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					CPT     Modifier Type of Service
00100            ANS
00102            ANS
00103            ANS
00104            ANS
00120            ANS
00124            ANS
00126            ANS
00140            ANS
00142            ANS
00144            ANS
00145            ANS
00147            ANS
00148            ANS
00160            ANS
00162            ANS
00164            ANS
00170            ANS
00172            ANS
00174            ANS
00176            ANS
00190            ANS
00192            ANS
00210            ANS
00212            ANS
00214            ANS
00215            ANS
00216            ANS
00218            ANS
00220            ANS
00222            ANS
0025T            EYE
00300            ANS
00320            ANS
00322            ANS
00350            ANS
00352            ANS
00400            ANS
00402            ANS
00404            ANS
00406            ANS
00410            ANS
00450            ANS
00452            ANS
00454            ANS
00470            ANS
00472            ANS
00474            ANS
00500            ANS
00520            ANS
00522            ANS
00524            ANS
00528            ANS
00530            ANS
00532            ANS
00534   ANS
00540   ANS
00542   ANS
00546   ANS
00548   ANS
00560   ANS
00562   ANS
00566   ANS
00567   ANS
00580   ANS
00600   ANS
00604   ANS
00620   ANS
00622   ANS
00630   ANS
00632   ANS
00634   ANS
00670   ANS
00700   ANS
00702   ANS
00730   ANS
00740   ANS
00750   ANS
00752   ANS
00754   ANS
00756   ANS
00770   ANS
00790   ANS
00792   ANS
00794   ANS
00796   ANS
00797   ANS
00800   ANS
00802   ANS
00810   ANS
00820   ANS
00830   ANS
00832   ANS
00840   ANS
00842   ANS
00844   ANS
00846   ANS
00848   ANS
00860   ANS
00862   ANS
00864   ANS
00866   ANS
00868   ANS
00870   ANS
00872   ANS
00873   ANS
00880   ANS
00882   ANS
00902   ANS
00904   ANS
00906        ANS
00908        ANS
00910        ANS
00912        ANS
00914        ANS
00916        ANS
00918        ANS
00920        ANS
00922        ANS
00924        ANS
00926        ANS
00928        ANS
0092T   62   SUR
00930        ANS
00932        ANS
00934        ANS
00936        ANS
00938        ANS
00940        ANS
00942        ANS
00944        ANS
00948        ANS
00950        ANS
00952        ANS
0099T        SUR
0099T   50   SUR
01112        ANS
01120        ANS
01130        ANS
01140        ANS
01150        ANS
01160        ANS
01170        ANS
01180        ANS
01190        ANS
01200        ANS
01202        ANS
01210        ANS
01212        ANS
01214        ANS
01215        ANS
01220        ANS
01230        ANS
01232        ANS
01234        ANS
01250        ANS
01260        ANS
01270        ANS
01272        ANS
01274        ANS
01320        ANS
01340        ANS
01360        ANS
01380        ANS
01382        ANS
01390        ANS
01392        ANS
01400        ANS
01402        ANS
01404        ANS
01420        ANS
01430        ANS
01432        ANS
01440        ANS
01442        ANS
01444        ANS
0144T   26   LAB
0144T   TC   LAB
01462        ANS
01464        ANS
01470        ANS
01472        ANS
01474        ANS
01480        ANS
01482        ANS
01484        ANS
01486        ANS
01490        ANS
01500        ANS
01502        ANS
01520        ANS
01522        ANS
01610        ANS
01620        ANS
01622        ANS
01630        ANS
01634        ANS
01636        ANS
01638        ANS
01650        ANS
01652        ANS
01654        ANS
01656        ANS
01670        ANS
01680        ANS
01682        ANS
01710        ANS
01712        ANS
01714        ANS
01716        ANS
01730        ANS
01732        ANS
01740        ANS
01742        ANS
01744        ANS
01756        ANS
01758        ANS
01760        ANS
01770        ANS
01772        ANS
01780        ANS
01782        ANS
01810        ANS
01820        ANS
01830        ANS
01832        ANS
01840        ANS
01842        ANS
01844        ANS
01850        ANS
01852        ANS
01860        ANS
01916        ANS
01920        ANS
01922        ANS
01926        ANS
0192T        Sur
0192T   WA   OSF
01961        ANS
01990        ANS
01996        ANS
01999        ANS
10021        SUR
10021   WA   OSF
10022        SUR
10022   WA   OSF
10060        SUR
10061        SUR
10061   WA   OSF
10120        SUR
10140        SUR
10160        SUR
10180        SUR
10180   WA   OSF
11000        SUR
11010   51   SUR
11041   WA   OSF
11042        SUR
11042   51   SUR
11042   WA   OSF
11043        SUR
11043   WA   OSF
11044        SUR
11055        SUR
11057        SUR
11100        SUR
11101        SUR
11200        SUR
11310        SUR
11400        SUR
11400   51   SUR
11401        SUR
11401   WA   OSF
11402        SUR
11402   51   SUR
11402   WA   OSF
11403        SUR
11403   51   SUR
11403   WA   OSF
11404        SUR
11404   WA   OSF
11406        SUR
11406   WA   OSF
11420        SUR
11421        SUR
11422        SUR
11423        SUR
11426        SUR
11440        SUR
11441        SUR
11441   WA   OSF
11442        SUR
11442   51   SUR
11443        SUR
11443   51   SUR
11444        SUR
11444   WA   OSF
11446        SUR
11446   WA   OSF
11450        SUR
11450   WA   OSF
11451   WA   OSF
11602        SUR
11603        SUR
11604        SUR
11606        SUR
11606   WA   OSF
11623        SUR
11641        SUR
11642        SUR
11642   WA   OSF
11643        SUR
11643   51   SUR
11644        SUR
11644   WA   OSF
11646        SUR
11646   WA   OSF
11719        SUR
11720        SUR
11721        SUR
11730        SUR
11750        SUR
11750   WA   OSF
11770        SUR
11770   WA   OSF
11771        SUR
11771   WA   OSF
11772        SUR
11772   WA   OSF
11900        SUR
11952        SUR
11952   80   SUR
11954        SUR
11960        SUR
11960   WA   OSF
11971        SUR
11971   WA   OSF
11976        SUR
12001        SUR
12020        SUR
12032        SUR
12035        SUR
12041        SUR
12042        SUR
12051        SUR
12051   51   SUR
12052        SUR
12052   51   SUR
12052   WA   OSF
12053        SUR
13120        SUR
13120   wa   SUR
13121        SUR
13132        SUR
13132   WA   OSF
13150        SUR
13150   51   SUR
13151        SUR
13152        SUR
13160        SUR
13160   51   SUR
13160   58   SUR
14020        SUR
14020   WA   OSF
14040        SUR
14040   51   SUR
14040   WA   OSF
14041        SUR
14060        SUR
14060   WA   OSF
14061        SUR
14300   WA   OSF
14301        SUR
15004        SUR
15050        SUR
15050   WA   OSF
15100        SUR
15100   WA   OSF
15101        SUR
15120        SUR
15200        SUR
15200   WA   OSF
15240        SUR
15240   47   SUR
15240   WA   OSF
15260        SUR
15260   51   SUR
15260   WA   OSF
15261        SUR
15261   WA   OSF
15400        SUR
15574        SUR
15574   WA   OSF
15576        SUR
15576   WA   OSF
15620        SUR
15620   WA   OSF
15732        SUR
15732   51   SUR
15732   52   SUR
15732   59   SUR
15732   WA   OSF
15738        SUR
15740        SUR
15760        SUR
15760   WA   OSF
15770        SUR
15770   51   SUR
15770   52   SUR
15775        SUR
15782        SUR
15782   WA   OSF
15821   50   SUR
15822        SUR
15822   50   SUR
15822   79   SUR
15822   80   SUR
15822   WA   OSF
15823        SUR
15823   50   SUR
15823   WA   OSF
15850        SUR
15850   WA   OSF
15852        SUR
15860        SUR
15935        SUR
15999        SUR
16020        SUR
17000        SUR
17003        SUR
17106        SUR
17106   WA   OSF
17108        SUR
17108   WA   OSF
17110        SUR
17111   51   SUR
17250        SUR
17264        SUR
17271        SUR
17272        SUR
17304        SUR
17305        SUR
17311        SUR
17312        SUR
17999        SUR
19000        SUR
19100        SUR
19101        SUR
19101   WA   OSF
19102   WA   OSF
19103        SUR
19120        SUR
19120   50   SUR
19120   WA   OSF
19125        SUR
19125   WA   OSF
19162   WA   OSF
19180        SUR
19180   WA   OSF
19290        SUR
19290   50   SUR
19295        SUR
19316        SUR
19316   WA   SUR
19318        SUR
19318   50   SUR
19318   WA   OSF
19328        SUR
19328   51   SUR
19328   WA   OSF
19330   WA   OSF
19350        SUR
19350   50   SUR
19350   WA   SUR
19357        SUR
19380        SUR
19380   WA   OSF
19499        SUR
20206        SUR
20240   WA   OSF
20500        SUR
20501        SUR
20525        SUR
20525   WA   OSF
20550        SUR
20550   50   SUR
20550   51   SUR
20550   WA   OSF
20551        SUR
20552        SUR
20552   50   SUR
20552   51   SUR
20553        SUR
20600        SUR
20600   51   SUR
20600   WA     OSF
20605          SUR
20610          SUR
20610   50     SUR
20610   51     SUR
20610   58     SUR
20610   5879   SUR
20610   59     SUR
20610   79     SUR
20610   WA     OSF
20612          SUR
20650          SUR
20650   WA     OSF
20660          SUR
20670          SUR
20670   58     SUR
20670   5878   SUR
20670   WA     OSF
20680          SUR
20680   22     SUR
20680   50     SUR
20680   51     SUR
20680   52     SUR
20680   58     SUR
20680   59     SUR
20680   80     SUR
20680   82     SUR
20680   WA     OSF
20690          SUR
20692          SUR
20694          SUR
20694   WA     OSF
20900          SUR
20900   59     SUR
20900   wa     SUR
20902          SUR
20902   80     SUR
20902   WA     OSF
20924          SUR
20924   WA     OSF
20926          SUR
20926   WA     OSF
20930          SUR
20931          SUR
20931   79     SUR
20931   80     SUR
20936          SUR
20936   62     SUR
20936   79     SUR
20936   80     SUR
20937          SUR
20937   62     SUR
20937   80     AST
20938          SUR
20938   80     SUR
20956        SUR
20962        SUR
20975        SUR
20999        SUR
21070        SUR
21080        SUR
21085        SUR
21085   76   SUR
21086        SUR
21086   WA   OSF
21110        SUR
21121        SUR
21141        SUR
21141   WA   OSF
21142        SUR
21142   WA   OSF
21147        SUR
21182        SUR
21182   WA   OSF
21188        SUR
21188   51   SUR
21193        SUR
21193   50   SUR
21193   WA   OSF
21194        SUR
21194   WA   OSF
21196        SUR
21206   WA   OSF
21208        SUR
21210        SUR
21210   WA   OSF
21230        SUR
21230   80   SUR
21230   WA   OSF
21235        SUR
21235   51   SUR
21240        SUR
21240   50   SUR
21240   WA   OSF
21243        SUR
21245        SUR
21245   51   SUR
21245   80   SUR
21245   WA   OSF
21248        SUR
21248   47   SUR
21248   WA   OSF
21256        SUR
21260        SUR
21260   80   SUR
21261        SUR
21267        SUR
21267   WA   OSF
21280        SUR
21299        SUR
21299   WA     OSF
21337          SUR
21337   WA     OSF
21387          SUR
21390          SUR
21390   WA     OSF
21395          SUR
21395   80     SUR
21407   51     SUR
21462          SUR
21470          SUR
21499          SUR
21501          SUR
21550          SUR
21556          SUR
21556   WA     OSF
21600          SUR
21615          SUR
21899          SUR
21925          SUR
21925   WA     OSF
21930          SUR
21930   WA     OSF
22325   51     SUR
22327          SUR
22327   51     SUR
22524   wa     OSF
22548          SUR
22551          SUR
22551   WA     SUR
22552          SUR
22554          SUR
22554   51     SUR
22554   59     SUR
22554   79     SUR
22554   80     SUR
22554   WA     OSF
22556          SUR
22558          SUR
22558   51     SUR
22558   WA     OSF
22585          SUR
22585   51     SUR
22585   79     SUR
22585   80     AST
22585   WA     OSF
22595          SUR
22600          SUR
22600   51     SUR
22600   62     SUR
22600   80     SUR
22610          SUR
22612          SUR
22612   51     SUR
22612   5180   SUR
22612   62     SUR
22612   79     SUR
22612   80     SUR
22612   WA     OSF
22614          SUR
22614   51     SUR
22614   59     SUR
22614   5979   SUR
22614   62     SUR
22614   80     SUR
22630          SUR
22630   51     SUR
22630   59     SUR
22630   62     SUR
22630   80     SUR
22632          SUR
22632   51     SUR
22632   80     SUR
22802          SUR
22830          SUR
22830   51     SUR
22830   78     SUR
22840          SUR
22840   51     SUR
22840   80     SUR
22841          SUR
22842          SUR
22842   62     SUR
22842   79     SUR
22842   80     SUR
22845          SUR
22845   59     SUR
22845   79     SUR
22845   80     SUR
22845   81     SUR
22845   WA     OSF
22846          SUR
22850   51     SUR
22851          SUR
22851   59     SUR
22851   62     SUR
22851   80     SUR
22852          SUR
22852   51     SUR
22852   59     SUR
22852   80     SUR
22852   WA     SUR
22899          SUR
22899   59     SUR
22900          SUR
22900   51     SUR
22999          SUR
23075          SUR
23076          SUR
23076   WA     OSF
23120        SUR
23120   51   SUR
23120   WA   OSF
23130        SUR
23130   51   SUR
23130   WA   OSF
23180        SUR
23350        SUR
23350   51   SUR
23350   WA   OSF
23410        SUR
23410   51   SUR
23410   WA   OSF
23412        SUR
23412   WA   OSF
23415        SUR
23415   51   SUR
23415   WA   OSF
23420        SUR
23420   80   SUR
23420   WA   OSF
23430        SUR
23430   WA   OSF
23440        SUR
23440   WA   OSF
23450        SUR
23450   WA   OSF
23455        SUR
23455   WA   OSF
23460        SUR
23462        SUR
23462   WA   OSF
23470        SUR
23470   80   SUR
23472        SUR
23472   80   SUR
23480        SUR
23485        SUR
23485   WA   OSF
23500        SUR
23515        SUR
23515   51   SUR
23515   WA   SUR
23550        SUR
23550   59   SUR
23550   wa   OSF
23552        SUR
23552   WA   OSF
23615        SUR
23615   WA   SUR
23616        SUR
23616   WA   SUR
23630        SUR
23660        SUR
23700        SUR
23700   51     SUR
23700   59     SUR
23700   WA     OSF
23802          SUR
23929          SUR
23929   WA     OSF
23935   59     SUR
24075          SUR
24076          SUR
24076   WA     OSF
24077          SUR
24101          SUR
24101   WA     OSF
24130          SUR
24130   WA     OSF
24138   WA     OSF
24145          SUR
24145   wa     SUR
24200   51     SUR
24201          SUR
24201   59     SUR
24341          SUR
24356          SUR
24356   51     SUR
24356   82     SUR
24356   WA     OSF
24400          SUR
24400   WA     SUR
24430          SUR
24430   WA     OSF
24435          SUR
24435   WA     OSF
24515          SUR
24615          SUR
24650          SUR
24665   5951   SUR
24930          SUR
24930   WA     OSF
24999          SUR
25000          SUR
25000   51     SUR
25000   WA     OSF
25066          SUR
25066   wa     SUR
25075          SUR
25101          SUR
25101   51     SUR
25101   WA     OSF
25107          SUR
25107   WA     OSF
25110          SUR
25110   WA     OSF
25111          SUR
25111   51     SUR
25111   WA     OSF
25112        SUR
25112   WA   OSF
25115        SUR
25119   WA   OSF
25145   WA   OSF
25240        SUR
25240   51   SUR
25240   82   SUR
25240   WA   OSF
25260   wa   SUR
25270        SUR
25295        SUR
25295   51   SUR
25295   80   SUR
25295   WA   OSF
25300        SUR
25300   WA   OSF
25301        SUR
25301   WA   OSF
25310        SUR
25310   WA   OSF
25320        SUR
25320   WA   OSF
25350        SUR
25360        SUR
25360   51   SUR
25360   WA   OSF
25365        SUR
25390        SUR
25390   WA   OSF
25405        SUR
25405   WA   OSF
25415   WA   SUR
25420        SUR
25420   WA   OSF
25440        SUR
25440   WA   OSF
25445        SUR
25445   80   SUR
25445   WA   OSF
25447        SUR
25447   80   SUR
25447   WA   OSF
25515        SUR
25515   WA   SUR
25545   59   SUR
25545   wa   SUR
25609        SUR
25609   WA   SUR
25628        SUR
25628   WA   OSF
25685        SUR
25800        SUR
25810        SUR
25810   WA   OSF
25999          SUR
26010   58     SUR
26010   59     SUR
26010   5979   SUR
26040          SUR
26040   WA     OSF
26045          SUR
26045   59     SUR
26045   WA     OSF
26055          SUR
26055   51     SUR
26055   59     SUR
26055   79     SUR
26055   WA     OSF
26060   WA     OSF
26080          SUR
26080   51     SUR
26080   WA     OSF
26110   WA     OSF
26115          SUR
26116          SUR
26116   WA     OSF
26121          SUR
26121   WA     OSF
26123          SUR
26123   51     SUR
26123   59     SUR
26123   80     SUR
26123   WA     OSF
26125          SUR
26125   59     SUR
26125   80     SUR
26135   51     SUR
26135   80     SUR
26145          SUR
26160          SUR
26160   WA     SUR
26180          SUR
26210          SUR
26210   WA     OSF
26230   59     SUR
26350          SUR
26350   51     SUR
26350   80     SUR
26350   WA     OSF
26352          SUR
26352   WA     OSF
26356          SUR
26356   WA     OSF
26358          SUR
26358   WA     OSF
26410          SUR
26410   WA     OSF
26418          SUR
26418   WA     OSF
26426   51   SUR
26428        SUR
26428   51   SUR
26433        SUR
26440        SUR
26440   wa   SUR
26442        SUR
26442   51   SUR
26442   80   SUR
26442   WA   OSF
26445        SUR
26445   51   SUR
26445   80   SUR
26445   WA   OSF
26471        SUR
26474        SUR
26478        SUR
26478   WA   OSF
26480        SUR
26480   51   SUR
26480   WA   OSF
26485        SUR
26490        SUR
26490   WA   OSF
26517        SUR
26520        SUR
26520   51   SUR
26520   80   SUR
26520   WA   OSF
26525        SUR
26525   WA   OSF
26531        SUR
26531   51   SUR
26531   WA   OSF
26540        SUR
26540   80   SUR
26540   WA   OSF
26546        SUR
26565        SUR
26565   51   SUR
26565   80   SUR
26565   WA   OSF
26567        SUR
26593        SUR
26593   51   SUR
26593   80   SUR
26600        SUR
26615        SUR
26615   51   SUR
26615   WA   OSF
26665        SUR
26665   51   SUR
26665   WA   OSF
26715   51   SUR
26715   80   SUR
26735        SUR
26820        SUR
26820   WA   OSF
26842        SUR
26842   WA   OSF
26843        SUR
26843   WA   OSF
26844        SUR
26844   WA   OSF
26850        SUR
26850   80   SUR
26850   WA   OSF
26852        SUR
26910        SUR
26951        SUR
26951   51   SUR
26952        SUR
26952   WA   OSF
26989        SUR
26990        SUR
26990   79   SUR
26992        SUR
26992   WA   OSF
27001   50   SUR
27030   79   SUR
27047        SUR
27047   WA   OSF
27048        SUR
27048   WA   OSF
27066   WA   SUR
27071   WA   SUR
27080        SUR
27090        SUR
27091        SUR
27093        SUR
27093   50   SUR
27093   WA   OSF
27096        SUR
27096   50   SUR
27096   WA   OSF
27125        SUR
27130        SUR
27130   80   SUR
27130   82   SUR
27130   WA   OSF
27132        SUR
27132   80   SUR
27134        SUR
27134   80   SUR
27134   WA   SUR
27137        SUR
27137   80   SUR
27170   59   SUR
27244        SUR
27250        SUR
27254          SUR
27254   WA     OSF
27266          SUR
27266   WA     OSF
27284          SUR
27299          SUR
27301          SUR
27301   51     SUR
27303          SUR
27303   51     SUR
27303   78     SUR
27310          SUR
27310   WA     OSF
27327          SUR
27327   51     SUR
27328          SUR
27328   WA     OSF
27331   WA     OSF
27332          SUR
27332   WA     OSF
27333   WA     OSF
27337          SUR
27337   wa     SUR
27339          SUR
27339   WA     SUR
27340   78     OSF
27340   WA     OSF
27345          SUR
27345   WA     OSF
27347          SUR
27350          SUR
27350   WA     OSF
27355          SUR
27355   51     SUR
27355   WA     OSF
27360          SUR
27380          SUR
27380   59     SUR
27380   5979   SUR
27380   79     SUR
27385          SUR
27385   wa     SUR
27386          SUR
27386   wa     SUR
27395   51     SUR
27405          SUR
27405   wa     SUR
27407          SUR
27407   59     SUR
27407   80     SUR
27409          SUR
27409   wa     SUR
27418          SUR
27422          SUR
27422   WA     OSF
27425          SUR
27425   51     SUR
27425   WA     OSF
27427          SUR
27428          SUR
27428   WA     OSF
27429          SUR
27429   59     SUR
27429   5979   SUR
27429   79     SUR
27437          SUR
27438          SUR
27442          SUR
27442   22     SUR
27442   80     SUR
27442   WA     OSF
27446          SUR
27446   WA     OSF
27447          SUR
27447   79     SUR
27447   80     SUR
27447   WA     OSF
27450          SUR
27450   80     SUR
27455          SUR
27457          SUR
27457   80     SUR
27470          SUR
27470   WA     OSF
27472          SUR
27472   80     SUR
27486          SUR
27487          SUR
27488          SUR
27488   80     SUR
27495          SUR
27495   AA     SUR
27495   WA     OSF
27506          SUR
27506   WA     OSF
27524          SUR
27570          SUR
27570   51     SUR
27570   WA     OSF
27590          SUR
27594          SUR
27596          SUR
27596   80     SUR
27599          SUR
27606          SUR
27610          SUR
27610   WA     OSF
27612          SUR
27612   51     OSF
27619          SUR
27635          SUR
27640          SUR
27640   WA     OSF
27641          SUR
27647          SUR
27647   wa     SUR
27650          SUR
27650   WA     OSF
27652          SUR
27652   WA     OSF
27654          SUR
27654   WA     OSF
27675          SUR
27675   WA     OSF
27685          SUR
27685   5051   SUR
27685   WA     OSF
27687          SUR
27687   WA     OSF
27690          SUR
27691          SUR
27691   WA     OSF
27695          SUR
27698          SUR
27698   WA     OSF
27700   WA     OSF
27702          SUR
27702   wa     SUR
27707          SUR
27709          SUR
27709   78     SUR
27709   WA     OSF
27720          SUR
27720   WA     OSF
27724          SUR
27724   80     SUR
27725          SUR
27758          SUR
27758   WA     OSF
27792          SUR
27792   WA     OSF
27814          SUR
27814   WA     OSF
27823          SUR
27870          SUR
27870   51     SUR
27870   80     SUR
27870   WA     OSF
27880          SUR
27880   WA     OSF
27881          SUR
27884          SUR
27884   WA     OSF
27886          SUR
27886   80     SUR
27888          SUR
27899          SUR
28002          SUR
28002   51     SUR
28002   WA     OSF
28005          SUR
28008          SUR
28008   51     SUR
28008   WA     OSF
28022          SUR
28035          SUR
28035   WA     OSF
28039          SUR
28039   WA     SUR
28045          SUR
28045   WA     OSF
28046          SUR
28046   WA     OSF
28060          SUR
28060   WA     OSF
28080          SUR
28080   59     SUR
28080   5979   SUR
28080   79     SUR
28080   WA     OSF
28090          SUR
28090   51     SUR
28090   WA     OSF
28104          SUR
28110          SUR
28110   WA     OSF
28111          SUR
28111   WA     OSF
28113          SUR
28113   WA     OSF
28114          SUR
28114   WA     OSF
28116          SUR
28116   59     SUR
28118          SUR
28118   WA     OSF
28119          SUR
28119   WA     OSF
28122          SUR
28124          SUR
28126          SUR
28153          SUR
28160          SUR
28160   59     SUR
28192          SUR
28226          SUR
28226   5979   SUR
28226   79     SUR
28232          SUR
28232   51     SUR
28234          SUR
28238          SUR
28238   WA     OSF
28240          SUR
28240   80     SUR
28240   WA     OSF
28250          SUR
28250   WA     OSF
28262          SUR
28285          SUR
28285   59     SUR
28285   5979   SUR
28285   79     SUR
28285   WA     OSF
28286          SUR
28288          SUR
28288   WA     OSF
28289          SUR
28290          SUR
28290   wa     SUR
28292          SUR
28292   59     SUR
28292   5979   SUR
28292   79     SUR
28292   WA     OSF
28293          SUR
28293   WA     OSF
28296          SUR
28296   WA     OSF
28297          SUR
28297   WA     OSF
28300          SUR
28304          SUR
28306          SUR
28307          SUR
28308          SUR
28308   WA     OSF
28315          SUR
28322          SUR
28465          SUR
28470          SUR
28485          SUR
28485   WA     OSF
28525          SUR
28531          SUR
28531   WA     OSF
28555          SUR
28705          SUR
28715          SUR
28715   51     SUR
28715   80     SUR
28715   WA     SUR
28725          SUR
28725   22     SUR
28725   80     SUR
28725   WA   OSF
28730        SUR
28730   WA   OSF
28735        SUR
28737        SUR
28737   WA   OSF
28740        SUR
28740   WA   OSF
28755        SUR
28755   WA   OSF
28760   WA   OSF
28800        SUR
28810        SUR
28820        SUR
28820   WA   OSF
28825        SUR
28825   WA   OSF
28899        SUR
29065        SUR
29065   58   SUR
29075        SUR
29075   58   SUR
29085        SUR
29105        SUR
29105   59   SUR
29125        SUR
29125   50   SUR
29125   51   SUR
29126        SUR
29130        SUR
29131        SUR
29345        SUR
29365        SUR
29405        SUR
29405   58   SUR
29425        SUR
29440        SUR
29445        SUR
29445   wa   SUR
29515        SUR
29515   51   SUR
29540        SUR
29540   50   SUR
29550        SUR
29580        SUR
29590        SUR
29700        SUR
29705        SUR
29799        SUR
29805        SUR
29805   51   SUR
29805   WA   OSF
29806        SUR
29806   WA   OSF
29807        SUR
29807   51     SUR
29807   WA     OSF
29815   59     SUR
29822          SUR
29822   59     SUR
29822   WA     OSF
29823          SUR
29823   51     SUR
29823   59     SUR
29823   5980   SUR
29823   80     SUR
29823   WA     OSF
29824          SUR
29824   51     SUR
29824   5180   SUR
29824   80     SUR
29824   WA     OSF
29825          SUR
29825   51     SUR
29825   59     SUR
29825   80     SUR
29825   WA     OSF
29826          SUR
29826   51     SUR
29826   5180   SUR
29826   80     SUR
29826   WA     OSF
29827          SUR
29827   51     SUR
29827   80     SUR
29827   WA     OSF
29834          SUR
29834   WA     OSF
29838          SUR
29838   51     SUR
29838   WA     OSF
29840          SUR
29840   WA     OSF
29843          SUR
29843   WA     SUR
29844          SUR
29844   51     SUR
29845          SUR
29845   59     SUR
29845   80     SUR
29845   82     AST
29845   WA     OSF
29846          SUR
29846   59     SUR
29846   82     SUR
29846   WA     OSF
29848          SUR
29848   WA     OSF
29866          SUR
29870          SUR
29870   51     SUR
29870   WA     OSF
29871          SUR
29873          SUR
29873   WA     OSF
29874          SUR
29874   51     SUR
29874   WA     OSF
29875          SUR
29875   WA     OSF
29876          SUR
29876   51     SUR
29876   59     SUR
29876   WA     OSF
29877          SUR
29877   51     SUR
29877   59     SUR
29877   WA     OSF
29879          SUR
29879   5879   SUR
29879   59     SUR
29879   5979   SUR
29879   79     SUR
29879   WA     OSF
29880          SUR
29880   52     SUR
29880   59     SUR
29880   79     SUR
29880   WA     OSF
29881          SUR
29881   50     SUR
29881   51     SUR
29881   59     SUR
29881   5979   SUR
29881   80     SUR
29881   WA     OSF
29882          SUR
29882   51     SUR
29882   80     SUR
29882   WA     OSF
29883          SUR
29884          SUR
29884   80     SUR
29884   WA     OSF
29885          SUR
29885   WA     OSF
29887          SUR
29887   WA     OSF
29888          SUR
29888   51     SUR
29888   80     SUR
29888   82     SUR
29888   WA     OSF
29889          SUR
29889   80     SUR
29889   WA   OSF
29891        SUR
29891   WA   SUR
29893        SUR
29893   WA   OSF
29894        SUR
29894   51   SUR
29894   WA   OSF
29898   51   SUR
29898   WA   OSF
29899        SUR
29999        SUR
30100        SUR
30115        SUR
30115   WA   OSF
30117        SUR
30117   WA   OSF
30124        SUR
30124   wa   SUR
30130        SUR
30130   51   SUR
30140        SUR
30140   50   SUR
30140   51   SUR
30140   WA   OSF
30200        SUR
30450        SUR
30460        SUR
30460   WA   OSF
30462        SUR
30520        SUR
30520   WA   OSF
30580        SUR
30580   51   SUR
30580   WA   OSF
30600        SUR
30600   WA   OSF
30620        SUR
30801        SUR
30802        SUR
30802   51   SUR
30802   WA   OSF
30901        SUR
30999        SUR
31020        SUR
31030        SUR
31032        SUR
31032   WA   OSF
31075        SUR
31081        SUR
31081   62   SUR
31084        SUR
31085        SUR
31085   51   SUR
31200   WA   OSF
31201        SUR
31205        SUR
31205   51   SUR
31205   WA   OSF
31230        SUR
31230   80   SUR
31231        SUR
31237        SUR
31237   58   SUR
31237   WA   OSF
31239   79   SUR
31239   80   SUR
31239   WA   OSF
31240        SUR
31240   WA   OSF
31254        SUR
31254   51   SUR
31254   WA   OSF
31255        SUR
31255   50   SUR
31255   51   SUR
31255   WA   OSF
31256        SUR
31256   50   SUR
31256   51   SUR
31256   WA   OSF
31267        SUR
31267   51   SUR
31267   WA   OSF
31276        SUR
31276   51   SUR
31276   WA   OSF
31287        SUR
31287   WA   OSF
31288        SUR
31288   51   SUR
31292        SUR
31299        SUR
31500        SUR
31505        SUR
31512   WA   OSF
31525        SUR
31535        SUR
31535   WA   OSF
31536        SUR
31536   WA   OSF
31540        SUR
31540   WA   OSF
31541        SUR
31541   WA   OSF
31570        SUR
31571        SUR
31575        SUR
31578        SUR
31579        SUR
31599        SUR
31600        SUR
31611        SUR
31612        SUR
31622        SUR
31622   51   SUR
31622   WA   OSF
31625        SUR
31625   51   SUR
31628        SUR
31628   WA   OSF
31899        SUR
32095        SUR
32405        SUR
32440        SUR
32480        SUR
32480   80   SUR
32484        SUR
32500        SUR
32657        SUR
32999        SUR
33010        SUR
33207        SUR
33207   WA   OSF
33208        SUR
33210        SUR
33213        SUR
33217        SUR
33405        SUR
33405   80   SUR
33413        SUR
33425        SUR
33430        SUR
33430   80   SUR
33511        SUR
33512        SUR
33514        SUR
33518        SUR
33519        SUR
33519   80   SUR
33521        SUR
33530        SUR
33533        SUR
33533   80   SUR
33534        SUR
33535        SUR
33572        SUR
33863        SUR
33999        SUR
35081        SUR
35226        SUR
35301        SUR
35331        SUR
35471        SUR
35556        SUR
35606        SUR
35631   51   SUR
35631   59   SUR
35645        SUR
35646        SUR
35646   80   SUR
35647        SUR
35647   51   SUR
35656        SUR
35661        SUR
35666        SUR
35681        SUR
35875        SUR
36000        SUR
36000   59   SUR
36010        SUR
36011        SUR
36015        SUR
36100        SUR
36140        SUR
36200        SUR
36200   59   SUR
36200   WA   OSF
36215        SUR
36215   51   SUR
36215   59   SUR
36215   WA   OSF
36216        SUR
36216   51   SUR
36216   59   SUR
36216   76   SUR
36216   WA   OSF
36217        SUR
36217   WA   OSF
36218        SUR
36218   76   SUR
36245        SUR
36245   50   SUR
36245   WA   OSF
36246        SUR
36299        SUR
36405        SUR
36430        SUR
36468        SUR
36471        SUR
36471   50   SUR
36475        SUR
36475   WA   OSF
36478        SUR
36478   50   SUR
36500        SUR
36556        SUR
36569        SUR
36571        SUR
36600        SUR
36620        SUR
36620   59   SUR
36800        SUR
36825        SUR
36825   WA   OSF
36832   WA   OSF
36860        SUR
37200        SUR
37202        SUR
37202   51   SUR
37600        SUR
37609        SUR
37620        SUR
37735        SUR
37735   WA   OSF
37760        SUR
37765        SUR
37765   50   SUR
37766        SUR
37799        SUR
38220        SUR
38220   51   SUR
38220   WA   OSF
38221        SUR
38221   51   SUR
38221   wa   SUR
38500        SUR
38500   WA   OSF
38510        SUR
38510   WA   OSF
38520        SUR
38525        SUR
38525   WA   OSF
38724        SUR
38740        SUR
38999        SUR
39010        SUR
39400        SUR
39499        SUR
39599        SUR
40490        SUR
40490   WA   OSF
40500        SUR
40510        SUR
40510   WA   OSF
40520        SUR
40520   WA   OSF
40720        SUR
40720   WA   OSF
40799        SUR
40810        SUR
40812        SUR
40812   WA   OSF
40814        SUR
40814   WA   OSF
40842        SUR
40899        SUR
41112   WA   OSF
41599        SUR
41805        SUR
41805   WA   OSF
41806        SUR
41823        SUR
41827        SUR
41827   WA   OSF
41828        SUR
41830        SUR
41874        SUR
41874   WA   OSF
41899        SUR
41899   WA   SUR
42106        SUR
42145        SUR
42145   WA   OSF
42210        SUR
42210   wa   SUR
42235        SUR
42235   WA   OSF
42299        SUR
42310        SUR
42330        SUR
42335        SUR
42335   WA   OSF
42410        SUR
42410   80   SUR
42410   WA   SUR
42440        SUR
42440   80   SUR
42440   WA   OSF
42450        SUR
42600        SUR
42699        SUR
42800        SUR
42804   WA   OSF
42821        SUR
42821   WA   OSF
42826        SUR
42826   WA   OSF
42830        SUR
42831   WA   OSF
42836        SUR
42836   WA   OSF
42960        SUR
42961        SUR
42962        SUR
42962   WA   OSF
42970        SUR
42999        SUR
43200        SUR
43200   51   SUR
43217        SUR
43217   WA   SUR
43220        SUR
43226        SUR
43226   WA   OSF
43235        SUR
43235   51   SUR
43235   59   SUR
43235   WA   OSF
43238        SUR
43239        SUR
43239   51   SUR
43239   WA   OSF
43245        SUR
43245   51   SUR
43245   WA   OSF
43246        SUR
43247        SUR
43247   WA   OSF
43249        SUR
43249   51   SUR
43249   WA   OSF
43255        SUR
43260        SUR
43260   WA   OSF
43262        SUR
43262   WA   OSF
43280        SUR
43280   WA   OSF
43450        SUR
43450   51   SUR
43450   WA   OSF
43499        SUR
43501   51   SUR
43501   80   SUR
43621        SUR
43659        SUR
43760   WA   OSF
43842        SUR
43842   80   SUR
43842   82   SUR
43846   22   SUR
43846   80   SUR
43870        SUR
43999        SUR
44005        SUR
44005   79   SUR
44015        SUR
44110        SUR
44120        SUR
44139        SUR
44140        SUR
44140   80   SUR
44143        SUR
44145        SUR
44147        SUR
44155        SUR
44160        SUR
44204        SUR
44205        SUR
44205   wa   SUR
44207        SUR
44207   80   SUR
44227        SUR
44227   wa   SUR
44310   51   SUR
44310   80   SUR
44320        SUR
44345        SUR
44345   WA   OSF
44361        SUR
44361   WA   OSF
44369        SUR
44369   WA   OSF
44388        SUR
44388   WA   OSF
44620        SUR
44620   80   SUR
44625        SUR
44625   80   SUR
44625   WA   OSF
44626        SUR
44626   79   SUR
44626   80   SUR
44626   81   SUR
44626   wa   SUR
44640        SUR
44799        SUR
44899        SUR
45020        SUR
45020   WA   OSF
45108        SUR
45108   WA   OSF
45123        SUR
45123   80   SUR
45300        SUR
45303        SUR
45305        SUR
45330        SUR
45330   WA   OSF
45331        SUR
45331   WA   OSF
45333        SUR
45355   WA   OSF
45378        SUR
45378   WA   OSF
45380        SUR
45380   52   SUR
45380   59   SUR
45380   WA   OSF
45383        SUR
45383   WA   OSF
45384        SUR
45384   51   SUR
45384   59   SUR
45384   WA   OSF
45385        SUR
45385   WA   OSF
45386        SUR
45395        SUR
45395   80   SUR
45505        SUR
45505   WA   OSF
45560        SUR
45999        SUR
46060        SUR
46060   WA   OSF
46083        SUR
46200        SUR
46200   WA   OSF
46255        SUR
46255   WA   OSF
46260        SUR
46260   WA   OSF
46261        SUR
46270   WA   OSF
46275        SUR
46280        SUR
46280   WA   OSF
46288        SUR
46288   WA   OSF
46600        SUR
46700        SUR
46700   WA   OSF
46900        SUR
46917        SUR
46917   WA   OSF
46924        SUR
46924   WA   OSF
46930   WA   OSF
46936   WA   OSF
46945        SUR
46945   WA   SUR
46999        SUR
47000        SUR
47000   WA   OSF
47001        SUR
47399        SUR
47525   WA   OSF
47562        SUR
47562   51   SUR
47562   80   SUR
47562   WA   OSF
47563        SUR
47563   80   SUR
47563   WA   OSF
47579   WA   SUR
47600        SUR
47600   51   SUR
47605        SUR
47605   51   SUR
47605   80   SUR
47610        SUR
47715        SUR
47999        SUR
48999        SUR
49000        SUR
49000   WA   OSF
49085   WA   OSF
49250        SUR
49255        SUR
49320        SUR
49320   51   SUR
49320   78   SUR
49320   80   SUR
49320   WA   OSF
49321   51   SUR
49322        SUR
49322   WA   OSF
49329        SUR
49505        SUR
49505   22   SUR
49505   50   SUR
49505   81   SUR
49505   WA   OSF
49507        SUR
49507   WA   OSF
49520        SUR
49520   50   SUR
49520   80   SUR
49520   AA   SUR
49520   WA   OSF
49525        SUR
49525   WA   OSF
49550        SUR
49550   WA   OSF
49560        SUR
49560   51   SUR
49560   80   SUR
49560   WA   OSF
49561        SUR
49561   80   SUR
49561   WA   OSF
49565        SUR
49565   WA   OSF
49566        SUR
49566   WA   OSF
49568        SUR
49568   80   SUR
49568   WA   OSF
49570        SUR
49570   WA   OSF
49572        SUR
49572   WA   SUR
49585        SUR
49585   51   SUR
49585   59   SUR
49585   WA   OSF
49587        SUR
49587   WA   OSF
49650        SUR
49650   WA   OSF
49653        SUR
49659        SUR
49659   WA   OSF
49900        SUR
49999        SUR
50080        SUR
50081        SUR
50081   wa   SUR
50220        SUR
50220   51   SUR
50220   WA   OSF
50230        SUR
50230   80   SUR
50236        SUR
50390        SUR
50392        SUR
50392   wa   SUR
50393        SUR
50393   wa   SUR
50546        SUR
50590        SUR
50590   WA   OSF
50684        SUR
51102        SUR
51600        SUR
51605        SUR
51610        SUR
51610   WA   OSF
51700        SUR
51701        SUR
51702        SUR
51725        SUR
51726        SUR
51726   26   SUR
51726   WA   OSF
51727        SUR
51727   WA   SUR
51729        SUR
51736        SUR
51741        SUR
51741   51   SUR
51784        SUR
51784   58   SUR
51785        SUR
51792        SUR
51797        SUR
51797   59   SUR
51798        SUR
51798   58   SUR
51840        SUR
51840   80   SUR
51845        SUR
51845   WA   OSF
51980        SUR
51980   51   SUR
51990        SUR
51990   51   SUR
52000        SUR
52000   51   SUR
52000   80   SUR
52000   WA   OSF
52005        SUR
52005   51   SUR
52005   59   SUR
52005   WA   OSF
52100   WA   OSF
52204        SUR
52204   WA   OSF
52214        SUR
52214   51   SUR
52224        SUR
52224   WA   OSF
52235        SUR
52235   WA   OSF
52240        SUR
52240   WA   OSF
52260        SUR
52260   WA   OSF
52270        SUR
52270   WA   OSF
52276        SUR
52276   80   AST
52276   WA   OSF
52281        SUR
52281   51   SUR
52281   WA   OSF
52283   51   SUR
52285        SUR
52285   WA   OSF
52310        SUR
52310   WA   OSF
52318        SUR
52318   51   SUR
52320        SUR
52320   WA   OSF
52330   WA   OSF
52332        SUR
52332   50   SUR
52332   51   SUR
52332   WA   OSF
52351        SUR
52351   wa   SUR
52352        SUR
52352   wa   SUR
52353        SUR
52353   WA   SUR
52500        SUR
52601        SUR
52601   WA   OSF
52640        SUR
52640   WA   OSF
53230        SUR
53601        SUR
53605        SUR
53660        SUR
53899        SUR
54161        SUR
54161   WA   OSF
54520   50   SUR
54530        SUR
54640        SUR
54640   WA   OSF
54840        SUR
54840   51   SUR
54860        SUR
54860   WA   OSF
55040        SUR
55040   WA   OSF
55060        SUR
55500        SUR
55500   wa   OHM
55520        SUR
55520   WA   OSF
55530        SUR
55540        SUR
55700        SUR
55845        SUR
55845   80   SUR
55845   82   AST
55899        SUR
56303        SUR
56303   WA   OSF
56304        SUR
56304   WA   OSF
56352   22   SUR
56405        SUR
56501        SUR
56501   51   SUR
56515        SUR
56605        SUR
56620        SUR
56740        SUR
56740   WA   OSF
56821        SUR
57061        SUR
57065        SUR
57065   51   SUR
57065   80   SUR
57100        SUR
57160        SUR
57180   WA   OSF
57210        SUR
57210   51   SUR
57240        SUR
57240   80   SUR
57250        SUR
57250   WA   OSF
57260        SUR
57260   51   SUR
57265        SUR
57267        SUR
57270        SUR
57280        SUR
57282        SUR
57283        SUR
57288        SUR
57288   51   SUR
57288   WA   SUR
57292        SUR
57410        SUR
57410   51   SUR
57452        SUR
57454        SUR
57460        SUR
57460   WA   OSF
57500        SUR
57510        SUR
57511        SUR
57520        SUR
57520   WA   OSF
57522        SUR
57522   51   SUR
57522   WA   OSF
58100        SUR
58120        SUR
58120   50   SUR
58120   51   SUR
58120   WA   OSF
58140        SUR
58140   80   SUR
58150        SUR
58150   51   SUR
58150   80   SUR
58150   82   SUR
58150   WA   OSF
58152        SUR
58152   80   SUR
58200        SUR
58200   80   SUR
58210        SUR
58260        SUR
58260   80   SUR
58260   WA   OSF
58262        SUR
58263        SUR
58267        SUR
58340        SUR
58340   WA   SUR
58350        SUR
58400        SUR
58545        SUR
58545   WA   OSF
58550        SUR
58550   80   SUR
58550   WA   OSF
58552        SUR
58552   80   SUR
58552   WA   OSF
58554        SUR
58554   80   SUR
58555        SUR
58558        SUR
58558   51   SUR
58558   WA   SUR
58563        SUR
58563   WA   OSF
58571        SUR
58571   wa   SUR
58660        SUR
58660   WA   OSF
58661        SUR
58661   WA   OSF
58662        SUR
58662   WA   OSF
58720        SUR
58720   80   SUR
58720   WA   OSF
58740        SUR
58925        SUR
58925   22   SUR
58925   62   SUR
58925   WA   OSF
58940        SUR
58951        SUR
58956        SUR
58956   51   SUR
58990        SUR
58999        SUR
59400        SUR
59510        SUR
59899        SUR
60100        SUR
60210   51   SUR
60220        SUR
60220   WA   OSF
60240        SUR
60240   80   SUR
60240   WA   SUR
60271        SUR
60271   80   SUR
60280        SUR
60280   WA   OSF
60500        SUR
60512        SUR
60520        SUR
60699        SUR
61055        SUR
61070        SUR
61070   58   SUR
61210        SUR
61330        SUR
61333        SUR
61343        SUR
61458        SUR
61458   80   SUR
61510        SUR
61512        SUR
61518        SUR
61518   WA   OSF
61520        SUR
61520   62   SUR
61521        SUR
61521   WA   OSF
61531        SUR
61548        SUR
61548   80   SUR
61548   WA   OSF
61583   51   SUR
61584        SUR
61584   51   SUR
61584   WA   OSF
61586        SUR
61586   51   SUR
61586   WA   OSF
61591        SUR
61595        SUR
61595   62   SUR
61595   80   SUR
61600        SUR
61600   51   SUR
61601        SUR
61605        SUR
61615        SUR
61615   62   SUR
61615   80   SUR
61618        SUR
61619   51   SUR
61624        SUR
61710        SUR
61710   80   SUR
61750        SUR
61770        SUR
61770   51   SUR
61885   51   SUR
62120        SUR
62121        SUR
62121   62   SUR
62140        SUR
62141        SUR
62143        SUR
62180        SUR
62223        SUR
62230        SUR
62230   WA   OSF
62256        SUR
62258   58   SUR
62270        SUR
62270   WA   OSF
62272        SUR
62273        SUR
62273   WA   OSF
62274   59   SUR
62284        SUR
62284   WA   OSF
62289   51   SUR
62290        SUR
62290   51   SUR
62290   WA   OSF
62291        SUR
62291   51   SUR
62291   WA   OSF
62310        INJ
62310   59   SUR
62310   WA   OSF
62311        SUR
62311   59   SUR
62311   WA   OSF
62318        SUR
62319        INJ
62319   59   SUR
62319   WA   OSF
62362   59   SUR
62626        SUR
63001        SUR
63001   80   SUR
63005        SUR
63012        SUR
63012   51   SUR
63012   62   SUR
63017        SUR
63020        SUR
63030        SUR
63030   50   SUR
63030   5059   SUR
63030   5079   SUR
63030   51     SUR
63030   59     SUR
63030   5980   SUR
63030   80     SUR
63030   WA     OSF
63035          SUR
63035   50     SUR
63035   5059   SUR
63035   5079   SUR
63035   51     SUR
63035   59     SUR
63035   80     SUR
63040          SUR
63042          SUR
63042   5059   SUR
63042   51     SUR
63042   80     SUR
63042   WA     OSF
63043          SUR
63044          SUR
63044   50     SUR
63044   80     SUR
63045          SUR
63047          SUR
63047   51     SUR
63047   5180   SUR
63047   59     SUR
63047   5979   SUR
63047   80     SUR
63047   WA     OSF
63048          SUR
63048   51     SUR
63048   59     SUR
63048   5979   SUR
63048   80     SUR
63056          SUR
63056   80     SUR
63064          SUR
63075          SUR
63075   51     SUR
63075   59     SUR
63075   79     SUR
63075   80     SUR
63076          SUR
63076   51     SUR
63076   79     SUR
63076   80     SUR
63077          SUR
63078          SUR
63081          SUR
63081   51     SUR
63081   80     SUR
63081   WA     OSF
63082        SUR
63082   51   SUR
63172        SUR
63200        SUR
63271        SUR
63272        SUR
63272   82   SUR
63277        SUR
63290        SUR
63650        SUR
63650   51   SUR
63650   58   SUR
63650   WA   OSF
63655        SUR
63655   WA   OSF
63660   WA   OSF
63685        SUR
63685   51   SUR
63685   58   SUR
63685   WA   OSF
63688        SUR
63688   51   SUR
63688   58   SUR
63688   WA   OSF
63706        SUR
63740        SUR
64400        INJ
64405        INJ
64405   WA   OSF
64413        SUR
64415        INJ
64415   55   SUR
64415   59   SUR
64417        INJ
64420        SUR
64421        SUR
64421   WA   OSF
64425        SUR
64425   50   SUR
64425   59   SUR
64435        SUR
64442   51   SUR
64445        SUR
64445   51   INJ
64447        INJ
64447   59   SUR
64448        SUR
64450        SUR
64450   51   SUR
64450   59   SUR
64470        SUR
64470   WA   OSF
64472        SUR
64475        SUR
64475   WA   OSF
64476        SUR
64479        SUR
64480        SUR
64483        SUR
64483   50   INJ
64483   WA   OSF
64484        SUR
64484   51   SUR
64493        SUR
64494        SUR
64495        SUR
64510        SUR
64510   WA   OSF
64520        SUR
64520   WA   OSF
64550        SUR
64550   wa   OSF
64612        SUR
64612   50   SUR
64612   51   SUR
64613        SUR
64622        SUR
64622   WA   OSF
64623        SUR
64626        SUR
64627        SUR
64640        SUR
64704        SUR
64708        SUR
64708   WA   OSF
64718        SUR
64718   51   SUR
64718   59   SUR
64718   79   SUR
64718   80   SUR
64718   82   SUR
64718   WA   OSF
64719        SUR
64719   WA   OSF
64721        SUR
64721   50   SUR
64721   51   SUR
64721   59   SUR
64721   79   SUR
64721   80   SUR
64721   WA   OSF
64722        SUR
64722   WA   OSF
64727        SUR
64727   WA   OSF
64750   WA   OSF
64761        SUR
64774        SUR
64774   51   SUR
64774   WA   OSF
64784        SUR
64784   51   SUR
64790        SUR
64790   80   SUR
64790   WA   OSF
64818        SUR
64831   51   SUR
64834   51   SUR
64835   59   SUR
64836        SUR
64856        SUR
64857        SUR
64868        SUR
64999        SUR
65091        SUR
65091   WA   OSF
65093        SUR
65093   WA   OSF
65101        SUR
65101   WA   SUR
65103        SUR
65103   WA   OSF
65105        SUR
65105   WA   OSF
65110        SUR
65110   WA   OSF
65112        SUR
65125        SUR
65130        SUR
65130   WA   OSF
65140        SUR
65140   WA   OSF
65155        SUR
65155   WA   OSF
65175        SUR
65175   WA   OSF
65210        SUR
65220        SUR
65222        SUR
65235        SUR
65235   WA   OSF
65260   51   SUR
65265   51   SUR
65280        SUR
65280   WA   OSF
65285        SUR
65285   WA   SUR
65286        SUR
65286   78   SUR
65286   79   SUR
65400        SUR
65400   51   SUR
65400   WA   OSF
65420        SUR
65420   50   SUR
65420   WA   OSF
65426        SUR
65426   51   SUR
65426   82   SUR
65426   WA   OSF
65430        SUR
65430   79   SUR
65435        SUR
65435   51   SUR
65436        SUR
65600        SUR
65710        SUR
65710   82   SUR
65710   WA   OSF
65730        SUR
65730   80   SUR
65730   82   SUR
65730   WA   OSF
65750        SUR
65750   80   SUR
65750   WA   OSF
65755        SUR
65755   82   SUR
65755   WA   OSF
65756        SUR
65756   WA   SUR
65760        SUR
65772        SUR
65772   WA   OSF
65775        SUR
65780        SUR
65780   51   SUR
65780   82   SUR
65780   WA   OSF
65782        SUR
65782   82   SUR
65800        SUR
65800   51   SUR
65800   WA   OSF
65805        SUR
65805   50   SUR
65805   51   SUR
65805   WA   OSF
65810        SUR
65810   WA   OSF
65815        SUR
65815   51   SUR
65815   WA   OSF
65850        SUR
65850   WA   OSF
65855        SUR
65855   50   SUR
65855   55   SUR
65855   WA   OSF
65860        SUR
65860   WA   OSF
65865        SUR
65865   WA   OSF
65870        SUR
65870   51   SUR
65870   WA   OSF
65875        SUR
65875   51   SUR
65875   WA   OSF
65920        SUR
65920   51   SUR
65920   WA   OSF
65930   WA   OSF
66020   WA   OSF
66030   WA   OSF
66150   WA   OSF
66155   WA   OSF
66160   WA   OSF
66170        SUR
66170   50   SUR
66170   51   SUR
66170   59   SUR
66170   82   SUR
66170   WA   OSF
66172        SUR
66172   80   SUR
66172   82   SUR
66172   WA   OSF
66180        SUR
66180   51   SUR
66180   80   SUR
66180   82   SUR
66180   WA   OSF
66185        SUR
66185   51   SUR
66185   82   SUR
66185   WA   OSF
66250        SUR
66250   78   SUR
66250   79   SUR
66250   WA   OSF
66600   WA   OSF
66605        SUR
66625        SUR
66625   51   SUR
66625   WA   OSF
66680        SUR
66682        SUR
66682   51   EYE
66682   WA   OSF
66710        SUR
66710   WA   OSF
66711        SUR
66720        SUR
66720   WA   OSF
66761          SUR
66761   51     SUR
66761   WA     OSF
66762          SUR
66770          SUR
66820          SUR
66820   WA     OSF
66821          SUR
66821   50     SUR
66821   54     SUR
66821   55     SUR
66821   79     SUR
66821   WA     OSF
66825          SUR
66825   51     SUR
66825   54     SUR
66825   55     SUR
66825   WA     OSF
66830          SUR
66830   WA     OSF
66840          SUR
66840   51     SUR
66840   WA     OSF
66850          SUR
66850   51     SUR
66850   62     SUR
66850   WA     OSF
66852          SUR
66852   51     SUR
66852   WA     OSF
66920          SUR
66920   WA     OSF
66940          SUR
66940   WA     OSF
66982          SUR
66982   51     SUR
66982   54     SUR
66982   5479   SUR
66982   55     SUR
66982   5579   SUR
66982   79     SUR
66982   WA     OSF
66984          SUR
66984   51     SUR
66984   54     SUR
66984   5479   SUR
66984   55     SUR
66984   5579   SUR
66984   58     SUR
66984   59     SUR
66984   74     SUR
66984   79     SUR
66984   WA     OSF
66985          SUR
66985   51     SUR
66985   54     SUR
66985   55     SUR
66985   62     SUR
66985   79     SUR
66985   WA     OSF
66986          SUR
66986   55     SUR
66986   WA     OSF
66999          SUR
66999   WA     OSF
67005          SUR
67005   51     SUR
67005   WA     OSF
67010          SUR
67010   51     SUR
67010   WA     OSF
67015          SUR
67015   WA     OSF
67025          SUR
67025   51     SUR
67028          SUR
67028   50     SUR
67028   51     SUR
67028   59     SUR
67028   79     SUR
67028   WA     OSF
67031          SUR
67031   WA     OSF
67036          SUR
67036   51     SUR
67036   62     SUR
67036   79     SUR
67036   WA     OSF
67039          SUR
67039   51     SUR
67039   WA     OSF
67040          SUR
67040   51     SUR
67040   59     SUR
67040   79     SUR
67040   WA     OSF
67041          SUR
67041   51     SUR
67041   5179   SUR
67041   WA     OSF
67042          SUR
67042   WA     SUR
67043          SUR
67043   WA     SUR
67101          SUR
67101   51     SUR
67105          SUR
67105   WA     OSF
67107          SUR
67107   51     SUR
67107   WA   OSF
67108        SUR
67108   51   EYE
67108   76   SUR
67108   78   SUR
67108   79   SUR
67108   WA   OSF
67110        SUR
67110   51   SUR
67110   WA   OSF
67112        SUR
67112   51   SUR
67112   WA   OSF
67113        SUR
67113   79   SUR
67113   WA   OSF
67115        SUR
67115   WA   OSF
67120        SUR
67120   51   SUR
67120   WA   OSF
67121        SUR
67121   51   SUR
67121   58   SUR
67121   81   SUR
67121   WA   OSF
67141        SUR
67141   51   SUR
67141   59   SUR
67141   WA   OSF
67145        SUR
67145   51   SUR
67208        SUR
67208   WA   OSF
67210        SUR
67210   51   SUR
67210   79   SUR
67210   WA   OSF
67218        SUR
67220        SUR
67221        SUR
67221   50   SUR
67221   79   SUR
67225        SUR
67227        SUR
67227   WA   OSF
67228        SUR
67228   50   SUR
67228   51   SUR
67228   58   SUR
67228   79   SUR
67228   WA   OSF
67255        SUR
67255   51   SUR
67255   55   SUR
67255   79   SUR
67255   82   SUR
67255   WA   OSF
67299        SUR
67311        SUR
67311   50   SUR
67311   51   SUR
67311   WA   OSF
67312        SUR
67312   50   SUR
67312   51   SUR
67312   WA   OSF
67314        SUR
67314   50   SUR
67314   51   SUR
67314   WA   OSF
67316        SUR
67316   WA   OSF
67318        SUR
67318   WA   OSF
67320   WA   OSF
67331   51   SUR
67332        SUR
67332   50   SUR
67332   51   SUR
67332   WA   OSF
67334        SUR
67335        SUR
67335   51   SUR
67335   WA   OSF
67340        SUR
67340   50   SUR
67340   51   SUR
67340   WA   OSF
67343        SUR
67343   51   SUR
67399        SUR
67400        SUR
67400   WA   OSF
67412        SUR
67412   WA   OSF
67413        SUR
67413   51   SUR
67413   WA   OSF
67414        SUR
67414   51   SUR
67414   WA   OSF
67420        SUR
67420   WA   OSF
67445        SUR
67445   WA   OSF
67450        SUR
67450   51   SUR
67500        SUR
67500   WA   OSF
67505        SUR
67515        SUR
67515   51   SUR
67550        SUR
67550   WA   OSF
67560        SUR
67560   WA   OSF
67570        SUR
67599        SUR
67599   51   SUR
67710        SUR
67715   WA   OSF
67800        SUR
67801        SUR
67805        SUR
67810        SUR
67820        SUR
67820   50   SUR
67820   51   SUR
67825        SUR
67825   WA   OSF
67840        SUR
67850        SUR
67875        SUR
67875   51   SUR
67880        SUR
67880   50   SUR
67880   WA   OSF
67882        SUR
67882   WA   OSF
67900        SUR
67900   50   SUR
67900   51   SUR
67900   WA   OSF
67901        SUR
67901   76   SUR
67901   WA   OSF
67902        SUR
67902   WA   OSF
67903        SUR
67904        SUR
67904   50   SUR
67904   51   SUR
67904   WA   OSF
67908        SUR
67908   50   SUR
67908   WA   OSF
67911        SUR
67911   50   SUR
67911   WA   OSF
67912        SUR
67912   WA   OSF
67916        SUR
67916   WA   OSF
67917        SUR
67917   50   SUR
67917   51   SUR
67917   WA   OSF
67921        SUR
67921   WA   OSF
67923        SUR
67923   WA   OSF
67924        SUR
67924   51   SUR
67924   WA   OSF
67938   51   SUR
67950        SUR
67950   51   SUR
67961        SUR
67961   51   SUR
67961   WA   OSF
67966        SUR
67966   WA   OSF
67971        SUR
67971   WA   OSF
67973        SUR
67974   WA   OSF
67975        SUR
67975   WA   OSF
67999        SUR
67999   wa   SUR
68020        SUR
68020   WA   OSF
68100        SUR
68100   WA   SUR
68110        SUR
68110   WA   OSF
68115        SUR
68115   WA   OSF
68200        SUR
68200   78   SUR
68320        SUR
68320   51   SUR
68320   WA   OSF
68326        SUR
68326   51   SUR
68326   WA   OSF
68328        SUR
68328   WA   OSF
68330        SUR
68330   WA   OSF
68335        SUR
68340        SUR
68362        SUR
68362   WA   OSF
68399        SUR
68399   51   SUR
68440   51   SUR
68530        SUR
68540        SUR
68540   WA   OSF
68700        SUR
68700   WA   OSF
68720        SUR
68720   WA   OSF
68760        SUR
68761        SUR
68761   50   SUR
68761   51   SUR
68761   E2   SUR
68761   E4   SUR
68801        SUR
68801   51   SUR
68801   WA   OSF
68811        SUR
68815        SUR
68815   51   SUR
68840        SUR
68840   WA   OSF
68899        SUR
69105        SUR
69145        SUR
69145   WA   OSF
69200        SUR
69205        SUR
69205   WA   OSF
69210        SUR
69210   50   SUR
69220        SUR
69222        SUR
69222   WA   OSF
69310        SUR
69320        SUR
69320   WA   OSF
69399        SUR
69401        SUR
69420        SUR
69420   WA   OSF
69421   WA   OSF
69424        SUR
69433        SUR
69433   50   SUR
69436        SUR
69436   50   SUR
69436   51   SUR
69436   WA   OSF
69440        SUR
69440   WA   OSF
69450        SUR
69450   59   SUR
69501   51   SUR
69501   62   SUR
69502        SUR
69502   WA   OSF
69505        SUR
69505   WA   OSF
69511        SUR
69511   WA   OSF
69550        SUR
69602        SUR
69602   WA   OSF
69610        SUR
69620        SUR
69620   WA   OSF
69631        SUR
69631   79   SUR
69631   WA   OSF
69632        SUR
69632   WA   OSF
69633        SUR
69633   WA   OSF
69635        SUR
69635   WA   OSF
69636        SUR
69636   WA   OSF
69637        SUR
69637   WA   OSF
69641        SUR
69641   51   SUR
69641   WA   OSF
69642        SUR
69642   WA   OSF
69643        SUR
69643   51   SUR
69643   80   AST
69643   WA   OSF
69644        SUR
69644   WA   OSF
69645        SUR
69645   WA   OSF
69646        SUR
69646   WA   OSF
69650        SUR
69660        SUR
69660   WA   OSF
69661        SUR
69661   WA   OSF
69662        SUR
69662   WA   OSF
69666        SUR
69667        SUR
69667   WA   OSF
69710        SUR
69710   WA   OSF
69714        SUR
69714   50   SUR
69714   51   SUR
69715   51   SUR
69799        SUR
69910        SUR
69930        SUR
69930   51   SUR
69930   WA   OSF
69949        SUR
69970        SUR
69979        SUR
69990        SUR
70010        XRY
70010   TC   XRY
70030        XRY
70030   26   XRY
70030   TC   XRY
70100        XRY
70100   TC   XRY
70110        XRY
70110   26   XRY
70110   TC   XRY
70130        XRY
70130   26   XRY
70130   TC   XRY
70140        XRY
70140   26   XRY
70140   TC   XRY
70150   26   XRY
70160        XRY
70160   TC   XRY
70190        XRY
70190   TC   XRY
70200        XRY
70200   26   XRY
70200   TC   XRY
70210        XRY
70210   26   XRY
70210   TC   XRY
70220        XRY
70220   26   XRY
70220   TC   XRY
70250        XRY
70250   26   XRY
70250   TC   XRY
70260        XRY
70260   26   XRY
70260   TC   XRY
70300        XRY
70300   TC   XRY
70320        XRY
70320   TC   XRY
70328        XRY
70328   TC   XRY
70330        XRY
70330   26   XRY
70332        XRY
70332   26   XRY
70332   TC   XRY
70336        XRY
70336   26   XRY
70336   TC   XRY
70350        XRY
70350   76   XRY
70350   TC   XRY
70355        XRY
70355   26   XRY
70355   TC   XRY
70360        XRY
70360   26   XRY
70360   TC   XRY
70450        XRY
70450   26   XRY
70450   TC   XRY
70460        XRY
70460   26   XRY
70460   TC   XRY
70470        XRY
70470   26   XRY
70470   TC   XRY
70480        XRY
70480   26   XRY
70480   TC   XRY
70481        XRY
70481   26   XRY
70481   TC   XRY
70482        XRY
70482   26   XRY
70482   TC   XRY
70486        XRY
70486   26   XRY
70486   TC   XRY
70487        XRY
70487   26   XRY
70487   TC   XRY
70488        XRY
70488   26   XRY
70488   TC   XRY
70490        XRY
70490   26   XRY
70490   TC   XRY
70491        XRY
70491   26   XRY
70491   TC   XRY
70492        XRY
70492   26   XRY
70492   TC   XRY
70496        XRY
70496   TC   XRY
70498        XRY
70498   26   XRY
70498   TC   XRY
70540        XRY
70540   26   XRY
70540   TC   XRY
70542        XRY
70543        XRY
70543   26   XRY
70543   TC   XRY
70544        XRY
70544   26   XRY
70544   TC   XRY
70545        XRY
70545   26   XRY
70545   TC   XRY
70546        XRY
70546   26   XRY
70546   TC   XRY
70547        XRY
70548        XRY
70549        XRY
70551        XRY
70551   26   XRY
70551   TC   XRY
70552        XRY
70552   26   XRY
70552   TC   XRY
70553        XRY
70553   26   XRY
70553   50   RAD
70553   TC   XRY
70559   26   XRY
70559   TC   XRY
71010        RAD
71010   26   XRY
71010   TC   XRY
71015        RAD
71015   TC   XRY
71020        RAD
71020   26   XRY
71020   TC   XRY
71021        XRY
71021   26   XRY
71021   TC   XRY
71022        XRY
71022   TC   XRY
71023   26   XRY
71023   TC   XRY
71030        XRY
71030   TC   XRY
71034        XRY
71035        XRY
71035   26   XRY
71035   TC   XRY
71090   26   XRY
71100        XRY
71100   26   XRY
71100   TC   XRY
71101        XRY
71101   26   XRY
71101   TC   XRY
71110        XRY
71110   26   XRY
71110   TC   XRY
71111   26   XRY
71111   TC   XRY
71120        XRY
71120   TC   XRY
71250   26   XRY
71250   TC   XRY
71260        XRY
71260   26   XRY
71260   TC   XRY
71270        XRY
71270   26   XRY
71270   TC   XRY
71275        XRY
71275   TC   XRY
71550        XRY
71552        XRY
71555        XRY
72010        XRY
72010   TC   XRY
72020        XRY
72020   26   XRY
72020   TC   XRY
72040        XRY
72040   26   XRY
72040   TC   XRY
72050        XRY
72050   26   XRY
72050   TC   XRY
72052        XRY
72052   26   XRY
72052   TC   XRY
72069        XRY
72069   26   XRY
72070        XRY
72070   26   XRY
72070   TC   XRY
72072        XRY
72072   26   XRY
72072   TC   XRY
72074        XRY
72074   26   XRY
72074   TC   XRY
72080        XRY
72080   26   XRY
72080   TC   XRY
72090        XRY
72090   26   XRY
72090   TC   XRY
72100        XRY
72100   26   XRY
72100   TC   XRY
72110          XRY
72110   26     XRY
72110   50     XRY
72110   TC     XRY
72114          XRY
72114   26     XRY
72114   TC     XRY
72120          XRY
72120   26     XRY
72120   TC     XRY
72125          XRY
72125   26     XRY
72125   TC     XRY
72126          XRY
72126   26     XRY
72126   TC     XRY
72127          XRY
72127   26     XRY
72127   TC     XRY
72128          XRY
72128   26     XRY
72128   TC     XRY
72129          XRY
72129   26     XRY
72130          XRY
72130   26     XRY
72130   TC     XRY
72131          XRY
72131   26     XRY
72131   TC     XRY
72132          XRY
72132   26     XRY
72132   TC     XRY
72133          XRY
72133   26     XRY
72133   TC     XRY
72141          XRY
72141   26     XRY
72141   TC     XRY
72142          XRY
72142   26     XRY
72142   TC     XRY
72146          XRY
72146   26     XRY
72146   TC     XRY
72146   TC50   XRY
72147          XRY
72148          XRY
72148   26     XRY
72148   TC     XRY
72149          XRY
72149   26     XRY
72149   TC     XRY
72156          XRY
72156   26     XRY
72156   TC     XRY
72157          XRY
72157   26     XRY
72157   TC     XRY
72158          XRY
72158   26     XRY
72158   TC     XRY
72159          XRY
72170          XRY
72170   26     XRY
72170   77     XRY
72170   TC     XRY
72190          XRY
72190   26     XRY
72190   TC     XRY
72191          XRY
72191   26     XRY
72191   TC     XRY
72192          XRY
72192   26     XRY
72192   TC     XRY
72193          XRY
72193   26     XRY
72193   TC     XRY
72194          XRY
72194   26     XRY
72194   TC     XRY
72195          XRY
72195   26     XRY
72195   TC     XRY
72196          XRY
72196   26     XRY
72196   TC     XRY
72197          XRY
72198   TC     XRY
72200          XRY
72200   26     XRY
72200   TC     XRY
72202          XRY
72202   TC     XRY
72220          XRY
72220   26     XRY
72220   TC     XRY
72240          XRY
72240   26     XRY
72240   TC     XRY
72255          XRY
72255   26     XRY
72255   TC     XRY
72265          XRY
72265   26     XRY
72265   2652   XRY
72265   52     XRY
72265   TC     XRY
72270          XRY
72270   26   XRY
72270   TC   XRY
72275        XRY
72275   26   XRY
72285        XRY
72285   26   XRY
72285   58   XRY
72285   59   XRY
72285   TC   XRY
72295        XRY
72295   26   XRY
72295   51   XRY
72295   TC   XRY
73000        XRY
73000   26   XRY
73000   TC   XRY
73010        XRY
73010   26   XRY
73010   TC   XRY
73014   0    XRY
73020        XRY
73020   26   XRY
73020   59   XRY
73020   TC   XRY
73030        XRY
73030   26   XRY
73030   50   XRY
73030   59   XRY
73030   TC   XRY
73040        XRY
73040   26   XRY
73040   TC   XRY
73050        XRY
73050   26   XRY
73050   TC   XRY
73060        XRY
73060   26   XRY
73060   TC   XRY
73070        XRY
73070   26   XRY
73070   50   XRY
73070   TC   XRY
73080        XRY
73080   26   XRY
73080   50   XRY
73080   TC   XRY
73090        XRY
73090   26   XRY
73090   TC   XRY
73100        XRY
73100   26   XRY
73100   50   XRY
73100   59   XRY
73100   TC   XRY
73110        XRY
73110   26     XRY
73110   50     XRY
73110   TC     XRY
73115          XRY
73115   TC     XRY
73120          XRY
73120   26     XRY
73120   50     XRY
73120   TC     XRY
73130          XRY
73130   26     XRY
73130   50     XRY
73130   TC     XRY
73140          XRY
73140   26     XRY
73140   50     XRY
73140   TC     XRY
73200          XRY
73200   26     XRY
73200   TC     XRY
73202          XRY
73202   TC     XRY
73212   650    XRY
73218          XRY
73218   26     XRY
73218   TC     XRY
73220          XRY
73220   26     XRY
73220   TC     XRY
73221          XRY
73221   26     XRY
73221   TC     XRY
73222          XRY
73222   26     XRY
73223          XRY
73223   26     XRY
73223   TC     XRY
73320          XRY
73500          XRY
73500   26     XRY
73500   2676   XRY
73500   50     XRY
73500   TC     XRY
73510          XRY
73510   26     XRY
73510   50     XRY
73510   80     XRY
73510   TC     XRY
73520          XRY
73520   26     XRY
73520   50     XRY
73520   TC     XRY
73525   26     XRY
73525   TC     XRY
73530          XRY
73530   26     XRY
73540          XRY
73540   TC     XRY
73542   59     XRY
73550          XRY
73550   26     XRY
73550   TC     XRY
73560          XRY
73560   26     XRY
73560   50     XRY
73560   59     XRY
73560   TC     XRY
73562          XRY
73562   26     XRY
73562   50     XRY
73562   5026   XRY
73562   TC     XRY
73564          XRY
73564   26     XRY
73564   50     XRY
73564   TC     XRY
73565          XRY
73565   26     XRY
73565   TC     XRY
73590          XRY
73590   26     XRY
73590   50     XRY
73590   59     XRY
73590   TC     XRY
73600          XRY
73600   26     XRY
73600   50     XRY
73600   TC     XRY
73610          XRY
73610   26     XRY
73610   50     XRY
73610   5026   XRY
73610   TC     XRY
73620          XRY
73620   26     XRY
73620   50     XRY
73620   59     XRY
73620   TC     XRY
73630          XRY
73630   26     XRY
73630   50     XRY
73630   TC     XRY
73650          XRY
73650   26     XRY
73650   TC     XRY
73660          XRY
73660   26     XRY
73660   TC     XRY
73700          XRY
73700   26     XRY
73700   TC     XRY
73701          XRY
73701   26     XRY
73701   TC     XRY
73706   26     XRY
73706   50     XRY
73706   TC     XRY
73718          XRY
73718   26     XRY
73718   TC     XRY
73720          XRY
73720   26     XRY
73720   TC     XRY
73721          XRY
73721   26     XRY
73721   2650   XRY
73721   50     XRY
73721   59     XRY
73721   TC     XRY
73721   TC50   XRY
73722          XRY
73722   26     XRY
73722   TC     XRY
73723          XRY
73723   26     XRY
73723   TC     XRY
73725          XRY
73725   TC     XRY
74000          XRY
74000   26     XRY
74000   TC     XRY
74010          XRY
74010   26     XRY
74010   TC     XRY
74020          XRY
74020   26     XRY
74020   TC     XRY
74022          XRY
74022   26     XRY
74022   TC     XRY
74150          XRY
74150   26     XRY
74150   TC     XRY
74160          XRY
74160   26     XRY
74160   TC     XRY
74170          XRY
74170   26     XRY
74170   TC     XRY
74175          XRY
74175   26     XRY
74175   TC     XRY
74176   26     XRY
74176   tc     XRY
74177   26     XRY
74178        XRY
74181        XRY
74181   26   XRY
74181   TC   XRY
74182        XRY
74183        XRY
74183   26   XRY
74183   TC   XRY
74185        XRY
74185   26   XRY
74185   TC   XRY
74220        XRY
74220   26   XRY
74220   TC   XRY
74230        XRY
74230   26   XRY
74230   TC   XRY
74240        XRY
74240   26   XRY
74240   TC   XRY
74241        XRY
74241   26   XRY
74241   TC   XRY
74245        XRY
74245   26   XRY
74245   TC   XRY
74246        XRY
74246   26   XRY
74246   TC   XRY
74247        XRY
74247   26   XRY
74247   TC   XRY
74249        XRY
74249   26   XRY
74250        XRY
74250   26   XRY
74250   TC   XRY
74270        XRY
74270   26   XRY
74270   TC   XRY
74280        XRY
74280   26   XRY
74280   TC   XRY
74291        XRY
74291   26   XRY
74291   TC   XRY
74300        XRY
74300   26   XRY
74300   52   XRY
74300   TC   XRY
74328   26   MED
74330        XRY
74330   26   XRY
74330   TC   XRY
74400        XRY
74400   26   XRY
74400   TC   XRY
74410        XRY
74410   26   XRY
74410   TC   XRY
74415        XRY
74415   26   XRY
74415   TC   XRY
74420        XRY
74420   26   XRY
74420   TC   XRY
74430   26   XRY
74455        XRY
74455   26   XRY
74455   TC   XRY
74456   TC   XRY
75605   26   XRY
75625        XRY
75625   26   XRY
75630        XRY
75630   26   XRY
75630   TC   XRY
75635        XRY
75635   26   XRY
75635   TC   XRY
75650        XRY
75650   26   XRY
75657        XRY
75657   TC   XRY
75660   26   XRY
75662        XRY
75662   26   XRY
75665        XRY
75665   26   XRY
75671        XRY
75671   26   XRY
75671   TC   XRY
75676   26   XRY
75676   TC   XRY
75680        XRY
75680   26   XRY
75680   TC   XRY
75685        XRY
75685   26   XRY
75685   76   XRY
75685   TC   XRY
75710   26   XRY
75716        XRY
75716   26   XRY
75716   TC   XRY
75724   TC   XRY
75774        XRY
75774   26   XRY
75774   TC   XRY
75809        XRY
75809   26   XRY
75809   TC   XRY
75820        XRY
75820   26   XRY
75820   TC   XRY
75822   26   XRY
75827   26   XRY
75833        XRY
75833   26   XRY
75880        XRY
75893        XRY
75893   26   XRY
75894        XRY
75894   26   XRY
75896   26   XRY
75898   26   XRY
75940   26   XRY
75966   26   XRY
75970        XRY
75970   26   XRY
76000        XRY
76000   26   XRY
76000   TC   XRY
76001        XRY
76001   26   XRY
76001   TC   XRY
76005   TC   XRY
76080        XRY
76080   26   XRY
76080   TC   XRY
76082   26   XRY
76082   TC   XRY
76098        XRY
76098   26   XRY
76098   TC   XRY
76100        XRY
76100   26   XRY
76100   TC   XRY
76101   26   XRY
76140        XRY
76140   TC   XRY
76376        XRY
76376   26   XRY
76376   TC   XRY
76377   26   XRY
76377   TC   XRY
76380        XRY
76380   26   XRY
76380   TC   XRY
76390        XRY
76499        XRY
76499   TC   XRY
76506        XRY
76506   TC   XRY
76511        XRY
76511   TC     XRY
76512          XRY
76512   26     XRY
76512   50TC   XRY
76512   TC     XRY
76514          XRY
76516          XRY
76516   TC     XRY
76519          XRY
76519   26     XRY
76519   79     XRY
76519   TC     XRY
76536          XRY
76536   26     XRY
76536   TC     XRY
76645          XRY
76645   26     XRY
76645   TC     XRY
76700          XRY
76700   26     XRY
76700   TC     XRY
76705          XRY
76705   26     XRY
76705   TC     XRY
76770          XRY
76770   26     XRY
76770   TC     XRY
76775          XRY
76775   26     XRY
76775   TC     XRY
76778          XRY
76778   TC     XRY
76805          XRY
76805   26     XRY
76805   TC     XRY
76830          XRY
76830   26     XRY
76830   51     XRY
76830   TC     XRY
76831          XRY
76831   26     XRY
76831   51     XRY
76831   TC     XRY
76856          XRY
76856   26     XRY
76856   TC     XRY
76857          XRY
76857   26     XRY
76857   tc     XRY
76870          XRY
76870   26     XRY
76870   TC     XRY
76872          XRY
76872   26     XRY
76872   TC     XRY
76925   26   XRY
76942        XRY
76942   26   XRY
76942   TC   XRY
76975        XRY
76975   TC   XRY
76977        XRY
76986        XRY
76998   26   XRY
76998   TC   XRY
76999        XRY
76999   TC   XRY
77002        XRY
77003        XRY
77003   26   XRY
77003   TC   XRY
77012        XRY
77052   26   XRY
77055        XRY
77056        XRY
77056   26   XRY
77056   TC   XRY
77057        XRY
77057   26   XRY
77057   TC   XRY
77073        XRY
77073   26   XRY
77073   TC   XRY
77079        XRY
77080   TC   XRY
77261        RAD
77261   TC   RAD
77263        RAD
77280        RAD
77280   TC   RAD
77290        RAD
77290   26   RAD
77290   TC   RAD
77295        RAD
77295   26   RAD
77295   TC   RAD
77299        RAD
77299   26   RAD
77299   TC   RAD
77300        RAD
77300   26   RAD
77300   TC   RAD
77310        RAD
77310   TC   RAD
77315        RAD
77315   26   RAD
77315   TC   RAD
77321        RAD
77321   26   RAD
77326   26   RAD
77331        RAD
77331   26   RAD
77332        RAD
77332   26   RAD
77334        RAD
77334   26   RAD
77334   TC   RAD
77336        RAD
77336   TC   RAD
77370        RAD
77399        RAD
77399   26   RAD
77399   TC   RAD
77401        RAD
77403        RAD
77411        RAD
77412        XRY
77413        RAD
77414        RAD
77416        RAD
77416   TC   RAD
77417        RAD
77427        RAD
77431        RAD
77431   26   RAD
77432        RAD
77470        RAD
77470   26   RAD
77499        RAD
77499   26   RAD
77499   TC   RAD
77761   26   RAD
77789        RAD
77789   TC   RAD
77790        RAD
77790   26   RAD
77790   TC   RAD
77799        RAD
77799   26   RAD
77799   TC   RAD
78000        RAD
78000   26   RAD
78000   TC   RAD
78001        RAD
78001   26   RAD
78003   26   RAD
78006        RAD
78006   26   RAD
78006   TC   RAD
78007        RAD
78007   26   RAD
78007   TC   RAD
78010        RAD
78010   26   RAD
78010   TC   RAD
78015   26   RAD
78070   26   RAD
78099        RAD
78099   26   RAD
78099   TC   RAD
78102   26   RAD
78103        RAD
78104        RAD
78104   TC   RAD
78192   26   RAD
78193   TC   RAD
78195   26   XRY
78199        RAD
78199   26   RAD
78199   TC   RAD
78201   26   RAD
78215        RAD
78215   TC   RAD
78220        RAD
78220   26   RAD
78223        RAD
78223   26   RAD
78223   TC   RAD
78264        RAD
78299        RAD
78299   26   RAD
78299   TC   RAD
78300        RAD
78300   26   RAD
78300   TC   RAD
78305        RAD
78305   26   RAD
78305   TC   RAD
78306        RAD
78306   26   RAD
78306   TC   RAD
78315        RAD
78315   26   RAD
78315   TC   RAD
78320   26   RAD
78350        XRY
78399        RAD
78399   26   RAD
78399   TC   RAD
78445        RAD
78445   26   RAD
78445   TC   RAD
78451        XRY
78452        XRY
78452   26   XRY
78452   TC   XRY
78453        XRY
78454        XRY
78460        RAD
78461        RAD
78461   26   RAD
78461   TC   RAD
78464        RAD
78464   26   RAD
78465        RAD
78465   26   RAD
78465   TC   RAD
78472        RAD
78472   26   RAD
78472   TC   RAD
78473        RAD
78478        RAD
78478   26   RAD
78478   TC   RAD
78480        RAD
78480   26   RAD
78480   TC   RAD
78483        RAD
78483   TC   RAD
78494        RAD
78499        RAD
78499   26   RAD
78499   TC   RAD
78580   26   RAD
78585   26   RAD
78587   26   RAD
78596        RAD
78596   TC   RAD
78599        RAD
78599   26   RAD
78599   TC   RAD
78601        RAD
78601   26   RAD
78601   TC   RAD
78607        RAD
78607   26   RAD
78645   26   RAD
78650        RAD
78699        RAD
78699   26   RAD
78699   TC   RAD
78700        RAD
78700   TC   RAD
78704        RAD
78704   TC   RAD
78707   26   RAD
78707   TC   RAD
78708        RAD
78708   26   RAD
78708   TC   RAD
78710        RAD
78710   26   RAD
78710   TC   RAD
78715   TC   RAD
78725   26   RAD
78725   TC   RAD
78730   26   RAD
78740   26   RAD
78799        RAD
78799   26   RAD
78799   TC   RAD
78802        RAD
78805        XRY
78805   26   RAD
78805   TC   XRY
78806        RAD
78806   26   RAD
78806   TC   RAD
78815        XRY
78815   26   XRY
78815   TC   XRY
78816        XRY
78999        RAD
78999   26   RAD
78999   TC   RAD
79000        RAD
79000   26   RAD
79000   TC   RAD
79005        XRY
79005   26   XRY
79005   TC   XRY
79101        XRY
79999        RAD
79999   TC   RAD
80002        LAB
80003        LAB
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80008        LAB
80009        LAB
80010        LAB
80011        LAB
80012        LAB
80016        LAB
80018        LAB
80031        LAB
80047        LAB
80048        LAB
80048   26   LAB
80048   TC   LAB
80050        LAB
80050   26   LAB
80050   TC   LAB
80051        LAB
80051   26   LAB
80051   TC   LAB
80053        LAB
80053   26   LAB
80053   TC   LAB
80060        LAB
80061        LAB
80061   26   LAB
80069        LAB
80074        LAB
80076        LAB
80076   26   LAB
80076   TC   LAB
80090        LAB
80099        LAB
80100        LAB
80101        LAB
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80102        LAB
80150        LAB
80156        LAB
80158        LAB
80162        LAB
80164        LAB
80168        LAB
80170   26   LAB
80170   tc   LAB
80172        LAB
80178        LAB
80184        LAB
80185        LAB
80186        LAB
80188        LAB
80192        LAB
80198        LAB
80202        LAB
80202   26   LAB
80299        LAB
80438        LAB
80439        LAB
80500        LAB
80500   26   LAB
81000        LAB
81000   26   LAB
81001        LAB
81001   26   LAB
81001   TC   LAB
81002        LAB
81002   26   LAB
81002   TC   LAB
81003        LAB
81003   26   LAB
81003   TC   LAB
81005        LAB
81015        LAB
81025        LAB
81050        LAB
81099        LAB
82009        LAB
82010        LAB
82024        LAB
82040        LAB
82042        LAB
82043        LAB
82044        LAB
82055        LAB
82055   26   XRY
82055   TC   LAB
82075        LAB
82085        LAB
82088        LAB
82103        LAB
82104        LAB
82104   26   LAB
82104   TC   LAB
82105        LAB
82105   26   LAB
82105   TC   LAB
82108        LAB
82128        LAB
82131        LAB
82140        LAB
82140   26   LAB
82140   TC   LAB
82145        LAB
82150        LAB
82150   26   LAB
82150   TC   LAB
82157        LAB
82164        LAB
82172        LAB
82175        LAB
82205        LAB
82247        LAB
82248        LAB
82270        LAB
82272        LAB
82300        LAB
82306        LAB
82310        LAB
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82310   TC   LAB
82330        LAB
82330   26   LAB
82340        LAB
82355        LAB
82370        LAB
82374        LAB
82375        LAB
82378        LAB
82380        LAB
82382        LAB
82384        LAB
82390        LAB
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82390   TC   LAB
82397        LAB
82435        LAB
82436        LAB
82438        LAB
82465        LAB
82465   26   LAB
82465   TC   LAB
82480        LAB
82486        LAB
82491        LAB
82492        LAB
82507        LAB
82525        LAB
82530        LAB
82533        LAB
82540        LAB
82541        LAB
82550        LAB
82552        LAB
82553        LAB
82553   26   LAB
82565        LAB
82565   26   LAB
82565   TC   LAB
82570        LAB
82575        LAB
82595        LAB
82607        LAB
82607   26   LAB
82607   TC   LAB
82608        LAB
82615        LAB
82626        LAB
82652        LAB
82668        LAB
82670        LAB
82671        LAB
82672        LAB
82679        LAB
82728        LAB
82728   26   LAB
82728   TC   LAB
82746        LAB
82746   26   LAB
82746   TC   LAB
82747        LAB
82784        LAB
82785        LAB
82785   26   LAB
82800        LAB
82803        LAB
82803   26   LAB
82805        LAB
82810        LAB
82820        LAB
82941        LAB
82944        LAB
82945        LAB
82945   26   LAB
82945   TC   LAB
82947        LAB
82947   26   LAB
82947   TC   LAB
82948        LAB
82948   26   LAB
82950        LAB
82951        LAB
82952        LAB
82953        LAB
82961        LAB
82962        LAB
82962   26   LAB
82977        LAB
82977   26   LAB
82977   TC   LAB
82985        LAB
83001        LAB
83002        LAB
83003        LAB
83013        LAB
83015        LAB
83018        LAB
83020        LAB
83021        LAB
83036        LAB
83036   26   LAB
83036   TC   LAB
83050        LAB
83060        LAB
83497        LAB
83498        LAB
83516        LAB
83518        LAB
83519        LAB
83520        LAB
83520   26   LAB
83520   TC   LAB
83525        LAB
83540        LAB
83540   26   LAB
83540   TC   LAB
83550        LAB
83550   26   LAB
83550   TC   LAB
83586        LAB
83605        LAB
83615        LAB
83625        LAB
83655        LAB
83690        LAB
83690   26   LAB
83690   TC   LAB
83700        LAB
83718        LAB
83719        LAB
83721        LAB
83721   59   LAB
83735        LAB
83735   26   LAB
83735   TC   LAB
83825        LAB
83835        LAB
83873        LAB
83873   26   LAB
83873   TC   LAB
83874   26   LAB
83880        LAB
83880   26   LAB
83883        LAB
83885        LAB
83890        LAB
83891        LAB
83892        LAB
83894        LAB
83896        LAB
83898        LAB
83902        LAB
83904        LAB
83912        LAB
83916        LAB
83916   26   LAB
83916   TC   LAB
83921        LAB
83925        LAB
83930        LAB
83935        LAB
83945        LAB
83970        LAB
83986        LAB
84060        LAB
84066        LAB
84075        LAB
84100        LAB
84100   26   LAB
84100   TC   LAB
84105        LAB
84110        LAB
84120        LAB
84132        LAB
84132   26   LAB
84133        LAB
84134        LAB
84134   26   LAB
84144        LAB
84146        LAB
84153        LAB
84155        LAB
84156        LAB
84157        LAB
84157   26   LAB
84157   TC   LAB
84160        LAB
84165        LAB
84165   26   LAB
84165   TC   LAB
84166        LAB
84207        LAB
84210        LAB
84238        LAB
84244        LAB
84295        LAB
84295   26   LAB
84300        LAB
84305        LAB
84305   TC   LAB
84392        LAB
84402        LAB
84403        LAB
84403   26   LAB
84425        LAB
84432        LAB
84436        LAB
84436   26   LAB
84436   TC   LAB
84437        LAB
84439        LAB
84439   26   LAB
84443        LAB
84443   26   LAB
84443   TC   LAB
84446        LAB
84449        LAB
84450        LAB
84460        LAB
84466        LAB
84478        LAB
84478   26   LAB
84478   TC   LAB
84479        LAB
84479   26   LAB
84479   TC   LAB
84480        LAB
84481        LAB
84484        LAB
84484   26   LAB
84520        LAB
84520   26   LAB
84520   TC   LAB
84540        LAB
84550        LAB
84560        LAB
84585        LAB
84590        LAB
84681        LAB
84702        LAB
84703        LAB
84703   26   LAB
84703   TC   LAB
84999        LAB
85002        LAB
85004        LAB
85007        LAB
85007   26   LAB
85008        LAB
85009        LAB
85013        LAB
85014        LAB
85014   26   LAB
85018        LAB
85018   26   LAB
85025        LAB
85025   26   LAB
85025   TC   LAB
85027        LAB
85027   26   LAB
85027   TC   LAB
85032        LAB
85041        LAB
85044        LAB
85045        LAB
85048        LAB
85049        LAB
85060        LAB
85097        LAB
85210        LAB
85220        LAB
85230        LAB
85240        LAB
85244        LAB
85245        LAB
85246        LAB
85250        LAB
85260        LAB
85300        LAB
85302        LAB
85335        LAB
85345        LAB
85362        LAB
85379        LAB
85384        LAB
85390   26   LAB
85441        LAB
85460        LAB
85520        LAB
85549        LAB
85576        LAB
85597        LAB
85610        LAB
85610   26   LAB
85610   TC   LAB
85611        LAB
85613        LAB
85651        LAB
85651   26   LAB
85652        LAB
85652   26   LAB
85660        LAB
85670        LAB
85730        LAB
85730   26   LAB
85730   TC   LAB
85732        LAB
85999        LAB
86003        LAB
86003   26   LAB
86005        LAB
86035   TC   LAB
86038        LAB
86038   26   LAB
86038   TC   LAB
86039        LAB
86039   26   LAB
86039   TC   LAB
86060        LAB
86063        LAB
86068        LAB
86140        LAB
86140   26   LAB
86141        LAB
86147        LAB
86160        LAB
86160   91   LAB
86161        LAB
86162        LAB
86171        LAB
86200        LAB
86225        LAB
86225   91   LAB
86226        LAB
86235        LAB
86235   91   LAB
86255        LAB
86255   26   LAB
86255   TC   LAB
86256        LAB
86256   26   LAB
86256   TC   LAB
86280        LAB
86293        LAB
86304        LAB
86308        LAB
86316        LAB
86317        LAB
86318        LAB
86320        LAB
86329        LAB
86331        LAB
86334        LAB
86340        LAB
86340   26   LAB
86340   TC   LAB
86361        LAB
86376        LAB
86403        LAB
86403   26   LAB
86403   TC   LAB
86430        LAB
86430   26   LAB
86430   TC   LAB
86431        LAB
86431   26   LAB
86580        LAB
86590        LAB
86592        LAB
86592   26   LAB
86592   TC   LAB
86593        LAB
86606        LAB
86609        LAB
86611        LAB
86617        LAB
86618        LAB
86644        LAB
86645        LAB
86663        LAB
86664        LAB
86665        LAB
86671        LAB
86677        LAB
86682        LAB
86687        LAB
86689        LAB
86689   26   LAB
86689   TC   LAB
86694        LAB
86695        LAB
86695   TC   LAB
86696        LAB
86696   TC   LAB
86698        LAB
86701        LAB
86703        LAB
86704        LAB
86704   26   LAB
86704   TC   LAB
86705        LAB
86705   26   LAB
86705   TC   LAB
86706        LAB
86706   26   LAB
86706   TC   LAB
86707        LAB
86708        LAB
86708   26   LAB
86708   TC   LAB
86709        LAB
86709   26   LAB
86709   TC   LAB
86735        LAB
86762        LAB
86765        LAB
86777        LAB
86778        LAB
86787        LAB
86790        LAB
86800        LAB
86803        LAB
86803   26   LAB
86803   TC   LAB
86804        LAB
86807        LAB
86812        LAB
86817        LAB
86849        LAB
86850        LAB
86850   26   LAB
86870        LAB
86885        LAB
86885   26   LAB
86886        LAB
86890        LAB
86900        LAB
86900   26   LAB
86901        LAB
86901   26   LAB
86920        LAB
86920   26   LAB
86921        LAB
86922        LAB
86923        LAB
86940        LAB
86941        LAB
86999        LAB
87015        LAB
87040        LAB
87040   26   LAB
87045        LAB
87045   26   LAB
87046        LAB
87070        LAB
87070   26   LAB
87070   TC   LAB
87075        LAB
87075   26   LAB
87076        LAB
87077        LAB
87077   26   LAB
87081        LAB
87086        LAB
87086   26   LAB
87086   TC   LAB
87088        LAB
87088   26   LAB
87088   tc   LAB
87101        LAB
87102        LAB
87102   26   LAB
87103        LAB
87106        LAB
87116        LAB
87116   26   LAB
87116   TC   LAB
87147        LAB
87147   26   LAB
87177        LAB
87181        LAB
87184        LAB
87185        LAB
87186        LAB
87186   26   LAB
87187        LAB
87205        LAB
87205   26   LAB
87205   TC   LAB
87206        LAB
87210        LAB
87220        LAB
87230        LAB
87324        LAB
87327        LAB
87328        LAB
87338        LAB
87339        LAB
87340        LAB
87340   26   LAB
87340   TC   LAB
87341        LAB
87350        LAB
87390        LAB
87400        LAB
87430        LAB
87449        LAB
87476   26   LAB
87490        LAB
87491        LAB
87517        LAB
87521        LAB
87522        LAB
87536        LAB
87590        LAB
87591        LAB
87797        LAB
87797   90   LAB
87798        LAB
87798   90   LAB
87801   26   LAB
87801   TC   LAB
87804        LAB
87880        LAB
87899        LAB
87902        LAB
87999        LAB
88099        LAB
88104        LAB
88104   26   LAB
88104   59   LAB
88106        LAB
88106   26   LAB
88107   26   LAB
88107   TC   LAB
88108        LAB
88108   26   LAB
88112   26   LAB
88112   TC   LAB
88141        LAB
88142        LAB
88147        LAB
88148        LAB
88150        LAB
88150   26   LAB
88151   26   LAB
88155        LAB
88155   26   LAB
88160        LAB
88161        LAB
88161   26   LAB
88164        LAB
88164   26   LAB
88164   TC   LAB
88173        LAB
88175        LAB
88180        LAB
88180   26   LAB
88184        LAB
88185        LAB
88188        LAB
88188   26   LAB
88188   TC   LAB
88189   26   LAB
88199        LAB
88199   26   LAB
88233        LAB
88237        LAB
88262        LAB
88264        LAB
88271        LAB
88273        LAB
88275        LAB
88291        LAB
88299        LAB
88300        LAB
88300   26   LAB
88300   59   LAB
88300   TC   LAB
88302        LAB
88302   26   LAB
88304        LAB
88304   26   LAB
88304   76   LAB
88304   TC   LAB
88305        LAB
88305   26   LAB
88305   59   LAB
88305   77   LAB
88305   TC   LAB
88307        LAB
88307   26   LAB
88309        LAB
88309   26   LAB
88311        LAB
88311   26   LAB
88312        LAB
88312   26   LAB
88312   tc   LAB
88313        LAB
88313   26   LAB
88313   tc   LAB
88314        LAB
88314   26   LAB
88319        LAB
88321        LAB
88321   26   LAB
88329        LAB
88331        LAB
88331   26   LAB
88331   59   LAB
88332        LAB
88332   26   LAB
88342        LAB
88342   26   LAB
88346   26   LAB
88348   26   LAB
88358        LAB
88399        LAB
89050        LAB
89051        LAB
89051   26   LAB
89051   TC   LAB
89055        LAB
89060        LAB
89125        LAB
89190        LAB
90471        INJ
90472        INJ
90515        DRV
90605        DRV
90632        INJ
90658        INJ
90703        INJ
90707        INJ
90713        INJ
90715        MED
90716        INJ
90732        INJ
90746        INJ
90749        INJ
90780        INJ
90788        INJ
90801        DRP
90802        DRP
90804        DRP
90805        DRP
90806        DRP
90807        DRP
90808        DRP
90809        DRP
90810        DRP
90811        DRP
90812        DRP
90813        DRP
90814        DRP
90815        DRP
90816        DRP
90817        DRP
90818        DRP
90819        DRP
90821        DRP
90823        DRP
90845        DRP
90846        DRP
90847        DRP
90853        DRP
90857        DRP
90862        DRP
90875        DRP
90876        DRP
90887        MED
90889        DRP
90899        DRP
90901        DRP
90999        MED
90999   LL   MED
91010   26   MED
91110        MED
91122        MED
91299        MED
92002        EYE
92004        EYE
92004   25   EYE
92004   57   EYE
92012        EYE
92012   24   EYE
92012   25   EYE
92012   57   EYE
92014        EYE
92014   24   EYE
92014   25   EYE
92014   57   EYE
92015        EYE
92018        EYE
92018   WA   OSF
92020        EYE
92020   24   EYE
92025        MED
92060        EYE
92060   22   MED
92065        EYE
92070        EYE
92081        EYE
92082        EYE
92083        EYE
92100        EYE
92120        EYE
92132        MED
92133        MED
92133   26   MED
92133   TC   MED
92134        MED
92134   26   MED
92134   TC   MED
92136        EYE
92136   26   EYE
92136   TC   Med
92140        EYE
92225        EYE
92225   50   EYE
92226        EYE
92226   50   EYE
92230        EYE
92235        EYE
92235   50   EYE
92235   57   EYE
92240        MED
92250        EYE
92250   25   EYE
92250   50   EYE
92270        EYE
92270   26   EYE
92275        EYE
92280   26   EYE
92283        EYE
92284        EYE
92285        EYE
92285   50   SUR
92286        EYE
92310        EYE
92311        EYE
92312        EYE
92313        EYE
92314        EYE
92315        EYE
92316        EYE
92317        Med
92325        EYE
92326        EYE
92340        EYE
92341        EYE
92342        EYE
92354        EYE
92355        EYE
92370        EYE
92499        EYE
92502        MED
92504        MED
92506        DRV
92507        MED
92508        MED
92511        MED
92516        MED
92520        MED
92526        MED
92531        MED
92532        MED
92533        MED
92541        MED
92542        MED
92543        MED
92544        MED
92545        MED
92546        MED
92547        MED
92548        MED
92550        EAR
92551        EAR
92552        EAR
92552   59   EAR
92553        EAR
92555        EAR
92556        EAR
92556   59   EAR
92557        EAR
92557   25   EAR
92557   32   EAR
92557   59   EAR
92561        EAR
92563        EAR
92565        EAR
92567        EAR
92568        EAR
92570        EAR
92571        EAR
92572        EAR
92577        EAR
92582        MED
92584        EAR
92585        EAR
92585   26   EAR
92585   59   EAR
92585   TC   EAR
92586        MED
92586   59   MED
92587        EAR
92587   26   EAR
92588        EAR
92588   26   EAR
92590        EAR
92591        EAR
92591   25   EAR
92592        EAR
92593        EAR
92595        EAR
92596        MED
92597        EAR
92603        EAR
92604        EAR
92607        EAR
92608        EAR
92609        EAR
92610        MED
92611        MED
92620        MED
92621        MED
92626        MED
92626   59   EAR
92630        MED
92700        MED
92960        SUR
92971        MED
92980        SUR
92980   WA   OSF
92981        MED
92982        MED
92982   51   MED
92984        MED
93000        MED
93000   21   MED
93000   26   MED
93000   TC   MED
93005        MED
93010        MED
93010   25   MED
93015        MED
93015   26   MED
93015   TC   MED
93016        MED
93016   26   MED
93017        MED
93018        MED
93024        MED
93040        MED
93041        MED
93042        MED
93224        MED
93225        MED
93225   TC   MED
93226        MED
93226   TC   MED
93227        MED
93268        MED
93270        MED
93271        MED
93272        MED
93278        MED
93278   26   MED
93278   TC   MED
93306        XRY
93306   26   MED
93307        XRY
93307   26   XRY
93307   TC   XRY
93308        XRY
93312        XRY
93312   26   XRY
93320        XRY
93320   26   XRY
93320   TC   XRY
93321        XRY
93321   26   XRY
93325        XRY
93325   26   XRY
93325   TC   XRY
93350        XRY
93350   26   XRY
93350   TC   XRY
93503        SUR
93503   59   SUR
93571   26   SUR
93609        MED
93609   26   MED
93620        MED
93620   26   MED
93621        MED
93623        MED
93623   26   MED
93624        MED
93624   26   MED
93641        MED
93641   WA   MED
93650        MED
93651        MED
93652        MED
93660        MED
93660   26   MED
93701        MED
93720        MED
93721        MED
93740        MED
93798        CRB
93799        MED
93875   26   MED
93880        MED
93880   26   MED
93880   TC   MED
93882        MED
93882   26   MED
93882   TC   MED
93922        MED
93922   26   MED
93923        MED
93923   26   MED
93924        MED
93925        MED
93925   26   MED
93926        MED
93926   26   MED
93926   TC   MED
93930        MED
93965        MED
93965   26   MED
93965   TC   MED
93970        MED
93970   26   MED
93970   TC   MED
93971        MED
93971   26   MED
93971   TC   MED
93975        MED
93975   26   MED
93976        MED
94010        MED
94010   26   MED
94010   TC   MED
94060        MED
94060   26   MED
94060   TC   MED
94070        MED
94150        MED
94200        MED
94240        MED
94240   26   MED
94240   TC   MED
94250        MED
94250   26   MED
94260        MED
94260   26   MED
94260   TC   MED
94360        MED
94360   26   MED
94360   TC   MED
94375        MED
94375   26   MED
94620        MED
94640        MED
94660        MED
94664        MED
94681        MED
94720        MED
94720   26   MED
94720   TC   MED
94750        MED
94760        MED
94761        MED
94762        MED
94770        MED
94799        MED
95000        ALG
95001        ALG
95002        ALG
95004        ALG
95010        MED
95015        MED
95024        ALG
95028        ALG
95044        ALG
95070        ALG
95115        ALG
95117        ALG
95144        ALG
95165        ALG
95170        ALG
95199        ALG
95805        MED
95805   26   MED
95805   TC   MED
95806        MED
95807        MED
95807   26   MED
95808        MED
95810        MED
95810   26   MED
95810   TC   MED
95811        MED
95811   26   MED
95811   TC   MED
95812        MED
95812   26   MED
95812   TC   MED
95813        MED
95813   26   MED
95813   TC   MED
95816        MED
95816   26   MED
95816   TC   MED
95819        MED
95819   26   MED
95819   TC   MED
95822        MED
95829        MED
95831        MED
95832        MED
95833        MED
95851        MED
95852        MED
95857        MED
95860        MED
95860   26   MED
95860   52   MED
95860   TC   MED
95860   WA   MED
95861        MED
95861   26   MED
95861   TC   MED
95863        MED
95864        MED
95864   26   MED
95864   TC   MED
95867        MED
95867   26   MED
95868        MED
95868   26   MED
95869        MED
95870        MED
95870   26   MED
95870   59   MED
95900        MED
95900   26   MED
95900   50   MED
95900   59   MED
95900   TC   MED
95903        MED
95903   26   MED
95903   59   THP
95903   TC   MED
95904        MED
95904   26   MED
95904   50   MED
95904   59   MED
95904   TC   MED
95920        MED
95920   26   MED
95920   TC   MED
95925        MED
95925   26   MED
95925   TC   MED
95926        MED
95926   26   MED
95926   TC   MED
95930        MED
95930   26   MED
95930   TC   MED
95933        MED
95934        MED
95934   26   MED
95934   50   MED
95934   TC   MED
95936        MED
95937        MED
95937   26   MED
95950        MED
95950   26   MED
95951        MED
95951   26   MED
95956        MED
95957        MED
95957   26   MED
95957   TC   MED
95961        MED
95961   26   MED
95971   58   MED
95972        MED
95972   51   MED
95972   58   MED
95999        MED
96101        MED
96102        MED
96103        DRP
96105        MED
96110        MED
96111        MED
96116        MED
96118        MED
96118   59   MED
96119        MED
96119   59   MED
96120        PSY
96360        MED
96365        MED
96366        MED
96372        INJ
96374        INJ
96375        MED
96376        INJ
96379        MED
96415        MED
96549        CHM
96900        MED
96912        MED
96920        MED
97001        PHT
97002        PHT
97002   25   PHT
97002   59   PHT
97003        PHT
97004        PHT
97010        THP
97012        THP
97014        THP
97014   52   THP
97016        THP
97018        THP
97022        THP
97024        THP
97026        MED
97032        THP
97033        THP
97034        THP
97035        THP
97036        THP
97039        THP
97065   51   MED
97110        THP
97110   59   THP
97112        THP
97112   59   THP
97113        THP
97116        THP
97124        THP
97124   59   THP
97139        THP
97140        THP
97140   59   THP
97150        THP
97530        THP
97530   59   THP
97532        THP
97533        THP
97535        THP
97537        THP
97542        THP
97545        THP
97546        THP
97597        MED
97601        THP
97602        THP
97605        MED
97605   51   SUR
97701        PHT
97750        PHT
97750   59   THP
97755        THP
97760        MED
97761        MED
97762        MED
97799        THP
97802        THP
97803        DRV
97804        THP
98925        THP
98926        THP
98928        MED
98940        CHT
98941        CHT
98942        CHT
98943        CHT
98960        MED
99000        LAB
99001        LAB
99002        DMP
99024        DRV
99024   25   DRV
99024   55   DRV
99050        DRV
99056        DRV
99058        DRV
99070        MSS
99071        MSS
99078        DRV
99080        MDR
99082        DRV
99090        MED
99100        ANS
99116        RFA
99135   25   MED
99140        ANS
99143        MED
99144        MED
99149        MED
99183        DRV
99183   59   DRV
99195        SUR
99199        MDR
99201        DRV
99201   25   MED
99202        DRV
99202   25   DRV
99203        DRV
99203   25   DRV
99203   57   DRV
99204          DRV
99204   25     DRV
99205          DRV
99205   25     DRV
99205   57     DRV
99211          DRV
99211   25     DRV
99212          DRV
99212   24     DRV
99212   25     DRV
99212   55     DRV
99212   57     DRV
99212   80     DRV
99213          DRV
99213   24     DRV
99213   25     DRV
99213   57     DRV
99214          DRV
99214   24     DRV
99214   25     DRV
99214   59     DRV
99215          DRV
99215   24     DRV
99215   25     DRV
99215   57     DRV
99217          DRV
99218          DRV
99219          DRV
99220   25     DRV
99221          DRV
99222          DRV
99223          DRV
99223   25     DRV
99223   2558   DRV
99223   57     DRV
99231          DRV
99231   24     DRV
99232          DRV
99232   57     DRV
99232   58     DRV
99233          DRV
99233   57     DRV
99234          DRV
99235          DRV
99238          DRV
99238   2558   DRV
99239          DRV
99241          DRV
99241   25     DRV
99242          DRV
99242   25     DRV
99242   57     DRV
99243          DRV
99243   25     DRV
99243   57     DRV
99244        DRV
99244   25   DRV
99244   57   DRV
99245        DRV
99245   57   DRV
99251        DRV
99251   24   DRV
99252        DRV
99253        DRV
99254        DRV
99255        DRV
99281        DRV
99282        DRV
99282   25   DRV
99283        DRV
99284        DRV
99284   25   DRV
99285        DRV
99291        DRV
99292        DRV
99305        DRV
99306        DRV
99307        DRV
99308        DRV
99315        DRV
99341        HHC
99343        HHC
99344        HHC
99345        HHC
99347        HHC
99348        HHC
99349        HHC
99350        HHC
99351        DRV
99354        DRV
99363        DRV
99385        DRV
99386        DRV
99394        DRV
99395        DRV
99396        DRV
99401        DRV
99404        DRV
99407        DRV
99412        DRV
99420        DRV
99429        DRV
99455        DRV
99456        MED
99499        DRV
99500        HHC
99509        HHC
99600        MED
99601        MED
99999   99   DEN
A4206        MSS
A4207        MSS
A4209        MSS
A4210        MSS
A4211        MSS
A4212        MSS
A4215        MSS
A4216        MSS
A4221        MSS
A4222        MSS
A4230        MSS
A4232        MSS
A4245        MSS
A4247        MSS
A4250        MSS
A4253        MSS
A4258        MSS
A4259        MSS
A4262        MSS
A4263        MSS
A4263   E2   MSS
A4263   E4   MSS
A4265        MSS
A4300        MSS
A4305        IVT
A4306        DMP
A4310        MSS
A4332        MSS
A4335        MSS
A4351        MSS
A4357        MSS
A4358        MSS
A4362        MSS
A4364        MSS
A4371        MSS
A4385        MSS
A4402        MSS
A4406        MSS
A4407        MSS
A4409        MED
A4410        MSS
A4414        MSS
A4420        MSS
A4425        MSS
A4450        MSS
A4455        MSS
A4456        MSS
A4495        MSS
A4510        MSS
A4520        MSS
A4550        MSS
A4554        MSS
A4556        MSS
A4557        MSS
A4562        MSS
A4565   MSS
A4570   MSS
A4580   MSS
A4590   MSS
A4595   MSS
A4616   MSS
A4624   MSS
A4630   MSS
A4636   MSS
A4637   MSS
A4641   MSS
A4647   MSS
A4649   MSS
A4660   MSS
A4663   MSS
A4670   MSS
A4772   MSS
A4927   MSS
A5054   MSS
A5061   MSS
A5062   MSS
A5063   MSS
A5105   MSS
A5120   DMP
A5500   MSS
A5501   MSS
A5503   MSS
A5504   MSS
A5505   MSS
A5506   MSS
A5512   MSS
A5513   MSS
A6025   MSS
A6154   MSS
A6217   MSS
A6222   MSS
A6223   MSS
A6242   MSS
A6248   MSS
A6250   DMP
A6251   MSS
A6257   MSS
A6258   DMP
A6259   MSS
A6260   MSS
A6402   MSS
A6446   DMP
A6450   DMP
A6454   DMP
A6530   DMP
A6534   MSS
A6549   DMP
A7003   MSS
A7027   MED
A7028   MED
A7029        MED
A7030   NU   DMP
A7031   NU   DMP
A7032        DMP
A7033        MED
A7034        MSS
A7035   NU   DMP
A7036   NU   MSS
A7037        MSS
A7037   NU   MSS
A7038   NU   DMP
A7039   NU   DMP
A7046   NU   DMP
A9150        MSS
A9270        MSS
A9279        DMP
A9300        MSS
A9500        MSS
A9502        MSS
A9503        MSS
A9505        MSS
A9516        MSS
A9517        MSS
A9530        MSS
A9537        DMP
A9552        MSS
A9561        MSS
A9569        MSS
A9579        INJ
A9900        DMP
A9901        MSS
A9999        MSS
C1300        MED
C1713        OHM
C1762        MED
C1769        OHM
C1776        DMP
c1780        DMP
C1781        MED
C1783        DMP
C1874        OHM
C1876        OHM
C1894        OHM
C2625        DMP
C9257        INJ
D0120        DEN
D0123        DEN
D0140        DEN
D0150        DEN
D0160        DEN
D0180        DEN
D0210        DEN
D0220        DEN
D0230        DEN
D0240        DEN
D0270   DEN
D0272   DEN
D0274   DEN
D0277   DEN
D0290   DEN
D0310   DEN
D0320   DEN
D0321   DEN
D0330   DEN
D0340   DEN
D0470   DEN
D0999   DEN
D1110   DEN
D1120   DEN
D1204   DEN
D1330   DEN
D1351   DEN
D1520   DEN
D2140   DEN
D2150   DEN
D2160   DEN
D2161   DEN
D2330   DEN
D2331   DEN
D2332   DEN
D2335   DEN
D2391   DEN
D2392   DEN
D2393   DEN
D2394   DEN
D2520   DEN
D2620   DEN
D2630   DEN
D2642   DEN
D2643   DEN
D2644   DEN
D2740   DEN
D2750   DEN
D2751   DEN
D2752   DEN
D2790   DEN
D2791   DEN
D2792   DEN
D2920   DEN
D2930   DEN
D2931   DEN
D2940   DEN
D2950   DEN
D2951   DEN
D2952   DEN
D2954   DEN
D2960   DEN
D2961   DEN
D2962   DEN
D2980   DEN
D3110   DEN
D3120   DEN
D3220   DEN
D3221   DEN
D3310   DEN
D3320   DEN
D3330   DEN
D3346   DEN
D3347   DEN
D3348   DEN
D3410   DEN
D4210   DEN
D4211   DEN
D4240   DEN
D4249   DEN
D4260   DEN
D4341   DEN
D4342   DEN
D4355   DEN
D4381   DEN
D4910   DEN
D4999   DEN
D5110   DEN
D5120   DEN
D5130   DEN
D5140   DEN
D5211   DEN
D5212   DEN
D5213   DEN
D5214   DEN
D5225   DEN
D5226   DEN
D5261   DEN
D5281   DEN
D5310   DEN
D5311   DEN
D5410   DEN
D5411   DEN
D5421   DEN
D5422   DEN
D5510   DEN
D5520   DEN
D5610   DEN
D5620   DEN
D5630   DEN
D5640   DEN
D5650   DEN
D5660   DEN
D5710   DEN
D5711   DEN
D5721   DEN
D5730   DEN
D5731   DEN
D5740   DEN
D5741   DEN
D5750        DEN
D5751        DEN
D5760        DEN
D5761        DEN
D5810        DEN
D5811        DEN
D5820        DEN
D5821        DEN
D5850        DEN
D5851        DEN
D5860        DEN
D5860   03   DEN
D5862        DEN
D5875        DEN
D5899        DEN
D5915        DEN
D5931        DEN
D5932        DEN
D5982        DEN
D5988        DEN
D5999        DEN
D6010        DEN
D6053        DEN
D6055        DEN
D6056        DEN
D6066        DEN
D6210        DEN
D6211        DEN
D6240        DEN
D6241        DEN
D6242        DEN
D6245        DEN
D6250        DEN
D6251        DEN
D6545        DEN
D6740        DEN
D6750        DEN
D6751        DEN
D6752        DEN
D6790        DEN
D6791        DEN
D6930        DEN
D6950        DEN
D6972        DEN
D6973        DEN
D6999        DEN
D7111        DEN
D7140        DEN
D7210        DEN
D7220        DEN
D7230        DEN
D7240        DEN
D7241        DEN
D7250        DEN
D7260        DEN
D7280   DEN
D7285   DEN
D7286   DEN
D7310   DEN
D7311   DEN
D7320   DEN
D7321   DEN
D7340   DEN
D7450   DEN
D7451   DEN
D7461   DEN
D7465   DEN
D7471   DEN
D7472   DEN
D7473   DEN
D7485   DEN
D7510   DEN
D7550   DEN
D7740   DEN
D7840   DEN
D7850   DEN
D7858   DEN
D7860   DEN
D7880   DEN
D7912   DEN
D7920   DEN
D7940   DEN
D7944   DEN
D7945   DEN
D7946   DEN
D7947   DEN
D7948   DEN
D7950   DEN
D7960   DEN
D7963   DEN
D7970   DEN
D7971   DEN
D7991   DEN
D7999   DEN
D8090   DEN
D8210   DEN
D8651   DEN
D9110   DEN
D9120   DEN
D9215   DEN
D9217   DEN
D9220   DEN
D9221   DEN
D9230   DEN
D9248   DEN
D9310   DEN
D9430   DEN
D9610   DEN
D9630   DEN
D9910   DEN
D9920        DEN
D9930        DEN
D9940        DEN
D9950        DEN
D9951        DEN
D9999        DEN
DRG          SUR
DRG35   9    SUR
DRG39   7    MED
DRG54   4    SUR
E0100        DMP
E0105        DMP
E0110        DMP
E0111   NU   DMP
E0112        DMP
E0114        DMP
E0116        DMP
E0118        DMP
E0130        DMP
E0135        DMP
E0140        DMP
E0141        DMP
E0141   LL   DMP
E0143        DMP
E0144        DMP
E0147        DMP
E0147   LL   DMP
E0147   RR   DMR
E0148        DMP
E0149   NU   DMP
E0154        DMP
E0155        DMP
E0156        DMP
E0158        DMP
E0159        DMP
E0163        DMP
E0165        DMP
E0168        DMP
E0176        DMP
E0177        DMP
E0178        DMP
E0179        DMP
E0181        DMP
E0185        DMP
E0186        DMP
E0188        DMP
E0188   NU   DMP
E0189        DMP
E0191        DMP
E0191   LL   DMP
E0192        DMP
E0193        DMP
E0196        DMP
E0197        DMP
E0215        DMP
E0217   NU   DMP
E0218        DMP
E0218   NU   DMP
E0235        DMP
E0240        DMP
E0240   LL   DMP
E0241        DMP
E0242        DMP
E0243        DMP
E0244        DMP
E0244   NU   DMP
E0245        DMP
E0246        DMP
E0247        DMP
E0248        DMP
E0249        DMP
E0255        DMP
E0255   LL   DMR
E0256        DMP
E0260        DMP
E0260   LL   DMR
E0261        DMP
E0261   LL   DMR
E0265        DMP
E0266        DMP
E0270        DMP
E0271        DMP
E0272        DMP
E0274        DMP
E0277        DMP
E0291        DMP
E0292        DMP
E0303   RR   DMR
E0305        DMP
E0305   LL   DMR
E0310        DMP
E0315        DMP
E0425   LL   DMR
E0430        DMP
E0431        DMP
E0431   RR   DMR
E0443        DMP
E0444        DMP
E0470        DMP
E0555        DMP
E0561   NU   DMP
E0562   NU   DMP
E0562   RR   DMR
E0570        DMP
E0574        DMP
E0575        DMP
E0600        DMP
E0601   NU   DMP
E0601   RR   DMR
E0607        DMP
E0620        DMP
E0621        DMP
E0625        DMP
E0627        DMP
E0628        DMP
E0630        DMP
E0635        DMP
E0636        DMP
E0637        DMP
E0650        DMP
E0650   RR   DMR
E0651        DMP
E0652   NU   DMP
E0652   RR   DMR
E0660        DMP
E0667        DMP
E0668        DMP
E0673   NU   DMP
E0675   RR   DMR
E0705   NU   DMP
E0710        DMP
E0720        DMP
E0720   LL   DMP
E0730        DMP
E0730   LL   DMR
E0730   NU   DMP
E0740        DMP
E0745        DMP
E0745   LL   DMR
E0747        DMP
E0747   LL   DMR
E0748        DMP
E0748   NU   DMP
E0770        DMP
E0776        DMP
E0776   LL   DMR
E0781   LL   DMR
E0781   NU   DMP
E0782   LL   DMR
E0782   NU   DMP
E0784        DMP
E0784   NU   DMP
E0791   LL   DMR
E0840        DMP
E0840   LL   DMR
E0850        DMP
E0855   NU   DMP
E0860        DMP
E0870        DMP
E0910        DMP
E0910   LL   DMR
E0935   LL   DMR
E0935   NU   DMP
E0935   RR   DMR
E0936        DMP
E0940        DMP
E0942        DMP
E0944        DMP
E0944   LL   DMR
E0945        DMP
E0945   LL   DMR
E0946        DMP
E0947        DMP
E0950        DMP
E0951        DMP
E0951   NU   DMP
E0952   NU   DMP
E0955        DMP
E0955   NU   DMP
E0956        DMP
E0956   NU   DMP
E0959        DMP
E0960        DMP
E0961        DMP
E0967        DMP
E0970        DMP
E0971        DMP
E0973        DMP
E0973   NU   DMP
E0974        DMP
E0978        DMP
E0981        DMP
E0981   NU   DMP
E0982        DMP
E0986   NU   DMP
E0990        DMP
E0992        DMP
E0994        DMP
E0995        DMP
E1002        DMP
E1004        DMP
E1005        DMP
E1007   NU   DMP
E1008        DMP
E1010        DMP
E1015   NU   DMP
E1016        DMP
E1020   NU   DMP
E1028        DMP
E1028   NU   DMP
E1050        DMP
E1060        DMP
E1060   LL   DMR
E1086        DMP
E1087   LL   DMR
E1088        DMP
E1088   LL   DMR
E1089        DMP
E1090        DMP
E1090   LL   DMR
E1092        DMP
E1093        DMP
E1130        DMP
E1130   LL   DMR
E1140        DMP
E1150        DMP
E1160        DMP
E1172        DMP
E1220        DMP
E1220   LL   DMR
E1223        DMP
E1223   LL   DMR
E1224        DMP
E1226   NU   DMP
E1226   RR   DMR
E1228        DMP
E1230        DMP
E1230   LL   DMR
E1234   NU   DMP
E1240        DMP
E1240   LL   DMR
E1260        DMP
E1260   LL   DMR
E1280        DMP
E1285   LL   DMR
E1296        DMP
E1297        DMP
E1298        DMP
E1300        DMP
E1390        DMP
E1390   RR   DMR
E1399        DMP
E1399   LL   DMR
E1399   NU   DMP
E1630        DMP
E1820        DMP
E2100        DMP
E2201        DMP
E2203        DMP
E2205        DMP
E2206        DMP
E2207   NU   DMP
E2210   NU   DMP
E2211   NU   DMP
E2212   NU   DMP
E2213        DMP
E2213   NU   DMP
E2214        DMP
E2215   NU   DMP
E2218   NU   DMP
E2219   NU   DMP
E2220   NU   DMP
E2221   NU   DMP
E2300        DMP
E2300   NU   DMP
E2301   NU   DMP
E2310        DMP
E2310   NU   DMP
E2311        DMP
E2311   NU   DMP
E2313        DMP
E2313   NU   DMP
E2321        DMP
E2323        DMP
E2323   NU   DMP
E2330   NU   DMP
E2331        DMP
E2360        DMP
E2361        DMP
E2363   NU   DMP
E2365        DMP
E2366   NU   DMP
E2367   NU   DMP
E2370        DMP
E2371   NU   DMP
E2373        DMP
E2374        DMP
E2375   NU   DMP
E2377        DMP
E2377   NU   DMP
E2381        DMP
E2383        DMP
E2384   NU   DMP
E2385   NU   DMP
E2386   NU   DMP
E2387   NU   DMP
E2391   NU   DMP
E2392        DMP
E2394        DMP
E2395        DMP
E2510        DMP
E2512        DMP
E2599        DMP
E2601        DMP
E2603        DMP
E2604        DMP
E2605        DMP
E2606   NU   DMP
E2607        DMP
E2609   NU   DMP
E2611        DMP
E2613   NU   DMP
E2614        DMP
E2614   NU   DMP
E2615   NU   DMP
E2619        DMP
E2620        DMP
E2620   NU   DMP
E2622        DMP
E2624        DMP
G0008        INJ
G0101        MED
g0103        DRV
G0108        DRV
G0109        DRV
G0151        HHC
G0152        HHC
G0154        HHC
G0156        HHC
G0180        MDR
G0206        MAM
G0268        DRV
G0275        SUR
G0283        MED
G0289        SUR
G0289   80   SUR
G0290        MED
G0291        MED
G0378        MED
G0399        MED
H0001        DRV
H0004        DRV
H0031        DRV
H0032        DRV
IP100   DG   SPR
IP200   DG   SPR
J0150        INJ
J0152        INJ
J0280        INJ
J0330        INJ
J0461        INJ
J0583        INJ
J0585        INJ
J0640        INJ
J0670        INJ
J0690        INJ
J0696        INJ
J0698        INJ
J0702        INJ
J0713        INJ
J0730        INJ
J0744        INJ
J0780        INJ
J0800        INJ
J0945        INJ
J1000        INJ
J1020        INJ
J1030        INJ
J1040        INJ
J1051        INJ
J1055        INJ
J1070        INJ
J1094        INJ
J1100        INJ
J1200        INJ
J1245   INJ
J1250   INJ
J1260   INJ
J1335   INJ
J1410   INJ
J1580   INJ
J1626   INJ
J1642   INJ
J1644   INJ
J1645   INJ
J1650   INJ
J1652   INJ
J1750   INJ
J1790   INJ
J1840   INJ
J1885   INJ
J1940   INJ
J1960   INJ
J2001   INJ
J2010   INJ
J2060   INJ
J2150   INJ
J2175   INJ
J2180   INJ
J2250   INJ
J2270   INJ
J2275   INJ
J2300   INJ
J2360   INJ
J2405   INJ
J2510   INJ
J2543   INJ
J2550   INJ
J2560   INJ
J2765   INJ
J2778   INJ
J2780   INJ
J2785   INJ
J2795   INJ
J2805   INJ
J2912   INJ
J2920   INJ
J2930   INJ
J3010   INJ
J3070   INJ
J3300   INJ
J3301   INJ
J3302   INJ
J3303   INJ
J3360   INJ
J3370   INJ
J3396   INJ
J3410   INJ
J3420   INJ
J3480   INJ
J3490        INJ
J3590        INJ
J7030        INJ
J7040        INJ
J7042        INJ
J7050        INJ
J7060        INJ
J7070        INJ
J7120        INJ
J7321        INJ
J7325        INJ
J7620        INJ
J9000        INJ
J9035        INJ
J9040        INJ
J9060        CHM
J9190        INJ
J9208        INJ
J9209        INJ
J9217        INJ
J9260        INJ
J9280        INJ
J9293        INJ
J9305        INJ
J9360        INJ
J9999        INJ
K0001        DMP
K0001   LL   DMR
K0004        DMP
K0004   LL   DMR
K0005        DMP
K0006        DMP
K0006   LL   DMR
K0007        DMP
K0007   LL   DMR
K0009        DMP
K0010        DMP
K0011        DMP
K0011   RR   DMR
K0012        DMP
K0014        DMP
K0014   NU   DMP
K0017        DMP
K0019        DMP
K0020        DMP
K0037        DMP
K0038        DMP
K0038   NU   DMP
K0040        DMP
K0040   NU   DMP
K0041        DMP
K0042        DMP
K0043        DMP
K0044        DMP
K0052        DMP
K0053        DMP
K0056        DMP
K0065   NU   DMP
K0069        DMP
K0070        DMP
K0072        DMP
K0081        DMP
K0108        DMP
k0108   NU   DMP
K0114        DMP
K0116        DMP
K0195        DMP
K0552        DMP
K0656        DMP
K0669        DMP
K0739        DMP
K0800   NU   DMP
K0801   NU   DMP
k0806   NU   DMP
K0807        DMP
K0808   NU   DMP
K0816   RR   DMR
K0822        DMP
K0823        DMP
K0825   NU   DMP
K0850        DMP
K0851   NU   DMP
K0856        DMP
K0856   NU   DMP
K0856   RR   DMR
K0858        DMP
K0860   NU   DMP
K0861        DMP
K0861   NU   DMP
K0862        DMP
K0868   NU   DMP
K0877        DMP
K0879        DMP
K0884        DMP
KO577        DMP
L0120        DMP
L0140        DMP
L0150        DMP
L0160        DMP
L0172        DMP
L0174        DMP
L0180        DMP
L0190        DMP
L0460        DMP
L0462        DMP
L0464        DMP
L0486        DMP
L0621        DMP
L0625        DMP
L0627        DMP
L0628   DMP
L0631   DMP
L0633   DMP
L0637   DMP
L0638   DMP
L0972   DMP
L0974   DMP
L0980   DMP
L1040   DMP
L1200   DMP
L1220   DMP
L1499   DMP
L1620   DMP
L1652   DMP
L1660   DMP
L1680   DMP
L1686   DMP
L1810   DMP
L1820   DMP
L1830   DMP
L1832   DMP
L1840   DMP
L1843   DMP
L1844   DMP
L1845   DMP
L1846   DMP
L1850   DMP
L1860   DMP
L1885   PRO
L1902   DMP
L1904   DMP
L1906   DMP
L1907   DMP
L1910   DMP
L1920   DMP
L1930   DMP
L1932   DMP
L1940   DMP
L1945   DMP
L1950   DMP
L1951   DMP
L1960   DMP
L1970   DMP
L1971   DMP
L1990   DMP
L2005   DMP
L2020   DMP
L2035   DMP
L2036   DMP
L2037   DMP
L2106   DMP
L2108   DMP
L2114   DMP
L2116   DMP
L2180   DMP
L2182   DMP
L2184   DMP
L2188   DMP
L2200   DMP
L2210   DMP
L2220   DMP
L2230   DMP
L2232   DMP
L2240   DMP
L2250   DMP
L2260   DMP
L2265   DMP
L2270   DMP
L2275   DMP
L2280   DMP
L2320   DMP
L2330   DMP
L2335   DMP
L2340   DMP
L2350   DMP
L2360   DMP
L2370   DMP
L2375   DMP
L2385   DMP
L2390   DMP
L2395   DMP
L2397   DMP
L2405   DMP
L2415   DMP
L2425   DMP
L2430   DMP
L2492   DMP
L2495   PRO
L2500   DMP
L2510   DMP
L2525   DMP
L2526   DMP
L2530   DMP
L2540   DMP
L2550   DMP
L2620   DMP
L2624   DMP
L2627   DMP
L2628   DMP
L2630   DMP
L2640   DMP
L2650   DMP
L2680   DMP
L2750   DMP
L2755   DMP
L2780   DMP
L2785   DMP
L2795   DMP
L2800   DMP
L2810   DMP
L2820        DMP
L2830        DMP
L2840        DMP
L2850        DMP
L2999        DMP
L3000        DMP
L3001        DMP
L3002        DMP
L3003        DMP
L3010        DMP
L3020        DMP
L3020   59   DMP
L3030        DMP
L3031        DMP
L3040        DMP
L3050        DMP
L3060        DMP
L3070        DMP
L3080        DMP
L3100        DMP
L3150        DMP
L3170        DMP
L3215        DMP
L3216        DMP
L3217        DMP
L3219        DMP
L3221        DMP
L3222        DMP
L3224        DMP
L3225        DMP
L3230        DMP
L3250        DMP
L3251        DMP
L3252        DMP
L3253        DMP
L3260        DMP
L3265        DMP
L3300        DMP
L3310        DMP
L3320        DMP
L3332        DMP
L3334        DMP
L3350        DMP
L3360        DMP
L3370        DMP
L3390        DMP
L3400        DMP
L3410        DMP
L3420        DMP
L3430        DMP
L3450        DMP
L3455        DMP
L3460        DMP
L3465        DMP
L3480        DMP
L3485   DMP
L3500   DMP
L3510   DMP
L3530   DMP
L3540   DMP
L3580   DMP
L3595   DMP
L3600   DMP
L3610   DMP
L3620   DMP
L3630   DMP
L3640   DMP
L3649   DMP
L3650   DMP
L3720   DMP
L3760   DMP
L3806   DMP
L3807   DMP
L3808   Ort
L3900   DMP
L3906   DMP
L3908   DMP
L3912   DMP
L3925   DMP
L3956   DMP
L3962   DMP
L3970   DMP
L3980   DMP
L3982   DMP
L3984   DMP
L3995   DMP
L3999   DMP
L4030   DMP
L4045   DMP
L4080   DMP
L4090   DMP
L4110   DMP
L4205   DMP
L4210   DMP
L4350   DMP
L4360   DMP
L4386   DMP
L4392   DMP
L4396   DMP
L5000   DMP
L5010   DMP
L5020   DMP
L5050   DMP
L5060   DMP
L5100   DMP
L5105   DMP
L5150   DMP
L5160   DMP
L5200   DMP
L5210   DMP
L5230   DMP
L5250   DMP
L5280   DMP
L5301   DMP
L5311   DMP
L5321   DMP
L5331   DMP
L5450   DMP
L5500   DMP
L5505   DMP
L5510   DMP
L5530   DMP
L5540   DMP
L5560   DMP
L5570   DMP
L5580   DMP
L5585   DMP
L5590   DMP
L5611   DMP
L5613   DMP
L5614   DMP
L5616   DMP
L5617   DMP
L5618   DMP
L5620   DMP
L5622   DMP
L5624   DMP
L5626   DMP
L5628   DMP
L5629   DMP
L5630   DMP
L5631   DMP
L5632   DMP
L5634   DMP
L5636   DMP
L5637   DMP
L5642   DMP
L5643   DMP
L5644   DMP
L5645   DMP
L5646   DMP
L5647   DMP
L5648   DMP
L5649   DMP
L5650   DMP
L5651   DMP
L5652   DMP
L5653   DMP
L5654   DMP
L5655   DMP
L5656   DMP
L5658   DMP
L5661   DMP
L5665   DMP
L5666   DMP
L5668   DMP
L5670   DMP
L5671   DMP
L5672   DMP
L5673   DMP
L5676   DMP
L5677   DMP
L5678   DMP
L5679   DMP
L5680   DMP
L5681   DMP
L5682   DMP
L5683   DMP
L5684   DMP
L5685   PRO
L5686   DMP
L5688   DMP
L5690   DMP
L5692   DMP
L5694   DMP
L5695   DMP
L5696   DMP
L5697   DMP
L5698   DMP
L5700   DMP
L5701   DMP
L5702   DMP
L5704   DMP
L5705   DMP
L5706   DMP
L5707   DMP
L5711   DMP
L5712   DMP
L5714   DMP
L5722   DMP
L5724   DMP
L5728   DMP
L5781   DMP
L5782   DMP
L5785   DMP
L5790   DMP
L5795   DMP
L5810   DMP
L5811   DMP
L5812   DMP
L5814   DMP
L5816   DMP
L5818   DMP
L5822   DMP
L5824   DMP
L5826   DMP
L5828   DMP
L5830   DMP
L5840   DMP
L5845   DMP
L5848   DMP
L5850   DMP
L5855   DMP
L5856   PRO
L5910   DMP
L5920   DMP
L5925   DMP
L5930   DMP
L5940   DMP
L5950   DMP
L5960   DMP
L5962   DMP
L5964   DMP
L5968   Ort
L5970   DMP
L5971   DMP
L5972   DMP
L5973   DMP
L5974   DMP
L5975   DMP
L5976   DMP
L5978   DMP
L5979   DMP
L5980   DMP
L5981   DMP
L5984   DMP
L5985   DMP
L5986   DMP
L5987   DMP
L5988   DMP
L5990   DMP
L5999   DMP
L6000   DMP
L6020   DMP
L6050   DMP
L6100   DMP
L6110   DMP
L6120   DMP
L6200   DMP
L6250   DMP
L6300   DMP
L6310   DMP
L6320   DMP
L6370   DMP
L6400   DMP
L6500   DMP
L6580   DMP
L6584   DMP
L6586   DMP
L6600   DMP
L6605   DMP
L6611   DMP
L6615   DMP
L6616   DMP
L6620   DMP
L6623   DMP
L6624   PRO
L6628   DMP
L6629   DMP
L6630   DMP
L6632   DMP
L6635   DMP
L6637   DMP
L6638   DMP
L6641   DMP
L6645   DMP
L6650   DMP
L6655   DMP
L6660   DMP
L6665   DMP
L6670   DMP
L6672   DMP
L6675   DMP
L6676   DMP
L6680   DMP
L6682   DMP
L6684   DMP
L6686   DMP
L6687   DMP
L6688   DMP
L6689   DMP
L6691   DMP
L6692   DMP
L6693   DMP
L6694   DMP
L6695   DMP
L6697   Ort
L6698   DMP
L6703   DMP
L6704   DMP
L6707   DMP
L6708   DMP
L6721   DMP
L6805   DMP
L6810   DMP
L6881   DMP
L6882   DMP
L6884   DMP
L6890   DMP
L6895   DMP
L6900   DMP
L6905   DMP
L6915   DMP
L6925   DMP
L6935   DMP
L6955   DMP
L6965   DMP
L7007   DMP
L7009   Ort
L7180   DMP
L7260   DMP
L7261   DMP
L7274   DMP
L7360   DMP
L7364   DMP
L7366   DMP
L7367   DMP
L7368   DMP
L7400   DMP
L7401   DMP
L7403   DMP
L7404   PRO
L7405   DMP
L7499   DMP
L7500   DMP
L7510   DMP
L7520   DMP
L7600   DMP
L8000   DMP
L8030   DMP
L8035   PRO
L8042   DMP
L8045   PRO
L8400   DMP
L8410   DMP
L8415   DMP
L8417   DMP
L8420   DMP
L8430   DMP
L8435   DMP
L8440   DMP
L8460   DMP
L8465   DMP
L8470   DMP
L8480   DMP
L8485   DMP
L8499   DMP
L8500   DMP
L8610   DMP
L8612   PRO
L8614   DMP
L8629   DMP
L8680   DMP
L8699   DMP
L9900   PRO
M0076   THP
P3000   LAB
P7001   LAB
P9615   LAB
Q0081   IVT
Q0084   CHM
Q0091   LAB
Q0092   XRY
Q0179   MED
Q0181   MED
Q1003        DMP
Q4010        MED
Q4021        MED
Q4038        DMP
Q4046        MED
Q9966        INJ
Q9967        INJ
R0075        XRY
S0020        INJ
S0077        INJ
S0512        DMP
S0516        DMP
S0592        EYE
S0810        EYE
S0830        XRY
S8424        DMP
S8450        MED
S9090        SUR
S9123        OTH
S9124        THP
S9131        THP
S9140        DRV
S9455        DRV
S9460        DRV
S9465        DRV
S9470        DRV
S9500        HHC
S9501        IVT
S9502        HHC
T1012        MED
V0100        EYE
V0120        EYE
V0799        DMP
V1045        EYE
V1299        SUR
V2020        DMP
V2020   22   DMP
V2025        DMP
V2100        DMP
V2101        DMP
V2102        DMP
V2103        DMP
V2104        DMP
V2105        DMP
V2107        DMP
V2108        DMP
V2109        DMP
V2111        DMP
V2112        DMP
V2113        DMP
V2114        DMP
V2115        DMP
V2121        EYE
V2199        DMP
V2200        DMP
V2201   DMP
V2202   DMP
V2203   DMP
V2204   DMP
V2205   DMP
V2206   DMP
V2207   DMP
V2208   DMP
V2209   DMP
V2210   DMP
V2211   DMP
V2212   DMP
V2213   DMP
V2214   DMP
V2215   DMP
V2218   DMP
V2219   DMP
V2220   DMP
V2299   DMP
V2300   DMP
V2301   DMP
V2302   DMP
V2303   DMP
V2304   DMP
V2306   DMP
V2307   DMP
V2308   DMP
V2311   DMP
V2312   DMP
V2313   DMP
V2315   DMP
V2318   DMP
V2319   DMP
V2320   DMP
V2399   DMP
V2410   DMP
V2430   DMP
V2499   DMP
V2500   DMP
V2501   EYE
V2510   DMP
V2511   DMP
V2512   DMP
V2513   DMP
V2520   DMP
V2521   DMP
V2522   DMP
V2523   DMP
V2530   DMP
V2531   DMP
V2599   DMP
V2600   DMP
V2610   DMP
V2615   DMP
V2623   DMP
V2624   DMP
V2625   DMP
V2626   DMP
V2627   DMP
V2628   DMP
V2629   DMP
V2630   DMP
V2632   DMP
V2700   DMP
V2710   DMP
V2715   DMP
V2718   DMP
V2730   DMP
V2744   DMP
V2745   DMP
V2750   DMP
V2755   DMP
V2756   DMP
V2760   DMP
V2762   DMP
V2780   DMP
V2781   DMP
V2782   DMP
V2783   DMP
V2784   DMP
V2785   DMP
V2786   DMP
V2787   DMP
V2788   Vis
V2790   DMP
V2797   DMP
V2799   DMP
V3610   EYE
V5010   EAR
V5011   EAR
V5014   EAR
V5020   EAR
V5030   DMP
V5040   DMP
V5050   DMP
V5060   DMP
V5090   DMP
V5100   DMP
V5110   DMP
V5130   DMP
V5140   DMP
V5150   DMP
V5160   DMP
V5170   DMP
V5180   DMP
V5200   DMP
V5210   DMP
V5220   DMP
V5230   DMP
V5240   EAR
V5241        DMP
V5249        DMP
V5251        DMP
V5252        DMP
V5253        DMP
V5254        DMP
V5255        DMP
V5256        DMP
V5257        DMP
V5258        DMP
V5258   50   DMP
V5259        DMP
V5260        DMP
V5261        DMP
V5264        DMP
V5265        DMP
V5266        DMP
V5267        DMP
V5268        DMP
V5269        DMP
V5271        EAR
V5272        DMP
V5273        DMP
V5274        DMP
V5275        DMP
V5299        DMP
Code Description
Anesthesia for procedures on salivary glands, inlcuding biopsy
Anesthesia for procedures involving plastic repair of cleft lip.
Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)
Anesthesia for electroconvulsive therapy
Anesthesia for procedures on external, middle, and inner ear including biopsy;
Anesthesia for procedures on external, middle, and inner ear including biopsy;
Anesthesia for procedures on external, middle, and inner ear including biopsy;
Anesthesia for procedures on eye; not otherwise specified
Anesthesia for procedures on eye; lens lens surgery
Anesthesia for procedures on eye; corne corneal transplant
Vitreoretinal surgery
Anesthesia for procedures on eye; iridectomy
Anesthesia for procedures on eye; ophth ophthalmoscopy
Anesthesia for procedures on nose and accessory sinuses; not otherwise specified
Anesthesia for procedures on nose and accessory sinuses; radical surgery
Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue
Anesthesia for intraoral procedures, including biopsy; not otherwise specified
Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor
Anesthesia for intraoral procedures, including biopsy; radical surgery
Anesthesia for procedures on facial bones or skull; not otherwise specifiednot otherwise specified
Anesthesia for procedures on facial bones; radical surgery (including prognathism)
Anesthesia for intracranial procedures; not otherwise specified
Anesthesia for intracranial procedures; subdural taps
Anesthesia for intracranial procedures; burr holes
Cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)
Anesthesia for intracranial procedures; vascular procedures
Anesthesia for intracranial procedures; procedures in sitting position
Cerebrospinal fluid shunting procedures
Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve
Pacemetry - measurement of the thickness of the cornea
Anesthesia for all procedures on integumentary system of neck, including subcutaneous tissue
Anesthesia for all procedures on esophagus, thyroid, larynx, trachea, and lymphatic system of neck; not otherwise specified, age 1 year or
Anesthesia for all procedures on esophagus, thyroid, larynx, trachea, and lymphatic system of neck;
Anesthesia for procedures on major vessels of neck; not otherwise specified
Anesthesia for procedures on major vessels of neck; simple ligation
Anesthesia for procedures on anterior integumentary system of chest, including subcutaneous tissue; not otherwise specified
Anesthesia for procedures on anterior integumentary system of chest, including subcutaneous tissue;
Anesthesia for procedures on anterior integumentary system of chest, including subcutaneous tissue;
Anesthesia for procedures on anterior integumentary system of chest, including subcutaneous tissue;
Anesthesia for procedures on anterior integumentary system of chest, including subcutaneous tissue;
Anesthesia for procedures on clavicle and scapula; not otherwise specified
Anesthesia for procedures on clavicle and scapula; radical surgery
Anesthesia for procedures on clavicle and scapula; biopsy of clavicle
Anesthesia for partial rib resection; not otherwise specified
Anesthesia for partial rib resection; thoracoplasty (any type)
Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)
Anesthesia for all procedures on esophagus
Anesthesia for closed chest procedures (including esophagoscopy, bronchoscopy, thoracoscopy);
Anesthesia for closed chest procedures (including esophagoscopy, bronchoscopy, thoracoscopy);
Anesthesia for closed chest procedures (including esophagoscopy, bronchoscopy, thoracoscopy);
Mediastinoscopy and diagnostic thoracosopy not utilizing one lung ventilation
Anesthesia for permanent transvenous pacemaker insertion
Anesthesia for access to central venous circulation
Anesthesia for transvenous insertion or replacement of cardioverter/defribrillator
Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum; not otherwise specified
Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum;
Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum;
Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum;
Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator
with pump oxygenator, age 1 yr. or older, for all non-coronary bypass procedures (eg, valve procedures) or for re-operation for coronary b
Anesthesia for direct coronary artery bypass grafting; without pump oxygenator
with pump oxygenator
Anesthesia for heart transplant or heart/lung transplant
Anesthesia for procedures on cervical spine and cord; not otherwise specified
Procedures with patient in the sitting position
Anesthesia for procedures on thoracic spine and cord; not otherwise specified
Anesthesia for procedures on thoracic spine and cord; thoracolumbar sympathectomy
Anesthesia for procedures in lumbar region; not otherwise specified
Anesthesia for procedures in lumbar region; lumbar sympathectomy
Anesthesia for procedures in lumbar region; chemonucleolysis
Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)
Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified
Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy
Anesthesia for procedures on upper posterior abdominal wall
Anesthesia for upper gastrointestinal endoscopic procedures
Anesthesia for hernia repairs in upper abdomen; not otherwise specified
Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence
Anesthesia for hernia repairs in upper abdomen; omphalocele
Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia
Anesthesia for all procedures on major abdominal blood vessels
Anesthesia for intraperitoneal procedures in upper abdomen, including laparoscopy; not otherwise specified
Partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)
Anesthesia for intraperitoneal procedures in upper abdomen, including bowel shunts;
Anesthesia for intraperitoneal procedures in upper abdomen, including bowel shunts;
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity
Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified
Anesthesia for procedures on lower anterior abdominal wall; panniculectomy
Anesthesia for intestinal endoscopic procedures
Anesthesia for procedures on lower posterior abdominal wall
Anesthesia for hernia repairs in lower abdomen; not otherwise specified
Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias
Anesthesia for intraperitoneal procedures in lower abdomen, including laparoscopy; not otherwise specified
Anesthesia for intraperitoneal procedures in lower abdomen; amniocentesis
Anesthesia for intraperitoneal procedures in lower abdomen; abdominoperineal resection
Anesthesia for intraperitoneal procedures in lower abdomen; radical hysterectomy
Anesthesia for intraperitoneal procedures in lower abdomen; pelvic exenteration
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;
Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract;
Anesthesia for lithotripsy, extracorporeal shock wave
Anesthesia for lithotripsy, extracorporeal shock wave; without water bath
Anesthesia for procedures on major lower abdominal vessels; not otherwise specified
Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation
Anesthesia for; anorectal procedure
Anesthesia for procedures on perineal integumentary system (including biopsy of male genital system);
Anesthesia for procedures on perineal integumentary system (including biopsy of male genital system);
Anesthesia for procedures on perineal integumentary system (including biopsy of male genital system);
Anesthesia for transurethral procedures (including urethrocystoscopy);
Anesthesia for transurethral procedures (including urethrocystoscopy);
Anesthesia for transurethral procedures (including urethrocystoscopy);
Anesthesia for transurethral procedures (including urethrocystoscopy);
Anesthesia for transurethral procedures (including urethrocystoscopy);
Anesthesia for procedures on male external genitalia; (including open urethral procedures); not otherwise specified
Anesthesia for procedures on male external genitalia; seminal vesicles
Anesthesia for procedures on male external genitalia; undescended testis, unilateral or bilateral
Anesthesia for procedures on male external genitalia; radical orchiectomy, inguinal
Anesthesia for procedures on male external genitalia; radical orchiectomy, abdominal
Tda (artificial disc), anterior approach, including diskectomy to prepare interspace;each additional interspace (add-on code - see cpt book f
Anesthesia for procedures on male external genitalia; orchiopexy, unilateral or bilateral
Anesthesia for procedures on male external genitalia; complete amputation of penis
Anesthesia for procedures on male external genitalia; radical amputation of penis with bilateral inguinal lymphadenectomy
Anesthesia for procedures on male external genitalia; radical amputation of penis with bilateral inguinal and iliac
Anesthesia for procedures on male external genitalia; insertion of penile prosthesis (perineal approach)
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified
Colpotomy, vaginectomy, colporrhaphy, and open urethral procedures
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium);
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium);
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium);
Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium);
Implantation of intrastromal corneal ring segments
Implantation of intrastromal corneal ring segments
Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior illiac crest.
Anesthesia for procedures on bony pelvis
Anesthesia for body cast application or revision
Anesthesia for interpelviabdominal (hind quarter) amputation
Anesthesia for radical procedures for tumor of pelvis, except hind quarter amputation
Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint
Anesthesia for open procedures involving symphysis pubis or sacroiliac joint
Anesthesia for obturator neurectomy; extrapelvic
Anesthesia for obturator neurectomy; intrapelvic
Anesthesia for all closed procedures involving hip joint
Anesthesia for arthroscopic procedures of hip joint
Anesthesia for open procedures involving hip joint; not otherwise specified
Anesthesia for open procedures involving hip joint; hip disarticulation
Total hip arthroplasty
Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty
Anesthesia for all closed procedures involving upper 2/3 of femur
Anesthesia for open procedures involving upper 2/3 of femur; not otherwise specified
Anesthesia for open procedures involving upper 2/3 of femur; amputation
Anesthesia for open procedures involving upper 2/3 of femur; radical resection
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg
Anesthesia for all procedures involving veins of upper leg, including exploration
Anesthesia for procedures involving arteries of upper leg, including bypass graft;
Anesthesia for procedures involving arteries of upper leg, including bypass graft;
Anesthesia for procedures involving arteries of upper leg, including bypass graft;
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area
Anesthesia for all closed procedures on lower 1/3 of femur
Anesthesia for all open procedures on lower 1/3 of femur
Anesthesia for all closed procedures on knee joint
Anesthesia for diagnostic arthroscopic procedures of knee joint
Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella
Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella
Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified
Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty
Anesthesia for open procedures on knee joint; disarticulation at knee
Anesthesia for all cast applications, removal, or repair involving knee joint
Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified
Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula
Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified
Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft
Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm
Ct heart wo dye; qual calc
Ct heart wo dye; qual calc
Anesthesia for all closed procedures on lower leg, ankle, and foot
Anesthesia for arthroscopic procedures of ankle and/or foot
Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified
Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot;
Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot;
Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified
Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection
Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula
Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement
Anesthesia for lower leg cast application, removal, or repair
Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified
Anesthesia for procedures on arteries of lower leg, including bypass graft;
Anesthesia for procedures on veins of lower leg; not otherwise specified
Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or catheter
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla
Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint
Anesthesia for diagnostic arthroscopic procedures of shoulder joint
Anesthesia for open or surgical procedures on humerial head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; n
Anesthesia for open procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint;
Anesthesia for open procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint;
Anesthesia for open procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint;
Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified
Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm
Anesthesia for procedures on arteries of shoulder and axilla; bypass graft
Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft
Anesthesia for all procedures on veins of shoulder and axilla
Anesthesia for shoulder cast application, removal or repair; not otherwise specified
Anesthesia for shoulder cast application, removal or repair; shoulder spica
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow;
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow;
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow;
Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow;
Anesthesia for all closed procedures on humerus and elbow
Anesthesia for diagnostic arthroscopic procedures of elbow joint
Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified
Anesthesia for open procedures on humerus and elbow; osteotomy of humerus
Anesthesia for open procedures on humerus and elbow; repair of nonunion or malunion of humerus
Anesthesia for open procedures on humerus and elbow; radical procedures
Anesthesia for open procedures on humerus and elbow; excision of cyst or tumor of humerus
Anesthesia for open procedures on humerus and elbow; total elbow replacement
Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified
Anesthesia for procedures on arteries of upper arm and elbow; embolectomy
Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified
Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy
Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand
Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones
Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specif
Anesthesia for open procedures on radius, ulna, wrist, or hand bones;
Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified
Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy
Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)
Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified
Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy
Anesthesia for forearm, wrist, or hand cast application, removal, or repair
Anesthesia for diagnostic arteography/venography
Anesthesia for cardiac catheterization including coronary angiography and and ventriculography (not to include swan-ganz catheter)
Anesthesia for non-invasive or radiation radiation therapy
Anesthesia for therapeutic interventional radiologic procedure involving the arterial system; intracranial, intracardiac or aortic
external approach
External approach
Anesthesia for cesarean delivery only
Physiological support for harvesting of organ(s) from brain-dead patient
Daily hospital management of epidural or subarachnoid continuous drug administration
Unlisted anesthesia procedure(s)
Fine needle aspiration; without imaging guidance
Fine needle aspiration; without imaging guidance
Fine needle aspiration; with imaging guidance
Fine needle aspiration; with imaging guidance
Incision and drainage of abscess (eg, carbuncle, suppurative *hidradenitis, and other cutaneous or subcutaneous abscesses);
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, and other cutaneous or subcutaneous abscesses);
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscesses);
Incision and removal of foreign body, subcutaneous tissues; *simple
Incision and drainage of hematoma, seroma or fluid collection
Puncture aspiration of abscess, hematoma, bulla, or cyst
Incision and drainage, complex, postoperative wound infection
Incision and drainage, complex, postoperative wound infection
Debridement of extensive eczematous or infected skin; *up to 10% of body surface
Debridement including removal of foreign material associated with open fracture(s) and/or dislocation(s); skin and subcutaneous tissues.
Debridement; skin full thickness
Debridement; skin, and subcutaneous tis skin, and subcutaneous tissue
Debridement; skin, and subcutaneous tissue
Debridement; skin, and subcutaneous tissue
Debridement; skin, subcutaneous tissue, skin, subcutaneous tissue, and muscle
Debridement; skin, subcutaneous tissue, and muscle
Debridement; skin, subcutaneous tissue, skin, subcutaneous tissue, muscle, and bone
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion
Paring or cutting of benign hyperkeratoic lesion (eg. corn or callus); morethan four lesions
Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed single lesion
Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless otherwise listed (separate
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions
Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
Excision, benign lesion, including margin, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less
Excision, benigh lesion, including margin, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less
Excised diameter, diameter 0.6 to 1.0 cm
Excised diameter 0.6 to 1.0 cm
Excised diameter 1.1 to 2.0 cm
Excised diameter 1.1 to 2.0 cm
Excised diameter 1.1 to 2.0 c.m
Excised diameter 2.1 to 3.0 cm
Excised diameter 2.1 to 3.0 cm
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk arms or legs; excised diameter 2.1 to 3.0 cm
Excised diameter 3.1 to 4.0 cm
Excision, benign lesion including margins, except skin tag(unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm
Excised diamter over 4.0
Excised diameter over 4.0 cm
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5
Excised diamter 0.6 to 1.0c
Excised diameter 1.1 to 2.0 cm
Excised diameter 2.1 to 3.0
Excised diameter over 4.0cm
Excised dia. 0.5cm or less
Excised dia. 0.6 to 1.0cm
Excised diameter 0.6 to 1.0 cm
Excised dia. 1.1 to 2.0cm
Excised diameter 1.1 to 2.0 cm
Excised dia. 2.1 to 3.0cm
Excised diameter 2.1 to 3.0 cm
Excised dia. 3.1 to 4.0cm
Excised diameter 3.1 to 4.0 c.m.
Excised dia. over 4.0 cm
Excised diameter over 4.0 cm
Excision of skin and subcutaneous tissue for hidradenitis, axillary;
Excision of skin and subcutaneous tissue for hidradenitis, axillary;
Excision of skin and subcutaneous tissue for hidradenitis, axillary;
Excised diameter 1.1 to 2.0 cm
Excised diameter 2.1 to 3.0 cm
Excised diameter 3.1 to 4.0 cm
Excised diameter over 4.0 cm
Excised diameter over 4.0 cm
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0
Excised diameter 0.6 to 1.0 cm
Excised diameter 1.1 to 2.0 cm
Excised diameter 1.1 to 2.0 cm
Excised diameter 2.1 to 3.0 cm
Excised diameter 2.1 to 3.0 cm
Excised diameter 3.1 to 4.0 cm
Excised diameter 3.1 to 4.0 cm
Excised diameter over 4.0 cm
Excised diameter over 4.0 cm
Trimming of nondystrophic nails, any number
Debridement of nail(s) by any method(s):
Debridement of nail(s) by any method(s); six or more
Avulsion of nail plate, partial or complete, simple; single
Excision of nail and nail matrix, partial or complete, (eg, ingrown or deformed nail) for permanent removal
Excision of nail and nail matrix, partial or complete, (eg, ingrown or defo
Excision of pilonidal cyst or sinus; simple
Excision of pilonidal cyst or sinus; simple
Excision of pilonidal cyst or sinus; extensive
Excision of pilonidal cyst or sinus; extensive
Excision of pilonidal cyst or sinus; complicated
Excision of pilonidal cyst or sinus; complicated
Injection, intralesional; up to and incl *up to and including seven lesions
Subcutaneous injection of ''filling'' material (eg, silicone); 5.1 to 10 cc
Subcutaneous injection of filling material (eg, silicone); 5.1 to 10 cc
Subcutaneous injection of ''filling'' material (eg, silicone); over 10 cc
Insertion of tissue expander(s) for other than breast, including subsequent expansion
Insertion of tissue expander (s)
Removal of tissue expander(s) without insertion of prosthesis
Removal of tissue expander(s) without insertion of prosthesis
Removal implantable contraceptive capsules
Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or
Treatment of superficial wound dehiscence; simple closure
Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less
12.6 cm to 20.0 cm
Repair, intermediate, wounds of the neck, hands, feet and/or external genitalia;2.5 cm or less
2.6 cm to 7.5 cm
Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
2.6 cm to 5.0 cm
2.6 cm to 5.0 cm
2.6 cm to 5.0 cm
5.1 cm to 7.5 cm
Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm
Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm
Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm
Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet 2.6 cm to 7.5 cm
Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm
Reapir complex, eyelids, nose, ears, and/or lips; 1.0 cm or less
Repair complex, eyelids, nose, ears, and/or lips; 1.0 cm or less
Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm
Secondary closure of surgical wound or dehiscence, extensive or complicated
Secondary closure of surgical wound or dehiscence, extensive or complicated
Secondary closure of surgical wound or dehiscence, extensive or complicated
Adjacent tissue transfer or rearrangement, scalp, arms, and/or legs; defect 10 sq cm or less
Adjacent tissue transfer or rearrangement, scalp, arms, and/or legs; defect 10 sq cm or less
Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands
Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands
Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands
Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands
Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips;
Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips;
Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips;
Adjacent tissue transfer or rearrangement, more than 30 sq cm, unusual or complicated, any area
Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm
SURGICAL PREPARATION OR CREATION OF RECIPIENT SITE BY EXCISION of open wounds, burn eschar, or scar (including subcutaneous tissu
Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on
Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on
Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or one percent of body area of infants and children (except 15050)
Split graft; trunk, scalp, arms, legs, hands, and/or feet (except mult dig)
Split graft, trunk, scalp, arms, legs, hands, and/or feet (except multiple digits);
Split-thickness authograft, face scalp, eyelids, mouth neck, ears, orbits, genitalia, hands feet, and/or multiple digits; first 100 sq cm or less,
Full thickness graft, free, including direct closure of donor site, trunk;
Full thickness graft, free, including direct closure of donor site, trunk;
Full thickness graft, free, including direct closure of donor site; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 2
Full thickness graft, free, including direct closure of donor site; foreheaad, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet;
Full thickness graft, free, including direct closure of donor site, forehea
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips;
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips: 20 sq cm or less
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq. cm or less
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips;
Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips;
Xenograft, skin (dermal), for temporary wound closure; trunk, arms, legs; first 100 sq cm or less, or one percent of body area of infants and
Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia,
Formation of direct or tubed pedicle, with or without transfer; forehead,
Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips or intraoral
Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips or intraoral
Intermediate ''delay'' of any flap, primary ''delay'' of small flap, or sectioning pedicle of tubed or direct flap;
Intermediate ''delay'' of any flap, primary ''delay'' of small flap, or sectioning pedicle of tubed or direct flap;
Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter muscle, sternocleidomastoid, levator scapulae)
Muscel, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter muscle, sternocleidomastoid, levator scapulae)
Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter, sternocleidomastoid,
Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temp- oralis, masseter muscle, sternocleidomastoid, levator scapulae
Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter, sternocleidomastoid,
Muscle, myocutaneous, or fasciocutaneous flap; lower extremity
Flap; island pedicle
Graft; composite (full thickness of ext composite (full thickness of external ear or nasal ala),
Graft; composite (full thickness of external ear or nasal ala),
Graft; derma-fat-fascia derma-fat-fascia
Graft; derma-fat-fascia
Graft; derma-fat-fascia
Punch graft for hair transplant; 1 to 1 1 to 15 punch grafts
Dermabrasion; regional, other than face regional, other than face
Dermabrasion; regional, other than face
Blepharoplasty, lower eyelid; with extensive herniated fat pad
Blepharoplasty, upper eyelid;
Blepharoplasty, upper eyelid; bilateral procedure
Blepharoplasty, upper eyelid;
Blepharoplasty, upper eyelid;
Blepharoplasty, upper eyelid;
Blepharoplasty, upper eyelid; with exce with excessive skin weighting down lid
Blepharoplasty, upper eyelid; with excessive skin weigting down lid
Blepharoplasty, upper eyelid; with excessive skin weighting down lid
Removal of sutures under anesthesia (other than local), same surgeon.
Removal of sutures under anesthesia (other than local), same surgeon.
Dressing change (for other than burns) under anesthesia (other than local)
Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft
Excision, sacral pressure ulcer, with local or regional skin flap closure
Unlisted procedure, excision pressure ulcer
Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettment), premalignant lesions (eg, actinic keratoses
Second through 14 lesions, each (list separately in addition to code for first lesion)
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm
Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or c
15 or more lesions
Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)
Destruction, malignant lesion, any method, trunk, arms or legs; lesion diameter 3.1 to 4.0 cm
Destruction, malignant lesion, any method, scalp, neck, hands, feet, genitalia;
lesion diameter 1.1 to 2.0cm
Chemosurgery (mohs micrographic technique), including removal of all gross tumor, surgical excision of tissue specimens, mapping, color c
Chemosurgery (mohs' technique); second second stage, fixed or fresh tissue, up to 5 specimens
Mohs mirographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specime
each additional stage after the first stage, up to 5 tissue blocks
Unlisted procedure, skin, mucous membrane and subcutaneous tissue
Puncture aspiration of cyst of breast;
Biopsy of breast; needle core (separate (separate procedure)
Biopsy of breast; incisional incisional
Biopsy of breast; incisional
Biopsy of breast; percutaneous, needle cor
Percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance
Excision of cyst, fibroadenoma, or other benign or malignant tumor aberrant breast tissue, duct lesion or nipple lesion (except 19300), ope
Excision of cyst, fibroadenoma, or other benign or malignant tumor aberrant breast tissue, duct lesion or nipple lesion (except
Excision of cyst, fibroadenoma, or other benign or malignant tumor aberrant breast tissue, duct lesion or nipple lesion (except
Excision of breast lesion identified by preop placement of radiological mar
Excision of breat lesion identified by pre-op placement of radiological mar
Mastectomy, partial; with axillary lymphadenectomy
Mastectomy, simple, complete
Mastectomy, simple, complete
Preoperative placement of needle localization wire, breast;
Preoperative placement of needle location wire, breast
Image guided placement, metallic localization clip, percutaneous, during breast biopsy (list separately in addition to code for primary proce
Mastopexy
Mastopexy
Reduction mammaplasty
Reduction mammoplasty
Reduction mammaplasty
Removal of intact mammary implant
Removal of intact mammary implant
Removal of intact mammary implant
Removal of mammary implant material
Nipple/areola reconstruction
Nipple/areola reconstruction
Nipple/areola reconstruction
Breast-reconstruction, immediate or delayed with tissue expander, including subsequent expansion
Revision of reconstructed breast
Revision of reconstructed breast
Unlisted procedure, breast
Biopsy, muscle, percutaneous needle
Biopsy, excisional; superficial (eg, ilium, sternum, spinous process, ribs,
Injection of sinus tract; therapeutic (separate procedure)
Injection of sinus tract; diagnostic (si diagnostic (sinogram)
Removal of foreign body in muscle or tendon sheath; deep or complicated
Removal of foreign body in muscle or tendon sheath; deep or complicated
Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia")
Injection(s); tendon sheath, ligament
Injection(s); tendon sheath, ligament
Injection(s); tendon sheath, ligament
Single tendon origin/insertion
Injection(s); sigle or multiple trigger point(s), one or two muslce(s)
Injection(s); sigle or multiple trigger point(s), one or two muslce(s)
Injection(s); sigle or multiple trigger point(s), one or two muslce(s)
single or multiple trigger point(s), three or more muscle(s)
Arthrocentesis, aspiration and/or injecttion; small joint or bursa (eg, fingers, toes)
Arthrocentesis, aspiration and/or injection; small joint
Arthrocentesis, aspiration and/or injection; small joint or bursa (eg, fingers, toes)
Arthrocentesis, aspiration and/or injecttion; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle,
Arthrocentesis, aspiration and/or injecttion; *major joint or bursa (eg, shoulder, hip, knee joint,
Arthrocentesis, aspiration and/or injecttion; *major joint or bursa (eg, shoulder, hip, knee joint,
Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
Arthrocentesis, aspiration and/or injecttion; *major joint or bursa (eg, shoulder, hip, knee joint,
Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
Aspiration and/or injection of ganglion cyst(s) any location
Insertion of wire or pin with applicatioon of skeletal traction, *including removal (separate procedure)
Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)
Application of cranial tongs, caliper, or stereotatic frame, including removal (separate procedure)
Removal of implant; superficial, (eg, buried wire, pin or rod)(separate procedure)
Removal of implant; superficial, (eg, buried wire, pin or rod)(separate procedure)
Removal of implant; superficial, (eg, buried wire, pin or rod)(separate procedure)
Removal of implant; superficial, (eg, buried wire, pin or rod) (separate procedure)
Removal of implant; deep, (eg, buried w deep, (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Removal of implant; deep, (eg buried wire, pin, screw, metal band, rod or plate)
Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Removal of implant; deep, (eg, buried wire, pin, screw, metal band nail, or rod or plate)
Removal of implant; deep, (eg buried wire, pin, screw, metal band, nail, rod or plate)
Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Removal of implant; deep, (eg buried wire, pin, screw, metal band, rod or plate)
Removal of implant; deep (eg. buried w deep) buried wire, pin, screw, metal
Removal of implant; deep, (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Removal of implant; deep, (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Application of uniplane (pins or wires in one plane), unilateral, external fixation system
Application of a multiplane (pins or wires in more than one plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type)
Removal, under anesthesia, of external ixation system
Removal, under anesthesia, of external fixation system
Bone graft, any donor area; minor or small (eg, dowel or button)
Bone graft; any donor area; minor or small (eg, dowel or button)
Bone graft, any donor area; minor or small (eg, dowel or button)
Bone graft, any donor area; major or large
Bone graft, any donor area; major or large
Bone graft, any donor area; major or large
Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)
Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)
Tissue grafts, other (eg, paratenon, fat, dermis)
Tissue grafts, other (eg, paratenon, fat, dermis)
Allograft for spine surgery only; morselized (List separately in addition to code for primary procedure)
Allograft for spine surgery only: structural (List separately in addition to code for primary procedure)
Allograft for spine surgery only; structural
Allograft for spine surgery only: structural
Autograph for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same
Autograph for spine surgery only (includes harvesting the graft); local (eg, ribs spinous process, or laminar fragments) obtained from same
Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same
Autograph for spine surgery only (includes harvesting the graft); local (eg, ribs spinous process, or laminar fragments) obtained from same
Autograph for spine surgery only (includes harvesting the graft); morselized (through separate skin or facial incision)
Autograph for spine surgery only (includes harvesting the graft); morselized (through separate skin or fasical incision)
Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fasical incision
Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tyricortical (through separate skin or fasical incision
Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tyricortical (through separate skin or fasical incision
Bone graft w/microvascular anastomosis; i
Other than fibula, iliac crest, or metatarsal
Electrical stimulation to aid bone healing; invasive (operative)
Unlisted procedure, musculoskeletal system, general
Coronoidectomy (separate procedure)
Impression and custom preparation; definitve obturator prothesis
Impression and custom preparation; oral surgical splint
Impression and custom preparation; oral surgical splint
Impression and custom preparation; auricular prosthesis
Impression and custom preparation; auricular prosthesis
Application of interdental fixation device for conditions other than fracture or dislocation, includes removal
Genioplasty; sliding osteotomy, single piece
Reconstruction mid-face lafort 1;single peice;w/o bone graft
Reconstruction midface, lefort i; single piece, segment movement in any direction (eg, for long face syndrome), without bone graft
Reconstruction midface, lefort i; two pi
Reconstruction midface, lefort i; two pi
Reconstruction midface, lefort i; three or more pieces, any direction, requiring bone grafts (includes obtaining autografts)
Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial b
Reconstruction of orbital walls, rims, orehead, nasoethmoid complex follow
Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)
Reconstruction midface, osteotomies (other than lefort type) and bone grafts (including obtaining autografts)
Reconstruction of mandibular ramus, horizontal, vertical, "c" or "l" osteotomy; without bone graft
Reconstruction of mandibular ramus, horizontal, vertical, "c" or "l" osteotomy; without bone graft
Reconstruction of mandibular ramus, horizontal, vertical, "c" or "l" osteotomy; without bone graft
Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft)
Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomywith bone graft (including obtaining graft)
Reconstruction of mandibular ramus, sagittal split; with internal rigid fixation
Osteotomy, maxilla, segmental (eg, wassmund or schuchard)
Osteoplasty, facial bones; augmentation augmentation (autograft, allograft, or prosthetic implant)
Graft, bone; nasal, maxillary or malar
Graft, bone; nasal, maxillary or malar
Graft; rib cartilage, autogenous, to fa rib cartilage, autogenous, to face, chin, nose or ear
Graft; rib cartilage, autogenous, to fa rib cartilage, autogenous, to face, chin, nose or ear
Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)
Graft; ear cartilage to nose or ear (in ear cartilage to nose or ear (includes obtaining graft)
Graft; ear cartilage, autogenous, to nose or ear (includes obtaing graft)
Arthroplasty, temporomandibular joint, with or without autograft
Arthroplasty, temporomandibular joint, with or without autograft
Arthroplasty, temporomandibular joint, with or without autograft
Arthroplasty, temporomandibular joint, with prosthetic joint replacement
Reconstruction of mandible or maxilla, subperiosteal implant; partial
Reconstruction of mandible or maxilla, subperiosteal implant; partial
Reconstruction of mandible or maxilla, subperiosteal implant; partial
Reconstruction of mandible or maxilla, sb-penosteal implant; partial
Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder);
Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder);
Reconstruction of mandible or maxilla, endosteal implant (eg blade, cylinder);
Reconstruction of orbit withosteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, microophthalmia)
Periorbital osteotomies for orbital hypertelorism, with bone grafts; extrac
Periorbital osteotomies for orbital hypertelorism, with bone grafts; extrac
Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach
Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts;
Orbital repositioning penorbital osteotomies, unilateral, with bone grafts;
Medial canthoplasty
Unlisted craniofacial and maxillofacial procedure
 unlisted craniofacial and maxillofacial procedure
Closed treatment of nasal septal fracture, with or without stabilization
Treatment of closed nasal septal fracture
combined approach
Open treatment of orbital floor "blowout" fracture; periorbital approach, with alloplastic or other implant
Open treatment of orbital floor "blowout" fracture; periorbital approach, with alloplastic or other implant
Open treatment of orbital floor "blowout" fracture; periorbital approach with bone graft (includes obtaining graft)
Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)
with implant
Open treatment of mandibular fracture; with interdental fixation
Open treatment of complicated mandibular fracture by multiple surgical approaches including intrnal fixation, and/or wiring if dentures or
Unlisted orthopedic procedure, head
Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;
Biopsy, soft tissue of neck or thorax
Excision tumor, soft tissue of neck or thorax subfascial; intramuscular
Excision benign tumor; deep, sufascial thorax; deep subfascial, intramuscular
Excision of rib, partial
Excision first and/or cervical rib; *
Unlisted procedure, neck or thorax
Biopsy, soft tissue of back or flank; deep
Biopsy, soft tissue of back or flank; deep
Excision, tumor, soft tissue of back or flank
Excision, tumor, soft tissue of back or flank
Open treatment and/or reduction of vertebral fracture(s) and/or dis- location(s) (including os odontoideum), anterior approach, including
Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, one fractured vertebra or dislocated
Open treatment and/or reduction of vertebral fracture(s) and/or dis- location(s), posterior approach, one fractured vertebra or dislocated
lumbar
Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with bone graft, with or without
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or
cervical below c2; each additional interspace
Arthrodesis, anterior interbody technique; cervical below c2, with bone graft
Arthrodesis, anterior interbody technique; cervical below c2, with bone graft
Arthrodesis, anterior interbody technique; cervical below c2, with bone graft
Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace (other than for decompression); cervical be
Arthrodesis, anterior interbody technique; cervical below c2, with bone graft
Arthrodesis, anterior interbody technique
Arthrodesis, anterior interbody technique; thoracic, with local bone (eg, rib) and/or bone allograft
Arthrodesis, anterior interbody technique; lumbar, with bone graft
Arthrodesis, anterior interbody technique; lumbar, with bone graft
Arthrodesis, anterior interbody technique; including minimal diskectomy to
Arthrodesis, anterior or anterolateral, each additional interspace (list separately in addition to single level
Arthrodesis, anterior or anterolateral, each add'l interspace (list separately in addition to single level)
Each additional interspace; arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace (other than for
Arthodesis, anterior interbody technique, including minimal diskectomy to prepare interspace (other than for decompression); each add'l i
Arthrodesis, anterior or anterolateral, each add'l interspace (list separately in addition to single level
Arthrodesis, posterior technique, atlas-axis (c1-c2)
Arthrodesis, posterior technique, cervical below c2 segment, local bone or bone allograft and/or internal fixation
Arthrodesis, posterior technique, cervical below c2 segment, local bone or bone allograft and/or internal fixation
Arthrodesis, posterior technique, cervical below c2 segment, localbone or bone allograft and/or internal fixation
Arthrodesis, posterior technique, cervical below c2 segment, local bone or bone allograft and/or internal fixation
Arthrodesis, posterior or posterolateral technique, single level; (with or without lateral transverse technique)
Arthrodesis, posterior or posterolateral technique, with local bone or bone allograft and/or internal fixation;
Arthrodesis, posterior or posterolateral technique, with local bone or bone allograft and/or internal fixation;
Arthrodesis, posterior or posterolateral technique, with local bone or bone allograft and/or internal fixation;
Arthrodesis, posterior or posterolateral technique, with local bone or bone
Arthrodesis, posterior or posterolateral technique, with local bone or bone allograft and/or internal fixation;
Lumbar (with or w/o lateral transverse technique)
Lumbar (with or without lateral transverse technique)
Arthrodesis, posterior or posterolateral
Arthrodesis, posterior or posterolateral
Arthrodesis, posterior or posterolateral
Arthrodesis, posterior or posterolateral
Arthrodesis, posterior or posterolateral
Arthrodesis, posterior or posterolateral technique, single level; each add'
Arthrodesis, posterior interbody technique, with local bone or bone allograft and/or internal wire fixation, lumbar
Arthrodesis, posterior interbody technique, with local bone or bone allograft and/or internal wire fixation, lumbar
Arthrodesis, posterior interbody technique, with local bone or bone allograft and/or internal wire fixation, lumbar
Arthrodesis, posterior interbody technique, with local bone or bone allograft and/or internal wire fixation, lumbar
Arthrodesis, posterior interbody technique, with local bone or bone allograft and/or interal wire fixation, lumbar
Each additional interspace; in addition to primary procedure code 22630
Each additional interspace; in addition to primary procedure code 22630
Each additional interspace; in addition to primary procedure code 22630
Arthrodesis, posterior, for spinal deformity, with or without cast, with bone graft;
Exploration of spinal fusion
Exploration of spinal fusion
Exploration of spinal fusion
Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular
Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular
Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across one interspace, atlantoaxial transarticular
Internal spinal fixation by wiring of spinous processes (List separately in addition to code for primary procedure)
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (
Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (
Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure)
Anterior instrumentation; 2 to 3 vertebral segments
Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure)
Removal of posterior nonsegmental instrumentation (eg, harrington rod)
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowell(s), methymethacrylate) to vetebral defe
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowell(s), methymethacrylate) to vetebral defe
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowell(s), methymethacrylate) to vetebral defe
Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), threaded bone dowell(s), methymethacrylate) to vetebral defe
Removal of posterior segmental instrumentation
Removal of posterior segmental instrumentation
Removal of posterior segmental instrumentation
Removal of posterior segmental instrumentation
Removal of posterior segmental instrumentation
Unlisted procedure, spine
Unlisted procedure, spine
Excision, tumor, soft tissue of abdominal wall, subfasial (eg, intramuscular); less than 5 cm
Excision, abdominal wall tumor, subfascial (eg, desmoid)
Unlisted procedure, abdomen, musculoskeletal system
Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm
Excision, tumor, shoulder area; subfascial intramuscular; less than 5 cm
Excision, tumor, shoulder area; deep, subfascial or intramuscular
Claviculectomy; partial
Claviculectomy; partial
Claviculectomy; partial
Acromioplasty or acromionectomy, partial
Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release
Acromioplasty or acromionectomy, partial
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis), clavicle
Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography
Injection procedure for shoulder arthrography
Injection procedure for shoulder arthrography or enhanced ct/mri shoulder
Repair of ruptured musculotendinous cuff (eg, rotator cuff); open; acute
Repair of ruptured musclotendinous cuff (eg, rotator cuff) open; acute
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute
Repair of ruptured supraspinatus tendon (rotator cuff) or musculotendinous cuff;
Repair of ruptured supraspinatus tendon (rotator cuff) or musculotendinous
Coracoacromial ligament release, with or without acromioplasty
Coracoacromial ligament release, with or without acromioplasty
Coracoacromial ligament release, with or without acromioplasty
Repair of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)
Repair of complete shoulder (rotator) cuff avulsion, chronic (includess acr
Repair of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)
Tenodesis of long tendon of biceps
Tenodesis of long tendon of biceps
Resection or transplantation of long tendon of biceps
Resection or transplantation of long tendon of biceps
Capsulorrhaphy, anterior: putti-platt procedure or magnuson type operation
Capsulorrhaphy for recurrent dislocation; anterior; putti-platt procedure or magnuson type operation
Capsulorrhaphy for recurrent dislocation, anterior;
Capsulorrhaphy for recurrent dislocation anterior; bankart type operation with or without stapling
Capsulorrhaphy, anterior, any type; with bone block *
Capsulorrhaphy for recurrent dislocation, anterior, any type;
Capsulorrhaphy for recurrent dislocation, anterior, any type; with coracoid process transfer
Arthroplasty with proximal humeral implant (eg, neer type operation)
Arthroplasty with proximal humeral implant (eg, neer type operation)
Arthroplasty with glenoid and proximal humeral replacement (eg, total shoulder)
Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))
Osteotomy, clavicle, with or without internal fixation;
Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion
Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion
Closed treatment of clavicular fracture; without manipulation
Open treatment of clavicular fracture includes internal fixation, when performed
Open treatment of clavicular fracture includes internal fixation, when performed
Open treatment of clavicular fracture includes internal fixation, when performed
Open treatment of acromioclavicular dislocation, acute or chronic;
Open treatment of acromioclavicular dislocation, acute or chronic;
Open treatment of acromioclavicular dislocation, acute or chronic;
Open treatment of closed or open acromioclavicular dislocation, acute or chronic;
Open treatment of closed or open acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of
with proximal humeral prosthetic replacement
with proximal humeral prosthetic replacement
Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed
Open treatment of acute shoulder dislocer dislocation
Manipulation under anesthesia, shoulder joint, including *application of fixation apparatus (dislocation excluded)
Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)
Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)
Open treatment of closed or open distal fibular fracture (lateral malleolus), with fixation
with autogenous graft (includes obtaining graft)
Unlisted procedure, shoulder
Unlisted procedure, shoulder
Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow
Excision,tumor, soft tissue of upper arm or elbow area subcutaneous; less than 3 cm
Excision, tumor, upper arm or elbow area; subfascial intramuscular; less than 5 cm
Excision, tumor, upper arm or elbow area; deep, subfascial or intramuscular
Radical resection of tumor (eg, malignant neoplasm), soft tissue of upper arm or elbow area; less than 5 cm
Arthrotomy, elbow; with joint explorati with joint exploration, with or without
Arthrotomy, elbow; with joint exploration, with or without
Excision, radial head
Excision, radial head
Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process
partial excision (craterization, saucerization, or diaphysectomy) bone (eg. osteomyelitis), radial head or neck
partial excision (craterization, saucerization, or diaphysectomy) bone (eg. osteomyelitis), radial head or neck
Removal of foreign body, upper arm or elbow area; subcutaneous
Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)
deep (subfacial or intramuscular)
Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff)
Fasciotomy, lateral or medial (eg, tennis elbow or epicondylitis); with partial ostectomy
Fasciotomy, lateral or medial (eg, tennis elbow or epicondyloitis); with partial ostectomy
Fasciotomy, lateral or medical (eg, tennis elbow or epicondylitis); with partial ostectomy
Fasciotomy, lateral or medial (eg, tennis elbow or epicondylitis); with partial ostectomy
Osteotomy, humerus, with or without internal fixation
Osteotomy, humerus, with or without internal fixation
Repair of nonunion or malunion, humerus; without graft (eg, compression technique)
Repair of nonunion or malunion, humerus; without graft (eg, compression technique)
Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)
Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)
Open treatment of humeral shaft fracture with plate/screws, with or withoutcerclage
Treatment of open monteggia type of fracture dislocation at elbow (fracture
Closed treatment of radial head or neck fracture; without manipulation
Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;
Amputation, arm through humerus; re-amputation
Amputation, arm through humerus; re-amputation
Unlisted procedure, humerus or elbow
Tendon sheath incision; at radial styloid (eg, for dequervain's disease)
Tendon sheath incision; at radial styloid (eg, for dequervain's disease
Incision, extensor tendon sheath, wrist (eg, dequervains disease)
Biopsy, soft tissue of forearm and/or wrist; deep
Biopsy, soft tissue of forearm and/or wrist; deep
Excision, tumor, soft tissue of forearm and/or wrist area; subcutaneous; less than 3 cm
with joint exploration, with or without biopsy, with or without removal of loose or foreign body
with joint exploration, with or without biopsy, with or without removal of loose or foreign body
Arthrotomy, wrist joint; with joint exploration, with or without
Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex
Arthrotomy, distal radioulnar joint including repair of triangular cartliage, comlex
Excision, lesion of tendon sheath, forearm and/or wrist
Excision, lesion of tendon sheath, forearm and/or wrist
Excision of ganglion, wrist (dorsal or volar); primary
Excision of ganglion, wrist (dorsal or volar); primary
Excision of ganglion, wrist (dorsal or volar); primary
Excision of ganglion, wrist (dorsal or volar); recurrent
Excision of ganglion, wrist (dorsal or volar); recurrent
Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc,
Synovectomy, extensor tendon sheath, wist, single compartment;
Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist
Excision distal ulna partial or complete (eg, darrach type or matched resection)
Excision distal ulna partial or complete (eg, darrach type or matched resection)
Excision distal ulna partial or complete (eg, darrach type or matched resection)
Excision distal ulna partial or complete (eg, darrach type or matched resection)
Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle.
Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle
Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each te
Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon
Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each te
Tenolysis, flexor or extensor tendon, foreare and/or wrist, singleeach tendon
Tenodesis at wrist; flexors of fingers flexors of fingers
Tenodesis at wrist; flexors of fingers
Tenodesis at wrist; extensors of finger extensors of fingers
Tenodesis at wrist; extensors of fingers
Tendon transplantation or transfer, flexor or extensor, forearm and/or wris
Tendon transplantation or transfer, flexor or extensor, forearm and/or wris
Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, liament repair, tendon transfer or graft) (includessynovectomy, capsuloto
Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, liga ment repair, tendon transfer or graft) (includes synovectomy, capsulo
Osteotomy, radius; distalthird
Osteotomy; ulna
Osteotomy; ulna
Osteotomy; ulna
Radius AND ulna
Osteoplasty, radius or ulna; shortening
Osteoplasty, radius or ulna; shortening
With autograft (includes obtaining graft)
Repair of nonunion or malunion, radius or ulna; with iliac or other autograft (includes obtaining graft)
Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression technique)
Repair of nonunion or malunion, radius and ulna; with iliac or other autograft (includes obtaining graft)
Repair of nonunion or malunion, radius and ulna; with iliac or other autograft (includes obtaining graft)
Repair of nonunion, scaphoid (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)
Repair of nonunion, scaphoid (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)
Arthroplasty with prosthetic replacement; trapezium
Arthroplasty with prosthetic replacement; trapezium
Arthroplasty with prosthetic replacement; trapezium
Arthroplasty, interposition, intercarpal or carpometacarpal joints
Arthroplasty, interposition, intercarpal or carpometacarpal joints
Arthroplasty, interposition, intercarpal or carpometacarpal joints
Open treatment of radial shaft fracture, includes interanl fixation, when performed
Open treatment of radial shaft fracture, includes interanl fixation, when performed
open treatment of ulnar shaft fracture, includes internal fixation, when performed
open treatment of ulnar shaft fracture, includes internal fixation, when performed
with internal fixation of 3 or more fragments
with internal fixation of 3 or more fragments
Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed
Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed
Open treatment of trans-scaphoperilunar type of fracture dislocation.
Arthrodesis, wrist joint (including radiocarpal and/or ulnocarpal fusion); without bone graft
Arthrodesis, wrist joint (including radiocarpal and/or ulnocarpal fusion);
Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)
Unlisted procedure, forearm or wrist
Drainage of finger abscess; simple
Drainage of finger abscess; simple
Drainage of finger abscess; simple
Fasciotomy, palmer, dor dupuytren's contracture; closed (subctaneous)
Fasciotomy, palmar, for dupuytren's contracture; closed (subcutaneous)
Fasciotomy, palmer (eg. dupuytren's contracture); open partial
Fasciotomy, palmer (eg. dupuytren's contracture); open partial
Fasciotomy, palmar (eg, dupuytren's contracture); open partial
Tendon sheath incision (eg, for trigger finger)
Tendon sheath incision (eg, for trigger finer)
Tendon sheath incision (eg, for trigger finger)
Tendon sheath incision (eg, for trigger finger)
Tendon sheath incision for trigger finger
Tenotomy, subcutaneous, single, each digit
Removal of implant; deep, (eg, buried wire, pin, screw, metal band nail, rod or plate)
Removal of implant; deep, (eg, buried wire, pin, screw, metal band, nail, rod or plate)
Removal of implant; deep, (eg, buried wire, pin, screw, metal band nail, rod or plate)
Arthrotomy for synovial biopsy; interphalangeal joint, each
Excision, tumor or vascular malformation, soft tissue of hand or finger; subcutaneous; less than 1.5 cm
Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial intramuscular; less than 1.5 cm
Excision, tumor or vascular malformation, hand or finger; deep, subfascial, intramuscular
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);
Fasciectomy, palmar, with or without z-plasty, other local tissue re- arrangement, or skin grafting (includes obtaining graft); partial excision
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrange
Fasciectomy, partial palmar with release
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);
Fasciectomy, palmar, with or without z-plasty, other local tissue re- arrangement, or skin grafting (includes obtaining graft); partial excision
Fasciectomy, palmar, with or without z-plasty, other local tissue rearrange
Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction,
Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction,
Synovectomy tendon sheath, radical (tenosynovectomy), flexor, palm or finger, single, each digit
Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger
Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion),
Excision of tendon, finger, flexor or extensor, each tendon
Excision or curettage of bone cyst or benign tumor of proximal, middle or distal phalanx of finger;
Excision or curettage of bone cyst or benign tumor of proximal, middle or distal phalanx of finger;
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal.
Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); primary or secondary without free gr
Flexor tendon repair or advancement, single, not in ''no man's land'';
Flexor tendon repair or advancement, single, not in "no man's land"
Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); primary or secondary without free gr
Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath; secondary with free graft (includes obtaining graft), each
Repair or advancement, flexor tendon, no in zone 2 digital flexor tendon sheath; secondary with free graft (includes obtaining graft) each t
Repair of advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); primary, without free graft, each tendon
Repair of advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); primary, without free graft, each tendon
Flexor tendon repair or advancement, acuteplace svc
Flexor tendon repair or advancement single
Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon
Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon
Repair extensor tendon, finger, primary or secondary; without freegraft, each tendon
Extensor tendon repair, dorsum of finger, single, primary or secondary;
Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger
Repair of extensor tensdon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger
Repair of extensor tensdon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger
Extensor tendon repair, distal insertion ("mallet finger"), open, primary or secondary repair;
Tenolysis, flexor tendon; palm or finger, each tendon
Tenolysis, flexor tendon; palm or finger, each tendon
Tenolysis, simple, flexor tendon; palm palm and finger, each tendon
Tenolysis, simple, flexor tendon; palm palm and finger, each tendon
Tenolysis, simple, flexor tendon; palm and finger, each tendon
Tenolysis, simple, flexor tendon; palm and finger, each tendon
Tenolysis, extensor tendon, hand or finger; each tendon
Tenolysis, extensor tendon, dorsum of hand or finger; each tendon
Tenolysis, extensor tendon, dorsum of hand or finger; each tendon
Tenolysis, extensor tendon, dorsum of hand or finger; each tendon
Tenodesis; of proximal interphalangeal joint, each joint
Tenodesis; for distal joint stabilizati for distal joint stabilization
Lengthening of tendon, flexor, hand or finger, each tendon
Lengthening of tendon, flexor, hand or finger, each tendon
Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon
Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon
Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon
Tendon transfer or transplant, palmar, single, each tendon; without free tendon graft
Opponens plasty; sublimis tendon transfer type
Opponens plasty; sublimis tendon transfer type
Capsulodesis for m-p joint stabilization; two digits
Capsulectomy or capsulotomy for contracture; metacarpophalangeal joint, single, each
Capsulectomy or capsulotomy for contracture; metacarpophalangeal joint, single, each
Capsulectomy or capsulotomy for contracture; metacarpophalangeal joint, sin
Capsulectomy or capsulotomy for contracture; metacarpophalangeal joint, single, each
Capsulectomy or capsulotomy for contracture; interphalangeal joint, single, each
Capsulectomy or capsulotomy for contracture; interphalangeal joint, single, each
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, single, each
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, single, each
Arthropolasty, metacarpophalangeal joint; with prosthetic implant,single, ea
Primary repair of collateral ligament, metacarpophalangeal joint;
Primary repair of collateral ligament, metacarpophalangeal joint;
Primary repair of collateral ligament, metacarpophalangeal joint;
Repair non-union, metacarpal or phalanx, (includes obtaining bone graft with or without external or internal fixation)
Osteotomy for correction of deformity; metacarpal
Osteotomy for correction of deformity; metacarpal
Osteotomy for correction of deformity; metacarpal
Osteotomy for correction of deformity; metacarpal
Osteotomy; phalanx of finger, each
Release, intrinsic muscles of hand (specify
Release, intrinsic muscles of hand (specify)
Release, intrinsic muscles of hand (specify
Closed treatment of metacarpal fracture, single; without manipulation, each bone
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture) includes internal fixation, when performed
carpometacarpal fracture dislocation, thumb (bennett fracture) includes internal fixation, when performed
Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture) includes internal fixation, when performed
Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed
Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed
Open treatment of phalangeal shaft fracture, proximal or middle phalax, finger or thumb, includes internal fixation, when performed, each
Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)
Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)
Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)
Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)
Arthrodesis, carpometacarpal joint, joint,digit, other than thumb each.
Arthrodesis, carpometacarpal joint, digits, other than thumb
Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)
Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)
Arthrodesis, metacarpophalangeal joint, with or w/o internal fixation
Arthrodesis, metacarpophalangeal joint, with or w/o internal fixation
Arthrodesis, metacarpophalangeal joint, w/ or w/o internal fixation;
Arthrodesis, metacarpophalangeal joint, w/ or w/o internal fixation; with a
Amputation, metacarpal, with finger or thumb, single, with or without interosseous transfer
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y
Unlisted procedure, hands or fingers
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)
Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)
Tenotomy, adductor of hip, open
Arthrotomy, hip, with drainage (eg, infection)
Excision, tumor, soft tissue of pelvis and hip area; subcutaneous; less than 3 cm
Excision, tumor, pelvis and hip area; subcutaneous tissue
Excision, tumor, pelvis and hip area; subfascial; (eg, intramuscular); less than 5 cm
Excision, tumor, pelvis and hip area; deep, subfascial, intramuscular
deep, with or without autograft
Deep (subfascial or intramuscular)
Coccygectomy, primary
Removal of hip prosthesis; (separate pr (separate procedure)
Removal of hip prosthesis; complicated, complicated, including ''total hip'' and methylmethacrylate,
Injection procedure for hip arthrography; without anesthesia
Injection procedure for hip arthorgraphy; without anesthesia
Injection procedure for hip arthography; without anesthesia
Injection procedure for sacroiliac joint
Injection procedure for sacroiliac joint, arthrography and/or anesthetic /steroid
Injection procedure for sacroliliac joint
Partial hip replacement, prosthesis (eg prosthesis (eg, femoral stem prosthesis, bipolar arthroplasty)
Arthroplasty, acetabular and proximal femoral prosthetic replacement (totalhip arthroplasty), withor without autograft or allograft.
Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip replacement),
Arthroplasty, acetabular nd proximal femoral prothetic replacement (total hip replacement)
Arthoplasty, acetabular and proximal femoral prosthetic replacement )total hip replacement), with or without autograft or allograft
Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft
Conversion of previous hip surgery to total hip arthroplasty, with or with-out autograft or allograft
Revision of total hip arthroplasty; bot both components, with or without autograft or allograft
Revision of total hip arthroplasty; bot both components, with or without autograft or allograft
Revision of total hip arthroplasty;both components, with or without autograft or allograft
Revision of total hip arthroplasty; ace acetabular component only, with or without autograft or allograft
Revision of total hip arthroplasty; ace acetabular component only, with or without autograft or allograft
Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)
Treatment of intertrochanteric, pertrochanteric or subtrochanteric femoral fracture,
Closed treatment of hip dislocation, traumatic; without anesthesia
Open treatment of hip dislocaiton, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation
Open treatment of hip dislocaiton, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation
Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia
Treatment of auaumatic hip dislocation arthoplasty dislcation; requiring regional or general anesthesia
Arthrodesis, hip joint (includes obtaining graft);
Unlisted procedure, pelvis or hip joint
Incision and drainage of deep abscess, infected bursa, or hematoma, thigh or knee region
Incision and drainage of deep abscess, infected bursa, or hematoma, thigh or knee region
Incision, deep, with opening of bone cor
Incision, deep, with opening of bone cor
Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)
Arthrotomy, knee, for infection, with exploration, drainage or remmoval of foreign body
Arthrotomy, knee, for infection, with exploration, drainage or removal of foreign body
Excision, tumor, soft tissue of thigh or knee area; subcutaneous; less than 3 cm
Excision, tumor, soft tissue of thigh or knee area; subcutaneous; less than 3 cm
Excision, tumor, thigh or knee area; subfascial (eg, intramuscular); less than 5 cm
Excision, tumor, thigh or knee area; deep, subfascial, or intramuscular
Arthrotomy, knee with joint exploration, with or without biopsy, with or without removal
Arthrotomy, knee, with excision of semilunar cartilage (meniscectomy);
Arthrotomy, knee, for excision of semilunar cartilage (memiscectomy); medical or lateral
Arthrotomy, knee, for excision of semilunar cartilage (meniscectomy); medial and lateral
Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater
Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramusculuar); 5 cm or greater
Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater
Excision, prepatellar bursa
Excision, prepatellar bursa
Excision of synovial cyst of popliteal space (baker's cyst)
Excision of synovial cyst of popliteal space (eg, baker's cyst)
Excision of lesion of meniscus or capsul
Patellectomy or hemipatellectomy
Patellectomy or hemipatellectomy
Excision or curettage of bone cyst or benign tumor of femur
Excision or curettage of bone cyst or benign tumor of femur
Excision or curettage of bone cyst or benign tumor of femur
Partial excision (craterization, saucerization, or diaphysectomy)bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone absces
Suture of infrapatellar tendon; primary primary
Suture of infrapatellar tendon; primary
Suture of infrapatellar tendon; primary
Suture of infrapatellar tendon; primary
Suture of quadriceps or hamstring muscle rupture; primary
Suture of quadriceps or hamstring muscle rupture; primary
secondary reconstruction, including fascial or tendon graft
secondary reconstruction, including fascial or tendon graft
Lengthening of hamstring tendon; multiple tendons, bilateral
Repair, primary, torn ligament and/or capsule, knee; collateral
Repair, primary, torn ligament and/or capsule, knee; collateral
Cruciate
Cruciate
Cruciate
Repair, primary, torn ligament and/or c ligament and/or capsule, knee;
Repair, primary, torn ligament and/or c ligament and/or capsule, knee;
Anterior tibial tubercleplasty (eg. for chondromalacia patellae)
Reconstruction for recurrent dislocating patella; with extensor realignmentand/or muscle advancement
Reconstruction for recurrent dislocating patella; with extensor realignment and/or muscle advancement
Lateral retinacular release open
Lateral retinacular release (any method)
Lateral retinacular release open
Ligamentous reconstruction (augmentation), knee extra-articular
Ligamentous reconstruction (augmentation), knee; intra-articular (open)
Ligamentous reconstruction (augmentation), knee; intra-articular (open)
Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular
Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular
Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular
Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular
Arthroplasty, patella; without prosthesis
Arthroplasty; patella; with prosthesis
Arthroplasty, knee, femoral condyles or tibial plateaus
Arthroplasty, knee, femoral condyles or tibial plateaus
Arthroplasty, knee, femoral condyles or tibial plateaus
Arthroplasty, knee, femoral condyles or tibial plateaus
Arthroplasty, knee, condyle and plateau; medial or lateral compartment
Arthroplasty, knee, condyle and plateau; medial or lateral compartment
Medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)
Medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)
Arthroplasty, knee, condyle and plateau; assist. phy. medial and lateral compartments with or without patella
Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella
Osteotomy, femur, shaft or supracondylar; with fixation
Osteotomy, femur, shaft or supracondylar; with fixation
Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of
Ostetomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus (bowleg) or genu valgus (knock-knee);
Ostetomy, proximal tibia, including fibular excision or osteotomy includes correction of genu varus (bowleg) or genu valgus (knock- knee);
Repair, nonunion or malunion, femur, distal to head and neck; without graft(eg, compression technique)
Repair, nonunion or malunion, femur
Repair, nonunion or malunion, femur, distal to head and neck;
Repair, nonunion or malunion, femur, distal to head and neck;
Revision of total knee arthroplasty, with or without allograft; one component
Revision of total knee arthroplasty, with or without allograft; all components
Removal of knee prosthesis, including "total knee," methylmethacrylate and insertion of spacer, when applicable
Removal of knee prosthesis, including "total knee," methylmethacrylate and insertion of spacer, when applicable
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femur
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femur
Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femur
Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cercl
Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cercl
Open treatment of patellar fracture, with internal fixation and/orpartial or complete patellectomy and soft tissue repair
Manipulation of knee joint under general anesthesia *(includes application of traction or other fixation devices)
Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices
Manipulation of knee joint under general anesthesia *(includes application of traction or other fixation devices)
Amputation, thigh, through femur, any level;
Secondary closure or scar revision
Amputation, thigh, through femur, any level; reamputation
re-amputation
Unlisted procedure, femur or knee
general anesthesia
Arthrotomy, ankle, for infection, with exploration, drainage or removal of foreign body
Arthrotomy, ankle, for infection, with exploration, drainage or removal of foreign body
Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening
Arthrotomy, posterior capsular release, ankle, with or without achilles
Excision, tumor, leg or ankle area; subfascial (eg, intramuscular); less than 5 cm
Excision or curettage of bone cyst or benign tumor, tibia or fibula;
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); tibia
Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis or exostosis); tibia
fibula
radical resection of tumor, bone: talus or calcaneus
radical resection of tumor, bone: talus or calcaneus
Repair, primary, open or percutaneous, ruptured achilles tendon
Repair, primary, open or percutaneous, ruptured achilles tendon
Repair, primary, open or percutaneous, ruptured achilles tendon; with graft
Repair, primary, open or percutaneous, ruptured achilles tendon; with graft
Repair, secondary, ruptured achilles tendonwith or without graft
Repair, secondary, ruptured achilles tendonwith or without graft
Repair, dislocating peroneal tendons; without fibular osteotomy
Repair, dislocating peroneal tendons; without fibular osteotomy
Lengthening or shortening of tendon, leg or ankle; single (separate procedure)
Lengthening or shortening of tendon, leg or ankle; single tendon
Lengthening or shortening of tendon, leg or ankle; single (separate procedure)
Gastrocnemius recession (eg, strayer procedure)
Gastrocnemius recession (eg, strayer procedure)
Transfer or transplant of single tendon (with muscle redirection or rerouting);
Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseo
Transfer or transplant of single tendon (with muscle redirection or rerouting);
Suture, primary, torn, ruptured or severed ligament, ankle;
Suture, secondary repair, torn, ruptured or severed ligament, ankle, collateral (eg, watson-jones
Suture, secondary repair, torn, ruptured or severed ligament, ankle; collateral (eg, watson-jone procedure)
Arthroplasty, ankle
Arthroplasty, ankle: with implant (total ankle)
Arthroplasty, ankle: with implant (total ankle)
Osteotomy; fibula fibula
Osteotomy; tibia and fibula
Osteotomy; tibia and fibula
Osteotomy; tibia and fibula
Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)
Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)
Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)
Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)
Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method
Open treatment of tibial shaft fracture, (with or without fibular fracture)with plate/screws, with or without cerclage
Open treatment of tibial shaft fracture, (with or without fibular fracture)with plate/screws, with or without cerclage
Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed
Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed
Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior mal
Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior mal
Open treatment of trimalleolar ankle fracture, with fixation of posterior lip
Arthrodesis, ankle, open
Arthrodesis, ankle, open
Arthrodesis, ankle, open
Arthrodesis, ankle, open
Amputation, leg, through tibia and fibula;
Amputation, leg, through tibia and fibula
Amputation, leg, through tibia and fibula; wiht immediate fitting technique including application of first cast
Amputation leg, through tibia and fibula; secondary closure or scar revision
Amputation leg, through tibia and fibula; secondary closure or scar revision
Amputation leg, through tibia and fibula; reamputation
Amputation leg, through tibia and fibula; reamputation
Amputation, ankle, through malleoli of tibia and fibula (eg, syme, pirogoff type procdures), with plastic closure and resection of nerves
Unlisted procedure, leg or ankle
Incision and drainage below fascia, withor without tendon sheath involve- ment, foot; single bursal space
Incision and drainage below fascia, with or without tendon sheath involve- ment, foot; single bursal space
Incision and drainage below fascia, withor without tendon sheath involve- ment, foot; single bursal space
Incision, deep, with opening of bone cortex (eg, for osteomyelitisor bone abscess), foot
Fasciotomy, foot and/or toe
Fasciotomy, foot and/or toe
Fasciotomy, foot and/or toe
Replantation, digit, excluding thumb (includes distal tip to sublimits tendon insertion), complete amputation
Tarsal tunnel release (posterior tibial nerve decompression)
Tarsal tunnel release (posterior tibial nerve decompression)
Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater
Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater
Excision, tumor, soft tissue of foot or toe, subfascial; (eg, intramuscular); less than 1.5 cm
Excision, tumor, foot; deep, subfascial, intramuscular
Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot or toe; less than 3 cm
Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot
Fasciectomy, excision of plantar fascia;
Fasciectomy, excision of plantar fascia; partial (separate procedure)
Excision of interdigital (morton) neuroma, single, each
Excision of interdigital (morton) neuroma, single, each
Excision of interdigital (morton) neuroma, single, each
Excision of interdigital (morton) neuroma, single, each
Excision of interdigital (morton) neuroma, single, each
Excision of lesion of tendon or fibrous sheath or capsule (including synovectomy) (cyst or ganglion);
Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganlion); foot
Excision of lesion of tendon or fibrous sheath or capsule (including synovectomy) (cyst or ganglion);
Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;
Ostectomy, partial excision, fifth metatarsal head (bunionette) separate procedure
Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)
Ostectomy, complete excision; first met first metatarsal head
Ostectomy, complete excision; first metatarsal head
Ostectomy, complete excision; fifth met fifth metatarsal head
Ostectomy, complete excision; fifth metatarsal head
Ostectomy, complete excision; all metat all metatarsal heads, with partial proximal phalangectomy,
Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy,
Ostectomy, excision of tarsal coalition
Ostectomy, excision of tarsal coalition
Ostectomy, calcaneus;
Ostectomy, calcaneus;
Ostectomy, calcaneus; for spur, with or for spur, with or without plantar fascial release
Ostectomy, calcaneus for spur, with or without plantar fascial release
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis or tarsal bossing),
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis or dorsal bossing), phalanx of toe
Resection, partial or complete, phalangeal base, single toe, each
Resection, head of phalanx, toe
Hemiphalangectomy or interphalangeal joint excision, toe, single, each
Hemiphalangectomy or interphalangeal joint excision, toe, single, each
Removal of foreign body, foot; deep deep
Tenolysis, extensor, foot; multiple tendons
Tenolysis, extensor, foot; multiple tendons
Tenolysis, extensor, foot; multiple tendons
Tentomy, open, flexor; toe, single (separate procedure)
Tentomy, open, flexor; toe, single (separate procedure)
Tenotomy, open, extensor, foot or toe
Recontruction (advancement) posterior tibial tendon with excision of accessory tarsal navicular bone (eg kidner type procedure)
Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, kinder type procedure)
Tenotomy, lengthening, or release, abductor hallucis muscle
Tenotomy, lengthening, or release, abductor hallucis muscle
Tenotomy, lengthening, or release, abductor hallucis muscle
Division of plantar fascia and muscle (''steindler stripping'') (separate procedure)
Division of plantar fascia and muscle (''steindler stripping'') (separate procedure)
Capsulotomy, midfoot; extensive, includ extensive, including posterior talotibial
Correction, Hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
Correction, Hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
Correction, Hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
Correction, Hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
Hammertoe operation; one toe (eg, interphalangeal fusion,
Correction, cock-up fifth toe, with plastic skin closure (eg, Ruiz-Mora type procedure)
Ostectomy, partial, exostectomy or condylectomy, single, metatarsal head, first through fifth,
Ostectomy, partial, exostectomy or condylectomy single, metatarsal head, first through fifth, each metataral head,
Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint
Hallux valgus (bunion) correction, with or without sesamoidectomy; simple exostectomy (silver type procedure)
Hallux valgus (bunion) correction, with or without sesamoidectomy; simple exostectomy (silver type procedure)
Hallux valgus (bunion) correction, with or without sesamoidectomy; keller, mcbride or mayo type procedure
Hallux valgus (bunion) correction, with or without sesamoidectomy; keller, mcbride or mayo type procedure
Hallux valgus (bunion) correction, with or without sesamoidectomy; keller, mcbride or mayo type procedure
Hallux valgus (bunion) correction, with or without sesamoidectomy; keller, mcbride or mayo type procedure
Hallux valgus (bunion) correction, with or without sesamoidectomy; keller, mcbride or mayo type procedure
Hallux valgus (bunion) correction, with or without sesamoidectomy;resectionof joint with implant
Hallux valgus (bunion) correction, with or without sesamoidectomy; resection of joint with implant
Hallux valgus (bunion) correction, with or without sesamoidectomy; with metatarsal osteotomy (eg, mitchell, chevron, or
Hallux valgus (bunion) correction, with or without sesamoidectomy; with metatarsal osteotomy (eg, mitchell, chevron, or
Lapidus-tupe procedure
Lapidus-tupe procedure
Osteotomy; calcaneus (dwyer or chambers calcaneus (dwyer or chambers type
Osteotomy, tarsal bones, other than calcaneus or talus;
Osteotomy, metatarsal, base or shaft, single, with or without lengthening, for shortening or angular correction;
Osteotomy, metatarsal, base or shaft, single, with or without lengthening, for shortening or angular correction;
Osteotomy, metatarsal, base or shaft, single, with or without lengthening, for shortening or angular correction;
Osteotomy, metatarsal, base or shaft, single, with or without lengthening, for shortening or angular correction;
Sesamoidectomy, first toe (separate procedure)
Repair of nonunion or malunion; metatar metatarsal, with or without bone graft
Open treatment of tarsal bone fracture (except talus and calcaneus), includes interal fixation,
Closed treatment of metatarsal fracture; without manipulation, each
Open treatment of metatarsal fracture, includes internal fixation, when performed, each
Open treatment of metatarsal fracture, includes internal fixation, when performed, each
Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each
Open treatment of sesamoid fracture, with or without internal fixation
Open treatment of sesamoid fracture, with or without internal fix-ation
Open treatment of tarsal bone dislocation, includes internal fixation, when performed
Pantalar arthrodesis
Triple arthrodesis
Arthrodesis; triple
 triple arthrodesis
Triple arthrodesis
Subtalar arthrodesis
Subtalar arthrodesis
Subtalar arthrodesis
Subtalar arthrodesis
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse
Arthrodesis, midtarsal or tarshometatarsal, multiple or transversewith osteotomy as for flatfoot correction
Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuniform (eg, miller type procedure)
Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuniform (eg, miller type procedure)
Arthrodesis, midtarsal or tarsometatarsal, single joint
Arthrodesis, midtarsal or tarsometatarsal, single joint
Arthrodesis, great toe; interphalangeal interphalangeal joint
Arthrodesis, great toe; interphalangeal joint
Arthrodesis, great toe, interphalangeal joint, with extensor hallucis longus transfer to first
Amputation, foot; midtarsal (chopart ty midtarsal (chopart type procedure)
Amputation, metatarsal, with toe, single
Amputation, toe; metatarsophalangeal joint
Amputation, toe; metatarsophalangeal joint
Amputation, toe; interphalangeal joint interphalangeal joint
Amputation, toe; interphalangeal joint
Unlisted procedure, foot or toes
Application; shoulder to hand (long arm shoulder to hand (long arm)
Application; shoulder to hand (long arm)
Application; elbow to finger (short arm elbow to finger (short arm)
Application; elbow to finger (short arm elbow to finger (short arm)
Application; hand and lower forearm (gauntlet)
application of long arm splint (shoulder to hand)
application of long arm splint (shoulder to hand)
Application of short arm splint (forearm to hand); static
Application of short arm splint (forearm to hand); static
Application of short arm splint (forearm to hand); static
Application of short arm splint (forearm to hand); dynamic
Application of finger splint; static static
Application of finger splint; dynamic
Application of long leg cast (thigh to toes):
Application of cylinder cast (thigh to ankle)
Application of short leg cast (below knee to toes);
Application of short leg cast (below knee to toes);
Application of short leg cast (below knee to toes); walking or ambulatory type
Adding walker to previously applied cast
Application of rigid total contact leg cast
Application of rigid total contact leg cast
Application of short leg splint (calf to foot)
Application of short leg splint (calf to foot)
Ankle and/or foot
ankle and/or foot
Strapping; toes toes
Strapping; unna boot unna boot
Denis-browne splint strapping
Removal or bivalving; gauntlet, boot or gauntlet, boot or body cast
Removal or bivalving; full arm or full full arm or full leg cast
Unlisted procedure, casting or strapping
Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, shoulder, diagnostic, with or w/o synovial biopsy (separate procedure)
Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, shoulder, surgical; capsulorrhaphy
Arthroscopy, shoulder, surgical; capsulorrhaphy
Arthroscopy, shoulder, surgical; repair of slap lesion
Arthroscopy, shoulder, surgical, repair of slap lesion
Arthroscopy, shoulder, surgical; repair of slap lesion
Arthroscopy, shoulder, diagnostic, with or without synovial biopsy(separateprocedure)
Arthroscopy, shoulder, surgical; debridement, limited
Arthroscopy, shoulder, surgical; debridement, limited
Arthroscopy, shoulder, surgical; debridement, limited
Arthroscopy, shoulder, surgical; debrid debridement, extensive
Arthroscopy, shoulder, surgical; debridement, extensive
Arthroscopy, shoulder, surgical; debridement, extensive
Arthroscopy, shoulder, surgical; debridement, extensive
Arthroscopy, shoulder, surgical; debridment, extensive
Arthroscopy, shoulder, surgical; debridement, extensive
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)
Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation
Arthorscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation
Arthroscopy, shoulder, surgical, with lysis and resection of adhesions, with or without manipulation
Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation
Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation
Arthroscopy, shoulder, surgical; decomp decompression of subacromial space with partial acromioplasty
Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release
Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release
Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty with or without coracoacrmial release
Arthroscopy shoulder, decompression of subacromial space with partial acrom
Arthroscopy, shoulder, surgical; with rotator cuff repair
Arthroscopy, shoulder, surgical, with rotator cuff repair
Arthroscopy, shoulder, surgical; with rotator cuff repair
Arthroscopy, shoulder, surgical; with rotator cuff repair
Arthroscopy, elbow, surgical; with removal of loose body or foreign body
Arthroscopy, elbow, surgical; with removal of loose body or foreign body
Arthroscopy, elbow, surgical; debridement, extensive
Arthroscopy, elbow, surgical; debridement, extensive
Arthroscopy, elbow, surgical; debridement, extensive
Arthroscopy, wrist, diagnostic, withh or without synovial biopsy (separate procedure)
Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, wrist, surgical; for infection, lavage and drainage
Arthroscopy, wrist, surgical; for infection, lavage and drainage
Arthroscopy, wrist, surgical; synovectomy, partial
Arthroscopy, wrist, surgical; synovectomy, partial
Arthroscopy, wrist, surgical; synovecto synovectomy, complete
Arthroscopy, wrist, surgical; synovecto synovectomy, complete
Arthroscopy, wrist, surgical; synovectomy, complete
Arthroscopy, wrist, surgical; synovectomy, complete
Arthroscopy, wrist, surgical; synovecto synovectomy, complete
Arthroscopy, wrist, surgical; excision of triangular fibrocartliage and/or joint debridement
Arthroscopy, wrist, surgical; excision of triangular fibrocartliage and/or joint debridment
Arthroscopy, wrist, surgical; excision of triangular fibrocartliage and/or joint debridement
Excision and/or repair of trianglar fibrocartilage and/or joint debridement
Arthroscopy, wrist, surgical; with release of transverse carpal ligament
Arthroscopy, wrist, surgical; with release of transverse carpal ligament
Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty)(includes harvesting of the autograft[s])
Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
Arthorscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
Arthroscopy, knee, surgical; for infection, lavage and drainage
Arthoscopy, knee, surgical; with lateral release
Arthoscopy, knee, surgical; with lateral release
Arthroscopy, knee, surgical; for remova for removal of loose body or foreign body (eg, osteochondritis
Arthroscopy, knee, surgical; for remova for removal of loose body or foreign body (eg, osteochondritis
Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis
Arthroscopy, knee, surgical; synovectom synovectomy, limited (eg, plica or shelf resection)
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection)
Arthroscopy, knee, surgical; synovectom synovectomy, major, two or more compartments (eg, medial or lateral)
synovectomy, major, two or more compartments (eg, medial or lateral)
Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (eg, medial or lateral)
Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (eg, medial or lateral)
Arthroscopy, knee, surgical; debridemen debridement/shaving of articular cartilage (chondroplasty)
Arthroscopy, knee, surgical; debridemen debridement/shaving of articular cartilage (chondroplasty)
Arthroscopyp; knee, surgical; debridement/shaving of articular cartliage
Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
Arthroscopy, knee, surgical; abrasion a abrasion arthroplasty (includes chondroplasty where necessary)
abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
Arthroscopy, knee, surgical;abrasion arthrplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
Arthroscopy, knee, surgical;abrasion arthrplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
Arthroscopy, knee, surgical; abrasion a abrasion arthroplasty (includes chondroplasty where necessary)
Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary)
Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with menis with meniscectomy (medial and lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with menis with meniscectomy (medial and lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with menis with meniscectomy (medial or lateral including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial or lateral including
Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial or lateral including any meniscal shaving)
Arthroscopy, knee, surgical; with meniscectomy (medial or lateral including any meniscal shaving)
Arthroscopy, knee, surgical; with menis with meniscus repair (medial or lateral)
Arthroscopy, knee, surgical; with meniscus repair (medical or lateral)
Arthroscopy, knee, surgical; with menis with meniscus repair (medial or lateral)
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)
Arthroscopy, knee, surgical; with meniscus repair (meidal and lateral)
Arthroscopy, knee, surgical; with lysis with lysis of adhesions with or without manipulation
Arthroscopy, knee, surgical; with lysis or adhesions with or without manipulation (separate procedure)
Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
Arthroscopy, knee, surgical; drilling f drilling for osteochondritis dissecans with bone grafting
Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting
Arthroscopy, knee, surgical; drilling f drilling for intact osteochondritis dissecans lesion with
Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with
Arthroscopically aided anterior cruciate ligament repair/ augmentation or reconstruction
Arthroscopically aided anterior cruciate ligament repair/augmentation or re
Arthroscopically aided anterior cruciate ligament replair/augmentation or
Arthroscopically aided anterior cruciate ligament repair/ augmentation or reconstruction
Arthroscopically aided anterior cruciate ligament repair/ augmentation or reconstruction
Arthroscopically aided posterior cruciate ligament repair/augmentation or r
Arthroscopically aided posterior cruciate ligament repair/augmentation or
Arthroscopically aided posterior cruciate ligament repair/augmentation or
Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect
Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect
Endoscopic plantar fasciotomy
Endoscopic plantar fasciotomy
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose or foreign body.
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive
with ankle arthrodesis
Unlisted procedure, arthroscopy
Biopsy, intranasal
Excision, nasal polyp(s), extensive
Excision, nasal polyp(s), extensive
Excision or destruction (eg, laser), , intranasal lesion; internal approach
Excision, intranasal lesion; internal approach
Excision dermoid cyst, nose: simple, skin, subcutaneous
Excision dermoid cyst, nose: simple, skin, subcutaneous
Excision inferior turbinate, partial or complete, any method
Excision inferior turbinate, partial or complete, any method
Submucous resection inferior turbinate, partial or complete, any method
Submucous resection turbinate, partial or complete
Submucous resection turbinate, partial or complete, any method
Submucous resection turbinate, partial or complete
Injection into turbinate(s), therapeutic
Rhinoplasty, secondary; major revision (nasal tip and osteotomies)
Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate,
Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate,
Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar
Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft
Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft
Repair fistula; oromaxillary (combine w oromaxillary (combine with 31030 if
Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)
Repair fistula; oromaxillary (combine with 31030 if
Repair fistula; oronasal oronasal
Repair fistula; oronasal
Septal or other intranasal dermatoplasty (does not include obtaining graft)
Ablation, soft tissue of inferior turbinates, unilateral orbilateral, any method (eg electrocautery, radiofrequency ablation, or tissue volume
Intramural (ie, submucosal)
Intramural (ie, submucosal)
Cautery and/or ablation, mucosa of turbinates, unilateral or bilateral, any method, (separate procedure), intramural
Control nasal hemorrhage, anteerior, simple (cauterization)
Unlisted procedure, nose
Sinusotomy, maxillary (antrotomy); intr intranasal
Sinusotomy, maxillary (antrotomy); radi radical (caldwell-luc) without removal of antrochoanal polyps
Sinusotomy, maxillary (antrotomy); radi radical (caldwell-luc) with removal of antrochoanal polyps
Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps
Sinusotomy frontal; transorbital, unila transorbital, unilateral (for mucocele or osteoma,
Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (9includes ablation)
Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision ( includes ablation)
Sinusotomy frontal; obliterative, with obliterative, with osteoplastic flap, brow incision
Sinusotomy frontal; obiterative, with osteoplastic flap, coronal incision
Csinusotomy frontal; obiterative, with osteoplastic frap, coronal incision
Ethmoidectomy; intranasal, anterior
Ethmoidectomy; intranasal, total intranasal, total
Ethmoidectomy; extranasal, total
Ethmoidectomy; extranasal, total
Ethmoidectomy; extranasal, total
Maxillectomy; with orbital exenteration with orbital exenteration (en bloc)
Maxillectomy; with orbital exenteration with orbital exenteration (en bloc)
Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)
Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
Nasal/sinus endoscopy, surgicial; with dscryocystorhinostomy
Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy
Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy
Nasal/sinus endoscopy, surgical; with concha bullosa resection
Nasal/sinus endoscopy, surgical; with concha bullosa resection
Nasal endoscopy, surgical; with ethmoid with ethmoidectomy, partial
Nasal endoscopy, surgical; with ethmoid with ethmoidectomy, partial
Nasal endoscopy, surgical; with ethmoidectomy, partial
Nasal endoscopy, surgical; with ethmoid with ethmoidectomy, anterior and posterior (total)
Nasal endoscopy, surgical; with ethmoidectomy, anterior and posterior (total)
Nasal endoscopy, surgical; with ethmoid with ethmoidectomy, anterior and posterior (total)
Nasal endoscopy, surgical; with ethmoidectomy; anterior and posterior (total)
Nasal endoscopy, surgical; with maxilla with maxillary antrostomy
Nasal endoscopy, surgical; with maxillary antrostomy
Nasal endoscopy, surgical; with maxilla with maxillary antrostomy
Nasal endoscopy, surgical; with maxillary antrostomy
Maxillary sinus endoscopy, surgical; with removal of mucous membrane and/or polyps
Maxillary sinus endoscopy, surgical; with removal of mucous membrane and/or polyps
Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal oftissue from maxillary sinus
Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of
Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of
Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of
Nasal/sinus endoscopy, surgical, with sphenoidotomy;
Nasal/sinus endoscopy, surgical, with sphenoidotomy;
Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from
Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from
Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall decompression
Unlisted procedure, accessory sinuses
Intubation, endotracheal, emergency procedure
Laryngoscopy, indirect; diagnostic (separate procedure)
Laryngoscopy, indirect (separate procedure); with removal of lesion
Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn
Larynogoscopy, direct, operative, with biopsy
Larynogoscopy, direct, operative, with biopsy
Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope
Laryngoscopy, direct, operative, with biopsy; with operating microscope
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescop
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;
Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;
Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope
Laryngoscopy, flexible fiberoptic; diagnostic
Laryngoscopy, flexible fiberoptic; with with removal of lesion
Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy
Unlisted procedure, larynx
Tracheostomy, planned (seperate procedure)
Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis
Tracheal puncture, percutaneous for transtrachael aspiration and/or injection
Bronchoscopy; rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate
Bronchoscopy; rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate
Bronchoscopy; diagnostic, (flexible or rigid), with or without cell
With bronchial or endobronchial biopsy(s), single or multiple sites
Bronchoscopy; with biopsy
With transbronchial lung biopsy(s), single lobe
Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with transbronchial lung biopsy(s), single lobe
Unlisted procedure, trachea, bronchi
Thoracotomy limited, for biopsy of lung or pleura
Biopsy, lung or mediastinum, percutaneous needle
Removal of lung, total pneumonectomy,
Removal of lung, other than total pneum nectomy; single lobe
Removal of lung, other than total pneum nectomy; single lobe
Removal of lung, other than total pneumonectomy single segment (segmentectomy)
Removal of lung, other than total pneum nectomy; wedge resection,single ormultiple
Thoracoscopy, surgical; with wedge resection of lung, single or multiple
Unlisted procedure, lungs and pleura
Pericardiocentesis; initial *initial
Insertion of permanent pacemaker with transvenous electrode(s); ventricular
Insertion of permanent pacemaker with transvenous electrode(s);
Insertion or replacement of permanent pacemaker with transvenous electrodesartial and ventricular
Insertion or replacement of temporary ansvenous single chamber cardiac electrode, or pacemaker catheter (sep procedure)
Insertion or replacement of pacemaker pulse generator only; dual chamber
Insertion of 2 transvenous electrodes, permanent pacemaker or cardiovascular-defibrillator
Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
By translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (ross procedure)
Valvuloplasty, mitral valve with cardio
Replacement, mitral valve, with cardiopulmonary bypass
Replacement, mitral valve, with cardiopulmonary bypass
Coronary artery bypass, vein only; two coronary venous grafts
Coronary artery bypass, vein only; three coronary venous grafts
Coronary artery bypass, vein only; five coronary venous grafts
Coronary artery bypass, using venous graft(s) and arterial graft(s); two venous grafts (List separately in addition to code for primary proced
Coronary artery bypass, using venous graft(s) and arterial graft(s); three venous grafts (List separately in addition to code for primary proce
Coronary artery bypass, using venous graft(s) and arterial graft(s); three venous grafts (List separately in addition to code for primary proce
Coronary artery bypass, using venous graft(s) and arterial graft(s); four venous grafts (List separately in addition to code for primary proced
Reoperation, coronary artery bypass procedure or valve procedure, more than one month after original operation
Coronary artery bypass, using arterial graft(s); single arterial graft
Coronary artery bypass, using arterial graft(s); single arterial graft
Coronary artery bypass, using arterial graft(s); two coronary arterial grafts
Coronary artery bypass, using arterial graft(s); three coronary arterial grafts
Coronary endarterectomy, open, any method, performed in conjunction with coronary artery bypass procedure, each vessel
Ascending aorta graft, with cardiopulmonary bypass, with or without valve suspension; with aortic root replacement using composite prot
Unlisted procedure, cardiac surgery
For aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal area; direct repair of aneur, pseudoaneurysm, or excision (p
Repair blood vessel, direct; lower extr lower extremity
Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision
Thromboendarterectomy, with or without patch graft; abdominal aorta
Transluminal angioplasty, percutaneous; renal or visceral artery
Bypass graft, with vein; femoral-poplit femoral-popliteal
Bypass graft, with other than vein; car carotid-subclavian
Bypass graft, with other than vein; aor aortoceliac, aortomesenteric, aortorenal
Bypass graft, with other than vein; aor aortoceliac, aortomesenteric, aortorenal
Bypass graft, with other than vein; sublavian-vertebral
Aortobifemoral
Bypass graft, with other than vein; aor aortofemoral or bifemoral
Bypass graft with other than vein; aortofemoral
Bypass graft with other than vein; aortofemoral
Bypass graft, with other than vein; femoral-popliteal
Bypass graft, with other than vein; fem femoral-femoral
Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery
Bypass graft; composite, prosthetic and vein (List separately in addition to code for primary procedure).
Thrombectomy of arterial or venous graft;
Introduction of needle or intracatheter,, vein
Introduction of needle or intracatheter, vein
Introduction of catheter, superior or inferior vena cava
Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)
Selective catheter placement, each segmental or subsegmental pulmonary artery
Introduction of needle or intracatheter, carotid or vertebral artery
Introduction of needle or intracatheter; extremity artery
Introduction of catheter, aorta
Introduction of catheter, aorta
Introduction of catheter, aorta
Selective catheter placement, arterial system; each order thoracic or bracheocephalic
Selective catheter placement, arterial system
Selective catheter placement, arterial system; each order thoracic or bracheocephalic
Selective catheter placement, arterial system; each first order thoracic or bracniocephalic branch,
Selective catheter placement, arterial system; initial second order thoracic or bracheocephalic
Selective catheter placement, arterial system; initial second order thoracic or bracheocephalic branch, within a vascular family
Selective cathether placement, arterial system; initial second order thoracic or bracheocephalic branch, within a vascular family
Selective catheter placement, arterial system; initial second order thoracic or bracheocephalic
Selective catheter placement, arterial system; initial second order thoracic or bracheocephalic branch, within a vascular family
Selective catheter placement, arterial system; initial third order or more selective thoracic or
Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular fam
Selective catheter placement, arterial system, additional second order, third order, and beyond,
Selective catheter placement, arterial system, additional second order, third order, and beyond,
Selective catheter placement, arterial system; each first order abdominal, pelvic or lower
Selective cather placement, arterial system; each first order abdominal, pelvic or lower extremity artery branch, within a vascular family
Selective catheter placement, arterial system; each first order abdominal
Selective catheter placement, arterial system; initial second order abdominal, pelvic or lower
Unlisted procedure, vascular injection
scalp vein
Transfusion, blood or blood components
Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk
Injection of sclerosing solution; multiple veins, same leg
Injection of sclerosing solution; multiple veins, same leg
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, readiofrequ
Endovenous ablation therapy of incompetent vein; first vein treated
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first v
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, laser; first vein treated
Venous catheterization for selective organ blood sampling
Insertion of non-tunneled centrally inserted central venous cather; age 5 years or older
Insertionof peripherally inserted central venous catheter (picc), without subcutaneous port or pump; age 5 years or older
Insertion of peripherally inserted central venous access device, with sub- cutaneous port; age 5 years or older
Arterial puncture, withdrawal of blood ffor diagnosis
Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure);
Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure);
Insertion of cannula for hemodialysis, other purpose; vein to vein
Creaton of arteriovenous fistula by other than direct arteriovenous anastomosis (seperate procedure); autogenous graft
Creaton of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft
Revision of an arteriovenous fistula, with or without thrombectomy, autogenous or nonautogenous graft
Cannula declotting (separate procedure) without balloon catheter
Transcatheter biopsy
Transcatheter therapy, infusion other than for thrombolysis, any type (eg, spasmolytic, vasconstrictive)
Transcatheter therapy, infusion other than for thromboysis, any type (eg,
Ligation; external carotid artery
Ligation or biopsy, temporal artery
Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular
Ligation and division and complete stripping of long and short saphenous ve
Ligation and division and complete stripping of long or short saphenous vei
Ligation of perforator veins, subfascial, radical (linton type, skin graft, when performed, open, 1 leg
Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions
Stab phelbectomy of vericose veins, one extremity; 10-20 stab incesions
more than 20 incisions
Unlisted procedure, vascular surgery
Bone marrow; aspiration only
Bone marrow; aspiration only
Bone marrow; aspiration only
biopsy, needle or trocar
biopsy, needle or trocar
biopsy, needle or trocar
Biopsy or excision of lymph node (2); superficial (separate procedure)
Biopsy or excision of lymph node(s); superficial (separate procedure)
Biopsy or excision of lymph node(s); deep cervical node(s)
Biopsy or excision of lymph node(s); deep cervical node(s)
Open, deep cervical node(s) with excision scalene fat pad
Biopsy or excision of lymph node(s); open, deep axillary node(s)
Biopsy or excision of lymph node(s); open, deep axillary node(s)
Cervical lymphadenectomy (modified radical neck dissection)
Axillary lymphadenectomy; superficial superficial
Unlisted procedure, hemic or lymphatic system
Mediastinotomy with exploration, drainage, or removal of foreign body;
Mediastinoscopy, with or without biopsy
Unlisted procedure, mediastinum
Unlisted procedure, diaphragm
Biopsy of lip
Biopsy of the lip
Vermilionectomy (lip shave), with mucosal advancement
Excision of lip; transverse wedge excis transverse wedge excision with primary closure
Excision of lip; transverse wedge excision with primary closure
Excision of lip; v-excision with primar v-excision with primary direct linear closure
Excision of lip; v-excision with primary direct linear closure
Plastic repair of cleft lip; secondary, secondary, by recreation of defect and reclosure
Plastic repair of cleft lip/nasal deform
Unlisted procedure, lips
Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair
Excision of lesion of mucosa and submucosa, vstibule of mouth; with simple repair
Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair
Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair
Excision of lision of mucosa and submucosa, vestibule of mouth; with complex repair
Vestibuloplasty; posterior, unilateral
Unlisted procedure, vestibule of mouth
Excision of lesion of tongue with closure; anterior two-thirds
Unlisted procedure, tongue, floor of mouth
Removal of embedded foreign body from dentoalveolar structures; soft tissues
Removal of embedded foreign body from dentoalveolar structures soft tissues
Removal of embedded foreign body from dentoalveolar structures; bone
Excision of osseous tuberosities, dentoalveolar structures
With complex repair
With complex repair
Excision of hyperplastic alveolar mucosa, each quadrant
Alveolectomy, including curettage of osteitis or sequestrectomy
Alveololasty, each quadrant (specify)
Alveololasty, each quadrant (specify)
Unlisted procedure, dentoalveolar structures
Unlisted procedure, dentoalveolar structures
Excision, lesion of palate, uvula; with with simple primary closure
Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)
Palatopharyngoplasty (eg, uvulopalatopharyngoplasty,
Palatoplasty for cleft palate, with closure of alveolar ridge;
Palatoplasty for cleft palate, with bone graft to alveolar ridge (includes obtaining graft)
Repair of anterior palate, including vomer flap
Repair of anterior palate, including vomer flap
Unlisted procedure, palate, uvula
Drainage of abscess; submaxillary or sublingual, intraoral
Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral
Sialolithotomy; submandibular (submaxillary), complicated, intraoral
Sialolithotomy; submandibular (submaxillary), complicated, intraoral
Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection
Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection
Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection
Excision of submandibular (submaxillary) gland
Excision of submandibular (submaxillary) gland
Excision of submandibular (submaxillary) gland
Excision of sublingual gland
Closure salivary fistula
Unlisted procedure, salivary glands or ducts
Biopsy; oropharynx oropharynx
Biopsy nasopharynx, visible lesion, simple
Tonsillectomy and adenoidectomy; age 12 age 12 or over
Tonsillectomy and adenoidectomy; age 12 or over
Tonsillectomy, primary or secondary; age 12 or over
Tonsillectomy, primary or secondary; age 12 or over
Adenoidectomy, primary; under age 12 under age 12
Adenoidectomy, primary; age 12 or over
Adenoidectomy, secondary; age 12 or over
Adenoidectomy, secondary; age 12 or over
Control oropharyngeal hemorrhage, primary or secondary (eg, posttonsillectomy);
Control oropharyngeal hemorrhage, primary or secondary (eg, posttonsillectomy);
Control oropharyngeal hemorrhage, primary or secondary (eg, posttonsillectomy);
Control oropharyngeal hemorrhage, primary or secondary (eg, posttonsillectomy);
Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or withou
Unlisted procedure, pharynx, adenoids, or tonsils
Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen)s)
Esophagoscopy, rigid or flexible; diagnostic, with or without collection ofspecimen(s) by brushing or washing (separate procedure)
Esophagoscopy, rigid or flexible;with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Esophagoscopy, rigid or flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Esophagoscopy, rigid or flexible with balloon dilation, (less than 30 mm diameter)
Esophagoscopy, rigid or flexible with in insertion of guide wire followed by dilation over guide wire
Esophagoscopy, rigid or flexible with in insertion of guide wire followed by dilation over guide wire
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including esophagus, stomach, andeither the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic with
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including exophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendo
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with biopsy, si
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
With dilation of gastric outlet for obstruction (eg, balloon, guide wire, bougie)
With dilation of gastric outlet for obstruction (eg, balloon, guide wire, bougie)
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or the jejunum as appropriate; with remo
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ballon dil
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duedenum and/or jejunum as appropriate; with balloon d
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ballon dil
Upper gastrointestinal endoscopy including esophagus
Endoscopic retrograde cholangiopancreatography (ercp), diagnostic with or without biopsy and/or collection of
Endoscopic retrogrande cholangiopancreatography (ercp), diagnostic with or without biopsy and/or collection of specimen(s) by brushing
Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy
Endoscopic retrograde choloangiopancreatography (ercp); with sphincterotomy/papillotomy
Laparoscopy, surgical, esophagogastric fun
Laparoscopy, surgical, esophagogastric fun
Dilation of esophagus, by unguided sound or bougie, *single or multiple passes
Dilation of esophagus, by unguided sound or bougie, single or multiple passes
Dilation of esophagus, by unguided sound or bougie, single or multiple passes
Unlisted procedure, esophagus
Gastrotomy; with suture repair of bleed with suture repair of bleeding ulcer or esophagogastric laceration
Gastrotomy; with suture repair of bleed with suture repair of bleeding ulcer or esophagogastric laceration
With roux-en y reconstruction
Unlisted laparoscopy procedure, stomach
Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance
Gastric restrictive procedure, w/o gastric bypass, for morbid obesity; vertical-banded gastroplasty
Gastric restrictive procedure, w/o gastric bypass, for morbid obesity; vertical-banded gastroplasty
Gastric restrictive procedure, w/o gastric bypass, for morbid obesity; vertical-banded gastroplasty
Gastric restrictive procedure, with gastricbypas for morbid oesity; with short limb (less than 100 cm) roux-en-y gastroenterostomy
Gastric restrictive procedure, with gastricbypass for morbid obesity;
Closure of gastrostomy, surgical
Unlisted procedure, stomach
Enterolysis (freeing of intestinal adhesion) for acute bowel obstruction (separate procedure)
Enterolysis (freeing of intestinal adhesion) for acute bowel obstruction (separate procedure)
Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (list separately in addition to primary procedure
Excision of one or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy
Enterectomy, resection of small intestine; single resection and anastomosis
Mobilization of splenic flexure performed in conjunction with partial colectomy (list seperately)
Colectomy, partial; with anastomosis with anastomosis
Colectomy, partial; with anastomosis with anastomosis
Colectomy, partial; with end colostomy with end colostomy and closure of distal segment
Colectomy, partial; with coloproctostom with coloproctostomy (low pelvic anastomosis)
Colectomy, partial; abdominal and trans abdominal and transanal approach
Colectomy, total, abdominal, with proctectomy; with ileostomy
Colectomy, partial, with removal of terminal ileum with ileocolostomy
colectomy, partial, with anastomosis
colectomy, partial, with removal of terminal ileum
colectomy, partial, with removal of terminal ileum
colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastromosis)
colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastromosis)
Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis
Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis
Ileostomy or jejunostomy, non-tube
Ileostomy or jejunostomy, non-tube
Colostomy or skin level cecostomy (do not report in conjection with 44141, 44144, 44146, 44605, 45100, 45119, 45126, 45563, 44805, 458
Revision of colostomy; complicated (reconstruction in depth)
Revision of colostomy; complicated (reconstruction in depth)
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum;
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum;
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum not including ileum; with abation of tumor(s), polyp(s),or ot
Small intestinal endoscopy, enteroscopy beyond second portion of duodenumn not including ileum; with ablation of tumor(s), polyp(s),or
Colonoscopy through stoma; diagnostic, with or without collection of speci
Colonoscopy through stoma; diagnositic, with or without collection of specimen(s) by brushing or
Closure of enterostomy, large or small intestine
Closure of enterostomy, large or small intestine
Closure of enterostomy, large or small intestine; with resection and anastomosis
Closure of enterostomy, large or small intestine; with resection and anastomosis
Closure of enterrostomy, large or small intestine; with resection and anastomosis
Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)
Closure of enterostomy, large or small intestine; with resection and anastromosis (eg, closure of hartmann type procedure)
Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)
Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)
Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)
Closure of intestinal custaneous fistula
Unlisted procedure, intestine
Unlisted procedure, meckel's diverticulum and the mesentery
Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess
Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess
Anorectal myomectomy
Anorectal myomectomy
Proctectomy, partial, without anastomosis, perineal approach
Proctectomy, partial, without anastomosis, perineal approach
Proctosigmoidoscopy rigid; diagnostic with or without collection of specimen(s) by
Proctosigmoidoscopy rigid with dilation any method
Proctosigmoidoscopy, rigid; with biopsy, single or multiple
Sigmoidoscopy, flexible fiberoptic with with or without collection of specimen(s) by
Sigmoidoscopy, flexible fiberoptic with or without collection of specimen(s) by brushing or washing (separate procedure)
Sigmoidoscopy, flexible with biopsy; single or mulitple
Sigmoidoscopy, flexible with biopsy; single or multiple
Sigmoidoscopy, flexible with removal of of tumor(s), polyp(s), or other lesion(s)
Colonoscopy, rigid or flexible, transabdominal via colotomy, single or multiple
Colonoscopy, fiberoptic, beyond splenic flexure; diagnostic , with or without colon decompression
Colonoscopy, fiberoptic, beyond splenic flexure; diagnostic procedure
Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumorspolyp(s), or other lesion(s) not amenable to removal by hot biops
Colonoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy foceps, bipolar cautery or snare
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s),
Colonoscopy,flexible, proximal to splenic flexure;with removal of tumor(s),polyp(s), or other lesion(s) by hot biopsy forceps or bipolar caut
Colonoscopy,flexible, proximal to splenic flexure;with removal of tumor(s),polyp(s), or other lesion(s) by hot biopsy forceps or bipolar caut
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s),
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s)
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s)
with dilation by balloon, 1 or more strictures
Laparoscopy, surgical; protectomy, complete, combine abdominoperineal, with colostomy
Laparoscopy, surgical; protectomy, complete, combine abdominoperineal, with colostomy
Proctoplasty; for prolapse of mucous me for prolapse of mucous membrane
Proctoplasty; for prolapse of mucous membrane
Repair of rectocele (separate procedure)
Unlisted procedure, rectum
Incision and drainage of ischiorectal or intramural abscess, with fistulectomy, submuscular
Incision and drainage of ischiorectal or intramural abscess, with fistulectomy, submuscular
Incision of thrombosed hemorrhoid, external
Fissurectomy, including sphincterotomy, when performed
Fissurectomy, with or without sphincterotomy
Hemorrhoidectomy internal and external, single coumn/group;
Hemorrhoidectomy internal and external, simple;
Hemorrhoidectomy, internal and external, 2 or more columns/groups
Hemorrhoidectomy, internal and external, complex or extensive;
Hemorrhoidectomy, internal and external, complex or extensive;
Surgical treatment of anal fistula (fist (fistulectomy/fistulotomy); subcutaneous
Intersphincteric
Transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed
Surgical treatment of anal fistula (fist (fistulectomy/fistulotomy); complex or multiple
Closure of anal fistula w/rectal advancement flap
Closure of anal fistula w/rectal advancement flap
Anoscopy; diagnostic with or without collection of specimen(s) by brushing or washing (separate procedure)
Anoplasty, plastic operation for stricture; adult
Anoplasty, plastic operation for stricture; adult
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle) simple; chemical
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum, contagiosum, herpetic vesicle), simple; laser surgery
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosur
Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum con- tagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosu
Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)
Destruction of hermorrhoids, any method; internal and external
Hemorrhoidectomy, internal, by litigation other than rubber band, single hemorrhoid column/group
Hemorrhoidectomy, internal, by litigation other than rubber band, single hemorrhoid column/group
Unlisted procedure, anus
Biopsy of liver, needle; percutaneous
Biopsy of liver, percutaneous needle
Biopsy of liver, needle; when done for indicated purpose at time of other than major procedure
Unlisted procedure, liver
Change of percutaneous biliary drainage catheter
Laparoscopy, surgical; cholecystectomy
Laparoscopy surgical; cholecystectomy
Laparoscopy, surgical; cholecystectomy
Laparoscopy, surgical, cholecystectomy
Laparoscopy, surgical; cholecystectomy w/c
Laparoscopy, surgical; cholecystectomy w/c
Laparoscopy, surgical, cholecystectomy, w/c
Unlisted laparoscopy procedure, biliary tract
Cholescystectomy
Cholecystectomy;
Cholecystectomy; with cholangiography with cholangiography
Cholecystectomy; with cholangiography
Cholecystectomy; with cholangiography
Cholecystectomy with exploration of common duct;
Excision of choledochal cyst
Unlisted procedure, biliary tract
Unlisted procedure, pancreas
Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
Removal of peritoneal foreign body from peritoneal cavity
umbilectomy, omphalectomy, excision of umbilicus (separate procedure)
Omentectomy, epiploectomy, resection of omentum (separate procedure)
Laparoscopy, abdomen, peritoneum, omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (seperate pro
Laparoscopy, abdomen, peritoneum, omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (seperate pro
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate
Laparoscopy, abdomen, peritoneum, omentum; d
Laparoscopy, surgical, abdomen, peritomeum, d
Laparoscopy, surgical; with biopsy (single or multiple)
Laparoscopy, surgical, abdomen, peritoneum
Laparoscopy, surgical, abdomen, peritoneum
Unlisted laparoscopy procedure, abdomen, peritoneum and omentum
Repair initial inguinal hernia, age 5 or over; reducible
Repair initial inguinal hernia, age 5 or over; reducible
Repair initial inguinal hernia, age 5 or over; reducible
Repair initial inguinal hernia, age 5 years or over; reducible
Repair initial inguinal hernia, age 5 or over; reducible
Repair initial inguinal hernia, age 5 yrs or over; incarcerated or strangulated
Repair initial inguinal hernia, age 5 yrs or over; incarcerated or strangulated
Repair recurrent inguinal hernia, any age; reducible
Repair recurrent inguinal hernia, any age; reducible
Repair recurrent inguinal hernia, any age; reducible
Repair recurrent inguinal hernia, any age; reducible
Repair recurrent inguinal hernia, any age; reducible
Repair inguinal hernia, sliding, any age *
Repair inguinal hernia, sliding, any age
Repair initial femoral hernia, any age; reducible
Repair initial femoral hernia, any age; reducible
Repair initial incisional hernia; reducible *
Repair initial incisional hernia; reducible *
Repair initial incisional hernia; reducible *
Repair initial incisional hernia; reducible (separate procedure)
Repair initial incisional hernia; incarcerated or strangulated
Repair initial incesional hernia; incarcerated or strangulated
Repair initial incisional hernia; incarcerated or strangulated
Repair recurrent incisional hernia; reducible *
Repair recurrent incisional hernia; reducible (separate procedure)
Repair recurrent incisional or ventral hernia; incarcerated or strangulated
Repair recurrent incisional or ventral hernia; incarcerated or strangulated
Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing sof
Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing sof
Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing sof
Repair epigastric hernia, (eg, properitoneal fat); reducible
Repair epigastric hernia, (eg, properitoneal fat); reducible
Repair epigastric hernia (eg, preperitoneal fat); incarcerated or strangulated
incarcerated or stangulated
Repair umbilical hernia, age 5 years or over; reducible
Repair umbilical hernia, age 5 years or older; reducable
Repair umbilical hernia, age 5 years or over; reducible
Repair umbilical hernia, age 5 years or over; reducible
Repair umbilical hernia, age 5 or over: incarcerated or strangulated
Repair umbilical hernia, age 5 years or over; incarcerated or strangulated
Laproscopy, surgical; repair initial inguinal hernia
Laparoscopy, surgical, repair initial ingu
Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or s
Unlisted laparoscopy, hernioplasty
Unlisted laparoscopy, hernioplasty,
Suture, secondary, of abdominal wall for eviscretation or dehiscene
Unlisted procedure, abdomen, peritoneum and omentum
Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting or
Percutaneous nephrostolithotomy or pyelostolithotom, with or without dilation, endoscopy, lithotripsy, stenting or basket extraction; over
Percutaneous nephrostolithotomy or pyelostolithotom, with or without dilation, endoscopy, lithotripsy, stenting or basket extraction; over
Nephrectomy, including partial ureterectomy, any open approach including rib resection;
Nephrectomy, including partial ureterectomy, any approach including rib resection;
Nephrectomy, including partial ureterectomy, any approach including rib resection;
Nephrectomy, including partial ureterectomy, any approach including rib resection;
Nephrectomy, including partial ureterectomy, any approach including rib resection;
Nephrectomy with total ureterectomy and bladder cuff; through s seperate incision
Aspiration and/or injection of renal cysst or pelvis by needle, *percutaneous
Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous
Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous
Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous
Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous
Laparoscopy, surgical; nephrectomy, including partial ureterectomy
Lithotripsy, extracorporeal shock wave
Lithotripsy, extracorporeal shock wave
Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter
Aspiration of bladder; with insertion of suprapubic catheter
Injection procedure for cystography or vvoiding urethrocystography
Injection procedure and placement of chain for contrast and/or chain urethrocystography
Injection procedure for retrograde urethrocystography
Injection procedure for retrograde urethrocystography
Bladder irrigation, simple, lavage and/oor instillation
Insertion of non-indwelling bladder catheter
Insertion of temporary indwelling bladder catheter, simple
Simple cystometrogram
Complex cystometrogram (ie, calibrated electronic equipment)
Complex cystometrogram (ie, calibrated electronic equipment)
Complex cystometrogram (eg, calibrated electronic equipment)
with urethral presure profile studies, any technique
with urethral presure profile studies, any technique
Complex cystometrogram; with voiding pressure studies and urethral pressure profile studies, any technique
Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)
Complex uroflowmetry (eg, calibrated electronic equipment)
Complex uroflowmetry (eg, calibrated electronic equipment)
Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique
Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique
Needle electromyography studies (emg) of anal or urethral sphincter, any technique
Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)
Voiding pressure studies, intra-abdominal (ie' rectal, gastric, intraperiotoneal) (List separately in additon to code for primary procedure)
Voiding pressure studies, intra-abdominal (ie' rectal, gastric, intraperiotoneal) (List separately in additon to code for primary procedure)
Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging
Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging
Anterior vesicourethropexy, or urethropexy (marshall-marchetti-krantz type);
Anterior vesicourethropexy, or urethropexy (marshall-marchetti-drantz type)
Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)
Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg stamey, raz,
Cutaneous vesicostomy
Cutaneous vesicostomy
Laproscopy, surgical; urethral suspension
Laproscopy, surgical; urethral suspension
Cystourethroscopy (separate procedure)
Cystourethroscopy (separate procedure)
Cystourethroscopy (separate procedure)
Cystourethroscopy (separate procedure)
Cystourethroscopy, with ureteral cathet with ureteral catheterization, with or without irrigation,
Cystourethroscopy, with uretheral catheterization, with or without irrigation
Cystourethroscopy, with ureteral catheterization, with or without irrigation
Cystourethroscopy, with ureteral catheterization, with or without irrigation,
Cystourethroscopy, hospital;
Cystourethroscopy, with biopsies
Cystourethroscopy, with biopsy
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethr
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethr
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm)
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm)
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of;
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of;
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of;
Cystourethroscopy, iwth dilation of bladder for interstitial cystitis;
Cystourethroscopy, iwth dilation of bladder for interstitial cystitis;
Cystourethroscopy, with internal urethrotomy; female
Cystourethroscopy, with internal urethrotomy; female
Cystourethroscopy with direct vision internal urethrotomy
Cystourethroscopy with direct vision internal urethrotomy
Cystourethroscopy with direct vision internal urethrotomy
Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy and injection
Cystourethroscopy, with calibration and/or dilation of urethral stricture o
Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy and injection
Cystourethroscopy, with steroid injection into stricture
Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral
Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure);
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure);
Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments, simple;
Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)
Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus
Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus
Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)
(bilateral) cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
Cystourethroscopy, w/reteroscopy/pyelosc
Cystourethroscopy, w/reteroscopy/pyelosc
Cytostourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (uretal catheterization is included)
Cytostourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (uretal catheterization is included)
Transurethral resection of bladder neck (separate procedure)
Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy,
Transurethral resection of prostate, in- cluding control of postop bleed
Transurethral resection; of postoperati of postoperative bladder neck contracture
Transurethral resection; of postoperative bladder neck contracture
Excision of urethral diverticulum (separate procedure); female
Dilation of urethral stricture by passagge of sound *or urethral dilator, male;
Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal)
Dilation of female urethra including supppository and/or *instillation;
Unlisted procedure, urinary system
Circumcision, surgical excision other than clamp or dorsal slit; older than 28 days of age
Circumcision, surgical excision other than clampor dorsal slit; except new
Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach
Orchiectomy, radical, for tumor; inguinal approach
Orchiopexy, inguinal approach with or without hernia repair
Orchiopexy, inguinal approach with or without hernia repair
Excision of spermatocele, with or with epididymectomy
Excision of spermatocele, with or without epididymectomy
Epididymectomy; unilateral
Ipididymectormy; unilateral
Excision of hydrocele; unilateral unilateral
Excision of hydrocele; unilateral
Repair of tunica vaginalis hydrocele (bottle type)
Excision of hydrocele of spermatic cord, unilateral
Exision of hydrocele of spermatic cord, unilateral
Excision of lesion of spermatic cord (separate procedure)
Excision of lesion of spermatic cord (separate procedure)
Excision of varicocele or ligation of spermatic veins for varicocele;
hernia repair
Biopsy, prostate; needle or punch, sing needle or punch, single or multiple, any approach
Prostatectomy, retropubic radical; with with bilateral pelvic lymphadenectomy, including external
Prostatectomy, retropubic radical; with with bilateral pelvic lymphadenectomy, including external
Prostatectomy. retropubic radical: with bilateral pelvic lymphadenectomy
Unlisted procedure, male genital system
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic
Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic
Laparoscopy, surgical; with lysis of adhesions
Laparoscopy, surgical; with lysis of adhesions
Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)
Incision and drainage of vulva or perineal abscess
Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery,cryosrugery, chemosurgery)
Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery,cryosrugery, chemosurgery)
Extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
Biopsy of vulva or perineum (separate procedure); one lesion
Vulvectomy; simple; partial *
Excision of Bartholin's gland or cyst
Excision of Bartholin's gland or cyst
Colposcopy of the vulva; with biopsy(s)
Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)
Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosur-gery, cryosurgery, chemosurgery)
Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosur-gery, cryosurgery, chemosurgery)
Destruction of vaginal lesion(s); extensive any method
Biopsy of vaginal mucosa; simple (separate procedure)
Insertion of pessary
Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal
Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstertical)
Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)
Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele (separate procedure)
Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele (separate procedure)
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
Combined anteroposterior colporrhaphy;
Combined anteroposterior colporrhaphy;
Combined anteroposterior colporrhaphy; with enterocele repair
Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list
Repair of enterocele, abdominal approach (separate procedure)
Colpopexy, abdominal approach
Sacrospinous ligament fixation for prolapse of vagina *
Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)
Sling operation for stress incontinence (eg, fascia or synthetic)
Sling operation for stress incontinence
Sling operation for stress incontinence (eg, fascia or synthetic) (for laparoscopic approach, use 51992)
Construction of artificial vagina; with with graft
Pelvic exam under anesthesia (other than local)
Pelvic exam under anesthesia (other than local)
Colposcopy of the cervix including upper/adjacent vagina
With biopsy(s) of of the cervix and endocervical curettage
With loop electrode biopsy(s) of the cervix
With loop electrode biopsy(s) of the cervix
Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)
Cautery of cervix; electro or thermal
Cauterization of cervix; cryocautery, i *cryocautery, initial or repeat
Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser
Biopsy of cervix, circumferential (cone), with or without dilation and curettage, with or without sturmdorff type repair
Conization of cervix, with or without fulguration with or without dilation and curettage,
Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision
Conization of cervix, with or without fulguration with or without dilation and curettage,
Endometrial and/or endocervical sampling (biopsy), without cervical dilation, any method
Dilation and curettage, diagnostic and/or therapeutic (nonobstretrical)
Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)
Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)
Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)
Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 grams or less and/or removal of s
Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 grams or less and/or removal of s
Total hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
Total abdominal hysterectomy (corpus and cervix), with our without removal of tube(s), with or without removal of ovary(s)
Total hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
Total hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
Total hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
Total hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
Total hysterectomy (corpus and cervix), with or without removal of tube(s)
Total abdominal hysterectomy, including partial vaginectomy, with para- aortic and pelvic lymph node sampling, with or without removal o
Total abdominal hysterectomy, including partial vaginectomy, with para- aortic and pelvic lymph node sampling, with or without removal o
Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy),
Vaginal hysterectomy, for uterus 250 grams or less
Vaginal hysterectomy; for uterus 250 grams or less
Vaginal hysterectomy for uterus 250 grams or less
Vaginal hysterectomy; with removal of tube(s), and/or ovary(s)
Vaginal hysterectomy: with removal of tube(s), and/or ovary(s), with repair of enterocele
Vaginal hysterectomy; with colpo-urethro
Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography
Catheterization and introduction of saline or contrast material for hyserosonography or hysterosalpingography
Chromotubation of oviduct, including materials
Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine
Laproscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 kilograms or less and/or removal of surfac
Laproscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 grams or less and/or removal of surface m
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 grams or less
Laproscopy, surgical; w/vaginal hysterectomy, for uterus 250 grams or less
Laparoscopy, surgical; w/vaginal hysterectomy, for uterus 250 grams or less
Laparoscopy, surgical, with vaginal hyterectomy, for uterus 250 grams or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 grams or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 grams or less; with removal of tube(s) and/or ovary(s)
Labaroscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 grams; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 grams; with removal of tube(s) and/or ovary(s)
Hysteroscopy, diagnostic (separate procedure)
Hysteroscopy, surgical; w/sampling (biopsy)
Hysteroscopy, surgical; w/sampling (biopsy)
Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c
With endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)
Laparoscopy, surgical, with total hystererctomy, for uterus 250g or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical, with total hystererctomy, for uterus 250g or less; with removal of tube(s) and/or ovary(s)
Laparoscopy, surgical with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
Laparoscopy, surgical with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)
Laparascopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
Laparascopy, surgical; with fulguration or excision of lesions of the ovary, pelvic visera, or peritoneal surface by any method
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)
Salpingo-oophorectomy, complete or partial; unilateral or bilateral (separate procedure)
Salpingo-oophorectomy, complete or partial, unilateral or bilateral (sep pr
Lysis of adhesions (salpingolysis, ovariolysis)
Ovarian cystectomy, unilateral or bilateral
Ovarian cystectomy, unilateral or bilateral
Ovarian cystectomy, unilateral or bilateral
Ovarian cystectomy, unilateral or bilateral
Oophorectomy, partial or total, unilateral or bilateral;
with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy
Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy
Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy
Hysteroscopy; diagnostic diagnostic
Unlisted procedure, female genital system (nonobstetrical)
Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care
Routine obstetric care including antepartum care, cesarean delivery, and postpartum care
Unlisted procedure, maternity care and delivery
Biopsy thyroid, percutaneuous core needle
Partial thyroid lobectomy, unilateral; withor without isthmusectomy
Total thyroid lobectomy, unilateral; with or without isthmusectomy
Total thyroid lobectomy, unilateral;
Thyroidectomy, total or complete
Thyroidectomy, total or complete
Thyroidectomy, total or complete
cervical approach
cervical approach
Excision of thyroglossal duct cyst or sinus;
Excision of thyroglossal duct cyst or sinus;
Parathyroidectomy or exploration of parathyroid(s)
Parathyroid autotransplantation (list seperately in addition to code for primary procedure)
Thymectomy, partial or total: transcervical approach (separate procedure)
Unlisted procedure, endocrine system
With injection of medication or other substance for diagnosis or treatment (eg, c1-c2)
Puncture of shunt tubing or reservoir foor aspiration *or injection procedure
Puncture of shunt tubing or reservoir for aspiration or injection procedure
Burr hole(s); for implanting ventricular catheter, reservoir, EE electrode(s), pressure recording device, or other cerebral monitoriing device
Decompression of orbit only, transcranial approach
Exploration of orbit (transcranial approach); with removal of lesion
Craniectomy, suboccipital with cervical laminectomy for decompression of me
Crainiectomy, suboccipital; for exploration or decompression of cranial nerves
Crainictomy, suboccipital; for exploration or decompression of cranial nerves
Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma
Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial
Craniectomy for excision of brain tumor, infratentorial or posterior fossa;except meningioma, cerebellopontine angle tumor, or midline tum
Craniectomy for excision of brain tumor, infratentorial or posterior fossa;except meningioma, cerebellopontine angle tumor, or midline tum
Craniectomy for excision of brain tumor, infratentorial or posterior fossa
Cranietomy for excision of brain tumor, infratentorial or posterior fossa
Craniectomy for excision of brain tumor, infratentorial or posterior fossa;midline tumor at base of skull
Craniectomy for excision of brain tumor, infratentorial or posterior fossa;midline tumor at base of skull
Subdural implanation of strip electrodes through one or more burr or trephine hole(s)
Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic
Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, non stereotactic
Hypophysectomy or excision of pituitary tumor, transnasal or transseptal
Anterior cranial fossa; intradural, including unilateral or bi- frontal craniotomy, elevation or resection of frontal lobe,
Orbitocranial approach to anterior cranial fossa; extradural, including supraorbital ridge osteotomy and elevation of frontal and/or tempor
Orbitocranial approach to anterior cranial fossa; extradural, including supraorbital ridge osteotomy and elevation of frontal and/or tempor
Orbitocranial approach to anterior cranial fossa; extradural, including supraorbital ridge osteotomy and elevation of frontal and/or tempor
Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graf
Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bore graft
Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without interal fixation, without bone graft
Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, caverous sinus, parasella
Transtemporal approach to posterior cranial fossa, jugular foramen or mid- line skull base, including mastoidectomy, decompression of sig
Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigm
Transtemporal approach to posterior cranial fossa, jugular foramen or mid- line skull base, including mastoidectomy, decompression of sig
Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural
Resection or excision of neoplastic, vascular or infectious lesionof base of anterior cranial fossa; extradural
Resection or excision of enoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or
Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa,
Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1
Resection or excision of neoplastic, vascular or infectious lesion of base posterior cranial fossa, jugular foramen, foramen magnum, or c1-c
Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1
Secondary repair of dura for csf leak, anterior middle or posterior cranial fossa following surgery
By local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon cat
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon cat
Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion
Stereotactic localization, any method, including burr hole(s); with insertion of catheter(s) for brachytherapy
Stereotactic localization, any method, including burr hole(s); with insertion of catheter(s) for brachytherapy
Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single el
Repair of encephalocele, skull vault, including cranioplasty
Craniotomy for repair of encephalocele, skull base
Craniotomy for repair of encephalocele, skull base two surgeons
Cranioplasty for skull defect; up to 5 up to 5 cm diameter
Cranioplasty for skull defect; larger than 5 cm diameter
Replacement of bone flap or prosthetic plate of skull
Vertriculocisternostomy (torkildsen type op)
Ventriculo-peritoneal, -plkeural, other terminus
Replacement or revision of csf shunt, obstructed valve, or distal catheter in shunt system
Replacement or revision of csf shunt, obstructed valve, or distal catheter in shunt system
Removal of complete csf shunt system; with replacement by similar or other
Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation
Spinal puncture, lumbar, diagnostic
Spinal puncture, lumbar, diagnostic
Spinal puncture, therapeutic, for drainaage of spinal fluid *(by needle or catheter)
Injection, lumbar epidural, of blood or clot patch
Injection, lumbar epidural, of blood or clot patch
Injection of anesthetic substance (including narcotics), diagnostic or ther
Injection procedure for myelography and/or computed tomography, spinal (other than C1-C2 and posterior fossa)
Injection procedure for myelography and/or computed tomography, spinal (other than C1-C2 and posterior fossa)
Injection of substance other than anesthhetic, contrast, *or neurolytic solutions;
Injection procedure for diskography, each level; lumbar
Injection procedure for diskography, each level; lumbar
Injection procedure for diskography, each level; lumbar
Injection procedure for diskography, each level; cervical
Injection procedure for diskography, each leve; cervical or thoracic
Injection procedure for diskography, each level; cervical
Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidu
Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidu
Inject, single (not via indwelling catheter)
Inject, single (not via indwelling catheter)
Lubmar, sacral; injection singe (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either local
Inject, single(not via indwelling catheter)
Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without con
Lumbar, sacral (caudal), injection, including catheter placement, con- tinuous infustion or intermittent bolus, not including neurolytic subs
Lumbar, sacral (caudal)
Lumbar, sacral (caudal), injection, including catheter placement, con- tinuous infusion or intermittent bolus, not including neurolytic subst
Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with
cervical or thoracic, single level
Laminectomy for exploration/decompression of spinal cord and/or cauda equin
Laminectomy for exploration/decompression of spinal cord and/or cauda equin
Laminectomy for exploration/decompression of spinal cord and/or cauda equina, one or two segments;
Laminectomy with removal of abnormal facetsand/or pars inter-articularis wi
Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spond
Laminectomy with removal of abnormal facetsand/or pars inter-articularis wi
Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or diskecto
Laminotomy (hemilaminectomy), for decompression of nerve root(s), including partial facetectomy, foraminotomy and/or
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
1 interspace, lumbar
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
each additional interspace, cervical or lumbar (list seperately in addition to code for primary procedure
Laminotomy (hemilaminectomy), for decompression of nerve root(s), including partial facetectomy, foraminotomy and/or
Laminotomy (hemilaminectomy), for decompression of nerve root(s), including partial facetectomy, foraminotomy and/or
Lumbar; laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excisio
Lumbar; laminoty (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision o
Laminotomy (hemilaminectomy), for decompression of nerve root(s), including partial facetectomy, foramintomy and/or excision of . . . ; lu
Lumbar; laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excisio
Each additional cervical interspace; laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, fo
Each additional lumbar interspace; laminotomy, with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or
Each additional lumbar interspace; laminotomy, with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or
Each additional lumbar interspace; laminotomy, with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or
Laminectomy, including unilateral or bilateral complete facetectomy or foraminotomy for decompression of spinal cord,
Laminectomy, including unilateral or bilateral complete facetectomy or foraminotomy for decompression of spinal cord,
Lumbar; laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or ner
Lumbar; laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or ner
Lumbar; laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or ner
Lumbar; laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or ner
Laminectomy, including unilateral or bilateral complete facetectomy or foraminotomy for decompression of spinal cord,
Lumbar; laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or ner
Laminectomy, including unilateral or bilateral complete facetectomy or foraminotomy for decompression of spinal cord,
Laminectomy, including unilateral or bilateral complete facetectomy or foraminotomy for decompression of spinal cord,
Laminectomy, including unilater or bilateral complete facetecomy or fora- minotomy for decompression of spinal cord, cauda equina and/
Laminectomy, including unilater or bilateral complete facetecomy or fora- minotomy for decompression of spinal cord, cauda equina and/
Laminectomy, including unilateral or bilateral complete facetectomy or foraminotomy for decompression of spinal cord,
Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s)(eg, herniated invertebral disk) single segment; lu
Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disk), single segmen
Costovertebral approach for decompression of spinal cord or nerve root(s), (eg, herniated intervertebral disk), thoracic;
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s), including osteophytectomy;
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s), including osteophytectomy;
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s_), including osteophytectomy;
Diskectomy, anterior, with decompression of spinal cord and/or nerve roots,including osteophytectomy; cervical, single interspace
Diskectomy, anterior, for decompression ofspinal cord and/or nerve roots
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s), including osteophytectomy;
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s), including osterophytectomy;
Cervical, each additional interspace; diskectomy, anterior, with decompression of spinal cord and/or root(s), including osteophytectomy
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s)including osteophytectomy; cervical, each additional interspac
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s), including osteophytectomy;
Diskectomy, anterior, for decompression of spinal cord and/or nerve root(s), including osteophytectomy;
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach
Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach for decompression of spinal cord and/or nerve roo
Vertebral corpectomy (vertebral body resection), partial or com- plete, anterior approach for decompression of spinal cord and/ornerve ro
Vertiebral corpectomy (vertebral body resection), partial or complete, anterior approach for decompression of spinal cord and/ornerve roo
Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space
Laminectomy, for release of tethered spinal cord, lumbar
Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic
lumbar
lumbar
Extradural, lumbar
Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level
Percutaneous implantation of neurostimulator electrode array, epidural
Percutaneous implantation of neurostimulator electrode array, epidural
Perc utaneous implantation of neurostimulator electrode array, epidural
Percutaneous implantation of neurostimulator eletrode array, epidural
Laminectomy for implantation of neurostimulator electrodes, plate/paddle epidural
Laminectomy for implantation of neurostimulator electrodes, plate/paddle epidural
Revision or removal of spinal neurostimulator electrode percutaneous array(s) or plate/paddle(s)
Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
Insertion or replacement of spinal neutostimulator pulse generator or receiver, direct or inductive coupling
Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling
Revision or removal of implanted surgical spinal neurostimulator pulse generator or receiver
Revision or removal of implanted spinal neurostimulator pulse generator or receiver
Revision or removal of implanted surgical spinal neurostimulator pulse generator or receiver
Revision or removal of implanted surgical spinal neurostimulator pulse generator or receiver
Repair of myelomeningocele; larger than larger than 5 cm diameter
Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other, including laminectomy
Injection, anesthetic agent; trigeminal *trigeminal nerve, any division or branch
Injection, anesthetic agent; great occipital nerve
Injection, anesthetic agent; great occipital nerve
Injection, anesthetic agent; cervical plexus
Injection, anesthetic agent; brachial plexus, single
Brachial plexus, single
Brachial plexus, single
Injection, anesthetic agent; axillary nerve
Injection, anesthetic agent; intercostal nerve, single
Injection, anesthetic agent; *intercostal nerves, multiple, regional block
Injection, anesthetic agent; *intercostal nerves, multiple, regional block
Injection, anesthetic agent; il ioinguinal, il iohypogastric nerves
 injection, anesthetic agent; il ioinguinal, il iohypogastric
Injection, anesthetic agent; intercostal nerves, multiple, regional block
Injection, anesthetic agent; paracervica *paracervical (uterine) nerve
Injection, anesthetic agent; paravertebr facet joint nerve, lumbar, single
Sciatic nerve, single
Sciatic nerve, single
Injection, anesthetic agent; femoral nerve, single
Injection, anesthetic agent; femoral nerve, single
femoral nerve, continuous infusion by catheter (including catheter placement)
Injection, anesthetic agent; other peripheral nerve or branch
Injection, anesthetic agent; other peripheral nerve or branch
Injection, anesthetic agent; other peripheral nerve or branch
Inject, anesthetic agent/steroid, paravert
Inject, anesthetic agent/steroid, paravert
Inject, anesthetic agent/steroid, paravert
Inject, anesthetic agent/steroid, paravert
Inject, anesthetic agent/steroid, paravert
Inject, anesthetic agent/steroid, paravert
Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level
Injection, anesthetic agent and/or steroid transforaminal epidural; cervical or thoracic, each additional level
Injection, anesthetic agent and/or steroid, transfomainal epidural; lumbar or sacral, single level
Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level
Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level
Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, each additional level (list separately in addition to cod
Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, each additional level (list separately in addion to code
Injecton(s), diag. or therapeutic agent, paravertebral facet joint with image guidance (fluoroscopy or CT), lumbar or sacral; single level
injections, diagnostic or therapeutic agent, paravertebral facetjoint with image guidance, lumbar or sacral, second level
injections, diagnostic or therapeutic agent, paravertebral facetjoint with image guidance, lumbar or sacral, third and any additional level(s)
Injection, anesthetic agent; stellate ga *stellate ganglion (cervical sympathetic)
Injection, anesthetic agent; *stellate ganglion (cervical sympathetic)
Injection, anesthetic agent
Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)
Application of surface (transcutaneous) neurostimulator
Application of surface neurostimulator
Destruction by neurolytic agent (chemodenervation of muscle endplate; muscles enervated by facial nerve
Destruction by neurolytic agent (chemodenervation of muscle endplate; muscles enervated by facial nerve
Destruction by neurolytic agent (chemodenervation of muscle endplate; muscles enervated by facial nerve
Chemodenervation of muscle(s); neck muscle(s) (eg, for spasmodic torticollis, spasmodic dysphonia)
Destruction by neurolytic agent; paravertebral facet joint nerve, lumbar, single level
Destruction by neurolytic agent; paravertebral facet joint nerve, lumbar single level
Destruction by neurolytic agent; paravertebral facet joint nerve, lumbar, each add'l level
cervical or thoracic, single level
cervical or thoracic, each additional level (list separately in addition to code for primary procedure)
Destruction by neurolytic agent; other other peripheral nerve or branch
Neuroplasty; nerve of hand or foot
Neuroplasty, major peripheral nerve, arm or leg; other than specified
Neuroplasty, major peripheral nerve, arm orleg; other than specified
Neuroplasty and/or transposition; ulnar ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at elbow
Neuroplast and/or transpositioning; ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at elbow
Neuroplasty and/or transposition; ulnar nerve at wrist
Neuroplasty and/or transposition; ulnar nerve at wrist
Neuroplasty and/or transposition; media median nerve at carpal tunnel
Neuroplasty and/oir transposition; media nerve at carpal tunnel
Neuroplasty and/or transposition; media median nerve at carpal tunnel
Neuroplasty and/or transposition; median nerve at carpal tunnel.
Neuroplasty and/or trasposition; median nerve at carpal tunnel
Neuroplasty and/or transposition; median nerve at carpal tunnel
Neuroplasty and/or transposition; median nerve at carpal tunnel
Decompression; unspecified nerve(s) (sp unspecified nerve(s) (specify)
Decompession; unspecified nerve(s) (specify)
Internal neurolysis, requiring use of operating microscope (list separately in addition to
Internal neurolysis, requiring use of operating microscope (list separately in addition to
Orbitotomy with bone flap, lateral approach (eg, kroenlein); for exploration, with or without biopsy
Transection or avulsion of; pudenal ner
Excision of neuroma; cutaneous nerve, surgically identifiable
Excision of neuroma; cutaneous nerve, surgically identifiable
Excision of neuroma; cutaneous nerve, surgically identifiable
Excision of neuroma; major peripherial nerve, except sciatic
Excision of neuroma; major peripherial nerve, except sciatic
Excision of neurofibroma or neurolemmoma; major peripheral nerve
Excision of neurofibroma or neurolemmoma; major peripheral nerve
Excision of neurofibroma or neurolemmoma; major peripheral nerve
Sympathectomy, lumbar
Suture of digital nerve, hand or foot; one nerve
Suture of one nerve; hand or foot, common sensory nerve
Median motor thenar
Suture of one nerve, hand or foot; ulnar motor
Suture of major peripheral nerve, arm or leg, except sciatic; including transposition
Suture of major peripheral nerve, arm or leg, except sciatic;
Anastomosis; facial - hypoglossal
Unlisted procedure, nervous system
Evisceration Ocular Contents; Without Implant
Evisceration of ocular contents; without implant
With Implant
Evisceration of ocular contents; with implant
Enucleation of eye; without implant
Enucleation of eye; without implant
With Implant, Muscles Not Attached To Implant
Enucleation of eye; with implant, muscles not attached to implant
With Implant, Muscles Attached To Implant
Enucleation of eye; with implant, muscles attached to implant
Exenteration of orbit (does not include skin graft), removal of orbital contents; only
Exenteration of orbit (does not include skin graft), removal of orbital contents;
Exenteration of orbit (does not include skin graft), removal of orbital contents; with terapeutic removal of bone
Modification of ocular implant with placement or replacement or pegs (eg, drilling receptacle for prosthesis appendage
Insertion of ocular implant secondary
Insertion of ocular implant secondary
Insertion of ocular implant secondary; after enucleation, muscles attached to implant
Insertion of ocular implant secondary; after enucleation, muscles attached to implant
Reinsertion of ocular implant; with use with use of foreign material for reinforcement and/or
Reinsertion of ocular implant; with use of foreign material for reinforcement and/or
Removal of ocular implant
Removal of ocular implant
Removal of foreign body, external eye; connjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating
Removal of foreign body, external eye; *corneal, without slit lamp
Removal of foreign body, external eye; *corneal, with slit lamp
Removal of foreign body, intraocular; from anterior chamber of eye or lens
Removal of foreign body, intraocular; from anterior chamber or lens
Removal of foreign body, intraocular; from posterior segment, magnetic ex- traction, anterior or posterior route
Removal of foreign body, intraocular; from poterior segment, nonmagnetic extraction
Repair of laceration; cornea and/or scl cornea and/or sclera, perforating, not involving uveal
Repair of laceration; cornea and/or sclera, perforating, not involving uveal
Cornea and/or sclera, perforating, with reposition or resection of uveal tissue
Cornea and/or sclera, perforating, with reposition or resection of uveal tissue
Repair of laceration; application of tissue glue, wounds of cornea and/or sclera
Repair of laceration; application of tissue glue, wounds of cornea and/or sclera
Repair of laceration; application of tissue glue, wounds of cornea and/or sclera
Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium
Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium
Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium
Excision or transposition of pterygium; without graft
Excision or transposition of pterygium; without graft
Excision or transposition of pterygium; without graft
Excision or transposition of pterygium; with graft
Excision or transposition of pterygium; with graft
Excision or transposition of pterygium; with graft
Excision or transposition of pterygium; with graft
Scraping of cornea, diagnostic, for smeaar and/or culture
Scraping of cornea, diagnostic, for smeaar and/or culture
Removal of corneal epithelium; with or w *with or without
Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)
Removal of corneal epithelium; with app with application of chelating agent (eg, edta)
Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)
Keratoplasty (corneal transplant), anterior lamellar
Keratoplasty (corneal transplant), anterior lamellar
Keratoplasty (corneal transplant), anterior lamellar
Keratoplasty (corneal transplant), penetrating (except in aphakia or pseudophakia), includes autografts, and fresh or preserved homograft
Keratoplasty (corneal transplant), penetrating (except in aphakia or pseudophakia), includes autografts, and fresh or preserved homograft
Keratoplasty (corneal transplant), penetrating (except in aphakia or pseudophakia), includes autografts, and fresh or preserved homograft
Keratoplasty (corneal transplant), penetrating (except in aphakia or pseudophakia), includes autografts, and fresh or preserved homograft
Keratoplasty (corneal transplant), penetrating (in aphakia), includes autografts and fresh or preserved homografts
Keratoplsty (corneal transplant), penetrating (in aphakia), includes auto- grafts and fresh or preserved homografts
Keratoplasty (corneal transplant), penetrating (in aphakia), includes autografts and fresh or preserved homografts
Keratoplasty (corneal transplant); penetrating (in pseudophakia)
Keratoplasty (corneal transplant); penetrating (in pseudophakia)
Keratoplasty (corneal transplant); penetrating
Keratoplasty, endothelial
Keratoplasty, endothelial
Keratomileusis
Corneal relaxing incision for correction of surgically induced astigmatism
Corneal relaxing incision for correction or surgically induced astigmatism
Corneal wedge resection for correction of surgically induced astigmatism
Ocular surface reconstruction; amniotic membrane transplantation
Ocular surface reconstruction; amniotic membrane transplantation
Ocular surface reconstruction; amniotic membrane transplantation
Ocular surface reconstruction; amniotic membrane transplantation
Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)
Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)
Paracentisis of anterior chamber of eye (separate procedure) w/diagnostic
paracentisis of anterior chamber of eye (separate procedure) w/diagnostic
Paracentesis of anterior chamber of eye
Paracentesis of anterior chamber of eye (separate procedure); *with therapeutic release of aqueous
Paracentesis of anterior chamber of eye (separate procedure); with therapeutic release of aqueous
Paracentesis of anterior chamber of eye (separate procedure); withtherapeutic release of aqueous
Paracentesis of anterior chamber of eye (separate procedure); *with therapeutic release of aqueous
Paracentesis of anterior chamber of eye (separate proced); with removal of
Paracentesis of anterior chamber of eye (separate proced); with removal of
Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air
Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection
Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air
Trabeculotomy ab externo
Trabeculotomy ab externo
Trabeculoplasty by laser surgery, one or more sessions (defined treatment series)
Trabeculoplasty by laser surgery, one or more sessions (defined treatment series)
Trabeculoplasty by laser surgery, one or more sessions (defined treatment series)
Trabeculoplasty by laser surgery, one or more sessions (defined treatment series)
Severing adhesions of anterior segment, laser technique (separate procedure)
Severing adhesions of anterior segment, laser technique (separate procedure)
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid)
Severing adhesions of anterior segment
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid)
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid)
Anterior synechiae, except goniosynechiae; severing adhesion of anterior segment of eye, incisional technique (withor without injection of
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid); posterior synechiae
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid); posterior synechiae
Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid); posterior synechiae
Removal of implanted material, anterior segment of eye
Removal of implanted material, anterior segment eye
Removal of implanted material, anterior segment eye
Removal of blood clot, anterior segment eye
Injection, anterior chamber (separate procedure); air or liquid
Injection, anterior chamber (separate procedure); *medication
Fistulization of sclera for glaucoma; trephination with iridectomy
Fistulization of sclera for glaucoma; thermocauterization with iridectomy
Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy
Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery
Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery
Fistulization of sclera for glaucoma; trabeculectomy ab externo
Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery
Fistulization of sclera for glaucuma
Fistulization of sclera for glaucoma; trabeculectomy ab externo
Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous
Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous oscular surgery or trauma (includes inj. of antif
Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous oscular surgery or trauma (includes inj. of antif
Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous
Aqueous shunt to extraocular reservoir, (eg, molteno, schocket, denver-krupin)
Aqueous shunt to extraocular reservoir, (eg, molteno, schocket, denver-drupin)
Aqueous shunt to extracular reservoir (eg, molteno, schocket, denver-krupin
Aqueous shunt to extraocular reservoir (eg, molteno, schocket, denver-krupin)
Aqueous shunt to extraocular reservoir
Revision of aqueous shunt to extraocular reservoir
Revision of aqueous shunt to extraocular reservoir
Revision of aqueous shunt to extraocular reservoir
Revision of aqueous shunt to extraocular reservoir
Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure
Iridectomy, with corneoscleral or corneal section; for removal of lesion
with cyclectomy
Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)
Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)
Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)
Repair of iris, ciliary body (as for iridodialysis)(for reposition or resection of uveal tissue with perforating wound of cornea or sclera -65285
Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)
Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)
Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)
Ciliary body destruction; cyclophotocoagulation
Ciliary body destruction; cyclophotocoagulation
Cyclophotocoagulation, endoscopic
Ciliary body destruction; cryotherapy
Ciliary body destruction; cryotherapy
Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (one or more sessions)
Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (one or more sessions)
Iridotomy by photocoagulation (one or more sessions) (eg, for glaucoma)
Coreoplasty by photocoagulation (one or more sessions) (eg, for improvement of vision)
Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)
Discission of secondary membraneous cataract ("after cataract") and/or anterior hyaloid;
Discission of secondary membranous cataract (opacified posterior lens cap- sule and/or interior hyaloid); stab incision technique (ziegler or
Discission of secondary membraneous cataract ("after cataract") and/or anterior hyaloid;
Discission of secondary membraneous (bilateral)
Discission of secondary membraneous cataract (after cataract)
Discission of secondary membraneous cataract (after cataract) and/or anterior hyaloid;
Discission of secondary membraneous cataract ("after cataract") and/or anterior hyaloid;
Discission of secondary membraneous cataract ("after cataract") and/or anterior hyaloid;
Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)
Removal of secondary membranous cataract (after cataract), with corneoscler
Removal of secondary membranous cataract (after cataract), with corneoscler
Removal of lens material; aspiration te aspiration technique, one or more stages
Removal of lens material; aspriation technique, one or more stages
Removal of lens material; aspiration technique, one or more stages
Removal of lens material; phacofragment phacofragmentation technique (mechanical or
Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification)k with aspiration
Removal of lens material; phacogragmentation technique (mechanical or ultrasonic)(eg, phacoemulsification), with aspiration
Removal of lens material; phacofragmentation technique (mechanical or
Removal of lens material; pars plana roach, with or without vitrectomy
Removal of lens material; pars plana roach, with or without vitrectomy
Removal of lens material; aspiration technique, one or more stages, pars plana approach,
Extraction of lens with or without iridectomy; intracapsular, with or without enzymes
Extraction of lens with or without iridectomy; intracapsular, with or without enzymes
Extraction of lens with or without iridectomy; extracapsular (other than 66840, 66850, 66915)
Extraction of lens with or without iridectomy; extracapsular (other than 66840, 66850, 66915)
Extracapsular cataract removal w/insertion of intraocular lens prothesis manual or mechanical technique (eg, irrigation and aspiration or p
Extracapsular cataract removal w/insertion
Extracapsular cataract removal w/insertion of intraocular lens prothesis manual or mechanical technique (eg, irrigation and aspiration or p
Extracapsular cataract removal w/insertion of intraocular lens prothesis manual or mechanical technique (eg, irrigation and aspiration or p
Extracapsular cataract removal w/insertion of intraocular lens prothesis manual or mechanical technique (eg, irrigation and aspiration or p
Extracapsular cataract removal w/insertion of intraocular lens prothesis manual or mechanical technique (eg, irrigation and aspiration or p
Extracapsular cataract removal w/insertion of intraocular lens prothesis manual or mechanical technique (eg, irrigation and aspiration or p
Extracapsular cataract removal with insertion of intraocular lens prothesis (one stage procedure), manual or mechanical techinque (eg, irri
Extracapsular Cataract Removal W/Insertion Of Intraocul
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure),
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure),
Extracapsular Cataract Removal W/Insertion Of Intraocul
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure),
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure)
Extracapsular Cataract Removal W/Insertion Of Intraocular lens
Extracapsular Cataract Removal W/Insertion Of Intraocular
Extracapsular Cataract Removal W/Insertion Of Intraocular lens
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure)
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or phacoemulsification techniq
Insertion of intraocular lens prosthesis (secondary implant) not associated with
Inseetion of intraocular lens prosthesis (secondary implant) not associatedwith concurrent cataract removal
Insertion of intraocular lens prosthesis (secondary implant) not associatedwith
Insertion of intraocular lens prosthesis (secondary implant) not associatedwith
Insertion of intraocular lens prothesis (secondary implant), not associated with concurrent cataract removal
Insertion of intraocular lens prosthesis (secondary implant) not associatedwith concurrent cataract removal
Insertion of intraocular lens subsequent to cataract removal (separate procedure)
Exchange of intraocular lens
Exchange of intraocular lens
Exchange of intraocular lens
Unlisted procedure, anterior segment of eye
Unlisted procedure, anterior segment of eye
Removal of vitreous, anterior approach (open sky technique or limbal incision);
Removal of vitreous; anterior approach (open sky technique or limbal incisi
Removal of vitreous, anterior approach (open sky technique or limbal incision);
Removal of vitreous, anterior approach (open sky technique or limbal incision);
Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal
Removal of vitreous, anterior approach (open sky technique or limbal incision);
Aspiration or release of vitreous, subretinal or choroidal fluid, pars plan
Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)
Injection of vitreous substitute, pars plana approach (separate procedure), excludes air or balanced salt
Injection of vitreous substitute, pars plana approach; (sep procedure), ex
Intravitreal injection of a pharmacologic agent (separate procedure)
Intervitreal injection of a pharmacologic agent (separate procedure)
Intravitreal injection of a pharmacologic agent (separate procedure)
Intravitreal injection of a pharmacologic agent (separate procedure)
Intravitreal injection of a pharmacologic agent (separate procedure)
Intravitreal injection of a pharmacologic agent (separate procedure)
Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (one or more stages)
Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery
Vitrectomy, mechanical, pars plana approach;
Vitrectomy, mechanical, pars plana approach
Virectomy, mechanical, pars plana approach
Vitrectomy, mechanical, pars plana approach;
Vitrectomy, mechanical, pars plana approach;
Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation
Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation
Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation
Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation
Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)
Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)
Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)
Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)
Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic
with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intra
with removal of subretinal membrane (eg, choroidal neovascularization), includs, if performed, intraocular tamponade (ie, air, gas or silico
with removal of subretinal membrane (eg, choroidal neovascularization), includs, if performed, intraocular tamponade (ie, air, gas or silico
Repair of retinal detachment, one or more sessions; cryotherapy or diathermy, with or without
Repair of retinal detachment, one or more sessions; cryotherapy or diathermy, with or without
Repair of retinal detachment, one or more sessions; photocoagulation (laser or xenon arc, one or more sessions),
Repair of retinal detachment, one or more sessions; photocoagulation (laser or xenon arc, one or more sessions),
Repair of retinal detachment, one or more sessions; scleral buckling (such as lamellar excision, imbrication
Repair of retinal, one or more sessions; scleral buckling (such as lamellar excision, imbrication
Repair of retinal detachment, one or more sessions; scleral buckling (such as lamellar excision, imbrication
Repair of retinal detachment, one or more sessions; with vitrectomy, any method, with or without air tamponade, may
Repair of retinal detachment, one or more sessions; with vitrectomy, any method, with or without air tamponade, may
Repair of retinal detachment, one or more sessions; with vitrectomy, any method, with or without air tamponade, may include procedures
Repair of retinal detachment, one or more sessions; with vitrectomy, any method, with or without air tamponade, may
Repair of retinal detachment, one or more sessions; with vitrectomy, any method, with or without air tamponade, may include procedures
Repair of retinal detachment, one or more sessions; with vitrectomy, any method, with or without air tamponade, may
Repair of retinal detachment, one or more session; by injection of air or other gas (eg, pneumatic retinopexy)
Repair of retinal detachment, one or more session; by injection of air or
Repair of retinal detachment, one or more session; by injection of air or other gas (eg, pneumatic retinopexy)
Repair of retinal detachment, one or more sessions; previously operated upon, any technique
Repair of retinal detachment, one or more sessions; previously operated upon, any technique
Repair of retinal detachment; by scleral buckling or vitrectomy, on patient having previous ipsilateral retinal detachment repair(s) using scl
Repair of complex retinal detachment, with vitrectomy and membrane peeling, may include air, gas, or silicone oil tamponace, cryotherapy
Repair of complex retinal detachment, with vitrectomy and membrane peeling, may include air, gas, or silicone oil tamponance, cryotherap
Repair of complex retinal detachment, with vitrectomy and membrane peeling, may include air, gas, or silicone oil tamponace, cryotherapy
Release of encircling material (posterior segment)
Release of encircling material (posterior segment)
Removal of implanted material, posterior segment; extraocular
Removal of implanted material, posterior segment; extraocular
Removal of implanted material, posterior segment; extraocular
Removal of implanted material, posterior segment; intraocular
Removal of implanted material, posterior segment; intraocular
Removal of implanted material, posterior segment; intraocular
Removal of implanted material, posterior segment; intraocular
Removal of implanted material, posterior segment; intraocular
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, one or more sessions;
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, one or more sessions; cryotherapy, diathermy
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration)without drainage, one or more sessions;
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, one or more
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, one or more sessions;
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy, small tumors), one or more sessions;
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy, small tumors), one or more sessions;
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy, small tumors), one or more sessions;
Destruction of localized lesion of retina (eg, maculopathy, choriodopathy, small tumors), one or more sessions; photocoagulation (laser or
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy, small tumors), one or more sessions; photocoagulation (laser or
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy, small tumors), one or more sessions;
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy, small tumors), one or more sessions;
Destruction of localized lesion of choroid
Distruction local lesion choroid - choroid
Distruction local lesion choroid
Distruction local lesion choroid - choroid
Destruction of localized lesion of choroid (eg, choroidal neovasculariza- tion); photodynamic therapy, second eye, at single session (add on
Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), one or more sessions; cryotherapy, diathermy
Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), one or more sessions; cryotherapy, diathermy
Treatment of extensive or progressive retinopathy, one more more sessions; (eg, diabetic retinopathy), photocoagulation
Treatment of extensive or progressive retinopathy, one more more sessions; (eg, diabetic retinopathy), photocoagulation
Treatment of extensive or progressive retinopathy, one more more sessions; (eg, diabetic retinopathy), photocoagulation
Treatment of extensive or progressive retinopathy, one more more sessions; (eg, diabetic retinopathy), photocoagulation
Treatment of extensive or progressive retinopathy, one more more sessions; (eg, diabetic retinopathy), photocoagulation
Treatment of extensive or progressive retinopathy, one more more sessions; (eg, diabetic retinopathy), photocoagulation
Scleral reinforcement (separate procedure); with graft
Scleral reinforcement (separate procedure); with graft
Scleral reinforcement (separate procedure); with graft
Scleral reinforcement (separate procedure); with graft
Scleral reinforcement (separate procedure) with graft
Scleral reinforcement (separate procedure); with graft
Unlisted procedure, posterior segment
Strabismus surgery on patient not previously operated on, any procedure, any muscle (may include minor displacement,
Strabismus surgery on patient not previously operated on, any procedure, any muscle (may include minor displacement,
Strabismus surgery on patient not previously operated on, any procedure, an
Strabismus surgery on patient not previously operated on, any procedure, any muscle (may include minor displacement,
Strabismus surgery, recession or resectously operated on, any procedure, any muscle (may include minor displacement,
Strabismus surgery, recession or resectously operated on, any procedure, any muscle (may include minor displacement,
Strambismus surgery, recession or resectously operated on, any procedure, any muscle (may include minor displacement,
Strabismus surgery on patient not previously operated on, any procedure, any muscle (may include minor displacement,
Strabismus surgery, recession or resection procedure (patient not previously operated on); one vertical
Strabismus surgery, recession or resection procedure (patient not previously operated on); one vertical
Strabismus surgery, recession or resection procedure (patient not prev. operated on); one vertical
Strabismus surgery, recession or resection procedure (patient not previously operated on);
Strayismus surgery, recession or resection procedure (patient not previously operated on); two or more
Strabismus surgery, recession or resection procedure (patient not previously operated on); two or more
Strayismus surgery, any procedure (patient not previously operated on), superior oblique muscle
Strayismus surgery, any procedure (patient not previously operatedon), superior oblique muscle
Transposition of extraocular muscle (eg, for paretic muscle), one or more stages, one or more muscles, with displacement
Strabismus sugery on patient with previous eye surgery or injury that did not involve the extraocular muscles (list separately in addition to
Strabismus surgery on patient previously operated on; involving reoperation of muscles
Strabismus surgery on patient previously operated on; involving reoperationof muscles
Strabismus surgery on patient previously operated on; involving reoperation
Strabismus surgery on patient previously operated on; involving reoperation of muscles
Strabismus surgery by posterior fixation suture technique with or without muscle recession
Placement of adjustable suture(s) durinbismus surgery
Placement of adjustable suture(s) durinbismus surgery
Placement of adjustable suture(s) durinsbismus surgery
Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s)
Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s)
Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s)
Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s)
Release of extensive scar tissue without detaching extraocular muscle (separate procedure)
Release of extensive scar tissue without detaching extraocular muscle (seperate procedure)
Unlisted procedure, ocular muscle
Orbitotomy without bone flap (frontal or
Orbitotomy without bone flap (frontal or)
Orbitotomy without bone flap (frontal ap
Orbitotomy without bone flap (frontal approach); with removal of lesion
Orbitotomy without bone flap (frontal or transconjuctival approach) with removal of foreign body
Orbitotomy without bone flap (frontal or transconjunctival approach) with removal of foreign body
Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body
Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression
Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression
with removal of bone for decompression
Orbitotomy with bone flap or window , lat
Orbitotomy with bone flap or window, lat
Orbitotomy with bone flap or window,lat
Orbitotomy with flap or window, lat
Orbitotomy with bone flap, lateral approach (eg, kroenlein); for exploration, with or without biopsy
Orbitotomy with bone flap, lateral approach (eg, kroenelin); for exploration, with or without biopsy
Retrobulbar injection; medication (separ *medication (separate
Retrobulbar injection; medication (separate procedure, does not include supply of medication)
Retrobulbar injection; alcohol alcohol
Injection of medication or other substance into tenoon's capsule
Injection of therapeutic agent into tenoon's capsule
Orbital implant (implant outside muscle cone); insertion
Orbital implant (implant outside muscle cone); insertion
Orbital implant (implant outside muscle)
Orbital implant (implant outside muscle)
Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)
Unlisted procedure, orbit
Unlisted procedure, orbit
Severing of tarsorrhaphy
Canthotomy (separate procedure)
Excision of chalazion; single single
Excision of chalazion; multiple, same lid
Excision of chalazion; multiple, different lids
Biopsy of eyelid
Correction of trichiasis; epilation, by *epilation, by forceps only
Correction of trichiasis; epilation, by *epilation, by forceps only
Correction of trichiasis; epilation, by forceps only
Correction of trichiasis; epilation by other than forceps (eg, by electro surgery or cryotherapy, laser surgery)
Correction of trichiasis; epilation by other than forceps (eg, by electro surgery or cryotherapy, laser surgery)
Excision of lesion of eyelid (except chaalazion) without closure *or with simple direct closure
Destruction of lesion of lid margin (up to 1 cm)
Temporary closure of eyelids by suture (eg, frost suture)
Temporary closure of eyelids by suture
Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;
Construction of intermarginal adhesions, median tarsorrhaphy
Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;
Construction of intermarginal adhesions, median tarsorrhaphy or canthorrhaphy; with transposition of tarsal plate
Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate
Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
Repair of brow ptosis (supraciliary, mid-forehead or coronal approach
Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)
Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)
Repair of blepharoptosis;frontalis muscle technique with suture or other material (eg, banked fascia)
Repair of blepharoptosis; frontalis muscle technique with autologous facial sling (includes obtaining fascia)
Frontalis muscle technique with fascial sling (includes obtaining fascia)
Repair of blepharoptosis; (tarso)levato (tarso)levator resection, internal approach
Repair of blepharoptosis; (tarso)levato (tarso)levator resection, external approach
(tarso) levator resection or advancement, internal approach
Repair of blepharoptosis; (tarso) levator resection or advancement, external approach
Repair of blepharoptosis; (tarso)levator resection, external approach
Repair of blepharoptosis; conjunctivo-ta conjunctiivo-tarso-mullar's muscle-levator resection
Repair of blepharoptosis; conjunctivo-tarso-muller's muscle-levator resection (eg, fasanella-servat type)
Repair of blepharoptosis; conjunctivo-ta conjunctivo-tarso-muller's muscle-levator resection (eg, fasanella-servat type)
Correction of lid retraction
Correction of lid retraction
Correction of lid retraction
Correction of lagophthalmos, with implantation of upper eye lid load (eg, gold weight)
Correction of lagophthalmos, with implantation of upper eye lid load (eg, gold weight)
Excision tarsal wedge
Repair of ectropion; excision tarsal wedge
Extensive (eg, tarsal strip operations)
Repair of ectropion; blepharoplasty, extensive (eg, kuhni-szymanowski or tarsal strip operations)
Repair of ectropion; blepharoplasty, extensive (eg, kuhnt-szymanowski or tarsal strip operations)
Repair of ectropion; blepharoplasty, extensive (eg, kuhnt-szymanowski operation)
Repair of entropion; suture suture
Repair of entropion; suture
Repair of entropion; blepharoplasty, ex blepharoplasty, excision tarsal wedge
Repair of entropion; blepharoplasty, excision tarsal wedge
Extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)
Repair of entropin; blepharoplasty, ex blepharoplasty, extensive (eg, wheeler operation)
Repair of entropion; blepharoplasty, extensive (eg, wheeler operation)
Removal of embedded foreign body; eyelid
Canthoplasty (reconstruction of canthus)
Canthoplasty (reconstruction of canthus)
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation
Excisionand repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pe
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid;
Reconstruction of eyelid, full thickness by transfer of tarsoconjuctival flap from opposing eyelid; up to two-thirds of eyelid, one stage or fir
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid;
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, one stage or first stag
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid;
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid;
Unlisted procedure, eyelids
Unlisted procedure, eyelids
Incision of conjunctiva, drainage of cyst
Incision of conjunctiva, drainage of cyst
Biopsy of conjunctiva
Biopsy of conjunctiva
Excision of lesion, conjunctiva; up to 1 cm
Excision of lesion,conjunctiva; up to 1 cm
Excision of lesion, conjunctiva; over 1 cm
Excision of lesion, conjunctiva; over 1 cm
Subconjunctival injection
Subconjunctival injection
Conjunctivoplasty; with conjunctival gr with conjunctival graft or
Conjunctivoplasty; with conjunctival graft or extensive rearrangement
Conjunctivoplasty; with conjunctival graft or
Conjunctivoplasty; reconstruction cul-de-sa w/ conjctival graft or extensi
Conjunctivoplasty; reconstruction cul-de-sac w/conjuctival graft of extensive rearrangement
Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement
Conjunctivoplasty, with buccal mucous membrane graft (includes obtaining graft)
Conjunctivoplasty, with buccal mucous membrane graft (includes obtaining graft)
Repair of symblepharon; conjunctivoplasty, without graft
Repair of symblepharon; conjunctivoplasty, without graft
Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)
Repair of symblepharon; division of sym division of symblepharon with or without insertion of conformer or
Conjunctival flap; total (such as gunde total (such as gunderson thin flap or purse string flap)
Conjunctival flap; total (such as gunderson thin flap or purse string flap)
Unlisted procedure, conjunctiva
Unlisted procedure, conjunctiva
Snip incision of lacrimal punctum
Removal of foreign body or dacryolith, lacrimal passages
Excision of lacrimal gland tumor; frontal approach
Excision of lacrimal gland tumor; frontal approach
Plastic repair of canaliculi
Plastic repair of canaliculi
Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)
Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)
Closure of lacrimal punctum; by thermocauterization, ligation, or laser surgery
Closure of the lacrimal punctum, by plug each
Closure of the lacrimal punctum; by plug, each
Closure of the lacrimal punctum, by plug each
Closure of the lacrimal punctum, by plug, each, lower left eyelid
Closure of the lacrimal punctum, by plug, each, lower right eyelid
Dilation of lacrimal punctum, w/ or w/o i
Dilation of lacrimal punctum, w/ or w/o irrigation
Dilation of lacrimal punctum, w/or w/o irrigation
Probing of nasolacrimal duct, with our without irrigation; requiring general anesthesia
Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent
Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent
Probing of lacrimal canaliculi, w/ or w/o irrigation
Probing of lacrimal canaliculi, w/ or w/o irrigation
Unlisted procedure, lacrimal system
Biopsy external auditory canal
Excision soft tissue lesion, external auditory canal
Excision soft tissue lesion, external auditory canal
Removal foreign body from external auditory canal; without general anesthesia
Removal foreign body from external auditory canal; with general anesthesia
Removal foreign body from external auditory canal; with general anesthesia
Removal impacted cerumen (separate procedure), one or both ears
Removal impacted cerumen (separate procedure), one or both ears
Debridement, mastoidectomy cavity, simple (eg, routine cleaning)
Debridement, mastoidectomy cavity, complete
Debridement, mastoidectomy cavity, complex (eg, eith anesthesia or more than routine cleaning)
Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection), (separate procedure)
Reconstruction external auditory canal for congenital atresia, single stage
Reconstruction external auditory canal for congenital atresia, single stage
Unlisted procedure, external ear
Eustachian tube inflation, transnasal; without catheterization
Myringotomy including aspiration and/or eustachian tube *inflation
Myringotomy including aspiration and/or eustachian tube *inflation
Myringotomy including aspiration and/ or eustachian tube inflation requiring general anesthesia
Ventilating tube removal requiring general anesthesia
Tympanostomy (requiring insertion of venntilating tube), local or *topical anesthesia
Tympanostomy (requiring insertion of venntilating tube), local or topical anesthesia
Tympanostomy (requiring insertion of ventilating tube), general anesthesia
Tympanostomy (requiring insertion of ventilating tube), general anesthesia
Tympanostomy (requiring insertion of ventilating tube), general anesthesia
Tympanostomy (requiring insertion of ventilating tube), general anesthesia
Middle ear exploration through postauricular or ear canal incision
Middle ear exploration through postauricular or ear canal incision
Tympanolysis, transcanal
Tympanolysis, transcanal
Transmastoid antrotomy (simple mastoidectomy)
Transmastoid antrotomy (simple mastoidectomy)
Mastoidectomy; complete complete
Mastoidectomy; complete
Mastoidectomy; modified radical modified radical
Mastoidectomy; modified radical
Mastoidectomy; radical radical
Mastoidectomy; radical
Excision aural glomus tumor; transcanal transcanal
Revision mastoidectomy; resulting in modified radical mastoidectomy
Revision mastoidectomy; resulting in modified radical mastoidectomy
Tympanic membrane repair, with or without site preparation or perforation for closure with or without patch
Myringoplasty (surgery confined to drumhead and donor area)
Myringoplasty (surgery confined to drumhead and donor area)
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision;
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision;
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision;
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision;
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision;
Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision;
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic
Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery tympanic membrane repair); without ossicular chain recons
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy
Tympanoplasy with mastoidectomy (including canalplasty, middle ear surgery,tympanic membrane repair); with intact or reconstructed wa
Tympanoplasty with mastoidectomy (including canalplasty
Tympanoplasty with mastoidectomy (including canalplasty
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair);
Stapes mobilization
Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;
Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;
Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;
Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;
Revision of stapedectomy or stapedotomy
Revision of stapedectomy or stapedotomy
Repair oval window fistula
Repair round window fistula
Repair round window fistula
Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone
Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone (replacement procedure includes remo
Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; w
Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; w
Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; w
With mastoidectomy implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/
Unlisted procedure, middle ear
Labyrinthectomy; with mastoidectomy
Cochlear device implantation, with or without mastoidectomy
Cochlear device implantation, with or without mastoidectomy
Cochlear device implantation, with or with out mastoidectomy
Unlisted procedure, inner ear
Removal of tumor, temporal bone
Unlisted procedure, temporal bone, middle fossa approach
Use of operating microscope
Myelography, posterior fossa, radiological supervision and
Myelography, posterior fossa, radiological supervision and
Radiologic examination, eye, for detect for detection of foreign body
Radiologic examination, eye, for detection of foreign body
Radiologic examination, eye, for detect for detection of foreign body
Radiologic examination, mandible; parti partial, less than four
Radiologic examination, mandible; parti partial, less than four
Radiologic examination, mandible; compl complete, minimum of four views
Radiologic examination, mandible; complete, minimum of four views
Radiologic examination, mandible; compl complete, minimum of four views
Radiologic examination, mastoids; compl complete, minimum of three views per side
Radiologic examination, mastoids; complete, minimum of three views per side
Radiologic examination, mastoids; compl complete, minimum of three views per side
Radiologic examination, facial bones; less than three views
Radiologic examination, facial bones; less than three views
Radiologic examination, facial bones; less than three views
Radiologic examination, facial bones; complete, minimum of three views
Radiologic examination, nasal bones, complete, minimum of three views
Radiologic examination, nasal bones, complete, minimum of three views
Radiologic examination; optic foramina optic foramina
Radiologic examination; optic foramina optic foramina
Radiologic exam; orbits, complete, minimum of four views
Radiologic examination; orbits, complete, minimum of four views
Radiologic exam; orbits, complete, minimum of four views
Radiologic examination, sinuses, paranasal, less than three views
Radiologic examination, sinuses, paranasal,less than three views
Radiologic examination, sinuses, paranasal, less than three views
Radiologic examination, sinuses, paranasal, complete, minimum of three views
Radiologic examination, sinuses, paranasal, complete, minimum of three views
Radiologic examination, sinuses, paranasal, complete, minimum of three views
Radiologic examination, skull; less than four views
Radiologic examination, skull; less than four views, with or
Radiologic examination, skull; less tha less than four views, with or
Complete, minimum of four views
Radiologic examination, skull; complete, minimum of four views, with or without stereo
Radiologic examination, skull; complete complete, minimum of four views, with or without stereo
Radiologic examination, teeth; single v single view
Radiologic examination, teeth; single v single view
Radiologic examination, teeth; complete complete, full mouth
Radiologic examination, teeth; complete complete, full mouth
Radiologic examination, temporomandibular joint, open and closed mouth;
Radiologic examination, temporomandibular joint, open and closed mouth;
Radiologic examination, temporomandibular joint, open and closed mouth;
Radiologic examination, temporomandibular joint, open and closed mouth;
Temporomandibular joint arthrography, radiological supervision and interpretation
Temporomandibular joint arthorography, radiological supervision and interpretation
Temporomandibular joint arthrography, radiological supervision and interpretation
Magnetic resonance (eg, proton) imaging, temporomandibular joint
Magnetic reasonance (eg, proton) imaging, temporomandibular joint
magnetic resonance (eg, proton) imaging, temporomandibular joint(s)
Cephalogram, orthodontic
Cephalogram, orthodontic
Cephalogram, orthodontic
Orthopantogram
Orthopantogram
Orthopantogram
Radiologic examination; neck, soft tiss neck, soft tissue
Radiologic examination; neck, soft tissue
Radiologic examination; neck, soft tiss neck, soft tissue
Computerized tomography, head or brain; without contrast material
Computed tomography, head;or brain; without contrast material
Computed tomography, head or brain; without contrast material
Computerized axial tomography, head or brain; with contrast material(s)
Computerized axial tomography, head;or brain with contrast material(s)
Computerized axial tomography, head or brain; with contrast material(s)
Computerized axial tomography, head or brain; without contrast material, followed by
Computerized axial tomography, head;or brain without contrast material, followed by
Computerized axial tomography, head or brain; without contrast material, followed by
Computerized tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material
Computed tomography, orbit, ella, or posterior fossa or outer, middle, or inner ear;
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear;
Computerized axial tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear;
Computerized axial tomography, orbit, ella, or posterior fossa or outer, middle, or inner ear;
Computerized axial tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear;
Computerized axial tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear;
Computerized axial tomography, orbit, ella, or posterior fossa or outer, middle, or inner ear;
Computerized axial tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear;
Computerized tomography, maxillofacial area; without contrast material
Computed tomography, maxilloacial area; without contrast material
Computed tomography, maxillofacial area; without contrast material
Computerized axial tomography, maxillofacial area; with contrast material(s)
Computerized axial tomography, maxilloacial area; with contrast material(s)
Computerized axial tomography, maxillofacial area; with contrast material(s)
Computerized axial tomography, maxillofacial area; without contrast material, followed by contrast material(s)
Computerized axial tomography, maxilloacial area; without contrast material, followed by contrast material(s)
Computerized axial tomography, maxillofacial area; without contrast material, followed by contrast material(s)
Computerized tomography, soft tissue neck; without contrast material
Computed tomography, soft issue neck; without contrast material
Computed tomography, soft tissue neck; without contrast material
Computerized axial tomography, soft tissue neck; with contrast material(s)
Computerized axial tomography, soft issue neck; with contrast material(s)
Computerized axial tomography, soft tissue neck; with contrast material(s)
Computerized axial tomography, soft tissue neck; without contrast material followed by contrast material(s)
Computerized axial tomography, soft tissue neck; without contrast material followed by contrast material(s)
Computerized axial tomography, soft tissue neck; without contrast material followed by contrast material(s)
Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Magnetic resonance (eg, proton) imaging; orbit, face, and/or neck; without contrast material(s)
Magnetic resonance (eg,proton) imaging); orbit, face, and neck
Magnetic resonance (eg, proton) imaging; orbit, face, and neck
Magnetic resonance (proton) imaging, orbit
Magnetic resonance (eg. proton) imaging, orbit, face and neck; without contrast material(s), followed by contrast material(s) and further s
Without contrast material(s), followed by contrast material(s) andfurther sequences
Without contrast material(s), followed by contrast material(s) andfurther sequences
Magnetic resonance angiography, head; without contrast
Magnetic resonance angiography, head; without contrast material(s)
Magnetic resonance angiography, head; without contrast
with contrast material
with contrast material(s)
with contrast material(s)
Magnetic resonance angiography, head, without contrast material(s), followed by contrast material(s) and further sequences
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences.
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences
Magnetic resonance angiography, neck; without contrast material(s)
Magnetic resonance angiography, neck; with contract material(s)
Magnetic resonance angiography neck; without contrast material(s), followed by contrast material(s) and further sequences
Magnetic resonance (eg, proton) imaging, brain (including brain stem);
Magnetic resonance (eg, proton) imaging, brain (including brain stem);
Magnetic resonance (eg, proton) imaging, brain (including brain stem);
Magnetic resonance (eg, proton) imaging, brain (including brain stem);
Magnetic resonance (eg, proton) imaging, brain (including brain stem);
Magnetic resonance (eg, proton) imaging, brain (including brain stem);
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material,
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and furt
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast
Without contrast material(s), followed by contrast material(s) and further sequences; magnetic resonance (eg, proton) imaging, brain (incl
Without contrast material(s), followed by contrast material(s) and further sequences; magnetic resonance (eg, proton) imaging, brain (incl
Radiologic Examination,Chest;Single View,Frontal
Radiologic examination, chest; single view, frontal
Radiologic examination, chest; single v single view, frontal
Stereo,Frontal
Radiologic examination, chest; stereo, stereo, frontal
Radiologic Exam,Chest,2 Views,Frontal & Lateral;
Radiologic examination, chest; s, frontal and lateral;
Radiologic examination, chest, two views, frontal and lateral;
Radiologic examination, chest, two views, frontal and lateral; with apical lordotic procedure
Radiologic examination, chest; two vies, frontal and lateral; with apical lordotic procedure
Radiologic examination, chest, two views, frontal and lateral; with apical lordotic procedure
Radiologic examination, chest, two views, frontal and lateral; with oblique projections
Radiologic examination, chest, two views, frontal and lateral; with oblique projections
Radiological examination, chest, two vis, frontal and lateral; with fluoroscopy
 radiological examination, chest, two vis, frontal and lateral; with fluoroscopy
Radiologic examination, chest, complete, minimum of four views;
Radiologic examination, chest, complete, minimum of four views;
Radiologic examination, chest, complete, minimum of four views; with fluoroscopy
Radiologic examination, chest, special views (eg, lateral decubitus, bucky studies)
Radiologic examination, chest, special views (eg, lateral decubitus, bucky studies)
Radiologic examination, chest, special views (eg, lateral decubitus, bucky studies)
Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation
Radiologic examination, ribs, unilateral; two views
Radiologic examination, ribs, unilaterl; two views
Radiologic examination, ribs, unilateral; two views
Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of three views
Radiologic examination, ribs, unilaterl; including posteroanterior chest, minimum of three views
Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of three views
Radiologic examination, ribs, bilateral; three views
Radiologic examination, ribs, bilatera; three views
Radiologic examination, ribs, bilateral; three views
Radiologic examination, ribs, bilatera; including posteroanterior chest, minimum of four views
Radiologic examination, ribs, bilatera; including posteroanterior chest, minimum of four views
Radiologic examination; sternum, minimu sternum, minimum of two views
Radiologic examination; sternum, minimu sternum, minimum of two views
Computerized axial tomography, thorax; without contrast material
Computerized axial tomography, thorax; without contract material
Computerized axial tomography, thorax; with contrast material(s)
Computerized axial tomography, thorax; with contrast material(s)
Computerized axial tomography, thorax; with contrast material(s)
Computerized axial tomography, thorax; without contrast material, followed by contrast material(s) and further sections
Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections
Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections
Computed tomographic angiography, chest, (noncoronary), with contrast material(s), including noncontrast images, if performed, and ima
Computed tomographic angiography, chest, (noncoronary), with contrast material(s), including noncontrast images, if performed, and ima
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy), without contrast material(s
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilarand mediastinal lymphadenopathy); without contrast material(s
Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)
Radiologic examination, spine, entire, survey study, anteroposterior and lateral
Radiologic examination, spine, entire, survey study, anteroposterior and lateral
Radiologic examination, spine, single view, specify level
Radiologic examination, spine, single iew, specify level
Radiologic examination, spine, single view, specify level
Radiologic examination, spine, cervical; anteroposterior and
Radiologic examination, spine, cervica; anteroposterior and
Radiologic examination, spine, cervical; anteroposterior and
Radiologic examination, spine, cervical; minimum of four views
Radiologic examination, spine, cervica; minimum of four views
Radiologic examination, spine, cervical; minimum of four views
Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension
Radiologic examination, spine, cervica; complete, including oblique and flexion and/or extension
Radiologic examination, spine, cervical; complete, including oblique and flexion and/or extension
Radiologic exam, spine, thoracolumbar, standing (scoliosis)
Radiologic exam, spine, thoracolumbar, standing (scoliosis)
Radiologic examination, spine; thoracic thoracic, anteroposterior and
Radiologic examination, spine; thoracic, anteroposterior and
Radiologic examination, spine; thoracic thoracic, anteroposterior and
Radiologic examination, spine; thoracic thoracic, anteroposterior and lateral, including swimmer's view of
Radiologic examination, spine; thoracic, anteroposterior and lateral, including swimmer's view of
Radiologic examination, spine; thoracic thoracic, anteroposterior and lateral, including swimmer's view of
Radiologic examination, spine; thoracic thoracic, complete, including obliques, minimum of four views
Radiologic examination, spine; thoracic, minimum of four views
Radiologic examination, spine; thoracic thoracic, complete, including obliques, minimum of four views
Radiologic examination, spine; thoracol thoracolumbar, anteroposterior and lateral
Radiologic examination, spine; thoracolumbar, anteroposterior and lateral
Radiologic examination, spine; thoracol thoracolumbar, anteroposterior and lateral
Radiologic examination, spine; scoliosi scoliosis study, including supine and erect studies
Radiologic examination, spine; scoliosis study, including supine and erect studies
Radiologic examination, spine; scoliosi scoliosis study, including supine and erect studies
Radiologic examination, spine, lumbosacral; anteroposterior
Radiologic examination, spine, lumbosaral; anteroposterior
Radiologic examination, spine, lumbosacral; anteroposterior
Radiologic examination, spine, lumbosacral; complete, with oblique views
Radiologic examination, spine, lumbosaral; complete, with oblique views
Radiologic examination, spine; minimum of four views
Radiologic examination, spine, lumbosacral; complete, with oblique views
Radiologic examination, spine, lumbosacral; complete, including bending views
Radiologic examination, spine, lumbosaral; complete, including bending views
Radiologic examination, spine, lumbosacral; complete, including bending views
Radiologic examination, spine, lumbosacral, bending views only, minimum of four views
Radiologic examination, spine, lumbosacral, bending views only, minimum of four views
Radiologic examination, spine, lumbosacral, bending views only, minimum of four views
Computerized tomography, cervical spine; without contrast material
Computerized axial tomography, cervica spine; without contrast material
Computerized axial tomography, cervical spine; without contrast material
Computerized axial tomography, cervical spine; with contrast material
Computerized axial tomography, cervica spine; with contrast material
Computerized axial tomography, cervical spine; with contrast material
Computerized axial tomography, cervical spine; without contrast material, followed by contrast material(s)
Computerized axial tomography, cervical spine; without contrast material, followed by contrast material(s)
Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections
Computerized axial tomography, thoraci spine; without contrast material
Computerized axial tomography, thoraci spine; without contrast material
Computerized axial tomography, thoracic spine; without contrast material
Computerized axial tomography, thoracic spine; with contrast material
Computed tomography, thoracic spine; with contrast material
Computerized axial tomography, thoracic spine; without contrast material, followed by contrast material(s)
Computerized axial tomography, thoracic spine; without contrast material, followed by contrast material(s)
Computerized axial tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections
Computerized tomography, lumbar spine; without contrast material
Computerized axial tomography, lumbar pine; without contrast material
Computerized axial tomography, lumbar spine; without contrast material
Computerized axial tomography, lumbar spine; with contrast material
Computerized axial tomography, lumbar pine; with contrast material
Computerized axial tomography, lumbar spine; with contrast material
Computerized axial tomography, lumbar spine; without contrast material, followed by contrast material(s)
Computerized axial tomography, lumbar spine; without contrast material, followed by contrast material(s)
Computerized axial tomography, lumbar spine; without contrast material, followed by contrast material(s)
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical;
Magnetic resonance (eg,proton) imaging,, spinal canal and contents, cervical;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic;
Magnetic resonance (eg, portion) imaging, spinal canal and contents, thoracic; with contract material(s)
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar;
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material,
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material,
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by
Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)
Radiologic examination, pelvis; anterop anteroposterior only
Radiologic examination, pelvis; anteroposterior only
Radiologic examination, pelvis; anterop anteroposterior only
Radiologic examination, pelvis; anterop anteroposterior only
Radiologic examination, pelvis; complet complete, minimum of three views
Radiologic examination, pelvis; complete, minimum of three views
Radiologic examination, pelvis; complet complete, minimum of three views
Computed tomographic angigraphy, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computed tomographic angigraphy, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computed tomographic angigraphy, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessin
Computerized tomography, pelvis; without contrast material
Computed tomography, pelvis; without contrast material
Computed tomography, pelvis; without contrast material
Computerized axial tomography, pelvis; with contrast material(s)
Computerized axial tomography, pelvis; with contrast material(s)
Computerized axial tomography, pelvis; with contrast material(s)
Computerized axial tomography, pelvis; without contrast material, followed by contrast
Computerized axial tomography, pelvis; without contrast material, followed by contrast
Computerized axial tomography, pelvis; without contrast material, followed by contrast
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) --- reading of mri only
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) --- taking of mri only
Magnetic resonance (eg, proton) imaging, pelvis
Magnetic resonance (eg, proton) imaging, pelvis
Magnetic resonance (eg, proton) imaging, pelvis
Without contrast material(s), followed by contrast material(s) and further sequences
Magnetic resonance angiography, pelvis, with or without contrast material(s)
Radiologic examination, sacroiliac joints; less than three
Radiologic examination, sacroiliac joints; less than three views
Radiologic examination, sacroiliac joints; less than three
Radiologic examination, sacroiliac joints; three or more views
Radiologic examination, sacroiliac joints; three or more views
Radiologic examination, sacrum and coccyx, minimum of two views
Radiologic examination, sacrum and cocyx, minimum of two views
Radiologic examination, sacrum and coccyx, minimum of two views
Myelography, cervical, radiological supervision and interpretation
Myelography, cervical, radiological supervision and interpretation
Myelography, cervical, radiological supervision and interpretation
Myelography, thoracic, radiological supervision and interpretation
Myelography, thoracic, radiological supervision and interpretation
Myelography, thoracic, radiological supervision and interpretation
Myelography, lumbosacral, radiological supervision and interpretation
Myelography, lumbosacral, radiological supervision and interpretation
Myelography, lumbosacral, radiological supervision and interpretation
Myelography, lumbosacral, radiological supervision and interpretation
Myelography, lumbosacral, radiological supervision and interpretation
Myelography, two or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervis
Myelography, entire spinal canal, radiological supervision and
Myelography, entire spinal canal, radiological supervision and
Epidurography, radiological supervision and interpretation
Epidurography, radiological supervision and interpretation
Diskography, cervical, radiological supervision and interpretation
Diskography, cervical, radiological surpervision and interpretation
Diskography, cervical or thoracic, radiological supervision and interpretation
Diskography, cervical or thoracic, radiological supervision and interpretation
Diskography, cervical, radiological supervision and interpretation
Diskography, lumbar, radiological supervision and interpretation
Diskography, lumbar, radiological supervision and interpretation
Diskography, lumbar, radiological; supervision and interpretation
Diskography, lumbar, radiological supervision and interpretation
Radiologic examination; clavicle, compl clavicle, complete
Radiologic examination; clavicle, complete
Radiologic examination; clavicle, compl clavicle, complete
Radiologic examination; scapula, comple scapula, complete
Radiologic examination; scapula, complete
Radiologic examination; scapula, comple scapula, complete
Radiologic examination, finger or fingers, minimum of two views
Radiologic examination, shoulder; one v one view
Radiologic examination, shoulder; one view
Radiologic examination, shoulder; one view
Radiologic examination, shoulder; one v one view
Radiologic examination, shoulder; compl complete, minimum of two views
Radiologic examination, shoulder; complete, minimum of two views
Radiologic examination, shoulder; complete, minimum of two views
Radiologic examination, shoulder; complete, minimum of two views
Radiologic examination, shoulder; compl complete, minimum of two views
Radiologic examination, shoulder, arthrography; radiological supervision
Radiologic examination, shoulder, arthrography; radiological supervision
Radiologic examination, shoulder, arthrography; radiological supervision
Radiologic examination; acromioclavicul acromioclavicular joints, bilateral,
Radiologic examination; acromioclavicular joints, bilateral,
Radiologic examination; acromioclavicul acromioclavicular joints, bilateral,
Radiologic examination; humerus, minimu humerus, minimum of two views
Radiologic examination; humerus, minimum of two views
Radiologic examination; humerus, minimu humerus, minimum of two views
Radiologic examination, elbow; anteropo anteroposterior and lateral
Radiologic examination, elbow; anteroposterior and lateral
Radiological exam, elbow; 2 views
Radiologic examination, elbow; anteropo anteroposterior and lateral
Radiologic examination, elbow; complete, minimum of three views
Radiologic examination, elbow; complete, minimum of three views
Radiologic examination, elbow; complete, minimum of three views
Radiologic examination, elbow; complete complete, minimum of three views
Radiologic examination; forearm, antero forearm, anteroposterior and lateral
Radiologic examination; forearm, anteroposterior and lateral
Radiologic examination; forearm, antero forearm, anteroposterior and lateral
Radiologic examination, wrist; anteroposterior and lateral
Radiologic examination, wrist; anteroposterior and lateral
Radiologic examination, wrist; two views
Radiologic examination, wrist; two views
Radiologic examination, wrist; anteropo anteroposterior and lateral
Radiologic examination, wrist; complete, minimum of three views.
Radiologic examination, wrist; complete, minimum of three views
Radiologic examination, wrist; complete complete, minimum of three views
Radiologic examination, wrist; complete complete, minimum of three views
Radiologic examination, wrist, arthrography; radiological supervision
Radiologic examination, wrist, arthrography; radiological supervision
Radiologic examination, hand; two views two views
Radiologic examination, hand; two views
Radiologic examination, hand; two views
Radiologic examination, hand; two views two views
Radiologic examination, hand; minimum o minimum of three views
Radiologic examination, hand; minimum of three views
Radiologic examination; hand; minimum of three views
Radiologic examination, hand; minimum o minimum of three views
Radiologic examination, finger or fingers, minimum of two views
Radiologic examination, finger or fingrs, minimum of two views
Radiologic examination, finger or fingers, minimum of two views
Radiologic examination, finger or fingers, minimum of two views
Computed tomography, upper extremity; without contrast material
Computed tomography, upper etremity; without contrast material
Computerized axial tomography, upper extremity; without contrast material
Computerized axial tomography, upper extremity; without contrast material, followed by contrast material(s) and
Computerized axial tomography, upper extremity; without contrast material, followed by contrast material(s) and
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance imaging, upper extremity, other than joint; without contrast material(s)
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)
Magnetic resonance (eg proton) imaging, upper extremity, other than joint; without contrast material(s)
Magnetic resosnance (eg, proton) imaging, upper extremity, other than joint
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint;without contrast material(s), followed by contrast material(s) a
Magnetic resonance (eg, proton) imaging, any joint of upper extremity
Magnetic resonance (eg, proton) imaging, any joint of upper extremity
Magnetic resonance (eg, proton) imaging, any joint of upper extremity
Mri (eg, proton) imaging, any joining of upper extremity; with contrast material(s)
Magnetic resonance (eg, proton)imaging, any joing of upper extremity; with contrast material(s)
Magnetic resonance (eg, proton)imaging, any joing of upper extremity; with contrast material(s)
Magnetic resonance imaging, joint, upper extremity
Magnetic resonance imaging, joint, upper extremity
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint
Radiologic examination, hip; unilateral unilateral, one view
Radiologic examination, hip; unilateral, one view
Radiologic examination, hip; unilateral, one view
Radiologic exam, hip; unilateral, one view
Radiologic examination, hip; unilateral unilateral, one view
Radiologic examination, hip; complete, complete, minimum of two views
Radiologic examination, hip; complete, minimum of two views
Radiologic examination, hip; complete, complete, minimum of two views
Radiologic examination, hip; complete, complete, minimum of two views
Radiologic examination, hip; complete, complete, minimum of two views
Radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis
Radiologic examination, hips, bilatera, minimum of two views of each hip, including anteroposterior view of pelvis
Radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis
Radiologic examination, hips, bilateral, minimum of two views of each hip, including anteroposterior view of pelvis
Radiologic examination, HIP, arthography, radiological supervision and interpretation
Radiologic examination, HIP, arthography, radiological supervision and interpretation
Radiologic exam, HIP, during operative procedure
Radiologic examination, hip, during oprative procedure
Radiologic examination, pelvis and hips, infant or child, minimum of two views
Radiologic examination, pelvis and hips, infant or child, minimum of two views
Radiological examination, sacroiliac join arthrography, radiological supervision and interpretation
Radiologic examination, femur, anteroposterior and lateral views
Radiologic examination, femur, anteropsterior and lateral views
Radiologic examination, femur, anteroposterior and lateral views
Radiologic examination, knee; anteropos anteroposterior and lateral
Radiologic examination, knee; anteropos anteroposterior and lateral
Radiologic examination, knee; anteroposterior and lateral
Radiologic examination; knee; one or two views
Radiologic examination, knee; anteropos anteroposterior and lateral
Radiologic examination, knee; anteropos anteroposterior and lateral, with oblique(s), minimum of
Radiologic examination, knee; anteroposterior and lateral, with oblique(s), minimum of
Radiologic examination, knee; anteroposterior and lateral, with oblique(s), minimum of 3 views
Radiologic examination, knee; anteroposterior and lateral, with oblique(s), minimum of 3 views
Radiologic examination, knee; anteropos anteroposterior and lateral, with oblique(s), minimum of
Radiologic examination, knee; complete, complete, including oblique(s), and tunnel, and/or
Radiologic examination, knee; complete, complete, including oblique(s), and tunnel, and/or
Radiologic examination, knee; complete, four or more views
Radiologic examination, knee; complete, complete, including oblique(s), and tunnel, and/or
Radiologic examination, knee; both knees, standing anteroposterior
Radiologic examination, knee; both knees, standing anteroposterior
Radiologic examination, knee; both knees, standing anteroposterior
Radiologic examination; tibia and fibul tibia and fibula, anteroposterior and
Radiologic examination; tibia and fibula, anteroposterior and
Radiologic examination; tibia and fibul tibia and fibula, anteroposterior and
Radiologic examination; tibia and fibul tibia and fibula, anteroposterior and
Radiologic examination; tibia and fibul tibia and fibula, anteroposterior and
Radiologic examination, ankle; anteropo anteroposterior and lateral
Radiologic examination, ankle; anteroposterior and lateral
Radiologic examination, ankle; two views
Radiologic examination, ankle; anteropo anteroposterior and lateral
Radiologic examination, ankle; complete, minimum of three views
Radiologic examination, ankle; complete, minimum of three views
Radiologic examination, ankle; complete, minimum of three views
Radiologic examination, ankle; complete, minimum of three views
Radiologic examination, ankle; complete complete, minimum of three views
Radiologic examination, foot; anteropos anteroposterior and lateral
Radiologic examination, foot; anteroposterior and lateral
Radiologic exam, foot; anteroposterior and lateral
Radiologic examination, foot; anteroposterior and lateral views
Radiologic examination, foot; anteropos anteroposterior and lateral
Radiologic examination, foot; complete, complete, minimum of three views
Radiologic examination, foot; complete, minimum of three views
Radiologic exam, foot; complete, minimum of three views
Radiologic examination, foot; complete, complete, minimum of three views
Radiologic examination; calcaneus, mini calcaneus, minimum of two views
Radiologic examination; calcaneus, minimum of two views
Radiologic examination; calcaneus, mini calcaneus, minimum of two views
Radiologic examination; toe or toes, mi toe or toes, minimum of two views
Radiologic examination; toe or toes, minimum of two views
Radiologic examination; toe or toes, mi toe or toes, minimum of two views
Computerized tomography, lower extremity; without contrast material
Computed tomography, lower etremity; without contrast material
Computed tomography, lower extremity; without contrast material
Computerized axial tomography, lower extremity; with contrast material(s)
Computerized axial tomography, lower extremity; with contrast material(s)
Computerized axial tomography, lower extremity; with contrast material(s)
Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image po
Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image po
Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image po
Magnetic resonance (eg, proton) imaging, lower extemity other than joint; without contrast material(s)
Magnetic resonance (eg, proton) imaging, lower extemity other than joint; without contrast material(s)
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)
Magnetic resonance (eg, proton) imaging, lower extremity, other than joint
Magnetic resonance (eg, proton) imaging, lower extremity, other than joint
Magnetic resonance (eg, proton) imaging, lower extremity, other than joint
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance (eg, proton) imaging, any joint of lower extremity
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast materials(s)
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast materials(s)
Without contrast material(s) followed by contrast martials(s) and further sequences
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and f
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and f
Magnetic resonance angiography, lower extremity, with or without contrast material(s)
Magnetic resonance angiography, lower extremity, with or without contrast material(s)
Radiologic examination, abdomen; single single anteroposterior view
Radiologic examination, abdomen; single anteroposterior view
Radiologic examination, abdomen; single single anteroposterior view
Radiologic examination, abdomen; antero anteroposterior and additional oblique and cone views
Radiologic examination, abdomen; anteroposterior and additional oblique and cone views
Radiologic examination, abdomen; antero anteroposterior and additional oblique and cone views
Radiologic examination, abdomen; comple complete, including decubitus and/or erect views
Radiologic examination, abdomen; complete, including decubitus and/or erect views
Radiologic examination, abdomen; comple complete, including decubitus and/or erect views
Complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest
Complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest
Complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest
Computerized tomography, abdomen; without contrast material
Computed tomography, abdomen without contrast material
Computed tomography, abdomen; without contrast material
Computerized axial tomography, abdomen; with contrast material(s)
Computerized axial tomography, abdomen with contrast material(s)
Computerized axial tomography, abdomen; with contrast material(s)
Computerized axial tomography, abdomen; without contrast material, followed by
Computerized axial tomography, abdomen without contrast material, followed by
Computerized axial tomography, abdomen; without contrast material, followed by
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postproc
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postproc
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postproc
Computed tomography, abdomen and pelvis; without contrast material
Computed tomography, abdomen and pelvis; without contrast material
Ct abdomen&pelvis w/contrast
computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and f
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s).
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)
Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)
Magnetic resonance imaging, abdomen; w/o contract
Magnetic resonance imaging, abdomen; w/o contrast
Magnetic resonance imaging, abdomen; w/o contrast
Magnetic resonance angiography, abdomen, with or w/o contrast material(s)
Magnetic resonance angiography, abdomen, with or w/o contrast material(s)
Magnetic resonance angiography, abdomen, with or w/o contrast material(s)
Radiologic examination; esophagus esophagus
Radiologic examination; esophagus
Radiologic examination; esophagus esophagus
Swallowing function, with cineradiography/videoradiography
Cineradiography, pharynx and/or esophaphagus, with cineradiography and/or video
Swallowing function, pharynx and/or esophagus, with cineradiography and/or video
Radiologic examination, gastrointestinal tract, upper; with or
Radiologic examination, gastrointestinl tract, upper; with or
Radiologic examination, gastrointestinal tract, upper; with or
Radiologic examination, gastrointestinal tract, upper; with or without delayed films, with kub
Radiologic examination, gastrointestinl tract, upper; with or without delayed films, with kub
Radiologic examination, gastrointestinal tract, upper; with or without delayed films, with kub
With small intestine, includes multiple serial films
Radiologic examination, gastrointestinl tract, upper; with small bowel, includes multiple serial films
Radiologic examination, gastrointestinal tract, upper; with small bowel, includes multiple serial films
Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
Radiological examination, gastrointestnal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
Radiological examination, gastrointestnal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
With small intestine follow-through
Radiological examination, gastrointestnal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without
Radiologic examination, small intestine, includes multiple serial films
Radiologic examination, small bowel, icludes multiple serial films
Radiologic examination, small bowel, includes multiple serial films
Radiologic examination, colon; contrast (eg, barium) enema, with or without kub
Radiologic examination, colon; contrast (eg, barium) enema, with or without kub
Radiologic examination, colon; contrast (eg, barium) enema, with or without kub
Radiologic examination, colon; air cont air contrast with specific high density barium,
Radiologic examination, colon; air contrast with specific high density barium,
Radiologic examination, colon; air cont air contrast with specific high density barium,
Cholecystography, oral contrast; additi additional or repeat examination or multiple day
Cholecystography, oral contrast; additional or repeat examination or multiple day
Cholecystography, oral contrast; additi additional or repeat examination or multiple day
Cholangiography and/or pancreatography; intraoperative, radiologic supervision and interpretation.
Cholangiography; and/or pancreatography; intraoperative, radiologic supervision
Cholangiography and/or pancreatography; intraoperative, radiologic supervision and interpretation.
Cholangiography and/or pancreatography; intraoperative, radiologic supervision
Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation
Combined endoscopic catheterization of the biliary and pancreatic ductal systems,
Combined endoscopic catheterization of the biliary and pancreatic ductal systems,
Combined endoscopic catheterization of the biliary and pancreatic ductal systems,
Urography (pyelography), intravenous, with or without kub; with or without tomography
Urography (pyelography), intravenous, ith or without kub;
Urography (pyelography), intravenous, with or without kub; with or without tomography
Urography, infusion, drip technique and/or bolus technique;
Urography, infusion, drip technique; a/or bolus technique;
Urography, infusion, drip technique and/or bolus technique;
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
Urography, infusion, drip technique; /or bolus technique; with nephrotomography
Urography, infusion, drip technique and/or bolus technique; with nephrotomography
Urography, retrograde, with or without kub
Urography, retrograde, with or withoutkub
Urography, retrograde, with or without kub
Cystography, minimum of three views; radiological supervision and interpretation
Urethrocystography, voiding, radiologic radiological supervision and
Urethrocystography, voiding, radiologic radiological supervision and
Urethrocystography, voiding, radiologic radiological supervision and
Urethrocystography, voiding; complete p complete procedure
Aortography, thoracic, by serialography, radiological supervision and
Aortography, abdominal, by serialography; radiological supervision and interpretation
Aortography, abdominal, by serialograph; radiological supervision and interpretation
Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and
Aortography, abdominal plus bilateral liofemoral lower extremity, catheter, by serialography, radiological supervision and
Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including
Angiography, cervicocerebral, catheter, including vessel origin; complete procedure
Angiography, cervicocerebral, catheter including vessel origin;
Angiography, cervicocerebral, selective catheter, including vessel origin;
Angiography, cervicocerebral, selective catheter, including vessel origin;
Angiography, carotid, cerebral, unilat, unilateral, selective; radiological supervision and interpretation
Angiography, external carotid, bilateral, selective, radiological supervision and interpretation
Angiography, carotid, cerebral, bilateral, selective; radiological supervision and interpretation
Angiography, carotid, cerebral, unilateral, radiological supervision and interpretation
Angiography, carotid, cerebral, unilatral; radiological supervision and
Angiography, carotid, cerebral, bilateral; radiological supervision and
Angiography, carotid, cerebral, bilateral, radiological supervision and
Angiography, carotid, cerebral, bilateral; radiological supervision and
Angiography, carotid, cervical, unilateral, radiological supervision and interpretation
Angiography, carotid, cervical, unilateral, radiological supervision and interpretation
Angiography, carotid, cervical, bilateral; radiological supervision and
Angiography, carotid, cervical, bilateral, radiological supervision and
Angiography, carotid, cervical, bilateral; radiological supervision and
Angiography, vertebral; cervical and/or intracranial, radiological supervision and interpretation
Angiography, vertebral; cervical and/or intracranical, radiological supervision and interpretation
Angiography, vertebral; cervical and/or intracranial, radiological supervision and interpretation
Angiography, vertebral; cervical and/or intracranial, radiological supervision and interpretation
Angiography, extremity, unilateral; radiological supervision and
Angiography, extremity, bilateral; radiological supervision and
Angiography, extremity, bilateral; radiologicla supervision and
Angiography, extremity, bilateral; radiological supervision and
Angiography, renal, bilateral, selective (including flush aortogram), radiological supervision and interpretation
Angiography, selective, each additional vessel studied after basic examination;
Angiography, selective, each additional vessel studied after basic examination;
Angiography, selective, each additional vessel studied after basic examination;
Shuntogram for investigation of previously placed indwelling nonvascular
Shuntogram for investigation of previously placed indwelling nonvascular sh
Shuntogram for investigation of previously placed indwelling nonvascular sh
Venography, extremity, unilateral; radiological supervision and
Venography, extremity, unilateral; radiological supervision and
Venography, extremity, unilateral; radiological supervision and
Venography, extremity, bilateral; radiological supervision and
Venography, caval, superior with seriallography; radiologicla supervision
Venography, renal, bilateral, selective; radiological supervision and
Venography, renal, bilateral, selective; radiological supervision and
Venography, orbital, radiological supervision and interpretation
Venous sampling through catheter with or without angiography (eg, for parathyroid hormone, renin),
Venous sampling through catheter with or without angiography (eg, for parathyroid hormone, renin)
Transcatheter therapy, embolization, any moethod, radiological supervision and interpretation
Transcatheter therapy, embolization, any method, radiological
Transcatheter therapy, infusion, any method (eg, thrombolysis other than coronary),
Angiogram through existing catheter fo follow-up study for transcatheter therapy, embolization or
Percutaneous placement of ivc filter, radiological supervision and interpretation
Transluminal angioplasty, any method, renal or other visceral artery, radiological supervision and interpretation
Transcatheter biopsy, radiological supervision and interpretation
Transcatheter biopsy, radiological supervision and interpretation
Fluoroscopy (separate procedure), up to one hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy)
Fluoroscopy (separate procedure), othe one hour physician time, other than 71023 or 71034
Fluoroscopy (separate procedure), up to one hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy)
Fluoroscopy, physician time more than one hour, assisting a non-radiologic physician (eg, nephrostolithotomy, ercp,
Fluoroscopy, physician time more than one hour, assisting a non- radiologic physician (eg, nephrostolithotomy, ercp,
Fluoroscopy, physician time more than one hour, assisting a non-radiologic physician (eg, nephrostolithotomy, ercp,
Fluoroscopic guidance/localization of needle or catheter tip for spine or paraspinoius diagnostic or theraputic injection procedures ***do n
Radiologic examination, fistula or sinus tract study; radiological supervision and interpretation
Radiologic examination, fistula or sinus tract study; radiological supervision and interpretation
Radiologic examination, fistula or sinus tract study; radiological supervision and interpretation
Computer aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpr
Computer aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpr
Radiological examination, surgical specimen
Radiological examination, surgical specimen
Radiological examination, surgical specimen
Radiologic examination, single plane body section (eg, tomography), other than with urography
Radiologic examination, single plane bdy section (eg, tomography), other than with urography
Radiologic examination, single plane body section (eg, tomography), other than with urography
Radiologic examination, complex motion(ie, hypercycloidal) body section (eg, mastoid polytomography), other than
Consultation on x-ray examination made elsewhere, written report
Consultation on x-ray examination made elsewhere, written report
3d rendering with interpretation and reporting of computed tomography, mag-netic resonance imaging, ultrasound or other tomographic
3d rendering with interpretation and reporting of computed tomography, mag-netic resonance imaging, ultrasound or other tomographic
3d rendering with interpretation and reporting of computed tomography, mri,ultrasound or other tomographic modality; not requiring im
3d rendering with interpretation and reporting of computed tomography, mri,ultrasound or other tomography modality; requiring image p
3d rendering with interpretation and reporting of computed tomography, mri, ultrasound or other tomographic modality; requiring image
Computerized tomography, limited or localized follow-up study
Computed tomography, limited or localized follow-up study
Computerized tomography, limited or localized follow-up study
Magnetic resonance spectroscopy
Unlisted diagnostic radiographic procedure
Unlisted diagnostic radiographic procedure
Echoencephalography, real time with image documentation (gray scale)(for determination of ventricular size, delineation of cerebral conte
Echoencephalography, real time with image documentation (gray scale)(for determination of ventricular size, delineation of cerebral conte
Ophthalmic ultrasound, echography; a-mo a-mode, with amplitude quantification
Ophthalmic ultrasound, echography; a-mo a-mode, with amplitude quantification
Ophthalmic ultrasound, echography; cont contact b-scan
Opthalmic ultrasound, echography
Ophthalmic ultrasound, echography; cont contact b-scan - Bilateral
Ophthalmic ultrasound, echography; cont contact b-scan
Opthalmic ultrasound, echography, diagnostic; corneal pachymetry,unilateralor bilateral (determination of corneal thickness)
Ophthalmic biometry by ultrasound echography, a-mode;
Ophthalmic biometry by ultrasound echography, a-mode;
Ophthalmic biometry by ultrasound echography, a-mode;
Opthalmic biometry by ultra sound echography, a-mode;
Ophthalmic biometry by ultrasound echography, a-scan; with introcular lens power calculation
Ophthalmic biometry by ultrasound echography, a-mode;
Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation
Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation
Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation
Ultrasound, breat(s) (unilateral or bilateral), real time with image documentation
Ultrasound, breast(s) (unilateral or bilateral), real time with image documentation
Ultrasound, breast(s) (unilateral or bilateral), real time with image documentation
Ultrasound, abdominal, real time with image documentation; complete
Ultrasound, abdominal, real time with image documentation; complete
Ultrasound, abdominal, real time with image documentation; complete
Echography, abdominal, b-scan and/or real time with image documentation;
Echography, abdominal, b-scan and/or ral time with image documentation;
Echography, abdominal, b-scan and/or real time with image documentation;
Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete
Ultrasound, retroperitoneal (eg, renal aorta, nodes), real time with image documentation; complete
Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete
Echography, retroperitoneal (eg, renal, aorta, nodes), b-scan and/or real time with image documentation;
Echography, retroperitoneal (eg, renal aorta, nodes), b-scan and/or real time with image documentation;
Echography, retroperitoneal (eg, renal, aorta, nodes), b-scan and/or real time with image documentation;
Ultrasound, transplanted kidney, b-scan and/or real time with image documentation, with or without duplex doppler study
Echography of transplanted kidney, b-scan and/or real time with image documentation, with or without duplex doppler studies
Ultrasound, pregnant uterus, eal time with image documentation; fetal and and maternal evaluation after first trimester (>or = 14 weeks 0
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (>or = 14 weeks 0 da
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (>or = 14 weeks 90 d
Ultrasound, transvaginal
Echography, transvaginal
Ultrasound, transvaginal
Echography, transvaginal
Saline infusion sonohysterography (sis), including color flow dopplor, whenperformed
Hysterosonography, with or without color flow doppler.
Saline infusion sonohysterography (sis), including color flow dopplor, whenperformed
Hysterosonography, with or without color flow doppler.
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete
Ultrasound, pelvic (non-obstetric), real time with image documentation; complete
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete
Echography, pelvic (non-obstetric) b-scan and/or real time with image documentation;
Echography, pelvic (non-obstetric) b-scan and/or real time with image documentation;
Echography, pelvic (non-obstetric) b-scan and/or real time with image documentation;
Ultrasound, crotum and contents
Echography, scrotum and contents
Echography, scrotum and contents
Ultrasound, transrectal
Echography, transrectal
Echography, transrectal
Imaging, peripheral (eg, b-scan, dopple(eg, b-scan, doppler or real-time scan)
Ultrasonic guidance for needle biopsy; radiological supervision and
Ultrasonic guidance for needle biopsy; radiological supervision and
Ultrasonic guidance for needle biopsy; radiological supervision and
Gastrointestinal endoscopic ultrasound, radiological supervision and interpretation
Gastrointestinal endoscopic ultrasound, radiological supervision and interpretation
Ultrasound bone density measurement and interpretation, peripheral site(s), any method
Echography, intraoperative
Ultrasonic guidance, intraoperative
Ultrasonic guidance, intraoperative
Unlisted ultrasound procedure (eg, diagnostic, interventional)
Unlisted ultrasound procedure (eg, diagnostic interventional)
Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device)
See CPT Book - this code cannot be billed with various other codes.
See CPT Book - this code cannot be billed with various other codes.
See CPT Book - this code cannot be billed with various other codes.
Computed tomography guidance for needle placement (eg biopsy, aspiration, injection, localization device), radiological supervision and in
Computer-aided detection with further physician review for interpretation with or without digitization of film radiographic images; screeni
Mamorgraphy; unilateral
Mammography; bilateral
Mammography; bilateral
Mammography; bilateral
Screening mammography, bilateral (2 view film study of each breast)
Screening mammography, bilaterial (2 view film study of each breast)
Screening mammography, bilateral (2-view film study of each breast)
Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites.
Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites.
Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites.
appendicular skeleton (peripheral) (eg, radius, wrist, heel)
Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)
Therapeutic radiology treatment planning; simple
Therapeutic radiology treatment planning; simple
Therapeutic radiology treatment planning; complex
Therapeutic radiology simulation-aided field setting; simple
Therapeutic radiology simulation-aided field setting; simple
Therapeutic radiology simulation-aided field setting; complex
Therapeutic radiology simulation aidedfield setting; complex
Therapeutic radiology simulation-aided field setting; complex
Therapeutic radiology simulation-aided field setting; three-dimensional
Therapeutic radiology simulation-aided field setting; three-dimensional
Therapeutic radiology simulation-aided field setting; three-dimensional
Unlisted procedure, therapeutic radiology clinical treatment planning
Unlisted procedure, therapeutic radiolgy clinical treatment planning
Unlisted procedure, therapeutic radiology clinical treatment planning
Basic radiation dosimetry calculation, central axis depth dose calculation,tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity fact
Basic radiation dosimetry calculation,central axis depth dose, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity
Basic radiation dosimetry calculation, central axis depth dose, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity
Teletherapy, isodose plan (whether hand or computer calculated); intermediate (three or more treatment ports directed to a
Teletherapy, isodose plan (whether hand or computer calculated); intermediate (three or more treatment ports directed to a
Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted y, tangential ports, the use of
Teletherapy, isodose plan (whether han or computer calculated); complex (mantle or inverted y, tangential ports, the use of
Teletherapy, isodose plan (whether hand or computer calculated); complex (mantle or inverted y, tangential ports, the use of
Special teletherapy port plan, particles, hemi-body, total body
Special teletherapy port plan, particls, hemi-body, total body
Brachytherapy isodose calculation; simple (calculation made from single plane, one to four
Special dosimetry (eg, tld, microdosimetry) (specify)
Special dosimetry (eg, tld, microdosimtry) (specify)
Treatment devices, design and construction; simple (simple block, simple bolus)
Treatment devices, design and construction; simple (simple block, simple bolus)
Treatment devices, design and construction; complex (irregular blocks, special shields, compensators,
Treatment devices, design and construction; complex (irregular blocks, special shields, compensators,
Treatment devices, design and construction; complex (irregular blocks, special shields, compensators,
Continuing medical radiation physics consultation in support of therapeutic radiologist, including continuing quality
Continuing medical radiation physics consultation in support of therapeutic radiologist, including continuing quality
Special medical radiation physics consultation
Unlisted procedure, medical radiation physics, dosimetry and treatment devices
Unlisted procedure, medical radiation physics, dosimetry. and treatment devices
Unlisted procedure, medical radiation physics, dosimetry and treatment devices
Radiation treatment delivery, superficial and/or ortho voltage
Radiation treatment delivery, single atment area, single port or parallel opposed ports, simple blocks
Radiation treatment delivery, two separate treatement areas, three or more ports on a single treatment area, use of
Radiation treatment delivery, three or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compe
Radiation treatment delivery, three or ore separate treatment areas, custom blocking, tangential ports, wedges, rotational
Radiation treatment delivery, three or ore separate treatment areas, custom blocking, tangential ports, wedges, rotational
Radiation treatment delivery, three or ore separate treatment areas, custom blocking, tangential ports, wedges, rotational
Radiation treatment delivery, three or ore separate treatment areas, custom blocking, tangential ports, wedges, rotational
Therapeutic radiology port film(s)
Radiation treatment management, five trmt
Radiation therapy management with complete course of therapy consisting of one or two fractions only
Radiation therapy management with complete course of therapy consisting of one or two fractions only
Stereotactic radiation treatment management of cranial lesion(s)(complete course of treatment consisting of one session)
Special treatment procedure (eg, total body irradiation, hermibody irradiation, per oral, vaginal cone irradiation)
Special treatment procedure (eg, totalbody irradiation, hemibody irradiation, per oral, vaginal cone irradiation)
Unlisted procedure, therapeutic radiology clinical treatment management
Unlisted procedure, therapeutic radiology clinical treatment management
Unlisted procedure, therapeutic radiology clinical treatment management
Intracavitary radioelement application; simple
Surface application of radioelement
Surface application of radioelement
Supervision, handling, loading of radioelement
Supervision, handling, loading of radioelement
Supervision, handling, loading of radioelement
Unlisted procedure, clinical brachytherapy
Unlisted procedure, clinical brachytherapy
Unlisted procedure, clinical brachytherapy
Thyroid uptake; single determination single determination
Thyroid uptake; single determination
Thyroid uptake; single determination single determination
Thyroid uptake; multiple determinations multiple determinations
Thyroid uptake; multiple determinations
Thyroid uptake; stimulation, suppression or discharge (not including initia
Thyroid imaging, with uptake; single de single determination
Thyroid imaging, with uptake; single determination
Thyroid imaging, with uptake; single de single determination
Thyroid imaging, with uptake; multiple multiple determinations
Thyroid imaging, with uptake; multiple determinations
Thyroid imaging, with uptake; multiple multiple determinations
Thyroid imaging; only
Thyroid imaging; only
Thyroid imaging; only
Thyroid carcinoma metastases imaging; imited area (eg, neck and chest only)
Parathryroid imaging
Unlisted endocrine procedure, diagnostic nuclear medicine
Unlisted endocrine procedure, diagnostic nuclear medicine
Unlisted endocrine procedure, diagnostic nuclear medicine
Bone marrow imaging; limited area
Bone marrow imaging; multiple areas
Bone marrow imaging; whole body whole body
Bone marrow imaging; whole body whole body
White blood cell localization, limited limited area scanning
White blood cell localization; whole bo whole body
Lymphatics and lymph glands imaging
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine
Liver imaging; static only
Liver and spleen imaging; static only static only
Liver and spleen imaging; static only static only
Liver function study with hepatobiliary agents, with serial images
Liver function study with hepatobiliary agents with serial images
Hepatobiliary ductal system imaging, including gallbladder
Hepatobiliary ductal system imaging, icluding gallbladder
Hepatobiliary ductal system imaging, including gallbladder
Gastric emptying study
Unlisted gastrointestinal procedure, diagnostic nuclear medicine
Unlisted gastrointestinal procedure, diagnostic nuclear medicine
Unlisted gastrointestinal procedure, diagnostic nuclear medicine
Bone imaging; limited area (eg, skull, limited area (eg, skull, pelvis)
Bone imaging; limited area (eg, skull, pelvis)
Bone imaging; limited area (eg, skull, limited area (eg, skull, pelvis)
Bone imaging; multiple areas multiple areas
Bone imaging; multiple areas
Bone imaging; multiple areas multiple areas
Bone imaging; whole body whole body
Bone imaging; whole body
Bone imaging; whole body whole body
Bone imaging; by three phase technique by three phase technique
Bone imaging; by three phase technique by three phase technique
Bone imaging; by three phase technique by three phase technique
Bone imaging tomographic (spect); super tomographic (spect)
Bone density (bone mineral content) study, one or more sites; single photon absorptiometry
Unlisted musculoskeletal procedure, diagnostic nuclear medicine
Unlisted musculoskeletal procedure, diagnostic nuclear medicine
Unlisted musculoskeletal procedure, diagnostic nuclear medicine
Vascular flow imaging (ie, angiography,venography)
Vascular flow imaging (ie, angiography venography)
Vascular flow imaging (ie, angiography,venography)
Myocardial perfusion imaging, tomographic, single study, at rest or stress
Multiple studies, at rest and/or stress and/or redistribution and/or rest reinjection
Multiple studies, at rest and/or stress and/or redistribution and/or rest reinjection
Multiple studies, at rest and/or stress and/or redistribution and/or rest reinjection
Myocardial perfusion imaging, planar, single study
multiple studies, at rest, and/or stress and/or redistribution and/or rest reinjection
Myocardial perfusion imaging; (planar) sdy,at rest or stress (exercise and
Myocardial perfusion imaging; multiple studies, at rest and/or stress (exercise and/or pharmacologic),
Myocardial perfusion imaging; multiple studies, resting and/or stress (exercise and/or pharmacologic),
Myocardial perfusion imaging; multiple studies, at rest and/or stress (exercise and/or pharmacologic),
Myocardial perfusion imaging; tomographic (spect) single study at rest or stress (exercise and/or
Myocardial perfusion imaging; tomographic (spect) single study at rest or stress (exercise and/or
Myocardial perfusion imaging; tomographic (spect) multiple studies, at rest and/or stress (exercise and/or
Myocardial perfusion imaging; tomographic (spect) multiple studies, resting and/or stress (exercise and/or
Myocardial perfusion imaging; tomographic (spect) multiple studies, at rest and/or stress (exercise and/or
Cardiac blood imaging, gated equilibrium, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fra
Cardiac blood imaging, gated equilibrium, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus
Cardiac blood imaging, gated equilibrium, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus
Cardiac blood pool imaging gated e
Myocardial perfusion study with wall motion, qualitative
Myocardial perfusion study with wall motion, qualitative or quantitative study (list separately in
Myocardial perfusion study with wall motion, qualitative
Myocardial perfusion study with ejection
Myocardial perfusion study with ejection fraction (list separately in add t
Myocardial perfusion study with ejection
Cardiac blood pool imaging, first pass technique: multiple studies, at rest and during stress (exercise and/or
Cardiac blood pool imaging, first pass technique: multiple studies, at rest and during stress (exercise and/or
Cardiac blood pool imaging, gated equil
Unlisted cardiovascular procedure, diagnostic nuclear medicine
Unlisted cardiovascular procedure, diaostic nuclear medicine
Unlisted cardiovascular procedure, diagnostic nuclear medicine
Pulmonary perfusion imaging; particulate
Pulmonary perfusion imaging, particulae, with ventilation; rebreathing and washout, with or without single breath
Pulmonary ventilation imaging, aerosol multiple projections (eg, anterior, posterior,
Pulmonary quantitative differential function (ventilation/perfusion) study
Pulmonary quantitative differential function (ventilation/perfusion) study
Unlisted respiratory procedure, diagnostic nuclear medicine
Unlisted respiratory procedure, diagnostic nuclear medicine
Unlisted respiratory procedure, diagnostic nuclear medicine
Brain imaging, less than 4 static views; with vascular flow
Brain imaging, less than 4 static views; with vascular flow
Brain imaging, less than 4 static views; with vascular flow
Brain imaging, tomographic (SPECT)
Brain imaging, tomographic (SPECT)
Cerebrospinal fluid flow, imaging; including introduction of material);
Cerebrospinal fluid leakage detection and localization
Unlisted nervous system procedure, diagnostic nuclear medicine
Unlisted nervous system procedure, diagnostic nuclear medicine
Unlisted nervous system procedure, diagnostic nuclear medicine
Kidney imaging; static only static only
Kidney imaging; morphology
Kidney imaging; with function study (ie with function study (ie, imaging renogram)
Kidney imaging; with function study (ie with function study (ie, imaging renogram)
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting e
Single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor
Single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor
Kidney imaging morphology; tomographic (spect)
Kidney imaging morphology; tomographic (spect)
Kidney imaging morphology; tomographic (spect)
Kidney vascular flow only
Kidney function study only (ie; blood
Kidney function study only
Urinary bladder residual study (list separately in addition to code for primary procedure)
Urinary bladder residual study ding cystogram)
Unlisted genitourinary procedure, diagnostic nuclear medicine
Unlisted genitourinary procedure, diagnostic nuclear medicine
Unlisted genitourinary procedure, diagnostic nuclear medicine
Whole body, single day imaging
radiopharmaceutical localization of inflammatory process; limited area
Abscess localization; limited area
radiopharmaceutical localization of inflammatory process; limited area
Radionuclide localization of abscess; whole body
Abscess localization; whole body
Radionuclide localization of abscess; whole body
(PET) imaging with (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh
(PET) imaging with (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh
(PET) imaging with (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh
(PET) imaging with (CT) for attenuation correction and anatomical localization imaging; whole body
Unlisted miscellaneous procedure, diagnostic nuclear medicine
Unlisted miscellaneous procedure, diagnostic nuclear medicine
Unlisted miscellaneous procedure, diagnostic nuclear medicine
Radiopharmaceutical therapy, hyperthyroidism; initial, including evaluation of patient
Radionuclide therapy,hyperthyroidism,in initial, including
Radiopharmaceutical therapy, hyperthyroidism; initial, including evaluation of patient
Radiopharmaceutical therpy, by oral administration
Radiopharmaceutical therapy, by oral administration
Radiopharmaceutical therapy, by oral administration
Radiopharmaceutical therapy, by intravenous administration
Unlisted radiopharmaceutical therapeutic procedure
Unlisted radiopharmaceutical therapeutic procedure
Automated multichannel test; 1 or 2 clinical chemistry test(s)
Automated multichannel test; 3 clinical chemistry tests
Automated multichannel test; 4 clinical chemistry tests
Automated multichannel test; 5 clinical chemistry tests
Automated multichannel test; 6 clinical chemistry tests
Automated multichannel test; 7 clinical chemistry tests
Automated multichannel test; 8 clinical chemistry tests
Automated multichannel test; 9 clinical chemistry tests
Automated multichannel test; 10 clinical chemistry tests
Automated multichannel test; 11 clinical chemistry tests
Automated multichannel test; 12 clinical chemistry tests
Automated multichannel test; 13-16 clinical chemistry tests
Automated multichannel test; 17-18 clinical chemistry tests
Therapeutic quantitative drug monitoring in body fluids and/or excreta;
Basic metabolic panel (calcium, ionized). Panel must include the following: Calcium, carbon dioxide, chloride, creatinine, glucose, pota
Basic metobolic panel (Calcium, total) Panal must include: 82310, 82374, 82435, 82565, 82947, 84132, 84295, and 84520
Basic metobolic panel (Calcium, total) Panal must include: 82310, 82374, 82435, 82565, 82947, 84132, 84295, and 84520
Basic metobolic panel (Calcium, total) Panal must include: 82310, 82374, 82435, 82565, 82947, 84132, 84295, and 84520
General health panel
General health panel
General health panel
Electrolyte panel
Electrolyte panel
Electrolyte panel
Comprehensive metabolic panel - this panel must include the following: 82040, 82247, 82310, 82374, 82435, 82565, 82947, 84075, 84132,
Comprehensive metabolic panel
General health panel
Hypertension panel
Lipid panel
Lipid panel
Renal, function panel
Acute hepatitis panel
Hepatic function panel
Heptatic function panel
Hepatic function panel
Torch antibody panel *
Unlisted panel
Drug, screen; multiple drug classes, eac each procedure
Drug screen; single class, each drug class
Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class
Drug confirmation, each procedure
Amikacin
Carbamazepine
Cyclosporine
Digoxin
Dipropylacetic acid (valproic acid)
Theraputic drug assays - ethosuximide
Gentamicin
Gentamicin
Gold
Lithium
Phenobarbital
Phenytoin; total
Phenytoin; free
Primidone
Procainamide; with metabolites (eg.n-ace (eg, n-acetyl procainamide)
Theophylline
Vancomycin
Vancomycin
Quantitation of drug, not elsewhere specified
Throtropin releasing hormone (trh) stimu stimulation panel; one hour
Thyrotropin relasing hormone stimulation panel; 2 hours
Clinical pathology consultation; limite limited, without review of patient's history and
Clinical pathology consultation; limited, without review of patient's history and
Urinalysis by dip stick or tablet reagennt for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite,ph, protein,
Urinalysis by dip stick or tablet reagennt for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite,ph, protein,
Urinalysis by dip stick or tablet reagen
Urinalysis by dip stick or tabletreagent for bilirubim
Urinalysis by dip stick or tablet reagen
Urinalysis by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukpcutes, nitrite, ph,
Urinalysis, by dip stick or tablet reagent for bilirubin, glucose,...; non-automated, without microscopy
Urinalysis, by dip stick or tablet reagent for bilirubin, glucose,...; non-automated, without microscopy
Urinalysis, by dip stick or tablet reafent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph,
Automated, without microscopy; urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrate, p
Automated, without mictroscopy; urinalysis, by dip stick or tablet reagent for the bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrit
Urinalysis; qualitative or semiquantitative except immunoassays
Urinalysis; microscopic only microscopic only
Urine pregnancy test, by visual color co comparison methods
Volume measurement for timed collection, each
Unlisted urinalysis procedure
Acetone or other ketone bodies, serum; qualitative
Acetone or other ketone bodies, serum; quantitative
Adrenocorticotropic hormone (acth)
Albumin; serum, plasma or whole blood
Albumin; urine, quantitative *
Albumin; urine, microalbumin, quantitative
Albumin; urine, microalbumin, semiquantitive
Alcohol (ethanol), any specimen except breath
Alcohol (ethanol); any specimen except breath
Alcohol (ethanol); any specimen except breath
Alcohol (ethanol); breath
Aldolase *
Aldosterone *
Alpha-1-antitrypsin; total
Alpha-1-antitrypsin; phenotype
Alpha-1-antitrypsin; phenotype
Alpha-1-antitrypsin; phenotype
Alpha-fetoprotein; serum
Alpha-fetoprotein; serum
Alpha-fetoprotein; serum
Aliminum
Amino acids, qualitative
Amino acids, quantitative, each
Ammonia
Ammonia
Ammonia
Amphetamine or methamphetamine
Amylase
Amylase
Amylase
Androstenedione
Angiotensin i - converting enzyme (ace)
Apolipoprotein, each
Arsenic *
Barbiturates, not elsewhere specified *
Bilirubin; total
Bilirubin; direct
Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorec
Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determination, performed for other than colorectal n
Cadmium
Vitamin D; 25 hydroxy, includes fraction(s), if performed
Calcium; total *
Calcium; total
Calcium; total
Calcium; ionized *
ionized
Calcium; urine quantitative, timed specimen
Calculus; qualitative analysis
Calculus; x-ray diffraction
Carbon dioxide (bicarbonate)
Carboxyhemoglobin; quantitative
Carcinoembryonic antigen (cea)
Carotene
Catecholamines; total urine *
Catecholamines (dopamine, norepinephrine, epinephrine); fractionated
Ceruloplasmin
Ceruloplasmin
Ceruloplasmin
Chemiluminescent assay
Chloride; blood *
Chloride; urine
Chloride; other source
Cholesterol, serum; total
Cholesterol, serum or whole blood, total
Cholesterol, serum or whole blood, total
Cholinesterase; serum
Chromatography, quantitative; column (eg, gass-liquid or high performance liquid
Chromatography, quantitative, column (et, gas liquid or HPLC); single analyte not elsewhere specified, single stationary and mobile phase
Multiple analytes, single stationary and mobile phase
Citrate
Copper *
Cortisol; free
Cortisol; total *
Creatine *
Column chromatography/mass spectrometry (eg, gc/ms, or hpls/ms), analyte not elsewhere specified; qualitative, single stationary and mo
Creatine kinase (ck), (cpk); total *
Creatine phosphokinase (cpk), blood; isoenzymes
MB fraction only
MB fraction only
Creatinine; blood *
Ceatinine; blood
Creatinine; blood
Creatinine; other source
Creatinine; clearance
Cryoglobulin
Cyanocobalamin (vitamin b-12); *
Cyanocobalamin (vitamin b-12);
Cyanocobalamin (vitimin b-12);
Cyanocobalamin (vitamin b-12); unsaturated binding capacity
Cystine and homocystine, urine, qualitative
Dehydroepiandrosterone (dehea)
1,25-dihydroxy, includes fraction(s), if performed
Erythropoietin
Estradiol
Estrogens; fractionated
Estrogens; total
Estrone
Ferritin
Ferritin
Ferritin
Folic acid; serum *
Folic acid; serum
Folic acid; serum
Folic acid; rbc
Gammaglobulin, (immunoglobulin); iga, igd, igg, igm, each,
igE
Gammaglobulin, ige
Gases, blood; ph only
Gases, blood; any combination of ph, pc02, po2, c02, hc02 (includign calculated 02 saturation);
Gases, blood, any combination of pH, PCO2, pO2, CO2, HCO3
Gases, blood any combination of ph, pc02 p02, c02, hc02 (including calculated 02 saturation;
Gases, blood, any combination of ph, pco2, po2, co2, hc03 (including calculated 02 saturation)
Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)
Gastrin
Glucosamine
Glucose, body fluid, other than blood
Glucose, body fluid, other than blood
Glucose, body fluid, other than blood
Glucose; quantitative *
Glucose; quantitative
Glucose; quantitative
Glucose; blood, reagent strip *
Glucose; blood,reagent strip
Glucose; post glucose dose (includes glucose dose)
Glucose; tolerance test (gtt), three specimens (includes glucose)
Glucose; tolerance test, each additional beyond three specimens
Glucose; tolbutamide tolerance test.
Glucose tolerance test, intravenous
Glucose, blood, by glucose monitoring devise(s) cleared by the fda specifically for home use
Glucose, blood, by glucose monitoring devise(s) cleared by the fda specifically for home use
Glutamyltransferase, gamma (ggt)
Glutamyltransferase, gamma (ggt)
Glutamyltransferase, gamma (ggt)
Glycated protein
Gonadotropin, follicle stimulating hormo hormone (fsh)
Gonadotropin, luteinizing hormone
Growth hormone, human (hgh)
Helicobacter pylori, analysis for urease activity, non-radioactive isotope
Heavy metal (arsenic, barium, beryllium bismuth, antimony, mercury);
Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); quantative, each
Hemoglobin, electrophoresis (eg a2, s, c (eg, a2, s, c)
chromatography
Hemoglobin; glycated (a1c) (for fecal hemoglobin detection by immunoassay, use 82274)
Hemoglobin; glycated (a1c) (for fecal hemoglobin detection by immunoassay, use 82274)
Hemoglobin; glycated (a1c) (for fecal hemoglobin detection by immunoassay, use 82274)
Hemoglobin; methemoglobin, quantitative
Hemoglobin; sulfhemoglobin, quantitative
Hydroxyindolacetic acid, 5-(hiaa)
Hydroxyprogesterone, 17-d
Immunoassay for analyte other than infectious agent antibody or infectious agent antigen, qualitative or semiquantitative, multiple step m
qualitaive or semiquantitative, single step method (eg, reagent strip)
quantitative, by radioimmunoasay (eg, ria)
quantitative, not otherwise specified
Immunoassay, analyte, quantitative; not otherwise specified
Immunoassay, analyte, quantitative; not otherwise specified
Insulin; total
Iron *
Iron
Iron
Iron binding capacity *
Iron binding capacity
Iron binding capacity
Ketosteroids, 17-(17-ks); total
Lactate (lactate acid)
Lactic dehydrogenase (ld), (ldh) *
Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation
Lead *
Lipase
Lipase
Lipase
Lipoprotein, blood; electrophoretic sepearation and quantitation
Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)
Lipoprotein, direct measurement; vldl cholesterol
Lipoprotein, direct measurement; ldl cholesterol
Lipoprotein, direct measurement; ldl cholesterol
Magnesium *
Magnesium
Magnesium
Mercury, quantitative
Metanephrines
Myelin basic protein, cerebrospinal fluid
Myelin basic protein, cerebrospinal fluid
Myelin basic protein, cerebrospinal fluid
Myoglobin
Natriuretic peptide
Natriuretic peptide
Nephelometry, each analyte not elsewhere specified
Nickel
Molecular diagnostics; molecular isolation or extraction, each nucleic acid type (ie, DNA or RNA
isolation or extraction of highly purified nucleic acid, each nucleic acid type (ie, DNA or RNA)
enzymatic digestion, each enzyme treatment
separation by gel electrophoresis (eg, agarose, polyacrylamide) each nucleic acid preparation
Nuclear molecular diagnostics; nucleic acid probe, each
Molecular diagnostics; amplification, target, each nucleic acid sequence.
Molecular diagnostics; reverse transcrip
Molecule mutation identify
Nucletic molecular diagnostics; interpretation and report
Oligoclonal immune (oligoclonal bands)
Oligoclonal immune (oligoclonal bands)
Oligoclonal immune (oligoclonal bands)
Organic acid, single, quantitative
Opiate(s), drug and metabolites, each procedure
Osmolality; blood
Osmolality; urine
Oxalate
Parathormone (parathyroid hormone)
Ph; body fluid, not otherwise specified
Phosphatase, acid; total *
Phosphatase, acid; prostatic *
Phosphatase, alkaline
Phosphorus inorganic (phosphate); *
Phosphourus inorganic (phosphate);
Phosphorus inorganic (phosphate);
Phosphorus inorganic (phosphate); urine
Porphobilinogen, urine; quantitative
Porphyrins; urine; quantitation and fractionation
Potassium; serum, plasma or whole blood
Potassium; serum, plasma or whole blood
Potassium; urine
Prealbumin
Prealbumin
Progesterone
Prolactin
Prostate specific antigen (psa)
Protein, total, except by refractometry; serum, plasma or whole blood
Protein, total, except by refractomery; urine
Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)
Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)
Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)
Protein,total, by refractometric, any source
Protein, electrophoretic fractionation and quantitation
Protein, total, serum; electrophoretic fractionation and quantitation
Protein, total, serum; electrophoretic fractionation and quantitation
Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF)
Pyridoxal phosphate (vitamin b-6)
Pyruvate
Receptor assay; non-endocrine (specify receptor)
Renin;
Sodium; serum, plasma or whole blood
Sodium; serum, plasma or whole blood
Sodium; urine
Somatomedin
Somatomedin
Sulfate, urine (sulfhemoglobin, see hemoglobin, 83055, 83060) (t-3, see 84479-84481) (t-4, see 84436-84439)
Testosterone; free
Testosterone; total
Testosterone; total
Thiamine (vitamin b-1)
Thyroglobulin
Thyroxine, total
Thyroxine, total
Thyroxine, total
Thyroxine; requiring elution (eg, neonatal)
Thyroxine, free
Thryoxine; free
Thyroid stimulating hormone (tsh)
Thyroid stimulating hormone (tsh)
Thyroid stimulating hormone (tsh)
Tocopherol alpha (vitamin e)
Transcortin (cortisol binding globulin)
Transferase; aspartate amino (ast) (sgot) *
Transferase; alanine amino (alt) (sgpt) *
Transferrin (iron binding capacity, use 83550)
Triglycerides
Triglycerides
Triglycerides
Tridothyronine (t-3), resin uptake
Thyroid hormone (t3 or t4) uptake or th
Thyroid hormone (t3 or t4) uptake or th
Tridothyronine (t-3); total (tt-3)
Tridothyronine (t-3); free
Troponin, quantitative
Troponin, quantitative
Urea nitrogen, quantitative *
Urea nitrogen, quantative
Urea nitrogen, quantative
Ura nitrogen, urine
Uric acid; blood
Uric acid; other source
Vanillymandelic acid (vma), urine
Vitamin a
C-peptide
Gonadotropin, chorionic (hcg) quantitative
Gonadotropin, chorionic; qualitative
Gonadotropin, chorionic; qualitative
Gonadotropin, chorionic; qualitative
Unlisted chemistry procedure
Bleeding time *
Blood count; automated differential wbc count
Blood smear, microscopic exam with manual differential wbc count
Blood smear, microscopic exam with manual differential wbc count
Blood smear microscopic exam without manual differential wbc count
Manual differential wbc count, buffy coat
Blood count; spun microhematocrit
Hematocrit (hct)
Hematocrit (hct)
Hemoglobin (hgb)
Hemoglobin (hgb)
Complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)
Complete (cbc), automated (hgb, rbc, wbc and platelet count) and automated differential wbc count
Complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count
Complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)
Complete (cbc), automated (hgb, hct, rbc, wbc, and platelet count)
Complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)
Blood count; manual cell cunt (erythrocyte, leukocyte, or platelet) each
Red blood cell (rbc) automated
Reticulocyte, manual
Blood count; reticulocyte, automated
Leukocyte (wbc), automated
Blood count; platelet, automated
Blood smear, peripheral, interpretation by physician with written report
Bone marrow, smear interpretation
Clotting; factor ii, prothrombin, specific
Factor v (acg or proaccelerin), labile factor
Clotting; factor vii (proconvertin, stable factor)
Clotting; factor viii (ahg), one stage
Clotting; factor viii related antigen *
Clotting; factor VIII, VW factor, ristocetin cofactor
Clotting; factor vii, vw factor antigen
Factor ix (ptc or christmas)
Clotting; factor x (stuart-prower)
Clotting inhibitors or anticoagulants; antithrombin iii, activity
Clotting inhibitors or anticoagulants; protein c, antigen
Factor inhibitor test
Coagulation time; lee and white
Fibrin(ogen) degredation (split) products (fdp(fsp); agglutination slide, semiquantitative
Fibrin degradation products, d-dimer; quantitative
Fibrinogen; activity
Fibrinolysins or coagulopathy screen, interpretation and report
Heinz bodies; direct
Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)
heparin assay
Muramidase
Platelet; aggregation (in vitro), any agent
Osmotic fragility, rbc; incubated
Prothrombin time;
Prothrombin time
Prothrombin time;
Prothrombin time; substitution, plasma fractions, each
Russell viper venom time (includes venom): diluted
Sedimentation rate, erythrocyte; non-automated
Sedimentation rate, erythrocyte; non-automated
Sedimentation rate, erythrocyte; automated
Sedimentation rate, erythrocyte; automated
Sickling of rbc, reduction, slide method
Thrombin time; plasma
Thromboplastin time, partial (ptt); plasma or whole blood
Thromboplastin time, partial (ptt); plasma
Thromboplastin time, partial (ptt); plasma or whole blood
Thromboplastin time, partial (ptt); substitution, plasma fractions, each
Unlisted hematology procedure
Allergin specific ige; quantitative or semiquantitative, each allergen
Allergen specific IgE; quantitative or semiquantitative, each allergen
Allergen specific ige; qualitative, multiallergen screen (dipstick or disk)
Antinuclear antibodies (ANA)
Antinuclear antibodies (ana)
Antinuclear antibodies (ana)
Antinuclear antibodies (ana)
Antinuclear antibodies (ana); titer
Antinucliear antibodies (ana); titer
Antinuclear antibodies (ana); titer
Antistreptolysin 0; titer
Antistreptolysin 0; screen
Blood compatibility test; crossmatch by crossmatch by immediate spin and antihuman globulin technique,
C-reactive protein
C-reactive protein
C-reactive protein; hih sensitivity (hscrp)
Cardiolipin (phospholipid) antibody
Complement; antigen, each component
Complement; antigen, each component
Complement; functional activity, each component
Complement; total hemolytic (ch50)
Complement fixation tests, each antigen
Cyclic citrullinated peptide, antibody
Deoxyribonucleic acid (dna) antibody native or double stranded
Deoxyribonuleic acid (dna) antibody native or double stranded
Deoxyribonucleic acid (dna) antibody; single stranded
Extractable nuclear antigen, antibody to any method (eg, nrnp, ss-a, ss-b,sm, rnp, sc170,
Extractable nuclear antigen, antibody to any method (eg, nrnp, ss-a, ss-b, sm, rnp, sc170
Fluorescent antibody; screen, each anti antibody
Fluorescent noninfectious agent antibody; screen, each antibody
Fluorescent noninfectious agent antibody; screen, each antibody
Fluorescent antibody; titer, each antibody
Fluorescent antibody; titer, each antibody
Fluorescent antibody; titer, each antibody
Hemagglutination inhibition test (hai) *
Hepatitis be antigen (hbeag)
Ca 125
Heterophile antibodies; screening
Immunoassay for tumor antigen (eg, cancer antigen 125), each
Immunoassay for infectious agent antobody, quantitative, not elsewhere specified
Immunoassay to infectious agent antibody, qualitative or semiquantitative, single step method
Immunoelectrophoresis; serum *
Immunodiffusion; not elsewhere specified *
Immunodiffusion; gel diffusion, qualitative (ouchterlony), each
Immunofixation electrophorsis
Intrinsic factor antibodies
Intrinsic factor antibodies
Intrinsic factor antibodies
Cd4 count
Microsomal antibodies (eg, thyroid or liver-kidney), each
Particle agglutination; screen, each antibody *
Particle agglutination; screen, each antibody
Particle agglutination; screen, each antibody
Rheumatoid factor, qualitative
Rheumatoid factor; qualitative
Rheumatoid factor; qualitative
Rheumatoid factor; quantitative
Rheumatoid factor; quantitative
Skin test; tuberculosis, intradermal tuberculosis, intradermal
Streptokinase, antibody
Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)
Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)
Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)
quantitative
Antibody; aspergillus
Antibody; bacterium not elsewhere specified
Bartonella
Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunblot)
Antibody; borellia bufgdorferi (lyme dis (lyme disease)
Antibody; cytomegalovirus (cmv)
Antibody: cytomegalovirus (cmv), igm
Antibody; epstein-barr (eb) virus, early antigen (ea)
Antibody; epstein-barr (eb) virus, nucle nuclear antigen (ebna)
Antibody; epstein-barr (eb) virus, viral capsid (vca)
Antibody; fungus, not elsewhere specified
Antibody; helicobacter pylori
Antibody; helminth, not elsewhere specified
Htlv-i
Htlv or hiv antibody, confirmatory test (eg, western blot)
Htlv or hiv antibody, confirmatory test (eg, western blot)
Htlv or hiv antibody, confirmatory test (eg, western blot)
Antibody; herpes simplex, non-specific type test
Antobody; herpes simplex, type 1
Antobody; herpes simplex, type 1
Antobody; herpes simplex, type 2
Antobody; herpes simplex, type 2
Antibody; histoplasma
Antibody; hiv-1
Antibody; hiv-1 and hiv-2, single assay
Hepatitis b core antibody (hbcab); igg and igm
Hepatitus b core antibody (hbcab); igg and igm
Hepatitis b core antibody (hbcab); igg and igm
Igm antibody
Igm antibody
Igm antibody
Hepatitis b surface antibody
Hepatitis b surface antibody
Hepatitis b surface antibody
Hepatitis be antibody
Hepatitis a - igg and igm
Hepatitis a - igg and igm
Hepatitis a - igg and igm
Hepititis a - lgm antibody
Hepatitis a - igm antibody
Hepatitis a - igm antibody
Antibody; mumps
Antibody; rubella
Rubeola
Toxoplasma
Toxoplasma, igm
Antibody; varicella-zoster
Antibody; virus, not elsewhere specified
Thyroglobulin antibody
Hepatitis c antibody
Hepatitis c antibody
Hepatitis c antibody
Hepatitis c anitbody: confirmatory test
Serum screening for cytotoxic percent reactive antibody (pra): quick method
Hla typing, a, b, or c (eg, a10, b7, b2 (eg, a10, b7, b27), single antigen
Hla typing, dr/do, multiple antigens *
Unlisted immunology procedure
Antibody screen, rbc, each serum technique
Antibody screen, rbc, each serum technique
Antibody identification, rbc antibodies, each panel for each serum technique
Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell
Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell
Antihuman globulintest (coombs test); indirect, each antibody titer
Autologous blood or component
Blood typing; abo
Blood typing, apo
Blood typing; rh(d)
Blood typing, rh
Compatibility test each unit; immediate spin technique
Compatibility test each unit; immediate spin technique
Compatibility test each unit; incubation technique
Compatibility test each unit; antiglobul antiglobulin technique
Compatibility test each unit; electronic
Hemolysins and agglutinins, auto, screen each
Hemolysins and agglutinins, auto, screen each; incubated
Unlisted transfusion medicine procedure
Concentration (any type), for parasites, ova, or tubercle bacillus (tb, afb)
Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (including anaerobic culture,, if appropriate)
Culture, bacterial, definitives; blood (includes anaerobic screen)
Stool, aerobic, with isolation and preliminary exam (eg, kia, lia), salmoneella and shigella species.
Culture, bacterial, definitive; stool
Stool, aerobic, additional pathogens, isolation and presumptive identification of isolates
Any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates
Culture, bacterial; any other source except urine, blood or stool, aerobic,with isolation and presumptive identification of isolates
Culture, bacterial; any other source except urine, blood or stool, aerobic,with isolation and presumptive identification of isolates
Any source, except blood, anaerobic with isolation and presumptive identification of isolates
Culture, bacterial; any source, except blood, anaerobic with isoloation and presumtive identification isolates
anaerobic isolate, additional methods required for definitive identification, each isolate
Aerobic isolate, additional methods required for definitive identification, each isolate
Aerobic isolate, additional methods required for definitive identification,each isolate
Culture, bacterial, screening only, for single organisms
Culture, bacterial, urine; quantitative, colony count
Culture, bacterial, urine; quantitative, colony count
Culture, bacterial, urine; quantitative, colony count
Culture, bacterial; with isoloation and presumptive identification of each isolate, urine
Culture, bacterial; with isoloation and presumptive identification of each isolate, urine
Culture, bacterial; with isoloation and presumptive identification of each isolate, urine
Culture, fungi, isolation; skin
Culture, fungi, isolation; other source (except blood)
Culture, fungi (mold or yeast) isolation, with preseumptive identification of isolates; other source (except blood)
Culture, fungi, isolation; blood
Culture, fungi, definitive identification of each fungus
Culture, tubercle or other acid-fast bacilli (eg, tb, afb, mycobacteria);
Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates
Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates
Culture, typing; immunologic method, other than immunofluoresence (eg, agglutination grouping), per antiserum
Culture, typing; immunologic method, other than immunofluoresence (eg, agglutination grouping), per antiserum
Ova and parasites, direct smears, concentration and identification
Sensitivity studies, antibiotic; agar diffusion method,
Sensitivity studies, antibiotic; disk method, per plate (12 or less disks)
Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme
Sensitivity studies, antibiotic; microtiter, minimum inhibitory concentration (mic),
Sensitivity studies, anitbiotic; microtiter, minimum inhibitory concentration (mic),
Sensitivity studies, antibiotic; minimum bactericidal concentration (mbc) (use in addition
Smear, primary source, with interpretation; routine stain
Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types
Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types
Smear, primary source, with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, or
Smear, primary source, with interpretation; wet mount with simple stain, for
Tissue exam for fungi (eg, koh slide)
Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)
Infectious agent antigen detection by enzyme immunoassy technique. qualitative or semiquantitative, multiple step method; clostridium d
Cryptococcus neoformans; infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multipl
Cryptosporidium
Helicobacter pylori, stool
Helicobacter pylori
Hepatitis b surface antigen
Hepatitis b surface antigen
Hepatitis b surface antigen
Hepatitis b surface antigen (hbsag) neutralization; infectious agent anti- gen detection by enzyme immunoassay technique, qualitative or s
Hepatitus be antigen
Hiv-1
Influenza, A or B, each
Streptococcus, group a, infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple st
Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; multiple step method, not otherwis
Borrelia burgdorferi, quantification
Chlamydia trachomatis, direct probe technique
Chlamydia trachomatis, amplified probe technique
Hepatitis b virus, quantification
Hepatitis c, amplified probe technique.
Hepatitis c, quantification
Viral load
Neisseria gonorrhoeae, direct probe technique
Neisseria gonorrhoeae, amplified probe technique
Infectious agent detection by nucleic acid (dna or rna); not otherwise specified, direct probe technique
Infectious agent detection by nucleic acid (dna or rna): not otherwise specified, direct probe technique
Not otherwise specified, amplified probe technique
Not otherwise specified, amplified probe technique
Infectious agent detection by nucleic acid (dna or rna),multiple organisms;amplified probe(s) technique
Infectious aent detection by necleic acid (dna or rna), multiple organisms;amplified probe(s) technique
Infectious agent antigen detection by immunoassay with direct optical ob- servation; influenza
Streptococcus, group a
Infectious agent detection by immunoassay with direct optical observation; not otherwise specified
Infectious agent genotype; hepatitis c
Unlisted microbiology procedure
Unlisted necropsy (autopsy) procedure
Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretationn
Cytopathology, fluids, washings or bruhings, with centrifugation except cervical or vaginal;
Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation
Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation
Cytopathology, fluids, washings or brushings, except for cervical or vaginal; simple filter method with interpretation
Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and simple filter preparation with interpretation
Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears and simple filter preparation with interpretation
Cytopathology, fluids, washings or brushings, with centrifugation except cervical or vaginal;
Cytopathology fluids washing or brus hings, with centrifugation except cervical or vaginal;
Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical o
Cytopathology, selective cellular enhancement technique with interpretation(eg, liquid based slide preparation method), except cervical o
Cytopathology
Cytopathology, cervical or vaginal (any reporting system), collected in perservative fluid, automated thin layer preparation; manual screen
Cytpath c/ vag automated
Cytpath c/ vag auto rescreen
Cytopathology, smears, cervical or vaginal, up to three smears;
Cytopathology, smears, cervical or vaginal (eg, papanicolaou), up to three smears;
Cytology; smears, cervical or vaginal nal (eg, papanicolaou), up to three smears;
Cytopathology, smears, cervical or vaginal (eg, papanicolaou), up to three smears;
Cytopathology, smears, cervical or vaginal (eg, papanicolaou), up to three smears;
Cytopathology, smears, any other source screening and interpretation
Cytopathology, any other source; prepar preparation, screening and interpretation
Cytopathology, any other source; preparation, screening and interpretation
Cypath tbs c/vag manual
Cypath tbs c/ vag manual
Cypath tbs c/vag manual
Evaluation of fine needle aspirate with or without preparation of smears;
Cytopathology, cervical or vaginal, collected in preservative fluid, automated thin layer preparation with screening by automated system
Flow cytometry; each cell surface marke each cell surface marker
Flow cytometry cachell surface marker each cell surface marker
Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker
Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition
Flow cytometry, interpretation; 9 to 15 markers
Flow cytometry, interpretation; 9 to 15 markers
Flow cytometry, interpretation; 9 to 15 markers
16 or more markers
Unlisted cytopathology procedure
Unlisted cytopathology procedure
Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy.
Tissue culture for neoplastic disorders; bone marrow, blood cells
Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding
Chromosome analysis; analyze 20-25 cells
Molecular cytogenetics; dna probe, each (eg, fish)
Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)
Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells
Cytogenetics and molecular cytogenetics, interpretation and report
Unlisted cytogenetic study
Surgical pathology, gross examination only
Surgical pathology, gross examination nly
Surgical pathology, gross examination onlly
Surgical pathology, gross exam only
Surgical pathology, gross and microscopic examination of presumptively normal tissue(s), for identification
Surgical pathology, gross and microscoic examination of presumptively normal tissue(s), for identification
Surgical pathology, gross and microscopic exam
Surgical pathology, gross and microscopic examination of presumptively abno
Surgical pathology; gross and microscopic exam of presumptively abnormal
Surgical pathology gross and microscopic examinatin of presumtively abnorma
Surgical pathology, gross and microscopic examination
Surgical pathology, gross and microscoic examination of presumptively abnormal tissue(s);
Surgical pathology, gross and microscopic examination
Surgical pathology, gross and microscopic examination
Surgical pathology, gross and microscopic exam of presumptively abnormal tissue(s);
Surgical pathology, gross and microscopic examination of presumptively abnormal tissue(s);
Surgical pathology, gross and microscoic examination of presumptively abnormal tissue(s);
Surgical pathology, gross and microscopic examination of presumptively abnormal tissue(s);
Surgical pathology, gross and microscoic examination of presumptively abnormal tissue(s);
Decalcification procedure (list separately in addition to code for surgical pathology examination)
Decalcification proc surg path ely in addition to code for surgical pathology examination)
Special stains; group i for microorganisms (eg, gridley, acid fast, methenamine silver), including interpretation and report, each
Special stains; group i for microorganisms (eg, gridley, acid fast, methenamine silver), including interpretation and report, each
Special stains; group i for microorganisms (eg, gridley, acid fast, methenamine silver), including interpretation and report, each
Group II, all other (eg, iron, trichrome), except immunocytochemistry and immunoperoxidase stains, including interpretation and report, e
Group II, all other (eg, iron, trichrome), except immunocytochemistry and immunoperoxidase stains, including interpretation and report, e
Group II, all other (eg, iron, trichrome), except immunocytochemistry and immunoperoxidase stains, including interpretation and report, e
histochemical staining with frozen section(s), including interpretation and report (list seperately in addition to code for primary procedure)
histochemical staining with frozen section(s), including interpretation and report (list seperately in addition to code for primary procedure)
Determinative histochemistry or cytochemistry to identify enzyme constituents, each
Consultation and report on referred slides prepared elsewhere
Consultation and report on referred slides prepared elsewhere
Pathology consultation during surgery
Consultation during surgery; with froze with frozen section(s), single specimen
Consultatioln during surgery with froze with frozen section(s), single specimen
Consultation during surgery; with froze section(s), single specimen
Consultation during surgery; each addit each additional tissue block with frozen section(s)
Consultation during surgery; each additional tissue block with frozen section(s)
Immunohistochemistry (including tissue immunoperoxidase), each antibody
Immunocytochemistry (including tissue) mmunoperoxidase), each antibody
Immunofluorescent study;each antibody direct method
Electron microscopy; diagnostic
Tumor (eg, dna ploidy)
Unlisted surgical pathology procedure
Cell count, miscellaneous body fluids (eg, csf, joint fluid), except blood;
Cell count, miscellaneous body fluids (eg, csf, joint fluid), except blood;
Cell count, miscellaneous body fluids (eg, cerebrospinal fluid,joint fluid)except blood; with differential count
Cell count, miscellanous body fluids (eg, cerebrospinal fluid, joint fluid)except blood; with different count
Leukocyte assessment, fecal, qualitative or semiquantitative
Crystal identification by compensated polarizing lens analysis, synovial fluid
Fat stain, feces, urine, or sputum
Nasal smear for eosinophils
Immunization administration (includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections); one vaccine (single or c
Immunization administration (includes percutaneous,intradermal, subcutaneous, intramuscular and jet injections); each additional vaccine
Emergency department service, new patient; intermediate service
Initial consultation; intermediate intermediate
Hepatitis A vaccine, adult dosage, for intramuscular use
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use
Tetanus toxoid absorbed, for intramuscular use
Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use
Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use.
Tetanus, diphtheria toxoids and acellular pertussis vaccine
Varicella virus vaccine, live, for subcutaneous use
Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or
Hepatitis B vaccine, adult dosage, for intramuscular use
Unlisted vaccine/toxoid
Iv infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour
Intramuscular injection of antibiotic (specify)
Psychiatric diagnostic interview examination
Interactive psychiatric diagnostic interview
Individual psychotherapy, insight orient
Individual psychotherapy, insight orient
Individual psychotherapy, insight orient
Individual psychotherapy, insight orient
Individual psychotherapy, insight orient
Individual psychotherapy, insight orient
Individual psychotherapy, interactive
Individual psychotherapy, interactive
Individual psychotherapy, interactive
Individual psychotherapy, interactive
Individual psychotherapy, interactive
Individual psychotherapy, interactive
Individual psychotherapy, insight oriented
Individual psychotherapy, insight oriented
Individual psychotherapy, insight oriented
Individual psychotherapy, insight oriented
Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an inpatient hospital, partial hospital or residentail ca
Individual psychotherapy, interactive, using play equipment, physical devices, language interpreter, or other mechanisms of non-verbal com
Medical psychoanalysis
Family psychotherapy (without the patient present)
Family psychotherapy (conjoint psychothpsychotherapy) by a physician, with continuing medical diagnostic eval, and drug management w
Group medical psychotherapy (other than of a multiple-family group) by a physician, with continuing medical diagnostic
Interactive group psychotherapy
Pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy
Individual psychophysiological therapy incorporating biofeed 20-30 mins.
Individual psycholphysiological therapy, incorporating biofeed 45-50 mins.
Interpretation or explanation of results of psychiatric, or ther medical examination and procedures, or other accumulated data to family or
Preparation of report of patient's psychiatric status, history, treatment, or progress (other than for legal or consultative
Unlisted psychiatric service or procedure
Biofeedback
Unlisted dialysis procedure, in hospitalized or out-patient
Dialysis supplies (rental) lized or out-patient
Esophageal motility study
Gastrointestinal tract imaging, with physician interpretation and report
Anorectal manometry
Unlisted diagnostic gastroenterology procedure
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;
Ophthalmological services, medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new
Ophthalmological services: medical exam and eval with initiation of diagnostic and treatment program
Ophthalmological services, medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment
Ophthalmological services; medical exam and eval, with initiation or continuation of diagnostic and threatment
Opthalmological services; medical exam and eval, with initiation or continuation of diagnostic and treatment
Ophthalmological services: medical exam and eval, with initiation or continuation of diagnostic and treatment
Ophthalmological services, medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; com
Ophthalmological services; medical exam and eval, with initiation or continuation of diagnostic and treatment
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; com
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment
Determination of refractive state
Opthalmological examination and evaluation under general anesthesia with or
Opthalmological examination and evaluation
Gonioscopy with medical diagnostic evaluation (separate procedure)
Gonioscopy with medical diagnostic eval (separate procedure)
Computerized corneal topography, unilateral or bilateral, with interpretation and report
Sensorimotor examination with medical diagnostic evaluation (separate procedure)
Sensorimotor exam with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and
Orthoptic and/or pleoptic training, with continuing medical direction and evaluation
Fitting of contact lens for treatment of disease, including supply of lens
Visual field examination with medical diagnostic evaluation; limited examination (eg, tangent screen, autoplot, arc
Visual field examination with medical diagnostic evaluation; intermediate examination (eg, multistimulus level, full
Visual field exam with medical diagnostic eval; extended, quantitative peri
Serial tonometry with medical diagnostic evaluation (separate procedure), one or more sessions, same day
Tonography with medical diagnostic evaluation, recording indentation tonometer method or perilimbal suction method
Cmptr ophth dx img ant segmt
cmptr ophth img optic nerve
cmptr ophth img optic nerve
cmptr ophth img optic nerve
cptr ophth dx img post segmt
cptr ophth dx img post segmt
cptr ophth dx img post segmt
Ophthalmic biometry/partial coherence
Ophthalmic biometry/partial coherence
Ophthalmicic biometry by partial coherence interferometry with intraocular lens power calculation
Provocative tests for glaucoma, with medical diagnostic evaluation, without tonography
Ophthalmoscopy, extended as for retinal detachment (may include use of contact lens, drawing or sketch, and/or fundus
Ophthalmoscopy, extended as for retinal detachment (may include use of contact lens, drawing or sketch, and/or fundus
Ophthalmoscopy, extended as for retinal detachment (may include use of contact lens, drawing or sketch, and/or fundus
Opthalmoscopy, extended as for retinal detachment, (may include use of cont
Fluorescein angioscopy with medical diagnostic evaluation;
Fluorescein angiography (includes multiframe imaging) with medical diagnostic evaluation
Fluorescein angiography (includes multiframe imaging) with medical diagnostic evaluation
Fluorescein angiography (includes multiframe imaging) with medical diagnostic evaluation
Indocyanine-green angiography (includes multiframe imaging) with interpretation and report
Fundus photography with medical diagnostic evaluation; *
Fundus photography with medical diagnostic evalutation
Fundus photography with medical diagnostic evaluation; *
Electro-oculography, with medical diagnostic evaluation
Electro-oculography, with medical diagnostic evaluation
Electroretinography, with medical diagnostic evaluation
Visually evoked potential (response) study, with medical diagnostic evaluation
Color vision examination, extended, eg, anomaloscope or equivalent
Dark adaptation examination, with medical diagnostic evaluation
External ocular photography with medical diagnostic evaluation for documentation of medical progress
External ocular photography with medical diagnostic evaluation for documentation of medical progress
Special anterior segment photography with medical diagnostic evaluation;
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation;
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation;
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation;
Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation;
Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and
Corneal lens for aphikia, one eye; prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation
Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and
corneoscleral lens
Modification of contact lens (separate procedure), with medical supervision of adaptation
Replacement of contact lens
Fitting of spectacles, except for aphakia; monofocal
Fitting of spectacles, except for aphakia; bifocal
Fitting of spectacles, except for aphakia; multifocal, other than bifocal
Fitting of spectacle mounted low vision aid; single element system
Fitting of spectacle mounted low vision aid; telescopic or other compound lens system
Repair and refitting spectacles; except for aphakia
Unlisted ophthalmological service or procedure
Otolaryngologic examination under general anesthesia
Binocular microscopy (separate diagnostic procedure)
Evaluation of speech, language, voice, communication, and/or auditory processing
Treatment of speech, language, voice communication and/or auditory processing disorder; individual
Speech, language, voice, communication, and/or auditory processingdisorder (includes aural rehabilitation); group, two or more individual
Nasopharyngoscopy with endoscope (separate procedure)
Facial nerve function studies (eg, electroneuronography)
Laryngeal function studies (ie, aerodynamic testing and acoustic testing)
Treatment of swallowing dysfunction and
Spontaneous nystagmus, including gaze
Positional nystagmus test
Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four tests)
Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
Positional nystagmus test, minimum of 4 positions, with recording
Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes four tests), with recording
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording
Oscillating tracking test, with recording
Torsion swing test, with recording
Use of vertical electrodes in any or all of above tests counts as one additional test
Computerized dynamic posturography
Tympanometry and reflex threshold measurements
Screening test, pure tone, air only
Pure tone audiometry (threshold); air only
Pure tone audiometry (threshold); air only
Pure tone audiometry (threshold); air a air and bone
Speech audiometry; threshold only threshold only
Speech audiometry; threshold; with speech recognition
Speech audiometry; threshold; with speech recognition
Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined).
Basic comprehensive audiometry (92553 and 92556 combined), (pure tone, air and bone, and speech, threshold and discrimination)
Basic comprehensive audiometry (92553 and 92556 combined), (pure tone, air and bone, and speech, threshold and discreminiation)
Basic comprehensive audiometry (92553 and 92556 combined), (pure tone, air and bone, and speech, threshold and discrimination)
Bekesy audiometry; diagnostic diagnostic
Tone decay test
Stenger test, pure tone
Tympanometry
Acoustic reflex testing; threshold
Acoustic immittance testing, includes tympanometry, acoustic reflex threshold testing, and acoustic reflex decay testing
Filtered speech test
Staggered spondaic word test
Stenger test, speech
Conditioning play audiometry
Electrocochleography
Brainstem evoked response recording
Brainstem evoked response recording
Brainstem evoked response recording
Brainstem evoked response recording
Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited
Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; limited
Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products)
Evoked otoacoustic emissions; limited (single stimulus level, either transient or distortion products)
Evoked otoacoustic emissions; comprehensive or diagnositc evaluation (comparison of transient and
Evoked otoacoustic emissions; comprehensive or diagnositc evaluation (comparison of transient and
Hearing aid examination and selection; monaural
Hearing aid examination and selection; binaural
Hearing aid examination and selection; binaural
Hearing aid check - mono.
Hearing aid check; binaural binaural
Electroacoustic evaluation for hearing aid; binaural
Ear protector attenuation measurements
Eval for use and/or fitting of voice prosthetic or augmentative/alternativecommunication device to supplement oral speech
Diagnostic analysis of chochlear implant, age 7 yrs or older; with programming
Subsequent reprogramming
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first h
Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with patient; each add
Therapeutic services for the use of speech-generating device, including programming and modification
Evaluation of oral and pharyngeal swallowing function
Motion fluoroscopic evaluation of swallowing function by cine or video recording
Evaluation of central auditory function, with report; initial 60 minutes
Evaulation of central auditory function, with report; each additional 15 minutes
Evaluation of auditory rehabilitation status; first hour
Eval of auditory rehab status; first hour
Auditory rehabilitation; prelingual hearing loss
Unlisted otorhinolarynogological service or procedure
Cardioversion, elective, electrical conversion of arrhythmia, external
external
Transcatheter placement of an intracoronary stent(s), percutaneous with or without other therapeutic intervention, any method, single ve
Transcathether placement of an intracoronary stent(s), precutaneous with orwithout other therapeutic intervention, any method, single ve
each additional vessle (list separately in addition to code for primary procedure)
Percutaneous transluminal coronary ballon angioplasty; single vessel
Percutaneous transluminal coronary ballon angioplasty; single vessel
Percutaneous transluminal coronary angioplasty; each additional vessel
Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report
Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report
Electrocardiogram, routine ecg with at least 12 leads; with iterpretation and report
Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report
Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report
Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only
Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only
Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise; continuous electrocardiographic
Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise;
Cardiovascular stress test using maximal or submaximal treadmill or bicycleexercise, continious electrocardiographic monitoring, and/or ph
Cardiovascular stress test using maximal or submaximal treadmill or bicycleexercise, continuous electrocardiographic monitoring, and/or
Cardiovascular stress test using maximal or submaximal treadmill or bicycleexercise, continuous electrocardiographic monitoring, and/or
Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise;
Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise;
Ergonovine provocation test
Rhythm ecg, one to three leads; with in with interpretation and report
Rhythm ecg, one to three leads; tracing tracing only without interpretation and report
Rhythm ecg, one to three leads; interpr interpretation and report only
Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage, with visua
Electrocardiographic monitoring for 24 hours by continuous original ecg waveform recording and storage, with visual
Recording (includes hook-up, recording, and disconnection); electrocardio- graphic monitoring for 24 hours by continuous original ecg wav
Electrocardiographic monitoring for 24 hours by continous originalecg waveform recording and storage, with visual superimposition scann
Scanning analysis with report; electrocardiographic monitoring for 24 hoursby continuous original ecg waveform recording and storage, wi
Electrocardiographic monitoring for 24 hours by continuous original ecg waveform recording and storage, with visual
Wearable patient activated electrocardiographic rhythm derived event recording with presymptom or memory loop, 24-hour attended mo
Recording (includes connection, recording, and disconnection); patient demand single or multiple event recording with presymptom memo
Monitoring, receipt of transmissions, and analysis; patient demand single or multiple event recording with presymptom memory loop, 24-a
Physician review and interpretation only; patient demand single or multiple event recording with presymtom memory loop, 24-hour atten
Signal-averaged electrocariography (saecg), with or without ecg
Signal-averaged electrocardiography (saecg), with or without ecg
Signal-averaged electrocariography (saecg), with or without ecg
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with
Echocardiography, transthoracic, real-time image documentation (2D), includes M-mode recording, when performed, complete, with spec
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording when performed complete, witho
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording when performed complete, witho
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording when performed complete, witho
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed , follow-up or lim
Echocardiography, real time with image documentation (2d) (with or without m-mode recording), transesophageal;
Echocardiography, real time with image documentation (2d) (with or without) m-mode recording, transesophageal
Doppler echocardiography, pulsed wave and/or continuous wave with spectral display;
Doppler echocardiography nd/or continuous wave with spectral display;
Doppler echocardiography, pulsed wave and/or continuous wave with spectral display;
Doppler echocardiography, pulsed wave and/or continuous wave with spectral display;
Doppler echocardiography, pulsed wave and/or continuous wave with spectral display; follow-up or limited study
Doppler color flow velocity mapping (list separately in addition to code for echocardiography 76825, 76826, 76827,
Doppler color flow velocity mapping (list separately in addition to code for echocardiography 93307, 93308,
Doppler color flow velocity mapping (list separately in addition to code for echocardiography 76825, 76826, 76827
Echocardiography, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascula
Echocardiography, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascula
Echocardiography, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascula
Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes
Insertion and placement of flow directed catheter (eg, sawn-ganz) for monitoring purposes
intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement during coronary angiography
Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin
Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin
Comphrehensive electrophysiologic eval including insertion and repositioning of multiple electrode catheters with induction or attempted
Comphrehensive electrophysicologic eval including insertion and reposition ing of multiple electrodes catheters with induction or attempte
With left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)
Programmed stimulation and pacing after intravenous drug infusion (list seperately in addition to code for primary procedure)
Programmed stimulation and pacing after intravenous drug infusion (list seperately in addition to code for primary procedure)
Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction o
Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction o
Electrophysiologic evaluation of cardioverter-defibrillator leads (includes defibrillation threshold testing and sensing
Electrophysicologic eval of cardioverter-defibrillator leads (in- cludes defibrillation threshold testing and sensing
Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete
Intracardiac catheter ablation of arrhythmogenic focus; for treat-ment of supraventricular tachycardia by ablation of fast or slow atriovent
Intracardiac catheter ablation of arrhythmogenic focus; for treatment of ventricular tachycardia
Autonomic nervous system evaluation of c cardiovascular function with tilt table
Evalutation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitorin
Biompedance-derived physiologic cardiovascular analysis
Plethysmography, total body; with interpretation and report
Plethysmography, total body; tracing on tracing only, without interpretation and report
Temperature gradient studies
Physician services for outpatient cardiac rehabilitation; with continuous ecg monitoring (per session)
Unlisted cardiovascular service or procedure
Noninvasive physio9logis studies of ext cranial arteries, complete bilateral study (eg, periorbital flow direction with arterial
Duplex scan of extracranial arteries; complete bilateral study
Duplex scan of extracranial arteries; complete bilateral study
Duplex scan of extracranial arteries; complete bilateral study
Duplex scan of extracranial arteries; unilateral or limited study
Duplex scan of extracranial arteries; unilateral or limited study
Duplex scan of extracranial arteries; unilateral or limited study
Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral (eg, ankle/brachial
Non-invasive physiologic studies of upper or lower extremity arteries, single level, bilateral (eg, ankle/brachial indices, doppler waveform a
Noninvasive physiologic studies of upper or lower extremity arteries, multiple levels or with provocative functional maneuvers, complete
Noninvasive physiological of the upper and lower extremity arteries
Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study
Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study
Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study
Non-invasive physiologic studies of extremity veins, complete bilateral study (eg, doppler waveform analysis with responses
Non-invasive physiologic studies of extremity veins, complete bilateral study (eg, doppler waveform analysis with responses
Noninvasive physiologic studies of extremity veins, complete bilateral study
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study
Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study
Duplex scan of extremity veins including responses to compression and othermaneuvers; complete bilateral study
Duplex scan of extremity veins including responses to comp. & other mane
Duplex scan of extremity veins including responses to compression and other maneuvers;
Duplex scan of extremity veins including responses to compression and other maneuvers; unilater or limited study
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, and/or retroperitoneal organs;
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, and/or retroperitoneal organs; complete study
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study
Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), and/or maximal
Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), and/or maximal
Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), and/or maximal voluntary ventil
Bronchospasm evaluation: spirometry as in 94010, before and after bronchodilator (aerosol or parenteral) or exercise
Brochospasm evaluation; spirometry as in 94010, before and after brochodilator (aerosol or parenteral)
Bronchospasm evaluation; spirometry as in 94010, before and after bronchodilator (aerosol or parenteral)
Prolonged postexposure evaluation of bronchospasm with multiple spirometric determinations after test dose of
Vital capacity, total (separate procedure)
Maximum breathing capacity, maximal voluntary ventilation
Functional residual capacity or residual volume: helium method, nitrogen open circuit method, or other method
Functional residual capacity or residual volume: helium method, nitrogen open circuit method, or
Functional residual capacity or residual volume: helium method, nitrogen open circuit method, or other method
Expired gas collection, quantitative, single procedure (separate procedure)
Expired gas collection, quanttitative, single procedure (separate procedure)
Thoracic gas volume
Thoracic gas volume
Thoracic gas volume
Determination of resistance to airflow, oscillatory or plethysmographic methods
Determination of resistance to airflow, oscillatory or plethysmographic methods
Determination of resistance to airflow, oscillatory or plethysmographic methods
Respiratory flow volume loop
Respiratory flow volume loop
Pulmonary stress testing; simple (eg, 6-minute walk test, prolonged exer- cise test for bronchospasm with pre- and post-spiometry and oxi
Pressurized inhalation treatment for acute airway obstruction or for sputuminduction for diagnostic purposes eg with an aerosol generato
Continuous positive airway pressure ventilation (cpap), initiation and management
Demonstration and/or eval of patient utilzation of an aerosol generator, nebulizer, metered dose inhaler or ippb device.
Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted
Carbon monoxide diffusing capacity, (eg, single breath, steady state)
Carbon monoxide diffusing capacity, any method
Carbon monoxide diffusing capacity (eg, single breath, steady state)
Pulmonary compliance study, (eg, plethysmography, volume and pressure meassurements)
Noninvasive ear or pulse oximetry for oxygen saturation; single determination
Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)
Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)
Carbon dioxide, expired gas determination by infrared analyzer
Unlisted pulmonary service or procedure
Percutaneous tests (scratch, puncture, prick) with allergenic extracts;
Percutaneous tests (scratch, puncture, prick) with allergenic extracts;
Percutaneous tests (scratch, puncture, prick) with allergenic extracts;
Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction,
Percutaneous tests (scratch, puncture, prick) sequential and incremental, with drugs, biologicals or venoms, immediate type reacion, speci
Intracutaneious (intradermal) tests, sequential and incremental, with drugs, biologicals, or venoms, immediate type reaction, specifiy num
Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report by a physician
Intracutaneous (intradermal) tests with allergenic extracts, delayed type
Patch or application tests (specify number of tests)
Inhalation bronchial challenge testing (not including necessary pulmonary function tests);
Professional services for allergen immunotherapy not including provision of allergenic extracts;
Professional services for allergen immunotherpay not including provision of allergenic extracts; two or more injections
Professional services for the supervision of preparation and provision of antigens for allegen immunotherapy; single dose vial(s) (specify nu
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (
Whole body extract of biting insect or other arthropod; professional services for the supervision of preparation and provision of antigens fo
Unlisted allergy/clinical immunologic service or procedure
Multiple sleep latency testing (mslt)_ recording analysis and interpretatio
Multiple sleep latency testing (mslt), recording analysis and interpretatio
Multiple sleep latency testing (mslt) recording analysis and interpretation
Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoa
Sleep study, 3 or more parameters of sleep other than sleep staging, attended by a technologist
Sleep study, 3 or more parameters of sleep
Polysommography; sleep staging with 1-3 additional parameters of sleep, att
Polysomnography; sleep staging with 4 or more additional parameters of sleep,
Polysomnography; sleep staging with 4 or more additional parameters of sleep,
Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist
Polysomnography, sleep staging with four or more additional parameters
Polysomnography, sleep staging with four or more additional parameters
Polysomnography, sleep staging with four or more additional parameters
Electroencephalogram (eeg) extended monitoring; 41-60 minutes
Electroencephalogram (eeg) extended monitoring; 41-60 minutes
Electroencephalogram (eeg) extended monitoring; 41 - 60 minutes
Electroencephalogram (EEG) extended monitoring; greater than one hour
Electroencephalogram (eeg) extended monitoring; greater than one hour
Electroencephalogram (eeg) extended monitoring; greater than one hour
Electroencephalogram (eeg), including recording awake and drowsy
Electroencephalogram (eeg) including recording awake and drowsy
Electroencephalogram (eeg) including recording awake and drowsy
Including recording awake, and asleep,
Including recording awake and asleep
Including recording awake and asleep
Recording in coma or sleep only
Electrocorticogram at surgery (seperate procedure)
Muscle testing, manual (separate procedure); extremity (excluding hand) tru
Muscle testing, manual (separate procedure); hand (with or without comparison with normal side)
Muscle testing, manual (separate procedure); total evaluation of body, excluding hands
Range of motion measurements and report (separate procedure); each extremity, (excluding hand) or each trunk section (spine)
Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side
Tensilon test for myasthenia gravis;
Needle electromyography; one extremity a and related paraspinal areas
Needle electromyography; one extremity a and related paraspinal areas
Needle electromyography; one extremity and related paraspinal areas
Needle electromyography; one extremity a and related paraspinal areas
Needle electromyography, one extremity with our without related paraspinal areas
Needle electromyography; two extremities and related paraspinal areas
Needle electromyography; two extremities and related paraspinal areas
Needle electromyography; two extremities and related paraspinal areas
Needle electromyography; three extremities and related paraspinal areas
Needle electromyography; four extremities and related paraspinal areas
Needle electromyography; four extremities and related paraspinal areas
Needle electromyography, four extremities with or without related paraspinal areas
Cranial nerve supplied muscle(s), unilateral
Cranial nerve supplied muscle(s), unilateral
Needle electromyography, cranial nerve supplied, bilateral
Needle electromyography, cranial nerve supplied, bilateral
Thoracic paraspinal muscles (excluding t1 or t12)
Limited study of muscles in one extremity or non-limb (axial) muscles (uni-lateral or bilateral), other than thoracic paraspinal, cranial nerve
Limited study of muscles in one extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve
Limited study of muscles in one extremity or non-limb (axial) muscles (uni-lateral or bilateral), other than thoracic paraspinal, carnial nerve
Nerve conduction, velocity and/or latency study; motor, each nerve
Nerve conduction, velocity and/or latency study; motor, each nerve
Nerve conduction, velocity and/or latency study; motor, each nerve
Nerve conduction, velocity and/or latency study; motor, each nerve
Nerve conduction, velocity and/or latency study; motor, each nerve
Nerve conduction, amplitude and latency
Nerve conduction, amplitude and latency/velocity study
Nerve conduction, amplitude and latency
Nerve conduction, amplitude and latency
Sensory, each nerve
Nerve conduction, velocity and/or latency study; sensory, each nerve
Nerve conduction, velocity and/or latency study; sensory, each nerve
Sensory, each nerve
Nerve conduction, velocity and/or latency study; sensory, each nerve
Intraoperative neurophysiology testing, per hour
Intraoperative neurophysiology testing, per hour
Intraoperative neurophysiology testing, per hour (list sepately in addition to code for primary procedure
Somatosensory testing (eg, cerebral evoked potentials), one or more nerves
Somatosensory testing (eg, cerebral evoked potentials), one or more nerves
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nerv
Short-latency somatosensory evoked poten
Short-latency somatosensory evoked potential study, in lower limbs
In lower limbs; short-latency somatosensory evoked potential study, stim- ulation of any/all peripheral nerves or skin sites, recording from
Visual evoked potential (vep) testing
Visual evoked potential (vep) testing
Visual evoked potential (vep) testing
Orbicularis oculi (blink) reflex, by ele
H-reflex, amplitude and latency study
H-reflex, amplitude and latency study; record gastroncnemius/soleus muscle
H-reflex, amplitude and latency study
H-reflex, amplitude and latency study
H-reflex, amplitude and latency study
Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any one method
Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve; any one method
Monitoring for identification and lateralization of cerebral seizure focus by attached electrodes;
Monitoring for localization of cerebral seizure focus, by attached electrodes or radiotelemetry;
Monitoring for identification and lateralization of s, cerebral seizure focus by attached electrodes;
Monitoring for localization of cerebral seizure focus, by attached electrodes or radiotelemetry; combined electroencephalograph (eeg) and
Monitoring for localization of cerebral seizure focus by cable or radio. 16 or more channel telemetry: electroencephalographic (eeg) record
Digital analysis of electroencephalogram (eeg)(eg, for epileptic spike analysis)
Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)
Digital analysis of electroencephalogram (eeg) (eg, flor epileptic spike analysis) (list separately in addition to code for primary procedure
Functional cortical mapping by stimulation of electrodes on brain surface, or of depth electrodes, to provoke seizures
Functional cortical mapping by stimulation of electrodes on brain surface, or of depth electrodes, to provoke seizures
Simple spinal cord, or peripheral (ie, peripheral nerve, autonomic nerve, neuromuscular) neurostimulator pulse generator/transmitter, wit
Complex spinal cord, or preipheral (except cranial nerve) neurostimulator pulse generator/trasmitter, with intraoperative or subsequent p
Complex spinal cord, or preipheral (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent
Complex spinal cord, or peripheral (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent
Unlisted neurological or neuromuscular diagnostic procedure
Psychological testing, per hour of the psychologist’s or physician’s time with the patient and time interpreting test results and preparing th
Psychological testing (includes psychodiagnostic assessment of emotionalityintellectual abilities, personality and psychopathology, eg, mm
Psychological testing (includes psychodiagnostic assessment of emotionality, intellectual abilities, personality and psychopathology, eg, mm
Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech p
Developmental testing; limited (eg, developmental screening test ii, early language milestone screen), with interpretation and report
Developmental testing; extended (includes assessment of motor, language, social and/or cognative functioning by standardized developme
Neurobehavioral status exam, per hour of the psychologist's or hysician's time, both face-to-face time with the patient and time interpretin
Neuropsychological testing, per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpretin
Neuropsychological testing, per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpretin
Neurophyschological testing, with qualified health care professional interpretation and report, administered by technician, per hour
Neurophyschological testing, with qualified health care professional interpretation and report, administered by technician, per hour
Neuropsychological testing, per hour
Intravenous infusion, hydration; initial, 31 minutes to 1 hour
Intravenous infusion, for therapy, prophylaxix, or diagnosis (specify substance or drug); initial, up to 1 hour
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
Intravenous push, single or initial substance/drug
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential push of a new substance/drug
each add'l sequential intravenous push of the same substance/drug provided in a facility
Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or indusion
Chemotheraphy administration, intravenous infusion techinque; each additional hour (list separately in addition to code for primary proce
Unlisted chemotherapy procedure
Actinotherapy (ultraviolet light)
Photochemotherapy; psoralens and ultrav psoralens and ultraviolet a (puva)
Laser treatment for inflammatory skin disease (psoriasis); total area less than 250 sq cm
Physical therapy evaluation
Physical therapy reevaluation
Physical therapy reevaluation
Physical therapy reevaluation
Occupational therapy evaluation
Occupational therapy re-evaluation
Application hot or cold packs *
Physical medicine treatment to one area; traction, mechanical
Physical medicine treatment to one area; electrical stimulation (unattended)
Physical medicine treatment to one area (reduced services)
Physical medicine treatment to one area; vasopneumatic devices
Physical medicine treatment to one area; paraffin bath
Physical medicine treatment to one area; whirlpool
Application of a modality to one or more areas; diathermy (eg, microwave)
infrared
Application of a modality to one or more area; electrical stimulation (manual), each 15 minutes
Application of a modality to one or more areas; iontophoresis, each 15 minutes
Application of a modality to one or more areas; contrast baths, ea. 15 min.
Application of a modality to one or more areas; ultrasound, each 15 minutes
Application of a modality to one or more areas, hubbard tank, each 15 mins.
Unlisted modality (specify type and time if constant attendance) *
Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instru
Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance,
Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion an
Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or stan
Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination
Therapeutic procedure, one or more areas, each 15 minutes; aquatic therapy with
Physical medicine treatment to one area, initial 30 minutes, each visit;
Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement
Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement
Therapeutic procedure, one or more areas, each 15 minutes; unlisted therapeutic procedure (specify)
Manual therapy techniques, one or more regions, each 15 minutes
Manual therapy techniques, one or more regions, each 15 minutes
Therapeutic procedure(s), group (2 or more individuals)
Therapeutic activities, direct (one on one) patient contact by the provider (use of dynamic activities to improve functional
Therapeutic activities, direct (one on one) patient contact by the provider (use of dynamic activities to improve functional
Develop/congnitive skills to improve attention, memory, problem solving, (includes compensatory training), direct (one-to-one) patient con
Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-to
Self care/home management training (eg, activities of daily living(adl) andcompensatory training, meal preparation, safety procedures, and
Community/work reintegration training leg, shopping, transportation, money management, avocational activities and/or work environmen
Wheelchair management (eg, assessment, fitting, training), each 15 minutes
Work hardening/conditioning; initial 2 hours
Work hardening/conditioning; each add'l hour
Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (eg, high pressure waterjet with/without suction,
Removal of devitalized tissue from wond; selective debridement, without anesthesia (eg, high pressure waterjet, sharp selective debridem
Removal of devitalized tissue from wound; non-selective debridement, with- out anesthesia
Negative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s), wound assessment, and instru
Nagative pressure wound therapy (eg, vacuum assisted drainage collection), including topical application(s)
Office visit, including one of the following tests or measurements, with report
Physical performance test or measurement, with written report, each 15 minutes
Physical performance test or measurement (eg, musculoskeletal, functional
Assistive technology assessment direct one-on-one
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(s), lower extremity
Prosthetic training, upper and/or lower extremity(s), each 15 minutes
checkout for orthotic/prosthetic use, established patient,
Unlisted physical medicine/rehabilitation service or procedure
Medical nutrition therapy; initial assess
Re-Assessment and intervention, individual, face-to-face with the patient, each 15 minutes
Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
Osteopathic manipulative treatment (omt); 1 to 2 body regions involved
Osteopathic manipulative treatment (omt); 3 to 4 body regions involved
Osteopathic manipulative treatment (omt); seven to eight body regions involved
Chiropractic manipulative treatment
Chiropractic manipulative treatment
Chiropractic manipulative treatment
Chiropractic manipulative treatment
Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum,
Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory
Handling and/or conveyance of specimen for transfer from the patient in other than a physician's office to a
Handling, conveyance, and/or any other service in connection with the implementation of an order involving devices (eg, designing, fitting
Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was perfor
Postoperative follow-up visit, included in global service
Postoperative follow-up visit, included in global service
Services provided in office at times other than regularly scheduled office hours, or days when the office is normally closed, in addition to b
Service(s) typically provided in the office, provided out of the office at request of patient, in addition to basic service
Service(s) provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service
Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or
Educational supplies, such as books, tapes, and pamphlets, provided by the physician for the patient's education at cost to physician
Physician educational services rendered to patients in a group setting (eg, prenatal, obesity, or diabetic instructions)
Special reports such as insurance forms, or the review of medical data to clarify a patient's status--more than the information
Unusual travel (eg, transportation and escort of a patient)
Analysis of clinical data stored in computers (eg, ecgs, blood pressures, hematologic data)
Anesthesia for patient of extreme age,younger than 1 year and older than 70
Anesthesia complicated by utilization of total body hypothermia
Anesthesia complicated by utilization of controlled hypotension
Anesthesia complicated by emergency conditions(specify)
Moderate sedation services provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, re
Moderate sedation services provided by the same physician performing the diagnostic or therapeutic service that the secation supports, re
Moderate sedation services, provided by a physician other than the health care professional . . . ; age 5 years or older, first 30 minutes intr
Physician attendance and supervision of hyperbaric oxygen therapy, per session
Physician attendance and supervision of hyperbaric oxygen therapy, per session
Phlebotomy, therapeutic (separate procedure)
Unlisted special service or report
Office Or Other Outpatient Visit For Eval & Management
Office visit
Office Or Other Outpatient Visit For Eval & Management
Office or other outpatient visit for the evaluation and management of a new patient which requires these three key components; a problem
Office Or Other Outpatient Visit For Eval & Management
Office or other outpatient visit for the eval and management of a new patient which requires these three components;
Office or other outpatient visit for the eval and management of a new patient which requires these three key components
Ofice or other outpatient visit for the eval and management of a new patient, which requires these 3 key components: comp history, comp
Office or other outpatient visit for the evaluation and management of a new patient which requires these three key components;
Office or other outpatient visit for the evaluation and management of a new patient which requires these three components: a comprehe
Office or other outpatient visit for the evaluation and mangement of a new patient which requires these three key components;
Office or other outpatient visit for the evaluation and management of a new patient which requires these three components: a comprehe
Office Or Other Outpatient Visit For Eval & Management
Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physic
Office Or Other Outpatient Visit For The Eval & Managem
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three key
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three key
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these
Office Or Other Outpatient Visit For The Eval & Managem
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three ke
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three key
Office or other outpatient visit for the evaluation and managementof an established patient which requires at least two of these
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three co
Office or other outpatient visit for the evaluation and management of an established patient
Office or other outpatient visit for the evaluation and management of an established patient (25 = same day of surgery)
Office or other outpatient visit for the evaluation and management of an established patient
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three com
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these three com
Office or other outpatient visit for the evaluation and management of an established patient which requires at least two of these
Office or outpatient visit for the evaluation and management of an established patient which requires at least two of these
Observation care discharge day management
Initial observation care, per day
Initial observation casre, per day, for the evaluation and management of a patient, which requires these three key components: a compreh
Initial observation care, per day, for the evaluation and management of a patient, which requires these three key components: a compreh
Initial hospital care, per day, for the evaluation and management of a patient which requires these three key components;
Initial hospital care, per day, for the evaluation and management of a patient which requires these three key components;
Initial hospital care, per day, for the evaluation and management of a patient which requires these three key components;
Initial hospital care, per day, for the evaluation and management of a patient which requires these three key components;
Initial hospital care, per day, for the evaluation and management of a patient which requires these three key components;
Initial hospital care, per day, for the evaluation and management of a patient which requires these three key components;
Sebsequent hospital care, per day, for he evaluation and management of a patient. which requires at least two of these three key
Sebsequent hospital care, per day, for he evaluation and management of a patient. which requires at least two of these three key
Subsequent hospital care, per day, for he evaluation and management of a patient. which requires at least two of these three key
Subsequent hospital care, per day, for he evaluation and management of a patient which requires at least two of these three key
Sebsequent hospital care, per day, for he evaluation and management of a patient. which requires at least two of these three key
Sebsequent hospital care, per day, for he evaluation and management of a patient. which requires at least two of these three key
Sebsequent hospital care, per day, for he evaluation and management of a patient. which requires at least two of these three key
Observation or inpatient hospital care for evaluation
Observation or inpatient hospital care
Hospital discharge day management; 30 minutes or less
Hospital discharge day management; 30 minutes or less
Hospital discharge day management; more than 30 minutes
Office consultation for a new or established patient, which requires these three key components; a problem focused history;
Office consultation for a new or establised patient, which requires these three components; a problem focused history; a problem focused
Office consultation for a new or established patient, which requires these three key components: an expanded problem
Office consultation for a new or established patient, which requires three key components.
Office consultation for a new or established patient, which requires these three key components; an expanded problem
Office consultation for a new or established patient, which requires these three key components: a detailed history;
Office consultation for a new or established patient, which requires these 3 key components; a detailed history;
Office consultation for a new or established patient, which requires these three key components: a detailed hisotry, a detailed exam, & me
Office consultation for a new or established patient, which requires these three key components: a comprehensive history;
Office consultation for a new or established patient, which re- quires these 3 key components; a comprehensive history;
Office consultation for a new or established patient, which requires these 3 key components; a comprehensive history;
Office consultation for a new or established patient, which requires these three key components: a comprehensive history;
Office consulation for a new or established patient, which requires these three key components; a comprehensive history
Inpatient consultation for a new or established patient, which requires these three key components: a problem focused
Initial inpatient consultation for a new or established patient, which requires these three key components: a problem focused
Inpatient consultation for a new or established patient, which requires these three key components: an expanded problem
Inpatient consultation for a new or established patient, which requires these three key components: a detailed history;
Inpatient consultation for a new or established patient, which requires three key components: a comprehensive history;
Inpatient consultation for a new or established patient, which requires these three key components: a comprehensive history;
Emergency department visit for the evaluation and management of a patient, which requires these three key components:
Emergency department visit for the evaluation and management of a patient, which requires these three key components:
Emergency department visit for the evaluation and management of a patient, which requires these three key components;
Emergency department visit for the evaluation and management of a patient, which requires these three key components:
Emergency department visit for the evaluation and management of a patient, which requires these three key components:
Emergency department visit for the evaluation and management of a patient; within global after surgery
Emergency department visit for the evaluation and management of a patient, which requires these three key components within the
Critical care, evaluation and management of the critically ill or critically injured patient,
Critical care, including the diagnostic and therapeutic services and direction of care of critically ill or multiply injured or comatose patient, r
Initial nursing facility care, per day, for the evaluation and management of a patient, which requires three key components
Initial nursing facility care, per day, for the eval and management of a patient
Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires 2 of 3 key components: focused
Subsequent nursing facility care, per day, for the eval and management of a patient, which requires at least 2 of these 3 components:
Nursing facility discharge day management; 30 minutes or less
Home visit for the eval and management of a new patient. which requires these three components: expanded prob focused history, an exp
Home visit for the evaluation and management of a new patient, which re- quires these three key components: a dteailed history; a detaile
Home visit; eval & management of a new patient, with requires comprehensivehistory, comprehensive exam, medical decision making of m
Home visit for the eval and management of a new patient, which requires these three key components: comp history, comp exam, & medi
Home visit for the eval and management of an established patient, which requires at least two of these three key components
Home visit, eval & mgmt of an established patient, that requires expanded problem focused interval history, expanded exam, and or medic
Home visit for the eval and management of an established patient, which re-quires at least two of these three key components:
Home visit for the evaluation and management of an established patient, which requires at least two of these three key components
Home visit for the eval and management of an established patient, which re-quires at least 2 of these 3 key components; a problem focuse
Prolonged physician service in the office or other outpatient setting requiring direct patient contact beyond the usual service, first hour
Antigoagulant management for an outpatient taking warfarin, physician review and interpretation of INR testing, patient instructions, dosa
18-39 years. Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropri
40-64 years; initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropri
Periodic reevaluation and management of a healthy individual requiring a comprehensive history, comprehensive examination, the
18-39 years; initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropri
40-64 years; periodic comprehensive preventive medicine.
Preventive medicine counseling and/or risk factor reduction interventions(s) provided to an individual (separate procedure); approximately
Counseling and/or risk factor reduction intervention(s) provided to a healthy individual(s)
smoking and tobacco use cessation counseling visit; intensive, greater than ten minutes
Counseling and/or risk factor reduction intervention(s) provided to a healty individuals in a group setting; approx. 60 mins.
Administration and interpretation of health risk assessment instrument (eg, health hazard appraisal).
Unlisted medicine procedure
Work related or disability exam
Work related or medical disability examination by other than the treating physician that includes: completion of a medical history commen
Unlisted evaluation and management service
Home visit/prenatal monitor-assessment
Home visit for assistance with activities of daily living and personal care
Unlisted home visit service or procedure
Home infusion/speciality drug administration, per visit (up to 2 hours)
Dental Surg
Syringe with needle, sterile, 1cc or less, each
Syringe with needle, sterile 2cc
Syringe with needle, sterile 5 cc or greater, each
Needle-free injection device, each
Supplies for self-administered injection
Non-coring needles or stylet with or without catheter
Needle sterile, any size, each
Sterile water, saline and/or dextrose, diluent/flush, 10 ml
Supplies for maintenance of drug infusion catheter, per week (list drug separately)
Infusion supplies for external drug infusion pump, per cassette or bag (li st drugs separately)
Infusion set for external insulin pump, non needle cannula type
Syringe with needle for external insulin pump, sterile, 3cc
Alcohol wipes, per box
Betadine or iodine swabs/wipes, per box
Urine test or reagent strips or tablets (100 tablets or strips)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
Spring powered device for lancet, each
Lancets, per box
Temporary, absorbable lacrimal duct implant, each
Permanent, long term, non-dissolvable lacrimal duct implant, each
Permanent, long term, non-dissolvable lacrimal duct implant, each, lower left eyelid
Permanent, long term, non-dissolvable lacrimal duct implant, each lower right eyelid
Paraffin
Implantable access catheter, (eg, venous, arterial, epidural, subarachnoid, or peritoneal, etc) external access
Disposable drug delivery system, flow rate of 50 ml or greater per hour
disposable drug delivery system, flow rate of less than 50 ml per hour
Insertion tray without drainage bag and without catheter (accessories only)
Lubricant, individual sterile packet, each
Incontinence supply; miscellaneous
Intermittent urinary catheter; straight tip
Urinary drainage bag
Urinary leg bag
Ostomy skin barrier
Ostomy skin bond or cement
Ostomy skin barrier, powder, per oz.
Ostomy skin barrier, solid 4x4 or equivalent, extended wear, without built-in convexity, each
Ostomy lubricant
Ostomy skin barrier, pectin-based, paste, per ounce
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4x4 inches or smaller, each
Ostomy skin barrier; with flange (solid, flexible, or accordion), extended wear, without built-in convexity, 4 x 4 each
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
Ostomy supplies necessary for the care of the ostomy and not part of the set
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each
Tape, non-waterproof, per 18 square inches
Adhesive remover or solvent (for tape, cement or other adhesive)
Adhesive remover, wipes, any type, each
Surgical stockings thigh length, each
Surgical stockings; full length, each
Incontinence garment, any type (e.g. brief, diaper) each
Surgical trays
Disposable underpads, all sizes, (e.g., chux's)
Electrodes, (e.g., apnea monitor) per pair
Lead wires, (e.g., apnea monitor)
Pessary, non-rubber, any type
Slings
Splint
Cast supplies (e.g. plaster)
Special casting materials (e.g. fibergla light cast
Tens supplies, 2 lead per month
Tubing (oxygen), per foot
Tracheal suction catheter, any type, each
Replacement batteries. medically necessary, transcustaneous electrical stimulator, owned by patient
Replacement, handgrip, cane, crutch or walker, each
Replacement, tip, cane, crutch, walker, each
Radiopharmaceutical, diagnostic, not otherwise classified
Supply of paramagnetic contrast material, eg., gadolinium
Surgical supplies not elsewhere classified
Sphygmomanometer/blood pressure apparatus with cuff and stethoscpoe
Blood pressure cuff only
Automatic blood pressure monitor
Dextrostick or glucose test strips, per box
Gloves, sterile or non-sterile, per pair
Ostomy pouch, closed; for use on barrier with flange (2 piece), each
Pouch, drainable; with barrier attached (1 piece)
Pouch, drainable; without barrier attached (1 piece)
Pouch, drainable; for use on barrier with flange (2 piece system)
Urinary suspensory with leg bag, with or without tube, each
Skin barrier, wipes or swabs, each
For diabetics only, fitting (including follow-up) custom preparation and supply of off-the-shelf depth-inlay
For diabetics only, fitting (including follow-up), custom preparaion and suppy of shoe molded from cast(s) of patient's foot (custom molded
For diabetics only, modification (including fitting) of off-the- shelf depth-inlay shoe or custom-moulded shoe with roller or rigid rocker bott
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with matatarsal bar, per shoe
For diabetics only, modification (including fitting(s) of off-the-shelf depth-inlay shoe or custom-moulded shoe with off-set heel(s), per shoe
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, to
For diabetics only, multiple density insert, direct formed, molded to foot or other external heat source of 230 degrees fahrenheit or higher
Gel sheet for dermal or epidermal application, (eg, silicone, hydrogel, other), each
Wound pouch, each
Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but lessthan or equal to 48 sq. in., without adhesive border, each dress
Gauze, impreg. other than water, 16 sq inch
Gauze, impreg, hydrogel, for direct wound contact, pad size greater than 16sq. in., each dressing
Hydrogel dressing, wound cov, 16 sq in or
Hydrogel dressing, wound filler, gel, per fluid ounce
Skin sealants, protectants, moisturizers, ointments, any type, any size
Specialty absorptive dressing, wound cover,pad size 16 sq. in. or less, w/o
Transparent film, 16 sq in. or less, each dressing
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing.
Transparent film, more than 48 sq. in., each dressing
Wound cleansers, any type, any size
Gauze, non-impreg, sterile 16 sq. in or less
Conforming bandage, non-elastic, sterile, width less than three inches, per yard.
Light compression bandace, elastic per yard
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard
Compression burn garment, not otherwise classified
Gradient compression stocking, thigh length, 30-40 mmhg, each
Gradient compression stocking, not otherwise specified
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable
Combination oral/nasal mask, used with continuous positive airway pressure device, each
Oral cushion for combination oral/nasal mask, replacement only, each
Nasal pillows for combination oral/nasal mask, replacement only, pair
Full face mask used with positive airway pressure device, each
Face mask interface, replacement for full face mask, each
Cushion for use on nasal mask interface, replacement only, each
Pillow for use on nasal cannula type interface, replacement only, pair
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
Headgear used with positive airway pressure device
Chinstrap used with positive airway pressure device
Tubing used with positive airway pressure device
Tubing used with positive airway pressure device
Filter, disposable, used with positive airway pressure device
Filter, nondisposable, used with positive aireay pressure device
Water chamber for humidifier used with positive airway pressure devide, replacement, each
Non-prescription drugs
Non covered service or item
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise clasifie
Exercise equipment
Technetium tc-99m sestamibi, diagnostic, per study dose, up to 40 millicuries
Technetium tc-99m tetrofosmin, diagnostic, per study dose, up to 40 millicuries
Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
Thallium tl-201 thallous chloride, diagnostic, per millicurie
Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries
Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie
Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 micro- curies
Technetium Tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries
Technetium Tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries
Technetium Tc-99m exametazime labeled autologous white blood cells, diagnostic, per study
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml
Miscellaneous DME supply, accessory, and/or service component of another HCPCS code
Dme delivery, set up, and/or dispensing service componenet of another hcpcscode
Miscellaneous dme supply or accessory, not otherwise specified.
Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval
Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)
connective tissue, human (includes fascia lata)
Guide wire
Joint device (implantable)
Lens, intraocular (new technology)
Mesh (implantable)
Ocular implant, aqueous drainage assist device
Stent
Stent
Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser
Stent, non-coronary, temporary, with delivery system
Injection, bevacizumab, 0.25mg
Periodic Oral Exam
Filling
Limited exam - problem focused
Comprehensive oral exam
Detailed and extensive oral evaluation - problem focused, by report
Comprehensive periodontal eval - new or established patient
Intraoral - Complete Series (Including Bitewing)
Intraoral - Single, First Film
Intraoral- periapical each additional film
Intraoral- occlusal film
Intraoral bitewing - single film (posterior teeth only)
Intraoral bitewing - two films (right and left posterior teeth only)
Bitewings-Four
Vertical bitewings - 7 to 8 films
Posteroanterior and/or lateral skull and facial bone, survey film
Sialography (single film)
Temperomandibular joint arthrogram,w/injuding injection
Other temperomandibular joint films, by report
Panoramic film
Cephalometric film
Diagnostic casts (study models)
Unspecified diagonstic procedure, by report
Prophylaxis, adult, annual (beginning at age 16)
Prophylaxis, child (without fluoride)
Dispensing home care fluoride (radiation therapy only)
Oral hygiene instruction
Sealants (ada accepted materials) tooth numbers 03, 14, 19, 30 through age 8
Space maintainer, removable-unilateral (anterior permanent teeth only, prior
Amalgam- one surface, permanent tooth
Amalgam-two surfaces, (any 2 spaces s
Amalgam- three surfaces, (any 3 surface, same tooth, same date of service),
Amalgam- four or more surfaces (same tooth same date of service), permanent tooth
Resin-one surface (anterior teeth only-facial or buccal, separate from d2331 or d2335),
Resin-two interproximal surfaces (anterior teeth only, typical class iii),
Resin-three contiguous surfaces, interproximal (must include up to 1/3 of facial or
Resin - four or more surfaces or involving incisal angle (anterior teeth only),
Resin-based composite - one surface, posterior
Resin-based composite - two surfaces, posterior
Resin-based composite - three surfaces, posterior
Resin-based composite - four or more surfaces, posterior
Inlay - metallic; two surfaces
Inlay - porcelain/ceramic; two surfaces
Inlay - porcelain/ceramic; three or more surfaces
Onlay - porcelain/ceramic; two surfaces
Onlay - porcelain/ceramic; three surfaces
Onlay - porcelain/ceramic; four or more surfaces
Porcelain
Crown-porcelain fused to high noble metal
Crown-porcelain fused to predominantly base metal (bwx, pa)
Crown-porcelain fused to noble metal
Crown - full cast high noble metal (gold)
Crown - full cast predominantly base metal (bwx, pa)
Crown - full cast noble metal
Recement crown
Prefabricated stainless steel crown deciduous tooth
Prefabricated stainless steel crown permrmanent tooth
Protective restoration
Crown build-up, including any pins (bwx, pa)
Pin retention-per tooth, in addition to restoration (bxw, pa)
Post and core in addition to crown, indirectly fabricated
Prefabricated post and core in addition to crown (bwx, pa)
Labial veneer (resin laminate - chairside with narrative (bwx, pa)
Labial veneer (resin laminate); laboratory
Labial veneer (porcelain laminate-laboratory) with narrative (bwx, pa)
Crown repair, by report
Pulp cap - direct (excluding final restoration)
Pulp cap -indirect (excluding final restoration)
Therapeutic pulpotomy (excluding final rstoration), including local anesthesia
Pulpectomy - deciduous tooth root canal, one or more canals (excluding final restoration)
Anterior (excluding final restoration) tooth numbers 6 through 11 and 22 through 27 only
Bicuspid (excluding final restoration) (bwx, pa)
Molar (excluding final restoration) (bwx, pa)
Retreatment-anterior (br,bwx, pa)
Retreatment-bicuspid (br, bwx, pa)
Retreatment of previous root canal therapy; molar (br, bwx, pa)
Apicoectomy/periradicular surgery-anterior teeth only (pa)
Gingivectomy or gingivoplasty, four or more continguous teeth or bounded teeth spaces per quandrant
Gingivecotomy or gingivoplasty, one to three continguous teeth or bounded teeth spaces per quandrant
Gingival flap procedure, including root planing; four or more contiguous teeth or bounded teeth spaces per quandrant
Clinical crown lengthening - hard tissue
Osseous surgery (including flap entry and closure); four or more contiguousteeth or bounded teeth spaces per quandrant
Periodontal scaling and root planing; four or more teeth per quandrant
Periodontal scaling and root planing ul quandrant
Full mouth debridement/comprehnsive eval
Localized delivery of antimicrobial agents via a controlled-released vehicle into diseased crevicular tissue, per tooth, by report
Periodontawl maintenance procedures following active therapy (periodontal prophylasix)
Unspecified peridontal procedure; by report
Complete upper denture (once every 5 years) *
Complete lower denture (once every 5 years)
Immediate upper denture includes one office reline
Immediate lower denture includes one office reline
Upper partial-resin base (including any conventional clasps, rests and teeth)
Lower partial-resin base (including any conventional clasps, rests and teeth)
Upper partial-cast metal base with resin saddles (including any conventional clasps, rests
Lower partial-cast metal base with resin saddles (including any conventional clasps, rests
Maxillary partial denture - flexible base (including any clasps, rests and teeth).
Mandibular partial denture - flexible base (including any clasps, rests and teeth)
Upper partial denture - with crome palatal bar and two claps, cast base
Unilateral partial denture-one piece predominantly base metal casting (frame),
Each additional clasp with rest
Each additional saddle (2 or more teeth)
Adjust complete denture-upper
Adjust complete denture-lower
Adjust partial denture - upper
Adjust partial denture - lower
Repair broken complete denture base
Replace missing or broken teeth-completete denture (each tooth)
Repair resin saddle or base (partial denture)
Repair to cast framework
Repair or replace broken clasp
Replace broken teeth - partial denture - per tooth
Add tooth to existing partial denture
Add clasp to existing partial denture
Rebase complete upper denture
Rebase complete lower denture
Rebase lower partial denture
Reline complete maxillary denture (chairside)
Reline complete mandibular denture (chairside)
Reline maxillary partial denture
Reline mandibular partial denture (chairside)
Reline upper complete denture (laboratory)
Reline lower complete denture (laboratory)
Reline upper partial denture (laboratory)
Reline lower partial denture (laboratory)
Temporary complete denture (upper)
Interim complete denture (mandibular)
Temprary partial - stay plate denture (upper)
Interim partial denture (mandibular)
Tissue conditioning - upper - per denture unit
Tissue conditioning - lower-per denture unit
Overdenture - complete, by report
Overdenture - complete, by report
Precision attachment, by report
Modification of removable prothesis following implant surgery
Unspecified removable prosthodontic proc
Orbital prosthesis
Obturator prosthesis, surgical
Obturator prosthesis, definitive
Surgical stent
Surgical splint
Unspecified maxillofacial prosthesis, by report
Surg placement of implant body-endosteal
Implant/abutment supported removable denture for completely edentulous arch
Connecting bar - implant supported or abutment supported
Prefabricated abutment - includes placement
Implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal)
Pontic; cast high noble metal
Pontic - cast predominantly base metal (bwx)(pa)
Pontic - porcelain fused to high noble metal
Pontic - porcelain fused to predominantly base metal (bwx) (pa)
Pontic - porcelain fused to noble metal
Pontic; porcelain/ceramic
Pontic-resin with high noble metal
Pontic - resin cured to predominantly base metal (bwx)(pa)
Retainer-cast metal for acid etched fixed prosthesis (bwx)
Crown; porcelain/ceramic
Crown - porcelain fused to high noble metal
Crown - porcelain fused to predominantlyase metal
Crown-porcelain fused to noble metal
Crown; full cast high noble metal
Crown - full cast predominantly base metal
Recement bridge (twelve months from date of original insertion or by other than original attending)
Precision attachment
Prefabricated post and core in addition to fixed partial denture retainer
Core build up for retainer, including any pins.
Unspecified, fixed prosthodontic procedure, by report
Extraction, coronal remnants - deciduous tooth
Extraction, erupted tooth or exposed root (elevation and/or forceps removal)
Surgical removal of erupted tooth requiring removal of bone and/or section of tooth, and evaluation of mucoperiosteal flap
Removal of impacted tooth - soft tissue
Removal of impacted tooth - partially bony
Removal of impacted tooth-completely bony
Removal of impacted tooth - completely bony, with unusual surgical complication
Surgical removal of residual tooth roots (cutting procedure)
Oral antral fistual closure
Surgical exposure of impacted or unerupted tooth for ortho- dontic reasons (including orthodontic attachments)
Biopsy of oral tissue; hard (bone, tooth)
Biopsy of oral tissue - soft
Alveoloplasty not in conjunction with extractions - one to three teeth or tooth spaces, per quadrant
Alveoplasty in conjunction with extractions - one to three teeth or tooth spaces, per quadrant
Alveoloplasty not in conjunction with extractions - per quadrant
Alveoloplasty not in conjunction with extractions - on to three teeth or tooth spaces, per quadrant
Vestibuloplasty - ridge extension (secondary epithelialization)
Removal of odontogenic cyst or tumor - lesion diameter up to 1.25 cm
Removal of odontogenic cyst or tumor - lesion diameter over 1.25 cm
Removal of nonodontogenic cyst or tumor,- lesion diameter over 1.25 cm
Destruction of lesion(s) by physical methods: electrosurgery, chemotherapy, cryotherapy, or laser
Mesenchymal origin: fibroma, myxoma, hemangioma, neuro-fibroma, torus, (pal
Removal of torus mandibularis
Removal of torus mandibularis
Surgical reduction of osseous tuberosity
Incision and drainage of abscess intraororal soft tissue
Sequestrectomy for osteomyelitis
Mandible-closed reduction- by report
Condylectomy right
Meniscectomy right
Joint reconstruction
Arthrotomy right
Occlusal orthotic appliance
Suture - over 5 cm
Skin graft (identify defect covered, location, and type of graft)
Osteoplasty for orthognathic deformities
Osteotomy-segmented or subapical
Osteotomy - body of mandible
Lefort i (maxilla - total)
Lefort i (maxilla - segmented)
Lefort ii or lefort iii (osteoplasty of fasical bones for midface hypoplasia or retrusion) - without bone graft
Osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla - autogenous or nonautogenous by report
Frenulectomy (frenectomy or frenotomy) - separate procedure not incidental to another procedure
Frenuloplasty
Excision of hyperplastic tissue, per arcch
Excision of pericoronal gingiva
Coronoidectomy
Unspecified oral surgery procedure, by report
Comprehensive orthodontic treatment; of the adult dentition
Removable appliance therapy
Monthly adjustment fee for all fixed ortho cases
Palliative(emergency)treatment of dentalal pain - minor procedures
Fixed partial denture sectioning
Local anesthesia in conjunction with operative or surgical procedures
Local anesthesia lower right quadrant
Start up and first 30 minutes of anesthetic *
General anesthesia - each addtl 15 minutes
Inhalation of nitrous oxide/analgesia, anxiolysis
Non-intravenous conscious sedation (Anesthesia)
Consultation-diagnostic service provided by dentist or physician other than requesting dentist or physician
Office visit for observation (regular hrsulary scheduled hours)
Theraputic parenteral drug, single administration
Other drugs and/or medicaments, by report
Application of desensitizing medicament
Behavior management, by report
Treatment of complications (postsurgical) - unusual circumstances, by report
Occlusal guards (bruxism splints)
Occlusion analysis (mounted case)
Occlusal adjustment-limited per tooth
Unspecified adjunctive procedure, by report
Uterine & adnexa proc dor non-malignacy w/o cc
Uterine and adnexa proc for non-malignancy w/o cc
Coagulation disorders
Major joint replacement or reattachment of lower extremity
Cane, includes canes of all materials, adjustable or fixed with tip
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tip
Crutch, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips
Crutch, forearm, includes crutches of various materials, adjustable or fixed, each with tip and handgrip
Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips
Crutches underarm, aluminum, adjustable or fixed, pair, with pads, tips and handgrips
Crutch underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each
Crutch substitute, lower leg platform, with or without wheels, each
Walker, rigid (pickup), adjustable or fixed height
Walker, folding (pickup), adjustable or fixed height
Walker, wheeled, with or without seat
Walker, rigid, wheeled, adjustable or fixed height
Walker, rigid, wheeled, adjustable or fixed height
Walker, folding, wheeled, adjustable or fixed height
Walker, enclosed, four sided framed rigid or folding, wheeled with posterior seat
Walker, heavy duty, multiple breaking system, variable wheel resistance
Walker, heavy duty, multiple breaking system, variable wheel resistance
Walker; heavy duty; multiple braking system, variable wheel resistance
Walker, heavy duty, without wheels, rigid or folding, any type, each
Walker, heavy duty, wheeled, rigid or folding, any type, each
Platform attachment, walker, each
Wheel attachment, rigid pick-up walker attachments
Seat attachment, walker
Leg extensions for a walker, per set of four (4)
Brake attachment for wheeled walker, replacement, each
Commode chair , mobile or stationary, with fixed arms
Commode chair, mobile or stationary, with detachable arms
Commode chair, extra wide/heavy duty, stat
Air pressure pad or cushion, nonpositiong
Water pressure pad or cushion, nonpositiong
Gel pressure pad or cushion, nonpositiong
Dry pressure pad or cushion, nonpositiong (e.g., eggcrate)
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty
Gel or gel-like presure pad for mattress *
Air pressure mattress
Synthetic sheepskin pad
Synthetic sheepskin pad
Lambswool sheepskin pad, any size
Heel or elbow protector, each
Heel or elbow protector, each
Low pressure and positioning equalization pad for wheelchair
Powered air flotation bed (low air loss therapy)
Gel pressure mattress
Air pressure pad for mattress
Electric heat pad, moist
Water circulating heat pad with pump
Water circulating cold pad with pump
Water circulating cold pad with pump
Paraffin bath unit, portable (see medical supply code a4265 for paraffin)
Bath and toilet aids
Bath and toilet aids
Bath tub wall rail, each
Bath tub rail, floor base
Toilet rail, each
Raised toilet seat
Raised toilet seat
Tub stool or bench
Transfer tub rail attachment
Transfer bench for tub or toilet with or without commode opening
Transfer bench, heavy duty, for tub or toilet withor without commode opening
Pad for water circulating heat unit
Hospital bed, with side rails, variable height (hi-lo), with matress
Hospital bed, with side rails, variable height (hi-lo), with matress
Hospital bed, variable height, hi-lo with any type side rails, without mattress
Hospital bed, with side rails, semi-electric, (head and foot adjustment), with mattress
Hospital bed, with side rails, semi-electric, head and foot adjustment, with mattress
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress
Hospital bed, total electric with siderails (head, foot and height adjustments, with mattress)
Hospital bed, with side rails, total electric head, foot, and height adjustments, without mattress
Hospital bed, institutional type includes: oscillating, circulating and stryker frame bed with mattress
Mattress, innerspring
Mattress, foam rubber
Over-bed table
Alternating pressure mattress or ankle
Hospital bed, fixed height, without side rails, without mattress
Hospital bed, variable height, hi-lo without side rails, with mattress
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 lbs.
Bed side rails, half length
Bed side rails, half length
Bed side rails, full length
Bed accessories: boards or tables, any type (non-covered)
Stationary compressed gas system, includes regulator with flow gauge, humidifier, cannula or mask and tubing
Portable gaseous oxygen system, includes regulator with flow gauge, humidifier, cannula or mask and tubing
Portable gaseous oxygen system
Portable gaseous oxygen system - rental only
Portable oxygen contents, per unit
Portable oxygen contents, liquid (for use with portable liquid systems when no stationary gas or liquid system is used)
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, eg., nasal or facial mas
Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter
Humidifier, non-heated, used with positive airway pressure device
Humidifier, heated, used with positive airway pressure device
humidifier, heated, used with positive airway pressure device
Nebulizer, with compressor ss pulmo-aid
Ultrasonic/electronic aerosol generator with small volume nebulizer
Nebulizer; ultrasonic
Respiratory suction pump, homemodel, portable or sationary, electric
Continuous airway pressure (cpap) device
Continuous airway pressure (cpap) device
Home blood glucose monitor
Skin piercing device for collection of capillary blood.
Sling or seat, patient lift, canvas or nylon
Patient lift, bathroom or toilet, not otherwise classified
Seat lift mechanism incorporated into a combination lift-chair mechanism
Separate seat lift mechanism for use with patient owned furniture-electric
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s), or pad(s)
Patient lift, electric with seat or sling
Multipositional patient support system, with integraged lift, patient accessible controls
Combination sit to stand system, any size, including pediatric, with seatlift feature, with or without wheels
Pneumatic compressor; non-segmental home model
Pneumatic compressor; non-segmental home model - rental per day
Pneumatic compressor, segmental home model (lymphedema pump) without calibrated gradient pressure
Pneumatic compressor, segmental home model (lymphedema pump) with calibrated gradient pressure
Pneumatic compressor, segmential home model (lymphedema pump) withcalibrated gradient pressure
Non-segmental pneumatic appliance for usic compressor, full leg
Segmental pneumatic appliance for use wial pneumatic compressor, leg
Segmental pneumatic appliance for use wial pneumatic compressor, arm
Segmental gradient pressure pneumatic appliance, half leg
Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)
Transfer device, any type
Restraints, any type (body, chest, wrist or ankle) (non-covered)
(tens) devide, two lead, localized stimulation
(tens) devide, two lead, localized stimulation
Tens, four lead, (larger area/multiple nerve stimulation)
Tens, four lead, larger area/multiple nerve stimulation
Tens, four lead, (larger area/multiple nerve stimulation)
Incontinance treatment system, pelvic floor stimulator, monitor, sensor and/or trainer
Neuromuscular stimulant, electronic shock unit, (non-clinical model) purchase price
Neuromuscular stimulant, electronic shock unit, non-clinical model
Osteogenesis stimulator (non-invasive)
Osteogenesis stimulator (non-invasive)
Osteogenisis stimulator, electrical, surgically implanted
Osteogenisis stimulator; electrical, noninvasive, spinal applications
Functional electrical stimulator, transcutaneous stimulation of nerve and/or muscle groups, any type, complete system, not otherwise spe
Iv pole
Iv pole
External ambulatory infusion pump with diminstrative equipment
Ambulatory infusion pump, single or multiple channels, with administrative equipment, worn by patient
Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)
Infusion pump, implantable, non-programmable (includes all components, eg, pump, catheter, connectors, etc
External ambulatory infusion pump, insul
External ambulatory infusion pump, insul
Parenteral infusion pump, stationary
Traction frame, attached to headboard, cimple cervical traction
Traction frame, attached to headboard, cimple cervical traction
Traction stand, free standing, cervical traction
Cervical traction equipment not requiring additional stand or frame
Traction equipment, overdoor, cervical
Traction frame, attached to footboard, eimple extremity traction, (e.g. buck's)
Trapeze equipment, fracture frame and other orthopedic devices
Trapeze bars, a/k/a/ patient helper, attached to bed with grab bar
Passive motion exercise device
Continuous passive motion exercise device for use on knee only
Continuous passive motion exercise device for use on knee only rental only - per day
Continuous passibe motion exercise device for use other than kneww.
Trapeze bar, free standing, complete with grab bar
Cervical head harness/halter
Pelvic belt/harness/boot
Pelvic belt/harness/boot
Extremity belt/harness
Extremity belt/harness
Fracture, frame, dual with cross bars, attached to bed, (e.g. balken, 4 poster)
Fracture frame, attachments for complex pelvic traction
Wheelchair accessory, tray, each
Heel, loopholder, any type, with or without ankle strap, each
Heel loop/holder, any type, with or without ankle strap, each
Toe loop/holder; any type
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
Wheelchair accessory, headread, cushioned, any type, including fixed mounting hardware, each
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
Manual wheelchair accessory, adapter for amputee, each
Wheelchair accessory, shoulder harness/straps or chest strap, including anytype mounting hardware
Brake extension, for wheelchair
Manual wheelchair accessory, hand rim with projections, any type, each
No.2 footplates, except for elevating leg rest
Manual wheelchair accessory, anti-tipping device, each
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each
Manual wheelchair accessory, anti-rollback device, each
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
Wheelchair accessory, seat upholstery, replacement only, each
Wheelchair accessory, seat upholstery, replacement only, each
Wheelchair accessory, back upholstery, replacement only, each
Manual wheelchair accessory, push activated power assist, each
Wheelchair accessory, elevating leg rest, complete assembly, each
Manual wheelchair accessory, solid seat insert
Arm rest, each
Wheelchair accessory, calf rest/pad, each
Wheelchair accessory, power seating system, tilt only
Wheelchair accessory, power seating system, recline only, with mechanical shear reduction
Replacement, batteries for medically necessary electric wheelchair owned by the patient
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction
Wheelchair accessory, power seating system, combination tilt and recline with power shear reduction
Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair
Shock absorber for manual wheelchair, each
Shock absorber for power wheelchair, each
Residual limb support system for wheelchair
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning
Wheelchair - fully-reclining
Fully-reclining wheelchair, detachable arms (desk or full length), swing away detachable elevating leg rests
Fully-reclining wheelchair, detachable arms (desk or full length), swing away detachable elevating leg rests
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests
High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating legs rests
High strength lightweight wheelchair; detachable arms desk or full length, swing away detachable elevating leg rests
High strength lightweight wheelchair, detachable elevating leg rests
High strength lightweight wheelchair, fixed length arms, swing away detachable footrest
High strength lightweight, wheelchair, detachable arms desk or full length, swing away detachable foot rests
High strength lightweight, wheelchair, detachable arms desk or full length, swing away detachable foot rests
Wide heavy duty wheel chair, detachable arms desk or full length, swing away detachable elevating leg rests
Wide heavy duty wheelchair, detachable arms,desk or full length arms, swing away detachable footrests
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests
Wheelchair, detachable arms, desk or full length, swing away detachable footrests
Wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests
Wheelchair, fixed full length arms, swing away detachable elevating legrests
Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest
Specially sized or constructed wheelchairs (indicate brand name, model number, and justification)
Specially sized or constructed wheelchairs (indicate brand name, model number, and justification)
Wheelchair with detachable arms, footrests
Wheelchair with detachable arms, footrests
Wheelchair with detachable arms, elevating leg rests
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each ***********purchase*************
Wheelchair accessory, manual fully reclining back, (recline greater than 80degrees), each *************rental***********
Special back height for wheelchair
Power operated vehicle, (3 wheel non-highway) indicate brand name and model number
Power operated vehicle, (3 wheel non-highway) indicate brand name and model number
Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seat-ing system
Lightweight wheelchair, detachable arms,(desk or full length) swing away detachable elevating legrest
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable elevating legrest
Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest
Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest
Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests
Heavy duty wheelchair, fixed full length arms, swing away detachable footrest
Special wheelchair seat height from floor
Special wheelchair; seat depth, by upholstery
Special wheelchair seat depth and/or width, by construction
Whirlpool, portable (overtub type) (non-covered)
Oxygen concentrator, single delivery port, capable of delivering 85 percentor greater oxygen concerntration at the prescribed flow rate
Oxygen concentrator, single delivert port, capable of delivering 85 percentor greater oxygen concentration at the prescribed flow rate
Durable medical equipment, not otherwise classified
Durable medical equipment, not otherwise classified
Durable medical equipment, not otherwise classified
Reciprocating peritoneal dialysis system
Replacement soft interface material, dynamic adjustable extension/flexion device
Blood glucose monitor with integrated voice synthesizer
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches
Manual wheel chair accessory, nonstandard seat frame depth, 20 to less than 22 inches.
Manual wheelchair accessory, handrim without projections, (includes ergonomic or contoured), any type, replacement only, each
Manual wheelchair accessory, wheel lock assembly, complete, each
Wheelchair accessory, crutch and cane holder, each.
Wheelchair accessory, bearings, any type, replacement only, each
Manual wheelchair accessory, pneumatic propulsion tire, any size, each
Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each
Manual wheelchair accessory, insert for pneumatic propulsion tire (re- moveable), any type, any size, each
Manual wheelchair accessory, insert for pneumatic propulsion tire (re- moveable), any type, any size, each
Manual wheelchair accessory, pneumatic caster tire, any size,
Manual wheelchair accessory, tube for pneumatic caster tire, any size, each
Manual wheelchair accessory, foam propulsion tire, any size, each
Manual wheelchair accessory, foam caster tire, any size, each
Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, each
Manual wheelchair accessory, solid (rubber/plastic) caster tiere (re- moveable), any size, each
Power wheelchair accessory, power seat elevation system.
Power wheelchair accessory, power seat elevation system.
Power wheelchair accessory, power standing system
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all relat
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all relat
Power wheelchair accessory, electronic connection between wheelchair con- troller and two or more power seating system motors, includ
Power wheelchair accessory, electronic connection between wheelchair con- troller and two or more power seating system motors, includ
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, ea
Power wheelchair accessory, harness for upgrade to expandable controller, including all
Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop sw
Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated
Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated
Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics
Power wheelchair accessory, attendant control, proportional, including all related electronics and fixed mounting hardware.
Power wheelchair accessory, 22 nf non-sealed lead acid battery, each
Power wheelchair accessory, 22 nf sealed lead acit battery, each (eg., gel cell, absorbed glassmat)
Power wheelchair accessory, group 24 sealed acid battery, each (eg., gel cell, absorbed glassmat)
Power wheelchair accessory, u-1 sealed lead acid battery, each (eg., gel cell, absorbed glassmat)
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each.
Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each
Power wheelchair comp9onent, motor and gear box combination, replacement only
Power wheelchair accessory, group 27 sealed lead acid battery, (e.g. gel cell, absorbed glass mat), each
Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware.
Power wheelchair accessory, hand or chin control interface, standard remote joystick
Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only.
Power wheelchair accessory, expandable controller, including all related electronics and moutning hardware, upgrade provided at initial is
Power wheelchair accessory, expandable controller, including all related electronics and moutning hardware, upgrade provided at initial is
Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each.
Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each
Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each
Power wheelchair accessory, insert for pneumatic drive wheel tire, any size, replacement only, each
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each
Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each
Power wheelchair accessory, solid caster tire with integrated wheel, any size, replacement
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each.
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each
Speech generating device, synthesized speech
Accessory for speech enerating device, mounting system
Accessory for speech generating device, not otherwise specified
General use wheelchair seat cushion, width less than 22 inches, any depth
Skin protection wheelchair seat cushion, width less than 22 inches, any depth
Skin portection wheelchair seat cushion, width 22 inches or greater, any depth
Positioning wheelchair seat cushion, width less than 22 inches, any depth
Positioning wheelchair seat cushion, width 22 in. or greater, any depth
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth
Custom fabricated wheelchair seat cushion, any size
General use wheelchair back cushion, width less than 22 inches, any height,including any type mounting hardware
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware
Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware
positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type of mounting hardware
Positioning wheelchair back cushion, posterior-lateral width less than 22 inches, any height, including any type mounting hardware
Replacement cover for wheelchair seat cushion or back cushion, each
Positioning wheelchair back cushion, planar back with lateral suppoers, width less than 22 inches, any height, including any type mounting
Positioning wheelchair back cushion, planar back with lateral suppoers, width less than 22 inches, any height, including any type mounting
skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth
Skin protecting and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth
Administration of influenza virus vaccine
Cervical or vaginal cancer screening; pelvic and clinical breast examination
Prostate cancer screening; prostate specific antigen test
Diabetes outpatient self-management training services, individual, per 30 minutes
Diabetes self-mgmt training services, group ses
Services of physical therapist in home
Services of occupational therapist in home health setting, each 15 minutes
Services of skilled nurse in home health setting, each 15 mins.
Services of home health aid in home health
physican certification services for Medicare-covered services provided by a participating home health agency (patient not present)
Diagnostic mammography, unilateral, all view
Removal of impacted cerumen (one or both ears) by physician on same date ofservice as audiologic function testing.
Renal artery angiography (uilateral or bilateral) performed at the time of cardiac catheterization, includes catheter placement, injection of
Electrical stimulation (unattended), to one or more areas for indication(s)other than wound care, as part of a therapy plan of care
Arthorscopy, knee, surgical, for removal of loose body, foreign body, de- bridement/shaving of articular cartilage (chondroplasty) at the tim
Arthroscopy, knee, surgical, for removal of loose body, foreign body, de- bridement/shaving of articular cartilage (chrondroplasty) at the ti
Transcatheter placement of a drug eluting intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any meth
Transcatheter placement of a drug eluting intracoronary stent(s), percutaneous, with or without other theraputic intervention, any metho
hospital observation service, per hour
Home sleep test (HST) with type III portable monitor, unattended: minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart r
Alcohol and/or drug assessment
Behavorial health counseling and therapy, per 15 minutes
Mental health assessment, by non-physician
Mental health service plan development by non-physician
Inpatient hospital stay - DRG
In-Patient Surgery
Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)
Injection, adenosine for diagnositic use, 30 mg (not to be used to report any adenosine phosphate compounds; instead use a9270)
Injection, aminophyllin up to 250 mg
Injection, succinylcholine chloride, (Anectine), up to 20 mg
Injection, atrophine sufate, per .01 MG
Injection, bivalirudin, 1 mg
Botulinum toxin type a, per each unit
Injection, calcium leucovorin, per 50 mgg
Injection, carbocaine
Injection, cefazolin sodium, ancef, kefzol, up to 500 mg
Injection, ceftriaxone sodium, per 250mgg
Cefotaxime sodium, {claforan}, per gram
Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg
Injection, ceftazidime, per 500 mg
Injection, chlor-trimeton, chlorpheniramine maleate, up to 200 mg
Injection, ciprofoxacin for intravenous infusion, 200 mg
Injection, compazine, up to 10mg
Injection, corticotropin, up to 40 units
Injection, dehist
Injection, depo-estradiol cypionate
Injection, depo-medrol, 20 mg
Injection methylprednisolone acetate
Injection, depo-medrol, 80 mg
Injection, medroxyprogesterone acetate, 50 mg
Injection, medroxyprogesterone acetate for contraceptive use, 150 mg
Injection, depo-testosterone cypionate, up to 100 mg
Injection, dexamethasone acetate, 1 mg
Injection, dexamethosone, up to 4mg/ml
Injection, diphenhydramine hcl, benadryl, up to 50 mg
Injection, dipyridamole, per 10 mg
Injection, dobutamine, hydrochloride per 250 mg
Injection, dolasetron mesylate, 10 mg
Injection, ertapenem sodium, 500 MG
Injection, estrogen, conjugated, per 25 mg
Injection, garamycin, gentamicin up to 80 mg
Injection, granisetron hydrochloride, 100 mcg
Injection, heprin sodium, (heprin lock flush), per 10 units
Injection, heparin sodium, per 1,000 units
Injection, dalteparin sodium, per 2500 iu
Injection, enoxaparin sodium, 10 mg
Injection, fondaparinux sodium, 0.5 mg
Injection, iron dextran, 50 mg
Injection, droperidol, up to 5mg
Injection, kantrex, kanamycin sulfate, up to 500 mg
Injection, ketorolac tromethamine, per 1 per 15 mg
Injection, lasix, up to 20 mg
Injection, levo-dromoran, up to 2 mg
Injection, lidocaine hci for intravenous infusion, 10 mg
Injection, lincomycin hc1, up to 300 mg
Injec, lorazepam, 2 mg
Injection, mannitol, 25% in 50 ml
Injection, meperidine hydrocholride, per 100 mg
Injection, mepergan, up to 50 mg
Injection, midazolam hydrochloride, per
Injection, morphine sulfate, up to 10mg
Injection, morphine sulfate (preservative- free sterile solution), per 10 mg
Injection, nalbuphine hydrochloride, per 10 mg
Injection, norflex, up to 60 mg
Injection, ondansetron hydrochloride, pe
Injection, penicillin, procaine aqueous, up to 600,000 units
Injection, piperacillin sodium/taxobactam sodium, 1 gram/0.125 grams (1.125 grams)
Injection, phenergan, up to 50 mg
Injection, phenobarbital, up to 120 mg
Injection, metoclopramide hcl, up to 10 mg
Injection, ranibizumab, 0.1 mg
Injection, ranitidine hydrochloride, 25m
Injection, regadenoson, 0.1 mg
Injection, ropivacaine hydrochloride, 1mg
Injection, sincalide, 5 micrograms
Injection, sodium chloride, 0.9%, per 2 ml
Injection, solu-medrol, up to 40 mg
Injection, solu-medrol, up to 125 mg
Injection, fentanyl citrate, up to 2 ml
Injection, talwin, up to 30 mg
Injection, triamcinolone, per mg
Injection triamcinolone acetonide, per 10mg
Injection triamcinolone diacetate, per 5 mg
Injection, triamcinolone hexacetonide
Injection, valium, up to 5 mg
Injection, vancocin hcl, up to 500 mg
Injection, verteporfin, 0.1 mg mcm: 35-100, 45-30
Injection, vistaril, up to 25 mg
Injection, vitamin b- 12, up to 1000 mcg
Injection, potassium chloride, per 2 meq
Unclassified drugs
Unclassified biologics
Infusion, normal saline solution , 1000 cc
Infusion, normal saline solution , sterile (500 ml=1 unit)
5% dextrose/normal salline solution (500 ml = 1 unit)
Infusion, normal saline solution , 250 cc
Infusion, d5w, 500 cc
Infusion, d5w, 1000 cc
Ringers lactate infusion, up to 1000 cc
Hyaluronana or derivative, Hyalgan or Supartz, for intra-articular injection, per dose
Hyaluronan or derivative, synvisc or Synvisc-One, for intra-articular
albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, FDA approved final product, non-compounded, administered through DME
Doxorubicin hcl, 10 mg
Injection, bevacizumab, 10 mg
Bleyomycin sulfate, 15 units
Cisplatin, {patinol}, powder or solution, per 10 mg
Fluorouracil, 500 mg
Ifosfomide, 1 gm
Mesna, 200 mg
Leuprolide acetate, (for depot suspension, 7.5mg)
Methotrexate sodium, 50 mg
Mitomycin, 5 mg
Injection, mitoxantrone hydrochloride, p
Injection, pemetrexed, 10 mg
Vinblastine sulfate, 1 mg
Not otherwise classified, antineoplastic drugs
Standard wheel chair
Standard wheel chair rental
High strength, light weight wheelchair
High strength, lightweight wheelchair
Ultra lightweight wheelchair
Heavy duty wheel chair
Extra heavy duty wheelchair, rental
Extra heavy duty wheelchair
Extra heavy duty wheelchair, rental
Other manual wheelchair/base
Standard - weight frame motorized power wheel chair
Wheelchair,standard - weight frame motorized/power
Standard-weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, ac
Lightweight portable motorized/power wheelchair.
Other motorized/power wheelchair base
Other motorized/power wheelchair base
Detachable, adjustable height armrest, upper portion, each
Arm pad, each
Fixed, adjustable height armrest, pair
High mount flip-up footrest.
Leg strap, each
Leg strap, each
Adjustable angle footplate, each
Adjustable angle footplate, each
Large size footplate, each
Standard size footplate, each
Foot rest, lower extension tube, each
Foot rest, upper hanger bracket, each
Swingaway, detachable foot rests, each
Elevating footrests, articulating, each
Seat height less than 17" or equal to or greater than 21" for a high stren gth, lightweight, or ultralightweight wheelchair.
Spoke protectors, each
Rear wheel assembly, complete, with solid tire, spokes or molded, each
With pneumatic tire, spokes or molded, each
Front caster assembly, complete; with semi-pneumatic tire, each
Wheel lock assembly; complete
Other accessories
Other accessories
Back support system for use with a wheelchair
Seating system, combined back and seat module, custom fabricated for attachment to wheelchair base
Elevating leg rests, pair
Supplies for external drug infusion pump, syringe type cartridge, sterile, each
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth.
Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criterion or no written coding verification from sadme
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a tech, labor component, p
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds
Power operated vehicle, group one heavy duty, patient weight capacity 301 - 450 pounds
Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 lbs.
Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds.
Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds.
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 lbs, monthly rate.
power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
Power wheelchair, group 2 standard, captain's chair, patient weight capacity up to and including 300 pounds
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 301 to 450 pounds
PURCHASE OF: Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including
PURCHASE OF: Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including
RENTAL RATE FOR: Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and inclu
Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 lbs.
Power wheelchair; group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 lbs.
Power wheelchair, group 3 standard, multiple power option, sling/solid seat back, patient weight capacity up to and including 300 pounds.
Power wheelchair, group 3 standard, multiple power option, sling/solid seat back, patient weight capacity up to and including 300 pounds.
Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 lbs.
Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 lbs.
Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds.
Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 lbs.
Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicon
Cervical, flexible, non-adjustable (foam collar)
Cervical, semi-rigid, adjustable (plastic collar)
Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)
Cervical, semi-rigid, wire frame occipital/mandibular support
Cervical collar, semi-rigid thermoplastic foam, two piece
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension
Cervical, multiple post collar, occupital/mandibular supports; adjustable
Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)
Tlso, tripanar control, modular segmented spinal system, two rigid plastic shells, prosterior extends from the sacrococcygeal juntion and te
TLSO, triplanar control, modular segmental spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and
TLSO, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and term
Tlso, triplaner control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include
Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to red
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels posterior extends from l-1 to below l-5 vertebra, produces intraca
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacroococcygeal junction to T-9 vertebra, produces
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vert
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9
LSO, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal juntion to T-9 vertebra
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal jun
Lso, corset front
Tlso, full corset
Peroneal straps, pair
Additions to ctlso or scloiosis orthoses, lumbar or lumbar rib pad
Thoracic-lumbar-sacral-orthoses (tlso), inclusive of furnishing initial orthosis only
Additions to tlso, (low profile) anterior thoracic extension
Unlisted procedure for spinal orthosis
Ho, abduction control of hip joints, flexible, pavlik harness
Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type
Ho, abduction control of hip joints, static, plastic, custom fitted
Ho, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho
Ho, abduction control of hip joint, post-operative hip abduction type, custom fitted
Ko, elastic with joints
Ko, elastic with condylar pads and joints, with or without patellar contro l, prefabricated, includes fitting and adjustment
Ko, immobilizer, canvas longitudinal
Knee orthosis, adjustable knee joints (unicentric or poly centric), positional orthosis, rigid support, prefabricated, includes fitting and adj
Ko, derotation, medial-lateral, anterior cruciate ligament, custom fabricated to patient model
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotat
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotat
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rota
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint, (unicentric or polycentric), medial-lateral and rot
Swedish type, pre-fabricated, includes fitting and adjustment - knee orthosis
Ko, modification of supracondylar prosthetic socket, molded to patient model (sk)
Ko, single or double upright, thigh and calf, with functional active resistance control
Afo, ankle gauntlet, custom fitted
Afo, molded ankle gauntlet, molded to patient model
Afo, multiligamentos ankle support
Afo; supramalleolar with straps, with or without interface/pads, custom fabricated
Afo, posterior, single bar, clasp attachment to shoe counter
Afo, single upright with static or adjustable stop (phelps or perlstein type)
Ankle foot orthosis; plastic or other material, prefabricated, includes fitting and adjustment
Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment
Afo, molded to patient model, plastic
Kafo, molded to patient model, plastic, rigid anterior tibial section (floor reaction)
Ankle foot orthosis; spiral, (irm type), plastic, custom fabricated
Ankle foot orthosis; spiral, plastic or other material, prefabricated, includes fitting and adjustment.
Afo, posterior solid ankle, molded to patient model, plastic
Afo, plastic molded to patient model, with ankle joint
Ankle foot orthosis; plastic or other material with ankle joint, pre- fabricated, includes fitting and adjustment
Afo, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar "bk" orthosis)
Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, mechanical activa
Kafo, double upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar "ak" orthosis)
Kafo, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment
Knee angle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricat
Knee ankle foot orthosis, full plastic, single upright, withor without freemotion knee, with or without free motion ankle, custom fabricated
Afo, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, molded to patient
Afo, fracture orthosis, tibial fracture cast orthosis, molded to patient model
Afo, fracture orthosis, tibial fracture orthosis, semi-rigid custom fitted
Afo, fracture orthosis, tibial fracture orthosis, rigid custom fitted
Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints
Addition to lower extremity fracture orthosis, drop lock knee joint
Addition to lower extremity fracture orthosis, limited motion knee joint
Addition to lower extremity fracture orthosis, quadrilateral brim
Additions to lower extremity, limited ankle motion, each joint
Additions to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
Additions to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint
Additions to lower extremity, split flat caliper stirrups, and plate attachment
Addition to lower extremity orthosis, rockeer bottom for total contact ankle foot orthosis, for custom babricated orthosis only.
Additions to lower extremity, round caliper and plate attach- ment
Additions to lower extremity, foot plate, molded to patient model, stirrup attachment
Additions to lower extremity, reinforced solid stirrup (scott-craig type)
Addition to lower extremity, long tongue stirrup
Additions to lower extremity, varus/valgus correction ("t") strap, padded/lined or malleolus pad
Addition to lower extremity, varus/valgus correction. plastic modification, padded/lined
Additions to lower extremity, molded inner boot
Addition to lower extremity, non-molded lacer, for custom fabricated orthosonly
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
Addition to lower extremity, anterior swing band
Additions to lower extremity, pre-tibial shell, molded to patient model
Additions to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)
Additions to lower extremity, extended steel shank
Addition to lower extremity, patten bottom
Addition to lower extremity, torsion control, straight knee joint, each
Addition to lower extremity, straight knee joint, heavy duty, each joint
Addition to lower extremity, offset knee joint, each joint
Addition to lower extremity, offset knee joint, heavy duty, each joint
Addition to lower extremity orthosis, suspension sleeve
Addition to knee joint, drop lock, each
Addition to knee joint, cam lock (seiss, french, bail types) each joint
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint
Addition to knee joint, ratchet lock for right knee joint; polycentric joint, each joint
lift loop for drop lock ring
Additions to lower extremity, offset knee joint, knee control, strap or pad
Additions to lower extremity, thigh/weight bearing, gulteal/ ischial weight bearing, ring
Additions to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model
Addition to lower extremity, thigh/weight bearing ischial containment/narrow m-l brim molded to patient model
Addition to lower extremity, thigh/weight bearing; ischial containment/narrow M-L brim, custom fitted
Additions to lower extremity, thigh-weight bearing, lacer, non-molded
Additions to lower extremity, thigh/weight bearing, lacer, molded to patient model
Additions to lower extremity, thigh/weight bearing, high roll cuff
Additions to lower extremity, pelvic control, hip joint, heavy duty, each
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each
Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables
Addition to lower extremity, pelvic control; metal frame, reciprocating hip joint and cables
Additions to lower extremity, pelvic control, band and belt unilateral
Additions to lower extremity, pelvic control, band and belt bilateral
Additions to lower extremity, pelvic and thoracic control, gluteal pad, each
Addition to lower extremity, thoracic control; lateral support uprights
Addition to lower extremity orthosis, plating chrome or nickel, per bar
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom
Addition to lower extremity orthosis, non-corrosive finish, per bar
Addition to lower extremity orthosis, drop lock retainer, each
Addition to lower extremity orthosis, knee control, full kneecap
Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only
Addition to lower extremity orthosis, knee control, condylar pad
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each
Addition to lower extremity orthosis
Unlisted procedures for lower extremity orthoses
Foot, insert, removable, molded to patient model, "ucb" type, berkeley shell, each
Foot insert, removable-molded to patient model, spenco, each
Foot insert, removable-molded to patient model, plastazote or equal, each
Foot insert, removable-molded to patient model, silicone gel, each
Foot, insert, removable, molded to patient model, longitudinal arch support, each
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal supports, each
Foot, insert, removable, molded to patient model, longitudinal/metatarsal supports each
Foot, insert, removable, formed to patient foot, each
Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg comp
Arch support, removable, premolded
Foot, arch support, removable, premolded, metatarsal, each
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each
Foot, arch support, nonremovable attached to shoe, longitudinal, each
Foot, arch support, nonremovable attached to shoe, metatarsal, each
Hallus-valgus night dynamic splint
Foot, rotation positioning device, withorowne type), clamped to shoe
Foot, plastic, silicone or equal, heel stabilizer, each
Orthopedic footwear, ladies shoe, oxford, each
Orthopedic footwear, ladies shoes, depth inlay, each
Orthopedic footwear, ladies shoe, hightop, depth inlay, each
Orthopedic footwear, mens shoe, oxford, each
Orthopedic footwear, mens shoe, depth inlay, each
Orthopedic footwear, mens shoe, hightop, depth inlay, each
Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)
Orthopedic footwear, man's shoe, oxford, used as an itegral part of a brace (orthosis)
Orthopedic footwear, custom shoe, depth inlay, each
Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each
Foot, shoe molded to patient model, silicone shoe, each
Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each
Foot, molded shoe plastazote (or similar) custom fitted, each
Ambulatory surgical boot-each
Plastazote sandal-each
Lifts, elevation, heel, tapered to metatarsals, per inch
Lifts, elevation, heel and sole, neoprene, per inch
Lifts, elevation, heel and sole, cork, per inch
Lifts, elevation, inside shoe, tapered, up to one-half inch
Lifts, elevation, heel, per inch
Heel wedge
Sole wedge, outside sole
Sole wedge; between sole
Outflare wedge
Metatarsal bar wedge, rocker
Metatarsal bar wedge, between sole
Full sole and heel wedge, between sole
Heel, counter, plastic reinforced
Heel, sach cushion type
Heel, new leather, standard
Heel, new rubber, standard
Heel, thomas with wedge
Heel, pad and depression for spur
Heel, pad, removable for spur
Miscellaneous shoe additions, insole, leather
Miscellaneous shoe additions, insole, rubber
Miscellaneous shoe additions, sole, half
Miscellaneous shoe additions, sole, full
Miscellaneous shoe additions, convert instep to velco closure
Miscellaneous shoe additions, march bar
Transfers of an orthosis from one shoe to another, caliper plate existing
Transfers of an orthosis from one shoe to another, caliper plate new
Transfers of an orthosis from one shoe to another, solid stirrup existing
Transfers of an orthosis from one shoe to another, solid stirrup new
Transfers of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes
Unlisted procedures for foot orthopedic shoes, shoe modifications and transfers
Shoulder orthoses, (so), figure of "8" design abduction re- strainer
Eo, double upright with forearm/arm cuffs, free motion
Elbow orthosis; with adjustable position locking joint(s), prefabricated, includes fitting and adjustment
Wrist-hand-finger-orthoses (WHFO); includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interfac
Wrist-hand-finger-orthoses; without joint(s), prefabricated, includes fitting and adjustment, any type
Wrist hand figer orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustmen
Whfo, dynamic flexor hinge, reciprocal wrist extension/flexion, finger flexion/extension, wrist or finger drive
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
Whfo, wrist extension control (cock-up), canvas or leather design, non-molded
Whfo, flexion glove with elastic finger control
Finger orthosis, proximal interphalangeal (PIP)/distal interphalangeal (DIP), non torsion joint/spring, extension/flexion
Addition of joint to upper extremity orthosis, any material; per joint
Shouler-elbow-wrist-hand orthoses; abduction positioning, Erbs palsey design, prefabricated, includesin fitting and adjustment
Sewho, additions to mobile arm supports, elevating proximal arm
Upper extremity fracture orthosis, humeral
Upper extremity fracture orthosis, radius/ulnar
Upper extremity fracture orthosis, wrist
Addition to upper extremity orthosis, sock, fracture or equal, each
Unlisted procedures for upper limb orthosis
Replace quadrilateral socket brim; custom fitted
Replace non-molded thigh lacer, for custom fabricated orthosis only
Replace metal bands kafo-afo, proximal thigh
Replace metal bands kafo-afo, calf or distal thigh
Replace leather cuff kafo-afo, calf or distal thigh
Repair of orthotic device, labor component
Repair of orthotic device, repair or replace minor parts
Ankle control orthosis, stirrup style, rigid, includes any type interface (eg, pneumatic, gel), prefabricated, includes fitting and adjustment
Walking boot, pneumatic, with or without joints, with or without interface material, prefabricated, includes fitting and adjustment
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, includs fitting and adjustment
Replace soft interface material, ankle c
Static ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, pressure reduction, may be used for
Partial foot, shoe insert with longitudinal arch, toe filler
Partial foot, molded socket, ankle height, with toe filler
Partial foot, molded socket, tibial tubercle height, with toe filler
Ankle, symes, molded socket, sach foot
Ankle, Symes, metal frame, molded leather socket, articulated ankle/foot
Below knee, molded socket, shin, sach foot
Below knee, plastic socket, joints and thigh lacer, sach foot
Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot
Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot
Above knee, molded socket, single axis constant friction knee, shin, sach foot
Above knee, short prosthesis, no knee joint ("stubbies"), with foot blocks, no ankle joints, each
Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot
Hip disarticulation; canadian type, molded socket, hip joint, single axis constant friction knee, shin, sach foot
Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
Below knee, molded socket, sach foot, endoskeletal system including soft cover and finishing
Knee disarticulation (or through knee)
Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee
Hip disarticulation, Canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot
Immediate post surgical or early fitting, application of non- weight bearing rigid dressing, below knee
Initial, below knee "ptb" type socket, "usmc" or equal pylon, no cover, sach foot, plaster socket, direct formed
Initial, above knee - knee disarticulation, ischial level socket, "usmc" or equal pylon, no cover, sach foot plaster socket, direct
Preparatory, below knee "ptb" type socket, "usmc" or equal pylon, no cover, sach foot plaster socket, molded to model
Preparatory, below knee "ptb" type socket, "usmc" or equal pylon, no cover, sach foot, thermoplastic or equal, molded to model
Preparatory, below knee "ptb" type socket, "usmc" or equal pylon, no cover, sach foot, laminated socket, molded to model
Prepartory, above knee - knee disarticulation, ischial level socket, non- alignable system, pylon, no cover, sach foot; plaster socket, molded
Preparatory, above knee-knee disarticulation, ischial level socket, "usmc" or equal pylon, no cover, sach foot, thermoplastic
Preparatory, above knee-knee disarticulation ischial level socket, "usmc" or equal pylon, no cover, sach foot, thermoplastic
Preparatory, above knee-knee disarticulartion, ischial level socket, "usmc" or equal pylon, no cover, sach foot, prefabricated adjustable
Preparatory, above knee-knee disarticulation ischial level socket, "usmc" or equal pylon no cover, sach foot, laminated
Addition to lower extremity, above knee-knee disarticulation, ohc 4-bar linkage, with friction swing phase control
Addition to lower extremity, above knee-knee disarticulation, ohc 4-bar linkage, with hydraulic swing phase control
Additions to lower extremity, above knee-knee disarticulation, 4-bar linkage, with pneumatic swing phase control
Additions to lower extremity, above knee, universal multiplex system, friction swing phase control
Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each
Additions to lower extremity, test socket, symes
Additions to lower extremity, test socket, below knee
Additions to lower extremity, test socket, knee disarticulat- ion
Additions to lower extremity, test socket, above knee
Additions to lower extremity, test socket, hip disarticulation
Additions to lower extremity, test socket, hemipelvectomy
Addition to lower extremity, below knee, acrylic socket
Additions to lower extremity, symes type, expandable wall socket
Addition to lower extremity, above knee or knee disarticulation, acrylic socket
Additions to lower extremity, symes type, "ptb" brim design socket
Addition to lower extremity, symes type; posterior opening (canadian) socket
Additions to lower extremity, symes type, medial opening socket
Addition to lower extremity, below knee, total contact
Additions to lower extremity, above knee, leather socket
Addition to lower extremity, hip disarticulation, flexible inner socket, external frame
Additions to lower extremity, above knee, wood socket
Addition to lower extremity, below knee, flexible inner socket, external frame
Additions to lower extremity, below knee, air, fluid, gel or equal, cushionsocket
Addition to lower extremity, below knee suction socket
Additions to lower extremity, above knee, air, fluid gel or equal, cushion socket
Addition to lower extremity, ischial containment/narrow m-l socket
Additions to lower extremity, total contact, above knee or knee disarticulation socket
Addition to lower extremity, above knee, flexible inner socket, external frame
Additions to lower extremity, suction suspension, above knee or knee disarticulation, socket
Additions to lower extremity, knee disarticulation, expandable wall socket
Additions to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)
Additions to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
Additions to lower extremity, socket insert, knee disarticul- ation, (kemblo, aliplast, plastazote or equal)
Additions to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
Addition to lower extremity, socket insert, multi-durometer symes
Addition to lower extremity, socket insert, multi-durometer, below knee
Additions to lower extremity, below knee, cuff suspension
Additions to lower extremity, below knee, molded distal cushion
Additions to lower extremity, below knee, molded supraconydular suspension ("pts" or similar)
Addition to lower extremity; below knee/above knee suspension locking mechanism (shuttle, lanyard or equal) excludes socket insert
Additions to lower extremity, below knee, removable medial brim suspension
Addition to lower extremity; below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, ela
Additions to lower extremity, below knee, knee joints, single axis, pair
Addition to lower extremity, below knee, knee joints, polycentric, pair
Additions to lower extremity, below knee, joint covers, pair
Addition to lower extremity; below knee/above knee, custom fabricated from existing mold or prefabricated socket insert, silicone gel, elas
Additions to lower extremity, below knee, thigh lacer, non- molded
Below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, fo
Additions to lower extremity, below knee, thigh lacer, gluteal/ischial, molded
Below knee/above knee, custome fabricated socket insert for other than congental or atypical traumatic amputee, silicone gel elastomeric
Additions to lower extremity, below knee, fork strap
Addition to lower extremity prothesis, below knee, suspension/sealing sleeve, with or without valve, any material, each
Additions to lower extremity, below knee, back check (extens- ion control)
Additions to lower extremity, below knee, waist belt, webbing
Additions to lower extremity, below knee, waist belt, padded and lined
Additions to lower extremity, above knee, pelvic control belt, light
Additions to lower extremity, above knee, pelvic control belt, padded and lined
Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each
Additions to lower extremity, above knee or knee disarticulat- ion, pelvic joint
Additions to lower extremity, above knee or knee disarticulat- ion, pelvic band
Additions to lower extremity, above knee or knee disarticulat- ion, silesian bandage
Replacement, socket, below knee, molded to patient model
Replacement, socket, above knee/knee disarticulation, including attachment plate, moded to patient model
Replacement, socket, hip disarticulation, including hip joint, molded to patient model
Replacement, custom shaped protective cover, below knee *
Replacement, custom shaped protective cover, above knee
Replacement, custom shaped protective cover, knee disarticulation
Custom shaped protective cover, hip disarticulation
Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material
Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control
Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
Addition, exoskeletal knee-shin system, single axis, fluid swing phase control
Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control
Addition to lower limb prothesis, vacuum pump, residual limb volume management and moisture evacuation system
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty
Additions exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
Additions exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
Additions endoskeletal knee-shin system, single axis, manual lock
Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material
Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
Addition, endoskeletal knee-shin system, single axis, variable friction swing phase control
Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock
Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control
Addition, endoskeletal knee-shin system, single axis; pneumatic swing, friction stance phase control
Addition, endoskeletal knee-shin system, single axis, fluid swing phase control
Hydraulic swing phase control, with miniature high activity frame
Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control
Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control
Addition, endoskeletal knee-shin system, 4-bar linkage or multiaxial, pneumatic swing phase control
Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable
Addition to endoskeletal knee-shin system, fluid stance extension, dampen- ing feature, with or without adjustability
Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist
Hip disarticulation, mechanical hip extension assist
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes e
Addition, endoskeletal system, below knee, alignable system
Addition, endoskeletal system, above knee or hip disarticulation, alignable system
Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation manual
Addition, endoskeletal system high acti
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
Addition, endoskeletal system, below knee, flexible protective outer surface covering system
Addition, endoskeletal system, above knee, flexible protective outer surface covering system
Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature
All lower extremity prostheses, foot, external keel, sach foot
All lower extremity prosthesis, solid ankle cushion keel (SACH) foot, replacement only
All lower extremity prostheses, flexible keel foot (safe, sten, bock dynamic or equal)
Endoskeletal andle foot system, microprocessor controlled feature, dorsiflexion and/cor plantar flexion control, includes power source
All lower extremity prostheses, foot, single axis ankle/foot
All lower extremity prosthesis, comb sing
All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)
All lower extremity prostheses, foot, multiaxial ankle/foot (creissinger or equal)
All lower extremity prosthesis, multiaxial ankle/foot, dynamic response
All lower extremity prosthese, flex foot system
All lower extremity prosthesis, flex-walk system or equal
All endoskeletal lower extremity prosthesis, axial rotation unit with or without adjustability
All endoskeletal lower extremity prosthesis
All lower extremity prosthese, multi-axial rotation unit (mcp or equal)
All lower extremity prosthesis, shank fo
All lower extremity prosthesis, comb vert
Addition to lower extremity pros. adj. heel
Unlisted procedures for lower extremity prosthesis
Partial hand, robin-aids, thumb remaining (or equal)
Partial hand, robin-aids, no finger remaining (or equal)
Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad
Below elbow, molded socket, flexible elbow hinge, triceps pad
Below elbow, molded socket, (muenster or northwestern sus- pension types)
Below elbow, molded double wall split socket, step-up hinges, half cuff
Elbow disarticulation, molded socket, outside locking hinge, forearm
Above elbow, molded double wall socket, internal locking elbow, forearm
Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
Shoulder disarticulation, passive restoration (complete prosthesis)
Shoulder disarticulation, passive restoration (shoulder cap only)
Interscapular thoracic, passive restoration (shoulder cap only)
Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping.
Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure
Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair
Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable
Upper extremity additions, polycentric hinge, pair
Upper extremity additions, single pivot hinge, pair
Addition to upper extremity prosthesis, external powered, additional switch, any type
Upper extremity additions, disconnect locking wrist unit
Upper extremity addition, additional disconnect insert for locking wrist unit, each
Upper extremity additions, flexion/extension wrist unit, with or without friction
upper extremity addition, spring assisted rotational wrist unit with latch release
Upper arm extremity addition, flexion/extension and rotation wrist unit
Upper extremity addition, quick disconnect hook adapter, otto bock or equal
Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal
Upper extremity additions, stainless steel, any wrist
Upper extremity addition, latex suspension sleeve, each
Upper extremity additions, lift assist for elbow
Upper extremity addition, nudge control elbow lock
Upper extremity addtion to prosthesis, electric locking feature, only for use with manually powered elbow
Upper extremity addition, excursion amplifier, pulley type
Upper extremity additions, shoulder flexion-abduction joint, each
Upper extremity additions, shoulder universal joint, each
Upper extremity additions, standard control cable, extra
Upper extremity additions, heavy duty control cable
Upper extremity additions, teflon, or equal, cable lining
Upper extremity additions, hook to hand, cable adapter
Upper extremity additions, harness, chest or shoulder, saddle type
Upper extremity addition, harness, (eg, figure of 8 type), single cable design
Upper extremity addition, harness, (eg, figure of 8 type), dual cable design
Upper extremity additions, test socket, wrist disarticulat- ion or below elbow
Upper extremity additions, test socket, elbow disarticulat- ion or above elbow
Upper extremity additions, test socket, shoulder dis- articulation or interscapular thoracic
Upper extremity addition, suction socket
Upper extremity addition, frame type socket, below elbow or wrist disarticulation
Upper extremity addition, frame type socket, above elbow or elbow disarticulation
Upper extremity addition, frame type socket, shoulder disarticulation
Upper extremity addition, removable insert, each
Upper extremity addition, silicone gel insert or equal, each
Upper extremity addition, external lockin
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, s
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, s
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical tr
Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert
Terminal device, passive hand/mitt, any material, any size
Terminal device, sport/recreational/work attachment, any material, any size
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined
Terminal device, hand, mechanical, voluntary opening, any material, any size
Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined
Addition to terminal device, modifier wrist unit
Addition to terminal device, precision pinch device
Automatic grasp feature, addition to upper limb electric prosthetic terminal device
Microprocessor control feature, addition to upper limb prothetic terminal device
Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power.
Addition to upper extremity prothesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
Addition ot upper extremity prosthesis, vlove for termianl device, any material, custom fabricated
Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining
Hand restoration (casts, shading and measurements included), partial hand; with glove, multiple fingers remaining
Hand restoration (shading, and measurements included), replacement glove for above
Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two
Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries a
Otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device; above elbow, external pow
Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical
Electric hand, switch or myoelectric controlled, adult
Electric hook, switch,or myoelectric controlled, adult
Electronic elbow; microprocessor sequential control of elbow and terminal device.
Electronic wrist rotator, otto bock or equal
Electronic wrist rotator, for utah arm
Proportional control, 12 volt, utah or equal
Six volt battery, each
Twelve volt battery, each
Battery charger, twelve volt, each
Lithium ion battery, replacement
Lithium ion battery charger
Addition to upper extremity prothesis; below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)
Addition to upper extremity prosthesis; above elbow disarticulation, ultra-light material (titanium, carbon fiber or equal)
Addition to upper extremity prothesis; below elbow/wrist disarticulation, acrylic material
Addition to upper extremity prothesis; above elbow disarticulation, acrylic material
Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material
Unlisted procedures for upper extremity prosthesis
Repair of prosthetic device, hourly rate
Repair prosthetic device, repair or replace minor parts
Repair prosthetic device, labor component
Prosthetic donning sleeve, any material, each
Breast prostheses, mastectomy bra
Breast prosthesis, silicone or equal
custom breast prosthesis, post mastectomy, molded to patient model
Orbital prothesis, provided by nonphysician
Auricular prosthesis, provided by a non-physician
Prosthetic sheath, below knee, each
Prosthetic sheath, above knee, each
Prosthetic sheath, upper limb, each
Prosthetic sheath/sock, including a gel
Prosthetic sock, wool, below knee, each
Prosthetic sock, wool, above knee, each
Prosthetic sock, wool, upper limb, each
Prosthetic shrinker, below knee, each
Prosthetic shrinker, above knee, each
Prothetic shrinker; upper limb, each
Stump sock, single ply, fitting, below knee, each
Stump sock, single ply, fitting, above knee, each
Stump sock, single ply, fitting, upper limb, each
Unlisted procedure for miscellaneous prosthetic services
Artifical larynx, any type
Ocular implant
Aqueous shunt
Cochlear device, includes all internal and external components
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
Implantable neurostimulator electrode, each
Prosthetic implant, not otherwise specified
Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code
Prolotherapy
Scrn, papanicolaou smr by tech w/phy supr
Culture, bacterial, urine; quantitative, sensitivity study
Catheterization for collection of specimen(s) (multiple patients)
Infusion therapy, using other than chemotherapeutic drugs, per visit
Chemotherapy administration by infusion technique only, per visit
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
Set-up portable x-ray equipment
Ondansetron Hydrochloride, 8 mg, oral, FDA approved anti-emtic, substitute for IV anti-emetic at time of chemo treatment
Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic a th
New technology intraocular lens category 3 (reduced spherical aberration)
Cast supplies, short arm cast, adult (11 years +) fiberglass
Cast supplies, short arm splint, adult (11 years +), plaster
Cast supplies, short leg cast, adult (11 years +), fiberglass
cast supplies, short leg splint, adult, fiberglass
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than
Injection, bupivicaine hci, 30 ml
Injection, clindamycin phosphate, 300 mg
Daily wear specialty contact lens, per lens
Safety eyeglss frames
Comprehensive contact lens eval
Photorefractive keratectomy (PRK)
Ultrasound pachymetry to determine corneal thickness, with interpretation and report, unilateral
Gradient pressure aid (sleeve), ready made
Splint, prefabricated, digit
Vertebral axial decompression, per session
Nursing care, in the home; by registered nurse, per hour
Nursing care, in the home; by licensed practical nurse, per hour
Physical therapy; in the home, per diem
Diabetic management program; follow-up visit to non-md provider
Diabetic mgmt prg, group session
Diabetic management program, nurse visit
Diabetic management program; dietician visit
Nutritional counseling, dietitian visit
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; one every 24 hours; administrative services, professional pharmacy
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy ser
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative servcies, professional pharmacy
Alcohol and/or substance abuse services, skills development
Visual examination, with refraction
Contact lens re-evaluation exam, includes biomicroscopic evalua- tion, multiple opthalmoscopies, pupil, cornea and lid evaluation
Dispensing, Not Otherwise Classified
Fitting of contact lens or fitting of artificial eye
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Frames, Purchases
Frames, purchased. unusual size
Deluxe Frame
Sphere, single vision, plano to plus or minus 4.00, per lens
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere,
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens
Spherocylinder, single vision, plus or minus 7.25 to plus or minus12.00d sphere; 4.25 to 6.00d cylinder, per lens
Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens
Lenticular, (myodisc), per lens, single vision
Lenticular lens, per lens, single
Not otherwise classified, single vision lens
Bifocal, Plus/Minus 4.00D
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens
Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d,per lens
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.000sphere, 2.12 to 4.000 cylinder, per lens
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere; 4.25 to 6.00d cylinder, per lens
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder,per lens
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.ood sphere,2.25 to 4.000 cylinder, per lens
Spherocylinder, bifocal, sphere over plus or minus 12.ood, per lens
Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens
Lenticular (myodisc), per lens, bifocal
Aniseikonic, per lens, bifocal
Bifocal seg width over 28mm
Bifocal add over 3.25d
Specialty bifocal (by report)
Sphere, trifocal, plano to plus or minus 4.00d, per lens
Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d per lens
Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens
Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens
Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d dylinder, per lens
Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens
Spherocylinder, trifocal, plus or minus 7.25 to plus or 12.00d sphere; 2.25 to 4.00d cylinder, per lens
Spherocylinder, trifocal, plus or minus 7.25 to plus or 12.00d sphere; 4.25 to 6.00d cylinder, per lens
Lenticular, (myodisc), per lens, trifocal
Aniseikonic lens, trifocal
Trifocal seg width over 28 mm
Trifocal add over 3.25d
Specialty trifocal (by report)
Variable asphericity lens, single vision, full field glass or plastic, per lens
Variable asphericity lens, bifocal, full field, glass or plastic, per lens
Not otherwise classified, variable sphericity lens
Contact lens, pmma; spherical, per lens
Contact lens, pmma; toric or prism ballast, per lens
Contact lens, gas permeable, spherical, per lens
Contact lens, gas permeable, toric, prism ballast, per lens
Contact lens, gas permeable, bifocal, per lens
Contact lens, gas permeable, extended wear, per lens
Contact lens hydrophilic, spherical, per lens
Contact lens hydrophilic, toric, or prism ballast, per lens
Contact lens hydrophilic, bifocal, per lens
Contact lens hydrophilic, extended wear, per lens
Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)
Contact lens, scleral, gas permeable, per lens (for contact lens modifi- cation, see 92325)
Not otherwise classified, contact lens
Hand held low vision aids and other nonspectacle mounted aids
Single lens spectacle mounted low vision aids
Telescopic and other compound lens system, including distance vision telescopic, near vision telescopes and compound
Prosthetic eye, plastic, custom
Polishing/resurfacing of ocular prosthesis
Enlargement of ocular prosthesis
Reduction of ocular prosthesis
Scleral cover shell
Fabrication and fitting of ocular conformer
Not otherwise classified, prosthetic eye
Anterior chamber intraocular lens
Posterior chamber intraocular lens
Balance lens, per lens
Slab off prism, glass or plastic. per lens
Prism, per lens
Press-on lens, fresnell prism, per lens
Special base curve, glass or plastic,per lens
Tint, photochromatic, per lens
Addition to lens, tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens
Anti-reflective coating, per lens
U-v lens, per lens
eye glass case
Scratch resistant coating, per lens
Polarization, any lens material, per lens
Oversize lens, per lens
Progressive lens, per lens
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excluding polycarbonate, per lens
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens
Lens, polycarbonate, or equal, any index, per lens
Processing, preserving and interpretating corneal tissue
specialty occupational multifocal lens, per lens
Astigmatism correcting function of intraocular lens
Presbyopia correcting function of intraocular lens
Amniotic membrane for surgical reconstruction, per procedure
Vision supply, accessory and/or service component of another HCPCS vision code.
Vision service, miscellaneous
Single lens spectacle mounted low vision aids
Assessment for hearing aid
Fitting/orientation/checking of hearing aid.
Repair/modification of a hearing aid
Conformity evaluation.
Hearing aid, monaural, body worn, air conduction
Hearing aid, monaural, body worn, bone conduction
Hearing aid, monaural, in the ear
Hearing aid, monaural, behind the ear
Dispensing fee
Hearing aid, bilateral, body worn
Dispensing fee, bilateral
Binaural, in the ear
Binaural; behind the ear,
Binaural, glasses
Dispensing fee, binaural
Hearing aid, cros, in the ear
Hearing aid, cros, behind the ear
Dispensing fee, cros
Hearing aid, bicros, in the ear
Hearing aid, bicros, behind the ear
Hearing aid, bicros, glasses
dispensing fee, BICROS
Dispensing fee, monaural hearing aid, any type
Hearing aid, analog, binaural, itc
Hearing aid, digitally programmable analog, binaural, itc
Hearing aid, digitally programmable, binaural, ite
Hearing aid, digitally programmable, binaural, bte
Hearing aid, digital, monaural, cic
Hearing aid, digital, monaural, ite
Hearing aid, digital, monaural, ite
Hearing aid, digital, monaural, bte
Hearing aid, digital, binaural, cic
Hearing aid, digital, binaural, cic
Hearing aid, digital, binaural, itc
Hearing aid, digital, binaural, ite
Hearing aid, digital, binaural, bte
Ear mold/insert, not disposable, any type
Ear mold/insert, disposable, any type
Battery for use in hearing device
Hearing aid supplies/accessories
Assistive Listening Device, telephone amplifier, any type
Assistive listening device, alerting, any type
Assistive listening device, television caption decoder
Assistive listening device, TDD
Assistive listening device, for use with cochlear implant
Assistive learning device, not otherwise specified
Ear impressions, each
Hearing services, micellaneous
Rate
417.24
463.60
350.00
185.44
370.88
185.44
185.44
417.24
463.60
463.60
463.60
463.60
162.26
370.88
394.06
162.26
370.88
370.88
324.52
440.42
509.96
556.32
857.66
185.44
394.06
800.00
973.56
764.94
486.78
417.24
0.00
347.70
417.24
139.08
463.60
301.34
347.70
417.24
463.60
649.04
208.62
301.34
509.96
162.26
370.88
602.68
672.22
811.30
278.16
162.26
162.26
370.88
347.70
347.70
348.00
741.76
718.58
718.58
718.58
1159.00
1274.90
0.00
0.00
767.00
602.68
672.22
602.68
672.22
556.32
533.14
394.06
1182.18
394.06
278.16
347.70
208.62
324.52
370.88
440.42
440.42
719.34
440.42
764.94
649.04
472.00
451.31
370.88
0.00
231.80
347.70
278.16
417.24
463.60
162.26
625.86
788.12
927.20
370.88
579.50
417.24
602.68
695.40
301.34
463.60
463.60
811.30
602.68
278.16
556.32
556.32
463.60
254.98
347.70
347.70
254.98
347.70
254.98
324.52
347.70
301.34
347.70
0.00
347.70
347.70
579.50
649.04
324.52
185.44
231.80
417.24
231.80
185.44
231.80
0.00
0.00
254.98
324.52
185.44
811.30
649.04
185.44
463.60
185.44
208.62
278.16
278.16
417.24
463.60
695.40
410.29
278.16
417.24
394.06
533.14
324.52
301.34
463.60
324.52
370.88
324.52
185.44
347.70
185.44
301.34
208.62
370.88
324.52
486.78
394.06
208.62
231.80
347.70
347.70
324.52
370.88
44.60
206.34
254.98
231.80
394.06
254.98
254.98
394.06
440.42
440.42
486.78
185.44
463.60
370.88
324.52
254.98
347.70
185.44
254.98
394.06
579.50
718.58
602.68
370.88
463.60
417.24
602.68
231.80
162.26
231.80
324.52
254.98
301.34
254.98
162.26
231.80
324.52
370.88
440.42
463.60
347.70
486.78
417.24
370.88
208.62
231.80
440.42
208.62
394.06
486.78
463.60
324.52
231.80
208.62
231.80
162.26
254.98
347.70
301.34
215.40
0.00
0.00
218.82
0.00
87.44
0.00
120.06
67.28
132.55
63.06
84.48
152.05
378.81
95.16
127.92
89.29
194.93
450.97
41.97
178.62
446.00
75.24
32.93
446.00
204.87
274.30
267.76
34.35
60.08
72.23
26.74
64.19
67.90
98.46
49.23
115.33
378.81
132.13
45.38
131.88
148.92
56.48
113.57
181.30
204.10
209.07
378.81
96.03
123.06
137.73
163.65
262.21
115.69
139.31
344.93
151.55
54.47
186.04
72.12
302.75
344.93
307.25
378.81
273.85
450.97
450.97
168.82
186.42
204.54
267.36
266.85
211.05
183.51
212.61
463.56
246.14
66.75
311.30
463.57
420.30
450.97
17.45
23.81
40.90
82.19
142.04
450.97
217.05
485.41
410.86
313.30
507.40
485.41
40.98
127.50
21.34
152.43
699.08
551.00
315.61
551.00
145.97
157.63
191.65
221.90
305.29
179.42
210.53
200.80
114.52
210.35
118.90
463.57
225.51
275.72
98.14
295.77
423.59
313.30
327.17
72.27
347.64
501.65
646.29
389.46
646.29
554.86
472.69
573.49
286.75
485.41
789.53
624.93
287.23
853.38
653.61
868.34
323.91
363.92
287.23
768.05
287.23
192.88
736.05
663.31
287.23
683.94
543.07
485.41
709.74
395.48
66.75
196.03
287.23
368.02
673.14
551.00
644.63
326.04
359.01
551.00
1295.06
647.53
1295.06
1295.06
1103.73
1290.65
722.63
656.96
287.23
537.80
259.25
537.80
259.36
305.42
491.16
501.22
364.22
546.33
362.44
72.84
326.04
532.84
799.26
440.70
0.00
94.87
94.51
136.78
926.25
0.00
73.80
55.07
14.33
335.53
378.81
827.58
551.00
78.35
48.82
59.67
167.55
118.84
145.31
553.70
233.19
536.67
314.21
0.00
98.99
119.59
275.83
485.41
274.30
653.78
367.51
410.39
485.41
395.28
485.41
551.00
624.36
653.61
146.95
254.40
109.68
673.72
673.72
1926.92
2890.38
551.00
392.47
196.24
392.47
485.41
814.86
1222.29
386.75
1180.12
618.98
618.98
0.00
211.51
450.97
240.10
128.10
438.98
313.30
52.30
48.89
16.29
52.86
68.11
55.83
74.40
27.92
49.62
46.65
23.33
20.50
51.00
61.78
65.80
30.89
61.78
61.78
42.89
61.78
62.53
50.44
167.66
529.48
203.07
288.10
288.10
288.10
450.97
506.83
506.83
760.25
253.42
506.83
506.83
506.83
101.37
101.37
485.41
271.90
372.06
389.96
485.41
461.40
293.28
968.92
525.64
88.03
653.60
450.47
326.04
380.92
551.00
0.00
176.67
72.16
35.33
0.00
0.00
0.00
0.00
206.42
103.21
41.28
223.34
44.66
3071.79
2818.67
226.06
0.00
548.22
1808.05
730.57
730.57
1501.59
0.00
429.00
636.51
1541.17
1019.41
1601.96
1166.28
2967.97
4395.52
326.04
3258.32
1629.16
1704.19
2556.28
1033.68
1400.58
1230.45
2920.99
1029.08
872.26
845.33
1033.68
774.82
154.96
485.41
632.13
292.85
1711.56
2567.34
386.75
1394.00
985.01
452.75
168.77
551.00
950.45
950.45
1033.69
1406.41
1435.35
287.07
1843.06
1305.30
551.00
477.26
0.00
0.00
272.11
485.41
601.59
801.57
551.00
797.73
184.18
259.81
1285.20
1207.87
0.00
302.24
198.44
351.58
463.57
612.17
733.58
0.00
447.64
463.56
374.65
378.81
571.25
1485.39
742.69
3010.82
1905.55
1526.54
0.00
357.27
1549.93
774.96
1549.93
830.81
309.99
463.56
1999.59
2241.48
1120.74
551.00
414.89
158.87
218.55
84.39
463.56
1609.01
1525.78
762.89
762.89
305.15
1334.71
1762.63
881.32
176.26
881.31
1762.63
333.94
0.00
456.88
228.44
456.88
456.88
228.44
91.37
2127.59
1063.79
2127.59
1276.55
425.51
395.39
395.39
79.07
2026.61
887.48
443.74
703.80
718.17
359.09
143.63
0.00
728.23
364.11
728.23
145.64
686.98
686.98
474.32
163.80
137.40
0.00
718.98
309.25
496.37
496.37
297.82
99.27
691.02
295.27
691.02
138.20
0.00
0.00
0.00
334.26
216.16
0.00
227.59
489.75
378.81
715.56
357.78
551.00
650.14
361.72
744.78
641.25
164.19
23.22
152.19
863.27
431.64
485.41
987.92
450.97
658.47
274.99
663.99
1109.50
221.90
1033.68
663.57
653.60
693.10
693.10
968.98
450.97
1336.28
921.53
1340.44
1209.88
450.97
1335.47
267.09
3208.70
641.74
732.52
908.86
326.04
243.74
513.54
256.77
313.30
578.49
578.49
718.42
574.48
450.97
703.80
1352.30
1017.07
1352.30
597.25
506.12
175.79
73.73
249.21
551.00
1008.72
0.00
0.00
422.98
319.18
414.29
266.85
797.86
510.42
551.00
481.20
485.41
450.97
525.41
968.92
52.22
455.96
455.96
570.94
570.25
285.13
114.05
529.47
706.36
784.06
1095.08
266.85
1218.21
266.85
919.20
683.94
264.48
270.29
648.48
648.48
0.00
361.47
180.74
360.60
322.41
704.77
347.17
317.31
158.65
485.41
573.73
529.47
388.12
388.12
292.04
146.02
485.41
356.39
386.75
821.90
450.97
450.97
437.36
193.66
77.47
653.60
688.76
649.95
672.01
174.26
69.70
529.48
626.76
287.23
600.20
287.23
761.96
551.00
859.83
529.47
820.35
794.04
397.02
510.00
777.80
937.83
529.47
1147.40
485.41
1071.03
1399.01
450.97
723.05
653.60
595.65
119.13
717.00
698.82
139.76
440.70
609.38
718.42
403.34
1339.27
609.38
1023.17
590.95
551.00
614.46
846.04
849.94
744.79
0.00
211.90
211.90
211.90
263.16
551.00
800.37
800.37
529.48
582.64
111.40
582.64
582.64
378.81
378.81
448.25
124.38
653.60
485.41
588.68
412.53
485.41
638.74
530.32
673.69
336.85
673.69
134.73
551.00
271.48
271.48
54.29
217.38
86.95
445.53
539.92
0.00
379.89
379.10
463.56
416.83
743.49
218.37
87.34
204.10
810.41
810.41
887.40
630.00
930.88
485.41
594.93
529.47
591.13
485.41
261.74
676.40
338.20
552.26
539.12
552.07
865.00
202.40
80.96
287.23
626.19
139.81
55.92
287.23
0.00
598.32
630.87
620.44
647.71
344.37
510.00
828.20
763.65
529.48
803.80
688.05
179.19
71.67
287.23
693.08
287.23
802.46
401.23
551.00
658.76
96.32
326.04
850.96
674.39
231.00
92.40
551.00
892.16
586.23
170.40
68.16
249.23
392.46
196.23
551.00
523.84
261.92
517.07
180.93
72.37
618.51
765.25
787.87
769.29
630.00
882.84
529.48
999.81
529.48
687.18
84.32
326.04
768.46
552.73
528.85
264.42
648.96
386.75
0.00
545.59
545.59
863.77
0.00
666.24
757.66
529.51
274.30
411.40
551.00
746.78
0.00
419.17
733.88
1636.27
178.87
874.61
197.21
434.54
358.73
197.10
1300.75
2129.46
425.89
2129.46
1766.89
1435.76
287.15
2900.59
580.12
0.00
2388.67
477.73
1018.64
1250.85
598.27
1129.64
1129.64
509.69
463.56
1403.07
0.00
496.82
388.76
566.71
265.80
531.61
1093.90
653.60
374.36
187.18
369.41
266.85
551.00
683.17
551.00
551.00
374.00
0.00
624.74
0.00
317.79
551.00
427.23
653.61
406.90
643.52
551.00
527.89
263.95
530.43
952.57
553.82
553.82
553.82
553.82
555.03
682.16
731.62
682.16
362.83
538.64
1349.80
828.65
828.65
165.73
1099.68
1053.03
836.06
837.20
1033.68
438.28
219.14
551.00
762.31
976.00
653.61
1022.90
1022.90
1022.90
1022.90
773.96
949.35
1005.78
1005.78
201.15
485.41
996.69
1008.94
2063.03
2063.03
412.59
326.04
1134.66
226.93
909.87
1089.89
217.97
1027.83
1034.41
1467.95
293.59
1153.53
2405.66
1629.12
325.84
1051.49
1051.49
1001.09
1109.13
386.75
820.03
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102.22
450.97
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235.27
563.37
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493.26
246.63
679.43
581.08
806.03
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656.10
953.75
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682.65
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326.04
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475.90
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524.54
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558.47
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433.25
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547.77
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320.27
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535.80
535.80
463.56
719.56
529.48
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529.47
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75.85
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70.00
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69.38
55.49
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72.54
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44.43
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57.09
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50.10
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0.00
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624.62
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542.97
542.97
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540.83
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329.61
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551.00
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673.74
539.97
415.17
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652.30
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551.00
799.25
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1035.83
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557.03
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301.85
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0.00
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450.97
265.41
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0.00
244.79
122.39
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1451.86
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533.69
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640.90
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397.97
411.78
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597.93
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403.83
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339.53
485.41
811.53
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353.60
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344.56
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294.47
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1449.34
710.41
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26.50
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261.56
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50.08
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2667.36
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281.73
312.34
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27.96
56.60
56.60
168.72
657.89
653.61
378.81
158.34
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317.90
153.75
740.60
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486.26
0.00
171.12
66.94
131.69
138.43
69.21
96.01
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431.60
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514.68
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349.09
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550.41
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389.86
0.00
0.00
107.14
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421.60
485.41
872.97
551.00
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128.45
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289.26
463.56
621.51
0.00
450.97
0.00
137.29
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223.00
318.97
315.44
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267.48
289.62
272.76
0.00
0.00
0.00
203.01
610.57
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136.79
193.38
255.46
232.72
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548.63
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551.00
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126.69
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300.42
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374.38
471.36
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327.38
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192.53
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341.50
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260.87
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238.12
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304.33
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306.71
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439.79
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1190.79
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67.59
333.00
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514.43
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250.80
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523.51
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636.49
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0.00
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263.05
263.04
0.00
1116.31
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0.00
291.68
266.85
279.21
446.00
734.45
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63.19
640.26
126.24
108.73
344.92
139.35
204.10
223.37
378.81
339.03
378.81
400.50
400.50
400.50
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520.14
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398.40
199.20
398.40
224.15
454.65
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514.78
1733.45
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551.00
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367.61
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488.02
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543.19
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379.45
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344.93
71.12
489.68
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159.42
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390.98
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139.50
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653.60
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429.52
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311.51
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532.30
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259.23
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42.67
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210.55
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256.97
256.97
13.07
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714.24
142.85
738.49
551.00
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286.86
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0.00
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463.57
338.25
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356.50
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608.52
473.00
540.59
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545.56
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316.11
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611.21
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398.25
464.43
202.09
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414.30
414.30
0.00
429.94
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118.45
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95.11
504.34
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227.44
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45.49
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373.56
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626.07
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645.92
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67.02
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101.86
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432.83
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980.62
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310.85
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377.28
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0.00
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744.78
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605.10
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440.70
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744.79
498.94
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567.11
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0.00
1690.00
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0.00
105.62
306.97
699.48
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198.27
838.07
866.61
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480.58
485.41
825.31
203.71
1249.83
0.00
127.32
68.62
69.01
337.33
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2364.52
2147.12
429.93
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2238.05
0.00
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0.00
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3110.63
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784.90
1752.45
3224.10
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947.99
247.05
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920.88
2016.06
2121.86
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1014.14
268.28
1031.28
748.07
1422.79
1598.12
319.63
1101.55
1420.63
710.31
239.38
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691.12
992.43
1224.55
967.94
1269.16
1058.70
767.93
224.15
468.50
887.33
144.01
378.81
173.24
172.19
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78.44
218.96
378.81
43.02
338.45
74.88
529.48
298.00
184.57
308.44
231.30
231.80
529.47
224.29
224.29
529.47
258.55
235.86
214.97
204.10
457.07
296.52
1493.33
298.66
1465.46
1403.73
701.87
701.86
1323.51
1273.19
1195.01
1792.51
1792.51
1792.51
597.50
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238.99
238.99
326.04
275.69
413.53
413.53
413.53
137.84
275.69
55.13
2338.31
1653.73
2480.60
545.87
330.75
529.48
0.00
0.00
0.00
0.00
3808.46
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1078.41
215.68
1117.52
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431.36
313.30
289.72
144.86
289.72
289.72
57.94
1248.35
249.67
1815.12
1655.10
827.55
1655.10
850.82
331.02
354.17
89.04
160.94
70.83
1503.84
222.66
1923.00
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364.80
529.47
346.77
173.39
1077.44
1219.33
1758.22
1507.75
301.55
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2211.50
365.64
182.82
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274.30
648.80
4013.85
333.00
416.90
208.45
416.90
274.30
336.59
166.29
336.23
204.10
2212.21
919.02
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100.54
0.00
99.71
149.69
53.46
53.46
156.53
160.75
240.87
224.15
131.12
196.68
131.12
141.30
40.29
144.78
30.08
72.39
74.23
69.91
90.17
33.20
66.40
230.19
344.92
184.17
206.31
0.00
194.11
315.35
138.02
319.39
498.59
204.10
142.78
79.62
136.52
78.89
80.09
151.45
450.97
201.09
333.00
19.20
0.00
160.57
240.85
80.28
172.17
364.48
344.93
117.20
296.52
126.58
243.74
364.44
496.95
287.23
500.22
219.02
500.22
282.70
92.93
92.93
463.56
319.58
446.00
338.75
508.12
169.38
266.21
266.21
67.75
485.41
390.65
485.41
240.83
551.00
744.78
400.45
361.08
165.98
485.41
608.36
304.18
688.01
95.59
313.30
686.70
297.92
299.48
0.00
682.46
846.20
887.61
997.85
0.00
326.04
326.04
591.40
326.04
532.61
687.28
643.35
326.04
699.73
326.04
1010.61
326.04
1180.83
421.16
606.76
485.41
674.41
529.47
709.45
287.23
554.51
287.23
58.97
47.06
60.35
575.03
463.56
369.60
405.93
558.40
326.04
814.36
959.41
543.79
543.79
543.79
512.63
240.88
224.15
404.85
144.60
224.15
444.33
159.24
88.87
224.15
217.87
217.87
78.30
18.14
350.65
313.34
899.78
872.75
326.04
943.53
188.70
129.06
326.04
1190.54
238.10
326.04
1249.82
249.97
326.04
0.00
0.00
2212.21
587.30
346.52
541.66
712.47
356.24
142.50
731.38
967.12
967.12
147.10
73.55
224.15
147.10
220.65
27.57
224.15
448.30
551.00
465.64
232.82
224.15
706.40
326.04
423.01
634.52
423.01
326.04
262.36
224.15
442.19
326.04
471.74
235.87
451.85
491.78
245.89
386.75
603.98
134.92
326.04
326.04
224.15
224.15
326.04
326.04
326.04
869.43
1304.15
249.07
869.43
99.63
326.04
1066.29
131.41
657.05
326.04
931.25
231.53
121.89
186.25
326.04
577.44
165.05
66.02
446.00
478.09
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39.67
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57.20
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31.22
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3.52
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2.70
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26.40
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14.38
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40.53
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26.37
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39.55
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131.84
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46.14
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26.37
13.18
11.87
19.78
164.80
56.69
79.10
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56.16
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259.56
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527.36
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32.43
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131.84
32.96
72.51
18.46
143.18
97.04
115.49
161.63
276.86
69.34
27.68
15.82
59.33
138.43
252.08
336.19
448.00
276.86
369.15
461.44
207.78
203.04
39.55
304.00
0.00
364.14
79.10
38.00
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0.00
57.68
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527.36
527.36
593.28
593.28
436.38
436.38
738.30
738.30
0.00
131.84
404.70
131.84
28.50
54.15
19.78
19.78
19.78
19.78
53.26
35.15
66.70
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111.01
69.34
91.23
131.84
249.44
249.44
249.44
57.68
57.68
0.00
0.00
167.70
167.70
154.78
154.78
231.00
205.00
101.02
335.70
45.62
45.62
397.10
0.00
0.00
0.00
511.28
2053.54
1205.55
2590.13
490.98
0.00
0.00
1200.00
0.00
0.00
0.00
0.00
0.00
329.60
259.56
448.26
259.56
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369.15
369.15
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259.56
527.36
259.56
0.00
395.52
64.61
0.00
97.04
129.17
0.00
64.96
52.74
98.88
98.88
131.84
177.98
197.76
72.51
357.28
55.10
129.96
54.35
152.65
0.00
57.68
75.60
77.90
249.44
498.62
1340.82
39.06
200.00
295.58
241.70
0.00
58.39
81.91
425.83
701.10
779.00
0.00
1977.60
553.73
284.05
0.00
3164.16
1197.00
1197.00
957.60
1197.00
1437.35
1558.00
90.52
0.00
158.21
114.14
0.00
0.00
0.00
421.89
92.29
26.37
0.00
6.59
4.75
161.63
46.14
18.05
0.00
39.55
14.50
0.00
0.00
0.00
0.00
0.00
131.84
115.49
13.18
0.00
0.00
0.00
0.00
0.00
18.50
38.50
97.98
53.26
36.00
43.00
21.50
0.00
56.89
61.56
70.00
70.00
12.00
115.89
303.75
387.12
38.72
52.02
121.55
213.53
75.71
19.40
26.43
32.86
17.87
76.00
106.00
144.38
101.24
101.24
101.24
9.97
300.00
306.01
0.00
18.00
26.43
51.96
2.50
2.50
351.06
0.00
0.00
179.65
48.00
496.47
0.00
0.00
110.00
0.00
0.00
25.00
75.00
15.00
50.00
50.00
25.00
20.00
0.00
0.00
84.66
795.00
79.50
0.00
1100.00
110.00
0.00
130.62
1100.00
1000.00
0.00
100.00
100.00
95.00
0.00
0.00
0.00
275.10
100.00
10.00
125.50
0.00
20.90
0.00
0.00
31.42
18.20
18.20
0.00
26.00
107.00
307.55
30.11
188.76
0.00
672.00
0.00
900.00
111.71
200.00
874.39
74.00
580.00
315.44
315.44
620.00
0.00
0.00
2104.97
720.22
88.87
802.29
5056.67
523.95
150.90
295.17
421.48
268.17
384.55
57.88
0.00
375.00
62.50
331.66
75.00
347.71
4.29
0.00
101.00
3364.35
327.72
3342.55
3577.94
0.00
72.39
15.85
252.64
2526.40
394.84
4180.54
0.00
0.00
301.60
58.00
5.80
55.00
502.63
45.00
45.00
125.00
12.50
18.43
0.00
22.73
0.00
175.00
30.00
25.00
2.50
35.94
3.60
0.00
578.46
99.15
17.18
17.97
17.04
202.18
202.18
98.58
0.00
50.00
90.98
20.00
77.00
27.00
47.00
99.77
99.77
50.00
29.00
0.00
42.71
43.80
4864.24
41.00
54.00
16.82
36.00
4113.02
4869.05
133.35
8741.27
8742.05
1143.79
114.70
134.07
255.58
206.54
206.54
600.00
717.00
71.70
0.00
120.67
0.00
143.81
0.00
0.00
129.88
660.00
585.00
400.00
40.00
475.00
550.00
465.00
450.00
0.00
0.00
475.00
47.50
550.00
545.65
56.16
0.00
2163.83
160.00
1928.95
660.00
66.00
585.00
58.50
660.00
50.00
468.97
88.92
404.09
0.00
0.00
198.45
0.00
0.00
0.00
0.00
81.74
643.19
373.10
503.00
32.67
40.68
43.35
6.55
40.91
5.88
30.41
30.41
0.00
10.08
0.00
41.85
29.95
25.55
0.00
0.00
0.00
1170.24
1170.24
2369.20
2369.20
336.27
0.00
2342.55
69.16
0.00
3093.89
0.00
112.34
142.40
189.91
114.53
244.08
379.27
8052.84
136.42
738.13
0.00
856.56
485.71
485.71
68.94
137.45
80.91
49.50
150.51
67.49
20.50
0.00
69.46
57.28
7106.66
0.00
0.00
88.65
223.04
188.41
321.69
419.93
295.60
0.00
312.35
393.04
492.26
492.26
452.32
51.32
547.70
547.70
299.68
302.14
0.00
34.39
0.00
27.35
15.88
0.00
0.00
0.00
0.00
46.44
45.44
20.84
13.23
10.57
85.93
17.19
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
34.80
66.56
5.00
3.28
0.02
2.88
4.62
27.00
1.85
5.00
15.84
14.39
4.45
3.74
5.00
3.79
10.22
83.15
5.00
1.70
2.40
6.11
7.40
5.48
53.54
4.43
0.25
5.41
5.00
30.00
6.71
13.85
28.65
55.04
5.00
7.09
0.00
9.25
14.04
6.11
7.40
12.52
3.45
5.00
10.57
5.00
3.37
0.17
6.13
15.20
1.02
3.00
4.02
2.54
0.75
4.39
2.43
4.85
8.05
8.58
5.13
4.00
2.40
2.37
405.63
1.99
0.00
0.06
0.00
7.75
3.45
9.25
2.79
4.67
3.21
6.26
8.81
2.48
1.65
5.00
9.90
1.08
7.00
0.00
0.00
0.00
10.00
10.00
8.45
10.00
10.00
10.00
10.51
132.69
11.95
0.00
200.00
57.08
200.00
4.96
25.00
134.55
31.45
500.58
200.00
200.00
321.52
58.74
200.00
200.00
0.00
52.10
0.00
127.47
1763.39
0.00
0.00
0.00
169.55
0.00
0.00
0.00
512.28
0.00
0.00
0.00
46.20
16.42
46.46
43.58
23.14
23.14
76.24
76.24
55.57
34.74
19.53
16.64
92.44
92.32
95.10
44.46
95.30
183.16
62.72
38.80
0.00
0.00
723.19
1730.82
0.00
2.65
136.24
0.00
13.41
1292.77
2084.22
1563.91
2147.61
3671.60
336.74
0.00
0.00
0.00
0.00
0.00
0.00
0.00
567.23
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
24.24
49.18
81.35
157.19
106.09
206.79
309.85
401.24
829.51
1136.56
1353.07
1473.83
75.19
44.59
394.25
72.72
0.00
275.03
1025.56
1264.72
100.08
151.29
17.53
66.76
1356.46
190.61
0.00
100.86
341.82
171.76
1084.26
686.66
80.52
108.30
65.85
457.65
850.47
726.19
1256.23
705.06
870.73
250.55
823.25
775.35
80.12
353.98
90.53
455.42
337.57
272.48
247.55
855.68
381.17
696.82
562.61
728.08
417.24
535.64
449.46
335.54
3930.31
878.96
1257.93
1467.53
1253.79
629.90
875.12
493.59
591.33
117.53
86.36
112.20
263.70
50.00
50.60
65.76
60.78
87.95
62.95
267.48
155.72
118.20
40.43
98.35
340.86
168.96
313.27
171.01
417.19
714.74
51.93
220.91
127.42
130.17
82.40
157.03
88.23
70.57
131.29
127.75
116.00
96.37
39.24
276.91
847.09
917.60
552.29
178.32
338.52
216.19
235.51
267.65
1290.44
1287.64
220.41
289.77
108.83
160.36
82.73
105.77
50.94
23.86
73.71
80.29
65.45
65.37
70.72
43.85
50.15
0.00
247.83
104.34
127.44
137.45
137.45
156.52
156.52
60.20
0.00
37.12
37.12
58.19
25.09
25.09
25.09
32.90
40.14
0.00
137.32
106.93
0.00
175.59
129.75
44.26
58.37
309.05
0.00
324.17
210.71
100.18
0.00
0.00
31.17
65.87
109.64
59.69
31.17
5.20
5.20
40.13
39.13
12.69
12.69
5.20
145.88
83.27
32.11
7.50
17.31
49.16
21.39
37.00
23.08
25.09
25.00
12.06
33.11
19.04
51.20
19.04
50.62
51.94
0.00
49.05
558.89
368.36
358.40
197.29
276.85
962.85
291.06
44.14
91.82
42.38
0.00
566.12
214.29
288.52
444.32
266.21
31.42
0.00
495.73
246.93
76.14
86.01
70.64
0.00
0.00
69.19
208.43
128.33
19.06
145.51
761.69
1226.75
2475.48
2319.92
2945.38
2279.69
2786.00
3320.85
3493.94
3036.50
2940.00
3342.16
4524.65
4680.07
2211.76
2952.05
3085.71
5224.82
435.64
1150.85
1859.84
1368.21
1589.14
1707.18
2053.17
2027.15
2263.47
2270.92
2221.93
1292.11
1990.24
1368.38
1452.27
510.30
444.32
444.32
444.32
585.00
585.00
585.00
339.82
414.83
469.82
178.07
249.07
204.34
308.91
512.45
1342.49
565.08
641.18
570.38
637.93
622.16
1948.55
459.41
1284.13
407.91
477.78
316.15
245.95
304.83
291.59
488.03
438.85
74.85
107.98
290.15
461.09
239.14
587.53
378.48
527.22
42.46
489.59
261.77
1066.68
511.72
1089.08
43.16
123.06
43.33
61.59
86.53
142.08
193.98
174.38
178.02
64.38
95.98
2297.57
2759.22
3490.83
429.83
768.01
752.87
1116.35
434.79
455.65
472.50
729.78
1614.00
1987.29
3244.65
3420.58
464.55
768.85
1148.09
431.09
638.58
483.22
3011.66
777.29
779.37
1365.67
1465.07
2532.42
2264.70
1670.18
2813.48
1453.47
871.99
136.79
275.65
23097.62
387.27
567.35
359.29
2729.48
536.37
831.92
1030.84
508.76
751.06
3314.34
182.54
205.10
343.61
15676.01
212.57
375.95
486.81
272.93
1829.90
3145.13
2401.93
539.18
228.98
536.47
5833.57
1619.98
1471.18
0.00
1200.35
1201.28
1845.45
1893.37
2009.86
2266.11
2554.83
2649.39
3190.40
2561.61
1541.11
1780.89
2262.38
2805.98
1317.83
1785.42
1975.73
200.57
198.05
0.00
155.70
66.18
269.03
606.96
3434.89
413.98
142.34
230.45
52.10
177.43
388.86
2505.96
156.42
323.00
339.16
74.26
82.78
49.25
51.28
142.69
100.06
105.19
248.09
242.91
279.54
519.73
462.58
546.73
572.11
276.83
570.62
2302.20
660.81
550.65
1199.72
518.60
362.56
653.14
1291.40
932.88
2145.13
383.82
199.46
3315.24
2514.77
2405.70
147.84
447.81
1239.97
1202.18
502.05
6205.50
6940.42
10520.58
15154.66
4138.41
4222.48
32758.24
3118.11
3368.10
5066.58
193.12
423.09
573.95
315.70
409.27
0.00
0.00
0.00
0.00
662.98
0.00
0.00
0.00
0.00
0.00
30.09
267.52
3341.43
2730.23
2032.58
13.47
18.47
18.75
60.97
16.68
18.31
19.34
35.43
61.64
52.16
13.47
13.47
8.92
0.00
623.48
532.01
514.07
16189.65
0.00
372.49
0.00
0.00
0.00
15.14
17.84
3.00
0.00
59.07
36.28
9.12
0.00
0.00
350.00
0.00
0.00
0.00
32.12
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
57.00
35.00
21.50
21.50
0.00
53.99
0.00
48.25
47.50
44.13
49.06
29.19
34.51
33.80
43.53
42.70
40.95
46.04
59.53
64.07
72.68
79.10
80.96
0.00
47.50
50.01
56.83
46.63
47.46
49.53
50.62
47.16
52.36
69.04
59.19
59.23
61.16
65.35
67.15
76.58
112.81
65.50
65.50
0.00
62.01
81.21
81.60
58.94
57.54
85.72
64.43
75.39
85.87
86.96
90.83
95.69
117.64
65.50
65.50
0.00
84.84
98.26
0.00
81.49
132.39
142.50
152.60
210.10
169.12
150.00
154.83
188.95
147.59
244.22
439.07
0.00
0.00
0.00
0.00
1400.00
64.05
307.63
213.33
1500.00
302.14
0.00
350.00
350.00
42.48
63.78
10.53
26.15
22.55
17.95
11.22
20.41
28.24
0.00
14.53
48.34
10.05
0.00
52.20
58.86
41.01
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
465.00
0.00
600.00
600.00
0.00
0.00
0.00
600.00
1200.00
0.00
0.00
0.00
525.00
0.00
0.00
525.00
0.00
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40.00
0.00

				
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