CT Scan |
CT HEAD/BRAIN W/O DYE | CPT 70450 (27) | Outpatient | 3500260 | $818 | |
CT MAXILLOFACIAL W/O DYE | CPT 70486 (27) | Outpatient | 3500350 | $802 | |
CT SOFT TISSUE NECK W/DYE | CPT 70491 (27) | Outpatient | 3500391 | $1,192 | |
CT ANGIOGRAPHY HEAD | CPT 70496 | Outpatient | 3500267 | $1,219 | |
CT THORAX DX C- | CPT 71250 (27) | Outpatient | 3500160 | $896 | |
CT THORAX DX C+ | CPT 71260 (27) | Outpatient | 3500151 | $1,287 | |
CT ANGIOGRAPHY CHEST | CPT 71275 | Outpatient | 3500153 | $1,971 | |
CT NECK SPINE W/O DYE | CPT 72125 (27) | Outpatient | 3500170 | $1,034 | |
CT LUMBAR SPINE W/O DYE | CPT 72131 (27) | Outpatient | 3500310 | $925 | |
(N/O) CT SCAN OF PELVIS WITH CONTRAST | CPT 72193 | - | - | - | - |
CT LOWER EXTREMITY W/O DYE | CPT 73700 (27) | Outpatient | 3500270 | $893 | |
CT ABD & PELVIS W/O CONTRAST | CPT 74176 | Outpatient | 3500047 | $2,182 | |
CT ABD & PELV W/CONTRAST | CPT 74177 | Outpatient | 3500048 | $2,057 | |
CT ABD & PELV 1/> REGNS | CPT 74178 | Outpatient | 3500049 | $3,070 | |
CT BONE DENSITY AXIAL | CPT 77078 | Outpatient | 3500083 | $279 | |
Cardiology |
CARDIOVASCULAR STRESS TEST | CPT 93017 | Outpatient | 4820000 | $692 | |
TTE W/DOPPLER COMPLETE | CPT 93306 | Outpatient | 4000204 | $1,716 | |
Clinic |
(N/O) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 30 MIN | CPT 99203 | - | - | - | - |
(N/O) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 45 MIN | CPT 99204 | - | - | - | - |
(N/O) NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT, 60 MIN | CPT 99205 | - | - | - | - |
(N/O) PATIENT OFFICE CONSULTATION, 40 MIN | CPT 99243 | - | - | - | - |
(N/O) PATIENT OFFICE CONSULTATION, 60 MIN | CPT 99244 | - | - | - | - |
(N/O) INITIAL NEW PATIENT PREVENTATIVE MEDICINE EVALUATION ... | CPT 99385 | - | - | - | - |
(N/O) INITIAL NEW PATIENT PREVENTATIVE MEDICINE EVALUATION ... | CPT 99386 | - | - | - | - |
EEG |
POLYSOM 6/> YRS 4/> PARAM | CPT 95810 | Outpatient | 7400010 | $1,770 | |
EEG AWAKE AND ASLEEP | CPT 95819 | Outpatient | 7400017 | $1,361 | |
EKG |
(N/O) ELECTROCARDIOGRAM, ROUTINE, WITH INTERPRETATION AND ... | CPT 93000 | - | - | - | - |
ELECTROCARDIOGRAM TRACING | CPT 93005 | Outpatient | 7300010 | $129 | |
ELECTROCARDIOGRAM REPORT | CPT 93010 | Outpatient | 7300011 | $129 | |
ECG MONIT/REPRT UP TO 48 HRS | CPT 93225 | Outpatient | 48000170 | $898 | |
ECG MONIT/REPRT UP TO 48 HRS | CPT 93226 | Outpatient | 4800171 | $164 | |
Emergency Room |
PLACE NEEDLE IN VEIN | CPT 36000 | Outpatient | 4500135 | $113 | |
HEART/LUNG RESUSCITATION CPR | CPT 92950 | Outpatient | 2701095 | $836 | |
TX/PRO/DX INJ SAME DRUG ADON | CPT 96376 | Outpatient | 4500157 | $14 | |
EMERGENCY DEPT VISIT | CPT 99281 | Outpatient | 4500032 | $242 | |
EMERGENCY DEPT VISIT | CPT 99282 | Outpatient | 4500042 | $410 | |
EMERGENCY DEPT VISIT | CPT 99283 | Outpatient | 4500052 | $734 | |
EMERGENCY DEPT VISIT | CPT 99284 | Outpatient | 4500062 | $2,396 | |
EMERGENCY DEPT VISIT | CPT 99285 (25) | Outpatient | 4500070 | $801 | |
IV Therapy |
HYDRATION IV INFUSION INIT | CPT 96360 | Outpatient | 2600901 | $164 | |
HYDRATE IV INFUSION ADD-ON | CPT 96361 (59) | Outpatient | 7620102 | $125 | |
THER/PROPH/DIAG IV INF INIT | CPT 96365 | Outpatient | 2600081 | $283 | |
THER/PROPH/DIAG IV INF ADDON | CPT 96366 | Outpatient | 2600781 | $113 | |
TX/PROPH/DG ADDL SEQ IV INF | CPT 96367 | Outpatient | 2600082 | $139 | |
Imaging |
US EXAM OF HEAD AND NECK | CPT 76536 | Outpatient | 4000310 | $352 | |
ULTRASOUND BREAST LIMITED | CPT 76642 (LT) | Outpatient | 4000116 | $157 | |
US EXAM ABDOM COMPLETE | CPT 76700 | Outpatient | 4000020 | $481 | |
ECHO EXAM OF ABDOMEN | CPT 76705 | Outpatient | 4000010 | $376 | |
US EXAM ABDO BACK WALL COMP | CPT 76770 | Outpatient | 4000050 | $411 | |
US EXAM ABDO BACK WALL LIM | CPT 76775 | Outpatient | 4000012 | $342 | |
OB US < 14 WKS SINGLE FETUS | CPT 76801 | Outpatient | 4000271 | $528 | |
(N/O) ABDOMIAL ULTRASOUND OF PREGNANT UTERUS | CPT 76805 | - | - | - | - |
OB US LIMITED FETUS(S) | CPT 76815 | Outpatient | 4000280 | $281 | |
TRANSVAGINAL US OBSTETRIC | CPT 76817 | Outpatient | 4000461 | $321 | |
TRANSVAGINAL US NON-OB | CPT 76830 | Outpatient | 4000470 | $363 | |
US EXAM PELVIC COMPLETE | CPT 76856 | Outpatient | 4000320 | $548 | |
US EXAM SCROTUM | CPT 76870 | Outpatient | 4000390 | $329 | |
US COMPL JOINT R-T W/IMG | CPT 76881 | Outpatient | 4000210 | $353 | |
DX MAMMO INCL CAD UNI | CPT 77065 (LT) | Outpatient | 3201700 | $269 | |
DX MAMMO INCL CAD BI | CPT 77066 | Outpatient | 3201690 | $281 | |
SCR MAMMO BI INCL CAD | CPT 77067 | Outpatient | 3201740 | $201 | |
Inpatient Procedures |
(N/O) CARDIAC VALVE OR CARDIOTHORACIC PROCEDURE WITH CARDI ... | DRG 216 | - | - | - | - |
(N/O) SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | DRG 460 | - | - | - | - |
(N/O) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXT ... | DRG 470 | - | - | - | - |
(N/O) CERVICAL SPINAL FUSION WITHOUT CC OR MCC | DRG 473 | - | - | - | - |
(N/O) UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WIT ... | DRG 743 | - | - | - | - |
Labor and Delivery |
FETAL NON-STRESS TEST | CPT 59025 | Outpatient | 7200090 | $262 | |
Laboratory |
METABOLIC PANEL TOTAL CA | CPT 80048 | Outpatient | 3001785 | $76 | |
COMPREHEN METABOLIC PANEL | CPT 80053 | Outpatient | 3001320 | $99 | |
(N/O) OBSTETRIC BLOOD TEST PANEL | CPT 80055 | - | - | - | - |
LIPID PANEL | CPT 80061 | Outpatient | 3003530 | $118 | |
RENAL FUNCTION PANEL | CPT 80069 | Outpatient | 3004905 | $163 | |
HEPATIC FUNCTION PANEL | CPT 80076 | Outpatient | 3003668 | $119 | |
ASSAY CARBAMAZEPINE TOTAL | CPT 80156 | Outpatient | 3002045 | $109 | |
DRUG ASSAY CYCLOSPORINE | CPT 80158 | Outpatient | 3002170 | $123 | |
ASSAY OF DIGOXIN TOTAL | CPT 80162 | Outpatient | 3002270 | $109 | |
DIPROPYLACETIC ACID FREE | CPT 80165 | Outpatient | 3006260 | $79 | |
ASSAY OF LITHIUM | CPT 80178 | Outpatient | 3003665 | $61 | |
ASSAY OF PHENYTOIN TOTAL | CPT 80185 | Outpatient | 3004655 | $127 | |
ASSAY OF TACROLIMUS | CPT 80197 | Outpatient | 3005535 | $200 | |
ASSAY OF VANCOMYCIN | CPT 80202 | Outpatient | 3006275 | $130 | |
DRUG TEST PRSMV CHEM ANLYZR | CPT 80307 | Outpatient | 3000821 | $280 | |
DRUG SCREEN QUANTALCOHOLS | CPT 80320 | Outpatient | 3002495 | $86 | |
DRUG SCREEN AMPHETAMINES 1/2 | CPT 80324 | Outpatient | 3003461 | $38 | |
ANALGESICS NON-OPIOID 1 OR 2 | CPT 80329 | Outpatient | 3000620 | $108 | |
(N/O) URINALYSIS TEST USING MICROSCOPE | CPT 81000 | - | - | - | - |
(N/O) URINALYSIS TEST USING MICROSCOPE | CPT 81001 | - | - | - | - |
(N/O) URINALYSIS TEST | CPT 81002 | - | - | - | - |
URINALYSIS AUTO W/O SCOPE | CPT 81003 | Outpatient | 3005725 | $23 | |
MICROSCOPIC EXAM OF URINE | CPT 81015 | Outpatient | 3005755 | $31 | |
URINALYSIS VOLUME MEASURE | CPT 81050 | Outpatient | 3005410 | $25 | |
TEST FOR ACETONE/KETONES | CPT 82009 | Outpatient | 3000635 | $57 | |
ASSAY OF SERUM ALBUMIN | CPT 82040 | Outpatient | 3000755 | $50 | |
UR ALBUMIN QUANTITATIVE | CPT 82043 | Outpatient | 3003840 | $56 | |
ALPHA-FETOPROTEIN SERUM | CPT 82105 | Outpatient | 3000004 | $97 | |
AMINO ACIDS SINGLE QUANT | CPT 82131 | Outpatient | 3003370 | $225 | |
ASSAY OF AMMONIA | CPT 82140 | Outpatient | 3000935 | $113 | |
ASSAY OF AMYLASE | CPT 82150 | Outpatient | 3000920 | $53 | |
BILIRUBIN TOTAL | CPT 82247 | Outpatient | 3001310 | $50 | |
BILIRUBIN DIRECT | CPT 82248 | Outpatient | 3001315 | $29 | |
VITAMIN D 25 HYDROXY | CPT 82306 | Outpatient | 3006360 | $137 | |
ASSAY OF CALCIUM | CPT 82310 | Outpatient | 3001565 | $50 | |
CARCINOEMBRYONIC ANTIGEN | CPT 82378 | Outpatient | 3001655 | $11 | |
ASSAY OF CK (CPK) | CPT 82550 | Outpatient | 3001850 | $43 | |
ASSAY OF CREATININE | CPT 82565 | Outpatient | 3002075 | $50 | |
ASSAY OF URINE CREATININE | CPT 82570 | Outpatient | 3005870 | $96 | |
VITAMIN B-12 | CPT 82607 | Outpatient | 3001145 | $82 | |
VIT D 1 25-DIHYDROXY | CPT 82652 | Outpatient | 3006370 | $160 | |
ASSAY OF ESTROGENS | CPT 82671 | Outpatient | 3002465 | $90 | |
ASSAY OF FERRITIN | CPT 82728 | Outpatient | 3002570 | $89 | |
ASSAY OF FOLIC ACID SERUM | CPT 82746 | Outpatient | 3002720 | $91 | |
ASSAY IGA/IGD/IGG/IGM EACH | CPT 82784 | Outpatient | 3003396 | $61 | |
BLOOD GASES ANY COMBINATION | CPT 82803 | Outpatient | 3001361 | $152 | |
BLOOD GASES W/O2 SATURATION | CPT 82805 | Outpatient | 3001360 | $166 | |
ASSAY GLUCOSE BLOOD QUANT | CPT 82947 | Outpatient | 3002990 | $64 | |
ASSAY OF GONADOTROPIN (FSH) | CPT 83001 | Outpatient | 3002735 | $84 | |
GLYCOSYLATED HEMOGLOBIN TEST | CPT 83036 | Outpatient | 3003065 | $61 | |
ASSAY OF IRON | CPT 83540 | Outpatient | 3002555 | $35 | |
IRON BINDING TEST | CPT 83550 | Outpatient | 3005500 | $40 | |
ASSAY OF LACTIC ACID | CPT 83605 | Outpatient | 3003470 | $121 | |
LACTATE (LD) (LDH) ENZYME | CPT 83615 | Outpatient | 3003500 | $59 | |
ASSAY OF LDH ENZYMES | CPT 83625 | Outpatient | 3001020 | $66 | |
ASSAY OF LIPASE | CPT 83690 | Outpatient | 3003650 | $61 | |
ASSAY OF BLOOD LIPOPROTEIN | CPT 83721 | Outpatient | 3001775 | $68 | |
ASSAY OF MAGNESIUM | CPT 83735 | Outpatient | 3003830 | $50 | |
ASSAY OF NATRIURETIC PEPTIDE | CPT 83880 | Outpatient | 3001330 | $85 | |
ASSAY OF PARATHORMONE | CPT 83970 | Outpatient | 3004646 | $363 | |
ASSAY OF BLOOD PKU | CPT 84030 | Outpatient | 3004220 | $148 | |
ASSAY OF PHOSPHORUS | CPT 84100 | Outpatient | 3004205 | $56 | |
EVAL AMNIOTIC FLUID PROTEIN | CPT 84112 | Outpatient | 3007318 | $88 | |
ASSAY OF SERUM POTASSIUM | CPT 84132 | Outpatient | 3003455 | $53 | |
ASSAY OF PREALBUMIN | CPT 84134 | Outpatient | 3000760 | $61 | |
PROCALCITONIN (PCT) | CPT 84145 | Outpatient | 3004480 | $94 | |
ASSAY OF PSA TOTAL | CPT 84153 | Outpatient | 3004520 | $100 | |
ASSAY OF PSA FREE | CPT 84154 | Outpatient | 3004510 | $83 | |
ASSAY OF PROTEIN URINE | CPT 84156 | Outpatient | 3002165 | $89 | |
PROTEIN E-PHORESIS SERUM | CPT 84165 | Outpatient | 3004175 | $73 | |
ASSAY OF FREE TESTOSTERONE | CPT 84402 | Outpatient | 3005406 | $152 | |
ASSAY OF TOTAL TESTOSTERONE | CPT 84403 | Outpatient | 3005405 | $158 | |
ASSAY OF TOTAL THYROXINE | CPT 84436 | Outpatient | 3005360 | $85 | |
ASSAY OF FREE THYROXINE | CPT 84439 | Outpatient | 3005365 | $73 | |
ASSAY THYROID STIM HORMONE | CPT 84443 | Outpatient | 3005636 | $116 | |
ALANINE AMINO (ALT) (SGPT) | CPT 84460 | Outpatient | 3005045 | $59 | |
ASSAY TRIIODOTHYRONINE (T3) | CPT 84480 | Outpatient | 3005660 | $96 | |
FREE ASSAY (FT-3) | CPT 84481 | Outpatient | 3005350 | $136 | |
ASSAY OF TROPONIN QUANT | CPT 84484 | Outpatient | 3001574 | $20 | |
ASSAY OF UREA NITROGEN | CPT 84520 | Outpatient | 3001355 | $53 | |
ASSAY OF BLOOD/URIC ACID | CPT 84550 | Outpatient | 3006140 | $60 | |
CHORIONIC GONADOTROPIN TEST | CPT 84702 | Outpatient | 3000003 | $137 | |
CHORIONIC GONADOTROPIN ASSAY | CPT 84703 | Outpatient | 3003275 | $48 | |
BL SMEAR W/DIFF WBC COUNT | CPT 85007 | Outpatient | 3001630 | $11 | |
HEMATOCRIT | CPT 85014 | Outpatient | 3003063 | $28 | |
HEMOGLOBIN | CPT 85018 | Outpatient | 3003064 | $28 | |
COMPLETE CBC W/AUTO DIFF WBC | CPT 85025 | Outpatient | 3001610 | $57 | |
COMPLETE CBC AUTOMATED | CPT 85027 | Outpatient | 3001621 | $90 | |
MANUAL RETICULOCYTE COUNT | CPT 85044 | Outpatient | 3004910 | $61 | |
FIBRIN DEGRADATION QUANT | CPT 85379 | Outpatient | 3002200 | $95 | |
PROTHROMBIN TIME | CPT 85610 | Outpatient | 3004535 | $38 | |
PROTHROMBIN TEST | CPT 85611 | Outpatient | 3004536 | $37 | |
RBC SED RATE NONAUTOMATED | CPT 85651 | Outpatient | 3002450 | $37 | |
THROMBOPLASTIN TIME PARTIAL | CPT 85730 | Outpatient | 3004669 | $60 | |
ANTINUCLEAR ANTIBODIES | CPT 86038 | Outpatient | 3000965 | $99 | |
C-REACTIVE PROTEIN | CPT 86140 | Outpatient | 3002090 | $49 | |
IMMUNOASSAY TUMOR CA 15-3 | CPT 86300 | Outpatient | 3001505 | $13 | |
IMMUNOASSAY TUMOR CA 125 | CPT 86304 | Outpatient | 3001490 | $29 | |
HETEROPHILE ANTIBODY SCREEN | CPT 86308 (QW) | Outpatient | 3003860 | $94 | |
SERUM IMMUNOELECTROPHORESIS | CPT 86320 | Outpatient | 3003400 | $211 | |
RHEUMATOID FACTOR QUANT | CPT 86431 | Outpatient | 3004885 | $57 | |
HELICOBACTER PYLORI ANTIBODY | CPT 86677 | Outpatient | 3003371 | $28 | |
HIV-1ANTIBODY | CPT 86701 | Outpatient | 3000740 | $79 | |
HEP B CORE ANTIBODY TOTAL | CPT 86704 | Outpatient | 3003215 | $62 | |
HEP B SURFACE ANTIBODY | CPT 86706 | Outpatient | 3003245 | $129 | |
HEPATITIS A ANTIBODY | CPT 86708 | Outpatient | 3003200 | $73 | |
HEPATITIS A IGM ANTIBODY | CPT 86709 | Outpatient | 3003205 | $244 | |
MUMPS ANTIBODY | CPT 86735 | Outpatient | 3002710 | $11 | |
RUBELLA ANTIBODY | CPT 86762 | Outpatient | 3002700 | $10 | |
RUBEOLA ANTIBODY | CPT 86765 | Outpatient | 3002695 | $11 | |
VARICELLA-ZOSTER ANTIBODY | CPT 86787 | Outpatient | 3002715 | $15 | |
HEPATITIS C AB TEST | CPT 86803 | Outpatient | 3003290 | $251 | |
RBC ANTIBODY SCREEN | CPT 86850 | Outpatient | 3900200 | $77 | |
COOMBS TEST DIRECT | CPT 86880 | Outpatient | 3900260 | $64 | |
BLOOD TYPING SEROLOGIC ABO | CPT 86900 | Outpatient | 3900101 | $48 | |
BLOOD TYPING SEROLOGIC RH(D) | CPT 86901 | Outpatient | 3900100 | $48 | |
COMPATIBILITY TEST SPIN | CPT 86920 | Outpatient | 3900310 | $184 | |
COMPATIBILITY TEST INCUBATE | CPT 86921 | Outpatient | 3900320 | $184 | |
COMPATIBILITY TEST ANTIGLOB | CPT 86922 | Outpatient | 3900300 | $184 | |
BLOOD CULTURE FOR BACTERIA | CPT 87040 | Outpatient | 3007041 | $122 | |
CULTURE OTHR SPECIMN AEROBIC | CPT 87070 | Outpatient | 3007065 | $67 | |
CULTR BACTERIA EXCEPT BLOOD | CPT 87075 | Outpatient | 3007030 | $175 | |
CULTURE AEROBIC IDENTIFY | CPT 87077 | Outpatient | 3003960 | $43 | |
CULTURE SCREEN ONLY | CPT 87081 | Outpatient | 3005170 | $82 | |
URINE CULTURE/COLONY COUNT | CPT 87086 | Outpatient | 3007430 | $62 | |
DNA/RNA AMPLIFIED PROBE | CPT 87150 | Outpatient | 3002717 | $1,502 | |
MICROBE SUSCEPTIBLE MIC | CPT 87186 | Outpatient | 3007355 | $127 | |
SMEAR GRAM STAIN | CPT 87205 | Outpatient | 3007150 | $46 | |
SMEAR WET MOUNT SALINE/INK | CPT 87210 | Outpatient | 3007210 | $53 | |
CLOSTRIDIUM AG IA | CPT 87324 | Outpatient | 3007060 | $91 | |
HPYLORI STOOL AG IA | CPT 87338 | Outpatient | 3003372 | $50 | |
HEPATITIS B SURFACE AG IA | CPT 87340 | Outpatient | 3003260 | $111 | |
RESP SYNCYTIAL VIRUS AG IA | CPT 87420 | Outpatient | 3007325 | $82 | |
CHYLMD TRACH DNA DIR PROBE | CPT 87490 | Outpatient | 3007172 | $53 | |
IADNA-DNA/RNA PROBE TQ 12-25 | CPT 87507 | Outpatient | 3002716 | $595 | |
HEPATITIS C REVRS TRNSCRPJ | CPT 87522 | Outpatient | 3003291 | $507 | |
N.GONORRHOEAE DNA DIR PROB | CPT 87590 | Outpatient | 3007171 | $53 | |
RESP VIRUS 12-25 TARGETS | CPT 87633 | Outpatient | 3002718 | $836 | |
STREP A DNA AMP PROBE | CPT 87651 | Outpatient | 3005160 | $89 | |
DETECT AGENT NOS DNA AMP | CPT 87798 | Outpatient | 3004150 | $86 | |
STREP B ASSAY W/OPTIC | CPT 87802 | Outpatient | 3002800 | $226 | |
INFLUENZA ASSAY W/OPTIC | CPT 87804 (QW) | Outpatient | 3007316 | $100 | |
STREP A ASSAY W/OPTIC | CPT 87880 | Outpatient | 3007315 | $51 | |
TISSUE EXAM BY PATHOLOGIST | CPT 88302 | Outpatient | 3100070 | $68 | |
TISSUE EXAM BY PATHOLOGIST | CPT 88304 | Outpatient | 3100080 | $88 | |
TISSUE EXAM BY PATHOLOGIST | CPT 88305 | Outpatient | 3100010 | $117 | |
SPECIAL STAINS GROUP 1 | CPT 88312 | Outpatient | 3100400 | $78 | |
SPECIAL STAINS GROUP 2 | CPT 88313 | Outpatient | 3007265 | $60 | |
Language Pathology |
SPEECH EVAL SND W/COMPR & EXP | CPT 92506 | Outpatient | 4400010 | $208 | |
SPEECH/HEARING THERAPY | CPT 92507 (GN) | Outpatient | 4400000 | $112 | |
ORAL FUNCTION THERAPY | CPT 92526 (GN) | Outpatient | 4400005 | $127 | |
EVALUATE SWALLOWING FUNCTION | CPT 92610 | Outpatient | 4400007 | $341 | |
MOTION FLUOROSCOPY/SWALLOW | CPT 92611 (GN) | Outpatient | 4400400 | $190 | |
MRI |
MRI BRAIN STEM W/O DYE | CPT 70551 | Outpatient | 6100210 | $1,848 | |
MRI BRAIN STEM W/O & W/DYE | CPT 70553 (27) | Outpatient | 6100215 | $2,482 | |
MRI NECK SPINE W/O DYE | CPT 72141 (27) | Outpatient | 6100110 | $1,849 | |
MRI LUMBAR SPINE W/O DYE | CPT 72148 (27) | Outpatient | 6100300 | $1,552 | |
MRI JOINT UPR EXTREM W/O DYE | CPT 73221 (RT) | Outpatient | 6100545 | $1,611 | |
MRI LOWER EXTREMITY W/O DYE | CPT 73718 (LT) | Outpatient | 6100287 | $1,354 | |
MRI JNT OF LWR EXTRE W/O DYE | CPT 73721 | Outpatient | 96100285 | $145 | |
Nuclear Medicine |
HEPATOBIL SYST IMAGE W/DRUG | CPT 78227 (27) | Outpatient | 3400140 | $1,069 | |
HT MUSCLE IMAGE SPECT MULT | CPT 78452 | Outpatient | 3400380 | $2,734 | |
Other Diagnostic |
WITHDRAWAL OF ARTERIAL BLOOD | CPT 36600 | Outpatient | 2700008 | $86 | |
VISUAL FIELD EXAMINATION(S) | CPT 92083 | Outpatient | 5100905 | $140 | |
OPHTHALMIC BIOMETRY | CPT 92136 | Outpatient | 5100910 | $163 | |
EXTRACRANIAL BILAT STUDY | CPT 93880 | Outpatient | 4000120 | $667 | |
UPR/LXTR ART STDY 3+ LVLS | CPT 93923 | Outpatient | 4000102 | $322 | |
EXTREMITY STUDY | CPT 93970 | Outpatient | 4000215 | $601 | |
SLEEP STUDY UNATT&RESP EFFT | CPT 95806 | Outpatient | 7400019 | $879 | |
POLYSOM 6/>YRS CPAP 4/> PARM | CPT 95811 | Outpatient | 7400012 | $3,053 | |
Other Procedures and Observation |
PURE TONE HEARING TEST AIR | CPT 92551 | Outpatient | 4700175 | $73 | |
Other Therapeutic |
CLEARANCE OF AIRWAYS | CPT 31720 | Outpatient | 4100182 | $266 | |
BLOOD TRANSFUSION SERVICE | CPT 36430 | Outpatient | 2600035 | $605 | |
INSJ PICC 5 YR+ W/O IMAGING | CPT 36569 | Outpatient | 1200026 | $2,160 | |
IMMUNIZATION ADMIN | CPT 90471 | Outpatient | 2609047 | $79 | |
THER/PROPH/DIAG INJ SC/IM | CPT 96372 | Outpatient | 2600782 | $103 | |
THER/PROPH/DIAG INJ IV PUSH | CPT 96374 | Outpatient | 2600784 | $140 | |
TX/PRO/DX INJ NEW DRUG ADDON | CPT 96375 | Outpatient | 2600900 | $127 | |
MEDICAL NUTRITION INDIV IN | CPT 97802 | Outpatient | 5100480 | $32 | |
PHLEBOTOMY | CPT 99195 | Outpatient | 3900340 | $121 | |
Psychiatric |
(N/O) PSYCHOTHERAPY, 30 MIN | CPT 90832 | - | - | - | - |
(N/O) PSYCHOTHERAPY, 45 MIN | CPT 90834 | - | - | - | - |
(N/O) PSYCHOTHERAPY, 60 MIN | CPT 90837 | - | - | - | - |
(N/O) FAMILY PSYCHOTHERAPY, NOT INCLUDING PATIENT, 50 MIN | CPT 90846 | - | - | - | - |
(N/O) FAMILY PSYCHOTHERAPY, INCLUDING PATIENT, 50 MIN | CPT 90847 | - | - | - | - |
(N/O) GROUP PSYCHOTHERAPY | CPT 90853 | - | - | - | - |
Pulmonary Function |
BREATHING CAPACITY TEST | CPT 94010 | Outpatient | 4100038 | $146 | |
EVALUATION OF WHEEZING | CPT 94060 | Outpatient | 4600020 | $385 | |
LUNG FUNCTION TEST (MBC/MVV) | CPT 94200 | Outpatient | 4600034 | $130 | |
RESPIRATORY FLOW VOLUME LOOP | CPT 94375 | Outpatient | 4600032 | $136 | |
PULM FUNCT TST PLETHYSMOGRAP | CPT 94726 | Outpatient | 4600037 | $130 | |
CO/MEMBANE DIFFUSE CAPACITY | CPT 94729 | Outpatient | 4600031 | $156 | |
MEASURE BLOOD OXYGEN LEVEL | CPT 94760 | Outpatient | 4100092 | $49 | |
MEASURE BLOOD OXYGEN LEVEL | CPT 94761 | Outpatient | 4100120 | $119 | |
MEASURE BLOOD OXYGEN LEVEL | CPT 94762 | Outpatient | 4100110 | $148 | |
PULMONARY SERVICE/PROCEDURE | CPT 94799 | Outpatient | 4100045 | $130 | |
Radiology |
X-RAY EXAM OF SKULL | CPT 70250 (27) | Outpatient | 3202509 | $195 | |
X-RAY EXAM CHEST 1 VIEW | CPT 71045 | Outpatient | 3200641 | $134 | |
X-RAY EXAM CHEST 2 VIEWS | CPT 71046 | Outpatient | 3200650 | $178 | |
X-RAY EXAM UNILAT RIBS/CHEST | CPT 71101 (27) | Outpatient | 3202141 | $194 | |
X-RAY EXAM NECK SPINE 2-3 VW | CPT 72040 (27) | Outpatient | 3200610 | $151 | |
X-RAY EXAM NECK SPINE 4/5VWS | CPT 72050 | Outpatient | 3200643 | $289 | |
X-RAY EXAM NECK SPINE 6/>VWS | CPT 72052 (27) | Outpatient | 3200630 | $343 | |
X-RAY EXAM THORAC SPINE 3VWS | CPT 72072 (27) | Outpatient | 3202711 | $283 | |
X-RAY EXAM L-S SPINE 2/3 VWS | CPT 72100 (27) | Outpatient | 3201630 | $191 | |
(N/O) X-RAY OF LOWER BACK | CPT 72110 | - | - | - | - |
X-RAY EXAM L-S SPINE BENDING | CPT 72114 (27) | Outpatient | 3201650 | $414 | |
X-RAY EXAM OF PELVIS | CPT 72170 (27) | Outpatient | 3202090 | $139 | |
X-RAY EXAM SACRUM TAILBONE | CPT 72220 (52) | Outpatient | 3200580 | $201 | |
X-RAY EXAM OF COLLAR BONE | CPT 73000 (27) | Outpatient | 3200560 | $211 | |
X-RAY EXAM OF HUMERUS | CPT 73060 (27) | Outpatient | 3201370 | $145 | |
X-RAY EXAM OF ELBOW | CPT 73070 (27) | Outpatient | 3200835 | $157 | |
X-RAY EXAM OF ELBOW | CPT 73080 (27) | Outpatient | 3200830 | $195 | |
X-RAY EXAM OF FOREARM | CPT 73090 (27) | Outpatient | 3201090 | $155 | |
X-RAY EXAM OF WRIST | CPT 73100 | Outpatient | 3202852 | $158 | |
X-RAY EXAM OF WRIST | CPT 73110 | Outpatient | 3201920 | $174 | |
X-RAY EXAM OF FINGER(S) | CPT 73140 (27) | Outpatient | 3200990 | $146 | |
X-RAY EXAM HIP UNI 2-3 VIEWS | CPT 73502 | Outpatient | 3201311 | $286 | |
X-RAY EXAM HIPS BI 3-4 VIEWS | CPT 73522 | Outpatient | 3201320 | $235 | |
X-RAY EXAM OF FEMUR 2/> | CPT 73552 | Outpatient | 3200940 | $178 | |
X-RAY EXAM OF KNEE 1 OR 2 | CPT 73560 (27) | Outpatient | 3201520 | $136 | |
X-RAY EXAM KNEE 4 OR MORE | CPT 73564 (27) | Outpatient | 3201500 | $209 | |
X-RAY EXAM OF KNEES | CPT 73565 (27) | Outpatient | 3209525 | $119 | |
X-RAY EXAM OF LOWER LEG | CPT 73590 (50) | Outpatient | 3201593 | $188 | |
X-RAY EXAM OF HEEL | CPT 73650 (27) | Outpatient | 3201230 | $126 | |
X-RAY EXAM OF TOE(S) | CPT 73660 (27) | Outpatient | 3202670 | $115 | |
KUB | CPT 74000 (27) | Outpatient | 3201550 | $127 | |
X-RAY EXAM ABDOMEN 1 VIEW | CPT 74018 (27) | Outpatient | 3200010 | $127 | |
X-RAY EXAM ABDOMEN 2 VIEWS | CPT 74019 | Outpatient | 3200015 | $151 | |
X-RAY EXAM COMPLETE ABDOMEN | CPT 74022 (27) | Outpatient | 3200040 | $323 | |
X-RAY XM SWLNG FUNCJ C+ | CPT 74230 (27) | Outpatient | 3200881 | $279 | |
FLUOROSCOPY <1 HR PHYS/QHP | CPT 76000 | Outpatient | 3200460 | $227 | |
US GUIDE VASCULAR ACCESS | CPT 76937 | Outpatient | 3709001 | $559 | |
Respiratory |
VENT MGMT INPAT INIT DAY | CPT 94002 | Outpatient | 4100015 | $1,057 | |
VENT MGMT INPAT SUBQ DAY | CPT 94003 | Outpatient | 4100016 | $527 | |
AIRWAY INHALATION TREATMENT | CPT 94640 | Outpatient | 4100086 | $76 | |
CBT 1ST HOUR | CPT 94644 | Outpatient | 4100161 | $170 | |
CHEST WALL MANIPULATION | CPT 94667 | Outpatient | 4100145 | $95 | |
CHEST WALL MANIPULATION | CPT 94668 | Outpatient | 4100150 | $62 | |
Surgical Procedures |
(N/O) REMOVAL OF ONE OR MORE BREAST GROWTH, OPEN PROCEDURE | CPT 19120 | - | - | - | - |
(N/O) SHAVING OF SHOULDER BONE USING ENDOSCOPE | CPT 29826 | - | - | - | - |
(N/O) REMOVAL OF ONE KNEE CARTILAGE USING AN ENDOSCOPE | CPT 29881 | - | - | - | - |
(N/O) REMOVAL OF TONSILS AND ADENOID GLANDS, PATIENT YOUNG ... | CPT 42820 | - | - | - | - |
EGD DIAGNOSTIC BRUSH WASH | CPT 43235 | Outpatient | 9812047 | $1,205 | |
EGD BIOPSY SINGLE/MULTIPLE | CPT 43239 | Outpatient | 9812059 | $1,205 | |
DIAGNOSTIC COLONOSCOPY | CPT 45378 | Outpatient | 9812063 | $1,335 | |
COLONOSCOPY AND BIOPSY | CPT 45380 | Outpatient | 9812045 | $1,335 | |
(N/O) REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ... | CPT 45385 | - | - | - | - |
(N/O) ULTRASOUND EXAMINATION OF LOWER LARGE BOWEL USING AN ... | CPT 45391 | - | - | - | - |
LAPAROSCOPIC CHOLECYSTECTOMY | CPT 47562 | Outpatient | 9812052 | $6,826 | |
PRP I/HERN INIT REDUC >5 YR | CPT 49505 | Outpatient | 9812077 | $4,689 | |
(N/O) BIOPSY OF PROSTATE GLAND | CPT 55700 | - | - | - | - |
(N/O) SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH N ... | CPT 55866 | - | - | - | - |
(N/O) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY | CPT 59400 | - | - | - | - |
(N/O) OBSTETRIC CARE, PLANNED CESAREAN DELIVERY | CPT 59510 | - | - | - | - |
(N/O) OBSTETRIC CARE, PLANNED VAGINAL DELIVERY (POST DELIV ... | CPT 59610 | - | - | - | - |
(N/O) INJECTION(S) OF THERAPEUTIC SUBSTANCE | CPT 62322 | - | - | - | - |
(N/O) INJECTION(S) OF THERAPEUTIC SUBSTANCE | CPT 62323 | - | - | - | - |
(N/O) INJECTION(S) OF ANESTHETIC INTO LOWER SPINE USING IM ... | CPT 64483 | - | - | - | - |
AFTER CATARACT LASER SURGERY | CPT 66821 | Outpatient | 5100898 | $1,742 | |
(N/O) REMOVAL OF CATARACT WITH INSERTION OF LENS | CPT 66984 | - | - | - | - |
(N/O) INSERTION OF CATHETER INTO LEFT HEART FOR DIAGNOSIS | CPT 93452 | - | - | - | - |
Therapy |
MECHANICAL TRACTION THERAPY | CPT 97012 | Outpatient | 4200610 | $64 | |
ELECTRIC STIMULATION THERAPY | CPT 97014 | Outpatient | 4200292 | $49 | |
WHIRLPOOL THERAPY | CPT 97022 | Outpatient | 4200631 | $36 | |
ELECTRIC CURRENT THERAPY | CPT 97033 | Outpatient | 4300045 | $57 | |
ULTRASOUND THERAPY | CPT 97035 | Outpatient | 4300280 | $40 | |
THERAPEUTIC EXERCISES | CPT 97110 (GP) | Outpatient | 4200450 | $71 | |
GAIT TRAINING THERAPY | CPT 97116 | Outpatient | 4200330 | $52 | |
MANUAL THERAPY 1/> REGIONS | CPT 97140 | Outpatient | 4300240 | $74 | |
PT EVAL LOW COMPLEX 20 MIN | CPT 97161 | Outpatient | 4200013 | $110 | |
PT EVAL MOD COMPLEX 30 MIN | CPT 97162 | Outpatient | 4200012 | $164 | |
PT EVAL HIGH COMPLEX 45 MIN | CPT 97163 | Outpatient | 4200014 | $245 | |
PT RE-EVAL EST PLAN CARE | CPT 97164 | Outpatient | 4200000 | $74 | |
OT EVAL LOW COMPLEX 30 MIN | CPT 97165 | Outpatient | 4300011 | $110 | |
OT EVAL MOD COMPLEX 45 MIN | CPT 97166 | Outpatient | 4300012 | $164 | |
THERAPEUTIC ACTIVITIES | CPT 97530 | Outpatient | 4200310 | $82 | |
SELF CARE MNGMENT TRAINING | CPT 97535 | Outpatient | 4300015 | $62 | |
Uncategorized |
DRAINAGE OF SKIN ABSCESS | CPT 10060 | Outpatient | 9810400 | $211 | |
REMOVE FOREIGN BODY | CPT 10120 | Outpatient | 9810490 | $407 | |
RPR S/N/AX/GEN/TRNK 2.5CM/< | CPT 12001 | Outpatient | 9810880 | $302 | |
RPR S/N/AX/GEN/TRNK2.6-7.5CM | CPT 12002 | Outpatient | 9810830 | $332 | |
RPR F/E/E/N/L/M 2.5 CM/< | CPT 12011 | Outpatient | 9810810 | $313 | |
RPR F/E/E/N/L/M 2.6-5.0 CM | CPT 12013 | Outpatient | 9810820 | $355 | |
TREAT SHOULDER DISLOCATION | CPT 23655 | Outpatient | 9810291 | $2,269 | |
APPLY LONG ARM SPLINT | CPT 29105 | Outpatient | 9810010 | $168 | |
APPLY FOREARM SPLINT | CPT 29125 | Outpatient | 9810020 | $168 | |
APPLICATION LONG LEG SPLINT | CPT 29505 | Outpatient | 9810040 | $168 | |
APPLICATION LOWER LEG SPLINT | CPT 29515 | Outpatient | 9810050 | $168 | |
X-RAY EXAM OF SHOULDER | CPT 73030 | Outpatient | 93202390 | $22 | |
X-RAY EXAM OF HAND | CPT 73130 | Outpatient | 93201260 | $19 | |
X-RAY EXAM OF KNEE 3 | CPT 73562 | Outpatient | 93201505 | $22 | |
X-RAY EXAM OF ANKLE | CPT 73610 | Outpatient | 93200150 | $20 | |
X-RAY EXAM OF FOOT | CPT 73630 | Outpatient | 93201130 | $19 | |
ECG MONIT/REPRT UP TO 48 HRS | CPT 93227 | Outpatient | 4800172 | $61 | |
EXTREMITY STUDY | CPT 93971 | Outpatient | 94000216 | $50 | |
CRITICAL CARE FIRST HOUR | CPT 99291 | Outpatient | 9811138 | $977 | |
CRITICAL CARE ADDL 30 MIN | CPT 99292 (Q6) | Outpatient | 9811144 | $313 | |