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Medi-Cal Rates Information

Medi-Cal Rates as of 03/15/2020 (Codes 33774 thru 36247)

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


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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
K 33774 REPAIR GREAT VESSELS DEFECT 47.03 $1750.93 --- $2208.06 004 1 0 0.00 $0.00 Y
O 33774 REPAIR GREAT VESSELS DEFECT 9.41 $350.33 --- $441.80 004 1 0 0.00 $0.00 Y
O 33775 REPAIR GREAT VESSELS DEFECT 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 33775 REPAIR GREAT VESSEL DEFECT 49.80 $1854.05 --- $2338.11 004 1 0 0.00 $0.00 Y
K 33776 REPAIR GREAT VESSEL DEFECT 52.10 $1939.68 --- $2446.10 004 1 0 0.00 $0.00 Y
O 33776 REPAIR GREAT VESSEL DEFECT 10.40 $387.19 --- $488.28 004 1 0 0.00 $0.00 Y
O 33777 REPAIR GREAT VESSEL DEFECT 10.40 $387.19 --- $488.28 004 1 0 0.00 $0.00 Y
K 33777 REPAIR GREAT VESSEL DEFECT 52.10 $1939.68 --- $2446.10 004 1 0 0.00 $0.00 Y
K 33778 REPAIR GREAT VESSELS DEFECT 53.34 $1985.85 --- $2504.31 004 1 0 0.00 $0.00 Y
O 33778 REPAIR GREAT VESSEL DEFECT 10.71 $398.73 --- $502.83 004 1 0 0.00 $0.00 Y
O 33779 REPAIR GREAT VESSEL DEFECT 10.62 $395.38 --- $498.61 004 1 0 0.00 $0.00 Y
K 33779 REPAIR GREAT VESSEL DEFECT 53.10 $1976.91 --- $2493.05 004 1 0 0.00 $0.00 Y
K 33780 REPAIR GREAT VESSEL DEFECT 56.40 $2099.77 --- $2647.98 004 1 0 0.00 $0.00 Y
O 33780 REPAIR GREAT VESSEL 11.28 $419.95 --- $529.60 004 1 0 0.00 $0.00 Y
O 33781 REPAIR GREAT VESSEL DEFECT 11.28 $419.95 --- $529.60 004 1 0 0.00 $0.00 Y
K 33781 REPAIR GREAT VESSEL DEFECT 56.40 $2099.77 --- $2647.98 004 1 0 0.00 $0.00 Y
K 33782 *10NIKAIDOH PROC 71.76 $2671.62 --- -- 004 0 0 0.00 $0.00 Y
O 33782 *10NIKAIDOH PROC 14.35 $534.25 --- -- 004 0 0 0.00 $0.00 Y
O 33783 *10NIKAIDOH PROC W/OSTIA IMPLT 15.51 $577.44 --- -- 004 0 0 0.00 $0.00 Y
K 33783 *10NIKAIDOH PROC W/OSTIA IMPLT 77.54 $2886.81 --- -- 004 0 0 0.00 $0.00 Y
K 33786 REPAIR ARTERIAL TRUNK 49.80 $1854.05 --- $2338.11 004 1 0 0.00 $0.00 Y
O 33786 REPAIR ARTERIAL TRUNK 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
O 33788 REVISION OF PULMONARY ARTERY 6.57 $244.60 --- $308.46 004 1 0 0.00 $0.00 Y
K 33788 REVISION OF PULMONARY ARTERY 32.85 $1223.01 --- $1542.31 004 1 0 0.00 $0.00 Y
K 33800 AORTIC SUSPENSION 24.63 $916.97 --- $1156.38 004 1 0 0.00 $0.00 Y
O 33800 AORTIC SUSPENSION 4.93 $183.54 --- $231.46 004 1 0 0.00 $0.00 Y
O 33802 REPAIR VESSEL DEFECT 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 33802 REPAIR VESSEL DEFECT 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 33803 REPAIR VESSEL DEFECT 28.15 $1048.02 --- $1321.64 004 1 0 0.00 $0.00 Y
O 33803 REPAIR VESSEL DEFECT 5.65 $210.35 --- $265.27 004 1 0 0.00 $0.00 Y
O 33813 REPAIR SEPTAL DEFECT 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 33813 REPAIR SEPTAL DEFECT 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 33814 REPAIR SEPTAL DEFECT 50.00 $1861.50 --- $2347.50 004 1 0 0.00 $0.00 Y
O 33814 REPAIR SEPTAL DEFECT 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
O 33820 REVISE MAJOR VESSEL 3.74 $139.24 --- $175.59 004 1 0 0.00 $0.00 Y
K 33820 REVISE MAJOR VESSEL 18.80 $699.92 --- $882.66 004 1 0 0.00 $0.00 Y
K 33822 REVISE MAJOR VESSEL 25.41 $946.01 --- $1193.00 004 1 0 0.00 $0.00 Y
O 33822 REVISE MAJOR VESSEL 5.08 $189.13 --- $238.51 004 1 0 0.00 $0.00 Y
O 33824 REVISE MAJOR VESSEL 7.20 $268.06 --- $338.04 004 1 0 0.00 $0.00 Y
K 33824 REVISE MAJOR VESSEL 36.00 $1340.28 --- $1690.20 004 1 0 0.00 $0.00 Y
K 33840 REMOVE AORTA CONSTRICTION 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
O 33840 REMOVE AORTA CONSTRICTION 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 33845 REMOVE AORTA CONSTRICTION 7.48 $278.48 --- $351.19 004 1 0 0.00 $0.00 Y
K 33845 REMOVE AORTA CONSTRICTION 37.60 $1399.85 --- $1765.32 004 1 0 0.00 $0.00 Y
K 33851 REMOVE AORTA CONSTRICTION 39.62 $1475.05 --- $1860.16 004 1 0 0.00 $0.00 Y
O 33851 REMOVE AORTA CONSTRICTION 7.92 $294.86 --- $371.84 004 1 0 0.00 $0.00 Y
O 33852 REPAIR SEPTAL DEFECT 7.48 $278.48 --- $351.19 004 1 0 0.00 $0.00 Y
K 33852 REPAIR SEPTAL DEFECT 37.60 $1399.85 --- $1765.32 004 1 0 0.00 $0.00 Y
K 33853 RPR OF HYPO/INTERR AORTIC ARCH USE AUTOG 43.36 $1614.29 --- $2035.75 004 1 0 0.00 $0.00 Y
O 33853 RPR OF HYPO/INTERR AORTIC ARCH USE AUTOG 8.68 $323.16 --- $407.53 004 1 0 0.00 $0.00 Y
O 33858 AS-AORT GRF F/AORTIC DSJ 15.41 $574.06 --- -- 004 0 0 0.00 $0.00 Y
K 33858 AS-AORT GRF F/AORTIC DSJ 77.09 $2870.32 --- -- 004 0 0 0.00 $0.00 Y
K 33859 AS-AORT GRF F/DS OTH/THN DSJ 55.43 $2063.81 --- -- 004 0 0 0.00 $0.00 Y
O 33859 AS-AORT GRF F/DS OTH/THN DSJ 11.08 $412.76 --- -- 004 0 0 0.00 $0.00 Y
O 33863 ASCENDING AORTIC GRAFT 10.89 $405.43 --- $511.29 004 1 0 0.00 $0.00 Y
K 33863 ASCENDING AORTIC GRAFT 54.46 $2027.55 --- $2556.90 004 1 0 0.00 $0.00 Y
K 33864 ASCENDING AORTIC GRAFT 65.91 $2453.83 --- -- 004 0 0 0.00 $0.00 Y
O 33864 ASCENDING AORTIC GRAFT 13.18 $490.69 --- -- 004 0 0 0.00 $0.00 Y
O 33866 AORTIC HEMIARCH GRAFT 4.63 $172.37 --- -- 004 0 0 0.00 $0.00 Y
K 33866 AORTIC HEMIARCH GRAFT 23.17 $862.62 --- -- 004 0 0 0.00 $0.00 Y
K 33871 TRANSVRS A-ARCH GRF HYPTHRM 74.07 $2757.99 --- -- 004 0 0 0.00 $0.00 Y
O 33871 TRANSVRS A-ARCH GRF HYPTHRM 14.81 $551.60 --- -- 004 0 0 0.00 $0.00 Y
O 33875 THORACIC AORTIC GRAFT 9.40 $349.96 --- $441.33 004 1 0 0.00 $0.00 Y
K 33875 THORACIC AORTIC GRAFT 47.00 $1749.81 --- $2206.65 004 1 0 0.00 $0.00 Y
K 33877 THORACOABDOMINAL GRAFT 62.26 $2317.94 --- $2923.11 004 1 0 0.00 $0.00 Y
O 33877 THORACOABDOMINAL GRAFT 12.45 $463.51 --- $584.53 004 1 0 0.00 $0.00 Y
O 33880 ENDOVASC TAA REPR INCL SUBCL 8.03 $298.96 --- $377.01 004 1 0 0.00 $0.00 Y
K 33880 ENDOVASC TAA REPR INCL SUBCL 40.14 $1494.41 --- $1884.57 004 1 0 0.00 $0.00 Y
K 33881 ENDOVASC TAA REPR W/O SUBCL 34.52 $1285.18 --- $1620.71 004 1 0 0.00 $0.00 Y
O 33881 ENDOVASC TAA REPR W/O SUBCL 6.90 $256.89 --- $323.96 004 1 0 0.00 $0.00 Y
O 33883 INSERT ENDOVASC PROSTH TAA 5.10 $189.88 --- $239.45 004 1 0 0.00 $0.00 Y
K 33883 INSERT ENDOVASC PROSTH TAA 25.51 $949.74 --- $1197.69 004 1 0 0.00 $0.00 Y
K 33884 ENDOVASC PROSTH TAA ADD-ON 9.40 $349.96 --- $441.33 004 1 0 0.00 $0.00 Y
O 33884 ENDOVASC PROSTH TAA ADD-ON 1.88 $69.99 --- $88.27 004 1 0 0.00 $0.00 Y
O 33886 ENDOVASC PROSTH DELAYED 4.41 $164.18 --- $207.05 004 1 0 0.00 $0.00 Y
K 33886 ENDOVASC PROSTH DELAYED 22.06 $821.29 --- $1035.72 004 1 0 0.00 $0.00 Y
K 33889 ARTERY TRANSPOSE/ENDOVAS TAA 18.74 $697.69 --- $879.84 004 1 0 0.00 $0.00 Y
O 33889 ARTERY TRANSPOSE/ENDOVAS TAA 3.75 $139.61 --- $176.06 004 1 0 0.00 $0.00 Y
O 33891 CARCAR BP GRFT/ENDOVAS TAA 4.79 $178.33 --- $224.89 004 1 0 0.00 $0.00 Y
K 33891 CARCAR BP GRFT/ENDOVAS TAA 23.94 $891.29 --- $1123.98 004 1 0 0.00 $0.00 Y
K 33910 REMOVE LUNG ARTERY EMBOLI 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
O 33910 REMOVE LUNG ARTERY EMBOLI 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
O 33915 REMOVE LUNG ARTERY EMBOLI 5.94 $221.15 --- $278.88 004 1 0 0.00 $0.00 Y
K 33915 REMOVE LUNG ARTERY EMBOLI 29.70 $1105.73 --- $1394.42 004 1 0 0.00 $0.00 Y
K 33916 SURGERY GREAT VESSEL 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
O 33916 SURGERY GREAT VESSEL 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
O 33917 RPR OF PULM ARTERY STEN BY RECONS WITH P 6.70 $249.44 --- $314.57 004 1 0 0.00 $0.00 Y
K 33917 RPR OF PULM ARTERY STEN BY RECONS WITH P 33.51 $1247.58 --- $1573.29 004 1 0 0.00 $0.00 Y
K 33920 RPR OF PULM ATRESIA W/VENT SEPTAL DEFECT 44.01 $1638.49 --- $2066.27 004 1 0 0.00 $0.00 Y
O 33920 RPR OF PULM ATRESIA W/VENT SEPTAL DEFECT 8.80 $327.62 --- $413.16 004 1 0 0.00 $0.00 Y
O 33922 TRANS OF PULM ARTERY W/CARDIOPULM BYPASS 6.43 $239.39 --- $301.89 004 1 0 0.00 $0.00 Y
K 33922 TRANS OF PULM ARTERY W/CARDIOPULM BYPASS 32.19 $1198.43 --- $1511.32 004 1 0 0.00 $0.00 Y
K 33924 LIGATION AND TAKEDOWN OF SYS-PULMO. ARTE 6.94 $258.38 --- $325.83 004 1 0 0.00 $0.00 Y
O 33924 LIGATION AND TAKEDOWN OF SYS-PULMO. ARTE 1.39 $51.75 --- $65.26 004 1 0 0.00 $0.00 Y
O 33925 RPR PUL ART UNIFOCAL W/O CPB 7.92 $294.86 --- $371.84 004 1 0 0.00 $0.00 Y
K 33925 RPR PUL ART UNIFOCAL W/O CPB 39.58 $1473.56 --- $1858.28 004 1 0 0.00 $0.00 Y
K 33926 REPR PUL ART UNIFOCAL W/CPB 53.30 $1984.36 --- $2502.44 004 1 0 0.00 $0.00 Y
O 33926 REPR PUL ART UNIFOCAL W/CPB 10.66 $396.87 --- $500.49 004 1 0 0.00 $0.00 Y
O 33935 TRANSPLANTATION HEART/LUNG 18.37 $683.92 --- $862.47 004 1 0 0.00 $0.00 Y
K 33935 TRANSPLANTATION HEART/LUNG 91.83 $3418.83 --- $4311.42 004 1 0 0.00 $0.00 Y
K 33945 TRANSPLANTATION OF HEART 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 33945 TRANSPLANTATION OF HEART 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 33946 ECMO/ECLS INITIATION VENOUS 5.70 $212.21 --- -- 004 0 0 0.00 $0.00 Y
K 33947 ECMO/ECLS INITIATION ARTERY 6.29 $234.18 --- -- 004 0 0 0.00 $0.00 Y
K 33948 ECMO/ECLS DAILY MGMT-VENOUS 4.51 $167.91 --- -- 004 0 0 0.00 $0.00 Y
K 33949 ECMO/ECLS DAILY MGMT ARTERY 4.39 $163.44 --- -- 004 0 0 0.00 $0.00 Y
K 33951 ECMO/ECLS INSJ PRPH CANNULA 8.12 $302.31 --- -- 004 0 0 0.00 $0.00 Y
K 33952 ECMO/ECLS INSJ PRPH CANNULA 7.89 $293.74 --- -- 004 0 0 0.00 $0.00 Y
K 33953 ECMO/ECLS INSJ PRPH CANNULA 9.07 $337.68 --- -- 004 0 0 0.00 $0.00 Y
K 33954 ECMO/ECLS INSJ PRPH CANNULA 8.81 $328.00 --- -- 004 0 0 0.00 $0.00 Y
K 33955 ECMO/ECLS INSJ CTR CANNULA 16.43 $611.69 --- -- 004 0 0 0.00 $0.00 Y
K 33956 ECMO/ECLS INSJ CTR CANNULA 15.44 $574.83 --- -- 004 0 0 0.00 $0.00 Y
K 33957 ECMO/ECLS REPOS PERPH CNULA 3.64 $135.52 --- -- 004 0 0 0.00 $0.00 Y
K 33958 ECMO/ECLS REPOS PERPH CNULA 3.51 $130.68 --- -- 004 0 0 0.00 $0.00 Y
K 33959 ECMO/ECLS REPOS PERPH CNULA 4.64 $172.75 --- -- 004 0 0 0.00 $0.00 Y
K 33962 ECMO/ECLS REPOS PERPH CNULA 4.32 $160.83 --- -- 004 0 0 0.00 $0.00 Y
K 33963 ECMO/ECLS REPOS PERPH CNULA 9.26 $344.75 --- -- 004 0 0 0.00 $0.00 Y
K 33964 ECMO/ECLS REPOS PERPH CNULA 9.44 $351.45 --- -- 004 0 0 0.00 $0.00 Y
K 33965 ECMO/ECLS RMVL PERPH CANNULA 3.65 $135.89 --- -- 004 0 0 0.00 $0.00 Y
K 33966 ECMO/ECLS RMVL PRPH CANNULA 4.35 $161.95 --- -- 004 0 0 0.00 $0.00 Y
K 33967 INSERT IA PERCUT DEVICE 5.82 $216.68 --- $273.25 004 1 0 0.00 $0.00 Y
K 33968 REMOVE AORTIC ASSIST DEVICE 0.72 $26.81 --- $33.80 004 1 0 0.00 $0.00 Y
O 33968 REMOVE AORTIC ASSIST DEVICE 0.14 $5.21 --- $6.57 004 1 0 0.00 $0.00 Y
K 33969 ECMO/ECLS RMVL PERPH CANNULA 5.39 $200.67 --- -- 004 0 0 0.00 $0.00 Y
K 33970 AORTIC CIRCULATION ASSIST 12.50 $465.38 --- $586.88 004 1 0 0.00 $0.00 Y
O 33970 AORTIC CIRCULATION ASSIST 2.50 $93.08 --- $117.38 004 1 0 0.00 $0.00 Y
O 33971 AORTIC CIRCULATION ASSIST 3.53 $131.42 --- $165.73 004 1 0 0.00 $0.00 Y
K 33971 AORTIC CIRCULATION ASSIST 17.66 $657.48 --- $829.14 004 1 0 0.00 $0.00 Y
K 33973 INS OF INTRA-AORTIC BALLN ASST DEV THRU 12.35 $459.79 --- $579.83 004 1 0 0.00 $0.00 Y
O 33973 INS OF INTRA-AORTIC BALLN ASST DEV THRU 2.47 $91.96 --- $115.97 004 1 0 0.00 $0.00 Y
O 33974 REM OF INTRA-AORTIC BALLN ASST DEV F/THE 2.88 $107.22 --- $135.22 004 1 0 0.00 $0.00 Y
K 33974 REM OF INTRA-AORTIC BALLN ASST DEV F/THE 14.38 $535.37 --- $675.14 004 1 0 0.00 $0.00 Y
K 33975 IMPLANT VENTRICULAR DEVICE 27.92 $1039.46 --- $1310.84 004 1 0 0.00 $0.00 Y
O 33975 IMPLANT VENTRICULAR DEVICE 5.58 $207.74 --- $261.98 004 1 0 0.00 $0.00 Y
O 33976 IMPLANT VENTRICULAR DEVICE 7.55 $281.09 --- $354.47 004 1 0 0.00 $0.00 Y
K 33976 IMPLANT VENTRICULAR DEVICE 37.73 $1404.69 --- $1771.42 004 1 0 0.00 $0.00 Y
K 33977 REMOVE VENTRICULAR DEVICE 24.41 $908.78 --- $1146.05 004 1 0 0.00 $0.00 Y
O 33977 REMOVE VENTRICULAR DEVICE 4.88 $181.68 --- $229.12 004 1 0 0.00 $0.00 Y
O 33978 REMOVE VENTRICULAR DEVICE 5.58 $207.74 --- $261.98 004 1 0 0.00 $0.00 Y
K 33978 REMOVE VENTRICULAR DEVICE 27.92 $1039.46 --- $1310.84 004 1 0 0.00 $0.00 Y
K 33979 INSERT INTRACORPOREAL DEVICE 27.92 $1039.46 --- $1310.84 004 1 0 0.00 $0.00 Y
O 33979 INSERT INTRACORPOREAL DEVICE 5.58 $207.74 --- $261.98 004 1 0 0.00 $0.00 Y
K 33980 REMOVE INTRACORPOREAL DEVICE 27.92 $1039.46 --- $1310.84 004 1 0 0.00 $0.00 Y
K 33981 REPLACE VAD PUMP EXT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 33981 REPLACE VAD PUMP EXT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 33982 REPLACE VAD INTRA W/O BP 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 33982 REPLACE VAD INTRA W/O BP 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 33983 REPLACE VAD INTRA W/BP 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 33983 REPLACE VAD INTRA W/BP 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 33984 ECMO/ECLS RMVL PRPH CANNULA 5.24 $195.09 --- -- 004 0 0 0.00 $0.00 Y
K 33985 ECMO/ECLS RMVL CTR CANNULA 10.14 $377.51 --- -- 004 0 0 0.00 $0.00 Y
K 33986 ECMO/ECLS RMVL CTR CANNULA 9.55 $355.55 --- -- 004 0 0 0.00 $0.00 Y
K 33987 ARTERY EXPOS/GRAFT ARTERY 3.83 $142.59 --- -- 004 0 0 0.00 $0.00 Y
K 33988 INSERTION OF LEFT HEART VENT 14.25 $530.53 --- -- 004 0 0 0.00 $0.00 Y
K 33989 REMOVAL OF LEFT HEART VENT 9.06 $337.30 --- -- 004 0 0 0.00 $0.00 Y
K 33990 INSERT VAD ARTERY ACCESS 9.43 $351.08 --- -- 004 0 0 0.00 $0.00 Y
O 33990 INSERT VAD ARTERY ACCESS 1.88 $69.99 --- -- 004 0 0 0.00 $0.00 Y
O 33991 INSERT VAD ART&VEIN ACCESS 2.74 $102.01 --- -- 004 0 0 0.00 $0.00 Y
K 33991 INSERT VAD ART&VEIN ACCESS 13.74 $511.54 --- -- 004 0 0 0.00 $0.00 Y
K 33992 REMOVE VAD DIFFERENT SESSION 4.46 $166.05 --- -- 004 0 0 0.00 $0.00 Y
O 33992 REMOVE VAD DIFFERENT SESSION 0.89 $33.13 --- -- 004 0 0 0.00 $0.00 Y
O 33993 REPOSITION VAD DIFF SESSION 0.78 $29.04 --- -- 004 0 0 0.00 $0.00 Y
K 33993 REPOSITION VAD DIFF SESSION 3.92 $145.94 --- -- 004 0 0 0.00 $0.00 Y
K 33999 CARDIAC SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 33999 CARDIAC SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 34001 REMOVAL OF ARTERY CLOT 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 34001 REMOVAL OF ARTERY CLOT 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 34051 REMOVAL OF ARTERY CLOT 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 34051 REMOVAL OF ARTERY CLOT 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 34101 REMOVAL OF ARTERY CLOT 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
K 34101 REMOVAL OF ARTERY CLOT 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 34111 REMOVAL OF ARM ARTERY CLOT 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
O 34111 REMOVAL OF ARM ARTERY CLOT 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
O 34151 REMOVAL OF ARTERY CLOT 4.41 $164.18 --- $207.05 004 1 0 0.00 $0.00 Y
K 34151 REMOVAL OF ARTERY CLOT 22.07 $821.67 --- $1036.19 004 1 0 0.00 $0.00 Y
K 34201 REMOVAL OF ARTERY CLOT 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
O 34201 REMOVAL OF ARTERY CLOT 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
O 34203 REMOVAL OF LEG ARTERY CLOT 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 34203 REMOVAL OF LEG ARTERY CLOT 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 34401 REMOVAL OF VEIN CLOT 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 34401 REMOVAL OF VEIN CLOT 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 34421 REMOVAL OF VEIN CLOT 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 34421 REMOVAL OF VEIN CLOT 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
K 34451 REMOVAL OF VEIN CLOT 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 34451 REMOVAL OF VEIN CLOT 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 34471 REMOVAL OF VEIN CLOT 3.32 $123.60 --- $155.87 004 1 0 0.00 $0.00 Y
K 34471 REMOVAL OF VEIN CLOT 16.60 $618.02 --- $779.37 004 1 0 0.00 $0.00 Y
K 34490 REMOVAL OF VEIN CLOT 16.60 $618.02 --- $779.37 004 1 0 0.00 $0.00 Y
O 34490 REMOVAL OF VEIN CLOT 3.32 $123.60 --- $155.87 004 1 0 0.00 $0.00 Y
O 34501 REPAIR VALVE FEMORAL VEIN 3.50 $130.31 --- $164.33 004 1 0 0.00 $0.00 Y
K 34501 REPAIR VALVE FEMORAL VEIN 17.49 $651.15 --- $821.16 004 1 0 0.00 $0.00 Y
K 34502 RECONSTRUCT VENA CAVA 35.16 $1309.01 --- $1650.76 004 1 0 0.00 $0.00 Y
O 34502 RECONSTRUCT VENA CAVA 7.03 $261.73 --- $330.06 004 1 0 0.00 $0.00 Y
O 34510 TRANSPOSITION OF VEIN VALVE 4.31 $160.46 --- $202.35 004 1 0 0.00 $0.00 Y
K 34510 TRANSPOSITION OF VEIN VALVE 21.53 $801.56 --- $1010.83 004 1 0 0.00 $0.00 Y
K 34520 CROSS-OVER VEIN GRAFT 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 34520 CROSS-OVER VEIN GRAFT 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 34530 LEG VEIN FUSION 3.40 $126.58 --- $159.63 004 1 0 0.00 $0.00 Y
K 34530 LEG VEIN FUSION 16.99 $632.54 --- $797.68 004 1 0 0.00 $0.00 Y
K 34701 EVASC RPR A-AO NDGFT 27.67 $1030.41 --- -- 004 0 0 0.00 $0.00 Y
O 34701 EVASC RPR A-AO NDGFT 5.53 $206.08 --- -- 004 0 0 0.00 $0.00 Y
O 34702 EVASC RPR A-AO NDGFT RPT 8.26 $307.74 --- -- 004 0 0 0.00 $0.00 Y
K 34702 EVASC RPR A-AO NDGFT RPT 41.32 $1538.70 --- -- 004 0 0 0.00 $0.00 Y
K 34703 EVASC RPR A-UNILAC NDGFT 31.02 $1155.23 --- -- 004 0 0 0.00 $0.00 Y
O 34703 EVASC RPR A-UNILAC NDGFT 6.20 $231.05 --- -- 004 0 0 0.00 $0.00 Y
O 34704 EVASC RPR A-UNILAC NDGFT RPT 10.32 $384.28 --- -- 004 0 0 0.00 $0.00 Y
K 34704 EVASC RPR A-UNILAC NDGFT RPT 51.60 $1921.42 --- -- 004 0 0 0.00 $0.00 Y
K 34705 EVAC RPR A-BIILIAC NDGFT 34.29 $1276.95 --- -- 004 0 0 0.00 $0.00 Y
O 34705 EVAC RPR A-BIILIAC NDGFT 6.85 $255.39 --- -- 004 0 0 0.00 $0.00 Y
O 34706 EVASC RPR A-BIILIAC RPT 10.31 $383.89 --- -- 004 0 0 0.00 $0.00 Y
K 34706 EVASC RPR A-BIILIAC RPT 51.55 $1919.44 --- -- 004 0 0 0.00 $0.00 Y
K 34707 EVASC RPR ILIO-ILIAC NDGFT 25.78 $959.85 --- -- 004 0 0 0.00 $0.00 Y
O 34707 EVASC RPR ILIO-ILIAC NDGFT 5.15 $191.97 --- -- 004 0 0 0.00 $0.00 Y
O 34708 EVASC RPR ILIO-ILIAC RPT 8.28 $308.54 --- -- 004 0 0 0.00 $0.00 Y
K 34708 EVASC RPR ILIO-ILIAC RPT 41.43 $1542.71 --- -- 004 0 0 0.00 $0.00 Y
K 34709 PLMT XTN PROSTH EVASC RPR 7.20 $268.12 --- -- 004 0 0 0.00 $0.00 Y
O 34709 PLMT XTN PROSTH EVASC RPR 1.44 $53.62 --- -- 004 0 0 0.00 $0.00 Y
O 34710 DLYD PLMT XTN PROSTH 1ST VSL 3.61 $134.50 --- -- 004 0 0 0.00 $0.00 Y
K 34710 DLYD PLMT XTN PROSTH 1ST VSL 18.06 $672.50 --- -- 004 0 0 0.00 $0.00 Y
K 34711 DLYD PLMT XTN PROSTH EA ADDL 6.64 $247.44 --- -- 004 0 0 0.00 $0.00 Y
O 34711 DLYD PLMT XTN PROSTH EA ADDL 1.32 $49.49 --- -- 004 0 0 0.00 $0.00 Y
O 34712 TCAT DLVR ENHNCD FIXJ DEV 3.12 $116.51 --- -- 004 0 0 0.00 $0.00 Y
K 34712 TCAT DLVR ENHNCD FIXJ DEV 15.64 $582.53 --- -- 004 0 0 0.00 $0.00 Y
K 34713 PERQ ACCESS & CLSR FEM ART 2.89 $107.89 --- -- 004 0 0 0.00 $0.00 Y
O 34713 PERQ ACCESS & CLSR FEM ART 0.57 $21.58 --- -- 004 0 0 0.00 $0.00 Y
O 34714 OPN FEM ART EXPOS CNDT CRTJ 1.21 $45.42 --- -- 004 0 0 0.00 $0.00 Y
K 34714 OPN FEM ART EXPOS CNDT CRTJ 6.09 $227.08 --- -- 004 0 0 0.00 $0.00 Y
K 34715 OPN AX/SUBCLA ART EXPOS 6.81 $253.74 --- -- 004 0 0 0.00 $0.00 Y
O 34715 OPN AX/SUBCLA ART EXPOS 1.36 $50.75 --- -- 004 0 0 0.00 $0.00 Y
O 34716 OPN AX/SUBCLA ART EXPOS CNDT 1.69 $63.16 --- -- 004 0 0 0.00 $0.00 Y
K 34716 OPN AX/SUBCLA ART EXPOS CNDT 8.48 $315.78 --- -- 004 0 0 0.00 $0.00 Y
K 34717 EVASC RPR A-ILIAC NDGFT 9.99 $372.05 --- -- 004 0 0 0.00 $0.00 Y
O 34717 EVASC RPR A-ILIAC NDGFT 1.99 $74.41 --- -- 004 0 0 0.00 $0.00 Y
O 34718 EVASC RPR N/A A-ILIAC NDGFT 5.61 $208.88 --- -- 004 0 0 0.00 $0.00 Y
K 34718 EVASC RPR N/A A-ILIAC NDGFT 28.05 $1044.38 --- -- 004 0 0 0.00 $0.00 Y
K 34808 ENDOVAS ILIAC A DEVICE ADDON 5.23 $194.71 --- $245.55 004 1 0 0.00 $0.00 Y
O 34808 ENDOVAS ILIAC A DEVICE ADDON 1.05 $39.09 --- $49.30 004 1 0 0.00 $0.00 Y
O 34812 XPOSE FOR ENDOPROSTH FEMORL 1.71 $63.66 --- $80.28 004 1 0 0.00 $0.00 Y
K 34812 XPOSE FOR ENDOPROSTH FEMORL 8.56 $318.69 --- $401.89 004 1 0 0.00 $0.00 Y
K 34813 FEMORAL ENDOVAS GRAFT ADD-ON 6.08 $226.36 --- $285.46 004 1 0 0.00 $0.00 Y
O 34813 FEMORAL ENDOVAS GRAFT ADD-ON 1.22 $45.42 --- $57.28 004 1 0 0.00 $0.00 Y
O 34820 XPOSE FOR ENDOPROSTH ILIAC 2.47 $91.96 --- $115.97 004 1 0 0.00 $0.00 Y
K 34820 XPOSE FOR ENDOPROSTH ILIAC 12.36 $460.16 --- $580.30 004 1 0 0.00 $0.00 Y
K 34830 OPEN AORTIC TUBE PROSTH REPR 42.95 $1599.03 --- $2016.50 004 1 0 0.00 $0.00 Y
O 34830 OPEN AORTIC TUBE PROSTH REPR 8.59 $319.81 --- $403.30 004 1 0 0.00 $0.00 Y
O 34831 OPEN AORTOILIAC PROSTH REPR 9.28 $345.49 --- $435.70 004 1 0 0.00 $0.00 Y
K 34831 OPEN AORTOILIAC PROSTH REPR 46.42 $1728.22 --- $2179.42 004 1 0 0.00 $0.00 Y
K 34832 OPEN AORTOFEMOR PROSTH REPR 46.42 $1728.22 --- $2179.42 004 1 0 0.00 $0.00 Y
O 34832 OPEN AORTOFEMOR PROSTH REPR 9.28 $345.49 --- $435.70 004 1 0 0.00 $0.00 Y
O 34833 XPOSE FOR ENDOPROSTH ILIAC 2.02 $75.22 --- $94.84 004 1 0 0.00 $0.00 Y
K 34833 XPOSE FOR ENDOPROSTH ILIAC 10.10 $376.12 --- $474.20 004 1 0 0.00 $0.00 Y
K 34834 XPOSE ENDOPROSTH BRACHIAL 4.62 $171.99 --- $216.91 004 1 0 0.00 $0.00 Y
O 34834 XPOSE ENDOPROSTH BRACHIAL 0.92 $34.40 --- $43.19 004 1 0 0.00 $0.00 Y
K 34839 PLNNING PT SPEC FENEST GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34841 ENDOVASC VISC AORTA 1 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34841 ENDOVASC VISC AORTA 1 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34842 ENDOVASC VISC AORTA 2 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34842 ENDOVASC VISC AORTA 2 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34843 ENDOVASC VISC AORTA 3 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34843 ENDOVASC VISC AORTA 3 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34844 ENDOVASC VISC AORTA 4 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34844 ENDOVASC VISC AORTA 4 GRAFT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34845 VISC & INFRAREN ABD 1 PROSTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34845 VISC & INFRAREN ABD 1 PROSTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34846 VISC & INFRAREN ABD 2 PROSTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34846 VISC & INFRAREN ABD 2 PROSTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34847 VISC & INFRAREN ABD 3 PROSTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34847 VISC & INFRAREN ABD 3 PROSTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
O 34848 VISC & INFRAREN ABD 4+ PROST 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 34848 VISC & INFRAREN ABD 4+ PROST 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 35001 REPAIR DEFECT OF ARTERY 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35001 REPAIR DEFECT OF ARTERY 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35002 REPAIR ARTERY RUPTURE NECK 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 35002 REPAIR ARTERY RUPTURE NECK 29.47 $1097.17 --- $1383.62 004 1 0 0.00 $0.00 Y
K 35005 REPAIR DEFECT OF ARTERY 24.99 $930.38 --- $1173.28 004 1 0 0.00 $0.00 Y
O 35005 REPAIR DEFECT OF ARTERY 5.00 $186.15 --- $234.75 004 1 0 0.00 $0.00 Y
O 35011 DIR REPR OF ANEURYSM,FLSE ANEURYSM,EXCIS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35011 DIR REPR OF ANEURYSM,FLSE ANEURYSM,EXCIS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35013 REPAIR ARTERY RUPTURE ARM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 35013 REPAIR ARTERY RUPTURE ARM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 35021 REPAIR DEFECT OF ARTERY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 35021 REPAIR DEFECT OF ARTERY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 35022 REPAIR ARTERY RUPTURE CHEST 33.77 $1257.26 --- $1585.50 004 1 0 0.00 $0.00 Y
O 35022 REPAIR ARTERY RUPTURE CHEST 6.75 $251.30 --- $316.91 004 1 0 0.00 $0.00 Y
O 35045 REPAIR DEFECT OF ARM ARTERY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35045 REPAIR DEFECT OF ARM ARTERY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35081 REPAIR DEFECT OF ARTERY 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
O 35081 REPAIR DEFECT OF ARTERY 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 35082 REPAIR ARTERY RUPTURE AORTA 8.61 $320.55 --- $404.24 004 1 0 0.00 $0.00 Y
K 35082 REPAIR ARTERY RUPTURE AORTA 43.27 $1610.94 --- $2031.53 004 1 0 0.00 $0.00 Y
K 35091 REPAIR DEFECT OF ARTERY 40.32 $1501.11 --- $1893.02 004 1 0 0.00 $0.00 Y
O 35091 REPAIR DEFECT OF ARTERY 8.06 $300.07 --- $378.42 004 1 0 0.00 $0.00 Y
O 35092 REPAIR ARTERY RUPTURE AORTA 10.77 $400.97 --- $505.65 004 1 0 0.00 $0.00 Y
K 35092 REPAIR ARTERY RUPTURE AORTA 53.85 $2004.84 --- $2528.26 004 1 0 0.00 $0.00 Y
K 35102 REPAIR DEFECT OF ARTERY 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
O 35102 REPAIR DEFECT OF ARTERY 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 35103 REPAIR ARTERY RUPTURE AORTA 9.00 $335.07 --- $422.55 004 1 0 0.00 $0.00 Y
K 35103 REPAIR ARTERY RUPTURE AORTA 45.00 $1675.35 --- $2112.75 004 1 0 0.00 $0.00 Y
K 35111 REPAIR DEFECT OF ARTERY 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
O 35111 REPAIR DEFECT OF ARTERY 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
O 35112 REPAIR ARTERY RUPTURE SPLEEN 5.37 $199.93 --- $252.12 004 1 0 0.00 $0.00 Y
K 35112 REPAIR ARTERY RUPTURE SPLEEN 26.85 $999.63 --- $1260.61 004 1 0 0.00 $0.00 Y
K 35121 REPAIR DEFECT OF ARTERY 33.71 $1255.02 --- $1582.68 004 1 0 0.00 $0.00 Y
O 35121 REPAIR DEFECT OF ARTERY 6.74 $250.93 --- $316.44 004 1 0 0.00 $0.00 Y
O 35122 REPAIR ARTERY RUPTURE BELLY 9.22 $343.26 --- $432.88 004 1 0 0.00 $0.00 Y
K 35122 REPAIR ARTERY RUPTURE BELLY 46.08 $1715.56 --- $2163.46 004 1 0 0.00 $0.00 Y
K 35131 REPAIR DEFECT OF ARTERY 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35131 REPAIR DEFECT OF ARTERY 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35132 REPAIR ARTERY RUPTURE GROIN 6.39 $237.90 --- $300.01 004 1 0 0.00 $0.00 Y
K 35132 REPAIR ARTERY RUPTURE GROIN 31.95 $1189.50 --- $1500.05 004 1 0 0.00 $0.00 Y
K 35141 REPAIR DEFECT OF ARTERY 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35141 REPAIR DEFECT OF ARTERY 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35142 REPAIR ARTERY RUPTURE THIGH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35142 REPAIR ARTERY RUPTURE THIGH 47.54 $1769.91 --- $2232.00 004 1 0 0.00 $0.00 Y
K 35151 REPAIR DEFECT OF ARTERY 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35151 REPAIR DEFECT OF ARTERY 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35152 REPAIR RUPTD POPLITEAL ART 5.00 $186.15 --- $234.75 004 1 0 0.00 $0.00 Y
K 35152 REPAIR RUPTD POPLITEAL ART 25.00 $930.75 --- $1173.75 004 1 0 0.00 $0.00 Y
K 35180 REPAIR BLOOD VESSEL LESION 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35180 REPAIR BLOOD VESSEL LESION 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35182 REPAIR BLOOD VESSEL LESION 4.88 $181.68 --- $229.12 004 1 0 0.00 $0.00 Y
K 35182 REPAIR BLOOD VESSEL LESION 24.42 $909.16 --- $1146.52 004 1 0 0.00 $0.00 Y
K 35184 REPAIR BLOOD VESSEL LESION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 35184 REPAIR BLOOD VESSEL LESION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 35188 REPAIR BLOOD VESSEL LESION 4.22 $157.11 --- $198.13 004 1 0 0.00 $0.00 Y
K 35188 REPAIR BLOOD VESSEL LESION 21.10 $785.55 --- $990.65 004 1 0 0.00 $0.00 Y
K 35189 REPAIR BLOOD VESSEL LESION 26.54 $988.08 --- $1246.05 004 1 0 0.00 $0.00 Y
O 35189 .EPAIR BLOOD VESSEL LESION 5.31 $197.69 --- $249.30 004 1 0 0.00 $0.00 Y
O 35190 REPAIR BLOOD VESSEL LESION 3.43 $127.70 --- $161.04 004 1 0 0.00 $0.00 Y
K 35190 REPAIR BLOOD VESSEL LESION 17.13 $637.75 --- $804.25 004 1 0 0.00 $0.00 Y
K 35201 REPAIR BLOOD VESSEL LESION 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35201 REPAIR BLOOD VESSEL LESION 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35206 REPAIR BLOOD VESSEL LESION 2.76 $102.75 --- $129.58 004 1 0 0.00 $0.00 Y
K 35206 REPAIR BLOOD VESSEL LESION 13.78 $513.03 --- $646.97 004 1 0 0.00 $0.00 Y
K 35207 REPAIR BLOOD VESSEL LESION 16.38 $609.83 --- $769.04 004 1 0 0.00 $0.00 Y
O 35207 REPAIR BLOOD VESSEL LESION 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
O 35211 REPAIR BLOOD VESSEL LESION 7.30 $271.78 --- $342.74 004 1 0 0.00 $0.00 Y
K 35211 REPAIR BLOOD VESSEL LESION 36.49 $1358.52 --- $1713.21 004 1 0 0.00 $0.00 Y
K 35216 REPAIR BLOOD VESSEL LESION 29.42 $1095.31 --- $1381.27 004 1 0 0.00 $0.00 Y
O 35216 REPAIR BLOOD VESSEL LESION 5.88 $218.91 --- $276.07 004 1 0 0.00 $0.00 Y
O 35221 REPAIR BLOOD VESSEL LESION 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 35221 REPAIR BLOOD VESSEL LESION 34.00 $1265.82 --- $1596.30 004 1 0 0.00 $0.00 Y
K 35226 REPAIR BLOOD VESSEL LESION 14.29 $532.02 --- $670.92 004 1 0 0.00 $0.00 Y
O 35226 REPAIR BLOOD VESSEL LESION 2.86 $106.48 --- $134.28 004 1 0 0.00 $0.00 Y
O 35231 REPAIR BLOOD VESSEL LESION 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
K 35231 REPAIR BLOOD VESSEL LESION 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
K 35236 REPAIR BLOOD VESSEL LESION 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35236 REPAIR BLOOD VESSEL LESION 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35241 REPAIR BLOOD VESSEL LESION 9.51 $354.06 --- $446.49 004 1 0 0.00 $0.00 Y
K 35241 REPAIR BLOOD VESSEL LESION 47.54 $1769.91 --- $2232.00 004 1 0 0.00 $0.00 Y
K 35246 REPAIR BLOOD VESSEL LESION 38.22 $1422.93 --- $1794.43 004 1 0 0.00 $0.00 Y
O 35246 REPAIR BLOOD VESSEL LESION 7.64 $284.44 --- $358.70 004 1 0 0.00 $0.00 Y
O 35251 REPAIR BLOOD VESSEL LESION 4.52 $168.28 --- $212.21 004 1 0 0.00 $0.00 Y
K 35251 REPAIR BLOOD VESSEL LESION 22.61 $841.77 --- $1061.54 004 1 0 0.00 $0.00 Y
K 35256 REPAIR BLOOD VESSEL LESION 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35256 REPAIR BLOOD VESSEL LESION 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35261 REPAIR BLOOD VESSEL LESION 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35261 REPAIR BLOOD VESSEL LESION 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
K 35266 REPAIR BLOOD VESSEL LESION 14.91 $555.10 --- $700.02 004 1 0 0.00 $0.00 Y
O 35266 REPAIR BLOOD VESSEL LESION 2.98 $110.95 --- $139.91 004 1 0 0.00 $0.00 Y
O 35271 REPAIR BLOOD VESSEL LESION 7.30 $271.78 --- $342.74 004 1 0 0.00 $0.00 Y
K 35271 REPAIR BLOOD VESSEL LESION 36.48 $1358.15 --- $1712.74 004 1 0 0.00 $0.00 Y
K 35276 REPAIR BLOOD VESSEL LESION 36.17 $1346.61 --- $1698.18 004 1 0 0.00 $0.00 Y
O 35276 REPAIR BLOOD VESSEL LESION 7.23 $269.17 --- $339.45 004 1 0 0.00 $0.00 Y
O 35281 REPAIR BLOOD VESSEL LESION 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 35281 REPAIR BLOOD VESSEL LESION 34.00 $1265.82 --- $1596.30 004 1 0 0.00 $0.00 Y
K 35286 REPAIR BLOOD VESSEL LESION 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35286 REPAIR BLOOD VESSEL LESION 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35301 RECHANNELING OF ARTERY 6.00 $223.38 --- -- 004 0 0 0.00 $0.00 Y
K 35301 RECHANNELING OF ARTERY 30.00 $1116.90 --- -- 004 0 0 0.00 $0.00 Y
K 35302 RECHANNELING OF ARTERY 26.50 $986.66 --- -- 004 0 0 0.00 $0.00 Y
O 35302 RECHANNELING OF ARTERY 5.30 $197.33 --- -- 004 0 0 0.00 $0.00 Y
O 35303 RECHANNELING OF ARTERY 5.82 $216.80 --- -- 004 0 0 0.00 $0.00 Y
K 35303 RECHANNELING OF ARTERY 29.12 $1084.02 --- -- 004 0 0 0.00 $0.00 Y
K 35304 RECHANNELING OF ARTERY 30.29 $1127.65 --- -- 004 0 0 0.00 $0.00 Y
O 35304 RECHANNELING OF ARTERY 6.06 $225.53 --- -- 004 0 0 0.00 $0.00 Y
O 35305 RECHANNELING OF ARTERY 5.82 $216.80 --- -- 004 0 0 0.00 $0.00 Y
K 35305 RECHANNELING OF ARTERY 29.12 $1084.02 --- -- 004 0 0 0.00 $0.00 Y
K 35306 RECHANNELING OF ARTERY 10.87 $404.77 --- -- 004 0 0 0.00 $0.00 Y
O 35306 RECHANNELING OF ARTERY 2.17 $80.95 --- -- 004 0 0 0.00 $0.00 Y
O 35311 RECHANNELING OF ARTERY 6.57 $244.60 --- $308.46 004 1 0 0.00 $0.00 Y
K 35311 RECHANNELING OF ARTERY 32.87 $1223.75 --- $1543.25 004 1 0 0.00 $0.00 Y
K 35321 RECHANNELING OF ARTERY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 35321 RECHANNELING OF ARTERY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 35331 RECHANNELING OF ARTERY 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
K 35331 RECHANNELING OF ARTERY 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
K 35341 RECHANNELING OF ARTERY 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
O 35341 RECHANNELING OF ARTERY 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 35351 RECHANNELING OF ARTERY 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35351 RECHANNELING OF ARTERY 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
K 35355 RECHANNELING OF ARTERY 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35355 RECHANNELIMG OF ARTERY 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35361 RECHANNELING OF ARTERY 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35361 RECHANNELING OF ARTERY 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
K 35363 RECHANNELING OF ARTERY 32.06 $1193.59 --- $1505.22 004 1 0 0.00 $0.00 Y
O 35363 RECHANNELING OF ARTERY 6.41 $238.64 --- $300.95 004 1 0 0.00 $0.00 Y
O 35371 RECHANNELING OF ARTERY 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
K 35371 RECHANNELING OF ARTERY 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
K 35372 RECHANNELING OF ARTERY 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35372 RECHANNELING OF ARTERY 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35390 REOPERATION CAROTID ADD-ON 0.79 $29.41 --- $37.09 004 1 0 0.00 $0.00 Y
K 35390 REOPERATION CAROTID ADD-ON 3.94 $146.69 --- $184.98 004 1 0 0.00 $0.00 Y
K 35400 ANGIOSCOPY 3.78 $140.73 --- $177.47 004 1 0 0.00 $0.00 Y
O 35400 ANGIOSCOPY 1.70 $63.29 --- $79.82 004 1 0 0.00 $0.00 Y
O 35500 HARVEST VEIN FOR BYPASS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35500 HARVEST VEIN FOR BYPASS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35501 ART BYP GRFT IPSILAT CAROTID 30.00 $1116.90 --- -- 004 0 0 0.00 $0.00 Y
O 35501 ART BYP GRFT IPSILAT CAROTID 6.00 $223.38 --- -- 004 0 0 0.00 $0.00 Y
O 35506 ART BYP GRFT SUBCLAV-CAROTID 6.00 $223.38 --- -- 004 0 0 0.00 $0.00 Y
K 35506 ART BYP GRFT SUBCLAV-CAROTID 30.00 $1116.90 --- -- 004 0 0 0.00 $0.00 Y
K 35508 ART BYP GRFT CAROTID-VERTBRL 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35508 ART BYP GRFT CAROTID-VERTBRL 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35509 ART BYP GRFT CONTRAL CAROTID 6.40 $238.27 --- -- 004 0 0 0.00 $0.00 Y
K 35509 ART BYP GRFT CONTRAL CAROTID 32.00 $1191.36 --- -- 004 0 0 0.00 $0.00 Y
K 35510 ART BYP GRFT CAROTID-BRCHIAL 19.74 $735.09 --- $926.79 004 1 0 0.00 $0.00 Y
O 35510 ART BYP GRFT CAROTID-BRCHIAL 3.95 $147.02 --- $185.45 004 1 0 0.00 $0.00 Y
O 35511 ART BYP GRFT SUBCLAV-SUBCLAV 4.50 $167.54 --- $211.28 004 1 0 0.00 $0.00 Y
K 35511 ART BYP GRFT SUBCLAV-SUBCLAV 22.40 $833.95 --- $1051.68 004 1 0 0.00 $0.00 Y
K 35512 ART BYP GRFT SUBCLAV-BRCHIAL 19.34 $720.13 --- $908.01 004 1 0 0.00 $0.00 Y
O 35512 ART BYP GRFT SUBCLAV-BRCHIAL 3.87 $144.03 --- $181.70 004 1 0 0.00 $0.00 Y
O 35515 ART BYP GRFT SUBCLAV-VERTBRL 4.91 $182.80 --- $230.52 004 1 0 0.00 $0.00 Y
K 35515 ART BYP GRFT SUBCLAV-VERTBRL 24.42 $909.16 --- $1146.52 004 1 0 0.00 $0.00 Y
K 35516 ART BYP GRFT SUBCLAV-AXILARY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 35516 ART BYP GRFT SUBCLAV-AXILARY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 35518 ART BYP GRFT AXILLARY-AXILRY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 35518 ART BYP GRFT AXILLARY-AXILRY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 35521 ART BYP GRFT AXILL-FEMORAL 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 35521 ART BYP GRFT AXILL-FEMORAL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 35522 ART BYP GRFT AXILL-BRACHIAL 3.75 $139.65 --- $176.06 004 1 0 0.00 $0.00 Y
K 35522 ART BYP GRFT AXILL-BRACHIAL 18.76 $698.27 --- $880.78 004 1 0 0.00 $0.00 Y
K 35523 ART BYP GRFT BRCHL-ULNR-RDL 27.06 $1007.44 --- -- 004 0 0 0.00 $0.00 Y
O 35523 ART BYP GRFT BRCHL-ULNR-RDL 5.41 $201.41 --- -- 004 0 0 0.00 $0.00 Y
O 35525 ART BYP GRFT BRACHIAL-BRCHL 3.57 $132.89 --- $167.61 004 1 0 0.00 $0.00 Y
K 35525 ART BYP GRFT BRACHIAL-BRCHL 17.85 $664.56 --- $838.06 004 1 0 0.00 $0.00 Y
K 35526 ART BYP GRFT AOR/CAROT/INNOM 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35526 ART BYP GRFT AOR/CAROT/INNOM 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35531 ART BYP GRFT AORCEL/AORMESEN 6.61 $246.09 --- $310.34 004 1 0 0.00 $0.00 Y
K 35531 ART BYP GRFT AORCEL/AORMESEN 33.06 $1230.82 --- $1552.17 004 1 0 0.00 $0.00 Y
K 35533 ART BYP GRFT AXILL/FEM/FEM 30.15 $1122.48 --- $1415.54 004 1 0 0.00 $0.00 Y
O 35533 ART BYP GRFT AXILL/FEM/FEM 6.03 $224.50 --- $283.11 004 1 0 0.00 $0.00 Y
O 35535 ART BYP GRFT HEPATORENAL 8.00 $297.84 --- -- 004 0 0 0.00 $0.00 Y
K 35535 ART BYP GRFT HEPATORENAL 39.98 $1488.46 --- -- 004 0 0 0.00 $0.00 Y
K 35536 ART BYP GRFT SPLENORENAL 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35536 ART BYP GRFT SPLENORENAL 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35537 ART BYP GRFT AORTOILIAC 10.24 $381.13 --- -- 004 0 0 0.00 $0.00 Y
K 35537 ART BYP GRFT AORTOILIAC 51.19 $1905.66 --- -- 004 0 0 0.00 $0.00 Y
K 35538 ART BYP GRFT AORTOBI-ILIAC 57.17 $2128.57 --- -- 004 0 0 0.00 $0.00 Y
O 35538 ART BYP GRFT AORTOBI-ILIAC 11.43 $425.71 --- -- 004 0 0 0.00 $0.00 Y
O 35539 ART BYP GRFT AORTOFEMORAL 10.75 $400.09 --- -- 004 0 0 0.00 $0.00 Y
K 35539 ART BYP GRFT AORTOFEMORAL 53.73 $2000.44 --- -- 004 0 0 0.00 $0.00 Y
K 35540 ART BYP GRFT AORTBIFEMORAL 59.88 $2229.40 --- -- 004 0 0 0.00 $0.00 Y
O 35540 ART BYP GRFT AORTBIFEMORAL 11.98 $445.88 --- -- 004 0 0 0.00 $0.00 Y
O 35556 ART BYP GRFT FEM-POPLITEAL 5.69 $211.84 --- $267.15 004 1 0 0.00 $0.00 Y
K 35556 ART BYP GRFT FEM-POPLITEAL 28.47 $1059.94 --- $1336.67 004 1 0 0.00 $0.00 Y
K 35558 ART BYP GRFT FEM-FEMORAL 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 35558 ART BYP GRFT FEM-FEMORAL 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 35560 ART BYP GRFT AORTORENAL 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35560 ART BYP GRFT AORTORENAL 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
K 35563 ART BYP GRFT ILIOILIAC 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35563 ART BYP GRFT ILIOILIAC 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35565 ART BYP GRFT ILIOFEMORAL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 35565 ART BYP GRFT ILIOFEMORAL 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 35566 ART BYP FEM-ANT-POST TIB/PRL 30.13 $1121.74 --- $1414.60 004 1 0 0.00 $0.00 Y
O 35566 ART BYP FEM-ANT-POST TIB/PRL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 35570 ART BYP TIBIAL-TIB/PERONEAL 6.19 $230.45 --- -- 004 0 0 0.00 $0.00 Y
K 35570 ART BYP TIBIAL-TIB/PERONEAL 30.94 $1151.90 --- -- 004 0 0 0.00 $0.00 Y
K 35571 ART BYP POP-TIBL-PRL-OTHER 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35571 ART BYP POP-TIBL-PRL-OTHER 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35572 HARVEST FEMOROPOPLITEAL VEIN 1.16 $43.25 --- $54.46 004 1 0 0.00 $0.00 Y
K 35572 HARVEST FEMOROPOPLITEAL VEIN 5.89 $219.37 --- $276.54 004 1 0 0.00 $0.00 Y
K 35583 VEIN BYP GRFT FEM-POPLITEAL 30.13 $1121.74 --- $1414.60 004 1 0 0.00 $0.00 Y
O 35583 VEIN BYP GRFT FEM-POPLITEAL 6.03 $224.50 --- $283.11 004 1 0 0.00 $0.00 Y
O 35585 VEIN BYP FEM-TIBIAL PERONEAL 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
K 35585 VEIN BYP FEM-TIBIAL PERONEAL 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
K 35587 VEIN BYP POP-TIBL PERONEAL 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35587 VEIN BYP POP-TIBL PERONEAL 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35600 HARVEST ART FOR CABG ADD-ON 1.28 $47.65 --- $60.10 004 1 0 0.00 $0.00 Y
K 35600 HARVEST ART FOR CABG ADD-ON 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35601 ART BYP COMMON IPSI CAROTID 25.19 $937.82 --- -- 004 0 0 0.00 $0.00 Y
O 35601 ART BYP COMMON IPSI CAROTID 5.04 $187.64 --- -- 004 0 0 0.00 $0.00 Y
O 35606 ART BYP CAROTID-SUBCLAVIAN 4.87 $181.31 --- $228.65 004 1 0 0.00 $0.00 Y
K 35606 ART BYP CAROTID-SUBCLAVIAN 24.57 $914.74 --- $1153.56 004 1 0 0.00 $0.00 Y
K 35612 ART BYP SUBCLAV-SUBCLAVIAN 20.94 $779.60 --- $983.13 004 1 0 0.00 $0.00 Y
O 35612 ART BYP SUBCLAV-SUBCLAVIAN 4.17 $155.25 --- $195.78 004 1 0 0.00 $0.00 Y
O 35616 ART BYP SUBCLAV-AXILLARY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 35616 ART BYP SUBCLAV-AXILLARY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 35621 ART BYP AXILLARY-FEMORAL 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 35621 ART BYP AXILLARY-FEMORAL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 35623 ART BYP AXILLARY-POP-TIBIAL 3.84 $142.96 --- $180.29 004 1 0 0.00 $0.00 Y
K 35623 ART BYP AXILLARY-POP-TIBIAL 19.22 $715.56 --- $902.38 004 1 0 0.00 $0.00 Y
K 35626 ART BYP AORSUBCL/CAROT/INNOM 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
O 35626 ART BYP AORSUBCL/CAROT/INNOM 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 35631 ART BYP AOR-CELIAC-MSN-RENAL 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35631 ART BYP AOR-CELIAC-MSN-RENAL 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
K 35632 ART BYP ILIO-CELIAC 37.97 $1413.62 --- -- 004 0 0 0.00 $0.00 Y
O 35632 ART BYP ILIO-CELIAC 7.59 $282.58 --- -- 004 0 0 0.00 $0.00 Y
O 35633 ART BYP ILIO-MESENTERIC 8.20 $305.29 --- -- 004 0 0 0.00 $0.00 Y
K 35633 ART BYP ILIO-MESENTERIC 40.99 $1526.06 --- -- 004 0 0 0.00 $0.00 Y
K 35634 ART BYP ILIORENAL 37.16 $1383.47 --- -- 004 0 0 0.00 $0.00 Y
O 35634 ART BYP ILIORENAL 7.43 $276.62 --- -- 004 0 0 0.00 $0.00 Y
O 35636 ART BYP SPENORENAL 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
K 35636 ART BYP SPENORENAL 32.00 $1191.36 --- $1502.40 004 1 0 0.00 $0.00 Y
K 35637 ART BYP AORTOILIAC 40.78 $1518.26 --- -- 004 0 0 0.00 $0.00 Y
O 35637 ART BYP AORTOILIAC 8.16 $303.65 --- -- 004 0 0 0.00 $0.00 Y
O 35638 ART BYP AORTOBI-ILIAC 8.29 $308.46 --- -- 004 0 0 0.00 $0.00 Y
K 35638 ART BYP AORTOBI-ILIAC 41.43 $1542.28 --- -- 004 0 0 0.00 $0.00 Y
K 35642 ART BYP CAROTID-VERTEBRAL 23.20 $863.74 --- $1089.24 004 1 0 0.00 $0.00 Y
O 35642 ART BYP CAROTID-VERTEBRAL 4.60 $171.26 --- $215.97 004 1 0 0.00 $0.00 Y
O 35645 ART BYP SUBCLAV-VERTEBRL 4.60 $171.26 --- $215.97 004 1 0 0.00 $0.00 Y
K 35645 ART BYP SUBCLAV-VERTEBRL 23.20 $863.74 --- $1089.24 004 1 0 0.00 $0.00 Y
K 35646 ART BYP AORTOBIFEMORAL 33.64 $1252.42 --- $1579.40 004 1 0 0.00 $0.00 Y
O 35646 ART BYP AORTOBIFEMORAL 7.15 $266.19 --- $335.69 004 1 0 0.00 $0.00 Y
O 35647 ART BYP AORTOFEMORAL 6.97 $259.49 --- $327.24 004 1 0 0.00 $0.00 Y
K 35647 ART BYP AORTOFEMORAL 34.87 $1298.21 --- $1637.15 004 1 0 0.00 $0.00 Y
K 35650 ART BYP AXILLARY-AXILLARY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 35650 ART BYP AXILLARY-AXILLARY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 35654 ART BYP AXILL-FEM-FEMORAL 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
K 35654 ART BYP AXILL-FEM-FEMORAL 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
K 35656 ART BYP FEMORAL-POPLITEAL 21.63 $805.28 --- $1015.53 004 1 0 0.00 $0.00 Y
O 35656 ART BYP FEMORAL-POPLITEAL 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
O 35661 ART BYP FEMORAL-FEMORAL 3.80 $141.47 --- $178.41 004 1 0 0.00 $0.00 Y
K 35661 ART BYP FEMORAL-FEMORAL 19.10 $711.09 --- $896.75 004 1 0 0.00 $0.00 Y
K 35663 ART BYP ILIOILIAC 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
O 35663 ART BYP ILIOILIAC 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
O 35665 ART BYP ILIOFEMORAL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35665 ART BYP ILIOFEMORAL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35666 ART BYP FEM-ANT-POST TIB/PRL 23.56 $877.14 --- $1106.14 004 1 0 0.00 $0.00 Y
O 35666 ART BYP FEM-ANT-POST TIB/PRL 4.77 $177.59 --- $223.95 004 1 0 0.00 $0.00 Y
O 35671 ART BYP POP-TIBL-PRL-OTHER 5.20 $193.60 --- $244.14 004 1 0 0.00 $0.00 Y
K 35671 ART BYP POP-TIBL-PRL-OTHER 26.00 $967.98 --- $1220.70 004 1 0 0.00 $0.00 Y
K 35681 COMPOSITE BYP GRFT PROS&VEIN 5.12 $190.62 --- $240.38 004 1 0 0.00 $0.00 Y
O 35681 COMPOSITE BYP GRFT PROS&VEIN 1.02 $37.97 --- $47.89 004 1 0 0.00 $0.00 Y
O 35682 COMPOSITE BYP GRFT 2 VEINS 2.02 $75.20 --- $94.84 004 1 0 0.00 $0.00 Y
K 35682 COMPOSITE BYP GRFT 2 VEINS 10.10 $376.02 --- $474.20 004 1 0 0.00 $0.00 Y
K 35683 COMPOSITE BYP GRFT 3/> SEGMT 11.62 $432.61 --- $545.56 004 1 0 0.00 $0.00 Y
O 35683 COMPOSITE BYP GRFT 3/> SEGMT 2.32 $86.37 --- $108.92 004 1 0 0.00 $0.00 Y
O 35685 BYPASS GRAFT PATENCY/PATCH 0.97 $36.11 --- $45.54 004 1 0 0.00 $0.00 Y
K 35685 BYPASS GRAFT PATENCY/PATCH 4.83 $179.82 --- $226.77 004 1 0 0.00 $0.00 Y
K 35686 BYPASS GRAFT/AV FIST PATENCY 3.99 $148.55 --- $187.33 004 1 0 0.00 $0.00 Y
O 35686 BYPASS GRAFT/AV FIST PATENCY 0.80 $29.78 --- $37.56 004 1 0 0.00 $0.00 Y
O 35691 ART TRNSPOSJ VERTBRL CAROTID 5.51 $205.14 --- $258.69 004 1 0 0.00 $0.00 Y
K 35691 ART TRNSPOSJ VERTBRL CAROTID 27.56 $1026.06 --- $1293.94 004 1 0 0.00 $0.00 Y
K 35693 ART TRNSPOSJ SUBCLAVIAN 19.33 $719.66 --- $907.54 004 1 0 0.00 $0.00 Y
O 35693 ART TRNSPOSJ SUBCLAVIAN 3.86 $143.71 --- $181.23 004 1 0 0.00 $0.00 Y
O 35694 ART TRNSPOSJ SUBCLAV CAROTID 4.45 $165.67 --- $208.93 004 1 0 0.00 $0.00 Y
K 35694 ART TRNSPOSJ SUBCLAV CAROTID 22.28 $829.48 --- $1046.05 004 1 0 0.00 $0.00 Y
K 35695 ART TRNSPOSJ CAROTID SUBCLAV 22.28 $829.48 --- $1046.05 004 1 0 0.00 $0.00 Y
O 35695 ART TRNSPOSJ CAROTID SUBCLAV 4.45 $165.67 --- $208.93 004 1 0 0.00 $0.00 Y
O 35697 REIMPLANT ARTERY EACH 0.53 $19.82 --- $24.88 004 1 0 0.00 $0.00 Y
K 35697 REIMPLANT ARTERY EACH 2.66 $99.11 --- $124.89 004 1 0 0.00 $0.00 Y
K 35700 REOPERATION BYPASS GRAFT 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
O 35700 REOPERATION BYPASS GRAFT 0.77 $28.67 --- $36.15 004 1 0 0.00 $0.00 Y
O 35701 EXPL N/FLWD SURG NECK ART 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
K 35701 EXPL N/FLWD SURG NECK ART 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 35702 EXPL N/FLWD SURG UXTR ART 9.43 $351.34 --- -- 004 0 0 0.00 $0.00 Y
O 35702 EXPL N/FLWD SURG UXTR ART 1.88 $70.27 --- -- 004 0 0 0.00 $0.00 Y
O 35703 EXPL N/FLWD SURG LXTR ART 1.90 $70.78 --- -- 004 0 0 0.00 $0.00 Y
P 35703 EXPL N/FLWD SURG LXTR ART 9.50 $353.88 --- -- 015 0 0 0.00 $0.00 Y
K 35703 EXPL N/FLWD SURG LXTR ART 9.50 $353.88 --- -- 004 0 0 0.00 $0.00 Y
K 35800 EXPLORE NECK FOR POSTOP HEMOR, ETC 10.66 $396.87 --- $500.49 004 1 0 0.00 $0.00 Y
O 35800 EXPLORE NECK FOR POSTOP HEMOR, ETC 2.13 $79.30 --- $100.00 004 1 0 0.00 $0.00 Y
O 35820 EXPLORE CHEST VESSELS 3.27 $121.74 --- $153.53 004 1 0 0.00 $0.00 Y
K 35820 EXPLORE CHEST VESSELS 16.37 $609.46 --- $768.57 004 1 0 0.00 $0.00 Y
K 35840 EXPLORE ABDOMINAL VESSELS 13.51 $502.98 --- $634.29 004 1 0 0.00 $0.00 Y
O 35840 EXPLORE ABDOMINAL VESSELS 2.70 $100.52 --- $126.77 004 1 0 0.00 $0.00 Y
O 35860 EXPLORE LIMB VESSELS 1.67 $62.17 --- $78.41 004 1 0 0.00 $0.00 Y
K 35860 EXPLORE LIMB VESSELS 8.35 $310.87 --- $392.03 004 1 0 0.00 $0.00 Y
K 35870 REPAIR VESSEL GRAFT DEFECT 29.27 $1089.72 --- $1374.23 004 1 0 0.00 $0.00 Y
O 35870 REPAIR VESSEL GRAFT DEFECT 5.85 $217.80 --- $274.66 004 1 0 0.00 $0.00 Y
O 35875 REMOVAL OF CLOT IN GRAFT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 35875 REMOVAL OF CLOT IN GRAFT 7.80 $290.39 --- $366.21 004 1 0 0.00 $0.00 Y
K 35876 THROMBECTOMY OF ARTERIAL/VENOUS GRAFT 17.36 $646.31 --- $815.05 004 1 0 0.00 $0.00 Y
O 35876 THROMBECTOMY OF ARTERIAL/VENOUS GRAFT 3.48 $129.56 --- $163.39 004 1 0 0.00 $0.00 Y
O 35879 REVISE GRAFT W/VEIN 3.48 $129.56 --- $163.39 004 1 0 0.00 $0.00 Y
K 35879 REVISE GRAFT W/VEIN 17.41 $648.17 --- $817.40 004 1 0 0.00 $0.00 Y
K 35881 REVISE GRAFT W/VEIN 19.05 $709.23 --- $894.40 004 1 0 0.00 $0.00 Y
O 35881 REVISE GRAFT W/VEIN 3.81 $141.85 --- $178.88 004 1 0 0.00 $0.00 Y
O 35883 REVISE GRAFT W/NONAUTO GRAFT 5.97 $222.34 --- -- 004 0 0 0.00 $0.00 Y
K 35883 REVISE GRAFT W/NONAUTO GRAFT 29.86 $1111.69 --- -- 004 0 0 0.00 $0.00 Y
K 35884 REVISE GRAFT W/VEIN 31.70 $1180.34 --- -- 004 0 0 0.00 $0.00 Y
O 35884 REVISE GRAFT W/VEIN 6.34 $236.07 --- -- 004 0 0 0.00 $0.00 Y
O 35901 EXCISION GRAFT NECK 2.47 $91.96 --- $115.97 004 1 0 0.00 $0.00 Y
K 35901 EXCISION GRAFT NECK 12.33 $459.05 --- $578.89 004 1 0 0.00 $0.00 Y
K 35903 EXCISION GRAFT EXTREMITY 13.33 $496.28 --- $625.84 004 1 0 0.00 $0.00 Y
O 35903 EXCISION GRAFT EXTREMITY 2.66 $99.03 --- $124.89 004 1 0 0.00 $0.00 Y
O 35905 EXCISION GRAFT THORAX 3.84 $142.96 --- $180.29 004 1 0 0.00 $0.00 Y
K 35905 EXCISION GRAFT THORAX 19.19 $714.44 --- $900.97 004 1 0 0.00 $0.00 Y
K 35907 EXCISION GRAFT ABDOMEN 19.75 $735.29 --- $927.26 004 1 0 0.00 $0.00 Y
O 35907 EXCISION GRAFT ABDOMEN 3.95 $147.06 --- $185.45 004 1 0 0.00 $0.00 Y
K 36000 ESTABLISH ACCESS TO VEIN 0.70 $26.06 --- $32.87 004 1 1 0.00 $0.00 Y
K 36002 PSEUDOANEURYSM INJECTION TRT 4.20 $156.37 --- $197.19 004 1 0 0.00 $0.00 Y
O 36002 PSEUDOANEURYSM INJECTION TRT 0.84 $31.27 --- $39.44 004 1 0 0.00 $0.00 Y
K 36005 INJECTION EXT VENOGRAPHY 7.72 $287.42 --- $362.45 004 1 0 0.00 $0.00 Y
K 36010 PLACE CATHETER IN VEIN 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 36011 PLACE CATHETER IN VEIN 2.17 $80.79 --- $101.88 004 1 0 0.00 $0.00 Y
K 36012 PLACE CATHETER IN VEIN 3.05 $113.55 --- $143.20 004 1 0 0.00 $0.00 Y
K 36013 PLACE CATHETER IN ARTERY 2.17 $80.79 --- $101.88 004 1 0 0.00 $0.00 Y
K 36014 PLACE CATHETER IN ARTERY 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
K 36015 PLACE CATHETER IN ARTERY 3.05 $113.55 --- $143.20 004 1 0 0.00 $0.00 Y
K 36100 ESTABLISH ACCESS TO ARTERY 5.00 $186.15 --- $234.75 004 1 1 0.00 $0.00 Y
K 36140 INTRO NDL ICATH UPR/LXTR ART 2.27 $84.51 --- $106.58 004 1 1 0.00 $0.00 Y
K 36160 ESTABLISH ACCESS TO AORTA 3.00 $111.69 --- $140.85 004 1 1 0.00 $0.00 Y
K 36200 ESTABLISH ACCESS TO AORTA 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 36215 PLACE CATHETER IN ARTERIES 4.84 $180.19 --- $227.24 004 1 0 0.00 $0.00 Y
O 36215 PLACE CATHETER IN ARTERIES 0.96 $35.74 --- $45.07 004 1 0 0.00 $0.00 Y
O 36216 PLACE CATHETER IN ARTERIES 1.18 $43.93 --- $55.40 004 1 0 0.00 $0.00 Y
K 36216 PLACE CATHETER IN ARTERIES 5.88 $218.91 --- $276.07 004 1 0 0.00 $0.00 Y
K 36217 PLACE CATHETER IN ARTERIES 7.06 $262.84 --- $331.47 004 1 0 0.00 $0.00 Y
O 36217 PLACE CATHETER IN ARTERIES 1.41 $52.49 --- $66.20 004 1 0 0.00 $0.00 Y
O 36218 PLACE CATHETER IN ARTERY 0.23 $8.56 --- $10.80 004 1 0 0.00 $0.00 Y
K 36218 PLACE CATHETER IN ARTERY 1.16 $43.19 --- $54.46 004 1 0 0.00 $0.00 Y
K 36221 PLACE CATH THORACIC AORTA 4.67 $173.86 --- -- 004 0 0 0.00 $0.00 Y
K 36222 PLACE CATH CAROTID/INOM ART 6.39 $237.90 --- -- 004 0 0 0.00 $0.00 Y
K 36223 PLACE CATH CAROTID/INOM ART 6.90 $256.89 --- -- 004 0 0 0.00 $0.00 Y
K 36224 PLACE CATH CAROTD ART 7.54 $280.71 --- -- 004 0 0 0.00 $0.00 Y
K 36225 PLACE CATH SUBCLAVIAN ART 6.87 $255.77 --- -- 004 0 0 0.00 $0.00 Y
K 36226 PLACE CATH VERTEBRAL ART 7.56 $281.46 --- -- 004 0 0 0.00 $0.00 Y
K 36227 PLACE CATH XTRNL CAROTID 2.38 $88.61 --- -- 004 0 0 0.00 $0.00 Y
K 36228 PLACE CATH INTRACRANIAL ART 4.87 $181.31 --- -- 004 0 0 0.00 $0.00 Y
K 36245 PLACE CATHETER IN ARTERIES 5.45 $202.90 --- $255.88 004 1 0 0.00 $0.00 Y
K 36246 PLACE CATHETER IN ARTERIES 6.54 $243.48 --- $307.05 004 1 0 0.00 $0.00 Y
K 36247 PLACE CATHETER IN ARTERIES 7.78 $289.65 --- $365.27 004 1 0 0.00 $0.00 Y