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Medi-Cal Rates Information

Medi-Cal Rates as of 02/15/2020 (Codes 50234 thru 54535)

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 50234 REMOVAL OF KIDNEY & URETER 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 50234 REMOVAL OF KIDNEY & URETER 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 50236 REMOVAL OF KIDNEY & URETER 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 50236 REMOVAL OF KIDNEY & URETER 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 50240 PARTIAL REMOVAL OF KIDNEY 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 50240 PARTIAL REMOVAL OF KIDNEY 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 50250 CRYOABLATE RENAL MASS OPEN 5.00 $186.15 --- $234.75 004 1 0 0.00 $0.00 Y
K 50250 CRYOABLATE RENAL MASS OPEN 25.01 $931.12 --- $1174.22 004 1 0 0.00 $0.00 Y
K 50280 REMOVAL OF KIDNEY LESION 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 50280 REMOVAL OF KIDNEY LESION 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 50290 REMOVAL OF KIDNEY LESION 3.91 $145.57 --- $183.57 004 1 0 0.00 $0.00 Y
K 50290 REMOVAL OF KIDNEY LESION 19.53 $727.10 --- $916.93 004 1 0 0.00 $0.00 Y
K 50320 REMOVE KIDNEY LIVING DONOR 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 50320 REMOVE KIDNEY LIVING DONOR 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 50340 REMOVAL OF KIDNEY 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 50340 REMOVAL OF KIDNEY 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
K 50360 TRANSPLANTATION OF KIDNEY 33.98 $1265.08 --- $1595.36 004 1 0 0.00 $0.00 Y
O 50360 TRANSPLANTATION OF KIDNEY 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 50365 TRANSPLANTATION OF KIDNEY 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 50365 TRANSPLANTATION OF KIDNEY 50.00 $1861.50 --- $2347.50 004 1 0 0.00 $0.00 Y
K 50370 REMOVAL OF TRANSPLANTED RENAL ALLOGRAFT 15.63 $581.90 --- $733.83 004 1 0 0.00 $0.00 Y
O 50370 REMOVAL OF TRANSPLANTED RENAL ALLOGRAFT 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 50380 REIMPLANTATION OF KIDNEY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 50380 REIMPLANTATION OF KIDNEY 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 50382 CHANGE URETER STENT PERCUT 36.61 $1362.99 --- $1718.84 004 1 0 0.00 $0.00 Y
K 50384 REMOVE URETER STENT PERCUT 35.39 $1317.57 --- $1661.56 004 1 0 0.00 $0.00 Y
K 50385 CHANGE STENT VIA TRANSURETH 29.55 $1100.15 --- -- 004 0 0 0.00 $0.00 Y
K 50386 REMOVE STENT VIA TRANSURETH 19.08 $710.35 --- -- 004 0 0 0.00 $0.00 Y
K 50387 CHANGE NEPHROURETERAL CATH 12.13 $451.60 --- $569.50 004 1 0 0.00 $0.00 Y
K 50389 REMOVE RENAL TUBE W/FLUORO 12.21 $454.58 --- $573.26 004 1 0 0.00 $0.00 Y
K 50390 DRAINAGE OF KIDNEY LESION 1.90 $70.74 --- $89.21 004 1 0 0.00 $0.00 Y
K 50391 INSTLL RX AGNT INTO RNAL TUB 3.20 $119.19 --- $150.24 004 1 0 0.00 $0.00 Y
K 50396 MEASURE KIDNEY PRESSURE 1.23 $45.79 --- $57.75 004 1 1 0.00 $0.00 Y
K 50400 REVISION OF KIDNEY/URETER 24.92 $927.77 --- $1169.99 004 1 0 0.00 $0.00 Y
O 50400 REVISION OF KIDNEY/URETER 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
O 50405 REVISION OF KIDNEY/URETER 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 50405 REVISION OF KIDNEY/URETER 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
K 50430 NJX PX NFROSGRM &/URTRGRM 12.76 $475.05 --- -- 004 0 0 0.00 $0.00 Y
K 50431 NJX PX NFROSGRM &/URTRGRM 3.95 $147.06 --- -- 004 0 0 0.00 $0.00 Y
K 50432 PLMT NEPHROSTOMY CATHETER 20.78 $773.64 --- -- 004 0 0 0.00 $0.00 Y
K 50433 PLMT NEPHROURETERAL CATHETER 28.02 $1043.18 --- -- 004 0 0 0.00 $0.00 Y
K 50434 CONVERT NEPHROSTOMY CATHETER 22.19 $826.13 --- -- 004 0 0 0.00 $0.00 Y
K 50435 EXCHANGE NEPHROSTOMY CATH 11.67 $434.37 --- -- 004 0 0 0.00 $0.00 Y
K 50436 DILAT XST TRC NDURLGC PX 3.53 $131.42 --- -- 004 0 0 0.00 $0.00 Y
K 50437 DILAT XST TRC NEW ACCESS RCS 5.88 $218.91 --- -- 004 0 0 0.00 $0.00 Y
K 50500 REPAIR OF KIDNEY WOUND 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 50500 REPAIR OF KIDNEY WOUND 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 50520 CLOSE KIDNEYSKIN FISTULA 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 50520 CLOSE KIDNEYSKIN FISTULA 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 50525 CLOSE NEPHROVISCERAL FISTULA 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 50525 CLOSE NEPHROVISCERAL FISTULA 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 50526 CLOSE NEPHROVISCERAL FISTULA 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 50526 CLOSE NEPHROVISCERAL FISTULA 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 50540 REVISION OF HORSESHOE KIDNEY 28.00 $1042.44 --- $1314.60 004 1 0 0.00 $0.00 Y
O 50540 REVISION OF HORSESHOE KIDNEY 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
O 50541 LAPARO ABLATE RENAL CYST 3.12 $116.16 --- $146.48 004 1 0 0.00 $0.00 Y
K 50541 LAPARO ABLATE RENAL CYST 15.58 $580.04 --- $731.48 004 1 0 0.00 $0.00 Y
K 50542 LAPARO ABLATE RENAL MASS 16.96 $631.54 --- $796.27 004 1 0 0.00 $0.00 Y
O 50542 LAPARO ABLATE RENAL MASS 3.39 $126.31 --- $159.16 004 1 0 0.00 $0.00 Y
O 50543 LAPARO PARTIAL NEPHRECTOMY 3.44 $128.25 --- $161.51 004 1 0 0.00 $0.00 Y
K 50543 LAPARO PARTIAL NEPHRECTOMY 17.22 $641.25 --- $808.48 004 1 0 0.00 $0.00 Y
K 50544 LAPAROSCOPY PYELOPLASTY 21.45 $798.58 --- $1007.08 004 1 0 0.00 $0.00 Y
O 50544 LAPAROSCOPY PYELOPLASTY 4.29 $159.72 --- $201.42 004 1 0 0.00 $0.00 Y
O 50545 LAPARO RADICAL NEPHRECTOMY 6.06 $225.61 --- $284.52 004 1 0 0.00 $0.00 Y
K 50545 LAPARO RADICAL NEPHRECTOMY 30.30 $1128.07 --- $1422.59 004 1 0 0.00 $0.00 Y
K 50546 LAPAROSCOPIC NEPHRECTOMY 19.89 $740.50 --- $933.84 004 1 0 0.00 $0.00 Y
O 50546 LAPAROSCOPIC NEPHRECTOMY 3.98 $148.18 --- $186.86 004 1 0 0.00 $0.00 Y
O 50547 LAPARO REMOVAL DONOR KIDNEY 5.11 $190.25 --- $239.91 004 1 0 0.00 $0.00 Y
K 50547 LAPARO REMOVAL DONOR KIDNEY 25.56 $951.60 --- $1200.04 004 1 0 0.00 $0.00 Y
K 50548 LAPARO REMOVE W/URETER 23.34 $868.95 --- $1095.81 004 1 0 0.00 $0.00 Y
O 50548 LAPARO REMOVE W/URETER 4.67 $173.86 --- $219.26 004 1 0 0.00 $0.00 Y
O 50549 LAPAROSCOPE PROC RENAL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 50549 LAPAROSCOPE PROC RENAL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 50551 KIDNEY ENDOSCOPY 4.68 $174.24 --- $219.73 004 1 1 0.00 $0.00 Y
K 50553 KIDNEY ENDOSCOPY 10.63 $395.75 --- $499.08 004 1 1 0.00 $0.00 Y
K 50555 KIDNEY ENDOSCOPY & BIOPSY 9.03 $336.19 --- $423.96 004 1 1 0.00 $0.00 Y
K 50557 KIDNEY ENDOSCOPY & TREATMENT 11.74 $437.08 --- $551.19 004 1 1 0.00 $0.00 Y
K 50561 KIDNEY ENDOSCOPY & TREATMENT 11.34 $422.19 --- $532.41 004 1 1 0.00 $0.00 Y
K 50562 RENAL SCOPE W/TUMOR RESECT 11.02 $410.40 --- $517.39 004 1 1 0.00 $0.00 Y
K 50570 KIDNEY ENDOSCOPY 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 50572 KIDNEY ENDOSCOPY 6.33 $235.67 --- $297.19 004 1 0 0.00 $0.00 Y
K 50574 KIDNEY ENDOSCOPY & BIOPSY 6.78 $252.42 --- $318.32 004 1 0 0.00 $0.00 Y
K 50575 RENAL ENDOSCOPY THRU NEPHR/PYEL, W/W/OUT 16.06 $597.91 --- $754.02 004 1 0 0.00 $0.00 Y
K 50576 KIDNEY ENDOSCOPY & TREATMENT 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 50580 KIDNEY ENDOSCOPY & TREATMENT 7.33 $272.90 --- $344.14 004 1 0 0.00 $0.00 Y
K 50590 FRAGMENTING OF KIDNEY STONE 18.00 $670.14 --- $845.10 004 1 0 0.00 $0.00 Y
K 50592 PERC RF ABLATE RENAL TUMOR 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 50593 PERC CRYO ABLATE RENAL TUM 104.63 $3895.37 --- -- 004 0 0 0.00 $0.00 Y
K 50600 EXPLORATION OF URETER 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 50600 EXPLORATION OF URETER 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 50605 INSERT URETERAL SUPPORT 4.10 $152.64 --- $192.50 004 1 0 0.00 $0.00 Y
K 50605 INSERT URETERAL SUPPORT 20.52 $763.96 --- $963.41 004 1 0 0.00 $0.00 Y
K 50606 ENDOLUMINAL BX URTR RNL PLVS 12.91 $480.64 --- -- 004 0 0 0.00 $0.00 Y
K 50610 REMOVAL OF URETER STONE 21.00 $781.83 --- $985.95 004 1 0 0.00 $0.00 Y
O 50610 REMOVAL OF URETER STONE 4.20 $156.37 --- $197.19 004 1 0 0.00 $0.00 Y
O 50620 REMOVAL OF URETER STONE 3.97 $147.80 --- $186.39 004 1 0 0.00 $0.00 Y
K 50620 REMOVAL OF URETER STONE 19.83 $738.27 --- $931.02 004 1 0 0.00 $0.00 Y
K 50630 REMOVAL OF URETER STONE 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 50630 REMOVAL OF URETER STONE 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 50650 REMOVAL OF URETER 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 50650 REMOVAL OF URETER 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 50660 REMOVAL OF URETER 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 50660 REMOVAL OF URETER 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 50684 INJECTION FOR URETER X-RAY 6.78 $252.42 --- $318.32 004 1 0 0.00 $0.00 Y
K 50686 MEASURE URETER PRESSURE 2.84 $105.73 --- $133.34 004 1 1 0.00 $0.00 Y
K 50688 CHANGE OF URETER TUBE/STENT 1.21 $45.05 --- $56.81 004 1 1 0.00 $0.00 Y
K 50690 INJECTION FOR URETER X-RAY 7.22 $268.80 --- $338.98 004 1 0 0.00 $0.00 Y
K 50693 PLMT URETERAL STENT PRQ 26.16 $973.94 --- -- 004 0 0 0.00 $0.00 Y
K 50694 PLMT URETERAL STENT PRQ 28.71 $1068.87 --- -- 004 0 0 0.00 $0.00 Y
K 50695 PLMT URETERAL STENT PRQ 34.97 $1301.93 --- -- 004 0 0 0.00 $0.00 Y
K 50700 REVISION OF URETER 20.31 $756.14 --- $953.55 004 1 0 0.00 $0.00 Y
O 50700 REVISION OF URETER 4.06 $151.15 --- $190.62 004 1 0 0.00 $0.00 Y
K 50705 URETERAL EMBOLIZATION/OCCL 42.38 $1577.81 --- -- 004 0 0 0.00 $0.00 Y
K 50706 BALLOON DILATE URTRL STRIX 18.80 $699.92 --- -- 004 0 0 0.00 $0.00 Y
K 50715 RELEASE OF URETER 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 50715 RELEASE OF URETER 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
O 50722 RELEASE OF URETER 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 50722 RELEASE OF URETER 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 50725 RELEASE/REVISE URETER 26.00 $967.98 --- $1220.70 004 1 0 0.00 $0.00 Y
O 50725 RELEASE/REVISE URETER 5.20 $193.60 --- $244.14 004 1 0 0.00 $0.00 Y
O 50727 REVISE URETER 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
K 50727 REVISE URETER 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 50728 REVISE URETER 14.74 $548.77 --- $692.04 004 1 0 0.00 $0.00 Y
O 50728 REVISE URETER 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
O 50740 FUSION OF URETER & KIDNEY 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 50740 FUSION OF URETER & KIDNEY 23.98 $892.78 --- $1125.86 004 1 0 0.00 $0.00 Y
K 50750 FUSION OF URETER & KIDNEY 24.92 $927.77 --- $1169.99 004 1 0 0.00 $0.00 Y
O 50750 FUSION OF URETER & KIDNEY 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
O 50760 FUSION OF URETERS 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 50760 FUSION OF URETERS 23.99 $893.15 --- $1126.33 004 1 0 0.00 $0.00 Y
K 50770 SPLICING OF URETERS 25.12 $935.22 --- $1179.38 004 1 0 0.00 $0.00 Y
O 50770 SPLICING OF URETERS 5.02 $186.89 --- $235.69 004 1 0 0.00 $0.00 Y
O 50780 REIMPLANT URETER IN BLADDER 4.77 $177.59 --- $223.95 004 1 0 0.00 $0.00 Y
K 50780 REIMPLANT URETER IN BLADDER 23.86 $888.31 --- $1120.23 004 1 0 0.00 $0.00 Y
K 50782 URETERONEOCYSTOSTOMY 24.96 $929.26 --- $1171.87 004 1 0 0.00 $0.00 Y
O 50782 URETERONEOCYSTOSTOMY 4.99 $185.78 --- $234.28 004 1 0 0.00 $0.00 Y
O 50783 URETERONEOCYSTOSTOMY 5.13 $190.99 --- $240.85 004 1 0 0.00 $0.00 Y
K 50783 URETERONEOCYSTOSTOMY 25.63 $954.20 --- $1203.33 004 1 0 0.00 $0.00 Y
K 50785 REIMPLANT URETER IN BLADDER 26.40 $982.87 --- $1239.48 004 1 0 0.00 $0.00 Y
O 50785 REIMPLANT URETER IN BLADDER 5.28 $196.57 --- $247.90 004 1 0 0.00 $0.00 Y
O 50800 IMPLANT URETER IN BOWEL 4.40 $163.81 --- $206.58 004 1 0 0.00 $0.00 Y
K 50800 IMPLANT URETER IN BOWEL 22.00 $819.06 --- $1032.90 004 1 0 0.00 $0.00 Y
K 50810 FUSION OF URETER & BOWEL 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 50810 FUSION OF URETER & BOWEL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 50815 URINE SHUNT TO INTESTINE 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 50815 URINE SHUNT TO INTESTINE 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 50820 CONSTRUCT BOWEL BLADDER 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 50820 CONSTRUCT BOWEL BLADDER 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 50825 CONSTRUCT BOWEL BLADDER 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 50825 CONSTRUCT BOWEL BLADDER 33.98 $1265.08 --- $1595.36 004 1 0 0.00 $0.00 Y
K 50830 REVISE URINE FLOW 34.75 $1293.74 --- $1631.51 004 1 0 0.00 $0.00 Y
O 50830 URINARY UNDIVERSION 6.95 $258.75 --- $326.30 004 1 0 0.00 $0.00 Y
O 50840 REPLACE URETER BY BOWEL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 50840 REPLACE URETER BY BOWEL 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
K 50845 CUTANEOUS APPENDICO-VESICOSTOMY 22.90 $852.57 --- $1075.16 004 1 0 0.00 $0.00 Y
O 50845 CUTANEOUS APPENDICO-VESICOSTOMY 4.58 $170.51 --- $215.03 004 1 0 0.00 $0.00 Y
O 50860 TRANSPLANT URETER TO SKIN 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 50860 TRANSPLANT URETER TO SKIN 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 50900 REPAIR OF URETER 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 50900 REPAIR OF URETER 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 50920 CLOSURE URETER/SKIN FISTULA 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 50920 CLOSURE URETER/SKIN FISTULA 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
K 50930 CLOSURE URETER/BOWEL FISTULA 24.11 $897.62 --- $1131.96 004 1 0 0.00 $0.00 Y
O 50930 CLOSURE URETER/BOWEL FISTULA 4.78 $177.96 --- $224.42 004 1 0 0.00 $0.00 Y
O 50940 RELEASE OF URETER 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 50940 RELEASE OF URETER 20.12 $749.07 --- $944.63 004 1 0 0.00 $0.00 Y
K 50945 LAPAROSCOPY URETEROLITHOTOMY 16.47 $613.18 --- $773.27 004 1 0 0.00 $0.00 Y
O 50945 LAPAROSCOPY URETEROLITHOTOMY 3.29 $122.49 --- $154.47 004 1 0 0.00 $0.00 Y
O 50947 LAPARO NEW URETER/BLADDER 6.56 $244.23 --- $307.99 004 1 0 0.00 $0.00 Y
K 50947 LAPARO NEW URETER/BLADDER 32.79 $1220.77 --- $1539.49 004 1 0 0.00 $0.00 Y
K 50948 LAPARO NEW URETER/BLADDER 29.97 $1115.78 --- $1407.09 004 1 0 0.00 $0.00 Y
O 50948 LAPARO NEW URETER/BLADDER 5.99 $223.01 --- $281.23 004 1 0 0.00 $0.00 Y
O 50949 LAPAROSCOPE PROC URETER 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 50949 LAPAROSCOPE PROC URETER 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 50951 ENDOSCOPY OF URETER 4.90 $182.43 --- $230.06 004 1 1 0.00 $0.00 Y
K 50953 ENDOSCOPY OF URETER 10.83 $403.20 --- $508.47 004 1 1 0.00 $0.00 Y
K 50955 URETER ENDOSCOPY & BIOPSY 9.06 $337.30 --- $425.37 004 1 1 0.00 $0.00 Y
K 50957 URETER ENDOSCOPY & TREATMENT 9.11 $339.17 --- $427.71 004 1 1 0.00 $0.00 Y
K 50961 URETER ENDOSCOPY & TREATMENT 13.41 $499.25 --- $629.60 004 1 1 0.00 $0.00 Y
K 50970 URETER ENDOSCOPY 4.43 $164.93 --- $207.99 004 1 0 0.00 $0.00 Y
K 50972 URETER ENDOSCOPY & CATHETER 4.25 $158.23 --- $199.54 004 1 0 0.00 $0.00 Y
K 50974 URETER ENDOSCOPY & BIOPSY 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
K 50976 URETER ENDOSCOPY & TREATMENT 5.60 $208.49 --- $262.92 004 1 0 0.00 $0.00 Y
K 50980 URETER ENDOSCOPY & TREATMENT 4.20 $156.37 --- $197.19 004 1 0 0.00 $0.00 Y
K 51020 INCISE & TREAT BLADDER 14.50 $539.84 --- $680.78 004 1 0 0.00 $0.00 Y
O 51020 INCISE & TREAT BLADDER 2.90 $107.97 --- $136.16 004 1 0 0.00 $0.00 Y
O 51030 INCISE & TREAT BLADDER 2.90 $107.97 --- $136.16 004 1 0 0.00 $0.00 Y
K 51030 INCISE & TREAT BLADDER 14.50 $539.84 --- $680.78 004 1 0 0.00 $0.00 Y
K 51040 INCISE & DRAIN BLADDER 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
O 51040 INCISE & DRAIN BLADDER 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
O 51045 INCISE BLADDER/DRAIN URETER 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
K 51045 INCISE BLADDER/DRAIN URETER 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
K 51050 REMOVAL OF BLADDER STONE 14.50 $539.84 --- $680.78 004 1 0 0.00 $0.00 Y
O 51050 REMOVAL OF BLADDER STONE 2.90 $107.97 --- $136.16 004 1 0 0.00 $0.00 Y
O 51060 REMOVAL OF URETER STONE 3.60 $134.03 --- $169.02 004 1 0 0.00 $0.00 Y
K 51060 REMOVAL OF URETER STONE 18.00 $670.14 --- $845.10 004 1 0 0.00 $0.00 Y
K 51065 REMOVE URETER CALCULUS 14.50 $539.84 --- $680.78 004 1 0 0.00 $0.00 Y
O 51065 REMOVE URETER CALCULUS 2.90 $107.97 --- $136.16 004 1 0 0.00 $0.00 Y
O 51080 DRAINAGE OF BLADDER ABSCESS 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
K 51080 DRAINAGE OF BLADDER ABSCESS 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 51100 DRAIN BLADDER BY NEEDLE 1.40 $52.12 --- $65.73 004 1 0 0.00 $0.00 Y
K 51101 DRAIN BLADDER BY TROCAR/CATH 2.86 $106.48 --- $134.28 004 1 0 0.00 $0.00 Y
K 51102 DRAIN BL W/CATH INSERTION 7.40 $275.50 --- $347.43 004 1 0 0.00 $0.00 Y
K 51500 REMOVAL OF BLADDER CYST 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
O 51500 REMOVAL OF BLADDER CYST 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
O 51520 REMOVAL OF BLADDER LESION 3.20 $119.14 --- $150.24 004 1 0 0.00 $0.00 Y
K 51520 REMOVAL OF BLADDER LESION 16.00 $595.68 --- $751.20 004 1 0 0.00 $0.00 Y
K 51525 REMOVAL OF BLADDER LESION 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 51525 REMOVAL OF BLADDER LESION 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 51530 REMOVAL OF BLADDER LESION 3.37 $125.47 --- $158.22 004 1 0 0.00 $0.00 Y
K 51530 REMOVAL OF BLADDER LESION 16.84 $626.95 --- $790.64 004 1 0 0.00 $0.00 Y
K 51535 REPAIR OF URETER LESION 17.19 $639.98 --- $807.07 004 1 0 0.00 $0.00 Y
O 51535 REPAIR OF URETER LESION 3.44 $128.07 --- $161.51 004 1 0 0.00 $0.00 Y
O 51550 PARTIAL REMOVAL OF BLADDER 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 51550 PARTIAL REMOVAL OF BLADDER 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 51555 PARTIAL REMOVAL OF BLADDER 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 51555 PARTIAL REMOVAL OF BLADDER 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 51565 REVISE BLADDER & URETER(S) 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 51565 REVISE BLADDER & URETER(S) 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 51570 REMOVAL OF BLADDER 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
O 51570 REMOVAL OF BLADDER 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
O 51575 REMOVAL OF BLADDER & NODES 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
K 51575 REMOVAL OF BLADDER & NODES 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
K 51580 REMOVE BLADDER/REVISE TRACT 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
O 51580 REMOVE BLADDER/REVISE TRACT 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
O 51585 REMOVAL OF BLADDER & NODES 8.87 $330.23 --- $416.45 004 1 0 0.00 $0.00 Y
K 51585 REMOVAL OF BLADDER & NODES 44.36 $1651.52 --- $2082.70 004 1 0 0.00 $0.00 Y
K 51590 REMOVE BLADDER/REVISE TRACT 44.00 $1638.12 --- $2065.80 004 1 0 0.00 $0.00 Y
O 51590 REMOVE BLADDER/REVISE TRACT 8.80 $327.62 --- $413.16 004 1 0 0.00 $0.00 Y
O 51595 REMOVE BLADDER/REVISE TRACT 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 51595 REMOVE BLADDER/REVISE TRACT 50.00 $1861.50 --- $2347.50 004 1 0 0.00 $0.00 Y
K 51596 REMOVE BLADDER/CREATE POUCH 49.27 $1834.32 --- $2313.23 004 1 0 0.00 $0.00 Y
O 51596 REMOVE BLADDER/CREATE POUCH 9.85 $366.72 --- $462.46 004 1 0 0.00 $0.00 Y
O 51597 REMOVAL OF PELVIC STRUCTURES 8.78 $326.88 --- $412.22 004 1 0 0.00 $0.00 Y
K 51597 REMOVAL OF PELVIC STRUCTURES 43.88 $1633.65 --- $2060.17 004 1 0 0.00 $0.00 Y
K 51600 INJECTION FOR BLADDER X-RAY 6.90 $256.89 --- $323.96 004 1 1 0.00 $0.00 Y
K 51605 PREPARATION FOR BLADDER XRAY 7.03 $261.73 --- $330.06 004 1 0 0.00 $0.00 Y
K 51610 INJECTION FOR BLADDER X-RAY 7.39 $275.13 --- $346.96 004 1 1 0.00 $0.00 Y
K 51700 IRRIGATION OF BLADDER 2.11 $78.56 --- $99.06 004 1 1 0.00 $0.00 Y
K 51701 INSERT BLADDER CATHETER 2.95 $109.71 --- $138.50 004 1 1 0.00 $0.00 Y
K 51702 INSERT TEMP BLADDER CATH 2.67 $99.46 --- $125.36 004 1 1 0.00 $0.00 Y
K 51703 INSERT BLADDER CATH COMPLEX 2.90 $108.11 --- $136.16 004 1 1 0.00 $0.00 Y
K 51705 CHANGE OF BLADDER TUBE 1.58 $58.82 --- $74.18 004 1 1 0.00 $0.00 Y
O 51705 CHANGE OF BLADDER TUBE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 51710 CHANGE OF BLADDER TUBE 2.82 $104.99 --- $132.40 004 1 0 0.00 $0.00 Y
K 51715 ENDOSCOPIC INJ OF IMPL MAT INTO SUBMUCOS 4.39 $163.44 --- $206.11 004 1 0 0.00 $0.00 Y
K 51720 TREATMENT OF BLADDER LESION 2.68 $99.78 --- -- 004 0 1 0.00 $0.00 Y
K 51725 SIMPLE CYSTOMETROGRAM 1.14 $42.44 --- $53.52 004 1 0 0.43 $0.00 Y
K 51726 COMPLEX CYSTOMETROGRAM 2.45 $91.21 --- $115.03 004 1 0 0.32 $0.00 Y
K 51727 CYSTOMETROGRAM W/UP 7.04 $262.10 --- -- 004 0 1 0.37 $0.00 Y
K 51728 CYSTOMETROGRAM W/VP 7.04 $262.10 --- -- 004 0 1 0.37 $0.00 Y
K 51729 CYSTOMETROGRAM W/VP&UP 7.55 $281.09 --- -- 004 0 1 0.41 $0.00 Y
K 51736 URINE FLOW MEASUREMENT 0.79 $29.41 --- $37.09 004 1 0 0.62 $0.00 Y
K 51741 ELECTRO-UROFLOWMETRY FIRST 1.13 $42.07 --- $53.05 004 1 0 0.72 $0.00 Y
K 51784 ELECTROMYOGRAPHY STUDIES ANAL/URETHRAL 1.95 $72.60 --- $91.55 004 1 0 0.44 $0.00 Y
K 51785 ANAL/URINARY MUSCLE STUDY 1.70 $63.29 --- $79.82 004 1 0 0.40 $0.00 Y
K 51792 URINARY REFLEX STUDY 2.85 $106.11 --- $133.81 004 1 0 0.30 $0.00 Y
K 51797 INTRAABDOMINAL PRESSURE TEST 1.59 $59.20 --- $74.65 004 1 0 0.40 $0.00 Y
K 51798 US URINE CAPACITY MEASURE 1.59 $59.20 --- -- 004 0 0 0.00 $0.00 Y
O 51798 US URINE CAPACITY MEASURE 0.32 $11.84 --- -- 004 0 0 0.00 $0.00 Y
O 51800 REVISION OF BLADDER/URETHRA 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 51800 REVISION OF BLADDER/URETHRA 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 51820 REVISION OF URINARY TRACT 30.00 $1116.90 --- $1408.50 004 1 0 0.00 $0.00 Y
O 51820 REVISION OF URINARY TRACT 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
O 51840 ATTACH BLADDER/URETHRA 2.92 $108.71 --- $137.09 004 1 0 0.00 $0.00 Y
K 51840 ATTACH BLADDER/URETHRA 14.59 $543.19 --- $685.00 004 1 0 0.00 $0.00 Y
K 51841 ATTACH BLADDER/URETHRA 16.42 $611.32 --- $770.92 004 1 0 0.00 $0.00 Y
O 51841 ATTACH BLADDER/URETHRA 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
O 51845 REPAIR BLADDER NECK 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 51845 REPAIR BLADDER NECK 13.36 $497.39 --- $627.25 004 1 0 0.00 $0.00 Y
K 51860 REPAIR OF BLADDER WOUND 16.42 $611.32 --- $770.92 004 1 0 0.00 $0.00 Y
O 51860 REPAIR OF BLADDER WOUND 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
O 51865 REPAIR OF BLADDER WOUND 4.01 $149.29 --- $188.27 004 1 0 0.00 $0.00 Y
K 51865 REPAIR OF BLADDER WOUND 20.18 $751.30 --- $947.45 004 1 0 0.00 $0.00 Y
K 51880 REPAIR OF BLADDER OPENING 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 51880 REPAIR OF BLADDER OPENING 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 51900 REPAIR BLADDER/VAGINA LESION 4.40 $163.81 --- $206.58 004 1 0 0.00 $0.00 Y
K 51900 REPAIR BLADDER/VAGINA LESION 22.00 $819.06 --- $1032.90 004 1 0 0.00 $0.00 Y
K 51920 CLOSE BLADDER-UTERUS FISTULA 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 51920 CLOSE BLADDER-UTERUS FISTULA 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 51925 HYSTERECTOMY/BLADDER REPAIR 4.22 $157.11 --- $198.13 004 1 0 0.00 $0.00 Y
K 51925 HYSTERECTOMY/BLADDER REPAIR 21.09 $785.18 --- $990.18 004 1 0 0.00 $0.00 Y
K 51940 CORRECTION OF BLADDER DEFECT 34.91 $1299.70 --- $1639.02 004 1 0 0.00 $0.00 Y
O 51940 CORRECTION OF BLADDER DEFECT 6.98 $259.87 --- $327.71 004 1 0 0.00 $0.00 Y
O 51960 REVISION OF BLADDER & BOWEL 6.05 $225.24 --- $284.05 004 1 0 0.00 $0.00 Y
K 51960 REVISION OF BLADDER & BOWEL 30.24 $1125.84 --- $1419.77 004 1 0 0.00 $0.00 Y
K 51980 CONSTRUCT BLADDER OPENING 18.00 $670.14 --- $845.10 004 1 0 0.00 $0.00 Y
O 51980 CONSTRUCT BLADDER OPENING 3.60 $134.03 --- $169.02 004 1 0 0.00 $0.00 Y
O 51990 LAPARO URETHRAL SUSPENSION 2.56 $95.31 --- $120.19 004 1 0 0.00 $0.00 Y
K 51990 LAPARO URETHRAL SUSPENSION 12.80 $476.54 --- $600.96 004 1 0 0.00 $0.00 Y
K 51992 LAPARO SLING OPERATION 13.93 $518.61 --- $654.01 004 1 0 0.00 $0.00 Y
O 51992 LAPARO SLING OPERATION 2.79 $103.87 --- $130.99 004 1 0 0.00 $0.00 Y
O 51999 LAPAROSCOPE PROC BLA 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 51999 LAPAROSCOPE PROC BLA 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 52000 CYSTOSCOPY 2.33 $86.75 --- $109.39 004 1 1 0.00 $0.00 Y
K 52001 CYSTOSCOPY REMOVAL OF CLOTS 2.97 $110.57 --- -- 004 0 0 0.00 $0.00 Y
K 52005 CYSTOSCOPY & URETER CATHETER 4.08 $151.90 --- $191.56 004 1 1 0.00 $0.00 Y
K 52007 CYSTOSCOPY AND BIOPSY 13.28 $494.41 --- $623.50 004 1 0 0.00 $0.00 Y
K 52010 CYSTOSCOPY & DUCT CATHETER 4.08 $151.90 --- $191.56 004 1 1 0.00 $0.00 Y
K 52204 CYSTOSCOPY W/BIOPSY(S) 3.67 $136.63 --- -- 004 0 1 0.00 $0.00 Y
K 52214 CYSTOSCOPY AND TREATMENT 4.46 $166.05 --- $209.40 004 1 1 0.00 $0.00 Y
K 52224 CYSTOSCOPY AND TREATMENT 4.13 $153.76 --- $193.90 004 1 1 0.00 $0.00 Y
K 52234 CYSTOSCOPY AND TREATMENT 6.80 $253.16 --- $319.26 004 1 1 0.00 $0.00 Y
O 52234 CYSTOSCOPY AND TREATMENT 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
O 52235 CYSTOSCOPY AND TREATMENT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 52235 CYSTOSCOPY AND TREATMENT 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
K 52240 CYSTOSCOPY AND TREATMENT 18.00 $670.14 --- $845.10 004 1 0 0.00 $0.00 Y
O 52240 CYSTOSCOPY AND TREATMENT 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 52250 CYSTOSCOPY AND RADIOTRACER 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 52260 CYSTOSCOPY AND TREATMENT 3.40 $126.58 --- $159.63 004 1 0 0.00 $0.00 Y
K 52265 CYSTOSCOPY AND TREATMENT 2.95 $109.83 --- $138.50 004 1 1 0.00 $0.00 Y
K 52270 CYSTOSCOPY & REVISE URETHRA 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 52275 CYSTOSCOPY & REVISE URETHRA 5.32 $198.06 --- $249.77 004 1 0 0.00 $0.00 Y
K 52276 OPTICAL INTERNAL URETHROTOMY 10.24 $381.24 --- $480.77 004 1 0 0.00 $0.00 Y
K 52277 CYSTOSCOPY AND TREATMENT 6.57 $244.60 --- $308.46 004 1 0 0.00 $0.00 Y
K 52281 CYSTOSCOPY AND TREATMENT 3.40 $126.58 --- $159.63 004 1 1 0.00 $0.00 Y
K 52282 CYSTOSCOPY IMPLANT STENT 8.83 $328.74 --- $414.57 004 1 0 0.00 $0.00 Y
K 52283 CYSTOSCOPY AND TREATMENT 4.59 $170.89 --- $215.50 004 1 1 0.00 $0.00 Y
K 52285 CYSTOSCOPY AND TREATMENT 4.63 $172.37 --- $217.38 004 1 0 0.00 $0.00 Y
K 52287 CYSTOSCOPY CHEMODENERVATION 3.69 $137.38 --- -- 004 0 0 0.00 $0.00 Y
K 52290 CYSTOSCOPY AND TREATMENT 4.53 $168.65 --- $212.68 004 1 1 0.00 $0.00 Y
K 52300 CYSTOSCOPY AND TREATMENT 6.11 $227.48 --- $286.86 004 1 0 0.00 $0.00 Y
K 52301 CYSTOSCOPY AND TREATMENT 6.30 $234.55 --- $295.79 004 1 0 0.00 $0.00 Y
O 52301 CYSTOSCOPY AND TREATMENT 1.26 $46.91 --- $59.16 004 1 0 0.00 $0.00 Y
K 52305 CYSTOSCOPY AND TREATMENT 6.10 $227.10 --- $286.40 004 1 0 0.00 $0.00 Y
K 52310 CYSTOSCOPY AND TREATMENT 7.92 $294.86 --- $371.84 004 1 1 0.00 $0.00 Y
K 52315 CYSTOSCOPY AND TREATMENT 367.37 $367.37 --- -- 042 0 0 0.00 $0.00 Y
K 52317 LITHOLAPAXY:CRUSH/FRAG OF CALCULUS BY AN 13.87 $516.38 --- $651.20 004 1 0 0.00 $0.00 Y
K 52318 REMOVE BLADDER STONE 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 52320 CYSTOSCOPY AND TREATMENT 7.00 $260.61 --- $328.65 004 1 0 0.00 $0.00 Y
K 52325 CYSTOSCOPY STONE REMOVAL 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 52327 CYSTOSCOPY INJECT MATERIAL 5.93 $220.77 --- -- 004 0 0 0.00 $0.00 Y
K 52330 CYSTOURESTHROS. W/MANIP.W/OUT REML.STONE 11.27 $419.58 --- $529.13 004 1 0 0.00 $0.00 Y
K 52332 CYSTOSCOPY AND TREATMENT 14.79 $550.63 --- $694.39 004 1 0 0.00 $0.00 Y
K 52334 CREATE PASSAGE TO KIDNEY 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 52341 CYSTO W/URETER STRICTURE TX 7.55 $281.09 --- $354.47 004 1 0 0.00 $0.00 Y
K 52342 CYSTO W/UP STRICTURE TX 8.17 $304.17 --- $383.58 004 1 0 0.00 $0.00 Y
K 52343 CYSTO W/RENAL STRICTURE TX 9.05 $336.93 --- $424.90 004 1 0 0.00 $0.00 Y
K 52344 CYSTO/URETERO STRICTURE TX 9.67 $360.01 --- $454.01 004 1 0 0.00 $0.00 Y
K 52345 CYSTO/URETERO W/UP STRICTURE 10.31 $383.84 --- $484.05 004 1 0 0.00 $0.00 Y
K 52346 CYSTOURETERO W/RENAL STRICT 11.60 $431.87 --- $544.62 004 1 0 0.00 $0.00 Y
K 52351 CYSTOURETERO & OR PYELOSCOPE 7.00 $260.61 --- $328.65 004 1 0 0.00 $0.00 Y
K 52352 CYSTOURETERO W/STONE REMOVE 8.23 $306.40 --- $386.40 004 1 0 0.00 $0.00 Y
K 52353 CYSTOURETERO W/LITHOTRIPSY 9.52 $354.43 --- $446.96 004 1 0 0.00 $0.00 Y
K 52354 CYSTOURETERO W/BIOPSY 8.78 $326.88 --- $412.22 004 1 0 0.00 $0.00 Y
K 52355 CYSTOURETERO W/EXCISE TUMOR 10.56 $393.15 --- $495.79 004 1 0 0.00 $0.00 Y
K 52356 CYSTO/URETERO W/LITHOTRIPSY 9.51 $354.06 --- -- 004 0 0 0.00 $0.00 Y
K 52400 CYSTOURETERO W/CONGEN REPR 13.54 $504.09 --- $635.70 004 1 0 0.00 $0.00 Y
O 52400 CYSTOURETERO W/CONGEN REPR 2.71 $100.89 --- $127.23 004 1 0 0.00 $0.00 Y
K 52402 CYSTOURETHRO CUT EJACUL DUCT 4.69 $174.78 --- $220.20 004 1 0 0.00 $0.00 Y
K 52441 CYSTOURETHRO W/IMPLANT 30.54 $1137.00 --- -- 004 0 0 0.00 $0.00 Y
K 52442 CYSTOURETHRO W/ADDL IMPLANT 23.62 $879.37 --- -- 004 0 0 0.00 $0.00 Y
K 52450 INCISION OF PROSTATE 8.89 $330.97 --- $417.39 004 1 0 0.00 $0.00 Y
O 52450 INCISION OF PROSTATE 1.78 $66.27 --- $83.57 004 1 0 0.00 $0.00 Y
O 52500 REVISION OF BLADDER NECK 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 52500 REVISION OF BLADDER NECK 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 52601 TRANSURET ELECTROSURG RESECT OF PROSTATE 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 52601 TRANSURET ELECTROSURG RESECT OF PROSTATE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 52630 REMOVE PROSTATE REGROWTH 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 52630 REMOVE PROSTATE REGROWTH 20.00 $744.60 --- -- 004 0 0 0.00 $0.00 Y
K 52640 RELIEVE BLADDER CONTRACTURE 10.17 $378.63 --- $477.48 004 1 0 0.00 $0.00 Y
O 52640 RELIEVE BLADDER CONTRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 52647 LASER SURGERY OF PROSTATE 2.66 $99.03 --- $124.89 004 1 0 0.00 $0.00 Y
K 52647 LASER SURGERY OF PROSTATE 13.29 $494.79 --- $623.97 004 1 0 0.00 $0.00 Y
K 52648 LASER SURGERY OF PROSTATE 15.71 $584.88 --- $737.58 004 1 0 0.00 $0.00 Y
O 52648 LASER SURGERY OF PROSTATE 3.14 $116.90 --- $147.42 004 1 0 0.00 $0.00 Y
O 52649 PROSTATE LASER ENUCLEATION 4.29 $159.72 --- -- 004 0 0 0.00 $0.00 Y
K 52649 PROSTATE LASER ENUCLEATION 21.45 $798.58 --- -- 004 0 0 0.00 $0.00 Y
K 52700 DRAINAGE OF PROSTATE ABSCESS 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 53000 INCISION OF URETHRA 4.15 $154.50 --- $194.84 004 1 0 0.00 $0.00 Y
K 53010 INCISION OF URETHRA 6.32 $235.29 --- $296.72 004 1 0 0.00 $0.00 Y
K 53020 INCISION OF URETHRA 2.67 $99.40 --- $125.36 004 1 1 0.00 $0.00 Y
K 53025 INCISION OF URETHRA 2.52 $93.82 --- $118.31 004 1 1 0.00 $0.00 Y
K 53040 DRAINAGE OF URETHRA ABSCESS 7.27 $270.66 --- $341.33 004 1 0 0.00 $0.00 Y
K 53060 DRAINAGE OF URETHRA ABSCESS 3.98 $148.18 --- $186.86 004 1 1 0.00 $0.00 Y
K 53080 DRAINAGE OF URINARY LEAKAGE 6.78 $252.42 --- $318.32 004 1 0 0.00 $0.00 Y
K 53085 DRAINAGE OF URINARY LEAKAGE 19.10 $711.09 --- $896.75 004 1 0 0.00 $0.00 Y
O 53085 DRAINAGE OF URINARY LEAKAGE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 53200 BIOPSY OF URETHRA 3.56 $132.54 --- $167.14 004 1 1 0.00 $0.00 Y
K 53210 REMOVAL OF URETHRA 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 53210 REMOVAL OF URETHRA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 53215 REMOVAL OF URETHRA 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 53215 REMOVAL OF URETHRA 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 53220 TREATMENT OF URETHRA LESION 8.78 $326.88 --- -- 004 0 0 0.00 $0.00 Y
O 53220 TREATMENT OF URETHRA LESION 1.76 $65.52 --- $82.63 004 1 0 0.00 $0.00 Y
O 53230 REMOVAL OF URETHRA LESION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 53230 REMOVAL OF URETHRA LESION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 53235 REMOVAL OF URETHRA LESION 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 53235 REMOVAL OF URETHRA LESION 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 53240 SURGERY FOR URETHRA POUCH 5.16 $192.11 --- $242.26 004 1 0 0.00 $0.00 Y
K 53250 REMOVAL OF URETHRA GLAND 11.80 $439.31 --- $554.01 004 1 0 0.00 $0.00 Y
O 53250 REMOVAL OF URETHRA GLAND 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
K 53260 TREATMENT OF URETHRA LESION 3.94 $146.69 --- $184.98 004 1 1 0.00 $0.00 Y
K 53265 TREATMENT OF URETHRA LESION 4.19 $155.99 --- $196.72 004 1 1 0.00 $0.00 Y
K 53270 REMOVAL OF URETHRA GLAND 4.02 $149.66 --- $188.74 004 1 1 0.00 $0.00 Y
K 53275 REPAIR OF URETHRA DEFECT 3.48 $129.56 --- $163.39 004 1 0 0.00 $0.00 Y
K 53400 REVISE URETHRA STAGE 1 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 53400 REVISE URETHRA STAGE 1 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 53405 REVISE URETHRA STAGE 2 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 53405 REVISE URETHRA STAGE 2 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 53410 RECONSTRUCTION OF URETHRA 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 53410 RECONSTRUCTION OF URETHRA 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
O 53415 RECONSTRUCTION OF URETHRA 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 53415 RECONSTRUCTION OF URETHRA 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 53420 RECONSTRUCT URETHRA STAGE 1 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 53420 RECONSTRUCT URETHRA STAGE 1 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 53425 RECONSTRUCT URETHRA STAGE 2 4.22 $157.11 --- $198.13 004 1 0 0.00 $0.00 Y
K 53425 RECONSTRUCT URETHRA STAGE 2 21.11 $785.93 --- $991.11 004 1 0 0.00 $0.00 Y
K 53430 RECONSTRUCTION OF URETHRA 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 53430 RECONSTRUCTION OF URETHRA 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 53431 RECONSTRUCT URETHRA/BLADDER 4.74 $176.47 --- -- 004 0 0 0.00 $0.00 Y
K 53431 RECONSTRUCT URETHRA/BLADDER 23.72 $883.10 --- -- 004 0 0 0.00 $0.00 Y
K 53440 MALE SLING PROCEDURE 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 53440 MALE SLING PROCEDURE 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 53442 REMOVE/REVISE MALE SLING 2.48 $92.33 --- $116.44 004 1 0 0.00 $0.00 Y
K 53442 REMOVE/REVISE MALE SLING 12.41 $462.02 --- $582.65 004 1 0 0.00 $0.00 Y
K 53444 INSERT TANDEM CUFF 17.09 $636.26 --- -- 004 0 0 0.00 $0.00 Y
O 53444 INSERT TANDEM CUFF 3.42 $127.33 --- -- 004 0 0 0.00 $0.00 Y
O 53445 INSERT URO/VES NCK SPHINCTER 3.41 $126.95 --- $160.10 004 1 0 0.00 $0.00 Y
K 53445 INSERT URO/VES NCK SPHINCTER 17.03 $634.03 --- $799.56 004 1 0 0.00 $0.00 Y
K 53446 REMOVE URO SPHINCTER 15.99 $595.31 --- -- 004 0 0 0.00 $0.00 Y
O 53446 REMOVE URO SPHINCTER 3.20 $119.14 --- -- 004 0 0 0.00 $0.00 Y
O 53447 REMOVE/REPLACE UR SPHINCTER 3.18 $118.39 --- $149.30 004 1 0 0.00 $0.00 Y
K 53447 REMOVE/REPLACE UR SPHINCTER 15.88 $591.21 --- $745.57 004 1 0 0.00 $0.00 Y
K 53448 REMOV/REPLC UR SPHINCTR COMP 28.58 $1064.03 --- -- 004 0 0 0.00 $0.00 Y
O 53448 REMOV/REPLC UR SPHINCTR COMP 5.72 $212.96 --- -- 004 0 0 0.00 $0.00 Y
O 53449 REPAIR URO SPHINCTER 2.87 $106.85 --- $134.75 004 1 0 0.00 $0.00 Y
K 53449 REPAIR URO SPHINCTER 14.34 $533.88 --- $673.26 004 1 0 0.00 $0.00 Y
K 53450 REVISION OF URETHRA 4.89 $182.05 --- $229.59 004 1 0 0.00 $0.00 Y
O 53450 REVISION OF URETHRA 0.98 $36.49 --- $46.01 004 1 0 0.00 $0.00 Y
K 53460 REVISION OF URETHRA 5.51 $205.14 --- $258.69 004 1 0 0.00 $0.00 Y
K 53500 URETHRLYS TRANSVAG W/ SCOPE 10.34 $384.90 --- $485.46 004 1 0 0.00 $0.00 Y
O 53500 URETHRLYS TRANSVAG W/ SCOPE 2.07 $76.98 --- $97.19 004 1 0 0.00 $0.00 Y
K 53502 REPAIR OF URETHRA INJURY 11.13 $414.37 --- $522.55 004 1 0 0.00 $0.00 Y
K 53505 REPAIR OF URETHRA INJURY 10.87 $404.69 --- $510.35 004 1 0 0.00 $0.00 Y
O 53505 REPAIR OF URETHRA INJURY 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
O 53510 REPAIR OF URETHRA INJURY 2.87 $106.85 --- $134.75 004 1 0 0.00 $0.00 Y
K 53510 REPAIR OF URETHRA INJURY 14.16 $527.18 --- $664.81 004 1 0 0.00 $0.00 Y
K 53515 REPAIR OF URETHRA INJURY 19.10 $711.09 --- $896.75 004 1 0 0.00 $0.00 Y
O 53515 REPAIR OF URETHRA INJURY 3.80 $141.47 --- $178.41 004 1 0 0.00 $0.00 Y
O 53520 REPAIR OF URETHRA DEFECT 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
K 53520 REPAIR OF URETHRA DEFECT 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 53600 DILATE URETHRA STRICTURE 2.34 $87.12 --- $109.86 004 1 1 0.00 $0.00 Y
K 53601 DILATE URETHRA STRICTURE 2.21 $82.28 --- $103.76 004 1 1 0.00 $0.00 Y
K 53605 DILATE URETHRA STRICTURE 0.79 $29.41 --- $37.09 004 1 0 0.00 $0.00 Y
K 53620 DILATE URETHRA STRICTURE 3.41 $126.95 --- $160.10 004 1 1 0.00 $0.00 Y
K 53621 DILATE URETHRA STRICTURE 3.28 $122.11 --- $154.00 004 1 1 0.00 $0.00 Y
K 53660 DILATION OF URETHRA 2.01 $74.83 --- $94.37 004 1 1 0.00 $0.00 Y
K 53661 DILATION OF URETHRA 2.04 $75.95 --- $95.78 004 1 1 0.00 $0.00 Y
K 53665 DILATION OF URETHRA 0.47 $17.50 --- $22.07 004 1 0 0.00 $0.00 Y
K 53850 PROSTATIC MICROWAVE THERMOTX 50.60 $1883.84 --- $2375.67 004 1 0 0.00 $0.00 Y
K 53852 PROSTATIC RF THERMOTX 46.46 $1729.71 --- $2181.30 004 1 1 0.00 $0.00 Y
K 53854 TRURL DSTRJ PRST8 TISS RF WV 45.58 $1696.94 --- -- 004 0 0 0.00 $0.00 Y
K 53855 INSERT PROST URETHRAL STENT 16.17 $602.01 --- $759.18 004 1 0 0.00 $0.00 Y
K 53860 TRANSURETHRAL RF TREATMENT 5.22 $194.16 --- -- 004 0 0 0.00 $0.00 Y
K 53899 UROLOGY SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 53899 UROLOGY SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 54000 SLITTING OF PREPUCE 3.16 $117.65 --- $148.36 004 1 1 0.00 $0.00 Y
K 54001 SLITTING OF PREPUCE 3.64 $135.52 --- $170.90 004 1 1 0.00 $0.00 Y
K 54015 DRAIN PENIS LESION 5.92 $220.40 --- $277.94 004 1 0 0.00 $0.00 Y
K 54050 DESTRUCTION PENIS LESION(S) 1.63 $60.68 --- $76.53 004 1 1 0.00 $0.00 Y
K 54055 DESTRUCTION PENIS LESION(S) 3.41 $126.95 --- $160.10 004 1 1 0.00 $0.00 Y
K 54056 CRYOSURGERY PENIS LESION(S) 1.87 $69.62 --- $87.80 004 1 0 0.00 $0.00 Y
K 54057 LASER SURG PENIS LESION(S) 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
K 54060 EXCISION OF PENIS LESION(S) 3.24 $120.63 --- $152.12 004 1 1 0.00 $0.00 Y
K 54065 DESTRUCTION PENIS LESION(S) 183.69 $183.69 --- -- 042 0 0 0.00 $0.00 Y
K 54100 BIOPSY OF PENIS 2.49 $92.70 --- $116.91 004 1 1 0.00 $0.00 Y
K 54105 BIOPSY OF PENIS 4.36 $162.32 --- $204.70 004 1 0 0.00 $0.00 Y
K 54110 TREATMENT OF PENIS LESION 8.83 $328.74 --- $414.57 004 1 0 0.00 $0.00 Y
O 54110 TREATMENT OF PENIS LESION 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
O 54111 TREAT PENIS LESION GRAFT 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 54111 TREAT PENIS LESION GRAFT 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 54112 TREAT PENIS LESION GRAFT 22.03 $820.18 --- $1034.31 004 1 0 0.00 $0.00 Y
O 54112 TREAT PENIS LESION GRAFT 4.41 $164.18 --- $207.05 004 1 0 0.00 $0.00 Y
O 54115 TREATMENT OF PENIS LESION 1.52 $56.59 --- $71.36 004 1 0 0.00 $0.00 Y
K 54115 TREATMENT OF PENIS LESION 7.59 $282.58 --- $356.35 004 1 0 0.00 $0.00 Y
K 54120 PARTIAL REMOVAL OF PENIS 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 54120 PARTIAL REMOVAL OF PENIS 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 54125 REMOVAL OF PENIS 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 54125 REMOVAL OF PENIS 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
K 54130 REMOVE PENIS & NODES 26.95 $1003.35 --- $1265.30 004 1 0 0.00 $0.00 Y
O 54130 REMOVE PENIS & NODES 5.39 $200.67 --- $253.06 004 1 0 0.00 $0.00 Y
O 54135 REMOVE PENIS & NODES 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 54135 REMOVE PENIS & NODES 33.98 $1265.08 --- $1595.36 004 1 0 0.00 $0.00 Y
K 54161 CIRCUM 28 DAYS OR OLDER 3.40 $126.58 --- -- 004 0 0 0.00 $0.00 Y
K 54162 LYSIS PENIL CIRCUMIC LESION 5.06 $188.38 --- -- 004 0 0 0.00 $0.00 Y
K 54163 REPAIR OF CIRCUMCISION 4.74 $176.47 --- -- 004 0 0 0.00 $0.00 Y
K 54164 FRENULOTOMY OF PENIS 4.17 $155.25 --- -- 004 0 0 0.00 $0.00 Y
K 54200 TREATMENT OF PENIS LESION 1.56 $58.08 --- $73.24 004 1 1 0.00 $0.00 Y
K 54205 TREATMENT OF PENIS LESION 8.83 $328.74 --- $414.57 004 1 0 0.00 $0.00 Y
O 54205 TREATMENT OF PENIS LESION 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
K 54220 TREATMENT OF PENIS LESION 3.63 $135.14 --- $170.43 004 1 0 0.00 $0.00 Y
K 54230 PREPARE PENIS STUDY 1.65 $61.43 --- $77.47 004 1 0 0.00 $0.00 Y
K 54240 PENIS PRESSURE STUDY 2.12 $78.93 --- $99.53 004 1 0 0.75 $0.00 Y
K 54250 TEST PENILE ERECTION 2.67 $99.40 --- $125.36 004 1 0 0.90 $0.00 Y
K 54300 REVISION OF PENIS 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 54300 REVISION OF PENIS 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 54304 REVISION OF PENIS 3.00 $111.69 --- $140.85 004 1 0 0.00 $0.00 Y
K 54304 REVISION OF PENIS 15.01 $558.82 --- $704.72 004 1 0 0.00 $0.00 Y
K 54308 RECONSTRUCTION OF URETHRA 17.68 $658.23 --- $830.08 004 1 0 0.00 $0.00 Y
O 54308 RECONSTRUCTION OF URETHRA 3.54 $131.79 --- $166.20 004 1 0 0.00 $0.00 Y
O 54312 RECONSTRUCTION OF URETHRA 3.96 $147.43 --- $185.92 004 1 0 0.00 $0.00 Y
K 54312 RECONSTRUCTION OF URETHRA 19.82 $737.90 --- $930.55 004 1 0 0.00 $0.00 Y
K 54316 RECONSTRUCTION OF URETHRA 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 54316 RECONSTRUCTION OF URETHRA 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 54318 RECONSTRUCTION OF URETHRA 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
K 54318 RECONSTRUCTION OF URETHRA 14.72 $548.03 --- $691.10 004 1 0 0.00 $0.00 Y
K 54322 RECONSTRUCTION OF URETHRA 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 54322 RECONSTRUCTION OF URETHRA 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
O 54324 RECONSTRUCTION OF URETHRA 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 54324 RECONSTRUCTION OF URETHRA 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 54326 RECONSTRUCTION OF URETHRA 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 54326 RECONSTRUCTION OF URETHRA 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
O 54328 REVISE PENIS/URETHRA 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 54328 REVISE PENIS/URETHRA 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
K 54332 REVISE PENIS/URETHRA 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 54332 REVISE PENIS/URETHRA 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 54336 REVISE PENIS/URETHRA 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
K 54336 REVISE PENIS/URETHRA 24.92 $927.77 --- $1169.99 004 1 0 0.00 $0.00 Y
K 54340 SECONDARY URETHRAL SURGERY 7.65 $284.81 --- $359.17 004 1 0 0.00 $0.00 Y
K 54344 SECONDARY URETHRAL SURGERY 12.03 $447.88 --- $564.81 004 1 0 0.00 $0.00 Y
O 54344 SECONDARY URETHRAL SURGERY 2.41 $89.72 --- $113.15 004 1 0 0.00 $0.00 Y
O 54348 SECONDARY URETHRAL SURGERY 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 54348 SECONDARY URETHRAL SURGERY 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 54352 RECONSTRUCT URETHRA/PENIS 24.92 $927.77 --- $1169.99 004 1 0 0.00 $0.00 Y
O 54352 RECONSTRUCT URETHRA/PENIS 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
O 54360 PENIS PLASTIC SURGERY 2.86 $106.48 --- $134.28 004 1 0 0.00 $0.00 Y
K 54360 PENIS PLASTIC SURGERY 14.30 $532.39 --- $671.39 004 1 0 0.00 $0.00 Y
K 54380 REPAIR PENIS 15.06 $560.68 --- $707.07 004 1 0 0.00 $0.00 Y
O 54380 REPAIR PENIS 3.06 $113.92 --- $143.67 004 1 0 0.00 $0.00 Y
O 54385 REPAIR PENIS 4.62 $172.00 --- $216.91 004 1 0 0.00 $0.00 Y
K 54385 REPAIR PENIS 23.11 $860.39 --- $1085.01 004 1 0 0.00 $0.00 Y
K 54390 REPAIR PENIS AND BLADDER 30.55 $1137.38 --- $1434.32 004 1 0 0.00 $0.00 Y
O 54390 REPAIR PENIS AND BLADDER 6.11 $227.48 --- $286.86 004 1 0 0.00 $0.00 Y
O 54400 INSERT SEMI-RIGID PROSTHESIS 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
K 54400 INSERT SEMI-RIGID PROSTHESIS 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 54406 REMOVE MUTI-COMP PENIS PROS 15.55 $578.93 --- $730.07 004 1 0 0.00 $0.00 Y
O 54406 REMOVE MUTI-COMP PENIS PROS 3.11 $115.79 --- $146.01 004 1 0 0.00 $0.00 Y
O 54408 REPAIR MULTI-COMP PENIS PROS 3.28 $122.11 --- $154.00 004 1 0 0.00 $0.00 Y
K 54408 REPAIR MULTI-COMP PENIS PROS 16.40 $610.57 --- $769.98 004 1 0 0.00 $0.00 Y
K 54410 REMOVE/REPLACE PENIS PROSTH 19.39 $721.89 --- $910.36 004 1 0 0.00 $0.00 Y
O 54410 REMOVE/REPLACE PENIS PROSTH 3.88 $144.45 --- $182.17 004 1 0 0.00 $0.00 Y
O 54411 REMOV/REPLC PENIS PROS COMP 4.24 $157.86 --- $199.07 004 1 0 0.00 $0.00 Y
K 54411 REMOV/REPLC PENIS PROS COMP 21.20 $789.28 --- $995.34 004 1 0 0.00 $0.00 Y
K 54415 REMOVE SELF-CONTD PENIS PROS 11.61 $432.24 --- $545.09 004 1 0 0.00 $0.00 Y
O 54415 REMOVE SELF-CONTD PENIS PROS 2.32 $86.37 --- $108.92 004 1 0 0.00 $0.00 Y
O 54416 REMV/REPL PENIS CONTAIN PROS 3.03 $112.81 --- $142.26 004 1 0 0.00 $0.00 Y
K 54416 REMV/REPL PENIS CONTAIN PROS 15.14 $563.66 --- $710.82 004 1 0 0.00 $0.00 Y
K 54417 REMV/REPLC PENIS PROS COMPL 18.64 $693.97 --- $875.15 004 1 0 0.00 $0.00 Y
O 54417 REMV/REPLC PENIS PROS COMPL 3.73 $138.87 --- $175.12 004 1 0 0.00 $0.00 Y
O 54420 REVISION OF PENIS 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
K 54420 REVISION OF PENIS 13.14 $489.20 --- $616.92 004 1 0 0.00 $0.00 Y
K 54430 REVISION OF PENIS 13.14 $489.20 --- $616.92 004 1 0 0.00 $0.00 Y
O 54430 REVISION OF PENIS 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
O 54435 REVISION OF PENIS 2.32 $86.37 --- $108.92 004 1 0 0.00 $0.00 Y
K 54435 REVISION OF PENIS 11.60 $431.87 --- $544.62 004 1 0 0.00 $0.00 Y
K 54437 REPAIR CORPOREAL TEAR 15.91 $592.33 --- -- 004 0 0 0.00 $0.00 Y
O 54437 REPAIR CORPOREAL TEAR 3.18 $118.39 --- -- 004 0 0 0.00 $0.00 Y
O 54438 REPLANTATION OF PENIS 6.36 $236.78 --- -- 004 0 0 0.00 $0.00 Y
K 54438 REPLANTATION OF PENIS 31.83 $1185.03 --- -- 004 0 0 0.00 $0.00 Y
K 54440 REPAIR OF PENIS 4.93 $183.54 --- -- 004 0 0 0.00 $0.00 Y
O 54440 REPAIR OF PENIS 0.99 $36.86 --- $46.48 004 1 0 0.00 $0.00 Y
K 54500 BIOPSY OF TESTIS 3.19 $118.76 --- $149.77 004 1 1 0.00 $0.00 Y
K 54505 BIOPSY OF TESTIS 3.40 $126.58 --- $159.63 004 1 0 0.00 $0.00 Y
K 54512 EXCISE LESION TESTIS 12.13 $451.60 --- $569.50 004 1 0 0.00 $0.00 Y
K 54520 REMOVAL OF TESTIS 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 54520 REMOVAL OF TESTIS 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
O 54522 ORCHIECTOMY PARTIAL 2.76 $102.75 --- $129.58 004 1 0 0.00 $0.00 Y
K 54522 ORCHIECTOMY PARTIAL 13.81 $514.15 --- $648.38 004 1 0 0.00 $0.00 Y
K 54530 REMOVAL OF TESTIS 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 54530 REMOVAL OF TESTIS 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 54535 EXTENSIVE TESTIS SURGERY 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 54535 EXTENSIVE TESTIS SURGERY 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y