Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Medi-Cal Rates Information

Medi-Cal Rates as of 02/15/2020 (Codes 00100 thru 14001)

Medi-Cal Rates are updated and effective as of the 15th of the month and published to the Medi-Cal website on the 16th of the month


CPT codes, descriptions and other data are copyright 2002 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.


Note: Should you have landed here as a result of a search engine or other link, be advised that these files contain material that is copyrighted by the American Medical Association. You are forbidden to download the materials unless you read, agree to and abide by the provisions of the copyright statement. Read the copyright statement now (you will be linked back to here).


  
Proc Type Proc Code Procedure Description Unit Value Basic Rate Child Rate ER Rate Conv Ind ER Ind Cut-back Ind Prof % Rental Rate Non-Physn. Med.Prac. Ind
J 00100 ANESTH SALIVARY GLAND 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00102 ANESTH REPAIR OF CLEFT LIP 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00103 ANESTH BLEPHAROPLASTY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00104 ANESTH ELECTROSHOCK 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00120 ANESTH EAR SURGERY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00124 ANESTH EAR EXAM 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00126 ANESTH TYMPANOTOMY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00140 ANESTH PROCEDURES ON EYE 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00142 ANESTH LENS SURGERY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00144 ANESTH CORNEAL TRANSPLANT 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00145 ANESTH VITREORETINAL SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00147 ANESTH IRIDECTOMY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00148 ANESTH EYE EXAM 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00160 ANESTH NOSE/SINUS SURGERY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00162 ANESTH NOSE/SINUS SURGERY 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00164 ANESTH BIOPSY OF NOSE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00170 ANESTH PROCEDURE ON MOUTH 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00172 ANESTH CLEFT PALATE REPAIR 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00174 ANESTH PHARYNGEAL SURGERY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00176 ANESTH PHARYNGEAL SURGERY 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00190 ANESTH FACE/SKULL BONE SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00192 ANESTH FACIAL BONE SURGERY 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00210 ANESTH CRANIAL SURG NOS 9.93 $139.12 --- -- 002 0 0 0.00 $0.00 Y
J 00211 ANESTH CRAN SURG HEMOTOMA 0.00 $0.00 --- -- 002 0 0 0.00 $0.00 Y
J 00212 ANESTH SKULL DRAINAGE 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00214 ANESTH SKULL DRAINAGE 8.13 $113.90 --- -- 002 0 0 0.00 $0.00 Y
J 00215 ANESTH SKULL REPAIR/FRACT 8.13 $113.90 --- -- 002 0 0 0.00 $0.00 Y
J 00216 ANESTH HEAD VESSEL SURGERY 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00218 ANESTH SPECIAL HEAD SURGERY 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00220 ANESTH INTRCRN NERVE 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00222 ANESTH HEAD NERVE SURGERY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00300 ANESTH HEAD/NECK/PTRUNK 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00320 ANESTH NECK ORGAN 1YR/> 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00322 ANESTH BIOPSY OF THYROID 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00326 ANESTH LARYNX/TRACH < 1 YR 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00350 ANESTH NECK VESSEL SURGERY 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00352 ANESTH NECK VESSEL SURGERY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00400 ANESTH SKIN EXT/PER/ATRUNK 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00402 ANESTH SURGERY OF BREAST 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00404 ANESTH SURGERY OF BREAST 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00406 ANESTH SURGERY OF BREAST 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00410 ANESTH CORRECT HEART RHYTHM 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00450 ANESTH SURGERY OF SHOULDER 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00454 ANESTH COLLAR BONE BIOPSY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00470 ANESTH REMOVAL OF RIB 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00472 ANESTH CHEST WALL REPAIR 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00474 ANESTH SURGERY OF RIB 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 N
J 00500 ANESTH ESOPHAGEAL SURGERY 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00520 ANESTH CHEST PROCEDURE 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00522 ANESTH CHEST LINING BIOPSY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00524 ANESTH CHEST DRAINAGE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00528 ANES MEDIASCPY & DX THORSCPY 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 N
J 00529 ANES MEDSCPY&THORSCPY 1 LUNG 9.93 $139.12 --- -- 002 0 0 0.00 $0.00 Y
J 00530 ANESTH PACEMAKER INSERTION 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00532 ANESTH VASCULAR ACCESS 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00534 ANESTH CARDIOVERTER/DEFIB 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00537 ANESTH CARDIAC ELECTROPHYS 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00539 ANESTH TRACH-BRONCH RECONST 16.25 $227.66 --- -- 002 0 0 0.00 $0.00 Y
J 00540 ANESTH CHEST SURGERY 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00541 ANESTH ONE LUNG VENTILATION 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00542 ANESTHESIA REMOVAL PLEURA 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00546 ANESTH LUNG CHEST WALL SURG 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00548 ANESTH TRACHEA BRONCHI SURG 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00550 ANESTH STERNAL DEBRIDEMENT 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00560 ANESTH HEART SURG W/O PUMP 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00561 ANESTH HEART SURG < 1 YR 22.58 $316.35 --- -- 002 0 0 0.00 $0.00 Y
J 00562 ANESTH HRT SURG W/PMP AGE 1+ 18.06 $253.02 --- -- 002 0 0 0.00 $0.00 Y
J 00563 ANESTH HEART SURG W/ARREST 22.58 $316.35 --- -- 002 0 0 0.00 $0.00 Y
J 00566 ANESTH CABG W/O PUMP 22.58 $316.35 --- -- 002 0 0 0.00 $0.00 Y
J 00567 ANESTH CABG W/PUMP 0.00 $0.00 --- -- 002 0 0 0.00 $0.00 Y
J 00580 ANESTH HEART/LUNG TRANSPLNT 18.06 $253.02 --- -- 002 0 0 0.00 $0.00 Y
J 00600 ANESTH SPINE CORD SURGERY 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00604 ANESTH SITTING PROCEDURE 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00620 ANESTH SPINE CORD SURGERY 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00625 ANES SPINE TRANTHOR W/O VENT 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00626 ANES SPINE TRANSTHOR W/VENT 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00630 ANESTH SPINE CORD SURGERY 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00632 ANESTH REMOVAL OF NERVES 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00635 ANESTH LUMBAR PUNCTURE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00640 ANESTH SPINE MANIPULATION 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00670 ANESTH SPINE CORD SURGERY 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00700 ANESTH ABDOMINAL WALL SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00702 ANESTH FOR LIVER BIOPSY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00730 ANESTH ABDOMINAL WALL SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00731 ANES UPR GI NDSC PX NOS 5.00 $70.05 --- -- 002 0 0 0.00 $0.00 Y
J 00732 ANES UPR GI NDSC PX ERCP 6.00 $84.06 --- -- 002 0 0 0.00 $0.00 Y
J 00750 ANESTH REPAIR OF HERNIA 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00752 ANESTH REPAIR OF HERNIA 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00754 ANESTH REPAIR OF HERNIA 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00756 ANESTH REPAIR OF HERNIA 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00770 ANESTH BLOOD VESSEL REPAIR 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00790 ANESTH SURG UPPER ABDOMEN 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00792 ANESTH HEMORR/EXCISE LIVER 11.74 $164.48 --- -- 002 0 0 0.00 $0.00 Y
J 00794 ANESTH PANCREAS REMOVAL 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00796 ANESTH FOR LIVER TRANSPLANT 27.09 $379.53 --- -- 002 0 0 0.00 $0.00 Y
J 00797 ANESTH SURGERY FOR OBESITY 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00800 ANESTH ABDOMINAL WALL SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00802 ANESTH FAT LAYER REMOVAL 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00811 ANES LWR INTST NDSC NOS 4.00 $56.04 --- -- 002 0 0 0.00 $0.00 Y
J 00812 ANES LWR INTST SCR COLSC 3.00 $42.03 --- -- 002 0 0 0.00 $0.00 Y
J 00813 ANES UPR LWR GI NDSC PX 5.00 $70.05 --- -- 002 0 0 0.00 $0.00 Y
J 00820 ANESTH ABDOMINAL WALL SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00830 ANESTH REPAIR OF HERNIA 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00832 ANESTH REPAIR OF HERNIA 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00834 ANESTH HERNIA REPAIR < 1 YR 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00836 ANESTH HERNIA REPAIR PREEMIE 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00840 ANESTH SURG LOWER ABDOMEN 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00842 ANESTH AMNIOCENTESIS 3.61 $61.59 --- -- 037 0 0 0.00 $0.00 Y
J 00844 ANESTH PELVIS SURGERY 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00846 ANESTH HYSTERECTOMY 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00848 ANESTH PELVIC ORGAN SURG 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00851 ANESTH TUBAL LIGATION 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00860 ANESTH SURGERY OF ABDOMEN 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00862 ANESTH KIDNEY/URETER SURG 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00864 ANESTH REMOVAL OF BLADDER 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00865 ANESTH REMOVAL OF PROSTATE 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00866 ANESTH REMOVAL OF ADRENAL 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00868 ANESTH KIDNEY TRANSPLANT 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00870 ANESTH BLADDER STONE SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00872 ANESTH KIDNEY STONE DESTRUCT 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00873 ANESTH KIDNEY STONE DESTRUCT 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00880 ANESTH ABDOMEN VESSEL SURG 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 00882 ANESTH MAJOR VEIN LIGATION 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 00902 ANESTH ANORECTAL SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00904 ANESTH PERINEAL SURGERY 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 00906 ANESTH REMOVAL OF VULVA 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00908 ANESTH REMOVAL OF PROSTATE 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00910 ANESTH BLADDER SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00912 ANESTH BLADDER TUMOR SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00914 ANESTH REMOVAL OF PROSTATE 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00916 ANESTH BLEEDING CONTROL 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00918 ANESTH STONE REMOVAL 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00920 ANESTH GENITALIA SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00921 ANESTH VASECTOMY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00922 ANESTH SPERM DUCT SURGERY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00924 ANESTH TESTIS EXPLORATION 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00926 ANESTH REMOVAL OF TESTIS 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00928 ANESTH REMOVAL OF TESTIS 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00930 ANESTH TESTIS SUSPENSION 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00932 ANESTH AMPUTATION OF PENIS 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00934 ANESTH PENIS NODES REMOVAL 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00936 ANESTH PENIS NODES REMOVAL 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 00938 ANESTH INSERT PENIS DEVICE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00940 ANESTH VAGINAL PROCEDURES 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 00942 ANESTH SURG ON VAG/URETHRAL 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 00944 ANESTH VAGINAL HYSTERECTOMY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 00948 ANESTH REPAIR OF CERVIX 3.61 $61.59 --- -- 037 0 0 0.00 $0.00 Y
J 00950 ANESTH VAGINAL ENDOSCOPY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 00952 ANESTH HYSTEROSCOPE/GRAPH 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01112 ANESTH BONE ASPIRATE/BX 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01120 ANESTH PELVIS SURGERY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01130 ANESTH BODY CAST PROCEDURE 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01140 ANESTH AMPUTATION AT PELVIS 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 01150 ANESTH PELVIC TUMOR SURGERY 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01160 ANESTH PELVIS PROCEDURE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01170 ANESTH PELVIS SURGERY 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01173 ANESTH FX REPAIR PELVIS 10.84 $151.87 --- -- 002 0 0 0.00 $0.00 Y
J 01200 ANESTH HIP JOINT PROCEDURE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01202 ANESTH ARTHROSCOPY OF HIP 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01210 ANESTH HIP JOINT SURGERY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01212 ANESTH HIP DISARTICULATION 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 01214 ANESTH HIP ARTHROPLASTY 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 01215 ANESTH REVISE HIP REPAIR 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 01220 ANESTH PROCEDURE ON FEMUR 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01230 ANESTH SURGERY OF FEMUR 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01232 ANESTH AMPUTATION OF FEMUR 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01234 ANESTH RADICAL FEMUR SURG 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01250 ANESTH UPPER LEG SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01260 ANESTH UPPER LEG VEINS SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01270 ANESTH THIGH ARTERIES SURG 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01272 ANESTH FEMORAL ARTERY SURG 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01274 ANESTH FEMORAL EMBOLECTOMY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01320 ANESTH KNEE AREA SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01340 ANESTH KNEE AREA PROCEDURE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01360 ANESTH KNEE AREA SURGERY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01380 ANESTH KNEE JOINT PROCEDURE 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01382 ANESTH DX KNEE ARTHROSCOPY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01390 ANESTH KNEE AREA PROCEDURE 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01392 ANESTH KNEE AREA SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01400 ANESTH KNEE JOINT SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01402 ANESTH KNEE ARTHROPLASTY 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01404 ANESTH AMPUTATION AT KNEE 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01420 ANESTH KNEE JOINT CASTING 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01430 ANESTH KNEE VEINS SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01432 ANESTH KNEE VESSEL SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01440 ANESTH KNEE ARTERIES SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01442 ANESTH KNEE ARTERY SURG 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01444 ANESTH KNEE ARTERY REPAIR 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01462 ANESTH LOWER LEG PROCEDURE 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01464 ANESTH ANKLE/FT ARTHROSCOPY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01470 ANESTH LOWER LEG SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01472 ANESTH ACHILLES TENDON SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01474 ANESTH LOWER LEG SURGERY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01480 ANESTH LOWER LEG BONE SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01482 ANESTH RADICAL LEG SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01484 ANESTH LOWER LEG REVISION 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01486 ANESTH ANKLE REPLACEMENT 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01490 ANESTH LOWER LEG CASTING 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01500 ANESTH LEG ARTERIES SURG 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01502 ANESTH LWR LEG EMBOLECTOMY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01520 ANESTH LOWER LEG VEIN SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01522 ANESTH LOWER LEG VEIN SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01610 ANESTH SURGERY OF SHOULDER 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01620 ANESTH SHOULDER PROCEDURE 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01622 ANES DX SHOULDER ARTHROSCOPY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01630 ANESTH SURGERY OF SHOULDER 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01634 ANESTH SHOULDER JOINT AMPUT 8.13 $113.90 --- -- 002 0 0 0.00 $0.00 Y
J 01636 ANESTH FOREQUARTER AMPUT 13.55 $189.84 --- -- 002 0 0 0.00 $0.00 Y
J 01638 ANESTH SHOULDER REPLACEMENT 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 01650 ANESTH SHOULDER ARTERY SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01652 ANESTH SHOULDER VESSEL SURG 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 01654 ANESTH SHOULDER VESSEL SURG 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01656 ANESTH ARM-LEG VESSEL SURG 9.03 $126.51 --- -- 002 0 0 0.00 $0.00 Y
J 01670 ANESTH SHOULDER VEIN SURG 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01680 ANESTH SHOULDER CASTING 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01710 ANESTH ELBOW AREA SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01712 ANESTH UPPR ARM TENDON SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01714 ANESTH UPPR ARM TENDON SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01716 ANESTH BICEPS TENDON REPAIR 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01730 ANESTH UPPR ARM PROCEDURE 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01732 ANESTH DX ELBOW ARTHROSCOPY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01740 ANESTH UPPER ARM SURGERY 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01742 ANESTH HUMERUS SURGERY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01744 ANESTH HUMERUS REPAIR 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01756 ANESTH RADICAL HUMERUS SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01758 ANESTH HUMERAL LESION SURG 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01760 ANESTH ELBOW REPLACEMENT 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01770 ANESTH UPPR ARM ARTERY SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01772 ANESTH UPPR ARM EMBOLECTOMY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01780 ANESTH UPPER ARM VEIN SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01782 ANESTH UPPR ARM VEIN REPAIR 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01810 ANESTH LOWER ARM SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01820 ANESTH LOWER ARM PROCEDURE 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01829 ANESTH DX WRIST ARTHROSCOPY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01830 ANESTH LOWER ARM SURGERY 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01832 ANESTH WRIST REPLACEMENT 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01840 ANESTH LWR ARM ARTERY SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01842 ANESTH LWR ARM EMBOLECTOMY 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01844 ANESTH VASCULAR SHUNT SURG 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01850 ANESTH LOWER ARM VEIN SURG 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01852 ANESTH LWR ARM VEIN REPAIR 3.61 $50.58 --- -- 002 0 0 0.00 $0.00 Y
J 01860 ANESTH LOWER ARM CASTING 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01916 ANESTH DX ARTERIOGRAPHY 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01920 ANESTH CATHETERIZE HEART 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01922 ANESTH CAT OR MRI SCAN 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01924 ANES THER INTERVEN RAD ARTRL 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01925 ANES THER INTERVEN RAD CARD 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01926 ANES TX INTERV RAD HRT/CRAN 7.22 $101.15 --- -- 002 0 0 0.00 $0.00 Y
J 01930 ANES THER INTERVEN RAD VEIN 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01931 ANES THER INTERVEN RAD TIPS 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01932 ANES TX INTERV RAD TH VEIN 5.42 $75.93 --- -- 002 0 0 0.00 $0.00 Y
J 01933 ANES TX INTERV RAD CRAN VEIN 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01935 ANESTH PERC IMG DX SP PROC 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01936 ANESTH PERC IMG TX SP PROC 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01951 ANESTH BURN LESS 4 PERCENT 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01952 ANESTH BURN 4-9 PERCENT 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01953 ANESTH BURN EACH 9 PERCENT 0.90 $12.61 --- -- 002 0 0 0.00 $0.00 Y
J 01958 ANESTH ANTEPARTUM MANIPUL 4.52 $77.11 --- -- 037 0 0 0.00 $0.00 Y
J 01960 ANESTH VAGINAL DELIVERY 4.52 $77.11 --- -- 037 0 0 0.00 $0.00 Y
J 01961 ANESTH CS DELIVERY 6.32 $107.82 --- -- 037 0 0 0.00 $0.00 Y
J 01962 ANESTH EMER HYSTERECTOMY 5.93 $101.17 --- -- 037 0 0 0.00 $0.00 Y
J 01963 ANESTH CS HYSTERECTOMY 5.93 $101.17 --- -- 037 0 0 0.00 $0.00 Y
J 01965 ANESTH INC/MISSED AB PROC 3.61 $61.59 --- -- 037 0 0 0.00 $0.00 Y
J 01966 ANESTH INDUCED AB PROCEDURE 3.61 $61.59 --- -- 037 0 0 0.00 $0.00 Y
J 01967 ANESTH/ANALG VAG DELIVERY 4.52 $77.11 --- -- 037 0 0 0.00 $0.00 Y
J 01968 ANES/ANALG CS DELIVER ADDON 1.81 $30.88 --- -- 037 0 0 0.00 $0.00 Y
J 01969 ANESTH/ANALG CS HYST ADDON 4.52 $77.11 --- -- 037 0 0 0.00 $0.00 Y
J 01990 SUPPORT FOR ORGAN DONOR 6.32 $88.54 --- -- 002 0 0 0.00 $0.00 Y
J 01991 ANESTH NERVE BLOCK/INJ 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01992 ANESTH N BLOCK/INJ PRONE 4.52 $63.33 --- -- 002 0 0 0.00 $0.00 Y
J 01996 HOSP MANAGE CONT DRUG ADMIN 2.71 $37.97 --- -- 002 0 0 0.00 $0.00 Y
J 01999 UNLISTED ANESTH PROCEDURE 0.00 $0.00 --- -- 002 0 0 0.00 $0.00 Y
R 0270 REV MEDICAL-SURGICAL SUPPLIES 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0420 REV - PHYSICAL THERAPY 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0421 REV PHYSICAL THERAPY, VISIT 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0430 REV - OCCUPATIONAL THERAPY 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0431 REV OCCUPATIONAL THERAPY, VISIT 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0440 REV - SPEECH THERAPY 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0441 REV MEDICAL SPEECH THERAPY VISIT 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0470 REV - AUDIOLOGY 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0510 REV - IHS-MOA CLINIC VISIT 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0520 REV - FREESTAND CLINIC 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0521 REV - FS-RURAL/CLINIC 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0522 REV - FS-RURAL/HOME 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0524 REV - FR/STD FAMILY CLINIC 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0525 REV - RHC/FQHC/SNF/NONCOVERED 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0527 REV - RHC/FQHC/HOME/VIS NURSE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0528 REV - RHC/FQHC/OTHER SITE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0529 REV - OTHER FS-CLINIC 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0551 REV SKILLED NURSING, VISIT CHARGE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0552 REV HOSPICE SRV - RHC SIA 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0561 REV - HH/MED SOC SVCS VISIT 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0571 REV HOME HEALTH AIDE VISIT CHARGE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0572 REV-HOME HEALTH AIDE,HOURLY CHARGE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0580 REV HOME HEALTH VISIT 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0583 REV HOME HEALTH OTHER VISITS ASSESS 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0589 REV HOME HEALTH OTHER VISITS; OTHER 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0650 REV HOSPICE SRV - RHC HIGH 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0651 REV HOSPICE SRV - ROUTINE HOME CARE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0652 REV HOSPICE SRV-CONTINUOUS HOME CARE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0655 REV HOSPICE SRV-INPATIENT RESPITE CARE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0656 REV HOSPICE SRV-GENERAL INPATIENT CARE 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0657 REV HOSPICE SRV-PHYSICIANS SERVICES 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0658 REV ROOM AND BOARD 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0659 REV HOSPICE SRV - RHC LOW 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0900 REV - BH/TREATMENTS 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0940 REV - OTHER RX SVCS 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
R 0969 REV - PRO FEE/OTHER 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
P 10004 FNA BX W/O IMG GDN EA ADDL 1.21 $45.05 --- -- 015 0 0 0.00 $0.00 Y
K 10004 FNA BX W/O IMG GDN EA ADDL 1.21 $45.05 --- -- 004 0 0 0.00 $0.00 Y
K 10005 FNA BX W/US GDN 1ST LES 3.00 $111.69 --- -- 004 0 0 0.00 $0.00 Y
P 10005 FNA BX W/US GDN 1ST LES 3.00 $111.69 --- -- 015 0 0 0.00 $0.00 Y
P 10006 FNA BX W/US GDN EA ADDL 1.39 $51.75 --- -- 015 0 0 0.00 $0.00 Y
K 10006 FNA BX W/US GDN EA ADDL 1.39 $51.75 --- -- 004 0 0 0.00 $0.00 Y
K 10007 FNA BX W/FLUOR GDN 1ST LES 6.97 $259.49 --- -- 004 0 0 0.00 $0.00 Y
P 10007 FNA BX W/FLUOR GDN 1ST LES 6.97 $259.49 --- -- 015 0 0 0.00 $0.00 Y
P 10008 FNA BX W/FLUOR GDN EA ADDL 3.91 $145.57 --- -- 015 0 0 0.00 $0.00 Y
K 10008 FNA BX W/FLUOR GDN EA ADDL 3.91 $145.57 --- -- 004 0 0 0.00 $0.00 Y
K 10009 FNA BX W/CT GDN 1ST LES 11.51 $428.52 --- -- 004 0 0 0.00 $0.00 Y
P 10009 FNA BX W/CT GDN 1ST LES 11.51 $428.52 --- -- 015 0 0 0.00 $0.00 Y
P 10010 FNA BX W/CT GDN EA ADDL 6.90 $256.89 --- -- 015 0 0 0.00 $0.00 Y
K 10010 FNA BX W/CT GDN EA ADDL 6.90 $256.89 --- -- 004 0 0 0.00 $0.00 Y
K 10011 FNA BX W/MR GDN 1ST LES 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
P 10011 FNA BX W/MR GDN 1ST LES 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
P 10012 FNA BX W/MR GDN EA ADDL 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
K 10012 FNA BX W/MR GDN EA ADDL 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 10021 FNA W/O IMAGE 1.97 $73.34 --- -- 004 0 0 0.00 $0.00 Y
P 10021 FNA BX W/O IMG GDN 1ST LES 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
P 10030 GUIDE CATHET FLUID DRAINAGE 3.58 $133.28 --- $168.08 004 1 0 0.00 $0.00 Y
K 10030 GUIDE CATHET FLUID DRAINAGE 3.58 $133.28 --- $168.08 004 1 0 0.00 $0.00 Y
K 10035 PERQ DEV SOFT TISS 1ST IMAG 13.23 $492.55 --- -- 004 0 0 0.00 $0.00 Y
K 10036 PERQ DEV SOFT TISS ADD IMAG 11.57 $430.75 --- -- 004 0 0 0.00 $0.00 Y
K 10040 ACNE SURGERY 1.29 $48.03 --- $60.57 004 1 1 0.00 $0.00 Y
K 10060 INCISION/DRAINAGE OF ABSCESS;SIMPLE 1.14 $42.44 --- $53.52 004 1 1 0.00 $0.00 Y
P 10060 INCISION/DRAINAGE OF ABSCESS;SIMPLE 1.14 $42.44 --- -- 015 0 1 0.00 $0.00 Y
P 10061 INCISION/DRAINAGE OF ABSCESS;COMPLICATED 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
O 10061 INCISION/DRAINAGE OF ABSCESS;COMPLICATED 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 10061 INCISION/DRAINAGE OF ABCESS;COMPLICATED 75.76 $75.76 --- -- 042 0 0 0.00 $0.00 Y
K 10080 DRAINAGE OF PILONIDAL CYST 1.48 $55.10 --- $69.49 004 1 1 0.00 $0.00 Y
K 10081 DRAINAGE OF PILONIDAL CYST 115.53 $115.53 --- -- 042 0 0 0.00 $0.00 Y
O 10081 DRAINAGE OF PILONIDAL CYST 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 10120 REMOVE FOREIGN BODY 1.39 $51.75 --- -- 015 0 1 0.00 $0.00 Y
K 10120 REMOVE FOREIGN BODY 1.39 $51.75 --- $65.26 004 1 1 0.00 $0.00 Y
K 10121 REMOVE FOREIGN BODY 93.91 $93.91 --- -- 042 0 0 0.00 $0.00 Y
P 10121 REMOVE FOREIGN BODY 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
O 10121 REMOVE FOREIGN BODY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 10140 DRAINAGE OF HEMATOMA/FLUID 1.34 $49.89 --- -- 015 0 1 0.00 $0.00 Y
K 10140 DRAINAGE OF HEMATOMA/FLUID 1.34 $49.89 --- $62.91 004 1 1 0.00 $0.00 Y
K 10160 PUNCTURE DRAINAGE OF LESION 1.26 $46.91 --- $59.16 004 1 1 0.00 $0.00 Y
P 10160 PUNCTURE DRAINAGE OF LESION 1.26 $46.91 --- -- 015 0 1 0.00 $0.00 Y
P 10180 COMPLEX DRAINAGE WOUND 3.16 $117.65 --- -- 015 0 0 0.00 $0.00 Y
O 10180 COMPLEX DRAINAGE WOUND 0.63 $23.45 --- $29.58 004 1 0 0.00 $0.00 Y
K 10180 COMPLEX DRAINAGE WOUND 3.16 $117.65 --- $148.36 004 1 0 0.00 $0.00 Y
K 11000 SURGICAL CLEANSING OF SKIN 0.53 $19.73 --- $24.88 004 1 1 0.00 $0.00 Y
P 11000 SURGICAL CLEANSING OF SKIN 0.52 $19.36 --- -- 015 0 1 0.00 $0.00 Y
K 11001 DEBRIDE INFECTED SKIN ADD-ON 0.28 $10.42 --- $13.15 004 1 1 0.00 $0.00 Y
K 11004 DEBRIDE GENITALIA & PERINEUM 9.11 $339.12 --- $427.71 004 1 0 0.00 $0.00 Y
O 11004 DEBRIDE GENITALIA & PERINEUM 1.82 $67.82 --- $85.45 004 1 0 0.00 $0.00 Y
O 11005 DEBRIDE ABDOM WALL 2.44 $90.78 --- $114.56 004 1 0 0.00 $0.00 Y
K 11005 DEBRIDE ABDOM WALL 12.19 $453.92 --- $572.32 004 1 0 0.00 $0.00 Y
K 11006 DEBRIDE GENIT/PER/ABDOM WALL 11.45 $426.26 --- $537.58 004 1 0 0.00 $0.00 Y
O 11006 DEBRIDE GENIT/PER/ABDOM WALL 2.29 $85.25 --- $107.52 004 1 0 0.00 $0.00 Y
O 11008 REMOVE MESH FROM ABD WALL 0.92 $34.32 --- $43.19 004 1 0 0.00 $0.00 Y
K 11008 REMOVE MESH FROM ABD WALL 4.61 $171.58 --- $216.44 004 1 0 0.00 $0.00 Y
K 11010 DEBRIDE SKIN AT FX SITE 6.05 $225.24 --- $284.05 004 1 0 0.00 $0.00 Y
O 11010 DEBRIDE SKIN AT FX SITE 1.21 $45.05 --- $56.81 004 1 0 0.00 $0.00 Y
P 11010 DEBRIDE SKIN AT FX SITE 6.05 $225.24 --- -- 015 0 0 0.00 $0.00 Y
P 11011 DEBRIDE SKIN MUSC AT FX SITE 7.58 $282.20 --- -- 015 0 0 0.00 $0.00 Y
O 11011 DEBRIDE SKIN MUSC AT FX SITE 1.52 $56.59 --- $71.36 004 1 0 0.00 $0.00 Y
K 11011 DEBRIDE SKIN MUSC AT FX SITE 7.59 $282.58 --- $356.35 004 1 0 0.00 $0.00 Y
K 11012 DEB SKIN BONE AT FX SITE 10.34 $384.96 --- $485.46 004 1 0 0.00 $0.00 Y
O 11012 DEB SKIN BONE AT FX SITE 2.06 $76.69 --- $96.72 004 1 0 0.00 $0.00 Y
P 11012 DEB SKIN BONE AT FX SITE 10.34 $384.96 --- -- 015 0 0 0.00 $0.00 Y
P 11042 DEB SUBQ TISSUE 20 SQ CM/< 2.79 $103.87 --- -- 015 1 1 0.00 $0.00 Y
K 11042 DEB SUBQ TISSUE 20 SQ CM/< 2.79 $103.87 --- $130.99 004 1 1 0.00 $0.00 Y
K 11043 DEB MUSC/FASCIA 20 SQ CM/< 4.21 $156.74 --- $197.66 004 1 0 0.00 $0.00 Y
P 11043 DEB MUSC/FASCIA 20 SQ CM/< 4.22 $157.11 --- -- 015 1 0 0.00 $0.00 Y
P 11044 DEB BONE 20 SQ CM/< 5.44 $202.53 --- -- 015 0 0 0.00 $0.00 Y
K 11044 DEB BONE 20 SQ CM/< 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 11045 DEB SUBQ TISSUE ADD-ON 0.39 $14.60 --- $18.31 004 1 0 0.00 $0.00 Y
P 11045 DEB SUBQ TISSUE ADD-ON 0.39 $14.60 --- -- 015 1 0 0.00 $0.00 Y
P 11046 DEB MUSC/FASCIA ADD-ON 0.84 $31.26 --- -- 015 1 0 0.00 $0.00 Y
K 11046 DEB MUSC/FASCIA ADD-ON 0.84 $31.26 --- $39.44 004 1 0 0.00 $0.00 Y
K 11047 DEB BONE ADD-ON 1.46 $54.33 --- $68.55 004 1 0 0.00 $0.00 Y
P 11047 DEB MUSC/FASCIA ADD-ON 1.46 $54.33 --- -- 015 1 0 0.00 $0.00 Y
P 11055 TRIM SKIN LESION 0.45 $16.75 --- -- 015 0 0 0.00 $0.00 Y
K 11055 TRIM SKIN LESION 0.45 $16.75 --- $21.13 004 1 0 0.00 $0.00 Y
K 11056 TRIM SKIN LESIONS 2 TO 4 0.68 $25.32 --- $31.93 004 1 0 0.00 $0.00 Y
P 11056 TRIM SKIN LESIONS 2 TO 4 0.68 $25.32 --- -- 015 0 0 0.00 $0.00 Y
P 11057 TRIM SKIN LESIONS OVER 4 0.72 $26.81 --- -- 015 0 0 0.00 $0.00 Y
K 11057 TRIM SKIN LESIONS OVER 4 0.72 $26.81 --- $33.80 004 1 0 0.00 $0.00 Y
K 11102 TANGNTL BX SKIN SINGLE LES 2.40 $89.35 --- -- 004 0 1 0.00 $0.00 Y
P 11102 TANGNTL BX SKIN SINGLE LES 2.40 $89.35 --- -- 015 0 1 0.00 $0.00 Y
P 11103 TANGNTL BX SKIN EA SEP/ADDL 1.29 $48.03 --- -- 015 0 1 0.00 $0.00 Y
K 11103 TANGNTL BX SKIN EA SEP/ADDL 1.29 $48.03 --- -- 004 0 1 0.00 $0.00 Y
K 11104 PUNCH BX SKIN SINGLE LESION 3.01 $112.06 --- -- 004 0 1 0.00 $0.00 Y
P 11104 PUNCH BX SKIN SINGLE LESION 3.01 $112.06 --- -- 015 0 1 0.00 $0.00 Y
P 11105 PUNCH BX SKIN EA SEP/ADDL 1.47 $54.73 --- -- 015 0 1 0.00 $0.00 Y
K 11105 PUNCH BX SKIN EA SEP/ADDL 1.47 $54.73 --- -- 004 0 1 0.00 $0.00 Y
K 11106 INCAL BX SKN SINGLE LES 3.65 $135.89 --- -- 004 0 1 0.00 $0.00 Y
P 11106 INCAL BX SKN SINGLE LES 3.65 $135.89 --- -- 015 0 1 0.00 $0.00 Y
P 11107 INCAL BX SKN EA SEP/ADDL 1.74 $64.78 --- -- 015 0 1 0.00 $0.00 Y
K 11107 INCAL BX SKN EA SEP/ADDL 1.74 $64.78 --- -- 004 0 1 0.00 $0.00 Y
K 11200 REMOVAL OF SKIN TAGS 0.85 $31.65 --- $39.91 004 1 1 0.00 $0.00 Y
P 11200 REMOVAL OF SKIN TAGS 0.85 $31.65 --- -- 015 0 1 0.00 $0.00 Y
K 11201 REMOVE SKIN TAGS ADD-ON 0.34 $12.66 --- $15.96 004 1 1 0.00 $0.00 Y
K 11300 SHAVE SKIN LESION 0.5 CM/< 0.71 $26.43 --- $33.33 004 1 1 0.00 $0.00 Y
K 11301 SHAVE SKIN LESION 0.6-1.0 CM 0.91 $33.88 --- $42.72 004 1 1 0.00 $0.00 Y
K 11302 SHAVE SKIN LESION 1.1-2.0 CM 1.05 $39.09 --- $49.30 004 1 1 0.00 $0.00 Y
K 11303 SHAVE SKIN LESION >2.0 CM 1.26 $46.91 --- $59.16 004 1 1 0.00 $0.00 Y
K 11305 SHAVE SKIN LESION 0.5 CM/< 0.69 $25.69 --- $32.40 004 1 1 0.00 $0.00 Y
K 11306 SHAVE SKIN LESION 0.6-1.0 CM 0.95 $35.37 --- $44.60 004 1 1 0.00 $0.00 Y
K 11307 SHAVE SKIN LESION 1.1-2.0 CM 1.07 $39.84 --- $50.24 004 1 1 0.00 $0.00 Y
K 11308 SHAVE SKIN LESION >2.0 CM 1.36 $50.63 --- $63.85 004 1 1 0.00 $0.00 Y
K 11310 SHAVE SKIN LESION 0.5 CM/< 0.86 $32.02 --- $40.38 004 1 1 0.00 $0.00 Y
K 11311 SHAVE SKIN LESION 0.6-1.0 CM 1.06 $39.46 --- $49.77 004 1 1 0.00 $0.00 Y
K 11312 SHAVE SKIN LESION 1.1-2.0 CM 1.16 $43.19 --- $54.46 004 1 1 0.00 $0.00 Y
K 11313 SHAVE SKIN LESION >2.0 CM 1.47 $54.73 --- $69.02 004 1 1 0.00 $0.00 Y
K 11400 EXC TR-EXT B9+MARG 0.5 CM< 1.56 $58.08 --- $73.24 004 1 1 0.00 $0.00 Y
K 11401 EXC TR-EXT B9+MARG 0.6-1 CM 1.76 $65.52 --- $82.63 004 1 1 0.00 $0.00 Y
K 11402 EXC TR-EXT B9+MARG 1.1-2 CM 1.93 $71.85 --- $90.61 004 1 1 0.00 $0.00 Y
K 11403 EXC TR-EXT B9+MARG 2.1-3CM 2.18 $81.16 --- $102.35 004 1 1 0.00 $0.00 Y
K 11404 EXC TREXT B9+MARG 3.14 CM 2.38 $88.61 --- $111.74 004 1 1 0.00 $0.00 Y
K 11406 EXC TR-EXT B9+MARG >4.0 CM 5.19 $193.22 --- $243.67 004 1 1 0.00 $0.00 Y
K 11420 EXC H-F-NK-SP B9+MARG 0.5/< 1.43 $53.24 --- $67.14 004 1 1 0.00 $0.00 Y
P 11420 EXC H-F-NK-SP B9+MARG 0.5/< 1.43 $53.24 --- -- 015 0 1 0.00 $0.00 Y
P 11421 EXC HFNKSP B9+MARG 0.61 1.80 $67.01 --- -- 015 0 1 0.00 $0.00 Y
K 11421 EXC H-F-NK-SP B9+MARG 0.6-1 1.80 $67.01 --- $84.51 004 1 1 0.00 $0.00 Y
K 11422 EXC H-F-NK-SP B9+MARG 1.1-2 1.99 $74.09 --- $93.43 004 1 1 0.00 $0.00 Y
P 11422 EXC HFNKSP B9+MARG 1.12 1.99 $74.09 --- -- 015 0 1 0.00 $0.00 Y
P 11423 EXC HFNKSP B9+MARG 2.13 2.33 $86.75 --- -- 015 0 1 0.00 $0.00 Y
K 11423 EXC HFNKSP B9+MARG 2.13 2.33 $86.75 --- $109.39 004 1 1 0.00 $0.00 Y
K 11424 EXC HFNKSP B9+MARG 3.14 2.72 $101.27 --- $127.70 004 1 1 0.00 $0.00 Y
P 11424 EXC HFNKSP B9+MARG 3.14 2.71 $100.89 --- -- 015 0 1 0.00 $0.00 Y
P 11426 EXC H-F-NK-SP B9+MARG >4 CM 6.45 $240.13 --- -- 015 0 1 0.00 $0.00 Y
K 11426 EXC H-F-NK-SP B9+MARG >4 CM 6.45 $240.13 --- $302.83 004 1 1 0.00 $0.00 Y
K 11440 EXC FACE-MM B9+MARG 0.5 CM/< 1.73 $64.41 --- $81.22 004 1 1 0.00 $0.00 Y
K 11441 EXC FACE-MM B9+MARG 0.6-1 CM 2.00 $74.46 --- $93.90 004 1 1 0.00 $0.00 Y
K 11442 EXC FACE-MM B9+MARG 1.1-2 CM 2.15 $80.04 --- $100.94 004 1 1 0.00 $0.00 Y
K 11443 EXC FACE-MM B9+MARG 2.1-3 CM 2.66 $99.03 --- $124.89 004 1 1 0.00 $0.00 Y
K 11444 EXC FACE-MM B9+MARG 3.1-4 CM 3.30 $122.86 --- $154.94 004 1 1 0.00 $0.00 Y
K 11446 EXC FACE-MM B9+MARG >4 CM 7.48 $278.48 --- $351.19 004 1 1 0.00 $0.00 Y
K 11450 REMOVAL SWEAT GLAND LESION 3.16 $117.65 --- $148.36 004 1 1 0.00 $0.00 Y
K 11451 REMOVAL SWEAT GLAND LESION 4.18 $155.62 --- $196.25 004 1 1 0.00 $0.00 Y
K 11462 REMOVAL SWEAT GLAND LESION 3.04 $113.18 --- $142.73 004 1 1 0.00 $0.00 Y
K 11463 REMOVAL SWEAT GLAND LESION 4.35 $161.95 --- $204.23 004 1 1 0.00 $0.00 Y
K 11470 REMOVAL SWEAT GLAND LESION 3.64 $135.52 --- $170.90 004 1 1 0.00 $0.00 Y
K 11471 REMOVAL SWEAT GLAND LESION 4.68 $174.24 --- $219.73 004 1 0 0.00 $0.00 Y
K 11600 EXC TR-EXT MAL+MARG 0.5 CM/< 1.86 $69.25 --- $87.33 004 1 1 0.00 $0.00 N
K 11601 EXC TR-EXT MAL+MARG 0.6-1 CM 2.13 $79.30 --- $100.00 004 1 1 0.00 $0.00 N
K 11602 EXC TR-EXT MAL+MARG 1.1-2 CM 2.27 $84.51 --- $106.58 004 1 1 0.00 $0.00 N
K 11603 EXC TR-EXT MAL+MARG 2.1-3 CM 4.52 $168.28 --- $212.21 004 1 0 0.00 $0.00 N
K 11604 EXC TR-EXT MAL+MARG 3.1-4 CM 4.88 $181.68 --- $229.12 004 1 0 0.00 $0.00 N
K 11606 EXC TR-EXT MAL+MARG >4 CM 6.10 $227.10 --- $286.40 004 1 0 0.00 $0.00 N
K 11620 EXC H-F-NK-SP MAL+MARG 0.5/< 2.27 $84.51 --- $106.58 004 1 1 0.00 $0.00 Y
P 11620 EXC H-F-NK-SP MAL+MARG 0.5/< 2.26 $84.14 --- -- 015 0 1 0.00 $0.00 Y
P 11621 EXC S/N/H/F/G MAL+MRG 0.6-1 3.39 $126.21 --- -- 015 0 1 0.00 $0.00 Y
K 11621 EXC S/N/H/F/G MAL+MRG 0.6-1 3.40 $126.58 --- $159.63 004 1 1 0.00 $0.00 Y
K 11622 EXC S/N/H/F/G MAL+MRG 1.1-2 4.48 $166.79 --- $210.34 004 1 1 0.00 $0.00 Y
P 11622 EXC S/N/H/F/G MAL+MRG 1.1-2 4.48 $166.79 --- -- 015 0 1 0.00 $0.00 Y
P 11623 EXC S/N/H/F/G MAL+MRG 2.1-3 4.92 $183.17 --- -- 015 0 0 0.00 $0.00 Y
K 11623 EXC S/N/H/F/G MAL+MRG 2.1-3 4.93 $183.54 --- $231.46 004 1 0 0.00 $0.00 Y
K 11624 EXC S/N/H/F/G MAL+MRG 3.1-4 5.63 $209.60 --- $264.33 004 1 0 0.00 $0.00 Y
P 11624 EXC S/N/H/F/G MAL+MRG 3.1-4 5.63 $209.60 --- -- 015 0 0 0.00 $0.00 Y
P 11626 EXC S/N/H/F/G MAL+MRG >4 CM 7.24 $269.55 --- -- 015 0 0 0.00 $0.00 Y
K 11626 EXC S/N/H/F/G MAL+MRG >4 CM 7.24 $269.55 --- $339.92 004 1 0 0.00 $0.00 Y
K 11640 EXC F/E/E/N/L MAL+MRG 0.5CM< 3.40 $126.58 --- $159.63 004 1 1 0.00 $0.00 N
K 11641 EXC F/E/E/N/L MAL+MRG 0.6-1 4.53 $168.65 --- $212.68 004 1 1 0.00 $0.00 N
K 11642 EXC F/E/E/N/L MAL+MRG 1.1-2 5.00 $186.15 --- $234.75 004 1 1 0.00 $0.00 N
K 11643 EXC F/E/E/N/L MAL+MRG 2.1-3 6.20 $230.83 --- $291.09 004 1 0 0.00 $0.00 N
K 11644 EXC F/E/E/N/L MAL+MRG 3.1-4 7.50 $279.23 --- $352.13 004 1 0 0.00 $0.00 N
K 11646 EXC F/E/E/N/L MAL+MRG >4 CM 9.52 $354.43 --- $446.96 004 1 0 0.00 $0.00 N
K 11720 DEBRIDE NAIL 1-5 0.53 $19.73 --- $24.88 004 1 1 0.00 $0.00 Y
P 11720 DEBRIDE NAIL 1-5 0.53 $19.73 --- -- 015 0 1 0.00 $0.00 Y
O 11720 DEBRIDE NAIL 1-5 0.10 $3.72 --- $4.70 004 1 0 0.00 $0.00 Y
O 11721 DEBRIDE NAIL 6 OR MORE 0.18 $6.70 --- $8.45 004 1 0 0.00 $0.00 Y
P 11721 DEBRIDE NAIL 6 OR MORE 0.90 $33.51 --- -- 015 0 1 0.00 $0.00 Y
K 11721 DEBRIDE NAIL 6 OR MORE 0.89 $33.13 --- $41.79 004 1 1 0.00 $0.00 Y
K 11730 REMOVAL OF NAIL PLATE 0.86 $32.02 --- $40.38 004 1 1 0.00 $0.00 Y
P 11730 REMOVAL OF NAIL PLATE 0.86 $32.02 --- -- 015 0 1 0.00 $0.00 Y
P 11732 REMOVE NAIL PLATE ADD-ON 0.40 $14.89 --- -- 015 0 1 0.00 $0.00 Y
K 11732 REMOVE NAIL PLATE ADD-ON 0.40 $14.89 --- $18.78 004 1 1 0.00 $0.00 Y
K 11740 DRAIN BLOOD FROM UNDER NAIL 19.59 $19.59 --- -- 042 0 1 0.00 $0.00 Y
P 11740 DRAIN BLOOD FROM UNDER NAIL 19.59 $19.59 --- -- 042 0 1 0.00 $0.00 Y
P 11750 REMOVAL OF NAIL BED 2.26 $84.14 --- -- 015 0 1 0.00 $0.00 Y
K 11750 REMOVAL OF NAIL BED 2.27 $84.51 --- $106.58 004 1 1 0.00 $0.00 Y
K 11755 BIOPSY NAIL UNIT 1.66 $61.80 --- $77.94 004 1 0 0.00 $0.00 Y
P 11755 BIOPSY NAIL UNIT 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
P 11760 REPAIR OF NAIL BED 2.71 $100.89 --- -- 015 0 1 0.00 $0.00 Y
K 11760 REPAIR OF NAIL BED 2.70 $100.52 --- $126.77 004 1 1 0.00 $0.00 Y
K 11762 RECONSTRUCTION OF NAIL BED WITH GRAFT 4.38 $163.07 --- $205.64 004 1 0 0.00 $0.00 Y
P 11762 RECONSTRUCTION OF NAIL BED WITH GRAFT 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
O 11762 RECONSTRUCTION OF NAIL BED WITH GRAFT 0.88 $32.76 --- $41.32 004 1 0 0.00 $0.00 Y
P 11765 EXCISION OF NAIL FOLD TOE 1.42 $52.87 --- -- 015 0 1 0.00 $0.00 Y
K 11765 EXCISION OF NAIL FOLD TOE 1.42 $52.87 --- $66.67 004 1 1 0.00 $0.00 Y
K 11770 REMOVE PILONIDAL CYST SIMPLE 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
K 11771 REMOVE PILONIDAL CYST EXTEN 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
O 11771 REMOVE PILONIDAL CYST EXTEN 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
O 11772 REMOVE PILONIDAL CYST COMPL 2.29 $85.26 --- $107.52 004 1 0 0.00 $0.00 Y
K 11772 REMOVE PILONIDAL CYST COMPL 427.08 $427.08 --- -- 042 0 0 0.00 $0.00 Y
K 11900 INJECT SKIN LESIONS 0.57 $21.22 --- $26.76 004 1 1 0.00 $0.00 Y
P 11900 INJECT SKIN LESIONS 0.57 $21.22 --- -- 015 0 1 0.00 $0.00 Y
P 11901 INJECT SKIN LESIONS >7 0.81 $30.16 --- -- 015 0 1 0.00 $0.00 Y
K 11901 INJECT SKIN LESIONS >7 0.82 $30.53 --- $38.50 004 1 1 0.00 $0.00 Y
K 11960 INSERT TISSUE EXPANDER(S) 9.74 $362.62 --- $457.29 004 1 0 0.00 $0.00 Y
P 11960 INSERT TISSUE EXPANDER (S) 9.74 $362.62 --- -- 015 1 0 0.00 $0.00 Y
O 11960 INSERT TISSUE EXPANDER(S) 1.95 $72.60 --- $91.55 004 1 0 0.00 $0.00 Y
O 11970 REPLACE TISSUE EXPANDER 2.07 $77.07 --- $97.19 004 1 0 0.00 $0.00 Y
K 11970 REPLACE TISSUE EXPANDER 10.37 $386.08 --- $486.87 004 1 0 0.00 $0.00 Y
K 11971 REMOVE TISSUE EXPANDER(S) 4.42 $164.56 --- $207.52 004 1 0 0.00 $0.00 Y
O 11971 REMOVE TISSUE EXPANDER(S) 0.88 $32.76 --- $41.32 004 1 0 0.00 $0.00 Y
K 11976 REMOVE CONTRACEPTIVE CAPSULE 99.67 $99.67 --- -- 042 0 1 0.00 $0.00 Y
K 11980 IMPLANT HORMONE PELLET(S) 2.07 $77.07 --- $97.19 004 1 1 0.00 $0.00 Y
K 11981 INSERT DRUG IMPLANT DEVICE 5.61 $208.86 --- -- 004 0 1 0.00 $0.00 Y
O 11981 INSERT DRUG IMPLANT DEVICE 1.12 $41.70 --- -- 004 0 1 0.00 $0.00 Y
P 11981 INSERT DRUG IMPLANT DEVICE 5.61 $208.86 --- -- 015 0 1 0.00 $0.00 Y
P 11982 REMOVE DRUG IMPLANT DEVICE 3.02 $112.43 --- -- 004 0 1 0.00 $0.00 Y
O 11982 REMOVE DRUG IMPLANT DEVICE 0.60 $22.34 --- -- 004 0 1 0.00 $0.00 Y
K 11982 REMOVE DRUG IMPLANT DEVICE 3.02 $112.43 --- -- 004 0 1 0.00 $0.00 Y
K 11983 REMOVE/INSERT DRUG IMPLANT 4.87 $181.31 --- -- 004 0 1 0.00 $0.00 Y
O 11983 REMOVE/INSERT DRUG IMPLANT 0.97 $36.11 --- -- 004 0 1 0.00 $0.00 Y
P 11983 REMOVE/INSERT DRUG IMPLANT 4.87 $181.31 --- -- 015 0 1 0.00 $0.00 Y
P 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< 1.88 $69.99 --- -- 015 0 1 0.00 $0.00 Y
K 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< 1.88 $69.99 --- $88.27 004 1 1 0.00 $0.00 Y
K 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM 2.00 $74.46 --- $93.90 004 1 1 0.00 $0.00 Y
P 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM 2.00 $74.46 --- -- 015 0 1 0.00 $0.00 Y
P 12004 RPR S/N/AX/GEN/TRK7.6-12.5CM 2.26 $84.14 --- -- 015 0 1 0.00 $0.00 Y
K 12004 RPR S/N/AX/GEN/TRK7.6-12.5CM 2.26 $84.14 --- $106.11 004 1 1 0.00 $0.00 Y
K 12005 RPR S/N/A/GEN/TRK12.6-20.0CM 2.74 $102.01 --- $128.64 004 1 1 0.00 $0.00 Y
P 12005 RPR S/N/A/GEN/TRK12.6-20.0CM 2.74 $102.01 --- -- 015 0 1 0.00 $0.00 Y
K 12006 RPR S/N/A/GEN/TRK20.1-30.0CM 3.70 $137.75 --- $173.72 004 1 1 0.00 $0.00 Y
K 12007 RPR S/N/AX/GEN/TRNK >30.0 CM 7.56 $281.46 --- $354.94 004 1 1 0.00 $0.00 Y
K 12011 RPR F/E/E/N/L/M 2.5 CM/< 1.96 $72.97 --- $92.02 004 1 1 0.00 $0.00 Y
K 12013 RPR F/E/E/N/L/M 2.6-5.0 CM 2.13 $79.30 --- $100.00 004 1 1 0.00 $0.00 Y
K 12014 RPR F/E/E/N/L/M 5.1-7.5 CM 2.49 $92.70 --- $116.91 004 1 1 0.00 $0.00 Y
K 12015 RPR F/E/E/N/L/M 7.6-12.5 CM 3.03 $112.81 --- $142.26 004 1 1 0.00 $0.00 Y
K 12016 RPR FE/E/EN/L/M 12.6-20.0 CM 4.19 $155.99 --- $196.72 004 1 1 0.00 $0.00 Y
K 12017 RPR FE/E/EN/L/M 20.1-30.0 CM 8.75 $325.76 --- $410.81 004 1 1 0.00 $0.00 Y
O 12017 RPR FE/E/EN/L/M 20.1-30.0 CM 1.75 $65.15 --- $82.16 004 1 0 0.00 $0.00 Y
O 12018 RPR F/E/E/N/L/M >30.0 CM 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
K 12018 RPR F/E/E/N/L/M >30.0 CM 10.21 $380.12 --- $479.36 004 1 1 0.00 $0.00 Y
K 12020 CLOSURE OF SPLIT WOUND 4.60 $171.26 --- $215.97 004 1 1 0.00 $0.00 Y
K 12021 CLOSURE OF SPLIT WOUND 3.38 $125.84 --- $158.69 004 1 1 0.00 $0.00 Y
K 12031 INTMD RPR S/A/T/EXT 2.5 CM/< 2.27 $84.51 --- $106.58 004 1 1 0.00 $0.00 Y
K 12032 INTMD RPR S/A/T/EXT 2.6-7.5 2.46 $91.59 --- $115.50 004 1 1 0.00 $0.00 Y
K 12034 INTMD RPR S/TR/EXT 7.6-12.5 2.79 $103.87 --- $130.99 004 1 1 0.00 $0.00 Y
K 12035 INTMD RPR S/A/T/EXT 12.6-20 3.04 $113.18 --- $142.73 004 1 0 0.00 $0.00 Y
K 12036 INTMD RPR S/A/T/EXT 20.1-30 4.25 $158.23 --- $199.54 004 1 0 0.00 $0.00 Y
K 12037 INTMD RPR S/TR/EXT >30.0 CM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 12037 INTMD RPR S/TR/EXT >30.0 CM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 12041 INTMD RPR N-HF/GENIT 2.5CM/< 2.52 $93.82 --- -- 015 1 1 0.00 $0.00 Y
K 12041 INTMD RPR N-HF/GENIT 2.5CM/< 2.52 $93.82 --- $118.31 004 1 1 0.00 $0.00 Y
K 12042 INTMD RPR N-HF/GENIT2.6-7.5 2.68 $99.78 --- $125.83 004 1 1 0.00 $0.00 Y
P 12042 INTMD RPR N-HF/GENIT2.6-7.5 2.69 $100.15 --- -- 015 1 1 0.00 $0.00 Y
P 12044 INTMD RPR N-HF/GENIT7.6-12.5 2.90 $107.97 --- -- 015 1 0 0.00 $0.00 Y
K 12044 INTMD RPR N-HF/GENIT7.6-12.5 2.91 $108.34 --- $136.62 004 1 0 0.00 $0.00 Y
K 12045 INTMD RPR N-HF/GENIT12.6-20 3.30 $122.86 --- $154.94 004 1 0 0.00 $0.00 Y
P 12045 INTMD RPR N-HF/GENIT12.6-20 3.30 $122.86 --- -- 015 1 0 0.00 $0.00 Y
O 12046 INTMD RPR N-HF/GENIT20.1-30 0.86 $32.02 --- $40.38 004 1 0 0.00 $0.00 Y
K 12046 INTMD RPR N-HF/GENIT20.1-30 4.34 $161.58 --- $203.76 004 1 0 0.00 $0.00 Y
K 12047 INTMD RPR N-HF/GENIT >30.0CM 9.24 $344.01 --- $433.82 004 1 0 0.00 $0.00 Y
O 12047 INTMD RPR N-HF/GENIT >30.0CM 1.85 $68.88 --- $86.86 004 1 0 0.00 $0.00 Y
K 12051 INTMD RPR FACE/MM 2.5 CM/< 2.53 $94.19 --- $118.78 004 1 1 0.00 $0.00 Y
K 12052 INTMD RPR FACE/MM 2.6-5.0 CM 2.66 $99.03 --- $124.89 004 1 1 0.00 $0.00 Y
K 12053 INTMD RPR FACE/MM 5.1-7.5 CM 2.89 $107.59 --- $135.69 004 1 1 0.00 $0.00 Y
K 12054 INTMD RPR FACE/MM 7.6-12.5CM 4.19 $155.99 --- $196.72 004 1 0 0.00 $0.00 Y
K 12055 INTMD RPR FACE/MM 12.6-20 CM 6.23 $231.94 --- $292.50 004 1 0 0.00 $0.00 Y
O 12055 INTMD RPR FACE/MM 12.6-20 CM 1.24 $46.17 --- $58.22 004 1 0 0.00 $0.00 Y
O 12056 INTMD RPR FACE/MM 20.1-30.0 1.91 $71.11 --- $89.67 004 1 0 0.00 $0.00 Y
K 12056 INTMD RPR FACE/MM 20.1-30.0 9.56 $355.92 --- $448.84 004 1 0 0.00 $0.00 Y
K 12057 INTMD RPR FACE/MM >30.0 CM 10.10 $376.02 --- $474.20 004 1 0 0.00 $0.00 Y
O 12057 INTMD RPR FACE/MM >30.0 CM 2.02 $75.20 --- $94.84 004 1 0 0.00 $0.00 Y
K 13100 CMPLX RPR TRUNK 1.1-2.5 CM 2.97 $110.57 --- $139.44 004 1 1 0.00 $0.00 Y
K 13101 CMPLX RPR TRUNK 2.6-7.5 CM 3.48 $129.56 --- $163.39 004 1 1 0.00 $0.00 Y
K 13102 CMPLX RPR TRUNK ADDL 5CM/< 1.35 $50.26 --- $63.38 004 1 1 0.00 $0.00 Y
K 13120 CMPLX RPR S/A/L 1.1-2.5 CM 3.12 $116.16 --- $146.48 004 1 1 0.00 $0.00 Y
K 13121 CMPLX RPR S/A/L 2.6-7.5 CM 4.53 $168.65 --- $212.68 004 1 1 0.00 $0.00 Y
K 13122 CMPLX RPR S/A/L ADDL 5 CM/> 1.57 $58.45 --- $73.71 004 1 1 0.00 $0.00 Y
K 13131 CMPLX RPR F/C/C/M/N/AX/G/H/F 3.47 $129.19 --- $162.92 004 1 1 0.00 $0.00 Y
P 13131 CMPLX RPR F/C/C/M/N/AX/G/H/F 3.47 $129.19 --- -- 015 0 1 0.00 $0.00 Y
P 13132 CMPLX RPR F/C/C/M/N/AX/G/H/F 6.80 $253.16 --- -- 015 0 1 0.00 $0.00 Y
O 13132 CMPLX RPR F/C/C/M/N/AX/G/H/F 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
K 13132 CMPLX RPR F/C/C/M/N/AX/G/H/F 6.80 $253.16 --- $319.26 004 1 1 0.00 $0.00 Y
K 13133 CMPLX RPR F/C/C/M/N/AX/G/H/F 2.33 $86.75 --- $109.39 004 1 1 0.00 $0.00 Y
O 13133 CMPLX RPR F/C/C/M/N/AX/G/H/F 0.47 $17.50 --- $22.07 004 1 1 0.00 $0.00 Y
P 13133 CMPLX RPR F/C/C/M/N/AX/G/H/F 0.47 $17.50 --- -- 015 1 1 0.00 $0.00 Y
K 13151 CMPLX RPR E/N/E/L 1.1-2.5 CM 4.39 $163.44 --- $206.11 004 1 0 0.00 $0.00 Y
K 13152 CMPLX RPR E/N/E/L 2.6-7.5 CM 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 13152 CMPLX RPR E/N/E/L 2.6-7.5 CM 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 13153 CMPLX RPR E/N/E/L ADDL 5CM/< 0.51 $18.99 --- $23.94 004 1 0 0.00 $0.00 Y
K 13153 CMPLX RPR E/N/E/L ADDL 5CM/< 2.56 $95.31 --- $120.19 004 1 0 0.00 $0.00 Y
K 13160 SEC. CLOSURE WOUND/DEHISCENCE 14.73 $548.40 --- $691.57 004 1 0 0.00 $0.00 Y
O 13160 SEC. CLOSURE WOUND/DEHISCENCE 2.95 $109.83 --- $138.50 004 1 0 0.00 $0.00 Y
P 13160 SEC. CLOSURE WOUND/DEHISCENCE 14.73 $548.40 --- -- 015 0 0 0.00 $0.00 Y
O 14000 TIS TRNFR TRUNK 10 SQ CM/< 1.20 $44.68 --- $56.34 004 1 0 0.00 $0.00 Y
K 14000 TIS TRNFR TRUNK 10 SQ CM/< 6.02 $224.12 --- $282.64 004 1 1 0.00 $0.00 Y
K 14001 TIS TRNFR TRUNK 10.1-30SQCM 7.84 $291.88 --- $368.09 004 1 0 0.00 $0.00 Y
O 14001 TIS TRNFR TRUNK 10.1-30SQCM 1.57 $58.45 --- $73.71 004 1 0 0.00 $0.00 Y