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Medi-Cal Rates Information

Medi-Cal Rates as of 02/15/2020 (Codes 42800 thru 45332)

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 42800 BIOPSY OF THROAT 1.78 $66.27 --- $83.57 004 1 1 0.00 $0.00 Y
K 42804 BIOPSY OF UPPER NOSE/THROAT 1.68 $62.55 --- $78.88 004 1 0 0.00 $0.00 Y
K 42806 BIOPSY OF UPPER NOSE/THROAT 3.74 $139.24 --- $175.59 004 1 1 0.00 $0.00 Y
O 42806 BIOPSY OF UPPER NOSE/THROAT 0.75 $27.92 --- $35.21 004 1 0 0.00 $0.00 Y
O 42808 EXCISION OR DESTRUCTION PHARYNX LESION 1.06 $39.46 --- $49.77 004 1 0 0.00 $0.00 Y
K 42808 EXCISION OR DESTRUCTION PHARYNX LESION 5.30 $197.32 --- $248.84 004 1 0 0.00 $0.00 Y
K 42809 REMOVE PHARYNX FOREIGN BODY 3.99 $148.55 --- $187.33 004 1 0 0.00 $0.00 Y
K 42810 EXCISION OF NECK CYST 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 42815 EXCISION OF NECK CYST 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 42815 EXCISION OF NECK CYST 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 42820 REMOVE TONSILS AND ADENOIDS 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 42821 REMOVE TONSILS AND ADENOIDS 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 42825 REMOVAL OF TONSILS 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 42826 REMOVAL OF TONSILS 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 42830 REMOVAL OF ADENOIDS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 42831 REMOVAL OF ADENOIDS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 42835 REMOVAL OF ADENOIDS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 42836 REMOVAL OF ADENOIDS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 42842 EXTENSIVE SURGERY OF THROAT 13.84 $515.26 --- $649.79 004 1 0 0.00 $0.00 Y
O 42842 EXTENSIVE SURGERY OF THROAT 2.77 $103.13 --- $130.05 004 1 0 0.00 $0.00 Y
O 42844 EXTENSIVE SURGERY OF THROAT 4.74 $176.47 --- $222.54 004 1 0 0.00 $0.00 Y
K 42844 EXTENSIVE SURGERY OF THROAT 23.72 $883.10 --- $1113.65 004 1 0 0.00 $0.00 Y
K 42845 EXTENSIVE SURGERY OF THROAT 39.31 $1463.51 --- $1845.60 004 1 0 0.00 $0.00 Y
O 42845 EXTENSIVE SURGERY OF THROAT 7.86 $292.63 --- $369.03 004 1 0 0.00 $0.00 Y
K 42860 EXCISION OF TONSIL TAGS 3.17 $118.02 --- $148.83 004 1 1 0.00 $0.00 Y
K 42870 EXCISION OR DESTRUCTION LINGUAL TONSIL 5.44 $202.53 --- $255.41 004 1 1 0.00 $0.00 Y
K 42890 PARTIAL REMOVAL OF PHARYNX 20.08 $747.58 --- $942.76 004 1 0 0.00 $0.00 Y
O 42890 PARTIAL REMOVAL OF PHARYNX 4.02 $149.66 --- $188.74 004 1 0 0.00 $0.00 Y
O 42892 REVISION OF PHARYNGEAL WALLS 4.78 $177.96 --- $224.42 004 1 0 0.00 $0.00 Y
K 42892 REVISION OF PHARYNGEAL WALLS 23.90 $889.80 --- $1122.11 004 1 0 0.00 $0.00 Y
K 42894 REVISION OF PHARYNGEAL WALLS 37.16 $1383.47 --- $1744.66 004 1 0 0.00 $0.00 Y
O 42894 REVISION OF PHARYNGEAL WALLS 7.43 $276.62 --- $348.84 004 1 0 0.00 $0.00 Y
O 42900 REPAIR THROAT WOUND 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 42900 REPAIR THROAT WOUND 4.15 $154.50 --- $194.84 004 1 0 0.00 $0.00 Y
K 42950 RECONSTRUCTION OF THROAT 6.98 $259.87 --- $327.71 004 1 0 0.00 $0.00 Y
O 42950 RECONSTRUCTION OF THROAT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 42953 REPAIR THROAT ESOPHAGUS 3.33 $123.98 --- $156.34 004 1 0 0.00 $0.00 Y
K 42953 REPAIR THROAT ESOPHAGUS 16.65 $619.88 --- $781.72 004 1 0 0.00 $0.00 Y
K 42955 SURGICAL OPENING OF THROAT 12.99 $483.62 --- $609.88 004 1 0 0.00 $0.00 Y
O 42955 SURGICAL OPENING OF THROAT 2.60 $96.80 --- $122.07 004 1 0 0.00 $0.00 Y
K 42960 CONTROL THROAT BLEEDING 1.99 $74.09 --- $93.43 004 1 0 0.00 $0.00 Y
K 42961 CONTROL THROAT BLEEDING 9.02 $335.81 --- $423.49 004 1 0 0.00 $0.00 Y
O 42961 CONTROL THROAT BLEEDING 1.80 $67.01 --- $84.51 004 1 0 0.00 $0.00 Y
K 42962 CONTROL THROAT BLEEDING 11.08 $412.51 --- $520.21 004 1 0 0.00 $0.00 Y
K 42970 CONTROL NOSE/THROAT BLEEDING 4.14 $154.13 --- $194.37 004 1 0 0.00 $0.00 Y
K 42971 CONTROL NOSE/THROAT BLEEDING 11.18 $416.23 --- $524.90 004 1 0 0.00 $0.00 Y
O 42971 CONTROL NOSE/THROAT BLEEDING 2.24 $83.40 --- $105.17 004 1 0 0.00 $0.00 Y
K 42972 CONTROL NOSE/THROAT BLEEDING 12.22 $454.95 --- $573.73 004 1 0 0.00 $0.00 Y
K 42999 THROAT SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 42999 THROAT SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43020 INCISION OF ESOPHAGUS 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
K 43020 INCISION OF ESOPHAGUS 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 43030 THROAT MUSCLE SURGERY 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
O 43030 THROAT MUSCLE SURGERY 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
O 43045 ESOPHAGOTOMY,THORACIC W/REMOVAL FOREIGN 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 43045 ESOPHAGOTOMY THORACIC W/REMOVAL FOREIGN 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
K 43100 EXCISION OF LESION ESOPHAGUS PRIM/REPAIR 19.00 $707.37 --- $892.05 004 1 0 0.00 $0.00 Y
O 43100 EXCISION OF LESION,ESOPHAGUS PRIM/REPAIR 3.80 $141.47 --- $178.41 004 1 0 0.00 $0.00 Y
O 43101 EXCISION OF LESION,ESOPHAGUS PRIM/REPAIR 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 43101 EXCISION OF LESION,ESOPHAGUS PRIM/REPAIR 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
K 43107 TOTAL ESOPHAGECTOMY WITHOUT THORACOTOMY 45.54 $1695.45 --- $2138.10 004 1 0 0.00 $0.00 Y
O 43107 TOTAL ESOPHAGECTOMY WITHOUT THORACOTOMY 9.11 $339.17 --- $427.71 004 1 0 0.00 $0.00 Y
O 43108 REMOVAL OF ESOPHAGUS 10.55 $392.78 --- $495.32 004 1 0 0.00 $0.00 Y
K 43108 REMOVAL OF ESOPHAGUS 52.77 $1964.63 --- $2477.55 004 1 0 0.00 $0.00 Y
K 43112 TOTAL ESOPHAGECTOMY WITH THORACOTOMY 46.70 $1738.64 --- $2192.57 004 1 0 0.00 $0.00 Y
O 43112 TOTAL ESOPHAGECTOMY WITH THORACOTOMY 9.34 $347.73 --- $438.51 004 1 0 0.00 $0.00 Y
O 43113 REMOVAL OF ESOPHAGUS 10.72 $399.11 --- $503.30 004 1 0 0.00 $0.00 Y
K 43113 REMOVAL OF ESOPHAGUS 53.59 $1995.16 --- $2516.05 004 1 0 0.00 $0.00 Y
K 43116 PARTIAL ESOPHAGECTOMY CERVIAL W/F GRAFT 50.32 $1873.41 --- $2362.52 004 1 0 0.00 $0.00 Y
O 43116 PARTIAL ESOPHAGECTOMY CERVICAL 10.06 $374.53 --- $472.32 004 1 0 0.00 $0.00 Y
O 43117 PARTIAL ESOPHAGECTOMY DISTAL TWOTHIRDS 9.86 $367.09 --- $462.93 004 1 0 0.00 $0.00 Y
K 43117 PARTIAL ESOPHAGECTOMY DISTAL TWOTHIRD 49.32 $1836.18 --- $2315.57 004 1 0 0.00 $0.00 Y
K 43118 PARTIAL REMOVAL OF ESOPHAGUS 51.96 $1934.47 --- $2439.52 004 1 0 0.00 $0.00 Y
O 43118 PARTIAL REMOVAL OF ESOPHAGUS 10.39 $386.82 --- $487.81 004 1 0 0.00 $0.00 Y
O 43121 PARTIAL ESOPHAGECTOMY DISTAL TWOTHIRD 8.96 $333.58 --- $420.67 004 1 0 0.00 $0.00 Y
K 43121 PARTIAL ESOPHAGECTOMY DISTAL TWOTHIRD 44.78 $1667.16 --- $2102.42 004 1 0 0.00 $0.00 Y
K 43122 PARTIAL REMOVAL OF ESOPHAGUS 44.78 $1667.16 --- $2102.42 004 1 0 0.00 $0.00 Y
O 43122 PARTIAL REMOVAL OF ESOPHAGUS 8.96 $333.58 --- $420.67 004 1 0 0.00 $0.00 Y
O 43123 PARTIAL REMOVAL OF ESOPHAGUS 10.39 $386.82 --- $487.81 004 1 0 0.00 $0.00 Y
K 43123 PARTIAL REMOVAL OF ESOPHAGUS 51.96 $1934.47 --- $2439.52 004 1 0 0.00 $0.00 Y
K 43124 ESOPHAGECTOMY WITHOUT RECONSTUCTION 43.50 $1619.51 --- $2042.33 004 1 0 0.00 $0.00 Y
O 43124 ESOPHAGECTOMY WITHOUT RECONSTRUCTION 8.70 $323.90 --- $408.47 004 1 0 0.00 $0.00 Y
O 43130 REMOVAL OF ESOPHAGUS POUCH 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 43130 REMOVAL OF ESOPHAGUS POUCH 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 43135 REMOVAL OF ESOPHAGUS POUCH 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 43135 REMOVAL OF ESOPHAGUS POUCH 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 43180 ESOPHAGOSCOPY RIGID TRNSO 13.05 $485.85 --- -- 004 0 0 0.00 $0.00 Y
K 43191 ESOPHAGOSCOPY RIGID TRNSO DX 2.97 $110.57 --- -- 004 0 0 0.00 $0.00 Y
K 43192 ESOPHAGOSCP RIG TRNSO INJECT 3.53 $131.42 --- -- 004 0 0 0.00 $0.00 Y
K 43193 ESOPHAGOSCP RIG TRNSO BIOPSY 4.20 $156.37 --- -- 004 0 0 0.00 $0.00 Y
K 43194 ESOPHAGOSCP RIG TRNSO REM FB 3.77 $140.36 --- -- 004 0 0 0.00 $0.00 Y
K 43195 ESOPHAGOSCOPY RIGID BALLOON 4.21 $156.74 --- -- 004 0 0 0.00 $0.00 Y
K 43196 ESOPHAGOSCP GUIDE WIRE DILAT 4.59 $170.89 --- -- 004 0 0 0.00 $0.00 Y
K 43197 ESOPHAGOSCOPY FLEX DX BRUSH 1.86 $69.25 --- -- 004 0 0 0.00 $0.00 Y
K 43198 ESOPHAGOSC FLEX TRNSN BIOPY 2.21 $82.28 --- -- 004 0 0 0.00 $0.00 Y
K 43200 ESOPHAGUS ENDOSCOPY 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 43201 ESOPH SCOPE W/SUBMUCOUS INJ 5.63 $209.42 --- $264.33 004 1 0 0.00 $0.00 Y
K 43202 ESOPHAGUS ENDOSCOPY BIOPSY 4.87 $181.31 --- $228.65 004 1 0 0.00 $0.00 Y
K 43204 ESOPH SCOPE W/SCLEROSIS INJ 7.50 $279.23 --- $352.13 004 1 0 0.00 $0.00 Y
K 43205 ESOPHAGOSCOPY, RIGID OR FLEXIBLE 4.76 $177.21 --- $223.48 004 1 0 0.00 $0.00 Y
K 43206 ESOPH OPTICAL ENDOMICROSCOPY 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 43210 EGD ESOPHAGOGASTRC FNDOPLSTY 10.01 $372.84 --- -- 004 0 0 0.00 $0.00 Y
K 43211 ESOPHAGOSCOP MUCOSAL RESECT 5.67 $211.09 --- -- 004 0 0 0.00 $0.00 Y
K 43212 ESOPHAGOSCOP STENT PLACEMENT 4.44 $165.30 --- -- 004 0 0 0.00 $0.00 Y
K 43213 ESOPHAGOSCOPY RETRO BALLOON 6.29 $234.18 --- -- 004 0 0 0.00 $0.00 Y
K 43214 ESOPHAGOSC DILATE BALLOON 30 4.56 $169.77 --- -- 004 0 0 0.00 $0.00 Y
K 43215 ESOPHAGUS ENDOSCOPY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 43216 ESOPHAGOSCOPY, RIGID OR FLEXIBLE 5.32 $198.06 --- $249.77 004 1 0 0.00 $0.00 Y
K 43217 ESOPHAGUS ENDOSCOPY 3.82 $142.22 --- $179.35 004 1 0 0.00 $0.00 Y
K 43220 ESOPH ENDOSCOPY DILATION 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 43226 ESOPH ENDOSCOPY DILATION 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 43227 ESOPH ENDOSCOPY REPAIR 4.63 $172.37 --- $217.38 004 1 0 0.00 $0.00 Y
K 43229 ESOPHAGOSCOPY LESION ABLATE 4.81 $179.08 --- -- 004 0 0 0.00 $0.00 Y
K 43231 ESOPH ENDOSCOPY W/US EXAM 5.34 $198.81 --- $250.71 004 1 0 0.00 $0.00 Y
K 43232 ESOPH ENDOSCOPY W/US FN BX 6.21 $231.20 --- $291.56 004 1 0 0.00 $0.00 Y
K 43233 EGD BALLOON DIL ESOPH30 MM/> 5.41 $201.41 --- -- 004 0 0 0.00 $0.00 Y
K 43235 UPPR GI ENDOSCOPY DIAGNOSIS 6.02 $224.12 --- $282.64 004 1 0 0.00 $0.00 Y
K 43236 UPPR GI SCOPE W/SUBMUC INJ 6.53 $243.18 --- $306.58 004 1 0 0.00 $0.00 Y
K 43237 ENDOSCOPIC US EXAM ESOPH 3.36 $125.12 --- $157.75 004 1 0 0.00 $0.00 Y
K 43239 UPPER GI ENDOSCOPY BIOPSY 6.29 $234.18 --- $295.32 004 1 0 0.00 $0.00 Y
K 43240 ESOPH ENDOSCOPE W/DRAIN CYST 9.40 $349.96 --- $441.33 004 1 0 0.00 $0.00 Y
K 43241 UPPER GI ENDOSCOPY WITH TUBE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43242 UPPR GI ENDOSCOPY W/US FN BX 6.74 $250.93 --- $316.44 004 1 0 0.00 $0.00 Y
K 43243 UPPER GI ENDOSCOPY & INJECT 8.20 $305.29 --- $384.99 004 1 0 0.00 $0.00 Y
K 43244 UPPER GASTRO ENDOSCOPY, INC ESOPH,STOMAC 5.77 $214.82 --- $270.90 004 1 0 0.00 $0.00 Y
K 43245 UPPR GI SCOPE DILATE STRICTR 6.50 $242.00 --- $305.18 004 1 0 0.00 $0.00 Y
K 43246 OPERATIVE UPPER GI ENDOSCOPY PERCUT TUBE 6.50 $242.00 --- $305.18 004 1 0 0.00 $0.00 Y
K 43247 OPERATIVE UPPER GI ENDOSCOPY 6.86 $255.40 --- $322.08 004 1 0 0.00 $0.00 Y
O 43247 OPERATIVE UPPER GI ENDOSCOPY 1.37 $51.01 --- $64.32 004 1 0 0.00 $0.00 Y
K 43248 UPPR GI ENDOSCOPY/GUIDE WIRE 3.97 $147.80 --- $186.39 004 1 0 0.00 $0.00 Y
K 43249 ESOPH ENDOSCOPY DILATION 5.99 $223.01 --- $281.23 004 1 0 0.00 $0.00 Y
O 43249 ESOPH ENDOSCOPY DILATION 1.20 $44.68 --- $56.34 004 1 0 0.00 $0.00 Y
K 43250 UPPER GASTRO ENDOSCOPY INC ESOPH, STOMAC 6.58 $244.97 --- $308.93 004 1 0 0.00 $0.00 Y
K 43251 OPERATIVE UPPER GI ENDOSCOPY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43252 UPPR GI OPTICL ENDOMICRSCOPY 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 43253 EGD US TRANSMURAL INJXN/MARK 6.27 $233.43 --- -- 004 0 0 0.00 $0.00 Y
K 43254 EGD ENDO MUCOSAL RESECTION 6.50 $242.00 --- -- 004 0 0 0.00 $0.00 Y
K 43255 OPERATIVE UPPER GI ENDOSCOPY 7.73 $287.79 --- $362.92 004 1 0 0.00 $0.00 Y
O 43255 OPERATIVE UPPER GI ENDOSCOPY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43257 UPPR GI SCOPE W/THRML TXMNT 0.97 $36.19 --- $45.54 004 1 0 0.00 $0.00 Y
K 43257 UPPR GI SCOPE W/THRML TXMNT 4.86 $180.97 --- $228.18 004 1 0 0.00 $0.00 Y
K 43259 ENDOSCOPIC ULTRASOUND EXAM 5.58 $207.74 --- $261.98 004 1 0 0.00 $0.00 Y
K 43260 ENDO CHOLANGIOPANCREATOGRAPH 8.30 $309.01 --- $389.69 004 1 0 0.00 $0.00 Y
O 43260 ENDO CHOLANGIOPANCREATOGRAPH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43261 ENDO CHOLANGIOPANCREATOGRAPH 9.16 $341.03 --- $430.06 004 1 0 0.00 $0.00 Y
K 43262 ENDO CHOLANGIOPANCREATOGRAPH 9.95 $370.44 --- $467.15 004 1 0 0.00 $0.00 Y
K 43263 ENDO CHOLANGIOPANCREATOGRAPH 7.17 $266.94 --- $336.63 004 1 0 0.00 $0.00 Y
K 43264 ENDO CHOLANGIOPANCREATOGRAPH 10.31 $383.84 --- $484.05 004 1 0 0.00 $0.00 Y
K 43266 EGD ENDOSCOPIC STENT PLACE 5.38 $200.30 --- -- 004 0 0 0.00 $0.00 Y
K 43270 EGD LESION ABLATION 5.66 $210.72 --- -- 004 0 0 0.00 $0.00 Y
K 43273 ENDOSCOPIC PANCREATOSCOPY 2.51 $93.45 --- -- 004 0 0 0.00 $0.00 Y
K 43274 ERCP DUCT STENT PLACEMENT 11.14 $414.74 --- -- 004 0 0 0.00 $0.00 Y
K 43275 ERCP REMOVE FORGN BODY DUCT 9.19 $342.14 --- -- 004 0 0 0.00 $0.00 Y
K 43276 ERCP STENT EXCHANGE W/DILATE 11.59 $431.50 --- -- 004 0 0 0.00 $0.00 Y
K 43277 ERCP EA DUCT/AMPULLA DILATE 9.24 $344.01 --- -- 004 0 0 0.00 $0.00 Y
K 43278 ERCP LESION ABLATE W/DILATE 10.51 $391.29 --- -- 004 0 0 0.00 $0.00 Y
K 43279 LAP MYOTOMY HELLER 23.12 $860.76 --- -- 004 0 0 0.00 $0.00 Y
O 43279 LAP MYOTOMY HELLER 4.62 $172.00 --- -- 004 0 0 0.00 $0.00 Y
O 43280 LAPAROSCOPY FUNDOPLASTY 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 43280 LAPAROSCOPY FUNDOPLASTY 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
K 43281 LAP PARAESOPHAG HERN REPAIR 34.18 $1272.52 --- -- 004 0 0 0.00 $0.00 Y
O 43281 LAP PARAESOPHAG HERN REPAIR 6.84 $254.65 --- -- 004 0 0 0.00 $0.00 Y
O 43282 LAP PARAESOPH HER RPR W/MESH 7.68 $285.93 --- -- 004 0 0 0.00 $0.00 Y
K 43282 LAP PARAESOPH HER RPR W/MESH 38.41 $1430.00 --- -- 004 0 0 0.00 $0.00 Y
K 43283 LAP ESOPH LENGTHENING 3.59 $133.81 --- -- 004 0 0 0.00 $0.00 Y
O 43283 LAP ESOPH LENGTHENING 0.72 $26.76 --- -- 004 0 0 0.00 $0.00 Y
O 43284 LAPS ESOPHGL SPHNCTR AGMNTJ 2.97 $110.57 --- -- 004 0 0 0.00 $0.00 Y
K 43284 LAPS ESOPHGL SPHNCTR AGMNTJ 14.89 $554.35 --- -- 004 0 0 0.00 $0.00 Y
K 43285 RMVL ESOPHGL SPHNCTR DEV 15.03 $559.57 --- -- 004 0 0 0.00 $0.00 Y
O 43285 RMVL ESOPHGL SPHNCTR DEV 3.00 $111.69 --- -- 004 0 0 0.00 $0.00 Y
O 43286 ESPHG TOT W/LAPS MOBLJ 14.35 $534.44 --- -- 004 0 0 0.00 $0.00 Y
K 43286 ESPHG TOT W/LAPS MOBLJ 71.77 $2672.21 --- -- 004 0 0 0.00 $0.00 Y
K 43287 ESPHG DSTL 2/3 W/LAPS MOBLJ 81.71 $3042.25 --- -- 004 0 0 0.00 $0.00 Y
O 43287 ESPHG DSTL 2/3 W/LAPS MOBLJ 16.34 $608.45 --- -- 004 0 0 0.00 $0.00 Y
O 43288 ESPHG THRSC MOBLJ 17.09 $636.50 --- -- 004 0 0 0.00 $0.00 Y
K 43288 ESPHG THRSC MOBLJ 85.48 $3182.48 --- -- 004 0 0 0.00 $0.00 Y
K 43289 LAPAROSCOPE PROC ESOPH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43289 LAPAROSCOPE PROC ESOPH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43300 REPAIR OF ESOPHAGUS 3.12 $116.16 --- $146.48 004 1 0 0.00 $0.00 Y
K 43300 REPAIR OF ESOPHAGUS 15.62 $581.53 --- $733.36 004 1 0 0.00 $0.00 Y
K 43305 REPAIR ESOPHAGUS AND FISTULA 24.92 $927.77 --- $1169.99 004 1 0 0.00 $0.00 Y
O 43305 REPAIR ESOPHAGUS AND FISTULA 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
O 43310 REPAIR OF ESOPHAGUS 5.78 $215.19 --- $271.37 004 1 0 0.00 $0.00 Y
K 43310 REPAIR OF ESOPHAGUS 29.11 $1083.77 --- $1366.71 004 1 0 0.00 $0.00 Y
K 43312 REPAIR ESOPHAGUS AND FISTULA 33.98 $1265.08 --- $1595.36 004 1 0 0.00 $0.00 Y
O 43312 REPAIR ESOPHAGUS AND FISTULA 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 43313 ESOPHAGOPLASTY CONGENITAL 11.82 $440.06 --- -- 004 0 0 0.00 $0.00 Y
K 43313 ESOPHAGOPLASTY CONGENITAL 59.10 $2200.29 --- -- 004 0 0 0.00 $0.00 Y
K 43314 TRACHEOESOPHAGOPLASTY CONG 64.97 $2418.83 --- -- 004 0 0 0.00 $0.00 Y
O 43314 TRACHEOESOPHAGOPLASTY CONG 12.99 $483.62 --- -- 004 0 0 0.00 $0.00 Y
O 43320 ESOPHAGOGASTROSTOMY W/O VAGOTOMY 4.75 $176.84 --- $223.01 004 1 0 0.00 $0.00 Y
K 43320 ESOPHAGOGASTROSTOMY W/O VAGOTOMY 23.77 $884.96 --- $1116.00 004 1 0 0.00 $0.00 Y
K 43325 REVISE ESOPHAGUS & STOMACH 20.73 $771.78 --- $973.27 004 1 0 0.00 $0.00 Y
O 43325 REVISE ESOPHAGUS & STOMACH 4.19 $155.99 --- $196.72 004 1 0 0.00 $0.00 Y
O 43327 ESOPH FUNDOPLASTY LAP 3.66 $136.42 --- -- 004 0 0 0.00 $0.00 Y
K 43327 ESOPH FUNDOPLASTY LAP 18.32 $682.10 --- -- 004 0 0 0.00 $0.00 Y
K 43328 ESOPH FUNDOPLASTY THOR 26.55 $988.55 --- -- 004 0 0 0.00 $0.00 Y
O 43328 ESOPH FUNDOPLASTY THOR 5.31 $197.71 --- -- 004 0 0 0.00 $0.00 Y
O 43330 ESOPHAGOMYOTOMY ABDOMINAL 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 43330 ESOPHAGOMYOTOMY ABDOMINAL 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
K 43331 ESOPHAGOMYOTOMY THORACIC 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
O 43331 ESOPHAGOMYOTOMY THORACIC 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
O 43332 TRANSAB ESOPH HIAT HERN RPR 5.23 $194.67 --- -- 004 0 0 0.00 $0.00 Y
K 43332 TRANSAB ESOPH HIAT HERN RPR 26.14 $973.33 --- -- 004 0 0 0.00 $0.00 Y
K 43333 TRANSAB ESOPH HIAT HERN RPR 28.37 $1056.13 --- -- 004 0 0 0.00 $0.00 Y
O 43333 TRANSAB ESOPH HIAT HERN RPR 5.67 $211.23 --- -- 004 0 0 0.00 $0.00 Y
O 43334 TRANSTHOR DIAPHRAG HERN RPR 5.72 $212.85 --- -- 004 0 0 0.00 $0.00 Y
K 43334 TRANSTHOR DIAPHRAG HERN RPR 28.59 $1064.23 --- -- 004 0 0 0.00 $0.00 Y
K 43335 TRANSTHOR DIAPHRAG HERN RPR 30.78 $1146.03 --- -- 004 0 0 0.00 $0.00 Y
O 43335 TRANSTHOR DIAPHRAG HERN RPR 6.16 $229.21 --- -- 004 0 0 0.00 $0.00 Y
O 43336 THORABD DIAPHR HERN REPAIR 6.73 $250.63 --- -- 004 0 0 0.00 $0.00 Y
K 43336 THORABD DIAPHR HERN REPAIR 33.66 $1253.17 --- -- 004 0 0 0.00 $0.00 Y
K 43337 THORABD DIAPHR HERN REPAIR 36.84 $1371.68 --- -- 004 0 0 0.00 $0.00 Y
O 43337 THORABD DIAPHR HERN REPAIR 7.37 $274.34 --- -- 004 0 0 0.00 $0.00 Y
O 43338 ESOPH LENGTHENING 0.60 $22.40 --- -- 004 0 0 0.00 $0.00 Y
K 43338 ESOPH LENGTHENING 3.01 $112.01 --- -- 004 0 0 0.00 $0.00 Y
K 43340 FUSE ESOPHAGUS & INTESTINE 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
O 43340 FUSE ESOPHAGUS & INTESTINE 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
O 43341 FUSE ESOPHAGUS & INTESTINE 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 43341 FUSE ESOPHAGUS & INTESTINE 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 43351 SURGICAL OPENING ESOPHAGUS 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 43351 SURGICAL OPENING ESOPHAGUS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 43352 SURGICAL OPENING ESOPHAGUS 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 43352 SURGICAL OPENING ESOPHAGUS 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 43360 GASTROINTESTINAL RECON FOR PRE ESOPHAG 43.43 $1616.90 --- $2039.04 004 1 0 0.00 $0.00 Y
O 43360 GASTROINTESTINAL RECON FOR PRE ESOPHAG 8.69 $323.53 --- $408.00 004 1 0 0.00 $0.00 Y
O 43361 GASTROINTESTINAL REPAIR 10.06 $374.53 --- $472.32 004 1 0 0.00 $0.00 Y
K 43361 GASTROINTESTINAL REPAIR 50.32 $1873.41 --- $2362.52 004 1 0 0.00 $0.00 Y
K 43400 LIGATE ESOPHAGUS VEINS 22.45 $835.81 --- $1054.03 004 1 0 0.00 $0.00 Y
O 43400 LIGATE ESOPHAGUS VEINS 4.49 $167.16 --- $210.81 004 1 0 0.00 $0.00 Y
O 43405 LIGATION/STAPLING AT GASTRO JUN FOR PRE 5.37 $199.93 --- $252.12 004 1 0 0.00 $0.00 Y
K 43405 LIGATION/STAPLING AT GASTRO JUN FOR PRE 26.86 $1000.00 --- $1261.08 004 1 0 0.00 $0.00 Y
K 43410 REPAIR ESOPHAGUS WOUND 18.72 $696.95 --- $878.90 004 1 0 0.00 $0.00 Y
O 43410 REPAIR ESOPHAGUS WOUND 3.74 $139.24 --- $175.59 004 1 0 0.00 $0.00 Y
O 43415 SUTURE ESOPHAGEAL WOUND OR INJURY 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 43415 SUTURE OF ESOPHAGEAL WOUND OR INJURY 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
K 43420 REPAIR ESOPHAGUS OPENING 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 43420 REPAIR ESOPHAGUS OPENING 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 43425 CLOSURE OF ESOPHAGOSTOMY OR FISTULA 5.20 $193.60 --- $244.14 004 1 0 0.00 $0.00 Y
K 43425 CLOSURE OF ESOPHAGOSTOMY OR FISTULA 26.00 $967.98 --- $1220.70 004 1 0 0.00 $0.00 Y
K 43450 DILATE ESOPHAGUS 1/MULT PASS 1.25 $46.54 --- $58.69 004 1 1 0.00 $0.00 Y
K 43453 DILATE ESOPHAGUS 2.70 $100.52 --- $126.77 004 1 1 0.00 $0.00 Y
K 43460 PRESSURE TREATMENT ESOPHAGUS 2.47 $91.96 --- $115.97 004 1 0 0.00 $0.00 Y
K 43496 FREE JEJUNUM FLAP MICROVASC 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43496 FREE JEJUNUM FLAP MICROVASC 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43499 ESOPHAGUS SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43499 ESOPHAGUS SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43500 GASTROTOMY 11.69 $435.22 --- $548.85 004 1 0 0.00 $0.00 Y
O 43500 GASTROTOMY 2.34 $87.12 --- $109.86 004 1 0 0.00 $0.00 Y
O 43501 GASTROTOMY 3.97 $147.80 --- $186.39 004 1 0 0.00 $0.00 Y
K 43501 GASTROTOMY 19.85 $739.02 --- $931.96 004 1 0 0.00 $0.00 Y
K 43502 GASTROTOMY 23.01 $856.66 --- $1080.32 004 1 0 0.00 $0.00 Y
O 43502 GASTROTOMY 4.61 $171.63 --- $216.44 004 1 0 0.00 $0.00 Y
O 43510 GASTROTOMYPENING OF STOMACH 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
K 43510 GASTROTOMY 14.69 $546.91 --- $689.70 004 1 0 0.00 $0.00 Y
K 43520 INCISION OF PYLORIC MUSCLE 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 43520 INCISION OF PYLORIC MUSCLE 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 43605 BIOPSY OF STOMACH 2.43 $90.47 --- $114.09 004 1 0 0.00 $0.00 Y
K 43605 BIOPSY OF STOMACH 12.15 $452.34 --- $570.44 004 1 0 0.00 $0.00 Y
K 43610 EXCISION OF STOMACH LESION 14.85 $552.87 --- $697.21 004 1 0 0.00 $0.00 Y
O 43610 EXCISION OF STOMACH LESION 2.97 $110.57 --- $139.44 004 1 0 0.00 $0.00 Y
O 43611 EXCISION, LOCAL 3.58 $133.28 --- $168.08 004 1 0 0.00 $0.00 Y
K 43611 EXCISION, LOCAL 17.90 $666.42 --- $840.41 004 1 0 0.00 $0.00 Y
K 43620 REMOVAL OF STOMACH 29.15 $1085.25 --- $1368.59 004 1 0 0.00 $0.00 Y
O 43620 REMOVAL OF STOMACH 5.83 $217.05 --- $273.72 004 1 0 0.00 $0.00 Y
O 43621 GASTRECTOMY, TOTAL 5.93 $220.77 --- $278.41 004 1 0 0.00 $0.00 Y
K 43621 GASTRECTOMY, TOTAL 29.69 $1105.36 --- $1393.95 004 1 0 0.00 $0.00 Y
K 43622 GASTRECTOMY, TOTAL 31.46 $1171.26 --- $1477.05 004 1 0 0.00 $0.00 Y
O 43622 GASTRECTOMY, TOTAL 6.29 $234.18 --- $295.32 004 1 0 0.00 $0.00 Y
O 43631 REMOVAL OF STOMACH PARTIAL 5.03 $187.27 --- $236.16 004 1 0 0.00 $0.00 Y
K 43631 REMOVAL OF STOMACH PARTIAL 25.15 $936.33 --- $1180.79 004 1 0 0.00 $0.00 Y
K 43632 REMOVAL OF STOMACH PARTIAL 25.09 $934.10 --- $1177.98 004 1 0 0.00 $0.00 Y
O 43632 REMOVAL OF STOMACH PARTIAL 5.02 $186.89 --- $235.69 004 1 0 0.00 $0.00 Y
O 43633 REMOVAL OF STOMACH PARTIAL 5.12 $190.62 --- $240.38 004 1 0 0.00 $0.00 Y
K 43633 REMOVAL OF STOMACH PARTIAL 25.61 $953.46 --- $1202.39 004 1 0 0.00 $0.00 Y
K 43634 REMOVAL OF STOMACH PARTIAL 33.42 $1244.23 --- $1569.07 004 1 0 0.00 $0.00 Y
O 43634 REMOVAL OF STOMACH PARTIAL 6.68 $248.70 --- $313.63 004 1 0 0.00 $0.00 Y
O 43635 REMOVAL OF STOMACH PARTIAL 4.20 $156.37 --- $197.19 004 1 0 0.00 $0.00 Y
K 43635 REMOVAL OF STOMACH PARTIAL 21.00 $781.83 --- $985.95 004 1 0 0.00 $0.00 Y
K 43640 VAGOTOMY & PYLORUS REPAIR 19.25 $716.68 --- $903.79 004 1 0 0.00 $0.00 Y
O 43640 VAGOTOMY & PYLORUS REPAIR 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
O 43641 VAGOTOMY & PYLORUS REPAIR 4.27 $158.97 --- $200.48 004 1 0 0.00 $0.00 Y
K 43641 VAGOTOMY & PYLORUS REPAIR 21.35 $794.86 --- $1002.38 004 1 0 0.00 $0.00 Y
K 43644 LAP GASTRIC BYPASS/ROUXENY 25.47 $948.37 --- $1195.82 004 1 0 0.00 $0.00 Y
O 43644 LAP GASTRIC BYPASS/ROUXENY 5.09 $189.67 --- $238.98 004 1 0 0.00 $0.00 Y
O 43645 LAP GASTR BYPASS INCL SMLL I 5.50 $204.89 --- $258.23 004 1 0 0.00 $0.00 Y
K 43645 LAP GASTR BYPASS INCL SMLL I 27.52 $1024.46 --- $1292.06 004 1 0 0.00 $0.00 Y
K 43651 LAPAROSCOPY VAGUS NERVE 9.67 $360.01 --- $454.01 004 1 0 0.00 $0.00 Y
O 43651 LAPAROSCOPY VAGUS NERVE 1.93 $71.85 --- $90.61 004 1 0 0.00 $0.00 Y
O 43652 LAPAROSCOPY VAGUS NERVE 2.32 $86.37 --- $108.92 004 1 0 0.00 $0.00 Y
K 43652 LAPAROSCOPY VAGUS NERVE 11.61 $432.24 --- $545.09 004 1 0 0.00 $0.00 Y
K 43653 LAPAROSCOPY GASTROSTOMY 10.30 $383.47 --- $483.59 004 1 0 0.00 $0.00 Y
O 43653 LAPAROSCOPY GASTROSTOMY 2.06 $76.69 --- $96.72 004 1 0 0.00 $0.00 Y
O 43659 LAPAROSCOPE PROC STOM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43659 LAPAROSCOPE PROC STOM 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43752 NASAL/OROGASTRIC W/STENT 3.49 $129.93 --- $163.86 004 1 0 0.00 $0.00 Y
K 43753 TX GASTRO INTUB W/ASP 0.46 $17.29 --- $21.60 004 1 0 0.00 $0.00 Y
O 43753 TX GASTRO INTUB W/ASP 0.09 $3.46 --- $4.23 004 1 0 0.00 $0.00 Y
O 43754 DX GASTR INTUB W/ASP SPEC 0.15 $5.47 --- $7.04 004 1 0 0.00 $0.00 Y
K 43754 DX GASTR INTUB W/ASP SPEC 0.74 $27.37 --- $34.74 004 1 0 0.00 $0.00 Y
K 43755 DX GASTR INTUB W/ASP SPECS 1.33 $49.47 --- $62.44 004 1 0 0.00 $0.00 Y
O 43755 DX GASTR INTUB W/ASP SPECS 0.27 $9.89 --- $12.68 004 1 0 0.00 $0.00 Y
O 43756 DX DUOD INTUB W/ASP SPEC 0.24 $9.03 --- $11.27 004 1 0 0.00 $0.00 Y
K 43756 DX DUOD INTUB W/ASP SPEC 1.21 $45.15 --- $56.81 004 1 0 0.00 $0.00 Y
K 43757 DX DUOD INTUB W/ASP SPECS 1.73 $64.52 --- $81.22 004 1 0 0.00 $0.00 Y
O 43757 DX DUOD INTUB W/ASP SPECS 0.35 $12.90 --- $16.43 004 1 0 0.00 $0.00 Y
K 43761 REPOSITION GASTROSTOMY TUBE 2.13 $79.30 --- $100.00 004 1 0 0.00 $0.00 Y
K 43762 RPLC GTUBE NO REVJ TRC 5.51 $205.14 --- -- 004 0 0 0.00 $0.00 Y
O 43762 RPLC GTUBE NO REVJ TRC 1.10 $40.95 --- -- 004 0 0 0.00 $0.00 Y
O 43763 RPLC GTUBE REVJ GSTRST TRC 1.62 $60.31 --- -- 004 0 0 0.00 $0.00 Y
K 43763 RPLC GTUBE REVJ GSTRST TRC 8.14 $303.05 --- -- 004 0 0 0.00 $0.00 Y
K 43770 LAP PLACE GASTR ADJ DEVICE 21.62 $804.91 --- $1015.06 004 1 0 0.00 $0.00 Y
O 43770 LAP PLACE GASTR ADJ DEVICE 4.32 $160.83 --- $202.82 004 1 0 0.00 $0.00 Y
O 43771 LAP REVISE GASTR ADJ DEVICE 4.97 $185.03 --- $233.34 004 1 0 0.00 $0.00 Y
K 43771 LAP REVISE GASTR ADJ DEVICE 24.86 $925.54 --- $1167.18 004 1 0 0.00 $0.00 Y
K 43772 LAP RMVL GASTR ADJ DEVICE 18.94 $705.14 --- $889.23 004 1 0 0.00 $0.00 Y
O 43772 LAP RMVL GASTR ADJ DEVICE 3.79 $141.10 --- $177.94 004 1 0 0.00 $0.00 Y
O 43773 LAP REPLACE GASTR ADJ DEVICE 4.97 $185.03 --- $233.34 004 1 0 0.00 $0.00 Y
K 43773 LAP REPLACE GASTR ADJ DEVICE 24.87 $925.91 --- $1167.65 004 1 0 0.00 $0.00 Y
K 43774 LAP RMVL GASTR ADJ ALL PARTS 19.01 $707.74 --- $892.52 004 1 0 0.00 $0.00 Y
O 43774 LAP RMVL GASTR ADJ ALL PARTS 3.80 $141.47 --- $178.41 004 1 0 0.00 $0.00 Y
O 43775 LAP SLEEVE GASTRECTOMY 5.77 $214.82 --- -- 004 0 0 0.00 $0.00 Y
K 43775 LAP SLEEVE GASTRECTOMY 28.83 $1073.34 --- -- 004 0 0 0.00 $0.00 Y
K 43800 RECONSTRUCTION OF PYLORUS 14.15 $526.80 --- $664.34 004 1 0 0.00 $0.00 Y
O 43800 RECONSTRUCTION OF PYLORUS 2.83 $105.36 --- $132.87 004 1 0 0.00 $0.00 Y
O 43810 FUSION OF STOMACH AND BOWEL 2.96 $110.20 --- $138.97 004 1 0 0.00 $0.00 Y
K 43810 FUSION OF STOMACH AND BOWEL 14.79 $550.63 --- $694.39 004 1 0 0.00 $0.00 Y
K 43820 GASTROJEJUNOSTOMY 15.53 $578.18 --- $729.13 004 1 0 0.00 $0.00 Y
O 43820 GASTROJEJUNOSTOMY 3.11 $115.79 --- $146.01 004 1 0 0.00 $0.00 Y
O 43825 FUSION OF STOMACH AND BOWEL 3.81 $141.85 --- $178.88 004 1 0 0.00 $0.00 Y
K 43825 FUSION OF STOMACH AND BOWEL 19.05 $709.23 --- $894.40 004 1 0 0.00 $0.00 Y
K 43830 PLACE GASTROSTOMY TUBE 13.00 $483.99 --- $610.35 004 1 0 0.00 $0.00 Y
O 43830 PLACE GASTROSTOMY TUBE 2.60 $96.80 --- $122.07 004 1 0 0.00 $0.00 Y
O 43831 SURGICAL OPENING OF STOMACH 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 43831 SURGICAL OPENING OF STOMACH 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 43832 PLACE GASTROSTOMY TUBE 16.04 $597.17 --- $753.08 004 1 0 0.00 $0.00 Y
O 43832 PLACE GASTROSTOMY TUBE 3.21 $119.51 --- $150.71 004 1 0 0.00 $0.00 Y
O 43840 REPAIR OF STOMACH LESION 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
K 43840 REPAIR OF STOMACH LESION 14.72 $548.03 --- $691.10 004 1 0 0.00 $0.00 Y
K 43842 V-BAND GASTROPLASTY 21.77 $810.50 --- -- 004 0 0 0.00 $0.00 Y
O 43842 V-BAND GASTROPLASTY 4.36 $162.32 --- -- 004 0 0 0.00 $0.00 Y
O 43843 GASTROPLASTY W/O V-BAND 4.25 $158.23 --- $199.54 004 1 0 0.00 $0.00 Y
K 43843 GASTROPLASTY W/O V-BAND 21.24 $790.77 --- $997.22 004 1 0 0.00 $0.00 Y
K 43845 *04 *05 GASTROPLASTY DUODENAL SWITCH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43845 *04 *05 GASTROPLASTY DUODENAL SWITCH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 43846 GASTRIC BYPASS FOR OBESITY 5.61 $208.86 --- $263.39 004 1 0 0.00 $0.00 Y
K 43846 GASTRIC BYPASS FOR OBESITY 28.03 $1043.56 --- $1316.01 004 1 0 0.00 $0.00 Y
K 43847 GASTRIC BYPASS INCL SMALL I 27.33 $1017.50 --- $1283.14 004 1 0 0.00 $0.00 Y
O 43847 GASTRIC BYPASS INCL SMALL I 5.47 $203.65 --- $256.82 004 1 0 0.00 $0.00 Y
O 43848 REVISION GASTROPLASTY 7.29 $271.41 --- $342.27 004 1 0 0.00 $0.00 Y
K 43848 REVISION GASTROPLASTY 36.46 $1357.41 --- $1711.80 004 1 0 0.00 $0.00 Y
K 43850 REVISE STOMACH-BOWEL FUSION 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 43850 REVISION OF GASTRIC RECTRIC MORB OBESITY 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 43855 REVISE STOMACH-BOWEL FUSION 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 43855 REVISE STOMACH-BOWEL FUSION 26.05 $969.84 --- $1223.05 004 1 0 0.00 $0.00 Y
K 43860 REVISE STOMACH-BOWEL FUSION 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 43860 REVISE STOMACH-BOWEL FUSION 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 43865 REVISE STOMACH-BOWEL FUSION 5.21 $193.97 --- $244.61 004 1 0 0.00 $0.00 Y
K 43865 REVISE STOMACH-BOWEL FUSION 26.05 $969.84 --- $1223.05 004 1 0 0.00 $0.00 Y
K 43870 REPAIR STOMACH OPENING 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
O 43870 REPAIR STOMACH OPENING 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
O 43880 REPAIR STOMACH-BOWEL FISTULA 5.53 $205.88 --- $259.63 004 1 0 0.00 $0.00 Y
K 43880 REPAIR STOMACH-BOWEL FISTULA 27.65 $1029.41 --- $1298.17 004 1 0 0.00 $0.00 Y
K 43886 REVISE GASTRIC PORT OPEN 6.14 $228.57 --- $288.27 004 1 0 0.00 $0.00 Y
O 43886 REVISE GASTRIC PORT OPEN 1.23 $45.79 --- $57.75 004 1 0 0.00 $0.00 Y
O 43887 REMOVE GASTRIC PORT OPEN 1.19 $44.30 --- $55.87 004 1 0 0.00 $0.00 Y
K 43887 REMOVE GASTRIC PORT OPEN 5.95 $221.52 --- $279.35 004 1 0 0.00 $0.00 Y
K 43888 CHANGE GASTRIC PORT OPEN 8.43 $313.85 --- $395.79 004 1 0 0.00 $0.00 Y
O 43888 CHANGE GASTRIC PORT OPEN 1.69 $62.92 --- $79.35 004 1 0 0.00 $0.00 Y
O 43999 STOMACH SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 43999 STOMACH SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44005 ENTEROLYSIS, SEPARATE PROCEDURE 16.42 $611.32 --- $770.92 004 1 0 0.00 $0.00 Y
O 44005 ENTEROLYSIS, SEPARATE PROCEDURE 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
O 44010 INCISION OF SMALL BOWEL 2.90 $107.97 --- $136.16 004 1 0 0.00 $0.00 Y
K 44010 INCISION OF SMALL BOWEL 14.51 $540.21 --- $681.24 004 1 0 0.00 $0.00 Y
K 44015 INSERT NEEDLE CATH BOWEL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44015 INSERT NEEDLE CATH BOWEL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44020 EXPLORE SMALL INTESTINE 3.13 $116.53 --- $146.95 004 1 0 0.00 $0.00 Y
K 44020 EXPLORE SMALL INTESTINE 15.64 $582.28 --- $734.30 004 1 0 0.00 $0.00 Y
K 44021 DECOMPRESS SMALL BOWEL 16.18 $602.38 --- $759.65 004 1 0 0.00 $0.00 Y
O 44021 DECOMPRESS SMALL BOWEL 3.24 $120.63 --- $152.12 004 1 0 0.00 $0.00 Y
O 44025 INCISION OF LARGE BOWEL 3.19 $118.76 --- $149.77 004 1 0 0.00 $0.00 Y
K 44025 INCISION OF LARGE BOWEL 15.97 $594.56 --- $749.79 004 1 0 0.00 $0.00 Y
K 44050 REDUCE BOWEL OBSTRUCTION 15.03 $559.57 --- $705.66 004 1 0 0.00 $0.00 Y
O 44050 REDUCE BOWEL OBSTRUCTION 3.01 $112.06 --- $141.32 004 1 0 0.00 $0.00 Y
O 44055 CORRECT MALROTATION OF BOWEL 3.43 $127.70 --- $161.04 004 1 0 0.00 $0.00 Y
K 44055 CORRECT MALROTATION OF BOWEL 17.13 $637.75 --- $804.25 004 1 0 0.00 $0.00 Y
K 44100 BIOPSY OF BOWEL 3.00 $111.69 --- $140.85 004 1 0 0.00 $0.00 Y
K 44110 EXCISE INTESTINE LESION(S) 16.00 $595.68 --- $751.20 004 1 0 0.00 $0.00 Y
O 44110 EXCISE INTESTINE LESION(S) 3.20 $119.14 --- $150.24 004 1 0 0.00 $0.00 Y
O 44111 EXCISION OF BOWEL LESION(S) 3.29 $122.49 --- $154.47 004 1 0 0.00 $0.00 Y
K 44111 EXCISION OF BOWEL LESION(S) 16.47 $613.18 --- $773.27 004 1 0 0.00 $0.00 Y
K 44120 ENTERECTOMY,RESECTION OF SMALL INTESTINE 18.77 $698.81 --- $881.25 004 1 0 0.00 $0.00 Y
O 44120 ENTERECTOMY,RESECTOMY OF SMALL INTESTINE 3.75 $139.61 --- $176.06 004 1 0 0.00 $0.00 Y
O 44121 REMOVAL OF SMALL INTESTINE 1.08 $40.21 --- $50.71 004 1 0 0.00 $0.00 Y
K 44121 REMOVAL OF SMALL INTESTINE 5.39 $200.67 --- $253.06 004 1 0 0.00 $0.00 Y
K 44125 ENTERECTOMY,RESECTION OF SMALL INTESTINE 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 44125 ENTERECTOMY,RESECTION OF SMALL INTESTINE 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 44126 ENTERECTOMY W/O TAPER CONG 8.90 $331.35 --- -- 004 0 0 0.00 $0.00 Y
K 44126 ENTERECTOMY W/O TAPER CONG 44.48 $1655.99 --- -- 004 0 0 0.00 $0.00 Y
K 44127 ENTERECTOMY W/TAPER CONG 51.13 $1903.57 --- -- 004 0 0 0.00 $0.00 Y
O 44127 ENTERECTOMY W/TAPER CONG 10.23 $380.86 --- -- 004 0 0 0.00 $0.00 Y
O 44128 ENTERECTOMY CONG ADD-ON 1.08 $40.13 --- -- 004 0 0 0.00 $0.00 Y
K 44128 ENTERECTOMY CONG ADD-ON 5.42 $201.79 --- -- 004 0 0 0.00 $0.00 Y
K 44130 ENTEROENTEROSTOMY,ANASTOMOSIS/INTESTINE 16.19 $602.75 --- $760.12 004 1 0 0.00 $0.00 Y
O 44130 ENTEROENTEROSTOMY ANASTOMOSIS/INTESTINE 3.24 $120.63 --- $152.12 004 1 0 0.00 $0.00 Y
O 44135 INTESTINE TRANSPLNT CADAVER 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44135 INTESTINE TRANSPLNT CADAVER 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44139 MOBILIZATION(TAKE-DOWN)SPLENIC FLEXURE 2.70 $100.52 --- $126.77 004 1 0 0.00 $0.00 Y
O 44139 MOBILIZATION(TAKE-DOWN)SPLENIC FLEXURE 0.54 $20.10 --- $25.35 004 1 0 0.00 $0.00 Y
O 44140 PARTIAL REMOVAL OF COLON 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 44140 PARTIAL REMOVAL OF COLON 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 44141 PARTIAL REMOVAL OF COLON 25.37 $944.53 --- $1191.12 004 1 0 0.00 $0.00 Y
O 44141 PARTIAL REMOVAL OF COLON 5.10 $189.87 --- $239.45 004 1 0 0.00 $0.00 Y
O 44143 PARTIAL REMOVAL OF COLON 4.76 $177.21 --- $223.48 004 1 0 0.00 $0.00 Y
K 44143 PARTIAL REMOVAL OF COLON 23.56 $877.14 --- $1106.14 004 1 0 0.00 $0.00 Y
K 44144 PARTIAL REMOVAL OF COLON 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 44144 PARTIAL REMOVAL OF COLON 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 44145 PARTIAL REMOVAL OF COLON 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 44145 PARTIAL REMOVAL OF COLON 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 44146 PARTIAL REMOVAL OF COLON 31.03 $1155.25 --- $1456.86 004 1 0 0.00 $0.00 Y
O 44146 PARTIAL REMOVAL OF COLON 6.23 $231.94 --- $292.50 004 1 0 0.00 $0.00 Y
O 44147 PARTIAL REMOVAL OF COLON 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44147 PARTIAL REMOVAL OF COLON 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44150 REMOVAL OF COLON 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
O 44150 REMOVAL OF COLON 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
O 44151 REMOVAL OF COLON/ILEOSTOMY 5.83 $217.05 --- $273.72 004 1 0 0.00 $0.00 Y
K 44151 REMOVAL OF COLON/ILEOSTOMY 29.13 $1084.51 --- $1367.65 004 1 0 0.00 $0.00 Y
K 44155 REMOVAL OF COLON/ILEOSTOMY 33.98 $1265.08 --- $1595.36 004 1 0 0.00 $0.00 Y
O 44155 REMOVAL OF COLON/ILEOSTOMY 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 44156 REMOVAL OF COLON/ILEOSTOMY 6.64 $247.21 --- $311.75 004 1 0 0.00 $0.00 Y
K 44156 REMOVAL OF COLON/ILEOSTOMY 33.20 $1236.04 --- $1558.74 004 1 0 0.00 $0.00 Y
K 44157 COLECTOMY W/ILEOANAL ANAST 47.07 $1752.24 --- -- 004 0 0 0.00 $0.00 Y
O 44157 COLECTOMY W/ILEOANAL ANAST 9.41 $350.45 --- -- 004 0 0 0.00 $0.00 Y
O 44158 COLECTOMY W/NEORECTUM POUCH 9.65 $359.43 --- -- 004 0 0 0.00 $0.00 Y
K 44158 COLECTOMY W/NEORECTUM POUCH 48.27 $1797.13 --- -- 004 0 0 0.00 $0.00 Y
K 44160 REMOVAL OF COLON 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44160 REMOVAL OF COLON 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44180 LAP ENTEROLYSIS 3.65 $135.89 --- $171.37 004 1 0 0.00 $0.00 Y
K 44180 LAP ENTEROLYSIS 18.26 $679.82 --- $857.31 004 1 0 0.00 $0.00 Y
K 44186 LAP JEJUNOSTOMY 12.88 $479.52 --- $604.72 004 1 0 0.00 $0.00 Y
O 44186 LAP JEJUNOSTOMY 2.58 $96.05 --- $121.13 004 1 0 0.00 $0.00 Y
O 44187 LAP ILEO/JEJUNO-STOMY 4.27 $158.97 --- $200.48 004 1 0 0.00 $0.00 Y
K 44187 LAP ILEO/JEJUNO-STOMY 21.34 $794.49 --- $1001.91 004 1 0 0.00 $0.00 Y
K 44188 LAP COLOSTOMY 23.38 $870.44 --- $1097.69 004 1 0 0.00 $0.00 Y
O 44188 LAP COLOSTOMY 4.68 $174.24 --- $219.73 004 1 0 0.00 $0.00 Y
O 44202 LAP ENTERECTOMY 5.16 $192.11 --- $242.26 004 1 0 0.00 $0.00 Y
K 44202 LAP ENTERECTOMY 25.81 $960.91 --- $1211.78 004 1 0 0.00 $0.00 Y
K 44203 LAP RESECT S/INTESTINE ADDL 5.26 $195.83 --- -- 004 0 0 0.00 $0.00 Y
O 44203 LAP RESECT S/INTESTINE ADDL 1.05 $39.09 --- -- 004 0 0 0.00 $0.00 Y
O 44204 LAPARO PARTIAL COLECTOMY 5.86 $218.17 --- -- 004 0 0 0.00 $0.00 Y
K 44204 LAPARO PARTIAL COLECTOMY 31.11 $1158.23 --- -- 004 0 0 0.00 $0.00 Y
K 44205 LAP COLECTOMY PART W/ILEUM 26.99 $1004.84 --- -- 004 0 0 0.00 $0.00 Y
O 44205 LAP COLECTOMY PART W/ILEUM 5.40 $201.04 --- -- 004 0 0 0.00 $0.00 Y
O 44206 LAP PART COLECTOMY W/STOMA 5.58 $207.78 --- $261.98 004 1 0 0.00 $0.00 Y
K 44206 LAP PART COLECTOMY W/STOMA 27.91 $1038.92 --- $1310.37 004 1 0 0.00 $0.00 Y
K 44207 L COLECTOMY/COLOPROCTOSTOMY 33.96 $1264.33 --- $1594.42 004 1 0 0.00 $0.00 Y
O 44207 L COLECTOMY/COLOPROCTOSTOMY 6.40 $238.27 --- $300.48 004 1 0 0.00 $0.00 Y
O 44208 L COLECTOMY/COLOPROCTOSTOMY 5.43 $202.21 --- $254.94 004 1 0 0.00 $0.00 Y
K 44208 L COLECTOMY/COLOPROCTOSTOMY 27.16 $1011.04 --- $1275.16 004 1 0 0.00 $0.00 Y
K 44210 LAPARO TOTAL PROCTOCOLECTOMY 23.84 $887.68 --- $1119.29 004 1 0 0.00 $0.00 Y
O 44210 LAPARO TOTAL PROCTOCOLECTOMY 4.77 $177.54 --- $223.95 004 1 0 0.00 $0.00 Y
O 44211 LAP COLECTOMY W/PROCTECTOMY 5.93 $220.80 --- -- 004 0 0 0.00 $0.00 Y
K 44211 LAP COLECTOMY W/PROCTECTOMY 29.65 $1103.98 --- -- 004 0 0 0.00 $0.00 Y
K 44212 LAPARO TOTAL PROCTOCOLECTOMY 27.60 $1027.46 --- $1295.82 004 1 0 0.00 $0.00 Y
O 44212 LAPARO TOTAL PROCTOCOLECTOMY 5.52 $205.49 --- $259.16 004 1 0 0.00 $0.00 Y
O 44213 LAP MOBIL SPLENIC FL ADD-ON 0.83 $30.90 --- $38.97 004 1 0 0.00 $0.00 Y
K 44213 LAP MOBIL SPLENIC FL ADD-ON 4.17 $155.25 --- $195.78 004 1 0 0.00 $0.00 Y
K 44227 LAP CLOSE ENTEROSTOMY 32.81 $1221.52 --- $1540.43 004 1 0 0.00 $0.00 Y
O 44227 LAP CLOSE ENTEROSTOMY 6.56 $244.23 --- $307.99 004 1 0 0.00 $0.00 Y
O 44238 LAPAROSCOPE PROC INTESTINE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44238 LAPAROSCOPE PROC INTESTINE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44300 OPEN BOWEL TO SKIN 9.63 $358.52 --- $452.13 004 1 0 0.00 $0.00 Y
O 44300 OPEN BOWEL TO SKIN 1.93 $71.85 --- $90.61 004 1 0 0.00 $0.00 Y
O 44310 ILEOSTOMY/JEJUNOSTOMY 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
K 44310 ILEOSTOMY/JEJUNOSTOMY 16.42 $611.32 --- $770.92 004 1 0 0.00 $0.00 Y
K 44312 REVISION OF ILEOSTOMY; SIMPLE, SEP PROCE 9.07 $337.68 --- $425.84 004 1 0 0.00 $0.00 Y
O 44312 REVISION OF ILEOSTOMY; SIMPLE, SEP PROCE 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 44314 REVIS OF ILEOSTOMY; COMPLICATED, SEP PRO 3.55 $132.17 --- $166.67 004 1 0 0.00 $0.00 Y
K 44314 REVIS OF ILEOSTOMY;COMPLICATED,SEP PROCE 17.76 $661.20 --- $833.83 004 1 0 0.00 $0.00 Y
K 44316 CONTINENT ILEOSTOMY, SEPARATE PROCEDURE 25.70 $956.81 --- $1206.62 004 1 0 0.00 $0.00 Y
O 44316 CONTINENT ILEOSTOMY, SEPARATE PROCEDURE 5.14 $191.36 --- $241.32 004 1 0 0.00 $0.00 Y
O 44320 COLOSTOMY 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 44320 COLOSTOMY 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
K 44322 COLOSTOMY WITH BIOPSIES 19.38 $721.52 --- $909.89 004 1 0 0.00 $0.00 Y
O 44322 COLOSTOMY WITH BIOPSIES 3.88 $144.45 --- $182.17 004 1 0 0.00 $0.00 Y
K 44340 REVISION OF COLOSTOMY; SIMPLE, SEP PROCE 4.59 $170.89 --- $215.50 004 1 0 0.00 $0.00 Y
K 44345 REVISION COLOSTOMY; COMPLICATED,SEP PROC 8.66 $322.41 --- $406.59 004 1 0 0.00 $0.00 Y
O 44345 REVISION COLOSTOMY; COMPLICATED,SEP PROC 1.73 $64.41 --- $81.22 004 1 0 0.00 $0.00 Y
O 44346 REVIS COLOSTOMY W/REPAIR; SEP PROCEDURE 3.49 $129.93 --- $163.86 004 1 0 0.00 $0.00 Y
K 44346 REVIS COLOSTOMY W/REPAIR, SEP PROCEDURE 17.44 $649.29 --- $818.81 004 1 0 0.00 $0.00 Y
K 44360 SMALL BOWEL ENDOSCOPY 4.09 $152.27 --- $192.03 004 1 0 0.00 $0.00 Y
K 44361 SMALL BOWEL ENDOSCOPY/BIOPSY 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 44363 SMALL BOWEL ENDOSCOPY 4.54 $169.02 --- $213.15 004 1 0 0.00 $0.00 Y
K 44364 SMALL BOWEL ENDOSCOPY 5.45 $202.90 --- $255.88 004 1 0 0.00 $0.00 Y
K 44365 SM INTEST ENDOSCOPY, ENTEROSC BEYOND 2ND 6.98 $259.87 --- $327.71 004 1 0 0.00 $0.00 Y
K 44366 SMALL BOWEL ENDOSCOPY 6.31 $234.92 --- $296.25 004 1 0 0.00 $0.00 Y
K 44369 SMALL BOWEL ENDOSCOPY 7.08 $263.59 --- $332.41 004 1 0 0.00 $0.00 Y
K 44370 SMALL BOWEL ENDOSCOPY/STENT 5.30 $197.32 --- $248.84 004 1 0 0.00 $0.00 Y
K 44372 SMALL BOWEL ENDOSCOPY 6.44 $239.76 --- $302.36 004 1 0 0.00 $0.00 Y
K 44373 SMALL BOWEL ENDOSCOPY 5.69 $211.84 --- $267.15 004 1 0 0.00 $0.00 Y
K 44376 SM INTEST ENDOSCOPY, ENTEROSC BEYOND 2ND 6.78 $252.42 --- $318.32 004 1 0 0.00 $0.00 Y
K 44377 SMALL BOWEL ENDOSCOPY/BIOPSY 7.17 $266.94 --- $336.63 004 1 0 0.00 $0.00 Y
K 44378 SMALL BOWEL ENDOSCOPY 9.35 $348.10 --- $438.98 004 1 0 0.00 $0.00 Y
K 44379 S BOWEL ENDOSCOPE W/STENT 8.64 $321.67 --- $405.65 004 1 0 0.00 $0.00 Y
K 44380 SMALL BOWEL ENDOSCOPY 2.26 $84.14 --- $106.11 004 1 0 0.00 $0.00 Y
K 44381 SMALL BOWEL ENDOSCOPY BR/WA 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44382 SMALL BOWEL ENDOSCOPY 2.93 $109.08 --- $137.56 004 1 0 0.00 $0.00 Y
K 44384 SMALL BOWEL ENDOSCOPY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44385 ENDOSCOPY OF BOWEL POUCH 3.23 $120.25 --- $151.65 004 1 0 0.00 $0.00 Y
K 44386 ENDOSCOPY BOWEL POUCH/BIOP 3.27 $121.74 --- $153.53 004 1 0 0.00 $0.00 Y
K 44388 COLONOSCOPY 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 44389 COLONOSCOPY WITH BIOPSY 4.86 $180.94 --- $228.18 004 1 0 0.00 $0.00 Y
K 44390 COLONOSCOPY FOR FOREIGN BODY 4.72 $175.73 --- $221.60 004 1 0 0.00 $0.00 Y
K 44391 COLONOSCOPY FOR BLEEDING 6.22 $231.57 --- $292.03 004 1 0 0.00 $0.00 Y
K 44392 COLONOSCOPY & POLYPECTOMY 6.42 $239.02 --- $301.42 004 1 0 0.00 $0.00 Y
K 44394 COLONOSCOPY THROUGH STOMACH 8.34 $310.50 --- $391.56 004 1 0 0.00 $0.00 Y
K 44401 COLONOSCOPY WITH ABLATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44402 COLONOSCOPY W/STENT PLCMT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44403 COLONOSCOPY W/RESECTION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44404 COLONOSCOPY W/INJECTION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44405 COLONOSCOPY W/DILATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44406 COLONOSCOPY W/ULTRASOUND 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44407 COLONOSCOPY W/NDL ASPIR/BX 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44408 COLONOSCOPY W/DECOMPRESSION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44500 INTRO GASTROINTESTINAL TUBE 0.52 $19.36 --- $24.41 004 1 0 0.00 $0.00 Y
K 44602 SUTURE SMALL INTESTINE 14.10 $524.94 --- $662.00 004 1 0 0.00 $0.00 Y
O 44602 SUTURE SMALL INTESTINE 2.82 $104.99 --- $132.40 004 1 0 0.00 $0.00 Y
O 44603 SUTURE SMALL INTESTINE 3.63 $135.14 --- $170.43 004 1 0 0.00 $0.00 Y
K 44603 SUTURE SMALL INTESTINE 18.20 $677.59 --- $854.49 004 1 0 0.00 $0.00 Y
K 44604 SUTURE LARGE INTESTINE 18.38 $684.29 --- $862.94 004 1 0 0.00 $0.00 Y
O 44604 SUTURE LARGE INTESTINE 3.68 $137.01 --- $172.78 004 1 0 0.00 $0.00 Y
O 44605 REPAIR OF BOWEL LESION 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 44605 REPAIR OF BOWEL LESION 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 44615 INTEST STRICT (ENTEROTOMY AND ENTERORRHA 15.21 $566.27 --- $714.11 004 1 0 0.00 $0.00 Y
O 44615 INTEST STRICT (ENTEROTOMY AND ENTERORRHA 3.05 $113.55 --- $143.20 004 1 0 0.00 $0.00 Y
O 44620 REPAIR BOWEL OPENING 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 44620 REPAIR BOWEL OPENING 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 44625 REPAIR BOWEL OPENING 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 44625 REPAIR BOWEL OPENING 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 44626 REPAIR BOWEL OPENING 5.56 $207.00 --- $261.04 004 1 0 0.00 $0.00 Y
K 44626 REPAIR BOWEL OPENING 27.83 $1036.11 --- $1306.62 004 1 0 0.00 $0.00 Y
K 44640 REPAIR BOWEL-SKIN FISTULA 16.12 $600.15 --- $756.83 004 1 0 0.00 $0.00 Y
O 44640 REPAIR BOWEL-SKIN FISTULA 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44650 REPAIR BOWEL FISTULA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 44650 REPAIR BOWEL FISTULA 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 44660 REPAIR BOWEL-BLADDER FISTULA 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 44660 REPAIR BOWEL-BLADDER FISTULA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 44661 REPAIR BOWEL-BLADDER FISTULA 4.38 $163.07 --- $205.64 004 1 0 0.00 $0.00 Y
K 44661 REPAIR BOWEL-BLADDER FISTULA 21.92 $816.08 --- $1029.14 004 1 0 0.00 $0.00 Y
K 44680 SURGICAL REVISION INTESTINE 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 44680 SURGICAL REVISION INTESTINE 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 44700 SUSPEND BOWEL W/PROSTHESIS 3.83 $142.59 --- $179.82 004 1 0 0.00 $0.00 Y
K 44700 SUSPEND BOWEL W/PROSTHESIS 19.16 $713.33 --- $899.56 004 1 0 0.00 $0.00 Y
K 44701 INTRAOP COLON LAVAGE ADDON 3.29 $122.34 --- $154.47 004 1 0 0.00 $0.00 Y
O 44701 INTRAOP COLON LAVAGE ADDON 0.66 $24.47 --- $30.99 004 1 0 0.00 $0.00 Y
K 44705 PREPARE FECAL MICROBIOTA 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 44799 UNLISTED PROCEDURE INTESTINE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44799 UNLISTED PROCEDURE INTESTINE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44800 EXCISION OF BOWEL POUCH 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 44800 EXCISION OF BOWEL POUCH 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 44820 EXCISION OF MESENTERY LESION 14.92 $555.47 --- $700.49 004 1 0 0.00 $0.00 Y
O 44820 EXCISION OF MESENTERY LESION 2.98 $110.95 --- $139.91 004 1 0 0.00 $0.00 Y
O 44850 REPAIR OF MESENTERY 2.60 $96.80 --- $122.07 004 1 0 0.00 $0.00 Y
K 44850 REPAIR OF MESENTERY 13.00 $483.99 --- $610.35 004 1 0 0.00 $0.00 Y
K 44899 BOWEL SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44899 BOWEL SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44900 DRAIN APP ABSCESS OPEN 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
K 44900 DRAIN APP ABSCESS OPEN 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
K 44950 APPENDECTOMY 10.76 $400.59 --- $505.18 004 1 0 0.00 $0.00 Y
O 44950 APPENDECTOMY 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
O 44955 APPENDECTOMY ADD-ON 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44955 APPENDECTOMY ADD-ON 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 44960 APPENDECTOMY 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 44960 APPENDECTOMY 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 44970 LAPAROSCOPY APPENDECTOMY 1.47 $54.73 --- $69.02 004 1 0 0.00 $0.00 Y
K 44970 LAPAROSCOPY APPENDECTOMY 7.34 $273.27 --- $344.61 004 1 0 0.00 $0.00 Y
K 44979 LAPAROSCOPE PROC APP 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 44979 LAPAROSCOPE PROC APP 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 45000 DRAINAGE OF PELVIC ABSCESS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 45000 DRAINAGE OF PELVIC ABSCESS 3.74 $139.24 --- $175.59 004 1 0 0.00 $0.00 Y
K 45005 DRAINAGE OF RECTAL ABSCESS 3.40 $126.58 --- $159.63 004 1 0 0.00 $0.00 Y
K 45020 DRAINAGE OF RECTAL ABSCESS 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 45020 DRAINAGE OF RECTAL ABSCESS 1.09 $40.58 --- $51.18 004 1 0 0.00 $0.00 Y
K 45100 BIOPSY OF RECTUM 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 45108 REMOVAL OF ANORECTAL LESION 9.22 $343.26 --- $432.88 004 1 0 0.00 $0.00 Y
O 45108 REMOVAL OF ANORECTAL LESION 1.84 $68.50 --- $86.39 004 1 0 0.00 $0.00 Y
O 45110 PROCTECTOMY 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 45110 PROCTECTOMY 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
K 45111 PROCTECTOMY 22.19 $826.13 --- $1041.82 004 1 0 0.00 $0.00 Y
O 45111 PROCTECTOMY 4.44 $165.30 --- $208.46 004 1 0 0.00 $0.00 Y
O 45112 PROCTECTOMY COMBINED ABDOMINOPERINEAL 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 45112 PROCTECTOMY COMBINED ABDOMINOPERINEAL 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
K 45113 PROCTECTOMY WITH RECTAL NUCOSEC ILEOANAL 37.18 $1384.21 --- $1745.60 004 1 0 0.00 $0.00 Y
O 45113 PROCTECTOMY WITH RECTAL MUCOSEC ILEOANAL 7.44 $276.99 --- $349.31 004 1 0 0.00 $0.00 Y
O 45114 PROCTECTOMY PARTIAL WITH ANASTOMOSIS 6.63 $246.83 --- $311.28 004 1 0 0.00 $0.00 Y
K 45114 PROCTECTOMY PARTIAL WITH ANASTOMOSIS 33.16 $1234.55 --- $1556.86 004 1 0 0.00 $0.00 Y
K 45116 PARTIAL REMOVAL OF RECTUM 29.25 $1088.98 --- $1373.29 004 1 0 0.00 $0.00 Y
O 45116 PARTIAL REMOVAL OF RECTUM 5.85 $217.80 --- $274.66 004 1 0 0.00 $0.00 Y
O 45119 REMOVE RECTUM W/RESERVOIR 6.70 $249.44 --- $314.57 004 1 0 0.00 $0.00 Y
K 45119 REMOVE RECTUM W/RESERVOIR 33.48 $1246.46 --- $1571.89 004 1 0 0.00 $0.00 Y
K 45120 PROCTECTOMY COMPLETE ABDOMINAL 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
O 45120 PROCTECTOMY COMPLETE ABDOMINAL 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
O 45121 PROCTECTOMY COMPLETE ABDOMINAL 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 45121 PROCTECTOMY COMPLETE ABDOMINAL 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
K 45123 PROCTECTOMY WITHOUT ANASTOM PERINEAL APP 23.25 $865.60 --- $1091.59 004 1 0 0.00 $0.00 Y
O 45123 PROCTECTOMY WITHOUT ANASTOM PERINEAL AAP 4.65 $173.12 --- $218.32 004 1 0 0.00 $0.00 Y
O 45126 PELVIC EXENTERATION 9.38 $349.22 --- $440.39 004 1 0 0.00 $0.00 Y
K 45126 PELVIC EXENTERATION 46.90 $1746.09 --- $2201.96 004 1 0 0.00 $0.00 Y
K 45130 EXCISION OF RECTAL PROLAPSE 16.42 $611.32 --- $770.92 004 1 0 0.00 $0.00 Y
O 45130 EXCISION OF RECTAL PROLAPSE 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
O 45135 EXCISION OF RECTAL PROLAPSE 5.20 $193.60 --- $244.14 004 1 0 0.00 $0.00 Y
K 45135 EXCISION OF RECTAL PROLAPSE 26.00 $967.98 --- $1220.70 004 1 0 0.00 $0.00 Y
K 45136 EXCISE ILEOANAL RESERVIOR 34.39 $1280.34 --- -- 004 0 0 0.00 $0.00 Y
O 45136 EXCISE ILEOANAL RESERVIOR 6.88 $256.14 --- -- 004 0 0 0.00 $0.00 Y
O 45150 EXCISION OF RECTAL STRICTURE 1.97 $73.34 --- $92.49 004 1 0 0.00 $0.00 Y
K 45150 EXCISION OF RECTAL STRICTURE 9.83 $365.97 --- $461.52 004 1 0 0.00 $0.00 Y
K 45160 EXCISION OF RECTAL LESION 18.61 $692.85 --- $873.74 004 1 0 0.00 $0.00 Y
O 45160 EXCISION OF RECTAL LESION 3.72 $138.50 --- $174.65 004 1 0 0.00 $0.00 Y
O 45171 EXC RECT TUM TRANSANAL PART 2.66 $99.03 --- -- 004 0 0 0.00 $0.00 Y
K 45171 EXC RECT TUM TRANSANAL PART 13.28 $494.41 --- -- 004 0 0 0.00 $0.00 Y
K 45172 EXC RECT TUM TRANSANAL FULL 18.08 $673.12 --- -- 004 0 0 0.00 $0.00 Y
O 45172 EXC RECT TUM TRANSANAL FULL 3.62 $134.77 --- -- 004 0 0 0.00 $0.00 Y
O 45190 DESTRUCTION RECTAL TUMOR 2.37 $88.24 --- $111.27 004 1 0 0.00 $0.00 Y
K 45190 DESTRUCTION RECTAL TUMOR 11.85 $441.18 --- $556.36 004 1 0 0.00 $0.00 Y
K 45300 PROCTOSIGMOIDOSCOPY DX 0.97 $36.11 --- $45.54 004 1 1 0.00 $0.00 Y
K 45303 PROCTOSIGMOIDOSCOPY DILATE 1.10 $40.95 --- $51.65 004 1 1 0.00 $0.00 Y
K 45305 PROCTOSIGMOIDOSCOPY W/BX 1.36 $50.63 --- $63.85 004 1 1 0.00 $0.00 Y
K 45307 PROCTOSIGMOIDOSCOPY FB 2.08 $77.44 --- $97.66 004 1 1 0.00 $0.00 Y
K 45308 PROCTOSIGMOIDOSCOPY REMOVAL 2.64 $98.29 --- $123.95 004 1 0 0.00 $0.00 Y
K 45309 PROCTOSIGMOIDOSCOPY REMOVAL 2.64 $98.29 --- $123.95 004 1 0 0.00 $0.00 Y
K 45315 PROCTOSIGMOIDOSCOPY REMOVAL 2.51 $93.45 --- $117.84 004 1 1 0.00 $0.00 Y
K 45317 PROCTOSIGMOIDOSCOPY BLEED 2.31 $86.00 --- $108.45 004 1 1 0.00 $0.00 Y
O 45317 PROCTOSIGMOIDOSCOPY BLEED 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 45320 PROCTOSIGMOIDOSCOPY ABLATE 2.70 $100.52 --- $126.77 004 1 0 0.00 $0.00 Y
K 45321 PROCTOSIGMOIDOSCOPY VOLVUL 2.34 $87.12 --- $109.86 004 1 1 0.00 $0.00 Y
K 45327 PROCTOSIGMOIDOSCOPY W/STENT 2.09 $77.81 --- $98.13 004 1 0 0.00 $0.00 Y
K 45330 DIAGNOSTIC SIGMOIDOSCOPY 1.47 $54.73 --- $69.02 004 1 1 0.00 $0.00 Y
K 45331 SIGMOIDOSCOPY AND BIOPSY 1.94 $72.23 --- $91.08 004 1 1 0.00 $0.00 Y
K 45332 SIGMOIDOSCOPY W/FB REMOVAL 2.52 $93.82 --- $118.31 004 1 1 0.00 $0.00 Y