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Medi-Cal Rates Information

Medi-Cal Rates as of 02/15/2020 (Codes 28322 thru 31590)

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 28322 REPAIR OF METATARSALS 7.30 $271.78 --- $342.74 004 1 0 0.00 $0.00 Y
P 28322 REPAIR OF METATARSALS 7.29 $271.41 --- -- 015 0 0 0.00 $0.00 Y
O 28322 REPAIR OF METATARSALS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 28340 RESECT ENLARGED TOE TISSUE 2.56 $95.31 --- $120.19 004 1 0 0.00 $0.00 Y
P 28340 RESECT ENLARGED TOE TISSUE 12.79 $476.17 --- -- 015 0 0 0.00 $0.00 Y
K 28340 RESECT ENLARGED TOE TISSUE 12.79 $476.17 --- $600.49 004 1 0 0.00 $0.00 Y
K 28341 RESECT ENLARGED TOE 14.40 $536.11 --- $676.08 004 1 0 0.00 $0.00 Y
P 28341 RESECT ENLARGED TOE 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
O 28341 RESECT ENLARGED TOE 2.88 $107.22 --- $135.22 004 1 0 0.00 $0.00 Y
O 28344 REPAIR EXTRA TOE(S) 1.72 $64.04 --- $80.75 004 1 0 0.00 $0.00 Y
P 28344 REPAIR EXTRA TOE(S) 8.61 $320.55 --- -- 015 0 0 0.00 $0.00 Y
K 28344 REPAIR EXTRA TOE(S) 8.60 $320.18 --- $403.77 004 1 0 0.00 $0.00 Y
K 28345 REPAIR WEBBED TOE(S) 11.12 $414.00 --- $522.08 004 1 0 0.00 $0.00 Y
P 28345 REPAIR WEBBED TOE(S) 11.12 $414.00 --- -- 015 0 0 0.00 $0.00 Y
O 28345 REPAIR WEBBED TOE(S) 2.22 $82.65 --- $104.23 004 1 0 0.00 $0.00 Y
O 28360 RECONSTRUCT CLEFT FOOT 4.79 $178.33 --- $224.89 004 1 0 0.00 $0.00 Y
P 28360 RECONSTRUCT CLEFT FOOT 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
K 28360 RECONSTRUCT CLEFT FOOT 23.97 $892.40 --- $1125.39 004 1 0 0.00 $0.00 Y
K 28400 TREATMENT OF HEEL FRACTURE 161.90 $161.90 --- -- 042 0 1 0.00 $0.00 Y
P 28400 TREATMENT OF HEEL FRACTURE 0.00 $0.00 --- -- 015 0 1 0.00 $0.00 Y
O 28400 TREATMENT OF HEEL FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 28405 TREATMENT OF HEEL FRACTURE 2.25 $83.77 --- $105.64 004 1 0 0.00 $0.00 Y
P 28405 TREATMENT OF HEEL FRACTURE 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
K 28405 TREATMENT OF HEEL FRACTURE 11.24 $418.47 --- $527.72 004 1 0 0.00 $0.00 Y
K 28406 REPAIR HEEL FRACTURE 12.21 $454.58 --- $573.26 004 1 0 0.00 $0.00 Y
P 28406 REPAIR OF HEEL FRACTURE 12.21 $454.58 --- -- 015 0 0 0.00 $0.00 Y
O 28406 REPAIR OF HEEL FRACTURE 2.44 $90.84 --- $114.56 004 1 0 0.00 $0.00 Y
O 28415 TREAT HEEL FRACTURE 4.94 $183.92 --- $231.93 004 1 0 0.00 $0.00 Y
P 28415 TREAT HEEL FRACTURE 24.70 $919.58 --- -- 015 0 0 0.00 $0.00 Y
K 28415 TREAT HEEL FRACTURE 24.71 $919.95 --- $1160.13 004 1 0 0.00 $0.00 Y
K 28420 TREAT/GRAFT HEEL FRACTURE 25.10 $934.47 --- $1178.45 004 1 0 0.00 $0.00 Y
O 28420 TREAT/GRAFT HEEL FRACTURE 5.02 $186.89 --- $235.69 004 1 0 0.00 $0.00 Y
P 28430 TREATMENT OF ANKLE FRACTURE 7.70 $286.67 --- -- 015 0 1 0.00 $0.00 Y
K 28430 TREATMENT OF ANKLE FRACTURE 7.71 $287.04 --- $361.98 004 1 1 0.00 $0.00 Y
K 28435 TREATMENT OF ANKLE FRACTURE 4.86 $180.94 --- $228.18 004 1 0 0.00 $0.00 Y
P 28435 TREATMENT OF ANKLE FRACTURE 4.86 $180.94 --- -- 015 0 0 0.00 $0.00 Y
P 28436 REPAIR OF ANKLE FRACTURE 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
K 28436 REPAIR OF ANKLE FRACTURE 10.61 $395.01 --- $498.14 004 1 0 0.00 $0.00 Y
K 28445 TREAT ANKLE FRACTURE 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
P 28445 TREAT ANKLE FRACTURE 11.33 $421.82 --- -- 015 0 0 0.00 $0.00 Y
O 28445 TREAT ANKLE FRACTURE 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 28446 OSTEOCHONDRAL TALUS AUTOGRFT 4.66 $173.49 --- -- 004 0 0 0.00 $0.00 Y
P 28446 OSTEOCHONDRAL TALUS AUTOGRFT 23.30 $867.46 --- -- 015 0 0 0.00 $0.00 Y
K 28446 OSTEOCHONDRAL TALUS AUTOGRFT 23.30 $867.46 --- -- 004 0 0 0.00 $0.00 Y
K 28450 TREAT MIDFOOT FRACTURE EACH 144.42 $144.42 --- -- 042 0 1 0.00 $0.00 Y
P 28450 TREAT MIDFOOT FRACTURE EACH 0.00 $0.00 --- -- 015 0 1 0.00 $0.00 Y
O 28450 TREAT MIDFOOT FRACTURE EACH 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28455 TREAT MIDFOOT FRACTURE EACH 3.91 $145.57 --- -- 015 0 0 0.00 $0.00 Y
K 28455 TREAT MIDFOOT FRACTURE EACH 3.91 $145.57 --- $183.57 004 1 0 0.00 $0.00 Y
K 28456 TREAT MIDFOOT FRACTURE 3.61 $134.40 --- $169.49 004 1 0 0.00 $0.00 Y
P 28456 TREAT MIDFOOT FRACTURE 3.61 $134.40 --- -- 015 0 0 0.00 $0.00 Y
P 28465 TREAT MIDFOOT FRACTURE EACH 13.19 $491.06 --- -- 015 0 0 0.00 $0.00 Y
K 28465 TREAT MIDFOOT FRACTURE EACH 13.19 $491.06 --- $619.27 004 1 0 0.00 $0.00 Y
K 28470 TREAT METATARSAL FRACTURE 138.66 $138.66 --- -- 042 0 1 0.00 $0.00 Y
P 28470 TREAT METATARSAL FRACTURE 0.00 $0.00 --- -- 015 1 1 0.00 $0.00 Y
P 28475 TREAT METATARSAL FRACTURE 4.16 $154.88 --- -- 015 1 1 0.00 $0.00 Y
K 28475 TREAT METATARSAL FRACTURE 4.16 $154.88 --- $195.31 004 1 1 0.00 $0.00 Y
K 28476 TREAT METATARSAL FRACTURE 4.22 $157.11 --- $198.13 004 1 0 0.00 $0.00 Y
P 28476 TREAT METATARSAL FRACTURE 4.22 $157.11 --- -- 015 1 0 0.00 $0.00 Y
P 28485 TREAT METATARSAL FRACTURE 12.61 $469.47 --- -- 015 0 0 0.00 $0.00 Y
O 28485 TREAT METATARSAL FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 28485 TREAT METATARSAL FRACTURE 12.61 $469.47 --- $592.04 004 1 0 0.00 $0.00 Y
K 28490 TREAT BIG TOE FRACTURE 57.06 $57.06 --- -- 042 0 1 0.00 $0.00 Y
P 28490 TREAT BIG TOE FRACTURE 0.00 $0.00 --- -- 015 1 1 0.00 $0.00 Y
P 28495 TREAT BIG TOE FRACTURE 1.77 $65.90 --- -- 015 1 1 0.00 $0.00 Y
K 28495 TREAT BIG TOE FRACTURE 1.77 $65.90 --- $83.10 004 1 1 0.00 $0.00 Y
K 28496 TREAT BIG TOE FRACTURE 4.27 $158.97 --- $200.48 004 1 0 0.00 $0.00 Y
P 28496 TREAT BIG TOE FRACTURE 4.27 $158.97 --- -- 015 1 0 0.00 $0.00 Y
P 28505 TREAT BIG TOE FRACTURE 10.34 $384.96 --- -- 015 0 0 0.00 $0.00 Y
O 28505 TREAT BIG TOE FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 28505 TREAT BIG TOE FRACTURE 10.35 $385.33 --- $485.93 004 1 0 0.00 $0.00 Y
K 28510 TREATMENT OF TOE FRACTURE 52.47 $52.47 --- -- 042 0 1 0.00 $0.00 Y
P 28510 TREATMENT OF TOE FRACTURE 0.00 $0.00 --- -- 015 0 1 0.00 $0.00 Y
P 28515 TREATMENT OF TOE FRACTURE 1.67 $62.17 --- -- 015 0 1 0.00 $0.00 Y
K 28515 TREATMENT OF TOE FRACTURE 1.66 $61.80 --- $77.94 004 1 1 0.00 $0.00 Y
K 28525 TREAT TOE FRACTURE 9.41 $350.33 --- $441.80 004 1 0 0.00 $0.00 Y
P 28525 TREAT TOE FRACTURE 9.41 $350.33 --- -- 015 0 0 0.00 $0.00 Y
O 28525 TREAT TOE FRACTURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28530 TREAT SESAMOID BONE FRACTURE 0.00 $0.00 --- -- 015 0 1 0.00 $0.00 Y
K 28530 TREAT SESAMOID BONE FRACTURE 4.44 $165.30 --- $208.46 004 1 1 0.00 $0.00 Y
K 28531 TREAT SESAMOID BONE FRACTURE 7.44 $276.99 --- $349.31 004 1 0 0.00 $0.00 Y
O 28531 TREAT SESAMOID BONE FRACTURE 1.48 $55.10 --- $69.49 004 1 0 0.00 $0.00 Y
P 28540 TREAT FOOT DISLOCATION 2.97 $110.57 --- -- 015 0 1 0.00 $0.00 Y
K 28540 TREAT FOOT DISLOCATION 2.96 $110.20 --- $138.97 004 1 1 0.00 $0.00 Y
K 28545 TREAT FOOT DISLOCATION 2.87 $106.85 --- $134.75 004 1 0 0.00 $0.00 Y
P 28545 TREAT FOOT DISLOCATION 2.87 $106.85 --- -- 015 0 0 0.00 $0.00 Y
P 28546 REPAIR FOOT DISLOCATION 3.80 $141.47 --- -- 015 0 0 0.00 $0.00 Y
K 28546 REPAIR FOOT DISLOCATION 3.80 $141.47 --- $178.41 004 1 0 0.00 $0.00 Y
K 28555 REPAIR FOOT DISLOCATION 7.67 $285.55 --- $360.11 004 1 0 0.00 $0.00 Y
P 28555 REPAIR FOOT DISLOCATION 7.67 $285.55 --- -- 015 0 0 0.00 $0.00 Y
O 28555 REPAIR FOOT DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28570 TREAT FOOT DISLOCATION 3.18 $118.39 --- -- 015 0 1 0.00 $0.00 Y
K 28570 TREAT FOOT DISLOCATION 3.18 $118.39 --- $149.30 004 1 1 0.00 $0.00 Y
K 28575 TREAT FOOT DISLOCATION 3.34 $124.35 --- $156.81 004 1 0 0.00 $0.00 Y
P 28575 TREAT FOOT DISLOCATION 3.34 $124.35 --- -- 015 0 0 0.00 $0.00 Y
O 28576 TREAT FOOT DISLOCATION 0.94 $35.00 --- $44.13 004 1 0 0.00 $0.00 Y
K 28576 TREAT FOOT DISLOCATION 4.71 $175.35 --- $221.13 004 1 0 0.00 $0.00 Y
K 28585 REPAIR FOOT DISLOCATION 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 28585 REPAIR FOOT DISLOCATION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
P 28585 REPAIR FOOT DISLOCATION 11.33 $421.82 --- -- 015 0 0 0.00 $0.00 Y
P 28600 TREAT FOOT DISLOCATION 3.52 $131.05 --- -- 015 0 1 0.00 $0.00 Y
K 28600 TREAT FOOT DISLOCATION 3.52 $131.05 --- $165.26 004 1 1 0.00 $0.00 Y
K 28605 TREAT FOOT DISLOCATION 4.15 $154.50 --- $194.84 004 1 0 0.00 $0.00 Y
P 28605 TREAT FOOT DISLOCATION 4.15 $154.50 --- -- 015 0 0 0.00 $0.00 Y
P 28606 REPAIR FOOT DISLOCATION 8.74 $325.39 --- -- 015 0 0 0.00 $0.00 Y
K 28606 REPAIR FOOT DISLOCATION 8.75 $325.76 --- $410.81 004 1 0 0.00 $0.00 Y
K 28615 REPAIR FOOT DISLOCATION 15.23 $567.01 --- $715.05 004 1 0 0.00 $0.00 Y
P 28615 REPAIR FOOT DISLOCATION 15.23 $567.01 --- -- 015 0 0 0.00 $0.00 Y
O 28615 REPAIR FOOT DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28630 TREAT TOE DISLOCATION 1.65 $61.43 --- -- 015 0 1 0.00 $0.00 Y
K 28630 TREAT TOE DISLOCATION 1.64 $61.06 --- $77.00 004 1 1 0.00 $0.00 Y
K 28635 TREAT TOE DISLOCATION 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
P 28635 TREAT TOE DISLOCATION 2.27 $84.51 --- -- 015 0 0 0.00 $0.00 Y
O 28636 TREAT TOE DISLOCATION 0.79 $29.41 --- $37.09 004 1 0 0.00 $0.00 Y
K 28636 TREAT TOE DISLOCATION 3.99 $148.55 --- $187.33 004 1 0 0.00 $0.00 Y
K 28645 REPAIR TOE DISLOCATION 5.67 $211.09 --- $266.21 004 1 0 0.00 $0.00 Y
O 28645 REPAIR TOE DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28645 REPAIR TOE DISLOCATION 5.66 $210.72 --- -- 015 0 0 0.00 $0.00 Y
P 28660 TREAT TOE DISLOCATION 2.42 $90.10 --- -- 015 0 1 0.00 $0.00 Y
K 28660 TREAT TOE DISLOCATION 2.41 $89.72 --- $113.15 004 1 1 0.00 $0.00 Y
K 28665 TREAT TOE DISLOCATION 2.41 $89.72 --- $113.15 004 1 0 0.00 $0.00 Y
P 28665 TREAT TOE DISLOCATION 2.41 $89.72 --- -- 015 0 0 0.00 $0.00 Y
O 28666 TREAT TOE DISLOCATION 1.05 $39.09 --- $49.30 004 1 0 0.00 $0.00 Y
K 28666 TREAT TOE DISLOCATION 5.28 $196.57 --- $247.90 004 1 0 0.00 $0.00 Y
K 28675 REPAIR OF TOE DISLOCATION 6.74 $250.93 --- $316.44 004 1 0 0.00 $0.00 Y
O 28675 REPAIR OF TOE DISLOCATION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28675 REPAIR OF TOE DISLOCATION 6.73 $250.56 --- -- 015 1 0 0.00 $0.00 Y
P 28705 FUSION OF FOOT BONES 20.67 $769.54 --- -- 015 0 0 0.00 $0.00 Y
O 28705 FUSION OF FOOT BONES 4.13 $153.76 --- $193.90 004 1 0 0.00 $0.00 Y
K 28705 FUSION OF FOOT BONES 20.67 $769.54 --- $970.46 004 1 0 0.00 $0.00 Y
K 28715 FUSION OF FOOT BONES 16.06 $597.91 --- $754.02 004 1 0 0.00 $0.00 Y
O 28715 FUSION OF FOOT BONES 3.22 $119.88 --- $151.18 004 1 0 0.00 $0.00 Y
P 28715 FUSION OF FOOT BONES 16.06 $597.91 --- -- 015 0 0 0.00 $0.00 Y
P 28725 FUSION OF FOOT BONES 11.33 $421.82 --- -- 015 0 0 0.00 $0.00 Y
O 28725 FUSION OF FOOT BONES 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 28725 FUSION OF FOOT BONES 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 28730 FUSION OF FOOT BONES 12.46 $463.89 --- $585.00 004 1 0 0.00 $0.00 Y
O 28730 FUSION OF FOOT BONES 2.49 $92.70 --- $116.91 004 1 0 0.00 $0.00 Y
P 28730 FUSION OF FOOT BONES 12.46 $463.89 --- -- 015 0 0 0.00 $0.00 Y
P 28735 FUSION OF FOOT BONES 15.85 $590.10 --- -- 015 0 0 0.00 $0.00 Y
O 28735 FUSION OF FOOT BONES 3.17 $118.02 --- $148.83 004 1 0 0.00 $0.00 Y
K 28735 FUSION OF FOOT BONES 15.86 $590.47 --- $744.63 004 1 0 0.00 $0.00 Y
K 28737 REVISION OF FOOT BONES 10.19 $379.37 --- $478.42 004 1 0 0.00 $0.00 Y
O 28737 REVISION OF FOOT BONES 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
P 28737 REVISION OF FOOT BONES 10.19 $379.37 --- -- 015 0 0 0.00 $0.00 Y
P 28740 FUSION OF FOOT BONES 10.19 $379.37 --- -- 015 0 0 0.00 $0.00 Y
O 28740 FUSION OF FOOT BONES 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
K 28740 FUSION OF FOOT BONES 10.19 $379.37 --- $478.42 004 1 0 0.00 $0.00 Y
K 28750 FUSION OF BIG TOE JOINT 8.04 $299.33 --- $377.48 004 1 0 0.00 $0.00 Y
O 28750 FUSION OF BIG TOE JOINT 1.61 $59.94 --- $75.59 004 1 0 0.00 $0.00 Y
P 28750 FUSION OF BIG TOE JOINT 8.04 $299.33 --- -- 015 0 0 0.00 $0.00 Y
P 28755 FUSION OF BIG TOE JOINT 5.52 $205.51 --- -- 015 0 0 0.00 $0.00 Y
O 28755 FUSION OF BIG TOE JOINT 1.10 $40.95 --- $51.65 004 1 0 0.00 $0.00 Y
K 28755 FUSION OF BIG TOE JOINT 5.52 $205.51 --- $259.16 004 1 0 0.00 $0.00 Y
K 28760 FUSION OF BIG TOE JOINT 7.02 $261.35 --- $329.59 004 1 0 0.00 $0.00 Y
O 28760 FUSION OF BIG TOE JOINT 1.41 $52.49 --- $66.20 004 1 0 0.00 $0.00 Y
P 28760 FUSION OF BIG TOE JOINT 7.02 $261.35 --- -- 015 0 0 0.00 $0.00 Y
P 28800 AMPUTATION OF MIDFOOT 11.33 $421.82 --- -- 015 0 0 0.00 $0.00 Y
O 28800 AMPUTATION OF MIDFOOT 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 28800 AMPUTATION OF MIDFOOT 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 28805 AMPUTATION THRU METATARSAL 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 28805 AMPUTATION THRU METATARSAL 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
P 28805 AMPUTATION, TRANSMETATARSAL 11.33 $421.82 --- -- 015 0 0 0.00 $0.00 Y
P 28810 AMPUTATION, METATARSAL W/TOE, SINGLE 6.80 $253.16 --- -- 015 0 0 0.00 $0.00 Y
O 28810 AMPUTATION TOE & METATARSAL 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 28810 AMPUTATION TOE & METATARSAL 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 28820 AMPUTATION OF TOE 6.13 $228.22 --- $287.80 004 1 0 0.00 $0.00 Y
O 28820 AMPUTATION OF TOE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
P 28820 AMPUT. TOE; METATARSOPHALANGEAL JOINT 6.13 $228.22 --- -- 015 0 0 0.00 $0.00 Y
P 28825 AMP. TOE; INTERPHALANGEAL JOINT 5.44 $202.53 --- -- 015 0 0 0.00 $0.00 Y
O 28825 PARTIAL AMPUTATION OF TOE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 28825 PARTIAL AMPUTATION OF TOE 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 28890 HI ENRGY ESWT PLANTAR FASCIA 7.97 $296.72 --- $374.19 004 1 0 0.00 $0.00 Y
P 28890 HI ENRGY ESWT PLANTAR FASCIA 7.97 $296.72 --- -- 015 1 0 0.00 $0.00 Y
P 28899 FOOT/TOES SURGERY PROCEDURE 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
O 28899 FOOT/TOES SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 28899 FOOT/TOES SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 29000 APPLICATION OF BODY CAST 5.82 $216.68 --- $273.25 004 1 0 0.00 $0.00 Y
O 29000 APPLICATION OF BODY CAST 1.16 $43.19 --- $54.46 004 1 0 0.00 $0.00 Y
K 29010 APPLICATION OF BODY CAST 5.73 $213.33 --- $269.02 004 1 0 0.00 $0.00 Y
K 29015 APPLICATION OF BODY CAST 5.41 $201.41 --- $254.00 004 1 0 0.00 $0.00 Y
K 29035 APPLICATION OF BODY CAST 6.58 $244.97 --- $308.93 004 1 0 0.00 $0.00 Y
K 29040 APPLICATION OF BODY CAST 5.16 $192.11 --- $242.26 004 1 0 0.00 $0.00 Y
K 29044 APPLICATION OF BODY CAST 8.19 $304.91 --- $384.52 004 1 0 0.00 $0.00 Y
K 29046 APPLICATION OF BODY CAST 8.33 $310.13 --- $391.09 004 1 0 0.00 $0.00 Y
K 29049 APPLICATION OF FIGURE EIGHT 3.25 $121.00 --- $152.59 004 1 1 0.00 $0.00 Y
K 29055 APPLICATION OF SHOULDER CAST 5.42 $201.79 --- $254.47 004 1 1 0.00 $0.00 Y
K 29058 APPLICATION OF SHOULDER CAST 3.71 $138.12 --- $174.18 004 1 1 0.00 $0.00 Y
K 29065 APPLICATION OF LONG ARM CAST 2.49 $92.70 --- $116.91 004 1 1 0.00 $0.00 Y
K 29075 APPLICATION OF FOREARM CAST 2.22 $82.65 --- $104.23 004 1 1 0.00 $0.00 Y
K 29085 APPLY HAND/WRIST CAST 2.24 $83.40 --- $105.17 004 1 1 0.00 $0.00 Y
K 29086 APPLY FINGER CAST 1.25 $46.54 --- -- 004 0 1 0.00 $0.00 Y
K 29105 APPLY LONG ARM SPLINT 1.78 $66.27 --- $83.57 004 1 1 0.00 $0.00 Y
K 29125 APPLY FOREARM SPLINT 1.42 $52.87 --- $66.67 004 1 1 0.00 $0.00 Y
K 29126 APPLY FOREARM SPLINT 1.73 $64.41 --- $81.22 004 1 1 0.00 $0.00 Y
K 29130 APPLICATION OF FINGER SPLINT 0.60 $22.34 --- $28.17 004 1 1 0.00 $0.00 Y
K 29131 APPLICATION OF FINGER SPLINT 0.90 $33.51 --- $42.26 004 1 1 0.00 $0.00 Y
K 29200 STRAPPING OF CHEST 0.94 $35.00 --- $44.13 004 1 0 0.00 $0.00 Y
K 29240 STRAPPING OF SHOULDER 0.96 $35.74 --- $45.07 004 1 0 0.00 $0.00 Y
K 29260 STRAPPING OF ELBOW OR WRIST 0.76 $28.29 --- $35.68 004 1 0 0.00 $0.00 Y
K 29280 STRAPPING OF HAND OR FINGER 1.40 $52.12 --- $65.73 004 1 1 0.00 $0.00 Y
K 29305 APPLICATION OF HIP CAST 6.65 $247.58 --- $312.22 004 1 0 0.00 $0.00 Y
K 29325 APPLICATION OF HIP CASTS 5.51 $205.14 --- $258.69 004 1 0 0.00 $0.00 Y
K 29345 APPLICATION OF LONG LEG CAST 3.26 $121.37 --- $153.06 004 1 1 0.00 $0.00 Y
P 29345 APPLICATION OF LONG LEG CAST 3.26 $121.37 --- -- 015 0 1 0.00 $0.00 Y
P 29355 APPLICATION OF LONG LEG CAST 3.44 $128.07 --- -- 015 0 1 0.00 $0.00 Y
K 29355 APPLICATION OF LONG LEG CAST 3.44 $128.07 --- $161.51 004 1 1 0.00 $0.00 Y
K 29358 APPLY LONG LEG CAST BRACE 3.70 $137.75 --- $173.72 004 1 1 0.00 $0.00 Y
P 29358 APPLY LONG LEG CAST BRACE 0.00 $0.00 --- -- 015 0 1 0.00 $0.00 Y
P 29365 APPLICATION OF LONG LEG CAST 2.77 $103.13 --- -- 015 0 1 0.00 $0.00 Y
K 29365 APPLICATION OF LONG LEG CAST 2.77 $103.13 --- $130.05 004 1 1 0.00 $0.00 Y
K 29405 APPLY SHORT LEG CAST 2.29 $85.26 --- $107.52 004 1 1 0.00 $0.00 Y
P 29405 APPLY SHORT LEG CAST 2.29 $85.26 --- -- 015 0 1 0.00 $0.00 Y
P 29425 APPLY SHORT LEG CAST 2.24 $83.40 --- -- 015 0 1 0.00 $0.00 Y
K 29425 APPLY SHORT LEG CAST 2.25 $83.77 --- $105.64 004 1 1 0.00 $0.00 Y
K 29435 APPLY SHORT LEG CAST 3.51 $130.68 --- $164.79 004 1 0 0.00 $0.00 Y
P 29435 APPLY SHORT LEG CAST 3.51 $130.68 --- -- 015 0 1 0.00 $0.00 Y
P 29440 ADDITION OF WALKER TO CAST 1.36 $50.63 --- -- 015 0 1 0.00 $0.00 Y
K 29440 ADDITION OF WALKER TO CAST 1.36 $50.63 --- $63.85 004 1 1 0.00 $0.00 Y
K 29445 APPLICAT OF RIGID TOTAL CONTACT LEG CAST 3.67 $136.63 --- $172.31 004 1 0 0.00 $0.00 Y
P 29445 APPLICAT OF RIGID TOTAL CONTACT LEG CAST 3.66 $136.26 --- -- 015 0 0 0.00 $0.00 Y
P 29450 APPLICATION OF LEG CAST 1.85 $68.88 --- -- 015 0 1 0.00 $0.00 Y
K 29450 APPLICATION OF LEG CAST 1.84 $68.50 --- $86.39 004 1 1 0.00 $0.00 Y
K 29505 APPLICATION LONG LEG SPLINT 1.85 $68.88 --- $86.86 004 1 1 0.00 $0.00 Y
P 29505 APPLICATION LONG LEG SPLINT 1.85 $68.88 --- -- 015 0 1 0.00 $0.00 Y
P 29515 APPLICATION LOWER LEG SPLINT 1.52 $56.59 --- -- 015 0 1 0.00 $0.00 Y
K 29515 APPLICATION LOWER LEG SPLINT 1.52 $56.59 --- $71.36 004 1 1 0.00 $0.00 Y
K 29520 STRAPPING OF HIP 0.81 $30.16 --- $38.03 004 1 1 0.00 $0.00 Y
K 29530 STRAPPING OF KNEE 0.80 $29.78 --- $37.56 004 1 1 0.00 $0.00 Y
K 29540 STRAPPING OF ANKLE AND/OR FT 0.47 $17.50 --- $22.07 004 1 1 0.00 $0.00 Y
P 29540 STRAPPING OF ANKLE AND/OR FT 0.47 $17.50 --- -- 015 0 1 0.00 $0.00 Y
P 29550 STRAPPING OF TOES 0.45 $16.75 --- -- 015 0 1 0.00 $0.00 Y
K 29550 STRAPPING OF TOES 0.45 $16.75 --- $21.13 004 1 1 0.00 $0.00 Y
K 29580 APPLICATION OF PASTE BOOT 0.73 $27.18 --- $34.27 004 1 1 0.00 $0.00 Y
P 29580 APPLICATION OF PASTE BOOT 0.73 $27.18 --- -- 015 0 1 0.00 $0.00 Y
P 29581 APPLY MULTLAY COMPRS LWR LEG 2.09 $77.81 --- -- 015 1 1 0.00 $0.00 Y
K 29581 APPLY MULTLAY COMPRS LWR LEG 2.09 $77.81 --- $98.13 004 1 1 0.00 $0.00 Y
K 29584 APPL MULTLAY COMPRS ARM/HAND 0.34 $12.83 --- $15.96 004 1 1 0.00 $0.00 Y
K 29700 REMOVAL/REVISION OF CAST 0.61 $22.71 --- $28.64 004 1 1 0.00 $0.00 Y
P 29700 REMOVAL/REVISION OF CAST 0.62 $23.08 --- -- 015 0 1 0.00 $0.00 Y
P 29705 REMOVAL/REVISION OF CAST 0.78 $29.04 --- -- 015 0 1 0.00 $0.00 Y
K 29705 REMOVAL/REVISION OF CAST 0.78 $29.04 --- $36.62 004 1 1 0.00 $0.00 Y
K 29710 REMOVAL/REVISION OF CAST 1.33 $49.52 --- $62.44 004 1 1 0.00 $0.00 Y
K 29720 REPAIR OF BODY CAST 2.42 $90.10 --- $113.62 004 1 1 0.00 $0.00 Y
K 29730 WINDOWING OF CAST 0.76 $28.29 --- $35.68 004 1 1 0.00 $0.00 Y
P 29730 WINDOWING OF CAST 0.76 $28.29 --- -- 015 0 1 0.00 $0.00 Y
P 29740 WEDGING OF CAST 1.96 $72.97 --- -- 015 0 1 0.00 $0.00 Y
K 29740 WEDGING OF CAST 1.96 $72.97 --- $92.02 004 1 1 0.00 $0.00 Y
K 29750 WEDGING OF CLUBFOOT CAST 1.67 $62.17 --- $78.41 004 1 1 0.00 $0.00 Y
P 29750 WEDGING OF CLUBFOOT CAST 1.67 $62.17 --- -- 015 0 1 0.00 $0.00 Y
P 29799 CASTING/STRAPPING PROCEDURE 0.00 $0.00 --- -- 015 0 0 0.00 $0.00 Y
K 29799 CASTING/STRAPPING PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 29800 ATHROSCOPY TMJ, W OR W/O SYNOVIAL BX 10.29 $383.10 --- -- 004 0 0 0.00 $0.00 Y
K 29804 ARTHROSCOPIC SURG. TEMPOROMANDIBULAR JT 12.38 $460.91 --- -- 004 0 0 0.00 $0.00 Y
K 29805 SHOULDER ARTHROSCOPY DX 8.09 $301.19 --- -- 004 0 0 0.00 $0.00 Y
K 29806 SHOULDER ARTHROSCOPY/SURGERY 22.73 $846.24 --- -- 004 0 0 0.00 $0.00 Y
O 29806 SHOULDER ARTHROSCOPY/SURGERY 4.55 $169.40 --- -- 004 0 0 0.00 $0.00 Y
O 29807 SHOULDER ARTHROSCOPY/SURGERY 4.42 $164.56 --- -- 004 0 0 0.00 $0.00 Y
K 29807 SHOULDER ARTHROSCOPY/SURGERY 22.11 $823.16 --- -- 004 0 0 0.00 $0.00 Y
K 29819 SHOULDER ARTHROSCOPY/SURGERY 7.93 $295.23 --- $372.31 004 1 0 0.00 $0.00 Y
K 29820 SHOULDER ARTHROSCOPY/SURGERY 10.29 $383.10 --- $483.12 004 1 0 0.00 $0.00 Y
K 29821 SHOULDER ARTHROSCOPY/SURGERY 11.25 $418.84 --- $528.19 004 1 0 0.00 $0.00 Y
K 29822 SHOULDER ARTHROSCOPY/SURGERY 10.94 $407.30 --- $513.63 004 1 0 0.00 $0.00 Y
K 29823 SHOULDER ARTHROSCOPY/SURGERY 11.93 $444.15 --- $560.11 004 1 0 0.00 $0.00 Y
K 29824 SHOULDER ARTHROSCOPY/SURGERY 13.90 $517.50 --- -- 004 0 0 0.00 $0.00 Y
O 29824 SHOULDER ARTHROSCOPY/SURGERY 2.78 $103.50 --- -- 004 0 0 0.00 $0.00 Y
K 29825 SHOULDER ARTHROSCOPY/SURGERY 11.14 $414.74 --- $523.02 004 1 0 0.00 $0.00 Y
K 29826 SHOULDER ARTHROSCOPY/SURGERY 11.33 $421.82 --- -- 004 0 0 0.00 $0.00 Y
K 29827 ARTHROSCOP ROTATOR CUFF REPR 13.27 $493.96 --- $623.03 004 1 0 0.00 $0.00 Y
K 29828 ARTHROSCOPY BICEPS TENODESIS 17.91 $666.79 --- -- 004 0 0 0.00 $0.00 Y
K 29830 ELBOW ARTHROSCOPY 10.39 $386.82 --- $487.81 004 1 0 0.00 $0.00 Y
K 29834 ELBOW ARTHROSCOPY/SURGERY 11.04 $411.02 --- $518.33 004 1 0 0.00 $0.00 Y
K 29835 ELBOW ARTHROSCOPY/SURGERY 9.59 $357.04 --- $450.25 004 1 0 0.00 $0.00 Y
K 29836 ELBOW ARTHROSCOPY/SURGERY 11.03 $410.65 --- $517.86 004 1 0 0.00 $0.00 Y
K 29837 ELBOW ARTHROSCOPY/SURGERY 10.07 $374.91 --- $472.79 004 1 0 0.00 $0.00 Y
K 29838 ELBOW ARTHROSCOPY/SURGERY 11.28 $419.95 --- $529.60 004 1 0 0.00 $0.00 Y
K 29840 WRIST ARTHROSCOPY 7.18 $267.31 --- $337.10 004 1 0 0.00 $0.00 Y
K 29843 WRIST ARTHROSCOPY/SURGERY 9.77 $363.74 --- $458.70 004 1 0 0.00 $0.00 Y
K 29844 WRIST ARTHROSCOPY/SURGERY 10.07 $374.91 --- $472.79 004 1 0 0.00 $0.00 Y
K 29845 WRIST ARTHROSCOPY/SURGERY 12.24 $455.70 --- $574.67 004 1 0 0.00 $0.00 Y
K 29846 WRIST ARTHROSCOPY/SURGERY 14.44 $537.60 --- $677.96 004 1 0 0.00 $0.00 Y
K 29847 WRIST ARTHROSCOPY/SURGERY 11.59 $431.50 --- $544.15 004 1 0 0.00 $0.00 Y
K 29848 WRIST ENDOSCOPY/SURGERY 6.73 $250.56 --- $315.97 004 1 0 0.00 $0.00 Y
K 29850 KNEE ARTHROSCOPY/SURGERY 12.96 $482.50 --- $608.47 004 1 0 0.00 $0.00 Y
O 29850 KNEE ARTHROSCOPY/SURGERY 2.59 $96.43 --- $121.60 004 1 0 0.00 $0.00 Y
O 29851 KNEE ARTHROSCOPY/SURGERY 3.43 $127.70 --- $161.04 004 1 0 0.00 $0.00 Y
K 29851 KNEE ARTHROSCOPY/SURGERY 17.14 $638.12 --- $804.72 004 1 0 0.00 $0.00 Y
K 29855 TIBIAL ARTHROSCOPY/SURGERY 17.14 $638.12 --- $804.72 004 1 0 0.00 $0.00 Y
O 29855 TIBIAL ARTHROSCOPY/SURGERY 3.43 $127.70 --- $161.04 004 1 0 0.00 $0.00 Y
O 29856 TIBIAL ARTHROSCOPY/SURGERY 3.67 $136.63 --- $172.31 004 1 0 0.00 $0.00 Y
K 29856 TIBIAL ARTHROSCOPY/SURGERY 18.36 $683.54 --- $862.00 004 1 0 0.00 $0.00 Y
K 29860 HIP ARTHROSCOPY DX 10.50 $390.92 --- $492.98 004 1 0 0.00 $0.00 Y
K 29861 HIP ARTHRO W/FB REMOVAL 15.28 $568.87 --- $717.40 004 1 0 0.00 $0.00 Y
K 29862 HIP ARTHR0 W/DEBRIDEMENT 16.29 $606.48 --- $764.82 004 1 0 0.00 $0.00 Y
K 29863 HIP ARTHR0 W/SYNOVECTOMY 15.74 $586.00 --- $738.99 004 1 0 0.00 $0.00 Y
K 29866 AUTGRFT IMPLNT KNEE W/SCOPE 13.25 $493.43 --- $622.09 004 1 0 0.00 $0.00 Y
K 29867 ALLGRFT IMPLNT KNEE W/SCOPE 16.13 $600.48 --- $757.30 004 1 0 0.00 $0.00 Y
K 29868 MENISCAL TRNSPL KNEE W/SCPE 22.72 $845.74 --- $1066.70 004 1 0 0.00 $0.00 Y
K 29870 KNEE ARTHROSCOPY DX 7.48 $278.48 --- $351.19 004 1 0 0.00 $0.00 Y
K 29871 KNEE ARTHROSCOPY/DRAINAGE 9.06 $337.30 --- $425.37 004 1 0 0.00 $0.00 Y
K 29873 KNEE ARTHROSCOPY/SURGERY 5.30 $197.24 --- $248.84 004 1 0 0.00 $0.00 Y
K 29874 KNEE ARTHROSCOPY/SURGERY 12.25 $456.07 --- $575.14 004 1 0 0.00 $0.00 Y
K 29875 KNEE ARTHROSCOPY/SURGERY 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
K 29876 KNEE ARTHROSCOPY/SURGERY 14.00 $521.22 --- $657.30 004 1 0 0.00 $0.00 Y
K 29877 KNEE ARTHROSCOPY/SURGERY 12.82 $477.29 --- $601.90 004 1 0 0.00 $0.00 Y
K 29879 KNEE ARTHROSCOPY/SURGERY 13.74 $511.54 --- $645.09 004 1 0 0.00 $0.00 Y
K 29880 KNEE ARTHROSCOPY/SURGERY 14.80 $551.00 --- -- 004 0 0 0.00 $0.00 Y
K 29881 KNEE ARTHROSCOPY/SURGERY 14.80 $551.00 --- -- 004 0 0 0.00 $0.00 Y
K 29882 KNEE ARTHROSCOPY/SURGERY 15.00 $558.45 --- $704.25 004 1 0 0.00 $0.00 Y
K 29883 KNEE ARTHROSCOPY/SURGERY 15.67 $583.39 --- $735.71 004 1 0 0.00 $0.00 Y
K 29884 KNEE ARTHROSCOPY/SURGERY 15.50 $577.07 --- $727.73 004 1 0 0.00 $0.00 Y
K 29885 KNEE ARTHROSCOPY/SURGERY 16.60 $618.02 --- $779.37 004 1 0 0.00 $0.00 Y
K 29886 KNEE ARTHROSCOPY/SURGERY 13.45 $500.74 --- $631.48 004 1 0 0.00 $0.00 Y
K 29887 KNEE ARTHROSCOPY/SURGERY 16.60 $618.02 --- $779.37 004 1 0 0.00 $0.00 Y
K 29888 KNEE ARTHROSCOPY/SURGERY 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 29888 KNEE ARTHROSCOPY/SURGERY 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
O 29889 KNEE ARTHROSCOPY/SURGERY 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 29889 KNEE ARTHROSCOPY/SURGERY 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
K 29891 ANKLE ARTHROSCOPY/SURGERY 14.58 $542.81 --- $684.53 004 1 0 0.00 $0.00 Y
P 29891 ANKLE ARTHROSCOPY/SURGERY 14.58 $542.81 --- -- 015 1 0 0.00 $0.00 Y
P 29892 ANKLE ARTHROSCOPY/SURGERY 15.22 $566.64 --- -- 015 1 0 0.00 $0.00 Y
K 29892 ANKLE ARTHROSCOPY/SURGERY 15.22 $566.64 --- $714.58 004 1 0 0.00 $0.00 Y
K 29893 SCOPE PLANTAR FASCIOTOMY 8.47 $315.34 --- $397.67 004 1 0 0.00 $0.00 Y
P 29893 SCOPE PLANTAR FASCIOTOMY 8.47 $315.34 --- -- 015 1 0 0.00 $0.00 Y
P 29894 ANKLE ARTHROSCOPY 11.33 $421.82 --- -- 015 1 0 0.00 $0.00 Y
K 29894 ANKLE ARTHROSCOPY/SURGERY 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
K 29895 ANKLE ARTHROSCOPY/SURGERY 9.59 $357.04 --- $450.25 004 1 0 0.00 $0.00 Y
P 29895 ANKLE ARTHROSCOPY/SURGERY 9.59 $357.04 --- -- 015 1 0 0.00 $0.00 Y
P 29897 ANKLE ARTHROSCOPY/SURGERY 10.80 $402.08 --- -- 015 1 0 0.00 $0.00 Y
K 29897 ANKLE ARTHROSCOPY/SURGERY 10.08 $375.28 --- $473.26 004 1 0 0.00 $0.00 Y
K 29898 ANKLE ARTHROSCOPY/SURGERY 11.17 $415.86 --- $524.43 004 1 0 0.00 $0.00 Y
P 29898 ANKLE ARTHROSCOPY/SURGERY 11.17 $415.86 --- -- 015 1 0 0.00 $0.00 Y
P 29899 ANKLE ARTHROSCOPY/SURGERY 19.83 $738.27 --- -- 015 1 0 0.00 $0.00 Y
K 29899 ANKLE ARTHROSCOPY/SURGERY 19.83 $738.27 --- -- 004 0 0 0.00 $0.00 Y
K 29900 MCP JOINT ARTHROSCOPY DX 8.90 $331.35 --- -- 004 0 0 0.00 $0.00 Y
K 29901 MCP JOINT ARTHROSCOPY SURG 10.92 $406.55 --- -- 004 0 0 0.00 $0.00 Y
O 29901 MCP JOINT ARTHROSCOPY SURG 2.18 $81.16 --- -- 004 0 0 0.00 $0.00 Y
O 29902 MCP JOINT ARTHROSCOPY SURG 2.34 $87.12 --- -- 004 0 0 0.00 $0.00 Y
K 29902 MCP JOINT ARTHROSCOPY SURG 11.71 $435.96 --- -- 004 0 0 0.00 $0.00 Y
K 29904 SUBTALAR ARTHRO W/FB RMVL 12.09 $450.11 --- -- 004 0 0 0.00 $0.00 Y
P 29904 SUBTALAR ARTHRO W/FB RMVL 12.09 $450.11 --- -- 015 0 0 0.00 $0.00 Y
P 29905 SUBTALAR ARTHRO W/EXC 13.03 $485.11 --- -- 015 0 0 0.00 $0.00 Y
K 29905 SUBTALAR ARTHRO W/EXC 13.03 $485.11 --- -- 004 0 0 0.00 $0.00 Y
K 29906 SUBTALAR ARTHRO W/DEB 13.73 $511.17 --- -- 004 0 0 0.00 $0.00 Y
P 29906 SUBTALAR ARTHRO W/DEB 13.73 $511.17 --- -- 015 0 0 0.00 $0.00 Y
P 29907 SUBTALAR ARTHRO W/FUSION 16.75 $623.60 --- -- 015 0 0 0.00 $0.00 Y
K 29907 SUBTALAR ARTHRO W/FUSION 16.75 $623.60 --- -- 004 0 0 0.00 $0.00 Y
K 29914 HIP ARTHRO W/FEMOROPLASTY 23.32 $868.08 --- -- 004 0 0 0.00 $0.00 Y
O 29914 HIP ARTHRO W/FEMOROPLASTY 4.66 $173.62 --- -- 004 0 0 0.00 $0.00 Y
O 29915 HIP ARTHRO ACETABULOPLASTY 4.75 $176.88 --- -- 004 0 0 0.00 $0.00 Y
K 29915 HIP ARTHRO ACETABULOPLASTY 23.76 $884.40 --- -- 004 0 0 0.00 $0.00 Y
K 29916 HIP ARTHRO W/LABRAL REPAIR 23.76 $884.40 --- -- 004 0 0 0.00 $0.00 Y
O 29916 HIP ARTHRO W/LABRAL REPAIR 4.75 $176.88 --- -- 004 0 0 0.00 $0.00 Y
O 29999 ARTHROSCOPY OF JOINT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 29999 ARTHROSCOPY OF JOINT 0.00 $0.00 --- -- 004 0 0 0.00 $0.00 Y
K 30000 DRAINAGE OF NOSE LESION 1.67 $62.17 --- $78.41 004 1 1 0.00 $0.00 Y
K 30020 DRAINAGE OF NOSE LESION 1.77 $65.90 --- $83.10 004 1 1 0.00 $0.00 Y
K 30100 INTRANASAL BIOPSY 0.97 $36.11 --- $45.54 004 1 1 0.00 $0.00 Y
K 30110 REMOVAL OF NOSE POLYP(S) 1.83 $68.13 --- $85.92 004 1 1 0.00 $0.00 Y
K 30115 REMOVAL OF NOSE POLYP(S) 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 30117 REMOVAL OF INTRANASAL LESION 6.10 $227.10 --- $286.40 004 1 0 0.00 $0.00 Y
O 30117 REMOVAL OF INTRANASAL LESION 1.22 $45.42 --- $57.28 004 1 0 0.00 $0.00 Y
O 30118 REMOVAL OF INTRANASAL LESION 3.35 $124.72 --- $157.28 004 1 0 0.00 $0.00 Y
K 30118 REMOVAL OF INTRANASAL LESION 16.76 $623.97 --- $786.88 004 1 0 0.00 $0.00 Y
K 30120 REVISION OF NOSE 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
K 30124 REMOVAL OF NOSE LESION 2.85 $106.11 --- $133.81 004 1 1 0.00 $0.00 Y
K 30125 REMOVAL OF NOSE LESION 13.08 $486.97 --- $614.11 004 1 0 0.00 $0.00 Y
O 30125 REMOVAL OF NOSE LESION 2.62 $97.54 --- $123.01 004 1 0 0.00 $0.00 Y
K 30130 EXCISE INFERIOR TURBINATE 3.22 $119.88 --- $151.18 004 1 0 0.00 $0.00 Y
K 30140 RESECT INFERIOR TURBINATE 6.41 $238.64 --- $300.95 004 1 0 0.00 $0.00 Y
K 30150 PARTIAL REMOVAL OF NOSE 16.10 $599.40 --- $755.90 004 1 0 0.00 $0.00 Y
O 30150 PARTIAL REMOVAL OF NOSE 3.22 $119.88 --- $151.18 004 1 0 0.00 $0.00 Y
O 30160 REMOVAL OF NOSE 3.38 $125.84 --- $158.69 004 1 0 0.00 $0.00 Y
K 30160 REMOVAL OF NOSE 16.89 $628.81 --- $792.99 004 1 0 0.00 $0.00 Y
K 30200 INJECTION TREATMENT OF NOSE 0.85 $31.65 --- $39.91 004 1 1 0.00 $0.00 Y
K 30210 NASAL SINUS THERAPY 1.33 $49.52 --- $62.44 004 1 1 0.00 $0.00 Y
K 30220 INSERT NASAL SEPTAL BUTTON 1.71 $63.66 --- $80.28 004 1 0 0.00 $0.00 Y
K 30300 REMOVE NASAL FOREIGN BODY 1.51 $56.22 --- $70.89 004 1 1 0.00 $0.00 Y
K 30310 REMOVE NASAL FOREIGN BODY 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
K 30320 REMOVE NASAL FOREIGN BODY 8.95 $333.21 --- $420.20 004 1 0 0.00 $0.00 Y
K 30400 RECONSTRUCTION OF NOSE 13.59 $505.96 --- $638.05 004 1 0 0.00 $0.00 Y
O 30400 RECONSTRUCTION OF NOSE 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
O 30410 RECONSTRUCTION OF NOSE 3.96 $147.43 --- $185.92 004 1 0 0.00 $0.00 Y
K 30410 RECONSTRUCTION OF NOSE 19.82 $737.90 --- $930.55 004 1 0 0.00 $0.00 Y
K 30420 RECONSTRUCTION OF NOSE 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 30420 RECONSTRUCTION OF NOSE 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 30430 REVISION OF NOSE 6.32 $235.29 --- $296.72 004 1 1 0.00 $0.00 Y
K 30435 REVISION OF NOSE 19.86 $739.39 --- $932.43 004 1 0 0.00 $0.00 Y
K 30450 REVISION OF NOSE 27.67 $1030.15 --- $1299.11 004 1 0 0.00 $0.00 Y
O 30450 REVISION OF NOSE 5.53 $205.88 --- $259.63 004 1 0 0.00 $0.00 Y
O 30460 REVISION OF NOSE 2.68 $99.78 --- $125.83 004 1 0 0.00 $0.00 Y
K 30460 REVISION OF NOSE 13.41 $499.25 --- $629.60 004 1 0 0.00 $0.00 Y
K 30462 REVISION OF NOSE 26.82 $998.51 --- $1259.20 004 1 0 0.00 $0.00 Y
O 30462 REVISION OF NOSE 5.37 $199.93 --- $252.12 004 1 0 0.00 $0.00 Y
O 30465 REPAIR NASAL STENOSIS 3.78 $140.73 --- $177.47 004 1 0 0.00 $0.00 Y
K 30465 REPAIR NASAL STENOSIS 18.88 $702.90 --- $886.42 004 1 0 0.00 $0.00 Y
K 30520 REPAIR OF NASAL SEPTUM 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
O 30520 REPAIR OF NASAL SEPTUM 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
O 30540 REPAIR NASAL DEFECT 2.30 $85.63 --- $107.99 004 1 0 0.00 $0.00 Y
K 30540 REPAIR NASAL DEFECT 11.48 $427.40 --- $538.99 004 1 0 0.00 $0.00 Y
K 30545 REPAIR NASAL DEFECT 20.00 $744.60 --- $939.00 004 1 0 0.00 $0.00 Y
O 30545 REPAIR NASAL DEFECT 4.00 $148.92 --- $187.80 004 1 0 0.00 $0.00 Y
K 30560 RELEASE OF NASAL ADHESIONS 1.51 $56.22 --- $70.89 004 1 1 0.00 $0.00 Y
K 30580 REPAIR UPPER JAW FISTULA 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
O 30580 REPAIR UPPER JAW FISTULA 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
O 30600 REPAIR MOUTH/NOSE FISTULA 1.77 $65.90 --- $83.10 004 1 0 0.00 $0.00 Y
K 30600 REPAIR MOUTH/NOSE FISTULA 8.84 $329.11 --- $415.04 004 1 0 0.00 $0.00 Y
K 30620 RECONSTRUCTION INNER NOSE 10.18 $379.00 --- $477.95 004 1 0 0.00 $0.00 Y
O 30620 RECONSTRUCTION INNER NOSE 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
O 30630 REPAIR NASAL SEPTUM DEFECT 2.62 $97.54 --- $123.01 004 1 0 0.00 $0.00 Y
K 30630 REPAIR NASAL SEPTUM DEFECT 13.11 $488.09 --- $615.51 004 1 0 0.00 $0.00 Y
K 30801 ABLATE INF TURBINATE SUPERF 1.54 $57.33 --- $72.30 004 1 1 0.00 $0.00 Y
K 30802 ABLATE INF TURBINATE SUBMUC 2.20 $81.91 --- $103.29 004 1 1 0.00 $0.00 Y
K 30901 CONTROL NASAL HEMORRAGE, SIMPLE 1.47 $54.73 --- $69.02 004 1 1 0.00 $0.00 Y
K 30903 CONTROL NASAL HEMORRAGE, COMPLEX 1.77 $65.90 --- $83.10 004 1 1 0.00 $0.00 Y
K 30905 CONTROL OF NOSEBLEED 2.82 $104.99 --- $132.40 004 1 1 0.00 $0.00 Y
K 30906 REPEAT CONTROL OF NOSEBLEED 3.19 $118.76 --- $149.77 004 1 1 0.00 $0.00 Y
K 30915 LIGATION NASAL SINUS ARTERY 11.33 $421.82 --- $531.94 004 1 0 0.00 $0.00 Y
O 30915 LIGATION NASAL SINUS ARTERY 2.27 $84.51 --- $106.58 004 1 0 0.00 $0.00 Y
O 30920 LIGATION UPPER JAW ARTERY 3.46 $128.82 --- $162.45 004 1 0 0.00 $0.00 Y
K 30920 LIGATION UPPER JAW ARTERY 17.31 $644.45 --- $812.70 004 1 0 0.00 $0.00 Y
K 30930 THER FX NASAL INF TURBINATE 2.04 $75.95 --- $95.78 004 1 0 0.00 $0.00 Y
K 30999 NASAL SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 30999 NASAL SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 31000 IRRIGATION MAXILLARY SINUS 1.48 $55.10 --- $69.49 004 1 1 0.00 $0.00 Y
K 31002 IRRIGATION SPHENOID SINUS 1.73 $64.41 --- $81.22 004 1 1 0.00 $0.00 Y
R 3101 REV - ADULT MED/SOC HR 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
K 31020 EXPLORATION MAXILLARY SINUS 3.40 $126.58 --- $159.63 004 1 0 0.00 $0.00 Y
R 3103 REV - ADULT MED/SOC DAY 0.00 $0.00 --- -- 009 0 0 0.00 $0.00 N
O 31030 EXPLORATION MAXILLARY SINUS 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
K 31030 EXPLORATION MAXILLARY SINUS 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
K 31032 EXPLORE SINUS REMOVE POLYPS 12.00 $446.76 --- $563.40 004 1 0 0.00 $0.00 Y
O 31032 EXPLORE SINUS REMOVE POLYPS 2.40 $89.35 --- $112.68 004 1 0 0.00 $0.00 Y
O 31040 EXPLORATION BEHIND UPPER JAW 2.73 $101.64 --- $128.17 004 1 0 0.00 $0.00 Y
K 31040 EXPLORATION BEHIND UPPER JAW 13.64 $507.82 --- $640.40 004 1 0 0.00 $0.00 Y
K 31050 EXPLORATION SPHENOID SINUS 11.00 $409.53 --- $516.45 004 1 0 0.00 $0.00 Y
O 31050 EXPLORATION SPHENOID SINUS 2.20 $81.91 --- $103.29 004 1 0 0.00 $0.00 Y
O 31051 SPHENOID SINUS SURGERY 2.28 $84.88 --- $107.05 004 1 0 0.00 $0.00 Y
K 31051 SPHENOID SINUS SURGERY 11.42 $425.17 --- $536.17 004 1 0 0.00 $0.00 Y
K 31070 EXPLORATION OF FRONTAL SINUS 10.00 $372.30 --- $469.50 004 1 0 0.00 $0.00 Y
O 31070 EXPLORATION OF FRONTAL SINUS 2.00 $74.46 --- $93.90 004 1 0 0.00 $0.00 Y
O 31075 EXPLORATION OF FRONTAL SINUS 3.20 $119.14 --- $150.24 004 1 0 0.00 $0.00 Y
K 31075 EXPLORATION OF FRONTAL SINUS 16.00 $595.68 --- $751.20 004 1 0 0.00 $0.00 Y
K 31080 REMOVAL OF FRONTAL SINUS 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
O 31080 REMOVAL OF FRONTAL SINUS 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
O 31081 REMOVAL OF FRONTAL SINUS 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 31081 REMOVAL OF FRONTAL SINUS 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
K 31084 REMOVAL OF FRONTAL SINUS 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
O 31084 REMOVAL OF FRONTAL SINUS 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
O 31085 REMOVAL OF FRONTAL SINUS 4.80 $178.70 --- $225.36 004 1 0 0.00 $0.00 Y
K 31085 REMOVAL OF FRONTAL SINUS 24.00 $893.52 --- $1126.80 004 1 0 0.00 $0.00 Y
K 31086 REMOVAL OF FRONTAL SINUS 21.67 $806.77 --- $1017.41 004 1 0 0.00 $0.00 Y
O 31086 REMOVAL OF FRONTAL SINUS 4.33 $161.21 --- $203.29 004 1 0 0.00 $0.00 Y
O 31087 REMOVAL OF FRONTAL SINUS 4.39 $163.44 --- $206.11 004 1 0 0.00 $0.00 Y
K 31087 REMOVAL OF FRONTAL SINUS 21.97 $817.94 --- $1031.49 004 1 0 0.00 $0.00 Y
K 31090 EXPLORATION OF SINUSES 26.00 $967.98 --- $1220.70 004 1 0 0.00 $0.00 Y
O 31090 EXPLORATION OF SINUSES 5.20 $193.60 --- $244.14 004 1 0 0.00 $0.00 Y
O 31200 REMOVAL OF ETHMOID SINUS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 31200 REMOVAL OF ETHMOID SINUS 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 31201 REMOVAL OF ETHMOID SINUS 7.22 $268.80 --- $338.98 004 1 0 0.00 $0.00 Y
O 31201 REMOVAL OF ETHMOID SINUS 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 31205 REMOVAL OF ETHMOID SINUS 2.94 $109.46 --- $138.03 004 1 0 0.00 $0.00 Y
K 31205 REMOVAL OF ETHMOID SINUS 14.72 $548.03 --- $691.10 004 1 0 0.00 $0.00 Y
K 31225 REMOVAL OF UPPER JAW 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
O 31225 REMOVAL OF UPPER JAW 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
O 31230 REMOVAL OF UPPER JAW 5.44 $202.53 --- $255.41 004 1 0 0.00 $0.00 Y
K 31230 REMOVAL OF UPPER JAW 27.18 $1011.91 --- $1276.10 004 1 0 0.00 $0.00 Y
K 31231 NASAL ENDOSCOPY DX 1.32 $49.14 --- $61.97 004 1 0 0.00 $0.00 Y
K 31233 NSL/SINS NDSC DX MAX SINUSC 2.24 $83.40 --- $105.17 004 1 0 0.00 $0.00 Y
K 31235 NSL/SINS NDSC DX SPHN SINUSC 3.93 $146.31 --- $184.51 004 1 0 0.00 $0.00 Y
K 31237 NASAL/SINUS ENDOSCOPY SURG 2.75 $102.38 --- $129.11 004 1 0 0.00 $0.00 Y
K 31238 NASAL/SINUS ENDOSCOPY SURG 4.68 $174.24 --- $219.73 004 1 0 0.00 $0.00 Y
K 31239 NASAL/SINUS ENDOSCOPY SURG 12.19 $453.83 --- $572.32 004 1 0 0.00 $0.00 Y
K 31240 NASAL/SINUS ENDOSCOPY SURG 3.55 $132.17 --- $166.67 004 1 0 0.00 $0.00 Y
K 31241 NSL/SINS NDSC W/ARTERY LIG 10.21 $380.25 --- -- 004 0 0 0.00 $0.00 Y
O 31241 NSL/SINS NDSC W/ARTERY LIG 2.04 $76.05 --- -- 004 0 0 0.00 $0.00 Y
K 31253 NSL/SINS NDSC TOTAL 11.47 $427.13 --- -- 004 0 0 0.00 $0.00 Y
K 31254 NSL/SINS NDSC W/PRTL ETHMDCT 6.42 $239.02 --- $301.42 004 1 0 0.00 $0.00 Y
K 31255 NASAL/SINUS ENDOSCOPY SURGICAL 9.63 $358.52 --- $452.13 004 1 0 0.00 $0.00 Y
K 31256 NASAL/SINUS ENDOSCOP SURG MAX ANTROSTOMY 4.55 $169.40 --- $213.62 004 1 0 0.00 $0.00 Y
K 31257 NSL/SINS NDSC TOT W/SPHENDT 10.22 $380.50 --- -- 004 0 0 0.00 $0.00 Y
K 31259 NSL/SINS NDSC SPHN TISS RMVL 10.83 $403.22 --- -- 004 0 0 0.00 $0.00 Y
K 31267 ENDOSCOPY MAXILLARY SINUS 6.97 $259.49 --- $327.24 004 1 0 0.00 $0.00 Y
K 31276 NSL/SINS NDSC FRNT TISS RMVL 9.07 $337.68 --- $425.84 004 1 0 0.00 $0.00 Y
K 31287 NASAL/SINUS ENDOSCOPY SURG 5.42 $201.79 --- $254.47 004 1 0 0.00 $0.00 Y
K 31288 NASAL/SINUS ENDOSCOPY SURG 6.33 $235.67 --- $297.19 004 1 0 0.00 $0.00 Y
K 31290 NASAL/SINUS ENDOSCOPY SURG 18.43 $686.15 --- $865.29 004 1 0 0.00 $0.00 Y
K 31291 NASAL/SINUS ENDOSCOPY SURG 19.36 $720.77 --- $908.95 004 1 0 0.00 $0.00 Y
K 31292 NSL/SINS NDSC MED/INF DCMPRN 14.94 $556.22 --- $701.43 004 1 0 0.00 $0.00 Y
K 31293 NSL/SINS NDSC MED&INF DCMPRN 16.37 $609.46 --- $768.57 004 1 0 0.00 $0.00 Y
K 31294 NSL/SINS NDSC SURG ON DCMPRN 18.73 $697.32 --- $879.37 004 1 0 0.00 $0.00 Y
K 31295 NSL/SINS NDSC SURG MAX SINS 4.01 $149.13 --- -- 004 0 0 0.00 $0.00 Y
K 31296 NSL/SINS NDSC SURG FRNT SINS 4.77 $177.74 --- -- 004 0 0 0.00 $0.00 Y
K 31297 NSL/SINS NDSC SURG SPHN SINS 3.92 $146.00 --- -- 004 0 0 0.00 $0.00 Y
K 31298 NSL/SINS NDSC SURG FRNT&SPHN 97.14 $3616.67 --- -- 004 0 0 0.00 $0.00 Y
O 31298 NSL/SINS NDSC SURG FRNT&SPHN 19.42 $723.33 --- -- 004 0 0 0.00 $0.00 Y
O 31299 SINUS SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 31299 SINUS SURGERY PROCEDURE 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 31300 REMOVAL OF LARYNX LESION 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 31300 REMOVAL OF LARYNX LESION 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
O 31360 REMOVAL OF LARYNX 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 31360 REMOVAL OF LARYNX 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
K 31365 REMOVAL OF LARYNX 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
O 31365 REMOVAL OF LARYNX 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
O 31367 PARTIAL REMOVAL OF LARYNX 5.89 $219.28 --- $276.54 004 1 0 0.00 $0.00 Y
K 31367 PARTIAL REMOVAL OF LARYNX 29.45 $1096.42 --- $1382.68 004 1 0 0.00 $0.00 Y
K 31368 PARTIAL REMOVAL OF LARYNX 38.51 $1433.73 --- $1808.04 004 1 0 0.00 $0.00 Y
O 31368 PARTIAL REMOVAL OF LARYNX 7.70 $286.67 --- $361.52 004 1 0 0.00 $0.00 Y
O 31370 PARTIAL REMOVAL OF LARYNX 6.80 $253.16 --- $319.26 004 1 0 0.00 $0.00 Y
K 31370 PARTIAL REMOVAL OF LARYNX 33.98 $1265.08 --- $1595.36 004 1 0 0.00 $0.00 Y
K 31375 PARTIAL REMOVAL OF LARYNX 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 31375 PARTIAL REMOVAL OF LARYNX 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 31380 PARTIAL REMOVAL OF LARYNX 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
K 31380 PARTIAL REMOVAL OF LARYNX 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
K 31382 PARTIAL REMOVAL OF LARYNX 22.65 $843.26 --- $1063.42 004 1 0 0.00 $0.00 Y
O 31382 PARTIAL REMOVAL OF LARYNX 4.53 $168.65 --- $212.68 004 1 0 0.00 $0.00 Y
O 31390 REMOVAL OF LARYNX & PHARYNX 10.89 $405.43 --- $511.29 004 1 0 0.00 $0.00 Y
K 31390 REMOVAL OF LARYNX & PHARYNX 54.47 $2027.92 --- $2557.37 004 1 0 0.00 $0.00 Y
K 31395 RECONSTRUCT LARYNX & PHARYNX 53.85 $2004.84 --- $2528.26 004 1 0 0.00 $0.00 Y
O 31395 RECONSTRUCT LARYNX & PHARYNX 10.77 $400.97 --- $505.65 004 1 0 0.00 $0.00 Y
O 31400 REVISION OF LARYNX 4.17 $155.25 --- $195.78 004 1 0 0.00 $0.00 Y
K 31400 REVISION OF LARYNX 20.86 $776.62 --- $979.38 004 1 0 0.00 $0.00 Y
K 31420 REMOVAL OF EPIGLOTTIS 18.12 $674.61 --- $850.73 004 1 0 0.00 $0.00 Y
O 31420 REMOVAL OF EPIGLOTTIS 3.62 $134.77 --- $169.96 004 1 0 0.00 $0.00 Y
K 31500 INSERTION OF WINDPIPE AIRWAY 1.59 $59.20 --- $74.65 004 1 0 0.00 $0.00 Y
K 31502 TRACHEOTOMY, TUBE CHANGE 1.60 $59.57 --- -- 004 0 0 0.00 $0.00 Y
K 31505 DIAGNOSTIC LARYNGOSCOPY 1.59 $59.20 --- $74.65 004 1 1 0.00 $0.00 Y
K 31510 LARYNGOSCOPY WITH BIOPSY 2.02 $75.20 --- $94.84 004 1 0 0.00 $0.00 Y
K 31511 REMOVE FOREIGN BODY LARYNX 2.23 $83.02 --- $104.70 004 1 0 0.00 $0.00 Y
K 31512 REMOVAL OF LARYNX LESION 2.16 $80.42 --- $101.41 004 1 0 0.00 $0.00 Y
K 31513 INJECTION INTO VOCAL CORD 3.53 $131.42 --- $165.73 004 1 0 0.00 $0.00 Y
K 31515 LARYNGOSCOPY FOR ASPIRATION 1.89 $70.36 --- $88.74 004 1 0 0.00 $0.00 Y
K 31520 DX LARYNGOSCOPY NEWBORN 2.72 $101.27 --- $127.70 004 1 0 0.00 $0.00 Y
K 31525 DX LARYNGOSCOPY EXCL NB 4.53 $168.65 --- $212.68 004 1 1 0.00 $0.00 Y
K 31526 DX LARYNGOSCOPY W/OPER SCOPE 3.71 $138.12 --- $174.18 004 1 0 0.00 $0.00 Y
K 31527 LARYNGOSCOPY FOR TREATMENT 7.00 $260.61 --- $328.65 004 1 0 0.00 $0.00 Y
K 31528 LARYNGOSCOPY AND DILATION 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 31529 LARYNGOSCOPY AND DILATION 5.00 $186.15 --- $234.75 004 1 0 0.00 $0.00 Y
K 31530 LARYNGOSCOPY W/FB REMOVAL 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 31531 LARYNGOSCOPY W/FB & OP SCOPE 4.98 $185.41 --- $233.81 004 1 0 0.00 $0.00 Y
K 31535 LARYNGOSCOPY W/BIOPSY 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 31536 LARYNGOSCOPY W/BX & OP SCOPE 7.20 $268.06 --- $338.04 004 1 0 0.00 $0.00 Y
K 31540 LARYNGOSCOPY W/EXC OF TUMOR 6.00 $223.38 --- $281.70 004 1 0 0.00 $0.00 Y
K 31541 LARYNSCOP W/TUMR EXC + SCOPE 7.20 $268.06 --- $338.04 004 1 0 0.00 $0.00 Y
K 31545 REMOVE VC LESION W/SCOPE 5.54 $206.24 --- $260.10 004 1 0 0.00 $0.00 Y
O 31545 REMOVE VC LESION W/SCOPE 1.11 $41.25 --- $52.11 004 1 0 0.00 $0.00 Y
O 31546 REMOVE VC LESION SCOPE/GRAFT 1.74 $64.75 --- $81.69 004 1 0 0.00 $0.00 Y
K 31546 REMOVE VC LESION SCOPE/GRAFT 8.70 $323.90 --- $408.47 004 1 0 0.00 $0.00 Y
K 31551 LARYNGOPLASTY LARYNGEAL STEN 33.20 $1236.04 --- -- 004 0 0 0.00 $0.00 Y
O 31551 LARYNGOPLASTY LARYNGEAL STEN 6.64 $247.21 --- -- 004 0 0 0.00 $0.00 Y
O 31552 LARYNGOPLASTY LARYNGEAL STEN 6.74 $250.93 --- -- 004 0 0 0.00 $0.00 Y
K 31552 LARYNGOPLASTY LARYNGEAL STEN 33.73 $1255.77 --- -- 004 0 0 0.00 $0.00 Y
K 31553 LARYNGOPLASTY LARYNGEAL STEN 36.82 $1370.81 --- -- 004 0 0 0.00 $0.00 Y
O 31553 LARYNGOPLASTY LARYNGEAL STEN 7.36 $274.01 --- -- 004 0 0 0.00 $0.00 Y
O 31554 LARYNGOPLASTY LARYNGEAL STEN 7.78 $289.65 --- -- 004 0 0 0.00 $0.00 Y
K 31554 LARYNGOPLASTY LARYNGEAL STEN 38.93 $1449.36 --- -- 004 0 0 0.00 $0.00 Y
K 31560 LARYNGOSCOP W/ARYTENOIDECTOM 15.00 $558.45 --- $704.25 004 1 0 0.00 $0.00 Y
O 31560 LARYNGOSCOP W/ARYTENOIDECTOM 3.00 $111.69 --- $140.85 004 1 0 0.00 $0.00 Y
O 31561 LARYNSCOP REMVE CART + SCOP 4.11 $153.02 --- $192.96 004 1 0 0.00 $0.00 Y
K 31561 LARYNSCOP REMVE CART + SCOP 21.78 $810.87 --- $1022.57 004 1 0 0.00 $0.00 Y
K 31570 LARYNGOSCOPE W/VC INJ 6.75 $251.30 --- $316.91 004 1 0 0.00 $0.00 Y
O 31570 LARYNGOSCOPE W/VC INJ 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
O 31571 LARYNGOSCOP W/VC INJ + SCOPE 1.19 $44.30 --- $55.87 004 1 0 0.00 $0.00 Y
K 31571 LARYNGOSCOP W/VC INJ + SCOPE 5.94 $221.15 --- $278.88 004 1 0 0.00 $0.00 Y
K 31572 LARGSC W/LASER DSTRJ LES 12.12 $451.23 --- -- 004 0 0 0.00 $0.00 Y
O 31572 LARGSC W/LASER DSTRJ LES 2.42 $90.10 --- -- 004 0 0 0.00 $0.00 Y
O 31573 LARGSC W/THER INJECTION 1.26 $46.91 --- -- 004 0 0 0.00 $0.00 Y
K 31573 LARGSC W/THER INJECTION 6.33 $235.67 --- -- 004 0 0 0.00 $0.00 Y
K 31574 LARGSC W/NJX AUGMENTATION 25.50 $949.37 --- -- 004 0 0 0.00 $0.00 Y
O 31574 LARGSC W/NJX AUGMENTATION 5.10 $189.87 --- -- 004 0 0 0.00 $0.00 Y
K 31575 DIAGNOSTIC LARYNGOSCOPY 2.07 $77.07 --- $97.19 004 1 0 0.00 $0.00 Y
K 31576 LARYNGOSCOPY WITH BIOPSY 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 31577 LARGSC W/RMVL FOREIGN BDY(S) 4.08 $151.90 --- $191.56 004 1 0 0.00 $0.00 Y
K 31578 LARGSC W/REMOVAL LESION 0.00 $0.00 --- -- 004 1 0 0.00 $0.00 Y
K 31579 LARYNGOSCOPY TELESCOPIC 4.22 $157.11 --- $198.13 004 1 0 0.00 $0.00 Y
K 31580 LARYNGOPLASTY LARYNGEAL WEB 22.96 $854.80 --- $1077.97 004 1 0 0.00 $0.00 Y
O 31580 LARYNGOPLASTY LARYNGEAL WEB 4.59 $170.89 --- $215.50 004 1 0 0.00 $0.00 Y
O 31584 LARYNGOPLASTY FX RDCTJ FIXJ 6.47 $240.88 --- $303.77 004 1 0 0.00 $0.00 Y
K 31584 LARYNGOPLASTY FX RDCTJ FIXJ 32.35 $1204.39 --- $1518.83 004 1 0 0.00 $0.00 Y
K 31587 LARYNGOPLASTY CRICOID SPLIT 26.11 $972.08 --- $1225.86 004 1 0 0.00 $0.00 Y
O 31587 LARYNGOPLASTY CRICOID SPLIT 5.22 $194.34 --- $245.08 004 1 0 0.00 $0.00 Y
O 31590 REINNERVATE LARYNX 3.57 $132.91 --- $167.61 004 1 0 0.00 $0.00 Y
K 31590 REINNERVATE LARYNX 17.84 $664.18 --- $837.59 004 1 0 0.00 $0.00 Y