Version 3.12 Update - Outpatient Facility,,,,,,,,,,,,, ,,,,,,,,,,,,, Item Code,Code Type,Description,Modifier,Service Category Code,Multiple Surgery Indicator,Primary/Pass-Through Indicator,Unit Charge,Base Charge,Unit Type,Inpatient Indicator,Skilled Nursing Facility Indicator,Start Date,End Date 10021,CPT,FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE,,30,,,$677.58,$0.00,1,0,1,20130101, 10022,CPT,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 10040,CPT,ACNE SURGERY,,30,,,$258.15,$0.00,1,0,1,20130101, 10060,CPT,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,,30,,,$730.81,$0.00,1,0,1,20130101, 10061,CPT,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,,30,,,$730.81,$0.00,1,0,1,20130101, 10080,CPT,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,,30,,,$730.81,$0.00,1,0,1,20130101, 10081,CPT,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 10120,CPT,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 10121,CPT,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 10140,CPT,I&D HEMATOMA SEROMA/FLUID COLLECTION,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 10160,CPT,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,,30,,,$730.81,$0.00,1,0,1,20130101, 10180,CPT,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 11000,CPT,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 11001,CPT,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,,30,,,$258.15,$0.00,1,0,1,20130101, 11010,CPT,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11011,CPT,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11012,CPT,DBRDMT FX&/DISLC SUBQ T/M/F BONE,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11042,CPT,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 11043,CPT,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 11044,CPT,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11045,CPT,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 11046,CPT,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 11047,CPT,DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11055,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,,30,,,$258.15,$0.00,1,0,1,20130101, 11056,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,,30,,,$258.15,$0.00,1,0,1,20130101, 11057,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,,30,,,$385.85,$0.00,1,0,1,20130101, 11100,CPT,BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION,,30,,,$385.85,$0.00,1,0,1,20130101, 11101,CPT,BIOPSY SKIN SUBQ&/MUCOUS MEMBRANE EA ADDL LESN,,30,,,$258.15,$0.00,1,0,1,20130101, 11200,CPT,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,,30,,,$258.15,$0.00,1,0,1,20130101, 11201,CPT,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,,30,,,$258.15,$0.00,1,0,1,20130101, 11300,CPT,SHAVING SKIN LES 1 TRUNK/ARM/LEG DIAM 0.5CM/<,,30,,,$258.15,$0.00,1,0,1,20130101, 11301,CPT,SHVG SKIN LES 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,,30,,,$258.15,$0.00,1,0,1,20130101, 11302,CPT,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,,30,,,$258.15,$0.00,1,0,1,20130101, 11303,CPT,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,,30,,,$385.85,$0.00,1,0,1,20130101, 11305,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,,30,,,$258.15,$0.00,1,0,1,20130101, 11306,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,,30,,,$258.15,$0.00,1,0,1,20130101, 11307,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,,30,,,$258.15,$0.00,1,0,1,20130101, 11308,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,,30,,,$385.85,$0.00,1,0,1,20130101, 11310,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,,30,,,$258.15,$0.00,1,0,1,20130101, 11311,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,,30,,,$258.15,$0.00,1,0,1,20130101, 11312,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,,30,,,$385.85,$0.00,1,0,1,20130101, 11313,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,,30,,,$385.85,$0.00,1,0,1,20130101, 11400,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/<,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11401,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11402,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 1.1-2.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11403,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11404,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11406,CPT,EXC B9 LES MRGN XCP SK TG T/A/L >4.0 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11420,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11421,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11422,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11423,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11424,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11426,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G > 4.0CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11440,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11441,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11442,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11443,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11444,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11446,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11450,CPT,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11451,CPT,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11462,CPT,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11463,CPT,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11470,CPT,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11471,CPT,EXCISION H/P/P/U COMPLEX REPAIR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11600,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11601,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11602,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11603,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11604,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11606,CPT,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11620,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11621,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11622,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11623,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11624,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11626,CPT,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11640,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11641,CPT,EXCISION MALIGNANT LES F/E/E/N/L 0.6-1.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11642,CPT,EXCISION MALIGNANT LES F/E/E/N/L 1.1-2.0 CM,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11643,CPT,EXCISION MALIGNANT LES F/E/E/N/L 2.1-3.0 CM/<,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 11644,CPT,EXCISION MALIGNANT LES F/E/E/N/L 3.1-4.0 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 11646,CPT,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11719,CPT,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,,30,,,$121.18,$0.00,1,0,1,20130101, 11720,CPT,DEBRIDEMENT NAIL ANY METHOD 1-5,,30,,,$258.15,$0.00,1,0,1,20130101, 11721,CPT,DEBRIDEMENT NAIL ANY METHOD 6/>,,30,,,$258.15,$0.00,1,0,1,20130101, 11730,CPT,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,,30,,,$258.15,$0.00,1,0,1,20130101, 11732,CPT,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,,30,,,$258.15,$0.00,1,0,1,20130101, 11740,CPT,EVACUATION SUBUNGUAL HEMATOMA,,30,,,$121.18,$0.00,1,0,1,20130101, 11750,CPT,EXCISION NAIL MATRIX PERMANENT REMOVAL,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11752,CPT,EXC NAIL MATRIX PRM RMVL W/AMP TUFT DSTL PHALANX,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11755,CPT,BIOPSY NAIL UNIT SEPARATE PROCEDURE,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11760,CPT,REPAIR NAIL BED,,30,,,$556.05,$0.00,1,0,1,20130101, 11762,CPT,RECONSTRUCTION NAIL BED W/GRAFT,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 11765,CPT,WEDGE EXCISION SKIN NAIL FOLD,,30,,,$258.15,$0.00,1,0,1,20130101, 11770,CPT,EXCISION PILONIDAL CYST/SINUS SIMPLE,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11771,CPT,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11772,CPT,EXCISION PILONIDAL CYST/SINUS COMPLICATED,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11900,CPT,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,,30,,,$258.15,$0.00,1,0,1,20130101, 11901,CPT,INJECTION INTRALESIONAL >7 LESIONS,,30,,,$258.15,$0.00,1,0,1,20130101, 11920,CPT,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 11921,CPT,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 11922,CPT,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 11950,CPT,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 11951,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 11952,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 11954,CPT,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,,30,,,$556.05,$0.00,1,0,1,20130101, 11960,CPT,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 11970,CPT,REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 11971,CPT,REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 11976,CPT,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 11980,CPT,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,,30,,,$317.65,$0.00,1,0,1,20130101, 11981,CPT,INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,30,,,$317.65,$0.00,1,0,1,20130101, 11982,CPT,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,30,,,$317.65,$0.00,1,0,1,20130101, 11983,CPT,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,,30,,,$317.65,$0.00,1,0,1,20130101, 12001,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,,30,,,$556.05,$0.00,1,0,1,20130101, 12002,CPT,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12004,CPT,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12005,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12006,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12007,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12011,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,,30,,,$556.05,$0.00,1,0,1,20130101, 12013,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12014,CPT,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12015,CPT,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12016,CPT,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12017,CPT,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12018,CPT,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12020,CPT,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 12021,CPT,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12031,CPT,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12032,CPT,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12034,CPT,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12035,CPT,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12036,CPT,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12037,CPT,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12041,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,,30,,,$556.05,$0.00,1,0,1,20130101, 12042,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12044,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12045,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12046,CPT,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12047,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12051,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12052,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12053,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12054,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,,30,,,$556.05,$0.00,1,0,1,20130101, 12055,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12056,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 12057,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13100,CPT,REPAIR COMPLEX TRUNK 1.1-2.5 CM,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 13101,CPT,REPAIR COMPLEX TRUNK 2.6-7.5 CM,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 13102,CPT,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13120,CPT,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13121,CPT,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13122,CPT,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,,30,,,$556.05,$0.00,1,0,1,20130101, 13131,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13132,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 13133,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13150,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.0 CM/<,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 13151,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 13152,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 13153,CPT,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 13160,CPT,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 14000,CPT,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14001,CPT,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14020,CPT,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14021,CPT,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14040,CPT,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14041,CPT,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14060,CPT,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14061,CPT,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 14301,CPT,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 14302,CPT,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM/<,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 14350,CPT,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15002,CPT,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 15003,CPT,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 15004,CPT,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 15005,CPT,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 15040,CPT,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 15050,CPT,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 15100,CPT,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15101,CPT,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15110,CPT,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHL,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 15111,CPT,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,30,,,"$2,209.66",$0.00,1,0,1,20130101, 15115,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15116,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/<,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 15120,CPT,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM//= 100SCM ADL 100SCM,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 15570,CPT,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15572,CPT,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15574,CPT,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15576,CPT,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15600,CPT,DELAY FLAP/SECTIONING FLAP TRUNK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15610,CPT,DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15620,CPT,DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15630,CPT,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15650,CPT,TRANSFER ANY PEDICLE FLAP ANY LOCATION,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15731,CPT,FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15732,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NC,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15734,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15736,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15738,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15740,CPT,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15750,CPT,FLAP NEUROVASCULAR PEDICLE,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15760,CPT,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15770,CPT,GRAFT DERMA-FAT-FASCIA,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15775,CPT,PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS,,30,,,$556.05,$0.00,1,0,1,20130101, 15776,CPT,PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS,,30,,,$556.05,$0.00,1,0,1,20130101, 15777,CPT,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15780,CPT,DERMABRASION TOTAL FACE,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15781,CPT,DERMABRASION SEGMENTAL FACE,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 15782,CPT,DERMABRASION REGIONAL OTHER THAN FACE,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 15783,CPT,DERMABRASION SUPERFICIAL ANY SITE,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 15786,CPT,ABRASION 1 LESION,,30,,,$258.15,$0.00,1,0,1,20130101, 15787,CPT,ABRASION EACH ADDITIONAL 4 LESIONS OR LESS,,30,,,$258.15,$0.00,1,0,1,20130101, 15788,CPT,CHEMICAL PEEL FACIAL EPIDERMAL,,30,,,$258.15,$0.00,1,0,1,20130101, 15789,CPT,CHEMICAL PEEL FACIAL DERMAL,,30,,,$385.85,$0.00,1,0,1,20130101, 15792,CPT,CHEMICAL PEEL NONFACIAL EPIDERMAL,,30,,,$385.85,$0.00,1,0,1,20130101, 15793,CPT,CHEMICAL PEEL NONFACIAL DERMAL,,30,,,$258.15,$0.00,1,0,1,20130101, 15819,CPT,CERVICOPLASTY,,30,,,"$1,143.64",$0.00,1,0,1,20130101, 15820,CPT,BLEPHAROPLASTY LOWER EYELID,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15821,CPT,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15822,CPT,BLEPHAROPLASTY UPPER EYELID,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15823,CPT,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15824,CPT,RHYTIDECTOMY FOREHEAD,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15825,CPT,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15826,CPT,RHYTIDECTOMY GLABELLAR FROWN LINES,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15828,CPT,RHYTIDECTOMY CHEEK CHIN & NECK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15829,CPT,RHYTIDECTOMY SMAS FLAP,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15830,CPT,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15832,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15833,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15834,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15835,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15836,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 15837,CPT,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 15838,CPT,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 15839,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 15840,CPT,GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15841,CPT,GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15842,CPT,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15845,CPT,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15847,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15850,CPT,REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 15851,CPT,REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 15852,CPT,DRESSING CHANGE UNDER ANESTHESIA,,30,,,$317.65,$0.00,1,0,1,20130101, 15860,CPT,IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT,,30,,,$317.65,$0.00,1,0,1,20130101, 15876,CPT,SUCTION ASSISTED LIPECTOMY HEAD & NECK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15877,CPT,SUCTION ASSISTED LIPECTOMY TRUNK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15878,CPT,SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15879,CPT,SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15920,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 15922,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15931,CPT,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15933,CPT,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15934,CPT,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15935,CPT,EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15936,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15937,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15940,CPT,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15941,CPT,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15944,CPT,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15945,CPT,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15946,CPT,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 15950,CPT,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15951,CPT,EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 15952,CPT,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15953,CPT,EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15956,CPT,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15958,CPT,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 15999,CPT,UNLISTED PROCEDURE EXCISION PRESSURE ULCER,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 16000,CPT,INITIAL TX 1ST DEGREE BURN LOCAL TX,,30,,,$258.15,$0.00,1,0,1,20130101, 16020,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,,30,,,$385.85,$0.00,1,0,1,20130101, 16025,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,,30,,,$385.85,$0.00,1,0,1,20130101, 16030,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,,30,,,$385.85,$0.00,1,0,1,20130101, 16035,CPT,ESCHAROTOMY FIRST INCISION,,30,,,$385.85,$0.00,1,0,1,20130101, 17000,CPT,DESTRUCTION PREMALIGNANT LESION 1ST,,30,,,$258.15,$0.00,1,0,1,20130101, 17003,CPT,DESTRUCTION PREMALIGNANT LESION 2-14 EA,,30,,,$121.18,$0.00,1,0,1,20130101, 17004,CPT,DESTRUCTION PREMALIGNANT LESION 15/>,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17106,CPT,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17107,CPT,DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17108,CPT,DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17110,CPT,DESTRUCTION BENIGN LESIONS UP TO 14,,30,,,$258.15,$0.00,1,0,1,20130101, 17111,CPT,DESTRUCTION BENIGN LESIONS 15/>,,30,,,$385.85,$0.00,1,0,1,20130101, 17250,CPT,CHEMICAL CAUTERIZATION GRANULATION TISSUE,,30,,,$385.85,$0.00,1,0,1,20130101, 17260,CPT,DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,,30,,,$385.85,$0.00,1,0,1,20130101, 17261,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,30,,,$385.85,$0.00,1,0,1,20130101, 17262,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,,30,,,$385.85,$0.00,1,0,1,20130101, 17263,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,,30,,,$385.85,$0.00,1,0,1,20130101, 17264,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,,30,,,$385.85,$0.00,1,0,1,20130101, 17266,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG < 4.0 CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17270,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,,30,,,$385.85,$0.00,1,0,1,20130101, 17271,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,,30,,,$385.85,$0.00,1,0,1,20130101, 17272,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,,30,,,$385.85,$0.00,1,0,1,20130101, 17273,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17274,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17276,CPT,DSTRJ MAL LES S/N/H/F/G LES DIAM > 4.0 CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17280,CPT,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,,30,,,$385.85,$0.00,1,0,1,20130101, 17281,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17282,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17283,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17284,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17286,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 17311,CPT,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,,30,,,"$2,052.57",$0.00,1,0,1,20130101, 17312,CPT,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,,30,,,"$2,052.57",$0.00,1,0,1,20130101, 17313,CPT,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,,30,,,"$2,052.57",$0.00,1,0,1,20130101, 17314,CPT,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,,30,,,"$2,052.57",$0.00,1,0,1,20130101, 17315,CPT,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,,30,,,"$2,052.57",$0.00,1,0,1,20130101, 17340,CPT,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,,30,,,$258.15,$0.00,1,0,1,20130101, 17360,CPT,CHEMICAL EXFOLIATION ACNE,,30,,,$385.85,$0.00,1,0,1,20130101, 17380,CPT,ELECTROLYSIS EPILATION EACH 30 MINUTES,,30,,,$385.85,$0.00,1,0,1,20130101, 17999,CPT,UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,,30,,,$121.18,$0.00,1,0,1,20130101, 19000,CPT,PUNCTURE ASPIRATION CYST BREAST,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 19001,CPT,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,,30,,,$677.58,$0.00,1,0,1,20130101, 19020,CPT,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 19100,CPT,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 19101,CPT,BIOPSY BREAST OPEN INCISIONAL,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19102,CPT,BIOPSY BREAST NEEDLE CORE W/IMAGING GUIDANCE,,30,,,"$3,514.90",$0.00,1,0,1,20130101, 19103,CPT,BREAST BIOPSY VACUUM ASSISTED/ROTATING DEVICE,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 19105,CPT,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19110,CPT,NIPPLE EXPLORATION,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19112,CPT,EXCISION LACTIFEROUS DUCT FISTULA,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19120,CPT,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19125,CPT,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19126,CPT,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19260,CPT,EXCISION CHEST WALL TUMOR INCLUDING RIBS,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 19290,CPT,PREOP PLACEMENT LOCALIZATION WIRE BREAST,,30,,,$317.65,$0.00,1,0,1,20130101, 19295,CPT,IMG GID PLMT MTLC LOCLZJ CLIP PRQ BRST BX/ASPIR,,30,,,$317.65,$0.00,1,0,1,20130101, 19296,CPT,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,,30,,,"$20,425.72",$0.00,1,0,1,20130101, 19297,CPT,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,,30,,,"$20,425.72",$0.00,1,0,1,20130101, 19298,CPT,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,,30,,,"$20,425.72",$0.00,1,0,1,20130101, 19300,CPT,MASTECTOMY GYNECOMASTIA,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19301,CPT,MASTECTOMY PARTIAL,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19302,CPT,MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY,,30,,,"$16,402.56",$0.00,1,0,1,20130101, 19303,CPT,MASTECTOMY SIMPLE COMPLETE,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19304,CPT,MASTECTOMY SUBCUTANEOUS,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19307,CPT,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,,30,,,"$16,402.56",$0.00,1,0,1,20130101, 19316,CPT,MASTOPEXY,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19318,CPT,REDUCTION MAMMAPLASTY,,30,,,"$16,402.56",$0.00,1,0,1,20130101, 19324,CPT,MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT,,30,,,"$16,402.56",$0.00,1,0,1,20130101, 19325,CPT,MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT,,30,,,"$20,425.72",$0.00,1,0,1,20130101, 19328,CPT,REMOVAL INTACT MAMMARY IMPLANT,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19330,CPT,REMOVAL MAMMARY IMPLANT MATERIAL,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19340,CPT,IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,30,,,"$16,402.56",$0.00,1,0,1,20130101, 19342,CPT,DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,30,,,"$20,425.72",$0.00,1,0,1,20130101, 19350,CPT,NIPPLE/AREOLA RECONSTRUCTION,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 19355,CPT,CORRECTION INVERTED NIPPLES,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19357,CPT,BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ,,30,,,"$20,425.72",$0.00,1,0,1,20130101, 19366,CPT,BREAST RECONSTRUCTION OTHER TECHNIQUE,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19370,CPT,OPEN PERIPROSTHETIC CAPSULOTOMY BREAST,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19371,CPT,PERIPROSTHETIC CAPSULECTOMY BREAST,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19380,CPT,REVISION RECONSTRUCTED BREAST,,30,,,"$16,402.56",$0.00,1,0,1,20130101, 19396,CPT,PREPARATION MOULAGE CUSTOM BREAST IMPLANT,,30,,,"$13,228.34",$0.00,1,0,1,20130101, 19499,CPT,UNLISTED PROCEDURE BREAST,,30,,,"$10,154.27",$0.00,1,0,1,20130101, 20005,CPT,I&D SOFT TISSUE ABSCESS SUBFASC,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 20100,CPT,EXPLORATION PENETRATING WOUND SPX NECK,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 20101,CPT,EXPLORATION PENETRATING WOUND SPX CHEST,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 20102,CPT,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 20103,CPT,EXPLORATION PENETRATING WOUND SPX EXTREMITY,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 20150,CPT,EXCISION EPIPHYSEAL BAR,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 20200,CPT,BIOPSY MUSCLE SUPERFICIAL,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 20205,CPT,BIOPSY MUSCLE DEEP,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 20206,CPT,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,,30,,,"$3,514.90",$0.00,1,0,1,20130101, 20220,CPT,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 20225,CPT,BIOPSY BONE TROCAR/NEEDLE DEEP,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 20240,CPT,BIOPSY BONE OPEN SUPERFICIAL,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 20245,CPT,BIOPSY BONE OPEN DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 20250,CPT,BIOPSY VERTEBRAL BODY OPEN THORACIC,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20251,CPT,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20500,CPT,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 20520,CPT,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 20525,CPT,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 20526,CPT,INJECTION THERAPEUTIC CARPAL TUNNEL,,30,,,$999.91,$0.00,1,0,1,20130101, 20527,CPT,INJECTION ENZYME PALMAR FASCIAL CORD,,30,,,$999.91,$0.00,1,0,1,20130101, 20550,CPT,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,,30,,,$999.91,$0.00,1,0,1,20130101, 20551,CPT,INJECTION SINGLE TENDON ORIGIN/INSERTION,,30,,,$999.91,$0.00,1,0,1,20130101, 20552,CPT,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,,30,,,$999.91,$0.00,1,0,1,20130101, 20553,CPT,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,,30,,,$999.91,$0.00,1,0,1,20130101, 20555,CPT,PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20600,CPT,ARTHROCENTESIS ASPIR&/INJECTION SMALL JT/BURSA,,30,,,$999.91,$0.00,1,0,1,20130101, 20605,CPT,ARTHROCENTESIS ASPIR&/INJECTION INTERM JT/BURS,,30,,,$999.91,$0.00,1,0,1,20130101, 20610,CPT,ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA,,30,,,$999.91,$0.00,1,0,1,20130101, 20612,CPT,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,,30,,,$999.91,$0.00,1,0,1,20130101, 20615,CPT,ASPIRATION & INJECTION TREATMENT BONE CYST,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 20650,CPT,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20660,CPT,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 20662,CPT,APPLICATION HALO PELVIC INCLUDING REMOVAL,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 20663,CPT,APPLICATION HALO FEMORAL INCLUDING REMOVAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20665,CPT,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,,30,,,$317.65,$0.00,1,0,1,20130101, 20670,CPT,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 20680,CPT,REMOVAL IMPLANT DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 20690,CPT,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20692,CPT,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20693,CPT,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20694,CPT,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 20696,CPT,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20697,CPT,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 20822,CPT,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 20900,CPT,BONE GRAFT ANY DONOR AREA MINOR/SMALL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20902,CPT,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20910,CPT,CARTILAGE GRAFT COSTOCHONDRAL,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 20912,CPT,CARTILAGE GRAFT NASAL SEPTUM,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 20920,CPT,FASCIA LATA GRAFT BY STRIPPER,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 20922,CPT,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 20924,CPT,TENDON GRAFT FROM A DISTANCE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 20926,CPT,TISSUE GRAFTS OTHER,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 20950,CPT,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,,30,,,$730.81,$0.00,1,0,1,20130101, 20972,CPT,FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 20973,CPT,FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 20979,CPT,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,,30,,,$317.65,$0.00,1,0,1,20130101, 20982,CPT,ABLATION BONE TUMOR RF PERCUTANEOUS CT GUIDANCE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 20999,CPT,UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 21010,CPT,ARTHROTOMY TEMPOROMANDIBULAR JOINT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21011,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 21012,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 21013,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 21014,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 21015,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21016,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/<,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21025,CPT,EXCISION BONE MANDIBLE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21026,CPT,EXCISION FACIAL BONE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21029,CPT,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21030,CPT,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21031,CPT,EXCISION TORUS MANDIBULARIS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21032,CPT,EXCISION MAXILLARY TORUS PALATINUS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21034,CPT,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21040,CPT,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21044,CPT,EXCISION MALIGNANT TUMOR MANDIBLE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21046,CPT,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21047,CPT,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21048,CPT,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21049,CPT,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21050,CPT,CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21060,CPT,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21070,CPT,CORONOIDECTOMY SEPARATE PROCEDURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21073,CPT,MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21076,CPT,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21077,CPT,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21079,CPT,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21080,CPT,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21081,CPT,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21082,CPT,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21083,CPT,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21084,CPT,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21085,CPT,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 21086,CPT,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21087,CPT,IMPRESSION & PREPARATION NASAL PROSTHESIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21088,CPT,IMPRESSION & PREPARATION FACIAL PROSTHESIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21089,CPT,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,,30,,,$504.36,$0.00,1,0,1,20130101, 21100,CPT,APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21110,CPT,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 21120,CPT,GENIOPLASTY AUGMENTATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21121,CPT,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21122,CPT,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21123,CPT,GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21125,CPT,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21127,CPT,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21137,CPT,REDUCTION FOREHEAD CONTOURING ONLY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21138,CPT,RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21139,CPT,RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21150,CPT,RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21172,CPT,RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21175,CPT,RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21181,CPT,RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21193,CPT,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21195,CPT,RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21198,CPT,OSTEOTOMY MANDIBLE SEGMENTAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21199,CPT,OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21206,CPT,OSTEOTOMY MAXILLA SEGMENTAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21208,CPT,OSTEOPLASTY FACIAL BONES AUGMENTATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21209,CPT,OSTEOPLASTY FACIAL BONES REDUCTION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21210,CPT,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21215,CPT,GRAFT BONE MANDIBLE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21230,CPT,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21235,CPT,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21240,CPT,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21242,CPT,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21243,CPT,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21244,CPT,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21245,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21246,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21248,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21249,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21256,CPT,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21260,CPT,PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21261,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21263,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21267,CPT,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21270,CPT,MALAR AUGMENTATION PROSTHETIC MATERIAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21275,CPT,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21280,CPT,MEDIAL CANTHOPEXY SEPARATE PROCEDURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21282,CPT,LATERAL CANTHOPEXY,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21295,CPT,REDUCTION MASSETER MUSCLE & BONE EXTRAORAL,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 21296,CPT,REDUCTION MASSETER MUSCLE & BONE INTRAORAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21299,CPT,UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE,,30,,,$504.36,$0.00,1,0,1,20130101, 21310,CPT,CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,,30,,,$504.36,$0.00,1,0,1,20130101, 21315,CPT,CLOSED TX NASAL FRACTURE W/O STABILIZATION,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21320,CPT,CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21325,CPT,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21330,CPT,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21335,CPT,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21336,CPT,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 21337,CPT,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21338,CPT,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21339,CPT,OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21340,CPT,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21345,CPT,CLOSED TX NASOMAXILLARY COMPLEX FRACTURE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21346,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21355,CPT,PERCUTANEOUS TX MALAR AREA FRACTURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21356,CPT,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21360,CPT,OPEN TX DEPRESSED MALAR FRACTURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21365,CPT,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21385,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21386,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21387,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21390,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21395,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21400,CPT,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 21401,CPT,CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 21406,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21407,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21408,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21421,CPT,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21440,CPT,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21445,CPT,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21450,CPT,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 21451,CPT,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21452,CPT,PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21453,CPT,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21454,CPT,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21461,CPT,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21462,CPT,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21465,CPT,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21470,CPT,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21480,CPT,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,,30,,,$504.36,$0.00,1,0,1,20130101, 21485,CPT,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21490,CPT,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 21495,CPT,OPEN TREATMENT HYOID FRACTURE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 21497,CPT,INTERDENTAL WIRING OTHER THAN FRACTURE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 21499,CPT,UNLISTED MUSCULOSKELETAL PROCEDURE HEAD,,30,,,$504.36,$0.00,1,0,1,20130101, 21501,CPT,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 21502,CPT,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 21550,CPT,BIOPSY SOFT TISSUE NECK/THORAX,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21552,CPT,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21554,CPT,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21555,CPT,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21556,CPT,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21557,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21558,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21600,CPT,EXCISION RIB PARTIAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 21610,CPT,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 21685,CPT,HYOID MYOTOMY & SUSPENSION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 21700,CPT,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 21720,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 21725,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/CAST,,30,,,$730.81,$0.00,1,0,1,20130101, 21742,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 21743,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 21800,CPT,CLOSED TX RIB FRACTURE UNCOMPLICATED EACH,,30,,,$745.03,$0.00,1,0,1,20130101, 21805,CPT,OPEN TX RIB FRACTURE W/O FIXATION EACH,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 21820,CPT,CLOSED TREATMENT STERNUM FRACTURE,,30,,,$745.03,$0.00,1,0,1,20130101, 21899,CPT,UNLISTED PROCEDURE NECK/THORAX,,30,,,$504.36,$0.00,1,0,1,20130101, 21920,CPT,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 21925,CPT,BIOPSY SOFT TISSUE BACK/FLANK DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21930,CPT,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21931,CPT,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21932,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21933,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 21935,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 21936,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 22100,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22101,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22102,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22103,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22222,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22305,CPT,CLOSED TX VERTEBRAL PROCESS FRACTURE,,30,,,$745.03,$0.00,1,0,1,20130101, 22310,CPT,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 22315,CPT,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 22505,CPT,MANIPULATION SPINE REQUIRING ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 22520,CPT,PERCUTANEOUS VERTEBROPLSTY THORACIC W/WO BONE BX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 22521,CPT,PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 22522,CPT,PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 22523,CPT,PERCUTANEOUS VERTEBRAL AUGMENTATION THORACIC,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 22524,CPT,PERCUTANEOUS VERTEBRAL AUGMENTATION LUMBAR,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 22525,CPT,PERQ VERTEBRAL AUGMENTATION EA ADDL THRC/LMBR,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 22526,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL,,30,,,"$2,265.71",$0.00,1,0,1,20130101, 22527,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,,30,,,"$2,265.71",$0.00,1,0,1,20130101, 22551,CPT,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22554,CPT,ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22612,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22614,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22851,CPT,APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 22856,CPT,TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 22899,CPT,UNLISTED PROCEDURE SPINE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 22900,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 22901,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 22902,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 22903,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 22904,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 22905,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 22999,CPT,UNLISTED PX ABDOMEN MUSCULOSKELETAL SYSTEM,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 23000,CPT,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 23020,CPT,CAPSULAR CONTRACTURE RELEASE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23030,CPT,I&D SHOULDER DEEP ABSCESS/HEMATOMA,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 23031,CPT,I&D SHOULDER INFECTED BURSA,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 23035,CPT,INCISION BONE CORTEX SHOULDER AREA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 23040,CPT,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23044,CPT,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23065,CPT,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 23066,CPT,BIOPSY SOFT TISSUE SHOULDER DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 23071,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 23073,CPT,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 23075,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 23076,CPT,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 23077,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 23078,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 23100,CPT,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 23101,CPT,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23105,CPT,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23106,CPT,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23107,CPT,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23120,CPT,CLAVICULECTOMY PARTIAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23125,CPT,CLAVICULECTOMY TOTAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23130,CPT,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23140,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 23145,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23146,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23150,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23155,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23156,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23170,CPT,SEQUESTRECTOMY CLAVICLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23172,CPT,SEQUESTRECTOMY SCAPULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23174,CPT,SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23180,CPT,PARTIAL EXCISION BONE CLAVICLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23182,CPT,PARTIAL EXCISION BONE SCAPULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23184,CPT,PARTIAL EXCISION BONE PROXIMAL HUMERUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23190,CPT,OSTECTOMY SCAPULA PARTIAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23195,CPT,RESECTION HUMERAL HEAD,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23330,CPT,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 23331,CPT,REMOVAL FOREIGN BODY SHOULDER DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 23395,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23397,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23400,CPT,SCAPULOPEXY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23405,CPT,TENOTOMY SHOULDER AREA 1 TENDON,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23406,CPT,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23410,CPT,OPEN REPAIR OF ROTATOR CUFF ACUTE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23412,CPT,OPEN REPAIR OF ROTATOR CUFF CHRONIC,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23415,CPT,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23420,CPT,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23430,CPT,TENODESIS LONG TENDON BICEPS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23440,CPT,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 23450,CPT,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23455,CPT,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23460,CPT,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23462,CPT,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23465,CPT,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23466,CPT,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23470,CPT,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 23473,CPT,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,,30,,,"$20,928.29",$0.00,1,0,1,20130101, 23480,CPT,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 23485,CPT,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23490,CPT,PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23491,CPT,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23500,CPT,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 23505,CPT,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 23515,CPT,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 23520,CPT,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 23525,CPT,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 23530,CPT,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 23532,CPT,OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 23540,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 23545,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 23550,CPT,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 23552,CPT,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 23570,CPT,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 23575,CPT,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 23585,CPT,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 23600,CPT,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 23605,CPT,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 23615,CPT,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 23616,CPT,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 23620,CPT,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 23625,CPT,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 23630,CPT,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 23650,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 23655,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 23660,CPT,OPEN TX ACUTE SHOULDER DISLOCATION,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 23665,CPT,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 23670,CPT,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 23675,CPT,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 23680,CPT,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 23700,CPT,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 23800,CPT,ARTHRODESIS GLENOHUMERAL JOINT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23802,CPT,ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 23921,CPT,DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 23929,CPT,UNLISTED PROCEDURE SHOULDER,,30,,,$745.03,$0.00,1,0,1,20130101, 23930,CPT,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 23931,CPT,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 23935,CPT,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24000,CPT,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24006,CPT,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24065,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 24066,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 24071,CPT,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 24073,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 24075,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 24076,CPT,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 24077,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 24079,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 24100,CPT,ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24101,CPT,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24102,CPT,ARTHROTOMY ELBOW W/SYNOVECTOMY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24105,CPT,EXCISION OLECRANON BURSA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24110,CPT,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24115,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24116,CPT,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24120,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24125,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24126,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24130,CPT,EXCISION RADIAL HEAD,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24134,CPT,SEQUESTRECTOMY SHAFT/DISTAL HUMERUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24136,CPT,SEQUESTRECTOMY RADIAL HEAD OR NECK,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24138,CPT,SEQUESTRECTOMY OLECRANON PROCESS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24140,CPT,PARTIAL EXCISION BONE HUMERUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24145,CPT,PARTIAL EXCISION BONE RADIAL HEAD/NECK,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24147,CPT,PARTIAL EXCISION BONE OLECRANON PROCESS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24149,CPT,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24150,CPT,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24152,CPT,RADICAL RESECTION TUMOR RADIAL HEAD/NECK,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24155,CPT,RESECTION ELBOW JOINT ARTHRECTOMY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24160,CPT,IMPLANT REMOVAL ELBOW JOINT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24164,CPT,IMPLANT REMOVAL RADIAL HEAD,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24200,CPT,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 24201,CPT,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 24300,CPT,MANIPULATION ELBOW UNDER ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 24301,CPT,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24305,CPT,TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24310,CPT,TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24320,CPT,TENOPLASTY ELBOW TO SHOULDER SINGLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24330,CPT,FLEXOR-PLASTY ELBOW,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24331,CPT,FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24332,CPT,TENOLYSIS TRICEPS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24340,CPT,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24341,CPT,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24342,CPT,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24343,CPT,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24344,CPT,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24345,CPT,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24346,CPT,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24357,CPT,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24358,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24359,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24360,CPT,ARTHROPLASTY ELBOW W/MEMBRANE,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 24361,CPT,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 24362,CPT,ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 24363,CPT,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 24365,CPT,ARTHROPLASTY RADIAL HEAD,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 24366,CPT,ARTHROPLASTY RADIAL HEAD W/IMPLANT,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 24370,CPT,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,,30,,,"$20,928.29",$0.00,1,0,1,20130101, 24371,CPT,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,,30,,,"$20,928.29",$0.00,1,0,1,20130101, 24400,CPT,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24410,CPT,MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24420,CPT,OSTEOPLASTY HUMERUS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24430,CPT,REPAIR NON/MALUNION HUMERUS W/O GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24435,CPT,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24470,CPT,HEMIEPIPHYSEAL ARREST,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24495,CPT,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 24498,CPT,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24500,CPT,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 24505,CPT,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24515,CPT,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24516,CPT,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24530,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24535,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 24538,CPT,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 24545,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24546,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24560,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24565,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24566,CPT,PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 24575,CPT,OPEN TX HUMERAL EPICONDYLAR FRACTURE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24576,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24577,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24579,CPT,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24582,CPT,PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 24586,CPT,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24587,CPT,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24600,CPT,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 24605,CPT,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 24615,CPT,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24620,CPT,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 24635,CPT,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24640,CPT,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24650,CPT,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 24655,CPT,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 24665,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 24666,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 24670,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24675,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 24685,CPT,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 24800,CPT,ARTHRODESIS ELBOW JOINT LOCAL,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 24802,CPT,ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24925,CPT,AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 24935,CPT,STUMP ELONGATION UPPER EXTREMITY,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 24999,CPT,UNLISTED PROCEDURE HUMERUS/ELBOW,,30,,,$745.03,$0.00,1,0,1,20130101, 25000,CPT,INCISION EXTENSOR TENDON SHEATH WRIST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25001,CPT,INCISION FLEXOR TENDON SHEATH WRIST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25020,CPT,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25023,CPT,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25024,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25025,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25028,CPT,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25031,CPT,INCISION & DRAINAGE FOREARM&/WRIST BURSA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25035,CPT,INCISION DEEP BONE CORTEX FOREARM&/WRIST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25040,CPT,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25065,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 25066,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 25071,CPT,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 25073,CPT,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 25075,CPT,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 25076,CPT,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 25077,CPT,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 25078,CPT,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 25085,CPT,CAPSULOTOMY WRIST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25100,CPT,ARTHROTOMY WRIST JOINT WITH BIOPSY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25101,CPT,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25105,CPT,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25107,CPT,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25109,CPT,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25110,CPT,EXCISION LESION TENDON SHEATH FOREARM&/WRIST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25111,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25112,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25115,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25116,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25118,CPT,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25119,CPT,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25120,CPT,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25125,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25126,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25130,CPT,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25135,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25136,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25145,CPT,SEQUESTRECTOMY FOREARM &/WRIST,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25150,CPT,PARTIAL EXCISION BONE ULNA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25151,CPT,PARTIAL EXCISION BONE RADIUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25170,CPT,RADICAL RESECTION TUMOR RADIUS OR ULNA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25210,CPT,CARPECTOMY 1 BONE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25215,CPT,CARPECTOMY ALL BONES PROXIMAL ROW,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25230,CPT,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25240,CPT,EXCISION DISTAL ULNA PARTIAL/COMPLETE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25248,CPT,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25250,CPT,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25251,CPT,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25259,CPT,MANIPULATION WRIST UNDER ANESTHESIA,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 25260,CPT,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25263,CPT,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25265,CPT,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25270,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25272,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25274,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25275,CPT,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25280,CPT,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25290,CPT,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25295,CPT,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25300,CPT,TENODESIS WRIST FLEXORS FINGERS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25301,CPT,TENODESIS WRIST EXTENSORS FINGERS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25310,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25312,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25315,CPT,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25316,CPT,FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25320,CPT,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25332,CPT,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 25335,CPT,CENTRALIZATION WRST ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25337,CPT,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25350,CPT,OSTEOTOMY RADIUS DISTAL THIRD,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25355,CPT,OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25360,CPT,OSTEOTOMY ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25365,CPT,OSTEOTOMY RADIUS & ULNA,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25370,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25375,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25390,CPT,OSTEOPLASTY RADIUS/ULNA SHORTENING,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25391,CPT,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25392,CPT,OSTEOPLASTY RADIUS & ULNA SHORTENING,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 25393,CPT,OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25394,CPT,OSTEOPLASTY CARPAL BONE SHORTENING,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25400,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25405,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25415,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25420,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25425,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25426,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25430,CPT,INSERTION VASCULAR PEDICLE CARPAL BONE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25431,CPT,REPAIR NONUNION CARPAL BONE EACH BONE,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25440,CPT,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25441,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 25442,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 25443,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 25444,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 25445,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 25446,CPT,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 25447,CPT,ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 25449,CPT,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 25450,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25455,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25490,CPT,PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25491,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25492,CPT,PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25500,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 25505,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 25515,CPT,OPEN TREATMENT RADIAL SHAFT FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25520,CPT,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 25525,CPT,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25526,CPT,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25530,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 25535,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 25545,CPT,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25560,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,,30,,,$745.03,$0.00,1,0,1,20130101, 25565,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 25574,CPT,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 25575,CPT,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 25600,CPT,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 25605,CPT,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 25606,CPT,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25607,CPT,OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 25608,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 25609,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 25622,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 25624,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 25628,CPT,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25630,CPT,CLTX CARPAL BONE FX W/O MANJ EACH BONE,,30,,,$745.03,$0.00,1,0,1,20130101, 25635,CPT,CLTX CARPAL BONE FX W/MANJ EACH BONE,,30,,,$745.03,$0.00,1,0,1,20130101, 25645,CPT,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25650,CPT,CLOSED TREATMENT ULNAR STYLOID FRACTURE,,30,,,$745.03,$0.00,1,0,1,20130101, 25651,CPT,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25652,CPT,OPEN TREATMENT ULNAR STYLOID FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 25660,CPT,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 25670,CPT,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25671,CPT,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25675,CPT,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 25676,CPT,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25680,CPT,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 25685,CPT,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25690,CPT,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 25695,CPT,OPEN TREATMENT LUNATE DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 25800,CPT,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25805,CPT,ARTHRODESIS WRIST W/SLIDING GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25810,CPT,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25820,CPT,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 25825,CPT,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25830,CPT,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 25907,CPT,AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25909,CPT,AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25922,CPT,DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25929,CPT,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 25931,CPT,TRANSMETACARPAL AMPUTATION RE-AMPUTATION,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 25999,CPT,UNLISTED PROCEDURE FOREARM/WRIST,,30,,,$745.03,$0.00,1,0,1,20130101, 26010,CPT,DRAINAGE FINGER ABSCESS SIMPLE,,30,,,$730.81,$0.00,1,0,1,20130101, 26011,CPT,DRAINAGE FINGER ABSCESS COMPLICATED,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 26020,CPT,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26025,CPT,DRAINAGE OF PALMAR BURSA SINGLE BURSA,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26030,CPT,DRAINAGE OF PALMAR BURSA MULTIPLE BURSA,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26034,CPT,INCISION BONE CORTEX HAND/FINGER,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26035,CPT,DECOMPRESSION FINGERS&/HAND INJECTION INJURY,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26037,CPT,DECOMPRESSIVE FASCIOTOMY HAND,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26040,CPT,FASCIOTOMY PALMAR PERCUTANEOUS,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26045,CPT,FASCIOTOMY PALMAR OPEN PARTIAL,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26055,CPT,TENDON SHEATH INCISION,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26060,CPT,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26070,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26075,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26080,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26100,CPT,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26105,CPT,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26110,CPT,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26111,CPT,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 26113,CPT,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 26115,CPT,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 26116,CPT,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 26117,CPT,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 26118,CPT,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 26121,CPT,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26123,CPT,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26125,CPT,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26130,CPT,SYNOVECTOMY CARPOMETACARPAL JOINT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26135,CPT,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26140,CPT,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26145,CPT,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26160,CPT,EXC LES TDN SHTH/JT CAPSL HAND/FNGR,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26170,CPT,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26180,CPT,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26185,CPT,SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26200,CPT,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26205,CPT,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26210,CPT,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26215,CPT,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26230,CPT,PARTIAL EXCISION BONE METACARPAL,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26235,CPT,PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26236,CPT,PARTIAL EXCISION DISTAL PHALANX FINGER,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26250,CPT,RADICAL RESECTION TUMOR METACARPAL,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26260,CPT,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26262,CPT,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26320,CPT,REMOVAL IMPLANT FROM FINGER/HAND,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 26340,CPT,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 26341,CPT,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 26350,CPT,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26352,CPT,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26356,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26357,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26358,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26370,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26372,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26373,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26390,CPT,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26392,CPT,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26410,CPT,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26412,CPT,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26415,CPT,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26416,CPT,RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26418,CPT,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26420,CPT,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26426,CPT,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26428,CPT,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26432,CPT,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26433,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26434,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26437,CPT,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26440,CPT,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26442,CPT,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26445,CPT,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26449,CPT,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26450,CPT,TENOTOMY FLEXOR PALM OPEN EACH TENDON,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26455,CPT,TENOTOMY FLEXOR FINGER OPEN EACH TENDON,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26460,CPT,TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26471,CPT,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26474,CPT,TENODESIS DISTAL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26476,CPT,LENGTHENING TENDON EXTENSOR HAND/FINGER EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26477,CPT,SHORTENING TENDON EXTENSOR HAND/FINGER EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26478,CPT,LENGTHENING TENDON FLEXOR HAND/FINGER EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26479,CPT,SHORTENING TENDON FLEXOR HAND/FINGER EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26480,CPT,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26483,CPT,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26485,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26489,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26490,CPT,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26492,CPT,OPPONENSPLASTY TDN TR W/GRF EA TDN,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26494,CPT,OPPONENSPLASTY HYPOTHENAR MUSC TR,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26496,CPT,OPPONENSPLASTY OTHER METHODS,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26497,CPT,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26498,CPT,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26499,CPT,CORRECTION CLAW FINGER OTHER METHODS,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26500,CPT,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26502,CPT,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26508,CPT,RELEASE THENAR MUSCLE,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26510,CPT,CROSS INTRINSIC TRANSFER EACH TENDON,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26516,CPT,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26517,CPT,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26518,CPT,CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26520,CPT,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26525,CPT,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26530,CPT,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 26531,CPT,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 26535,CPT,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 26536,CPT,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 26540,CPT,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26541,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26542,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26545,CPT,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26546,CPT,RPR NON-UNION MTCRPL/PHALANX,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26548,CPT,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26550,CPT,POLLICIZATION DIGIT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26555,CPT,TR FNGR AXH POS W/O MVASC ANAST,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26560,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26561,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26562,CPT,REPAIR SYNDACTYLY EACH SPACE COMPLEX,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26565,CPT,OSTEOTOMY METACARPAL EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26567,CPT,OSTEOTOMY PHALANX FINGER EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26568,CPT,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26580,CPT,REPAIR CLEFT HAND,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26587,CPT,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26590,CPT,REPAIR MACRODACTYLIA EACH DIGIT,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26591,CPT,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26593,CPT,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26596,CPT,EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26600,CPT,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,,30,,,$745.03,$0.00,1,0,1,20130101, 26605,CPT,CLTX METACARPAL FX W/MANIPULATION EACH BONE,,30,,,$745.03,$0.00,1,0,1,20130101, 26607,CPT,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 26608,CPT,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26615,CPT,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 26641,CPT,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 26645,CPT,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 26650,CPT,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26665,CPT,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 26670,CPT,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 26675,CPT,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 26676,CPT,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26685,CPT,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26686,CPT,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 26700,CPT,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 26705,CPT,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 26706,CPT,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 26715,CPT,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26720,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,,30,,,$745.03,$0.00,1,0,1,20130101, 26725,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,,30,,,$745.03,$0.00,1,0,1,20130101, 26727,CPT,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26735,CPT,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26740,CPT,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 26742,CPT,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 26746,CPT,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26750,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,,30,,,$745.03,$0.00,1,0,1,20130101, 26755,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,,30,,,$745.03,$0.00,1,0,1,20130101, 26756,CPT,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26765,CPT,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26770,CPT,CLTX IPHAL JT DISLC W/MANJ W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 26775,CPT,CLTX IPHAL JT DISLC W/MANJ REQ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 26776,CPT,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26785,CPT,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 26820,CPT,FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26841,CPT,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26842,CPT,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26843,CPT,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26844,CPT,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26850,CPT,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26852,CPT,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26860,CPT,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26861,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26862,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26863,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26910,CPT,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 26951,CPT,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26952,CPT,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,,30,,,"$6,646.11",$0.00,1,0,1,20130101, 26989,CPT,UNLISTED PROCEDURE HANDS/FINGERS,,30,,,$745.03,$0.00,1,0,1,20130101, 26990,CPT,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 26991,CPT,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27000,CPT,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27001,CPT,TENOTOMY ADDUCTOR HIP OPEN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27003,CPT,TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27006,CPT,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27027,CPT,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27033,CPT,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27035,CPT,DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27040,CPT,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 27041,CPT,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 27043,CPT,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27045,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27047,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27048,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27049,CPT,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27050,CPT,ARTHROTOMY W/BIOPSY SACROILIAC JOINT,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27052,CPT,ARTHROTOMY W/BIOPSY HIP JOINT,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27057,CPT,DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27059,CPT,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27060,CPT,EXCISION ISCHIAL BURSA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27062,CPT,EXCISION TROCHANTERIC BURSA/CALCIFICATION,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27065,CPT,EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27066,CPT,EXCISION BONE CYST/BENIGN TUMOR DEEP,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27067,CPT,EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27080,CPT,COCCYGECTOMY PRIMARY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27086,CPT,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 27087,CPT,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27096,CPT,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,,30,,,"$1,396.58",$0.00,1,0,1,20130101, 27097,CPT,RELEASE/RECESSION HAMSTRING PROXIMAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27098,CPT,TRANSFER ADDUCTOR ISCHIUM,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27100,CPT,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27105,CPT,TR PARASPI MUSC HIP FASC/TDN XTN GRF,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27110,CPT,TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27111,CPT,TRANSFER ILIOPSOAS FEMORAL NECK,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27179,CPT,OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27193,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27194,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/MANJ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27200,CPT,CLOSED TREATMENT COCCYGEAL FRACTURE,,30,,,$745.03,$0.00,1,0,1,20130101, 27202,CPT,OPEN TREATMENT COCCYGEAL FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27216,CPT,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,,30,,,"$16,758.97",$0.00,1,0,1,20130101, 27220,CPT,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27230,CPT,CLTX FEM FX PROX END NCK W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27235,CPT,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27238,CPT,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 27246,CPT,CLTX GREATER TROCHANTERIC FX W/O MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 27250,CPT,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,,30,,,$745.03,$0.00,1,0,1,20130101, 27252,CPT,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27256,CPT,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 27257,CPT,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27265,CPT,CLTX POST HIP ARTHRP DISLC W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 27266,CPT,CLTX POST HIP ARTHRP DISLC REQ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27267,CPT,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27275,CPT,MANIPULATION HIP JOINT GENERAL ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27299,CPT,UNLISTED PROCEDURE PELVIS/HIP JOINT,,30,,,$745.03,$0.00,1,0,1,20130101, 27301,CPT,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 27305,CPT,FASCIOTOMY ILIOTIBIAL OPEN,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27306,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27307,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27310,CPT,ARTHRT KNE W/EXPL DRG/RMVL FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27323,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 27324,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27325,CPT,NEURECTOMY HAMSTRING MUSCLE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 27326,CPT,NEURECTOMY POPLITEAL,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 27327,CPT,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27328,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27329,CPT,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27330,CPT,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27331,CPT,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27332,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27333,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27334,CPT,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27335,CPT,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27337,CPT,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27339,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27340,CPT,EXCISION PREPATELLAR BURSA,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27345,CPT,EXCISION SYNOVIAL CYST POPLITEAL SPACE,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27347,CPT,EXCISION LESION MENISCUS/CAPSULE KNEE,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27350,CPT,PATELLECTOMY/HEMIPATELLECTOMY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27355,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27356,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27357,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27358,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27360,CPT,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27364,CPT,RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27372,CPT,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27380,CPT,SUTURE INFRAPATELLAR TENDON PRIMARY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27381,CPT,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27385,CPT,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27386,CPT,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27390,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27391,CPT,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27392,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27393,CPT,LENGTHENING HAMSTRING TENDON SINGLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27394,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27395,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27396,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27397,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27400,CPT,TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27403,CPT,ARTHROTOMY W/MENISCUS REPAIR KNEE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27405,CPT,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27407,CPT,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27409,CPT,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27412,CPT,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27415,CPT,OSTEOCHONDRAL ALLOGRAFT KNEE OPEN,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27416,CPT,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27418,CPT,ANTERIOR TIBIAL TUBERCLEPLASTY,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27420,CPT,RCNSTJ DISLOCATING PATELLA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27422,CPT,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27424,CPT,RCNSTJ DISLC PATELLA W/PATELLECTOMY,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27425,CPT,LATERAL RETINACULAR RELEASE OPEN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27427,CPT,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27428,CPT,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27429,CPT,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27430,CPT,QUADRICEPSPLASTY,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27435,CPT,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27437,CPT,ARTHROPLASTY PATELLA W/O PROSTHESIS,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 27438,CPT,ARTHROPLASTY PATELLA W/PROSTHESIS,,30,,,"$20,009.98",$0.00,1,0,1,20130101, 27440,CPT,ARTHROPLASTY KNEE TIBIAL PLATEAU,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 27441,CPT,ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 27442,CPT,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 27443,CPT,ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 27446,CPT,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 27475,CPT,ARREST EPIPHYSEAL DISTAL FEMUR,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27479,CPT,ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27496,CPT,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27497,CPT,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27498,CPT,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27499,CPT,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&am,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27500,CPT,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 27501,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27502,CPT,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27503,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27508,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27509,CPT,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 27510,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 27516,CPT,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27517,CPT,CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL,,30,,,$745.03,$0.00,1,0,1,20130101, 27520,CPT,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 27524,CPT,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27530,CPT,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 27532,CPT,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27538,CPT,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,,30,,,$745.03,$0.00,1,0,1,20130101, 27550,CPT,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,,30,,,$745.03,$0.00,1,0,1,20130101, 27552,CPT,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27560,CPT,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,,30,,,$745.03,$0.00,1,0,1,20130101, 27562,CPT,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27566,CPT,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27570,CPT,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27594,CPT,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27599,CPT,UNLISTED PROCEDURE FEMUR/KNEE,,30,,,$745.03,$0.00,1,0,1,20130101, 27600,CPT,DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27601,CPT,DCMPRN FASCT LEG POST COMPARTMENT ONLY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27602,CPT,DCMPRN FASCT LEG ANT&/LAT&PST CMPRT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27603,CPT,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 27604,CPT,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27605,CPT,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 27606,CPT,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27607,CPT,INCISION LEG/ANKLE,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27610,CPT,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27612,CPT,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27613,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 27614,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27615,CPT,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27616,CPT,RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27618,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27619,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 27620,CPT,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27625,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27626,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27630,CPT,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27632,CPT,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27634,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 27635,CPT,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27637,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27638,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27640,CPT,PARTIAL EXCISION BONE TIBIA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27641,CPT,PARTIAL EXCISION BONE FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27647,CPT,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27650,CPT,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27652,CPT,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27654,CPT,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27656,CPT,REPAIR FASCIAL DEFECT LEG,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27658,CPT,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27659,CPT,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27664,CPT,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27665,CPT,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27675,CPT,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27676,CPT,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27680,CPT,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27681,CPT,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27685,CPT,LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27686,CPT,LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27687,CPT,GASTROCNEMIUS RECESSION,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27690,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27691,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27692,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27695,CPT,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27696,CPT,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27698,CPT,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27700,CPT,ARTHROPLASTY ANKLE,,30,,,"$15,093.67",$0.00,1,0,1,20130101, 27704,CPT,REMOVAL ANKLE IMPLANT,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27705,CPT,OSTEOTOMY TIBIA,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27707,CPT,OSTEOTOMY FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27709,CPT,OSTEOTOMY TIBIA & FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27720,CPT,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27722,CPT,REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 27726,CPT,REPAIR FIBULA NONUNION/MALUNION W INT FIXATION,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27730,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27732,CPT,ARREST EPIPHYSEAL OPEN DISTAL FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27734,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27740,CPT,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27742,CPT,ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR,,30,,,"$17,099.02",$0.00,1,0,1,20130101, 27745,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27750,CPT,CLTX TIBIAL SHAFT FX W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 27752,CPT,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27756,CPT,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 27758,CPT,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27759,CPT,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 27760,CPT,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 27762,CPT,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27766,CPT,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27767,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27768,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27769,CPT,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27780,CPT,CLTX PROX FIBULA/SHFT FX W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27781,CPT,CLTX PROX FIBULA/SHFT FX W/MANJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27784,CPT,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27786,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27788,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27792,CPT,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27808,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27810,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27814,CPT,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27816,CPT,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 27818,CPT,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,,30,,,"$2,238.84",$0.00,1,0,1,20130101, 27822,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27823,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 27824,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 27825,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27826,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27827,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 27828,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 27829,CPT,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27830,CPT,CLTX PROX TIBFIB JT DISLC W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 27831,CPT,CLTX PROX TIBFIB JT DISLC REQ ANES,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 27832,CPT,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27840,CPT,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,,30,,,$745.03,$0.00,1,0,1,20130101, 27842,CPT,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27846,CPT,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27848,CPT,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 27860,CPT,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 27870,CPT,ARTHRODESIS ANKLE OPEN,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27871,CPT,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 27884,CPT,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 27889,CPT,ANKLE DISARTICULATION,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27892,CPT,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27893,CPT,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27894,CPT,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 27899,CPT,UNLISTED PROCEDURE LEG/ANKLE,,30,,,$745.03,$0.00,1,0,1,20130101, 28001,CPT,INCISION&DRAINAGE BURSA FOOT,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 28002,CPT,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 28003,CPT,I&D BELOW FASCIA FOOT MULTIPLE AREAS,,30,,,"$8,775.66",$0.00,1,0,1,20130101, 28005,CPT,INCISION BONE CORTEX FOOT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28008,CPT,FASCIOTOMY FOOT&/TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28010,CPT,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28011,CPT,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28020,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28022,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28024,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28035,CPT,RELEASE TARSAL TUNNEL,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 28039,CPT,EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 28041,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 28043,CPT,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 28045,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 28046,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 28047,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 28050,CPT,ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28052,CPT,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28054,CPT,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28055,CPT,NEURECTOMY INTRINSIC MUSCULATURE OF FOOT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 28060,CPT,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28062,CPT,FASCIOTOMY PLANTAR FASCIA RADICAL SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28070,CPT,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28072,CPT,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28080,CPT,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28086,CPT,SYNOVECTOMY TENDON SHEATH FOOT FLEXOR,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28088,CPT,SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28090,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28092,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28100,CPT,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28102,CPT,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28103,CPT,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28104,CPT,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28106,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28107,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28108,CPT,EXC/CURTG CST/B9 TUM PHALANGES FOOT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28110,CPT,OSTECTOMY PRTL 5TH METAR HEAD SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28111,CPT,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28112,CPT,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28113,CPT,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28114,CPT,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28116,CPT,OSTECTOMY TARSAL COALITION,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28118,CPT,OSTECTOMY CALCANEUS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28119,CPT,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28120,CPT,PARTIAL EXCISION BONE TALUS/CALCANEUS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28122,CPT,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28124,CPT,PARTICAL EXCISION BONE PHALANX TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28126,CPT,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28130,CPT,TALECTOMY ASTRAGALECTOMY,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28140,CPT,METATARSECTOMY,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28150,CPT,PHALANGECTOMY TOE EACH TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28153,CPT,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28160,CPT,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28171,CPT,RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28173,CPT,RADICAL RESECTION TUMOR METATARSAL,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28175,CPT,RADICAL RESECTION TUMOR PHALANX OR TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28190,CPT,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 28192,CPT,REMOVAL FOREIGN BODY FOOT DEEP,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 28193,CPT,REMOVAL FOREIGN BODY FOOT COMPLICATED,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 28200,CPT,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28202,CPT,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28208,CPT,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28210,CPT,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28220,CPT,TENOLYSIS FLEXOR FOOT SINGLE TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28222,CPT,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28225,CPT,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28226,CPT,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28230,CPT,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28232,CPT,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28234,CPT,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28238,CPT,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28240,CPT,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28250,CPT,DIVISION PLANTAR FASCIA & MUSCLE SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28260,CPT,CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28261,CPT,CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28262,CPT,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28264,CPT,CAPSULOTOMY MIDTARSAL,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28270,CPT,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28272,CPT,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28280,CPT,SYNDACTYLIZATION TOES,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28285,CPT,CORRECTION HAMMERTOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28286,CPT,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28288,CPT,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28289,CPT,HALLUX RIGIDUS CORRECT W/CHEILECTOMY 1ST MP JT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28290,CPT,CORRJ HALLUX VALGUS W/WO SESMDC SMPL EXOSTECTOMY,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28292,CPT,KELLER/MCBRIDE/MAYO PROCEDURE,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28293,CPT,CORRJ HALLUX VALGUS W/WO SESMDC RESCJ JT W/IMPLT,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28294,CPT,CORRJ HALLUX VALGUS W/WO SESMDC W/TDN TRNSPLS,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28296,CPT,CORRJ HALLUX VALGUS W/WO SESMDC W/METAR OSTEOT,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28297,CPT,CORRJ HALLUX VALGUS W/WO SESMDC LAPIDUS-TYP PX,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28298,CPT,CORRJ HALLUX VALGUS W/WO SESMDC PHALANX OSTEOT,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28299,CPT,CORRJ HALLUX VALGUS W/WO SESMDC 2 OSTEOT,,30,,,"$13,290.79",$0.00,1,0,1,20130101, 28300,CPT,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28302,CPT,OSTEOTOMY TALUS,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28304,CPT,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28305,CPT,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28306,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28307,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28308,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28309,CPT,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28310,CPT,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28312,CPT,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28313,CPT,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28315,CPT,SESAMOIDECTOMY FIRST TOE SPX,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28320,CPT,REPAIR NONUNION/MALUNION TARSAL BONES,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28322,CPT,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28340,CPT,RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28341,CPT,RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28344,CPT,RECONSTRUCTION TOE POLYDACTYLY,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28345,CPT,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28360,CPT,RECONSTRUCTION CLEFT FOOT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28400,CPT,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 28405,CPT,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 28406,CPT,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28415,CPT,OPEN TREATMENT CALCANEAL FRACTURE,,30,,,"$21,371.86",$0.00,1,0,1,20130101, 28420,CPT,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 28430,CPT,CLOSED TX TALUS FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 28435,CPT,CLOSED TX TALUS FRACTURE W/MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 28436,CPT,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28445,CPT,OPEN TREATMENT TALUS FRACTURE,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 28446,CPT,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28450,CPT,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28455,CPT,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28456,CPT,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28465,CPT,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 28470,CPT,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,,30,,,$745.03,$0.00,1,0,1,20130101, 28475,CPT,CLTX METAR FX W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28476,CPT,PRQ SKEL FIXJ METAR FX W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28485,CPT,OPEN TREATMENT METATARSAL FRACTURE EACH,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 28490,CPT,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28495,CPT,CLTX FX GRT TOE PHLX/PHLG W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28496,CPT,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28505,CPT,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28510,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28515,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,,30,,,$745.03,$0.00,1,0,1,20130101, 28525,CPT,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28530,CPT,CLOSED TREATMENT SESAMOID FRACTURE,,30,,,$745.03,$0.00,1,0,1,20130101, 28531,CPT,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28540,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 28545,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28546,CPT,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28555,CPT,OPEN TREATMENT TARSAL BONE DISLOCATION,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 28570,CPT,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 28575,CPT,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,,30,,,"$5,015.55",$0.00,1,0,1,20130101, 28576,CPT,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28585,CPT,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28600,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 28605,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 28606,CPT,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28615,CPT,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,,30,,,"$18,113.02",$0.00,1,0,1,20130101, 28630,CPT,CLTX METATARSOPHLNGL JT DISLC W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 28635,CPT,CLTX METATARSOPHLNGL JT DISLC REQ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 28636,CPT,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28645,CPT,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28660,CPT,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,,30,,,$745.03,$0.00,1,0,1,20130101, 28665,CPT,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,,30,,,"$5,836.04",$0.00,1,0,1,20130101, 28666,CPT,PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28675,CPT,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 28705,CPT,ARTHRODESIS PANTALAR,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28715,CPT,ARTHRODESIS TRIPLE,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 28725,CPT,ARTHRODESIS SUBTALAR,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28730,CPT,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28735,CPT,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28737,CPT,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28740,CPT,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28750,CPT,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28755,CPT,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28760,CPT,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,,30,,,"$19,731.12",$0.00,1,0,1,20130101, 28805,CPT,AMPUTATION FOOT TRANSMETARSAL,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28810,CPT,AMPUTATION METATARSAL W/TOE SINGLE,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28820,CPT,AMPUTATION TOE METATARSOPHALANGEAL JOINT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28825,CPT,AMPUTATION TOE INTERPHALANGEAL JOINT,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 28890,CPT,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 28899,CPT,UNLISTED PROCEDURE FOOT/TOES,,30,,,$745.03,$0.00,1,0,1,20130101, 29000,CPT,APPLICATION HALO TYPE BODY CAST,,30,,,$418.68,$0.00,1,0,1,20130101, 29010,CPT,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29015,CPT,APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29020,CPT,APPLICATION TURNBUCKLE JACKET BODY ONLY,,30,,,$418.68,$0.00,1,0,1,20130101, 29025,CPT,APPLICATION TURNBUCKLE JACKET BODY W/HEAD,,30,,,$418.68,$0.00,1,0,1,20130101, 29035,CPT,APPLICATION BODY CAST SHOULDER HIPS,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29040,CPT,APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA,,30,,,$418.68,$0.00,1,0,1,20130101, 29044,CPT,APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29046,CPT,APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29049,CPT,APPLICATION CAST FIGURE-OF-8,,30,,,$418.68,$0.00,1,0,1,20130101, 29055,CPT,APPLICATION CAST SHOULDER SPICA,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29058,CPT,APPLICATION CAST PLASTER VELPEAU,,30,,,$418.68,$0.00,1,0,1,20130101, 29065,CPT,APPLICATION CAST SHOULDER HAND LONG ARM,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29075,CPT,APPLICATION CAST ELBOW FINGER SHORT ARM,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29085,CPT,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,,30,,,$418.68,$0.00,1,0,1,20130101, 29086,CPT,APPLICATION CAST FINGER,,30,,,$418.68,$0.00,1,0,1,20130101, 29105,CPT,APPLICATION LONG ARM SPLINT SHOULDER HAND,,30,,,$418.68,$0.00,1,0,1,20130101, 29125,CPT,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,,30,,,$418.68,$0.00,1,0,1,20130101, 29126,CPT,APPLICATION SHORT ARM SPLINT DYNAMIC,,30,,,$418.68,$0.00,1,0,1,20130101, 29130,CPT,APPLICATION FINGER SPLINT STATIC,,30,,,$328.67,$0.00,1,0,1,20130101, 29131,CPT,APPLICATION FINGER SPLINT DYNAMIC,,30,,,$328.67,$0.00,1,0,1,20130101, 29200,CPT,STRAPPING THORAX,,30,,,$328.67,$0.00,1,0,1,20130101, 29240,CPT,STRAPPING SHOULDER,,30,,,$328.67,$0.00,1,0,1,20130101, 29260,CPT,STRAPPING ELBOW/WRIST,,30,,,$328.67,$0.00,1,0,1,20130101, 29280,CPT,STRAPPING HAND/FINGER,,30,,,$328.67,$0.00,1,0,1,20130101, 29305,CPT,APPLICATION HIP SPICA CAST 1 LEG,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29325,CPT,APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29345,CPT,APPLICATION LONG LEG CAST THIGH-TOE,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29355,CPT,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29358,CPT,APPLICATION LONG LEG CAST BRACE,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29365,CPT,APPLICATION CYLINDER CAST THIGH ANKLE,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29405,CPT,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29425,CPT,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29435,CPT,APPLICATION PATELLAR TENDON BEARING CAST,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29440,CPT,ADDING WALKER PREVIOUSLY APPLIED CAST,,30,,,$418.68,$0.00,1,0,1,20130101, 29445,CPT,APPLICATION RIGID TOTAL CONTACT LEG CAST,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29450,CPT,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,,30,,,$418.68,$0.00,1,0,1,20130101, 29505,CPT,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,,30,,,$418.68,$0.00,1,0,1,20130101, 29515,CPT,APPLICATION SHORT LEG SPLINT CALF FOOT,,30,,,$418.68,$0.00,1,0,1,20130101, 29520,CPT,STRAPPING HIP,,30,,,$328.67,$0.00,1,0,1,20130101, 29530,CPT,STRAPPING KNEE,,30,,,$328.67,$0.00,1,0,1,20130101, 29540,CPT,STRAPPING ANKLE &/FOOT,,30,,,$328.67,$0.00,1,0,1,20130101, 29550,CPT,STRAPPING TOES,,30,,,$328.67,$0.00,1,0,1,20130101, 29580,CPT,STRAPPING UNNA BOOT,,30,,,$418.68,$0.00,1,0,1,20130101, 29581,CPT,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,,30,,,$418.68,$0.00,1,0,1,20130101, 29582,CPT,APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE,,30,,,$328.67,$0.00,1,0,1,20130101, 29583,CPT,APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM,,30,,,$328.67,$0.00,1,0,1,20130101, 29584,CPT,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,,30,,,$328.67,$0.00,1,0,1,20130101, 29700,CPT,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,,30,,,$418.68,$0.00,1,0,1,20130101, 29705,CPT,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,,30,,,$418.68,$0.00,1,0,1,20130101, 29710,CPT,RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET,,30,,,"$1,063.51",$0.00,1,0,1,20130101, 29715,CPT,REMOVAL/BIVALVING TURNBUCKLE JACKET,,30,,,$418.68,$0.00,1,0,1,20130101, 29720,CPT,REPAIR SPICA BODY CAST/JACKET,,30,,,$418.68,$0.00,1,0,1,20130101, 29730,CPT,WINDOWING CAST,,30,,,$418.68,$0.00,1,0,1,20130101, 29740,CPT,WEDGING CAST EXCEPT CLUBFOOT CASTS,,30,,,$418.68,$0.00,1,0,1,20130101, 29750,CPT,WEDGING CLUBFOOT CAST,,30,,,$418.68,$0.00,1,0,1,20130101, 29799,CPT,UNLISTED PROCEDURE CASTING/STRAPPING,,30,,,$418.68,$0.00,1,0,1,20130101, 29800,CPT,ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29804,CPT,ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29805,CPT,ARTHROSCOPY SHOULDER DX W/WO SYNOVIAL BIOPSY SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29806,CPT,ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29807,CPT,ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29819,CPT,ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29820,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29821,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29822,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29823,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29824,CPT,ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29825,CPT,ARTHROSCOPY SHOULDER AHESIOLYSIS W/WO MANIPJ,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29826,CPT,ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29827,CPT,ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29828,CPT,ARTHROSCOPY SHOULDER BICEPS TENODESIS,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29830,CPT,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29834,CPT,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29835,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29836,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29837,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29838,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29840,CPT,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29843,CPT,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29844,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29845,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29846,CPT,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29847,CPT,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29848,CPT,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29850,CPT,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29851,CPT,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29855,CPT,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29856,CPT,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29860,CPT,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29861,CPT,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29862,CPT,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29863,CPT,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29866,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29867,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29868,CPT,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29870,CPT,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29871,CPT,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29873,CPT,ARTHROSCOPY KNEE LATERAL RELEASE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29874,CPT,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29875,CPT,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29876,CPT,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29877,CPT,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29879,CPT,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29880,CPT,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29881,CPT,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29882,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29883,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29884,CPT,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29885,CPT,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29886,CPT,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29887,CPT,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29888,CPT,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 29889,CPT,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 29891,CPT,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29892,CPT,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 29893,CPT,ENDOSCOPIC PLANTAR FASCIOTOMY,,30,,,"$5,601.44",$0.00,1,0,1,20130101, 29894,CPT,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29895,CPT,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29897,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29898,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29899,CPT,ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29900,CPT,ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29901,CPT,ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29902,CPT,ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29904,CPT,ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29905,CPT,ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29906,CPT,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 29907,CPT,ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29914,CPT,ARTHROSCOPY HIP W/FEMOROPLASTY,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29915,CPT,ARTHROSCOPY HIP W/ACETABULOPLASTY,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29916,CPT,ARTHROSCOPY HIP W/LABRAL REPAIR,,30,,,"$11,514.67",$0.00,1,0,1,20130101, 29999,CPT,UNLISTED PROCEDURE ARTHROSCOPY,,30,,,"$10,556.00",$0.00,1,0,1,20130101, 30000,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 30020,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 30100,CPT,BIOPSY INTRANASAL,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 30110,CPT,EXCISION NASAL POLYP SIMPLE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 30115,CPT,EXCISION NASAL POLYP EXTENSIVE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30117,CPT,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 30118,CPT,EXCISION/DESTRUCTION INTRANASAL LESION XTRNL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30120,CPT,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30124,CPT,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30125,CPT,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30130,CPT,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30140,CPT,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30150,CPT,RHINECTOMY PARTIAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30160,CPT,RHINECTOMY TOTAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30200,CPT,INJECTION TURBINATE THERAPEUTIC,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 30210,CPT,DISPLACEMENT THERAPY PROETZ TYPE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 30220,CPT,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 30300,CPT,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,,30,,,$317.65,$0.00,1,0,1,20130101, 30310,CPT,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 30320,CPT,RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30400,CPT,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30410,CPT,RHINP PRIM COMPLETE XTRNL PARTS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30420,CPT,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30430,CPT,RHINOPLASTY SECONDARY MINOR REVISION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30435,CPT,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30450,CPT,RHINOPLASTY SECONDARY MAJOR REVISION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30460,CPT,RHINP DFRM W/COLUM LNGTH TIP ONLY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30462,CPT,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30465,CPT,REPAIR NASAL VESTIBULAR STENOSIS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30520,CPT,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30540,CPT,REPAIR CHOANAL ATRESIA INTRANASAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30545,CPT,REPAIR CHOANAL ATRESIA TRANSPALATINE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30560,CPT,LYSIS INTRANASAL SYNECHIA,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 30580,CPT,REPAIR FISTULA OROMAXILLARY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30600,CPT,REPAIR FISTULA ORONASAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30620,CPT,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 30630,CPT,REPAIR NASAL SEPTAL PERFORATIONS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30801,CPT,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 30802,CPT,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 30901,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,,30,,,$504.36,$0.00,1,0,1,20130101, 30903,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,,30,,,$504.36,$0.00,1,0,1,20130101, 30905,CPT,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,,30,,,$504.36,$0.00,1,0,1,20130101, 30906,CPT,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,,30,,,$504.36,$0.00,1,0,1,20130101, 30915,CPT,LIGATION ARTERIES ETHMOIDAL,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 30920,CPT,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 30930,CPT,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 30999,CPT,UNLISTED PROCEDURE NOSE,,30,,,$504.36,$0.00,1,0,1,20130101, 31000,CPT,LAVAGE CANNULATION MAXILLARY SINUS,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 31002,CPT,LAVAGE CANNULATION SPHENOID SINUS,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 31020,CPT,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31030,CPT,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31032,CPT,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31040,CPT,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31050,CPT,SINUSOTOMY SPHENOID W/WO BIOPSY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31051,CPT,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31070,CPT,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31075,CPT,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31080,CPT,SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31081,CPT,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31084,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31085,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31086,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31087,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31090,CPT,SINUSOT UNI 3/> PARANSL SINUSES,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31200,CPT,ETHMOIDECTOMY INTRANASAL ANTERIOR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31201,CPT,ETHMOIDECTOMY INTRANASAL TOTAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31205,CPT,ETHMOIDECTOMY EXTRANASAL TOTAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31231,CPT,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,,30,,,$801.33,$0.00,1,0,1,20130101, 31233,CPT,NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY,,30,,,$801.33,$0.00,1,0,1,20130101, 31235,CPT,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31237,CPT,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31238,CPT,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31239,CPT,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31240,CPT,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31254,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY PARTIAL,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31255,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY TOTAL,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31256,CPT,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31267,CPT,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31276,CPT,NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31287,CPT,NASAL/SINUS ENDOSCOPY W/SPHENOIDECTOMY,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31288,CPT,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31292,CPT,NSL/SINUS NDSC SURG W/MEDIAL/INF ORB WALL DCMPRN,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31293,CPT,NASAL/SINUS NDSC MEDIAL ORB&NF ORB WALL DCMPR,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31294,CPT,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31295,CPT,NASAL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31296,CPT,NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31297,CPT,NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31299,CPT,UNLISTED PROCEDURE ACCESSORY SINUSES,,30,,,$504.36,$0.00,1,0,1,20130101, 31300,CPT,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31320,CPT,LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31400,CPT,ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31420,CPT,EPIGLOTTIDECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31500,CPT,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,,30,,,"$1,035.29",$0.00,1,0,1,20130101, 31502,CPT,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,,30,,,$654.39,$0.00,1,0,1,20130101, 31505,CPT,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,,30,,,$432.21,$0.00,1,0,1,20130101, 31510,CPT,LARYNGOSCOPY INDIRECT W/BIOPSY,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31511,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,,30,,,$801.33,$0.00,1,0,1,20130101, 31512,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL LESION,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31513,CPT,LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION,,30,,,$801.33,$0.00,1,0,1,20130101, 31515,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31520,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,,30,,,$801.33,$0.00,1,0,1,20130101, 31525,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31526,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31527,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31528,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31529,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31530,CPT,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31531,CPT,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31535,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31536,CPT,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31540,CPT,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31541,CPT,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31545,CPT,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31546,CPT,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31560,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31561,CPT,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31570,CPT,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31571,CPT,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,,30,,,"$11,402.93",$0.00,1,0,1,20130101, 31575,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGNOSTIC,,30,,,$801.33,$0.00,1,0,1,20130101, 31576,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC W/BIOPSY,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31577,CPT,LARYNGOSCOPY FLX FIBEROPTIC RMVL FOREIGN BODY,,30,,,"$1,899.46",$0.00,1,0,1,20130101, 31578,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC REMOVAL LESION,,30,,,"$7,605.53",$0.00,1,0,1,20130101, 31579,CPT,LARYNGOSCOPY FLX/RGD FIBOPT W/STROBOSCOPY,,30,,,"$1,899.46",$0.00,1,0,1,20130101, 31580,CPT,LARYNGOPLASTY LARYN WEB 2 STG W/KEEL INSJ&RMVL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31582,CPT,LARYNGP LARYN STENOSIS GRF/CORE MOLD W/TRACHT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31588,CPT,LARYNGOPLASTY NOT OTHERWISE SPECIFIED,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31590,CPT,LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31595,CPT,SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31599,CPT,UNLISTED PROCEDURE LARYNX,,30,,,$504.36,$0.00,1,0,1,20130101, 31600,CPT,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31601,CPT,TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31603,CPT,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 31605,CPT,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 31610,CPT,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31611,CPT,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31612,CPT,TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31613,CPT,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31614,CPT,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31615,CPT,TRACHEOBRNCHSC THRU EST TRACHS INC,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 31622,CPT,BRNCHSC INCL FLUOR GID DX W/CELL WASHG SPX,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31623,CPT,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31624,CPT,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31625,CPT,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31626,CPT,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31628,CPT,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31629,CPT,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31630,CPT,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31631,CPT,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31632,CPT,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31633,CPT,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31634,CPT,BRONCHOSCOPY BALLOON OCCLUSION,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31635,CPT,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31636,CPT,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31637,CPT,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31638,CPT,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31640,CPT,BRONCHOSCOPY W/EXCISION TUMOR,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31641,CPT,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,,30,,,"$8,748.37",$0.00,1,0,1,20130101, 31643,CPT,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31645,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE 1ST,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31646,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE SBSQ,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 31647,CPT,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,,30,,,"$8,813.47",$0.00,1,0,1,20130101, 31648,CPT,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,,30,,,"$8,813.47",$0.00,1,0,1,20130101, 31649,CPT,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,,30,,,"$3,911.15",$0.00,1,0,1,20130101, 31651,CPT,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,,30,,,"$8,813.47",$0.00,1,0,1,20130101, 31660,CPT,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,,30,,,"$8,813.47",$0.00,1,0,1,20130101, 31661,CPT,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,,30,,,"$8,813.47",$0.00,1,0,1,20130101, 31717,CPT,CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY,,30,,,"$1,899.46",$0.00,1,0,1,20130101, 31720,CPT,CATHETER ASPIRATION NASOTRACHEAL SPX,,30,,,$182.97,$0.00,1,0,1,20130101, 31730,CPT,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,,30,,,"$1,899.46",$0.00,1,0,1,20130101, 31750,CPT,TRACHEOPLASTY CERVICAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31755,CPT,TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 31785,CPT,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31820,CPT,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31825,CPT,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31830,CPT,REVISION TRACHEOSTOMY SCAR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 31899,CPT,UNLISTED PROCEDURE TRACHEA BRONCHI,,30,,,"$3,922.21",$0.00,1,0,1,20130101, 32201,CPT,PNEUMONOSTOMY PERCUTANEOUS DRAINAGE ABSCESS/CYST,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32400,CPT,BIOPSY PLEURA PERCUTANEOUS NEEDLE,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 32405,CPT,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 32550,CPT,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,,30,,,"$12,448.66",$0.00,1,0,1,20130101, 32551,CPT,TUBE THORACOSTOMY INCLUDES WATER SEAL,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32552,CPT,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32553,CPT,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,,30,,,"$5,975.13",$0.00,1,0,1,20130101, 32554,CPT,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,,30,,,"$2,311.78",$0.00,1,0,1,20130101, 32555,CPT,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,,30,,,"$2,311.78",$0.00,1,0,1,20130101, 32556,CPT,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,,30,,,"$2,311.78",$0.00,1,0,1,20130101, 32557,CPT,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,,30,,,"$2,311.78",$0.00,1,0,1,20130101, 32560,CPT,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32561,CPT,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32562,CPT,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32601,CPT,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 32604,CPT,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 32606,CPT,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 32607,CPT,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 32608,CPT,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 32609,CPT,THORACOSCOPY WITH BIOPSYIES OF PLEURA,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 32960,CPT,PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 32998,CPT,ABLATION PULMONARY TUMOR PERQ RADIOFREQUENCY UNI,,30,,,"$19,012.98",$0.00,1,0,1,20130101, 32999,CPT,UNLISTED PROCEDURE LUNGS & PLEURA,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 33010,CPT,PERICARDIOCENTESIS INITIAL,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 33011,CPT,PERICARDIOCENTESIS SUBSEQUENT,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 33206,CPT,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,,30,,,"$22,988.81",$0.00,1,0,1,20130101, 33207,CPT,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,,30,,,"$22,988.81",$0.00,1,0,1,20130101, 33208,CPT,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,,30,,,"$20,519.44",$0.00,1,0,1,20130101, 33210,CPT,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,,30,,,"$18,169.59",$0.00,1,0,1,20130101, 33211,CPT,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,,30,,,"$18,169.59",$0.00,1,0,1,20130101, 33212,CPT,INS PM PLS GEN W/EXIST SINGLE LEAD,,30,,,"$23,356.98",$0.00,1,0,1,20130101, 33213,CPT,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,,30,,,"$23,404.75",$0.00,1,0,1,20130101, 33214,CPT,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,,30,,,"$20,519.44",$0.00,1,0,1,20130101, 33215,CPT,RPSG PREV IMPLTED PM/CVDFB R ATR/R VENTR ELTRD,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33216,CPT,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER OR CVDFB,,30,,,"$18,169.59",$0.00,1,0,1,20130101, 33217,CPT,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER OR CVDFB,,30,,,"$18,169.59",$0.00,1,0,1,20130101, 33218,CPT,RPR 1 ELTRD PRM PM/PACING CVDFB,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33220,CPT,RPR 2 ELTRDS PRM PM/PACING CVDFB,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33221,CPT,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,,30,,,"$23,404.75",$0.00,1,0,1,20130101, 33222,CPT,REVISION/RELOCATION SKIN POCKET PACEMAKER,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 33223,CPT,REVJ SKN POCKET FOR CARDIOVERTER-DEFIBRILLATOR,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 33224,CPT,INSJ ELTRD CAR VEN SYS ATTCH PM/CVDFB PLS GEN,,30,,,"$20,519.44",$0.00,1,0,1,20130101, 33225,CPT,INSJ ELTRD CAR VEN SYS TM INSJ CVDFB/PM PLS GEN,,30,,,"$20,519.44",$0.00,1,0,1,20130101, 33226,CPT,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33227,CPT,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,,30,,,"$23,356.98",$0.00,1,0,1,20130101, 33228,CPT,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,,30,,,"$23,404.75",$0.00,1,0,1,20130101, 33229,CPT,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,,30,,,"$23,404.75",$0.00,1,0,1,20130101, 33230,CPT,INS PACNG CVDFB PLS GEN ONLY W/EXIST DUAL LEADS,,30,,,"$44,662.06",$0.00,1,0,1,20130101, 33231,CPT,INS PACNG CVDFB PLS GEN ONLY W/EXIST MULTI LEADS,,30,,,"$44,662.06",$0.00,1,0,1,20130101, 33233,CPT,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33234,CPT,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33235,CPT,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33240,CPT,INSJ 1/2 CHMBR PACING CARDIOVERTERDEFIB PLS GEN,,30,,,"$44,662.06",$0.00,1,0,1,20130101, 33241,CPT,REMVL PAC CVDFB PLS GEN ONLY,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33244,CPT,RMVL 1/2CHMBR PACG CVDFB ELTRD TRANSVNS XTRJ,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 33249,CPT,INS/REP PAC PERM CVDFB TRNSVEN LEADS 1/2 CHAMBER,,30,,,"$61,426.90",$0.00,1,0,1,20130101, 33262,CPT,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEA,,30,,,"$44,662.06",$0.00,1,0,1,20130101, 33263,CPT,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEA,,30,,,"$44,662.06",$0.00,1,0,1,20130101, 33264,CPT,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEA,,30,,,"$44,662.06",$0.00,1,0,1,20130101, 33282,CPT,IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER,,30,,,"$22,726.91",$0.00,1,0,1,20130101, 33284,CPT,RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 33999,CPT,UNLISTED CARDIAC SURGERY,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 34101,CPT,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34111,CPT,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34201,CPT,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34203,CPT,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34421,CPT,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34471,CPT,THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34490,CPT,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34501,CPT,VALVULOPLASTY FEMORAL VEIN,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34510,CPT,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34520,CPT,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 34530,CPT,SAPHENOPOPLITEAL VEIN ANASTOMOSIS,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35011,CPT,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,,30,,,"$13,225.12",$0.00,1,0,1,20130101, 35045,CPT,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35180,CPT,REPAIR CONGENITAL AV FISTULA HEAD & NECK,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35184,CPT,RPR CONGENITAL AV FISTULA EXTREMITIES,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35188,CPT,RPR/TRAUMATIC AV FISTULA HEAD & NECK,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35190,CPT,RPR/TRAUMATIC AV FISTULA EXTREMITIES,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35201,CPT,REPAIR BLOOD VESSEL DIRECT NECK,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35206,CPT,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35207,CPT,REPAIR BLOOD VESSEL DIRECT HAND FINGER,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35226,CPT,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,,30,,,"$3,212.97",$0.00,1,0,1,20130101, 35231,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35236,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35256,CPT,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35261,CPT,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,,30,,,"$13,225.12",$0.00,1,0,1,20130101, 35266,CPT,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,,30,,,"$13,225.12",$0.00,1,0,1,20130101, 35286,CPT,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,,30,,,"$13,225.12",$0.00,1,0,1,20130101, 35321,CPT,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35458,CPT,TRLUML BALO ANGIOP OPN BRCH/CPHLC TRNK/BRNCH EA,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 35460,CPT,TRLUML BALLOON ANGIOPLASTY OPEN VENOUS,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 35471,CPT,TRLUML BALLOON ANGIOP PRQ RENAL/VISCERAL ART,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 35472,CPT,TRLUML BALLOON ANGIOPLASTY PERCUTANEOUS AORTIC,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 35475,CPT,TRLUML BALO ANGIOP PRQ BRCH/CPHLC TRNK/BRNCH EA,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 35476,CPT,TRLUML BALLOON ANGIOPLASTY PERCUTANEOUS VENOUS,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 35500,CPT,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,,30,,,"$6,533.84",$0.00,1,0,1,20130101, 35685,CPT,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35686,CPT,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35761,CPT,EXPL N/FLWD SURG RPR W/WO LYSIS OTHER ARTERY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35860,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 35875,CPT,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35876,CPT,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35879,CPT,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35881,CPT,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35883,CPT,REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35884,CPT,REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 35903,CPT,EXCISION INFECTED GRAFT EXTREMITY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 36002,CPT,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 36147,CPT,INTRO NDL/CATH AV SHUNT IST ACCESS W/ RAD EVAL,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 36221,CPT,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,,30,,,"$12,230.89",$0.00,1,0,1,20130101, 36222,CPT,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,,30,,,"$12,230.89",$0.00,1,0,1,20130101, 36223,CPT,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,,30,,,"$12,230.89",$0.00,1,0,1,20130101, 36224,CPT,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,,30,,,"$17,692.77",$0.00,1,0,1,20130101, 36225,CPT,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,,30,,,"$12,230.89",$0.00,1,0,1,20130101, 36226,CPT,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,,30,,,"$17,692.77",$0.00,1,0,1,20130101, 36251,CPT,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 36252,CPT,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 36253,CPT,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 36254,CPT,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 36260,CPT,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36261,CPT,REVJ IMPLANTED INTRA-ARTERIAL INFUSION PUMP,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 36262,CPT,REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 36415,CPT,COLLECTION VENOUS BLOOD VENIPUNCTURE,,30,,,$31.54,$0.00,1,0,1,20130101, 36420,CPT,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,,30,,,$150.41,$0.00,1,0,1,20130101, 36425,CPT,VENIPUNCTURE CUTDOWN AGE 1 YR/>,,30,,,$150.41,$0.00,1,0,1,20130101, 36430,CPT,TRANSFUSION BLOOD/BLOOD COMPONENTS,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 36440,CPT,PUSH TRANSFUSION BLOOD 2 YR/UNDER,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 36450,CPT,EXCHNG TRANSFUSION BLOOD NEWBORN,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 36455,CPT,EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 36460,CPT,TRANSFUSION INTRAUTERINE FETAL,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 36468,CPT,1/MLT NJXS SCLRSG SLNS SPIDER VEINS LIMB/TRUNK,,30,,,$258.15,$0.00,1,0,1,20130101, 36469,CPT,1/MLT NJXS SCLRSG SLNS SPIDER VEINS FACE,,30,,,$385.85,$0.00,1,0,1,20130101, 36470,CPT,NJX SCLEROSING SOLUTION SINGLE VEIN,,30,,,$385.85,$0.00,1,0,1,20130101, 36471,CPT,NJX SCLEROSING SOLUTION MULTIPLE VEINS SAME LEG,,30,,,$385.85,$0.00,1,0,1,20130101, 36475,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 36476,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 36478,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 36479,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 36511,CPT,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,,30,,,"$5,345.29",$0.00,1,0,1,20130101, 36512,CPT,THERAPEUTIC APHERESIS RED BLOOD CELLS,,30,,,"$5,345.29",$0.00,1,0,1,20130101, 36513,CPT,THERAPEUTIC APHERESIS PLATELETS,,30,,,"$5,345.29",$0.00,1,0,1,20130101, 36514,CPT,THERAPEUTIC APHERESIS PLASMA PHERESIS,,30,,,"$5,345.29",$0.00,1,0,1,20130101, 36515,CPT,THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 36516,CPT,THER APHRS XTRCORP SLCTV ADSRPJ/FILTRJ & REINFSJ,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 36522,CPT,PHOTOPHERESIS EXTRACORPOREAL,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 36555,CPT,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36556,CPT,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36557,CPT,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36558,CPT,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36560,CPT,INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36561,CPT,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36563,CPT,INSJ TUNNELED CTR VAD W/SUBQ PUMP,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36565,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36566,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36568,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP UNDER 5 YR,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36569,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36570,CPT,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36571,CPT,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36575,CPT,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 36576,CPT,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36578,CPT,RPLCMT CATH CTR VAD SUBQ PORT/PMP,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36580,CPT,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36581,CPT,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36582,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36583,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36584,CPT,RPLCMT COMPL PRPH CVC W/O SUBQ PORT/PMP,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36585,CPT,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36589,CPT,RMVL TUN CVC W/O SUBQ PORT/PMP,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 36590,CPT,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36591,CPT,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,,30,,,$319.07,$0.00,1,0,1,20130101, 36592,CPT,COLLECT BLOOD FROM CATHETER VENOUS NOS,,30,,,$319.07,$0.00,1,0,1,20130101, 36593,CPT,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,,30,,,"$1,108.56",$0.00,1,0,1,20130101, 36595,CPT,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,,30,,,"$9,822.19",$0.00,1,0,1,20130101, 36596,CPT,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36597,CPT,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDN,,30,,,"$4,557.38",$0.00,1,0,1,20130101, 36598,CPT,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,,30,,,"$1,108.56",$0.00,1,0,1,20130101, 36600,CPT,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,,30,,,$150.41,$0.00,1,0,1,20130101, 36640,CPT,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 36680,CPT,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,,30,,,$677.58,$0.00,1,0,1,20130101, 36800,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,,30,,,"$14,783.54",$0.00,1,0,1,20130101, 36810,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,,30,,,"$14,783.54",$0.00,1,0,1,20130101, 36815,CPT,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,,30,,,"$14,783.54",$0.00,1,0,1,20130101, 36818,CPT,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36819,CPT,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36820,CPT,ARVEN ANAST OPN F/ARM VEIN TRPOS,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36821,CPT,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36825,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36830,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36831,CPT,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36832,CPT,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36833,CPT,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36835,CPT,INSERTION THOMAS SHUNT SEPARATE PROCEDURE,,30,,,"$14,783.54",$0.00,1,0,1,20130101, 36838,CPT,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 36860,CPT,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,,30,,,"$1,108.56",$0.00,1,0,1,20130101, 36861,CPT,XTRNL CANNULA DECLTNG SPX W/BALO CATH,,30,,,"$14,783.54",$0.00,1,0,1,20130101, 36870,CPT,THRMBC PRQ ARVEN FSTL AUTOG/NONAUTOG GRF,,30,,,"$13,225.12",$0.00,1,0,1,20130101, 37183,CPT,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37184,CPT,PRIM PRQ TRLUML MCHNL THRMBC 1ST VSL,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 37185,CPT,PRIM PRQ TRLUML MCHNL THRMBC SBSQ VSL,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 37186,CPT,SEC PRQ TRANSLUMINAL THROMBECTOMY NONCORONARY,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 37187,CPT,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 37188,CPT,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 37191,CPT,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 37192,CPT,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 37193,CPT,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 37195,CPT,THROMBOLYSIS CEREBRAL IV INFUSION,,30,,,"$1,108.56",$0.00,1,0,1,20130101, 37197,CPT,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,,30,,,"$11,417.12",$0.00,1,0,1,20130101, 37200,CPT,TRANSCATHETER BIOPSY,,30,,,"$11,528.18",$0.00,1,0,1,20130101, 37202,CPT,TCAT THER INFUSION OTH/THN THROMBOLYSIS ANY TYPE,,30,,,"$6,533.84",$0.00,1,0,1,20130101, 37204,CPT,TCAT OCCLS/EMBOLJ PRQ NON-CNS NON-HEAD/NCK,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 37205,CPT,TCAT PLMT IV STENT PERCUTANEOUS 1ST VESSEL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37206,CPT,TCAT PLMT IV STENT PERCUTANEOUS EACH ADDL VESSEL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37207,CPT,TCAT PLMT IV STENT OPEN 1ST VESSEL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37208,CPT,TCAT PLMT IV STENT OPEN EACH ADDL VESSEL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37210,CPT,UTERINE FIBROID EMBOLIZATION PERQ W/RAD GID,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37211,CPT,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,,30,,,"$4,555.49",$0.00,1,0,1,20130101, 37212,CPT,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,,30,,,"$4,555.49",$0.00,1,0,1,20130101, 37213,CPT,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,,30,,,"$9,833.17",$0.00,1,0,1,20130101, 37214,CPT,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,,30,,,"$9,833.17",$0.00,1,0,1,20130101, 37220,CPT,REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37221,CPT,REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37222,CPT,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37223,CPT,REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37224,CPT,REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37225,CPT,REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37226,CPT,REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37227,CPT,REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL,,30,,,"$29,258.80",$0.00,1,0,1,20130101, 37228,CPT,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37229,CPT,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37230,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37231,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,,30,,,"$29,258.80",$0.00,1,0,1,20130101, 37232,CPT,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37233,CPT,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL,,30,,,"$22,554.53",$0.00,1,0,1,20130101, 37234,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37235,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 37500,CPT,VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 37501,CPT,UNLISTED VASCULAR ENDOSCOPY PROCEDURE,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37565,CPT,LIGATION INTERNAL JUGULAR VEIN,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 37600,CPT,LIGATION EXTERNAL CAROTID ARTERY,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 37605,CPT,LIGATION INTERNAL/COMMON CAROTID ARTERY,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 37606,CPT,LIG INT/COMMON CAROTID ART W/GRADUAL OCCLUSION,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37607,CPT,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37609,CPT,LIGATION/BIOPSY TEMPORAL ARTERY,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 37615,CPT,LIGATION MAJOR ARTERY NECK,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37619,CPT,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 37650,CPT,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37700,CPT,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37718,CPT,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37722,CPT,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 37735,CPT,LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS,,30,,,"$15,577.89",$0.00,1,0,1,20130101, 37760,CPT,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37761,CPT,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37765,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37766,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37780,CPT,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37785,CPT,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,,30,,,"$10,988.73",$0.00,1,0,1,20130101, 37790,CPT,PENILE VENOUS OCCLUSIVE PROCEDURE,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 37799,CPT,UNLISTED PROCEDURE VASCULAR SURGERY,,30,,,$319.07,$0.00,1,0,1,20130101, 38120,CPT,LAPAROSCOPIC SURGICAL SPLENECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 38129,CPT,UNLISTED LAPAROSCOPY PROCEDURE SPLEEN,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 38205,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,,30,,,"$8,480.73",$0.00,1,0,1,20130101, 38206,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,,30,,,"$5,345.29",$0.00,1,0,1,20130101, 38207,CPT,TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 38208,CPT,TRNSPL PREP HEMATOP PROGEN THAW PREV HRV PER DNR,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 38209,CPT,TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 38210,CPT,TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 38211,CPT,TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 38212,CPT,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 38213,CPT,TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 38214,CPT,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 38215,CPT,TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 38220,CPT,MARROW ASPIRATION ONLY,,30,,,"$1,522.05",$0.00,1,0,1,20130101, 38221,CPT,BONE MARROW BIOPSY NEEDLE/TROCAR,,30,,,"$1,522.05",$0.00,1,0,1,20130101, 38230,CPT,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 38232,CPT,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 38240,CPT,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 38241,CPT,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 38242,CPT,ALLOGENEIC LYMPHOCYTE INFUSIONS,,30,,,"$5,345.29",$0.00,1,0,1,20130101, 38243,CPT,TRNSPLJ HEMATOPOIETIC CELL BOOST,,30,,,"$5,329.17",$0.00,1,0,1,20130101, 38300,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 38305,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS X10SV,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 38308,CPT,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38500,CPT,BX/EXC LYMPH NODE OPEN SUPERFICIAL,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38505,CPT,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,,30,,,"$3,514.90",$0.00,1,0,1,20130101, 38510,CPT,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38520,CPT,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38525,CPT,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38530,CPT,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38542,CPT,DISSECTION DEEP JUGULAR NODE,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 38550,CPT,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38555,CPT,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38570,CPT,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 38571,CPT,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 38572,CPT,LAPS BI TOT PEL LMPHADEC&PRI-AORTIC LYMPH BX 1,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 38589,CPT,UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 38700,CPT,SUPRAHYOID LYMPHADENECTOMY,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38720,CPT,CERVICAL LYMPHADENECTOMY,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38740,CPT,AXILLARY LYMPHADENECTOMY SUPERFICIAL,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 38745,CPT,AXILLARY LYMPHADENECTOMY COMPLETE,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 38760,CPT,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,,30,,,"$10,203.14",$0.00,1,0,1,20130101, 38792,CPT,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 38999,CPT,UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,,30,,,"$1,524.44",$0.00,1,0,1,20130101, 39400,CPT,MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED,,30,,,"$13,725.30",$0.00,1,0,1,20130101, 40490,CPT,BIOPSY OF LIP,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 40500,CPT,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 40510,CPT,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40520,CPT,EXC LIP V-EXC W/PRIM DIR LINR CLSR,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 40525,CPT,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40527,CPT,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40530,CPT,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40650,CPT,RPR LIP FULL THICKNESS VERMILION ONLY,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 40652,CPT,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 40654,CPT,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 40700,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40701,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40702,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40720,CPT,PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40761,CPT,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40799,CPT,UNLISTED PROCEDURE LIPS,,30,,,$504.36,$0.00,1,0,1,20130101, 40800,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,,30,,,$730.81,$0.00,1,0,1,20130101, 40801,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 40804,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,,30,,,$317.65,$0.00,1,0,1,20130101, 40805,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40806,CPT,INCISION LABIAL FRENUM FRENOTOMY,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 40808,CPT,BIOPSY VESTIBULE MOUTH,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 40810,CPT,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 40812,CPT,EXC LES MUCOSA & SBMCSL VESTIBULE SMPL RPR,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 40814,CPT,EXC LES MUCOSA & SBMCSL VESTIBULE CPLX RPR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40816,CPT,EXC LES MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40818,CPT,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 40819,CPT,EXC FRENUM LABIAL/BUCCAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 40820,CPT,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 40830,CPT,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 40831,CPT,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 40840,CPT,VESTIBULOPLASTY ANTERIOR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40842,CPT,VESTIBULOPLASTY POSTERIOR UNILATERAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40843,CPT,VESTIBULOPLASTY POSTERIOR BILATERAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 40844,CPT,VESTIBULOPLASTY ENTIRE ARCH,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40845,CPT,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 40899,CPT,UNLISTED PROCEDURE VESTIBULE MOUTH,,30,,,$504.36,$0.00,1,0,1,20130101, 41000,CPT,INTRAORAL I&D TONGUE/FLOOR LINGUAL,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41005,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 41006,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41007,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41008,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41009,CPT,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 41010,CPT,INCISION LINGUAL FRENUM FRENOTOMY,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41015,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 41016,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41017,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41018,CPT,XTRORAL I&D FLOOR MASTICATOR SPACE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41019,CPT,PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41100,CPT,BIOPSY TONGUE ANTERIOR TWO-THIRDS,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41105,CPT,BIOPSY TONGUE POSTERIOR ONE-THIRD,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41108,CPT,BIOPSY FLOOR MOUTH,,30,,,"$2,117.04",$0.00,1,0,1,20130101, 41110,CPT,EXCISION LESION TONGUE W/O CLOSURE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41112,CPT,EXC LES TONGUE W/CLSR ANTERIOR TWO-THIRDS,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41113,CPT,EXC LES TONGUE W/CLSR POSTERIOR ONE-THIRD,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41114,CPT,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41115,CPT,EXCIISION LINGUAL FRENUM FRENECTOMY,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41116,CPT,EXCISION LESION FLOOR MOUTH,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41120,CPT,GLOSSECTOMY 2.6 CM/CPLX,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41500,CPT,FIXJ TONGUE MECHANICAL OTHER/THAN SUTURE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41510,CPT,SUTURE TONGUE LIP MICROGNATHIA,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41512,CPT,TONGUE BASE SUSPENSION PERMANENT SUTURE TQ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41520,CPT,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41530,CPT,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41599,CPT,UNLISTED PROCEDURE TONGUE FLOOR MOUTH,,30,,,$504.36,$0.00,1,0,1,20130101, 41800,CPT,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,,30,,,$730.81,$0.00,1,0,1,20130101, 41805,CPT,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41806,CPT,RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41820,CPT,GINGIVECTOMY EXC GINGIVA EACH QUADRANT,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41821,CPT,OPRCULECTOMY EXC PRICORONAL TISSUE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 41822,CPT,EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41823,CPT,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 41825,CPT,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 41826,CPT,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41827,CPT,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41828,CPT,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41830,CPT,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41850,CPT,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41870,CPT,PERIODONTAL MUCOSAL GRAFTING,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 41872,CPT,GINGIVOPLASTY EACH QUADRANT SPECIFY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41874,CPT,ALVEOLOPLASTY EACH QUADRANT SPECIFY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 41899,CPT,UNLISTED PROCEDURE DENTOALVEOLAR STRUCTURES,,30,,,$504.36,$0.00,1,0,1,20130101, 42000,CPT,DRAINAGE ABSCESS PALATE UVULA,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 42100,CPT,BIOPSY PALATE UVULA,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 42104,CPT,EXC LESION PALATE UVULA W/O CLOSURE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42106,CPT,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42107,CPT,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42120,CPT,RESCJ PALATE/EXTENSIVE RESCJ LESION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42140,CPT,UVULECTOMY EXCISION UVULA,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42145,CPT,PALATOPHARYNGOPLASTY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42160,CPT,DSTRJ LES PALATE/UVULA THERMAL CRYO/CHEM,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42180,CPT,REPAIR LACERATION PALATE 2 CM/COMPLEX,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42200,CPT,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42205,CPT,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42210,CPT,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42215,CPT,PALATOPLASTY CLEFT PALATE MAJOR REVJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42220,CPT,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42225,CPT,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42226,CPT,LENGTHENING PALATE & PHARYNGEAL FLAP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42227,CPT,LENGTHENING PALATE W/ISLAND FLAP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42235,CPT,REPAIR ANTERIOR PALATE W/VOMER FLAP,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42260,CPT,REPAIR NASOLABIAL FISTULA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42280,CPT,MAXILLARY IMPRESJ PALATAL PROSTHESIS,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 42281,CPT,INSJ PIN-RETAINED PALATAL PROSTHESIS,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42299,CPT,UNLISTED PROCEDURE PALATE UVULA,,30,,,$504.36,$0.00,1,0,1,20130101, 42300,CPT,DRAINAGE ABSCESS PAROTID SIMPLE,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 42305,CPT,DRAINAGE ABSCESS PAROTID COMPLICATED,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42310,CPT,DRG ABSC SUBMAXILLARY/SUBLINGUAL INTRAORAL,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 42320,CPT,DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 42330,CPT,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42335,CPT,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42340,CPT,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42400,CPT,BIOPSY SALIVARY GLAND NEEDLE,,30,,,"$3,514.90",$0.00,1,0,1,20130101, 42405,CPT,BIOPSY SALIVARY GLAND INCISIONAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42408,CPT,EXC SUBLINGUAL SALIVARY CYST RANULA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42409,CPT,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42410,CPT,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42415,CPT,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42420,CPT,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42425,CPT,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42440,CPT,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42450,CPT,EXISION OF SUBLINGUAL GLAND,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42500,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42505,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42507,CPT,PAROTID DUCT DIVERSION BILATERAL WILKE PX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42508,CPT,PAROTID DUCT DIVERSION BI W/EXC 1 SUBMNDBLR GLND,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42509,CPT,PAROTID DUCT DVRJ BI W/EXC BOTH SUBMNDBLR GLANDS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42510,CPT,PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42600,CPT,CLOSURE SALIVARY FISTULA,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42650,CPT,DILATION SALIVARY DUCT,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42660,CPT,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 42665,CPT,LIGATION SALIVARY DUCT INTRAORAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42699,CPT,UNLISTED PX SALIVARY GLANDS/DUCTS,,30,,,$504.36,$0.00,1,0,1,20130101, 42700,CPT,I&D ABSCESS PERITONSILLAR,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 42720,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42725,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42800,CPT,BIOPSY OROPHARYNX,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42802,CPT,BIOPSY HYPOPHARYNX,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42804,CPT,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42806,CPT,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42808,CPT,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42809,CPT,REMOVAL FOREIGN BODY PHARYNX,,30,,,$317.65,$0.00,1,0,1,20130101, 42810,CPT,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42815,CPT,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42820,CPT,TONSILLECTOMY & ADENOIDECTOMY ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42825,CPT,TONSILLECTOMY ONE-HALF ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42830,CPT,ADENOIDECTOMY PRIMARY ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42835,CPT,ADENOIDECTOMY SECONDARY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42842,CPT,RADICAL RESECTION TONSIL W/O CLOSURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42844,CPT,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42860,CPT,EXCISION TONSIL TAGS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42870,CPT,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42890,CPT,LIMITED PHARYNGECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42892,CPT,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42900,CPT,SUTURE PHARYNX WOUND/INJURY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42950,CPT,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 42955,CPT,PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42960,CPT,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,,30,,,$504.36,$0.00,1,0,1,20130101, 42962,CPT,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 42970,CPT,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,,30,,,$504.36,$0.00,1,0,1,20130101, 42972,CPT,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 42999,CPT,UNLISTED PROCEDURE PHARYNX ADENOIDS/TONSILS,,30,,,$504.36,$0.00,1,0,1,20130101, 43020,CPT,ESOPHAGOTOMY CERVICAL APPR W/RMVL FB,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 43030,CPT,CRICOPHARYNGEAL MYOTOMY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 43130,CPT,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 43200,CPT,ESPHGSC RGD/FLX DX W/WO COLLJ SPEC BR/WA SPX,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43201,CPT,ESPHGSC RGD/FLX W/SUBMUCOSAL INJ ANY SBST,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43202,CPT,ESPHGSC RGD/FLX W/BIOPSY SINGLE/MULTIPLE,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43204,CPT,ESPHGSC RGD/FLX W/NJX SCLEROSIS ESOPHGL VARC,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43205,CPT,ESPHGSC RGD/FLX W/BAND LIGATION ESOPHGL VARICES,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43206,CPT,ESPHGSC W/OPTICAL ENDOMICROSCOPY,,30,,,"$4,680.05",$0.00,1,0,1,20130101, 43215,CPT,ESPHGSC RGD/FLX W/RMVL FOREIGN BODY,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43216,CPT,ESPHGSC RGD/FLX RMVL TUM HOT BX FORCEPS/CAUT,,30,,,"$10,520.78",$0.00,1,0,1,20130101, 43217,CPT,ESPHGSC RGD/FLX W/RMVL TUMOR SNARE TECHNIQUE,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43219,CPT,ESPHGSC RGD/FLX W/INSJ PLSTC TUBE/STENT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 43220,CPT,ESPHGSC RGD/FLX W/BALLOON DILAT <30 MM DIAM,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43226,CPT,ESPHGSC RGD/FLX W/INSJ GUIDE WIRE DILATION,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43227,CPT,ESPHGSC RGD/FLX W/CTRL BLEEDING,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43228,CPT,ESPHGSC RGD/FLX ABLTJ TUM XCP HOT BX/CAUT/SNARE,,30,,,"$10,520.78",$0.00,1,0,1,20130101, 43231,CPT,ESPHGSC RGD/FLX W/NDSC ULTRASOUND EXAMINATION,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43232,CPT,ESPHGSC RGD/FLX W/TNDSC US-GID FINE NDL ASPIR/BX,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43235,CPT,UPPER GI NDSC DX W/WO COLLECTION SPECIMEN,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43236,CPT,UPPER GI NDSC W/SUBMUCOSAL INJECTION,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43237,CPT,UPR GI NDSC & US NDSC EXAM LMTD ESOPHAGUS,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43238,CPT,UPR GI NDSC TNDSC US FINE NDL ASPIR/BX ESOPH,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43239,CPT,UPPER NDSC BIOPSY SINGLE/MULTIPLE,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43240,CPT,UPR GI NDSC TRANSMURAL DRAINAGE PSEUDOCYST,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43241,CPT,UPR GI NDSC TNDSC INTRALUMINAL TUBE/CATH PLMT,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43242,CPT,UPPER GI NDSC ULTRASOUND GUIDED BIOPSY,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43243,CPT,UPR GI NDSC NJX SCLEROSIS ESOPHGL&/GSTR VARICE,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43244,CPT,UPR GI NDSC BAND LIG ESOPHGL&/GSTR VARICES,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43245,CPT,UPR GI NDSC DILAT GSTR OUTLET FOR OBSTRCJ,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43246,CPT,UPR GI NDSC PLMT PRQ GASTROSTOMY TUBE,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43247,CPT,UPPER GI NDSC W/FOREIGN BODY REMOVAL,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43248,CPT,UPR GI NDSC INSJ GUIDE WIRE DILAT ESOPHAGUS,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43249,CPT,UPR GI NDSC BALLOON DILAT ESOPH <30 MM DIAM,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43250,CPT,UPR GI NDSC RMVL LESION HOT BX/BIPOLAR CAUTERY,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43251,CPT,UPR GI NDSC RMVL TUM POLYP/OTH LES SNARE TQ,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43252,CPT,UPR GI W/OPTICAL ENDOMICROSCOPY,,30,,,"$4,680.05",$0.00,1,0,1,20130101, 43255,CPT,UPR GI NDSC CONTROL BLEEDING ANY METHOD,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43256,CPT,UPR GI NDSC TNDSC STENT PLMT W/PREDILAT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 43257,CPT,UPR GI NDSC DLVR THERMAL NRG SPHNCTR/CARDIA,,30,,,"$10,520.78",$0.00,1,0,1,20130101, 43258,CPT,UPR GI NDSC ABLTJ LES X RMVL FORCEPS/CAUT/SNARE,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43259,CPT,UPPER GI NDSC W/NDSC ULTRASOUND EXAM,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43260,CPT,ERCP DX W/WO COLLJ SPEC BRUSHING/WASHING SPX,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43261,CPT,ERCP W/BIOPSY SINGLE/MULTIPLE,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43262,CPT,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43263,CPT,ERCP W/PRESSURE MEAS SPHINCTER ODDI,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43264,CPT,ERCP W/RMVCALCULI BILIARY&/PANCREATIC DUCTS,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43265,CPT,ERCP W/DSTRJ LITHOTRIPSY CALCULI ANY METHOD,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43267,CPT,ERCP W/INSJ NASOBILIARY/NASOPNCRTC DRAINAGE TUBE,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43268,CPT,ERCP W/INSJ TUBE/STENT BILE/PANCREATIC DUCT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 43269,CPT,ERCP W/RTRGR RMVL FB&/CHNG TUBE/STENT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 43271,CPT,ERCP W/BALO DILAT AMPULLA BILIARY&/PNCRTC DUX,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43272,CPT,ERCP W/ABLTJ LES X RMVL FORCEPS/CAUT/SNARE,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43273,CPT,ENDOSCOPIC PAPILLA CANNULATION BILE PANCREATIC,,30,,,"$9,691.66",$0.00,1,0,1,20130101, 43280,CPT,LAPS SURG ESOPG/GSTR FUNDOPLASTY,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 43281,CPT,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 43289,CPT,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 43420,CPT,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 43450,CPT,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,,30,,,"$2,720.07",$0.00,1,0,1,20130101, 43453,CPT,DILATION ESOPHAGUS GUIDE WIRE,,30,,,"$2,720.07",$0.00,1,0,1,20130101, 43456,CPT,DILAT ESOPHAGUS BALLOON/DILATOR RETROGRADE,,30,,,"$2,720.07",$0.00,1,0,1,20130101, 43458,CPT,DILAT ESOPH BALLOON 30 MM DIAM/> ACHALASIA,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 43499,CPT,UNLISTED PROCEDURE ESOPHAGUS,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43510,CPT,GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43647,CPT,LAPS IMPLTJ/RPLCMT GASTRIC NSTIM ELTRD ANTRUM,,30,,,"$23,456.98",$0.00,1,0,1,20130101, 43648,CPT,LAPS REVISION/RMVL GASTRIC NSTIM ELTRD ANTRUM,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 43651,CPT,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 43652,CPT,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 43653,CPT,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 43659,CPT,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 43752,CPT,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,,30,,,$722.77,$0.00,1,0,1,20130101, 43753,CPT,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,,30,,,$317.65,$0.00,1,0,1,20130101, 43754,CPT,GASTRIC INTUBAT DX W/ASPIRATION SINGLE SPECIMEN,,30,,,$317.65,$0.00,1,0,1,20130101, 43755,CPT,GASTRIC INTUBATION DX & ASPIRATJ MULTIPLE SPEC,,30,,,$434.94,$0.00,1,0,1,20130101, 43756,CPT,DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN,,30,,,$722.77,$0.00,1,0,1,20130101, 43757,CPT,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,,30,,,$722.77,$0.00,1,0,1,20130101, 43760,CPT,CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE,,30,,,"$1,108.56",$0.00,1,0,1,20130101, 43761,CPT,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43770,CPT,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,,30,,,"$21,514.33",$0.00,1,0,1,20130101, 43775,CPT,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,,30,,,"$19,460.02",$0.00,1,0,1,20130101, 43830,CPT,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,,30,,,"$10,520.78",$0.00,1,0,1,20130101, 43831,CPT,GASTROSTOMY OPN NEONATAL FEEDING,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 43870,CPT,CLOSURE GASTROSTOMY SURG,,30,,,"$10,520.78",$0.00,1,0,1,20130101, 43886,CPT,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 43887,CPT,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,,30,,,"$6,194.26",$0.00,1,0,1,20130101, 43888,CPT,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 43999,CPT,UNLISTED PROCEDURE STOMACH,,30,,,"$3,467.85",$0.00,1,0,1,20130101, 44100,CPT,BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 44180,CPT,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 44186,CPT,LAPAROSCOPY SURGICAL JEJUNOSTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 44206,CPT,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 44207,CPT,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 44208,CPT,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 44213,CPT,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 44238,CPT,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 44312,CPT,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 44340,CPT,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,,30,,,"$8,490.34",$0.00,1,0,1,20130101, 44360,CPT,ENDOSCOPY UPPER SMALL INTESTINE,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44361,CPT,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44363,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44364,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44365,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44366,CPT,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44369,CPT,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44370,CPT,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 44372,CPT,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44373,CPT,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44376,CPT,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44377,CPT,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44378,CPT,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,,30,,,"$6,268.41",$0.00,1,0,1,20130101, 44379,CPT,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 44380,CPT,ILEOSCOPY STOMA DX W/WO COLLJ SPEC BR/WA SPX,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44382,CPT,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 44383,CPT,ILEOSCOPY STOMA W/TNDSC STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 44385,CPT,NDSC EVAL INTSTINAL POUCH DX W/WO COLLJ SPEC SPX,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44386,CPT,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44388,CPT,COLONOSCOPY STOMA DX W/WO COLLJ SPEC SPX,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44389,CPT,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44390,CPT,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44391,CPT,COLONOSCOPY STOMA CONTROL BLEEDING,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44392,CPT,COLONOSCOPY STOMA RMVL LESION CAUTERY,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44393,CPT,COLONOSCOPY STOMA ABLATION LESION,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44394,CPT,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 44397,CPT,COLONOSCOPY STOMA W/TNDSC STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 44500,CPT,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 44799,CPT,UNLISTED PROCEDURE INTESTINE,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 44901,CPT,I&D APPENDICEAL ABSC PRQ,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 44950,CPT,APPENDECTOMY,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 44955,CPT,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 44970,CPT,LAPAROSCOPIC APPENDECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 44979,CPT,UNLISTED LAPAROSCOPY PROCEDURE APPENDIX,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 45000,CPT,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45005,CPT,I&D SUBMUCOSAL ABSCESS RECTUM,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45020,CPT,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45100,CPT,BX ANORECTAL WALL ANAL APPROACH,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45108,CPT,ANORECTAL MYOMECTOMY,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45150,CPT,DIVISION STRICTURE RECTUM,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45160,CPT,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45171,CPT,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45172,CPT,EXC RCT TUM INCL MUSCULARIS PROPRIA,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 45190,CPT,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45300,CPT,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 45303,CPT,PROCTOSGMDSC RIGID W/DILATION,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45305,CPT,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45307,CPT,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,,30,,,"$8,894.76",$0.00,1,0,1,20130101, 45308,CPT,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45309,CPT,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45315,CPT,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45317,CPT,PROCTOSGMDSC RIGID CONTROL BLEEDING,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45320,CPT,PROCTOSGMDSC RIGID ABLATION LESION,,30,,,"$8,894.76",$0.00,1,0,1,20130101, 45321,CPT,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,,30,,,"$8,894.76",$0.00,1,0,1,20130101, 45327,CPT,PROCTOSGMDSC RIGID TNDSC STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 45330,CPT,SIGMOIDOSCOPY FLX DX W/WO COLLJ SPECIMENS,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 45331,CPT,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 45332,CPT,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 45333,CPT,SIGMOIDOSCOPY FLX W/RMVL TUMOR CAUTERY,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 45334,CPT,SIGMOIDOSCOPY FLX CONTROL BLEEDING,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45335,CPT,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 45337,CPT,SGMDSC FLX DCMPRN VOLVULUS ANY METHOD,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45338,CPT,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45339,CPT,SIGMOIDOSCOPY FLX ABLTJ LESION,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45340,CPT,SIGMOIDOSCOPY FLX DILAT BALO 1/MORE STRIXS,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45341,CPT,SIGMOIDOSCOPY FLX NDSC US XM,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45342,CPT,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 45345,CPT,SIGMOIDOSCOPY FLX TNDSC STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 45355,CPT,COLSC RGD/FLX TABDL VIA COLOTOMY 1/MLT,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45378,CPT,COLONOSCOPY FLX DX W/WO COLLJ SPECIMENS,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45379,CPT,COLSC FLX PROX SPLENIC FLXR RMVL FB,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45380,CPT,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45381,CPT,COLSC FLX PROX SPLENIC FLXR SBMCSL NJX,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45382,CPT,COLSC FLX PROX SPLENIC FLXR CTRL BLD,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45383,CPT,COLSC FLX PROX SPLENIC FLXR ABLTJ LES,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45384,CPT,COLSC FLX PROX SPLENIC FLXR RMVL LES CAUT,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45385,CPT,COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45386,CPT,COLSC FLX PROX SPLENIC FLXR DILAT BALO 1/> STRI,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45387,CPT,COLSC FLX PROX SPLENIC FLXR TNDSC STENT PLMT,,30,,,"$11,740.56",$0.00,1,0,1,20130101, 45391,CPT,COLSC FLX PROX SPLENIC FLXR NDSC US XM,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45392,CPT,COLSC FLX PROX SPLENIC FLXR US GID NDL ASPIR/BX,,30,,,"$3,870.54",$0.00,1,0,1,20130101, 45499,CPT,UNLISTED LAPAROSCOPY PROCEDURE RECTUM,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 45500,CPT,PROCTOPLASTY STENOSIS,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 45505,CPT,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 45520,CPT,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,,30,,,$385.85,$0.00,1,0,1,20130101, 45541,CPT,PROCTOPEXY PERINEAL APPROACH,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 45560,CPT,REPAIR RECTOCELE SEPARATE PROCEDURE,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 45900,CPT,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 45905,CPT,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45910,CPT,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45915,CPT,RMVL FECAL IMPACTION/FB SPX UNDER ANES,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45990,CPT,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 45999,CPT,UNLISTED PROCEDURE RECTUM,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46020,CPT,PLACEMENT SETON,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46030,CPT,REMOVAL ANAL SETON OTHER MARKER,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46040,CPT,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46045,CPT,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46050,CPT,I&D PERIANAL ABSCESS SUPERFICIAL,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46060,CPT,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46070,CPT,INCISION ANAL SEPTUM INFANT,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46080,CPT,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46083,CPT,INCISION THROMBOSED HEMORRHOID EXTERNAL,,30,,,$845.70,$0.00,1,0,1,20130101, 46200,CPT,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46220,CPT,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46221,CPT,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46230,CPT,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46250,CPT,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46255,CPT,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46257,CPT,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46258,CPT,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46260,CPT,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46261,CPT,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46262,CPT,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46270,CPT,SURG TX ANAL FISTULA SUBQ,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46275,CPT,SURG TX ANAL FISTULA INTERSPHINCTERIC,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46280,CPT,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46285,CPT,SURG TX ANAL FISTULA 2ND STAGE,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46288,CPT,CLSR ANAL FSTL W/RCT ADVMNT FLAP,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46320,CPT,EXC THROMBOSED HEMORRHOID XTRNL,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46500,CPT,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46505,CPT,CHEMODENERVATION INTERNAL ANAL SPHINCTER,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46600,CPT,ANOSCOPY DX W/WO COLLJ SPEC BR/WA SPX,,30,,,$317.65,$0.00,1,0,1,20130101, 46604,CPT,ANOSCOPY W/DILATION,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 46606,CPT,ANOSCOPY W/BX SINGLE/MULTIPLE,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 46608,CPT,ANOSCOPY W/RMVL FOREIGN BODY,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 46610,CPT,ANOSCOPY W/RMVL LESION CAUTERY,,30,,,"$8,894.76",$0.00,1,0,1,20130101, 46611,CPT,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,,30,,,"$4,017.53",$0.00,1,0,1,20130101, 46612,CPT,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,,30,,,"$8,894.76",$0.00,1,0,1,20130101, 46614,CPT,ANOSCOPY CONTROL BLEEDING,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 46615,CPT,ANOSCOPY ABLATION LESION,,30,,,"$8,894.76",$0.00,1,0,1,20130101, 46700,CPT,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46706,CPT,REPAIR ANAL FISTULA W/FIBRIN GLUE,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46707,CPT,REPAIR ANORECTAL FISTULA PLUG,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46750,CPT,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46753,CPT,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46754,CPT,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46760,CPT,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46761,CPT,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46762,CPT,SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46900,CPT,DSTRJ LESION ANUS SIMPLE CHEMICAL,,30,,,"$1,224.83",$0.00,1,0,1,20130101, 46910,CPT,DSTRJ LESION ANUS SMPL ELTRDSICCATION,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 46916,CPT,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,,30,,,$385.85,$0.00,1,0,1,20130101, 46917,CPT,DSTRJ LESION ANUS SIMPLE LASER SURG,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 46922,CPT,DSTRJ LESION ANUS SIMPLE SURG EXCISION,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 46924,CPT,DSTRJ LESION ANUS EXTENSIVE,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 46930,CPT,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46940,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 46942,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 46945,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 1 COL/GRP,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46946,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 2/> COL/GRP,,30,,,"$10,247.23",$0.00,1,0,1,20130101, 46947,CPT,HEMORRHOIDOPEXY STAPLING,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 46999,CPT,UNLISTED PROCEDURE ANUS,,30,,,"$2,524.22",$0.00,1,0,1,20130101, 47000,CPT,BIOPSY LIVER NEEDLE PERCUTANEOUS,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 47011,CPT,HEPATOTOMY PRQ DRG ABSCESS/CYST 1/2 STAGES,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 47370,CPT,LAPS SURG ABLTJ 1/> LVR TUM RF,,30,,,"$21,901.75",$0.00,1,0,1,20130101, 47371,CPT,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,,30,,,"$21,901.75",$0.00,1,0,1,20130101, 47379,CPT,UNLIS LAPAROSCOPIC PROCEDURE LIVER,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 47382,CPT,ABLTJ 1/> LVR TUM PRQ RF,,30,,,"$19,012.98",$0.00,1,0,1,20130101, 47399,CPT,UNLISTED PROCEDURE LIVER,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 47490,CPT,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47510,CPT,INTRO PRQ TRANSHEPATC CATH BILIARY DRG,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47511,CPT,INTRODUCJ PERCUT TRANSHEPATC STENT BILIARY DRG,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47525,CPT,CHANGE PERCUTANEOUS BILIARY DRAINAGE CATHETER,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 47530,CPT,REVISION &/REINSERTION TRANSHEPATC TUBE,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 47552,CPT,BILIARY NDSC PRQ T-TUBE DX W/WO COLLJ SPEC SPX,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47553,CPT,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47554,CPT,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47555,CPT,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47556,CPT,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,,30,,,"$19,012.98",$0.00,1,0,1,20130101, 47560,CPT,LAPS SURG W/GID TRANSHEPATC CHOLANGRPH W/O BX,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 47561,CPT,LAPS SURG W/GID TRANSHEPATC CHOLANGRPH W/BX,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 47562,CPT,LAPAROSCOPY SURG CHOLECYSTECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 47563,CPT,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 47564,CPT,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 47579,CPT,UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 47630,CPT,BILIARY DUCT STONE XTRJ PRQ VIA BASKET/SNARE,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 47999,CPT,UNLISTED PROCEDURE BILIARY TRACT,,30,,,"$11,013.27",$0.00,1,0,1,20130101, 48102,CPT,BIOPSY PANCREA PERCUTANEOUS NEEDLE,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 48511,CPT,XTRNL DRG PSEUDOCYST PANCREAS PRQ,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 48999,CPT,UNLISTED PROCEDURE PANCREAS,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 49021,CPT,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS PRQ,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 49041,CPT,DRG SUBDIAPHRAGMATIC/SUBPHRENIC ABSCESS PRQ,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 49061,CPT,DRG RETROPERITONEAL ABSCESS PERCUTANEOUS,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 49082,CPT,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 49083,CPT,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 49084,CPT,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,,30,,,"$2,309.04",$0.00,1,0,1,20130101, 49180,CPT,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 49250,CPT,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 49320,CPT,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49321,CPT,LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49322,CPT,LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49323,CPT,LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49324,CPT,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49325,CPT,LAPS W/REVISION INTRAPERITONEAL CATHETER,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49326,CPT,LAPAROSCOPY W/OMENTOPEXY,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49327,CPT,LAPS W/INSERTION NTRSTL DEV W/IMG GID 1/MLT,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49329,CPT,UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49402,CPT,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 49411,CPT,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,,30,,,"$5,975.13",$0.00,1,0,1,20130101, 49418,CPT,INSJ INTRAPERITONEAL CATHETER W/IMG GID,,30,,,"$12,448.66",$0.00,1,0,1,20130101, 49419,CPT,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,,30,,,"$14,783.54",$0.00,1,0,1,20130101, 49421,CPT,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,,30,,,"$12,448.66",$0.00,1,0,1,20130101, 49422,CPT,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 49423,CPT,EXCHNG ABSC/CST DRG CATH RAD GID SPX,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 49426,CPT,REVIS PERITONEAL-VENOUS SHUNT,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 49429,CPT,RMVL PERITONEAL-VENOUS SHUNT,,30,,,"$9,857.59",$0.00,1,0,1,20130101, 49435,CPT,INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 49436,CPT,DELAYED CREATION EXIT SITE EMBEDDED CATHETER,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 49440,CPT,INSERT GASTROSTOMY TUBE PERCUTANEOUS,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 49441,CPT,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 49442,CPT,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,,30,,,"$7,236.97",$0.00,1,0,1,20130101, 49446,CPT,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 49450,CPT,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 49451,CPT,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 49452,CPT,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 49460,CPT,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 49465,CPT,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,,30,,,$794.32,$0.00,1,0,1,20130101, 49491,CPT,RPR 1ST INGUN HRNA PRETERM INFT RDC,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49492,CPT,RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49495,CPT,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49496,CPT,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49500,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49501,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49505,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49507,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49520,CPT,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49521,CPT,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49525,CPT,RPR INGUN HERNIA SLIDING ANY AGE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49540,CPT,REPAIR LUMBAR HERNIA,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49550,CPT,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49553,CPT,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49555,CPT,RPR RECRT FEM HERNIA REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49557,CPT,RPR RECRT FEM HRNA INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49560,CPT,REPAIR FIRST ABDOMINAL WALL HERNIA,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49561,CPT,RPR 1ST INCAL/VNT HERNIA INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49565,CPT,RPR RECRT INCAL/VNT HERNIA REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49566,CPT,RPR RECRT INCAL/VNT HERNIA INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49568,CPT,IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49570,CPT,RPR EPIGASTRIC HERNIA REDUCIBLE SPX,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49572,CPT,RPR EPIGASTRIC HERNIA INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49580,CPT,RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49582,CPT,RPR UMBILICAL HERNIA < 5 YRS INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49585,CPT,RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49587,CPT,RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49590,CPT,RPR SPIGELIAN HERNIA,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49600,CPT,RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 49650,CPT,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 49651,CPT,LAPS SURG RPR RECURRENT INGUINAL HERNIA,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 49652,CPT,LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 49653,CPT,LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 49654,CPT,LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 49655,CPT,LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 49656,CPT,LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 49657,CPT,LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 49659,CPT,UNLIS LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 49999,CPT,UNLISTED PROCEDURE ABDOMEN PERITONEUM & OMENTUM,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 50020,CPT,DRAINAGE PERIRENAL/RENAL ABSCESS OPEN,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50021,CPT,DRAINAGE PERIRENAL/RENAL ABSCESS PRW,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 50080,CPT,PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY 2 CM,,30,,,"$16,443.42",$0.00,1,0,1,20130101, 50200,CPT,RENAL BIOPSY PRQ TROCAR/NEEDLE,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 50382,CPT,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50384,CPT,REMOVAL INDWELLING URETERAL STENT PRQ,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 50385,CPT,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50386,CPT,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50387,CPT,RMVL & RPLCMT XTRNLLY ACCESSIBLE URETERAL STENT,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 50389,CPT,RMVL NFROS TUBE REQ FLUORO GUIDANCE,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50390,CPT,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 50391,CPT,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,,30,,,$511.00,$0.00,1,0,1,20130101, 50392,CPT,INTRO INTRACATH/CATH IN RNL PELVIS DRG&/NJX PRQ,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 50393,CPT,INTRO URETER CATH/STNT RENAL PELVIS DRG&/NJX,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50395,CPT,INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50396,CPT,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,,30,,,$845.70,$0.00,1,0,1,20130101, 50398,CPT,CHANGE NEPHROSTOMY/PYELOSTOMY TUBE,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 50541,CPT,LAPAROSCOPY SURG ABLATION RENAL CYSTS,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 50542,CPT,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,,30,,,"$21,901.75",$0.00,1,0,1,20130101, 50543,CPT,LAPAROSCOPY SURG PARTIAL NEPHRECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 50544,CPT,LAPAROSCOPY SURG PYELOPLASTY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 50549,CPT,UNLISTED LAPAROSCOPY PROCEDURE RENAL,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 50551,CPT,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50553,CPT,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50555,CPT,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50557,CPT,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50561,CPT,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50562,CPT,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50570,CPT,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50572,CPT,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50574,CPT,RENAL NDSC NEPHROTOMY W/BIOPSY,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50575,CPT,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 50576,CPT,RNL NDSC NFROT FULGURATION &/INCISION W/WO BX,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 50580,CPT,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 50590,CPT,LITHOTRIPSY XTRCORP SHOCK WAVE,,30,,,"$14,886.55",$0.00,1,0,1,20130101, 50592,CPT,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,,30,,,"$19,012.98",$0.00,1,0,1,20130101, 50593,CPT,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,,30,,,"$19,012.98",$0.00,1,0,1,20130101, 50686,CPT,MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH,,30,,,$511.00,$0.00,1,0,1,20130101, 50688,CPT,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 50727,CPT,REVJ URINARY-CUTANEOUS ANASTAMOSIS,,30,,,"$8,017.52",$0.00,1,0,1,20130101, 50945,CPT,LAPAROSCOPY URTROLITHOTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 50947,CPT,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 50948,CPT,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 50949,CPT,UNLISTED LAPAROSCOPY PROCEDURE URETER,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 50951,CPT,URETERAL ENDOSCOPY VIA URETEROSTOMY,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50953,CPT,URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50955,CPT,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50957,CPT,URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50961,CPT,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 50970,CPT,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50972,CPT,NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 50974,CPT,URETERAL ENDOSCOPY VIA URETEROT W/O IMAGING W/BX,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 50976,CPT,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 50980,CPT,NDSC URETEROTOMY RMVL FB/CALCULUS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51020,CPT,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51030,CPT,CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51040,CPT,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51045,CPT,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 51050,CPT,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51060,CPT,TRANSVESICAL URETROLITHOTOMY,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 51065,CPT,CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51080,CPT,DRG PRIVESICAL/PREVESICAL SPACE ABSC,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 51100,CPT,ASPIRATION BLADDER NEEDLE,,30,,,$845.70,$0.00,1,0,1,20130101, 51101,CPT,ASPIRATION BLADDER TROCAR/INTRACATHETER,,30,,,$511.00,$0.00,1,0,1,20130101, 51102,CPT,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,,30,,,"$8,017.52",$0.00,1,0,1,20130101, 51500,CPT,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 51520,CPT,CYSTOTOMY SIMPLE EXCISION VESICAL NECK,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51535,CPT,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51700,CPT,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,,30,,,$845.70,$0.00,1,0,1,20130101, 51701,CPT,INSJ NON-NDWELLG BLADDER CATHETER,,30,,,$317.65,$0.00,1,0,1,20130101, 51702,CPT,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,,30,,,$317.65,$0.00,1,0,1,20130101, 51703,CPT,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,,30,,,$511.00,$0.00,1,0,1,20130101, 51705,CPT,CHANGE CYSTOSTOMY TUBE SIMPLE,,30,,,$845.70,$0.00,1,0,1,20130101, 51710,CPT,CHANGE CYSTOSTOMY TUBE COMPLICATED,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 51715,CPT,NDSC NJX IMPLT MATRL URT&/BLDR NCK,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 51720,CPT,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 51725,CPT,SIMPLE CYSTOMETROGRAM,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 51736,CPT,SIMPLE UROFLOMETRY,,30,,,$317.65,$0.00,1,0,1,20130101, 51741,CPT,COMPLEX UROFLOMETRY,,30,,,$511.00,$0.00,1,0,1,20130101, 51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,,30,,,$511.00,$0.00,1,0,1,20130101, 51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,,30,,,$845.70,$0.00,1,0,1,20130101, 51792,CPT,STIMULUS EVOKED RESPONSE,,30,,,$511.00,$0.00,1,0,1,20130101, 51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,,30,,,$845.70,$0.00,1,0,1,20130101, 51798,CPT,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,,30,,,$317.65,$0.00,1,0,1,20130101, 51845,CPT,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 51860,CPT,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51880,CPT,CLOSURE CYSTOSTOMY SEPARATE PROCEDURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 51990,CPT,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 51992,CPT,LAPAROSCOPY SLING OPERATION STRESS INCONT,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 51999,CPT,UNLISTED LAPAROSCOPY PROCEDURE BLADDER,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 52000,CPT,CYSTOURETHROSCOPY,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 52001,CPT,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 52005,CPT,CYSTO BLADDER W/URETERAL CATHETERIZATION,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52007,CPT,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52010,CPT,CYSTO W/EJACULATORY DUCT CATHETERIZATION,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 52204,CPT,CYSTOURETHROSCOPY WITH BIOPSY,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52214,CPT,CYSTO W/DESTRUCTION OF LESIONS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52224,CPT,CYSTO W/REMOVAL OF LESIONS SMALL,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52234,CPT,CYSTO W/REMOVAL OF TUMORS SMALL,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52235,CPT,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52240,CPT,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52250,CPT,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52260,CPT,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 52265,CPT,CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA,,30,,,"$2,961.52",$0.00,1,0,1,20130101, 52270,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 52275,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52276,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52277,CPT,CYSTOURETHROSCOPY W/RESECJ EXTERNAL SPHINCTER,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52281,CPT,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 52282,CPT,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 52283,CPT,CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52285,CPT,CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 52287,CPT,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,,30,,,"$6,341.69",$0.00,1,0,1,20130101, 52290,CPT,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52300,CPT,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52301,CPT,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52305,CPT,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52310,CPT,CYSTO W/SIMPLE REMOVAL STONE & STENT,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 52315,CPT,CYSTO W/COMPLEX REMOVAL STONE & STENT,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52317,CPT,LITHOLAPAXY SMPL/SM <2.5 CM,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52318,CPT,LITHOLAPAXY COMP/LG > 2.5 CM,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52320,CPT,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52325,CPT,CYSTO FRAGMENTATION URETERAL STONE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52327,CPT,CYSTO W/SUBURTRIC NJX IMPLT MATRL,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 52330,CPT,CYSTO MANJ W/O RMVL URETERAL STONE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52332,CPT,CYSTO W/INSERT URETERAL STENT,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52334,CPT,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52341,CPT,CYSTO W/TX URETERAL STRICTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52342,CPT,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52343,CPT,CYSTO W/TX INTRA-RENAL STRICTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52344,CPT,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52345,CPT,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52346,CPT,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52351,CPT,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52352,CPT,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52353,CPT,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 52354,CPT,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52355,CPT,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52400,CPT,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52402,CPT,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52450,CPT,TRANSURETHRAL INCISION PROSTATE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52500,CPT,TRANSURETHRAL RESECTION PROSTATE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52601,CPT,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 52630,CPT,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 52640,CPT,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 52647,CPT,LASER COAGULATION OF PROSTATE FOR URINE FLOW,,30,,,"$16,443.42",$0.00,1,0,1,20130101, 52648,CPT,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,,30,,,"$16,443.42",$0.00,1,0,1,20130101, 52649,CPT,LASER ENUCLEATION PROSTATE W/MORCELLATION,,30,,,"$16,443.42",$0.00,1,0,1,20130101, 52700,CPT,TRURL DRAINAGE PROSTATIC ABSCESS,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 53000,CPT,URTT/URTS XTRNL SPX PENDULOUS URETHRA,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53010,CPT,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53020,CPT,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53025,CPT,MEATOTOMY CUTTING MEATUS SPX INFANT,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53040,CPT,DRAINAGE DEEP PERIURETHRAL ABSCESS,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53060,CPT,DRG OF SKENE'S GLAND ABSCESS OR CYST,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53080,CPT,DRG PERINEAL URINARY XTRVASATION UNCOMP SPX,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53085,CPT,DRG PERINEAL URINARY XTRVASATION COMPLIC,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53200,CPT,BIOPSY URETHRA,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53210,CPT,URETHRECTOMY TOT W/CYSTOST FEMALE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53215,CPT,URETHRECTOMY TOT W/CYSTOST MALE,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53220,CPT,EXC/FULGURATION CARCINOMA URETHRA,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53230,CPT,EXC URETHRAL DIVERTICULUM SPX FEMALE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53235,CPT,EXC URETHRAL DIVERTICULUM SPX MALE,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53240,CPT,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53250,CPT,EXCISION OF BULBOURETHRAL GLAND,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53260,CPT,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53265,CPT,EXC/FULGURATION URETHRAL CARUNCLE,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53270,CPT,EXCISION OR FULGURATION SKENES GLANDS,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53275,CPT,EXCISION/FULGURATION URETHRAL PROLAPSE,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53400,CPT,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53405,CPT,URETHROPLASTY 2ND STAGE W/URINARY DIVERSION,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53410,CPT,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53420,CPT,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53425,CPT,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53430,CPT,URETHROPLASTY RCNSTJ FEMALE URETHRA,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53431,CPT,URTP W/TUBULARIZATION POST URT&/LWR BLDR,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53440,CPT,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,,30,,,"$23,407.69",$0.00,1,0,1,20130101, 53442,CPT,RMVL/REVJ SLING MALE URINARY INCONTINENCE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53444,CPT,INSERTION TANDEM CUFF,,30,,,"$23,407.69",$0.00,1,0,1,20130101, 53445,CPT,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,,30,,,"$25,081.08",$0.00,1,0,1,20130101, 53446,CPT,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53447,CPT,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,,30,,,"$25,081.08",$0.00,1,0,1,20130101, 53449,CPT,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53450,CPT,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53460,CPT,URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53500,CPT,URETHROLSS TRVG SEC OPN W/CSTO,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53502,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53505,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53510,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53515,CPT,URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53520,CPT,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,,30,,,"$12,928.90",$0.00,1,0,1,20130101, 53600,CPT,DILAT URETHRAL STRIX DILATOR MALE 1ST,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 53601,CPT,DILAT URETHRAL STRIX DILATOR MALE SBSQ,,30,,,$511.00,$0.00,1,0,1,20130101, 53605,CPT,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 53620,CPT,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,,30,,,"$8,017.52",$0.00,1,0,1,20130101, 53621,CPT,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,,30,,,$845.70,$0.00,1,0,1,20130101, 53660,CPT,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,,30,,,$511.00,$0.00,1,0,1,20130101, 53661,CPT,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,,30,,,$511.00,$0.00,1,0,1,20130101, 53665,CPT,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 53850,CPT,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,,30,,,"$16,443.42",$0.00,1,0,1,20130101, 53852,CPT,TRURL DSTRJ PRSTATE TISS RF THERMOTH,,30,,,"$16,443.42",$0.00,1,0,1,20130101, 53855,CPT,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,,30,,,$845.70,$0.00,1,0,1,20130101, 53860,CPT,TRURL RF FEMALE BLADDER NECK STRS URIN INCONT,,30,,,"$8,017.52",$0.00,1,0,1,20130101, 53899,CPT,UNLISTED PROCEDURE URINARY SYSTEM,,30,,,$511.00,$0.00,1,0,1,20130101, 54000,CPT,SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 54001,CPT,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,,30,,,"$8,708.71",$0.00,1,0,1,20130101, 54015,CPT,I&D PENIS DEEP,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 54050,CPT,DSTRJ LESION PENIS SIMPLE CHEMICAL,,30,,,$385.85,$0.00,1,0,1,20130101, 54055,CPT,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 54056,CPT,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,,30,,,$258.15,$0.00,1,0,1,20130101, 54057,CPT,DSTRJ LESION PENIS SIMPLE LASER,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 54060,CPT,DSTRJ LESION PENIS SIMPLE SURG EXCISION,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 54065,CPT,DSTRJ LESION PENIS EXTENSIVE,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 54100,CPT,BIOPSY PENIS SEPARATE PROCEDURE,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 54105,CPT,BIOPSY PENIS DEEP STRUCTURES,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 54110,CPT,EXCISION OF PENILE PLAQUE,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54111,CPT,EXC PENILE PLAQUE GRAFT &/5 CM LENGTH,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54112,CPT,EXC PENILE PLAQUE GRAFT > 5 CM LENGTH,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54115,CPT,REMOVAL FOREIGN BODY DEEP PENILE TISSUE,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 54120,CPT,AMPUTATION PENIS PARTIAL,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54150,CPT,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54160,CPT,CIRCUMCISION NEONATE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54161,CPT,CIRCUMCISION AGE >28 DAYS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54162,CPT,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54163,CPT,REPAIR INCOMPLETE CIRCUMCISION,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54164,CPT,FRENULOTOMY PENIS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54200,CPT,INJECTION PEYRONIE DISEASE,,30,,,$845.70,$0.00,1,0,1,20130101, 54205,CPT,NJX PEYRONIE W/SURG EXPOS PLAQUE,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54220,CPT,IRRIGATION CORPORA CAVERNOSA PRIAPISM,,30,,,$845.70,$0.00,1,0,1,20130101, 54231,CPT,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,,30,,,"$8,017.52",$0.00,1,0,1,20130101, 54235,CPT,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,,30,,,$845.70,$0.00,1,0,1,20130101, 54240,CPT,PENILE PLETHYSMOGRAPY,,30,,,$511.00,$0.00,1,0,1,20130101, 54250,CPT,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,,30,,,$845.70,$0.00,1,0,1,20130101, 54300,CPT,PENIS STRAIGHTENING CHORDEE,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54304,CPT,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54308,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54312,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54316,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54318,CPT,URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54322,CPT,1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54324,CPT,1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54326,CPT,1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54328,CPT,1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54332,CPT,1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54336,CPT,1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54340,CPT,RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54344,CPT,RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54348,CPT,RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54352,CPT,RPR HYPOSPADIAS CRIPPLE W/DSJ & EXC & GRFS/FLAP,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54360,CPT,PLASTIC RPR PENIS CORRECT ANGULATION,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54380,CPT,PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54385,CPT,PLASTIC PENIS EPISPADIAS DSTL SPHNCTR W/INCONT,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54400,CPT,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,,30,,,"$23,407.69",$0.00,1,0,1,20130101, 54401,CPT,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,,30,,,"$25,081.08",$0.00,1,0,1,20130101, 54405,CPT,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,,30,,,"$25,081.08",$0.00,1,0,1,20130101, 54406,CPT,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54408,CPT,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54410,CPT,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,,30,,,"$25,081.08",$0.00,1,0,1,20130101, 54415,CPT,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54416,CPT,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,,30,,,"$25,081.08",$0.00,1,0,1,20130101, 54420,CPT,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54435,CPT,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54440,CPT,PLASTIC OPERATION PENIS INJURY,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54450,CPT,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 54500,CPT,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,,30,,,"$6,283.93",$0.00,1,0,1,20130101, 54505,CPT,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54512,CPT,EXC XTRPARENCHYMAL LESION TESTIS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54520,CPT,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54522,CPT,ORCHIECTOMY PARTIAL,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54530,CPT,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 54535,CPT,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,,30,,,"$14,315.47",$0.00,1,0,1,20130101, 54550,CPT,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 54560,CPT,EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54600,CPT,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54620,CPT,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54640,CPT,ORCHIOPEXY INGUINAL APPROACH W/WO HERNIA RPR,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 54650,CPT,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 54660,CPT,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54670,CPT,SUTURE/REPAIR TESTICULAR INJURY,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54680,CPT,TRANSPLANTATION TESTIS TO THIGH,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54690,CPT,LAPAROSCOPY SURGICAL ORCHIECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 54692,CPT,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 54699,CPT,UNLISTED LAPAROSCOPY PROCEDURE TESTIS,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 54700,CPT,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54800,CPT,BIOPSY EPIDIDYMIS NEEDLE,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 54830,CPT,EXCISION LOCAL LESION EPIDIDYMIS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54840,CPT,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54860,CPT,EPIDIDYMECTOMY UNILATERAL,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54861,CPT,EPIDIDYMECTOMY BILATERAL,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54865,CPT,EXPLORATION EPIDIDYMIS W/WO BIOPSY,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54900,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 54901,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55000,CPT,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 55040,CPT,EXCISION HYDROCELE UNILATERAL,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 55041,CPT,EXCISION HYDROCELE BILATERAL,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 55060,CPT,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55100,CPT,DRAINAGE SCROTAL WALL ABSCESS,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 55110,CPT,SCROTAL EXPLORATION,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55120,CPT,REMOVAL FOREIGN BODY SCROTUM,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55150,CPT,RESECTION SCROTUM,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55175,CPT,SCROTOPLASTY SIMPLE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55180,CPT,SCROTOPLASTY COMPLICATED,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55200,CPT,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55250,CPT,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55400,CPT,VASOVASOSTOMY VASOVASORRHAPHY,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55450,CPT,LIGATION PRQ VAS DEFERENS UNI/BI SPX,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55500,CPT,EXC HYDROCELE SPRMATIC CORD UNI SPX,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55520,CPT,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55530,CPT,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55535,CPT,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 55540,CPT,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,,30,,,"$12,104.59",$0.00,1,0,1,20130101, 55550,CPT,LAPS LIGATION SPERMATIC VEINS VARICOCELE,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 55559,CPT,UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 55600,CPT,VESICULOTOMY,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55680,CPT,EXCISION MULLERIAN DUCT CYST,,30,,,"$9,527.41",$0.00,1,0,1,20130101, 55700,CPT,PROSTATE NEEDLE BIOPSY ANY APPROACH,,30,,,"$5,439.35",$0.00,1,0,1,20130101, 55705,CPT,BIOPSY PROSTATE INCISIONAL ANY APPROACH,,30,,,"$5,439.35",$0.00,1,0,1,20130101, 55706,CPT,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,,30,,,"$5,439.35",$0.00,1,0,1,20130101, 55720,CPT,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 55725,CPT,PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED,,30,,,"$9,292.79",$0.00,1,0,1,20130101, 55860,CPT,EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST,,30,,,"$8,017.52",$0.00,1,0,1,20130101, 55870,CPT,ELECTROEJACULATION,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 55873,CPT,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,,30,,,"$23,348.61",$0.00,1,0,1,20130101, 55875,CPT,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,,30,,,"$14,451.39",$0.00,1,0,1,20130101, 55876,CPT,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,,30,,,"$5,975.13",$0.00,1,0,1,20130101, 55899,CPT,UNLISTED PROCEDURE MALE GENITAL SYSTEM,,30,,,$511.00,$0.00,1,0,1,20130101, 55920,CPT,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,,30,,,"$9,865.39",$0.00,1,0,1,20130101, 56405,CPT,I&D VULVA/PERINEAL ABSCESS,,30,,,$664.64,$0.00,1,0,1,20130101, 56420,CPT,I&D OF BARTHOLINS GLAND ABSCESS,,30,,,$664.64,$0.00,1,0,1,20130101, 56440,CPT,MARSUPIALIZATION BARTHOLINS GLAND CYST,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56441,CPT,LYSIS LABIAL ADHESIONS,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56442,CPT,HYMENOTOMY SIMPLE INCISION,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56501,CPT,DESTRUCTION LESIONS VULVA SIMPLE,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 56515,CPT,DESTRUCTION LESIONS VULVA EXTENSIVE,,30,,,"$8,009.23",$0.00,1,0,1,20130101, 56605,CPT,BIOPSY VULVA/PERINEUM 1 LESION SPX,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 56606,CPT,BIOPSY VULVA/PERINEUM EACH ADDL LESION,,30,,,$664.64,$0.00,1,0,1,20130101, 56620,CPT,VULVECTOMY SIMPLE PARTIAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56625,CPT,VULVECTOMY SIMPLE COMPLETE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56700,CPT,PRTL HYMENECTOMY/REVJ HYMENAL RING,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56740,CPT,EXC BARTHOLINS GLAND/CYST,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56800,CPT,PLASTIC REPAIR INTROITUS,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56805,CPT,CLITOROPLASTY INTERSEX STATE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56810,CPT,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 56820,CPT,COLPOSCOPY VULVA,,30,,,$664.64,$0.00,1,0,1,20130101, 56821,CPT,COLPOSCOPY VULVA W/BIOPSY,,30,,,$664.64,$0.00,1,0,1,20130101, 57000,CPT,COLPOTOMY W/EXPLORATION,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57010,CPT,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57020,CPT,COLPOCENTESIS SEPARATE PROCEDURE,,30,,,"$2,810.93",$0.00,1,0,1,20130101, 57022,CPT,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 57023,CPT,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,,30,,,"$7,287.78",$0.00,1,0,1,20130101, 57061,CPT,DESTRUCTION VAGINAL LESIONS SIMPLE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57065,CPT,DESTRUCTION VAGINAL LESIONS EXTENSIVE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57100,CPT,BIOPSY VAGINAL MUCOSA SIMPLE,,30,,,"$2,810.93",$0.00,1,0,1,20130101, 57105,CPT,BIOPSY VAGINAL MUCOSA EXTENSIVE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57106,CPT,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57107,CPT,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57109,CPT,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57120,CPT,COLPOCLEISIS LE FORT TYPE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57130,CPT,EXCISION VAGINAL SEPTUM,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57135,CPT,EXCISION VAGINAL CYST/TUMOR,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57150,CPT,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,,30,,,$664.64,$0.00,1,0,1,20130101, 57155,CPT,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,,30,,,"$2,810.93",$0.00,1,0,1,20130101, 57156,CPT,INSERTION VAGINAL RADIATION DEVICE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 57160,CPT,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,,30,,,$664.64,$0.00,1,0,1,20130101, 57170,CPT,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,,30,,,$49.13,$0.00,1,0,1,20130101, 57180,CPT,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,,30,,,$664.64,$0.00,1,0,1,20130101, 57200,CPT,COLPORRHAPHY SUTURE INJURY VAGINA,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57210,CPT,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57220,CPT,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57230,CPT,PLASTIC REPAIR URETHROCELE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57240,CPT,ANT COLPORRHAPHY CYSTOCELE W/WO RPR URETHROCELE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57250,CPT,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57260,CPT,COMBINED ANTEROPOSTERIOR COLPORRHAPHY,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57265,CPT,CMBND ANTEROPOST COLPORRHAPHY W/ENTEROCELE RPR,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57267,CPT,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57268,CPT,REPAIR ENTEROCELE VAGINAL APPROACH SPX,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57282,CPT,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57283,CPT,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57284,CPT,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57285,CPT,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57287,CPT,RMVL/REVJ SLING STRESS INCONTINENCE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57288,CPT,SLING OPERATION STRESS INCONTINENCE,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57289,CPT,PEREYRA PX W/ANTERIOR COLPORRHAPHY,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57291,CPT,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57292,CPT,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57295,CPT,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57300,CPT,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57310,CPT,CLOSURE URETHROVAGINAL FISTULA,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57320,CPT,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57330,CPT,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57335,CPT,VAGINOPLASTY INTERSEX STATE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57400,CPT,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57410,CPT,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57415,CPT,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57420,CPT,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 57421,CPT,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 57423,CPT,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57425,CPT,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 57426,CPT,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57452,CPT,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,,30,,,$664.64,$0.00,1,0,1,20130101, 57454,CPT,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 57455,CPT,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 57456,CPT,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 57460,CPT,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57461,CPT,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57500,CPT,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,,30,,,"$2,810.93",$0.00,1,0,1,20130101, 57505,CPT,ENDOCERVICAL CURETTAGE W/DILATION & CURETTAGE,,30,,,"$2,810.93",$0.00,1,0,1,20130101, 57510,CPT,CAUTERY CERVIX ELECTRO/THERMAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57511,CPT,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,,30,,,$664.64,$0.00,1,0,1,20130101, 57513,CPT,CAUTERY CERVIX LASER ABLATION,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57520,CPT,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57522,CPT,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57530,CPT,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57550,CPT,EXCISION CERVICAL STUMP VAGINAL APPROACH,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57555,CPT,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 57556,CPT,EXC CRV STUMP VAG APPR W/RPR NTRCL,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 57558,CPT,DILATION & CURETTAGE CERVICAL STUMP,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57700,CPT,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57720,CPT,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 57800,CPT,DILATION CERVICAL CANAL INSTRUMENTAL SPX,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58100,CPT,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,,30,,,$664.64,$0.00,1,0,1,20130101, 58120,CPT,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58145,CPT,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58260,CPT,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58262,CPT,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58263,CPT,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58270,CPT,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58290,CPT,VAGINAL HYSTERECTOMY UTERUS > 250 GM,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 58291,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 58292,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 58294,CPT,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 58300,CPT,INSERTION INTRAUTERINE DEVICE IUD,,30,,,"$1,810.67",$0.00,1,0,1,20130101, 58301,CPT,REMOVAL INTRAUTERINE DEVICE IUD,,30,,,$664.64,$0.00,1,0,1,20130101, 58321,CPT,ARTIFICIAL INSEMINATION INTRA-CERVICAL,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 58322,CPT,ARTIFICIAL INSEMINATION INTRA-UTERINE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 58323,CPT,SPERM WASHING ARTIFICIAL INSEMINATION,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 58345,CPT,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58346,CPT,INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58350,CPT,CHROMOTUBATION OVIDUCT W/MATERIALS,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58353,CPT,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GID,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58356,CPT,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 58541,CPT,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 58542,CPT,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 58543,CPT,LAPS SUPRACERVICAL HYSTERECTOMY >250,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 58544,CPT,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 58545,CPT,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 58546,CPT,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58550,CPT,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,,30,,,"$21,466.17",$0.00,1,0,1,20130101, 58552,CPT,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58553,CPT,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58554,CPT,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58555,CPT,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,,30,,,"$9,426.68",$0.00,1,0,1,20130101, 58558,CPT,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,,30,,,"$9,426.68",$0.00,1,0,1,20130101, 58559,CPT,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,,30,,,"$9,426.68",$0.00,1,0,1,20130101, 58560,CPT,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,,30,,,"$14,203.29",$0.00,1,0,1,20130101, 58561,CPT,HYSTEROSCOPY REMOVAL LEIOMYOMATA,,30,,,"$14,203.29",$0.00,1,0,1,20130101, 58562,CPT,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,,30,,,"$9,426.68",$0.00,1,0,1,20130101, 58563,CPT,HYSTEROSCOPY ENDOMETRIAL ABLATION,,30,,,"$14,203.29",$0.00,1,0,1,20130101, 58565,CPT,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,,30,,,"$16,990.01",$0.00,1,0,1,20130101, 58570,CPT,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/>,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58571,CPT,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58572,CPT,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58573,CPT,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58578,CPT,UNLISTED LAPAROSCOPY PROCEDURE UTERUS,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 58579,CPT,UNLISTED HYSTEROSCOPY PROCEDURE UTERUS,,30,,,"$9,426.68",$0.00,1,0,1,20130101, 58600,CPT,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58615,CPT,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58660,CPT,LAPAROSCOPY W/LYSIS OF ADHESIONS,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58661,CPT,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58662,CPT,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58670,CPT,LAPAROSCOPY FULGURATION OVIDUCTS,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58671,CPT,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58672,CPT,LAPAROSCOPY FIMBRIOPLASTY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58673,CPT,LAPAROSCOPY SALPINGOSTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 58679,CPT,UNLISTED LAPAROSCOPY PROCEDURE OVIDUCT/OVARY,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 58770,CPT,SALPINGOSTOMY,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58800,CPT,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58805,CPT,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58820,CPT,DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58823,CPT,DRG PELVIC ABSCESS TRANSVAG/TRANSRECTAL APPR,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58900,CPT,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 58920,CPT,WEDGE RESCJ/BISCTJ OVARY UNI/BI,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58925,CPT,OVARIAN CYSTECTOMY UNI/BI,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 58970,CPT,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 58974,CPT,EMBRYO TRANSFER INTRAUTERINE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 58976,CPT,GAMETE ZYGOTE/EMBRYO FALLOPIAN TRANSFER ANY METH,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 58999,CPT,UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL,,30,,,$49.13,$0.00,1,0,1,20130101, 59000,CPT,AMNIOCENTESIS DIAGNOSIC,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59001,CPT,AMNIOCENTESISS THER AMNIOTIC FLUID RDCTJ US GID,,30,,,"$2,810.93",$0.00,1,0,1,20130101, 59012,CPT,CORDOCENTESIS INTRAUTERINE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59015,CPT,CHORIONIC VILLUS SAMPLING,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59020,CPT,FETAL CONTRACTION STRESS TEST,,30,,,$664.64,$0.00,1,0,1,20130101, 59025,CPT,FETAL NONSTRESS TEST,,30,,,$664.64,$0.00,1,0,1,20130101, 59030,CPT,FETAL SCALP BLOOD SAMPLING,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59050,CPT,FETAL MONITORING LABOR PHYS WRITTEN REPORT,,30,,,$656.15,$0.00,1,0,1,20130101, 59051,CPT,FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY,,30,,,$517.27,$0.00,1,0,1,20130101, 59070,CPT,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,,30,,,$664.64,$0.00,1,0,1,20130101, 59072,CPT,FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59074,CPT,FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59076,CPT,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59100,CPT,HYSTEROTOMY ABDOMINAL,,30,,,"$14,052.70",$0.00,1,0,1,20130101, 59150,CPT,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 59151,CPT,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,,30,,,"$17,254.50",$0.00,1,0,1,20130101, 59160,CPT,CURETTAGE POSTPARTUM,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59200,CPT,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,,30,,,$664.64,$0.00,1,0,1,20130101, 59300,CPT,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59320,CPT,CERCLAGE CERVIX PREGNANCY VAGINAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59400,CPT,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,,30,,,"$4,296.91",$0.00,1,0,1,20130101, 59409,CPT,VAGINAL DELIVERY ONLY,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59410,CPT,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,,30,,,"$3,483.98",$0.00,1,0,1,20130101, 59412,CPT,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59414,CPT,DELIVERY PLACENTA SEPARATE PROCEDURE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59425,CPT,ANTEPARTUM CARE ONLY 4-6 VISITS,,30,,,$693.31,$0.00,1,0,1,20130101, 59426,CPT,ANTEPARTUM CARE ONLY 7/> VISITS,,30,,,$696.35,$0.00,1,0,1,20130101, 59430,CPT,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,,30,,,$251.90,$0.00,1,0,1,20130101, 59612,CPT,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59812,CPT,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59820,CPT,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59821,CPT,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59840,CPT,INDUCED ABORTION DILATION AND CURETTAGE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59841,CPT,INDUCED ABORTION DILATION & EVAUCATION,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59866,CPT,MULTIFETAL PREGNANCY REDUCTION,,30,,,"$1,313.03",$0.00,1,0,1,20130101, 59870,CPT,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59871,CPT,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,,30,,,"$8,146.20",$0.00,1,0,1,20130101, 59897,CPT,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,,30,,,$49.13,$0.00,1,0,1,20130101, 59898,CPT,UNLISTED LAPAROSCOPY PX MATERNITY CARE&DELIVERY,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 59899,CPT,UNLISTED PROCEDURE MATERNITY CARE & DELIVERY,,30,,,$49.13,$0.00,1,0,1,20130101, 60000,CPT,I&D THYROGLOSSAL DUCT CYST INFECTED,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 60100,CPT,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 60200,CPT,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60210,CPT,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60212,CPT,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60220,CPT,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60225,CPT,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60240,CPT,THYROIDECTOMY TOTAL/COMPLETE,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60252,CPT,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 60260,CPT,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 60271,CPT,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 60280,CPT,EXCISION THYROGLOSSAL DUCT CYST/SINUS,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60281,CPT,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 60300,CPT,ASPIRATION AND/OR INJECTION THYROID CYST,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 60500,CPT,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 60502,CPT,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 60512,CPT,PARATHYROID AUTOTRANSPLANTATION ADD-ON,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 60520,CPT,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 60659,CPT,UNLISTED LAPAROSCOPY PROCEDURE ENDOCRINE SYSTEM,,30,,,"$14,357.79",$0.00,1,0,1,20130101, 60699,CPT,UNLISTED PROCEDURE ENDOCRINE SYSTEM,,30,,,"$17,832.51",$0.00,1,0,1,20130101, 61000,CPT,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 61001,CPT,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI SBSQ,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 61020,CPT,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 61026,CPT,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 61050,CPT,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 61055,CPT,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 61070,CPT,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,,30,,,"$2,463.04",$0.00,1,0,1,20130101, 61215,CPT,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,,30,,,"$16,197.47",$0.00,1,0,1,20130101, 61330,CPT,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 61334,CPT,EXPL ORBIT TRANSCRANIAL W/RMVL FOREIGN BODY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 61623,CPT,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 61626,CPT,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 61720,CPT,CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 61770,CPT,STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 61790,CPT,CREATE LES STRTCTC PRQ NEUROLYTIC GASSERIAN,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 61791,CPT,CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 61796,CPT,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,,30,,,"$19,067.64",$0.00,1,0,1,20130101, 61797,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,,30,,,"$6,355.88",$0.00,1,0,1,20130101, 61798,CPT,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,,30,,,"$20,656.61",$0.00,1,0,1,20130101, 61799,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,,30,,,"$7,944.85",$0.00,1,0,1,20130101, 61800,CPT,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,,30,,,"$3,972.42",$0.00,1,0,1,20130101, 61880,CPT,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 61885,CPT,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,,30,,,"$33,354.02",$0.00,1,0,1,20130101, 61886,CPT,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,,30,,,"$42,172.74",$0.00,1,0,1,20130101, 61888,CPT,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,,30,,,"$13,979.24",$0.00,1,0,1,20130101, 62000,CPT,ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 62194,CPT,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62225,CPT,RPLCMT/IRRIGATION VENTRICULAR CATHETER,,30,,,"$6,696.14",$0.00,1,0,1,20130101, 62230,CPT,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,,30,,,"$16,197.47",$0.00,1,0,1,20130101, 62252,CPT,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,,30,,,"$1,073.76",$0.00,1,0,1,20130101, 62263,CPT,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 62264,CPT,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 62267,CPT,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,,30,,,"$1,863.54",$0.00,1,0,1,20130101, 62268,CPT,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62269,CPT,BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE,,30,,,"$3,708.56",$0.00,1,0,1,20130101, 62270,CPT,SPINAL PUNCTURE LUMBAR DIAGNOSTIC,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 62272,CPT,SPINAL PUNCTURE THER DRAIN CEREBROSPINAL FLUID,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 62273,CPT,INJECTION EPIDURAL BLOOD/CLOT PATCH,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62280,CPT,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62281,CPT,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 62282,CPT,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 62287,CPT,DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 62292,CPT,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62294,CPT,NJX ARTERIAL OCCLUSION ARVEN MALFRMJ SPINAL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62310,CPT,NJX DX/THER SBST EPIDURAL/SUBRACH CERV/THORACIC,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62311,CPT,NJX DX/THER SBST EPIDURAL/SUBARACH LUMBAR/SACRAL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62318,CPT,NJXS INFUS/BOLUS DX/SBST EDRL/SUBARACH CRV/THRC,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 62319,CPT,NJX INFUS/BOLUS DX/SBST EDRL/SUBARACH LUM/SACRAL,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 62350,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,,30,,,"$16,197.47",$0.00,1,0,1,20130101, 62351,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 62355,CPT,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 62360,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,,30,,,"$16,197.47",$0.00,1,0,1,20130101, 62361,CPT,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,,30,,,"$28,284.00",$0.00,1,0,1,20130101, 62362,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,,30,,,"$28,284.00",$0.00,1,0,1,20130101, 62365,CPT,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 62367,CPT,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,,30,,,"$1,073.76",$0.00,1,0,1,20130101, 62368,CPT,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,,30,,,"$1,073.76",$0.00,1,0,1,20130101, 62369,CPT,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,,30,,,"$1,073.76",$0.00,1,0,1,20130101, 62370,CPT,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,,30,,,"$1,073.76",$0.00,1,0,1,20130101, 63001,CPT,LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63003,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63005,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63011,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63012,CPT,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63015,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63016,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63017,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63020,CPT,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63030,CPT,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63035,CPT,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63040,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63042,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63045,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63046,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63047,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63048,CPT,LAM FACETECTOMY&FORAMTOMY 1 SGM EA CRV THRC/LMBR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63055,CPT,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63056,CPT,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63057,CPT,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63064,CPT,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63066,CPT,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63075,CPT,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63076,CPT,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 63600,CPT,CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 63610,CPT,STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 63615,CPT,STRTCTC BX ASPIRAT/EXC LESION SPINAL CORD,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 63620,CPT,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,,30,,,"$17,160.88",$0.00,1,0,1,20130101, 63621,CPT,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,,30,,,"$4,766.91",$0.00,1,0,1,20130101, 63650,CPT,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 63655,CPT,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,,30,,,"$23,456.98",$0.00,1,0,1,20130101, 63661,CPT,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 63662,CPT,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 63663,CPT,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 63664,CPT,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 63685,CPT,INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING,,30,,,"$33,354.02",$0.00,1,0,1,20130101, 63688,CPT,REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR,,30,,,"$13,979.24",$0.00,1,0,1,20130101, 63741,CPT,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,,30,,,"$16,197.47",$0.00,1,0,1,20130101, 63744,CPT,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,,30,,,"$16,197.47",$0.00,1,0,1,20130101, 63746,CPT,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 64400,CPT,NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH,,30,,,$999.91,$0.00,1,0,1,20130101, 64402,CPT,INJECTION ANESTHETIC AGENT FACIAL NERVE,,30,,,$999.91,$0.00,1,0,1,20130101, 64405,CPT,INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64408,CPT,INJECTION ANESTHETIC AGENT VAGUS NERVE,,30,,,$999.91,$0.00,1,0,1,20130101, 64410,CPT,INJECTION ANESTHETIC AGENT PHRENIC NERVE,,30,,,$999.91,$0.00,1,0,1,20130101, 64412,CPT,INJECTION ANESTHETIC AGENT SPINAL ACCESSORY NRV,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64413,CPT,INJECTION ANESTHETIC AGENT CERVICAL PLEXUS,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64415,CPT,SINGLE NERVE BLOCK INJECTION ARM NERVE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64416,CPT,INJECTION ANES BRACHIAL PLEXUS CONT NFS CATH,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64417,CPT,INJECTION ANESTHETIC AGENT AXILLARY NERVE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64418,CPT,INJECTION ANESTHETIC AGENT SUPRASCAPULAR NERVE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64420,CPT,INJECTION ANESTHETIC AGENT 1 INTERCOSTAL NERVE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64421,CPT,MULTIPLE NERVE BLOCK INJECTIONS RIB NERVES,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64425,CPT,INJECTION ANES ILIOINGUINAL ILIOHYPOGASTRIC NRVS,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64430,CPT,INJECTION ANESTHETIC AGENT PUDENDAL NERVE,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64435,CPT,INJECTION ANESTHETIC PARACERVICAL UTERINE NERVE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64445,CPT,INJECTION ANESTHETIC AGENT SCIATIC NRV SINGLE,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64446,CPT,INJECTION ANES SCIATIC NERVE CONT INFUSION CATH,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64447,CPT,INJECTION ANESTHETIC AGENT FEMORAL NERVE SINGLE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64448,CPT,INJECTION ANES FEMORAL NERVE CONT INFUSION CATH,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64449,CPT,INJECTION ANES LUMBAR PLEXUS POST CONT NFS CATH,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64450,CPT,INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64455,CPT,NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE,,30,,,$999.91,$0.00,1,0,1,20130101, 64479,CPT,NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC 1 LVL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64480,CPT,NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC EA LV,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64483,CPT,NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64484,CPT,NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC EA LV,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64490,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64491,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,,30,,,$999.91,$0.00,1,0,1,20130101, 64492,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,,30,,,$999.91,$0.00,1,0,1,20130101, 64493,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64494,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,,30,,,$999.91,$0.00,1,0,1,20130101, 64495,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,,30,,,$999.91,$0.00,1,0,1,20130101, 64505,CPT,INJECTION ANES AGENT SPHENOPALATINE GANGLION,,30,,,$999.91,$0.00,1,0,1,20130101, 64508,CPT,INJECTION ANESTHETIC AGENT CAROTID SINUS SPX,,30,,,$999.91,$0.00,1,0,1,20130101, 64510,CPT,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64517,CPT,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64520,CPT,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64530,CPT,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64550,CPT,APPLICATION SURFACE NEUROSTIMULATOR,,30,,,$556.14,$0.00,1,0,1,20130101, 64553,CPT,PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 64555,CPT,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 64561,CPT,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 64565,CPT,PRQ IMPLTJ NSTIM ELTRD NEUROMUSCULAR,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 64566,CPT,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,,30,,,$999.91,$0.00,1,0,1,20130101, 64568,CPT,INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER,,30,,,"$52,291.12",$0.00,1,0,1,20130101, 64569,CPT,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,,30,,,"$19,915.20",$0.00,1,0,1,20130101, 64570,CPT,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64575,CPT,INC IMPLTJ PERIPH NERVE NEUROSTIMULATOR ELTRD,,30,,,"$23,456.98",$0.00,1,0,1,20130101, 64580,CPT,INC IMPLTJ NSTIM ELTRD NEUROMUSCULAR,,30,,,"$23,456.98",$0.00,1,0,1,20130101, 64581,CPT,INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL NERVE,,30,,,"$23,456.98",$0.00,1,0,1,20130101, 64585,CPT,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 64590,CPT,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,,30,,,"$33,354.02",$0.00,1,0,1,20130101, 64595,CPT,REVISION/RMVL PERIPHERAL/GASTRIC NPGR,,30,,,"$13,979.24",$0.00,1,0,1,20130101, 64600,CPT,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 64605,CPT,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64610,CPT,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64611,CPT,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,,30,,,$999.91,$0.00,1,0,1,20130101, 64612,CPT,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,,30,,,$999.91,$0.00,1,0,1,20130101, 64613,CPT,CHEMODENERVATION NECK MUSCLE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64614,CPT,CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 64615,CPT,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,,30,,,$999.41,$0.00,1,0,1,20130101, 64620,CPT,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 64630,CPT,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64632,CPT,DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE,,30,,,$999.91,$0.00,1,0,1,20130101, 64633,CPT,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64634,CPT,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,,30,,,$999.91,$0.00,1,0,1,20130101, 64635,CPT,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 64636,CPT,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64640,CPT,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 64650,CPT,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,,30,,,$999.91,$0.00,1,0,1,20130101, 64653,CPT,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,,30,,,$999.91,$0.00,1,0,1,20130101, 64680,CPT,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 64681,CPT,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,,30,,,"$4,822.61",$0.00,1,0,1,20130101, 64702,CPT,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64704,CPT,NEUROPLASTY NERVE HAND/FOOT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64708,CPT,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64712,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64713,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64714,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64716,CPT,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64718,CPT,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64719,CPT,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64721,CPT,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64722,CPT,DECOMPRESSION UNSPECIFIED NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64726,CPT,DECOMPRESSION PLANTAR DIGITAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64727,CPT,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64732,CPT,TRANSECTION/AVULSION SUPRAORBITAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64734,CPT,TRANSECTION/AVULSION INFRAORBITAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64736,CPT,TRANSECTION/AVULSION MENTAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64738,CPT,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64740,CPT,TRANSECTION/AVULSION LINGUAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64742,CPT,TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64744,CPT,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64746,CPT,TRANSECTION/AVULSION PHRENIC NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64761,CPT,TRANSECTION/AVULSION PUDENDAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64763,CPT,TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64766,CPT,TRNSXJ/AVLSN OBTURAT NRV INPELV W/WO TENOTOMY,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64771,CPT,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64772,CPT,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64774,CPT,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64776,CPT,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64778,CPT,EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64782,CPT,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64783,CPT,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64784,CPT,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64786,CPT,EXCISION NEUROMA SCIATIC NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64787,CPT,IMPLANTATION NERVE END BONE/MUSCLE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64788,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64790,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64792,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA X10SV,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64795,CPT,BIOPSY NERVE,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64802,CPT,SYMPATHECTOMY CERVICAL,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64804,CPT,SYMPATHECTOMY CERVICOTHORACIC,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64820,CPT,SYMPATHECTOMY DIGITAL ARTERIES EACH DIGIT,,30,,,"$7,260.11",$0.00,1,0,1,20130101, 64821,CPT,SYMPATHECTOMY ULNAR ARTERY,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 64822,CPT,SYMPATHECTOMY ULNAR ARTERY,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 64823,CPT,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,,30,,,"$11,517.43",$0.00,1,0,1,20130101, 64831,CPT,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64832,CPT,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64834,CPT,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64835,CPT,SUTURE 1 NERVE MEDIAN MOTOR THENAR,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64836,CPT,SUTURE 1 NERVE ULNAR MOTOR,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64837,CPT,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64840,CPT,SUTURE POSTERIOR TIBIAL NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64856,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64857,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64858,CPT,SUTURE SCIATIC NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64859,CPT,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64861,CPT,SUTURE BRACHIAL PLEXUS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64862,CPT,SUTURE LUMBAR PLEXUS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64864,CPT,SUTURE FACIAL NERVE EXTRACRANIAL,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64865,CPT,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64870,CPT,ANASTOMOSIS FACIAL-PHRENIC,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64872,CPT,SUTURE NERVE REQ SECONDARY/DELAYED SUTURE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64874,CPT,SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64876,CPT,SUTURE NERVE REQ SHORTENING BONE EXTREMITY,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64885,CPT,NERVE GRAFT HEAD/NECK 4 CM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64890,CPT,NERVE GRAFT 1 STRAND HAND/FOOT 4 CM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64892,CPT,NERVE GRAFT 1 STRAND ARM/LEG <4 CM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64893,CPT,NERVE GRAFT 1 STRAND ARM/LEG >4 CM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64895,CPT,NERVE GRAFT MLT STRANDS HAND/FOOT 4 CM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64897,CPT,NERVE GRAFT MLT STRANDS ARM/LEG 4 CM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64901,CPT,NERVE GRAFT EACH NERVE 1 STRAND,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64902,CPT,NERVE GRAFT EACH NERVE MULTIPLE STRANDS,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64905,CPT,NERVE PEDICLE TRANSFER FIRST STAGE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64907,CPT,NERVE PEDICAL TRANSFER SECOND STAGE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64910,CPT,NERVE REPAIR W/CONDUIT EACH NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64911,CPT,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 64999,CPT,UNLISTED PROCEDURE NERVOUS SYSTEM,,30,,,$999.91,$0.00,1,0,1,20130101, 65091,CPT,EVISCERATION OCULAR CONTENTS W/O IMPLANT,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65093,CPT,EVISCERATION OCULAR CONTENTS W/IMPLANT,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65101,CPT,ENUCLEATION OF EYE W/O IMPLANT,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65103,CPT,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65105,CPT,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65110,CPT,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65112,CPT,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65114,CPT,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65125,CPT,MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 65130,CPT,INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 65135,CPT,INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 65140,CPT,INSJ OC IMPLT AFTER ENCL MUSC ATTACHED,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65150,CPT,REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 65155,CPT,REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 65175,CPT,REMOVAL OCULAR IMPLANT,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 65205,CPT,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,,30,,,$354.27,$0.00,1,0,1,20130101, 65210,CPT,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,,30,,,$354.27,$0.00,1,0,1,20130101, 65220,CPT,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,,30,,,$354.27,$0.00,1,0,1,20130101, 65222,CPT,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,,30,,,$354.27,$0.00,1,0,1,20130101, 65235,CPT,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65260,CPT,RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 65265,CPT,RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 65270,CPT,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 65272,CPT,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65275,CPT,RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65280,CPT,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 65285,CPT,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 65286,CPT,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 65290,CPT,RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 65400,CPT,EXCISION LESION CORNEA XCP PTERYGIUM,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65410,CPT,BIOPSY CORNEA,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65420,CPT,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65426,CPT,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65430,CPT,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,,30,,,$354.27,$0.00,1,0,1,20130101, 65435,CPT,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,,30,,,"$3,423.87",$0.00,1,0,1,20130101, 65436,CPT,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65450,CPT,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,,30,,,$804.02,$0.00,1,0,1,20130101, 65600,CPT,MULTIPLE PUNCTURES ANTERIOR CORNEA,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 65710,CPT,KERATOPLASTY ANTERIOR LAMELLAR,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65730,CPT,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65750,CPT,KERATOPLASTY PENETRAING APHAKIA,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65755,CPT,KERATOPLASTY PENETRATING PSEUDOPHAKIA,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65756,CPT,KERATOPLASTY ENDOTHELIAL,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65760,CPT,KERATOMILEUSIS,,30,,,"$9,423.17",$0.00,1,0,1,20130101, 65765,CPT,KERATOPHAKIA,,30,,,"$9,423.17",$0.00,1,0,1,20130101, 65767,CPT,EPIKERATOPLASTY,,30,,,"$9,423.17",$0.00,1,0,1,20130101, 65770,CPT,KERATOPROSTHESIS,,30,,,"$22,397.09",$0.00,1,0,1,20130101, 65771,CPT,RADIAL KERATOTOMY,,30,,,"$3,426.61",$0.00,1,0,1,20130101, 65772,CPT,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65775,CPT,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65778,CPT,PLACE AMNIOTIC MEMB OCULAR SURFACE SELF RETAIN,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65779,CPT,PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65780,CPT,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65781,CPT,OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65782,CPT,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,,30,,,"$15,372.89",$0.00,1,0,1,20130101, 65800,CPT,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 65810,CPT,PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65815,CPT,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65820,CPT,GONIOTOMY,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65850,CPT,TRABECULOTOMY AB EXTERNO,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65855,CPT,TRABECULOPLASTY LASER SURG 1/> SESSIONS,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 65860,CPT,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 65865,CPT,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65870,CPT,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65875,CPT,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65880,CPT,SEVERING ADS ANT SEG INCAL SPX CORNEOVITREAL,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 65900,CPT,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,,30,,,$845.81,$0.00,1,0,1,20130101, 65920,CPT,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 65930,CPT,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66020,CPT,INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66030,CPT,INJX ANTERIOR CHAMBER EYE MEDICATION SPX,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66130,CPT,EXCISION LESION SCLERA,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66150,CPT,FSTLJ SCLERA GLAUCOMA TREPHIN W/IRIDECTOMY,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66155,CPT,FSTLJ SCLERA GLAUCOMA THERMOCAUT IRRIDEC,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66160,CPT,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66165,CPT,FSTLJ SCLERA GLAUCOMA IRIDENCLEISIS/IRIDOTASIS,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66170,CPT,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66172,CPT,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66174,CPT,TRLUML DILAT AQUEOUS CANAL W/O DEVICE/STENT,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66175,CPT,TRLUML DILAT AQUEOUS CANAL W/DEVICE/STENT,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66180,CPT,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66185,CPT,REVISION AQUEOUS SHUNT EXTRAOCULAR RESERVOIR,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66220,CPT,REPAIR SCLERAL STAPHYLOMA W/O GRAFT,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 66225,CPT,REPAIR SCLERAL STAPHYLOMA W/GRAFT,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66250,CPT,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66500,CPT,IRIDOTOMY STAB INC SPX XCP TRANSFIXION,,30,,,$845.81,$0.00,1,0,1,20130101, 66505,CPT,IRIDOTOMY STAB INC SPX TRANSFIXION,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 66600,CPT,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66605,CPT,IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 66625,CPT,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 66630,CPT,IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66635,CPT,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66680,CPT,REPAIR IRIS CILIARY BODY,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66682,CPT,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66700,CPT,CILIARY BODY DESTRUCTION DIATHERMY,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66710,CPT,CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66711,CPT,CILIARY BODY DSTRJ CYCLOPHOTOCOAG ENDOSCOPIC,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66720,CPT,CILIARY BODY DESTRUCTION CRYOTHERAPY,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66740,CPT,CILIARY BODY DESTRUCTION CYCLODIAL,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66761,CPT,IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 66762,CPT,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 66770,CPT,DSTRJ CYST/LESION IRIS/CILIARY BODY,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 66820,CPT,DISCISSION SECONDARY MEMBRANOUS CATARACT,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 66821,CPT,POST-CATARACT LASER SURGERY,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 66825,CPT,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 66830,CPT,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 66840,CPT,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 66850,CPT,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,,30,,,"$11,677.52",$0.00,1,0,1,20130101, 66852,CPT,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,,30,,,"$11,677.52",$0.00,1,0,1,20130101, 66920,CPT,RMVL LENS MATERIAL INTRACAPSULAR,,30,,,"$11,677.52",$0.00,1,0,1,20130101, 66930,CPT,REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS,,30,,,"$11,677.52",$0.00,1,0,1,20130101, 66940,CPT,REMOVAL LENS MATERIAL EXTRACAPSULAR,,30,,,"$3,746.66",$0.00,1,0,1,20130101, 66982,CPT,XCAPSULAR CATARACT RMVL INSJ LENS PROSTH 1 STG,,30,,,"$8,759.17",$0.00,1,0,1,20130101, 66983,CPT,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,,30,,,"$8,759.17",$0.00,1,0,1,20130101, 66984,CPT,CATARACT REMOVAL INSERTION OF LENS,,30,,,"$8,759.17",$0.00,1,0,1,20130101, 66985,CPT,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,,30,,,"$8,759.17",$0.00,1,0,1,20130101, 66986,CPT,EXCHANGE INTRAOCULAR LENS,,30,,,"$8,759.17",$0.00,1,0,1,20130101, 66999,CPT,UNLISTED PROCEDURE ANTERIOR SEGMENT EYE,,30,,,$845.81,$0.00,1,0,1,20130101, 67005,CPT,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67010,CPT,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67015,CPT,ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67025,CPT,INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67027,CPT,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67028,CPT,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67030,CPT,DISCISSION VITREOUS STRANS PARS PLANA APPROACH,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67031,CPT,SEVERING VITREOUS STRANS LASER 1/> STAGES,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 67036,CPT,VITRECTOMY MECHANICAL PARS PLANA,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67039,CPT,VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67040,CPT,VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67041,CPT,VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67042,CPT,VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67043,CPT,VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67101,CPT,RPR RETINAL DTCHMNT 1/>SES CRYOTX/DTHRM W/WO DR,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67105,CPT,RPR RETINAL DTCHMNT 1/> SES PC W/WO DRG SUBRETI,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 67107,CPT,RPR RETINAL DTCHMNT SCLERAL BUCKLING W/WO IMPLT,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67108,CPT,RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67110,CPT,RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67112,CPT,RPR RETINAL DTCHMNT SCLERAL BUCKLING/VITRECTOMY,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67113,CPT,RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67115,CPT,RELEASE ENCIRCLING MATERIAL POSTERIOR SEGMENT,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67120,CPT,RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67121,CPT,RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 67141,CPT,PROPH RTA DTCHMNT W/O DRG 1/> SESS CRTX DTHRM,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 67145,CPT,PROPH RTA DTCHMNT W/O DRG 1/> SESS,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 67208,CPT,DSTRJ LOCLZD LES RETINA 1/> SESS CRTX DTHRM,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 67210,CPT,DSTRJ LOCLZD LES RETINA 1/> SESS PC,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 67218,CPT,DSTRJ LES RETINA 1/> SESS RADJ IMPLTJ,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67220,CPT,DSTRJ LES CHOROID PC 1/> SESS,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 67221,CPT,DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 67225,CPT,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 67227,CPT,DESTRUCTION RETINOPATHY 1/> SESS DIATHERMY,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67228,CPT,EXTENSIVE RETINOPATHY 1/> SESS PHOTOCOAGULATION,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 67229,CPT,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,,30,,,"$2,276.40",$0.00,1,0,1,20130101, 67250,CPT,SCLERAL REINFORCEMENT SPX W/O GRAFT,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67255,CPT,SCLERAL REINFORCEMENT SPX W/GRAFT,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 67299,CPT,UNLISTED PROCEDURE POSTERIOR SEGMENT,,30,,,"$2,323.55",$0.00,1,0,1,20130101, 67311,CPT,STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67312,CPT,STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67314,CPT,STRABISMUS RECESSION/RESCJ 1 VER MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67316,CPT,STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67318,CPT,STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67320,CPT,TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67331,CPT,STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67332,CPT,STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67334,CPT,STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67335,CPT,PLACEMENT ADJUSTABLE SUTURE STRABISMUS,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67340,CPT,STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67343,CPT,RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67345,CPT,CHEMODENERVATION EXTRAOCULAR MUSCLE,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67346,CPT,BIOPSY EXTRAOCULAR MUSCLE,,30,,,"$6,372.22",$0.00,1,0,1,20130101, 67399,CPT,UNLISTED PROCEDURE OCULAR MUSCLE,,30,,,"$10,137.71",$0.00,1,0,1,20130101, 67400,CPT,ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67405,CPT,ORBITOTOMY W/O BONE FLAP EXPL W/DRAINAGE ONLY,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 67412,CPT,ORBITOTOMY W/O BONE FLAP W/REMOVAL LESION,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67413,CPT,ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 67414,CPT,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67415,CPT,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67420,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67430,CPT,ORBITOTOMY BONE FLAP/WINDOW LATERAL RMVL FB,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67440,CPT,ORBITOTOMY BONE FLAP/WINDOW LATERAL W/DRG,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67445,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67450,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67500,CPT,RETROBULBAR INJECTION MEDICATION SPX,,30,,,$804.02,$0.00,1,0,1,20130101, 67505,CPT,RETROBULBAR INJECTION ALCOHOL,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67515,CPT,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67550,CPT,ORBITAL IMPLANT INSERTION,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67560,CPT,ORBITAL IMPLANT REMOVAL/REVISION,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 67570,CPT,OPTIC NERVE DECOMPRESSION,,30,,,"$14,700.79",$0.00,1,0,1,20130101, 67599,CPT,UNLISTED PROCEDURE ORBIT,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67700,CPT,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67710,CPT,SEVERING TARSORRHAPHY,,30,,,"$3,423.87",$0.00,1,0,1,20130101, 67715,CPT,CANTHOTOMY SEPARATE PROCEDURE,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67800,CPT,EXCISION CHALAZION SINGLE,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67801,CPT,EXCISION CHALAZION MULTIPLE SAME LID,,30,,,"$3,423.87",$0.00,1,0,1,20130101, 67805,CPT,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67808,CPT,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67810,CPT,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67820,CPT,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,,30,,,$354.27,$0.00,1,0,1,20130101, 67825,CPT,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 67830,CPT,CORRECTION TRICHIASIS INCCISION LID MARGIN,,30,,,"$3,423.87",$0.00,1,0,1,20130101, 67835,CPT,CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67840,CPT,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,,30,,,"$3,423.87",$0.00,1,0,1,20130101, 67850,CPT,DESTRUCTION LESION LID MARGIN ONE-FOURTH LID MARGIN,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67966,CPT,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 67971,CPT,RCNSTJ EYELID FULL THICKNESS 1 CM,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68130,CPT,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,,30,,,"$6,285.72",$0.00,1,0,1,20130101, 68135,CPT,DESTRUCTION LESION CONJUNCTIVA,,30,,,"$3,423.87",$0.00,1,0,1,20130101, 68200,CPT,SUBCONJUNCTIVAL INJECTION,,30,,,$204.26,$0.00,1,0,1,20130101, 68320,CPT,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68325,CPT,CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68326,CPT,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68328,CPT,CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68330,CPT,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 68335,CPT,RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68340,CPT,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68360,CPT,CONJUNCTIVAL FLAP BRIDGE/PARTIAL SPX,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 68362,CPT,CONJUNCTIVAL FLAP TOTAL,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 68371,CPT,HARVESTING CONJUNCIVAL ALLOGRAPHY LIVING DONOR,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 68399,CPT,UNLISTED PROCEDURE CONJUNCTIVA,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68400,CPT,INCISION DRAINAGE LACRIMAL GLAND,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68420,CPT,INCISION DRAINAGE LACRIMAL SAC,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68440,CPT,SNIP INCISION LACRIMAL PUNCTUM,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68500,CPT,EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68505,CPT,EXCISION LACRIMAL GLAND XCPT TUMOR PRTL,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68510,CPT,BIOPSY LACRIMAL GLAND,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68520,CPT,EXCISION LACRIMAL SAC,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68525,CPT,BIOPSY LACRIMAL SAC,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68530,CPT,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68540,CPT,EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68550,CPT,EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68700,CPT,PLASTIC REPAIR CANALICULI,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68705,CPT,CORRECTION EVERTED PUNCTUM CAUTERY,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68720,CPT,DACRYOCSTORHINOSTOMY,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68745,CPT,CONJUNCTIVORHINOSTOMY W/O TUBE,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68750,CPT,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68760,CPT,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68761,CPT,CLSR LACRIMAL PUNCTUM PLUG EACH,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68770,CPT,CLOSURE LACRIMAL FISTULA SPX,,30,,,"$10,761.45",$0.00,1,0,1,20130101, 68801,CPT,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,,30,,,$354.27,$0.00,1,0,1,20130101, 68810,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 68811,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68815,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68816,CPT,PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION,,30,,,"$7,673.32",$0.00,1,0,1,20130101, 68840,CPT,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,,30,,,$804.02,$0.00,1,0,1,20130101, 68899,CPT,UNLISTED PROCEDURE LACRIMAL SYSTEM,,30,,,"$1,013.69",$0.00,1,0,1,20130101, 69000,CPT,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,,30,,,$730.81,$0.00,1,0,1,20130101, 69005,CPT,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,,30,,,"$4,132.99",$0.00,1,0,1,20130101, 69020,CPT,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,,30,,,$730.81,$0.00,1,0,1,20130101, 69100,CPT,BIOPSY EXTERNAL EAR,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 69105,CPT,BIOPSY EXTERNAL AUDITORY CANAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69110,CPT,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 69120,CPT,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69140,CPT,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69145,CPT,EXCISION SOFT TIS LES EXTERNAL AUDITORY CANAL,,30,,,"$6,017.47",$0.00,1,0,1,20130101, 69150,CPT,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69200,CPT,RMVL FB XTRNL AUDITORY CANAL W/O ANES,,30,,,$317.65,$0.00,1,0,1,20130101, 69205,CPT,RMVL FB XTRNL AUDITORY CANAL ANES,,30,,,"$9,316.15",$0.00,1,0,1,20130101, 69210,CPT,RMVL IMPACTED CERUMEN SPX 1/BOTH EARS,,30,,,$317.65,$0.00,1,0,1,20130101, 69220,CPT,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,,30,,,$258.15,$0.00,1,0,1,20130101, 69222,CPT,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 69300,CPT,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69310,CPT,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69320,CPT,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69399,CPT,UNLISTED PROCEDURE EXTERNAL EAR,,30,,,$504.36,$0.00,1,0,1,20130101, 69400,CPT,EUSTACHIAN TUBE NFLTJ TRANSNSL CATHJ,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 69401,CPT,EUSTACHIAN TUBE NFLTJ TRANSNSL W/O CATHJ,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 69405,CPT,EUSTACHIAN TUBE CATHJ TRANSTYMPANIC,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69420,CPT,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 69421,CPT,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69424,CPT,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69433,CPT,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,,30,,,"$2,809.59",$0.00,1,0,1,20130101, 69436,CPT,TYMPANOSTOMY GENERAL ANESTHESIA,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69440,CPT,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69450,CPT,TYMPANOLYSIS TRANSCANAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69501,CPT,TRANSMASTOID ANTROTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69502,CPT,MASTOIDECTOMY COMPLETE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69505,CPT,MASTOIDECTOMY MODIFIED RADICAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69511,CPT,MASTOIDECTOMY RADICAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69530,CPT,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69540,CPT,EXCISION AURAL POLYP,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69550,CPT,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69552,CPT,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69601,CPT,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69602,CPT,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69603,CPT,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69604,CPT,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69605,CPT,REVJ MASTOIDECTOMY W/APICECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69610,CPT,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69620,CPT,MYRINGOPLASTY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69631,CPT,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69632,CPT,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69633,CPT,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69635,CPT,TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69636,CPT,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69637,CPT,TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69641,CPT,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69642,CPT,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69643,CPT,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69644,CPT,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69645,CPT,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69646,CPT,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69650,CPT,STAPES MOBILIZATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69660,CPT,STAPEDECTOMY/STAPEDOTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69661,CPT,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69662,CPT,REVISION STAPEDECTOMY/STAPEDOTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69666,CPT,REPAIR OVAL WINDOW FISTULA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69667,CPT,REPAIR ROUND WINDOW FISTULA,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69670,CPT,MASTOID OBLITERATION SEPARATE PROCEDURE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69676,CPT,TYMPANIC NEURECTOMY,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69700,CPT,CLOSURE POSTAURICULAR FISTULA MASTOID SPX,,30,,,"$10,061.13",$0.00,1,0,1,20130101, 69710,CPT,IMPLTJ/RPLCMT EMGNT BONE CNDJ DEV TEMPORAL BONE,,30,,,"$10,573.87",$0.00,1,0,1,20130101, 69711,CPT,RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69714,CPT,IMPLTJ OSSEOINTEGRATED TEMPORAL BONE W/MASTOID,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 69715,CPT,IMPLJ OSSEOINTEGRATED TEMPORAL BONE W/O MASTOID,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 69717,CPT,RPLMCT OSSEOINTEGRATE IMPLNT W/O MASTOIDECTOMY,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 69718,CPT,RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY,,30,,,"$22,139.21",$0.00,1,0,1,20130101, 69720,CPT,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69725,CPT,DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69740,CPT,SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69745,CPT,SUTR NRV ITPRL W/WO GRF/DCMPRN MEDIAL GENICULATE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69799,CPT,UNLISTED PROCEDURE MIDDLE EAR,,30,,,$504.36,$0.00,1,0,1,20130101, 69801,CPT,LABYRINTHOTOMY TRANSCANAL,,30,,,"$6,476.76",$0.00,1,0,1,20130101, 69805,CPT,ENDOLYMPHATIC SAC W/O SHUNT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69806,CPT,ENDOLYMPHATIC SAC SHUNT,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69820,CPT,FENESTRATION SEMICIRCULAR CANAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69840,CPT,REVISION FENESTRATION OPERATION,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69905,CPT,LABYRINTHECTOMY TRANSCANAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69910,CPT,LABYRINTHECTOMY W/MASTOIDECTOMY,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69915,CPT,VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69930,CPT,COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY,,30,,,"$61,420.96",$0.00,1,0,1,20130101, 69949,CPT,UNLISTED PROCEDURE INNER EAR,,30,,,$504.36,$0.00,1,0,1,20130101, 69955,CPT,TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69960,CPT,DECOMPRESSION INTERNAL AUDITORY CANAL,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69970,CPT,REMOVAL TUMOR TEMPORAL BONE,,30,,,"$16,495.62",$0.00,1,0,1,20130101, 69979,CPT,UNLISTED PROCEDURE TEMPORAL BONE MIDDLE FOSSA,,30,,,$504.36,$0.00,1,0,1,20130101, 70010,CPT,MYELOGRAPY POST FOSSA RS&I,,30,,,"$3,183.44",$0.00,1,0,1,20130101, 70015,CPT,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,,30,,,"$3,183.44",$0.00,1,0,1,20130101, 70030,CPT,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,,30,,,$299.21,$0.00,1,0,1,20130101, 70100,CPT,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 70110,CPT,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 70120,CPT,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,,30,,,$460.67,$0.00,1,0,1,20130101, 70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,,30,,,$299.21,$0.00,1,0,1,20130101, 70134,CPT,RADEX INTERNAL AUDITORY MEATI COMPLETE,,30,,,$460.67,$0.00,1,0,1,20130101, 70140,CPT,RADEX FACIAL BONES < 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 70150,CPT,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 70160,CPT,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 70190,CPT,RADEX OPTIC FORAMINA,,30,,,$299.21,$0.00,1,0,1,20130101, 70200,CPT,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 70210,CPT,RADEX SINUSES PARANASAL <3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 70220,CPT,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 70240,CPT,RADIOLOGIC EXAMINATION SELLA TURCICA,,30,,,$299.21,$0.00,1,0,1,20130101, 70250,CPT,RADIOLOGIC EXAMINATION SKULL 4/> VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 70260,CPT,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 70300,CPT,RADIOLOGIC EXAMINATION TEETH 1 VIEW,,30,,,$234.08,$0.00,1,0,1,20130101, 70310,CPT,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,,30,,,$234.08,$0.00,1,0,1,20130101, 70320,CPT,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,,30,,,$234.08,$0.00,1,0,1,20130101, 70328,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,,30,,,$299.21,$0.00,1,0,1,20130101, 70330,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,,30,,,$299.21,$0.00,1,0,1,20130101, 70332,CPT,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 70336,CPT,MRI TEMPOROMANDIBULAR JOINT,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70350,CPT,CEPHALOGRAM ORTHODONTIC,,30,,,$299.21,$0.00,1,0,1,20130101, 70355,CPT,ORTHOPANTOGRAM,,30,,,$234.08,$0.00,1,0,1,20130101, 70360,CPT,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,,30,,,$299.21,$0.00,1,0,1,20130101, 70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,,30,,,$722.77,$0.00,1,0,1,20130101, 70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,,30,,,$722.77,$0.00,1,0,1,20130101, 70373,CPT,LARYNGOGRAPY CONTRAST RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 70380,CPT,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,,30,,,$299.21,$0.00,1,0,1,20130101, 70390,CPT,SIALOGRAPY RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 70450,CPT,CT HEAD/BRAIN W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 70460,CPT,CT HEAD/BRAIN W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 70470,CPT,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 70486,CPT,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 70487,CPT,CT MAXILLOFACIAL W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 70488,CPT,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 70490,CPT,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 70491,CPT,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 70492,CPT,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70542,CPT,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 70543,CPT,MRI ORBIT FACE & NCK W/O & W/CONTRAST MATRL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 70544,CPT,MRA HEAD W/O CONTRST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70545,CPT,MRA HEAD W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 70546,CPT,MRA HEAD W/O & W/CONTRAST MATERIAL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 70547,CPT,MRA NECK W/O CONTRST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70548,CPT,MRA NECK W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 70549,CPT,MRA NECK W/O &W/CONTRAST MATERIAL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 70551,CPT,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70552,CPT,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 70553,CPT,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70557,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 70558,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 70559,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 71010,CPT,RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL,,30,,,$299.21,$0.00,1,0,1,20130101, 71015,CPT,RADIOLOGIC EXAMINATION CHEST STERO FRONTAL,,30,,,$299.21,$0.00,1,0,1,20130101, 71020,CPT,RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL,,30,,,$299.21,$0.00,1,0,1,20130101, 71021,CPT,RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX,,30,,,$299.21,$0.00,1,0,1,20130101, 71022,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ,,30,,,$299.21,$0.00,1,0,1,20130101, 71023,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO,,30,,,$722.77,$0.00,1,0,1,20130101, 71030,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 71034,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO,,30,,,$722.77,$0.00,1,0,1,20130101, 71035,CPT,RADEX CHEST SPECIAL VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 71100,CPT,RADEX RIBS UNILATERAL 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 71110,CPT,RADEX RIBS BILATERAL 3 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 71130,CPT,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 71250,CPT,CT THORAX W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 71260,CPT,CT THORAX W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 71270,CPT,CT THORAX W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 71550,CPT,MRI CHEST W/O CONTRAST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 71551,CPT,MRI CHEST W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 71552,CPT,MRI CHEST W/O & W/CONTRAST MATERIAL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 71555,CPT,MRA CHEST W/O & W/CONTRAST MATERIAL,,30,,,"$5,518.91",$0.00,1,0,1,20130101, 72010,CPT,RADEX SPINE ENTIRE SURVEY STD ANTEROPOST & LAT,,30,,,$460.67,$0.00,1,0,1,20130101, 72020,CPT,RADEX SPINE 1 VIEW SPECIFY LEVEL,,30,,,$299.21,$0.00,1,0,1,20130101, 72040,CPT,RADEX SPINE CERVICAL 3 VIEWS OR LESS,,30,,,$299.21,$0.00,1,0,1,20130101, 72050,CPT,RADEX SPINE CERVICAL 4 OR 5 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 72052,CPT,RADEX SPINE CERVICAL 6 OR MORE VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 72069,CPT,RADEX SPINE THORACOLMBR STANDING SCOLIOSIS,,30,,,$299.21,$0.00,1,0,1,20130101, 72070,CPT,RADEX SPINE THORACIC 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72072,CPT,RADEX SPINE THORACIC 3 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 72074,CPT,RADEX SPINE THORACIC MINIMUM 4 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72080,CPT,RADEX SPINE THORACOLUMBAR 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72090,CPT,RADEX SPINE SCOLIOS STUDY W/SUPINE & ERECT STUDY,,30,,,$460.67,$0.00,1,0,1,20130101, 72100,CPT,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72110,CPT,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 72114,CPT,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,,30,,,$460.67,$0.00,1,0,1,20130101, 72120,CPT,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 72125,CPT,CT CERVICAL SPINE W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 72126,CPT,CT CERVICAL SPINE W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 72127,CPT,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 72128,CPT,CT THORACIC SPINE W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 72129,CPT,CT THORACIC SPINE W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 72130,CPT,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 72131,CPT,CT LUMBAR SPINE W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 72132,CPT,CT LUMBAR SPINE W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 72133,CPT,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 72141,CPT,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 72142,CPT,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 72146,CPT,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 72147,CPT,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 72148,CPT,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 72149,CPT,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 72156,CPT,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 72157,CPT,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 72158,CPT,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 72159,CPT,MRA SPINAL CANAL W/WO CONTRAST MATERIAL,,30,,,"$5,617.26",$0.00,1,0,1,20130101, 72170,CPT,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72190,CPT,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 72192,CPT,CT PELVIS W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 72193,CPT,CT PELVIS W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 72194,CPT,CT PELVIS W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 72195,CPT,MRI PELVIS W/O CONTRAST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 72196,CPT,MRI PELVIS W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 72197,CPT,MRI PELVIS W/O & W/CONTRAST MATERIAL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 72198,CPT,MRA PELVIS W/WO CONTRAST MATERIAL,,30,,,"$5,289.86",$0.00,1,0,1,20130101, 72200,CPT,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72202,CPT,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72220,CPT,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 72240,CPT,MYELOGRAPY CERVICAL RS&I,,30,,,"$3,183.44",$0.00,1,0,1,20130101, 72255,CPT,MYELOGRAPY THORACIC RS&I,,30,,,"$3,183.44",$0.00,1,0,1,20130101, 72265,CPT,MYELOGRAPY LUMBOSACRAL RS&I,,30,,,"$3,183.44",$0.00,1,0,1,20130101, 72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,,30,,,"$3,183.44",$0.00,1,0,1,20130101, 72285,CPT,DISKOGRAPY CERVICAL/THORACIC RS&I,,30,,,"$9,867.86",$0.00,1,0,1,20130101, 72295,CPT,DISKOGRAPY LUMBAR RS&I,,30,,,"$9,867.86",$0.00,1,0,1,20130101, 73000,CPT,RADEX CLAVICLE COMPLETE,,30,,,$299.21,$0.00,1,0,1,20130101, 73010,CPT,RADEX SCAPULA COMPLETE,,30,,,$299.21,$0.00,1,0,1,20130101, 73020,CPT,RADEX SHOULDER 1 VIEW,,30,,,$299.21,$0.00,1,0,1,20130101, 73030,CPT,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73040,CPT,RADEX SHOULDER ARTHROGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 73050,CPT,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,,30,,,$299.21,$0.00,1,0,1,20130101, 73060,CPT,RADEX HUMERUS MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73070,CPT,RADEX ELBOW 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73080,CPT,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73085,CPT,RADEX ELBOW ARTHROGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 73090,CPT,RADEX FOREARM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73092,CPT,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73100,CPT,RADEX WRIST 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73110,CPT,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73115,CPT,RADEX WRIST ARTHROGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 73120,CPT,RADEX HAND 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73130,CPT,RADEX HAND MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73140,CPT,RADEX FINGR MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73200,CPT,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 73201,CPT,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 73202,CPT,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 73218,CPT,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 73219,CPT,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 73220,CPT,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 73221,CPT,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 73222,CPT,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 73223,CPT,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 73225,CPT,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,,30,,,"$3,612.68",$0.00,1,0,1,20130101, 73500,CPT,RADEX HIP UNILATERAL 1 VIEW,,30,,,$299.21,$0.00,1,0,1,20130101, 73510,CPT,RADEX HIP UNILATERAL COMPLETE MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73520,CPT,RADEX HIPS BILATERAL 2 VIEWS ANTEROPOST PELVIS,,30,,,$460.67,$0.00,1,0,1,20130101, 73525,CPT,RADEX HIP ARTHROGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 73540,CPT,RADEX PELVIS&HIPS INFT/CHLD MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73550,CPT,RADIOLOGIC EXAMINATION FEMUR 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73560,CPT,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73562,CPT,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73564,CPT,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,,30,,,$460.67,$0.00,1,0,1,20130101, 73565,CPT,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,,30,,,$299.21,$0.00,1,0,1,20130101, 73580,CPT,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 73590,CPT,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73592,CPT,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73600,CPT,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73610,CPT,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73615,CPT,RADEX ANKLE ARTHROGGRAPHY RS&I,,30,,,"$1,907.54",$0.00,1,0,1,20130101, 73620,CPT,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73630,CPT,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73660,CPT,RADEX TOE MINIMUM 2 VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 73700,CPT,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 73701,CPT,CT LOWER EXTREMITY W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 73702,CPT,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 73718,CPT,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 73719,CPT,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 73720,CPT,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 73721,CPT,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 73722,CPT,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 73723,CPT,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 73725,CPT,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,,30,,,"$3,944.86",$0.00,1,0,1,20130101, 74000,CPT,RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW,,30,,,$299.21,$0.00,1,0,1,20130101, 74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 74020,CPT,RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS,,30,,,$299.21,$0.00,1,0,1,20130101, 74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,,30,,,$460.67,$0.00,1,0,1,20130101, 74150,CPT,CT ABDOMEN W/O CONTRAST MATERIAL,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 74160,CPT,CT ABDOMEN W/CONTRAST MATERIAL,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 74170,CPT,CT ABDOMEN W/O & W/CONTRAST MATERIAL,,30,,,"$2,103.26",$0.00,1,0,1,20130101, 74174,CPT,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,,30,,,"$3,043.71",$0.00,1,0,1,20130101, 74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 74176,CPT,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,,30,,,"$1,953.64",$0.00,1,0,1,20130101, 74177,CPT,CT ABDOEN & PELVIS W/CONTRAST MATERIAL,,30,,,"$3,043.71",$0.00,1,0,1,20130101, 74178,CPT,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,,30,,,"$3,043.71",$0.00,1,0,1,20130101, 74181,CPT,MRI ABDOMEN W/O CONTRAST MATERIAL,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 74182,CPT,MRI ABDOMEN W/CONTRAST MATERIAL,,30,,,"$2,859.72",$0.00,1,0,1,20130101, 74183,CPT,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 74185,CPT,MRA ABDOMEN W/WO CONTRAST MATERIAL,,30,,,"$6,947.95",$0.00,1,0,1,20130101, 74190,CPT,PERITONEOGRAM RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 74210,CPT,RADEX PHARYNX&/CERVICAL ESOPHAGUS,,30,,,$536.30,$0.00,1,0,1,20130101, 74220,CPT,RADEX ESOPHAGUS,,30,,,$536.30,$0.00,1,0,1,20130101, 74230,CPT,SWALLOWING FUNCJ W/CINERADIOGRAPY/VIDRADIOG,,30,,,$536.30,$0.00,1,0,1,20130101, 74240,CPT,RADEX GI TRACT UPPER W/WO DELAYED FILMS W/O KUB,,30,,,$794.32,$0.00,1,0,1,20130101, 74241,CPT,RADEX GI TRACT UPPER W/WO DELAYED FILMS W/KUB,,30,,,$794.32,$0.00,1,0,1,20130101, 74245,CPT,RADEX GI TRACT UPR W/SM INT W/MULT SERIAL FLMS,,30,,,$794.32,$0.00,1,0,1,20130101, 74246,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY FILMS W/O KUB,,30,,,$794.32,$0.00,1,0,1,20130101, 74247,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY FLMS W/KUB,,30,,,$794.32,$0.00,1,0,1,20130101, 74249,CPT,RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU,,30,,,$794.32,$0.00,1,0,1,20130101, 74250,CPT,RADEX SMALL INTESTINE W/MULTIPLE SERIAL FILMS,,30,,,$536.30,$0.00,1,0,1,20130101, 74251,CPT,RADEX SM INT W/MLT SRL FLMS VIA ENTEROCLSS TUBE,,30,,,$794.32,$0.00,1,0,1,20130101, 74260,CPT,DUODENOGRAPY HYPOTONIC,,30,,,$536.30,$0.00,1,0,1,20130101, 74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,,30,,,"$1,119.05",$0.00,1,0,1,20130101, 74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,,30,,,"$1,897.36",$0.00,1,0,1,20130101, 74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,,30,,,$794.32,$0.00,1,0,1,20130101, 74270,CPT,RADEX COLON BARIUM ENEMA W/WOKUB,,30,,,$794.32,$0.00,1,0,1,20130101, 74280,CPT,RADEX COLON W/SPEC HI DNS BARIUM W/WO GLUCAGON,,30,,,$794.32,$0.00,1,0,1,20130101, 74283,CPT,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,,30,,,$794.32,$0.00,1,0,1,20130101, 74290,CPT,CHOLECYSTOGRAPHY ORAL CONTRST,,30,,,$536.30,$0.00,1,0,1,20130101, 74291,CPT,CHOLECYST ORAL CNTRST ADDL/REPEAT XM/MULT DAY XM,,30,,,$536.30,$0.00,1,0,1,20130101, 74305,CPT,CHOLANGIO&/PANCREATOGRAPHY THRU CATH RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 74320,CPT,CHOLANGIO&/PANCREATOGRAPHY TRANSHEPATC RS&I,,30,,,"$1,547.17",$0.00,1,0,1,20130101, 74400,CPT,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74410,CPT,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74415,CPT,UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74420,CPT,X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74425,CPT,UROGRAPHY ANTEGRADE RS&I,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74430,CPT,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74445,CPT,CORPORA CAVERNOSOGRAPY RS&I,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74450,CPT,URETHROCYSTOGRAPHY RETROGRADE RS&I,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74455,CPT,URETHROCYSTOGRAPHY VOIDING RS&I,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 74470,CPT,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 74475,CPT,INTRO CATH IN RENAL PELVIS DRG&/NJX PRQ RS&I,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 74480,CPT,INTRO URETERAL CATH/STENT PRQ RS&I,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 74485,CPT,DILATION NEPHROSTOMY/URETER/URETHRA RS&I,,30,,,"$6,302.70",$0.00,1,0,1,20130101, 74710,CPT,PELVIMETRY W/WOPLACENTAL LOCALIZATION,,30,,,$460.67,$0.00,1,0,1,20130101, 74740,CPT,HYSTEROSALPINGOGRAPHY RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 74775,CPT,PERINEOGRAM,,30,,,"$1,337.74",$0.00,1,0,1,20130101, 75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 75559,CPT,CARDIAC MRI W/O CONTRAST W STRESS IMAGING,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 75561,CPT,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 75563,CPT,CARDIAC MRI W/W/O CONTRAST W STRESS,,30,,,"$3,447.14",$0.00,1,0,1,20130101, 75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,,30,,,$317.65,$0.00,1,0,1,20130101, 75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,,30,,,"$1,711.30",$0.00,1,0,1,20130101, 75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D,,30,,,"$1,711.30",$0.00,1,0,1,20130101, 75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,,30,,,"$1,711.30",$0.00,1,0,1,20130101, 75600,CPT,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75605,CPT,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75625,CPT,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75630,CPT,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75635,CPT,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,,30,,,"$2,165.22",$0.00,1,0,1,20130101, 75658,CPT,ANIOGRAPHY BRACHIAL RETROGRADE RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75676,CPT,ARTERY X-RAYS NECK,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75705,CPT,ANGIOGRAPHY SPINAL SELECTIVE RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75710,CPT,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75716,CPT,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75726,CPT,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75731,CPT,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75733,CPT,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75736,CPT,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75741,CPT,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75743,CPT,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75746,CPT,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75756,CPT,ANGIOGRAPHY INTERNAL MAMMARY RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR S&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75801,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I,,30,,,"$1,547.17",$0.00,1,0,1,20130101, 75803,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,,30,,,"$1,547.17",$0.00,1,0,1,20130101, 75805,CPT,ANGRPH CATH F/U STUDY THER/EMBOLIZATION/INFUSION,,30,,,"$1,547.17",$0.00,1,0,1,20130101, 75807,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,,30,,,"$1,547.17",$0.00,1,0,1,20130101, 75809,CPT,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,,30,,,$460.67,$0.00,1,0,1,20130101, 75810,CPT,SPLENOPORTOGRAPY RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75820,CPT,VENOGRAPHY EXTREMITY UNILATERAL RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75822,CPT,VENOGRAPHY EXTREMITY BILATERAL RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75825,CPT,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75827,CPT,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75831,CPT,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75833,CPT,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75840,CPT,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75842,CPT,VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75860,CPT,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75870,CPT,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75872,CPT,VENOGRAPHY EPIDURAL RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75880,CPT,VENOGRAPHY ORBITAL RS&I,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,,30,,,"$4,457.36",$0.00,1,0,1,20130101, 75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75893,CPT,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,,30,,,"$12,227.60",$0.00,1,0,1,20130101, 75898,CPT,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,,30,,,"$2,105.62",$0.00,1,0,1,20130101, 75945,CPT,IV ULTRASOUND RS&I INITIAL VESSEL,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 75962,CPT,TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 75966,CPT,TRLUML BALO ANGIOPLASTY RENAL/OTH VISC ART RS&,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 75978,CPT,TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RS&I,,30,,,"$12,367.21",$0.00,1,0,1,20130101, 76000,CPT,FLUOROSCOPY SPX UP TO 1 HOUR PHYS/QHP TIME,,30,,,$722.77,$0.00,1,0,1,20130101, 76010,CPT,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,,30,,,$299.21,$0.00,1,0,1,20130101, 76080,CPT,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 76098,CPT,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,,30,,,"$1,547.17",$0.00,1,0,1,20130101, 76100,CPT,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,,30,,,$460.67,$0.00,1,0,1,20130101, 76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,30,,,$722.77,$0.00,1,0,1,20130101, 76140,CPT,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,,30,,,$127.90,$0.00,1,0,1,20130101, 76380,CPT,CT LIMITED/LOCALIZED FOLLOW UP STUDY,,30,,,$640.90,$0.00,1,0,1,20130101, 76390,CPT,MRI SPECTROSCOPY,,30,,,"$5,136.74",$0.00,1,0,1,20130101, 76496,CPT,UNLISTED FLUOROSCOPIC PROCEDURE,,30,,,$722.77,$0.00,1,0,1,20130101, 76497,CPT,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,,30,,,$640.90,$0.00,1,0,1,20130101, 76498,CPT,UNLISTED MAGNETIC RESONANCE PROCEDURE,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 76499,CPT,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,,30,,,$299.21,$0.00,1,0,1,20130101, 76506,CPT,ECHOENCEPHALOGRAPY REAL TIME IMAGING,,30,,,$419.58,$0.00,1,0,1,20130101, 76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,,30,,,$845.81,$0.00,1,0,1,20130101, 76511,CPT,OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY,,30,,,$643.53,$0.00,1,0,1,20130101, 76512,CPT,OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,,30,,,$643.53,$0.00,1,0,1,20130101, 76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,,30,,,$643.53,$0.00,1,0,1,20130101, 76514,CPT,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,,30,,,$150.41,$0.00,1,0,1,20130101, 76516,CPT,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,,30,,,$419.58,$0.00,1,0,1,20130101, 76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,,30,,,$643.53,$0.00,1,0,1,20130101, 76529,CPT,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,,30,,,$419.58,$0.00,1,0,1,20130101, 76536,CPT,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,,30,,,$643.53,$0.00,1,0,1,20130101, 76604,CPT,US CHEST REAL TIME W/IMAGE DOCUMENTATION,,30,,,$419.58,$0.00,1,0,1,20130101, 76645,CPT,US BREAST REAL TIME W/IMAGE DOCUMENTATION,,30,,,$419.58,$0.00,1,0,1,20130101, 76700,CPT,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,,30,,,$643.53,$0.00,1,0,1,20130101, 76705,CPT,ULTRASOUND ABDOMINAL REAL TIME W/IMAGE LIMITED,,30,,,$643.53,$0.00,1,0,1,20130101, 76770,CPT,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,,30,,,$643.53,$0.00,1,0,1,20130101, 76775,CPT,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,,30,,,$643.53,$0.00,1,0,1,20130101, 76776,CPT,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,,30,,,$643.53,$0.00,1,0,1,20130101, 76800,CPT,ULTRASOUND SPINAL CANAL & CONTENTS,,30,,,$643.53,$0.00,1,0,1,20130101, 76801,CPT,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,,30,,,$643.53,$0.00,1,0,1,20130101, 76802,CPT,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,,30,,,$419.58,$0.00,1,0,1,20130101, 76805,CPT,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,,30,,,$643.53,$0.00,1,0,1,20130101, 76810,CPT,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,,30,,,$643.53,$0.00,1,0,1,20130101, 76811,CPT,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 76812,CPT,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,,30,,,$419.58,$0.00,1,0,1,20130101, 76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,,30,,,$419.58,$0.00,1,0,1,20130101, 76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,,30,,,$419.58,$0.00,1,0,1,20130101, 76815,CPT,US PREGNANT UTERUS LIMITED 1/> FETUSES,,30,,,$419.58,$0.00,1,0,1,20130101, 76816,CPT,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,,30,,,$419.58,$0.00,1,0,1,20130101, 76817,CPT,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,,30,,,$419.58,$0.00,1,0,1,20130101, 76818,CPT,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,,30,,,$643.53,$0.00,1,0,1,20130101, 76819,CPT,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,,30,,,$643.53,$0.00,1,0,1,20130101, 76820,CPT,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,,30,,,$419.58,$0.00,1,0,1,20130101, 76821,CPT,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,,30,,,$419.58,$0.00,1,0,1,20130101, 76825,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,,30,,,"$1,358.28",$0.00,1,0,1,20130101, 76826,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,,30,,,"$1,358.28",$0.00,1,0,1,20130101, 76827,CPT,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,,30,,,$419.58,$0.00,1,0,1,20130101, 76828,CPT,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,,30,,,$419.58,$0.00,1,0,1,20130101, 76830,CPT,ULTRASOUND TRANSVAGINAL,,30,,,$643.53,$0.00,1,0,1,20130101, 76831,CPT,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 76856,CPT,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,,30,,,$643.53,$0.00,1,0,1,20130101, 76857,CPT,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,,30,,,$419.58,$0.00,1,0,1,20130101, 76870,CPT,ULTRASOUND SCROTUM & CONTENTS,,30,,,$643.53,$0.00,1,0,1,20130101, 76872,CPT,ULTRASOUND TRANSRECTAL,,30,,,$643.53,$0.00,1,0,1,20130101, 76873,CPT,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 76881,CPT,US EXTREMITY NON-VASC REAL-TIME IMG COMPL,,30,,,$643.53,$0.00,1,0,1,20130101, 76882,CPT,US EXTREMITY NON-VASC REAL-TIME IMG LMTD,,30,,,$419.58,$0.00,1,0,1,20130101, 76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,,30,,,$419.58,$0.00,1,0,1,20130101, 76886,CPT,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,,30,,,$419.58,$0.00,1,0,1,20130101, 76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,,30,,,$702.32,$0.00,1,0,1,20130101, 76970,CPT,US STUDY FOLLOW UP,,30,,,$419.58,$0.00,1,0,1,20130101, 76975,CPT,GI ENDOSCOPIC ULTRASOUND RS&I,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 76977,CPT,US BONE DENSITY MEAS & INTERP PERIPH ANY METHO,,30,,,$317.65,$0.00,1,0,1,20130101, 76999,CPT,UNLISTED ULTRASOUND PROCEDURE,,30,,,$419.58,$0.00,1,0,1,20130101, 77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,,30,,,"$1,644.10",$0.00,1,0,1,20130101, 77058,CPT,MRI BREAST UNILATERAL,,30,,,"$7,830.59",$0.00,1,0,1,20130101, 77059,CPT,MRI BREAST BILATERAL,,30,,,"$10,659.48",$0.00,1,0,1,20130101, 77071,CPT,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,,30,,,$299.21,$0.00,1,0,1,20130101, 77072,CPT,BONE AGE STUDIES,,30,,,$299.21,$0.00,1,0,1,20130101, 77073,CPT,BONE LENGTH STUDIES,,30,,,$460.67,$0.00,1,0,1,20130101, 77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,,30,,,$460.67,$0.00,1,0,1,20130101, 77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,,30,,,$460.67,$0.00,1,0,1,20130101, 77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,,30,,,$460.67,$0.00,1,0,1,20130101, 77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,,30,,,$299.21,$0.00,1,0,1,20130101, 77078,CPT,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,,30,,,$479.43,$0.00,1,0,1,20130101, 77080,CPT,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,,30,,,$479.43,$0.00,1,0,1,20130101, 77081,CPT,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,,30,,,$227.08,$0.00,1,0,1,20130101, 77082,CPT,DXA BONE DENSITY STUDY VERTEBRAL FRACTURE,,30,,,$299.21,$0.00,1,0,1,20130101, 77084,CPT,BONE MARROW BLOOD SUPPLY,,30,,,"$2,159.76",$0.00,1,0,1,20130101, 77280,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,,30,,,$708.73,$0.00,1,0,1,20130101, 77285,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77290,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77295,CPT,THER RAD SIMULAJ-AIDED FLD SETTING 3-DIMENSIONAL,,30,,,"$5,975.13",$0.00,1,0,1,20130101, 77299,CPT,UNLIS PX THER RADIOL CLINICAL TX PLANNING,,30,,,$708.73,$0.00,1,0,1,20130101, 77300,CPT,BASIC RADIATION DOSIMETRY CALCULATION,,30,,,$708.73,$0.00,1,0,1,20130101, 77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,,30,,,"$5,975.13",$0.00,1,0,1,20130101, 77305,CPT,TELETHERAPY ISODOSE PLAN SIMPLE,,30,,,$708.73,$0.00,1,0,1,20130101, 77310,CPT,TELETHERAPY ISODOSE PLAN INTERMEDIATE,,30,,,$708.73,$0.00,1,0,1,20130101, 77315,CPT,TELETHERAPY ISODOSE PLAN COMPLETE,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77326,CPT,BRACHYTHERAPY ISODOSE PLAN SIMPLE,,30,,,$708.73,$0.00,1,0,1,20130101, 77327,CPT,BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77328,CPT,BRACHYTHERAPY ISODOSE PLAN COMPLEX,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,,30,,,$708.73,$0.00,1,0,1,20130101, 77332,CPT,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,,30,,,"$1,296.24",$0.00,1,0,1,20130101, 77333,CPT,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,,30,,,"$1,296.24",$0.00,1,0,1,20130101, 77334,CPT,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,,30,,,"$1,296.24",$0.00,1,0,1,20130101, 77336,CPT,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,,30,,,$708.73,$0.00,1,0,1,20130101, 77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,30,,,"$1,853.96",$0.00,1,0,1,20130101, 77370,CPT,SPEC MEDICAL RADJ PHYSICS CONSLTJ,,30,,,$708.73,$0.00,1,0,1,20130101, 77371,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,,30,,,"$23,210.13",$0.00,1,0,1,20130101, 77372,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,,30,,,"$12,032.31",$0.00,1,0,1,20130101, 77373,CPT,STEREOTACTIC BODY RADIATION DELIVERY,,30,,,"$22,438.77",$0.00,1,0,1,20130101, 77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,30,,,$708.73,$0.00,1,0,1,20130101, 77401,CPT,RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA,,30,,,$622.08,$0.00,1,0,1,20130101, 77402,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL <5MEV,,30,,,$622.08,$0.00,1,0,1,20130101, 77403,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 6-10MEV,,30,,,$622.08,$0.00,1,0,1,20130101, 77404,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 11-19MEV,,30,,,$622.08,$0.00,1,0,1,20130101, 77406,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 20MEV/<,,30,,,$622.08,$0.00,1,0,1,20130101, 77407,CPT,RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS <5MEV,,30,,,$622.08,$0.00,1,0,1,20130101, 77408,CPT,RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS 6-1MEV,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77409,CPT,RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS 11-19MEV,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77411,CPT,RADJ DLVR 2 AREAS 3/> PORTS 1 TX AREA 20 MEV/<,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77412,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING <5MEV,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77413,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING 6-10MEV,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77414,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING 11-19MEV,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77416,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING 20MEV/<,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77418,CPT,NTSTY MODUL DLVR 1/MLT FLDS/ARCS PR TX SESSION,,30,,,"$3,043.53",$0.00,1,0,1,20130101, 77422,CPT,HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77423,CPT,HIGH ENERGY NEUTRON RADJ TX DLVR 1/> ISOCENTER,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77424,CPT,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,,30,,,"$5,483.89",$0.00,1,0,1,20130101, 77425,CPT,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,,30,,,"$5,483.89",$0.00,1,0,1,20130101, 77470,CPT,SPECIAL TREATMENT PROCEDURE,,30,,,"$2,491.84",$0.00,1,0,1,20130101, 77499,CPT,UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT,,30,,,$431.08,$0.00,1,0,1,20130101, 77520,CPT,PROTON TX DELIVERY SIMPLE W/O COMPENSATION,,30,,,"$6,817.98",$0.00,1,0,1,20130101, 77522,CPT,PROTON TX DELIVERY SIMPLE W/COMPENSATION,,30,,,"$6,817.98",$0.00,1,0,1,20130101, 77523,CPT,PROTON TX DELIVERY INTERMEDIATE,,30,,,"$4,232.98",$0.00,1,0,1,20130101, 77525,CPT,PROTON TX DELIVERY COMPLEX,,30,,,"$4,232.98",$0.00,1,0,1,20130101, 77600,CPT,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,,30,,,"$2,491.84",$0.00,1,0,1,20130101, 77605,CPT,HYPERTHERMIA EXTERNAL GENERATED DEEP,,30,,,"$2,491.84",$0.00,1,0,1,20130101, 77610,CPT,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,,30,,,"$2,491.84",$0.00,1,0,1,20130101, 77615,CPT,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,,30,,,"$2,491.84",$0.00,1,0,1,20130101, 77620,CPT,HYPERTHERMIA INTRACAVITARY PROBES,,30,,,"$2,491.84",$0.00,1,0,1,20130101, 77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE,,30,,,"$1,148.28",$0.00,1,0,1,20130101, 77761,CPT,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,,30,,,"$2,751.45",$0.00,1,0,1,20130101, 77762,CPT,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,,30,,,"$2,751.45",$0.00,1,0,1,20130101, 77763,CPT,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,,30,,,"$2,751.45",$0.00,1,0,1,20130101, 77776,CPT,INTERSTITIAL RADIATION SOURCE APPLIC SIMPLE,,30,,,"$2,751.45",$0.00,1,0,1,20130101, 77777,CPT,INTERSTITIAL RADIATION SOURCE APPLIC INTERMED,,30,,,"$2,751.45",$0.00,1,0,1,20130101, 77778,CPT,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,,30,,,"$5,745.88",$0.00,1,0,1,20130101, 77785,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 1 CHANNEL,,30,,,"$4,248.66",$0.00,1,0,1,20130101, 77786,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 2-12 CHANNEL,,30,,,"$4,248.66",$0.00,1,0,1,20130101, 77787,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX > 12 CHANNEL,,30,,,"$4,248.66",$0.00,1,0,1,20130101, 77789,CPT,SURFACE APPLICATION RADIATION SOURCE,,30,,,$622.08,$0.00,1,0,1,20130101, 77799,CPT,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,,30,,,"$2,751.45",$0.00,1,0,1,20130101, 78012,CPT,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,,30,,,$736.62,$0.00,1,0,1,20130101, 78013,CPT,THYROID IMAGING WITH VASCULAR FLOW,,30,,,$966.80,$0.00,1,0,1,20130101, 78014,CPT,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,,30,,,"$1,492.26",$0.00,1,0,1,20130101, 78015,CPT,THYROID CARCINOMA METASTASES IMG LMTD AREA,,30,,,"$1,918.15",$0.00,1,0,1,20130101, 78016,CPT,THYROID CARCINOMA METASTASES IMG ADDL STUDY,,30,,,"$1,918.15",$0.00,1,0,1,20130101, 78018,CPT,THYROID CARCINOMA METASTASES IMG WHOLE BODY,,30,,,"$1,918.15",$0.00,1,0,1,20130101, 78070,CPT,PARATHYROID PLANAR IMAGING,,30,,,"$1,500.01",$0.00,1,0,1,20130101, 78071,CPT,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,,30,,,"$1,528.89",$0.00,1,0,1,20130101, 78072,CPT,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,,30,,,"$1,528.89",$0.00,1,0,1,20130101, 78075,CPT,ADRENAL IMAGING CORTEX &/MEDULLA,,30,,,"$5,924.65",$0.00,1,0,1,20130101, 78099,CPT,UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE,,30,,,$969.35,$0.00,1,0,1,20130101, 78102,CPT,BONE MARROW IMAGING LIMITED AREA,,30,,,"$1,786.35",$0.00,1,0,1,20130101, 78103,CPT,BONE MARROW IMAGING MULTIPLE AREAS,,30,,,"$1,786.35",$0.00,1,0,1,20130101, 78104,CPT,BONE MARROW IMAGING WHOLE BODY,,30,,,"$1,786.35",$0.00,1,0,1,20130101, 78110,CPT,PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78111,CPT,PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78120,CPT,RED CELL VOLUME DETERMINATION SPX 1 SAMPLING,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78121,CPT,RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78122,CPT,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78130,CPT,RED CELL SURVIVAL STUDY,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78135,CPT,RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78140,CPT,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,,30,,,"$2,675.39",$0.00,1,0,1,20130101, 78185,CPT,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,,30,,,"$1,786.35",$0.00,1,0,1,20130101, 78190,CPT,KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78191,CPT,PLATELET SURVIVAL STUDY,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78195,CPT,LYMPHATICS & LYMPH NODES IMAGING,,30,,,"$1,786.35",$0.00,1,0,1,20130101, 78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,,30,,,"$1,786.35",$0.00,1,0,1,20130101, 78201,CPT,LIVER IMAGING STATIC ONLY,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78202,CPT,LIVER IMAGING W/VASCULAR FLOW,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78205,CPT,LIVER IMAGING SPECT,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78206,CPT,LIVER IMAGING SPECT W/VASCULAR FLOW,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78215,CPT,LIVER & SPLEEN IMAGING STATIC ONLY,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78216,CPT,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78226,CPT,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78227,CPT,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,,30,,,"$2,004.92",$0.00,1,0,1,20130101, 78230,CPT,SALIVARY GLAND IMAGING,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78231,CPT,SALIVARY GLAND IMAGING SERIAL IMAGES,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78232,CPT,SALIVARY GLAND FUNCTION STUDY,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78258,CPT,ESOPHAGEAL MOTILITY,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78261,CPT,GASTRIC MUCOSA IMAGING,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78262,CPT,GASTROESOPHAGEAL REFLUX STUDY,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78264,CPT,GASTRIC EMPTYING STUDY,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78270,CPT,VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78271,CPT,VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78272,CPT,VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78278,CPT,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78282,CPT,GASTROINTESTINAL PROTEIN LOSS,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78290,CPT,INTESTINE IMAGING,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78291,CPT,PERITONEAL-VENOUS SHUNT PATENCY TEST,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78299,CPT,UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE,,30,,,"$1,645.80",$0.00,1,0,1,20130101, 78300,CPT,BONE &/JOINT IMAGING LIMITED AREA,,30,,,"$1,678.06",$0.00,1,0,1,20130101, 78305,CPT,BONE &/JOINT IMAGING MULTIPLE AREAS,,30,,,"$1,678.06",$0.00,1,0,1,20130101, 78306,CPT,BONE &/JOINT IMAGING WHOLE BODY,,30,,,"$1,678.06",$0.00,1,0,1,20130101, 78315,CPT,BONE &/JOINT IMAGING 3 PHASE STUDY,,30,,,"$1,678.06",$0.00,1,0,1,20130101, 78320,CPT,BONE &/JOINT IMAGING TOMOGRAPHIC SPECT,,30,,,"$1,678.06",$0.00,1,0,1,20130101, 78350,CPT,BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY,,30,,,$677.48,$0.00,1,0,1,20130101, 78351,CPT,BONE DENSTY 1/> SITES DUAL PHOTON ABSORPTIOMETR,,30,,,$742.44,$0.00,1,0,1,20130101, 78399,CPT,UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE,,30,,,"$1,678.06",$0.00,1,0,1,20130101, 78414,CPT,CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78428,CPT,CARDIAC SHUNT DETECTION,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78445,CPT,NONCARDIAC VASCULAR FLOW IMAGING,,30,,,"$2,105.62",$0.00,1,0,1,20130101, 78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,,30,,,"$4,233.40",$0.00,1,0,1,20130101, 78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,,30,,,"$4,233.40",$0.00,1,0,1,20130101, 78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,,30,,,"$4,233.40",$0.00,1,0,1,20130101, 78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,,30,,,"$4,233.40",$0.00,1,0,1,20130101, 78456,CPT,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,,30,,,"$2,105.62",$0.00,1,0,1,20130101, 78457,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,,30,,,"$2,105.62",$0.00,1,0,1,20130101, 78458,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,,30,,,"$2,105.62",$0.00,1,0,1,20130101, 78459,CPT,MYOCARDIAL IMAGING PET METABOLIC EVALUATION,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78466,CPT,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78469,CPT,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78472,CPT,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78473,CPT,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78481,CPT,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78483,CPT,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78491,CPT,MYOCRD IMAGE PET PERFUS SINGLE STUDY REST/STRESS,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78492,CPT,MYOCRD IMAGE PET PERFUS MULTPL STUDY REST/STRESS,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78494,CPT,CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78499,CPT,UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE,,30,,,"$1,970.78",$0.00,1,0,1,20130101, 78579,CPT,PULMONARY VENTILATION IMAGING,,30,,,"$1,411.34",$0.00,1,0,1,20130101, 78580,CPT,PULMONARY PERFUSION IMAGING PARTICULATE,,30,,,"$1,411.34",$0.00,1,0,1,20130101, 78582,CPT,PULMONARY VENTILATION & PERFUSION IMAGING,,30,,,"$2,134.81",$0.00,1,0,1,20130101, 78597,CPT,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,,30,,,"$1,411.34",$0.00,1,0,1,20130101, 78598,CPT,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,,30,,,"$2,134.81",$0.00,1,0,1,20130101, 78599,CPT,UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE,,30,,,"$1,411.34",$0.00,1,0,1,20130101, 78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,,30,,,"$1,682.20",$0.00,1,0,1,20130101, 78601,CPT,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78605,CPT,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,,30,,,"$1,682.20",$0.00,1,0,1,20130101, 78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78608,CPT,BRAIN IMAGING PET METABOLIC EVALUATION,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78609,CPT,BRAIN IMAGING PET PERFUSION EVALUATION,,30,,,"$4,503.61",$0.00,1,0,1,20130101, 78610,CPT,BRAIN IMAGING VASCULAR FLOW ONLY,,30,,,"$1,682.20",$0.00,1,0,1,20130101, 78630,CPT,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78635,CPT,CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78645,CPT,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,,30,,,"$1,682.20",$0.00,1,0,1,20130101, 78647,CPT,CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78650,CPT,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,,30,,,"$3,003.17",$0.00,1,0,1,20130101, 78660,CPT,RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY,,30,,,"$1,682.20",$0.00,1,0,1,20130101, 78699,CPT,UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE,,30,,,"$1,682.20",$0.00,1,0,1,20130101, 78700,CPT,KIDNEY IMAGING MORPHOLOGY,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78701,CPT,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78725,CPT,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78730,CPT,URINARY BLADDER RESIDUAL STUDY,,30,,,$745.84,$0.00,1,0,1,20130101, 78740,CPT,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78799,CPT,UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE,,30,,,"$2,116.55",$0.00,1,0,1,20130101, 78800,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT LIMITED AREA,,30,,,"$1,918.15",$0.00,1,0,1,20130101, 78801,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT MULTIPLE AREAS,,30,,,"$3,187.62",$0.00,1,0,1,20130101, 78802,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT WHOLE BDY 1 DAY,,30,,,"$3,187.62",$0.00,1,0,1,20130101, 78803,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT TOMOG SPECT,,30,,,"$3,187.62",$0.00,1,0,1,20130101, 78804,CPT,RP LOCLZJ TUMOR/DSTRBJ AGT WHOL BDY REQ 2/> DAY,,30,,,"$5,924.65",$0.00,1,0,1,20130101, 78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA,,30,,,"$3,187.62",$0.00,1,0,1,20130101, 78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY,,30,,,"$3,187.62",$0.00,1,0,1,20130101, 78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,,30,,,"$3,187.62",$0.00,1,0,1,20130101, 78808,CPT,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,,30,,,"$1,270.66",$0.00,1,0,1,20130101, 78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78813,CPT,PET IMAGING WHOLE BODY,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,,30,,,"$6,385.07",$0.00,1,0,1,20130101, 78999,CPT,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,,30,,,$745.84,$0.00,1,0,1,20130101, 79005,CPT,RP THERAPY ORAL ADMINISTRATION,,30,,,"$1,519.72",$0.00,1,0,1,20130101, 79101,CPT,RP THERAPY INTRAVENOUS ADMINISTRATION,,30,,,"$1,519.72",$0.00,1,0,1,20130101, 79200,CPT,RP THERAPY INRACAVITARY ADMINISTRATION,,30,,,"$1,888.87",$0.00,1,0,1,20130101, 79300,CPT,RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN,,30,,,"$1,519.72",$0.00,1,0,1,20130101, 79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,,30,,,"$1,888.87",$0.00,1,0,1,20130101, 79440,CPT,RP THERAPY INTRA-ARTICULAR ADMINISTRATION,,30,,,"$1,888.87",$0.00,1,0,1,20130101, 79445,CPT,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,,30,,,"$1,519.72",$0.00,1,0,1,20130101, 79999,CPT,RP THERAPY UNLISTED PROCEDURE,,30,,,"$1,519.72",$0.00,1,0,1,20130101, 80047,CPT,BASIC METABOLIC PANEL CALCIUM IONIZED,,30,,,$231.61,$0.00,1,0,1,20130101, 80050,CPT,GENERAL HEALTH PANEL,,30,,,$530.78,$0.00,1,0,1,20130101, 80055,CPT,OBSTETRIC PANEL,,30,,,$772.05,$0.00,1,0,1,20130101, 80100,CPT,DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX,,30,,,$434.28,$0.00,1,0,1,20130101, 80101,CPT,DRUG SCR QUAL 1 DRUG CLASS METH EA DRUG CLASS,,30,,,$366.72,$0.00,1,0,1,20130101, 80104,CPT,DRUG SCRN QUAL MLT CLASS NONCHROMOTOGRAPHIC EACH,,30,,,$463.23,$0.00,1,0,1,20130101, 80500,CPT,CLINICAL PATHOLOGY CONSULTATION LIMITED,,30,,,$152.17,$0.00,1,0,1,20130101, 80502,CPT,CLINICAL PATHOLOGY CONSULTATION COMPREHENSIVE,,30,,,$81.12,$0.00,1,0,1,20130101, 84181,CPT,PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID,,30,,,$355.75,$0.00,1,0,1,20130101, 84182,CPT,PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL,,30,,,$574.67,$0.00,1,0,1,20130101, 84704,CPT,GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN,,30,,,$259.97,$0.00,1,0,1,20130101, 85060,CPT,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,,30,,,$136.87,$0.00,1,0,1,20130101, 85097,CPT,BONE MARROW SMEAR INTERPRETATION,,30,,,$247.55,$0.00,1,0,1,20130101, 85390,CPT,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,,30,,,$81.55,$0.00,1,0,1,20130101, 86077,CPT,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,,30,,,$81.12,$0.00,1,0,1,20130101, 86078,CPT,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,,30,,,$152.17,$0.00,1,0,1,20130101, 86079,CPT,BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT,,30,,,$152.17,$0.00,1,0,1,20130101, 86152,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID FLUID SPEC,,30,,,$82.62,$0.00,1,0,1,20130101, 86153,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP,,30,,,$82.62,$0.00,1,0,1,20130101, 86255,CPT,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,,30,,,$104.95,$0.00,1,0,1,20130101, 86256,CPT,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,,30,,,$95.95,$0.00,1,0,1,20130101, 86335,CPT,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,,30,,,$287.86,$0.00,1,0,1,20130101, 86485,CPT,SKIN TEST CANDIDA,,30,,,$44.20,$0.00,1,0,1,20130101, 86486,CPT,SKIN TEST UNLISTED ANTIGEN EACH,,30,,,$44.20,$0.00,1,0,1,20130101, 86490,CPT,SKIN TEST COCCIDIOIDOMYCOSIS,,30,,,$44.20,$0.00,1,0,1,20130101, 86510,CPT,SKIN TEST HISTOPLASMOSIS,,30,,,$44.20,$0.00,1,0,1,20130101, 86580,CPT,SKIN TEST TUBERCULOSIS INTRADERMAL,,30,,,$44.20,$0.00,1,0,1,20130101, 86850,CPT,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,,30,,,$116.74,$0.00,1,0,1,20130101, 86860,CPT,ANTIBODY ELUTION RBC EACH ELUTION,,30,,,$160.62,$0.00,1,0,1,20130101, 86870,CPT,ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,,30,,,$222.22,$0.00,1,0,1,20130101, 86880,CPT,ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM,,30,,,$62.86,$0.00,1,0,1,20130101, 86885,CPT,ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL,,30,,,$62.86,$0.00,1,0,1,20130101, 86886,CPT,ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER,,30,,,$62.86,$0.00,1,0,1,20130101, 86890,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE PREDEPOSITED,,30,,,$222.22,$0.00,1,0,1,20130101, 86891,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE SALVAGE,,30,,,$116.74,$0.00,1,0,1,20130101, 86900,CPT,BLOOD TYPING ABO,,30,,,$62.86,$0.00,1,0,1,20130101, 86901,CPT,BLOOD TYPING RH D,,30,,,$62.86,$0.00,1,0,1,20130101, 86902,CPT,BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH,,30,,,$116.74,$0.00,1,0,1,20130101, 86904,CPT,BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT,,30,,,$116.74,$0.00,1,0,1,20130101, 86905,CPT,BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH,,30,,,$116.74,$0.00,1,0,1,20130101, 86906,CPT,BLOOD TYPING RH PHENOTYPING COMPLETE,,30,,,$116.74,$0.00,1,0,1,20130101, 86910,CPT,BLOOD TYPING PATERNITY PR INDIV ABO RH&MN,,30,,,$146.60,$0.00,1,0,1,20130101, 86911,CPT,BLOOD TYPING PATERNITY INDIV ADDL ANTIGEN SYS,,30,,,$126.61,$0.00,1,0,1,20130101, 86920,CPT,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,,30,,,$116.74,$0.00,1,0,1,20130101, 86921,CPT,COMPATIBILITY EACH UNIT INCUBATION,,30,,,$116.74,$0.00,1,0,1,20130101, 86922,CPT,COMPATIBILITY EACH UNIT ANTIGLOBULIN,,30,,,$160.62,$0.00,1,0,1,20130101, 86923,CPT,COMPATIBILITY EACH UNIT ELECTRONIC,,30,,,$116.74,$0.00,1,0,1,20130101, 86927,CPT,FRESH FROZEN PLASMA THAWING EACH UNIT,,30,,,$116.74,$0.00,1,0,1,20130101, 86930,CPT,FROZEN BLOOD EACH UNIT FREEZING,,30,,,$222.22,$0.00,1,0,1,20130101, 86931,CPT,FROZEN BLOOD EACH UNIT THAWING,,30,,,$222.22,$0.00,1,0,1,20130101, 86932,CPT,FROZEN BLOOD EACH UNIT FREEZING & THAWING,,30,,,$222.22,$0.00,1,0,1,20130101, 86945,CPT,IRRADIATION BLOOD PRODUCT EACH UNIT,,30,,,$116.74,$0.00,1,0,1,20130101, 86950,CPT,LEUKOCYTE TRANSFUSION,,30,,,$116.74,$0.00,1,0,1,20130101, 86960,CPT,VOLUME REDUCTION BLOOD/BLOOD PRODUCT EACH UNIT,,30,,,$116.74,$0.00,1,0,1,20130101, 86965,CPT,POOLING PLATELETS/OTHER BLOOD PRODUCTS,,30,,,$160.62,$0.00,1,0,1,20130101, 86970,CPT,PRETX RBC ANTIBODY INCUBAT W/CHEM AGNTS/DRUGS EA,,30,,,$116.74,$0.00,1,0,1,20130101, 86971,CPT,PRETX RBC ANTIBODY INCUBAT W/ENZYMES EACH,,30,,,$116.74,$0.00,1,0,1,20130101, 86972,CPT,PRETX RBC ANTIBODY INCUBAT W/DENSITY GRAD SEP,,30,,,$116.74,$0.00,1,0,1,20130101, 86975,CPT,PRETX SERUM RBC ANTIBODY INCUBATION DRUGS EACH,,30,,,$222.22,$0.00,1,0,1,20130101, 86976,CPT,PRETX SERUM RBC ANTIBODY IDENTIFICATION DILUTION,,30,,,$116.74,$0.00,1,0,1,20130101, 86977,CPT,PRETX SERUM RBC ANTB ID INCUBATION INHIBITORS EA,,30,,,$222.22,$0.00,1,0,1,20130101, 86978,CPT,PRETX SERUM RBC ANTIBODY ID DIFFIAL EACH ABSRPJ,,30,,,$160.62,$0.00,1,0,1,20130101, 86985,CPT,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,,30,,,$116.74,$0.00,1,0,1,20130101, 86999,CPT,UNLISTED TRANSFUSION MEDICINE PROCEDURE,,30,,,$116.74,$0.00,1,0,1,20130101, 87207,CPT,SMR PRIM SRC SPEC STAIN BODIES/PARASITS,,30,,,$176.60,$0.00,1,0,1,20130101, 87500,CPT,INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE,,30,,,$693.81,$0.00,1,0,1,20130101, 87809,CPT,INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS,,30,,,$252.29,$0.00,1,0,1,20130101, 88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,,30,,,$152.17,$0.00,1,0,1,20130101, 88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,,30,,,$152.17,$0.00,1,0,1,20130101, 88108,CPT,CYTP CONCENTRATION SMEARS & INTERPRETATION,,30,,,$152.17,$0.00,1,0,1,20130101, 88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,,30,,,$152.17,$0.00,1,0,1,20130101, 88120,CPT,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,,30,,,"$1,003.70",$0.00,1,0,1,20130101, 88121,CPT,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,,30,,,"$1,003.70",$0.00,1,0,1,20130101, 88125,CPT,CYTOPATHOLOGY FORENSIC,,30,,,$152.17,$0.00,1,0,1,20130101, 88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,,30,,,$81.12,$0.00,1,0,1,20130101, 88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,,30,,,$81.12,$0.00,1,0,1,20130101, 88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,,30,,,$152.17,$0.00,1,0,1,20130101, 88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,,30,,,$152.17,$0.00,1,0,1,20130101, 88173,CPT,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,,30,,,$247.55,$0.00,1,0,1,20130101, 88177,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,,30,,,$81.12,$0.00,1,0,1,20130101, 88182,CPT,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,,30,,,$247.55,$0.00,1,0,1,20130101, 88184,CPT,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST,,30,,,$152.17,$0.00,1,0,1,20130101, 88185,CPT,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA,,30,,,$81.12,$0.00,1,0,1,20130101, 88187,CPT,FLOW CYTOMETRY INTERPJ 2-8 MARKERS,,30,,,$152.17,$0.00,1,0,1,20130101, 88188,CPT,FLOW CYTOMETRY INTERPJ 9-15 MARKERS,,30,,,$152.17,$0.00,1,0,1,20130101, 88189,CPT,FLOW CYTOMETRY INTERPJ 16/> MARKERS,,30,,,$152.17,$0.00,1,0,1,20130101, 88199,CPT,UNLISTED CYTOPATHOLOGY PROCEDURE,,30,,,$81.12,$0.00,1,0,1,20130101, 88299,CPT,UNLISTED CYTOGENETIC STUDY,,30,,,$81.12,$0.00,1,0,1,20130101, 88300,CPT,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,,30,,,$81.12,$0.00,1,0,1,20130101, 88302,CPT,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,$152.17,$0.00,1,0,1,20130101, 88304,CPT,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXA,,30,,,$152.17,$0.00,1,0,1,20130101, 88305,CPT,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,$247.55,$0.00,1,0,1,20130101, 88307,CPT,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,$391.38,$0.00,1,0,1,20130101, 88309,CPT,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,30,,,"$1,003.70",$0.00,1,0,1,20130101, 88311,CPT,DECALCIFICATION PROCEDURE,,30,,,$81.12,$0.00,1,0,1,20130101, 88312,CPT,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,,30,,,$152.17,$0.00,1,0,1,20130101, 88313,CPT,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,,30,,,$152.17,$0.00,1,0,1,20130101, 88314,CPT,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,,30,,,$152.17,$0.00,1,0,1,20130101, 88319,CPT,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,,30,,,$152.17,$0.00,1,0,1,20130101, 88321,CPT,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,,30,,,$81.12,$0.00,1,0,1,20130101, 88323,CPT,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,,30,,,$247.55,$0.00,1,0,1,20130101, 88325,CPT,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,,30,,,$391.38,$0.00,1,0,1,20130101, 88329,CPT,PATHOLOGY CONSULTATION DURING SURGERY,,30,,,$81.12,$0.00,1,0,1,20130101, 88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,,30,,,$152.17,$0.00,1,0,1,20130101, 88332,CPT,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,,30,,,$81.12,$0.00,1,0,1,20130101, 88333,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,,30,,,$152.17,$0.00,1,0,1,20130101, 88334,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,,30,,,$81.12,$0.00,1,0,1,20130101, 88342,CPT,IMCYTCHM TISS IMMUNOPROXIDASE EA ANTIBODY,,30,,,$247.55,$0.00,1,0,1,20130101, 88346,CPT,IMMUNOFLUORESCENT STUDY EA ANTIBODY DIR METHOD,,30,,,$247.55,$0.00,1,0,1,20130101, 88347,CPT,IMMUNOFLUORESCENT STUDY EA ANTIBODY INDIR METHOD,,30,,,$152.17,$0.00,1,0,1,20130101, 88348,CPT,ELECTRON MICROSCOPY DIAGNOSTIC,,30,,,"$1,003.70",$0.00,1,0,1,20130101, 88349,CPT,ELECTRON MICROSCOPY SCANNING,,30,,,"$1,003.70",$0.00,1,0,1,20130101, 88355,CPT,MORPHOMETRIC ANALYSIS SKELETAL MUSCLE,,30,,,$247.55,$0.00,1,0,1,20130101, 88356,CPT,MORPHOMETRIC ANALYSIS NERVE,,30,,,$247.55,$0.00,1,0,1,20130101, 88358,CPT,MORPHOMETRIC ANALYSIS TUMOR,,30,,,$247.55,$0.00,1,0,1,20130101, 88360,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,,30,,,$247.55,$0.00,1,0,1,20130101, 88361,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,,30,,,$247.55,$0.00,1,0,1,20130101, 88362,CPT,NERVE TEASING PREPARATIONS,,30,,,$391.38,$0.00,1,0,1,20130101, 88363,CPT,EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSI,,30,,,$81.12,$0.00,1,0,1,20130101, 88365,CPT,IN SITU HYBRIDIZATION EACH PROBE,,30,,,$247.55,$0.00,1,0,1,20130101, 88367,CPT,M/PHMTRC ALYS ISH EA PRB CPTR-ASST TECHNOLOGY,,30,,,$247.55,$0.00,1,0,1,20130101, 88368,CPT,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,,30,,,$391.38,$0.00,1,0,1,20130101, 88371,CPT,PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO,,30,,,$489.22,$0.00,1,0,1,20130101, 88372,CPT,PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA,,30,,,$477.98,$0.00,1,0,1,20130101, 88375,CPT,OPTICAL ENDOMICROSCOPIC IMAGE INTERP & REPORT,,30,,,$82.62,$0.00,1,0,1,20130101, 88399,CPT,UNLISTED SURGICAL PATHOLOGY PROCEDURE,,30,,,$81.12,$0.00,1,0,1,20130101, 89049,CPT,CAFFEINE HALOTHANE CONTRACTURE TEST,,30,,,$81.12,$0.00,1,0,1,20130101, 89060,CPT,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,,30,,,$49.20,$0.00,1,0,1,20130101, 89220,CPT,SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX,,30,,,$152.17,$0.00,1,0,1,20130101, 89230,CPT,SWEAT COLLECTION IONTOPHORESIS,,30,,,$247.55,$0.00,1,0,1,20130101, 89240,CPT,UNLIS MISC PATH,,30,,,$81.12,$0.00,1,0,1,20130101, 89250,CPT,CUL OOCYTE/EMBRYO <4 DAYS,,30,,,$391.38,$0.00,1,0,1,20130101, 89251,CPT,CUL OOCYTE/EMBRYO < 4 D CO-CULT OCYTE/EMBRY,,30,,,$391.38,$0.00,1,0,1,20130101, 89253,CPT,ASSTD EMBRYO HATCHING MICROTQS ANY METH,,30,,,$391.38,$0.00,1,0,1,20130101, 89254,CPT,OOCYTE ID FROM FOLLICULAR FLU,,30,,,$391.38,$0.00,1,0,1,20130101, 89255,CPT,PREPJ EMBRYO TR,,30,,,$391.38,$0.00,1,0,1,20130101, 89257,CPT,SPRM ID FROM ASPIR OTH/THN SEMINAL,,30,,,$152.17,$0.00,1,0,1,20130101, 89258,CPT,CRYOPRSRV EMBRYO,,30,,,$391.38,$0.00,1,0,1,20130101, 89259,CPT,CRYOPRSRV SPRM,,30,,,$152.17,$0.00,1,0,1,20130101, 89260,CPT,SPRM ISOL SMPL PREP INSEMINATION/DX SEMEN ALYS,,30,,,$247.55,$0.00,1,0,1,20130101, 89261,CPT,SPRM ISOL CPLX PREP INSEMINATION/DX SEMEN ALYS,,30,,,$247.55,$0.00,1,0,1,20130101, 89264,CPT,SPRM ID FROM TSTIS TISS FRSH/CRYOPRSRVD,,30,,,$391.38,$0.00,1,0,1,20130101, 89268,CPT,INSEMINATION OOCYTES,,30,,,$391.38,$0.00,1,0,1,20130101, 89272,CPT,EXTND CUL OOCYTE/EMBRYO 4-7 DAYS,,30,,,$391.38,$0.00,1,0,1,20130101, 89280,CPT,ASSTD FERTILIZATION MICROTQ 10 OOCYTES,,30,,,$391.38,$0.00,1,0,1,20130101, 89290,CPT,BX OOCYTE MICROTQ >/EQUAL 5 EMBRY,,30,,,$391.38,$0.00,1,0,1,20130101, 89291,CPT,BX OOCYTE MICROTQ >5 EMBRY,,30,,,$391.38,$0.00,1,0,1,20130101, 89322,CPT,SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,,30,,,$492.04,$0.00,1,0,1,20130101, 89335,CPT,CRYOPRSRV REPRODUCTIVE TISSUE TESTICULAR,,30,,,$391.38,$0.00,1,0,1,20130101, 89342,CPT,STORAGE PER YEAR EMBRYO,,30,,,$391.38,$0.00,1,0,1,20130101, 89343,CPT,STORAGE PER YEAR SPERM/SEMEN,,30,,,$391.38,$0.00,1,0,1,20130101, 89344,CPT,STORAGE PER YR REPRDTVE TISS TSTICULAR/OVARIAN,,30,,,$391.38,$0.00,1,0,1,20130101, 89346,CPT,STORAGE PER YEAR OOCYTE,,30,,,$391.38,$0.00,1,0,1,20130101, 89352,CPT,THAWING CRYOPRESERVED EMBRYO,,30,,,$391.38,$0.00,1,0,1,20130101, 89353,CPT,THAWING CRYOPRESERVED SPERM/SEMEN EACH ALIQUOT,,30,,,$391.38,$0.00,1,0,1,20130101, 89354,CPT,THAWING CRYOPRESERVED TESTICULAR/OVARIAN,,30,,,$391.38,$0.00,1,0,1,20130101, 89356,CPT,THAWING CRYOPRESERVED OOCYTES EACH ALIQUOT,,30,,,$391.38,$0.00,1,0,1,20130101, 89398,CPT,UNLISTED REPRODUCTIVE MEDICINE LAB PROCEDURE,,30,,,$81.12,$0.00,1,0,1,20130101, 90281,CPT,IMMUNE GLOBULIN IG HUMAN IM USE,,30,,,$116.13,$0.00,1,0,1,20130101, 90283,CPT,IMMUNE GLOBULIN IGIV HUMAN IV USE,,30,,,"$1,896.48",$0.00,1,0,1,20130101, 90291,CPT,CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN IV,,30,,,$792.67,$0.00,1,0,1,20130101, 90371,CPT,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,,30,,,$730.78,$0.00,1,0,1,20130101, 90375,CPT,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,,30,,,"$1,201.20",$0.00,1,0,1,20130101, 90376,CPT,RABIES IG HEAT-TREATED HUMAN IM/SUBQ,,30,,,"$1,125.15",$0.00,1,0,1,20130101, 90378,CPT,RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E,,30,,,"$7,061.37",$0.00,1,0,1,20130101, 90384,CPT,RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM,,30,,,$443.63,$0.00,1,0,1,20130101, 90389,CPT,TETANUS IMMUNE GLOBULIN TIG HUMAN IM,,30,,,$261.35,$0.00,1,0,1,20130101, 90393,CPT,VACCINIA IMMUNE GLOBULIN HUMAN IM,,30,,,$379.62,$0.00,1,0,1,20130101, 90396,CPT,VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM,,30,,,$494.25,$0.00,1,0,1,20130101, 90460,CPT,IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,,30,,,$45.20,$0.00,1,0,1,20130101, 90461,CPT,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,,30,,,$44.60,$0.00,1,0,1,20130101, 90471,CPT,IMADM PRQ ID SUBQ/IM NJXS 1 VACCINE,,30,,,$253.90,$0.00,1,0,1,20130101, 90472,CPT,IMADM PRQ ID SUBQ/IM NJXS EA VACCINE,,30,,,$175.99,$0.00,1,0,1,20130101, 90473,CPT,IMADM INTRANSL/ORAL 1 VACCINE,,30,,,$175.99,$0.00,1,0,1,20130101, 90474,CPT,IMADM INTRANSL/ORAL EA VACCINE,,30,,,$175.99,$0.00,1,0,1,20130101, 90581,CPT,ANTHRAX VACCINE SUBCUTANEOUS/IM USE,,30,,,$729.12,$0.00,1,0,1,20130101, 90585,CPT,BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ,,30,,,$735.72,$0.00,1,0,1,20130101, 90586,CPT,BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL,,30,,,$600.81,$0.00,1,0,1,20130101, 90649,CPT,HUMAN PAPILLOMA VIRUS VACCINE QUADRIV 3 DOSE IM,,30,,,$432.01,$0.00,1,0,1,20130101, 90650,CPT,HUMAN PAPILLOMA VIRUS BIVALENT VACCINE 3 DOSE IM,,30,,,$841.12,$0.00,1,0,1,20130101, 90654,CPT,INFLUENZA VACCINE SPLIT VIRUS PRSRV FREE ID,,30,,,$47.94,$0.00,1,0,1,20130101, 90655,CPT,INFLUENZA VACC TRIVALENT PRSRV FREE 6-35 MO IM,,30,,,$39.85,$0.00,1,0,1,20130101, 90656,CPT,INFLUENZA VIRUS VACC SPLIT PRSRV FREE 3 YRS/> IM,,30,,,$54.41,$0.00,1,0,1,20130101, 90657,CPT,INFLUENZA VIRUS VACCINE SPLIT VIRUS 6-35 MO IM,,30,,,$40.65,$0.00,1,0,1,20130101, 90658,CPT,INFLUENZA VIRUS VACCINE SPLIT VIRUS 3/> YRS IM,,30,,,$55.74,$0.00,1,0,1,20130101, 90660,CPT,INFLUENZA VIRUS VACCINE LIVE INTRANASAL,,30,,,$46.45,$0.00,1,0,1,20130101, 90662,CPT,INFLUENZA VACCINE SPLT PRSRV FREE INC ANTIGEN IM,,30,,,$51.10,$0.00,1,0,1,20130101, 90669,CPT,PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM,,30,,,$256.65,$0.00,1,0,1,20130101, 90670,CPT,PNEUMOCOCCAL CONJ VACCINE 13 VALENT IM,,30,,,$596.00,$0.00,1,0,1,20130101, 90675,CPT,RABIES VACCINE INTRAMUSCULAR,,30,,,"$1,291.62",$0.00,1,0,1,20130101, 90676,CPT,RABIES VACCINE INTRADERMAL,,30,,,"$1,010.64",$0.00,1,0,1,20130101, 90681,CPT,ROTAVIRUS VACC HUMAN ATTENUATED 2 DOSE LIVE ORAL,,30,,,$702.12,$0.00,1,0,1,20130101, 90693,CPT,TYPHOID VACCINE AKD SUBQ U.S. MILITARY,,30,,,$379.62,$0.00,1,0,1,20130101, 90716,CPT,VARICELLA VIRUS VACCINE LIVE SUBQ,,30,,,$269.43,$0.00,1,0,1,20130101, 90723,CPT,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,,30,,,$228.78,$0.00,1,0,1,20130101, 90725,CPT,CHOLERA VACCINE INJECTABLE,,30,,,$584.31,$0.00,1,0,1,20130101, 90732,CPT,PNEUMOCOCCAL POLYSAC VACCINE 23-V 2 YRS/>SUBQ/IM,,30,,,$187.68,$0.00,1,0,1,20130101, 90733,CPT,MENINGOCOCCAL POLYSAC VACCINE SUBCUTANEOUS,,30,,,$729.24,$0.00,1,0,1,20130101, 90734,CPT,MENINGOCOCCAL CONJ VACCINE TETRAVALENT IM,,30,,,$567.18,$0.00,1,0,1,20130101, 90735,CPT,JAPANESE ENCEPHALITIS VIRUS VACCINE SUBCUTANEOUS,,30,,,$659.97,$0.00,1,0,1,20130101, 90736,CPT,ZOSTER SHINGLES VACCINE LIVE SUBCUTANEOUS,,30,,,$440.59,$0.00,1,0,1,20130101, 90738,CPT,JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM,,30,,,$452.92,$0.00,1,0,1,20130101, 90740,CPT,HEPATITIS B VACCINE DIALYSIS DOSAGE 3 DOSE IM,,30,,,$379.62,$0.00,1,0,1,20130101, 90743,CPT,HEPATITIS B VACCINE ADOLESCENT 2 DOSE IM,,30,,,$238.23,$0.00,1,0,1,20130101, 90744,CPT,HEPATITIS B VACCINE PEDIATRIC3 DOSE IM,,30,,,$123.10,$0.00,1,0,1,20130101, 90746,CPT,HEPATITIS B VACCINE ADULT 3 DOSE IM,,30,,,$283.36,$0.00,1,0,1,20130101, 90747,CPT,HEPATITIS B VACCINE DIALYSIS DOSAGE 4 DOSE IM,,30,,,$379.62,$0.00,1,0,1,20130101, 90748,CPT,HEPB-HIB VACCINE INTRAMUSCULAR,,30,,,$171.52,$0.00,1,0,1,20130101, 90791,CPT,PSYCHIATRIC DIAGNOSTIC EVALUATION,,30,,,$540.28,$0.00,1,0,1,20130101, 90792,CPT,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,,30,,,$540.28,$0.00,1,0,1,20130101, 90832,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES,,30,,,$406.39,$0.00,1,0,1,20130101, 90834,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES,,30,,,$540.28,$0.00,1,0,1,20130101, 90837,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES,,30,,,$540.28,$0.00,1,0,1,20130101, 90839,CPT,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,,30,,,$540.28,$0.00,1,0,1,20130101, 90845,CPT,PSYCHOANALYSIS,,30,,,$540.28,$0.00,1,0,1,20130101, 90846,CPT,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT,,30,,,$532.15,$0.00,1,0,1,20130101, 90847,CPT,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT,,30,,,$532.15,$0.00,1,0,1,20130101, 90849,CPT,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,,30,,,$291.76,$0.00,1,0,1,20130101, 90853,CPT,GROUP PSYCHOTHERAPY,,30,,,$291.76,$0.00,1,0,1,20130101, 90865,CPT,NARCOSYNTHESIS PSYC DX&THER PURPOSES,,30,,,$540.28,$0.00,1,0,1,20130101, 90867,CPT,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,,30,,,"$1,096.05",$0.00,1,0,1,20130101, 90868,CPT,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,,30,,,"$1,096.05",$0.00,1,0,1,20130101, 90869,CPT,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,,30,,,"$1,096.05",$0.00,1,0,1,20130101, 90870,CPT,ELECTROCONVULSIVE THERAPY,,30,,,"$2,705.24",$0.00,1,0,1,20130101, 90875,CPT,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,,30,,,$124.13,$0.00,1,0,1,20130101, 90876,CPT,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,,30,,,$595.76,$0.00,1,0,1,20130101, 90880,CPT,HYPNOTHERAPY,,30,,,$540.28,$0.00,1,0,1,20130101, 90882,CPT,ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT,,30,,,$269.90,$0.00,1,0,1,20130101, 90899,CPT,UNLISTED PSYCHIATRIC SERVICE/PROCEDURE,,30,,,$406.39,$0.00,1,0,1,20130101, 90901,CPT,BIOFEEDBACK TRAINING ANY MODALITY,,30,,,$158.47,$0.00,1,0,1,20130101, 90911,CPT,BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,,30,,,$511.00,$0.00,1,0,1,20130101, 90935,CPT,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,,30,,,"$2,501.58",$0.00,1,0,1,20130101, 90937,CPT,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,,30,,,$974.31,$0.00,1,0,1,20130101, 90945,CPT,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,,30,,,"$1,118.41",$0.00,1,0,1,20130101, 90947,CPT,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,,30,,,$360.25,$0.00,1,0,1,20130101, 90954,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,,30,,,$756.02,$0.00,1,0,1,20130101, 90955,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,,30,,,$430.41,$0.00,1,0,1,20130101, 90956,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,,30,,,$117.20,$0.00,1,0,1,20130101, 90960,CPT,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,,30,,,$348.40,$0.00,1,0,1,20130101, 90966,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,,30,,,$343.71,$0.00,1,0,1,20130101, 90968,CPT,ESRD RELATED SVC YR OLD,,30,,,"$1,587.66",$0.00,1,0,1,20130101, 90989,CPT,DIALYSIS TRAINING PATIENT COMPLETED COURSE,,30,,,$997.06,$0.00,1,0,1,20130101, 90993,CPT,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,,30,,,"$2,646.18",$0.00,1,0,1,20130101, 90997,CPT,HEMOPERFUSION,,30,,,$45.94,$0.00,1,0,1,20130101, 90999,CPT,UNLISTED DIALYSIS PROCEDURE INPATIENT/OUTPATIENT,,30,,,$638.07,$0.00,1,0,1,20130101, 91010,CPT,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91013,CPT,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91020,CPT,GASTRIC MOTILITY MANOMETRIC STUDIES,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91022,CPT,DUODENAL MOTILITY MANOMETRIC STUDY,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91030,CPT,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91034,CPT,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91035,CPT,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91037,CPT,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,,30,,,$810.99,$0.00,1,0,1,20130101, 91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 91040,CPT,ESOPHGL BALO DISTENSION PROVOCATION STD,,30,,,$810.99,$0.00,1,0,1,20130101, 91065,CPT,BREATH HYDROGEN TEST,,30,,,$810.99,$0.00,1,0,1,20130101, 91110,CPT,GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,,30,,,"$4,148.90",$0.00,1,0,1,20130101, 91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R,,30,,,"$4,680.06",$0.00,1,0,1,20130101, 91112,CPT,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,,30,,,"$1,802.32",$0.00,1,0,1,20130101, 91117,CPT,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 91120,CPT,RECTAL SESATION TONE & COMPLIANCE TEST,,30,,,$511.00,$0.00,1,0,1,20130101, 91122,CPT,ANORECTAL MANOMETRY,,30,,,"$1,284.40",$0.00,1,0,1,20130101, 91132,CPT,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,,30,,,$810.99,$0.00,1,0,1,20130101, 91133,CPT,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,,30,,,$810.99,$0.00,1,0,1,20130101, 91299,CPT,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,,30,,,$810.99,$0.00,1,0,1,20130101, 92002,CPT,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,,30,,,$222.68,$0.00,1,0,1,20130101, 92004,CPT,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,,30,,,$222.68,$0.00,1,0,1,20130101, 92012,CPT,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,,30,,,$170.16,$0.00,1,0,1,20130101, 92014,CPT,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,,30,,,$170.16,$0.00,1,0,1,20130101, 92015,CPT,DETERMINATION REFRACTIVE STATE,,30,,,$108.44,$0.00,1,0,1,20130101, 92018,CPT,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,,30,,,"$6,372.22",$0.00,1,0,1,20130101, 92019,CPT,OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD,,30,,,"$6,372.22",$0.00,1,0,1,20130101, 92020,CPT,GONIOSCOPY SEPARATE PROCEDURE,,30,,,$204.26,$0.00,1,0,1,20130101, 92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,,30,,,$204.26,$0.00,1,0,1,20130101, 92060,CPT,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,,30,,,$204.26,$0.00,1,0,1,20130101, 92065,CPT,ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ,,30,,,$204.26,$0.00,1,0,1,20130101, 92081,CPT,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,,30,,,$204.26,$0.00,1,0,1,20130101, 92082,CPT,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,,30,,,$204.26,$0.00,1,0,1,20130101, 92083,CPT,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,,30,,,$354.27,$0.00,1,0,1,20130101, 92132,CPT,CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI,,30,,,$204.26,$0.00,1,0,1,20130101, 92133,CPT,COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE,,30,,,$204.26,$0.00,1,0,1,20130101, 92134,CPT,COMPUTERIZED OPHTHALMIC IMAGING RETINA,,30,,,$204.26,$0.00,1,0,1,20130101, 92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,,30,,,$354.27,$0.00,1,0,1,20130101, 92140,CPT,PROVOCATIVE TESTS GLAUCOMA I&R W/O TONOGRAPHY,,30,,,$204.26,$0.00,1,0,1,20130101, 92225,CPT,OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R 1ST,,30,,,$204.26,$0.00,1,0,1,20130101, 92226,CPT,OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R SBS,,30,,,$204.26,$0.00,1,0,1,20130101, 92227,CPT,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/B,,30,,,$150.41,$0.00,1,0,1,20130101, 92228,CPT,REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B,,30,,,$150.41,$0.00,1,0,1,20130101, 92230,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,,30,,,$354.27,$0.00,1,0,1,20130101, 92235,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,,30,,,$804.02,$0.00,1,0,1,20130101, 92240,CPT,INDOCYANINE GREEN ANGIOGRAPHY W/INTERP & REPOR,,30,,,$804.02,$0.00,1,0,1,20130101, 92250,CPT,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,,30,,,$204.26,$0.00,1,0,1,20130101, 92260,CPT,OPHTHALMODYNAMOMETRY,,30,,,$204.26,$0.00,1,0,1,20130101, 92265,CPT,NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R,,30,,,$204.26,$0.00,1,0,1,20130101, 92270,CPT,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,,30,,,$204.26,$0.00,1,0,1,20130101, 92275,CPT,ELECTRORETINOGRAPY W/INTERPRETATION & REPORT,,30,,,$804.02,$0.00,1,0,1,20130101, 92283,CPT,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,,30,,,$204.26,$0.00,1,0,1,20130101, 92284,CPT,DARK ADAPTATION XM W/INTERPRETATION & REPORT,,30,,,$204.26,$0.00,1,0,1,20130101, 92285,CPT,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,,30,,,$204.26,$0.00,1,0,1,20130101, 92286,CPT,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,,30,,,$354.27,$0.00,1,0,1,20130101, 92287,CPT,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,,30,,,$354.27,$0.00,1,0,1,20130101, 92310,CPT,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,,30,,,$69.68,$0.00,1,0,1,20130101, 92311,CPT,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,,30,,,$354.27,$0.00,1,0,1,20130101, 92312,CPT,RX&FITG CONTACT CORNEAL LENS APHAKIA BOTH EYES,,30,,,$204.26,$0.00,1,0,1,20130101, 92313,CPT,RX&FITG CORNEOSCLERAL LENS,,30,,,$354.27,$0.00,1,0,1,20130101, 92314,CPT,RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA,,30,,,$48.05,$0.00,1,0,1,20130101, 92315,CPT,RX CONTACT CORNEAL LENS APHAKIA 1 EYE,,30,,,$354.27,$0.00,1,0,1,20130101, 92316,CPT,RX CONTACT CORNEAL LENS APHAKIA BOTH EYES,,30,,,$354.27,$0.00,1,0,1,20130101, 92317,CPT,RX CONTACT CORNEOSCLERAL LENS,,30,,,$204.26,$0.00,1,0,1,20130101, 92325,CPT,MODIFICAJ CONTACT LENX SPX SUPVJ ADAPTATION,,30,,,$354.27,$0.00,1,0,1,20130101, 92326,CPT,REPLACEMENT CONTACT LENS,,30,,,$204.26,$0.00,1,0,1,20130101, 92340,CPT,FITTING SPECTACLES XCPT APHAKIA MONOFOCAL,,30,,,$44.71,$0.00,1,0,1,20130101, 92341,CPT,FITTING SPECTACLES XCPT APHAKIA BIFOCAL,,30,,,$64.03,$0.00,1,0,1,20130101, 92352,CPT,FITTING SPECTACLE PROSTH APHAKIA MONOFOCAL,,30,,,$354.27,$0.00,1,0,1,20130101, 92353,CPT,FITTING SPECTACLE PROSTH APHAKIA MULTIFOCAL,,30,,,$354.27,$0.00,1,0,1,20130101, 92354,CPT,FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT,,30,,,$204.26,$0.00,1,0,1,20130101, 92355,CPT,FITTING SPECTACLE MOUNTED LW VIS AID TLSCP,,30,,,$204.26,$0.00,1,0,1,20130101, 92358,CPT,PROSTHESIS SERVICE APHAKIA TEMPORARY,,30,,,$204.26,$0.00,1,0,1,20130101, 92371,CPT,RPR&REFITG SPECTACLE PROSTHESIS APHAKIA,,30,,,$354.27,$0.00,1,0,1,20130101, 92499,CPT,UNLIVSTED OPHTHALMOLOGICAL SERVICE/PROCEDURE,,30,,,$204.26,$0.00,1,0,1,20130101, 92502,CPT,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,,30,,,"$1,272.14",$0.00,1,0,1,20130101, 92511,CPT,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,,30,,,$432.21,$0.00,1,0,1,20130101, 92512,CPT,NASAL FUNCTION STUDIES,,30,,,$394.97,$0.00,1,0,1,20130101, 92516,CPT,FACIAL NERVE FUNCTION STUDIES,,30,,,$394.97,$0.00,1,0,1,20130101, 92520,CPT,LARYNGEAL FUNCTION STUDIES,,30,,,$791.66,$0.00,1,0,1,20130101, 92526,CPT,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,,30,,,$200.77,$0.00,1,0,1,20130101, 92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK,,30,,,$791.66,$0.00,1,0,1,20130101, 92541,CPT,SPONTANEOUS NYSTAGMUS TEST,,30,,,$394.97,$0.00,1,0,1,20130101, 92542,CPT,POSITIONAL NYSTAGMUS TEST,,30,,,$394.97,$0.00,1,0,1,20130101, 92543,CPT,CALORIC VESTIBULAR TEST EA IRRIGATION W/RECORD,,30,,,$791.66,$0.00,1,0,1,20130101, 92544,CPT,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,,30,,,$394.97,$0.00,1,0,1,20130101, 92545,CPT,OSCILLATING TRACKING TEST W/RECORDING,,30,,,$394.97,$0.00,1,0,1,20130101, 92546,CPT,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,,30,,,$791.66,$0.00,1,0,1,20130101, 92548,CPT,COMPUTERIZED DYNAMIC POSTUROGRAPY,,30,,,$791.66,$0.00,1,0,1,20130101, 92550,CPT,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,,30,,,$134.84,$0.00,1,0,1,20130101, 92551,CPT,SCREENING TEST PURE TONE AIR ONLY,,30,,,$80.82,$0.00,1,0,1,20130101, 92552,CPT,PURE TONE AUDIOMETRY AIR ONLY,,30,,,$134.84,$0.00,1,0,1,20130101, 92553,CPT,PURE TONE AUDIOMETRY AIR & BONE,,30,,,$306.92,$0.00,1,0,1,20130101, 92555,CPT,SPEECH AUDIOMETRY THRESHOLD,,30,,,$134.84,$0.00,1,0,1,20130101, 92556,CPT,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,,30,,,$134.84,$0.00,1,0,1,20130101, 92557,CPT,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,,30,,,$306.92,$0.00,1,0,1,20130101, 92558,CPT,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,,30,,,$425.05,$0.00,1,0,1,20130101, 92560,CPT,BEKESY AUDIOMETRY SCREENING,,30,,,$180.01,$0.00,1,0,1,20130101, 92561,CPT,BEKESY AUDIOMETRY DIAGNOSTIC,,30,,,$306.92,$0.00,1,0,1,20130101, 92562,CPT,LOUDNESS BALANCE BINAURAL/MONAURAL,,30,,,$134.84,$0.00,1,0,1,20130101, 92563,CPT,TONE DECAY TEST,,30,,,$134.84,$0.00,1,0,1,20130101, 92564,CPT,SHORT INCREMENT SENSITIVITY INDEX,,30,,,$134.84,$0.00,1,0,1,20130101, 92565,CPT,STENGER TEST PURE TONE,,30,,,$134.84,$0.00,1,0,1,20130101, 92567,CPT,TYMPANOMETRY,,30,,,$134.84,$0.00,1,0,1,20130101, 92568,CPT,ACOUSTIC REFLEX THRESHOLD,,30,,,$134.84,$0.00,1,0,1,20130101, 92570,CPT,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,,30,,,$306.92,$0.00,1,0,1,20130101, 92571,CPT,FILTERED SPEECH TEST,,30,,,$134.84,$0.00,1,0,1,20130101, 92572,CPT,STAGGERED SPONDAIC WORD,,30,,,$700.84,$0.00,1,0,1,20130101, 92575,CPT,SENSORINEURAL ACUITY LEVEL,,30,,,$134.84,$0.00,1,0,1,20130101, 92576,CPT,SYNTHETIC SENTENCE IDENTIFICATION TEST,,30,,,$134.84,$0.00,1,0,1,20130101, 92577,CPT,STENGER TEST SPEECH,,30,,,$700.84,$0.00,1,0,1,20130101, 92579,CPT,VISUAL REINFORCEMENT AUDIOMETRY,,30,,,$306.92,$0.00,1,0,1,20130101, 92582,CPT,CONDITIONING PLAY AUDIOMETRY,,30,,,$306.92,$0.00,1,0,1,20130101, 92583,CPT,SELECT PICTURE AUDIOMETRY,,30,,,$134.84,$0.00,1,0,1,20130101, 92584,CPT,ELECTROCOCHLEOGRAPY,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 92585,CPT,AUDITORY EVOKED POTENTIALS COMPREHENSIVE,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 92586,CPT,AUDITORY EVOKED POTENTIALS LIMITED,,30,,,$522.20,$0.00,1,0,1,20130101, 92587,CPT,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,,30,,,$394.97,$0.00,1,0,1,20130101, 92588,CPT,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,,30,,,$394.97,$0.00,1,0,1,20130101, 92590,CPT,HEARING AID EXAMINATION & SELECTION MONAURAL,,30,,,$166.96,$0.00,1,0,1,20130101, 92591,CPT,HEARING AID EXAMINATION & SELECTION BINAURAL,,30,,,$245.90,$0.00,1,0,1,20130101, 92592,CPT,HEARING AID CHECK MONAURAL,,30,,,$94.40,$0.00,1,0,1,20130101, 92593,CPT,HEARING AID CHECK BINAURAL,,30,,,$135.82,$0.00,1,0,1,20130101, 92594,CPT,ELECTROACOUS EVAL HEARING AID MONAURAL,,30,,,$42.16,$0.00,1,0,1,20130101, 92595,CPT,ELECTROACOUS EVAL HEARING AID BINAURAL,,30,,,$73.31,$0.00,1,0,1,20130101, 92596,CPT,EAR PROTECTOR ATTENUATION MEASUREMENTS,,30,,,$134.84,$0.00,1,0,1,20130101, 92601,CPT,ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG,,30,,,$700.84,$0.00,1,0,1,20130101, 92602,CPT,ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG,,30,,,$700.84,$0.00,1,0,1,20130101, 92603,CPT,ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG,,30,,,$700.84,$0.00,1,0,1,20130101, 92604,CPT,ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG,,30,,,$700.84,$0.00,1,0,1,20130101, 92620,CPT,EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,,30,,,$306.92,$0.00,1,0,1,20130101, 92625,CPT,ASSESSMENT TINNITUS,,30,,,$306.92,$0.00,1,0,1,20130101, 92626,CPT,EVALUATION AUDITORY REHAB STATUS 1ST HR,,30,,,$700.84,$0.00,1,0,1,20130101, 92630,CPT,AUDITORY REHABILITATION PRELINGUAL HEARING LOSS,,30,,,$306.13,$0.00,1,0,1,20130101, 92633,CPT,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,,30,,,$368.49,$0.00,1,0,1,20130101, 92640,CPT,ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR,,30,,,$306.92,$0.00,1,0,1,20130101, 92700,CPT,UNLISTED OTORHINOLARYNGOLOGICAL SERVICE,,30,,,$134.84,$0.00,1,0,1,20130101, 92920,CPT,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,,30,,,"$15,751.36",$0.00,1,0,1,20130101, 92921,CPT,PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH,,30,,,"$15,751.36",$0.00,1,0,1,20130101, 92924,CPT,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,,30,,,"$23,401.67",$0.00,1,0,1,20130101, 92925,CPT,PRQ TRLUML CORONARY ANGIO/ATHEREC ADDL ART/BRNCH,,30,,,"$23,401.67",$0.00,1,0,1,20130101, 92928,CPT,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92929,CPT,PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92933,CPT,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92934,CPT,PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92937,CPT,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92938,CPT,PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92941,CPT,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92943,CPT,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92944,CPT,PRQ TRLUML CORONRY CHRNIC OCCLUS REVASC ADDL VSL,,30,,,"$22,942.80",$0.00,1,0,1,20130101, 92950,CPT,CARDIOPULMONARY RESUSCITATION,,30,,,"$1,035.29",$0.00,1,0,1,20130101, 92953,CPT,TEMPORARY TRANSCUTANEOUS PACING,,30,,,"$1,035.29",$0.00,1,0,1,20130101, 92960,CPT,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,,30,,,"$2,533.62",$0.00,1,0,1,20130101, 92961,CPT,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,,30,,,"$2,533.62",$0.00,1,0,1,20130101, 92973,CPT,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,,30,,,"$15,849.44",$0.00,1,0,1,20130101, 92974,CPT,TCAT PLMT RADJ DLVR DEV SBSQ C IV BRACHYTX,,30,,,"$6,533.84",$0.00,1,0,1,20130101, 92977,CPT,THROMBOLYSIS CORONARY INTRAVENOUS INFUSION,,30,,,"$1,108.56",$0.00,1,0,1,20130101, 92986,CPT,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 92987,CPT,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 92990,CPT,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 92997,CPT,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 92998,CPT,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,,30,,,"$16,529.99",$0.00,1,0,1,20130101, 93005,CPT,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,,30,,,$173.59,$0.00,1,0,1,20130101, 93017,CPT,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,,30,,,"$1,143.19",$0.00,1,0,1,20130101, 93024,CPT,ERGONOVINE PROVOCATION TST,,30,,,"$1,143.19",$0.00,1,0,1,20130101, 93025,CPT,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,,30,,,"$1,143.19",$0.00,1,0,1,20130101, 93041,CPT,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,,30,,,$150.41,$0.00,1,0,1,20130101, 93225,CPT,XTRNL ECG & 48 HR RECORDING,,30,,,$434.94,$0.00,1,0,1,20130101, 93226,CPT,EXTERNAL ECG SCANNING ANALYSIS REPORT,,30,,,$434.94,$0.00,1,0,1,20130101, 93229,CPT,XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT,,30,,,"$1,110.47",$0.00,1,0,1,20130101, 93270,CPT,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,,30,,,$434.94,$0.00,1,0,1,20130101, 93271,CPT,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,,30,,,$670.33,$0.00,1,0,1,20130101, 93278,CPT,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,,30,,,$150.41,$0.00,1,0,1,20130101, 93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,,30,,,$220.34,$0.00,1,0,1,20130101, 93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,,30,,,$220.34,$0.00,1,0,1,20130101, 93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,,30,,,$220.34,$0.00,1,0,1,20130101, 93282,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN 1 LD CARD/DFB,,30,,,$220.34,$0.00,1,0,1,20130101, 93283,CPT,PROGRM EVAL IMPLANTABLE IN PRSN DUAL L CARD/DFB,,30,,,$220.34,$0.00,1,0,1,20130101, 93284,CPT,PROGRM EVAL IMPLANTABLE IN PRSN MLT LD CARD/DFB,,30,,,$220.34,$0.00,1,0,1,20130101, 93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,,30,,,$220.34,$0.00,1,0,1,20130101, 93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,,30,,,$220.34,$0.00,1,0,1,20130101, 93289,CPT,INTERROGATION EVAL F2F 1/DUAL/MLT LEADS CVDFB,,30,,,$220.34,$0.00,1,0,1,20130101, 93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,,30,,,$150.41,$0.00,1,0,1,20130101, 93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,,30,,,$220.34,$0.00,1,0,1,20130101, 93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,,30,,,$220.34,$0.00,1,0,1,20130101, 93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,,30,,,$220.34,$0.00,1,0,1,20130101, 93296,CPT,INTERROGATION REMOTE HR REC ONL,,30,,,$434.94,$0.00,1,0,1,20130101, 93788,CPT,AMBL BLD PRESS W/TAPE/DISK 24/>HR ALYS W/REPRT,,30,,,$434.94,$0.00,1,0,1,20130101, 93797,CPT,OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR,,30,,,$259.67,$0.00,1,0,1,20130101, 93798,CPT,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,,30,,,$259.67,$0.00,1,0,1,20130101, 93799,CPT,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,,30,,,$434.94,$0.00,1,0,1,20130101, 93880,CPT,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93882,CPT,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93886,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93888,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,,30,,,$419.58,$0.00,1,0,1,20130101, 93890,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY,,30,,,$643.53,$0.00,1,0,1,20130101, 93892,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,,30,,,$643.53,$0.00,1,0,1,20130101, 93893,CPT,TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,,30,,,$643.53,$0.00,1,0,1,20130101, 93922,CPT,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,,30,,,$434.94,$0.00,1,0,1,20130101, 93923,CPT,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,,30,,,$702.32,$0.00,1,0,1,20130101, 93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,,30,,,$702.32,$0.00,1,0,1,20130101, 93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,,30,,,$643.53,$0.00,1,0,1,20130101, 93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,,30,,,$643.53,$0.00,1,0,1,20130101, 93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,,30,,,$702.32,$0.00,1,0,1,20130101, 93970,CPT,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93971,CPT,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,,30,,,$643.53,$0.00,1,0,1,20130101, 93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,,30,,,$643.53,$0.00,1,0,1,20130101, 93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD S,,30,,,"$1,001.02",$0.00,1,0,1,20130101, 93982,CPT,IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC,,30,,,$434.94,$0.00,1,0,1,20130101, 93990,CPT,DUPLEX SCAN HEMODIALYSIS ACCESS,,30,,,$643.53,$0.00,1,0,1,20130101, 93998,CPT,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,,30,,,$150.41,$0.00,1,0,1,20130101, 94002,CPT,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,,30,,,"$1,541.81",$0.00,1,0,1,20130101, 94003,CPT,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,,30,,,"$1,541.81",$0.00,1,0,1,20130101, 94010,CPT,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,,30,,,$407.84,$0.00,1,0,1,20130101, 94011,CPT,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT&/2 Y,,30,,,$291.71,$0.00,1,0,1,20130101, 94012,CPT,MEAS SPIRO FRCD EXP FLO PRE&POST BRONCH INF/2YRS,,30,,,$291.71,$0.00,1,0,1,20130101, 94013,CPT,MEASUREMENT LUNG VOLUMES INFANT/CHILD/2 YRS,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94014,CPT,PT-INITIATE SPIROMETRIC RECORDING PHYS/QHP R&I,,30,,,$407.84,$0.00,1,0,1,20130101, 94015,CPT,PATIENT-INITIATED SPIROMETRIC RECORDING,,30,,,$407.84,$0.00,1,0,1,20130101, 94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,,30,,,$654.39,$0.00,1,0,1,20130101, 94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94150,CPT,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,,30,,,$291.71,$0.00,1,0,1,20130101, 94200,CPT,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,,30,,,$291.71,$0.00,1,0,1,20130101, 94250,CPT,EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX,,30,,,$291.71,$0.00,1,0,1,20130101, 94375,CPT,RESPIRATORY FLOW VOLUME LOOP,,30,,,$291.71,$0.00,1,0,1,20130101, 94400,CPT,BREATHING RESPONSE TO CO2,,30,,,$291.71,$0.00,1,0,1,20130101, 94450,CPT,BREATHING RESPONSE TO HYPOXIA,,30,,,$407.84,$0.00,1,0,1,20130101, 94452,CPT,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,,30,,,$407.84,$0.00,1,0,1,20130101, 94453,CPT,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,,30,,,$407.84,$0.00,1,0,1,20130101, 94610,CPT,INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP,,30,,,$182.97,$0.00,1,0,1,20130101, 94620,CPT,PULMONARY STRESS TESTING SIMPLE,,30,,,$407.84,$0.00,1,0,1,20130101, 94621,CPT,PULMONARY STRESS TESTING COMPLEX,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94640,CPT,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,,30,,,$182.97,$0.00,1,0,1,20130101, 94642,CPT,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,,30,,,$654.39,$0.00,1,0,1,20130101, 94644,CPT,CONTINUOUS INHALATION TREATMENT 1ST HR,,30,,,$317.65,$0.00,1,0,1,20130101, 94645,CPT,CONTINUOUS INHALATION TREATMENT EA ADDL HR,,30,,,$317.65,$0.00,1,0,1,20130101, 94660,CPT,CPAP VENTILATION CPAP INITIATION&MGMT,,30,,,$654.39,$0.00,1,0,1,20130101, 94662,CPT,CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM,,30,,,"$1,541.81",$0.00,1,0,1,20130101, 94664,CPT,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,,30,,,$182.97,$0.00,1,0,1,20130101, 94667,CPT,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,,30,,,$182.97,$0.00,1,0,1,20130101, 94668,CPT,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,,30,,,$182.97,$0.00,1,0,1,20130101, 94680,CPT,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94690,CPT,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,,30,,,$291.71,$0.00,1,0,1,20130101, 94726,CPT,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,,30,,,$291.71,$0.00,1,0,1,20130101, 94727,CPT,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,,30,,,$291.71,$0.00,1,0,1,20130101, 94728,CPT,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,,30,,,$291.71,$0.00,1,0,1,20130101, 94729,CPT,CO DIFFUSING CAPACITY,,30,,,$407.84,$0.00,1,0,1,20130101, 94750,CPT,PULMONARY COMPLIANCE STUDY,,30,,,$291.71,$0.00,1,0,1,20130101, 94762,CPT,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,,30,,,$434.94,$0.00,1,0,1,20130101, 94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94772,CPT,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 94775,CPT,PEDIATRIC APNEA MONITOR ATTACHMENT,,30,,,$434.94,$0.00,1,0,1,20130101, 94776,CPT,PEDIATRIC APNEA MONITOR ANALYSES COMPUTER,,30,,,$434.94,$0.00,1,0,1,20130101, 94780,CPT,CAR SEAT/BED TESTING W/INTERP & REPORT 60 MIN,,30,,,$317.65,$0.00,1,0,1,20130101, 94781,CPT,CAR SEAT/BED TESTNG W/INTERP & REPORT ADDL 30MIN,,30,,,$317.65,$0.00,1,0,1,20130101, 94799,CPT,UNLISTED PULMONARY SERVICE/PROCEDURE,,30,,,$291.71,$0.00,1,0,1,20130101, 95004,CPT,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,30,,,$170.48,$0.00,1,0,1,20130101, 95012,CPT,NITRIC OXIDE EXPIRED GAS DETERMINATION,,30,,,$291.71,$0.00,1,0,1,20130101, 95017,CPT,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,,30,,,$161.20,$0.00,1,0,1,20130101, 95018,CPT,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,,30,,,$161.20,$0.00,1,0,1,20130101, 95024,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,30,,,$170.48,$0.00,1,0,1,20130101, 95027,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,,30,,,$170.48,$0.00,1,0,1,20130101, 95028,CPT,IQ TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,,30,,,$170.48,$0.00,1,0,1,20130101, 95044,CPT,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,,30,,,$170.48,$0.00,1,0,1,20130101, 95052,CPT,PHOTO PATCH TEST SPECIFY NUMBER TSTS,,30,,,$170.48,$0.00,1,0,1,20130101, 95056,CPT,PHOTO TESTS,,30,,,$629.60,$0.00,1,0,1,20130101, 95060,CPT,OPHTHALMIC MUCOUS MEMBRANE TESTS,,30,,,$629.60,$0.00,1,0,1,20130101, 95065,CPT,DIRECT NASAL MUCOUS MEMBRANE TEST,,30,,,$170.48,$0.00,1,0,1,20130101, 95070,CPT,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 95071,CPT,INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES,,30,,,$407.84,$0.00,1,0,1,20130101, 95076,CPT,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,,30,,,"$1,802.32",$0.00,1,0,1,20130101, 95079,CPT,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,,30,,,$817.60,$0.00,1,0,1,20130101, 95115,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,,30,,,$175.99,$0.00,1,0,1,20130101, 95117,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,,30,,,$175.99,$0.00,1,0,1,20130101, 95120,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX,,30,,,$61.00,$0.00,1,0,1,20130101, 95125,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX,,30,,,$86.52,$0.00,1,0,1,20130101, 95132,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 3 STING INSECT,,30,,,$78.16,$0.00,1,0,1,20130101, 95133,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 4 STING INSECT,,30,,,$88.83,$0.00,1,0,1,20130101, 95144,CPT,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,,30,,,$253.90,$0.00,1,0,1,20130101, 95145,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,,30,,,$175.99,$0.00,1,0,1,20130101, 95146,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,,30,,,$484.78,$0.00,1,0,1,20130101, 95147,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,,30,,,$484.78,$0.00,1,0,1,20130101, 95148,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,,30,,,$253.90,$0.00,1,0,1,20130101, 95149,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,,30,,,$253.90,$0.00,1,0,1,20130101, 95165,CPT,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,,30,,,$175.99,$0.00,1,0,1,20130101, 95170,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,,30,,,$253.90,$0.00,1,0,1,20130101, 95180,CPT,RAPID DESENSITIZATION PROCEDURE EACH HOUR,,30,,,$629.60,$0.00,1,0,1,20130101, 95199,CPT,UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SRVC/PX,,30,,,$170.48,$0.00,1,0,1,20130101, 95250,CPT,GLUC MNTR CONT REC FROM INTERSTITIAL TISS FLUID,,30,,,$222.68,$0.00,1,0,1,20130101, 95782,CPT,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95783,CPT,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95800,CPT,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95801,CPT,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,,30,,,$522.20,$0.00,1,0,1,20130101, 95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95808,CPT,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95810,CPT,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95811,CPT,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95812,CPT,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95813,CPT,ELECTROENCEPHALOGRAM EXTND MNTR >1 HR,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95816,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95819,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95822,CPT,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95824,CPT,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95827,CPT,ELECTROENCEPHALOGRAM ALL NIGHT RECORDING,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95830,CPT,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,,30,,,$313.56,$0.00,1,0,1,20130101, 95831,CPT,MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK,,30,,,$169.12,$0.00,1,0,1,20130101, 95832,CPT,MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE,,30,,,$110.30,$0.00,1,0,1,20130101, 95833,CPT,MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS,,30,,,$168.45,$0.00,1,0,1,20130101, 95834,CPT,MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS,,30,,,$119.34,$0.00,1,0,1,20130101, 95851,CPT,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI,,30,,,$89.68,$0.00,1,0,1,20130101, 95852,CPT,ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID,,30,,,$89.68,$0.00,1,0,1,20130101, 95857,CPT,CHOLINESTERASE INHIBITOR CHALLENGE TEST,,30,,,$522.20,$0.00,1,0,1,20130101, 95860,CPT,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$522.20,$0.00,1,0,1,20130101, 95861,CPT,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$522.20,$0.00,1,0,1,20130101, 95863,CPT,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$522.20,$0.00,1,0,1,20130101, 95864,CPT,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,,30,,,$522.20,$0.00,1,0,1,20130101, 95865,CPT,NEEDLE ELECTROMYOGRAPHY LARYNX,,30,,,$522.20,$0.00,1,0,1,20130101, 95866,CPT,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,,30,,,$522.20,$0.00,1,0,1,20130101, 95867,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,,30,,,$522.20,$0.00,1,0,1,20130101, 95868,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,,30,,,$522.20,$0.00,1,0,1,20130101, 95869,CPT,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,,30,,,$280.25,$0.00,1,0,1,20130101, 95870,CPT,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,,30,,,$280.25,$0.00,1,0,1,20130101, 95872,CPT,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,,30,,,$522.20,$0.00,1,0,1,20130101, 95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,,30,,,$522.20,$0.00,1,0,1,20130101, 95885,CPT,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,,30,,,$522.20,$0.00,1,0,1,20130101, 95886,CPT,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,,30,,,$522.20,$0.00,1,0,1,20130101, 95887,CPT,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,,30,,,$280.25,$0.00,1,0,1,20130101, 95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,,30,,,$280.25,$0.00,1,0,1,20130101, 95907,CPT,MOTOR &/SENS 1-2 NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$256.77,$0.00,1,0,1,20130101, 95908,CPT,MOTOR &/SENS 3-4 NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$256.77,$0.00,1,0,1,20130101, 95909,CPT,MOTOR &/SENS 5-6 NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$256.77,$0.00,1,0,1,20130101, 95910,CPT,MOTOR &/SENS 7-8 NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$256.77,$0.00,1,0,1,20130101, 95911,CPT,MOTOR &/SENS 9-10 NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$516.92,$0.00,1,0,1,20130101, 95912,CPT,MOTOR &/SENS 11-12 NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$516.92,$0.00,1,0,1,20130101, 95913,CPT,MOTOR &/SENS 13/> NRV CNDJ PRECONF ELTRODE LIMB,,30,,,$516.92,$0.00,1,0,1,20130101, 95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,,30,,,$522.20,$0.00,1,0,1,20130101, 95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,,30,,,$522.20,$0.00,1,0,1,20130101, 95923,CPT,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,,30,,,$522.20,$0.00,1,0,1,20130101, 95924,CPT,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,,30,,,$516.92,$0.00,1,0,1,20130101, 95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,,30,,,$522.20,$0.00,1,0,1,20130101, 95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,,30,,,$522.20,$0.00,1,0,1,20130101, 95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95933,CPT,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,,30,,,$280.25,$0.00,1,0,1,20130101, 95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,,30,,,$522.20,$0.00,1,0,1,20130101, 95938,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95939,CPT,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,,30,,,$522.20,$0.00,1,0,1,20130101, 95943,CPT,PARASYMP & SYMP NRV FUNCJ HRT RATE VARIABILITY,,30,,,$256.77,$0.00,1,0,1,20130101, 95950,CPT,MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95951,CPT,LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95953,CPT,LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95954,CPT,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,,30,,,$522.20,$0.00,1,0,1,20130101, 95956,CPT,MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR,,30,,,"$4,716.09",$0.00,1,0,1,20130101, 95958,CPT,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,,30,,,"$1,113.97",$0.00,1,0,1,20130101, 95961,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95962,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 95965,CPT,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,,30,,,"$12,859.10",$0.00,1,0,1,20130101, 95966,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,,30,,,"$5,416.55",$0.00,1,0,1,20130101, 95967,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,,30,,,"$5,416.55",$0.00,1,0,1,20130101, 95970,CPT,ELEC ALYS NSTIM PLS GEN BRN/SC/PERPH W/O REPRGRM,,30,,,$522.20,$0.00,1,0,1,20130101, 95971,CPT,ELEC ALYS NSTIM PLS GEN SMPL SC/PERPH W/PRGRMG,,30,,,$670.33,$0.00,1,0,1,20130101, 95972,CPT,ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH 1ST HR,,30,,,$670.33,$0.00,1,0,1,20130101, 95973,CPT,ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH EA 30 MIN,,30,,,$522.20,$0.00,1,0,1,20130101, 95974,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR,,30,,,$670.33,$0.00,1,0,1,20130101, 95975,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN,,30,,,$522.20,$0.00,1,0,1,20130101, 95978,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR,,30,,,$670.33,$0.00,1,0,1,20130101, 95979,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN,,30,,,$670.33,$0.00,1,0,1,20130101, 95981,CPT,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,,30,,,$522.20,$0.00,1,0,1,20130101, 95982,CPT,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,,30,,,$670.33,$0.00,1,0,1,20130101, 95990,CPT,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,,30,,,$776.50,$0.00,1,0,1,20130101, 95991,CPT,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,,30,,,$776.50,$0.00,1,0,1,20130101, 95992,CPT,CANALITH REPOSITIONING PROCEDURE,,30,,,$448.42,$0.00,1,0,1,20130101, 95999,CPT,UNLIS NEUROLOGICAL/NEUROMUSCULAR DX PX,,30,,,$280.25,$0.00,1,0,1,20130101, 96000,CPT,COMPRE CPTR MTN ALYS VIDEO TAPING 3-D KINEMATICS,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 96001,CPT,COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG,,30,,,"$1,082.96",$0.00,1,0,1,20130101, 96002,CPT,DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC,,30,,,$522.20,$0.00,1,0,1,20130101, 96003,CPT,DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC,,30,,,$522.20,$0.00,1,0,1,20130101, 96040,CPT,MEDICAL GENETICS COUNSELING EACH 30 MINUTES,,30,,,$268.27,$0.00,1,0,1,20130101, 96101,CPT,PSYCHOLOGICAL TESTING PR HR WITH PATIENT,,30,,,"$1,067.14",$0.00,1,0,1,20130101, 96102,CPT,PSYCHOLOGICAL TESTING ADMN BY TECH PR HR,,30,,,$506.06,$0.00,1,0,1,20130101, 96103,CPT,PSYCHOLOGICAL TESTING COMPUTER W/PROF I&R,,30,,,$506.06,$0.00,1,0,1,20130101, 96105,CPT,ASSESSMENT PHASIA W/INTERP & REPORT PER HOUR,,30,,,$487.93,$0.00,1,0,1,20130101, 96110,CPT,DEVELOPMENTAL SCREENING W/INTERP&REPRT STD FOR,,30,,,$428.24,$0.00,1,0,1,20130101, 96111,CPT,DEVELOPMENTAL TESTING W/INTERP & REPORT,,30,,,$506.06,$0.00,1,0,1,20130101, 96116,CPT,NUBHVL STATUS XM PR HR W/PT INTERPJ&PREPJ,,30,,,"$1,067.14",$0.00,1,0,1,20130101, 96118,CPT,NUROPSYC TESTING PR HR W/PT & INTERPJ TIME,,30,,,"$1,067.14",$0.00,1,0,1,20130101, 96119,CPT,NUROPSYC TSTG WPROF I&R ADMN BY TECH PR HR,,30,,,"$1,067.14",$0.00,1,0,1,20130101, 96120,CPT,NEUROPSYCHOLOG TESTING COMPUTER W/PROF I&R,,30,,,$506.06,$0.00,1,0,1,20130101, 96150,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT 1ST ASSMT,,30,,,$189.87,$0.00,1,0,1,20130101, 96151,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT RE-ASSMT,,30,,,$189.87,$0.00,1,0,1,20130101, 96152,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN INDIV,,30,,,$189.87,$0.00,1,0,1,20130101, 96153,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN GRP 2/>PTS,,30,,,$93.09,$0.00,1,0,1,20130101, 96154,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/PT,,30,,,$189.87,$0.00,1,0,1,20130101, 96155,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/O PT,,30,,,$103.36,$0.00,1,0,1,20130101, 96360,CPT,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,,30,,,$484.78,$0.00,1,0,1,20130101, 96361,CPT,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,,30,,,$175.99,$0.00,1,0,1,20130101, 96365,CPT,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,,30,,,$776.50,$0.00,1,0,1,20130101, 96366,CPT,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,,30,,,$175.99,$0.00,1,0,1,20130101, 96367,CPT,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,,30,,,$253.90,$0.00,1,0,1,20130101, 96369,CPT,SUBCUTANEOUS INFUSION INITIAL 1 HR W/PUMP SET-UP,,30,,,$776.50,$0.00,1,0,1,20130101, 96370,CPT,SUBCUTANEOUS INFUSION EACH ADDITIONAL HOUR,,30,,,$253.90,$0.00,1,0,1,20130101, 96371,CPT,SUBQ INFUSION ADDITIONAL PUMP INFUSION SITE,,30,,,$253.90,$0.00,1,0,1,20130101, 96372,CPT,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,,30,,,$253.90,$0.00,1,0,1,20130101, 96373,CPT,THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,,30,,,$253.90,$0.00,1,0,1,20130101, 96374,CPT,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,,30,,,$253.90,$0.00,1,0,1,20130101, 96375,CPT,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,,30,,,$253.90,$0.00,1,0,1,20130101, 96379,CPT,UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS,,30,,,$175.99,$0.00,1,0,1,20130101, 96401,CPT,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,,30,,,$253.90,$0.00,1,0,1,20130101, 96402,CPT,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,,30,,,$253.90,$0.00,1,0,1,20130101, 96405,CPT,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL 7,,30,,,$776.50,$0.00,1,0,1,20130101, 96409,CPT,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,,30,,,$776.50,$0.00,1,0,1,20130101, 96411,CPT,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,,30,,,$484.78,$0.00,1,0,1,20130101, 96413,CPT,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,,30,,,"$1,353.27",$0.00,1,0,1,20130101, 96415,CPT,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,,30,,,$253.90,$0.00,1,0,1,20130101, 96416,CPT,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,,30,,,"$1,353.27",$0.00,1,0,1,20130101, 96417,CPT,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,,30,,,$484.78,$0.00,1,0,1,20130101, 96420,CPT,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,,30,,,$484.78,$0.00,1,0,1,20130101, 96422,CPT,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS 8 HR PRTBLE IMPLTBL PMP,,30,,,"$1,353.27",$0.00,1,0,1,20130101, 96440,CPT,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,,30,,,$776.50,$0.00,1,0,1,20130101, 96446,CPT,CHEMOTX ADMN PRTL CAVITY PORT/CATH,,30,,,$776.50,$0.00,1,0,1,20130101, 96450,CPT,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,,30,,,"$1,353.27",$0.00,1,0,1,20130101, 96521,CPT,REFILLING & MAINTENANCE PORTABLE PUMP,,30,,,$776.50,$0.00,1,0,1,20130101, 96522,CPT,REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC,,30,,,$776.50,$0.00,1,0,1,20130101, 96523,CPT,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,,30,,,$319.07,$0.00,1,0,1,20130101, 96542,CPT,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,,30,,,$484.78,$0.00,1,0,1,20130101, 96549,CPT,UNLISTED CHEMOTHERAPY PROCEDURE,,30,,,$175.99,$0.00,1,0,1,20130101, 96567,CPT,PDT XTRNL APPL LIGHT DSTR LES SKN BY ACTIVJ RX,,30,,,$385.85,$0.00,1,0,1,20130101, 96570,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,,30,,,$385.85,$0.00,1,0,1,20130101, 96571,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,,30,,,$385.85,$0.00,1,0,1,20130101, 96900,CPT,ACTINOTHERAPY ULTRAVIOLET LIGHT,,30,,,$223.56,$0.00,1,0,1,20130101, 96910,CPT,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,,30,,,$223.56,$0.00,1,0,1,20130101, 96912,CPT,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,,30,,,$223.56,$0.00,1,0,1,20130101, 96913,CPT,PHOTOCHEMOTHERAPY DERMATOSES 4-8 HRS SUPERVISION,,30,,,"$1,016.83",$0.00,1,0,1,20130101, 96920,CPT,LASER SKIN DISEASE PSORIASIS TOT AREA <250 SQ C,,30,,,$385.85,$0.00,1,0,1,20130101, 96921,CPT,LASER SKIN DISEASE PSORIASIS 250-500 SQ CM,,30,,,$385.85,$0.00,1,0,1,20130101, 96922,CPT,LASER SKIN DISEASE PSORIASIS >500 SQ CM,,30,,,$385.85,$0.00,1,0,1,20130101, 96999,CPT,UNLISTED SPECIAL DERMATOLOGICAL SERVICE/PROCED,,30,,,$121.18,$0.00,1,0,1,20130101, 97005,CPT,ATHLETIC TRAINING EVALUATION,,30,,,$97.57,$0.00,1,0,1,20130101, 97006,CPT,ATHLETIC TRAINING RE-EVALUATION,,30,,,$65.05,$0.00,1,0,1,20130101, 97014,CPT,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,,30,,,$65.05,$0.00,1,0,1,20130101, 97597,CPT,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,,30,,,$385.85,$0.00,1,0,1,20130101, 97598,CPT,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,,30,,,$385.85,$0.00,1,0,1,20130101, 97602,CPT,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,,30,,,$258.15,$0.00,1,0,1,20130101, 97605,CPT,NEGATIVE PRESSURE WOUND THERAPY 50 SQ CM,,30,,,$385.85,$0.00,1,0,1,20130101, 97810,CPT,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MI,,30,,,$85.36,$0.00,1,0,1,20130101, 97811,CPT,ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN,,30,,,$47.95,$0.00,1,0,1,20130101, 97813,CPT,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,,30,,,$125.69,$0.00,1,0,1,20130101, 97814,CPT,ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ,,30,,,$88.96,$0.00,1,0,1,20130101, 98925,CPT,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98926,CPT,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98927,CPT,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98928,CPT,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98929,CPT,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98940,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98941,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98942,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,,30,,,$116.39,$0.00,1,0,1,20130101, 98943,CPT,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,,30,,,$53.02,$0.00,1,0,1,20130101, 98960,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT,,30,,,$81.12,$0.00,1,0,1,20130101, 98961,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS,,30,,,$92.72,$0.00,1,0,1,20130101, 98962,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS,,30,,,$67.25,$0.00,1,0,1,20130101, 99000,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,,30,,,$31.44,$0.00,1,0,1,20130101, 99001,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,,30,,,$44.24,$0.00,1,0,1,20130101, 99002,CPT,HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP,,30,,,$101.89,$0.00,1,0,1,20130101, 99024,CPT,POSTOP FOLLOW UP VISIT RELATED TO ORIGINAL PX,,30,,,$172.49,$0.00,1,0,1,20130101, 99026,CPT,HOSPITAL MANDATED CALL SERVICE IN-HOSPITAL EA HR,,30,,,$81.56,$0.00,1,0,1,20130101, 99050,CPT,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,,30,,,$90.17,$0.00,1,0,1,20130101, 99051,CPT,SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS,,30,,,$131.47,$0.00,1,0,1,20130101, 99053,CPT,SERVICES PROVIDED BTW 10 PM&8 AM AT 24-HR FACI,,30,,,$136.68,$0.00,1,0,1,20130101, 99058,CPT,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,,30,,,$28.90,$0.00,1,0,1,20130101, 99060,CPT,SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC,,30,,,"$1,390.94",$0.00,1,0,1,20130101, 99070,CPT,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,,30,,,$261.30,$0.00,1,0,1,20130101, 99071,CPT,EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST,,30,,,$56.61,$0.00,1,0,1,20130101, 99080,CPT,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,,30,,,$15.22,$0.00,1,0,1,20130101, 99082,CPT,UNUSUAL TRAVEL,,30,,,$123.19,$0.00,1,0,1,20130101, 99090,CPT,ANALYSIS CLINICAL DATA STORED IN COMPUTERS,,30,,,$267.94,$0.00,1,0,1,20130101, 99100,CPT,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,,30,,,$393.48,$0.00,1,0,1,20130101, 99140,CPT,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,,30,,,$337.95,$0.00,1,0,1,20130101, 99170,CPT,ANOGENITAL XM W/COLPOSCOPY CHILD/SUSPECT TRAUMA,,30,,,$49.13,$0.00,1,0,1,20130101, 99172,CPT,VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM,,30,,,$184.10,$0.00,1,0,1,20130101, 99173,CPT,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,,30,,,$80.13,$0.00,1,0,1,20130101, 99183,CPT,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX /SESSION,,30,,,"$1,909.68",$0.00,1,0,1,20130101, 99195,CPT,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,,30,,,$319.07,$0.00,1,0,1,20130101, 99199,CPT,UNLISTED SPECIAL SERVICE PROCEDURE/REPORT,,30,,,$477.60,$0.00,1,0,1,20130101, 99201,CPT,OFFICE OUTPATIENT NEW 10 MINUTES,,30,,,$140.45,$0.00,1,0,1,20130101, 99202,CPT,OFFICE OUTPATIENT NEW 20 MINUTES,,30,,,$170.16,$0.00,1,0,1,20130101, 99203,CPT,OFFICE OUTPATIENT NEW 30 MINUTES,,30,,,$222.68,$0.00,1,0,1,20130101, 99204,CPT,OFFICE OUTPATIENT NEW 45 MINUTES,,30,,,$364.18,$0.00,1,0,1,20130101, 99205,CPT,OFFICE OUTPATIENT NEW 60 MINUTES,,30,,,"$1,118.41",$0.00,1,0,1,20130101, 99211,CPT,OFFICE OUTPATIENT VISIT 5 MINUTES,,30,,,$140.45,$0.00,1,0,1,20130101, 99212,CPT,OFFICE OUTPATIENT VISIT 10 MINUTES,,30,,,$170.16,$0.00,1,0,1,20130101, 99213,CPT,OFFICE OUTPATIENT VISIT 15 MINUTES,,30,,,$170.16,$0.00,1,0,1,20130101, 99214,CPT,OFFICE OUTPATIENT VISIT 25 MINUTES,,30,,,$222.68,$0.00,1,0,1,20130101, 99215,CPT,OFFICE OUTPATIENT VISIT 40 MINUTES,,30,,,$364.18,$0.00,1,0,1,20130101, 99217,CPT,OBSERVATION CARE DISCHARGE MANAGEMENT,,30,,,$84.89,$0.00,1,1,1,20130101, 99218,CPT,INITIAL OBSERVATION CARE/DAY 30 MINUTES,,30,,,$84.89,$357.65,2,1,1,20130101, 99219,CPT,INITIAL OBSERVATION CARE/DAY 50 MINUTES,,30,,,$84.89,$357.65,2,1,1,20130101, 99220,CPT,INITIAL OBSERVATION CARE/DAY 70 MINUTES,,30,,,$84.89,$357.65,2,1,1,20130101, 99224,CPT,SBSQ OBSERVATION CARE/DAY 15 MINUTES,,30,,,$102.50,$0.00,1,0,1,20130101, 99225,CPT,SBSQ OBSERVATION CARE/DAY 25 MINUTES,,30,,,$182.57,$0.00,1,0,1,20130101, 99226,CPT,SBSQ OBSERVATION CARE/DAY 35 MINUTES,,30,,,$259.44,$0.00,1,0,1,20130101, 99231,CPT,SBSQ HOSPITAL CARE/DAY 15 MINUTES,,30,,,$88.62,$0.00,1,0,1,20130101, 99232,CPT,SBSQ HOSPITAL CARE/DAY 25 MINUTES,,30,,,$165.81,$0.00,1,0,1,20130101, 99233,CPT,SBSQ HOSPITAL CARE/DAY 35 MINUTES,,30,,,$234.43,$0.00,1,0,1,20130101, 99234,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES,,30,,,$84.89,$357.65,2,1,1,20130101, 99235,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES,,30,,,$84.89,$357.65,2,1,1,20130101, 99236,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES,,30,,,$84.89,$357.65,2,1,1,20130101, 99238,CPT,HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<,,30,,,$278.72,$0.00,1,0,1,20130101, 99239,CPT,HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN,,30,,,$293.82,$0.00,1,0,1,20130101, 99241,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN,,30,,,$133.07,$0.00,1,0,1,20130101, 99242,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN,,30,,,$282.77,$0.00,1,0,1,20130101, 99243,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN,,30,,,$393.65,$0.00,1,0,1,20130101, 99244,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN,,30,,,$632.06,$0.00,1,0,1,20130101, 99245,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN,,30,,,$765.13,$0.00,1,0,1,20130101, 99252,CPT,INITL INPATIENT CONSULT NEW/ESTAB PT 40 MIN,,30,,,$407.32,$0.00,1,0,1,20130101, 99253,CPT,INITL INPATIENT CONSULT NEW/ESTAB PT 55 MIN,,30,,,$468.12,$0.00,1,0,1,20130101, 99254,CPT,INITL INPATIENT CONSULT NEW/ESTAB PT 80 MIN,,30,,,$598.88,$0.00,1,0,1,20130101, 99281,CPT,EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB,,30,,,$219.00,$0.00,1,1,1,20130101, 99282,CPT,EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY,,30,,,$464.30,$0.00,1,1,1,20130101, 99283,CPT,EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY,,30,,,$855.02,$0.00,1,1,1,20130101, 99284,CPT,EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY,,30,,,"$1,467.93",$0.00,1,1,1,20130101, 99285,CPT,EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ,,30,,,"$2,186.43",$0.00,1,1,1,20130101, 99288,CPT,PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS,,30,,,$222.57,$0.00,1,1,1,20130101, 99291,CPT,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,,30,,,"$3,319.17",$0.00,1,1,1,20130101, 99304,CPT,INITIAL NURSING FACILITY CARE/DAY 25 MINUTES,,30,,,$169.55,$0.00,1,0,1,20130101, 99305,CPT,INITIAL NURSING FACILITY CARE/DAY 35 MINUTES,,30,,,$212.52,$0.00,1,0,1,20130101, 99306,CPT,INITIAL NURSING FACILITY CARE/DAY 45 MINUTES,,30,,,$250.85,$0.00,1,0,1,20130101, 99307,CPT,SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN,,30,,,$92.91,$0.00,1,0,1,20130101, 99308,CPT,SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN,,30,,,$117.29,$0.00,1,0,1,20130101, 99309,CPT,SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN,,30,,,$170.71,$0.00,1,0,1,20130101, 99310,CPT,SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 35 MIN,,30,,,$252.01,$0.00,1,0,1,20130101, 99315,CPT,NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES,,30,,,$149.23,$0.00,1,0,1,20130101, 99316,CPT,NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES,,30,,,$184.65,$0.00,1,0,1,20130101, 99318,CPT,E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN,,30,,,$155.62,$0.00,1,0,1,20130101, 99324,CPT,DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN,,30,,,$121.58,$0.00,1,0,1,20130101, 99325,CPT,DOMICIL/REST HOME NEW PT VISIT MOD SEVER 30 MIN,,30,,,$162.11,$0.00,1,0,1,20130101, 99326,CPT,DOMICIL/REST HOME NEW PT HI-MOD SEVER 45 MINUTES,,30,,,$265.68,$0.00,1,0,1,20130101, 99334,CPT,DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES,,30,,,$130.07,$0.00,1,0,1,20130101, 99335,CPT,DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES,,30,,,$145.17,$0.00,1,0,1,20130101, 99336,CPT,DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES,,30,,,$246.20,$0.00,1,0,1,20130101, 99337,CPT,DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES,,30,,,$397.17,$0.00,1,0,1,20130101, 99341,CPT,HOME VISIT NEW PATIENT LOW SEVERITY 20 MINUTES,,30,,,$188.26,$0.00,1,0,1,20130101, 99342,CPT,HOME VISIT NEW PATIENT MOD SEVERITY 30 MINUTES,,30,,,$251.01,$0.00,1,0,1,20130101, 99343,CPT,HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES,,30,,,$394.97,$0.00,1,0,1,20130101, 99344,CPT,HOME VISIT NEW PATIENT HI SEVERITY 60 MINUTES,,30,,,$583.23,$0.00,1,0,1,20130101, 99345,CPT,HOME VISIT NEW PT UNSTABL/SIGNIF NEW PROB 75 MIN,,30,,,$679.20,$0.00,1,0,1,20130101, 99347,CPT,HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES,,30,,,$140.58,$0.00,1,0,1,20130101, 99348,CPT,HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES,,30,,,$198.94,$0.00,1,0,1,20130101, 99349,CPT,HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES,,30,,,$305.04,$0.00,1,0,1,20130101, 99350,CPT,HOME VST EST PT UNSTABLE/SIGNIF NEW PROB 60 MINS,,30,,,$405.84,$0.00,1,0,1,20130101, 99360,CPT,PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES,,30,,,$262.72,$0.00,1,0,1,20130101, 99363,CPT,ANTICOAGULANT MGMT OUTPATIENT INIT 90 DAYS,,30,,,$160.04,$0.00,1,0,1,20130101, 99364,CPT,ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS,,30,,,$84.38,$0.00,1,0,1,20130101, 99375,CPT,SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>,,30,,,$160.94,$0.00,1,0,1,20130101, 99381,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR,,30,,,$224.14,$0.00,1,0,1,20130101, 99382,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS,,30,,,$256.65,$0.00,1,0,1,20130101, 99383,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS,,30,,,$290.33,$0.00,1,0,1,20130101, 99384,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,,30,,,$278.72,$0.00,1,0,1,20130101, 99385,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,,30,,,$288.01,$0.00,1,0,1,20130101, 99386,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,,30,,,$384.56,$0.00,1,0,1,20130101, 99387,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,,30,,,$243.88,$0.00,1,0,1,20130101, 99391,CPT,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,,30,,,$191.62,$0.00,1,0,1,20130101, 99392,CPT,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,,30,,,$224.14,$0.00,1,0,1,20130101, 99393,CPT,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,,30,,,$224.14,$0.00,1,0,1,20130101, 99394,CPT,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,,30,,,$247.12,$0.00,1,0,1,20130101, 99395,CPT,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,,30,,,$139.70,$0.00,1,0,1,20130101, 99396,CPT,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,,30,,,$228.19,$0.00,1,0,1,20130101, 99397,CPT,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,,30,,,$191.34,$0.00,1,0,1,20130101, 99401,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 M,,30,,,$89.24,$0.00,1,0,1,20130101, 99402,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 M,,30,,,$242.14,$0.00,1,0,1,20130101, 99403,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 M,,30,,,$294.92,$0.00,1,0,1,20130101, 99404,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,,30,,,$428.65,$0.00,1,0,1,20130101, 99406,CPT,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,,30,,,$93.09,$0.00,1,0,1,20130101, 99407,CPT,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,,30,,,$93.09,$0.00,1,0,1,20130101, 99408,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,,30,,,$98.24,$0.00,1,0,1,20130101, 99411,CPT,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M,,30,,,$53.13,$0.00,1,0,1,20130101, 99412,CPT,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M,,30,,,$83.37,$0.00,1,0,1,20130101, 99420,CPT,ADMN & INTERPJ HEALTH RISK ASSESSMENT INSTRUMENT,,30,,,$49.94,$0.00,1,0,1,20130101, 99429,CPT,UNLISTED PREVENTIVE MEDICINE SERVICE,,30,,,$31.36,$0.00,1,0,1,20130101, 99456,CPT,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,,30,,,$126.71,$0.00,1,0,1,20130101, 99460,CPT,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,,30,,,$170.16,$0.00,1,0,1,20130101, 99461,CPT,1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER,,30,,,$196.26,$0.00,1,0,1,20130101, 99463,CPT,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,,30,,,$170.16,$0.00,1,0,1,20130101, 99465,CPT,DELIVERY/BIRTHING ROOM RESUSCITATION,,30,,,"$1,035.29",$0.00,1,0,1,20130101, 99495,CPT,TRANSITIONAL CARE MANAGE SERVICE 14 DAY DISCHRGE,,30,,,$169.40,$0.00,1,0,1,20130101, 99496,CPT,TRANSITIONAL CARE MANAGE SERVICE 7 DAY DISCHARGE,,30,,,$222.55,$0.00,1,0,1,20130101, 99499,CPT,UNLISTED EVALUATION AND MANAGEMENT SERVICE,,30,,,$283.94,$0.00,1,0,1,20130101, 99500,CPT,HOME VISIT PRENATAL MONITORING & ASSESSMENT,,30,,,$887.55,$0.00,1,0,1,20130101, 99501,CPT,HOME VISIT POSTNATAL ASSMT&F-UP CARE,,30,,,$317.04,$0.00,1,0,1,20130101, 99502,CPT,HOME VISIT NEWBORN CARE & ASSESSMENT,,30,,,$262.46,$0.00,1,0,1,20130101, 99503,CPT,HOME VISIT RESPIRATORY THERAPY CARE,,30,,,$241.09,$0.00,1,0,1,20130101, 99505,CPT,HOME VISIT STOMA CARE&MAINT CLST&CSTOST,,30,,,$151.31,$0.00,1,0,1,20130101, 99506,CPT,HOME VISIT INTRAMUSCULAR INJECTIONS,,30,,,$174.20,$0.00,1,0,1,20130101, 99507,CPT,HOME VISIT CARE&MAINT CATH,,30,,,$184.59,$0.00,1,0,1,20130101, 99509,CPT,HOME VISIT ASSISTANCE DAILY LIV&PRSONAL CARE,,30,,,$216.01,$0.00,1,0,1,20130101, 99510,CPT,HOME VISIT INDIV FAM/MARRIAGE COUNSELING,,30,,,$315.88,$0.00,1,0,1,20130101, 99512,CPT,HOME VISIT HEMODIALYSIS,,30,,,$964.57,$0.00,1,0,1,20130101, 99600,CPT,UNLISTED HOME VISIT SERVICE/PROCEDURE,,30,,,$209.04,$0.00,1,0,1,20130101, 99601,CPT,HOME NFS/SPECTY DRUG ADMN PR VST /EQUAL 200 CC TISS,,30,,,"$16,554.03",$0.00,1,0,1,20130101, 0073T,CPT,COMPNSTR-BASED BEAM MODLJ TX DLVR INVERSE 3> FLD,,30,,,"$3,043.53",$0.00,1,0,1,20130101, 0085T,CPT,BREATH TEST HEART TRANSPLANT REJECTION,,30,,,$66.21,$0.00,1,0,1,20130101, 0099T,CPT,IMPLTJ INTRASTROMAL CORNEAL RING SEGMENTS,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 0100T,CPT,PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA,,30,,,"$14,522.49",$0.00,1,0,1,20130101, 0101T,CPT,EXTRCORPL SHOCK WAVE MUSCSKELE NOS HIGH ENERGY,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 0102T,CPT,EXTRCRPL SHOCK WAVE W/ANES LAT HUMERL EPICONDYLE,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 0106T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/TOUCH STIMULI,,30,,,$44.20,$0.00,1,0,1,20130101, 0107T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/VIBRJ STIMULI,,30,,,$44.20,$0.00,1,0,1,20130101, 0108T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/COOL STIMULI,,30,,,$44.20,$0.00,1,0,1,20130101, 0109T,CPT,QUANT SENAORY TEST&INTERPJ/XTR W/HT-PN STIMULI,,30,,,$44.20,$0.00,1,0,1,20130101, 0110T,CPT,QUANT SENSORY TEST&INTERPJ/XTR OTHER STIMULI,,30,,,$44.20,$0.00,1,0,1,20130101, 0123T,CPT,FISTULIZATION SCLERA GLAUCOMA CILIARY BODY,,30,,,"$9,354.13",$0.00,1,0,1,20130101, 0124T,CPT,CONJUNCTVL INC W/POST XTRSCLERA PLCMT PHARM AGNT,,30,,,$845.81,$0.00,1,0,1,20130101, 0126T,CPT,COMMON CAROTID INTIMA MEDIA THICKNESS STUDY,,30,,,$317.65,$0.00,1,0,1,20130101, 0171T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR 1 LVL,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 0172T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR EA LVL,,30,,,"$22,711.46",$0.00,1,0,1,20130101, 0179T,CPT,64 LEAD ECG W/TRACING & GRAPHICS,,30,,,"$1,143.19",$0.00,1,0,1,20130101, 0181T,CPT,CORNEAL HYSTERESIS AIR IMPULSE STIMJ BI W/I&R,,30,,,$204.26,$0.00,1,0,1,20130101, 0182T,CPT,HDR ELECTRONIC BRACHYTHERAPY PER FRACTION,,30,,,"$4,248.66",$0.00,1,0,1,20130101, 0183T,CPT,LOW FREQUENCY WOUND ULTRASOUND,,30,,,$258.15,$0.00,1,0,1,20130101, 0184T,CPT,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 0186T,CPT,SUPRACHOROIDAL PHARMACOLOGIC AGENT DELIVERY,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 0190T,CPT,INTRAOCULAR RADIATION SRC APPLICATOR PLACEMENT,,30,,,"$8,021.77",$0.00,1,0,1,20130101, 0191T,CPT,ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR INT,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 0192T,CPT,ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR EXT,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 0198T,CPT,MEAS OCULAR BLOOD FLOW REPEAT IO PRES SAMP W/I&R,,30,,,$354.27,$0.00,1,0,1,20130101, 0199T,CPT,PHYSIOL REC TRMR W/ACCEL & GYRO FREQ&L & I&O,,30,,,$280.25,$0.00,1,0,1,20130101, 0200T,CPT,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 0201T,CPT,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 0206T,CPT,RMT ALGRTHMC ALYS ECG W/CPTR PRBLTY ASSMT,,30,,,$317.65,$0.00,1,0,1,20130101, 0207T,CPT,EVAC MEIBOMIAN GLNDS AUTO HT& INTMT PRESS UNI,,30,,,$204.26,$0.00,1,0,1,20130101, 0208T,CPT,PURE TONE AUDIOMETRY AUTOMATED AIR ONLY,,30,,,$150.41,$0.00,1,0,1,20130101, 0209T,CPT,PURE TONE AUDIOMETRY AUTOMATED AIR & BONE,,30,,,$150.41,$0.00,1,0,1,20130101, 0210T,CPT,SPEECH AUDIOMETRY THRESHOLD AUTOMATED,,30,,,$150.41,$0.00,1,0,1,20130101, 0211T,CPT,SPEECH AUDIOM THRESHLD AUTO W/SPEECH RECOGNITION,,30,,,$150.41,$0.00,1,0,1,20130101, 0212T,CPT,COMPRE AUDIOM THRESHOLD EVAL & SPEECH RECOG,,30,,,$306.92,$0.00,1,0,1,20130101, 0213T,CPT,NJX DX/THER PARAVER FCT JT W/US CER/THOR 1 LVL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 0214T,CPT,NJX DX/THER PARAVER FCT JT W/US CER/THOR 2ND LVL,,30,,,$999.91,$0.00,1,0,1,20130101, 0215T,CPT,NJX PARAVERTBRL FACET JT W/US CER/THOR 3RD&> LVL,,30,,,$999.91,$0.00,1,0,1,20130101, 0216T,CPT,NJX DX/THER PARAVER FCT JT W/US LUMB/SAC 1 LVL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 0217T,CPT,NJX DX/THER PARAVER FCT JT W/US LUMB/SAC LVL 2,,30,,,$999.91,$0.00,1,0,1,20130101, 0218T,CPT,NJX PARAVERTBRL FCT JT W/US LUMB/SAC 3RD&> LVL,,30,,,$999.91,$0.00,1,0,1,20130101, 0221T,CPT,PLMT POST FACET IMPLT UNI/BI W/IMG & GRFT LUMB,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 0222T,CPT,PLACE POSTERIOR INTRAFACET IMPLANT ADDL SEGMENT,,30,,,"$12,604.15",$0.00,1,0,1,20130101, 0223T,CPT,ACOUSTIC CARDIOGRAPHY W/INTERPRETATION & REPORT,,30,,,$173.59,$0.00,1,0,1,20130101, 0224T,CPT,ACOUSTIC CARDIOGRAPHY MULT ANALYSIS W/I&R,,30,,,$220.34,$0.00,1,0,1,20130101, 0225T,CPT,ACOUSTIC CARDIOGRAPHY MULT ALYS W/I&R & REPROG,,30,,,$220.34,$0.00,1,0,1,20130101, 0226T,CPT,ANOSCOPY HIGH RESOLUTION W/SPECIMEN COLLECTION,,30,,,$317.65,$0.00,1,0,1,20130101, 0227T,CPT,ANOSCOPY HIGH RESOLUTION W/BIOPSY,,30,,,"$2,350.89",$0.00,1,0,1,20130101, 0228T,CPT,NJX ANES/STEROID TFRML EDRL W/US CER/THOR 1 LVL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 0229T,CPT,NJX ANES/STERD TFRML EDRL W/US CER/THOR EA ADDL,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 0230T,CPT,NJX ANES/STEROID TFRML EDRL W/US LUM/SAC 1 LVL,,30,,,"$3,282.70",$0.00,1,0,1,20130101, 0231T,CPT,NJX ANES/STEROID TFRML EDRL W/US LUM/SAC EA ADDL,,30,,,"$1,598.29",$0.00,1,0,1,20130101, 0232T,CPT,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,,30,,,$317.65,$0.00,1,0,1,20130101, 0234T,CPT,TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 0236T,CPT,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 0237T,CPT,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 0238T,CPT,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,,30,,,"$23,451.05",$0.00,1,0,1,20130101, 0239T,CPT,BIOIMPEDANCE SPECTROSCOPY LIMB DIFFERENCES,,30,,,$434.94,$0.00,1,0,1,20130101, 0240T,CPT,ESOPH MOTILITY 3D PRESSURE TOPOGRAPHY W/I&R,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 0241T,CPT,ESOPH/GASTROESOPH MOTILITY W/STIM/PERFU W/I&R,,30,,,"$1,803.19",$0.00,1,0,1,20130101, 0243T,CPT,INTERMIT MEAS WHEEZE RATE BRONCHODIL DX W/I&R,,30,,,$654.39,$0.00,1,0,1,20130101, 0244T,CPT,CONT MEAS WHEEZE RATE BRONCHODIL SLEEP 3-24 HRS,,30,,,"$1,089.74",$0.00,1,0,1,20130101, 0245T,CPT,OPEN TX RIB FRACTURE W/INT FIX UNI 1-2 RIBS,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 0246T,CPT,OPEN TX RIB FRACTURE W/INT FIX UNI 3-4 RIBS,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 0247T,CPT,OPEN TX RIB FRACTURE W/INT FIX UNI 5-6 RIBS,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 0248T,CPT,OPEN TX RIB FRACTURE W/INT FIXATION UNI 7/> RIBS,,30,,,"$10,713.05",$0.00,1,0,1,20130101, 0249T,CPT,LIGATION HEMORRHOID BUNDLE W/US,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 0253T,CPT,INSJ ANT SGM FLUID DRG DEV W/O RSVR INT APPR,,30,,,"$15,448.40",$0.00,1,0,1,20130101, 0263T,CPT,AUTO BONE MARRW CELL RX COMPLT BONE MARRW HARVST,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 0264T,CPT,AUTO BONE MARRW CELL RX COMP W/O BONE MAR HARVST,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 0265T,CPT,BONE MAR HARVST ONLY FOR INTMUSC AUTOLO CELL RX,,30,,,"$15,000.86",$0.00,1,0,1,20130101, 0267T,CPT,IM/REPL CARTD SINS BAROREFLX ACTIV DEV LEAD ONLY,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 0268T,CPT,IM/REPL CARTD SINS BARREFLX ACT DEV PLS GEN ONLY,,30,,,"$33,354.02",$0.00,1,0,1,20130101, 0269T,CPT,REV/REMVL CARTD SINS BARREFLX ACT DEV TOT SYSTEM,,30,,,"$13,202.03",$0.00,1,0,1,20130101, 0270T,CPT,REV/REMVL CARTD SINS BARREFLX ACT DEV LEAD ONLY,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 0271T,CPT,REV/REM CARTD SINS BARREFLX ACT DEV PLS GEN ONLY,,30,,,"$13,979.24",$0.00,1,0,1,20130101, 0272T,CPT,INTRGORTION DEV EVAL CARTD SINS BARREFLX W/I&R,,30,,,$522.20,$0.00,1,0,1,20130101, 0273T,CPT,INTROGATION DEV EVAL CARTD SINS BARREFLX W/PRGRM,,30,,,$522.20,$0.00,1,0,1,20130101, 0274T,CPT,PERC LAMINO-/LAMINECTOMY IMAGE GUIDE CERV/THORAC,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 0275T,CPT,PERC LAMINO-/LAMINECTOMY INDIR IMAG GUIDE LUMBAR,,30,,,"$18,142.52",$0.00,1,0,1,20130101, 0278T,CPT,TRNSCUT ELECT MODLATION PAIN REPROCES EA TX SESS,,30,,,$280.25,$0.00,1,0,1,20130101, 0282T,CPT,PERC/OPEN IMPLNT NEUROSTIM ELECTRODE SUBQ TRIAL,,30,,,"$20,079.82",$0.00,1,0,1,20130101, 0283T,CPT,PERC/OPEN IMPLNT NEUROSTIM ELECTRODE SUBQ PERM,,30,,,"$52,291.12",$0.00,1,0,1,20130101, 0284T,CPT,REV/REMVL PG/ELCTRODES IMAGNG ADDN NEW ELCTRODES,,30,,,"$8,831.17",$0.00,1,0,1,20130101, 0285T,CPT,ELEC ANLYS IMPLANT SUBQ FIELD STIM PG REPROGRAMM,,30,,,$522.20,$0.00,1,0,1,20130101, 0288T,CPT,ANSCPY W/DELVRY THERMAL ENERGY MUSCLE ANAL CANAL,,30,,,"$12,885.94",$0.00,1,0,1,20130101, 0296T,CPT,EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD,,30,,,$434.94,$0.00,1,0,1,20130101, 0297T,CPT,EXT ECG > 48HR TO 21 DAY SCAN ANALYSIS W/REPORT,,30,,,$434.94,$0.00,1,0,1,20130101, 0299T,CPT,ESW HI ENERGY W/TOPCAL APP &DRESNG CARE 1ST WND,,30,,,$555.02,$0.00,1,0,1,20130101, 0300T,CPT,ESW HI ENERGY W/TOPCAL APP &DRESNG CARE ADL WND,,30,,,$555.02,$0.00,1,0,1,20130101, 0301T,CPT,DEST/REDUC MALIG BRST TUMR W/US THRMORX GUIDANCE,,30,,,"$5,416.55",$0.00,1,0,1,20130101, 0302T,CPT,INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS COMPL,,30,,,"$23,031.50",$0.00,1,0,1,20130101, 0303T,CPT,INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS ELTRD,,30,,,"$18,123.39",$0.00,1,0,1,20130101, 0304T,CPT,INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS DEVICE,,30,,,"$23,330.12",$0.00,1,0,1,20130101, 0305T,CPT,PROGRAM EVAL ICAR ISCHM MNTRNG SYS,,30,,,$220.54,$0.00,1,0,1,20130101, 0306T,CPT,INTERROGATION EVAL ICAR ISCHM MNTRNG SYS,,30,,,$220.54,$0.00,1,0,1,20130101, 0307T,CPT,RMVL INTRACARDIAC ISCHEMIA MONITORING DEVICE,,30,,,"$9,681.32",$0.00,1,0,1,20130101, 0308T,CPT,INSJ OCULAR TELESCOPE PROSTH,,30,,,"$9,398.83",$0.00,1,0,1,20130101, 0310T,CPT,MOTOR FUNCTION MAPPING NAVIGATED TMS TX PLAN,,30,,,$516.92,$0.00,1,0,1,20130101, 0311T,CPT,N-INVAS CAL & ALYS CNTRL ARTL PRESSURE WAVEFORM,,30,,,$173.33,$0.00,1,0,1,20130101, 0313T,CPT,LAPS REVJ/REPLCMT NSTIM ELTRD ARRAY VAGUS NRV,,30,,,"$8,470.84",$0.00,1,0,1,20130101, 0314T,CPT,LAPS RMVL NSTIM ELTRD ARRAY & PLS GEN VAGUS NRV,,30,,,"$13,872.45",$0.00,1,0,1,20130101, 0315T,CPT,REMOVAL PULSE GENERATOR VAGUS NERVE,,30,,,"$13,872.45",$0.00,1,0,1,20130101, 0316T,CPT,REPLACEMENT PULSE GENERATOR VAGUS NERVE,,30,,,"$32,789.46",$0.00,1,0,1,20130101, 0317T,CPT,ELEC ALYS NSTIM PLS GEN VAGUS NRV W/REPRGRMG,,30,,,$220.54,$0.00,1,0,1,20130101, 0319T,CPT,INSERT SUBQ DEFIB W/ELTRD,,30,,,"$45,024.08",$0.00,1,0,1,20130101, 0320T,CPT,INSERT SUBQ DEFIB ELECTRODE,,30,,,"$18,123.39",$0.00,1,0,1,20130101, 0321T,CPT,INSERT SUBQ DEFIB PLS GEN,,30,,,"$45,024.08",$0.00,1,0,1,20130101, 0322T,CPT,RMVL SUBQ DEFIB PLS GEN,,30,,,"$9,681.32",$0.00,1,0,1,20130101, 0323T,CPT,RMVL & REPLC SUBQ PLS GEN,,30,,,"$45,024.08",$0.00,1,0,1,20130101, 0324T,CPT,RMVL SUBQ DEFIB ELECTRODE,,30,,,"$9,681.32",$0.00,1,0,1,20130101, 0325T,CPT,REPOS SUBQ DEFIB ELTRD &/GEN,,30,,,"$9,681.32",$0.00,1,0,1,20130101, 0327T,CPT,IMPLT SUBQ DEFIB INTEROGAT,,30,,,$220.54,$0.00,1,0,1,20130101, 0328T,CPT,IMPLT SUBQ DEFIB SYS DEV EVL,,30,,,$220.54,$0.00,1,0,1,20130101, A0380,HCPCS,BLS MILEAGE (PER MILE),,30,,,$16.84,$0.00,4,1,1,20130101, A0390,HCPCS,ALS MILEAGE (PER MILE),,30,,,$16.84,$0.00,4,1,1,20130101, A0425,HCPCS,"GROUND MILEAGE, PER STATUTE MILE",,30,,,$16.84,$0.00,4,1,1,20130101, A0426,HCPCS,"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, NON-EMERGENCY TRANSPORT, LEVEL 1 (ALS 1)",,30,,,$987.13,$0.00,1,1,1,20130101, A0427,HCPCS,"AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS1-EMERGENCY)",,30,,,"$1,161.33",$0.00,1,1,1,20130101, A0428,HCPCS,"AMBULANCE SERVICE, BASIC LIFE SUPPORT, NON-EMERGENCY TRANSPORT, (BLS)",,30,,,$679.65,$0.00,1,1,1,20130101, A0429,HCPCS,"AMBULANCE SERVICE, BASIC LIFE SUPPORT, EMERGENCY TRANSPORT (BLS-EMERGENCY)",,30,,,$802.75,$0.00,1,1,1,20130101, A0430,HCPCS,"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (FIXED WING)",,30,,,"$15,010.14",$0.00,1,1,1,20130101, A0431,HCPCS,"AMBULANCE SERVICE, CONVENTIONAL AIR SERVICES, TRANSPORT, ONE WAY (ROTARY WING)",,30,,,"$15,386.41",$0.00,1,1,1,20130101, A0433,HCPCS,"ADVANCED LIFE SUPPORT, LEVEL 2 (ALS 2)",,30,,,"$1,358.75",$0.00,1,1,1,20130101, A0434,HCPCS,SPECIALTY CARE TRANSPORT (SCT),,30,,,"$2,366.14",$0.00,1,1,1,20130101, A0435,HCPCS,"FIXED WING AIR MILEAGE, PER STATUTE MILE",,30,,,$129.99,$0.00,4,1,1,20130101, A0436,HCPCS,"ROTARY WING AIR MILEAGE, PER STATUTE MILE",,30,,,$163.64,$0.00,4,1,1,20130101, A9150,HCPCS,MISC/EXPER NON-PRESCRIPT DRU,,30,,,$14.10,$0.00,1,0,1,20130101, A9152,HCPCS,SINGLE VITAMIN NOS,,30,,,$37.85,$0.00,1,0,1,20130101, A9153,HCPCS,MULTI-VITAMIN NOS,,30,,,$31.34,$0.00,1,0,1,20130101, A9517,HCPCS,"I131 IODIDE CAP, RX",,30,,,$264.26,$0.00,1,0,1,20130101, A9527,HCPCS,IODINE I-125 SODIUM IODIDE,,30,,,$135.59,$0.00,1,0,1,20130101, A9530,HCPCS,"I131 IODIDE SOL, RX",,30,,,$72.80,$0.00,1,0,1,20130101, A9543,HCPCS,"Y90 IBRITUMOMAB, RX",,30,,,"$73,225.58",$0.00,1,0,1,20130101, A9545,HCPCS,"I131 TOSITUMOMAB, RX",,30,,,"$60,377.12",$0.00,1,0,1,20130101, A9563,HCPCS,P32 NA PHOSPHATE,,30,,,"$1,146.94",$0.00,1,0,1,20130101, A9564,HCPCS,P32 CHROMIC PHOSPHATE,,30,,,$742.51,$0.00,1,0,1,20130101, A9584,HCPCS,IODINE I-123 IOFLUPANE,,30,,,"$10,767.84",$0.00,1,0,1,20130101, A9600,HCPCS,SR89 STRONTIUM,,30,,,"$5,931.69",$0.00,1,0,1,20130101, A9604,HCPCS,SM 153 LEXIDRONAM,,30,,,"$23,372.25",$0.00,1,0,0,20130101, A9700,HCPCS,ECHOCARDIOGRAPHY CONTRAST,,30,,,$239.91,$0.00,1,0,1,20130101, B4150,HCPCS,EF COMPLET W/INTACT NUTRIENT,,30,,,$1.19,$0.00,1,0,1,20130101, B4152,HCPCS,EF CALORIE DENSE>/=1.5KCAL,,30,,,$0.91,$0.00,1,0,1,20130101, B4153,HCPCS,EF HYDROLYZED/AMINO ACIDS,,30,,,$4.02,$0.00,1,0,1,20130101, B4154,HCPCS,EF SPEC METABOLIC NONINHERIT,,30,,,$2.44,$0.00,1,0,1,20130101, B4155,HCPCS,EF INCOMPLETE/MODULAR,,30,,,$1.82,$0.00,1,0,1,20130101, B4160,HCPCS,EF PED CALORIC DENSE>/=0.7KC,,30,,,$3.93,$0.00,1,0,1,20130101, B4161,HCPCS,EF PED HYDROLYZED/AMINO ACID,,30,,,$10.24,$0.00,1,0,1,20130101, B4180,HCPCS,PARENTERAL SOL CARB > 50%,,30,,,$63.21,$0.00,1,0,1,20130101, B4185,HCPCS,PARENTERAL SOL 10 GM LIPIDS,,30,,,$28.69,$0.00,1,0,1,20130101, B4189,HCPCS,PARENTERAL SOL AMINO ACID &,,30,,,$467.40,$0.00,1,0,1,20130101, B4193,HCPCS,PARENTERAL SOL 52-73 GM PROT,,30,,,$604.29,$0.00,1,0,1,20130101, B4197,HCPCS,PARENTERAL SOL 74-100 GM PRO,,30,,,$735.92,$0.00,1,0,1,20130101, B4199,HCPCS,PARENTERAL SOL > 100GM PROTE,,30,,,$841.07,$0.00,1,0,1,20130101, C1300,HCPCS,HYPERBARIC OXYGEN,,30,,,$698.41,$0.00,1,0,1,20130101, C1716,HCPCS,"BRACHYTX, NON-STR, GOLD-198",,30,,,$658.68,$0.00,1,0,1,20130101, C1717,HCPCS,"BRACHYTX, NON-STR, HDR IR-192",,30,,,"$1,591.20",$0.00,1,0,1,20130101, C1719,HCPCS,"BRACHYTX, NS, NON-HDRIR-192",,30,,,$217.26,$0.00,1,0,1,20130101, C2616,HCPCS,"BRACHYTX, NON-STR, YTTRIUM-90",,30,,,"$31,457.70",$0.00,1,0,1,20130101, C2634,HCPCS,"BRACHYTX, NON-STR, HA, I-125",,30,,,$396.93,$0.00,1,0,1,20130101, C2635,HCPCS,"BRACHYTX, NON-STR, HA, P-103",,30,,,$180.03,$0.00,1,0,1,20130101, C2636,HCPCS,"BRACHY LINEAR, NON-STR, P-103",,30,,,$212.50,$0.00,1,0,1,20130101, C2638,HCPCS,"BRACHYTX, STRANDED, I-125",,30,,,$274.83,$0.00,1,0,1,20130101, C2639,HCPCS,"BRACHYTX, NON-STRANDED, I-125",,30,,,$212.98,$0.00,1,0,1,20130101, C2640,HCPCS,"BRACHYTX, STRANDED, P-103",,30,,,$450.46,$0.00,1,0,1,20130101, C2641,HCPCS,"BRACHYTX, NON-STRANDED, P-103",,30,,,$356.67,$0.00,1,0,1,20130101, C2642,HCPCS,"BRACHYTX, STRANDED, C-131",,30,,,$654.93,$0.00,1,0,1,20130101, C2643,HCPCS,"BRACHYTX, NON-STRANDED, C-131",,30,,,$394.67,$0.00,1,0,1,20130101, C2698,HCPCS,"BRACHYTX, STRANDED, NOS",,30,,,$274.83,$0.00,1,0,1,20130101, C2699,HCPCS,"BRACHYTX, NON-STRANDED, NOS",,30,,,$180.03,$0.00,1,0,1,20130101, C8900,HCPCS,"MRA W/CONT, ABD",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8901,HCPCS,"MRA W/O CONT, ABD",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8902,HCPCS,"MRA W/O FOL W/CONT, ABD",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8903,HCPCS,"MRI W/CONT, BREAST, UNI",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8904,HCPCS,"MRI W/O CONT, BREAST, UNI",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8905,HCPCS,"MRI W/O FOL W/CONT, BRST, UN",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8906,HCPCS,"MRI W/CONT, BREAST, BI",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8907,HCPCS,"MRI W/O CONT, BREAST, BI",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8908,HCPCS,"MRI W/O FOL W/CONT, BREAST,",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8909,HCPCS,"MRA W/CONT, CHEST",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8910,HCPCS,"MRA W/O CONT, CHEST",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8911,HCPCS,"MRA W/O FOL W/CONT, CHEST",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8912,HCPCS,"MRA W/CONT, LWR EXT",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8913,HCPCS,"MRA W/O CONT, LWR EXT",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8914,HCPCS,"MRA W/O FOL W/CONT, LWR EXT",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8918,HCPCS,"MRA W/CONT, PELVIS",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8919,HCPCS,"MRA W/O CONT, PELVIS",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8920,HCPCS,"MRA W/O FOL W/CONT, PELVIS",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8921,HCPCS,"TTE W OR W/O FOL W/CONT, COM",,30,,,"$3,076.90",$0.00,1,0,1,20130101, C8922,HCPCS,"TTE W OR W/O FOL W/CONT, F/U",,30,,,"$2,740.49",$0.00,1,0,1,20130101, C8923,HCPCS,"2D TTE W OR W/O FOL W/CON, CO",,30,,,"$2,740.49",$0.00,1,0,1,20130101, C8924,HCPCS,"2D TTE W OR W/O FOL W/CON, FU",,30,,,"$2,740.49",$0.00,1,0,1,20130101, C8925,HCPCS,"2D TEE W OR W/O FOL W/CON, IN",,30,,,"$3,076.90",$0.00,1,0,1,20130101, C8926,HCPCS,"TEE W OR W/O FOL W/CONT, CONG",,30,,,"$3,076.90",$0.00,1,0,1,20130101, C8927,HCPCS,"TEE W OR W/O FOL W/CONT, MON",,30,,,"$2,740.49",$0.00,1,0,1,20130101, C8928,HCPCS,"TTE W OR W/O FOL W/CON, STRES",,30,,,"$3,076.90",$0.00,1,0,1,20130101, C8929,HCPCS,"TTE W OR WO FOL WCON, DOPPLER",,30,,,"$3,076.90",$0.00,1,0,1,20130101, C8930,HCPCS,"TTE W OR W/O CONTR, CONT ECG",,30,,,"$3,076.90",$0.00,1,0,1,20130101, C8931,HCPCS,"MRA, W/DYE, SPINAL CANAL",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8932,HCPCS,"MRA, W/O DYE, SPINAL CANAL",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8933,HCPCS,"MRA, W/O&W/DYE, SPINAL CANAL",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8934,HCPCS,"MRA, W/DYE, UPPER EXTREMITY",,30,,,"$2,859.72",$0.00,1,0,1,20130101, C8935,HCPCS,"MRA, W/O DYE, UPPER EXTR",,30,,,"$2,159.76",$0.00,1,0,1,20130101, C8936,HCPCS,"MRA, W/O&W/DYE, UPPER EXTR",,30,,,"$3,447.14",$0.00,1,0,1,20130101, C8957,HCPCS,"PROLONGED IV INF, REQ PUMP",,30,,,"$1,353.27",$0.00,1,0,1,20130101, C9121,HCPCS,"INJECTION, ARGATROBAN",,30,,,$124.61,$0.00,1,0,1,20130101, C9248,HCPCS,"INJ, CLEVIDIPINE BUTYRATE",,30,,,$17.84,$0.00,1,0,1,20130101, C9250,HCPCS,ARTISS FIBRIN SEALANT,,30,,,$395.67,$0.00,1,0,1,20130101, C9257,HCPCS,BEVACIZUMAB INJECTION,,30,,,$9.10,$0.00,1,0,1,20130101, C9285,HCPCS,"PATCH, LIDOCAINE/TETRACAINE",,30,,,$78.74,$0.00,1,0,1,20130101, C9286,HCPCS,"INJECTION, BELATACEPT",,30,,,$24.77,$0.00,1,0,1,20130101, C9287,HCPCS,"INJ, BRENTUXIMAB VEDOTIN",,30,,,$617.07,$0.00,1,0,1,20130101, C9288,HCPCS,"INJ, CENTRUROIDES (SCORPION)",,30,,,"$19,269.53",$0.00,1,0,1,20130101, C9289,HCPCS,"INJ, ERWINIA CHRYSANTHEMI",,30,,,"$2,144.87",$0.00,1,0,1,20130101, C9290,HCPCS,"INJ, BUPIVACAINE LIPOSOME",,30,,,$7.41,$0.00,1,0,1,20130101, C9292,HCPCS,"INJECTION, PERTUZUMAB",,30,,,$664.98,$0.00,1,0,1,20130101, C9293,HCPCS,"INJECTION, GLUCARPIDASE",,30,,,"$1,497.24",$0.00,1,0,1,20130101, C9294,HCPCS,"INJ, TALIGLUCERASE ALFA",,30,,,$204.92,$0.00,1,0,1,20130101, C9295,HCPCS,"INJECTION, CARFILZOMIB",,30,,,$190.33,$0.00,1,0,1,20130101, C9296,HCPCS,"INJECTION, ZIV-AFLIBERCEPT",,30,,,$110.24,$0.00,1,0,1,20130101, C9358,HCPCS,"SURGIMEND, FETAL",,30,,,$67.38,$0.00,1,0,1,20130101, C9360,HCPCS,"SURGIMEND, NEONATAL",,30,,,$68.99,$0.00,1,0,1,20130101, C9363,HCPCS,INTEGRA MESHED BIL WOUND MAT,,30,,,$143.84,$0.00,1,0,1,20130101, C9366,HCPCS,EPIFIX WOUND COVER,,30,,,$606.93,$0.00,1,0,1,20130101, C9367,HCPCS,ENDOFORM DERMAL TEMPLATE,,30,,,$26.35,$0.00,1,0,1,20130101, C9368,HCPCS,GRAFIX CORE,,30,,,$50.67,$0.00,1,0,1,20130101, C9369,HCPCS,GRAFIX PRIME,,30,,,$3.88,$0.00,1,0,1,20130101, C9600,HCPCS,PERC DRUG-EL COR STENT SING,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9601,HCPCS,PERC DRUG-EL COR STENT BRAN,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9602,HCPCS,PERC D-E COR STENT ATHER S,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9603,HCPCS,PERC D-E COR STENT ATHER BR,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9604,HCPCS,PERC D-E COR REVASC T CABG S,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9605,HCPCS,PERC D-E COR REVASC T CABG B,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9606,HCPCS,PERC D-E COR REVASC W AMI S,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9607,HCPCS,PERC D-E COR REVASC CHRO SIN,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9608,HCPCS,PERC D-E COR REVASC CHRO ADD,,30,,,"$23,360.12",$0.00,1,0,1,20130101, C9724,HCPCS,EPS STOMACH PLIC,,30,,,"$10,520.78",$0.00,1,0,1,20130101, C9725,HCPCS,PLACE ENDORECTAL APP,,30,,,"$2,524.22",$0.00,1,0,1,20130101, C9726,HCPCS,RXT BREAST APPL PLACE/REMOV,,30,,,"$10,154.27",$0.00,1,0,1,20130101, C9727,HCPCS,INSERT PALATE IMPLANTS,,30,,,"$2,809.59",$0.00,1,0,1,20130101, C9728,HCPCS,"PLACE DEVICE/MARKER, NON PRO",,30,,,"$5,975.13",$0.00,1,0,1,20130101, C9733,HCPCS,NON-OPHTHALMIC FVA,,30,,,"$2,105.62",$0.00,1,0,1,20130101, C9800,HCPCS,DERMAL FILLER INJ PX/SUPPL,,30,,,"$2,209.66",$0.00,1,0,1,20130101, G0008,HCPCS,ADMIN INFLUENZA VIRUS VAC,,30,,,$144.72,$0.00,1,0,1,20130101, G0009,HCPCS,ADMIN PNEUMOCOCCAL VACCINE,,30,,,$144.72,$0.00,1,0,1,20130101, G0010,HCPCS,ADMIN HEPATITIS B VACCINE,,30,,,$175.99,$0.00,1,0,1,20130101, G0101,HCPCS,CA SCREEN;PELVIC/BREAST EXAM,,30,,,$140.45,$0.00,1,0,1,20130101, G0104,HCPCS,CA SCREEN;FLEXI SIGMOIDSCOPE,,30,,,"$2,319.01",$0.00,1,0,1,20130101, G0105,HCPCS,COLORECTAL SCRN; HI RISK IND,,30,,,"$3,485.95",$0.00,1,0,1,20130101, G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,,30,,,"$1,040.44",$0.00,1,0,1,20130101, G0117,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,30,,,$354.27,$0.00,1,0,1,20130101, G0118,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,30,,,$204.26,$0.00,1,0,1,20130101, G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,,30,,,"$1,040.44",$0.00,1,0,1,20130101, G0121,HCPCS,COLON CA SCRN NOT HI RSK IND,,30,,,"$3,485.95",$0.00,1,0,1,20130101, G0124,HCPCS,SCREEN C/V THIN LAYER BY MD,,30,,,$87.10,$0.00,1,0,1,20130101, G0127,HCPCS,TRIM NAIL(S),,30,,,$121.18,$0.00,1,0,1,20130101, G0128,HCPCS,CORF SKILLED NURSING SERVICE,,30,,,$66.50,$0.00,1,0,1,20130101, G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,,30,,,$460.67,$0.00,1,0,1,20130101, G0141,HCPCS,"SCR C/V CYTO, AUTOSYS AND MD",,30,,,$124.44,$0.00,1,0,1,20130101, G0151,HCPCS,"HHCP-SERV OF PT, EA 15 MIN",,30,,,$58.07,$0.00,1,0,1,20130101, G0152,HCPCS,"HHCP-SERV OF OT, EA 15 MIN",,30,,,$56.32,$0.00,1,0,1,20130101, G0153,HCPCS,"HHCP-SVS OF S/L PATH, EA 15MN",,30,,,$55.16,$0.00,1,0,1,20130101, G0154,HCPCS,"HHCP-SVS OF RN, EA 15 MIN",,30,,,$53.71,$0.00,1,0,1,20130101, G0155,HCPCS,"HHCP-SVS OF CSW, EA 15 MIN",,30,,,$66.78,$0.00,1,0,1,20130101, G0156,HCPCS,"HHCP-SVS OF AIDE, EA 15 MIN",,30,,,$26.13,$0.00,1,0,1,20130101, G0157,HCPCS,HHC PT ASSISTANT EA 15,,30,,,$125.07,$0.00,1,0,1,20130101, G0158,HCPCS,HHC OT ASSISTANT EA 15,,30,,,$56.97,$0.00,1,0,1,20130101, G0159,HCPCS,HHC PT MAINT EA 15 MIN,,30,,,$58.52,$0.00,1,0,1,20130101, G0160,HCPCS,HHC OCCUP THERAPY EA 15,,30,,,$56.97,$0.00,1,0,1,20130101, G0161,HCPCS,HHC SLP EA 15 MIN,,30,,,$56.97,$0.00,1,0,1,20130101, G0162,HCPCS,"HHC RN E&M PLAN SVS, 15 MIN",,30,,,$53.90,$0.00,1,0,1,20130101, G0163,HCPCS,HHC LPN/RN OBS/ASSES EA 15,,30,,,$177.92,$0.00,1,0,1,20130101, G0164,HCPCS,HHC LIS NURSE TRAIN EA 15,,30,,,$53.90,$0.00,1,0,1,20130101, G0166,HCPCS,"EXTRNL COUNTERPULSE, PER TX",,30,,,$600.21,$0.00,1,0,1,20130101, G0168,HCPCS,WOUND CLOSURE BY ADHESIVE,,30,,,$249.10,$0.00,1,0,1,20130101, G0173,HCPCS,LINEAR ACC STEREO RADSUR COM,,30,,,"$16,554.03",$0.00,1,0,1,20130101, G0175,HCPCS,"OPPS SERVICE, SCHED TEAM CONF",,30,,,"$1,118.41",$0.00,1,0,1,20130101, G0179,HCPCS,MD RECERTIFICATION HHA PT,,30,,,$180.01,$0.00,1,0,1,20130101, G0180,HCPCS,MD CERTIFICATION HHA PATIENT,,30,,,$196.84,$0.00,1,0,1,20130101, G0186,HCPCS,"DSTRY EYE LESN, FDR VSSL TECH",,30,,,"$2,323.55",$0.00,1,0,1,20130101, G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,30,,,$519.11,$0.00,1,0,1,20130101, G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,30,,,$412.27,$0.00,1,0,1,20130101, G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,,30,,,"$2,111.08",$0.00,1,0,1,20130101, G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,,30,,,"$2,111.08",$0.00,1,0,1,20130101, G0237,HCPCS,THERAPEUTIC PROCD STRG ENDUR,,30,,,$182.97,$0.00,1,0,1,20130101, G0238,HCPCS,"OTH RESP PROC, INDIV",,30,,,$182.97,$0.00,1,0,1,20130101, G0239,HCPCS,"OTH RESP PROC, GROUP",,30,,,$182.97,$0.00,1,0,1,20130101, G0245,HCPCS,INITIAL FOOT EXAM PT LOPS,,30,,,$140.45,$0.00,1,0,1,20130101, G0246,HCPCS,FOLLOWUP EVAL OF FOOT PT LOP,,30,,,$140.45,$0.00,1,0,1,20130101, G0247,HCPCS,ROUTINE FOOTCARE PT W LOPS,,30,,,$258.15,$0.00,1,0,1,20130101, G0248,HCPCS,DEMONSTRATE USE HOME INR MON,,30,,,$364.18,$0.00,1,0,1,20130101, G0249,HCPCS,PROVIDE INR TEST MATER/EQUIP,,30,,,$364.18,$0.00,1,0,1,20130101, G0251,HCPCS,LINEAR ACC BASED STERO RADIO,,30,,,"$5,416.55",$0.00,1,0,1,20130101, G0257,HCPCS,UNSCHED DIALYSIS ESRD PT HOS,,30,,,"$2,501.58",$0.00,1,0,1,20130101, G0260,HCPCS,INJ FOR SACROILIAC JT ANESTH,,30,,,"$3,282.70",$0.00,1,0,1,20130101, G0282,HCPCS,ELECT STIM WOUND CARE NOT PD,,30,,,$143.64,$0.00,1,0,1,20130101, G0290,HCPCS,"DRUG-ELUTING STENTS, SINGLE",,30,,,"$23,377.15",$0.00,1,0,1,20130101, G0291,HCPCS,"DRUG-ELUTING STENTS,EACH ADD",,30,,,"$23,377.15",$0.00,1,0,1,20130101, G0293,HCPCS,"NON-COV SURG PROC, CLIN TRIAL",,30,,,$317.65,$0.00,1,0,1,20130101, G0294,HCPCS,"NON-COV PROC, CLINICAL TRIAL",,30,,,$317.65,$0.00,1,0,1,20130101, G0302,HCPCS,PRE-OP SERVICE LVRS COMPLETE,,30,,,"$4,716.09",$0.00,1,0,1,20130101, G0303,HCPCS,PRE-OP SERVICE LVRS 10-15DOS,,30,,,"$4,716.09",$0.00,1,0,1,20130101, G0304,HCPCS,PRE-OP SERVICE LVRS 1-9 DOS,,30,,,"$1,113.97",$0.00,1,0,1,20130101, G0305,HCPCS,POST OP SERVICE LVRS MIN 6,,30,,,"$1,113.97",$0.00,1,0,1,20130101, G0339,HCPCS,"ROBOT LIN-RADSURG COM, FIRST",,30,,,"$16,554.03",$0.00,1,0,1,20130101, G0340,HCPCS,ROBT LIN-RADSURG FRACTX 2-5,,30,,,"$12,859.10",$0.00,1,0,1,20130101, G0364,HCPCS,BONE MARROW ASPIRATE &BIOPSY,,30,,,$317.65,$0.00,1,0,1,20130101, G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,,30,,,"$1,001.02",$0.00,1,0,1,20130101, G0378,HCPCS,HOSPITAL OBSERVATION PER HR,,30,,,$84.89,$0.00,1,1,1,20130101, G0379,HCPCS,DIRECT REFER HOSPITAL OBSERV,,30,,,$84.89,$0.00,1,1,1,20130101, G0380,HCPCS,LEV 1 HOSP TYPE B ED VISIT,,30,,,$423.04,$0.00,1,1,1,20130101, G0381,HCPCS,LEV 2 HOSP TYPE B ED VISIT,,30,,,$339.69,$0.00,1,1,1,20130101, G0382,HCPCS,LEV 3 HOSP TYPE B ED VISIT,,30,,,$583.90,$0.00,1,1,1,20130101, G0383,HCPCS,LEV 4 HOSP TYPE B ED VISIT,,30,,,$842.10,$0.00,1,1,1,20130101, G0384,HCPCS,LEV 5 HOSP TYPE B ED VISIT,,30,,,"$1,270.69",$0.00,1,1,1,20130101, G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,,30,,,$643.53,$0.00,1,0,1,20130101, G0390,HCPCS,TRAUMA RESPONS W/HOSP CRITI,,30,,,"$3,051.53",$0.00,1,1,1,20130101, G0396,HCPCS,ALCOHOL/SUBS INTERV 15-30MN,,30,,,$189.87,$0.00,1,0,1,20130101, G0397,HCPCS,ALCOHOL/SUBS INTERV >30 MIN,,30,,,$189.87,$0.00,1,0,1,20130101, G0398,HCPCS,HOME SLEEP TEST/TYPE 2 PORTA,,30,,,"$1,113.97",$0.00,1,0,1,20130101, G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,30,,,"$1,113.97",$0.00,1,0,1,20130101, G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,,30,,,"$1,113.97",$0.00,1,0,1,20130101, G0402,HCPCS,INITIAL PREVENTIVE EXAM,,30,,,$222.68,$0.00,1,0,1,20130101, G0404,HCPCS,EKG TRACING FOR INITIAL PREV,,30,,,$173.59,$0.00,1,0,1,20130101, G0413,HCPCS,PELVIC RING FRACTURE UNI/BIL,,30,,,"$12,604.15",$0.00,1,0,1,20130101, G0416,HCPCS,SAT BIOPSY 10-20,,30,,,"$1,003.70",$0.00,1,0,1,20130101, G0417,HCPCS,SAT BIOPSY PROSTATE 21-40,,30,,,"$1,003.70",$0.00,1,0,1,20130101, G0418,HCPCS,SAT BIOPSY PROSTATE 41-60,,30,,,"$1,003.70",$0.00,1,0,1,20130101, G0419,HCPCS,SAT BIOPSY PROSTATE: >60,,30,,,"$1,003.70",$0.00,1,0,1,20130101, G0422,HCPCS,INTENS CARDIAC REHAB W/EXERC,,30,,,$259.67,$0.00,1,0,1,20130101, G0423,HCPCS,INTENS CARDIAC REHAB NO EXER,,30,,,$259.67,$0.00,1,0,1,20130101, G0424,HCPCS,PULMONARY REHAB W EXER,,30,,,$257.01,$0.00,1,0,1,20130101, G0436,HCPCS,TOBACCO-USE COUNSEL 3-10 MIN,,30,,,$93.09,$0.00,1,0,1,20130101, G0437,HCPCS,TOBACCO-USE COUNSEL>10MIN,,30,,,$189.87,$0.00,1,0,1,20130101, G0442,HCPCS,ANNUAL ALCOHOL SCREEN 15 MIN,,30,,,$189.87,$0.00,1,0,1,20130101, G0443,HCPCS,BRIEF ALCOHOL MISUSE COUNSEL,,30,,,$189.87,$0.00,1,0,1,20130101, G0444,HCPCS,DEPRESSION SCREEN ANNUAL,,30,,,$189.87,$0.00,1,0,1,20130101, G0445,HCPCS,HIGH INTEN BEH COUNS STD 30M,,30,,,$189.87,$0.00,1,0,1,20130101, G0446,HCPCS,INTENS BEHAVE THER CARDIO DX,,30,,,$189.87,$0.00,1,0,1,20130101, G0447,HCPCS,BEHAVIOR COUNSEL OBESITY 15M,,30,,,$189.87,$0.00,1,0,1,20130101, G0451,HCPCS,DEVLOPMENT TEST INTERPT&REP,,30,,,$189.87,$0.00,1,0,1,20130101, G0455,HCPCS,FECAL MICROBIOTA PREP INSTIL,,30,,,$322.11,$0.00,1,0,1,20130101, G0456,HCPCS,NEG PRE WOUND <=50 SQ CM,,30,,,"$1,224.69",$0.00,1,0,1,20130101, G0457,HCPCS,NEG PRES WOUND >50 SQ CM,,30,,,"$1,224.69",$0.00,1,0,1,20130101, G3001,HCPCS,"ADMIN + SUPPLY, TOSITUMOMAB",,30,,,"$11,281.22",$0.00,1,0,1,20130101, G9141,HCPCS,"INFLUENZA A H1N1,ADMIN W COU",,30,,,$144.72,$0.00,1,0,1,20130101, G9142,HCPCS,"INFLUENZA A H1N1, VACCINE",,30,,,$6.82,$0.00,1,0,1,20130101, J0129,HCPCS,ABATACEPT INJECTION,,30,,,$140.92,$0.00,1,0,0,20130101, J0130,HCPCS,ABCIXIMAB INJECTION,,30,,,"$3,440.10",$0.00,1,0,0,20130101, J0131,HCPCS,ACETAMINOPHEN INJECTION,,30,,,$0.72,$0.00,1,0,0,20130101, J0132,HCPCS,ACETYLCYSTEINE INJECTION,,30,,,$18.46,$0.00,1,0,0,20130101, J0135,HCPCS,ADALIMUMAB INJECTION,,30,,,"$2,707.31",$0.00,1,0,0,20130101, J0152,HCPCS,ADENOSINE INJECTION,,30,,,$542.53,$0.00,1,0,0,20130101, J0178,HCPCS,AFLIBERCEPT INJECTION,,30,,,"$5,950.60",$0.00,1,0,0,20130101, J0180,HCPCS,AGALSIDASE BETA INJECTION,,30,,,$910.33,$0.00,1,0,0,20130101, J0205,HCPCS,ALGLUCERASE INJECTION,,30,,,$272.61,$0.00,1,0,0,20130101, J0207,HCPCS,AMIFOSTINE,,30,,,"$2,060.37",$0.00,1,0,0,20130101, J0210,HCPCS,METHYLDOPATE HCL INJECTION,,30,,,$275.27,$0.00,1,0,0,20130101, J0215,HCPCS,ALEFACEPT,,30,,,$248.46,$0.00,1,0,0,20130101, J0220,HCPCS,ALGLUCOSIDASE ALFA INJECTION,,30,,,"$1,317.88",$0.00,1,0,0,20130101, J0221,HCPCS,LUMIZYME INJECTION,,30,,,$973.94,$0.00,1,0,0,20130101, J0256,HCPCS,ALPHA 1 PROTEINASE INHIBITOR,,30,,,$25.55,$0.00,1,0,0,20130101, J0257,HCPCS,GLASSIA INJECTION,,30,,,$25.22,$0.00,1,0,0,20130101, J0270,HCPCS,ALPROSTADIL FOR INJECTION,,30,,,$8.60,$0.00,1,0,0,20130101, J0287,HCPCS,AMPHOTERICIN B LIPID COMPLEX,,30,,,$67.86,$0.00,1,0,0,20130101, J0288,HCPCS,AMPHO B CHOLESTERYL SULFATE,,30,,,$96.46,$0.00,1,0,0,20130101, J0289,HCPCS,AMPHOTERICIN B LIPOSOME INJ,,30,,,$94.77,$0.00,1,0,0,20130101, J0300,HCPCS,AMOBARBITAL 125 MG INJ,,30,,,$855.14,$0.00,1,0,0,20130101, J0348,HCPCS,ANIDULAFUNGIN INJECTION,,30,,,$8.84,$0.00,1,0,0,20130101, J0365,HCPCS,"APROTONIN, 10,000 KIU",,30,,,$17.23,$0.00,1,0,0,20130101, J0395,HCPCS,ARBUTAMINE HCL INJECTION,,30,,,$559.01,$0.00,1,0,0,20130101, J0475,HCPCS,BACLOFEN 10 MG INJECTION,,30,,,"$1,179.12",$0.00,1,0,0,20130101, J0476,HCPCS,BACLOFEN INTRATHECAL TRIAL,,30,,,$493.80,$0.00,1,0,0,20130101, J0480,HCPCS,BASILIXIMAB,,30,,,"$12,266.48",$0.00,1,0,0,20130101, J0485,HCPCS,BELATACEPT INJECTION,,30,,,$24.70,$0.00,1,0,0,20130101, J0490,HCPCS,BELIMUMAB INJECTION,,30,,,$248.85,$0.00,1,0,0,20130101, J0583,HCPCS,BIVALIRUDIN,,30,,,$18.07,$0.00,1,0,0,20130101, J0585,HCPCS,"INJECTION, ONABOTULINUMTOXINA",,30,,,$35.56,$0.00,1,0,0,20130101, J0586,HCPCS,ABOBOTULINUMTOXINA,,30,,,$46.93,$0.00,1,0,0,20130101, J0587,HCPCS,"INJ, RIMABOTULINUMTOXINB",,30,,,$71.05,$0.00,1,0,0,20130101, J0588,HCPCS,INCOBOTULINUMTOXIN A,,30,,,$29.64,$0.00,1,0,0,20130101, J0594,HCPCS,BUSULFAN INJECTION,,30,,,$124.02,$0.00,1,0,0,20130101, J0597,HCPCS,"C-1 ESTERASE, BERINERT",,30,,,$200.18,$0.00,1,0,0,20130101, J0598,HCPCS,"C-1 ESTERASE, CINRYZE",,30,,,$296.49,$0.00,1,0,0,20130101, J0600,HCPCS,EDETATE CALCIUM DISODIUM INJ,,30,,,"$1,215.53",$0.00,1,0,0,20130101, J0630,HCPCS,CALCITONIN SALMON INJECTION,,30,,,$370.26,$0.00,1,0,0,20130101, J0637,HCPCS,CASPOFUNGIN ACETATE,,30,,,$82.03,$0.00,1,0,0,20130101, J0638,HCPCS,CANAKINUMAB INJECTION,,30,,,$576.77,$0.00,1,0,0,20130101, J0641,HCPCS,LEVOLEUCOVORIN INJECTION,,30,,,$10.79,$0.00,1,0,0,20130101, J0712,HCPCS,CEFTAROLINE FOSAMIL INJ,,30,,,$4.75,$0.00,1,0,0,20130101, J0716,HCPCS,CENTRUROIDES IMMUNE F(AB),,30,,,"$17,710.23",$0.00,1,0,0,20130101, J0718,HCPCS,CERTOLIZUMAB PEGOL INJ,,30,,,$28.28,$0.00,1,0,0,20130101, J0740,HCPCS,CIDOFOVIR INJECTION,,30,,,"$4,671.57",$0.00,1,0,0,20130101, J0775,HCPCS,"COLLAGENASE, CLOST HIST INJ",,30,,,$248.27,$0.00,1,0,0,20130101, J0795,HCPCS,CORTICORELIN OVINE TRIFLUTAL,,30,,,$34.58,$0.00,1,0,0,20130101, J0800,HCPCS,CORTICOTROPIN INJECTION,,30,,,"$14,262.53",$0.00,1,0,0,20130101, J0833,HCPCS,COSYNTROPIN INJECTION NOS,,30,,,$657.40,$0.00,1,0,0,20130101, J0840,HCPCS,CROTALIDAE POLY IMMUNE FAB,,30,,,"$11,922.87",$0.00,1,0,0,20130101, J0850,HCPCS,CYTOMEGALOVIRUS IMM IV /VIAL,,30,,,"$5,869.43",$0.00,1,0,0,20130101, J0878,HCPCS,DAPTOMYCIN INJECTION,,30,,,$3.32,$0.00,1,0,0,20130101, J0881,HCPCS,"DARBEPOETIN ALFA, NON-ESRD",,30,,,$21.19,$0.00,1,0,0,20130101, J0885,HCPCS,"EPOETIN ALFA, NON-ESRD",,30,,,$63.44,$0.00,1,0,0,20130101, J0894,HCPCS,DECITABINE INJECTION,,30,,,$215.87,$0.00,1,0,0,20130101, J0897,HCPCS,DENOSUMAB INJECTION,,30,,,$95.36,$0.00,1,0,0,20130101, J0900,HCPCS,TESTOSTERONE ENANTHATE INJ,,30,,,$216.71,$0.00,1,0,0,20130101, J1055,HCPCS,MEDRXYPROGESTER ACETATE INJ,,30,,,$140.36,$0.00,1,0,0,20130101, J1162,HCPCS,DIGOXIN IMMUNE FAB (OVINE),,30,,,"$4,824.54",$0.00,1,0,0,20130101, J1190,HCPCS,DEXRAZOXANE HCL INJECTION,,30,,,"$1,023.89",$0.00,1,0,0,20130101, J1205,HCPCS,CHLOROTHIAZIDE SODIUM INJ,,30,,,"$1,771.33",$0.00,1,0,0,20130101, J1212,HCPCS,DIMETHYL SULFOXIDE 50% 50 ML,,30,,,$560.30,$0.00,1,0,0,20130101, J1290,HCPCS,ECALLANTIDE INJECTION,,30,,,"$1,852.58",$0.00,1,0,0,20130101, J1300,HCPCS,ECULIZUMAB INJECTION,,30,,,"$1,255.52",$0.00,1,0,0,20130101, J1324,HCPCS,ENFUVIRTIDE INJECTION,,30,,,$3.45,$0.00,1,0,0,20130101, J1327,HCPCS,EPTIFIBATIDE INJECTION,,30,,,$152.75,$0.00,1,0,0,20130101, J1410,HCPCS,INJ ESTROGEN CONJUGATE 25 MG,,30,,,$743.15,$0.00,1,0,0,20130101, J1430,HCPCS,ETHANOLAMINE OLEATE 100 MG,,30,,,"$1,912.41",$0.00,1,0,0,20130101, J1435,HCPCS,INJECTION ESTRONE PER 1 MG,,30,,,$10.01,$0.00,1,0,0,20130101, J1438,HCPCS,ETANERCEPT INJECTION,,30,,,"$1,406.42",$0.00,1,0,0,20130101, J1440,HCPCS,FILGRASTIM 300 MCG INJECTION,,30,,,"$1,151.33",$0.00,1,0,0,20130101, J1441,HCPCS,FILGRASTIM 480 MCG INJECTION,,30,,,"$1,670.01",$0.00,1,0,0,20130101, J1451,HCPCS,"FOMEPIZOLE, 15 MG",,30,,,$45.96,$0.00,1,0,0,20130101, J1452,HCPCS,INTRAOCULAR FOMIVIRSEN NA,,30,,,$550.20,$0.00,1,0,0,20130101, J1453,HCPCS,FOSAPREPITANT INJECTION,,30,,,$11.12,$0.00,1,0,0,20130101, J1458,HCPCS,GALSULFASE INJECTION,,30,,,"$2,199.27",$0.00,1,0,0,20130101, J1459,HCPCS,INJ IVIG PRIVIGEN 500 MG,,30,,,$227.60,$0.00,1,0,0,20130101, J1460,HCPCS,GAMMA GLOBULIN 1 CC INJ,,30,,,$151.71,$0.00,1,0,0,20130101, J1557,HCPCS,GAMMAPLEX INJECTION,,30,,,$246.84,$0.00,1,0,0,20130101, J1559,HCPCS,HIZENTRA INJECTION,,30,,,$47.39,$0.00,1,0,0,20130101, J1560,HCPCS,GAMMA GLOBULIN > 10 CC INJ,,30,,,"$1,494.97",$0.00,1,0,0,20130101, J1561,HCPCS,GAMUNEX-C/GAMMAKED,,30,,,$244.25,$0.00,1,0,0,20130101, J1562,HCPCS,"VIVAGLOBIN, INJ",,30,,,$82.68,$0.00,1,0,0,20130101, J1566,HCPCS,"IMMUNE GLOBULIN, POWDER",,30,,,$204.66,$0.00,1,0,0,20130101, J1568,HCPCS,OCTAGAM INJECTION,,30,,,$225.01,$0.00,1,0,0,20130101, J1569,HCPCS,GAMMAGARD LIQUID INJECTION,,30,,,$261.09,$0.00,1,0,0,20130101, J1570,HCPCS,GANCICLOVIR SODIUM INJECTION,,30,,,$490.19,$0.00,1,0,0,20130101, J1571,HCPCS,HEPAGAM B IM INJECTION,,30,,,$312.54,$0.00,1,0,0,20130101, J1572,HCPCS,FLEBOGAMMA INJECTION,,30,,,$226.89,$0.00,1,0,0,20130101, J1573,HCPCS,"HEPAGAM B INTRAVENOUS, INJ",,30,,,$312.54,$0.00,1,0,0,20130101, J1590,HCPCS,GATIFLOXACIN INJECTION,,30,,,$560.04,$0.00,1,0,0,20130101, J1595,HCPCS,INJECTION GLATIRAMER ACETATE,,30,,,$730.46,$0.00,1,0,0,20130101, J1610,HCPCS,GLUCAGON HYDROCHLORIDE/1 MG,,30,,,$715.72,$0.00,1,0,0,20130101, J1620,HCPCS,GONADORELIN HYDROCH/ 100 MCG,,30,,,$39.39,$0.00,1,0,0,20130101, J1640,HCPCS,"HEMIN, 1 MG",,30,,,$86.19,$0.00,1,0,0,20130101, J1670,HCPCS,TETANUS IMMUNE GLOBULIN INJ,,30,,,"$1,609.87",$0.00,1,0,0,20130101, J1680,HCPCS,HUMAN FIBRINOGEN CONC INJ,,30,,,$173.66,$0.00,1,0,0,20130101, J1725,HCPCS,HYDROXYPROGESTERONE CAPROATE,,30,,,$14.95,$0.00,1,0,0,20130101, J1730,HCPCS,DIAZOXIDE INJECTION,,30,,,$571.49,$0.00,1,0,0,20130101, J1740,HCPCS,IBANDRONATE SODIUM INJECTION,,30,,,$978.65,$0.00,1,0,0,20130101, J1742,HCPCS,IBUTILIDE FUMARATE INJECTION,,30,,,$897.88,$0.00,1,0,0,20130101, J1743,HCPCS,IDURSULFASE INJECTION,,30,,,"$2,869.42",$0.00,1,0,0,20130101, J1744,HCPCS,ICATIBANT INJECTION,,30,,,"$1,505.55",$0.00,1,0,0,20130101, J1745,HCPCS,INFLIXIMAB INJECTION,,30,,,$319.99,$0.00,1,0,0,20130101, J1750,HCPCS,INJ IRON DEXTRAN,,30,,,$78.65,$0.00,1,0,0,20130101, J1786,HCPCS,IMUGLUCERASE INJECTION,,30,,,$272.61,$0.00,1,0,0,20130101, J1810,HCPCS,DROPERIDOL/FENTANYL INJ,,30,,,$23.10,$0.00,1,0,0,20130101, J1826,HCPCS,INTERFERON BETA-1A INJ,,30,,,"$1,502.64",$0.00,1,0,0,20130101, J1830,HCPCS,INTERFERON BETA-1B / 0.25 MG,,30,,,"$1,437.09",$0.00,1,0,0,20130101, J1835,HCPCS,ITRACONAZOLE INJECTION,,30,,,$571.24,$0.00,1,0,0,20130101, J1930,HCPCS,LANREOTIDE INJECTION,,30,,,$215.94,$0.00,1,0,0,20130101, J1931,HCPCS,LARONIDASE INJECTION,,30,,,$174.44,$0.00,1,0,0,20130101, J1945,HCPCS,LEPIRUDIN,,30,,,"$3,455.32",$0.00,1,0,0,20130101, J1950,HCPCS,LEUPROLIDE ACETATE /3.75 MG,,30,,,"$3,787.68",$0.00,1,0,0,20130101, J1955,HCPCS,INJ LEVOCARNITINE PER 1 GM,,30,,,$24.25,$0.00,1,0,0,20130101, J2020,HCPCS,LINEZOLID INJECTION,,30,,,$240.56,$0.00,1,0,0,20130101, J2212,HCPCS,METHYLNALTREXONE INJECTION,,30,,,$2.41,$0.00,1,0,0,20130101, J2248,HCPCS,MICAFUNGIN SODIUM INJECTION,,30,,,$6.24,$0.00,1,0,0,20130101, J2265,HCPCS,MINOCYCLINE HYDROCHLORIDE,,30,,,$3.77,$0.00,1,0,0,20130101, J2278,HCPCS,ZICONOTIDE INJECTION,,30,,,$42.97,$0.00,1,0,0,20130101, J2315,HCPCS,"NALTREXONE, DEPOT FORM",,30,,,$18.46,$0.00,1,0,0,20130101, J2323,HCPCS,NATALIZUMAB INJECTION,,30,,,$72.22,$0.00,1,0,0,20130101, J2325,HCPCS,NESIRITIDE INJECTION,,30,,,$319.59,$0.00,1,0,0,20130101, J2353,HCPCS,"OCTREOTIDE INJECTION, DEPOT",,30,,,$794.70,$0.00,1,0,0,20130101, J2355,HCPCS,OPRELVEKIN INJECTION,,30,,,"$1,560.01",$0.00,1,0,0,20130101, J2357,HCPCS,OMALIZUMAB INJECTION,,30,,,$147.75,$0.00,1,0,0,20130101, J2358,HCPCS,OLANZAPINE LONG-ACTING INJ,,30,,,$17.88,$0.00,1,0,0,20130101, J2425,HCPCS,PALIFERMIN INJECTION,,30,,,$76.51,$0.00,1,0,0,20130101, J2426,HCPCS,PALIPERIDONE PALMITATE INJ,,30,,,$44.40,$0.00,1,0,0,20130101, J2469,HCPCS,PALONOSETRON HCL,,30,,,$119.86,$0.00,1,0,0,20130101, J2503,HCPCS,PEGAPTANIB SODIUM INJECTION,,30,,,"$6,230.81",$0.00,1,0,0,20130101, J2504,HCPCS,"PEGADEMASE BOVINE, 25 IU",,30,,,"$1,660.55",$0.00,1,0,0,20130101, J2505,HCPCS,"INJECTION, PEGFILGRASTIM 6MG",,30,,,"$13,079.88",$0.00,1,0,0,20130101, J2507,HCPCS,PEGLOTICASE INJECTION,,30,,,"$1,925.51",$0.00,1,0,0,20130101, J2545,HCPCS,PENTAMIDINE NON-COMP UNIT,,30,,,$156.70,$0.00,1,0,0,20130101, J2562,HCPCS,PLERIXAFOR INJECTION,,30,,,"$1,825.33",$0.00,1,0,0,20130101, J2597,HCPCS,INJ DESMOPRESSIN ACETATE,,30,,,$37.25,$0.00,1,0,0,20130101, J2700,HCPCS,OXACILLIN SODIUM INJECITON,,30,,,$18.27,$0.00,1,0,0,20130101, J2724,HCPCS,PROTEIN C CONCENTRATE,,30,,,$85.22,$0.00,1,0,0,20130101, J2725,HCPCS,INJ PROTIRELIN PER 250 MCG,,30,,,$193.77,$0.00,1,0,0,20130101, J2730,HCPCS,PRALIDOXIME CHLORIDE INJ,,30,,,$548.85,$0.00,1,0,0,20130101, J2770,HCPCS,QUINUPRISTIN/DALFOPRISTIN,,30,,,"$1,122.10",$0.00,1,0,0,20130101, J2778,HCPCS,RANIBIZUMAB INJECTION,,30,,,"$2,536.70",$0.00,1,0,0,20130101, J2783,HCPCS,RASBURICASE,,30,,,"$1,292.25",$0.00,1,0,0,20130101, J2785,HCPCS,REGADENOSON INJECTION,,30,,,$341.57,$0.00,1,0,0,20130101, J2788,HCPCS,RHO D IMMUNE GLOBULIN 50 MCG,,30,,,$163.28,$0.00,1,0,0,20130101, J2790,HCPCS,RHO D IMMUNE GLOBULIN INJ,,30,,,$542.93,$0.00,1,0,0,20130101, J2791,HCPCS,RHOPHYLAC INJECTION,,30,,,$33.74,$0.00,1,0,0,20130101, J2792,HCPCS,"RHO(D) IMMUNE GLOBULIN H, SD",,30,,,$106.67,$0.00,1,0,0,20130101, J2793,HCPCS,RILONACEPT INJECTION,,30,,,$156.59,$0.00,1,0,0,20130101, J2794,HCPCS,"RISPERIDONE, LONG ACTING",,30,,,$34.39,$0.00,1,0,0,20130101, J2796,HCPCS,ROMIPLOSTIM INJECTION,,30,,,$309.88,$0.00,1,0,0,20130101, J2820,HCPCS,SARGRAMOSTIM INJECTION,,30,,,$205.24,$0.00,1,0,0,20130101, J2850,HCPCS,INJ SECRETIN SYNTHETIC HUMAN,,30,,,$178.72,$0.00,1,0,0,20130101, J2940,HCPCS,SOMATREM INJECTION,,30,,,$127.42,$0.00,1,0,0,20130101, J2941,HCPCS,SOMATROPIN INJECTION,,30,,,$409.71,$0.00,1,0,0,20130101, J2993,HCPCS,RETEPLASE INJECTION,,30,,,"$12,597.86",$0.00,1,0,0,20130101, J2997,HCPCS,ALTEPLASE RECOMBINANT,,30,,,$300.89,$0.00,1,0,0,20130101, J3095,HCPCS,TELAVANCIN INJECTION,,30,,,$17.23,$0.00,1,0,0,20130101, J3101,HCPCS,TENECTEPLASE INJECTION,,30,,,$362.38,$0.00,1,0,0,20130101, J3110,HCPCS,TERIPARATIDE INJECTION,,30,,,$25.97,$0.00,1,0,0,20130101, J3240,HCPCS,THYROTROPIN INJECTION,,30,,,"$6,357.77",$0.00,1,0,0,20130101, J3243,HCPCS,TIGECYCLINE INJECTION,,30,,,$8.65,$0.00,1,0,0,20130101, J3246,HCPCS,TIROFIBAN HCL,,30,,,$56.62,$0.00,1,0,0,20130101, J3262,HCPCS,TOCILIZUMAB INJECTION,,30,,,$22.95,$0.00,1,0,0,20130101, J3285,HCPCS,TREPROSTINIL INJECTION,,30,,,$397.06,$0.00,1,0,0,20130101, J3300,HCPCS,TRIAMCINOLONE A INJ PRS-FREE,,30,,,$22.75,$0.00,1,0,0,20130101, J3305,HCPCS,INJ TRIMETREXATE GLUCORONATE,,30,,,$106.64,$0.00,1,0,0,20130101, J3315,HCPCS,TRIPTORELIN PAMOATE,,30,,,"$1,244.82",$0.00,1,0,0,20130101, J3320,HCPCS,SPECTINOMYCN DI-HCL INJ,,30,,,$86.00,$0.00,1,0,0,20130101, J3355,HCPCS,"UROFOLLITROPIN, 75 IU",,30,,,$400.48,$0.00,1,0,0,20130101, J3357,HCPCS,USTEKINUMAB INJECTION,,30,,,$826.31,$0.00,1,0,0,20130101, J3365,HCPCS,"UROKINASE 250,000 IU INJ",,30,,,"$2,885.89",$0.00,1,0,0,20130101, J3385,HCPCS,VELAGLUCERASE ALFA,,30,,,"$2,261.27",$0.00,1,0,0,20130101, J3396,HCPCS,VERTEPORFIN INJECTION,,30,,,$65.39,$0.00,1,0,0,20130101, J3465,HCPCS,"INJECTION, VORICONAZOLE",,30,,,$42.71,$0.00,1,0,0,20130101, J3487,HCPCS,ZOLEDRONIC ACID,,30,,,"$1,120.56",$0.00,1,0,0,20130101, J3488,HCPCS,RECLAST INJECTION,,30,,,"$1,155.99",$0.00,1,0,0,20130101, J3535,HCPCS,METERED DOSE INHALER DRUG,,30,,,$17.63,$0.00,1,0,0,20130101, J7178,HCPCS,HUMAN FIBRINOGEN CONC INJ,,30,,,$5.92,$0.00,1,0,0,20130101, J7180,HCPCS,FACTOR XIII ANTI-HEM FACTOR,,30,,,$41.67,$0.00,1,0,0,20130101, J7183,HCPCS,WILATE INJECTION,,30,,,$5.72,$0.00,1,0,0,20130101, J7185,HCPCS,XYNTHA INJ,,30,,,$7.09,$0.00,1,0,0,20130101, J7186,HCPCS,ANTIHEMOPHILIC VIII/VWF COMP,,30,,,$5.98,$0.00,1,0,0,20130101, J7187,HCPCS,"HUMATE-P, INJ",,30,,,$5.79,$0.00,1,0,0,20130101, J7189,HCPCS,FACTOR VIIA,,30,,,$10.27,$0.00,1,0,0,20130101, J7190,HCPCS,FACTOR VIII,,30,,,$5.85,$0.00,1,0,0,20130101, J7192,HCPCS,FACTOR VIII RECOMBINANT NOS,,30,,,$7.22,$0.00,1,0,0,20130101, J7193,HCPCS,FACTOR IX NON-RECOMBINANT,,30,,,$5.98,$0.00,1,0,0,20130101, J7194,HCPCS,FACTOR IX COMPLEX,,30,,,$5.72,$0.00,1,0,0,20130101, J7195,HCPCS,FACTOR IX RECOMBINANT,,30,,,$7.74,$0.00,1,0,0,20130101, J7196,HCPCS,ANTITHROMBIN RECOMBINANT,,30,,,$668.12,$0.00,1,0,0,20130101, J7197,HCPCS,ANTITHROMBIN III INJECTION,,30,,,$17.88,$0.00,1,0,0,20130101, J7198,HCPCS,ANTI-INHIBITOR,,30,,,$10.60,$0.00,1,0,0,20130101, J7199,HCPCS,HEMOPHILIA CLOT FACTOR NOC,,30,,,$1.36,$0.00,1,0,0,20130101, J7300,HCPCS,INTRAUT COPPER CONTRACEPTIVE,,30,,,$965.12,$0.00,1,0,0,20130101, J7302,HCPCS,LEVONORGESTREL IU CONTRACEPT,,30,,,"$1,004.68",$0.00,1,0,0,20130101, J7306,HCPCS,LEVONORGESTREL IMPLANT SYS,,30,,,"$1,004.68",$0.00,1,0,0,20130101, J7307,HCPCS,ETONOGESTREL IMPLANT SYSTEM,,30,,,$912.95,$0.00,1,0,0,20130101, J7308,HCPCS,AMINOLEVULINIC ACID HCL TOP,,30,,,$971.26,$0.00,1,0,0,20130101, J7309,HCPCS,"METHYL AMINOLEVULINATE, TOP",,30,,,$484.84,$0.00,1,0,0,20130101, J7310,HCPCS,GANCICLOVIR LONG ACT IMPLANT,,30,,,"$33,920.00",$0.00,1,0,0,20130101, J7311,HCPCS,FLUOCINOLONE ACETONIDE IMPLT,,30,,,"$38,690.00",$0.00,1,0,0,20130101, J7312,HCPCS,DEXAMETHASONE INTRA IMPLANT,,30,,,"$1,258.56",$0.00,1,0,0,20130101, J7321,HCPCS,HYALGAN/SUPARTZ INJ PER DOSE,,30,,,$579.08,$0.00,1,0,0,20130101, J7323,HCPCS,EUFLEXXA INJ PER DOSE,,30,,,$949.90,$0.00,1,0,0,20130101, J7324,HCPCS,ORTHOVISC INJ PER DOSE,,30,,,"$1,070.86",$0.00,1,0,0,20130101, J7325,HCPCS,SYNVISC OR SYNVISC-ONE,,30,,,$80.28,$0.00,1,0,0,20130101, J7326,HCPCS,GEL-ONE,,30,,,"$3,833.27",$0.00,1,0,0,20130101, J7335,HCPCS,CAPSAICIN 8% PATCH,,30,,,$169.25,$0.00,1,0,0,20130101, J7501,HCPCS,AZATHIOPRINE PARENTERAL,,30,,,$932.23,$0.00,1,0,0,20130101, J7504,HCPCS,LYMPHOCYTE IMMUNE GLOBULIN,,30,,,"$3,852.21",$0.00,1,0,0,20130101, J7505,HCPCS,MONOCLONAL ANTIBODIES,,30,,,"$6,924.62",$0.00,1,0,0,20130101, J7511,HCPCS,ANTITHYMOCYTE GLOBULN RABBIT,,30,,,"$2,808.37",$0.00,1,0,0,20130101, J7513,HCPCS,"DACLIZUMAB, PARENTERAL",,30,,,"$3,302.17",$0.00,1,0,0,20130101, J7525,HCPCS,TACROLIMUS INJECTION,,30,,,$900.25,$0.00,1,0,0,20130101, J7527,HCPCS,ORAL EVEROLIMUS,,30,,,$40.17,$0.00,1,0,0,20130101, J7607,HCPCS,LEVALBUTEROL COMP CON,,30,,,$13.02,$0.00,1,0,0,20130101, J7608,HCPCS,ACETYLCYSTEINE NON-COMP UNIT,,30,,,$8.60,$0.00,1,0,0,20130101, J7609,HCPCS,ALBUTEROL COMP UNIT,,30,,,$12.56,$0.00,1,0,0,20130101, J7610,HCPCS,ALBUTEROL COMP CON,,30,,,$16.13,$0.00,1,0,0,20130101, J7611,HCPCS,ALBUTEROL NON-COMP CON,,30,,,$1.23,$0.00,1,0,0,20130101, J7612,HCPCS,LEVALBUTEROL NON-COMP CON,,30,,,$1.23,$0.00,1,0,0,20130101, J7613,HCPCS,ALBUTEROL NON-COMP UNIT,,30,,,$1.23,$0.00,1,0,0,20130101, J7614,HCPCS,LEVALBUTEROL NON-COMP UNIT,,30,,,$1.23,$0.00,1,0,0,20130101, J7615,HCPCS,LEVALBUTEROL COMP UNIT,,30,,,$7.37,$0.00,1,0,0,20130101, J7620,HCPCS,ALBUTEROL IPRATROP NON-COMP,,30,,,$1.23,$0.00,1,0,0,20130101, J7626,HCPCS,BUDESONIDE NON-COMP UNIT,,30,,,$17.76,$0.00,1,0,0,20130101, J7633,HCPCS,BUDESONIDE NON-COMP CON,,30,,,$26.60,$0.00,1,0,0,20130101, J7636,HCPCS,ATROPINE COMP UNIT,,30,,,$14.25,$0.00,1,0,0,20130101, J7637,HCPCS,DEXAMETHASONE COMP CON,,30,,,$1.01,$0.00,1,0,0,20130101, J7638,HCPCS,DEXAMETHASONE COMP UNIT,,30,,,$1.01,$0.00,1,0,0,20130101, J7642,HCPCS,GLYCOPYRROLATE COMP CON,,30,,,$0.74,$0.00,1,0,0,20130101, J7643,HCPCS,GLYCOPYRROLATE COMP UNIT,,30,,,$0.74,$0.00,1,0,0,20130101, J7644,HCPCS,IPRATROPIUM BROMIDE NON-COMP,,30,,,$1.23,$0.00,1,0,0,20130101, J7645,HCPCS,IPRATROPIUM BROMIDE COMP,,30,,,$0.62,$0.00,1,0,0,20130101, J7659,HCPCS,ISOPROTERENOL NON-COMP UNIT,,30,,,$11.70,$0.00,1,0,0,20130101, J7676,HCPCS,PENTAMIDINE COMP UNIT DOSE,,30,,,$515.52,$0.00,1,0,0,20130101, J7699,HCPCS,INHALATION SOLUTION FOR DME,,30,,,$6.68,$0.00,1,0,0,20130101, J8498,HCPCS,ANTIEMETIC RECTAL/SUPP NOS,,30,,,$1.36,$0.00,1,0,0,20130101, J8499,HCPCS,ORAL PRESCRIP DRUG NON CHEMO,,30,,,$1.19,$0.00,1,0,0,20130101, J8501,HCPCS,ORAL APREPITANT,,30,,,$40.17,$0.00,1,0,0,20130101, J8510,HCPCS,ORAL BUSULFAN,,30,,,$34.52,$0.00,1,0,0,20130101, J8520,HCPCS,"CAPECITABINE, ORAL, 150 MG",,30,,,$51.16,$0.00,1,0,0,20130101, J8521,HCPCS,"CAPECITABINE, ORAL, 500 MG",,30,,,$169.12,$0.00,1,0,0,20130101, J8560,HCPCS,ETOPOSIDE ORAL 50 MG,,30,,,$305.87,$0.00,1,0,0,20130101, J8561,HCPCS,ORAL EVEROLIMUS,,30,,,$37.57,$0.00,1,0,0,20130101, J8562,HCPCS,ORAL FLUDARABINE PHOSPHATE,,30,,,$539.52,$0.00,1,0,0,20130101, J8565,HCPCS,GEFITINIB ORAL,,30,,,$142.94,$0.00,1,0,0,20130101, J8650,HCPCS,NABILONE ORAL,,30,,,$152.30,$0.00,1,0,0,20130101, J8700,HCPCS,TEMOZOLOMIDE,,30,,,$66.04,$0.00,1,0,0,20130101, J8705,HCPCS,TOPOTECAN ORAL,,30,,,$529.86,$0.00,1,0,0,20130101, J8999,HCPCS,ORAL PRESCRIPTION DRUG CHEMO,,30,,,$13.63,$0.00,1,0,0,20130101, J9001,HCPCS,DOXORUBICIN HCL LIPOSOME INJ,,30,,,"$3,377.25",$0.00,1,0,0,20130101, J9002,HCPCS,DOXIL INJECTION,,30,,,"$3,336.50",$0.00,1,0,0,20130101, J9010,HCPCS,ALEMTUZUMAB INJECTION,,30,,,"$3,665.06",$0.00,1,0,0,20130101, J9015,HCPCS,ALDESLEUKIN INJECTION,,30,,,"$6,605.45",$0.00,1,0,0,20130101, J9017,HCPCS,ARSENIC TRIOXIDE INJECTION,,30,,,$263.48,$0.00,1,0,0,20130101, J9019,HCPCS,ERWINAZE INJECTION,,30,,,"$2,126.43",$0.00,1,0,0,20130101, J9020,HCPCS,"ASPARAGINASE, NOS",,30,,,$410.16,$0.00,1,0,0,20130101, J9025,HCPCS,AZACITIDINE INJECTION,,30,,,$35.04,$0.00,1,0,0,20130101, J9027,HCPCS,CLOFARABINE INJECTION,,30,,,$791.12,$0.00,1,0,0,20130101, J9031,HCPCS,BCG LIVE INTRAVESICAL VAC,,30,,,$774.09,$0.00,1,0,0,20130101, J9033,HCPCS,BENDAMUSTINE INJECTION,,30,,,$122.33,$0.00,1,0,0,20130101, J9035,HCPCS,BEVACIZUMAB INJECTION,,30,,,$323.07,$0.00,1,0,0,20130101, J9041,HCPCS,BORTEZOMIB INJECTION,,30,,,$261.47,$0.00,1,0,0,20130101, J9042,HCPCS,BRENTUXIMAB VEDOTIN INJ,,30,,,$617.07,$0.00,1,0,0,20130101, J9043,HCPCS,CABAZITAXEL INJECTION,,30,,,$883.00,$0.00,1,0,0,20130101, J9050,HCPCS,CARMUSTINE INJECTION,,30,,,"$1,130.74",$0.00,1,0,0,20130101, J9055,HCPCS,CETUXIMAB INJECTION,,30,,,$327.15,$0.00,1,0,0,20130101, J9065,HCPCS,INJ CLADRIBINE PER 1 MG,,30,,,$183.52,$0.00,1,0,0,20130101, J9070,HCPCS,CYCLOPHOSPHAMIDE 100 MG INJ,,30,,,$152.62,$0.00,1,0,0,20130101, J9098,HCPCS,CYTARABINE LIPOSOME INJ,,30,,,"$3,222.53",$0.00,1,0,0,20130101, J9120,HCPCS,DACTINOMYCIN INJECTION,,30,,,"$3,617.30",$0.00,1,0,0,20130101, J9150,HCPCS,DAUNORUBICIN INJECTION,,30,,,$114.66,$0.00,1,0,0,20130101, J9151,HCPCS,DAUNORUBICIN CITRATE INJ,,30,,,"$1,560.64",$0.00,1,0,0,20130101, J9155,HCPCS,DEGARELIX INJECTION,,30,,,$19.31,$0.00,1,0,0,20130101, J9160,HCPCS,DENILEUKIN DIFTITOX INJ,,30,,,"$9,496.22",$0.00,1,0,0,20130101, J9165,HCPCS,DIETHYLSTILBESTROL INJECTION,,30,,,$58.31,$0.00,1,0,0,20130101, J9171,HCPCS,DOCETAXEL INJECTION,,30,,,$43.49,$0.00,1,0,0,20130101, J9178,HCPCS,"INJ, EPIRUBICIN HCL, 2 MG",,30,,,$11.05,$0.00,1,0,0,20130101, J9179,HCPCS,ERIBULIN MESYLATE INJECTION,,30,,,$589.05,$0.00,1,0,0,20130101, J9185,HCPCS,FLUDARABINE PHOSPHATE INJ,,30,,,$576.70,$0.00,1,0,0,20130101, J9200,HCPCS,FLOXURIDINE INJECTION,,30,,,$339.89,$0.00,1,0,0,20130101, J9201,HCPCS,GEMCITABINE HCL INJECTION,,30,,,$79.63,$0.00,1,0,0,20130101, J9202,HCPCS,GOSERELIN ACETATE IMPLANT,,30,,,"$1,112.31",$0.00,1,0,0,20130101, J9207,HCPCS,IXABEPILONE INJECTION,,30,,,$425.20,$0.00,1,0,0,20130101, J9208,HCPCS,IFOSFAMIDE INJECTION,,30,,,$205.95,$0.00,1,0,0,20130101, J9211,HCPCS,IDARUBICIN HCL INJECTION,,30,,,$675.05,$0.00,1,0,0,20130101, J9212,HCPCS,INTERFERON ALFACON-1 INJ,,30,,,$110.89,$0.00,1,0,0,20130101, J9214,HCPCS,INTERFERON ALFA-2B INJ,,30,,,$116.74,$0.00,1,0,0,20130101, J9216,HCPCS,INTERFERON GAMMA 1-B INJ,,30,,,"$13,534.68",$0.00,1,0,0,20130101, J9217,HCPCS,LEUPROLIDE ACETATE SUSPNSION,,30,,,"$1,378.88",$0.00,1,0,0,20130101, J9218,HCPCS,LEUPROLIDE ACETATE INJECITON,,30,,,$33.61,$0.00,1,0,0,20130101, J9219,HCPCS,LEUPROLIDE ACETATE IMPLANT,,30,,,"$20,903.19",$0.00,1,0,0,20130101, J9225,HCPCS,VANTAS IMPLANT,,30,,,"$15,996.04",$0.00,1,0,0,20130101, J9226,HCPCS,SUPPRELIN LA IMPLANT,,30,,,"$31,872.04",$0.00,1,0,0,20130101, J9228,HCPCS,IPILIMUMAB INJECTION,,30,,,$808.01,$0.00,1,0,0,20130101, J9230,HCPCS,MECHLORETHAMINE HCL INJ,,30,,,"$1,016.63",$0.00,1,0,0,20130101, J9245,HCPCS,INJ MELPHALAN HYDROCHL 50 MG,,30,,,"$7,979.11",$0.00,1,0,0,20130101, J9261,HCPCS,NELARABINE INJECTION,,30,,,$771.98,$0.00,1,0,0,20130101, J9263,HCPCS,OXALIPLATIN,,30,,,$63.57,$0.00,1,0,0,20130101, J9264,HCPCS,PACLITAXEL PROTEIN BOUND,,30,,,$62.34,$0.00,1,0,0,20130101, J9266,HCPCS,PEGASPARGASE INJECTION,,30,,,"$22,700.85",$0.00,1,0,0,20130101, J9268,HCPCS,PENTOSTATIN INJECTION,,30,,,"$5,148.45",$0.00,1,0,0,20130101, J9280,HCPCS,MITOMYCIN INJECTION,,30,,,$148.85,$0.00,1,0,0,20130101, J9293,HCPCS,MITOXANTRONE HYDROCHL / 5 MG,,30,,,$235.25,$0.00,1,0,0,20130101, J9300,HCPCS,GEMTUZUMAB OZOGAMICIN INJ,,30,,,"$14,464.47",$0.00,1,0,0,20130101, J9302,HCPCS,OFATUMUMAB INJECTION,,30,,,$300.44,$0.00,1,0,0,20130101, J9303,HCPCS,PANITUMUMAB INJECTION,,30,,,$564.48,$0.00,1,0,0,20130101, J9305,HCPCS,PEMETREXED INJECTION,,30,,,$356.50,$0.00,1,0,0,20130101, J9307,HCPCS,PRALATREXATE INJECTION,,30,,,"$1,086.38",$0.00,1,0,0,20130101, J9310,HCPCS,RITUXIMAB INJECTION,,30,,,"$2,566.24",$0.00,1,0,0,20130101, J9315,HCPCS,ROMIDEPSIN INJECTION,,30,,,"$1,476.12",$0.00,1,0,0,20130101, J9320,HCPCS,STREPTOZOCIN INJECTION,,30,,,"$1,751.41",$0.00,1,0,0,20130101, J9328,HCPCS,TEMOZOLOMIDE INJECTION,,30,,,$31.27,$0.00,1,0,0,20130101, J9330,HCPCS,TEMSIROLIMUS INJECTION,,30,,,$338.47,$0.00,1,0,0,20130101, J9340,HCPCS,THIOTEPA INJECTION,,30,,,"$1,127.56",$0.00,1,0,0,20130101, J9351,HCPCS,TOPOTECAN INJECTION,,30,,,$20.35,$0.00,1,0,0,20130101, J9355,HCPCS,TRASTUZUMAB INJECTION,,30,,,$481.56,$0.00,1,0,0,20130101, J9357,HCPCS,VALRUBICIN INJECTION,,30,,,"$6,013.34",$0.00,1,0,0,20130101, J9395,HCPCS,"INJECTION, FULVESTRANT",,30,,,$557.15,$0.00,1,0,0,20130101, J9600,HCPCS,PORFIMER SODIUM INJECTION,,30,,,"$38,651.58",$0.00,1,0,0,20130101, M0064,HCPCS,VISIT FOR DRUG MONITORING,,30,,,$222.68,$0.00,1,0,1,20130101, P3001,HCPCS,SCREENING PAP SMEAR BY PHYS,,30,,,$156.71,$0.00,1,0,1,20130101, P7001,HCPCS,CULTURE BACTERIAL URINE,,30,,,$104.79,$0.00,1,0,1,20130101, P9010,HCPCS,WHOLE BLOOD FOR TRANSFUSION,,30,,,"$1,011.06",$0.00,1,0,1,20130101, P9011,HCPCS,BLOOD SPLIT UNIT,,30,,,$842.93,$0.00,1,0,1,20130101, P9012,HCPCS,CRYOPRECIPITATE EACH UNIT,,30,,,$482.04,$0.00,1,0,1,20130101, P9016,HCPCS,RBC LEUKOCYTES REDUCED,,30,,,$680.13,$0.00,1,0,1,20130101, P9017,HCPCS,PLASMA 1 DONOR FRZ W/IN 8 HR,,30,,,$459.73,$0.00,1,0,1,20130101, P9019,HCPCS,"PLATELETS, EACH UNIT",,30,,,$533.01,$0.00,1,0,1,20130101, P9020,HCPCS,PLAELET RICH PLASMA UNIT,,30,,,"$1,036.57",$0.00,1,0,1,20130101, P9021,HCPCS,RED BLOOD CELLS UNIT,,30,,,$621.98,$0.00,1,0,1,20130101, P9022,HCPCS,WASHED RED BLOOD CELLS UNIT,,30,,,"$1,857.85",$0.00,1,0,1,20130101, P9023,HCPCS,"FROZEN PLASMA, POOLED, SD",,30,,,$431.48,$0.00,1,0,1,20130101, P9031,HCPCS,PLATELETS LEUKOCYTES REDUCED,,30,,,$704.71,$0.00,1,0,1,20130101, P9032,HCPCS,"PLATELETS, IRRADIATED",,30,,,$796.12,$0.00,1,0,1,20130101, P9033,HCPCS,PLATELETS LEUKOREDUCED IRRAD,,30,,,$908.41,$0.00,1,0,1,20130101, P9034,HCPCS,"PLATELETS, PHERESIS",,30,,,"$2,567.73",$0.00,1,0,1,20130101, P9035,HCPCS,PLATELET PHERES LEUKOREDUCED,,30,,,"$3,033.89",$0.00,1,0,1,20130101, P9036,HCPCS,PLATELET PHERESIS IRRADIATED,,30,,,"$3,943.01",$0.00,1,0,1,20130101, P9037,HCPCS,PLATE PHERES LEUKOREDU IRRAD,,30,,,"$4,014.74",$0.00,1,0,1,20130101, P9038,HCPCS,RBC IRRADIATED,,30,,,"$1,213.33",$0.00,1,0,1,20130101, P9039,HCPCS,RBC DEGLYCEROLIZED,,30,,,"$2,929.57",$0.00,1,0,1,20130101, P9040,HCPCS,RBC LEUKOREDUCED IRRADIATED,,30,,,$914.24,$0.00,1,0,1,20130101, P9041,HCPCS,"ALBUMIN (HUMAN), 5%, 50ML",,30,,,$131.97,$0.00,1,0,1,20130101, P9043,HCPCS,"PLASMA PROTEIN FRACT, 5%, 50ML",,30,,,$148.27,$0.00,1,0,1,20130101, P9044,HCPCS,CRYOPRECIPITATEREDUCEDPLASMA,,30,,,$398.71,$0.00,1,0,1,20130101, P9045,HCPCS,"ALBUMIN (HUMAN), 5%, 250 ML",,30,,,$359.52,$0.00,1,0,1,20130101, P9046,HCPCS,"ALBUMIN (HUMAN), 25%, 20 ML",,30,,,$180.62,$0.00,1,0,1,20130101, P9047,HCPCS,"ALBUMIN (HUMAN), 25%, 50ML",,30,,,$413.34,$0.00,1,0,1,20130101, P9048,HCPCS,"PLASMAPROTEIN FRACT, 5%, 250ML",,30,,,$284.76,$0.00,1,0,1,20130101, P9050,HCPCS,"GRANULOCYTES, PHERESIS UNIT",,30,,,"$9,380.74",$0.00,1,0,1,20130101, P9051,HCPCS,"BLOOD, L/R, CMV-NEG",,30,,,"$1,087.84",$0.00,1,0,1,20130101, P9052,HCPCS,"PLATELETS, HLA-M, L/R, UNIT",,30,,,"$4,635.71",$0.00,1,0,1,20130101, P9053,HCPCS,"PLT, PHER, L/R CMV-NEG, IRR",,30,,,"$3,867.06",$0.00,1,0,1,20130101, P9054,HCPCS,"BLOOD, L/R, FROZ/DEGLY/WASH",,30,,,$747.83,$0.00,1,0,1,20130101, P9055,HCPCS,"PLT, APH/PHER, L/R, CMV-NEG",,30,,,"$2,031.10",$0.00,1,0,1,20130101, P9056,HCPCS,"BLOOD, L/R, IRRADIATED",,30,,,"$1,053.29",$0.00,1,0,1,20130101, P9057,HCPCS,"RBC, FRZ/DEG/WSH, L/R, IRRAD",,30,,,"$2,230.75",$0.00,1,0,1,20130101, P9058,HCPCS,"RBC, L/R, CMV-NEG, IRRAD",,30,,,"$1,712.20",$0.00,1,0,1,20130101, P9059,HCPCS,"PLASMA, FRZ BETWEEN 8-24HOUR",,30,,,$447.30,$0.00,1,0,1,20130101, P9060,HCPCS,FR FRZ PLASMA DONOR RETESTED,,30,,,$352.50,$0.00,1,0,1,20130101, PHOSP,PHOSP,PARTIAL HOSPITALIZATION PER DIEM,,30,,,$408.97,$0.00,1,0,0,20130101, Q0035,HCPCS,CARDIOKYMOGRAPHY,,30,,,"$1,143.19",$0.00,1,0,1,20130101, Q0081,HCPCS,INFUSION THER OTHER THAN CHE,,30,,,$258.98,$0.00,1,0,1,20130101, Q0083,HCPCS,CHEMO BY OTHER THAN INFUSION,,30,,,$160.53,$0.00,1,0,1,20130101, Q0084,HCPCS,CHEMOTHERAPY BY INFUSION,,30,,,$832.34,$0.00,1,0,1,20130101, Q0085,HCPCS,CHEMO BY BOTH INFUSION AND O,,30,,,$814.79,$0.00,1,0,1,20130101, Q0091,HCPCS,OBTAINING SCREEN PAP SMEAR,,30,,,$49.13,$0.00,1,0,1,20130101, Q0138,HCPCS,"FERUMOXYTOL, NON-ESRD",,30,,,$4.10,$0.00,1,0,1,20130101, Q0144,HCPCS,"AZITHROMYCIN DIHYDRATE, ORAL",,30,,,$38.87,$0.00,1,0,0,20130101, Q0181,HCPCS,UNSPECIFIED ORAL ANTI-EMETIC,,30,,,$47.32,$0.00,1,0,0,20130101, Q0512,HCPCS,PX SUP FEE ANTI-CAN SUB PRES,,30,,,$22.80,$0.00,1,0,1,20130101, Q0515,HCPCS,SERMORELIN ACETATE INJECTION,,30,,,$11.70,$0.00,1,0,0,20130101, Q2017,HCPCS,"TENIPOSIDE, 50 MG",,30,,,"$2,051.35",$0.00,1,0,1,20130101, Q2035,HCPCS,"AFLURIA VACC, 3 YRS & >, IM",,30,,,$53.84,$0.00,1,0,1,20130101, Q2036,HCPCS,"FLULAVAL VACC, 3 YRS & >, IM",,30,,,$40.65,$0.00,1,0,1,20130101, Q2037,HCPCS,"FLUVIRIN VACC, 3 YRS & >, IM",,30,,,$46.45,$0.00,1,0,1,20130101, Q2038,HCPCS,"FLUZONE VACC, 3 YRS & >, IM",,30,,,$34.84,$0.00,1,0,1,20130101, Q2039,HCPCS,"NOS FLU VACC, 3 YRS & >, IM",,30,,,$40.65,$0.00,1,0,1,20130101, Q2043,HCPCS,SIPULEUCEL-T AUTO CD54+,,30,,,"$66,983.84",$0.00,1,0,1,20130101, Q2045,HCPCS,HUMAN FIBRINOGEN CONC INJ,,30,,,$4.83,$0.00,1,0,1,20130101, Q2046,HCPCS,AFLIBERCEPT INJECTION,,30,,,"$2,483.06",$0.00,1,0,1,20130101, Q2048,HCPCS,DOXIL INJECTION,,30,,,"$1,362.45",$0.00,1,0,1,20130101, Q2049,HCPCS,IMPORTED LIPODOX INJ,,30,,,"$3,132.37",$0.00,1,0,1,20130101, Q3001,HCPCS,BRACHYTHERAPY RADIOELEMENTS,,30,,,$95.84,$0.00,1,0,1,20130101, Q3025,HCPCS,IM INJ INTERFERON BETA 1-A,,30,,,"$1,602.89",$0.00,1,0,1,20130101, Q4074,HCPCS,ILOPROST NON-COMP UNIT DOSE,,30,,,$185.08,$0.00,1,0,1,20130101, Q4101,HCPCS,APLIGRAF,,30,,,$217.44,$0.00,1,0,1,20130101, Q4102,HCPCS,OASIS WOUND MATRIX,,30,,,$44.07,$0.00,1,0,1,20130101, Q4103,HCPCS,OASIS BURN MATRIX,,30,,,$44.07,$0.00,1,0,1,20130101, Q4104,HCPCS,INTEGRA BMWD,,30,,,$112.23,$0.00,1,0,1,20130101, Q4105,HCPCS,INTEGRA DRT,,30,,,$67.90,$0.00,1,0,1,20130101, Q4106,HCPCS,DERMAGRAFT,,30,,,$245.69,$0.00,1,0,1,20130101, Q4107,HCPCS,GRAFTJACKET,,30,,,$565.00,$0.00,1,0,1,20130101, Q4108,HCPCS,INTEGRA MATRIX,,30,,,$160.34,$0.00,1,0,1,20130101, Q4110,HCPCS,PRIMATRIX,,30,,,$187.28,$0.00,1,0,1,20130101, Q4111,HCPCS,GAMMAGRAFT,,30,,,$41.93,$0.00,1,0,1,20130101, Q4112,HCPCS,CYMETRA INJECTABLE,,30,,,"$2,791.07",$0.00,1,0,1,20130101, Q4113,HCPCS,GRAFTJACKET XPRESS,,30,,,"$2,791.07",$0.00,1,0,1,20130101, Q4114,HCPCS,INTEGRA FLOWABLE WOUND MATRI,,30,,,"$6,623.94",$0.00,1,0,1,20130101, Q4115,HCPCS,ALLOSKIN,,30,,,$60.69,$0.00,1,0,1,20130101, Q4116,HCPCS,ALLODERM,,30,,,$192.10,$0.00,1,0,1,20130101, Q4118,HCPCS,MATRISTEM MICROMATRIX,,30,,,$17.54,$0.00,1,0,1,20130101, Q4119,HCPCS,MATRISTEM WOUND MATRIX,,30,,,$28.25,$0.00,1,0,1,20130101, Q4121,HCPCS,THERASKIN,,30,,,$133.76,$0.00,1,0,1,20130101, Q4122,HCPCS,DERMACELL,,30,,,$515.86,$0.00,1,0,1,20130101, Q4123,HCPCS,ALLOSKIN,,30,,,$91.20,$0.00,1,0,1,20130101, Q4124,HCPCS,OASIS TRI-LAYER WOUND MATRIX,,30,,,$61.62,$0.00,1,0,1,20130101, Q4125,HCPCS,ARTHROFLEX,,30,,,$813.19,$0.00,1,0,1,20130101, Q4128,HCPCS,FLEXHD/ALLOPATCHHD/MATRIXHD,,30,,,$264.26,$0.00,1,0,1,20130101, Q4129,HCPCS,UNITE BIOMATRIX,,30,,,$234.99,$0.00,1,0,1,20130101, Q4131,HCPCS,EPIFIX,,30,,,$770.60,$0.00,1,0,1,20130101, Q4132,HCPCS,GRAFIX CORE,,30,,,$886.58,$0.00,1,0,1,20130101, Q4133,HCPCS,GRAFIX PRIME,,30,,,$706.93,$0.00,1,0,1,20130101, Q5001,HCPCS,HOSPICE IN PATIENT HOME,,30,,,$232.27,$0.00,1,0,1,20130101, Q5002,HCPCS,HOSPICE IN ASSISTED LIVING,,30,,,$209.04,$0.00,1,0,1,20130101, Q5003,HCPCS,HOSPICE IN LT/NON-SKILLED NF,,30,,,$237.40,$0.00,1,0,1,20130101, Q5004,HCPCS,HOSPICE IN SNF,,30,,,$360.01,$0.00,1,0,1,20130101, Q5005,HCPCS,"HOSPICE, INPATIENT HOSPITAL",,30,,,"$1,387.95",$0.00,1,0,1,20130101, Q5006,HCPCS,HOSPICE IN HOSPICE FACILITY,,30,,,$975.08,$0.00,1,0,1,20130101, Q5007,HCPCS,HOSPICE IN LTCH,,30,,,$479.63,$0.00,1,0,1,20130101, Q5009,HCPCS,"HOSPICE CARE, NOS",,30,,,$467.37,$0.00,1,0,1,20130101, Q9968,HCPCS,VISUALIZATION ADJUNCT,,30,,,$11.51,$0.00,1,0,1,20130101, Q9969,HCPCS,NON-HEU TC-99M ADD-ON/DOSE,,30,,,$65.00,$0.00,1,0,1,20130101, R0070,HCPCS,TRANSPORT PORTABLE X-RAY,,30,,,$127.90,$0.00,1,0,1,20130101, R0075,HCPCS,TRANSPORT PORT X-RAY MULTIPL,,30,,,$68.72,$0.00,1,0,1,20130101, S0020,HCPCS,"INJECTION, BUPIVICAINE HYDRO",,30,,,$11.20,$0.00,1,0,1,20130101, S0023,HCPCS,"INJECTION, CIMETIDINE HYDROC",,30,,,$6.64,$0.00,1,0,0,20130101, S0028,HCPCS,"INJECTION, FAMOTIDINE, 20 MG",,30,,,$8.04,$0.00,1,0,0,20130101, S0030,HCPCS,"INJECTION, METRONIDAZOLE",,30,,,$23.35,$0.00,1,0,0,20130101, S0032,HCPCS,"INJECTION, NAFCILLIN SODIUM",,30,,,$52.85,$0.00,1,0,0,20130101, S0034,HCPCS,"INJECTION, OFLOXACIN, 400 MG",,30,,,$30.97,$0.00,1,0,0,20130101, S0039,HCPCS,"INJECTION, SULFAMETHOXAZOLE",,30,,,$22.49,$0.00,1,0,0,20130101, S0040,HCPCS,"INJECTION, TICARCILLIN DISOD",,30,,,$33.57,$0.00,1,0,0,20130101, S0073,HCPCS,"INJECTION, AZTREONAM, 500 MG",,30,,,$41.47,$0.00,1,0,0,20130101, S0074,HCPCS,"INJECTION, CEFOTETAN DISODIU",,30,,,$53.76,$0.00,1,0,0,20130101, S0077,HCPCS,"INJECTION, CLINDAMYCIN PHOSP",,30,,,$9.49,$0.00,1,0,0,20130101, S0078,HCPCS,"INJECTION, FOSPHENYTOIN SODI",,30,,,$406.70,$0.00,1,0,0,20130101, S0080,HCPCS,"INJECTION, PENTAMIDINE ISETH",,30,,,$158.10,$0.00,1,0,0,20130101, S0092,HCPCS,HYDROMORPHONE 250 MG,,30,,,$238.50,$0.00,1,0,0,20130101, S0093,HCPCS,MORPHINE 500 MG,,30,,,$32.35,$0.00,1,0,0,20130101, S0106,HCPCS,BUPROPION HCL SR 60 TABLETS,,30,,,$252.30,$0.00,1,0,0,20130101, S0109,HCPCS,METHADONE ORAL 5MG,,30,,,$0.65,$0.00,1,0,0,20130101, S0119,HCPCS,ONDANSETRON 4 MG,,30,,,$43.55,$0.00,1,0,0,20130101, S0132,HCPCS,INJ GANIRELIX ACETAT 250 MCG,,30,,,$243.72,$0.00,1,0,0,20130101, S0136,HCPCS,"CLOZAPINE, 25 MG",,30,,,$2.99,$0.00,1,0,0,20130101, S0137,HCPCS,"DIDANOSINE, 25 MG",,30,,,$15.50,$0.00,1,0,0,20130101, S0138,HCPCS,"FINASTERIDE, 5 MG",,30,,,$6.50,$0.00,1,0,0,20130101, S0145,HCPCS,PEG INTERFERON ALFA-2A/180,,30,,,$51.89,$0.00,1,0,1,20130101, S0157,HCPCS,"BECAPLERMIN GEL 1%, 0.5 GM",,30,,,$40.57,$0.00,1,0,0,20130101, S0164,HCPCS,INJECTION PANTROPRAZOLE,,30,,,$29.92,$0.00,1,0,0,20130101, S0171,HCPCS,BUMETANIDE 0.5 MG,,30,,,$2.74,$0.00,1,0,0,20130101, S0183,HCPCS,PROCHLORPERAZINE 5 MG,,30,,,$1.52,$0.00,1,0,0,20130101, S0187,HCPCS,TAMOXIFEN 10 MG,,30,,,$5.09,$0.00,1,0,0,20130101, S0191,HCPCS,"MISOPROSTOL, ORAL, 200 MCG",,30,,,$6.02,$0.00,1,0,0,20130101, S0195,HCPCS,PNEUMO VACCINE 5-9 YRS,,30,,,$67.99,$0.00,1,0,1,20130101, S0199,HCPCS,MED ABORTION INC ALL EX DRUG,,30,,,"$2,642.88",$0.00,1,0,1,20130101, S0201,HCPCS,PARTIAL HOSPITALIZATION SERV,,30,,,$685.18,$0.00,1,0,1,20130101, S0208,HCPCS,PARAMED INTRCEPT NONVOL,,30,,,$614.51,$0.00,1,0,1,20130101, S0220,HCPCS,MEDICAL CONFERENCE BY PHYSIC,,30,,,$99.45,$0.00,1,0,1,20130101, S0221,HCPCS,"MEDICAL CONFERENCE, 60 MIN",,30,,,$334.46,$0.00,1,0,1,20130101, S0255,HCPCS,HOSPICE REFER VISIT NONMD,,30,,,$137.66,$0.00,1,0,1,20130101, S0257,HCPCS,END OF LIFE COUNSELING,,30,,,$192.74,$0.00,1,0,1,20130101, S0260,HCPCS,H&P FOR SURGERY,,30,,,$94.49,$0.00,1,0,1,20130101, S0265,HCPCS,GENETIC COUNSEL 15 MINS,,30,,,$94.49,$0.00,1,0,1,20130101, S0302,HCPCS,COMPLETED EPSDT,,30,,,$85.94,$0.00,1,0,1,20130101, S0315,HCPCS,DISEASE MANAGEMENT PROGRAM,,30,,,$94.49,$0.00,1,0,1,20130101, S0316,HCPCS,FOLLOW-UP/REASSESSMENT,,30,,,$186.97,$0.00,1,0,1,20130101, S0320,HCPCS,RN TELEPHONE CALLS TO DMP,,30,,,$81.29,$0.00,1,0,1,20130101, S0390,HCPCS,ROUT FOOT CARE PER VISIT,,30,,,$29.03,$0.00,1,0,1,20130101, S0400,HCPCS,GLOBAL ESWL KIDNEY,,30,,,"$23,303.87",$0.00,1,0,1,20130101, S0592,HCPCS,COMP CONT LENS EVAL,,30,,,"$1,235.13",$0.00,1,0,1,20130101, S0601,HCPCS,SCREENING PROCTOSCOPY,,30,,,$326.12,$0.00,1,0,1,20130101, S0612,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,30,,,$197.43,$0.00,1,0,1,20130101, S0613,HCPCS,ANN BREAST EXAM,,30,,,$94.49,$0.00,1,0,1,20130101, S0618,HCPCS,AUDIOMETRY FOR HEARING AID,,30,,,$57.75,$0.00,1,0,1,20130101, S0622,HCPCS,PHYS EXAM FOR COLLEGE,,30,,,$94.49,$0.00,1,0,1,20130101, S0630,HCPCS,REMOVAL OF SUTURES,,30,,,$85.94,$0.00,1,0,1,20130101, S0810,HCPCS,PHOTOREFRACTIVE KERATECTOMY,,30,,,"$3,169.71",$0.00,1,0,1,20130101, S0812,HCPCS,PHOTOTHERAP KERATECT,,30,,,"$3,169.71",$0.00,1,0,1,20130101, S1040,HCPCS,CRANIAL REMOLDING ORTHOSIS,,30,,,$585.74,$0.00,1,0,1,20130101, S2070,HCPCS,CYSTO LASER TX URETERAL CALC,,30,,,"$5,251.87",$0.00,1,0,1,20130101, S2080,HCPCS,LAUP,,30,,,"$11,267.73",$0.00,1,0,1,20130101, S2083,HCPCS,ADJUSTMENT GASTRIC BAND,,30,,,$696.80,$0.00,1,0,1,20130101, S2095,HCPCS,TRANSCATH EMBOLIZ MICROSPHER,,30,,,"$13,219.88",$0.00,1,0,1,20130101, S2117,HCPCS,"ARTHROEREISIS, SUBTALAR",,30,,,"$5,879.52",$0.00,1,0,1,20130101, S2120,HCPCS,LOW DENSITY LIPOPROTEIN(LDL),,30,,,"$19,423.57",$0.00,1,0,1,20130101, S2140,HCPCS,CORD BLOOD HARVESTING,,30,,,"$1,331.20",$0.00,1,0,1,20130101, S2142,HCPCS,CORD BLOOD-DERIVED STEM-CELL,,30,,,"$3,178.32",$0.00,1,0,1,20130101, S2150,HCPCS,BMT HARV/TRANSPL 28D PKG,,30,,,"$1,116.72",$0.00,1,0,1,20130101, S2202,HCPCS,ECHOSCLEROTHERAPY,,30,,,$140.43,$0.00,1,0,1,20130101, S2225,HCPCS,MYRINGOTOMY LASER-ASSIST,,30,,,"$7,864.41",$0.00,1,0,1,20130101, S2230,HCPCS,IMPLANT SEMI-IMP HEAR,,30,,,"$5,201.41",$0.00,1,0,1,20130101, S2235,HCPCS,IMPLANT AUDITORY BRAIN IMP,,30,,,"$48,328.22",$0.00,1,0,1,20130101, S2300,HCPCS,"ARTHROSCOPY, SHOULDER, SURGI",,30,,,"$14,127.66",$0.00,1,0,1,20130101, S2325,HCPCS,HIP CORE DECOMPRESSION,,30,,,$597.17,$0.00,1,0,1,20130101, S2340,HCPCS,CHEMODENERVATION OF ABDUCTOR,,30,,,"$7,171.68",$0.00,1,0,1,20130101, S2341,HCPCS,CHEMODENERV ADDUCT VOCAL,,30,,,"$7,171.68",$0.00,1,0,1,20130101, S2342,HCPCS,NASAL ENDOSCOP PO DEBRID,,30,,,"$10,533.50",$0.00,1,0,1,20130101, S2348,HCPCS,DECOMPRESS DISC RF LUMBAR,,30,,,"$8,549.31",$0.00,1,0,1,20130101, S2360,HCPCS,VERTEBROPLAST CERV 1ST,,30,,,"$12,821.68",$0.00,1,0,1,20130101, S2361,HCPCS,VERTEBROPLAST CERV ADDL,,30,,,"$2,604.48",$0.00,1,0,1,20130101, S2900,HCPCS,ROBOTIC SURGICAL SYSTEM,,30,,,"$8,849.15",$0.00,1,0,1,20130101, S3005,HCPCS,EVAL SELF-ASSESS DEPRESSION,,30,,,$94.49,$0.00,1,0,1,20130101, S3600,HCPCS,STAT LAB,,30,,,$64.05,$0.00,1,0,1,20130101, S3620,HCPCS,NEWBORN METABOLIC SCREENING,,30,,,$177.10,$0.00,1,0,1,20130101, S3630,HCPCS,EOSINOPHIL BLOOD COUNT,,30,,,$50.04,$0.00,1,0,1,20130101, S3708,HCPCS,GASTROINTESTINAL FAT ABSORPT,,30,,,$416.54,$0.00,1,0,1,20130101, S3870,HCPCS,CGH TEST DEVELOPMENTAL DELAY,,30,,,"$1,092.81",$0.00,1,0,1,20130101, S3900,HCPCS,SURFACE EMG,,30,,,"$1,258.38",$0.00,1,0,1,20130101, S4005,HCPCS,INTERIM LABOR FACILITY GLOBA,,30,,,"$1,892.79",$0.00,1,0,1,20130101, S4011,HCPCS,IVF PACKAGE,,30,,,"$7,864.04",$0.00,1,0,1,20130101, S4015,HCPCS,COMPLETE IVF NOS CASE RATE,,30,,,"$10,442.83",$0.00,1,0,1,20130101, S4021,HCPCS,IVF CANC P ASPIR CASE RATE,,30,,,"$1,108.72",$0.00,1,0,1,20130101, S4981,HCPCS,INSERT LEVONORGESTREL IUS,,30,,,"$1,388.64",$0.00,1,0,1,20130101, S4990,HCPCS,NICOTINE PATCH LEGEND,,30,,,$29.71,$0.00,1,0,1,20130101, S4991,HCPCS,NICOTINE PATCH NONLEGEND,,30,,,$24.37,$0.00,1,0,1,20130101, S5000,HCPCS,"PRESCRIPTION DRUG, GENERIC",,30,,,$22.13,$0.00,1,0,1,20130101, S5001,HCPCS,"PRESCRIPTION DRUG, BRAND NAME",,30,,,$94.55,$0.00,1,0,1,20130101, S5010,HCPCS,5% DEXTROSE AND 0.45% SALINE,,30,,,$22.66,$0.00,1,0,1,20130101, S5011,HCPCS,5% DEXTROSE IN LACTATED RING,,30,,,$24.38,$0.00,1,0,1,20130101, S5012,HCPCS,5% DEXTROSE WITH POTASSIUM,,30,,,$78.77,$0.00,1,0,1,20130101, S5013,HCPCS,5%DEXTROSE/0.45%SALINE1000ML,,30,,,$21.96,$0.00,1,0,1,20130101, S5014,HCPCS,D5W/0.45NS W KCL AND MGS04,,30,,,$13.25,$0.00,1,0,1,20130101, S5105,HCPCS,CENTERBASED DAY CARE PERDIEM,,30,,,$245.34,$0.00,1,0,1,20130101, S5190,HCPCS,WELLNESS ASSESSMENT BY NONPH,,30,,,$234.32,$0.00,1,0,1,20130101, S5498,HCPCS,HIT SIMPLE CATH CARE,,30,,,$38.36,$0.00,1,0,1,20130101, S5501,HCPCS,HIT COMPLEX CATH CARE,,30,,,$41.36,$0.00,1,0,1,20130101, S5502,HCPCS,HIT INTERIM CATH CARE,,30,,,$72.85,$0.00,1,0,1,20130101, S5550,HCPCS,INSULIN RAPID 5 U,,30,,,$0.14,$0.00,1,0,1,20130101, S5551,HCPCS,INSULIN MOST RAPID 5 U,,30,,,$0.14,$0.00,1,0,1,20130101, S8030,HCPCS,TANTALUM RING APPLICATION,,30,,,"$9,005.40",$0.00,1,0,1,20130101, S8037,HCPCS,MRCP,,30,,,"$4,538.35",$0.00,1,0,1,20130101, S8040,HCPCS,TOPOGRAPHIC BRAIN MAPPING,,30,,,"$1,306.10",$0.00,1,0,1,20130101, S8055,HCPCS,US GUIDANCE FETAL REDUCT,,30,,,"$1,068.29",$0.00,1,0,1,20130101, S8080,HCPCS,SCINTIMAMMOGRAPHY,,30,,,$908.67,$0.00,1,0,1,20130101, S8092,HCPCS,ELECTRON BEAM COMPUTED TOMOG,,30,,,$231.10,$0.00,1,0,1,20130101, S8120,HCPCS,O2 CONTENTS GAS CUBIC FT,,30,,,$16.55,$0.00,1,0,1,20130101, S8948,HCPCS,LOW-LEVEL LASER TRMT 15 MIN,,30,,,$52.26,$0.00,1,0,1,20130101, S9024,HCPCS,PARANASAL SINUS ULTRASOUND,,30,,,$694.35,$0.00,1,0,1,20130101, S9034,HCPCS,ESWL FOR GALLSTONES,,30,,,"$4,349.22",$0.00,1,0,1,20130101, S9061,HCPCS,MEDICAL SUPPLIES AND EQUIPME,,30,,,$68.99,$0.00,1,0,1,20130101, S9083,HCPCS,URGENT CARE CENTER GLOBAL,,30,,,$299.62,$0.00,1,0,1,20130101, S9088,HCPCS,SERVICES PROVIDED IN URGENT,,30,,,$836.40,$0.00,1,0,1,20130101, S9097,HCPCS,HOME VISIT WOUND CARE,,30,,,$203.23,$0.00,1,0,1,20130101, S9098,HCPCS,HOME PHOTOTHERAPY VISIT,,30,,,$493.56,$0.00,1,0,1,20130101, S9117,HCPCS,BACK SCHOOL VISIT,,30,,,$94.49,$0.00,1,0,1,20130101, S9122,HCPCS,HOME HEALTH AIDE OR CERTIFIE,,30,,,$158.09,$0.00,1,0,1,20130101, S9123,HCPCS,NURSING CARE IN HOME RN,,30,,,$255.49,$0.00,1,0,1,20130101, S9124,HCPCS,"NURSING CARE, IN THE HOME; B",,30,,,$535.66,$0.00,1,0,1,20130101, S9125,HCPCS,"RESPITE CARE, IN THE HOME, P",,30,,,$172.86,$0.00,1,0,1,20130101, S9126,HCPCS,"HOSPICE CARE, IN THE HOME, P",,30,,,$232.27,$0.00,1,0,1,20130101, S9127,HCPCS,"SOCIAL WORK VISIT, IN THE HO",,30,,,$349.56,$0.00,1,0,1,20130101, S9128,HCPCS,"SPEECH THERAPY, IN THE HOME,",,30,,,$209.04,$0.00,1,0,1,20130101, S9129,HCPCS,"OCCUPATIONAL THERAPY, IN THE",,30,,,$214.85,$0.00,1,0,1,20130101, S9131,HCPCS,PT IN THE HOME PER DIEM,,30,,,$226.46,$0.00,1,0,1,20130101, S9140,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$101.04,$0.00,1,0,1,20130101, S9145,HCPCS,INSULIN PUMP INITIATION,,30,,,$524.90,$0.00,1,0,1,20130101, S9152,HCPCS,"SPEECH THERAPY, RE-EVAL",,30,,,$580.66,$0.00,1,0,1,20130101, S9208,HCPCS,HOME MGMT PRETERM LABOR,,30,,,$257.88,$0.00,1,0,1,20130101, S9211,HCPCS,HOME MGMT GEST HYPERTENSION,,30,,,$109.29,$0.00,1,0,1,20130101, S9214,HCPCS,HM GEST DM PER DIEM,,30,,,$236.12,$0.00,1,0,1,20130101, S9326,HCPCS,HIT CONT PAIN PER DIEM,,30,,,$187.01,$0.00,1,0,1,20130101, S9327,HCPCS,HIT INT PAIN PER DIEM,,30,,,$185.56,$0.00,1,0,1,20130101, S9329,HCPCS,HIT CHEMO PER DIEM,,30,,,$201.10,$0.00,1,0,1,20130101, S9330,HCPCS,HIT CONT CHEM DIEM,,30,,,$197.78,$0.00,1,0,1,20130101, S9331,HCPCS,HIT INTERMIT CHEMO DIEM,,30,,,$220.24,$0.00,1,0,1,20130101, S9336,HCPCS,HIT CONT ANTICOAG DIEM,,30,,,$189.15,$0.00,1,0,1,20130101, S9338,HCPCS,HIT IMMUNOTHERAPY DIEM,,30,,,$234.35,$0.00,1,0,1,20130101, S9340,HCPCS,HIT ENTERAL PER DIEM,,30,,,$78.17,$0.00,1,0,1,20130101, S9341,HCPCS,HIT ENTERAL GRAV DIEM,,30,,,$53.66,$0.00,1,0,1,20130101, S9342,HCPCS,HIT ENTERAL PUMP DIEM,,30,,,$57.63,$0.00,1,0,1,20130101, S9343,HCPCS,HIT ENTERAL BOLUS NURS,,30,,,$35.75,$0.00,1,0,1,20130101, S9345,HCPCS,HIT ANTI-HEMOPHIL DIEM,,30,,,$119.29,$0.00,1,0,1,20130101, S9346,HCPCS,HIT ALPHA-1-PROTEINAS DIEM,,30,,,$83.48,$0.00,1,0,1,20130101, S9348,HCPCS,HIT SYMPATHOMIM DIEM,,30,,,$206.47,$0.00,1,0,1,20130101, S9349,HCPCS,HIT TOCOLYSIS DIEM,,30,,,$297.82,$0.00,1,0,1,20130101, S9351,HCPCS,HIT CONT ANTIEMETIC DIEM,,30,,,$378.87,$0.00,1,0,1,20130101, S9353,HCPCS,HIT CONT INSULIN DIEM,,30,,,$518.05,$0.00,1,0,1,20130101, S9357,HCPCS,HIT ENZYME REPLACE DIEM,,30,,,$168.10,$0.00,1,0,1,20130101, S9359,HCPCS,HIT ANTI-TNF PER DIEM,,30,,,$307.65,$0.00,1,0,1,20130101, S9364,HCPCS,HIT TPN TOTAL DIEM,,30,,,$352.15,$0.00,1,0,1,20130101, S9365,HCPCS,HIT TPN 1 LITER DIEM,,30,,,$405.85,$0.00,1,0,1,20130101, S9366,HCPCS,HIT TPN 2 LITER DIEM,,30,,,$495.26,$0.00,1,0,1,20130101, S9367,HCPCS,HIT TPN 3 LITER DIEM,,30,,,$551.46,$0.00,1,0,1,20130101, S9368,HCPCS,HIT TPN OVER 3L DIEM,,30,,,$706.48,$0.00,1,0,1,20130101, S9370,HCPCS,HT INJ ANTIEMETIC DIEM,,30,,,$143.11,$0.00,1,0,1,20130101, S9373,HCPCS,HIT HYDRA TOTAL DIEM,,30,,,$108.66,$0.00,1,0,1,20130101, S9374,HCPCS,HIT HYDRA 1 LITER DIEM,,30,,,$157.04,$0.00,1,0,1,20130101, S9375,HCPCS,HIT HYDRA 2 LITER DIEM,,30,,,$201.19,$0.00,1,0,1,20130101, S9376,HCPCS,HIT HYDRA 3 LITER DIEM,,30,,,$219.29,$0.00,1,0,1,20130101, S9379,HCPCS,HIT NOC PER DIEM,,30,,,$76.31,$0.00,1,0,1,20130101, S9401,HCPCS,ANTICOAG CLINIC PER SESSION,,30,,,$156.78,$0.00,1,0,1,20130101, S9436,HCPCS,LAMAZE CLASS,,30,,,$126.58,$0.00,1,0,1,20130101, S9441,HCPCS,ASTHMA EDUCATION,,30,,,$170.71,$0.00,1,0,1,20130101, S9442,HCPCS,BIRTHING CLASS,,30,,,$107.50,$0.00,1,0,1,20130101, S9443,HCPCS,LACTATION CLASS,,30,,,$197.70,$0.00,1,0,1,20130101, S9445,HCPCS,PT EDUCATION NOC INDIVID,,30,,,$653.15,$0.00,1,0,0,20130101, S9449,HCPCS,WEIGHT MGMT CLASS,,30,,,$86.73,$0.00,1,0,1,20130101, S9452,HCPCS,NUTRITION CLASS,,30,,,$162.59,$0.00,1,0,1,20130101, S9453,HCPCS,SMOKING CESSATION CLASS,,30,,,$222.56,$0.00,1,0,1,20130101, S9455,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$96.56,$0.00,1,0,1,20130101, S9460,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$169.27,$0.00,1,0,1,20130101, S9465,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,30,,,$176.49,$0.00,1,0,1,20130101, S9470,HCPCS,"NUTRITIONAL COUNSELING, DIET",,30,,,$117.29,$0.00,1,0,1,20130101, S9472,HCPCS,CARDIAC REHABILITATION PROGR,,30,,,$329.82,$0.00,1,0,0,20130101, S9473,HCPCS,PULMONARY REHABILITATION PRO,,30,,,$219.09,$0.00,1,0,0,20130101, S9474,HCPCS,ENTEROSTOMAL THERAPY BY A RE,,30,,,$227.16,$0.00,1,0,1,20130101, S9475,HCPCS,AMBULATORY SETTING SUBSTANCE,,30,,,$209.31,$0.00,1,0,1,20130101, S9476,HCPCS,VESTIBULAR REHAB PER DIEM,,30,,,$305.72,$0.00,1,0,0,20130101, S9480,HCPCS,INTENSIVE OUTPATIENT PSYCHIA,,30,,,$183.99,$0.00,1,0,1,20130101, S9484,HCPCS,CRISIS INTERVENTION PER HOUR,,30,,,$71.41,$0.00,1,0,1,20130101, S9485,HCPCS,CRISIS INTERVENTION MENTAL H,,30,,,$183.99,$0.00,1,0,1,20130101, S9490,HCPCS,HIT CORTICOSTEROID/DIEM,,30,,,$243.46,$0.00,1,0,1,20130101, S9494,HCPCS,HIT ANTIBIOTIC TOTAL DIEM,,30,,,$194.29,$0.00,1,0,1,20130101, S9497,HCPCS,HIT ANTIBIOTIC Q3H DIEM,,30,,,$242.27,$0.00,1,0,1,20130101, S9500,HCPCS,HIT ANTIBIOTIC Q24H DIEM,,30,,,$278.09,$0.00,1,0,1,20130101, S9501,HCPCS,HIT ANTIBIOTIC Q12H DIEM,,30,,,$271.79,$0.00,1,0,1,20130101, S9502,HCPCS,HIT ANTIBIOTIC Q8H DIEM,,30,,,$339.20,$0.00,1,0,1,20130101, S9503,HCPCS,HIT ANTIBIOTIC Q6H DIEM,,30,,,$312.75,$0.00,1,0,1,20130101, S9504,HCPCS,HIT ANTIBIOTIC Q4H DIEM,,30,,,$288.37,$0.00,1,0,1,20130101, S9529,HCPCS,VENIPUNCTURE HOME/SNF,,30,,,$96.89,$0.00,1,0,1,20130101, S9537,HCPCS,HT HEM HORM INJ DIEM,,30,,,$80.66,$0.00,1,0,1,20130101, S9542,HCPCS,HT INJ NOC PER DIEM,,30,,,$76.31,$0.00,1,0,1,20130101, S9560,HCPCS,HT INJ HORMONE DIEM,,30,,,$89.71,$0.00,1,0,1,20130101, S9562,HCPCS,HT INJ PALIVIZUMAB DIEM,,30,,,$89.71,$0.00,1,0,1,20130101, V5010,HCPCS,ASSESSMENT FOR HEARING AID,,30,,,$311.75,$0.00,1,0,1,20130101,