[Federal Register: September 8, 1998 (Volume 63, Number 173)] [Proposed Rules] [Page 47601-47650] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr08se98-35] [[pp. 47601-47650]] Medicare Program; Prospective Payment System for Hospital Outpatient Services [[Continued from page 47600]] [[Page 47601]] [GRAPHIC] [TIFF OMITTED] TP08SE98.002 [[Page 47602]] [GRAPHIC] [TIFF OMITTED] TP08SE98.003 [[Page 47603]] [GRAPHIC] [TIFF OMITTED] TP08SE98.004 [[Page 47604]] [GRAPHIC] [TIFF OMITTED] TP08SE98.005 BILLING CODE 4120-01-C [[Page 47605]] XI. Delay in Implementation Date Like other public and private organizations that depend upon the smooth functioning of computer systems, the Medicare program faces the challenge making changes to assure that computers can recognize dates in the year 2000 and later. Computer programming, which has commonly employed only two digits to record the year in the date for transactions and other entries, will not be able to distinguish the year 2000 from the year 1900 without reprogramming. Such confusion in the context of Medicare enrollment and claims processing could create massive errors, as computers could mistakenly determine that beneficiaries are not eligible for benefits or that services were rendered before the effective date of benefit provisions. For Medicare, achieving year 2000 (Y2K) compliance involves renovating all computer and information systems. The year 2000 especially affects HCFA because of our extensive reliance on multiple computer systems. More than 183 systems are used in administering the Medicare and Medicaid programs, and 98 of these are considered ``mission critical'' for establishing beneficiary eligibility and making payments to providers, plans, and states. Medicare is the most automated health care payer in the country. The Medicare program processes nearly one billion claims each year, or about 17 million transactions each week. Fully 98 percent of inpatient hospital and other Medicare Part A claims are processed electronically, as are 85 percent of physician and other Medicare Part B claims. The renovation process is complicated because each piece in the systems used by Medicare, its 60-plus claims processing contractors, interfaces with state Medicaid programs, and some 1.6 million providers must be thoroughly reviewed and renovated by those responsible for each particular system. Programs must be tested, both alone and for the complicated interfaces among them. To fix only the Medicare systems, 49 million lines of code must be renovated. All Medicare-specific software must be renovated, and tested to assure that it continues to work with new versions of vendor-supplied software, including operating systems that drive the hardware. Some hardware must be upgraded, and our telecommunications equipment and software must be compliant. We must assure that all data exchanges with thousands of partners are compliant. Testing of year 2000 changes presents a far greater burden than testing of routine system changes because we must test multiple times on a range of different dates. For example, February 29, 2000 and March 1, 2000 must both be tested because CY 2000 is a leap year. Because this process is necessary to keep program payments going out to beneficiaries and providers, year 2000 work must take precedence over other projects that require systems changes, including some Balanced Budget Act provisions. The Y2K project must be completed before other projects simply because activity on these other projects would divert resources from the Y2K project and could even compromise the effort to assure Y2K compliance if implemented in tandem. Many other private and public organizations, including most major insurance companies, have reached the same conclusion and are halting other projects involving information technology changes to clear the decks for the year 2000. HCFA's independent year 2000 verification and validation contractor, Intermetrics, has advised the agency to delay all projects that could interfere with year 2000 work. Intermetrics specifically advised the agency to ``seek necessary relief from Congressional mandates, system transitions and version releases to allow near-term, focused attention to achieving Y2K compliant systems.'' This includes projects that are complex, or which would occur during a critical window between October 1999 and March 2000. Otherwise, they warned, ``many of your most critical system renovations have risk of significant schedule slippage.'' Implementation of outpatient PPS is one of the projects that must be delayed by the year 2000 system renovations, because it requires massive system changes. Major contractor systems will be affected: the Fiscal Intermediary Standard Systems (FISS), the Arkansas Part A Standard System (APASS), the Common Working File (CWF), the Outpatient Code Editor (OCE), and the various systems operated by Fiscal Intermediaries and their corporate entities. Several HCFA systems will also be affected, including the National Claims History (NCH), the Provider Statistical & Reimbursement System (PS&R), and the Electronic Data Interchange (EDI). The scope of the required changes is also substantial. Among the required changes are: Expansion of the claim record of FISS, APASS, EDI, NCH and CWF to accept and retain specific information related to how a service is being paid or why it's denied. Conversion of all claims history to correspond with expanded format. Rewriting the program for FISS to process claims using line item dates of service. Rewriting the program for CWF to accept non covered charges by claim and line item. Developing, installing and testing an outpatient PRICER which determines payment amounts based on the HCFA Common Procedural Codes (HCPCS). Revision of interfaces with the fiscal intermediaries, providers, Billing Agents, EDI, OCE, PS&R and NCH and create an interface for PRICER. Developing, installing and testing a program to calculate the variable co-insurance per payment code grouping for each provider who elects to accept a reduced co-insurance. Revision of all claims processing output and interfaces including: Medicare Summary Notices (MSN), Beneficiary Denial Letters (BDL), Explanation of Medicare Benefits (EOMB), Notice of Utilization (NOU), Remittance Advice (RA). The consequence of all these required changes to basic systems will be to change the entire way Fiscal Intermediaries process and pay hospital outpatient and community mental health center claims. There is also a major impact on the many systems that are required to receive this revised output. Changes of this magnitude require massive testing by all of the systems maintainers as well as each Fiscal Intermediary. Additionally, the impact on the Fiscal Intermediary systems has a domino effect. The intermediaries are doing business for Medicare under the auspices of their respective corporate entities. These corporate systems must be modified to accept, edit and relay the new information necessary to process outpatient PPS claims. They are also working toward becoming millennium compliant and competing for the same resources to scope, program, test and rework these changes, as well as the multitude of other BBA changes and Y2K. In the light of this, HCFA has no choice but to suspend implementing such massive change while the Intermediaries, their respective corporate entities, the standard systems maintainers as well as the provider community are working diligently to become Y2K compliant. It would be irresponsible to continue activity that would create a real danger that basic enrollment and claims processing activities will be disrupted, with far worse consequences for providers and beneficiaries than delay in implementation of outpatient PPS will cause. [[Page 47606]] We analyzed whether existing systems could be used to mimic processing of bills under the outpatient PPS. In every case, there were insuperable obstacles. In no case, for example, could these other systems compute the coinsurance correctly: the other available systems compute coinsurance as 20 percent of charges or 20 percent of a fee schedule amount. We have therefore reluctantly concluded that there is no alternative to a delay in implementation. As previously noted, the outpatient PPS will be implemented as soon as possible after January 1, 2000. A notice of the anticipated implementation date will be published in the Federal Register at least 90 days in advance. We expect that there will be no negative impact on hospitals generally from the delay in implementation. The effect on individual hospitals will, of course, vary depending on how their current cost- based reimbursement compares to the total payments they would receive under the proposed system. Hospitals altogether should receive about the same level of Medicare program payments under the existing payment system, as they would have received in program payments under the outpatient PPS. When beneficiary coinsurance is taken into account, we expect that hospitals generally will receive about 3.8 percent more in total payments under the existing payment system, than they would have received in total payments under the outpatient PPS. We should note that payment rates will be established at the level they would have been if the PPS had been implemented on January 1, 1999. The major impact of the delay in implementation will be on beneficiaries who will continue to pay coinsurance based on 20 percent of the hospital's charges. In the aggregate, we estimate beneficiary coinsurance would have been 6.9 percent lower under the outpatient prospective payment system in 1999 than under the current system. Under the prospective payment system, coinsurance will be based on our estimate of the median coinsurance amount for each APC under the current system in 1999. In the aggregate, estimated median coinsurance amounts are 6.9 percent lower than estimated mean coinsurance amounts for each APC. The actual impact will depend on the extent to which hospitals raise their charges in 1999. For example, the impact on beneficiaries would be moderated if hospitals show restraint in increasing charges (which have been increasing more rapidly than cost). We will actively encourage hospitals to voluntarily restrain from increasing their current charges. The actual impact on a given beneficiary will also depend on the hospital's charge structure relative to national charge levels. A beneficiary receiving services from a hospital with relatively low charges could be advantaged by the delay whereas a hospital with relatively high charges would be disadvantaged by the delay. We note that the impact will not be carried over to the prospective payment system. List of Subjects 42 CFR Part 409 Health facilities, Medicare. 42 CFR Part 410 Health facilities, Health professions, Kidney diseases, Laboratories, Medicare, Rural areas, X-rays. 42 CFR Part 411 Kidney diseases, Medicare, Reporting and recordkeeping requirements. 42 CFR Part 412 Administrative practice and procedure, Health facilities, Medicare, Puerto Rico, Reporting and recordkeeping requirements. 42 CFR Part 413 Health facilities, Kidney diseases, Medicare, Puerto Rico, Reporting and recordkeeping requirements. 42 CFR Part 419 Health facilities, Hospitals, Medicare. 42 CFR Part 489 Health facilities, Medicare, Reporting and recordkeeping requirements. 42 CFR Part 498 Administrative practice and procedure, Health facilities, Health professions, Medicare, Reporting and recordkeeping requirements. 42 CFR Part 1003 Administrative practice and procedure, Archives and records, grant program--social programs, Maternal and Child Health, Medicaid, Medicare, Penalties. For the reasons set forth in the preamble, 42 CFR chapters IV and V would be amended as follows: PART 409--HOSPITAL INSURANCE BENEFITS A. Part 409 is amended as set forth below: 1. The authority citation for part 409 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395(hh)). Subpart B--Inpatient Hospital Services and Inpatient Critical Access Hospital Services 2. In Sec. 409.10, paragraph (b) is revised to read as follows: Sec. 409.10 Included services. * * * * * (b) Inpatient hospital services does not include the following types of services: (1) Post-hospital SNF care, as described in Sec. 409.20, furnished by a hospital or a critical access hospital that has a swing-bed approval. (2) Nursing facility services, described in Sec. 440.155 of this chapter, that may be furnished as a Medicaid service under title XIX of the Act in a swing-bed hospital that has an approval to furnish nursing facility services. (3) Physician services that meet the requirements of Sec. 415.102(a) of this chapter for payment on a fee schedule basis. (4) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act. (5) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. (6) Certified nurse mid-wife services, as defined in section 1861(gg) of the Act. (7) Qualified psychologist services, as defined in section 1861(ii) of the Act. (8) Services of an anesthetist, as defined in Sec. 410.69 of this chapter. PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS B. Part 410 is amended as set forth below: 1. The authority citation for part 410 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395(hh)), unless otherwise indicated. Subpart A--General Provisions 2. In Sec. 410.2, the following definitions are added in alphabetical order to read as follows: Sec. 410.2 Definitions. As used in this part-- * * * * * Encounter means a direct personal contact between a patient and a physician, or other person who is authorized by State licensure law and, if applicable, by hospital or CAH staff bylaws, to order or furnish hospital services for diagnosis or treatment of the patient. * * * * * [[Page 47607]] Outpatient means a person who has not been admitted as an inpatient but who is registered on the hospital or CAH records as an outpatient and receives services (rather than supplies alone) directly from the hospital or CAH. * * * * * Subpart B--Medical and Other Health Services 3. In Sec. 410.27, the section heading is revised, the introductory text to paragraph (a) is revised, the introductory text to paragraph (a)(1) is republished, and new paragraphs (a)(1)(iii), (e), and (f) are added to read as follows: Sec. 410.27 Outpatient hospital services and supplies incident to a physician service: Conditions. (a) Medicare Part B pays for hospital services and supplies furnished incident to a physician service to outpatients, including drugs and biologicals that cannot be self-administered, if-- (1) They are furnished-- * * * * * (iii) In the hospital or at a location (other than an RHC or an FQHC) that HCFA designates as qualifying as a department of a provider under Sec. 413.65 of this chapter; and * * * * * (e) Services furnished by an entity other than the hospital are subject to the limitations specified in Sec. 410.39(a). (f) Services furnished at a location (other than an RHC or an FQHC) that HCFA designates as having provider-based status under Sec. 413.65 of this chapter must be under the direct supervision of a physician as defined in Sec. 410.32(b)(3)(ii). 4. In Sec. 410.28, paragraph (a)(4) is removed, paragraph (c) is redesignated as paragraph (d), and new paragraphs (c) and (e) are added to read as follows: Sec. 410.28 Hospital or CAH diagnostic services furnished to outpatients: Conditions. * * * * * (c) Diagnostic services furnished by an entity other than the hospital or CAH are subject to the limitations specified in Sec. 410.39(a). * * * * * (e) Medicare Part B makes payment under section 1833(t) of the Act for diagnostic tests performed at a facility (other than an RHC or an FQHC) that HCFA designates as having provider-based status only when the diagnostic tests are furnished under the appropriate level of physician supervision specified by HCFA in accordance with the definitions in Sec. 410.32(b)(3)(i), (b)(3)(ii), and (b)(3)(iii). 5. A new Sec. 410.39 is added to read as follows: Sec. 410.39 Limitations on coverage of certain services furnished to hospital outpatients. (a) Except as provided in paragraph (c) of this section, Medicare Part B does not pay for any item or service that is furnished to a hospital outpatient (as defined in Sec. 410.2) during an encounter (as defined in Sec. 410.2) by an entity other than the hospital unless the hospital has an arrangement (as defined in Sec. 409.3 of this chapter) with that entity to furnish that particular service to its patients. (b) As used in paragraph (a) of this section, the term ``hospital'' includes a CAH. (c) The limitations stated in paragraphs (a) and (b) of this section do not apply to the following services: (1) Physician services that meet the requirements of Sec. 415.102(a) of this chapter for payment on a fee schedule basis. (2) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act. (3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. (4) Certified nurse mid-wife services, as defined in section 1861(gg) of the Act. (5) Qualified psychologist services, as defined in section 1861(ii) of the Act. (6) Services of an anesthetist, as defined in Sec. 410.69. PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT C. Part 411 is amended as set forth below: 1. The authority citation for part 411 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395(hh)). Subpart A--General Exclusions and Exclusion of Particular Services 2. In Sec. 411.15, the introductory text is republished; the section heading to paragraph (m) is revised; paragraph (m)(1) is revised; the introductory text to paragraph (m)(2) is republished; paragraphs (m)(2)(iii), (m)(2)(iv), and (m)(2)(v) are redesignated as paragraphs (m)(2)(iv), (m)(2)(v), and (m)(2)(vi), respectively; and new paragraphs (m)(2)(iii) and (m)(3) are added to read as follows: Sec. 411.15 Particular services excluded from coverage. The following services are excluded from coverage. * * * * * (m) Services to hospital patients--(1) Basic rule. Except as provided in paragraph (m)(2) of this section, any service furnished to an inpatient of a hospital or to a hospital outpatient (as defined in Sec. 410.2 of this chapter) during an encounter (as defined in Sec. 410.2 of this chapter) by an entity other than the hospital, unless the hospital has an arrangement (as defined in Sec. 409.3 of this chapter) with that entity to furnish that particular service to the hospital's patients. (As used in this paragraph (m)(1), the term ``hospital'' includes a CAH.) (2) Exceptions. The following services are not excluded from coverage: * * * * * (iii) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. * * * * * (3) Scope of exclusion. Services subject to exclusion under the provisions of this paragraph (m) include, but are not limited to, clinical laboratory services; pacemakers and other prostheses and prosthetic devices (other than dental) that replace all or part of an internal body organ (for example, intraocular lenses); artificial limbs, knees, and hips; equipment and supplies covered under the prosthetic device benefits; and services incident to a physician service. * * * * * PART 412--PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES D. Part 412 is amended as set forth below: 1. The authority citation for part 412 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395(hh)). Subpart C--Conditions for Payment Under the Prospective Payment Systems for Inpatient Operating Costs and Inpatient Capital-Related Costs 2. In Sec. 412.50, paragraphs (a) and (b) are revised to read as follows: Sec. 412.50 Furnishing of inpatient hospital services directly or under arrangements. (a) The applicable payments made under the prospective payment systems, as described in subparts H and M of this part, are payment in full for all inpatient hospital services, as defined in Sec. 409.10 [[Page 47608]] of this chapter. Inpatient hospital services do not include the following types of services: (1) Physician services that meet the requirements of Sec. 415.102(a) of this chapter for payment on a fee schedule basis. (2) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act. (3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. (4) Certified nurse mid-wife services, as defined in section 1861(gg) of the Act. (5) Qualified psychologist services, as defined in section 1861(ii) of the Act. (6) Services of an anesthetist, as defined in Sec. 410.69 of this chapter. (b) HCFA does not pay any provider or supplier other than the hospital for services furnished to a beneficiary who is an inpatient, except for the services described in paragraphs (a)(1) through (a)(6) of this section. * * * * * PART 413--PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES E. Part 413 is amended as set forth below: 1. The authority citation for part 413 continues to read as follows: Authority: Secs. 1102, 1861(v)(1)(A), and 1871 of the Social Security Act (42 U.S.C. 1302, 1395x(v)(1)(A), and 1395hh). Subpart A--Introduction and General Rules Sec. 413.1 [Amended] 2. In Sec. 413.1, paragraph (a)(2)(viii) is removed. Subpart B--Accounting Records and Reports 3. In Sec. 413.24, the heading to paragraph (d) is published, and a new paragraph (d)(6) is added to read as follows: Sec. 413.24 Adequate cost data and cost finding. * * * * * (d) Cost finding methods. * * * (6) Management contracts. (i) If the main provider purchases services for a department of the provider or a provider-based entity through a management contract or otherwise directly assigns costs to the department or entity, the like costs of the main provider must be carved out to ensure that they are not allocated to the department of the provider or provider-based entity. However, if the like costs of the main provider cannot be separately identified, the costs of the services purchased through a management contract must be included in the main provider's administrative and general costs and allocated among the provider's overall statistics. (ii) Costs of free-standing entities may not be shown in the provider's trial balance for purposes of stepping down overhead costs to such entities. The provider must develop detailed work papers showing the exact cost of the services (including overhead) provided to or by the free-standing entity and show those carved out costs as non- reimbursable cost centers in the provider's trial balance. * * * * * Subpart E--Payments to Providers 4. A new Sec. 413.65 is added to read as follows: Sec. 413.65 Requirements for a determination that a facility or an organization is a department of a provider or a provider-based entity. (a) Definitions. In this subpart E, unless the context indicates otherwise-- Department of a provider means a facility or organization or a physician office that is either created by, or acquired by, a main provider for the purpose of furnishing health care services under the name, ownership, and financial and administrative control of the main provider, in accordance with the provisions of this section. A department of a provider may not be licensed to provide health care services in its own right, and Medicare conditions of participation do not apply to a department as an independent entity. For purposes of this part, the term ``department of a provider'' does not include an RHC or an FQHC. Free-standing facility means an entity that furnishes health care services to Medicare beneficiaries and that is not integrated with any other entity as a main provider, a department of a provider, or a provider-based entity. Main provider means a provider that either creates, or acquires ownership of, another entity to deliver additional health care services under its name, ownership, and financial and administrative control. Provider-based entity means a provider of health care services, or an RHC or an FQHC as defined in Sec. 405.2401(b) of this chapter, that is either created by, or acquired by, a main provider for the purpose of furnishing health care services under the name, ownership, and administrative and financial control of the main provider, in accordance with the provisions of this section. Provider-based status means the relationship between a main provider and a provider-based entity or a department of a provider, that complies with the provisions of this section. (b) Responsibility for obtaining provider-based determinations. (1) A facility or organization is not entitled to be treated as provider- based simply because it or the main provider believe it is provider- based. (2) A provider or a facility or organization must contact HCFA and the facility or organization must be determined by HCFA to be provider- based before the main provider begins billing for services of the facility or organization as if they were furnished by a department of the provider or provider-based entity, or before it includes costs of those services on its cost report. (3) A facility that is not located on the campus of a hospital and is used as a site of physician services of the kind ordinarily furnished in physician offices will be presumed to be a free-standing facility, unless it is determined by HCFA to have provider-based status. (c) Reporting. (1) A main provider that acquires a facility or organization for which it wishes to claim provider-based status, including any physician offices that a hospital wishes to operate as a hospital outpatient department or clinic, must report its acquisition of the facility or organization to HCFA and must furnish all information needed for a determination as to whether the facility or organization meets the requirements in paragraph (d) of this section for provider-based status. (2) A main provider that has had one or more facilities or organizations considered provider-based also must report to HCFA any material change in the relationship between it and any provider-based facility or organization, such as a change in ownership of the facility or organization or entry into a new or different management contract that could affect the provider-based status of the facility or organization. (d) Requirements. An entity must meet the following requirements to be determined by HCFA to be a provider-based entity or a department of a provider: (1) Licensure. The department of the provider and the main provider are operated under the same license, except in areas where the State requires a separate license for the department of [[Page 47609]] the provider. If a State health facilities' cost review commission or other agency that has authority to regulate the rates charged by hospitals or other providers in a State finds that a particular facility or organization is not part of a provider, HCFA will determine that the facility or organization does not have provider-based status. (2) Operation under the ownership and control of the main provider. The facility or organization seeking provider-based status is operated under the ownership and control of the main provider, as evidenced by the following: (i) The facility or organization is 100 percent owned by the provider. (ii) The main provider and the facility or organization seeking status as a department of the provider have the same governing body. (iii) The facility or organization is operated under the same organizational documents as the main provider. For example, the facility or organization seeking provider-based status must be subject to common bylaws and operating decisions of the governing body of the provider where it is based. (iv) The main provider has final responsibility for administrative decisions, final approval for contracts with outside parties, final approval for personnel actions, final responsibility for personnel policies (such as fringe benefits/code of conduct), and final approval for medical staff appointments in the facility or organization. (3) Administration and supervision. The reporting relationship between the facility or organization seeking provider-based status and the main provider must have the same frequency, intensity, and level of accountability that exists in the relationship between the main provider and one of its departments, as evidenced by compliance with all of the following requirements: (i) The facility or organization is under the direct supervision of the provider where it is located. (ii) The facility or organization is operated under the same monitoring and oversight by the provider as any other department of the provider, and is operated just as any other department of the provider with regard to supervision and accountability. The facility or organization director or individual responsible for daily operations at the entity-- (A) Maintains a day-to-day reporting relationship with a manager at the main provider; and (B) Is accountable to the governing body of the main provider, in the same manner as any department head of the provider. (iii) The following administrative functions of the facility or organization are integrated with those of the provider where the facility or organization is based: billing services, records, human resources, payroll, employee benefit package, salary structure, and purchasing services. Either the same employees or group of employees handle these administrative functions for the facility or organization and the main provider, or the administrative functions for both the facility or organization and the entity are-- (A) Contracted out under the same contract agreement; or (B) Handled under different contract agreements, with the contract of the facility or organization being managed by the main provider's billing department. (4) Clinical services. The clinical services of the facility or organization seeking provider-based status and the main provider are integrated as evidenced by the following: (i) Professional staff of the facility or organization have clinical privileges at the main provider. (ii) The main provider maintains the same monitoring and oversight of the facility or organization as it does for any other department of the provider. (iii) The medical director of the facility or organization seeking provider-based status maintains a day-to-day reporting relationship with the Chief Medical Officer or other similar official of the main provider, and is under the same type of supervision and accountability as any other director, medical or otherwise, of the main provider. (iv) Medical staff committees or other professional committees at the main provider are responsible for medical activities in the facility or organization including quality assurance, utilization review, and the coordination and integration of services, to the extent practicable, between the facility or organization seeking provider- based status and the main provider. (v) Medical records for patients treated in the facility or organization are integrated into a unified retrieval system (or cross reference) of the main provider. (vi) Inpatient and outpatient services of the facility or organization and the main provider are integrated, and patients treated at the facility or organization who require further care have full access to all services of the main provider and are referred where appropriate to the corresponding inpatient or outpatient department or service of the main provider. (5) Financial integration. The financial operations of the facility or organization are fully integrated within the financial system of the main provider, as evidenced by shared income and expenses between the main provider and the facility or organization. The costs of the facility or organization are reported in a cost center of the provider, and the financial status of the facility or organization is incorporated and readily identified in the main provider's trial balance. (6) Public awareness. The facility or organization seeking status as a department of a provider is held out to the public and other payers as part of the main provider. When patients enter the provider- based facility or organization, they are aware that they are entering the main provider and are billed accordingly. (7) Location in immediate vicinity. The facility or organization and the main provider are located on the same campus, except where the following requirements are met: (i) The facility or organization demonstrates a high level of integration with the main provider by showing that it meets all of the other provider-based criteria, and demonstrates that it serves the same patient population as the main provider, either by submitting records such as common patient lists and/or demographic data showing that a high percentage of patients of both the main provider and the applicant entity come from the same geographic area, or by submitting data substantiating that the patients served by the entity also receive services from the main provider (for example, the patients of an RHC receive inpatient hospital services from the main provider). (ii) A facility or organization is not considered to be in the ``immediate vicinity'' of the main provider if the facility or organization and the main provider are located in different States. (e) Provider-based status not applicable to joint ventures. A facility or organization cannot be considered provider-based if the entity is owned by two or more providers engaged in a joint venture. For example, where a hospital has jointly purchased or jointly created free-standing facilities under joint venture arrangements, neither party to the joint venture arrangement can claim the free-standing facility as a provider-based entity. (f) Management contracts. Facilities and organizations operated under management contracts are considered provider-based if all of the following criteria are met: (1) The staff of the facility or organization are employed by the [[Page 47610]] provider or by another organization other than the management company. (2) The administrative functions of the facility or organization are integrated with those of the main provider, as determined under criteria in paragraph (b)(3)(iii) of this section. (3) The main provider has significant day-to-day control over the operations of the facility or organization as determined under criteria in paragraph (b)(3)(ii) of this section. (4) The management contract is held by the main provider itself, not by a parent organization that has control over both the main provider and the facility or organization. (g) Obligations of hospital outpatient departments and hospital- based entities. (1) Hospital outpatient departments located either on or off the main premises of the hospital must comply with the anti- dumping rules in Secs. 489.20(l), (m), (q), and (r) and 489.24 of this chapter. If any individual comes to any hospital-based entity (including an RHC) located on the main hospital campus, and a request is made on the individual's behalf for examination or treatment of a medical condition, as described in Sec. 489.24, the hospital must comply with the anti-dumping rules in Sec. 489.24. (2) Physician services furnished in hospital outpatient departments or hospital-based entities (other than RHCs) must be billed with the correct site-of-service indicator, so that applicable site-of-service reductions to physician and practitioner payment amounts can be applied. (3) Hospital outpatient departments must comply with all the terms of the hospital's provider agreement. (4) Physicians who work in hospital outpatient departments or hospital-based entities are obligated to comply with the non- discrimination provisions in Sec. 489.10(b) of this chapter. (5) Hospital outpatient departments (other than RHCs) must hold themselves out to other payers as outpatient departments of that hospital, and must treat all patients, for billing purposes, as hospital outpatients. The department must not treat some patients as hospital outpatients and others as physician office patients. (6) In the case of a patient admitted to the hospital as an inpatient after receiving treatment in the hospital outpatient department or hospital-based entity, payments for services in the hospital outpatient department or hospital-based entity are subject to the payment window provisions applicable to PPS hospitals and to hospitals and units excluded from PPS set forth at Sec. 412.2(c)(5) of this chapter and at Sec. 413.40(c)(2), respectively. (7) When a Medicare beneficiary is treated in a hospital outpatient department or hospital-based entity (other than an RHC), the hospital has a duty to notify the beneficiary, prior to the delivery of services, of the beneficiary's potential financial liability (that is, a coinsurance liability for an outpatient visit to the hospital as well as for the physician service). (8) Hospital outpatient departments must meet applicable hospital health and safety rules for Medicare-participating hospitals in part 482 of this chapter. (9) A facility or organization may not qualify for provider-based status if all services furnished at the facility are furnished under arrangement. (h) Inappropriate treatment of a facility or organization as provider-based. If HCFA learns of a provider treating a facility or organization as provider-based without notifying HCFA to obtain a determination of provider-based status, HCFA reconsiders all payments to that provider for all cost reporting periods subject to re-opening in accordance with Secs. 405.1885 and 405.1889 of this chapter. HCFA then investigates and determines whether the requirements in paragraph (d) of this section were met. If the facility or organization did not qualify for a provider-based determination, HCFA recovers the difference between the amount of payments that actually were made and the amount of payments that should have been made in the absence of a determination of provider-based status, except that recovery will not be made for any period prior to [insert the effective date of final rule] if during all of that period the management of the entity made a good faith effort to operate it as a provider-based facility or organization, as described in paragraph (i)(2) of this section. (i) Inappropriate billing. (1) If HCFA determines that a provider has been inappropriately billing Medicare for services furnished in a physician office or other facility or organization as if they had been furnished in a hospital outpatient department or other department of a provider or in a provider-based entity, HCFA stops all payments to the provider for outpatient services until the provider can demonstrate which payments are proper. If overpayments have been made, HCFA recovers the difference between the amount of payments that actually were made and the amount of the payments that should have been made in the absence of the determination of provider-based status. However, past payments attributable to treatment as a department of a provider or a provider-based entity for any period prior to [insert effective date of final rule] are not recovered if during all of that period the management of a facility or an organization made a good faith effort to operate it as a department of a provider or a provider-based entity, as described in paragraph (i)(2) of this section, prior to [insert effective date of final rule]. (2) HCFA determines that the management of a facility has made a good faith effort to operate it as a provider-based entity if-- (i) The requirements regarding licensure and public awareness in paragraphs (d)(1) and (d)(6) of this section are met; (ii) All facility services were billed as if they had been furnished by a department of a provider or a provider-based entity of the main provider; and (iii) All professional services of physicians and other practitioners were billed with the correct site-of-service indicator, as described in paragraph (g)(7) of this section. (j) Correction of errors. HCFA may review a past determination of provider-based status if it believes that the determination may be inappropriate, based on the provisions of this section. If HCFA determines that a previous determination was in error, and the entity should not be considered provider-based, HCFA notifies the main provider. Treatment of the facility or organization as provider-based ceases with the first day of the next cost report period following notification of the redetermination. Subpart F--Specific Categories of Costs 5. In Sec. 413.118, the heading to paragraph (d) is republished, and a new paragraph (d)(5) is added to read as follows: Sec. 413.118 Payment for facility services related to covered ASC surgical procedures performed in hospitals on an outpatient basis. * * * * * (d) Blended payment amount. * * * (5) For portions of cost reporting periods beginning on or after October 1, 1997, for purposes of calculating the blended payment amount under paragraph (d)(4) of this section, the ASC payment amount is the sum of the standard overhead amounts reduced by deductibles and coinsurance as defined in section 1866(a)(2)(ii) of the Act. * * * * * 6. In Sec. 413.122, the heading to paragraph (b) is republished, a new [[Page 47611]] paragraph (b)(5) is added, the heading to paragraph (c) is republished, and a new paragraph (c)(4) is added to read as follows: 413.122 Payment for hospital outpatient radiology services and other diagnostic procedures. * * * * * (b) Payment for hospital outpatient radiology services. * * * (5) For hospital outpatient radiology services furnished on or after October 1, 1997, the blended payment amount is equal to the sum of-- (i) 42 percent of the hospital-specific amount; and (ii) 58 percent of the fee schedule amount calculated as 62 percent of the sum of the fee schedule amounts payable for the same services when furnished by participating physicians in their offices in the same locality, less deductible and coinsurance as defined in section 1866(a)(2)(A)(ii) of the Act. (c) Payment for other diagnostic procedures. * * * (4) For other diagnostic services furnished on or after October 1, 1997, the blended payment amount is equal to the sum of-- (i) 50 percent of the hospital-specific amount; and (ii) 50 percent of the fee schedule amount calculated as 42 percent of the sum of the fee schedule amounts payable for the same services when furnished by participating physicians in their offices in the same locality, less deductible and coinsurance as defined in section 1866(a)(2)(A)(ii) of the Act. 7. In Sec. 413.124, paragraph (a) is revised to read as follows: Sec. 413.124 Reduction to hospital outpatient operating costs. (a) Except for sole community hospitals, as defined in Sec. 412.92 of this chapter, and critical access hospitals, the reasonable costs of outpatient hospital services (other than capital-related costs of such services) are reduced by 5.8 percent for services furnished during portions of cost reporting periods occurring on or after October 1, 1990 and before January 1, 2000. * * * * * Subpart G--Capital-Related Costs 8. In Sec. 413.130, the heading to paragraph (j) and the introductory text to paragraph (j)(1) are republished, and paragraph (j)(1)(ii) is revised to read as follows: Sec. 413.130 Introduction to capital-related costs. * * * * * (j) Reduction to capital-related costs. (1) Except for sole community hospitals and critical access hospitals, the amount of capital-related costs of all hospital outpatient services is reduced by-- * * * * * (ii) 10 percent for portions of cost reporting periods occurring on or after October 1, 1991 through December 31, 1999 and before January 1, 2000. * * * * * F. A new part 419, consisting of Secs. 419.1, 419.2, 419.20, 419.21, 419.22, 419.30, 419.31, 419.32, 419.40, 419.41, 419.42, 419.43, 419.44, 419.50, 419.51, and 419.60, is added to read as follows: PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Subpart A--General Provisions Sec. 419.1 Scope of part. 419.2 Basis of payment. Subpart B--Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System 419.20 Hospitals subject to the hospital outpatient prospective payment system. 419.21 Hospital outpatient services subject to the outpatient prospective payment system. 419.22 Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. Subpart C--Basic Methodology for Determining Prospective Payment Rates for Hospital Outpatient Services 419.30 Base expenditure target for calendar year 1999. 419.31 Ambulatory Payment Classification (APC) system and payment weights. 419.32 Calculation of prospective payment rates for hospital outpatient services. Subpart D--Payments to Hospitals 419.40 Payment concepts. 419.41 Calculation of national beneficiary copayment amounts and national Medicare program payment amounts. 419.42 Hospital election to reduce copayment. 419.43 Adjustments to national program payment and beneficiary copayment amounts. 419.44 Payment reductions for surgical procedures. Subpart E--Updates 419.50 Revisions to groups, weights, and other adjustments. 419.51 Volume control measures for services furnished in CY 2000. Subpart F--Limitations on Review 419.60 Limitations on administrative and judicial review. Authority: Secs. 1102, 1833(t), and 1871 of the Social Security Act (42 U.S.C. 1302, 1395l(t), and 1395(hh)). PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Subpart A--General Provisions Sec. 419.1 Scope of part. (a) Purpose. This part implements section 1833(t) of the Act by establishing a prospective payment system for services furnished by hospital outpatient departments to Medicare beneficiaries who are registered on hospital records as outpatients, effective for services furnished on or after the implementation date. (b) Summary of content. This subpart describes the basis of payment for outpatient hospital services under the prospective payment system. Subpart B sets forth the categories of hospitals and services that are subject to the outpatient hospital prospective payment system and those categories of hospitals and services that are excluded from the outpatient hospital prospective payment system. Subpart C sets forth requirements and the basic methodology by which prospective payment rates for hospital outpatient services are determined. Subpart D describes Medicare payment amounts, beneficiary copayment amounts, and methods of payment to hospitals under the hospital outpatient prospective payment system. Subpart E describes how the hospital outpatient prospective payment system may be revised to take into account changes in medical practice and technology, the addition or deletion of services, new cost data, and other relevant information and factors. Sec. 419.2 Basis of payment. (a) Unit of payment. Under the hospital outpatient prospective payment system, hospitals are paid a predetermined amount for designated services, which are identified by codes established under the Health Care Financing Administration Common Procedure Coding System (HCPCS), furnished to Medicare beneficiaries. The prospective payment rate for each service or procedure for which payment is allowed under the hospital outpatient prospective payment system is determined according to the methodology described in subpart C of this part. The manner in which the Medicare payment amount and the beneficiary copayment amount for each service or procedure are determined is described in subpart D of this part. (b) Costs included in determination of hospital outpatient department payment rates. The prospective payment system establishes a national payment rate, [[Page 47612]] standardized for geographic wage differences, for operating and capital-related costs that are directly related and integral to performing a procedure or furnishing a service on an outpatient basis, including, but not limited to-- (1) Use of an operating suite, procedure room, or treatment room; (2) Use of recovery room; (3) Use of an observation bed; (4) Anesthesia, drugs, biologicals, other pharmaceuticals, and blood; medical and surgical supplies and equipment; surgical dressings; splints, casts, and other devices used for reduction of fractures and dislocations; (5) Supplies and equipment for administering and monitoring anesthesia or sedation; (6) Intra-ocular lenses (IOLs); (7) Incidental services such as venipuncture; (8) Capital-related costs. (c) Costs excluded from determination of hospital outpatient prospective payment rates. The following costs are excluded from the hospital outpatient prospective payment rates: (1) Medical education costs for approved nursing and allied health education programs. (2) Costs for services listed in Sec. 419.22. Subpart B--Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System Sec. 419.20 Hospitals subject to the hospital outpatient prospective payment system. (a) Applicability. The hospital outpatient prospective payment system is applicable to any hospital participating in the Medicare program, except those specified in paragraph (b) of this section, for services furnished on or after the implementation date. (b) Hospitals excluded from the outpatient prospective payment system. (1) Those services furnished by Maryland hospitals that are paid under a cost containment waiver in accordance with section 1814(b)(3) of the Act are excluded from the hospital outpatient prospective payment system. (2) Critical access hospitals (CAHs) are excluded from the hospital outpatient prospective payment system. Sec. 419.21 Hospital outpatient services subject to the outpatient prospective payment system. Beginning on the implementation date, except for services described in Sec. 419.22, payment is made under the hospital outpatient prospective payment system for-- (a) Medicare Part B services furnished to hospital outpatients designated by HCFA under this part that are not otherwise excluded under Sec. 419.22; (b) Services that are covered under Medicare Part B when furnished to hospital inpatients who are either not entitled to benefits under Part A or who have exhausted their Part A benefits, but are entitled to benefits under Part B of the program; (c) Partial hospitalization services furnished by community mental health centers (CMHCs); (d) The following medical and other health services furnished by a comprehensive outpatient rehabilitation facility (CORF) when they fall outside the definition of CORF services at section 1861(cc)(1) of the Act; or by a home health agency (HHA) to patients who are not under an HHA plan or treatment; or, by a hospice program furnishing services to patients outside the hospice benefit: (1) Antigens. (2) Splints and casts. (3) Pneumococcal vaccine, influenza vaccine, hepatitis B vaccine. Sec. 419.22 Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. The following services are not paid for under the hospital outpatient prospective payment system: (a) Physician services. (b) Nurse practitioner services. (c) Physician assistant services. (d) Certified nurse-midwife services. (e) Services of qualified psychologists. (f) Services of an anesthetist as defined in Sec. 410.69 of this chapter. (g) Clinical social worker services as defined in section 1861(hh)(2) of the Act. (h) Rehabilitation services described in section 1833(a)(8) of the Act. (i) Ambulance services. (j) Prosthetics and prosthetic supplies, prosthetic devices, prosthetic implants (except IOLs), and orthotic devices. (k) Durable medical equipment supplied by the hospital for the patient to take home. (l) Clinical diagnostic laboratory services. (m) Dialysis services furnished to ESRD patients. (n) Services and procedures that are not safely furnished in an outpatient setting or that require inpatient care. (o) Services specific to other sites such as nursing homes. (p) Services furnished to persons who are inpatients of a SNF and furnished pursuant to the resident assessment or comprehensive care plan but that are covered under the SNF prospective payment system, furnished ``under arrangement,'' and billable only by the SNF. (q) Services that are not covered by Medicare by statute. (r) Services that are not reasonable or necessary for the diagnosis or treatment of an illness or disease. Subpart C--Basic Methodology for Determining Prospective Payment Rates for Hospital Outpatient Services Sec. 419.30 Base expenditure target for calendar year 1999. (a) HCFA estimates the aggregate amount that would be payable for hospital outpatient services in calendar year 1999 by summing-- (1) The total amounts that would be payable from the Trust Fund for covered hospital outpatient services without regard to the outpatient prospective payment system described in this part; and (2) The total amounts of copayments estimated to be paid by beneficiaries, under the prospective payment system described in this part, to hospitals for covered hospital outpatient services. (b) The aggregate amount under paragraph (a) of this section is determined as though the deductible required under section 1833(b) of the Act did not apply. Sec. 419.31 Ambulatory Payment Classification (APC) system and payment weights. (a) APC groups. (1) HCFA classifies hospital outpatient services and procedures that are comparable clinically and similar in terms of resource use into APC groups. (2) The payment rate determined for an APC group in accordance with Sec. 419.32 and the copayment amount and program payment amount determined for an APC group in accordance with subpart D of this part apply to every individual service or procedure within the APC group. (b) APC weighting factors. (1) Using hospital claims data from calendar year 1996 and data from the most recent available hospital cost reports, HCFA determines the median costs for the services and procedures within each APC group. (2) HCFA assigns to each APC group an appropriate weighting factor to reflect the relative median costs for the services within the APC group compared to the median costs for the services in all APC groups. (c) Standardizing amounts. (1) HCFA determines the portion of costs determined in paragraph (b)(1) of this section that is labor-related. This is known as the ``labor-related portion'' of hospital outpatient costs. (2) HCFA standardizes the median costs determined in paragraph (b)(1) of [[Page 47613]] this section by adjusting for variations in hospital labor costs across geographic areas. Sec. 419.32 Calculation of prospective payment rates for hospital outpatient services. (a) Conversion factor for 1999. HCFA calculates a conversion factor in such a manner as to ensure that payment for hospital outpatient services furnished in 1999 would have equalled the base expenditure target calculated in Sec. 419.30, taking APC group weights and estimated service volume into account. (b) Conversion factor for calendar years 2000, 2001, and 2002. (1) Subject to paragraph (c)(2) of this section, the conversion factor for each of the calendar years 2000, 2001, and 2002 is equal to the conversion factor calculated under paragraph (a) of this section for the previous year adjusted by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act for fiscal years 2000, 2001, and 2002, respectively, reduced by one percentage point. (2) Beginning in calendar year 2000, HCFA may substitute for the hospital inpatient market basket percentage in paragraph (c)(1) of this section a market basket percentage increase that is determined and applied to hospital outpatient services in the same manner that the hospital inpatient market basket percentage increase is determined and applied to inpatient hospital services. (c) Payment rates. The payment rate for services and procedures for which payment is made under the hospital outpatient prospective payment system is the product of the conversion factor calculated under paragraph (a) or paragraph (b) of this section and the relative weight determined under Sec. 419.31(b). Subpart D--Payments to Hospitals Sec. 419.40 Payment concepts. In addition to the payment rate described in Sec. 419.32, for each APC group there is a predetermined beneficiary copayment amount as described in Sec. 419.41(a). The Medicare payment for each APC is calculated by applying the program payment percentage as described in Sec. 419.41(b). (b) For purposes of this section-- Copayment percentage is calculated as the difference between the program payment percentage and 100 percent. The copayment percentage in any year is thus defined for each APC group as the greater of the following: the ratio of the APC group unadjusted copayment amount to the annual APC group payment rate, or 20 percent. Program payment percentage is calculated as the lower of the following: the ratio of the APC group payment rate minus the APC group unadjusted copayment amount, to the APC group payment rate, or 80 percent. Unadjusted copayment amount is calculated as 20 percent of the wage-adjusted national median of charges for services within an APC group furnished during 1996, updated to 1999 using an actuarial projection of charge increases for hospital outpatient department services during the period 1996 to 1999. Sec. 419.41 Calculation of national beneficiary copayment amounts and national Medicare program payment amounts. (a) Calculation of the national beneficiary copayment amount. To calculate the unadjusted copayment amount for each APC group, HCFA-- (1) Standardizes 1996 hospital charges for the services within each APC group to offset variations in hospital labor costs across geographic areas; (2) Identifies the median of the wage-neutralized 1996 charges for each APC group; and, (3) Determines the value equal to 20 percent of the wage- neutralized 1996 median charge for each APC group and multiplies that value by an actuarial projection of increases in charges for hospital outpatient department services during the period 1996 to 1999. The result is the unadjusted beneficiary copayment amount for the APC group. (b) Calculation of the program payment amount for each APC group. (1) HCFA calculates annually the program payment percentage for every APC group on the basis of each group's unadjusted copayment amount and its payment rate after the payment rate is adjusted in accordance with Sec. 419.32. (2) The Medicare program payment amounts are calculated annually by multiplying the updated APC group payment rates by the program payment percentage. (c) To determine payment amounts due for a service paid for under the hospital outpatient prospective payment system, HCFA makes the following calculations: (1) Makes the wage index adjustment and any other adjustments that are appropriate in accordance with Sec. 419.43. (2) Subtracts the amount of the applicable Part B deductible provided under Sec. 410.160 of this chapter. (3) Multiplies the remainder by the program payment percentage for the group to determine the program payment amount. (4) Subtracts the program payment amount from the amount determined in paragraph (c)(2) of this section to determine the copayment amount. Sec. 419.42 Hospital election to reduce copayment. (a) A hospital may elect to reduce copayments for any or all APC groups on a calendar year basis. A hospital may not elect to reduce copayment for some, but not all, services within the same group. (b) A hospital must notify its fiscal intermediary of its election to reduce copayments no later than 90 days prior to the start of the calendar year. (c) The hospital's election must be properly documented. It must specifically identify the APCs to which it applies and the copayment level (within the limits identified below) that the hospital has selected for each group. (d) The election of reduced copayment must remain in effect unchanged during the year for which the election was made. (e) The hospital may advertise and otherwise disseminate information concerning the reduced level(s) of copayment that it has elected. (f) In electing reduced copayment, a hospital may elect a level that is less than that year's national copayment amount for the group, but not less than 20 percent of the APC payment rate as determined in Sec. 419.32. Sec. 419.43 Adjustments to national program payment and beneficiary copayment amounts. (a) General rule. HCFA determines national prospective payment rates for hospital outpatient department services and determines a wage adjustment factor to adjust the portion of the APC payment and national beneficiary copayment amount attributable to labor-related costs for relative differences in labor and labor-related costs across geographic regions in a budget neutral manner. (b) Labor-related portion of payment and copayment rates for hospital outpatient services. HCFA determines the portion of hospital outpatient costs attributable to labor and labor-related costs (known as the ``labor-related portion'' of hospital outpatient costs) in accordance with Sec. 419.31(c)(1). (c) Wage index factor. HCFA uses the hospital inpatient prospective payment system wage index established in accordance with section 1886(d)(3)(E) of the Act and part 412 of this chapter to make the adjustment referred to in paragraph (a) of this section. (d) Other adjustments. Any other adjustments to payment amounts made by HCFA to ensure equitable payments are made in a budget neutral manner. [[Page 47614]] Sec. 419.44 Payment reductions for surgical procedures. (a) Multiple surgical procedures. When more than one surgical procedure for which payment is made under the hospital outpatient prospective payment system is performed during a single surgical encounter, the Medicare program payment amount and the beneficiary copayment amount are based on-- (1) The full amounts for the procedure with the highest APC payment rate; and (2) One half of the full program and beneficiary payment amounts for all other covered procedures. (b) Terminated procedures. When a surgical procedure is terminated prior to completion due to extenuating circumstances or circumstances that threaten the well-being of the patient, the Medicare program payment amount and the beneficiary copayment amount are based on-- (1) The full amounts if the procedure is discontinued after the induction of anesthesia or after the procedure is started; and (2) One-half of the full program and beneficiary payment amounts if the procedure is discontinued after the patient is prepared for surgery and taken to the room where the procedure is to be performed, but before anesthesia is induced. Subpart E--Updates Sec. 419.50 Revisions to groups, weights, and other adjustments. (a) HCFA periodically reviews and updates groups, relative payment weights, and the wage and other adjustments to take into account changes in medical practice, changes in technology, the addition of new services, new cost data, and other relevant information and factors. (1) Changes in the APC system. HCFA may make a change in the group composition of the APC system or recalibrate any APC weight, as needed, but not more frequently than once a year. HCFA makes these changes based on evidence that a reassignment would improve the consistency of the group(s) either clinically or with respect to resource consumption. (2) New services. HCFA assigns a new service to the APC group that is most similar clinically and with respect to resource consumption. (3) Budget neutrality. HCFA adjusts the conversion factor so that any adjustments determined under paragraphs (a)(1) through (a)(3) of this section do not increase or decrease the amount of expenditures that would have been made under this section if the adjustments had not been made. (b) Annual update to conversion factor. HCFA updates the conversion factor annually as specified in Sec. 419.32. Sec. 419.51 Volume control measures for services furnished in CY 2000. HCFA uses the target amount specified under section 1833(t)(3)(A) of the Act as an expenditure target for services furnished in CY 1999. HCFA updates the target amount to CY 2000 based on the adjustment to the conversion factor in Sec. 419.32(b), estimated changes in the volume and intensity of hospital outpatient services, and estimated changes in beneficiary enrollment. HCFA compares the CY 2000 target to an estimate of CY 2000 actual payments to hospitals. If unnecessary volume increases cause payments to exceed the target, HCFA determines the percentage by which the target is exceeded, and adjusts the CY 2002 update to the conversion factor by the same percentage. Subpart F--Limitations on Review Sec. 419.60 Limitations on administrative and judicial review. There can be no administrative or judicial review under sections 1869 and 1878 of the Act, or otherwise of-- (a) The development of the APC system, including-- (1) Establishment of the groups and relative payment weights; (2) Wage adjustment factors; (3) Other adjustments; and (4) Methods for controlling unnecessary increases in volume. (b) The calculation of base amounts described in section 1833(t)(3) of the Act; (c) Periodic adjustments described in section 1833(t)(6) of the Act; and (d) The establishment of a separate conversion factor for hospitals described in section 1886(d)(1)(B)(v) of the Act. PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL G. Part 489 is amended as set forth below: 1. The authority citation to part 489 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh). Subpart B--Essentials of Provider Agreements 2. In Sec. 489.20, the introductory text to the section is republished; the introductory text to paragraph (d) is revised; paragraphs (d)(3), (d)(4), and (d)(5) are redesignated as paragraphs (d)(4), (d)(5), and (d)(6), respectively; and a new paragraph (d)(3) is added to read as follows: Sec. 489.20 Basic commitments. The provider agrees to the following: * * * * * (d) In the case of a hospital or a CAH that furnishes services to Medicare beneficiaries, either to furnish directly or to make arrangements (as defined in Sec. 409.3 of this chapter) for all Medicare-covered services to inpatients and outpatients of a hospital or a CAH except the following: * * * * * (3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. * * * * * 3. In Sec. 489.24(b), the definition for ``Comes to the emergency department'' is revised to read as follows: Sec. 489.24 Special responsibilities of Medicare hospitals in emergency cases. * * * * * (b) * * * Comes to the emergency department means, with respect to an individual requesting examination or treatment, that the individual is on the hospital property. For purposes of this section, ``property'' means the entire main hospital campus, including the parking lot, sidewalk, and driveway, as well as any facility or organization that is located off the main hospital campus but has been determined under Sec. 416.35 of this chapter to be a department of the hospital. Property also includes ambulances owned and operated by the hospital, even if the ambulance is not on hospital grounds. An individual in a nonhospital-owned ambulance on hospital property is considered to have come to the hospital's emergency department. An individual in a nonhospital-owned ambulance off hospital property is not considered to have come to the hospital's emergency department, even if a member of the ambulance staff contacts the hospital by telephone or telemetry communications and informs the hospital that they want to transport the individual to the hospital for examination and treatment. In such situations, the hospital may deny access if it is in ``diversionary status,'' that is, it does not have the staff or facilities to accept any additional emergency patients. If, however, the ambulance staff disregards the hospital's instructions and transports the individual on to hospital property, the individual is considered to have come to the emergency department. * * * * * [[Page 47615]] PART 498--APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN THE MEDICARE PROGRAM AND FOR DETERMINATIONS THAT AFFECT THE PARTICIPATION OF ICFs/MR AND CERTAIN NFs IN THE MEDICAID PROGRAM H. Part 498 is amended as set forth below: 1. The authority citation for part 498 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395(hh). 2. In Sec. 498.2, the introductory text is republished, and the definition of ``Provider'' is revised to read as follows: Sec. 498.2 Definitions. As used in this part -- * * * * * Provider means a hospital, critical access hospital (CAH), skilled nursing facility (SNF), comprehensive outpatient rehabilitation facility (CORF), home health agency (HHA), or hospice, that has in effect an agreement to participate in Medicare, that has in effect an agreement to participate in Medicaid, or a clinic, rehabilitation agency, or public health agency that has a similar agreement but only to furnish outpatient physical therapy or outpatient speech pathology services, and prospective provider means any of the listed entities that seeks to participate in Medicare as a provider or to have any facility or organization determined to be a department of the provider or provider-based entity under Sec. 412.65 of this chapter. * * * * * 3. In Sec. 498.3, the introductory text to paragraph (b) is republished; paragraphs (b)(2) through (b)(14) are redesignated as paragraphs (b)(3) through (b)(15), respectively; and a new paragraph (b)(2) is added to read as follows: Sec. 498.3 Scope and applicability. * * * * * (b) Initial determinations by HCFA. HCFA makes initial determinations with respect to the following matters: * * * * * (2) Whether a prospective department of a provider or provider- based entity qualifies as a department of a provider or provider-based entity under Sec. 413.65 of this chapter. * * * * * PART 1003--CIVIL MONEY PENALTIES, ASSESSMENTS AND EXCLUSIONS I. Part 1003 is amended as set forth below: 1. The authority citation for part 1003 is revised to read as follows: Authority: 42 U.S.C. 1302, 1320-7, 1320a-7a, 1320b-10, 1395u(j), 1395u(k), 1395cc(g), 1395dd(d)(1), 1395mm, 1395nn(g), 1395ss(d), 1396b(m), 11131(c) and 11137(b)(2). 2. Section 1003.100 is amended by revising paragraph (a) to read as follows: Sec. 1003.100 Basis and purpose. (a) Basis. This part implements sections 1102, 1128(c), 1128A, 1140, 1842(j), 1842(k), 1866(g), 1876(i)(6), 1877(g), 1882(d) and 1903(m)(5) of the Social Security Act, and sections 421(c) and 427(b)(2) of Pub. L. 99-660 (42 U.S.C. 1302, 1320a-7, 1320a-7a, 1320b- 10, 1395u(j), 1395u(k), 1395cc(g), 1395mm(i)(6), 1395nn(g), 1395ss(d), 1396d(m)(5), 11131(c) and 11137(b)(2)). * * * * * 3. Section 1003.102 is amended by republishing the introductory text to paragraph (b), by reserving paragraphs (b)(11) through (b)(13), and by adding a new paragraph (b)(14) to read as follows: Sec. 1003.102 Basis for civil money penalties and assessments. * * * * * (b) The OIG may impose a penalty, and where authorized, an assessment against any person (including an insurance company in the case of paragraphs (b)(5) and (b)(6) of this section) whom it determines in accordance with this part-- * * * * * (11) [Reserved] (12) [Reserved] (13) [Reserved] (14) Has knowingly and willfully presented, or caused to be presented, a bill or request for payment for an item or service furnished to a hospital patient for which payment may be made under the Medicare or another Federal health care program, if that bill or request is inconsistent with an arrangement under section 1866(a)(1)(H) of the Act, or violates the requirements for such an arrangement. * * * * * 4. Section 1003.103 is amended by revising paragraph (a) to read as follows: Sec. 1003.103 Amount of penalty. (a) Except as provided in paragraphs (b) through (f) of this section, the OIG may impose a penalty of not more than $10,000 for each item or service that is subject to a determination under Sec. 1003.102. * * * * * 5. Section 1003.105 is amended by revising paragraph (a)(1)(i) to read as follows: Sec. 1003.105 Exclusion from participation in Medicare and State health care programs. (a)(1) * * * (i) Any person who is subject to a penalty or assessment under Sec. 1003.102(a), (b)(1) through (b)(4), or (b)(14). * * * * * (Catalog of Federal Domestic Assistance 93.774, Medicare-- Supplementary Medical Insurance Program) Dated: June 29, 1998. Nancy-Ann Min DeParle, Administrator, Health Care Financing Administration. Dated: June 29, 1998. June G. Brown, Inspector General, Department of Health and Human Services. Approved: August 15, 1998. Donna E. Shalala, Secretary. Note: The following addenda will not appear in the Code of Federal Regulations. [[Page 47615]] Addendum A.--List of Proposed Hospital Outpatient Ambulatory Payment Classes With Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts ---------------------------------------------------------------------------------------------------------------- National Minimum APC \1\ Group title Status Relative Payment unadjusted unadjusted \2\ indicator weight rate coinsurance coinsurance ---------------------------------------------------------------------------------------------------------------- 020...... Partial .................. S 4.11 $208.01 $46.78 $41.60 Hospitalization per diem. 031...... Dental procedures. .................. S 1.34 $67.90 $13.58 $13.58 061...... Level I .................. X 1.04 $52.70 $36.61 $10.54 Chemotherapeutic agents. 062...... Level II .................. X 1.69 $85.63 $36.61 $17.13 Chemotherapeutic agents. [[Page 47616]] 063...... Level III .................. X 2.89 $146.43 $110.97 $29.29 Chemotherapeutic agents. 064...... Level IV .................. X 4.17 $211.29 $140.12 $42.26 Chemotherapeutic agents. 089...... Neuropsychological .................. X 2.54 $128.70 $37.29 $25.74 Testing. 090...... Monitoring .................. X 0.85 $43.07 $12.43 $8.61 psychiatric drugs. 091...... Brief Individual .................. S 1.09 $55.23 $14.01 $11.05 Psychotherapy. 092...... Extended .................. S 1.57 $79.55 $21.92 $15.91 Individual Psychotherapy. 093...... Family .................. S 1.54 $78.03 $20.11 $15.61 Psychotherapy. 094...... Group .................. S 1.24 $62.83 $20.11 $12.57 Psychotherapy. 121...... Level I needle .................. T 0.67 $33.95 $20.91 $6.79 biopsy/aspiration. 122...... Level II needle .................. T 4.87 $246.76 $115.03 $49.35 biopsy/aspiration. 131...... Level I incision & .................. T 1.94 $98.30 $36.61 $19.66 drainage. 132...... Level II incision .................. T 6.04 $306.04 $134.13 $61.21 & drainage. 137...... Nail procedures... .................. T 0.46 $23.31 $4.66 $4.66 141...... Level I .................. T 0.59 $29.90 $9.49 $5.98 Destruction of lesion. 142...... Level II .................. T 3.77 $191.02 $73.00 $38.20 Destruction of lesion. 151...... Level I .................. T 1.74 $88.16 $35.71 $17.63 debridement/ destruction. 152...... Level II .................. T 10.43 $528.48 $261.71 $105.70 debridement/ destruction. 161...... Level I excision/ .................. T 3.50 $177.34 $75.48 $35.47 biopsy. 162...... Level II excision/ .................. T 5.67 $287.30 $125.43 $57.46 biopsy. 163...... Level III excision/ .................. T 10.69 $541.66 $264.65 $108.33 biopsy. 181...... Level I skin .................. T 2.19 $110.97 $43.84 $22.19 repair. 182...... Level II skin .................. T 4.00 $202.68 $84.98 $40.54 repair. 183...... Level III skin .................. T 11.17 $565.98 $286.46 $113.20 repair. 184...... Level IV skin .................. T 15.17 $768.66 $396.40 $153.73 repair. 197...... Incision/excision .................. T 12.13 $614.62 $310.75 $122.92 breast. 198...... Breast .................. T 19.17 $971.33 $530.20 $194.27 reconstruction/ mastectomy. 200...... Arthrocentesis & .................. T 1.89 $95.77 $39.10 $19.15 Ligament/Tendon Injection. 207...... Closed treatment .................. T 1.70 $86.14 $31.64 $17.23 fracture finger/ toe/trunk. 209...... Closed treatment .................. T 1.94 $98.30 $37.29 $19.66 fracture/ dislocation/ except finger/toe/ trunk. 210...... Bone/joint .................. T 10.46 $530.00 $283.40 $106.00 manipulation under anesthesia. 216...... Open/percutaneous .................. T 20.13 $1,019.98 $520.82 $204.00 treatment fracture or dislocation. 217...... Arthroplasty...... .................. T 20.48 $1,037.71 $526.81 $207.54 218...... Arthroplasty with .................. T 27.49 $1,392.90 $715.52 $278.58 prosthesis. *226..... Maxillofacial .................. T 1.59 $80.56 $21.92 $16.11 prostheses. 231...... Level I skull and .................. T 12.02 $609.05 $299.90 $121.81 facial bone procedures. 232...... Level II skull and .................. T 23.93 $1,212.52 $639.35 $242.50 facial bone procedures. 251...... Level I .................. T 14.26 $722.55 $366.12 $144.51 Musculoskeletal Procedures. 252...... Level II .................. T 19.39 $982.48 $509.18 $196.50 Musculoskeletal Procedures. 253...... Level III .................. T 26.33 $1,334.13 $699.24 $266.83 Musculoskeletal Procedures. 254...... Level IV .................. T 34.37 $1,741.51 $937.11 $348.30 Musculoskeletal Procedures. 261...... Level I Hand .................. T 10.54 $534.06 $261.48 $106.81 Musculoskeletal Procedures. 262...... Level II Hand .................. T 18.35 $929.78 $480.82 $185.96 Musculoskeletal Procedures. 271...... Level I Foot .................. T 14.41 $730.15 $368.38 $146.03 Musculoskeletal Procedures. 272...... Level II Foot .................. T 16.56 $839.09 $409.74 $167.82 Musculoskeletal Procedures. 276...... Bunion Procedures. .................. T 19.19 $972.35 $500.14 $194.47 280...... Diagnostic .................. T 22.20 $1,124.86 $581.72 $224.97 Arthroscopy. 281...... Level I Surgical .................. T 22.65 $1,147.66 $590.20 $229.53 Arthroscopy. 282...... Level II Surgical .................. T 23.94 $1,213.03 $614.04 $242.61 Arthroscopy. 286...... Arthroscopically- .................. T 26.76 $1,355.91 $802.41 $271.18 Aided Procedures. 311...... Level I ENT .................. T 1.43 $72.46 $20.57 $14.49 Procedures. 312...... Level II ENT .................. T 7.26 $367.86 $178.31 $73.57 Procedures. 313...... Level III ENT .................. T 15.81 $801.08 $411.09 $160.22 Procedures. 314...... Level IV ENT .................. T 25.65 $1,299.67 $693.37 $259.93 Procedures. *317..... Implantation of .................. T ......... ......... ........... ........... Cochlear Device. 318...... Nasal .................. T 2.07 $104.89 $38.65 $20.98 Cauterization/ Packing. 319...... Tonsil/Adenoid .................. T 17.30 $876.58 $480.02 $175.32 Procedures. 320...... Thoracentesis/ .................. T 3.17 $160.62 $79.33 $32.12 Lavage Procedures. 331...... Level I Endoscopy .................. T 0.69 $34.96 $14.01 $6.99 Upper Airway. 332...... Level II Endoscopy .................. T 9.74 $493.52 $244.98 $98.70 Upper Airway. 333...... Level III .................. T 17.24 $873.54 $464.20 $174.71 Endoscopy Upper Airway. 336...... Endoscopy Lower .................. T 7.44 $376.98 $197.98 $75.40 Airway. 339...... Injection of .................. T 1.02 $51.68 $19.66 $10.34 Sclerosing Solution. 341...... Level I Needle and .................. T 0.13 $6.59 $2.94 $1.32 Catheter Placement. 342...... Level II Needle .................. T 3.20 $162.14 $80.23 $32.43 and Catheter Placement. 343...... Level III Needle .................. T 9.52 $482.37 $224.87 $96.47 and Catheter Placement. 346...... Placement .................. T 4.83 $244.73 $120.23 $48.95 Transvenous Caths/ Cutdown. 347...... Injection .................. T 2.93 $148.46 $62.15 $29.69 Procedures for Interventional Radiology. 360...... Removal/Revision, .................. T 6.09 $308.58 $140.12 $61.72 Pacemaker/ Vascular Device. 367...... Vascular Ligation. .................. T 17.59 $891.28 $449.06 $178.26 368...... Vascular Repair/ .................. T 22.83 $1,156.78 $648.85 $231.36 Fistula Construction. 369...... Blood and Blood .................. T 4.33 $219.40 $97.18 $43.88 Product Exchange. [[Page 47617]] 396...... Lymph Node .................. T 13.28 $672.89 $338.77 $134.58 Excisions. 397...... Thyroid/ .................. T 18.36 $930.29 $496.86 $186.06 Lymphadenectomy Procedures. 406...... Esophageal .................. T 4.31 $218.39 $108.48 $43.68 Dilation without Endoscopy. 407...... Esophagoscopy..... .................. T 7.06 $357.73 $189.84 $71.55 417...... Diagnostic Upper .................. T 6.44 $326.31 $181.70 $65.26 GI Endoscopy. 418...... Therapeutic Upper .................. T 7.59 $384.58 $214.25 $76.92 GI Endoscopy. 419...... Small Intestine .................. T 7.13 $361.27 $164.08 $72.25 Endoscopy. 426...... Diagnostic Lower .................. T 6.85 $347.09 $187.81 $69.42 GI Endoscopy. 427...... Therapeutic Lower .................. T 8.22 $416.50 $224.19 $83.30 GI Endoscopy. 437...... Therapeutic .................. T 2.91 $147.45 $76.61 $29.49 Anoscopy. 446...... Diagnostic .................. T 2.59 $131.23 $65.09 $26.25 Sigmoidoscopy. 447...... Therapeutic .................. T 6.87 $348.10 $184.76 $69.62 Proctosigmoidosco py. 448...... Therapeutic .................. T 5.37 $272.09 $141.25 $54.42 Flexible Sigmoidoscopy. 449...... Complex GI .................. T 7.80 $395.22 $215.38 $79.04 Endoscopy. 451...... Level I Anal/ .................. T 2.56 $129.71 $54.24 $25.94 Rectal Procedures. 452...... Level II Anal/ .................. T 4.82 $244.23 $109.61 $48.85 Rectal Procedures. 453...... Level III Anal/ .................. T 16.87 $854.79 $445.22 $170.96 Rectal Procedures. 456...... Endoscopic .................. T 9.78 $495.55 $257.19 $99.11 Retrograde Cholangio- Pancreatography (ERCP). 458...... Percutaneous .................. T 7.23 $366.34 $181.59 $73.27 Biliary Endoscopic Procedures. 459...... Peritoneal and .................. T 18.06 $915.09 $496.52 $183.02 Abdominal Procedures. 466...... Hernia/Hydrocele .................. T 21.43 $1,085.85 $562.97 $217.17 Procedures. 470...... Tube Procedures... .................. T 2.22 $112.49 $54.92 $22.50 521...... Level I .................. T 5.06 $256.39 $112.10 $51.28 Cystourethroscopy and other Genitourinary Procedures. 522...... Level II .................. T 10.46 $530.00 $262.39 $106.00 Cystourethroscopy and other Genitourinary Procedures. 523...... Level III .................. T 16.87 $854.79 $447.03 $170.96 Cystourethroscopy and other Genitourinary Procedures. 524...... Level IV .................. T 28.89 $1,463.84 $833.38 $292.77 Cystourethroscopy and other Genitourinary Procedures. 527...... Lithotripsy....... .................. T 51.56 $2,612.52 $1,372.95 $522.50 529...... Simple Urinary .................. T 2.50 $126.67 $63.05 $25.33 Studies and Procedures. 530...... Genitourinary .................. T 2.52 $127.69 $54.69 $25.54 Procedures. 531...... Level I Urethral .................. T 18.94 $959.68 $527.26 $191.94 Procedures. 532...... Level II Urethral .................. T 25.50 $1,292.07 $602.18 $258.41 Procedures. 536...... Circumcision...... .................. T 13.17 $667.32 $326.57 $133.46 537...... Penile Procedures. .................. T 28.72 $1,455.23 $864.34 $291.05 538...... Insertion of .................. T 45.59 $2,310.02 $1,540.64 $462.00 Penile Prosthesis. 546...... Testes/Epididymis .................. T 17.14 $868.47 $453.81 $173.69 Procedures. 547...... Prostate Biopsy... .................. T 4.39 $222.44 $125.20 $44.49 550...... Surgical .................. T 16.89 $855.81 $447.93 $171.16 Hysteroscopy. 551...... Level I .................. T 24.78 $1,255.59 $711.67 $251.12 Laparoscopy. 552...... Level II .................. T 37.71 $1,910.75 $1,053.16 $382.15 Laparoscopy. 561...... Level I Female .................. T 1.52 $77.02 $24.63 $15.40 Reproductive Procedures. 562...... Level II Female .................. T 12.76 $646.54 $330.75 $129.31 Reproductive Procedures. 563...... Level III Female .................. T 16.90 $856.31 $464.88 $171.26 Reproductive Procedures. 567...... D & C............. .................. T 13.61 $689.61 $364.09 $137.92 568...... Infertility .................. T 2.49 $126.17 $49.49 $25.23 Procedures. 578...... Pregnancy and .................. T 1.26 $63.84 $33.90 $12.77 Neonatal Care Procedures. 580...... Vaginal Delivery.. .................. T 4.59 $232.57 $146.34 $46.51 586...... Therapeutic .................. T 12.50 $633.37 $431.89 $126.67 Abortion. 587...... Spontaneous .................. T 13.25 $671.37 $347.02 $134.27 Abortion. 600...... Spinal Tap........ .................. T 2.63 $133.26 $61.47 $26.65 601...... Level I Nervous .................. T 3.11 $157.58 $74.13 $31.52 System Injections. 602...... Level II Nervous .................. T 3.33 $168.73 $87.69 $33.75 System Injections. 616...... Implantation of .................. T 14.43 $731.16 $366.57 $146.23 Neurostimulator Electrodes. 617...... Revision/Removal .................. T 11.56 $585.74 $287.59 $117.15 Neurological Device. 618...... Implantation of .................. T 25.56 $1,295.11 $780.49 $259.02 Neurological Device. 631...... Level I Nerve .................. T 12.98 $657.69 $333.80 $131.54 Procedures. 632...... Level II Nerve .................. T 18.13 $918.64 $461.04 $183.73 Procedures. 648...... Laser Retinal .................. T 3.94 $199.64 $95.15 $39.93 Procedures. 649...... Laser Eye .................. T 4.44 $224.97 $111.64 $44.99 Procedures except Retinal. 651...... Level I Anterior .................. T 7.24 $366.85 $174.70 $73.37 Segment Eye Procedures. 652...... Level II Anterior .................. T 16.48 $835.03 $433.69 $167.01 Segment Eye Procedures. 667...... Cataract .................. T 15.33 $776.40 $521.72 $155.28 Procedures. 668...... Cataract .................. T 19.28 $976.91 $530.87 $195.38 Procedures with IOL Insert. 670...... Corneal Transplant .................. T 29.23 $1,481.07 $847.50 $296.21 676...... Posterior Segment .................. T 6.30 $319.22 $140.35 $63.84 Eye Procedures. 677...... Strabismus/Muscle .................. T 16.26 $823.89 $436.63 $164.78 Procedures. 681...... Level I Eye .................. T 1.67 $84.62 $30.51 $16.92 Procedures. 682...... Level II Eye .................. T 3.54 $179.37 $81.36 $35.87 Procedures. 683...... Level III Eye .................. T 10.19 $516.32 $257.87 $103.26 Procedures. 684...... Level IV Eye .................. T 13.48 $683.02 $348.94 $136.60 Procedures. [[Page 47618]] 690...... Vitrectomy........ .................. T 30.54 $1,547.45 $852.02 $309.49 700...... Plain Film........ .................. X 0.78 $39.52 $22.37 $7.90 706...... Miscellaneous .................. X 1.96 $99.31 $57.63 $19.86 Radiological Procedures. 710...... Computerized Axial .................. S 5.06 $256.39 $176.28 $51.28 Tomography. 716...... Fluoroscopy....... .................. X 1.59 $80.56 $47.91 $16.11 720...... Magnetic Resonance .................. S 6.34 $321.24 $206.11 $64.25 Angiography. 726...... Magnetic Resonance .................. S 7.96 $403.33 $258.09 $80.67 Imaging. 728...... Myelography....... .................. S 4.07 $206.22 $113.23 $41.24 730...... Arthography....... .................. S 2.48 $125.66 $72.09 $25.13 736...... Digestive .................. S 1.85 $93.74 $54.24 $18.75 Radiology. 737...... Diagnostic .................. S 2.81 $142.38 $86.56 $28.48 Urography. 738...... Therapeutic .................. S 4.48 $227.00 $133.23 $45.40 Radiologic Procedures. 739...... Diagnostic .................. S 5.83 $295.40 $168.71 $59.08 Angiography and Venography. 746...... Mammography....... .................. S 0.69 $34.96 $19.44 $6.99 747...... Diagnostic .................. S 1.65 $83.60 $54.69 $16.72 Ultrasound Except Vascular. 749...... Guidance under .................. X 2.44 $123.63 $76.16 $24.73 Ultrasound. 750...... Therapeutic .................. X 0.91 $46.11 $25.54 $9.22 Radiation Treatment Planning. 751...... Level I .................. X 1.15 $58.27 $33.22 $11.65 Therapeutic Radiation Treatment Preparation. 752...... Level II .................. X 3.54 $179.37 $88.82 $35.87 Therapeutic Radiation Treatment Preparation. 757...... Radiation Therapy. .................. S 2.30 $116.54 $52.43 $23.31 758...... Hyperthermic .................. S 3.41 $172.78 $76.84 $34.56 Therapies. 759...... Brachytherapy and .................. S 7.98 $404.34 $160.01 $80.87 Complex Radioelement Applications. 760...... PET Scans......... .................. S 17.26 $874.55 $419.46 $174.91 *761..... Standard Non- .................. S 2.04 $103.37 $61.47 $20.67 Imaging Nuclear Medicine. *762..... Complex Non- .................. S 1.78 $90.19 $51.53 $18.04 Imaging Nuclear Medicine. 771...... Standard Planar .................. S 3.78 $191.53 $116.84 $38.31 Nuclear Medicine. 772...... Complex Planar .................. S 4.22 $213.83 $127.92 $42.77 Nuclear Medicine. 781...... Standard SPECT .................. S 5.26 $266.52 $145.77 $53.30 Nuclear Medicine. 782...... Complex SPECT .................. S 9.28 $470.21 $275.04 $94.04 Nuclear Medicine. *791..... Standard .................. S 15.83 $802.10 $562.06 $160.42 Therapeutic Nuclear Medicine. *792..... Complex .................. S 4.80 $243.21 $144.19 $48.64 Therapeutic Nuclear Medicine. 861...... Immunology Tests.. .................. X 0.13 $6.59 $3.62 $1.32 881...... Level I Pathology. .................. X 0.20 $10.13 $6.78 $2.03 882...... Level II Pathology .................. X 0.39 $19.76 $11.75 $3.95 883...... Level III .................. X 0.65 $32.94 $20.34 $6.59 Pathology. 900...... Critical Care..... .................. V 7.44 $376.98 $144.87 $75.40 901...... Level I .................. X 0.07 $3.55 $2.49 $0.71 Immunization. *902..... Level II .................. X 1.78 $90.19 $41.47 $18.04 Immunization. *903..... Level III .................. X 1.16 $58.78 $25.65 $11.76 Immunization. 906...... Infusion Therapy .................. X 1.46 $73.98 $42.49 $14.80 except Chemotherapy. 907...... Intramuscular .................. X 0.85 $43.07 $11.98 $8.61 Injections. +91111... Low Level Clinic Well care and V 1.06 $53.71 $12.66 $10.74 Visits. administrative. 91118.... Low Level Clinic Skin and breast V 0.83 $42.06 $9.27 $8.41 Visits. diseases. 91124.... Low Level Clinic Musculoskeletal V 0.87 $44.08 $9.49 $8.82 Visits. diseases. 91131.... Low Level Clinic Ear, nose, mouth V 0.81 $41.04 $9.04 $8.21 Visits. and throat diseases. 91133.... Low Level Clinic Respiratory system V 0.80 $40.54 $8.59 $8.11 Visits. diseases. 91136.... Low Level Clinic Cardiovascular V 0.85 $43.07 $8.61 $8.61 Visits. system diseases. 91141.... Low Level Clinic Digestive system V 0.98 $49.66 $10.40 $9.93 Visits. diseases. 91153.... Low Level Clinic Kidney, urinary V 0.91 $46.11 $9.27 $9.22 Visits. tract and male genital diseases. 91156.... Low Level Clinic Female genital V 0.93 $47.12 $9.42 $9.42 Visits. system diseases. *91157... Low Level Clinic Pregnancy and V 1.33 $67.39 $14.46 $13.48 Visits. neonatal care. 91163.... Low Level Clinic Nervous system V 0.98 $49.66 $10.17 $9.93 Visits. diseases. *91168... Low Level Clinic Eye diseases...... V 0.98 $49.66 $10.62 $9.93 Visits. *91172... Low Level Clinic Trauma and V 1.06 $53.71 $14.24 $10.74 Visits. poisoning. *91178... Low Level Clinic Major signs, V 1.52 $77.02 $21.58 $15.40 Visits. symptoms and findings. 91182.... Low Level Clinic Endocrine, V 0.87 $44.08 $9.04 $8.82 Visits. nutritional and metabolic diseases. *91186... Low Level Clinic Immunologic and V 1.09 $55.23 $11.30 $11.05 Visits. hematologic diseases. 91188.... Low Level Clinic Malignancy........ V 0.72 $36.48 $8.14 $7.30 Visits. +91191... Low Level Clinic Psychiatric V 1.09 $55.23 $14.01 $11.05 Visits. disorders. 91197.... Low Level Clinic Infectious disease V 1.02 $51.68 $11.53 $10.34 Visits. +91199... Low Level Clinic Unknown cause of V 1.31 $66.38 $20.79 $13.28 Visits. mortality. +91311... Mid Level Clinic Well care and V 1.06 $53.71 $12.66 $10.74 Visits. administrative. 91318.... Mid Level Clinic Skin and breast V 0.98 $49.66 $9.93 $9.93 Visits. diseases. 91324.... Mid Level Clinic Musculoskeletal V 0.98 $49.66 $9.93 $9.93 Visits. diseases. 91331.... Mid Level Clinic Ear, nose, mouth V 0.94 $47.63 $9.53 $9.53 Visits. and throat diseases. 91333.... Mid Level Clinic Respiratory system V 0.93 $47.12 $9.42 $9.42 Visits. diseases. 91336.... Mid Level Clinic Cardiovascular V 1.00 $50.67 $10.13 $10.13 Visits. system diseases. 91341.... Mid Level Clinic Digestive system V 1.00 $50.67 $10.13 $10.13 Visits. diseases. 91353.... Mid Level Clinic Kidney, urinary V 1.04 $52.70 $10.54 $10.54 Visits. tract and male genital diseases. [[Page 47619]] 91356.... Mid Level Clinic Female genital V 1.06 $53.71 $10.74 $10.74 Visits. system diseases. *91357... Mid Level Clinic Pregnancy and V 1.22 $61.82 $12.66 $12.36 Visits. neonatal care. 91363.... Mid Level Clinic Nervous system V 1.04 $52.70 $10.54 $10.54 Visits. diseases. *91368... Mid Level Clinic Eye diseases...... V 0.87 $44.08 $8.82 $8.82 Visits. *91372... Mid Level Clinic Trauma and V 1.06 $53.71 $10.85 $10.74 Visits. poisoning. *91378... Mid Level Clinic Major signs, V 1.13 $57.26 $11.45 $11.45 Visits. symptoms and findings. 91382.... Mid Level Clinic Endocrine, V 1.00 $50.67 $10.13 $10.13 Visits. nutritional and metabolic diseases. *91386... Mid Level Clinic Immunologic and V 1.04 $52.70 $10.54 $10.54 Visits. hematologic diseases. 91388.... Mid Level Clinic Malignancy........ V 0.83 $42.06 $8.41 $8.41 Visits. +91391... Mid Level Clinic Psychiatric V 1.09 $55.23 $14.01 $11.05 Visits. disorders. 91397.... Mid Level Clinic Infectious disease V 1.06 $53.71 $10.74 $10.74 Visits. +91399... Mid Level Clinic Unknown cause of V 1.31 $66.38 $20.79 $13.28 Visits. mortality. +91511... High Level Clinic Well care and V 1.06 $53.71 $12.66 $10.74 Visits. administrative. 91518.... High Level Clinic Skin and breast V 1.69 $85.63 $19.21 $17.13 Visits. diseases. 91524.... High Level Clinic Musculoskeletal V 1.37 $69.42 $15.37 $13.88 Visits. diseases. 91531.... High Level Clinic Ear, nose, mouth V 1.31 $66.38 $14.92 $13.28 Visits. and throat diseases. 91533.... High Level Clinic Respiratory system V 1.33 $67.39 $13.79 $13.48 Visits. diseases. 91536.... High Level Clinic Cardiovascular V 1.43 $72.46 $15.37 $14.49 Visits. system diseases. 91541.... High Level Clinic Digestive system V 1.50 $76.00 $16.05 $15.20 Visits. diseases. 91553.... High Level Clinic Kidney, urinary V 1.30 $65.87 $14.01 $13.17 Visits. tract and male genital diseases. 91556.... High Level Clinic Female genital V 1.43 $72.46 $14.49 $14.49 Visits. system diseases. 91557.... High Level Clinic Pregnancy and V 1.81 $91.71 $22.15 $18.34 Visits. neonatal care. 91563.... High Level Clinic Nervous system V 1.50 $76.00 $16.72 $15.20 Visits. diseases. 91568.... High Level Clinic Eye diseases...... V 1.31 $66.38 $13.79 $13.28 Visits. 91572.... High Level Clinic Trauma and V 1.69 $85.63 $22.15 $17.13 Visits. poisoning. 91578.... High Level Clinic Major signs, V 1.89 $95.77 $29.15 $19.15 Visits. symptoms and findings. 91582.... High Level Clinic Endocrine, V 1.41 $71.44 $15.14 $14.29 Visits. nutritional and metabolic diseases. 91586.... High Level Clinic Immunologic and V 1.65 $83.60 $18.98 $16.72 Visits. hematologic diseases. 91588.... High Level Clinic Malignancy........ V 1.09 $55.23 $12.43 $11.05 Visits. 91591.... High Level Clinic Psychiatric V 1.57 $79.55 $21.92 $15.91 Visits. disorders. 91597.... High Level Clinic Infectious disease V 1.76 $89.18 $19.66 $17.84 Visits. +91599... High Level Clinic Unknown cause of V 1.31 $66.38 $20.79 $13.28 Visits. mortality. 919...... Electroconvulsive .................. S 3.17 $160.62 $80.00 $32.12 Therapy. 920...... Biofeedback and .................. S 1.17 $59.28 $29.61 $11.86 other Training. *921..... Diabetes Education .................. S ......... ......... ........... ........... 926...... Dialysis for other .................. S 4.28 $216.87 $69.83 $43.37 than ESRD patients. 928...... Alimentary Tests.. .................. X 3.11 $157.58 $83.85 $31.52 930...... Minor Eye .................. X 1.02 $51.68 $22.83 $10.34 Examinations. 931...... Level I Eye Tests. .................. X 0.74 $37.50 $21.47 $7.50 932...... Level II Eye Tests .................. X 2.52 $127.69 $65.09 $25.54 936...... Fitting of Vision .................. X 0.52 $26.35 $9.49 $5.27 Aids. 940...... Otorhinolaryngolog .................. X 3.04 $154.04 $51.98 $30.81 ic Function Tests. 941...... Level I Audiometry .................. X 0.74 $37.50 $13.56 $7.50 942...... Level II .................. X 1.48 $74.99 $22.15 $15.00 Audiometry. 947...... Resuscitation and .................. S 4.07 $206.22 $109.61 $41.24 Cardioversion. 948...... Cardiac .................. X 0.81 $41.04 $16.95 $8.21 Rehabilitation. 949...... Cardiovascular .................. X 1.46 $73.98 $62.83 $14.80 Stress Test. 950...... Electrocardiogram .................. X 0.35 $17.73 $15.82 $3.55 (ECG). +95111... Low Level ER Well care and V 1.06 $53.71 $12.66 $10.74 Visits. administrative. 95118.... Low Level ER Skin and breast V 1.17 $59.28 $19.21 $11.86 Visits. diseases. 95124.... Low Level ER Musculoskeletal V 1.17 $59.28 $19.89 $11.86 Visits. diseases. 95131.... Low Level ER Ear, nose, mouth V 1.11 $56.24 $17.63 $11.25 Visits. and throat diseases. 95133.... Low Level ER Respiratory system V 1.15 $58.27 $18.31 $11.65 Visits. diseases. 95136.... Low Level ER Cardiovascular V 1.24 $62.83 $19.89 $12.57 Visits. system diseases. 95141.... Low Level ER Digestive system V 1.30 $65.87 $21.02 $13.17 Visits. diseases. 95153.... Low Level ER Kidney, urinary V 1.43 $72.46 $24.41 $14.49 Visits. tract and male genital diseases. 95156.... Low Level ER Female genital V 1.41 $71.44 $23.73 $14.29 Visits. system diseases. 95157.... Low Level ER Pregnancy and V 1.44 $72.96 $24.18 $14.59 Visits. neonatal care. 95163.... Low Level ER Nervous system V 1.31 $66.38 $22.83 $13.28 Visits. diseases. 95168.... Low Level ER Eye diseases...... V 1.20 $60.80 $20.79 $12.16 Visits. 95172.... Low Level ER Trauma and V 1.28 $64.86 $22.15 $12.97 Visits. poisoning. 95178.... Low Level ER Major signs, V 2.02 $102.35 $37.97 $20.47 Visits. symptoms and findings. 95182.... Low Level ER Endocrine, V 1.50 $76.00 $24.63 $15.20 Visits. nutritional and metabolic diseases. 95186.... Low Level ER Immunologic and V 1.43 $72.46 $25.76 $14.49 Visits. hematologic diseases. 95188.... Low Level ER Malignancy........ V 1.52 $77.02 $26.44 $15.40 Visits. 95191.... Low Level ER Psychiatric V 1.09 $55.23 $14.01 $11.05 Visits. Disorders. 95197.... Low Level ER Infectious disease V 1.24 $62.83 $20.57 $12.57 Visits. +95199... Low Level ER Unknown cause of V 1.31 $66.38 $20.79 $13.28 Visits. mortality. +95311... Mid Level ER Well care and V 1.06 $53.71 $12.66 $10.74 Visits. administrative. 95318.... Mid Level ER Skin and breast V 1.89 $95.77 $34.80 $19.15 Visits. diseases. [[Page 47620]] 95324.... Mid Level ER Musculoskeletal V 1.78 $90.19 $32.32 $18.04 Visits. diseases. 95331.... Mid Level ER Ear, nose, mouth V 1.81 $91.71 $31.64 $18.34 Visits. and throat diseases. 95333.... Mid Level ER Respiratory system V 1.91 $96.78 $33.67 $19.36 Visits. diseases. 95336.... Mid Level ER Cardiovascular V 2.02 $102.35 $36.16 $20.47 Visits. system diseases. 95341.... Mid Level ER Digestive system V 2.02 $102.35 $36.61 $20.47 Visits. diseases. 95353.... Mid Level ER Kidney, urinary V 2.06 $104.38 $38.19 $20.88 Visits. tract and male genital diseases. 95356.... Mid Level ER Female genital V 2.04 $103.37 $36.61 $20.67 Visits. system diseases. 95357.... Mid Level ER Pregnancy and V 2.06 $104.38 $39.78 $20.88 Visits. neonatal care. 95363.... Mid Level ER Nervous system V 2.00 $101.34 $37.29 $20.27 Visits. diseases. 95368.... Mid Level ER Eye diseases...... V 1.69 $85.63 $33.00 $17.13 Visits. 95372.... Mid Level ER Trauma and V 2.02 $102.35 $38.87 $20.47 Visits. poisoning. 95378.... Mid Level ER Major signs, V 3.07 $155.56 $58.76 $31.11 Visits. symptoms and findings. 95382.... Mid Level ER Endocrine, V 2.30 $116.54 $43.62 $23.31 Visits. nutritional and metabolic diseases. 95386.... Mid Level ER Immunologic and V 2.39 $121.10 $47.01 $24.22 Visits. hematologic diseases. 95388.... Mid Level ER Malignancy........ V 2.15 $108.94 $41.13 $21.79 Visits. 95391.... Mid Level ER Psychiatric V 2.00 $101.34 $35.93 $20.27 Visits. Disorders. 95397.... Mid Level ER Infectious disease V 1.98 $100.33 $36.61 $20.07 Visits. +95399... Mid Level ER Unknown cause of V 1.31 $66.38 $20.79 $13.28 Visits. mortality. +95511... High Level ER Well care and V 1.06 $53.71 $12.66 $10.74 Visits. administrative. 95518.... High Level ER Skin and breast V 2.61 $132.25 $46.56 $26.45 Visits. diseases. 95524.... High Level ER Musculoskeletal V 2.44 $123.63 $41.36 $24.73 Visits. diseases. 95531.... High Level ER Ear, nose, mouth V 2.56 $129.71 $44.07 $25.94 Visits. and throat diseases. 95533.... High Level ER Respiratory system V 3.19 $161.64 $54.69 $32.33 Visits. diseases. 95536.... High Level ER Cardiovascular V 3.17 $160.62 $54.69 $32.12 Visits. system diseases. 95541.... High Level ER Digestive system V 2.89 $146.43 $54.69 $29.29 Visits. diseases. 95553.... High Level ER Kidney, urinary V 2.89 $146.43 $54.69 $29.29 Visits. tract and male genital diseases. 95556.... High Level ER Female genital V 2.73 $138.33 $50.85 $27.67 Visits. system diseases. 95557.... High Level ER Pregnancy and V 2.93 $148.46 $54.92 $29.69 Visits. neonatal care. 95563.... High Level ER Nervous system V 3.04 $154.04 $58.08 $30.81 Visits. diseases. 95568.... High Level ER Eye diseases...... V 2.31 $117.05 $40.00 $23.41 Visits. 95572.... High Level ER Trauma and V 2.74 $138.83 $50.17 $27.77 Visits. poisoning. 95578.... High Level ER Major signs, V 6.85 $347.09 $148.48 $69.42 Visits. symptoms and findings. 95582.... High Level ER Endocrine, V 3.28 $166.20 $64.64 $33.24 Visits. nutritional and metabolic diseases. 95586.... High Level ER Immunologic and V 3.70 $187.48 $74.35 $37.50 Visits. hematologic diseases. 95588.... High Level ER Malignancy........ V 3.67 $185.96 $61.70 $37.19 Visits. 95591.... High Level ER Psychiatric V 3.48 $176.33 $62.38 $35.27 Visits. Disorders. 95597.... High Level ER Infectious disease V 2.81 $142.38 $53.34 $28.48 Visits. +95599... High Level ER Unknown cause of V 1.31 $66.38 $20.79 $13.28 Visits. mortality. 956...... Continuous ECG and .................. X 1.11 $56.24 $55.82 $11.25 Blood Pressure Monitoring. 957...... Echocardiography.. .................. S 2.83 $143.39 $117.07 $28.68 958...... Diagnostic Cardiac .................. T 26.11 $1,322.98 $659.47 $264.60 Catheterization. 960...... Cardiac .................. S 4.24 $214.84 $144.41 $42.97 Electrophysiologi c Tests/ Procedures. 966...... Electronic .................. X 0.39 $19.76 $12.43 $3.95 Analysis of Pacemakers/other Devices. 967...... Non-Invasive .................. X 1.70 $86.14 $57.40 $17.23 Vascular Studies. 968...... Vascular .................. X 2.37 $120.09 $79.55 $24.02 Ultrasound. 969...... Hyperbaric Oxygen. .................. S 2.65 $134.27 $141.70 $26.85 971...... Level I Pulmonary .................. X 0.78 $39.52 $21.47 $7.90 Tests. 972...... Level II Pulmonary .................. X 1.02 $51.68 $29.38 $10.34 Tests. 973...... Level III .................. S 1.89 $95.77 $55.82 $19.15 Pulmonary Tests. 976...... Pulmonary Therapy. .................. S 0.44 $22.29 $14.92 $4.46 977...... Allergy Tests..... .................. X 0.63 $31.92 $12.66 $6.38 978...... Allergy Injections .................. X 0.31 $15.71 $3.39 $3.14 979...... Extended EEG .................. S 10.17 $515.31 $288.83 $103.06 Studies and Sleep Studies. 980...... Electroencephalogr .................. S 2.15 $108.94 $57.86 $21.79 am. *981..... Level I Nerve and .................. X 1.46 $73.98 $41.81 $14.80 Muscle Tests. *982..... Level II Nerve and .................. X 1.39 $70.43 $38.87 $14.09 Muscle Tests. 987...... Subcutaneous or .................. S 0.65 $32.94 $13.33 $6.59 Intramuscular Chemotherapy. 988...... Chemotherapy .................. S 4.15 $210.28 $97.52 $42.06 except by Extended Infusion. 989...... Chemotherapy by .................. S 1.72 $87.15 $40.68 $17.43 Extended Infusion. 990...... Photochemotherapy. .................. S 0.43 $21.79 $8.14 $4.36 997...... Manipulation .................. S 0.69 $34.96 $7.23 $6.99 Therapy. 999...... Therapeutic .................. X 0.43 $21.79 $10.85 $4.36 Phlebotomy. ---------------------------------------------------------------------------------------------------------------- [[Page 47621]] Addendum B.--Proposed Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information ---------------------------------------------------------------------------------------------------------------- Proposed National Minimum CPT \1\/ HOPD status Description Proposed Relative payment unadjusted unadjusted HCPCS indicator APC weight rate coinsurance coinsurance ---\2\---------------------------------------------------------------------------------------------------------- 00100... N Anesth, skin surgery... ......... ......... ......... ........... ........... 00102... N Anesth, repair of cleft ......... ......... ......... ........... ........... lip. 00103... N Anesth, blepharoplasty. ......... ......... ......... ........... ........... 00104... N Anesth for electroshock ......... ......... ......... ........... ........... 00120... N Anesthesia for ear ......... ......... ......... ........... ........... surgery. 00124... N Anesthesia for ear exam ......... ......... ......... ........... ........... 00126... N Anesth, tympanotomy.... ......... ......... ......... ........... ........... 00140... N Anesth, procedures on ......... ......... ......... ........... ........... eye. 00142... N Anesthesia for lens ......... ......... ......... ........... ........... surgery. 00144... N Anesth, corneal ......... ......... ......... ........... ........... transplant. 00145... N Anesth, vitrectomy..... ......... ......... ......... ........... ........... 00147... N Anesth, iridectomy..... ......... ......... ......... ........... ........... 00148... N Anesthesia for eye exam ......... ......... ......... ........... ........... 00160... N Anesth, nose, sinus ......... ......... ......... ........... ........... surgery. 00162... N Anesth, nose, sinus ......... ......... ......... ........... ........... surgery. 00164... N Anesth, biopsy of nose. ......... ......... ......... ........... ........... 00170... N Anesth, procedure on ......... ......... ......... ........... ........... mouth. 00172... N Anesth, cleft palate ......... ......... ......... ........... ........... repair. 00174... C Anesth, pharyngeal ......... ......... ......... ........... ........... surgery. 00176... C Anesth, pharyngeal ......... ......... ......... ........... ........... surgery. 00190... N Anesth, facial bone ......... ......... ......... ........... ........... surgery. 00192... C Anesth, facial bone ......... ......... ......... ........... ........... surgery. 00210... N Anesth, open head ......... ......... ......... ........... ........... surgery. 00212... N Anesth, skull drainage. ......... ......... ......... ........... ........... 00214... C Anesth, skull drainage. ......... ......... ......... ........... ........... 00215... C Anesth, skull fracture. ......... ......... ......... ........... ........... 00216... N Anesth, head vessel ......... ......... ......... ........... ........... surgery. 00218... N Anesth, special head ......... ......... ......... ........... ........... surgery. 00220... N Anesth, spinal fluid ......... ......... ......... ........... ........... shunt. 00222... N Anesth, head nerve ......... ......... ......... ........... ........... surgery. 00300... N Anesth, skin surgery, ......... ......... ......... ........... ........... neck. 00320... N Anesth, neck organ ......... ......... ......... ........... ........... surgery. 00322... N Anesth, biopsy of ......... ......... ......... ........... ........... thyroid. 00350... N Anesth, neck vessel ......... ......... ......... ........... ........... surgery. 00352... N Anesth, neck vessel ......... ......... ......... ........... ........... surgery. 00400... N Anesth, chest skin ......... ......... ......... ........... ........... surgery. 00402... N Anesth, surgery of ......... ......... ......... ........... ........... breast. 00404... C Anesth, surgery of ......... ......... ......... ........... ........... breast. 00406... C Anesth, surgery of ......... ......... ......... ........... ........... breast. 00410... N Anesth, correct heart ......... ......... ......... ........... ........... rhythm. 00420... N Anesth, skin surgery, ......... ......... ......... ........... ........... back. 00450... N Anesth, surgery of ......... ......... ......... ........... ........... shoulder. 00452... C Anesth, surgery of ......... ......... ......... ........... ........... shoulder. 00454... N Anesth, collarbone ......... ......... ......... ........... ........... biopsy. 00470... N Anesth, removal of rib. ......... ......... ......... ........... ........... 00472... N Anesth, chest wall ......... ......... ......... ........... ........... repair. 00474... C Anesth, surgery of ......... ......... ......... ........... ........... rib(s). 00500... N Anesth, esophageal ......... ......... ......... ........... ........... surgery. 00520... N Anesth, chest procedure ......... ......... ......... ........... ........... 00522... N Anesth, chest lining ......... ......... ......... ........... ........... biopsy. 00524... C Anesth, chest drainage. ......... ......... ......... ........... ........... 00528... N Anesth, chest partition ......... ......... ......... ........... ........... view. 00530... C Anesth, pacemaker ......... ......... ......... ........... ........... insertion. 00532... N Anesth, vascular access ......... ......... ......... ........... ........... 00534... N Anesth, cardioverter/ ......... ......... ......... ........... ........... defib. 00540... C Anesth, chest surgery.. ......... ......... ......... ........... ........... 00542... C Anesth, release of lung ......... ......... ......... ........... ........... 00544... C Anesth, chest lining ......... ......... ......... ........... ........... removal. 00546... C Anesth, lung,chest wall ......... ......... ......... ........... ........... surg. 00548... N Anesth, trachea,bronchi ......... ......... ......... ........... ........... surg. 00560... C Anesth, open heart ......... ......... ......... ........... ........... surgery. 00562... C Anesth, open heart ......... ......... ......... ........... ........... surgery. 00580... C Anesth,heart/lung ......... ......... ......... ........... ........... transplant. 00600... N Anesth, spine, cord ......... ......... ......... ........... ........... surgery. 00604... C Anesth, surgery of ......... ......... ......... ........... ........... vertebra. 00620... N Anesth, spine, cord ......... ......... ......... ........... ........... surgery. 00622... C Anesth, removal of ......... ......... ......... ........... ........... nerves. 00630... N Anesth, spine, cord ......... ......... ......... ........... ........... surgery. 00632... C Anesth, removal of ......... ......... ......... ........... ........... nerves. 00634... C Anesth for ......... ......... ......... ........... ........... chemonucleolysis. 00670... C Anesth, spine, cord ......... ......... ......... ........... ........... surgery. 00700... N Anesth, abdominal wall ......... ......... ......... ........... ........... surg. 00702... N Anesth, for liver ......... ......... ......... ........... ........... biopsy. 00730... N Anesth, abdominal wall ......... ......... ......... ........... ........... surg. 00740... N Anesth, gi ......... ......... ......... ........... ........... visualization. [[Page 47622]] 00750... N Anesth, repair of ......... ......... ......... ........... ........... hernia. 00752... N Anesth, repair of ......... ......... ......... ........... ........... hernia. 00754... N Anesth, repair of ......... ......... ......... ........... ........... hernia. 00756... N Anesth, repair of ......... ......... ......... ........... ........... hernia. 00770... N Anesth, blood vessel ......... ......... ......... ........... ........... repair. 00790... N Anesth, surg upper ......... ......... ......... ........... ........... abdomen. 00792... C Anesth, part liver ......... ......... ......... ........... ........... removal. 00794... C Anesth, pancreas ......... ......... ......... ........... ........... removal. 00796... C Anesth, for liver ......... ......... ......... ........... ........... transplant. 00800... N Anesth, abdominal wall ......... ......... ......... ........... ........... surg. 00802... C Anesth, fat layer ......... ......... ......... ........... ........... removal. 00810... N Anesth, intestine ......... ......... ......... ........... ........... endoscopy. 00820... N Anesth, abdominal wall ......... ......... ......... ........... ........... surg. 00830... N Anesth, repair of ......... ......... ......... ........... ........... hernia. 00832... N Anesth, repair of ......... ......... ......... ........... ........... hernia. 00840... N Anesth, surg lower ......... ......... ......... ........... ........... abdomen. 00842... N Anesth, amniocentesis.. ......... ......... ......... ........... ........... 00844... C Anesth, pelvis surgery. ......... ......... ......... ........... ........... 00846... C Anesth, hysterectomy... ......... ......... ......... ........... ........... 00848... C Anesth, pelvic organ ......... ......... ......... ........... ........... surg. 00850... C Anesth, cesarean ......... ......... ......... ........... ........... section. 00855... C Anesth, hysterectomy... ......... ......... ......... ........... ........... 00857... C Analgesia, labor & c- ......... ......... ......... ........... ........... section. 00860... N Anesth, surgery of ......... ......... ......... ........... ........... abdomen. 00862... N Anesth, kidney, ureter ......... ......... ......... ........... ........... surg. 00864... C Anesth, removal of ......... ......... ......... ........... ........... bladder. 00865... C Anesth, removal of ......... ......... ......... ........... ........... prostate. 00866... C Anesth, removal of ......... ......... ......... ........... ........... adrenal. 00868... C Anesth, kidney ......... ......... ......... ........... ........... transplant. 00870... N Anesth, bladder stone ......... ......... ......... ........... ........... surg. 00872... N Anesth,kidney stone ......... ......... ......... ........... ........... destruct. 00873... N Anesth,kidney stone ......... ......... ......... ........... ........... destruct. 00880... N Anesth, abdomen vessel ......... ......... ......... ........... ........... surg. 00882... C Anesth, major vein ......... ......... ......... ........... ........... ligation. 00884... C Anesth, major vein ......... ......... ......... ........... ........... revision. 00900... N Anesth, perineal ......... ......... ......... ........... ........... procedure. 00902... N Anesth, anorectal ......... ......... ......... ........... ........... surgery. 00904... C Anesth, perineal ......... ......... ......... ........... ........... surgery. 00906... N Anesth, removal of ......... ......... ......... ........... ........... vulva. 00908... C Anesth, removal of ......... ......... ......... ........... ........... prostate. 00910... N Anesth, bladder surgery ......... ......... ......... ........... ........... 00912... N Anesth, bladder tumor ......... ......... ......... ........... ........... surg. 00914... N Anesth, removal of ......... ......... ......... ........... ........... prostate. 00916... N Anesth, bleeding ......... ......... ......... ........... ........... control. 00918... N Anesth, stone removal.. ......... ......... ......... ........... ........... 00920... N Anesth, genitalia ......... ......... ......... ........... ........... surgery. 00922... N Anesth, sperm duct ......... ......... ......... ........... ........... surgery. 00924... N Anesth, testis ......... ......... ......... ........... ........... exploration. 00926... N Anesth, removal of ......... ......... ......... ........... ........... testis. 00928... C Anesth, removal of ......... ......... ......... ........... ........... testis. 00930... N Anesth, testis ......... ......... ......... ........... ........... suspension. 00932... C Anesth, amputation of ......... ......... ......... ........... ........... penis. 00934... C Anesth, penis, nodes ......... ......... ......... ........... ........... removal. 00936... C Anesth, penis, nodes ......... ......... ......... ........... ........... removal. 00938... N Anesth, insert penis ......... ......... ......... ........... ........... device. 00940... N Anesth, vaginal ......... ......... ......... ........... ........... procedures. 00942... N Anesth, surgery on ......... ......... ......... ........... ........... vagina. 00944... C Anesth, vaginal ......... ......... ......... ........... ........... hysterectomy. 00946... N Anesth, vaginal ......... ......... ......... ........... ........... delivery. 00948... N Anesth, repair of ......... ......... ......... ........... ........... cervix. 00950... N Anesth, vaginal ......... ......... ......... ........... ........... endoscopy. 00952... N Anesth, uterine ......... ......... ......... ........... ........... endoscopy. 00955... C Analgesia, vaginal ......... ......... ......... ........... ........... delivery. 01000... N Anesth, skin surgery, ......... ......... ......... ........... ........... pelvis. 01110... N Anesth, skin surgery, ......... ......... ......... ........... ........... pelvis. 01120... N Anesth, pelvis surgery. ......... ......... ......... ........... ........... 01130... N Anesth, body cast ......... ......... ......... ........... ........... procedure. 01140... C Anesth, amputation at ......... ......... ......... ........... ........... pelvis. 01150... C Anesth, pelvic tumor ......... ......... ......... ........... ........... surgery. 01160... N Anesth, pelvis ......... ......... ......... ........... ........... procedure. 01170... N Anesth, pelvis surgery. ......... ......... ......... ........... ........... 01180... N Anesth, pelvis nerve ......... ......... ......... ........... ........... removal. 01190... C Anesth, pelvis nerve ......... ......... ......... ........... ........... removal. 01200... N Anesth, hip joint ......... ......... ......... ........... ........... procedure. 01202... N Anesth, arthroscopy of ......... ......... ......... ........... ........... hip. [[Page 47623]] 01210... N Anesth, hip joint ......... ......... ......... ........... ........... surgery. 01212... C Anesth, hip ......... ......... ......... ........... ........... disarticulation. 01214... C Anesth, replacement of ......... ......... ......... ........... ........... hip. 01220... N Anesth, procedure on ......... ......... ......... ........... ........... femur. 01230... N Anesth, surgery of ......... ......... ......... ........... ........... femur. 01232... C Anesth, amputation of ......... ......... ......... ........... ........... femur. 01234... C Anesth, radical femur ......... ......... ......... ........... ........... surg. 01240... N Anesth, upper leg skin ......... ......... ......... ........... ........... surg. 01250... N Anesth, upper leg ......... ......... ......... ........... ........... surgery. 01260... N Anesth, upper leg veins ......... ......... ......... ........... ........... surg. 01270... N Anesth, thigh arteries ......... ......... ......... ........... ........... surg. 01272... C Anesth, femoral artery ......... ......... ......... ........... ........... surg. 01274... C Anesth, femoral ......... ......... ......... ........... ........... embolectomy. 01300... N Anesth, skin surgery, ......... ......... ......... ........... ........... knee. 01320... N Anesth, knee area ......... ......... ......... ........... ........... surgery. 01340... N Anesth, knee area ......... ......... ......... ........... ........... procedure. 01360... N Anesth, knee area ......... ......... ......... ........... ........... surgery. 01380... N Anesth, knee joint ......... ......... ......... ........... ........... procedure. 01382... N Anesth, knee ......... ......... ......... ........... ........... arthroscopy. 01390... N Anesth, knee area ......... ......... ......... ........... ........... procedure. 01392... N Anesth, knee area ......... ......... ......... ........... ........... surgery. 01400... N Anesth, knee joint ......... ......... ......... ........... ........... surgery. 01402... C Anesth, replacement of ......... ......... ......... ........... ........... knee. 01404... C Anesth, amputation at ......... ......... ......... ........... ........... knee. 01420... N Anesth, knee joint ......... ......... ......... ........... ........... casting. 01430... N Anesth, knee veins ......... ......... ......... ........... ........... surgery. 01432... N Anesth, knee vessel ......... ......... ......... ........... ........... surg. 01440... N Anesth, knee arteries ......... ......... ......... ........... ........... surg. 01442... C Anesth, knee artery ......... ......... ......... ........... ........... surg. 01444... C Anesth, knee artery ......... ......... ......... ........... ........... repair. 01460... N Anesth, lower leg skin ......... ......... ......... ........... ........... surg. 01462... N Anesth, lower leg ......... ......... ......... ........... ........... procedure. 01464... N Anesth, ankle ......... ......... ......... ........... ........... arthroscopy. 01470... N Anesth, lower leg ......... ......... ......... ........... ........... surgery. 01472... N Anesth, achilles tendon ......... ......... ......... ........... ........... surg. 01474... N Anesth, lower leg ......... ......... ......... ........... ........... surgery. 01480... N Anesth, lower leg bone ......... ......... ......... ........... ........... surg. 01482... N Anesth, radical leg ......... ......... ......... ........... ........... surgery. 01484... N Anesth, lower leg ......... ......... ......... ........... ........... revision. 01486... C Anesth, ankle ......... ......... ......... ........... ........... replacement. 01490... N Anesth, lower leg ......... ......... ......... ........... ........... casting. 01500... N Anesth, leg arteries ......... ......... ......... ........... ........... surg. 01502... C Anesth, lowerleg ......... ......... ......... ........... ........... embolectomy. 01520... N Anesth, lower leg vein ......... ......... ......... ........... ........... surg. 01522... N Anesth, lower leg vein ......... ......... ......... ........... ........... surg. 01600... N Anesth, shoulder skin ......... ......... ......... ........... ........... surg. 01610... N Anesth, surgery of ......... ......... ......... ........... ........... shoulder. 01620... N Anesth, shoulder ......... ......... ......... ........... ........... procedure. 01622... N Anesth, shoulder ......... ......... ......... ........... ........... arthroscopy. 01630... N Anesth, surgery of ......... ......... ......... ........... ........... shoulder. 01632... C Anesth, surgery of ......... ......... ......... ........... ........... shoulder. 01634... C Anesth, shoulder joint ......... ......... ......... ........... ........... amput. 01636... C Anesth, forequarter ......... ......... ......... ........... ........... amput. 01638... C Anesth, shoulder ......... ......... ......... ........... ........... replacement. 01650... N Anesth, shoulder artery ......... ......... ......... ........... ........... surg. 01652... C Anesth, shoulder vessel ......... ......... ......... ........... ........... surg. 01654... C Anesth, shoulder vessel ......... ......... ......... ........... ........... surg. 01656... C Anesth, arm-leg vessel ......... ......... ......... ........... ........... surg. 01670... N Anesth, shoulder vein ......... ......... ......... ........... ........... surg. 01680... N Anesth, shoulder ......... ......... ......... ........... ........... casting. 01682... N Anesth, airplane cast.. ......... ......... ......... ........... ........... 01700... N Anesth, elbow area skin ......... ......... ......... ........... ........... surg. 01710... N Anesth, elbow area ......... ......... ......... ........... ........... surgery. 01712... N Anesth, upperarm tendon ......... ......... ......... ........... ........... surg. 01714... N Anesth, upperarm tendon ......... ......... ......... ........... ........... surg. 01716... N Anesth, biceps tendon ......... ......... ......... ........... ........... repair. 01730... N Anesth, upperarm ......... ......... ......... ........... ........... procedure. 01732... N Anesth, elbow ......... ......... ......... ........... ........... arthroscopy. 01740... N Anesth, upper arm ......... ......... ......... ........... ........... surgery. 01742... N Anesth, humerus surgery ......... ......... ......... ........... ........... 01744... N Anesth, humerus repair. ......... ......... ......... ........... ........... 01756... C Anesth, radical humerus ......... ......... ......... ........... ........... surg. 01758... N Anesth, humeral lesion ......... ......... ......... ........... ........... surg. 01760... N Anesth, elbow ......... ......... ......... ........... ........... replacement. 01770... N Anesth, upperarm artery ......... ......... ......... ........... ........... surg. [[Page 47624]] 01772... C Anesth, upperarm ......... ......... ......... ........... ........... embolectomy. 01780... N Anesth, upper arm vein ......... ......... ......... ........... ........... surg. 01782... C Anesth, upperarm vein ......... ......... ......... ........... ........... repair. 01784... N Anesth, av fistula ......... ......... ......... ........... ........... repair. 01800... N Anesth, lower arm skin ......... ......... ......... ........... ........... surg. 01810... N Anesth, lower arm ......... ......... ......... ........... ........... surgery. 01820... N Anesth, lower arm ......... ......... ......... ........... ........... procedure. 01830... N Anesth, lower arm ......... ......... ......... ........... ........... surgery. 01832... N Anesth, wrist ......... ......... ......... ........... ........... replacement. 01840... N Anesth, lowerarm artery ......... ......... ......... ........... ........... surg. 01842... C Anesth, lowerarm ......... ......... ......... ........... ........... embolectomy. 01844... N Anesth, vascular shunt ......... ......... ......... ........... ........... surg. 01850... N Anesth, lower arm vein ......... ......... ......... ........... ........... surg. 01852... C Anesth, lowerarm vein ......... ......... ......... ........... ........... repair. 01860... N Anesth, lower arm ......... ......... ......... ........... ........... casting. 01900... N Anesth, uterus/tube ......... ......... ......... ........... ........... inject. 01902... C Anesth, burr holes, ......... ......... ......... ........... ........... skull. 01904... C Anesth, skull x-ray ......... ......... ......... ........... ........... inject. 01906... N Anesth, lumbar ......... ......... ......... ........... ........... myelography. 01908... N Anesth, cervical ......... ......... ......... ........... ........... myelography. 01910... N Anesth, skull ......... ......... ......... ........... ........... myelography. 01912... N Anesth, lumbar ......... ......... ......... ........... ........... discography. 01914... N Anesth, cervical ......... ......... ......... ........... ........... discography. 01916... C Anesth, head ......... ......... ......... ........... ........... arteriogram. 01918... C Anesth, limb ......... ......... ......... ........... ........... arteriogram. 01920... N Anesth, catheterize ......... ......... ......... ........... ........... heart. 01921... C Anesth, vessel surgery. ......... ......... ......... ........... ........... 01922... N Anesth, cat or MRI scan ......... ......... ......... ........... ........... 01990... C Support for organ donor ......... ......... ......... ........... ........... 01995... N Regional anesthesia, ......... ......... ......... ........... ........... limb. 01996... N Manage daily drug ......... ......... ......... ........... ........... therapy. 01999... N Unlisted anesth ......... ......... ......... ........... ........... procedure. 10040... T Acne surgery of skin 131 1.94 $102.84 $36.61 $20.57 abscess. 10060... T Drainage of skin 131 1.94 $102.84 $36.61 $20.57 abscess. 10061... T Drainage of skin 131 1.94 $102.84 $36.61 $20.57 abscess. 10080... T Drainage of pilonidal 131 1.94 $102.84 $36.61 $20.57 cyst. 10081... T Drainage of pilonidal 131 1.94 $102.84 $36.61 $20.57 cyst. 10120... T Remove foreign body.... 131 1.94 $102.84 $36.61 $20.57 10121... T Remove foreign body.... 163 10.69 $565.14 $264.65 $113.03 10140... T Drainage of hematoma/ 131 1.94 $102.84 $36.61 $20.57 fluid. 10160... T Puncture drainage of 131 1.94 $102.84 $36.61 $20.57 lesion. 10180... T Complex drainage, wound 131 1.94 $102.84 $36.61 $20.57 11000... T Debride infected skin.. 151 1.74 $92.07 $35.71 $18.41 11001... T Debride infect skin add 151 1.74 $92.07 $35.71 $18.41 11010... T Debride skin, fx....... 163 10.69 $565.14 $264.65 $113.03 11011... T Debride skin/muscle, fx 163 10.69 $565.14 $264.65 $113.03 11012... T Debride skin/muscle/ 163 10.69 $565.14 $264.65 $113.03 bone, fx. 11040... T Debride skin partial... 151 1.74 $92.07 $35.71 $18.41 11041... T Debride skin full...... 151 1.74 $92.07 $35.71 $18.41 11042... T Debride skin/tissue.... 151 1.74 $92.07 $35.71 $18.41 11043... T Debride tissue/muscle.. 162 5.67 $299.71 $125.43 $59.94 11044... T Debride tissue/muscle/ 162 5.67 $299.71 $125.43 $59.94 bone. 11055... T Trim skin lesion....... 151 1.74 $92.07 $35.71 $18.41 11056... T Trim 2 to 4 skin 151 1.74 $92.07 $35.71 $18.41 lesions. 11057... T Trim over 4 skin 151 1.74 $92.07 $35.71 $18.41 lesions. 11100... T Biopsy of skin lesion.. 161 3.50 $185.12 $75.48 $37.02 11101... T Biopsy, each added 161 3.50 $185.12 $75.48 $37.02 lesion. 11200... T Removal of skin tags... 151 1.74 $92.07 $35.71 $18.41 11201... T Removal of added skin 151 1.74 $92.07 $35.71 $18.41 tags. 11300... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11301... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11302... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11303... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11305... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11306... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11307... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11308... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11310... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11311... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11312... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11313... T Shave skin lesion...... 151 1.74 $92.07 $35.71 $18.41 11400... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11401... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11402... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11403... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 [[Page 47625]] 11404... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94 11406... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11420... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11421... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11422... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11423... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11424... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94 11426... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11440... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11441... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11442... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11443... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11444... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94 11446... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11450... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03 lesion. 11451... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03 lesion. 11462... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03 lesion. 11463... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03 lesion. 11470... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03 lesion. 11471... T Removal, sweat gland 163 10.69 $565.14 $264.65 $113.03 lesion. 11600... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11601... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11602... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11603... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11604... T Removal of skin lesion. 162 5.67 $299.71 $125.43 $59.94 11606... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11620... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11621... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11622... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11623... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11624... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11626... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11640... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11641... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11642... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11643... T Removal of skin lesion. 161 3.50 $185.12 $75.48 $37.02 11644... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11646... T Removal of skin lesion. 163 10.69 $565.14 $264.65 $113.03 11719... T Trim nail(s)........... 137 0.46 $24.49 $4.90 $4.90 11720... T Debride nail, 1-5...... 137 0.46 $24.49 $4.90 $4.90 11721... T Debride nail, 6 or more 137 0.46 $24.49 $4.90 $4.90 11730... T Removal of nail plate.. 151 1.74 $92.07 $35.71 $18.41 11731... T Removal of second nail 151 1.74 $92.07 $35.71 $18.41 plate. 11732... T Remove additional nail 151 1.74 $92.07 $35.71 $18.41 plate. 11740... T Drain blood from under 137 0.46 $24.49 $4.90 $4.90 nail. 11750... T Removal of nail bed.... 161 3.50 $185.12 $75.48 $37.02 11752... T Remove nail bed/finger 163 10.69 $565.14 $264.65 $113.03 tip. 11755... T Biopsy, nail unit...... 137 0.46 $24.49 $4.90 $4.90 11760... T Reconstruction of nail 181 2.19 $115.58 $43.84 $23.12 bed. 11762... T Reconstruction of nail 181 2.19 $115.58 $43.84 $23.12 bed. 11765... T Excision of nail fold, 151 1.74 $92.07 $35.71 $18.41 toe. 11770... T Removal of pilonidal 162 5.67 $299.71 $125.43 $59.94 lesion. 11771... T Removal of pilonidal 163 10.69 $565.14 $264.65 $113.03 lesion. 11772... T Removal of pilonidal 163 10.69 $565.14 $264.65 $113.03 lesion. 11900... T Injection into skin 151 1.74 $92.07 $35.71 $18.41 lesions. 11901... T Added skin lesions 151 1.74 $92.07 $35.71 $18.41 injection. 11920... T Correct skin color 181 2.19 $115.58 $43.84 $23.12 defects. 11921... T Correct skin color 181 2.19 $115.58 $43.84 $23.12 defects. 11922... T Correct skin color 181 2.19 $115.58 $43.84 $23.12 defects. 11950... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12 defects. 11951... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12 defects. 11952... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12 defects. 11954... T Therapy for contour 181 2.19 $115.58 $43.84 $23.12 defects. 11960... T Insert tissue 183 11.17 $590.61 $286.57 $118.12 expander(s). 11970... T Replace tissue expander 183 11.17 $590.61 $286.57 $118.12 11971... T Remove tissue 163 10.69 $565.14 $264.65 $113.03 expander(s). 11975... E Insert contraceptive ......... ......... ......... ........... ........... cap. 11976... T Removal of 131 1.94 $102.84 $36.61 $20.57 contraceptive cap. 11977... E Removal/reinsert contra ......... ......... ......... ........... ........... cap. 12001... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12002... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12004... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12005... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12006... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12007... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). [[Page 47626]] 12011... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12013... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12014... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12015... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12016... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12017... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12018... T Repair superficial 181 2.19 $115.58 $43.84 $23.12 wound(s). 12020... T Closure of split wound. 181 2.19 $115.58 $43.84 $23.12 12021... T Closure of split wound. 181 2.19 $115.58 $43.84 $23.12 12031... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12032... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12034... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12035... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12036... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12037... T Layer closure of 183 11.17 $590.61 $286.57 $118.12 wound(s). 12041... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12042... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12044... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12045... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12046... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12047... T Layer closure of 183 11.17 $590.61 $286.57 $118.12 wound(s). 12051... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12052... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12053... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12054... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12055... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12056... T Layer closure of 181 2.19 $115.58 $43.84 $23.12 wound(s). 12057... T Layer closure of 183 11.17 $590.61 $286.57 $118.12 wound(s). 13100... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13101... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13120... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13121... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13131... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13132... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13150... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13151... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13152... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 13160... T Late closure of wound.. 182 4.00 $211.56 $84.98 $42.31 13300... T Repair of wound or 182 4.00 $211.56 $84.98 $42.31 lesion. 14000... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14001... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14020... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14021... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14040... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14041... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14060... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14061... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14300... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 14350... T Skin tissue 183 11.17 $590.61 $286.57 $118.12 rearrangement. 15000... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12 15050... T Skin pinch graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15100... T Skin split graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15101... T Skin split graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15120... T Skin split graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15121... T Skin split graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15200... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15201... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15220... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15221... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15240... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15241... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15260... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15261... T Skin full graft 183 11.17 $590.61 $286.57 $118.12 procedure. 15350... T Skin homograft 183 11.17 $590.61 $286.57 $118.12 procedure. 15400... T Skin heterograft 183 11.17 $590.61 $286.57 $118.12 procedure. 15570... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12 15572... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12 15574... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12 15576... T Form skin pedicle flap. 183 11.17 $590.61 $286.57 $118.12 15580... T Attach skin pedicle 183 11.17 $590.61 $286.57 $118.12 graft. 15600... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12 15610... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12 15620... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12 15625... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12 15630... T Skin graft procedure... 183 11.17 $590.61 $286.57 $118.12 [[Page 47627]] 15650... T Transfer skin pedicle 183 11.17 $590.61 $286.57 $118.12 flap. 15732... T Muscle-skin graft, head/ 184 15.17 $802.17 $396.40 $160.43 neck. 15734... T Muscle-skin graft, 184 15.17 $802.17 $396.40 $160.43 trunk. 15736... T Muscle-skin graft, arm. 184 15.17 $802.17 $396.40 $160.43 15738... T Muscle-skin graft, leg. 184 15.17 $802.17 $396.40 $160.43 15740... T Island pedicle flap 184 15.17 $802.17 $396.40 $160.43 graft. 15750... T Neurovascular pedicle 184 15.17 $802.17 $396.40 $160.43 graft. 15756... C Free muscle flap, ......... ......... ......... ........... ........... microvasc. 15757... C Free skin flap, ......... ......... ......... ........... ........... microvasc. 15758... C Free fascial flap, ......... ......... ......... ........... ........... microvasc. 15760... T Composite skin graft... 184 15.17 $802.17 $396.40 $160.43 15770... T Derma-fat-fascia graft. 184 15.17 $802.17 $396.40 $160.43 15775... T Hair transplant punch 183 11.17 $590.61 $286.57 $118.12 grafts. 15776... T Hair transplant punch 183 11.17 $590.61 $286.57 $118.12 grafts. 15780... T Abrasion treatment of 163 10.69 $565.14 $264.65 $113.03 skin. 15781... T Abrasion treatment of 163 10.69 $565.14 $264.65 $113.03 skin. 15782... T Abrasion treatment of 163 10.69 $565.14 $264.65 $113.03 skin. 15783... T Abrasion treatment of 151 1.74 $92.07 $35.71 $18.41 skin. 15786... T Abrasion treatment of 151 1.74 $92.07 $35.71 $18.41 lesion. 15787... T Abrasion, added skin 151 1.74 $92.07 $35.71 $18.41 lesions. 15788... T Chemical peel, face, 151 1.74 $92.07 $35.71 $18.41 epiderm. 15789... T Chemical peel, face, 151 1.74 $92.07 $35.71 $18.41 dermal. 15792... T Chemical peel, 151 1.74 $92.07 $35.71 $18.41 nonfacial. 15793... T Chemical peel, 151 1.74 $92.07 $35.71 $18.41 nonfacial. 15810... T Salabrasion............ 151 1.74 $92.07 $35.71 $18.41 15811... T Salabrasion............ 163 10.69 $565.14 $264.65 $113.03 15819... T Plastic surgery, neck.. 183 11.17 $590.61 $286.57 $118.12 15820... T Revision of lower 183 11.17 $590.61 $286.57 $118.12 eyelid. 15821... T Revision of lower 183 11.17 $590.61 $286.57 $118.12 eyelid. 15822... T Revision of upper 183 11.17 $590.61 $286.57 $118.12 eyelid. 15823... T Revision of upper 183 11.17 $590.61 $286.57 $118.12 eyelid. 15824... T Removal of forehead 184 15.17 $802.17 $396.40 $160.43 wrinkles. 15825... T Removal of neck 183 11.17 $590.61 $286.57 $118.12 wrinkles. 15826... T Removal of brow 184 15.17 $802.17 $396.40 $160.43 wrinkles. 15828... T Removal of face 184 15.17 $802.17 $396.40 $160.43 wrinkles. 15829... T Removal of skin 183 11.17 $590.61 $286.57 $118.12 wrinkles. 15831... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15832... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15833... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15834... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15835... T Excise excessive skin 183 11.17 $590.61 $286.57 $118.12 tissue. 15836... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15837... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15838... T Excise excessive skin 163 10.69 $565.14 $264.65 $113.03 tissue. 15839... T Excise excessive skin 184 15.17 $802.17 $396.40 $160.43 tissue. 15840... T Graft for face nerve 184 15.17 $802.17 $396.40 $160.43 palsy. 15841... T Graft for face nerve 184 15.17 $802.17 $396.40 $160.43 palsy. 15842... T Graft for face nerve 184 15.17 $802.17 $396.40 $160.43 palsy. 15845... T Skin and muscle repair, 184 15.17 $802.17 $396.40 $160.43 face. 15850... T Removal of sutures..... 151 1.74 $92.07 $35.71 $18.41 15851... T Removal of sutures..... 151 1.74 $92.07 $35.71 $18.41 15852... T Dressing change, not 151 1.74 $92.07 $35.71 $18.41 for burn. 15860... N Test for blood flow in ......... ......... ......... ........... ........... graft. 15876... T Suction assisted 184 15.17 $802.17 $396.40 $160.43 lipectomy. 15877... T Suction assisted 184 15.17 $802.17 $396.40 $160.43 lipectomy. 15878... T Suction assisted 184 15.17 $802.17 $396.40 $160.43 lipectomy. 15879... T Suction assisted 184 15.17 $802.17 $396.40 $160.43 lipectomy. 15920... T Removal of tail bone 163 10.69 $565.14 $264.65 $113.03 ulcer. 15922... T Removal of tail bone 184 15.17 $802.17 $396.40 $160.43 ulcer. 15931... T Remove sacrum pressure 163 10.69 $565.14 $264.65 $113.03 sore. 15933... T Remove sacrum pressure 163 10.69 $565.14 $264.65 $113.03 sore. 15934... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15935... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15936... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15937... T Remove sacrum pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15940... T Removal of pressure 163 10.69 $565.14 $264.65 $113.03 sore. 15941... T Removal of pressure 163 10.69 $565.14 $264.65 $113.03 sore. 15944... T Removal of pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15945... T Removal of pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15946... T Removal of pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15950... T Remove thigh pressure 163 10.69 $565.14 $264.65 $113.03 sore. 15951... T Remove thigh pressure 163 10.69 $565.14 $264.65 $113.03 sore. 15952... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15953... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15956... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43 sore. [[Page 47628]] 15958... T Remove thigh pressure 184 15.17 $802.17 $396.40 $160.43 sore. 15999... T Removal of pressure 163 10.69 $565.14 $264.65 $113.03 sore. 16000... T Initial treatment of 151 1.74 $92.07 $35.71 $18.41 burn(s). 16010... T Treatment of burn(s)... 152 10.43 $551.43 $261.71 $110.29 16015... T Treatment of burn(s)... 152 10.43 $551.43 $261.71 $110.29 16020... T Treatment of burn(s)... 151 1.74 $92.07 $35.71 $18.41 16025... T Treatment of burn(s)... 151 1.74 $92.07 $35.71 $18.41 16030... T Treatment of burn(s)... 151 1.74 $92.07 $35.71 $18.41 16035... T Incision of burn scab.. 162 5.67 $299.71 $125.43 $59.94 16040... T Burn wound excision.... 162 5.67 $299.71 $125.43 $59.94 16041... T Burn wound excision.... 162 5.67 $299.71 $125.43 $59.94 16042... T Burn wound excision.... 162 5.67 $299.71 $125.43 $59.94 17000... T Destroy benign/premal 141 0.59 $31.34 $9.49 $6.27 lesion. 17003... T Destroy 2-14 lesions... 141 0.59 $31.34 $9.49 $6.27 17004... T Destroy 15 & more 142 3.78 $199.81 $73.00 $39.96 lesions. 17106... T Destruction of skin 141 0.59 $31.34 $9.49 $6.27 lesions. 17107... T Destruction of skin 142 3.78 $199.81 $73.00 $39.96 lesions. 17108... T Destruction of skin 142 3.78 $199.81 $73.00 $39.96 lesions. 17110... T Destruct lesion, 1-14.. 141 0.59 $31.34 $9.49 $6.27 17111... T Destruct lesion, 15 or 142 3.78 $199.81 $73.00 $39.96 more. 17250... T Chemical cautery, 151 1.74 $92.07 $35.71 $18.41 tissue. 17260... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17261... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17262... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17263... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17264... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17266... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17270... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17271... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17272... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17273... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17274... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17276... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17280... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17281... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17282... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17283... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17284... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17286... T Destruction of skin 151 1.74 $92.07 $35.71 $18.41 lesions. 17304... T Chemosurgery of skin 162 5.67 $299.71 $125.43 $59.94 lesion. 17305... T 2nd stage chemosurgery. 162 5.67 $299.71 $125.43 $59.94 17306... T 3rd stage chemosurgery. 162 5.67 $299.71 $125.43 $59.94 17307... T Followup skin lesion 162 5.67 $299.71 $125.43 $59.94 therapy. 17310... T Extensive skin 162 5.67 $299.71 $125.43 $59.94 chemosurgery. 17340... T Cryotherapy of skin.... 151 1.74 $92.07 $35.71 $18.41 17360... T Skin peel therapy...... 151 1.74 $92.07 $35.71 $18.41 17380... T Hair removal by 151 1.74 $92.07 $35.71 $18.41 electrolysis. 17999... T Skin tissue procedure.. 121 0.67 $35.26 $21.02 $7.05 19000... T Drainage of breast 121 0.67 $35.26 $21.02 $7.05 lesion. 19001... T Drain added breast 121 0.67 $35.26 $21.02 $7.05 lesion. 19020... T Incision of breast 132 6.04 $319.30 $134.24 $63.86 lesion. 19030... T Injection for breast x- 347 2.93 $154.75 $62.15 $30.95 ray. 19100... T Biopsy of breast....... 122 4.87 $257.60 $115.03 $51.52 19101... T Biopsy of breast....... 197 12.13 $641.54 $310.75 $128.31 19110... T Nipple exploration..... 197 12.13 $641.54 $310.75 $128.31 19112... T Excise breast duct 197 12.13 $641.54 $310.75 $128.31 fistula. 19120... T Removal of breast 197 12.13 $641.54 $310.75 $128.31 lesion. 19125... T Excision, breast lesion 197 12.13 $641.54 $310.75 $128.31 19126... T Excision, add'l breast 197 12.13 $641.54 $310.75 $128.31 lesion. 19140... T Removal of breast 197 12.13 $641.54 $310.75 $128.31 tissue. 19160... T Removal of breast 198 19.17 $1,013.73 $530.20 $202.75 tissue. 19162... T Remove breast tissue, 198 19.17 $1,013.73 $530.20 $202.75 nodes. 19180... T Removal of breast...... 198 19.17 $1,013.73 $530.20 $202.75 19182... T Removal of breast...... 198 19.17 $1,013.73 $530.20 $202.75 19200... C Removal of breast...... ......... ......... ......... ........... ........... 19220... C Removal of breast...... ......... ......... ......... ........... ........... 19240... C Removal of breast...... ......... ......... ......... ........... ........... 19260... C Removal of chest wall ......... ......... ......... ........... ........... lesion. 19271... C Revision of chest wall. ......... ......... ......... ........... ........... 19272... C Extensive chest wall ......... ......... ......... ........... ........... surgery. 19290... T Place needle wire, 197 12.13 $641.54 $310.75 $128.31 breast. 19291... T Place needle wire, 197 12.13 $641.54 $310.75 $128.31 breast. 19316... T Suspension of breast... 198 19.17 $1,013.73 $530.20 $202.75 19318... T Reduction of large 198 19.17 $1,013.73 $530.20 $202.75 breast. 19324... T Enlarge breast......... 198 19.17 $1,013.73 $530.20 $202.75 [[Page 47629]] 19325... T Enlarge breast with 198 19.17 $1,013.73 $530.20 $202.75 implant. 19328... T Removal of breast 198 19.17 $1,013.73 $530.20 $202.75 implant. 19330... T Removal of implant 198 19.17 $1,013.73 $530.20 $202.75 material. 19340... T Immediate breast 198 19.17 $1,013.73 $530.20 $202.75 prosthesis. 19342... T Delayed breast 198 19.17 $1,013.73 $530.20 $202.75 prosthesis. 19350... T Breast reconstruction.. 198 19.17 $1,013.73 $530.20 $202.75 19355... T Correct inverted 198 19.17 $1,013.73 $530.20 $202.75 nipple(s). 19357... T Breast reconstruction.. 198 19.17 $1,013.73 $530.20 $202.75 19361... C Breast reconstruction.. ......... ......... ......... ........... ........... 19364... C Breast reconstruction.. ......... ......... ......... ........... ........... 19366... T Breast reconstruction.. 198 19.17 $1,013.73 $530.20 $202.75 19367... C Breast reconstruction.. ......... ......... ......... ........... ........... 19368... C Breast reconstruction.. ......... ......... ......... ........... ........... 19369... C Breast reconstruction.. ......... ......... ......... ........... ........... 19370... T Surgery of breast 198 19.17 $1,013.73 $530.20 $202.75 capsule. 19371... T Removal of breast 198 19.17 $1,013.73 $530.20 $202.75 capsule. 19380... T Revise breast 198 19.17 $1,013.73 $530.20 $202.75 reconstruction. 19396... T Design custom breast 197 12.13 $641.54 $310.75 $128.31 implant. 19499... T Breast surgery 197 12.13 $641.54 $310.75 $128.31 procedure. 20000... T Incision of abscess.... 131 1.94 $102.84 $36.61 $20.57 20005... T Incision of deep 251 14.26 $754.18 $366.12 $150.84 abscess. 20100... C Explore wound, neck.... ......... ......... ......... ........... ........... 20101... C Explore wound, chest... ......... ......... ......... ........... ........... 20102... C Explore wound, abdomen. ......... ......... ......... ........... ........... 20103... C Explore wound, ......... ......... ......... ........... ........... extremity. 20150... C Excise epiphyseal bar.. ......... ......... ......... ........... ........... 20200... T Muscle biopsy.......... 162 5.67 $299.71 $125.43 $59.94 20205... T Deep muscle biopsy..... 162 5.67 $299.71 $125.43 $59.94 20206... T Needle biopsy, muscle.. 122 4.87 $257.6 $115.03 $51.52 20220... T Bone biopsy, trocar/ 162 5.67 $299.71 $125.43 $59.94 needle. 20225... T Bone biopsy, trocar/ 162 5.67 $299.71 $125.43 $59.94 needle. 20240... T Bone biopsy, excisional 163 10.69 $565.14 $264.65 $113.03 20245... T Bone biopsy, excisional 163 10.69 $565.14 $264.65 $113.03 20250... T Open bone biopsy....... 251 14.26 $754.18 $366.12 $150.84 20251... T Open bone biopsy....... 251 14.26 $754.18 $366.12 $150.84 20500... T Injection of sinus 181 2.19 $115.58 $43.84 $23.12 tract. 20501... T Inject sinus tract for 347 2.93 $154.75 $62.15 $30.95 x-ray. 20520... T Removal of foreign body 161 3.50 $185.12 $75.48 $37.02 20525... T Removal of foreign body 163 10.69 $565.14 $264.65 $113.03 20550... T Inj tendon/ligament/ 200 1.89 $99.90 $39.10 $19.98 cyst. 20600... T Drain/inject joint/ 200 1.89 $99.90 $39.10 $19.98 bursa. 20605... T Drain/inject joint/ 200 1.89 $99.90 $39.10 $19.98 bursa. 20610... T Drain/inject joint/ 200 1.89 $99.90 $39.10 $19.98 bursa. 20615... T Treatment of bone cyst. 121 0.67 $35.26 $21.02 $7.05 20650... T Insert and remove bone 251 14.26 $754.18 $366.12 $150.84 pin. 20660... C Apply,remove fixation ......... ......... ......... ........... ........... device. 20661... C Application of head ......... ......... ......... ........... ........... brace. 20662... C Application of pelvis ......... ......... ......... ........... ........... brace. 20663... C Application of thigh ......... ......... ......... ........... ........... brace. 20664... C Halo brace application. ......... ......... ......... ........... ........... 20665... N Removal of fixation ......... ......... ......... ........... ........... device. 20670... T Removal of support 162 5.67 $299.71 $125.43 $59.94 implant. 20680... T Removal of support 163 10.69 $565.14 $264.65 $113.03 implant. 20690... T Apply bone fixation 252 19.39 $1,025.49 $509.18 $205.10 device. 20692... T Apply bone fixation 252 19.39 $1,025.49 $509.18 $205.10 device. 20693... T Adjust bone fixation 251 14.26 $754.18 $366.12 $150.84 device. 20694... T Remove bone fixation 251 14.26 $754.18 $366.12 $150.84 device. 20802... C Replantation, arm, ......... ......... ......... ........... ........... complete. 20805... C Replant forearm, ......... ......... ......... ........... ........... complete. 20808... C Replantation, hand, ......... ......... ......... ........... ........... complete. 20816... C Replantation digit, ......... ......... ......... ........... ........... complete. 20822... C Replantation digit, ......... ......... ......... ........... ........... complete. 20824... C Replantation thumb, ......... ......... ......... ........... ........... complete. 20827... C Replantation thumb, ......... ......... ......... ........... ........... complete. 20838... C Replantation, foot, ......... ......... ......... ........... ........... complete. 20900... T Removal of bone for 252 19.39 $1,025.49 $509.18 $205.10 graft. 20902... T Removal of bone for 252 19.39 $1,025.49 $509.18 $205.10 graft. 20910... T Remove cartilage for 183 11.17 $590.61 $286.57 $118.12 graft. 20912... T Remove cartilage for 183 11.17 $590.61 $286.57 $118.12 graft. 20920... T Removal of fascia for 183 11.17 $590.61 $286.57 $118.12 graft. 20922... T Removal of fascia for 183 11.17 $590.61 $286.57 $118.12 graft. 20924... T Removal of tendon for 252 19.39 $1,025.49 $509.18 $205.10 graft. 20926... T Removal of tissue for 183 11.17 $590.61 $286.57 $118.12 graft. 20930... C Spinal bone allograft.. ......... ......... ......... ........... ........... 20931... C Spinal bone allograft.. ......... ......... ......... ........... ........... [[Page 47630]] 20936... C Spinal bone autograft.. ......... ......... ......... ........... ........... 20937... C Spinal bone autograft.. ......... ......... ......... ........... ........... 20938... C Spinal bone autograft.. ......... ......... ......... ........... ........... 20950... T Record fluid 132 6.04 $319.30 $134.24 $63.86 pressure,muscle. 20955... C Fibula bone graft, ......... ......... ......... ........... ........... microvasc. 20956... C Iliac bone graft, ......... ......... ......... ........... ........... microvasc. 20957... C Mt bone graft, ......... ......... ......... ........... ........... microvasc. 20962... C Other bone graft, ......... ......... ......... ........... ........... microvasc. 20969... C Bone/skin graft, ......... ......... ......... ........... ........... microvasc. 20970... C Bone/skin graft, iliac ......... ......... ......... ........... ........... crest. 20972... C Bone-skin graft, ......... ......... ......... ........... ........... metatarsal. 20973... C Bone-skin graft, great ......... ......... ......... ........... ........... toe. 20974... A Electrical bone ......... ......... ......... ........... ........... stimulation. 20975... T Electrical bone 251 14.26 $754.18 $366.12 $150.84 stimulation. 20999... N Musculoskeletal surgery ......... ......... ......... ........... ........... 21010... T Incision of jaw joint.. 232 23.93 $1,265.45 $639.35 $253.09 21015... T Resection of facial 231 12.02 $635.66 299.90 $127.13 tumor. 21025... T Excision of bone, lower 231 12.02 $635.66 299.90 $127.13 jaw. 21026... T Excision of facial 231 12.02 $635.66 299.90 $127.13 bone(s). 21029... T Contour of face bone 231 12.02 $635.66 299.90 $127.13 lesion. 21030... T Removal of face bone 231 12.02 $635.66 299.90 $127.13 lesion. 21031... T Remove exostosis, 231 12.02 $635.66 299.90 $127.13 mandible. 21032... T Remove exostosis, 231 12.02 $635.66 299.90 $127.13 maxilla. 21034... T Removal of face bone 232 23.93 $1,265.45 $639.35 $253.09 lesion. 21040... T Removal of jaw bone 231 12.02 $635.66 299.90 $127.13 lesion. 21041... T Removal of jaw bone 231 12.02 $635.66 299.90 $127.13 lesion. 21044... T Removal of jaw bone 232 23.93 $1,265.45 $639.35 $253.09 lesion. 21045... C Extensive jaw surgery.. ......... ......... ......... ........... ........... 21050... T Removal of jaw joint... 232 23.93 $1,265.45 $639.35 $253.09 21060... T Remove jaw joint 232 23.93 $1,265.45 $639.35 $253.09 cartilage. 21070... T Remove coronoid process 232 23.93 $1,265.45 $639.35 $253.09 21076... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21077... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21079... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21080... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21081... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21082... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21083... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21084... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21085... N Prepare face/oral ......... ......... ......... ........... ........... prosthesis. 21086... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21087... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21088... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21089... T Prepare face/oral 226 1.59 $84.23 $21.92 $16.85 prosthesis. 21100... T Maxillofacial fixation. 231 12.02 $635.66 299.90 $127.13 21110... T Interdental fixation... 231 12.02 $635.66 299.90 $127.13 21116... T Injection, jaw joint x- 347 2.93 $154.75 $62.15 $30.95 ray. 21120... T Reconstruction of chin. 231 12.02 $635.66 299.90 $127.13 21121... T Reconstruction of chin. 232 23.93 $1,265.45 $639.35 $253.09 21122... T Reconstruction of chin. 232 23.93 $1,265.45 $639.35 $253.09 21123... T Reconstruction of chin. 232 23.93 $1,265.45 $639.35 $253.09 21125... T Augmentation lower jaw 231 12.02 $635.66 299.90 $127.13 bone. 21127... T Augmentation lower jaw 232 23.93 $1,265.45 $639.35 $253.09 bone. 21137... C Reduction of forehead.. ......... ......... ......... ........... ........... 21138... C Reduction of forehead.. ......... ......... ......... ........... ........... 21139... C Reduction of forehead.. ......... ......... ......... ........... ........... 21141... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21142... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21143... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21145... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21146... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21147... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21150... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21151... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21154... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21155... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21159... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21160... C Reconstruct midface, ......... ......... ......... ........... ........... lefort. 21172... C Reconstruct orbit/ ......... ......... ......... ........... ........... forehead. 21175... C Reconstruct orbit/ ......... ......... ......... ........... ........... forehead. 21179... C Reconstruct entire ......... ......... ......... ........... ........... forehead. 21180... C Reconstruct entire ......... ......... ......... ........... ........... forehead. 21181... T Contour cranial bone 232 23.93 $1,265.45 $639.35 $253.09 lesion. 21182... C Reconstruct cranial ......... ......... ......... ........... ........... bone. 21183... C Reconstruct cranial ......... ......... ......... ........... ........... bone. [[Page 47631]] 21184... C Reconstruct cranial ......... ......... ......... ........... ........... bone. 21188... C Reconstruction of ......... ......... ......... ........... ........... midface. 21193... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21194... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21195... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21196... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21198... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21206... T Reconstruct upper jaw 232 23.93 $1,265.45 $639.35 $253.09 bone. 21208... T Augmentation of facial 232 23.93 $1,265.45 $639.35 $253.09 bones. 21209... T Reduction of facial 232 23.93 $1,265.45 $639.35 $253.09 bones. 21210... T Face bone graft........ 232 23.93 $1,265.45 $639.35 $253.09 21215... T Lower jaw bone graft... 232 23.93 $1,265.45 $639.35 $253.09 21230... T Rib cartilage graft.... 232 23.93 $1,265.45 $639.35 $253.09 21235... T Ear cartilage graft.... 232 23.93 $1,265.45 $639.35 $253.09 21240... T Reconstruction of jaw 232 23.93 $1,265.45 $639.35 $253.09 joint. 21242... T Reconstruction of jaw 232 23.93 $1,265.45 $639.35 $253.09 joint. 21243... T Reconstruction of jaw 218 27.50 $1,454.49 $715.52 $290.90 joint. 21244... T Reconstruction of lower 232 23.93 $1,265.45 $639.35 $253.09 jaw. 21245... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09 21246... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09 21247... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21248... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09 21249... T Reconstruction of jaw.. 232 23.93 $1,265.45 $639.35 $253.09 21255... C Reconstruct lower jaw ......... ......... ......... ........... ........... bone. 21256... C Reconstruction of orbit ......... ......... ......... ........... ........... 21260... T Revise eye sockets..... 232 23.93 $1,265.45 $639.35 $253.09 21261... C Revise eye sockets..... ......... ......... ......... ........... ........... 21263... C Revise eye sockets..... ......... ......... ......... ........... ........... 21267... T Revise eye sockets..... 232 23.93 $1,265.45 $639.35 $253.09 21268... C Revise eye sockets..... ......... ......... ......... ........... ........... 21270... T Augmentation cheek bone 232 23.93 $1,265.45 $639.35 $253.09 21275... T Revision orbitofacial 232 23.93 $1,265.45 $639.35 $253.09 bones. 21280... T Revision of eyelid..... 231 12.02 $635.66 $299.90 $127.13 21282... T Revision of eyelid..... 231 12.02 $635.66 $299.90 $127.13 21295... T Revision of jaw muscle/ 231 12.02 $635.66 $299.90 $127.13 bone. 21296... T Revision of jaw muscle/ 231 12.02 $635.66 $299.90 $127.13 bone. 21299... T Cranio/maxillofacial 231 12.02 $635.66 $299.90 $127.13 surgery. 21300... T Treatment of skull 231 12.02 $635.66 $299.90 $127.13 fracture. 21310... T Treatment of nose 231 12.02 $635.66 $299.90 $127.13 fracture. 21315... T Treatment of nose 231 12.02 $635.66 $299.90 $127.13 fracture. 21320... T Treatment of nose 231 12.02 $635.66 $299.90 $127.13 fracture. 21325... T Repair of nose fracture 231 12.02 $635.66 $299.90 $127.13 21330... T Repair of nose fracture 232 23.93 $1,265.45 $639.35 $253.09 21335... T Repair of nose fracture 232 23.93 $1,265.45 $639.35 $253.09 21336... T Repair nasal septal 216 20.13 $1,064.67 $520.93 $212.93 fracture. 21337... T Repair nasal septal 231 12.02 $635.66 $299.90 $127.13 fracture. 21338... T Repair nasoethmoid 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21339... T Repair nasoethmoid 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21340... T Repair of nose fracture 232 23.93 $1,265.45 $639.35 $253.09 21343... T Repair of sinus 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21344... C Repair of sinus ......... ......... ......... ........... ........... fracture. 21345... T Repair of nose/jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21346... C Repair of nose/jaw ......... ......... ......... ........... ........... fracture. 21347... C Repair of nose/jaw ......... ......... ......... ........... ........... fracture. 21348... C Repair of nose/jaw ......... ......... ......... ........... ........... fracture. 21355... T Repair cheek bone 231 12.02 $635.66 $299.90 $127.13 fracture. 21356... C Repair cheek bone ......... ......... ......... ........... ........... fracture. 21360... C Repair cheek bone ......... ......... ......... ........... ........... fracture. 21365... C Repair cheek bone ......... ......... ......... ........... ........... fracture. 21366... C Repair cheek bone ......... ......... ......... ........... ........... fracture. 21385... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21386... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21387... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21390... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21395... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21400... T Treat eye socket 231 12.02 $635.66 $299.90 $127.13 fracture. 21401... T Repair eye socket 231 12.02 $635.66 $299.90 $127.13 fracture. 21406... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21407... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21408... C Repair eye socket ......... ......... ......... ........... ........... fracture. 21421... T Treat mouth roof 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21422... C Repair mouth roof ......... ......... ......... ........... ........... fracture. 21423... C Repair mouth roof ......... ......... ......... ........... ........... fracture. 21431... C Treat craniofacial ......... ......... ......... ........... ........... fracture. 21432... C Repair craniofacial ......... ......... ......... ........... ........... fracture. [[Page 47632]] 21433... C Repair craniofacial ......... ......... ......... ........... ........... fracture. 21435... C Repair craniofacial ......... ......... ......... ........... ........... fracture. 21436... C Repair craniofacial ......... ......... ......... ........... ........... fracture. 21440... T Repair dental ridge 231 12.02 $635.66 $299.90 $127.13 fracture. 21445... T Repair dental ridge 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21450... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21451... T Treat lower jaw 231 12.02 $635.66 $299.90 $127.13 fracture. 21452... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21453... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21454... T Treat lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21461... T Repair lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21462... T Repair lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21465... T Repair lower jaw 232 23.93 $1,265.45 $639.35 $253.09 fracture. 21470... C Repair lower jaw ......... ......... ......... ........... ........... fracture. 21480... T Reset dislocated jaw... 231 12.02 $635.66 $299.90 $127.13 21485... T Reset dislocated jaw... 231 12.02 $635.66 $299.90 $127.13 21490... T Repair dislocated jaw.. 232 23.93 $1,265.45 $639.35 $253.09 21493... T Treat hyoid bone 231 12.02 $635.66 $299.90 $127.13 fracture. 21494... T Repair hyoid bone 231 12.02 $635.66 $299.90 $127.13 fracture. 21495... C Repair hyoid bone ......... ......... ......... ........... ........... fracture. 21497... T Interdental wiring..... 231 12.02 $635.66 $299.90 $127.13 21499... T Head surgery procedure. 231 12.02 $635.66 $299.90 $127.13 21501... T Drain neck/chest lesion 132 6.04 $319.30 $134.24 $63.86 21502... T Drain chest lesion..... 252 19.39 $1,025.49 $509.18 $205.10 21510... C Drainage of bone lesion ......... ......... ......... ........... ........... 21550... T Biopsy of neck/chest... 161 3.50 $185.12 $75.48 $37.02 21555... T Remove lesion neck/ 163 10.69 $565.14 $264.65 $113.03 chest. 21556... T Remove lesion neck/ 163 10.69 $565.14 $264.65 $113.03 chest. 21557... C Remove tumor, neck or ......... ......... ......... ........... ........... chest. 21600... T Partial removal of rib. 252 19.39 $1,025.49 $509.18 $205.10 21610... T Partial removal of rib. 252 19.39 $1,025.49 $509.18 $205.10 21615... C Removal of rib......... ......... ......... ......... ........... ........... 21616... C Removal of rib and ......... ......... ......... ........... ........... nerves. 21620... C Partial removal of ......... ......... ......... ........... ........... sternum. 21627... C Sternal debridement.... ......... ......... ......... ........... ........... 21630... C Extensive sternum ......... ......... ......... ........... ........... surgery. 21632... C Extensive sternum ......... ......... ......... ........... ........... surgery. 21700... T Revision of neck muscle 132 6.04 $319.30 $134.24 $63.86 21705... C Revision of neck muscle/ ......... ......... ......... ........... ........... rib. 21720... T Revision of neck muscle 132 6.04 $319.30 $134.24 $63.86 21725... T Revision of neck muscle 132 6.04 $319.30 $134.24 $63.86 21740... C Reconstruction of ......... ......... ......... ........... ........... sternum. 21750... C Repair of sternum ......... ......... ......... ........... ........... separation. 21800... T Treatment of rib 207 1.70 $90.11 $31.64 $18.02 fracture. 21805... T Treatment of rib 216 20.13 $1,064.67 $520.93 $212.93 fracture. 21810... C Treatment of rib ......... ......... ......... ........... ........... fracture(s). 21820... T Treat sternum fracture. 207 1.70 $90.11 $31.64 $18.02 21825... C Repair sternum fracture ......... ......... ......... ........... ........... 21899... T Neck/chest surgery 207 1.70 $90.11 $31.64 $18.02 procedure. 21920... T Biopsy soft tissue of 161 3.50 $185.12 $75.48 $37.02 back. 21925... T Biopsy soft tissue of 163 10.69 $565.14 $264.65 $113.03 back. 21930... T Remove lesion, back or 163 10.69 $565.14 $264.65 $113.03 flank. 21935... T Remove tumor of back... 163 10.69 $565.14 $264.65 $113.03 22100... C Remove part of neck ......... ......... ......... ........... ........... vertebra. 22101... C Remove part, thorax ......... ......... ......... ........... ........... vertebra. 22102... C Remove part, lumbar ......... ......... ......... ........... ........... vertebra. 22103... C Remove extra spine ......... ......... ......... ........... ........... segment. 22110... C Remove part of neck ......... ......... ......... ........... ........... vertebra. 22112... C Remove part, thorax ......... ......... ......... ........... ........... vertebra. 22114... C Remove part, lumbar ......... ......... ......... ........... ........... vertebra. 22116... C Remove extra spine ......... ......... ......... ........... ........... segment. 22210... C Revision of neck spine. ......... ......... ......... ........... ........... 22212... C Revision of thorax ......... ......... ......... ........... ........... spine. 22214... C Revision of lumbar ......... ......... ......... ........... ........... spine. 22216... C Revise, extra spine ......... ......... ......... ........... ........... segment. 22220... C Revision of neck spine. ......... ......... ......... ........... ........... 22222... C Revision of thorax ......... ......... ......... ........... ........... spine. 22224... C Revision of lumbar ......... ......... ......... ........... ........... spine. 22226... C Revise, extra spine ......... ......... ......... ........... ........... segment. 22305... T Treat spine process 207 1.70 $90.11 $31.64 $18.02 fracture. 22310... T Treat spine fracture... 207 1.70 $90.11 $31.64 $18.02 22315... T Treat spine fracture... 207 1.70 $90.11 $31.64 $18.02 22325... C Repair of spine ......... ......... ......... ........... ........... fracture. 22326... C Repair neck spine ......... ......... ......... ........... ........... fracture. 22327... C Repair thorax spine ......... ......... ......... ........... ........... fracture. [[Page 47633]] 22328... C Repair each add spine ......... ......... ......... ........... ........... fx. 22505... T Manipulation of spine.. 210 10.46 $553.39 $283.4 $110.68 22548... C Neck spine fusion...... ......... ......... ......... ........... ........... 22554... C Neck spine fusion...... ......... ......... ......... ........... ........... 22556... C Thorax spine fusion.... ......... ......... ......... ........... ........... 22558... C Lumbar spine fusion.... ......... ......... ......... ........... ........... 22585... C Additional spinal ......... ......... ......... ........... ........... fusion. 22590... C Spine & skull spinal ......... ......... ......... ........... ........... fusion. 22595... C Neck spinal fusion..... ......... ......... ......... ........... ........... 22600... C Neck spine fusion...... ......... ......... ......... ........... ........... 22610... C Thorax spine fusion.... ......... ......... ......... ........... ........... 22612... C Lumbar spine fusion.... ......... ......... ......... ........... ........... 22614... C Spine fusion, extra ......... ......... ......... ........... ........... segment. 22630... C Lumbar spine fusion.... ......... ......... ......... ........... ........... 22632... C Spine fusion, extra ......... ......... ......... ........... ........... segment. 22800... C Fusion of spine........ ......... ......... ......... ........... ........... 22802... C Fusion of spine........ ......... ......... ......... ........... ........... 22804... C Fusion of spine........ ......... ......... ......... ........... ........... 22808... C Fusion of spine........ ......... ......... ......... ........... ........... 22810... C Fusion of spine........ ......... ......... ......... ........... ........... 22812... C Fusion of spine........ ......... ......... ......... ........... ........... 22818... C Kyphectomy, 1-2 ......... ......... ......... ........... ........... segments. 22819... C Kyphectomy, 3 & more ......... ......... ......... ........... ........... segment. 22830... C Exploration of spinal ......... ......... ......... ........... ........... fusion. 22840... C Insert spine fixation ......... ......... ......... ........... ........... device. 22841... C Insert spine fixation ......... ......... ......... ........... ........... device. 22842... C Insert spine fixation ......... ......... ......... ........... ........... device. 22843... C Insert spine fixation ......... ......... ......... ........... ........... device. 22844... C Insert spine fixation ......... ......... ......... ........... ........... device. 22845... C Insert spine fixation ......... ......... ......... ........... ........... device. 22846... C Insert spine fixation ......... ......... ......... ........... ........... device. 22847... C Insert spine fixation ......... ......... ......... ........... ........... device. 22848... C Insert pelvic fixation ......... ......... ......... ........... ........... device. 22849... C Reinsert spinal ......... ......... ......... ........... ........... fixation. 22850... C Remove spine fixation ......... ......... ......... ........... ........... device. 22851... C Apply spine prosth ......... ......... ......... ........... ........... device. 22852... C Remove spine fixation ......... ......... ......... ........... ........... device. 22855... C Remove spine fixation ......... ......... ......... ........... ........... device. 22899... T Spine surgery procedure 207 1.70 $90.11 $31.64 $18.02 22900... T Remove abdominal wall 163 10.69 $565.14 $264.65 $113.03 lesion. 22999... T Abdomen surgery 163 10.69 $565.14 $264.65 $113.03 procedure. 23000... T Removal of calcium 162 5.67 $299.71 $125.43 $59.94 deposits. 23020... T Release shoulder joint. 253 26.33 $1,392.78 $699.24 $278.56 23030... T Drain shoulder lesion.. 132 6.04 $319.30 $134.24 $63.86 23031... T Drain shoulder bursa... 132 6.04 $319.30 $134.24 $63.86 23035... C Drain shoulderbone ......... ......... ......... ........... ........... lesion. 23040... T Exploratory shoulder 252 19.39 $1,025.49 $509.18 $205.10 surgery. 23044... T Exploratory shoulder 252 19.39 $1,025.49 $509.18 $205.10 surgery. 23065... T Biopsy shoulder tissues 161 3.50 $185.12 $75.48 $37.02 23066... T Biopsy shoulder tissues 163 10.69 $565.14 $264.65 $113.03 23075... T Removal of shoulder 162 5.67 $299.71 $125.43 $59.94 lesion. 23076... T Removal of shoulder 163 10.69 $565.14 $264.65 $113.03 lesion. 23077... T Remove tumor of 163 10.69 $565.14 $264.65 $113.03 shoulder. 23100... T Biopsy of shoulder 251 14.26 $754.18 $366.12 $150.84 joint. 23101... T Shoulder joint surgery. 252 19.39 $1,025.49 $509.18 $205.10 23105... T Remove shoulder joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 23106... T Incision of collarbone 252 19.39 $1,025.49 $509.18 $205.10 joint. 23107... T Explore, treat shoulder 252 19.39 $1,025.49 $509.18 $205.10 joint. 23120... T Partial removal, 253 26.33 $1,392.78 $699.24 $278.56 collarbone. 23125... C Removal of collarbone.. ......... ......... ......... ........... ........... 23130... T Partial removal, 253 26.33 $1,392.78 $699.24 $278.56 shoulderbone. 23140... T Removal of bone lesion. 251 14.26 $754.18 $366.12 $150.84 23145... T Removal of bone lesion. 252 19.39 $1,025.49 $509.18 $205.10 23146... T Removal of bone lesion. 252 19.39 $1,025.49 $509.18 $205.10 23150... T Removal of humerus 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23155... T Removal of humerus 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23156... T Removal of humerus 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23170... T Remove collarbone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23172... T Remove shoulder blade 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23174... T Remove humerus lesion.. 252 19.39 $1,025.49 $509.18 $205.10 23180... T Remove collarbone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23182... T Remove shoulderblade 252 19.39 $1,025.49 $509.18 $205.10 lesion. 23184... T Remove humerus lesion.. 252 19.39 $1,025.49 $509.18 $205.10 23190... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10 scapula. 23195... C Removal of head of ......... ......... ......... ........... ........... humerus. [[Page 47634]] 23200... C Removal of collarbone.. ......... ......... ......... ........... ........... 23210... C Removal of ......... ......... ......... ........... ........... shoulderblade. 23220... C Partial removal of ......... ......... ......... ........... ........... humerus. 23221... C Partial removal of ......... ......... ......... ........... ........... humerus. 23222... C Partial removal of ......... ......... ......... ........... ........... humerus. 23330... T Remove shoulder foreign 163 10.69 $565.14 $264.65 $113.03 body. 23331... T Remove shoulder foreign 163 10.69 $565.14 $264.65 $113.03 body. 23332... C Remove shoulder foreign ......... ......... ......... ........... ........... body. 23350... T Injection for shoulder 347 2.93 $154.75 $62.15 $30.95 x-ray. 23395... C Muscle transfer, ......... ......... ......... ........... ........... shoulder/arm. 23397... C Muscle transfers....... ......... ......... ......... ........... ........... 23400... C Fixation of ......... ......... ......... ........... ........... shoulderblade. 23405... T Incision of tendon & 252 19.39 $1,025.49 $509.18 $205.10 muscle. 23406... T Incise tendon(s) & 252 19.39 $1,025.49 $509.18 $205.10 muscle(s). 23410... T Repair of tendon(s).... 254 34.37 $1,817.86 $937.22 $363.57 23412... T Repair of tendon(s).... 254 34.37 $1,817.86 $937.22 $363.57 23415... T Release of shoulder 253 26.33 $1,392.78 $699.24 $278.56 ligament. 23420... T Repair of shoulder..... 254 34.37 $1,817.86 $937.22 $363.57 23430... T Repair biceps tendon... 254 34.37 $1,817.86 $937.22 $363.57 23440... C Removal/transplant ......... ......... ......... ........... ........... tendon. 23450... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57 23455... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57 23460... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57 23462... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57 23465... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57 23466... T Repair shoulder capsule 254 34.37 $1,817.86 $937.22 $363.57 23470... C Reconstruct shoulder ......... ......... ......... ........... ........... joint. 23472... C Reconstruct shoulder ......... ......... ......... ........... ........... joint. 23480... T Revision of collarbone. 253 26.33 $1,392.78 $699.24 $278.56 23485... T Revision of collarbone. 253 26.33 $1,392.78 $699.24 $278.56 23490... T Reinforce clavicle..... 253 26.33 $1,392.78 $699.24 $278.56 23491... T Reinforce shoulderbones 253 26.33 $1,392.78 $699.24 $278.56 23500... T Treat clavicle fracture 207 1.70 $90.11 $31.64 $18.02 23505... T Treat clavicle fracture 207 1.70 $90.11 $31.64 $18.02 23515... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 23520... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02 dislocation. 23525... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02 dislocation. 23530... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 23532... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 23540... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02 dislocation. 23545... T Treat clavicle 207 1.70 $90.11 $31.64 $18.02 dislocation. 23550... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 23552... T Repair clavicle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 23570... T Treat shoulderblade 207 1.70 $90.11 $31.64 $18.02 fracture. 23575... T Treat shoulderblade 207 1.70 $90.11 $31.64 $18.02 fracture. 23585... T Repair scapula fracture 216 20.13 $1,064.67 $520.93 $212.93 23600... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 23605... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 23615... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 23616... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 23620... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 23625... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 23630... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 23650... T Treat shoulder 207 1.70 $90.11 $31.64 $18.02 dislocation. 23655... T Treat shoulder 210 10.46 $553.39 $283.40 $110.68 dislocation. 23660... T Repair shoulder 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 23665... T Treat dislocation/ 209 1.94 $102.84 $37.29 $20.57 fracture. 23670... T Repair dislocation/ 216 20.13 $1,064.67 $520.93 $212.93 fracture. 23675... T Treat dislocation/ 209 1.94 $102.84 $37.29 $20.57 fracture. 23680... T Repair dislocation/ 216 20.13 $1,064.67 $520.93 $212.93 fracture. 23700... T Fixation of shoulder... 210 10.46 $553.39 $283.40 $110.68 23800... T Fusion of shoulder 253 26.33 $1,392.78 $699.24 $278.56 joint. 23802... T Fusion of shoulder 253 26.33 $1,392.78 $699.24 $278.56 joint. 23900... C Amputation of arm & ......... ......... ......... ........... ........... girdle. 23920... C Amputation at shoulder ......... ......... ......... ........... ........... joint. 23921... T Amputation follow-up 183 11.17 $590.61 $286.57 $118.12 surgery. 23929... T Shoulder surgery 207 1.70 $90.11 $31.64 $18.02 procedure. 23930... T Drainage of arm lesion. 132 6.04 $319.30 $134.24 $63.86 23931... T Drainage of arm bursa.. 132 6.04 $319.30 $134.24 $63.86 23935... T Drain arm/elbow bone 251 14.26 $754.18 $366.12 $150.84 lesion. 24000... T Exploratory elbow 252 19.39 $1,025.49 $509.18 $205.10 surgery. 24006... T Release elbow joint.... 252 19.39 $1,025.49 $509.18 $205.10 24065... T Biopsy arm/elbow soft 161 3.50 $185.12 $75.48 $37.02 tissue. 24066... T Biopsy arm/elbow soft 163 10.69 $565.14 $264.65 $113.03 tissue. 24075... T Remove arm/elbow lesion 162 5.67 $299.71 $125.43 $59.94 [[Page 47635]] 24076... T Remove arm/elbow lesion 163 10.69 $565.14 $264.65 $113.03 24077... T Remove tumor of arm/ 163 10.69 $565.14 $264.65 $113.03 elbow. 24100... T Biopsy elbow joint 251 14.26 $754.18 $366.12 $150.84 lining. 24101... T Explore/treat elbow 252 19.39 $1,025.49 $509.18 $205.10 joint. 24102... T Remove elbow joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 24105... T Removal of elbow bursa. 251 14.26 $754.18 $366.12 $150.84 24110... T Remove humerus lesion.. 251 14.26 $754.18 $366.12 $150.84 24115... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24116... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24120... T Remove elbow lesion.... 251 14.26 $754.18 $366.12 $150.84 24125... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24126... T Remove/graft bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24130... T Removal of head of 252 19.39 $1,025.49 $509.18 $205.10 radius. 24134... T Removal of arm bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24136... T Remove radius bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24138... T Remove elbow bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 24140... T Partial removal of arm 252 19.39 $1,025.49 $509.18 $205.10 bone. 24145... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10 radius. 24147... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10 elbow. 24149... C Radical resection of ......... ......... ......... ........... ........... elbow. 24150... C Extensive humerus ......... ......... ......... ........... ........... surgery. 24151... C Extensive humerus ......... ......... ......... ........... ........... surgery. 24152... C Extensive radius ......... ......... ......... ........... ........... surgery. 24153... C Extensive radius ......... ......... ......... ........... ........... surgery. 24155... T Removal of elbow joint. 253 26.33 $1,392.78 $699.24 $278.56 24160... T Remove elbow joint 252 19.39 $1,025.49 $509.18 $205.10 implant. 24164... T Remove radius head 252 19.39 $1,025.49 $509.18 $205.10 implant. 24200... T Removal of arm foreign 161 3.50 $185.12 $75.48 $37.02 body. 24201... T Removal of arm foreign 163 10.69 $565.14 $264.65 $113.03 body. 24220... T Injection for elbow x- 347 2.93 $154.75 $62.15 $30.95 ray. 24301... T Muscle/tendon transfer. 252 19.39 $1,025.49 $509.18 $205.10 24305... T Arm tendon lengthening. 252 19.39 $1,025.49 $509.18 $205.10 24310... T Revision of arm tendon. 251 14.26 $754.18 $366.12 $150.84 24320... T Repair of arm tendon... 253 26.33 $1,392.78 $699.24 $278.56 24330... T Revision of arm muscles 253 26.33 $1,392.78 $699.24 $278.56 24331... T Revision of arm muscles 253 26.33 $1,392.78 $699.24 $278.56 24340... T Repair of biceps tendon 253 26.33 $1,392.78 $699.24 $278.56 24341... T Repair tendon/muscle 253 26.33 $1,392.78 $699.24 $278.56 arm. 24342... T Repair of ruptured 253 26.33 $1,392.78 $699.24 $278.56 tendon. 24350... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10 24351... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10 24352... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10 24354... T Repair of tennis elbow. 252 19.39 $1,025.49 $509.18 $205.10 24356... T Revision of tennis 252 19.39 $1,025.49 $509.18 $205.10 elbow. 24360... T Reconstruct elbow joint 217 20.48 $1,083.27 $526.81 $216.65 24361... T Reconstruct elbow joint 218 27.50 $1,454.49 $715.52 $290.90 24362... T Reconstruct elbow joint 218 27.50 $1,454.49 $715.52 $290.90 24363... T Replace elbow joint.... 218 27.50 $1,454.49 $715.52 $290.90 24365... T Reconstruct head of 217 20.48 $1,083.27 $526.81 $216.65 radius. 24366... T Reconstruct head of 218 27.50 $1,454.49 $715.52 $290.90 radius. 24400... T Revision of humerus.... 252 19.39 $1,025.49 $509.18 $205.10 24410... T Revision of humerus.... 252 19.39 $1,025.49 $509.18 $205.10 24420... T Revision of humerus.... 253 26.33 $1,392.78 $699.24 $278.56 24430... T Repair of humerus...... 253 26.33 $1,392.78 $699.24 $278.56 24435... T Repair humerus with 253 26.33 $1,392.78 $699.24 $278.56 graft. 24470... T Revision of elbow joint 253 26.33 $1,392.78 $699.24 $278.56 24495... T Decompression of 252 19.39 $1,025.49 $509.18 $205.10 forearm. 24498... T Reinforce humerus...... 253 26.33 $1,392.78 $699.24 $278.56 24500... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24505... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24515... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 24516... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 24530... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24535... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24538... T Treat humerus fracture. 216 20.13 $1,064.67 $520.93 $212.93 24545... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 24546... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 24560... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24565... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24566... T Treat humerus fracture. 216 20.13 $1,064.67 $520.93 $212.93 24575... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 24576... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24577... T Treat humerus fracture. 209 1.94 $102.84 $37.29 $20.57 24579... T Repair humerus fracture 216 20.13 $1,064.67 $520.93 $212.93 24582... T Treat humerus fracture. 216 20.13 $1,064.67 $520.93 $212.93 [[Page 47636]] 24586... T Repair elbow fracture.. 216 20.13 $1,064.67 $520.93 $212.93 24587... T Repair elbow fracture.. 216 20.13 $1,064.67 $520.93 $212.93 24600... T Treat elbow dislocation 209 1.94 $102.84 $37.29 $20.57 24605... T Treat elbow dislocation 210 10.46 $553.39 $283.40 $110.68 24615... T Repair elbow 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 24620... T Treat elbow fracture... 209 1.94 $102.84 $37.29 $20.57 24635... T Repair elbow fracture.. 216 20.13 $1,064.67 $520.93 $212.93 24640... T Treat elbow dislocation 209 1.94 $102.84 $37.29 $20.57 24650... T Treat radius fracture.. 209 1.94 $102.84 $37.29 $20.57 24655... T Treat radius fracture.. 209 1.94 $102.84 $37.29 $20.57 24665... T Repair radius fracture. 216 20.13 $1,064.67 $520.93 $212.93 24666... T Repair radius fracture. 216 20.13 $1,064.67 $520.93 $212.93 24670... T Treatment of ulna 209 1.94 $102.84 $37.29 $20.57 fracture. 24675... T Treatment of ulna 209 1.94 $102.84 $37.29 $20.57 fracture. 24685... T Repair ulna fracture... 216 20.13 $1,064.67 $520.93 $212.93 24800... T Fusion of elbow joint.. 253 26.33 $1,392.78 $699.24 $278.56 24802... T Fusion/graft of elbow 253 26.33 $1,392.78 $699.24 $278.56 joint. 24900... C Amputation of upper arm ......... ......... ......... ........... ........... 24920... C Amputation of upper arm ......... ......... ......... ........... ........... 24925... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84 surgery. 24930... C Amputation follow-up ......... ......... ......... ........... ........... surgery. 24931... C Amputate upper arm & ......... ......... ......... ........... ........... implant. 24935... C Revision of amputation. ......... ......... ......... ........... ........... 24940... C Revision of upper arm.. ......... ......... ......... ........... ........... 24999... T Upper arm/elbow surgery 209 1.94 $102.84 $37.29 $20.57 25000... T Incision of tendon 251 14.26 $754.18 $366.12 $150.84 sheath. 25020... T Decompression of 251 14.26 $754.18 $366.12 $150.84 forearm. 25023... T Decompression of 252 19.39 $1,025.49 $509.18 $205.10 forearm. 25028... T Drainage of forearm 251 14.26 $754.18 $366.12 $150.84 lesion. 25031... T Drainage of forearm 251 14.26 $754.18 $366.12 $150.84 bursa. 25035... T Treat forearm bone 251 14.26 $754.18 $366.12 $150.84 lesion. 25040... T Explore/treat wrist 252 19.39 $1,025.49 $509.18 $205.10 joint. 25065... T Biopsy forearm soft 161 3.50 $185.12 $75.48 $37.02 tissues. 25066... T Biopsy forearm soft 163 10.69 $565.14 $264.65 $113.03 tissues. 25075... T Removal of forearm 162 5.67 $299.71 $125.43 $59.94 lesion. 25076... T Removal of forearm 163 10.69 $565.14 $264.65 $113.03 lesion. 25077... T Remove tumor, forearm/ 163 10.69 $565.14 $264.65 $113.03 wrist. 25085... T Incision of wrist 251 14.26 $754.18 $366.12 $150.84 capsule. 25100... T Biopsy of wrist joint.. 251 14.26 $754.18 $366.12 $150.84 25101... T Explore/treat wrist 252 19.39 $1,025.49 $509.18 $205.10 joint. 25105... T Remove wrist joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 25107... T Remove wrist joint 252 19.39 $1,025.49 $509.18 $205.10 cartilage. 25110... T Remove wrist tendon 251 14.26 $754.18 $366.12 $150.84 lesion. 25111... T Remove wrist tendon 261 10.54 $557.31 $261.48 $111.46 lesion. 25112... T Remove wrist tendon 261 10.54 $557.31 $261.48 $111.46 lesion. 25115... T Remove wrist/forearm 251 14.26 $754.18 $366.12 $150.84 lesion. 25116... T Remove wrist/forearm 251 14.26 $754.18 $366.12 $150.84 lesion. 25118... T Excise wrist tendon 252 19.39 $1,025.49 $509.18 $205.10 sheath. 25119... T Partial removal of ulna 252 19.39 $1,025.49 $509.18 $205.10 25120... T Removal of forearm 252 19.39 $1,025.49 $509.18 $205.10 lesion. 25125... T Remove/graft forearm 252 19.39 $1,025.49 $509.18 $205.10 lesion. 25126... T Remove/graft forearm 252 19.39 $1,025.49 $509.18 $205.10 lesion. 25130... T Removal of wrist lesion 252 19.39 $1,025.49 $509.18 $205.10 25135... T Remove & graft wrist 252 19.39 $1,025.49 $509.18 $205.10 lesion. 25136... T Remove & graft wrist 252 19.39 $1,025.49 $509.18 $205.10 lesion. 25145... T Remove forearm bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 25150... T Partial removal of ulna 252 19.39 $1,025.49 $509.18 $205.10 25151... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10 radius. 25170... C Extensive forearm ......... ......... ......... ........... ........... surgery. 25210... T Removal of wrist bone.. 262 18.35 $970.64 $480.93 $194.13 25215... T Removal of wrist bones. 262 18.35 $970.64 $480.93 $194.13 25230... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10 radius. 25240... T Partial removal of ulna 252 19.39 $1,025.49 $509.18 $205.10 25246... T Injection for wrist x- 347 2.93 $154.75 $62.15 $30.95 ray. 25248... T Remove forearm foreign 251 14.26 $754.18 $366.12 $150.84 body. 25250... T Removal of wrist 252 19.39 $1,025.49 $509.18 $205.10 prosthesis. 25251... T Removal of wrist 252 19.39 $1,025.49 $509.18 $205.10 prosthesis. 25260... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10 muscle. 25263... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10 muscle. 25265... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10 muscle. 25270... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10 muscle. 25272... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10 muscle. 25274... T Repair forearm tendon/ 252 19.39 $1,025.49 $509.18 $205.10 muscle. 25280... T Revise wrist/forearm 252 19.39 $1,025.49 $509.18 $205.10 tendon. 25290... T Incise wrist/forearm 252 19.39 $1,025.49 $509.18 $205.10 tendon. [[Page 47637]] 25295... T Release wrist/forearm 251 14.26 $754.18 $366.12 $150.84 tendon. 25300... T Fusion of tendons at 252 19.39 $1,025.49 $509.18 $205.10 wrist. 25301... T Fusion of tendons at 252 19.39 $1,025.49 $509.18 $205.10 wrist. 25310... T Transplant forearm 253 26.33 $1,392.78 $699.24 $278.56 tendon. 25312... T Transplant forearm 253 26.33 $1,392.78 $699.24 $278.56 tendon. 25315... T Revise palsy hand 253 26.33 $1,392.78 $699.24 $278.56 tendon(s). 25316... T Revise palsy hand 253 26.33 $1,392.78 $699.24 $278.56 tendon(s). 25320... T Repair/revise wrist 253 26.33 $1,392.78 $699.24 $278.56 joint. 25332... T Revise wrist joint..... 217 20.48 $1,083.27 $526.81 $216.65 25335... T Realignment of hand.... 253 26.33 $1,392.78 $699.24 $278.56 25337... T Reconstruct ulna/ 253 26.33 $1,392.78 $699.24 $278.56 radioulnar. 25350... T Revision of radius..... 253 26.33 $1,392.78 $699.24 $278.56 25355... T Revision of radius..... 253 26.33 $1,392.78 $699.24 $278.56 25360... T Revision of ulna....... 252 19.39 $1,025.49 $509.18 $205.10 25365... T Revise radius & ulna... 252 19.39 $1,025.49 $509.18 $205.10 25370... T Revise radius or ulna.. 253 26.33 $1,392.78 $699.24 $278.56 25375... T Revise radius & ulna... 253 26.33 $1,392.78 $699.24 $278.56 25390... C Shorten radius/ulna.... ......... ......... ......... ........... ........... 25391... C Lengthen radius/ulna... ......... ......... ......... ........... ........... 25392... C Shorten radius & ulna.. ......... ......... ......... ........... ........... 25393... C Lengthen radius & ulna. ......... ......... ......... ........... ........... 25400... T Repair radius or ulna.. 252 19.39 $1,025.49 $509.18 $205.10 25405... C Repair/graft radius or ......... ......... ......... ........... ........... ulna. 25415... T Repair radius & ulna... 252 19.39 $1,025.49 $509.18 $205.10 25420... C Repair/graft radius & ......... ......... ......... ........... ........... ulna. 25425... T Repair/graft radius or 253 26.33 $1,392.78 $699.24 $278.56 ulna. 25426... T Repair/graft radius & 253 26.33 $1,392.78 $699.24 $278.56 ulna. 25440... T Repair/graft wrist bone 253 26.33 $1,392.78 $699.24 $278.56 25441... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90 25442... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90 25443... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90 25444... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90 25445... T Reconstruct wrist joint 218 27.50 $1,454.49 $715.52 $290.90 25446... T Wrist replacement...... 218 27.50 $1,454.49 $715.52 $290.90 25447... T Repair wrist joint(s).. 217 20.48 $1,083.27 $526.81 $216.65 25449... T Remove wrist joint 217 20.48 $1,083.27 $526.81 $216.65 implant. 25450... T Revision of wrist joint 253 26.33 $1,392.78 $699.24 $278.56 25455... T Revision of wrist joint 253 26.33 $1,392.78 $699.24 $278.56 25490... T Reinforce radius....... 253 26.33 $1,392.78 $699.24 $278.56 25491... T Reinforce ulna......... 253 26.33 $1,392.78 $699.24 $278.56 25492... T Reinforce radius and 253 26.33 $1,392.78 $699.24 $278.56 ulna. 25500... T Treat fracture of 209 1.94 $102.84 $37.29 $20.57 radius. 25505... T Treat fracture of 209 1.94 $102.84 $37.29 $20.57 radius. 25515... T Repair fracture of 216 20.13 $1,064.67 $520.93 $212.93 radius. 25520... T Repair fracture of 209 1.94 $102.84 $37.29 $20.57 radius. 25525... T Repair fracture of 216 20.13 $1,064.67 $520.93 $212.93 radius. 25526... T Repair fracture of 216 20.13 $1,064.67 $520.93 $212.93 radius. 25530... T Treat fracture of ulna. 209 1.94 $102.84 $37.29 $20.57 25535... T Treat fracture of ulna. 209 1.94 $102.84 $37.29 $20.57 25545... T Repair fracture of ulna 216 20.13 $1,064.67 $520.93 $212.93 25560... T Treat fracture radius & 209 1.94 $102.84 $37.29 $20.57 ulna. 25565... T Treat fracture radius & 209 1.94 $102.84 $37.29 $20.57 ulna. 25574... T Treat fracture radius & 216 20.13 $1,064.67 $520.93 $212.93 ulna. 25575... T Repair fracture radius/ 216 20.13 $1,064.67 $520.93 $212.93 ulna. 25600... T Treat fracture radius/ 209 1.94 $102.84 $37.29 $20.57 ulna. 25605... T Treat fracture radius/ 209 1.94 $102.84 $37.29 $20.57 ulna. 25611... T Repair fracture radius/ 216 20.13 $1,064.67 $520.93 $212.93 ulna. 25620... T Repair fracture radius/ 216 20.13 $1,064.67 $520.93 $212.93 ulna. 25622... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57 fracture. 25624... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57 fracture. 25628... T Repair wrist bone 216 20.13 $1,064.67 $520.93 $212.93 fracture. 25630... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57 fracture. 25635... T Treat wrist bone 209 1.94 $102.84 $37.29 $20.57 fracture. 25645... T Repair wrist bone 216 20.13 $1,064.67 $520.93 $212.93 fracture. 25650... T Repair wrist bone 209 1.94 $102.84 $37.29 $20.57 fracture. 25660... T Treat wrist dislocation 209 1.94 $102.84 $37.29 $20.57 25670... T Repair wrist 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 25675... T Treat wrist dislocation 209 1.94 $102.84 $37.29 $20.57 25676... T Repair wrist 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 25680... T Treat wrist fracture... 209 1.94 $102.84 $37.29 $20.57 25685... T Repair wrist fracture.. 216 20.13 $1,064.67 $520.93 $212.93 25690... T Treat wrist dislocation 209 1.94 102.84 $37.29 $20.57 25695... T Repair wrist 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 25800... T Fusion of wrist joint.. 253 26.33 $1,392.78 $699.24 $278.56 25805... T Fusion/graft of wrist 253 26.33 $1,392.78 $699.24 $278.56 joint. [[Page 47638]] 25810... T Fusion/graft of wrist 253 26.33 $1,392.78 $699.24 $278.56 joint. 25820... T Fusion of hand bones... 261 10.54 $557.31 $261.48 $111.46 25825... T Fusion hand bones with 262 18.35 $970.64 $480.93 $194.13 graft. 25830... T Fusion radioulnar jnt/ 253 26.33 $1,392.78 $699.24 $278.56 ulna. 25900... C Amputation of forearm.. ......... ......... ......... ........... ........... 25905... C Amputation of forearm.. ......... ......... ......... ........... ........... 25907... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84 surgery. 25909... C Amputation follow-up ......... ......... ......... ........... ........... surgery. 25915... C Amputation of forearm.. ......... ......... ......... ........... ........... 25920... C Amputate hand at wrist. ......... ......... ......... ........... ........... 25922... T Amputate hand at wrist. 251 14.26 $754.18 $366.12 $150.84 25924... C Amputation follow-up ......... ......... ......... ........... ........... surgery. 25927... C Amputation of hand..... ......... ......... ......... ........... ........... 25929... T Amputation follow-up 183 11.17 $590.61 $286.57 $118.12 surgery. 25931... C Amputation follow-up ......... ......... ......... ........... ........... surgery. 25999... T Forearm or wrist 209 1.94 $102.84 $37.29 $20.57 surgery. 26010... T Drainage of finger 131 1.94 $102.84 $36.61 $20.57 abscess. 26011... T Drainage of finger 131 1.94 $102.84 $36.61 $20.57 abscess. 26020... T Drain hand tendon 261 10.54 $557.31 $261.48 $111.46 sheath. 26025... T Drainage of palm bursa. 261 10.54 $557.31 $261.48 $111.46 26030... T Drainage of palm 261 10.54 $557.31 $261.48 $111.46 bursa(s). 26034... T Treat hand bone lesion. 261 10.54 $557.31 $261.48 $111.46 26035... T Decompress fingers/hand 261 10.54 $557.31 $261.48 $111.46 26037... T Decompress fingers/hand 261 10.54 $557.31 $261.48 $111.46 26040... T Release palm 262 18.35 $970.64 $480.93 $194.13 contracture. 26045... T Release palm 262 18.35 $970.64 $480.93 $194.13 contracture. 26055... T Incise finger tendon 261 10.54 $557.31 $261.48 $111.46 sheath. 26060... T Incision of finger 261 10.54 $557.31 $261.48 $111.46 tendon. 26070... T Explore/treat hand 261 10.54 $557.31 $261.48 $111.46 joint. 26075... T Explore/treat finger 261 10.54 $557.31 $261.48 $111.46 joint. 26080... T Explore/treat finger 261 10.54 $557.31 $261.48 $111.46 joint. 26100... T Biopsy hand joint 261 10.54 $557.31 $261.48 $111.46 lining. 26105... T Biopsy finger joint 261 10.54 $557.31 $261.48 $111.46 lining. 26110... T Biopsy finger joint 261 10.54 $557.31 $261.48 $111.46 lining. 26115... T Removal of hand lesion. 163 10.69 $565.14 $264.65 $113.03 26116... T Removal of hand lesion. 163 10.69 $565.14 $264.65 $113.03 26117... T Remove tumor, hand/ 163 10.69 $565.14 $264.65 $113.03 finger. 26121... T Release palm 262 18.35 $970.64 $480.93 $194.13 contracture. 26123... T Release palm 262 18.35 $970.64 $480.93 $194.13 contracture. 26125... T Release palm 262 18.35 $970.64 $480.93 $194.13 contracture. 26130... T Remove wrist joint 261 10.54 $557.31 $261.48 $111.46 lining. 26135... T Revise finger joint, 262 18.35 $970.64 $480.93 $194.13 each. 26140... T Revise finger joint, 261 10.54 $557.31 $261.48 $111.46 each. 26145... T Tendon excision, palm/ 261 10.54 $557.31 $261.48 $111.46 finger. 26160... T Remove tendon sheath 261 10.54 $557.31 $261.48 $111.46 lesion. 26170... T Removal of palm tendon, 261 10.54 $557.31 $261.48 $111.46 each. 26180... T Removal of finger 261 10.54 $557.31 $261.48 $111.46 tendon. 26185... T Remove finger bone..... 261 10.54 $557.31 $261.48 $111.46 26200... T Remove hand bone lesion 261 10.54 $557.31 $261.48 $111.46 26205... T Remove/graft bone 262 18.35 $970.64 $480.93 $194.13 lesion. 26210... T Removal of finger 261 10.54 $557.31 $261.48 $111.46 lesion. 26215... T Remove/graft finger 261 10.54 $557.31 $261.48 $111.46 lesion. 26230... T Partial removal of hand 261 10.54 $557.31 $261.48 $111.46 bone. 26235... T Partial removal, finger 261 10.54 $557.31 $261.48 $111.46 bone. 26236... T Partial removal, finger 261 10.54 $557.31 $261.48 $111.46 bone. 26250... T Extensive hand surgery. 261 10.54 $557.31 $261.48 $111.46 26255... T Extensive hand surgery. 262 18.35 $970.64 $480.93 $194.13 26260... T Extensive finger 261 10.54 $557.31 $261.48 $111.46 surgery. 26261... T Extensive finger 261 10.54 $557.31 $261.48 $111.46 surgery. 26262... T Partial removal of 261 10.54 $557.31 $261.48 $111.46 finger. 26320... T Removal of implant from 163 10.69 $565.14 $264.65 $113.03 hand. 26350... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26352... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26356... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26357... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26358... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26370... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26372... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26373... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26390... T Revise hand/finger 262 18.35 $970.64 $480.93 $194.13 tendon. 26392... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26410... T Repair hand tendon..... 261 10.54 $557.31 $261.48 $111.46 26412... T Repair/graft hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26415... T Excision, hand/finger 262 18.35 $970.64 $480.93 $194.13 tendon. 26416... T Graft hand or finger 262 18.35 $970.64 $480.93 $194.13 tendon. [[Page 47639]] 26418... T Repair finger tendon... 261 10.54 $557.31 $261.48 $111.46 26420... T Repair/graft finger 262 18.35 $970.64 $480.93 $194.13 tendon. 26426... T Repair finger/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26428... T Repair/graft finger 262 18.35 $970.64 $480.93 $194.13 tendon. 26432... T Repair finger tendon... 261 10.54 $557.31 $261.48 $111.46 26433... T Repair finger tendon... 261 10.54 $557.31 $261.48 $111.46 26434... T Repair/graft finger 262 18.35 $970.64 $480.93 $194.13 tendon. 26437... T Realignment of tendons. 261 10.54 $557.31 $261.48 $111.46 26440... T Release palm/finger 261 10.54 $557.31 $261.48 $111.46 tendon. 26442... T Release palm & finger 262 18.35 $970.64 $480.93 $194.13 tendon. 26445... T Release hand/finger 261 10.54 $557.31 $261.48 $111.46 tendon. 26449... T Release forearm/hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26450... T Incision of palm tendon 261 10.54 $557.31 $261.48 $111.46 26455... T Incision of finger 261 10.54 $557.31 $261.48 $111.46 tendon. 26460... T Incise hand/finger 261 10.54 $557.31 $261.48 $111.46 tendon. 26471... T Fusion of finger 261 10.54 $557.31 $261.48 $111.46 tendons. 26474... T Fusion of finger 261 10.54 $557.31 $261.48 $111.46 tendons. 26476... T Tendon lengthening..... 261 10.54 $557.31 $261.48 $111.46 26477... T Tendon shortening...... 261 10.54 $557.31 $261.48 $111.46 26478... T Lengthening of hand 261 10.54 $557.31 $261.48 $111.46 tendon. 26479... T Shortening of hand 261 10.54 $557.31 $261.48 $111.46 tendon. 26480... T Transplant hand tendon. 262 18.35 $970.64 $480.93 $194.13 26483... T Transplant/graft hand 262 18.35 $970.64 $480.93 $194.13 tendon. 26485... T Transplant palm tendon. 262 18.35 $970.64 $480.93 $194.13 26489... T Transplant/graft palm 262 18.35 $970.64 $480.93 $194.13 tendon. 26490... T Revise thumb tendon.... 262 18.35 $970.64 $480.93 $194.13 26492... T Tendon transfer with 262 18.35 $970.64 $480.93 $194.13 graft. 26494... T Hand tendon/muscle 262 18.35 $970.64 $480.93 $194.13 transfer. 26496... T Revise thumb tendon.... 262 18.35 $970.64 $480.93 $194.13 26497... T Finger tendon transfer. 262 18.35 $970.64 $480.93 $194.13 26498... T Finger tendon transfer. 262 18.35 $970.64 $480.93 $194.13 26499... T Revision of finger..... 262 18.35 $970.64 $480.93 $194.13 26500... T Hand tendon 261 10.54 $557.31 $261.48 $111.46 reconstruction. 26502... T Hand tendon 262 18.35 $970.64 $480.93 $194.13 reconstruction. 26504... T Hand tendon 262 18.35 $970.64 $480.93 $194.13 reconstruction. 26508... T Release thumb 261 10.54 $557.31 $261.48 $111.46 contracture. 26510... T Thumb tendon transfer.. 262 18.35 $970.64 $480.93 $194.13 26516... T Fusion of knuckle joint 262 18.35 $970.64 $480.93 $194.13 26517... T Fusion of knuckle 262 18.35 $970.64 $480.93 $194.13 joints. 26518... T Fusion of knuckle 262 18.35 $970.64 $480.93 $194.13 joints. 26520... T Release knuckle 261 10.54 $557.31 $261.48 $111.46 contracture. 26525... T Release finger 261 10.54 $557.31 $261.48 $111.46 contracture. 26530... T Revise knuckle joint... 217 20.48 $1,083.27 $526.81 $216.65 26531... T Revise knuckle with 218 27.50 $1,454.49 $715.52 $290.90 implant. 26535... T Revise finger joint.... 217 20.48 $1,083.27 $526.81 $216.65 26536... T Revise/implant finger 218 27.50 $1,454.49 $715.52 $290.90 joint. 26540... T Repair hand joint...... 261 10.54 $557.31 $261.48 $111.46 26541... T Repair hand joint with 262 18.35 $970.64 $480.93 $194.13 graft. 26542... T Repair hand joint with 261 10.54 $557.31 $261.48 $111.46 graft. 26545... T Reconstruct finger 262 18.35 $970.64 $480.93 $194.13 joint. 26546... T Repair non-union hand.. 262 18.35 $970.64 $480.93 $194.13 26548... T Reconstruct finger 262 18.35 $970.64 $480.93 $194.13 joint. 26550... T Construct thumb 262 18.35 $970.64 $480.93 $194.13 replacement. 26551... C Great toe-hand transfer ......... ......... ......... ........... ........... 26553... C Single toe-hand ......... ......... ......... ........... ........... transfer. 26554... C Double toe-hand ......... ......... ......... ........... ........... transfer. 26555... T Positional change of 262 18.35 $970.64 $480.93 $194.13 finger. 26556... C Toe joint transfer..... ......... ......... ......... ........... ........... 26560... T Repair of web finger... 261 10.54 $557.31 $261.48 $111.46 26561... T Repair of web finger... 262 18.35 $970.64 $480.93 $194.13 26562... T Repair of web finger... 262 18.35 $970.64 $480.93 $194.13 26565... T Correct metacarpal flaw 262 18.35 $970.64 $480.93 $194.13 26567... T Correct finger 262 18.35 $970.64 $480.93 $194.13 deformity. 26568... T Lengthen metacarpal/ 262 18.35 $970.64 $480.93 $194.13 finger. 26580... T Repair hand deformity.. 262 18.35 $970.64 $480.93 $194.13 26585... T Repair finger deformity 262 18.35 $970.64 $480.93 $194.13 26587... T Reconstruct extra 261 10.54 $557.31 $261.48 $111.46 finger. 26590... T Repair finger deformity 262 18.35 $970.64 $480.93 $194.13 26591... T Repair muscles of hand. 262 18.35 $970.64 $480.93 $194.13 26593... T Release muscles of hand 261 10.54 $557.31 $261.48 $111.46 26596... T Excision constricting 262 18.35 $970.64 $480.93 $194.13 tissue. 26597... T Release of scar 262 18.35 $970.64 $480.93 $194.13 contracture. 26600... T Treat metacarpal 209 1.94 $102.84 $37.29 $20.57 fracture. 26605... T Treat metacarpal 209 1.94 $102.84 $37.29 $20.57 fracture. 26607... T Treat metacarpal 209 1.94 $102.84 $37.29 $20.57 fracture. [[Page 47640]] 26608... T Treat metacarpal 216 20.13 $1,064.67 $520.93 $212.93 fracture. 26615... T Repair metacarpal 216 20.13 $1,064.67 $520.93 $212.93 fracture. 26641... T Treat thumb dislocation 209 1.94 $102.84 $37.29 $20.57 26645... T Treat thumb fracture... 209 1.94 $102.84 $37.29 $20.57 26650... T Repair thumb fracture.. 216 20.13 $1,064.67 $520.93 $212.93 26665... T Repair thumb fracture.. 216 20.13 $1,064.67 $520.93 $212.93 26670... T Treat hand dislocation. 209 1.94 $102.84 $37.29 $20.57 26675... T Treat hand dislocation. 210 10.46 $553.39 $283.4 $110.68 26676... T Pin hand dislocation... 216 20.13 $1,064.67 $520.93 $212.93 26685... T Repair hand dislocation 216 20.13 $1,064.67 $520.93 $212.93 26686... T Repair hand dislocation 216 20.13 $1,064.67 $520.93 $212.93 26700... T Treat knuckle 207 1.70 $90.11 $31.64 $18.02 dislocation. 26705... T Treat knuckle 210 10.46 $553.39 $283.4 $110.68 dislocation. 26706... T Pin knuckle dislocation 209 1.94 $102.84 $37.29 $20.57 26715... T Repair knuckle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 26720... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02 each. 26725... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02 each. 26727... T Treat finger fracture, 216 20.13 $1,064.67 $520.93 $212.93 each. 26735... T Repair finger fracture, 216 20.13 $1,064.67 $520.93 $212.93 each. 26740... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02 each. 26742... T Treat finger fracture, 209 1.94 $102.84 $37.29 $20.57 each. 26746... T Repair finger fracture, 216 20.13 $1,064.67 $520.93 $212.93 each. 26750... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02 each. 26755... T Treat finger fracture, 207 1.70 $90.11 $31.64 $18.02 each. 26756... T Pin finger fracture, 216 20.13 $1,064.67 $520.93 $212.93 each. 26765... T Repair finger fracture, 216 20.13 $1,064.67 $520.93 $212.93 each. 26770... T Treat finger 207 1.70 $90.11 $31.64 $18.02 dislocation. 26775... T Treat finger 210 10.46 $553.39 $283.4 $110.68 dislocation. 26776... T Pin finger dislocation. 216 20.13 $1,064.67 $520.93 $212.93 26785... T Repair finger 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 26820... T Thumb fusion with graft 262 18.35 $970.64 $480.93 $194.13 26841... T Fusion of thumb........ 262 18.35 $970.64 $480.93 $194.13 26842... T Thumb fusion with graft 262 18.35 $970.64 $480.93 $194.13 26843... T Fusion of hand joint... 262 18.35 $970.64 $480.93 $194.13 26844... T Fusion/graft of hand 262 18.35 $970.64 $480.93 $194.13 joint. 26850... T Fusion of knuckle...... 262 18.35 $970.64 $480.93 $194.13 26852... T Fusion of knuckle with 262 18.35 $970.64 $480.93 $194.13 graft. 26860... T Fusion of finger joint. 262 18.35 $970.64 $480.93 $194.13 26861... T Fusion of finger joint, 262 18.35 $970.64 $480.93 $194.13 added. 26862... T Fusion/graft of finger 262 18.35 $970.64 $480.93 $194.13 joint. 26863... T Fuse/graft added joint. 262 18.35 $970.64 $480.93 $194.13 26910... T Amputate metacarpal 262 18.35 $970.64 $480.93 $194.13 bone. 26951... T Amputation of finger/ 261 10.54 $557.31 $261.48 $111.46 thumb. 26952... T Amputation of finger/ 261 10.54 $557.31 $261.48 $111.46 thumb. 26989... T Hand/finger surgery.... 207 1.70 $90.11 $31.64 $18.02 26990... T Drainage of pelvis 251 14.26 $754.18 $366.12 $150.84 lesion. 26991... T Drainage of pelvis 251 14.26 $754.18 $366.12 $150.84 bursa. 26992... C Drainage of bone lesion ......... ......... ......... ........... ........... 27000... T Incision of hip tendon. 251 14.26 $754.18 $366.12 $150.84 27001... T Incision of hip tendon. 252 19.39 $1,025.49 $509.18 $205.10 27003... T Incision of hip tendon. 252 19.39 $1,025.49 $509.18 $205.10 27005... C Incision of hip tendon. ......... ......... ......... ........... ........... 27006... C Incision of hip tendons ......... ......... ......... ........... ........... 27025... C Incision of hip/thigh ......... ......... ......... ........... ........... fascia. 27030... C Drainage of hip joint.. ......... ......... ......... ........... ........... 27033... T Exploration of hip 253 26.33 $1,392.78 $699.24 $278.56 joint. 27035... C Denervation of hip ......... ......... ......... ........... ........... joint. 27036... C Excision of hip joint/ ......... ......... ......... ........... ........... muscle. 27040... T Biopsy of soft tissues. 162 5.67 $299.71 $125.43 $59.94 27041... T Biopsy of soft tissues. 163 10.69 $565.14 $264.65 $113.03 27047... T Remove hip/pelvis 163 10.69 $565.14 $264.65 $113.03 lesion. 27048... T Remove hip/pelvis 163 10.69 $565.14 $264.65 $113.03 lesion. 27049... T Remove tumor, hip/ 163 10.69 $565.14 $264.65 $113.03 pelvis. 27050... T Biopsy of sacroiliac 251 14.26 $754.18 $366.12 $150.84 joint. 27052... T Biopsy of hip joint.... 251 14.26 $754.18 $366.12 $150.84 27054... C Removal of hip joint ......... ......... ......... ........... ........... lining. 27060... T Removal of ischial 251 14.26 $754.18 $366.12 $150.84 bursa. 27062... T Remove femur lesion/ 251 14.26 $754.18 $366.12 $150.84 bursa. 27065... T Removal of hip bone 251 14.26 $754.18 $366.12 $150.84 lesion. 27066... T Removal of hip bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 27067... T Remove/graft hip bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 27070... C Partial removal of hip ......... ......... ......... ........... ........... bone. 27071... C Partial removal of hip ......... ......... ......... ........... ........... bone. 27075... C Extensive hip surgery.. ......... ......... ......... ........... ........... 27076... C Extensive hip surgery.. ......... ......... ......... ........... ........... [[Page 47641]] 27077... C Extensive hip surgery.. ......... ......... ......... ........... ........... 27078... C Extensive hip surgery.. ......... ......... ......... ........... ........... 27079... C Extensive hip surgery.. ......... ......... ......... ........... ........... 27080... T Removal of tail bone... 252 19.39 $1,025.49 $509.18 $205.10 27086... T Remove hip foreign body 251 14.26 $754.18 $366.12 $150.84 27087... T Remove hip foreign body 251 14.26 $754.18 $366.12 $150.84 27090... C Removal of hip ......... ......... ......... ........... ........... prosthesis. 27091... C Removal of hip ......... ......... ......... ........... ........... prosthesis. 27093... T Injection for hip x-ray 347 2.93 $154.75 $62.15 $30.95 27095... T Injection for hip x-ray 347 2.93 $154.75 $62.15 $30.95 27097... T Revision of hip tendon. 252 19.39 $1,025.49 $509.18 $205.10 27098... T Transfer tendon to 252 19.39 $1,025.49 $509.18 $205.10 pelvis. 27100... T Transfer of abdominal 253 26.33 $1,392.78 $699.24 $278.56 muscle. 27105... T Transfer of spinal 253 26.33 $1,392.78 $699.24 $278.56 muscle. 27110... T Transfer of iliopsoas 253 26.33 $1,392.78 $699.24 $278.56 muscle. 27111... T Transfer of iliopsoas 253 26.33 $1,392.78 $699.24 $278.56 muscle. 27120... C Reconstruction of hip ......... ......... ......... ........... ........... socket. 27122... C Reconstruction of hip ......... ......... ......... ........... ........... socket. 27125... C Partial hip replacement ......... ......... ......... ........... ........... 27130... C Total hip replacement.. ......... ......... ......... ........... ........... 27132... C Total hip replacement.. ......... ......... ......... ........... ........... 27134... C Revise hip joint ......... ......... ......... ........... ........... replacement. 27137... C Revise hip joint ......... ......... ......... ........... ........... replacement. 27138... C Revise hip joint ......... ......... ......... ........... ........... replacement. 27140... C Transplant of femur ......... ......... ......... ........... ........... ridge. 27146... C Incision of hip bone... ......... ......... ......... ........... ........... 27147... C Revision of hip bone... ......... ......... ......... ........... ........... 27151... C Incision of hip bones.. ......... ......... ......... ........... ........... 27156... C Revision of hip bones.. ......... ......... ......... ........... ........... 27158... C Revision of pelvis..... ......... ......... ......... ........... ........... 27161... C Incision of neck of ......... ......... ......... ........... ........... femur. 27165... C Incision/fixation of ......... ......... ......... ........... ........... femur. 27170... C Repair/graft femur head/ ......... ......... ......... ........... ........... neck. 27175... C Treat slipped epiphysis ......... ......... ......... ........... ........... 27176... C Treat slipped epiphysis ......... ......... ......... ........... ........... 27177... C Repair slipped ......... ......... ......... ........... ........... epiphysis. 27178... C Repair slipped ......... ......... ......... ........... ........... epiphysis. 27179... C Revise head/neck of ......... ......... ......... ........... ........... femur. 27181... C Repair slipped ......... ......... ......... ........... ........... epiphysis. 27185... C Revision of femur ......... ......... ......... ........... ........... epiphysis. 27187... C Reinforce hip bones.... ......... ......... ......... ........... ........... 27193... T Treat pelvic ring 209 1.94 $102.84 $37.29 $20.57 fracture. 27194... T Treat pelvic ring 210 10.46 $553.39 $283.4 $110.68 fracture. 27200... T Treat tail bone 207 1.70 $90.11 $31.64 $18.02 fracture. 27202... T Repair tail bone 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27215... C Pelvic fracture(s) ......... ......... ......... ........... ........... treatment. 27216... C Treat pelvic ring ......... ......... ......... ........... ........... fracture. 27217... C Treat pelvic ring ......... ......... ......... ........... ........... fracture. 27218... C Treat pelvic ring ......... ......... ......... ........... ........... fracture. 27220... T Treat hip socket 209 1.94 $102.84 $37.29 $20.57 fracture. 27222... C Treat hip socket ......... ......... ......... ........... ........... fracture. 27226... C Treat hip wall fracture ......... ......... ......... ........... ........... 27227... C Treat hip fracture(s).. ......... ......... ......... ........... ........... 27228... C Treat hip fracture(s).. ......... ......... ......... ........... ........... 27230... T Treat fracture of thigh 209 1.94 $102.84 $37.29 $20.57 27232... C Treat fracture of thigh ......... ......... ......... ........... ........... 27235... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27236... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27238... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27240... C Treatment of thigh ......... ......... ......... ........... ........... fracture. 27244... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27245... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27246... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27248... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27250... T Treat hip dislocation.. 209 1.94 $102.84 $37.29 $20.57 27252... T Treat hip dislocation.. 210 10.46 $553.39 $283.4 $110.68 27253... C Repair of hip ......... ......... ......... ........... ........... dislocation. 27254... C Repair of hip ......... ......... ......... ........... ........... dislocation. 27256... T Treatment of hip 209 1.94 $102.84 $37.29 $20.57 dislocation. 27257... T Treatment of hip 210 10.46 $553.39 $283.4 $110.68 dislocation. 27258... C Repair of hip ......... ......... ......... ........... ........... dislocation. 27259... C Repair of hip ......... ......... ......... ........... ........... dislocation. 27265... T Treatment of hip 209 1.94 $102.84 $37.29 $20.57 dislocation. 27266... T Treatment of hip 217 20.48 $1,083.27 $526.81 $216.65 dislocation. 27275... T Manipulation of hip 210 10.46 $553.39 $283.4 $110.68 joint. [[Page 47642]] 27280... C Fusion of sacroiliac ......... ......... ......... ........... ........... joint. 27282... C Fusion of pubic bones.. ......... ......... ......... ........... ........... 27284... C Fusion of hip joint.... ......... ......... ......... ........... ........... 27286... C Fusion of hip joint.... ......... ......... ......... ........... ........... 27290... C Amputation of leg at ......... ......... ......... ........... ........... hip. 27295... C Amputation of leg at ......... ......... ......... ........... ........... hip. 27299... T Pelvis/hip joint 207 1.70 $90.11 $31.64 $18.02 surgery. 27301... T Drain thigh/knee lesion 132 6.04 $319.3 $134.24 $63.86 27303... C Drainage of bone lesion ......... ......... ......... ........... ........... 27305... T Incise thigh tendon & 251 14.26 $754.18 $366.12 $150.84 fascia. 27306... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84 tendon. 27307... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84 tendons. 27310... T Exploration of knee 252 19.39 $1,025.49 $509.18 $205.10 joint. 27315... T Partial removal, thigh 631 12.98 $686.6 $333.8 $137.32 nerve. 27320... T Partial removal, thigh 631 12.98 $686.6 $333.8 $137.32 nerve. 27323... T Biopsy thigh soft 162 5.67 $299.71 $125.43 $59.94 tissues. 27324... T Biopsy thigh soft 163 10.69 $565.14 $264.65 $113.03 tissues. 27327... T Removal of thigh lesion 163 10.69 $565.14 $264.65 $113.03 27328... T Removal of thigh lesion 163 10.69 $565.14 $264.65 $113.03 27329... T Remove tumor, thigh/ 163 10.69 $565.14 $264.65 $113.03 knee. 27330... T Biopsy knee joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 27331... T Explore/treat knee 252 19.39 $1,025.49 $509.18 $205.10 joint. 27332... T Removal of knee 252 19.39 $1,025.49 $509.18 $205.10 cartilage. 27333... T Removal of knee 252 19.39 $1,025.49 $509.18 $205.10 cartilage. 27334... T Remove knee joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 27335... T Remove knee joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 27340... T Removal of kneecap 251 14.26 $754.18 $366.12 $150.84 bursa. 27345... T Removal of knee cyst... 251 14.26 $754.18 $366.12 $150.84 27350... T Removal of kneecap..... 252 19.39 $1,025.49 $509.18 $205.10 27355... T Remove femur lesion.... 252 19.39 $1,025.49 $509.18 $205.10 27356... T Remove femur lesion/ 252 19.39 $1,025.49 $509.18 $205.10 graft. 27357... T Remove femur lesion/ 252 19.39 $1,025.49 $509.18 $205.10 graft. 27358... T Remove femur lesion/ 252 19.39 $1,025.49 $509.18 $205.10 fixation. 27360... T Partial removal leg 252 19.39 $1,025.49 $509.18 $205.10 bone(s). 27365... C Extensive leg surgery.. ......... ......... ......... ........... ........... 27370... T Injection for knee x- 347 2.93 $154.75 $62.15 $30.95 ray. 27372... T Removal of foreign body 163 10.69 $565.14 $264.65 $113.03 27380... T Repair of kneecap 251 14.26 $754.18 $366.12 $150.84 tendon. 27381... T Repair/graft kneecap 251 14.26 $754.18 $366.12 $150.84 tendon. 27385... T Repair of thigh muscle. 251 14.26 $754.18 $366.12 $150.84 27386... T Repair/graft of thigh 251 14.26 $754.18 $366.12 $150.84 muscle. 27390... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84 tendon. 27391... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84 tendons. 27392... T Incision of thigh 251 14.26 $754.18 $366.12 $150.84 tendons. 27393... T Lengthening of thigh 252 19.39 $1,025.49 $509.18 $205.10 tendon. 27394... T Lengthening of thigh 252 19.39 $1,025.49 $509.18 $205.10 tendons. 27395... T Lengthening of thigh 253 26.33 $1,392.78 $699.24 $278.56 tendons. 27396... T Transplant of thigh 252 19.39 $1,025.49 $509.18 $205.10 tendon. 27397... T Transplants of thigh 253 26.33 $1,392.78 $699.24 $278.56 tendons. 27400... T Revise thigh muscles/ 253 26.33 $1,392.78 $699.24 $278.56 tendons. 27403... T Repair of knee 252 19.39 $1,025.49 $509.18 $205.10 cartilage. 27405... T Repair of knee ligament 253 26.33 $1,392.78 $699.24 $278.56 27407... T Repair of knee ligament 253 26.33 $1,392.78 $699.24 $278.56 27409... T Repair of knee 253 26.33 $1,392.78 $699.24 $278.56 ligaments. 27418... T Repair degenerated 253 26.33 $1,392.78 $699.24 $278.56 kneecap. 27420... T Revision of unstable 253 26.33 $1,392.78 $699.24 $278.56 kneecap. 27422... T Revision of unstable 253 26.33 $1,392.78 $699.24 $278.56 kneecap. 27424... T Revision/removal of 253 26.33 $1,392.78 $699.24 $278.56 kneecap. 27425... T Lateral retinacular 252 19.39 $1,025.49 $509.18 $205.10 release. 27427... T Reconstruction, knee... 254 34.37 $1,817.86 $937.22 $363.57 27428... T Reconstruction, knee... 254 34.37 $1,817.86 $937.22 $363.57 27429... T Reconstruction, knee... 254 34.37 $1,817.86 $937.22 $363.57 27430... T Revision of thigh 253 26.33 $1,392.78 $699.24 $278.56 muscles. 27435... T Incision of knee joint. 253 26.33 $1,392.78 $699.24 $278.56 27437... T Revise kneecap......... 217 20.48 $1,083.27 $526.81 $216.65 27438... T Revise kneecap with 218 27.50 $1,454.49 $715.52 $290.90 implant. 27440... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65 27441... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65 27442... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65 27443... T Revision of knee joint. 217 20.48 $1,083.27 $526.81 $216.65 27445... C Revision of knee joint. ......... ......... ......... ........... ........... 27446... C Revision of knee joint. ......... ......... ......... ........... ........... 27447... C Total knee replacement. ......... ......... ......... ........... ........... 27448... C Incision of thigh...... ......... ......... ......... ........... ........... 27450... C Incision of thigh...... ......... ......... ......... ........... ........... [[Page 47643]] 27454... C Realignment of thigh ......... ......... ......... ........... ........... bone. 27455... C Realignment of knee.... ......... ......... ......... ........... ........... 27457... C Realignment of knee.... ......... ......... ......... ........... ........... 27465... C Shortening of thigh ......... ......... ......... ........... ........... bone. 27466... C Lengthening of thigh ......... ......... ......... ........... ........... bone. 27468... C Shorten/lengthen thighs ......... ......... ......... ........... ........... 27470... C Repair of thigh........ ......... ......... ......... ........... ........... 27472... C Repair/graft of thigh.. ......... ......... ......... ........... ........... 27475... C Surgery to stop leg ......... ......... ......... ........... ........... growth. 27477... C Surgery to stop leg ......... ......... ......... ........... ........... growth. 27479... C Surgery to stop leg ......... ......... ......... ........... ........... growth. 27485... C Surgery to stop leg ......... ......... ......... ........... ........... growth. 27486... C Revise knee joint ......... ......... ......... ........... ........... replace. 27487... C Revise knee joint ......... ......... ......... ........... ........... replace. 27488... C Removal of knee ......... ......... ......... ........... ........... prosthesis. 27495... C Reinforce thigh........ ......... ......... ......... ........... ........... 27496... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84 knee. 27497... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84 knee. 27498... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84 knee. 27499... T Decompression of thigh/ 251 14.26 $754.18 $366.12 $150.84 knee. 27500... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27501... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27502... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27503... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27506... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27507... C Treatment of thigh ......... ......... ......... ........... ........... fracture. 27508... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27509... T Treatment of thigh 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27510... T Treatment of thigh 209 1.94 $102.84 $37.29 $20.57 fracture. 27511... C Treatment of thigh ......... ......... ......... ........... ........... fracture. 27513... C Treatment of thigh ......... ......... ......... ........... ........... fracture. 27514... C Repair of thigh ......... ......... ......... ........... ........... fracture. 27516... T Repair of thigh growth 209 1.94 $102.84 $37.29 $20.57 plate. 27517... T Repair of thigh growth 209 1.94 $102.84 $37.29 $20.57 plate. 27519... C Repair of thigh growth ......... ......... ......... ........... ........... plate. 27520... T Treat kneecap fracture. 209 1.94 $102.84 $37.29 $20.57 27524... C Repair of kneecap ......... ......... ......... ........... ........... fracture. 27530... T Treatment of knee 209 1.94 $102.84 $37.29 $20.57 fracture. 27532... T Treatment of knee 209 1.94 $102.84 $37.29 $20.57 fracture. 27535... C Treatment of knee ......... ......... ......... ........... ........... fracture. 27536... C Repair of knee fracture ......... ......... ......... ........... ........... 27538... T Treat knee fracture(s). 209 1.94 $102.84 $37.29 $20.57 27540... C Repair of knee fracture ......... ......... ......... ........... ........... 27550... T Treat knee dislocation. 209 1.94 $102.84 $37.29 $20.57 27552... T Treat knee dislocation. 210 10.46 $553.39 $283.40 $110.68 27556... T Repair of knee 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 27557... C Repair of knee ......... ......... ......... ........... ........... dislocation. 27558... C Repair of knee ......... ......... ......... ........... ........... dislocation. 27560... T Treat kneecap 209 1.94 $102.84 $37.29 $20.57 dislocation. 27562... T Treat kneecap 210 10.46 $553.39 $283.40 $110.68 dislocation. 27566... T Repair kneecap 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 27570... T Fixation of knee joint. 210 10.46 $553.39 $283.40 $110.68 27580... C Fusion of knee......... ......... ......... ......... ........... ........... 27590... C Amputate leg at thigh.. ......... ......... ......... ........... ........... 27591... C Amputate leg at thigh.. ......... ......... ......... ........... ........... 27592... C Amputate leg at thigh.. ......... ......... ......... ........... ........... 27594... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84 surgery. 27596... C Amputation follow-up ......... ......... ......... ........... ........... surgery. 27598... C Amputate lower leg at ......... ......... ......... ........... ........... knee. 27599... T Leg surgery procedure.. 209 1.94 $102.84 $37.29 $20.57 27600... T Decompression of lower 251 14.26 $754.18 $366.12 $150.84 leg. 27601... T Decompression of lower 251 14.26 $754.18 $366.12 $150.84 leg. 27602... T Decompression of lower 251 14.26 $754.18 $366.12 $150.84 leg. 27603... T Drain lower leg lesion. 132 6.04 $319.3 $134.24 $63.86 27604... T Drain lower leg bursa.. 251 14.26 $754.18 $366.12 $150.84 27605... T Incision of achilles 271 14.41 $762.01 $368.38 $152.40 tendon. 27606... T Incision of achilles 251 14.26 $754.18 $366.12 $150.84 tendon. 27607... T Treat lower leg bone 251 14.26 $754.18 $366.12 $150.84 lesion. 27610... T Explore/treat ankle 252 19.39 $1,025.49 $509.18 $205.10 joint. 27612... T Exploration of ankle 252 19.39 $1,025.49 $509.18 $205.10 joint. 27613... T Biopsy lower leg soft 161 3.50 $185.12 $75.48 $37.02 tissue. 27614... T Biopsy lower leg soft 163 10.69 $565.14 $264.65 $113.03 tissue. 27615... T Remove tumor, lower leg 216 20.13 $1,064.67 $520.93 $212.93 27618... T Remove lower leg lesion 163 10.69 $565.14 $264.65 $113.03 27619... T Remove lower leg lesion 163 10.69 $565.14 $264.65 $113.03 [[Page 47644]] 27620... T Explore, treat ankle 252 19.39 $1,025.49 $509.18 $205.10 joint. 27625... T Remove ankle joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 27626... T Remove ankle joint 252 19.39 $1,025.49 $509.18 $205.10 lining. 27630... T Removal of tendon 251 14.26 $754.18 $366.12 $150.84 lesion. 27635... T Remove lower leg bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 27637... T Remove/graft leg bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 27638... T Remove/graft leg bone 252 19.39 $1,025.49 $509.18 $205.10 lesion. 27640... T Partial removal of 253 26.33 $1,392.78 $699.24 $278.56 tibia. 27641... T Partial removal of 252 19.39 $1,025.49 $509.18 $205.10 fibula. 27645... C Extensive lower leg ......... ......... ......... ........... ........... surgery. 27646... C Extensive lower leg ......... ......... ......... ........... ........... surgery. 27647... T Extensive ankle/heel 253 26.33 $1,392.78 $699.24 $278.56 surgery. 27648... T Injection for ankle x- 347 2.93 $154.75 $62.15 $30.95 ray. 27650... T Repair achilles tendon. 253 26.33 $1,392.78 $699.24 $278.56 27652... T Repair/graft achilles 253 26.33 $1,392.78 $699.24 $278.56 tendon. 27654... T Repair of achilles 253 26.33 $1,392.78 $699.24 $278.56 tendon. 27656... T Repair leg fascia 251 14.26 $754.18 $366.12 $150.84 defect. 27658... T Repair of leg tendon, 251 14.26 $754.18 $366.12 $150.84 each. 27659... T Repair of leg tendon, 251 14.26 $754.18 $366.12 $150.84 each. 27664... T Repair of leg tendon, 251 14.26 $754.18 $366.12 $150.84 each. 27665... T Repair of leg tendon, 252 19.39 $1,025.49 $509.18 $205.10 each. 27675... T Repair lower leg 251 14.26 $754.18 $366.12 $150.84 tendons. 27676... T Repair lower leg 252 19.39 $1,025.49 $509.18 $205.10 tendons. 27680... T Release of lower leg 252 19.39 $1,025.49 $509.18 $205.10 tendon. 27681... T Release of lower leg 252 19.39 $1,025.49 $509.18 $205.10 tendons. 27685... T Revision of lower leg 252 19.39 $1,025.49 $509.18 $205.10 tendon. 27686... T Revise lower leg 252 19.39 $1,025.49 $509.18 $205.10 tendons. 27687... T Revision of calf tendon 252 19.39 $1,025.49 $509.18 $205.10 27690... T Revise lower leg tendon 253 26.33 $1,392.78 $699.24 $278.56 27691... T Revise lower leg tendon 253 26.33 $1,392.78 $699.24 $278.56 27692... T Revise additional leg 253 26.33 $1,392.78 $699.24 $278.56 tendon. 27695... T Repair of ankle 252 19.39 $1,025.49 $509.18 $205.10 ligament. 27696... T Repair of ankle 252 19.39 $1,025.49 $509.18 $205.10 ligaments. 27698... T Repair of ankle 252 19.39 $1,025.49 $509.18 $205.10 ligament. 27700... T Revision of ankle joint 217 20.48 $1,083.27 $526.81 $216.65 27702... C Reconstruct ankle joint ......... ......... ......... ........... ........... 27703... C Reconstruction, ankle ......... ......... ......... ........... ........... joint. 27704... T Removal of ankle 251 14.26 $754.18 $366.12 $150.84 implant. 27705... T Incision of tibia...... 253 26.33 $1,392.78 $699.24 $278.56 27707... T Incision of fibula..... 251 14.26 $754.18 $366.12 $150.84 27709... T Incision of tibia & 252 19.39 $1,025.49 $509.18 $205.10 fibula. 27712... C Realignment of lower ......... ......... ......... ........... ........... leg. 27715... C Revision of lower leg.. ......... ......... ......... ........... ........... 27720... C Repair of tibia........ ......... ......... ......... ........... ........... 27722... C Repair/graft of tibia.. ......... ......... ......... ........... ........... 27724... C Repair/graft of tibia.. ......... ......... ......... ........... ........... 27725... C Repair of lower leg.... ......... ......... ......... ........... ........... 27727... C Repair of lower leg.... ......... ......... ......... ........... ........... 27730... T Repair of tibia 252 19.39 $1,025.49 $509.18 $205.10 epiphysis. 27732... T Repair of fibula 252 19.39 $1,025.49 $509.18 $205.10 epiphysis. 27734... T Repair lower leg 252 19.39 $1,025.49 $509.18 $205.10 epiphyses. 27740... T Repair of leg epiphyses 252 19.39 $1,025.49 $509.18 $205.10 27742... T Repair of leg epiphyses 253 26.33 $1,392.78 $699.24 $278.56 27745... T Reinforce tibia........ 253 26.33 $1,392.78 $699.24 $278.56 27750... T Treatment of tibia 209 1.94 $102.84 $37.29 $20.57 fracture. 27752... T Treatment of tibia 209 1.94 $102.84 $37.29 $20.57 fracture. 27756... T Repair of tibia 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27758... T Repair of tibia 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27759... T Repair of tibia 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27760... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27762... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27766... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27780... T Treatment of fibula 209 1.94 $102.84 $37.29 $20.57 fracture. 27781... T Treatment of fibula 209 1.94 $102.84 $37.29 $20.57 fracture. 27784... T Repair of fibula 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27786... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27788... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27792... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27808... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27810... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27814... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27816... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27818... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 27822... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27823... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. [[Page 47645]] 27824... T Treat lower leg 209 1.94 $102.84 $37.29 $20.57 fracture. 27825... T Treat lower leg 209 1.94 $102.84 $37.29 $20.57 fracture. 27826... T Treat lower leg 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27827... T Treat lower leg 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27828... T Treat lower leg 216 20.13 $1,064.67 $520.93 $212.93 fracture. 27829... T Treat lower leg joint.. 216 20.13 $1,064.67 $520.93 $212.93 27830... T Treat lower leg 209 1.94 $102.84 $37.29 $20.57 dislocation. 27831... T Treat lower leg 210 10.46 $553.39 $283.40 $110.68 dislocation. 27832... T Repair lower leg 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 27840... T Treat ankle dislocation 209 1.94 $102.84 $37.29 $20.57 27842... T Treat ankle dislocation 210 10.46 $553.39 $283.40 $110.68 27846... T Repair ankle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 27848... T Repair ankle 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 27860... T Fixation of ankle joint 210 10.46 $553.39 $283.40 $110.68 27870... T Fusion of ankle joint.. 253 26.33 $1,392.78 $699.24 $278.56 27871... T Fusion of tibiofibular 253 26.33 $1,392.78 $699.24 $278.56 joint. 27880... C Amputation of lower leg ......... ......... ......... ........... ........... 27881... C Amputation of lower leg ......... ......... ......... ........... ........... 27882... C Amputation of lower leg ......... ......... ......... ........... ........... 27884... T Amputation follow-up 251 14.26 $754.18 $366.12 $150.84 surgery. 27886... C Amputation follow-up ......... ......... ......... ........... ........... surgery. 27888... C Amputation of foot at ......... ......... ......... ........... ........... ankle. 27889... T Amputation of foot at 252 19.39 $1,025.49 $509.18 $205.10 ankle. 27892... T Decompression of leg... 251 14.26 $754.18 $366.12 $150.84 27893... T Decompression of leg... 251 14.26 $754.18 $366.12 $150.84 27894... T Decompression of leg... 251 14.26 $754.18 $366.12 $150.84 27899... T Leg/ankle surgery 209 1.94 $102.84 $37.29 $20.57 procedure. 28001... T Drainage of bursa of 132 6.04 $319.3 $134.24 $63.86 foot. 28002... T Treatment of foot 251 14.26 $754.18 $366.12 $150.84 infection. 28003... T Treatment of foot 251 14.26 $754.18 $366.12 $150.84 infection. 28005... T Treat foot bone lesion. 271 14.41 $762.01 $368.38 $152.40 28008... T Incision of foot fascia 271 14.41 $762.01 $368.38 $152.40 28010... T Incision of toe tendon. 271 14.41 $762.01 $368.38 $152.40 28011... T Incision of toe tendons 271 14.41 $762.01 $368.38 $152.40 28020... T Exploration of a foot 271 14.41 $762.01 $368.38 $152.40 joint. 28022... T Exploration of a foot 271 14.41 $762.01 $368.38 $152.40 joint. 28024... T Exploration of a toe 271 14.41 $762.01 $368.38 $152.40 joint. 28030... T Removal of foot nerve.. 631 12.98 $686.60 $333.80 $137.32 28035... T Decompression of tibia 631 12.98 $686.60 $333.80 $137.32 nerve. 28043... T Excision of foot lesion 162 5.67 $299.71 $125.43 $59.94 28045... T Excision of foot lesion 271 14.41 $762.01 $368.38 $152.40 28046... T Resection of tumor, 271 14.41 $762.01 $368.38 $152.40 foot. 28050... T Biopsy of foot joint 271 14.41 $762.01 $368.38 $152.40 lining. 28052... T Biopsy of foot joint 271 14.41 $762.01 $368.38 $152.40 lining. 28054... T Biopsy of toe joint 271 14.41 $762.01 $368.38 $152.40 lining. 28060... T Partial removal foot 272 16.56 $875.63 $409.74 $175.13 fascia. 28062... T Removal of foot fascia. 272 16.56 $875.63 $409.74 $175.13 28070... T Removal of foot joint 272 16.56 $875.63 $409.74 $175.13 lining. 28072... T Removal of foot joint 272 16.56 $875.63 $409.74 $175.13 lining. 28080... T Removal of foot lesion. 271 14.41 $762.01 $368.38 $152.40 28086... T Excise foot tendon 271 14.41 $762.01 $368.38 $152.40 sheath. 28088... T Excise foot tendon 271 14.41 $762.01 $368.38 $152.40 sheath. 28090... T Removal of foot lesion. 271 14.41 $762.01 $368.38 $152.40 28092... T Removal of toe lesions. 271 14.41 $762.01 $368.38 $152.40 28100... T Removal of ankle/heel 271 14.41 $762.01 $368.38 $152.40 lesion. 28102... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13 lesion. 28103... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13 lesion. 28104... T Removal of foot lesion. 271 14.41 $762.01 $368.38 $152.40 28106... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13 lesion. 28107... T Remove/graft foot 272 16.56 $875.63 $409.74 $175.13 lesion. 28108... T Removal of toe lesions. 271 14.41 $762.01 $368.38 $152.40 28110... T Part removal of 276 19.19 $1,014.71 $500.14 $202.94 metatarsal. 28111... T Part removal of 271 14.41 $762.01 $368.38 $152.40 metatarsal. 28112... T Part removal of 271 14.41 $762.01 $368.38 $152.40 metatarsal. 28113... T Part removal of 271 14.41 $762.01 $368.38 $152.40 metatarsal. 28114... T Removal of metatarsal 271 14.41 $762.01 $368.38 $152.40 heads. 28116... T Revision of foot....... 271 14.41 $762.01 $368.38 $152.40 28118... T Removal of heel bone... 271 14.41 $762.01 $368.38 $152.40 28119... T Removal of heel spur... 271 14.41 $762.01 $368.38 $152.40 28120... T Part removal of ankle/ 271 14.41 $762.01 $368.38 $152.40 heel. 28122... T Partial removal of foot 271 14.41 $762.01 $368.38 $152.40 bone. 28124... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40 28126... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40 28130... T Removal of ankle bone.. 271 14.41 $762.01 $368.38 $152.40 28140... T Removal of metatarsal.. 271 14.41 $762.01 $368.38 $152.40 [[Page 47646]] 28150... T Removal of toe......... 271 14.41 $762.01 $368.38 $152.40 28153... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40 28160... T Partial removal of toe. 271 14.41 $762.01 $368.38 $152.40 28171... T Extensive foot surgery. 271 14.41 $762.01 $368.38 $152.40 28173... T Extensive foot surgery. 271 14.41 $762.01 $368.38 $152.40 28175... T Extensive foot surgery. 271 14.41 $762.01 $368.38 $152.40 28190... T Removal of foot foreign 161 3.50 $185.12 $75.48 $37.02 body. 28192... T Removal of foot foreign 163 10.69 $565.14 $264.65 $113.03 body. 28193... T Removal of foot foreign 163 10.69 $565.14 $264.65 $113.03 body. 28200... T Repair of foot tendon.. 271 14.41 $762.01 $368.38 $152.40 28202... T Repair/graft of foot 272 16.56 $875.63 $409.74 $175.13 tendon. 28208... T Repair of foot tendon.. 271 14.41 $762.01 $368.38 $152.40 28210... T Repair/graft of foot 271 14.41 $762.01 $368.38 $152.40 tendon. 28220... T Release of foot tendon. 271 14.41 $762.01 $368.38 $152.40 28222... T Release of foot tendons 271 14.41 $762.01 $368.38 $152.40 28225... T Release of foot tendon. 271 14.41 $762.01 $368.38 $152.40 28226... T Release of foot tendons 271 14.41 $762.01 $368.38 $152.40 28230... T Incision of foot 271 14.41 $762.01 $368.38 $152.40 tendon(s). 28232... T Incision of toe tendon. 271 14.41 $762.01 $368.38 $152.40 28234... T Incision of foot tendon 271 14.41 $762.01 $368.38 $152.40 28238... T Revision of foot tendon 272 16.56 $875.63 $409.74 $175.13 28240... T Release of big toe..... 271 14.41 $762.01 $368.38 $152.40 28250... T Revision of foot fascia 272 16.56 $875.63 $409.74 $175.13 28260... T Release of midfoot 272 16.56 $875.63 $409.74 $175.13 joint. 28261... T Revision of foot tendon 272 16.56 $875.63 $409.74 $175.13 28262... T Revision of foot and 272 16.56 $875.63 $409.74 $175.13 ankle. 28264... T Release of midfoot 272 16.56 $875.63 $409.74 $175.13 joint. 28270... T Release of foot 271 14.41 $762.01 $368.38 $152.40 contracture. 28272... T Release of toe joint, 271 14.41 $762.01 $368.38 $152.40 each. 28280... T Fusion of toes......... 271 14.41 $762.01 $368.38 $152.40 28285... T Repair of hammertoe.... 271 14.41 $762.01 $368.38 $152.40 28286... T Repair of hammertoe.... 271 14.41 $762.01 $368.38 $152.40 28288... T Partial removal of foot 272 16.56 $875.63 $409.74 $175.13 bone. 28290... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28292... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28293... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28294... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28296... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28297... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28298... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28299... T Correction of bunion... 276 19.19 $1,014.71 $500.14 $202.94 28300... T Incision of heel bone.. 272 16.56 $875.63 $409.74 $175.13 28302... T Incision of ankle bone. 272 16.56 $875.63 $409.74 $175.13 28304... T Incision of midfoot 272 16.56 $875.63 $409.74 $175.13 bones. 28305... T Incise/graft midfoot 272 16.56 $875.63 $409.74 $175.13 bones. 28306... T Incision of metatarsal. 272 16.56 $875.63 $409.74 $175.13 28307... T Incision of metatarsal. 272 16.56 $875.63 $409.74 $175.13 28308... T Incision of metatarsal. 272 16.56 $875.63 $409.74 $175.13 28309... T Incision of metatarsals 272 16.56 $875.63 $409.74 $175.13 28310... T Revision of big toe.... 271 14.41 $762.01 $368.38 $152.40 28312... T Revision of toe........ 271 14.41 $762.01 $368.38 $152.40 28313... T Repair deformity of toe 271 14.41 $762.01 $368.38 $152.40 28315... T Removal of sesamoid 271 14.41 $762.01 $368.38 $152.40 bone. 28320... T Repair of foot bones... 272 16.56 $875.63 $409.74 $175.13 28322... T Repair of metatarsals.. 272 16.56 $875.63 $409.74 $175.13 28340... T Resect enlarged toe 271 14.41 $762.01 $368.38 $152.40 tissue. 28341... T Resect enlarged toe.... 271 14.41 $762.01 $368.38 $152.40 28344... T Repair extra toe(s).... 272 16.56 $875.63 $409.74 $175.13 28345... T Repair webbed toe(s)... 272 16.56 $875.63 $409.74 $175.13 28360... T Reconstruct cleft foot. 272 16.56 $875.63 $409.74 $175.13 28400... T Treatment of heel 209 1.94 $102.84 $37.29 $20.57 fracture. 28405... T Treatment of heel 209 1.94 $102.84 $37.29 $20.57 fracture. 28406... T Treatment of heel 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28415... T Repair of heel fracture 216 20.13 $1,064.67 $520.93 $212.93 28420... T Repair/graft heel 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28430... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 28435... T Treatment of ankle 209 1.94 $102.84 $37.29 $20.57 fracture. 28436... T Treatment of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28445... T Repair of ankle 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28450... T Treat midfoot fracture, 209 1.94 $102.84 $37.29 $20.57 each. 28455... T Treat midfoot fracture, 209 1.94 $102.84 $37.29 $20.57 each. 28456... T Repair midfoot fracture 216 20.13 $1,064.67 $520.93 $212.93 28465... T Repair midfoot 216 20.13 $1,064.67 $520.93 $212.93 fracture, each. 28470... T Treat metatarsal 209 1.94 $102.84 $37.29 $20.57 fracture. 28475... T Treat metatarsal 209 1.94 $102.84 $37.29 $20.57 fracture. [[Page 47647]] 28476... T Repair metatarsal 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28485... T Repair metatarsal 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28490... T Treat big toe fracture. 207 1.70 $90.11 $31.64 $18.02 28495... T Treat big toe fracture. 207 1.70 $90.11 $31.64 $18.02 28496... T Repair big toe fracture 216 20.13 $1,064.67 $520.93 $212.93 28505... T Repair big toe fracture 216 20.13 $1,064.67 $520.93 $212.93 28510... T Treatment of toe 207 1.70 $90.11 $31.64 $18.02 fracture. 28515... T Treatment of toe 207 1.70 $90.11 $31.64 $18.02 fracture. 28525... T Repair of toe fracture. 216 20.13 $1,064.67 $520.93 $212.93 28530... T Treat sesamoid bone 209 1.94 $102.84 $37.29 $20.57 fracture. 28531... T Treat sesamoid bone 216 20.13 $1,064.67 $520.93 $212.93 fracture. 28540... T Treat foot dislocation. 209 1.94 $102.84 $37.29 $20.57 28545... T Treat foot dislocation. 210 10.46 $553.39 $283.40 $110.68 28546... T Treat foot dislocation. 216 20.13 $1,064.67 $520.93 $212.93 28555... T Repair foot dislocation 216 20.13 $1,064.67 $520.93 $212.93 28570... T Treat foot dislocation. 209 1.94 $102.84 $37.29 $20.57 28575... T Treat foot dislocation. 210 10.46 $553.39 $283.40 $110.68 28576... T Treat foot dislocation. 216 20.13 $1,064.67 $520.93 $212.93 28585... T Repair foot dislocation 216 20.13 $1,064.67 $520.93 $212.93 28600... T Treat foot dislocation. 209 1.94 $102.84 $37.29 $20.57 28605... T Treat foot dislocation. 210 10.46 $553.39 $283.40 $110.68 28606... T Treat foot dislocation. 216 20.13 $1,064.67 $520.93 $212.93 28615... T Repair foot dislocation 216 20.13 $1,064.67 $520.93 $212.93 28630... T Treat toe dislocation.. 207 1.70 $90.11 $31.64 $18.02 28635... T Treat toe dislocation.. 210 10.46 $553.39 $283.40 $110.68 28636... T Treat toe dislocation.. 216 20.13 $1,064.67 $520.93 $212.93 28645... T Repair toe dislocation. 216 20.13 $1,064.67 $520.93 $212.93 28660... T Treat toe dislocation.. 207 1.70 $90.11 $31.64 $18.02 28665... T Treat toe dislocation.. 210 10.46 $553.39 $283.40 $110.68 28666... T Treat toe dislocation.. 216 20.13 $1,064.67 $520.93 $212.93 28675... T Repair of toe 216 20.13 $1,064.67 $520.93 $212.93 dislocation. 28705... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13 28715... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13 28725... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13 28730... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13 28735... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13 28737... T Revision of foot bones. 271 14.41 $762.01 $368.38 $152.40 28740... T Fusion of foot bones... 272 16.56 $875.63 $409.74 $175.13 28750... T Fusion of big toe joint 271 14.41 $762.01 $368.38 $152.40 28755... T Fusion of big toe joint 271 14.41 $762.01 $368.38 $152.40 28760... T Fusion of big toe joint 272 16.56 $875.63 $409.74 $175.13 28800... C Amputation of midfoot.. ......... ......... ......... ........... ........... 28805... C Amputation thru ......... ......... ......... ........... ........... metatarsal. 28810... T Amputation toe & 271 14.41 $762.01 $368.38 $152.40 metatarsal. 28820... T Amputation of toe...... 271 14.41 $762.01 $368.38 $152.40 28825... T Partial amputation of 271 14.41 $762.01 $368.38 $152.40 toe. 28899... T Foot/toes surgery 207 1.70 $90.11 $31.64 $18.02 procedure. 29000... N Application of body ......... ......... ......... ........... ........... cast. 29010... N Application of body ......... ......... ......... ........... ........... cast. 29015... N Application of body ......... ......... ......... ........... ........... cast. 29020... N Application of body ......... ......... ......... ........... ........... cast. 29025... N Application of body ......... ......... ......... ........... ........... cast. 29035... N Application of body ......... ......... ......... ........... ........... cast. 29040... N Application of body ......... ......... ......... ........... ........... cast. 29044... N Application of body ......... ......... ......... ........... ........... cast. 29046... N Application of body ......... ......... ......... ........... ........... cast. 29049... N Application of figure ......... ......... ......... ........... ........... eight. 29055... N Application of shoulder ......... ......... ......... ........... ........... cast. 29058... N Application of shoulder ......... ......... ......... ........... ........... cast. 29065... N Application of long arm ......... ......... ......... ........... ........... cast. 29075... N Application of forearm ......... ......... ......... ........... ........... cast. 29085... N Apply hand/wrist cast.. ......... ......... ......... ........... ........... 29105... N Apply long arm splint.. ......... ......... ......... ........... ........... 29125... N Apply forearm splint... ......... ......... ......... ........... ........... 29126... N Apply forearm splint... ......... ......... ......... ........... ........... 29130... N Application of finger ......... ......... ......... ........... ........... splint. 29131... N Application of finger ......... ......... ......... ........... ........... splint. 29200... N Strapping of chest..... ......... ......... ......... ........... ........... 29220... N Strapping of low back.. ......... ......... ......... ........... ........... 29240... N Strapping of shoulder.. ......... ......... ......... ........... ........... 29260... N Strapping of elbow or ......... ......... ......... ........... ........... wrist. 29280... N Strapping of hand or ......... ......... ......... ........... ........... finger. 29305... N Application of hip cast ......... ......... ......... ........... ........... 29325... N Application of hip ......... ......... ......... ........... ........... casts. 29345... N Application of long leg ......... ......... ......... ........... ........... cast. [[Page 47648]] 29355... N Application of long leg ......... ......... ......... ........... ........... cast. 29358... N Apply long leg cast ......... ......... ......... ........... ........... brace. 29365... N Application of long leg ......... ......... ......... ........... ........... cast. 29405... N Apply short leg cast... ......... ......... ......... ........... ........... 29425... N Apply short leg cast... ......... ......... ......... ........... ........... 29435... N Apply short leg cast... ......... ......... ......... ........... ........... 29440... N Addition of walker to ......... ......... ......... ........... ........... cast. 29445... N Apply rigid leg cast... ......... ......... ......... ........... ........... 29450... N Application of leg cast ......... ......... ......... ........... ........... 29505... N Application long leg ......... ......... ......... ........... ........... splint. 29515... N Application lower leg ......... ......... ......... ........... ........... splint. 29520... N Strapping of hip....... ......... ......... ......... ........... ........... 29530... N Strapping of knee...... ......... ......... ......... ........... ........... 29540... N Strapping of ankle..... ......... ......... ......... ........... ........... 29550... N Strapping of toes...... ......... ......... ......... ........... ........... 29580... N Application of paste ......... ......... ......... ........... ........... boot. 29590... N Application of foot ......... ......... ......... ........... ........... splint. 29700... N Removal/revision of ......... ......... ......... ........... ........... cast. 29705... N Removal/revision of ......... ......... ......... ........... ........... cast. 29710... N Removal/revision of ......... ......... ......... ........... ........... cast. 29715... N Removal/revision of ......... ......... ......... ........... ........... cast. 29720... N Repair of body cast.... ......... ......... ......... ........... ........... 29730... N Windowing of cast...... ......... ......... ......... ........... ........... 29740... N Wedging of cast........ ......... ......... ......... ........... ........... 29750... N Wedging of clubfoot ......... ......... ......... ........... ........... cast. 29799... N Casting/strapping ......... ......... ......... ........... ........... procedure. 29800... T Jaw arthroscopy/surgery 280 22.20 $1,174.36 $581.72 $234.87 29804... T Jaw arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57 29815... T Shoulder arthroscopy... 280 22.20 $1,174.36 $581.72 $234.87 29819... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29820... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29821... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29822... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29823... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29825... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29826... T Shoulder arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29830... T Elbow arthroscopy...... 280 22.20 $1,174.36 $581.72 $234.87 29834... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29835... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29836... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29837... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29838... T Elbow arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29840... T Wrist arthroscopy...... 280 22.20 $1,174.36 $581.72 $234.87 29843... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29844... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29845... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29846... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29847... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29848... T Wrist arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29850... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29851... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29855... T Tibial arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29856... T Tibial arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29860... T Hip arthroscopy, dx.... 281 22.65 $1,197.87 $590.31 $239.57 29861... T Hip arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57 29862... T Hip arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57 29863... T Hip arthroscopy/surgery 281 22.65 $1,197.87 $590.31 $239.57 29870... T Knee arthroscopy, 280 22.20 $1,174.36 $581.72 $234.87 diagnostic. 29871... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 drainage. 29874... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29875... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29876... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 surgery. 29877... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29879... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29880... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29881... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29882... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 surgery. 29883... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 surgery. 29884... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29885... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 surgery. 29886... T Knee arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29887... T Knee arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 surgery. 29888... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29889... T Knee arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29891... T Ankle arthroscopy/ 282 23.94 $1,266.43 $614.04 $253.29 surgery. [[Page 47649]] 29892... T Ankle arthroscopy/ 286 26.76 $1,415.31 $802.53 $283.06 surgery. 29893... T Scope, plantar 271 14.41 $762.01 $368.38 $152.40 fasciotomy. 29894... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29895... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29897... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29898... T Ankle arthroscopy/ 281 22.65 $1,197.87 $590.31 $239.57 surgery. 29909... T Arthroscopy of joint... 280 22.20 $1,174.36 $581.72 $234.87 30000... T Drainage of nose lesion 311 1.43 $75.42 $20.57 $15.08 30020... T Drainage of nose lesion 311 1.43 $75.42 $20.57 $15.08 30100... T Intranasal biopsy...... 311 1.43 $75.42 $20.57 $15.08 30110... T Removal of nose 311 1.43 $75.42 $20.57 $15.08 polyp(s). 30115... T Removal of nose 313 15.81 $836.45 $411.09 $167.29 polyp(s). 30117... T Removal of intranasal 311 1.43 $75.42 $20.57 $15.08 lesion. 30118... T Removal of intranasal 313 15.81 $836.45 $411.09 $167.29 lesion. 30120... T Revision of nose....... 313 15.81 $836.45 $411.09 $167.29 30124... T Removal of nose lesion. 311 1.43 $75.42 $20.57 $15.08 30125... T Removal of nose lesion. 313 15.81 $836.45 $411.09 $167.29 30130... T Removal of turbinate 313 15.81 $836.45 $411.09 $167.29 bones. 30140... T Removal of turbinate 313 15.81 $836.45 $411.09 $167.29 bones. 30150... T Partial removal of nose 313 15.81 $836.45 $411.09 $167.29 30160... T Removal of nose........ 313 15.81 $836.45 $411.09 $167.29 30200... T Injection treatment of 347 2.93 $154.75 $62.15 $30.95 nose. 30210... T Nasal sinus therapy.... 311 1.43 $75.42 $20.57 $15.08 30220... T Insert nasal septal 311 1.43 $75.42 $20.57 $15.08 button. 30300... T Remove nasal foreign 311 1.43 $75.42 $20.57 $15.08 body. 30310... T Remove nasal foreign 313 15.81 $836.45 $411.09 $167.29 body. 30320... T Remove nasal foreign 313 15.81 $836.45 $411.09 $167.29 body. 30400... T Reconstruction of nose. 314 25.65 $1,356.54 $693.37 $271.31 30410... T Reconstruction of nose. 314 25.65 $1,356.54 $693.37 $271.31 30420... T Reconstruction of nose. 314 25.65 $1,356.54 $693.37 $271.31 30430... T Revision of nose....... 313 15.81 $836.45 $411.09 $167.29 30435... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31 30450... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31 30460... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31 30462... T Revision of nose....... 314 25.65 $1,356.54 $693.37 $271.31 30520... T Repair of nasal septum. 313 15.81 $836.45 $411.09 $167.29 30540... T Repair nasal defect.... 313 15.81 $836.45 $411.09 $167.29 30545... T Repair nasal defect.... 314 25.65 $1,356.54 $693.37 $271.31 30560... T Release of nasal 311 1.43 $75.42 $20.57 $15.08 adhesions. 30580... T Repair upper jaw 313 15.81 $836.45 $411.09 $167.29 fistula. 30600... T Repair mouth/nose 313 15.81 $836.45 $411.09 $167.29 fistula. 30620... T Intranasal 313 15.81 $836.45 $411.09 $167.29 reconstruction. 30630... T Repair nasal septum 313 15.81 $836.45 $411.09 $167.29 defect. 30801... T Cauterization inner 312 7.26 $383.95 $178.31 $76.79 nose. 30802... T Cauterization inner 312 7.26 $383.95 $178.31 $76.79 nose. 30901... T Control of nosebleed... 318 2.07 $109.70 $38.65 $21.94 30903... T Control of nosebleed... 318 2.07 109.70 $38.65 $21.94 30905... T Control of nosebleed... 318 2.07 $109.70 $38.65 $21.94 30906... T Repeat control of 318 2.07 $109.70 $38.65 $21.94 nosebleed. 30915... T Ligation nasal sinus 367 17.59 $930.48 $449.06 $186.10 artery. 30920... T Ligation upper jaw 367 17.59 $930.48 $449.06 $186.10 artery. 30930... T Therapy fracture of 312 7.26 $383.95 $178.31 $76.79 nose. 30999... T Nasal surgery procedure 318 2.07 $109.70 $38.65 $21.94 31000... T Irrigation maxillary 311 1.43 $75.42 $20.57 $15.08 sinus. 31002... T Irrigation sphenoid 311 1.43 $75.42 $20.57 $15.08 sinus. 31020... T Exploration maxillary 313 15.81 $836.45 $411.09 $167.29 sinus. 31030... T Exploration maxillary 313 15.81 $836.45 $411.09 $167.29 sinus. 31032... T Explore sinus, remove 313 15.81 $836.45 $411.09 $167.29 polyps. 31040... T Exploration behind 314 25.65 $1,356.54 $693.37 $271.31 upper jaw. 31050... T Exploration sphenoid 313 15.81 $836.45 $411.09 $167.29 sinus. 31051... T Sphenoid sinus surgery. 313 15.81 $836.45 $411.09 $167.29 31070... T Exploration of frontal 313 15.81 $836.45 $411.09 $167.29 sinus. 31075... T Exploration of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31080... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31081... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31084... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31085... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31086... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31087... T Removal of frontal 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31090... T Exploration of sinuses. 314 25.65 $1,356.54 $693.37 $271.31 31200... T Removal of ethmoid 313 15.81 $836.45 $411.09 $167.29 sinus. 31201... T Removal of ethmoid 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31205... T Removal of ethmoid 314 25.65 $1,356.54 $693.37 $271.31 sinus. 31225... C Removal of upper jaw... ......... ......... ......... ........... ........... 31230... C Removal of upper jaw... ......... ......... ......... ........... ........... [[Continued on page 47651]]