90281 Human ig, im $17.00
90283 Human ig, iv By Report
90287 Botulinum antitoxin $0.00
90288 Botulism ig, iv $0.00
90291 Cmv ig, iv $0.00
90296 Diphtheria antitoxin $0.00
90371 Hep b ig, im $968.00
90375 Rabies ig, im/sc By Report
90376 Rabies ig, heat treated $0.00
90378 Rsv ig, im, 50mg $833.24
90379 Rsv ig, iv $0.00
90384 Rh ig, full-dose, im $149.45
90385 Rh ig, minidose, im $30.00
90386 Rh ig, iv $875.00
90389 Tetanus ig, im By Report
90393 Vaccina ig, im By Report
90396 Varicella-zoster ig, im By Report
90399 Immune globulin $0.00
90471 Immunization admin $12.76
90472 Immunization admin, each add $9.98
90473 Immune admin oral/nasal $18.97
90474 Immune admin oral/nasal addl $20.00
90476 Adenovirus vaccine, type 4 By Report
90477 Adenovirus vaccine, type 7 By Report
90581 Anthrax vaccine, sc $0.00
90585 Bcg vaccine, percut $200.00
90586 Bcg vaccine, intravesical $0.00
90632 Hep a vaccine, adult im $107.02
90633 Hep a vacc, ped/adol, 2 dose $75.68
90634 Hep a vacc, ped/adol, 3 dose $47.00
90636 Hep a/hep b vacc, adult im $152.84
90645 Hib vaccine, hboc, im $42.49
90646 Hib vaccine, prp-d, im $28.41
90647 Hib vaccine, prp-omp, im $54.12
90648 Hib vaccine, prp-t, im $40.15
90655 Flu vaccine, 6-35 mo, im $24.22
90657 Flu vaccine, 6-35 mo, im $15.25
90658 Flu vaccine, 3 yrs, im $18.32
90659 Flu vaccine, whole, im $19.98
90660 Flu vaccine, nasal $95.12
90665 Lyme disease vaccine, im By Report
90669 Pneumococcal vacc, ped <5 $119.17
90675 Rabies vaccine, im $149.00
90676 Rabies vaccine, id By Report
90680 Rotovirus vaccine, oral By Report
90690 Typhoid vaccine, oral $53.00
90691 Typhoid vaccine, im $78.00
90692 Typhoid vaccine, h-p, sc/id $54.91
90693 Typhoid vaccine, akd, sc $0.00
90698 Dtap-hib-ip vaccine, im $0.00
90700 Dtap vaccine, im $44.58
90701 Dtp vaccine, im $46.69
90702 Dt vaccine < 7, im $24.59
90703 Tetanus vaccine, im $23.39
90704 Mumps vaccine, sc $27.96
90705 Measles vaccine, sc $27.96
90706 Rubella vaccine, sc $27.96
90707 Mmr vaccine, sc $65.20
90708 Measles-rubella vaccine, sc $38.11
90710 Mmrv vaccine, sc $66.07
90712 Oral poliovirus vaccine $32.59
90713 Poliovirus, ipv, sc $45.11
90715 Tdap vaccine >7 im $80.00
90716 Chicken pox vaccine, sc $102.51
90717 Yellow fever vaccine, sc $97.65
90718 Td vaccine > 7, im $25.33
90719 Diphtheria vaccine, im $10.99
90720 Dtp/hib vaccine, im $56.29
90721 Dtap/hib vaccine, im $69.35
90723 Dtap-hep b-ipv vaccine, im $134.03
90725 Cholera vaccine, injectable $33.02
90727 Plague vaccine, im $16.07
90732 Pneumococcal vaccine $33.91
90733 Meningococcal vaccine, sc $114.67
90734 Meningococcal vaccine, im $0.00
90735 Encephalitis vaccine, sc $33.02
90740 Hepb vacc, ill pat 3 dose im $0.00
90743 Hep b vacc, adol, 2 dose, im $79.91
90744 Hepb vacc ped/adol 3 dose im $49.87
90746 Hep b vaccine, adult, im $93.44
90747 Hepb vacc, ill pat 4 dose im $121.36
90748 Hep b/hib vaccine, im $84.94
90749 Vaccine toxoid $0.00
90780 IV infusion therapy, 1 hour $152.51
90781 IV infusion, additional hour $45.74
90782 Injection, sc/im $21.04
90783 Injection, ia $33.02
90784 Injection, iv $60.34
90788 Injection of antibiotic $22.02
90799 Ther/prophylactic/dx inject $0.00
90801 Psy dx interview $175.23
90802 Intac psy dx interview $186.08
90804 Psytx, office, 20-30 min $75.28
90805 Psytx, off, 20-30 min w/e&m $101.77
90806 Psytx, off, 45-50 min $113.28
90807 Psytx, off, 45-50 min w/e&m $151.14
90808 Psytx, office, 75-80 min $169.20
90809 Psytx, off, 75-80, w/e&m $247.18
90810 Intac psytx, off, 20-30 min $83.63
90811 Intac psytx, 20-30, w/e&m $102.08
90812 Intac psytx, off, 45-50 min $122.13
90813 Intac psytx, 45-50 min w/e&m $148.88
90814 Intac psytx, off, 75-80 min $191.86
90815 Intac psytx, 75-80 w/e&m $222.49
90816 Psytx, hosp, 20-30 min $75.83
90817 Psytx, hosp, 20-30 min w/e&m $82.59
90818 Psytx, hosp, 45-50 min $114.21
90819 Psytx, hosp, 45-50 min w/e&m $140.39
90821 Psytx, hosp, 75-80 min $182.00
90822 Psytx, hosp, 75-80 min w/e&m $220.73
90823 Intac psytx, hosp, 20-30 min $86.71
90824 Intac psytx, hsp 20-30 w/e&m $105.08
90826 Intac psytx, hosp, 45-50 min $135.83
90827 Intac psytx, hsp 45-50 w/e&m $154.21
90828 Intac psytx, hosp, 75-80 min $210.25
90829 Intac psytx, hsp 75-80 w/e&m $228.70
90845 Psychoanalysis $133.69
90846 Family psytx w/o patient $114.70
90847 Family psytx w/patient $134.13
90849 Multiple family group psytx $62.99
90853 Group psychotherapy $45.83
90857 Intac group psytx $41.03
90862 Medication management $80.18
90865 Narcosynthesis $194.57
90870 Electroconvulsive therapy $117.90
90871 Electroconvulsive therapy $212.39
90875 Psychophysiological therapy $91.77
90876 Psychophysiological therapy $134.08
90880 Hypnotherapy $142.32
90882 Environmental manipulation $131.00
90885 Psy evaluation of records $59.16
90887 Consultation with family $101.01
90889 Preparation of report $100.00
90899 Psychiatric service/therapy $0.00
90901 Biofeedback train, any meth $46.05
90911 Biofeedback peri/uro/rectal $146.00
90918 ESRD related services, month $1,351.07
90919 ESRD related services, month $927.14
90920 ESRD related services, month $812.34
90921 ESRD related services, month $508.60
90922 ESRD related services, day $43.12
90923 Esrd related services, day $30.20
90924 Esrd related services, day $26.53
90925 Esrd related services, day $17.05
90935 Hemodialysis, one evaluation $138.60
90937 Hemodialysis, repeated eval $227.44
90939 Hemodialysis study, transcut $0.00
90940 Hemodialysis access study $0.00
90945 Dialysis, one evaluation $145.49
90947 Dialysis, repeated eval $233.24
90989 Dialysis training, complete $498.03
90993 Dialysis training, incompl $119.75
90997 Hemoperfusion $236.54
90999 Dialysis procedure $0.00
91000 Esophageal intubation $78.95
91000.26 Esophageal intubation $73.10
91010 Esophagus motility study $268.88
91010.26 Esophagus motility study $118.33
91011 Esophagus motility study $289.75
91011.26 Esophagus motility study $129.67
91012 Esophagus motility study $310.63
91012.26 Esophagus motility study $132.40
91020 Gastric motility $188.23
91020.26 Gastric motility $85.79
91030 Acid perfusion of esophagus $141.15
91030.26 Acid perfusion of esophagus $55.23
91032 Esophagus, acid reflux test $226.05
91032.26 Esophagus, acid reflux test $72.38
91033 Prolonged acid reflux test $233.59
91033.26 Prolonged acid reflux test $78.07
91052 Gastric analysis test $160.56
91052.26 Gastric analysis test $60.37
91055 Gastric intubation for smear $154.89
91055.26 Gastric intubation for smear $59.45
91060 Gastric saline load test $55.63
91060.26 Gastric saline load test $43.93
91065 Breath hydrogen test $150.91
91065.26 Breath hydrogen test $20.10
91100 Pass intestine bleeding tube $103.01
91105 Gastric intubation treatment $34.51
91110 Gi tract capsule endoscopy $1,303.44
91110.26 Gi tract capsule endoscopy $272.79
91122 Anal pressure record $333.76
91122.26 Anal pressure record $106.56
91123 Irrigate fecal impaction Paid Elsewhere
91132 Electrogastrography $36.10
91132.26 Electrogastrography $36.10/td>
91133 Electrogastrography w/test $48.77
91133.26 Electrogastrography w/test $48.77
91299 Gastroenterology procedure $0.00
91299.26 Gastroenterology procedure $0.00
92002 Eye exam, new patient $87.68
92004 Eye exam, new patient $147.83
92012 Eye exam established pat $72.36
92014 Eye exam & treatment $106.70
92015 Refraction $78.78
92018 New eye exam & treatment $217.84
92019 Eye exam & treatment $137.75
92020 Special eye evaluation $50.69
92060 Special eye evaluation $75.49
92060.26 Special eye evaluation $53.28
92065 Orthoptic/pleoptic training $65.49
92065.26 Orthoptic/pleoptic training $38.30
92070 Fitting of contact lens $107.28
92081 Visual field examination(s) $79.44
92081.26 Visual field examination(s) $34.65
92082 Visual field examination(s) $105.19
92082.26 Visual field examination(s) $43.19
92083 Visual field examination(s) $93.52
92083.26 Visual field examination(s) $38.12
92100 Serial tonometry exam(s) $93.68
92120 Tonography & eye evaluation $79.67
92130 Water provocation tonography $87.51
92135 Opthalmic dx imaging $80.52
92135.26 Opthalmic dx imaging $37.49
92136 Ophthalmic biometry $147.57
92136.26 Ophthalmic biometry $52.22
92140 Glaucoma provocative tests $61.44
92225 Special eye exam, initial $43.87
92226 Special eye exam, subsequent $39.44
92230 Eye exam with photos $160.47
92235 Eye exam with photos $264.79
92235.26 Eye exam with photos $86.59
92240 Icg angiography $341.34
92240.26 Icg angiography $69.94
92250 Eye exam with photos $91.59
92250.26 Eye exam with photos $28.18
92260 Ophthalmoscopy/dynamometry $35.24
92265 Eye muscle evaluation $191.30
92265.26 Eye muscle evaluation $80.45
92270 Electro-oculography $169.95
92270.26 Electro-oculography $85.27
92275 Electroretinography $200.28
92275.26 Electroretinography $100.32
92283 Color vision examination $70.53
92283.26 Color vision examination $17.86
92284 Dark adaptation eye exam $106.59
92284.26 Dark adaptation eye exam $14.68
92285 Eye photography $53.57
92285.26 Eye photography $12.88
92286 Internal eye photography $172.52
92286.26 Internal eye photography $42.95
92287 Internal eye photography $147.83
92310 Contact lens fitting $99.51
92311 Contact lens fitting $163.26
92312 Contact lens fitting $175.33
92313 Contact lens fitting $149.25
92314 Prescription of contact lens $116.59
92315 Prescription of contact lens $99.35
92316 Prescription of contact lens $119.97
92317 Prescription of contact lens $106.24
92325 Modification of contact lens $27.19
92326 Replacement of contact lens $68.98
92330 Fitting of artificial eye $156.72
92335 Fitting of artificial eye $103.49
92340 Fitting of spectacles $76.17
92341 Fitting of spectacles $68.59
92342 Fitting of spectacles $92.25
92352 Special spectacles fitting $68.28
92353 Special spectacles fitting $71.31
92354 Special spectacles fitting $369.30
92355 Special spectacles fitting $179.49
92358 Eye prosthesis service $68.50
92370 Repair & adjust spectacles $57.58
92371 Repair & adjust spectacles $43.37
92390 Supply of spectacles $116.06
92391 Supply of contact lenses $144.76
92392 Supply of low vision aids $156.98
92393 Supply of artificial eye $829.22
92395 Supply of spectacles $91.56
92396 Supply of contact lenses $111.54
92499 Eye service or procedure $0.00
92499.26 Eye service or procedure $0.00
92502 Ear and throat examination $115.78
92504 Ear microscopy examination $47.52
92506 Speech/hearing evaluation $237.29
92507 Speech/hearing therapy $117.32
92508 Speech/hearing therapy $51.74
92510 Rehab for ear implant $257.62
92511 Nasopharyngoscopy $197.76
92512 Nasal function studies $77.15
92516 Facial nerve function test $85.90
92520 Laryngeal function studies $92.55
92526 Oral function therapy $93.63
92531 Spontaneous nystagmus study $28.32
92532 Positional nystagmus test $39.07
92533 Caloric vestibular test $22.51
92534 Optokinetic nystagmus test $11.73
92541 Spontaneous nystagmus test $98.03
92541.26 Spontaneous nystagmus test $43.64
92542 Positional nystagmus test $98.65
92542.26 Positional nystagmus test $36.00
92543 Caloric vestibular test $44.64
92543.26 Caloric vestibular test $11.25
92544 Optokinetic nystagmus test $78.28
92544.26 Optokinetic nystagmus test $28.02
92545 Oscillating tracking test $72.60
92545.26 Oscillating tracking test $25.09
92546 Sinusoidal rotational test $146.61
92546.26 Sinusoidal rotational test $30.95
92547 Supplemental electrical test $74.60
92548 Posturography $175.36
92548.26 Posturography $37.41
92551 Pure tone hearing test, air $21.23
92552 Pure tone audiometry, air $31.67
92553 Audiometry, air & bone $47.50
92555 Speech threshold audiometry $26.85
92556 Speech audiometry, complete $41.30
92557 Comprehensive hearing test $86.04
92559 Group audiometric testing $40.07
92560 Bekesy audiometry, screen $22.51
92561 Bekesy audiometry, diagnosis $45.91
92562 Loudness balance test $17.51
92563 Tone decay hearing test $17.51
92564 Sisi hearing test $20.44
92565 Stenger test, pure tone $17.51
92567 Tympanometry $37.86
92568 Acoustic reflex testing $26.85
92569 Acoustic reflex decay test $28.91
92571 Filtered speech hearing test $17.51
92572 Staggered spondaic word test $6.54
92573 Lombard test $18.51
92575 Sensorineural acuity test $18.51
92576 Synthetic sentence test $19.20
92577 Stenger test, speech $31.18
92579 Visual audiometry (vra) $52.32
92582 Conditioning play audiometry $52.32
92583 Select picture audiometry $38.41
92584 Electrocochleography $154.39
92585 Auditor evoke potent, compre $186.03
92585.26 Auditor evoke potent, compre $53.17
92586 Auditor evoke potent, limit $132.86
92587 Evoked auditory test $85.56
92587.26 Evoked auditory test $11.69
92588 Evoked auditory test $144.60
92588.26 Evoked auditory test $38.93
92589 Auditory function test(s) $38.55
92590 Hearing aid exam, one ear $125.97
92591 Hearing aid exam, both ears $98.09
92592 Hearing aid check, one ear $45.79
92593 Hearing aid check, both ears $68.47
92594 Electro hearng aid test, one $45.91
92595 Electro hearng aid tst, both $68.47
92596 Ear protector evaluation $42.68
92597 Oral speech device eval $182.29
92601 Cochlear implt f/up exam < 7 $203.12
92602 Reprogram cochlear implt < 7 $140.70
92603 Cochlear implt f/up exam 7 > $133.88
92604 Reprogram cochlear implt 7 > $88.97
92605 Eval for nonspeech device rx Paid Elsewhere
92606 Non-speech device service Paid Elsewhere
92607 Ex for speech device rx, 1hr $190.46
92608 Ex for speech device rx addl $41.07
92609 Use of speech device service $94.81
92610 Evaluate swallowing function $200.28
92611 Motion fluoroscopy/swallow $200.28
92612 Endoscopy swallow tst (fees) $170.50
92613 Endoscopy swallow tst (fees) $68.47
92614 Laryngoscopic sensory test $158.10
92615 Eval laryngoscopy sense tst $68.47
92616 Fees w/laryngeal sense test $221.79
92617 Interprt fees/laryngeal test $91.00
92700 Ent procedure/service $0.00
92950 Heart/lung resuscitation cpr $359.06
92953 Temporary external pacing $33.35
92960 Cardioversion electric, ext $629.99
92961 Cardioversion, electric, int $493.85
92970 Cardioassist, internal $342.98
92971 Cardioassist, external $182.47
92973 Percut coronary thrombectomy $338.55
92974 Cath place, cardio brachytx $311.09
92975 Dissolve clot, heart vessel $743.37
92977 Dissolve clot, heart vessel $572.08
92978 Intravasc us, heart add-on $509.26
92978.26 Intravasc us, heart add-on $185.70
92979 Intravasc us, heart add-on $310.61
92979.26 Intravasc us, heart add-on $147.80
92980 Insert intracoronary stent $1,554.08
92981 Insert intracoronary stent $431.79
92982 Coronary artery dilation $1,153.30
92984 Coronary artery dilation $307.48
92986 Revision of aortic valve $2,472.67
92987 Revision of mitral valve $2,568.44
92990 Revision of pulmonary valve $1,993.01
92992 Revision of heart chamber $8,235.99
92993 Revision of heart chamber $8,744.63
92995 Coronary atherectomy $1,268.19
92996 Coronary atherectomy add-on $338.08
92997 Pul art balloon repr, percut $1,254.58
92998 Pul art balloon repr, percut $612.14
93000 Electrocardiogram, complete $48.84
93005 Electrocardiogram, tracing $31.67
93010 Electrocardiogram report $17.17
93012 Transmission of ecg $253.21
93014 Report on transmitted ecg $52.60
93015 Cardiovascular stress test $196.79
93016 Cardiovascular stress test $45.65
93017 Cardiovascular stress test $120.13
93018 Cardiovascular stress test $31.01
93024 Cardiac drug stress test $199.92
93024.26 Cardiac drug stress test $120.07
93025 Microvolt t-wave assess $623.66
93025.26 Microvolt t-wave assess $76.66
93040 Rhythm ECG with report $26.40
93041 Rhythm ECG, tracing $10.67
93042 Rhythm ECG, report $15.73
93224 ECG monitor/report, 24 hrs $296.98
93225 ECG monitor/record, 24 hrs $88.12
93226 ECG monitor/report, 24 hrs $155.58
93227 ECG monitor/review, 24 hrs $53.29
93230 ECG monitor/report, 24 hrs $316.26
93231 Ecg monitor/record, 24 hrs $108.42
93232 ECG monitor/report, 24 hrs $154.55
93233 ECG monitor/review, 24 hrs $53.29
93235 ECG monitor/report, 24 hrs $230.84
93236 ECG monitor/report, 24 hrs $185.19
93237 ECG monitor/review, 24 hrs $45.65
93268 ECG record/review $343.99
93270 ECG recording $88.12
93271 Ecg/monitoring and analysis $253.21
93272 Ecg/review, interpret only $52.60
93278 ECG/signal-averaged $108.84
93278.26 ECG/signal-averaged $25.90
93303 Echo transthoracic $406.17
93303.26 Echo transthoracic $131.84
93304 Echo transthoracic $214.68
93304.26 Echo transthoracic $75.97
93307 Echo exam of heart $369.19
93307.26 Echo exam of heart $94.86
93308 Echo exam of heart $193.44
93308.26 Echo exam of heart $54.72
93312 Echo transesophageal $492.99
93312.26 Echo transesophageal $222.10
93313 Echo transesophageal $87.46
93314 Echo transesophageal $398.30
93314.26 Echo transesophageal $127.42
93315 Echo transesophageal $980.06
93315.26 Echo transesophageal $281.94
93316 Echo transesophageal $89.52
93317 Echo transesophageal $784.09
93317.26 Echo transesophageal $185.18
93318 Echo transesophageal intraop $618.12
93318.26 Echo transesophageal intraop $199.04
93320 Doppler echo exam, heart $161.58
93320.26 Doppler echo exam, heart $39.05
93321 Doppler echo exam, heart $95.53
93321.26 Doppler echo exam, heart $15.67
93325 Doppler color flow add-on $215.19
93325.26 Doppler color flow add-on $7.64
93350 Echo transthoracic $276.77
93350.26 Echo transthoracic $150.45
93501 Right heart catheterization $1,514.90
93501.26 Right heart catheterization $311.21
93503 Insert/place heart catheter $270.63
93505 Biopsy of heart lining $594.78
93505.26 Biopsy of heart lining $452.28
93508 Cath placement, angiography $1,350.43
93508.26 Cath placement, angiography $457.89
93510 Left heart catheterization $3,113.74
93510.26 Left heart catheterization $481.94
93511 Left heart catheterization $3,116.10
93511.26 Left heart catheterization $554.18
93514 Left heart catheterization $3,319.25
93514.26 Left heart catheterization $757.32
93524 Left heart catheterization $4,100.70
93524.26 Left heart catheterization $752.61
93526 Rt & Lt heart catheters $4,093.39
93526.26 Rt & Lt heart catheters $653.39
93527 Rt & Lt heart catheters $4,136.01
93527.26 Rt & Lt heart catheters $787.92
93528 Rt & Lt heart catheters $4,317.80
93528.26 Rt & Lt heart catheters $969.71
93529 Rt, lt heart catheterization $3,873.73
93529.26 Rt, lt heart catheterization $525.64
93530 Rt heart cath, congenital $1,662.33
93530.26 Rt heart cath, congenital $458.64
93531 R & l heart cath, congenital $4,328.80
93531.26 R & l heart cath, congenital $888.81
93532 R & l heart cath, congenital $4,409.68
93532.26 R & l heart cath, congenital $1,061.59
93533 R & l heart cath, congenital $4,058.96
93533.26 R & l heart cath, congenital $710.87
93539 Injection, cardiac cath $41.23
93540 Injection, cardiac cath $44.16
93541 Injection for lung angiogram $29.57
93542 Injection for heart x-rays $29.57
93543 Injection for heart x-rays $30.26
93544 Injection for aortography $25.90
93545 Inject for coronary x-rays $41.23
93555 Imaging, cardiac cath $529.30
93555.26 Imaging, cardiac cath $83.89
93556 Imaging, cardiac cath $787.23
93556.26 Imaging, cardiac cath $86.07
93561 Cardiac output measurement $86.90
93561.26 Cardiac output measurement $49.04
93562 Cardiac output measurement $39.14
93562.26 Cardiac output measurement $15.73
93571 Heart flow reserve measure $509.25
93571.26 Heart flow reserve measure $185.69
93572 Heart flow reserve measure $311.97
93572.26 Heart flow reserve measure $149.15
93580 Transcath closure of asd $1,880.72
93581 Transcath closure of vsd $2,507.66
93600 Bundle of His recording $359.31
93600.26 Bundle of His recording $219.91
93602 Intra-atrial recording $299.77
93602.26 Intra-atrial recording $220.25
93603 Right ventricular recording $339.35
93603.26 Right ventricular recording $219.22
93609 Map tachycardia, add-on $721.58
93609.26 Map tachycardia, add-on $528.48
93610 Intra-atrial pacing $409.65
93610.26 Intra-atrial pacing $312.58
93612 Intraventricular pacing $427.89
93612.26 Intraventricular pacing $312.58
93613 Electrophys map 3d, add-on $733.60
93615 Esophageal recording $116.61
93615.26 Esophageal recording $93.89
93616 Esophageal recording $165.30
93616.26 Esophageal recording $142.58
93618 Heart rhythm pacing $724.54
93618.26 Heart rhythm pacing $442.29
93619 Electrophysiology evaluation $1,330.97
93619.26 Electrophysiology evaluation $781.96
93620 Electrophysiology evaluation $3,918.60
93620.26 Electrophysiology evaluation $1,223.28
93621 Electrophysiology evaluation $4,310.65
93621.26 Electrophysiology evaluation $219.44
93622 Electrophysiology evaluation $4,310.65
93622.26 Electrophysiology evaluation $342.56
93623 Stimulation, pacing heart $1,110.22
93623.26 Stimulation, pacing heart $296.10
93624 Electrophysiologic study $661.66
93624.26 Electrophysiologic study $520.19
93631 Heart pacing, mapping $1,231.66
93631.26 Heart pacing, mapping $785.61
93640 Evaluation heart device $873.40
93640.26 Evaluation heart device $363.29
93641 Electrophysiology evaluation $1,124.61
93641.26 Electrophysiology evaluation $614.49
93642 Electrophysiology evaluation $1,033.89
93642.26 Electrophysiology evaluation $523.77
93650 Ablate heart dysrhythm focus $1,112.34
93651 Ablate heart dysrhythm focus $1,684.47
93652 Ablate heart dysrhythm focus $1,831.81
93660 Tilt table evaluation $311.53
93660.26 Tilt table evaluation $194.48
93662 Intracardiac ecg (ice) $691.95
93662.26 Intracardiac ecg (ice) $302.31
93668 Peripheral vascular rehab $0.00
93701 Bioimpedance, thoracic $83.61
93701.26 Bioimpedance, thoracic $17.86
93720 Total body plethysmography $67.42
93721 Plethysmography tracing $50.94
93722 Plethysmography report $16.48
93724 Analyze pacemaker system $786.40
93724.26 Analyze pacemaker system $504.15
93727 Analyze ilr system $54.66
93731 Analyze pacemaker system $81.79
93731.26 Analyze pacemaker system $46.68
93732 Analyze pacemaker system $131.34
93732.26 Analyze pacemaker system $94.86
93733 Telephone analy, pacemaker $70.17
93733.26 Telephone analy, pacemaker $17.86
93734 Analyze pacemaker system $63.83
93734.26 Analyze pacemaker system $39.05
93735 Analyze pacemaker system $108.26
93735.26 Analyze pacemaker system $76.60
93736 Telephonic analy, pacemaker $61.11
93736.26 Telephonic analy, pacemaker $15.67
93740 Temperature gradient studies $26.40
93740.26 Temperature gradient studies $15.04
93741 Analyze ht pace device sngl $114.85
93741.26 Analyze ht pace device sngl $72.87/td>
93742 Analyze ht pace device sngl $140.93
93742.26 Analyze ht pace device sngl $93.43
93743 Analyze ht pace device dual $158.15
93743.26 Analyze ht pace device dual $105.83
93744 Analyze ht pace device dual $168.66
93744.26 Analyze ht pace device dual $121.16
93760 Cephalic thermogram $313.47
93762 Peripheral thermogram $392.04
93770 Measure venous pressure $18.14
93770.26 Measure venous pressure $15.73
93784 Ambulatory BP monitoring $136.12
93786 Ambulatory BP recording $63.00
93788 Ambulatory BP analysis $35.46
93790 Review/report BP recording $37.67
93797 Cardiac rehab $39.26
93798 Cardiac rehab/monitor $54.99
93799 Cardiovascular procedure $0.00
93799.26 Cardiovascular procedure $0.00
93875 Extracranial study $134.83
93875.26 Extracranial study $22.28
93880 Extracranial study $346.31
93880.26 Extracranial study $60.98
93882 Extracranial study $246.36
93882.26 Extracranial study $41.22
93886 Intracranial study $393.38
93886.26 Intracranial study $97.73
93888 Intracranial study $265.19
93888.26 Intracranial study $63.85
93922 Extremity study $156.69
93922.26 Extremity study $25.55
93923 Extremity study $249.41
93923.26 Extremity study $45.64
93924 Extremity study $306.84
93924.26 Extremity study $51.10
93925 Lower extremity study $392.32
93925.26 Lower extremity study $58.80
93926 Lower extremity study $278.66
93926.26 Lower extremity study $39.44
93930 Upper extremity study $313.48
93930.26 Upper extremity study $46.74
93931 Upper extremity study $226.22
93931.26 Upper extremity study $31.41
93965 Extremity study $159.00
93965.26 Extremity study $35.08
93970 Extremity study $339.88
93970.26 Extremity study $68.67
93971 Extremity study $241.14
93971.26 Extremity study $45.30
93975 Vascular study $554.32
93975.26 Vascular study $180.18
93976 Vascular study $341.26
93976.26 Vascular study $120.30
93978 Vascular study $309.76
93978.26 Vascular study $65.74
93979 Vascular study $225.25
93979.26 Vascular study $44.90
93980 Penile vascular study $436.84
93980.26 Penile vascular study $124.31
93981 Penile vascular study $361.57
93981.26 Penile vascular study $43.87
93990 Doppler flow testing $262.71
93990.26 Doppler flow testing $25.55
94010 Breathing capacity test $59.85
94010.26 Breathing capacity test $16.48
94014 Patient recorded spirometry $92.87
94015 Patient recorded spirometry $41.65
94016 Review patient spirometry $51.22
94060 Evaluation of wheezing $102.66
94060.26 Evaluation of wheezing $30.38
94070 Evaluation of wheezing $254.78
94070.26 Evaluation of wheezing $58.57
94150 Vital capacity test $29.29
94150.26 Vital capacity test $5.74
94200 Lung function test (MBC/MVV) $39.54
94200.26 Lung function test (MBC/MVV) $10.62
94240 Residual lung capacity $69.67
94240.26 Residual lung capacity $25.27
94250 Expired gas collection $45.66
94250.26 Expired gas collection $9.04
94260 Thoracic gas volume $50.67
94260.26 Thoracic gas volume $12.80
94350 Lung nitrogen washout curve $72.77
94350.26 Lung nitrogen washout curve $25.27
94360 Measure airflow resistance $69.32
94360.26 Measure airflow resistance $25.27
94370 Breath airway closing volume $64.15
94370.26 Breath airway closing volume $23.15
94375 Respiratory flow volume loop $66.18
94375.26 Respiratory flow volume loop $30.38
94400 CO2 breathing response curve $90.10
94400.26 CO2 breathing response curve $38.47
94450 Hypoxia response curve $78.06
94450.26 Hypoxia response curve $38.82
94620 Pulmonary stress test/simple $218.52
94620.26 Pulmonary stress test/simple $62.25
94621 Pulm stress test/complex $253.35
94621.26 Pulm stress test/complex $137.70
94640 Airway inhalation treatment $22.72
94642 Aerosol inhalation treatment $130.97
94656 Initial ventilator mgmt $174.75
94657 Continued ventilator mgmt $132.20
94660 Pos airway pressure, CPAP $103.56
94662 Neg press ventilation, cnp $73.96
94664 Evaluate pt use of inhaler $23.40
94667 Chest wall manipulation $38.89
94668 Chest wall manipulation $32.36
94680 Exhaled air analysis, o2 $151.94
94680.26 Exhaled air analysis, o2 $25.27
94681 Exhaled air analysis, o2/co2 $199.78
94681.26 Exhaled air analysis, o2/co2 $20.10
94690 Exhaled air analysis $142.58
94690.26 Exhaled air analysis $6.95
94720 Monoxide diffusing capacity $90.66
94720.26 Monoxide diffusing capacity $25.27
94725 Membrane diffusion capacity $208.70
94725.26 Membrane diffusion capacity $23.45
94750 Pulmonary compliance study $111.84
94750.26 Pulmonary compliance study $22.34
94760 Measure blood oxygen level $3.44
94761 Measure blood oxygen level $6.88
94762 Measure blood oxygen level $30.97
94770 Exhaled carbon dioxide test $114.41
94770.26 Exhaled carbon dioxide test $12.69
94772 Breath recording, infant $313.72
94772.26 Breath recording, infant $313.72
94799 Pulmonary service/procedure $0.00
94799.26 Pulmonary service/procedure $0.00
95004 Percut allergy skin tests $7.23
95010 Percut allergy titrate test $20.56
95015 Id allergy titrate-drug/bug $19.55
95024 Id allergy test, drug/bug $10.67
95027 Id allergy titrate-airborne $10.67
95028 Id allergy test-delayed type $12.84
95044 Allergy patch tests $14.01
95052 Photo patch test $10.95
95056 Photosensitivity tests $8.56
95060 Eye allergy tests $18.18
95065 Nose allergy test $14.80
95070 Bronchial allergy tests $158.35
95071 Bronchial allergy tests $202.42
95075 Ingestion challenge test $129.46
95078 Provocative testing $18.59
95115 Immunotherapy, one injection $23.00
95117 Immunotherapy injections $28.35
95120 Immunotherapy, one injection $18.78
95125 Immunotherapy, many antigens $34.82
95130 Immunotherapy, insect venom $59.89
95131 Immunotherapy, insect venoms $52.28
95132 Immunotherapy, insect venoms $98.24
95133 Immunotherapy, insect venoms $110.66
95134 Immunotherapy, insect venoms $122.99
95144 Antigen therapy services $15.15
95145 Antigen therapy services $20.40
95146 Antigen therapy services $35.12
95147 Antigen therapy services $33.74
95148 Antigen therapy services $44.76
95149 Antigen therapy services $60.59
95165 Antigen therapy services $17.07
95170 Antigen therapy services $14.46
95180 Rapid desensitization $256.46
95199 Allergy immunology services $0.00
95250 Glucose monitoring, cont $196.36
95805 Multiple sleep latency test $764.37
95805.26 Multiple sleep latency test $112.94
95806 Sleep study, unattended $399.30
95806.26 Sleep study, unattended $162.85
95807 Sleep study, attended $590.66
95807.26 Sleep study, attended $101.69
95808 Polysomnography, 1-3 $1,045.44
95808.26 Polysomnography, 1-3 $251.39
95810 Polysomnography, 4 or more $1,453.88
95810.26 Polysomnography, 4 or more $348.90
95811 Polysomnography w/cpap $1,573.53
95811.26 Polysomnography w/cpap $375.94
95812 Eeg, 41-60 minutes $355.34
95812.26 Eeg, 41-60 minutes $113.35
95813 Eeg, over 1 hour $474.79
95813.26 Eeg, over 1 hour $179.78
95816 Eeg, awake and drowsy $297.31
95816.26 Eeg, awake and drowsy $112.27
95819 Eeg, awake and asleep $339.85
95819.26 Eeg, awake and asleep $114.03
95822 Eeg, coma or sleep only $319.02
95822.26 Eeg, coma or sleep only $93.60
95824 Eeg, cerebral death only $421.24
95824.26 Eeg, cerebral death only $79.35
95827 Eeg, all night recording $272.71
95827.26 Eeg, all night recording $109.56
95829 Surgery electrocorticogram $1,578.82
95829.26 Surgery electrocorticogram $381.65
95830 Insert electrodes for EEG $337.01
95831 Limb muscle testing, manual $44.66
95832 Hand muscle testing, manual $39.21
95833 Body muscle testing, manual $66.42
95834 Body muscle testing, manual $79.92
95851 Range of motion measurements $37.77
95852 Range of motion measurements $26.46
95857 Tensilon test $82.26
95858 Tensilon test & myogram $192.56
95858.26 Tensilon test & myogram $164.34
95860 Muscle test, one limb $173.58
95860.26 Muscle test, one limb $101.98
95861 Muscle test, 2 limbs $216.88
95861.26 Muscle test, 2 limbs $163.87
95863 Muscle test, 3 limbs $264.59
95863.26 Muscle test, 3 limbs $197.81
95864 Muscle test, 4 limbs $338.26
95864.26 Muscle test, 4 limbs $210.90
95867 Muscle test cran nerv unilat $125.77
95867.26 Muscle test cran nerv unilat $84.46
95868 Muscle test cran nerve bilat $174.85
95868.26 Muscle test cran nerve bilat $124.94
95869 Muscle test, thor paraspinal $54.82
95869.26 Muscle test, thor paraspinal $38.99
95870 Muscle test, nonparaspinal $54.82
95870.26 Muscle test, nonparaspinal $38.99
95872 Muscle test, one fiber $200.13
95872.26 Muscle test, one fiber $157.10
95875 Limb exercise test $186.43
95875.26 Limb exercise test $115.53
95900 Motor nerve conduction test $121.21
95900.26 Motor nerve conduction test $44.79
95903 Motor nerve conduction test $129.48
95903.26 Motor nerve conduction test $63.39
95904 Sense nerve conduction test $102.84
95904.26 Sense nerve conduction test $36.06
95920 Intraop nerve test add-on $320.70
95920.26 Intraop nerve test add-on $228.11
95921 Autonomic nerv function test $117.46
95921.26 Autonomic nerv function test $91.30
95922 Autonomic nerv function test $126.76
95922.26 Autonomic nerv function test $100.60
95923 Autonomic nerv function test $185.76
95923.26 Autonomic nerv function test $82.23
95925 Somatosensory testing $121.56
95925.26 Somatosensory testing $56.85
95926 Somatosensory testing $122.24
95926.26 Somatosensory testing $57.53
95927 Somatosensory testing $123.62
95927.26 Somatosensory testing $58.91
95930 Visual evoked potential test $125.28
95930.26 Visual evoked potential test $36.81
95933 Blink reflex test $117.72
95933.26 Blink reflex test $61.27
95934 H-reflex test $69.75
95934.26 H-reflex test $53.92
95936 H-reflex test $74.11
95936.26 H-reflex test $58.28
95937 Neuromuscular junction test $91.91
95937.26 Neuromuscular junction test $67.81
95950 Ambulatory eeg monitoring $438.69
95950.26 Ambulatory eeg monitoring $160.25
95951 EEG monitoring/videorecord $2,277.49
95951.26 EEG monitoring/videorecord $632.47
95953 EEG monitoring/computer $774.87
95953.26 EEG monitoring/computer $322.93
95954 EEG monitoring/giving drugs $484.49
95954.26 EEG monitoring/giving drugs $259.36
95955 EEG during surgery $243.73
95955.26 EEG during surgery $102.26
95956 Eeg monitoring, cable/radio $1,180.47
95956.26 Eeg monitoring, cable/radio $312.76
95957 EEG digital analysis $330.97
95957.26 EEG digital analysis $209.12
95958 EEG monitoring/function test $569.59
95958.26 EEG monitoring/function test $444.65
95961 Electrode stimulation, brain $412.80
95961.26 Electrode stimulation, brain $320.21
95962 Electrode stim, brain add-on $435.20
95962.26 Electrode stim, brain add-on $342.61
95965 Meg, spontaneous $2,007.55
95965.26 Meg, spontaneous $844.80
95966 Meg, evoked, single $1,180.47
95966.26 Meg, evoked, single $423.23
95967 Meg, evoked, each add’l $927.73
95967.26 Meg, evoked, each add’l $357.67
95970 Analyze neurostim, no prog $46.68
95971 Analyze neurostim, simple $79.92
95972 Analyze neurostim, complex $159.83
95973 Analyze neurostim, complex $98.29
95974 Cranial neurostim, complex $319.01
95975 Cranial neurostim, complex $179.95
95990 Spin/brain pump refil & main $105.33
95991 Spin/brain pump refil & main $94.81
95999 Neurological procedure $0.00
96000 Motion analysis, video/3d $172.97
96001 Motion test w/ft press meas $206.68
96002 Dynamic surface emg $41.63
96003 Dynamic fine wire emg $38.64
96004 Phys review of motion tests $228.64
96100 Psychological testing $128.03
96105 Assessment of aphasia $128.03
96110 Developmental test, lim $19.25
96111 Developmental test, extend $273.99
96115 Neurobehavior status exam $128.03
96117 Neuropsych test battery $128.03
96150 Assess lth/behave, init $51.10
96151 Assess hlth/behave, subseq $44.81
96152 Intervene hlth/behave, indiv $46.74
96153 Intervene hlth/behave, group $10.56
96154 Interv hlth/behav, fam w/pt $45.99
96155 Interv hlth/behav fam no pt $45.94
96400 Chemotherapy, sc/im $90.15
96405 Intralesional chemo admin $120.79
96406 Intralesional chemo admin $164.32
96408 Chemotherapy, push technique $137.01
96410 Chemotherapy,infusion method $217.59
96412 Chemo, infuse method add-on $66.04
96414 Chemo, infuse method add-on $224.90
96420 Chemotherapy, push technique $125.34
96422 Chemotherapy,infusion method $223.66
96423 Chemo, infuse method add-on $97.51
96425 Chemotherapy,infusion method $204.66
96440 Chemotherapy, intracavitary $456.90
96445 Chemotherapy, intracavitary $453.00
96450 Chemotherapy, into CNS $388.51
96520 Port pump refill & main $171.61
96530 Syst pump refill & main $127.00
96542 Chemotherapy injection $253.43
96545 Provide chemotherapy agent $90.20
96549 Chemotherapy, unspecified $0.00
96567 Photodynamic tx, skin $68.84
96570 Photodynamic tx, 30 min $109.33
96571 Photodynamic tx, addl 15 min $55.53
96900 Ultraviolet light therapy $33.73
96902 Trichogram $48.17
96910 Photochemotherapy with UV-B $55.79
96912 Photochemotherapy with UV-A $63.38
96913 Photochemotherapy, UV-A or B $125.98
96920 Laser tx, skin < 250 sq cm $370.64
96921 Laser tx, skin 250-500 sq cm $374.42
96922 Laser tx, skin > 500 sq cm $448.31
96999 Dermatological procedure $0.00
97001 Pt evaluation $129.24
97002 Pt re-evaluation $69.97
97003 Ot evaluation $132.48
97004 Ot re-evaluation $86.80
97005 Athletic train eval $123.87
97006 Athletic train reeval $67.41
97010 Hot or cold packs therapy $8.27
97012 Mechanical traction therapy $28.65
97014 Electric stimulation therapy $26.87
97016 Vasopneumatic device therapy $26.87
97018 Paraffin bath therapy $12.40
97020 Microwave therapy $8.95
97022 Whirlpool therapy $28.18
97024 Diathermy treatment $11.02
97026 Infrared therapy $8.95
97028 Ultraviolet therapy $11.14
97032 Electrical stimulation $30.03
97033 Electric current therapy $39.38
97034 Contrast bath therapy $27.04
97035 Ultrasound therapy $23.60
97036 Hydrotherapy $43.97
97039 Physical therapy treatment $22.16
97110 Therapeutic exercises $53.97
97112 Neuromuscular reeducation $53.31
97113 Aquatic therapy/exercises $59.98
97116 Gait training therapy $47.08
97124 Massage therapy $41.59
97139 Physical medicine procedure $29.79
97140 Manual therapy $50.62
97150 Group therapeutic procedures $33.24
97504 Orthotic training $50.50
97520 Prosthetic training $49.88
97530 Therapeutic activities $44.23
97532 Cognitive skills development $47.66
97533 Sensory integration $49.72
97535 Self care mngment training $45.64
97537 Community/work reintegration $52.54
97542 Wheelchair mngment training $53.22
97545 Work hardening $202.20
97546 Work hardening add-on $55.94
97601 Wound(s) care, selective $72.79
97602 Wound(s) care non-selective $37.54
97703 Prosthetic checkout $47.58
97750 Physical performance test $54.94
97755 Assistive technology assess $51.94
97780 Acupuncture w/o stimul $51.75
97781 Acupuncture w/stimul $96.41
97799 Physical medicine procedure $0.00
97802 Medical nutrition, indiv, in $29.40
97803 Med nutrition, indiv, subseq $26.04
97804 Medical nutrition, group $13.42
98925 Osteopathic manipulation $48.41
98926 Osteopathic manipulation $78.14
98927 Osteopathic manipulation $60.87
98928 Osteopathic manipulation $71.76
98929 Osteopathic manipulation $82.44
98940 Chiropractic manipulation $35.75
98941 Chiropractic manipulation $41.93
98942 Chiropractic manipulation $56.48
98943 Chiropractic manipulation $30.83
99000 Specimen handling $17.02
99001 Specimen handling $13.51
99002 Device handling $9.77
99024 Postop follow-up visit $35.00
99025 Initial surgical evaluation $27.11
99026 In-hospital on call service $46.86
99027 Out-of-hosp on call service $23.39
99050 Medical services after hrs $45.97
99052 Medical services at night $39.86
99054 Medical servcs, unusual hrs $38.91
99056 Non-office medical services $22.55
99058 Office emergency care $67.01
99070 Special supplies $43.18
99071 Patient education materials $15.61
99075 Medical testimony $164.91
99078 Group health education $45.12
99080 Special reports or forms $23.29
99082 Unusual physician travel $0.00
99090 Computer data analysis $105.71
99091 Collect/review data from pt $52.73
99100 Special anesthesia service $5.00
99116 Anesthesia with hypothermia $23.39
99135 Special anesthesia procedure $27.71
99140 Emergency anesthesia $59.04
99141 Sedation, iv/im or inhalant $193.65
99142 Sedation, oral/rectal/nasal $68.60
99170 Anogenital exam, child $151.11
99172 Ocular function screen $0.00
99173 Visual acuity screen $20.60
99175 Induction of vomiting $59.89
99183 Hyperbaric oxygen therapy $303.95
99185 Regional hypothermia $27.26
99186 Total body hypothermia $83.20
99190 Special pump services $405.22
99191 Special pump services $301.40
99192 Special pump services $200.53
99195 Phlebotomy $28.06
99199 Special service/proc/report $0.00
99201 Office/outpatient visit, new $66.14
99202 Office/outpatient visit, new $89.06
99203 Office/outpatient visit, new $122.56
99204 Office/outpatient visit, new $174.13
99205 Office/outpatient visit, new $239.68
99211 Office/outpatient visit, est $39.28
99212 Office/outpatient visit, est $53.51
99213 Office/outpatient visit, est $72.09
99214 Office/outpatient visit, est $110.89
99215 Office/outpatient visit, est $164.24
99217 Observation care discharge $125.87
99218 Observation care $127.25
99219 Observation care $212.80
99220 Observation care $290.28
99221 Initial hospital care $128.62
99222 Initial hospital care $214.18
99223 Initial hospital care $298.99
99231 Subsequent hospital care $64.31
99232 Subsequent hospital care $106.00
99233 Subsequent hospital care $150.62
99234 Observ/hosp same date $215.15
99235 Observ/hosp same date $275.58
99236 Observ/hosp same date $317.48
99238 Hospital discharge day $121.03
99239 Hospital discharge day $167.29
99241 Office consultation $94.26
99242 Office consultation $153.13
99243 Office consultation $203.09
99244 Office consultation $324.14
99245 Office consultation $335.53
99251 Initial inpatient consult $68.21
99252 Initial inpatient consult $136.42
99253 Initial inpatient consult $186.50
99254 Initial inpatient consult $269.76
99255 Initial inpatient consult $370.93
99261 Follow-up inpatient consult $43.06
99262 Follow-up inpatient consult $86.19
99263 Follow-up inpatient consult $127.53
99271 Confirmatory consultation $69.94
99272 Confirmatory consultation $103.35
99273 Confirmatory consultation $142.24
99274 Confirmatory consultation $193.07
99275 Confirmatory consultation $246.44
99281 Emergency dept visit $31.52
99282 Emergency dept visit $52.77
99283 Emergency dept visit $117.37
99284 Emergency dept visit $182.77
99285 Emergency dept visit $285.96
99288 Direct advanced life support $329.09
99289 Ped crit care transport $336.89
99290 Ped crit care transport addl $168.88
99291 Critical care, first hour $415.90
99292 Critical care, add’l 30 min $207.86
99293 Ped critical care, initial $1,087.15
99294 Ped critical care, subseq $591.16
99295 Neonate crit care, initial $1,649.92
99296 Neonate critical care subseq $781.82
99298 Ic for lbw infant < 1500 gm $273.50
99299 Ic, lbw infant 1500-2500 gm $213.49
99301 Nursing facility care $101.63
99302 Nursing facility care $139.75
99303 Nursing facility care $197.20
99311 Nursing fac care, subseq $67.84
99312 Nursing fac care, subseq $91.21
99313 Nursing fac care, subseq $110.26
99315 Nursing fac discharge day $112.47
99316 Nursing fac discharge day $133.03
99321 Rest home visit, new patient $69.85
99322 Rest home visit, new patient $105.23
99323 Rest home visit, new patient $135.17
99331 Rest home visit, est pat $41.57
99332 Rest home visit, est pat $87.27
99333 Rest home visit, est pat $107.03
99341 Home visit, new patient $84.04
99342 Home visit, new patient $105.23
99343 Home visit, new patient $142.60
99344 Home visit, new patient $186.97
99345 Home visit, new patient $244.79
99347 Home visit, est patient $75.62
99348 Home visit, est patient $92.00
99349 Home visit, est patient $134.91
99350 Home visit, est patient $205.88
99354 Prolonged service, office $172.80
99355 Prolonged service, office $169.65
99356 Prolonged service, inpatient $172.78
99357 Prolonged service, inpatient $104.08
99358 Prolonged serv, w/o contact $136.18
99359 Prolonged serv, w/o contact $67.45
99360 Physician standby services $126.42
99361 Physician/team conference $84.04
99362 Physician/team conference $151.76
99371 Physician phone consultation $11.77
99372 Physician phone consultation $34.39
99373 Physician phone consultation $50.52
99374 Home health care supervision $81.41
99375 Home health care supervision $143.62
99377 Hospice care supervision $79.23
99378 Hospice care supervision $159.09
99379 Nursing fac care supervision $79.03
99380 Nursing fac care supervision $143.62
99381 Prev visit, new, infant $116.31
99382 Prev visit, new, age 1-4 $135.62
99383 Prev visit, new, age 5-11 $141.76
99384 Prev visit, new, age 12-17 $133.82
99385 Prev visit, new, age 18-39 $153.38
99386 Prev visit, new, age 40-64 $159.72
99387 Prev visit, new, 65 & over $230.14
99391 Prev visit, est, infant $93.04
99392 Prev visit, est, age 1-4 $106.73
99393 Prev visit, est, age 5-11 $113.39
99394 Prev visit, est, age 12-17 $111.16
99395 Prev visit, est, age 18-39 $122.81
99396 Prev visit, est, age 40-64 $129.30
99397 Prev visit, est, 65 & over $143.45
99401 Preventive counseling, indiv $47.32
99402 Preventive counseling, indiv $80.26
99403 Preventive counseling, indiv $111.27
99404 Preventive counseling, indiv $142.93
99411 Preventive counseling, group $23.94
99412 Preventive counseling, group $36.22
99420 Health risk assessment test $134.56
99429 Unlisted preventive service $0.00
99431 Initial care, normal newborn $115.25
99432 Newborn care, not in hosp $151.76
99433 Normal newborn care/hospital $60.75
99435 Newborn discharge day hosp $148.49
99436 Attendance, birth $145.74
99440 Newborn resuscitation $287.97
99450 Life/disability evaluation $159.88
99455 Disability examination $74.04
99456 Disability examination $252.85
99499 Unlisted e&m service $0.00
99500 Home visit, prenatal $95.00
99501 Home visit, postnatal $50.00
99502 Home visit, nb care $50.00
99503 Home visit, resp therapy By Report
99504 Home visit mech ventilator $0.00
99505 Home visit, stoma care By Report
99506 Home visit, im injection $0.00
99507 Home visit, cath maintain $80.00
99509 Home visit day life activity $42.00
99510 Home visit, sing/m/fam couns $0.00
99511 Home visit, fecal/enema mgmt $0.00
99512 Home visit for hemodialysis $0.00
99551 Home infus, pain mgmt, iv/sc $65.00
99554 Home infus, hormone/platelet $80.00
99555 Home infuse, chemotheraphy $80.00
99556 Home infus, antibio/fung/vir $80.00
99558 Home infuse, immunotherapy $80.00
99561 Home infuse, hydration tx $80.00
99562 Home infus, parent nutrition $170.00
99567 Home infuse, sympath agent $80.00
99568 Home infus, misc drug, daily $466.00
99569 Home infuse, each addl tx $80.00
99600 Home visit nos By Report
99601 Home infusion/visit, 2 hrs $75.00
99602 Home infusion, each addtl hr $75.00
