N   3    $13.45   6/1/1994   12/31/2299
27500   F   TREATMENT OF CLOSED FEMORAL SHAFT FX (INCLUD SUPRA   N   3   $225.80   3/1/2004   12/31/2299
27501   2   CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR   N   3   $217.10   1/1/1993   12/31/2299
27501   7   CLOSED TRTMT SUPARCNDLR/TRANSCNDYLR FEML W/O MANIL   N   3    $13.45   6/1/1994   12/31/2299
27501   F   CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR   N   3   $306.00   3/1/2004   12/31/2299
27502   2   TREATMENT OF CLOSED FEMORAL SHAFT FX (INCLUD SUPRA   N   3   $450.00   1/2/1995   12/31/2299
27502   7   TREATMENT OF CLOSED FEMORAL SHAFT FX (INCLUD SUPRA   N   3    $13.45   6/1/1994   12/31/2299
27502   F   TREATMENT OF CLOSED FEMORAL SHAFT FX (INCLUD SUPRA   N   3   $306.00   3/1/2004   12/31/2299
27503   2   CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR   N   3   $295.82   1/1/1993   12/31/2299
27503   7   CLOSED TRTMT SUPARCNDLR/TRANSCNDYLR FEML W/MANIPLT   N   3    $13.45   6/1/1994   12/31/2299
27503   F   CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR   N   3   $351.00   3/1/2004   12/31/2299
27506   2   OPEN TREAT OF CLOSED OR OPEN FEMORAL SHAFT FX(INCL   N   3   $446.00   1/1/1973   12/31/2299
27506   7   OPEN TREAT OF CLOSED OR OPEN FEMORAL SHAFT FX(INCL   N   3    $13.45   6/1/1994   12/31/2299
27506   8   OPEN TREAT OF CLOSED OR OPEN FEMORAL SHAFT FX(INCL   N   3    $90.00   1/1/1973   12/31/2299
27507   2   OPEN TREATMENT OF FEMORAL SHAFT FRACTURE WITH PLAT   N   3   $587.42   1/1/2004   12/31/2299
27507   7   OPEN TRTMT OF FEMORL SHAFT FX WITH PLATE/SCREWS      N   3    $13.45   6/1/1994   12/31/2299
27507   8   OPEN TRTMT OF FEMORL SHAFT FX WITH PLATE/SCREWS      N   3   $117.48   1/1/2003   12/31/2299
27508   2   TREAT OF CLOSED FEMORAL FX, DISTAL END, MEDIAL OR    N   3    $50.00   8/1/1979   12/31/2299
27508   7   TREAT OF CLOSED FEMORAL FX, DISTAL END, MEDIAL OR    N   3    $13.45   6/1/1994   12/31/2299
27508   F   TREAT OF CLOSED FEMORAL FX, DISTAL END, MEDIAL OR    N   3   $225.80   3/1/2004   12/31/2299
27509   2   PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR   N   3   $219.72   1/1/1993   12/31/2299
27509   7   PERCUTANEOUS SKLTL FIXATION SUPRACONDLR OR TRANSCD   N   3    $13.45   6/1/1994   12/31/2299
27509   F   PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR   N   3   $351.00   3/1/2004   12/31/2299
27510   2   TREAT OF CLOSED FEMORAL FX, DISTAL END, MEDIAL OR    N   3   $200.00   1/1/1973   12/31/2299
27510   7   TREAT OF CLOSED FEMORAL FX, DISTAL END, MEDIAL OR    N   3    $13.45   6/1/1994   12/31/2299
27510   F   TREAT OF CLOSED FEMORAL FX, DISTAL END, MEDIAL OR    N   3   $225.80   3/1/2004   12/31/2299
27511   2   OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCO   N   3   $648.05   1/1/1993   12/31/2299
27511   7   OPEN TRTMT OF FEMORAL SUPRACONDYLR OR TRANSSCNDR     N   3    $13.45   6/1/1994   12/31/2299
27513   2   OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCO   N   3   $668.26   1/1/1993   12/31/2299
27513   7   OPEN TRTMT OF FEMORAL SUPRACONDYLR OR TRANSSCNDR     N   3    $13.45   6/1/1994   12/31/2299
27513   8   OPEN TRTMT OF FEMORAL SUPRACONDYLR OR TRANSSCNDR     N   3   $159.46   1/1/2005   12/31/2299
27514   2   OPEN TRT OF CLSD/OPEN FEMORAL FX,DIST END,MEDIAL O   N   3   $500.00   1/1/1973   12/31/2299
27514   7   OPEN TRT OF CLSD/OPEN FEMORAL FX,DIST END,MEDIAL O   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       88
27514   8   OPEN TRT OF CLSD/OPEN FEMORAL FX,DIST END,MEDIAL O   N   3   $100.00   1/1/1973   12/31/2299
27516   F   TREAT OF CLOSED DISTAL FEMORAL EPIPHYSEAL SEPARATI   N   3   $225.80   3/1/2004   12/31/2299
27517   2   TREATMENT OF CLOSED DISTAL FEMORAL EPIPHYSEAL SEPA   N   3   $150.00   1/1/1984   12/31/2299
27517   7   TREATMENT OF CLOSED DISTAL FEMORAL EPIPHYSEAL SEPA   N   3    $13.45   6/1/1994   12/31/2299
27517   F   TREATMENT OF CLOSED DISTAL FEMORAL EPIPHYSEAL SEPA   N   3   $225.80   3/1/2004   12/31/2299
27519   2   OPEN TREAT OF CLSD OR OPEN DISTAL FEMORAL EPIPHYSE   N   3   $425.00   1/1/1984   12/31/2299
27519   7   OPEN TREAT OF CLSD OR OPEN DISTAL FEMORAL EPIPHYSE   N   3    $13.45   6/1/1994   12/31/2299
27519   8   OPEN TREAT OF CLSD OR OPEN DISTAL FEMORAL EPIPHYSE   N   3    $85.00   1/1/1984   12/31/2299
27520   2   TREATMENT OF CLOSED PATELLAR FRACTURE, WITHOUT MAN   N   3    $35.00   1/1/1973   12/31/2299
27520   7   TREATMENT OF CLOSED PATELLAR FRACTURE, WITHOUT MAN   N   3    $13.45   6/1/1994   12/31/2299
27520   F   TREATMENT OF CLOSED PATELLAR FRACTURE, WITHOUT MAN   N   3   $225.80   3/1/2004   12/31/2299
27524   2   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR FRACTURE   N   3   $300.00   1/1/1998   12/31/2299
27524   7   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR FRACTURE   N   3    $13.45   6/1/1994   12/31/2299
27524   8   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR FRACTURE   N   3    $60.00   1/1/1973   12/31/2299
27530   2   TREATMENT OF CLOSED TIBIAL FRACTURE, PROXIMAL (PLA   N   3    $50.00   8/1/1979   12/31/2299
27530   7   TREATMENT OF CLOSED TIBIAL FRACTURE, PROXIMAL (PLA   N   3    $13.45   6/1/1994   12/31/2299
27530   F   TREATMENT OF CLOSED TIBIAL FRACTURE, PROXIMAL (PLA   N   3   $225.80   3/1/2004   12/31/2299
27532   2   TREATMENT OF CLOSED TIBIAL FRACTURE, PROXIMAL (PLA   N   3   $125.00   1/1/1971   12/31/2299
27532   7   TREATMENT OF CLOSED TIBIAL FRACTURE, PROXIMAL (PLA   N   3    $13.45   6/1/1994   12/31/2299
27532   F   TREATMENT OF CLOSED TIBIAL FRACTURE, PROXIMAL (PLA   N   3   $225.80   3/1/2004   12/31/2299
27535   2   OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATE   N   3   $433.75   1/1/1993   12/31/2299
27535   7   OPEN TRTMT OF TIBIAL FX PROXIMAL PALTEAU             N   3    $13.45   6/1/1994   12/31/2299
27536   2   OPEN TREAT OF CLOSD OR OPEN TIBIAL FX, PROXIMAL (P   N   3   $350.00   1/1/1973   12/31/2299
27536   7   OPEN TREAT OF CLOSD OR OPEN TIBIAL FX, PROXIMAL (P   N   3    $13.45   6/1/1994   12/31/2299
27536   8   OPEN TREAT OF CLOSD OR OPEN TIBIAL FX, PROXIMAL (P   N   3    $70.00   1/1/1973   12/31/2299
27538   2   TREATMENT OF CLOSED INTERCONDYLAR SPINE(S) FRACTUR   N   3    $50.00   8/1/1979   12/31/2299
27538   7   TREATMENT OF CLOSED INTERCONDYLAR SPINE(S) FRACTUR   N   3    $13.45   6/1/1994   12/31/2299
27538   F   TREATMENT OF CLOSED INTERCONDYLAR SPINE(S) FRACTUR   N   3   $225.80   3/1/2004   12/31/2299
27540   2   OPEN TREATMENT OF CLOSED OR OPEN INTERCONDYLAR SPI   N   3   $350.00   1/1/1973   12/31/2299
27540   7   OPEN TREATMENT OF CLOSED OR OPEN INTERCONDYLAR SPI   N   3    $13.45   6/1/1994   12/31/2299
27540   8   OPEN TREATMENT OF CLOSED OR OPEN INTERCONDYLAR SPI   N   3    $70.00   1/1/1973   12/31/2299
27550   2   TREATMENT OF CLOSED KNEE DISLOCATION; WITHOUT ANES   N   3    $30.00   8/1/1979   12/31/2299
27550   7   TREATMENT OF CLOSED KNEE DISLOCATION; WITHOUT ANES   N   3    $13.45   6/1/1994   12/31/2299
27550   F   TREATMENT OF CLOSED KNEE DISLOCATION; WITHOUT ANES   N   3   $225.80   3/1/2004   12/31/2299
27552   2   TREATMENT OF CLOSED KNEE DISLOCATION; REQUIRING AN   N   3    $90.00   1/1/1973   12/31/2299
27552   7   TREATMENT OF CLOSED KNEE DISLOCATION; REQUIRING AN   N   3    $13.45   6/1/1994   12/31/2299
27552   F   TREATMENT OF CLOSED KNEE DISLOCATION; REQUIRING AN   N   3   $225.80   3/1/2004   12/31/2299
27556   2   OPEN TRT OF CLSD/OPEN KNEE DISLOC, W OR W/O INTER/   N   3   $325.00   8/1/1979   12/31/2299
27556   7   OPEN TRT OF CLSD/OPEN KNEE DISLOC, W OR W/O INTER/   N   3    $13.45   6/1/1994   12/31/2299
27556   8   OPEN TRT OF CLSD/OPEN KNEE DISLOC, W OR W/O INTER/   N   3    $75.00   1/1/1973   12/31/2299
27557   7   OPEN TRT OF CLSD/OPEN KNEE DISLOC, W OR W/O INTER/   N   3    $13.45   6/1/1994   12/31/2299
27558   2   OPEN TREATMENT OF KNEE DISLOCATION, WITH OR WITHOU   N   3   $635.17   1/1/1993   12/31/2299
27558   7   OPEN TRTMT OF KNEE DISLOCATION W/WO INTERNAL         N   3    $13.45   6/1/1994   12/31/2299
27560   2   TREATMENT OF CLOSED PATELLAR DISLOCATION; WITHOUT    N   3   $108.00   1/2/1994   12/31/2299
27560   7   TREATMENT OF CLOSED PATELLAR DISLOCATION; WITHOUT    N   3    $13.45   6/1/1994   12/31/2299
27560   F   TREATMENT OF CLOSED PATELLAR DISLOCATION; WITHOUT    N   3   $225.80   3/1/2004   12/31/2299
27562   2   TREATMENT OF CLOSED PATELLAR DISLOCATION; REQUIRIN   N   3    $60.00   8/1/1979   12/31/2299
27562   7   TREATMENT OF CLOSED PATELLAR DISLOCATION; REQUIRIN   N   3    $13.45   6/1/1994   12/31/2299
27562   F   TREATMENT OF CLOSED PATELLAR DISLOCATION; REQUIRIN   N   3   $225.80   3/1/2004   12/31/2299
27566   2   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR DISLOC,    N   3   $300.00   1/1/1973   12/31/2299
27566   7   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR DISLOC,    N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       89
27566   8   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR DISLOC,    N   3    $60.00   1/1/1973   12/31/2299
27566   F   OPEN TREATMENT OF CLOSED OR OPEN PATELLAR DISLOC,    N   3   $306.00   3/1/2004   12/31/2299
27570   2   MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESI   N   3    $47.80   1/2/1992   12/31/2299
27570   7   MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESI   N   3    $13.45   6/1/1994   12/31/2299
27570   F   MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESI   N   3   $225.80   3/1/2004   12/31/2299
27580   2   FUSION OF KNEE, ANY TECHNIQUE                        N   3   $500.00   1/1/1973   12/31/2299
27580   7   FUSION OF KNEE, ANY TECHNIQUE                        N   3    $13.45   6/1/1994   12/31/2299
27580   8   FUSION OF KNEE, ANY TECHNIQUE                        N   3   $100.00   1/1/1973   12/31/2299
27590   2   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;         N   3   $318.50   8/1/1979   12/31/2299
27590   7   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;         N   3    $13.45   6/1/1994   12/31/2299
27590   8   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;         N   3    $63.75   8/1/1979   12/31/2299
27591   2   AMPUTATION, THIGH                                    N   3   $350.00   1/1/1984   12/31/2299
27591   7   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; IMMED   N   3    $13.45   6/1/1994   12/31/2299
27591   8   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; IMMED   N   3    $70.00   1/1/1984   12/31/2299
27592   2   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; OPEN,   N   3   $280.00   1/1/1973   12/31/2299
27592   7   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; OPEN,   N   3    $13.45   6/1/1994   12/31/2299
27592   8   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; OPEN,   N   3    $56.00   8/1/1979   12/31/2299
27594   2   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; SECON   N   3    $75.00   8/1/1979   12/31/2299
27594   7   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; SECON   N   3    $13.45   6/1/1994   12/31/2299
27594   F   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; SECON   N   3   $351.00   3/1/2004   12/31/2299
27596   2   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; REAMP   N   3   $426.00   1/2/1994   12/31/2299
27596   7   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; REAMP   N   3    $13.45   6/1/1994   12/31/2299
27596   8   AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; REAMP   N   3    $60.00   1/1/1984   12/31/2299
27598   2   DISARTICULATION AT KNEE                              N   3   $350.00   1/1/1973   12/31/2299
27598   7   DISARTICULATION AT KNEE                              N   3    $13.45   6/1/1994   12/31/2299
27598   8   DISARTICULATION AT KNEE                              N   3    $70.00   1/1/1973   12/31/2299
27599   7   UNLISTED PROCEDURE, FEMUR OR KNEE                    N   3    $13.45   6/1/1994   12/31/2299
27600   2   FASCIOTOMY, LEG, ANTERIOR COMPARTMENT, FOR CLOSED    N   3   $125.00   1/1/1973   12/31/2299
27600   7   FASCIOTOMY, LEG, ANTERIOR COMPARTMENT, FOR CLOSED    N   3    $13.45   6/1/1994   12/31/2299
27600   8   FASCIOTOMY, LEG, ANTERIOR COMPARTMENT, FOR CLOSED    N   3    $50.45   1/1/2005   12/31/2299
27600   F   FASCIOTOMY, LEG, ANTERIOR COMPARTMENT, FOR CLOSED    N   3   $351.00   3/1/2004   12/31/2299
27601   2   FASCIOTOMY,LEG, CLOSED SPACE DECOMPRESS/POSTERIOR    N   3   $125.00   1/1/1984   12/31/2299
27601   8   FASCIOTOMY,LEG, CLOSED SPACE DECOMPRESS/POSTERIOR    N   3    $25.00   1/1/1984   12/31/2299
27601   F   FASCIOTOMY,LEG, CLOSED SPACE DECOMPRESS/POSTERIOR    N   3   $351.00   3/1/2004   12/31/2299
27602   2   FASCIOTOMY, LEG, ANT.COMPARTMENT, FOR CLSD SP DECO   N   3   $216.00   1/1/1995   12/31/2299
27602   7   FASCIOTOMY, LEG, ANT.COMPARTMENT, FOR CLSD SP DECO   N   3    $13.45   6/1/1994   12/31/2299
27602   8   FASCIOTOMY, LEG, ANT.COMPARTMENT, FOR CLSD SP DECO   N   3    $35.00   1/1/1984   12/31/2299
27602   F   FASCIOTOMY, LEG, ANT.COMPARTMENT, FOR CLSD SP DECO   N   3   $351.00   3/1/2004   12/31/2299
27603   2   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA      N   3    $60.00   1/1/1984   12/31/2299
27603   7   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA      N   3    $13.45   6/1/1994   12/31/2299
27603   F   INCISION AND DRAINAGE; DEEP ABSCESS OR HEMATOMA      N   3   $306.00   3/1/2004   12/31/2299
27604   7   INCISION AND DRAINAGE; INFECTED BURSA                N   3    $13.45   6/1/1994   12/31/2299
27604   F   INCISION AND DRAINAGE; INFECTED BURSA                N   3   $306.00   3/1/2004   12/31/2299
27605   2   TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS (SEPARATE    N   3    $78.00   1/2/1992   12/31/2299
27605   7   TENOTOMY ACH TEND SUBCU SEP PROC                     N   3    $13.45   6/1/1994   12/31/2299
27605   F   TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS (SEPARATE    N   3   $225.80   3/1/2004   12/31/2299
27606   2   TENOTOMY,ACHILLES TENDON, SUBCUTANEOUS(SEPARATE      N   3    $50.00   1/1/1987   12/31/2299
27606   7   TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS (SEPARATE    N   3    $13.45   6/1/1994   12/31/2299
27606   F   TENOTOMY,ACHILLES TENDON, SUBCUTANEOUS(SEPARATE      N   3   $225.80   3/1/2004   12/31/2299
27607   2   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3   $324.00   1/2/1994   12/31/2299
27607   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       90
27607   F   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3   $306.00   3/1/2004   12/31/2299
27608   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299
27610   2   ARTHROTOMY, ANKLE, WITH EXPLORATION, DRAINAGE OR R   N   3   $225.00   1/1/1973   12/31/2299
27610   7   ARTHROTOMY, ANKLE, WITH EXPLORATION, DRAINAGE OR R   N   3    $13.45   6/1/1994   12/31/2299
27610   8   ARTHROTOMY, ANKLE, WITH EXPLORATION, DRAINAGE OR R   N   3    $45.00   1/1/1973   12/31/2299
27610   F   ARTHROTOMY, ANKLE, WITH EXPLORATION, DRAINAGE OR R   N   3   $306.00   3/1/2004   12/31/2299
27611   7   ARTHROTOMY, ANKLE, WITH EXPLOR, DRAIN OR REMOVAL O   N   3    $13.45   6/1/1994   12/31/2299
27612   2   ARTHROTOMY, ANKLE, POSTERIOR CAPSULAR RELEASE, W O   N   3   $250.00   1/1/1973   12/31/2299
27612   7   ARTHROTOMY, ANKLE, POSTERIOR CAPSULAR RELEASE, W O   N   3    $13.45   6/1/1994   12/31/2299
27612   8   ARTHROTOMY, ANKLE, POSTERIOR CAPSULAR RELEASE, W O   N   3    $50.00   1/1/1973   12/31/2299
27612   F   ARTHROTOMY, ANKLE, POSTERIOR CAPSULAR RELEASE, W O   N   3   $351.00   3/1/2004   12/31/2299
27613   2   BIOPSY, SOFT TISSUES; SUPERFICIAL                    N   3    $45.00   1/1/1984   12/31/2299
27614   2   BIOPSY, SOFT TISSUES; DEEP                           N   3    $75.00   1/1/1984   12/31/2299
27614   7   BIOPSY SOFT TISSUE DEEP                              N   3    $13.45   6/1/1994   12/31/2299
27614   F   BIOPSY, SOFT TISSUES; DEEP                           N   3   $306.00   3/1/2004   12/31/2299
27615   2   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $557.83   1/1/2003   12/31/2299
27615   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3    $13.45   6/1/1994   12/31/2299
27615   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $351.00   3/1/2004   12/31/2299
27618   2   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3   $280.22   1/1/2004   12/31/2299
27618   7   ANESTHESIA, EXCISION BENIGN TUMOR, SUBCUTANEOUS      N   3    $13.45   1/2/1994   12/31/2299
27618   F   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3   $306.00   3/1/2004   12/31/2299
27619   2   EXCISION, BENIGN TUMOR; DEEP SUBFASCIAL OR INTRAMU   N   3   $200.00   1/2/1992   12/31/2299
27619   7   EXCISION, BENIGN TUMOR; DEEP SUBFASCIAL OR INTRAMU   N   3    $13.45   6/1/1994   12/31/2299
27619   F   EXCISION, BENIGN TUMOR; DEEP SUBFASCIAL OR INTRAMU   N   3   $351.00   3/1/2004   12/31/2299
27620   2   ARTHROTOMY, ANKLE, FOR BIOPSY                        N   3   $225.00   1/1/1973   12/31/2299
27620   7   ARTHROTOMY, ANKLE, FOR BIOPSY                        N   3    $13.45   6/1/1994   12/31/2299
27620   F   ARTHROTOMY, ANKLE, FOR BIOPSY                        N   3   $432.00   3/1/2004   12/31/2299
27625   2   ARTHROTOMY, ANKLE, FOR SYNOVECTOMY;                  N   3   $300.00   1/1/1973   12/31/2299
27625   7   ARTHROTOMY, ANKLE, FOR SYNOVECTOMY;                  N   3    $13.45   6/1/1994   12/31/2299
27625   8   ARTHROTOMY, ANKLE, FOR SYNOVECTOMY;                  N   3    $60.00   1/1/1973   12/31/2299
27625   F   ARTHROTOMY, ANKLE, FOR SYNOVECTOMY;                  N   3   $432.00   3/1/2004   12/31/2299
27626   7   ARTHROTOMY, ANKLE, FOR SYNOVECTOMY; INCLUDING TENO   N   3    $13.45   6/1/1994   12/31/2299
27626   F   ARTHROTOMY, ANKLE, FOR SYNOVECTOMY; INCLUDING TENO   N   3   $432.00   3/1/2004   12/31/2299
27630   2   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG   N   3    $60.00   1/1/1973   12/31/2299
27630   7   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG   N   3    $13.45   6/1/1994   12/31/2299
27630   8   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG   N   3    $52.85   1/1/2005   12/31/2299
27630   F   EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG   N   3   $351.00   3/1/2004   12/31/2299
27635   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $250.00   1/1/1973   12/31/2299
27635   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
27635   8   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $50.00   1/1/1973   12/31/2299
27635   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $351.00   3/1/2004   12/31/2299
27637   2   EXCIS/CURET OF BONE CYST/BENIGN TUMOR, TIBIA OR FI   N   3   $325.00   1/1/1973   12/31/2299
27637   7   EXCIS/CURET OF BONE CYST/BENIGN TUMOR, TIBIA OR FI   N   3    $13.45   6/1/1994   12/31/2299
27637   8   EXCIS/CURET OF BONE CYST/BENIGN TUMOR, TIBIA OR FI   N   3    $65.00   1/1/1973   12/31/2299
27637   F   EXCIS/CURET OF BONE CYST/BENIGN TUMOR, TIBIA OR FI   N   3   $351.00   3/1/2004   12/31/2299
27638   2   EXCIS/CURETT OF BONE CYST/BENIGN TUMOR, TIBIA OR F   N   3   $464.95   1/1/2004   12/31/2299
27638   7   EXCIS/CURETT OF BONE CYST/BENIGN TUMOR, TIBIA OR F   N   3    $13.45   6/1/1994   12/31/2299
27638   8   EXCIS/CURETT OF BONE CYST/BENIGN TUMOR, TIBIA OR F   N   3   $104.91   1/1/2004   12/31/2299
27638   F   EXCIS/CURETT OF BONE CYST/BENIGN TUMOR, TIBIA OR F   N   3   $351.00   3/1/2004   12/31/2299
27640   2   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3   $300.00   1/1/1973   12/31/2299
27640   7   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       91
27640   8   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3    $60.00   1/1/1973   12/31/2299
27640   F   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3   $306.00   3/1/2004   12/31/2299
27641   2   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3   $300.00   1/1/1984   12/31/2299
27641   7   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3    $13.45   6/1/1994   12/31/2299
27641   8   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3    $60.00   1/1/1984   12/31/2299
27641   F   PARTIAL EXCISION (CRATERIZATION, SAUCERIZ. OR DIAP   N   3   $306.00   3/1/2004   12/31/2299
27645   7   RESECTION FOR TUMOR, RADICAL; TIBIA                  N   3    $13.45   6/1/1994   12/31/2299
27646   7   RESECTION FOR TUMOR, RADICAL; FIBULA                 N   3    $13.45   6/1/1994   12/31/2299
27647   7   RESECTION FOR TUMOR, RADICAL; TALUS OR CALCANEUS     N   3    $13.45   6/1/1994   12/31/2299
27647   F   RESECTION FOR TUMOR, RADICAL; TALUS OR CALCANEUS     N   3   $351.00   3/1/2004   12/31/2299
27648   2   INJECTION PROCEDURE FOR ANKLE ARTHROGRAPHY           N   3   $131.63   1/1/2003   12/31/2299
27650   2   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON;           N   3   $275.00   1/1/1973   12/31/2299
27650   7   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON;           N   3    $13.45   6/1/1994   12/31/2299
27650   8   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON;           N   3    $55.00   1/1/1984   12/31/2299
27650   F   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON;           N   3   $351.00   3/1/2004   12/31/2299
27652   2   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON; WITH GR   N   3   $350.00   1/1/1973   12/31/2299
27652   7   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON; WITH GR   N   3    $13.45   6/1/1994   12/31/2299
27652   8   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON; WITH GR   N   3    $70.00   1/1/1973   12/31/2299
27652   F   SUTURE, PRIMARY, RUPTURED ACHILLES TENDON; WITH GR   N   3   $351.00   3/1/2004   12/31/2299
27654   7   SUTURE, SECONDARY, RUPTURED ACHILLES TENDON, WITH    N   3    $13.45   6/1/1994   12/31/2299
27654   F   SUTURE, SECONDARY, RUPTURED ACHILLES TENDON, WITH    N   3   $351.00   3/1/2004   12/31/2299
27656   2   REPAIR, FASCIAL DEFECT OF LEG                        N   3   $150.00   1/1/1973   12/31/2299
27656   7   REPAIR, FASCIAL DEFECT OF LEG                        N   3    $13.45   6/1/1994   12/31/2299
27656   F   REPAIR, FASCIAL DEFECT OF LEG                        N   3   $306.00   3/1/2004   12/31/2299
27658   2   REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; PRIMARY,   N   3    $35.00   8/1/1979   12/31/2299
27658   7   REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; PRIMARY,   N   3    $13.45   6/1/1994   12/31/2299
27658   F   REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; PRIMARY,   N   3   $225.80   3/1/2004   12/31/2299
27659   2   REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; SECONDAR   N   3    $50.00   8/1/1979   12/31/2299
27659   7   REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; SECONDAR   N   3    $13.45   6/1/1994   12/31/2299
27659   F   REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; SECONDAR   N   3   $306.00   3/1/2004   12/31/2299
27664   2   REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; PRIMAR   N   3    $50.00   8/1/1979   12/31/2299
27664   7   REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; PRIMAR   N   3    $13.45   6/1/1994   12/31/2299
27664   F   REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; PRIMAR   N   3   $306.00   3/1/2004   12/31/2299
27665   2   REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; SECOND   N   3    $50.00   8/1/1979   12/31/2299
27665   7   REPAIR OF SUT OF EXT TEND OF LEG SINGLE TEND         N   3    $13.45   6/1/1994   12/31/2299
27665   F   REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; SECOND   N   3   $306.00   3/1/2004   12/31/2299
27675   2   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITHOUT F   N   3   $150.00   1/1/1984   12/31/2299
27675   7   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITHOUT F   N   3    $13.45   6/1/1994   12/31/2299
27675   F   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITHOUT F   N   3   $306.00   3/1/2004   12/31/2299
27676   2   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITH FIBU   N   3   $175.00   1/1/1984   12/31/2299
27676   7   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITH FIBU   N   3    $13.45   6/1/1994   12/31/2299
27676   8   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITH FIBU   N   3    $35.00   1/1/1984   12/31/2299
27676   F   REPAIR FOR DISLOCATING PERONEAL TENDONS; WITH FIBU   N   3   $351.00   3/1/2004   12/31/2299
27680   2   TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXO   N   3   $125.00   1/1/1973   12/31/2299
27680   7   TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXO   N   3    $13.45   6/1/1994   12/31/2299
27680   F   TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXO   N   3   $351.00   3/1/2004   12/31/2299
27681   2   TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXO   N   3   $150.00   1/1/1973   12/31/2299
27681   7   TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXO   N   3    $13.45   6/1/1994   12/31/2299
27681   F   TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXO   N   3   $306.00   3/1/2004   12/31/2299
27685   2   LENGTHENING OR SHORTENING OF TENDON; SINGLE (SEPAR   N   3   $198.00   1/2/1992   12/31/2299
27685   7   LENGTHENING OR SHORTENING OF TENDON; SINGLE (SEPAR   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       92
27685   8   LENGTHENING OR SHORTENING OF TENDON; SINGLE (SEPAR                N   3    $35.00   1/1/1984   12/31/2299
27685   F   LENGTHENING OR SHORTENING OF TENDON; SINGLE (SEPAR                N   3   $351.00   3/1/2004   12/31/2299
27686   2   LENGTHENING OR SHORTENING OF TENDON; MULTIPLE, THR                N   3   $270.00   1/2/1993   12/31/2299
27686   7   LENGTHENING OR SHORTENING OF TENDON; MULTIPLE, THR                N   3    $13.45   6/1/1994   12/31/2299
27686   8   LENGTHENING OR SHORTENING OF TENDON; MULTIPLE, THR                N   3    $50.00   1/1/1984   12/31/2299
27686   F   LENGTHENING OR SHORTENING OF TENDON; MULTIPLE, THR                N   3   $351.00   3/1/2004   12/31/2299
27687   2   GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)                   N   3   $282.00   1/1/1999   12/31/2299
27687   7   GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)                   N   3    $13.45   6/1/1994   12/31/2299
27687   8   GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)                   N   3    $66.48   1/1/2002   12/31/2299
27687   F   GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)                   N   3   $351.00   3/1/2004   12/31/2299
27690   2   TRANSFER/TRANSPL OF SINGL TENDON(W/MUSCLE REDIR/RE                N   3   $300.00   1/2/1992   12/31/2299
27690   7   TRANSFER/TRANSPL OF SINGL TENDON(W/MUSCLE REDIR/RE                N   3    $13.45   6/1/1994   12/31/2299
27690   8   TRANSFER/TRANSPL OF SINGL TENDON(W/MUSCLE REDIR/RE                N   3    $30.00   1/1/1984   12/31/2299
27690   F   TRANSFER/TRANSPL OF SINGL TENDON(W/MUSCLE REDIR/RE                N   3   $432.00   3/1/2004   12/31/2299
27691   2   FLEXOR HALLICUS, LONGUS, OR PERONEAL TENDON TO MIDFOOT/HINDFOOT   N   3   $342.00   1/1/1996   12/31/2299
27691   7   TRANSF/TRANSPL SINGL TEN(W/MUSCLE REDIR/REROUT);AN                N   3    $13.45   6/1/1994   12/31/2299
27691   8   TRANSF/TRANSPL SINGL TEN(W/MUSCLE REDIR/REROUT);AN                N   3    $30.00   1/1/1984   12/31/2299
27691   F   FLEXOR HALLICUS, LONGUS, OR PERONEAL TENDON TO MIDFOOT/HINDFOOT   N   3   $432.00   3/1/2004   12/31/2299
27692   2   TRANSF/TRANSPL SINGL TEN(W/MUSC REDIR/REROUT); ANT                N   3    $66.85   1/1/2002   12/31/2299
27692   7   TRANSF/TRANSPL SINGL TEN(W/MUSC REDIR/REROUT); ANT                N   3    $13.45   6/1/1994   12/31/2299
27692   F   TRANSF/TRANSPL SINGL TEN(W/MUSC REDIR/REROUT); ANT                N   3   $351.00   3/1/2004   12/31/2299
27695   2   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3   $250.00   8/1/1979   12/31/2299
27695   7   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3    $13.45   6/1/1994   12/31/2299
27695   8   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3    $50.00   8/1/1979   12/31/2299
27695   F   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3   $306.00   3/1/2004   12/31/2299
27696   2   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3   $350.00   8/1/1979   12/31/2299
27696   7   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3    $13.45   6/1/1994   12/31/2299
27696   8   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3    $70.00   8/1/1979   12/31/2299
27696   F   SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMEN                N   3   $306.00   3/1/2004   12/31/2299
27698   2   SUTURE,SECONDARY REPAIR,TORN,RUPT OR SEVERED LIG,                 N   3   $540.00   1/1/1995   12/31/2299
27698   7   SUTURE,SECONDARY REPAIR,TORN,RUPT OR SEVERED LIG,                 N   3    $13.45   6/1/1994   12/31/2299
27698   8   SUTURE,SECONDARY REPAIR,TORN,RUPT OR SEVERED LIG,                 N   3   $108.00   1/1/1995   12/31/2299
27698   F   SUTURE,SECONDARY REPAIR,TORN,RUPT OR SEVERED LIG,                 N   3   $306.00   3/1/2004   12/31/2299
27700   2   ARTHROPLASTY, ANKLE;                                              N   3   $400.00   1/1/1984   12/31/2299
27700   7   ARTHROPLASTY, ANKLE;                                              N   3    $13.45   6/1/1994   12/31/2299
27700   8   ARTHROPLASTY, ANKLE;                                              N   3    $80.00   1/1/1984   12/31/2299
27700   F   ARTHROPLASTY, ANKLE;                                              N   3   $495.00   3/1/2004   12/31/2299
27702   7   ARTHROPLASTY, ANKLE; WITH IMPLANT ("TOTAL ANKLE")                 N   3    $13.45   6/1/1994   12/31/2299
27703   7   ARTHROPLASTY, ANKLE                                               N   3    $13.45   6/1/1994   12/31/2299
27704   7   REMOVAL OF ANKLE IMPLANT                                          N   3    $13.45   6/1/1994   12/31/2299
27704   F   REMOVAL OF ANKLE IMPLANT                                          N   3   $306.00   3/1/2004   12/31/2299
27705   2   OSTEOTOMY; TIBIA                                                  N   3   $300.00   1/1/1973   12/31/2299
27705   7   OSTEOTOMY; TIBIA                                                  N   3    $13.45   6/1/1994   12/31/2299
27705   8   OSTEOTOMY; TIBIA                                                  N   3    $60.00   1/1/1973   12/31/2299
27705   F   OSTEOTOMY; TIBIA                                                  N   3   $306.00   3/1/2004   12/31/2299
27707   2   OSTEOTOMY; FIBULA                                                 N   3   $175.00   1/1/1973   12/31/2299
27707   7   OSTEOTOMY; FIBULA                                                 N   3    $13.45   6/1/1994   12/31/2299
27707   F   OSTEOTOMY; FIBULA                                                 N   3   $306.00   3/1/2004   12/31/2299
27709   2   OSTEOTOMY; TIBIA AND FIBULA                                       N   3   $350.00   1/1/1973   12/31/2299
27709   7   OSTEOTOMY; TIBIA AND FIBULA                                       N   3    $13.45   6/1/1994   12/31/2299
27709   8   OSTEOTOMY; TIBIA AND FIBULA                                       N   3    $70.00   1/1/1973   12/31/2299




                                                                                                                    93
27709   F   OSTEOTOMY; TIBIA AND FIBULA                          N   3   $306.00   3/1/2004   12/31/2299
27712   2   OSTEOTOMY; MULTIPLE, W/REALIGNMENT ON INTRAMEDULLA   N   3   $450.00   1/1/1973   12/31/2299
27712   7   OSTEOTOMY; MULTIPLE, W/REALIGNMENT ON INTRAMEDULLA   N   3    $13.45   6/1/1994   12/31/2299
27712   8   OSTEOTOMY; MULTIPLE, W/REALIGNMENT ON INTRAMEDULLA   N   3    $90.00   1/1/1973   12/31/2299
27715   7   OSTEOPLASTY, TIBIA AND FIBULA, LENGTHENING           N   3    $13.45   6/1/1994   12/31/2299
27720   2   REPAIR OF NONUNION OR MALUNION, TIBIA; W/O GRAFT (   N   3   $450.00   8/1/1979   12/31/2299
27720   7   REPAIR OF NONUNION OR MALUNION, TIBIA; W/O GRAFT (   N   3    $13.45   6/1/1994   12/31/2299
27720   8   REPAIR OF NONUNION OR MALUNION, TIBIA; W/O GRAFT (   N   3    $90.00   8/1/1979   12/31/2299
27722   2   REPAIR OF NONUNION OR MALUNION, TIBIA; WITH SLIDIN   N   3   $500.00   1/1/1973   12/31/2299
27722   7   REPAIR OF NONUNION OR MALUNION, TIBIA; WITH SLIDIN   N   3    $13.45   6/1/1994   12/31/2299
27722   8   REPAIR OF NONUNION OR MALUNION, TIBIA; WITH SLIDIN   N   3   $100.00   1/1/1973   12/31/2299
27724   2   REPAIR OF NONUNION OR MALUNION, TIBIA; W/ ILIAC OR   N   3   $550.00   1/1/1973   12/31/2299
27724   7   REPAIR OF NONUNION OR MALUNION, TIBIA; W/ ILIAC OR   N   3    $13.45   6/1/1994   12/31/2299
27724   8   REPAIR OF NONUNION OR MALUNION, TIBIA; W/ ILIAC OR   N   3   $110.00   1/1/1973   12/31/2299
27725   2   REPAIR OF NONUNION OR MALUNION, TIBIA; BY SYNOSTOS   N   3   $731.51   1/1/2001   12/31/2299
27725   7   REPAIR OF NONUNION OR MALUNION, TIBIA; BY SYNOSTOS   N   3    $13.45   6/1/1994   12/31/2299
27725   8   REPAIR OF NONUNION OR MALUNION, TIBIA; BY SYNOSTOS   N   3   $146.30   1/1/2001   12/31/2299
27727   7   REPAIR OF CONGENITAL PSEUDARTHROSIS, TIBIA           N   3    $13.45   6/1/1994   12/31/2299
27730   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $300.00   1/1/1999   12/31/2299
27730   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $13.45   6/1/1994   12/31/2299
27730   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $60.00   1/1/1999   12/31/2299
27730   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $306.00   3/1/2004   12/31/2299
27732   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $150.00   1/1/1999   12/31/2299
27732   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $13.45   6/1/1994   12/31/2299
27732   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $30.00   1/1/1999   12/31/2299
27732   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $306.00   3/1/2004   12/31/2299
27734   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $350.00   1/1/1999   12/31/2299
27734   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $13.45   6/1/1994   12/31/2299
27734   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3    $70.00   1/1/1999   12/31/2299
27734   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; D   N   3   $306.00   3/1/2004   12/31/2299
27740   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3   $450.00   1/1/1973   12/31/2299
27740   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3    $13.45   6/1/1994   12/31/2299
27740   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3    $90.00   1/1/1973   12/31/2299
27740   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3   $306.00   3/1/2004   12/31/2299
27742   2   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3   $550.00   1/1/1999   12/31/2299
27742   7   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3    $13.45   6/1/1994   12/31/2299
27742   8   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3   $110.00   1/1/1999   12/31/2299
27742   F   EPIPHYSEAL ARREST BY EPIPHYSIODESIS/STAPLING, COMB   N   3   $306.00   3/1/2004   12/31/2299
27745   7   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3    $13.45   6/1/1994   12/31/2299
27745   F   PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING    N   3   $351.00   3/1/2004   12/31/2299
27750   2   TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE; WITHOUT   N   3    $35.00   8/1/1979   12/31/2299
27750   7   TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE; WITHOUT   N   3    $13.45   6/1/1994   12/31/2299
27750   F   TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE; WITHOUT   N   3   $225.80   3/1/2004   12/31/2299
27752   2   TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE; WITH MA   N   3   $270.00   1/2/1995   12/31/2299
27752   7   TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE; WITH MA   N   3    $13.45   6/1/1994   12/31/2299
27752   F   TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE; WITH MA   N   3   $225.80   3/1/2004   12/31/2299
27756   2   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,    N   3   $300.00   1/1/1973   12/31/2299
27756   7   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,    N   3    $13.45   6/1/1994   12/31/2299
27756   8   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,    N   3    $50.00   1/1/1971   12/31/2299
27756   F   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,    N   3   $351.00   3/1/2004   12/31/2299
27758   2   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,    N   3   $400.00   1/1/1984   12/31/2299




                                                                                                       94
27758   7   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,                   N   3    $13.45   6/1/1994   12/31/2299
27758   8   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,                   N   3    $80.00   1/1/1984   12/31/2299
27758   F   OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT FX,                   N   3   $432.00   3/1/2004   12/31/2299
27759   2   OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR W                  N   3   $702.00   1/2/1995   12/31/2299
27759   7   OPEN TRTMT OF TIBIAL SHAFT FX W/WO FIBULAR                          N   3    $13.45   6/1/1994   12/31/2299
27759   8   OPEN TRTMT OF TIBIAL SHAFT FX W/WO FIBULAR                          N   3   $140.00   1/2/1995   12/31/2299
27759   F   OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR W                  N   3   $432.00   3/1/2004   12/31/2299
27760   2   TREATMENT OF CLOSED DISTAL TIBIAL FX (MEDIAL MALLE                  N   3    $40.00   8/1/1979   12/31/2299
27760   7   TREATMENT OF CLOSED DISTAL TIBIAL FX (MEDIAL MALLE                  N   3    $13.45   6/1/1994   12/31/2299
27760   F   TREATMENT OF CLOSED DISTAL TIBIAL FX (MEDIAL MALLE                  N   3   $225.80   3/1/2004   12/31/2299
27762   2   TREATMENT OF CLOSED DISTAL TIBIAL FX (MEDIAL MALLE                  N   3    $75.00   1/1/1971   12/31/2299
27762   7   TREATMENT OF CLOSED DISTAL TIBIAL FX (MEDIAL MALLE                  N   3    $13.45   6/1/1994   12/31/2299
27762   F   TREATMENT OF CLOSED DISTAL TIBIAL FX (MEDIAL MALLE                  N   3   $225.80   3/1/2004   12/31/2299
27766   2   OPEN TREAT OF CLOSED OR OPEN DISTAL TIBIAL FX(MEDI                  N   3   $411.00   1/2/1995   12/31/2299
27766   7   OPEN TREAT OF CLOSED OR OPEN DISTAL TIBIAL FX(MEDI                  N   3    $13.45   6/1/1994   12/31/2299
27766   8   OPEN TREAT OF CLOSED OR OPEN DISTAL TIBIAL FX(MEDI                  N   3    $45.00   1/1/1973   12/31/2299
27766   F   OPEN TREAT OF CLOSED OR OPEN DISTAL TIBIAL FX(MEDI                  N   3   $351.00   3/1/2004   12/31/2299
27780   2   TREATMENT OF CLOSED PROXIMAL FIBULA OR SHAFT FX, W                  N   3    $35.00   1/1/1973   12/31/2299
27780   7   TREATMENT OF CLOSED PROXIMAL FIBULA OR SHAFT FX, W                  N   3    $13.45   6/1/1994   12/31/2299
27780   F   TREATMENT OF CLOSED PROXIMAL FIBULA OR SHAFT FX, W                  N   3   $225.80   3/1/2004   12/31/2299
27781   2   TREATMENT OF CLOSED PROXIMAL FIBULA OR SHAFT FX, W                  N   3    $60.00   1/1/1984   12/31/2299
27781   7   TREATMENT OF CLOSED PROXIMAL FIBULA OR SHAFT FX, W                  N   3    $13.45   6/1/1994   12/31/2299
27781   F   TREATMENT OF CLOSED PROXIMAL FIBULA OR SHAFT FX, W                  N   3   $225.80   3/1/2004   12/31/2299
27784   2   OPEN TREAT OF CLOSED OR OPEN PROX FIB OR SHAFT FX,                  N   3   $200.00   1/1/1973   12/31/2299
27784   7   OPEN TREAT OF CLOSED OR OPEN PROX FIB OR SHAFT FX,                  N   3    $13.45   6/1/1994   12/31/2299
27784   8   OPEN TREAT OF CLOSED OR OPEN PROX FIB OR SHAFT FX,                  N   3    $40.00   1/1/1973   12/31/2299
27784   F   OPEN TREAT OF CLOSED OR OPEN PROX FIB OR SHAFT FX,                  N   3   $351.00   3/1/2004   12/31/2299
27786   2   CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS WO   N   3   $132.00   1/1/1998   12/31/2299
27786   7   TREAT OF CLOSED DISTAL FIBULAR FX (LATERAL MALLEOL                  N   3    $13.45   6/1/1994   12/31/2299
27786   F   CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS WO   N   3   $225.80   3/1/2004   12/31/2299
27788   2   TREAT OF CLOSED DISTAL FIBULAR FX (LATERAL MALLEOL                  N   3    $70.00   1/1/1971   12/31/2299
27788   7   TREAT OF CLOSED DISTAL FIBULAR FX (LATERAL MALLEOL                  N   3    $13.45   6/1/1994   12/31/2299
27788   F   TREAT OF CLOSED DISTAL FIBULAR FX (LATERAL MALLEOL                  N   3   $225.80   3/1/2004   12/31/2299
27792   2   OPEN TREAT OF CLOSED OR OPEN DISTAL FIB FX (LATERA                  N   3   $200.00   1/1/1973   12/31/2299
27792   7   OPEN TREAT OF CLOSED OR OPEN DISTAL FIB FX (LATERA                  N   3    $13.45   6/1/1994   12/31/2299
27792   8   OPEN TREAT OF CLOSED OR OPEN DISTAL FIB FX (LATERA                  N   3    $40.00   1/1/1973   12/31/2299
27792   F   OPEN TREAT OF CLOSED OR OPEN DISTAL FIB FX (LATERA                  N   3   $351.00   3/1/2004   12/31/2299
27808   2   TREATMENT OF CLOSED BIMALLEOLAR ANKLE FX,(INCLUD P                  N   3    $50.00   1/1/1973   12/31/2299
27808   7   TREATMENT OF CLOSED BIMALLEOLAR ANKLE FX,(INCLUD P                  N   3    $13.45   6/1/1994   12/31/2299
27808   F   TREATMENT OF CLOSED BIMALLEOLAR ANKLE FX,(INCLUD P                  N   3   $225.80   3/1/2004   12/31/2299
27810   2   TREATMENT OF CLOSED BIMALLEOLAR ANKLE FX,(INCLUD P                  N   3   $150.00   1/1/1971   12/31/2299
27810   7   TREATMENT OF CLOSED BIMALLEOLAR ANKLE FX,(INCLUD P                  N   3    $13.45   6/1/1994   12/31/2299
27810   F   TREATMENT OF CLOSED BIMALLEOLAR ANKLE FX,(INCLUD P                  N   3   $225.80   3/1/2004   12/31/2299
27814   2   OPEN TREATMENT OF CLOSED OR OPEN BIMALLEOLAR ANKLE                  N   3   $263.00   1/1/1973   12/31/2299
27814   7   OPEN TREATMENT OF CLOSED OR OPEN BIMALLEOLAR ANKLE                  N   3    $13.45   6/1/1994   12/31/2299
27814   8   OPEN TREATMENT OF CLOSED OR OPEN BIMALLEOLAR ANKLE                  N   3    $53.00   1/1/1973   12/31/2299
27814   F   OPEN TREATMENT OF CLOSED OR OPEN BIMALLEOLAR ANKLE                  N   3   $351.00   3/1/2004   12/31/2299
27816   2   TREATMENT OF CLOSED TRIMALLEOLAR ANKLE FRACTURE; W                  N   3    $50.00   1/1/1973   12/31/2299
27816   7   TREATMENT OF CLOSED TRIMALLEOLAR ANKLE FRACTURE; W                  N   3    $13.45   6/1/1994   12/31/2299
27816   F   TREATMENT OF CLOSED TRIMALLEOLAR ANKLE FRACTURE; W                  N   3   $225.80   3/1/2004   12/31/2299
27818   2   TREATMENT OF CLOSED TRIMALLEOLAR ANKLE FRACTURE; W                  N   3   $150.00   1/1/1973   12/31/2299




                                                                                                                      95
27818   7   TREATMENT OF CLOSED TRIMALLEOLAR ANKLE FRACTURE; W   N   3    $13.45   6/1/1994   12/31/2299
27818   F   TREATMENT OF CLOSED TRIMALLEOLAR ANKLE FRACTURE; W   N   3   $225.80   3/1/2004   12/31/2299
27822   2   OPEN TREAT OF CLSD OR OPN TRIMA ANKLE FX, W OR W/O   N   3   $412.00   1/2/1992   12/31/2299
27822   7   OPEN TREAT OF CLSD OR OPN TRIMA ANKLE FX, W OR W/O   N   3    $13.45   6/1/1994   12/31/2299
27822   8   OPEN TREAT OF CLSD OR OPN TRIMA ANKLE FX, W OR W/O   N   3    $70.00   1/1/1973   12/31/2299
27822   F   OPEN TREAT OF CLSD OR OPN TRIMA ANKLE FX, W OR W/O   N   3   $351.00   3/1/2004   12/31/2299
27823   2   OPN TRT, CLSD/OPN TRI ANK FX,W OR W/O INT-EXT FIX,   N   3   $400.00   1/1/1984   12/31/2299
27823   7   OPN TRT, CLSD/OPN TRI ANK FX,W OR W/O INT-EXT FIX,   N   3    $13.45   6/1/1994   12/31/2299
27823   8   OPN TRT, CLSD/OPN TRI ANK FX,W OR W/O INT-EXT FIX,   N   3   $119.05   1/1/2004   12/31/2299
27823   F   OPN TRT, CLSD/OPN TRI ANK FX,W OR W/O INT-EXT FIX,   N   3   $351.00   3/1/2004   12/31/2299
27824   2   CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ART   N   3    $54.51   1/1/1993   12/31/2299
27824   7   CLSD TRTMT OF FX WEIGHT BEARING ARTCLR PORTION       N   3    $13.45   6/1/1994   12/31/2299
27824   F   CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ART   N   3   $225.80   3/1/2004   12/31/2299
27825   2   CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ART   N   3   $241.01   1/1/1993   12/31/2299
27825   7   CLSD TRTMT OF FX WEIGHT BEARING ARTCLR PORTION       N   3    $13.45   6/1/1994   12/31/2299
27825   F   CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ART   N   3   $306.00   3/1/2004   12/31/2299
27826   2   OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTIC   N   3   $387.84   1/1/1993   12/31/2299
27826   7   OPEN TRTMT OF FX OF WEIGHT BEARNG ARTICULR SUF FIB   N   3    $13.45   6/1/1994   12/31/2299
27826   F   OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTIC   N   3   $351.00   3/1/2004   12/31/2299
27827   2   OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTIC   N   3   $398.54   1/1/1993   12/31/2299
27827   7   OPEN TRTMT OF FX OF WEIGHT BEARING ARTICUL SURFACE   N   3    $13.45   6/1/1994   12/31/2299
27827   8   OPEN TRTMT OF FX OF WEIGHT BEARING ARTICUL SURFACE   N   3   $134.36   1/1/2003   12/31/2299
27827   F   OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTIC   N   3   $351.00   3/1/2004   12/31/2299
27828   2   OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTIC   N   3   $464.74   1/1/1993   12/31/2299
27828   7   OPEN TRTMT FRACTURE OF WEIGHT LEARNING ARTICULAR S   N   3    $13.45   6/1/1994   12/31/2299
27828   8   OPEN TRTMT FRACTURE OF WEIGHT LEARNING ARTICULAR S   N   3   $126.00   1/2/1994   12/31/2299
27828   F   OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTIC   N   3   $432.00   3/1/2004   12/31/2299
27829   2   OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDE   N   3   $278.77   1/1/1993   12/31/2299
27829   7   OPEN TRTMT OF DISTAL TIBIOFIBULAR JOINT DISRUPTION   N   3    $13.45   6/1/1994   12/31/2299
27829   F   OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDE   N   3   $306.00   3/1/2004   12/31/2299
27830   7   TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATI   N   3    $13.45   6/1/1994   12/31/2299
27830   F   TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATI   N   3   $225.80   3/1/2004   12/31/2299
27831   7   TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATI   N   3    $13.45   6/1/1994   12/31/2299
27831   F   TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATI   N   3   $225.80   3/1/2004   12/31/2299
27832   2   OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISL   N   3   $200.00   1/1/1973   12/31/2299
27832   7   OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISL   N   3    $13.45   6/1/1994   12/31/2299
27832   F   OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISL   N   3   $306.00   3/1/2004   12/31/2299
27840   2   TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA   N   3   $726.00   1/2/1992   12/31/2299
27840   F   TREATMENT OF ANKLE DISLOCATION; WITHOUT ANESTHESIA   N   3   $225.80   3/1/2004   12/31/2299
27842   2   TREATMENT OF ANKLE DISLOCATION; REQUIRING ANESTHES   N   3    $50.00   1/1/1973   12/31/2299
27842   7   TREATMENT OF ANKLE DISLOCATION; REQUIRING ANESTHES   N   3    $13.45   6/1/1994   12/31/2299
27842   F   TREATMENT OF ANKLE DISLOCATION; REQUIRING ANESTHES   N   3   $225.80   3/1/2004   12/31/2299
27846   2   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3   $300.00   1/1/1973   12/31/2299
27846   7   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3    $13.45   6/1/1994   12/31/2299
27846   8   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3    $60.00   1/1/1973   12/31/2299
27846   F   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3   $351.00   3/1/2004   12/31/2299
27848   2   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3   $498.00   1/2/1995   12/31/2299
27848   7   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3    $13.45   6/1/1994   12/31/2299
27848   8   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3   $100.00   1/2/1995   12/31/2299
27848   F   OPEN TREATMENT OF CLOSED OR OPEN ANKLE DISLOCATION   N   3   $351.00   3/1/2004   12/31/2299
27851   7   ANTERIOR TIBIAL TUBERCLE PLASTY FOR CHONDROMALACIA   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       96
27860   2   MANIPULATION OF ANKLE UNDER GENERAL ANESTHESIA (IN   N   3    $25.00   1/1/1973   12/31/2299
27860   7   MANIPULATION OF ANKLE UNDER GENERAL ANESTHESIA (IN   N   3    $13.45   6/1/1994   12/31/2299
27860   F   MANIPULATION OF ANKLE UNDER GENERAL ANESTHESIA (IN   N   3   $225.80   3/1/2004   12/31/2299
27870   2   ARTHRODESIS, ANKLE, ANY METHOD                       N   3   $340.00   1/1/1973   12/31/2299
27870   7   ARTHRODESIS, ANKLE, ANY METHOD                       N   3    $13.45   6/1/1994   12/31/2299
27870   8   ARTHRODESIS, ANKLE, ANY METHOD                       N   3    $65.00   1/1/1973   12/31/2299
27870   F   ARTHRODESIS, ANKLE, ANY METHOD                       N   3   $432.00   3/1/2004   12/31/2299
27871   7   ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTA   N   3    $13.45   6/1/1994   12/31/2299
27871   F   ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTA   N   3   $432.00   3/1/2004   12/31/2299
27880   2   AMPUTATION LEG, THROUGH TIBIA AND FIBULA;            N   3   $280.00   1/1/1993   12/31/2299
27880   7   AMPUTATION LEG, THROUGH TIBIA AND FIBULA;            N   3    $13.45   6/1/1994   12/31/2299
27880   8   AMPUTATION LEG, THROUGH TIBIA AND FIBULA;            N   3    $56.00   1/1/1993   12/31/2299
27881   2   AMPUTATION LEG                                       N   3   $275.00   1/1/1984   12/31/2299
27881   7   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; W/IMMEDI   N   3    $13.45   6/1/1994   12/31/2299
27881   8   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; W/IMMEDI   N   3    $55.00   1/1/1984   12/31/2299
27882   2   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; OPEN FLA   N   3   $265.00   1/1/1973   12/31/2299
27882   7   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; OPEN FLA   N   3    $13.45   6/1/1994   12/31/2299
27882   8   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; OPEN FLA   N   3    $53.00   8/1/1979   12/31/2299
27884   2   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; SECONDAR   N   3   $282.00   1/2/1995   12/31/2299
27884   7   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; SECONDAR   N   3    $13.45   6/1/1994   12/31/2299
27884   F   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; SECONDAR   N   3   $351.00   3/1/2004   12/31/2299
27886   2   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; REAMPUTA   N   3   $200.00   1/1/1984   12/31/2299
27886   7   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; REAMPUTA   N   3    $13.45   6/1/1994   12/31/2299
27886   8   AMPUTATION LEG, THROUGH TIBIA AND FIBULA; REAMPUTA   N   3    $40.00   1/1/1984   12/31/2299
27888   2   AMPUTAT,ANKLE,THRU MALLEOLI TIBIA & FIBULA(SYME,PI   N   3   $300.00   1/1/1973   12/31/2299
27888   7   AMPUTAT,ANKLE,THRU MALLEOLI TIBIA & FIBULA(SYME,PI   N   3    $13.45   6/1/1994   12/31/2299
27888   8   AMPUTAT,ANKLE,THRU MALLEOLI TIBIA & FIBULA(SYME,PI   N   3    $60.00   1/1/1973   12/31/2299
27889   7   ANKLE DISARTICULATION                                N   3    $13.45   6/1/1994   12/31/2299
27889   F   ANKLE DISARTICULATION                                N   3   $351.00   3/1/2004   12/31/2299
27892   2   DECOMPRESSION FASCIOTOMY, LEG;                       N   3   $189.10   1/1/1993   12/31/2299
27892   7   MISCELLANEOUS                                        N   3    $13.45   6/1/1994   12/31/2299
27892   F   DECOMPRESSION FASCIOTOMY, LEG;                       N   3   $351.00   3/1/2004   12/31/2299
27893   2   DECOMPRESSION FASCIOTOMY, LEG;                       N   3   $188.51   1/1/1993   12/31/2299
27893   7   DECOMPRESSION FASCOTOMY, LEG POSTERIOR COMPARTMENT   N   3    $13.45   6/1/1994   12/31/2299
27893   F   DECOMPRESSION FASCIOTOMY, LEG;                       N   3   $351.00   3/1/2004   12/31/2299
27894   2   DECOMPRESSION FASCIOTOMY, LEG;                       N   3   $233.65   1/1/1993   12/31/2299
27894   7   DECOMPRESSION FASCIOTOMY LEG ANTERIOR/LATERAL COMP   N   3    $13.45   6/1/1994   12/31/2299
27894   F   DECOMPRESSION FASCIOTOMY, LEG;                       N   3   $351.00   3/1/2004   12/31/2299
27899   7   UNLISTED PROCEDURE, LEG OR ANKLE                     N   3    $13.45   6/1/1994   12/31/2299
28001   2   INCISION AND DRAINAGE, INFECTED BURSA                N   3    $25.00   1/1/1984   12/31/2299
28001   7   INCISION AND DRAINAGE, INFECTED BURSA - FOOT         N   3    $13.45   6/1/1994   12/31/2299
28002   2   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3    $50.00   1/1/1984   12/31/2299
28002   7   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3    $13.45   6/1/1994   12/31/2299
28002   F   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3   $351.00   3/1/2004   12/31/2299
28003   2   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3    $65.00   1/1/1984   12/31/2299
28003   7   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3    $13.45   6/1/1994   12/31/2299
28003   8   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3    $13.00   1/1/1984   12/31/2299
28003   F   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3   $351.00   3/1/2004   12/31/2299
28004   7   DEEP INFECT,BELOW FASC,REQUIR DEEP DISSECT, W OR W   N   3    $13.45   6/1/1994   12/31/2299
28005   2   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3   $125.00   1/1/1984   12/31/2299
28005   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                       97
28005   8   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $25.00   1/1/1984   12/31/2299
28005   F   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3   $351.00   3/1/2004   12/31/2299
28006   7   INCISION, DEEP, WITH OPENING OF BONE CORTEX FOR OS   N   3    $13.45   6/1/1994   12/31/2299
28008   2   FASCIOTOMY, PLANTAR AND/OR TOE, SUBCUTANEOUS         N   3    $60.00   1/1/1971   12/31/2299
28008   7   FASCIOTOMY, PLANTAR AND/OR TOE, SUBCUTANEOUS         N   3    $13.45   6/1/1994   12/31/2299
28008   F   FASCIOTOMY, PLANTAR AND/OR TOE, SUBCUTANEOUS         N   3   $351.00   3/1/2004   12/31/2299
28010   2   TENOTOMY, SUBCUTANEOUS, TOE; SINGLE                  N   3    $20.00   1/1/1973   12/31/2299
28010   7   TENOTOMY, SUBCUTANEOUS, TOE; SINGLE                  N   3    $13.45   6/1/1994   12/31/2299
28011   2   TENOTOMY, SUBCUTANEOUS, TOE; MULTIPLE                N   3    $10.00   1/1/1979   12/31/2299
28011   7   TENOTOMY, SUBCUTANEOUS, TOE; MULTIPLE                N   3    $13.45   6/1/1994   12/31/2299
28011   F   TENOTOMY, SUBCUTANEOUS, TOE; MULTIPLE                N   3   $351.00   3/1/2004   12/31/2299
28020   2   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3   $150.00   1/1/1979   12/31/2299
28020   7   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3    $13.45   6/1/1994   12/31/2299
28020   F   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3   $306.00   3/1/2004   12/31/2299
28022   2   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3    $90.00   1/2/1994   12/31/2299
28022   7   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3    $13.45   6/1/1994   12/31/2299
28022   F   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3   $306.00   3/1/2004   12/31/2299
28024   2   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3    $90.00   1/1/1984   12/31/2299
28024   7   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3    $13.45   6/1/1994   12/31/2299
28024   F   ARTHROTOMY,W/EXPLOR,DRAIN OR REMOV OF LOOSE OR FOR   N   3   $306.00   3/1/2004   12/31/2299
28030   F   NEURECTOMY OF INTRINSIC MUSCULATURE OF FOOT          N   3   $432.00   3/1/2004   12/31/2299
28035   2   TARSAL TUNNEL RELEASE (POSTERIOR TIBIAL NERVE DECO   N   3   $200.00   1/1/1973   12/31/2299
28035   7   TARSAL TUNNEL RELEASE (POSTERIOR TIBIAL NERVE DECO   N   3    $13.45   6/1/1994   12/31/2299
28035   8   TARSAL TUNNEL RELEASE (POSTERIOR TIBIAL NERVE DECO   N   3    $40.00   1/1/1984   12/31/2299
28035   F   TARSAL TUNNEL RELEASE (POSTERIOR TIBIAL NERVE DECO   N   3   $432.00   3/1/2004   12/31/2299
28043   2   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3    $50.00   1/1/1984   12/31/2299
28043   7   EXCISION, BENIGN TUMOR, SUBCUTANEOUS                 N   3    $13.45   1/2/1994   12/31/2299
28043   F   EXCISION, BENIGN TUMOR; SUBCUTANEOUS                 N   3   $306.00   3/1/2004   12/31/2299
28045   2   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3   $125.00   1/2/1994   12/31/2299
28045   7   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3    $13.45   6/1/1994   12/31/2299
28045   8   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3    $45.11   1/1/2005   12/31/2299
28045   F   EXCISION, BENIGN TUMOR; DEEP, SUBFASCIAL, INTRAMUS   N   3   $351.00   3/1/2004   12/31/2299
28046   2   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $517.45   1/1/2003   12/31/2299
28046   7   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3    $13.45   6/1/1994   12/31/2299
28046   F   RADICAL RESECTION OF TUMOR (EG, MALIGNANT NEOPLASM   N   3   $351.00   3/1/2004   12/31/2299
28050   2   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERTARSAL OR TAR   N   3   $150.00   1/1/1979   12/31/2299
28050   7   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERTARSAL OR TAR   N   3    $13.45   6/1/1994   12/31/2299
28050   F   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERTARSAL OR TAR   N   3   $306.00   3/1/2004   12/31/2299
28052   2   ARTHROTOMY FOR SYNOVIAL BIOPSY; METATARSOPHALANGEA   N   3    $90.00   1/1/1979   12/31/2299
28052   7   ARTHROTOMY FOR SYNOVIAL BIOPSY; METATARSOPHALANGEA   N   3    $13.45   6/1/1994   12/31/2299
28052   F   ARTHROTOMY FOR SYNOVIAL BIOPSY; METATARSOPHALANGEA   N   3   $306.00   3/1/2004   12/31/2299
28054   2   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JO   N   3    $70.00   1/1/1973   12/31/2299
28054   7   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JO   N   3    $13.45   6/1/1994   12/31/2299
28054   F   ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JO   N   3   $306.00   3/1/2004   12/31/2299
28055   2   NEURECTOMY, FOOT                                     N   3   $213.43   1/1/2007   12/31/2299
28055   7   NEURECTOMY, FOOT                                     N   3   $213.43   1/1/2007   12/31/2299
28055   8   NEURECTOMY, FOOT                                     N   3    $42.00   1/1/2007   12/31/2299
28060   2   FASCIECTOMY, EXCISION OF PLANTAR FASCIA; PARTIAL (   N   3   $120.00   1/1/1979   12/31/2299
28060   7   FASCIECTOMY, EXCISION OF PLANTAR FASCIA; PARTIAL (   N   3    $13.45   6/1/1994   12/31/2299
28060   8   FASCIECTOMY, EXCISION OF PLANTAR FASCIA; PARTIAL (   N   3    $50.72   1/1/2004   12/31/2299
28060   F   FASCIECTOMY, EXCISION OF PLANTAR FASCIA; PARTIAL (   N   3   $306.00   3/1/2004   12/31/2299




                                                                                                       98
28062   7   FASCIECTOMY, EXCISION OF PLANTAR FASCIA; RADICAL (   N   3    $13.45   6/1/1994   12/31/2299
28062   F   FASCIECTOMY, EXCISION OF PLANTAR FASCIA; RADICAL (   N   3   $351.00   3/1/2004   12/31/2299
28070   2   SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT,   N   3   $150.00   1/1/1973   12/31/2299
28070   7   SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT,   N   3    $13.45   6/1/1994   12/31/2299
28070   F   SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT,   N   3   $351.00   3/1/2004   12/31/2299
28072   2   SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH         N   3    $90.00   1/1/1979   12/31/2299
28072   7   SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH         N   3    $13.45   6/1/1994   12/31/2299
28072   F   SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH         N   3   $351.00   3/1/2004   12/31/2299
28080   2   EXCISION OF MORTON NEUROMA, SINGLE, EACH             N   3   $180.00   1/1/1994   12/31/2299
28080   7   EXCISION OF MORTON NEUROMA, SINGLE, EACH             N   3    $13.45   6/1/1994   12/31/2299
28080   F   EXCISION OF MORTON NEUROMA, SINGLE, EACH             N   3   $351.00   3/1/2004   12/31/2299
28086   7   SYNOVECTOMY, TENDON SHEATH; FLEXOR                   N   3    $13.45   6/1/1994   12/31/2299
28086   F   SYNOVECTOMY, TENDON SHEATH; FLEXOR                   N   3   $306.00   3/1/2004   12/31/2299
28088   2   SYNOVECTOMY, TENDON SHEATH; EXTENSOR                 N   3   $180.00   1/2/1994   12/31/2299
28088   7   SYNOVECTOMY, TENDON SHEATH; EXTENSOR                 N   3    $13.45   6/1/1994   12/31/2299
28088   F   SYNOVECTOMY, TENDON SHEATH; EXTENSOR                 N   3   $306.00   3/1/2004   12/31/2299
28090   2   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3    $90.00   1/1/1979   12/31/2299
28090   7   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3    $13.45   6/1/1994   12/31/2299
28090   8   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3    $18.00   1/1/1984   12/31/2299
28090   F   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3   $351.00   3/1/2004   12/31/2299
28092   2   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3   $214.93   9/1/2005   12/31/2299
28092   7   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3    $13.45   6/1/1994   12/31/2299
28092   F   EXCIS OF LESION OF TENDON OR FIBR SHEATH OR CAPSUL   N   3   $351.00   3/1/2004   12/31/2299
28100   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $125.00   1/1/1973   12/31/2299
28100   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
28100   F   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3   $306.00   3/1/2004   12/31/2299
28102   2   EXCIS OR CURET BONE CYST/BENIGN TUMOR,TALUS/CALCAN   N   3   $175.00   1/1/1973   12/31/2299
28102   7   EXCIS/CURET BONE CYST/BENI TUM/TAL/CALC WITH GRAFT   N   3    $13.45   6/1/1994   12/31/2299
28102   8   EXCIS OR CURET BONE CYST/BENIGN TUMOR,TALUS OR CAL   N   3    $35.00   1/1/1973   12/31/2299
28102   F   EXCIS OR CURET BONE CYST/BENIGN TUMOR,TALUS/CALCAN   N   3   $351.00   3/1/2004   12/31/2299
28103   7   EXCIS OR CURET BONE CYST OR BENIGN TUMOR, TALUS OR   N   3    $13.45   6/1/1994   12/31/2299
28103   F   EXCIS OR CURET BONE CYST OR BENIGN TUMOR, TALUS OR   N   3   $351.00   3/1/2004   12/31/2299
28104   2   EXCIS OR CURET BONE CYST OR BENIGN TUMOR, TARSAL O   N   3   $120.00   1/1/1971   12/31/2299
28104   7   EXCIS OR CURET BONE CYST OR BENIGN TUMOR, TARSAL O   N   3    $13.45   6/1/1994   12/31/2299
28104   F   EXCIS OR CURET BONE CYST OR BENIGN TUMOR, TARSAL O   N   3   $306.00   3/1/2004   12/31/2299
28106   2   EXC/CURET BONE CYST/BENIGN TUM,TARS OR METATAR BON   N   3   $140.00   1/1/1973   12/31/2299
28106   7   EXC/CURET BONE CYST/BENIGN TUM,TARS OR METATAR BON   N   3    $13.45   6/1/1994   12/31/2299
28106   8   EXC/CURET BONE CYST/BENIGN TUM,TARS OR METATAR BON   N   3    $28.00   1/1/1973   12/31/2299
28106   F   EXC/CURET BONE CYST/BENIGN TUM,TARS OR METATAR BON   N   3   $351.00   3/1/2004   12/31/2299
28107   7   EXCIS/CURET BONE CYST OR BENIGN TUMOR, TARSAL OR M   N   3    $13.45   6/1/1994   12/31/2299
28107   F   EXCIS/CURET BONE CYST OR BENIGN TUMOR, TARSAL OR M   N   3   $351.00   3/1/2004   12/31/2299
28108   2   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $90.00   1/1/1973   12/31/2299
28108   7   EXCIS/CURET BONE CYST/BENI TUM/PHALANGES             N   3    $13.45   6/1/1994   12/31/2299
28109   7   EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR   N   3    $13.45   6/1/1994   12/31/2299
28110   2   OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL (BUN   N   3    $60.00   1/1/1973   12/31/2299
28110   7   OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL (BUN   N   3    $13.45   6/1/1994   12/31/2299
28110   F   OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL (BUN   N   3   $351.00   3/1/2004   12/31/2299
28111   2   OSTECTOMY; COMPLETE EXCISION OF FIRST METATARSAL H   N   3   $100.00   1/1/1979   12/31/2299
28111   7   OSTECTOMY; COMPLETE EXCISION OF FIRST METATARSAL H   N   3    $13.45   6/1/1994   12/31/2299
28111   8   OSTECTOMY; COMPLETE EXCISION OF FIRST METATARSAL H   N   3    $20.00   1/1/1984   12/31/2299
28111   F   OSTECTOMY; COMPLETE EXCISION OF FIRST METATARSAL H   N   3   $351.00   3/1/2004   12/31/2299




                                                                                                       99
28112   2   OSTECTOMY; OTHER METATARSAL HEAD (SECOND,THIRD OR    N   3   $100.00   1/1/1984   12/31/2299
28112   7   OSTECTOMY; OTHER METATARSAL HEAD (SECOND,THIRD OR    N   3    $13.45   6/1/1994   12/31/2299
28112   8   OSTECTOMY; OTHER METATARSAL HEAD (SECOND,THIRD OR    N   3    $20.00   1/1/1984   12/31/2299
28112   F   OSTECTOMY; OTHER METATARSAL HEAD (SECOND,THIRD OR    N   3   $351.00   3/1/2004   12/31/2299
28113   2   OSTECTOMY; FIFTH METATARSAL HEAD                     N   3   $100.00   1/1/1984   12/31/2299
28113   7   OSTECTOMY; FIFTH METATARSAL HEAD                     N   3    $13.45   6/1/1994   12/31/2299
28113   F   OSTECTOMY; FIFTH METATARSAL HEAD                     N   3   $351.00   3/1/2004   12/31/2299
28114   2   OSTECTOMY; ALL METATARSAL HEADS WITH PARTIAL PROXI   N   3   $300.00   1/1/1973   12/31/2299
28114   7   OSTECTOMY; ALL METATARSAL HEADS WITH PARTIAL PROXI   N   3    $13.45   6/1/1994   12/31/2299
28114   F   OSTECTOMY; ALL METATARSAL HEADS WITH PARTIAL PROXI   N   3   $351.00   3/1/2004   12/31/2299
28116   2   OSTECTOMY, EXCISION OF TARSAL COALITION              N   3   $175.00   1/1/1973   12/31/2299
28116   7   OSTECTOMY, EXCISION OF TARSAL COALITION              N   3    $13.45   6/1/1994   12/31/2299
28116   8   OSTECTOMY, EXCISION OF TARSAL COALITION              N   3    $67.64   1/1/2005   12/31/2299
28116   F   OSTECTOMY, EXCISION OF TARSAL COALITION              N   3   $351.00   3/1/2004   12/31/2299
28118   2   OSTECTOMY, CALCANEUS; PARTIAL                        N   3   $228.00   1/2/1992   12/31/2299
28118   7   OSTECTOMY, CALCANEUS; PARTIAL                        N   3    $13.45   6/1/1994   12/31/2299
28118   8   OSTECTOMY, CALCANEUS; PARTIAL                        N   3    $57.32   1/1/2004   12/31/2299
28118   F   OSTECTOMY, CALCANEUS; PARTIAL                        N   3   $432.00   3/1/2004   12/31/2299
28119   2   OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PL   N   3   $258.00   1/1/1994   12/31/2299
28119   7   OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PL   N   3    $13.45   6/1/1994   12/31/2299
28119   8   OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PL   N   3    $51.60   1/1/1994   12/31/2299
28119   F   OSTECTOMY, CALCANEUS; FOR SPUR, WITH OR WITHOUT PL   N   3   $432.00   3/1/2004   12/31/2299
28120   2   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3   $150.00   1/1/1973   12/31/2299
28120   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3    $13.45   6/1/1994   12/31/2299
28120   8   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3    $30.00   1/1/1984   12/31/2299
28120   F   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3   $495.00   3/1/2004   12/31/2299
28121   7   PARTIAL EXCISION OF BONE (CRATERIZATION, SAUCERIZA   N   3    $13.45   6/1/1994   12/31/2299
28122   2   PARTIAL EXCISION OF BONE (CRATERIZATION),TARSAL OR   N   3   $120.00   1/1/1979   12/31/2299
28122   7   PARTIAL EXCISION OF BONE (CRATERIZATION),TARSAL OR   N   3    $13.45   6/1/1994   12/31/2299
28122   8   PARTIAL EXCISION OF BONE (CRATERIZATION),TARSAL OR   N   3    $24.00   1/1/1984   12/31/2299
28122   F   PARTIAL EXCISION OF BONE (CRATERIZATION),TARSAL OR   N   3   $351.00   3/1/2004   12/31/2299
28123   7   PARTIAL EXCISION OF BONE (CRATERIZATION),TARSAL OR   N   3    $13.45   6/1/1994   12/31/2299
28124   2   PARTIAL EXCISION OF BONE (CRATERIZATION), PHALANX    N   3    $90.00   1/2/1994   12/31/2299
28124   7   PARTIAL EXCISION OF BONE (CRATERIZATION), PHALANX    N   3    $13.45   6/1/1994   12/31/2299
28126   2   CONDYLECTOMY, PHALANGEAL BASE, SINGLE TOE, EACH      N   3    $75.00   1/1/1984   12/31/2299
28126   7   CONDYLECTOMY, PHALANGEAL BASE, SINGLE TOE, EACH      N   3    $13.45   6/1/1994   12/31/2299
28126   F   CONDYLECTOMY, PHALANGEAL BASE, SINGLE TOE, EACH      N   3   $351.00   3/1/2004   12/31/2299
28130   2   TALECTOMY (ASTRAGALECTOMY)                           N   3   $250.00   1/1/1973   12/31/2299
28130   7   TALECTOMY (ASTRAGALECTOMY)                           N   3    $13.45   6/1/1994   12/31/2299
28130   8   TALECTOMY (ASTRAGALECTOMY)                           N   3    $50.00   1/1/1973   12/31/2299
28130   F   TALECTOMY (ASTRAGALECTOMY)                           N   3   $351.00   3/1/2004   12/31/2299
28140   2   METATARSECTOMY                                       N   3   $150.00   1/1/1973   12/31/2299
28140   7   METATARSECTOMY                                       N   3    $13.45   6/1/1994   12/31/2299
28140   F   METATARSECTOMY                                       N   3   $351.00   3/1/2004   12/31/2299
28150   2   PHALANGECTOMY, SINGLE, EACH                          N   3    $90.00   1/1/1973   12/31/2299
28150   7   PHALANGECTOMY, SINGLE, EACH                          N   3    $13.45   6/1/1994   12/31/2299
28150   F   PHALANGECTOMY, SINGLE, EACH                          N   3   $351.00   3/1/2004   12/31/2299
28153   2   RESECTION, HEAD OF PHALANX                           N   3   $100.00   1/1/1984   12/31/2299
28153   7   RESECTION, HEAD OF PHALANX                           N   3    $13.45   6/1/1994   12/31/2299
28153   F   RESECTION, HEAD OF PHALANX                           N   3   $351.00   3/1/2004   12/31/2299
28160   2   HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISIO   N   3    $75.00   1/1/1997   12/31/2299




                                                                                                      100
28160   7   HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISIO   N   3    $13.45   6/1/1994   12/31/2299
28160   F   HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISIO   N   3   $351.00   3/1/2004   12/31/2299
28171   7   RADICAL RESECTION FOR TUMOR TARSAL (EXCEPT TALUS O   N   3    $13.45   6/1/1994   12/31/2299
28171   F   RADICAL RESECTION FOR TUMOR TARSAL (EXCEPT TALUS R   N   3   $351.00   3/1/2004   12/31/2299
28173   7   RADICAL RESECTION FOR TUMOR METATARSAL (EXCEPT TAL   N   3    $13.45   6/1/1994   12/31/2299
28175   7   RADICAL RESECTION FOR TUMOR PHALANX (EXCEPT TALUS    N   3    $13.45   6/1/1994   12/31/2299
28175   F   RADICAL RESECTION FOR TUMOR PHALANX (EXCEPT TALUS    N   3   $351.00   3/1/2004   12/31/2299
28190   2   REMOVE FOREIGN BODY; SUBCUTANEOUS                    N   3    $20.00   1/1/1984   12/31/2299
28190   7   REMOVE FOREIGN BODY SUBCUTANEOUS                     N   3    $13.45   6/1/1994   12/31/2299
28192   2   REMOVE FOREIGN BODY; DEEP                            N   3   $125.00   1/1/1984   12/31/2299
28192   7   REMOVAL OF FOREIGN BODY FOOT SUBCUTANEOUS DEEP       N   3    $13.45   6/1/1994   12/31/2299
28192   F   REMOVE FOREIGN BODY; DEEP                            N   3   $306.00   3/1/2004   12/31/2299
28193   2   REMOVE FOREIGN BODY; COMPLICATED                     N   3   $156.00   1/2/1992   12/31/2299
28193   7   REMOVE FOREIGN BODY; COMPLICATED                     N   3    $13.45   6/1/1994   12/31/2299
28193   F   REMOVE FOREIGN BODY; COMPLICATED                     N   3   $432.00   3/1/2004   12/31/2299
28200   2   REPAIR OR SUTURE OF TENDON,FOOT,FLEXOR,SINGLE;PRIM   N   3    $35.00   1/1/1979   12/31/2299
28200   7   REPAIR OR SUTURE OF TENDON,FOOT,FLEXOR,SINGLE;PRIM   N   3    $13.45   6/1/1994   12/31/2299
28200   F   REPAIR OR SUTURE OF TENDON,FOOT,FLEXOR,SINGLE;PRIM   N   3   $351.00   3/1/2004   12/31/2299
28202   2   REPAIR OR SUTURE OF TENDON,FOOT,FLEXOR,SINGLE; SEC   N   3    $50.00   1/1/1973   12/31/2299
28202   7   REPAIR OR SUTURE OF TENDON,FOOT,FLEXOR,SINGLE; SEC   N   3    $13.45   6/1/1994   12/31/2299
28202   F   REPAIR OR SUTURE OF TENDON,FOOT,FLEXOR,SINGLE; SEC   N   3   $351.00   3/1/2004   12/31/2299
28208   2   REPAIR OR SUTURE OF TENDON,FOOT,EXTENSOR,SINGLE; P   N   3    $25.00   1/2/1994   12/31/2299
28208   7   REPAIR OR SUTURE OF TENDON,FOOT,EXTENSOR,SINGLE; P   N   3    $13.45   6/1/1994   12/31/2299
28208   F   REPAIR OR SUTURE OF TENDON,FOOT,EXTENSOR,SINGLE; P   N   3   $351.00   3/1/2004   12/31/2299
28210   2   REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE   N   3   $100.00   1/1/1979   12/31/2299
28210   7   REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE   N   3    $13.45   6/1/1994   12/31/2299
28210   F   REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE   N   3   $351.00   3/1/2004   12/31/2299
28220   2   TENOLYSIS, FLEXOR; SINGLE                            N   3   $125.00   1/1/1979   12/31/2299
28220   7   TENOLYSIS, FLEXOR; SINGLE                            N   3    $13.45   6/1/1994   12/31/2299
28222   2   TENOLYSIS, FLEXOR; MULTIPLE, EACH                    N   3   $150.00   1/1/1973   12/31/2299
28222   7   TENOLYSIS, FLEXOR; MULTIPLE, EACH                    N   3    $13.45   6/1/1994   12/31/2299
28222   F   TENOLYSIS, FLEXOR; MULTIPLE, EACH                    N   3   $225.80   3/1/2004   12/31/2299
28225   2   TENOLYSIS, EXTENSOR; SINGLE                          N   3    $70.00   1/1/1979   12/31/2299
28225   7   TENOLYSIS, EXTENSOR; SINGLE                          N   3    $13.45   6/1/1994   12/31/2299
28225   F   TENOLYSIS, EXTENSOR; SINGLE                          N   3   $225.80   3/1/2004   12/31/2299
28226   2   TENOLYSIS, EXTENSOR; MULTIPLE, EACH                  N   3    $90.00   1/1/1973   12/31/2299
28226   7   TENOLYSIS, EXTENSOR; MULTIPLE, EACH                  N   3    $13.45   6/1/1994   12/31/2299
28226   F   TENOLYSIS, EXTENSOR; MULTIPLE, EACH                  N   3   $225.80   3/1/2004   12/31/2299
28230   2   TENOTOMY, OPEN, FLEXOR; FOOT, SINGLE OR MULTIPLE     N   3    $92.00   1/2/1992   12/31/2299
28230   7   TENOTOMY, OPEN, FLEXOR; FOOT, SINGLE OR MULTIPLE     N   3    $13.45   6/1/1994   12/31/2299
28230   8   TENOTOMY, OPEN, FLEXOR; FOOT, SINGLE OR MULTIPLE     N   3    $15.00   1/1/1984   12/31/2299
28232   2   TENOTOMY, OPEN, FLEXOR; TOE, SINGLE                  N   3    $35.00   1/2/1994   12/31/2299
28232   7   TENOTOMY, OPEN, FLEXOR; TOE, SINGLE                  N   3    $13.45   6/1/1994   12/31/2299
28234   2   TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE                N   3    $25.00   1/2/1994   12/31/2299
28234   7   TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE                N   3    $13.45   6/1/1994   12/31/2299
28234   F   TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE                N   3   $306.00   3/1/2004   12/31/2299
28236   7   TRANSFER OF TENDON, ANTERIOR TIBIAL INTO TARSAL BO   N   3    $13.45   6/1/1994   12/31/2299
28238   2   ADVANCEMENT OF POSTERIOR TIBIAL TENDON WITH EXCISI   N   3   $290.00   1/2/1992   12/31/2299
28238   7   ADVANCEMENT OF POSTERIOR TIBIAL TENDON WITH EXCISI   N   3    $13.45   6/1/1994   12/31/2299
28238   F   ADVANCEMENT OF POSTERIOR TIBIAL TENDON WITH EXCISI   N   3   $351.00   3/1/2004   12/31/2299
28240   2   TENOTOMY OR RELEASE, ABDUCTOR HALLUCIS MUSCLE        N   3    $90.00   1/1/1973   12/31/2299




                                                                                                      101
28240   7   TENOTOMY OR RELEASE, ABDUCTOR HALLUCIS MUSCLE         N   3    $13.45   6/1/1994   12/31/2299
28240   F   TENOTOMY OR RELEASE, ABDUCTOR HALLUCIS MUSCLE         N   3   $306.00   3/1/2004   12/31/2299
28250   2   DIVISION OF PLANTAR FASCIA AND MUSCLE (''STEINDLER    N   3   $150.00   1/1/1999   12/31/2299
28250   7   DIVISION OF PLANTAR FASCIA AND MUSCLE (''STEINDLER    N   3    $13.45   6/1/1994   12/31/2299
28250   8   DIVISION OF PLANTAR FASCIA AND MUSCLE (''STEINDLER    N   3    $30.00   1/1/1984   12/31/2299
28250   F   DIVISION OF PLANTAR FASCIA AND MUSCLE (''STEINDLER    N   3   $351.00   3/1/2004   12/31/2299
28260   2   CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY             N   3   $200.00   1/1/1979   12/31/2299
28260   7   CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY             N   3    $13.45   6/1/1994   12/31/2299
28260   8   CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY             N   3    $40.00   8/1/1979   12/31/2299
28260   F   CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY             N   3   $351.00   3/1/2004   12/31/2299
28261   2   CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING         N   3   $235.00   8/1/1979   12/31/2299
28261   7   CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING         N   3    $13.45   6/1/1994   12/31/2299
28261   8   CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING         N   3    $45.00   1/1/1979   12/31/2299
28261   F   CAPSULOTOMY, MIDFOOT; WITH TENDON LENGTHENING         N   3   $351.00   3/1/2004   12/31/2299
28262   2   CAPSULOTOMY MIDFOOT EXT                               N   3   $300.00   1/1/1989   12/31/2299
28262   7   CAPSULOTOMY, MIDFOOT;EXTENSIVE,INCLUDING POSTERIOR    N   3    $13.45   6/1/1994   12/31/2299
28262   8   CAPSULOTOMY, MIDFOOT;EXTENSIVE,INCLUDING POSTERIOR    N   3    $60.00   1/1/1989   12/31/2299
28262   F   CAPSULOTOMY MIDFOOT EXT                               N   3   $432.00   3/1/2004   12/31/2299
28264   2   CAPSULOTOMY, MIDTARSAL (HEYMAN TYPE PROCEDURE)        N   3   $300.00   1/1/1979   12/31/2299
28264   7   CAPSULOTOMY, MIDTARSAL (HEYMAN TYPE PROCEDURE)        N   3    $13.45   6/1/1994   12/31/2299
28264   8   CAPSULOTOMY, MIDTARSAL (HEYMAN TYPE PROCEDURE)        N   3    $60.00   1/1/1973   12/31/2299
28264   F   CAPSULOTOMY, MIDTARSAL (HEYMAN TYPE PROCEDURE)        N   3   $225.80   3/1/2004   12/31/2299
28270   2   CAPSULOTOMY FOR CONTRACTURE;METATARSOPHALANGEAL JO    N   3    $15.00   1/1/1984   12/31/2299
28270   7   CAPSULOTOMY FOR CONTRACTURE;METATARSOPHALANGEAL JO    N   3    $13.45   6/1/1994   12/31/2299
28270   8   CAPSULOTOMY FOR CONTRACTURE;METATARSOPHALANGEAL JO    N   3    $15.00   1/1/1984   12/31/2299
28270   F   CAPSULOTOMY FOR CONTRACTURE;METATARSOPHALANGEAL JO    N   3   $351.00   3/1/2004   12/31/2299
28272   2   CAPSULOTOMY FOR CONTRACTURE;INTERPHALANGEAL JOINT,    N   3    $35.00   1/1/1979   12/31/2299
28272   7   CAPSULOTOMY FOR CONTRACTURE;INTERPHALANGEAL JOINT,    N   3    $13.45   6/1/1994   12/31/2299
28280   2   WEBBING OPERATION (CREATE SYNDACTYLISM OF TOES) FO    N   3    $90.00   1/1/1979   12/31/2299
28280   7   WEBBING OPERATION (CREATE SYNDACTYLISM OF TOES) FO    N   3    $13.45   6/1/1994   12/31/2299
28280   F   WEBBING OPERATION (CREATE SYNDACTYLISM OF TOES) FO    N   3   $306.00   3/1/2004   12/31/2299
28285   2   HAMMERTOE OPERATION; ONE TOE                          N   3   $213.00   1/3/1994   12/31/2299
28285   7   HAMMERTOE OPERATION; ONE TOE                          N   3    $13.45   6/1/1994   12/31/2299
28285   8   HAMMER TOE REPAIR ONE TOE                             N   3    $42.60   1/1/1994   12/31/2299
28285   F   HAMMERTOE OPERATION ONE TOE                           N   3   $351.00   3/1/2004   12/31/2299
28286   2   HAMMERTOE OPERATION; FOR COCK-UP FIFTH TOE WITH PL    N   3   $125.00   8/1/1979   12/31/2299
28286   7   HAMMERTOE OPERATION; FOR COCK-UP FIFTH TOE WITH PL    N   3    $13.45   6/1/1994   12/31/2299
28286   F   HAMMERTOE OPERATION; FOR COCK-UP FIFTH TOE WITH PL    N   3   $432.00   3/1/2004   12/31/2299
28288   2   OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY,SI    N   3   $135.00   1/1/1984   12/31/2299
28288   7   OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY,SI    N   3    $13.45   6/1/1994   12/31/2299
28288   F   OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY,SI    N   3   $351.00   3/1/2004   12/31/2299
28289   2   HALLUX RIGIDUS CORRECTION WITH CHEILECTOMY            N   3   $213.65   1/1/1999   12/31/2299
28289   7   HALLUX RIGIDUS CORRECTION W/CHEILECTOMY DEBRIDEMENT   N   3   $213.65   1/1/1999   12/31/2299
28289   F   HALLUX RIGIDUS CORRECTION WITH CHEILECTOMY            N   3   $351.00   3/1/2004   12/31/2299
28290   2   HALLUX VALGUS (BUNION),CORRECTION W OR W/OUT SESAM    N   3    $96.00   1/1/1979   12/31/2299
28290   7   HALLUX VALGUS (BUNION),CORRECTION W OR W/OUT SESAM    N   3    $13.45   6/1/1994   12/31/2299
28290   F   HALLUX VALGUS (BUNION),CORRECTION W OR W/OUT SESAM    N   3   $306.00   3/1/2004   12/31/2299
28292   2   HALLUX VALGUS (BUNION),W OR W/OUT SESAMOIDECTOMY;S    N   3   $324.00   1/1/1994   12/31/2299
28292   7   HALLUX VALGUS (BUNION),W OR W/OUT SESAMOIDECTOMY;S    N   3    $13.45   6/1/1994   12/31/2299
28292   8   HALLUX VALGUS (BUNION),W OR W/OUT SESAMOIDECTOMY;S    N   3    $64.80   1/1/1994   12/31/2299
28292   F   HALLUX VALGUS (BUNION),W OR W/OUT SESAMOIDECTOMY;S    N   3   $306.00   3/1/2004   12/31/2299




                                                                                                       102
28293   2   HALLUX VALGUS (BUNION);RESECTION OF JOINT WITH IMP   N   3   $200.00   1/1/1984   12/31/2299
28293   7   HALLUX VALGUS (BUNION);RESECTION OF JOINT WITH IMP   N   3    $13.45   6/1/1994   12/31/2299
28293   8   HALLUX VALGUS (BUNION);RESECTION OF JOINT WITH IMP   N   3    $40.00   1/1/1984   12/31/2299
28293   F   HALLUX VALGUS (BUNION);RESECTION OF JOINT WITH IMP   N   3   $351.00   3/1/2004   12/31/2299
28294   2   HALLUX VALGUS (BUNION); WITH TENDON TRANSPLANTS      N   3   $237.50   1/1/1979   12/31/2299
28294   7   HALLUX VALGUS (BUNION); WITH TENDON TRANSPLANTS      N   3    $13.45   6/1/1994   12/31/2299
28294   F   HALLUX VALGUS (BUNION); WITH TENDON TRANSPLANTS      N   3   $351.00   3/1/2004   12/31/2299
28296   2   HALLUX VALGUS (BUNION); WITH METATARSAL OSTEOTOMY;   N   3   $432.00   1/3/1994   12/31/2299
28296   7   HALLUX VALGUS (BUNION); WITH METATARSAL OSTECTOMY;   N   3    $13.45   6/1/1994   12/31/2299
28296   8   HALLUX VALGUS (BUNION); WITH METATARSAL OSTECTOMY;   N   3    $86.40   1/3/1994   12/31/2299
28296   F   HALLUX VALGUS (BUNION); WITH METATARSAL OSTEOTOMY;   N   3   $351.00   3/1/2004   12/31/2299
28297   2   HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT   N   3   $414.49   1/1/2005   12/31/2299
28297   7   HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT   N   3    $13.45   6/1/1994   12/31/2299
28297   F   HALLUX VALGUS (BUNION) CORRECTION, WITH OR WITHOUT   N   3   $351.00   3/1/2004   12/31/2299
28298   2   HALLUX VALGUS (BUNION) CORRECTION; BY PHALANX OSTE   N   3   $175.00   1/1/1984   12/31/2299
28298   7   HALLUX VALGUS (BUNION) CORRECTION; BY PHALANX OSTE   N   3    $13.45   6/1/1994   12/31/2299
28298   8   HALLUX VALGUS (BUNION) CORRECTION; BY PHALANX OSTE   N   3    $70.20   1/1/2004   12/31/2299
28298   F   HALLUX VALGUS (BUNION) CORRECTION; BY PHALANX OSTE   N   3   $351.00   3/1/2004   12/31/2299
28299   2   HALLUX VALGUS (BUNION) CORRECTION; BY OTHER METHOD   N   3   $372.00   1/2/1992   12/31/2299
28299   7   HALLUX VALGUS (BUNION) CORRECTION; BY OTHER METHOD   N   3    $13.45   6/1/1994   12/31/2299
28299   F   HALLUX VALGUS (BUNION) CORRECTION; BY OTHER METHOD   N   3   $495.00   3/1/2004   12/31/2299
28300   2   OSTEOTOMY; CALCANEUS, WITH OR WITHOUT INTERNAL FIX   N   3   $237.50   1/1/1971   12/31/2299
28300   7   OSTEOTOMY; CALCANEUS, WITH OR WITHOUT INTERNAL FIX   N   3    $13.45   6/1/1994   12/31/2299
28300   8   OSTEOTOMY; CALCANEUS, WITH OR WITHOUT INTERNAL FIX   N   3    $45.00   1/1/1979   12/31/2299
28300   F   OSTEOTOMY; CALCANEUS, WITH OR WITHOUT INTERNAL FIX   N   3   $306.00   3/1/2004   12/31/2299
28302   2   OSTEOTOMY; TALUS                                     N   3   $225.00   1/1/1973   12/31/2299
28302   7   OSTEOTOMY; TALUS                                     N   3    $13.45   6/1/1994   12/31/2299
28302   F   OSTEOTOMY; TALUS                                     N   3   $306.00   3/1/2004   12/31/2299
28304   2   OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS O   N   3   $200.00   1/1/1973   12/31/2299
28304   7   OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS O   N   3    $13.45   6/1/1994   12/31/2299
28304   8   OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS O   N   3    $40.00   1/1/1984   12/31/2299
28304   F   OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS O   N   3   $306.00   3/1/2004   12/31/2299
28305   7   OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS O   N   3    $13.45   6/1/1994   12/31/2299
28305   F   OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS O   N   3   $351.00   3/1/2004   12/31/2299
28306   2   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3   $277.00   1/2/1992   12/31/2299
28306   7   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3    $13.45   6/1/1994   12/31/2299
28306   8   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3    $57.00   1/2/1994   12/31/2299
28306   F   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3   $432.00   3/1/2004   12/31/2299
28307   7   OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, WITH   N   3    $13.45   6/1/1994   12/31/2299
28307   F   OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, WITH   N   3   $432.00   3/1/2004   12/31/2299
28308   2   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3   $216.00   1/2/1992   12/31/2299
28308   7   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3    $13.45   6/1/1994   12/31/2299
28308   8   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3    $49.05   1/1/2005   12/31/2299
28308   F   OSTEOTOMY,METATARSAL,BASE OR SHAFT,SINGLE,FOR SHOR   N   3   $306.00   3/1/2004   12/31/2299
28309   2   OSTEOTOMY, METATARSALS, MULTIPLE, FOR CAVUS FOOT     N   3   $390.00   1/2/1994   12/31/2299
28309   7   OSTEOTOMY, METATARSALS, MULTIPLE, FOR CAVUS FOOT     N   3    $13.45   6/1/1994   12/31/2299
28309   F   OSTEOTOMY, METATARSALS, MULTIPLE, FOR CAVUS FOOT     N   3   $432.00   3/1/2004   12/31/2299
28310   2   OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CO   N   3   $214.00   1/2/1992   12/31/2299
28310   7   OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CO   N   3    $13.45   6/1/1994   12/31/2299
28310   F   OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CO   N   3   $351.00   3/1/2004   12/31/2299
28312   2   OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CO   N   3    $50.00   1/1/1973   12/31/2299




                                                                                                      103
28312   7   OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CO                  N   3    $13.45   6/1/1994   12/31/2299
28312   F   OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CO                  N   3   $351.00   3/1/2004   12/31/2299
28313   7   RECONSTRUCTION, ANGULAR DEFORMITY OF TOE (OVERLAPP                  N   3    $13.45   6/1/1994   12/31/2299
28313   F   RECONSTRUCTION, ANGULAR DEFORMITY OF TOE (OVERLAPP                  N   3   $306.00   3/1/2004   12/31/2299
28315   2   SESAMOIDECTOMY FIRST TOE (SEPARATE PROCEDURE)                       N   3   $120.00   1/1/1984   12/31/2299
28315   7   SESAMOIDECTOMY FIRST TOE (SEPARATE PROCEDURE)                       N   3    $13.45   6/1/1994   12/31/2299
28315   8   SESAMIODECTOMY FIRST TOE (SEPARATE PROCEDURE)                       N   3    $24.00   1/1/1984   12/31/2299
28315   F   SESAMOIDECTOMY FIRST TOE (SEPARATE PROCEDURE)                       N   3   $432.00   3/1/2004   12/31/2299
28320   2   REPAIR OF NONUNION OR MALUNION; TARSAL BONES                        N   3   $250.00   1/1/1973   12/31/2299
28320   7   REPAIR OF NONUNION OR MALUNION; TARSAL BONES                        N   3    $13.45   6/1/1994   12/31/2299
28320   8   REPAIR OF NONUNION OR MALUNION; TARSAL BONES                        N   3    $50.00   1/1/1973   12/31/2299
28320   F   REPAIR OF NONUNION OR MALUNION; TARSAL BONES                        N   3   $432.00   3/1/2004   12/31/2299
28322   2   REPAIR OF NONUNION OR MALUNION; METATARSAL, WITH O                  N   3   $120.00   1/1/1973   12/31/2299
28322   7   REPAIR OF NONUNION OR MALUNION; METATARSAL, WITH O                  N   3    $13.45   6/1/1994   12/31/2299
28322   8   REPAIR OF NONUNION OR MALUNION; METATARSAL, WITH O                  N   3    $24.00   1/1/1973   12/31/2299
28322   F   REPAIR OF NONUNION OR MALUNION; METATARSAL, WITH O                  N   3   $432.00   3/1/2004   12/31/2299
28340   7   RECONSTRUCTION, TOE, MACRODACTYLY                                   N   3    $13.45   6/1/1994   12/31/2299
28340   F   RECONSTRUCTION, TOE, MACRODACTYLY                                   N   3   $432.00   3/1/2004   12/31/2299
28341   7   RECONSTRUCTION, TOE, MACRODACTYLY                                   N   3    $13.45   6/1/1994   12/31/2299
28341   F   RECONSTRUCTION, TOE, MACRODACTYLY                                   N   3   $432.00   3/1/2004   12/31/2299
28344   2   RECONSTRUCTION, TOE(S)                                              N   3   $204.00   1/2/1995   12/31/2299
28344   7   RECONSTRUCTION, TOE(S)                                              N   3    $13.45   6/1/1994   12/31/2299
28344   8   RECONSTRUCTION, TOE(S)                                              N   3    $41.00   1/2/1995   12/31/2299
28344   F   RECONSTRUCTION, TOE(S)                                              N   3   $432.00   3/1/2004   12/31/2299
28345   2   RECONSTR TOE;SYNDACTYLY,W OR W/O SKIN GRAFT EA WEB                  N   3   $300.00   1/1/1984   12/31/2299
28345   7   RECONSTR TOE;SYNDACTYLY,W OR W/O SKIN GRAFT EA WEB                  N   3    $13.45   6/1/1994   12/31/2299
28345   8   RECONSTR TOE;SYNDACTYLY,W OR W/O SKIN GRAFT EA WEB                  N   3    $60.00   1/1/1984   12/31/2299
28345   F   RECONSTR TOE;SYNDACTYLY,W OR W/O SKIN GRAFT EA WEB                  N   3   $432.00   3/1/2004   12/31/2299
28360   7   RECONSTRUCTION, CLEFT FOOT                                          N   3    $13.45   6/1/1994   12/31/2299
28400   2   TREATMENT OF CLOSED CALCANEAL FRACTURE; WITHOUT MA                  N   3    $40.00   1/1/1979   12/31/2299
28400   7   TREATMENT OF CLOSED CALCANEAL FRACTURE; WITHOUT MA                  N   3    $13.45   6/1/1994   12/31/2299
28400   F   TREATMENT OF CLOSED CALCANEAL FRACTURE; WITHOUT MA                  N   3   $225.80   3/1/2004   12/31/2299
28405   2   TREATMENT OF CLOSED CALCANEAL FRACTURE;WITH MANIPU                  N   3   $216.00   1/2/1995   12/31/2299
28405   7   TREATMENT OF CLOSED CALCANEAL FRACTURE;WITH MANIPU                  N   3    $13.45   6/1/1994   12/31/2299
28405   F   TREATMENT OF CLOSED CALCANEAL FRACTURE;WITH MANIPU                  N   3   $306.00   3/1/2004   12/31/2299
28406   2   TREATMENT OF CLOSED CALCANEAL FRACTURE;WITH MANIPU                  N   3   $100.00   1/1/1984   12/31/2299
28406   7   ANESTHESIA,TREATMENT OF CLOSED CALCANEAL FRACTURE;WITH MANIPULATI   N   3    $13.45   1/1/1984   12/31/2299
28406   F   TREATMENT OF CLOSED CALCANEAL FRACTURE;WITH MANIPU                  N   3   $306.00   3/1/2004   12/31/2299
28415   2   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3   $576.00   1/2/1995   12/31/2299
28415   7   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3    $13.45   6/1/1994   12/31/2299
28415   8   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3    $50.00   1/1/1979   12/31/2299
28415   F   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3   $351.00   3/1/2004   12/31/2299
28420   2   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3   $370.00   1/1/1973   12/31/2299
28420   7   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3    $13.45   6/1/1994   12/31/2299
28420   8   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3    $70.00   1/1/1973   12/31/2299
28420   F   OPEN TREATMENT OF CLOSED OR OPEN CALCANEAL FRACTUR                  N   3   $432.00   3/1/2004   12/31/2299
28430   2   TREATMENT OF CLOSED TALUS FRACTURE; WITHOUT MANIPU                  N   3    $35.00   8/1/1979   12/31/2299
28430   7   TREATMENT OF CLOSED TALUS FRACTURE; WITHOUT MANIPU                  N   3    $13.45   6/1/1994   12/31/2299
28435   2   TREATMENT OF CLOSED TALUS FRACTURE; WITH MANIPULAT                  N   3    $75.00   1/1/1979   12/31/2299
28435   7   TREATMENT OF CLOSED TALUS FRACTURE; WITH MANIPULAT                  N   3    $13.45   6/1/1994   12/31/2299
28435   F   TREATMENT OF CLOSED TALUS FRACTURE; WITH MANIPULAT                  N   3   $306.00   3/1/2004   12/31/2299




                                                                                                                     104
28436   7   TREATMENT OF CLOSED TALUS FRACTURE                   N   3    $13.45   6/1/1994   12/31/2299
28436   F   TREATMENT OF CLOSED TALUS FRACTURE                   N   3   $306.00   3/1/2004   12/31/2299
28445   2   OPEN TREATMENT OF CLOSED OR OPEN TALUS FRACTURE, W   N   3   $250.00   1/1/1973   12/31/2299
28445   7   OPEN TREATMENT OF CLOSED OR OPEN TALUS FRACTURE, W   N   3    $13.45   6/1/1994   12/31/2299
28445   8   OPEN TREATMENT OF CLOSED OR OPEN TALUS FRACTURE, W   N   3    $50.00   1/1/1979   12/31/2299
28445   F   OPEN TREATMENT OF CLOSED OR OPEN TALUS FRACTURE, W   N   3   $351.00   3/1/2004   12/31/2299
28450   2   TREATMENT OF CLOSED TARSAL BONE FRACTURE (EXCEPT T   N   3    $35.00   1/1/1979   12/31/2299
28450   7   TREATMENT OF CLOSED TARSAL BONE FRACTURE (EXCEPT T   N   3    $13.45   6/1/1994   12/31/2299
28455   2   TREATMENT OF CLOSED TARSAL BONE FRACTURE (EXCEPT T   N   3    $50.00   1/1/1973   12/31/2299
28455   7   TREATMENT OF CLOSED TARSAL BONE FRACTURE (EXCEPT T   N   3    $13.45   6/1/1994   12/31/2299
28456   7   TREATMENT OF CLOSED TARSAL BONE FRACTURE (EXCEPT     N   3    $13.45   6/1/1994   12/31/2299
28456   F   TREATMENT OF CLOSED TARSAL BONE FRACTURE (EXCEPT     N   3   $306.00   3/1/2004   12/31/2299
28465   2   OPEN TREAT OF CLO OR OPEN TARSAL BONE FRAC(EX TALU   N   3   $150.00   1/1/1979   12/31/2299
28465   7   OPEN TREAT OF CLO OR OPEN TARSAL BONE FRAC(EX TALU   N   3    $13.45   6/1/1994   12/31/2299
28465   8   OPEN TREAT CLOS/OPEN TARSBONE FRAC INT/EXT SKEL FI   N   3    $60.00   1/1/1973   12/31/2299
28465   F   OPEN TREAT OF CLO OR OPEN TARSAL BONE FRAC(EX TALU   N   3   $351.00   3/1/2004   12/31/2299
28470   2   TREATMENT OF CLOSED METATARSAL FRACTURE; WITHOUT M   N   3    $90.00   1/2/1995   12/31/2299
28470   7   TREATMENT OF CLOSED METATARSAL FRACTURE; WITHOUT M   N   3    $13.45   6/1/1994   12/31/2299
28475   2   TREATMENT OF CLOSED METATARSAL FRACTURE; WITH MANI   N   3    $58.00   1/1/1979   12/31/2299
28475   7   TREATMENT OF CLOSED METATARSAL FRACTURE; WITH MANI   N   3    $13.45   6/1/1994   12/31/2299
28476   2   TREATMENT OF CLOSED METATARSAL FRACTURE              N   3   $226.91   1/1/2004   12/31/2299
28476   7   TREATMENT OF CLOSED METATARSAL FRACTURE              N   3    $13.45   6/1/1994   12/31/2299
28476   8   TREATMENT OF CLOSED METATARSAL FRACTURE              N   3    $45.38   1/1/2003   12/31/2299
28476   F   TREATMENT OF CLOSED METATARSAL FRACTURE              N   3   $306.00   3/1/2004   12/31/2299
28485   2   OPEN TREAT OF CLO OR OPEN METATARSAL FRAC,W OR W/O   N   3   $150.00   1/2/1994   12/31/2299
28485   7   OPEN TREAT OF CLO OR OPEN METATARSAL FRAC,W OR W/O   N   3    $13.45   6/1/1994   12/31/2299
28485   F   OPEN TREAT OF CLO OR OPEN METATARSAL FRAC,W OR W/O   N   3   $432.00   3/1/2004   12/31/2299
28490   2   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX OR   N   3    $15.00   1/1/1979   12/31/2299
28490   7   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX OR   N   3    $13.45   6/1/1994   12/31/2299
28495   2   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX OR   N   3    $25.00   1/1/1971   12/31/2299
28495   7   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX OR   N   3    $13.45   6/1/1994   12/31/2299
28496   2   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX      N   3   $142.59   9/1/2005   12/31/2299
28496   7   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX      N   3    $13.45   6/1/1994   12/31/2299
28496   F   TREATMENT OF CLOSED FRACTURE GREAT TOE, PHALANX      N   3   $306.00   3/1/2004   12/31/2299
28505   2   OPEN TREAT OF CLO OR OPEN FRAC GREAT TOE,PHALANX,P   N   3    $90.00   1/1/1979   12/31/2299
28505   7   OPEN TREAT OF CLO OR OPEN FRAC GREAT TOE,PHALANX,P   N   3    $13.45   6/1/1994   12/31/2299
28505   F   OPEN TREAT OF CLO OR OPEN FRAC GREAT TOE,PHALANX,P   N   3   $351.00   3/1/2004   12/31/2299
28510   2   TREAT OF CLOSED FRAC,PHALANX OR PHALANGES,OTHER TH   N   3    $15.00   1/1/1979   12/31/2299
28510   7   TREAT OF CLOSED FRAC,PHALANX OR PHALANGES,OTHER TH   N   3    $13.45   6/1/1994   12/31/2299
28515   2   TREAT OF CLOSED FRAC,PHALANX OR PHALANGES,OTHER TH   N   3    $22.00   1/1/1979   12/31/2299
28515   7   TREAT OF CLOSED FRAC,PHALANX OR PHALANGES,OTHER TH   N   3    $13.45   6/1/1994   12/31/2299
28525   2   OPEN TREAT OF CLO OR OPEN FRAC;WITH OR WITHOUT INT   N   3    $75.00   1/1/1973   12/31/2299
28525   7   OPEN TREAT OF CLO OR OPEN FRAC;WITH OR WITHOUT INT   N   3    $13.45   6/1/1994   12/31/2299
28525   F   OPEN TREAT OF CLO OR OPEN FRAC;WITH OR WITHOUT INT   N   3   $351.00   3/1/2004   12/31/2299
28530   7   TREATMENT OF CLOSED SESAMOID FRACTURE                N   3    $13.45   6/1/1994   12/31/2299
28531   2   OPEN TREATMENT OF SESAMOID FRACTURE, WITH OR WITHO   N   3    $79.70   1/1/1993   12/31/2299
28531   7   OPEN TRTMT OF SESAMOID FX W/OR WO ENTERNAL FIXATIO   N   3    $13.45   6/1/1994   12/31/2299
28531   F   OPEN TREATMENT OF SESAMOID FRACTURE, WITH OR WITHO   N   3   $351.00   3/1/2004   12/31/2299
28540   2   TREATMENT OF CLOSED TARSAL BONE DISLOCATION; WITHO   N   3    $40.00   1/1/1979   12/31/2299
28545   2   TREATMENT OF CLOSED TARSAL BONE DISLOCATION; REQUI   N   3    $50.00   1/1/1979   12/31/2299
28545   7   TREATMENT OF CLOSED TARSAL BONE DISLOCATION; REQUI   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                      105
28545   F   TREATMENT OF CLOSED TARSAL BONE DISLOCATION; REQUI   N   3   $225.80   3/1/2004   12/31/2299
28546   7   TREATMENT OF CLOSED TARSAL BONE DISLOCATION, WITH    N   3    $13.45   6/1/1994   12/31/2299
28546   F   TREATMENT OF CLOSED TARSAL BONE DISLOCATION, WITH    N   3   $306.00   3/1/2004   12/31/2299
28555   2   OPEN TREAT OF CLO OR OPEN TARSAL BONE DISLOCATION,   N   3   $150.00   8/1/1979   12/31/2299
28555   7   OPEN TREAT OF CLO OR OPEN TARSAL BONE DISLOCATION,   N   3    $13.45   6/1/1994   12/31/2299
28555   8   OPEN TREAT OF CLO OR OPEN TARSAL BONE DISLOCATION,   N   3    $30.00   1/1/1979   12/31/2299
28555   F   OPEN TREAT OF CLO OR OPEN TARSAL BONE DISLOCATION,   N   3   $306.00   3/1/2004   12/31/2299
28570   2   TREATMENT OF CLOSED TALOTARSAL JOINT DISLOCATION;    N   3    $45.00   1/1/1979   12/31/2299
28575   2   TREATMENT OF CLOSED TALOTARSAL JOINT DISLOCATION;    N   3    $60.00   1/1/1979   12/31/2299
28575   7   TREATMENT OF CLOSED TALOTARSAL JOINT DISLOCATION;    N   3    $13.45   6/1/1994   12/31/2299
28575   F   TREATMENT OF CLOSED TALOTARSAL JOINT DISLOCATION;    N   3   $225.80   3/1/2004   12/31/2299
28576   2   PERCUTANEOUS SKELETAL FIXATION OF TALOTARSAL JOINT   N   3   $130.87   1/1/1993   12/31/2299
28576   7   PERCUTANEOUS SLELETAL FIXATION OF TALOTARSAL JNT     N   3    $13.45   6/1/1994   12/31/2299
28576   F   PERCUTANEOUS SKELETAL FIXATION OF TALOTARSAL JOINT   N   3   $351.00   3/1/2004   12/31/2299
28585   2   OPEN TREAT OF CLO OR OPEN TALOTARSAL JOINT DISLO,W   N   3   $250.00   1/1/1973   12/31/2299
28585   7   OPEN TREAT OF CLO OR OPEN TALOTARSAL JOINT DISLO,W   N   3    $13.45   6/1/1994   12/31/2299
28585   8   OPEN TREAT OF CLO OR OPEN TALOTARSAL JOINT DISLO,W   N   3    $50.00   1/1/1979   12/31/2299
28585   F   OPEN TREAT OF CLO OR OPEN TALOTARSAL JOINT DISLO,W   N   3   $351.00   3/1/2004   12/31/2299
28600   2   TREATMENT OF CLOSED TARSOMETATARSAL JOINT DISLOCAT   N   3    $18.00   1/1/1979   12/31/2299
28605   2   TREATMENT OF CLOSED TARSOMETATARSAL JOINT DISLOCAT   N   3    $50.00   1/1/1979   12/31/2299
28605   7   TREATMENT OF CLOSED TARSOMETATARSAL JOINT DISLOCAT   N   3    $13.45   6/1/1994   12/31/2299
28605   F   TREATMENT OF CLOSED TARSOMETATARSAL JOINT DISLOCAT   N   3   $225.80   3/1/2004   12/31/2299
28606   7   TREAT OF CLOSED TARSOMETATARSAL JOINT DISLOCATION,   N   3    $13.45   6/1/1994   12/31/2299
28606   F   TREAT OF CLOSED TARSOMETATARSAL JOINT DISLOCATION,   N   3   $306.00   3/1/2004   12/31/2299
28615   2   OPEN TREAT OF CLO OR OPEN TARSOMETATARSAL DIS,W OR   N   3   $120.00   1/1/1973   12/31/2299
28615   7   OPEN TREAT OF CLO OR OPEN TARSOMETATARSAL DIS,W OR   N   3    $13.45   6/1/1994   12/31/2299
28615   8   OPEN TREAT OF CLO OR OPEN TARSOMETATARSAL DIS,W OR   N   3    $25.00   1/1/1979   12/31/2299
28615   F   OPEN TREAT OF CLO OR OPEN TARSOMETATARSAL DIS,W OR   N   3   $351.00   3/1/2004   12/31/2299
28630   2   TREAT OF CLOSED METATARSOPHALANGEAL JOINT DISLOCAT   N   3    $18.00   1/1/1979   12/31/2299
28635   2   TREAT OF CLOSED METATARSOPHALANGEAL JOINT DISLOCAT   N   3    $35.00   1/1/1979   12/31/2299
28635   7   TREAT OF CLOSED METATARSOPHALANGEAL JOINT DISLOCAT   N   3    $13.45   6/1/1994   12/31/2299
28635   F   TREAT OF CLOSED METATARSOPHALANGEAL JOINT DISLOCAT   N   3   $225.80   3/1/2004   12/31/2299
28636   2   PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANG   N   3   $106.31   1/1/1993   12/31/2299
28636   7   PERCUTANEOUS SKELETAL FIXATION METATARSOPHALANGEAL   N   3    $13.45   6/1/1994   12/31/2299
28636   F   PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANG   N   3   $351.00   3/1/2004   12/31/2299
28645   2   OPEN TREATMENT OF CLOSED OR OPEN METATARSOPHALANGE   N   3   $100.00   1/1/1973   12/31/2299
28645   7   OPEN TREATMENT OF CLOSED OR OPEN METATARSOPHALANGE   N   3    $13.45   6/1/1994   12/31/2299
28645   F   OPEN TREATMENT OF CLOSED OR OPEN METATARSOPHALANGE   N   3   $351.00   3/1/2004   12/31/2299
28660   2   TREATMENT OF CLOSED INTERPHALANGEAL JOINT DISLOCAT   N   3    $18.00   1/1/1979   12/31/2299
28665   2   TREATMENT OF CLOSED INTERPHALANGEAL JOINT DISLOCAT   N   3    $30.00   1/1/1979   12/31/2299
28665   7   TREATMENT OF CLOSED INTERPHALANGEAL JOINT DISLOCAT   N   3    $13.45   6/1/1994   12/31/2299
28665   F   TREATMENT OF CLOSED INTERPHALANGEAL JOINT DISLOCAT   N   3   $225.80   3/1/2004   12/31/2299
28666   2   PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL    N   3   $101.54   1/1/1993   12/31/2299
28666   7   PERCUTANEOUS SKELETAL FIXATION INTERPHALANGEAL JOI   N   3    $13.45   6/1/1994   12/31/2299
28666   F   PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL    N   3   $351.00   3/1/2004   12/31/2299
28675   2   OPERN RED INTER FRA                                  N   3    $60.00   1/1/1973   12/31/2299
28675   7   OPEN TREATMENT OF CLOSED OR OPEN INTERPHALANGEAL J   N   3    $13.45   6/1/1994   12/31/2299
28675   F   OPERN RED INTER FRA                                  N   3   $351.00   3/1/2004   12/31/2299
28705   2   PANTALAR ARTHRODESIS                                 N   3   $500.00   1/1/1979   12/31/2299
28705   7   PANTALAR ARTHRODESIS                                 N   3    $13.45   6/1/1994   12/31/2299
28705   8   PANTALAR ARTHRODESIS                                 N   3   $100.00   8/1/1979   12/31/2299




                                                                                                      106
28705   F   PANTALAR ARTHRODESIS                                 N   3   $432.00   3/1/2004   12/31/2299
28715   2   TRIPLE ARTHRODESIS                                   N   3   $498.00   1/2/1992   12/31/2299
28715   7   TRIPLE ARTHRODESIS                                   N   3    $13.45   6/1/1994   12/31/2299
28715   8   TRIPLE ARTHRODESIS                                   N   3    $68.00   8/1/1979   12/31/2299
28715   F   TRIPLE ARTHRODESIS                                   N   3   $432.00   3/1/2004   12/31/2299
28725   2   SUBTALAR ARTHRODESIS (INCLUDES GRICE TYPE PROCEDUR   N   3   $250.00   1/1/1979   12/31/2299
28725   7   SUBTALAR ARTHRODESIS (INCLUDES GRICE TYPE PROCEDUR   N   3    $13.45   6/1/1994   12/31/2299
28725   8   SUBTALAR ARTHRODESIS (INCLUDES GRICE TYPE PROCEDUR   N   3    $50.00   1/1/1974   12/31/2299
28725   F   SUBTALAR ARTHRODESIS (INCLUDES GRICE TYPE PROCEDUR   N   3   $432.00   3/1/2004   12/31/2299
28730   2   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPL   N   3   $200.00   1/1/1973   12/31/2299
28730   7   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPL   N   3    $13.45   6/1/1994   12/31/2299
28730   8   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPL   N   3    $40.00   1/1/1979   12/31/2299
28730   F   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPL   N   3   $432.00   3/1/2004   12/31/2299
28735   2   ARTHRODESIS,MIDTARSAL OR TARSOMETATARSAL,MULT OR T   N   3   $350.00   1/1/1979   12/31/2299
28735   7   ARTHRODESIS,MIDTARSAL OR TARSOMETATARSAL,MULT OR T   N   3    $13.45   6/1/1994   12/31/2299
28735   8   ARTHRODESIS,MIDTARSAL OR TARSOMETATARSAL,MULT OR T   N   3    $70.00   1/1/1973   12/31/2299
28735   F   ARTHRODESIS,MIDTARSAL OR TARSOMETATARSAL,MULT OR T   N   3   $432.00   3/1/2004   12/31/2299
28737   2   ARTHRODESIS,MIDTARSAL NAVICULAR-CUNEIFORM,WITH TEN   N   3   $433.05   1/1/2002   12/31/2299
28737   7   ARTHRODESIS,MIDTARSAL NAVICULAR-CUNEIFORM,WITH TEN   N   3    $13.45   6/1/1994   12/31/2299
28737   F   ARTHRODESIS,MIDTARSAL NAVICULAR-CUNEIFORM,WITH TEN   N   3   $495.00   3/1/2004   12/31/2299
28740   2   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE    N   3   $225.00   1/1/1973   12/31/2299
28740   7   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE    N   3    $13.45   6/1/1994   12/31/2299
28740   F   ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE    N   3   $432.00   3/1/2004   12/31/2299
28750   2   ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT    N   3   $180.00   1/2/1992   12/31/2299
28750   7   ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT    N   3    $13.45   6/1/1994   12/31/2299
28750   F   ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT    N   3   $432.00   3/1/2004   12/31/2299
28755   2   ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT        N   3   $100.00   1/1/1973   12/31/2299
28755   7   ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT        N   3    $13.45   6/1/1994   12/31/2299
28755   F   ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT        N   3   $432.00   3/1/2004   12/31/2299
28760   2   ARTHRODESIS,GREAT TOE,INTERPHALANGEAL JOINT,WITH E   N   3   $150.00   1/1/1979   12/31/2299
28760   7   ARTHRODESIS,GREAT TOE,INTERPHALANGEAL JOINT,WITH E   N   3    $13.45   6/1/1994   12/31/2299
28760   F   ARTHRODESIS,GREAT TOE,INTERPHALANGEAL JOINT,WITH E   N   3   $432.00   3/1/2004   12/31/2299
28800   2   AMPUTATION, FOOT; MIDTARSAL                          N   3   $250.00   1/1/1997   12/31/2299
28800   7   AMPUTATION, FOOT; MIDTARSAL                          N   3    $13.45   6/1/1994   12/31/2299
28800   8   AMPUTATION, FOOT; MIDTARSAL                          N   3    $50.00   1/1/1973   12/31/2299
28805   2   AMPUTATION, FOOT; TRANSMETATARSAL                    N   3   $250.00   1/1/1998   12/31/2299
28805   7   AMPUTATION, FOOT; TRANSMETATARSAL                    N   3    $13.45   6/1/1994   12/31/2299
28805   8   AMPUTATION, FOOT; TRANSMETATARSAL                    N   3    $50.00   1/1/1973   12/31/2299
28810   2   AMPUTATION, METATARSAL, WITH TOE, SINGLE             N   3   $150.00   1/1/1971   12/31/2299
28810   7   AMPUTATION, METATARSAL, WITH TOE, SINGLE             N   3    $13.45   6/1/1994   12/31/2299
28810   8   AMPUTATION, METATARSAL, WITH TOE, SINGLE             N   3    $30.00   1/1/1984   12/31/2299
28810   F   AMPUTATION, METATARSAL, WITH TOE, SINGLE             N   3   $306.00   3/1/2004   12/31/2299
28820   2   AMPUTATION, TOE; METATARSOPHALANGEAL JOINT           N   3    $75.00   1/1/1997   12/31/2299
28820   7   AMPUTATION, TOE; METATARSOPHALANGEAL JOINT           N   3    $13.45   6/1/1994   12/31/2299
28820   F   AMPUTATION, TOE; METATARSOPHALANGEAL JOINT           N   3   $306.00   3/1/2004   12/31/2299
28825   2   AMPUTATION, TOE; INTERPHALANGEAL JOINT               N   3    $50.00   1/1/1973   12/31/2299
28825   7   AMPUTATION, TOE; INTERPHALANGEAL JOINT               N   3    $13.45   6/1/1994   12/31/2299
28825   F   AMPUTATION, TOE; INTERPHALANGEAL JOINT               N   3   $306.00   3/1/2004   12/31/2299
28899   7   UNLISTED PROCEDURE, FOOT OR TOES                     N   3    $13.45   6/1/1994   12/31/2299
29000   2   APPLICATION OF HALO TYPE BODY CAST (SEE 20661-2066   N   3   $125.00   1/1/1971   12/31/2299
29000   7   APPLIC OF HALO TYPE BODY CAST                        N   3    $13.45   6/1/1994   12/31/2299




                                                                                                      107
29010   2   APPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONL   N   3   $65.00   8/1/1979   12/31/2299
29010   7   APPLIC RISSER JACKET LOCALIZER BODY ONLY             N   3   $13.45   6/1/1994   12/31/2299
29015   2   APPLICATION OF RISSER JACKET, LOCALIZER, BODY; INC   N   3   $90.00   1/1/1973   12/31/2299
29015   7   APPLIC RISSER JACK LOCAL BODY INCLUDING HEAD         N   3   $13.45   6/1/1994   12/31/2299
29020   2   APPLICATION OF TURNBUCKLE JACKET, BODY; ONLY         N   3   $75.00   1/1/1973   12/31/2299
29020   7   APPLIC TURNBUCKLE JACKET BODY ONLY                   N   3   $13.45   6/1/1994   12/31/2299
29025   2   APPLICATION OF TURNBUCKLE JACKET, BODY; INCLUDING    N   3   $90.00   1/1/1973   12/31/2299
29025   7   APPLIC TURNBUCKLE JACKET BODY INCLUD HEAD            N   3   $13.45   6/1/1994   12/31/2299
29035   2   APPLICATION OF BODY CAST, SHOULDER TO HIPS;          N   3   $93.60   1/2/1994   12/31/2299
29035   7   APPLIC BODY CAST SHOULDER TO HIPS                    N   3   $13.45   6/1/1994   12/31/2299
29040   2   APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUD   N   3   $55.00   1/1/1973   12/31/2299
29040   7   APPLIC BODY CAST SHOULDER TO HIP INC HEAD MINERVA    N   3   $13.45   6/1/1994   12/31/2299
29044   2   APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUD   N   3   $64.00   1/1/1971   12/31/2299
29044   7   APPLIC BODY CAST SHOULDER TO HIP WITH ONE THIGH      N   3   $13.45   6/1/1994   12/31/2299
29046   2   APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUD   N   3   $70.00   8/1/1979   12/31/2299
29046   7   APPLIC BODY CAST SHOULDER TO HIP WITH BOTH THIGHS    N   3   $13.45   6/1/1994   12/31/2299
29049   2   APPLICATION; PLASTER FIGURE OF EIGHT                 N   3   $15.00   1/1/2002   12/31/2299
29055   2   APPLICATION; SHOULDER SPICA                          N   3   $30.00   8/1/1979   12/31/2299
29055   7   APPLIC SHOULDER SPICA                                N   3   $13.45   6/1/1994   12/31/2299
29065   2   APPLICATION; SHOULDER TO HAND CAST                   N   3   $37.00   1/2/1998   12/31/2299
29075   2   APPLICATION; ELBOW TO FINGER - CASTING               N   3   $35.00   1/2/1997   12/31/2299
29085   2   APPLICATION; HAND AND LOWER FOREARM                  N   3   $15.00   1/1/1971   12/31/2299
29086   1   APPLICATION, CAST, FINGER (EG CONTRACTURE)           N   3   $32.65   1/1/2002   12/31/2299
29086   2   APPLICATION, CAST, FINGER (EG CONTRACTURE)           N   3   $32.65   1/1/2002   12/31/2299
29105   2   APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND)    N   3   $25.00   1/2/1994   12/31/2299
29125   2   APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND);   N   3   $18.00   1/2/1994   12/31/2299
29126   2   APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND);   N   3   $25.00   1/1/1984   12/31/2299
29130   2   APPLICATION OF FINGER SPLINT; STATIC                 N   3    $9.00   8/1/1979   12/31/2299
29131   2   FINGER SPLINT                                        N   3   $21.00   1/2/1994   12/31/2299
29200   2   STRAPPING; THORAX                                    N   3   $10.00   1/1/1971   12/31/2299
29220   2   STRAPPING; LOW BACK                                  N   3   $10.00   1/1/1971   12/31/2299
29240   2   STRAPPING; SHOULDER                                  N   3   $12.00   1/1/1973   12/31/2299
29260   2   STRAPPING; ELBOW OR WRIST                            N   3    $6.00   1/1/1971   12/31/2299
29280   2   STRAPPING; HAND OR FINGER                            N   3    $5.00   1/1/1984   12/31/2299
29305   2   APPLICATION OF HIP SPICA CAST; UNILATERAL            N   3   $60.00   1/1/1971   12/31/2299
29305   7   APPLICATION OF HIP SPICA CAST; UNILATERAL            N   3   $13.45   6/1/1994   12/31/2299
29325   2   APPLICATION OF HIP SPICA CAST; BILATERAL, OR ONE A   N   3   $75.00   8/1/1977   12/31/2299
29325   7   APPLIC HIP SPICA CAST BILAT/ONE-ONE HALF SPICA       N   3   $13.45   6/1/1994   12/31/2299
29345   2   APPLICATION OF LONG LEG CAST (THIGH TO TOES)         N   3   $26.00   1/1/1979   12/31/2299
29345   7   APPLICATION OF LONG LEG CAST (THIGH TO TOES)         N   3   $13.45   6/1/1994   12/31/2299
29355   2   APPLICATION OF LONG LEG CAST (THIGH TO TOES); WALK   N   3   $31.75   8/1/1979   12/31/2299
29356   8   FLEXOR TENDON REPAIR OR ADUANCE, SINGL, IN NO MAN'   N   3   $35.00   1/1/1984   12/31/2299
29358   2   APPLICATION OF LONG LEG CAST BRACE                   N   3   $75.00   1/1/1998   12/31/2299
29365   2   APPLICATION OF CYLINDER CAST (THIGH TO ANKLE)        N   3   $42.00   7/1/1994   12/31/2299
29405   2   APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES)   N   3   $19.00   1/1/1997   12/31/2299
29425   2   APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES)   N   3   $39.00   1/2/1992   12/31/2299
29435   2   APPLICATION OF PATELLAR TENDON BEARING (PTB) CAST    N   3   $55.00   1/1/1998   12/31/2299
29440   2   ADDING WALKER TO PREVIOUSLY APPLIED CAST             N   3    $3.00   1/1/1984   12/31/2299
29445   2   APPLICATION OF RIGID TOTAL CONTACT LEG CAST          N   3   $87.00   1/1/1995   12/31/2299
29450   2   APPL OF CLUBFOOT CAS W/MOLDING OR MANIPULATING       N   3   $33.60   7/1/1994   12/31/2299
29450   7   APPLIC CLUBFOOT CAST MOLD/MANIP LONG/SHORT LEG UNI   N   3   $13.45   6/1/1994   12/31/2299




                                                                                                     108
29505   2   APPLICATION OF LONG LEG SPLINT (THIGH TO ANKLE OR                   N   3    $15.00   1/1/1998   12/31/2299
29515   2   APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)                      N   3    $20.00   1/1/1996   12/31/2299
29520   2   STRAPPING; HIP                                                      N   3    $12.50   1/1/1973   12/31/2299
29530   2   STRAPPING; KNEE                                                     N   3     $9.00   1/1/1973   12/31/2299
29540   2   STRAPPING; ANKLE                                                    N   3    $10.95   1/2/1994   12/31/2299
29550   2   STRAPPING; TOES                                                     N   3     $5.00   1/2/1994   12/31/2299
29580   2   STRAPPING; UNNA BOOT                                                N   3    $30.00   1/2/1998   12/31/2299
29590   2   DENIS-BROWNE SPLINT STRAPPING                                       N   3    $10.00   1/1/1984   12/31/2299
29700   2   REMOVAL OR BIVALVING; GAUNTLET, BOOT OR BODY CAST                   N   3    $20.00   1/2/1992   12/31/2299
29705   2   REMOVAL OR BIVALVING; FULL ARM OR FULL LEG CAST                     N   3     $9.00   1/1/1984   12/31/2299
29705   7   REMOVAL OR BIVALVING FULL ARM OR FULL LEG                           N   3    $13.45   6/1/1994   12/31/2299
29710   2   REMOVAL OR BIVALVING; SHOULDER OR HIP SPICA, MINER                  N   3    $12.50   1/1/1973   12/31/2299
29710   7   REMOVAL OR BIVALVING; SHOULDER OR HIP SPICA, MINER                  N   3    $13.45   6/1/1994   12/31/2299
29715   2   REMOVAL OR BIVALVING; TURNBUCKLE JACKET                             N   3    $17.50   1/1/1973   12/31/2299
29720   2   REPAIR OF SPICA, BODY CAST OR JACKET                                N   3    $13.00   1/1/1971   12/31/2299
29730   2   WINDOWING OF CAST                                                   N   3     $6.00   1/1/1973   12/31/2299
29740   2   WEDGING OF CAST (EXCEPT CLUBFOOT CASTS)                             N   3     $7.50   1/1/1973   12/31/2299
29799   7   UNLISTED PROCEDURE, CASTING OR STRAPPING                            N   3    $13.45   6/1/1994   12/31/2299
29800   7   ARTHROSCOPY                                                         N   3    $13.45   6/1/1994   12/31/2299
29800   F   ARTHROSCOPY                                                         N   3   $351.00   3/1/2004   12/31/2299
29804   7   ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICAL                      N   3    $13.45   6/1/1994   12/31/2299
29804   F   ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICAL                      N   3   $351.00   3/1/2004   12/31/2299
29805   2   ARTHROSCOPY CHOULDER, DIAGNOSTIC WITH OR W/O SYNOVIAL BIOPSY        N   3   $213.27   1/1/2002   12/31/2299
29805   F   ARTHROSCOPY CHOULDER, DIAGNOSTIC WITH OR W/O SYNOVIAL BIOPSY        N   3   $351.00   3/1/2004   12/31/2299
29806   2   ARTHROXCOPY, SHOULDER, SURGICAL CAPSULORRHAPHY                      N   3   $597.22   1/2/2002   12/31/2299
29806   F   ARTHROXCOPY, SHOULDER, SURGICAL CAPSULORRHAPHY                      N   3   $351.00   3/1/2004   12/31/2299
29807   2   ARTHROSCOPY, SHOULDER, SURGICAL REPAIR OF SLAP LESION               N   3   $581.12   1/1/2002   12/31/2299
29807   F   ARTHROSCOPY, SHOULDER, SURGICAL REPAIR OF SLAP LESION               N   3   $351.00   3/1/2004   12/31/2299
29815   7   ARTHROSCOPY SHOULD DIAGNOSTIC W/WO BIOP SEPR PROCD                  N   3    $13.45   6/1/1994   12/31/2299
29819   2   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $349.67   1/1/2004   12/31/2299
29819   7   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3    $13.45   6/1/1994   12/31/2299
29819   F   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $351.00   3/1/2004   12/31/2299
29820   2   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $298.24   1/1/2003   12/31/2299
29820   7   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3    $13.45   6/1/1994   12/31/2299
29820   F   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $351.00   3/1/2004   12/31/2299
29821   7   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3    $13.45   6/1/1994   12/31/2299
29821   F   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $351.00   3/1/2004   12/31/2299
29822   2   ARTHROSCOPY SHLDR SURG W LMTD DEBRIDEMNT                            N   3   $125.00   1/1/1984   12/31/2299
29822   7   ANESTHESIA FOR ARTHROSCOPY SHOULDER SURGERY WITH LIMITED DEBRIDME   N   3    $13.45   1/1/1995   12/31/2299
29822   F   ARTHROSCOPY SHLDR SURG W LMTD DEBRIDEMNT                            N   3   $351.00   3/1/2004   12/31/2299
29823   2   ARTHROSCOPY SHLDR SURGICAL W EXTENSIVE DEBRIDEMENT                  N   3   $250.00   1/1/1984   12/31/2299
29823   7   ANESTHESIA, ARTHROSCOPY SHOULDER SURGICAL W/EXTENSIVE DEBRIDMENT    N   3    $13.45   1/1/1997   12/31/2299
29823   F   ARTHROSCOPY SHLDR SURGICAL W EXTENSIVE DEBRIDEMENT                  N   3   $351.00   3/1/2004   12/31/2299
29824   2   ARTHOSCOPY, SHOULDER SURGICAL DISTAL CLAVICULECTOMY INC DISTAL      N   3   $364.80   1/1/2002   12/31/2299
29824   F   ARTHOSCOPY, SHOULDER SURGICAL DISTAL CLAVICULECTOMY INC DISTAL      N   3   $495.00   3/1/2004   12/31/2299
29825   2   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $320.74   1/1/2004   12/31/2299
29825   7   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3    $13.45   6/1/1994   12/31/2299
29825   F   ARTHROSCOPY, SHOULDER, SURGICAL                                     N   3   $351.00   3/1/2004   12/31/2299
29826   2   DCMPRSSN SBCRML SP W PRTL ACRMPLSTY W/WO CRCRML RL                  N   3   $480.00   1/2/1993   12/31/2299
29826   7   DCMPRSSN SBCRML SP W PRTL ACRMPLSTY W/WO CRCRML RL                  N   3    $13.45   6/1/1994   12/31/2299
29826   8   DCMPRSSN SBCRML SP W PRTL ACRMPLSTY W/WO CRCRML RL                  N   3    $96.00   1/2/1993   12/31/2299




                                                                                                                     109
29826   F   DCMPRSSN SBCRML SP W PRTL ACRMPLSTY W/WO CRCRML RL                  N   3   $351.00   3/1/2004   12/31/2299
29827   2   ARTHROSCOPY SHOULDER SURG W/ROTATOR CUFF REPAIR                     N   3   $630.71   1/1/2003   12/31/2299
29827   4   ARTHROSCOPY SHOULDER SURG W/ ROTATOR CUFF REPAIR                    N   3   $630.71   1/1/2003   12/31/2299
29830   2   ARTHROSCOPY ELBW DIAGNOSTIC W/WO BIOP INDPT PROCDR                  N   3   $100.00   1/1/1984   12/31/2299
29830   7   ARTHROSCOPY ELBW DIAGNOSTIC W/WO BIOP INDPT PROCDR                  N   3    $13.45   6/1/1994   12/31/2299
29830   F   ARTHROSCOPY ELBW DIAGNOSTIC W/WO BIOP INDPT PROCDR                  N   3   $351.00   3/1/2004   12/31/2299
29834   2   ARTHROSCOPY ELBOW SURG W RMVL LS BDY FOR BDY                        N   3   $150.00   1/1/1984   12/31/2299
29834   7   ANESTHESIA,ARTHROSCOPY ELBOW SURG. W/REMOV.LS BDY FOR BDY           N   3    $13.45   1/1/1998   12/31/2299
29834   F   ARTHROSCOPY ELBOW SURG W RMVL LS BDY FOR BDY                        N   3   $351.00   3/1/2004   12/31/2299
29835   7   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29835   F   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29836   2   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3   $318.67   1/1/2003   12/31/2299
29836   7   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29836   F   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29837   2   ARTHROSCOPY-ELBOW/DEBRIDEMENT LIMITED                               N   3   $175.00   1/1/1984   12/31/2299
29837   7   ARTHROSCOPY-ELBOW/DEBRIDEMENT LIMITED                               N   3    $13.45   6/1/1994   12/31/2299
29837   F   ARTHROSCOPY-ELBOW/DEBRIDEMENT LIMITED                               N   3   $351.00   3/1/2004   12/31/2299
29838   7   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29838   F   ARTHROSCOPY, ELBOW, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29840   2   ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SY                  N   3   $268.00   1/1/2005   12/31/2299
29840   7   ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SY                  N   3    $13.45   6/1/1994   12/31/2299
29840   F   ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SY                  N   3   $351.00   3/1/2004   12/31/2299
29843   2   ARTHROSCOPY, WRIST, SURGICAL                                        N   3   $259.74   1/1/2004   12/31/2299
29843   7   ARTHROSCOPY, WRIST, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29843   F   ARTHROSCOPY, WRIST, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29844   2   ARTHROSCOPY, WRIST, SURGICAL                                        N   3   $240.00   1/2/1992   12/31/2299
29844   7   ARTHROSCOPY, WRIST, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29844   F   ARTHROSCOPY, WRIST, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29845   7   ARTHROSCOPY, WRIST, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29845   F   ARTHROSCOPY, WRIST, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29846   2   ARTHRSCPY EXCSN TRNGLR FBRCRTLGE / JNT DBRDMNT                      N   3   $200.00   1/1/1989   12/31/2299
29846   7   ARTHRSCPY EXCSN TRNGLR FBRCRTLGE / JNT DBRDMNT                      N   3    $13.45   6/1/1994   12/31/2299
29846   F   ARTHRSCPY EXCSN TRNGLR FBRCRTLGE / JNT DBRDMNT                      N   3   $351.00   3/1/2004   12/31/2299
29847   7   ARTHROSCOPY, WRIST, SURGICAL                                        N   3    $13.45   6/1/1994   12/31/2299
29847   F   ARTHROSCOPY, WRIST, SURGICAL                                        N   3   $351.00   3/1/2004   12/31/2299
29848   2   ARTHROSCOPY, WRIST, SURGICAL;                                       N   3   $228.00   1/2/1997   12/31/2299
29848   7   ARTHROSCOPY, WRIST, SURGICAL;                                       N   3    $13.45   6/1/1994   12/31/2299
29848   F   ARTHROSCOPY, WRIST, SURGICAL;                                       N   3   $495.00   3/1/2004   12/31/2299
29850   2   ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR                   N   3   $388.63   1/1/1993   12/31/2299
29850   7   ARTHPOSCOPICALLY AIDED TRTMT OF INTERCONDYLAR SPIN                  N   3    $13.45   6/1/1994   12/31/2299
29850   F   ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR                   N   3   $432.00   3/1/2004   12/31/2299
29851   2   ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR                   N   3   $472.01   1/1/1993   12/31/2299
29851   7   ARTHROSCOPICALLY AIDED TRTMT OF INTER SPINE W/EXT                   N   3    $13.45   6/1/1994   12/31/2299
29851   F   ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR                   N   3   $432.00   3/1/2004   12/31/2299
29855   2   ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTUR                  N   3   $433.75   1/1/1993   12/31/2299
29855   7   ARTHROSCOPICALLY AIDED TRTMT OF TIBIAL FX PROXIMAL                  N   3    $13.45   6/1/1994   12/31/2299
29855   F   ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTUR                  N   3   $432.00   3/1/2004   12/31/2299
29856   2   ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTUR                  N   3   $505.52   1/1/1993   12/31/2299
29856   7   ARTHROSCOP AIDED TRTMT OF TIBIAL FX PROXIMAL BIOCO                  N   3    $13.45   6/1/1994   12/31/2299
29856   F   ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTUR                  N   3   $432.00   3/1/2004   12/31/2299
29860   2   ARTHROSCOPY,HIP,DIAGNOSTIC;W/WO SYNOVIAL BIOPSY(SEPARATE PROCEDUR   N   3   $286.85   1/1/1998   12/31/2299




                                                                                                                     110
29860   7   ARTHROSCOPY,HIP,DIAG.;W/WO SYNOVIAL BIOPSY (SEPARATE PROCEDURE)     N   3      $13.45   1/1/1998   12/31/2299
29860   8   ARTHROSCOPY,HIP,DIAG.;W/WO SYNOVIAL BIOPSY (SEPARATE PROCEDURE)     N   3      $57.38   1/1/1998   12/31/2299
29860   F   ARTHROSCOPY,HIP,DIAGNOSTIC;W/WO SYNOVIAL BIOPSY(SEPARATE PROCEDUR   N   3    $432.00    3/1/2004   12/31/2299
29861   2   ARTHROSCOPY,HIP,SURGICAL;WITH REMOVAL LOOSE OR FOREIGN BODY         N   3    $432.73    1/1/1998   12/31/2299
29861   7   ARTHROSCOPY,HIP,SURGICAL;W/REMOVAL LOOSE OR FOREIGN BODY            N   3      $13.45   1/1/1998   12/31/2299
29861   8   ARTHROSCOPY,HIP,SURGICAL;W/REMOVAL OF LOOSE/FOREIGN BODY            N   3      $86.54   1/1/1998   12/31/2299
29861   F   ARTHROSCOPY,HIP,SURGICAL;WITH REMOVAL LOOSE OR FOREIGN BODY         N   3    $432.00    3/1/2004   12/31/2299
29862   2   ARTHROSCOPY,HIP,SURGICAL;W/DEBRIDE/SHAVING ARTICULAR CARTILAGE      N   3    $475.92    1/1/1998   12/31/2299
29862   8   ARTHORSCOPY,HIP,SURGICAL;W/DEBRIDE/SHAVING ARTICULAR CARTILAGE      N   3      $95.18   1/1/1998   12/31/2299
29862   F   ARTHROSCOPY,HIP,SURGICAL;W/DEBRIDE/SHAVING ARTICULAR CARTILAGE      N   3    $495.00    3/1/2004   12/31/2299
29863   2   ARTHROSCOPY,HIP,SURGICAL;W/SYNOVECTOMY                              N   3    $432.66    1/1/1998   12/31/2299
29863   7   ARTHROSCOPY,HIP,SURGICAL;W/DEBRIDE/SHAVING,ARTICULAR CARTILAGE      N   3      $13.45   1/1/1998   12/31/2299
29863   8   ARTHROSCOPY,HIP,SURGICAL;W/SYNOVECTOMY                              N   3      $86.54   1/1/1998   12/31/2299
29863   F   ARTHROSCOPY,HIP,SURGICAL;W/SYNOVECTOMY                              N   3    $432.00    3/1/2004   12/31/2299
29866   2   ARTHROSCOPY KNEE SURGICAL OSTEOCHAONDRAL AUTOGRAFTS                 Y   3    $632.15    1/1/2005   12/31/2299
29866   7   ARTHROSCOPY KNEE SURGICAL OSTEOCHONDRAL AUTOGRA                     Y   3      $13.45   1/1/2005   12/31/2299
29867   2   ARTHROSCOPY KNEE SURGICAL OSTEOCHONDRAL ALLOGRAFT                   Y   3    $754.99    1/1/2005   12/31/2299
29867   7   ARTHROSCOPY KNEE SURGICAL OSTEOCHONDRAL ALLOGRAFT                   N   3      $13.45   1/1/2005   12/31/2299
29868   2   ARTHROSCOPY KNEE SURGICAL MENISCAL TRANSPLANTATION                  N   3   $1,022.00   1/1/2005   12/31/2299
29868   7   ARTHROSCOPY,KNEE,SURGICAL,MENSICAL TRANSPL                          N   3      $13.45   1/1/2005   12/31/2299
29870   2   ARTHROSCOPY KNEE DIAGNOSTIC W/WO BIOP SEP PROCEDUR                  N   3    $196.00    1/2/1993   12/31/2299
29870   7   ARTHROSCOPY KNEE DIAGNOSTIC W/WO BIOP SEP PROCEDUR                  N   3      $13.45   6/1/1994   12/31/2299
29870   F   ARTHROSCOPY KNEE DIAGNOSTIC W/WO BIOP SEP PROCEDUR                  N   3    $351.00    3/1/2004   12/31/2299
29871   2   ARTHROSCOPY KNEE SURG FOR INFCTN LVGE DRAINAGE                      N   3    $100.00    1/1/1984   12/31/2299
29871   7   ARTHROSCOPY KNEE SURG FOR INFCTN LVGE DRAINAGE                      N   3      $13.45   6/1/1994   12/31/2299
29871   F   ARTHROSCOPY KNEE SURG FOR INFCTN LVGE DRAINAGE                      N   3    $351.00    3/1/2004   12/31/2299
29873   2   ARTHOSCOPY KNEE SURG W/LATERAL RELEASE                              N   3    $293.00    1/1/2003   12/31/2299
29873   4   ARTHROSCOPY KNEE SURG W/ LATERAL RELEASE                            N   3    $293.00    1/1/2003   12/31/2299
29874   2   ARTHRSCPY KNE FOR REMUL LOOSE BDY OR F.B.                           N   3    $354.00    1/2/1992   12/31/2299
29874   7   ARTHRSCPY KNE FOR REMUL LOOSE BDY OR F.B.                           N   3      $13.45   6/1/1994   12/31/2299
29874   8   ARTHRSCPY KNE FOR REMUL LOOSE BOY OR FB                             N   3      $70.80   1/2/1992   12/31/2299
29874   F   ARTHRSCPY KNE FOR REMUL LOOSE BDY OR F.B.                           N   3    $351.00    3/1/2004   12/31/2299
29875   2   ARTHROTOMY KNEE SYNOVECTOMY LIMTD EG PLICA                          N   3    $425.00    1/1/1989   12/31/2299
29875   7   ARTHROSCOPY KNEE W SYNOVECTMY LMTD EG PLICA                         N   3      $13.45   6/1/1994   12/31/2299
29875   F   ARTHROTOMY KNEE SYNOVECTOMY LIMTD EG PLICA                          N   3    $432.00    3/1/2004   12/31/2299
29876   2   ARTHROSCOPY KNEE W SYNOVECTOMY MJR TWO OR MO CMPTS                  N   3    $150.00    1/1/1984   12/31/2299
29876   7   ARTHROSCOPY KNEE W SYNOVECTOMY MJR TWO OR MO CMPTS                  N   3      $13.45   6/1/1994   12/31/2299
29876   F   ARTHROSCOPY KNEE W SYNOVECTOMY MJR TWO OR MO CMPTS                  N   3    $432.00    3/1/2004   12/31/2299
29877   2   ARTHROSCOPY DEBRIDEMENT 1 SHAVING CHONDROPLASTY KN                  N   3    $376.60    1/2/1992   12/31/2299
29877   7   ARTHROSCOPY DEBRIDEMENT 1 SHAVING CHONDROPLASTY KN                  N   3      $13.45   6/1/1994   12/31/2299
29877   8   ARTHROSCOPY DEBRIDEMENT 1 SHAVING CHONDROPLASTY KN                  N   3      $50.00   1/1/1984   12/31/2299
29877   F   ARTHROSCOPY DEBRIDEMENT 1 SHAVING CHONDROPLASTY KN                  N   3    $432.00    3/1/2004   12/31/2299
29879   2   ARTHRSCPY KNEE SURG ABRSN ARTRPLAST CHNDPLAST DRIL                  N   3    $366.00    1/2/1992   12/31/2299
29879   F   ARTHRSCPY KNEE SURG ABRSN ARTRPLAST CHNDPLAST DRIL                  N   3    $351.00    3/1/2004   12/31/2299
29880   2   ABRASION ARTHROPLASTY/WITH MANISCETOMY                              N   3    $500.00    1/1/1989   12/31/2299
29880   7   ABRASION ARTHROPLASTY/WITH MANISCETOMY                              N   3      $13.45   6/1/1994   12/31/2299
29880   F   ABRASION ARTHROPLASTY/WITH MANISCETOMY                              N   3    $432.00    3/1/2004   12/31/2299
29881   2   ARTHROSCOPY KNEE W MENISECTOMY INCL SHAVING                         N   3    $462.00    1/2/1996   12/31/2299
29881   7   ARTHROSCOPY KNEE W MENISECTOMY INCL SHAVING                         N   3      $13.45   6/1/1994   12/31/2299
29881   8   ARTHROSCOPY KNEE W/MENISECTOMY INC SHAVING                          N   3      $92.00   1/2/1996   12/31/2299
29881   F   ARTHROSCOPY KNEE W MENISECTOMY INCL SHAVING                         N   3    $432.00    3/1/2004   12/31/2299




                                                                                                                       111
29882   2   ARTHROSCOPY KNEE SURG W MENISCUS REPAIR M OR LAT                    N   3   $495.00   1/2/1994   12/31/2299
29882   7   ARTRSCPY KNE SURG W MEISC RPR MED OR LAT                            N   3    $13.45   6/1/1994   12/31/2299
29882   8   ARTHROSCOPY KNEE SURGERY W/MENISCUS REPAIR MEDIAL OR LATERAL        N   3    $85.00   1/2/1994   12/31/2299
29882   F   ARTHROSCOPY KNEE SURG W MENISCUS REPAIR M OR LAT                    N   3   $351.00   3/1/2004   12/31/2299
29883   2   ARTHROSCOPY, KNEE, SURGICAL                                         N   3   $493.20   1/1/2003   12/31/2299
29883   7   ARTHROSCOPY, KNEE, SURGICAL                                         N   3    $13.45   6/1/1994   12/31/2299
29883   F   ARTHROSCOPY, KNEE, SURGICAL                                         N   3   $351.00   3/1/2004   12/31/2299
29884   2   ARTHROSCOPY KNEE SURG W LYSIS ADNSNS W WO MANIP SP                  N   3   $125.00   1/1/1984   12/31/2299
29884   F   ARTHROSCOPY KNEE SURG W LYSIS ADNSNS W WO MANIP SP                  N   3   $351.00   3/1/2004   12/31/2299
29885   2   ARTHROSCOPY, KNEE, SURGICAL                                         N   3   $342.00   1/2/1992   12/31/2299
29885   7   ARTHROSCOPY, KNEE, SURGICAL                                         N   3    $13.45   6/1/1994   12/31/2299
29885   F   ARTHROSCOPY, KNEE, SURGICAL                                         N   3   $351.00   3/1/2004   12/31/2299
29886   2   ARTHROSCOPY KNEE SURG DRLLNG FOR INTCT OSTECHNDRTS                  N   3   $282.00   1/2/1993   12/31/2299
29886   7   ARTHROSCOPY KNEE SURG DRLLNG FOR INTCT OSTERCHNDRT                  N   3    $13.45   6/1/1994   12/31/2299
29886   F   ARTHROSCOPY KNEE SURG DRLLNG FOR INTCT OSTECHNDRTS                  N   3   $351.00   3/1/2004   12/31/2299
29887   2   ARTHROSCOPY KNEE SURG W DRLLNG FOR OST DESI INT FX                  N   3   $390.00   1/2/1993   12/31/2299
29887   F   ARTHROSCOPY KNEE SURG W DRLLNG FOR OST DESI INT FX                  N   3   $351.00   3/1/2004   12/31/2299
29888   2   ARTHROSCOPICALLT AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTA   N   3   $780.00   1/2/1994   12/31/2299
29888   7   RTHRSCPCLLY ADD NTRR CRCT LGMNT RPR/AGMNTTN OR REC                  N   3    $13.45   6/1/1994   12/31/2299
29888   8   ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTA   N   3   $156.00   1/2/1994   12/31/2299
29888   F   ARTHROSCOPICALLT AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTA   N   3   $351.00   3/1/2004   12/31/2299
29889   2   ARTHROSCOPICALLY AIDED POST CRUCIATE LIGAMENT REP                   N   3   $350.00   1/1/1984   12/31/2299
29889   7   ARTHROSCOPICALLY AIDED POST CRUCIATE LIGAMENT REP                   N   3    $13.45   6/1/1994   12/31/2299
29889   8   ARTHROSCOPICALLY AIDED POST CRUCIATE LIGAMENT REP                   N   3    $70.00   1/1/1984   12/31/2299
29889   F   ARTHROSCOPICALLY AIDED POST CRUCIATE LIGAMENT REP                   N   3   $351.00   3/1/2004   12/31/2299
29891   2   ARTHROSCOPY,ANKLE,SURG;EXCISION OF OSTEOCHONDRAL/INC.DRILL DEFECT   N   3   $406.78   1/1/1998   12/31/2299
29891   7   ARTHROSCOPY,ANKLE,SURG;EXCISION OF OSTEOCHONDRAL/INC.DRILL DEFECT   N   3    $13.45   1/1/1998   12/31/2299
29891   8   ARTHROSCOPY,ANKLE,SURG;EXCISION OF OSTEOCHONDRAL;INC.DRILL DEFECT   N   3    $81.36   1/1/1998   12/31/2299
29891   F   ARTHROSCOPY,ANKLE,SURG;EXCISION OF OSTEOCHONDRAL/INC.DRILL DEFECT   N   3   $351.00   3/1/2004   12/31/2299
29892   2   ARTHROSCOPICALLY REPAIR LG.OSTEOCHONDRITIS DISSECANS LESION         N   3   $418.75   1/1/1998   12/31/2299
29892   7   ARTHORSCOPICALLY REPAIR LG OSTEOCHONDRITIS DISSECANS LESION         N   3    $13.45   1/1/1998   12/31/2299
29892   8   ARTHROSCOPICALLY REPAIR LG.OSTEOCHONDRITIS DISSECANS LESION         N   3    $83.76   1/1/1998   12/31/2299
29892   F   ARTHROSCOPICALLY REPAIR LG.OSTEOCHONDRITIS DISSECANS LESION         N   3   $351.00   3/1/2004   12/31/2299
29893   2   ENDOSCOPIC PLANTAR FASIOTOMY                                        N   3   $232.23   1/1/1998   12/31/2299
29893   7   ENDOSCOPIC PLANTAR FASCIOTOMY                                       N   3    $13.45   1/1/1998   12/31/2299
29893   8   ENDOSCOPIC PLANTAR FASCIATOMY                                       N   3    $46.44   1/1/1998   12/31/2299
29893   F   ENDOSCOPIC PLANTAR FASIOTOMY                                        N   3   $495.00   3/1/2004   12/31/2299
29894   2   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3   $420.00   1/2/1995   12/31/2299
29894   7   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3    $13.45   6/1/1994   12/31/2299
29894   8   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3    $84.00   1/2/1995   12/31/2299
29894   F   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3   $351.00   3/1/2004   12/31/2299
29895   2   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3   $360.00   1/2/1992   12/31/2299
29895   7   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3    $13.45   6/1/1994   12/31/2299
29895   8   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3    $55.87   1/1/2003   12/31/2299
29895   F   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3   $351.00   3/1/2004   12/31/2299
29897   2   ARTHROSCOPY/SURGICAL/ANKLE                                          N   3   $425.00   1/1/1984   12/31/2299
29897   7   ARTHROSCOPY/SURGICAL/ANKLE                                          N   3    $13.45   1/1/1994   12/31/2299
29897   8   ARTHROSCOPY/SURGICAL/ANKLE - ASSISTANT                              N   3    $86.00   1/2/1994   12/31/2299
29897   F   ARTHROSCOPY/SURGICAL/ANKLE                                          N   3   $351.00   3/1/2004   12/31/2299
29898   2   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3   $425.00   1/2/1992   12/31/2299
29898   7   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     112
29898   F   ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOI                 N   3   $351.00   3/1/2004   12/31/2299
29899   2   ARTHROSCOPY ANKLE(TIBIOTALAR&FIBULOTALAR JOINTS)SURG               N   3   $578.74   1/1/2003   12/31/2299
29899   4   ARTHROSCOPY ANKLE(TIBIOTALAR&FIBULOTALAR JOINTS)SURG               N   3   $578.74   1/1/2003   12/31/2299
29900   2   ARTHROXCOPY METACARPOPHALANGEAL JOINT, DIAG, INC SYNOVIAL BIOPSY   N   3   $259.98   1/1/2002   12/31/2299
29900   F   ARTHROXCOPY METACARPOPHALANGEAL JOINT, DIAG, INC SYNOVIAL BIOPSY   N   3   $351.00   3/1/2004   12/31/2299
29901   2   ARTHROXCOPY METARPOPHALANGEAL JOINT SURGICAL, WITH DEBRIDEMENT     N   3   $286.28   1/1/2002   12/31/2299
29901   F   ARTHROXCOPY METARPOPHALANGEAL JOINT SURGICAL, WITH DEBRIDEMENT     N   3   $351.00   3/1/2004   12/31/2299
29902   2   ARTHROXCOPY METACARPOPHALANGEAL JOINT, SURGICAL, WITH REDUCTION    N   3   $307.08   1/1/2002   12/31/2299
29902   F   ARTHROXCOPY METACARPOPHALANGEAL JOINT, SURGICAL, WITH REDUCTION    N   3   $351.00   3/1/2004   12/31/2299
29909   7   UNLISTED PROC ARTHROSCOPY                                          N   3    $13.45   6/1/1994   12/31/2299
30000   2   DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPR                 N   3    $39.00   1/2/1992   12/31/2299
30000   7   DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPR                 N   3    $13.45   6/1/1994   12/31/2299
30020   2   DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM                         N   3    $39.00   1/2/1992   12/31/2299
30020   7   DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM                         N   3    $13.45   6/1/1994   12/31/2299
30100   2   BIOPSY, INTRANASAL                                                 N   3    $26.00   1/2/1992   12/31/2299
30100   7   BIOPSY, INTRANASAL                                                 N   3    $13.45   6/1/1994   12/31/2299
30110   2   EXCISION, NASAL POLYP(S), SIMPLE; UNILATERAL                       N   3    $55.00   1/2/1992   12/31/2299
30110   7   EXCISION, NASAL POLYP(S), SIMPLE; UNILATERAL                       N   3    $13.45   6/1/1994   12/31/2299
30115   2   EXCISION, NASAL POLYP(S), EXTENSIVE, UNILAT                        N   3   $106.00   1/2/1992   12/31/2299
30115   7   EXCISION, NASAL POLYP(S), EXTENSIVE; UNILATERAL                    N   3    $13.45   6/1/1994   12/31/2299
30115   F   EXCISION, NASAL POLYP(S), EXTENSIVE, UNILAT                        N   3   $306.00   3/1/2004   12/31/2299
30117   2   EXCISION, INTRANASAL LESION; INTERNAL APPROACH                     N   3   $112.00   1/2/1992   12/31/2299
30117   7   EXCISION, INTRANASAL LESION; INTERNAL APPROACH                     N   3    $13.45   6/1/1994   12/31/2299
30117   F   EXCISION, INTRANASAL LESION; INTERNAL APPROACH                     N   3   $351.00   3/1/2004   12/31/2299
30118   2   EXCISION, INTRANASAL LESION; EXTERNAL APPROACH                     N   3   $248.00   1/2/1992   12/31/2299
30118   7   EXCISION, INTRANASAL LESION; EXTERNAL APPROACH                     N   3    $13.45   6/1/1994   12/31/2299
30118   F   EXCISION, INTRANASAL LESION; EXTERNAL APPROACH                     N   3   $351.00   3/1/2004   12/31/2299
30120   2   EXCISION OR SURGICAL PLANING OF SKIN OF NOSE FOR R                 N   3   $246.00   1/2/1992   12/31/2299
30120   7   EXCISION OR SURGICAL PLANING OF SKIN OF NOSE FOR R                 N   3    $13.45   6/1/1994   12/31/2299
30120   F   EXCISION OR SURGICAL PLANING OF SKIN OF NOSE FOR R                 N   3   $225.80   3/1/2004   12/31/2299
30124   2   EXCISION DERMOID CYST, NOSE; SIMPLE, SKIN, SUBCUTA                 N   3    $84.00   1/2/1992   12/31/2299
30125   2   EXCISION DERMOID CYST, NOSE; COMPLEX, UNDER BONE O                 N   3   $246.00   1/2/1992   12/31/2299
30125   7   EXCISION DERMOID CYST, NOSE; COMPLEX, UNDER BONE O                 N   3    $13.45   6/1/1994   12/31/2299
30125   F   EXCISION DERMOID CYST, NOSE; COMPLEX, UNDER BONE O                 N   3   $306.00   3/1/2004   12/31/2299
30130   2   EXCISION TURBINATE, PARTIAL OR COMPLETE                            N   3    $50.00   1/1/1998   12/31/2299
30130   7   EXCISION TURBINATE, PARTIAL OR COMPLETE                            N   3    $13.45   6/1/1994   12/31/2299
30130   F   EXCISION TURBINATE, PARTIAL OR COMPLETE                            N   3   $351.00   3/1/2004   12/31/2299
30140   2   SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE                 N   3   $144.60   1/2/1992   12/31/2299
30140   7   SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE                 N   3    $13.45   6/1/1994   12/31/2299
30140   F   SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE                 N   3   $306.00   3/1/2004   12/31/2299
30150   2   RHINECTOMY; PARTIAL                                                N   3   $330.00   1/2/1992   12/31/2299
30150   7   RHINECTOMY; PARTIAL                                                N   3    $13.45   6/1/1994   12/31/2299
30150   F   RHINECTOMY; PARTIAL                                                N   3   $351.00   3/1/2004   12/31/2299
30160   2   RHINECTOMY; TOTAL                                                  N   3   $436.00   1/2/1992   12/31/2299
30160   7   RHINECTOMY; TOTAL                                                  N   3    $13.45   6/1/1994   12/31/2299
30160   8   RHINECTOMY; TOTAL                                                  N   3    $50.00   1/1/1984   12/31/2299
30160   F   RHINECTOMY; TOTAL                                                  N   3   $432.00   3/1/2004   12/31/2299
30200   2   INJECTION INTO TURBINATE(S), THERAPEUTIC                           N   3    $23.00   1/2/1992   12/31/2299
30210   2   DISPLACEMENT THERAPY (PROETZ TYPE)                                 N   3    $25.00   1/2/1992   12/31/2299
30220   2   INSERTION NASAL SEPTAL PROSTHESIS(BUTTON)                          N   3    $60.00   1/2/1992   12/31/2299
30220   7   INSERTION NASAL SEPTAL PROSTHESIS(BUTTON)                          N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                    113
30230   7   ENDOSCOPY                                                           N   3    $13.45   6/1/1994   12/31/2299
30300   2   REMOVAL FOREIGN BODY, INTRANASAL; OFFICE TYPE PROC                  N   3    $16.00   1/2/1992   12/31/2299
30310   2   REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERA                  N   3    $70.00   1/2/1992   12/31/2299
30310   7   REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERA                  N   3    $13.45   6/1/1994   12/31/2299
30310   F   REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERA                  N   3   $225.80   3/1/2004   12/31/2299
30320   2   REMOVAL FOREIGN BODY, INTRANASAL; BY LATERAL RHINO                  N   3   $173.00   1/2/1992   12/31/2299
30320   7   REMOVAL FOREIGN BODY, INTRANASAL; BY LATERAL RHINO                  N   3    $13.45   6/1/1994   12/31/2299
30320   F   REMOVAL FOREIGN BODY, INTRANASAL; BY LATERAL RHINO                  N   3   $306.00   3/1/2004   12/31/2299
30400   2   RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES                   N   3   $450.34   1/1/2004   12/31/2299
30400   7   RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES                   N   3    $13.45   6/1/1994   12/31/2299
30400   F   RHINOPLASTY, PRIMARY; LATERAL AND ALAR CARTILAGES                   N   3   $432.00   3/1/2004   12/31/2299
30410   2   RHINOPLASTY, PRIMARY; COMPLETE, EXT INCL BONY PYRA                  N   3   $508.59   1/1/2004   12/31/2299
30410   7   RHINOPLASTY, PRIMARY; COMPLETE, EXT INCL BONY PYRA                  N   3    $13.45   6/1/1994   12/31/2299
30410   F   RHINOPLASTY, PRIMARY; COMPLETE, EXT INCL BONY PYRA                  N   3   $495.00   3/1/2004   12/31/2299
30420   2   RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL REPAI                  N   3   $650.00   1/2/1994   12/31/2299
30420   7   RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL REPAI                  N   3    $13.45   6/1/1994   12/31/2299
30420   F   RHINOPLASTY, PRIMARY; INCLUDING MAJOR SEPTAL REPAI                  N   3   $495.00   3/1/2004   12/31/2299
30430   2   RHINOPLASTY, SECONDARY; MINOR REVISION                              N   3   $310.81   1/1/2003   12/31/2299
30430   F   RHINOPLASTY, SECONDARY; MINOR REVISION                              N   3   $351.00   3/1/2004   12/31/2299
30450   2   RHINOPLASTY, SECONDARY; MAJOR REVISION                              N   3   $779.08   1/1/2004   12/31/2299
30450   F   RHINOPLASTY, SECONDARY; MAJOR REVISION                              N   3   $495.00   3/1/2004   12/31/2299
30460   2   RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGE                  N   3   $360.71   1/1/1993   12/31/2299
30460   7   RHINOPLASTY NASAL DEFORMITY 2ND TO CONGENITAL CLEF                  N   3    $13.45   6/1/1994   12/31/2299
30460   F   RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGE                  N   3   $495.00   3/1/2004   12/31/2299
30462   2   RHINOPLASTY FOR NASAL DEFORMITY 2ND TO CLEFT LIP                    N   3   $720.00   1/3/1992   12/31/2299
30462   7   RHINOPLASTY NASAL DEFORMITY 2ND TO CONGE CLEFT TIP                  N   3    $13.45   6/1/1994   12/31/2299
30462   F   RHINOPLASTY FOR NASAL DEFORMITY 2ND TO CLEFT LIP                    N   3   $495.00   3/1/2004   12/31/2299
30465   2   REPAIR OF NASAL VESTIB.STENOSIS SPREAD.GRAFTING,LAT.NASAL WLL.REC   N   3   $497.06   1/1/2001   12/31/2299
30465   F   REPAIR OF NASAL VESTIB.STENOSIS SPREAD.GRAFTING,LAT.NASAL WLL.REC   N   3   $495.00   3/1/2004   12/31/2299
30500   2   SUBMUCOUS RESECTION NASAL SEPTUM, CLASSIC                           N   3   $150.00   1/1/1973   12/31/2299
30500   7   SUBMUCOUS RESECTION NASAL SEPTUM, CLASSIC                           N   3    $13.45   6/1/1994   12/31/2299
30500   8   SUBMUCOUS RESECTION NASAL SEPTUM, CLASSIC                           N   3    $30.00   1/1/1973   12/31/2299
30520   2   SEPTOPLASTY WITH OR WITHOUT CARTILAGE IMPLANT (SEP                  N   3   $330.00   1/2/1997   12/31/2299
30520   7   SEPTOPLASTY WITH OR WITHOUT CARTILAGE IMPLANT (SEP                  N   3    $13.45   6/1/1994   12/31/2299
30520   8   SEPTOPLASTY WITH OR WITHOUT CARTILAGE IMPLANT (SEP                  N   3    $66.00   1/2/1997   12/31/2299
30520   F   SEPTOPLASTY WITH OR WITHOUT CARTILAGE IMPLANT (SEP                  N   3   $432.00   3/1/2004   12/31/2299
30540   2   REPAIR CHOANAL ATRESIA; INTRANASAL                                  N   3   $281.00   1/2/1992   12/31/2299
30540   7   REPAIR CHOANAL ATRESIA; INTRANASAL                                  N   3    $13.45   6/1/1994   12/31/2299
30540   8   REPAIR CHOANAL ATRESIA; INTRANASAL                                  N   3    $55.00   1/1/1973   12/31/2299
30540   F   REPAIR CHOANAL ATRESIA; INTRANASAL                                  N   3   $495.00   3/1/2004   12/31/2299
30545   2   REPAIR CHOANAL ATRESIA; TRANSPALATINE                               N   3   $432.00   1/2/1992   12/31/2299
30545   7   REPAIR CHOANAL ATRESIA; TRANSPALATINE                               N   3    $13.45   6/1/1994   12/31/2299
30545   8   REPAIR CHOANAL ATRESIA; TRANSPALATINE                               N   3   $100.00   1/1/1973   12/31/2299
30545   F   REPAIR CHOANAL ATRESIA; TRANSPALATINE                               N   3   $495.00   3/1/2004   12/31/2299
30560   2   LYSIS INTRANASAL SYNECHIA                                           N   3    $35.00   1/2/1992   12/31/2299
30560   7   LYSIS INTRANASAL SYNECHIA                                           N   3    $13.45   6/1/1994   12/31/2299
30560   F   LYSIS INTRANASAL SYNECHIA                                           N   3   $306.00   3/1/2004   12/31/2299
30580   2   REPAIR FISTULA; OROMAXILLARY                                        N   3   $253.00   1/2/1992   12/31/2299
30580   7   REPAIR FISTULA; OROMAXILLARY                                        N   3    $13.45   6/1/1994   12/31/2299
30580   8   REPAIR FISTULA; OROMAXILLARY                                        N   3    $50.00   1/1/1973   12/31/2299
30580   F   REPAIR FISTULA; OROMAXILLARY                                        N   3   $432.00   3/1/2004   12/31/2299




                                                                                                                     114
30600   2   REPAIR FISTULA; ORONASAL                             N   3   $189.50   1/2/1992   12/31/2299
30600   7   REPAIR FISTULA; ORONASAL                             N   3    $13.45   6/1/1994   12/31/2299
30600   F   REPAIR FISTULA; ORONASAL                             N   3   $432.00   3/1/2004   12/31/2299
30620   2   RECONSTRUCTION, FUNCTIONAL, INTERNAL NOSE (SEPTAL    N   3   $360.00   1/3/1992   12/31/2299
30620   7   RECONSTRUCTION, FUNCTIONAL, INTERNAL NOSE (SEPTAL    N   3    $13.45   6/1/1994   12/31/2299
30620   8   RECONSTRUCTION, FUNCTIONAL, INTERNAL NOSE (SEPTAL    N   3    $50.00   1/1/1973   12/31/2299
30620   F   RECONSTRUCTION, FUNCTIONAL, INTERNAL NOSE (SEPTAL    N   3   $495.00   3/1/2004   12/31/2299
30630   2   REPAIR NASAL SEPTAL PERFORATIONS                     N   3   $262.00   1/2/1992   12/31/2299
30630   7   REPAIR NASAL SEPTAL PERFORATIONS                     N   3    $13.45   6/1/1994   12/31/2299
30630   8   REPAIR NASAL SEPTAL PERFORATIONS                     N   3    $40.00   1/1/1984   12/31/2299
30630   F   REPAIR NASAL SEPTAL PERFORATIONS                     N   3   $495.00   3/1/2004   12/31/2299
30801   2   DESTRUCTION                                          N   3    $50.00   1/2/1992   12/31/2299
30801   7   DESTRUCTION                                          N   3    $13.45   6/1/1994   12/31/2299
30801   F   DESTRUCTION                                          N   3   $225.80   3/1/2004   12/31/2299
30802   2   CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATE   N   3    $57.00   1/2/1992   12/31/2299
30802   7   CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATE   N   3    $13.45   6/1/1994   12/31/2299
30802   F   CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATE   N   3   $225.80   3/1/2004   12/31/2299
30901   2   CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE(CAUTERIZA   N   3    $30.00   1/2/1992   12/31/2299
30901   7   CONTROL NASAL HEMORRHAGE ANTERIOR ANTERIOR SIMPLE    N   3    $13.45   6/1/1994   12/31/2299
30903   2   CONTROL NASAL HEMORRHAGE,COMPLEX(CAUTERIZATION WIT   N   3    $47.00   1/2/1992   12/31/2299
30903   7   CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX            N   3    $13.45   6/1/1994   12/31/2299
30903   F   CONTROL NASAL HEMORRHAGE,COMPLEX(CAUTERIZATION WIT   N   3   $225.80   3/1/2004   12/31/2299
30905   2   CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIO   N   3    $75.00   1/2/1992   12/31/2299
30905   7   CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIO   N   3    $13.45   6/1/1994   12/31/2299
30905   F   CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIO   N   3   $225.80   3/1/2004   12/31/2299
30906   2   CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIO   N   3    $50.00   1/2/1992   12/31/2299
30906   7   CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIO   N   3    $13.45   6/1/1994   12/31/2299
30906   F   CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIO   N   3   $225.80   3/1/2004   12/31/2299
30915   2   LIGATION ARTERIES; ETHMOIDAL                         N   3   $231.00   1/2/1992   12/31/2299
30915   7   LIGATION ARTERIES; ETHMOIDAL                         N   3    $13.45   6/1/1994   12/31/2299
30915   8   LIGATION ARTERIES; ETHMOIDAL                         N   3    $50.00   1/1/1973   12/31/2299
30915   F   LIGATION ARTERIES; ETHMOIDAL                         N   3   $306.00   3/1/2004   12/31/2299
30920   2   LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY, TRAN   N   3   $285.00   1/2/1992   12/31/2299
30920   7   LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY, TRAN   N   3    $13.45   6/1/1994   12/31/2299
30920   8   LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY, TRAN   N   3    $70.00   1/1/1984   12/31/2299
30920   F   LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY, TRAN   N   3   $351.00   3/1/2004   12/31/2299
30930   2   FRACTURE NASAL TURBINATE(S),THERAPEUTIC              N   3    $38.00   1/2/1992   12/31/2299
30930   7   FRACTURE NASAL TURBINATE(S),THERAPEUTIC              N   3    $13.45   6/1/1994   12/31/2299
30930   F   FRACTURE NASAL TURBINATE(S),THERAPEUTIC              N   3   $432.00   3/1/2004   12/31/2299
30999   7   UNLISTED PROCEDURE, NOSE                             N   3    $13.45   6/1/1994   12/31/2299
31000   2   LAVAGE BY CANNULATION; MAXILLARY SINUS UNILAT        N   3    $26.00   1/2/1992   12/31/2299
31000   7   LAVAGE BY CANNULATION; MAXILLARY SINUS, UNILATERAL   N   3    $13.45   6/1/1994   12/31/2299
31002   2   LAVAGE BY CANNULATION; SPHENOID SINUS                N   3    $45.00   1/2/1992   12/31/2299
31002   7   LAVAGE BY CANNULATION; SPHENOID SINUS                N   3    $13.45   6/1/1994   12/31/2299
31020   2   SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL, UNI   N   3   $110.00   1/2/1992   12/31/2299
31020   7   SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL, UNI   N   3    $13.45   6/1/1994   12/31/2299
31020   F   SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL, UNI   N   3   $306.00   3/1/2004   12/31/2299
31030   2   SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL UNILAT    N   3   $331.80   1/2/1994   12/31/2299
31030   7   SINUSOTOMY,MAXILLARY(ANTROTOMY);RADICAL,UNILATERAL   N   3    $13.45   6/1/1994   12/31/2299
31030   8   SINUSOTOMY,MAXILLARY(ANTROTOMY);RADICAL,UNILATERAL   N   3    $60.00   1/1/1973   12/31/2299
31030   F   SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL UNILAT    N   3   $351.00   3/1/2004   12/31/2299




                                                                                                      115
31031   7   SINUSOTOMY,MAXILLARY(ANTROTOMY);RADICAL,BILATERAL    N   3    $13.45   6/1/1994   12/31/2299
31032   2   SINUSTOMY,MAXILLARY;RADICAL UNILATERAL (CALDWELL-L   N   3   $327.00   1/2/1992   12/31/2299
31032   7   SINUSTOMY,MAXILLARY;RADICAL UNILATERAL (CALDWELL-L   N   3    $13.45   6/1/1994   12/31/2299
31032   8   SINUSTOMY,MAXILLARY;RADICAL UNILATERAL (CALDWELL-L   N   3    $60.00   1/1/1984   12/31/2299
31032   F   SINUSTOMY,MAXILLARY;RADICAL UNILATERAL (CALDWELL-L   N   3   $432.00   3/1/2004   12/31/2299
31040   2   SURGERY ON PTERYGOMAXILLARY FOSSA CONTENTS BY TRAN   N   3   $336.00   1/2/1992   12/31/2299
31040   7   SURGERY ON PTERYGOMAXILLARY FOSSA CONTENTS BY TRAN   N   3    $13.45   6/1/1994   12/31/2299
31050   2   SINUSOTOMY, SPHENOID                                 N   3   $222.00   1/2/1992   12/31/2299
31050   7   SINUSOTOMY, SPHENOID                                 N   3    $13.45   6/1/1994   12/31/2299
31050   8   SINUSOTOMY, SPHENOID                                 N   3    $55.00   1/1/1973   12/31/2299
31050   F   SINUSOTOMY, SPHENOID                                 N   3   $306.00   3/1/2004   12/31/2299
31051   2   SNSTMY SPHND W MCSL STPPING OR RMVL OF POLYP(S)      N   3   $302.00   1/2/1992   12/31/2299
31051   7   SNSTMY SPHND W MCSL STPPING OR RMVL OF POLYP(S)      N   3    $13.45   6/1/1994   12/31/2299
31051   8   SNSTMY SPHND W MCSL STPPING OR RMVL OF POLYP(S)      N   3    $60.00   1/1/1984   12/31/2299
31051   F   SNSTMY SPHND W MCSL STPPING OR RMVL OF POLYP(S)      N   3   $432.00   3/1/2004   12/31/2299
31070   2   SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE                 N   3   $180.00   1/2/1992   12/31/2299
31070   7   SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE                 N   3    $13.45   6/1/1994   12/31/2299
31070   8   SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE                 N   3    $50.00   1/1/1973   12/31/2299
31070   F   SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE                 N   3   $306.00   3/1/2004   12/31/2299
31075   2   SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL         N   3   $362.00   1/2/1992   12/31/2299
31075   7   SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL         N   3    $13.45   6/1/1994   12/31/2299
31075   8   SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL         N   3    $80.00   1/1/1973   12/31/2299
31075   F   SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL         N   3   $432.00   3/1/2004   12/31/2299
31080   2   SINUSOTOMY FRONTAL;OBLITERATIVE WITHOUT OSTEOPLAST   N   3   $399.00   1/2/1992   12/31/2299
31080   7   SINUSOTOMY FRONTAL;OBLITERATIVE WITHOUT OSTEOPLAST   N   3    $13.45   6/1/1994   12/31/2299
31080   F   SINUSOTOMY FRONTAL;OBLITERATIVE WITHOUT OSTEOPLAST   N   3   $432.00   3/1/2004   12/31/2299
31081   2   SINUSOTOMY FRONTAL;OBLITERATIVE W/O OSTEOPLASTIC F   N   3   $450.00   1/2/1992   12/31/2299
31081   7   SINUSOTOMY FRONTAL;OBLITERATIVE W/O OSTEOPLASTIC F   N   3    $13.45   6/1/1994   12/31/2299
31081   F   SINUSOTOMY FRONTAL;OBLITERATIVE W/O OSTEOPLASTIC F   N   3   $432.00   3/1/2004   12/31/2299
31084   2   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3   $552.00   1/2/1992   12/31/2299
31084   7   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3    $13.45   6/1/1994   12/31/2299
31084   8   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3   $120.00   1/1/1973   12/31/2299
31084   F   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3   $432.00   3/1/2004   12/31/2299
31085   2   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3   $552.00   1/2/1992   12/31/2299
31085   7   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3    $13.45   6/1/1994   12/31/2299
31085   8   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3   $140.00   1/1/1984   12/31/2299
31085   F   SINUSOTOMY FRONTAL; OBLITERATIVE, WITH OSTEOPLASTI   N   3   $432.00   3/1/2004   12/31/2299
31086   2   SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLA   N   3   $456.00   1/2/1992   12/31/2299
31086   F   SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLA   N   3   $432.00   3/1/2004   12/31/2299
31087   2   SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLA   N   3   $450.00   1/2/1992   12/31/2299
31087   F   SINUSOTOMY FRONTAL; NONOBLITERATIVE, WITH OSTEOPLA   N   3   $432.00   3/1/2004   12/31/2299
31090   2   SINUSOTOMY COMBINED, THREE OR MORE SINUSES           N   3   $840.00   1/2/1992   12/31/2299
31090   7   SINUSOTOMY COMBINED, THREE OR MORE SINUSES           N   3    $13.45   6/1/1994   12/31/2299
31090   8   SINUSOTOMY COMBINED, THREE OR MORE SINUSES           N   3   $130.00   1/1/1973   12/31/2299
31090   F   SINUSOTOMY COMBINED, THREE OR MORE SINUSES           N   3   $495.00   3/1/2004   12/31/2299
31200   2   ETHMOIDECTOMY; INTRANASAL, ANTERIOR                  N   3   $240.00   1/2/1994   12/31/2299
31200   7   ETHMOIDECTOMY; INTRANASAL, ANTERIOR                  N   3    $13.45   6/1/1994   12/31/2299
31200   8   ETHMOIDECTOMY; INTRANASAL, ANTERIOR                  N   3    $30.00   1/1/1973   12/31/2299
31200   F   ETHMOIDECTOMY; INTRANASAL, ANTERIOR                  N   3   $306.00   3/1/2004   12/31/2299
31201   2   ETHMOIDECTOMY; INTRANASAL, TOTAL                     N   3   $298.00   1/2/1992   12/31/2299
31201   7   ETHMOIDECTOMY; INTRANASAL, TOTAL                     N   3    $13.45   6/1/1994   12/31/2299




                                                                                                      116
31201   8   ETHMOIDECTOMY; INTRANASAL, TOTAL                                 N   3    $45.00   1/1/1973   12/31/2299
31201   F   ETHMOIDECTOMY; INTRANASAL, TOTAL                                 N   3   $495.00   3/1/2004   12/31/2299
31205   2   ETHMOIDECTOMY; EXTRANASAL, TOTAL                                 N   3   $352.00   1/2/1992   12/31/2299
31205   7   ETHMOIDECTOMY; EXTRANASAL, TOTAL                                 N   3    $13.45   6/1/1994   12/31/2299
31205   8   ETHMOIDECTOMY; EXTRANASAL, TOTAL                                 N   3    $98.00   1/1/1973   12/31/2299
31205   F   ETHMOIDECTOMY; EXTRANASAL, TOTAL                                 N   3   $351.00   3/1/2004   12/31/2299
31225   2   MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION                       N   3   $732.00   1/2/1992   12/31/2299
31225   7   MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION                       N   3    $13.45   6/1/1994   12/31/2299
31225   8   MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION                       N   3   $110.00   1/1/1984   12/31/2299
31230   2   MAXILLECTOMY; WITH ORBITAL EXENTERATION                          N   3   $648.00   1/2/1992   12/31/2299
31230   7   MAXILLECTOMY; WITH ORBITAL EXENTERATION                          N   3    $13.45   6/1/1994   12/31/2299
31230   8   MAXILLECTOMY; WITH ORBITAL EXENTERATION                          N   3   $120.00   1/1/1973   12/31/2299
31231   2   NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATER               N   3    $37.40   1/1/1994   12/31/2299
31231   7   NASAL ENDOSCOPY, DIAG, UNILATERAL OR BILATERAL                   N   3    $13.45   1/1/1994   12/31/2299
31233   2   NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY S               N   3   $114.30   1/1/1994   12/31/2299
31233   7   ANESTHESIA,NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY S    N   3    $13.45   1/1/1994   12/31/2299
31233   F   NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY S               N   3   $306.00   3/1/2004   12/31/2299
31235   2   NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SI               N   3   $136.75   1/1/1994   12/31/2299
31235   F   NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SI               N   3   $225.80   3/1/2004   12/31/2299
31237   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3    $96.04   1/1/1994   12/31/2299
31237   7   NASAL/SINUS ENDOSCOPY                                            N   3    $13.65   5/1/1994   12/31/2299
31237   F   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $306.00   3/1/2004   12/31/2299
31238   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $101.48   1/1/1994   12/31/2299
31238   7   NASAL/SINUS ENDOSCOPY,SURGICAL                                   N   3    $13.45   1/2/1995   12/31/2299
31238   F   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $225.80   3/1/2004   12/31/2299
31239   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $424.03   1/1/1994   12/31/2299
31239   8   NASAL/SINUS ENDOSCOPY, SURGICAL                                  N   3    $84.81   1/1/2005   12/31/2299
31239   F   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $432.00   3/1/2004   12/31/2299
31240   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $147.23   1/1/1994   12/31/2299
31240   F   NASAL/SINUS ENDOSCOPY, SURGICAL;                                 N   3   $306.00   3/1/2004   12/31/2299
31254   2   NASAL ENDO SURG W ETHMOIDECTOMY PARTIAL                          N   3   $274.08   5/2/1994   12/31/2299
31254   7   NASAL ENDO SURG W/ETHMOIDECTOMY PARTIAL                          N   3    $13.45   1/1/1995   12/31/2299
31254   F   NASAL ENDO SURG W ETHMOIDECTOMY PARTIAL                          N   3   $351.00   3/1/2004   12/31/2299
31255   2   ENDOSCOPY WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR)     N   3   $405.00   5/2/1994   12/31/2299
31255   3   NASAL ENDO W ETHMOIDECTOMY ANT - POST TOTAL                      N   3   $250.00   1/1/1989   12/31/2299
31255   7   ENDOSCOPY WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR)     N   3    $13.45   6/2/1994   12/31/2299
31255   F   ENDOSCOPY WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR)     N   3   $495.00   3/1/2004   12/31/2299
31256   2   NASAL ENDOSCOPY-SURGICAL WITH MAXILLARY ANTROSTOMY               N   3   $192.00   5/2/1994   12/31/2299
31256   7   NASAL ENDOSCOPY-SURGICAL WITH MAXILLARY ANTROSTOMY               N   3    $13.45   6/3/1995   12/31/2299
31256   F   NASAL ENDOSCOPY-SURGICAL WITH MAXILLARY ANTROSTOMY               N   3   $351.00   3/1/2004   12/31/2299
31267   2   NASAL SINUS ENDOSCOPY, REMOVAL OF TISSUE FROM MAXILLARY SINUS    N   3   $267.00   1/1/1995   12/31/2299
31267   7   ANESTHESIA- NASAL SINUS ENDOSCOPY                                N   3    $13.45   1/2/1996   12/31/2299
31267   F   NASAL SINUS ENDOSCOPY, REMOVAL OF TISSUE FROM MAXILLARY SINUS    N   3   $351.00   3/1/2004   12/31/2299
31276   2   NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXPLORATION   N   3   $346.00   1/2/1994   12/31/2299
31276   F   NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXPLORATION   N   3   $351.00   3/1/2004   12/31/2299
31287   2   NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOM               N   3   $195.47   1/1/1994   12/31/2299
31287   F   NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOM               N   3   $351.00   3/1/2004   12/31/2299
31288   2   NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOM               N   3   $228.55   1/1/1994   12/31/2299
31288   F   NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOM               N   3   $351.00   3/1/2004   12/31/2299
31290   2   NASAL/SINUS ENDOSCOPY, SURGICAL, WITH REPAIR OF CE               N   3   $642.22   1/1/1994   12/31/2299
31291   2   NASAL/SINUS ENDOSCOPY, SURGICAL, WITH REPAIR OF CE               N   3   $674.75   1/1/1994   12/31/2299




                                                                                                                  117
31292   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                     N   3    $521.72    1/1/1994   12/31/2299
31293   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                     N   3    $570.67    1/1/1994   12/31/2299
31294   2   NASAL/SINUS ENDOSCOPY, SURGICAL;                     N   3    $652.21    1/1/1994   12/31/2299
31299   7   UNLISTED PROCEDURE, ACCESSORY SINUSES                N   3      $13.45   6/1/1994   12/31/2299
31300   2   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMO   N   3    $390.00    1/2/1992   12/31/2299
31300   7   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMO   N   3      $13.45   6/1/1994   12/31/2299
31300   8   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMO   N   3      $80.00   1/1/1973   12/31/2299
31300   F   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); WITH REMO   N   3    $495.00    3/1/2004   12/31/2299
31320   2   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); DIAGNOSTI   N   3    $208.00    1/2/1992   12/31/2299
31320   7   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); DIAGNOSTI   N   3      $13.45   6/1/1994   12/31/2299
31320   F   LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); DIAGNOSTI   N   3    $306.00    3/1/2004   12/31/2299
31360   2   LARYNGECTOMY; TOTAL, WITHOUT RADICAL NECK DISSECTI   N   3    $780.00    1/2/1992   12/31/2299
31360   7   LARYNGECTOMY; TOTAL, WITHOUT RADICAL NECK DISSECTI   N   3      $13.45   6/1/1994   12/31/2299
31360   8   LARYNGECTOMY; TOTAL, WITHOUT RADICAL NECK DISSECTI   N   3    $130.00    1/1/1973   12/31/2299
31365   2   LARYNGECTOMY; TOTAL, WITH RADICAL NECK DISSECTION    N   3    $995.00    1/2/1992   12/31/2299
31365   7   LARYNGECTOMY; TOTAL, WITH RADICAL NECK DISSECTION    N   3      $13.45   6/1/1994   12/31/2299
31365   8   LARYNGECTOMY; TOTAL, WITH RADICAL NECK DISSECTION    N   3    $150.00    8/1/1979   12/31/2299
31367   2   LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITHOUT RADIC   N   3    $720.00    1/2/1992   12/31/2299
31367   7   LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITHOUT RADIC   N   3      $13.45   6/1/1994   12/31/2299
31368   2   LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITH RADICAL    N   3    $858.00    1/2/1992   12/31/2299
31368   7   LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITH RADICAL    N   3      $13.45   6/1/1994   12/31/2299
31368   8   LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, WITH RADICAL    N   3    $120.00    1/1/1984   12/31/2299
31370   2   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); HORIZONTA   N   3    $714.00    1/2/1992   12/31/2299
31370   7   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); HORIZONTA   N   3      $13.45   6/1/1994   12/31/2299
31370   8   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); HORIZONTA   N   3    $150.00    1/1/1973   12/31/2299
31375   2   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); LATEROVER   N   3    $660.00    1/2/1992   12/31/2299
31375   7   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); LATEROVER   N   3      $13.45   6/1/1994   12/31/2299
31375   8   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); LATEROVER   N   3    $100.00    1/1/1973   12/31/2299
31380   2   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTEROVER   N   3    $720.00    1/2/1992   12/31/2299
31380   7   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTEROVER   N   3      $13.45   6/1/1994   12/31/2299
31380   8   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTEROVER   N   3    $100.00    1/1/1973   12/31/2299
31382   2   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTERO-LA   N   3    $690.00    1/2/1992   12/31/2299
31382   7   PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTERO-LA   N   3      $13.45   6/1/1994   12/31/2299
31390   2   PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION   N   3   $1,140.00   1/2/1992   12/31/2299
31390   7   PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION   N   3      $13.45   6/1/1994   12/31/2299
31390   8   PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION   N   3    $160.00    1/1/1984   12/31/2299
31395   2   PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION   N   3   $1,290.00   1/2/1992   12/31/2299
31395   7   PHARYNGOLARYNGECTOMY, WITH RADICAL NECK DISSECTION   N   3      $13.45   6/1/1994   12/31/2299
31400   2   ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROA   N   3    $336.00    1/2/1992   12/31/2299
31400   7   ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROA   N   3      $13.45   6/1/1994   12/31/2299
31400   8   ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROA   N   3    $100.00    1/1/1973   12/31/2299
31400   F   ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROA   N   3    $306.00    3/1/2004   12/31/2299
31420   2   EPIGLOTTIDECTOMY                                     N   3    $342.00    1/2/1992   12/31/2299
31420   7   EPIGLOTTIDECTOMY                                     N   3      $13.45   6/1/1994   12/31/2299
31420   8   EPIGLOTTIDECTOMY                                     N   3      $80.00   1/1/1973   12/31/2299
31420   F   EPIGLOTTIDECTOMY                                     N   3    $306.00    3/1/2004   12/31/2299
31500   2   INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE        N   3      $70.00   1/2/1995   12/31/2299
31500   7   INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE        N   3      $13.45   6/1/1994   12/31/2299
31502   2   TRACHEOTOMY TUBE CHANGE PRIOR TO ESTABLISHMENT OF    N   3      $25.00   1/2/1992   12/31/2299
31502   7   TRACHEOTOMY TUBE CHANGE PRIOR TO ESTABLISHMENT OF    N   3      $13.45   6/1/1994   12/31/2299
31505   2   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); DIAGN   N   3      $20.00   1/2/1992   12/31/2299




                                                                                                        118
31505   7   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); DIAGN   N   3    $13.45   6/1/1994   12/31/2299
31510   2   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3    $50.00   1/2/1992   12/31/2299
31510   7   LARYGOSCOPY INDIR SEP PROC WITH BIOPSY               N   3    $13.45   6/1/1994   12/31/2299
31510   F   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3   $306.00   3/1/2004   12/31/2299
31511   2   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3    $60.00   1/2/1992   12/31/2299
31511   7   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3    $13.45   6/1/1994   12/31/2299
31511   F   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3   $306.00   3/1/2004   12/31/2299
31512   2   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3    $78.00   1/2/1992   12/31/2299
31512   7   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3    $13.45   6/1/1994   12/31/2299
31512   F   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3   $306.00   3/1/2004   12/31/2299
31513   2   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3   $114.00   1/2/1992   12/31/2299
31513   7   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3    $13.45   6/1/1994   12/31/2299
31513   F   LARYNGOSCOPY, INDIRECT (SEPARATE PROCEDURE); WITH    N   3   $306.00   3/1/2004   12/31/2299
31515   2   LARYNGOSCOPY DIRECT; FOR ASPIRATION                  N   3    $84.00   1/2/1992   12/31/2299
31515   7   LARYNGOSCOPY DIRECT FOR ASPIRATION                   N   3    $13.45   6/1/1994   12/31/2299
31515   F   LARYNGOSCOPY DIRECT; FOR ASPIRATION                  N   3   $225.80   3/1/2004   12/31/2299
31520   2   LARYNGOSCOPY DIRECT; DIAGNOSTIC, NEWBORN             N   3    $84.00   1/2/1992   12/31/2299
31520   7   LARYNGOSCOPY DIRECT; DIAGNOSTIC, NEWBORN             N   3    $13.45   6/1/1994   12/31/2299
31525   2   LARYNGOSCOPY DIRECT; DIAGNOSTIC, EXCEPT NEWBORN      N   3   $105.10   1/2/1992   12/31/2299
31525   7   LARYNGOSCOPY DIRECT; DIAGNOSTIC, EXCEPT NEWBORN      N   3    $13.45   6/1/1994   12/31/2299
31525   F   LARYNGOSCOPY DIRECT; DIAGNOSTIC, EXCEPT NEWBORN      N   3   $225.80   3/1/2004   12/31/2299
31526   2   LARYNGOSCOPY DIRECT; DIAGNOSTIC, WITH OPERATING MI   N   3   $198.00   1/2/1992   12/31/2299
31526   7   LARYNGOSCOPY DIRECT; DIAGNOSTIC, WITH OPERATING MI   N   3    $13.45   6/1/1994   12/31/2299
31526   F   LARYNGOSCOPY DIRECT; DIAGNOSTIC, WITH OPERATING MI   N   3   $306.00   3/1/2004   12/31/2299
31527   2   LARYNGOSCOPY DIRECT; WITH INSERTION OF OBTURATOR     N   3   $126.00   1/2/1992   12/31/2299
31527   7   LARYNGOSCOPY DIRECT; WITH INSERTION OF OBTURATOR     N   3    $13.45   6/1/1994   12/31/2299
31527   F   LARYNGOSCOPY DIRECT; WITH INSERTION OF OBTURATOR     N   3   $225.80   3/1/2004   12/31/2299
31528   2   LARYNGOSCOPY DIRECT; WITH DILATATION, INITIAL        N   3   $102.00   1/2/1992   12/31/2299
31528   7   LARYNGOSCOPY, DIRECT; WITH DILATATION, INITIAL       N   3    $13.45   6/1/1994   12/31/2299
31528   F   LARYNGOSCOPY DIRECT; WITH DILATATION, INITIAL        N   3   $306.00   3/1/2004   12/31/2299
31529   2   LARYNGOSCOPY, DIRECT; WITH DILATATION, SUBSEQUENT    N   3   $102.00   1/2/1992   12/31/2299
31529   7   LARYNGOSCOPY, DIRECT; WITH DILATATION, SUBSEQUENT    N   3    $13.45   6/1/1994   12/31/2299
31529   F   LARYNGOSCOPY, DIRECT; WITH DILATATION, SUBSEQUENT    N   3   $306.00   3/1/2004   12/31/2299
31530   2   LARYNGOSCOPY, OPERATIVE, WITH FOREIGN BODY REMOVAL   N   3   $138.00   1/2/1992   12/31/2299
31530   7   LARYNGOSCOPY, OPERATIVE, WITH FOREIGN BODY REMOVAL   N   3    $13.45   6/1/1994   12/31/2299
31530   F   LARYNGOSCOPY, OPERATIVE, WITH FOREIGN BODY REMOVAL   N   3   $306.00   3/1/2004   12/31/2299
31531   2   LARYNGOSCOPY, OPERATIVE, WITH FOREIGN BODY REMOVAL   N   3   $186.00   1/2/1992   12/31/2299
31531   7   LARYNGOSCOPY, OPERATIVE, WITH FOREIGN BODY REMOVAL   N   3    $13.45   6/1/1994   12/31/2299
31531   F   LARYNGOSCOPY, OPERATIVE, WITH FOREIGN BODY REMOVAL   N   3   $351.00   3/1/2004   12/31/2299
31535   2   LARYNGOSCOPY, OPERATIVE, WITH BIOPSY;                N   3   $162.00   1/2/1992   12/31/2299
31535   7   LARYNGOSCOPY, OPERATIVE, WITH BIOPSY;                N   3    $13.45   6/1/1994   12/31/2299
31535   F   LARYNGOSCOPY, OPERATIVE, WITH BIOPSY;                N   3   $306.00   3/1/2004   12/31/2299
31536   2   LARYNGOSCOPY, OPERATIVE, WITH BIOPSY; WITH OPERATI   N   3   $180.00   1/2/1992   12/31/2299
31536   7   LARYNGOSCOPY, OPERATIVE, WITH BIOPSY; WITH OPERATI   N   3    $13.45   6/1/1994   12/31/2299
31536   F   LARYNGOSCOPY, OPERATIVE, WITH BIOPSY; WITH OPERATI   N   3   $351.00   3/1/2004   12/31/2299
31540   2   LARYNGOSCOPY, OPERATIVE, WITH EXCISION OF TUMOR AN   N   3   $198.00   1/2/1992   12/31/2299
31540   7   LARYNGOSCOPY, OPERATIVE, WITH EXCISION OF TUMOR AN   N   3    $13.45   6/1/1994   12/31/2299
31540   F   LARYNGOSCOPY, OPERATIVE, WITH EXCISION OF TUMOR AN   N   3   $351.00   3/1/2004   12/31/2299
31541   2   LARYNGOSCOPY, OPERATIVE, WITH EXCISION OF TUMOR AN   N   3   $216.00   1/2/1992   12/31/2299
31541   7   LARYNGOSCOPY, OPERATIVE, WITH EXCISION OF TUMOR AN   N   3    $13.45   6/1/1994   12/31/2299
31541   F   LARYNGOSCOPY, OPERATIVE, WITH EXCISION OF TUMOR AN   N   3   $432.00   3/1/2004   12/31/2299




                                                                                                      119
31545   2   LARYNGOSCOPY, DIRECT OPERATIVE WITH OPERATING MICROSCOPE OR TELES   N   3   $232.37   1/1/2005   12/31/2299
31545   7   LARYNGOSCOPY DIRECT OP WITH MICROSCOPE OR TELESCOPE                 N   3    $13.45   1/1/2005   12/31/2299
31546   2   LARYNGOSCOPY DIRECT OP WITH MICROSCOPE OR TELESCOPE                 N   3   $354.24   1/1/2005   12/31/2299
31546   7   LARYNGOSCOPY, DIR OPERATIVE WITH OPERATING MICROSCOPE OF TELESCOP   N   3    $13.45   1/1/2005   12/31/2299
31560   2   LARYNGOSCOPY, OPERATIVE, WITH ARYTENOIDECTOMY;                      N   3   $210.00   1/2/1992   12/31/2299
31560   7   LARYNGOSCOPY, OPERATIVE, WITH ARYTENOIDECTOMY;                      N   3    $13.45   6/1/1994   12/31/2299
31560   F   LARYNGOSCOPY, OPERATIVE, WITH ARYTENOIDECTOMY;                      N   3   $495.00   3/1/2004   12/31/2299
31561   2   LARYNGOSCOPY, OPERATIVE, WITH ARYTENOIDECTOMY; WIT                  N   3   $306.00   1/2/1992   12/31/2299
31561   7   LARYNGOSCOPY, OPERATIVE, WITH ARYTENOIDECTOMY; WIT                  N   3    $13.45   6/1/1994   12/31/2299
31561   F   LARYNGOSCOPY, OPERATIVE, WITH ARYTENOIDECTOMY; WIT                  N   3   $495.00   3/1/2004   12/31/2299
31570   2   LARYNGOSCOPY WITH INJECTION INTO VOCAL CORD(S), TH                  N   3   $192.00   1/2/1992   12/31/2299
31570   7   LARYNGOSCOPY WITH INJECTION INTO VOCAL CORD(S), TH                  N   3    $13.45   6/1/1994   12/31/2299
31570   F   LARYNGOSCOPY WITH INJECTION INTO VOCAL CORD(S), TH                  N   3   $306.00   3/1/2004   12/31/2299
31571   2   LARYNGOSCOPY WITH INJECTION INTO VOCAL CORD(S), TH                  N   3   $192.00   1/2/1992   12/31/2299
31571   7   LARYNGOSCOPY WITH INJECTION INTO VOCAL CORD(S), TH                  N   3    $13.45   6/1/1994   12/31/2299
31571   F   LARYNGOSCOPY WITH INJECTION INTO VOCAL CORD(S), TH                  N   3   $306.00   3/1/2004   12/31/2299
31575   2   LARYNGOSCOPY FLEXIBLE FIBERSCOPIC; DIAGNOSTIC                       N   3    $54.00   1/2/1992   12/31/2299
31575   7   LARYNGOSCOPY FLEXIBLE FIBERSCOPIC; DIAGNOSTIC                       N   3    $13.45   6/1/1994   12/31/2299
31576   2   LARYNGOSCOPY FLEXIBLE FIBERSCOPIC; WITH BIOPSY                      N   3   $102.00   1/2/1992   12/31/2299
31576   7   LARYNGOSCOPY FLEXIBLE FIBERSCOPIC; WITH BIOPSY                      N   3    $13.45   6/1/1994   12/31/2299
31576   F   LARYNGOSCOPY FLEXIBLE FIBERSCOPIC; WITH BIOPSY                      N   3   $306.00   3/1/2004   12/31/2299
31577   2   LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC; WITH REMOVAL O                  N   3   $126.00   1/2/1992   12/31/2299
31577   7   LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC; WITH REMOVAL O                  N   3    $13.45   6/1/1994   12/31/2299
31577   F   LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC; WITH REMOVAL O                  N   3   $306.00   3/1/2004   12/31/2299
31578   2   LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC; WITH REMOVAL O                  N   3   $150.00   1/2/1992   12/31/2299
31578   7   LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC; WITH REMOVAL O                  N   3    $13.45   6/1/1994   12/31/2299
31578   F   LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC; WITH REMOVAL O                  N   3   $306.00   3/1/2004   12/31/2299
31579   2   LARYNGOSCOPY, FLEX OR RIG FIBROPTIC, W/STROBOSCOPY                  N   3    $47.25   1/2/1992   12/31/2299
31579   7   LARYNGOSCOPY, FLEXIBLE FIBEROPTIC                                   N   3    $13.45   6/1/1994   12/31/2299
31580   2   LARYNGOPLASTY; FOR LARYNGEAL WEB, TWO STAGE, WITH                   N   3   $400.00   1/1/1973   12/31/2299
31580   7   LARYNGOPLASTY; FOR LARYNGEAL WEB, TWO STAGE, WITH                   N   3    $13.45   6/1/1994   12/31/2299
31580   8   LARYNGOPLASTY; FOR LARYNGEAL WEB, TWO STAGE, WITH                   N   3    $80.00   1/1/1973   12/31/2299
31580   F   LARYNGOPLASTY; FOR LARYNGEAL WEB, TWO STAGE, WITH                   N   3   $495.00   3/1/2004   12/31/2299
31582   2   LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT                   N   3   $400.00   1/1/1973   12/31/2299
31582   7   LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT                   N   3    $13.45   6/1/1994   12/31/2299
31582   8   LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT                   N   3    $80.00   1/1/1973   12/31/2299
31582   F   LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT                   N   3   $495.00   3/1/2004   12/31/2299
31584   7   LARYNGOPLASTY; WITH OPEN REDUCTION OF FRACTURE                      N   3    $13.45   6/1/1994   12/31/2299
31587   7   LARYNGOPLASTY, CRICOID SPLIT                                        N   3    $13.45   6/1/1994   12/31/2299
31588   2   LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (EG, FOR BU                  N   3   $649.82   1/1/2004   12/31/2299
31588   7   LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (EG, FOR BU                  N   3    $13.45   6/1/1994   12/31/2299
31588   F   LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (EG, FOR BU                  N   3   $495.00   3/1/2004   12/31/2299
31590   2   LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE                    N   3   $700.00   1/1/1984   12/31/2299
31590   7   LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE                    N   3    $13.45   6/1/1994   12/31/2299
31590   8   LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE                    N   3   $140.00   1/1/1984   12/31/2299
31590   F   LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE                    N   3   $495.00   3/1/2004   12/31/2299
31595   7   SECTIN RECURRENT LARYNGEAL NERVE THERAPEUTIC(SEPAR                  N   3    $13.45   6/1/1994   12/31/2299
31595   F   SECTION RECURRENT LARYNGEAL NERVE THERAPEUTIC(SEPA                  N   3   $306.00   3/1/2004   12/31/2299
31599   7   UNLISTED PROCEDURE, LARYNX                                          N   3    $13.45   6/1/1994   12/31/2299
31600   2   TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE)                          N   3   $150.00   8/1/1979   12/31/2299
31600   7   TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE)                          N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     120
31600   8   TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE)           N   3    $30.00   1/1/1984   12/31/2299
31601   2   TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE); UNDER    N   3   $150.00   1/1/1984   12/31/2299
31601   7   TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE); UNDER    N   3    $13.45   6/1/1994   12/31/2299
31603   2   TRACHEOSTOMY EMERGENCY PEOCEDURE;TRANSTRACHEAL       N   3   $150.00   1/1/1984   12/31/2299
31603   7   TRACHEASTOMY EMERGENCY PROCEDURE;TRANSTRACHEAL       N   3    $13.45   6/1/1994   12/31/2299
31603   8   TRACHEOSTOMY EMERGENCY PROCEDURE;TRANSTRACHEAL       N   3    $30.00   1/1/1984   12/31/2299
31605   2   TRACHEOSTOMY; CRICOTHYROID MEMBRANE ACHE             N   3   $100.00   1/1/1984   12/31/2299
31605   7   TRACHEOSTOMY; CRICOTHYROID MEMBRANE REPA             N   3    $13.45   6/1/1994   12/31/2299
31610   2   TRACHEOSTOMY, FENESTRATION PROCEDURE WITH SKIN FLA   N   3   $175.00   1/1/1973   12/31/2299
31610   7   TRACHEOSTOMY, FENESTRATION PROCEDURE WITH SKIN FLA   N   3    $13.45   6/1/1994   12/31/2299
31611   2   CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBS   N   3   $312.00   1/2/1994   12/31/2299
31611   7   CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBS   N   3    $13.45   6/1/1994   12/31/2299
31611   F   CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBS   N   3   $351.00   3/1/2004   12/31/2299
31612   2   TRACHEAL PUNCTURE, PERCUTANEOUS FOR ASPIRATION OF    N   3    $54.00   1/2/1995   12/31/2299
31612   7   TRACHEAL PUNCTURE, PERCUTANEOUS FOR ASPIRATION OF    N   3    $13.45   6/1/1994   12/31/2299
31612   F   TRACHEAL PUNCTURE, PERCUTANEOUS FOR ASPIRATION OF    N   3   $225.80   3/1/2004   12/31/2299
31613   2   TRACHEOSTOMA REVISION; SIMPLE WITHOUT FLAP ROTATIO   N   3   $175.00   1/1/1984   12/31/2299
31613   7   TRACHEASOTMA REVISION; SIMPLE WITHOUT FLAP ROTATIO   N   3    $13.45   6/1/1994   12/31/2299
31613   F   TRACHEOSTOMA REVISION; SIMPLE WITHOUT FLAP ROTATIO   N   3   $306.00   3/1/2004   12/31/2299
31614   2   TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION   N   3   $378.74   1/1/2005   12/31/2299
31614   7   TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION   N   3    $13.45   6/1/1994   12/31/2299
31614   F   TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION   N   3   $306.00   3/1/2004   12/31/2299
31615   2   TRACHEOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCI   N   3    $75.00   1/1/1984   12/31/2299
31615   7   TRACHEOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCI   N   3    $13.45   6/1/1994   12/31/2299
31615   F   TRACHEOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCI   N   3   $225.80   3/1/2004   12/31/2299
31620   2   ENDOBRONCHIAL ULTRASOUND                             N   3    $47.06   1/1/2005   12/31/2299
31620   7   ENDOBRONCHIAL ULTRASOUND                             N   3    $13.45   6/1/1994   12/31/2299
31621   7   BRONCHOSCOPY; DIAGNOSTIC, FIBEROPTIC BRONCHOSCOPE    N   3    $13.45   6/1/1994   12/31/2299
31622   2   BRONCHOSCOPY DIAG FLX OR RIGD W W/O CL WASH OR BRS   N   3   $138.00   1/2/1994   12/31/2299
31622   7   BRONCHOSCOPY DIAGNOSTIC FLEX OR RIGID-ANESTHESIA     N   3    $13.45   6/1/1994   12/31/2299
31622   F   BRONCHOSCOPY DIAG FLX OR RIGD W W/O CL WASH OR BRS   N   3   $225.80   3/1/2004   12/31/2299
31623   2   BRONCHOSCOPY W/BRUSHING OR PROTECTED BRUSHINGS       N   3   $140.59   1/1/1999   12/31/2299
31623   F   BRONCHOSCOPY W/BRUSHING OR PROTECTED BRUSHINGS       N   3   $306.00   3/1/2004   12/31/2299
31624   2   BRONCHOSCOPY W/BRONCHIAL ALVEOLAR LAVAGE             N   3   $141.85   1/1/1999   12/31/2299
31624   F   BRONCHOSCOPY W/BRONCHIAL ALVEOLAR LAVAGE             N   3   $306.00   3/1/2004   12/31/2299
31625   2   BRONCHOSCOPY; WITH BIOPSY, RIGID BRONCHOSCOPE        N   3   $160.00   1/2/1995   12/31/2299
31625   7   BRONCHOSCOPY; WITH BIOPSY, RIGID BRONCHOSCOPE        N   3    $13.45   6/1/1994   12/31/2299
31625   F   BRONCHOSCOPY; WITH BIOPSY, RIGID BRONCHOSCOPE        N   3   $306.00   3/1/2004   12/31/2299
31626   2   BRONCHOSCOPY; WITH BIOPSY, FIBEROPTIC BRONCHOSCOPE   N   3   $125.00   1/1/1984   12/31/2299
31626   7   BRONCHOSCOPY; WITH BIOPSY, FIBEROPTIC BRONCHOSCOPE   N   3    $13.45   6/1/1994   12/31/2299
31627   2   BRONCHOSCOPY; WITH BRUSHING, FIBEROPTIC BRONCHOSCO   N   3   $100.00   1/1/1984   12/31/2299
31627   7   BRONCHOSCOPY; WITH BRUSHING, FIBEROPTIC BRONCHOSCO   N   3    $13.45   6/1/1994   12/31/2299
31628   2   BRONCHOSCOPY;W TRANSBRONCHIAL LUNG BIOPSY, FIBEROP   N   3   $186.00   1/2/1995   12/31/2299
31628   7   BRONCHOSCOPY;W TRANSBRONCHIAL LUNG BIOPSY, FIBEROP   N   3    $13.45   6/1/1994   12/31/2299
31628   F   BRONCHOSCOPY;W TRANSBRONCHIAL LUNG BIOPSY, FIBEROP   N   3   $306.00   3/1/2004   12/31/2299
31629   2   BRONCHOSCOPY WITH NEEDLE ASPIRATION                  N   3   $155.00   1/1/1984   12/31/2299
31629   7   BRONCHOSCOPY WITH NEEDLE ASPIRATION                  N   3    $13.45   6/1/1994   12/31/2299
31629   F   BRONCHOSCOPY WITH NEEDLE ASPIRATION                  N   3   $306.00   3/1/2004   12/31/2299
31630   2   BRONCHOSCOPY; WITH TRACHEAL OR BRONCHIAL DILATION    N   3   $150.00   1/1/1973   12/31/2299
31630   7   BRONCHOSCOPY; WITH TRACHEAL OR BRONCHIAL DILATION    N   3    $13.45   6/1/1994   12/31/2299
31630   F   BRONCHOSCOPY; WITH TRACHEAL OR BRONCHIAL DILATION    N   3   $306.00   3/1/2004   12/31/2299




                                                                                                      121
31631   7   BRONCHOSCOPY                                                        N   3    $13.45   6/1/1994   12/31/2299
31631   F   BRONCHOSCOPY                                                        N   3   $306.00   3/1/2004   12/31/2299
31632   2   BROCHOSCOPY, RIGID OR FLEXIBLE WITH OR WITHOUT FLOUROSCOPIC GUIDA   N   3    $33.82   1/1/2004   12/31/2299
31633   2   BRONCHOSCOPY, RIGID OR FLEXIBLE WITH OR WITHOUT FLUOROSCOPIC GUID   N   3    $42.16   1/1/2004   12/31/2299
31635   2   BRONCHOSCOPY; WITH REMOVAL OF FOREIGN BODY                          N   3   $190.00   1/2/1995   12/31/2299
31635   7   BRONCHOSCOPY; WITH REMOVAL OF FOREIGN BODY                          N   3    $13.45   6/1/1994   12/31/2299
31635   F   BRONCHOSCOPY; WITH REMOVAL OF FOREIGN BODY                          N   3   $306.00   3/1/2004   12/31/2299
31636   2   BRONCHOSCOPY RIGID OR FLEXIBLE W/WOUT FLUOROSCOPIC                  N   3   $145.60   1/1/2005   12/31/2299
31636   7   BRONCHOSCOPY RIGID OR FLEXIBLE W/WITHOUT FLUOROSCOPIC               N   3    $13.45   1/1/2005   12/31/2299
31637   2   BRONSCHOSCOPY RIGID OR FLEXIBLE W/WOUT FLUOROSCOPIC                 N   3    $51.82   1/1/2005   12/31/2299
31637   7   BRONCHOSCOPY RIGID OR FLEXIBLE W/WOUT FLUOROSCOPIC                  N   3    $13.45   1/1/2005   12/31/2299
31638   2   BRONCHOSCOPY RIGID/FLEXIBLE W/WITHOUT FLUOROSCOPIC                  N   3   $161.77   1/1/2005   12/31/2299
31638   7   BRONSCHOSCOPY RIGID/FLEXIBLE W/WITHOUT FLUOROSCOPIC                 N   3    $13.45   1/1/2005   12/31/2299
31640   2   BRONCHOSCOPY; WITH EXCISION OF TUMOR                                N   3   $125.00   1/1/1973   12/31/2299
31640   7   BRONCHOSCOPY; WITH EXCISION OF TUMOR                                N   3    $13.45   6/1/1994   12/31/2299
31640   F   BRONCHOSCOPY; WITH EXCISION OF TUMOR                                N   3   $306.00   3/1/2004   12/31/2299
31641   2   BRONCHOSCOPY; W/ DESTRUC OF TUMOR OR REL OF STEN                    N   3   $175.00   1/1/1984   12/31/2299
31641   F   BRONCHOSCOPY; W/ DESTRUC OF TUMOR OR REL OF STEN                    N   3   $306.00   3/1/2004   12/31/2299
31643   2   BRONSCHOSCOPY W/PLACEMENT OF CATHERTER FOR INTRACAVITARY            N   3   $123.23   1/1/1999   12/31/2299
31643   7   BRONCHOSCOPY W/PLACEMENT OF CATHETER FOR INTRACAVITARY RADIOELEMT   N   3   $123.23   1/1/1999   12/31/2299
31643   F   BRONSCHOSCOPY W/PLACEMENT OF CATHERTER FOR INTRACAVITARY            N   3   $306.00   3/1/2004   12/31/2299
31645   2   BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACH                  N   3   $134.40   1/2/1992   12/31/2299
31645   7   BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACH                  N   3    $13.45   6/1/1994   12/31/2299
31645   F   BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACH                  N   3   $225.80   3/1/2004   12/31/2299
31646   2   BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACH                  N   3   $111.00   1/2/1995   12/31/2299
31646   7   BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACH                  N   3    $13.45   6/1/1994   12/31/2299
31646   F   BRONCHOSCOPY; WITH THERAPEUTIC ASPIRATION OF TRACH                  N   3   $225.80   3/1/2004   12/31/2299
31650   2   BRONCHOSCOPY; WITH DRAINAGE OF LUNG ABSCESS OR CAV                  N   3   $100.00   1/1/1973   12/31/2299
31650   7   BRONCHOSCOPY; WITH DRAINAGE OF LUNG ABSCESS OR CAV                  N   3    $13.45   6/1/1994   12/31/2299
31651   2   BRONCHOSCOPY; WITH DRAINAGE OF LUNG ABSCESS OR CAV                  N   3    $65.00   1/1/1973   12/31/2299
31651   7   BRONCHOSCOPY; WITH DRAINAGE OF LUNG ABSCESS OR CAV                  N   3    $13.45   6/1/1994   12/31/2299
31656   7   BRONCHOSCOPY; WITH INJECTION OF CONTRACT MATERIAL                   N   3    $13.45   6/1/1994   12/31/2299
31656   F   BRONCHOSCOPY; WITH INJECTION OF CONTRACT MATERIAL                   N   3   $225.80   3/1/2004   12/31/2299
31717   7   CATHETERIZATION WITH BRONCHIAL BRUSH BIOPSY                         N   3    $13.45   6/1/1994   12/31/2299
31717   F   CATHETERIZATION WITH BRONCHIAL BRUSH BIOPSY                         N   3   $225.80   3/1/2004   12/31/2299
31720   2   CATHETER ASPIRATION (SEPARATE PROCEDURE); NASOTRAC                  N   3    $25.00   1/1/1984   12/31/2299
31720   F   CATHETER ASPIRATION (SEPARATE PROCEDURE); NASOTRAC                  N   3   $225.80   3/1/2004   12/31/2299
31730   2   TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDL                  N   3   $103.22   1/1/1993   12/31/2299
31730   7   TRANSTRACHEAL INTRODUCTIO OF NEEDLE WIRE DILATOR                    N   3    $13.45   6/1/1994   12/31/2299
31730   F   TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDL                  N   3   $225.80   3/1/2004   12/31/2299
31750   2   TRACHEOPLASTY; CERVICAL                                             N   3   $400.00   8/1/1979   12/31/2299
31750   7   TRACHEOPLASTY; CERVICAL                                             N   3    $13.45   6/1/1994   12/31/2299
31750   8   TRACHEOPLASTY; CERVICAL                                             N   3    $80.00   8/1/1979   12/31/2299
31750   F   TRACHEOPLASTY; CERVICAL                                             N   3   $495.00   3/1/2004   12/31/2299
31755   7   TRACHEOPLASTY; TRACHEOPHARYNGEAL FISTULIZATION, EA                  N   3    $13.45   6/1/1994   12/31/2299
31755   F   TRACHEOPLASTY; TRACHEOPHARYNGEAL FISTULIZATION, EA                  N   3   $306.00   3/1/2004   12/31/2299
31760   2   TRACHEOPLASTY; INTRATHORACIC                                        N   3   $450.00   8/1/1979   12/31/2299
31760   7   TRACHEOPLASTY; INTRATHORACIC                                        N   3    $13.45   6/1/1994   12/31/2299
31760   8   TRACHEOPLASTY; INTRATHORACIC                                        N   3    $90.00   8/1/1979   12/31/2299
31766   7   CARINAL RECONSTRUCTION                                              N   3    $13.45   6/1/1994   12/31/2299
31770   7   BRONCHOPLASTY; GRAFT REPAIR                                         N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     122
31775   7   BRONCHOPLASTY; EXCISION STENOSIS AND ANASTOMOSIS       N   3      $13.45   6/1/1994   12/31/2299
31780   2   EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVIC     N   3    $500.00    1/1/1984   12/31/2299
31780   7   EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVIC     N   3      $13.45   6/1/1994   12/31/2299
31781   2   EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVIC     N   3   $1,000.00   1/1/1984   12/31/2299
31781   7   EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVIC     N   3      $13.45   6/1/1994   12/31/2299
31785   7   EXCISION OF TRACHEAL TUMOR OR CARCINOMA; CERVICAL      N   3      $13.45   6/1/1994   12/31/2299
31786   7   EXCISION OF TRACHEAL TUMOR OR CARCINOMA; THORACIC      N   3      $13.45   6/1/1994   12/31/2299
31800   2   SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY; CERVI     N   3    $200.00    8/1/1979   12/31/2299
31800   7   SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY; CERVI     N   3      $13.45   6/1/1994   12/31/2299
31800   8   SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY; CERVI     N   3      $40.00   8/1/1979   12/31/2299
31805   2   SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY; INTRA     N   3    $450.00    8/1/1979   12/31/2299
31805   7   SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY; INTRA     N   3      $13.45   6/1/1994   12/31/2299
31805   8   SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY; INTRA     N   3      $90.00   8/1/1979   12/31/2299
31820   2   SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT      N   3    $100.00    1/1/1973   12/31/2299
31820   7   SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT      N   3      $13.45   6/1/1994   12/31/2299
31820   F   SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT      N   3    $225.80    3/1/2004   12/31/2299
31825   2   SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLA     N   3    $150.00    1/1/1973   12/31/2299
31825   7   SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLA     N   3      $13.45   6/1/1994   12/31/2299
31825   F   SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLA     N   3    $306.00    3/1/2004   12/31/2299
31830   7   REVISION OF TRACHEOSTOMY SCAR                          N   3      $13.45   6/1/1994   12/31/2299
31830   F   REVISION OF TRACHEOSTOMY SCAR                          N   3    $306.00    3/1/2004   12/31/2299
31899   7   UNLISTED PROCEDURE, TRACHEA, BRONCHI                   N   3      $13.45   6/1/1994   12/31/2299
32000   2   THORACENTESIS, PUNCTURE OF PLEURAL CAVITY ASPRTN       N   3      $49.00   1/2/1995   12/31/2299
32000   F   THORACENTESIS, PUNCTURE OF PLEURAL CAVITY ASPRTN       N   3    $225.80    3/1/2004   12/31/2299
32002   2   THORACENTESIS W/INSERT OF TUBE W OR W/O WATER SEAL     N   3    $112.00    1/2/1995   12/31/2299
32005   2   CHEMICAL PLEURODESIS (EG, FOR RECURRENT OR PERSIST     N   3      $40.00   1/1/1989   12/31/2299
32019   2   INSERTION OF INDWELLING TUNNELED PLEURAL CATH W CUFF   N   3    $142.42    1/1/2005   12/31/2299
32019   7   INSERTION OF INDWELLING TUNNELED PLEURAL CATH W CUFF   N   3      $13.45   1/1/2005   12/31/2299
32020   2   TUBE THORACOSTOMY WITH WATER SEAL (EG, PNEUMOTHORA     N   3    $150.00    1/1/1971   12/31/2299
32020   7   TUBE THORACOSTOMY WITH WATER SEAL                      N   3      $13.45   6/1/1994   12/31/2299
32020   8   TUBE THORACOSTOMY WITH WATER SEAL (EG, PNEUMOTHORA     N   3      $30.00   1/1/1984   12/31/2299
32035   2   THORACOSTOMY; WITH RIB RESECTION FOR EMPYEMA           N   3    $250.00    1/1/1973   12/31/2299
32035   7   THORACOSTOMY; WITH RIB RESECTION FOR EMPYEMA           N   3      $13.45   6/1/1994   12/31/2299
32035   8   THORACOSTOMY; WITH RIB RESECTION FOR EMPYEMA           N   3      $50.00   1/1/1973   12/31/2299
32036   2   THORACOSTOMY; WITH OPEN FLAP DRAINAGE FOR EMPYEMA      N   3    $372.00    1/2/1994   12/31/2299
32036   7   THORACOSTOMY; WITH OPEN FLAP DRAINAGE FOR EMPYEMA      N   3      $13.45   6/1/1994   12/31/2299
32095   2   THORACOTOMY LIMITED, FOR BIOPSY OF LUNG OR PLEURA      N   3    $350.00    1/1/1984   12/31/2299
32095   7   THORACOTOMY LIMITED, FOR BIOPSY OF LUNG OR PLEURA      N   3      $13.45   6/1/1994   12/31/2299
32095   8   THORACOTOMY LIMITED, FOR BIOPSY OF LUNG OR PLEURA      N   3      $70.00   1/1/1984   12/31/2299
32100   2   THORACOTOMY, MAJOR; WITH EXPLORATION AND BIOPSY        N   3    $560.00    1/2/1997   12/31/2299
32100   7   THORACOTOMY, MAJOR; WITH EXPLORATION AND BIOPSY        N   3      $13.45   6/1/1994   12/31/2299
32100   8   THORACOTOMY, MAJOR; WITH EXPLORATION AND BIOPSY        N   3    $112.00    1/2/1997   12/31/2299
32110   2   THORACOTOMY, MAJOR; WITH CONTROL OF TRAUMATIC HEMO     N   3    $400.00    1/1/1973   12/31/2299
32110   7   THORACOTOMY, MAJOR; WITH CONTROL OF TRAUMATIC HEMO     N   3      $13.45   6/1/1994   12/31/2299
32110   8   THORACOTOMY, MAJOR; WITH CONTROL OF TRAUMATIC HEMO     N   3      $80.00   1/1/1973   12/31/2299
32120   2   THORACOTOMY, MAJOR; FOR POSTOPERATIVE COMPLICATION     N   3    $463.35    1/1/2003   12/31/2299
32120   7   THORACOTOMY, MAJOR; FOR POSTOPERATIVE COMPLICATION     N   3      $13.45   6/1/1994   12/31/2299
32124   2   THORACOTOMY, MAJOR; WITH OPEN INTRAPLEURAL PNEUMON     N   3    $435.00    8/1/1979   12/31/2299
32124   7   THORACOTOMY, MAJOR; WITH OPEN INTRAPLEURAL PNEUMON     N   3      $13.45   6/1/1994   12/31/2299
32124   8   THORACOTOMY, MAJOR; WITH OPEN INTRAPLEURAL PNEUMON     N   3      $87.00   8/1/1979   12/31/2299
32140   2   THORACOTOMY, MAJOR; WITH CYST(S) REMOVAL WITH OR W     N   3    $400.00    1/1/1973   12/31/2299




                                                                                                          123
32140   7   THORACOTOMY, MAJOR; WITH CYST(S) REMOVAL WITH OR W         N   3    $13.45   6/1/1994   12/31/2299
32140   8   THORACOTOMY, MAJOR; WITH CYST(S) REMOVAL WITH OR W         N   3    $80.00   1/1/1973   12/31/2299
32141   2   THORACOTOMY, MAJOR; WITH EXCISION-PLICATION OF BUL         N   3   $435.00   1/1/1984   12/31/2299
32141   7   THORACOTOMY, MAJOR; WITH EXCISION-PLICATION OF BUL         N   3    $13.45   6/1/1994   12/31/2299
32141   8   THORACOTOMY, MAJOR; WITH EXCISION-PLICATION OF BUL         N   3    $87.00   1/1/1984   12/31/2299
32150   2   THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPLEURAL F         N   3   $350.00   1/1/1973   12/31/2299
32150   7   THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPLEURAL F         N   3    $13.45   6/1/1994   12/31/2299
32150   8   THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPLEURAL F         N   3    $70.00   1/1/1973   12/31/2299
32151   2   THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPULMONARY         N   3   $350.00   1/1/1973   12/31/2299
32151   7   THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPULMONARY         N   3    $13.45   6/1/1994   12/31/2299
32151   8   THORACOTOMY, MAJOR; WITH REMOVAL OF INTRAPULMONARY         N   3    $70.00   1/1/1973   12/31/2299
32160   7   THORACOTOMY, MAJOR; WITH CARDIAC MASSAGE                   N   3    $13.45   6/1/1994   12/31/2299
32200   2   PNEUMONOSTOMY, WITH OPEN DRAINAGE OF ABSCESS OR CY         N   3   $350.00   1/1/1973   12/31/2299
32200   7   PNEUMONOSTOMY, WITH OPEN DRAINAGE OF ABSCESS OR CY         N   3    $13.45   6/1/1994   12/31/2299
32200   8   PNEUMONOSTOMY, WITH OPEN DRAINAGE OF ABSCESS OR CY         N   3    $70.00   1/1/1973   12/31/2299
32201   2   PNEUMONOSTOMY;W/PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST   N   3   $156.17   1/1/1998   12/31/2299
32201   7   PNEUMONOSTOMY;W/PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST   N   3    $13.45   1/1/1998   12/31/2299
32201   8   PNEUMONOSTOMY;W/PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST   N   3    $31.24   1/1/1998   12/31/2299
32202   7   INSERT EPICARD ELTRD, OPEN                                 N   3    $13.45   1/1/2007   12/31/2299
32215   2   PLEURAL SCARIFICATION FOR REPEAT PNEUMOTHORAX              N   3   $452.03   1/1/2005   12/31/2299
32215   7   PLEURAL SCARIFICATION FOR REPEAT PNEUMOTHORAX              N   3    $13.45   6/1/1994   12/31/2299
32220   2   DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); TO         N   3   $500.00   1/1/1973   12/31/2299
32220   7   DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); TO         N   3    $13.45   6/1/1994   12/31/2299
32220   8   DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); TO         N   3   $100.00   1/1/1973   12/31/2299
32225   2   DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); PA         N   3   $350.00   1/1/1973   12/31/2299
32225   7   DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); PA         N   3    $13.45   6/1/1994   12/31/2299
32225   8   DECORTICATION, PULMONARY, (SEPARATE PROCEDURE); PA         N   3    $70.00   1/1/1973   12/31/2299
32310   2   PLEURECTOMY; PARIETAL                                      N   3   $480.00   8/1/1979   12/31/2299
32310   7   PLEURECTOMY; PARIETAL                                      N   3    $13.45   6/1/1994   12/31/2299
32310   8   PLEURECTOMY; PARIETAL                                      N   3    $96.00   8/1/1979   12/31/2299
32320   7   DECORTICATION AND PARIETAL PLEURECTOMY                     N   3    $13.45   6/1/1994   12/31/2299
32400   2   BIOPSY, PLEURA; PERCUTANEOUS NEEDLE                        N   3    $65.00   1/2/1995   12/31/2299
32400   7   BIOPSY, PLEURA; PERCUTANEOUS NEEDLE                        N   3    $13.45   6/1/1994   12/31/2299
32400   F   BIOPSY, PLEURA; PERCUTANEOUS NEEDLE                        N   3   $225.80   3/1/2004   12/31/2299
32402   2   BIOPSY, PLEURA; OPEN                                       N   3   $300.00   1/1/1990   12/31/2299
32402   7   BIOPSY, PLEURA; OPEN                                       N   3    $13.45   6/1/1994   12/31/2299
32402   8   BIOPSY, PLEURA; OPEN                                       N   3    $60.00   1/1/1990   12/31/2299
32405   2   BIOPSY, LUNG, PERCUTANEOUS NEEDLE                          N   3    $84.00   1/2/1994   12/31/2299
32405   7   BIOPSY, LUNG, PERCUTANEOUS NEEDLE                          N   3    $13.45   6/1/1994   12/31/2299
32405   F   BIOPSY, LUNG, PERCUTANEOUS NEEDLE                          N   3   $225.80   3/1/2004   12/31/2299
32420   2   PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION          N   3    $68.35   1/1/2002   12/31/2299
32420   7   PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION          N   3    $13.45   6/1/1994   12/31/2299
32420   F   PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION          N   3   $225.80   3/1/2004   12/31/2299
32440   2   PNEUMONECTOMY, TOTAL                                       N   3   $750.00   1/1/1973   12/31/2299
32440   7   PNEUMONECTOMY, TOTAL                                       N   3    $13.45   6/1/1994   12/31/2299
32440   8   PNEUMONECTOMY, TOTAL                                       N   3   $150.00   1/1/1973   12/31/2299
32442   2   REMOVAL OF LUNG, TOTAL PNEUMONECTOMY;                      N   3   $938.14   1/1/1994   12/31/2299
32445   7   PNEUMONECTOMY, EXTRAPLEURAL; WITHOUT EMPYEMECTOMY          N   3    $13.45   6/1/1994   12/31/2299
32480   2   LOBECTOMY, TOTAL OR SEGMENTAL;                             N   3   $650.00   1/1/1973   12/31/2299
32480   7   LOBECTOMY, TOTAL OR SEGMENTAL;                             N   3    $13.45   6/1/1994   12/31/2299
32480   8   LOBECTOMY, TOTAL OR SEGMENTAL;                             N   3   $130.00   1/1/1973   12/31/2299




                                                                                                            124
32482   2   REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;                    N   3    $960.00    1/2/1995   12/31/2299
32482   7   ANESTHESIA, REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY         N   3      $13.45   1/2/1995   12/31/2299
32482   8   ASSISTANT FEE REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY       N   3    $192.00    1/2/1995   12/31/2299
32484   2   REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;                    N   3    $942.00    1/2/1997   12/31/2299
32484   7   ANESTHESIA;REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY          N   3      $13.45   1/1/1994   12/31/2299
32484   8   ASSISTANT FEE;REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY       N   3    $189.00    1/2/1997   12/31/2299
32485   7   LOBECTOMY, TOTAL OR SEGMENTAL; WITH BRONCHOPLASTY                   N   3      $13.45   6/1/1994   12/31/2299
32486   2   REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;                    N   3    $864.85    1/1/1994   12/31/2299
32488   2   REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;                    N   3    $927.89    1/1/1994   12/31/2299
32500   2   WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE                         N   3    $550.00    1/1/1973   12/31/2299
32500   7   WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE                         N   3      $13.45   6/1/1994   12/31/2299
32500   8   WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE                         N   3    $110.00    1/1/1973   12/31/2299
32501   2   RESECTION/REPAIR OF BRONCHUS AT TIME OF LOBE/SEGMENTECTOMY          N   3    $238.22    1/1/1996   12/31/2299
32501   8   RESECTION/REPAIR OF BRONCHUS AT TIME OF LOBE/SEGMENTECTOMY          N   3      $47.64   1/1/1996   12/31/2299
32503   2   RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CH   N   3   $1,077.38   1/1/2006   12/31/2299
32503   7   RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CH   N   3      $13.45   1/1/2006   12/31/2299
32503   8   RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CH   N   3    $215.48    1/1/2006   12/31/2299
32504   2   RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CH   N   3   $1,231.77   1/1/2006   12/31/2299
32504   7   RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CH   N   3      $13.45   1/1/2006   12/31/2299
32504   8   RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CH   N   3    $241.35    1/1/2006   12/31/2299
32540   2   EXTRAPLEURAL ENUCLEATION OF EMPYEMA (EMPYEMECTOMY)                  N   3    $500.00    1/1/1971   12/31/2299
32540   7   EXTRAPLEURAL ENUCLEATION OF EMPYEMA (EMPYEMECTOMY)                  N   3      $13.45   6/1/1994   12/31/2299
32540   8   EXTRAPLEURAL ENUCLEATION OF EMPYEMA (EMPYEMECTOMY)                  N   3    $100.00    1/1/1973   12/31/2299
32601   2   THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE);                      N   3    $194.24    1/1/1994   12/31/2299
32601   7   THORACOSCOPY, DIAGNOSTIC - ANESTHESIA                               N   3      $13.45   1/1/1994   12/31/2299
32602   2   THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE);                      N   3    $214.01    1/1/1994   12/31/2299
32602   7   ANESTHESIA FOR THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE)        N   3      $13.45   1/1/1994   12/31/2299
32602   8   THORACOSCOPY, DIAGNOSTIC -ASSISTANT SURGEON                         N   3      $42.80   1/1/1994   12/31/2299
32603   2   THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE);                      N   3    $242.54    1/1/1994   12/31/2299
32604   2   THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE);                      N   3    $271.85    1/1/1994   12/31/2299
32605   2   THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE);                      N   3    $224.48    1/1/1994   12/31/2299
32606   2   THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE);                      N   3    $263.93    1/1/1994   12/31/2299
32650   2   THORACOSCOPY, SURGICAL;                                             N   3    $387.19    1/1/1994   12/31/2299
32651   2   THORACOSCOPY, SURGICAL;                                             N   3    $532.80    1/1/1994   12/31/2299
32652   2   THORACOSCOPY, SURGICAL;                                             N   3    $624.19    1/1/1994   12/31/2299
32653   2   THORACOSCOPY, SURGICAL;                                             N   3    $503.74    1/1/1994   12/31/2299
32654   2   THORACOSCOPY, SURGICAL;                                             N   3    $515.31    1/1/1994   12/31/2299
32655   2   THORACOSCOPY, SURGICAL;                                             N   3    $459.95    1/1/1994   12/31/2299
32655   7   ANESTHESIA FOR THORACOSCOPY, SURGICAL                               N   3      $13.45   1/1/1994   12/31/2299
32656   2   THORACOSCOPY, SURGICAL;                                             N   3    $513.22    1/1/1994   12/31/2299
32657   2   THORACOSCOPY, SURGICAL;                                             N   3    $647.40    1/1/1994   12/31/2299
32658   2   THORACOSCOPY, SURGICAL;                                             N   3    $545.66    1/1/1994   12/31/2299
32659   2   THORACOSCOPY, SURGICAL;                                             N   3    $619.54    1/1/1994   12/31/2299
32659   7   THOROSCOPY WITH CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTI   N   3      $13.45   1/2/1994   12/31/2299
32660   2   THORACOSCOPY, SURGICAL;                                             N   3    $816.38    1/1/1994   12/31/2299
32661   2   THORACOSCOPY, SURGICAL;                                             N   3    $478.89    1/1/1994   12/31/2299
32662   2   THORACOSCOPY, SURGICAL;                                             N   3    $672.37    1/1/1994   12/31/2299
32663   2   THORACOSCOPY, SURGICAL;                                             N   3    $799.21    1/1/1994   12/31/2299
32664   2   THORACOSCOPY, SURGICAL;                                             N   3    $533.77    1/1/1994   12/31/2299
32665   2   THORACOSCOPY, SURGICAL;                                             N   3    $563.66    1/1/1994   12/31/2299
32710   7   EMBOLIZATION UTERINE FIBROID                                        N   3      $13.45   1/1/2007   12/31/2299




                                                                                                                       125
32800   7   REPAIR LUNG HERNIA THROUGH CHEST WALL                               N   3      $13.45   6/1/1994   12/31/2299
32800   8   REPAIR LUNG HERNIA THROUGH CHEST WALL                               N   3      $70.00   1/1/1992   12/31/2299
32810   2   CLOSURE OF CHEST WALL                                               N   3    $509.09    1/1/2003   12/31/2299
32810   7   CLOSURE OF CHEST WALL FOLLOWING OPEN FLAP DRAINAGE                  N   3      $13.45   6/1/1994   12/31/2299
32815   7   OPEN CLOSURE OF MAJOR BRONCHIAL FISTULA                             N   3      $13.45   6/1/1994   12/31/2299
32820   2   MAJOR RECONSTRUCTION, CHEST WALL (POST-TRAUMATIC)                   N   3    $350.00    1/1/1990   12/31/2299
32820   7   MAJOR RECONSTRUCTION, CHEST WALL (POST-TRAUMATIC)                   N   3      $13.45   6/1/1994   12/31/2299
32820   8   MAJOR RECONSTRUCTION, CHEST WALL (POST-TRAUMATIC)                   N   3      $70.00   1/1/1990   12/31/2299
32900   2   RESECTION OF RIBS, EXTRAPLEURAL, ALL STAGES                         N   3    $250.00    1/1/1973   12/31/2299
32900   7   RESECTION OF RIBS, EXTRAPLEURAL, ALL STAGES                         N   3      $13.45   6/1/1994   12/31/2299
32900   8   RESECTION OF RIBS, EXTRAPLEURAL, ALL STAGES                         N   3      $85.00   1/1/1971   12/31/2299
32905   2   THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL ST                  N   3    $759.84    1/1/2004   12/31/2299
32905   7   THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL ST                  N   3      $13.45   6/1/1994   12/31/2299
32905   8   THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL ST                  N   3    $151.97    1/1/2004   12/31/2299
32906   7   THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL; WITH C                  N   3      $13.45   6/1/1994   12/31/2299
32940   2   PNEUMONOLYSIS, EXTRAPERIOSTEAL, INCLUDING FILLING                   N   3    $350.00    1/1/1973   12/31/2299
32940   7   PNEUMONOLYSIS, EXTRAPERIOSTEAL, INCLUDING FILLING                   N   3      $13.45   6/1/1994   12/31/2299
32940   8   PNEUMONOLYSIS, EXTRAPERIOSTEAL, INCLUDING FILLING                   N   3      $70.00   1/1/1973   12/31/2299
32960   2   PNEUMOTHORAX, THERAPEUTIC, INTRAPLEURAL INJECTION                   N   3      $25.00   1/1/1973   12/31/2299
32997   2   TOTAL LUNG LAVAGE (UNILATERAL)                                      N   3    $194.87    1/1/2000   12/31/2299
32998   2   PERQ RF ABLATE TX, PUL TUMOR                                        N   3    $154.76    1/1/2007   12/31/2299
32998   7   PERQ RF ABLATE TX, PUL TUMOR                                        N   3      $13.45   1/1/2007   12/31/2299
32999   7   UNLISTED PROCEDURE, LUNGS AND PLEURA                                N   3      $13.45   6/1/1994   12/31/2299
33010   2   PERICARDIOCENTESIS; INITIAL                                         N   3      $30.00   1/1/1973   12/31/2299
33010   7   PERICARDIOCENTESIS INITIAL                                          N   3      $13.45   6/1/1994   12/31/2299
33010   F   PERICARDIOCENTESIS; INITIAL                                         N   3    $306.00    3/1/2004   12/31/2299
33011   2   PERICARDIOCENTESIS; SUBSEQUENT                                      N   3      $30.00   1/1/1984   12/31/2299
33011   7   PERFCARDIOCENTESIS; SUBSEQUENT                                      N   3      $13.45   6/1/1994   12/31/2299
33011   F   PERICARDIOCENTESIS; SUBSEQUENT                                      N   3    $306.00    3/1/2004   12/31/2299
33015   2   TUBE PERICARDIOSTOMY                                                N   3    $246.74    1/1/2003   12/31/2299
33015   7   TUBE PERICARDIOSTOMY                                                N   3      $13.45   6/1/1994   12/31/2299
33020   2   PERICARDIOTOMY FOR REMOVAL OF CLOT OR FOREIGN BODY                  N   3    $500.00    1/1/1973   12/31/2299
33020   7   PERICARDIOTOMY FOR REMOVAL OF CLOT OR FOREIGN BODY                  N   3      $13.45   6/1/1994   12/31/2299
33020   8   PERICARDIOTOMY FOR REMOVAL OF CLOT OR FOREIGN BODY                  N   3    $100.00    1/1/1973   12/31/2299
33025   2   CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTIO                  N   3    $500.00    1/1/1984   12/31/2299
33025   7   CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTIO                  N   3      $13.45   6/1/1994   12/31/2299
33025   8   CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTIO                  N   3      $90.00   1/1/1984   12/31/2299
33030   2   PARTIAL RESECTION FOR CHRONIC CONSTRICTIVE PERICAR                  N   3    $696.93    1/1/2004   12/31/2299
33030   7   PARTIAL RESECTION FOR CHRONIC CONSTRICTIVE PERICAR                  N   3      $13.45   6/1/1994   12/31/2299
33031   7   PERICARDIECTOMY, SUBTOTAL OR COMPLETE                               N   3      $13.45   6/1/1994   12/31/2299
33050   7   EXCISION OF PERICARDIAL CYST OR TUMOR                               N   3      $13.45   6/1/1994   12/31/2299
33120   2   EXCISION OF INTRACARDIAC TUMOR, RESECTION WITH CAR                  N   3   $1,250.00   1/1/1973   12/31/2299
33120   7   EXCISION OF INTRACARDIAC TUMOR, RESECTION WITH CAR                  N   3      $13.45   6/1/1994   12/31/2299
33120   8   EXCISION OF INTRACARDIAC TUMOR, RESECTION WITH CAR                  N   3    $250.00    1/1/1973   12/31/2299
33130   7   RESECTION OF EXTERNAL CARDIAC TUMOR                                 N   3      $13.45   6/1/1994   12/31/2299
33140   2   TRANSMYOCARDIAL LASER REVASCULARIZATION BY THORACOTOMY(SPERATE PR   N   3    $789.47    1/1/2000   12/31/2299
33140   7   TRANSMYOCARDIAL LASER REVASCULARIZATION BY THORACOTOMY SEPERATE P   N   3      $13.45   1/1/2000   12/31/2299
33140   8   TRANSMYOCARDIAL LASER REVASCULARIZATION BY THORACOTOMY SEPERATE P   N   3    $157.89    1/1/2000   12/31/2299
33141   2   TRANSMYOC.LASER REVASC.BY THORACOTOMY PERFOMED AT THE TIME          N   3    $168.98    1/1/2001   12/31/2299
33202   2   INSERT EPICARD ELTRD, OPEN                                          N   3    $422.98    1/1/2007   12/31/2299
33202   8   INSERT EPICARD ELTRD, OPEN                                          N   3      $84.00   1/1/2007   12/31/2299




                                                                                                                       126
33203   2   INSERT EPICARD ELTRD, ENDO                                         N   3   $432.72   1/1/2007   12/31/2299
33203   7   INSERT EPICARD ELTRD, ENDO                                         N   3    $13.45   1/1/2007   12/31/2299
33203   8   INSERT EPICARD ELTRD, ENDO                                         N   3    $86.00   1/1/2007   12/31/2299
33205   7   INSERTION OF PERMANENT PACEMAKER WITH TRANSVENOUS                  N   3    $13.45   6/1/1994   12/31/2299
33206   2   INSERTION OF PERMANENT PACEMAKER WITH TRANSVENOUS                  N   3   $477.00   8/1/1979   12/31/2299
33206   7   INSERTION OF PERMANENT PACEMAKER WITH TRANSVENOUS                  N   3    $13.45   6/1/1994   12/31/2299
33207   2   INSERTION OF PERMANENT PACEMAKER W/TRANSVENOUS ELE                 N   3   $420.00   8/1/1997   12/31/2299
33207   7   INSERTION OF PERMANENT PACEMAKER W/TRANSVENOUS ELE                 N   3    $13.45   6/1/1994   12/31/2299
33207   8   INSERTION OF PERMANENT PACEMAKER W/TRANSVENOUS ELE                 N   3    $84.00   8/1/1997   12/31/2299
33208   2   INSERTION OF PERMANENT PACEMAKER W/TRANSVENOUS ELE                 N   3   $360.00   8/1/1997   12/31/2299
33208   7   INSERTION OF PERMANENT PACEMAKER W/TRANSVENOUS ELE                 N   3    $13.45   6/1/1994   12/31/2299
33208   8   INSERTION OF PERMANENT PACEMAKER W/TRANSVENOUS ELE                 N   3    $72.00   8/1/1997   12/31/2299
33210   2   INSERTION OF TEMPORARY TRANSVENOUS CARDIAC ELECTRO                 N   3   $175.00   1/1/1971   12/31/2299
33210   7   INSERTION OF TEMPORARY TRANSVENOUS CARDIAC ELECTRO                 N   3    $13.45   6/1/1994   12/31/2299
33211   2   INSERTION OR REPLACEMENT OF TEMPORARY TRANSVENOUS                  N   3   $138.14   1/1/1994   12/31/2299
33212   2   INSERTION OR REPLACEMENT OF PULSE GENERATOR ONLY                   N   3   $200.00   8/1/1979   12/31/2299
33212   7   INSERTION OR REPLACEMENT OF PULSE GENERATOR ONLY                   N   3    $13.45   6/1/1994   12/31/2299
33213   2   INSERTION OR REPLACEMENT OF PACEMAKER PULSE GENERA                 N   3   $253.54   1/1/1994   12/31/2299
33214   2   UPGRADE OF IMPLANTED PACEMAKER SYSTEM, CONVERSION                  N   3   $282.43   1/1/1994   12/31/2299
33215   1   REPOS PREV IMPLAN TRANSVENOUS PACEMAKER R ATRIAL R VENTRICU        N   3   $181.75   1/1/2003   12/31/2299
33215   2   REPOS PREV IMPLAN TRANSVENOUS PACEMAKER R ATRIAL RVENTRI           N   3   $181.75   1/1/2003   12/31/2299
33216   2   INSERTION, REPLACEMENT, OR REPOSITIONING OF PERMAN                 N   3   $300.00   1/1/1971   12/31/2299
33216   7   INSERTION, REPLACEMENT, OR REPOSITIONING OF PERMAN                 N   3    $13.45   6/1/1994   12/31/2299
33217   2   INSERTION, REPLACEMENT OR REPOSITIONING OF PERMANE                 N   3   $231.90   1/1/1994   12/31/2299
33218   2   REPAIR OF PACEMAKER; ELECTRODES ONLY                               N   3   $125.00   1/1/1984   12/31/2299
33218   7   REPAIR OF PACEMAKER; ELECTRODES ONLY                               N   3    $13.45   6/1/1994   12/31/2299
33220   2   REPAIR OF PACEMAKER ELECTRODE(S) ONLY;                             N   3   $181.88   1/1/1994   12/31/2299
33222   2   REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKE                 N   3   $264.00   1/2/1994   12/31/2299
33222   7   REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKE                 N   3    $13.45   6/1/1994   12/31/2299
33222   F   REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKE                 N   3   $306.00   3/1/2004   12/31/2299
33223   2   REVISION OR RELOCATION OF SKIN POCKET FOR IMPLANTA                 N   3   $261.82   1/1/1994   12/31/2299
33223   F   REVISION OR RELOCATION OF SKIN POCKET FOR IMPLANTA                 N   3   $306.00   3/1/2004   12/31/2299
33224   1   INS PACING ELECTRODE L VENTRICULAR W/ATT PREV PACEMAKER            N   3   $292.62   1/1/2003   12/31/2299
33224   2   INS PACING E.ECTRODE L VENTRICULAR W/ATT PREV PACEMAKER            N   3   $292.62   1/1/2003   12/31/2299
33225   1   INS PACING ELEC CARDIAC VEN SYSTEM L VENTR AT TIME OF INSERTION    N   3   $258.76   1/1/2003   12/31/2299
33225   2   INS PACING ELEC CARDIAC VEN SYSTEM L VENTR AT TIME OF INSERTI      N   3   $258.76   1/1/2003   12/31/2299
33226   1   REPOS PREV IMPL CARD VENOUS L VENTR INC REM INS REPL GENERATO      N   3   $281.83   1/1/2003   12/31/2299
33226   2   REPOS PREV IMPL CARD VENOUS L VENTR INC REM INS REPL GENERA        N   3   $281.83   1/1/2003   12/31/2299
33233   2   REMOVAL OF PERMANENT PACEMAKER;                                    N   3   $115.42   1/1/1994   12/31/2299
33234   2   REMOVAL OF TRANSVENOUS PACEMAKER ELECTRODE(S) SINGLE LEAD SYSTEM   N   3   $192.82   1/1/1994   12/31/2299
33235   2   REMOVAL OF TRANSVENOUS PACEMAKER ELECTRODE(S) DUAL LEAD SYSTEM     N   3   $233.55   1/1/1994   12/31/2299
33236   2   REMOVAL OF PERMANENT EPICARDIAL PACEMAKER AND ELEC                 N   3   $334.01   1/1/1994   12/31/2299
33237   2   REMOVAL OF PERMANENT EPICARDIAL PACEMAKER AND ELEC                 N   3   $482.58   1/1/1994   12/31/2299
33238   2   REMOVAL OF PERMANENT TRANSVENOUS ELECTRODE(S) BY T                 N   3   $537.97   1/1/1994   12/31/2299
33240   2   INSERTION OR REPLACEMENT OF IMPLANTABLE CARDIOVERT                 N   3   $275.05   1/1/1994   12/31/2299
33240   7   ANESTHESIA,INSERTION OR REPLACEMENT OF IMPLANTABLE CARDIOVERTER    N   3    $13.45   1/1/1994   12/31/2299
33241   2   REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR                  N   3   $107.06   1/1/1994   12/31/2299
33243   2   REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR                  N   3   $654.88   1/1/1994   12/31/2299
33244   2   REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR                  N   3   $385.39   1/1/1994   12/31/2299
33249   2   INSERTION OR REPLACEMENT OF IMPLANTABLE CARDIOVERT                 N   3   $709.64   1/1/1994   12/31/2299
33249   7   ANESTHESIA, INSERTION OR REPLACEMENT OF IMPLANTABLE CARDIOVERT     N   3    $13.45   1/1/1994   12/31/2299




                                                                                                                    127
33250   2   OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGE              N   3    $791.39    1/1/2002   12/31/2299
33250   7   OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGE              N   3      $13.45   6/1/1994   12/31/2299
33251   2   OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGE              N   3    $890.54    1/1/2003   12/31/2299
33251   7   OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGE              N   3      $13.45   6/1/1994   12/31/2299
33251   8   OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGE              N   3    $178.11    1/1/2003   12/31/2299
33254   2   ABLATE ATRIA, LMTD                                              N   3    $737.13    1/1/2007   12/31/2299
33254   7   ABLATE ATRIA, LMTD                                              N   3      $13.45   1/1/2007   12/31/2299
33254   8   ABLATE ATRIA, LMTD                                              N   3    $147.00    1/1/2007   12/31/2299
33255   2   ABLATE ATRIA W/O BYPASS, EXT                                    N   3    $886.61    1/1/2007   12/31/2299
33255   7   ABLATE ATRIA W/O BYPASS, EXT                                    N   3      $13.45   1/1/2007   12/31/2299
33255   8   ABLATE ATRIA W/O BYPASS, EXT                                    N   3    $177.00    1/1/2007   12/31/2299
33256   2   ABLATE ATRIA W/BYPASS, EXTEN                                    N   3   $1,058.44   1/1/2007   12/31/2299
33256   7   ABLATE ATRIA W/BYPASS, EXTEN                                    N   3      $13.45   1/1/2007   12/31/2299
33256   8   ABLATE ATRIA W/BYPASS, EXTEN                                    N   3    $211.00    1/1/2007   12/31/2299
33260   7   OPERATIVE ABLATION OF ARRHYTHMOGENIC FOCUS OR PATH              N   3      $13.45   6/1/1994   12/31/2299
33261   7   OPERATIVE ABLATION OF ARRHYTHMOGENIC FOCUS OR PATH              N   3      $13.45   6/1/1994   12/31/2299
33265   2   ABLATE ATRIA W/BYPASS, ENDO                                     N   3    $737.13    1/1/2007   12/31/2299
33265   7   ABLATE ATRIA W/BYPASS, ENDO                                     N   3      $13.45   1/1/2007   12/31/2299
33265   8   ABLATE ATRIA W/BYPASS, ENDO                                     N   3    $147.00    1/1/2007   12/31/2299
33266   2   ABLATE ATRIA W/O BYPASS ENDO                                    N   3   $1,007.39   1/1/2007   12/31/2299
33266   7   ABLATE ATRIA W/O BYPASS ENDO                                    N   3      $13.45   1/1/2007   12/31/2299
33266   8   ABLATE ATRIA W/O BYPASS ENDO                                    N   3    $201.00    1/1/2007   12/31/2299
33282   2   IMPLANT OF PATIENT ACTIVATED CARDIAC EVENT RECORDER             N   3    $238.24    1/1/2000   12/31/2299
33282   7   IMPLANT PATIENT ACTIVATED CARDIAC EVENT RECORDER                N   3      $13.45   1/1/2000   12/31/2299
33284   2   REMOVAL OF IMPLANT PATIENT ACTIVATED CARDIAC EVENT RECORDER     N   3    $185.51    1/1/2000   12/31/2299
33284   7   REMOVAL OF IMPLANT PATIENT ACTIVATED CARDIAC EVENT RECORDER     N   3      $13.45   1/1/2000   12/31/2299
33300   2   REPAIR OF CARDIAC WOUND; WITHOUT BYPASS                         N   3    $600.00    1/1/1973   12/31/2299
33300   7   REPAIR OF CARDIAC WOUND; WITHOUT BYPASS                         N   3      $13.45   6/1/1994   12/31/2299
33300   8   REPAIR OF CARDIAC WOUND; WITHOUT BYPASS                         N   3    $120.00    1/1/1973   12/31/2299
33305   7   REPAIR OF CARDIAC WOUND; WITH CARDIOPULMONARY BYPA              N   3      $13.45   6/1/1994   12/31/2299
33310   2   CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREI              N   3    $600.00    1/1/1973   12/31/2299
33310   7   CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREI              N   3      $13.45   6/1/1994   12/31/2299
33310   8   CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREI              N   3    $120.00    1/1/1973   12/31/2299
33315   2   CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREI              N   3   $1,000.00   1/1/1973   12/31/2299
33315   7   CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREI              N   3      $13.45   6/1/1994   12/31/2299
33315   8   CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREI              N   3    $200.00    1/1/1973   12/31/2299
33320   7   SUTURE REPAIR OF AORTA OR GREAT VESSELS; WITHOUT B              N   3      $13.45   6/1/1994   12/31/2299
33321   2   SUTURE OR REPAIR OR AORTA OF GREAT VESSELS WITH SHUNT BYPASS    N   3   $1,023.00   1/1/1995   12/31/2299
33322   7   SUTURE REPAIR OF AORTA OR GREAT VESSELS; WITH CARD              N   3      $13.45   6/1/1994   12/31/2299
33330   7   INSERTION OF GRAFT; WITHOUT BYPASS                              N   3      $13.45   6/1/1994   12/31/2299
33332   2   INSERTION OF GRAFT, AORTA OR GREAT VESSELS, WITH SHUNT BYPASS   N   3    $927.00    1/1/1995   12/31/2299
33335   7   INSERTION OF GRAFT; WITH CARDIOPULMONARY BYPASS                 N   3      $13.45   6/1/1994   12/31/2299
33350   7   GREAT VESSEL REPAIR WITH OTHER MAJOR PROCEDURE                  N   3      $13.45   6/1/1994   12/31/2299
33400   2   VALVULOPLASTY, AORTIC VALVE, OPEN, WITH CARDIOPULM              N   3   $1,250.00   1/1/1973   12/31/2299
33400   7   VALVULOPLASTY, AORTIC VALVE, OPEN, WITH CARDIOPULM              N   3      $13.45   6/1/1994   12/31/2299
33400   8   VALVULOPLASTY, AORTIC VALVE, OPEN, WITH CARDIOPULM              N   3    $250.00    1/1/1973   12/31/2299
33401   2   VALVULOPLASTY, AORTIC VALVE;                                    N   3    $853.57    1/1/1994   12/31/2299
33403   2   VALVULOPLASTY, AORTIC VALVE;                                    N   3    $890.79    1/1/1994   12/31/2299
33404   7   CONSTRUCTION OF APICAL-AORTIC CONDUIT                           N   3      $13.45   6/1/1994   12/31/2299
33405   2   REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BY              N   3   $1,300.00   1/1/1973   12/31/2299
33405   7   REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BY              N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                   128
33405   8   REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BY                  N   3    $260.00    1/1/1973   12/31/2299
33406   2   REPLACEMENT, AORTIC VALVE, WITH CARDIOPULMONARY BY                  N   3   $1,419.85   1/1/1994   12/31/2299
33410   2   REPLACE AROTIC VALVE W/CARDIOPULMONARY BYPASS W/STENTLESS TIS VAL   N   3   $1,326.29   1/1/2000   12/31/2299
33410   7   REPLACE AORTIC VALVE W/CARDIOPULMONARY BYPASS W/STENTLESS TIS VAL   N   3      $13.45   1/1/2000   12/31/2299
33410   8   REPLACE AORTIC VAVLE W/CARDIOPULMONARY BYPASS W/STENTLESS TIS VAL   N   3    $265.28    1/1/2000   12/31/2299
33411   2   REPLACEMENT, AORTIC VALVE                                           N   3   $1,344.76   1/1/2004   12/31/2299
33411   7   REPLACEMENT, AORTIC VALVE                                           N   3      $13.45   6/1/1994   12/31/2299
33411   8   REPLACEMENT, AORTIC VALVE                                           N   3    $268.95    1/1/2005   12/31/2299
33412   7   REPLACEMENT, AORTIC VALVE                                           N   3      $13.45   6/1/1994   12/31/2299
33413   2   REPLACEMENT, AORTIC VALVE;                                          N   3   $1,299.21   1/1/1994   12/31/2299
33413   8   ASSISTANT FEE,REPLACEMENT, AORTIC VALVE                             N   3    $259.84    1/1/1994   12/31/2299
33414   2   REPAIR OF LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTI                  N   3   $1,113.38   1/1/1994   12/31/2299
33415   2   RESECTION OF AORTIC VALVE FOR SUBVALVULAR STENOSIS                  N   3   $1,000.00   1/1/1990   12/31/2299
33415   7   RESECTION OF AORTIC VALVE FOR SUBVALVULAR STENOSIS                  N   3      $13.45   6/1/1994   12/31/2299
33415   8   RESECTION OF AORTIC VALVE FOR SUBVALVULAR STENOSIS                  N   3    $200.00    1/1/1990   12/31/2299
33416   2   VENTRICULOMYOTOMY (-MYECTOMY) FOR IDIOPATHIC HYPER                  N   3   $1,084.16   1/1/2004   12/31/2299
33416   7   VENTRICULOMYOTOMY (-MYECTOMY) FOR IDIOPATHIC HYPER                  N   3      $13.45   6/1/1994   12/31/2299
33416   8   VENTRICULOMYOTOMY (-MYECTOMY) FOR IDIOPATHIC HYPER                  N   3    $216.83    1/1/2004   12/31/2299
33417   7   AORTOPLASTY (GUSSET) FOR SUPRAVALVULAR STENOSIS                     N   3      $13.45   6/1/1994   12/31/2299
33420   2   VALVOTOMY, MITRAL VALVE (COMMISSUROTOMY); CLOSED                    N   3    $800.00    1/1/1973   12/31/2299
33420   7   VALVOTOMY, MITRAL VALVE (COMMISSUROTOMY); CLOSED                    N   3      $13.45   6/1/1994   12/31/2299
33420   8   VALVOTOMY, MITRAL VALVE (COMMISSUROTOMY); CLOSED                    N   3    $160.00    1/1/1973   12/31/2299
33422   2   VALVOTOMY, MITRAL VALVE (COMMISSUROTOMY); OPEN WIT                  N   3   $1,300.00   1/1/1984   12/31/2299
33422   7   VALVOTOMY, MITRAL VALVE (COMMISSUROTOMY); OPEN WIT                  N   3      $13.45   6/1/1994   12/31/2299
33422   8   HEART VALV OPERATN                                                  N   3    $260.00    1/1/1984   12/31/2299
33425   2   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3   $1,300.00   1/1/1973   12/31/2299
33425   7   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3      $13.45   6/1/1994   12/31/2299
33425   8   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3    $260.00    1/1/1973   12/31/2299
33426   2   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3   $1,092.62   1/1/2003   12/31/2299
33426   7   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3      $13.45   6/1/1994   12/31/2299
33426   8   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3    $218.52    1/1/2003   12/31/2299
33427   2   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3   $1,692.00   1/2/1994   12/31/2299
33427   7   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3      $13.45   6/1/1994   12/31/2299
33427   8   VALVULOPLASTY, MITRAL VALVE, WITH CARDIOPULMONARY                   N   3    $339.00    1/2/1994   12/31/2299
33430   2   REPLACEMENT, MITRAL VALVE, WITH CARDIOPULMONARY BY                  N   3   $1,200.00   1/2/1992   12/31/2299
33430   7   REPLACEMENT, MITRAL VALVE, WITH CARDIOPULMONARY BY                  N   3      $13.45   6/1/1994   12/31/2299
33430   8   REPLACEMENT, MITRAL VALVE, WITH CARDIOPULMONARY BY                  N   3    $260.00    1/1/1973   12/31/2299
33460   2   VALVULOPLASTY OR VALVECTOMY, TRICUSPID VALVE; WITH                  N   3   $1,250.00   1/1/1973   12/31/2299
33460   7   VALVULOPLASTY OR VALVECTOMY, TRICUSPID VALVE; WITH                  N   3      $13.45   6/1/1994   12/31/2299
33460   8   VALVULOPLASTY OR VALVECTOMY, TRICUSPID VALVE; WITH                  N   3    $250.00    1/1/1973   12/31/2299
33463   2   VALVULOPLASTY, TRICUSPID VALVE;                                     N   3    $918.80    1/1/1994   12/31/2299
33464   2   VALVULOPLASTY, TRICUSPID VALVE;                                     N   3    $983.62    1/1/1994   12/31/2299
33464   8   VALVULOPLASTY, TRICUSPID VALVE;                                     N   3    $983.62    1/1/1994   12/31/2299
33465   2   VALVULOPLASTY OR VALVECTOMY, TRICUSPID VALVE, WITH                  N   3   $1,300.00   1/1/1973   12/31/2299
33465   7   VALVULOPLASTY OR VALVECTOMY, TRICUSPID VALVE, WITH                  N   3      $13.45   6/1/1994   12/31/2299
33465   8   VALVULOPLASTY OR VALVECTOMY, TRICUSPID VALVE, WITH                  N   3    $260.00    1/1/1973   12/31/2299
33468   2   TRICUSPID VALVE REPOSITIONING AND PLICATION FOR EB                  N   3   $1,086.49   1/1/2004   12/31/2299
33468   7   TRICUSPID VALVE REPOSITIONING AND PLICATION FOR EB                  N   3      $13.45   6/1/1994   12/31/2299
33470   2   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); CLOSE                  N   3    $800.00    1/1/1973   12/31/2299
33470   7   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); CLOSE                  N   3      $13.45   6/1/1994   12/31/2299
33470   8   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); CLOSE                  N   3    $160.00    1/1/1973   12/31/2299




                                                                                                                       129
33472   2   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); OPEN,                  N   3    $800.00    1/1/1973   12/31/2299
33472   7   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); OPEN,                  N   3      $13.45   6/1/1994   12/31/2299
33472   8   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); OPEN,                  N   3    $160.00    1/1/1973   12/31/2299
33474   2   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); OPEN                   N   3   $1,250.00   1/1/1973   12/31/2299
33474   7   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); OPEN                   N   3      $13.45   6/1/1994   12/31/2299
33474   8   VALVOTOMY, PULMONARY VALVE (COMMISSUROTOMY); OPEN                   N   3    $250.00    1/1/1973   12/31/2299
33475   2   REPLACEMENT, PULMONARY VALVE                                        N   3   $1,039.48   1/1/1994   12/31/2299
33476   7   RIGHT VENTRICULAR RESECTION FOR INFUNDIBULAR STENO                  N   3      $13.45   6/1/1994   12/31/2299
33478   2   OUTFLOW TRACT AUGMENTATION (GUSSET), W OR W/OUT CO                  N   3   $1,000.00   1/1/1989   12/31/2299
33478   7   OUTFLOW TRACT AUGMENTATION (GUSSET), W OR W/OUT CO                  N   3      $13.45   6/1/1994   12/31/2299
33478   8   OUTFLOW TRACT AUGMENTATION (GUSSET), W OR W/OUT CO                  N   3    $200.00    1/1/1988   12/31/2299
33496   2   REPAIR NON-STRUCTURAL PROSTETIC VALVE DYSFUNC,W/CARDIO BYPASS       N   3   $1,339.04   1/1/1998   12/31/2299
33496   7   REPAIR NON-STRUCTURAL PROSTHETIC VALVE DYSFUNC W/CARDIO BYPASS      N   3      $13.45   1/1/1998   12/31/2299
33496   8   REPAIR NON-STRUCTURAL PROSTHETIC VALVE DYSFUNC W/CARDIO BYPASS      N   3    $267.80    1/1/1998   12/31/2299
33500   7   CORONARY ARTERY PROCEDURES                                          N   3      $13.45   6/1/1994   12/31/2299
33501   2   REPAIR OF CORONARY ARTERIOVENOUS OR ARTERIOCARDIAC                  N   3    $645.56    1/1/1993   12/31/2299
33501   7   REPAIR OF CORONARY ARTERIOVENOUS/ARTERIOCARD CHAMB                  N   3      $13.45   6/1/1994   12/31/2299
33502   7   ANOMALOUS CORONARY ARTERY; LIGATION                                 N   3      $13.45   6/1/1994   12/31/2299
33503   2   ANOMALOUS CORONARY ARTERY; GRAFT, WITHOUT BYPASS                    N   3    $800.00    1/1/1973   12/31/2299
33503   7   ANOMALOUS CORONARY ARTERY; GRAFT, WITHOUT BYPASS                    N   3      $13.45   6/1/1994   12/31/2299
33503   8   ANOMALOUS CORONARY ARTERY; GRAFT, WITHOUT BYPASS                    N   3    $160.00    1/1/1973   12/31/2299
33504   2   ANOMALOUS CORONARY ARTERY; GRAFT, WITH BYPASS                       N   3   $1,250.00   1/1/1973   12/31/2299
33504   7   ANOMALOUS CORONARY ARTERY; GRAFT, WITH BYPASS                       N   3      $13.45   6/1/1994   12/31/2299
33504   8   ANOMALOUS CORONARY ARTERY; GRAFT, WITH BYPASS                       N   3    $250.00    1/1/1973   12/31/2299
33505   2   REPAIR OF ANOMALOUS CORONARY ARTERY;                                N   3    $964.69    1/1/1994   12/31/2299
33506   2   REPAIR OF ANOMALOUS CORONARY ARTERY;                                N   3    $964.69    1/1/1994   12/31/2299
33507   2   REPAIR OF ANOMALOUS (EG INTRAMURAL) AORTIC ORIGIN OF CORONARY ART   N   3   $1,038.95   1/1/2006   12/31/2299
33507   7   REPAIR OF ANOMALOUS (EG INTRAMURAL) AORTIC ORIGIN OF CORONARY ART   N   3      $13.45   1/1/2006   12/31/2299
33507   8   REPAIR OF ANOMALOUS (EG INTRAMURAL) AORTIC ORIGIN OF CORONARY ART   N   3    $207.79    1/1/2006   12/31/2299
33508   2   ENDOSCOPY,SURG,INC VIDEO ASSIS HARVEST VEIN(S) CORON ARTERY         N   3       $9.79   1/1/2003   12/31/2299
33510   2   CORONARY ARTERY BYPASS,AUTOGENOUS GRAFT,EG,SAPHENO                  N   3   $1,000.00   8/1/1979   12/31/2299
33510   7   CORONARY ARTERY BYPASS,AUTOGENOUS GRAFT,EG,SAPHENO                  N   3      $13.45   6/1/1994   12/31/2299
33510   8   CORONARY ARTERY BYPASS,AUTOGENOUS GRAFT,EG,SAPHENO                  N   3    $200.00    8/1/1979   12/31/2299
33511   2   TWO COROMARY ARTERIES                                               N   3   $1,250.00   8/1/1979   12/31/2299
33511   7   TWO CORONARY ARTERIES                                               N   3      $13.45   6/1/1994   12/31/2299
33511   8   TWO CORONARY ARTERIES                                               N   3    $250.00    8/1/1979   12/31/2299
33512   2   THREE CORONARY ARTERIES                                             N   3   $1,560.00   1/2/1992   12/31/2299
33512   7   THREE CORONARY ARTERIES                                             N   3      $13.45   6/1/1994   12/31/2299
33512   8   THREE CORONARY ARTERIES                                             N   3    $300.00    8/1/1979   12/31/2299
33513   2   FOUR CORONARY ARTERIES                                              N   3   $1,500.00   1/1/1984   12/31/2299
33513   7   FOUR CORONARY ARTERIES                                              N   3      $13.45   6/1/1994   12/31/2299
33513   8   FOUR CORONARY ARTERIES                                              N   3    $300.00    1/1/1984   12/31/2299
33514   2   FIVE CORONARY ARTERIES                                              N   3   $1,500.00   1/1/1984   12/31/2299
33514   7   FIVE CORONARY ARTERIES                                              N   3      $13.45   6/1/1994   12/31/2299
33514   8   FIVE CORONARY ARTERIES                                              N   3    $300.00    1/1/1984   12/31/2299
33516   2   SIX OR MORE CORONARY ARTERIES                                       N   3   $1,980.00   1/2/1994   12/31/2299
33516   7   SIX OR MORE CORONARY ARTERIES                                       N   3      $13.45   6/1/1994   12/31/2299
33516   8   SIX OR MORE CORONARY ARTERIES                                       N   3    $400.00    1/2/1994   12/31/2299
33517   2   CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND                   N   3    $139.76    1/1/1993   12/31/2299
33517   7   COMBINED ARTERIAL-VENOUS GRAFTING FOR CORONARY BPS                  N   3      $13.45   6/1/1994   12/31/2299
33517   8   COMBINED ARTERIAL-VENOUS GRAFTING FOR CORONARY BPS                  N   3      $30.00   1/2/1994   12/31/2299




                                                                                                                       130
33518   2   CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND                   N   3    $263.06    1/1/1993   12/31/2299
33518   7   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-2GRAFTS                  N   3      $13.45   6/1/1994   12/31/2299
33518   8   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-2GRAFTS                  N   3      $57.00   1/2/1994   12/31/2299
33519   2   CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND                   N   3    $217.40    1/1/1993   12/31/2299
33519   7   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-3GRAFTS                  N   3      $13.45   6/1/1994   12/31/2299
33519   8   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-3GRAFTS                  N   3      $71.00   1/2/1994   12/31/2299
33521   2   CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND                   N   3    $161.97    1/1/1993   12/31/2299
33521   7   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-4GRAFTS                  N   3      $13.45   6/1/1994   12/31/2299
33521   8   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-4GRAFTS                  N   3      $74.67   1/1/2002   12/31/2299
33522   2   CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND                   N   3    $330.95    1/1/1993   12/31/2299
33522   7   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-5GRAFTS                  N   3      $13.45   6/1/1994   12/31/2299
33523   2   OPER INCIS/RECONS OF ATRIA FOR ATRL FBRILLATION/ATRIAL FLUTTER      N   3   $1,373.12   1/1/1996   12/31/2299
33523   7   CORONARY ARTERY BYPASS USING VENOUS GRAFTS-6GRAFTS                  N   3      $13.45   6/1/1994   12/31/2299
33523   8   OPER INCIS/RECONS OF ATRIA FOR ATRIAL FBRILLATION/ATRIAL FLUTTER    N   3    $274.62    1/1/1996   12/31/2299
33530   2   REOPERATION, CORONARY ARTERY BYPASS PROCEDURE, MOR                  N   3    $341.00    1/2/1994   12/31/2299
33530   7   REOPERATION, CORONARY ARTERY BYPASS PROCEDURE, MOR                  N   3      $13.45   6/1/1994   12/31/2299
33530   8   REOPERATION, CORONARY ARTERY BYPASS PROCEDURE, MOR                  N   3      $65.00   1/2/1994   12/31/2299
33532   7   MYOCARDIAL IMPLANTATION, ONE OR MORE SYSTEMIC ARTE                  N   3      $13.45   6/1/1994   12/31/2299
33533   2   CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S);                    N   3   $1,266.49   1/1/1993   12/31/2299
33533   7   ARTERIAL GRAFTING FOR CORONARY ARTERY BYPASS                        N   3      $13.45   6/1/1994   12/31/2299
33533   8   ARTERIAL GRAFTING FOR CORONARY ARTERY BYPASS                        N   3    $295.00    1/2/1994   12/31/2299
33534   2   CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S);                    N   3   $1,489.28   1/1/1993   12/31/2299
33534   7   CORONARY ARTERY BYPASS USING 2 CORONARY GRAFTS                      N   3      $13.45   6/1/1994   12/31/2299
33534   8   CORONARY ARTERY BYPASS USING 2 CORONARY GRAFTS                      N   3    $229.00    1/1/2003   12/31/2299
33535   2   CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S);                    N   3   $1,608.92   1/1/1993   12/31/2299
33535   7   CORONARY ARTERY BYPASS USING 3 CORONARY GRAFTS                      N   3      $13.45   6/1/1994   12/31/2299
33536   2   CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S);                    N   3   $1,668.41   1/1/1993   12/31/2299
33536   7   CORONARY ARTERY BYPASS USING 4 CORONARY GRAFTS                      N   3      $13.45   6/1/1994   12/31/2299
33542   2   MYOCARDIAL RESECTION (EG, VENTRICULAR ANEURYSMECTO                  N   3   $1,300.00   1/1/1973   12/31/2299
33542   7   MYOCARDIAL RESECTION (EG, VENTRICULAR ANEURYSMECTO                  N   3      $13.45   6/1/1994   12/31/2299
33542   8   MYOCARDIAL RESECTION (EG, VENTRICULAR ANEURYSMECTO                  N   3    $260.00    1/1/1973   12/31/2299
33545   2   REPAIR OF POSTINFARCTION VENTRICULAR SEPTAL DEFECT                  N   3   $1,309.22   1/1/2003   12/31/2299
33545   7   REPAIR OF POSTINFARCTION VENTRICULAR SEPTAL DEFECT                  N   3      $13.45   6/1/1994   12/31/2299
33545   8   REPAIR OF POSTINFARCTION VENTRICULAR SEPTAL DEFECT                  N   3    $261.84    1/1/2003   12/31/2299
33548   2   SURGICAL VENTRICULAR RESTORATION PROCEDURE, INCLUDES PROSTHETIC P   N   3   $1,368.20   1/1/2006   12/31/2299
33548   7   SURGICAL VENTRICULAR RESTORATION PROCEDURE, INCLUDES PROSTHETIC P   N   3      $13.45   1/1/2006   12/31/2299
33548   8   SURGICAL VENTRICULAR RESTORATION PROCEDURE, INCLUDES PROSTHETIC P   N   3    $273.64    1/1/2006   12/31/2299
33572   2   CORONARY ENDARTERECTOMY, EACH VESSEL                                N   3    $192.00    1/1/1995   12/31/2299
33600   2   CLOSURE OF ATRIOVENTRICULAR VALVE (MITRAL OR TRICU                  N   3   $1,076.50   1/1/1994   12/31/2299
33602   2   CLOSURE OF SEMILUNAR VALVE (AORTIC OR PULMONARY) B                  N   3   $1,039.48   1/1/1994   12/31/2299
33606   2   ANASTOMOSIS OF PULMONARY ARTERY TO AORTA (DAMUS-KA                  N   3   $1,113.38   1/1/1994   12/31/2299
33608   2   REPAIR OF COMPLEX CARDIAC ANOMALY OTHER THAN PULMO                  N   3   $1,141.31   1/1/1994   12/31/2299
33610   2   REPAIR OF COMPLEX CARDIAC ANOMALIES (EG, SINGLE VE                  N   3   $1,113.38   1/1/1994   12/31/2299
33611   2   REPAIR OF DOUBLE OUTLET RIGHT VENTRICLE WITH INTRA                  N   3   $1,187.75   1/1/1994   12/31/2299
33612   2   REPAIR OF DOUBLE OUTLET RIGHT VENTRICLE WITH INTRA                  N   3   $1,219.34   1/1/1994   12/31/2299
33615   2   REPAIR OF COMPLEX CARDIAC ANOMALIES (EG, TRICUSPID                  N   3   $1,159.61   1/1/1994   12/31/2299
33615   7   ANESTHESIA,REPAIR OF COMPLEX CARDIAC ANOMALIES (EG,TRICUSPID        N   3      $13.45   1/1/1999   12/31/2299
33615   8   ASSIST @ REPAIR OF COMPLEX CARDIAC ANOMALIES (EG,TRICUSPID ATRESI   N   3    $231.92    1/1/1999   12/31/2299
33617   2   REPAIR OF COMPLEX CARDIAC ANOMALIES (EG, SINGLE VENTRICLES          N   3   $1,224.77   1/1/1994   12/31/2299
33617   7   ANESTHESIA,REPAIR OF COMPLEX CARDIAC ANOMALIES (EG,SINGLE VENTTRI   N   3      $13.45   1/1/1999   12/31/2299
33617   8   ASSISTANT@ REPAIR OF COMPLEY CARDIAC ANOMALIES (EG,SINGLE VENTRIC   N   3    $244.95    1/1/1999   12/31/2299




                                                                                                                       131
33619   2   REPAIR OF SINGLE VENTRICLE WITH AORTIC OUTFLOW OBS               N   3   $1,345.52   1/1/1994   12/31/2299
33619   7   ANESTHESIA, REPAIR OF SINGLE VENTRICLE WITH AORTIC OUTFLOW OBS   N   3      $13.45   1/1/1997   12/31/2299
33619   8   ASSISTANT,REPAIR OF SINGLE VENTRICLE WITH AORTIC OUTFLOW OBS     N   3    $269.10    1/1/1997   12/31/2299
33641   2   REPAIR ATRIAL SEPTAL DEFECT, SECUNDUM; WITH CARDIO               N   3   $1,150.00   1/1/1973   12/31/2299
33641   7   REPAIR ATRIAL SEPTAL DEFECT, SECUNDUM; WITH CARDIO               N   3      $13.45   6/1/1994   12/31/2299
33641   8   REPAIR ATRIAL SEPTAL DEFECT, SECUNDUM; WITH CARDIO               N   3    $230.00    1/1/1973   12/31/2299
33645   2   DIRECT OR PATCH CLOSURE,SINUS VENOSUS,W OR W/OUT A               N   3   $1,150.00   1/1/1973   12/31/2299
33645   7   DIRECT OR PATCH CLOSURE,SINUS VENOSUS,W OR W/OUT A               N   3      $13.45   6/1/1994   12/31/2299
33645   8   DIRECT OR PATCH CLOSURE,SINUS VENOSUS,W OR W/OUT A               N   3    $230.00    1/1/1973   12/31/2299
33647   2   REPAIR OF ATRIAL SEPTAL DEFECT AND VENTRICULAR SEP               N   3   $1,590.00   1/2/1994   12/31/2299
33647   7   REPAIR OF ATRIAL SEPTAL DEFECT AND VENTRICULAR SEP               N   3      $13.45   6/1/1994   12/31/2299
33647   8   REPAIR OF ATRIAL SEPTAL DEFECT AND VENTRICULAR SEP               N   3    $208.71    1/1/2005   12/31/2299
33660   2   PATCH CLOSURE,ENDOCARDIAL CUSHION DEFECT,W OR W/OU               N   3   $1,250.00   1/1/1971   12/31/2299
33660   7   PATCH CLOSURE,ENDOCARDIAL CUSHION DEFECT,W OR W/OU               N   3      $13.45   6/1/1994   12/31/2299
33660   8   PATCH CLOSURE,ENDOCARDIAL CUSHION DEFECT,W OR W/OU               N   3    $250.00    1/1/1973   12/31/2299
33665   2   PATCH CLOSURE, ENDOCARDIAL CUSHION DEFECT;WITH REP               N   3   $1,010.71   6/1/1994   12/31/2299
33665   7   PATCH CLOSURE, ENDOCARDIAL CUSHION DEFECT, WITH RE               N   3      $13.45   6/1/1994   12/31/2299
33665   8   PATCH CLOSURE, ENDOCARDIAL CUSHION DEFECT, WITH RE               N   3    $202.14    6/1/1994   12/31/2299
33670   2   REPAIR OF COMPLETE ATRIOVENTRICULAR CANAL, WITH OR               N   3   $1,100.00   1/1/1984   12/31/2299
33670   7   REPAIR OF COMPLETE ATRIOVENTRICULAR CANAL, WITH OR               N   3      $13.45   6/1/1994   12/31/2299
33670   8   REPAIR OF COMPLETE ATRIOVENTRICULAR CANAL, WITH OR               N   3    $220.00    1/1/1984   12/31/2299
33675   2   VLODR MULT VSD                                                   N   3   $1,178.27   1/1/2007   12/31/2299
33675   7   CLOSE MULT VSD                                                   N   3      $13.45   1/1/2007   12/31/2299
33675   8   CLOSE MULT VSD                                                   N   3    $235.00    1/1/2007   12/31/2299
33676   2   CLOSE MULT VSD W/RESECTION                                       N   3   $1,214.92   1/1/2007   12/31/2299
33676   7   CLOSE MULT VSD W/RESECTION                                       N   3      $13.45   1/1/2007   12/31/2299
33676   8   CLOSE MULT VSD W/RESECTION                                       N   3    $242.00    1/1/2007   12/31/2299
33677   2   CL MULT VSD W/REM PUL BAND                                       N   3   $1,262.72   1/1/2007   12/31/2299
33677   7   CL MULT VSD W/REM PUL BAND                                       N   3      $13.45   1/1/2007   12/31/2299
33677   8   CL MULT VSD W/REM PUL BAND                                       N   3    $252.00    1/1/2007   12/31/2299
33681   2   CLOSURE VENTRICULAR SEPTAL DEFECT; DIRECT                        N   3   $1,500.00   1/2/1992   12/31/2299
33681   7   CLOSURE VENTRICULAR SEPTAL DEFECT; DIRECT                        N   3      $13.45   6/1/1994   12/31/2299
33681   8   CLOSURE VENTRICULAR SEPTAL DEFECT; DIRECT                        N   3    $250.00    1/1/1973   12/31/2299
33684   2   CLOSURE VENTRICULAR SEPTAL DEFECT; WITH PULMONARY                N   3   $1,760.00   1/2/1992   12/31/2299
33684   7   CLOSURE VENTRICULAR SEPTAL DEFECT; WITH PULMONARY                N   3      $13.45   6/1/1994   12/31/2299
33688   2   CLOSURE VENTRICULAR SEPTAL DEFECT;WITH REMOVAL OF                N   3   $1,740.00   1/2/1994   12/31/2299
33688   7   CLOSURE VENTRICULAR SEPTAL DEFECT;WITH REMOVAL OF                N   3      $13.45   6/1/1994   12/31/2299
33688   8   CLOSURE VENTRICULAR SEPTAL DEFECT;WITH REMOVAL OF                N   3    $348.00    1/2/1994   12/31/2299
33690   2   BANDING OF PULMONARY ARTERY                                      N   3    $600.00    1/1/1973   12/31/2299
33690   7   BANDING OF PULMONARY ARTERY                                      N   3      $13.45   6/1/1994   12/31/2299
33690   8   BANDING OF PULMONARY ARTERY                                      N   3    $120.00    1/1/1973   12/31/2299
33692   2   TOTAL REPAIR TETRALOGY OF FALLOT; INTACT OUTFLOW T               N   3   $1,250.00   1/1/1973   12/31/2299
33692   7   TOTAL REPAIR TETRALOGY OF FALLOT; INTACT OUTFLOW T               N   3      $13.45   6/1/1994   12/31/2299
33692   8   TOTAL REPAIR TETRALOGY OF FALLOT; INTACT OUTFLOW T               N   3    $250.00    8/1/1979   12/31/2299
33694   2   TOTAL REPAIR TETRALOGY OF FALLOT; WITH OUTFLOW TRA               N   3   $1,162.48   1/1/2003   12/31/2299
33694   7   TOTAL REPAIR TETRALOGY OF FALLOT; WITH OUTFLOW TRA               N   3      $13.45   6/1/1994   12/31/2299
33694   8   TOTAL REPAIR TETRALOGY OF FALLOT; WITH OUTFLOW TRA               N   3    $232.50    1/1/2003   12/31/2299
33696   7   TOTAL REPAIR TETRALOGY OF FALLOT; WITH CLOSURE OF                N   3      $13.45   6/1/1994   12/31/2299
33697   2   COMPLETE REPAIR TETRALOGY OF FALLOT WITH PULMONARY               N   3   $1,224.77   1/1/1994   12/31/2299
33702   2   REPAIR SINUS OF VALSALVA FISTULA, WITH CARDIOPULMO               N   3   $1,250.00   1/1/1971   12/31/2299
33702   7   REPAIR SINUS OF VALSALVA FISTULA, WITH CARDIOPULMO               N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                    132
33702   8   REPAIR SINUS OF VALSALVA FISTULA, WITH CARDIOPULMO                  N   3    $250.00    1/1/1973   12/31/2299
33710   7   REPAIR SINUS OF VALSALVA FISTULA, WITH REPAIR OF V                  N   3      $13.45   6/1/1994   12/31/2299
33718   7   LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN             N   3    $240.32    1/1/2006   12/31/2299
33718   8   LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN             N   3    $240.32    1/1/2006   12/31/2299
33720   2   REPAIR SINUS OF VALSALVA ANEURYSM, WITH CARDIOPULM                  N   3    $850.00    1/1/1984   12/31/2299
33720   7   REPAIR SINUS OF VALSALVA ANEURYSM, WITH CARDIOPULM                  N   3      $13.45   6/1/1994   12/31/2299
33722   2   CLOSURE OF AORTICO-LEFT VENTRICULAR TUNNEL                          N   3   $1,039.48   1/1/1994   12/31/2299
33724   7   REPAIR VENOUS ANOMALY                                               N   3      $13.45   1/1/2007   12/31/2299
33724   8   REPAIR VENOUS ANOMALY                                               N   3    $167.00    1/1/2007   12/31/2299
33726   2   REPAIR PUL VENOUS STENOSIS                                          N   3   $1,105.24   1/1/2007   12/31/2299
33726   7   REPAIR PUL VENOUS STENOSIS                                          N   3      $13.45   1/1/2007   12/31/2299
33726   8   REPAIR PUL VENOUS STENOSIS                                          N   3    $221.00    1/1/2007   12/31/2299
33727   2   REPAIR VENOUS ANOMALY                                               N   3    $839.53    1/1/2007   12/31/2299
33730   2   COMPLETE REPAIR OF ANOMALOUS VENOUS RETURN                          N   3   $1,250.00   1/1/1973   12/31/2299
33730   7   COMPLETE REPAIR OF ANOMALOUS VENOUS RETURN                          N   3      $13.45   6/1/1994   12/31/2299
33730   8   COMPLETE REPAIR OF ANOMALOUS VENOUS RETURN                          N   3    $250.00    1/1/1973   12/31/2299
33732   2   REPAIR OF COR TRIATRIATUM OR SUPRAVALVULAR MITRAL                   N   3   $1,030.06   1/1/1994   12/31/2299
33735   2   ATRIAL SEPTECTOMY; CLOSED                                           N   3    $750.00    1/1/1971   12/31/2299
33735   7   ATRIAL SEPTECTOMY; CLOSED                                           N   3      $13.45   6/1/1994   12/31/2299
33735   8   ATRIAL SEPTECTOMY; CLOSED                                           N   3    $150.00    8/1/1979   12/31/2299
33736   2   ATRIAL SEPTECTOMY OR SEPTOSTOMY;                                    N   3    $759.46    1/1/1994   12/31/2299
33737   2   ATRIAL SEPTECTOMY; OPEN, WITH INFLOW OCCLUSION                      N   3    $950.00    1/1/1973   12/31/2299
33737   7   ATRIAL SEPTECTOMY; OPEN, WITH INFLOW OCCLUSION                      N   3      $13.45   6/1/1994   12/31/2299
33737   8   ATRIAL SEPTECTOMY; OPEN, WITH INFLOW OCCLUSION                      N   3    $190.00    1/1/1973   12/31/2299
33750   2   SHUNT; SUBCLAVIAN TO PULMONARY ARTERY                               N   3    $750.00    1/1/1973   12/31/2299
33750   7   SHUNT; SUBCLAVIAN TO PULMONARY ARTERY                               N   3      $13.45   6/1/1994   12/31/2299
33750   8   SHUNT; SUBCLAVIAN TO PULMONARY ARTERY                               N   3    $150.00    1/1/1973   12/31/2299
33755   7   SHUNT; ASCENDING AORTA TO PULMONARY ARTERY                          N   3      $13.45   6/1/1994   12/31/2299
33762   7   SHUNT; DESCENDING AORTA TO PULMONARY ARTERY                         N   3      $13.45   6/1/1994   12/31/2299
33764   2   SHUNT                                                               N   3    $567.00    1/2/1992   12/31/2299
33764   7   SHUNT                                                               N   3      $13.45   6/1/1994   12/31/2299
33766   2   SHUNT; VENA CAVA TO PULMONARY ARTERY                                N   3    $567.00    1/2/1992   12/31/2299
33766   7   SHUNT; VENA CAVA TO PULMONARY ARTERY                                N   3      $13.45   6/1/1994   12/31/2299
33766   8   SHUNT; VENA CAVA TO PULMONARY ARTERY                                N   3    $150.00    1/1/1973   12/31/2299
33767   2   SHUNT;                                                              N   3    $890.79    1/1/1994   12/31/2299
33767   7   SHUNT                                                               N   3      $13.45   1/1/1994   12/31/2299
33768   2   ANASTOMOSIS, CAVOPULMONARY, SECOND SUPERIOR VENA CAVA (LIST SEPAR   N   3    $257.50    1/1/2006   12/31/2299
33768   7   ANASTOMOSIS, CAVOPULMONARY, SECOND SUPERIOR VENA CAVA (LIST SEPAR   N   3      $13.45   1/1/2006   12/31/2299
33768   8   ANASTOMOSIS, CAVOPULMONARY, SECOND SUPERIOR VENA CAVA (LIST SEPAR   N   3      $51.50   1/1/2006   12/31/2299
33770   2   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES WITH                  N   3   $1,215.35   1/1/1994   12/31/2299
33771   2   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES WITH                  N   3   $1,261.99   1/1/1994   12/31/2299
33774   7   TRANSPOSITION OF THE GREAT VESSELS                                  N   3      $13.45   6/1/1994   12/31/2299
33775   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATR                  N   3      $13.45   6/1/1994   12/31/2299
33776   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATR                  N   3      $13.45   6/1/1994   12/31/2299
33777   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATR                  N   3      $13.45   6/1/1994   12/31/2299
33778   2   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AOR                  N   3   $1,401.88   1/1/2004   12/31/2299
33778   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AOR                  N   3      $13.45   6/1/1994   12/31/2299
33779   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AOR                  N   3      $13.45   6/1/1994   12/31/2299
33780   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AOR                  N   3      $13.45   6/1/1994   12/31/2299
33781   7   REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AOR                  N   3      $13.45   6/1/1994   12/31/2299
33785   7   REPAIR TRANSPOSITION OF GREAT VESSELS,                              N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                       133
33786   2   TOTAL REPAIR, TRUNCUS ARTERIOSUS (RASTELLI TYPE OP                  N   3   $1,397.65   1/1/2005   12/31/2299
33786   7   TOTAL REPAIR, TRUNCUS ARTERIOSUS (RASTELLI TYPE OP                  N   3      $13.45   6/1/1994   12/31/2299
33788   7   REPLANT PULMONARY ARTERY FOR HEMITRUNCUS                            N   3      $13.45   6/1/1994   12/31/2299
33800   2   AORTIC SUSPENSION (AORTOPEXY) FOR TRACHEAL DECOMPR                  N   3    $531.67    1/1/1993   12/31/2299
33800   7   AORTIC ANOMALIES                                                    N   3      $13.45   6/1/1994   12/31/2299
33802   2   DIVISION OF ABERRANT VESSEL (VASCULAR RING);                        N   3    $600.00    1/1/1973   12/31/2299
33802   7   DIVISION OF ABERRANT VESSEL (VASCULAR RING);                        N   3      $13.45   6/1/1994   12/31/2299
33802   8   DIVISION OF ABERRANT VESSEL (VASCULAR RING);                        N   3    $120.00    1/1/1973   12/31/2299
33803   7   DIVISION OF ABERRANT VESSEL (VASCULAR RING); WITH                   N   3      $13.45   6/1/1994   12/31/2299
33813   7   OBLITERATION OF AORTOPULMONARY SEPTAL DEFECT                        N   3      $13.45   6/1/1994   12/31/2299
33814   7   OBLITERATION OF AORTOPULMONARY SEPTAL DEFECT                        N   3      $13.45   6/1/1994   12/31/2299
33820   2   PATENT DUCTUS ARTERIOSUS; LIGATION                                  N   3    $500.00    1/1/1984   12/31/2299
33820   7   PATENT DUCTUS ARTERIOSUS; LIGATION                                  N   3      $13.45   6/1/1994   12/31/2299
33820   8   PATENT DUCTUS ARTERIOSUS; LIGATION                                  N   3    $100.00    1/1/1984   12/31/2299
33822   2   PATENT DUCTUS ARTERIOSUS; DIVISION, UNDER 18 YEARS                  N   3    $600.00    1/1/1973   12/31/2299
33822   7   PATENT DUCTUS ARTERIOSUS; DIVISION, UNDER 18 YEARS                  N   3      $13.45   6/1/1994   12/31/2299
33822   8   PATENT DUCTUS ARTERIOSUS; DIVISION, UNDER 18 YEARS                  N   3    $120.00    1/1/1973   12/31/2299
33824   2   PATENT DUCTUS ARTERIOSUS; DIVISION, 18 YEARS AND OLDER              N   3    $900.00    1/1/1973   12/31/2299
33824   7   PATENT DUCTUS ARTERIOSUS; DIVISION, 18 YEARS AND O                  N   3      $13.45   6/1/1994   12/31/2299
33824   8   PATENT DUCTUS ARTERIOSUS; DIVISION, 18 YEARS AND O                  N   3    $180.00    1/1/1973   12/31/2299
33840   2   EX OF COARCTATION OF AORTA,W OR W/OUT ASSOCIATED P                  N   3    $800.00    8/1/1979   12/31/2299
33840   7   EX OF COARCTATION OF AORTA,W OR W/OUT ASSOCIATED P                  N   3      $13.45   6/1/1994   12/31/2299
33840   8   EX OF COARCTATION OF AORTA,W OR W/OUT ASSOCIATED P                  N   3    $160.00    8/1/1979   12/31/2299
33845   2   EX OF COARCTATION OF AORTA, W OR W/OUT ASSOCIATED                   N   3    $756.00    1/2/1992   12/31/2299
33845   7   EX OF COARCTATION OF AORTA, W OR W/OUT ASSOCIATED                   N   3      $13.45   6/1/1994   12/31/2299
33845   8   EX OF COARCTATION OF AORTA, W OR W/OUT ASSOCIATED                   N   3    $151.20    1/2/1992   12/31/2299
33850   2   EX OF COARCTATION OF AORTA; WITH SHUNT, LEFT SUBCL                  N   3   $1,250.00   1/1/1973   12/31/2299
33850   7   EX OF COARCTATION OF AORTA; WITH SHUNT, LEFT SUBCL                  N   3      $13.45   6/1/1994   12/31/2299
33850   8   EX OF COARCTATION OF AORTA; WITH SHUNT, LEFT SUBCL                  N   3    $250.00    1/1/1973   12/31/2299
33851   2   EXCISION OF COARCTATION OF AORTA, WITH OR WITHOUT                   N   3    $800.65    1/1/2004   12/31/2299
33851   7   EXCISION OF COARCTATION OF AORTA, WITH OR WITHOUT                   N   3      $13.45   6/1/1994   12/31/2299
33852   7   EXCISION OF COARCTATION OF AORTA, WITH OR WITHOUT                   N   3      $13.45   6/1/1994   12/31/2299
33853   2   REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH U                  N   3   $1,150.61   1/1/1994   12/31/2299
33853   7   ANESTHESIA,REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH USING   N   3      $13.45   1/1/1994   12/31/2299
33853   8   ASSISTANT/REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH          N   3    $230.12    1/1/1994   12/31/2299
33860   2   ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3   $1,255.33   1/1/2004   12/31/2299
33860   7   ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3      $13.45   6/1/1994   12/31/2299
33860   8   ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3    $266.90    1/1/2004   12/31/2299
33861   2   ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3   $1,341.38   1/1/1994   12/31/2299
33863   2   ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3   $1,354.58   1/1/1994   12/31/2299
33870   7   TRANSVERSE ARCH GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3      $13.45   6/1/1994   12/31/2299
33870   8   TRANSVERSE ARCH GRAFT, WITH CARDIOPULMONARY BYPASS                  N   3    $306.45    1/1/2004   12/31/2299
33875   2   DESCENDING THORACIC AORTA GRAFT, WITH OR WITHOUT B                  N   3   $1,200.00   1/1/1971   12/31/2299
33875   7   DESCENDING THORACIC AORTA GRAFT, WITH OR WITHOUT B                  N   3      $13.45   6/1/1994   12/31/2299
33875   8   DESCENDING THORACIC AORTA GRAFT, WITH OR WITHOUT B                  N   3    $240.00    1/1/1973   12/31/2299
33877   7   REPAIR OF THORACOABDOMINAL AORTIC ANEURYSM WITH GR                  N   3      $13.45   6/1/1994   12/31/2299
33880   2   ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA (EG ANEURYSM, PS   N   3   $1,073.50   1/1/2006   12/31/2299
33880   7   ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA (EG ANEURYSM, PS   N   3      $13.45   1/1/2006   12/31/2299
33880   8   ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA (EG ANEURYSM, PS   N   3    $214.70    1/1/2006   12/31/2299
33881   2   ENDOVASCULAR REPAIR OF DECENDING THORACIC AORTA (EG, ANEURYSM, PS   N   3    $922.49    1/1/2006   12/31/2299
33881   7   ENDOVASCULAR REPAIR OF DECENDING THORACIC AORTA (EG, ANEURYSM, PS   N   3      $13.45   1/1/2006   12/31/2299




                                                                                                                       134
33881   8   ENDOVASCULAR REPAIR OF DECENDING THORACIC AORTA (EG, ANEURYSM, PS   N   3    $184.50    1/1/2006   12/31/2299
33883   2   PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAI   N   3    $682.37    1/1/2006   12/31/2299
33883   7   PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAI   N   3      $13.45   1/1/2006   12/31/2299
33883   8   PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAI   N   3    $136.47    1/1/2006   12/31/2299
33884   2   PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAI   N   3    $253.09    1/1/2006   12/31/2299
33884   7   PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAI   N   3      $13.45   1/1/2006   12/31/2299
33884   8   PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAI   N   3      $50.62   1/1/2006   12/31/2299
33886   2   PLACEMENT OF DISTAL EXTENSION PROSTHESIS(S) DELAYED AFTER ENDOVAS   N   3    $589.52    1/1/2006   12/31/2299
33886   7   PLACEMENT OF DISTAL EXTENSION PROSTHESIS(S) DELAYED AFTER ENDOVAS   N   3      $13.45   1/1/2006   12/31/2299
33886   8   PLACEMENT OF DISTAL EXTENSION PROSTHESIS(S) DELAYED AFTER ENDOVAS   N   3    $117.90    1/1/2006   12/31/2299
33889   2   OPEN SUBCLAVIAN TO CAROTID ARTERY TRANSPOSITION PERFORMED IN CONJ   N   3    $505.63    1/1/2006   12/31/2299
33889   7   OPEN SUBCLAVIAN TO CAROTID ARTERY TRANSPOSITION PERFORMED IN CONJ   N   3      $13.45   1/1/2006   12/31/2299
33889   8   OPEN SUBCLAVIAN TO CAROTID ARTERY TRANSPOSITION PERFORMED IN CONJ   N   3    $111.24    1/1/2006   12/31/2299
33891   2   BYPASS GRAFT, WITH OTHER THAN VEIN, TRANSCERVICAL RETROPHARYNGEAL   N   3    $645.34    1/1/2006   12/31/2299
33891   7   BYPASS GRAFT, WITH OTHER THAN VEIN, TRANSCERVICAL RETROPHARYNGEAL   N   3      $13.45   1/1/2006   12/31/2299
33891   8   BYPASS GRAFT, WITH OTHER THAN VEIN, TRANSCERVICAL RETROPHARYNGEAL   N   3    $129.07    1/1/2006   12/31/2299
33910   7   PULMONARY ARTERY EMBOLECTOMY; WITH CARDIOPULMONARY                  N   3      $13.45   6/1/1994   12/31/2299
33915   2   PULMONARY ARTERY EMBOLECTOMY; WITHOUT BYPASS                        N   3    $500.00    8/1/1979   12/31/2299
33915   7   PULMONARY ARTERY EMBOLECTOMY; WITHOUT BYPASS                        N   3      $13.45   6/1/1994   12/31/2299
33915   8   PULMONARY ARTERY EMBOLECTOMY; WITHOUT BYPASS                        N   3    $100.00    8/1/1979   12/31/2299
33916   7   PULMONARY ENDARTERECTOMY WITH OR WITHOUT EMBOLECTO                  N   3      $13.45   6/1/1994   12/31/2299
33917   2   REPAIR OF PULMONARY ARTERY STENOSIS BY RECONSTRUCT                  N   3    $890.79    1/1/1994   12/31/2299
33920   2   REPAIR OF PULMONARY ATRESIA WITH VENTRICULAR SEPTA                  N   3   $1,168.91   1/1/1994   12/31/2299
33922   2   TRANSECTION OF PULMONARY ARTERY WITH CARDIOPULMONA                  N   3    $853.57    1/1/1994   12/31/2299
33924   2   LIG/TAKE SYST/PULM ART SHNT,IN CONJ W/CONGEN HEART PROCEDURE        N   3    $251.75    1/1/1996   12/31/2299
33924   8   LIG/TAKE SYST/PULM ART SHNT,IN CONJUNC W/CONGEN HEART PROCEDURE     N   3      $50.35   1/1/1996   12/31/2299
33925   2   REPAIR OF PULMONARY ARTERY ARBORIZATION ANOMALIES BY UNIFOLCALIZA   N   3   $1,062.08   1/1/2006   12/31/2299
33925   7   REPAIR OF PULMONARY ARTERY ARBORIZATION ANOMALIES BY UNIFOLCALIZA   N   3      $13.45   1/1/2006   12/31/2299
33925   8   REPAIR OF PULMONARY ARTERY ARBORIZATION ANOMALIES BY UNIFOLCALIZA   N   3    $212.42    1/1/2006   12/31/2299
33926   2   REPAIR OF PULMONARY ARTERY ARBORIZATION ANOMALIES BY UNIFOCALIZAT   N   3   $1,433.68   1/1/2006   12/31/2299
33926   7   REPAIR OF PULMONARY ARTERY ARBORIZATION ANOMALIES BY UNIFOCALIZAT   N   3      $13.45   1/1/2006   12/31/2299
33926   8   REPAIR OF PULMONARY ARTERY ARBORIZATION ANOMALIES BY UNIFOCALIZAT   N   3    $286.74    1/1/2006   12/31/2299
33930   7   MISCELLANEOUS                                                       N   3      $13.45   6/1/1994   12/31/2299
33935   7   HEART-LUNG TRANSPLANT WITH RECIPIENT CARDIECTOMY-P                  N   3      $13.45   6/1/1994   12/31/2299
33940   7   DONOR CARDIECTOMY, WITH PREPARATION AND MAINTENANC                  N   3      $13.45   6/1/1994   12/31/2299
33945   2   HEART TRANSPLANT, WITH OR WITHOUT RECIPIENT CARDIE                  N   3   $1,483.49   1/1/2003   12/31/2299
33945   7   HEART TRANSPLANT, WITH OR WITHOUT RECIPIENT CARDIECTOMY             N   3      $13.45   6/1/1994   12/31/2299
33960   2   PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPULMONARY INSUFFIC   N   3    $630.00    1/2/1994   12/31/2299
33960   7   PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPUL                  N   3      $13.45   6/1/1994   12/31/2299
33961   2   PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPUL                  N   3    $387.51    1/1/1994   12/31/2299
33967   2   INSERTION OF INTRA-AORTIC BALLOON ASSIS DEVICE, PERCUTANEOUS        N   3    $153.67    1/1/2002   12/31/2299
33968   2   REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE PERCUTANEOUS          N   3      $25.57   1/1/2000   12/31/2299
33970   2   INTRA-AORTIC BALLOON COUNTERPULSATION; INSERTION A                  N   3    $300.00    8/1/1979   12/31/2299
33970   7   INTRA-AORTIC BALLOON COUNTERPULSATION; INSERTION A                  N   3      $13.45   6/1/1994   12/31/2299
33970   8   INTRA-AORTIC BALLOON COUNTERPULSATION; INSERTION A                  N   3      $60.00   1/1/1984   12/31/2299
33971   2   INTRA-AORTIC BALLOON COUNTERPULSATION                               N   3    $380.06    1/1/2004   12/31/2299
33971   7   REMOVAL OF BALLOON INC REPAIR OF ARTERY W W/O GRAF                  N   3      $13.45   6/1/1994   12/31/2299
33973   2   INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE TH                  N   3    $380.06    1/1/1994   12/31/2299
33974   2   REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE FROM                  N   3    $391.90    1/1/1994   12/31/2299
33975   2   IMPLANTATION OF VENTRICULAR ASSIST DEVICE;                          N   3    $742.19    1/1/1994   12/31/2299
33976   2   IMPLANTATION OF VENTRICULAR ASSIST DEVICE;                          N   3   $1,011.34   1/1/1994   12/31/2299




                                                                                                                       135
33977   2   REMOVAL OF VENTRICULAR ASSIST DEVICE;                           N   3   $649.36   1/1/1994   12/31/2299
33978   2   REMOVAL OF VENTRICULAR ASSIST DEVICE;                           N   3   $742.19   1/1/1994   12/31/2299
33999   7   UNLISTED PROCEDURE, CARDIAC SURGERY                             N   3    $13.45   6/1/1994   12/31/2299
34001   2   EMBOLECTOMY OR THROMBECTOMY,W OR W/OUT CATHETER;CA              N   3   $350.00   1/1/1973   12/31/2299
34001   7   EMBOLECTOMY OR THROMBECTOMY,W OR W/OUT CATHETER;CA              N   3    $13.45   6/1/1994   12/31/2299
34001   8   EMBOLECTOMY OR THROMBECTOMY,W OR W/OUT CATHETER;CA              N   3    $70.00   1/1/1973   12/31/2299
34051   7   EMBOLECTOMY OR THROMBECTOMY,W OR W/OUT CATHETER;IN              N   3    $13.45   6/1/1994   12/31/2299
34101   2   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;AXILLARY              N   3   $350.00   1/1/1971   12/31/2299
34101   7   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;AXILLARY              N   3    $13.45   6/1/1994   12/31/2299
34101   8   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;AXILLARY              N   3    $70.00   1/1/1973   12/31/2299
34111   2   EMBLCTMY / THRMBCTMY W/WO CTHTR RADIL / ULNR ARTRY              N   3   $250.00   1/1/1984   12/31/2299
34111   7   EMBLCTMY / THRMBCTMY W/WO CTHTR RADIL / ULNR ARTRY              N   3    $13.45   6/1/1994   12/31/2299
34111   8   EMBLCTMY / THRMBCTMY W/WO CTHTR RADIL / ULNR ARTRY              N   3    $50.00   1/1/1984   12/31/2299
34151   2   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;RENAL,CE              N   3   $400.00   1/1/1971   12/31/2299
34151   7   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;RENAL,CE              N   3    $13.45   6/1/1994   12/31/2299
34151   8   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;RENAL,CE              N   3    $80.00   1/1/1973   12/31/2299
34201   2   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;FEMOROPO              N   3   $327.13   1/1/1973   12/31/2299
34201   7   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;FEMOROPO              N   3    $13.45   6/1/1994   12/31/2299
34201   8   EMBOLECTOMY OR THROMBECTOMY,W/WO CATHETER;FEMOROPO              N   3    $65.43   1/1/1973   12/31/2299
34203   2   EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHE              N   3   $420.00   1/2/1992   12/31/2299
34203   7   EMBOLECTOMY OR THROMBECTOMY, WITH OR WITHOUT CATHE              N   3    $13.45   6/1/1994   12/31/2299
34401   2   THROMBECTOMY,DIRECT OR WITH CATHETER;VENA CAVA,ILI              N   3   $450.00   1/1/1971   12/31/2299
34401   7   THROMBECTOMY,DIRECT OR WITH CATHETER;VENA CAVA,ILI              N   3    $13.45   6/1/1994   12/31/2299
34401   8   THROMBECTOMY,DIRECT OR WITH CATHETER;VENA CAVA,ILI              N   3    $90.00   1/1/1973   12/31/2299
34421   2   THROMBECTOMY,DIR OR WITH CATHETER;VENA CAVA,ILIAC,              N   3   $500.00   1/1/1971   12/31/2299
34421   7   THROMBECTOMY,DIR OR WITH CATHETER;VENA CAVA,ILIAC,              N   3    $13.45   6/1/1994   12/31/2299
34421   8   THROMBECTOMY,DIR OR WITH CATHETER;VENA CAVA,ILIAC,              N   3    $60.00   1/1/1973   12/31/2299
34451   2   THROMBECTOMY, DIRECT OR WITH CATHETER;BY ABDOMINAL              N   3   $600.00   1/1/1971   12/31/2299
34451   7   THROMBECTOMY, DIRECT OR WITH CATHETER;BY ABDOMINAL              N   3    $13.45   6/1/1994   12/31/2299
34451   8   THROMBECTOMY, DIRECT OR WITH CATHETER;BY ABDOMINAL              N   3   $120.00   1/1/1973   12/31/2299
34471   2   THROMBECTOMY, DIRECT OR WITH CATHETER;SUBCLAVIAN V              N   3   $329.14   1/1/2003   12/31/2299
34471   7   THROMBECTOMY, DIRECT OR WITH CATHETER;SUBCLAVIAN V              N   3    $13.45   6/1/1994   12/31/2299
34490   7   THROMBECTOMY, DIRECT OR WITH CATHETER;AXILLARY AND              N   3    $13.45   6/1/1994   12/31/2299
34501   7   VENOUS RECONSTRUCTION                                           N   3    $13.45   6/1/1994   12/31/2299
34502   2   RECONSTRUCTION OF VENA CAVA, ANY METHOD                         N   3   $975.36   1/1/1994   12/31/2299
34510   7   VENOUS VALVE TRANSPOSITION, ANY VEIN DONOR                      N   3    $13.45   6/1/1994   12/31/2299
34520   2   CROSS-OVER VEIN GRAFT TO VENOUS SYSTEM                          N   3   $534.00   1/2/1994   12/31/2299
34520   7   CROSS-OVER VEIN GRAFT TO VENOUS SYSTEM                          N   3    $13.45   6/1/1994   12/31/2299
34530   7   SAPHENOPOPLITEAL VEIN ANASTOMOSIS                               N   3    $13.45   6/1/1994   12/31/2299
34690   7   PLCMNT CV CATH SUBCL JUG CUT DOWN UNDER 2YRS                    N   3    $13.45   6/1/1994   12/31/2299
34800   2   ENDOVAS.REPAIR OF INFRARE.ABDOM.AORTIC ANEURISM OR DISSECTION   N   3   $731.81   1/1/2001   12/31/2299
34800   7   ENDOVAS.REPAIR OF INFRARENAL ABDOM.AORTIC ANEUR.OR DISSECTION   N   3    $13.45   1/1/2001   12/31/2299
34800   8   ENDOVAS.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.OR DISS.            N   3   $146.36   1/1/2001   12/31/2299
34802   2   ENDOVASC.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.OR DISS.           N   3   $807.49   1/1/2001   12/31/2299
34802   7   ENDOVAS.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.OR DISSECTION       N   3    $13.45   1/1/2001    12/1/2299
34802   8   ENVAS.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.DISSEC.               N   3   $161.50   1/1/2001   12/31/2299
34803   2   ENDOVASCULAR REPAIR ABD AORTIC ANEURYSM                         N   3   $827.24   1/1/2005   12/31/2299
34803   7   ENDOVASCULAR REPAIR INFRARENAL ABD AORTIC ANEURYSM              N   3    $13.45   1/1/2005   12/31/2299
34803   8   ENDOVASCULAR REPAIR INFRARENAL ABD AORTIC ANEURYSM              N   3   $165.45   1/1/2005   12/31/2299
34804   2   ENDOVAS.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.OR DISSEC.          N   3   $807.49   1/1/2001   12/31/2299
34804   7   ENDOVASC.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.OR DISSEC.         N   3    $13.45   1/1/2001   12/31/2299




                                                                                                                 136
34804   8   ENDOVASC.REPAIR OF INFRAR.ABDOM.AORTIC ANEUR.OR DISSEC.             N   3    $161.50    1/1/2001   12/31/2299
34805   2   ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM         N   3    $747.14    1/1/2004   12/31/2299
34808   2   ENDOVAS.PLACEM.OF ILIAC ARTER.OCCLUS.DEV.                           N   3    $138.77    1/1/2001   12/31/2299
34808   7   ENDOVASC.PLACEM.OF ILIAC ARTER.OCCLU.DEV.                           N   3      $13.45   1/1/2001   12/31/2299
34812   2   OPEN FEMORAL ARTERY EXPO.FOR DELIV.OF AORTIC ENDOVAS.               N   3    $227.23    1/1/2001   12/31/2299
34812   7   OPEN FEM.ARTEY EXPOS.FOR DELIV.OF AORTIC ENDOV.PROSTH.              N   3      $13.45   1/1/2001   12/31/2299
34813   2   PLACEMENT OF FEMORAL-FEMORAL PROSTHETIC GRAFT DURING ENDOVALCULAR   N   3    $161.41    1/1/2001   12/31/2299
34813   7   PLACEM.OF FEMORAL PROST.GRAFT DURI.ENDOV.AORTI.ANEUR.               N   3      $13.45   1/1/2001   12/31/2299
34820   2   OPEN ILIAC ARTERY FOR DELIV.OF ENDOVASC.THERAPY                     N   3    $328.06    1/1/2001   12/31/2299
34820   7   OPEN ILIAC ARTERY EXP.FOR DELIV.OF ENDOVAS.THER.                    N   3      $13.45   1/1/2001   12/31/2299
34825   2   PLACEM.OF DIST.XET.PROSTH.FOR ENDOV.REPAIR OF INFRARENAL            N   3    $437.60    1/1/2001   12/31/2299
34825   7   PLACEM.OF PROX.OR DIST.EXT.PROST.FOR ENDOV.REPR.                    N   3      $13.45   1/1/2001   12/31/2299
34826   2   PLACEMENT OF PROXIMAL OR DISTAL EXTENSION PROSTHESIS FOR ENDOVASC   N   3    $138.77    1/1/2001   12/31/2299
34826   7   ANESTHESIA,PLACEMENT OF PROXIMAL OR DISTAL EXTENSION PROSTHESIS     N   3      $13.45   1/1/2001   12/31/2299
34830   2   OPEN REPAIR OFINFRARENO AORTIC ANEURYSM OR DISSECTIONAND REPAIR     N   3   $1,138.58   1/1/2001   12/31/2299
34830   7   OPEN REPAIR OF INFRARENAL ABDOM.                                    N   3      $13.45   1/1/2001   12/31/2299
34830   8   OPEN REPAIR OF INFRAREN.AORTIC ANEURYSM OR DISSECT.                 N   3    $227.72    1/1/2001   12/31/2299
34831   2   OPEN REPR. OF INFRAR.AORTIC ANEURSYM OR DISSEC.                     N   3   $1,230.71   1/1/2001   12/31/2299
34831   7   OPEN REPAIR OF INFRAR.AORTIC ANEURSYM OR DISSEC.                    N   3      $13.45   1/1/2001   12/31/2299
34831   8   OPEN REPAIR OF INFRAR.AORTIC ANEURYSM OR DISSEC.                    N   3    $246.14    1/1/2001   12/31/2299
34832   2   OPEN REPAIR OF INFRAR.AORTIC ANEURYSM OR DISSECTION                 N   3   $1,230.71   1/1/2001   12/31/2299
34832   7   OPEN RPR.OF INFRAR.AORTIC ANEURSYM OR DISSECTION                    N   3      $13.45   1/1/2001   12/31/2299
34832   8   OPEN REPAIR OF INFRAR.AOORTIC ANEURSYM OR DISSECTION                N   3    $246.14    1/1/2001   12/31/2299
34833   2   OPEN ILIAC ART W/CREATION CONDUIT DELIV INFRARENAL AORTIC OR        N   3    $387.11    1/1/2003   12/31/2299
34834   2   OPEN BRACHIAL ART TO ASSIST DEPLOYMENT INFRARENAL/ILIAC ENDOV       N   3    $181.73    1/1/2003   12/31/2299
34900   2   ENDOVAS GRAFT REPL REPAIR ILIAC ART(ANEURYSM,PSEUDOANEURYS          N   3    $570.92    1/1/2003   12/31/2299
35001   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3    $700.00    1/1/1971   12/31/2299
35001   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3      $13.45   6/1/1994   12/31/2299
35001   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3    $140.00    1/1/1973   12/31/2299
35005   2   DIRECT REPAIR OF ANEURYSM OR EXCISION (PARTIAL OR                   N   3    $592.10    1/1/2002   12/31/2299
35005   7   DIRECT REPAIR OF ANEURYSM OR EXCISION (PARTIAL OR                   N   3      $13.45   6/1/1994   12/31/2299
35011   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3    $618.68    1/1/2004   12/31/2299
35011   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3      $13.45   6/1/1994   12/31/2299
35021   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3    $750.00    1/1/1971   12/31/2299
35021   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3      $13.45   6/1/1994   12/31/2299
35021   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W - W/O PATCH                  N   3    $150.00    1/1/1973   12/31/2299
35045   2   DIRECT REPAIR OF ANEURYSM OR EXCISION (PARTIAL OR                   N   3    $577.41    1/1/2002   12/31/2299
35045   7   DIRECT REPAIR OF ANEURYSM OR EXCISION (PARTIAL OR                   N   3      $13.45   6/1/1994   12/31/2299
35081   2   DIR RPR OF ANEU OR EXC & GRFT INSERT, W-W/O PATCH                   N   3   $1,000.00   1/1/1973   12/31/2299
35081   7   DIR RPR OF ANEU OR EXC & GRFT INSERT, W-W/O PATCH                   N   3      $13.45   6/1/1994   12/31/2299
35081   8   DIR RPR OF ANEU OR EXC & GRFT INSERT, W-W/O PATCH                   N   3    $200.00    1/1/1973   12/31/2299
35082   2   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,W                  N   3   $1,000.00   1/1/1984   12/31/2299
35082   7   DIR REPAIR ANEU OR EXIS (PART OR TOT)+ GR INSERT                    N   3      $13.45   6/1/1994   12/31/2299
35082   8   DIR REPAIR ANEU OR EXIS (PART OR TOT)+ GR INSERT                    N   3    $200.00    1/1/1984   12/31/2299
35091   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G                  N   3   $1,200.00   1/1/1984   12/31/2299
35091   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G                  N   3      $13.45   6/1/1994   12/31/2299
35091   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G                  N   3    $240.00    1/1/1984   12/31/2299
35102   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G                  N   3    $900.00    1/1/1984   12/31/2299
35102   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G                  N   3      $13.45   6/1/1994   12/31/2299
35102   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G                  N   3    $180.00    1/1/1984   12/31/2299
35103   2   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,                   N   3   $1,200.00   1/1/1984   12/31/2299




                                                                                                                       137
35103   7   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,              N   3      $13.45   6/1/1994   12/31/2299
35103   8   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,              N   3    $240.00    1/1/1984   12/31/2299
35111   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $600.00    1/1/1973   12/31/2299
35111   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3      $13.45   6/1/1994   12/31/2299
35111   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $120.00    1/1/1973   12/31/2299
35112   2   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,              N   3    $702.00    1/1/1996   12/31/2299
35112   7   ANESTHESIA/DIR REPAIR ANEU OR EXCIS(PART OR TOT) & GR INSERT   N   3      $13.45   1/1/1996   12/31/2299
35112   8   ASSIST/DIR REPAIR ANEU OR EXCIS(PART OR TOT) & GR INSERT,      N   3    $141.00    1/1/1996   12/31/2299
35121   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3   $1,000.00   1/1/1973   12/31/2299
35121   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3      $13.45   6/1/1994   12/31/2299
35121   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $200.00    1/1/1973   12/31/2299
35131   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $800.00    1/1/1971   12/31/2299
35131   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3      $13.45   6/1/1994   12/31/2299
35131   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $160.00    1/1/1973   12/31/2299
35141   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $600.00    8/1/1979   12/31/2299
35141   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3      $13.45   6/1/1994   12/31/2299
35141   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $120.00    1/1/1973   12/31/2299
35142   2   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,              N   3    $600.00    1/1/1984   12/31/2299
35142   7   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,              N   3      $13.45   6/1/1994   12/31/2299
35142   8   DIR REPAIR ANEU OR EXCIS(PART OR TOT)& GR INSERT,              N   3    $120.00    1/1/1984   12/31/2299
35151   2   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $600.00    8/1/1979   12/31/2299
35151   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3      $13.45   6/1/1994   12/31/2299
35151   8   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3    $140.00    1/1/1973   12/31/2299
35161   7   DIR RPR OF ANEU OR EXC & GRFT INSERT,W-W/O PATCH G             N   3      $13.45   6/1/1994   12/31/2299
35180   7   REPAIR ARTERIOVENOUS FISTULA                                   N   3      $13.45   6/1/1994   12/31/2299
35182   2   REPAIR CONG A-V FISTULA THORAX OR ABDOMEN                      N   3    $200.00    1/1/1984   12/31/2299
35184   7   REPAIR, CONGENITAL ARTERIOVENOUS FISTULA                       N   3      $13.45   6/1/1994   12/31/2299
35188   7   REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTUL             N   3      $13.45   6/1/1994   12/31/2299
35188   F   REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTUL             N   3    $432.00    3/1/2004   12/31/2299
35189   7   REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTUL             N   3      $13.45   6/1/1994   12/31/2299
35190   2   REPAIR ARTERIOVENOUS FISTULA; EXTREMITIES                      N   3    $350.00    1/1/1984   12/31/2299
35190   7   REP,AQUIR/TRAUM ARTVNS FISTULA; THORAX AND ABDOMEN             N   3      $13.45   6/1/1994   12/31/2299
35190   8   REPAIR ARTERIOVENOUS FISTULA; EXTREMITIES                      N   3      $70.00   1/1/1984   12/31/2299
35201   2   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; NECK              N   3    $700.00    1/1/1973   12/31/2299
35201   7   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; NECK              N   3      $13.45   6/1/1994   12/31/2299
35201   8   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; NECK              N   3    $140.00    1/1/1973   12/31/2299
35206   2   REPAIR BLOOD VESSEL: UPPER EXTREMITY                           N   3    $600.00    1/2/1992   12/31/2299
35206   7   REPAIR BLOOD VESSEL: UPPER EXTREMITY                           N   3      $13.45   6/1/1994   12/31/2299
35206   8   REPAIR BLOOD VESSEL: UPPER EXTREMITY                           N   3      $50.00   1/1/1984   12/31/2299
35207   2   REPAIR BLOOD VSL, DIRECT HAND                                  N   3    $522.00    1/2/1995   12/31/2299
35207   7   ANESTHESIA, REPAIR BLOOD VESSEL, DIRECT HAND                   N   3      $13.45   1/2/1995   12/31/2299
35207   8   REPAIR BLOOD VSL, DIRECT HAND                                  N   3    $104.00    1/2/1995   12/31/2299
35207   F   REPAIR BLOOD VSL, DIRECT HAND                                  N   3    $432.00    3/1/2004   12/31/2299
35211   2   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3    $970.93    1/1/2002   12/31/2299
35211   7   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3      $13.45   6/1/1994   12/31/2299
35216   2   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3    $850.00    1/1/1973   12/31/2299
35216   7   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3      $13.45   6/1/1994   12/31/2299
35216   8   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3    $170.00    1/1/1973   12/31/2299
35221   2   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3    $745.49    1/1/2003   12/31/2299
35221   7   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; INTRA             N   3      $13.45   6/1/1994   12/31/2299
35226   2   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; LOWER             N   3    $480.00    1/2/1994   12/31/2299




                                                                                                                  138
35226   7   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; LOWER                  N   3    $13.45   6/1/1994   12/31/2299
35226   8   REPAIR BLOOD VESSELS OR A-V FISTULA, DIRECT; LOWER                  N   3    $96.00   1/2/1994   12/31/2299
35231   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35236   2   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3   $500.00   1/1/1989   12/31/2299
35236   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35236   8   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3   $100.00   1/1/1989   12/31/2299
35241   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35246   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35251   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35256   2   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3   $300.00   1/1/1984   12/31/2299
35256   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35256   8   REPAIR BLOOD VESSEL OR A-V FISTULA WITH VEIN GRAFT                  N   3    $60.00   1/1/1984   12/31/2299
35261   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3    $13.45   6/1/1994   12/31/2299
35266   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3    $13.45   6/1/1994   12/31/2299
35271   2   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3   $660.00   1/2/1992   12/31/2299
35271   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3    $13.45   6/1/1994   12/31/2299
35276   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3    $13.45   6/1/1994   12/31/2299
35281   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3    $13.45   6/1/1994   12/31/2299
35286   2   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3   $600.00   1/1/1984   12/31/2299
35286   7   REPAIR BLOOD VESSEL OR A-V FISTULA WITH GRAFT OTHE                  N   3    $13.45   6/1/1994   12/31/2299
35301   2   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;CAROTID,VE                  N   3   $750.00   1/1/1973   12/31/2299
35301   7   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;CAROTID,VE                  N   3    $13.45   6/1/1994   12/31/2299
35301   8   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;CAROTID,VE                  N   3   $150.00   1/1/1973   12/31/2299
35302   2   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $623.46   1/1/2007   12/31/2299
35302   7   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3    $13.45   1/1/2007   12/31/2299
35302   8   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $124.00   1/1/2007   12/31/2299
35303   2   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $684.73   1/1/2007   12/31/2299
35303   7   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3    $13.45   1/1/2007   12/31/2299
35303   8   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $136.00   1/1/2007   12/31/2299
35304   2   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $712.36   1/1/2007   12/31/2299
35304   7   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3    $13.45   1/1/2007   12/31/2299
35304   8   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $142.00   1/1/2007   12/31/2299
35305   2   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $684.73   1/1/2007   12/31/2299
35305   7   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3    $13.45   1/1/2007   12/31/2299
35305   8   THROMBOENDARTERECTORY, INC PATCH GRAFT, IF PERFORMED SUPERFICIAL,   N   3   $136.00   1/1/2007   12/31/2299
35306   2   THOMBOENDARTERECTORY, INC PATCH GRAFT, IF PERF, EA ADD              N   3   $255.92   1/1/2007   12/31/2299
35306   7   THOMBOENDARTERECTORY, INC PATCH GRAFT, IF PERF, EA ADD              N   3    $13.45   1/1/2007   12/31/2299
35306   8   THOMBOENDARTERECTORY, INC PATCH GRAFT, IF PERF, EA ADD              N   3    $51.00   1/1/2007   12/31/2299
35311   2   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;SUBCLAVIAN                  N   3   $750.00   8/1/1979   12/31/2299
35311   7   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;SUBCLAVIAN                  N   3    $13.45   6/1/1994   12/31/2299
35311   8   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;SUBCLAVIAN                  N   3   $150.00   8/1/1979   12/31/2299
35321   2   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT; AXILLARY-                  N   3   $750.00   1/1/1984   12/31/2299
35321   7   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT; AXILLARY-                  N   3    $13.45   6/1/1994   12/31/2299
35321   8   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT; AXILLARY-                  N   3   $150.00   1/1/1984   12/31/2299
35331   2   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3   $713.70   1/2/1992   12/31/2299
35331   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35341   2   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3   $800.00   1/1/1973   12/31/2299
35341   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35341   8   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3   $160.00   1/1/1973   12/31/2299
35351   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
35355   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     139
35361   2   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3   $1,000.00   1/1/1973   12/31/2299
35361   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3      $13.45   6/1/1994   12/31/2299
35361   8   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $200.00    1/1/1973   12/31/2299
35363   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3      $13.45   6/1/1994   12/31/2299
35371   2   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;COMMON AND                  N   3    $600.00    1/2/1992   12/31/2299
35371   7   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;COMMON AND                  N   3      $13.45   6/1/1994   12/31/2299
35371   8   THROMBOENDARTERECTOMY, W/WO PATCH GRAFT;COMMON AND                  N   3    $170.00    1/1/1984   12/31/2299
35372   2   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $559.81    1/1/2003   12/31/2299
35372   7   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3      $13.45   6/1/1994   12/31/2299
35372   8   THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT                  N   3    $111.96    1/1/2003   12/31/2299
35390   2   REOPERATION, CAROTID, THROMBOENDARTERECTOMY, MORE                   N   3    $106.54    1/1/1994   12/31/2299
35400   2   ANGIOSCOPY(NON-CORONARY VESSELS/GRAFTS)DURING THERAPEUTIC INTERVE   N   3    $117.23    1/1/1998   12/31/2299
35400   7   ANGIOSCOPY(NON-CORONARY VESSELS/GRAFTS)THERAPEUTIC INTERVENTION     N   3      $13.45   1/1/1998   12/31/2299
35400   8   ANGIOSCOPY(NON-CORONARY VESSELS/GRAFTS)THERAPEUTIC INTERVENTION     N   3      $23.44   1/1/1998   12/31/2299
35450   7   TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE                            N   3      $13.45   6/1/1994   12/31/2299
35452   7   TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE                  N   3      $13.45   6/1/1994   12/31/2299
35454   7   TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE                  N   3      $13.45   6/1/1994   12/31/2299
35456   2   TRSLUMNL ANGPLSTY INTRAOP SEP PROC FEM - POPLT                      N   3    $350.00    1/1/1984   12/31/2299
35456   7   TRSLUMNL ANGPLSTY INTRAOP SEP PROC FEM - POPLT                      N   3      $13.45   6/1/1994   12/31/2299
35456   8   TRSLUMNL ANGPLSTY INTRAOP SEP PROC FEM - POPLITEAL                  N   3      $70.00   1/1/1984   12/31/2299
35458   7   TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE                  N   3      $13.45   6/1/1994   12/31/2299
35459   7   TRANSLUMINAL ANGIOPLASTY, OPEN;                                     N   3      $13.45   6/1/1994   12/31/2299
35460   7   TRANSLUMINAL ANGIOPLASTY, OPEN;                                     N   3      $13.45   6/1/1994   12/31/2299
35470   2   (FOR MONITORING, OPERATION OF PUMP AND OTHER NONSU                  N   3    $293.81    1/1/2004   12/31/2299
35470   7   (FOR MONITORING, OPERATION OF PUMP AND OTHER NONSU                  N   3      $13.45   6/1/1994   12/31/2299
35471   2   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3    $308.40    1/2/1992   12/31/2299
35471   7   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $13.45   6/1/1994   12/31/2299
35472   2   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3    $231.59    1/1/2002   12/31/2299
35472   7   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $13.45   6/1/1994   12/31/2299
35473   2   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3    $310.00    1/2/1992   12/31/2299
35473   7   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $13.45   6/1/1994   12/31/2299
35474   2   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3    $390.00    1/2/1995   12/31/2299
35474   7   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $13.45   6/1/1994   12/31/2299
35474   8   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $78.00   1/2/1995   12/31/2299
35475   2   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3    $317.33    1/1/2004   12/31/2299
35475   7   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $13.45   6/1/1994   12/31/2299
35476   2   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3    $201.00    1/2/1994   12/31/2299
35476   7   TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS;                             N   3      $13.45   6/1/1994   12/31/2299
35480   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;                          N   3    $492.56    1/1/1993   12/31/2299
35480   7   TRANSLUMINAL ATHERECTOMY                                            N   3      $13.45   6/1/1994   12/31/2299
35481   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;                          N   3    $237.46    1/1/1993   12/31/2299
35481   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN                           N   3      $13.45   6/1/1994   12/31/2299
35482   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;                          N   3    $328.33    1/1/1993   12/31/2299
35482   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN AROTIC                    N   3      $13.45   6/1/1994   12/31/2299
35483   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;                          N   3    $379.58    1/1/1993   12/31/2299
35483   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN ILIAC                     N   3      $13.45   6/1/1994   12/31/2299
35484   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;                          N   3    $420.04    1/1/1993   12/31/2299
35484   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY,FEMORAL POPILI                  N   3      $13.45   6/1/1994   12/31/2299
35485   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;                          N   3    $281.74    1/1/1993   12/31/2299
35485   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY,BRACHIOCEPHALI                  N   3      $13.45   6/1/1994   12/31/2299
35490   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;                  N   3    $481.58    1/1/1993   12/31/2299




                                                                                                                       140
35490   7   TRANSLUMINAL ATHERECTOMY, PERCUTANEOUS                            N   3      $13.45   6/1/1994   12/31/2299
35491   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;                N   3    $232.16    1/1/1993   12/31/2299
35491   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY PERCUTAN AORTI                N   3      $13.45   6/1/1994   12/31/2299
35492   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;                N   3    $321.01    1/1/1993   12/31/2299
35492   7   TRANSLUMINAL PERIPHERAL ATHERECTOMY PERCUTAN ILIAC                N   3      $13.45   6/1/1994   12/31/2299
35493   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;                N   3    $371.11    1/1/1993   12/31/2299
35493   7   TRANSLUMINAL PERIPHERAL ATHERTMY PERCUTN FEMORL PO                N   3      $13.45   6/1/1994   12/31/2299
35494   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;                N   3    $410.67    1/1/1993   12/31/2299
35494   7   TRANSLUMINAL PERIPHERAL ATHERTMY PERCUTN BRACHIOCE                N   3      $13.45   6/1/1994   12/31/2299
35495   2   TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;                N   3    $275.45    1/1/1993   12/31/2299
35495   7   TRANSLUMINAL PERIPHERAL ATHERTMY PERCUTN TIB TRUNK                N   3      $13.45   6/1/1994   12/31/2299
35500   2   HARVEST OF UPPER EXTREMITY VEIN ONE SEGMENT FOR LOWER EXTREMITY   N   3    $812.04    1/1/1999   12/31/2299
35501   2   BYPASS GRAFT, VEIN; CAROTID                                       N   3    $750.00    1/1/1973   12/31/2299
35501   7   BYPASS GRAFT, VEIN; CAROTID                                       N   3      $13.45   6/1/1994   12/31/2299
35501   8   BYPASS GRAFT, VEIN; CAROTID                                       N   3    $150.00    1/1/1973   12/31/2299
35506   7   BYPASS GRAFT, VEIN; CAROTID-SUBCLAVIAN                            N   3      $13.45   6/1/1994   12/31/2299
35508   7   BYPASS GRAFT, WITH VEIN                                           N   3      $13.45   6/1/1994   12/31/2299
35509   7   BYPASS GRAFT, VEIN; CAROTID-CAROTID                               N   3      $13.45   6/1/1994   12/31/2299
35510   2   BYPASS GRAFT WITH VEIN CAROTID BRACHIAL                           N   3    $790.79    1/1/2004   12/31/2299
35511   7   BYPASS GRAFT, VEIN; SUBCLAVIAN-SUBCLAVIAN                         N   3      $13.45   6/1/1994   12/31/2299
35512   2   BYPASS GRAFT, WITH VEIN, SUBCLAVIAN-BRACHIAL                      N   3    $775.67    1/1/2004   12/31/2299
35515   7   BYPASS GRAFT, WITH VEIN                                           N   3      $13.45   6/1/1994   12/31/2299
35516   7   BYPASS GRAFT, VEIN; SUBCLAVIAN-AXILLARY                           N   3      $13.45   6/1/1994   12/31/2299
35518   7   BYPASS GRAFT, WITH VEIN                                           N   3      $13.45   6/1/1994   12/31/2299
35521   2   BYPASS GRAFT, VEIN; AXILLARY-FEMORAL                              N   3    $750.00    1/1/1984   12/31/2299
35521   7   BYPASS GRAFT, VEIN; AXILLARY-FEMORAL                              N   3      $13.45   6/1/1994   12/31/2299
35521   8   BYPASS GRAFT, VEIN; AXILLARY-FEMORAL                              N   3    $150.00    1/1/1984   12/31/2299
35522   2   BYPASS GRAFT, WITH VEIN AXILLARY BRACHIAL                         N   3    $753.09    1/1/2004   12/31/2299
35525   2   BYPASS GRAFT, WITH VEIN BRACHIAL - BRACHIAL                       N   3    $718.78    1/1/2004   12/31/2299
35526   2   BYPASS GRAFT, VEIN; AORTOSUBCLAVIAN OR CAROTID                    N   3    $800.00    8/1/1979   12/31/2299
35526   7   BYPASS GRAFT, VEIN; AORTOSUBCLAVIAN OR CAROTID                    N   3      $13.45   6/1/1994   12/31/2299
35526   8   BYPASS GRAFT, VEIN; AORTOSUBCLAVIAN OR CAROTID                    N   3    $160.00    8/1/1979   12/31/2299
35531   2   BYPASS GRAFT, VEIN; AORTOCELIAC, MESENTERIC, OR RE                N   3    $800.00    8/1/1979   12/31/2299
35531   7   BYPASS GRAFT, VEIN; AORTOCELIAC, MESENTERIC, OR RE                N   3      $13.45   6/1/1994   12/31/2299
35531   8   BYPASS GRAFT, VEIN; AORTOCELICA, MESENTERIC, OR RE                N   3    $160.00    8/1/1979   12/31/2299
35533   2   AXILLARY-FEMORAL GRAFT BYPASS                                     N   3   $1,000.00   1/1/1984   12/31/2299
35533   7   AXILLARY-FEMORAL GRAFT BYPASS                                     N   3      $13.45   6/1/1994   12/31/2299
35533   8   AXILLARY-FEMORAL-GRAFT BYPASS                                     N   3    $200.00    1/1/1984   12/31/2299
35536   7   BYPASS GRAFT, VEIN; SPLENORENAL                                   N   3      $13.45   6/1/1994   12/31/2299
35537   2   BYPASS GRAFT, WITH VEIN, AORTOILIAC                               N   3   $1,203.53   1/1/2007   12/31/2299
35537   7   BYPASS GRAFT, WITH VEIN, AORTOILIAC                               N   3      $13.45   1/1/2007   12/31/2299
35537   8   BYPASS GRAFT, WITH VEIN, AORTOILIAC                               N   3    $240.00    1/1/2007   12/31/2299
35538   2   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3   $1,344.18   1/1/2007   12/31/2299
35538   7   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3      $13.45   1/1/2007   12/31/2299
35538   8   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3    $268.00    1/1/2007   12/31/2299
35539   2   BYPASS GRAFT, WITH VEIN; AORTOFEMORAL                             N   3   $1,263.44   1/1/2007   12/31/2299
35539   7   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3      $13.45   1/1/2007   12/31/2299
35539   8   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3    $252.00    1/1/2007   12/31/2299
35540   2   BYPASS GRAFT, WITH VEIN AORTOBIFEMORAL                            N   3   $1,408.02   1/1/2007   12/31/2299
35540   7   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3      $13.45   1/1/2007   12/31/2299
35540   8   BYPASS GRAFT, WITH VEIN; AORTOBILIAC                              N   3    $281.00    1/1/2007   12/31/2299




                                                                                                                     141
35548   2   BYPASS GRAFT, VEIN; AORTOILIOFEMORAL, UNILATERAL               N   3   $800.00   1/1/1984   12/31/2299
35548   7   BYPASS GRAFT, VEIN; AORTOILIOFEMORAL, UNILATERAL               N   3    $13.45   6/1/1994   12/31/2299
35549   7   BYPASS GRAFT, VEIN; AORTOILIOFEMORAL, BILATERAL                N   3    $13.45   6/1/1994   12/31/2299
35551   2   BYPASS GRAFT, VEIN; AORTOILIOFEMORAL-POPLITEAL                 N   3   $750.00   1/1/1984   12/31/2299
35551   7   BYPASS GRAFT, VEIN; AORTOILIOFEMORAL-POPLITEAL                 N   3    $13.45   6/1/1994   12/31/2299
35551   8   BYPASS GRAFT, VEIN; AORTOILIOFEMORAL-POPLITEAL                 N   3   $150.00   1/1/1984   12/31/2299
35556   2   BYPASS GRAFT, VEIN; FEMORAL-POPLITEAL                          N   3   $780.90   1/2/1992   12/31/2299
35556   7   BYPASS GRAFT, VEIN; FEMORAL-POPLITEAL                          N   3    $13.45   6/1/1994   12/31/2299
35556   8   BYPASS GRAFT, VEIN; FEMORAL-POPLITEAL                          N   3   $150.00   8/1/1979   12/31/2299
35558   2   BYPASS GRAFT, VEIN; FEMORAL-FEMORAL                            N   3   $750.00   1/1/1984   12/31/2299
35558   7   BYPASS GRAFT, VEIN; FEMORAL-FEMORAL                            N   3    $13.45   6/1/1994   12/31/2299
35558   8   BYPASS GRAFT, VEIN; FEMORAL-FEMORAL                            N   3   $150.00   1/1/1984   12/31/2299
35560   7   BYPASS GRAFT, WITH VEIN                                        N   3    $13.45   6/1/1994   12/31/2299
35563   7   BYPASS GRAFT, VEIN; ILIOILIAC                                  N   3    $13.45   6/1/1994   12/31/2299
35565   2   BYPASS GRAFT, VEIN; ILIOFEMORAL                                N   3   $864.00   1/2/1995   12/31/2299
35565   7   BYPASS GRAFT, VEIN; ILIOFEMORAL                                N   3    $13.45   6/1/1994   12/31/2299
35565   8   BYPASS GRAFT, VEIN; ILIOFEMORAL                                N   3   $173.00   1/2/1995   12/31/2299
35566   2   BYPASS GRAFT, VEIN; FEMORAL-ANTERIOR TIBIAL, POSTE             N   3   $750.00   8/1/1979   12/31/2299
35566   7   BYPASS GRAFT, VEIN; FEMORAL-ANTERIOR TIBIAL, POSTE             N   3    $13.45   6/1/1994   12/31/2299
35566   8   BYPASS GRAFT, VEIN; FEMORAL-ANTERIOR TIBIAL, POSTE             N   3   $150.00   8/1/1979   12/31/2299
35571   2   BYPASS GRAFT, VEIN; POPLITEAL-TIBIAL                           N   3   $650.00   1/1/1984   12/31/2299
35571   7   BYPASS GRAFT, VEIN; POPLITEAL-TIBIAL                           N   3    $13.45   6/1/1994   12/31/2299
35571   8   BYPASS GRAFT, VEIN; POPLITEAL-TIBIAL                           N   3   $130.00   1/1/1984   12/31/2299
35572   2   HARVEST FEMOROPOPLITEAL VEIN ONE SEGMENT-RECON VASCULAR        N   3   $218.32   1/1/2003   12/31/2299
35582   7   IN-SITU VEIN BYPASS                                            N   3    $13.45   6/1/1994   12/31/2299
35583   2   IN-SITU VEIN BY PASS FEM POPLITEAL                             N   3   $996.00   1/2/1995   12/31/2299
35583   7   IN-SITU VEIN BY PASS FEM POPLITEAL                             N   3    $13.45   6/1/1994   12/31/2299
35583   8   IN-SITU VEIN BY PASS FEM POPLITEAL                             N   3   $199.20   1/2/1995   12/31/2299
35585   2   IN SITU VEIN BYPASS FEM ANT TIB POST TIB PERON ART             N   3   $850.00   1/1/1984   12/31/2299
35585   7   IN SITU VEIN BYPASS FEM ANT TIB POST TIB PERON ART             N   3    $13.45   6/1/1994   12/31/2299
35585   8   IN-SITU VN BYPASS FEM ANT TIB POS TIB OR PERON ART             N   3   $170.00   1/1/1984   12/31/2299
35587   2   IN SITU VEIN BYPASS: POPLITEAL-TIBIAL, PERONEAL                N   3   $500.00   1/1/1984   12/31/2299
35587   7   IN SITU VEIN BYPASS: POPLITEAL-TIBIAL, PERONEAL                N   3    $13.45   6/1/1994   12/31/2299
35587   8   IN SITU VEIN BYPASS: POPLITEAL-TIBIAL, PERONEAL                N   3   $100.00   1/1/1984   12/31/2299
35600   2   HARVEST OF UPPER EXTREM.ARTERY ONE SEGM.FOR CORON.ART.BYPASS   N   3   $170.45   1/1/2001   12/31/2299
35601   7   BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID                    N   3    $13.45   6/1/1994   12/31/2299
35606   7   BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-SUBCLA             N   3    $13.45   6/1/1994   12/31/2299
35612   7   BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-SUB             N   3    $13.45   6/1/1994   12/31/2299
35616   7   BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-AXI             N   3    $13.45   6/1/1994   12/31/2299
35621   2   BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMOR             N   3   $750.00   8/1/1979   12/31/2299
35621   7   BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMOR             N   3    $13.45   6/1/1994   12/31/2299
35621   8   BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMOR             N   3   $150.00   8/1/1979   12/31/2299
35623   2   BYPASS GRAFT, WITH OTHER THAN VEIN;                            N   3   $514.31   1/1/1994   12/31/2299
35626   7   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOSUBCLAVIA             N   3    $13.45   6/1/1994   12/31/2299
35631   2   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOCELIAC, M             N   3   $984.00   1/2/1994   12/31/2299
35631   7   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOCELIAC, M             N   3    $13.45   6/1/1994   12/31/2299
35631   8   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOCELIAC, M             N   3   $197.00   1/2/1994   12/31/2299
35636   7   BYPASS GRAFT, WITH OTHER THAN VEIN; SPLENORENAL                N   3    $13.45   6/1/1994   12/31/2299
35637   2   BYPASS GRAFT, WITH OTHER THAN VEIN                             N   3   $958.63   1/1/2007   12/31/2299
35642   7   BYPASS GRAFT, WITH OTHER THAN VEIN                             N   3    $13.45   6/1/1994   12/31/2299
35645   7   BYPASS GRAFT, WITH OTHER THAN VEIN                             N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                142
35646   2   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL                    N   3   $1,320.00   1/2/1992   12/31/2299
35646   7   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL                    N   3      $13.45   6/1/1994   12/31/2299
35646   8   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL                    N   3    $160.00    1/1/1984   12/31/2299
35647   2   BYPASS GRAFT W/OTHER THAN VEIN;AORTOFEMORAL                         N   3    $920.81    1/1/2002    12/3/2299
35647   7   BYPASS W/OTHER THAN VEIN AORTAFEMORAL                               N   3      $13.45   1/1/2002   12/31/2299
35647   8   BYPASS GRAFT W/OTHER THAN VEIN;AORTOFEMORAL                         N   3    $184.00    1/1/2002   12/31/2299
35650   7   BYPASS GRAFT, WITH OTHER THAN VEIN                                  N   3      $13.45   6/1/1994   12/31/2299
35651   2   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL-P                  N   3    $800.00    1/1/1984   12/31/2299
35651   7   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL-P                  N   3      $13.45   6/1/1994   12/31/2299
35651   8   BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL-P                  N   3    $160.00    1/1/1984   12/31/2299
35654   2   BY PASS GRAFT W OTHR THN VEIN AXIL FEMOR FEMOR                      N   3    $850.00    1/1/1984   12/31/2299
35654   7   BY PASS GRAFT W/OTHR THN VEIN AXIL FEMOR FEMOR                      N   3      $13.45   6/1/1994   12/31/2299
35654   8   BY PASS GRAFT W/OTHR THN VEIN AXIL FEMOR-FEMOR                      N   3    $170.00    1/1/1984   12/31/2299
35656   2   BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-POPLIT                  N   3    $700.00    1/1/1984   12/31/2299
35656   7   BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-POPLIT                  N   3      $13.45   6/1/1994   12/31/2299
35656   8   BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-POPLIT                  N   3    $140.00    1/1/1984   12/31/2299
35661   2   BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-FEMORA                  N   3    $750.00    8/1/1979   12/31/2299
35661   7   BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-FEMORA                  N   3      $13.45   6/1/1994   12/31/2299
35661   8   BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-FEMORA                  N   3    $150.00    8/1/1979   12/31/2299
35663   7   BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOILIAC                       N   3      $13.45   6/1/1994   12/31/2299
35665   2   BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOFEMORAL                     N   3    $750.00    1/1/1984   12/31/2299
35665   7   BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOFEMORAL                     N   3      $13.45   6/1/1994   12/31/2299
35665   8   BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOFEMORAL                     N   3    $150.00    1/1/1984   12/31/2299
35666   2   BYPASS GRAFT,WITH OTHER THAN VEIN;FEMORAL-ANTERIOR                  N   3    $750.00    1/1/1984   12/31/2299
35666   7   BYPASS GRAFT,WITH OTHER THAN VEIN;FEMORAL-ANTERIOR                  N   3      $13.45   6/1/1994   12/31/2299
35666   8   BYPASS GRAFT,WITH OTHER THAN VEIN;FEMORAL-ANTERIOR                  N   3    $150.00    9/9/1984   12/31/2299
35671   7   BYPASS GRAFT, WITH OTHER THAN VEIN; POPLITEAL-TIBI                  N   3      $13.45   6/1/1994   12/31/2299
35681   2   BYPASS GRAFT COMPOSITE                                              N   3      $25.00   1/1/1984   12/31/2299
35681   7   BYPASS GRAFT COMPOSITE                                              N   3      $13.45   6/1/1994   12/31/2299
35681   8   BYPASS GRAFT COMPOSITE                                              N   3       $5.00   1/1/1984   12/31/2299
35682   2   BYPASS GRAFT:AUTOGENOUS COMPOSITE 2 SEGMENTS OF VEIN FROM 2 LOCAT   N   3    $266.78    1/1/1999   12/31/2299
35682   7   BYPASS GRAFT AUTOGENOUS COMPOSITE 2 SEGMENTS OF VEIN FROM 2LOCATI   N   3    $266.78    1/1/1999   12/31/2299
35682   8   BYPASS GRAFT AUTOGENOUS COMPOSITE 2 SEGMENTS OF VEINS FROM 2 LOCA   N   3    $266.78    1/1/1999   12/31/2299
35683   2   BYPASS GRAFT OF 3 OR MORE SEGMENTS OF VEIN FROM 2OR MORE LOCATION   N   3    $304.52    1/1/1999   12/31/2299
35683   7   BYPASS GRAFT WITH 3 OR MORE SEGMENTS OF VEIN FROM 2 OR MORE LOCAT   N   3    $304.52    1/1/1999   12/31/2299
35683   8   BYPASS GRAFT AUTOGENOUS OF 3 OR MORE SEGMENTS OF VEIN               N   3    $304.52    1/1/1999   12/31/2299
35685   2   PLACE OF VEIN PATCH OR CUFF AT DISTAL ANSTOMOSIS OF BYPASS          N   3    $127.64    1/1/2002   12/31/2299
35685   8   PLACE OF VEIN PATCH OR CUFF AT DISTAL ANASTOMOSIS BYPASS            N   3      $25.53   1/1/2002   12/31/2299
35686   2   CREAT/DISTAL ARERIOVEOUS FISTULA/BYPASS SURGERY LIST SEPARATELY     N   3    $105.58    1/1/2002   12/31/2299
35686   8   CREAT/DISTAL ARTERIOVENOUS FISTULA /LOWER BYPASS LIST SEPARATELY    N   3      $21.12   1/1/2002   12/31/2299
35691   2   TRANSPOSITION AND/OR REIMPLANTATION;                                N   3    $814.77    1/1/1994   12/31/2299
35693   2   TRANSPOSITION AND/OR REIMPLANTATION;                                N   3    $514.67    1/1/1994   12/31/2299
35694   2   TRANSPOSITION AND/OR REIMPLANTATION;                                N   3    $594.40    1/1/1994   12/31/2299
35695   2   TRANSPOSITION AND/OR REIMPLANTATION;                                N   3    $594.40    1/1/1994   12/31/2299
35697   2   REIMPLANTATION, VISCERAL ARTERY IN INFRARENAL AORTIC PROSTHESIS     N   3      $99.08   1/1/2004   12/31/2299
35700   2   REOPERATION, FEMORAL-POPLITEAL OR FEMORAL (POPLITE                  N   3    $102.70    1/1/1994   12/31/2299
35701   2   EXPLORATION; CAROTID ARTERY                                         N   3    $250.00    1/1/1973   12/31/2299
35701   7   EXPLORATION; CAROTID ARTERY                                         N   3      $13.45   6/1/1994   12/31/2299
35701   8   EXPLORATION; CAROTID ARTERY                                         N   3      $50.00   1/1/1973   12/31/2299
35721   2   EXPLORATION; FEMORAL ARTERY                                         N   3    $200.00    1/1/1973   12/31/2299
35721   7   EXPLORATION; FEMORAL ARTERY                                         N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                       143
35721   8   EXPLORATION; FEMORAL ARTERY                                         N   3    $40.00   1/1/1973   12/31/2299
35741   2   EXPLORATION; POPLITEAL ARTERY                                       N   3   $200.00   1/1/1973   12/31/2299
35741   7   EXPLORATION; POPLITEAL ARTERY                                       N   3    $13.45   6/1/1994   12/31/2299
35741   8   EXPLORATION; POPLITEAL ARTERY                                       N   3    $40.00   1/1/1973   12/31/2299
35761   2   EXPLORATION; OTHER VESSELS                                          N   3   $289.35   1/2/1992   12/31/2299
35761   7   EXPLORATION; OTHER VESSELS                                          N   3    $13.45   6/1/1994   12/31/2299
35800   7   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $13.45   6/1/1994   12/31/2299
35820   2   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3   $480.00   1/2/1994   12/31/2299
35820   7   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $13.45   6/1/1994   12/31/2299
35820   8   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $96.00   1/2/1994   12/31/2299
35840   2   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3   $420.00   1/2/1995   12/31/2299
35840   7   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $13.45   6/1/1994   12/31/2299
35840   8   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $84.00   1/2/1995   12/31/2299
35860   2   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3   $215.00   1/2/1992   12/31/2299
35860   7   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $13.45   6/1/1994   12/31/2299
35860   8   EXPLORATION FOR POSTOPERATIVE HEMORRHAGE OR THROMB                  N   3    $54.00   1/2/1994   12/31/2299
35870   2   REPAIR OF GRAFT-ENTERIC FISTULA                                     N   3   $800.00   1/1/1984   12/31/2299
35870   7   REPAIR OF GRAFT-ENTERIC                                             N   3    $13.45   6/1/1994   12/31/2299
35875   2   THROMBECTOMY OF ARTERIAL GRAFT                                      N   3   $400.00   1/1/1984   12/31/2299
35875   7   THROMBECTOMY OF ARTERIAL GRAFT                                      N   3    $13.45   6/1/1994   12/31/2299
35875   8   THROMBECTOMY OF ARTERIAL GRAFT                                      N   3    $80.00   1/1/1984   12/31/2299
35875   F   THROMBECTOMY OF ARTERIAL GRAFT                                      N   3   $495.00   3/1/2004   12/31/2299
35876   2   THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT;                           N   3   $463.04   1/1/1994   12/31/2299
35876   7   ANESTHESIA FOR THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT             N   3    $13.45   1/1/1994   12/31/2299
35876   8   ASSISTANT, THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT;                N   3    $93.00   1/1/1998   12/31/2299
35876   F   THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT;                           N   3   $495.00   3/1/2004   12/31/2299
35879   2   REVIS LOW EXTREM ARTERIAL BYPASS W/O THROMBECTOMY W/VEIN PAT ANGI   N   3   $583.10   1/1/2000   12/31/2299
35879   7   REVIS LOW EXTREM ARTERIAL BYPASS W/O THROMBECTOMY W/VEIN PAT ANGI   N   3    $13.45   1/1/2000   12/31/2299
35879   8   REVIS LOW EXTREM ARTERIAL BYPASS W/O THROMBECTOMY W/VEIN PAT ANGI   N   3   $116.62   1/1/2000   12/31/2299
35881   2   REVIS LOW EXTREM ARTERIAL BYPASS W/O THROMBECTOMY W/SEG VEIN INT    N   3   $638.88   1/1/2000   12/31/2299
35881   7   REVIS LOW EXTREM ARTERIAL BYPASS W/O THROMBECTOMY W/SEG VEIN INT    N   3    $13.45   1/1/2000   12/31/2299
35881   8   REVIS LOW EXTREM ARTERIAL BYPASS W/O THROMBECTOMY W/SEG VEIN INT    N   3   $127.78   1/1/2000   12/31/2299
35883   2   REVISE GRAFT W/NON AUTO GRAFT                                       N   3   $702.41   1/1/2007   12/31/2299
35883   7   REVISE GRAFT W/NON AUTO GRAFT                                       N   3    $13.45   1/1/2007   12/31/2299
35884   2   REVISE GRAFT W/VEIN                                                 N   3   $745.85   1/1/2007   12/31/2299
35884   7   REVISE GRAFT W/VEIN                                                 N   3    $13.45   1/1/2007   12/31/2299
35884   8   REVISE GRAFT W/VEIN                                                 N   3   $149.00   1/1/2007   12/31/2299
35901   2   EXCISION OF INFECTED GRAFT;                                         N   3   $376.35   1/1/1994   12/31/2299
35903   2   EXCISION OF INFECTED GRAFT;                                         N   3   $385.73   1/1/1994   12/31/2299
35903   7   EXCISION OF INFECTED GRAFT                                          N   3    $13.45   1/2/1994   12/31/2299
35903   8   ASSISTANT, EXCISION OF INFECTED GRAFT                               N   3    $77.00   1/1/1998   12/31/2299
35905   2   EXCISION OF INFECTED GRAFT;                                         N   3   $441.64   1/1/1994   12/31/2299
35907   2   EXCISION OF INFECTED GRAFT;                                         N   3   $447.00   1/1/1994   12/31/2299
36000   2   INTRODUCTION OF NEEDLE OR INTRACATHETER, VEIN; UNI                  N   3    $25.00   1/1/1971   12/31/2299
36002   2   INJ PROC/PERCUTANEOUS TREATMENT/EXTREMITY PSEUDOANEURYSM            N   3   $109.40   1/1/2002   12/31/2299
36005   2   INJECTION PROCEDURE FOR CONTRAST VENOGRAPHY (INCLU                  N   3    $24.53   1/1/1993   12/31/2299
36005   7   INJCTN PROC FOR CONTRAST VENOGRAPHY INCLUD INTROD                   N   3    $13.45   6/1/1994   12/31/2299
36010   2   INTRODUC OF CATHETER IN SUPERIOR OR INFERIOR VENA                   N   3    $98.00   1/2/1995   12/31/2299
36010   7   INTRODUC OF CATHETER IN SUPERIOR OR INFERIOR VENA                   N   3    $13.45   6/1/1994   12/31/2299
36011   2   SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM;                        N   3    $87.75   1/2/1992   12/31/2299
36011   7   SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM;                        N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     144
36012   2   SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM;         N   3   $123.00   1/2/1992   12/31/2299
36012   7   SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM;         N   3    $13.45   6/1/1994   12/31/2299
36013   2   INTRODUCTION OF CATHETER, RIGHT HEART OR MAIN PULM   N   3    $68.80   1/1/2003   12/31/2299
36013   7   INTRODUCTION OF CATHETER, RIGHT HEART OR MAIN PULM   N   3    $13.45   6/1/1994   12/31/2299
36014   2   SELECTIVE CATHETER PLACEMENT, LEFT OR RIGHT PULMON   N   3   $108.00   1/2/1994   12/31/2299
36014   7   SELECTIVE CATHETER PLACEMENT, LEFT OR RIGHT PULMON   N   3    $13.45   6/1/1994   12/31/2299
36015   2   SELECTIVE CATHETER PLACEMENT, EACH SEGMENTAL OR SU   N   3   $105.99   1/1/2003   12/31/2299
36015   7   SELECTIVE CATHETER PLACEMENT, EACH SEGMENTAL OR SU   N   3    $13.45   6/1/1994   12/31/2299
36020   7   INTRO OF CATH IN SUPER/INFER VC, RT HEART/PULMONAR   N   3    $13.45   6/1/1994   12/31/2299
36100   2   INTRODUC OF NEEDLE OR INTRACATHETER, CAROTID OR VE   N   3   $125.00   1/1/1971   12/31/2299
36100   7   INTRODUC OF NEEDLE OR INTRACATHETER, CAROTID OR VE   N   3    $13.45   6/1/1994   12/31/2299
36120   2   INTRODUCTION OF NEEDLE OR INTRACATHETER; RETROGRAD   N   3   $125.00   1/1/1973   12/31/2299
36120   7   INTRODUCTION OF NEEDLE OR INTRACATHETER; RETROGRAD   N   3    $13.45   6/1/1994   12/31/2299
36140   2   INTRODUCTION OF NEEDLE OR INTRACATHETER; EXTREMITY   N   3    $50.00   1/1/1973   12/31/2299
36140   7   INTRODUCTION OF NEEDLE OR INTRACATHETER; EXTREMITY   N   3    $13.45   6/1/1994   12/31/2299
36145   2   ARTERIOVENOUS SHUNT FOR DIALYSIS (CANNULA, FISTULA   N   3    $20.00   1/1/1984   12/31/2299
36145   7   ARTERIOVENOUS SHUNT FOR DIALYSIS (CANNULA, FISTULA   N   3    $13.45   6/1/1994   12/31/2299
36160   2   INTRODUCTION OF NEEDLE OR INTRACATHETER, AORTIC, T   N   3    $75.00   1/1/1971   12/31/2299
36160   7   INTRODUCTION OF NEEDLE OR INTRACATHETER, AORTIC, T   N   3    $13.45   6/1/1994   12/31/2299
36200   2   INTRODUCTION OF CATHETER; AORTA                      N   3   $120.00   1/2/1995   12/31/2299
36200   7   INTRODUCTION OF CATHETER; AORTA                      N   3    $13.45   6/1/1994   12/31/2299
36210   2   INTRODUCTION OF CATHETER; CEREBRAL ARTERY, SELECTI   N   3   $126.00   8/1/1979   12/31/2299
36210   7   INTRODUCTION OF CATHETER; CEREBRAL ARTERY, SELECTI   N   3    $13.45   6/1/1994   12/31/2299
36215   2   EACH ADDL SELECT THOR AND OR CEREB ART CATH PLCMNT   N   3    $40.00   1/1/1984   12/31/2299
36216   2   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3   $174.00   1/2/1995   12/31/2299
36216   7   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $13.45   6/1/1994   12/31/2299
36217   2   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3   $200.00   1/2/1992   12/31/2299
36217   7   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $13.45   6/1/1994   12/31/2299
36218   2   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $35.00   1/1/1992   12/31/2299
36218   7   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $13.45   6/1/1994   12/31/2299
36220   2   INTRODUCTION OF CATHETER; MULTIPLE CEREBRAL ARTERI   N   3    $40.00   8/1/1979   12/31/2299
36220   7   INTRODUCTION OF CATHETER; MULTIPLE CEREBRAL ARTERI   N   3    $13.45   6/1/1994   12/31/2299
36240   2   INTRO OF CATHETER;RENAL,CELIAC,MESENTERIC,OR OTHER   N   3   $125.00   8/1/1979   12/31/2299
36240   7   INTRO OF CATHETER;RENAL,CELIAC,MESENTERIC,OR OTHER   N   3    $13.45   6/1/1994   12/31/2299
36245   2   INTRODUCTION OF CATHETER,                            N   3   $132.00   1/2/1992   12/31/2299
36245   7   INTRODUCTION OF CATHETER,                            N   3    $13.45   6/1/1994   12/31/2299
36246   2   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3   $180.00   1/2/1995   12/31/2299
36246   7   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $13.45   6/1/1994   12/31/2299
36247   2   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3   $200.00   1/2/1992   12/31/2299
36247   7   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $13.45   6/1/1994   12/31/2299
36248   2   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $72.00   1/2/1992   12/31/2299
36248   7   SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM;       N   3    $13.45   6/1/1994   12/31/2299
36250   2   INTRODUCTION OF CATHETER; BILATERAL RENAL OR MULTI   N   3   $125.00   1/1/1984   12/31/2299
36250   7   INTRODUCTION OF CATHETER; BILATERAL RENAL OR MULTI   N   3    $13.45   6/1/1994   12/31/2299
36260   7   INSERTION OF IMPLANTABLE INTRA-ART INFUS PUMP        N   3    $13.45   6/1/1994   12/31/2299
36260   F   INSERTION OF IMPLANTABLE INFUSION PUMP (EG, FOR CH   N   3   $351.00   3/1/2004   12/31/2299
36261   F   REVISION OF IMPLANTED INFUSION PUMP                  N   3   $306.00   3/1/2004   12/31/2299
36262   F   REMVL IMPLANTD INFUSION PMP                          N   3   $225.80   3/1/2004   12/31/2299
36299   7   UNLISTED PROCEDURE, VASCULAR INJECTION               N   3    $13.45   6/1/1994   12/31/2299
36400   2   VENIPUNCTURE, UNDER AGE 3 YEARS; FEMORAL, JUGULAR    N   3    $10.00   8/1/1979   12/31/2299
36405   2   VENIPUNCTURE, UNDER AGE 3 YEARS; SCALP VEIN          N   3    $15.00   1/1/1973   12/31/2299




                                                                                                      145
36406   2   VENIPUNCTURE UNDER AGE 3,OTHER VEIN                           N   3    $15.00    1/1/1984   12/31/2299
36410   2   VP,CHILD OVER 3 YRS OR ADULT,NEC PHYSICIAN'S SKILL            N   3    $10.00    1/1/1973   12/31/2299
36410   7   ANESTH-VP CHILD OVER 3YRS OR ADULT-PHYSICIAN SVC              N   3    $13.45    6/1/1994   12/31/2299
36416   2   COLLEC CAPILLARY BLOOD SPEC FINGER,HEEL,EAR STICK             N   3    $12.00   10/1/2003   12/31/2299
36416   5   COLLEC CAPILLARY BLOOD SPEC FINGER,HEE. EAR STICK             N   3    $12.00   10/1/2003   12/31/2299
36420   2   VENIPUNCTURE, CUTDOWN; UNDER AGE 1 YEAR                       N   3    $10.00    1/1/1984   12/31/2299
36425   2   VENIPUNCTURE, CUTDOWN; AGE 1 OR OVER                          N   3    $20.00    8/1/1979   12/31/2299
36425   7   VEINPUNCTURE, CUTDOWN - AGE 1 OR OVER                         N   3    $13.45    6/1/1994   12/31/2299
36430   2   TRANSFUSION, BLOOD OR BLOOD COMPONENTS; INDIRECT              N   3    $18.00    1/2/1993   12/31/2299
36431   2   TRANSFUSION, BLOOD OR BLOOD COMPONENTS; DIRECT                N   3    $24.00    1/1/1973   12/31/2299
36440   2   PUSH TRANSFUSION, BLOOD, 2 YEARS OR UNDER                     N   3    $42.00    1/2/1992   12/31/2299
36450   2   EXCHANGE TRANSFUSION, BLOOD; NEWBORN                          N   3   $175.00    1/1/1971   12/31/2299
36455   2   EXCHANGE TRANSFUSION, BLOOD; OTHER THAN NEWBORN               N   3    $69.61    1/1/2003   12/31/2299
36460   2   TRANSFUSION, INTRAUTERINE, FETAL                              N   3   $130.00    8/1/1979   12/31/2299
36468   2   SINGLE OR MULTIPLE INJ OF SCLEROSING SOLUTIONS                N   3    $30.00    1/1/1984   12/31/2299
36469   7   SINGLE OR MULTIPLE INJECTIONS OF SCLEROSING SOLUTI            N   3    $13.45    6/1/1994   12/31/2299
36470   2   INJECTION OF SCLEROSING SOLUTION; SINGLE VEIN                 N   3    $32.00    1/2/1995   12/31/2299
36471   2   INJECTION OF SCLEROSING SOLUTION; MULTIPLE VEINS,             N   3    $46.80    1/1/1995   12/31/2299
36475   2   ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN               Y   3   $219.92    1/1/2005   12/31/2299
36476   2   ENDOVENOUS ABLATION THERAPY SEPARATE ACCESSITES               Y   3   $107.39    1/1/2005   12/31/2299
36478   2   ENDOVENOUS FIRST VEIN TREATED                                 Y   3   $220.04    1/1/2005   12/31/2299
36479   2   ENDOVENOUS ABLATION THERAPY LIST SEPARATE                     Y   3   $107.39    1/1/2005   12/31/2299
36481   2   PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY ME            N   3   $300.00    1/2/1994   12/31/2299
36481   7   PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY ME            N   3    $13.45    6/1/1994   12/31/2299
36488   F   PERCUT CV CATH SUBCLAV JUG OR OTHER UP TO 2YRS                N   3   $225.80    3/1/2004   12/31/2299
36489   F   PERCUT CV CATH SUBCLAV JUG OR OTHER OVER 2 YRS                N   3   $225.80    3/1/2004   12/31/2299
36490   F   CUTDOWN PLACEMENT OF CENTRAL VENOUS CATHETER (EG,H            N   3   $225.80    3/1/2004   12/31/2299
36491   F   CUTDOWN PLACEMENT OF CENTRAL VENOUS CATHETER FOR H            N   3   $225.80    3/1/2004   12/31/2299
36500   2   VENOUS CATHETERIZATION FOR SELECTIVE ORGAN BLOOD S            N   3    $68.00    1/2/1992   12/31/2299
36510   2   CATHETERIZATION OF UMBILICAL VEIN FOR DIAGNOSIS OR            N   3    $15.00    1/1/1973   12/31/2299
36511   1   THERAPEUTIC APHERESIS WHITE BLOOD CELLS                       N   3    $54.87    1/1/2003   12/31/2299
36511   2   THERAPEUTIC APHERESIS WHITE BLOOD CELLS                       N   3    $54.87    1/1/2003   12/31/2299
36512   1   THERAPEUTIC APHERESIS RED BLOOD CELLS                         N   3    $54.87    1/1/2003   12/31/2299
36512   2   THERAPEUTIC APHERESIS RED BLOOD CELLS                         N   3    $54.87    1/1/2003   12/31/2299
36513   1   THERAPEUTIC APHERESIS FOR PLATELETS                           N   3    $54.87    1/1/2003   12/31/2299
36513   2   THERAPEUTIC APHERESIS FOR PLATELETS                           N   3    $54.87    1/1/2003   12/31/2299
36514   1   THERAPEUTIC APHERESIS PLASMA PHERESIS                         N   3    $54.87    1/1/2003   12/31/2299
36514   2   THERAPEUTIC APHERESIS PLASMA PHERESIS                         N   3    $54.87    1/1/2003   12/31/2299
36515   1   THER APHERESIS EXTRACORPOREAL IMMUNOADSORPTION PLASMA REI     N   3    $54.87    3/1/2004   12/31/2299
36515   2   THER APHERESIS EXTRACORPOREAL IMMUNOADSORPTION PLASMA REI     N   3    $54.87    1/1/2003   12/31/2299
36516   1   THER APHRESIS W/EXTRACORPOREAL SELEC ADSORPTION OR SEL FILT   N   3    $55.00    3/1/2004   12/31/2299
36516   2   THER APHRESIS W/EXTRACORPOREAL SELEC ADSORPTION OR SEL FI     N   3    $54.87    1/1/2003   12/31/2299
36522   7   PHOTOPHERESIS, EXTRACORPOREAL                                 N   3    $13.45    6/1/1994   12/31/2299
36530   F   INSERTION OF IMPLANTABLE INTRAVENOUS INFUSION PUMP            N   3   $351.00    3/1/2004   12/31/2299
36531   F   REVISION OF IMPLANTABLE INTRAVENOUS INFUSION PUMP             N   3   $306.00    3/1/2004   12/31/2299
36532   F   REMOVAL OF IMPLANTABLE INTRAVENOUS INFUSION PUMP              N   3   $225.80    3/1/2004   12/31/2299
36533   F   INSERTION OF IMPLANTABLE VENOUS ACCESS PORT, WITH             N   3   $351.00    3/1/2004   12/31/2299
36534   F   REVISION OF IMPLANTABLE VENOUS ACCESS PORT AND/OR             N   3   $306.00    3/1/2004   12/31/2299
36535   2   REMOVAL OF IMPLANTABLE VENOUS ACCESS PORT AND/OR S            N   3   $288.00    1/2/1992   12/31/2299
36535   F   REMOVAL OF IMPLANTABLE VENOUS ACCESS PORT AND/OR S            N   3   $225.80    3/1/2004   12/31/2299
36540   2   COLLECTION OF BLOOD SPECIMEN FROM APARTIALLY OR COMPLETELY    N   3    $20.52    3/5/2002   12/31/2299




                                                                                                                146
36550   2   DECLOT BY THROMBOLYTIC AGENT IMPLANT VASC ACCESS DEVICE OR CATH     N   3    $18.70   1/1/2000   12/31/2299
36555   2   INSERTION OF NONTUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATHET   N   3    $83.11   1/1/2004   12/31/2299
36556   2   INSERTION OF NON TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATH    N   3    $75.06   1/1/2004   12/31/2299
36557   2   INSERTION OF TUNNELED CENTRALLY INSTERTED CENTRAL VENOUS CATHETER   N   3   $185.23   1/1/2004   12/31/2299
36558   2   INSERTED CENTRAL VENOUS CATH 5 YRS OR OLDER                         N   3   $175.97   1/1/2004   12/31/2299
36560   2   INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DE   N   3   $219.76   1/1/2004   12/31/2299
36561   2   INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DE   N   3   $212.09   1/1/2004   12/31/2299
36563   2   INSERTION OF TUNNELED CENTRALLY VENOUS DEVICE SUB PUMP              N   3   $220.88   1/1/2004   12/31/2299
36565   2   INSERTION OF TUNNELED CENTRALLY INSERTED VENOUS ACCESS DEVICE       N   3   $212.09   1/1/2004   12/31/2299
36566   2   INSERTION OF TUNNELED CENTRALLY INSERTED VENOUS ACCESS DEVICE       N   3   $227.21   1/1/2004   12/31/2299
36568   2   INSERTION OF PERIPHERALLY CENTRAL VENOUS CATHETER UNDER 5           N   3    $60.78   1/1/2004   12/31/2299
36569   2   INS PERIPHERALLY INSERTED CENTRAL VENOUS CATH 5 OR OLDER            N   3    $57.09   1/1/2004   12/31/2299
36570   2   INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS ACCESS DEVICE     N   3   $191.54   1/1/2004   12/31/2299
36571   2   INS OF PERIPHERALLY VENOUS DEVICE 5 YRS OR OLDER                    N   3   $190.87   1/1/2004   12/31/2299
36575   2   REPAIR OF TUNNELED OR NON TUNNELED CENTRAL VENOUS CATHETER          N   3    $32.68   1/1/2004   12/31/2299
36576   2   REPAIR OF CENTRAL VENOUS ACCESS DEVICE, WITH SUB PORT OR PUMP CE    N   3   $123.74   1/1/2004   12/31/2299
36578   2   REPLACEMENT OF CATH ON, OF CENTRAL VENOUS ACCESS DEVICE, WITH SUB   N   3   $140.62   1/1/2004   12/31/2299
36580   2   REPLACEMENT COMPLETE OF NON TUNNELED CENTRALLY INSERTED VENOUS CA   N   3    $41.97   1/1/2004   12/31/2299
36581   2   REPLACEMENT COMPLETE OF TUNNELED CENTRALLY INSERTED VENOUS CATHET   N   3   $130.97   1/1/2004   12/31/2299
36582   2   REPLACEMENT, COMPLETE OF A TUNNELED CENTRALLY INSERTED VENOUS DEV   N   3   $191.63   1/1/2004   12/31/2299
36583   2   REPLACEMENT COMPLETE OF TUNNELED CENTRALLY INS VENOUS ACCESS DEVI   N   3   $192.98   1/1/2004   12/31/2299
36584   2   REPLACEMENT COMPLETE OF PERIPHERALLY INS VENOUS CATH                N   3    $42.51   1/1/2004   12/31/2299
36585   2   REPLACEMENT COMPLETE OF A PERIPHERALLY INSERTED CENTRAL VENOUS DE   N   3   $179.44   1/1/2004   12/31/2299
36589   2   REMOVAL OF TUNNELED CENTRAL VENOUS CATH WITHOUT PORT OR PUMP        N   3    $88.33   1/1/2004   12/31/2299
36590   2   REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE WITH SUBCUTANEOU   N   3   $119.88   1/1/2004   12/31/2299
36595   2   MECH REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL (EG FIBRIN SHEA   N   3   $119.65   1/1/2004   12/31/2299
36596   2   MECHANICAL REMOVAL OF INTRALUMINAL (INTRACATHETER) OBSTURCTIVE MA   N   3    $29.10   1/1/2004   12/31/2299
36597   2   REPOSITIONING OF PREVIOUSLY PLACED CENTRAL VENOUS CATHETER UNDER    N   3    $38.41   1/1/2004   12/31/2299
36598   2   CONTRAST INJECTIONS(S) FOR RADIOLOGIC EVALUATION OF EXISTING CENT   N   3    $76.16   1/1/2006   12/31/2299
36598   7   CONTRAST INJECTIONS(S) FOR RADIOLOGIC EVALUATION OF EXISTING CENT   N   3    $13.45   1/1/2006   12/31/2299
36598   8   CONTRAST INJECTIONS(S) FOR RADIOLOGIC EVALUATION OF EXISTING CENT   N   3    $15.23   1/1/2006   12/31/2299
36600   2   ARTERIAL PUNCT BLOOD FOR DIAGNOSIS                                  N   3     $5.00   1/1/1971   12/31/2299
36600   7   ARTERY PUNCT FOR DIAGNOSIS                                          N   3    $13.45   6/1/1994   12/31/2299
36620   2   ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING,MONITORING     N   3    $39.00   1/2/1995   12/31/2299
36620   7   ARTERIAL CATH OR CANULIZEFOR MONTRING TRANS PERCUT                  N   3    $13.45   6/1/1994   12/31/2299
36625   2   ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMP,M                  N   3    $35.00   1/1/1973   12/31/2299
36625   7   ARTER CATH / CANNUL FOR SAMPLING MNTRING CUT DOWN                   N   3    $13.45   6/1/1994   12/31/2299
36640   2   ARTERIAL CATHETERIZATION FOR PROLONGED INFUSION TH                  N   3    $35.00   1/1/1984   12/31/2299
36640   F   ARTERIAL CATHETERIZATION FOR PROLONGED INFUSION TH                  N   3   $225.80   3/1/2004   12/31/2299
36660   2   CATHETERIZATION, UMBILICAL ARTERY, NEWBORN, FOR DI                  N   3    $25.00   1/1/1973   12/31/2299
36680   2   PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSTION                      N   3    $41.11   1/1/2005   12/31/2299
36680   7   INTRAOSSEOUS                                                        N   3    $13.45   6/1/1994   12/31/2299
36800   2   INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPO                  N   3    $75.00   1/1/1973   12/31/2299
36800   7   INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPO                  N   3    $13.45   6/1/1994   12/31/2299
36800   F   INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPO                  N   3   $351.00   3/1/2004   12/31/2299
36810   2   INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPO                  N   3   $175.00   1/1/1989   12/31/2299
36810   7   INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPO                  N   3    $13.45   6/1/1994   12/31/2299
36810   F   INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPO                  N   3   $351.00   3/1/2004   12/31/2299
36815   2   INSERT OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE;                  N   3   $150.00   1/1/1973   12/31/2299
36815   7   INSERT OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE;                  N   3    $13.45   6/1/1994   12/31/2299
36815   F   INSERT OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE;                  N   3   $351.00   3/1/2004   12/31/2299




                                                                                                                     147
36818   2   ARTERIOVENOUS OPEN UPPER ARM                                        N   3   $443.30   1/1/2005   12/31/2299
36818   7   ARTERIOVEOUS OPEN UPPER ARM CEPHALIC VEIN                           N   3    $13.50   1/1/2005   12/31/2299
36818   8   ARTERIOVENOUS ANASTOMOSIS OPEN UPPER ARM                            N   3    $88.66   1/1/2005   12/31/2299
36819   2   ARTERIOVENOUS ANASTOMOSIS OPEN BY BASILIC VEIN TRANSPOSITION        N   3   $489.27   1/1/2000   12/31/2299
36819   7   ARTERIOVENOUS ANASTOMOSIS OPEN BY BASILIC VEIN TRANSPOSITION        N   3    $13.45   1/1/2000   12/31/2299
36819   8   ARTERIOVENOUS ANASTOMOSIS OPEN BY BASILIC VEIN TRANSPOSITION        N   3    $97.85   1/1/2000   12/31/2299
36819   F   ARTERIOVENOUS ANASTOMOSIS OPEN BY BASILIC VEIN TRANSPOSITION        N   3   $351.00   3/1/2004   12/31/2299
36820   2   ARTERIOVENOUS ANASTOMOSIS, OPEN; BY FOREARM VEIN TRANSPOSITION      N   3   $473.99   1/1/2002   12/31/2299
36820   F   ARTERIOVENOUS ANASTOMOSIS, OPEN; BY FOREARM VEIN TRANSPOSITION      N   3   $351.00   3/1/2004   12/31/2299
36821   2   ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE                         N   3   $346.80   6/1/1993   12/31/2299
36821   7   ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE                         N   3    $13.45   6/1/1994   12/31/2299
36821   8   ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE                         N   3    $50.00   8/1/1979   12/31/2299
36821   F   ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE                         N   3   $351.00   3/1/2004   12/31/2299
36822   2   INSERT CANNULA/PROLONGED ECMO INSUFFICIENCY                         N   3   $200.00   1/1/1984   12/31/2299
36822   7   INSERT CANNULA/PROLONGED ECHM INSUFFICIENCY                         N   3    $13.45   6/1/1994   12/31/2299
36823   2   INSERTION OF ARTERIAL VENOUS CANNULA FOR ISOLATED EXTRACORPOREALI   N   3   $200.00   1/1/1999   12/31/2299
36825   2   ARTERIOVENOUS FISTULA; AUTOGENOUS GRAFT                             N   3   $200.00   1/1/1988   12/31/2299
36825   7   ARTERIOVENOUS FISTULA; AUTOGENOUS GRAFT                             N   3    $13.45   6/1/1994   12/31/2299
36825   8   ARTERIOVENOUS FISTULA; AUTOGENOUS GRAFT                             N   3    $80.00   8/1/1979   12/31/2299
36825   F   ARTERIOVENOUS FISTULA; AUTOGENOUS GRAFT                             N   3   $432.00   3/1/2004   12/31/2299
36830   2   ARTERIOVENOUS FISTULA; NONAUTOGENOUS GRAFT                          N   3   $250.00   1/1/1988   12/31/2299
36830   7   ARTERIOVENOUS FISTULA; NONAUTOGENOUS GRAFT                          N   3    $13.45   6/1/1994   12/31/2299
36830   8   ARTERIOVENOUS FISTULA; NONAUTOGENOUS GRAFT                          N   3    $85.00   1/1/1984   12/31/2299
36830   F   ARTERIOVENOUS FISTULA; NONAUTOGENOUS GRAFT                          N   3   $432.00   3/1/2004   12/31/2299
36831   2   THROMBECTOMY ARTERIOVENOUS FISTULA W/OUT REVISION                   N   3   $243.17   1/1/1999   12/31/2299
36831   F   THROMBECTOMY ARTERIOVENOUS FISTULA W/OUT REVISION                   N   3   $495.00   3/1/2004   12/31/2299
36832   2   RVSN OF ARTRVNS FSTL W/O THRMBCTM W/O AUTGNS GRAFT                  N   3   $200.00   1/1/1984   12/31/2299
36832   7   RVSN OF ARTRVNS FSTL W/O THRMBCTM W/O AUTGNS GRAFT                  N   3    $13.45   6/1/1994   12/31/2299
36832   8   RVSN OF ARTRVNS FSTL W/O THRMBCTM W/O AUTGNS GRAFT                  N   3    $40.00   1/1/1984   12/31/2299
36832   F   RVSN OF ARTRVNS FSTL W/O THRMBCTM W/O AUTGNS GRAFT                  N   3   $432.00   3/1/2004   12/31/2299
36833   2   REVISION AV FISTULA W/THROMBECTOMY AUTOGENOUS OR NONAUTOGENOUS      N   3   $370.57   1/1/1999   12/31/2299
36833   7   REVISION AV FISTULA WITH THROMBECTOMY AUTOGENOUS OR NONAUTOGENOUS   N   3   $370.57   1/1/1999   12/31/2299
36833   8   REVISION AV FISTULA W/THROMBECTOMY AUTOGENOUS OR NONAUTOGENOUS      N   3   $370.57   1/1/1999   12/31/2299
36833   F   REVISION AV FISTULA W/THROMBECTOMY AUTOGENOUS OR NONAUTOGENOUS      N   3   $432.00   3/1/2004   12/31/2299
36834   2   PLASTIC REPAIR OF ARTERIOVENOUS ANEURYSM (SEPARATE PROCEDURE)       N   3   $434.00   1/1/1995   12/31/2299
36835   7   THOMAS SHUNT                                                        N   3    $13.45   6/1/1994   12/31/2299
36838   2   DISTAL REVASCULARIZATION AND INTERVAL LIGATION UPPER EXTREMITY      N   3   $736.61   1/1/2004   12/31/2299
36860   2   CANNULA DECLOTTING; WITHOUT BALLOON CATHETER                        N   3    $60.00   1/1/1984   12/31/2299
36860   7   CANNULA DECLOTTING; WITHOUT BALLOON CATHETER                        N   3    $13.45   6/1/1994   12/31/2299
36860   8   CANNULA DECLOTTING; WITHOUT BALLOON CATHETER                        N   3    $12.00   1/1/1984   12/31/2299
36860   F   CANNULA DECLOTTING; WITHOUT BALLOON CATHETER                        N   3   $306.00   3/1/2004   12/31/2299
36861   2   CANNULA DECLOTTING; WITH BALLOON CATHETER                           N   3    $50.00   1/1/1984   12/31/2299
36861   7   CANNULA DECLOTTING; WITH BALLOON CATHETER                           N   3    $13.45   6/1/1994   12/31/2299
36861   8   CANNULA DECLOTTING; WITH BALLOON CATHETER                           N   3    $10.00   1/1/1984   12/31/2299
36861   F   CANNULA DECLOTTING; WITH BALLOON CATHETER                           N   3   $351.00   3/1/2004   12/31/2299
36870   2   THROMBECT.PERCUT.ATERIO.FISTULA AUTOGENOUS OR NONAUTOGEOUS          N   3   $851.90   1/1/2001   12/31/2299
36870   7   THROMBEC.PERCUT.ARTERIO.FISTULA AUTOGENOUS OR NONAUTOGENOUS         N   3    $13.45   1/1/2001   12/31/2299
36870   8   THROMBEC.PERCUT.ARTERIO.FISTULA AUTOGENOUS OR NONAUTOGENOUS         N   3   $170.38   1/1/2001   12/31/2299
36870   F   THROMBECT.PERCUT.ATERIO.FISTULA AUTOGENOUS OR NONAUTOGEOUS          N   3   $495.00   3/1/2004   12/31/2299
37140   2   ANASTOMOSIS; PORTACAVAL                                             N   3   $800.00   1/1/1973   12/31/2299
37140   7   ANASTOMOSIS; PORTACAVAL                                             N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     148
37140   8   ANASTOMOSIS; PORTACAVAL                                             N   3    $160.00    1/1/1973   12/31/2299
37145   7   ANASTOMOSIS; RENOPORTAL                                             N   3      $13.45   6/1/1994   12/31/2299
37160   2   ANASTOMOSIS; CAVAL-MESENTERIC                                       N   3    $700.00    1/1/1984   12/31/2299
37160   7   ANASTOMOSIS; CAVAL-MESENTERIC                                       N   3      $13.45   6/1/1994   12/31/2299
37160   8   ANASTOMOSIS; CAVAL-MESENTERIC                                       N   3    $140.00    1/1/1984   12/31/2299
37180   7   ANASTOMOSIS; SPLENORENAL, PROXIMAL                                  N   3      $13.45   6/1/1994   12/31/2299
37181   2   ANASTOMOSIS; SPLENORENAL, DISTAL (SELECTIVE DECOMP                  N   3    $800.00    1/2/1994   12/31/2299
37181   8   ASSISTANT @ ANASTOMOSIS;SPLENORENAL, DISTAL (SELECTIVE DECOMP       N   3    $200.00    1/1/1992   12/31/2299
37182   1   INS TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S)                 N   3    $549.08    1/1/2005   12/31/2299
37184   2   PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCOR   N   3   $1,802.03   1/1/2006   12/31/2299
37184   7   PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCOR   N   3      $13.45   1/1/2006   12/31/2299
37184   8   PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCOR   N   3    $360.40    1/1/2006   12/31/2299
37185   2   PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCOR   N   3    $587.10    1/1/2006   12/31/2299
37185   7   PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCOR   N   3      $13.45   1/1/2006   12/31/2299
37185   8   PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCOR   N   3    $117.42    1/1/2006   12/31/2299
37186   2   SECONDARY PERCUTANEOUS TRANSLUMINAL THROMBECTOMY (EG NONPRIMARY M   N   3   $1,217.47   1/1/2006   12/31/2299
37186   7   SECONDARY PERCUTANEOUS TRANSLUMINAL THROMBECTOMY (EG NONPRIMARY M   N   3      $13.45   1/1/2006   12/31/2299
37186   8   SECONDARY PERCUTANEOUS TRANSLUMINAL THROMBECTOMY (EG NONPRIMARY M   N   3    $243.49    1/1/2006   12/31/2299
37187   2   PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, VEIN(S), INCLU   N   3   $1,753.66   1/1/2006   12/31/2299
37187   7   PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, VEIN(S), INCLU   N   3      $13.45   1/1/2006   12/31/2299
37188   2   PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBOTOMY, VEIN(S) INCLUDI   N   3   $1,516.97   1/1/2006   12/31/2299
37188   7   PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBOTOMY, VEIN(S) INCLUDI   N   3      $13.45   1/1/2006   12/31/2299
37188   8   PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBOTOMY, VEIN(S) INCLUDI   N   3    $303.39    1/1/2006   12/31/2299
37195   2   THROMBOLYSIS,CEREBRAL,BY INTRAVENOUS INFUSION                       N   3    $186.28    1/1/1998   12/31/2299
37195   7   THROMBOLYSIS,CEREBRAL,BY INTRAVENOUS INFUSION                       N   3      $13.45   1/1/1998   12/31/2299
37195   8   THROMBOLYSIS,CEREBRAL, BY INTRAVENOUS INFUSION                      N   3      $37.26   1/1/1998   12/31/2299
37200   2   (FOR MONITORING, OPERATION OF PUMP AND OTHER NONSU                  N   3    $136.85    1/1/2003   12/31/2299
37200   7   (FOR MONITORING, OPERATION OF PUMP AND OTHER NONSU                  N   3      $13.45   6/1/1994   12/31/2299
37201   2   TRANSCATHETER THERAPY, INFUSION FOR THROMBOLYSIS                    N   3    $276.00    1/2/1994   12/31/2299
37201   7   TRANSCATHETER THERAPY, INFUSION FOR THROMBOLYSIS                    N   3      $13.45   6/1/1994   12/31/2299
37202   2   TRANSCATHETER THERAPY, INFUSION OTHER THAN FOR THR                  N   3    $216.00    1/2/1994   12/31/2299
37202   7   TRANSCATHETER THERAPY, INFUSION OTHER THAN FOR THR                  N   3      $13.45   6/1/1994   12/31/2299
37203   2   TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVAS                  N   3    $161.39    1/1/2003   12/31/2299
37203   7   TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVAS                  N   3      $13.45   6/1/1994   12/31/2299
37204   2   TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR T                  N   3    $684.00    1/2/1994   12/31/2299
37204   7   TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR T                  N   3      $13.45   6/1/1994   12/31/2299
37205   2   TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(                  N   3    $320.00    1/2/1995   12/31/2299
37205   7   TRANSCATHETER THERAPY AND BIOPSY                                    N   3      $13.45   6/1/1994   12/31/2299
37206   2   TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(                  N   3    $131.83    1/1/1993   12/31/2299
37206   7   TRANSCATH PLCMNT INTRAVASCULAR STENT EACH VESSEL                    N   3      $13.45   6/1/1994   12/31/2299
37207   2   TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(                  N   3    $263.97    1/1/1993   12/31/2299
37207   7   TRANSCATH PLCMNT INTRAVASCULAR STENT OPEN INITAL V                  N   3      $13.45   6/1/1994   12/31/2299
37208   2   TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(                  N   3    $131.83    1/1/1993   12/31/2299
37208   7   TRANSCATH PLCMNT INTRAVASCULAR STENT EACH ADDITL V                  N   3      $13.45   6/1/1994   12/31/2299
37209   2   EXCHANGE OF PREVIOUSLY PLACED ARTERIAL CATHETER                     N   3      $51.00   1/1/1995   12/31/2299
37210   2   EMBOLIZATION UTERINE FIBROID                                        N   3    $283.40    1/1/2007   12/31/2299
37215   2   TRANSCATHETER PLACEMENT CAROTID ARTERY                              N   3    $661.47    1/1/2005   12/31/2299
37215   7   TRANSCATHETER PLACEMENT OF VASCULAR STENTS                          N   3      $13.45   1/1/2005   12/31/2299
37215   8   TRANSCATHER PLACEMENT OF STENTS CAROTID ARTERY                      N   3    $132.29    1/1/2005   12/31/2299
37216   2   TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENTS                     N   3    $637.25    1/1/2005   12/31/2299
37216   7   TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT                      N   3      $13.45   1/1/2005   12/31/2299




                                                                                                                       149
37250   2   INTRAVASCULA ULTRASOUND(NON-CORONARY VESSEL)DURING THERA.INTERVEN   N   3    $54.14   1/1/1997   12/31/2299
37250   4   INTRASVASCULAR ULTRASOUND(NON-CORONARY VESSEL)DURING THERA/INTERV   N   3    $54.14   1/1/1997   12/31/2299
37251   2   INTRASVASCULAR ULTRASOUND(NON-CORONARY VESSEL)EA.ADDIT.VESSEL       N   3    $41.29   1/1/1997   12/31/2299
37251   4   INTRASVASCULAR ULTRASOUND(NON-CORONARY VESSEL)EA.ADD.VESSEL         N   3    $41.29   1/1/1997   12/31/2299
37251   7   INTRASVASCULAR ULTRASOUND W/THERAPEUTIC INTERVENTION;EA.ADDIT.VES   N   3    $13.45   1/1/1997   12/31/2299
37400   2   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3   $300.00   1/1/1973   12/31/2299
37400   7   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3    $13.45   6/1/1994   12/31/2299
37400   8   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3    $60.00   1/1/1973   12/31/2299
37420   2   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3   $500.00   1/1/1973   12/31/2299
37420   7   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3    $13.45   6/1/1994   12/31/2299
37420   8   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3   $100.00   1/1/1973   12/31/2299
37440   2   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3   $500.00   1/1/1973   12/31/2299
37440   7   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3    $13.45   6/1/1994   12/31/2299
37440   8   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3   $100.00   1/1/1973   12/31/2299
37460   2   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3   $250.00   1/1/1973   12/31/2299
37460   7   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3    $13.45   6/1/1994   12/31/2299
37460   8   ARTERIORRHAPHY, SUTURE OF MAJOR ARTERY, WOUND OR I                  N   3    $50.00   1/1/1973   12/31/2299
37470   7   REPAIR MULTIPLE ARTERIES AND/OR VEINS                               N   3    $13.45   6/1/1994   12/31/2299
37500   2   VASCULAR ENDOSCOPY SURG W/LIGATION PERFORATOR VEINS SUBFAS          N   3   $444.45   1/1/2003   12/31/2299
37500   7   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3    $13.45   6/1/1994   12/31/2299
37500   8   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3    $50.00   1/1/1973   12/31/2299
37520   2   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3   $500.00   1/1/1973   12/31/2299
37520   7   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3    $13.45   6/1/1994   12/31/2299
37520   8   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3   $100.00   1/1/1973   12/31/2299
37540   2   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3   $500.00   1/1/1973   12/31/2299
37540   7   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3    $13.45   6/1/1994   12/31/2299
37540   8   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3   $100.00   1/1/1973   12/31/2299
37560   2   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3   $200.00   1/1/1973   12/31/2299
37560   7   PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJU                  N   3    $13.45   6/1/1994   12/31/2299
37565   2   LIGATION OF INTERNAL JUGULAR VEIN                                   N   3   $200.00   8/1/1979   12/31/2299
37565   7   LIGATION OF INTERNAL JUGULAR VEIN                                   N   3    $13.45   6/1/1994   12/31/2299
37565   8   LIGATION OF INTERNAL JUGULAR VEIN                                   N   3    $40.00   8/1/1979   12/31/2299
37600   2   LIGATION; EXTERNAL CAROTID ARTERY                                   N   3   $250.00   1/1/1973   12/31/2299
37600   7   LIGATION; EXTERNAL CAROTID ARTERY                                   N   3    $13.45   6/1/1994   12/31/2299
37600   8   LIGATION; EXTERNAL CAROTID ARTERY                                   N   3    $50.00   1/1/1973   12/31/2299
37605   2   LIGATION; INTERNAL OR COMMON CAROTID ARTERY                         N   3   $250.00   1/1/1973   12/31/2299
37605   7   LIGATION; INTERNAL OR COMMON CAROTID ARTERY                         N   3    $13.45   6/1/1994   12/31/2299
37605   8   LIGATION; INTERNAL OR COMMON CAROTID ARTERY                         N   3    $50.00   1/1/1973   12/31/2299
37606   2   LIGATION; WITH GRADUAL OCCLUSION, AS WITH SELVERST                  N   3   $250.00   1/1/1973   12/31/2299
37606   7   LIGATION; WITH GRADUAL OCCLUSION, AS WITH SELVERST                  N   3    $13.45   6/1/1994   12/31/2299
37606   8   LIGATION; WITH GRADUAL OCCLUSION, AS WITH SELVERST                  N   3    $50.00   1/1/1973   12/31/2299
37607   2   LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS F                  N   3   $194.98   1/1/1994   12/31/2299
37607   7   ANESTHESIA, LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS        N   3    $13.45   1/1/1994   12/31/2299
37607   F   LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS F                  N   3   $351.00   3/1/2004   12/31/2299
37609   2   LIGATION OR BIOPSY, TEMPORAL ARTERY                                 N   3    $75.00   1/1/1971   12/31/2299
37609   7   LIGATION OR BIOPSY, TEMPORAL ARTERY                                 N   3    $13.45   6/1/1994   12/31/2299
37609   F   LIGATION OR BIOPSY, TEMPORAL ARTERY                                 N   3   $306.00   3/1/2004   12/31/2299
37615   2   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3   $200.00   1/1/1984   12/31/2299
37615   7   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3    $13.45   6/1/1994   12/31/2299
37615   8   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3    $40.00   1/1/1984   12/31/2299
37616   2   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3   $500.00   1/1/1984   12/31/2299




                                                                                                                     150
37616   7   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3    $13.45   6/1/1994   12/31/2299
37616   8   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3   $100.00   1/1/1984   12/31/2299
37617   2   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3   $552.00   1/2/1996   12/31/2299
37617   7   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3    $13.45   6/1/1994   12/31/2299
37617   8   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3   $110.00   1/2/1996   12/31/2299
37618   2   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3   $200.00   8/1/1979   12/31/2299
37618   7   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3    $13.45   6/1/1994   12/31/2299
37618   8   LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTUR                  N   3    $40.00   8/1/1979   12/31/2299
37620   2   INTERR,PARTIAL OR COMP,OF INF VENA CAVA BY SUTURE,                  N   3   $462.00   1/2/1996   12/31/2299
37620   7   INTERR,PARTIAL OR COMP,OF INF VENA CAVA BY SUTURE,                  N   3    $13.45   6/1/1994   12/31/2299
37620   8   INTERR,PARTIAL OR COMP,OF INF VENA CAVA BY SUTURE,                  N   3    $92.40   1/2/1996   12/31/2299
37650   2   INTERR,PARTIAL OR COMP,OF FEMORAL VEIN,BY LIGATURE                  N   3   $225.00   1/1/1984   12/31/2299
37650   7   INTERR,PARTIAL OR COMP,OF FEMORAL VEIN,BY LIGATURE                  N   3    $13.45   6/1/1994   12/31/2299
37650   8   INTERR,PARTIAL OR COMP,OF FEMORAL VEIN,BY LIGATURE                  N   3    $45.00   1/1/1984   12/31/2299
37650   F   INTERR,PARTIAL OR COMP,OF FEMORAL VEIN,BY LIGATURE                  N   3   $306.00   3/1/2004   12/31/2299
37660   2   INTERR, PARTIAL OR COMP, OF COMMON ILIAC VEIN BY L                  N   3   $300.00   1/1/1973   12/31/2299
37660   7   INTERR, PARTIAL OR COMP, OF COMMON ILIAC VEIN BY L                  N   3    $13.45   6/1/1994   12/31/2299
37660   8   INTERR, PARTIAL OR COMP, OF COMMON ILIAC VEIN BY L                  N   3    $60.00   1/1/1973   12/31/2299
37700   2   LIGATION AND DIV OF LONG SAPHENOUS VEIN AT SAPHENO                  N   3   $147.00   1/1/1992   12/31/2299
37700   7   LIGATION AND DIV OF LONG SAPHENOUS VEIN AT SAPHENO                  N   3    $13.45   6/1/1994   12/31/2299
37700   F   LIGATION AND DIV OF LONG SAPHENOUS VEIN AT SAPHENO                  N   3   $306.00   3/1/2004   12/31/2299
37718   2   LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN             N   3   $240.32   1/1/2006   12/31/2299
37722   2   LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS   N   3   $285.21   1/1/2006   12/31/2299
37722   7   LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS   N   3    $13.45   1/1/2006   12/31/2299
37722   8   LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS   N   3    $57.04   1/1/2006   12/31/2299
37735   2   LIGATION AND DIV;W RADICAL EX OF ULCER & SKIN GRAF                  N   3   $300.00   8/1/1979   12/31/2299
37735   7   LIGATION AND DIV;W RADICAL EX OF ULCER & SKIN GRAF                  N   3    $13.45   6/1/1994   12/31/2299
37735   8   LIGATION AND DIV;W RADICAL EX OF ULCER & SKIN GRAF                  N   3    $60.00   1/1/1971   12/31/2299
37735   F   LIGATION AND DIV;W RADICAL EX OF ULCER & SKIN GRAF                  N   3   $351.00   3/1/2004   12/31/2299
37760   2   LIGATION OF PERFORATORS, SUBFASCIAL, RADICAL, WITH                  N   3   $250.00   1/1/1973   12/31/2299
37760   7   LIGATION OF PERFORATORS, SUBFASCIAL, RADICAL, WITH                  N   3    $13.45   6/1/1994   12/31/2299
37760   8   LIGATION OF PERFORATORS, SUBFASCIAL, RADICAL, WITH                  N   3    $50.00   8/1/1979   12/31/2299
37760   F   LIGATION OF PERFORATORS, SUBFASCIAL, RADICAL, WITH                  N   3   $351.00   3/1/2004   12/31/2299
37765   2   STAB PHLEBECTOOF VARICOSE VEINS, ONE EXTREMITY STAB INCISIONS       N   3   $278.92   1/1/2004   12/31/2299
37766   2   STAB PHLEBECTOMY OF VARICOSE VEINS, ONCE EXTREMITY MORE THAN 20 I   N   3   $338.99   1/1/2004   12/31/2299
37780   2   LIGATION AND DIV OF SHORT SAPHENOUS VEIN AT SAPHEN                  N   3    $50.00   1/1/1973   12/31/2299
37780   7   LIGATION AND DIV OF SHORT SAPHENOUS VEIN AT SAPHEN                  N   3    $13.45   6/1/1994   12/31/2299
37780   F   LIGATION AND DIV OF SHORT SAPHENOUS VEIN AT SAPHEN                  N   3   $351.00   3/1/2004   12/31/2299
37785   2   LIGATION AND DIVISION OF MINOR VARICOSE VEIN LEG                    N   3    $50.75   1/2/1992   12/31/2299
37785   7   LIGATION AND DIVISION OF MINOR VARICOSE VEIN OF LE                  N   3    $13.45   6/1/1994   12/31/2299
37785   F   LIGATION AND DIVISION OF MINOR VARICOSE VEIN LEG                    N   3   $351.00   3/1/2004   12/31/2299
37788   7   PENILE REVASCULARIZATION, ARTERY, WITH OR WITHOUT                   N   3    $13.45   6/1/1994   12/31/2299
37790   2   PENILE VENOUS OCCLUSIVE PROCEDURE                                   N   3   $251.03   1/1/1994   12/31/2299
37790   F   PENILE VENOUS OCCLUSIVE PROCEDURE                                   N   3   $351.00   3/1/2004   12/31/2299
37799   7   UNLISTED PROCEDURE, VASCULAR SURGERY                                N   3    $13.45   6/1/1994   12/31/2299
38100   2   SPLENECTOMY                                                         N   3   $262.50   1/1/1971   12/31/2299
38100   7   SPLENECTOMY                                                         N   3    $13.45   6/1/1994   12/31/2299
38100   8   SPLENECTOMY                                                         N   3    $50.00   1/1/1973   12/31/2299
38101   2   SPENECTOMY; PARTIAL                                                 N   3   $527.20   1/1/2004   12/31/2299
38101   7   SPLENECTOMY; PARTIAL                                                N   3    $13.45   6/1/1994   12/31/2299
38102   2   SPLENECTOMY;                                                        N   3   $160.09   1/1/1994   12/31/2299




                                                                                                                     151
38115   2   REPAIR OF RUPTURED SPLEEN W/WO PARTIAL SPLENECTOMY                  N   3   $408.00   1/2/1992   12/31/2299
38115   7   REPAIR OF RUPTURED SPLEEN W/WO PARTIAL SPLENECTOMY                  N   3    $13.45   6/1/1994   12/31/2299
38115   8   REPAIR OF RUPTURED SPLEEN W/WO PARTIAL SPLENECTOMY                  N   3    $55.00   1/1/1984   12/31/2299
38120   2   LAPAROSCOPY SURGICAL SPLENECTOMY                                    N   3   $592.96   1/1/2002   12/31/2299
38200   2   INJECTION PROCEDURE FOR SPLENOPORTOGRAPHY                           N   3    $50.00   1/1/1971   12/31/2299
38200   7   INJECTION PROCEDURE FOR SPLENOPORTOGRAPHY                           N   3    $13.45   6/1/1994   12/31/2299
38205   2   BLOOD DERIVE HEMATOPEIETIC PROGENITOR CELL HARV TRANS ALLO          N   3    $47.42   1/1/2003   12/31/2299
38205   9   BLOOD DERIVE HEMATOPEIETIC PROGENITOR CELL HARV TRANS ALLOG         N   3    $47.42   1/1/2003   12/31/2299
38206   2   BLOOD DERIVED HEMATOPOIETIC PROGENITOR HARVEST AUTOLOGO             N   3    $47.42   1/1/2003   12/31/2299
38206   9   BLOOD DERIVED HEMATOPOIETIC PROGENITOR HARVEST AUTOLOGOUS           N   3    $47.42   1/1/2003   12/31/2299
38220   2   BONE MARROW ASPIRATION                                              N   3   $127.47   1/1/2002   12/31/2299
38221   2   BONE MARROW BIOPSY,NEEDLE OR TROCAR                                 N   3   $136.09   1/1/2002   12/31/2299
38230   2   BONE MARROW HARVESTING FOR TRANSPLANTATION                          Y   3   $148.93   1/1/2003   12/31/2299
38230   7   BONE MARROW HARVESTING FOR TRANSPLANTATION                          N   3    $13.45   6/1/1994   12/31/2299
38231   8   BLOOD DERIVED PERIPH STEM CELL HARVEST FOR TRANSPLANT PER COLLECT   Y   3    $12.35   1/1/1996   12/31/2299
38240   2   BONE MARROW OR BLOOD-DERIVED PRPHRL STEM CELL TRANSPLANT, ALLOGEN   Y   3    $75.92   1/1/2005   12/31/2299
38240   7   BONE MARROW TRANSPLANTATION                                         N   3    $13.45   6/1/1994   12/31/2299
38241   2   BONE MARROW TRANSPLANTATION                                         N   3    $76.16   1/1/2005   12/31/2299
38241   2   BONE MARROW TRANSPLANTATION                                         Y   3    $76.16   1/1/2005   12/31/2299
38241   7   BONE MARROW TRANSPLANTATION                                         N   3    $13.45   6/1/1994   12/31/2299
38242   1   BONE MARROW/BLOOD DERIVED PERIPHERAL STEM CELL TRANP ALLOG          N   3    $54.04   1/1/2003   12/31/2299
38242   2   BONE MARROW/BLOOD DERIVED PERIPHERAL STEM CELL TRANS ALL            N   3    $54.04   1/1/2003   12/31/2299
38300   2   DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; S                  N   3    $15.00   1/1/1973   12/31/2299
38300   7   DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; S                  N   3    $13.45   6/1/1994   12/31/2299
38300   F   DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; S                  N   3   $225.80   3/1/2004   12/31/2299
38305   2   DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; E                  N   3   $155.00   1/2/1994   12/31/2299
38305   7   DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; E                  N   3    $13.45   6/1/1994   12/31/2299
38305   F   DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS; E                  N   3   $306.00   3/1/2004   12/31/2299
38308   7   LYMPHANGIOTOMY OR OTHER OPERATIONS ON LYMPHATIC CH                  N   3    $13.45   6/1/1994   12/31/2299
38308   F   LYMPHANGIOTOMY OR OTHER OPERATIONS ON LYMPHATIC CH                  N   3   $306.00   3/1/2004   12/31/2299
38380   2   SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL                   N   3   $250.00   1/1/1973   12/31/2299
38380   7   SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL                   N   3    $13.45   6/1/1994   12/31/2299
38380   8   SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL                   N   3    $50.00   1/1/1973   12/31/2299
38381   2   SUTURE AND/OR LIGATION OF THORACIC DUCT; THORACIC                   N   3   $500.00   1/1/1973   12/31/2299
38381   7   SUTURE AND/OR LIGATION OF THORACIC DUCT; THORACIC                   N   3    $13.45   6/1/1994   12/31/2299
38381   8   SUTURE AND/OR LIGATION OF THORACIC DUCT; THORACIC                   N   3   $100.00   1/1/1973   12/31/2299
38382   7   SUTURE AND/OR LIGATION OF THORACIC DUCT                             N   3    $13.45   6/1/1994   12/31/2299
38500   2   BIOPSY OR EXCISION OF LYMPH NODE; UNSPECIFIED                       N   3    $79.50   1/2/1992   12/31/2299
38500   7   BIOPSY OR EXCISION OF LYMPH NODE; UNSPECIFIED                       N   3    $13.45   6/1/1994   12/31/2299
38500   F   BIOPSY OR EXCISION OF LYMPH NODE; UNSPECIFIED                       N   3   $306.00   3/1/2004   12/31/2299
38505   2   BIOPSY OR EXCISION OF LYMPH NODE(S)                                 N   3    $45.37   1/2/1992   12/31/2299
38505   7   BIOPSY OR EXCISION OF LYMPH NODE(S)                                 N   3    $13.45   6/1/1994   12/31/2299
38505   F   BIOPSY OR EXCISION OF LYMPH NODE(S)                                 N   3   $225.80   3/1/2004   12/31/2299
38510   2   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3    $85.00   8/1/1979   12/31/2299
38510   7   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3    $13.45   6/1/1994   12/31/2299
38510   8   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3    $17.00   1/1/1984   12/31/2299
38510   F   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3   $306.00   3/1/2004   12/31/2299
38520   2   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3   $125.00   1/1/1973   12/31/2299
38520   7   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3    $13.45   6/1/1994   12/31/2299
38520   F   BIOPSY OR EXCISION OF LYMPH NODE; DEEP CERVICAL NO                  N   3   $306.00   3/1/2004   12/31/2299
38525   2   BIOPSY OR EXCISION OF LYMPH NODES-DEEP AXILLARY                     N   3   $125.00   1/1/1984   12/31/2299




                                                                                                                     152
38525   7   BIOPSY OR EXCISION OF LYMPH NODES-DEEP AXILLARY                     N   3    $13.45   6/1/1994   12/31/2299
38525   8   BIOPSY OR EXCISION OF LYMPH NODES-DEEP AXILLARY                     N   3    $25.00   1/1/1984   12/31/2299
38525   F   BIOPSY OR EXCISION OF LYMPH NODES-DEEP AXILLARY                     N   3   $306.00   3/1/2004   12/31/2299
38530   2   BIOPSY OR EXCISION OF LYMPH NODE; INTERNAL MAMMARY                  N   3   $175.00   1/1/1973   12/31/2299
38530   7   BIOPSY OR EXCISION OF LYMPH NODE; INTERNAL MAMMARY                  N   3    $13.45   6/1/1994   12/31/2299
38530   8   BIOPSY OR EXCISION OF LYMPH NODE; INTERNAL MAMMARY                  N   3    $35.00   1/1/1973   12/31/2299
38530   F   BIOPSY OR EXCISION OF LYMPH NODE; INTERNAL MAMMARY                  N   3   $306.00   3/1/2004   12/31/2299
38542   2   DISSECTION; DEEP JUGULAR NODE                                       N   3   $240.00   1/2/1994   12/31/2299
38542   7   DISSECTION; DEEP JUGULAR NODE                                       N   3    $13.45   6/1/1994   12/31/2299
38542   F   DISSECTION; DEEP JUGULAR NODE                                       N   3   $306.00   3/1/2004   12/31/2299
38550   2   EXCISION OF CYSTIC HYGROMA,AXILLARY OR CERVICAL,W/                  N   3   $150.00   1/1/1973   12/31/2299
38550   7   EXCISION OF CYSTIC HYGROMA,AXILLARY OR CERVICAL,W/                  N   3    $13.45   6/1/1994   12/31/2299
38550   F   EXCISION OF CYSTIC HYGROMA,AXILLARY OR CERVICAL,W/                  N   3   $351.00   3/1/2004   12/31/2299
38555   7   EXCISION OF CYSTIC HYGROMA,AXILLARY OR CERVICAL,W/                  N   3    $13.45   6/1/1994   12/31/2299
38555   F   EXCISION OF CYSTIC HYGROMA,AXILLARY OR CERVICAL,W/                  N   3   $432.00   3/1/2004   12/31/2299
38562   7   LIMITED LYMPHADENECTOMY FOR STAGING (SEPARATE PROC                  N   3    $13.45   6/1/1994   12/31/2299
38564   2   LMTD LYMPHADENCTOMY FOR STAGING RETROPERITONEAL                     N   3   $350.00   1/1/1984   12/31/2299
38564   7   LMTD LYMPHADENCTOMY FOR STAGING RETROPERITONEAL                     N   3    $13.45   6/1/1994   12/31/2299
38564   8   LMTD LYMPHADENCTOMY FOR STAGING RETROPERITONEAL                     N   3    $70.00   1/1/1984   12/31/2299
38570   2   LAPAROSCOPY SURG W/RETROPERITONEAL LYMPH NODE BIOPSY SINGLE/MULTI   N   3   $349.05   1/1/2000   12/31/2299
38570   7   LAPAROSCOY SURG W/RETROPERITONEAL LYMPH NODE BIOPSY SINGLE/MULTI    N   3    $13.45   1/1/2000   12/31/2299
38570   F   LAPAROSCOPY SURG W/RETROPERITONEAL LYMPH NODE BIOPSY SINGLE/MULTI   N   3   $495.00   3/1/2004   12/31/2299
38571   2   LAPAROSCOPY SURGICAL W/BILATERAL TOTAL PELVIC LYMPHADENECTOMY       N   3   $452.40   1/1/2000   12/31/2299
38571   7   LAPAROSCOPY SURGICAL W/BILATERAL TOTAL PELVIC LYMPHADENECTOMY       N   3    $13.45   1/1/2000   12/31/2299
38571   8   LAPAROSCOPY SURGICAL W/BILATERAL TOTAL PELVIC LYMPHADENECTOMY       N   3    $90.48   1/1/2000   12/31/2299
38571   F   LAPAROSCOPY SURGICAL W/BILATERAL TOTAL PELVIC LYMPHADENECTOMY       N   3   $495.00   3/1/2004   12/31/2299
38572   2   LAPAROSCOPY SURG W/BILAT TOT PELV LYMPHAD&PERI-AORTIC LYMPH NODE    N   3   $526.62   1/1/2000   12/31/2299
38572   7   LAPAROSCOPY SURG W/BILAT TOT PELV LYMPHAD&PERI-AORTIC LYMPH NODE    N   3    $13.45   1/1/2000   12/31/2299
38572   8   LAPAROSCOPY SURG W/BILAT TOT PELV LYMPHAD&PERI-AORTIC LYMPH NODE    N   3   $105.32   1/1/2000   12/31/2299
38572   F   LAPAROSCOPY SURG W/BILAT TOT PELV LYMPHAD&PERI-AORTIC LYMPH NODE    N   3   $495.00   3/1/2004   12/31/2299
38589   7   UNLISTED LAPAROSCOPY PROCEDURE LYMPHATIC SYSTEM                     N   3    $13.45   1/1/2000   12/31/2299
38700   2   SUPRAHYOID LYMPHADENECTOMY; UNILATERAL                              N   3   $300.00   1/1/1973   12/31/2299
38700   7   SUPRAHYOID LYMPHADENECTOMY; UNILATERAL                              N   3    $13.45   6/1/1994   12/31/2299
38700   8   SUPRAHYOID LYMPHADENECTOMY; UNILATERAL                              N   3    $60.00   1/1/1973   12/31/2299
38720   2   CERVICAL LYMPHADENECTOMY (COMPLETE); UNILATERAL                     N   3   $475.00   1/1/1973   12/31/2299
38720   7   CERVICAL LYMPHADENECTOMY (COMPLETE); UNILATERAL                     N   3    $13.45   6/1/1994   12/31/2299
38720   8   CERVICAL LYMPHADENECTOMY (COMPLETE); UNILATERAL                     N   3    $95.00   1/1/1973   12/31/2299
38724   2   CERVICAL LYMPHADENECTOMY (MOD RAD NCK)                              N   3   $475.00   1/1/1984   12/31/2299
38724   7   CERVICAL LYMPHADENECTOMY (MOD RAD NECK)                             N   3    $13.45   6/1/1994   12/31/2299
38724   8   CERVICAL LYMPHADENECTOMY (MOD RAD NCK DISSEC)                       N   3    $95.00   1/1/1984   12/31/2299
38740   2   AXILLARY LYMPHADENECTOMY; SUPERFICIAL                               N   3   $200.00   8/1/1979   12/31/2299
38740   7   AXILLARY LYMPHADENECTOMY; SUPERFICIAL                               N   3    $13.45   6/1/1994   12/31/2299
38740   8   AXILLARY LYMPHADENECTOMY; SUPERFICIAL                               N   3    $40.00   8/1/1979   12/31/2299
38740   F   AXILLARY LYMPHADENECTOMY; SUPERFICIAL                               N   3   $306.00   3/1/2004   12/31/2299
38745   2   AXILLARY LYMPHADENECTOMY; COMPLETE                                  N   3   $375.00   8/1/1979   12/31/2299
38745   7   AXILLARY LYMPHADENECTOMY; COMPLETE                                  N   3    $13.45   6/1/1994   12/31/2299
38745   8   AXILLARY LYMPHADENECTOMY; COMPLETE                                  N   3    $75.00   8/1/1979   12/31/2299
38745   F   AXILLARY LYMPHADENECTOMY; COMPLETE                                  N   3   $432.00   3/1/2004   12/31/2299
38746   2   THORACIC LYMPHADENECTOMY, REGIONAL, INCLUDING MEDI                  N   3   $146.44   1/1/1994   12/31/2299
38747   2   ABDOMINAL LYMPHADENECTOMY, REGIONAL, INCLUDING CEL                  N   3   $163.10   1/1/1994   12/31/2299
38760   2   INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLU                  N   3   $200.00   8/1/1979   12/31/2299




                                                                                                                     153
38760   7   INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLU        N   3    $13.45   6/1/1994   12/31/2299
38760   8   INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLU        N   3    $40.00   8/1/1979   12/31/2299
38760   F   INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, INCLU        N   3   $306.00   3/1/2004   12/31/2299
38765   2   INGUINOFEMORAL LYMPHADENECTOMY,SUPERFICIAL,IN CONT        N   3   $500.00   8/1/1979   12/31/2299
38765   7   INGUINOFEMORAL LYMPHADENECTOMY,SUPERFICIAL,IN CONT        N   3    $13.45   6/1/1994   12/31/2299
38765   8   INGUINOFEMORAL LYMPHADENECTOMY,SUPERFICIAL,IN CONT        N   3   $100.00   8/1/1979   12/31/2299
38770   2   PELVIC LYMPHADENECTOMY,INCL EXTERNAL ILIAC,HYPOGAS        N   3   $618.00   1/2/1994   12/31/2299
38770   7   PELVIC LYMPHADENECTOMY, INCLUD EXTERNAL ILIAC, HYP        N   3    $13.45   6/1/1994   12/31/2299
38780   2   RETROPERITONEAL LYMPHADENECTOMY, EXTENSIVE, INCLUD        N   3   $700.00   1/1/1973   12/31/2299
38780   7   RETROPERITONEAL LYMPHADENECTOMY, EXTENSIVE, INCLUD        N   3    $13.45   6/1/1994   12/31/2299
38780   8   RETROPERITONEAL LYMPHADENECTOMY, EXTENSIVE, INCLUD        N   3   $140.00   1/1/1973   12/31/2299
38790   2   INJECTION PROCEDURE FOR LYMPHANGIOGRAPHY; UNILATER        N   3    $75.00   1/1/1973   12/31/2299
38790   7   INJECTION PROCEDURE FOR LYMPHANGIOGRAPHY; UNILATER        N   3    $13.45   6/1/1994   12/31/2299
38792   2   INJECTION PROCEDURE FOR IDENTIFICATION OF SENTINEL NODE   N   3   $235.15   1/1/1999   12/31/2299
38794   7   CANNULATION, THORACIC DUCT                                N   3    $13.45   6/1/1994   12/31/2299
38999   7   UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM             N   3    $13.45   6/1/1994   12/31/2299
39000   2   MEDIASTINOTOMY WITH EXPLORATION OR DRAINAGE; CERVI        N   3   $150.00   1/1/1973   12/31/2299
39000   7   MEDIASTINOTOMY WITH EXPLORATION OR DRAINAGE; CERVI        N   3    $13.45   6/1/1994   12/31/2299
39000   8   MEDIASTINOTOMY WITH EXPLORATION OR DRAINAGE; CERVI        N   3    $30.00   1/1/1973   12/31/2299
39010   2   MEDIASTINOTOMY WITH EXPLORATION OR DRAINAGE; CERVI        N   3   $300.00   1/1/1973   12/31/2299
39010   7   MEDIASTINOTOMY WITH EXPLORATION OR DRAINAGE; CERVI        N   3    $13.45   6/1/1994   12/31/2299
39010   8   MEDIASTINOTOMY WITH EXPLORATION OR DRAINAGE; CERVI        N   3    $60.00   1/1/1973   12/31/2299
39200   2   EXCISION OF MEDIASTINAL CYST                              N   3   $450.00   1/1/1973   12/31/2299
39200   7   EXCISION OF MEDIASTINAL CYST                              N   3    $13.45   6/1/1994   12/31/2299
39200   8   EXCISION OF MEDIASTINAL CYST                              N   3    $90.00   1/1/1973   12/31/2299
39220   2   EXCISION OF MEDIASTINAL TUMOR                             N   3   $786.00   1/2/1994   12/31/2299
39220   7   EXCISION OF MEDIASTINAL TUMOR                             N   3    $13.45   6/1/1994   12/31/2299
39400   2   MEDIASTINOSCOPY, WITH OR WITHOUT BIOPSY                   N   3   $254.24   1/1/2004   12/31/2299
39400   7   MEDIASTINOSCOPY, WITH OR WITHOUT BIOPSY                   N   3    $13.45   6/1/1994   12/31/2299
39400   8   MEDIASTINOSCOPY, WITH OR WITHOUT BIOPSY                   N   3    $57.87   1/1/2003   12/31/2299
39499   7   UNLISTED PROCEDURE, MEDIASTINUM                           N   3    $13.45   6/1/1994   12/31/2299
39500   7   REPAIR, DIAPHRAGM HERNIA (ESOPHA HIATAL), TRANSABD        N   3    $13.45   6/1/1994   12/31/2299
39501   2   REPAIR DIAPHRAGM LACERATION                               N   3   $400.00   1/1/1984   12/31/2299
39501   7   REPAIR DIAPHRAGM LACERATION                               N   3    $13.45   6/1/1994   12/31/2299
39501   8   REPAIR DIAPHRAGM LACERATION                               N   3    $80.00   1/1/1984   12/31/2299
39502   2   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL),         N   3   $450.00   1/1/1971   12/31/2299
39502   7   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL),         N   3    $13.45   6/1/1994   12/31/2299
39502   8   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL),         N   3    $90.00   8/1/1979   12/31/2299
39503   2   REPAIR, DIAPHRAGMATIC HERNIA TRANSABDOMINAL; NEONA        N   3   $500.00   8/1/1979   12/31/2299
39503   7   REPAIR, DIAPHRAGMATIC HERNIA, TRANSABDOMINAL, NEON        N   3    $13.45   6/1/1994   12/31/2299
39503   8   REPAIR, DIAPHRAGMATIC HERNIA, TRANSABDOMINAL; NEON        N   3   $100.00   8/1/1979   12/31/2299
39510   7   REPAIR, DIAPHRAGM HERNIA (ESOPHA HIATAL),TRANSAB F        N   3    $13.45   6/1/1994   12/31/2299
39520   2   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);         N   3   $450.00   8/1/1979   12/31/2299
39520   7   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);         N   3    $13.45   6/1/1994   12/31/2299
39520   8   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);         N   3    $90.00   8/1/1979   12/31/2299
39530   2   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);         N   3   $600.00   1/2/1992   12/31/2299
39530   7   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);         N   3    $13.45   6/1/1994   12/31/2299
39530   8   REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);         N   3    $95.00   1/1/1973   12/31/2299
39531   7   REPAIR, DIAPHRAGM HERNIA (ESOPHA HIATAL);COMB THOR        N   3    $13.45   6/1/1994   12/31/2299
39540   7   REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL)        N   3    $13.45   6/1/1994   12/31/2299
39541   7   REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL)        N   3    $13.45   6/1/1994   12/31/2299




                                                                                                           154
39545   2   IMBRICATION OF DIAPHRAGM FOR EVENTRATION; PARALYTI                  N   3   $518.75   1/1/2005   12/31/2299
39545   7   IMBRICATION OF DIAPHRAGM FOR EVENTRATION; PARALYTI                  N   3    $13.45   6/1/1994   12/31/2299
39545   8   IMBRICATION OF DIAPHRAGM FOR EVENTRATION; PARALYTI                  N   3   $103.75   1/1/2005   12/31/2299
39560   2   RESECTION DIAPHRAGM WITH SIMPLE REPAIR (PRIMARY SUTURE)             N   3   $487.08   1/1/2000   12/31/2299
39560   7   RESECTION DIAPHRAGM WITH SIMPLE REPAIR (PRIMARY SUTURE)             N   3    $13.45   1/1/2000   12/31/2299
39561   2   RESECTION DIAPHRAGM W/COMPLEX REPAIR (PROSTHETIC MATERIAL LOCAL M   N   3   $666.79   1/1/2000   12/31/2299
39561   7   RESECT DIAPHRAGM W/COMPLEX REPAIR(PROSTHETIC MATERIAL LOCAL MUSCL   N   3    $13.45   1/1/2000   12/31/2299
39561   8   RESECT DIAPHRAGM W/COMPLEX REPAIR(PROSTHETIC MATERIAL LOCAL MUSCL   N   3   $133.36   1/1/2000   12/31/2299
39599   7   UNLISTED PROCEDURE, DIAPHRAGM                                       N   3    $13.45   6/1/1994   12/31/2299
40480   7   DIGESTIVE SYSTEM                                                    N   3    $13.45   6/1/1994   12/31/2299
40490   2   BIOPSY LIP                                                          N   3    $20.00   1/1/1984   12/31/2299
40490   7   BIOPSY LIP                                                          N   3    $13.45   6/1/1994   12/31/2299
40500   2   VERMILIONECTOMY(LIP SHAVE) WITH MUCOSAL ADVANCEMEN                  N   3   $262.00   8/1/1979   12/31/2299
40500   7   VERMILIONECTOMY(LIP SHAVE) WITH MUCOSAL ADVANCEMEN                  N   3    $13.45   6/1/1994   12/31/2299
40500   F   VERMILIONECTOMY(LIP SHAVE) WITH MUCOSAL ADVANCEMEN                  N   3   $306.00   3/1/2004   12/31/2299
40510   2   EXCISION LIP; TRANSVERSE WEDGE EXCISION WITH PRIMA                  N   3   $262.00   8/1/1979   12/31/2299
40510   7   EXCISION LIP; TRANSVERSE WEDGE EXCISION WITH PRIMA                  N   3    $13.45   6/1/1994   12/31/2299
40510   F   EXCISION LIP; TRANSVERSE WEDGE EXCISION WITH PRIMA                  N   3   $306.00   3/1/2004   12/31/2299
40520   2   EXCISION LIP; V-EXCISION W/PRIMARY DIRECT LINEAR C                  N   3   $150.00   1/1/1973   12/31/2299
40520   7   EXCISION LIP; V-EXCISION W/PRIMARY DIRECT LINEAR C                  N   3    $13.45   6/1/1994   12/31/2299
40520   F   EXCISION LIP; V-EXCISION W/PRIMARY DIRECT LINEAR C                  N   3   $306.00   3/1/2004   12/31/2299
40525   7   EXCISION LIP; FULL THICKNESS, RECONSTRUCTION WITH                   N   3    $13.45   6/1/1994   12/31/2299
40525   F   EXCISION LIP; FULL THICKNESS, RECONSTRUCTION WITH                   N   3   $306.00   3/1/2004   12/31/2299
40527   7   EXCISION LIP; FULL THICKNESS, RECONSTRUCTION WITH                   N   3    $13.45   6/1/1994   12/31/2299
40527   F   EXCISION LIP; FULL THICKNESS, RECONSTRUCTION WITH                   N   3   $306.00   3/1/2004   12/31/2299
40530   2   RESECTION LIP, MORE THAN ONE-FOURTH, WITHOUT RECON                  N   3   $150.00   1/1/1973   12/31/2299
40530   7   RESECT LIP MORE THAN ONE FOURTH WITHOUT RECONSTR                    N   3    $13.45   6/1/1994   12/31/2299
40530   F   RESECTION LIP, MORE THAN ONE-FOURTH, WITHOUT RECON                  N   3   $306.00   3/1/2004   12/31/2299
40650   2   REPAIR LIP, FULL THICKNESS; VERMILLION ONLY                         N   3   $196.51   1/1/2004   12/31/2299
40650   7   REPAIR LIP, FULL THICKNESS; VERMILLION ONLY                         N   3    $13.45   6/1/1994   12/31/2299
40650   F   REPAIR LIP, FULL THICKNESS; VERMILLION ONLY                         N   3   $351.00   3/1/2004   12/31/2299
40652   2   REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HE                  N   3   $200.00   1/1/1984   12/31/2299
40652   7   REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HE                  N   3    $13.45   6/1/1994   12/31/2299
40652   8   REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HE                  N   3    $40.00   1/1/1984   12/31/2299
40652   F   REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HE                  N   3   $351.00   3/1/2004   12/31/2299
40654   2   REPAIR LIP, FULL THICKNESS; OVER ONE HALF VERTICAL                  N   3   $246.00   1/2/1992   12/31/2299
40654   7   REPAIR LIP, FULL THICKNESS; OVER ONE HALF VERTICAL                  N   3    $13.45   6/1/1994   12/31/2299
40654   F   REPAIR LIP, FULL THICKNESS; OVER ONE HALF VERTICAL                  N   3   $351.00   3/1/2004   12/31/2299
40700   2   PLASTIC REPAIR OF CLEFT LIP; PRIMARY, PARTIAL OR C                  N   3   $400.00   1/1/1971   12/31/2299
40700   7   PLASTIC REPAIR OF CLEFT LIP; PRIMARY, PARTIAL OR C                  N   3    $13.45   6/1/1994   12/31/2299
40700   8   PLASTIC REPAIR OF CLEFT LIP; PRIMARY, PARTIAL OR C                  N   3    $80.00   1/1/1973   12/31/2299
40700   F   PLASTIC REPAIR OF CLEFT LIP; PRIMARY, PARTIAL OR C                  N   3   $495.00   3/1/2004   12/31/2299
40701   2   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3   $500.00   1/1/1973   12/31/2299
40701   7   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3    $13.45   6/1/1994   12/31/2299
40701   8   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3   $100.00   1/1/1973   12/31/2299
40701   F   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3   $495.00   3/1/2004   12/31/2299
40702   2   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3   $350.00   1/1/1973   12/31/2299
40702   7   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3    $13.45   6/1/1994   12/31/2299
40702   8   PLASTIC REPAIR OF CLEFT LIP; PRIMARY BILATERAL, ON                  N   3    $70.00   1/1/1973   12/31/2299
40720   2   PLASTIC REPAIR OF CLEFT LIP; SECONDARY, UNILATERAL                  N   3   $454.50   1/2/1992   12/31/2299
40720   7   PLASTIC REPAIR OF CLEFT LIP; SECONDARY, UNILATERAL                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     155
40720   F   PLASTIC REPAIR OF CLEFT LIP; SECONDARY, UNILATERAL    N   3   $495.00   3/1/2004   12/31/2299
40760   7   PLASTIC REPAIR OF CLEFT LIP; W/CROSS LIP PEDICLE F    N   3    $13.45   6/1/1994   12/31/2299
40761   2   PLASTIC REPAIR OF CLEFT LIP; W/CROSS LIP PED FLAP     N   3   $590.26   1/1/2003   12/31/2299
40761   7   PLASTIC REPAIR OF CLEFT LIP; W/CROSS LIP PED FLAP     N   3    $13.45   6/1/1994   12/31/2299
40761   F   PLASTIC REPAIR OF CLEFT LIP; W/CROSS LIP PED FLAP     N   3   $351.00   3/1/2004   12/31/2299
40799   7   UNLISTED PROCEDURE, LIPS                              N   3    $13.45   6/1/1994   12/31/2299
40800   7   DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF     N   3    $13.45   6/1/1994   12/31/2299
40801   2   DRAINAGE OF ABSCESS                                   N   3    $82.14   1/2/1992   12/31/2299
40801   7   DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF     N   3    $13.45   6/1/1994   12/31/2299
40801   F   DRAINAGE OF ABSCESS                                   N   3   $306.00   3/1/2004   12/31/2299
40804   7   REMOVAL OF EMBEDDED FOREIGN BODY; SIMPLE              N   3    $13.45   6/1/1994   12/31/2299
40805   7   REMOVAL OF EMBEDDED FOREIGN BODY; COMPLICATED         N   3    $13.45   6/1/1994   12/31/2299
40806   2   INCISION OF LABIAL FRENUM (FRENOTOMY)                 N   3    $20.00   1/1/1984   12/31/2299
40806   7   INCISION OF LABIAL FRENUM (FRENOTOMY)                 N   3    $13.45   6/1/1994   12/31/2299
40808   2   BIOPSY, VESTIBULE OF MOUTH                            N   3    $25.00   1/1/1984   12/31/2299
40808   7   BIOPSY, VESTIBULE OF MOUTH                            N   3    $13.45   6/1/1994   12/31/2299
40810   2   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/OUT     N   3    $25.00   8/8/1989   12/31/2299
40810   7   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/OUT     N   3    $13.45   6/1/1994   12/31/2299
40812   2   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/SIMP    N   3   $114.20   1/1/2002   12/31/2299
40812   7   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/SIMP    N   3    $13.45   6/1/1994   12/31/2299
40814   2   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/COMP    N   3   $100.00   1/1/1984   12/31/2299
40814   7   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/COMP    N   3    $13.45   6/1/1994   12/31/2299
40814   F   EXCISION OF LESION OF MUCOSA AND SUBMUCOSA; W/COMP    N   3   $306.00   3/1/2004   12/31/2299
40816   2   EXCISION OF LESION OF MUCOSA, SUBMUCOSA, AND UNDER    N   3   $200.00   1/1/1984   12/31/2299
40816   7   EXCISION OF LESION OF MUCOSA, SUBMUCOSA, AND UNDER    N   3    $13.45   6/1/1994   12/31/2299
40816   8   EXCISION OF LESION OF MUCOSA, SUBMUCOSA, AND UNDER    N   3    $40.00   1/1/1984   12/31/2299
40816   F   EXCISION OF LESION OF MUCOSA, SUBMUCOSA, AND UNDER    N   3   $306.00   3/1/2004   12/31/2299
40818   7   EXCISION OF MUCOSA AS DONOR GRAFT                     N   3    $13.45   6/1/1994   12/31/2299
40818   F   EXCISION OF MUCOSA AS DONOR GRAFT                     N   3   $225.80   3/1/2004   12/31/2299
40819   2   EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY    N   3    $15.00   1/1/1984   12/31/2299
40819   7   EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY    N   3    $13.45   6/1/1994   12/31/2299
40819   F   EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY    N   3   $225.80   3/1/2004   12/31/2299
40820   2   DESTRUCTION OF SCAR                                   N   3    $25.00   1/1/1989   12/31/2299
40820   7   DESTRUCTION OF LESION OR SCAR BY PHYSICAL METHODS     N   3    $13.45   6/1/1994   12/31/2299
40830   2   CLOSURE OF LACERATION; UP TO 2 CM                     N   3    $30.00   1/1/1984   12/31/2299
40830   7   CLOSURE OF LACERATION; UP TO 2 CM                     N   3    $13.45   6/1/1994   12/31/2299
40831   2   CLOSURE OF LACERATION; OVER 2 CM OR COMPLEX           N   3   $108.00   3/1/1996   12/31/2299
40831   7   CLOSURE OF LACERATION; OVER 2 CM OR COMPLEX           N   3    $13.45   6/1/1994   12/31/2299
40831   F   CLOSURE OF LACERATION; OVER 2 CM OR COMPLEX           N   3   $225.80   3/1/2004   12/31/2299
40840   7   VESTIBULOPLASTY; ANTERIOR                             N   3    $13.45   6/1/1994   12/31/2299
40842   7   VESTIBULOPLASTY; POSTERIOR, UNILATERAL                N   3    $13.45   6/1/1994   12/31/2299
40843   7   VESTIBULOPLASTY; POSTERIOR, BILATERAL                 N   3    $13.45   6/1/1994   12/31/2299
40844   7   VESTIBULOPLASTY; ENTIRE ARCH                          N   3    $13.45   6/1/1994   12/31/2299
40845   7   VESTIBULOPLASTY; COMPLEX (INCLUDING RIDGE EXTENSIO    N   3    $13.45   6/1/1994   12/31/2299
40899   7   UNLISTED PROCEDURE, VESTIBULE OF MOUTH                N   3    $13.45   6/1/1994   12/31/2299
41000   2   I&D OF INTRAORAL ABSCESS, CYST, OR HEMATOMA OF TON    N   3    $15.00   8/1/1979   12/31/2299
41000   7   I&D OF INTRAORAL ABSCESS, CYST, OR HEMATOMA OF TON    N   3    $13.45   6/1/1994   12/31/2299
41005   2   I&D OF INTRAORAL ABSCESS,CYST,OR HEMATOMA OF TONGUE   N   3    $15.00   1/1/1973   12/31/2299
41005   7   I&D OF INTRAORAL ABSCESS,CYST,OR HEMATOMA OF TONGU    N   3    $13.45   6/1/1994   12/31/2299
41005   F   I&D OF INTRAORAL ABSCESS,CYST,OR HEMATOMA OF TONGUE   N   3   $225.80   3/1/2004   12/31/2299
41006   2   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR    N   3   $121.80   1/2/1992   12/31/2299




                                                                                                       156
41006   7   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3    $13.45   6/1/1994   12/31/2299
41006   F   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3   $225.80   3/1/2004   12/31/2299
41007   7   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3    $13.45   6/1/1994   12/31/2299
41007   F   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3   $225.80   3/1/2004   12/31/2299
41008   7   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3    $13.45   6/1/1994   12/31/2299
41008   F   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3   $225.80   3/1/2004   12/31/2299
41009   7   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3    $13.45   6/1/1994   12/31/2299
41009   F   I&D OF INTRAORAL ABSCESS,CYST,OR HEMA OF TONGUE OR   N   3   $225.80   3/1/2004   12/31/2299
41010   2   INCISION OF LINGUAL FRENUM (FRENOTOMY)               N   3    $30.00   1/2/1992   12/31/2299
41010   7   INCISION OF LINGUAL FRENUM (FRENOTOMY)               N   3    $13.45   6/1/1994   12/31/2299
41010   F   INCISION OF LINGUAL FRENUM (FRENOTOMY)               N   3   $225.80   3/1/2004   12/31/2299
41015   2   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3    $96.00   1/2/1994   12/31/2299
41015   7   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3    $13.45   6/1/1994   12/31/2299
41015   F   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3   $225.80   3/1/2004   12/31/2299
41016   7   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3    $13.45   6/1/1994   12/31/2299
41016   F   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3   $225.80   3/1/2004   12/31/2299
41017   7   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3    $13.45   6/1/1994   12/31/2299
41017   F   I&D OF EXTRAORAL ABSCESS,CYST OR HEMA OF MOUTH FLO   N   3   $225.80   3/1/2004   12/31/2299
41018   7   I&D OF EXTRAORAL ABSCESS,CYST,OR HEMA OF MOUTH FLO   N   3    $13.45   6/1/1994   12/31/2299
41018   F   I&D OF EXTRAORAL ABSCESS,CYST,OR HEMA OF MOUTH FLO   N   3   $225.80   3/1/2004   12/31/2299
41100   2   BIOPSY TONGUE; ANTERIOR TWO-THIRDS                   N   3    $25.00   1/1/1984   12/31/2299
41100   7   BIOPSY TONGUE; ANTERIOR TWO-THIRDS                   N   3    $13.45   6/1/1994   12/31/2299
41105   2   BIOPSY TONGUE; POSTERIOR ONE-THIRD                   N   3    $50.00   8/1/1979   12/31/2299
41105   7   BIOPSY TONGUE; POSTERIOR ONE-THIRD                   N   3    $13.45   6/1/1994   12/31/2299
41108   2   BIOPSY, FLOOR OF MOUTH                               N   3    $25.00   1/1/1984   12/31/2299
41108   7   BIOPSY, FLOOR OF MOUTH                               N   3    $13.45   6/1/1994   12/31/2299
41110   2   EXCISION OF LESION OF TONGUE WITHOUT CLOSURE         N   3    $40.00   1/1/1984   12/31/2299
41110   7   EXCISION OF LESION OF TONGUE WITHOUT CLOSURE         N   3    $13.45   6/1/1994   12/31/2299
41112   2   EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIO   N   3   $100.00   1/1/1984   12/31/2299
41112   7   EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIO   N   3    $13.45   6/1/1994   12/31/2299
41112   F   EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIO   N   3   $306.00   3/1/2004   12/31/2299
41113   2   EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERI   N   3   $180.00   1/2/1997   12/31/2299
41113   7   EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERI   N   3    $13.45   6/1/1994   12/31/2299
41113   F   EXCISION OF LESION OF TONGUE WITH CLOSURE; POSTERI   N   3   $306.00   3/1/2004   12/31/2299
41114   7   EXCISION OF LESION OF TONGUE WITH CLOSURE; WITH LO   N   3    $13.45   6/1/1994   12/31/2299
41114   F   EXCISION OF LESION OF TONGUE WITH CLOSURE; WITH LO   N   3   $306.00   3/1/2004   12/31/2299
41115   2   EXCISION OF LINGUAL FRENUM (FRENECTOMY)              N   3    $78.60   1/1/1998   12/31/2299
41115   7   EXCISION OF LINGUAL FRENUM (FRENECTOMY)              N   3    $13.45   6/1/1994   12/31/2299
41116   2   EXCISION LESION OF FLOOR OF MOUTH                    N   3   $111.00   1/2/1997   12/31/2299
41116   7   EXCISION LESION OF FLOOR OF MOUTH                    N   3    $13.45   6/1/1994   12/31/2299
41116   8   EXCISION LESION OF FLOOR OF MOUTH                    N   3    $22.00   1/2/1997   12/31/2299
41116   F   EXCISION LESION OF FLOOR OF MOUTH                    N   3   $225.80   3/1/2004   12/31/2299
41120   2   GLOSSECTOMY; LESS THAN ONE-HALF TONGUE               N   3   $200.00   1/1/1973   12/31/2299
41120   7   GLOSSECTOMY; LESS THAN ONE-HALF TONGUE               N   3    $13.45   6/1/1994   12/31/2299
41120   8   GLOSSECTOMY; LESS THAN ONE-HALF TONGUE               N   3    $40.00   1/1/1973   12/31/2299
41120   F   GLOSSECTOMY; LESS THAN ONE-HALF TONGUE               N   3   $495.00   3/1/2004   12/31/2299
41130   2   GLOSSECTOMY; HEMIGLOSSECTOMY                         N   3   $300.00   1/1/1973   12/31/2299
41130   7   GLOSSECTOMY; HEMIGLOSSECTOMY                         N   3    $13.45   6/1/1994   12/31/2299
41130   8   GLOSSECTOMY; HEMIGLOSSECTOMY                         N   3    $60.00   1/1/1973   12/31/2299
41135   2   GLOSSECTOMY; PARTIAL, W/UNILATERAL RADICAL NECK DI   N   3   $600.00   8/1/1979   12/31/2299
41135   7   GLOSSECTOMY; PARTIAL, W/UNILATERAL RADICAL NECK DI   N   3    $13.45   6/1/1994   12/31/2299




                                                                                                      157
41135   8   GLOSSECTOMY; PARTIAL, W/UNILATERAL RADICAL NECK DI   N   3    $120.00    8/1/1979   12/31/2299
41140   2   GLOSSECTOMY; COMPLETE OR TOTAL, W/OR W/OUT TRACHEO   N   3    $450.00    1/1/1973   12/31/2299
41140   7   GLOSSECTOMY; COMPLETE OR TOTAL, W/OR W/OUT TRACHEO   N   3      $13.45   6/1/1994   12/31/2299
41140   8   GLOSSECTOMY; COMPLETE OR TOTAL, W/OR W/OUT TRACHEO   N   3      $90.00   1/1/1973   12/31/2299
41145   2   GLOSSECTOMY; COMPLETE OR TOTAL W/OR W/OUT TRACHEOS   N   3    $575.00    1/1/1984   12/31/2299
41145   7   GLOSSECTOMY; COMPLETE OR TOTAL W/OR W/OUT TRACHEOS   N   3      $13.45   6/1/1994   12/31/2299
41145   8   GLOSSECTOMY; COMPLETE OR TOTAL W/OR W/OUT TRACHEOS   N   3    $115.00    1/1/1984   12/31/2299
41150   2   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH & MA   N   3    $500.00    1/1/1989   12/31/2299
41150   7   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH & MA   N   3      $13.45   6/1/1994   12/31/2299
41150   8   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH & MA   N   3    $100.00    1/1/1989   12/31/2299
41153   7   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH W/SU   N   3      $13.45   6/1/1994   12/31/2299
41155   2   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH MAND   N   3   $1,028.78   1/1/2004   12/31/2299
41155   7   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH MAND   N   3      $13.45   6/1/1994   12/31/2299
41155   8   GLOSSECTOMY; COMP PROC W/RESEC FLOOR OF MOUTH MAND   N   3    $217.42    1/1/2003   12/31/2299
41250   2   REPAIR LACERATION UP TO 2 CM; FLOOR OF MOUTH &/OR    N   3      $90.72   1/1/2003   12/31/2299
41250   7   REPAIR LACERATION UP TO 2 CM; FLOOR OF MOUTH &/OR    N   3      $13.45   6/1/1994   12/31/2299
41251   7   REPAIR LACERATION UP TO 2 CM; POSTERIOR ONE-THIRD    N   3      $13.45   6/1/1994   12/31/2299
41251   F   REPAIR LACERATION UP TO 2 CM; POSTERIOR ONE-THIRD    N   3    $306.00    3/1/2004   12/31/2299
41252   2   REPAIR LACERATION OF TONGUE, FLOOR OF MOUTH, OVER    N   3      $25.00   1/1/1984   12/31/2299
41252   7   REPAIR LACERATION OF TONGUE, FLOOR OF MOUTH, OVER    N   3      $13.45   6/1/1994   12/31/2299
41252   F   REPAIR LACERATION OF TONGUE, FLOOR OF MOUTH, OVER    N   3    $306.00    3/1/2004   12/31/2299
41500   2   FIXATION TONGUE, MECHANICAL, OTHER THAN SUTURE (EG   N   3    $125.00    1/1/1973   12/31/2299
41500   7   FIXATION TONGUE, MECHANICAL, OTHER THAN SUTURE (EG   N   3      $13.45   6/1/1994   12/31/2299
41500   F   FIXATION TONGUE, MECHANICAL, OTHER THAN SUTURE (EG   N   3    $225.80    3/1/2004   12/31/2299
41510   2   SUTURE TONGUE TO LIP FOR MICROGNATHIA (DOUGLAS TYP   N   3    $250.00    1/1/1973   12/31/2299
41510   7   SUTURE TONGUE TO LIP FOR MICROGNATHIA (DOUGLAS TYP   N   3      $13.45   6/1/1994   12/31/2299
41510   F   SUTURE TONGUE TO LIP FOR MICROGNATHIA (DOUGLAS TYP   N   3    $225.80    3/1/2004   12/31/2299
41520   2   FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITH   N   3      $75.00   1/1/1984   12/31/2299
41520   7   FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITH   N   3      $13.45   6/1/1994   12/31/2299
41520   8   FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITH   N   3      $15.00   1/1/1984   12/31/2299
41520   F   FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, WITH   N   3    $306.00    3/1/2004   12/31/2299
41599   7   UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH           N   3      $13.45   6/1/1994   12/31/2299
41800   2   DRAINAGE ABSCESS, CYST, HEMATOMA                     N   3      $10.00   1/1/1975   12/31/2299
41800   7   DRAINAGE ABSCESS, CYST, HEMATOMA                     N   3      $13.45   6/1/1994   12/31/2299
41800   F   DRAINAGE ABSCESS, CYST, HEMATOMA                     N   3    $225.80    3/1/2004   12/31/2299
41805   2   REMOVAL EMBEDDED FOREIGN BODY; FROM SOFT TISSUE      N   3      $50.00   1/2/1994   12/31/2299
41805   7   REMOVAL EMBEDDED FOREIGN BODY; FROM SOFT TISSUE      N   3      $13.45   6/1/1994   12/31/2299
41806   7   REMOVAL EMBEDDED FOREIGN BODY; FROM BONE             N   3      $13.45   6/1/1994   12/31/2299
41820   2   GINGIVECTOMY, EXCISION GINGIVA, EACH QUADRANT        N   3      $50.00   8/1/1979   12/31/2299
41820   7   GINGIVECTOMY, EXCISION GINGIVA, EACH QUADRANT        N   3      $13.45   6/1/1994   12/31/2299
41821   7   OPERCULECTOMY, EXCISION PERICORONAL TISSUES          N   3      $13.45   6/1/1994   12/31/2299
41823   7   EXCISION OSSEOUS TUBEROSITIES                        N   3      $13.45   6/1/1994   12/31/2299
41825   2   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3      $35.00   8/1/1979   12/31/2299
41825   7   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3      $13.45   6/1/1994   12/31/2299
41826   2   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3    $133.67    1/1/2004   12/31/2299
41826   7   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3      $13.45   6/1/1994   12/31/2299
41827   2   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3    $180.00    1/2/1997   12/31/2299
41827   7   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3      $13.45   6/1/1994   12/31/2299
41827   F   EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE);   N   3    $306.00    3/1/2004   12/31/2299
41828   7   EXCISION OF HYPERPLASTIC ALVEOLAR MUCOSA, EACH SEX   N   3      $13.45   6/1/1994   12/31/2299
41830   2   ALVEOLECTOMY, INCLUDING CURETTAGE OF OSTEITIS OR S   N   3      $65.00   1/1/1990   12/31/2299




                                                                                                        158
41830   7   ALVEOLECTOMY, INCLUDING CURETTAGE OF OSTEITIS OR S                  N   3    $13.45   6/1/1994   12/31/2299
41850   7   DESTRUCTION OF LESION (EXCEPT EXCISION)                             N   3    $13.45   6/1/1994   12/31/2299
41870   7   PERIODONTAL MUCOSAL GRAFTING                                        N   3    $13.45   6/1/1994   12/31/2299
41872   2   GINGIVOPLASTY                                                       N   3   $139.71   1/1/1993   12/31/2299
41872   7   GINGIVOPLASTY                                                       N   3    $13.45   6/1/1994   12/31/2299
41872   8   GINGIVOPLASTY                                                       N   3    $27.94   1/1/1993   12/31/2299
41874   2   ALVEOPLASTY                                                         N   3    $40.00   1/1/1984   12/31/2299
41874   7   ALVEOPLASTY                                                         N   3    $13.45   6/1/1994   12/31/2299
41899   7   UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES                        N   3    $13.45   6/1/1994   12/31/2299
42000   2   DRAINAGE OF ABSCESS OF PALATE, UVULA                                N   3    $15.00   8/1/1979   12/31/2299
42000   7   DRAINAGE OF ABSCESS OF PALATE, UVULA                                N   3    $13.45   6/1/1994   12/31/2299
42000   F   DRAINAGE OF ABSCESS OF PALATE, UVULA                                N   3   $306.00   3/1/2004   12/31/2299
42100   2   BIOPSY OF PALATE, UVULA                                             N   3    $15.00   1/1/1973   12/31/2299
42100   7   BIOPSY OF PALATE, UVULA                                             N   3    $13.45   6/1/1994   12/31/2299
42104   2   EXCISION LESION OF PALATE, UVULA; W/OUT CLOSURE                     N   3    $50.00   1/1/1984   12/31/2299
42104   7   EXCISION LESION OF PALATE, UVULA; W/OUT CLOSURE                     N   3    $13.45   6/1/1994   12/31/2299
42106   2   EXCISION LESION OF PALATE, UVULA; WITH SIMPLE PRIM                  N   3    $65.00   1/1/1984   12/31/2299
42106   7   EXCISION LESION OF PALATE, UVULA; WITH SIMPLE PRIM                  N   3    $13.45   6/1/1994   12/31/2299
42107   2   EXCISION LESION OF PALATE, UVULA; WITH LOCAL FLAP                   N   3   $150.00   1/1/1984   12/31/2299
42107   7   EXCISION LESION OF PALATE, UVULA; WITH LOCAL FLAP                   N   3    $13.45   6/1/1994   12/31/2299
42107   8   EXCISION LESION OF PALATE,                                          N   3    $30.00   1/1/1984   12/31/2299
42107   F   EXCISION LESION OF PALATE, UVULA; WITH LOCAL FLAP                   N   3   $306.00   3/1/2004   12/31/2299
42120   2   RESECTION PALATE OR EXTENSIVE RESECTION OF LESION                   N   3   $312.00   1/2/1994   12/31/2299
42120   7   RESECTION PALATE OR EXTENSIVE RESECTION OF LESION                   N   3    $13.45   6/1/1994   12/31/2299
42120   F   RESECTION PALATE OR EXTENSIVE RESECTION OF LESION                   N   3   $432.00   3/1/2004   12/31/2299
42140   2   UVULECTOMY, EXCISION OF UVULA                                       N   3    $15.00   1/1/1971   12/31/2299
42140   7   UVULECTOMY, EXCISION OF UVULA                                       N   3    $13.45   6/1/1994   12/31/2299
42140   F   UVULECTOMY, EXCISION OF UVULA                                       N   3   $306.00   3/1/2004   12/31/2299
42145   2   PALATOPHARYNCOPLASTY(EG,UVULOPALATOPHARYNGOPLASTY,UVULOPHARYNOGOP   N   3   $450.00   1/1/1984   12/31/2299
42145   7   PALATOPHARYNOCOPLASTY                                               N   3    $13.45   6/1/1994   12/31/2299
42145   F   PALATOPHARYNCOPLASTY(EG,UVULOPALATOPHARYNGOPLASTY,UVULOPHARYNOGOP   N   3   $495.00   3/1/2004   12/31/2299
42160   7   DESTRUCTION OF LESION, PALATE OR UVULA (THERMAL, C                  N   3    $13.45   6/1/1994   12/31/2299
42180   7   REPAIR LACERATION OF PALATE; UP TO 2 CM                             N   3    $13.45   6/1/1994   12/31/2299
42180   F   REPAIR LACERATION OF PALATE; UP TO 2 CM                             N   3   $225.80   3/1/2004   12/31/2299
42182   2   REPAIR LACERATION OF PALATE; OVER 2 CM OR COMPLEX                   N   3   $176.21   1/1/2004   12/31/2299
42182   7   REPAIR LACERATION OF PALATE; OVER 2 CM OR COMPLEX                   N   3    $13.45   6/1/1994   12/31/2299
42182   F   REPAIR LACERATION OF PALATE; OVER 2 CM OR COMPLEX                   N   3   $306.00   3/1/2004   12/31/2299
42200   2   PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PA                  N   3   $500.00   1/2/1997   12/31/2299
42200   7   PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PA                  N   3    $13.45   6/1/1994   12/31/2299
42200   8   PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PA                  N   3    $80.00   1/1/1973   12/31/2299
42200   F   PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PA                  N   3   $495.00   3/1/2004   12/31/2299
42205   2   PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALV                  N   3   $552.00   1/2/1997   12/31/2299
42205   7   PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALV                  N   3    $13.45   6/1/1994   12/31/2299
42205   8   PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALV                  N   3   $100.00   1/1/1973   12/31/2299
42205   F   PALATOPLASTY FOR CLEFT PALATE, WITH CLOSURE OF ALV                  N   3   $495.00   3/1/2004   12/31/2299
42210   2   PALATOPLASTY FOR CLEFT PALATE, W/BONE GRAFT TO ALV                  N   3   $720.00   1/2/1997   12/31/2299
42210   7   PALATOPLASTY FOR CLEFT PALATE, W/BONE GRAFT TO ALV                  N   3    $13.45   6/1/1994   12/31/2299
42210   8   PALATOPLASTY FOR CLEFT PALATE, W/BONE GRAFT TO ALV                  N   3   $110.00   1/1/1973   12/31/2299
42210   F   PALATOPLASTY FOR CLEFT PALATE, W/BONE GRAFT TO ALV                  N   3   $495.00   3/1/2004   12/31/2299
42215   2   PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION                       N   3   $450.00   1/2/1997   12/31/2299
42215   7   PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION                       N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     159
42215   8   PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION        N   3    $80.00    1/1/1973   12/31/2299
42215   F   PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION        N   3   $495.00    3/1/2004   12/31/2299
42220   2   PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENI   N   3   $336.00    1/2/1997   12/31/2299
42220   7   PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENI   N   3    $13.45    6/1/1994   12/31/2299
42220   F   PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENI   N   3   $495.00    3/1/2004   12/31/2299
42225   2   PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGE   N   3   $444.00    1/2/1997   12/31/2299
42225   7   PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGE   N   3    $13.45    6/1/1994   12/31/2299
42225   8   PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGE   N   3    $80.00   9/10/1991   12/31/2299
42226   2   LENGTHENING OF PALATE, AND PHARYNGEAL FLAP           N   3   $480.00    1/2/1997   12/31/2299
42226   7   LENGTHENING OF PALATE, AND PHARYNGEAL FLAP           N   3    $13.45    6/1/1994   12/31/2299
42226   F   LENGTHENING OF PALATE, AND PHARYNGEAL FLAP           N   3   $495.00    3/1/2004   12/31/2299
42227   2   LENGTHENING OF PALATE, WITH ISLAND FLAP              N   3   $438.00    1/2/1997   12/31/2299
42227   7   LENGTHENING OF PALATE, WITH ISLAND FLAP              N   3    $13.45    6/1/1994   12/31/2299
42235   2   REPAIR ANTERIOR PALATE, INCLUDING VOMER FLAP         N   3   $360.00    1/2/1997   12/31/2299
42235   7   REPAIR ANTERIOR PALATE, INCLUDING VOMER FLAP         N   3    $13.45    6/1/1994   12/31/2299
42235   8   REPAIR ANTERIOR PALATE, INCLUDING VOMER FLAP         N   3    $30.00    1/1/1984   12/31/2299
42235   F   REPAIR ANTERIOR PALATE, INCLUDING VOMER FLAP         N   3   $495.00    3/1/2004   12/31/2299
42260   7   REPAIR NASOLABIAL FISTULA                            N   3    $13.45    6/1/1994   12/31/2299
42260   F   REPAIR NASOLABIAL FISTULA                            N   3   $432.00    3/1/2004   12/31/2299
42281   7   INSERTION OF PIN-RETAINED PALATAL PROSTHESIS         N   3    $13.45    6/1/1994   12/31/2299
42299   7   UNLISTED PROCEDURE, PALATE, UVULA                    N   3    $13.45    6/1/1994   12/31/2299
42300   2   DRAINAGE ABSCESS; PAROTID, SIMPLE                    N   3    $35.00    1/1/1973   12/31/2299
42300   7   DRAINAGE ABSCESS; PAROTID, SIMPLE                    N   3    $13.45    6/1/1994   12/31/2299
42300   F   DRAINAGE ABSCESS; PAROTID, SIMPLE                    N   3   $225.80    3/1/2004   12/31/2299
42305   7   DRAINAGE ABSCESS; PAROTID COMPLICATED                N   3    $13.45    6/1/1994   12/31/2299
42305   F   DRAINAGE ABSCESS; PAROTID COMPLICATED                N   3   $306.00    3/1/2004   12/31/2299
42310   2   DRAINAGE ABSCESS; SUBMAXILLARY OR SUBLINGUAL, INTR   N   3    $30.00    8/1/1979   12/31/2299
42310   7   DRAINAGE ABSCESS; SUBMAXILLARY OR SUBLINGUAL, INTR   N   3    $13.45    6/1/1994   12/31/2299
42310   F   DRAINAGE ABSCESS; SUBMAXILLARY OR SUBLINGUAL, INTR   N   3   $225.80    3/1/2004   12/31/2299
42320   2   DRAINAGE ABSCESS; SUBMAXILLARY, EXTERNAL             N   3    $75.00    1/1/1973   12/31/2299
42320   7   DRAINAGE ABSCESS; SUBMAXILLARY, EXTERNAL             N   3    $13.45    6/1/1994   12/31/2299
42320   F   DRAINAGE ABSCESS; SUBMAXILLARY, EXTERNAL             N   3   $225.80    3/1/2004   12/31/2299
42330   2   SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAX) SUBLINGUAL    N   3    $60.00    8/1/1979   12/31/2299
42330   7   SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAX) SUBLINGUAL    N   3    $13.45    6/1/1994   12/31/2299
42335   7   SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAX) OR SUBLINGU   N   3    $13.45    6/1/1994   12/31/2299
42340   2   SIALOLITHOTOMY; PAROTID, EXTRAORAL OR COMPLICATED    N   3   $150.00    8/1/1979   12/31/2299
42340   7   SIALOLITHOTOMY; PAROTID, EXTRAORAL OR COMPLICATED    N   3    $13.45    6/1/1994   12/31/2299
42340   F   SIALOLITHOTOMY; PAROTID, EXTRAORAL OR COMPLICATED    N   3   $306.00    3/1/2004   12/31/2299
42400   2   BIOPSY SALIVARY GLAND; NEEDLE                        N   3    $20.00    1/1/1973   12/31/2299
42405   2   BIOPSY SALIVARY GLAND; INCISIONAL                    N   3    $50.00    1/1/1973   12/31/2299
42405   7   BIOPSY SALIVARY GLAND; INCISIONAL                    N   3    $13.45    6/1/1994   12/31/2299
42405   F   BIOPSY SALIVARY GLAND; INCISIONAL                    N   3   $306.00    3/1/2004   12/31/2299
42408   2   EXCISION SUBLINGUAL SALIVARY CYST (RANULA)           N   3   $192.00    1/1/1994   12/31/2299
42408   7   EXCISION SUBLINGUAL SALIVARY CYST (RANULA)           N   3    $13.45    6/1/1994   12/31/2299
42408   8   EXCISION SUBLINGUAL SALIVARY CYST (RANULA)           N   3    $38.40    1/1/1994   12/31/2299
42408   F   EXCISION SUBLINGUAL SALIVARY CYST (RANULA)           N   3   $351.00    3/1/2004   12/31/2299
42409   7   MARSUPIALIZATION SUBLINGUAL SALIVARY CYST (RANULA)   N   3    $13.45    6/1/1994   12/31/2299
42409   F   MARSUPIALIZATION SUBLINGUAL SALIVARY CYST (RANULA)   N   3   $351.00    3/1/2004   12/31/2299
42410   2   EXCISION PAROTID TUMOR OR PAROTID GLAND; LATERAL L   N   3   $150.00    1/1/1973   12/31/2299
42410   7   EXCISION PAROTID TUMOR OR PAROTID GLAND; LATERAL L   N   3    $13.45    6/1/1994   12/31/2299
42410   8   EXCISION PAROTID TUMOR OR PAROTID GLAND; LATERAL L   N   3    $30.00    1/1/1984   12/31/2299




                                                                                                       160
42410   F   EXCISION PAROTID TUMOR OR PAROTID GLAND; LATERAL L   N   3   $351.00   3/1/2004   12/31/2299
42415   2   EXCISION PAROTID TUMOR OR PAROTID GLAND LATERL LOB   N   3   $750.00   1/2/1995   12/31/2299
42415   7   EXCISION PAROTID TUMOR OR PAROTID GLAND LATERL LOB   N   3    $13.45   6/1/1994   12/31/2299
42415   8   EXCISION PAROTID TUMOR OR PAROTID GLAND LATERL LOB   N   3    $72.00   8/1/1979   12/31/2299
42415   F   EXCISION PAROTID TUMOR OR PAROTID GLAND LATERL LOB   N   3   $495.00   3/1/2004   12/31/2299
42420   2   EXCISION PAROTID TUMOR OR PAROTID GLAND; TOTAL W/D   N   3   $450.00   1/1/1973   12/31/2299
42420   7   EXCISION PAROTID TUMOR OR PAROTID GLAND; TOTAL W/D   N   3    $13.45   6/1/1994   12/31/2299
42420   8   EXCISION PAROTID TUMOR OR PAROTID GLAND; TOTAL W/D   N   3    $90.00   1/1/1973   12/31/2299
42420   F   EXCISION PAROTID TUMOR OR PAROTID GLAND; TOTAL W/D   N   3   $495.00   3/1/2004   12/31/2299
42425   2   EX PAROTID TUMOR OR PAROTID GLAND; TOTAL EN BLOC R   N   3   $300.00   1/1/1973   12/31/2299
42425   7   EX PAROTID TUMOR OR PAROTID GLAND; TOTAL EN BLOC R   N   3    $13.45   6/1/1994   12/31/2299
42425   8   EX PAROTID TUMOR OR PAROTID GLAND; TOTAL EN BLOC R   N   3    $60.00   1/1/1973   12/31/2299
42425   F   EX PAROTID TUMOR OR PAROTID GLAND; TOTAL EN BLOC R   N   3   $495.00   3/1/2004   12/31/2299
42426   2   EXCISION PAROTID TUMOR OR PAROTID GLAND; TOTAL W/U   N   3   $828.83   1/1/2003   12/31/2299
42426   7   EXCISION PAROTID TUMOR OR PAROTID GLAND;             N   3    $13.45   6/1/1994   12/31/2299
42440   2   EXCISION SUBMANDIBULAR (SUBMAXILLARY) GLAND          N   3   $372.24   1/2/1996   12/31/2299
42440   7   EXCISION SUBMANDIBULAR (SUBMAXILLARY) GLAND          N   3    $13.45   6/1/1994   12/31/2299
42440   8   EXCISION SUBMANDIBULAR (SUBMAXILLARY) GLAND          N   3    $74.44   1/2/1996   12/31/2299
42440   F   EXCISION SUBMANDIBULAR (SUBMAXILLARY) GLAND          N   3   $351.00   3/1/2004   12/31/2299
42450   2   EXCISION SUBLINGUAL GLAND                            N   3   $168.00   1/3/1992   12/31/2299
42450   7   EXCISION SUBLINGUAL GLAND                            N   3    $13.45   6/1/1994   12/31/2299
42450   F   EXCISION SUBLINGUAL GLAND                            N   3   $306.00   3/1/2004   12/31/2299
42500   2   PLASTIC REPAIR SALIVARY DUCT, SIALODOCHOPLASTY; PR   N   3   $175.00   8/1/1979   12/31/2299
42500   7   PLASTIC REPAIR SALIVARY DUCT, SIALODOCHOPLASTY; PR   N   3    $13.45   6/1/1994   12/31/2299
42500   F   PLASTIC REPAIR SALIVARY DUCT, SIALODOCHOPLASTY; PR   N   3   $351.00   3/1/2004   12/31/2299
42505   2   PLASTIC REPAIR SALIVARY DUCT, SIALODOCHOPLASTY; SE   N   3   $294.00   1/3/1992   12/31/2299
42505   7   PLASTIC REPAIR SALIVARY DUCT, SIALODOCHOPLASTY; SE   N   3    $13.45   6/1/1994   12/31/2299
42505   F   PLASTIC REPAIR SALIVARY DUCT, SIALODOCHOPLASTY; SE   N   3   $432.00   3/1/2004   12/31/2299
42507   7   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3    $13.45   6/1/1994   12/31/2299
42507   F   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3   $351.00   3/1/2004   12/31/2299
42508   7   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3    $13.45   6/1/1994   12/31/2299
42508   F   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3   $432.00   3/1/2004   12/31/2299
42509   2   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3   $402.00   1/2/1994   12/31/2299
42509   7   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3    $13.45   6/1/1994   12/31/2299
42509   F   PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROC   N   3   $432.00   3/1/2004   12/31/2299
42510   7   PAROTID DUCT DIVERSION, BILATERAL; WITH LIGATION O   N   3    $13.45   6/1/1994   12/31/2299
42510   F   PAROTID DUCT DIVERSION, BILATERAL; WITH LIGATION O   N   3   $432.00   3/1/2004   12/31/2299
42550   2   INJECTION PROCEDURE FOR SIALOGRAPHY                  N   3    $10.00   1/1/1973   12/31/2299
42600   7   CLOSURE SALIVARY FISTULA                             N   3    $13.45   6/1/1994   12/31/2299
42600   F   CLOSURE SALIVARY FISTULA                             N   3   $225.80   3/1/2004   12/31/2299
42650   2   DILATION SALIVARY DUCT                               N   3    $10.00   1/1/1973   12/31/2299
42650   7   DILATION SALIVARY DUCT                               N   3    $13.45   6/1/1994   12/31/2299
42660   2   DILATION AND CATHETERIZATION OF SALIVARY DUCT, WIT   N   3    $25.00   1/1/1984   12/31/2299
42660   7   DILATION AND CATHETERIZATION OF SALIVARY DUCT, WIT   N   3    $13.45   6/1/1994   12/31/2299
42665   2   LIGATION SALIVARY DUCT, INTRAORAL                    N   3    $75.00   1/1/1984   12/31/2299
42665   7   LIGATION SALIVARY DUCT, INTRAORAL                    N   3    $13.45   6/1/1994   12/31/2299
42699   7   UNLISTED PROCEDURE, SALIVARY GLANDS OR DUCTS         N   3    $13.45   6/1/1994   12/31/2299
42700   2   INCISION AND DRAINAGE ABSCESS; PERITONSILLAR         N   3    $48.00   1/1/1995   12/31/2299
42700   7   INCISION AND DRAINAGE ABSCESS; PERITONSILLAR         N   3    $13.45   6/1/1994   12/31/2299
42700   F   INCISION AND DRAINAGE ABSCESS; PERITONSILLAR         N   3   $225.80   3/1/2004   12/31/2299
42720   2   INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR    N   3    $60.00   1/1/1973   12/31/2299




                                                                                                      161
42720   7   INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR    N   3    $13.45   6/1/1994   12/31/2299
42720   F   INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR    N   3   $225.80   3/1/2004   12/31/2299
42725   2   INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR    N   3   $438.54   1/1/2003   12/31/2299
42725   7   INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR    N   3    $13.45   6/1/1994   12/31/2299
42800   2   BIOPSY; OROPHARYNX                                   N   3    $30.00   8/1/1979   12/31/2299
42800   7   BIOPSY; OROPHARYNX                                   N   3    $13.45   6/1/1994   12/31/2299
42802   2   BIOPSY; HYPOPHARYNX                                  N   3    $96.25   1/1/2003   12/31/2299
42802   7   BIOPSY; HYPOPHARYNX                                  N   3    $13.45   6/1/1994   12/31/2299
42802   F   BIOPSY; HYPOPHARYNX                                  N   3   $225.80   3/1/2004   12/31/2299
42804   2   BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE          N   3    $20.00   1/1/1984   12/31/2299
42804   7   BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE          N   3    $13.45   6/1/1994   12/31/2299
42804   F   BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE          N   3   $225.80   3/1/2004   12/31/2299
42806   2   BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LE   N   3    $60.00   1/1/1984   12/31/2299
42806   7   BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LE   N   3    $13.45   6/1/1994   12/31/2299
42806   F   BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY LE   N   3   $306.00   3/1/2004   12/31/2299
42808   2   EXCISION OF LESION OF PHARYNX                        N   3    $95.40   1/2/1992   12/31/2299
42808   7   EXCISION OF LESION OF PHARYNX                        N   3    $13.45   6/1/1994   12/31/2299
42808   F   EXCISION OF LESION OF PHARYNX                        N   3   $306.00   3/1/2004   12/31/2299
42809   2   REMOVAL OF FOREIGN BODY FROM PHARYNX                 N   3    $40.00   1/1/1984   12/31/2299
42809   7   REMOVAL OF FOREIGN BODY FROM PHARYNX                 N   3    $13.45   6/1/1994   12/31/2299
42810   2   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE; CONFINED   N   3   $100.00   1/1/1973   12/31/2299
42810   7   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE; CONFINED   N   3    $13.45   6/1/1994   12/31/2299
42810   F   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE; CONFINED   N   3   $351.00   3/1/2004   12/31/2299
42815   2   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE; EXTENDIN   N   3   $250.00   1/1/1973   12/31/2299
42815   7   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE;            N   3    $13.45   6/1/1994   12/31/2299
42815   8   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE;            N   3    $50.00   1/1/1973   12/31/2299
42815   F   EXCISION BRANCHIAL CLEFT CYST OR VESTIGE; EXTENDIN   N   3   $495.00   3/1/2004   12/31/2299
42820   2   TONSILLECTOMY AND ADENOIDECTOMY; UNDER AGE 12        N   3   $179.00   1/2/1992   12/31/2299
42820   7   TONSILLECTOMY AND ADENOIDECTOMY; UNDER AGE 12        N   3    $13.45   6/1/1994   12/31/2299
42820   F   TONSILLECTOMY AND ADENOIDECTOMY; UNDER AGE 12        N   3   $351.00   3/1/2004   12/31/2299
42821   2   TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER      N   3   $215.00   1/2/1992   12/31/2299
42821   7   TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER      N   3    $13.45   6/1/1994   12/31/2299
42821   F   TONSILLECTOMY AND ADENOIDECTOMY; AGE 12 OR OVER      N   3   $495.00   3/1/2004   12/31/2299
42825   2   TONSILLECTOMY, PRIMARY OR SECONDARY; UNDER AGE 12    N   3   $156.00   1/2/1992   12/31/2299
42825   7   TONSILLECTOMY, PRIMARY OR SECONDARY; UNDER AGE 12    N   3    $13.45   6/1/1994   12/31/2299
42825   F   TONSILLECTOMY, PRIMARY OR SECONDARY; UNDER AGE 12    N   3   $432.00   3/1/2004   12/31/2299
42826   2   TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVE   N   3   $230.00   1/2/1992   12/31/2299
42826   7   TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVE   N   3    $13.45   6/1/1994   12/31/2299
42826   F   TONSILLECTOMY, PRIMARY OR SECONDARY; AGE 12 OR OVE   N   3   $432.00   3/1/2004   12/31/2299
42830   2   ADENOIDECTOMY, PRIMARY; UNDER AGE 12                 N   3    $94.00   1/2/1992   12/31/2299
42830   7   ADENOIDECTOMY, PRIMARY; UNDER AGE 12                 N   3    $13.45   6/1/1994   12/31/2299
42830   F   ADENOIDECTOMY, PRIMARY; UNDER AGE 12                 N   3   $432.00   3/1/2004   12/31/2299
42831   2   ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER               N   3    $70.00   1/1/1973   12/31/2299
42831   7   ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER               N   3    $13.45   6/1/1994   12/31/2299
42831   F   ADENOIDECTOMY, PRIMARY; AGE 12 OR OVER               N   3   $432.00   3/1/2004   12/31/2299
42835   2   ADENOIDECTOMY, SECONDARY; UNDER AGE 12               N   3   $103.00   1/2/1996   12/31/2299
42835   7   ADENOIDECTOMY, SECONDARY; UNDER AGE 12               N   3    $13.45   6/1/1994   12/31/2299
42835   F   ADENOIDECTOMY, SECONDARY; UNDER AGE 12               N   3   $432.00   3/1/2004   12/31/2299
42836   2   ADENOIDECTOMY, SECONDARY; UNDER AGE 12               N   3    $70.00   1/1/1984   12/31/2299
42836   7   ADENOIDECTOMY, SECONDARY; AGE 12 OR OVER             N   3    $13.45   6/1/1994   12/31/2299
42836   F   ADENOIDECTOMY, SECONDARY; UNDER AGE 12               N   3   $432.00   3/1/2004   12/31/2299




                                                                                                      162
42842   7   RADICAL RESEC OF TONSIL,TONSILLAR PILLARS,&/OR RET                  N   3    $13.45   6/1/1994   12/31/2299
42844   7   RAD RESEC OF TONSIL,TONSILLAR PILLARS,&/OR RETROMO                  N   3    $13.45   6/1/1994   12/31/2299
42845   7   RAD RESEC OF TONSIL,TONSILLAR PILLARS,&/OR RETROMO                  N   3    $13.45   6/1/1994   12/31/2299
42860   2   EXCISION OF TONSIL TAGS                                             N   3    $70.00   1/1/1973   12/31/2299
42860   7   EXCISION OF TONSIL TAGS                                             N   3    $13.45   6/1/1994   12/31/2299
42860   F   EXCISION OF TONSIL TAGS                                             N   3   $351.00   3/1/2004   12/31/2299
42870   2   EXCISION LINGUAL TONSIL (SEPARATE PROCEDURE)                        N   3   $120.00   1/1/1973   12/31/2299
42870   7   EXCISION LINGUAL TONSIL (SEPARATE PROCEDURE)                        N   3    $13.45   6/1/1994   12/31/2299
42870   F   EXCISION LINGUAL TONSIL (SEPARATE PROCEDURE)                        N   3   $351.00   3/1/2004   12/31/2299
42880   2   EXCISION NASOPHARYNGEAL LESION (EG, FIBROMA)                        N   3   $264.00   1/2/1994   12/31/2299
42880   7   EXCISION NASOPHARYNGEAL LESION (EG, FIBROMA)                        N   3    $13.45   6/1/1994   12/31/2299
42890   2   LIMITED PHARYNGECTOMY                                               N   3   $526.72   1/1/2004   12/31/2299
42890   7   LIMITED PHARYNGECTOMY                                               N   3    $13.45   6/1/1994   12/31/2299
42890   8   LIMITED PHARYNGECTOMY                                               N   3   $129.64   1/1/2005   12/31/2299
42890   F   LIMITED PHARYNGECTOMY                                               N   3   $495.00   3/1/2004   12/31/2299
42892   7   RESEC OF LAT PHARYN WALL OR PYRIFORM SINUS,DIR CLO                  N   3    $13.45   6/1/1994   12/31/2299
42892   F   RESEC OF LAT PHARYN WALL OR PYRIFORM SINUS,DIR CLO                  N   3   $495.00   3/1/2004   12/31/2299
42894   2   RESECTION OF PHARYNGEAL WALL REQUIRING CLOSURE WITH MYOCUTANEOUS    N   3   $912.00   1/3/1997   12/31/2299
42894   7   RESECTION OF PHARYNGEAL WALL REQUIRING CLOSURE WIT                  N   3    $13.45   6/1/1994   12/31/2299
42894   8   ASSISTANT,RESECTION OF PHARYNGEAL WALL REQUIREING CLOSING W/MYOCT   N   3   $182.00   1/2/1997   12/31/2299
42895   7   LIMITED PHARYNGECTOMY; W/RADICAL NECK DISSECTION                    N   3    $13.45   6/1/1994   12/31/2299
42900   7   SUTURE PHARYNX FOR WOUND OR INJURY                                  N   3    $13.45   6/1/1994   12/31/2299
42900   F   SUTURE PHARYNX FOR WOUND OR INJURY                                  N   3   $225.80   3/1/2004   12/31/2299
42950   2   PHARYNGOPLASTY (PLASTIC OR RECONSTRUCTIVE OPERATIO                  N   3   $336.46   1/1/2003   12/31/2299
42950   7   PHARYNGOPLASTY (PLASTIC OR RECONSTRUCTIVE OPERATIO                  N   3    $13.45   6/1/1994   12/31/2299
42953   7   PHARYNGOESOPHAGEAL REPAIR                                           N   3    $13.45   6/1/1994   12/31/2299
42955   2   PHARYNGOSTOMY (FISTULIZATION OF PHARYNX, EXTERNAL                   N   3   $100.00   1/1/1984   12/31/2299
42955   7   PHARYNGOSTOMY (FISTULIZATION OF PHARYNX, EXTERNAL                   N   3    $13.45   6/1/1994   12/31/2299
42955   F   PHARYNGOSTOMY (FISTULIZATION OF PHARYNX, EXTERNAL                   N   3   $306.00   3/1/2004   12/31/2299
42960   2   3ONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3    $84.00   1/2/1994   12/31/2299
42960   7   CONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3    $13.45   6/1/1994   12/31/2299
42960   F   3ONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3   $225.80   3/1/2004   12/31/2299
42961   2   CONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3    $50.00   1/1/1984   12/31/2299
42961   7   CONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3    $13.45   6/1/1994   12/31/2299
42962   2   CONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3   $251.40   1/2/1992   12/31/2299
42962   7   CONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3    $13.45   6/1/1994   12/31/2299
42962   F   CONTROL OROPHARYNGEAL HEMORRHAGE (PRIMARY OR SECON                  N   3   $306.00   3/1/2004   12/31/2299
42970   2   CNTRL OF NSOPHAR HMRG PRI OR SEC PSTADNOIEC SIMP W                  N   3   $212.18   1/1/2002   12/31/2299
42971   7   CONTROL OF NSOPHARG HMRG PRIM OR SEC POSTADNOIDECT                  N   3    $13.45   6/1/1994   12/31/2299
42972   2   CONTROL OF NASOPHARYNGEAL HEMORRHAGE (PRIMARY OR S                  N   3   $292.06   1/1/2003   12/31/2299
42972   7   CONTROL OF NASOPHARYNGEAL HEMORRHAGE (PRIMARY OR S                  N   3    $13.45   6/1/1994   12/31/2299
42972   F   CONTROL OF NASOPHARYNGEAL HEMORRHAGE (PRIMARY OR S                  N   3   $351.00   3/1/2004   12/31/2299
42999   7   UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS                   N   3    $13.45   6/1/1994   12/31/2299
43020   2   ESOPHAGOTOMY, CERVICAL APPROACH; W/REMOVAL OF FORE                  N   3   $350.00   1/1/1973   12/31/2299
43020   7   ESOPHAGOTOMY, CERVICAL APPROACH; W/REMOVAL OF FORE                  N   3    $13.45   6/1/1994   12/31/2299
43020   8   ESOPHAGOTOMY, CERVICAL APPROACH; W/REMOVAL OF FORE                  N   3    $70.00   1/1/1973   12/31/2299
43030   2   CRICOPHARYNGEAL MYOTOMY                                             N   3   $300.00   1/1/1984   12/31/2299
43030   7   CRICOPHARYNGEAL MYOTOMY                                             N   3    $13.45   6/1/1994   12/31/2299
43030   8   CRICOPHARYNGEAL MYOTOMY                                             N   3    $60.00   1/1/1984   12/31/2299
43045   2   ESOPHAGOTOMY, THORACIC APPROACH; W/REMOVAL OF FORE                  N   3   $475.00   1/1/1973   12/31/2299
43045   7   ESOPHAGOTOMY, THORACIC APPROACH; W/REMOVAL OF FORE                  N   3    $13.45   6/1/1994   12/31/2299




                                                                                                                     163
43045   8   ESOPHAGOTOMY, THORACIC APPROACH; W/REMOVAL OF FORE                  N   3      $95.00   1/1/1973   12/31/2299
43100   2   EXCISION OF LOCAL LESION, ESOPHAGUS, WITH PRIMARY                   N   3    $475.00    1/1/1973   12/31/2299
43100   7   EXCISION OF LOCAL LESION, ESOPHAGUS, WITH PRIMARY                   N   3      $13.45   6/1/1994   12/31/2299
43100   8   EXCISION OF LOCAL LESION, ESOPHAGUS, WITH PRIMARY                   N   3      $95.00   1/1/1973   12/31/2299
43101   7   EXCISION OF LOCAL LESION, ESOPHAGUS, WITH PRIMARY                   N   3      $13.45   6/1/1994   12/31/2299
43107   2   TOTAL OR NEAR TOTAL ESOPHAGECTOMY                                   N   3   $1,206.00   1/1/1995   12/31/2299
43107   7   TOTAL OR NEAR TOTAL ESOPHAGECTOMY                                   N   3      $13.45   1/1/1995   12/31/2299
43107   8   ASSIST.SURGEON,TOTAL OR NEAR TOTAL ESOPHAGECTOMY                    N   3    $241.20    1/1/1998   12/31/2299
43108   2   ESOPHAGECTOMY WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCT   N   3   $1,450.00   1/1/1995   12/31/2299
43108   7   ANESTHESIA,WITH COLON INTERPOSITION OR SMALL BOWEL                  N   3      $13.45   1/1/1998   12/31/2299
43108   8   ASSIST.SURGEON-WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUC   N   3    $290.00    1/1/1998   12/31/2299
43110   7   ESOPHAGECTOMY (AT UPPER TWO-THIRDS LEVEL) AND GAST                  N   3      $13.45   6/1/1994   12/31/2299
43112   2   ESOPHAGECTOMY WITH THORACOTOMY                                      N   3   $1,284.00   1/1/1995   12/31/2299
43112   7   ANESTHESIA,TOTAL OR NEAR TOTAL ESOPHAGECTOMY,WITH THORACOTOMY       N   3      $13.45   1/1/1998   12/31/2299
43112   8   ASSIST.FEE-TOTAL OR NEAR TOTAL ESOPHAGECTOMY,WITH THORACOTOMY       N   3    $256.80    1/1/1998   12/31/2299
43113   2   ESOPHAGECTOMY WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCT   N   3   $1,473.00   1/1/1995   12/31/2299
43113   7   ANESTHESIA-WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION   N   3      $13.45   1/1/1998   12/31/2299
43113   8   ASSIST.FEE-WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION   N   3    $294.60    1/1/1998   12/31/2299
43116   2   PARTIAL ESOPHAGECTOMY, CERVICAL, WITH FREE INTESTINAL GRAFT         N   3   $1,382.00   1/1/1995   12/31/2299
43116   7   ANESTHESIA-PARTIAL ESOPHAGECTOMY,CERVICAL,WITH FREE INTESTINAL GR   N   3      $13.45   1/1/1998   12/31/2299
43116   8   ASSIST.FEE PARTIAL ESOPHAGECTOMY,CERVICAL,WITH FREE INTESTINAL GR   N   3    $276.40    1/1/1998   12/31/2299
43117   2   PARTIAL ESOPHAGECTOMY, DISTAL TWO THIRDS                            N   3   $1,354.00   1/1/1995   12/31/2299
43117   7   ANESTHESIA,PARTIAL ESOPHAGECTOMY,DISTAL TWO THIRDS                  N   3      $13.45   1/1/1995   12/31/2299
43117   8   ASSIST.SURGEON -PARTIAL ESOPHAGECTOMY,DISTAL TWO THIRDS             N   3    $271.00    1/1/1995   12/31/2299
43118   2   PARTIAL ESOPHAGECTOMY, WITH COLON INTERPOSITION OR SMALL BOWEL      N   3   $1,427.00   1/1/1995   12/31/2299
43118   7   ANESTHESIA-WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION   N   3      $13.45   1/1/1998   12/31/2299
43118   8   ASSIST.SURGEON-WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUC   N   3    $285.40    1/1/1998   12/31/2299
43121   2   PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, WITH THORACOTOMY ONLY,    N   3   $1,152.00   1/1/1998   12/31/2299
43121   7   ANESTHESIA, PARTIAL ESOPHAGECTOMY, DISTAL TOW-THIRDS, WITH THORAC   N   3      $13.45   1/1/1998   12/31/2299
43121   8   ASSISTANT FEE,PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, WITH THOR   N   3    $231.00    1/1/1998   12/31/2299
43122   2   PARTIAL ESOPHAGECTOMY, THORACOABDOMINAL                             N   3   $1,231.00   1/1/1995   12/31/2299
43122   7   ANESTHESIA-PARTIAL ESOPHAGECTOMY,THORACOABDOMINAL OR ABDOMINAL AP   N   3      $13.45   1/1/1998   12/31/2299
43122   8   ASSISTANT FEE-PARTIAL ESOPHAGECTOMY,THORACOABDOMINAL OR ABDOMINAL   N   3    $246.20    1/1/1998   12/31/2299
43123   2   PARTIAL ESOPHAGECTOMY, WITH COLON INTERPOSITION OR SMALL BOWELL     N   3   $1,427.00   1/1/1995   12/31/2299
43123   7   ANESTHESIA-WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION   N   3      $13.45   1/1/1998   12/31/2299
43123   8   ASSIST.SURGEON - WITH COLON INTERPOSITION OR SMALL BOWEL RECONSTR   N   3    $285.40    1/1/1998   12/31/2299
43124   2   TOTAL OR PARTIAL ESOPHAGECTOMY, WITHOUT RECONSTRUCTION              N   3   $1,177.00   1/1/1995   12/31/2299
43124   7   ANESTHESIA-TOTAL OR PARTIAL ESOPHAGECTOMY,WITHOUT RECONSTRUCTION    N   3      $13.45   1/1/1998   12/31/2299
43124   8   ASSIST.SURGEON-TOTAL OR PARTIAL ESOPHAGECTOMY,WITHOUT RECONSTRUCT   N   3    $235.40    1/1/1998   12/31/2299
43127   2   PARTIAL ESOPHAGECTOMY, DISTAL TWO THIRDS, WITH THORACOTOMY          N   3   $1,231.00   1/1/1995   12/31/2299
43130   2   DIVERTICULECTOMY HYPOPHARYNX OR ESOPHAGUS, W/WOUT                   N   3    $350.00    1/1/1973   12/31/2299
43130   7   DIVERTICULECTOMY HYPOPHARYNX OR ESOPHAGUS, W/WOUT                   N   3      $13.45   6/1/1994   12/31/2299
43130   8   DIVERTICULECTOMY HYPOPHARYNX OR ESOPHAGUS, W/WOUT                   N   3      $70.00   1/1/1973   12/31/2299
43135   2   DIVERTICULECTOMY HYPOPHARYNX OR ESOPHAGUS, W/WOUT                   N   3    $500.00    1/1/1973   12/31/2299
43135   7   DIVERTICULECTOMY HYPOPHARYNX OR ESOPHAGUS, W/WOUT                   N   3      $13.45   6/1/1994   12/31/2299
43135   8   DIVERTICULECTOMY HYPOPHARYNX OR ESOPHAGUS, W/WOUT                   N   3    $100.00    1/1/1973   12/31/2299
43200   2   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); DIAG                  N   3    $115.00    8/1/1979   12/31/2299
43200   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); DIAG                  N   3      $13.45   6/1/1994   12/31/2299
43200   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); DIAG                  N   3    $225.80    3/1/2004   12/31/2299
43201   1   ESOPHAGOSCOPY RIGID/FLEXIBLE W/DIRECT SUBMUCOSAL INJ ANY SUB        N   3    $141.61    1/1/2003   12/31/2299
43201   2   ESOPHAGOSCOPY RIGID/FLEXIBLE W/DIRECT SUBMUCOSAL INJ ANY S          N   3    $141.61    1/1/2003   12/31/2299




                                                                                                                       164
43202   2   ESOPHAGSCPY, RIGD OR FIBROPTC (SPECIFY); W/BX &/OR                 N   3   $130.00   8/1/1979   12/31/2299
43202   7   ESOPHAGSCPY, RIGD OR FIBROPTC (SPECIFY); W/BX &/OR                 N   3    $13.45   6/1/1994   12/31/2299
43202   F   ESOPHAGSCPY, RIGD OR FIBROPTC (SPECIFY); W/BX &/OR                 N   3   $225.80   3/1/2004   12/31/2299
43204   2   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC(SPECIFY);WITH I                 N   3   $135.00   1/1/1984   12/31/2299
43204   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC(SPECIFY);WITH I                 N   3    $13.45   6/1/1994   12/31/2299
43204   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC(SPECIFY);WITH I                 N   3   $225.80   3/1/2004   12/31/2299
43205   2   ESOPHAGOSCOPY, RIGID OR FLEXIBLE;                                  N   3   $128.59   1/1/1994   12/31/2299
43205   F   ESOPHAGOSCOPY, RIGID OR FLEXIBLE;                                  N   3   $225.80   3/1/2004   12/31/2299
43215   2   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/RE                 N   3   $144.00   8/1/1979   12/31/2299
43215   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/RE                 N   3    $13.45   6/1/1994   12/31/2299
43215   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/RE                 N   3   $225.80   3/1/2004   12/31/2299
43216   2   ESOPHAGOSCOPY, RIGID OR FLEXIBLE;                                  N   3   $140.18   1/1/1994   12/31/2299
43216   F   ESOPHAGOSCOPY, RIGID OR FLEXIBLE;                                  N   3   $225.80   3/1/2004   12/31/2299
43217   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/RE                 N   3    $13.45   6/1/1994   12/31/2299
43217   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/RE                 N   3   $225.80   3/1/2004   12/31/2299
43218   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/IR                 N   3    $13.45   6/1/1994   12/31/2299
43219   2   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/IN                 N   3   $140.00   1/1/1984   12/31/2299
43219   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/IN                 N   3    $13.45   6/1/1994   12/31/2299
43219   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/IN                 N   3   $225.80   3/1/2004   12/31/2299
43220   2   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/DI                 N   3   $120.00   1/1/1971   12/31/2299
43220   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/DI                 N   3    $13.45   6/1/1994   12/31/2299
43220   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); W/DI                 N   3   $225.80   3/1/2004   12/31/2299
43221   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; DIAGNOSTIC                        N   3    $13.45   6/1/1994   12/31/2299
43222   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/BX &/OR SPECI B                 N   3    $13.45   6/1/1994   12/31/2299
43223   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/REMOVAL OF FORE                 N   3    $13.45   6/1/1994   12/31/2299
43224   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/REMOVAL OF POLY                 N   3    $13.45   6/1/1994   12/31/2299
43225   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/RPR OF HYPOPHAR                 N   3    $13.45   6/1/1994   12/31/2299
43226   2   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/INSERTION OF WI                 N   3   $125.00   1/1/1984   12/31/2299
43226   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/INSERTION OF WI                 N   3    $13.45   6/1/1994   12/31/2299
43226   F   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/INSERTION OF WI                 N   3   $225.80   3/1/2004   12/31/2299
43227   2   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); WITH                 N   3   $117.01   1/1/2002   12/31/2299
43227   7   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); WITH                 N   3    $13.45   6/1/1994   12/31/2299
43227   F   ESOPHAGOSCOPY, RIGID OR FIBEROPTIC (SPECIFY); WITH                 N   3   $306.00   3/1/2004   12/31/2299
43228   2   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/FULGURATION OF                  N   3   $200.00   1/1/1984   12/31/2299
43228   7   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/FULGURATION OF                  N   3    $13.45   6/1/1994   12/31/2299
43228   F   ESOPHAGOGASTROSCOPY, FIBEROPTIC; W/FULGURATION OF                  N   3   $306.00   3/1/2004   12/31/2299
43231   2   ESOPAGOSCOPY RIGID OR FLEXIBLE W/ENDOSCOP.ULTRAS.EXAM.             N   3   $141.32   1/1/2001   12/31/2299
43231   F   ESOPAGOSCOPY RIGID OR FLEXIBLE W/ENDOSCOP.ULTRAS.EXAM.             N   3   $306.00   3/1/2004   12/31/2299
43232   2   ESOPHAG.RIGID OR FLEX.W/TRANSENDOSCOPIC ULTRASOUND GUIDED          N   3   $164.26   1/1/2001   12/31/2299
43232   F   ESOPHAG.RIGID OR FLEX.W/TRANSENDOSCOPIC ULTRASOUND GUIDED          N   3   $306.00   3/1/2004   12/31/2299
43234   2   UPPER GASTROINTESTINAL ENDOSCOPY SIMPLE PRIM EXAM                  N   3   $100.00   1/1/1984   12/31/2299
43234   7   ANESTHESIA, UPPER GASTROINTESTINAL ENDOSCOPY SIMPLE PRIM EXAM      N   3    $13.45   1/1/1997   12/31/2299
43234   F   UPPER GASTROINTESTINAL ENDOSCOPY SIMPLE PRIM EXAM                  N   3   $225.80   3/1/2004   12/31/2299
43235   2   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS,ST                 N   3   $150.00   8/1/1979   12/31/2299
43235   7   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS,ST                 N   3    $13.45   6/1/1994   12/31/2299
43235   F   UPPER GASTROINESTINAL ENDOSCOPY INCL ESOPHAGUS, ST                 N   3   $225.80   3/1/2004   12/31/2299
43236   1   UPPER GASTROINTESTINAL ENDOSCOPY INC ESOPHAGUS,STOMACH             N   3   $172.94   1/1/2003   12/31/2299
43236   2   UPPER GASTROINTESTINAL ENDOSCOPY INC ESOPHAGUS,STOMACH             N   3   $172.94   1/1/2003   12/31/2299
43237   2   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH AN   N   3   $131.65   1/1/2004   12/31/2299
43238   2   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS, STOMACH, AND EI   N   3   $163.26   1/1/2004   12/31/2299
43239   2   ESOPHAGOGASTRODUODENOSCOPY; W/BX &/OR COLLEC OF SP                 N   3   $126.00   1/1/1998   12/31/2299




                                                                                                                    165
43239   7   ESOPHAGOGASTRODUODENOSCOPY; W/BX &/OR COLLEC OF SP               N   3    $13.45   6/1/1994   12/31/2299
43239   F   ESOPHAGOGASTRODUODENOSCOPY; W/BX &/OR COLLEC OF SP               N   3   $306.00   3/1/2004   12/31/2299
43240   2   UPPER GASTROIN.ENDOSCOPY INCLUD.ESOPH.STOMA.AND EITHER THE       N   3   $249.17   1/1/2001   12/31/2299
43240   F   UPPER GASTROIN.ENDOSCOPY INCLUD.ESOPH.STOMA.AND EITHER THE       N   3   $306.00   3/1/2004   12/31/2299
43241   2   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH     N   3   $175.00   1/1/1984   12/31/2299
43241   7   UPPER GASTROINTESTSTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH   N   3    $13.45   6/1/1994   12/31/2299
43241   F   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS,STOMACH     N   3   $306.00   3/1/2004   12/31/2299
43242   2   UPPER GASTROIN.ENDOSCOP.INCLU.ESOPH.STOM.AND EITHER              N   3   $178.91   1/1/2001   12/31/2299
43242   F   UPPER GASTROIN.ENDOSCOP.INCLU.ESOPH.STOM.AND EITHER              N   3   $306.00   3/1/2004   12/31/2299
43243   2   FOR INJECTION SCLEROSIS ESOPHAGEAL &/ GASTRIC VRCS               N   3   $200.00   1/1/1990   12/31/2299
43243   7   FOR INJECTION SCLEROSIS ESOPHAGEAL &/ GASTRIC VRCS               N   3    $13.45   6/1/1994   12/31/2299
43243   F   FOR INJECTION SCLEROSIS ESOPHAGEAL &/ GASTRIC VRCS               N   3   $306.00   3/1/2004   12/31/2299
43244   2   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $155.91   1/1/1994   12/31/2299
43244   F   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $306.00   3/1/2004   12/31/2299
43245   2   UPPER GI ENDOSCOPY WITH DILATION GASTRIC OUTLET                  N   3   $175.00   1/1/1984   12/31/2299
43245   7   UPER GI ENDOSCOPY WITH DILATION GASTRIC OUTLET                   N   3    $13.45   6/1/1994   12/31/2299
43245   F   UPPER GI ENDOSCOPY WITH DILATION GASTRIC OUTLET                  N   3   $306.00   3/1/2004   12/31/2299
43246   2   UPPER G.I. ENDOSCOPY FOR PLCMNT OF PERCUT GAS TUBE               N   3   $150.00   1/1/1984   12/31/2299
43246   7   ANESTHESIOLOGIST PERCUTANEOUS GASTROSTOMY TUBE                   N   3    $13.45   6/1/1994   12/31/2299
43246   8   AASSISTANT UPPER G.I. ENDOSCOPY FOR PLCMNT OF PERCUT GAS TUBE    N   3    $30.00   1/2/1994   12/31/2299
43246   F   UPPER G.I. ENDOSCOPY FOR PLCMNT OF PERCUT GAS TUBE               N   3   $306.00   3/1/2004   12/31/2299
43247   2   ESOPHAGOGASTRODUODENOSCOPY; W/REMOVAL OF FOREIGN B               N   3   $120.00   8/1/1979   12/31/2299
43247   7   ESOPHAGOGASTRODUODENOSCOPY; W/REMOVAL OF FOREIGN B               N   3    $13.45   6/1/1994   12/31/2299
43247   F   ESOPHAGOGASTRODUODENOSCOPY; W/REMOVAL OF FOREIGN B               N   3   $306.00   3/1/2004   12/31/2299
43248   2   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $107.29   1/1/1994   12/31/2299
43248   F   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $306.00   3/1/2004   12/31/2299
43249   2   UPPER GASTROINTESTINAL ENDOSCOPY WITH BALLOON DILATION           N   3   $143.00   1/1/1995   12/31/2299
43249   F   UPPER GASTROINTESTINAL ENDOSCOPY WITH BALLOON DILATION           N   3   $306.00   3/1/2004   12/31/2299
43250   2   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $239.39   1/1/1994   12/31/2299
43250   F   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $306.00   3/1/2004   12/31/2299
43251   2   ESOPHAGOGASTRODUODENOSCOPY; W/REMOVAL OF POLYP(S)                N   3   $180.00   1/1/1984   12/31/2299
43251   7   ESOPHAGOGASTRODUODENOSCOPY; W/REMOVAL OF POLYP(S)                N   3    $13.45   6/1/1994   12/31/2299
43251   F   ESOPHAGOGASTRODUODENOSCOPY; W/REMOVAL OF POLYP(S)                N   3   $306.00   3/1/2004   12/31/2299
43255   2   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS,ST               N   3   $170.00   1/1/1984   12/31/2299
43255   7   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS,ST               N   3    $13.45   6/1/1994   12/31/2299
43255   F   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS,ST               N   3   $306.00   3/1/2004   12/31/2299
43256   2   UPPER GASTROIN.ENDOSCOP.INCLU.ESOPH.STOMA.AND EITHER THE         N   3   $140.99   1/1/2001   12/31/2299
43256   F   UPPER GASTROIN.ENDOSCOP.INCLU.ESOPH.STOMA.AND EITHER THE         N   3   $351.00   3/1/2004   12/31/2299
43257   2   ENDOSCOPY GASTROINTESTINAL ESOPHAGUS, STOMACH                    Y   3   $184.25   1/1/2005   12/31/2299
43257   7   ENDOSCOPY GASTROINTESTINAL ESOPHAGUS,STOMACH,DUODENUM            Y   3    $13.45   1/1/2005   12/31/2299
43258   2   ESOPHAGOGASTRODUODENOSCOPY; W/FULGURATION OF MUCOS               N   3   $145.90   1/1/2003   12/31/2299
43258   7   ESOPHAGOGASTRODUODENOSCOPY; W/FULGURATION OF MUCOS               N   3    $13.45   6/1/1994   12/31/2299
43258   F   ESOPHAGOGASTRODUODENOSCOPY; W/FULGURATION OF MUCOS               N   3   $351.00   3/1/2004   12/31/2299
43259   2   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $133.25   1/1/1994   12/31/2299
43259   F   UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG               N   3   $351.00   3/1/2004   12/31/2299
43260   2   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY(ERC               N   3   $200.00   8/1/1979   12/31/2299
43260   7   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY(ERC               N   3    $13.45   6/1/1994   12/31/2299
43260   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY(ERC               N   3   $306.00   3/1/2004   12/31/2299
43261   2   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER               N   3   $263.99   1/1/1994   12/31/2299
43261   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER               N   3   $306.00   3/1/2004   12/31/2299
43262   2   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS;WI               N   3   $250.00   1/1/1984   12/31/2299




                                                                                                                  166
43262   7   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS;WI                  N   3      $13.45   6/1/1994   12/31/2299
43262   F   UPPER GASTROINTESTINAL ENDOSCOPY INCL ESOPHAGUS;WI                  N   3    $306.00    3/1/2004   12/31/2299
43263   2   UPPER GASTRO ENDOSCOPY INCL ESOPHAGUS,STOMACH;W PR                  N   3    $250.00    1/1/1990   12/31/2299
43263   7   UPPER GASTRO ENDOSCOPY INCL ESOPHAGUS,STOMACH;W PR                  N   3      $13.45   6/1/1994   12/31/2299
43263   F   UPPER GASTRO ENDOSCOPY INCL ESOPHAGUS,STOMACH;W PR                  N   3    $306.00    3/1/2004   12/31/2299
43264   2   ESOPHAGOGASTRODUODENOSCOPY; W/EXTRAC OF STONE FROM                  N   3    $300.00    1/1/1984   12/31/2299
43264   7   ESOPHAGOGASTRODUODENOSCOPY; W/EXTRAC OF STONE FROM                  N   3      $13.45   6/1/1994   12/31/2299
43264   F   ESOPHAGOGASTRODUODENOSCOPY; W/EXTRAC OF STONE FROM                  N   3    $306.00    3/1/2004   12/31/2299
43265   2   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $311.37    1/1/2003   12/31/2299
43265   7   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3      $13.45   6/1/1994   12/31/2299
43265   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $306.00    3/1/2004   12/31/2299
43267   7   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3      $13.45   6/1/1994   12/31/2299
43267   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $306.00    3/1/2004   12/31/2299
43268   2   ENDOS RETRO CHOLANG (ERCP), W/WO SPEC COLL FOR CYT                  N   3    $312.00    1/2/1992   12/31/2299
43268   7   ENDOS RETRO CHOLANG (ERCP) W/WO SPEC COLL FOR CYTO                  N   3      $13.45   6/1/1994   12/31/2299
43268   F   ENDOS RETRO CHOLANG (ERCP), W/WO SPEC COLL FOR CYT                  N   3    $306.00    3/1/2004   12/31/2299
43269   2   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $300.00    1/2/1994   12/31/2299
43269   7   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3      $13.45   6/1/1994   12/31/2299
43269   8   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3      $58.00   1/1/1993   12/31/2299
43269   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $306.00    3/1/2004   12/31/2299
43271   2   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $220.12    1/1/2003   12/31/2299
43271   7   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3      $13.45   6/1/1994   12/31/2299
43271   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $306.00    3/1/2004   12/31/2299
43272   2   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $270.00    1/2/1994   12/31/2299
43272   7   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3      $13.45   6/1/1994   12/31/2299
43272   F   ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ER                  N   3    $306.00    3/1/2004   12/31/2299
43280   2   LAPAROSCOPY SURG ESOPHAGOGASTRIC FUNDOPLASTY(NISSEN TOUPET PROCS)   N   3    $666.04    1/1/2000   12/31/2299
43280   7   LAPAROSCOPY SURG ESOPHAGOGASTRIC FUNDOPLASTY(NISSEN TOUPET PROCS)   N   3      $13.45   1/1/2000   12/31/2299
43280   8   LAPAROSCOPY SURG ESOPHAGOGASTRIC FUNDOPLASTY(NISSEN TOUPET PROCS)   N   3    $132.01    1/1/2000   12/31/2299
43289   7   UNLISTED LAPAROSCOPY PROCEDURE ESOPHAGUS                            N   3      $13.45   1/1/2000   12/31/2299
43300   7   ESOPHAGOPLASTY, (PLSTC REPR OR RECONSTRUC) CERVICA                  N   3      $13.45   6/1/1994   12/31/2299
43305   2   ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION)                  N   3    $550.00    1/1/1973   12/31/2299
43305   7   ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION)                  N   3      $13.45   6/1/1994   12/31/2299
43305   8   ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION)                  N   3    $110.00    1/1/1973   12/31/2299
43310   2   ESOPHAGOPLASTY, (PLSTC REPR OR RECONSTRUC) THORAC                   N   3    $650.00    1/1/1984   12/31/2299
43310   7   ESOPHAGOPLASTY, (PLSTC REPR OR RECONSTRUC) THORAC                   N   3      $13.45   6/1/1994   12/31/2299
43310   8   ESOPHAGOPLASTY, (PLSTC REPR OR RECONSTRUC) THORAC                   N   3    $130.00    1/1/1984   12/31/2299
43312   7   ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUC) THO                  N   3      $13.45   6/1/1994   12/31/2299
43313   2   ESOPHAGOPLASTY/CONGENITAL DEFECT THORACIS APPROACH                  N   3   $1,559.38   1/1/2002   12/31/2299
43313   8   ESOPHAGOPLASTY/CONGENITAL DEFECT/THORACIC APPROACH W/REPAIR         N   3    $311.88    1/1/2002   12/31/2299
43314   2   ESOPHAGOPLASTY/CONGENITAL DEFECT;THORACIC APPROACH W/REPAIR         N   3   $1,714.12   1/1/2002   12/31/2299
43314   8   ESOPHAGOPLASTY/CONGENITAL DEFECT;THRACIC APPROACH W/REPAIR          N   3    $342.82    1/1/2002   12/31/2299
43320   2   ESOPHAGOGASTROSTOMY (CARDIOPLASTY) WITH OR WITHOUT                  N   3    $110.00    8/1/1979   12/31/2299
43320   7   ESOPHAGOGASTROSTOMY (CARDIOPLASTY) WITH OR WITHOUT                  N   3      $13.45   6/1/1994   12/31/2299
43320   8   ESOPHAGOGASTROSTOMY (CARDIOPLASTY) WITH OR WITHOUT                  N   3    $100.00    1/1/1973   12/31/2299
43324   2   ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, BELSEY IV                  N   3    $600.00    1/2/1994   12/31/2299
43324   7   ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, BELSEY IV                  N   3      $13.45   6/1/1994   12/31/2299
43324   8   ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, BELSEY IV                  N   3    $120.00    1/2/1994   12/31/2299
43325   2   ESOPHAGOGASTRIC FUNDOPLASTY WITH FUNDIC PATCH (THA                  N   3    $500.00    1/1/1984   12/31/2299
43325   7   ESOPHAGOGASTRIC FUNDOPLASTY WITH FUNDIC PATCH (THA                  N   3      $13.45   6/1/1994   12/31/2299
43325   8   ESOPHAGOGASTRIC FUNDOPLASTY WITH FUNDIC PATCH (THA                  N   3    $100.00    1/1/1984   12/31/2299




                                                                                                                       167
43326   7   ESOPHAGOGASTRIC FUNDOPLASTY;                                   N   3      $13.45   6/1/1994   12/31/2299
43330   2   ESOPHAGOMYOTOMY (HELLER TYPE) WITH OR WITHOUT HIAT             N   3    $475.00    1/1/1973   12/31/2299
43330   7   ESOPHAGOMYOTOMY (HELLER TYPE) WITH OR WITHOUT HIAT             N   3      $13.45   6/1/1994   12/31/2299
43330   8   ESOPHAGOMYOTOMY (HELLER TYPE) WITH OR WITHOUT HIAT             N   3      $95.00   1/1/1973   12/31/2299
43331   7   ESOPHAGOMYOTOMY (HELLER TYPE) WITH OR WITHOUT HIAT             N   3      $13.45   6/1/1994   12/31/2299
43340   2   ESOPHAGOJEJUNOSTOMY (WITHOUT TOTAL GASTRECTOMY); A             N   3    $600.00    1/1/1973   12/31/2299
43340   7   ESOPHAGOJEJUNOSTOMY (WITHOUT TOTAL GASTRECTOMY); A             N   3      $13.45   6/1/1994   12/31/2299
43340   8   ESOPHAGOJEJUNOSTOMY (WITHOUT TOTAL GASTRECTOMY); A             N   3    $120.00    1/1/1973   12/31/2299
43341   7   ESOPHAGOJEJUNOSTOMY (WITHOUT TOTAL GASTRECTOMY); T             N   3      $13.45   6/1/1994   12/31/2299
43350   2   ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNA             N   3    $350.00    1/1/1973   12/31/2299
43350   7   ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNA             N   3      $13.45   6/1/1994   12/31/2299
43350   8   ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNA             N   3      $70.00   9/1/1982   12/31/2299
43351   7   ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, THORACIC APPROACH   N   3      $13.45   6/1/1994   12/31/2299
43352   7   ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGOS, CERVICAL APPROACH   N   3      $13.45   6/1/1994   12/31/2299
43360   2   GASTROINTESTINAL RECONSTRUCTION FOR PREVIOUS ESOPHAGECTOMY     N   3   $1,193.00   1/1/1995   12/31/2299
43361   2   GASTROINTESTINAL RECONSTRUCT WITH COLON INTERPOSITION          N   3   $1,382.00   1/1/1995   12/31/2299
43400   2   LIGATION, DIRECT, ESOPHAGEAL VARICES                           N   3    $500.00    1/1/1973   12/31/2299
43400   7   LIGATION, DIRECT, ESOPHAGEAL VARICES                           N   3      $13.45   6/1/1994   12/31/2299
43400   8   LIGATION, DIRECT, ESOPHAGEAL VARICES                           N   3    $100.00    1/1/1973   12/31/2299
43401   7   TRANSECTION OF ESOPHAGUS WITH REPAIR, FOR ESOPHAGE             N   3      $13.45   6/1/1994   12/31/2299
43405   2   LITIGATION OR STAPLING @ GASTROINTESTINAL JUNCTION             N   3    $684.00    1/1/1995   12/31/2299
43410   2   SUTURE ESOPHAGEAL WOUND OR INJURY; CERVICAL APPROA             N   3    $350.00    8/1/1979   12/31/2299
43410   7   SUTURE ESOPHAGEAL WOUND OR INJURY; CERVICAL APPROA             N   3      $13.45   6/1/1994   12/31/2299
43410   8   SUTURE ESOPHAGEAL WOUND OR INJURY; CERVICAL APPROA             N   3      $70.00   8/1/1979   12/31/2299
43415   2   SUTURE ESOPHAGEAL WOUND OR INJURY; THORACIC APPROA             N   3    $475.00    1/1/1973   12/31/2299
43415   7   SUTURE ESOPHAGEAL WOUND OR INJURY; THORACIC APPROA             N   3      $13.45   6/1/1994   12/31/2299
43415   8   SUTURE ESOPHAGEAL WOUND OR INJURY; THORACIC APPROA             N   3      $95.00   1/1/1973   12/31/2299
43420   2   CLOSURE ESOPHAGOSTOMY OR FISTULA; CERVICAL APPROAC             N   3    $350.00    1/1/1973   12/31/2299
43420   7   CLOSURE ESOPHAGOSTOMY OR FISTULA; CERVICAL APPROAC             N   3      $13.45   6/1/1994   12/31/2299
43420   8   CLOSURE ESOPHAGOSTOMY OR FISTULA; CERVICAL APPROAC             N   3      $70.00   1/1/1973   12/31/2299
43425   2   CLOSURE ESOPHAGOSTOMY OR FISTULA; THORACIC APPROAC             N   3    $650.00    1/1/1973   12/31/2299
43425   7   CLOSURE ESOPHAGOSTOMY OR FISTULA; THORACIC APPROAC             N   3      $13.45   6/1/1994   12/31/2299
43425   8   CLOSURE ESOPHAGOSTOMY OR FISTULA; THORACIC APPROAC             N   3    $130.00    1/1/1973   12/31/2299
43450   2   DILATION ESOPHAGUS, BY UNGUIDED SOUND(S) OR BOUGIE             N   3      $35.00   1/2/1992   12/31/2299
43450   7   DILATION ESOPHAGUS, BY UNGUIDED SOUND(S) OR BOUGIE             N   3      $13.45   6/1/1994   12/31/2299
43450   F   DILATION ESOPHAGUS, BY UNGUIDED SOUND(S) OR BOUGIE             N   3    $225.80    3/1/2004   12/31/2299
43453   2   DILATION ESOPHAGUS, OVER GUIDE WIRE OR STRING                  N   3      $24.00   8/1/1979   12/31/2299
43453   7   DILATION ESOPHAGUS, OVER GUIDE WIRE OR STRING                  N   3      $13.45   6/1/1994   12/31/2299
43453   F   DILATION ESOPHAGUS, OVER GUIDE WIRE OR STRING                  N   3    $225.80    3/1/2004   12/31/2299
43456   2   BRUSQUE ESOPHAGEAL DILATION BY BALLOON OR STARK DI             N   3    $232.84    1/1/2004   12/31/2299
43456   7   BRUSQUE ESOPHAGEAL DILATION BY BALLOON OR STARK DI             N   3      $13.45   6/1/1994   12/31/2299
43456   F   BRUSQUE ESOPHAGEAL DILATION BY BALLOON OR STARK DI             N   3    $306.00    3/1/2004   12/31/2299
43458   2   DILATION OF ESOPHAGUS WITH BALLOON (30 MM DIAMETER             N   3    $104.90    1/1/1994   12/31/2299
43458   F   DILATION OF ESOPHAGUS WITH BALLOON (30 MM DIAMETER             N   3    $306.00    3/1/2004   12/31/2299
43460   2   ESOPHAGOGASTRIC TAMPONADE, WITH BALLOON (SENGSTAAK             N   3    $100.00    8/1/1979   12/31/2299
43460   7   ESOPHAGOGASTRIC TAMPONADE, WITH BALLOON (SENGSTAAK             N   3      $13.45   6/1/1994   12/31/2299
43496   2   FREE JEJUNUM TRANSFER W/MICROVASCULAR ANASTOMOSIS              N   3   $1,189.88   1/1/2005   12/31/2299
43496   7   FREE JEJUNUM TRANSFER W/MICROVASCULAR ANASTOMOSIS              N   3      $13.45   1/1/1997   12/31/2299
43499   7   UNLISTED PROCEDURE, ESOPHAGUS                                  N   3      $13.45   6/1/1994   12/31/2299
43500   2   GASTROTOMY WITH EXPLORATION OR FOREIGN BODY REMOVA             N   3    $300.00    1/1/1973   12/31/2299
43500   7   GASTROTOMY WITH EXPLORATION OR FOREIGN BODY REMOVA             N   3      $13.45   6/1/1994   12/31/2299




                                                                                                                  168
43500   8   GASTROTOMY WITH EXPLORATION OR FOREIGN BODY REMOVA                  N   3    $45.00   1/1/1984   12/31/2299
43501   7   GASTROTOMY                                                          N   3    $13.45   6/1/1994   12/31/2299
43502   2   GASTROTOMY WITH SUTURE REPAIR OF ESOPHAGOGASTRIC LACERATION         N   3   $605.00   1/1/1995   12/31/2299
43510   7   GASTROTOMY WITH EXPLORATION OR FOREIGN BODY REMOVA                  N   3    $13.45   6/1/1994   12/31/2299
43520   2   PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE (FREDET-R                  N   3   $225.00   8/1/1979   12/31/2299
43520   7   PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE (FREDET-R                  N   3    $13.45   6/1/1994   12/31/2299
43520   8   PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE (FREDET-R                  N   3    $45.00   8/1/1979   12/31/2299
43600   2   BIOPSY OF STOMACH; BY CAPSULE, TUBE, PERORAL (ONE                   N   3    $75.00   1/1/1973   12/31/2299
43600   7   BIOPSY OF STOMACH; BY CAPSULE, TUBE, PERORAL (ONE                   N   3    $13.45   6/1/1994   12/31/2299
43600   F   BIOPSY