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Medi-Cal Rates Information

Medi-Cal Rates as of 03/15/2020 (Codes 54550 thru 60699)

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 54550 EXPLORATION FOR TESTIS 8.83 $328.74 --- $414.57 004 1 0 0.00 $0.00 Y
O 54550 EXPLORATION FOR TESTIS 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
O 54560 EXPLORATION FOR TESTIS 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 54560 EXPLORATION FOR TESTIS 13.36 $497.39 --- $627.25 004 1 0 0.00 $0.00 Y
K 54600 REDUCE TESTIS TORSION 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 54600 REDUCE TESTIS TORSION 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 54620 SUSPENSION OF TESTIS 0.91 $33.88 --- $42.72 004 1 0 0.00 $0.00 Y
K 54620 SUSPENSION OF TESTIS 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 54640 ORCHIOPEXY INGUN/SCROT APPR 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
O 54640 ORCHIOPEXY INGUN/SCROT APPR 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
O 54650 ORCHIOPEXY, ABD APP, F/INTRAABD TESTIS 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
K 54650 ORCHIOPEXY, ABD APP, F/INTRAABD TESTIS 13.99 $520.85 --- $656.83 004 1 0 0.00 $0.00 Y
K 54670 REPAIR TESTIS INJURY 8.80 $327.62 --- $413.16 004 1 0 0.00 $0.00 Y
O 54670 REPAIR TESTIS INJURY 1.76 $65.52 --- $82.63 004 1 0 0.00 $0.00 Y
O 54680 RELOCATION OF TESTIS(ES) 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
K 54680 RELOCATION OF TESTIS(ES) 10.87 $404.69 --- $510.35 004 1 0 0.00 $0.00 Y
K 54690 LAPAROSCOPY ORCHIECTOMY 12.94 $481.76 --- $607.53 004 1 0 0.00 $0.00 Y
O 54690 LAPAROSCOPY ORCHIECTOMY 2.59 $96.43 --- $121.60 004 1 0 0.00 $0.00 Y
K 54692 LAPAROSCOPY ORCHIOPEXY 12.77 $475.43 --- $599.55 004 1 0 0.00 $0.00 Y
K 54699 LAPAROSCOPE PROC TESTIS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 54699 LAPAROSCOPE PROC TESTIS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 54700 DRAINAGE OF SCROTUM 5.33 $198.44 --- $250.24 004 1 0 0.00 $0.00 Y
K 54800 BIOPSY OF EPIDIDYMIS 3.68 $137.01 --- $172.78 004 1 1 0.00 $0.00 Y
K 54830 REMOVE EPIDIDYMIS LESION 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 54830 REMOVE EPIDIDYMIS LESION 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
O 54840 REMOVE EPIDIDYMIS LESION 1.60 $59.57 --- $75.12 004 1 0 0.00 $0.00 Y
K 54840 REMOVE EPIDIDYMIS LESION 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
K 54860 REMOVAL OF EPIDIDYMIS 8.84 $329.11 --- $415.04 004 1 0 0.00 $0.00 Y
O 54860 REMOVAL OF EPIDIDYMIS 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
O 54861 REMOVAL OF EPIDIDYMES 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 54861 REMOVAL OF EPIDIDYMES 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 54865 EXPLORE EPIDIDYMIS 9.11 $339.01 --- -- 004 0 0 0.00 $0.00 Y
O 54865 EXPLORE EPIDIDYMIS 1.82 $67.80 --- -- 004 0 0 0.00 $0.00 Y
K 55000 DRAINAGE OF HYDROCELE 1.50 $55.85 --- $70.43 004 1 1 0.00 $0.00 Y
K 55040 REMOVAL OF HYDROCELE 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 55040 REMOVAL OF HYDROCELE 1.60 $59.57 --- $75.12 004 1 0 0.00 $0.00 Y
O 55041 REMOVAL OF HYDROCELES 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
K 55041 REMOVAL OF HYDROCELES 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
K 55060 REPAIR OF HYDROCELE 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 55060 REPAIR OF HYDROCELE 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
K 55100 DRAINAGE OF SCROTUM ABSCESS 5.24 $195.09 --- $246.02 004 1 1 0.00 $0.00 Y
K 55110 EXPLORE SCROTUM 7.85 $292.26 --- $368.56 004 1 0 0.00 $0.00 Y
O 55110 EXPLORE SCROTUM 1.57 $58.45 --- $73.71 004 1 0 0.00 $0.00 Y
O 55120 REMOVAL OF SCROTUM LESION 1.51 $56.22 --- $70.89 004 1 0 0.00 $0.00 Y
K 55120 REMOVAL OF SCROTUM LESION 7.57 $281.83 --- $355.41 004 1 0 0.00 $0.00 Y
K 55150 REMOVAL OF SCROTUM 8.22 $306.03 --- -- 004 0 0 0.00 $0.00 Y
O 55150 REMOVAL OF SCROTUM 1.64 $61.06 --- $77.00 004 1 0 0.00 $0.00 Y
O 55175 REVISION OF SCROTUM 1.40 $52.12 --- $65.73 004 1 0 0.00 $0.00 Y
K 55175 REVISION OF SCROTUM 7.00 $260.61 --- $328.65 004 1 0 0.00 $0.00 Y
K 55180 REVISION OF SCROTUM 14.43 $537.23 --- $677.49 004 1 0 0.00 $0.00 Y
O 55180 REVISION OF SCROTUM 2.89 $107.59 --- $135.69 004 1 0 0.00 $0.00 Y
K 55200 INCISION OF SPERM DUCT 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 55250 REMOVAL OF SPERM DUCT(S) 7.00 $260.61 --- $328.65 004 1 1 0.00 $0.00 Y
K 55300 PREPARE SPERM DUCT X-RAY 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 55500 REMOVAL OF HYDROCELE 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
O 55500 REMOVAL OF HYDROCELE 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
O 55520 REMOVAL OF SPERM CORD LESION 1.36 $50.63 --- $63.85 004 1 0 0.00 $0.00 Y
K 55520 REMOVAL OF SPERM CORD LESION 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 55530 REVISE SPERMATIC CORD VEINS 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 55530 REVISE SPERMATIC CORD VEINS 1.60 $59.57 --- $75.12 004 1 0 0.00 $0.00 Y
O 55535 REVISE SPERMATIC CORD VEINS 1.90 $70.74 --- $89.21 004 1 0 0.00 $0.00 Y
K 55535 REVISE SPERMATIC CORD VEINS 9.50 $353.69 --- $446.03 004 1 0 0.00 $0.00 Y
K 55540 REVISE HERNIA & SPERM VEINS 10.49 $390.54 --- $492.51 004 1 0 0.00 $0.00 Y
O 55540 REVISE HERNIA & SPERM VEINS 2.10 $78.18 --- $98.60 004 1 0 0.00 $0.00 Y
O 55550 LAPARO LIGATE SPERMATIC VEIN 1.34 $49.89 --- $62.91 004 1 0 0.00 $0.00 Y
K 55550 LAPARO LIGATE SPERMATIC VEIN 6.72 $250.19 --- $315.50 004 1 0 0.00 $0.00 Y
K 55559 LAPARO PROC SPERMATIC CORD 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 55559 LAPARO PROC SPERMATIC CORD 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 55600 INCISE SPERM DUCT POUCH 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
K 55600 INCISE SPERM DUCT POUCH 8.83 $328.74 --- $414.57 004 1 0 0.00 $0.00 Y
K 55605 INCISE SPERM DUCT POUCH 13.30 $495.16 --- $624.44 004 1 0 0.00 $0.00 Y
O 55605 INCISE SPERM DUCT POUCH 2.70 $100.52 --- $126.77 004 1 0 0.00 $0.00 Y
O 55650 REMOVE SPERM DUCT POUCH 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 55650 REMOVE SPERM DUCT POUCH 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
K 55680 REMOVE SPERM POUCH LESION 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 55680 REMOVE SPERM POUCH LESION 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 55700 BIOPSY OF PROSTATE 2.35 $87.49 --- $110.33 004 1 0 0.00 $0.00 Y
K 55705 BIOPSY OF PROSTATE 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
O 55705 BIOPSY OF PROSTATE 1.60 $59.57 --- $75.12 004 1 0 0.00 $0.00 Y
K 55706 PROSTATE SATURATION SAMPLING 7.99 $297.47 --- -- 004 0 0 0.00 $0.00 Y
K 55720 DRAINAGE OF PROSTATE ABSCESS 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
O 55720 DRAINAGE OF PROSTATE ABSCESS 1.81 $67.39 --- $84.98 004 1 0 0.00 $0.00 Y
O 55725 DRAINAGE OF PROSTATE ABSCESS 2.80 $104.24 --- $131.46 004 1 0 0.00 $0.00 Y
K 55725 DRAINAGE OF PROSTATE ABSCESS 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 55801 REMOVAL OF PROSTATE 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 55801 REMOVAL OF PROSTATE 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 55810 EXTENSIVE PROSTATE SURGERY 5.72 $212.96 --- $268.55 004 1 0 0.00 $0.00 Y
K 55810 EXTENSIVE PROSTATE SURGERY 28.62 $1065.52 --- $1343.71 004 1 0 0.00 $0.00 Y
K 55812 EXTENSIVE PROSTATE SURGERY 35.11 $1307.15 --- $1648.41 004 1 0 0.00 $0.00 Y
O 55812 EXTENSIVE PROSTATE SURGERY 7.02 $261.35 --- $329.59 004 1 0 0.00 $0.00 Y
O 55815 EXTENSIVE PROSTATE SURGERY 8.00 $297.84 --- $375.60 004 1 0 0.00 $0.00 Y
K 55815 EXTENSIVE PROSTATE SURGERY 40.00 $1489.20 --- $1878.00 004 1 0 0.00 $0.00 Y
K 55821 REMOVAL OF PROSTATE 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 55821 REMOVAL OF PROSTATE 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
O 55831 REMOVAL OF PROSTATE 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 55831 REMOVAL OF PROSTATE 20.42 $760.24 --- $958.72 004 1 0 0.00 $0.00 Y
K 55840 EXTENSIVE PROSTATE SURGERY 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
O 55840 EXTENSIVE PROSTATE SURGERY 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
O 55842 EXTENSIVE PROSTATE SURGERY 6.12 $227.85 --- $287.33 004 1 0 0.00 $0.00 Y
K 55842 EXTENSIVE PROSTATE SURGERY 30.58 $1138.49 --- $1435.73 004 1 0 0.00 $0.00 Y
K 55845 EXTENSIVE PROSTATE SURGERY 36.12 $1344.75 --- $1695.83 004 1 0 0.00 $0.00 Y
O 55845 EXTENSIVE PROSTATE SURGERY 7.18 $267.31 --- $337.10 004 1 0 0.00 $0.00 Y
O 55860 SURGICAL EXPOSURE PROSTATE 2.61 $97.17 --- $122.54 004 1 0 0.00 $0.00 Y
K 55860 SURGICAL EXPOSURE PROSTATE 13.03 $485.11 --- $611.76 004 1 0 0.00 $0.00 Y
K 55862 EXTENSIVE PROSTATE SURGERY 14.72 $548.03 --- $691.10 004 1 0 0.00 $0.00 Y
O 55862 EXTENSIVE PROSTATE SURGERY 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
O 55865 EXTENSIVE PROSTATE SURGERY 5.21 $193.97 --- $244.61 004 1 0 0.00 $0.00 Y
K 55865 EXTENSIVE PROSTATE SURGERY 26.05 $969.84 --- $1223.05 004 1 0 0.00 $0.00 Y
K 55866 LAPARO RADICAL PROSTATECTOMY 25.60 $953.26 --- $1201.92 004 1 0 0.00 $0.00 Y
O 55866 LAPARO RADICAL PROSTATECTOMY 5.12 $190.65 --- $240.38 004 1 0 0.00 $0.00 Y
K 55874 TPRNL PLMT BIODEGRDABL MATRL 93.49 $3480.82 --- -- 004 0 0 0.00 $0.00 Y
K 55875 TRANSPERI NEEDLE PLACE PROS 19.29 $718.22 --- -- 004 0 0 0.00 $0.00 Y
O 55875 TRANSPERI NEEDLE PLACE PROS 3.86 $143.64 --- -- 004 0 0 0.00 $0.00 Y
K 55876 PLACE RT DEVICE/MARKER PROS 3.55 $132.28 --- -- 004 0 0 0.00 $0.00 Y
K 55899 GENITAL SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 55899 GENITAL SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 55920 PLACE NEEDLES PELVIC FOR RT 1.85 $68.88 --- -- 004 0 0 0.00 $0.00 Y
K 55920 PLACE NEEDLES PELVIC FOR RT 9.24 $344.01 --- -- 004 0 0 0.00 $0.00 Y
K 56405 I & D OF VULVA / PERINEUM 1.79 $90.70 --- -- 016 0 0 0.00 $0.00 Y
K 56420 INCIS DRAIN OF BARTHOLIN'S GLAND ABSCESS 1.24 $62.83 --- -- 016 0 1 0.00 $0.00 Y
K 56440 SURGERY FOR VULVA LESION 4.00 $202.68 --- -- 016 0 1 0.00 $0.00 Y
K 56441 LYSIS OF LABIAL ADHESIONS 1.49 $75.50 --- -- 016 0 0 0.00 $0.00 Y
K 56442 HYMENOTOMY 1.72 $87.11 --- -- 016 0 0 0.00 $0.00 Y
K 56501 DESTROY VULVA LESIONS SIM 1.58 $80.06 --- -- 016 0 0 0.00 $0.00 Y
K 56515 DESTROY VULVA LESION/S COMPL 2.42 $122.62 --- -- 016 0 1 0.00 $0.00 Y
O 56515 DESTROY VULVA LESION/S COMPL 0.48 $24.32 --- -- 016 0 0 0.00 $0.00 Y
K 56605 BIOPSY OF VULVA / PERINEUM 1.16 $58.78 --- -- 016 0 0 0.00 $0.00 Y
K 56606 BIOPSY OF VULVA/PERINEUM 0.69 $34.96 --- -- 016 0 0 0.00 $0.00 Y
K 56620 PARTIAL REMOVAL OF VULVA 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 56620 PARTIAL REMOVAL OF VULVA 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 56625 COMPLETE REMOVAL OF VULVA 3.00 $152.01 --- -- 016 0 0 0.00 $0.00 Y
K 56625 COMPLETE REMOVAL OF VULVA 15.00 $760.05 --- -- 016 0 0 0.00 $0.00 Y
K 56630 EXTENSIVE VULVA SURGERY 20.00 $1013.40 --- -- 016 0 0 0.00 $0.00 Y
O 56630 EXTENSIVE VULVA SURGERY 4.00 $202.68 --- -- 016 0 0 0.00 $0.00 Y
O 56631 VULVECTOMY, RADICAL, PARTIAL 5.84 $295.91 --- -- 016 0 0 0.00 $0.00 Y
K 56631 VULVECTOMY, RADICAL, PARTIAL 29.19 $1479.06 --- -- 016 0 0 0.00 $0.00 Y
K 56632 VULVECTOMY, RADICAL, PARTIAL 28.56 $1447.14 --- -- 016 0 0 0.00 $0.00 Y
O 56632 VULVECTOMY, RADICAL, PARTIAL 5.71 $289.33 --- -- 016 0 0 0.00 $0.00 Y
O 56633 VULVECTOMY, RADICAL, COMPLETE 4.61 $233.59 --- -- 016 0 0 0.00 $0.00 Y
K 56633 VULVECTOMY, RADICAL, COMPLETE 23.03 $1166.93 --- -- 016 0 0 0.00 $0.00 Y
K 56634 VULVECTOMY, RADICAL, COMPLETE 30.11 $1525.67 --- -- 016 0 0 0.00 $0.00 Y
O 56634 VULVECTOMY, RADICAL, COMPLETE 6.02 $305.03 --- -- 016 0 0 0.00 $0.00 Y
O 56637 VULVECTOMY, RADICAL, COMPLETE 6.14 $311.11 --- -- 016 0 0 0.00 $0.00 Y
K 56637 VULVECTOMY, RADICAL, COMPLETE 30.70 $1555.57 --- -- 016 0 0 0.00 $0.00 Y
K 56640 VULVECTOMY, RADICAL, COMPLETE 26.00 $1317.42 --- -- 016 0 0 0.00 $0.00 Y
O 56640 VULVECTOMY, RADICAL, COMPLETE 5.20 $263.48 --- -- 016 0 0 0.00 $0.00 Y
K 56700 PARTIAL HYMENECTOMY OR REVISION 2.72 $137.82 --- -- 016 0 0 0.00 $0.00 Y
K 56740 REMOVE VAGINA GLAND LESION 4.80 $243.22 --- -- 016 0 0 0.00 $0.00 Y
K 56800 REPAIR OF VAGINA 4.80 $243.22 --- -- 016 0 0 0.00 $0.00 Y
O 56800 REPAIR OF VAGINA 0.96 $48.64 --- -- 016 0 0 0.00 $0.00 Y
O 56805 CLITOROPLASTY FOR INTERSEX STATE 3.49 $176.84 --- -- 016 0 0 0.00 $0.00 Y
K 56805 CLITOROPLASTY FOR INTERSEX STATE 17.46 $884.70 --- -- 016 0 0 0.00 $0.00 Y
K 56810 REPAIR OF PERINEUM 4.90 $248.28 --- -- 016 0 0 0.00 $0.00 Y
O 56810 REPAIR OF PERINEUM 0.98 $49.66 --- -- 016 0 0 0.00 $0.00 Y
K 56820 EXAM OF VULVA W/SCOPE 2.48 $125.61 --- -- 016 0 1 0.00 $0.00 Y
K 56821 EXAM/BIOPSY OF VULVA W/SCOPE 3.21 $162.50 --- -- 016 0 1 0.00 $0.00 Y
K 57000 EXPLORATION OF VAGINA 4.00 $202.68 --- -- 016 0 0 0.00 $0.00 Y
O 57000 EXPLORATION OF VAGINA 0.80 $40.54 --- -- 016 0 0 0.00 $0.00 Y
O 57010 DRAINAGE OF PELVIC ABSCESS 0.91 $46.11 --- -- 016 0 0 0.00 $0.00 Y
K 57010 DRAINAGE OF PELVIC ABSCESS 4.53 $229.54 --- -- 016 0 0 0.00 $0.00 Y
K 57020 DRAINAGE OF PELVIC FLUID 1.01 $51.18 --- -- 016 0 1 0.00 $0.00 Y
K 57061 DESTROY VAG LESIONS SIMPLE 1.16 $58.78 --- -- 016 0 0 0.00 $0.00 Y
K 57065 DESTROY VAG LESIONS COMPLEX 1.84 $93.23 --- -- 016 0 0 0.00 $0.00 Y
K 57100 BIOPSY OF VAGINA 0.81 $41.04 --- -- 016 0 1 0.00 $0.00 Y
K 57105 BIOPSY OF VAGINA 1.93 $97.79 --- -- 016 0 0 0.00 $0.00 Y
O 57105 BIOPSY OF VAGINA 0.39 $19.76 --- -- 016 0 0 0.00 $0.00 Y
O 57106 REMOVE VAGINA WALL PARTIAL 1.17 $59.28 --- -- 016 1 0 0.00 $0.00 Y
K 57106 REMOVE VAGINA WALL PARTIAL 5.83 $295.41 --- -- 016 1 0 0.00 $0.00 Y
K 57107 REMOVE VAGINA TISSUE PART 20.16 $1021.51 --- -- 016 1 0 0.00 $0.00 Y
O 57107 REMOVE VAGINA TISSUE PART 4.03 $204.20 --- -- 016 1 0 0.00 $0.00 Y
O 57109 VAGINECTOMY PARTIAL W/NODES 4.93 $249.80 --- -- 016 1 0 0.00 $0.00 Y
K 57109 VAGINECTOMY PARTIAL W/NODES 24.68 $1250.54 --- -- 016 1 0 0.00 $0.00 Y
K 57110 REMOVE VAGINA WALL COMPLETE 14.00 $709.38 --- -- 016 0 0 0.00 $0.00 Y
O 57110 REMOVE VAGINA WALL COMPLETE 2.80 $141.88 --- -- 016 0 0 0.00 $0.00 Y
O 57111 REMOVE VAGINA TISSUE COMPL 4.94 $250.31 --- -- 016 1 0 0.00 $0.00 Y
K 57111 REMOVE VAGINA TISSUE COMPL 24.73 $1253.07 --- -- 016 1 0 0.00 $0.00 Y
K 57112 VAGINECTOMY W/NODES COMPL 26.34 $1334.65 --- -- 016 1 0 0.00 $0.00 Y
O 57112 VAGINECTOMY W/NODES COMPL 5.28 $267.54 --- -- 016 1 0 0.00 $0.00 Y
O 57120 CLOSURE OF VAGINA 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
K 57120 CLOSURE OF VAGINA 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
K 57130 REMOVE VAGINA LESION 3.20 $162.14 --- -- 016 0 0 0.00 $0.00 Y
O 57130 REMOVE VAGINA LESION 0.64 $32.43 --- -- 016 0 0 0.00 $0.00 Y
O 57135 REMOVE VAGINA LESION 0.54 $27.36 --- -- 016 0 0 0.00 $0.00 Y
K 57135 REMOVE VAGINA LESION 2.72 $137.82 --- -- 016 0 1 0.00 $0.00 Y
K 57150 TREAT VAGINA INFECTION 0.50 $25.34 --- -- 016 0 1 0.00 $0.00 Y
K 57155 INSERT UTERI TANDEM/OVOIDS 6.35 $321.75 --- -- 016 0 0 0.00 $0.00 Y
K 57156 INS VAG BRACHYTX DEVICE 2.33 $86.82 --- -- 016 0 0 0.00 $0.00 Y
K 57160 INSERT PESSARY/OTHER DEVICE 0.74 $37.50 --- -- 016 0 1 0.00 $0.00 Y
K 57170 FITTING OF DIAPHRAGM 0.75 $38.00 --- -- 016 0 1 0.00 $0.00 Y
K 57180 TREAT VAGINAL BLEEDING 1.27 $64.35 --- -- 016 0 0 0.00 $0.00 Y
K 57200 REPAIR OF VAGINA 3.63 $183.93 --- -- 016 0 0 0.00 $0.00 Y
O 57200 REPAIR OF VAGINA 0.72 $36.48 --- -- 016 0 0 0.00 $0.00 Y
O 57210 REPAIR VAGINA/PERINEUM 0.00 $0.00 --- -- 016 0 0 0.00 $0.00 Y
K 57210 REPAIR VAGINA/PERINEUM 147.28 $147.28 --- -- 042 0 0 0.00 $0.00 Y
K 57220 PLASTIC OPERATION ON URETHRAL SPHINCTER 7.00 $354.69 --- -- 016 0 0 0.00 $0.00 Y
O 57220 PLASTIC OPERATION ON URETHRAL SPHINCTER 1.40 $70.94 --- -- 016 0 0 0.00 $0.00 Y
O 57230 PLASTIC REPAIR OF URETHROCELE 1.40 $70.94 --- -- 016 0 0 0.00 $0.00 Y
K 57230 PLASTIC REPAIR OF URETHROCELE 7.00 $354.69 --- -- 016 0 0 0.00 $0.00 Y
K 57240 ANTERIOR COLPORRHAPHY, REPAIR CYSTOCELE 8.50 $430.70 --- -- 016 0 0 0.00 $0.00 Y
O 57240 ANTERIOR COLPORRHAPHY, REPAIR CYSTOCELE 1.70 $86.14 --- -- 016 0 0 0.00 $0.00 Y
O 57250 POSTERIOR COLPORRHAPHY, REPAIR RECTOCELE 1.40 $70.94 --- -- 016 0 0 0.00 $0.00 Y
K 57250 POSTERIOR COLPORRHAPHY, REPAIR RECTOCELE 7.00 $354.69 --- -- 016 0 0 0.00 $0.00 Y
K 57260 CMBN ANT PST COLPRHY 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 57260 CMBN ANT PST COLPRHY 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 57265 EXTENSIVE REPAIR OF VAGINA 2.80 $141.88 --- -- 016 0 0 0.00 $0.00 Y
K 57265 EXTENSIVE REPAIR OF VAGINA 14.00 $709.38 --- -- 016 0 0 0.00 $0.00 Y
K 57267 INSERT MESH/PELVIC FLR ADDON 3.33 $168.73 --- -- 016 0 0 0.00 $0.00 Y
O 57267 INSERT MESH/PELVIC FLR ADDON 0.67 $33.95 --- -- 016 0 0 0.00 $0.00 Y
O 57268 REPAIR OF BOWEL BULGE 1.80 $91.21 --- -- 016 0 0 0.00 $0.00 Y
K 57268 REPAIR OF BOWEL BULGE 9.00 $456.03 --- -- 016 0 0 0.00 $0.00 Y
K 57270 REPAIR OF BOWEL POUCH 14.00 $709.38 --- -- 016 0 0 0.00 $0.00 Y
O 57270 REPAIR OF BOWEL POUCH 2.80 $141.88 --- -- 016 0 0 0.00 $0.00 Y
O 57280 SUSPENSION OF VAGINA 2.82 $142.89 --- -- 016 0 0 0.00 $0.00 Y
K 57280 SUSPENSION OF VAGINA 14.13 $715.97 --- -- 016 0 0 0.00 $0.00 Y
K 57282 COLPOPEXY EXTRAPERITONEAL 6.91 $350.13 --- -- 016 0 0 0.00 $0.00 Y
O 57282 COLPOPEXY EXTRAPERITONEAL 1.38 $69.92 --- -- 016 0 0 0.00 $0.00 Y
O 57283 COLPOPEXY INTRAPERITONEAL 1.44 $72.89 --- -- 016 1 0 0.00 $0.00 Y
K 57283 COLPOPEXY INTRAPERITONEAL 7.19 $364.43 --- -- 016 1 0 0.00 $0.00 Y
K 57284 REPAIR PARAVAG DEFECT OPEN 16.05 $813.25 --- -- 016 0 0 0.00 $0.00 Y
O 57284 REPAIR PARAVAG DEFECT OPEN 3.21 $162.65 --- -- 016 0 0 0.00 $0.00 Y
O 57285 REPAIR PARAVAG DEFECT VAG 1.97 $99.82 --- -- 016 0 0 0.00 $0.00 Y
K 57285 REPAIR PARAVAG DEFECT VAG 9.85 $499.10 --- -- 016 0 0 0.00 $0.00 Y
K 57287 REVISE/REMOVE SLING REPAIR 11.78 $596.89 --- -- 016 0 0 0.00 $0.00 Y
O 57287 REVISE/REMOVE SLING REPAIR 2.36 $119.58 --- -- 016 1 0 0.00 $0.00 Y
O 57288 REPAIR BLADDER DEFECT 3.10 $157.08 --- -- 016 0 0 0.00 $0.00 Y
K 57288 REPAIR BLADDER DEFECT 15.30 $775.25 --- -- 016 0 0 0.00 $0.00 Y
K 57289 REPAIR BLADDER & VAGINA 11.80 $597.91 --- -- 016 0 0 0.00 $0.00 Y
O 57289 REPAIR BLADDER & VAGINA 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 57291 CONSTRUCTION OF VAGINA 1.49 $75.50 --- -- 016 0 0 0.00 $0.00 Y
K 57291 CONSTRUCTION OF VAGINA 7.46 $378.00 --- -- 016 0 0 0.00 $0.00 Y
K 57292 CONSTRUCT VAGINA WITH GRAFT 12.63 $639.96 --- -- 016 0 0 0.00 $0.00 Y
O 57292 CONSTRUCT VAGINA WITH GRAFT 2.53 $128.20 --- -- 016 0 0 0.00 $0.00 Y
O 57295 REVISE VAG GRAFT VIA VAGINA 1.54 $78.03 --- -- 016 0 0 0.00 $0.00 Y
K 57295 REVISE VAG GRAFT VIA VAGINA 7.70 $390.16 --- -- 016 0 0 0.00 $0.00 Y
K 57296 REVISE VAG GRAFT OPEN ABD 15.61 $791.04 --- -- 016 0 0 0.00 $0.00 Y
O 57296 REVISE VAG GRAFT OPEN ABD 3.12 $158.21 --- -- 016 0 0 0.00 $0.00 Y
O 57300 REPAIR RECTUM-VAGINA FISTULA 2.90 $146.94 --- -- 016 0 0 0.00 $0.00 Y
K 57300 REPAIR RECTUM-VAGINA FISTULA 14.50 $734.72 --- -- 016 0 0 0.00 $0.00 Y
K 57305 REPAIR RECTUM-VAGINA FISTULA 18.00 $912.06 --- -- 016 0 0 0.00 $0.00 Y
O 57305 REPAIR RECTUM-VAGINA FISTULA 3.60 $182.41 --- -- 016 0 0 0.00 $0.00 Y
O 57307 FISTULA REPAIR & COLOSTOMY 4.00 $202.68 --- -- 016 0 0 0.00 $0.00 Y
K 57307 FISTULA REPAIR & COLOSTOMY 20.00 $1013.40 --- -- 016 0 0 0.00 $0.00 Y
K 57308 FISTULA REPAIR TRANSPERINE 12.72 $644.52 --- -- 016 0 0 0.00 $0.00 Y
O 57308 FISTULA REPAIR TRANSPERINE 2.54 $128.70 --- -- 016 0 0 0.00 $0.00 Y
O 57310 REPAIR URETHROVAGINAL LESION 2.90 $146.94 --- -- 016 0 0 0.00 $0.00 Y
K 57310 REPAIR URETHROVAGINAL LESION 14.50 $734.72 --- -- 016 0 0 0.00 $0.00 Y
K 57311 REPAIR URETHROVAGINAL LESION 8.52 $431.71 --- -- 016 0 0 0.00 $0.00 Y
O 57311 REPAIR URETHROVAGINAL LESION 1.70 $86.14 --- -- 016 0 0 0.00 $0.00 Y
O 57320 REPAIR BLADDER-VAGINA LESION 2.90 $146.94 --- -- 016 0 0 0.00 $0.00 Y
K 57320 REPAIR BLADDER-VAGINA LESION 14.50 $734.72 --- -- 016 0 0 0.00 $0.00 Y
K 57330 REPAIR BLADDER-VAGINA LESION 12.79 $648.07 --- -- 016 0 0 0.00 $0.00 Y
O 57330 REPAIR BLADDER-VAGINA LESION 2.56 $129.72 --- -- 016 0 0 0.00 $0.00 Y
O 57335 VAGINOPLASTY FOR INTERSEX STATE 3.50 $177.35 --- -- 016 0 0 0.00 $0.00 Y
K 57335 VAGINOPLASTY FOR INTERSEX STATE 17.52 $887.74 --- -- 016 0 0 0.00 $0.00 Y
K 57400 DILATION OF VAGINA 1.19 $60.30 --- -- 016 0 0 0.00 $0.00 Y
K 57410 PELVIC EXAMINATION 1.48 $74.99 --- -- 016 0 0 0.00 $0.00 Y
K 57415 REMOVE VAGINAL FOREIGN BODY 1.86 $94.25 --- -- 016 0 0 0.00 $0.00 Y
K 57420 EXAM OF VAGINA W/SCOPE 2.69 $136.26 --- -- 016 0 1 0.00 $0.00 Y
K 57421 EXAM/BIOPSY OF VAG W/SCOPE 2.69 $136.30 --- -- 016 0 1 0.00 $0.00 Y
K 57423 REPAIR PARAVAG DEFECT LAP 13.58 $688.10 --- -- 016 0 0 0.00 $0.00 Y
O 57423 REPAIR PARAVAG DEFECT LAP 2.72 $137.82 --- -- 016 0 0 0.00 $0.00 Y
O 57425 LAPAROSCOPY SURG COLPOPEXY 2.02 $102.11 --- -- 016 1 0 0.00 $0.00 Y
K 57425 LAPAROSCOPY SURG COLPOPEXY 10.08 $510.57 --- -- 016 1 0 0.00 $0.00 Y
K 57426 REVISE PROSTH VAG GRAFT LAP 14.09 $713.94 --- -- 016 0 0 0.00 $0.00 Y
O 57426 REVISE PROSTH VAG GRAFT LAP 2.82 $142.89 --- -- 016 0 0 0.00 $0.00 Y
K 57452 EXAM OF CERVIX W/SCOPE 1.02 $51.68 --- -- 016 0 1 0.00 $0.00 Y
K 57454 BX/CURETT OF CERVIX W/SCOPE 1.70 $86.14 --- -- 016 0 1 0.00 $0.00 Y
K 57455 BIOPSY OF CERVIX W/SCOPE 1.57 $79.55 --- -- 016 0 1 0.00 $0.00 Y
K 57456 ENDOCERV CURETTAGE W/SCOPE 1.48 $74.99 --- -- 016 0 1 0.00 $0.00 Y
K 57460 BX OF CERVIX W/SCOPE LEEP 3.69 $186.97 --- -- 016 0 1 0.00 $0.00 Y
K 57461 CONZ OF CERVIX W/SCOPE LEEP 5.57 $282.23 --- -- 016 0 1 0.00 $0.00 Y
K 57500 BIOPSY OF CERVIX 0.80 $40.54 --- -- 016 0 1 0.00 $0.00 Y
K 57505 ENDOCERVICAL CURETTAGE 1.00 $50.67 --- -- 016 0 1 0.00 $0.00 Y
K 57510 CAUTERIZATION OF CERVIX 1.67 $84.62 --- -- 016 0 1 0.00 $0.00 Y
K 57511 CRYOCAUTERY OF CERVIX 1.42 $71.95 --- -- 016 0 1 0.00 $0.00 Y
K 57513 CAUTERIZATION OF CERVIX, LASER 4.34 $219.91 --- -- 016 0 0 0.00 $0.00 Y
K 57520 CONIZATION OF CERVIX,W/OR W/OUT FULGURAT 5.09 $257.91 --- -- 016 0 0 0.00 $0.00 Y
K 57522 CONIZATION OF CERVIX W/O FULGURATION 4.43 $224.47 --- -- 016 0 0 0.00 $0.00 Y
K 57530 REMOVAL OF CERVIX 5.20 $263.48 --- -- 016 0 0 0.00 $0.00 Y
O 57530 REMOVAL OF CERVIX 1.04 $52.70 --- -- 016 0 0 0.00 $0.00 Y
O 57531 REMOVAL OF CERVIX RADICAL 5.99 $303.51 --- -- 016 0 0 0.00 $0.00 Y
K 57531 REMOVAL OF CERVIX RADICAL 29.94 $1517.06 --- -- 016 0 0 0.00 $0.00 Y
K 57540 REMOVAL OF RESIDUAL CERVIX 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 57540 REMOVAL OF RESIDUAL CERVIX 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 57545 REMOVE CERVIX/REPAIR PELVIS 2.63 $133.26 --- -- 016 0 0 0.00 $0.00 Y
K 57545 REMOVE CERVIX/REPAIR PELVIS 13.16 $666.82 --- -- 016 0 0 0.00 $0.00 Y
K 57550 REMOVAL OF RESIDUAL CERVIX 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 57550 REMOVAL OF RESIDUAL CERVIX 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 57555 REMOVE CERVIX/REPAIR VAGINA 2.90 $146.94 --- -- 016 0 0 0.00 $0.00 Y
K 57555 REMOVE CERVIX/REPAIR VAGINA 14.50 $734.72 --- -- 016 0 0 0.00 $0.00 Y
K 57556 REMOVE CERVIX REPAIR BOWEL 14.50 $734.72 --- -- 016 0 0 0.00 $0.00 Y
O 57556 REMOVE CERVIX REPAIR BOWEL 2.90 $146.94 --- -- 016 0 0 0.00 $0.00 Y
K 57558 D&C OF CERVICAL STUMP 4.00 $202.68 --- -- 016 0 0 0.00 $0.00 Y
K 57700 REVISION OF CERVIX 6.00 $304.02 --- -- 016 0 0 0.00 $0.00 Y
O 57700 REVISION OF CERVIX 1.20 $60.80 --- -- 016 0 0 0.00 $0.00 Y
O 57720 REVISION OF CERVIX 1.20 $60.80 --- -- 016 0 0 0.00 $0.00 Y
K 57720 REVISION OF CERVIX 6.00 $304.02 --- -- 016 0 0 0.00 $0.00 Y
K 57800 DILATION OF CERVICAL CANAL 0.68 $34.46 --- -- 016 0 1 0.00 $0.00 Y
K 58100 ENDOMET SAMPL,W/WO ENDOCERVICAL SAMP,ANY 0.81 $41.04 --- -- 016 0 1 0.00 $0.00 Y
K 58110 BX DONE W/COLPOSCOPY ADDON 0.85 $43.07 --- -- 016 1 1 0.00 $0.00 Y
O 58110 BX DONE W/COLPOSCOPY ADDON 0.17 $8.61 --- -- 016 1 1 0.00 $0.00 Y
K 58120 DILATION AND CURETTAGE 4.40 $222.95 --- -- 016 0 1 0.00 $0.00 Y
K 58140 MYOMECTOMY ABDOM METHOD 14.00 $709.38 --- -- 016 0 0 0.00 $0.00 Y
O 58140 MYOMECTOMY ABDOM METHOD 2.80 $141.88 --- -- 016 0 0 0.00 $0.00 Y
O 58145 MYOMECTOMY VAG METHOD 1.47 $74.48 --- -- 016 0 0 0.00 $0.00 Y
K 58145 MYOMECTOMY VAG METHOD 7.36 $372.93 --- -- 016 0 0 0.00 $0.00 Y
K 58146 MYOMECTOMY ABDOM COMPLEX 11.92 $604.02 --- -- 016 0 0 0.00 $0.00 Y
O 58146 MYOMECTOMY ABDOM COMPLEX 2.38 $120.80 --- -- 016 0 0 0.00 $0.00 Y
O 58150 TOTAL ABDOMINAL HYSTERECTOMY 3.20 $162.14 --- -- 016 0 0 0.00 $0.00 Y
K 58150 TOTAL ABDOMINAL HYSTERECTOMY 16.00 $810.72 --- -- 016 0 0 0.00 $0.00 Y
K 58152 TOTAL HYSTERECTOMY 19.10 $967.80 --- -- 016 0 0 0.00 $0.00 Y
O 58152 TOTAL HYSTERECTOMY 3.80 $192.55 --- -- 016 0 0 0.00 $0.00 Y
O 58180 SUPRACERVICAL ABDO HYSTERECTOMY,SUBTOTAL 3.20 $162.14 --- -- 016 0 0 0.00 $0.00 Y
K 58180 SUPRACERVICAL ABDO HYSTERECTOMY,SUBTOTAL 16.00 $810.72 --- -- 016 0 0 0.00 $0.00 Y
K 58200 TOT ABDO HYSTERECTOMY,W/PAR. VAGINECTOMY 20.47 $1037.21 --- -- 016 0 0 0.00 $0.00 Y
O 58200 TOT ABDO HYSTERECTOMY,W/PAR. VAGINECTOMY 4.09 $207.24 --- -- 016 0 0 0.00 $0.00 Y
O 58210 RADICAL ABDOMINAL HYSTERECTOMY, ET AL 6.00 $304.02 --- -- 016 0 0 0.00 $0.00 Y
K 58210 RADICAL ABDOMINAL HYSTERECTOMY, ET AL 30.00 $1520.10 --- -- 016 0 0 0.00 $0.00 Y
K 58240 PELVIC EXENTERATION FOR GYN MALIGNANCY 35.97 $1822.60 --- -- 016 0 0 0.00 $0.00 Y
O 58240 PELVIC EXENTERATION FOR GYN MALIGNANCY 7.19 $364.32 --- -- 016 0 0 0.00 $0.00 Y
O 58260 VAGINAL HYSTERECTOMY 3.20 $162.14 --- -- 016 0 0 0.00 $0.00 Y
K 58260 VAGINAL HYSTERECTOMY 16.00 $810.72 --- -- 016 0 0 0.00 $0.00 Y
K 58262 VAG HYST INCLUDING T/O 15.94 $807.68 --- -- 016 0 0 0.00 $0.00 Y
O 58262 VAG HYST INCLUDING T/O 3.19 $161.64 --- -- 016 0 0 0.00 $0.00 Y
O 58263 VAG HYST W/T/O & VAG REPAIR 3.40 $172.28 --- -- 016 0 0 0.00 $0.00 Y
K 58263 VAG HYST W/T/O & VAG REPAIR 17.02 $862.40 --- -- 016 0 0 0.00 $0.00 Y
K 58267 VAG HYST W/URINARY REPAIR 20.80 $1053.94 --- -- 016 0 0 0.00 $0.00 Y
O 58267 VAG HYST W/URINARY REPAIR 4.20 $212.81 --- -- 016 0 0 0.00 $0.00 Y
O 58270 VAG HYST W/ENTEROCELE REPAIR 3.50 $177.35 --- -- 016 0 0 0.00 $0.00 Y
K 58270 VAG HYST W/ENTEROCELE REPAIR 17.40 $881.66 --- -- 016 0 0 0.00 $0.00 Y
K 58275 HYSTERECTOMY/REVISE VAGINA 18.00 $912.06 --- -- 016 0 0 0.00 $0.00 Y
O 58275 HYSTERECTOMY/REVISE VAGINA 3.60 $182.41 --- -- 016 0 0 0.00 $0.00 Y
O 58280 HYSTERECTOMY/REVISE VAGINA 3.60 $182.41 --- -- 016 0 0 0.00 $0.00 Y
K 58280 HYSTERECTOMY/REVISE VAGINA 18.00 $912.06 --- -- 016 0 0 0.00 $0.00 Y
K 58285 EXTENSIVE HYSTERECTOMY 24.00 $1216.08 --- -- 016 0 0 0.00 $0.00 Y
O 58285 EXTENSIVE HYSTERECTOMY 4.80 $243.22 --- -- 016 0 0 0.00 $0.00 Y
O 58290 VAG HYST COMPLEX 2.36 $119.58 --- -- 016 0 0 0.00 $0.00 Y
K 58290 VAG HYST COMPLEX 11.81 $598.46 --- -- 016 0 0 0.00 $0.00 Y
K 58291 VAG HYST INCL T/O COMPLEX 12.96 $656.64 --- -- 016 0 0 0.00 $0.00 Y
O 58291 VAG HYST INCL T/O COMPLEX 2.59 $131.24 --- -- 016 0 0 0.00 $0.00 Y
O 58292 VAG HYST T/O & REPAIR COMPL 2.76 $139.68 --- -- 016 0 0 0.00 $0.00 Y
K 58292 VAG HYST T/O & REPAIR COMPL 13.78 $698.39 --- -- 016 0 0 0.00 $0.00 Y
K 58293 VAG HYST W/URO REPAIR COMPL 14.34 $726.76 --- -- 016 0 0 0.00 $0.00 Y
O 58293 VAG HYST W/URO REPAIR COMPL 2.87 $145.35 --- -- 016 0 0 0.00 $0.00 Y
O 58294 VAG HYST W/ENTEROCELE COMPL 2.53 $128.03 --- -- 016 0 0 0.00 $0.00 Y
K 58294 VAG HYST W/ENTEROCELE COMPL 12.63 $640.16 --- -- 016 0 0 0.00 $0.00 Y
K 58300 INSERT INTRAUTERINE DEVICE 3.32 $168.22 --- -- 016 0 1 0.00 $0.00 Y
K 58301 REMOVE INTRAUTERINE DEVICE 0.96 $48.64 --- -- 016 0 1 0.00 $0.00 Y
K 58340 CATHETER FOR HYSTEROGRAPHY 3.66 $185.45 --- -- 016 0 1 0.00 $0.00 Y
K 58346 INSERT HEYMAN UTERI CAPSULE 6.77 $343.04 --- -- 016 0 0 0.00 $0.00 Y
K 58350 CHROMOTUBATION OF OVIDUCT,INC MATERIALS 1.13 $57.26 --- -- 016 0 1 0.00 $0.00 Y
K 58353 ENDOMETR ABLATE THERMAL 21.07 $1067.62 --- -- 016 0 0 0.00 $0.00 Y
K 58356 ENDOMETRIAL CRYOABLATION 46.08 $2334.87 --- -- 016 1 1 0.00 $0.00 Y
O 58356 ENDOMETRIAL CRYOABLATION 9.22 $467.18 --- -- 016 1 1 0.00 $0.00 Y
O 58520 REPAIR OF RUPTURED UTERUS 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
K 58520 REPAIR OF RUPTURED UTERUS 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
K 58541 LSH UTERUS 250 G OR LESS 14.03 $710.90 --- -- 016 0 0 0.00 $0.00 Y
O 58541 LSH UTERUS 250 G OR LESS 2.81 $142.15 --- -- 016 0 0 0.00 $0.00 Y
O 58542 LSH W/T/O UT 250 G OR LESS 3.75 $139.61 --- -- 016 0 0 0.00 $0.00 Y
K 58542 LSH W/T/O UT 250 G OR LESS 18.77 $698.81 --- -- 016 0 0 0.00 $0.00 Y
K 58543 LSH UTERUS ABOVE 250 G 15.79 $800.08 --- -- 016 0 0 0.00 $0.00 Y
O 58543 LSH UTERUS ABOVE 250 G 3.16 $160.06 --- -- 016 0 0 0.00 $0.00 Y
O 58544 LSH W/T/O UTERUS ABOVE 250 G 3.42 $173.22 --- -- 016 0 0 0.00 $0.00 Y
K 58544 LSH W/T/O UTERUS ABOVE 250 G 17.09 $865.95 --- -- 016 0 0 0.00 $0.00 Y
K 58545 LAPAROSCOPIC MYOMECTOMY 9.32 $472.04 --- -- 016 0 0 0.00 $0.00 Y
O 58545 LAPAROSCOPIC MYOMECTOMY 1.86 $94.48 --- -- 016 0 0 0.00 $0.00 Y
O 58546 LAPARO-MYOMECTOMY COMPLEX 1.50 $76.01 --- -- 016 0 0 0.00 $0.00 Y
K 58546 LAPARO-MYOMECTOMY COMPLEX 7.50 $380.03 --- -- 016 0 0 0.00 $0.00 Y
K 58548 LAP RADICAL HYST 29.87 $1513.51 --- -- 016 0 0 0.00 $0.00 Y
O 58548 LAP RADICAL HYST 5.97 $302.71 --- -- 016 0 0 0.00 $0.00 Y
O 58550 LAPARO-ASST VAG HYSTERECTOMY 2.17 $109.95 --- -- 016 0 0 0.00 $0.00 Y
K 58550 LAPARO-ASST VAG HYSTERECTOMY 11.54 $584.73 --- -- 016 1 0 0.00 $0.00 Y
K 58552 LAPAROVAG HYST INCL T/O 12.17 $616.65 --- -- 016 0 0 0.00 $0.00 Y
O 58552 LAPAROVAG HYST INCL T/O 2.29 $116.03 --- -- 016 0 0 0.00 $0.00 Y
O 58553 LAPARO-VAG HYST COMPLEX 2.64 $133.77 --- -- 016 0 0 0.00 $0.00 Y
K 58553 LAPARO-VAG HYST COMPLEX 14.02 $710.39 --- -- 016 0 0 0.00 $0.00 Y
K 58554 LAPARO-VAG HYST W/T/O COMPL 15.32 $776.26 --- -- 016 0 0 0.00 $0.00 Y
O 58554 LAPARO-VAG HYST W/T/O COMPL 2.89 $146.44 --- -- 016 0 0 0.00 $0.00 Y
K 58555 HYSTEROSCOPY DX SEP PROC 3.18 $161.13 --- -- 016 0 0 0.00 $0.00 Y
K 58558 HYSTEROSCOPY BIOPSY 3.46 $175.32 --- -- 016 0 0 0.00 $0.00 Y
K 58559 HYSTEROSCOPY LYSIS 5.19 $262.98 --- -- 016 0 0 0.00 $0.00 Y
K 58560 HYSTEROSCOPY RESECT SEPTUM 5.42 $274.63 --- -- 016 0 0 0.00 $0.00 Y
O 58560 HYSTEROSCOPY RESECT SEPTUM 1.09 $55.23 --- -- 016 0 0 0.00 $0.00 Y
K 58561 HYSTEROSCOPY REMOVE MYOMA 7.51 $380.53 --- -- 016 0 0 0.00 $0.00 Y
K 58562 HYSTEROSCOPY REMOVE FB 3.60 $182.41 --- -- 016 0 0 0.00 $0.00 Y
K 58563 HYSTEROSCOPY ABLATION 33.55 $1699.98 --- -- 016 0 0 0.00 $0.00 Y
K 58565 HYSTEROSCOPY STERILIZATION 14.56 $737.76 --- -- 016 1 0 0.00 $0.00 Y
K 58570 TLH UTERUS 250 G OR LESS 13.47 $682.52 --- -- 016 0 0 0.00 $0.00 Y
O 58570 TLH UTERUS 250 G OR LESS 2.69 $136.30 --- -- 016 0 0 0.00 $0.00 Y
O 58571 TLH W/T/O 250 G OR LESS 2.95 $149.48 --- -- 016 0 0 0.00 $0.00 Y
K 58571 TLH W/T/O 250 G OR LESS 14.77 $748.40 --- -- 016 0 0 0.00 $0.00 Y
K 58572 TLH UTERUS OVER 250 G 16.71 $846.70 --- -- 016 0 0 0.00 $0.00 Y
O 58572 TLH UTERUS OVER 250 G 3.34 $169.24 --- -- 016 0 0 0.00 $0.00 Y
O 58573 TLH W/T/O UTERUS OVER 250 G 3.78 $191.53 --- -- 016 0 0 0.00 $0.00 Y
K 58573 TLH W/T/O UTERUS OVER 250 G 18.88 $956.65 --- -- 016 0 0 0.00 $0.00 Y
K 58575 LAPS TOT HYST RESJ MAL 31.44 $1593.12 --- -- 016 0 0 0.00 $0.00 Y
O 58575 LAPS TOT HYST RESJ MAL 6.28 $318.62 --- -- 016 0 0 0.00 $0.00 Y
K 58578 LAPARO PROC UTERUS 0.00 $0.00 --- -- 016 1 0 0.00 $0.00 Y
K 58579 HYSTEROSCOPE PROCEDURE 0.00 $0.00 --- -- 016 1 0 0.00 $0.00 Y
K 58600 DIVISION OF FALLOPIAN TUBE 13.59 $757.51 --- -- 054 0 0 0.00 $0.00 Y
O 58600 DIVISION OF FALLOPIAN TUBE 2.72 $151.61 --- -- 054 0 0 0.00 $0.00 Y
O 58605 DIVISION OF FALLOPIAN TUBE 1.59 $88.63 --- -- 054 0 0 0.00 $0.00 Y
K 58605 DIVISION OF FALLOPIAN TUBE 7.93 $442.02 --- -- 054 0 0 0.00 $0.00 Y
K 58611 LIGATE OVIDUCT(S) ADD-ON 0.89 $49.61 --- -- 054 1 0 0.00 $0.00 Y
O 58611 LIGATE OVIDUCT(S) ADD-ON 0.18 $10.03 --- -- 054 0 0 0.00 $0.00 Y
O 58615 OCCLUDE FALLOPIAN TUBE(S) 2.00 $111.48 --- -- 054 0 0 0.00 $0.00 Y
K 58615 OCCLUDE FALLOPIAN TUBE(S) 10.00 $557.40 --- -- 054 0 0 0.00 $0.00 Y
K 58660 LAPAROSCOPY LYSIS 7.54 $280.71 --- $354.00 004 1 0 0.00 $0.00 Y
O 58660 LAPAROSCOPY LYSIS 1.51 $56.22 --- $70.89 004 1 0 0.00 $0.00 Y
O 58661 LAPAROSCOPY REMOVE ADNEXA 1.93 $97.79 --- -- 016 0 0 0.00 $0.00 Y
K 58661 LAPAROSCOPY REMOVE ADNEXA 9.65 $488.97 --- -- 016 0 0 0.00 $0.00 Y
K 58662 LAPAROSCOPY EXCISE LESIONS 8.21 $305.66 --- $385.46 004 1 0 0.00 $0.00 Y
O 58662 LAPAROSCOPY EXCISE LESIONS 1.64 $61.06 --- $77.00 004 1 0 0.00 $0.00 Y
K 58670 LAPAROSCOPY TUBAL CAUTERY 7.56 $421.39 --- -- 054 0 0 0.00 $0.00 Y
K 58671 LAPAROSCOPY TUBAL BLOCK 8.00 $445.92 --- -- 054 0 0 0.00 $0.00 Y
K 58674 LAPS ABLTJ UTERINE FIBROIDS 18.77 $698.81 --- -- 004 0 0 0.00 $0.00 Y
O 58674 LAPS ABLTJ UTERINE FIBROIDS 3.75 $139.61 --- -- 004 0 0 0.00 $0.00 Y
O 58679 LAPARO PROC OVIDUCT-OVARY 0.00 $0.00 --- -- 016 1 0 0.00 $0.00 Y
K 58679 LAPARO PROC OVIDUCT-OVARY 0.00 $0.00 --- -- 016 1 0 0.00 $0.00 Y
K 58700 REMOVAL OF FALLOPIAN TUBE 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 58700 REMOVAL OF FALLOPIAN TUBE 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 58720 REMOVAL OF OVARY/TUBE(S) 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
K 58720 REMOVAL OF OVARY/TUBE(S) 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
K 58740 ADHESIOLYSIS TUBE OVARY 14.00 $709.38 --- -- 016 0 0 0.00 $0.00 Y
O 58740 ADHESIOLYSIS TUBE OVARY 2.80 $141.88 --- -- 016 0 0 0.00 $0.00 Y
K 58800 DRAINAGE OF OVARIAN CYST(S) 4.53 $229.54 --- -- 016 0 0 0.00 $0.00 Y
K 58805 DRAINAGE OF OVARIAN CYST(S) 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 58805 DRAINAGE OF OVARIAN CYST(S) 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
K 58820 DRAIN OVARY ABSCESS OPEN 4.53 $229.54 --- -- 016 0 0 0.00 $0.00 Y
K 58822 DRAIN OVARY ABSCESS PERCUT 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 58822 DRAIN OVARY ABSCESS PERCUT 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 58900 BIOPSY OF OVARY(S) 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
K 58900 BIOPSY OF OVARY(S) 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
K 58920 PARTIAL REMOVAL OF OVARY(S) 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 58920 PARTIAL REMOVAL OF OVARY(S) 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 58925 REMOVAL OF OVARIAN CYST(S) 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
K 58925 REMOVAL OF OVARIAN CYST(S) 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
K 58940 REMOVAL OF OVARY(S) 12.00 $608.04 --- -- 016 0 0 0.00 $0.00 Y
O 58940 REMOVAL OF OVARY(S) 2.40 $121.61 --- -- 016 0 0 0.00 $0.00 Y
O 58943 REMOVAL OF OVARY(S) 3.53 $178.87 --- -- 016 0 0 0.00 $0.00 Y
K 58943 REMOVAL OF OVARY(S) 17.66 $894.83 --- -- 016 0 0 0.00 $0.00 Y
K 58950 RESECT OVARIAN MALIGNANCY 14.91 $755.49 --- -- 016 0 0 0.00 $0.00 Y
O 58950 RESECT OVARIAN MALIGNANCY 2.98 $151.00 --- -- 016 0 0 0.00 $0.00 Y
O 58951 RESECT OVARIAN MALIGNANCY 4.14 $209.77 --- -- 016 0 0 0.00 $0.00 Y
K 58951 RESECT OVARIAN MALIGNANCY 20.68 $1047.86 --- -- 016 0 0 0.00 $0.00 Y
K 58952 RESECT OVARIAN MALIGNANCY 23.50 $1190.75 --- -- 016 0 0 0.00 $0.00 Y
O 58952 RESECT OVARIAN MALIGNANCY 4.70 $238.15 --- -- 016 0 0 0.00 $0.00 Y
O 58953 TAH RAD DISSECT FOR DEBULK 6.08 $308.07 --- -- 016 0 0 0.00 $0.00 Y
K 58953 TAH RAD DISSECT FOR DEBULK 30.40 $1540.37 --- -- 016 0 0 0.00 $0.00 Y
K 58954 TAH RAD DEBULK/LYMPH REMOVE 33.04 $1674.14 --- -- 016 0 0 0.00 $0.00 Y
O 58954 TAH RAD DEBULK/LYMPH REMOVE 6.61 $334.93 --- -- 016 0 0 0.00 $0.00 Y
O 58956 BSO OMENTECTOMY W/TAH 2.96 $149.98 --- -- 016 1 0 0.00 $0.00 Y
K 58956 BSO OMENTECTOMY W/TAH 14.78 $748.90 --- -- 016 1 0 0.00 $0.00 Y
K 58957 RESECT RECURRENT GYN MAL 24.13 $1222.52 --- -- 016 0 0 0.00 $0.00 Y
O 58957 RESECT RECURRENT GYN MAL 4.83 $244.50 --- -- 016 0 0 0.00 $0.00 Y
O 58958 RESECT RECUR GYN MAL W/LYM 5.34 $270.56 --- -- 016 0 0 0.00 $0.00 Y
K 58958 RESECT RECUR GYN MAL W/LYM 26.70 $1352.81 --- -- 016 0 0 0.00 $0.00 Y
K 58960 EXPLORATION OF ABDOMEN 14.31 $725.09 --- -- 016 0 0 0.00 $0.00 Y
O 58960 EXPLORATION OF ABDOMEN 2.86 $144.92 --- -- 016 0 0 0.00 $0.00 Y
O 58999 GENITAL SURGERY PROCEDURE 0.00 $0.00 --- -- 016 0 0 0.00 $0.00 Y
K 58999 GENITAL SURGERY PROCEDURE 0.00 $0.00 --- -- 016 0 0 0.00 $0.00 Y
K 59000 AMNIOCENTESIS DIAGNOSTIC 1.13 $57.26 --- -- 040 0 1 0.00 $0.00 Y
K 59001 AMNIOCENTESIS THERAPEUTIC 2.76 $139.85 --- -- 040 0 1 0.00 $0.00 Y
K 59012 FETAL CORD PUNCTURE PRENATAL 2.96 $149.98 --- -- 040 0 0 0.00 $0.00 Y
K 59015 CHORION BIOPSY 2.19 $110.97 --- -- 040 1 0 0.00 $0.00 Y
O 59015 CHORION BIOPSY 0.44 $22.29 --- -- 040 1 0 0.00 $0.00 Y
K 59020 FETAL CONTRACTION STRESS TEST 1.00 $50.67 --- -- 040 0 0 0.20 $0.00 Y
K 59025 FETAL NONSTRESS TEST 0.45 $22.80 --- -- 040 0 0 0.40 $0.00 Y
K 59030 FETAL SCALP BLOOD SAMPLE 1.13 $57.26 --- -- 040 0 0 0.00 $0.00 Y
K 59050 FETAL MONITOR W/REPORT 1.60 $81.07 --- -- 040 0 0 0.00 $0.00 N
K 59051 FETAL MONITORING DURING LABOR BY CONSULT 1.47 $74.48 --- -- 040 0 0 0.00 $0.00 N
K 59070 TRANSABDOM AMNIOINFUS W/US 6.54 $331.38 --- -- 040 1 0 0.00 $0.00 Y
K 59072 UMBILICAL CORD OCCLUD W/US 5.61 $284.26 --- -- 040 1 0 0.00 $0.00 Y
K 59074 FETAL FLUID DRAINAGE W/US 6.20 $314.15 --- -- 040 1 0 0.00 $0.00 Y
K 59076 FETAL SHUNT PLACEMENT W/US 5.61 $284.26 --- -- 040 1 0 0.00 $0.00 Y
K 59100 REMOVE UTERUS LESION 14.00 $709.38 --- -- 040 0 0 0.00 $0.00 Y
O 59100 REMOVE UTERUS LESION 2.80 $141.88 --- -- 040 0 0 0.00 $0.00 Y
O 59120 TREAT ECTOPIC PREGNANCY 2.80 $141.88 --- -- 040 0 0 0.00 $0.00 Y
K 59120 TREAT ECTOPIC PREGNANCY 14.00 $709.38 --- -- 040 0 0 0.00 $0.00 Y
K 59121 TREAT ECTOPIC PREGNANCY 14.00 $709.38 --- -- 040 0 0 0.00 $0.00 Y
O 59121 TREAT ECTOPIC PREGNANCY 2.80 $141.88 --- -- 040 0 0 0.00 $0.00 Y
O 59130 TREAT ECTOPIC PREGNANCY 2.74 $138.84 --- -- 040 0 0 0.00 $0.00 Y
K 59130 TREAT ECTOPIC PREGNANCY 13.68 $693.17 --- -- 040 0 0 0.00 $0.00 Y
K 59135 TREAT ECTOPIC PREGNANCY 16.60 $841.12 --- -- 040 0 0 0.00 $0.00 Y
O 59135 TREAT ECTOPIC PREGNANCY 3.30 $167.21 --- -- 040 0 0 0.00 $0.00 Y
O 59136 TREAT ECTOPIC PREGNANCY 3.32 $168.22 --- -- 040 0 0 0.00 $0.00 Y
K 59136 TREAT ECTOPIC PREGNANCY 16.60 $841.12 --- -- 040 0 0 0.00 $0.00 Y
K 59140 TREAT ECTOPIC PREGNANCY 5.88 $297.94 --- -- 040 0 0 0.00 $0.00 Y
O 59140 TREAT ECTOPIC PREGNANCY 1.18 $59.79 --- -- 040 0 0 0.00 $0.00 Y
K 59150 TREAT ECTOPIC PREGNANCY 7.60 $385.09 --- -- 040 0 0 0.00 $0.00 Y
K 59151 TREAT ECTOPIC PREGNANCY 7.84 $397.25 --- -- 040 0 0 0.00 $0.00 Y
K 59160 D & C AFTER DELIVERY 4.00 $202.68 --- -- 040 0 0 0.00 $0.00 Y
K 59300 EPISIOTOMY OR VAGINAL REPAIR 0.61 $22.71 --- -- 004 0 0 0.00 $0.00 Y
K 59320 REVISION CERVIX 2.11 $106.91 --- -- 040 0 0 0.00 $0.00 Y
O 59320 REVISION CERVIX 0.42 $21.28 --- -- 040 0 0 0.00 $0.00 Y
O 59325 REVISION CERVIX 0.87 $44.08 --- -- 040 0 0 0.00 $0.00 Y
K 59325 REVISION CERVIX 4.34 $219.91 --- -- 040 0 0 0.00 $0.00 Y
K 59350 REPAIR OF UTERUS 13.80 $699.25 --- -- 040 0 0 0.00 $0.00 Y
O 59350 REPAIR OF UTERUS 2.80 $141.88 --- -- 040 0 0 0.00 $0.00 Y
K 59400 OBSTETRICAL CARE 11.57 $1390.14 --- -- 034 0 0 0.00 $0.00 Y
K 59409 VAG DELIVERY ONLY (WITH OR W/OUT EPISIOT 4.53 $544.28 --- -- 034 0 0 0.00 $0.00 Y
O 59409 VAG DELIVERY ONLY (WITH OR W/OUT EPISIOT 1.55 $186.23 --- -- 034 0 0 0.00 $0.00 Y
O 59414 DELIVER PLACENTA 0.15 $18.02 --- -- 034 0 0 0.00 $0.00 Y
K 59414 DELIVER PLACENTA 0.74 $88.91 --- -- 034 0 0 0.00 $0.00 Y
K 59510 CESARIAN DELIVERY 16.93 $1390.97 --- -- 003 0 0 0.00 $0.00 Y
K 59514 CAESAREAN DELIVERY ONLY 6.63 $544.72 --- -- 003 0 0 0.00 $0.00 Y
O 59514 CAESAREAN DELIVERY ONLY 2.27 $186.50 --- -- 003 0 0 0.00 $0.00 Y
O 59525 REMOVE UTERUS AFTER CESAREAN 0.45 $36.97 --- -- 003 0 0 0.00 $0.00 Y
K 59525 REMOVE UTERUS AFTER CESAREAN 2.91 $239.09 --- -- 003 0 0 0.00 $0.00 Y
K 59610 *96 ROUTINE OB W/VAG DEL PREV C-SECTION 11.57 $1390.14 --- -- 034 0 0 0.00 $0.00 Y
K 59612 *96 VAG DEL ONLY AFTER PREV C-SECTION 4.53 $544.28 --- -- 034 0 0 0.00 $0.00 Y
O 59612 VAG. DEL. ONLY AFTER PRE. CSECTION 1.55 $186.23 --- -- 034 0 0 0.00 $0.00 Y
K 59618 *96 ATT VAG DEL,CSECT DEL, ROUTINE OB 16.93 $1390.97 --- -- 003 0 0 0.00 $0.00 Y
K 59620 CSECT ONLY FOLL. ATTEMP. VAG DELIVERY 6.63 $544.72 --- -- 003 0 0 0.00 $0.00 Y
O 59620 CSECT ONLY FOLL. ATTEMP. VAG DELIVERY 2.27 $186.50 --- -- 003 0 0 0.00 $0.00 Y
K 59812 TREATMENT OF MISCARRAIGE 4.53 $168.65 --- -- 035 0 0 0.00 $0.00 Y
K 59820 CARE OF MISCARRIAGE 4.53 $168.65 --- -- 035 0 0 0.00 $0.00 Y
K 59821 TREATMENT OF MISCARRIAGE 4.53 $168.65 --- -- 035 0 0 0.00 $0.00 Y
K 59830 TREAT UTERUS INFECTION 8.50 $316.46 --- -- 035 0 0 0.00 $0.00 Y
K 59840 ABORTION 9.52 $250.85 --- -- 020 0 1 0.00 $0.00 Y
K 59841 ABORTION 9.52 $354.43 --- -- 035 0 0 0.00 $0.00 Y
K 59850 ABORTION 9.52 $328.06 --- -- 014 0 0 0.00 $0.00 Y
K 59851 ABORTION 9.52 $328.06 --- -- 014 0 0 0.00 $0.00 Y
K 59852 ABORTION 19.60 $729.71 --- -- 035 0 0 0.00 $0.00 Y
O 59852 ABORTION 3.92 $145.94 --- -- 035 0 0 0.00 $0.00 Y
K 59855 INDUCED ABORTION BY ONE/MORE VAG/SUPP 8.23 $283.61 --- -- 014 0 0 0.00 $0.00 Y
K 59856 INDUCED ABORTION BY ONE/MORE VAG/SUPP 11.87 $409.04 --- -- 014 0 0 0.00 $0.00 Y
K 59857 INDUCED ABORTION BY ONE/MORE VAG/SUPP 22.16 $825.02 --- -- 035 0 0 0.00 $0.00 Y
K 59870 EVACUATE MOLE UTERUS 6.00 $304.02 --- -- 040 0 0 0.00 $0.00 Y
K 59871 REMOVE CERCLAGE SUTURE 2.66 $134.78 --- -- 040 0 0 0.00 $0.00 Y
O 59871 REMOVE CERCLAGE SUTURE 0.53 $26.86 --- -- 040 0 0 0.00 $0.00 Y
O 59897 FETAL INVAS PX W/US 0.00 $0.00 --- -- 040 1 0 0.00 $0.00 Y
K 59897 FETAL INVAS PX W/US 0.00 $0.00 --- -- 040 1 0 0.00 $0.00 Y
K 59898 LAPARO PROC OB CARE/DELIVER 0.00 $0.00 --- -- 040 1 0 0.00 $0.00 Y
O 59898 LAPARO PROC OB CARE/DELIVER 0.00 $0.00 --- -- 040 1 0 0.00 $0.00 Y
O 59899 MATERNITY CARE PROCEDURE 0.00 $0.00 --- -- 040 0 0 0.00 $0.00 Y
K 59899 MATERNITY CARE PROCEDURE 0.00 $0.00 --- -- 040 0 0 0.00 $0.00 Y
K 60000 DRAIN THYROID/TONGUE CYST 1.82 $67.76 --- $85.45 004 1 1 0.00 $0.00 Y
K 60100 BIOPSY THYROID,PERCUTANEOUS CORE NEEDLE 1.43 $53.24 --- $67.14 004 1 1 0.00 $0.00 Y
K 60200 REMOVE THYROID LESION 10.76 $400.59 --- $505.18 004 1 0 0.00 $0.00 Y
O 60200 REMOVE THYROID LESION 2.15 $80.04 --- $100.94 004 1 0 0.00 $0.00 Y
O 60210 PARTIAL THYROID EXCISION 3.03 $112.81 --- $142.26 004 1 0 0.00 $0.00 Y
K 60210 PARTIAL THYROID EXCISION 15.19 $565.52 --- $713.17 004 1 0 0.00 $0.00 Y
K 60212 PARTIAL THYROID EXCISION 19.66 $731.94 --- $923.04 004 1 0 0.00 $0.00 Y
O 60212 PARTIAL THYROID EXCISION 3.93 $146.31 --- $184.51 004 1 0 0.00 $0.00 Y
O 60220 TOTAL THYROID LOBECTOMY,UNILATERAL 2.98 $110.95 --- $139.91 004 1 0 0.00 $0.00 Y
K 60220 TOTAL THYROID LOBECTOMY,UNILATERAL 14.88 $553.98 --- $698.62 004 1 0 0.00 $0.00 Y
K 60225 TOTAL THYROID LOBECTOMY,UNILATERAL 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
O 60225 TOTAL THYROID LOBECTOMY,UNILATERAL 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
O 60240 REMOVAL OF THYROID 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 60240 REMOVAL OF THYROID 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 60252 REMOVAL OF THYROID 25.06 $932.98 --- $1176.57 004 1 0 0.00 $0.00 Y
O 60252 REMOVAL OF THYROID 5.01 $186.52 --- $235.22 004 1 0 0.00 $0.00 Y
O 60254 EXTENSIVE THYROID SURGERY 6.34 $236.04 --- $297.66 004 1 0 0.00 $0.00 Y
K 60254 EXTENSIVE THYROID SURGERY 31.71 $1180.56 --- $1488.78 004 1 0 0.00 $0.00 Y
K 60260 THYROIDECTOMY,REM OF ALL REMAIN THY TISS 16.99 $632.54 --- $797.68 004 1 0 0.00 $0.00 Y
O 60260 THYROIDECTOMY,REM OF ALL REMAIN THY TISS 3.40 $126.58 --- $159.63 004 1 0 0.00 $0.00 Y
O 60270 REMOVAL OF THYROID 4.87 $181.31 --- $228.65 004 1 0 0.00 $0.00 Y
K 60270 REMOVAL OF THYROID 24.46 $910.65 --- $1148.40 004 1 0 0.00 $0.00 Y
K 60271 THYROIDECTOMY INCLUDING SUB/THY/GLAND 21.23 $790.39 --- $996.75 004 1 0 0.00 $0.00 Y
O 60271 THYROIDECTOMY INCLUDING SUB/THY/GLAND 4.25 $158.23 --- $199.54 004 1 0 0.00 $0.00 Y
O 60280 REMOVE THYROID DUCT LESION 2.20 $81.91 --- $103.29 004 1 0 0.00 $0.00 Y
K 60280 REMOVE THYROID DUCT LESION 11.00 $409.53 --- $516.45 004 1 0 0.00 $0.00 Y
K 60281 REMOVE THYROID DUCT LESION 13.14 $489.20 --- $616.92 004 1 0 0.00 $0.00 Y
O 60281 REMOVE THYROID DUCT LESION 2.63 $97.91 --- $123.48 004 1 0 0.00 $0.00 Y
K 60300 ASPIR/INJ THYROID CYST 2.26 $84.14 --- $106.11 004 1 0 0.00 $0.00 Y
K 60500 EXPLORE PARATHYROID GLANDS 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 60500 EXPLORE PARATHYROID GLANDS 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 60502 RE-EXPLORE PARATHYROIDS 5.34 $198.81 --- $250.71 004 1 0 0.00 $0.00 Y
K 60502 RE-EXPLORE PARATHYROIDS 26.72 $994.79 --- $1254.50 004 1 0 0.00 $0.00 Y
K 60505 EXPLORE PARATHYROID GLANDS 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 60505 EXPLORE PARATHYROID GLANDS 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 60512 AUTOTRANSPLANT PARATHYROID 1.09 $40.58 --- $51.18 004 1 0 0.00 $0.00 Y
K 60512 AUTOTRANSPLANT PARATHYROID 5.45 $202.90 --- $255.88 004 1 0 0.00 $0.00 Y
K 60520 THYMECTOMY,PARTIAL OR TOTAL 20.39 $759.12 --- $957.31 004 1 0 0.00 $0.00 Y
O 60520 THYMECTOMY,PARTIAL OR TOTAL 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
O 60521 REMOVAL OF THYMUS GLAND 5.09 $189.50 --- $238.98 004 1 0 0.00 $0.00 Y
K 60521 REMOVAL OF THYMUS GLAND 25.40 $945.64 --- $1192.53 004 1 0 0.00 $0.00 Y
K 60522 THYMECTOMY PARTIAL OR TOTAL 28.33 $1054.73 --- $1330.09 004 1 0 0.00 $0.00 Y
O 60522 THYMECTOMY PARTIAL OR TOTAL 5.66 $210.72 --- $265.74 004 1 0 0.00 $0.00 Y
O 60540 EXPLORE ADRENAL GLAND 4.30 $160.09 --- $201.89 004 1 0 0.00 $0.00 Y
K 60540 EXPLORE ADRENAL GLAND 21.52 $801.19 --- $1010.36 004 1 0 0.00 $0.00 Y
K 60545 EXPLORE ADRENAL GLAND 24.92 $927.77 --- $1169.99 004 1 0 0.00 $0.00 Y
O 60545 EXPLORE ADRENAL GLAND 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
O 60600 REMOVE CAROTID BODY LESION 3.85 $143.34 --- $180.76 004 1 0 0.00 $0.00 Y
K 60600 REMOVE CAROTID BODY LESION 19.25 $716.68 --- $903.79 004 1 0 0.00 $0.00 Y
K 60605 REMOVE CAROTID BODY LESION 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 60605 REMOVE CAROTID BODY LESION 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 60650 LAPAROSCOPY ADRENALECTOMY 4.73 $176.10 --- $222.07 004 1 0 0.00 $0.00 Y
K 60650 LAPAROSCOPY ADRENALECTOMY 23.64 $880.12 --- $1109.90 004 1 0 0.00 $0.00 Y
K 60659 LAPARO PROC ENDOCRINE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 60659 LAPARO PROC ENDOCRINE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 60699 ENDOCRINE SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 60699 ENDOCRINE SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y