Version 3.7 Update - Professional Services and Supplies Charge Table,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Item Code,Code Type,Decription,Modifier,"Technical, Professional Indicator",Service Category Code,Primary/Bundled Indicator,Charge Type Indicator,Work Expense Units,Provider-Based Practice Expense Units,Non-Provider-Based Practice Expense Units,Total Expense Units, Anesthesia Base Units,Unit Charge,Base Charge,Unit Type,Facility Indicator,Outpatient Indicator,Inpatient Indicator,Skilled Nursing Facility Carveout,Freestanding Carve-out,Start Date,End Date00100,CPT,ANESTHESIA SALIVARY GLANDS WITH BIOPSY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00102,CPT,ANESTHESIA CLEFT LIP INVOLVING PLASTIC REPAIR,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00103,CPT,ANESTHESIA EYELID RECONSTRUCTIVE PROCEDURE,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00104,CPT,ANESTHESIA ELECTROCONVULSIVE THERAPY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00120,CPT,ANESTHESIA EXTERNAL MIDDLE & INNER EAR W/BIOPSY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00124,CPT,ANES EXTERNAL MIDDLE & INNER EAR W/BX OTOSCOPY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00126,CPT,ANES XTRNL MID & INNER EAR W/BX TYMPANOTOMY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00140,CPT,ANESTHESIA EYE NOT OTHERWISE SPECIFIED,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00142,CPT,ANESTHESIA EYE LENS SURGERY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00144,CPT,ANESTHESIA EYE CORNEAL TRANSPLANT,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00145,CPT,ANESTHESIA EYE VITREORETINAL SURGERY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00147,CPT,ANESTHESIA EYE IRIDECTOMY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00148,CPT,ANESTHESIA EYE OPHTHALMOSCOPY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00160,CPT,ANESTHESIA NOSE & ACCESSORY SINUSES,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00162,CPT,ANES NOSE & ACCESSORY SINUSES RADICAL SURGERY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00164,CPT,ANES NOSE&ACCESSORY SINUSES BIOPSY SOFT TISSUE,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00170,CPT,ANESTHESIA INTRAORAL WITH BIOPSY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00172,CPT,ANES INTRAORAL W/BIOPSY REPAIR CLEFT PALATE,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00174,CPT,ANES INTRAORAL W/BX EXC RETROPHARYNGEAL TUMOR,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00176,CPT,ANESTHESIA INTRAORAL W/BIOPSY RADICAL SURGERY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00190,CPT,ANESTHESIA FACIAL BONES OR SKULL,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00192,CPT,ANES FACIAL BONES/SKULL RAD SURG W/PROGNATHISM,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0019T,CPT,ESWT INVG MUSCSKEL SYS NOS LW NRG,,,21 ,,TotalUnits,,,,3.87 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00210,CPT,ANESTHESIA INTRACRANIAL PROCEDURE NOS,,,3 ,,Anesth,,,,,11.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00211,CPT,ANES INTRACRANIAL CRANIOTOMY/CRANIECTOMY HMTMA,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00212,CPT,ANESTHESIA INTRACRANIAL PROCEDURE SUBDURAL TAPS,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00214,CPT,ANES INTRACRANIAL BURR HOLES W/VENTRICULOGRAPHY,,,3 ,,Anesth,,,,,9.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00215,CPT,ANES ICRA CRNOP/ELEVATION DEPRS SKULL FX XDRL,,,3 ,,Anesth,,,,,9.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00216,CPT,ANESTHESIA INTRACRANIAL VASCULAR PROCEDURE,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00218,CPT,ANES INTRACRANIAL PROCEDURE IN SITTING POSITION,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00220,CPT,ANES INTRACRANIAL CEREBROSPINAL FLUID SHUNTING,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00222,CPT,ANES INTRACRANIAL ELECTROCOAGULATION ICRA NERVE,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00300,CPT,ANES INTEG MUSC&NRV HEAD NCK&POSTERIOR TRUNK,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0030T,CPT,ANTIPROTHROMBIN ANTB EA IG CLASS,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00320,CPT,ANES ESOPH THYR LARX TRACH&LYMPHTC NECK 1YR/>,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00322,CPT,ANES ESOPH THYR LARX TRACH&LYMPHTC NCK BX THYR,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00326,CPT,ANESTHESIA LARYNX & TRACHEA CHILDREN <1YEAR,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00350,CPT,ANESTHESIA MAJOR VESSELS NECK,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00352,CPT,ANESTHESIA MAJOR VESSELS NECK SIMPLE LIGATION,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00400,CPT,ANES INTEG EXTREMITIES ANTERIOR TRUNK PERINEUM,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00402,CPT,ANESTHESIA RECONSTRUCTIVE BREAST,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00404,CPT,ANESTHESIA RADICAL/MODIFIED RADICAL BREAST,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00406,CPT,ANES RADICAL/MODIFIED RADICAL BREAST W/NODE,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00410,CPT,ANES INTEG SYS ELEC CONVERSION ARRHYTHMIAS,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0042T,CPT,CERE PRFJ ALYS CT C+,,,20 ,,TotalUnits,,,,2.95 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00450,CPT,ANESTHESIA CLAVICLE AND SCAPULA,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00452,CPT,ANES CLAVICLE AND SCAPULA RADICAL SURGERY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00454,CPT,ANES CLAVICLE AND SCAPULA W/BIOPSY CLAVICLE,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00470,CPT,ANESTHESIA PARTIAL RIB RESECTION,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00472,CPT,ANESTHESIA PARTIAL RIB RESECTION THORACOPLASTY,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00474,CPT,ANESTHESIA PARTIAL RIB RESECTION RADICAL,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0048T,CPT,IMPLTJ VENTR ASSIST DEV XTRCORP PRQ T-SEPTAL,,,21 ,,TotalUnits,,,,13.44 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00500,CPT,ANESTHESIA ESOPHAGUS,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00520,CPT,ANESTHESIA CLOSED CHEST W/BRONCHOSCOPY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00522,CPT,ANESTHESIA CLOSED CHEST NEEDLE BIOPSY PLEURA,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00524,CPT,ANESTHESIA CLOSED CHEST PNEUMOCENTESIS,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00528,CPT,ANES CLSD CHEST MEDIASTSC&THRSC W/O 1 LUNG VNTJ,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00529,CPT,ANES CLOSED CHEST MEDIASTSC&THRSC W/1 LUNG VNTJ,,,3 ,,Anesth,,,,,11.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00530,CPT,ANES PERMANENT TRANSVENOUS PACEMAKER INSERTION,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00532,CPT,ANESTHESIA ACCESS CENTRAL VENOUS CIRCULATION,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00534,CPT,ANES TRANSVENOUS INSJ/REPLACEMENT PACING CVDFB,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00537,CPT,ANES CARDIAC ELECTROPHYSIOLOGIC W/RF ABLATION,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00539,CPT,ANESTHESIA TRACHEOBRONCHIAL RECONSTRUCTION,,,3 ,,Anesth,,,,,18.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00540,CPT,ANESTHESIA THRCM LUNG PLEURA DPHRM&MED THRSC,,,3 ,,Anesth,,,,,12.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00541,CPT,ANES THRCM LUNG PLEURA DPHRM&MED THRSC 1 LUNG,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00542,CPT,ANES THRCM LUNG PLEURA DPHRM&MED THRSC DCRTCTJ,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00546,CPT,ANES THRCM LNG PLEUR DPHRM&MED THRSC PULM RESCJ,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00548,CPT,ANES THRCM LNG PLEUR DPHRM&MED THRSC TRACH&BRNCH,,,3 ,,Anesth,,,,,17.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00550,CPT,ANESTHESIA FOR STERNAL DEBRIDEMENT,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00560,CPT,ANES HRT PRCRD SAC&GREAT VESSEL CH W/O PMP OXTJ,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00561,CPT,ANES HRT PRCRD SAC&GREAT VSL CH W/PMP OXTJ <1YR,,,3 ,,Anesth,,,,,25.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00562,CPT,ANES HRT PRCRD&GRT VSL CH W/PMP OXTJ PT AGE 1/>,,,3 ,,Anesth,,,,,20.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00563,CPT,ANES HRT PRCRD&GREAT VSL CH W/PUMP OXTJ HYPTHRM,,,3 ,,Anesth,,,,,25.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00566,CPT,ANES DIR CAB GRFG W/O PMP OXTJ,,,3 ,,Anesth,,,,,25.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00567,CPT,ANES DIRECT CAB GRAFTING W/ PUMP OXYGENATOR,,,3 ,,Anesth,,,,,18.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00580,CPT,ANES HEART TRANSPLANT/HEART/LUNG TRANSPLANT,,,3 ,,Anesth,,,,,20.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00600,CPT,ANESTHESIA CERVICAL SPINE & CORD,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00604,CPT,ANES CERVICAL SPINE&CORD W/PATIENT SITTING,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00620,CPT,ANESTHESIA THORACIC SPINE & CORD,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00622,CPT,ANES THORACIC SPINE&CORD THORACOLMBR SYMPTH,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00625,CPT,ANES THRC SPINE & CORD ANT APPR W/O 1 LUNG VNTJ,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00626,CPT,ANES THORACIC SPINE & C/D ANT APPR W/1 LNG VNTJ,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00630,CPT,ANESTHESIA LUMBAR REGION,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00632,CPT,ANESTHESIA LUMBAR REGION LUMBAR SYMPATHECTOMY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00634,CPT,ANESTHESIA LUMBAR CHEMONUCLEOLYSIS,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00635,CPT,ANES DIAGNOSTIC/THERAPEUTIC LUMBAR PUNCTURE,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00640,CPT,ANES MNPJ SPINE/CLSD CRV THORACIC/LUMBAR SPINE,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00670,CPT,ANESTHESIA EXTENSIVE SPINE & SPINAL CORD,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00700,CPT,ANESTHESIA UPPER ANTERIOR ABDOMINAL WALL,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00702,CPT,ANES UPR ANT ABDL WALL PERCUTANEOUS LIVER BX,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00730,CPT,ANESTHESIA UPPER POSTERIOR ABDOMINAL WALL,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0073T,CPT,COMPNSTR-BASED BEAM MODLJ TX DLVR INVERSE 3> FLD,,TC,20 ,,RBRVS,,13.84 ,13.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,00740,CPT,ANES UPPER GI ENDOSCOPIC PROXIMAL TO DUODENUM,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00750,CPT,ANESTHESIA HERNIA REPAIR UPPER ABDOMEN,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00752,CPT,ANES HRNA RPR UPR ABD LMBR&VNT HRNAS&/WND DEHSN,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00754,CPT,ANES HERNIA REPAIR UPPER ABDOMEN OMPHALOCELE,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00756,CPT,ANES HRNA REPAIR UPR ABD TABDL RPR DIPHRG HRNA,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0075T,CPT,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,,,21 ,,TotalUnits,,,,14.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0075T,CPT,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,26,,21 ,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0075T,CPT,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,TC,,21 ,,TotalUnits,,,,13.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,00770,CPT,ANESTHESIA MAJOR ABDOMINAL BLOOD VESSELS,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0078T,CPT,EVASC RPR AAA PSEUDOARYSM ABDL AORTA VISC,,,21 ,,TotalUnits,,,,26.80 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00790,CPT,ANES INTRAPERITONEAL UPPER ABDOMEN W/LAPS,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00792,CPT,ANES IPR UPR ABD LAPS PRTL HPTC/MGMT LVR HEMRRG,,,3 ,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00794,CPT,ANES IPR UPPER ABD W/LAPS PNCRTECT PRTL/TOTAL,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00796,CPT,ANES IPR UPPER ABD W/LAPS LIVER TRANSPLANT,,,3 ,,Anesth,,,,,30.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00797,CPT,ANES IPR UPPER ABDOMEN LAPS GASTRIC RSTCV MO,,,3 ,,Anesth,,,,,11.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0079T,CPT,PLMT VISC XTN PROSTH EVASC RPR AAA EA VISC,,,21 ,,TotalUnits,,,,38.75 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00800,CPT,ANESTHESIA LOWER ANTERIOR ABDOMINAL WALL,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00802,CPT,ANES LOWER ANT ABDOMINAL WALL PANNICULECTOMY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0080T,CPT,EVASC RPR AAA PSEUDOARYSM ABDL AORTA VISC RS&I,,,21 ,,TotalUnits,,,,4.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00810,CPT,ANES LOWER INTESTINAL NDSC DISTAL DUODENUM,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0081T,CPT,PLMT VISC XTN PROSTH EVASC RPR AAA EA VISC RS&I,,,21 ,,TotalUnits,,,,6.43 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,00820,CPT,ANESTHESIA LOWER POSTERIOR ABDOMINAL WALL,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00830,CPT,ANESTHESIA HERNIA REPAIR LOWER ABDOMEN,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00832,CPT,ANES HRNA RPR LWR ABD VENTRAL&INCAL HRNAS,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00834,CPT,ANES HERNIA REPAIR LOWER ABDOMEN NOS <1YR AGE,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00836,CPT,ANES HRNA RPR LWR ABD NOS INFTS<37WK BRTH<50WK,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00840,CPT,ANESTHESIA INTRAPERITONEAL LOWER ABD W/LAPS,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00842,CPT,ANES IPR LOWER ABDOMEN W/LAPS AMNIOCENTESIS,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00844,CPT,ANES IPR LOWER ABD W/LAPS ABDOMINOPRNL RESCJ,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00846,CPT,ANES IPR LOWER ABD W/LAPS RAD HYSTERECTOMY,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00848,CPT,ANES IPR PX LWR ABD W/LAPS PELVIC EXENTERATION,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00851,CPT,ANES IPR PX LWR ABD W/LAPS TUBAL LIG/TRNSECTION,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00860,CPT,ANES EXTRAPERITONEAL PX LWR ABD W/UR TRC NOS,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00862,CPT,ANES XTRPRTL LOWER ABD UR TRACT RENAL DON NFRCT,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00864,CPT,ANES XTRPRTL LOWER ABD W/URINARY TRACT TOT CSTC,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00865,CPT,ANES XTRPRTL LWR ABD W/UR TRC RAD PRST8ECT,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00866,CPT,ANES XTRPRTL LOWER ABD W/UR TRC ADRNLECTOMY,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00868,CPT,ANES XTRPRTL LOWER ABD W/UR TRACT RENAL TRNSPL,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00870,CPT,ANES XTRPRTL LOWER ABD W/UR TRACT CSTOLITHOTOMY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00872,CPT,ANES LITHOTRP XTRCORP SHOCK WAVE W/WATER BATH,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00873,CPT,ANES LITHOTRP XTRCORP SHOCK WAVE W/O WATER BATH,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00880,CPT,ANESTHESIA MAJOR LOWER ABDOMINAL VESSELS,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00882,CPT,ANES MAJOR LOWER ABDOMINAL VESSELS IVC LIGATION,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00902,CPT,ANESTHESIA ANORECTAL PROCEDURE,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00904,CPT,ANESTHESIA RADICAL PERINEAL PROCEDURE,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00906,CPT,ANESTHESIA VULVECTOMY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00908,CPT,ANESTHESIA PERINEAL PROSTATECTOMY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00910,CPT,ANESTHESIA TRANSURETHRAL W/URETHROCYSTOSCOPY,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00912,CPT,ANES TRANSURETHRAL RESECTION OF BLADDER TUMOR,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00914,CPT,ANESTHESIA TRANSURETHRAL RESECTION OF PROSTATE,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00916,CPT,ANES TRURL POST-TRURL RESECTION BLEEDING,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00918,CPT,ANES TRURL FRAGMNTJ MNPJ&/RMVL URTRL CALCULUS,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00920,CPT,ANESTHESIA MALE GENITALIA INCL OPEN URETHRAL PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00921,CPT,ANES VASECTOMY UNI/BI INCL OPEN URETHRAL PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00922,CPT,ANES SEMINAL VESICLES INCL OPEN URETHRAL PX,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00924,CPT,ANES UNDSCND TESTIS UNI/BI INCL OPEN URTL PX,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00926,CPT,ANES RAD ORCHIECTOMY INGUN INCL OPEN URTL PX,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00928,CPT,ANES RAD ORCHIECTOMY ABDOMINAL INCL OPN URTL,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0092T,CPT,TOT DISC ARTHRP ANT APPR DSKC PREP CRV EA NTRSPC,,,21 ,,RBRVS,4.04 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,00930,CPT,ANES ORCHIOPEXY UNI/BI INCL OPEN URETHRAL PX,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00932,CPT,ANES COMPLETE AMPUTATION PENIS INCL OPEN URTL,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00934,CPT,ANES RAD AMP PENIS W/BI INGUINAL NODE OPN URTL,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00936,CPT,ANES RAD AMP PNS W/BI INGUN&ILIAC INCL OPN URTL,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00938,CPT,ANES INSJ PENILE PROSTH PRNL INCL OPEN URTL,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00940,CPT,ANESTHESIA VAGINAL PROCEDURE INCL BIOPSY,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00942,CPT,ANES COLPTMY VAGNC COLPRPHY INCL BX W/OPN URTL,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00944,CPT,ANESTHESIA VAGINAL HYSTERECTOMY INCL BIOPSY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00948,CPT,ANESTHESIA CERVICAL CERCLAGE INCLUDING BIOPSY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00950,CPT,ANESTHESIA CULDOSCOPY INCLUDING BIOPSY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,00952,CPT,ANES HYSTEROSCOPY&/HYSTEROSALPINGOGRAPHY W/BX,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0095T,CPT,RMVL TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,,,21 ,,RBRVS,4.04 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0098T,CPT,REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,,,21 ,,RBRVS,4.04 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0099T,CPT,IMPLTJ INTRASTROMAL CRNL RING SEG,,,21 ,,TotalUnits,,,,5.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0100T,CPT,PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA,,,21 ,,TotalUnits,,,,12.92 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0101T,CPT,ESWT INVG MUSCSKEL SYS NOS HI NRG,,,21 ,,TotalUnits,,,,5.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0102T,CPT,ESWT HI NRG PHYS ANES LAT HUMRL EPICONDYLE,,,21 ,,TotalUnits,,,,5.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0106T,CPT,QST&INTERPJ XTR W/TOUCH STIMULI,,,14 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0107T,CPT,QST&INTERPJ XTR W/VIBRJ STIMULI,,,14 ,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0108T,CPT,QST&INTERPJ XTR W/COOL STIMULI,,,14 ,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0109T,CPT,QST&INTERPJ XTR W/HT-PN STIMULI,,,14 ,,TotalUnits,,,,0.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0110T,CPT,QST&INTERPJ PR XTR OTH STIMULI,,,14 ,,TotalUnits,,,,0.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01112,CPT,ANES BONE MARROW ASPIR&/BX ANT/PST ILIAC CREST,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01120,CPT,ANESTHESIA ON BONY PELVIS,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01130,CPT,ANESTHESIA BODY CAST APPLICATION OR REVISION,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01140,CPT,ANESTHESIA INTERPELVIABDOMINAL AMPUTATION,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01150,CPT,ANES RADICAL TUMOR PELVIS XCP HINDQUARTER AMP,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01160,CPT,ANES CLOSED SYMPHYSIS PUBIS/SACROILIAC JOINT,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01170,CPT,ANES OPEN SYMPHYSIS PUBIS/SACROILIAC JOINT,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01173,CPT,ANES OPN RPR DISRPJ PELVIS/COLUMN FX ACETABULUM,,,3 ,,Anesth,,,,,12.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01180,CPT,ANESTHESIA OBTURATOR NEURECTOMY EXTRAPELVIC,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01190,CPT,ANESTHESIA OBTURATOR NEURECTOMY INTRAPELVIC,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01200,CPT,ANESTHESIA HIP JOINT,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01202,CPT,ANESTHESIA ARTHROSCOPY HIP JOINT,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01210,CPT,ANESTHESIA OPEN PX HIP JOINT,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01212,CPT,ANESTHESIA OPEN HIP JOINT DISARTICULATION,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01214,CPT,ANESTHESIA OPEN TOTAL HIP ARTHROPLASTY,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01215,CPT,ANESTHESIA OPEN REVISION TOTAL HIP ARTHROPLASTY,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01220,CPT,ANESTHESIA UPPER 2/3 FEMUR CLOSED PROCEDURES,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01230,CPT,ANESTHESIA UPPER 2/3 FEMUR OPEN PROCEDURES,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01232,CPT,ANESTHESIA UPPER 2/3 FEMUR AMPUTATION,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01234,CPT,ANES UPPER 2/3 FEMUR RADICAL RESCECTION,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01250,CPT,ANES NERVE MUSC TENDON FASCIA&BURSAE UPPER LEG,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01260,CPT,ANES VEINS OF UPPER LEG INCLUDING EXPLORATION,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0126T,CPT,COMMON CRTD IMT RISK FACTOR ASSMT,,,4 ,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01270,CPT,ANESTHESIA ARTERIES UPPER LEG INCL BYPASS GRAFT,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01272,CPT,ANES ART UPPER LEG W/BYPASS GRAFT FEM ART LIG,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01274,CPT,ANES ARTERIES UPPER LEG W/BYP GRF FEM ART EMBLC,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01320,CPT,ANES NERVE MUSC TENDON FSCA&BRS KNEE&/POP AREA,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01340,CPT,ANESTHESIA LOWER 1/3 FEMUR CLOSED PROCEDURES,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01360,CPT,ANESTHESIA LOWER 1/3 FEMUR OPEN PROCEDURES,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01380,CPT,ANESTHESIA KNEE JOINT CLOSED PROCEDURES,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01382,CPT,ANESTHESIA DIAGNOSTIC ARTHROSCOPIC KNEE JOINT,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01390,CPT,ANES UPPER ENDS TIBIA FIBULA&/PATELLA CLOSED,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01392,CPT,ANES UPPER ENDS TIBIA FIBULA&/PATELLA OPEN,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01400,CPT,ANES OPEN/SURGICAL ARTHROSCOPIC KNEE JOINT,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01402,CPT,ANESTHESIA ARTHROSCOPIC TOTAL KNEE ARTHROPLASTY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01404,CPT,ANESTHESIA ARTHROSCOPIC KNEE DISARTICULATION,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01420,CPT,ANES CAST APPLICATION REMOVAL/REPAIR KNEE JOINT,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01430,CPT,ANESTHESIA VEINS KNEE & POPLITEAL AREA,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01432,CPT,ANESTHESIA VEINS KNEE & POPLITEAL ARVEN FISTULA,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01440,CPT,ANESTHESIA ARTERIES OF KNEE & POPLITEAL AREA,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01442,CPT,ANES ART KNEE & POP/POP TEAEC +-PATCH GRAFT,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01444,CPT,ANES ART KNE&POP/POP EXC&GRF/RPR OCCLS/ARYSM,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01462,CPT,ANESTHESIA LOWER LEG ANKLE & FOOT CLOSED PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01464,CPT,ANESTHESIA ANKLE &/FOOT ARTHROSCOPIC PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01470,CPT,ANES NRV/MUS/TND/FASC LOWER LEG/ANKLE/FOOT,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01472,CPT,ANES RPR RUPTURED ACHILLES TENDON +-PATCH GRAFT,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01474,CPT,ANESTHESIA GASTROCNEMIUS RECESSION,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01480,CPT,ANESTHESIA BONES LOWER LEG/ANKLE/FOOT OPEN PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01482,CPT,ANES RADICAL RESECTION INCL BELOW KNEE AMP,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01484,CPT,ANES OSTEOTOMY/OSTEOPLASTY TIBIA&/FIBULA OPEN,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01486,CPT,ANESTHESIA TOTAL ANKLE REPLACEMENT OPEN,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01490,CPT,ANES LOWER LEG CAST APPLICATION REMOVAL/REPAIR,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01500,CPT,ANESTHESIA ARTERIES LOWER LEG W/BYPASS GRAFT,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01502,CPT,ANES ART LOWER LEG W/BYP GRAFT EMBLC DIR/W/CATH,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01520,CPT,ANESTHESIA VEINS OF LOWER LEG,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01522,CPT,ANES VEINS LOWER LEG VENOUS THRMBC DIR/W/CATH,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0155T,CPT,LAPS IMPLTJ/ RPLCMT GASTRIC ELTRD < CURVATURE,,,21 ,,TotalUnits,,,,22.57 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0156T,CPT,LAPS REVJ/RMVL GASTRIC ELTRD < CURVATURE,,,21 ,,TotalUnits,,,,22.57 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0157T,CPT,LAPT IMPLTJ/ RPLCMT GASTRIC ELTRD < CURVATURE,,,21 ,,TotalUnits,,,,1.86 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0158T,CPT,LAPT REVJ/RMVL GASTRIC ELTRD < CURVATURE,,,21 ,,TotalUnits,,,,1.86 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0159T,CPT,CPTR AID DETCJ BREAST MRI,,,20 ,,TotalUnits,,,,1.92 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,0159T,CPT,CPTR AID DETCJ BREAST MRI,,PC,20 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,0159T,CPT,CPTR AID DETCJ BREAST MRI,,TC,20 ,,TotalUnits,,,,1.31 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,01610,CPT,ANES NERVE MUSCLE TENDON FSCA&BRS SHO&AXILLA,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01620,CPT,ANES CLOSED HUMRL H/N STRNCLAV JOINT&SHO JOINT,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01622,CPT,ANES SHOULDER JOINT DIAGNOSTIC ARTHROSCOPIC PX,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01630,CPT,ANES ARTHRS HUMERAL H/N STRNCLAV&SHOULDER JOINT,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01634,CPT,ANESTHESIA ARTHROSCOPIC SHOULDER DISARTICULATION,,,3 ,,Anesth,,,,,9.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01636,CPT,ANES ARTHRS INTERTHORACOSCAPULAR AMPUTATION,,,3 ,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01638,CPT,ANES ARTHROSCOPIC TOTAL SHOULDER REPLACEMENT,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01650,CPT,ANESTHESIA ARTERIES SHOULDER & AXILLA,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01652,CPT,ANESTHESIA AXILLARY-BRACHIAL ANEURYSM,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01654,CPT,ANES ARTERIES SHOULDER & AXILLA BYPASS GRAFT,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01656,CPT,ANESTHESIA AXILLARY-FEMORAL BYPASS GRAFT,,,3 ,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01670,CPT,ANESTHESIA VEINS SHOULDER & AXILLA,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01680,CPT,ANES SHOULDER CAST APPLICATION REMOVAL/REPAIR,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01682,CPT,ANES SHOULDER SPICA APPLICATION REMOVAL/REPAIR,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01710,CPT,ANES NRV MUSC TDN FSCA&BRS UPR ARM/ELBOW,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01712,CPT,ANESTHESIA TENOTOMY ELBOW TO SHOULDER OPEN,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01714,CPT,ANESTHESIA TENOPLASTY ELBOW TO SHOULDER,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01716,CPT,ANESTHESIA BICEPS TENODESIS RUPTURE LONG TENDON,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0171T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR 1 LVL,,,21 ,,TotalUnits,,,,30.47 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0172T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR EA LVL,,,21 ,,TotalUnits,,,,16.55 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01730,CPT,ANESTHESIA HUMERUS & ELBOW CLOSED PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01732,CPT,ANESTHESIA ELBOW JOINT DIAGNOSTIC ARTHROSCOPIC,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01740,CPT,ANESTHESIA ELBOW OPEN/SURGICAL ARTHROSCOPIC,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01742,CPT,ANESTHESIA HUMERUS ARTHROSCOPIC OSTEOTOMY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01744,CPT,ANES HUMERUS ARTHROSCOPIC REPAIR NON/MALUNION,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0174T,CPT,CAD CHEST RADIOGRAPH W PRIMARY INTERPJ,,,20 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01756,CPT,ANESTHESIA ELBOW ARTHROSCOPIC RADICAL PX,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01758,CPT,ANES HUMERUS ARTHROSCOPIC EXCISION CYST/TUMOR,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01760,CPT,ANES ARTHROSCOPIC TOTAL ELBOW REPLACEMENT,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01770,CPT,ANESTHESIA ARTERIES UPPER ARM & ELBOW,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01772,CPT,ANESTHESIA ARTERIES UPPER ARM&ELBOW EMBOLECTOMY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01780,CPT,ANESTHESIA VEINS UPPER ARM & ELBOW,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01782,CPT,ANESTHESIA VEINS UPPER ARM&ELBOW PHLEBORRHAPHY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01810,CPT,ANES NERVE MUSCLE TDN FSCA&BRS F/ARM WRST&HAND,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0181T,CPT,CORNEAL HYSTERESIS AIR IMPULSE,,,14 ,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01820,CPT,ANES RADIUS ULNA WRIST/HAND BONES CLOSED PX,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01829,CPT,ANESTHESIA WRIST DIAGNOSTIC ARTHROSCOPIC,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01830,CPT,ANES ARTHRS/ENDOSCOPIC DSTL RADIUS DSTL U/W/H,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01832,CPT,ANESTHESIA ARTHROSCOPIC TOTAL WRIST REPLACEMENT,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0183T,CPT,LOW FREQUENCY WOUND ULTRASOUND,,,20 ,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01840,CPT,ANESTHESIA ARTERIES FOREARM WRIST & HAND,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01842,CPT,ANES ARTERIES FOREARM WRIST&HAND EMBOLECTOMY,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01844,CPT,ANESTHESIA VASCULAR SHUNT/SHUNT REVISION,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01850,CPT,ANESTHESIA VEINS FOREARM WRIST & HAND,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01852,CPT,ANES VEINS FOREARM WRIST&HAND PHLEBORRHAPHY,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01860,CPT,ANES FOREARM WRIST/HAND CAST APPL RMVL/REPAIR,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01916,CPT,ANESTHESIA DIAGNOSTIC ARTERIOGRAPHY/VENOGRAPH,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01920,CPT,ANES C-CATHJ W/C ANGIOGRAPHY&VENTRICULOGRAPHY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01922,CPT,ANES NON-INVASIVE IMAGING/RADIATION THERAPY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01924,CPT,ANESTHESIA THER IVNTL RADIOLOGICAL ARTERIAL,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01925,CPT,ANESTHESIA CAROTID/CORONARY THER IVNTL RAD,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01926,CPT,ANES ICRA ICAR/AORTIC THER IVNTL RAD ARTL,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0192T,CPT,ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR EXT,,,21 ,,TotalUnits,,,,20.31 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01930,CPT,ANESTHESIA VENOUS/LYMPHATIC NOS THER IVNTL RAD,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01931,CPT,ANESTHESIA INTRAHEPATIC/PORTAL THER IVNTL RAD,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01932,CPT,ANESTHESIA INTRATHORACIC/JUGULAR THER IVNTL RAD,,,3 ,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01933,CPT,ANES INTRACRANIAL THER IVNTL RAD VENS/LYMPHTC,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01935,CPT,ANESTHESIA PERQ IMAGE GUIDED SPINE DIAGNOSTIC,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01936,CPT,ANESTHESIA PERQ IMAGE GUIDED SPINE THERAPEUTIC,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01951,CPT,ANES 2/3 DGR BRN EXC/DBRDMT +-GRF <4 % TBSA,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01952,CPT,ANES 2/3 DGR BRN EXC/DBRDMT +-GRF 4-9 % TBSA,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01953,CPT,ANES 2/3 DGR BRN EXC/DBRDMT +-GRF EA >9 % TBSA,,,3 ,,Anesth,,,,,1.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01958,CPT,ANESTHESIA EXTERNAL CEPHALIC VERSION,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01960,CPT,ANESTHESIA VAGINAL DELIVERY ONLY,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01961,CPT,ANESTHESIA CESAREAN DELIVERY ONLY,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01962,CPT,ANES URGENT HYSTERECTOMY FOLLOWING DELIVERY,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01963,CPT,ANESTHESIA C HYST W/O ANY LABOR ANALG/ANES CARE,,,3 ,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01965,CPT,ANESTHESIA INCOMPLETE/MISSED ABORTION,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01966,CPT,ANESTHESIA INDUCED ABORTION,,,3 ,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01967,CPT,NEURAXIAL LABOR ANALG/ANES PLND VAG DLVR,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01968,CPT,ANES C DLVR FLWG NEURAXIAL LABOR ANALG/ANES,,,3 ,,Anesth,,,,,2.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01969,CPT,ANES C HYST FLWG NEURAXIAL LABOR ANALG/ANES,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01990,CPT,PHYSIOL SUPPORT HRVG ORGAN FROM BRN-DEAD PT,,,3 ,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01991,CPT,ANES DX/THER NRV BLK/NJX OTH/THN PRONE POS,,,3 ,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01992,CPT,ANES DX/THER NERVE BLOCK/INJECTION PRONE POS,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,01996,CPT,DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN,,,3 ,,TotalUnits,,,,3.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,01999,CPT,UNLISTED ANESTHESIA PROCEDURE,,,3 ,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20110101,0228T,CPT,US TFRML EDRL INJ CRV/T 1LVL,,,21 ,,TotalUnits,,,,7.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0229T,CPT,US TFRML EDRL INJ CRV/T +LVL,,,21 ,,TotalUnits,,,,3.53 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0230T,CPT,US TFRML EDRL INJ L/S 1LVL,,,21 ,,TotalUnits,,,,6.90 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0231T,CPT,US TFRML EDRL INJ L/S +LVL,,,21 ,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0234T,CPT,TRLUML PERIP ATHRC RENAL ART,,,21 ,,RBRVS,5.53 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0235T,CPT,TRLUML PERIP ATHRC VISCERAL,,,21 ,,RBRVS,5.53 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0236T,CPT,TRLUML PERIP ATHRC ABD AORTA,,,21 ,,RBRVS,7.60 ,3.18 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0237T,CPT,TRLUML PERIP ATHRC BRCHIOCPH,,,21 ,,RBRVS,10.42 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0238T,CPT,TRLUML PERIP ATHRC ILIAC ART,,,21 ,,RBRVS,6.64 ,3.19 ,3.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,0502F,CPT,SBSQ PRENATAL CARE VST,,,14 ,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0509F,CPT,URINARY INCONTINENCE PLAN OF CARE DOCUMENTED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,0519F,CPT,PLAND CHEMO REG DOCD B/4 START NEW TXMNT REG,,,14 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,1000F,CPT,TOBACCO USE ASSESSED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,10021,CPT,FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE,,,21 ,,RBRVS,1.27 ,0.46 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10022,CPT,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,,,21 ,,RBRVS,1.27 ,0.43 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10040,CPT,ACNE SURGERY,,,21 ,,RBRVS,1.21 ,0.99 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10060,CPT,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,,,21 ,,RBRVS,1.22 ,1.10 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10061,CPT,INCISION&DRAINAGE ABSCESS COMPLICATED/MULTIPLE,,,21 ,,RBRVS,2.45 ,1.57 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,1006F,CPT,OSTEOARTHRITIS SYMPTOMS&FUNCJAL STATUS ASSES,,,14 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,10080,CPT,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,,,21 ,,RBRVS,1.22 ,1.17 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10081,CPT,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,,,21 ,,RBRVS,2.50 ,1.59 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10120,CPT,INCISION&REMOVAL FOREIGN BODY SUBQ TISS SMPL,,,21 ,,RBRVS,1.25 ,1.01 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10121,CPT,INCISION&REMOVAL FOREIGN BODY SUBQ TISS COMP,,,21 ,,RBRVS,2.74 ,1.77 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10140,CPT,I&D HEMATOMA SEROMA/FLUID COLLECTION,,,21 ,,RBRVS,1.58 ,1.33 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10160,CPT,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,,,21 ,,RBRVS,1.25 ,1.11 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,10180,CPT,INCISION&DRAINAGE COMPLEX PO WOUND INFECTION,,,21 ,,RBRVS,2.30 ,1.95 ,3.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,1036F,CPT,CURRENT TOBACCO NON-USER CAD CAP COPD PV DM,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,1055F,CPT,VISUAL FUNCTIONAL STATUS ASSESSED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,1090F,CPT,PRESENCE/ABSENCE URINARY INCONTINENCE ASSESSED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,1091F,CPT,URINE INCONTINENCE TYPIFIED (EG FREQ VOL ETC),,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,11000,CPT,DBRDMT X10SV ECZMT/INFCT SKN UP 10% BDY SURF,,,21 ,,RBRVS,0.60 ,0.18 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11001,CPT,DBRDMT X10SV ECZMT/INFCT SKN EA 10% BDY SURF,,,21 ,,RBRVS,0.30 ,0.09 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11004,CPT,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,,,21 ,,RBRVS,10.80 ,3.70 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11005,CPT,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,,,21 ,,RBRVS,14.24 ,4.73 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11006,CPT,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,,,21 ,,RBRVS,13.10 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11008,CPT,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,,,21 ,,RBRVS,5.00 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,1100F,CPT,PT FALLS ASSESS DOC 2+ FALLS/FALL W/INJURY/YR,,,14 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,11010,CPT,DBRDMT W/RMVL FM FX&/DISLC SKN&SUBQ TISS,,,21 ,,RBRVS,4.19 ,2.63 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11011,CPT,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,,,21 ,,RBRVS,4.94 ,2.34 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11012,CPT,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,,,21 ,,RBRVS,6.87 ,3.60 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,1101F,CPT,PT FALLS ASSESS DOC 0-1 FALLS W/OUT INJ PAST YR,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,11042,CPT,REMOVAL DAMAGED SKIN AND UNDERLYING TISSUE,,,21 ,,RBRVS,0.80 ,0.30 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11043,CPT,DEBRIDEMENT SUBCUTANEOUS TISSUE&MUSCLE,,,21 ,,RBRVS,3.14 ,2.75 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11044,CPT,DEBRIDEMENT SUBCUTANEOUS TISSUE&MUSCLE&BONE,,,21 ,,RBRVS,4.26 ,3.86 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11045,CPT,DEB SUBQ TISSUE ADD-ON,,,21 ,,RBRVS,0.33 ,0.51 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11046,CPT,DEB MUSC/FASCIA ADD-ON,,,21 ,,RBRVS,0.70 ,0.77 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11047,CPT,DEB BONE ADD-ON,,,21 ,,RBRVS,1.20 ,1.19 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11055,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,,,21 ,,RBRVS,0.43 ,0.13 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11056,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4<,,,21 ,,RBRVS,0.61 ,0.17 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11057,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,,,21 ,,RBRVS,0.79 ,0.22 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11100,CPT,BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION,,,21 ,,RBRVS,0.81 ,0.43 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11101,CPT,BIOPSY SKN SUBQ&/MUC MEMB EA SPX ADDL LESION,,,21 ,,RBRVS,0.41 ,0.22 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,1111F,CPT,DISCHRG MEDS RECONCILED W/ CURRENT MED LIST,,,14 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,11200,CPT,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA UP&W/15<,,,21 ,,RBRVS,0.82 ,0.92 ,1.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11201,CPT,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10<,,,21 ,,RBRVS,0.29 ,0.13 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11300,CPT,SHAVING SKIN LES 1 TRUNK/ARM/LEG DIAM 0.5CM/<,,,21 ,,RBRVS,0.51 ,0.24 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11301,CPT,SHVG SKIN LES 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,,,21 ,,RBRVS,0.85 ,0.43 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11302,CPT,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,,,21 ,,RBRVS,1.05 ,0.53 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11303,CPT,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,,,21 ,,RBRVS,1.24 ,0.61 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11305,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,,,21 ,,RBRVS,0.67 ,0.23 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11306,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,,,21 ,,RBRVS,0.99 ,0.41 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11307,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,,,21 ,,RBRVS,1.14 ,0.53 ,1.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11308,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,,,21 ,,RBRVS,1.41 ,0.55 ,1.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11310,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,,,21 ,,RBRVS,0.73 ,0.35 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11311,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,,,21 ,,RBRVS,1.05 ,0.54 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11312,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,,,21 ,,RBRVS,1.20 ,0.63 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11313,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,,,21 ,,RBRVS,1.62 ,0.81 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11400,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/<,,,21 ,,RBRVS,0.90 ,0.99 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11401,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0 CM,,,21 ,,RBRVS,1.28 ,1.20 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11402,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 1.1-2.0 CM,,,21 ,,RBRVS,1.45 ,1.27 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11403,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0 CM,,,21 ,,RBRVS,1.84 ,1.62 ,2.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11404,CPT,EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM,,,21 ,,RBRVS,2.11 ,1.72 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11406,CPT,EXC B9 LES MRGN XCP SK TG T/A/L > 4.0 CM,,,21 ,,RBRVS,3.52 ,2.20 ,3.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11420,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,,,21 ,,RBRVS,1.03 ,0.97 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11421,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,,,21 ,,RBRVS,1.47 ,1.22 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11422,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,,,21 ,,RBRVS,1.68 ,1.57 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11423,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,,,21 ,,RBRVS,2.06 ,1.72 ,2.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11424,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,,,21 ,,RBRVS,2.48 ,1.85 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11426,CPT,EXC B9 LES MRGN XCP SK TG S/N/H/F/G > 4.0CM,,,21 ,,RBRVS,4.09 ,2.47 ,3.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11440,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,,,21 ,,RBRVS,1.05 ,1.39 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11441,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,,,21 ,,RBRVS,1.53 ,1.63 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11442,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,,,21 ,,RBRVS,1.77 ,1.73 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11443,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,,,21 ,,RBRVS,2.34 ,1.96 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11444,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,,,21 ,,RBRVS,3.19 ,2.31 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11446,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,,,21 ,,RBRVS,4.80 ,2.99 ,4.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11450,CPT,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,,,21 ,,RBRVS,3.22 ,2.54 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11451,CPT,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,,,21 ,,RBRVS,4.43 ,3.05 ,6.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11462,CPT,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,,,21 ,,RBRVS,3.00 ,2.56 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11463,CPT,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,,,21 ,,RBRVS,4.43 ,3.19 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11470,CPT,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,,,21 ,,RBRVS,3.74 ,2.78 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11471,CPT,EXCISION H/P/P/U COMPLEX REPAIR,,,21 ,,RBRVS,4.89 ,3.22 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11600,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,,,21 ,,RBRVS,1.63 ,1.20 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11601,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,,21 ,,RBRVS,2.07 ,1.56 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11602,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,,,21 ,,RBRVS,2.27 ,1.73 ,3.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11603,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,,,21 ,,RBRVS,2.82 ,1.92 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11604,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,,,21 ,,RBRVS,3.17 ,2.01 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11606,CPT,EXCISION MALIGNANT LESION TRUNK/ARM/LEG >4.0 CM,,,21 ,,RBRVS,5.02 ,2.59 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11620,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,,,21 ,,RBRVS,1.64 ,1.24 ,2.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11621,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,,,21 ,,RBRVS,2.08 ,1.59 ,3.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11622,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,,,21 ,,RBRVS,2.41 ,1.81 ,3.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11623,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,,,21 ,,RBRVS,3.11 ,2.06 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11624,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,,,21 ,,RBRVS,3.62 ,2.22 ,4.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11626,CPT,EXCISION MALIGNANT LESION S/N/H/F/G > 4.0 CM,,,21 ,,RBRVS,4.61 ,2.58 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11640,CPT,EXCISION MALIGNANT LESION F/E/E/N/L/M 0.5 CM/<,,,21 ,,RBRVS,1.67 ,1.34 ,3.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11641,CPT,EXCISION MALIGNANT LES F/E/E/N/L/M 0.6-1.0 CM,,,21 ,,RBRVS,2.17 ,1.71 ,3.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11642,CPT,EXCISION MALIGNANT LES F/E/E/N/L/M 1.1-2.0 CM,,,21 ,,RBRVS,2.62 ,1.95 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11643,CPT,EXCISION MALIGNANT LES F/E/E/N/L/M 2.1-3.0 CM,,,21 ,,RBRVS,3.42 ,2.26 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11644,CPT,EXCISION MALIGNANT LES F/E/E/N/L/M 3.1-4.0 CM,,,21 ,,RBRVS,4.34 ,2.69 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11646,CPT,EXCISION MALIGNANT LESION F/E/E/N/L/M > 4.0 CM,,,21 ,,RBRVS,6.26 ,3.53 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11719,CPT,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,,,21 ,,RBRVS,0.17 ,0.05 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11720,CPT,DEBRIDEMENT NAIL ANY METHOD 1-5,,,21 ,,RBRVS,0.32 ,0.09 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11721,CPT,DEBRIDEMENT NAIL ANY METHOD 6/>,,,21 ,,RBRVS,0.54 ,0.16 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11730,CPT,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,,,21 ,,RBRVS,1.10 ,0.31 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11732,CPT,AVULSION NAIL PLATE PARTIAL/COMPLETE SMPL EA,,,21 ,,RBRVS,0.57 ,0.17 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11740,CPT,EVACUATION SUBUNGUAL HEMATOMA,,,21 ,,RBRVS,0.37 ,0.42 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11750,CPT,EXCISION NAIL MATRIX PERMANENT REMOVAL,,,21 ,,RBRVS,2.50 ,1.89 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11752,CPT,EXC NAIL MATRIX PRM RMVL W/AMP TUFT DSTL PHALANX,,,21 ,,RBRVS,3.63 ,2.92 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11755,CPT,BIOPSY NAIL UNIT SPX,,,21 ,,RBRVS,1.31 ,0.78 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11760,CPT,REPAIR NAIL BED,,,21 ,,RBRVS,1.63 ,1.59 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11762,CPT,RECONSTRUCTION NAIL BED W/GRAFT,,,21 ,,RBRVS,2.94 ,1.89 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11765,CPT,WEDGE EXCISION SKIN NAIL FOLD,,,21 ,,RBRVS,0.74 ,0.97 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11770,CPT,EXCISION PILONIDAL CYST/SINUS SIMPLE,,,21 ,,RBRVS,2.66 ,1.65 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11771,CPT,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,,,21 ,,RBRVS,6.09 ,3.98 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11772,CPT,EXCISION PILONIDAL CYST/SINUS COMPLICATED,,,21 ,,RBRVS,7.35 ,5.87 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11900,CPT,INJECTION INTRALESIONAL UP TO & INCL 7,,,21 ,,RBRVS,0.52 ,0.27 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11901,CPT,INJECTION INTRALESIONAL >7,,,21 ,,RBRVS,0.80 ,0.43 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11920,CPT,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,,,21 ,,RBRVS,1.61 ,1.19 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11921,CPT,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,,,21 ,,RBRVS,1.93 ,1.36 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11922,CPT,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,,,21 ,,RBRVS,0.49 ,0.25 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11950,CPT,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,,,21 ,,RBRVS,0.84 ,0.44 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11951,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,,,21 ,,RBRVS,1.19 ,0.58 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11952,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,,,21 ,,RBRVS,1.69 ,0.76 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11954,CPT,SUBCUTANEOUS INJECTION FILLING MATRL > 10.0 CC,,,21 ,,RBRVS,1.85 ,0.96 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11960,CPT,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,,,21 ,,RBRVS,11.49 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11970,CPT,REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS,,,21 ,,RBRVS,8.01 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11971,CPT,REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS,,,21 ,,RBRVS,3.41 ,4.16 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11975,CPT,INSERTION IMPLANTABLE CONTRACEPTIVE CAPSULES,,,21 ,,RBRVS,1.48 ,0.53 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11976,CPT,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,,,21 ,,RBRVS,1.78 ,0.59 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11977,CPT,RMVL W/RINSJ IMPLANTABLE CONTRACEPTIVE CAPSULES,,,21 ,,RBRVS,3.30 ,1.18 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11980,CPT,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,,,21 ,,RBRVS,1.48 ,0.54 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11981,CPT,INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,,21 ,,RBRVS,1.48 ,0.63 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11982,CPT,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,,21 ,,RBRVS,1.78 ,0.77 ,2.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,11983,CPT,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,,,21 ,,RBRVS,3.30 ,1.38 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12001,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,,,21 ,,RBRVS,1.75 ,0.81 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12002,CPT,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,,,21 ,,RBRVS,1.91 ,0.92 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12004,CPT,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,,,21 ,,RBRVS,2.29 ,1.02 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12005,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,,,21 ,,RBRVS,2.91 ,1.18 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12006,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,,,21 ,,RBRVS,3.71 ,1.44 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12007,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,,,21 ,,RBRVS,4.16 ,1.67 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12011,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,,,21 ,,RBRVS,1.81 ,0.82 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12013,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM,,,21 ,,RBRVS,2.04 ,0.96 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12014,CPT,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5CM,,,21 ,,RBRVS,2.51 ,1.07 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12015,CPT,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5CM,,,21 ,,RBRVS,3.24 ,1.23 ,3.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12016,CPT,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0CM,,,21 ,,RBRVS,3.97 ,1.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12017,CPT,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0CM,,,21 ,,RBRVS,4.75 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12018,CPT,SIMPLE REPAIR F/E/E/N/L/M >30.0CM,,,21 ,,RBRVS,5.57 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12020,CPT,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,,,21 ,,RBRVS,2.67 ,1.89 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12021,CPT,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,,,21 ,,RBRVS,1.89 ,1.42 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12031,CPT,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,,,21 ,,RBRVS,2.20 ,1.73 ,3.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12032,CPT,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,,,21 ,,RBRVS,2.52 ,2.29 ,4.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12034,CPT,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,,,21 ,,RBRVS,2.97 ,2.01 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12035,CPT,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,,,21 ,,RBRVS,3.47 ,2.28 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12036,CPT,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,,,21 ,,RBRVS,4.09 ,2.46 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12037,CPT,REPAIR INTERMEDIATE S/A/T/E > 30.0 CM,,,21 ,,RBRVS,4.71 ,2.89 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12041,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,,,21 ,,RBRVS,2.42 ,1.77 ,3.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12042,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,,,21 ,,RBRVS,2.79 ,2.12 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12044,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,,,21 ,,RBRVS,3.19 ,2.01 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12045,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,,,21 ,,RBRVS,3.68 ,2.28 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12046,CPT,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,,,21 ,,RBRVS,4.29 ,2.83 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12047,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,,,21 ,,RBRVS,4.69 ,3.14 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12051,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.5 CM/<,,,21 ,,RBRVS,2.52 ,1.95 ,4.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12052,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.6-5.0 CM,,,21 ,,RBRVS,2.87 ,2.46 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12053,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 5.1-7.5 CM,,,21 ,,RBRVS,3.17 ,2.14 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12054,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 7.6-12.5 CM,,,21 ,,RBRVS,3.50 ,2.09 ,5.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12055,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 12.6-20.0CM,,,21 ,,RBRVS,4.47 ,2.28 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12056,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 20.1-30.0CM,,,21 ,,RBRVS,5.28 ,2.61 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,12057,CPT,REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC > 30.0 CM,,,21 ,,RBRVS,6.00 ,3.35 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13100,CPT,REPAIR COMPLEX TRUNK 1.1 CM-2.5 CM,,,21 ,,RBRVS,3.17 ,2.62 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13101,CPT,REPAIR COMPLEX TRUNK 2.6 CM-7.5 CM,,,21 ,,RBRVS,3.96 ,3.10 ,5.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13102,CPT,REPAIR COMPLEX TRUNK EA 5 CM/<,,,21 ,,RBRVS,1.24 ,0.60 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13120,CPT,REPAIR COMPLEX SCALP/ARM/LEG 1.1 CM-2.5 CM,,,21 ,,RBRVS,3.35 ,2.71 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13121,CPT,REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5 CM,,,21 ,,RBRVS,4.42 ,3.67 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13122,CPT,REPAIR COMPLEX SCALP/ARM/LEG EA 5 CM/<,,,21 ,,RBRVS,1.44 ,0.66 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13131,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1 CM-2.5 CM,,,21 ,,RBRVS,3.83 ,3.02 ,4.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13132,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 CM-7.5 CM,,,21 ,,RBRVS,6.58 ,5.11 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13133,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA 5 CM/<,,,21 ,,RBRVS,2.19 ,1.11 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13150,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.0 CM/<,,,21 ,,RBRVS,3.85 ,2.92 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13151,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,,,21 ,,RBRVS,4.49 ,3.42 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13152,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,,,21 ,,RBRVS,6.37 ,4.26 ,7.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13153,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP EA 5 CM/<,,,21 ,,RBRVS,2.38 ,1.17 ,2.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,13160,CPT,SEC CLSR SURG WOUND/DEHSN EXTENSIVE/COMPLICATED,,,21 ,,RBRVS,12.04 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14000,CPT,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 CM/<,,,21 ,,RBRVS,6.37 ,5.99 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14001,CPT,ATT/REARRANGEMENT TRUNK 10.1-30.0CM,,,21 ,,RBRVS,8.78 ,7.51 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14020,CPT,ATT/REARRANGEMENT SCALP/ARM/LEG 10 CM/<,,,21 ,,RBRVS,7.22 ,6.92 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14021,CPT,ATT/REARRANGEMENT SCALP/ARM/LEG 10.1-30.0 CM,,,21 ,,RBRVS,9.72 ,8.43 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14040,CPT,ATT/REARRANGEMENT F/C/C/M/N/AX/G/H/F 10 CM/<,,,21 ,,RBRVS,8.60 ,7.44 ,10.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14041,CPT,ATT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0CM,,,21 ,,RBRVS,10.83 ,8.97 ,12.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14060,CPT,ATT/REARGMT E/N/E/L DFCT 10 CM/<,,,21 ,,RBRVS,9.23 ,7.70 ,9.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14061,CPT,ATT/REARGMT EYELID/NOSE/EAR/LIP 10.1-30.0 CM,,,21 ,,RBRVS,11.48 ,9.67 ,13.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14301,CPT,ATT/R ANY AREA DEFECT 30.1-60SQCM,,,21 ,,RBRVS,12.65 ,9.98 ,14.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14302,CPT,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,,,21 ,,RBRVS,3.73 ,2.09 ,2.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,14350,CPT,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,,,21 ,,RBRVS,11.05 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15002,CPT,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,,,21 ,,RBRVS,3.65 ,1.86 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15003,CPT,PREP SITE T/A/L ADDL 100 SQ CM/1PCT,,,21 ,,RBRVS,0.80 ,0.31 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15004,CPT,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,,,21 ,,RBRVS,4.58 ,2.26 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15005,CPT,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,,,21 ,,RBRVS,1.60 ,0.60 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15040,CPT,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,,,21 ,,RBRVS,2.00 ,1.13 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15050,CPT,PINCH GRAFT 1/MLT C> SM ULCER TIP/OTH AREA 2CM,,,21 ,,RBRVS,5.57 ,5.32 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15100,CPT,SPLIT AGRFT T/A/L 1ST 100 CM/</1% BDY INFT/CHLD,,,21 ,,RBRVS,9.90 ,7.45 ,10.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15101,CPT,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,,21 ,,RBRVS,1.72 ,0.99 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15110,CPT,EPIDRM AGRFT T/A/L 1ST 100 CM/</1% BDY INFT/CHLD,,,21 ,,RBRVS,10.97 ,6.85 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15111,CPT,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,,21 ,,RBRVS,1.85 ,0.73 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15115,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM,,,21 ,,RBRVS,11.28 ,7.24 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15116,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA,,,21 ,,RBRVS,2.50 ,1.16 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15120,CPT,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM<1 %,,,21 ,,RBRVS,11.16 ,8.09 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15121,CPT,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,,,21 ,,RBRVS,2.67 ,1.50 ,3.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15130,CPT,DERMAL AUTOGRAFT TRUNK/ARM/LEG 1ST 100 CM,,,21 ,,RBRVS,7.53 ,6.05 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15131,CPT,DERMAL AUTOGRAFT TRUNK/ARM/LEG EA 100 CM/EA,,,21 ,,RBRVS,1.50 ,0.59 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15135,CPT,DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100,,,21 ,,RBRVS,11.03 ,7.65 ,9.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15136,CPT,DERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA,,,21 ,,RBRVS,1.50 ,0.52 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15150,CPT,CLTR EPIDERMAL AUTOGRAFT T/A/L 1ST 25 CM/<,,,21 ,,RBRVS,9.39 ,5.93 ,7.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15151,CPT,CLTR EPIDERMAL AGRFT T/A/L ADDL 1 CM-75 CM,,,21 ,,RBRVS,2.00 ,0.77 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15152,CPT,CLTR EPIDRM AGRFT T/A/L EA 100 CM/EA 1 % BDY,,,21 ,,RBRVS,2.50 ,1.11 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15155,CPT,CLTR EPIDRM AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<,,,21 ,,RBRVS,10.14 ,5.85 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15156,CPT,CLTR EPIDRM AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM,,,21 ,,RBRVS,2.75 ,1.25 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15157,CPT,CLTR EPIDRM AGRFT F/S/N/H/F/G/M/D GT EA 100 EA,,,21 ,,RBRVS,3.00 ,1.28 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15170,CPT,ACLR DRM RPLCMT T/A/L 1ST 100 CM/</1 % BDY,,,21 ,,RBRVS,5.99 ,2.95 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15171,CPT,ACLR DRM RPLCMT T/A/L EA 100 CM/EA 1 % BDY,,,21 ,,RBRVS,1.55 ,0.59 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15175,CPT,ACLR DRM RPLCMT F/S/N/H/F/G/M/D GT 1ST 100 CM,,,21 ,,RBRVS,7.99 ,3.59 ,4.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15176,CPT,ACLR DRM RPLCMT F/S/N/H/F/G/M/D GT EA 100 CM/EA,,,21 ,,RBRVS,2.45 ,0.94 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15200,CPT,FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<,,,21 ,,RBRVS,9.15 ,6.99 ,10.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15201,CPT,FTH/GFT FR W/DIR CLSR TRNK EA 20 CM,,,21 ,,RBRVS,1.32 ,0.60 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15220,CPT,FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<,,,21 ,,RBRVS,8.09 ,7.10 ,10.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15221,CPT,FTH/GFT FR W/DIR CLSR S/A/L EA 20 CM,,,21 ,,RBRVS,1.19 ,0.59 ,2.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15240,CPT,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<,,,21 ,,RBRVS,10.41 ,9.26 ,12.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15241,CPT,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA 20CM,,,21 ,,RBRVS,1.86 ,0.93 ,2.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15260,CPT,FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 CM/<,,,21 ,,RBRVS,11.64 ,9.79 ,12.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15261,CPT,FTH/GFT FR W/DIR CLSR N/E/E/L EA 20 CM,,,21 ,,RBRVS,2.23 ,1.33 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15300,CPT,ALGRFT TEMPORARY CLOSURE T/A/L 1ST 100 CM/</1,,,21 ,,RBRVS,4.65 ,2.41 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15301,CPT,ALGRFT TEMPORARY CLOSURE T/A/L EA 100 CM/EA,,,21 ,,RBRVS,1.00 ,0.40 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15320,CPT,ALGRFT TEMP CLOSURE F/S/N/H/F/G/M/D 1ST 100CM,,,21 ,,RBRVS,5.36 ,2.53 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15321,CPT,ALGRFT TEMP CLOSURE F/S/N/H/F/G/M/D EA 100CM,,,21 ,,RBRVS,1.50 ,0.60 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15330,CPT,ACLR DERMAL ALLOGRAFT TRUNK/ARM/LEG 1ST 100 CM,,,21 ,,RBRVS,3.99 ,2.40 ,3.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15331,CPT,ACLR DERMAL ALLOGRAFT TRUNK/ARM/LEG EA 100CM/EA,,,21 ,,RBRVS,1.00 ,0.41 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15335,CPT,ACLR DRM ALLOGRAFT F/S/N/H/F/G/M/D GT 1ST 100CM,,,21 ,,RBRVS,4.50 ,2.19 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15336,CPT,ACLR DRM ALGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA,,,21 ,,RBRVS,1.43 ,0.44 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15340,CPT,TISSUE CULTURED ALLOGENEIC SKIN 1ST 25CM/<,,,21 ,,RBRVS,3.82 ,2.80 ,3.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15341,CPT,TISS CLTR ALGC SKN EA 25 CM,,,21 ,,RBRVS,0.50 ,0.16 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15360,CPT,TISSUE CLTR ALGC DRM TRUNK/ARM/LEG 1ST 100 CM,,,21 ,,RBRVS,4.02 ,3.47 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15361,CPT,TISSUE CLTR ALGC DERMAL T/A/L EA 100CM/EA 1 PCT,,,21 ,,RBRVS,1.15 ,0.39 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15365,CPT,TISS CLTR ALGC DRM F/S/N/H/F/G/M/D 1ST 100 CM,,,21 ,,RBRVS,4.30 ,3.12 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15366,CPT,TISS CLTR ALGC DRM F/S/N/H/F/G/M/D EA 100 CM,,,21 ,,RBRVS,1.45 ,0.45 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15400,CPT,XENOGRAFT TEMP CLOSURE TRUNK/ARM/LEG 1ST 100CM,,,21 ,,RBRVS,4.47 ,4.23 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15401,CPT,XENOGRAFT TEMP CLOSURE TRUNK/ARM/LEG EA 100CM,,,21 ,,RBRVS,1.00 ,0.38 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15420,CPT,XENOGRF TEMP CLOSURE F/S/N/H/F/G/M/D 1ST 100CM,,,21 ,,RBRVS,4.98 ,4.61 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15421,CPT,XENOGRAFT TEMP CLOSURE F/S/N/H/F/G/M/D EA 100CM,,,21 ,,RBRVS,1.50 ,0.57 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15430,CPT,ACELLULAR XENOGRAFT IMPLANT 1ST 100 CM/1 PCT,,,21 ,,RBRVS,6.20 ,6.33 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15431,CPT,ACELLULAR XENOGRAFT IMPLANT EA 100 CM/1 PCT,,,21 ,,TotalUnits,,,,4.86 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,15570,CPT,FRMJ DIRECT/TUBED PEDICLE +-TRANSFER TRUNK,,,21 ,,RBRVS,10.21 ,7.17 ,11.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15572,CPT,FRMJ DIRECT/TUBED PEDICLE +-TR SCALP ARMS/LEGS,,,21 ,,RBRVS,10.12 ,7.62 ,10.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15574,CPT,FRMJ DIR/TUBED PEDCL +-TR FT/CH/CH/M/N/AX/G/H/F,,,21 ,,RBRVS,10.70 ,8.04 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15576,CPT,FRMJ DIRECT/TUBED PEDICLE +-TR E/N/E/L/NTRORAL,,,21 ,,RBRVS,9.37 ,7.17 ,10.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15600,CPT,DELAY FLAP/SECTIONING FLAP TRUNK,,,21 ,,RBRVS,2.01 ,2.94 ,5.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15610,CPT,DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS,,,21 ,,RBRVS,2.52 ,3.29 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15620,CPT,DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F,,,21 ,,RBRVS,3.75 ,4.10 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15630,CPT,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,,,21 ,,RBRVS,4.08 ,4.48 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15650,CPT,TRANSFER ANY PEDICLE FLAP ANY LOCATION,,,21 ,,RBRVS,4.77 ,4.78 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15731,CPT,FOREHEAD FLAP W/ PRESERVATION VASCULAR PEDICLE,,,21 ,,RBRVS,14.38 ,10.75 ,13.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15732,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NCK,,,21 ,,RBRVS,19.90 ,12.57 ,16.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15734,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,,,21 ,,RBRVS,19.86 ,12.88 ,17.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15736,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,,,21 ,,RBRVS,17.04 ,11.01 ,15.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15738,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,,,21 ,,RBRVS,19.04 ,11.45 ,15.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15740,CPT,FLAP ISLAND PEDICLE,,,21 ,,RBRVS,11.80 ,9.77 ,13.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15750,CPT,FLAP NEUROVASCULAR PEDICLE,,,21 ,,RBRVS,12.96 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15756,CPT,FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST,,,21 ,,RBRVS,36.94 ,21.03 ,21.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15757,CPT,FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS,,,21 ,,RBRVS,37.15 ,20.65 ,20.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15758,CPT,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,,,21 ,,RBRVS,36.90 ,20.63 ,20.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15760,CPT,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,,,21 ,,RBRVS,9.86 ,7.65 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15770,CPT,GRAFT DERMA-FAT-FASCIA,,,21 ,,RBRVS,8.96 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15775,CPT,PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS,,,21 ,,RBRVS,3.95 ,1.66 ,3.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15776,CPT,PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS,,,21 ,,RBRVS,5.53 ,2.43 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15780,CPT,DERMABRASION TOTAL FACE,,,21 ,,RBRVS,8.73 ,7.17 ,11.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15781,CPT,DERMABRASION SEGMENTAL FACE,,,21 ,,RBRVS,5.02 ,5.60 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15782,CPT,DERMABRASION REGIONAL OTHER THAN FACE,,,21 ,,RBRVS,4.44 ,5.86 ,9.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15783,CPT,DERMABRASION SUPERFICIAL ANY SITE,,,21 ,,RBRVS,4.41 ,4.82 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15786,CPT,ABRASION 1 LESION,,,21 ,,RBRVS,2.08 ,1.38 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15787,CPT,ABRASION EACH ADDITIONAL 4 LESIONS OR LESS,,,21 ,,RBRVS,0.33 ,0.13 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15788,CPT,CHEMICAL PEEL FACIAL EPIDERMAL,,,21 ,,RBRVS,2.09 ,3.84 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15789,CPT,CHEMICAL PEEL FACIAL DERMAL,,,21 ,,RBRVS,4.91 ,5.59 ,8.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15792,CPT,CHEMICAL PEEL NONFACIAL EPIDERMAL,,,21 ,,RBRVS,1.86 ,4.57 ,8.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15793,CPT,CHEMICAL PEEL NONFACIAL DERMAL,,,21 ,,RBRVS,3.96 ,4.96 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15819,CPT,CERVICOPLASTY,,,21 ,,RBRVS,10.65 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15820,CPT,BLEPHAROPLASTY LOWER EYELID,,,21 ,,RBRVS,6.27 ,5.85 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15821,CPT,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,,,21 ,,RBRVS,6.84 ,6.02 ,7.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15822,CPT,BLEPHAROPLASTY UPPER EYELID,,,21 ,,RBRVS,4.62 ,4.60 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15823,CPT,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,,,21 ,,RBRVS,8.32 ,6.96 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15824,CPT,RHYTIDECTOMY FOREHEAD,,,21 ,,RBRVS,15.63 ,10.69 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15825,CPT,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,,,21 ,,RBRVS,17.58 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15826,CPT,RHYTIDECTOMY GLABELLAR FROWN LINES,,,21 ,,RBRVS,12.70 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15828,CPT,RHYTIDECTOMY CHEEK CHIN&NECK,,,21 ,,RBRVS,33.21 ,22.72 ,22.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15829,CPT,RHYTIDECTOMY SMAS FLAP,,,21 ,,RBRVS,37.12 ,25.39 ,25.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15830,CPT,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,,,21 ,,RBRVS,17.11 ,10.89 ,10.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15832,CPT,EXCISION EXCESSIVE SKIN&SUBQ TISSUE THIGH,,,21 ,,RBRVS,12.85 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15833,CPT,EXCISION EXCESSIVE SKIN&SUBQ TISSUE LEG,,,21 ,,RBRVS,11.90 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15834,CPT,EXCISION EXCESSIVE SKIN&SUBQ TISSUE HIP,,,21 ,,RBRVS,12.17 ,8.48 ,8.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15835,CPT,EXCISION EXCESSIVE SKIN&SUBQ TISSUE BUTTOCK,,,21 ,,RBRVS,12.99 ,8.88 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15836,CPT,EXCISION EXCESSIVE SKIN&SUBQ TISSUE ARM,,,21 ,,RBRVS,10.61 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15837,CPT,EXC EXCESSIVE SKIN&SUBQ TISSUE FOREARM/HAND,,,21 ,,RBRVS,9.55 ,6.56 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15838,CPT,EXC EXCSV SKIN&SUBQ TISSUE SUBMENTAL FAT PAD,,,21 ,,RBRVS,8.25 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15839,CPT,EXCISION EXCESSIVE SKIN&SUBQ TISSUE OTHER AREA,,,21 ,,RBRVS,10.50 ,7.18 ,10.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15840,CPT,GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT,,,21 ,,RBRVS,14.99 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15841,CPT,GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT,,,21 ,,RBRVS,25.99 ,15.29 ,15.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15842,CPT,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,,,21 ,,RBRVS,41.01 ,22.03 ,22.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15845,CPT,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,,,21 ,,RBRVS,14.32 ,9.83 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15847,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN,,,21 ,,TotalUnits,,,,8.44 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,15850,CPT,REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON,,,21 ,,RBRVS,0.78 ,0.28 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15851,CPT,REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON,,,21 ,,RBRVS,0.86 ,0.29 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15852,CPT,DRESSING CHANGE UNDER ANESTHESIA,,,21 ,,RBRVS,0.86 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15860,CPT,IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT,,,21 ,,RBRVS,1.95 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15876,CPT,SUCTION ASSISTED LIPECTOMY HEAD&NECK,,,21 ,,TotalUnits,,,,21.15 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,15877,CPT,SUCTION ASSISTED LIPECTOMY TRUNK,,,21 ,,TotalUnits,,,,11.22 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,15878,CPT,SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY,,,21 ,,TotalUnits,,,,13.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,15879,CPT,SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,,,21 ,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,15920,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,,,21 ,,RBRVS,8.29 ,5.99 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15922,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR,,,21 ,,RBRVS,10.38 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15931,CPT,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,,,21 ,,RBRVS,10.07 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15933,CPT,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,,,21 ,,RBRVS,11.77 ,8.19 ,8.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15934,CPT,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,,,21 ,,RBRVS,13.68 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15935,CPT,EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY,,,21 ,,RBRVS,15.78 ,10.60 ,10.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15936,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,,,21 ,,RBRVS,13.16 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15937,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,,,21 ,,RBRVS,15.14 ,9.80 ,9.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15940,CPT,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,,,21 ,,RBRVS,10.20 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15941,CPT,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,,,21 ,,RBRVS,12.41 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15944,CPT,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,,,21 ,,RBRVS,12.44 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15945,CPT,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,,21 ,,RBRVS,13.75 ,9.89 ,9.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15946,CPT,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,,,21 ,,RBRVS,24.12 ,15.28 ,15.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15950,CPT,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,,,21 ,,RBRVS,8.03 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15951,CPT,EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY,,,21 ,,RBRVS,11.58 ,7.89 ,7.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15952,CPT,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,,,21 ,,RBRVS,12.31 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15953,CPT,EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,,21 ,,RBRVS,13.57 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15956,CPT,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,,,21 ,,RBRVS,16.79 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15958,CPT,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,,,21 ,,RBRVS,16.75 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,15999,CPT,UNLISTED PROCEDURE EXCISION PRESSURE ULCER,,,21 ,,TotalUnits,,,,22.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,16000,CPT,INITIAL TX 1ST DEGREE BURN LOCAL TX,,,21 ,,RBRVS,0.89 ,0.27 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,16020,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,,,21 ,,RBRVS,0.80 ,0.60 ,1.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,16025,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,,,21 ,,RBRVS,1.85 ,0.98 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,16030,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,,,21 ,,RBRVS,2.08 ,1.13 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,16035,CPT,ESCHAROTOMY FIRST INCISION,,,21 ,,RBRVS,3.74 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,16036,CPT,ESCHAROTOMY EACH ADDITIONAL INCISION,,,21 ,,RBRVS,1.50 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17000,CPT,DESTRUCTION PREMALIGNANT LESION 1ST,,,21 ,,RBRVS,0.65 ,0.73 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17003,CPT,DESTRUCTION PREMALIGNANT LESION 2-14 EA,,,21 ,,RBRVS,0.07 ,0.04 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17004,CPT,DESTRUCTION PREMALIGNANT LESION 15/>,,,21 ,,RBRVS,1.85 ,1.50 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17106,CPT,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,,,21 ,,RBRVS,3.69 ,3.20 ,4.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17107,CPT,DESTRUCTION CUTANEOUS VASCULAR PRLF 10.0-50.0CM,,,21 ,,RBRVS,4.79 ,4.13 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17108,CPT,DESTRUCTION CUTANEOUS VASCULAR PRLF >50.0CM,,,21 ,,RBRVS,7.49 ,5.40 ,7.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17110,CPT,DESTRUCTION BENIGN LESIONS UP TO 14,,,21 ,,RBRVS,0.70 ,1.01 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17111,CPT,DESTRUCTION BENIGN LESIONS 15/>,,,21 ,,RBRVS,0.97 ,1.15 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17250,CPT,CHEMICAL CAUTERIZATION GRANULATION TISSUE,,,21 ,,RBRVS,0.50 ,0.39 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17260,CPT,DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,,,21 ,,RBRVS,0.96 ,0.74 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17261,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,,21 ,,RBRVS,1.22 ,1.07 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17262,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,,,21 ,,RBRVS,1.63 ,1.29 ,2.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17263,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,,,21 ,,RBRVS,1.84 ,1.39 ,2.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17264,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,,,21 ,,RBRVS,1.99 ,1.46 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17266,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM,,,21 ,,RBRVS,2.39 ,1.63 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17270,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,,,21 ,,RBRVS,1.37 ,1.11 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17271,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,,,21 ,,RBRVS,1.54 ,1.24 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17272,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,,,21 ,,RBRVS,1.82 ,1.40 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17273,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,,,21 ,,RBRVS,2.10 ,1.53 ,3.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17274,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM,,,21 ,,RBRVS,2.64 ,1.81 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17276,CPT,DSTRJ MAL LES S/N/H/F/G LES DIAM > 4.0 CM,,,21 ,,RBRVS,3.25 ,2.07 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17280,CPT,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,,,21 ,,RBRVS,1.22 ,1.04 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17281,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM,,,21 ,,RBRVS,1.77 ,1.36 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17282,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,,,21 ,,RBRVS,2.09 ,1.54 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17283,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,,,21 ,,RBRVS,2.69 ,1.84 ,3.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17284,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM,,,21 ,,RBRVS,3.26 ,2.13 ,3.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17286,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M > 4.0 CM,,,21 ,,RBRVS,4.48 ,2.72 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17311,CPT,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,,,21 ,,RBRVS,6.20 ,3.43 ,10.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17312,CPT,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,,,21 ,,RBRVS,3.30 ,1.82 ,6.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17313,CPT,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,,,21 ,,RBRVS,5.56 ,3.08 ,9.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17314,CPT,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,,,21 ,,RBRVS,3.06 ,1.69 ,6.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17315,CPT,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,,,21 ,,RBRVS,0.87 ,0.48 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17340,CPT,CRYOTHERAPY CO2 SLUSH LIQ N2 ACNE,,,21 ,,RBRVS,0.77 ,0.40 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17360,CPT,CHEMICAL EXFOLIATION ACNE,,,21 ,,TotalUnits,,,,2.12 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,17380,CPT,ELECTROLYSIS EPILATION EA 30 MINUTES,,,21 ,,RBRVS,1.09 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,17999,CPT,UNLISTED PX SKIN MUC MEMBRANE &SUBQ TISSUE,,,21 ,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,19000,CPT,PUNCTURE ASPIRATION CYST BREAST,,,21 ,,RBRVS,0.84 ,0.30 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19001,CPT,PUNCTURE ASPIRATION BREAST EA ADDL CYST,,,21 ,,RBRVS,0.42 ,0.15 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19020,CPT,MASTOTOMY W/EXPL/DRAINAGE ABSCESS DEEP,,,21 ,,RBRVS,3.83 ,3.18 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19030,CPT,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,,,21 ,,RBRVS,1.53 ,0.55 ,2.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19100,CPT,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,,,21 ,,RBRVS,1.27 ,0.40 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19101,CPT,BIOPSY BREAST OPEN INCISIONAL,,,21 ,,RBRVS,3.23 ,1.96 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19102,CPT,BIOPSY BREAST NEEDLE CORE W/IMAGING GUIDANCE,,,21 ,,RBRVS,2.00 ,0.71 ,3.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19103,CPT,BREAST BIOPSY VACUUM ASSISTED/ROTATING DEVICE,,,21 ,,RBRVS,3.69 ,1.28 ,10.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19105,CPT,ABLTJ CRYOSURGICAL W/ US GID EA FIBROADENOMA,,,21 ,,RBRVS,3.69 ,1.32 ,49.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19110,CPT,NIPPLE EXPLORATION,,,21 ,,RBRVS,4.44 ,3.43 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19112,CPT,EXCISION LACTIFEROUS DUCT FISTULA,,,21 ,,RBRVS,3.81 ,3.31 ,6.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19120,CPT,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LES,,,21 ,,RBRVS,5.92 ,3.62 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19125,CPT,EXC BRST LES PREOP PLMT RAD MARKER OPN 1 LES,,,21 ,,RBRVS,6.69 ,3.92 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19126,CPT,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,,,21 ,,RBRVS,2.93 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19260,CPT,EXCISION CHEST WALL TUMOR INCLUDING RIBS,,,21 ,,RBRVS,17.78 ,11.11 ,11.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19271,CPT,EXC CHEST TUMOR W/RCNSTJ W/O MEDSTNL LMPHADEC,,,21 ,,RBRVS,22.19 ,17.30 ,17.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19272,CPT,EXC CHEST TUMOR W/RCNSTJ W/MEDSTNL LMPHADEC,,,21 ,,RBRVS,25.17 ,18.36 ,18.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19290,CPT,PREOP PLACEMENT LOCALIZATION WIRE BREAST,,,21 ,,RBRVS,1.27 ,0.46 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19291,CPT,PREOP PLMT LOCALIZATION WIRE BREAST EA LESION,,,21 ,,RBRVS,0.63 ,0.22 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19295,CPT,IMG GID PLMT MTLC LOCLZJ CLIP PRQ BRST BX/ASPIR,,,21 ,,RBRVS,,2.31 ,2.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,19296,CPT,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,,,21 ,,RBRVS,3.63 ,1.42 ,95.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19297,CPT,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,,,21 ,,RBRVS,1.72 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19298,CPT,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,,,21 ,,RBRVS,6.00 ,2.39 ,26.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19300,CPT,MASTECTOMY GYNECOMASTIA,,,21 ,,RBRVS,5.31 ,4.06 ,6.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19301,CPT,MASTECTOMY PARTIAL,,,21 ,,RBRVS,10.13 ,4.89 ,4.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19302,CPT,MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY,,,21 ,,RBRVS,13.99 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19303,CPT,MASTECTOMY SIMPLE COMPLETE,,,21 ,,RBRVS,15.85 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19304,CPT,MASTECTOMY SUBCUTANEOUS,,,21 ,,RBRVS,7.95 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19305,CPT,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,,,21 ,,RBRVS,17.46 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19306,CPT,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,,,21 ,,RBRVS,18.13 ,9.59 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19307,CPT,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,,,21 ,,RBRVS,18.23 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19316,CPT,MASTOPEXY,,,21 ,,RBRVS,11.09 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19318,CPT,REDUCTION MAMMAPLASTY,,,21 ,,RBRVS,16.03 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19324,CPT,MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT,,,21 ,,RBRVS,6.80 ,4.77 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19325,CPT,MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT,,,21 ,,RBRVS,8.64 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19328,CPT,REMOVAL INTACT MAMMARY IMPLANT,,,21 ,,RBRVS,6.48 ,5.38 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19330,CPT,REMOVAL MAMMARY IMPLANT MATERIAL,,,21 ,,RBRVS,8.54 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19340,CPT,IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,,21 ,,RBRVS,13.99 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19342,CPT,DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,,21 ,,RBRVS,12.63 ,9.69 ,9.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19350,CPT,NIPPLE/AREOLA RECONSTRUCTION,,,21 ,,RBRVS,9.11 ,7.21 ,11.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19355,CPT,CORRECTION INVERTED NIPPLES,,,21 ,,RBRVS,8.52 ,5.09 ,8.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19357,CPT,BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ,,,21 ,,RBRVS,21.07 ,16.67 ,16.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19361,CPT,BRST RCNSTJ W/LATSMS D/SI FLAP WO PRSTHC IMPL,,,21 ,,RBRVS,23.36 ,17.21 ,17.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19364,CPT,BREAST RECONSTRUCTION FREE FLAP,,,21 ,,RBRVS,42.58 ,24.95 ,24.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19366,CPT,BREAST RECONSTRUCTION OTHER TECHNIQUE,,,21 ,,RBRVS,21.84 ,11.38 ,11.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19367,CPT,BREAST RECONSTRUCTION TRAM FLAP 1 PEDICLE,,,21 ,,RBRVS,26.80 ,16.96 ,16.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19368,CPT,BREAST RECONSTRUCTION TRAM 1 PEDCL MVASC ANAST,,,21 ,,RBRVS,33.90 ,20.12 ,20.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19369,CPT,BREAST RECONSTRUCTION TRAM FLAP DOUBLE PEDICLE,,,21 ,,RBRVS,31.31 ,18.45 ,18.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19370,CPT,OPEN PERIPROSTHETIC CAPSULOTOMY BREAST,,,21 ,,RBRVS,9.17 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19371,CPT,PERIPROSTHETIC CAPSULECTOMY BREAST,,,21 ,,RBRVS,10.62 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19380,CPT,REVISION RECONSTRUCTED BREAST,,,21 ,,RBRVS,10.41 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19396,CPT,PREPARATION MOULAGE CUSTOM BREAST IMPLANT,,,21 ,,RBRVS,2.17 ,1.03 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,19499,CPT,UNLISTED PROCEDURE BREAST,,,21 ,,TotalUnits,,,,6.06 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20005,CPT,INCISION SOFT TISSUE ABSCESS DEEP/COMPLICATED,,,21 ,,RBRVS,3.58 ,2.20 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20100,CPT,EXPLORATION PENETRATING WOUND SPX NECK,,,21 ,,RBRVS,10.38 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20101,CPT,EXPLORATION PENETRATING WOUND SPX CHEST,,,21 ,,RBRVS,3.23 ,1.62 ,6.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20102,CPT,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,,,21 ,,RBRVS,3.98 ,2.06 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20103,CPT,EXPLORATION PENETRATING WOUND SPX EXTREMITY,,,21 ,,RBRVS,5.34 ,3.17 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,2010F,CPT,VITAL SIGNS RECORDED,,,14 ,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,2014F,CPT,MENTAL STATUS ASSESSED,,,14 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20150,CPT,EXCISION EPIPHYSEAL BAR,,,21 ,,RBRVS,14.75 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,2019F,CPT,DILATED MACULAR EXAM PERFORMED,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20200,CPT,BIOPSY MUSCLE SUPERFICIAL,,,21 ,,RBRVS,1.46 ,0.77 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20205,CPT,BIOPSY MUSCLE DEEP,,,21 ,,RBRVS,2.35 ,1.24 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20206,CPT,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,,,21 ,,RBRVS,0.99 ,0.60 ,5.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,2020F,CPT,DILATED FUNDUS EVALUATION PERFORMED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,2021F,CPT,DILATED MACULAR OR FUNDUS EXAM PERFORMED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20220,CPT,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,,,21 ,,RBRVS,1.27 ,0.71 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20225,CPT,BIOPSY BONE TROCAR/NEEDLE DEEP,,,21 ,,RBRVS,1.87 ,1.08 ,14.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,2022F,CPT,DILAT RETINAL EYE EXAM W/INTERPJ,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20240,CPT,BIOPSY BONE OPEN SUPERFICIAL,,,21 ,,RBRVS,3.28 ,2.28 ,2.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20245,CPT,BIOPSY BONE OPEN DEEP,,,21 ,,RBRVS,8.95 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20250,CPT,BIOPSY VERTEBRAL BODY OPEN THORACIC,,,21 ,,RBRVS,5.19 ,3.77 ,3.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20251,CPT,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,,,21 ,,RBRVS,5.72 ,4.16 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,2027F,CPT,OPTIC NERVE HEAD EVALUATION PERFORMED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20500,CPT,INJECTION SINUS TRACT THERAPEUTIC SPX,,,21 ,,RBRVS,1.28 ,1.03 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20501,CPT,INJECTION SINUS TRACT DIAGNOSTIC,,,21 ,,RBRVS,0.76 ,0.28 ,2.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20520,CPT,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,,,21 ,,RBRVS,1.90 ,1.61 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20525,CPT,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,,,21 ,,RBRVS,3.54 ,2.47 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20526,CPT,INJECTION THERAPEUTIC CARPAL TUNNEL,,,21 ,,RBRVS,0.94 ,0.47 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20550,CPT,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,,,21 ,,RBRVS,0.75 ,0.29 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20551,CPT,INJECTION SINGLE TENDON ORIGIN/INSERTION,,,21 ,,RBRVS,0.75 ,0.32 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20552,CPT,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,,,21 ,,RBRVS,0.66 ,0.27 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20553,CPT,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,,,21 ,,RBRVS,0.75 ,0.29 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20555,CPT,PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT,,,21 ,,RBRVS,6.00 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20600,CPT,ARTHROCENTESIS ASPIR&/INJECTION SMALL JT/BURSA,,,21 ,,RBRVS,0.66 ,0.33 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20605,CPT,ARTHROCENTESIS ASPIR&/INJECTION INTERM JT/BURSA,,,21 ,,RBRVS,0.68 ,0.35 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20610,CPT,ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA,,,21 ,,RBRVS,0.79 ,0.44 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20612,CPT,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATION,,,21 ,,RBRVS,0.70 ,0.36 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20615,CPT,ASPIRATION&INJECTION TREATMENT BONE CYST,,,21 ,,RBRVS,2.33 ,1.61 ,3.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20650,CPT,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,,,21 ,,RBRVS,2.28 ,1.53 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20660,CPT,APPLICATION CRANIAL TONG/STRTCTC FRAME W/REMOVAL,,,21 ,,RBRVS,4.00 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20661,CPT,APPLICATION HALO CRANIAL INCLUDING REMOVAL,,,21 ,,RBRVS,5.26 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20662,CPT,APPLICATION HALO PELVIC INCLUDING REMOVAL,,,21 ,,RBRVS,6.38 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20663,CPT,APPLICATION HALO FEMORAL INCLUDING REMOVAL,,,21 ,,RBRVS,5.74 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20664,CPT,APPL HALO 6/> PINS THIN SKULL OSTEOLOGY ANES,,,21 ,,RBRVS,10.06 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20665,CPT,REMOVAL TONG/HALO APPLIED BY ANOTHER PHYSICIAN,,,21 ,,RBRVS,1.36 ,1.09 ,1.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20670,CPT,REMOVAL IMPLANT SUPERFICIAL SPX,,,21 ,,RBRVS,1.79 ,1.84 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20680,CPT,REMOVAL IMPLANT DEEP,,,21 ,,RBRVS,5.96 ,4.29 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20690,CPT,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,,,21 ,,RBRVS,8.78 ,4.95 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20692,CPT,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,,,21 ,,RBRVS,16.27 ,9.61 ,9.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20693,CPT,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,,,21 ,,RBRVS,6.06 ,5.03 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20694,CPT,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,,,21 ,,RBRVS,4.28 ,3.88 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20696,CPT,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST&SUBQ,,,21 ,,RBRVS,17.56 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20697,CPT,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,,,21 ,,RBRVS,,34.94 ,34.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,20802,CPT,REPLANTATION ARM COMPLETE AMPUTATION,,,21 ,,RBRVS,42.62 ,17.97 ,17.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20805,CPT,REPLANTATION FOREARM COMPLETE AMPUTATION,,,21 ,,RBRVS,51.46 ,24.34 ,24.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20808,CPT,REPLANTATION HAND COMPLETE AMPUTATION,,,21 ,,RBRVS,63.09 ,37.96 ,37.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20816,CPT,RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP,,,21 ,,RBRVS,31.95 ,22.08 ,22.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20822,CPT,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,,,21 ,,RBRVS,26.66 ,19.17 ,19.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20824,CPT,RPLJ THMB CARP/MTCRPL JT MP JT COMPL AMPUTATION,,,21 ,,RBRVS,31.95 ,21.89 ,21.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20827,CPT,RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION,,,21 ,,RBRVS,27.48 ,20.38 ,20.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20838,CPT,REPLANTATION FOOT COMPLETE AMPUTATION,,,21 ,,RBRVS,42.88 ,20.13 ,20.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20900,CPT,BONE GRAFT ANY DONOR AREA MINOR/SMALL,,,21 ,,RBRVS,3.00 ,2.95 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20902,CPT,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,,,21 ,,RBRVS,4.58 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20910,CPT,CARTILAGE GRAFT COSTOCHONDRAL,,,21 ,,RBRVS,5.53 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20912,CPT,CARTILAGE GRAFT NASAL SEPTUM,,,21 ,,RBRVS,6.54 ,5.47 ,5.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20920,CPT,FASCIA LATA GRAFT BY STRIPPER,,,21 ,,RBRVS,5.51 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20922,CPT,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,,,21 ,,RBRVS,6.93 ,5.31 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20924,CPT,TENDON GRAFT FROM A DISTANCE,,,21 ,,RBRVS,6.68 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20926,CPT,TISSUE GRAFTS OTHER,,,21 ,,RBRVS,5.79 ,4.82 ,4.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20930,CPT,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,,,21 ,,TotalUnits,,,,4.30 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20931,CPT,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,,,21 ,,RBRVS,1.81 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20936,CPT,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,,,21 ,,TotalUnits,,,,5.32 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,20937,CPT,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,,,21 ,,RBRVS,2.79 ,1.28 ,1.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20938,CPT,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,,,21 ,,RBRVS,3.02 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20950,CPT,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,,,21 ,,RBRVS,1.26 ,0.94 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20955,CPT,BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA,,,21 ,,RBRVS,40.26 ,22.51 ,22.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20956,CPT,BONE GRAFT MICROVASCULAR ANAST ILIAC CREST,,,21 ,,RBRVS,41.18 ,22.99 ,22.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20957,CPT,BONE GRAFT MICROVASCULAR ANAST METATARSAL,,,21 ,,RBRVS,42.61 ,19.80 ,19.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20962,CPT,B1 GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR,,,21 ,,RBRVS,39.21 ,24.06 ,24.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20969,CPT,FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE,,,21 ,,RBRVS,45.43 ,24.64 ,24.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20970,CPT,FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST,,,21 ,,RBRVS,44.58 ,24.58 ,24.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20972,CPT,FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL,,,21 ,,RBRVS,44.51 ,17.20 ,17.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20973,CPT,FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE,,,21 ,,RBRVS,47.27 ,19.01 ,19.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20974,CPT,ELECTRICAL STIMULATION BONE HEALING NONINVASIVE,,,21 ,,RBRVS,0.62 ,0.54 ,1.01 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,20975,CPT,ELECTRICAL STIMULATION BONE HEALING INVASIVE,,,21 ,,RBRVS,2.60 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20979,CPT,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,,,21 ,,RBRVS,0.62 ,0.24 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20982,CPT,ABLATION BONE TUMOR RF PERCUTANEOUS CT GUIDANCE,,,21 ,,RBRVS,7.27 ,2.85 ,84.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20985,CPT,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,,,21 ,,RBRVS,2.50 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,20999,CPT,UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL,,,21 ,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21010,CPT,ARTHROTOMY TEMPOROMANDIBULAR JOINT,,,21 ,,RBRVS,11.04 ,7.26 ,7.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21011,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,,,21 ,,RBRVS,2.99 ,3.33 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21012,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,,,21 ,,RBRVS,4.45 ,4.13 ,4.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21013,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,,,21 ,,RBRVS,5.42 ,4.69 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21014,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,,,21 ,,RBRVS,7.13 ,6.10 ,6.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21015,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,,,21 ,,RBRVS,9.89 ,5.49 ,5.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21016,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2+CM,,,21 ,,RBRVS,15.26 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21025,CPT,EXCISION BONE MANDIBLE,,,21 ,,RBRVS,10.03 ,8.38 ,11.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21026,CPT,EXCISION FACIAL BONE,,,21 ,,RBRVS,5.70 ,6.39 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21029,CPT,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,,,21 ,,RBRVS,8.39 ,7.13 ,10.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21030,CPT,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,,,21 ,,RBRVS,4.91 ,5.10 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21031,CPT,EXCISION TORUS MANDIBULARIS,,,21 ,,RBRVS,3.30 ,3.78 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21032,CPT,EXCISION MAXILLARY TORUS PALATINUS,,,21 ,,RBRVS,3.34 ,3.66 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21034,CPT,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,,,21 ,,RBRVS,17.38 ,11.68 ,15.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21040,CPT,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL&/CURTG,,,21 ,,RBRVS,4.91 ,5.07 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21044,CPT,EXCISION MALIGNANT TUMOR MANDIBLE,,,21 ,,RBRVS,12.80 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21045,CPT,EXCISION MALIGNANT TUMOR MANDIBLE RADICAL,,,21 ,,RBRVS,18.37 ,12.21 ,12.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21046,CPT,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,,,21 ,,RBRVS,14.21 ,12.73 ,12.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21047,CPT,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDBLC,,,21 ,,RBRVS,20.07 ,12.29 ,12.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21048,CPT,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,,,21 ,,RBRVS,14.71 ,12.72 ,12.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21049,CPT,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLCT,,,21 ,,RBRVS,19.32 ,12.04 ,12.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21050,CPT,CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX,,,21 ,,RBRVS,11.76 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21060,CPT,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,,,21 ,,RBRVS,11.07 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21070,CPT,CORONOIDECTOMY SPX,,,21 ,,RBRVS,8.62 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21073,CPT,MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA,,,21 ,,RBRVS,3.45 ,2.58 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21076,CPT,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHESIS,,,21 ,,RBRVS,13.40 ,6.99 ,10.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21077,CPT,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,,,21 ,,RBRVS,33.70 ,18.07 ,24.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21079,CPT,IMPRESSION&PREPARATION INTERIM OBTURATOR PROSTH,,,21 ,,RBRVS,22.31 ,11.93 ,17.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21080,CPT,IMPRESSION&PREPJ DEFINITIVE OBTURATOR PROSTHESIS,,,21 ,,RBRVS,25.06 ,13.27 ,19.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21081,CPT,IMPRESSION&PREPJ MANDIBULAR RESECTION PROSTHESIS,,,21 ,,RBRVS,22.85 ,12.20 ,18.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21082,CPT,IMPRESSION&PREPJ PALATAL AUGMENTATION PROSTHESIS,,,21 ,,RBRVS,20.84 ,11.68 ,17.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21083,CPT,IMPRESSION&PREPARATION PALATAL LIFT PROSTHESIS,,,21 ,,RBRVS,19.27 ,10.86 ,17.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21084,CPT,IMPRESSION&PREPARATION SPEECH AID PROSTHESIS,,,21 ,,RBRVS,22.48 ,12.69 ,19.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21085,CPT,IMPRESSION&PREPARATION ORAL SURGICAL SPLINT,,,21 ,,RBRVS,8.99 ,4.92 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21086,CPT,IMPRESSION&PREPARATION AURICULAR PROSTHESIS,,,21 ,,RBRVS,24.88 ,12.90 ,17.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21087,CPT,IMPRESSION&PREPARATION NASAL PROSTHESIS,,,21 ,,RBRVS,24.88 ,12.87 ,17.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21088,CPT,IMPRESSION&PREPARATION FACIAL PROSTHESIS,,,21 ,,TotalUnits,,,,37.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21089,CPT,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,,,21 ,,TotalUnits,,,,40.54 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21100,CPT,APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX,,,21 ,,RBRVS,4.73 ,5.14 ,12.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21110,CPT,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,,,21 ,,RBRVS,5.99 ,9.88 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21116,CPT,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,,,21 ,,RBRVS,0.81 ,0.30 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21120,CPT,GENIOPLASTY AUGMENTATION,,,21 ,,RBRVS,5.10 ,7.25 ,10.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21121,CPT,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,,,21 ,,RBRVS,7.81 ,8.23 ,11.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21122,CPT,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,,,21 ,,RBRVS,8.71 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21123,CPT,GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS,,,21 ,,RBRVS,11.34 ,10.01 ,10.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21125,CPT,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,,,21 ,,RBRVS,10.80 ,8.18 ,67.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21127,CPT,AGMNTJ MNDBLR BDY/ANGL W/B1 GRF ONLAY/INTERPOSAL,,,21 ,,RBRVS,12.44 ,8.80 ,78.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21137,CPT,REDUCTION FOREHEAD CONTOURING ONLY,,,21 ,,RBRVS,10.24 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21138,CPT,RDCTJ FHD CNTRG&PROSTHETIC MATRL/BONE GRAFT,,,21 ,,RBRVS,12.87 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21139,CPT,RDCTJ FHD CNTRG&SETBACK ANT FRONTAL SINUS WALL,,,21 ,,RBRVS,15.02 ,9.55 ,9.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21141,CPT,RCNSTJ MIDFACE LEFORT I 1 PIECE W/O BONE GRAFT,,,21 ,,RBRVS,19.57 ,13.67 ,13.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21142,CPT,RCNSTJ MIDFACE LEFORT I 2 PIECES W/O BONE GRAFT,,,21 ,,RBRVS,20.28 ,13.10 ,13.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21143,CPT,RCNSTJ MIDFACE LEFORT I 3/>PIECE W/O BONE GRAFT,,,21 ,,RBRVS,21.05 ,13.12 ,13.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21145,CPT,RCNSTJ MIDFACE LEFORT I 1 PIECE W/BONE GRAFTS,,,21 ,,RBRVS,23.94 ,14.68 ,14.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21146,CPT,RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS,,,21 ,,RBRVS,24.87 ,16.20 ,16.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21147,CPT,RCNSTJ MIDFACE LEFORT I 3/>PIECE W/BONE GRAFTS,,,21 ,,RBRVS,26.47 ,16.30 ,16.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21150,CPT,RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION,,,21 ,,RBRVS,25.96 ,14.98 ,14.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21151,CPT,RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS,,,21 ,,RBRVS,29.02 ,21.02 ,21.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21154,CPT,RCNSTJ MIDFACE LEFORT III W/O LEFORT I,,,21 ,,RBRVS,31.29 ,19.93 ,19.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21155,CPT,RCNSTJ MIDFACE LEFORT III W/LEFORT I,,,21 ,,RBRVS,35.22 ,21.02 ,21.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21159,CPT,RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I,,,21 ,,RBRVS,43.14 ,24.05 ,24.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21160,CPT,RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I,,,21 ,,RBRVS,47.19 ,23.32 ,23.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21172,CPT,RCNSTJ SUPERIOR-LATERAL ORBITAL RIM&LOWER FHD,,,21 ,,RBRVS,28.20 ,16.02 ,16.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21175,CPT,RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS&LWR FHD,,,21 ,,RBRVS,33.56 ,18.76 ,18.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21179,CPT,RCNSTJ FOREHEAD&/SUPRAORB RIMS W/ALGRF/PROSTC,,,21 ,,RBRVS,22.65 ,13.16 ,13.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21180,CPT,RCNSTJ FOREHEAD&/SUPRAORBITAL RIMS W/AUTOGRAFT,,,21 ,,RBRVS,25.58 ,14.93 ,14.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21181,CPT,RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC,,,21 ,,RBRVS,10.28 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21182,CPT,RCNSTJ ORBIT/FHD/NASETHMD EXC B9 TUM GRF <40 CM,,,21 ,,RBRVS,32.58 ,17.72 ,17.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21183,CPT,RCNSTJ ORBIT/FHD/NASETHMD EXC B9 GRF >40 <80 CM,,,21 ,,RBRVS,35.70 ,20.50 ,20.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21184,CPT,RCNSTJ ORBIT/FHD/NASETHMD EXC B9 TUM GRF>80 CM,,,21 ,,RBRVS,38.62 ,20.42 ,20.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21188,CPT,RCNSTJ MDFC OTH/THN LEFORT OSTEOT&BONE GRAFTS,,,21 ,,RBRVS,23.15 ,18.22 ,18.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21193,CPT,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,,,21 ,,RBRVS,18.90 ,10.94 ,10.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21194,CPT,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRF,,,21 ,,RBRVS,21.82 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21195,CPT,RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD,,,21 ,,RBRVS,19.16 ,14.36 ,14.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21196,CPT,RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FIXJ,,,21 ,,RBRVS,20.83 ,15.55 ,15.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21198,CPT,OSTEOTOMY MANDIBLE SEGMENTAL,,,21 ,,RBRVS,15.71 ,12.95 ,12.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21199,CPT,OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT,,,21 ,,RBRVS,16.73 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21206,CPT,OSTEOTOMY MAXILLA SEGMENTAL,,,21 ,,RBRVS,15.59 ,13.24 ,13.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21208,CPT,OSTEOPLASTY FACIAL BONES AUGMENTATION,,,21 ,,RBRVS,11.42 ,9.21 ,32.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21209,CPT,OSTEOPLASTY FACIAL BONES REDUCTION,,,21 ,,RBRVS,7.82 ,8.30 ,12.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21210,CPT,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,,,21 ,,RBRVS,11.69 ,9.00 ,40.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21215,CPT,GRAFT BONE MANDIBLE,,,21 ,,RBRVS,12.23 ,9.24 ,77.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21230,CPT,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,,,21 ,,RBRVS,11.17 ,7.83 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21235,CPT,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,,,21 ,,RBRVS,7.50 ,6.66 ,10.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21240,CPT,ARTHRP TEMPOROMANDIBULAR JOINT +-AUTOGRAFT,,,21 ,,RBRVS,16.07 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21242,CPT,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,,,21 ,,RBRVS,14.59 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21243,CPT,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,,,21 ,,RBRVS,24.53 ,16.94 ,16.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21244,CPT,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,,,21 ,,RBRVS,13.62 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21245,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,,,21 ,,RBRVS,13.12 ,9.62 ,14.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21246,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,,,21 ,,RBRVS,12.92 ,8.09 ,8.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21247,CPT,RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS,,,21 ,,RBRVS,24.37 ,15.22 ,15.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21248,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,,,21 ,,RBRVS,12.74 ,9.08 ,13.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21249,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,,,21 ,,RBRVS,18.77 ,12.01 ,17.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21255,CPT,RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG,,,21 ,,RBRVS,18.46 ,16.53 ,16.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21256,CPT,RECONSTRUCTION ORBIT W/OSTEOTOMIES&BONE GRAFTS,,,21 ,,RBRVS,17.66 ,11.79 ,11.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21260,CPT,PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL,,,21 ,,RBRVS,17.90 ,14.26 ,14.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21261,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA&XTRC,,,21 ,,RBRVS,34.07 ,21.43 ,21.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21263,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD,,,21 ,,RBRVS,31.01 ,18.64 ,18.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21267,CPT,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,,,21 ,,RBRVS,20.69 ,18.11 ,18.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21268,CPT,ORBITAL REPOSITIONING W/BONE GRAFTS ICRA&XTRC,,,21 ,,RBRVS,27.07 ,21.27 ,21.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21270,CPT,MALAR AUGMENTATION PROSTHETIC MATERIAL,,,21 ,,RBRVS,10.63 ,7.11 ,12.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21275,CPT,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,,,21 ,,RBRVS,11.76 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21280,CPT,MEDIAL CANTHOPEXY SPX,,,21 ,,RBRVS,7.13 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21282,CPT,LATERAL CANTHOPEXY,,,21 ,,RBRVS,4.27 ,4.66 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21295,CPT,REDUCTION MASSETER MUSCLE&BONE EXTRAORAL,,,21 ,,RBRVS,1.90 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21296,CPT,REDUCTION MASSETER MUSCLE&BONE INTRAORAL,,,21 ,,RBRVS,4.78 ,5.92 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21299,CPT,UNLISTED CRANIOFACIAL&MAXILLOFACIAL PROCEDURE,,,21 ,,TotalUnits,,,,29.84 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21310,CPT,CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,0.58 ,0.13 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21315,CPT,CLOSED TX NASAL FRACTURE W/O STABILIZATION,,,21 ,,RBRVS,1.83 ,1.87 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21320,CPT,CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION,,,21 ,,RBRVS,1.88 ,1.51 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21325,CPT,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,,,21 ,,RBRVS,4.18 ,7.50 ,7.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21330,CPT,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FIXJ,,,21 ,,RBRVS,5.79 ,8.37 ,8.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21335,CPT,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,,,21 ,,RBRVS,9.02 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21336,CPT,OPEN TX NASAL SEPTAL FRACTURE +-STABILIZATION,,,21 ,,RBRVS,6.77 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21337,CPT,CLOSED TX NASAL SEPTAL FRACTURE +-STABILIZATION,,,21 ,,RBRVS,3.39 ,3.78 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21338,CPT,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,,,21 ,,RBRVS,6.87 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21339,CPT,OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION,,,21 ,,RBRVS,8.50 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21340,CPT,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,,,21 ,,RBRVS,11.49 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21343,CPT,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,,,21 ,,RBRVS,14.32 ,14.42 ,14.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21344,CPT,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,,,21 ,,RBRVS,21.57 ,15.61 ,15.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21345,CPT,CLOSED TX NASOMAXILLARY COMPLEX FRACTURE,,,21 ,,RBRVS,9.06 ,7.10 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21346,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG&FIXJ,,,21 ,,RBRVS,11.45 ,11.93 ,11.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21347,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN,,,21 ,,RBRVS,13.53 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21348,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE W/B1 GRFG,,,21 ,,RBRVS,17.52 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21355,CPT,PERCUTANEOUS TX MALAR AREA FRACTURE,,,21 ,,RBRVS,4.45 ,3.68 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21356,CPT,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,,,21 ,,RBRVS,4.83 ,4.45 ,7.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21360,CPT,OPEN TX DEPRESSED MALAR FRACTURE,,,21 ,,RBRVS,7.19 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21365,CPT,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,,,21 ,,RBRVS,16.77 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21366,CPT,OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT,,,21 ,,RBRVS,18.60 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21385,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,,,21 ,,RBRVS,9.57 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21386,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,,,21 ,,RBRVS,9.57 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21387,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,,,21 ,,RBRVS,10.11 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21390,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,,,21 ,,RBRVS,11.23 ,8.03 ,8.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21395,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/B1 GRF,,,21 ,,RBRVS,14.70 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21400,CPT,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,,,21 ,,RBRVS,1.50 ,2.12 ,2.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21401,CPT,CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION,,,21 ,,RBRVS,3.68 ,3.60 ,7.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21406,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,,,21 ,,RBRVS,7.42 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21407,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,,,21 ,,RBRVS,9.02 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21408,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,,,21 ,,RBRVS,12.78 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21421,CPT,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,,,21 ,,RBRVS,6.02 ,9.49 ,12.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21422,CPT,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,,,21 ,,RBRVS,8.73 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21423,CPT,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,,,21 ,,RBRVS,10.85 ,8.61 ,8.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21431,CPT,CLOSED TX CRANIOFACIAL SEPARATION,,,21 ,,RBRVS,7.90 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21432,CPT,OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ,,,21 ,,RBRVS,8.82 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21433,CPT,OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR,,,21 ,,RBRVS,26.29 ,15.00 ,15.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21435,CPT,OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIXJ,,,21 ,,RBRVS,20.26 ,12.67 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21436,CPT,OPTX CRANFCL SEP LEFT III TYP COMP INT FIXJ W/B1,,,21 ,,RBRVS,30.30 ,18.81 ,18.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21440,CPT,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,,21 ,,RBRVS,3.44 ,7.57 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21445,CPT,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,,21 ,,RBRVS,6.26 ,8.99 ,12.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21450,CPT,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,3.71 ,7.82 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21451,CPT,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,,,21 ,,RBRVS,5.65 ,9.71 ,12.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21452,CPT,PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ,,,21 ,,RBRVS,2.40 ,5.85 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21453,CPT,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,,,21 ,,RBRVS,6.64 ,11.93 ,14.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21454,CPT,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,,,21 ,,RBRVS,7.36 ,6.42 ,6.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21461,CPT,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,,,21 ,,RBRVS,9.31 ,13.48 ,39.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21462,CPT,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,,,21 ,,RBRVS,11.01 ,14.13 ,40.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21465,CPT,OPEN TX MANDIBULAR CONDYLAR FX,,,21 ,,RBRVS,13.12 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21470,CPT,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,,,21 ,,RBRVS,17.54 ,11.87 ,11.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21480,CPT,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,,,21 ,,RBRVS,0.61 ,0.19 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21485,CPT,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,,,21 ,,RBRVS,4.77 ,9.13 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21490,CPT,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,,,21 ,,RBRVS,12.95 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21495,CPT,OPEN TREATMENT HYOID FRACTURE,,,21 ,,RBRVS,6.79 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21497,CPT,INTERDENTAL WIRING OTHER THAN FRACTURE,,,21 ,,RBRVS,4.64 ,9.30 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21499,CPT,UNLISTED MUSCULOSKELETAL PROCEDURE HEAD,,,21 ,,TotalUnits,,,,19.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21501,CPT,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,,,21 ,,RBRVS,3.98 ,3.80 ,6.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21502,CPT,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RIB,,,21 ,,RBRVS,7.55 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21510,CPT,INCISION DEEP OPENING BONE CORTEX THORAX,,,21 ,,RBRVS,6.20 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21550,CPT,BIOPSY SOFT TISSUE NECK/THORAX,,,21 ,,RBRVS,2.11 ,1.82 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21552,CPT,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,,,21 ,,RBRVS,6.49 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21554,CPT,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,,,21 ,,RBRVS,11.13 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21555,CPT,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,,,21 ,,RBRVS,3.96 ,3.56 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21556,CPT,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,,,21 ,,RBRVS,7.66 ,4.65 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21557,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,,,21 ,,RBRVS,14.75 ,6.15 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21558,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,,,21 ,,RBRVS,21.58 ,12.94 ,12.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21600,CPT,EXCISION RIB PARTIAL,,,21 ,,RBRVS,7.26 ,6.25 ,6.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21610,CPT,COSTOTRANSVERSECTOMY SPX,,,21 ,,RBRVS,15.91 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21615,CPT,EXCISION 1ST&/CERVICAL RIB,,,21 ,,RBRVS,10.45 ,5.74 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21616,CPT,EXCISION 1ST&/CERVICAL RIB W/SYMPATHECTOMY,,,21 ,,RBRVS,12.69 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21620,CPT,OSTECTOMY STERNUM PARTIAL,,,21 ,,RBRVS,7.28 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21627,CPT,STERNAL DEBRIDEMENT,,,21 ,,RBRVS,7.30 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21630,CPT,RADICAL RESECTION STERNUM,,,21 ,,RBRVS,19.18 ,11.56 ,11.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21632,CPT,RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC,,,21 ,,RBRVS,19.68 ,10.56 ,10.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21685,CPT,HYOID MYOTOMY & SUSPENSION,,,21 ,,RBRVS,15.26 ,9.86 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21700,CPT,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,,,21 ,,RBRVS,6.31 ,3.94 ,3.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21705,CPT,DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,,,21 ,,RBRVS,9.92 ,5.22 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21720,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST,,,21 ,,RBRVS,5.80 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21725,CPT,DIVISION STERNOCLEIDOMASTOID OPEN CAST,,,21 ,,RBRVS,7.19 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21740,CPT,REPAIR PECTUS EXCAVATUM/CARINATUM OPEN,,,21 ,,RBRVS,17.57 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21742,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,,,21 ,,RBRVS,16.44 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21743,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,,,21 ,,TotalUnits,,,,42.30 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21750,CPT,CLOSURE MEDIAN STERNOTOMY SEP +-DEBRIDEMENT SPX,,,21 ,,RBRVS,11.40 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21800,CPT,CLOSED TX RIB FRACTURE UNCOMPLICATED EACH,,,21 ,,RBRVS,1.01 ,1.48 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21805,CPT,OPEN TX RIB FRACTURE W/O FIXATION EACH,,,21 ,,RBRVS,2.88 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21810,CPT,TX RIB FRACTURE EXTERNAL FIXATION FLAIL CHEST,,,21 ,,RBRVS,7.03 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21820,CPT,CLOSED TREATMENT STERNUM FRACTURE,,,21 ,,RBRVS,1.36 ,1.92 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21825,CPT,OPEN TX STERNUM FRACTURE +-SKELETAL FIXATION,,,21 ,,RBRVS,7.76 ,5.98 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21899,CPT,UNLISTED PROCEDURE NECK/THORAX,,,21 ,,TotalUnits,,,,8.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,21920,CPT,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,,,21 ,,RBRVS,2.11 ,1.86 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21925,CPT,BIOPSY SOFT TISSUE BACK/FLANK DEEP,,,21 ,,RBRVS,4.63 ,3.59 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21930,CPT,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,,,21 ,,RBRVS,4.94 ,3.88 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21931,CPT,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,,,21 ,,RBRVS,6.88 ,4.82 ,4.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21932,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,,,21 ,,RBRVS,9.82 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21933,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,,,21 ,,RBRVS,11.13 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21935,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,,,21 ,,RBRVS,15.72 ,9.39 ,9.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,21936,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,,,21 ,,RBRVS,22.55 ,13.16 ,13.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22010,CPT,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHRC,,,21 ,,RBRVS,12.75 ,9.15 ,9.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22015,CPT,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,,,21 ,,RBRVS,12.64 ,9.16 ,9.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22100,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,,,21 ,,RBRVS,11.00 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22101,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,,,21 ,,RBRVS,11.08 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22102,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,,,21 ,,RBRVS,11.08 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22103,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,,,21 ,,RBRVS,2.34 ,1.07 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22110,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV,,,21 ,,RBRVS,14.00 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22112,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC,,,21 ,,RBRVS,14.07 ,9.69 ,9.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22114,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,,,21 ,,RBRVS,14.07 ,9.89 ,9.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22116,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA,,,21 ,,RBRVS,2.32 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22206,CPT,OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC,,,21 ,,RBRVS,37.18 ,19.76 ,19.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22207,CPT,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,,,21 ,,RBRVS,36.68 ,19.62 ,19.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22208,CPT,OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM,,,21 ,,RBRVS,9.66 ,4.23 ,4.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22210,CPT,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,,,21 ,,RBRVS,25.38 ,15.96 ,15.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22212,CPT,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,,,21 ,,RBRVS,20.99 ,13.76 ,13.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22214,CPT,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,,,21 ,,RBRVS,21.02 ,13.93 ,13.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22216,CPT,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,,,21 ,,RBRVS,6.03 ,2.77 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22220,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM CRV,,,21 ,,RBRVS,22.94 ,14.37 ,14.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22222,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC,,,21 ,,RBRVS,23.09 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22224,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM LMBR,,,21 ,,RBRVS,23.09 ,14.29 ,14.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22226,CPT,OSTEOT SPI W/DSKC ANT APPR 1 VRT SGM EA VRT SGM,,,21 ,,RBRVS,6.03 ,2.73 ,2.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22305,CPT,CLOSED TX VERTEBRAL PROCESS FRACTURE,,,21 ,,RBRVS,2.13 ,1.96 ,2.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22310,CPT,CLTX VRT BDY FX W/O MNPJ REQ&W/CSTING/BRACING,,,21 ,,RBRVS,3.89 ,2.71 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22315,CPT,CLTX VRT FX&/DISLC CSTING/BRACING MNPJ/TRCJ,,,21 ,,RBRVS,10.11 ,7.90 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22318,CPT,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRFG,,,21 ,,RBRVS,22.72 ,14.16 ,14.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22319,CPT,OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ GRF,,,21 ,,RBRVS,25.33 ,15.13 ,15.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22325,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LMBR,,,21 ,,RBRVS,19.87 ,13.17 ,13.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22326,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CRV,,,21 ,,RBRVS,20.84 ,13.19 ,13.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22327,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM THRC,,,21 ,,RBRVS,20.77 ,13.42 ,13.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22328,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA SGM,,,21 ,,RBRVS,4.60 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22505,CPT,MANIPULATION SPINE REQUIRING ANESTHESIA,,,21 ,,RBRVS,1.87 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22520,CPT,PERCUTANEOUS VERTEBROPLASTY THORACIC,,,21 ,,RBRVS,9.22 ,4.40 ,47.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22521,CPT,PERCUTANEOUS VERTEBROPLASTY LUMBAR,,,21 ,,RBRVS,8.65 ,4.21 ,46.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22522,CPT,PERCUTANEOUS VERTEBROPLASTY EA ADDL THRC/LMBR,,,21 ,,RBRVS,4.30 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22523,CPT,PERCUTANEOUS VERTEBRAL AUGMENTATION THORACIC,,,21 ,,RBRVS,9.26 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22524,CPT,PERCUTANEOUS VERTEBRAL AUGMENTATION LUMBAR,,,21 ,,RBRVS,8.86 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22525,CPT,PERQ VERTEBRAL AUGMENTATION EA ADDL THRC/LMBR,,,21 ,,RBRVS,4.47 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22526,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LVL,,,21 ,,RBRVS,6.10 ,2.19 ,44.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22527,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,,,21 ,,RBRVS,3.03 ,0.71 ,36.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22532,CPT,ARTHRODESIS LATERAL EXTRACAVITARY THORACIC,,,21 ,,RBRVS,25.99 ,15.24 ,15.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22533,CPT,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,,,21 ,,RBRVS,24.79 ,14.76 ,14.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22534,CPT,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,,,21 ,,RBRVS,5.99 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22548,CPT,ARTHRD ANT TRANSORAL/XTRORAL C1-C2 +-EXC ODNTD,,,21 ,,RBRVS,27.06 ,16.19 ,16.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22551,CPT,NECK SPINE FUSE&REMOVE ADDL,,,21 ,,RBRVS,25.00 ,18.65 ,18.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22552,CPT,ADDL NECK SPINE FUSION,,,21 ,,RBRVS,6.50 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22554,CPT,ARTHRODESIS ANTERIOR INTERBODY CERVICAL BELW C2,,,21 ,,RBRVS,17.69 ,11.76 ,11.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22556,CPT,ARTHRODESIS ANTERIOR INTERBODY THORACIC,,,21 ,,RBRVS,24.70 ,14.41 ,14.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22558,CPT,ARTHRODESIS ANTERIOR INTERBODY LUMBAR,,,21 ,,RBRVS,23.53 ,13.05 ,13.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22585,CPT,ARTHRODESIS ANTERIOR INTERBODY EA ADDL NTRSPC,,,21 ,,RBRVS,5.52 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22590,CPT,ARTHRODESIS POSTERIOR CRANIOCERVICAL,,,21 ,,RBRVS,21.76 ,14.10 ,14.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22595,CPT,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,,,21 ,,RBRVS,20.64 ,13.54 ,13.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22600,CPT,ARTHRODESIS PST/PSTLAT CERVICAL BELW C2 SGM,,,21 ,,RBRVS,17.40 ,12.00 ,12.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22610,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC,,,21 ,,RBRVS,17.28 ,11.83 ,11.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22612,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR,,,21 ,,RBRVS,23.53 ,14.00 ,14.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22614,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL,,,21 ,,RBRVS,6.43 ,2.92 ,2.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22630,CPT,ARTHRODESIS POSTERIOR INTERBODY LUMBAR,,,21 ,,RBRVS,22.09 ,13.81 ,13.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22632,CPT,ARTHRODESIS POSTERIOR INTERBODY EA ADDL,,,21 ,,RBRVS,5.22 ,2.36 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22800,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM UP 6 VRT SEG,,,21 ,,RBRVS,19.50 ,12.53 ,12.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22802,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG,,,21 ,,RBRVS,32.11 ,18.38 ,18.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22804,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM 13/> VRT SEG,,,21 ,,RBRVS,37.50 ,20.84 ,20.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22808,CPT,ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SEG,,,21 ,,RBRVS,27.51 ,15.69 ,15.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22810,CPT,ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SEG,,,21 ,,RBRVS,31.50 ,16.95 ,16.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22812,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM 8/> VRT SEG,,,21 ,,RBRVS,34.25 ,19.22 ,19.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22818,CPT,KYPHECTOMY SINGLE OR TWO SEGMENTS,,,21 ,,RBRVS,34.33 ,18.56 ,18.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22819,CPT,KYPHECTOMY 3 OR MORE SEGMENTS,,,21 ,,RBRVS,39.38 ,21.57 ,21.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22830,CPT,EXPLORATION SPINAL FUSION,,,21 ,,RBRVS,11.22 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22840,CPT,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,,,21 ,,RBRVS,12.52 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22841,CPT,INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS,,,21 ,,TotalUnits,,,,15.67 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,22842,CPT,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,,,21 ,,RBRVS,12.56 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22843,CPT,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,,,21 ,,RBRVS,13.44 ,6.07 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22844,CPT,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SEG,,,21 ,,RBRVS,16.42 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22845,CPT,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,,,21 ,,RBRVS,11.94 ,5.34 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22846,CPT,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,,,21 ,,RBRVS,12.40 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22847,CPT,ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS,,,21 ,,RBRVS,13.78 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22848,CPT,PELVIC FIXATION OTHER THAN SACRUM,,,21 ,,RBRVS,5.99 ,2.79 ,2.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22849,CPT,REINSERTION SPINAL FIXATION DEVICE,,,21 ,,RBRVS,19.17 ,11.46 ,11.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22850,CPT,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,,,21 ,,RBRVS,9.82 ,7.03 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22851,CPT,APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE,,,21 ,,RBRVS,6.70 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22852,CPT,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,,,21 ,,RBRVS,9.37 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22855,CPT,REMOVAL ANTERIOR INSTRUMENTATION,,,21 ,,RBRVS,15.86 ,9.99 ,9.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22856,CPT,TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV,,,21 ,,RBRVS,24.05 ,14.27 ,14.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22857,CPT,TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC LMBR,,,21 ,,RBRVS,27.13 ,13.96 ,13.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22861,CPT,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV,,,21 ,,RBRVS,33.36 ,13.99 ,13.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22862,CPT,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR,,,21 ,,RBRVS,32.63 ,14.45 ,14.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22864,CPT,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL,,,21 ,,RBRVS,29.40 ,12.62 ,12.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22865,CPT,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR,,,21 ,,RBRVS,31.75 ,18.89 ,18.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22899,CPT,UNLISTED PROCEDURE SPINE,,,21 ,,TotalUnits,,,,18.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,22900,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,,,21 ,,RBRVS,8.32 ,4.12 ,4.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22901,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,,,21 ,,RBRVS,10.11 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22902,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,,,21 ,,RBRVS,4.42 ,4.14 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22903,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,,,21 ,,RBRVS,6.39 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22904,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,,,21 ,,RBRVS,16.69 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22905,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,,,21 ,,RBRVS,21.58 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,22999,CPT,UNLISTED PX ABDOMEN MUSCULOSKELETAL SYSTEM,,,21 ,,TotalUnits,,,,12.44 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,23000,CPT,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,,,21 ,,RBRVS,4.48 ,4.21 ,8.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23020,CPT,CAPSULAR CONTRACTURE RELEASE,,,21 ,,RBRVS,9.36 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23030,CPT,I&D SHOULDER DEEP ABSCESS/HEMATOMA,,,21 ,,RBRVS,3.47 ,2.67 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23031,CPT,I&D SHOULDER INFECTED BURSA,,,21 ,,RBRVS,2.79 ,2.32 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23035,CPT,INCISION BONE CORTEX SHOULDER AREA,,,21 ,,RBRVS,9.16 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23040,CPT,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,,,21 ,,RBRVS,9.75 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23044,CPT,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,,,21 ,,RBRVS,7.59 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23065,CPT,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,,,21 ,,RBRVS,2.30 ,1.80 ,2.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23066,CPT,BIOPSY SOFT TISSUE SHOULDER DEEP,,,21 ,,RBRVS,4.30 ,3.94 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23071,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,,,21 ,,RBRVS,5.91 ,4.52 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23073,CPT,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,,,21 ,,RBRVS,10.13 ,7.11 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23075,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,,,21 ,,RBRVS,4.21 ,2.33 ,4.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23076,CPT,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,,,21 ,,RBRVS,7.41 ,5.62 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23077,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,,,21 ,,RBRVS,17.66 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23078,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,,,21 ,,RBRVS,22.55 ,11.99 ,11.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23100,CPT,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,,,21 ,,RBRVS,6.20 ,5.57 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23101,CPT,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,,,21 ,,RBRVS,5.72 ,5.03 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23105,CPT,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY +-BIOPSY,,,21 ,,RBRVS,8.48 ,6.80 ,6.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23106,CPT,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT +-BX,,,21 ,,RBRVS,6.13 ,5.42 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23107,CPT,ARTHRT GLENOHUMRL JT W/JT EXPL +-RMVL LOOSE/FB,,,21 ,,RBRVS,8.87 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23120,CPT,CLAVICULECTOMY PARTIAL,,,21 ,,RBRVS,7.39 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23125,CPT,CLAVICULECTOMY TOTAL,,,21 ,,RBRVS,9.64 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23130,CPT,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,,,21 ,,RBRVS,7.77 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23140,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,,,21 ,,RBRVS,7.12 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23145,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT,,,21 ,,RBRVS,9.40 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23146,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,,,21 ,,RBRVS,8.08 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23150,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,,,21 ,,RBRVS,8.91 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23155,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT,,,21 ,,RBRVS,10.86 ,8.13 ,8.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23156,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT,,,21 ,,RBRVS,9.11 ,7.06 ,7.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23170,CPT,SEQUESTRECTOMY CLAVICLE,,,21 ,,RBRVS,7.21 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23172,CPT,SEQUESTRECTOMY SCAPULA,,,21 ,,RBRVS,7.31 ,5.95 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23174,CPT,SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK,,,21 ,,RBRVS,10.05 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23180,CPT,PARTIAL EXCISION BONE CLAVICLE,,,21 ,,RBRVS,8.99 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23182,CPT,PARTIAL EXCISION BONE SCAPULA,,,21 ,,RBRVS,8.61 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23184,CPT,PARTIAL EXCISION BONE PROXIMAL HUMERUS,,,21 ,,RBRVS,9.90 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23190,CPT,OSTECTOMY SCAPULA PARTIAL,,,21 ,,RBRVS,7.47 ,5.99 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23195,CPT,RESECTION HUMERAL HEAD,,,21 ,,RBRVS,10.36 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23200,CPT,RADICAL RESECTION TUMOR CLAVICLE,,,21 ,,RBRVS,22.71 ,10.02 ,10.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23210,CPT,RADICAL RESECTION TUMOR SCAPULA,,,21 ,,RBRVS,27.21 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23220,CPT,RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS,,,21 ,,RBRVS,30.21 ,12.15 ,12.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23330,CPT,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,,,21 ,,RBRVS,1.90 ,1.73 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23331,CPT,REMOVAL FOREIGN BODY SHOULDER DEEP,,,21 ,,RBRVS,7.63 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23332,CPT,REMOVAL FOREIGN BODY SHOULDER COMPLICATED,,,21 ,,RBRVS,12.37 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23350,CPT,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,,,21 ,,RBRVS,1.00 ,0.36 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23395,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,,,21 ,,RBRVS,18.54 ,12.56 ,12.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23397,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,,,21 ,,RBRVS,16.76 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23400,CPT,SCAPULOPEXY,,,21 ,,RBRVS,13.87 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23405,CPT,TENOTOMY SHOULDER AREA 1 TENDON,,,21 ,,RBRVS,8.54 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23406,CPT,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,,,21 ,,RBRVS,11.01 ,7.83 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23410,CPT,OPEN REPAIR OF ROTATOR CUFF ACUTE,,,21 ,,RBRVS,11.39 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23412,CPT,OPEN REPAIR OF ROTATOR CUFF CHRONIC,,,21 ,,RBRVS,11.93 ,8.83 ,8.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23415,CPT,CORACOACROMIAL LIGAMENT RELEASE +-ACROMIOPLASTY,,,21 ,,RBRVS,9.23 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23420,CPT,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,,,21 ,,RBRVS,13.54 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23430,CPT,TENODESIS LONG TENDON BICEPS,,,21 ,,RBRVS,10.17 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23440,CPT,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,,,21 ,,RBRVS,10.64 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23450,CPT,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,,,21 ,,RBRVS,13.70 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23455,CPT,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,,,21 ,,RBRVS,14.67 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23460,CPT,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,,,21 ,,RBRVS,15.82 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23462,CPT,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,,,21 ,,RBRVS,15.72 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23465,CPT,CAPSULORRHAPHY GLENOHUMERAL JT PST +-BONE BLK,,,21 ,,RBRVS,16.30 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23466,CPT,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,,,21 ,,RBRVS,15.80 ,11.23 ,11.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23470,CPT,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,,,21 ,,RBRVS,17.89 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23472,CPT,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,,,21 ,,RBRVS,22.65 ,13.80 ,13.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23480,CPT,OSTEOTOMY CLAVICLE +-INTERNAL FIXATION,,,21 ,,RBRVS,11.54 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23485,CPT,OSTEOTOMY CLAV +-INT FIXJ W/B1 GRF NON/MAL,,,21 ,,RBRVS,13.91 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23490,CPT,PROPH TX +-METHYLMETHACRYLATE CLAVICLE,,,21 ,,RBRVS,12.16 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23491,CPT,PROPH TX +-METHYLMETHACRYLATE PROXIMAL HUMERUS,,,21 ,,RBRVS,14.54 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23500,CPT,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.21 ,2.83 ,2.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23505,CPT,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,,,21 ,,RBRVS,3.83 ,3.91 ,4.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23515,CPT,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,,,21 ,,RBRVS,9.69 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23520,CPT,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,,,21 ,,RBRVS,2.29 ,2.99 ,2.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23525,CPT,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,,,21 ,,RBRVS,3.79 ,3.98 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23530,CPT,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,,,21 ,,RBRVS,7.48 ,5.64 ,5.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23532,CPT,OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,,21 ,,RBRVS,8.20 ,6.69 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23540,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,,,21 ,,RBRVS,2.36 ,2.78 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23545,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,,,21 ,,RBRVS,3.43 ,3.48 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23550,CPT,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,,,21 ,,RBRVS,7.59 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23552,CPT,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,,21 ,,RBRVS,8.82 ,6.99 ,6.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23570,CPT,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.36 ,3.10 ,3.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23575,CPT,CLTX SCAPULAR FX W/MANIPULATION +-SKEL TRACTION,,,21 ,,RBRVS,4.23 ,4.41 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23585,CPT,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,,,21 ,,RBRVS,14.23 ,9.16 ,9.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23600,CPT,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,3.11 ,3.86 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23605,CPT,CLTX PROX HUMRL FX W/MANIPULATION +-SKEL TRACJ,,,21 ,,RBRVS,5.06 ,5.00 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23615,CPT,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,,,21 ,,RBRVS,12.30 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23616,CPT,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,,,21 ,,RBRVS,18.37 ,12.17 ,12.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23620,CPT,CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ,,,21 ,,RBRVS,2.55 ,3.31 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23625,CPT,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,,,21 ,,RBRVS,4.10 ,4.24 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23630,CPT,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,,,21 ,,RBRVS,10.57 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23650,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,,,21 ,,RBRVS,3.53 ,2.94 ,3.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23655,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,,,21 ,,RBRVS,4.76 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23660,CPT,OPEN TX ACUTE SHOULDER DISLOCATION,,,21 ,,RBRVS,7.66 ,6.28 ,6.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23665,CPT,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MNPJ,,,21 ,,RBRVS,4.66 ,4.66 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23670,CPT,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,,,21 ,,RBRVS,12.28 ,8.44 ,8.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23675,CPT,CLTX SHOULDER DISLC W/SURG/ANTMCL NCK FX W/MNPJ,,,21 ,,RBRVS,6.27 ,5.57 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23680,CPT,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,,,21 ,,RBRVS,13.15 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23700,CPT,MNPJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,,,21 ,,RBRVS,2.57 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23800,CPT,ARTHRODESIS GLENOHUMERAL JOINT,,,21 ,,RBRVS,14.73 ,10.02 ,10.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23802,CPT,ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT,,,21 ,,RBRVS,18.42 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23900,CPT,INTERTHORACOSCAPULAR AMPUTATION,,,21 ,,RBRVS,20.72 ,11.65 ,11.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23920,CPT,DISARTICULATION SHOULDER,,,21 ,,RBRVS,16.23 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23921,CPT,DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION,,,21 ,,RBRVS,5.72 ,3.99 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23929,CPT,UNLISTED PROCEDURE SHOULDER,,,21 ,,TotalUnits,,,,14.52 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,23930,CPT,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,,,21 ,,RBRVS,2.99 ,2.21 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23931,CPT,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,,,21 ,,RBRVS,1.84 ,1.95 ,4.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,23935,CPT,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,,,21 ,,RBRVS,6.38 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24000,CPT,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,,,21 ,,RBRVS,6.08 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24006,CPT,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,,,21 ,,RBRVS,9.74 ,7.38 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24065,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL,,,21 ,,RBRVS,2.13 ,1.98 ,4.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24066,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP,,,21 ,,RBRVS,5.35 ,4.28 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24071,CPT,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,,,21 ,,RBRVS,5.70 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24073,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,,,21 ,,RBRVS,10.13 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24075,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,,,21 ,,RBRVS,4.24 ,3.55 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24076,CPT,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,,,21 ,,RBRVS,7.41 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24077,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,,,21 ,,RBRVS,15.72 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24079,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5+CM,,,21 ,,RBRVS,20.61 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24100,CPT,ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY,,,21 ,,RBRVS,5.07 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24101,CPT,ARTHRT ELBOW W/JOINT EXPL +-BX +-RMVL LOOSE/FB,,,21 ,,RBRVS,6.30 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24102,CPT,ARTHROTOMY ELBOW W/SYNOVECTOMY,,,21 ,,RBRVS,8.26 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24105,CPT,EXCISION OLECRANON BURSA,,,21 ,,RBRVS,3.78 ,4.37 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24110,CPT,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,,,21 ,,RBRVS,7.58 ,6.39 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24115,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT,,,21 ,,RBRVS,10.12 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24116,CPT,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,,,21 ,,RBRVS,12.23 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24120,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,,,21 ,,RBRVS,6.82 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24125,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT,,,21 ,,RBRVS,8.14 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24126,CPT,EXC/CURTG B1 CST/B9 TUM H/N RDS/OLECRN W/ALGRFT,,,21 ,,RBRVS,8.62 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24130,CPT,EXCISION RADIAL HEAD,,,21 ,,RBRVS,6.42 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24134,CPT,SEQUESTRECTOMY SHAFT/DISTAL HUMERUS,,,21 ,,RBRVS,10.22 ,7.83 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24136,CPT,SEQUESTRECTOMY RADIAL HEAD OR NECK,,,21 ,,RBRVS,8.40 ,6.08 ,6.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24138,CPT,SEQUESTRECTOMY OLECRANON PROCESS,,,21 ,,RBRVS,8.50 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24140,CPT,PARTIAL EXCISION BONE HUMERUS,,,21 ,,RBRVS,9.55 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24145,CPT,PARTIAL EXCISION BONE RADIAL HEAD/NECK,,,21 ,,RBRVS,7.81 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24147,CPT,PARTIAL EXCISION BONE OLECRANON PROCESS,,,21 ,,RBRVS,7.84 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24149,CPT,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,,,21 ,,RBRVS,16.22 ,11.90 ,11.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24150,CPT,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,,,21 ,,RBRVS,23.46 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24152,CPT,RADICAL RESECTION TUMOR RADIAL HEAD/NECK,,,21 ,,RBRVS,19.99 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24155,CPT,RESECTION ELBOW JOINT ARTHRECTOMY,,,21 ,,RBRVS,12.09 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24160,CPT,IMPLANT REMOVAL ELBOW JOINT,,,21 ,,RBRVS,8.00 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24164,CPT,IMPLANT REMOVAL RADIAL HEAD,,,21 ,,RBRVS,6.43 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24200,CPT,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,,,21 ,,RBRVS,1.81 ,1.51 ,2.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24201,CPT,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,,,21 ,,RBRVS,4.70 ,4.05 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24220,CPT,INJECTION ELBOW ARTHROGRAPHY,,,21 ,,RBRVS,1.31 ,0.50 ,2.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24300,CPT,MANIPULATION ELBOW UNDER ANESTHESIA,,,21 ,,RBRVS,4.04 ,5.53 ,5.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24301,CPT,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,,,21 ,,RBRVS,10.38 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24305,CPT,TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON,,,21 ,,RBRVS,7.62 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24310,CPT,TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON,,,21 ,,RBRVS,6.12 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24320,CPT,TENOPLASTY ELBOW TO SHOULDER SINGLE,,,21 ,,RBRVS,10.86 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24330,CPT,FLEXOR-PLASTY ELBOW,,,21 ,,RBRVS,9.79 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24331,CPT,FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT,,,21 ,,RBRVS,10.95 ,8.03 ,8.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24332,CPT,TENOLYSIS TRICEPS,,,21 ,,RBRVS,7.91 ,6.66 ,6.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24340,CPT,TENODESIS BICEPS TENDON ELBOW SPX,,,21 ,,RBRVS,8.08 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24341,CPT,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,,,21 ,,RBRVS,9.49 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24342,CPT,RINSJ RPTD BICEPS/TRICEPS TDN DSTL +-TDN GRF,,,21 ,,RBRVS,10.86 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24343,CPT,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,,,21 ,,RBRVS,9.16 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24344,CPT,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,,,21 ,,RBRVS,15.21 ,11.10 ,11.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24345,CPT,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,,,21 ,,RBRVS,9.16 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24346,CPT,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,,,21 ,,RBRVS,15.21 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24357,CPT,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,,,21 ,,RBRVS,5.44 ,5.22 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24358,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,,,21 ,,RBRVS,6.66 ,5.86 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24359,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,,,21 ,,RBRVS,8.98 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24360,CPT,ARTHROPLASTY ELBOW W/MEMBRANE,,,21 ,,RBRVS,12.67 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24361,CPT,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,,,21 ,,RBRVS,14.41 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24362,CPT,ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ,,,21 ,,RBRVS,15.32 ,10.27 ,10.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24363,CPT,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCMT,,,21 ,,RBRVS,22.65 ,13.72 ,13.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24365,CPT,ARTHROPLASTY RADIAL HEAD,,,21 ,,RBRVS,8.62 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24366,CPT,ARTHROPLASTY RADIAL HEAD W/IMPLANT,,,21 ,,RBRVS,9.36 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24400,CPT,OSTEOTOMY HUMERUS +-INTERNAL FIXATION,,,21 ,,RBRVS,11.33 ,8.46 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24410,CPT,MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT,,,21 ,,RBRVS,15.11 ,10.14 ,10.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24420,CPT,OSTEOPLASTY HUMERUS,,,21 ,,RBRVS,13.73 ,10.10 ,10.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24430,CPT,REPAIR NON/MALUNION HUMERUS W/O GRAFT,,,21 ,,RBRVS,15.25 ,10.21 ,10.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24435,CPT,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,,,21 ,,RBRVS,14.99 ,10.89 ,10.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24470,CPT,HEMIEPIPHYSEAL ARREST,,,21 ,,RBRVS,8.93 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24495,CPT,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,,,21 ,,RBRVS,8.41 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24498,CPT,PROPHYLACTIC TX +-METHYLMETHACRYLATE HUMRL SHFT,,,21 ,,RBRVS,12.28 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24500,CPT,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,3.41 ,4.03 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24505,CPT,CLTX HUMERAL SHFT FX W/MANIPULATION +-SKEL TRACJ,,,21 ,,RBRVS,5.39 ,5.30 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24515,CPT,OPTX HUMERAL SHFT FX W/PLATE/SCREWS +-CERCLAGE,,,21 ,,RBRVS,12.12 ,8.99 ,8.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24516,CPT,TX HUMERAL SHAFT FX W/INSJ IMED IMPLT +-CERCLAGE,,,21 ,,RBRVS,12.19 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24530,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX+-MNPJ,,,21 ,,RBRVS,3.69 ,4.27 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24535,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MNPJ,,,21 ,,RBRVS,7.11 ,6.43 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24538,CPT,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,,,21 ,,RBRVS,9.77 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24545,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,,,21 ,,RBRVS,13.15 ,9.07 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24546,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,,,21 ,,RBRVS,14.91 ,10.36 ,10.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24560,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MNPJ,,,21 ,,RBRVS,2.98 ,3.58 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24565,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MNPJ,,,21 ,,RBRVS,5.78 ,5.44 ,6.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24566,CPT,PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MNPJ,,,21 ,,RBRVS,9.06 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24575,CPT,OPEN TX HUMERAL EPICONDYLAR FRACTURE,,,21 ,,RBRVS,9.71 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24576,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MNPJ,,,21 ,,RBRVS,3.06 ,3.93 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24577,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MNPJ,,,21 ,,RBRVS,6.01 ,5.60 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24579,CPT,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,,,21 ,,RBRVS,11.44 ,8.63 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24582,CPT,PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MNPJ,,,21 ,,RBRVS,10.14 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24586,CPT,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBOW,,,21 ,,RBRVS,15.78 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24587,CPT,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHRP,,,21 ,,RBRVS,15.79 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24600,CPT,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,,,21 ,,RBRVS,4.37 ,3.44 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24605,CPT,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,,,21 ,,RBRVS,5.64 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24615,CPT,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,,,21 ,,RBRVS,9.83 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24620,CPT,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MNPJ,,,21 ,,RBRVS,7.22 ,5.97 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24635,CPT,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,,,21 ,,RBRVS,8.80 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24640,CPT,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MNPJ,,,21 ,,RBRVS,1.25 ,0.85 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24650,CPT,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,,,21 ,,RBRVS,2.31 ,3.14 ,3.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24655,CPT,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,,,21 ,,RBRVS,4.62 ,4.75 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24665,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE,,,21 ,,RBRVS,8.36 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24666,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,,,21 ,,RBRVS,9.86 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24670,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MNPJ,,,21 ,,RBRVS,2.69 ,3.34 ,4.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24675,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W MNPJ,,,21 ,,RBRVS,4.91 ,4.93 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24685,CPT,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,,,21 ,,RBRVS,8.37 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24800,CPT,ARTHRODESIS ELBOW JOINT LOCAL,,,21 ,,RBRVS,11.41 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24802,CPT,ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT,,,21 ,,RBRVS,14.32 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24900,CPT,AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE,,,21 ,,RBRVS,10.18 ,7.20 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24920,CPT,AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR,,,21 ,,RBRVS,10.13 ,7.11 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24925,CPT,AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ,,,21 ,,RBRVS,7.30 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24930,CPT,AMPUTATION ARM THRU HUMERUS RE-AMPUTATION,,,21 ,,RBRVS,10.83 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24931,CPT,AMPUTATION ARM THRU HUMERUS W/IMPLANT,,,21 ,,RBRVS,13.44 ,6.69 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24935,CPT,STUMP ELONGATION UPPER EXTREMITY,,,21 ,,RBRVS,16.45 ,9.04 ,9.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24940,CPT,CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE,,,21 ,,RBRVS,14.89 ,10.19 ,10.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,24999,CPT,UNLISTED PROCEDURE HUMERUS/ELBOW,,,21 ,,TotalUnits,,,,12.52 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,25000,CPT,INCISION EXTENSOR TENDON SHEATH WRIST,,,21 ,,RBRVS,3.55 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25001,CPT,INCISION FLEXOR TENDON SHEATH WRIST,,,21 ,,RBRVS,3.79 ,4.26 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25020,CPT,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,,,21 ,,RBRVS,6.06 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25023,CPT,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,,,21 ,,RBRVS,13.83 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25024,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DBRDMT,,,21 ,,RBRVS,10.79 ,7.86 ,7.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25025,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT NV,,,21 ,,RBRVS,17.94 ,11.10 ,11.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25028,CPT,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,,,21 ,,RBRVS,5.39 ,7.02 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25031,CPT,INCISION & DRAINAGE FOREARM&/WRIST BURSA,,,21 ,,RBRVS,4.26 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25035,CPT,INCISION DEEP BONE CORTEX FOREARM&/WRIST,,,21 ,,RBRVS,7.65 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25040,CPT,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,,,21 ,,RBRVS,7.50 ,6.22 ,6.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25065,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,,,21 ,,RBRVS,2.04 ,2.02 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25066,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,,,21 ,,RBRVS,4.27 ,4.71 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25071,CPT,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,,,21 ,,RBRVS,5.91 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25073,CPT,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,,,21 ,,RBRVS,7.13 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25075,CPT,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,,,21 ,,RBRVS,3.96 ,4.03 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25076,CPT,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,,,21 ,,RBRVS,6.74 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25077,CPT,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3CM,,,21 ,,RBRVS,12.93 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25078,CPT,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,,,21 ,,RBRVS,17.69 ,10.19 ,10.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25085,CPT,CAPSULOTOMY WRIST,,,21 ,,RBRVS,5.64 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25100,CPT,ARTHROTOMY WRIST JOINT WITH BIOPSY,,,21 ,,RBRVS,4.02 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25101,CPT,ARTHRT WRST JT W/JT EXPL +-BX +-RMVL LOOSE/FB,,,21 ,,RBRVS,4.83 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25105,CPT,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,,,21 ,,RBRVS,6.02 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25107,CPT,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,,,21 ,,RBRVS,7.70 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25109,CPT,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,,,21 ,,RBRVS,6.94 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25110,CPT,EXCISION LESION TENDON SHEATH FOREARM&/WRIST,,,21 ,,RBRVS,4.04 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25111,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,,,21 ,,RBRVS,3.53 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25112,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,,,21 ,,RBRVS,4.67 ,4.56 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25115,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,,,21 ,,RBRVS,10.09 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25116,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,,,21 ,,RBRVS,7.56 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25118,CPT,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,,,21 ,,RBRVS,4.51 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25119,CPT,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,,,21 ,,RBRVS,6.21 ,5.93 ,5.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25120,CPT,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,,,21 ,,RBRVS,6.27 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25125,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT,,,21 ,,RBRVS,7.67 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25126,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,,,21 ,,RBRVS,7.74 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25130,CPT,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,,,21 ,,RBRVS,5.43 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25135,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,,,21 ,,RBRVS,7.08 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25136,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,,,21 ,,RBRVS,6.14 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25145,CPT,SEQUESTRECTOMY FOREARM &/WRIST,,,21 ,,RBRVS,6.54 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25150,CPT,PARTIAL EXCISION BONE ULNA,,,21 ,,RBRVS,7.38 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25151,CPT,PARTIAL EXCISION BONE RADIUS,,,21 ,,RBRVS,7.68 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25170,CPT,RADICAL RESECTION TUMOR RADIUS OR ULNA,,,21 ,,RBRVS,22.21 ,11.05 ,11.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25210,CPT,CARPECTOMY 1 BONE,,,21 ,,RBRVS,6.12 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25215,CPT,CARPECTOMY ALL BONES PROXIMAL ROW,,,21 ,,RBRVS,8.14 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25230,CPT,RADICAL STYLOIDECTOMY SPX,,,21 ,,RBRVS,5.37 ,5.14 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25240,CPT,EXCISION DISTAL ULNA PARTIAL/COMPLETE,,,21 ,,RBRVS,5.31 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25246,CPT,INJECTION WRIST ARTHROGRAPHY,,,21 ,,RBRVS,1.45 ,0.54 ,2.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25248,CPT,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,,,21 ,,RBRVS,5.31 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25250,CPT,REMOVAL WRIST PROSTHESIS SPX,,,21 ,,RBRVS,6.77 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25251,CPT,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,,,21 ,,RBRVS,9.82 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25259,CPT,MANIPULATION WRIST UNDER ANESTHESIA,,,21 ,,RBRVS,4.04 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25260,CPT,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MUSC,,,21 ,,RBRVS,8.04 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25263,CPT,RPR TDN/MUSC FLXR F/ARM&/WRST SEC 1 EA TDN/MUSC,,,21 ,,RBRVS,8.04 ,8.09 ,8.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25265,CPT,RPR TDN/MUSC FLXR F/ARM&/WRST SEC FR GRF EA,,,21 ,,RBRVS,10.10 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25270,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRST PRIM 1 EA TDN,,,21 ,,RBRVS,6.17 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25272,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC 1 EA TDN/MUSC,,,21 ,,RBRVS,7.21 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25274,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,,,21 ,,RBRVS,8.94 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25275,CPT,RPR TENDON SHEATH EXTENSOR F/ARM&/WRST W/GRAFT,,,21 ,,RBRVS,8.96 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25280,CPT,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRST 1 EA TDN,,,21 ,,RBRVS,7.39 ,7.38 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25290,CPT,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,,21 ,,RBRVS,5.43 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25295,CPT,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,,21 ,,RBRVS,6.72 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25300,CPT,TENODESIS WRIST FLEXORS FINGERS,,,21 ,,RBRVS,9.02 ,7.50 ,7.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25301,CPT,TENODESIS WRIST EXTENSORS FINGERS,,,21 ,,RBRVS,8.59 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25310,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,,,21 ,,RBRVS,8.08 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25312,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GRF,,,21 ,,RBRVS,9.82 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25315,CPT,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,,,21 ,,RBRVS,10.68 ,9.09 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25316,CPT,FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFER,,,21 ,,RBRVS,12.90 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25320,CPT,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,,,21 ,,RBRVS,12.75 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25332,CPT,ARTHRP WRST +-INTERPOS +-XTRNL/INT FIXJ,,,21 ,,RBRVS,11.74 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25335,CPT,CENTRALIZATION WRST ULNA,,,21 ,,RBRVS,13.39 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25337,CPT,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,,,21 ,,RBRVS,11.73 ,9.86 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25350,CPT,OSTEOTOMY RADIUS DISTAL THIRD,,,21 ,,RBRVS,9.09 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25355,CPT,OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD,,,21 ,,RBRVS,10.53 ,9.09 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25360,CPT,OSTEOTOMY ULNA,,,21 ,,RBRVS,8.74 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25365,CPT,OSTEOTOMY RADIUS & ULNA,,,21 ,,RBRVS,12.91 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25370,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,,,21 ,,RBRVS,14.10 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25375,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA,,,21 ,,RBRVS,13.55 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25390,CPT,OSTEOPLASTY RADIUS/ULNA SHORTENING,,,21 ,,RBRVS,10.70 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25391,CPT,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,,,21 ,,RBRVS,14.28 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25392,CPT,OSTEOPLASTY RADIUS & ULNA SHORTENING,,,21 ,,RBRVS,14.58 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25393,CPT,OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAFT,,,21 ,,RBRVS,16.56 ,12.00 ,12.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25394,CPT,OSTEOPLASTY CARPAL BONE SHORTENING,,,21 ,,RBRVS,10.85 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25400,CPT,RPIR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,,,21 ,,RBRVS,11.28 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25405,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,,,21 ,,RBRVS,15.01 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25415,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAFT,,,21 ,,RBRVS,13.80 ,11.06 ,11.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25420,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,,,21 ,,RBRVS,17.04 ,12.50 ,12.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25425,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA,,,21 ,,RBRVS,13.72 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25426,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA,,,21 ,,RBRVS,16.45 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25430,CPT,INSERTION VASCULAR PEDICLE CARPAL BONE,,,21 ,,RBRVS,9.71 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25431,CPT,REPAIR NONUNION CARPAL BONE EACH BONE,,,21 ,,RBRVS,10.89 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25440,CPT,RPR NONUNION SCAPHOID CARPAL BONE +-RDL STYLODC,,,21 ,,RBRVS,10.68 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25441,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,,,21 ,,RBRVS,13.29 ,9.59 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25442,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA,,,21 ,,RBRVS,11.12 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25443,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL,,,21 ,,RBRVS,10.66 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25444,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE,,,21 ,,RBRVS,11.42 ,7.80 ,7.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25445,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,,,21 ,,RBRVS,9.88 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25446,CPT,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,,,21 ,,RBRVS,17.30 ,11.31 ,11.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25447,CPT,ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS,,,21 ,,RBRVS,11.14 ,8.72 ,8.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25449,CPT,REVJ ARTHRP W/RMVL IMPLT WRST JT,,,21 ,,RBRVS,14.94 ,10.07 ,10.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25450,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,,,21 ,,RBRVS,8.06 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25455,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&U,,,21 ,,RBRVS,9.71 ,6.77 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25490,CPT,PROPH TX N/P/PLTWR +-MMA RDS,,,21 ,,RBRVS,9.73 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25491,CPT,PROPH TX N/P/PLTWR +-MMA U,,,21 ,,RBRVS,10.15 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25492,CPT,PROPH TX N/P/PLTWR +-MMA RDS&U,,,21 ,,RBRVS,12.66 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25500,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.60 ,3.03 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25505,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,,,21 ,,RBRVS,5.45 ,5.42 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25515,CPT,OPEN TREATMENT RADIAL SHAFT FRACTURE,,,21 ,,RBRVS,8.80 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25520,CPT,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,,,21 ,,RBRVS,6.50 ,5.88 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25525,CPT,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,,,21 ,,RBRVS,10.55 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25526,CPT,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,,,21 ,,RBRVS,13.15 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25530,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.24 ,3.14 ,3.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25535,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,,,21 ,,RBRVS,5.36 ,5.32 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25545,CPT,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,,,21 ,,RBRVS,7.94 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25560,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MNPJ,,,21 ,,RBRVS,2.59 ,3.02 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25565,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MNPJ,,,21 ,,RBRVS,5.85 ,5.39 ,6.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25574,CPT,OPEN TX RADIAL & ULNAR SHAFT FX FIXJ RADIUS/ULNA,,,21 ,,RBRVS,8.80 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25575,CPT,OPEN TX RDL& ULNAR SHAFT FX FIXJ RADIUS &ULNA,,,21 ,,RBRVS,12.29 ,9.31 ,9.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25600,CPT,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ,,,21 ,,RBRVS,2.78 ,3.34 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25605,CPT,CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ,,,21 ,,RBRVS,7.25 ,6.59 ,7.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25606,CPT,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,,,21 ,,RBRVS,8.31 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25607,CPT,OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP,,,21 ,,RBRVS,9.56 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25608,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG,,,21 ,,RBRVS,11.07 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25609,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG,,,21 ,,RBRVS,14.38 ,10.57 ,10.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25622,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MNPJ,,,21 ,,RBRVS,2.79 ,3.51 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25624,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/MNPJ,,,21 ,,RBRVS,4.77 ,5.15 ,6.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25628,CPT,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,,,21 ,,RBRVS,9.67 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25630,CPT,CLTX CARPL B1 FX W/O MNPJ EA B1,,,21 ,,RBRVS,3.03 ,3.40 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25635,CPT,CLTX CARPL B1 FX W/MNPJ EA B1,,,21 ,,RBRVS,4.61 ,4.68 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25645,CPT,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,,,21 ,,RBRVS,7.42 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25650,CPT,CLOSED TREATMENT ULNAR STYLOID FRACTURE,,,21 ,,RBRVS,3.23 ,3.62 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25651,CPT,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,,,21 ,,RBRVS,5.82 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25652,CPT,OPEN TREATMENT ULNAR STYLOID FRACTURE,,,21 ,,RBRVS,8.06 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25660,CPT,CLTX RDCRPL/INTERCARPL DISLC 1+ B1S W/MNPJ,,,21 ,,RBRVS,4.98 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25670,CPT,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1+ BONES,,,21 ,,RBRVS,8.09 ,6.53 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25671,CPT,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,,,21 ,,RBRVS,6.46 ,6.04 ,6.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25675,CPT,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MNPJ,,,21 ,,RBRVS,4.89 ,4.48 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25676,CPT,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,,,21 ,,RBRVS,8.29 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25680,CPT,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MNPJ,,,21 ,,RBRVS,6.23 ,4.85 ,4.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25685,CPT,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,,,21 ,,RBRVS,10.09 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25690,CPT,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,,,21 ,,RBRVS,5.72 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25695,CPT,OPEN TREATMENT LUNATE DISLOCATION,,,21 ,,RBRVS,8.51 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25800,CPT,ARTHRD WRST COMPL W/O B1 GRF,,,21 ,,RBRVS,10.07 ,7.84 ,7.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25805,CPT,ARTHRD WRST W/SLIDING GRF,,,21 ,,RBRVS,11.73 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25810,CPT,ARTHRD WRST W/ILIAC/OTH AGRFT,,,21 ,,RBRVS,11.95 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25820,CPT,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,,,21 ,,RBRVS,7.64 ,7.14 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25825,CPT,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,,,21 ,,RBRVS,9.69 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25830,CPT,ARTHRD DSTL RAD/ULN JT SGMTL RESCJ U +-B1 GRF,,,21 ,,RBRVS,10.88 ,12.05 ,12.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25900,CPT,AMPUTATION FOREARM THROUGH RADIUS & ULNA,,,21 ,,RBRVS,9.61 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25905,CPT,AMP FOREARM THRU RADIUS&ULNA OPEN CIRCULAR,,,21 ,,RBRVS,9.59 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25907,CPT,AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR REVJ,,,21 ,,RBRVS,8.09 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25909,CPT,AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION,,,21 ,,RBRVS,9.31 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25915,CPT,KRUKENBERG PROCEDURE,,,21 ,,RBRVS,17.52 ,11.01 ,11.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25920,CPT,DISARTICULATION THROUGH WRIST,,,21 ,,RBRVS,9.03 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25922,CPT,DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ,,,21 ,,RBRVS,7.65 ,5.95 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25924,CPT,DISARTICULATION THRU WRIST RE-AMPUTATION,,,21 ,,RBRVS,8.81 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25927,CPT,TRANSMETACARPAL AMPUTATION,,,21 ,,RBRVS,9.09 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25929,CPT,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,,,21 ,,RBRVS,7.82 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25931,CPT,TRANSMETACARPAL AMPUTATION RE-AMPUTATION,,,21 ,,RBRVS,8.04 ,8.95 ,8.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,25999,CPT,UNLISTED PROCEDURE FOREARM/WRIST,,,21 ,,TotalUnits,,,,14.10 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,26010,CPT,DRAINAGE FINGER ABSCESS SIMPLE,,,21 ,,RBRVS,1.59 ,1.64 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26011,CPT,DRAINAGE FINGER ABSCESS COMPLICATED,,,21 ,,RBRVS,2.24 ,2.18 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26020,CPT,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,,,21 ,,RBRVS,5.08 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26025,CPT,DRAINAGE OF PALMAR BURSA SINGLE BURSA,,,21 ,,RBRVS,5.08 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26030,CPT,DRAINAGE OF PALMAR BURSA MULTIPLE BURSA,,,21 ,,RBRVS,6.25 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26034,CPT,INCISION BONE CORTEX HAND/FINGER,,,21 ,,RBRVS,6.63 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26035,CPT,DECOMPRESSION FINGERS&/HAND INJECTION INJURY,,,21 ,,RBRVS,11.37 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26037,CPT,DECOMPRESSIVE FASCIOTOMY HAND,,,21 ,,RBRVS,7.57 ,6.10 ,6.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26040,CPT,FASCIOTOMY PALMAR PERCUTANEOUS,,,21 ,,RBRVS,3.46 ,3.92 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26045,CPT,FASCIOTOMY PALMAR OPEN PARTIAL,,,21 ,,RBRVS,5.73 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26055,CPT,TENDON SHEATH INCISION,,,21 ,,RBRVS,3.11 ,4.09 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26060,CPT,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,,,21 ,,RBRVS,2.91 ,3.39 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26070,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,,,21 ,,RBRVS,3.81 ,3.42 ,3.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26075,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,,,21 ,,RBRVS,3.91 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26080,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,,,21 ,,RBRVS,4.47 ,4.73 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26100,CPT,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,,,21 ,,RBRVS,3.79 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26105,CPT,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,,,21 ,,RBRVS,3.83 ,4.05 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26110,CPT,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,,,21 ,,RBRVS,3.65 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26111,CPT,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,,,21 ,,RBRVS,5.42 ,5.01 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26113,CPT,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,,,21 ,,RBRVS,7.13 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26115,CPT,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,,,21 ,,RBRVS,3.96 ,4.45 ,10.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26116,CPT,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,,,21 ,,RBRVS,6.74 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26117,CPT,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,,,21 ,,RBRVS,10.13 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26118,CPT,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3+CM,,,21 ,,RBRVS,14.81 ,11.84 ,11.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26121,CPT,FASCT PALM +-Z-PLASTY TISS REARGMT/SKN GRF,,,21 ,,RBRVS,7.73 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26123,CPT,FASCT PRTL PLMR 1 DGT PROX IPHAL JT +-TISS,,,21 ,,RBRVS,10.88 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26125,CPT,FASCT PRTL PLMR 1 DGT PROX IPHAL JT +-Z-PLASTY,,,21 ,,RBRVS,4.60 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26130,CPT,SYNOVECTOMY CARPOMETACARPAL JOINT,,,21 ,,RBRVS,5.59 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26135,CPT,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,,,21 ,,RBRVS,7.13 ,6.09 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26140,CPT,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,,,21 ,,RBRVS,6.34 ,5.74 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26145,CPT,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,,,21 ,,RBRVS,6.49 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26160,CPT,EXC LES TDN SHTH/JT CAPSL HAND/FNGR,,,21 ,,RBRVS,3.57 ,4.23 ,10.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26170,CPT,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,,,21 ,,RBRVS,4.91 ,4.79 ,4.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26180,CPT,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,,,21 ,,RBRVS,5.35 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26185,CPT,SESAMOIDECTOMY THUMB/FINGER SPX,,,21 ,,RBRVS,6.52 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26200,CPT,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,,,21 ,,RBRVS,5.65 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26205,CPT,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,,,21 ,,RBRVS,7.93 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26210,CPT,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,,,21 ,,RBRVS,5.32 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26215,CPT,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,,,21 ,,RBRVS,7.27 ,6.09 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26230,CPT,PARTIAL EXCISION BONE METACARPAL,,,21 ,,RBRVS,6.47 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26235,CPT,PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER,,,21 ,,RBRVS,6.33 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26236,CPT,PARTIAL EXCISION DISTAL PHALANX FINGER,,,21 ,,RBRVS,5.46 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26250,CPT,RADICAL RESECTION TUMOR METACARPAL,,,21 ,,RBRVS,15.21 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26260,CPT,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,,,21 ,,RBRVS,11.16 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26262,CPT,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,,,21 ,,RBRVS,8.29 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26320,CPT,REMOVAL IMPLANT FROM FINGER/HAND,,,21 ,,RBRVS,4.10 ,4.16 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26340,CPT,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,,,21 ,,RBRVS,2.80 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26350,CPT,RPR/ADVMNT FLXR TDN N/Z/2 1/2 W/O FR GRF EA TDN,,,21 ,,RBRVS,6.21 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26352,CPT,RPR/ADVMNT FLXR TDN N/Z/2 2W/FR GRF EA TDN,,,21 ,,RBRVS,7.87 ,11.60 ,11.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26356,CPT,RPR/ADVMNT FLXR TDN ZONE 2 1W/O FR GRF EA TDN,,,21 ,,RBRVS,10.62 ,15.38 ,15.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26357,CPT,RPR/ADVMNT FLXR TDN ZONE 2 2W/O FR GRF EA TDN,,,21 ,,RBRVS,8.77 ,12.04 ,12.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26358,CPT,RPR/ADVMNT FLXR TDN ZONE 2 2W/FR GRF EA TDN,,,21 ,,RBRVS,9.36 ,12.66 ,12.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26370,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,,,21 ,,RBRVS,7.28 ,11.17 ,11.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26372,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN 2 W/FR GRF EA,,,21 ,,RBRVS,9.01 ,12.31 ,12.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26373,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN 2 W/O FR GRF EA,,,21 ,,RBRVS,8.41 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26390,CPT,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,,,21 ,,RBRVS,9.43 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26392,CPT,RMVL SYNTH ROD&INSJ FLXR TDN GRF H/F EA ROD,,,21 ,,RBRVS,10.50 ,12.78 ,12.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26410,CPT,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,,,21 ,,RBRVS,4.77 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26412,CPT,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,,,21 ,,RBRVS,6.48 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26415,CPT,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,,,21 ,,RBRVS,8.51 ,8.83 ,8.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26416,CPT,RMVL SYNTH ROD&INSJ XTNSR TDN GRF H/F EA ROD,,,21 ,,RBRVS,9.56 ,9.85 ,9.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26418,CPT,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,,,21 ,,RBRVS,4.47 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26420,CPT,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,,,21 ,,RBRVS,6.94 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26426,CPT,RPR XTNSR TDN CTR SLIP 2 TISS W/LAT BAND EA FNGR,,,21 ,,RBRVS,6.32 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26428,CPT,RPR XTNSR TDN CTR SLIP SEC W/FR GRF EA FNGR,,,21 ,,RBRVS,7.40 ,10.64 ,10.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26432,CPT,CLTX DSTL XTNSR TDN INSJ +-PRQ PINNING,,,21 ,,RBRVS,4.16 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26433,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,,,21 ,,RBRVS,4.70 ,8.08 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26434,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,,,21 ,,RBRVS,6.26 ,9.09 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26437,CPT,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,,,21 ,,RBRVS,5.99 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26440,CPT,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,,,21 ,,RBRVS,5.16 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26442,CPT,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDON,,,21 ,,RBRVS,9.75 ,13.28 ,13.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26445,CPT,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,,,21 ,,RBRVS,4.45 ,9.55 ,9.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26449,CPT,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,,,21 ,,RBRVS,8.59 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26450,CPT,TENOTOMY FLEXOR PALM OPEN EACH TENDON,,,21 ,,RBRVS,3.79 ,5.89 ,5.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26455,CPT,TENOTOMY FLEXOR FINGER OPEN EACH TENDON,,,21 ,,RBRVS,3.76 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26460,CPT,TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON,,,21 ,,RBRVS,3.58 ,5.78 ,5.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26471,CPT,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,,,21 ,,RBRVS,5.90 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26474,CPT,TENODESIS DISTAL JOINT EACH,,,21 ,,RBRVS,5.49 ,8.72 ,8.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26476,CPT,LENGTHENING TENDON EXTENSOR HAND/FINGER EACH,,,21 ,,RBRVS,5.35 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26477,CPT,SHORTENING TENDON EXTENSOR HAND/FINGER EACH,,,21 ,,RBRVS,5.32 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26478,CPT,LENGTHENING TENDON FLEXOR HAND/FINGER EACH,,,21 ,,RBRVS,5.97 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26479,CPT,SHORTENING TENDON FLEXOR HAND/FINGER EACH,,,21 ,,RBRVS,5.91 ,8.98 ,8.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26480,CPT,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,,,21 ,,RBRVS,6.90 ,11.26 ,11.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26483,CPT,TR/TRNSPL TDN CARP/MTCRPL AND W/FR TDN GRF EA,,,21 ,,RBRVS,8.48 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26485,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,,,21 ,,RBRVS,7.89 ,11.66 ,11.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26489,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,,,21 ,,RBRVS,9.86 ,11.60 ,11.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26490,CPT,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,,,21 ,,RBRVS,8.60 ,10.25 ,10.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26492,CPT,OPPONENSPLASTY TDN TR W/GRF EA TDN,,,21 ,,RBRVS,9.84 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26494,CPT,OPPONENSPLASTY HYPOTHENAR MUSC TR,,,21 ,,RBRVS,8.66 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26496,CPT,OPPONENSPLASTY OTH METHS,,,21 ,,RBRVS,9.78 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26497,CPT,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,,,21 ,,RBRVS,9.76 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26498,CPT,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,,,21 ,,RBRVS,14.21 ,13.24 ,13.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26499,CPT,CORRECTION CLAW FINGER OTHER METHODS,,,21 ,,RBRVS,9.17 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26500,CPT,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,,,21 ,,RBRVS,6.13 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26502,CPT,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,,,21 ,,RBRVS,7.31 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26508,CPT,RELEASE THENAR MUSCLE,,,21 ,,RBRVS,6.18 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26510,CPT,CROSS INTRINSIC TRANSFER EACH TENDON,,,21 ,,RBRVS,5.60 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26516,CPT,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,,,21 ,,RBRVS,7.32 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26517,CPT,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,,,21 ,,RBRVS,9.08 ,10.67 ,10.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26518,CPT,CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS,,,21 ,,RBRVS,9.27 ,10.72 ,10.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26520,CPT,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,,,21 ,,RBRVS,5.47 ,10.27 ,10.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26525,CPT,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,,,21 ,,RBRVS,5.50 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26530,CPT,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,,,21 ,,RBRVS,6.88 ,5.97 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26531,CPT,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,,,21 ,,RBRVS,8.13 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26535,CPT,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,,,21 ,,RBRVS,5.41 ,4.38 ,4.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26536,CPT,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,,,21 ,,RBRVS,6.56 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26540,CPT,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,,,21 ,,RBRVS,6.60 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26541,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,,,21 ,,RBRVS,8.81 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26542,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,,,21 ,,RBRVS,6.95 ,9.38 ,9.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26545,CPT,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,,,21 ,,RBRVS,7.11 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26546,CPT,RPR NON-UNION MTCRPL/PHALANX,,,21 ,,RBRVS,10.83 ,12.81 ,12.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26548,CPT,RPR&RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL JT,,,21 ,,RBRVS,8.22 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26550,CPT,POLLICIZATION DIGIT,,,21 ,,RBRVS,21.68 ,15.18 ,15.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26551,CPT,TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND,,,21 ,,RBRVS,48.48 ,28.90 ,28.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26553,CPT,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1,,,21 ,,RBRVS,48.17 ,21.83 ,21.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26554,CPT,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2,,,21 ,,RBRVS,57.01 ,28.98 ,28.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26555,CPT,TR FNGR AXH POS W/O MVASC ANAST,,,21 ,,RBRVS,17.08 ,16.06 ,16.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26556,CPT,TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS,,,21 ,,RBRVS,49.75 ,19.76 ,19.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26560,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,,,21 ,,RBRVS,5.52 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26561,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFTS,,,21 ,,RBRVS,11.10 ,10.41 ,10.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26562,CPT,REPAIR SYNDACTYLY EACH SPACE COMPLEX,,,21 ,,RBRVS,16.68 ,14.01 ,14.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26565,CPT,OSTEOTOMY METACARPAL EACH,,,21 ,,RBRVS,6.91 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26567,CPT,OSTEOTOMY PHALANX FINGER EACH,,,21 ,,RBRVS,6.99 ,9.41 ,9.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26568,CPT,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,,,21 ,,RBRVS,9.27 ,12.21 ,12.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26580,CPT,REPAIR CLEFT HAND,,,21 ,,RBRVS,19.75 ,14.68 ,14.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26587,CPT,RCNSTJ POLYDACTYLOUS DGT SOFT TISS&B1,,,21 ,,RBRVS,14.50 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26590,CPT,REPAIR MACRODACTYLIA EACH DIGIT,,,21 ,,RBRVS,18.67 ,12.45 ,12.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26591,CPT,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,,,21 ,,RBRVS,3.38 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26593,CPT,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,,,21 ,,RBRVS,5.50 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26596,CPT,EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES,,,21 ,,RBRVS,9.14 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26600,CPT,CLTX MTCRPL FX 1 W/O MNPJ EA B1,,,21 ,,RBRVS,2.60 ,3.55 ,4.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26605,CPT,CLTX MTCRPL FX 1 W/MNPJ EA B1,,,21 ,,RBRVS,3.03 ,3.76 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26607,CPT,CLTX MTCRPL FX W/MNPJ W/XTRNL FIXJ EA B1,,,21 ,,RBRVS,5.48 ,5.03 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26608,CPT,PRQ SKEL FIXJ MTCRPL FX EA B1,,,21 ,,RBRVS,5.55 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26615,CPT,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,,,21 ,,RBRVS,7.07 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26641,CPT,CLTX CARP/MTCRPL DISLC THMB W/MNPJ,,,21 ,,RBRVS,4.13 ,3.76 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26645,CPT,CLTX CARP/MTCRPL FX DISLC THMB W/MNPJ,,,21 ,,RBRVS,4.58 ,4.40 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26650,CPT,PRQ SKEL FIXATION CARP/MTCRPL FX DISLOCATE THUMB,,,21 ,,RBRVS,5.35 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26665,CPT,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,,,21 ,,RBRVS,7.94 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26670,CPT,CLTX CARP/MTCRPL DISLC THMB MNPJ EA W/O ANES,,,21 ,,RBRVS,3.83 ,3.18 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26675,CPT,CLTX CARP/MTCRPL DISLC THMB MNPJ EA JT REQ ANES,,,21 ,,RBRVS,4.83 ,4.73 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26676,CPT,PRQ SKEL FIXJ CARP/MTCRPL DISLC THMB MNPJ EA JT,,,21 ,,RBRVS,5.74 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26685,CPT,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,,,21 ,,RBRVS,7.07 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26686,CPT,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,,,21 ,,RBRVS,8.17 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26700,CPT,CLTX MTCARPHLNGL DISLC 1 W/MNPJ W/O ANES,,,21 ,,RBRVS,3.83 ,3.10 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26705,CPT,CLTX MTCARPHLNGL DISLC 1 W/MNPJ REQ ANES,,,21 ,,RBRVS,4.38 ,4.37 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26706,CPT,PRQ SKEL FIXJ MTCARPHLNGL DISLC 1 W/MNPJ,,,21 ,,RBRVS,5.31 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26715,CPT,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION 1,,,21 ,,RBRVS,7.03 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26720,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MNPJ EA,,,21 ,,RBRVS,1.76 ,2.39 ,2.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26725,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MNPJ EA,,,21 ,,RBRVS,3.48 ,3.65 ,4.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26727,CPT,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,,,21 ,,RBRVS,5.42 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26735,CPT,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,,,21 ,,RBRVS,7.42 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26740,CPT,CLTX ARTICULAR FX INVG MTCARPHLNGL/IPHAL JT W/O,,,21 ,,RBRVS,2.07 ,2.86 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26742,CPT,CLTX ARTICULAR FX INVG MTCARPHLNGL/IPHAL JT W/,,,21 ,,RBRVS,3.99 ,3.88 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26746,CPT,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,,,21 ,,RBRVS,9.80 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26750,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/O MNPJ EA,,,21 ,,RBRVS,1.80 ,2.34 ,2.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26755,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/MNPJ EA,,,21 ,,RBRVS,3.23 ,3.15 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26756,CPT,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,,,21 ,,RBRVS,4.58 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26765,CPT,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,,,21 ,,RBRVS,5.86 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26770,CPT,CLTX IPHAL JT DISLC 1 W/MNPJ W/O ANES,,,21 ,,RBRVS,3.15 ,2.66 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26775,CPT,CLTX IPHAL JT DISLC 1 W/MNPJ REQ ANES,,,21 ,,RBRVS,3.90 ,4.13 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26776,CPT,PRQ SKEL FIXJ IPHAL JT DISLC 1 W/MNPJ,,,21 ,,RBRVS,4.99 ,5.51 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26785,CPT,OPEN TX INTERPHALANGEAL JOINT DISLOCATION 1,,,21 ,,RBRVS,6.60 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26820,CPT,FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT,,,21 ,,RBRVS,8.45 ,10.39 ,10.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26841,CPT,ARTHRD CARP/MTCRPL JT THMB +-INT FIXJ,,,21 ,,RBRVS,7.35 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26842,CPT,ARTHRD CARP/MTCRPL JT THMB +-INT FIXJ W/AGRFT,,,21 ,,RBRVS,8.49 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26843,CPT,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,,,21 ,,RBRVS,7.78 ,9.82 ,9.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26844,CPT,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,,,21 ,,RBRVS,8.98 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26850,CPT,ARTHRD MTCARPHLNGL JT +-INT FIXJ,,,21 ,,RBRVS,7.14 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26852,CPT,ARTHRD MTCARPHLNGL JT +-INT FIXJ W/AGRFT,,,21 ,,RBRVS,8.71 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26860,CPT,ARTHRD IPHAL JT +-INT FIXJ,,,21 ,,RBRVS,4.88 ,8.63 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26861,CPT,ARTHRD IPHAL JT +-INT FIXJ EA IPHAL JT,,,21 ,,RBRVS,1.74 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26862,CPT,ARTHRD IPHAL JT +-INT FIXJ W/AGRFT,,,21 ,,RBRVS,7.56 ,9.89 ,9.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26863,CPT,ARTHRD IPHAL JT +-INT FIXJ W/AGRFT EA JT,,,21 ,,RBRVS,3.89 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26910,CPT,AMP MTCRPL W/FNGR/THMB 1 +-INTEROSS TR,,,21 ,,RBRVS,7.79 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26951,CPT,AMP F/TH 1/2 JT/PHALANX 1 W/NEURECT W/DIR CLSR,,,21 ,,RBRVS,6.04 ,9.17 ,9.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26952,CPT,AMP F/TH 1/2 JT/PHALANX 1 W/NEURECT LOCAL FLAP,,,21 ,,RBRVS,6.48 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26989,CPT,UNLIS PX HANDS/FNGRS,,,21 ,,TotalUnits,,,,10.29 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,26990,CPT,I&D PELVIS/HIP JT AREA DP ABSC/HMTMA,,,21 ,,RBRVS,7.95 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26991,CPT,I&D PELVIS/HIP JT AREA INFCT BURSA,,,21 ,,RBRVS,7.06 ,5.43 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,26992,CPT,INCISION BONE CORTEX PELVIS&/HIP JOINT,,,21 ,,RBRVS,13.48 ,9.64 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27000,CPT,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,,,21 ,,RBRVS,5.74 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27001,CPT,TENOTOMY ADDUCTOR HIP OPEN,,,21 ,,RBRVS,7.14 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27003,CPT,TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY,,,21 ,,RBRVS,7.81 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27005,CPT,TENOTOMY HIP FLEXOR OPEN SPX,,,21 ,,RBRVS,10.07 ,7.43 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27006,CPT,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,,,21 ,,RBRVS,10.11 ,7.61 ,7.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27025,CPT,FASCIOTOMY HIP/THIGH ANY TYPE,,,21 ,,RBRVS,12.89 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27027,CPT,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,,,21 ,,RBRVS,13.04 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27030,CPT,ARTHROTOMY HIP W/DRAINAGE,,,21 ,,RBRVS,13.65 ,9.11 ,9.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27033,CPT,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,,,21 ,,RBRVS,14.11 ,9.47 ,9.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27035,CPT,DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH,,,21 ,,RBRVS,17.37 ,9.78 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27036,CPT,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,,,21 ,,RBRVS,14.38 ,9.91 ,9.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27040,CPT,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,,,21 ,,RBRVS,2.92 ,2.03 ,5.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27041,CPT,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,,,21 ,,RBRVS,10.18 ,6.40 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27043,CPT,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,,,21 ,,RBRVS,6.88 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27045,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,,,21 ,,RBRVS,11.13 ,7.43 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27047,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,,,21 ,,RBRVS,4.94 ,4.56 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27048,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,,,21 ,,RBRVS,8.85 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27049,CPT,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5CM,,,21 ,,RBRVS,21.55 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27050,CPT,ARTHROTOMY W/BIOPSY SACROILIAC JOINT,,,21 ,,RBRVS,4.74 ,4.02 ,4.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27052,CPT,ARTHROTOMY W/BIOPSY HIP JOINT,,,21 ,,RBRVS,7.42 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27054,CPT,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,,,21 ,,RBRVS,9.21 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27057,CPT,DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI,,,21 ,,RBRVS,14.91 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27059,CPT,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,,,21 ,,RBRVS,29.35 ,15.99 ,15.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27060,CPT,EXCISION ISCHIAL BURSA,,,21 ,,RBRVS,5.87 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27062,CPT,EXCISION TROCHANTERIC BURSA/CALCIFICATION,,,21 ,,RBRVS,5.75 ,5.07 ,5.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27065,CPT,EXC B1 CST/B9 TUM SUPFC +-AGRFT,,,21 ,,RBRVS,6.55 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27066,CPT,EXC B1 CST/B9 TUM DP +-AGRFT,,,21 ,,RBRVS,11.20 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27067,CPT,EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC,,,21 ,,RBRVS,14.72 ,10.23 ,10.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27070,CPT,PRTL EXC CRATRZTJ SAUCRZTJ SUPFC,,,21 ,,RBRVS,11.56 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27071,CPT,PRTL EXC CRATRZTJ SAUCRZTJ DP,,,21 ,,RBRVS,12.39 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27075,CPT,RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL,,,21 ,,RBRVS,32.71 ,18.43 ,18.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27076,CPT,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,,,21 ,,RBRVS,40.21 ,16.12 ,16.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27077,CPT,RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL,,,21 ,,RBRVS,45.21 ,22.49 ,22.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27078,CPT,RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR,,,21 ,,RBRVS,32.21 ,12.20 ,12.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27080,CPT,COCCYGECTOMY PRIMARY,,,21 ,,RBRVS,6.89 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27086,CPT,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,,,21 ,,RBRVS,1.92 ,1.67 ,4.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27087,CPT,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,,,21 ,,RBRVS,8.83 ,6.42 ,6.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27090,CPT,REMOVAL HIP PROSTHESIS SPX,,,21 ,,RBRVS,11.69 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27091,CPT,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,,,21 ,,RBRVS,24.35 ,14.41 ,14.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27093,CPT,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,,,21 ,,RBRVS,1.30 ,0.52 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27095,CPT,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,,,21 ,,RBRVS,1.50 ,0.59 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27096,CPT,INJECTION SI JOINT ARTHROGRAPHY&/ANES/STEROID,,,21 ,,RBRVS,1.40 ,0.41 ,3.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27097,CPT,RELEASE/RECESSION HAMSTRING PROXIMAL,,,21 ,,RBRVS,9.27 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27098,CPT,TRANSFER ADDUCTOR ISCHIUM,,,21 ,,RBRVS,9.32 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27100,CPT,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,,,21 ,,RBRVS,11.35 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27105,CPT,TR PARASPI MUSC HIP FASC/TDN XTN GRF,,,21 ,,RBRVS,12.04 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27110,CPT,TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR,,,21 ,,RBRVS,13.77 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27111,CPT,TRANSFER ILIOPSOAS FEMORAL NECK,,,21 ,,RBRVS,12.60 ,8.26 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27120,CPT,ACETABULOPLASTY,,,21 ,,RBRVS,19.25 ,11.98 ,11.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27122,CPT,ACETABULOPLASTY RESECTION FEMORAL HEAD,,,21 ,,RBRVS,16.09 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27125,CPT,HEMIARTHROPLASTY HIP PARTIAL,,,21 ,,RBRVS,16.64 ,10.71 ,10.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27130,CPT,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,,,21 ,,RBRVS,21.79 ,13.25 ,13.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27132,CPT,CONV PREVIOUS HIP TOT HIP ARTHRP +-AGRFT/ALGRFT,,,21 ,,RBRVS,25.69 ,15.24 ,15.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27134,CPT,REVJ TOT HIP ARTHRP BTH +-AGRFT/ALGRFT,,,21 ,,RBRVS,30.28 ,16.87 ,16.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27137,CPT,REVJ TOT HIP ARTHRP ACTBLR ONLY +-AGRFT/ALGRFT,,,21 ,,RBRVS,22.70 ,13.36 ,13.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27138,CPT,REVJ TOT HIP ARTHRP FEM ONLY +-ALGRFT,,,21 ,,RBRVS,23.70 ,13.82 ,13.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27140,CPT,OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX,,,21 ,,RBRVS,12.78 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27146,CPT,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE,,,21 ,,RBRVS,18.92 ,11.83 ,11.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27147,CPT,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ,,,21 ,,RBRVS,22.07 ,13.52 ,13.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27151,CPT,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT,,,21 ,,RBRVS,24.12 ,13.22 ,13.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27156,CPT,OSTEOT ILIAC ACTBLR/INNOMINATE B1 OSTEOT RDCTJ,,,21 ,,RBRVS,26.23 ,15.26 ,15.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27158,CPT,OSTEOTOMY PELVIS BILATERAL,,,21 ,,RBRVS,21.04 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27161,CPT,OSTEOTOMY FEMORAL NECK SPX,,,21 ,,RBRVS,17.89 ,11.61 ,11.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27165,CPT,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,,,21 ,,RBRVS,20.29 ,12.93 ,12.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27170,CPT,B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA,,,21 ,,RBRVS,17.61 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27175,CPT,TX SLP FEM EPIPHYSIS TRCJ W/O RDCTJ,,,21 ,,RBRVS,9.38 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27176,CPT,TX SLP FEM EPIPHYSIS 1/MLT PINNING SITU,,,21 ,,RBRVS,12.92 ,9.09 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27177,CPT,OPTX SLP FEM EPIPHYSIS 1/MLT PINNING/B1 GRF,,,21 ,,RBRVS,16.09 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27178,CPT,OPTX SLP FEM EPIPHYSIS CLSD MNPJ 1/MLT PINNING,,,21 ,,RBRVS,12.92 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27179,CPT,OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX,,,21 ,,RBRVS,13.97 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27181,CPT,OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ,,,21 ,,RBRVS,16.18 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27185,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR,,,21 ,,RBRVS,9.79 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27187,CPT,PROPH TX N/P/PLTWR +-MMA FEM NCK&PROX FEMUR,,,21 ,,RBRVS,14.23 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27193,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/O MNPJ,,,21 ,,RBRVS,6.09 ,5.20 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27194,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/MNPJ ANES,,,21 ,,RBRVS,10.20 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27200,CPT,CLOSED TREATMENT COCCYGEAL FRACTURE,,,21 ,,RBRVS,1.92 ,2.34 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27202,CPT,OPEN TREATMENT COCCYGEAL FRACTURE,,,21 ,,RBRVS,7.31 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27215,CPT,OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD,,,21 ,,RBRVS,10.45 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27216,CPT,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DISLC,,,21 ,,RBRVS,15.73 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27217,CPT,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFRMD,,,21 ,,RBRVS,14.65 ,9.01 ,9.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27218,CPT,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,,,21 ,,RBRVS,20.93 ,11.39 ,11.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27220,CPT,CLTX ACETABULUM HIP/SOCKT FX W/O MNPJ,,,21 ,,RBRVS,6.83 ,5.67 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27222,CPT,CLTX ACETABULUM HIP/SOCKT FX MNPJ +-SKEL TRACJ,,,21 ,,RBRVS,14.11 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27226,CPT,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,,,21 ,,RBRVS,15.57 ,9.62 ,9.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27227,CPT,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,,,21 ,,RBRVS,25.41 ,15.09 ,15.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27228,CPT,OPTX ACTBLR FX INVG ANT&PST 2 COLUMNS FX W/INT,,,21 ,,RBRVS,29.33 ,16.97 ,16.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27230,CPT,CLTX FEM FX PROX END NCK W/O MNPJ,,,21 ,,RBRVS,5.81 ,5.30 ,5.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27232,CPT,CLTX FEM FX PROX END NCK W/MNPJ +-SKEL TRACJ,,,21 ,,RBRVS,11.72 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27235,CPT,PRQ SKEL FIXJ FEM FX PROX END NCK,,,21 ,,RBRVS,13.00 ,8.99 ,8.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27236,CPT,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,,,21 ,,RBRVS,17.61 ,11.29 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27238,CPT,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MNPJ,,,21 ,,RBRVS,5.75 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27240,CPT,CLTX INTR/PERI/SBTRCHNTC FEM FX W/MNPJ,,,21 ,,RBRVS,13.81 ,9.29 ,9.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27244,CPT,TX INTER/PR/SUBTRCHNTRIC FEM FX SCREW IMPLT,,,21 ,,RBRVS,18.18 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27245,CPT,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,,,21 ,,RBRVS,18.18 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27246,CPT,CLTX GRTER TRCHNTRIC FX W/O MNPJ,,,21 ,,RBRVS,4.83 ,4.34 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27248,CPT,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,,,21 ,,RBRVS,10.78 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27250,CPT,CLTX HIP DISLC TRAUMTC W/O ANES,,,21 ,,RBRVS,3.82 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27252,CPT,CLTX HIP DISLC TRAUMTC REQ ANES,,,21 ,,RBRVS,11.03 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27253,CPT,OPTX HIP DISLC TRAUMTC W/O INT FIXJ,,,21 ,,RBRVS,13.58 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27254,CPT,OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD FX,,,21 ,,RBRVS,18.94 ,11.78 ,11.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27256,CPT,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,,,21 ,,RBRVS,4.28 ,1.64 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27257,CPT,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MNPJ ANES,,,21 ,,RBRVS,5.38 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27258,CPT,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM,,,21 ,,RBRVS,16.18 ,10.60 ,10.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27259,CPT,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT,,,21 ,,RBRVS,23.26 ,14.30 ,14.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27265,CPT,CLTX POST HIP ARTHRP DISLC W/O ANES,,,21 ,,RBRVS,5.24 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27266,CPT,CLTX POST HIP ARTHRP DISLC REQ ANES,,,21 ,,RBRVS,7.78 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27267,CPT,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MNPJ,,,21 ,,RBRVS,5.50 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27268,CPT,CLOSED TX FEMORAL FRACTURE PROX HEAD W MNPJ,,,21 ,,RBRVS,7.12 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27269,CPT,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,,,21 ,,RBRVS,18.89 ,10.65 ,10.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27275,CPT,MANIPULATION HIP JOINT GENERAL ANESTHESIA,,,21 ,,RBRVS,2.32 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27280,CPT,ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT,,,21 ,,RBRVS,14.64 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27282,CPT,ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT,,,21 ,,RBRVS,11.85 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27284,CPT,ARTHRODESIS HIP JOINT W/OBTAINING GRAFT,,,21 ,,RBRVS,25.06 ,12.88 ,12.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27286,CPT,ARTHRD HIP JT W/OBTG GRF W/SUBTRCHNTRIC OSTEOT,,,21 ,,RBRVS,25.17 ,15.11 ,15.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27290,CPT,INTERPELVIABDOMINAL AMPUTATION,,,21 ,,RBRVS,24.55 ,13.94 ,13.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27295,CPT,DISARTICULATION HIP,,,21 ,,RBRVS,19.66 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27299,CPT,UNLISTED PROCEDURE PELVIS/HIP JOINT,,,21 ,,TotalUnits,,,,3.41 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,27301,CPT,I&D DP ABSC BURSA/HMTMA THI/KNE REGION,,,21 ,,RBRVS,6.78 ,5.14 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27303,CPT,INC DP W/OPNG B1 CORTEX FEMUR/KNE,,,21 ,,RBRVS,8.63 ,6.71 ,6.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27305,CPT,FASCIOTOMY ILIOTIBIAL OPEN,,,21 ,,RBRVS,6.18 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27306,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,,,21 ,,RBRVS,4.74 ,4.39 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27307,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,,,21 ,,RBRVS,6.06 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27310,CPT,ARTHRT KNE W/EXPL DRG/RMVL FB,,,21 ,,RBRVS,10.00 ,7.51 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27323,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,,,21 ,,RBRVS,2.33 ,2.03 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27324,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,,,21 ,,RBRVS,5.04 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27325,CPT,NEURECTOMY HAMSTRING MUSCLE,,,21 ,,RBRVS,7.20 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27326,CPT,NEURECTOMY POPLITEAL,,,21 ,,RBRVS,6.47 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27327,CPT,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,,,21 ,,RBRVS,3.96 ,3.76 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27328,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,,,21 ,,RBRVS,8.85 ,4.86 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27329,CPT,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,,,21 ,,RBRVS,15.72 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27330,CPT,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,,,21 ,,RBRVS,5.11 ,4.47 ,4.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27331,CPT,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,,,21 ,,RBRVS,6.02 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27332,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNE MEDIAL/LAT,,,21 ,,RBRVS,8.46 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27333,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNE MEDIAL&LAT,,,21 ,,RBRVS,7.55 ,6.38 ,6.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27334,CPT,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,,,21 ,,RBRVS,9.19 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27335,CPT,ARTHRT W/SYNVCT KNE ANT&PST W/POP AREA,,,21 ,,RBRVS,10.55 ,7.86 ,7.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27337,CPT,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,,,21 ,,RBRVS,5.91 ,4.55 ,4.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27339,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,,,21 ,,RBRVS,11.13 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27340,CPT,EXCISION PREPATELLAR BURSA,,,21 ,,RBRVS,4.32 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27345,CPT,EXCISION SYNOVIAL CYST POPLITEAL SPACE,,,21 ,,RBRVS,6.09 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27347,CPT,EXCISION LESION MENISCUS/CAPSULE KNEE,,,21 ,,RBRVS,6.73 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27350,CPT,PATELLECTOMY/HEMIPATELLECTOMY,,,21 ,,RBRVS,8.66 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27355,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR,,,21 ,,RBRVS,8.00 ,6.46 ,6.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27356,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,,,21 ,,RBRVS,10.09 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27357,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,,,21 ,,RBRVS,11.16 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27358,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,,,21 ,,RBRVS,4.73 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27360,CPT,PRTL EXC B1 FEMUR PROX TIBIA&/FIBULA,,,21 ,,RBRVS,11.46 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27364,CPT,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,,,21 ,,RBRVS,24.49 ,14.57 ,14.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27365,CPT,RADICAL RESECTION TUMOR FEMOR OR KNEE,,,21 ,,RBRVS,32.21 ,13.44 ,13.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27370,CPT,INJECTION KNEE ARTHROGRAPHY,,,21 ,,RBRVS,0.96 ,0.38 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27372,CPT,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,,,21 ,,RBRVS,5.21 ,4.49 ,9.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27380,CPT,SUTURE INFRAPATELLAR TENDON PRIMARY,,,21 ,,RBRVS,7.45 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27381,CPT,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,,,21 ,,RBRVS,10.76 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27385,CPT,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,,,21 ,,RBRVS,8.11 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27386,CPT,SUTR QUADRICEPS/HAMSTRING MUSC RPT 2 RCNSTJ,,,21 ,,RBRVS,11.13 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27390,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,,,21 ,,RBRVS,5.53 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27391,CPT,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,,,21 ,,RBRVS,7.49 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27392,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI,,,21 ,,RBRVS,9.63 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27393,CPT,LENGTHENING HAMSTRING TENDON SINGLE,,,21 ,,RBRVS,6.59 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27394,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG,,,21 ,,RBRVS,8.79 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27395,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL,,,21 ,,RBRVS,12.24 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27396,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,,,21 ,,RBRVS,8.15 ,6.59 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27397,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,,,21 ,,RBRVS,12.66 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27400,CPT,TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR,,,21 ,,RBRVS,9.33 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27403,CPT,ARTHROTOMY W/MENISCUS REPAIR KNEE,,,21 ,,RBRVS,8.62 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27405,CPT,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,,,21 ,,RBRVS,9.08 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27407,CPT,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIATE,,,21 ,,RBRVS,10.85 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27409,CPT,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE LIGMS,,,21 ,,RBRVS,13.71 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27412,CPT,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,,,21 ,,RBRVS,24.74 ,15.22 ,15.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27415,CPT,OSTEOCHONDRAL ALLOGRAFT KNEE OPEN,,,21 ,,RBRVS,20.00 ,13.03 ,13.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27416,CPT,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,,,21 ,,RBRVS,14.16 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27418,CPT,ANTERIOR TIBIAL TUBERCLEPLASTY,,,21 ,,RBRVS,11.60 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27420,CPT,RCNSTJ DISLOCATING PATELLA,,,21 ,,RBRVS,10.26 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27422,CPT,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RLS,,,21 ,,RBRVS,10.21 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27424,CPT,RCNSTJ DISLC PATELLA W/PATELLECTOMY,,,21 ,,RBRVS,10.24 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27425,CPT,LATERAL RETINACULAR RELEASE OPEN,,,21 ,,RBRVS,5.39 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27427,CPT,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,,,21 ,,RBRVS,9.79 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27428,CPT,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,,,21 ,,RBRVS,15.58 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27429,CPT,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,,,21 ,,RBRVS,17.54 ,12.48 ,12.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27430,CPT,QUADRICEPSPLASTY,,,21 ,,RBRVS,10.16 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27435,CPT,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,,,21 ,,RBRVS,10.88 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27437,CPT,ARTHROPLASTY PATELLA W/O PROSTHESIS,,,21 ,,RBRVS,8.93 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27438,CPT,ARTHROPLASTY PATELLA W/PROSTHESIS,,,21 ,,RBRVS,11.89 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27440,CPT,ARTHROPLASTY KNEE TIBIAL PLATEAU,,,21 ,,RBRVS,11.09 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27441,CPT,ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT,,,21 ,,RBRVS,11.54 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27442,CPT,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,,,21 ,,RBRVS,12.37 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27443,CPT,ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL,,,21 ,,RBRVS,11.41 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27445,CPT,ARTHROPLASTY KNEE HINGE PROSTHESIS,,,21 ,,RBRVS,18.66 ,11.81 ,11.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27446,CPT,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,,,21 ,,RBRVS,16.38 ,10.56 ,10.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27447,CPT,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT CMPRTS,,,21 ,,RBRVS,23.25 ,14.23 ,14.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27448,CPT,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,,,21 ,,RBRVS,11.60 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27450,CPT,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,,,21 ,,RBRVS,14.61 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27454,CPT,OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT,,,21 ,,RBRVS,19.17 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27455,CPT,OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL,,,21 ,,RBRVS,13.36 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27457,CPT,OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL,,,21 ,,RBRVS,14.03 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27465,CPT,OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876,,,21 ,,RBRVS,18.60 ,11.33 ,11.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27466,CPT,OSTEOPLASTY FEMUR LENGTHENING,,,21 ,,RBRVS,17.28 ,11.39 ,11.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27468,CPT,OSTPL FEMUR CMBN LNGTH&SHRT W/FEM SGM TR,,,21 ,,RBRVS,19.97 ,12.40 ,12.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27470,CPT,RPR NON/MAL FEMUR DSTL H/N W/O GRF,,,21 ,,RBRVS,17.14 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27472,CPT,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG B1 GRF,,,21 ,,RBRVS,18.72 ,12.07 ,12.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27475,CPT,ARREST EPIPHYSEAL DISTAL FEMUR,,,21 ,,RBRVS,8.93 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27477,CPT,ARREST EPIPHYSEAL TIBIA&FIBULA PROXIMAL,,,21 ,,RBRVS,10.14 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27479,CPT,ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB,,,21 ,,RBRVS,13.16 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27485,CPT,ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA,,,21 ,,RBRVS,9.13 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27486,CPT,REVJ TOT KNE ARTHRP +-ALGRFT 1 COMP,,,21 ,,RBRVS,21.12 ,13.15 ,13.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27487,CPT,REVJ TOT KNE ARTHRP FEM&ENTIRE TIBL COMP,,,21 ,,RBRVS,27.11 ,15.94 ,15.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27488,CPT,RMVL PROSTH TOT KNE PROSTH MMA +-INSJ SPACER,,,21 ,,RBRVS,17.60 ,11.51 ,11.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27495,CPT,PROPH TX N/P/PLTWR +-MMA FEMUR,,,21 ,,RBRVS,16.54 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27496,CPT,DCMPRN FASCT THI&/KNE 1 CMPRT,,,21 ,,RBRVS,6.78 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27497,CPT,DCMPRN FASCT THI&/KNE 1 DBRDMT NV MUSC&/NRV,,,21 ,,RBRVS,7.79 ,5.53 ,5.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27498,CPT,DCMPRN FASCT THI&/KNE MLT CMPRTS,,,21 ,,RBRVS,8.66 ,6.01 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27499,CPT,DCMPRN FASCT THI&/KNE MLT DBRDMT NV MUSC&/NRV,,,21 ,,RBRVS,9.43 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27500,CPT,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,,,21 ,,RBRVS,6.30 ,5.07 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27501,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MNPJ,,,21 ,,RBRVS,6.45 ,5.40 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27502,CPT,CLTX FEM SHFT FX W/MNPJ +-SKN/SKEL TRACJ,,,21 ,,RBRVS,11.36 ,7.61 ,7.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27503,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MNPJ,,,21 ,,RBRVS,11.27 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27506,CPT,OPTX FEM SHFT FX W/INSJ IMED IMPLT +-SCREW,,,21 ,,RBRVS,19.65 ,12.73 ,12.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27507,CPT,OPTX FEM SHFT FX W/PLATE/SCREWS +-CERCLAGE,,,21 ,,RBRVS,14.48 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27508,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MNPJ,,,21 ,,RBRVS,6.20 ,5.51 ,6.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27509,CPT,PRQ SKEL FIXJ FEM FX DSTL END,,,21 ,,RBRVS,8.14 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27510,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MNPJ,,,21 ,,RBRVS,9.80 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27511,CPT,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,,,21 ,,RBRVS,15.11 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27513,CPT,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W XTN,,,21 ,,RBRVS,19.25 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27514,CPT,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,,,21 ,,RBRVS,14.60 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27516,CPT,CLTX DSTL FEM EPIPHYSL SEP W/O MNPJ,,,21 ,,RBRVS,5.59 ,5.50 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27517,CPT,CLTX DSTL FEM EPIPHYSL SEP W/MNPJ +-SKN/SKEL,,,21 ,,RBRVS,9.12 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27519,CPT,OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION,,,21 ,,RBRVS,13.25 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27520,CPT,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,3.04 ,3.73 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27524,CPT,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,,,21 ,,RBRVS,10.37 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27530,CPT,CLTX TIBL FX PROX W/O MNPJ,,,21 ,,RBRVS,4.09 ,4.57 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27532,CPT,CLTX TIBL FX PROX +-MNPJ W/SKEL TRACJ,,,21 ,,RBRVS,7.55 ,6.24 ,7.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27535,CPT,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,,,21 ,,RBRVS,13.41 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27536,CPT,OPTX TIBL FX PROX BICONDYLAR +-INT FIXJ,,,21 ,,RBRVS,17.39 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27538,CPT,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE +-MNPJ,,,21 ,,RBRVS,5.09 ,5.28 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27540,CPT,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,,,21 ,,RBRVS,11.30 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27550,CPT,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,,,21 ,,RBRVS,5.98 ,4.95 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27552,CPT,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,,,21 ,,RBRVS,8.18 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27556,CPT,OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR,,,21 ,,RBRVS,13.00 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27557,CPT,OPEN TX KNEE DISLOCATION W LIGAMENTOUS REPAIR,,,21 ,,RBRVS,15.90 ,10.19 ,10.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27558,CPT,OPEN TX KNEE DISLOCATION W REPAIR/RECONSTRUCTION,,,21 ,,RBRVS,18.39 ,11.12 ,11.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27560,CPT,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,,,21 ,,RBRVS,3.99 ,4.03 ,4.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27562,CPT,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,,,21 ,,RBRVS,5.98 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27566,CPT,OPTX PATELLAR DISLC +-PRTL/TOT PATELLECTOMY,,,21 ,,RBRVS,12.71 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27570,CPT,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,,,21 ,,RBRVS,1.79 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27580,CPT,ARTHRODESIS KNEE ANY TECHNIQUE,,,21 ,,RBRVS,21.10 ,13.89 ,13.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27590,CPT,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,,,21 ,,RBRVS,13.47 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27591,CPT,AMP THI THRU FEMUR LVL IMMT FITG TQ W/1ST CST,,,21 ,,RBRVS,13.94 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27592,CPT,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,,,21 ,,RBRVS,10.98 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27594,CPT,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,,,21 ,,RBRVS,7.29 ,5.18 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27596,CPT,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,,,21 ,,RBRVS,11.29 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27598,CPT,DISARTICULATION KNEE,,,21 ,,RBRVS,11.22 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27599,CPT,UNLISTED PROCEDURE FEMUR/KNEE,,,21 ,,TotalUnits,,,,26.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,27600,CPT,DCMPRN FASCT LEG ANT&/LAT CMPRTS ONLY,,,21 ,,RBRVS,6.03 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27601,CPT,DCMPRN FASCT LEG PST CMPRT ONLY,,,21 ,,RBRVS,6.05 ,4.73 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27602,CPT,DCMPRN FASCT LEG ANT&/LAT&PST CMPRT,,,21 ,,RBRVS,7.82 ,4.75 ,4.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27603,CPT,INCISION&DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,,,21 ,,RBRVS,5.23 ,4.22 ,7.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27604,CPT,INCISION&DRAINAGE LEG/ANKLE INFECTED BURSA,,,21 ,,RBRVS,4.59 ,3.67 ,6.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27605,CPT,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,,,21 ,,RBRVS,2.92 ,1.94 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27606,CPT,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,,,21 ,,RBRVS,4.18 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27607,CPT,INCISION LEG/ANKLE,,,21 ,,RBRVS,8.62 ,6.28 ,6.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27610,CPT,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,,,21 ,,RBRVS,9.13 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27612,CPT,ARTHRT PST CAPSULAR RLS ANKLE +-ACHLL TDN LNGTH,,,21 ,,RBRVS,8.15 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27613,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,,,21 ,,RBRVS,2.22 ,1.88 ,3.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27614,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,,,21 ,,RBRVS,5.80 ,4.22 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27615,CPT,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,,,21 ,,RBRVS,15.72 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27616,CPT,RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5+CM,,,21 ,,RBRVS,19.63 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27618,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,,,21 ,,RBRVS,3.96 ,3.92 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27619,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <3CM,,,21 ,,RBRVS,6.91 ,5.50 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27620,CPT,ARTHRT ANKLE W/JT EXPL +-BX +-RMVL LOOSE/FB,,,21 ,,RBRVS,6.15 ,5.07 ,5.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27625,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE,,,21 ,,RBRVS,8.49 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27626,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,,,21 ,,RBRVS,9.10 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27630,CPT,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANKLE,,,21 ,,RBRVS,4.94 ,4.09 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27632,CPT,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 5+CM,,,21 ,,RBRVS,5.91 ,4.47 ,4.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27634,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,,,21 ,,RBRVS,10.13 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27635,CPT,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,,,21 ,,RBRVS,8.03 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27637,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,,,21 ,,RBRVS,10.31 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27638,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,,,21 ,,RBRVS,10.99 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27640,CPT,PARTIAL EXCISION BONE TIBIA,,,21 ,,RBRVS,12.24 ,8.63 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27641,CPT,PARTIAL EXCISION BONE FIBULA,,,21 ,,RBRVS,9.84 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27645,CPT,RADICAL RESECTION OF TUMOR TIBIA,,,21 ,,RBRVS,27.21 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27646,CPT,RADICAL RESECTION TUMOR BONE FIBULA,,,21 ,,RBRVS,23.21 ,10.58 ,10.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27647,CPT,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,,,21 ,,RBRVS,20.26 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27648,CPT,INJECTION ANKLE ARTHROGRAPHY,,,21 ,,RBRVS,0.96 ,0.37 ,3.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27650,CPT,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,,,21 ,,RBRVS,9.21 ,7.20 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27652,CPT,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,,,21 ,,RBRVS,10.78 ,7.02 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27654,CPT,REPAIR SECONDARY ACHILLES TENDON +-GRAFT,,,21 ,,RBRVS,10.53 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27656,CPT,REPAIR FASCIAL DEFECT LEG,,,21 ,,RBRVS,4.71 ,4.09 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27658,CPT,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,,,21 ,,RBRVS,5.12 ,4.23 ,4.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27659,CPT,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,,,21 ,,RBRVS,7.10 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27664,CPT,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,,,21 ,,RBRVS,4.73 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27665,CPT,RPR EXTENSOR TENDON LEG SECONDARY +/-GRAFT EACH,,,21 ,,RBRVS,5.57 ,4.65 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27675,CPT,RPR DISLOCATING PERONEAL TENDON W/O FIB OSTEOT,,,21 ,,RBRVS,7.35 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27676,CPT,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,,,21 ,,RBRVS,8.73 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27680,CPT,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,,,21 ,,RBRVS,5.88 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27681,CPT,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,,,21 ,,RBRVS,7.05 ,5.66 ,5.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27685,CPT,LNGTH/SHRT TDN LEG/ANKLE 1 TDN SPX,,,21 ,,RBRVS,6.69 ,4.98 ,8.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27686,CPT,LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA,,,21 ,,RBRVS,7.75 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27687,CPT,GASTROCNEMIUS RECESSION,,,21 ,,RBRVS,6.41 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27690,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,,,21 ,,RBRVS,9.17 ,6.53 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27691,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,,,21 ,,RBRVS,10.49 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27692,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,,,21 ,,RBRVS,1.87 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27695,CPT,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,,,21 ,,RBRVS,6.70 ,5.34 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27696,CPT,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,,,21 ,,RBRVS,8.58 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27698,CPT,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,,,21 ,,RBRVS,9.61 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27700,CPT,ARTHROPLASTY ANKLE,,,21 ,,RBRVS,9.66 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27702,CPT,ARTHROPLASTY ANKLE W/IMPLANT,,,21 ,,RBRVS,14.42 ,9.67 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27703,CPT,ARTHROPLASTY ANKLE REVISION TOTAL ANKLE,,,21 ,,RBRVS,16.94 ,10.98 ,10.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27704,CPT,REMOVAL ANKLE IMPLANT,,,21 ,,RBRVS,7.81 ,6.03 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27705,CPT,OSTEOTOMY TIBIA,,,21 ,,RBRVS,10.86 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27707,CPT,OSTEOTOMY FIBULA,,,21 ,,RBRVS,4.78 ,4.86 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27709,CPT,OSTEOTOMY TIBIA&FIBULA,,,21 ,,RBRVS,17.48 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27712,CPT,OSTEOT MLT W/RELIGNMT IMED ROD,,,21 ,,RBRVS,15.87 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27715,CPT,OSTEOPLASTY TIBIA&FIBULA LENGTHENING/SHORTENING,,,21 ,,RBRVS,15.50 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27720,CPT,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,,,21 ,,RBRVS,12.36 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27722,CPT,REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT,,,21 ,,RBRVS,12.45 ,8.83 ,8.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27724,CPT,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,,,21 ,,RBRVS,19.31 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27725,CPT,RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH,,,21 ,,RBRVS,17.41 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27726,CPT,REPAIR FIBULA NONUNION/MALUNION W INT FIXATION,,,21 ,,RBRVS,14.34 ,8.55 ,8.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27727,CPT,REPAIR CONGENITAL PSEUDARTHROSIS TIBIA,,,21 ,,RBRVS,14.84 ,9.04 ,9.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27730,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA,,,21 ,,RBRVS,7.70 ,6.27 ,6.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27732,CPT,ARREST EPIPHYSEAL OPEN DISTAL FIBULA,,,21 ,,RBRVS,5.46 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27734,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,,,21 ,,RBRVS,8.83 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27740,CPT,ARRST EPIPHYSL ANY METH TIBFIB,,,21 ,,RBRVS,9.61 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27742,CPT,ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR,,,21 ,,RBRVS,10.63 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27745,CPT,PROPH TX N/P/PLTWR +-MMA TIBIA,,,21 ,,RBRVS,10.49 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27750,CPT,CLTX TIBL SHFT FX W/O MNPJ,,,21 ,,RBRVS,3.37 ,3.99 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27752,CPT,CLTX TIBL SHFT FX W/MNPJ +-SKEL TRACJ,,,21 ,,RBRVS,6.27 ,5.58 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27756,CPT,PRQ SKEL FIXJ TIBL SHFT FX,,,21 ,,RBRVS,7.45 ,6.30 ,6.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27758,CPT,OPTX TIBL SHFT FX W/PLATE/SCREWS +-CERCLAGE,,,21 ,,RBRVS,12.54 ,8.95 ,8.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27759,CPT,TX TIBL SHFT FX IMED IMPLT +-SCREWS&/CERCLAGE,,,21 ,,RBRVS,14.45 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27760,CPT,CLTX MEDIAL MALLS FX W/O MNPJ,,,21 ,,RBRVS,3.21 ,3.87 ,4.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27762,CPT,CLTX MEDIAL MALLS FX W/MNPJ +-SKN/SKEL TRACJ,,,21 ,,RBRVS,5.47 ,5.08 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27766,CPT,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,,,21 ,,RBRVS,7.89 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27767,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MNPJ,,,21 ,,RBRVS,2.64 ,3.75 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27768,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W MNPJ,,,21 ,,RBRVS,5.14 ,4.79 ,4.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27769,CPT,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,,,21 ,,RBRVS,10.14 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27780,CPT,CLTX PROX FIBULA/SHFT FX W/O MNPJ,,,21 ,,RBRVS,2.83 ,3.52 ,4.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27781,CPT,CLTX PROX FIBULA/SHFT FX W/MNPJ,,,21 ,,RBRVS,4.59 ,4.69 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27784,CPT,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,,,21 ,,RBRVS,9.67 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27786,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/O MNPJ,,,21 ,,RBRVS,3.02 ,3.62 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27788,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/MNPJ,,,21 ,,RBRVS,4.64 ,4.57 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27792,CPT,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,,,21 ,,RBRVS,9.71 ,7.38 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27808,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ,,,21 ,,RBRVS,3.03 ,3.92 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27810,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ,,,21 ,,RBRVS,5.32 ,4.96 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27814,CPT,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,,,21 ,,RBRVS,10.62 ,8.10 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27816,CPT,CLTX TRIMAL ANKLE FX W/O MNPJ,,,21 ,,RBRVS,3.07 ,3.53 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27818,CPT,CLTX TRIMAL ANKLE FX W/MNPJ,,,21 ,,RBRVS,5.69 ,4.80 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27822,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,,,21 ,,RBRVS,11.21 ,9.33 ,9.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27823,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W FIXJ PST LIP,,,21 ,,RBRVS,13.16 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27824,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MNPJ,,,21 ,,RBRVS,3.31 ,3.76 ,4.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27825,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,,,21 ,,RBRVS,6.69 ,5.27 ,6.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27826,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,,,21 ,,RBRVS,11.10 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27827,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,,,21 ,,RBRVS,14.79 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27828,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,,,21 ,,RBRVS,18.43 ,13.08 ,13.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27829,CPT,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,,,21 ,,RBRVS,8.80 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27830,CPT,CLTX PROX TIBFIB JT DISLC W/O ANES,,,21 ,,RBRVS,3.96 ,4.07 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27831,CPT,CLTX PROX TIBFIB JT DISLC REQ ANES,,,21 ,,RBRVS,4.73 ,4.48 ,4.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27832,CPT,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,,,21 ,,RBRVS,10.17 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27840,CPT,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,,,21 ,,RBRVS,4.77 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27842,CPT,CLTX ANKLE DISLC REQ ANES +-PRQ SKEL FIXJ,,,21 ,,RBRVS,6.46 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27846,CPT,OPTX ANKLE DISLC W/O RPR/INT FIXJ,,,21 ,,RBRVS,10.28 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27848,CPT,OPTX ANKLE DISLC W/RPR/INT/XTRNL FIXJ,,,21 ,,RBRVS,11.68 ,8.46 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27860,CPT,MNPJ ANKLE UNDER GENERAL ANES,,,21 ,,RBRVS,2.39 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27870,CPT,ARTHRODESIS ANKLE OPEN,,,21 ,,RBRVS,15.41 ,10.14 ,10.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27871,CPT,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,,,21 ,,RBRVS,9.54 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27880,CPT,AMPUTATION LEG THROUGH TIBIA&FIBULA,,,21 ,,RBRVS,15.37 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27881,CPT,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,,,21 ,,RBRVS,13.47 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27882,CPT,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,,,21 ,,RBRVS,9.79 ,5.57 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27884,CPT,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REVJ,,,21 ,,RBRVS,8.76 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27886,CPT,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,,,21 ,,RBRVS,10.02 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27888,CPT,AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV,,,21 ,,RBRVS,10.37 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27889,CPT,ANKLE DISARTICULATION,,,21 ,,RBRVS,10.86 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27892,CPT,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NRV,,,21 ,,RBRVS,7.94 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27893,CPT,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,,,21 ,,RBRVS,7.90 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27894,CPT,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUSC&/NRV,,,21 ,,RBRVS,12.67 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,27899,CPT,UNLISTED PROCEDURE LEG/ANKLE,,,21 ,,TotalUnits,,,,16.04 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,28001,CPT,INCISION&DRAINAGE BURSA FOOT,,,21 ,,RBRVS,2.78 ,1.70 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28002,CPT,I&D BELW FSCA FOOT 1 BURSAL SPACE,,,21 ,,RBRVS,5.93 ,3.74 ,6.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28003,CPT,I&D BELW FSCA FOOT MLT AREAS,,,21 ,,RBRVS,9.06 ,4.86 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28005,CPT,INCISION BONE CORTEX FOOT,,,21 ,,RBRVS,9.44 ,5.83 ,5.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28008,CPT,FASCIOTOMY FOOT&/TOE,,,21 ,,RBRVS,4.59 ,3.05 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28010,CPT,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,,,21 ,,RBRVS,2.97 ,2.39 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28011,CPT,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,,,21 ,,RBRVS,4.28 ,3.21 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28020,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,,,21 ,,RBRVS,5.15 ,3.82 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28022,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,,,21 ,,RBRVS,4.81 ,3.49 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28024,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,,,21 ,,RBRVS,4.52 ,3.34 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28035,CPT,RELEASE TARSAL TUNNEL,,,21 ,,RBRVS,5.23 ,3.84 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28039,CPT,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,,,21 ,,RBRVS,5.42 ,3.38 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28041,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,,,21 ,,RBRVS,7.13 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28043,CPT,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,,,21 ,,RBRVS,3.96 ,2.89 ,4.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28045,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,,,21 ,,RBRVS,5.45 ,3.49 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28046,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,,,21 ,,RBRVS,12.38 ,6.28 ,6.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28047,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3+CM,,,21 ,,RBRVS,17.45 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28050,CPT,ARTHRT W/BX INTERTARSAL/TARS JT,,,21 ,,RBRVS,4.39 ,3.35 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28052,CPT,ARTHRT W/BX METATARSOPHALANGEAL JT,,,21 ,,RBRVS,4.06 ,3.12 ,6.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28054,CPT,ARTHRT W/BX IPHAL JT,,,21 ,,RBRVS,3.57 ,2.84 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28055,CPT,NEURECTOMY INTRINSIC MUSCULATURE OF FOOT,,,21 ,,RBRVS,6.29 ,3.60 ,3.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28060,CPT,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,,,21 ,,RBRVS,5.40 ,3.71 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28062,CPT,FASCIOTOMY PLANTAR FASCIA RADICAL SPX,,,21 ,,RBRVS,6.69 ,3.94 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28070,CPT,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,,,21 ,,RBRVS,5.24 ,3.61 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28072,CPT,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,,,21 ,,RBRVS,4.72 ,3.90 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28080,CPT,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,,,21 ,,RBRVS,4.86 ,4.19 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28086,CPT,SYNOVECTOMY TENDON SHEATH FOOT FLEXOR,,,21 ,,RBRVS,4.92 ,4.07 ,7.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28088,CPT,SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR,,,21 ,,RBRVS,3.98 ,3.49 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28090,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,,,21 ,,RBRVS,4.55 ,3.32 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28092,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,,,21 ,,RBRVS,3.78 ,3.15 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28100,CPT,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,,,21 ,,RBRVS,5.83 ,4.36 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28102,CPT,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,,,21 ,,RBRVS,7.92 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28103,CPT,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,,,21 ,,RBRVS,6.67 ,4.28 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28104,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR,,,21 ,,RBRVS,5.26 ,3.63 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28106,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT,,,21 ,,RBRVS,7.35 ,4.31 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28107,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,,,21 ,,RBRVS,5.73 ,3.85 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28108,CPT,EXC/CURTG CST/B9 TUM PHALANGES FOOT,,,21 ,,RBRVS,4.30 ,3.09 ,6.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28110,CPT,OSTECTOMY PRTL 5TH METAR HEAD SPX,,,21 ,,RBRVS,4.22 ,3.16 ,6.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28111,CPT,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,,,21 ,,RBRVS,5.15 ,3.42 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28112,CPT,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,,,21 ,,RBRVS,4.63 ,3.41 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28113,CPT,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,,,21 ,,RBRVS,6.11 ,4.68 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28114,CPT,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,,,21 ,,RBRVS,12.00 ,8.77 ,13.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28116,CPT,OSTECTOMY TARSAL COALITION,,,21 ,,RBRVS,9.14 ,5.37 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28118,CPT,OSTECTOMY CALCANEUS,,,21 ,,RBRVS,6.13 ,4.28 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28119,CPT,OSTECTOMY CALCANEUS SPUR +-PLNTAR FSCAL RLS,,,21 ,,RBRVS,5.56 ,3.69 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28120,CPT,PRTL EXC B1 TALUS/CALCANEUS,,,21 ,,RBRVS,8.27 ,4.58 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28122,CPT,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,,,21 ,,RBRVS,7.72 ,5.03 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28124,CPT,PRTL EXC B1 PHALANX TOE,,,21 ,,RBRVS,5.00 ,3.56 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28126,CPT,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,,,21 ,,RBRVS,3.64 ,2.79 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28130,CPT,TALECTOMY ASTRAGALECTOMY,,,21 ,,RBRVS,9.50 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28140,CPT,METATARSECTOMY,,,21 ,,RBRVS,7.14 ,4.39 ,7.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28150,CPT,PHALANGECTOMY TOE EA TOE,,,21 ,,RBRVS,4.23 ,3.11 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28153,CPT,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,,,21 ,,RBRVS,3.80 ,2.93 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28160,CPT,HEMIPHALANGC/IPHAL JT EXC TOE,,,21 ,,RBRVS,3.88 ,3.10 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28171,CPT,RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS,,,21 ,,RBRVS,16.41 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28173,CPT,RADICAL RESECTION TUMOR METATARSAL,,,21 ,,RBRVS,14.16 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28175,CPT,RADICAL RESECTION TUMOR PHALANX OR TOE,,,21 ,,RBRVS,8.29 ,3.97 ,3.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28190,CPT,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,,,21 ,,RBRVS,2.01 ,1.41 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28192,CPT,REMOVAL FOREIGN BODY FOOT DEEP,,,21 ,,RBRVS,4.78 ,3.34 ,6.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28193,CPT,REMOVAL FOREIGN BODY FOOT COMPLICATED,,,21 ,,RBRVS,5.90 ,3.75 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28200,CPT,RPR TDN FLXR FOOT 1/2 W/O FR GRF EA TDN,,,21 ,,RBRVS,4.74 ,3.35 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28202,CPT,RPR TDN FLXR FOOT SEC W/FR GRF EA TDN,,,21 ,,RBRVS,7.07 ,4.14 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28208,CPT,RPR TDN XTNSR FOOT 1/2 EA TDN,,,21 ,,RBRVS,4.51 ,3.32 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28210,CPT,RPR TDN XTNSR FOOT SEC W/FR GRF EA TDN,,,21 ,,RBRVS,6.52 ,4.03 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28220,CPT,TENOLYSIS FLEXOR FOOT SINGLE TENDON,,,21 ,,RBRVS,4.67 ,3.19 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28222,CPT,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,,,21 ,,RBRVS,5.76 ,3.53 ,6.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28225,CPT,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,,,21 ,,RBRVS,3.78 ,2.76 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28226,CPT,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,,,21 ,,RBRVS,4.67 ,3.35 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28230,CPT,TX OPN TDN FLXR FOOT 1/MLT TDN SPX,,,21 ,,RBRVS,4.36 ,3.07 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28232,CPT,TX OPN TDN FLXR TOE 1 TDN SPX,,,21 ,,RBRVS,3.51 ,2.86 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28234,CPT,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,,,21 ,,RBRVS,3.54 ,3.22 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28238,CPT,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,,,21 ,,RBRVS,7.96 ,4.65 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28240,CPT,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,,,21 ,,RBRVS,4.48 ,3.16 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28250,CPT,DIVISION PLANTAR FASCIA&MUSCLE SPX,,,21 ,,RBRVS,6.06 ,4.09 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28260,CPT,CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX,,,21 ,,RBRVS,8.19 ,4.89 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28261,CPT,CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING,,,21 ,,RBRVS,13.11 ,6.70 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28262,CPT,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,,,21 ,,RBRVS,17.21 ,10.60 ,15.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28264,CPT,CAPSULOTOMY MIDTARSAL,,,21 ,,RBRVS,10.65 ,6.23 ,9.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28270,CPT,CAPSUL MTTARPHLNGL JT +-TENORRHAPHY EA JT SPX,,,21 ,,RBRVS,4.93 ,3.61 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28272,CPT,CAPSUL IPHAL JT EA JT SPX,,,21 ,,RBRVS,3.92 ,2.72 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28280,CPT,SYNDACTYLIZATION TOES,,,21 ,,RBRVS,5.33 ,3.83 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28285,CPT,CORRECTION HAMMERTOE,,,21 ,,RBRVS,4.76 ,3.45 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28286,CPT,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,,,21 ,,RBRVS,4.70 ,3.13 ,6.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28288,CPT,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,,,21 ,,RBRVS,6.02 ,4.86 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28289,CPT,HALLUX RGDUS CORRJ W/CHEILC,,,21 ,,RBRVS,8.31 ,5.61 ,9.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28290,CPT,CORRJ HALLUX VALGUS +-SESMDC SMPL EXOSTECTOMY,,,21 ,,RBRVS,5.83 ,4.23 ,8.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28292,CPT,KELLER/MCBRIDE/MAYO PROCEDURE,,,21 ,,RBRVS,9.05 ,6.22 ,10.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28293,CPT,CORRJ HALLUX VALGUS +-SESMDC RESCJ JT W/IMPLT,,,21 ,,RBRVS,11.48 ,6.87 ,13.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28294,CPT,CORRJ HALLUX VALGUS +-SESMDC W/TDN TRNSPLS,,,21 ,,RBRVS,8.75 ,4.93 ,9.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28296,CPT,CORRJ HALLUX VALGUS +-SESMDC W/METAR OSTEOT,,,21 ,,RBRVS,8.35 ,5.21 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28297,CPT,CORRJ HALLUX VALGUS +-SESMDC LAPIDUS-TYP PX,,,21 ,,RBRVS,9.43 ,5.73 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28298,CPT,CORRJ HALLUX VALGUS +-SESMDC PHALANX OSTEOT,,,21 ,,RBRVS,8.13 ,4.86 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28299,CPT,CORRJ HALLUX VALGUS +-SESMDC 2 OSTEOT,,,21 ,,RBRVS,11.57 ,6.01 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28300,CPT,OSTEOTOMY CALCANEUS +-INTERNAL FIXATION,,,21 ,,RBRVS,9.73 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28302,CPT,OSTEOTOMY TALUS,,,21 ,,RBRVS,9.74 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28304,CPT,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,,,21 ,,RBRVS,9.41 ,5.55 ,9.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28305,CPT,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,,,21 ,,RBRVS,10.77 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28306,CPT,OSTEOT +-LNGTH SHRT/CORRJ 1ST METAR,,,21 ,,RBRVS,6.00 ,4.20 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28307,CPT,OSTEOT +-LNGTH SHRT/CORRJ 1ST METAR XCP 1ST TOE,,,21 ,,RBRVS,6.50 ,5.25 ,10.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28308,CPT,OSTEOT +-LNGTH SHRT/CORRJ METAR XCP 1ST EA,,,21 ,,RBRVS,5.48 ,3.96 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28309,CPT,OSTEOT +-LNGTH SHRT/ANGULAR CORRJ METAR MLT,,,21 ,,RBRVS,14.16 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28310,CPT,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,,,21 ,,RBRVS,5.57 ,3.53 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28312,CPT,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,,,21 ,,RBRVS,4.69 ,3.43 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28313,CPT,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,,,21 ,,RBRVS,5.15 ,4.12 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28315,CPT,SESAMOIDECTOMY FIRST TOE SPX,,,21 ,,RBRVS,5.00 ,3.31 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28320,CPT,REPAIR NONUNION/MALUNION TARSAL BONES,,,21 ,,RBRVS,9.37 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28322,CPT,RPR NON/MAL METAR +-B1 GRF,,,21 ,,RBRVS,8.53 ,5.87 ,10.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28340,CPT,RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION,,,21 ,,RBRVS,7.15 ,4.00 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28341,CPT,RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION,,,21 ,,RBRVS,8.72 ,4.48 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28344,CPT,RECONSTRUCTION TOE POLYDACTYLY,,,21 ,,RBRVS,4.40 ,3.40 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28345,CPT,RCNSTJ TOE SYNDACTYLY +-SKN GRF EA WEB,,,21 ,,RBRVS,6.09 ,4.03 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28360,CPT,RECONSTRUCTION CLEFT FOOT,,,21 ,,RBRVS,14.92 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28400,CPT,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.31 ,3.08 ,3.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28405,CPT,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,,,21 ,,RBRVS,4.74 ,3.96 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28406,CPT,PRQ SKEL FIXJ CALCANEAL FX W/MNPJ,,,21 ,,RBRVS,6.56 ,6.15 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28415,CPT,OPEN TREATMENT CALCANEAL FRACTURE,,,21 ,,RBRVS,16.19 ,11.50 ,11.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28420,CPT,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,,,21 ,,RBRVS,17.52 ,11.99 ,11.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28430,CPT,CLOSED TX TALUS FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.22 ,2.68 ,3.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28435,CPT,CLOSED TX TALUS FRACTURE W/ MANIPULATION,,,21 ,,RBRVS,3.54 ,3.65 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28436,CPT,PRQ SKELETAL FIXATION TALUS FRACTURE W/MNPJ,,,21 ,,RBRVS,4.90 ,5.50 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28445,CPT,OPEN TREATMENT TALUS FRACTURE,,,21 ,,RBRVS,15.76 ,10.41 ,10.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28446,CPT,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,,,21 ,,RBRVS,17.71 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28450,CPT,TX TARSAL B1 FX XCP TALUS&CALCN W/O MNPJ,,,21 ,,RBRVS,2.03 ,2.53 ,3.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28455,CPT,TX TARSAL B1 FX XCP TALUS&CALCN W/MNPJ,,,21 ,,RBRVS,3.24 ,3.29 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28456,CPT,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MNPJ,,,21 ,,RBRVS,2.86 ,4.11 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28465,CPT,OPEN TX TARSAL FRACTURE XCP TALUS &CALCANEUS EA,,,21 ,,RBRVS,8.80 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28470,CPT,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,,,21 ,,RBRVS,2.03 ,2.50 ,3.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28475,CPT,CLTX METAR FX W/MNPJ,,,21 ,,RBRVS,3.01 ,2.74 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28476,CPT,PRQ SKEL FIXJ METAR FX W/MNPJ,,,21 ,,RBRVS,3.60 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28485,CPT,OPEN TREATMENT METATARSAL FRACTURE EACH,,,21 ,,RBRVS,7.44 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28490,CPT,CLTX FX GRT TOE PHLX/PHLG W/O MNPJ,,,21 ,,RBRVS,1.17 ,1.74 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28495,CPT,CLTX FX GRT TOE PHLX/PHLG W/MNPJ,,,21 ,,RBRVS,1.68 ,1.97 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28496,CPT,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MNPJ,,,21 ,,RBRVS,2.48 ,3.10 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28505,CPT,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,,,21 ,,RBRVS,7.44 ,4.87 ,8.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28510,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MNPJ,,,21 ,,RBRVS,1.17 ,1.65 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28515,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MNPJ,,,21 ,,RBRVS,1.56 ,1.89 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28525,CPT,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,,,21 ,,RBRVS,5.62 ,4.20 ,8.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28530,CPT,CLOSED TREATMENT SESAMOID FRACTURE,,,21 ,,RBRVS,1.11 ,1.41 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28531,CPT,OPEN TX SESAMOID FRACTURE +-INTERNAL FIXATION,,,21 ,,RBRVS,2.57 ,2.48 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28540,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,,,21 ,,RBRVS,2.19 ,2.33 ,2.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28545,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,,,21 ,,RBRVS,2.60 ,3.04 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28546,CPT,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MNPJ,,,21 ,,RBRVS,3.40 ,4.12 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28555,CPT,OPEN TREATMENT TARSAL BONE DISLOCATION,,,21 ,,RBRVS,9.65 ,6.65 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28570,CPT,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,,,21 ,,RBRVS,1.76 ,1.92 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28575,CPT,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,,,21 ,,RBRVS,3.49 ,4.00 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28576,CPT,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MNPJ,,,21 ,,RBRVS,4.60 ,4.23 ,4.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28585,CPT,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,,,21 ,,RBRVS,11.13 ,7.16 ,11.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28600,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,,,21 ,,RBRVS,2.02 ,2.53 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28605,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,,,21 ,,RBRVS,2.89 ,3.41 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28606,CPT,PRQ SKEL FIXJ TARS JT DISLC W/MNPJ,,,21 ,,RBRVS,5.09 ,4.41 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28615,CPT,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,,,21 ,,RBRVS,10.70 ,8.50 ,8.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28630,CPT,CLTX METATARSOPHLNGL JT DISLC W/O ANES,,,21 ,,RBRVS,1.75 ,0.98 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28635,CPT,CLTX METATARSOPHLNGL JT DISLC REQ ANES,,,21 ,,RBRVS,1.96 ,1.41 ,2.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28636,CPT,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MNPJ,,,21 ,,RBRVS,2.77 ,2.18 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28645,CPT,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,,,21 ,,RBRVS,7.44 ,4.53 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28660,CPT,CLTX IPHAL JT DISLC W/O ANES,,,21 ,,RBRVS,1.28 ,0.84 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28665,CPT,CLTX IPHAL JT DISLC REQ ANES,,,21 ,,RBRVS,1.97 ,1.40 ,1.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28666,CPT,PRQ SKEL FIXJ IPHAL JT DISLC W/MNPJ,,,21 ,,RBRVS,2.66 ,2.18 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28675,CPT,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,,,21 ,,RBRVS,5.62 ,4.49 ,8.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28705,CPT,ARTHRODESIS PANTALAR,,,21 ,,RBRVS,20.33 ,11.84 ,11.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28715,CPT,ARTHRODESIS TRIPLE,,,21 ,,RBRVS,14.60 ,9.38 ,9.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28725,CPT,ARTHRODESIS SUBTALAR,,,21 ,,RBRVS,12.18 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28730,CPT,ARTHRD MIDTARSL/TARS MLT/TRANSVRS,,,21 ,,RBRVS,12.42 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28735,CPT,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,,,21 ,,RBRVS,12.23 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28737,CPT,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFORM,,,21 ,,RBRVS,11.03 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28740,CPT,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,,,21 ,,RBRVS,9.29 ,6.41 ,11.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28750,CPT,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,,,21 ,,RBRVS,8.57 ,6.39 ,11.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28755,CPT,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,,,21 ,,RBRVS,4.88 ,3.54 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28760,CPT,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,,,21 ,,RBRVS,9.14 ,5.61 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28800,CPT,AMPUTATION FOOT MIDTARSAL,,,21 ,,RBRVS,8.79 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28805,CPT,AMPUTATION FOOT TRANSMETARSAL,,,21 ,,RBRVS,12.71 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28810,CPT,AMPUTATION METATARSAL W/TOE SINGLE,,,21 ,,RBRVS,6.64 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28820,CPT,AMPUTATION TOE METATARSOPHALANGEAL JOINT,,,21 ,,RBRVS,5.00 ,3.73 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28825,CPT,AMPUTATION TOE INTERPHALANGEAL JOINT,,,21 ,,RBRVS,6.01 ,4.16 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28890,CPT,ESWT HI NRG PFRMD PHYS W/US GDN INVG PLNTAR FSCA,,,21 ,,RBRVS,3.45 ,2.28 ,4.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,28899,CPT,UNLISTED PROCEDURE FOOT/TOES,,,21 ,,TotalUnits,,,,9.70 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,29000,CPT,APPLICATION HALO TYPE BODY CAST,,,21 ,,RBRVS,2.25 ,1.78 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29010,CPT,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,,,21 ,,RBRVS,2.06 ,1.42 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29015,CPT,APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD,,,21 ,,RBRVS,2.41 ,1.44 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29020,CPT,APPLICATION TURNBUCKLE JACKET BODY ONLY,,,21 ,,RBRVS,2.11 ,1.34 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29025,CPT,APPLICATION TURNBUCKLE JACKET BODY W/HEAD,,,21 ,,RBRVS,2.40 ,1.86 ,3.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29035,CPT,APPLICATION BODY CAST SHOULDER HIPS,,,21 ,,RBRVS,1.77 ,1.60 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29040,CPT,APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA,,,21 ,,RBRVS,2.22 ,1.53 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29044,CPT,APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH,,,21 ,,RBRVS,2.12 ,1.78 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29046,CPT,APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS,,,21 ,,RBRVS,2.41 ,2.00 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29049,CPT,APPLICATION CAST FIGURE-OF-8,,,21 ,,RBRVS,0.89 ,0.63 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29055,CPT,APPLICATION CAST SHOULDER SPICA,,,21 ,,RBRVS,1.78 ,1.48 ,3.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29058,CPT,APPLICATION CAST PLASTER VELPEAU,,,21 ,,RBRVS,1.31 ,0.68 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29065,CPT,APPLICATION CAST SHOULDER HAND LONG ARM,,,21 ,,RBRVS,0.87 ,0.76 ,1.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29075,CPT,APPLICATION CAST ELBOW FINGER SHORT ARM,,,21 ,,RBRVS,0.77 ,0.71 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29085,CPT,APPLICATION CAST HAND&LOWER FOREARM GAUNTLET,,,21 ,,RBRVS,0.87 ,0.73 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29086,CPT,APPLICATION CAST FINGER,,,21 ,,RBRVS,0.62 ,0.59 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29105,CPT,APPLICATION LONG ARM SPLINT SHOULDER HAND,,,21 ,,RBRVS,0.87 ,0.57 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29125,CPT,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,,,21 ,,RBRVS,0.59 ,0.45 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29126,CPT,APPLICATION SHORT ARM SPLINT DYNAMIC,,,21 ,,RBRVS,0.77 ,0.52 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29130,CPT,APPLICATION FINGER SPLINT STATIC,,,21 ,,RBRVS,0.50 ,0.21 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29131,CPT,APPLICATION FINGER SPLINT DYNAMIC,,,21 ,,RBRVS,0.55 ,0.27 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29200,CPT,STRAPPING THORAX,,,21 ,,RBRVS,0.65 ,0.37 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29240,CPT,STRAPPING SHOULDER,,,21 ,,RBRVS,0.71 ,0.40 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29260,CPT,STRAPPING ELBOW/WRIST,,,21 ,,RBRVS,0.55 ,0.38 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29280,CPT,STRAPPING HAND/FINGER,,,21 ,,RBRVS,0.51 ,0.38 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29305,CPT,APPLICATION HIP SPICA CAST 1 LEG,,,21 ,,RBRVS,2.03 ,1.76 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29325,CPT,APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS,,,21 ,,RBRVS,2.32 ,1.95 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29345,CPT,APPLICATION LONG LEG CAST THIGH-TOE,,,21 ,,RBRVS,1.40 ,1.04 ,1.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29355,CPT,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,,,21 ,,RBRVS,1.53 ,1.06 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29358,CPT,APPLICATION LONG LEG CAST BRACE,,,21 ,,RBRVS,1.43 ,1.06 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29365,CPT,APPLICATION CYLINDER CAST THIGH ANKLE,,,21 ,,RBRVS,1.18 ,0.94 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29405,CPT,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,,,21 ,,RBRVS,0.86 ,0.70 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29425,CPT,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,,,21 ,,RBRVS,1.01 ,0.71 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29435,CPT,APPLICATION PATELLAR TENDON BEARING CAST,,,21 ,,RBRVS,1.18 ,0.89 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29440,CPT,ADDING WALKER PREVIOUSLY APPLIED CAST,,,21 ,,RBRVS,0.57 ,0.28 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29445,CPT,APPLICATION RIGID TOTAL CONTACT LEG CAST,,,21 ,,RBRVS,1.78 ,0.95 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29450,CPT,APPL CLUBFOOT CAST MOLDING/MNPJ LONG/SHORT LEG,,,21 ,,RBRVS,2.08 ,0.94 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29505,CPT,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,,,21 ,,RBRVS,0.69 ,0.48 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29515,CPT,APPLICATION SHORT LEG SPLINT CALF FOOT,,,21 ,,RBRVS,0.73 ,0.49 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29520,CPT,STRAPPING HIP,,,21 ,,RBRVS,0.54 ,0.38 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29530,CPT,STRAPPING KNEE,,,21 ,,RBRVS,0.57 ,0.37 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29540,CPT,STRAPPING ANKLE &/FOOT,,,21 ,,RBRVS,0.51 ,0.31 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29550,CPT,STRAPPING TOES,,,21 ,,RBRVS,0.47 ,0.30 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29580,CPT,STRAPPING UNNA BOOT,,,21 ,,RBRVS,0.55 ,0.35 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29581,CPT,APPL MLT-LAYER VENOUS WOUND COMPRESS BELOW KNEE,,,21 ,,RBRVS,0.60 ,0.23 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29590,CPT,DENIS-BROWNE SPLINT STRAPPING,,,21 ,,RBRVS,0.76 ,0.27 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29700,CPT,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,,,21 ,,RBRVS,0.57 ,0.28 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29705,CPT,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,,,21 ,,RBRVS,0.76 ,0.40 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29710,CPT,RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET,,,21 ,,RBRVS,1.34 ,0.67 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29715,CPT,REMOVAL/BIVALVING TURNBUCKLE JACKET,,,21 ,,RBRVS,0.94 ,0.44 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29720,CPT,REPAIR SPICA BODY CAST/JACKET,,,21 ,,RBRVS,0.68 ,0.39 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29730,CPT,WINDOWING CAST,,,21 ,,RBRVS,0.75 ,0.37 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29740,CPT,WEDGING CAST EXCEPT CLUBFOOT CASTS,,,21 ,,RBRVS,1.12 ,0.50 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29750,CPT,WEDGING CLUBFOOT CAST,,,21 ,,RBRVS,1.26 ,0.61 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29799,CPT,UNLISTED PROCEDURE CASTING/STRAPPING,,,21 ,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,29800,CPT,ARTHRS TMPRMAND JT DX +-SYNVAL BX SPX,,,21 ,,RBRVS,6.84 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29804,CPT,ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL,,,21 ,,RBRVS,8.87 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29805,CPT,ARTHROSCOPY SHOULDER DX +-SYNOVIAL BIOPSY SPX,,,21 ,,RBRVS,6.03 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29806,CPT,ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY,,,21 ,,RBRVS,15.14 ,10.56 ,10.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29807,CPT,ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION,,,21 ,,RBRVS,14.67 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29819,CPT,ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB,,,21 ,,RBRVS,7.79 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29820,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL,,,21 ,,RBRVS,7.21 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29821,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE,,,21 ,,RBRVS,7.89 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29822,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED,,,21 ,,RBRVS,7.60 ,6.25 ,6.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29823,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE,,,21 ,,RBRVS,8.36 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29824,CPT,ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY,,,21 ,,RBRVS,8.98 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29825,CPT,ARTHROSCOPY SHOULDER LYSIS&RESCJ ADHESION +-MNPJ,,,21 ,,RBRVS,7.79 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29826,CPT,"SHOULDER SCOPE, BONE SHAVING",,,21 ,,RBRVS,9.16 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29827,CPT,ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR,,,21 ,,RBRVS,15.59 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29828,CPT,ARTHROSCOPY SHOULDER BICEPS TENODESIS,,,21 ,,RBRVS,13.16 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29830,CPT,ARTHROSCOPY ELBOW DIAGNOSTIC +-SYNOVIAL BX SPX,,,21 ,,RBRVS,5.88 ,5.01 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29834,CPT,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,,,21 ,,RBRVS,6.42 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29835,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,,,21 ,,RBRVS,6.62 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29836,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,,,21 ,,RBRVS,7.72 ,6.31 ,6.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29837,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,,,21 ,,RBRVS,7.01 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29838,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,,,21 ,,RBRVS,7.88 ,6.39 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29840,CPT,ARTHROSCOPY WRIST DIAGNOSTIC +-SYNOVIAL BX SPX,,,21 ,,RBRVS,5.68 ,5.11 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29843,CPT,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,,,21 ,,RBRVS,6.15 ,5.42 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29844,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,,,21 ,,RBRVS,6.51 ,5.47 ,5.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29845,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,,,21 ,,RBRVS,7.69 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29846,CPT,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JT DBRDMT,,,21 ,,RBRVS,6.89 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29847,CPT,ARTHRS WRST SURG INT FIXJ F/FX/INS,,,21 ,,RBRVS,7.22 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29848,CPT,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,,,21 ,,RBRVS,6.39 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29850,CPT,ARTHRS AID TX SPI&/FX KNE W/O FIXJ,,,21 ,,RBRVS,8.27 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29851,CPT,ARTHRS AID TX SPI&/FX KNE W/FIXJ,,,21 ,,RBRVS,13.26 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29855,CPT,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,,,21 ,,RBRVS,10.76 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29856,CPT,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,,,21 ,,RBRVS,14.28 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29860,CPT,ARTHROSCOPY HIP DIAGNOSTIC +-SYNOVIAL BIOPSY SPX,,,21 ,,RBRVS,9.00 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29861,CPT,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,,,21 ,,RBRVS,10.10 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29862,CPT,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,,,21 ,,RBRVS,11.17 ,8.44 ,8.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29863,CPT,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,,,21 ,,RBRVS,11.17 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29866,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,,,21 ,,RBRVS,14.67 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29867,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,,,21 ,,RBRVS,18.39 ,12.33 ,12.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29868,CPT,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,,,21 ,,RBRVS,25.10 ,15.42 ,15.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29870,CPT,ARTHROSCOPY KNEE DIAGNOSTIC +-SYNOVIAL BX SPX,,,21 ,,RBRVS,5.19 ,4.65 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29871,CPT,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,,,21 ,,RBRVS,6.69 ,5.62 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29873,CPT,ARTHROSCOPY KNEE LATERAL RELEASE,,,21 ,,RBRVS,6.24 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29874,CPT,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,,,21 ,,RBRVS,7.19 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29875,CPT,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,,,21 ,,RBRVS,6.45 ,5.46 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29876,CPT,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,,,21 ,,RBRVS,8.87 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29877,CPT,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,,,21 ,,RBRVS,8.30 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29879,CPT,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,,,21 ,,RBRVS,8.99 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29880,CPT,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,,,21 ,,RBRVS,9.45 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29881,CPT,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,,,21 ,,RBRVS,8.71 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29882,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,,,21 ,,RBRVS,9.60 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29883,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,,,21 ,,RBRVS,11.77 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29884,CPT,ARTHROSCOPY KNEE W/LYSIS ADHESIONS+-MNPJ SPX,,,21 ,,RBRVS,8.28 ,6.60 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29885,CPT,ARTHRS KNE DRLG OSTEO DISS GRFG,,,21 ,,RBRVS,10.21 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29886,CPT,ARTHRS KNE DRLG OSTEO DISS LES,,,21 ,,RBRVS,8.49 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29887,CPT,ARTHRS KNE DRLG OSTEO DISS LES INT FIXJ,,,21 ,,RBRVS,10.16 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29888,CPT,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,,21 ,,RBRVS,14.30 ,9.69 ,9.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29889,CPT,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,,21 ,,RBRVS,17.41 ,12.06 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29891,CPT,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,,,21 ,,RBRVS,9.67 ,7.28 ,7.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29892,CPT,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,,,21 ,,RBRVS,10.27 ,7.36 ,7.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29893,CPT,ENDOSCOPIC PLANTAR FASCIOTOMY,,,21 ,,RBRVS,6.32 ,4.58 ,8.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29894,CPT,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,,,21 ,,RBRVS,7.35 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29895,CPT,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,,,21 ,,RBRVS,7.13 ,5.01 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29897,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,,,21 ,,RBRVS,7.32 ,5.40 ,5.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29898,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,,,21 ,,RBRVS,8.49 ,5.74 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29899,CPT,ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS,,,21 ,,RBRVS,15.41 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29900,CPT,ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY,,,21 ,,RBRVS,5.88 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29901,CPT,ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT,,,21 ,,RBRVS,6.59 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29902,CPT,ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM,,,21 ,,RBRVS,7.16 ,6.22 ,6.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29904,CPT,ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY,,,21 ,,RBRVS,8.65 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29905,CPT,ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY,,,21 ,,RBRVS,9.18 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29906,CPT,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,,,21 ,,RBRVS,9.65 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29907,CPT,ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS,,,21 ,,RBRVS,12.18 ,8.65 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29914,CPT,HIP ARTHRO W/FEMOROPLASTY,,,21 ,,RBRVS,14.67 ,12.79 ,12.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29915,CPT,HIP ARTHRO ACETABULOPLASTY,,,21 ,,RBRVS,15.00 ,12.99 ,12.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29916,CPT,HIP ARTHRO W/LABRAL REPAIR,,,21 ,,RBRVS,15.00 ,12.99 ,12.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,29999,CPT,UNLISTED PROCEDURE ARTHROSCOPY,,,21 ,,TotalUnits,,,,15.93 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30000,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,,,21 ,,RBRVS,1.48 ,1.45 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30020,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,,,21 ,,RBRVS,1.48 ,1.48 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30100,CPT,BIOPSY INTRANASAL,,,21 ,,RBRVS,0.94 ,0.81 ,2.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30110,CPT,EXCISION NASAL POLYP SIMPLE,,,21 ,,RBRVS,1.68 ,1.58 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30115,CPT,EXCISION NASAL POLYP EXTENSIVE,,,21 ,,RBRVS,4.44 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30117,CPT,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,,,21 ,,RBRVS,3.26 ,5.05 ,17.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30118,CPT,EXCISION/DESTRUCTION INTRANASAL LESION XTRNL,,,21 ,,RBRVS,9.92 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30120,CPT,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,,,21 ,,RBRVS,5.39 ,5.63 ,7.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30124,CPT,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,,,21 ,,RBRVS,3.20 ,3.56 ,3.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30125,CPT,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,,,21 ,,RBRVS,7.30 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30130,CPT,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,,,21 ,,RBRVS,3.47 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30140,CPT,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,,,21 ,,RBRVS,3.57 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30150,CPT,RHINECTOMY PARTIAL,,,21 ,,RBRVS,9.55 ,9.86 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30160,CPT,RHINECTOMY TOTAL,,,21 ,,RBRVS,9.99 ,9.59 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3017F,CPT,COLORECTAL CANCER SCREENING RESULTS DOC&REV,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30200,CPT,INJECTION TURBINATE THERAPEUTIC,,,21 ,,RBRVS,0.78 ,0.72 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30210,CPT,DISPLACEMENT THERAPY PROETZ TYPE,,,21 ,,RBRVS,1.13 ,1.35 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3021F,CPT,LEFT VENTRICULAR EJECTION FRACTION < 40%,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30220,CPT,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,,,21 ,,RBRVS,1.59 ,1.55 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3022F,CPT,LEFT VENTRICULAR EJECTION FRACTION >= 40%,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3023F,CPT,SPIROMETRY RESULTS DOCUMENTED AND REVIEWED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3025F,CPT,SPIROMETRY TEST RESULTS DEMONSTRATE FEV/FVC <70%,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3028F,CPT,OXYGEN SATURATION RESULTS DOCUMENTED & REVIEWED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30300,CPT,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,,,21 ,,RBRVS,1.09 ,1.96 ,4.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30310,CPT,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,,,21 ,,RBRVS,2.01 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30320,CPT,RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY,,,21 ,,RBRVS,4.64 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30400,CPT,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NSL TIP,,,21 ,,RBRVS,10.86 ,14.75 ,14.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30410,CPT,RHINP PRIM COMPLETE XTRNL PARTS,,,21 ,,RBRVS,14.00 ,16.17 ,16.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30420,CPT,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,,,21 ,,RBRVS,16.90 ,17.26 ,17.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30430,CPT,RHINOPLASTY SECONDARY MINOR REVISION,,,21 ,,RBRVS,8.24 ,14.12 ,14.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30435,CPT,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,,,21 ,,RBRVS,12.73 ,16.48 ,16.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3044F,CPT,MOST RECENT HEMOGLOBIN A1C LEVEL LT 7.0%,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30450,CPT,RHINOPLASTY SECONDARY MAJOR REVISION,,,21 ,,RBRVS,19.66 ,19.05 ,19.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3045F,CPT,MOST RECENT HEMOGLOBIN A1C LEVEL GT 7.0 – 9.0 %,,,14 ,,TotalUnits,,,,0.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30460,CPT,RHINP DFRM W/COLUM LNGTH TIP ONLY,,,21 ,,RBRVS,10.32 ,8.75 ,8.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30462,CPT,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,,,21 ,,RBRVS,20.28 ,16.67 ,16.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30465,CPT,REPAIR NASAL VESTIBULAR STENOSIS,,,21 ,,RBRVS,12.36 ,12.00 ,12.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3046F,CPT,MOST RECENT HEMOGLOBIN A1C LEVEL > 9.0%,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3048F,CPT,MOST RECENT LDL-C < 100 MG/DL,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3049F,CPT,MOST RECENT LDL-C 100-129 MG/DL,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3050F,CPT,MOST RECENT LDL-C >= 130 MG/DL,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30520,CPT,SEPTOP/SBMCSL RESCJ,,,21 ,,RBRVS,7.01 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30540,CPT,REPAIR CHOANAL ATRESIA INTRANASAL,,,21 ,,RBRVS,7.92 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30545,CPT,REPAIR CHOANAL ATRESIA TRANSPALATINE,,,21 ,,RBRVS,11.62 ,11.28 ,11.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30560,CPT,LYSIS INTRANASAL SYNECHIA,,,21 ,,RBRVS,1.31 ,2.13 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30580,CPT,REPAIR FISTULA OROMAXILLARY,,,21 ,,RBRVS,6.88 ,5.47 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30600,CPT,REPAIR FISTULA ORONASAL,,,21 ,,RBRVS,6.16 ,4.73 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3060F,CPT,POSITIVE MICROALBUMINURIA TEST RESULT DOC&REV,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3061F,CPT,NEGATIVE MICROALBUMINURIA TEST RESULT DOC&REV,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30620,CPT,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,,,21 ,,RBRVS,6.16 ,9.13 ,9.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30630,CPT,REPAIR NASAL SEPTAL PERFORATIONS,,,21 ,,RBRVS,7.29 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3073F,CPT,DOCUMENTED LENGTH CORNEAL POWER & LENS POWER,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3074F,CPT,MOST RECENT SYSTOLIC BLOOD PRESSURE <130 MM HG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3075F,CPT,MOST RECENT SYSTOLIC BLOOD PRESS GE 130-139MM HG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3077F,CPT,MOST RECENT SYSTOLIC BLOOD PRESSURE >= 140 MM HG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3078F,CPT,MOST RECENT DIASTOLIC BLOOD PRESSURE < 80 MM HG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3079F,CPT,MOST RECENT DIASTOLIC BLOOD PRESSURE 80-89 MM HG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30801,CPT,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC,,,21 ,,RBRVS,1.14 ,2.18 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30802,CPT,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,,,21 ,,RBRVS,2.08 ,2.61 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3080F,CPT,MOST RECENT DIASTOLIC BLOOD PRESSURE >= 90 MM HG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,30901,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,,,21 ,,RBRVS,1.21 ,0.35 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30903,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,,,21 ,,RBRVS,1.54 ,0.50 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30905,CPT,CTRL NSL HEMRRG PST PST NSL PACKS&/CAUT 1ST,,,21 ,,RBRVS,1.97 ,0.63 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30906,CPT,CTRL NSL HEMRRG PST PST NSL PACKS&/CAUT SBSQ,,,21 ,,RBRVS,2.45 ,0.98 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30915,CPT,LIGATION ARTERIES ETHMOIDAL,,,21 ,,RBRVS,7.44 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30920,CPT,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,,,21 ,,RBRVS,11.14 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30930,CPT,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,,,21 ,,RBRVS,1.31 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,30999,CPT,UNLISTED PROCEDURE NOSE,,,21 ,,TotalUnits,,,,10.72 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,31000,CPT,LAVAGE CANNULATION MAXILLARY SINUS,,,21 ,,RBRVS,1.20 ,1.42 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31002,CPT,LAVAGE CANNULATION SPHENOID SINUS,,,21 ,,RBRVS,1.96 ,3.02 ,3.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3100F,CPT,CAROT BLK DOCD REF AMNT DISTAL INT CAROT DIAM,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,31020,CPT,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,,,21 ,,RBRVS,3.07 ,5.65 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31030,CPT,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,,,21 ,,RBRVS,6.01 ,6.89 ,11.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31032,CPT,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,,,21 ,,RBRVS,6.69 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31040,CPT,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,,,21 ,,RBRVS,9.77 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31050,CPT,SINUSOTOMY SPHENOID +-BIOPSY,,,21 ,,RBRVS,5.37 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31051,CPT,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,,,21 ,,RBRVS,7.25 ,8.75 ,8.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31070,CPT,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,,,21 ,,RBRVS,4.40 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31075,CPT,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,,,21 ,,RBRVS,9.51 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31080,CPT,SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC,,,21 ,,RBRVS,12.74 ,12.51 ,12.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31081,CPT,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,,,21 ,,RBRVS,14.19 ,16.62 ,16.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31084,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC,,,21 ,,RBRVS,14.95 ,14.33 ,14.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31085,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,,,21 ,,RBRVS,15.64 ,16.32 ,16.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31086,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,,,21 ,,RBRVS,14.36 ,13.57 ,13.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31087,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,,,21 ,,RBRVS,14.57 ,12.73 ,12.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31090,CPT,SINUSOT UNI 3/> PARANSL SINUSES,,,21 ,,RBRVS,11.17 ,13.94 ,13.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3110F,CPT,PRES/ABSN HMRHG/MASS LESION/ACUTE INFRC DOCD,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,3111F,CPT,CT OR MRI BRAIN DONE W/IN 24 HRS HOSP ARRIVAL,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,31200,CPT,ETHMOIDECTOMY INTRANASAL ANTERIOR,,,21 ,,RBRVS,5.14 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31201,CPT,ETHMOIDECTOMY INTRANASAL TOTAL,,,21 ,,RBRVS,8.60 ,9.57 ,9.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31205,CPT,ETHMOIDECTOMY EXTRANASAL TOTAL,,,21 ,,RBRVS,10.58 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3120F,CPT,12-LEAD ECG PERFORMED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,31225,CPT,MAXILLECTOMY W/O ORBITAL EXENTERATION,,,21 ,,RBRVS,26.70 ,19.55 ,19.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31230,CPT,MAXILLECTOMY W/ORBITAL EXENTERATION,,,21 ,,RBRVS,30.82 ,20.96 ,20.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31231,CPT,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,,,21 ,,RBRVS,1.10 ,0.85 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31233,CPT,NSL/SINUS NDSC DX MAX SINUSC,,,21 ,,RBRVS,2.18 ,1.31 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31235,CPT,NSL/SINUS NDSC DX SPHENOID SINUSOSCOPY,,,21 ,,RBRVS,2.64 ,1.51 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31237,CPT,NSL/SINUS NDSC SURG W/BX POLYPC/DBRDMT SPX,,,21 ,,RBRVS,2.98 ,1.66 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31238,CPT,NSL/SINUS NDSC SURG W/CTRL NSL HEMRRG,,,21 ,,RBRVS,3.26 ,1.79 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31239,CPT,NSL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,,,21 ,,RBRVS,9.33 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31240,CPT,NSL/SINUS NDSC SURG W/CONCHA BULLOSA RESCJ,,,21 ,,RBRVS,2.61 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31254,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY PARTIAL,,,21 ,,RBRVS,4.64 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31255,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY TOTAL,,,21 ,,RBRVS,6.95 ,3.37 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31256,CPT,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,,,21 ,,RBRVS,3.29 ,1.80 ,1.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31267,CPT,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,,,21 ,,RBRVS,5.45 ,2.73 ,2.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31276,CPT,NSL/SINUS NDSC W/FRNT SINUS EXPL,,,21 ,,RBRVS,8.84 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31287,CPT,NASAL/SINUS ENDOSCOPY W/SPHENOIDECTOMY,,,21 ,,RBRVS,3.91 ,2.07 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31288,CPT,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,,,21 ,,RBRVS,4.57 ,2.35 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31290,CPT,NSL/SINUS NDSC RPR CEREBSP FLU LEAK ETHMOID,,,21 ,,RBRVS,18.61 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31291,CPT,NSL/SINUS NDSC RPR CEREBSP FLU LEAK SPHENOID,,,21 ,,RBRVS,19.56 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31292,CPT,NSL/SINUS NDSC SURG W/MEDIAL/INF ORB WALL DCMPRN,,,21 ,,RBRVS,15.90 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31293,CPT,NSL/SINUS NDSC MEDIAL ORB&INF ORB WALL DCMPRN,,,21 ,,RBRVS,17.47 ,10.24 ,10.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31294,CPT,NSL/SINUS NDSC SURG W/OPTIC NRV DCMPRN,,,21 ,,RBRVS,20.31 ,11.44 ,11.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31295,CPT,SINUS ENDO W/BALLOON DIL,,,21 ,,RBRVS,2.70 ,57.07 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31296,CPT,SINUS ENDO W/BALLOON DIL,,,21 ,,RBRVS,3.29 ,108.70 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31297,CPT,SINUS ENDO W/BALLOON DIL,,,21 ,,RBRVS,2.64 ,108.37 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31299,CPT,UNLISTED PROCEDURE ACCESSORY SINUSES,,,21 ,,TotalUnits,,,,4.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,31300,CPT,LRYNGOT W/RMVL TUM/LARYNGOCELE CORDECTOMY,,,21 ,,RBRVS,15.91 ,15.71 ,15.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31320,CPT,LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX,,,21 ,,RBRVS,5.73 ,10.47 ,10.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31360,CPT,LARGTOM TOT W/O RAD NCK DSJ,,,21 ,,RBRVS,29.91 ,21.19 ,21.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31365,CPT,LARGTOM TOT W/RAD NCK DSJ,,,21 ,,RBRVS,38.81 ,24.81 ,24.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31367,CPT,LARGTOM STOT SUPRAGLOTTIC W/O RAD NCK DSJ,,,21 ,,RBRVS,30.57 ,24.21 ,24.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31368,CPT,LARGTOM STOT SUPRAGLOTTIC W/RAD NCK DSJ,,,21 ,,RBRVS,34.19 ,26.78 ,26.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31370,CPT,PRTL LARGTOM HEMILARGTOM HRZNTL,,,21 ,,RBRVS,27.57 ,23.92 ,23.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31375,CPT,PRTL LARGTOM HEMILARGTOM LATER>,,,21 ,,RBRVS,26.07 ,22.71 ,22.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31380,CPT,PRTL LARGTOM HEMILARGTOM ANTER>,,,21 ,,RBRVS,25.57 ,22.45 ,22.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31382,CPT,PRTL LARGTOM HEMILARGTOM ANTERO-LATERO-VER,,,21 ,,RBRVS,28.57 ,24.13 ,24.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31390,CPT,PHARYNGOLARGTOM W/RAD NCK DSJ W/O RCNSTJ,,,21 ,,RBRVS,42.51 ,28.06 ,28.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31395,CPT,PHARYNGOLARGTOM W/RAD NCK DSJ W/RCNSTJ,,,21 ,,RBRVS,43.80 ,31.06 ,31.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31400,CPT,ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPR,,,21 ,,RBRVS,11.60 ,13.47 ,13.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31420,CPT,EPIGLOTTIDECTOMY,,,21 ,,RBRVS,11.43 ,9.55 ,9.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31500,CPT,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,,,21 ,,RBRVS,2.33 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31502,CPT,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,,,21 ,,RBRVS,0.65 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31505,CPT,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,,,21 ,,RBRVS,0.61 ,0.63 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31510,CPT,LARYNGOSCOPY INDIRECT W/BIOPSY,,,21 ,,RBRVS,1.92 ,1.16 ,3.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31511,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,,,21 ,,RBRVS,2.16 ,1.13 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31512,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL LESION,,,21 ,,RBRVS,2.07 ,1.26 ,3.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31513,CPT,LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION,,,21 ,,RBRVS,2.10 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31515,CPT,LARYNGOSCOPY +-TRACHEOSCOPY ASPIRATION,,,21 ,,RBRVS,1.80 ,1.01 ,3.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31520,CPT,LARYNGOSCOPY +-TRACHEOSCOPY DIAGNOSTIC NEWBORN,,,21 ,,RBRVS,2.56 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31525,CPT,LARYNGOSCOPY +-TRACHEOSCOPY DX EXCEPT NEWBORN,,,21 ,,RBRVS,2.63 ,1.46 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31526,CPT,LARYNGOSCOPY +-TRACHEOSCOPY MICROSCOPE/TELESCOPE,,,21 ,,RBRVS,2.57 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31527,CPT,LARYNGOSCOPY +-TRACHEOSCOPY INSERTION OBTURATOR,,,21 ,,RBRVS,3.27 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31528,CPT,LARYNGOSCOPY +-TRACHEOSCOPY W/DILATION INITIAL,,,21 ,,RBRVS,2.37 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31529,CPT,LARYNGOSCOPY +-TRACHEOSCOPY DILATION SUBSEQUENT,,,21 ,,RBRVS,2.68 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31530,CPT,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,,,21 ,,RBRVS,3.38 ,1.71 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31531,CPT,LARYNGOSCOPY F BODY RMVL MICROSCOPE/TELESCOPE,,,21 ,,RBRVS,3.58 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31535,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,,,21 ,,RBRVS,3.16 ,1.73 ,1.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31536,CPT,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,,,21 ,,RBRVS,3.55 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31540,CPT,LARGSC EXC TUM&/STRIPPING CORDS/EPIGL,,,21 ,,RBRVS,4.12 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31541,CPT,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,,,21 ,,RBRVS,4.52 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31545,CPT,LARGSC MCRSCP/TLSCP RMVL LES VOCAL C/D FLAP,,,21 ,,RBRVS,6.30 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31546,CPT,LARGSC MCRSCP/TLSCP RMVL LES VOCAL C/D GRF,,,21 ,,RBRVS,9.73 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31560,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,,,21 ,,RBRVS,5.45 ,2.67 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31561,CPT,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,,,21 ,,RBRVS,5.99 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31570,CPT,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,,,21 ,,RBRVS,3.86 ,2.01 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31571,CPT,LARGSC W/NJX VOCAL CORD THER W/MCRSCP/TLSCP,,,21 ,,RBRVS,4.26 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31575,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGNOSTIC,,,21 ,,RBRVS,1.10 ,0.85 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31576,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC W/BIOPSY,,,21 ,,RBRVS,1.97 ,1.20 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31577,CPT,LARYNGOSCOPY FLX FIBEROPTIC RMVL FOREIGN BODY,,,21 ,,RBRVS,2.47 ,1.36 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31578,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC REMOVAL LESION,,,21 ,,RBRVS,2.84 ,1.54 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31579,CPT,LARYNGOSCOPY FLX/RGD FIBOPT W/STROBOSCOPY,,,21 ,,RBRVS,2.26 ,1.35 ,3.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31580,CPT,LARYNGOPLASTY LARYN WEB 2 STG W/KEEL INSJ&RMVL,,,21 ,,RBRVS,14.66 ,15.64 ,15.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31582,CPT,LARYNGP LARYN STENOSIS GRF/CORE MOLD W/TRACHT,,,21 ,,RBRVS,23.22 ,24.60 ,24.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31584,CPT,LARYNGOPLASTY W/OPN RDCTJ FX,,,21 ,,RBRVS,20.47 ,17.49 ,17.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31587,CPT,LARYNGOPLASTY CRICOID SPLIT,,,21 ,,RBRVS,15.27 ,9.80 ,9.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31588,CPT,LARYNGOPLASTY NOT OTHERWISE SPECIFIED,,,21 ,,RBRVS,14.99 ,13.62 ,13.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31590,CPT,LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE,,,21 ,,RBRVS,7.85 ,14.40 ,14.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31595,CPT,SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX,,,21 ,,RBRVS,8.84 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31599,CPT,UNLISTED PROCEDURE LARYNX,,,21 ,,TotalUnits,,,,2.84 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,31600,CPT,TRACHEOSTOMY PLANNED SPX,,,21 ,,RBRVS,7.17 ,2.77 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31601,CPT,TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX,,,21 ,,RBRVS,4.44 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31603,CPT,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,,,21 ,,RBRVS,4.14 ,1.48 ,1.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31605,CPT,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,,,21 ,,RBRVS,3.57 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31610,CPT,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,,,21 ,,RBRVS,9.38 ,8.37 ,8.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31611,CPT,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,,,21 ,,RBRVS,6.00 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31612,CPT,TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX,,,21 ,,RBRVS,0.91 ,0.31 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31613,CPT,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,,,21 ,,RBRVS,4.71 ,6.40 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31614,CPT,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,,,21 ,,RBRVS,8.63 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31615,CPT,TRACHEOBRNCHSC THRU EST TRACHS INC,,,21 ,,RBRVS,2.09 ,1.17 ,2.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31620,CPT,ENDOBRNCL US BRONCHOSCOPIC DX/THER IVNTJ,,,21 ,,RBRVS,1.40 ,0.41 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31622,CPT,BRNCHSC INCL FLUOR GID DX W/CELL WASHG SPX,,,21 ,,RBRVS,2.78 ,0.99 ,5.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31623,CPT,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,,,21 ,,RBRVS,2.88 ,0.97 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31624,CPT,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,,,21 ,,RBRVS,2.88 ,0.99 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31625,CPT,BRNCHSC BRNCL/ENDOBRNCL BX 1+ SITS,,,21 ,,RBRVS,3.36 ,1.12 ,5.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31626,CPT,BRNCHSC W/PLMT FIDUCIAL MARKERS 1/MLT,,,21 ,,RBRVS,4.16 ,1.46 ,7.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31627,CPT,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,,,21 ,,RBRVS,2.00 ,0.73 ,29.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,31628,CPT,BRNCHSC W/TRANSBRNCL LUNG BX 1 LOBE,,,21 ,,RBRVS,3.80 ,1.21 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31629,CPT,BRNCHSC NDL BX TRACHEA MAIN STEM&/BRONCHUSI,,,21 ,,RBRVS,4.09 ,1.30 ,11.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31630,CPT,BRNCHSC W/TRACHEAL/BRNCL DILAT/CLSD RDCTJ FX,,,21 ,,RBRVS,3.81 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31631,CPT,BRNCHSC W/PLACEMENT TRACHEAL STENT,,,21 ,,RBRVS,4.36 ,1.60 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31632,CPT,BRNCHSC W/TRANSBRNCL LUNG BX EA LOBE,,,21 ,,RBRVS,1.03 ,0.27 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31633,CPT,BRNCHSC W/TRANSBRNCL NDL ASPIR BX EA LOBE,,,21 ,,RBRVS,1.32 ,0.36 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31634,CPT,BRONCH W/BALLOON OCCLUSION,,,21 ,,RBRVS,4.00 ,48.98 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31635,CPT,BRNCHSC W/REMOVAL FOREIGN BODY,,,21 ,,RBRVS,3.67 ,1.27 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31636,CPT,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,,,21 ,,RBRVS,4.30 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31637,CPT,BRNCHSC EA MAJOR BRONCHUS STENTED,,,21 ,,RBRVS,1.58 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31638,CPT,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,,,21 ,,RBRVS,4.88 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31640,CPT,BRNCHSC W/EXCISION TUMOR,,,21 ,,RBRVS,4.93 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31641,CPT,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,,,21 ,,RBRVS,5.02 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31643,CPT,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,,,21 ,,RBRVS,3.49 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31645,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE 1ST,,,21 ,,RBRVS,3.16 ,1.06 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31646,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE SBSQ,,,21 ,,RBRVS,2.72 ,0.93 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31656,CPT,BRNCHSC W/NJX CONTRAST SGMTL BRONCHOG,,,21 ,,RBRVS,2.17 ,0.76 ,5.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31715,CPT,TRANSTRACHEAL INJECTION BRONCHOGRAPHY,,,21 ,,RBRVS,1.11 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31717,CPT,CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY,,,21 ,,RBRVS,2.12 ,0.75 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31720,CPT,CATHETER ASPIRATION NASOTRACHEAL SPX,,,21 ,,RBRVS,1.06 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31725,CPT,CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX,,,21 ,,RBRVS,1.96 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31730,CPT,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,,,21 ,,RBRVS,2.85 ,0.91 ,21.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31750,CPT,TRACHEOPLASTY CERVICAL,,,21 ,,RBRVS,15.39 ,18.35 ,18.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31755,CPT,TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG,,,21 ,,RBRVS,17.54 ,25.40 ,25.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31760,CPT,TRACHEOPLASTY INTRATHORACIC,,,21 ,,RBRVS,23.48 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31766,CPT,CARINAL RECONSTRUCTION,,,21 ,,RBRVS,31.67 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31770,CPT,BRONCHOPLASTY GRAFT REPAIR,,,21 ,,RBRVS,23.54 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31775,CPT,BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS,,,21 ,,RBRVS,24.59 ,9.86 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31780,CPT,EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICAL,,,21 ,,RBRVS,19.84 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31781,CPT,EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC,,,21 ,,RBRVS,24.85 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31785,CPT,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,,,21 ,,RBRVS,18.35 ,9.12 ,9.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31786,CPT,EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC,,,21 ,,RBRVS,25.42 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31800,CPT,SUTURE TRACHEAL WOUND/INJURY CERVICAL,,,21 ,,RBRVS,8.18 ,9.40 ,9.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31805,CPT,SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC,,,21 ,,RBRVS,13.42 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31820,CPT,SURG CLSR TRACHS/FSTL W/O PLSTC RPR,,,21 ,,RBRVS,4.64 ,3.60 ,6.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31825,CPT,SURG CLSR TRACHS/FSTL W/PLSTC RPR,,,21 ,,RBRVS,7.07 ,5.08 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31830,CPT,REVISION TRACHEOSTOMY SCAR,,,21 ,,RBRVS,4.62 ,3.88 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,31899,CPT,UNLISTED PROCEDURE TRACHEA BRONCHI,,,21 ,,TotalUnits,,,,3.95 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,32035,CPT,THORACOSTOMY W/RIB RESECTION EMPYEMA,,,21 ,,RBRVS,11.29 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32036,CPT,THORACOSTOMY OPEN FLAP DRAINAGE EMPYEMA,,,21 ,,RBRVS,12.30 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32095,CPT,THORACOTOMY LIMITED BIOPSY LUNG/PLEURA,,,21 ,,RBRVS,10.14 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32100,CPT,THORACOTOMY MAJOR W/EXPLORATION & BIOPSY,,,21 ,,RBRVS,16.16 ,7.70 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32110,CPT,THORCOM MAJOR CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,,,21 ,,RBRVS,25.28 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32120,CPT,THORACOTOMY MAJOR POSTOPERATIVE COMPLICATIONS,,,21 ,,RBRVS,14.39 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32124,CPT,THORACOTOMY MAJOR OPN INTRAPLEURAL PNEUMONOLYSIS,,,21 ,,RBRVS,15.45 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32140,CPT,THORCOM MAJOR W/CST RMVL +-PLEURAL PX,,,21 ,,RBRVS,16.66 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32141,CPT,THORCOM MAJOR EXC-PLCTJ BULLAE +-ANY PLEURAL PX,,,21 ,,RBRVS,27.18 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32150,CPT,THORCOM MAJOR W/RMVL INTRAPLEURAL FB/FIBRIN DEP,,,21 ,,RBRVS,16.82 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32151,CPT,THORCOM MAJOR W/RMVL IPUL FB,,,21 ,,RBRVS,16.94 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32160,CPT,THORACOTOMY MAJOR W/CARDIAC MASSAGE,,,21 ,,RBRVS,13.10 ,6.15 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32200,CPT,PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST,,,21 ,,RBRVS,18.68 ,9.38 ,9.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32201,CPT,PNEUMONOSTOMY PERCUTANEOUS DRAINAGE ABSCESS/CYST,,,21 ,,RBRVS,3.99 ,1.45 ,19.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32215,CPT,PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX,,,21 ,,RBRVS,13.05 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32220,CPT,DECORTICATION PULMONARY TOTAL SPX,,,21 ,,RBRVS,26.65 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32225,CPT,DECORTICATION PULMONARY PARTIAL SPX,,,21 ,,RBRVS,16.75 ,8.03 ,8.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32310,CPT,PLEURECTOMY PARIETAL SPX,,,21 ,,RBRVS,15.28 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32320,CPT,DECORTICATION & PARIETAL PLEURECTOMY,,,21 ,,RBRVS,27.25 ,12.57 ,12.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32400,CPT,BIOPSY PLEURA PERCUTANEOUS NEEDLE,,,21 ,,RBRVS,1.76 ,0.59 ,2.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32402,CPT,BIOPSY PLEURA OPEN,,,21 ,,RBRVS,8.97 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32405,CPT,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,,,21 ,,RBRVS,1.93 ,0.70 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32420,CPT,PNEUMOCENTESIS PUNCTURE LUNG ASPIRATION,,,21 ,,RBRVS,2.18 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32421,CPT,THORACENTESIS PUNCTURE PLEURAL CAVITY ASPIRATION,,,21 ,,RBRVS,1.54 ,0.50 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32422,CPT,THORACENTESIS WITH INSERTION TUBE WATER SEAL,,,21 ,,RBRVS,2.19 ,1.08 ,2.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32440,CPT,REMOVAL LUNG TOTAL PNEUMONECTOMY,,,21 ,,RBRVS,27.28 ,12.17 ,12.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32442,CPT,TOT PNUMEC RESCJ SGM TRACHEA BRNCTRAC ANAST,,,21 ,,RBRVS,56.47 ,18.16 ,18.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32445,CPT,REMOVAL LUNG TOTAL PNEUMONECTOMY EXTRAPLEURAL,,,21 ,,RBRVS,63.84 ,22.56 ,22.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32480,CPT,RMVL LNG OTH/THN TOT PNUMEC 1 LOBE LOBEC,,,21 ,,RBRVS,25.82 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32482,CPT,RMVL LNG OTH/THN TOT PNUMEC 2 LOBES BILOBEC,,,21 ,,RBRVS,27.44 ,12.39 ,12.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32484,CPT,RMVL LNG OTH/THN TOT PNUMEC 1 SGM SGMECTOMY,,,21 ,,RBRVS,25.38 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32486,CPT,RMVL LNG XCP TOT PNUMEC SLEEVE LOBECTOMY,,,21 ,,RBRVS,42.88 ,15.66 ,15.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32488,CPT,RMVL LNG OTH/THN TOT PNUMEC COMPLETION PNUMEC,,,21 ,,RBRVS,42.99 ,16.34 ,16.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32491,CPT,RMVL LNG OTH/THN TOT PNUMEC EXC-PLCTJ EMPHY LNG,,,21 ,,RBRVS,25.24 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32500,CPT,RMVL LNG OTH/THN TOT PNUMEC WEDGE RESCJ 1/MLT,,,21 ,,RBRVS,24.64 ,11.50 ,11.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32501,CPT,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,,,21 ,,RBRVS,4.68 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32503,CPT,RESCJ APICAL LNG TUM W/O CH WALL RCNSTJ,,,21 ,,RBRVS,31.74 ,13.55 ,13.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32504,CPT,RESCJ APICAL LNG TUM W/CH WALL RCNSTJ,,,21 ,,RBRVS,36.54 ,15.37 ,15.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32540,CPT,EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY,,,21 ,,RBRVS,30.35 ,12.38 ,12.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32550,CPT,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,,,21 ,,RBRVS,4.17 ,1.65 ,16.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32551,CPT,TUBE THORACOSTOMY INCLUDES WATER SEAL,,,21 ,,RBRVS,3.29 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32552,CPT,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,,,21 ,,RBRVS,2.53 ,1.49 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32553,CPT,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,,,21 ,,RBRVS,3.80 ,1.30 ,11.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32560,CPT,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,,,21 ,,RBRVS,1.54 ,0.62 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32561,CPT,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,,,21 ,,RBRVS,1.39 ,0.43 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32562,CPT,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,,,21 ,,RBRVS,1.24 ,0.39 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32601,CPT,THORACOSCOPY DX LUNGS&PLEURAL SPACE W/O BX SPX,,,21 ,,RBRVS,5.45 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32602,CPT,THORACOSCOPY DX LUNGS&PLEURAL SPACE W/BX SPX,,,21 ,,RBRVS,5.95 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32603,CPT,THORACOSCOPY DX PERICARDIAL SAC W/O BIOPSY SPX,,,21 ,,RBRVS,7.80 ,3.05 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32604,CPT,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,,,21 ,,RBRVS,8.77 ,3.40 ,3.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32605,CPT,THORACOSCOPY DX MEDIASTINAL SPACE W/O BIOPSY SPX,,,21 ,,RBRVS,6.92 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32606,CPT,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,,,21 ,,RBRVS,8.39 ,3.27 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,3260F,CPT,TUMOR/NODES/HISTO GRADE DOCUMENTED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,32650,CPT,THORACOSCOPY W/PLEURODESIS,,,21 ,,RBRVS,10.83 ,5.93 ,5.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32651,CPT,THORACOSCOPY W/PARTIAL PULMONARY DECORTICATION,,,21 ,,RBRVS,18.78 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32652,CPT,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,,,21 ,,RBRVS,29.13 ,11.88 ,11.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32653,CPT,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,,,21 ,,RBRVS,18.17 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32654,CPT,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,,,21 ,,RBRVS,20.52 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32655,CPT,THRSC EXC-PLCTJ BULLAE ANY PLEURAL PX,,,21 ,,RBRVS,16.17 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32656,CPT,THORACOSCOPY W/PARIETAL PLEURECTOMY,,,21 ,,RBRVS,13.26 ,6.80 ,6.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32657,CPT,THRSC W/WEDGE RESCJ LNG 1/MLT,,,21 ,,RBRVS,12.93 ,6.77 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32658,CPT,THRSC W/RMVL CLOT/FB FROM PRCRD SAC,,,21 ,,RBRVS,11.71 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32659,CPT,THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC,,,21 ,,RBRVS,11.94 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32660,CPT,THORACOSCOPY W/TOTAL PERICARDIECTOMY,,,21 ,,RBRVS,17.77 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32661,CPT,THRSC W/EXC PRCRD CST TUM/MASS,,,21 ,,RBRVS,13.33 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32662,CPT,THRSC W/EXC MEDSTNL CST TUM/MASS,,,21 ,,RBRVS,14.99 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32663,CPT,THORACOSCOPY W/LOBECTOMY TOTAL/SEGMENTAL,,,21 ,,RBRVS,24.64 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32664,CPT,THORACOSCOPY W/THORACIC SYMPATHECTOMY,,,21 ,,RBRVS,14.28 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32665,CPT,THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE,,,21 ,,RBRVS,21.53 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32800,CPT,REPAIR LUNG HERNIA THROUGH CHEST WALL,,,21 ,,RBRVS,15.71 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32810,CPT,CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA,,,21 ,,RBRVS,14.95 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32815,CPT,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,,,21 ,,RBRVS,50.03 ,18.54 ,18.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32820,CPT,MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC,,,21 ,,RBRVS,22.51 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32851,CPT,LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS,,,21 ,,RBRVS,41.61 ,23.33 ,23.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32852,CPT,LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS,,,21 ,,RBRVS,45.48 ,26.53 ,26.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32853,CPT,LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS,,,21 ,,RBRVS,50.78 ,26.37 ,26.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32854,CPT,LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS,,,21 ,,RBRVS,54.74 ,29.78 ,29.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32855,CPT,BKBENCH STANDARD PREPJ CDVR DON LNG ALGRFT UNI,,,21 ,,TotalUnits,,,,11.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,32900,CPT,RESECTION RIBS EXTRAPLEURAL ALL STAGES,,,21 ,,RBRVS,23.81 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32905,CPT,THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL,,,21 ,,RBRVS,23.29 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32906,CPT,THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL,,,21 ,,RBRVS,29.30 ,12.07 ,12.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32940,CPT,PNEUMONOLSS XTRPRIOSTEAL W/FILLING/PACKING PX,,,21 ,,RBRVS,21.34 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32960,CPT,PNEUMOTHORAX THER INTRAPLEURAL NJX AIR,,,21 ,,RBRVS,1.84 ,0.73 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32997,CPT,TOTAL LUNG LAVAGE UNILATERAL,,,21 ,,RBRVS,7.31 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32998,CPT,ABLATION PULMONARY TUMOR PERQ RF UNI,,,21 ,,RBRVS,5.68 ,2.25 ,67.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,32999,CPT,UNLISTED PROCEDURE LUNGS & PLEURA,,,21 ,,TotalUnits,,,,2.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,33010,CPT,PERICARDIOCENTESIS INITIAL,,,21 ,,RBRVS,2.24 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33011,CPT,PERICARDIOCENTESIS SUBSEQUENT,,,21 ,,RBRVS,2.24 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33015,CPT,TUBE PERICARDIOSTOMY,,,21 ,,RBRVS,8.52 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33020,CPT,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,,,21 ,,RBRVS,14.95 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33025,CPT,CREATION PERICARDIAL WINDOW/PRTL RESECJ DRAINAGE,,,21 ,,RBRVS,13.70 ,6.40 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33030,CPT,PRICARDIECTOMY STOT/COMPL W/O CARD BYP,,,21 ,,RBRVS,22.39 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33031,CPT,PRICARDIECTOMY STOT/COMPL W/CARD BYP,,,21 ,,RBRVS,25.38 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33050,CPT,EXCISION PERICARDIAL CYST/TUMOR,,,21 ,,RBRVS,16.97 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33120,CPT,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,,,21 ,,RBRVS,27.45 ,11.70 ,11.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33130,CPT,RESECTION EXTERNAL CARDIAC TUMOR,,,21 ,,RBRVS,24.17 ,12.26 ,12.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33140,CPT,TRANSMYOCRD LASER REVSC THORCOM SPX,,,21 ,,RBRVS,28.34 ,11.41 ,11.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33141,CPT,TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX,,,21 ,,RBRVS,2.54 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33202,CPT,INSERTION EPICARDIAL ELECTRODE OPEN,,,21 ,,RBRVS,13.20 ,6.37 ,6.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33203,CPT,INSERTION EPICARDIAL ELECTRODE ENDOSCOPIC,,,21 ,,RBRVS,13.97 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33206,CPT,INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR,,,21 ,,RBRVS,7.39 ,4.72 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33207,CPT,INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD VENTR,,,21 ,,RBRVS,8.05 ,4.84 ,4.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33208,CPT,INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR&VENTR,,,21 ,,RBRVS,8.77 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33210,CPT,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,,,21 ,,RBRVS,3.30 ,1.48 ,1.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33211,CPT,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,,,21 ,,RBRVS,3.39 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33212,CPT,INSJ/RPLCMT PM PLS GEN ONLY 1CHMBR ATR/VENTR,,,21 ,,RBRVS,5.52 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33213,CPT,INSJ/RPLCMT PM PLS GEN ONLY 2CHMBR,,,21 ,,RBRVS,6.37 ,3.88 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33214,CPT,UPG PM SYS CONV 1CHMBR SYS 2CHMBR SYS,,,21 ,,RBRVS,7.84 ,4.94 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33215,CPT,RPSG PREV IMPLTED PM/CVDFB R ATR/R VENTR ELTRD,,,21 ,,RBRVS,4.92 ,3.21 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33216,CPT,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER OR CVDFB,,,21 ,,RBRVS,5.87 ,4.21 ,4.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33217,CPT,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER OR CVDFB,,,21 ,,RBRVS,5.84 ,4.15 ,4.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33218,CPT,RPR 1 ELTRD 1CHMBR PRM PM/1CHMBR CVDFB,,,21 ,,RBRVS,6.07 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33220,CPT,RPR 2 ELTRDS 2 CHMBR PRM PM/2CHMBR CVDFB,,,21 ,,RBRVS,6.15 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33222,CPT,REVISION/RELOCATION SKIN POCKET PACEMAKER,,,21 ,,RBRVS,5.10 ,4.10 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33223,CPT,REVJ SKN POCKET FOR CARDIOVERTER-DEFIBRILLATOR,,,21 ,,RBRVS,6.55 ,4.52 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33224,CPT,INSJ ELTRD CAR VEN SYS ATTCH PM/CVDFB PLS GEN,,,21 ,,RBRVS,9.04 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33225,CPT,INSJ ELTRD CAR VEN SYS TM INSJ CVDFB/PM PLS GEN,,,21 ,,RBRVS,8.33 ,3.82 ,3.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33226,CPT,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,,,21 ,,RBRVS,8.68 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33233,CPT,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR,,,21 ,,RBRVS,3.39 ,3.04 ,3.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33234,CPT,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,,,21 ,,RBRVS,7.91 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33235,CPT,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,,,21 ,,RBRVS,10.15 ,6.74 ,6.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33236,CPT,RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS,,,21 ,,RBRVS,12.73 ,7.03 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33237,CPT,RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SYS,,,21 ,,RBRVS,13.84 ,7.74 ,7.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33238,CPT,RMVL PRM TRANSVNS ELTRD THORCOM,,,21 ,,RBRVS,15.40 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33240,CPT,INSJ 1/2CHMBR PACG CVDFB PLS GEN,,,21 ,,RBRVS,7.64 ,4.75 ,4.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33241,CPT,SUBQ RMVL 1/2CHMBR PACG CVDFB PLS GEN,,,21 ,,RBRVS,3.29 ,2.77 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33243,CPT,RMVL 1/2CHMBR PACG CVDFB ELTRD THORCOM,,,21 ,,RBRVS,23.57 ,11.41 ,11.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33244,CPT,RMVL 1/2CHMBR PACG CVDFB ELTRD TRANSVNS XTRJ,,,21 ,,RBRVS,13.99 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33249,CPT,INSJ/RPSG LEAD 1/2CHMBR CVDFB&INSJ PLS GEN,,,21 ,,RBRVS,15.17 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33250,CPT,ABLTJ ARRHYTGNIC FOC/PTHWY TRC&/FOC,,,21 ,,RBRVS,25.90 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33251,CPT,ABLTJ ARRHYTGNIC FOC/PTHWY TRC&/FOC CARD BYP,,,21 ,,RBRVS,28.92 ,12.20 ,12.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33254,CPT,ABLATION & RCNSTJ ATRIA LMTD,,,21 ,,RBRVS,23.71 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33255,CPT,ABLATION & RCNSTJ ATRIA X10SV W/O BYPASS,,,21 ,,RBRVS,29.04 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33256,CPT,ABLATION & RCNSTJ ATRIA X10SV W/BYPASS,,,21 ,,RBRVS,34.90 ,14.83 ,14.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33257,CPT,ATRIA ABLATE & RCNSTJ W OTHER PROCEDURE LIMITED,,,21 ,,RBRVS,9.63 ,5.15 ,5.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33258,CPT,ATRIA ABLTJ &RCNSTJ W OTHER PX EXTENSIVE W/O BYP,,,21 ,,RBRVS,11.00 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33259,CPT,ATRIA ABLATE &RCNSTJ W OTHER PX EXTENSIVE W BYP,,,21 ,,RBRVS,14.14 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33261,CPT,OPRATIVE ABLTJ VENTR ARRHYTGNIC FOC W/CARD BYP,,,21 ,,RBRVS,28.92 ,11.90 ,11.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33265,CPT,NDSC ABLATION & RCNSTJ ATRIA LMTD W/O BYPASS,,,21 ,,RBRVS,23.71 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33266,CPT,NDSC ABLATION & RCNSTJ ATRIA X10SV W/O BYPASS,,,21 ,,RBRVS,33.04 ,13.69 ,13.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33282,CPT,IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER,,,21 ,,RBRVS,4.80 ,3.90 ,3.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33284,CPT,RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER,,,21 ,,RBRVS,3.14 ,3.16 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33300,CPT,REPAIR CARDIAC WOUND W/O BYPASS,,,21 ,,RBRVS,44.97 ,15.37 ,15.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33305,CPT,REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS,,,21 ,,RBRVS,76.93 ,24.50 ,24.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33310,CPT,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,,,21 ,,RBRVS,20.34 ,9.22 ,9.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33315,CPT,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,,,21 ,,RBRVS,26.17 ,11.31 ,11.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33320,CPT,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,,,21 ,,RBRVS,18.54 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33321,CPT,SUTR RPR AORTA/GRT VSL W/SHUNT BYP,,,21 ,,RBRVS,20.81 ,9.15 ,9.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33322,CPT,SUTR RPR AORTA/GRT VSL W/CARD BYP,,,21 ,,RBRVS,24.42 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33330,CPT,INSJ GRF AORTA/GRT VSL W/O SHUNT/CARD BYP,,,21 ,,RBRVS,25.29 ,10.81 ,10.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33332,CPT,INSJ GRF AORTA/GRT VSL W/SHUNT BYP,,,21 ,,RBRVS,24.56 ,10.68 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33335,CPT,INSJ GRF AORTA/GRT VSL W/CARD BYP,,,21 ,,RBRVS,33.91 ,13.75 ,13.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33400,CPT,VLVP AORTIC VALVE OPN W/CARD BYP,,,21 ,,RBRVS,41.50 ,16.41 ,16.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33401,CPT,VLVP AORTIC VALVE OPN W/INFL OCCLUSION,,,21 ,,RBRVS,24.63 ,12.59 ,12.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33403,CPT,VLVP AORTIC VALVE W/TRANSVENTR DILAT W/CARD BYP,,,21 ,,RBRVS,25.61 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33404,CPT,CONSTRUCTION APICAL-AORTIC CONDUIT,,,21 ,,RBRVS,31.37 ,13.46 ,13.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33405,CPT,RPLCMT A-VALVE PROSTC XCP HOMOGRF/STENT< VALVE,,,21 ,,RBRVS,41.32 ,17.00 ,17.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33406,CPT,RPLCMT A-VALVE ALGRFT VALVE FRHAND,,,21 ,,RBRVS,52.68 ,20.14 ,20.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33410,CPT,RPLCMT A-VALVE STENT< TISS VALVE,,,21 ,,RBRVS,46.41 ,18.02 ,18.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33411,CPT,RPLCMT A-VALVE AORTIC ANNULUS ENLGMENT NONC CUSP,,,21 ,,RBRVS,62.07 ,22.55 ,22.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33412,CPT,RPLCMT A-VALVE KONNO PROCEDURE,,,21 ,,RBRVS,43.94 ,18.50 ,18.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33413,CPT,RPLCMT A-VALVE ROSS PX,,,21 ,,RBRVS,59.87 ,22.26 ,22.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33414,CPT,RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC,,,21 ,,RBRVS,39.37 ,15.42 ,15.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33415,CPT,RESCJ/INC SUBVALVULAR TISSUE,,,21 ,,RBRVS,37.27 ,13.93 ,13.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33416,CPT,VENTRICULOMYOTOMY-MYECTOMY,,,21 ,,RBRVS,36.56 ,14.64 ,14.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33417,CPT,AORTOPLASTY SUPRAVALVULAR STENOSIS,,,21 ,,RBRVS,29.33 ,13.06 ,13.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33420,CPT,VALVOTOMY MITRAL VALVE CLOSED HEART,,,21 ,,RBRVS,25.79 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33422,CPT,VALVOTOMY MITRAL VALVE OPN HRT W/CARD BYP,,,21 ,,RBRVS,29.73 ,12.81 ,12.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33425,CPT,VLVP MITRAL VALVE W/CARD BYP,,,21 ,,RBRVS,49.96 ,18.15 ,18.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33426,CPT,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,,,21 ,,RBRVS,43.28 ,17.38 ,17.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33427,CPT,VLVP MITRAL VALVE W/CARD BYP RAD RCNSTJ +-RING,,,21 ,,RBRVS,44.83 ,17.73 ,17.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33430,CPT,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,,,21 ,,RBRVS,50.93 ,19.90 ,19.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33460,CPT,VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP,,,21 ,,RBRVS,44.70 ,19.05 ,19.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33463,CPT,VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION,,,21 ,,RBRVS,57.08 ,20.01 ,20.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33464,CPT,VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION,,,21 ,,RBRVS,44.62 ,16.82 ,16.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33465,CPT,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,,,21 ,,RBRVS,50.72 ,18.18 ,18.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33468,CPT,TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY,,,21 ,,RBRVS,32.94 ,14.40 ,14.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33470,CPT,VALVOTOMY PULMONARY VALVE CLSD HEART TRANSVENTR,,,21 ,,RBRVS,21.54 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33471,CPT,VALVOTOMY PULM VALVE CLSD HRT VIA P-ART,,,21 ,,RBRVS,22.96 ,10.51 ,10.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33472,CPT,VALVOTOMY PULM VALVE OPN HRT W/INFL OCCLUSION,,,21 ,,RBRVS,23.06 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33474,CPT,VALVOTOMY PULM VALVE OPN HRT W/CARD BYP,,,21 ,,RBRVS,39.40 ,13.84 ,13.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33475,CPT,REPLACEMENT PULMONARY VALVE,,,21 ,,RBRVS,42.40 ,16.34 ,16.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33476,CPT,R VENTR RESCJ INFUND STEN +-COMMISSUROTOMY,,,21 ,,RBRVS,26.57 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33478,CPT,O/F TRC AGMNTJ +-COMMISSUROTOMY/INFUND RESCJ,,,21 ,,RBRVS,27.54 ,12.10 ,12.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33496,CPT,RPR NON-STRUCTURAL PROSTC VALVE DYSF CARD BYP,,,21 ,,RBRVS,29.84 ,12.62 ,12.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33500,CPT,RPR C ARVEN/ARTERIOCAR CHAMBER FSTL W/CARD BYP,,,21 ,,RBRVS,27.94 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33501,CPT,RPR C ARVEN/ARTERIOCAR CHAMBER FSTL W/O CARD BYP,,,21 ,,RBRVS,19.51 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33502,CPT,RPR ANOM C ART FROM P-ART ORIGIN LIG,,,21 ,,RBRVS,21.85 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33503,CPT,RPR ANOM C ART FROM P-ART ORIGIN GRF,,,21 ,,RBRVS,22.51 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33504,CPT,RPR ANOM C ART FROM P-ART ORIGIN GRF W/CARD BYP,,,21 ,,RBRVS,25.46 ,11.21 ,11.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33505,CPT,RPR ANOM C ART W/CONSTJ INTRAP-ART TUNNEL,,,21 ,,RBRVS,38.40 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33506,CPT,RPR ANOM C ART FROM P-ART TO AORTA,,,21 ,,RBRVS,37.85 ,14.04 ,14.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33507,CPT,RPR ANOM AORTIC ORIGIN C ART UNROOFING/TLCJ,,,21 ,,RBRVS,31.40 ,12.37 ,12.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33508,CPT,NDSC SURG W/VID-ASSTD HARVEST VEIN CAB,,,21 ,,RBRVS,0.31 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33510,CPT,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,,,21 ,,RBRVS,34.98 ,14.71 ,14.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33511,CPT,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,,,21 ,,RBRVS,38.45 ,15.96 ,15.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33512,CPT,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,,,21 ,,RBRVS,43.98 ,17.60 ,17.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33513,CPT,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,,,21 ,,RBRVS,45.37 ,17.57 ,17.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33514,CPT,CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS,,,21 ,,RBRVS,48.08 ,18.79 ,18.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33516,CPT,CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT,,,21 ,,RBRVS,49.76 ,19.45 ,19.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33517,CPT,CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 1 VEIN,,,21 ,,RBRVS,3.61 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33518,CPT,CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 2 VEIN,,,21 ,,RBRVS,7.93 ,2.44 ,2.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33519,CPT,CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 3 VEIN,,,21 ,,RBRVS,10.49 ,3.28 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33521,CPT,CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 4 VEIN,,,21 ,,RBRVS,12.59 ,3.99 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33522,CPT,CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 5 VEIN,,,21 ,,RBRVS,14.14 ,4.55 ,4.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33523,CPT,CORONARY ARTERY BYP W VEIN &ARTERY GRAFT 6 VEIN,,,21 ,,RBRVS,16.08 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33530,CPT,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,,,21 ,,RBRVS,10.13 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33533,CPT,CAB W/ARTL GRF 1 ARTL GRF,,,21 ,,RBRVS,33.75 ,14.39 ,14.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33534,CPT,CAB W/ARTL GRF 2 C ARTL GRFS,,,21 ,,RBRVS,39.88 ,16.53 ,16.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33535,CPT,CAB W/ARTL GRF 3 C ARTL GRFS,,,21 ,,RBRVS,44.75 ,18.02 ,18.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33536,CPT,CAB W/ARTL GRF 4/> C ARTL GRFS,,,21 ,,RBRVS,48.43 ,18.93 ,18.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33542,CPT,MYOCARDIAL RESECTION,,,21 ,,RBRVS,48.21 ,17.53 ,17.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33545,CPT,RPR POSTINFRCJ VENTR SEPTAL DFCT,,,21 ,,RBRVS,57.06 ,20.28 ,20.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33548,CPT,SURG VENTR RSTRJ PX W/PROSTC PATCH PFRMD,,,21 ,,RBRVS,54.14 ,21.33 ,21.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33572,CPT,C ENDARTERCOMY OPN ANY METH,,,21 ,,RBRVS,4.44 ,1.46 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33600,CPT,CLSR ATRIOVENTRICULAR VALVE SUTURE/PATCH,,,21 ,,RBRVS,30.31 ,12.71 ,12.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33602,CPT,CLSR SEMILUNAR VALVE AORTIC/PULM SUTR/PATCH,,,21 ,,RBRVS,29.34 ,12.61 ,12.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33606,CPT,ANAST P-ART AORTA DAMUS-KAYE-STANSEL PX,,,21 ,,RBRVS,31.53 ,13.78 ,13.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33608,CPT,RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT,,,21 ,,RBRVS,31.88 ,13.76 ,13.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33610,CPT,RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT,,,21 ,,RBRVS,31.40 ,13.28 ,13.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33611,CPT,RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR,,,21 ,,RBRVS,35.57 ,13.83 ,13.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33612,CPT,RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ,,,21 ,,RBRVS,36.57 ,13.88 ,13.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33615,CPT,RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX,,,21 ,,RBRVS,35.89 ,14.96 ,14.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33617,CPT,RPR CPLX CAR ANOMAL MODF FONTAN PX,,,21 ,,RBRVS,39.09 ,15.05 ,15.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33619,CPT,RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLASIA,,,21 ,,RBRVS,48.76 ,18.26 ,18.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33620,CPT,APPLY R&L PULM ART BANDS,,,21 ,,RBRVS,30.00 ,13.45 ,13.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33621,CPT,TRANSTHOR CATH FOR STENT,,,21 ,,RBRVS,16.18 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33622,CPT,REDO COMPL CARDIAC ANOMALY,,,21 ,,RBRVS,64.00 ,28.32 ,28.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33641,CPT,RPR ATR SEPTAL DFCT SECUNDUM W/CARD BYP +-PATCH,,,21 ,,RBRVS,29.58 ,11.60 ,11.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33645,CPT,DIR/PATCH CLSR SINUS VENOSUS +-ANOM PULM VEN DRG,,,21 ,,RBRVS,28.10 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33647,CPT,RPR ATR&VENTR SEPTAL DFCT DIR/PATCH CLSR,,,21 ,,RBRVS,29.53 ,15.53 ,15.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33660,CPT,RPR INCOMPL/PRTL AV CANAL +-AV VALVE RPR,,,21 ,,RBRVS,31.83 ,12.45 ,12.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33665,CPT,RPR INTRM/TRANSJ AV CANAL +-AV VALVE RPR,,,21 ,,RBRVS,34.85 ,16.12 ,16.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33670,CPT,RPR COMPL AV CANAL +-PROSTC VALVE,,,21 ,,RBRVS,36.63 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33675,CPT,CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS,,,21 ,,RBRVS,35.95 ,13.75 ,13.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33676,CPT,CLOSURE MULTIPLE VSD W/RESECTION,,,21 ,,RBRVS,36.95 ,14.93 ,14.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33677,CPT,CLOSURE MULTIPLE VSD W/REMOVAL ARTERY BAND,,,21 ,,RBRVS,38.45 ,15.45 ,15.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33681,CPT,CLSR 1 VENTR SEPTAL DFCT +- PATCH,,,21 ,,RBRVS,32.34 ,14.08 ,14.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33684,CPT,CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ,,,21 ,,RBRVS,34.37 ,15.85 ,15.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33688,CPT,CLSR V-SEPTL DFCT W/RMVL P-ART BAND +-GUSSET,,,21 ,,RBRVS,34.75 ,12.47 ,12.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33690,CPT,BANDING PULMONARY ARTERY,,,21 ,,RBRVS,20.36 ,9.48 ,9.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33692,CPT,COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA,,,21 ,,RBRVS,31.54 ,13.11 ,13.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33694,CPT,COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH,,,21 ,,RBRVS,35.57 ,14.05 ,14.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33697,CPT,COMPL RPR T-FALLOT W/PULM ATRESIA,,,21 ,,RBRVS,37.57 ,16.41 ,16.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33702,CPT,RPR SINUS VALSALVA FISTULA,,,21 ,,RBRVS,27.24 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33710,CPT,RPR SINUS VALSALVA FSTL W/RPR V-SEPTL DFCT,,,21 ,,RBRVS,30.41 ,15.56 ,15.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33720,CPT,RPR SINUS VALSALVA ANEURYSM,,,21 ,,RBRVS,27.26 ,11.82 ,11.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33722,CPT,CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL,,,21 ,,RBRVS,29.21 ,11.48 ,11.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33724,CPT,REPAIR ISOLATED PARTIAL PULM VENOUS RETURN,,,21 ,,RBRVS,27.63 ,11.76 ,11.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33726,CPT,REPAIR PULMONARY VENOUS STENOSIS,,,21 ,,RBRVS,37.12 ,14.59 ,14.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33730,CPT,COMPL RPR ANOM VEN RETURN,,,21 ,,RBRVS,36.14 ,13.45 ,13.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33732,CPT,RPR C TRIATM/SUPVALVR RING RESCJ L ATR MEMB,,,21 ,,RBRVS,28.96 ,12.62 ,12.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33735,CPT,ATR SEPTECT/SEPTOST CLSD HRT,,,21 ,,RBRVS,22.20 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33736,CPT,ATR SEPTECT/SEPTOST OPN HRT W/CARD BYP,,,21 ,,RBRVS,24.32 ,11.08 ,11.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33737,CPT,ATR SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION,,,21 ,,RBRVS,22.47 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33750,CPT,SHUNT SUBCLA P-ART,,,21 ,,RBRVS,22.22 ,12.91 ,12.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33755,CPT,SHUNT ASCENDING AORTA P-ART,,,21 ,,RBRVS,22.60 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33762,CPT,SHUNT DESCENDING AORTA P-ART,,,21 ,,RBRVS,22.60 ,10.10 ,10.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33764,CPT,SHUNT CTR W/PROSTC GRF,,,21 ,,RBRVS,22.60 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33766,CPT,SHUNT SUPRIOR V/C P-ART FLO 1 LNG,,,21 ,,RBRVS,23.57 ,11.06 ,11.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33767,CPT,SHUNT SUPRIOR V/C P-ART FLO BTH LNGS,,,21 ,,RBRVS,25.30 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33768,CPT,ANAST CAVOPULM 2ND SUPRIOR V/C,,,21 ,,RBRVS,8.00 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33770,CPT,RPR TGA W/O SURG ENLGMNT V-SEPTL DFCT,,,21 ,,RBRVS,39.07 ,15.18 ,15.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33771,CPT,RPR TGA ENLGMNT V-SEPTL DFCT,,,21 ,,RBRVS,40.63 ,14.97 ,14.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33774,CPT,RPR TGA ATR BAFFLE W/CARD BYP,,,21 ,,RBRVS,31.73 ,13.75 ,13.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33775,CPT,RPR TGA ATR BAFFLE W/RMVL PULM BAND,,,21 ,,RBRVS,32.99 ,14.49 ,14.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33776,CPT,RPR TGA ATR BAFFLE W/CLSR V-SEPTL DFCT,,,21 ,,RBRVS,34.75 ,15.38 ,15.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33777,CPT,RPR TGA ATR BAFFLE RPR SBPULMC OBSTRCJ,,,21 ,,RBRVS,34.17 ,14.54 ,14.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33778,CPT,RPR TGA AORTIC P-ART RCNSTJ,,,21 ,,RBRVS,42.75 ,17.43 ,17.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33779,CPT,RPR TGA AORTIC P-ART RCNSTJ W/RMVL PULM BAND,,,21 ,,RBRVS,43.23 ,16.48 ,16.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33780,CPT,RPR TGA AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT,,,21 ,,RBRVS,43.90 ,20.18 ,20.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33781,CPT,RPR TGA AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ,,,21 ,,RBRVS,43.21 ,15.89 ,15.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33782,CPT,A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ,,,21 ,,RBRVS,60.08 ,20.69 ,20.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33783,CPT,A-ROOT TLCJ VSD PULM STNS RPR W/ RIMPLTJ C OSTIA,,,21 ,,RBRVS,65.08 ,22.20 ,22.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33786,CPT,TOTAL REPAIR TRUNCUS ARTERIOSUS,,,21 ,,RBRVS,41.87 ,16.37 ,16.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33788,CPT,REIMPLANTATION ANOMALOUS PULMONARY ARTERY,,,21 ,,RBRVS,27.42 ,11.81 ,11.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33800,CPT,AORTIC SSP TRACHEAL DCMPRN SPX,,,21 ,,RBRVS,17.28 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33802,CPT,DIVISION ABERRANT VESSEL VASCULAR RING,,,21 ,,RBRVS,18.37 ,8.45 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33803,CPT,DIVISION ABERRANT VESSEL W/REANASTOMOSIS,,,21 ,,RBRVS,20.31 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33813,CPT,OBLTRJ AORTOPULM SEPTAL DFCT W/O CARD BYP,,,21 ,,RBRVS,21.36 ,10.98 ,10.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33814,CPT,OBLTRJ AORTOPULM SEPTAL DFCT W/CARD BYP,,,21 ,,RBRVS,26.57 ,11.85 ,11.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33820,CPT,REPAIR PATENT DUCTUS ARTERIOSUS LIGATION,,,21 ,,RBRVS,16.69 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33822,CPT,RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR,,,21 ,,RBRVS,17.71 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33824,CPT,RPR PATENT DUXUS ARTERIOSUS DIV 18 YR&OLDER,,,21 ,,RBRVS,20.23 ,9.65 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33840,CPT,EXC COARCJ AORTA +-PDA W/DIR ANAST,,,21 ,,RBRVS,21.34 ,9.05 ,9.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33845,CPT,EXC COARCTATION AORTA +-PDA W/GRF,,,21 ,,RBRVS,22.93 ,11.49 ,11.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33851,CPT,EXC COARCJ AORTA W/L SUBCLA ART/PROSTC AS GUSSET,,,21 ,,RBRVS,21.98 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33852,CPT,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC,,,21 ,,RBRVS,24.41 ,12.67 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33853,CPT,RPR HYPOPLSTC A-ARCH AGRFT/PROSTC CARD BYP,,,21 ,,RBRVS,32.51 ,17.18 ,17.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33860,CPT,ASCENDING AORTA GRF W/CARD BYP +-VALVE SSP,,,21 ,,RBRVS,59.46 ,21.24 ,21.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33863,CPT,AS-AORT GRF +-VALVE SSP AORTIC ROOT RPLCMT,,,21 ,,RBRVS,58.79 ,21.01 ,21.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33864,CPT,ASCENDING AORTA GRF VALVE SPARE ANNULUS REMODEL,,,21 ,,RBRVS,60.08 ,21.90 ,21.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33870,CPT,TRANSVERSE ARCH GRAFT W/CARDIOPULMONARY BYPASS,,,21 ,,RBRVS,46.06 ,18.04 ,18.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33875,CPT,DESCENDING THORACIC AORTA GRAFT +-BYPASS,,,21 ,,RBRVS,35.78 ,14.13 ,14.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33877,CPT,RPR THORACOAAA W/GRF +-CARD BYP,,,21 ,,RBRVS,69.03 ,21.98 ,21.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33880,CPT,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,,,21 ,,RBRVS,34.58 ,12.44 ,12.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33881,CPT,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,,,21 ,,RBRVS,29.58 ,10.82 ,10.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33883,CPT,PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,,,21 ,,RBRVS,21.09 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33884,CPT,PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN,,,21 ,,RBRVS,8.20 ,2.42 ,2.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33886,CPT,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,,,21 ,,RBRVS,18.09 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33889,CPT,OPN SUBCLA CRTD ART TRPOS NCK INC ULAT,,,21 ,,RBRVS,15.92 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33891,CPT,BYP GRF W/DTA RPR NCK INC,,,21 ,,RBRVS,20.00 ,5.60 ,5.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33910,CPT,PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS,,,21 ,,RBRVS,29.71 ,12.47 ,12.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33915,CPT,PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS,,,21 ,,RBRVS,24.95 ,9.69 ,9.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33916,CPT,PULM ENDARTERCOMY +-EMBOLECTOMY W/CARD BYP,,,21 ,,RBRVS,28.42 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33917,CPT,RPR P-ART STENOSIS RCNSTJ W/PATCH/GRF,,,21 ,,RBRVS,25.30 ,12.37 ,12.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33920,CPT,RPR PULM ATRESIA W/CONSTJ/RPLCMT CONDUIT,,,21 ,,RBRVS,32.74 ,13.01 ,13.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33922,CPT,TRANSECTION PULMONARY ARTERY W/CARD BYPASS,,,21 ,,RBRVS,24.22 ,10.69 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33924,CPT,LIG&TKDN SYSIC-TO-P-ART SHUNT W/CGEN HRT PX,,,21 ,,RBRVS,5.49 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33925,CPT,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O CARD BYP,,,21 ,,RBRVS,31.30 ,12.72 ,12.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33926,CPT,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/CARD BYP,,,21 ,,RBRVS,44.73 ,15.32 ,15.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33935,CPT,HRT-LNG TRNSPL W/RCP CARDIECTOMY-PNUMEC,,,21 ,,RBRVS,62.01 ,25.34 ,25.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33940,CPT,DONOR CARDIECTOMY,,,21 ,,TotalUnits,,,,39.56 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,33944,CPT,BKBENCH STANDARD PREPJ CDVR DON HRT ALGRFT,,,21 ,,TotalUnits,,,,27.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,33945,CPT,HEART TRANSPLANT +-RECIPIENT CARDIECTOMY,,,21 ,,RBRVS,89.50 ,31.14 ,31.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33960,CPT,PROLNG XTRCORP CRCJ 1ST 24 HR,,,21 ,,RBRVS,19.33 ,5.93 ,5.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33961,CPT,PROLNG XTRCORP CRCJ EA 24 HR,,,21 ,,RBRVS,10.91 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33967,CPT,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PRQ,,,21 ,,RBRVS,4.84 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33968,CPT,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,,,21 ,,RBRVS,0.64 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33970,CPT,INSJ I-AORT BALO ASSIST DEV THRU FEM ART OPN,,,21 ,,RBRVS,6.74 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33971,CPT,RMVL I-AORT BALO ASSIST DEV W/RPR FEM ART +-GRF,,,21 ,,RBRVS,11.99 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33973,CPT,INSJ I-AORT BALO ASSIST DEV THRU AS-AORT,,,21 ,,RBRVS,9.75 ,3.72 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33974,CPT,RMVL I-AORT BALO DEV FROM AS-AORT RPR AS-AORT,,,21 ,,RBRVS,15.03 ,8.10 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33975,CPT,INSJ VENTR ASSIST DEV XTRCORP 1 VNTRC,,,21 ,,RBRVS,20.97 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33976,CPT,INSJ VENTR ASSIST DEV XTRCORP BIVENTR,,,21 ,,RBRVS,22.97 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33977,CPT,REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE,,,21 ,,RBRVS,20.28 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33978,CPT,REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR,,,21 ,,RBRVS,22.72 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33979,CPT,INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,,,21 ,,RBRVS,45.93 ,14.98 ,14.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33980,CPT,RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,,,21 ,,RBRVS,65.20 ,26.21 ,26.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,33999,CPT,UNLISTED CARDIAC SURGERY,,,21 ,,TotalUnits,,,,12.15 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,34001,CPT,EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART,,,21 ,,RBRVS,17.88 ,7.14 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34051,CPT,EMBLC/THRMBC INNOMINATE SUBCLA ART,,,21 ,,RBRVS,16.99 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34101,CPT,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,,,21 ,,RBRVS,10.93 ,4.84 ,4.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34111,CPT,EMBLC/THRMBC +-CATH RDL/UR ART ARM INC,,,21 ,,RBRVS,10.93 ,4.85 ,4.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34151,CPT,EMBLC/THRMBC RNL CELIAC MESENTERY A-ILIAC ART,,,21 ,,RBRVS,26.52 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34201,CPT,EMBLC/THRMBC FEMPOP A-ILIAC ART,,,21 ,,RBRVS,19.48 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34203,CPT,EMBLC/THRMBC POP-TIBIO-PRONEAL ART LEG INC,,,21 ,,RBRVS,17.86 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34401,CPT,THRMBC DIR/W/CATH V/C ILIAC VEIN ABDL INC,,,21 ,,RBRVS,26.52 ,11.02 ,11.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34421,CPT,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,,,21 ,,RBRVS,13.37 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34451,CPT,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG,,,21 ,,RBRVS,28.52 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34471,CPT,THRMBC DIR/W/CATH SUBCLA VEIN NCK INC,,,21 ,,RBRVS,21.11 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34490,CPT,THRMBC DIR/W/CATH AX&SUBCLA VEIN ARM INC,,,21 ,,RBRVS,10.91 ,4.96 ,4.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34501,CPT,VALVULOPLASTY FEMORAL VEIN,,,21 ,,RBRVS,16.85 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34502,CPT,RECONSTRUCTION VENA CAVA ANY METHOD,,,21 ,,RBRVS,28.07 ,11.50 ,11.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34510,CPT,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,,,21 ,,RBRVS,19.91 ,8.46 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34520,CPT,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,,,21 ,,RBRVS,19.18 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34530,CPT,SAPHENOPOPLITEAL VEIN ANASTOMOSIS,,,21 ,,RBRVS,17.93 ,8.10 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34800,CPT,EVASC RPR AAA W/AORTO-AORTIC TUBE PROSTH,,,21 ,,RBRVS,21.54 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34802,CPT,EVASC RPR AAA W/MDLR BFRC PROSTH 1 LIMB,,,21 ,,RBRVS,23.79 ,9.05 ,9.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34803,CPT,EVASC RPR AAA W/MDLR BFRC PROSTH 2 LIMBS,,,21 ,,RBRVS,24.82 ,9.05 ,9.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34804,CPT,EVASC RPR AAA W/UNIBDY BFRC PROSTH,,,21 ,,RBRVS,23.79 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34805,CPT,EVASC RPR AAA AORTO-UNIILIAC/AORTO-UNIFEM PROSTH,,,21 ,,RBRVS,22.67 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34806,CPT,TCAT PLACEMENT PHYSIOLOGIC SENSOR ANEURYSMAL SAC,,,21 ,,RBRVS,2.06 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34808,CPT,EVASC PLMT ILIAC ART OCCLUSION DEV,,,21 ,,RBRVS,4.12 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34812,CPT,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,,,21 ,,RBRVS,6.74 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34813,CPT,PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR,,,21 ,,RBRVS,4.79 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34820,CPT,ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI,,,21 ,,RBRVS,9.74 ,2.88 ,2.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34825,CPT,PLMT XTN PROSTH EVASC RPR ARYSM/DSJ 1ST VSL,,,21 ,,RBRVS,12.80 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34826,CPT,PLMT XTN PROSTH EVASC RPR ARYSM/DSJ EA VSL,,,21 ,,RBRVS,4.12 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34830,CPT,OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH,,,21 ,,RBRVS,35.23 ,11.89 ,11.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34831,CPT,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,,,21 ,,RBRVS,37.98 ,12.07 ,12.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34832,CPT,OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH,,,21 ,,RBRVS,37.98 ,12.66 ,12.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34833,CPT,ILIAC ART EXPOS W/CRTJ CONDUIT UNI,,,21 ,,RBRVS,11.98 ,3.83 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34834,CPT,BRACH ART EXPOS DPLMNT AORTIC/ILIAC PROSTH UNI,,,21 ,,RBRVS,5.34 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,34900,CPT,EVASC GRF PLMT RPR ILIAC ART,,,21 ,,RBRVS,16.85 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35001,CPT,DIR RPR ARYSM/&GRF INSJ CRTD SUBCLA ART,,,21 ,,RBRVS,20.81 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35002,CPT,DIR RPR ARYSM&GRF INSJ RPTD ARYSM CRTD SUBCLA,,,21 ,,RBRVS,22.23 ,9.33 ,9.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35005,CPT,DIR RPR ARYSM&GRF INSJ VRT ART,,,21 ,,RBRVS,19.29 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35011,CPT,DIR RPR ARYSM&GRF INSJ AX-BRACH ART,,,21 ,,RBRVS,18.58 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35013,CPT,DIR RPR ARYSM&GRF INSJ AX-BRACH ART,,,21 ,,RBRVS,23.23 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35021,CPT,DIR RPR ARYSM&GRF INSJ INNOMINATE SUBCLA ART,,,21 ,,RBRVS,22.17 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35022,CPT,DIR RPR ARYSM&GRF RPTD ARYSM INNOM SUBCLA ART,,,21 ,,RBRVS,25.70 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35045,CPT,DIR RPR ARYSM&GRF INSJ RDL/UR ART,,,21 ,,RBRVS,18.01 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35081,CPT,DIR RPR ARYSM&GRF INSJ ABDL AORTA,,,21 ,,RBRVS,33.53 ,11.88 ,11.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35082,CPT,DIR RPR ARYSM&GRF INSJ RPTD ARYSM ABDL AORTA,,,21 ,,RBRVS,42.09 ,14.59 ,14.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35091,CPT,DIR RPR ARYSM&GRF INSJ ABDL AORTA VISC VSL,,,21 ,,RBRVS,35.35 ,11.73 ,11.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35092,CPT,DIR RPR ARYSM&GRF RPTD ARYSM ABDL AORTA VISC VSL,,,21 ,,RBRVS,50.97 ,16.73 ,16.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35102,CPT,DIR RPR ARYSM&GRF INSJ ABDL AORTA ILIAC VSL,,,21 ,,RBRVS,36.53 ,12.63 ,12.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35103,CPT,DIR RPR ARYSM&GRF RPTD ARYSM ABDL AORTA ILIAC,,,21 ,,RBRVS,43.62 ,14.75 ,14.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35111,CPT,DIR RPR ARYSM&GRF INSJ SPLENIC ART,,,21 ,,RBRVS,26.28 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35112,CPT,DIR RPR ARYSM&GRF INSJ RPTD ARYSM SPLENIC ART,,,21 ,,RBRVS,32.57 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35121,CPT,DIR RPR ARYSM&GRF INSJ HEPATC CELIAC RNL/MSN ART,,,21 ,,RBRVS,31.52 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35122,CPT,DIR RPR ARYSM&GRF RPTD ARYSM HEPATC CEL RNL/MSN,,,21 ,,RBRVS,37.89 ,14.10 ,14.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35131,CPT,DIR RPR ARYSM&GRF INSJ ILIAC ART,,,21 ,,RBRVS,26.40 ,9.91 ,9.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35132,CPT,DIR RPR ARYSM&GRF INSJ RPTD ARYSM ILIAC ART,,,21 ,,RBRVS,32.57 ,11.51 ,11.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35141,CPT,DIR RPR ARYSM&GRF INSJ COMMON FEM ART,,,21 ,,RBRVS,20.91 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35142,CPT,DIR RPR ARYSM&GRF INSJ RPTD ARYSM COMMON FEM ART,,,21 ,,RBRVS,25.16 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35151,CPT,DIR RPR ARYSM&GRF INSJ POP ART,,,21 ,,RBRVS,23.72 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35152,CPT,DIR RPR ARYSM&GRF INSJ RPTD ARYSM POP ART,,,21 ,,RBRVS,27.66 ,9.90 ,9.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35180,CPT,REPAIR CONGENITAL ARTERIOVENOUS FISTULA HEAD&NCK,,,21 ,,RBRVS,15.10 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35182,CPT,RPR CONGENITAL ARTERIOVENOUS FISTULA THORAX&ABD,,,21 ,,RBRVS,31.71 ,13.34 ,13.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35184,CPT,RPR CONGENITAL ARTERIOVENOUS FISTULA EXTREMITIES,,,21 ,,RBRVS,18.82 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35188,CPT,RPR/TRAUMTC ARVEN FSTL HEAD&NCK,,,21 ,,RBRVS,15.16 ,7.20 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35189,CPT,RPR/TRAUMTC ARVEN FSTL THORAX&ABD,,,21 ,,RBRVS,29.98 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35190,CPT,RPR/TRAUMTC ARVEN FSTL XTR,,,21 ,,RBRVS,13.42 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35201,CPT,REPAIR BLOOD VESSEL DIRECT NECK,,,21 ,,RBRVS,16.93 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35206,CPT,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,,,21 ,,RBRVS,13.84 ,5.99 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35207,CPT,REPAIR BLOOD VESSEL DIRECT HAND FINGER,,,21 ,,RBRVS,10.94 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35211,CPT,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS,,,21 ,,RBRVS,24.58 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35216,CPT,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS,,,21 ,,RBRVS,36.61 ,13.81 ,13.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35221,CPT,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,,,21 ,,RBRVS,26.62 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35226,CPT,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,,,21 ,,RBRVS,15.30 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35231,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,,,21 ,,RBRVS,21.16 ,9.40 ,9.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35236,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,,,21 ,,RBRVS,18.02 ,7.28 ,7.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35241,CPT,RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP,,,21 ,,RBRVS,25.58 ,10.94 ,10.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35246,CPT,RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP,,,21 ,,RBRVS,28.23 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35251,CPT,REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL,,,21 ,,RBRVS,31.91 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35256,CPT,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,,,21 ,,RBRVS,19.06 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35261,CPT,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,,,21 ,,RBRVS,18.96 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35266,CPT,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,,,21 ,,RBRVS,15.83 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35271,CPT,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP,,,21 ,,RBRVS,24.58 ,10.47 ,10.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35276,CPT,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP,,,21 ,,RBRVS,25.83 ,10.80 ,10.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35281,CPT,RPR BLVSL W/GRF OTH/THN VEIN INTRA-ABDL,,,21 ,,RBRVS,30.06 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35286,CPT,RPR BLVSL W/GRF OTH/THN VEIN LXTR,,,21 ,,RBRVS,17.19 ,7.20 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35301,CPT,TEAEC W/PATCH GRF CRTD VRT SUBCLA NCK INC,,,21 ,,RBRVS,19.61 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35302,CPT,TEAEC W/GRAFT SUPERFICIAL FEMORAL ART,,,21 ,,RBRVS,21.35 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35303,CPT,TEAEC W/GRAFT POPLITEAL ART,,,21 ,,RBRVS,23.60 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35304,CPT,TEAEC W/GRAFT TIBIOPERONEAL TRUNK ART,,,21 ,,RBRVS,24.60 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35305,CPT,TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL,,,21 ,,RBRVS,23.60 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35306,CPT,TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART,,,21 ,,RBRVS,9.25 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35311,CPT,TEAEC +-PATCH GRF SUBCLA INNOMINATE THRC INC,,,21 ,,RBRVS,28.60 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35321,CPT,TEAEC +-PATCH GRF AX-BRACH,,,21 ,,RBRVS,16.59 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35331,CPT,TEAEC +-PATCH GRF ABDL AORTA,,,21 ,,RBRVS,27.72 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35341,CPT,TEAEC +-PATCH GRF MESENTERIC CELIAC/RNL,,,21 ,,RBRVS,26.21 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35351,CPT,TEAEC +-PATCH GRF ILIAC,,,21 ,,RBRVS,24.61 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35355,CPT,TEAEC +-PATCH GRF ILIOFEM,,,21 ,,RBRVS,19.86 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35361,CPT,TEAEC +-PATCH GRF CMBN AORTOILIAC,,,21 ,,RBRVS,30.24 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35363,CPT,TEAEC +-PATCH GRF CMBN AORTOILIOFEM,,,21 ,,RBRVS,32.35 ,12.39 ,12.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35371,CPT,TEAEC +-PATCH GRF COMMON FEM,,,21 ,,RBRVS,15.31 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35372,CPT,TEAEC +-PATCH GRF DP PROFUNDA FEM,,,21 ,,RBRVS,18.58 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35390,CPT,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATION,,,21 ,,RBRVS,3.19 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35400,CPT,ANGIOSCOPY NON-C VSL/GRFS THER IVNTJ,,,21 ,,RBRVS,3.00 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35450,CPT,TRLUML BALO ANGIOP OPN RNL/OTH VISC ART,,,21 ,,RBRVS,10.05 ,3.34 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35452,CPT,TRLUML BALO ANGIOP OPN AORTIC,,,21 ,,RBRVS,6.90 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35458,CPT,TRLUML BALO ANGIOP OPN BRCH/CPHLC TRNK/BRNCH EA,,,21 ,,RBRVS,9.48 ,3.19 ,3.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35460,CPT,TRLUML BALO ANGIOP OPN VEN,,,21 ,,RBRVS,6.03 ,2.07 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35471,CPT,TRLUML BALO ANGIOP PRQ RNL/VISC ART,,,21 ,,RBRVS,10.05 ,4.35 ,68.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35472,CPT,TRLUML BALO ANGIOP PRQ AORTIC,,,21 ,,RBRVS,6.90 ,2.73 ,48.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35475,CPT,TRLUML BALO ANGIOP PRQ BRCH/CPHLC TRNK/BRNCH EA,,,21 ,,RBRVS,9.48 ,3.56 ,49.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35476,CPT,TRLUML BALO ANGIOP PRQ VEN,,,21 ,,RBRVS,6.03 ,2.34 ,38.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35500,CPT,HARVEST UXTR VEIN 1 SGM LXTR/CAB PX,,,21 ,,RBRVS,6.44 ,1.89 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35501,CPT,BYP W/VEIN COMMON-IPSILATERAL CRTD,,,21 ,,RBRVS,29.09 ,11.58 ,11.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35506,CPT,BYP W/VEIN CAROTID-SUBCLA/ SUBCLA CAROTID,,,21 ,,RBRVS,25.33 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35508,CPT,BYP W/VEIN CRTD-VRT,,,21 ,,RBRVS,26.09 ,10.19 ,10.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35509,CPT,BYP W/VEIN CAROTID-CONTRALATERAL CAROTID,,,21 ,,RBRVS,28.09 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35510,CPT,BYP W/VEIN CRTD-BRACH,,,21 ,,RBRVS,24.39 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35511,CPT,BYP W/VEIN SUBCLA-SUBCLA,,,21 ,,RBRVS,22.20 ,9.03 ,9.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35512,CPT,BYP W/VEIN SUBCLA-BRACH,,,21 ,,RBRVS,23.89 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35515,CPT,BYP W/VEIN SUBCLA-VRT,,,21 ,,RBRVS,26.09 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35516,CPT,BYP W/VEIN SUBCLA-AX,,,21 ,,RBRVS,24.21 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35518,CPT,BYP W/VEIN AX-AX,,,21 ,,RBRVS,22.65 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35521,CPT,BYP W/VEIN AX-FEM,,,21 ,,RBRVS,24.13 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35522,CPT,BYP W/VEIN AX-BRACH,,,21 ,,RBRVS,23.15 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35523,CPT,BYPASS GRAFT WITH VEIN BRACHIAL-ULNAR/–RADIAL,,,21 ,,RBRVS,24.13 ,9.64 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35525,CPT,BYP W/VEIN BRACH-BRACH,,,21 ,,RBRVS,21.69 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35526,CPT,BYP W/VEIN AORTOSUBCLA/CRTD,,,21 ,,RBRVS,31.55 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35531,CPT,BYP W/VEIN AORTOCELIAC/AORTOMESENTERIC,,,21 ,,RBRVS,39.11 ,13.57 ,13.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35533,CPT,BYP W/VEIN AX-FEM-FEM,,,21 ,,RBRVS,29.92 ,11.57 ,11.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35535,CPT,BYPASS GRAFT WITH VEIN HEPATORENAL,,,21 ,,RBRVS,38.13 ,13.98 ,13.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35536,CPT,BYP W/VEIN SPLENORNL,,,21 ,,RBRVS,33.73 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35537,CPT,BYP W/VEIN AORTOILIAC,,,21 ,,RBRVS,41.88 ,13.81 ,13.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35538,CPT,BYP W/VEIN AORTOBI-ILIAC,,,21 ,,RBRVS,47.03 ,15.50 ,15.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35539,CPT,BYP W/VEIN AORTOFEMORAL,,,21 ,,RBRVS,44.11 ,13.95 ,13.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35540,CPT,BYP W/VEIN AORTOBIFEMORAL,,,21 ,,RBRVS,49.33 ,16.28 ,16.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35548,CPT,BYP W/VEIN AORTOILIOFEM UNI,,,21 ,,RBRVS,22.68 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35549,CPT,BYP W/VEIN AORTOILIOFEM BI,,,21 ,,RBRVS,24.45 ,9.18 ,9.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35551,CPT,BYP W/VEIN AORTOFEMPOP,,,21 ,,RBRVS,27.83 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35556,CPT,BYP W/VEIN FEMPOP,,,21 ,,RBRVS,26.75 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35558,CPT,BYP W/VEIN FEM-FEM,,,21 ,,RBRVS,23.13 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35560,CPT,BYP W/VEIN AORTORNL,,,21 ,,RBRVS,34.03 ,12.19 ,12.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35563,CPT,BYP W/VEIN ILIOILIAC,,,21 ,,RBRVS,26.12 ,10.07 ,10.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35565,CPT,BYP W/VEIN ILIOFEM,,,21 ,,RBRVS,25.13 ,9.39 ,9.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35566,CPT,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,,,21 ,,RBRVS,32.35 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35570,CPT,BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL,,,21 ,,RBRVS,29.15 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35571,CPT,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,,,21 ,,RBRVS,25.52 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35572,CPT,HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX,,,21 ,,RBRVS,6.81 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35583,CPT,IN-SITU VEIN BYP FEMPOP,,,21 ,,RBRVS,27.75 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35585,CPT,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,,,21 ,,RBRVS,32.35 ,11.45 ,11.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35587,CPT,IN-SITU VEIN BYP POP-TIBL PRONEAL,,,21 ,,RBRVS,26.21 ,9.81 ,9.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35600,CPT,HARVEST UPPER EXTREMITY ART 1 SEGMENT FOR CABG,,,21 ,,RBRVS,4.94 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35601,CPT,BYP OTH/THN VEIN COMMON-IPSILATERAL CRTD,,,21 ,,RBRVS,27.09 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35606,CPT,BYP OTH/THN VEIN CRTD-SUBCLA,,,21 ,,RBRVS,22.46 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35612,CPT,BYP OTH/THN VEIN SUBCLA-SUBCLA,,,21 ,,RBRVS,16.82 ,6.99 ,6.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35616,CPT,BYP OTH/THN VEIN SUBCLA-AX,,,21 ,,RBRVS,21.82 ,8.37 ,8.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35621,CPT,BYP OTH/THN VEIN AX-FEM,,,21 ,,RBRVS,21.03 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35623,CPT,BYP OTH/THN VEIN AX-POP/-TIBL,,,21 ,,RBRVS,25.92 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35626,CPT,BYP OTH/THN VEIN AORTOSUBCLA/CRTD,,,21 ,,RBRVS,29.14 ,11.33 ,11.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35631,CPT,BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL,,,21 ,,RBRVS,36.03 ,12.18 ,12.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35632,CPT,BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC,,,21 ,,RBRVS,36.13 ,13.35 ,13.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35633,CPT,BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC,,,21 ,,RBRVS,39.11 ,14.28 ,14.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35634,CPT,BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL,,,21 ,,RBRVS,35.33 ,13.10 ,13.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35636,CPT,BYP OTH/THN VEIN SPLENORNL,,,21 ,,RBRVS,31.75 ,10.97 ,10.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35637,CPT,BYP OTH/THN VEIN AORTOILIAC,,,21 ,,RBRVS,33.05 ,11.57 ,11.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35638,CPT,BYP OTH/THN VEIN AORTOBI-ILIAC,,,21 ,,RBRVS,33.60 ,11.91 ,11.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35642,CPT,BYP OTH/THN VEIN CRTD-VRT,,,21 ,,RBRVS,18.94 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35645,CPT,BYP OTH/THN VEIN SUBCLA-VRT,,,21 ,,RBRVS,18.43 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35646,CPT,BYP OTH/THN VEIN AORTOBIFEM,,,21 ,,RBRVS,32.98 ,11.92 ,11.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35647,CPT,BYP OTH/THN VEIN AORTOFEM,,,21 ,,RBRVS,29.73 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35650,CPT,BYP OTH/THN VEIN AX-AX,,,21 ,,RBRVS,20.16 ,7.68 ,7.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35651,CPT,BYP OTH/THN VEIN AORTOFEMPOP,,,21 ,,RBRVS,26.08 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35654,CPT,BYP OTH/THN VEIN AX-FEM-FEM,,,21 ,,RBRVS,26.28 ,9.62 ,9.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35656,CPT,BYP OTH/THN VEIN FEMPOP,,,21 ,,RBRVS,20.47 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35661,CPT,BYP OTH/THN VEIN FEM-FEM,,,21 ,,RBRVS,20.35 ,8.09 ,8.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35663,CPT,BYP OTH/THN VEIN ILIOILIAC,,,21 ,,RBRVS,23.93 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35665,CPT,BYP OTH/THN VEIN ILIOFEM,,,21 ,,RBRVS,22.35 ,8.45 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35666,CPT,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,,,21 ,,RBRVS,23.66 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35671,CPT,BYP OTH/THN VEIN POP-TIBL/-PRONEAL ART,,,21 ,,RBRVS,20.77 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35681,CPT,BYP COMPOSIT PROSTC&VEIN,,,21 ,,RBRVS,1.60 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35682,CPT,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,,,21 ,,RBRVS,7.19 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35683,CPT,BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATIONS,,,21 ,,RBRVS,8.49 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35685,CPT,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,,,21 ,,RBRVS,4.04 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35686,CPT,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,,,21 ,,RBRVS,3.34 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35691,CPT,TRPOS&/RIMPLTJ VRT CRTD ART,,,21 ,,RBRVS,18.41 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35693,CPT,TRPOS&/RIMPLTJ VRT SUBCLA ART,,,21 ,,RBRVS,15.73 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35694,CPT,TRPOS&/RIMPLTJ SUBCLA CRTD ART,,,21 ,,RBRVS,19.28 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35695,CPT,TRPOS&/RIMPLTJ CRTD SUBCLA ART,,,21 ,,RBRVS,20.06 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35697,CPT,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,,,21 ,,RBRVS,3.00 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35700,CPT,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,,,21 ,,RBRVS,3.08 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35701,CPT,EXPL N/FLWD SURG RPR +-LSS ART CRTD ART,,,21 ,,RBRVS,9.19 ,4.95 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35721,CPT,EXPL N/FLWD SURG RPR +-LSS ART FEM ART,,,21 ,,RBRVS,7.72 ,4.11 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35741,CPT,EXPL N/FLWD SURG RPR +-LSS ART POP ART,,,21 ,,RBRVS,8.69 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35761,CPT,EXPL N/FLWD SURG RPR +-LSS ART OTH VSL,,,21 ,,RBRVS,5.93 ,3.84 ,3.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35800,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,,,21 ,,RBRVS,8.07 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35820,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,,,21 ,,RBRVS,36.89 ,12.85 ,12.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35840,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,,,21 ,,RBRVS,10.96 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35860,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,,,21 ,,RBRVS,6.80 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35870,CPT,RPR GRF-ENTERIC FSTL,,,21 ,,RBRVS,24.50 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35875,CPT,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,,,21 ,,RBRVS,10.72 ,4.79 ,4.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35876,CPT,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,,,21 ,,RBRVS,17.82 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35879,CPT,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,,,21 ,,RBRVS,17.41 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35881,CPT,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,,,21 ,,RBRVS,19.35 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35883,CPT,REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT,,,21 ,,RBRVS,23.15 ,8.08 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35884,CPT,REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT,,,21 ,,RBRVS,24.65 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35901,CPT,EXC INFCT GRF NCK,,,21 ,,RBRVS,8.38 ,4.73 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35903,CPT,EXC INFCT GRF XTR,,,21 ,,RBRVS,9.53 ,5.23 ,5.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35905,CPT,EXC INFCT GRF THORAX,,,21 ,,RBRVS,33.52 ,11.44 ,11.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,35907,CPT,EXC INFCT GRF ABD,,,21 ,,RBRVS,37.27 ,12.64 ,12.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36000,CPT,INTRO NDL/INTRACATH VEIN,,,21 ,,RBRVS,0.18 ,0.07 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36002,CPT,NJX PX PRQ TX XTR PSEUDOARYSM,,,21 ,,RBRVS,1.96 ,0.91 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36005,CPT,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,,,21 ,,RBRVS,0.95 ,0.36 ,7.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36010,CPT,INTRO CATH SUPRIOR/IVC,,,21 ,,RBRVS,2.43 ,0.83 ,12.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36011,CPT,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,,,21 ,,RBRVS,3.14 ,1.08 ,20.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36012,CPT,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANCH,,,21 ,,RBRVS,3.51 ,1.27 ,19.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36013,CPT,INTRO CATH R HRT/MAIN P-ART,,,21 ,,RBRVS,2.52 ,0.87 ,18.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36014,CPT,SLCTV CATH PLMT L/R P-ART,,,21 ,,RBRVS,3.02 ,1.13 ,19.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36015,CPT,SLCTV CATH PLMT SGMTL/SUBSGMTL P-ART,,,21 ,,RBRVS,3.51 ,1.29 ,20.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36100,CPT,INTRO NDL/INTRACATH CRTD/VRT ART,,,21 ,,RBRVS,3.02 ,1.14 ,10.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36120,CPT,INTRO NDL/INTRACATH RTRGR BRACH ART,,,21 ,,RBRVS,2.01 ,0.64 ,9.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36140,CPT,INTRO NDL/INTRACATH XTR ART,,,21 ,,RBRVS,2.01 ,0.71 ,10.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36147,CPT,INTRO NDL/CATH AV SHUNT IST ACCESS W/ RAD EVAL,,,21 ,,RBRVS,3.72 ,1.21 ,17.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36148,CPT,INTRO NDL/CATH AV SHUNT ADDL ACCESS THER IVNTJ,,,21 ,,RBRVS,1.00 ,0.31 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36160,CPT,INTRO NDL/INTRACATH AORTIC TRANSLMBR,,,21 ,,RBRVS,2.52 ,0.95 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36200,CPT,INTRO CATH AORTA,,,21 ,,RBRVS,3.02 ,1.04 ,13.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36215,CPT,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,,,21 ,,RBRVS,4.67 ,1.82 ,25.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36216,CPT,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,,,21 ,,RBRVS,5.27 ,2.04 ,27.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36217,CPT,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,,,21 ,,RBRVS,6.29 ,2.43 ,47.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36218,CPT,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,,,21 ,,RBRVS,1.01 ,0.38 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36245,CPT,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,,,21 ,,RBRVS,4.67 ,1.95 ,27.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36246,CPT,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,,,21 ,,RBRVS,5.27 ,1.97 ,27.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36247,CPT,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,,,21 ,,RBRVS,6.29 ,2.32 ,44.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36248,CPT,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,,,21 ,,RBRVS,1.01 ,0.37 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36260,CPT,INSJ IMPLTABLE IA NFS PMP,,,21 ,,RBRVS,9.91 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36261,CPT,REVJ IMPLTED IA NFS PMP,,,21 ,,RBRVS,5.63 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36262,CPT,RMVL IMPLTED IA NFS PMP,,,21 ,,RBRVS,4.11 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36299,CPT,UNLIS PX VASC NJX,,,21 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,36400,CPT,VNPNXR <3 YEARS PHYS SKILL FEM/JUG VEIN,,,21 ,,RBRVS,0.38 ,0.10 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36405,CPT,VNPNXR <3 YEARS PHYS SKILL SCALP VEIN,,,21 ,,RBRVS,0.31 ,0.10 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36406,CPT,VNPNXR <3 YEARS PHYS SKILL OTHER VEIN,,,21 ,,RBRVS,0.18 ,0.06 ,0.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36410,CPT,VNPNXR 3 YEARS/> PHYS SKILL,,,21 ,,RBRVS,0.18 ,0.05 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36415,CPT,COLLJ VEN BLD VNPNXR,,,17 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,36416,CPT,COLLJ CAPILLARY BLD SPEC,,,17 ,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,36420,CPT,VNPNXR CUTDOWN UNDER AGE 1 YR,,,21 ,,RBRVS,1.01 ,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36425,CPT,VNPNXR CUTDOWN AGE 1/>,,,21 ,,RBRVS,0.76 ,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36430,CPT,TRANSFUSION BLD/BLD COMPONENTS,,,21 ,,RBRVS,,0.91 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36440,CPT,PUSH TRANSFUSION BLD 2 YR/UNDER,,,21 ,,RBRVS,1.03 ,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36450,CPT,EXCHNG TRANSFUSION BLD NB,,,21 ,,RBRVS,2.23 ,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36455,CPT,EXCHNG TRANSFUSION BLD OTH/THN NB,,,21 ,,RBRVS,2.43 ,0.95 ,0.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36460,CPT,TRANSFUSION INTRAUTERINE FTL,,,21 ,,RBRVS,6.58 ,2.08 ,2.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36468,CPT,1/MLT NJXS SCLRSG SLNS SPIDER VEINS LIMB/TRNK,,,21 ,,TotalUnits,,,,2.03 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,36469,CPT,1/MLT NJXS SCLRSG SLNS SPIDER VEINS FACE,,,21 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,36470,CPT,NJX SCLRSG SLN 1 VEIN,,,21 ,,RBRVS,1.10 ,0.71 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36471,CPT,NJX SCLRSG SLN MLT VEINS SM LEG,,,21 ,,RBRVS,1.65 ,0.89 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36475,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,,,21 ,,RBRVS,6.72 ,2.28 ,40.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36476,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,,,21 ,,RBRVS,3.38 ,1.02 ,6.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36478,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,,,21 ,,RBRVS,6.72 ,2.34 ,31.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36479,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,,,21 ,,RBRVS,3.38 ,1.05 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36481,CPT,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,,,21 ,,RBRVS,6.98 ,2.42 ,14.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36500,CPT,VEN CATHJ SLCTV ORGAN BLD SAMPLING,,,21 ,,RBRVS,3.51 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36510,CPT,CATHJ UMBILICAL VEIN DX/THER NB,,,21 ,,RBRVS,1.09 ,0.40 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36511,CPT,THER APHERESIS WHITE BLD CELLS,,,21 ,,RBRVS,1.74 ,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36512,CPT,THER APHERESIS RED BLD CELLS,,,21 ,,RBRVS,1.74 ,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36513,CPT,THER APHERESIS PLTLTS,,,21 ,,RBRVS,1.74 ,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36514,CPT,THER APHERESIS PLSM PHERESIS,,,21 ,,RBRVS,1.74 ,0.62 ,11.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36515,CPT,THER APHERESIS W/XTRCORP IMMUNODSPTJ&PLSM RENFS,,,21 ,,RBRVS,1.74 ,0.59 ,48.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36516,CPT,THER APHRS XTRCORP SLCTV ADSRPJ/FILTRJ&RENFS,,,21 ,,RBRVS,1.22 ,0.43 ,54.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36522,CPT,PHOTOPHERESIS XTRCORP,,,21 ,,RBRVS,1.67 ,0.99 ,33.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36555,CPT,INSJ NON-TUN CTR CVC UNDER 5 YR,,,21 ,,RBRVS,2.68 ,0.62 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36556,CPT,INSJ NON-TUN CTR CVC AGE 5 YR/>,,,21 ,,RBRVS,2.50 ,0.65 ,3.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36557,CPT,INSJ TUN CTR CVC W/O SUBQ PORT/PMP UNDER 5 YR,,,21 ,,RBRVS,5.14 ,2.73 ,17.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36558,CPT,INSJ TUN CTR CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,,21 ,,RBRVS,4.84 ,2.52 ,16.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36560,CPT,INSJ TUN CTR CTR VAD W/SUBQ PORT UNDER 5 YR,,,21 ,,RBRVS,6.29 ,2.86 ,22.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36561,CPT,INSJ TUN CTR CTR VAD W/SUBQ PORT AGE 5 YR/>,,,21 ,,RBRVS,6.04 ,2.93 ,24.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36563,CPT,INSJ TUN CTR CTR VAD W/SUBQ PMP,,,21 ,,RBRVS,6.24 ,2.96 ,24.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36565,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,,,21 ,,RBRVS,6.04 ,2.78 ,19.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36566,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,,,21 ,,RBRVS,6.54 ,2.96 ,98.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36568,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP UNDER 5 YR,,,21 ,,RBRVS,1.92 ,0.64 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36569,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,,21 ,,RBRVS,1.82 ,0.68 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36570,CPT,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,,,21 ,,RBRVS,5.36 ,2.77 ,24.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36571,CPT,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,,,21 ,,RBRVS,5.34 ,2.69 ,26.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36575,CPT,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,,,21 ,,RBRVS,0.67 ,0.25 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36576,CPT,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,,,21 ,,RBRVS,3.24 ,1.73 ,6.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36578,CPT,RPLCMT CATH CTR VAD SUBQ PORT/PMP,,,21 ,,RBRVS,3.54 ,2.12 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36580,CPT,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,,,21 ,,RBRVS,1.31 ,0.47 ,4.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36581,CPT,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,,,21 ,,RBRVS,3.48 ,1.84 ,16.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36582,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,,,21 ,,RBRVS,5.24 ,2.68 ,22.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36583,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,,,21 ,,RBRVS,5.29 ,2.77 ,24.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36584,CPT,RPLCMT COMPL PRPH CVC W/O SUBQ PORT/PMP,,,21 ,,RBRVS,1.20 ,0.62 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36585,CPT,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,,,21 ,,RBRVS,4.84 ,2.56 ,23.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36589,CPT,RMVL TUN CVC W/O SUBQ PORT/PMP,,,21 ,,RBRVS,2.28 ,1.34 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36590,CPT,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,,,21 ,,RBRVS,3.35 ,1.76 ,3.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36591,CPT,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,,,21 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36592,CPT,COLLECT BLOOD FROM CATHETER VENOUS NOS,,,21 ,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36593,CPT,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,,,21 ,,RBRVS,,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,36595,CPT,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,,,21 ,,RBRVS,3.59 ,1.47 ,12.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36596,CPT,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,,,21 ,,RBRVS,0.75 ,0.45 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36597,CPT,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDN,,,21 ,,RBRVS,1.21 ,0.47 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36598,CPT,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,,,21 ,,RBRVS,0.74 ,0.73 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36600,CPT,ARTL PNXR W/DRAWAL BLD DX,,,21 ,,RBRVS,0.32 ,0.08 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36620,CPT,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,,,21 ,,RBRVS,1.15 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36625,CPT,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,,,21 ,,RBRVS,2.11 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36640,CPT,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,,,21 ,,RBRVS,2.10 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36660,CPT,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,,,21 ,,RBRVS,1.40 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36680,CPT,PLMT NDL INTRAOSS NFS,,,21 ,,RBRVS,1.20 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36800,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,,,21 ,,RBRVS,2.43 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36810,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,,,21 ,,RBRVS,3.96 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36815,CPT,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,,,21 ,,RBRVS,2.62 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36818,CPT,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,,,21 ,,RBRVS,11.89 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36819,CPT,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,,,21 ,,RBRVS,14.47 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36820,CPT,ARVEN ANAST OPN F/ARM VEIN TRPOS,,,21 ,,RBRVS,14.47 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36821,CPT,HEMODIALYSIS ACCESS BY JOINING ARTERY AND VEIN,,,21 ,,RBRVS,12.11 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36822,CPT,INSJ CANNULA PROLNG XC-CIRCJ ECMO SPX,,,21 ,,RBRVS,5.57 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36823,CPT,INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL,,,21 ,,RBRVS,22.98 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36825,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,,,21 ,,RBRVS,15.13 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36830,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,,,21 ,,RBRVS,12.03 ,4.77 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36831,CPT,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,,,21 ,,RBRVS,8.04 ,3.63 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36832,CPT,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,,,21 ,,RBRVS,10.53 ,4.31 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36833,CPT,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,,,21 ,,RBRVS,11.98 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36835,CPT,INSJ THOMAS SHUNT SPX,,,21 ,,RBRVS,7.51 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36838,CPT,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,,,21 ,,RBRVS,21.69 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36860,CPT,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,,,21 ,,RBRVS,2.01 ,0.72 ,3.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36861,CPT,XTRNL CANNULA DECLTNG SPX W/BALO CATH,,,21 ,,RBRVS,2.52 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,36870,CPT,THRMBC PRQ ARVEN FSTL AUTOG/NONAUTOG GRF,,,21 ,,RBRVS,5.20 ,2.90 ,43.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37140,CPT,VEN ANAST OPN PORTOCAVAL,,,21 ,,RBRVS,25.23 ,10.27 ,10.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37145,CPT,VEN ANAST OPN RENOPORTAL,,,21 ,,RBRVS,26.24 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37160,CPT,VEN ANAST OPN CAVAL-MESENTERIC,,,21 ,,RBRVS,23.24 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37180,CPT,VEN ANAST OPN SPLENORNL PROX,,,21 ,,RBRVS,26.24 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37181,CPT,VEN ANAST OPN SPLENORNL DSTL,,,21 ,,RBRVS,28.37 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37182,CPT,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,,,21 ,,RBRVS,16.97 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37183,CPT,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,,,21 ,,RBRVS,7.99 ,3.15 ,127.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37184,CPT,PRIM PRQ TRLUML MCHNL THRMBC 1ST VSL,,,21 ,,RBRVS,8.66 ,3.40 ,53.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37185,CPT,PRIM PRQ TRLUML MCHNL THRMBC SBSQ VSL,,,21 ,,RBRVS,3.28 ,1.16 ,17.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37186,CPT,SEC PRQ TRLUML THRMBC,,,21 ,,RBRVS,4.92 ,1.86 ,36.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37187,CPT,PRQ TRLUML MCHNL THRMBC VEIN,,,21 ,,RBRVS,8.03 ,3.16 ,51.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37188,CPT,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,,,21 ,,RBRVS,5.71 ,2.37 ,44.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37195,CPT,THROMBOLSS CERE IV NFS,,,21 ,,TotalUnits,,,,8.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,37200,CPT,TCAT BX,,,21 ,,RBRVS,4.55 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37201,CPT,TCAT THER NFS THROMBOLSS OTH/THN C,,,21 ,,RBRVS,4.99 ,2.42 ,2.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37202,CPT,TCAT THER NFS OTH/THN THROMBOLSS ANY TYP,,,21 ,,RBRVS,5.67 ,3.20 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37203,CPT,TCAT RETRIEVAL PRQ IV FB,,,21 ,,RBRVS,5.02 ,2.10 ,30.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37204,CPT,TCAT OCCLS/EMBOLJ PRQ NON-CNS NON-HEAD/NCK,,,21 ,,RBRVS,18.11 ,6.46 ,6.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37205,CPT,TCAT PLMT IV STENT XCP C CRTD&VRT PRQ 1ST VSL,,,21 ,,RBRVS,8.27 ,3.29 ,103.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37206,CPT,TCAT PLMT AN IV STENT XCP C CRTD&VRT PRQ EA,,,21 ,,RBRVS,4.12 ,1.53 ,63.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37207,CPT,TCAT PLMT AN IV STENT NON-C VSL OPN 1ST VSL,,,21 ,,RBRVS,8.27 ,2.79 ,2.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37208,CPT,TCAT PLMT AN IV STENT NON-C VSL OPN EA VSL,,,21 ,,RBRVS,4.12 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37209,CPT,EXCHNG PREV PLACED IV CATH THROMBOLYTIC THER,,,21 ,,RBRVS,2.27 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37210,CPT,UTERINE FIBROID EMBOLIZATION PERQ W/RAD GID,,,21 ,,RBRVS,10.60 ,4.13 ,82.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37215,CPT,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,,,21 ,,RBRVS,19.68 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37216,CPT,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,,,21 ,,RBRVS,18.95 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37220,CPT,ILIAC REVASC,,,21 ,,RBRVS,8.15 ,83.88 ,3.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37221,CPT,ILIAC REVASC W/STENT,,,21 ,,RBRVS,10.00 ,126.56 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37222,CPT,ILIAC REVASC ADD-ON,,,21 ,,RBRVS,3.73 ,22.52 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37223,CPT,ILIAC REVASC W/STENT ADD-ON,,,21 ,,RBRVS,4.25 ,132.39 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37224,CPT,FEM/POPL REVAS W/TLA,,,21 ,,RBRVS,9.00 ,101.76 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37225,CPT,FEM/POPL REVAS W/ATHER,,,21 ,,RBRVS,12.00 ,303.34 ,4.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37226,CPT,FEM/POPL REVASC W/STENT,,,21 ,,RBRVS,10.49 ,254.28 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37227,CPT,FEM/POPL REVASC STNT & ATHER,,,21 ,,RBRVS,14.50 ,412.19 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37228,CPT,TIB/PER REVASC W/TLA,,,21 ,,RBRVS,11.00 ,146.98 ,4.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37229,CPT,TIB/PER REVASC W/ATHER,,,21 ,,RBRVS,14.05 ,298.12 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37230,CPT,TIB/PER REVASC W/STENT,,,21 ,,RBRVS,13.80 ,231.18 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37231,CPT,TIB/PER REVASC STENT & ATHER,,,21 ,,RBRVS,15.00 ,379.46 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37232,CPT,TIB/PER REVASC ADD-ON,,,21 ,,RBRVS,4.00 ,31.17 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37233,CPT,TIBPER REVASC W/ATHER ADD-ON,,,21 ,,RBRVS,6.50 ,36.11 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37234,CPT,REVSC OPN/PRQ TIB/PERO STENT,,,21 ,,RBRVS,5.50 ,108.02 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37235,CPT,TIB/PER REVASC STNT & ATHER,,,21 ,,RBRVS,7.80 ,113.10 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37250,CPT,IV US NON-C VSL DX EVAL&/THER IVNTJ 1ST VSL,,,21 ,,RBRVS,2.10 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37251,CPT,IV US NON-C VSL DX EVAL&/THER IVNTJ EA VSL,,,21 ,,RBRVS,1.60 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37500,CPT,VASC NDSC SEPS,,,21 ,,RBRVS,11.67 ,6.10 ,6.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37501,CPT,UNLIS VASC NDSC PX,,,21 ,,TotalUnits,,,,17.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,37565,CPT,LIG INT JUG VEIN,,,21 ,,RBRVS,12.05 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37600,CPT,LIG XTRNL CRTD ART,,,21 ,,RBRVS,12.42 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37605,CPT,LIG INT/COMMON CRTD ART,,,21 ,,RBRVS,14.28 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37606,CPT,LIG INT/COMMON CRTD ART W/GRADUAL OCCLS,,,21 ,,RBRVS,8.81 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37607,CPT,LIG/BANDING ANGIOACCESS ARVEN FSTL,,,21 ,,RBRVS,6.25 ,3.36 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37609,CPT,LIG/BX TEMPORAL ART,,,21 ,,RBRVS,3.05 ,2.02 ,4.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37615,CPT,LIG MAJOR ART NCK,,,21 ,,RBRVS,7.80 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37616,CPT,LIG MAJOR ART CH,,,21 ,,RBRVS,18.97 ,8.63 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37617,CPT,LIG MAJOR ART ABD,,,21 ,,RBRVS,23.79 ,9.04 ,9.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37618,CPT,LIG MAJOR ART XTR,,,21 ,,RBRVS,6.03 ,3.64 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37620,CPT,INTERRUPJ IVC SUTR LIG PLCTJ CLIP XTRVASC IV,,,21 ,,RBRVS,11.57 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37650,CPT,LIG FEM VEIN,,,21 ,,RBRVS,8.49 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37660,CPT,LIG COMMON ILIAC VEIN,,,21 ,,RBRVS,22.28 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37700,CPT,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,,,21 ,,RBRVS,3.82 ,2.61 ,2.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37718,CPT,LIG DIV&STRIPPING SHORT SAPHENOUS VEIN,,,21 ,,RBRVS,7.13 ,3.93 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37722,CPT,LIG DIV&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,,,21 ,,RBRVS,8.16 ,4.15 ,4.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37735,CPT,LIG&DIV&COMPL STRIP LONG/SHORT SAPH RAD EXC,,,21 ,,RBRVS,10.90 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37760,CPT,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,,,21 ,,RBRVS,10.78 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37761,CPT,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,,,21 ,,RBRVS,9.13 ,5.37 ,5.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37765,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,,,21 ,,RBRVS,7.71 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37766,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,,,21 ,,RBRVS,9.66 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37780,CPT,LIG&DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,,,21 ,,RBRVS,3.93 ,2.72 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37785,CPT,LIG DIV&/EXC VARICOSE VEIN CLUSTER 1 LEG,,,21 ,,RBRVS,3.93 ,2.73 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37788,CPT,PEN REVSC ART +-VEIN GRF,,,21 ,,RBRVS,23.33 ,11.88 ,11.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37790,CPT,PEN VEN OCCLUSIVE PX,,,21 ,,RBRVS,8.43 ,4.51 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,37799,CPT,UNLIS PX VASC SURG,,,21 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,38100,CPT,SPLENC TOT SPX,,,21 ,,RBRVS,19.55 ,7.61 ,7.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38101,CPT,SPLENC PRTL SPX,,,21 ,,RBRVS,19.55 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38102,CPT,SPLENC TOT EN BLOC X10SV DS CONJUNCT W/OTH PX,,,21 ,,RBRVS,4.79 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38115,CPT,RPR RPTD SPLEEN SPLENORRHAPHY +-PRTL SPLENC,,,21 ,,RBRVS,21.88 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38120,CPT,LAPS SURG SPLENC,,,21 ,,RBRVS,17.07 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38129,CPT,UNLIS LAPS PX SPLEEN,,,21 ,,TotalUnits,,,,24.88 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,38200,CPT,NJX PX SPLENOPORTOGRAPY,,,21 ,,RBRVS,2.64 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38204,CPT,MGMT RCP HEMATOP PROGENITOR CELL DON SEARCH&CELL,,,21 ,,RBRVS,2.00 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38205,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,,,21 ,,RBRVS,1.50 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38206,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,,,21 ,,RBRVS,1.50 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38207,CPT,TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV&STRG,,,21 ,,RBRVS,0.89 ,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38208,CPT,TRNSPL PREPJ HEMATOP PROGEN THAW PREV HRV,,,21 ,,RBRVS,0.56 ,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38209,CPT,TRNSPL PREPJ HEMATOP PROGEN THAW PREV HRV WASHG,,,21 ,,RBRVS,0.24 ,0.12 ,0.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38210,CPT,TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL,,,21 ,,RBRVS,1.57 ,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38211,CPT,TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ,,,21 ,,RBRVS,1.42 ,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38212,CPT,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,,,21 ,,RBRVS,0.94 ,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38213,CPT,TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ,,,21 ,,RBRVS,0.24 ,0.12 ,0.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38214,CPT,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,,,21 ,,RBRVS,0.81 ,0.41 ,0.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38215,CPT,TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM,,,21 ,,RBRVS,0.94 ,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38220,CPT,MARROW ASPIRATION ONLY,,,21 ,,RBRVS,1.08 ,0.51 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38221,CPT,MARROW BX NDL/TROCAR,,,21 ,,RBRVS,1.37 ,0.64 ,2.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38230,CPT,MARROW HRVG TRNSPLJ,,,21 ,,RBRVS,4.85 ,3.31 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38240,CPT,MARROW/BLD-DRV PRPH STEM CELL TRNSPLJ ALLOGENIC,,,21 ,,RBRVS,2.24 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38241,CPT,MARROW/BLD-DRV PRPH STEM CELL TRNSPLJ AUTOL,,,21 ,,RBRVS,2.24 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38242,CPT,MARROW/BLD-DRV PRPH STEM CELL TRNSPLJ ALGC DON,,,21 ,,RBRVS,1.71 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38300,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,,,21 ,,RBRVS,2.36 ,2.13 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38305,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS X10SV,,,21 ,,RBRVS,6.68 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38308,CPT,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,,,21 ,,RBRVS,6.81 ,3.91 ,3.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38380,CPT,SUTR&/LIG THRC DUX CRV APPR,,,21 ,,RBRVS,8.46 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38381,CPT,SUTR&/LIG THRC DUX THRC APPR,,,21 ,,RBRVS,13.38 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38382,CPT,SUTR&/LIG THRC DUX ABDL APPR,,,21 ,,RBRVS,10.65 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38500,CPT,BX/EXC LYMPH NODE OPN SUPFC,,,21 ,,RBRVS,3.79 ,2.23 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38505,CPT,BX/EXC LYMPH NODE NDL SUPFC,,,21 ,,RBRVS,1.14 ,0.77 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38510,CPT,BX/EXC LYMPH NODE OPN DP CRV NODE,,,21 ,,RBRVS,6.74 ,3.52 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38520,CPT,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,,,21 ,,RBRVS,7.03 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38525,CPT,BX/EXC LYMPH NODE OPN DP AX NODE,,,21 ,,RBRVS,6.43 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38530,CPT,BX/EXC LYMPH NODE OPN INT MAM NODE,,,21 ,,RBRVS,8.34 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38542,CPT,DSJ DP JUG NODE,,,21 ,,RBRVS,7.95 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38550,CPT,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,,,21 ,,RBRVS,7.11 ,4.60 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38555,CPT,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,,,21 ,,RBRVS,15.59 ,8.35 ,8.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38562,CPT,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,,,21 ,,RBRVS,11.06 ,6.15 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38564,CPT,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,,,21 ,,RBRVS,11.38 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38570,CPT,LAPS SURG RPR LYMPH NODE BX 1/MLT,,,21 ,,RBRVS,9.34 ,4.34 ,4.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38571,CPT,LAPS SURG BI TOT PEL LMPHADEC,,,21 ,,RBRVS,14.76 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38572,CPT,LAPS BI TOT PEL LMPHADEC&PRI-AORTIC LYMPH BX 1/+,,,21 ,,RBRVS,16.94 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38589,CPT,UNLIS LAPS PX LYMPHATIC SYS,,,21 ,,TotalUnits,,,,21.58 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,38700,CPT,SUPRAHYOID LMPHADEC,,,21 ,,RBRVS,12.81 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38720,CPT,CRV LMPHADEC COMPL,,,21 ,,RBRVS,21.95 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38724,CPT,CRV LMPHADEC MODF RAD NCK DSJ,,,21 ,,RBRVS,23.95 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38740,CPT,AX LMPHADEC SUPFC,,,21 ,,RBRVS,10.70 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38745,CPT,AX LMPHADEC COMPL,,,21 ,,RBRVS,13.87 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38746,CPT,THRC LMPHADEC REGIONAL W/MEDSTNL&PRITRACHEAL NOD,,,21 ,,RBRVS,4.88 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38747,CPT,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,,,21 ,,RBRVS,4.88 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38760,CPT,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,,,21 ,,RBRVS,13.62 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38765,CPT,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,,,21 ,,RBRVS,21.91 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38770,CPT,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,,,21 ,,RBRVS,14.06 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38780,CPT,RPR TABDL LMPHADEC X10SV W/PEL AORTIC&RNL,,,21 ,,RBRVS,17.70 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38790,CPT,NJX PX LYMPHANGRPH,,,21 ,,RBRVS,1.29 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38792,CPT,INJECTION FOR IDENTIFICATION OF SENTINEL NODE,,,21 ,,RBRVS,0.52 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38794,CPT,CANNULATION THRC DUX,,,21 ,,RBRVS,4.62 ,3.30 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,38900,CPT,IO MAP OF SENT LYMPH NODE,,,21 ,,RBRVS,2.50 ,1.02 ,1.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,38999,CPT,UNLIS PX HEMIC/LYMPHATIC SYS,,,21 ,,TotalUnits,,,,3.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,39000,CPT,MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR,,,21 ,,RBRVS,7.57 ,4.71 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39010,CPT,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,,,21 ,,RBRVS,13.19 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39200,CPT,EXC MEDSTNL CST,,,21 ,,RBRVS,15.09 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39220,CPT,EXC MEDSTNL TUM,,,21 ,,RBRVS,19.55 ,8.98 ,8.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39400,CPT,MEDIASTINOSCOPY +-BX,,,21 ,,RBRVS,8.05 ,4.56 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39499,CPT,UNLIS PX MED,,,21 ,,TotalUnits,,,,12.61 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,39501,CPT,RPR LAC DPHRM ANY APPR,,,21 ,,RBRVS,13.98 ,6.54 ,6.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39503,CPT,RPR NEONATAL DIPHRG HRNA +-CH TUBE INSJ,,,21 ,,RBRVS,108.91 ,35.76 ,35.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39540,CPT,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,,,21 ,,RBRVS,14.57 ,6.38 ,6.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39541,CPT,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,,,21 ,,RBRVS,15.75 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39545,CPT,IMBRCJ OF DIAPHRAGM,,,21 ,,RBRVS,14.67 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39560,CPT,RESCJ DPHRM SMPL RPR,,,21 ,,RBRVS,13.06 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39561,CPT,RESCJ DPHRM CPLX RPR,,,21 ,,RBRVS,19.99 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,39599,CPT,UNLIS PX DPHRM,,,21 ,,TotalUnits,,,,24.66 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4005F,CPT,PHARMACOLOGIC OSTEOPOROSIS THERAPY PRESCRIBED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4006F,CPT,BETA-BLKER THER PRESCRIBED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4009F,CPT,ACE/ARB INHIBITOR THERAPY PRESCRIBED,,,14 ,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4011F,CPT,ORAL ANTIPLTLT THER PRESCRIBED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4025F,CPT,INHALED BRONCHODILATOR PRESCRIBED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4040F,CPT,PNEUMOCOCCAL VACCINE ADMIN RCVD B/4,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4041F,CPT,DOC ORDER CEFAZOLIN/CEFUROXIME ANTIMICRB PROPHYL,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4044F,CPT,DOC ORDER VTE PROPHYL W/IN 24 HRS B/4 SURGERY,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4046F,CPT,DOC ANTIBIO GIVEN W/IN 4 HRS B/4 SURG/INCISION,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4047F,CPT,DOC ORDER ANTIBIO GIVEN W/IN 1 HR B/4 SURG/INCIS,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,4048F,CPT,DOC ANTIBIO GIVEN W/IN 1 HR B/4 SURG/INCIS,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,40490,CPT,BX LIP,,,21 ,,RBRVS,1.22 ,0.66 ,2.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,4049F,CPT,DOC ORDER GIVEN TO STOP ANTIBIO W/IN 24 HRS SURG,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,40500,CPT,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,,,21 ,,RBRVS,4.47 ,4.58 ,7.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40510,CPT,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,,,21 ,,RBRVS,4.82 ,4.02 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40520,CPT,EXC LIP V-EXC W/PRIM DIR LINR CLSR,,,21 ,,RBRVS,4.79 ,4.13 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40525,CPT,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,,,21 ,,RBRVS,7.72 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40527,CPT,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,,,21 ,,RBRVS,9.32 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40530,CPT,RESCJ LIP > ONE-4TH W/O RCNSTJ,,,21 ,,RBRVS,5.54 ,4.59 ,7.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40650,CPT,RPR LIP FULL THKNS VERMILION ONLY,,,21 ,,RBRVS,3.78 ,3.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40652,CPT,RPR LIP FULL THKNS UP HALF VER H8,,,21 ,,RBRVS,4.43 ,4.25 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40654,CPT,RPR LIP FULL THKNS > ONE-HALF VER H8/CPLX,,,21 ,,RBRVS,5.48 ,5.04 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40700,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI,,,21 ,,RBRVS,14.17 ,9.15 ,9.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40701,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX,,,21 ,,RBRVS,17.23 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40702,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,,,21 ,,RBRVS,14.27 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40720,CPT,PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT&RECLSR,,,21 ,,RBRVS,14.72 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40761,CPT,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,,,21 ,,RBRVS,15.84 ,10.58 ,10.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40799,CPT,UNLIS PX LIPS,,,21 ,,TotalUnits,,,,3.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,40800,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,,,21 ,,RBRVS,1.23 ,1.96 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40801,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,,,21 ,,RBRVS,2.63 ,2.83 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40804,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,,,21 ,,RBRVS,1.30 ,1.95 ,3.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40805,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,,,21 ,,RBRVS,2.79 ,2.88 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40806,CPT,INC LABIAL FRENUM FREXOMY,,,21 ,,RBRVS,0.31 ,0.53 ,2.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40808,CPT,BX VESTIBULE MOUTH,,,21 ,,RBRVS,1.01 ,1.66 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40810,CPT,EXC LES MUCOSA&SBMCSL VESTIBULE MOUTH W/O RPR,,,21 ,,RBRVS,1.36 ,1.80 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40812,CPT,EXC LES MUCOSA&SBMCSL VESTIBULE SMPL RPR,,,21 ,,RBRVS,2.37 ,2.49 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40814,CPT,EXC LES MUCOSA&SBMCSL VESTIBULE CPLX RPR,,,21 ,,RBRVS,3.52 ,4.00 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40816,CPT,EXC LES MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,,,21 ,,RBRVS,3.77 ,4.10 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40818,CPT,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,,,21 ,,RBRVS,2.83 ,3.99 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40819,CPT,EXC FRENUM LABIAL/BUCCAL,,,21 ,,RBRVS,2.51 ,3.29 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40820,CPT,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,,,21 ,,RBRVS,1.34 ,2.94 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40830,CPT,CLSR LAC VESTIBULE MOUTH 2.5 CM/<,,,21 ,,RBRVS,1.82 ,2.13 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40831,CPT,CLSR LAC VESTIBULE MOUTH > 2.5 CM/CPLX,,,21 ,,RBRVS,2.57 ,2.94 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40840,CPT,VESTIBULOPLASTY ANT,,,21 ,,RBRVS,9.15 ,6.43 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40842,CPT,VESTIBULOPLASTY PST UNI,,,21 ,,RBRVS,9.15 ,6.47 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40843,CPT,VESTIBULOPLASTY PST BI,,,21 ,,RBRVS,12.79 ,7.00 ,12.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40844,CPT,VESTIBULOPLASTY ENTIRE ARCH,,,21 ,,RBRVS,16.80 ,10.78 ,16.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40845,CPT,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,,,21 ,,RBRVS,19.36 ,11.85 ,17.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,40899,CPT,UNLIS PX VESTIBULE MOUTH,,,21 ,,TotalUnits,,,,4.39 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41000,CPT,INTRAORAL I&D TONGUE/FLOOR LNGL,,,21 ,,RBRVS,1.35 ,1.43 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41005,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,,,21 ,,RBRVS,1.31 ,1.87 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41006,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD,,,21 ,,RBRVS,3.34 ,3.09 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41007,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,,,21 ,,RBRVS,3.20 ,3.05 ,5.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41008,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,,,21 ,,RBRVS,3.46 ,3.19 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41009,CPT,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,,,21 ,,RBRVS,3.71 ,3.52 ,5.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,4100F,CPT,BISPHOS THXPY VENOUS ORDERED OR RECEIVED,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41010,CPT,INC LNGL FRENUM FREXOMY,,,21 ,,RBRVS,1.11 ,1.65 ,3.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41015,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL,,,21 ,,RBRVS,4.08 ,4.29 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41016,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENTAL,,,21 ,,RBRVS,4.19 ,4.45 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41017,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDBLR,,,21 ,,RBRVS,4.19 ,4.48 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41018,CPT,XTRORAL I&D FLOOR MASTICATOR SPACE,,,21 ,,RBRVS,5.22 ,4.90 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41019,CPT,PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT,,,21 ,,RBRVS,8.84 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41100,CPT,BX TONGUE ANT 2-3RD,,,21 ,,RBRVS,1.42 ,1.31 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41105,CPT,BX TONGUE PST ONE-3RD,,,21 ,,RBRVS,1.47 ,1.32 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41108,CPT,BX FLOOR MOUTH,,,21 ,,RBRVS,1.10 ,1.16 ,2.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41110,CPT,EXC LES TONGUE W/O CLSR,,,21 ,,RBRVS,1.56 ,1.74 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41112,CPT,EXC LES TONGUE W/CLSR ANT 2-3RD,,,21 ,,RBRVS,2.83 ,3.43 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41113,CPT,EXC LES TONGUE W/CLSR PST ONE-3RD,,,21 ,,RBRVS,3.29 ,3.64 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41114,CPT,EXC LES TONGUE W/CLSR W/LOCAL TONGUE FLAP,,,21 ,,RBRVS,8.82 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41115,CPT,EXC LNGL FRENUM FRENECTOMY,,,21 ,,RBRVS,1.79 ,1.93 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41116,CPT,EXC LES FLOOR MOUTH,,,21 ,,RBRVS,2.52 ,2.96 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41120,CPT,GLSSC < ONE-HALF TONGUE,,,21 ,,RBRVS,11.14 ,15.25 ,15.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41130,CPT,GLSSC HEMIGLSSC,,,21 ,,RBRVS,15.74 ,16.89 ,16.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41135,CPT,GLSSC PRTL W/UNI RAD NCK DSJ,,,21 ,,RBRVS,30.14 ,23.94 ,23.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41140,CPT,GLSSC COMPL/TOT +-TRACHS W/O RAD NCK DSJ,,,21 ,,RBRVS,29.15 ,26.13 ,26.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41145,CPT,GLSSC COMPL/TOT +-TRACHS W/UNI RAD NCK DSJ,,,21 ,,RBRVS,37.93 ,31.56 ,31.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41150,CPT,GLSSC COMPOSIT W/RESCJ FLOOR&MNDBLR RESCJ,,,21 ,,RBRVS,29.86 ,25.21 ,25.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41153,CPT,GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ,,,21 ,,RBRVS,33.59 ,26.18 ,26.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41155,CPT,GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ&RAD NCK,,,21 ,,RBRVS,44.30 ,30.25 ,30.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41250,CPT,RPR LAC 2.5 CM/< FLOOR MOUTH&/ANT 2-3RD TONGUE,,,21 ,,RBRVS,1.96 ,1.60 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41251,CPT,RPR LAC 2.5 CM/< PST ONE-3RD TONGUE,,,21 ,,RBRVS,2.32 ,1.80 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41252,CPT,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,,,21 ,,RBRVS,3.02 ,2.26 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41500,CPT,FIXJ TONGUE MCHNL OTH/THN SUTR,,,21 ,,RBRVS,3.80 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41510,CPT,SUTR TONGUE LIP MICROGNATHIA,,,21 ,,RBRVS,3.51 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41512,CPT,TONGUE BASE SUSPENSION PERMANENT SUTURE TQ,,,21 ,,RBRVS,6.86 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41520,CPT,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,,,21 ,,RBRVS,2.83 ,3.51 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41530,CPT,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,,,21 ,,RBRVS,4.51 ,5.81 ,74.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41599,CPT,UNLIS PX TONGUE FLOOR MOUTH,,,21 ,,TotalUnits,,,,4.04 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41800,CPT,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,,,21 ,,RBRVS,1.27 ,2.05 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41805,CPT,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,,,21 ,,RBRVS,1.34 ,2.87 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41806,CPT,RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS B1,,,21 ,,RBRVS,2.79 ,3.52 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41820,CPT,GINGIVECTOMY EXC GINGIVA EA QUADRANT,,,21 ,,TotalUnits,,,,5.31 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41821,CPT,OPRCULECTOMY EXC PRICORONAL TISS,,,21 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41822,CPT,EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS,,,21 ,,RBRVS,2.41 ,1.98 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41823,CPT,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,,,21 ,,RBRVS,3.77 ,4.18 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41825,CPT,EXC LES/TUM XCP LISTED ABOVE DENTALVLR,,,21 ,,RBRVS,1.41 ,1.73 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41826,CPT,EXC LES/TUM XCP LISTED ABOVE DENTALVLR SMPL RPR,,,21 ,,RBRVS,2.41 ,2.68 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41827,CPT,EXC LES/TUM XCP LISTED ABOVE DENTALVLR CPLX RPR,,,21 ,,RBRVS,3.83 ,3.76 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41828,CPT,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,,,21 ,,RBRVS,3.14 ,2.17 ,4.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41830,CPT,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,,,21 ,,RBRVS,3.45 ,3.47 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41850,CPT,DSTRJ LES XCP EXC DENTOALVEOLAR STRUXS,,,21 ,,TotalUnits,,,,2.66 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41870,CPT,PDONTAL MUCOSAL GRFG,,,21 ,,TotalUnits,,,,6.64 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,41872,CPT,GINGIVOPLASTY EA QUADRANT SPEC,,,21 ,,RBRVS,3.01 ,3.51 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41874,CPT,ALVEOLOPLASTY EA QUADRANT SPEC,,,21 ,,RBRVS,3.19 ,3.08 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,41899,CPT,UNLIS PX DENTOALVEOLAR STRUXS,,,21 ,,TotalUnits,,,,8.75 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,42000,CPT,DRG ABSC PALATE UVULA,,,21 ,,RBRVS,1.28 ,1.31 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42100,CPT,BX PALATE UVULA,,,21 ,,RBRVS,1.36 ,1.37 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42104,CPT,EXC LES PALATE UVULA W/O CLSR,,,21 ,,RBRVS,1.69 ,1.76 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42106,CPT,EXC LES PALATE UVULA W/SMPL PRIM CLSR,,,21 ,,RBRVS,2.15 ,2.30 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42107,CPT,EXC LES PALATE UVULA W/LOCAL FLAP CLSR,,,21 ,,RBRVS,4.56 ,4.09 ,6.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42120,CPT,RESCJ PALATE/X10SV RESCJ LES,,,21 ,,RBRVS,11.86 ,12.89 ,12.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42140,CPT,UVULECTOMY EXC UVULA,,,21 ,,RBRVS,1.70 ,2.21 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42145,CPT,PALATOPHARYNGOPLASTY,,,21 ,,RBRVS,9.78 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42160,CPT,DSTRJ LES PALATE/UVULA THERMAL CRYO/CHEM,,,21 ,,RBRVS,1.85 ,1.94 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42180,CPT,RPR LAC PALATE UP 2 CM,,,21 ,,RBRVS,2.55 ,2.09 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42182,CPT,RPR LAC PALATE > 2 CM/CPLX,,,21 ,,RBRVS,3.87 ,2.76 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42200,CPT,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,,,21 ,,RBRVS,12.53 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42205,CPT,PALATOP W/CLSR ALVEOLAR RIDGE SOFT TISS,,,21 ,,RBRVS,13.66 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42210,CPT,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,,,21 ,,RBRVS,15.03 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42215,CPT,PALATOP CL PALATE MAJOR REVJ,,,21 ,,RBRVS,8.99 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42220,CPT,PALATOP CL PALATE SEC LNGTH PX,,,21 ,,RBRVS,7.16 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42225,CPT,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,,,21 ,,RBRVS,9.77 ,13.54 ,13.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42226,CPT,LNGTH PALATE&PHARYNGEAL FLAP,,,21 ,,RBRVS,10.35 ,12.85 ,12.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42227,CPT,LNGTH PALATE W/ISLAND FLAP,,,21 ,,RBRVS,9.90 ,12.45 ,12.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42235,CPT,RPR ANT PALATE W/VOMER FLAP,,,21 ,,RBRVS,8.01 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42260,CPT,RPR NASOLABIAL FSTL,,,21 ,,RBRVS,10.22 ,6.68 ,10.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42280,CPT,MAX IMPRESJ PALATAL PROSTH,,,21 ,,RBRVS,1.59 ,1.04 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42281,CPT,INSJ PIN-RETAINED PALATAL PROSTH,,,21 ,,RBRVS,1.98 ,1.85 ,3.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42299,CPT,UNLIS PX PALATE UVULA,,,21 ,,TotalUnits,,,,7.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,42300,CPT,DRG ABSC PRTD SMPL,,,21 ,,RBRVS,1.98 ,1.85 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42305,CPT,DRG ABSC PRTD COMP,,,21 ,,RBRVS,6.31 ,4.57 ,4.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42310,CPT,DRG ABSC SUBMAX/SUBLNGL INTRAORAL,,,21 ,,RBRVS,1.61 ,1.53 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42320,CPT,DRG ABSC SUBMAX XTRNL,,,21 ,,RBRVS,2.40 ,2.07 ,3.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42330,CPT,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,,,21 ,,RBRVS,2.26 ,1.90 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42335,CPT,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,,,21 ,,RBRVS,3.41 ,3.12 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42340,CPT,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,,,21 ,,RBRVS,4.72 ,3.84 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42400,CPT,BX SALIVARY GLND NDL,,,21 ,,RBRVS,0.78 ,0.69 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42405,CPT,BX SALIVARY GLND INCAL,,,21 ,,RBRVS,3.34 ,2.40 ,4.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42408,CPT,EXC SUBLNGL SALIVARY CST RANULA,,,21 ,,RBRVS,4.66 ,3.62 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42409,CPT,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,,,21 ,,RBRVS,2.91 ,2.74 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42410,CPT,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,,,21 ,,RBRVS,9.57 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42415,CPT,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NRV,,,21 ,,RBRVS,18.12 ,10.14 ,10.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42420,CPT,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NRV,,,21 ,,RBRVS,21.00 ,11.35 ,11.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42425,CPT,EXC PRTD TUM/PRTD GLND TOT EN BLOC RMVL,,,21 ,,RBRVS,13.42 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42426,CPT,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,,,21 ,,RBRVS,22.66 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42440,CPT,EXC SUBMNDBLR SUBMAX GLND,,,21 ,,RBRVS,7.13 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42450,CPT,EXC SUBLNGL GLND,,,21 ,,RBRVS,4.74 ,4.33 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42500,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,,,21 ,,RBRVS,4.42 ,4.21 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42505,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,,,21 ,,RBRVS,6.32 ,5.20 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42507,CPT,PRTD DUX DVRJ BI,,,21 ,,RBRVS,6.25 ,6.77 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42508,CPT,PRTD DUX DVRJ BI W/EXC 1 SUBMNDBLR GLND,,,21 ,,RBRVS,9.33 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42509,CPT,PRTD DUX DVRJ BI W/EXC BTH SUBMNDBLR GLNDS,,,21 ,,RBRVS,11.76 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42510,CPT,PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS,,,21 ,,RBRVS,8.35 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42550,CPT,NJX SIALOGRAPY,,,21 ,,RBRVS,1.25 ,0.45 ,2.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42600,CPT,CLSR SALIVARY FSTL,,,21 ,,RBRVS,4.94 ,4.00 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42650,CPT,DILAT SALIVARY DUX,,,21 ,,RBRVS,0.77 ,0.72 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42660,CPT,DILAT&CATHJ SALIVARY DUX +-NJX,,,21 ,,RBRVS,1.13 ,0.85 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42665,CPT,LIG SALIVARY DUX INTRAORAL,,,21 ,,RBRVS,2.63 ,2.62 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42699,CPT,UNLIS PX SALIVARY GLNDS/DUXS,,,21 ,,TotalUnits,,,,14.97 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,42700,CPT,I&D ABSC PRITONSILLAR,,,21 ,,RBRVS,1.67 ,1.76 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42720,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,,,21 ,,RBRVS,6.31 ,3.70 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42725,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,,,21 ,,RBRVS,12.41 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42800,CPT,BX OROPHARYNX,,,21 ,,RBRVS,1.44 ,1.40 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42802,CPT,BX HYPOPHARYNX,,,21 ,,RBRVS,1.59 ,1.85 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42804,CPT,BX NASOPHARYNX VISIBLE LES SMPL,,,21 ,,RBRVS,1.29 ,1.63 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42806,CPT,BX NASOPHARYNX SURV UNKNOWN PRIM LES,,,21 ,,RBRVS,1.63 ,1.77 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42808,CPT,EXC/DSTRJ LES PHARYNX ANY METH,,,21 ,,RBRVS,2.35 ,1.81 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42809,CPT,RMVL FB FROM PHARYNX,,,21 ,,RBRVS,1.86 ,1.42 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42810,CPT,EXC BRANCHIAL CL CST CONFINED SKN&SUBQ TISS,,,21 ,,RBRVS,3.38 ,3.87 ,6.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42815,CPT,EXC BRANCHIAL CL CST EXTG BELW SUBQ TISS&/PHRNX,,,21 ,,RBRVS,7.31 ,6.72 ,6.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42820,CPT,TONSILLECTOMY&ADENOIDECTOMY UNDER AGE 12,,,21 ,,RBRVS,4.22 ,3.19 ,3.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42821,CPT,TONSILLECTOMY&ADENOIDECTOMY AGE 12/>,,,21 ,,RBRVS,4.36 ,3.34 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42825,CPT,TONSILLECTOMY 1/2 UNDER AGE 12,,,21 ,,RBRVS,3.51 ,3.16 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42826,CPT,TONSILLECTOMY 1/2 AGE 12/>,,,21 ,,RBRVS,3.45 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42830,CPT,ADENOIDECTOMY PRIM UNDER AGE 12,,,21 ,,RBRVS,2.65 ,2.61 ,2.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42831,CPT,ADENOIDECTOMY PRIM AGE 12/>,,,21 ,,RBRVS,2.81 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42835,CPT,ADENOIDECTOMY SEC UNDER AGE 12,,,21 ,,RBRVS,2.38 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42836,CPT,ADENOIDECTOMY SEC AGE 12/>,,,21 ,,RBRVS,3.26 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42842,CPT,RAD RESCJ TONSIL W/O CLSR,,,21 ,,RBRVS,12.23 ,12.58 ,12.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42844,CPT,RAD RESCJ TONSIL CLSR W/LOCAL FLAP,,,21 ,,RBRVS,17.78 ,16.74 ,16.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42845,CPT,RAD RESCJ TONSIL CLSR W/OTH FLAP,,,21 ,,RBRVS,32.56 ,23.65 ,23.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42860,CPT,EXC TONSIL TAGS,,,21 ,,RBRVS,2.30 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42870,CPT,EXC/DSTRJ LNGL TONSIL ANY METH SPX,,,21 ,,RBRVS,5.52 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42890,CPT,LMTD PHARYNGECTOMY,,,21 ,,RBRVS,19.13 ,16.17 ,16.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42892,CPT,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,,,21 ,,RBRVS,26.03 ,20.42 ,20.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42894,CPT,RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS,,,21 ,,RBRVS,33.92 ,25.29 ,25.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42900,CPT,SUTR PHARYNX WND/INJ,,,21 ,,RBRVS,5.29 ,3.40 ,3.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42950,CPT,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,,,21 ,,RBRVS,8.27 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42953,CPT,PHARYNGOESOPHGL RPR,,,21 ,,RBRVS,9.45 ,15.00 ,15.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42955,CPT,PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING,,,21 ,,RBRVS,8.01 ,10.81 ,10.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42960,CPT,CTRL OROPHARYNGEAL HEMRRG 1/2 SMPL,,,21 ,,RBRVS,2.38 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42961,CPT,CTRL OROPHARYNGEAL HEMRRG 1/2 COMP REQ HOSPITJ,,,21 ,,RBRVS,5.77 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42962,CPT,CTRL OROPHARYNGEAL HEMRRG 1/2 W/SEC SURG IVNTJ,,,21 ,,RBRVS,7.40 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42970,CPT,CTRL NASPHRYNGL HEMRRG 1/2 SMPL W/PST NSL PACKS,,,21 ,,RBRVS,5.82 ,4.06 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42971,CPT,CTRL NASPHRYNGL HEMRRG 1/2 COMP REQ HOSPIZATION,,,21 ,,RBRVS,6.60 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42972,CPT,CTRL NASPHRYNGL HEMRRG 1/2 W/SEC SURG IVNTJ,,,21 ,,RBRVS,7.59 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,42999,CPT,UNLIS PX PHARYNX ADENOIDS/TONSILS,,,21 ,,TotalUnits,,,,6.41 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,43020,CPT,ESOPHAGOTOMY CRV APPR W/RMVL FB,,,21 ,,RBRVS,8.23 ,5.14 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43030,CPT,CRICOPHARYNGEAL MYOTOMY,,,21 ,,RBRVS,7.99 ,5.18 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43045,CPT,ESOPHAGOTOMY THRC APPR W/RMVL FB,,,21 ,,RBRVS,21.88 ,10.46 ,10.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43100,CPT,EXC LES ESOPH W/PRIM RPR CRV APPR,,,21 ,,RBRVS,9.66 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43101,CPT,EXC LES ESOPH W/PRIM RPR THRC/ABDL APPR,,,21 ,,RBRVS,17.07 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43107,CPT,TOT ESPHG W/O THORCOM PHRNGSTRSTY/EGST,,,21 ,,RBRVS,44.18 ,18.32 ,18.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43108,CPT,TOT ESPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ,,,21 ,,RBRVS,82.87 ,26.92 ,26.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43112,CPT,TOT ESPHG W/THORCOM W/PHRNGSTRSTY/EGST,,,21 ,,RBRVS,47.48 ,19.00 ,19.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43113,CPT,TOT ESPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ,,,21 ,,RBRVS,80.06 ,28.89 ,28.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43116,CPT,PRTL ESPHG CRV W/FR INTSTINAL GRF,,,21 ,,RBRVS,92.99 ,34.67 ,34.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43117,CPT,PRTL ESPHG DSTL THORCOM ABDL INC EGST,,,21 ,,RBRVS,43.65 ,17.22 ,17.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43118,CPT,PRTL ESPHG DSTL THORCOM ABDL INC NTRPSTJ/RCNSTJ,,,21 ,,RBRVS,67.07 ,22.75 ,22.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43121,CPT,PRTL ESPHG DSTL THORCOM ONLY THRC EGST,,,21 ,,RBRVS,51.43 ,18.53 ,18.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43122,CPT,PRTL ESPHG THORACOABDL/ABDL APPR EGST,,,21 ,,RBRVS,44.18 ,17.77 ,17.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43123,CPT,PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ,,,21 ,,RBRVS,83.12 ,27.45 ,27.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43124,CPT,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,,,21 ,,RBRVS,69.09 ,23.83 ,23.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43130,CPT,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,,,21 ,,RBRVS,12.53 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43135,CPT,DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR,,,21 ,,RBRVS,26.17 ,10.37 ,10.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43200,CPT,ESPHGSC RGD/FLX DX +-COLLJ SPEC BR/WA SPX,,,21 ,,RBRVS,1.59 ,1.07 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43201,CPT,ESPHGSC RGD/FLX DIRED SBMCSL NJX ANY SBST,,,21 ,,RBRVS,2.09 ,1.22 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43202,CPT,ESPHGSC RGD/FLX W/BX 1/MLT,,,21 ,,RBRVS,1.89 ,1.04 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43204,CPT,ESPHGSC RGD/FLX W/NJX SCLEROSIS ESOPHGL VARC,,,21 ,,RBRVS,3.76 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43205,CPT,ESPHGSC RGD/FLX W/BAND LIG ESOPHGL VARC,,,21 ,,RBRVS,3.78 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43215,CPT,ESPHGSC RGD/FLX W/RMVL FB,,,21 ,,RBRVS,2.60 ,1.33 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43216,CPT,ESPHGSC RGD/FLX RMVL TUM HOT BX FORCEPS/CAUT,,,21 ,,RBRVS,2.40 ,1.26 ,2.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43217,CPT,ESPHGSC RGD/FLX W/RMVL TUM SNARE TQ,,,21 ,,RBRVS,2.90 ,1.41 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43219,CPT,ESPHGSC RGD/FLX W/INSJ PLSTC TUBE/STENT,,,21 ,,RBRVS,2.80 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43220,CPT,ESPHGSC RGD/FLX W/BALO DILAT < 30 MM DIAM,,,21 ,,RBRVS,2.10 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43226,CPT,ESPHGSC RGD/FLX W/INSJ GD WIRE DILAT,,,21 ,,RBRVS,2.34 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43227,CPT,ESPHGSC RGD/FLX W/CTRL BLD,,,21 ,,RBRVS,3.59 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43228,CPT,ESPHGSC RGD/FLX ABLTJ TUM XCP HOT BX/CAUT/SNARE,,,21 ,,RBRVS,3.76 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43231,CPT,ESPHGSC RGD/FLX W/NDSC US XM,,,21 ,,RBRVS,3.19 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43232,CPT,ESPHGSC RGD/FLX W/TNDSC US-GID FINE NDL ASPIR/BX,,,21 ,,RBRVS,4.47 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43234,CPT,"UPPER STOMACH-INTESTINE SCOPE, SIMPLE",,,21 ,,RBRVS,2.01 ,1.04 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43235,CPT,UPPER STOMACH-INTESTINE SCOPE FOR DIAGNOSIS,,,21 ,,RBRVS,2.39 ,1.32 ,5.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43236,CPT,"STOMACH-INTESTINE SCOPE, INJECT INTESTINE WALL",,,21 ,,RBRVS,2.92 ,1.59 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43237,CPT,UPR GI NDSC NDSC US XM LMTD ESOPH,,,21 ,,RBRVS,3.98 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43238,CPT,UPR GI NDSC TNDSC US FINE NDL ASPIR/BX ESOPH,,,21 ,,RBRVS,5.02 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43239,CPT,UPPER STOMACH-INTESTINE SCOPE FOR BIOPSY,,,21 ,,RBRVS,2.87 ,1.52 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43240,CPT,UPR GI NDSC TRANSMURAL DRG PSEUDOCST,,,21 ,,RBRVS,6.85 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43241,CPT,UPR GI NDSC TNDSC INTRAL TUBE/CATH PLMT,,,21 ,,RBRVS,2.59 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43242,CPT,STOMACH-INTESTINE SCOPE ULTRASOUND GUIDED BIOPSY,,,21 ,,RBRVS,7.30 ,3.58 ,3.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43243,CPT,UPR GI NDSC NJX SCLEROSIS ESOPHGL&/GSTR VARC,,,21 ,,RBRVS,4.56 ,2.31 ,2.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43244,CPT,UPR GI NDSC BAND LIG ESOPHGL&/GSTR VARC,,,21 ,,RBRVS,5.04 ,2.56 ,2.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43245,CPT,UPR GI NDSC DILAT GSTR OUTLET FOR OBSTRCJ,,,21 ,,RBRVS,3.18 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43246,CPT,UPR GI NDSC DIRED PLMT PRQ GASTROSTOMY TUBE,,,21 ,,RBRVS,4.32 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43247,CPT,STOMACH-INTESTINE SCOPE FOR FOREIGN BODY REMOVAL,,,21 ,,RBRVS,3.38 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43248,CPT,UPR GI NDSC INSJ GD WIRE DILAT ESOPH > GD WIRE,,,21 ,,RBRVS,3.15 ,1.70 ,1.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43249,CPT,UPR GI NDSC BALO DILAT ESOPH < 30 MM DIAM,,,21 ,,RBRVS,2.90 ,1.57 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43250,CPT,UPR GI NDSC RMVL LES HOT BX/BIPOLAR CAUT,,,21 ,,RBRVS,3.20 ,1.60 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43251,CPT,UPR GI NDSC RMVL TUM POLYP/OTH LES SNARE TQ,,,21 ,,RBRVS,3.69 ,1.89 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43255,CPT,UPR GI NDSC CTRL BLD ANY METH,,,21 ,,RBRVS,4.81 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43256,CPT,UPR GI NDSC TNDSC STENT PLMT W/PREDILAT,,,21 ,,RBRVS,4.34 ,2.18 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43257,CPT,UPR GI NDSC DLVR THERMAL NRG SPHNCTR/CARDIA,,,21 ,,RBRVS,5.50 ,2.60 ,2.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43258,CPT,UPR GI NDSC ABLTJ LES X RMVL FORCEPS/CAUT/SNARE,,,21 ,,RBRVS,4.54 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43259,CPT,STOMACH-INTESTINE SCOPE WITH ULTRASOUND EXAM,,,21 ,,RBRVS,5.19 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43260,CPT,ERCP DX COLLJ SPEC BR/WA SPX,,,21 ,,RBRVS,5.95 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43261,CPT,ERCP W/BX 1/MLT,,,21 ,,RBRVS,6.26 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43262,CPT,ERCP W/SPHNCTROTOMY/PAPILLOTOMY,,,21 ,,RBRVS,7.38 ,3.63 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43263,CPT,ERCP W/PRESS MEAS SPHNCTR ODDI,,,21 ,,RBRVS,7.28 ,3.59 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43264,CPT,ERCP W/RMVL ST1/CALCULI BILIARY&/PNCRTC DUXS,,,21 ,,RBRVS,8.89 ,4.32 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43265,CPT,ERCP W/DSTRJ LITHOTRP ST1/CALCULI ANY METH,,,21 ,,RBRVS,10.00 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43267,CPT,ERCP W/INSJ NASOBILIARY/NASOPNCRTC DRG TUBE,,,21 ,,RBRVS,7.38 ,3.59 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43268,CPT,ERCP W/INSJ TUBE/STENT BILE/PNCRTC DUX,,,21 ,,RBRVS,7.38 ,3.77 ,3.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43269,CPT,ERCP W/RTRGR RMVL FB&/CHNG TUBE/STENT,,,21 ,,RBRVS,8.20 ,4.00 ,4.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43271,CPT,ERCP W/BALO DILAT AMPULLA BILIARY&/PNCRTC DUX,,,21 ,,RBRVS,7.38 ,3.62 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43272,CPT,ERCP W/ABLTJ LES X RMVL FORCEPS/CAUT/SNARE,,,21 ,,RBRVS,7.38 ,3.61 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43273,CPT,NDSC CANNULATION PAPILLA VIS BILE &/ PNCRTC DUX,,,21 ,,RBRVS,2.24 ,1.07 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43279,CPT,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,,,21 ,,RBRVS,22.10 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43280,CPT,LAPS SURG ESOPG/GSTR FUNDOPLASTY,,,21 ,,RBRVS,18.10 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43281,CPT,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,,,21 ,,RBRVS,26.60 ,12.06 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43282,CPT,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,,,21 ,,RBRVS,30.10 ,13.35 ,13.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43283,CPT,LAP ESOPH LENGTHENING,,,21 ,,RBRVS,2.95 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43289,CPT,UNLIS LAPS PX ESOPH,,,21 ,,TotalUnits,,,,25.72 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,43300,CPT,ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL,,,21 ,,RBRVS,9.33 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43305,CPT,ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL,,,21 ,,RBRVS,18.10 ,9.86 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43310,CPT,ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL,,,21 ,,RBRVS,26.26 ,11.11 ,11.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43312,CPT,ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL,,,21 ,,RBRVS,29.25 ,11.44 ,11.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43313,CPT,ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL,,,21 ,,RBRVS,48.45 ,18.10 ,18.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43314,CPT,ESPHGP CGEN DFCT THRC APPR W/RPR FSTL,,,21 ,,RBRVS,53.43 ,23.94 ,23.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43320,CPT,EGST+-VAGOTOMY&PYLOROPLASTY TABDL/TTHRC APPR,,,21 ,,RBRVS,23.31 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43325,CPT,ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH,,,21 ,,RBRVS,22.60 ,9.48 ,9.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43327,CPT,ESOPH FUNDOPLASTY LAP,,,21 ,,RBRVS,13.35 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43328,CPT,ESOPH FUNDOPLASTY THOR,,,21 ,,RBRVS,19.91 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43330,CPT,ESOPHAGOMYOTOMY HELLER TYP ABDL APPR,,,21 ,,RBRVS,22.19 ,9.17 ,9.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43331,CPT,ESOPHAGOMYOTOMY HELLER TYP THRC APPR,,,21 ,,RBRVS,23.06 ,10.37 ,10.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43332,CPT,TRANSAB ESOPH HIAT HERN RPR,,,21 ,,RBRVS,19.62 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43333,CPT,TRANSAB ESOPH HIAT HERN RPR,,,21 ,,RBRVS,21.46 ,11.85 ,11.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43334,CPT,TRANSTHOR DIAPHRAG HERN RPR,,,21 ,,RBRVS,22.12 ,11.44 ,11.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43335,CPT,TRANSTHOR DIAPHRAG HERN RPR,,,21 ,,RBRVS,23.97 ,12.18 ,12.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43336,CPT,THORABD DIAPHR HERN REPAIR,,,21 ,,RBRVS,25.81 ,13.52 ,13.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43337,CPT,THORABD DIAPHR HERN REPAIR,,,21 ,,RBRVS,27.65 ,15.40 ,15.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43338,CPT,ESOPH LENGTHENING,,,21 ,,RBRVS,2.21 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43340,CPT,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR,,,21 ,,RBRVS,22.99 ,9.76 ,9.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43341,CPT,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR,,,21 ,,RBRVS,24.23 ,11.53 ,11.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43350,CPT,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL ABDL APPR,,,21 ,,RBRVS,19.49 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43351,CPT,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR,,,21 ,,RBRVS,22.05 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43352,CPT,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR,,,21 ,,RBRVS,17.81 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43360,CPT,GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH,,,21 ,,RBRVS,40.11 ,16.02 ,16.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43361,CPT,GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT,,,21 ,,RBRVS,45.68 ,18.55 ,18.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43400,CPT,LIG DIR ESOPHGL VARC,,,21 ,,RBRVS,25.60 ,14.01 ,14.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43401,CPT,TRNSXJ ESOPH W/RPR ESOPHGL VARC,,,21 ,,RBRVS,26.49 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43405,CPT,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J,,,21 ,,RBRVS,24.73 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43410,CPT,SUTR ESOPHGL WND/INJ CRV APPR,,,21 ,,RBRVS,16.41 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43415,CPT,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,,,21 ,,RBRVS,28.91 ,12.91 ,12.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43420,CPT,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,,,21 ,,RBRVS,16.78 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43425,CPT,CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR,,,21 ,,RBRVS,25.04 ,11.75 ,11.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43450,CPT,OPENING OF ESOPHAGUS,,,21 ,,RBRVS,1.38 ,0.89 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43453,CPT,DILAT ESOPH > GD WIRE,,,21 ,,RBRVS,1.51 ,0.96 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43456,CPT,DILAT ESOPH BALO/DILATOR RTRGR,,,21 ,,RBRVS,2.57 ,1.40 ,12.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43458,CPT,DILAT ESOPH BALO 30 MM DIAM/LGR ACHALASIA,,,21 ,,RBRVS,3.06 ,1.58 ,6.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43460,CPT,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYP,,,21 ,,RBRVS,3.79 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43496,CPT,FR JEJUNUM TR W/MVASC ANAST,,,21 ,,TotalUnits,,,,3.93 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,43499,CPT,UNLIS PX ESOPH,,,21 ,,TotalUnits,,,,4.73 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,43500,CPT,GSTRT W/EXPL/FB RMVL,,,21 ,,RBRVS,12.79 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43501,CPT,GSTRT W/SUTR RPR BLD ULCER,,,21 ,,RBRVS,22.60 ,9.18 ,9.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43502,CPT,GSTRT W/SUTR RPR PRE-ESOPG/GSTR LAC,,,21 ,,RBRVS,25.69 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43510,CPT,GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE,,,21 ,,RBRVS,15.14 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43520,CPT,PYLOROMYOTOMY CUTTING PYLORIC MUSC,,,21 ,,RBRVS,11.29 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43605,CPT,BX STOMACH LAPT,,,21 ,,RBRVS,13.72 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43610,CPT,EXC LOCAL ULCER/B9 TUM STOMACH,,,21 ,,RBRVS,16.34 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43611,CPT,EXC LOCAL MAL TUM STOMACH,,,21 ,,RBRVS,20.38 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43620,CPT,GSTRCT TOT W/ESOPHAGONTRSTM,,,21 ,,RBRVS,34.04 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43621,CPT,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,,,21 ,,RBRVS,39.53 ,14.12 ,14.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43622,CPT,GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYP,,,21 ,,RBRVS,40.03 ,14.28 ,14.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43631,CPT,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,,,21 ,,RBRVS,24.51 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43632,CPT,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,,,21 ,,RBRVS,35.14 ,12.47 ,12.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43633,CPT,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,,,21 ,,RBRVS,33.14 ,11.99 ,11.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43634,CPT,GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH,,,21 ,,RBRVS,36.64 ,13.21 ,13.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43635,CPT,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,,,21 ,,RBRVS,2.06 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43640,CPT,VGTMY W/PYPS +-GASTROSTOMY TRUNCAL/SLCTV,,,21 ,,RBRVS,19.56 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43641,CPT,VGTMY W/PYPS +-GASTROSTOMY PARIETAL CELL,,,21 ,,RBRVS,19.81 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43644,CPT,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y <150 CM,,,21 ,,RBRVS,29.40 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43645,CPT,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,,,21 ,,RBRVS,31.53 ,12.39 ,12.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43651,CPT,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,,,21 ,,RBRVS,10.13 ,5.22 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43652,CPT,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,,,21 ,,RBRVS,12.13 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43653,CPT,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,,,21 ,,RBRVS,8.48 ,4.85 ,4.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43659,CPT,UNLIS LAPS PX STOMACH,,,21 ,,TotalUnits,,,,41.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,43752,CPT,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDN,,,21 ,,RBRVS,0.81 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43753,CPT,TX GASTRO INTUB W/ASP,,,21 ,,RBRVS,0.45 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43754,CPT,DX GASTR INTUB W/ASP SPEC,,,21 ,,RBRVS,0.45 ,1.84 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43755,CPT,DX GASTR INTUB W/ASP SPECS,,,21 ,,RBRVS,0.94 ,2.53 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43756,CPT,DX DUOD INTUB W/ASP SPEC,,,21 ,,RBRVS,0.77 ,5.62 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43757,CPT,DX DUOD INTUB W/ASP SPECS,,,21 ,,RBRVS,1.26 ,6.95 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43760,CPT,CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GUIDE,,,21 ,,RBRVS,0.90 ,0.37 ,8.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43761,CPT,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,,,21 ,,RBRVS,2.01 ,0.74 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43770,CPT,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,,,21 ,,RBRVS,18.00 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43771,CPT,LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE,,,21 ,,RBRVS,20.79 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43772,CPT,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE,,,21 ,,RBRVS,15.70 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43773,CPT,LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE,,,21 ,,RBRVS,20.79 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43774,CPT,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE &PORT,,,21 ,,RBRVS,15.76 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43775,CPT,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,,,21 ,,RBRVS,21.56 ,11.01 ,11.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43800,CPT,PYLOROPLASTY,,,21 ,,RBRVS,15.43 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43810,CPT,GASTRODUODENOSTOMY,,,21 ,,RBRVS,16.88 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43820,CPT,GASTROJEJUNOSTOMY W/O VAGOTOMY,,,21 ,,RBRVS,22.53 ,8.82 ,8.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43825,CPT,GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYP,,,21 ,,RBRVS,21.76 ,8.94 ,8.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43830,CPT,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,,,21 ,,RBRVS,10.85 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43831,CPT,GASTROSTOMY OPN NEONATAL FEEDING,,,21 ,,RBRVS,8.49 ,5.38 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43832,CPT,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,,,21 ,,RBRVS,17.34 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43840,CPT,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,,,21 ,,RBRVS,22.83 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43842,CPT,GSTR RSTCV W/O BYP VER-BANDED GSTP,,,21 ,,RBRVS,21.03 ,9.18 ,9.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43843,CPT,GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP,,,21 ,,RBRVS,21.21 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43845,CPT,GSTR RSTCV W/PRTL GSTRCT 50-100 CM,,,21 ,,RBRVS,33.30 ,12.93 ,12.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43846,CPT,GSTR RSTCV W/BYP W/SHORT LIMB 150 CM/<,,,21 ,,RBRVS,27.41 ,11.22 ,11.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43847,CPT,GSTR RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ,,,21 ,,RBRVS,30.28 ,11.91 ,11.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43848,CPT,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,,,21 ,,RBRVS,32.75 ,12.89 ,12.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43850,CPT,REVJ GASTRODUOL ANAST W/RCNSTJ W/O VAGOTOMY,,,21 ,,RBRVS,27.58 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43855,CPT,REVJ GASTRODUOL ANAST W/RCNSTJ W/VGTMY,,,21 ,,RBRVS,28.69 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43860,CPT,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,,,21 ,,RBRVS,27.89 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43865,CPT,REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY,,,21 ,,RBRVS,29.05 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43870,CPT,CLSR GASTROSTOMY SURG,,,21 ,,RBRVS,11.44 ,5.35 ,5.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43880,CPT,CLSR GASTROCOLIC FSTL,,,21 ,,RBRVS,27.18 ,10.68 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43886,CPT,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,,,21 ,,RBRVS,4.64 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43887,CPT,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,,,21 ,,RBRVS,4.32 ,3.26 ,3.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43888,CPT,GSTR RSTCV OPN RMVL&RPLCMT SUBQ PORT,,,21 ,,RBRVS,6.44 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,43999,CPT,UNLIS PX STOMACH,,,21 ,,TotalUnits,,,,3.43 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,44005,CPT,ENTEROLSS FRING INTSTINAL ADHESION SPX,,,21 ,,RBRVS,18.46 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44010,CPT,DUODEXOMY EXPL BX/FB RMVL,,,21 ,,RBRVS,14.26 ,6.19 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44015,CPT,TUBE/NDL CATH JEJUNOSTOMY ANY METH,,,21 ,,RBRVS,2.62 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44020,CPT,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,,,21 ,,RBRVS,16.22 ,6.74 ,6.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44021,CPT,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,,,21 ,,RBRVS,16.31 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44025,CPT,COLOTOMY EXPL BX/FB RMVL,,,21 ,,RBRVS,16.51 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44050,CPT,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,,,21 ,,RBRVS,15.52 ,6.58 ,6.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44055,CPT,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,,,21 ,,RBRVS,25.63 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44100,CPT,BX INT CAPSL TUBE PRORAL 1+ SPECS,,,21 ,,RBRVS,2.01 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44110,CPT,EXC 1+ < SM/LG INT 1 ENTEROTOMY,,,21 ,,RBRVS,14.04 ,6.07 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44111,CPT,EXC 1+ < SM/LG INT MLT ENTEROTOMIES,,,21 ,,RBRVS,16.52 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44120,CPT,ENTRC RESCJ SM INT 1 RESCJ&ANAST,,,21 ,,RBRVS,20.82 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44121,CPT,ENTRC RESCJ SM INT EA RESCJ&ANAST,,,21 ,,RBRVS,4.44 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44125,CPT,ENTRC RESCJ SM INT W/NTRSTM,,,21 ,,RBRVS,20.03 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44126,CPT,ENTRC RESCJ ATRESIA RESCJ&ANAST W/O TAPRING,,,21 ,,RBRVS,42.23 ,15.72 ,15.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44127,CPT,ENTRC RESCJ ATRESIA RESCJ&ANAST SGM W/TAPRING,,,21 ,,RBRVS,49.30 ,17.86 ,17.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44128,CPT,ENTRC RESCJ ATRESIA EA RESCJ&ANAST,,,21 ,,RBRVS,4.44 ,1.40 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44130,CPT,ENTERONTRSTM ANAST INT +-CUTAN NTRSTM SPX,,,21 ,,RBRVS,22.11 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44139,CPT,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,,,21 ,,RBRVS,2.23 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44140,CPT,COLCT PRTL W/ANAST,,,21 ,,RBRVS,22.59 ,9.26 ,9.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44141,CPT,COLCT PRTL W/SKN LVL CECOSTOMY/CLST,,,21 ,,RBRVS,29.91 ,12.91 ,12.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44143,CPT,COLCT PRTL W/END CLST&CLSR DSTL SGM,,,21 ,,RBRVS,27.79 ,11.68 ,11.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44144,CPT,COLCT PRTL W/RESCJ W/CLST/ILEOST&MUCOFSTL,,,21 ,,RBRVS,29.91 ,11.83 ,11.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44145,CPT,COLCT PRTL W/COLOPXTSTMY LW PEL ANAST,,,21 ,,RBRVS,28.58 ,11.10 ,11.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44146,CPT,COLCT PRTL W/COLOPXTSTMY LW PEL ANAST W/CLST,,,21 ,,RBRVS,35.30 ,14.98 ,14.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44147,CPT,COLCT PRTL ABDL&TRANSANAL APPR,,,21 ,,RBRVS,33.69 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44150,CPT,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,,,21 ,,RBRVS,30.18 ,13.98 ,13.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44151,CPT,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,,,21 ,,RBRVS,34.92 ,15.42 ,15.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44155,CPT,COLCT TOT ABDL W/PRCTECT W/ILEOST,,,21 ,,RBRVS,34.42 ,15.08 ,15.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44156,CPT,COLCT TOT ABDL W/PRCTECT W/CONTINENT ILEOST,,,21 ,,RBRVS,37.42 ,16.73 ,16.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44157,CPT,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST,,,21 ,,RBRVS,35.70 ,15.63 ,15.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44158,CPT,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,,,21 ,,RBRVS,36.70 ,15.84 ,15.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44160,CPT,COLCT PRTL W/RMVL TERMINAL ILE W/ILEOCLST,,,21 ,,RBRVS,20.89 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44180,CPT,LAPS ENTEROLSS FRING INTSTINAL ADHESION SPX,,,21 ,,RBRVS,15.27 ,6.59 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44186,CPT,LAPS JEJUNOSTOMY,,,21 ,,RBRVS,10.38 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44187,CPT,LAPS ILEOST/JEJUNOSTOMY NON-TUBE,,,21 ,,RBRVS,17.40 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44188,CPT,LAPS CLST/SKN LVL CECOSTOMY,,,21 ,,RBRVS,19.35 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44202,CPT,LAPS ENTRC RESCJ SM INT 1 RESCJ&ANAST,,,21 ,,RBRVS,23.39 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44203,CPT,LAPS EA SM INT RESCJ&ANAST,,,21 ,,RBRVS,4.44 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44204,CPT,LAPS COLCT PRTL W/ANAST,,,21 ,,RBRVS,26.42 ,10.37 ,10.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44205,CPT,LAPS COLCT PRTL W/RMVL TERMINAL ILE,,,21 ,,RBRVS,22.95 ,9.12 ,9.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44206,CPT,LAPS COLCT PRTL W/END CLST&CLSR DSTL SGM,,,21 ,,RBRVS,29.79 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44207,CPT,LAPS COLCT PRTL W/COLOPXTSTMY LW ANAST,,,21 ,,RBRVS,31.92 ,11.92 ,11.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44208,CPT,LAPS COLCT PRTL W/COLOPXTSTMY LW ANAST W/CLST,,,21 ,,RBRVS,33.99 ,13.82 ,13.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44210,CPT,LAPS COLCT TOT W/O PRCTECT W/ILEOST/ILEOPXTS,,,21 ,,RBRVS,30.09 ,12.80 ,12.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44211,CPT,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANAST&RSVR,,,21 ,,RBRVS,37.08 ,15.65 ,15.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44212,CPT,LAPS COLCT ABDL W/PRCTECT W/ILEOST,,,21 ,,RBRVS,34.58 ,14.90 ,14.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44213,CPT,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLCT,,,21 ,,RBRVS,3.50 ,1.09 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44227,CPT,LAPS CLSR NTRSTM LG/SM INT W/RESCJ&ANAST,,,21 ,,RBRVS,28.62 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44238,CPT,UNLIS LAPS PX INT XCP RECTUM,,,21 ,,TotalUnits,,,,32.93 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,44300,CPT,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,,,21 ,,RBRVS,13.75 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44310,CPT,ILEOST/JEJUNOSTOMY NON-TUBE,,,21 ,,RBRVS,17.59 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44312,CPT,REVJ ILEOST SMPL RLS SUPFC SCAR SPX,,,21 ,,RBRVS,9.43 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44314,CPT,REVJ ILEOST COMP RCNSTJ IN-DEPTH SPX,,,21 ,,RBRVS,16.74 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44316,CPT,CONTINENT ILEOST KOCK PX SPX,,,21 ,,RBRVS,23.59 ,9.61 ,9.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44320,CPT,CLST/SKN LVL CECOSTOMY,,,21 ,,RBRVS,19.91 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44322,CPT,CLST/SKN LVL CECOSTOMY W/MLT BXS SPX,,,21 ,,RBRVS,13.32 ,9.78 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44340,CPT,REVJ CLST SMPL RLS SUPFC SCAR SPX,,,21 ,,RBRVS,9.28 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44345,CPT,REVJ CLST COMP RCNSTJ IN-DEPTH SPX,,,21 ,,RBRVS,17.22 ,7.75 ,7.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44346,CPT,REVJ CLST W/RPR PARACLST HRNA SPX,,,21 ,,RBRVS,19.63 ,8.45 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44360,CPT,SCOPE OF UPPER SMALL INTESTINE,,,21 ,,RBRVS,2.59 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44361,CPT,SCOPE OF UPPER SMALL INTESTINE WITH BIOPSY,,,21 ,,RBRVS,2.87 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44363,CPT,ENTEROSCOPY > 2ND PRTN X ILE RMVL FB,,,21 ,,RBRVS,3.49 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44364,CPT,ENTEROSCOPY > 2ND PRTN X ILE RMVL LES SNARE,,,21 ,,RBRVS,3.73 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44365,CPT,ENTEROSCOPY > 2ND PRTN X ILE RMVL LES CAUT,,,21 ,,RBRVS,3.31 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44366,CPT,ENTEROSCOPY > 2ND PRTN X ILE CTRL BLD,,,21 ,,RBRVS,4.40 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44369,CPT,ENTEROSCOPY > 2ND PRTN X ILE ABLTJ LES,,,21 ,,RBRVS,4.51 ,2.32 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44370,CPT,ENTEROSCOPY > 2ND PRTN X ILE TNDSC STENT PLMT,,,21 ,,RBRVS,4.79 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44372,CPT,ENTEROSCOPY > 2ND PRTN X ILE W/PLMT PRQ TUBE,,,21 ,,RBRVS,4.40 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44373,CPT,ENTEROSCOPY > 2ND PRTN X ILE CONV GSTRST TUBE,,,21 ,,RBRVS,3.49 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44376,CPT,ENTEROSCOPY > 2ND PRTN W/ILE +-COLLJ SPEC SPX,,,21 ,,RBRVS,5.25 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44377,CPT,ENTEROSCOPY > 2ND PRTN W/ILE W/BX 1/MLT,,,21 ,,RBRVS,5.52 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44378,CPT,ENTEROSCOPY > 2ND PRTN ILE CTRL BLD,,,21 ,,RBRVS,7.12 ,3.47 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44379,CPT,ENTEROSCOPY > 2ND PRTN W/ILE W/STENT PLMT,,,21 ,,RBRVS,7.46 ,3.74 ,3.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44380,CPT,ILESC THRU STOMA DX +-COLLJ SPEC BR/WA SPX,,,21 ,,RBRVS,1.05 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44382,CPT,ILESC THRU STOMA W/BX 1/MLT,,,21 ,,RBRVS,1.27 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44383,CPT,ILESC THRU STOMA W/TNDSC STENT PLMT,,,21 ,,RBRVS,2.94 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44385,CPT,NDSC EVAL INTSTINAL POUCH DX +-COLLJ SPEC SPX,,,21 ,,RBRVS,1.82 ,0.89 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44386,CPT,NDSC EVAL INTSTINAL POUCH W/BX 1/MLT,,,21 ,,RBRVS,2.12 ,1.05 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44388,CPT,SCOPE OF COLON THRU OSTOMY FOR DIAGNOSIS,,,21 ,,RBRVS,2.82 ,1.38 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44389,CPT,SCOPE OF COLON WITH BIOPSY THRU OSTOMY,,,21 ,,RBRVS,3.13 ,1.57 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44390,CPT,COLSC THRU STOMA W/RMVL FB,,,21 ,,RBRVS,3.82 ,1.85 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44391,CPT,COLSC THRU STOMA CTRL BLD,,,21 ,,RBRVS,4.31 ,2.11 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44392,CPT,COLSC THRU STOMA RMVL LES CAUT,,,21 ,,RBRVS,3.81 ,1.73 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44393,CPT,COLSC THRU STOMA ABLTJ LES,,,21 ,,RBRVS,4.83 ,2.22 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44394,CPT,COLSC THRU STOMA W/RMVL TUM POLYP/OTH LES SNARE,,,21 ,,RBRVS,4.42 ,2.11 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44397,CPT,COLSC THRU STOMA W/TNDSC STENT PLMT,,,21 ,,RBRVS,4.70 ,2.35 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44500,CPT,INTRO LONG GI TUBE SPX,,,21 ,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44602,CPT,ENTERORRHAPHY 1 PRF8J,,,21 ,,RBRVS,24.72 ,8.44 ,8.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44603,CPT,ENTERORRHAPHY MLT PRF8J,,,21 ,,RBRVS,28.16 ,9.92 ,9.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44604,CPT,SUTR LG INT 1/MLT PRF8J W/O CLST,,,21 ,,RBRVS,18.16 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44605,CPT,SUTR LG INT 1/MLT PRF8J W/CLST,,,21 ,,RBRVS,22.08 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44615,CPT,INTSTINAL STRICTUROPLASTY+-DILAT OBSTRCJ,,,21 ,,RBRVS,18.16 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44620,CPT,CLSR NTRSTM LG/SM INT,,,21 ,,RBRVS,14.43 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44625,CPT,CLSR NTRSTM LG/SM RESCJ&ANAST OTH/THN CLRCT,,,21 ,,RBRVS,17.28 ,7.03 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44626,CPT,CLSR NTRSTM LG/SM RESCJ&CLRCT ANAST,,,21 ,,RBRVS,27.90 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44640,CPT,CLSR INTSTINAL CUTAN FSTL,,,21 ,,RBRVS,24.20 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44650,CPT,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,,,21 ,,RBRVS,25.12 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44660,CPT,CLSR ENTEROVES FSTL W/O INTSTINAL/BLDR RESCJ,,,21 ,,RBRVS,23.91 ,9.85 ,9.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44661,CPT,CLSR ENTEROVES FSTL W/INT&/BLDR RESCJ,,,21 ,,RBRVS,27.35 ,10.51 ,10.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44680,CPT,INTSTINAL PLCTJ SPX,,,21 ,,RBRVS,17.96 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44700,CPT,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,,,21 ,,RBRVS,17.48 ,7.10 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44701,CPT,INTRAOP COLONIC LVG,,,21 ,,RBRVS,3.10 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44720,CPT,BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA,,,21 ,,RBRVS,5.00 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44721,CPT,BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA,,,21 ,,RBRVS,7.00 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44799,CPT,UNLIS PX INT,,,21 ,,TotalUnits,,,,11.12 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,44800,CPT,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,,,21 ,,RBRVS,12.05 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44820,CPT,EXC LES MESENTERY SPX,,,21 ,,RBRVS,13.73 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44850,CPT,SUTR MESENTERY SPX,,,21 ,,RBRVS,12.11 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44899,CPT,UNLIS PX MECKEL'S DIVERTICULUM AND THE MESENTERY,,,21 ,,TotalUnits,,,,18.07 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,44900,CPT,I&D APPENDICEAL ABSC OPN,,,21 ,,RBRVS,12.57 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44901,CPT,I&D APPENDICEAL ABSC PRQ,,,21 ,,RBRVS,3.37 ,1.20 ,21.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44950,CPT,APPENDEC,,,21 ,,RBRVS,10.60 ,4.60 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44955,CPT,APPENDEC INDICATED PURPOSE OTH MAJOR PX X SPX,,,21 ,,RBRVS,1.53 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44960,CPT,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,,,21 ,,RBRVS,14.50 ,6.09 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44970,CPT,LAPS SURG APPENDEC,,,21 ,,RBRVS,9.45 ,4.64 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,44979,CPT,UNLIS LAPS PX APPENDIX,,,21 ,,TotalUnits,,,,14.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,45000,CPT,TRANSRCT DRG PEL ABSC,,,21 ,,RBRVS,6.30 ,3.77 ,3.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45005,CPT,I&D SBMCSL ABSC RECTUM,,,21 ,,RBRVS,2.02 ,1.68 ,4.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45020,CPT,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,,,21 ,,RBRVS,8.56 ,4.72 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45100,CPT,BX ANRCT WALL ANAL APPR,,,21 ,,RBRVS,4.04 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45108,CPT,ANRCT MYOMECTOMY,,,21 ,,RBRVS,5.12 ,3.35 ,3.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45110,CPT,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,,,21 ,,RBRVS,30.76 ,13.48 ,13.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45111,CPT,PRCTECT PRTL RESCJ RECTUM TABDL APPR,,,21 ,,RBRVS,18.01 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45112,CPT,PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX,,,21 ,,RBRVS,33.18 ,12.26 ,12.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45113,CPT,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,,,21 ,,RBRVS,33.22 ,13.56 ,13.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45114,CPT,PRCTECT PRTL W/ANAST ABDL&TRANSSAC APPR,,,21 ,,RBRVS,30.79 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45116,CPT,PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY,,,21 ,,RBRVS,27.72 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45119,CPT,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,,,21 ,,RBRVS,33.48 ,13.44 ,13.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45120,CPT,PRCTECT COMPL W/PULL-THRU PX&ANAST,,,21 ,,RBRVS,26.40 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45121,CPT,PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS,,,21 ,,RBRVS,29.08 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45123,CPT,PRCTECT PRTL W/O ANAST PRNL APPR,,,21 ,,RBRVS,18.86 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45126,CPT,PEL EXNTJ CLRCT MAL,,,21 ,,RBRVS,49.10 ,19.96 ,19.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45130,CPT,EXC RCT PROCIDENTIA W/ANAST PRNL APPR,,,21 ,,RBRVS,18.50 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45135,CPT,EXC RCT PROCIDENTIA W/ANAST ABDL&PRNL APPR,,,21 ,,RBRVS,22.36 ,9.64 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45136,CPT,EXC ILEOANAL RSVR W/ILEOST,,,21 ,,RBRVS,30.82 ,13.53 ,13.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45150,CPT,DIV STRIX RECTUM,,,21 ,,RBRVS,5.85 ,3.72 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45160,CPT,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,,,21 ,,RBRVS,16.33 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45171,CPT,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,,,21 ,,RBRVS,8.13 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45172,CPT,EXC RCT TUM INCL MUSCULARIS PROPRIA,,,21 ,,RBRVS,12.13 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45190,CPT,DSTRJ RCT TUM TRANSANAL APPR,,,21 ,,RBRVS,10.42 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45300,CPT,PROCTOSGMDSC RGD DX +-COLLJ SPEC BR/WA SPX,,,21 ,,RBRVS,0.80 ,0.47 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45303,CPT,PROCTOSGMDSC RGD W/DILAT,,,21 ,,RBRVS,1.50 ,0.66 ,19.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45305,CPT,PROCTOSGMDSC RGD W/BX 1/MLT,,,21 ,,RBRVS,1.25 ,0.64 ,3.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45307,CPT,PROCTOSGMDSC RGD W/RMVL FB,,,21 ,,RBRVS,1.70 ,0.72 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45308,CPT,PROCTOSGMDSC RGD RMVL 1 LES CAUT,,,21 ,,RBRVS,1.40 ,0.66 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45309,CPT,PROCTOSGMDSC RGD RMVL 1 LES SNARE TQ,,,21 ,,RBRVS,1.50 ,0.78 ,3.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45315,CPT,PROCTOSGMDSC RGD RMVL MLT TUM < CAUT/SNARE,,,21 ,,RBRVS,1.80 ,0.86 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45317,CPT,PROCTOSGMDSC RGD CTRL BLD,,,21 ,,RBRVS,2.00 ,0.83 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45320,CPT,PROCTOSGMDSC RGD ABLTJ LES,,,21 ,,RBRVS,1.78 ,0.88 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45321,CPT,PROCTOSGMDSC RGD DCMPRN VOLVULUS,,,21 ,,RBRVS,1.75 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45327,CPT,PROCTOSGMDSC RGD TNDSC STENT PLMT,,,21 ,,RBRVS,2.00 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45330,CPT,SCOPE OF SIGMOID COLON ONLY FOR DIAGNOSIS,,,21 ,,RBRVS,0.96 ,0.62 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45331,CPT,SCOPE OF SIGMOID COLON ONLY WITH BIOPSY,,,21 ,,RBRVS,1.15 ,0.76 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45332,CPT,SGMDSC FLX RMVL FB,,,21 ,,RBRVS,1.79 ,1.00 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45333,CPT,SGMDSC FLX RMVL LES CAUT,,,21 ,,RBRVS,1.79 ,0.99 ,5.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45334,CPT,SGMDSC FLX CTRL BLD,,,21 ,,RBRVS,2.73 ,1.48 ,1.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45335,CPT,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,,,21 ,,RBRVS,1.46 ,0.87 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45337,CPT,SGMDSC FLX DCMPRN VOLVULUS ANY METH,,,21 ,,RBRVS,2.36 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45338,CPT,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,,,21 ,,RBRVS,2.34 ,1.26 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45339,CPT,SGMDSC FLX ABLTJ LES,,,21 ,,RBRVS,3.14 ,1.62 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45340,CPT,SGMDSC FLX DILAT BALO 1/MORE STRIXS,,,21 ,,RBRVS,1.89 ,1.04 ,9.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45341,CPT,SGMDSC FLX NDSC US XM,,,21 ,,RBRVS,2.60 ,1.42 ,1.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45342,CPT,SGMDSC FLX TNDSC US GID NDL ASPIR/BX,,,21 ,,RBRVS,4.05 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45345,CPT,SGMDSC FLX TNDSC STENT PLMT,,,21 ,,RBRVS,2.92 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45355,CPT,COLSC RGD/FLX TABDL VIA COLOTOMY 1/MLT,,,21 ,,RBRVS,3.51 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45378,CPT,SCOPE OF COLON FOR DIAGNOSIS,,,21 ,,RBRVS,3.69 ,1.82 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45379,CPT,COLSC FLX PROX SPLENIC FLXR RMVL FB,,,21 ,,RBRVS,4.68 ,2.21 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45380,CPT,SCOPE OF COLON WITH BIOPSY,,,21 ,,RBRVS,4.43 ,2.20 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45381,CPT,COLSC FLX PROX SPLENIC FLXR SBMCSL NJX,,,21 ,,RBRVS,4.19 ,2.11 ,7.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45382,CPT,COLSC FLX PROX SPLENIC FLXR CTRL BLD,,,21 ,,RBRVS,5.68 ,2.81 ,9.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45383,CPT,COLSC FLX PROX SPLENIC FLXR ABLTJ LES,,,21 ,,RBRVS,5.86 ,2.67 ,8.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45384,CPT,COLSC FLX PROX SPLENIC FLXR RMVL LES CAUT,,,21 ,,RBRVS,4.69 ,2.20 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45385,CPT,COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ,,,21 ,,RBRVS,5.30 ,2.57 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45386,CPT,COLSC FLX PROX SPLENIC FLXR DILAT BALO 1+ STRIXS,,,21 ,,RBRVS,4.57 ,2.19 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45387,CPT,COLSC FLX PROX SPLENIC FLXR TNDSC STENT PLMT,,,21 ,,RBRVS,5.90 ,2.92 ,2.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45391,CPT,COLSC FLX PROX SPLENIC FLXR NDSC US XM,,,21 ,,RBRVS,5.09 ,2.51 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45392,CPT,COLSC FLX PROX SPLENIC FLXR US GID NDL ASPIR/BX,,,21 ,,RBRVS,6.54 ,3.15 ,3.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45395,CPT,LAPS PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,,,21 ,,RBRVS,33.00 ,14.84 ,14.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45397,CPT,LAPS PRCTECT CMBN PULL-THRU CRTJ RSVR,,,21 ,,RBRVS,36.50 ,15.51 ,15.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45400,CPT,LAPS PROCTOPEXY FOR PROLAPSE,,,21 ,,RBRVS,19.44 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45402,CPT,LAPS PROCTOPEXY FOR PROLAPSE SIGMOID RESCJ,,,21 ,,RBRVS,26.51 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45499,CPT,UNLIS LAPS PX RECTUM,,,21 ,,TotalUnits,,,,47.84 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,45500,CPT,PROCTOPLASTY STENOSIS,,,21 ,,RBRVS,7.73 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45505,CPT,PROCTOPLASTY PROLAPSE MUC MEMB,,,21 ,,RBRVS,8.36 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45520,CPT,PRIRCT NJX SCLRSG SLN PROLAPSE,,,21 ,,RBRVS,0.55 ,0.41 ,2.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45540,CPT,PROCTOPEXY ABDL APPR,,,21 ,,RBRVS,18.12 ,7.38 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45541,CPT,PROCTOPEXY PRNL APPR,,,21 ,,RBRVS,14.85 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45550,CPT,PROCTOPEXY W/SIGMOID RESCJ ABDL APPR,,,21 ,,RBRVS,24.80 ,10.27 ,10.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45560,CPT,RPR RECTOCELE SPX,,,21 ,,RBRVS,11.50 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45562,CPT,EXPL RPR&PRESAC DRG RCT INJ,,,21 ,,RBRVS,17.98 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45563,CPT,EXPL RPR&PRESAC DRG RCT INJ W/CLST,,,21 ,,RBRVS,26.38 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45800,CPT,CLSR RECTOVESICAL FSTL,,,21 ,,RBRVS,20.31 ,9.41 ,9.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45805,CPT,CLSR RECTOVESICAL FSTL W/CLST,,,21 ,,RBRVS,23.32 ,10.78 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45820,CPT,CLSR RECTOURTL FSTL,,,21 ,,RBRVS,20.37 ,9.11 ,9.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45825,CPT,CLSR RECTOURTL FSTL W/CLST,,,21 ,,RBRVS,24.17 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45900,CPT,RDCTJ PROCIDENTIA SPX UNDER ANES,,,21 ,,RBRVS,2.99 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45905,CPT,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,,,21 ,,RBRVS,2.35 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45910,CPT,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,,,21 ,,RBRVS,2.85 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45915,CPT,RMVL FECAL IMPACTION/FB SPX UNDER ANES,,,21 ,,RBRVS,3.19 ,2.17 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45990,CPT,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,,,21 ,,RBRVS,1.80 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,45999,CPT,UNLIS PX RECTUM,,,21 ,,TotalUnits,,,,7.03 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,46020,CPT,PLMT SETON,,,21 ,,RBRVS,3.00 ,2.40 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46030,CPT,RMVL ANAL SETON OTH MARKER,,,21 ,,RBRVS,1.26 ,0.86 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46040,CPT,I&D ISCHIORCT&/PRIRCT ABSC SPX,,,21 ,,RBRVS,5.37 ,4.21 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46045,CPT,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,,,21 ,,RBRVS,5.87 ,4.06 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46050,CPT,I&D PRIANAL ABSC SUPFC,,,21 ,,RBRVS,1.24 ,1.02 ,3.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46060,CPT,I&D ISCHIORCT/INTRAMURAL ABSC +-SETON,,,21 ,,RBRVS,6.37 ,4.57 ,4.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46070,CPT,INC ANAL SEPTUM INFT,,,21 ,,RBRVS,2.79 ,2.67 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46080,CPT,SPHNCTROTOMY ANAL DIV SPHNCTR SPX,,,21 ,,RBRVS,2.52 ,1.25 ,3.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46083,CPT,INC THROMBOSED HEMORRHOID XTRNL,,,21 ,,RBRVS,1.45 ,1.12 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46200,CPT,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,,,21 ,,RBRVS,3.59 ,3.80 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46220,CPT,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,,,21 ,,RBRVS,1.61 ,1.17 ,3.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46221,CPT,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,,,21 ,,RBRVS,2.36 ,2.08 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46230,CPT,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,,,21 ,,RBRVS,2.62 ,1.47 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46250,CPT,HEMORRHOIDECTOMY XTRNL 2+ COLUMN/GROUP,,,21 ,,RBRVS,4.25 ,3.05 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46255,CPT,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,,,21 ,,RBRVS,4.96 ,3.30 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46257,CPT,HRHC SMPL W/FISSURECTOMY,,,21 ,,RBRVS,5.76 ,3.97 ,3.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46258,CPT,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,,,21 ,,RBRVS,6.41 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46260,CPT,HEMORRHOIDECTOMY INT & XTRNL 2+ COLUMN/GROUP,,,21 ,,RBRVS,6.73 ,4.26 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46261,CPT,HRHC CPLX/X10SV W/FISSURECTOMY,,,21 ,,RBRVS,7.76 ,4.59 ,4.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46262,CPT,HRHC 2+ COL/GRP W/FSTULECTMY INCL FSSRECTMY,,,21 ,,RBRVS,7.91 ,4.97 ,4.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46270,CPT,SURG TX ANAL FSTL SUBQ,,,21 ,,RBRVS,4.92 ,4.00 ,6.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46275,CPT,SURG TX ANAL FISTULA INTERSPHINCTERIC,,,21 ,,RBRVS,5.42 ,4.10 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46280,CPT,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,,,21 ,,RBRVS,6.39 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46285,CPT,SURG TX ANAL FSTL 2ND STG,,,21 ,,RBRVS,5.42 ,4.05 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46288,CPT,CLSR ANAL FSTL W/RCT ADVMNT FLAP,,,21 ,,RBRVS,7.81 ,4.95 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46320,CPT,EXC THROMBOSED HEMORRHOID XTRNL,,,21 ,,RBRVS,1.64 ,0.97 ,2.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46500,CPT,NJX SCLRSG SLN HEMORRHOIDS,,,21 ,,RBRVS,1.69 ,1.34 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46505,CPT,CHEMODNRVTJ INT ANAL SPHNCTR,,,21 ,,RBRVS,3.18 ,2.41 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46600,CPT,ANOSC DX +-COLLJ SPEC BR/WA SPX,,,21 ,,RBRVS,0.55 ,0.40 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46604,CPT,ANOSC DILAT,,,21 ,,RBRVS,1.03 ,0.58 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46606,CPT,ANOSC BX 1/MLT,,,21 ,,RBRVS,1.20 ,0.61 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46608,CPT,ANOSC RMVL FB,,,21 ,,RBRVS,1.30 ,0.63 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46610,CPT,ANOSC RMVL 1 LES CAUT,,,21 ,,RBRVS,1.28 ,0.66 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46611,CPT,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,,,21 ,,RBRVS,1.30 ,0.67 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46612,CPT,ANOSC RMVL MLT TUMS CAUT/SNARE,,,21 ,,RBRVS,1.50 ,0.79 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46614,CPT,ANOSC CTRL BLD,,,21 ,,RBRVS,1.00 ,0.63 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46615,CPT,ANOSC ABLTJ LES,,,21 ,,RBRVS,1.50 ,0.79 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46700,CPT,ANOPLASTY PLSTC OPRATION STRIX ADLT,,,21 ,,RBRVS,9.81 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46705,CPT,ANOPLASTY PLSTC OPRATION STRIX INFT,,,21 ,,RBRVS,7.43 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46706,CPT,RPR ANAL FSTL W/FIBRIN GLUE,,,21 ,,RBRVS,2.44 ,1.57 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46707,CPT,RPR ANORECTAL FISTULA W/ PLUG,,,21 ,,RBRVS,6.39 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46710,CPT,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR,,,21 ,,RBRVS,17.14 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46712,CPT,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR,,,21 ,,RBRVS,36.45 ,15.35 ,15.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46715,CPT,RPR LW IMPRF8 ANUS W/ANOPRNL FSTL CUT-BK,,,21 ,,RBRVS,7.62 ,4.55 ,4.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46716,CPT,RPR LW IMPRF8 ANUS W/TRPOS FSTL,,,21 ,,RBRVS,17.54 ,12.15 ,12.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46730,CPT,RPR HI IMPRF8 ANUS W/O FSTL PRNL/SACROPRNL APPR,,,21 ,,RBRVS,30.65 ,17.28 ,17.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46735,CPT,RPR HI IMPRF8 ANUS W/O FSTL CMBN APPR,,,21 ,,RBRVS,36.14 ,16.91 ,16.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46740,CPT,RPR HI IMPRF8 ANUS W/FSTL PRNL/SACROPRNL APPR,,,21 ,,RBRVS,33.90 ,15.96 ,15.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46742,CPT,RPR HI IMPRF8 ANUS W/FSTL TABDL&SACROPRNL,,,21 ,,RBRVS,40.14 ,18.24 ,18.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46744,CPT,RPR CLOACAL ANOMAL SACROPRNL,,,21 ,,RBRVS,58.94 ,22.89 ,22.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46746,CPT,RPR CLOACAL ANOMAL CMBN ABDL&SACROPRNL,,,21 ,,RBRVS,65.44 ,27.55 ,27.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46748,CPT,RPR CLOACAL ANOMAL CMBN ABDL&SACROPRNL W/GRF,,,21 ,,RBRVS,71.42 ,28.96 ,28.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46750,CPT,SPHNCTROP ANAL INCONT/PROLAPSE ADLT,,,21 ,,RBRVS,12.15 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46751,CPT,SPHNCTROP ANAL INCONT/PROLAPSE CHLD,,,21 ,,RBRVS,9.30 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46753,CPT,GRF THIERSCH RCT INCONT&/PROLAPSE,,,21 ,,RBRVS,8.89 ,4.96 ,4.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46754,CPT,RMVL THIERSCH WIRE/SUTR ANAL CANAL,,,21 ,,RBRVS,3.01 ,2.34 ,3.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46760,CPT,SPHNCTROP ANAL MUSC TRNSPL,,,21 ,,RBRVS,17.45 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46761,CPT,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,,,21 ,,RBRVS,15.29 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46762,CPT,SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR,,,21 ,,RBRVS,14.82 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46900,CPT,DSTRJ LES ANUS SMPL CHEM,,,21 ,,RBRVS,1.91 ,1.42 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46910,CPT,DSTRJ LES ANUS SMPL ELTRDSICCATION,,,21 ,,RBRVS,1.91 ,1.29 ,3.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46916,CPT,DSTRJ LES ANUS SMPL CRYOSURG,,,21 ,,RBRVS,1.91 ,1.65 ,3.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46917,CPT,DSTRJ LES ANUS SMPL LASER SURG,,,21 ,,RBRVS,1.91 ,1.29 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46922,CPT,DSTRJ LES ANUS SMPL SURG EXC,,,21 ,,RBRVS,1.91 ,1.27 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46924,CPT,DSTRJ LES ANUS X10SV,,,21 ,,RBRVS,2.81 ,1.64 ,9.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46930,CPT,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,,,21 ,,RBRVS,1.61 ,2.10 ,3.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46940,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,,,21 ,,RBRVS,2.35 ,1.18 ,2.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46942,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,,,21 ,,RBRVS,2.07 ,1.08 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46945,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 1 COL/GRP,,,21 ,,RBRVS,2.21 ,2.99 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46946,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 2+ COL/GRP,,,21 ,,RBRVS,2.63 ,2.70 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46947,CPT,HEMORRHOIDOPEXY STAPLING,,,21 ,,RBRVS,5.57 ,3.34 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,46999,CPT,UNLIS PX ANUS,,,21 ,,TotalUnits,,,,5.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,47000,CPT,BX LVR NDL PRQ,,,21 ,,RBRVS,1.90 ,0.71 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47001,CPT,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,,,21 ,,RBRVS,1.90 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47010,CPT,HEPATOTOMY OPN DRG ABSC/CST 1/2 STGS,,,21 ,,RBRVS,19.40 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47011,CPT,HEPATOTOMY PRQ DRG ABSC/CST 1/2 STGS,,,21 ,,RBRVS,3.69 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47015,CPT,LAPT W/ASPIR&/NJX HEPATC PARASITIC CST/ABSCES,,,21 ,,RBRVS,18.50 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47100,CPT,BX LVR WEDGE,,,21 ,,RBRVS,12.91 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47120,CPT,HPTC RESCJ LVR PRTL LOBEC,,,21 ,,RBRVS,39.01 ,16.09 ,16.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47122,CPT,HPTC RESCJ LVR TRISGMECTOMY,,,21 ,,RBRVS,59.48 ,22.02 ,22.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47125,CPT,HPTC RESCJ LVR TOT L LOBEC,,,21 ,,RBRVS,53.04 ,19.99 ,19.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47130,CPT,HPTC RESCJ LVR TOT R LOBEC,,,21 ,,RBRVS,57.19 ,21.25 ,21.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47135,CPT,LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE,,,21 ,,RBRVS,83.64 ,32.31 ,32.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47136,CPT,LVR ALTRNSPLJ HTRTPC PRTL/WHL DON ANY AGE,,,21 ,,RBRVS,70.74 ,28.35 ,28.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47140,CPT,DON HPTC LIV DON L LAT SGM ONLY II&III,,,21 ,,RBRVS,59.40 ,24.56 ,24.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47141,CPT,DON HPTC LIV DON TOT L LOBEC II III&IV,,,21 ,,RBRVS,71.50 ,28.41 ,28.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47142,CPT,DON HPTC LIV DON TOT R LOBEC V VI VII&VIII,,,21 ,,RBRVS,79.44 ,31.50 ,31.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47143,CPT,BKBENCH PREPJ CDVR WHL LVR GRF W/O TRISGM/LOBE,,,21 ,,TotalUnits,,,,15.66 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,47146,CPT,BKBENCH RCNSTJ LVR GRF VEN ANAST EA,,,21 ,,RBRVS,6.00 ,1.89 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47147,CPT,BKBENCH RCNSTJ LVR GRF ARTL ANAST EA,,,21 ,,RBRVS,7.00 ,2.20 ,2.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47300,CPT,MARSUPIALIZATION CST/ABSC LVR,,,21 ,,RBRVS,18.14 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47350,CPT,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,,,21 ,,RBRVS,22.49 ,9.92 ,9.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47360,CPT,MGMT LVR HEMRRG CPLX SUTR WND/INJ,,,21 ,,RBRVS,31.31 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47361,CPT,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,,,21 ,,RBRVS,52.60 ,19.41 ,19.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47362,CPT,MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING,,,21 ,,RBRVS,23.54 ,10.28 ,10.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47370,CPT,LAPS SURG ABLTJ 1+ LVR TUM RF,,,21 ,,RBRVS,20.80 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47371,CPT,LAPS SURG ABLTJ 1+ LVR TUM CRYOSURG,,,21 ,,RBRVS,20.80 ,9.15 ,9.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47379,CPT,UNLIS LAPAROSCOPIC PX LVR,,,21 ,,TotalUnits,,,,29.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,47380,CPT,ABLTJ OPN 1+ LVR TUM RF,,,21 ,,RBRVS,24.56 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47381,CPT,ABLTJ OPN 1+ LVR TUM CRYOSURG,,,21 ,,RBRVS,24.88 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47382,CPT,ABLTJ 1+ LVR TUM PRQ RF,,,21 ,,RBRVS,15.22 ,6.34 ,101.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47399,CPT,UNLIS PX LVR,,,21 ,,TotalUnits,,,,3.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,47400,CPT,HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1,,,21 ,,RBRVS,36.36 ,14.48 ,14.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47420,CPT,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,,,21 ,,RBRVS,22.03 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47425,CPT,CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP,,,21 ,,RBRVS,22.31 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47460,CPT,TRANSDUOL SPHNCTROTOMY/SPHNCTROP +-XTRJ ST1 SPX,,,21 ,,RBRVS,20.52 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47480,CPT,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,,,21 ,,RBRVS,13.25 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47490,CPT,PRQ CHOLECSTOST,,,21 ,,RBRVS,8.13 ,5.42 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47500,CPT,NJX PRQ TRANSHEPATC CHOLANGRPH,,,21 ,,RBRVS,1.96 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47505,CPT,NJX CHOLANGRPH THRU AN CATH,,,21 ,,RBRVS,0.76 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47510,CPT,INTRO PRQ TRANSHEPATC CATH BILIARY DRG,,,21 ,,RBRVS,8.03 ,4.78 ,4.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47511,CPT,INTRO PRQ TRANSHEPATC STENT BILIARY DRG,,,21 ,,RBRVS,10.77 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47525,CPT,CHNG PRQ BILIARY DRG CATH,,,21 ,,RBRVS,1.54 ,1.20 ,11.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47530,CPT,REVJ&/RINSJ TRANSHEPATC TUBE,,,21 ,,RBRVS,6.05 ,3.57 ,31.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47550,CPT,BILIARY NDSC INTRAOP,,,21 ,,RBRVS,3.02 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47552,CPT,BILIARY NDSC PRQ T-TUBE DX +-COLLJ SPEC SPX,,,21 ,,RBRVS,6.03 ,2.58 ,2.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47553,CPT,BILIARY NDSC PRQ T-TUBE W/BX 1/MLT,,,21 ,,RBRVS,6.34 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47554,CPT,BILIARY NDSC PRQ T-TUBE RMVL ST1,,,21 ,,RBRVS,9.05 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47555,CPT,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/O STENT,,,21 ,,RBRVS,7.55 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47556,CPT,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,,,21 ,,RBRVS,8.55 ,3.16 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47560,CPT,LAPS SURG W/GID TRANSHEPATC CHOLANGRPH W/O BX,,,21 ,,RBRVS,4.88 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47561,CPT,LAPS SURG W/GID TRANSHEPATC CHOLANGRPH W/BX,,,21 ,,RBRVS,5.17 ,1.87 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47562,CPT,LAPS SURG CHOLECSTC,,,21 ,,RBRVS,11.76 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47563,CPT,LAPS SURG CHOLECSTC W/CHOLANGRPH,,,21 ,,RBRVS,12.11 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47564,CPT,LAPS SURG CHOLECSTC W/EXPL COMMON DUX,,,21 ,,RBRVS,14.24 ,6.19 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47570,CPT,LAPS SURG CHOLECSTONTRSTM,,,21 ,,RBRVS,12.56 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47579,CPT,UNLIS LAPS PX BILIARY TRC,,,21 ,,TotalUnits,,,,17.56 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,47600,CPT,CHOLECSTC,,,21 ,,RBRVS,17.48 ,7.85 ,7.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47605,CPT,CHOLECSTC CHOLANGRPH,,,21 ,,RBRVS,15.98 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47610,CPT,CHOLECSTC EXPL DUX,,,21 ,,RBRVS,20.92 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47612,CPT,CHOLECSTC EXPL DUX CHOLEDOCHONTRSTM,,,21 ,,RBRVS,21.21 ,8.72 ,8.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47620,CPT,CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP,,,21 ,,RBRVS,23.07 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47630,CPT,BILIARY DUX STONE XTRJ PRQ VIA BASKET/SNARE,,,21 ,,RBRVS,9.65 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47700,CPT,EXPL CGEN ATRESIA BILE DUXS,,,21 ,,RBRVS,16.50 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47701,CPT,PORTONTRSTM,,,21 ,,RBRVS,28.73 ,13.24 ,13.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47711,CPT,EXC BILE DUX TUM +-PRIM RPR XTRHEPATC,,,21 ,,RBRVS,25.90 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47712,CPT,EXC BILE DUX TUM +-PRIM RPR INTRAHEPATC,,,21 ,,RBRVS,33.72 ,13.37 ,13.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47715,CPT,EXC CHOLEDOCHAL CST,,,21 ,,RBRVS,21.55 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47720,CPT,CHOLECSTONTRSTM DIR,,,21 ,,RBRVS,18.34 ,8.60 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47721,CPT,CHOLECSTONTRSTM W/GASTRONTRSTM,,,21 ,,RBRVS,21.99 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47740,CPT,CHOLECSTONTRSTM ROUX-EN-Y,,,21 ,,RBRVS,21.23 ,9.44 ,9.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47741,CPT,CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM,,,21 ,,RBRVS,24.21 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47760,CPT,ANAST XTRHEPATC BILIARY DUXS&GI,,,21 ,,RBRVS,38.32 ,14.41 ,14.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47765,CPT,ANAST INTRAHEPATC DUXS&GI,,,21 ,,RBRVS,52.19 ,18.32 ,18.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47780,CPT,ANAST ROUX-EN-Y XTRHEPATC BILIARY DUXS&GI,,,21 ,,RBRVS,42.32 ,15.50 ,15.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47785,CPT,ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUXS&GI,,,21 ,,RBRVS,56.19 ,19.49 ,19.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47800,CPT,RCNSTJ PLSTC BILIARY DUXS W/END-TO-END ANAST,,,21 ,,RBRVS,26.17 ,11.02 ,11.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47801,CPT,PLMT CHOLEDOCHAL STENT,,,21 ,,RBRVS,17.60 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47802,CPT,U-TUBE HEPATCONTRSTM,,,21 ,,RBRVS,24.93 ,10.89 ,10.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47900,CPT,SUTR XTRHEPATC BILIARY DUX F/PRE-INJ SPX,,,21 ,,RBRVS,22.44 ,9.80 ,9.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,47999,CPT,UNLIS PX BILIARY TRC,,,21 ,,TotalUnits,,,,17.56 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,48000,CPT,PLMT DRAINS PRIPNCRTC F/AQT PNCRTS,,,21 ,,RBRVS,31.95 ,12.52 ,12.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48001,CPT,PLMT DRAINS PRIPNCRTC F/AQT PNCRTS W/CHOLECSTOST,,,21 ,,RBRVS,39.69 ,14.88 ,14.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48020,CPT,RMVL PNCRTC ST1,,,21 ,,RBRVS,19.09 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48100,CPT,BX PNCRS OPN,,,21 ,,RBRVS,14.46 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48102,CPT,BX PNCRS PRQ NDL,,,21 ,,RBRVS,4.70 ,1.98 ,9.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48105,CPT,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,,,21 ,,RBRVS,49.26 ,18.23 ,18.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48120,CPT,EXC LES PNCRS,,,21 ,,RBRVS,18.41 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48140,CPT,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,,,21 ,,RBRVS,26.32 ,10.60 ,10.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48145,CPT,PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY,,,21 ,,RBRVS,27.39 ,10.98 ,10.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48146,CPT,PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX,,,21 ,,RBRVS,30.60 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48148,CPT,EXC AMPULLA VATER,,,21 ,,RBRVS,20.39 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48150,CPT,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,,,21 ,,RBRVS,52.84 ,20.72 ,20.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48152,CPT,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,,,21 ,,RBRVS,48.65 ,19.46 ,19.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48153,CPT,PNCRTECT W/PANCREATOJEJUNOSTOMY,,,21 ,,RBRVS,52.79 ,20.64 ,20.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48154,CPT,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,,,21 ,,RBRVS,48.88 ,19.42 ,19.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48155,CPT,PNCRTECT TOT,,,21 ,,RBRVS,29.45 ,13.22 ,13.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48160,CPT,PNCRTECT TOT/STOT W/TRNSPLJ PNCRS/ISLET,,,21 ,,RBRVS,44.96 ,30.76 ,30.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48400,CPT,NJX PX F/INTRAOP PANCREATOGRAPY,,,21 ,,RBRVS,1.95 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48500,CPT,MARSUPIALIZATION PNCRTC CST,,,21 ,,RBRVS,18.16 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48510,CPT,XTRNL DRG PSEUDOCST PNCRS OPN,,,21 ,,RBRVS,17.19 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48511,CPT,XTRNL DRG PSEUDOCST PNCRS PRQ,,,21 ,,RBRVS,3.99 ,1.47 ,20.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48520,CPT,INT ANAST PNCRTC CST GI TRC DIR,,,21 ,,RBRVS,18.15 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48540,CPT,INT ANAST PNCRTC CST GI TRC ROUX-EN-Y,,,21 ,,RBRVS,21.94 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48545,CPT,PANCREATORRHAPHY INJ,,,21 ,,RBRVS,22.23 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48547,CPT,DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ,,,21 ,,RBRVS,30.38 ,11.75 ,11.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48548,CPT,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,,,21 ,,RBRVS,28.09 ,11.23 ,11.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48552,CPT,BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA,,,21 ,,RBRVS,4.30 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48554,CPT,TRNSPLJ PNCRTC ALGRFT,,,21 ,,RBRVS,37.80 ,22.05 ,22.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48556,CPT,RMVL TRNSPLED PNCRTC ALGRFT,,,21 ,,RBRVS,19.47 ,10.21 ,10.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,48999,CPT,UNLIS PX PNCRS,,,21 ,,TotalUnits,,,,7.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,49000,CPT,EXPL LAPT EXPL CELIOTOMY +-BX SPX,,,21 ,,RBRVS,12.54 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49002,CPT,REOPNG RECENT LAPT,,,21 ,,RBRVS,17.63 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49010,CPT,EXPL RPR AREA +-BX SPX,,,21 ,,RBRVS,16.06 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49020,CPT,DRG PRTL ABSC/LOCLZD PRITONITIS OPN,,,21 ,,RBRVS,26.67 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49021,CPT,DRG PRTL ABSC/LOCLZD PRITONITIS PRQ,,,21 ,,RBRVS,3.37 ,1.24 ,19.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49040,CPT,DRG SUBDIPHRG/SUBPHRENIC ABSC OPN,,,21 ,,RBRVS,16.52 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49041,CPT,DRG SUBDIPHRG/SUBPHRENIC ABSC PRQ,,,21 ,,RBRVS,3.99 ,1.46 ,19.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49060,CPT,DRG RPR ABSC OPN,,,21 ,,RBRVS,18.53 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49061,CPT,DRG RPR ABSC PRQ,,,21 ,,RBRVS,3.69 ,1.35 ,19.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49062,CPT,DRG XTRPRTL LYMPHOCELE PRTL CAVITY OPN,,,21 ,,RBRVS,12.22 ,5.67 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49080,CPT,PRITONEOCNTS ABDL PCNTS/PRTL LVG 1ST,,,21 ,,RBRVS,1.35 ,0.50 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49081,CPT,PRITONEOCNTS ABDL PCNTS/PRTL LVG SBSQ,,,21 ,,RBRVS,1.26 ,0.48 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49180,CPT,BX ABDL/RPR MASS PRQ NDL,,,21 ,,RBRVS,1.73 ,0.63 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49203,CPT,EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5 CM,,,21 ,,RBRVS,20.13 ,8.61 ,8.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49204,CPT,EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM,,,21 ,,RBRVS,26.13 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49205,CPT,EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM,,,21 ,,RBRVS,30.13 ,11.76 ,11.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49215,CPT,EXC PRESAC/SACROCOCCYGEAL TUM,,,21 ,,RBRVS,37.81 ,14.65 ,14.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49220,CPT,STAGING LAPT F/HODGKINS DISEASE/LYMPHOMA,,,21 ,,RBRVS,15.79 ,7.14 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49250,CPT,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,,,21 ,,RBRVS,9.01 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49255,CPT,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,,,21 ,,RBRVS,12.56 ,6.19 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49320,CPT,LAPS ABD PRTM&OMENTUM DX +-SPEC BR/WA SPX,,,21 ,,RBRVS,5.14 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49321,CPT,LAPS SURG W/BX 1/MLT,,,21 ,,RBRVS,5.44 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49322,CPT,LAPS SURG W/ASPIR CAVITY/CST 1/MLT,,,21 ,,RBRVS,6.01 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49323,CPT,LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY,,,21 ,,RBRVS,10.23 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49324,CPT,LAPS W/INSERTION PERM INTRAPERITONEAL CATHETER,,,21 ,,RBRVS,6.32 ,3.07 ,3.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49325,CPT,LAPS W/REVISION INTRAPERITONEAL CATHETER,,,21 ,,RBRVS,6.82 ,3.20 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49326,CPT,LAPS W/OMENTOPEXY,,,21 ,,RBRVS,3.50 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49327,CPT,LAP INS DEVICE FOR RT,,,21 ,,RBRVS,2.38 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49329,CPT,UNLIS LAPS PX ABD PRTM&OMENTUM,,,21 ,,TotalUnits,,,,7.85 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,49400,CPT,NJX AIR/CNTRST IN PRTL CAVITY SPX,,,21 ,,RBRVS,1.88 ,0.67 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49402,CPT,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,,,21 ,,RBRVS,14.09 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49411,CPT,PLMT NTRSTL DEV PRQ IABDL IPELVC &/ RPER 1/MLT,,,21 ,,RBRVS,3.82 ,1.43 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49412,CPT,INS DEVICE FOR RT GUIDE OPEN,,,21 ,,RBRVS,1.50 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49418,CPT,INSERT TUN IP CATH PERC,,,21 ,,RBRVS,4.21 ,40.03 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49419,CPT,INSJ IPR CANNULA/CATH W/SUBQ RSVR PRM,,,21 ,,RBRVS,7.08 ,3.74 ,3.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49421,CPT,INSJ IPR CANNULA/CATH F/DRG/DIAL PRM,,,21 ,,RBRVS,5.90 ,3.37 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49422,CPT,RMVL PRM IPR CANNULA/CATH,,,21 ,,RBRVS,6.29 ,2.94 ,2.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49423,CPT,EXCHNG ABSC/CST DRG CATH RAD GID SPX,,,21 ,,RBRVS,1.46 ,0.57 ,13.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49424,CPT,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,,,21 ,,RBRVS,0.76 ,0.31 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49425,CPT,INSJ PRTL-VEN SHUNT,,,21 ,,RBRVS,12.22 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49426,CPT,REVJ PRTL-VEN SHUNT,,,21 ,,RBRVS,10.41 ,5.00 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49427,CPT,NJX PX F/EVAL PREVIOUSLY PLACED PRTL-VEN SHUNT,,,21 ,,RBRVS,0.89 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49428,CPT,LIG PRTL-VEN SHUNT,,,21 ,,RBRVS,6.87 ,3.57 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49429,CPT,RMVL PRTL-VEN SHUNT,,,21 ,,RBRVS,7.44 ,3.38 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49435,CPT,INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER,,,21 ,,RBRVS,2.25 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49436,CPT,DELAYED CREATION EXIT SITE EMBEDDED CATHETER,,,21 ,,RBRVS,2.72 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49440,CPT,INSERT GASTROSTOMY TUBE PERCUTANEOUS,,,21 ,,RBRVS,4.18 ,1.87 ,23.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49441,CPT,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,,21 ,,RBRVS,4.77 ,2.08 ,25.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49442,CPT,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,,,21 ,,RBRVS,4.00 ,1.70 ,22.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49446,CPT,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,,,21 ,,RBRVS,3.31 ,1.23 ,22.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49450,CPT,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,,,21 ,,RBRVS,1.36 ,0.47 ,17.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49451,CPT,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,,21 ,,RBRVS,1.84 ,0.69 ,16.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49452,CPT,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,,,21 ,,RBRVS,2.86 ,1.06 ,20.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49460,CPT,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,,,21 ,,RBRVS,0.96 ,0.34 ,19.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49465,CPT,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,,,21 ,,RBRVS,0.62 ,0.23 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49491,CPT,RPR 1ST INGUN HRNA PRETERM INFT RDC,,,21 ,,RBRVS,12.53 ,5.97 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49492,CPT,RPR 1ST INGUN HRNA PRETERM INFT NCRC8,,,21 ,,RBRVS,15.43 ,6.59 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49495,CPT,RPR 1ST INGUN HRNA FULL TERM INFT<6 MO RDC,,,21 ,,RBRVS,6.20 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49496,CPT,RPR 1ST INGUN HRNA FULL TERM INFT<6 MO NCRC8,,,21 ,,RBRVS,9.42 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49500,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS RDC,,,21 ,,RBRVS,5.84 ,3.61 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49501,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS NCRC8,,,21 ,,RBRVS,9.36 ,4.77 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49505,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,,,21 ,,RBRVS,7.96 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49507,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> NCRC8,,,21 ,,RBRVS,10.05 ,4.94 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49520,CPT,RPR RECRT INGUN HRNA ANY AGE RDC,,,21 ,,RBRVS,9.99 ,4.87 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49521,CPT,RPR RECRT INGUN HRNA ANY AGE NCRC8,,,21 ,,RBRVS,12.44 ,5.62 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49525,CPT,RPR INGUN HRNA SLIDING ANY AGE,,,21 ,,RBRVS,8.93 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49540,CPT,RPR LMBR HRNA,,,21 ,,RBRVS,10.74 ,5.15 ,5.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49550,CPT,RPR 1ST FEM HRNA ANY AGE RDC,,,21 ,,RBRVS,8.99 ,4.55 ,4.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49553,CPT,RPR 1ST FEM HRNA ANY AGE NCRC8,,,21 ,,RBRVS,9.92 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49555,CPT,RPR RECRT FEM HRNA RDC,,,21 ,,RBRVS,9.39 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49557,CPT,RPR RECRT FEM HRNA NCRC8,,,21 ,,RBRVS,11.62 ,5.44 ,5.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49560,CPT,REPAIR FIRST ABDOMINAL WALL HERNIA,,,21 ,,RBRVS,11.92 ,5.49 ,5.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49561,CPT,RPR 1ST INCAL/VNT HRNA NCRC8,,,21 ,,RBRVS,15.38 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49565,CPT,RPR RECRT INCAL/VNT HRNA RDC,,,21 ,,RBRVS,12.37 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49566,CPT,RPR RECRT INCAL/VNT HRNA NCRC8,,,21 ,,RBRVS,15.53 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49568,CPT,IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE,,,21 ,,RBRVS,4.88 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49570,CPT,RPR EPIGSTR HRNA RDC SPX,,,21 ,,RBRVS,6.05 ,3.64 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49572,CPT,RPR EPIGSTR HRNA NCRC8,,,21 ,,RBRVS,7.87 ,4.15 ,4.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49580,CPT,RPR UMBILICAL HRNA < 5 YRS RDC,,,21 ,,RBRVS,4.47 ,3.44 ,3.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49582,CPT,RPR UMBILICAL HRNA <5 YRS NCRC8,,,21 ,,RBRVS,7.13 ,4.07 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49585,CPT,RPR UMBILICAL HRNA 5 YRS/> RDC,,,21 ,,RBRVS,6.59 ,3.80 ,3.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49587,CPT,RPR UMBILICAL HRNA AGE 5 YRS/> NCRC8,,,21 ,,RBRVS,8.04 ,4.24 ,4.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49590,CPT,RPR SPIGELIAN HRNA,,,21 ,,RBRVS,8.90 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49600,CPT,RPR SM OMPHALOCELE W/PRIM CLSR,,,21 ,,RBRVS,11.55 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49605,CPT,RPR LG OMPHALOCELE/GASTROSCHISIS +-PROSTH,,,21 ,,RBRVS,87.09 ,31.41 ,31.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49606,CPT,RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH,,,21 ,,RBRVS,19.00 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49610,CPT,RPR OMPHALOCELE GROSS TYP OPRATION 1ST STG,,,21 ,,RBRVS,10.91 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49611,CPT,RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG,,,21 ,,RBRVS,9.34 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49650,CPT,LAPS SURG RPR 1ST INGUN HRNA,,,21 ,,RBRVS,6.36 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49651,CPT,LAPS SURG RPR RECRT INGUN HRNA,,,21 ,,RBRVS,8.38 ,4.62 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49652,CPT,LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE,,,21 ,,RBRVS,12.88 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49653,CPT,LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED,,,21 ,,RBRVS,16.21 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49654,CPT,LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE,,,21 ,,RBRVS,15.03 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49655,CPT,LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED,,,21 ,,RBRVS,18.11 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49656,CPT,LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE,,,21 ,,RBRVS,15.08 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49657,CPT,LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED,,,21 ,,RBRVS,22.11 ,9.07 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49659,CPT,UNLIS LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,,,21 ,,TotalUnits,,,,10.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,49900,CPT,SUTR SEC ABDL WALL F/EVSC/DEHSN,,,21 ,,RBRVS,12.41 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49904,CPT,OMENTAL FLAP XTR-ABDL,,,21 ,,RBRVS,22.35 ,13.22 ,13.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49905,CPT,OMENTAL FLAP INTRA-ABDL,,,21 ,,RBRVS,6.54 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,49999,CPT,UNLIS PX ABD PRTM&OMENTUM,,,21 ,,TotalUnits,,,,12.21 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50010,CPT,RNL EXPL X NECESSITATING OTH SPEC PX,,,21 ,,RBRVS,12.28 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50020,CPT,DRG PRIRNL/RNL ABSC OPN,,,21 ,,RBRVS,18.08 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50021,CPT,DRG PRIRNL/RNL ABSC PRQ,,,21 ,,RBRVS,3.37 ,1.23 ,20.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50040,CPT,NFROS NFROT W/DRG,,,21 ,,RBRVS,16.68 ,8.60 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50045,CPT,NFROT W/EXPL,,,21 ,,RBRVS,16.82 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,5005F,CPT,COUNSEL NEW/CHANGING MOLES SELF-EXAMINATION,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50060,CPT,NEPHROLITHOTOMY RMVL ST1,,,21 ,,RBRVS,20.95 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50065,CPT,NEPHROLITHOTOMY SEC SURG OPRATION F/ST1,,,21 ,,RBRVS,22.32 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50070,CPT,NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY,,,21 ,,RBRVS,21.85 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50075,CPT,NEPHROLITHOTOMY RMVL LG STAGHORN ST1,,,21 ,,RBRVS,27.09 ,13.01 ,13.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50080,CPT,PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY UP 2 CM,,,21 ,,RBRVS,15.74 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50081,CPT,PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY > 2 CM,,,21 ,,RBRVS,23.50 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50100,CPT,TRNSXJ/RPSG ABERRANT RNL VSL SPX,,,21 ,,RBRVS,17.45 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,5010F,CPT,COMMUNICATE DILAT MACULAR/FUNDUS XM TO DM PHYS,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50120,CPT,PLOT W/EXPL,,,21 ,,RBRVS,17.21 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50125,CPT,PLOT W/DRG PYELOSTOMY,,,21 ,,RBRVS,17.82 ,9.28 ,9.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50130,CPT,PLOT W/RMVL ST1,,,21 ,,RBRVS,18.82 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50135,CPT,PLOT COMP,,,21 ,,RBRVS,20.59 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50200,CPT,RNL BX PRQ TROCAR/NDL,,,21 ,,RBRVS,2.63 ,1.24 ,12.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50205,CPT,RNL BX SURG EXPOS KDN,,,21 ,,RBRVS,12.29 ,5.86 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50220,CPT,NFRCT W/PRTL URTREC ANY OPN RIB RESCJ,,,21 ,,RBRVS,18.68 ,9.26 ,9.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50225,CPT,NFRCT W/PRTL URTREC ANY OPN RIB RESCJ COMP,,,21 ,,RBRVS,21.88 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50230,CPT,NFRCT W/PRTL URTREC ANY OPN RIB RESCJ RAD,,,21 ,,RBRVS,23.81 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50234,CPT,NFRCT W/TOT URTREC&BLDR CUFF THRU SM INC,,,21 ,,RBRVS,24.05 ,11.51 ,11.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50236,CPT,NFRCT TOT URTREC&BLDR CUFF THRU SEP INC,,,21 ,,RBRVS,26.94 ,13.31 ,13.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50240,CPT,NFRCT PRTL,,,21 ,,RBRVS,24.21 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50250,CPT,ABLTJ OPN 1+ RNL LES CRYOSURG W/INTRAOP US,,,21 ,,RBRVS,22.22 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50280,CPT,EXC/UNROOFING CST KDN,,,21 ,,RBRVS,17.09 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50290,CPT,EXC PRINEPHRIC CST,,,21 ,,RBRVS,16.15 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50300,CPT,DON NFRCT FROM CDVR DON UNI/BI,,,21 ,,TotalUnits,,,,23.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50320,CPT,DON NFRCT OPN FROM LIV DON,,,21 ,,RBRVS,22.43 ,12.88 ,12.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50323,CPT,BKBENCH PREPJ CDVR RNL ALGRFT,,,21 ,,TotalUnits,,,,10.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50325,CPT,BKBENCH PREPJ LIV RNL ALGRFT OPN/LAPS,,,21 ,,TotalUnits,,,,9.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50327,CPT,BKBENCH RCNSTJ RNL ALGRFT VEN ANAST EA,,,21 ,,RBRVS,4.00 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50328,CPT,BKBENCH RCNSTJ RNL ALGRFT ARTL ANAST EA,,,21 ,,RBRVS,3.50 ,1.15 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50329,CPT,BKBENCH RCNSTJ ALGRFT URTRL ANAST EA,,,21 ,,RBRVS,3.34 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50340,CPT,RCP NFRCT SPX,,,21 ,,RBRVS,14.04 ,8.04 ,8.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50360,CPT,RNL ALTRNSPLJ IMPLTJ GRF W/O RCP NFRCT,,,21 ,,RBRVS,40.90 ,19.83 ,19.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50365,CPT,RNL ALTRNSPLJ IMPLTJ GRF W/RCP NFRCT,,,21 ,,RBRVS,46.13 ,21.86 ,21.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50370,CPT,RMVL TRNSPLED RNL ALGRFT,,,21 ,,RBRVS,18.88 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50380,CPT,RNL AUTOTRNSPLJ RIMPLTJ KDN,,,21 ,,RBRVS,30.11 ,18.04 ,18.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50382,CPT,RMVL&RPLCMT INTLY DWELLING URTRL STENT,,,21 ,,RBRVS,5.50 ,2.10 ,28.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50384,CPT,RMVL INTLY DWELLING URTRL STENT,,,21 ,,RBRVS,5.00 ,1.92 ,23.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50385,CPT,REMOVE & REPLACE INT DWELL URETERAL STENT TRURL,,,21 ,,RBRVS,4.44 ,2.05 ,28.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50386,CPT,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,,,21 ,,RBRVS,3.30 ,1.61 ,18.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50387,CPT,RMVL&RPLCMT XTRNLLY ACCESSIBLE URTRL STENT,,,21 ,,RBRVS,2.00 ,0.75 ,13.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50389,CPT,RMVL NFROS TUBE REQ FLUOR GID,,,21 ,,RBRVS,1.10 ,0.41 ,7.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50390,CPT,ASPIR&/NJX RNL CST/PELVIS NDL PRQ,,,21 ,,RBRVS,1.96 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50391,CPT,INSTLJ AGT RNL PELVIS&/URTR THRU TUBE,,,21 ,,RBRVS,1.96 ,0.78 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50392,CPT,INTRO INTRACATH/CATH IN RNL PELVIS DRG&/NJX PRQ,,,21 ,,RBRVS,3.37 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50393,CPT,INTRO URTRL CATH/STENT THRU PELVIS DRG&/NJX PRQ,,,21 ,,RBRVS,4.15 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50394,CPT,NJX PX PLOG THRU TUBE/CATH,,,21 ,,RBRVS,0.76 ,0.60 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50395,CPT,INTRO GD PELVIS&/URTR W/DILAT NFROS TRC,,,21 ,,RBRVS,3.37 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50396,CPT,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,,,21 ,,RBRVS,2.09 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50398,CPT,CHNG NFROS/PYELOSTOMY TUBE,,,21 ,,RBRVS,1.46 ,0.58 ,12.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50400,CPT,PLOP RNL PELVIS SMPL,,,21 ,,RBRVS,21.27 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50405,CPT,PLOP RNL PELVIS COMP,,,21 ,,RBRVS,25.86 ,12.39 ,12.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50500,CPT,NEPHRORRHAPHY SUTR KDN WND/INJ,,,21 ,,RBRVS,21.22 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50520,CPT,CLSR NEPHROCUTAN/PYELOCUTAN FSTL,,,21 ,,RBRVS,18.88 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50525,CPT,CLSR NEPHROVISC FSTL W/VISC RPR ABDL APPR,,,21 ,,RBRVS,24.39 ,11.53 ,11.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50526,CPT,CLSR NEPHROVISC FSTL W/VISC RPR THRC APPR,,,21 ,,RBRVS,26.31 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50540,CPT,SYMPHYSIOTOMY HORSESHOE KDN +-PLOP UNI/BI,,,21 ,,RBRVS,21.10 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50541,CPT,LAPS ABLTJ RNL CSTS,,,21 ,,RBRVS,16.86 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50542,CPT,LAPS ABLTJ RNL MASS LES,,,21 ,,RBRVS,21.36 ,10.67 ,10.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50543,CPT,LAPS PRTL NFRCT,,,21 ,,RBRVS,27.41 ,13.44 ,13.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50544,CPT,LAPS PLOP,,,21 ,,RBRVS,23.37 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50545,CPT,LAPS RADICAL NFRCT,,,21 ,,RBRVS,25.06 ,11.76 ,11.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50546,CPT,LAPS NFRCT W/PRTL URTREC,,,21 ,,RBRVS,21.87 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50547,CPT,LAPS DON NFRCT FROM LIV DON,,,21 ,,RBRVS,26.34 ,13.07 ,13.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50548,CPT,LAPS NFRCT W/TOT URTREC,,,21 ,,RBRVS,25.36 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50549,CPT,UNLIS LAPS PX RNL,,,21 ,,TotalUnits,,,,36.82 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50551,CPT,RNL NDSC NFROS/PYELOSTOMY,,,21 ,,RBRVS,5.59 ,2.55 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50553,CPT,RNL NDSC NFROS/PYELOSTOMY URTRL CATHJ,,,21 ,,RBRVS,5.98 ,2.63 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50555,CPT,RNL NDSC NFROS/PYELOSTOMY BX,,,21 ,,RBRVS,6.52 ,2.89 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50557,CPT,RNL NDSC NFROS/PYELOSTOMY FULG&/INC +-BX,,,21 ,,RBRVS,6.61 ,2.94 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50561,CPT,RNL NDSC NFROS/PYELOSTOMY RMVL FB/ST1,,,21 ,,RBRVS,7.58 ,3.33 ,5.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50562,CPT,RNL NDSC NFROS/PYELOSTOMY RESCJ TUM,,,21 ,,RBRVS,10.90 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50570,CPT,RNL NDSC NFROT/PLOT,,,21 ,,RBRVS,9.53 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50572,CPT,RNL NDSC NFROT/PLOT W/URTRL CATHJ +-DILAT URTR,,,21 ,,RBRVS,10.33 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50574,CPT,RNL NDSC NFROT/PLOT BX,,,21 ,,RBRVS,11.00 ,4.65 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50575,CPT,RNL NDSC NFROT/PLOT W/ENDOPLOT,,,21 ,,RBRVS,13.96 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50576,CPT,RNL NDSC NFROT FULGURATION&/INC +-BX,,,21 ,,RBRVS,10.97 ,4.65 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50580,CPT,RNL NDSC NFROT/PLOT W/RMVL FB/ST1,,,21 ,,RBRVS,11.84 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50590,CPT,LITHOTRP XTRCORP SHOCK WAVE,,,21 ,,RBRVS,9.77 ,5.70 ,15.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50592,CPT,ABLTJ 1+ RNL TUM PRQ UNI RF,,,21 ,,RBRVS,6.80 ,3.12 ,86.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50593,CPT,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,,,21 ,,RBRVS,9.13 ,3.62 ,114.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50600,CPT,URTROTOMY W/EXPL/DRG SPX,,,21 ,,RBRVS,17.17 ,8.46 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50605,CPT,URTROTOMY F/INSJ NDWELLG STENT ALL TYPS,,,21 ,,RBRVS,16.79 ,7.96 ,7.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50610,CPT,URTROLITHOTOMY UPR ONE-3RD URTR,,,21 ,,RBRVS,17.25 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50620,CPT,URTROLITHOTOMY MIDDLE ONE-3RD URTR,,,21 ,,RBRVS,16.43 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50630,CPT,URTROLITHOTOMY LWR ONE-3RD URTR,,,21 ,,RBRVS,16.21 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50650,CPT,URTREC W/BLDR CUFF SPX,,,21 ,,RBRVS,18.82 ,9.47 ,9.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50660,CPT,URTREC TOT ECTOPIC URTR CMBN APPR,,,21 ,,RBRVS,21.02 ,10.24 ,10.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50684,CPT,NJX URTRG/URTROPLOG THRU URTROST/URTRL CATH,,,21 ,,RBRVS,0.76 ,0.60 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50686,CPT,MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH,,,21 ,,RBRVS,1.51 ,0.97 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50688,CPT,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,,,21 ,,RBRVS,1.20 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50690,CPT,NJX VISUALIZATION ILEAL CONDUIT&/URTROPLOG,,,21 ,,RBRVS,1.16 ,0.75 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50700,CPT,URTROPLASTY PLSTC OPRATION URTR,,,21 ,,RBRVS,16.69 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50715,CPT,URTROLSS +-RPSG URTR F/RPR FIBROSIS,,,21 ,,RBRVS,20.64 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50722,CPT,URTROLSS F/OVARIAN VEIN SYND,,,21 ,,RBRVS,17.95 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50725,CPT,URTROLSS RETROCAVAL URTR W/REANAST,,,21 ,,RBRVS,20.20 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50727,CPT,REVJ UR-CUTAN ANAST,,,21 ,,RBRVS,8.28 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50728,CPT,REVJ UR-CUTAN ANAST RPR FSCAL DFCT&HRNA,,,21 ,,RBRVS,12.18 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50740,CPT,URTROPYELOSTOMY ANAST URTR&RNL PELVIS,,,21 ,,RBRVS,20.07 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50750,CPT,URTROCALYCOSTOMY ANAST URTR RNL CALYX,,,21 ,,RBRVS,21.22 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50760,CPT,URTROURTROST,,,21 ,,RBRVS,20.07 ,9.64 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50770,CPT,TRANSURTROURTROST ANAST URTR CLAT URTR,,,21 ,,RBRVS,21.22 ,9.69 ,9.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50780,CPT,URTRONEOCSTOST ANAST 1 URTR BLDR,,,21 ,,RBRVS,19.95 ,9.78 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50782,CPT,URTRONEOCSTOST ANAST DUPLICATED URTR BLDR,,,21 ,,RBRVS,19.66 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50783,CPT,URTRONEOCSTOST W/X10SV URTRL TAILORING,,,21 ,,RBRVS,20.70 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50785,CPT,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,,,21 ,,RBRVS,22.23 ,10.80 ,10.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50800,CPT,URTRONTRSTM DIR ANAST URTR INT,,,21 ,,RBRVS,16.41 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50810,CPT,URTROSIGMOIDOSTOMY CRTJ CLST INT ANAST,,,21 ,,RBRVS,22.61 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50815,CPT,URTROCOLON CONDUIT INT ANAST,,,21 ,,RBRVS,22.26 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50820,CPT,URTROILEAL CONDUIT W/INT ANAST,,,21 ,,RBRVS,24.07 ,11.46 ,11.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50825,CPT,CONTINENT DVRJ W/INT ANAST W/ANY SGM SM&/LG INT,,,21 ,,RBRVS,30.68 ,14.45 ,14.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50830,CPT,UR UNDVRJ,,,21 ,,RBRVS,33.77 ,15.21 ,15.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50840,CPT,RPLCMT ALL/PART URTR INT SGM W/INT ANAST,,,21 ,,RBRVS,22.39 ,11.29 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50845,CPT,CUTAN APPENDICO-VESICOSTOMY,,,21 ,,RBRVS,22.46 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50860,CPT,URTROST TRNSPLJ URTR SKN,,,21 ,,RBRVS,17.08 ,8.72 ,8.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50900,CPT,URTRORRHAPHY SUTR URTR SPX,,,21 ,,RBRVS,15.04 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50920,CPT,CLSR URTROCUTAN FSTL,,,21 ,,RBRVS,15.81 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50930,CPT,CLSR URTROVISC FSTL W/VISC RPR,,,21 ,,RBRVS,20.19 ,9.16 ,9.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50940,CPT,DELIG URTR,,,21 ,,RBRVS,15.93 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50945,CPT,LAPS URTROLITHOTOMY,,,21 ,,RBRVS,17.97 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50947,CPT,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,,,21 ,,RBRVS,25.78 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50948,CPT,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,,,21 ,,RBRVS,23.82 ,11.32 ,11.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50949,CPT,UNLIS LAPS PX URTR,,,21 ,,TotalUnits,,,,37.75 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,50951,CPT,NDSC THRU URTROST,,,21 ,,RBRVS,5.83 ,2.66 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50953,CPT,NDSC URTROST W/URTRL CATHJ,,,21 ,,RBRVS,6.23 ,3.13 ,4.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50955,CPT,NDSC THRU URTROST BX,,,21 ,,RBRVS,6.74 ,3.35 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50957,CPT,NDSC THRU URTROST FULG&/INC +-BX,,,21 ,,RBRVS,6.78 ,3.01 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50961,CPT,NDSC THRU URTROST RMVL FB/ST1,,,21 ,,RBRVS,6.04 ,2.73 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50970,CPT,NDSC THRU URTROTOMY,,,21 ,,RBRVS,7.13 ,3.13 ,3.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50972,CPT,NDSC THRU URTROTOMY URTRL CATHJ +-DILAT,,,21 ,,RBRVS,6.88 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50974,CPT,NDSC THRU URTROTOMY BX,,,21 ,,RBRVS,9.16 ,3.93 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50976,CPT,NDSC THRU URTROTOMY FULG&/INC +-BX,,,21 ,,RBRVS,9.03 ,3.85 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,50980,CPT,NDSC THRU URTROTOMY RMVL FB/ST1,,,21 ,,RBRVS,6.84 ,3.02 ,3.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51020,CPT,CSTOTOMY/CSTOST FULG&/INSJ RADACT MATRL,,,21 ,,RBRVS,7.69 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51030,CPT,CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES,,,21 ,,RBRVS,7.81 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51040,CPT,CSTOST CSTOTOMY W/DRG,,,21 ,,RBRVS,4.49 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51045,CPT,CSTOTOMY W/INSJ URTRL CATH/STENT SPX,,,21 ,,RBRVS,7.81 ,5.00 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51050,CPT,CSTOLITHOTOMY CSTOTOMY W/RMVL ST1,,,21 ,,RBRVS,7.97 ,4.96 ,4.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51060,CPT,TRANSVESICAL URTROLITHOTOMY,,,21 ,,RBRVS,9.95 ,5.97 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51065,CPT,CSTOTOMY W/ST1 BASKET XTRJ&/FRAGMENTATION,,,21 ,,RBRVS,9.95 ,5.86 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51080,CPT,DRG PRIVESICAL/PREVESICAL SPACE ABSC,,,21 ,,RBRVS,6.71 ,4.39 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51100,CPT,ASPIRATION BLADDER NEEDLE,,,21 ,,RBRVS,0.78 ,0.28 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51101,CPT,ASPIRATION BLADDER TROCAR/INTRACATHETER,,,21 ,,RBRVS,1.02 ,0.38 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51102,CPT,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,,,21 ,,RBRVS,2.70 ,1.33 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51500,CPT,EXC URACHAL CST/SINUS +-UMBILICAL HRNA RPR,,,21 ,,RBRVS,11.05 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51520,CPT,CSTOTOMY F/SMPL EXC VESICAL NCK SPX,,,21 ,,RBRVS,10.21 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51525,CPT,CSTOTOMY F/EXC BLDR DIVERTICULUM 1/MLT SPX,,,21 ,,RBRVS,15.42 ,8.08 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51530,CPT,CSTOTOMY F/EXC BLDR TUM,,,21 ,,RBRVS,13.71 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51535,CPT,CSTOTOMY F/EXC INC/RPR URTROCELE,,,21 ,,RBRVS,13.90 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51550,CPT,CSTC PRTL SMPL,,,21 ,,RBRVS,17.23 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51555,CPT,CSTC PRTL COMP,,,21 ,,RBRVS,23.18 ,11.08 ,11.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51565,CPT,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,,,21 ,,RBRVS,23.68 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51570,CPT,CSTC COMPL SPX,,,21 ,,RBRVS,27.46 ,12.67 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51575,CPT,CSTC COMPL W/BI PEL LMPHADEC,,,21 ,,RBRVS,34.18 ,15.83 ,15.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51580,CPT,CSTC COMPL W/TRNSPLJS,,,21 ,,RBRVS,35.37 ,16.75 ,16.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51585,CPT,CSTC COMPL W/TRNSPLJS W/LMPHADEC,,,21 ,,RBRVS,39.64 ,18.40 ,18.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51590,CPT,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,,,21 ,,RBRVS,36.33 ,16.57 ,16.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51595,CPT,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,,,21 ,,RBRVS,41.32 ,18.76 ,18.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51596,CPT,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,,,21 ,,RBRVS,44.26 ,20.36 ,20.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51597,CPT,PEL EXNTJ COMPL MAL,,,21 ,,RBRVS,42.86 ,19.52 ,19.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51600,CPT,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,,,21 ,,RBRVS,0.88 ,0.33 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51605,CPT,NJX&PLMT CHAIN C+&/URETHROCSTOGRAPY,,,21 ,,RBRVS,0.64 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51610,CPT,NJX RTRGR URETHROCSTOGRAPY,,,21 ,,RBRVS,1.05 ,0.68 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51700,CPT,BLDR IRRIGATION SMPL LVG&/INSTLJ,,,21 ,,RBRVS,0.88 ,0.34 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51701,CPT,INSJ NON-NDWELLG BLDR CATH,,,21 ,,RBRVS,0.50 ,0.24 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51702,CPT,INSJ TEMP NDWELLG BLDR CATH SMPL,,,21 ,,RBRVS,0.50 ,0.32 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51703,CPT,INSJ TEMP NDWELLG BLDR CATH COMP,,,21 ,,RBRVS,1.47 ,0.76 ,2.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51705,CPT,CHNG CSTOST TUBE SMPL,,,21 ,,RBRVS,1.05 ,0.79 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51710,CPT,CHNG CSTOST TUBE COMP,,,21 ,,RBRVS,1.52 ,1.08 ,2.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51715,CPT,NDSC NJX IMPLT MATRL URT&/BLDR NCK,,,21 ,,RBRVS,3.73 ,1.69 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51720,CPT,BLDR INSTLJ ANTICARCINOGENIC AGT,,,21 ,,RBRVS,1.50 ,0.74 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51725,CPT,SMPL CSTOMETROGRAM,,,21 ,,RBRVS,1.51 ,4.31 ,4.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51725,CPT,SMPL CSTOMETROGRAM,26,,21 ,,RBRVS,1.51 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51725,CPT,SMPL CSTOMETROGRAM,TC,,21 ,,RBRVS,,3.74 ,3.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,,,21 ,,RBRVS,1.71 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,26,,21 ,,RBRVS,1.71 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,TC,,21 ,,RBRVS,,6.18 ,6.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,,,21 ,,RBRVS,2.11 ,5.78 ,5.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,26,,21 ,,RBRVS,2.11 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,TC,,21 ,,RBRVS,,5.03 ,5.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,,,21 ,,RBRVS,2.11 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,26,,21 ,,RBRVS,2.11 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,TC,,21 ,,RBRVS,,5.04 ,5.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,,,21 ,,RBRVS,2.51 ,6.08 ,6.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,26,,21 ,,RBRVS,2.51 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,TC,,21 ,,RBRVS,,5.19 ,5.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51736,CPT,SMPL UROFLOMETRY,,,21 ,,RBRVS,0.61 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51736,CPT,SMPL UROFLOMETRY,26,,21 ,,RBRVS,0.61 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51736,CPT,SMPL UROFLOMETRY,TC,,21 ,,RBRVS,,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51741,CPT,CPLX UROFLOMETRY,,,21 ,,RBRVS,1.14 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51741,CPT,CPLX UROFLOMETRY,26,,21 ,,RBRVS,1.14 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51741,CPT,CPLX UROFLOMETRY,TC,,21 ,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,,,21 ,,RBRVS,1.53 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,26,,21 ,,RBRVS,1.53 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,TC,,21 ,,RBRVS,,3.32 ,3.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,,,21 ,,RBRVS,1.53 ,4.38 ,4.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,26,,21 ,,RBRVS,1.53 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,TC,,21 ,,RBRVS,,3.80 ,3.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51792,CPT,STIMULUS EVOKED RSPSE,,,21 ,,RBRVS,1.10 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51792,CPT,STIMULUS EVOKED RSPSE,26,,21 ,,RBRVS,1.10 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51792,CPT,STIMULUS EVOKED RSPSE,TC,,21 ,,RBRVS,,4.56 ,4.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,,,21 ,,RBRVS,0.80 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,26,,21 ,,RBRVS,0.80 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,TC,,21 ,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51798,CPT,MEAS POST-VOIDING RESIDUAL URINE&/BLDR CAP,,,21 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,51800,CPT,CSTOPLASTY/CSTOURTP PLSTC ANY,,,21 ,,RBRVS,18.89 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51820,CPT,CSTOURTP W/UNI/BI URTRONEOCSTOST,,,21 ,,RBRVS,19.59 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51840,CPT,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,,,21 ,,RBRVS,11.36 ,5.98 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51841,CPT,ANT VESICOURETHROPEXY/URETHROPEXY COMP,,,21 ,,RBRVS,13.68 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51845,CPT,ABDOMINO-VAG VESICAL NCK SSP +-NDSC CTRL,,,21 ,,RBRVS,10.15 ,5.67 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51860,CPT,CSTORR SUTR BLDR WND INJ/RPT SMPL,,,21 ,,RBRVS,12.60 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51865,CPT,CSTORR SUTR BLDR WND INJ/RPT COMP,,,21 ,,RBRVS,15.80 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51880,CPT,CLSR CSTOST SPX,,,21 ,,RBRVS,7.87 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51900,CPT,CLSR VESICOVAG FSTL ABDL APPR,,,21 ,,RBRVS,14.63 ,7.63 ,7.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51920,CPT,CLSR VESICOUTERINE FSTL,,,21 ,,RBRVS,13.41 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51925,CPT,CLSR VESICOUTERINE FSTL W/HYST,,,21 ,,RBRVS,17.53 ,9.08 ,9.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51940,CPT,CLSR EXSTROPHY BLDR,,,21 ,,RBRVS,30.66 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51960,CPT,ENTEROCSTOPLASTY W/INTSTINAL ANAST,,,21 ,,RBRVS,25.40 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51980,CPT,CUTAN VESICOSTOMY,,,21 ,,RBRVS,12.57 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51990,CPT,LAPS SURG URTL SSP F/STRS INCONT,,,21 ,,RBRVS,13.36 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51992,CPT,LAPS SURG SLING OPRATION F/STRS INCONT,,,21 ,,RBRVS,14.87 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,51999,CPT,UNLIS LAPS PX BLDR,,,21 ,,TotalUnits,,,,21.80 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,52000,CPT,"SCOPE OF BLADDER AND URETHRA, FOR DIAGNOSIS",,,21 ,,RBRVS,2.23 ,1.20 ,3.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52001,CPT,CSTO W/IRRG&EVAC MLT OBSTRUCTING CLOTS,,,21 ,,RBRVS,5.44 ,2.47 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52005,CPT,"SCOPE BLADDER, INSERT TUBE FOR INJECTION",,,21 ,,RBRVS,2.37 ,1.28 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52007,CPT,CSTO W/URTRL CATHJ BRUSH BX URTR&/RNL PELVIS,,,21 ,,RBRVS,3.02 ,1.54 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52010,CPT,CSTO W/EJACULATORY DUX CATHJ,,,21 ,,RBRVS,3.02 ,1.43 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52204,CPT,"SCOPE BLADDER AND URETHRA, WITH BIOPSY",,,21 ,,RBRVS,2.59 ,1.29 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52214,CPT,"SCOPE BLADDER, DESTRUCTION OF LESIONS",,,21 ,,RBRVS,3.70 ,2.17 ,12.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52224,CPT,"SCOPE BLADDER, REMOVAL OF LESIONS, SMALL",,,21 ,,RBRVS,3.14 ,1.52 ,18.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52234,CPT,"SCOPE BLADDER, REMOVAL OF TUMORS,SMALL",,,21 ,,RBRVS,4.62 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52235,CPT,"SCOPE BLADDER, REMOVAL OF TUMORS, MEDIUM",,,21 ,,RBRVS,5.44 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52240,CPT,"SCOPE BLADDER, REMOVAL OF TUMORS, LARGE",,,21 ,,RBRVS,9.71 ,4.20 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52250,CPT,CSTO INSJ RADACT SBST +-BX/FULG,,,21 ,,RBRVS,4.49 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52260,CPT,"SCOPE BLADDER, OPENING OF BLADDER",,,21 ,,RBRVS,3.91 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52265,CPT,CSTO DILAT BLDR F/NTRSTL CSTITIS LOCAL ANES,,,21 ,,RBRVS,2.94 ,1.43 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52270,CPT,CSTO INT URETHROTOMY FEMALE,,,21 ,,RBRVS,3.36 ,1.65 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52275,CPT,CSTO INT URETHROTOMY MALE,,,21 ,,RBRVS,4.69 ,2.17 ,10.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52276,CPT,CSTO DIR VIS INT URETHROTOMY,,,21 ,,RBRVS,4.99 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52277,CPT,CSTO RESCJ XTRNL SPHNCTR,,,21 ,,RBRVS,6.16 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52281,CPT,CSTO CALIBRATION DILAT URTL STRIX/STENOSIS,,,21 ,,RBRVS,2.80 ,1.45 ,5.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52282,CPT,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,,,21 ,,RBRVS,6.39 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52283,CPT,CSTO STRD NJX IN STRIX,,,21 ,,RBRVS,3.73 ,1.80 ,3.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52285,CPT,"SCOPE BLADDER, OPEN NARROWED FEMALE URETHRA",,,21 ,,RBRVS,3.60 ,1.75 ,4.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52290,CPT,CSTO URTRL MEATOTOMY UNI/BI,,,21 ,,RBRVS,4.58 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52300,CPT,CSTO ORTHOTOPIC URTROCELE UNI/BI,,,21 ,,RBRVS,5.30 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52301,CPT,CSTO ECTOPIC URTROCELE UNI/BI,,,21 ,,RBRVS,5.50 ,2.59 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52305,CPT,CSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,,,21 ,,RBRVS,5.30 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52310,CPT,"SCOPE BLADDER, SIMPLE REMOVAL STONE, STENT",,,21 ,,RBRVS,2.81 ,1.36 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52315,CPT,"SCOPE BLADDER, COMPLEX REMOVAL STONE, STENT",,,21 ,,RBRVS,5.20 ,2.38 ,6.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52317,CPT,LITHOLAPAXY SMPL/SM < 2.5 CM,,,21 ,,RBRVS,6.71 ,2.90 ,18.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52318,CPT,LITHOLAPAXY COMP/LG > 2.5 CM,,,21 ,,RBRVS,9.18 ,3.92 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52320,CPT,CSTO RMVL URTRL ST1,,,21 ,,RBRVS,4.69 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52325,CPT,CSTO FRAGMENTATION URTRL ST1,,,21 ,,RBRVS,6.15 ,2.70 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52327,CPT,CSTO W/SUBURTRIC NJX IMPLT MATRL,,,21 ,,RBRVS,5.18 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52330,CPT,CSTO MNPJ W/O RMVL URTRL ST1,,,21 ,,RBRVS,5.03 ,2.25 ,14.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52332,CPT,"SCOPE BLADDER & URETER, INSERT STENT INTO URETER",,,21 ,,RBRVS,2.83 ,1.46 ,10.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52334,CPT,CSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,,,21 ,,RBRVS,4.82 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52341,CPT,CSTO W/TX URTRL STRIX,,,21 ,,RBRVS,5.35 ,2.66 ,2.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52342,CPT,CSTO W/TX URTROPEL JUNCT STRIX,,,21 ,,RBRVS,5.85 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52343,CPT,CSTO W/TX INTRA-RNL STRIX,,,21 ,,RBRVS,6.55 ,3.14 ,3.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52344,CPT,CSTO W/URTROSCOPY W/TX URTRL STRIX,,,21 ,,RBRVS,7.05 ,3.46 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52345,CPT,CSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,,,21 ,,RBRVS,7.55 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52346,CPT,CSTO W/URTROSCOPY W/TX INTRA-RNL STRIX,,,21 ,,RBRVS,8.58 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52351,CPT,CSTO W/URTROSCOPY&/PYELOSCOPY DX,,,21 ,,RBRVS,5.85 ,2.81 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52352,CPT,"SCOPE BLADDER & URETER, REMOVE OR MOVE STONES",,,21 ,,RBRVS,6.87 ,3.30 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52353,CPT,"SCOPE BLADDER & URETER, BREAK UP KIDNEY STONE",,,21 ,,RBRVS,7.96 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52354,CPT,CSTO/PYELOSCOPY BX&/FULG PEL LES,,,21 ,,RBRVS,7.33 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52355,CPT,CSTO/PYELOSCOPY RESCJ PEL TUM,,,21 ,,RBRVS,8.81 ,4.07 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52400,CPT,CSTO INC FULG/RESCJ URTL VALVES/FOLDS,,,21 ,,RBRVS,8.69 ,4.28 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52402,CPT,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,,,21 ,,RBRVS,5.27 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52450,CPT,TRURL INC PRST8,,,21 ,,RBRVS,7.78 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52500,CPT,SURGERY ON BLADDER NECK THROUGH URETHRA,,,21 ,,RBRVS,8.14 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52601,CPT,TRURL ELECTROSURG RESCJ PRST8 CTRL BLD COMPL,,,21 ,,RBRVS,15.26 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52630,CPT,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRST8 TISSUE,,,21 ,,RBRVS,7.73 ,4.42 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52640,CPT,OPENING OF POSTOPERATIVE BLADDER NECK NARROWING,,,21 ,,RBRVS,4.79 ,3.39 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52647,CPT,LASER COAGULATION OF PROSTATE FOR URINE FLOW,,,21 ,,RBRVS,11.30 ,6.41 ,45.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52648,CPT,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,,,21 ,,RBRVS,12.15 ,6.73 ,46.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52649,CPT,LASER ENUCLEATION PROSTATE W MORCELLATION,,,21 ,,RBRVS,17.29 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,52700,CPT,TRURL DRG PROSTATIC ABSC,,,21 ,,RBRVS,7.49 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53000,CPT,URTT/URTS XTRNL SPX PENDULOUS URT,,,21 ,,RBRVS,2.33 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53010,CPT,URTT/URTS XTRNL SPX PRNL URT XTRNL,,,21 ,,RBRVS,4.45 ,3.60 ,3.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53020,CPT,MEATOTOMY CUTTING MEATUS SPX XCP INFT,,,21 ,,RBRVS,1.77 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53025,CPT,MEATOTOMY CUTTING MEATUS SPX INFT,,,21 ,,RBRVS,1.13 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53040,CPT,DRG DP PRIURTL ABSC,,,21 ,,RBRVS,6.55 ,4.16 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53060,CPT,DRG OF SKENE'S GLAND ABSC OR CYST,,,21 ,,RBRVS,2.68 ,1.52 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53080,CPT,DRG PRNL UR XTRVASATION UNCOMP SPX,,,21 ,,RBRVS,6.92 ,4.87 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53085,CPT,DRG PRNL UR XTRVASATION COMP,,,21 ,,RBRVS,11.18 ,5.69 ,5.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53200,CPT,BX URT,,,21 ,,RBRVS,2.59 ,1.25 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53210,CPT,URETHRECTOMY TOT W/CSTOST FEMALE,,,21 ,,RBRVS,13.72 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53215,CPT,URETHRECTOMY TOT W/CSTOST MALE,,,21 ,,RBRVS,16.85 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53220,CPT,EXC/FULGURATION CARC URT,,,21 ,,RBRVS,7.63 ,4.73 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53230,CPT,EXC URTL DIVERTICULUM SPX FEMALE,,,21 ,,RBRVS,10.44 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53235,CPT,EXC URTL DIVERTICULUM SPX MALE,,,21 ,,RBRVS,10.99 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53240,CPT,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,,,21 ,,RBRVS,7.08 ,4.62 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53250,CPT,EXC OF BULBOURTL GLAND,,,21 ,,RBRVS,6.52 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53260,CPT,EXC/FULGURATION URTL POLYP DSTL URT,,,21 ,,RBRVS,3.03 ,1.76 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53265,CPT,EXC/FULGURATION URTL CARUNCLE,,,21 ,,RBRVS,3.17 ,1.86 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53270,CPT,EXC OR FULGURATION SKENE'S GLANDS,,,21 ,,RBRVS,3.14 ,1.79 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53275,CPT,EXC/FULGURATION URTL PROLAPSE,,,21 ,,RBRVS,4.57 ,2.66 ,2.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53400,CPT,URTP 1ST STG F/FSTL DIVERTICULUM/STRIX,,,21 ,,RBRVS,14.13 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53405,CPT,URTP 2ND STG W/UR DVRJ,,,21 ,,RBRVS,15.66 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53410,CPT,URTP ONE-STG RCNSTJ MALE ANT URT,,,21 ,,RBRVS,17.68 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53415,CPT,URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT,,,21 ,,RBRVS,20.70 ,10.29 ,10.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53420,CPT,URTP 2-STG RCNSTJ/RPR URT 1ST STG,,,21 ,,RBRVS,15.17 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53425,CPT,URTP 2-STG RCNSTJ/RPR URT 2ND STG,,,21 ,,RBRVS,17.07 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53430,CPT,URTP RCNSTJ FEMALE URT,,,21 ,,RBRVS,17.43 ,8.52 ,8.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53431,CPT,URTP W/TUBULARIZATION POST URT&/LWR BLDR,,,21 ,,RBRVS,21.18 ,10.46 ,10.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53440,CPT,SLING OPRATION CORRJ MALE UR INCONT,,,21 ,,RBRVS,15.54 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53442,CPT,RMVL/REVJ SLING MALE UR INCONT,,,21 ,,RBRVS,13.49 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53444,CPT,INSJ TANDEM CUFF,,,21 ,,RBRVS,14.19 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53445,CPT,INSJ NFLTBL URTL/BLDR NCK SPHNCTR,,,21 ,,RBRVS,15.39 ,8.75 ,8.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53446,CPT,RMVL NFLTBL URTL/BLDR NCK SPHNCTR,,,21 ,,RBRVS,11.02 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53447,CPT,RMVL&RPLCMT NFLTBL NCK SPHNCTR SM SESS,,,21 ,,RBRVS,14.28 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53448,CPT,RMVL&RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD,,,21 ,,RBRVS,23.44 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53449,CPT,RPR NFLTBL URTL/BLDR NCK SPHNCTR,,,21 ,,RBRVS,10.56 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53450,CPT,URETHROMEATOPLASTY W/MUCOSAL ADVMNT,,,21 ,,RBRVS,6.77 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53460,CPT,URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM,,,21 ,,RBRVS,7.75 ,4.81 ,4.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53500,CPT,URETHROLSS TRVG SEC OPN W/CSTO,,,21 ,,RBRVS,13.00 ,7.19 ,7.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53502,CPT,URTORR SUTR URTL WND/INJ FEMALE,,,21 ,,RBRVS,8.26 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53505,CPT,URTORR SUTR URTL WND/INJ PEN,,,21 ,,RBRVS,8.26 ,5.07 ,5.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53510,CPT,URTORR SUTR URTL WND/INJ PRNL,,,21 ,,RBRVS,10.96 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53515,CPT,URTORR SUTR URTL WND/INJ PROSTATOMEMBRANOUS,,,21 ,,RBRVS,14.22 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53520,CPT,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,,,21 ,,RBRVS,9.48 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53600,CPT,DILAT URTL STRIX DILATOR MALE 1ST,,,21 ,,RBRVS,1.21 ,0.55 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53601,CPT,DILAT URTL STRIX DILATOR MALE SBSQ,,,21 ,,RBRVS,0.98 ,0.50 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53605,CPT,DILAT URTL STRIX/VESICAL NCK DILATOR MALE ANES,,,21 ,,RBRVS,1.28 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53620,CPT,DILAT URTL STRIX FILIFORM&FOLLWR MALE 1ST,,,21 ,,RBRVS,1.62 ,0.79 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53621,CPT,DILAT URTL STRIX FILIFORM&FOLLWR MALE SBSQ,,,21 ,,RBRVS,1.35 ,0.64 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53660,CPT,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ 1ST,,,21 ,,RBRVS,0.71 ,0.42 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53661,CPT,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,,,21 ,,RBRVS,0.72 ,0.39 ,1.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53665,CPT,DILAT FEMALE URT GENERAL/CNDJ SPI ANES,,,21 ,,RBRVS,0.76 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53850,CPT,TRURL DSTRJ PRST8 TISS MICROWAVE THERMOTH,,,21 ,,RBRVS,10.08 ,5.49 ,55.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53852,CPT,TRURL DSTRJ PRST8 TISS RF THERMOTH,,,21 ,,RBRVS,10.83 ,6.18 ,51.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53855,CPT,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,,,21 ,,RBRVS,1.64 ,0.54 ,16.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53860,CPT,TRANSURETHRAL RF TREATMENT,,,21 ,,RBRVS,3.97 ,38.52 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,53899,CPT,UNLIS PX UR SYS,,,21 ,,TotalUnits,,,,2.90 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,54000,CPT,SLITTING PREPUCE DORSAL/LAT SPX NB,,,21 ,,RBRVS,1.59 ,1.35 ,2.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54001,CPT,SLITTING PREPUCE DORSAL/LAT SPX XCP NB,,,21 ,,RBRVS,2.24 ,1.53 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54015,CPT,I&D PNS DP,,,21 ,,RBRVS,5.36 ,3.10 ,3.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54050,CPT,DSTRJ LES PNS SMPL CHEM,,,21 ,,RBRVS,1.29 ,1.36 ,2.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54055,CPT,DSTRJ LES PNS SMPL ELTRDSICCATION,,,21 ,,RBRVS,1.25 ,1.16 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54056,CPT,DSTRJ LES PNS SMPL CRYOSURG,,,21 ,,RBRVS,1.29 ,1.48 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54057,CPT,DSTRJ LES PNS SMPL LASER SURG,,,21 ,,RBRVS,1.29 ,1.23 ,2.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54060,CPT,DSTRJ LES PNS SMPL SURG EXC,,,21 ,,RBRVS,1.98 ,1.51 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54065,CPT,DSTRJ LES PNS X10SV,,,21 ,,RBRVS,2.47 ,1.90 ,3.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54100,CPT,BX PNS SPX,,,21 ,,RBRVS,1.90 ,1.31 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54105,CPT,BX PNS DP STRUXS,,,21 ,,RBRVS,3.54 ,2.33 ,3.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54110,CPT,EXC PEN PLAQUE,,,21 ,,RBRVS,10.92 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54111,CPT,EXC PEN PLAQUE GRF 5 CM LENGTH,,,21 ,,RBRVS,14.42 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54112,CPT,EXC PEN PLAQUE GRF > 5 CM LENGTH,,,21 ,,RBRVS,16.98 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54115,CPT,RMVL FB FROM DP PEN TISS,,,21 ,,RBRVS,6.95 ,4.62 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54120,CPT,AMP PNS PRTL,,,21 ,,RBRVS,11.01 ,6.30 ,6.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54125,CPT,AMP PNS COMPL,,,21 ,,RBRVS,14.56 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54130,CPT,AMP PNS RAD W/BI INGUINOFEM LMPHADEC,,,21 ,,RBRVS,21.84 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54135,CPT,AMP PNS RAD BI PEL LMPHADEC,,,21 ,,RBRVS,28.17 ,13.45 ,13.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54150,CPT,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,,,21 ,,RBRVS,1.90 ,0.74 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54160,CPT,CIRCUMCISION NEONATE,,,21 ,,RBRVS,2.53 ,1.43 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54161,CPT,CIRCUMCISION >28 DAYS,,,21 ,,RBRVS,3.32 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54162,CPT,LSS/EXC PEN POST-CIRCUMCISION ADS,,,21 ,,RBRVS,3.32 ,2.08 ,4.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54163,CPT,RPR INCOMPL CIRCUMCISION,,,21 ,,RBRVS,3.32 ,2.65 ,2.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54164,CPT,FRENULOTOMY PNS,,,21 ,,RBRVS,2.82 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54200,CPT,NJX PEYRONIE,,,21 ,,RBRVS,1.11 ,1.20 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54205,CPT,NJX PEYRONIE EXPOS PLAQUE,,,21 ,,RBRVS,8.97 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54220,CPT,IRRG C/P/A CAVERNOSA F/PRIAPISM,,,21 ,,RBRVS,2.42 ,1.26 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54230,CPT,NJX F/C/P/A CAVERNOSOGRAPY,,,21 ,,RBRVS,1.34 ,0.85 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54231,CPT,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,,,21 ,,RBRVS,2.04 ,1.16 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54235,CPT,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,,,21 ,,RBRVS,1.19 ,0.82 ,1.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54240,CPT,PEN PLETHYSMOGRAPY,,,21 ,,RBRVS,1.31 ,1.42 ,1.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,54240,CPT,PEN PLETHYSMOGRAPY,26,,21 ,,RBRVS,1.31 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54240,CPT,PEN PLETHYSMOGRAPY,TC,,21 ,,RBRVS,,0.91 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,54250,CPT,NOCTURNAL PEN TUMESCENCE&/RGDITY TST,,,21 ,,RBRVS,2.22 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,54250,CPT,NOCTURNAL PEN TUMESCENCE&/RGDITY TST,26,,21 ,,RBRVS,2.22 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54250,CPT,NOCTURNAL PEN TUMESCENCE&/RGDITY TST,TC,,21 ,,RBRVS,,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,54300,CPT,PNS STRAIGHTENING CHORDEE,,,21 ,,RBRVS,11.20 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54304,CPT,PNS CORRJ CHORDEE 1ST STG HYPSPAD RPR,,,21 ,,RBRVS,13.28 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54308,CPT,URTP 2ND STG HYPSPAD RPR < 3 CM,,,21 ,,RBRVS,12.62 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54312,CPT,URTP 2ND STG HYPSPAD RPR > 3 CM,,,21 ,,RBRVS,14.51 ,8.17 ,8.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54316,CPT,URTP 2ND STG HYPSPAD RPR SKN GRF,,,21 ,,RBRVS,18.05 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54318,CPT,URTP 3RD STG HYPSPAD RPR RLS PNS,,,21 ,,RBRVS,12.43 ,7.34 ,7.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54322,CPT,1 STG DSTL HYPSPAD RPR W/SMPL MEATAL ADVMNT,,,21 ,,RBRVS,13.98 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54324,CPT,1 STG DSTL HYPSPAD RPR W/URTP SKN FLAPS,,,21 ,,RBRVS,17.55 ,9.31 ,9.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54326,CPT,1 STG DSTL HYPSPAD RPR URTP SKN FLAPS&MOBLJ,,,21 ,,RBRVS,17.02 ,8.42 ,8.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54328,CPT,1 STG DSTL HYPSPAD RPR W/X10SV DSJ,,,21 ,,RBRVS,16.89 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54332,CPT,1 STG PROX PEN/PENOSCROTAL HYPSPAD RPR,,,21 ,,RBRVS,18.37 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54336,CPT,1 STG PRNL HYPSPAD RPR REQ X10SV DSJ SKN GRF,,,21 ,,RBRVS,21.62 ,9.96 ,9.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54340,CPT,RPR HYPSPAD COMPLCTJS CLSR INC/EXC SMPL,,,21 ,,RBRVS,9.71 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54344,CPT,RPR HYPSPAD COMPLCTJS MOBLJ FLAPS&URTP,,,21 ,,RBRVS,17.06 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54348,CPT,RPR HYPSPAD COMPLCTJS X10SV DSJ&URTP FLAP/GRF,,,21 ,,RBRVS,18.32 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54352,CPT,RPR HYPSPAD CRIPPLE REQ X10SV DSJ&EXC,,,21 ,,RBRVS,26.13 ,13.14 ,13.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54360,CPT,PLSTC PNS CORRECT ANGULATION,,,21 ,,RBRVS,12.78 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54380,CPT,PLSTC PNS EPSPAD DSTL SPHNCTR,,,21 ,,RBRVS,14.18 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54385,CPT,PLSTC PNS EPSPAD DSTL SPHNCTR W/INCONT,,,21 ,,RBRVS,16.56 ,10.69 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54390,CPT,PLSTC PNS EPSPAD DSTL SPHNCTR W/EXSTROPHY BLDR,,,21 ,,RBRVS,22.77 ,9.97 ,9.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54400,CPT,INSJ PEN PROSTH NON-NFLTBL SEMI-RGD,,,21 ,,RBRVS,9.17 ,5.42 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54401,CPT,INSJ PEN PROSTH NFLTBL SELF-CONTAINED,,,21 ,,RBRVS,10.44 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54405,CPT,INSJ MULTI-COMPONENT NFLTBL PEN PROSTH,,,21 ,,RBRVS,14.52 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54406,CPT,RMVL NFLTBL PEN PROSTH W/O RPLCMT PROSTH,,,21 ,,RBRVS,12.89 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54408,CPT,RPR COMPONENT MULTI-COMPONENT NFLTBL PEN PROSTH,,,21 ,,RBRVS,13.91 ,7.75 ,7.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54410,CPT,RMVL&RPLCMT NFLTBL PEN PROSTH SM SESS,,,21 ,,RBRVS,15.18 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54411,CPT,RMVL&RPLCMT NFLTBL PEN PROSTH THRU INFCT FLD,,,21 ,,RBRVS,18.35 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54415,CPT,RMVL NON-NFLTBL/NFLTBL PEN PROSTH W/O RPLCMT,,,21 ,,RBRVS,8.88 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54416,CPT,RMVL&RPLCMT NON-NFLTBL/NFLTBL PROSTH SM SESS,,,21 ,,RBRVS,12.08 ,7.36 ,7.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54417,CPT,RMVL&RPLCMT NON-NFLTBL/NFLTBL PEN INFCT SM SESS,,,21 ,,RBRVS,16.10 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54420,CPT,C/P/A CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,,,21 ,,RBRVS,12.39 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54430,CPT,C/P/A CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,,,21 ,,RBRVS,11.06 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54435,CPT,C/P/A CAVERNOSA-GLANS PNS FSTLJ F/PRIAPISM,,,21 ,,RBRVS,6.81 ,4.64 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54440,CPT,PLSTC OPRATION PNS F/INJ,,,21 ,,TotalUnits,,,,17.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,54450,CPT,FORESKN MNPJ W/LSS PREPUTIAL ADS&STRETCHING,,,21 ,,RBRVS,1.12 ,0.48 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54500,CPT,BX TSTIS NDL SPX,,,21 ,,RBRVS,1.31 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54505,CPT,BX TSTIS INCAL SPX,,,21 ,,RBRVS,3.50 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54512,CPT,EXC XTRPARENCHYMAL LES TSTIS,,,21 ,,RBRVS,9.33 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54520,CPT,ORCHIECTOMY SMPL SCROTAL/INGUN APPR,,,21 ,,RBRVS,5.30 ,3.52 ,3.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54522,CPT,ORCHIECTOMY PRTL,,,21 ,,RBRVS,10.25 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54530,CPT,ORCHIECTOMY RAD TUM INGUN APPR,,,21 ,,RBRVS,8.46 ,5.38 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54535,CPT,ORCHIECTOMY RAD TUM W/ABDL EXPL,,,21 ,,RBRVS,13.19 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54550,CPT,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,,,21 ,,RBRVS,8.41 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54560,CPT,EXPL UNDESCENDED TSTIS W/ABDL EXPL,,,21 ,,RBRVS,12.10 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54600,CPT,RDCTJ TORSION TSTIS +-FIXJ CLAT TSTIS,,,21 ,,RBRVS,7.64 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54620,CPT,FIXJ CLAT TSTIS SPX,,,21 ,,RBRVS,5.21 ,3.06 ,3.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54640,CPT,ORCHIOPEXY INGUN APPR +-HRNA RPR,,,21 ,,RBRVS,7.73 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54650,CPT,ORCHIOPEXY ABDL APPR INTRA-ABDL TSTIS,,,21 ,,RBRVS,12.39 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54660,CPT,INSJ TSTICULAR PROSTH SPX,,,21 ,,RBRVS,5.74 ,3.99 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54670,CPT,SUTR/RPR TSTICULAR INJ,,,21 ,,RBRVS,6.65 ,4.41 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54680,CPT,TRNSPLJ TSTIS THI,,,21 ,,RBRVS,14.04 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54690,CPT,LAPS ORCHIECTOMY,,,21 ,,RBRVS,11.70 ,5.93 ,5.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54692,CPT,LAPS ORCHIOPEXY F/INTRA-ABDL TSTIS,,,21 ,,RBRVS,13.74 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54699,CPT,UNLIS LAPS PX TSTIS,,,21 ,,TotalUnits,,,,20.90 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,54700,CPT,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,,,21 ,,RBRVS,3.47 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54800,CPT,BX EPIDIDYMIS NDL,,,21 ,,RBRVS,2.33 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54830,CPT,EXC LOCAL LES EPIDIDYMIS,,,21 ,,RBRVS,6.01 ,4.12 ,4.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54840,CPT,EXC SPRMATOCELE +-EPIDIDYMECTOMY,,,21 ,,RBRVS,5.27 ,3.55 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54860,CPT,EPIDIDYMECTOMY UNI,,,21 ,,RBRVS,6.95 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54861,CPT,EPIDIDYMECTOMY BI,,,21 ,,RBRVS,9.70 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54865,CPT,EXPLORATION EPIDIDYMIS W/WO BIOPSY,,,21 ,,RBRVS,5.77 ,4.00 ,4.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54900,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,,,21 ,,RBRVS,14.20 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,54901,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,,,21 ,,RBRVS,19.10 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55000,CPT,PNXR ASPIR HYDROCELE TUNICA VAGIS +-NJX MED,,,21 ,,RBRVS,1.43 ,0.87 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55040,CPT,EXC HYDROCELE UNI,,,21 ,,RBRVS,5.45 ,3.72 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55041,CPT,EXC HYDROCELE BI,,,21 ,,RBRVS,8.54 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55060,CPT,RPR TUNICA VAGIS HYDROCELE BOTTLE TYP,,,21 ,,RBRVS,6.15 ,4.16 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55100,CPT,DRG SCROTAL WALL ABSC,,,21 ,,RBRVS,2.45 ,1.97 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55110,CPT,SCROTAL EXPL,,,21 ,,RBRVS,6.33 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55120,CPT,RMVL FB SCROTUM,,,21 ,,RBRVS,5.72 ,3.94 ,3.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55150,CPT,RESCJ SCROTUM,,,21 ,,RBRVS,8.14 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55175,CPT,SCROTOPLASTY SMPL,,,21 ,,RBRVS,5.87 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55180,CPT,SCROTOPLASTY COMP,,,21 ,,RBRVS,11.78 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55200,CPT,VASOTOMY CANNULIZATION +-INC VAS UNI/BI SPX,,,21 ,,RBRVS,4.55 ,2.99 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55250,CPT,VASECT UNI/BI SPX W/PO SEMEN XM,,,21 ,,RBRVS,3.37 ,2.82 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55300,CPT,VASOTOMY VASOGRAMS UNI/BI,,,21 ,,RBRVS,3.50 ,1.46 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55400,CPT,VASOVASOSTOMY VASOVASORRHAPHY,,,21 ,,RBRVS,8.61 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55450,CPT,LIG PRQ VAS DEFERENS UNI/BI SPX,,,21 ,,RBRVS,4.43 ,2.56 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55500,CPT,EXC HYDROCELE SPRMATIC CORD UNI SPX,,,21 ,,RBRVS,6.22 ,4.05 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55520,CPT,EXC LES SPRMATIC CORD SPX,,,21 ,,RBRVS,6.66 ,4.01 ,4.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55530,CPT,EXC VARICOCELE/LIG SPRMATIC VEINS SPX,,,21 ,,RBRVS,5.75 ,3.86 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55535,CPT,EXC VARICOCELE/LIG SPRMATIC VEINS ABDL,,,21 ,,RBRVS,7.19 ,4.51 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55540,CPT,EXC VARICOCELE/LIG VEINS W/HRNA RPR,,,21 ,,RBRVS,8.30 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55550,CPT,LAPS LIG SPRMATIC VEINS VARICOCELE,,,21 ,,RBRVS,7.20 ,4.35 ,4.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55559,CPT,UNLIS LAPS SPRMATIC CORD,,,21 ,,TotalUnits,,,,11.55 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,55600,CPT,VESICULOTOMY,,,21 ,,RBRVS,7.01 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55605,CPT,VESICULOTOMY COMP,,,21 ,,RBRVS,8.76 ,5.08 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55650,CPT,VESICULECTOMY ANY APPR,,,21 ,,RBRVS,12.65 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55680,CPT,EXC MULLERIAN DUX CST,,,21 ,,RBRVS,5.67 ,3.60 ,3.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55700,CPT,"PROSTATE NEEDLE BIOPSY, ANY APPROACH",,,21 ,,RBRVS,2.58 ,1.20 ,3.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55705,CPT,BX PRST8 INCAL ANY APPR,,,21 ,,RBRVS,4.61 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55706,CPT,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,,,21 ,,RBRVS,6.28 ,4.21 ,4.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55720,CPT,PROSTATOTOMY XTRNL DRG ABSC SMPL,,,21 ,,RBRVS,7.73 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55725,CPT,PROSTATOTOMY XTRNL DRG ABSC COMP,,,21 ,,RBRVS,10.05 ,6.07 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55801,CPT,PRST8ECT PRNL STOT,,,21 ,,RBRVS,19.80 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55810,CPT,PRST8ECT PRNL RAD,,,21 ,,RBRVS,24.29 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55812,CPT,PRST8ECT PRNL RAD LYMPH NODE BX,,,21 ,,RBRVS,29.89 ,14.28 ,14.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55815,CPT,PRST8ECT PRNL RAD BI PEL LMPHADEC,,,21 ,,RBRVS,32.95 ,15.52 ,15.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55821,CPT,PRST8ECT SUPRAPUBIC STOT 1/2 STGS,,,21 ,,RBRVS,15.76 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55831,CPT,PRST8ECT RETROPUBIC STOT,,,21 ,,RBRVS,17.19 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55840,CPT,PRST8ECT RETROPUBIC RAD +-NRV SPARING,,,21 ,,RBRVS,24.63 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55842,CPT,PRST8ECT RETROPUBIC RAD LYMPH NODE BX,,,21 ,,RBRVS,26.49 ,12.87 ,12.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55845,CPT,PRST8ECT RETROPUBIC RAD W/BI PEL LMPHADEC,,,21 ,,RBRVS,30.67 ,14.28 ,14.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55860,CPT,EXPOS PRST8 ANY APPR INSJ RADACT SBST,,,21 ,,RBRVS,15.84 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55862,CPT,EXPOS PRST8 INSJ RADACT NODE BX,,,21 ,,RBRVS,20.04 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55865,CPT,EXPOS PRST8 INSJ RADACT BI PEL LMPHADEC,,,21 ,,RBRVS,24.57 ,12.16 ,12.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55866,CPT,LAPS PRST8ECT RETROPUBIC RAD W/NRV SPARING,,,21 ,,RBRVS,32.46 ,15.35 ,15.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55870,CPT,ELECTROEJACULATION,,,21 ,,RBRVS,2.58 ,1.36 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55873,CPT,CRYOSURG ABLATION PROSTATE US & MONITORING,,,21 ,,RBRVS,13.60 ,10.13 ,146.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55875,CPT,TPRNL PLMT NDL/CATHS INTO PRST8 RADJ INSJ,,,21 ,,RBRVS,13.46 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55876,CPT,PLACE INTSTITL DEV RADIATN TX PERQ PROSTATE 1+,,,21 ,,RBRVS,1.73 ,1.07 ,2.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,55899,CPT,UNLIS MALE GEN SYS,,,21 ,,TotalUnits,,,,5.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,55920,CPT,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,,,21 ,,RBRVS,8.31 ,3.55 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56405,CPT,I&D VULVA/PRNL ABSC,,,21 ,,RBRVS,1.49 ,1.20 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56420,CPT,I&D OF BARTHOLIN'S GLAND ABSC,,,21 ,,RBRVS,1.44 ,0.88 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56440,CPT,MARSUPIALIZATION BARTHOLIN'S GLAND CYST,,,21 ,,RBRVS,2.89 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56441,CPT,LSS LABIAL ADS,,,21 ,,RBRVS,2.02 ,1.55 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56442,CPT,HYMENOTOMY SIMPLE INCISION,,,21 ,,RBRVS,0.68 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56501,CPT,DSTRJ LES VULVA SMPL,,,21 ,,RBRVS,1.58 ,1.28 ,1.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56515,CPT,DSTRJ LES VULVA X10SV,,,21 ,,RBRVS,3.08 ,1.88 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56605,CPT,BX VULVA/PR SPX 1 LES,,,21 ,,RBRVS,1.10 ,0.41 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56606,CPT,BX VULVA/PR SPX EA SEP ADDL LES,,,21 ,,RBRVS,0.55 ,0.19 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56620,CPT,VULVECTOMY SMPL PRTL,,,21 ,,RBRVS,7.53 ,4.94 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56625,CPT,VULVECTOMY SMPL COMPL,,,21 ,,RBRVS,9.68 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56630,CPT,VULVECTOMY RAD PRTL,,,21 ,,RBRVS,14.80 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56631,CPT,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADEC,,,21 ,,RBRVS,18.99 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56632,CPT,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADEC,,,21 ,,RBRVS,21.86 ,10.32 ,10.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56633,CPT,VULVECTOMY RAD COMPL,,,21 ,,RBRVS,19.62 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56634,CPT,VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADEC,,,21 ,,RBRVS,20.66 ,9.40 ,9.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56637,CPT,VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADEC,,,21 ,,RBRVS,24.75 ,10.64 ,10.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56640,CPT,VULVECTOMY RAD COMPL ILIAC&PEL LMPHADEC,,,21 ,,RBRVS,24.78 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56700,CPT,PRTL HYMENECTOMY/REVJ HYMENAL RING,,,21 ,,RBRVS,2.84 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56740,CPT,EXC BARTHOLIN'S GLAND OR CYST,,,21 ,,RBRVS,4.88 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56800,CPT,PLSTC RPR INTROITUS,,,21 ,,RBRVS,3.93 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56805,CPT,CLITOROPLASTY F/INTERSEX STATE,,,21 ,,RBRVS,19.88 ,8.82 ,8.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56810,CPT,PRINEOPLASTY RPR PR NONOBAL SPX,,,21 ,,RBRVS,4.29 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56820,CPT,COLPOSCOPY VULVA,,,21 ,,RBRVS,1.50 ,0.62 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,56821,CPT,COLPOSCOPY VULVA W/BX,,,21 ,,RBRVS,2.05 ,0.81 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57000,CPT,COLPOTOMY W/EXPL,,,21 ,,RBRVS,3.02 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57010,CPT,COLPOTOMY W/DRG PEL ABSC,,,21 ,,RBRVS,6.84 ,4.00 ,4.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57020,CPT,COLPOCNTS SPX,,,21 ,,RBRVS,1.50 ,0.53 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57022,CPT,I&D VAG HMTMA OBAL/POSTPARTUM,,,21 ,,RBRVS,2.73 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57023,CPT,I&D VAG HMTMA NON-OBAL,,,21 ,,RBRVS,5.18 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57061,CPT,DSTRJ VAG LES SMPL,,,21 ,,RBRVS,1.30 ,1.15 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57065,CPT,DSTRJ VAG LES X10SV,,,21 ,,RBRVS,2.66 ,1.62 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57100,CPT,BX VAG MUCOSA SMPL SPX,,,21 ,,RBRVS,1.20 ,0.44 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57105,CPT,BX VAG MUCOSA X10SV REQ SUTR,,,21 ,,RBRVS,1.74 ,1.40 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57106,CPT,VAGNC PRTL RMVL VAG WALL,,,21 ,,RBRVS,7.50 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57107,CPT,VAGNC PRTL RMVL VAG WALL PARAVAG TISS,,,21 ,,RBRVS,24.56 ,10.40 ,10.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57109,CPT,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,,,21 ,,RBRVS,28.40 ,11.65 ,11.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57110,CPT,VAGNC COMPL RMVL VAG WALL,,,21 ,,RBRVS,15.48 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57111,CPT,VAGNC COMPL RMVL VAG WALL PARAVAG TISS,,,21 ,,RBRVS,28.40 ,12.01 ,12.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57112,CPT,VAGNC COMPL RMVL VAG WALL TOT PEL LMPHADEC BX,,,21 ,,RBRVS,30.52 ,12.61 ,12.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57120,CPT,COLPOCLEISIS LE FORT TYP,,,21 ,,RBRVS,8.28 ,4.56 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57130,CPT,EXC VAG SEPTUM,,,21 ,,RBRVS,2.46 ,1.56 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57135,CPT,EXC VAG CST/TUM,,,21 ,,RBRVS,2.70 ,1.64 ,2.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57150,CPT,IRRG VAG&/APPL MEDICAMENT DISEASE,,,21 ,,RBRVS,0.55 ,0.19 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57155,CPT,INSJ UTERINE TANDEMS&/VAG OVOIDS,,,21 ,,RBRVS,6.87 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57156,CPT,INS VAG BRACHYTX DEVICE,,,21 ,,RBRVS,1.87 ,2.41 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57160,CPT,FITG&INSJ PESSARY/OTH INTRAVAG SUPPORT DEV,,,21 ,,RBRVS,0.89 ,0.31 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57170,CPT,DPHRM/CRV CAP FITG W/INSTRUCTIONS,,,21 ,,RBRVS,0.91 ,0.30 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57180,CPT,INTRO ANY HEMOSTATIC AGT/PACK VAG HEMRRG SPX,,,21 ,,RBRVS,1.63 ,1.05 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57200,CPT,COLPORRHAPHY SUTR INJ VAG,,,21 ,,RBRVS,4.42 ,3.07 ,3.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57210,CPT,COLPOPRINEORRHAPHY SUTR INJ VAG&/PR,,,21 ,,RBRVS,5.71 ,3.51 ,3.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57220,CPT,PLSTC URTL SPHNCTR VAG APPR,,,21 ,,RBRVS,4.85 ,3.20 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57230,CPT,PLSTC RPR URETHROCELE,,,21 ,,RBRVS,6.30 ,3.78 ,3.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57240,CPT,ANT COLPORRHAPHY RPR CSTOCELE +-RPR URETHROCELE,,,21 ,,RBRVS,11.50 ,5.46 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57250,CPT,POST COLPORRHAPHY RPR RECTOCELE +-PRINEORRHAPHY,,,21 ,,RBRVS,11.50 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57260,CPT,CMBN ANTEROPOST COLPORRHAPHY,,,21 ,,RBRVS,14.44 ,6.21 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57265,CPT,CMBN ANTEROPOST COLPORRHAPHY W/NTRCL RPR,,,21 ,,RBRVS,15.94 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57267,CPT,INSJ MESH/PROSTH PEL FLOOR DFCT EA SIT,,,21 ,,RBRVS,4.88 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57268,CPT,RPR NTRCL VAG APPR SPX,,,21 ,,RBRVS,7.57 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57270,CPT,RPR NTRCL ABDL APPR SPX,,,21 ,,RBRVS,13.67 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57280,CPT,COLPOPEXY ABDL APPR,,,21 ,,RBRVS,16.72 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57282,CPT,COLPOPEXY VAG XTR-PRTL APPR,,,21 ,,RBRVS,7.97 ,4.75 ,4.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57283,CPT,COLPOPEXY VAG INTRA-PRTL APPR,,,21 ,,RBRVS,11.66 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57284,CPT,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,,,21 ,,RBRVS,14.33 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57285,CPT,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,,,21 ,,RBRVS,11.60 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57287,CPT,RMVL/REVJ SLING F/STRS INCONT,,,21 ,,RBRVS,11.15 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57288,CPT,SLING OPRATION F/STRS INCONT,,,21 ,,RBRVS,12.13 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57289,CPT,PREYRA PX W/ANT COLPORRHAPHY,,,21 ,,RBRVS,12.80 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57291,CPT,CONSTJ ARTIF VAG W/O GRF,,,21 ,,RBRVS,8.64 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57292,CPT,CONSTJ ARTIF VAG W/GRF,,,21 ,,RBRVS,14.01 ,6.74 ,6.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57295,CPT,REVJ RMVL PROSTC VAG GRF VAG APPR,,,21 ,,RBRVS,7.82 ,4.47 ,4.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57296,CPT,REVJ W/RMVL PROSTHETIC VAG GRF ABD APPRO,,,21 ,,RBRVS,16.56 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57300,CPT,CLSR RECTOVAG FSTL VAG/TRANSANAL APPR,,,21 ,,RBRVS,8.71 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57305,CPT,CLSR RECTOVAG FSTL ABDL APPR,,,21 ,,RBRVS,15.35 ,6.96 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57307,CPT,CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST,,,21 ,,RBRVS,17.17 ,7.84 ,7.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57308,CPT,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,,,21 ,,RBRVS,10.59 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57310,CPT,CLSR URETHROVAG FSTL,,,21 ,,RBRVS,7.65 ,4.78 ,4.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57311,CPT,CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL,,,21 ,,RBRVS,8.91 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57320,CPT,CLSR VESICOVAG FSTL VAG APPR,,,21 ,,RBRVS,8.88 ,5.25 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57330,CPT,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,,,21 ,,RBRVS,13.21 ,6.71 ,6.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57335,CPT,VAGINOPLASTY F/INTERSEX STATE,,,21 ,,RBRVS,20.02 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57400,CPT,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,,,21 ,,RBRVS,2.27 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57410,CPT,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,,,21 ,,RBRVS,1.75 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57415,CPT,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,,,21 ,,RBRVS,2.49 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57420,CPT,COLPOSCOPY ENTIRE VAG W/CERVIX IF PRESENT,,,21 ,,RBRVS,1.60 ,0.65 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57421,CPT,COLPOSCOPY ENTIRE VAG W/CERVIX BX,,,21 ,,RBRVS,2.20 ,0.86 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57423,CPT,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,,,21 ,,RBRVS,16.08 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57425,CPT,LAPS SURG COLPOPEXY SSP VAG APEX,,,21 ,,RBRVS,17.03 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57426,CPT,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,,,21 ,,RBRVS,14.30 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57452,CPT,COLPOSCOPY CERVIX UPR/ADJ VAG,,,21 ,,RBRVS,1.50 ,0.79 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57454,CPT,COLPOSCOPY CERVIX BX CERVIX&ENDOCRV CURTG,,,21 ,,RBRVS,2.33 ,1.08 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57455,CPT,COLPOSCOPY CERVIX VAG BX CERVIX,,,21 ,,RBRVS,1.99 ,0.78 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57456,CPT,COLPOSCOPY CERVIX VAG ENDOCRV CURTG,,,21 ,,RBRVS,1.85 ,0.74 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57460,CPT,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,,,21 ,,RBRVS,2.83 ,1.26 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57461,CPT,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,,,21 ,,RBRVS,3.43 ,1.28 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57500,CPT,BIOPSY CERVIX 1/MLT OR EXCISION OF LESION,,,21 ,,RBRVS,1.20 ,0.68 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57505,CPT,ENDOCRV CURTG X DONE AS PART DILAT&CURTG,,,21 ,,RBRVS,1.19 ,1.10 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57510,CPT,CAUT CERVIX ELECTRO/THERMAL,,,21 ,,RBRVS,1.90 ,0.99 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57511,CPT,CAUT CERVIX CRYOCAUT 1ST/REPEAT,,,21 ,,RBRVS,1.95 ,1.35 ,1.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57513,CPT,CAUT CERVIX LASER ABLTJ,,,21 ,,RBRVS,1.95 ,1.37 ,1.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57520,CPT,CONIZATION CERVIX +-D&C RPR KNIFE/LASER,,,21 ,,RBRVS,4.11 ,2.72 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57522,CPT,CONIZATION CERVIX +-D&C RPR ELTRD EXC,,,21 ,,RBRVS,3.67 ,2.41 ,2.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57530,CPT,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,,,21 ,,RBRVS,5.27 ,3.36 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57531,CPT,RAD TRACHELECTOMY W/BI PEL LMPHADEC,,,21 ,,RBRVS,29.95 ,12.57 ,12.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57540,CPT,EXC CRV STUMP ABDL APPR,,,21 ,,RBRVS,13.29 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57545,CPT,EXC CRV STUMP ABDL APPR W/PEL FLOOR RPR,,,21 ,,RBRVS,14.10 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57550,CPT,EXC CRV STUMP VAG APPR,,,21 ,,RBRVS,6.34 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57555,CPT,EXC CRV STUMP VAG APPR W/ANT&/POST RPR,,,21 ,,RBRVS,9.94 ,5.08 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57556,CPT,EXC CRV STUMP VAG APPR W/RPR NTRCL,,,21 ,,RBRVS,9.36 ,5.01 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57558,CPT,DILATION & CURETTAGE CERVICAL STUMP,,,21 ,,RBRVS,1.72 ,1.13 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57700,CPT,CERCLAGE UTERINE CERVIX NONOBAL,,,21 ,,RBRVS,4.35 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57720,CPT,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,,,21 ,,RBRVS,4.61 ,3.10 ,3.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,57800,CPT,DILAT CRV CANAL INSTRUMENTAL SPX,,,21 ,,RBRVS,0.77 ,0.45 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58100,CPT,ENDOMETRIAL BX +-ENDOCRV BX W/O DILAT SPX,,,21 ,,RBRVS,1.53 ,0.66 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58110,CPT,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,,,21 ,,RBRVS,0.77 ,0.27 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58120,CPT,D&C DX&/THER,,,21 ,,RBRVS,3.59 ,1.83 ,2.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58140,CPT,MYOMECTOMY 1-4 250 GM ABDL,,,21 ,,RBRVS,15.79 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58145,CPT,MYOMECTOMY 1-4 250 GM/< VAG,,,21 ,,RBRVS,8.91 ,4.68 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58146,CPT,MYOMECTOMY 5+ > 250 GM ABDL,,,21 ,,RBRVS,20.34 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58150,CPT,TAH +-RMVL TUBE +-RMVL OVARY,,,21 ,,RBRVS,17.31 ,7.44 ,7.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58152,CPT,TAH +-RMVL TUBE OVARY COLPO-URTCSTOPEXY,,,21 ,,RBRVS,21.86 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58180,CPT,SUPRACRV ABDL HYST +-RMVL TUBE OVARY,,,21 ,,RBRVS,16.60 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58200,CPT,TAH W/PRTL VAGNC PEL LYMPH NODE SAMPLING,,,21 ,,RBRVS,23.10 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58210,CPT,RAD ABDL HYST W/BI PEL LMPHADEC,,,21 ,,RBRVS,30.91 ,12.62 ,12.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58240,CPT,PEL EXNTJ GYNECOLOGIC MAL,,,21 ,,RBRVS,49.33 ,19.85 ,19.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58260,CPT,VAG HYST 250 GM/<,,,21 ,,RBRVS,14.15 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58262,CPT,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,,,21 ,,RBRVS,15.94 ,7.11 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58263,CPT,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,,,21 ,,RBRVS,17.23 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58267,CPT,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,,,21 ,,RBRVS,18.36 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58270,CPT,VAG HYST 250 GM/< W/RPR NTRCL,,,21 ,,RBRVS,15.30 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58275,CPT,VAG HYST W/TOT/PRTL VAGNC,,,21 ,,RBRVS,17.03 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58280,CPT,VAG HYST W/TOT/PRTL VAGNC W/RPR NTRCL,,,21 ,,RBRVS,18.33 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58285,CPT,VAG HYST RAD SCHAUTA,,,21 ,,RBRVS,23.38 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58290,CPT,VAG HYST F/UTER > 250 GM,,,21 ,,RBRVS,20.27 ,8.52 ,8.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58291,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY,,,21 ,,RBRVS,22.06 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58292,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR NTRCL,,,21 ,,RBRVS,23.35 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58293,CPT,VAG HYST > 250 GM COLPO-URTCSTOPEXY +-NDSC CTRL,,,21 ,,RBRVS,24.33 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58294,CPT,VAG HYST > 250 GM RPR NTRCL,,,21 ,,RBRVS,21.55 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58300,CPT,INSJ INTRAUTERINE DEV,,,21 ,,RBRVS,1.01 ,0.36 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58301,CPT,RMVL INTRAUTERINE DEV,,,21 ,,RBRVS,1.27 ,0.43 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58321,CPT,ARTIF INSEMINATION INTRA-CRV,,,21 ,,RBRVS,0.92 ,0.32 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58322,CPT,ARTIF INSEMINATION INTRA-UTERINE,,,21 ,,RBRVS,1.10 ,0.37 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58323,CPT,SPRM WASHG ARTIF INSEMINATION,,,21 ,,RBRVS,0.23 ,0.08 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58340,CPT,CATHJ&INTRO SALINE NFS SHG/HSG,,,21 ,,RBRVS,0.88 ,0.61 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58345,CPT,TRANSCRV INTRO FLP TUBE CATH +-HSG,,,21 ,,RBRVS,4.70 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58346,CPT,INSJ HEYMAN CAPSLS CLINICAL BRACHYTX,,,21 ,,RBRVS,7.56 ,4.10 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58350,CPT,CHROMOTUBATION OVIDUX MATRLS,,,21 ,,RBRVS,1.06 ,0.92 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58353,CPT,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GID,,,21 ,,RBRVS,3.60 ,1.91 ,24.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58356,CPT,ENDOMETRIAL CRYOABLTJ US CURTG,,,21 ,,RBRVS,6.41 ,2.29 ,45.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58400,CPT,UTERINE SSP SPX,,,21 ,,RBRVS,7.14 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58410,CPT,UTERINE SSP PRESAC SYMPTH,,,21 ,,RBRVS,13.80 ,6.28 ,6.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58520,CPT,HYSTERORRHAPHY RPR RPTD,,,21 ,,RBRVS,13.48 ,6.27 ,6.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58540,CPT,HYSTEROPLASTY RPR UTERINE ANOMAL,,,21 ,,RBRVS,15.71 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58541,CPT,LAPS SUPRACRV HYST 250 G/<,,,21 ,,RBRVS,14.70 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58542,CPT,LAPS SUPRACRV HYST 250 G/< RMVL TUBE/OVARY,,,21 ,,RBRVS,16.56 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58543,CPT,LAPS SUPRACRV HYST >250 G,,,21 ,,RBRVS,16.87 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58544,CPT,LAPS SUPRACRV HYST >250 G RMVL TUBE/OVARY,,,21 ,,RBRVS,18.37 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58545,CPT,LAPS MYOMECTOMY EXC 1-4 250 GM/<,,,21 ,,RBRVS,15.55 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58546,CPT,LAPS MYOMECTOMY EXC 5+ > 250 GRAMS,,,21 ,,RBRVS,19.94 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58548,CPT,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,,,21 ,,RBRVS,31.63 ,12.68 ,12.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58550,CPT,LAPS W/VAG HYST 250 GM/<,,,21 ,,RBRVS,15.10 ,6.96 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58552,CPT,LAPS W/VAG HYST 250 GM/< RMVL TUBE&/OVARY,,,21 ,,RBRVS,16.91 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58553,CPT,LAPS W/VAG HYST > 250 GRAMS,,,21 ,,RBRVS,20.06 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58554,CPT,LAPS VAG HYST > 250 GM RMVL TUBE&/OVARY,,,21 ,,RBRVS,23.11 ,9.64 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58555,CPT,HYSTSC DX SPX,,,21 ,,RBRVS,3.33 ,1.42 ,3.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58558,CPT,HYSTSC BX ENDOMETRIUM&/POLYPC +-D&C,,,21 ,,RBRVS,4.74 ,1.95 ,3.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58559,CPT,HYSTSC LSS INTRAUTERINE ADS,,,21 ,,RBRVS,6.16 ,2.44 ,2.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58560,CPT,HYSTSC DIV/RESCJ INTRAUTERINE SEPTUM,,,21 ,,RBRVS,6.99 ,2.72 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58561,CPT,HYSTSC RMVL LEIOMYOMATA,,,21 ,,RBRVS,9.99 ,3.75 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58562,CPT,HYSTSC RMVL IMPACTED FB,,,21 ,,RBRVS,5.20 ,2.09 ,3.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58563,CPT,HYSTSC ENDOMETRIAL ABLTJ,,,21 ,,RBRVS,6.16 ,2.44 ,40.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58565,CPT,HYSTSC OCCLUSION PLMT PRM,,,21 ,,RBRVS,7.12 ,3.74 ,42.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58570,CPT,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 G/<,,,21 ,,RBRVS,15.88 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58571,CPT,LAPS TOTAL HYSTERECTOMY 250 G/<W TUBE/OVARY,,,21 ,,RBRVS,17.69 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58572,CPT,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS>250 G,,,21 ,,RBRVS,20.09 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58573,CPT,LAPAROSCOPY TOT HYSTERECTOMY >250 G W TUBE/OVARY,,,21 ,,RBRVS,23.11 ,9.50 ,9.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58578,CPT,UNLIS LAPS UTER,,,21 ,,TotalUnits,,,,22.30 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,58579,CPT,UNLIS HYSTSC UTER,,,21 ,,TotalUnits,,,,6.91 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,58600,CPT,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,,,21 ,,RBRVS,5.91 ,3.18 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58605,CPT,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,,,21 ,,RBRVS,5.28 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58611,CPT,LIG/TRNSXJ FLP TUBE DONE TM C DLVR/SURG,,,21 ,,RBRVS,1.45 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58615,CPT,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,,,21 ,,RBRVS,3.94 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58660,CPT,LAPS LSS ADS SPX,,,21 ,,RBRVS,11.59 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58661,CPT,LAPS RMVL ADNEXAL STRUXS,,,21 ,,RBRVS,11.35 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58662,CPT,LAPS FULG/EXC OVARY VISCERA/PRTL SURF,,,21 ,,RBRVS,12.15 ,5.44 ,5.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58670,CPT,LAPS FULG OVIDUXS,,,21 ,,RBRVS,5.91 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58671,CPT,LAPS OCCLUSION OVIDUXS DEV,,,21 ,,RBRVS,5.91 ,3.22 ,3.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58672,CPT,LAPS FIMBRIOPLASTY,,,21 ,,RBRVS,12.91 ,5.50 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58673,CPT,LAPS SALPINGOSTOMY,,,21 ,,RBRVS,14.04 ,6.01 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58679,CPT,UNLIS LAPS PX OVIDUX OVARY,,,21 ,,TotalUnits,,,,16.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,58700,CPT,SALPINGECTOMY COMPL/PRTL UNI/BI SPX,,,21 ,,RBRVS,12.95 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58720,CPT,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,,,21 ,,RBRVS,12.16 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58740,CPT,LSS ADS,,,21 ,,RBRVS,14.90 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58750,CPT,TUBOTUBAL ANAST,,,21 ,,RBRVS,15.64 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58752,CPT,TUBOUTERINE IMPLTJ,,,21 ,,RBRVS,15.64 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58760,CPT,FIMBRIOPLASTY,,,21 ,,RBRVS,13.93 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58770,CPT,SALPINGOSTOMY,,,21 ,,RBRVS,14.77 ,6.27 ,6.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58800,CPT,DRG OVARIAN CST UNI/BI SPX VAG,,,21 ,,RBRVS,4.62 ,2.91 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58805,CPT,DRG OVARIAN CST UNI/BI SPX ABDL,,,21 ,,RBRVS,6.42 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58820,CPT,DRG OVARIAN ABSC VAG OPN,,,21 ,,RBRVS,4.70 ,3.16 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58822,CPT,DRG OVARIAN ABSC ABDL,,,21 ,,RBRVS,11.81 ,6.03 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58823,CPT,DRG PEL ABSC TRVG/TRANSRCT PRQ,,,21 ,,RBRVS,3.37 ,1.22 ,20.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58825,CPT,TRPOS OVARY,,,21 ,,RBRVS,11.78 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58900,CPT,BX OVARY UNI/BI SPX,,,21 ,,RBRVS,6.59 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58920,CPT,WEDGE RESCJ/BISCTJ OVARY UNI/BI,,,21 ,,RBRVS,11.95 ,5.50 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58925,CPT,OVARIAN CSTC UNI/BI,,,21 ,,RBRVS,12.43 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58940,CPT,OOPHORECTOMY PRTL/TOT UNI/BI,,,21 ,,RBRVS,8.22 ,4.39 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58943,CPT,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MAL,,,21 ,,RBRVS,19.52 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58950,CPT,RESCJ PRIM PRTL MAL W/BSO&OMNTC,,,21 ,,RBRVS,18.37 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58951,CPT,RESCJ PRIM PRTL MAL W/BSO&OMNTC TAH&LMPHADEC,,,21 ,,RBRVS,24.26 ,10.05 ,10.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58952,CPT,RESCJ PRIM PRTL MAL W/BSO&OMNTC RAD DEBULKING,,,21 ,,RBRVS,27.29 ,11.40 ,11.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58953,CPT,BSO W/OMNTC TAH&RAD DSJ DEBULKING,,,21 ,,RBRVS,34.13 ,13.80 ,13.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58954,CPT,BSO W/OMNTC TAH DEBULKING W/LMPHADEC,,,21 ,,RBRVS,37.13 ,14.87 ,14.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58956,CPT,BSO TOT OMNTC TAH MAL,,,21 ,,RBRVS,22.80 ,9.93 ,9.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58957,CPT,RESECTION RECRT MAL W/OMENTECTOMY,,,21 ,,RBRVS,26.22 ,10.81 ,10.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58958,CPT,RESECTION RECRT MAL W/OMENTECTOMY PEL LMPHADEC,,,21 ,,RBRVS,29.22 ,11.90 ,11.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58960,CPT,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,,,21 ,,RBRVS,15.79 ,7.20 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58970,CPT,FOLLICLE PNXR OOCYTE RETRIEVAL ANY METH,,,21 ,,RBRVS,3.52 ,1.46 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58974,CPT,EMBRYO TR INTRAUTERINE,,,21 ,,TotalUnits,,,,4.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,58976,CPT,GAMETE ZYGOTE/EMBRYO INTRAFLP TR ANY METH,,,21 ,,RBRVS,3.82 ,1.72 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,58999,CPT,UNLIS PX FEMALE GEN SYS,,,21 ,,TotalUnits,,,,2.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,59000,CPT,AMNIOCNTS DX,,,12 ,,RBRVS,1.30 ,0.62 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59001,CPT,AMNIOCNTS THER AMNIOTIC FLU RDCTJ US GID,,,12 ,,RBRVS,3.00 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59012,CPT,CORDOCNTS INTRAUTERINE,,,12 ,,RBRVS,3.44 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59015,CPT,CHORNC VILLUS SAMPLING,,,12 ,,RBRVS,2.20 ,0.93 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59020,CPT,FTL CONTRCJ STRS TST,,,12 ,,RBRVS,0.66 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,59020,CPT,FTL CONTRCJ STRS TST,26,,12 ,,RBRVS,0.66 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59020,CPT,FTL CONTRCJ STRS TST,TC,,12 ,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,59025,CPT,FTL NON-STRS TST,,,12 ,,RBRVS,0.53 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,59025,CPT,FTL NON-STRS TST,26,,12 ,,RBRVS,0.53 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59025,CPT,FTL NON-STRS TST,TC,,12 ,,RBRVS,,0.42 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,59030,CPT,FTL SCALP BLD SAMPLING,,,12 ,,RBRVS,1.99 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59050,CPT,FTL MNTR LABOR PHYS WRTTN REPRT S&I,,,12 ,,RBRVS,0.89 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59051,CPT,FTL MNTR LABOR PHYS WRTTN REPRT INTERPJ ONLY,,,12 ,,RBRVS,0.74 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59070,CPT,TABDL AMNIONFS US GID,,,12 ,,RBRVS,5.24 ,2.19 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59072,CPT,FTL UMBILICAL CORD OCCLUSION W/US GID,,,12 ,,RBRVS,8.99 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59074,CPT,FTL FLU DRG US GID,,,12 ,,RBRVS,5.24 ,2.17 ,4.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59076,CPT,FTL SHUNT PLMT US GID,,,12 ,,RBRVS,8.99 ,3.26 ,3.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59100,CPT,HYSTOT ABDL,,,12 ,,RBRVS,13.37 ,6.21 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59120,CPT,TX ECTOPIC PREGNANCY REQ SO,,,12 ,,RBRVS,12.67 ,6.07 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59121,CPT,TX ECTOPIC PREGNANCY W/O SO,,,12 ,,RBRVS,12.74 ,6.04 ,6.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59130,CPT,TX ECTOPIC PREGNANCY ABDL PREGNANCY,,,12 ,,RBRVS,15.08 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59135,CPT,TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST,,,12 ,,RBRVS,14.92 ,7.10 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59136,CPT,TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER,,,12 ,,RBRVS,14.25 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59140,CPT,TX ECTOPIC PREGNANCY CRV W/EVAC,,,12 ,,RBRVS,5.94 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59150,CPT,LAPS TX ECTOPIC PREGNANCY W/O SO,,,12 ,,RBRVS,12.29 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59151,CPT,LAPS TX ECTOPIC PREGNANCY W/SO,,,12 ,,RBRVS,12.11 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59160,CPT,CURTG POSTPARTUM,,,12 ,,RBRVS,2.76 ,1.48 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59200,CPT,INSJ CRV DILATOR SPX,,,12 ,,RBRVS,0.79 ,0.27 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59300,CPT,EPISIOTOMY/VAG RPR OTH/THN ATTENDING PHYS,,,12 ,,RBRVS,2.41 ,1.06 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59320,CPT,CERCLAGE CERVIX PREGNANCY VAG,,,12 ,,RBRVS,2.48 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59325,CPT,CERCLAGE CERVIX PREGNANCY ABDL,,,12 ,,RBRVS,4.06 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59350,CPT,HYSTERORRHAPHY RPTD UTER,,,12 ,,RBRVS,4.94 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59400,CPT,OB CARE ANTEPARTUM VAG DLVR&POSTPARTUM,,,13 ,,RBRVS,27.48 ,15.40 ,15.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59409,CPT,VAG DLVR ONLY,,,13 ,,RBRVS,13.48 ,4.59 ,4.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59410,CPT,VAG DLVR ONLY POSTPARTUM CARE,,,13 ,,RBRVS,15.37 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59412,CPT,XTRNL CEPHALIC VERSION +-TOCOLSS,,,13 ,,RBRVS,1.71 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59414,CPT,DLVR PLACENTA SPX,,,13 ,,RBRVS,1.61 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59425,CPT,ANTEPARTUM CARE ONLY 4-6 VSTS,,,13 ,,RBRVS,6.50 ,2.02 ,4.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59426,CPT,ANTEPARTUM CARE ONLY 7+ VSTS,,,13 ,,RBRVS,11.57 ,3.57 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59430,CPT,POSTPARTUM CARE ONLY SPX,,,13 ,,RBRVS,2.13 ,0.84 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59510,CPT,OB ANTEPARTUM CARE C DLVR&POSTPARTUM,,,11 ,,RBRVS,31.07 ,17.39 ,17.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59514,CPT,C DLVR ONLY,,,11 ,,RBRVS,15.95 ,5.46 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59515,CPT,C DLVR ONLY W/POSTPARTUM CARE,,,11 ,,RBRVS,18.39 ,7.26 ,7.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59525,CPT,STOT/TOT HYST AFTER C DLVR,,,21 ,,RBRVS,8.53 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59610,CPT,OB ANTEPARTUM VAG DLVR&POSTPARTUM AFTER C DLVR,,,13 ,,RBRVS,28.86 ,16.16 ,16.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59612,CPT,VAG DLVR AFTER C DLVR,,,13 ,,RBRVS,15.04 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59614,CPT,VAG DLVR AFTER C DLVR POSTPARTUM CARE,,,13 ,,RBRVS,16.64 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59618,CPT,ANTEPARTUM C DLVR&POSTPARTUM FA V AP C DLVER,,,11 ,,RBRVS,32.51 ,18.07 ,18.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59620,CPT,C DLVR ONLY FA V AP C DLVER,,,11 ,,RBRVS,17.50 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59622,CPT,C DLVR ONLY FA V AP C DLVER W/POSTPARTUM CARE,,,11 ,,RBRVS,19.83 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59812,CPT,TX INCOMPL AB ANY TRI COMPLD SURGLY,,,12 ,,RBRVS,4.44 ,2.55 ,3.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59820,CPT,TX MISSED AB COMPLD SURGLY 1ST TRI,,,12 ,,RBRVS,4.84 ,3.63 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59821,CPT,TX MISSED AB COMPLD SURGLY 2ND TRI,,,12 ,,RBRVS,5.09 ,3.39 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59830,CPT,TX SEPTIC AB COMPLD SURGLY,,,12 ,,RBRVS,6.59 ,3.78 ,3.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59840,CPT,INDUCED AB DILAT&CURTG,,,12 ,,RBRVS,3.01 ,1.96 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59841,CPT,INDUCED AB DILAT&EVAC,,,12 ,,RBRVS,5.65 ,2.85 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59850,CPT,INDUCED AB 1+ IAM NJXS DLVR FETUS,,,12 ,,RBRVS,5.90 ,3.28 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59851,CPT,INDUCED AB 1+ IAM NJXS DLVR FETUS D&C&EVAC,,,12 ,,RBRVS,5.92 ,3.57 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59852,CPT,INDUCED AB 1+ IAM NJXS DLVR FETUS HYSTOT,,,12 ,,RBRVS,8.23 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59855,CPT,INDUCED AB 1+ VAG SUPP DLVR FETUS,,,12 ,,RBRVS,6.43 ,3.40 ,3.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59856,CPT,INDUCED AB 1+ VAG SUPP DLVR FETUS D&C&/EVAC,,,12 ,,RBRVS,7.79 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59857,CPT,INDUCED AB 1+ VAG SUPP DLVR FETUS HYSTOT,,,12 ,,RBRVS,9.33 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59866,CPT,MULTIFTL PREGNANCY RDCTJ,,,12 ,,RBRVS,3.99 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59870,CPT,UTERINE EVAC&CURTG HYDATIDIFORM MOLE,,,12 ,,RBRVS,6.57 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59871,CPT,RMVL CERCLAGE SUTR UNDER ANES,,,12 ,,RBRVS,2.13 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,59897,CPT,UNLIS FTL INVASIVE W/US GID,,,12 ,,TotalUnits,,,,2.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,59898,CPT,UNLIS LAPS MATERNITY CARE&DLVR,,,12 ,,TotalUnits,,,,17.69 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,59899,CPT,UNLIS MATERNITY CARE&DLVR,,,12 ,,TotalUnits,,,,9.44 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,60000,CPT,I&D THYROGLOSSAL DUX CST INFCT,,,21 ,,RBRVS,1.81 ,1.85 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60100,CPT,BX THYR PRQ CORE NDL,,,21 ,,RBRVS,1.56 ,0.55 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60200,CPT,EXC CST/ADENOMA THYR/TRNSXJ ISTHMUS,,,21 ,,RBRVS,10.02 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60210,CPT,PRTL THYR LOBEC UNI +-ISTHMUSECTOMY,,,21 ,,RBRVS,11.23 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60212,CPT,PRTL THYR LOBEC UNI W/CLAT STOT LOBEC,,,21 ,,RBRVS,16.43 ,8.04 ,8.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60220,CPT,TOT THYR LOBEC UNI +-ISTHMUSECTOMY,,,21 ,,RBRVS,12.37 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60225,CPT,TOT THYR LOBEC UNI W/CLAT STOT LOBEC,,,21 ,,RBRVS,14.79 ,7.80 ,7.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60240,CPT,TRDEC TOT/COMPL,,,21 ,,RBRVS,16.22 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60252,CPT,TRDEC TOT/STOT F/MAL W/LMTD NCK DSJ,,,21 ,,RBRVS,22.01 ,10.23 ,10.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60254,CPT,TRDEC TOT/STOT F/MAL W/RAD NCK DSJ,,,21 ,,RBRVS,28.42 ,13.27 ,13.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60260,CPT,TRDEC RMVL REMAINING TISS FLWG RMVL PRTN,,,21 ,,RBRVS,18.26 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60270,CPT,TRDEC W/SUBSTERNAL THYR STERNAL SPLT/TTHRC,,,21 ,,RBRVS,23.20 ,10.62 ,10.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60271,CPT,TRDEC W/SUBSTERNAL THYR CRV APPR,,,21 ,,RBRVS,17.62 ,8.42 ,8.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60280,CPT,EXC THYROGLOSSAL DUX CST/SINUS,,,21 ,,RBRVS,6.16 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60281,CPT,EXC THYROGLOSSAL DUX CST/SINUS RECRT,,,21 ,,RBRVS,8.82 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60300,CPT,ASPIRATION AND/OR INJECTION THYROID CYST,,,21 ,,RBRVS,0.97 ,0.33 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,6030F,CPT,ALL ELEM OF MAX STERILE BARRIER TECHNQ FLLWD,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,60500,CPT,PARATRDEC/EXPL PARATHYR,,,21 ,,RBRVS,16.78 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60502,CPT,PARATRDEC/EXPL PARATHYR RE-EXPL,,,21 ,,RBRVS,21.15 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60505,CPT,PARATRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC,,,21 ,,RBRVS,23.06 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60512,CPT,PARATHYR AUTOTRNSPLJ,,,21 ,,RBRVS,4.44 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60520,CPT,THYMECTOMY PRTL/TOT TRANSCRV APPR SPX,,,21 ,,RBRVS,17.16 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60521,CPT,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,,,21 ,,RBRVS,19.18 ,9.09 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60522,CPT,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,,,21 ,,RBRVS,23.48 ,10.76 ,10.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60540,CPT,ADRNLECTOMY EXPL ADRNL TABDL LMBR/DORSAL SPX,,,21 ,,RBRVS,18.02 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60545,CPT,ADRNLECTOMY EXPL ADRNL SPX EXC ADJ TUM,,,21 ,,RBRVS,20.93 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60600,CPT,EXC CRTD BDY TUM W/O EXC CRTD ART,,,21 ,,RBRVS,25.09 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60605,CPT,EXC CRTD BDY TUM W/EXC CRTD ART,,,21 ,,RBRVS,31.96 ,14.04 ,14.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60650,CPT,LAPS ADRNLECTOMY PRTL/COMPL TABDL,,,21 ,,RBRVS,20.73 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,60659,CPT,UNLIS LAPS ENDOC SYS,,,21 ,,TotalUnits,,,,29.53 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,60699,CPT,UNLIS ENDOC SYS,,,21 ,,TotalUnits,,,,10.64 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,61000,CPT,SDRL TAP THRU FONTANELLE/SUTR INFT UNI/BI 1ST,,,21 ,,RBRVS,1.58 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61001,CPT,SDRL TAP THRU FONTANELLE/SUTR INFT UNI/BI SBSQ,,,21 ,,RBRVS,1.49 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61020,CPT,VENTR PNXR PREVIOUS BURR HOLE W/O NJX,,,21 ,,RBRVS,1.51 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61026,CPT,VENTR PNXR PREVIOUS BURR HOLE W/NJX,,,21 ,,RBRVS,1.69 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61050,CPT,CISTERNAL/LAT CRV C1-C2 PNXR W/O NJX SPX,,,21 ,,RBRVS,1.51 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61055,CPT,CISTERNAL/LAT CRV C1-C2 PNXR W/NJX,,,21 ,,RBRVS,2.10 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61070,CPT,PNXR SHUNT TUBING/RSVR ASPIR/NJX,,,21 ,,RBRVS,0.89 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61105,CPT,TDH SDRL/VENTR PNXR,,,21 ,,RBRVS,5.45 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61107,CPT,TDH SDRL/VENTR PNXR IMPLTING VENTR CATH/DEV,,,21 ,,RBRVS,4.99 ,2.18 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61108,CPT,TDH SDRL/VENTR PNXR EVAC&/DRG SDRL HMTMA,,,21 ,,RBRVS,11.64 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61120,CPT,BURR HOLE VENTR PNXR,,,21 ,,RBRVS,9.60 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61140,CPT,BURR HOLE/TREPHINE W/BX BRN/ICRA LES,,,21 ,,RBRVS,17.23 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61150,CPT,BURR HOLE/TREPHINE W/DRG BRN ABSC/CST,,,21 ,,RBRVS,18.90 ,11.32 ,11.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61151,CPT,BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST,,,21 ,,RBRVS,13.49 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61154,CPT,BURR HOLE W/EVAC&/DRG HMTMA XDRL/SDRL,,,21 ,,RBRVS,17.07 ,11.21 ,11.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61156,CPT,BURR HOLE W/ASPIR HMTMA/CST ICERE,,,21 ,,RBRVS,17.45 ,10.51 ,10.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61210,CPT,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,,,21 ,,RBRVS,5.83 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61215,CPT,INSJ SUBQ RSVR PMP/NFS SYS VENTR CATH,,,21 ,,RBRVS,5.85 ,5.34 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61250,CPT,BURR HOLE/TREPHINE STTL EXPL N/FLWD OTH SURG,,,21 ,,RBRVS,11.49 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61253,CPT,BURR HOLE/TREPHINE ITTL UNI/BI,,,21 ,,RBRVS,13.49 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61304,CPT,CRNEC/CRX EXPL STTL,,,21 ,,RBRVS,23.41 ,13.51 ,13.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61305,CPT,CRNEC/CRX EXPL ITTL,,,21 ,,RBRVS,28.64 ,16.36 ,16.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61312,CPT,CRNEC/CRX F/EVAC HMTMA STTL XDRL/SDRL,,,21 ,,RBRVS,30.17 ,16.43 ,16.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61313,CPT,CRNEC/CRX F/EVAC HMTMA STTL ICERE,,,21 ,,RBRVS,28.09 ,16.30 ,16.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61314,CPT,CRNEC/CRX F/EVAC HMTMA ITTL XDRL/SDRL,,,21 ,,RBRVS,25.90 ,14.99 ,14.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61315,CPT,CRNEC/CRX F/EVAC HMTMA ITTL INTRACEREBELLAR,,,21 ,,RBRVS,29.65 ,16.78 ,16.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61316,CPT,INC&SUBQ PLMT CRNL B1 GRF,,,21 ,,RBRVS,1.39 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61320,CPT,CRNEC/CRX DRG ICRA ABSC STTL,,,21 ,,RBRVS,27.42 ,15.46 ,15.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61321,CPT,CRNEC/CRX DRG ICRA ABSC ITTL,,,21 ,,RBRVS,30.53 ,16.76 ,16.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61322,CPT,CRNEC/CRX DCMPRIVE W/O LOBEC,,,21 ,,RBRVS,34.26 ,18.48 ,18.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61323,CPT,CRNEC/CRX DCMPRIVE W/LOBEC,,,21 ,,RBRVS,35.06 ,18.23 ,18.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61330,CPT,DCMPRN ORBIT ONLY TRANSCRNL,,,21 ,,RBRVS,25.30 ,13.44 ,13.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61332,CPT,EXPL ORBIT TRANSCRNL BX,,,21 ,,RBRVS,28.60 ,15.03 ,15.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61333,CPT,EXPL ORBIT TRANSCRNL RMVL LES,,,21 ,,RBRVS,29.27 ,15.92 ,15.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61334,CPT,EXPL ORBIT TRANSCRNL W/RMVL FB,,,21 ,,RBRVS,19.60 ,10.40 ,10.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61340,CPT,STPL CRNL DCMPRN,,,21 ,,RBRVS,20.11 ,12.05 ,12.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61343,CPT,CRNEC SOPL CRV LAM DCMPRN MEDULLA&SPI CORD,,,21 ,,RBRVS,31.86 ,17.52 ,17.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61345,CPT,OTH CRNL DCMPRN POST FOSSA,,,21 ,,RBRVS,29.23 ,16.51 ,16.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61440,CPT,CRX SCTJ TENTORIUM CEREBELLI SPX,,,21 ,,RBRVS,28.66 ,16.15 ,16.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61450,CPT,CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION,,,21 ,,RBRVS,27.69 ,15.25 ,15.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61458,CPT,CRNEC SOPL EXPL/DCMPRN CRNL NRV,,,21 ,,RBRVS,28.84 ,16.30 ,16.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61460,CPT,CRNEC SOPL SCTJ 1+ CRNL NRV,,,21 ,,RBRVS,30.24 ,16.45 ,16.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61470,CPT,CRNEC SOPL MEDULLARY TRCOTOMY,,,21 ,,RBRVS,27.62 ,15.35 ,15.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61480,CPT,CRNEC SOPL MESENCEPHAL TRCOTOMY/PEDUNCULOTOMY,,,21 ,,RBRVS,28.05 ,12.40 ,12.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61490,CPT,CRX LOBOTOMY W/CINGULOTOMY,,,21 ,,RBRVS,27.22 ,15.30 ,15.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61500,CPT,CRNEC EXC TUM/OTH B1 LES SKL,,,21 ,,RBRVS,19.18 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61501,CPT,CRNEC OSTEOMYELITIS,,,21 ,,RBRVS,16.35 ,10.31 ,10.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61510,CPT,CRNEC TREPH B1 FLAP CRX EXC TUM STTL,,,21 ,,RBRVS,30.83 ,18.15 ,18.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61512,CPT,CRNEC TREPH B1 FLAP CRX EXC MENINGIOMA STTL,,,21 ,,RBRVS,37.14 ,20.22 ,20.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61514,CPT,CRNEC TREPH B1 FLAP CRX EXC BRN ABSC STTL,,,21 ,,RBRVS,27.23 ,15.54 ,15.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61516,CPT,CRNEC TREPH B1 FLAP CRX EXC CST STTL,,,21 ,,RBRVS,26.58 ,15.12 ,15.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61517,CPT,IMPLTJ BRN INTRCV CHEMOTX AGT,,,21 ,,RBRVS,1.38 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61518,CPT,CRNEC EXC TUM ITTL/PFOS MENINGIOMA,,,21 ,,RBRVS,39.89 ,22.03 ,22.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61519,CPT,CRNEC EXC TUM ITTL/PFOS MENINGIOMA,,,21 ,,RBRVS,43.43 ,22.90 ,22.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61520,CPT,CRNEC EXC TUM ITTL/PFOS CRBLOPNT ANGL TUM,,,21 ,,RBRVS,57.09 ,29.23 ,29.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61521,CPT,CRNEC EXC TUM ITTL/PFOS MIDLINE TUM BASE SKL,,,21 ,,RBRVS,46.99 ,24.37 ,24.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61522,CPT,CRNEC ITTL/PFOS EXC ABSC,,,21 ,,RBRVS,31.54 ,17.57 ,17.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61524,CPT,CRNEC ITTL/PFOS EXC/FENESTRATION CST,,,21 ,,RBRVS,29.89 ,16.60 ,16.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61526,CPT,CRNEC EXC CRBLOPNT ANGL TUM,,,21 ,,RBRVS,54.08 ,26.54 ,26.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61530,CPT,CRNEC EXC CRBLOPNT ANGL TUM MIDDLE/PFOS,,,21 ,,RBRVS,45.56 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61531,CPT,SDRL IMPLTJ STRIP ELTRDS SEIZURE MNTR,,,21 ,,RBRVS,16.41 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61533,CPT,CRX B1 FLAP IMPLTJ ELTRD RA SEIZURE MNTR,,,21 ,,RBRVS,21.46 ,12.63 ,12.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61534,CPT,CRX B1 FLAP EXC EPILEPTOGENIC FOC W/O ECOG,,,21 ,,RBRVS,23.01 ,13.80 ,13.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61535,CPT,CRX B1 FLAP RMVL ELTRD RA W/O EXC CERE TISS SPX,,,21 ,,RBRVS,13.15 ,9.13 ,9.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61536,CPT,CRX B1 FLAP EXC CERE FOC W/ECOG,,,21 ,,RBRVS,37.72 ,20.34 ,20.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61537,CPT,CRX B1 FLAP TEMPORAL LOBE W/O ECOG,,,21 ,,RBRVS,36.45 ,18.24 ,18.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61538,CPT,CRX B1 FLAP LOBEC TEMPORAL LOBE W/ECOG,,,21 ,,RBRVS,39.45 ,19.44 ,19.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61539,CPT,CRX B1 FLAP LOBEC OTH/THN TEMPORAL LOBE W/ECOG,,,21 ,,RBRVS,34.28 ,18.45 ,18.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61540,CPT,CRX B1 FLAP LOBEC OTH/THN TEMPORAL LOBE W/O ECOG,,,21 ,,RBRVS,31.43 ,17.61 ,17.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61541,CPT,CRX B1 FLAP TRNSXJ CORPUS CALLOSUM,,,21 ,,RBRVS,30.94 ,17.15 ,17.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61542,CPT,CRX B1 FLAP TOT HEMISPHERCOMY,,,21 ,,RBRVS,33.16 ,18.29 ,18.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61543,CPT,CRX B1 FLAP PRTL/STOT HEMISPHERCOMY,,,21 ,,RBRVS,31.31 ,16.95 ,16.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61544,CPT,CRX B1 FLAP EXC/COAGJ CHOROID PLEXUS,,,21 ,,RBRVS,27.36 ,13.20 ,13.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61545,CPT,CRX B1 FLAP EXC CRANIOPHARYNGIOMA,,,21 ,,RBRVS,46.43 ,24.83 ,24.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61546,CPT,CRX HYPPHSEC/EXC PITUITARY TUM ICRA,,,21 ,,RBRVS,33.44 ,18.21 ,18.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61548,CPT,HYPPHSEC/EXC PITUITARY TUM TRANSNSL/SEPTAL,,,21 ,,RBRVS,23.37 ,12.90 ,12.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61550,CPT,CRNEC CRANIOSYNOSTOSIS 1 CRNL SUTR,,,21 ,,RBRVS,15.59 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61552,CPT,CRNEC CRANIOSYNOSTOSIS MLT CRNL SUTRS,,,21 ,,RBRVS,20.40 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61556,CPT,CRX CRANIOSYNOSTOSIS FRNT/PARIETAL B1 FLAP,,,21 ,,RBRVS,24.09 ,13.50 ,13.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61557,CPT,CRX CRANIOSYNOSTOSIS BIFRNT B1 FLAP,,,21 ,,RBRVS,23.31 ,14.52 ,14.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61558,CPT,X10SV CRNEC MLT SUTR CRANIOSYNOSTOSIS X W/B1 GRF,,,21 ,,RBRVS,26.50 ,15.61 ,15.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61559,CPT,X10SV CRNEC MLT SUTR CRANIOSYNOSTOSIS B1 AGRFT,,,21 ,,RBRVS,34.02 ,18.29 ,18.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61563,CPT,EXC B9 TUM CRNL B1 W/O OPTIC NRV DCMPRN,,,21 ,,RBRVS,28.44 ,16.00 ,16.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61564,CPT,EXC B9 TUM CRNL B1 W/OPTIC NRV DCMPRN,,,21 ,,RBRVS,34.74 ,19.35 ,19.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61566,CPT,CRX B1 FLAP SLCTV AMYGDALOHIPPOCAMPECTOMY,,,21 ,,RBRVS,32.45 ,18.21 ,18.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61567,CPT,CRX B1 FLAP MLT SUBPIAL TRNSXJS W/ECOG,,,21 ,,RBRVS,37.00 ,20.83 ,20.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61570,CPT,CRNEC/CRX EXC FB FROM BRN,,,21 ,,RBRVS,26.51 ,15.02 ,15.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61571,CPT,CRNEC/CRX TX PENTRG WND BRN,,,21 ,,RBRVS,28.42 ,16.25 ,16.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61575,CPT,TRANSORAL SB BX DCMPRN/EXC LES,,,21 ,,RBRVS,36.56 ,18.78 ,18.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61576,CPT,TRANSORAL SB BX DCMPRN/EXC LES SPLTTING TONGUE,,,21 ,,RBRVS,55.31 ,34.44 ,34.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61580,CPT,CRANFCL ACF XDRL W/O ORB EXNTJ,,,21 ,,RBRVS,34.51 ,25.30 ,25.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61581,CPT,CRANFCL ACF XDRL ORB EXNTJ,,,21 ,,RBRVS,39.13 ,28.24 ,28.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61582,CPT,CRANFCL ACF XDRL ELVTN LOBE,,,21 ,,RBRVS,35.14 ,31.90 ,31.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61583,CPT,CRANFCL ACF IDRL ELVTN/RESCJ LOBE,,,21 ,,RBRVS,38.50 ,27.10 ,27.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61584,CPT,OC ACF XDRL W/O ORB EXNTJ,,,21 ,,RBRVS,37.70 ,26.68 ,26.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61585,CPT,OC ACF XDRL W/ORB EXNTJ,,,21 ,,RBRVS,42.57 ,27.72 ,27.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61586,CPT,BICORONAL TRANSZYGMTC&/LEFT W/O B1 GRF,,,21 ,,RBRVS,27.48 ,24.41 ,24.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61590,CPT,ITPRL PRE-AUR MCF&MSB,,,21 ,,RBRVS,47.04 ,28.27 ,28.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61591,CPT,ITPRL POST-AUR MCF,,,21 ,,RBRVS,47.02 ,28.47 ,28.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61592,CPT,OC ZYGMTC MCF,,,21 ,,RBRVS,43.08 ,28.79 ,28.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61595,CPT,TRANSTEMPORAL PCF JUG FORAMEN/MSB,,,21 ,,RBRVS,33.74 ,23.29 ,23.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61596,CPT,TRANSCOCHLEAR PCF JUG FORAMEN/MSB,,,21 ,,RBRVS,39.43 ,23.73 ,23.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61597,CPT,TRANSCONDYLAR PCF JUG FORAMEN/MSB,,,21 ,,RBRVS,40.82 ,24.91 ,24.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61598,CPT,TRANSPETROSAL PCF CLIVUS/FORAMEN MAGNUM,,,21 ,,RBRVS,36.53 ,24.09 ,24.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61600,CPT,RESCJ/EXC LES BASE ACF XDRL,,,21 ,,RBRVS,30.01 ,21.44 ,21.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61601,CPT,RESCJ/EXC LES BASE ACF IDRL W/RPR,,,21 ,,RBRVS,31.14 ,22.95 ,22.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61605,CPT,RESCJ/EXC LES ITPRL FOSSA SPACE APEX XDRL,,,21 ,,RBRVS,32.57 ,21.94 ,21.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61606,CPT,RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR,,,21 ,,RBRVS,42.05 ,26.76 ,26.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61607,CPT,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL,,,21 ,,RBRVS,40.93 ,24.16 ,24.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61608,CPT,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,,,21 ,,RBRVS,45.54 ,27.89 ,27.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61609,CPT,TRNSXJ/LIG CRTD ART SINUS W/O RPR,,,21 ,,RBRVS,9.88 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61610,CPT,TRNSXJ/LIG CRTD ART SINUS W/RPR ANAST/GRF,,,21 ,,RBRVS,29.63 ,12.73 ,12.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61611,CPT,TRNSXJ/LIG CRTD ART PETROUS CANAL W/O RPR,,,21 ,,RBRVS,7.41 ,3.09 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61612,CPT,TRNSXJ/LIG CRTD ART PETROUS CANAL RPR ANAST/GRF,,,21 ,,RBRVS,27.84 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61613,CPT,OBLTRJ CRTD ARYSM ARVEN CRTD-FSTL DSJ,,,21 ,,RBRVS,45.03 ,28.02 ,28.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61615,CPT,RESCJ/EXC LES BASE PCF VRT BODIES XDRL,,,21 ,,RBRVS,35.77 ,23.09 ,23.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61616,CPT,RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL,,,21 ,,RBRVS,46.74 ,29.37 ,29.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61618,CPT,SEC RPR DURA CSF LEAK FR TISS GRF,,,21 ,,RBRVS,18.69 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61619,CPT,SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP,,,21 ,,RBRVS,22.10 ,12.47 ,12.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61623,CPT,EVASC TEMP BALO ARTL OCCLUSION,,,21 ,,RBRVS,9.95 ,3.99 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61624,CPT,TCAT PRM OCCLUSION/EMBOLIZATION PRQ CNS,,,21 ,,RBRVS,20.12 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61626,CPT,TCAT PRM OCCLUSION/EMBOLIZATION PRQ NON-CNS,,,21 ,,RBRVS,16.60 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61630,CPT,BALO ANGIOP ICRA PRQ,,,21 ,,RBRVS,22.07 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61635,CPT,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,,,21 ,,RBRVS,24.28 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61640,CPT,BALO DILAT ICRA PRQ 1ST VSL,,,21 ,,RBRVS,12.32 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61641,CPT,BALO DILAT ICRA PRQ EA VSL SM VASC FAM,,,21 ,,RBRVS,4.33 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61642,CPT,BALO DILAT ICRA PRQ EA VSL DIFF VASC FAM,,,21 ,,RBRVS,8.66 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61680,CPT,SURG ICRA ARVEN MALFRMJ STTL SMPL,,,21 ,,RBRVS,32.55 ,18.29 ,18.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61682,CPT,SURG ICRA ARVEN MALFRMJ STTL CPLX,,,21 ,,RBRVS,63.41 ,30.99 ,30.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61684,CPT,SURG ICRA ARVEN MALFRMJ ITTL SMPL,,,21 ,,RBRVS,41.64 ,21.80 ,21.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61686,CPT,SURG ICRA ARVEN MALFRMJ ITTL CPLX,,,21 ,,RBRVS,67.50 ,33.97 ,33.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61690,CPT,SURG ICRA ARVEN MALFRMJ DURAL SMPL,,,21 ,,RBRVS,31.34 ,17.55 ,17.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61692,CPT,SURG ICRA ARVEN MALFRMJ DURAL CPLX,,,21 ,,RBRVS,54.59 ,27.56 ,27.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61697,CPT,SURG CPLX ICRA ARYSM ICRA APPR CRTD CRCJ,,,21 ,,RBRVS,63.40 ,31.14 ,31.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61698,CPT,CPLX ICRA ICRA VERTEBROBASILAR CRCJ,,,21 ,,RBRVS,69.63 ,33.28 ,33.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61700,CPT,SMPL ICRA ICRA APPR CRTD CRCJ,,,21 ,,RBRVS,50.62 ,26.69 ,26.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61702,CPT,SMPL ICRA ICRA VERTEBROBASILAR CRCJ,,,21 ,,RBRVS,60.04 ,29.57 ,29.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61703,CPT,ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART,,,21 ,,RBRVS,18.80 ,11.67 ,11.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61705,CPT,ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART,,,21 ,,RBRVS,38.10 ,19.66 ,19.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61708,CPT,ARYSM VASC MALFRMJ/ICRA ELECTROTHROMBOSIS,,,21 ,,RBRVS,37.20 ,16.09 ,16.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61710,CPT,ARYSM VASC MALFRMJ IA EMBOLIZATION,,,21 ,,RBRVS,31.29 ,14.74 ,14.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61711,CPT,ANAST ARTL XTRC-ICRA ARTS,,,21 ,,RBRVS,38.23 ,20.08 ,20.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61720,CPT,CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS,,,21 ,,RBRVS,17.62 ,9.83 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61735,CPT,CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN,,,21 ,,RBRVS,22.35 ,11.88 ,11.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61750,CPT,STRTCTC BX ASPIR/EXC BURR ICRA LES,,,21 ,,RBRVS,19.83 ,11.69 ,11.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61751,CPT,STRTCTC BX ASPIR/EXC BURR ICRA LES W/CT&/MRG,,,21 ,,RBRVS,18.79 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61760,CPT,STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MNTR,,,21 ,,RBRVS,22.39 ,12.39 ,12.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61770,CPT,STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC,,,21 ,,RBRVS,23.19 ,12.25 ,12.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61781,CPT,SCAN PROC CRANIAL INTRA,,,21 ,,RBRVS,3.75 ,2.14 ,2.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,61782,CPT,SCAN PROC CRANIAL EXTRA,,,21 ,,RBRVS,3.18 ,1.81 ,1.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,61783,CPT,SCAN PROC SPINAL,,,21 ,,RBRVS,3.75 ,2.14 ,2.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,61790,CPT,CRTJ LES STRTCTC PRQ NULYT GASSERIAN,,,21 ,,RBRVS,11.60 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61791,CPT,CRTJ LES STRTCTC PRQ NULYT TRIGEMINAL TRC,,,21 ,,RBRVS,15.41 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61796,CPT,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,,,21 ,,RBRVS,13.93 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61797,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,,,21 ,,RBRVS,3.48 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61798,CPT,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,,,21 ,,RBRVS,19.85 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61799,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,,,21 ,,RBRVS,4.81 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61800,CPT,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,,,21 ,,RBRVS,2.25 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61850,CPT,TDH/BURR IMPLTJ NSTIM ELTRD CORTICAL,,,21 ,,RBRVS,13.34 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61860,CPT,CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL,,,21 ,,RBRVS,22.26 ,12.85 ,12.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61863,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/O MER 1ST RA,,,21 ,,RBRVS,20.71 ,13.02 ,13.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61864,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/O MER EA RA,,,21 ,,RBRVS,4.49 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61867,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/MER 1ST RA,,,21 ,,RBRVS,33.03 ,18.29 ,18.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61868,CPT,STRTCTC IMPLTJ NSTIM ELTRDW/MER EA RA,,,21 ,,RBRVS,7.91 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61870,CPT,CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR CORTICAL,,,21 ,,RBRVS,16.34 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61875,CPT,CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR SUBCORTICAL,,,21 ,,RBRVS,16.46 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61880,CPT,REVJ/RMVL ICRA NSTIM ELTRDS,,,21 ,,RBRVS,6.95 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61885,CPT,INSJ/RPLCMT CRNL NPGR 1 ELTRD RA,,,21 ,,RBRVS,7.57 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61886,CPT,INSJ/RPLCMT CRNL NPGR 2+ ELTRD RA,,,21 ,,RBRVS,9.93 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,61888,CPT,REVJ/RMVL CRNL NPGR,,,21 ,,RBRVS,5.23 ,3.70 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62000,CPT,ELVTN DEPRS SKL FX SMPL XDRL,,,21 ,,RBRVS,13.93 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62005,CPT,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,,,21 ,,RBRVS,17.63 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62010,CPT,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,,,21 ,,RBRVS,21.43 ,12.55 ,12.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62100,CPT,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,,,21 ,,RBRVS,23.53 ,13.12 ,13.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62115,CPT,RDCTJ CRANIOMEGALIC SKL X W/B1 GRFS/CRNOP,,,21 ,,RBRVS,22.91 ,9.07 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62116,CPT,RDCTJ CRANIOMEGALIC SKL W/SMPL CRNOP,,,21 ,,RBRVS,25.02 ,14.74 ,14.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62117,CPT,RDCTJ CRANIOMEGALIC REQ CRX&RCNSTJ +-B1 GRF,,,21 ,,RBRVS,28.35 ,15.57 ,15.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62120,CPT,RPR ENCEPHALOCELE SKL VAULT W/CRNOP,,,21 ,,RBRVS,24.59 ,18.55 ,18.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62121,CPT,CRX F/RPR ENCEPHALOCELE SB,,,21 ,,RBRVS,23.03 ,16.09 ,16.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62140,CPT,CRNOP F/SKL DFCT UP 5 CM DIAM,,,21 ,,RBRVS,14.55 ,9.08 ,9.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62141,CPT,CRNOP F/SKL DFCT > 5 CM DIAM,,,21 ,,RBRVS,16.07 ,9.90 ,9.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62142,CPT,RMVL B1 FLAP/PROSTC PLATE SKL,,,21 ,,RBRVS,11.83 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62143,CPT,RPLCMT B1 FLAP/PROSTC PLATE SKL,,,21 ,,RBRVS,14.15 ,9.08 ,9.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62145,CPT,CRNOP F/SKL DFCT W/REPARATIVE BRN SURG,,,21 ,,RBRVS,20.09 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62146,CPT,CRNOP W/AGRFT UP 5 CM DIAM,,,21 ,,RBRVS,17.28 ,10.31 ,10.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62147,CPT,CRNOP W/AGRFT > 5 CM DIAM,,,21 ,,RBRVS,20.67 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62148,CPT,INC&RETRIEVAL SUBQ CRNL B1 GRF F/CRNOP,,,21 ,,RBRVS,2.00 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62160,CPT,NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS,,,21 ,,RBRVS,3.00 ,1.32 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62161,CPT,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,,,21 ,,RBRVS,21.23 ,12.78 ,12.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62162,CPT,NUNDSC ICRA FENESTRATION/EXC CST PLMT CATH DRG,,,21 ,,RBRVS,26.80 ,15.72 ,15.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62163,CPT,NUNDSC ICRA W/RETRIEVAL FB,,,21 ,,RBRVS,16.53 ,10.97 ,10.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62164,CPT,NUNDSC ICRA EXC TUM PLMT CATH DRG,,,21 ,,RBRVS,29.43 ,16.80 ,16.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62165,CPT,NUNDSC ICRA EXC PITUITARY TUM,,,21 ,,RBRVS,23.23 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62180,CPT,VENTRICULOCISTERNOSTOMY,,,21 ,,RBRVS,22.58 ,13.31 ,13.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62190,CPT,CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR,,,21 ,,RBRVS,12.17 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62192,CPT,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,,,21 ,,RBRVS,13.35 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62194,CPT,RPLCMT/IRRG SARACH/SDRL CATH,,,21 ,,RBRVS,5.78 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62200,CPT,VENTRICULOCISTERNOSTOMY 3RD VNTRC,,,21 ,,RBRVS,19.29 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62201,CPT,VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC,,,21 ,,RBRVS,16.04 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62220,CPT,CRTJ SHUNT VENTRICULO-ATR-JUG-AUR,,,21 ,,RBRVS,14.10 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62223,CPT,CRTJ SHUNT VENTRICULO-PRTL-PLEURAL OTH,,,21 ,,RBRVS,14.05 ,9.66 ,9.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62225,CPT,RPLCMT/IRRIGATION VENTR CATH,,,21 ,,RBRVS,6.19 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62230,CPT,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,,,21 ,,RBRVS,11.43 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62252,CPT,REPRGRMG PRGRBL CEREBSP SHUNT,,,21 ,,RBRVS,0.74 ,1.70 ,1.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,62252,CPT,REPRGRMG PRGRBL CEREBSP SHUNT,26,,21 ,,RBRVS,0.74 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62252,CPT,REPRGRMG PRGRBL CEREBSP SHUNT,TC,,21 ,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,62256,CPT,RMVL COMPL CEREBSP FLU SHUNT SYS W/O RPLCMT,,,21 ,,RBRVS,7.38 ,5.92 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62258,CPT,RMVL COMPL CSF SHUNT SYS W/RPLCMT,,,21 ,,RBRVS,15.64 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62263,CPT,PRQ LSS EDRL ADS SLN NJX/MCHNL LOCLZJ 2+ D,,,21 ,,RBRVS,6.54 ,3.36 ,10.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62264,CPT,PRQ LSS EDRL ADS SLN NJX/MCHNL LOCLZJ 1 D,,,21 ,,RBRVS,4.42 ,1.51 ,5.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62267,CPT,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,,,21 ,,RBRVS,3.00 ,1.25 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62268,CPT,PRQ ASPIR SPI CORD CST/SYRINX,,,21 ,,RBRVS,4.73 ,1.96 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62269,CPT,BX SPI CORD PRQ NDL,,,21 ,,RBRVS,5.01 ,1.81 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62270,CPT,SPI PNXR LMBR DX,,,21 ,,RBRVS,1.37 ,0.60 ,2.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62272,CPT,SPI PNXR THER F/DRG CEREBSP FLU,,,21 ,,RBRVS,1.35 ,0.68 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62273,CPT,NJX EDRL BLD/CLOT PATCH,,,21 ,,RBRVS,2.15 ,0.69 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62280,CPT,NJX/NFS NULYT SBST SBST SARACH,,,21 ,,RBRVS,2.63 ,1.20 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62281,CPT,NJX/NFS NULYT SBST EDRL CRV/THRC,,,21 ,,RBRVS,2.66 ,1.13 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62282,CPT,NJX/NFS NULYT SBST EDRL LMBR SAC,,,21 ,,RBRVS,2.33 ,1.16 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62284,CPT,INJECTION PROCEDURE MYELOGRAPHY/CT SPINAL,,,21 ,,RBRVS,1.54 ,0.73 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62287,CPT,DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR,,,21 ,,RBRVS,9.03 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62290,CPT,NJX DISKOGRAPY EA LVL LMBR,,,21 ,,RBRVS,3.00 ,1.34 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62291,CPT,NJX DISKOGRAPY EA LVL CRV/THRC,,,21 ,,RBRVS,2.91 ,1.28 ,4.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62292,CPT,NJX CHEMONUCLEOLSS DISKOGRAPY 1+ LMBR,,,21 ,,RBRVS,9.24 ,3.26 ,3.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62294,CPT,NJX ARTL OCCLUSION ARVEN MALFRMJ SPI,,,21 ,,RBRVS,12.87 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62310,CPT,NJX C+-DX/THER SBST EDRL/SARACH CRV/THRC,,,21 ,,RBRVS,1.91 ,0.70 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62311,CPT,NJX C+-DX/THER SBST EDRL/SARACH LMBR SAC,,,21 ,,RBRVS,1.54 ,0.63 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62318,CPT,NJX NFS/BOLUS DX/SBST EDRL/SARACH CRV/THRC,,,21 ,,RBRVS,2.04 ,0.53 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62319,CPT,NJX NFS/BOLUS DX/SBST EDRL/SARACH LMBR SAC,,,21 ,,RBRVS,1.87 ,0.55 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62350,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,,,21 ,,RBRVS,6.05 ,3.38 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62351,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,,,21 ,,RBRVS,11.66 ,8.13 ,8.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62355,CPT,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,,,21 ,,RBRVS,4.35 ,2.80 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62360,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,,,21 ,,RBRVS,4.33 ,2.81 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62361,CPT,IMPLTJ/RPLCMT ITHCL/EDRL NFS NON-PRGRBL PMP,,,21 ,,RBRVS,5.65 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62362,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PMP,,,21 ,,RBRVS,6.10 ,3.69 ,3.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62365,CPT,RMVL SUBQ RSVR/PMP,,,21 ,,RBRVS,4.65 ,3.16 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62367,CPT,ELEC ALYS PRGRBL PMP W/O REPRGRMG,,,21 ,,RBRVS,0.48 ,0.14 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,62368,CPT,ELEC ALYS PRGRBL PMP REPRGRMG,,,21 ,,RBRVS,0.75 ,0.22 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63001,CPT,LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV,,,21 ,,RBRVS,17.61 ,10.47 ,10.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63003,CPT,LAM W/O FFD 1/2 VRT SEG THRC,,,21 ,,RBRVS,17.74 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63005,CPT,LAM W/O FFD 1/2 VRT SEG LMBR,,,21 ,,RBRVS,16.43 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63011,CPT,LAM W/O FFD 1/2 VRT SEG SAC,,,21 ,,RBRVS,15.91 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63012,CPT,LAM W/RMVL ABNORMAL FACETS LMBR,,,21 ,,RBRVS,16.85 ,10.57 ,10.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63015,CPT,LAM W/O FFD > 2 VRT SEG CRV,,,21 ,,RBRVS,20.85 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63016,CPT,LAM W/O FFD > 2 VRT SEG THRC,,,21 ,,RBRVS,22.03 ,12.69 ,12.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63017,CPT,LAM W/O FFD > 2 VRT SEG LMBR,,,21 ,,RBRVS,17.33 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63020,CPT,LAMINOTOMY INCL OPN & NDSC 1 INTERSPACE CERVICAL,,,21 ,,RBRVS,16.20 ,10.57 ,10.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63030,CPT,LAMINOTOMY INCL OPEN & NDSC 1 INTERSPACE LUMBAR,,,21 ,,RBRVS,13.18 ,9.17 ,9.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63035,CPT,LAMOT INCL OPEN&NDSC EA ADDL INTERSPACE CRV/LMBR,,,21 ,,RBRVS,3.15 ,1.42 ,1.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63040,CPT,LAMOT PRTL FFD HRNA8 REEXPL 1 NTRSPC CRV,,,21 ,,RBRVS,20.31 ,11.99 ,11.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63042,CPT,LAMOT PRTL FFD HRNA8 REEXPL 1 NTRSPC LMBR,,,21 ,,RBRVS,18.76 ,11.61 ,11.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63043,CPT,LAMOT PRTL FFD HRNA8 REEXPL 1 NTRSPC EA CRV,,,21 ,,TotalUnits,,,,17.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,63044,CPT,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,,,21 ,,TotalUnits,,,,16.75 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,63045,CPT,LAM FACETEC&FORAMOT 1 SGM CRV,,,21 ,,RBRVS,17.95 ,11.09 ,11.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63046,CPT,LAM FACETEC&FORAMOT 1 SGM THRC,,,21 ,,RBRVS,17.25 ,10.69 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63047,CPT,LAM FACETEC&FORAMOT 1 SGM LMBR,,,21 ,,RBRVS,15.37 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63048,CPT,LAM FACETEC&FORAMOT 1 SGM EA CRV THRC/LMBR,,,21 ,,RBRVS,3.47 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63050,CPT,LAMOP CRV W/DCMPRN SPI CORD 2/MORE VRT SEG,,,21 ,,RBRVS,22.01 ,12.90 ,12.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63051,CPT,LAMOP CRV DCMPRN SPI CORD 2+ SEG RCNSTJ B1,,,21 ,,RBRVS,25.51 ,14.34 ,14.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63055,CPT,TRANSPEDICULAR DCMPRN SPI CORD 1 SGM THRC,,,21 ,,RBRVS,23.55 ,13.61 ,13.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63056,CPT,TRANSPEDICULAR DCMPRN SPI CORD 1 SGM LMBR,,,21 ,,RBRVS,21.86 ,12.58 ,12.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63057,CPT,TRANSPEDICULAR DCMPRN 1 SGM EA THRC/LMBR,,,21 ,,RBRVS,5.25 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63064,CPT,COSTOVRT DCMPRN THRC 1 SGM,,,21 ,,RBRVS,26.22 ,14.51 ,14.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63066,CPT,COSTOVRT DCMPRN THRC EA SGM,,,21 ,,RBRVS,3.26 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63075,CPT,DSKC ANT DCMPRN CRV 1 NTRSPC,,,21 ,,RBRVS,19.60 ,12.07 ,12.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63076,CPT,DSKC ANT DCMPRN CRV EA NTRSPC,,,21 ,,RBRVS,4.04 ,1.81 ,1.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63077,CPT,DSKC ANT DCMPRN THRC 1 NTRSPC,,,21 ,,RBRVS,22.88 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63078,CPT,DSKC ANT DCMPRN THRC EA NTRSPC,,,21 ,,RBRVS,3.28 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63081,CPT,VCRPEC ANT DCMPRN CRV 1 SGM,,,21 ,,RBRVS,26.10 ,14.81 ,14.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63082,CPT,VCRPEC ANT DCMPRN CRV EA SGM,,,21 ,,RBRVS,4.36 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63085,CPT,VCRPEC TTHRC DCMPRN THRC 1 SGM,,,21 ,,RBRVS,29.47 ,15.21 ,15.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63086,CPT,VCRPEC TTHRC DCMPRN THRC EA SGM,,,21 ,,RBRVS,3.19 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63087,CPT,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SGM,,,21 ,,RBRVS,37.53 ,19.10 ,19.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63088,CPT,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SGM,,,21 ,,RBRVS,4.32 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63090,CPT,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SGM,,,21 ,,RBRVS,30.93 ,16.13 ,16.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63091,CPT,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SGM,,,21 ,,RBRVS,3.03 ,1.33 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63101,CPT,VCRPEC LAT XTRCAVITARY DCMPRN THRC 1 SGM,,,21 ,,RBRVS,34.10 ,19.20 ,19.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63102,CPT,VCRPEC LAT XTRCAVITARY DCMPRN LMBR 1 SGM,,,21 ,,RBRVS,34.10 ,18.97 ,18.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63103,CPT,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SGM,,,21 ,,RBRVS,4.82 ,2.18 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63170,CPT,LAM W/MYELOTOMY CRV THRC/THORACOLMBR,,,21 ,,RBRVS,22.21 ,12.98 ,12.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63172,CPT,LAM W/DRG IMED CST/SYRINX SARACH SPACE,,,21 ,,RBRVS,19.76 ,11.67 ,11.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63173,CPT,LAM W/DRG IMED CST/SYRINX PRTL/PLEURAL SPACE,,,21 ,,RBRVS,24.31 ,14.35 ,14.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63180,CPT,LAM&SCTJ DENTATE LIGMS CRV 1/2 SEG,,,21 ,,RBRVS,20.53 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63182,CPT,LAM&SCTJ DENTATE LIGMS CRV > 2 SEG,,,21 ,,RBRVS,22.82 ,11.45 ,11.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63185,CPT,LAM W/RHIZOTOMY 1/2 SEG,,,21 ,,RBRVS,16.49 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63190,CPT,LAM W/RHIZOTOMY > 2 SEG,,,21 ,,RBRVS,18.89 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63191,CPT,LAM W/SCTJ SPI ACCESSORY NRV,,,21 ,,RBRVS,18.92 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63194,CPT,LAM CORDOTOMY SCTJ 1 TRC 1 STG CRV,,,21 ,,RBRVS,22.10 ,12.47 ,12.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63195,CPT,LAM CORDOTOMY SCTJ 1 TRC 1 STG THRC,,,21 ,,RBRVS,21.64 ,12.46 ,12.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63196,CPT,LAM CORDOTOMY SCTJ BTH TRCS 1 STG CRV,,,21 ,,RBRVS,25.27 ,13.49 ,13.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63197,CPT,LAM CORDOTOMY SCTJ BTH TRCS 1 STG THRC,,,21 ,,RBRVS,24.08 ,14.15 ,14.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63198,CPT,LAM CORDOTOMY SCTJ BTH TRCS 2 STGS CRV,,,21 ,,RBRVS,29.90 ,11.94 ,11.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63199,CPT,LAM CORDOTOMY SCTJ BTH TRCS 2 STGS THRC,,,21 ,,RBRVS,31.47 ,15.57 ,15.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63200,CPT,LAM RLS TETHERED SPI CORD LMBR,,,21 ,,RBRVS,21.44 ,12.71 ,12.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63250,CPT,LAM EXC/OCCLUSION AVM SPI CORD CRV,,,21 ,,RBRVS,43.86 ,22.48 ,22.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63251,CPT,LAM EXC/OCCLUSION AVM SPI CORD THRC,,,21 ,,RBRVS,44.64 ,23.43 ,23.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63252,CPT,LAM EXC/OCCLUSION AVM SPI CORD THORACOLMBR,,,21 ,,RBRVS,44.63 ,23.37 ,23.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63265,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CRV,,,21 ,,RBRVS,23.82 ,13.94 ,13.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63266,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THRC,,,21 ,,RBRVS,24.68 ,14.20 ,14.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63267,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL LMBR,,,21 ,,RBRVS,19.45 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63268,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SAC,,,21 ,,RBRVS,20.02 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63270,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL CRV,,,21 ,,RBRVS,29.80 ,16.56 ,16.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63271,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL THRC,,,21 ,,RBRVS,29.92 ,16.65 ,16.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63272,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL LMBR,,,21 ,,RBRVS,27.50 ,15.55 ,15.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63273,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL SAC,,,21 ,,RBRVS,26.47 ,14.51 ,14.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63275,CPT,LAM BX/EXC ISPI NEO XDRL CRV,,,21 ,,RBRVS,25.86 ,14.72 ,14.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63276,CPT,LAM BX/EXC ISPI NEO XDRL THRC,,,21 ,,RBRVS,25.69 ,14.68 ,14.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63277,CPT,LAM BX/EXC ISPI NEO XDRL LMBR,,,21 ,,RBRVS,22.39 ,13.16 ,13.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63278,CPT,LAM BX/EXC ISPI NEO XDRL SAC,,,21 ,,RBRVS,22.12 ,13.06 ,13.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63280,CPT,LAM BX/EXC ISPI NEO IDRL XMED CRV,,,21 ,,RBRVS,30.29 ,17.32 ,17.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63281,CPT,LAM BX/EXC ISPI NEO IDRL XMED THRC,,,21 ,,RBRVS,29.99 ,17.09 ,17.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63282,CPT,LAM BX/EXC ISPI NEO IDRL XMED LMBR,,,21 ,,RBRVS,28.15 ,16.32 ,16.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63283,CPT,LAM BX/EXC ISPI NEO IDRL SAC,,,21 ,,RBRVS,26.76 ,15.59 ,15.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63285,CPT,LAM BX/EXC ISPI NEO IDRL IMED CRV,,,21 ,,RBRVS,38.05 ,20.27 ,20.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63286,CPT,LAM BX/EXC ISPI NEO IDRL IMED THRC,,,21 ,,RBRVS,37.62 ,20.36 ,20.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63287,CPT,LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR,,,21 ,,RBRVS,40.08 ,21.35 ,21.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63290,CPT,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,,,21 ,,RBRVS,40.82 ,21.66 ,21.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63295,CPT,OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX,,,21 ,,RBRVS,5.25 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63300,CPT,VCRPEC LES 1 SGM XDRL CRV,,,21 ,,RBRVS,26.80 ,15.01 ,15.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63301,CPT,VCRPEC LES 1 SGM XDRL THRC TTHRC,,,21 ,,RBRVS,31.57 ,16.60 ,16.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63302,CPT,VCRPEC LES 1 SGM XDRL THRC THORACOLMBR,,,21 ,,RBRVS,31.15 ,16.56 ,16.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63303,CPT,VCRPEC LES 1 SGM XDRL LMBR/SAC TRANSPRTL/RPR,,,21 ,,RBRVS,33.55 ,16.62 ,16.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63304,CPT,VCRPEC LES 1 SGM IDRL CRV,,,21 ,,RBRVS,33.85 ,18.57 ,18.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63305,CPT,VCRPEC LES 1 SGM IDRL THRC TTHRC,,,21 ,,RBRVS,36.24 ,18.24 ,18.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63306,CPT,VCRPEC LES 1 SGM IDRL THRC THORACOLMBR,,,21 ,,RBRVS,35.55 ,19.53 ,19.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63307,CPT,VCRPEC LES 1 SGM IDRL LMBR/SAC TRANSPRTL/RPR,,,21 ,,RBRVS,34.96 ,17.22 ,17.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63308,CPT,VCRPEC LES 1 SGM EA SGM,,,21 ,,RBRVS,5.24 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63600,CPT,CRTJ LES SPI CORD STRTCTC PRQ,,,21 ,,RBRVS,15.12 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63610,CPT,STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG,,,21 ,,RBRVS,8.72 ,1.82 ,22.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63615,CPT,STRTCTC BX ASPIR/EXC LES SPI CORD,,,21 ,,RBRVS,17.32 ,8.94 ,8.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63620,CPT,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,,,21 ,,RBRVS,15.60 ,7.68 ,7.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63621,CPT,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,,,21 ,,RBRVS,4.00 ,1.62 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63650,CPT,PRQ IMPLTJ NSTIM ELTRD RA EDRL,,,21 ,,RBRVS,7.20 ,3.24 ,3.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63655,CPT,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,,,21 ,,RBRVS,11.56 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63661,CPT,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,,,21 ,,RBRVS,5.08 ,3.18 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63662,CPT,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,,,21 ,,RBRVS,11.00 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63663,CPT,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,,,21 ,,RBRVS,7.75 ,4.26 ,13.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63664,CPT,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,,,21 ,,RBRVS,11.52 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63685,CPT,INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING,,,21 ,,RBRVS,6.05 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63688,CPT,REVJ/RMVL IMPLTED SPI NPGR,,,21 ,,RBRVS,5.30 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63700,CPT,RPR MENINGOCELE < 5 CM DIAM,,,21 ,,RBRVS,17.47 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63702,CPT,RPR MENINGOCELE > 5 CM DIAM,,,21 ,,RBRVS,19.41 ,12.32 ,12.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63704,CPT,RPR MYELOMENINGOCELE < 5 CM DIAM,,,21 ,,RBRVS,22.43 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63706,CPT,RPR MYELOMENINGOCELE > 5 CM DIAM,,,21 ,,RBRVS,25.35 ,15.32 ,15.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63707,CPT,RPR DURAL/CEREBSP FLU LEAK X REQ LAM,,,21 ,,RBRVS,12.65 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63709,CPT,RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM,,,21 ,,RBRVS,15.65 ,9.83 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63710,CPT,DURAL GRF SPI,,,21 ,,RBRVS,15.40 ,9.85 ,9.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63740,CPT,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM,,,21 ,,RBRVS,12.63 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63741,CPT,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,,,21 ,,RBRVS,9.12 ,5.00 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63744,CPT,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,,,21 ,,RBRVS,8.94 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,63746,CPT,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,,,21 ,,RBRVS,7.33 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64400,CPT,NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH,,,21 ,,RBRVS,1.11 ,0.51 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64402,CPT,NJX ANES FACIAL NRV,,,21 ,,RBRVS,1.25 ,0.58 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64405,CPT,NJX ANES GRTER OCCIPITAL NRV,,,21 ,,RBRVS,1.32 ,0.56 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64408,CPT,NJX ANES VAGUS NRV,,,21 ,,RBRVS,1.41 ,0.85 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64410,CPT,NJX ANES PHRENIC NRV,,,21 ,,RBRVS,1.43 ,0.56 ,2.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64412,CPT,NJX ANES SPI ACCESSORY NRV,,,21 ,,RBRVS,1.18 ,0.62 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64413,CPT,NJX ANES CRV PLEXUS,,,21 ,,RBRVS,1.40 ,0.54 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64415,CPT,"SINGLE NERVE BLOCK INJECTION, ARM NERVE",,,21 ,,RBRVS,1.48 ,0.37 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64416,CPT,INJECTION ANES BRACHIAL PLEXUS CONT NFS CATH,,,21 ,,RBRVS,1.81 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64417,CPT,NJX ANES AX NRV,,,21 ,,RBRVS,1.44 ,0.38 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64418,CPT,NJX ANES SUPRASCAPULAR NRV,,,21 ,,RBRVS,1.32 ,0.55 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64420,CPT,NJX ANES INTERCOSTAL NRV 1,,,21 ,,RBRVS,1.18 ,0.50 ,2.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64421,CPT,"MULTIPLE NERVE BLOCK INJECTIONS, RIB NERVES",,,21 ,,RBRVS,1.68 ,0.62 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64425,CPT,NJX ANES ILIOINGUN ILIOHYPOGSTR NRV,,,21 ,,RBRVS,1.75 ,0.62 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64430,CPT,NJX ANES PUDENDAL NRV,,,21 ,,RBRVS,1.46 ,0.73 ,2.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64435,CPT,NJX ANES PARACRV NRV,,,21 ,,RBRVS,1.45 ,0.64 ,2.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64445,CPT,NJX ANES SCIATIC NRV 1,,,21 ,,RBRVS,1.48 ,0.55 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64446,CPT,INJECTION ANES SCIATIC NERVE CONT INFUSION CATH,,,21 ,,RBRVS,1.81 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64447,CPT,NJX ANES FEM NRV 1,,,21 ,,RBRVS,1.50 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64448,CPT,INJECTION ANES FEMORAL NERVE CONT INFUSION CATH,,,21 ,,RBRVS,1.63 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64449,CPT,INJECTION ANES LUMBAR PLEXUS POST CONT NFS CATH,,,21 ,,RBRVS,1.81 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64450,CPT,NJX ANES OTH PRPH NRV/BRANCH,,,21 ,,RBRVS,1.27 ,0.51 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64455,CPT,NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE,,,21 ,,RBRVS,0.75 ,0.25 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64479,CPT,NJX ANES&/STRD TFRML EDRL CRV/THRC 1 LVL,,,21 ,,RBRVS,2.20 ,0.96 ,4.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64480,CPT,NJX ANES&/STRD TFRML EDRL CRV/THRC EA LVL,,,21 ,,RBRVS,1.54 ,0.50 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64483,CPT,NJX ANES&/STRD TFRML EDRL LMBR/SAC 1 LVL,,,21 ,,RBRVS,1.90 ,0.88 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64484,CPT,NJX ANES&/STRD TFRML EDRL LMBR/SAC EA LVL,,,21 ,,RBRVS,1.33 ,0.42 ,2.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64490,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,,,21 ,,RBRVS,1.82 ,1.02 ,3.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64491,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,,,21 ,,RBRVS,1.16 ,0.46 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64492,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,,,21 ,,RBRVS,1.16 ,0.49 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64493,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,,,21 ,,RBRVS,1.52 ,0.90 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64494,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,,,21 ,,RBRVS,1.00 ,0.39 ,1.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64495,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,,,21 ,,RBRVS,1.00 ,0.42 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64505,CPT,NJX ANES SPHENOPALATINE GANGLION,,,21 ,,RBRVS,1.36 ,0.75 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64508,CPT,NJX ANES CRTD SINUS SPX,,,21 ,,RBRVS,1.12 ,0.68 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64510,CPT,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,,,21 ,,RBRVS,1.22 ,0.53 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64517,CPT,NJX ANES SUPRIOR HYPOGSTR PLEXUS,,,21 ,,RBRVS,2.20 ,0.87 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64520,CPT,NJX ANES LMBR/THRC PVRT SYMPATHETIC,,,21 ,,RBRVS,1.35 ,0.62 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64530,CPT,NJX ANES CELIAC PLEXUS +-RAD MNTR,,,21 ,,RBRVS,1.58 ,0.73 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64550,CPT,APPL SURF TC NSTIM,,,21 ,,RBRVS,0.18 ,0.05 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64553,CPT,PRQ IMPLTJ NSTIM ELTRDS CRNL NRV,,,21 ,,RBRVS,2.36 ,1.64 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64555,CPT,PRQ IMPLTJ NSTIM ELTRDS PRPH NRV,,,21 ,,RBRVS,2.32 ,1.53 ,2.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64560,CPT,PRQ IMPLTJ NSTIM ELTRDS AUTONOMIC NRV,,,21 ,,RBRVS,2.41 ,1.55 ,2.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64561,CPT,PRQ IMPLTJ NSTIM ELTRDS SAC NRV,,,21 ,,RBRVS,7.15 ,3.60 ,20.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64565,CPT,PRQ IMPLTJ NSTIM ELTRDS NEUROMUSCULAR,,,21 ,,RBRVS,1.81 ,1.26 ,2.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64566,CPT,NEUROELTRD STIM POST TIBIAL,,,21 ,,RBRVS,0.60 ,3.17 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64568,CPT,INC FOR VAGUS N ELECT IMPL,,,21 ,,RBRVS,9.00 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64569,CPT,REVISE/REPL VAGUS N ELTRD,,,21 ,,RBRVS,11.00 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64570,CPT,REMOVE VAGUS N ELTRD,,,21 ,,RBRVS,9.10 ,4.06 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64575,CPT,INC IMPLTJ NSTIM ELTRDS PRPH NRV,,,21 ,,RBRVS,4.42 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64577,CPT,INC IMPLTJ NSTIM ELTRDS AUTONOMIC NRV,,,21 ,,RBRVS,4.69 ,3.98 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64580,CPT,INC IMPLTJ NSTIM ELTRDS NEUROMUSCULAR,,,21 ,,RBRVS,4.19 ,3.15 ,3.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64581,CPT,INC IMPLTJ NSTIM ELTRDS SAC NRV,,,21 ,,RBRVS,14.23 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64585,CPT,REVJ/RMVL PRPH NSTIM ELTRDS,,,21 ,,RBRVS,2.11 ,1.83 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64590,CPT,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,,,21 ,,RBRVS,2.45 ,1.96 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64595,CPT,REVISION/RMVL PERIPHERAL/GASTRIC NPGR,,,21 ,,RBRVS,1.78 ,1.69 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64600,CPT,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,,,21 ,,RBRVS,3.49 ,1.88 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64605,CPT,DSTRJ NULYT TRIGEMINAL NRV 2/3 DIV,,,21 ,,RBRVS,5.65 ,2.89 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64610,CPT,DSTRJ NULYT TRIGEMINAL NRV 2/3 DIV RAD MNTR,,,21 ,,RBRVS,7.20 ,4.04 ,9.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64611,CPT,CHEMODENERV SALIV GLANDS,,,21 ,,RBRVS,1.03 ,1.64 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64612,CPT,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV,,,21 ,,RBRVS,2.01 ,1.50 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64613,CPT,CHEMODNRVTJ MUSC NCK MUSC,,,21 ,,RBRVS,2.01 ,1.29 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64614,CPT,CHEMODNRVTJ MUSC XTR&/TRNK MUSC,,,21 ,,RBRVS,2.20 ,1.44 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64620,CPT,DSTRJ NULYT INTERCOSTAL NRV,,,21 ,,RBRVS,2.89 ,1.38 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64622,CPT,DSTRJ NULYT PVRT FACET JT NRV LMBR/SAC 1 LVL,,,21 ,,RBRVS,3.05 ,1.53 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64623,CPT,DSTRJ NULYT PVRT FACET JT NRV LMBR/SAC EA LVL,,,21 ,,RBRVS,0.99 ,0.28 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64626,CPT,DSTRJ NULYT PVRT FACET JT NRV CRV/THRC 1 LVL,,,21 ,,RBRVS,3.92 ,2.24 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64627,CPT,DSTRJ NULYT PVRT FACET JT NRV CRV/THRC EA LVL,,,21 ,,RBRVS,1.16 ,0.33 ,3.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64630,CPT,DSTRJ NULYT PUDENDAL NRV,,,21 ,,RBRVS,3.05 ,1.76 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64632,CPT,DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE,,,21 ,,RBRVS,1.23 ,0.66 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64640,CPT,DSTRJ NULYT OTH PRPH NRV/BRANCH,,,21 ,,RBRVS,2.81 ,1.56 ,2.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64650,CPT,CHEMODNRVTJ ECCRINE GLNDS BTH AX,,,21 ,,RBRVS,0.70 ,0.29 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64653,CPT,CHEMODNRVTJ ECCRINE GLNDS OTH AREA PR D,,,21 ,,RBRVS,0.88 ,0.35 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64680,CPT,DSTRJ NULYT +-RAD MNTR CELIAC PLEXUS,,,21 ,,RBRVS,2.67 ,1.43 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64681,CPT,DSTRJ NULYT +-RAD MNTR SUPRIOR HYPOGSTR PLEXUS,,,21 ,,RBRVS,3.78 ,1.46 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64702,CPT,NEURP DGTAL 1/BTH SM DGT,,,21 ,,RBRVS,6.26 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64704,CPT,NEURP NRV HAND/FOOT,,,21 ,,RBRVS,4.69 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64708,CPT,NEURP MAJOR PRPH NRV ARM/LEG OTH/THN SPECIFIED,,,21 ,,RBRVS,6.36 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64712,CPT,NEURP MAJOR PRPH NRV ARM/LEG SCIATIC NRV,,,21 ,,RBRVS,8.07 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64713,CPT,NEURP MAJOR PRPH NRV ARM/LEG BRACH PLEXUS,,,21 ,,RBRVS,11.40 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64714,CPT,NEURP MAJOR PRPH NRV ARM/LEG LMBR PLEXUS,,,21 ,,RBRVS,10.55 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64716,CPT,NEURP&/TRPOS CRNL NRV,,,21 ,,RBRVS,6.99 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64718,CPT,NEURP&/TRPOS UR NRV ELBW,,,21 ,,RBRVS,7.26 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64719,CPT,NEURP&/TRPOS UR NRV WRST,,,21 ,,RBRVS,4.97 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64721,CPT,NEURP&/TRPOS MEDIAN NRV CARPL TUNNEL,,,21 ,,RBRVS,4.97 ,5.12 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64722,CPT,DCMPRN UNSPECIFIED NRV,,,21 ,,RBRVS,4.82 ,3.47 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64726,CPT,DCMPRN PLNTAR DGTAL NRV,,,21 ,,RBRVS,4.27 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64727,CPT,INT NEUROLSS REQ MCRSCP,,,21 ,,RBRVS,3.10 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64732,CPT,TRNSXJ/AVLSN SUPRAORB NRV,,,21 ,,RBRVS,4.89 ,4.42 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64734,CPT,TRNSXJ/AVLSN INFRAORB NRV,,,21 ,,RBRVS,5.55 ,4.73 ,4.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64736,CPT,TRNSXJ/AVLSN MENTAL NRV,,,21 ,,RBRVS,5.23 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64738,CPT,TRNSXJ/AVLSN INF ALVEOLAR NRV OSTEOM,,,21 ,,RBRVS,6.36 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64740,CPT,TRNSXJ/AVLSN LNGL NRV,,,21 ,,RBRVS,6.22 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64742,CPT,TRNSXJ/AVLSN FACIAL NRV DIFFIAL/COMPL,,,21 ,,RBRVS,6.85 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64744,CPT,TRNSXJ/AVLSN GRTER OCCIPITAL NRV,,,21 ,,RBRVS,5.72 ,4.37 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64746,CPT,TRNSXJ/AVLSN PHRENIC NRV,,,21 ,,RBRVS,6.56 ,4.41 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64752,CPT,TRNSXJ/AVLSN VAGUS NRV TTHRC,,,21 ,,RBRVS,7.69 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64755,CPT,TRNSXJ/AVLSN VAGUS NRV PROX STOMACH,,,21 ,,RBRVS,15.05 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64760,CPT,TRNSXJ/AVLSN VAGUS NRV ABDL,,,21 ,,RBRVS,7.59 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64761,CPT,TRNSXJ/AVLSN PUDENDAL NRV,,,21 ,,RBRVS,7.04 ,4.13 ,4.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64763,CPT,TRNSXJ/AVLSN OBTURATOR NRV XTRPEL,,,21 ,,RBRVS,7.56 ,5.44 ,5.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64766,CPT,TRNSXJ/AVLSN OBTURATOR NRV INTRAPEL,,,21 ,,RBRVS,9.47 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64771,CPT,TRNSXJ/AVLSN OTH CRNL NRV XDRL,,,21 ,,RBRVS,8.15 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64772,CPT,TRNSXJ/AVLSN OTH SPI NRV XDRL,,,21 ,,RBRVS,7.84 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64774,CPT,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,,,21 ,,RBRVS,5.80 ,4.22 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64776,CPT,EXC NEUROMA DGTAL NRV 1/BTH SM DGT,,,21 ,,RBRVS,5.60 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64778,CPT,EXC NEUROMA DGTAL NRV EA DGT,,,21 ,,RBRVS,3.11 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64782,CPT,EXC NEUROMA HAND/FOOT XCP DGTAL NRV,,,21 ,,RBRVS,6.86 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64783,CPT,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,,,21 ,,RBRVS,3.71 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64784,CPT,EXC NEUROMA MAJOR PRPH NRV XCP SCIATIC,,,21 ,,RBRVS,10.62 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64786,CPT,EXC NEUROMA SCIATIC NRV,,,21 ,,RBRVS,16.25 ,9.62 ,9.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64787,CPT,IMPLTJ NRV END IN B1/MUSC,,,21 ,,RBRVS,4.29 ,1.87 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64788,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,,,21 ,,RBRVS,5.24 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64790,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,,,21 ,,RBRVS,12.10 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64792,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA X10SV,,,21 ,,RBRVS,15.86 ,9.97 ,9.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64795,CPT,BX NRV,,,21 ,,RBRVS,3.01 ,1.60 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64802,CPT,SYMPTH CRV,,,21 ,,RBRVS,10.37 ,4.87 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64804,CPT,SYMPTH CERVICOTHRC,,,21 ,,RBRVS,15.91 ,5.41 ,5.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64809,CPT,SYMPTH THORACOLMBR,,,21 ,,RBRVS,14.71 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64818,CPT,SYMPTH LMBR,,,21 ,,RBRVS,11.34 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64820,CPT,SYMPTH DGTAL ARTS EA DGT,,,21 ,,RBRVS,10.74 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64821,CPT,SYMPTH RDL ART,,,21 ,,RBRVS,9.33 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64822,CPT,SYMPTH UR ART,,,21 ,,RBRVS,9.33 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64823,CPT,SYMPTH SUPFC PLMR ARCH,,,21 ,,RBRVS,10.94 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64831,CPT,SUTR DGTAL NRV HAND/FOOT 1 NRV,,,21 ,,RBRVS,9.16 ,7.26 ,7.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64832,CPT,SUTR DGTAL NRV HAND/FOOT EA DGTAL NRV,,,21 ,,RBRVS,5.65 ,2.72 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64834,CPT,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,,,21 ,,RBRVS,10.81 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64835,CPT,SUTURE 1 NERVE MEDIAN MOTOR THENAR,,,21 ,,RBRVS,11.73 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64836,CPT,SUTURE 1 NERVE ULNAR MOTOR,,,21 ,,RBRVS,11.73 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64837,CPT,SUTR EA NRV HAND/FOOT,,,21 ,,RBRVS,6.25 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64840,CPT,SUTR POST TIBL NRV,,,21 ,,RBRVS,14.02 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64856,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,,,21 ,,RBRVS,15.07 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64857,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,,,21 ,,RBRVS,15.82 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64858,CPT,SUTR SCIATIC NRV,,,21 ,,RBRVS,17.82 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64859,CPT,SUTR EA MAJOR PRPH NRV,,,21 ,,RBRVS,4.25 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64861,CPT,SUTR BRACH PLEXUS,,,21 ,,RBRVS,20.89 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64862,CPT,SUTR LMBR PLEXUS,,,21 ,,RBRVS,21.09 ,11.09 ,11.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64864,CPT,SUTR FACIAL NRV XTRC,,,21 ,,RBRVS,13.41 ,8.26 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64865,CPT,SUTR FACIAL NRV ITPRL +-GRFG,,,21 ,,RBRVS,16.09 ,12.59 ,12.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64866,CPT,ANAST FACIAL-SPI ACCESSORY,,,21 ,,RBRVS,16.83 ,12.71 ,12.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64868,CPT,ANAST FACIAL-HYPOGLOSSAL,,,21 ,,RBRVS,14.90 ,11.17 ,11.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64870,CPT,ANAST FACIAL-PHRENIC,,,21 ,,RBRVS,17.08 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64872,CPT,SUTR NRV REQ SEC/DLYD SUTR,,,21 ,,RBRVS,1.99 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64874,CPT,SUTR NRV REQ X10SV MOBLJ/TRPOS NRV,,,21 ,,RBRVS,2.98 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64876,CPT,SUTR NRV REQ SHRT B1 XTR,,,21 ,,RBRVS,3.37 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64885,CPT,NRV GRF HEAD/NCK <4 CM,,,21 ,,RBRVS,17.60 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64886,CPT,NRV GRF HEAD/NCK >4 CM,,,21 ,,RBRVS,20.82 ,12.49 ,12.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64890,CPT,NRV GRF 1 STRAND HAND/FOOT <4 CM,,,21 ,,RBRVS,16.24 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64891,CPT,NRV GRF 1 STRAND HAND/FOOT >4 CM,,,21 ,,RBRVS,17.35 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64892,CPT,NRV GRF 1 STRAND ARM/LEG <4 CM,,,21 ,,RBRVS,15.74 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64893,CPT,NRV GRF 1 STRAND ARM/LEG >4 CM,,,21 ,,RBRVS,16.87 ,10.02 ,10.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64895,CPT,NRV GRF MLT STRANDS HAND/FOOT <4 CM,,,21 ,,RBRVS,20.39 ,11.47 ,11.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64896,CPT,NRV GRF MLT STRANDS HAND/FOOT > 4 CM,,,21 ,,RBRVS,21.96 ,13.22 ,13.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64897,CPT,NRV GRF MLT STRANDS ARM/LEG <4 CM,,,21 ,,RBRVS,19.38 ,11.33 ,11.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64898,CPT,NRV GRF MLT STRANDS ARM/LEG >4 CM,,,21 ,,RBRVS,20.97 ,12.48 ,12.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64901,CPT,NRV GRF EA NRV 1 STRAND,,,21 ,,RBRVS,10.20 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64902,CPT,NRV GRF EA NRV MLT STRANDS,,,21 ,,RBRVS,11.81 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64905,CPT,NRV PEDCL TR 1ST STG,,,21 ,,RBRVS,15.11 ,9.76 ,9.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64907,CPT,NRV PEDCL TR 2ND STG,,,21 ,,RBRVS,20.03 ,10.94 ,10.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64910,CPT,NERVE REPAIR W/CONDUIT EA NERVE,,,21 ,,RBRVS,11.39 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64911,CPT,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,,,21 ,,RBRVS,14.39 ,9.93 ,9.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,64999,CPT,UNLIS PX NRVS SYS,,,21 ,,TotalUnits,,,,3.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,65091,CPT,EVSC OC CNTS W/O IMPLT,,,21 ,,RBRVS,7.26 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65093,CPT,EVSC OC CNTS W/IMPLT,,,21 ,,RBRVS,7.04 ,7.89 ,7.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65101,CPT,ENCL EYE W/O IMPLT,,,21 ,,RBRVS,8.30 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65103,CPT,ENCL EYE IMPLT MUSC X ATTACHED IMPLT,,,21 ,,RBRVS,8.84 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65105,CPT,ENCL EYE IMPLT MUSC ATTACHED IMPLT,,,21 ,,RBRVS,9.93 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65110,CPT,EXNTJ ORBIT RMVL ORB CNTS ONLY,,,21 ,,RBRVS,15.70 ,13.26 ,13.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65112,CPT,EXNTJ ORBIT RMVL ORB CNTS W/THER RMVL B1,,,21 ,,RBRVS,18.51 ,15.38 ,15.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65114,CPT,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,,,21 ,,RBRVS,19.65 ,15.82 ,15.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65125,CPT,MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX,,,21 ,,RBRVS,3.27 ,3.58 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65130,CPT,INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL,,,21 ,,RBRVS,8.42 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65135,CPT,INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED,,,21 ,,RBRVS,8.60 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65140,CPT,INSJ OC IMPLT AFTER ENCL MUSC ATTACHED,,,21 ,,RBRVS,9.46 ,9.64 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65150,CPT,RINSJ OC IMPLT +-CJNCL GRF,,,21 ,,RBRVS,6.43 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65155,CPT,RINSJ OC IMPLT RNFCMT&/ATTACHMENT MUSC,,,21 ,,RBRVS,10.10 ,9.97 ,9.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65175,CPT,RMVL OC IMPLT,,,21 ,,RBRVS,7.40 ,8.10 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65205,CPT,RMVL FB XTRNL EYE CJNCL SUPFC,,,21 ,,RBRVS,0.71 ,0.35 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65210,CPT,RMVL FB XTRNL EYE EMBEDDED SCJNCL/SCLL NONPRF8,,,21 ,,RBRVS,0.84 ,0.45 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65220,CPT,RMVL FB XTRNL EYE CRNL W/O SLIT LAMP,,,21 ,,RBRVS,0.71 ,0.32 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65222,CPT,RMVL FB XTRNL EYE CRNL W/SLIT LAMP,,,21 ,,RBRVS,0.93 ,0.48 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65235,CPT,RMVL FB IO FROM ANT CHAMBER EYE/LENS,,,21 ,,RBRVS,9.01 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65260,CPT,RMVL FB IO FROM POST SGM MAG XTRJ ANT/POST ROUTE,,,21 ,,RBRVS,12.54 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65265,CPT,RMVL FB IO FROM POST SGM NONMAG XTRJ,,,21 ,,RBRVS,14.34 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65270,CPT,RPR LAC CJNC +-NONPRF8 LAC SCL DIR CLSR,,,21 ,,RBRVS,1.95 ,1.41 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65272,CPT,RPR LAC CJNC MOBLJ&REARGMT W/O HOSPIZATION,,,21 ,,RBRVS,4.62 ,3.65 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65273,CPT,RPR LAC CJNC MOBLJ&REARGMT W/HOSPIZATION,,,21 ,,RBRVS,5.16 ,3.88 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65275,CPT,RPR LAC CRN NONPRF8 +-RMVL FB,,,21 ,,RBRVS,6.29 ,4.52 ,6.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65280,CPT,RPR LAC CRN&/SCL PRF8 X INVG UVEAL TISS,,,21 ,,RBRVS,9.10 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65285,CPT,RPR LAC CRN&/SCL PRF8 W/REPOS/RESCJ UVEAL TISS,,,21 ,,RBRVS,14.71 ,9.92 ,9.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65286,CPT,RPR LAC APPL TISS GLUE WND CRN&/SCL,,,21 ,,RBRVS,6.63 ,5.07 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65290,CPT,RPR WND EO MUSCLE TENDON&/TENON'S CAPSULE,,,21 ,,RBRVS,6.53 ,5.11 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65400,CPT,EXC LES CRN XCP PTERYGIUM,,,21 ,,RBRVS,7.50 ,6.65 ,8.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65410,CPT,BX CRN,,,21 ,,RBRVS,1.47 ,1.01 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65420,CPT,EXC/TRPOS PTERYGIUM W/O GRF,,,21 ,,RBRVS,4.36 ,4.50 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65426,CPT,EXC/TRPOS PTERYGIUM W/GRF,,,21 ,,RBRVS,6.05 ,5.23 ,9.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65430,CPT,SCRAPING CRN DX F/SMR&/CULTURE,,,21 ,,RBRVS,1.47 ,1.01 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65435,CPT,RMVL CRNL EPITHE +-CHEMOCAUT,,,21 ,,RBRVS,0.92 ,0.74 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65436,CPT,RMVL CRNL EPITHE W/APPL CHELATING AGT,,,21 ,,RBRVS,4.82 ,3.94 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65450,CPT,DSTRJ LES CRN CRTX PC/THERMOCAUT,,,21 ,,RBRVS,3.47 ,4.04 ,4.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65600,CPT,MLT PNXRS ANT CRN,,,21 ,,RBRVS,4.20 ,3.81 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65710,CPT,KERATOPLASTY ANTERIOR LAMELLAR,,,21 ,,RBRVS,14.45 ,11.75 ,11.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65730,CPT,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,,,21 ,,RBRVS,16.35 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65750,CPT,KERATOPLASTY PENTRG APHK,,,21 ,,RBRVS,16.90 ,12.47 ,12.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65755,CPT,KERATOPLASTY PENTRG PSEUDOPHAKIA,,,21 ,,RBRVS,16.79 ,12.42 ,12.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65756,CPT,KERATOPLASTY ENDOTHELIAL,,,21 ,,RBRVS,16.84 ,11.26 ,11.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65757,CPT,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,,,21 ,,TotalUnits,,,,7.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,65760,CPT,KERATOMILEUSIS,,,21 ,,TotalUnits,,,,23.36 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,65765,CPT,KERATOPHAKIA,,,21 ,,RBRVS,23.32 ,15.95 ,15.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65767,CPT,EPIKERATOPLASTY,,,21 ,,RBRVS,21.71 ,14.85 ,14.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65770,CPT,KERATOPROSTH,,,21 ,,RBRVS,19.74 ,13.79 ,13.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65771,CPT,RDL KERATOTOMY,,,21 ,,TotalUnits,,,,13.21 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,65772,CPT,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,,,21 ,,RBRVS,5.09 ,4.46 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65775,CPT,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,,,21 ,,RBRVS,6.91 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65778,CPT,COVER EYE W/MEMBRANE,,,21 ,,RBRVS,1.19 ,35.71 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65779,CPT,COVER EYE W/MEMBRANE STENT,,,21 ,,RBRVS,3.92 ,29.05 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65780,CPT,OC SURF RCNSTJ AMNIOTIC MEMB TRNSPLJ,,,21 ,,RBRVS,10.73 ,10.25 ,10.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65781,CPT,OC SURF RCNSTJ LIMBAL STEM CELL ALGRFT,,,21 ,,RBRVS,18.14 ,13.71 ,13.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65782,CPT,OC SURF RCNSTJ LIMBAL CJNCL AGRFT,,,21 ,,RBRVS,15.43 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65800,CPT,PCNTS EYE SPX DX ASPIR AQUEOUS,,,21 ,,RBRVS,1.91 ,1.22 ,1.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65805,CPT,PCNTS EYE SPX THER RLS AQUEOUS,,,21 ,,RBRVS,1.91 ,1.23 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65810,CPT,PCNTS EYE SPX RMVL VTS&/DSCJ MEMB,,,21 ,,RBRVS,5.82 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65815,CPT,PCNTS EYE SPX RMVL BLD,,,21 ,,RBRVS,6.00 ,5.22 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65820,CPT,GONIOTOMY,,,21 ,,RBRVS,8.91 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65850,CPT,TRABECULOTOMY AB EXTERNO,,,21 ,,RBRVS,11.39 ,8.61 ,8.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65855,CPT,TRABECULOPLASTY LASER SURG 1+ SESS,,,21 ,,RBRVS,3.99 ,3.10 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65860,CPT,SEVERING ADS ANT SGM LASER TQ SPX,,,21 ,,RBRVS,3.59 ,2.49 ,3.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65865,CPT,SEVERING ADS ANT SGM INCAL TQ SPX GONIOSYNECHIAE,,,21 ,,RBRVS,5.77 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65870,CPT,SEVERING ADS ANT SGM INCAL SPX ANT SYNECHIAE,,,21 ,,RBRVS,7.39 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65875,CPT,SEVERING ADS ANT SGM INCAL SPX POST SYNECHIAE,,,21 ,,RBRVS,7.81 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65880,CPT,SEVERING ADS ANT SGM INCAL SPX CORNEOVITREAL,,,21 ,,RBRVS,8.36 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65900,CPT,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,,,21 ,,RBRVS,12.51 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65920,CPT,RMVL IMPLTED MATRL ANT SGM EYE,,,21 ,,RBRVS,9.99 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,65930,CPT,RMVL BLD CLOT ANT SGM EYE,,,21 ,,RBRVS,8.39 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66020,CPT,NJX ANT CHAMBER EYE SPX AIR/LIQ,,,21 ,,RBRVS,1.64 ,1.47 ,2.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66030,CPT,NJX ANT CHAMBER EYE SPX MED,,,21 ,,RBRVS,1.30 ,1.31 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66130,CPT,EXC LES SCL,,,21 ,,RBRVS,7.83 ,5.75 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66150,CPT,FSTLJ SCL GLC TREPH IRDEC,,,21 ,,RBRVS,10.53 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66155,CPT,FSTLJ SCL GLC THERMOCAUT IRDEC,,,21 ,,RBRVS,10.52 ,9.99 ,9.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66160,CPT,FSTLJ SCL GLC SCLERCOMY PUNCH/SCISSORS IRDEC,,,21 ,,RBRVS,12.39 ,10.85 ,10.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66165,CPT,FSTLJ SCL GLC IRIDENCLEISIS/IRIDOTASIS,,,21 ,,RBRVS,10.24 ,9.86 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66170,CPT,FSTLJ SCL GLC TRBEC AB EXTERNO,,,21 ,,RBRVS,15.02 ,13.17 ,13.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66172,CPT,FSTLJ SCL GLC TRBEC AB EXTERNO SCARRING,,,21 ,,RBRVS,18.86 ,16.64 ,16.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66174,CPT,TRANSLUM DIL EYE CANAL,,,21 ,,RBRVS,12.85 ,13.84 ,13.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66175,CPT,TRNSLUM DIL EYE CANAL W/STNT,,,21 ,,RBRVS,13.60 ,14.37 ,14.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66180,CPT,AQUEOUS SHUNT EO RSVR,,,21 ,,RBRVS,16.30 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66185,CPT,REVJ AQUEOUS SHUNT EO RSVR,,,21 ,,RBRVS,9.58 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66220,CPT,RPR SCLL STAPHYLOMA W/O GRF,,,21 ,,RBRVS,9.21 ,8.08 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66225,CPT,RPR SCLL STAPHYLOMA W/GRF,,,21 ,,RBRVS,12.63 ,9.44 ,9.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66250,CPT,REVJ/RPR OPRATIVE WND ANT SGM,,,21 ,,RBRVS,7.10 ,5.99 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66500,CPT,IRIDOTOMY STAB INC SPX XCP TRANSFIXION,,,21 ,,RBRVS,3.83 ,4.48 ,4.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66505,CPT,IRIDOTOMY STAB INC SPX TRANSFIXION,,,21 ,,RBRVS,4.22 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66600,CPT,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,,,21 ,,RBRVS,10.12 ,9.29 ,9.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66605,CPT,IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY,,,21 ,,RBRVS,14.22 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66625,CPT,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,,,21 ,,RBRVS,5.30 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66630,CPT,IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX,,,21 ,,RBRVS,7.28 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66635,CPT,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,,,21 ,,RBRVS,7.37 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66680,CPT,RPR IRIS CILIARY BDY,,,21 ,,RBRVS,6.39 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66682,CPT,SUTR IRIS CILIARY BDY SPX RETRIEVAL SUTR,,,21 ,,RBRVS,7.33 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66700,CPT,CILIARY BDY DSTRJ DTHRM,,,21 ,,RBRVS,5.14 ,4.16 ,5.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66710,CPT,CILIARY BDY DSTRJ CYCLOPC TRANSSCLL,,,21 ,,RBRVS,5.14 ,4.14 ,5.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66711,CPT,CILIARY BDY DSTRJ CYCLOPC NDSC,,,21 ,,RBRVS,7.93 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66720,CPT,CILIARY BDY DSTRJ CRTX,,,21 ,,RBRVS,5.00 ,4.87 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66740,CPT,CILIARY BDY DSTRJ CYCLODIAL,,,21 ,,RBRVS,5.14 ,4.18 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66761,CPT,IRIDOTOMY/IRDEC LASER SURG 1+ SESS,,,21 ,,RBRVS,5.02 ,4.72 ,5.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66762,CPT,IRIDOPLASTY PC 1+ SESS,,,21 ,,RBRVS,5.38 ,4.64 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66770,CPT,DSTRJ CST/LES IRIS/CILIARY BDY,,,21 ,,RBRVS,6.13 ,5.24 ,6.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66820,CPT,DSCJ SEC MEMBRANOUS CTRC STAB INC,,,21 ,,RBRVS,4.01 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66821,CPT,POST-CATARACT LASER SURGERY,,,21 ,,RBRVS,3.42 ,3.82 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66825,CPT,RPSG IO LENS PROSTH REQ INC SPX,,,21 ,,RBRVS,9.01 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66830,CPT,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,,,21 ,,RBRVS,9.47 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66840,CPT,RMVL LENS MATRL ASPIR TQ 1+ STGS,,,21 ,,RBRVS,9.18 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66850,CPT,RMVL LENS MATRL PHACOFRAGMENTATION ASPIR,,,21 ,,RBRVS,10.55 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66852,CPT,RMVL LENS MATRL PARS PLNA APPR +-VTRC,,,21 ,,RBRVS,11.41 ,8.61 ,8.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66920,CPT,RMVL LENS MATRL ICAPSL,,,21 ,,RBRVS,10.13 ,7.74 ,7.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66930,CPT,RMVL LENS MATRL ICAPSL F/DISLC LENS,,,21 ,,RBRVS,11.61 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66940,CPT,RMVL LENS MATRL XCAPSL,,,21 ,,RBRVS,10.37 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66982,CPT,XCAPSL CTRC RMVL INSJ LENS PROSTH 1 STG,,,21 ,,RBRVS,15.02 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66983,CPT,ICAPSL CTRC XTRJ INSJ IO LENS PROSTH 1 STG,,,21 ,,RBRVS,10.43 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66984,CPT,"CATARACT REMOVAL, INSERTION OF LENS",,,21 ,,RBRVS,10.52 ,7.63 ,7.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66985,CPT,INSJ IO LENS PROSTH X W/CNCRNT RMVL,,,21 ,,RBRVS,9.98 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66986,CPT,EXCHNG IO LENS,,,21 ,,RBRVS,12.26 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66990,CPT,USE OPH ENDOSCOPE,,,21 ,,RBRVS,1.51 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,66999,CPT,UNLIS ANT SGM EYE,,,21 ,,TotalUnits,,,,18.15 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,67005,CPT,RMVL VTS ANT APPR PRTL RMVL,,,21 ,,RBRVS,5.89 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67010,CPT,RMVL VTS ANT APPR STOT RMVL VTRC,,,21 ,,RBRVS,7.06 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67015,CPT,ASPIR/RLS FLU PARS PLNA,,,21 ,,RBRVS,7.14 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67025,CPT,NJX VTS SUB PARS PLNA/LIMBAL SPX,,,21 ,,RBRVS,8.11 ,6.76 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67027,CPT,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,,,21 ,,RBRVS,11.62 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67028,CPT,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,,,21 ,,RBRVS,2.52 ,1.51 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67030,CPT,DSCJ VTS STRANDS PARS PLNA,,,21 ,,RBRVS,6.11 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67031,CPT,SEVERING VTS STRANDS LASER 1+ STGS,,,21 ,,RBRVS,4.47 ,3.91 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67036,CPT,VTRC MCHNL PARS PLNA,,,21 ,,RBRVS,13.32 ,9.52 ,9.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67039,CPT,VTRC MCHNL PARS PLNA FOCAL ENDOLASER PC,,,21 ,,RBRVS,16.74 ,12.59 ,12.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67040,CPT,VTRC MCHNL PARS PLNA ENDOLASER PANRTA PC,,,21 ,,RBRVS,19.61 ,14.18 ,14.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67041,CPT,VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE,,,21 ,,RBRVS,19.25 ,12.24 ,12.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67042,CPT,VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA,,,21 ,,RBRVS,22.38 ,13.64 ,13.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67043,CPT,VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE,,,21 ,,RBRVS,23.24 ,14.61 ,14.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67101,CPT,RPR RTA DTCHMNT 1+ SESS CRTX/DTHRM +-DRG,,,21 ,,RBRVS,8.80 ,7.09 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67105,CPT,RPR RTA DTCHMNT 1+ SESS PC +-DRG SUBRTA,,,21 ,,RBRVS,8.53 ,6.68 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67107,CPT,RPR RTA DTCHMNT SCLL BUCKLING +-IMPLT,,,21 ,,RBRVS,16.71 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67108,CPT,RPR RTA DTCHMNT W/VTRC ANY METH,,,21 ,,RBRVS,22.89 ,15.35 ,15.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67110,CPT,RPR RTA DTCHMNT NJX AIR/OTH GAS,,,21 ,,RBRVS,10.25 ,8.03 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67112,CPT,RPR RTA DTCHMNT SCLL BUCKLING/VTRC PT,,,21 ,,RBRVS,18.75 ,12.78 ,12.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67113,CPT,RPR COMPLEX RETINA DETACH VITRECTOMY & MEMB PEEL,,,21 ,,RBRVS,25.35 ,16.12 ,16.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67115,CPT,RLS ENCIRCLING MATRL,,,21 ,,RBRVS,6.11 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67120,CPT,RMVL IMPLTED MATRL POST SGM EO,,,21 ,,RBRVS,7.10 ,6.03 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67121,CPT,RMVL IMPLTED MATRL POST SGM IO,,,21 ,,RBRVS,12.25 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67141,CPT,PROPH RTA DTCHMNT W/O DRG 1+ SESS CRTX DTHRM,,,21 ,,RBRVS,6.15 ,5.30 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67145,CPT,PROPH RTA DTCHMNT W/O DRG 1+ SESS,,,21 ,,RBRVS,6.32 ,5.38 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67208,CPT,DSTRJ LOCLZD LES RETINA 1+ SESS CRTX DTHRM,,,21 ,,RBRVS,7.65 ,6.00 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67210,CPT,DSTRJ LOCLZD LES RETINA 1+ SESS PC,,,21 ,,RBRVS,9.45 ,6.40 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67218,CPT,DSTRJ LES RETINA 1+ SESS RADJ IMPLTJ,,,21 ,,RBRVS,20.36 ,12.77 ,12.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67220,CPT,DSTRJ LES CHOROID PC 1+ SESS,,,21 ,,RBRVS,14.39 ,9.66 ,10.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67221,CPT,DSTRJ LES CHOROID PDT,,,21 ,,RBRVS,3.45 ,1.76 ,3.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67225,CPT,DSTRJ LES CHOROID PDT 2ND EYE 1 SESS,,,21 ,,RBRVS,0.47 ,0.22 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67227,CPT,DESTRUCTION RETINOPATHY 1+ SESS DIATHERMY,,,21 ,,RBRVS,7.53 ,5.95 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67228,CPT,EXTENSIVE RETINOPATHY 1+ SESS PHOTOCOAGULATION,,,21 ,,RBRVS,13.82 ,11.22 ,14.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67229,CPT,EXTENSIVE RETINOPATHY 1+ SESS PRETERM INFANT,,,21 ,,RBRVS,16.30 ,11.05 ,11.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67250,CPT,SCLL RNFCMT SPX W/O GRF,,,21 ,,RBRVS,9.61 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67255,CPT,SCLL RNFCMT SPX W/GRF,,,21 ,,RBRVS,10.17 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67299,CPT,UNLIS POST SGM,,,21 ,,TotalUnits,,,,12.81 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,67311,CPT,STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC,,,21 ,,RBRVS,7.77 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67312,CPT,STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC,,,21 ,,RBRVS,9.66 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67314,CPT,STRABISMUS RECESSION/RESCJ 1 VER MUSC,,,21 ,,RBRVS,8.79 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67316,CPT,STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC,,,21 ,,RBRVS,10.93 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67318,CPT,STRABISMUS ANY SUPRIOR OBLQ MUSC,,,21 ,,RBRVS,9.12 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67320,CPT,TRPOS ANY EO MUSC,,,21 ,,RBRVS,5.40 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67331,CPT,STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC,,,21 ,,RBRVS,5.13 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67332,CPT,STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY,,,21 ,,RBRVS,5.56 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67334,CPT,STRABISMUS POST FIXJ SUTR TQ +-MUSC RECESSION,,,21 ,,RBRVS,5.05 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67335,CPT,PLMT ADJUSTABLE SUTR STRABISMUS,,,21 ,,RBRVS,2.49 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67340,CPT,STRABISMUS EXPL&/RPR DETACHED EO MUSC,,,21 ,,RBRVS,6.00 ,2.67 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67343,CPT,RLS X10SV SCAR TISS W/O DETACHING EO MUSC SPX,,,21 ,,RBRVS,8.47 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67345,CPT,CHEMODNRVTJ EO MUSC,,,21 ,,RBRVS,3.01 ,2.01 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67346,CPT,BIOPSY EXTRAOCULAR MUSCLE,,,21 ,,RBRVS,2.87 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67399,CPT,UNLIS OC MUSC,,,21 ,,TotalUnits,,,,14.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,67400,CPT,ORBT W/O B1 FLAP EXPL +-BX,,,21 ,,RBRVS,11.20 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67405,CPT,ORBT W/O B1 FLAP DRG ONLY,,,21 ,,RBRVS,9.20 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67412,CPT,ORBT W/O B1 FLAP RMVL LES,,,21 ,,RBRVS,10.30 ,10.02 ,10.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67413,CPT,ORBT W/O B1 FLAP RMVL FB,,,21 ,,RBRVS,10.24 ,10.13 ,10.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67414,CPT,ORBT W/O B1 FLAP RMVL B1 DCMPRN,,,21 ,,RBRVS,17.94 ,13.41 ,13.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67415,CPT,FINE NDL ASPIR ORB CNTS,,,21 ,,RBRVS,1.76 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67420,CPT,ORBT B1 FLAP/WINDOW LAT RMVL LES,,,21 ,,RBRVS,21.87 ,16.84 ,16.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67430,CPT,ORBT B1 FLAP/WINDOW LAT RMVL FB,,,21 ,,RBRVS,15.29 ,14.31 ,14.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67440,CPT,ORBT B1 FLAP/WINDOW LAT DRG,,,21 ,,RBRVS,14.84 ,13.78 ,13.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67445,CPT,ORBT B1 FLAP/WINDOW LAT RMVL B1 DCMPRN,,,21 ,,RBRVS,19.12 ,14.27 ,14.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67450,CPT,ORBT B1 FLAP/WINDOW LAT EXPL +-BX,,,21 ,,RBRVS,15.41 ,14.33 ,14.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67500,CPT,RETROBULBAR NJX MED SPX,,,21 ,,RBRVS,1.44 ,0.50 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67505,CPT,RETROBULBAR NJX ALCOHOL,,,21 ,,RBRVS,1.27 ,0.63 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67515,CPT,NJX MED/OTHER SBST TENON'S CAPSULE,,,21 ,,RBRVS,1.40 ,0.69 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67550,CPT,ORB IMPLT INSJ,,,21 ,,RBRVS,11.77 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67560,CPT,ORB IMPLT RMVL/REVJ,,,21 ,,RBRVS,12.18 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67570,CPT,OPTIC NRV DCMPRN,,,21 ,,RBRVS,14.40 ,12.94 ,12.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67599,CPT,UNLIS ORBIT,,,21 ,,TotalUnits,,,,2.24 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,67700,CPT,BLEPHAROTOMY DRG ABSC EYELID,,,21 ,,RBRVS,1.40 ,1.32 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67710,CPT,SEVERING TARSORRHAPHY,,,21 ,,RBRVS,1.07 ,1.21 ,4.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67715,CPT,CANTHOTOMY SPX,,,21 ,,RBRVS,1.27 ,1.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67800,CPT,EXC CHALAZION 1,,,21 ,,RBRVS,1.41 ,1.06 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67801,CPT,EXC CHALAZION MLT SM LID,,,21 ,,RBRVS,1.91 ,1.29 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67805,CPT,EXC CHALAZION MLT DIFF LIDS,,,21 ,,RBRVS,2.27 ,1.67 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67808,CPT,EXC CHALAZION ANES REQ HOSPIZATION 1/MLT,,,21 ,,RBRVS,4.60 ,4.07 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67810,CPT,BX EYELID,,,21 ,,RBRVS,1.48 ,0.77 ,3.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67820,CPT,CORRJ TRICHIASIS EPILATION FORCEPS ONLY,,,21 ,,RBRVS,0.71 ,0.57 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67825,CPT,CORRJ TRICHIASIS EPILATION OTH/THN FORCEPS,,,21 ,,RBRVS,1.43 ,1.43 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67830,CPT,CORRJ TRICHIASIS INC LID MRGN,,,21 ,,RBRVS,1.75 ,1.52 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67835,CPT,CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF,,,21 ,,RBRVS,5.70 ,4.72 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67840,CPT,EXC LES EYELID W/O CLSR/W/SMPL DIR CLSR,,,21 ,,RBRVS,2.09 ,1.68 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67850,CPT,DSTRJ LES LID MRGN <1 CM,,,21 ,,RBRVS,1.74 ,1.61 ,3.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67875,CPT,TEMP CLSR EYELIDS SUTR,,,21 ,,RBRVS,1.35 ,0.97 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67880,CPT,CONSTJ ADS MEDIAN TRPH/CTRPH,,,21 ,,RBRVS,4.60 ,4.07 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67882,CPT,CONSTJ ADS MEDIAN TRPH/CTRPH TRPOS PLATE,,,21 ,,RBRVS,6.02 ,5.12 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67900,CPT,RPR BROW PTOSIS,,,21 ,,RBRVS,6.82 ,5.34 ,8.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67901,CPT,RPR BLPOS FRNTIS MUSC SUTR/OTH MATRL,,,21 ,,RBRVS,7.59 ,6.00 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67902,CPT,RPR BLPOS FRNTIS MUSC AUTOL FSCAL SLING,,,21 ,,RBRVS,9.82 ,7.10 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67903,CPT,RPR BLPOS LEVATOR RESCJ/ADVMNT INT,,,21 ,,RBRVS,6.51 ,5.14 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67904,CPT,RPR BLPOS LEVATOR RESCJ/ADVMNT XTRNL,,,21 ,,RBRVS,7.97 ,6.09 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67906,CPT,RPR BLPOS SUPRIOR RECTUS FSCAL SLING,,,21 ,,RBRVS,6.93 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67908,CPT,RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ,,,21 ,,RBRVS,5.30 ,4.88 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67909,CPT,RDCTJ >CORRJ PTOSIS,,,21 ,,RBRVS,5.57 ,4.86 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67911,CPT,CORRJ LID RETRCJ,,,21 ,,RBRVS,7.50 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67912,CPT,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,,,21 ,,RBRVS,6.36 ,5.44 ,14.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67914,CPT,RPR ECTROPION SUTR,,,21 ,,RBRVS,3.75 ,3.11 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67915,CPT,RPR ECTROPION THERMOCAUT,,,21 ,,RBRVS,3.26 ,2.80 ,4.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67916,CPT,RPR ECTROPION EXC TARSAL WEDGE,,,21 ,,RBRVS,5.48 ,4.79 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67917,CPT,RPR ECTROPION X10SV,,,21 ,,RBRVS,6.19 ,5.12 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67921,CPT,RPR ENTROPION SUTR,,,21 ,,RBRVS,3.47 ,2.96 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67922,CPT,RPR ENTROPION THERMOCAUT,,,21 ,,RBRVS,3.14 ,2.70 ,4.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67923,CPT,RPR ENTROPION EXC TARSAL WEDGE,,,21 ,,RBRVS,6.05 ,5.03 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67924,CPT,RPR ENTROPION X10SV,,,21 ,,RBRVS,5.93 ,4.75 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67930,CPT,SUTR RECENT WND EYELID PRTL THKNS,,,21 ,,RBRVS,3.65 ,2.18 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67935,CPT,SUTR RECENT WND EYELID FULL THKNS,,,21 ,,RBRVS,6.36 ,4.30 ,7.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67938,CPT,RMVL EMBEDDED FB EYELID,,,21 ,,RBRVS,1.38 ,1.36 ,4.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67950,CPT,CANTHOPLASTY,,,21 ,,RBRVS,5.99 ,5.09 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67961,CPT,EXC&RPR EYELID < ONE-4TH LID MRGN,,,21 ,,RBRVS,5.86 ,4.99 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67966,CPT,EXC&RPR EYELID > ONE-4TH LID MRGN,,,21 ,,RBRVS,8.97 ,6.53 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67971,CPT,RCNSTJ EYELID FULL THKNS < 2-3RD 1 STG,,,21 ,,RBRVS,10.01 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67973,CPT,RCNSTJ EYELID FULL THKNS TOT LWR 1 STG,,,21 ,,RBRVS,13.13 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67974,CPT,RCNSTJ EYELID FULL THKNS TOT UPR 1 STG,,,21 ,,RBRVS,13.10 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67975,CPT,RCNSTJ EYELID FULL THKNS 2ND STG,,,21 ,,RBRVS,9.35 ,7.02 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,67999,CPT,UNLIS EYELIDS,,,21 ,,TotalUnits,,,,5.21 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,68020,CPT,INC CJNC DRG CST,,,21 ,,RBRVS,1.42 ,1.21 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68040,CPT,EXPRESSION CJNCL FOLLICLES,,,21 ,,RBRVS,0.85 ,0.43 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68100,CPT,BX CJNC,,,21 ,,RBRVS,1.35 ,0.99 ,2.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68110,CPT,EXC LES CJNC UP 1 CM,,,21 ,,RBRVS,1.82 ,1.69 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68115,CPT,EXC LES CJNC > 1 CM,,,21 ,,RBRVS,2.41 ,1.95 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68130,CPT,EXC LES CJNC W/ADJ SCL,,,21 ,,RBRVS,5.10 ,4.65 ,7.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68135,CPT,DSTRJ LES CJNC,,,21 ,,RBRVS,1.89 ,1.69 ,1.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68200,CPT,SCJNCL NJX,,,21 ,,RBRVS,0.49 ,0.34 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68320,CPT,CJP CJNCL GRF/X10SV REARGMT,,,21 ,,RBRVS,6.64 ,6.01 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68325,CPT,CJP BUCCAL MUC MEMB GRF,,,21 ,,RBRVS,8.63 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68326,CPT,CJP RCNSTJ CUL-DE-SAC CJNCL GRF/REARGMT,,,21 ,,RBRVS,8.42 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68328,CPT,CJP RCNSTJ CUL-DE-SAC BUCCAL MUC MEMB GRF,,,21 ,,RBRVS,9.45 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68330,CPT,RPR SYMBLEPHARON CJP W/O GRF,,,21 ,,RBRVS,5.78 ,5.07 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68335,CPT,RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB,,,21 ,,RBRVS,8.46 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68340,CPT,RPR SYMBLEPHARON DIV,,,21 ,,RBRVS,4.97 ,4.41 ,7.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68360,CPT,CJNCL FLAP BRIDGE/PRTL SPX,,,21 ,,RBRVS,5.17 ,4.51 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68362,CPT,CJNCL FLAP TOT,,,21 ,,RBRVS,8.61 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68371,CPT,HRVG CJNCL ALGRFT LIV DON,,,21 ,,RBRVS,5.09 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68399,CPT,UNLIS CJNC,,,21 ,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,68400,CPT,INC DRG LACRIMAL GLND,,,21 ,,RBRVS,1.74 ,1.48 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68420,CPT,INC DRG LACRIMAL SAC,,,21 ,,RBRVS,2.35 ,1.77 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68440,CPT,SNIP INC LACRIMAL PUNCTUM,,,21 ,,RBRVS,0.99 ,1.31 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68500,CPT,EXC LACRIMAL GLND XCP TUM TOT,,,21 ,,RBRVS,12.77 ,10.29 ,10.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68505,CPT,EXC LACRIMAL GLND XCP TUM PRTL,,,21 ,,RBRVS,12.69 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68510,CPT,BX LACRIMAL GLND,,,21 ,,RBRVS,4.60 ,2.43 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68520,CPT,EXC LACRIMAL SAC,,,21 ,,RBRVS,8.78 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68525,CPT,BX LACRIMAL SAC,,,21 ,,RBRVS,4.42 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68530,CPT,RMVL FB/DACRYOLITH LACRIMAL PSAGES,,,21 ,,RBRVS,3.70 ,2.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68540,CPT,EXC LACRIMAL GLND TUM FRNT APPR,,,21 ,,RBRVS,12.18 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68550,CPT,EXC LACRIMAL GLND TUM INVG OSTEOM,,,21 ,,RBRVS,15.16 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68700,CPT,PLSTC RPR CANALICULI,,,21 ,,RBRVS,7.87 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68705,CPT,CORRJ EVERTED PUNCTUM CAUT,,,21 ,,RBRVS,2.11 ,1.83 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68720,CPT,DACRYOCSTORHINOSTOMY,,,21 ,,RBRVS,9.96 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68745,CPT,CONJUNCTIVORHINOSTOMY W/O TUBE,,,21 ,,RBRVS,9.90 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68750,CPT,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,,,21 ,,RBRVS,10.10 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68760,CPT,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,,,21 ,,RBRVS,1.78 ,1.67 ,2.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68761,CPT,CLSR LACRIMAL PUNCTUM PLUG EA,,,21 ,,RBRVS,1.41 ,1.40 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68770,CPT,CLSR LACRIMAL FSTL SPX,,,21 ,,RBRVS,8.29 ,6.01 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68801,CPT,DILAT LACRIMAL PUNCTUM +-IRRG,,,21 ,,RBRVS,1.00 ,1.53 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68810,CPT,PROBE NASOLACRIMAL DUX +-IRRG,,,21 ,,RBRVS,2.15 ,2.34 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68811,CPT,PROBE NASOLACRIMAL DUX +-IRRG ANES,,,21 ,,RBRVS,2.45 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68815,CPT,PROBE NASOLACRIMAL DUX +-IRRG INSJ TUBE/STENT,,,21 ,,RBRVS,3.30 ,2.82 ,7.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68816,CPT,PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION,,,21 ,,RBRVS,3.06 ,2.83 ,13.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68840,CPT,PROBE LACRIMAL CANALICULI +-IRRG,,,21 ,,RBRVS,1.30 ,1.38 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68850,CPT,NJX CNTRST MEDIUM DACRYOCSTOGRAPY,,,21 ,,RBRVS,0.80 ,0.65 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,68899,CPT,UNLIS LACRIMAL SYS,,,21 ,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69000,CPT,DRG XTRNL EAR ABSC/HMTMA SMPL,,,21 ,,RBRVS,1.50 ,1.43 ,3.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69005,CPT,DRG XTRNL EAR ABSC/HMTMA COMP,,,21 ,,RBRVS,2.16 ,1.79 ,3.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69020,CPT,DRG XTRNL AUD CANAL ABSC,,,21 ,,RBRVS,1.53 ,2.05 ,4.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69090,CPT,EAR PIERCING,,,14 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69100,CPT,BX XTRNL EAR,,,21 ,,RBRVS,0.81 ,0.43 ,1.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69105,CPT,BX XTRNL AUD CANAL,,,21 ,,RBRVS,0.85 ,0.77 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69110,CPT,EXC XTRNL EAR PRTL SMPL RPR,,,21 ,,RBRVS,3.53 ,4.63 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69120,CPT,EXC XTRNL EAR COMPL AMP,,,21 ,,RBRVS,4.14 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69140,CPT,EXC EXOSTOSIS XTRNL AUD CANAL,,,21 ,,RBRVS,8.14 ,13.75 ,13.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69145,CPT,EXC SOFT TISS LES XTRNL AUD CANAL,,,21 ,,RBRVS,2.70 ,3.52 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69150,CPT,RAD EXC XTRNL AUD CANAL LES W/O NCK DSJ,,,21 ,,RBRVS,13.61 ,12.71 ,12.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69155,CPT,RAD EXC XTRNL AUD CANAL LES NCK DSJ,,,21 ,,RBRVS,23.35 ,19.04 ,19.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69200,CPT,RMVL FB XTRNL AUD CANAL W/O ANES,,,21 ,,RBRVS,0.77 ,0.64 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69205,CPT,RMVL FB XTRNL AUD CANAL ANES,,,21 ,,RBRVS,1.21 ,1.33 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69210,CPT,RMVL IMPACTED CERUMEN SPX 1/BTH EARS,,,21 ,,RBRVS,0.61 ,0.21 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69220,CPT,DBRDMT MSTDC CAVITY SMPL,,,21 ,,RBRVS,0.83 ,0.74 ,2.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69222,CPT,DBRDMT MSTDC CAVITY CPLX,,,21 ,,RBRVS,1.45 ,2.02 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69300,CPT,OTOPLASTY PROTRUDING EAR +-SIZE RDCTJ,,,21 ,,RBRVS,6.69 ,5.27 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69310,CPT,RCNSTJ XTRNL AUD CANAL SPX,,,21 ,,RBRVS,10.97 ,16.26 ,16.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69320,CPT,RCNSTJ XTRNL AUD CANAL CGEN ATRESIA 1 STG,,,21 ,,RBRVS,17.18 ,21.47 ,21.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69399,CPT,UNLIS XTRNL EAR,,,21 ,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69400,CPT,EUSTACHIAN TUBE NFLTJ TRANSNSL CATHJ,,,21 ,,RBRVS,0.83 ,0.73 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69401,CPT,EUSTACHIAN TUBE NFLTJ TRANSNSL W/O CATHJ,,,21 ,,RBRVS,0.63 ,0.62 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69405,CPT,EUSTACHIAN TUBE CATHJ TRANSTYMPANIC,,,21 ,,RBRVS,2.68 ,2.20 ,3.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69420,CPT,MRGT ASPIR&/EUSTACHIAN TUBE NFLTJ,,,21 ,,RBRVS,1.38 ,1.65 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69421,CPT,MRGT ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,,,21 ,,RBRVS,1.78 ,2.02 ,2.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69424,CPT,VENTILATING TUBE RMVL ANES,,,21 ,,RBRVS,0.85 ,0.72 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69433,CPT,TMPST LOCAL/TOPICAL ANES,,,21 ,,RBRVS,1.57 ,1.69 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69436,CPT,TMPST ANES,,,21 ,,RBRVS,2.01 ,2.09 ,2.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69440,CPT,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,,,21 ,,RBRVS,7.71 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69450,CPT,TYMPANOLSS TRANSCANAL,,,21 ,,RBRVS,5.69 ,7.86 ,7.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69501,CPT,TRANSMASTOID ANTRT,,,21 ,,RBRVS,9.21 ,9.18 ,9.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69502,CPT,MSTDC COMPL,,,21 ,,RBRVS,12.56 ,11.84 ,11.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69505,CPT,MSTDC MODF RAD,,,21 ,,RBRVS,13.17 ,17.08 ,17.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69511,CPT,MSTDC RAD,,,21 ,,RBRVS,13.70 ,17.38 ,17.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69530,CPT,PETROUS APICECTOMY RAD MSTDC,,,21 ,,RBRVS,20.38 ,21.39 ,21.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69535,CPT,RESCJ TEMPORAL B1 XTRNL,,,21 ,,RBRVS,37.42 ,30.02 ,30.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69540,CPT,EXC AURAL POLYP,,,21 ,,RBRVS,1.25 ,1.95 ,3.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69550,CPT,EXC AURAL GLOMUS TUM TRANSCANAL,,,21 ,,RBRVS,11.15 ,15.02 ,15.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69552,CPT,EXC AURAL GLOMUS TUM TRANSMASTOID,,,21 ,,RBRVS,19.81 ,19.87 ,19.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69554,CPT,EXC AURAL GLOMUS TUM EXTND,,,21 ,,RBRVS,35.97 ,26.49 ,26.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69601,CPT,REVJ MSTDC RSLTG COMPL MSTDC,,,21 ,,RBRVS,13.45 ,12.91 ,12.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69602,CPT,REVJ MSTDC RSLTG MODF RAD MSTDC,,,21 ,,RBRVS,13.76 ,13.64 ,13.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69603,CPT,REVJ MSTDC RSLTG RAD MSTDC,,,21 ,,RBRVS,14.20 ,17.71 ,17.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69604,CPT,REVJ MSTDC RSLTG TMPP,,,21 ,,RBRVS,14.20 ,14.00 ,14.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69605,CPT,REVJ MSTDC W/APICECTOMY,,,21 ,,RBRVS,18.69 ,20.71 ,20.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69610,CPT,TYMPANIC MEMB RPR +-SIT PREPJ PRF8J PATCH,,,21 ,,RBRVS,4.47 ,2.99 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69620,CPT,MYRINGOPLASTY,,,21 ,,RBRVS,6.03 ,6.27 ,11.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69631,CPT,TMPP W/O MSTDC 1ST/REVJ W/O OCR,,,21 ,,RBRVS,10.05 ,12.06 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69632,CPT,TMPP W/O MSTDC 1ST/REVJ OCR,,,21 ,,RBRVS,12.96 ,14.12 ,14.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69633,CPT,TMPP W/O MSTDC 1ST/REVJ PROSTH TORP,,,21 ,,RBRVS,12.31 ,13.82 ,13.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69635,CPT,TMPP ANTRT/MASTOIDOTOMY W/O OCR,,,21 ,,RBRVS,13.51 ,17.13 ,17.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69636,CPT,TMPP ANTRT/MASTOIDOTOMY OCR,,,21 ,,RBRVS,15.43 ,19.32 ,19.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69637,CPT,TMPP ANTRT/MASTOIDOTOMY PROSTH TORP,,,21 ,,RBRVS,15.32 ,19.28 ,19.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69641,CPT,TMPP MSTDC W/O OCR,,,21 ,,RBRVS,12.89 ,13.30 ,13.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69642,CPT,TMPP MSTDC OCR,,,21 ,,RBRVS,17.06 ,16.67 ,16.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69643,CPT,TMPP MSTDC NTC/RCNSTED WALL W/O OCR,,,21 ,,RBRVS,15.59 ,15.22 ,15.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69644,CPT,TMPP MSTDC NTC/RCNSTED CANAL WALL OCR,,,21 ,,RBRVS,17.23 ,20.10 ,20.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69645,CPT,TMPP MSTDC RAD/COMPL W/O OCR,,,21 ,,RBRVS,16.71 ,19.87 ,19.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69646,CPT,TMPP MSTDC RAD/COMPL OCR,,,21 ,,RBRVS,18.37 ,20.50 ,20.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69650,CPT,STAPES MOBLJ,,,21 ,,RBRVS,9.80 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69660,CPT,STAPEDECTOMY/STAPEDOTOMY,,,21 ,,RBRVS,12.03 ,11.36 ,11.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69661,CPT,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,,,21 ,,RBRVS,15.92 ,14.63 ,14.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69662,CPT,REVJ STAPEDECTOMY/STAPEDOTOMY,,,21 ,,RBRVS,15.60 ,13.66 ,13.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69666,CPT,RPR OVAL WINDOW FSTL,,,21 ,,RBRVS,9.89 ,10.36 ,10.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69667,CPT,RPR ROUND WINDOW FSTL,,,21 ,,RBRVS,9.90 ,10.41 ,10.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69670,CPT,MASTOID OBLTRJ SPX,,,21 ,,RBRVS,11.73 ,11.98 ,11.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69676,CPT,TYMPANIC NEURECTOMY,,,21 ,,RBRVS,9.69 ,11.21 ,11.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69700,CPT,CLSR POSTAUR FSTL MASTOID SPX,,,21 ,,RBRVS,8.37 ,9.01 ,9.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69710,CPT,IMPLTJ/RPLCMT EMGNT B1 CNDJ DEV TEMPORAL B1,,,21 ,,TotalUnits,,,,19.59 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69711,CPT,RMVL/RPR EMGNT B1 CNDJ DEV TEMPORAL B1,,,21 ,,RBRVS,10.62 ,11.17 ,11.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69714,CPT,IMPLTJ OI IMPLT B1 W/O MSTDC,,,21 ,,RBRVS,14.45 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69715,CPT,IMPLTJ OI IMPLT B1 MSTDC,,,21 ,,RBRVS,18.96 ,14.78 ,14.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69717,CPT,RPLCMT OI IMPLT B1 W/O MSTDC,,,21 ,,RBRVS,15.43 ,13.41 ,13.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69718,CPT,RPLCMT OI IMPLT B1 MSTDC,,,21 ,,RBRVS,19.21 ,14.92 ,14.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69720,CPT,DCMPRN NRV ITPRL LAT GENICULATE,,,21 ,,RBRVS,14.71 ,14.86 ,14.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69725,CPT,DCMPRN NRV ITPRL MEDIAL GENICULATE,,,21 ,,RBRVS,27.64 ,20.07 ,20.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69740,CPT,SUTR NRV ITPRL +-GRF/DCMPRN LAT GENICULATE,,,21 ,,RBRVS,16.27 ,13.34 ,13.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69745,CPT,SUTR NRV ITPRL +-GRF/DCMPRN MEDIAL GENICULATE,,,21 ,,RBRVS,17.02 ,14.55 ,14.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69799,CPT,UNLIS MIDDLE EAR,,,21 ,,TotalUnits,,,,4.85 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69801,CPT,LABYRINTHOTOMY TRANSCANAL,,,21 ,,RBRVS,8.70 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69802,CPT,LABYRINTHOTOMY MSTDC,,,21 ,,RBRVS,13.50 ,12.76 ,12.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69805,CPT,ENDOLYMPHATIC SAC W/O SHUNT,,,21 ,,RBRVS,14.71 ,11.93 ,11.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69806,CPT,ENDOLYMPHATIC SAC SHUNT,,,21 ,,RBRVS,12.63 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69820,CPT,FENESTRATION SEMICIRCULAR CANAL,,,21 ,,RBRVS,10.52 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69840,CPT,REVJ FENESTRATION OPRATION,,,21 ,,RBRVS,10.44 ,12.70 ,12.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69905,CPT,LABYRINTHECTOMY TRANSCANAL,,,21 ,,RBRVS,11.26 ,11.89 ,11.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69910,CPT,LABYRINTHECTOMY MSTDC,,,21 ,,RBRVS,13.91 ,11.92 ,11.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69915,CPT,VSTBLR NRV SCTJ TRANSLABYRINTHINE APPR,,,21 ,,RBRVS,22.77 ,15.26 ,15.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69930,CPT,COCHLEAR DEV IMPLTJ +-MSTDC,,,21 ,,RBRVS,17.73 ,13.55 ,13.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69949,CPT,UNLIS INNER EAR,,,21 ,,TotalUnits,,,,31.28 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69950,CPT,VSTBLR NRV SCTJ TRANSCRNL,,,21 ,,RBRVS,27.63 ,18.22 ,18.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69955,CPT,TOT FACIAL NRV DCMPRN&/RPR,,,21 ,,RBRVS,29.42 ,20.91 ,20.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69960,CPT,DCMPRN INT AUD CANAL,,,21 ,,RBRVS,29.42 ,19.54 ,19.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69970,CPT,RMVL TUM TEMPORAL B1,,,21 ,,RBRVS,32.41 ,22.21 ,22.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,69979,CPT,UNLIS TEMPORAL B1 MIDDLE FOSSA,,,21 ,,TotalUnits,,,,54.62 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,69990,CPT,MICROSURG TQS REQ USE OPRATING MCRSCP,,,21 ,,RBRVS,3.46 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70010,CPT,MYELOGRAPY POST FOSSA RS&I,,,20 ,,RBRVS,1.19 ,3.11 ,3.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70010,CPT,MYELOGRAPY POST FOSSA RS&I,26,,20 ,,RBRVS,1.19 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70010,CPT,MYELOGRAPY POST FOSSA RS&I,TC,,20 ,,RBRVS,,2.69 ,2.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70015,CPT,CISTRNG POSITIVE CNTRST RS&I,,,20 ,,RBRVS,1.19 ,2.63 ,2.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70015,CPT,CISTRNG POSITIVE CNTRST RS&I,26,,20 ,,RBRVS,1.19 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70015,CPT,CISTRNG POSITIVE CNTRST RS&I,TC,,20 ,,RBRVS,,2.19 ,2.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70030,CPT,RADEX EYE DETCJ FB,,,20 ,,RBRVS,0.17 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70030,CPT,RADEX EYE DETCJ FB,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70030,CPT,RADEX EYE DETCJ FB,TC,,20 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70100,CPT,RADEX MNDBL PRTL < 4 VIEWS,,,20 ,,RBRVS,0.18 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70100,CPT,RADEX MNDBL PRTL < 4 VIEWS,26,,20 ,,RBRVS,0.18 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70100,CPT,RADEX MNDBL PRTL < 4 VIEWS,TC,,20 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70110,CPT,RADEX MNDBL COMPL MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.25 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70110,CPT,RADEX MNDBL COMPL MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70110,CPT,RADEX MNDBL COMPL MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70120,CPT,RADEX MASTOIDS < 3 VIEWS PR SIDE,,,20 ,,RBRVS,0.18 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70120,CPT,RADEX MASTOIDS < 3 VIEWS PR SIDE,26,,20 ,,RBRVS,0.18 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70120,CPT,RADEX MASTOIDS < 3 VIEWS PR SIDE,TC,,20 ,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,,,20 ,,RBRVS,0.34 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,26,,20 ,,RBRVS,0.34 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,TC,,20 ,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70134,CPT,RADEX INT AUD MEATI COMPL,,,20 ,,RBRVS,0.34 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70134,CPT,RADEX INT AUD MEATI COMPL,26,,20 ,,RBRVS,0.34 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70134,CPT,RADEX INT AUD MEATI COMPL,TC,,20 ,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70140,CPT,RADEX FACIAL B1S < 3 VIEWS,,,20 ,,RBRVS,0.19 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70140,CPT,RADEX FACIAL B1S < 3 VIEWS,26,,20 ,,RBRVS,0.19 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70140,CPT,RADEX FACIAL B1S < 3 VIEWS,TC,,20 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70150,CPT,RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.26 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70150,CPT,RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.26 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70150,CPT,RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70160,CPT,RADEX NSL B1S COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70160,CPT,RADEX NSL B1S COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70160,CPT,RADEX NSL B1S COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUX RS&I,,,20 ,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUX RS&I,26,,20 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUX RS&I,TC,,20 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,70190,CPT,RADEX OPTIC FORAMINA,,,20 ,,RBRVS,0.21 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70190,CPT,RADEX OPTIC FORAMINA,26,,20 ,,RBRVS,0.21 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70190,CPT,RADEX OPTIC FORAMINA,TC,,20 ,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70200,CPT,RADEX ORBITS COMPL MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.28 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70200,CPT,RADEX ORBITS COMPL MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.28 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70200,CPT,RADEX ORBITS COMPL MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70210,CPT,RADEX SINUSES PARANSL < 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70210,CPT,RADEX SINUSES PARANSL < 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70210,CPT,RADEX SINUSES PARANSL < 3 VIEWS,TC,,20 ,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70220,CPT,RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.25 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70220,CPT,RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.25 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70220,CPT,RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70240,CPT,RADEX SELLA TURCICA,,,20 ,,RBRVS,0.19 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70240,CPT,RADEX SELLA TURCICA,26,,20 ,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70240,CPT,RADEX SELLA TURCICA,TC,,20 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70250,CPT,RADEX SKL < 4 VIEWS,,,20 ,,RBRVS,0.24 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70250,CPT,RADEX SKL < 4 VIEWS,26,,20 ,,RBRVS,0.24 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70250,CPT,RADEX SKL < 4 VIEWS,TC,,20 ,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70260,CPT,RADEX SKL COMPL MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.34 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70260,CPT,RADEX SKL COMPL MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.34 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70260,CPT,RADEX SKL COMPL MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70300,CPT,RADEX TEETH 1 VIEW,,,20 ,,RBRVS,0.10 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70300,CPT,RADEX TEETH 1 VIEW,26,,20 ,,RBRVS,0.10 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70300,CPT,RADEX TEETH 1 VIEW,TC,,20 ,,RBRVS,,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70310,CPT,RADEX TEETH PRTL XM < FULL MOUTH,,,20 ,,RBRVS,0.16 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70310,CPT,RADEX TEETH PRTL XM < FULL MOUTH,26,,20 ,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70310,CPT,RADEX TEETH PRTL XM < FULL MOUTH,TC,,20 ,,RBRVS,,0.70 ,0.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70320,CPT,RADEX TEETH COMPL FULL MOUTH,,,20 ,,RBRVS,0.22 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70320,CPT,RADEX TEETH COMPL FULL MOUTH,26,,20 ,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70320,CPT,RADEX TEETH COMPL FULL MOUTH,TC,,20 ,,RBRVS,,0.96 ,0.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70328,CPT,RADEX TMPRMAND JT OPN&CLSD MOUTH UNI,,,20 ,,RBRVS,0.18 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70328,CPT,RADEX TMPRMAND JT OPN&CLSD MOUTH UNI,26,,20 ,,RBRVS,0.18 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70328,CPT,RADEX TMPRMAND JT OPN&CLSD MOUTH UNI,TC,,20 ,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70330,CPT,RADEX TMPRMAND JT OPN&CLSD MOUTH BI,,,20 ,,RBRVS,0.24 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70330,CPT,RADEX TMPRMAND JT OPN&CLSD MOUTH BI,26,,20 ,,RBRVS,0.24 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70330,CPT,RADEX TMPRMAND JT OPN&CLSD MOUTH BI,TC,,20 ,,RBRVS,,0.90 ,0.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70332,CPT,TMPRMAND JT ARTHG RS&I,,,20 ,,RBRVS,0.54 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70332,CPT,TMPRMAND JT ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70332,CPT,TMPRMAND JT ARTHG RS&I,TC,,20 ,,RBRVS,,1.46 ,1.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70336,CPT,MRI TMPRMAND JT,,,20 ,,RBRVS,1.48 ,10.72 ,10.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70336,CPT,MRI TMPRMAND JT,26,,20 ,,RBRVS,1.48 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70336,CPT,MRI TMPRMAND JT,TC,,20 ,,RBRVS,,10.20 ,10.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70350,CPT,CEPHALOGRAM ORTHODONTIC,,,20 ,,RBRVS,0.17 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70350,CPT,CEPHALOGRAM ORTHODONTIC,26,,20 ,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70350,CPT,CEPHALOGRAM ORTHODONTIC,TC,,20 ,,RBRVS,,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70355,CPT,ORTHOPANTOGRAM,,,20 ,,RBRVS,0.20 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70355,CPT,ORTHOPANTOGRAM,26,,20 ,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70355,CPT,ORTHOPANTOGRAM,TC,,20 ,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70360,CPT,RADEX NCK SOFT TISS,,,20 ,,RBRVS,0.17 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70360,CPT,RADEX NCK SOFT TISS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70360,CPT,RADEX NCK SOFT TISS,TC,,20 ,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,,,20 ,,RBRVS,0.32 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,26,,20 ,,RBRVS,0.32 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,TC,,20 ,,RBRVS,,1.57 ,1.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,,,20 ,,RBRVS,0.84 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,26,,20 ,,RBRVS,0.84 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,TC,,20 ,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70373,CPT,LARYNGOGRAPY CNTRST RS&I,,,20 ,,RBRVS,0.44 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70373,CPT,LARYNGOGRAPY CNTRST RS&I,26,,20 ,,RBRVS,0.44 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70373,CPT,LARYNGOGRAPY CNTRST RS&I,TC,,20 ,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70380,CPT,RADEX SALIVARY GLND F/ST1,,,20 ,,RBRVS,0.17 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70380,CPT,RADEX SALIVARY GLND F/ST1,26,,20 ,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70380,CPT,RADEX SALIVARY GLND F/ST1,TC,,20 ,,RBRVS,,0.74 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70390,CPT,SIALOGRAPY RS&I,,,20 ,,RBRVS,0.38 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70390,CPT,SIALOGRAPY RS&I,26,,20 ,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70390,CPT,SIALOGRAPY RS&I,TC,,20 ,,RBRVS,,2.07 ,2.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70450,CPT,CT HEAD/BRN C-MATRL,,,20 ,,RBRVS,0.85 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70450,CPT,CT HEAD/BRN C-MATRL,26,,20 ,,RBRVS,0.85 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70450,CPT,CT HEAD/BRN C-MATRL,TC,,20 ,,RBRVS,,4.13 ,4.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70460,CPT,CT HEAD/BRN C+ MATRL,,,20 ,,RBRVS,1.13 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70460,CPT,CT HEAD/BRN C+ MATRL,26,,20 ,,RBRVS,1.13 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70460,CPT,CT HEAD/BRN C+ MATRL,TC,,20 ,,RBRVS,,5.34 ,5.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70470,CPT,CT HEAD/BRN C-/C+,,,20 ,,RBRVS,1.27 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70470,CPT,CT HEAD/BRN C-/C+,26,,20 ,,RBRVS,1.27 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70470,CPT,CT HEAD/BRN C-/C+,TC,,20 ,,RBRVS,,6.58 ,6.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR C-MATRL,,,20 ,,RBRVS,1.28 ,6.99 ,6.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR C-MATRL,26,,20 ,,RBRVS,1.28 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR C-MATRL,TC,,20 ,,RBRVS,,6.53 ,6.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL,,,20 ,,RBRVS,1.38 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL,26,,20 ,,RBRVS,1.38 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL,TC,,20 ,,RBRVS,,7.72 ,7.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR C-/C+,,,20 ,,RBRVS,1.45 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR C-/C+,26,,20 ,,RBRVS,1.45 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR C-/C+,TC,,20 ,,RBRVS,,8.97 ,8.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70486,CPT,CT MAXLFCL AREA C-MATRL,,,20 ,,RBRVS,1.14 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70486,CPT,CT MAXLFCL AREA C-MATRL,26,,20 ,,RBRVS,1.14 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70486,CPT,CT MAXLFCL AREA C-MATRL,TC,,20 ,,RBRVS,,5.39 ,5.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70487,CPT,CT MAXLFCL AREA C+ MATRL,,,20 ,,RBRVS,1.30 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70487,CPT,CT MAXLFCL AREA C+ MATRL,26,,20 ,,RBRVS,1.30 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70487,CPT,CT MAXLFCL AREA C+ MATRL,TC,,20 ,,RBRVS,,6.60 ,6.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70488,CPT,CT MAXLFCL AREA C-/C+,,,20 ,,RBRVS,1.42 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70488,CPT,CT MAXLFCL AREA C-/C+,26,,20 ,,RBRVS,1.42 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70488,CPT,CT MAXLFCL AREA C-/C+,TC,,20 ,,RBRVS,,8.25 ,8.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70490,CPT,CT SOFT TISS NCK C-MATRL,,,20 ,,RBRVS,1.28 ,5.58 ,5.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70490,CPT,CT SOFT TISS NCK C-MATRL,26,,20 ,,RBRVS,1.28 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70490,CPT,CT SOFT TISS NCK C-MATRL,TC,,20 ,,RBRVS,,5.11 ,5.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70491,CPT,CT SOFT TISS NCK C+ MATRL,,,20 ,,RBRVS,1.38 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70491,CPT,CT SOFT TISS NCK C+ MATRL,26,,20 ,,RBRVS,1.38 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70491,CPT,CT SOFT TISS NCK C+ MATRL,TC,,20 ,,RBRVS,,6.35 ,6.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70492,CPT,CT SOFT TISS NCK C-/C+,,,20 ,,RBRVS,1.45 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70492,CPT,CT SOFT TISS NCK C-/C+,26,,20 ,,RBRVS,1.45 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70492,CPT,CT SOFT TISS NCK C-/C+,TC,,20 ,,RBRVS,,7.99 ,7.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,,,20 ,,RBRVS,1.75 ,15.58 ,15.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,26,,20 ,,RBRVS,1.75 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,TC,,20 ,,RBRVS,,14.94 ,14.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,,,20 ,,RBRVS,1.75 ,15.60 ,15.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,26,,20 ,,RBRVS,1.75 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,TC,,20 ,,RBRVS,,14.96 ,14.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,,,20 ,,RBRVS,1.35 ,12.07 ,12.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,26,,20 ,,RBRVS,1.35 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,TC,,20 ,,RBRVS,,11.59 ,11.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70542,CPT,MRI ORBIT FACE&NCK C+ MATRL,,,20 ,,RBRVS,1.62 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70542,CPT,MRI ORBIT FACE&NCK C+ MATRL,26,,20 ,,RBRVS,1.62 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70542,CPT,MRI ORBIT FACE&NCK C+ MATRL,TC,,20 ,,RBRVS,,12.72 ,12.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70543,CPT,MRI ORBIT FACE&NCK C-/C+,,,20 ,,RBRVS,2.15 ,17.96 ,17.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70543,CPT,MRI ORBIT FACE&NCK C-/C+,26,,20 ,,RBRVS,2.15 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70543,CPT,MRI ORBIT FACE&NCK C-/C+,TC,,20 ,,RBRVS,,17.20 ,17.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70544,CPT,MRA HEAD C-MATRL,,,20 ,,RBRVS,1.20 ,14.68 ,14.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70544,CPT,MRA HEAD C-MATRL,26,,20 ,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70544,CPT,MRA HEAD C-MATRL,TC,,20 ,,RBRVS,,14.25 ,14.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70545,CPT,MRA HEAD C+ MATRL,,,20 ,,RBRVS,1.20 ,14.59 ,14.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70545,CPT,MRA HEAD C+ MATRL,26,,20 ,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70545,CPT,MRA HEAD C+ MATRL,TC,,20 ,,RBRVS,,14.16 ,14.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70546,CPT,MRA HEAD C-/C+,,,20 ,,RBRVS,1.80 ,23.29 ,23.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70546,CPT,MRA HEAD C-/C+,26,,20 ,,RBRVS,1.80 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70546,CPT,MRA HEAD C-/C+,TC,,20 ,,RBRVS,,22.65 ,22.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70547,CPT,MRA NCK C-MATRL,,,20 ,,RBRVS,1.20 ,14.64 ,14.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70547,CPT,MRA NCK C-MATRL,26,,20 ,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70547,CPT,MRA NCK C-MATRL,TC,,20 ,,RBRVS,,14.21 ,14.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70548,CPT,MRA NCK C+ MATRL,,,20 ,,RBRVS,1.20 ,15.34 ,15.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70548,CPT,MRA NCK C+ MATRL,26,,20 ,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70548,CPT,MRA NCK C+ MATRL,TC,,20 ,,RBRVS,,14.91 ,14.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70549,CPT,MRA NCK C-/C+,,,20 ,,RBRVS,1.80 ,23.29 ,23.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70549,CPT,MRA NCK C-/C+,26,,20 ,,RBRVS,1.80 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70549,CPT,MRA NCK C-/C+,TC,,20 ,,RBRVS,,22.65 ,22.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70551,CPT,MRI BRN BRN STEM C-MATRL,,,20 ,,RBRVS,1.48 ,12.32 ,12.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70551,CPT,MRI BRN BRN STEM C-MATRL,26,,20 ,,RBRVS,1.48 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70551,CPT,MRI BRN BRN STEM C-MATRL,TC,,20 ,,RBRVS,,11.79 ,11.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70552,CPT,MRI BRN BRN STEM C+ MATRL,,,20 ,,RBRVS,1.78 ,13.63 ,13.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70552,CPT,MRI BRN BRN STEM C+ MATRL,26,,20 ,,RBRVS,1.78 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70552,CPT,MRI BRN BRN STEM C+ MATRL,TC,,20 ,,RBRVS,,12.99 ,12.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70553,CPT,MRI BRN BRN STEM C-/C+,,,20 ,,RBRVS,2.36 ,17.57 ,17.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70553,CPT,MRI BRN BRN STEM C-/C+,26,,20 ,,RBRVS,2.36 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70553,CPT,MRI BRN BRN STEM C-/C+,TC,,20 ,,RBRVS,,16.73 ,16.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,,,20 ,,RBRVS,2.11 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,26,,20 ,,RBRVS,2.11 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,TC,,20 ,,RBRVS,,12.26 ,12.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,,,20 ,,TotalUnits,,,,20.22 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,26,,20 ,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,TC,,20 ,,TotalUnits,,,,16.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,70557,CPT,MRI BRN OPN ICRA PX C-MATRL,,,20 ,,TotalUnits,,,,37.47 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,70557,CPT,MRI BRN OPN ICRA PX C-MATRL,26,,20 ,,TotalUnits,,,,4.10 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,70557,CPT,MRI BRN OPN ICRA PX C-MATRL,TC,,20 ,,TotalUnits,,,,33.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,70558,CPT,MRI BRN OPN ICRA PX C+ MATRL,,,20 ,,RBRVS,3.20 ,36.28 ,36.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,70558,CPT,MRI BRN OPN ICRA PX C+ MATRL,26,,20 ,,RBRVS,3.20 ,1.15 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,70558,CPT,MRI BRN OPN ICRA PX C+ MATRL,TC,,20 ,,RBRVS,,35.13 ,35.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,70559,CPT,MRI BRN OPN ICRA PX C-/C+,,,20 ,,TotalUnits,,,,49.33 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,70559,CPT,MRI BRN OPN ICRA PX C-/C+,26,,20 ,,TotalUnits,,,,4.43 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,70559,CPT,MRI BRN OPN ICRA PX C-/C+,TC,,20 ,,TotalUnits,,,,44.90 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,71010,CPT,RADEX CH 1 VIEW FRNT,,,20 ,,RBRVS,0.18 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71010,CPT,RADEX CH 1 VIEW FRNT,26,,20 ,,RBRVS,0.18 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71010,CPT,RADEX CH 1 VIEW FRNT,TC,,20 ,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71015,CPT,RADEX CH STEREO FRNT,,,20 ,,RBRVS,0.21 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71015,CPT,RADEX CH STEREO FRNT,26,,20 ,,RBRVS,0.21 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71015,CPT,RADEX CH STEREO FRNT,TC,,20 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71020,CPT,RADEX CH 2 VIEWS FRNT&LAT,,,20 ,,RBRVS,0.22 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71020,CPT,RADEX CH 2 VIEWS FRNT&LAT,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71020,CPT,RADEX CH 2 VIEWS FRNT&LAT,TC,,20 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71021,CPT,RADEX CH 2 VIEWS FRNT&LAT APICAL LORDOTIC PX,,,20 ,,RBRVS,0.27 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71021,CPT,RADEX CH 2 VIEWS FRNT&LAT APICAL LORDOTIC PX,26,,20 ,,RBRVS,0.27 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71021,CPT,RADEX CH 2 VIEWS FRNT&LAT APICAL LORDOTIC PX,TC,,20 ,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71022,CPT,RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ,,,20 ,,RBRVS,0.31 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71022,CPT,RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ,26,,20 ,,RBRVS,0.31 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71022,CPT,RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ,TC,,20 ,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71023,CPT,RADEX CH 2 VIEWS FRNT&LAT FLUOR,,,20 ,,RBRVS,0.38 ,1.40 ,1.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71023,CPT,RADEX CH 2 VIEWS FRNT&LAT FLUOR,26,,20 ,,RBRVS,0.38 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71023,CPT,RADEX CH 2 VIEWS FRNT&LAT FLUOR,TC,,20 ,,RBRVS,,1.25 ,1.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71030,CPT,RADEX CH COMPL MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.31 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71030,CPT,RADEX CH COMPL MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.31 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71030,CPT,RADEX CH COMPL MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71034,CPT,RADEX CH COMPL MINIMUM 4 VIEWS W/FLUOR,,,20 ,,RBRVS,0.46 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71034,CPT,RADEX CH COMPL MINIMUM 4 VIEWS W/FLUOR,26,,20 ,,RBRVS,0.46 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71034,CPT,RADEX CH COMPL MINIMUM 4 VIEWS W/FLUOR,TC,,20 ,,RBRVS,,1.70 ,1.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71035,CPT,RADEX CH SPEC VIEWS,,,20 ,,RBRVS,0.18 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71035,CPT,RADEX CH SPEC VIEWS,26,,20 ,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71035,CPT,RADEX CH SPEC VIEWS,TC,,20 ,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71040,CPT,BRONCHOGRAPY UNI RS&I,,,20 ,,RBRVS,0.58 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71040,CPT,BRONCHOGRAPY UNI RS&I,26,,20 ,,RBRVS,0.58 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71040,CPT,BRONCHOGRAPY UNI RS&I,TC,,20 ,,RBRVS,,1.73 ,1.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71060,CPT,BRONCHOGRAPY BI RS&I,,,20 ,,RBRVS,0.74 ,2.94 ,2.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71060,CPT,BRONCHOGRAPY BI RS&I,26,,20 ,,RBRVS,0.74 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71060,CPT,BRONCHOGRAPY BI RS&I,TC,,20 ,,RBRVS,,2.67 ,2.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71090,CPT,INSJ PM FLUOR&RADIOGRAPY RS&I,,,20 ,,TotalUnits,,,,1.67 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,71090,CPT,INSJ PM FLUOR&RADIOGRAPY RS&I,26,,20 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,71090,CPT,INSJ PM FLUOR&RADIOGRAPY RS&I,TC,,20 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,71100,CPT,RADEX RIBS UNI 2 VIEWS,,,20 ,,RBRVS,0.22 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71100,CPT,RADEX RIBS UNI 2 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71100,CPT,RADEX RIBS UNI 2 VIEWS,TC,,20 ,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.27 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.27 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71110,CPT,RADEX RIBS BI 3 VIEWS,,,20 ,,RBRVS,0.27 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71110,CPT,RADEX RIBS BI 3 VIEWS,26,,20 ,,RBRVS,0.27 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71110,CPT,RADEX RIBS BI 3 VIEWS,TC,,20 ,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.32 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.32 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.20 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.20 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71130,CPT,RADEX STRNCLAV JT/JTS MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.22 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71130,CPT,RADEX STRNCLAV JT/JTS MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71130,CPT,RADEX STRNCLAV JT/JTS MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71250,CPT,CT THORAX C-MATRL,,,20 ,,RBRVS,1.16 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71250,CPT,CT THORAX C-MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71250,CPT,CT THORAX C-MATRL,TC,,20 ,,RBRVS,,5.35 ,5.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71260,CPT,CT THORAX C+ MATRL,,,20 ,,RBRVS,1.24 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71260,CPT,CT THORAX C+ MATRL,26,,20 ,,RBRVS,1.24 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71260,CPT,CT THORAX C+ MATRL,TC,,20 ,,RBRVS,,6.63 ,6.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71270,CPT,CT THORAX C-/C+,,,20 ,,RBRVS,1.38 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71270,CPT,CT THORAX C-/C+,26,,20 ,,RBRVS,1.38 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71270,CPT,CT THORAX C-/C+,TC,,20 ,,RBRVS,,8.37 ,8.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,,,20 ,,RBRVS,1.92 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,26,,20 ,,RBRVS,1.92 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,TC,,20 ,,RBRVS,,11.02 ,11.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71550,CPT,MRI CH C-MATRL,,,20 ,,RBRVS,1.46 ,13.58 ,13.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71550,CPT,MRI CH C-MATRL,26,,20 ,,RBRVS,1.46 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71550,CPT,MRI CH C-MATRL,TC,,20 ,,RBRVS,,13.06 ,13.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71551,CPT,MRI CH C+ MATRL,,,20 ,,RBRVS,1.73 ,15.16 ,15.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71551,CPT,MRI CH C+ MATRL,26,,20 ,,RBRVS,1.73 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71551,CPT,MRI CH C+ MATRL,TC,,20 ,,RBRVS,,14.55 ,14.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71552,CPT,MRI CH C-/C+,,,20 ,,RBRVS,2.26 ,20.58 ,20.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71552,CPT,MRI CH C-/C+,26,,20 ,,RBRVS,2.26 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71552,CPT,MRI CH C-/C+,TC,,20 ,,RBRVS,,19.76 ,19.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,71555,CPT,MRA CH C+-MATRL,,,20 ,,RBRVS,1.81 ,14.20 ,14.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,71555,CPT,MRA CH C+-MATRL,26,,20 ,,RBRVS,1.81 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,71555,CPT,MRA CH C+-MATRL,TC,,20 ,,RBRVS,,13.53 ,13.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72010,CPT,RADEX SPI ENTIRE SURV STD ANTEROPOST&LAT,,,20 ,,RBRVS,0.45 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72010,CPT,RADEX SPI ENTIRE SURV STD ANTEROPOST&LAT,26,,20 ,,RBRVS,0.45 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72010,CPT,RADEX SPI ENTIRE SURV STD ANTEROPOST&LAT,TC,,20 ,,RBRVS,,1.26 ,1.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72020,CPT,RADEX SPI 1 VIEW SPEC LVL,,,20 ,,RBRVS,0.15 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72020,CPT,RADEX SPI 1 VIEW SPEC LVL,26,,20 ,,RBRVS,0.15 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72020,CPT,RADEX SPI 1 VIEW SPEC LVL,TC,,20 ,,RBRVS,,0.41 ,0.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72040,CPT,RADEX SPI CRV 2/3 VIEWS,,,20 ,,RBRVS,0.22 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72040,CPT,RADEX SPI CRV 2/3 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72040,CPT,RADEX SPI CRV 2/3 VIEWS,TC,,20 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72050,CPT,RADEX SPI CRV MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.31 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72050,CPT,RADEX SPI CRV MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.31 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72050,CPT,RADEX SPI CRV MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.94 ,0.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72052,CPT,RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS,,,20 ,,RBRVS,0.36 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72052,CPT,RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS,26,,20 ,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72052,CPT,RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS,TC,,20 ,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72069,CPT,RADEX SPI THORACOLMBR STANDING SCOLIOSIS,,,20 ,,RBRVS,0.22 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72069,CPT,RADEX SPI THORACOLMBR STANDING SCOLIOSIS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72069,CPT,RADEX SPI THORACOLMBR STANDING SCOLIOSIS,TC,,20 ,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72070,CPT,RADEX SPI THRC 2 VIEWS,,,20 ,,RBRVS,0.22 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72070,CPT,RADEX SPI THRC 2 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72070,CPT,RADEX SPI THRC 2 VIEWS,TC,,20 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72072,CPT,RADEX SPI THRC 3 VIEWS,,,20 ,,RBRVS,0.22 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72072,CPT,RADEX SPI THRC 3 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72072,CPT,RADEX SPI THRC 3 VIEWS,TC,,20 ,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72074,CPT,RADEX SPI THRC MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.22 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72074,CPT,RADEX SPI THRC MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72074,CPT,RADEX SPI THRC MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72080,CPT,RADEX SPI THORACOLMBR 2 VIEWS,,,20 ,,RBRVS,0.22 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72080,CPT,RADEX SPI THORACOLMBR 2 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72080,CPT,RADEX SPI THORACOLMBR 2 VIEWS,TC,,20 ,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72090,CPT,RADEX SPI SCOLIOSIS STD W/SUP&ERC STDS,,,20 ,,RBRVS,0.28 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72090,CPT,RADEX SPI SCOLIOSIS STD W/SUP&ERC STDS,26,,20 ,,RBRVS,0.28 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72090,CPT,RADEX SPI SCOLIOSIS STD W/SUP&ERC STDS,TC,,20 ,,RBRVS,,0.85 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72100,CPT,RADEX SPI LUMBOSAC 2/3 VIEWS,,,20 ,,RBRVS,0.22 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72100,CPT,RADEX SPI LUMBOSAC 2/3 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72100,CPT,RADEX SPI LUMBOSAC 2/3 VIEWS,TC,,20 ,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72110,CPT,RADEX SPI LUMBOSAC MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.31 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72110,CPT,RADEX SPI LUMBOSAC MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.31 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72110,CPT,RADEX SPI LUMBOSAC MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.99 ,0.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72114,CPT,RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS,,,20 ,,RBRVS,0.36 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72114,CPT,RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS,26,,20 ,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72114,CPT,RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS,TC,,20 ,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72120,CPT,RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS,,,20 ,,RBRVS,0.22 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72120,CPT,RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72120,CPT,RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS,TC,,20 ,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72125,CPT,CT CRV SPI C-MATRL,,,20 ,,RBRVS,1.16 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72125,CPT,CT CRV SPI C-MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72125,CPT,CT CRV SPI C-MATRL,TC,,20 ,,RBRVS,,5.37 ,5.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72126,CPT,CT CRV SPI C+ MATRL,,,20 ,,RBRVS,1.22 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72126,CPT,CT CRV SPI C+ MATRL,26,,20 ,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72126,CPT,CT CRV SPI C+ MATRL,TC,,20 ,,RBRVS,,6.65 ,6.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72127,CPT,CT CRV SPI C-/C+,,,20 ,,RBRVS,1.27 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72127,CPT,CT CRV SPI C-/C+,26,,20 ,,RBRVS,1.27 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72127,CPT,CT CRV SPI C-/C+,TC,,20 ,,RBRVS,,8.36 ,8.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72128,CPT,CT THRC SPI C-MATRL,,,20 ,,RBRVS,1.16 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72128,CPT,CT THRC SPI C-MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72128,CPT,CT THRC SPI C-MATRL,TC,,20 ,,RBRVS,,5.35 ,5.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72129,CPT,CT THRC SPI C+ MATRL,,,20 ,,RBRVS,1.22 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72129,CPT,CT THRC SPI C+ MATRL,26,,20 ,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72129,CPT,CT THRC SPI C+ MATRL,TC,,20 ,,RBRVS,,6.65 ,6.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72130,CPT,CT THRC SPI C-/C+,,,20 ,,RBRVS,1.27 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72130,CPT,CT THRC SPI C-/C+,26,,20 ,,RBRVS,1.27 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72130,CPT,CT THRC SPI C-/C+,TC,,20 ,,RBRVS,,8.39 ,8.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72131,CPT,CT LMBR SPI C-MATRL,,,20 ,,RBRVS,1.16 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72131,CPT,CT LMBR SPI C-MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72131,CPT,CT LMBR SPI C-MATRL,TC,,20 ,,RBRVS,,5.34 ,5.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72132,CPT,CT LMBR SPI C+ MATRL,,,20 ,,RBRVS,1.22 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72132,CPT,CT LMBR SPI C+ MATRL,26,,20 ,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72132,CPT,CT LMBR SPI C+ MATRL,TC,,20 ,,RBRVS,,6.63 ,6.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72133,CPT,CT LMBR SPI C-/C+,,,20 ,,RBRVS,1.27 ,8.83 ,8.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72133,CPT,CT LMBR SPI C-/C+,26,,20 ,,RBRVS,1.27 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72133,CPT,CT LMBR SPI C-/C+,TC,,20 ,,RBRVS,,8.37 ,8.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72141,CPT,MRI SPI CANAL&CNTS CRV C-MATRL,,,20 ,,RBRVS,1.60 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72141,CPT,MRI SPI CANAL&CNTS CRV C-MATRL,26,,20 ,,RBRVS,1.60 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72141,CPT,MRI SPI CANAL&CNTS CRV C-MATRL,TC,,20 ,,RBRVS,,10.38 ,10.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72142,CPT,MRI SPI CANAL&CNTS CRV C+ MATRL,,,20 ,,RBRVS,1.92 ,13.67 ,13.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72142,CPT,MRI SPI CANAL&CNTS CRV C+ MATRL,26,,20 ,,RBRVS,1.92 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72142,CPT,MRI SPI CANAL&CNTS CRV C+ MATRL,TC,,20 ,,RBRVS,,12.99 ,12.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72146,CPT,MRI SPI CANAL&CNTS THRC C-MATRL,,,20 ,,RBRVS,1.60 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72146,CPT,MRI SPI CANAL&CNTS THRC C-MATRL,26,,20 ,,RBRVS,1.60 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72146,CPT,MRI SPI CANAL&CNTS THRC C-MATRL,TC,,20 ,,RBRVS,,10.63 ,10.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72147,CPT,MRI SPI CANAL&CNTS THRC C+ MATRL,,,20 ,,RBRVS,1.92 ,12.24 ,12.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72147,CPT,MRI SPI CANAL&CNTS THRC C+ MATRL,26,,20 ,,RBRVS,1.92 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72147,CPT,MRI SPI CANAL&CNTS THRC C+ MATRL,TC,,20 ,,RBRVS,,11.55 ,11.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72148,CPT,MRI SPI CANAL&CNTS LMBR C-MATRL,,,20 ,,RBRVS,1.48 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72148,CPT,MRI SPI CANAL&CNTS LMBR C-MATRL,26,,20 ,,RBRVS,1.48 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72148,CPT,MRI SPI CANAL&CNTS LMBR C-MATRL,TC,,20 ,,RBRVS,,10.62 ,10.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72149,CPT,MRI SPI CANAL&CNTS LMBR C+ MATRL,,,20 ,,RBRVS,1.78 ,13.59 ,13.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72149,CPT,MRI SPI CANAL&CNTS LMBR C+ MATRL,26,,20 ,,RBRVS,1.78 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72149,CPT,MRI SPI CANAL&CNTS LMBR C+ MATRL,TC,,20 ,,RBRVS,,12.95 ,12.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72156,CPT,MRI SPI CANAL&CNTS C-/C+ CRV,,,20 ,,RBRVS,2.57 ,17.39 ,17.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72156,CPT,MRI SPI CANAL&CNTS C-/C+ CRV,26,,20 ,,RBRVS,2.57 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72156,CPT,MRI SPI CANAL&CNTS C-/C+ CRV,TC,,20 ,,RBRVS,,16.47 ,16.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72157,CPT,MRI SPI CANAL&CNTS C-/C+,,,20 ,,RBRVS,2.57 ,16.30 ,16.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72157,CPT,MRI SPI CANAL&CNTS C-/C+,26,,20 ,,RBRVS,2.57 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72157,CPT,MRI SPI CANAL&CNTS C-/C+,TC,,20 ,,RBRVS,,15.38 ,15.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72158,CPT,MRI SPI CANAL&CNTS C-/C+ LMBR,,,20 ,,RBRVS,2.36 ,17.29 ,17.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72158,CPT,MRI SPI CANAL&CNTS C-/C+ LMBR,26,,20 ,,RBRVS,2.36 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72158,CPT,MRI SPI CANAL&CNTS C-/C+ LMBR,TC,,20 ,,RBRVS,,16.45 ,16.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72159,CPT,MRA SPI CANAL&CNTS C+-MATRL,,,20 ,,RBRVS,1.80 ,15.74 ,15.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72159,CPT,MRA SPI CANAL&CNTS C+-MATRL,26,,20 ,,RBRVS,1.80 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72159,CPT,MRA SPI CANAL&CNTS C+-MATRL,TC,,20 ,,RBRVS,,15.09 ,15.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72170,CPT,RADEX PELVIS 1/2 VIEWS,,,20 ,,RBRVS,0.17 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72170,CPT,RADEX PELVIS 1/2 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72170,CPT,RADEX PELVIS 1/2 VIEWS,TC,,20 ,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72190,CPT,RADEX PELVIS COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.21 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72190,CPT,RADEX PELVIS COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.21 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72190,CPT,RADEX PELVIS COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,,,20 ,,RBRVS,1.81 ,11.32 ,11.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,26,,20 ,,RBRVS,1.81 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,TC,,20 ,,RBRVS,,10.66 ,10.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72192,CPT,CT PELVIS C-MATRL,,,20 ,,RBRVS,1.09 ,5.47 ,5.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72192,CPT,CT PELVIS C-MATRL,26,,20 ,,RBRVS,1.09 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72192,CPT,CT PELVIS C-MATRL,TC,,20 ,,RBRVS,,5.07 ,5.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72193,CPT,CT PELVIS C+ MATRL,,,20 ,,RBRVS,1.16 ,6.72 ,6.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72193,CPT,CT PELVIS C+ MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72193,CPT,CT PELVIS C+ MATRL,TC,,20 ,,RBRVS,,6.30 ,6.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72194,CPT,CT PELVIS C-/C+,,,20 ,,RBRVS,1.22 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72194,CPT,CT PELVIS C-/C+,26,,20 ,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72194,CPT,CT PELVIS C-/C+,TC,,20 ,,RBRVS,,8.40 ,8.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72195,CPT,MRI PELVIS C-MATRL,,,20 ,,RBRVS,1.46 ,12.28 ,12.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72195,CPT,MRI PELVIS C-MATRL,26,,20 ,,RBRVS,1.46 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72195,CPT,MRI PELVIS C-MATRL,TC,,20 ,,RBRVS,,11.76 ,11.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72196,CPT,MRI PELVIS C+ MATRL,,,20 ,,RBRVS,1.73 ,13.50 ,13.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72196,CPT,MRI PELVIS C+ MATRL,26,,20 ,,RBRVS,1.73 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72196,CPT,MRI PELVIS C+ MATRL,TC,,20 ,,RBRVS,,12.88 ,12.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72197,CPT,MRI PELVIS C-/C+,,,20 ,,RBRVS,2.26 ,18.13 ,18.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72197,CPT,MRI PELVIS C-/C+,26,,20 ,,RBRVS,2.26 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72197,CPT,MRI PELVIS C-/C+,TC,,20 ,,RBRVS,,17.32 ,17.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72198,CPT,MRA PELVIS C+-MATRL,,,20 ,,RBRVS,1.80 ,14.13 ,14.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72198,CPT,MRA PELVIS C+-MATRL,26,,20 ,,RBRVS,1.80 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72198,CPT,MRA PELVIS C+-MATRL,TC,,20 ,,RBRVS,,13.48 ,13.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72200,CPT,RADEX SI JTS < 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72200,CPT,RADEX SI JTS < 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72200,CPT,RADEX SI JTS < 3 VIEWS,TC,,20 ,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72202,CPT,RADEX SI JTS 3/MORE VIEWS,,,20 ,,RBRVS,0.19 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72202,CPT,RADEX SI JTS 3/MORE VIEWS,26,,20 ,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72202,CPT,RADEX SI JTS 3/MORE VIEWS,TC,,20 ,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72220,CPT,RADEX SACRUM&COCCYX MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.17 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72220,CPT,RADEX SACRUM&COCCYX MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72220,CPT,RADEX SACRUM&COCCYX MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72240,CPT,MYELOGRAPY CRV RS&I,,,20 ,,RBRVS,0.91 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72240,CPT,MYELOGRAPY CRV RS&I,26,,20 ,,RBRVS,0.91 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72240,CPT,MYELOGRAPY CRV RS&I,TC,,20 ,,RBRVS,,2.69 ,2.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72255,CPT,MYELOGRAPY THRC RS&I,,,20 ,,RBRVS,0.91 ,2.73 ,2.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72255,CPT,MYELOGRAPY THRC RS&I,26,,20 ,,RBRVS,0.91 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72255,CPT,MYELOGRAPY THRC RS&I,TC,,20 ,,RBRVS,,2.42 ,2.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72265,CPT,MYELOGRAPY LUMBOSAC RS&I,,,20 ,,RBRVS,0.83 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72265,CPT,MYELOGRAPY LUMBOSAC RS&I,26,,20 ,,RBRVS,0.83 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72265,CPT,MYELOGRAPY LUMBOSAC RS&I,TC,,20 ,,RBRVS,,2.56 ,2.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,,,20 ,,RBRVS,1.33 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,26,,20 ,,RBRVS,1.33 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,TC,,20 ,,RBRVS,,3.95 ,3.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72275,CPT,EPIDUROGRAPY RS&I,,,20 ,,RBRVS,0.76 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72275,CPT,EPIDUROGRAPY RS&I,26,,20 ,,RBRVS,0.76 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72275,CPT,EPIDUROGRAPY RS&I,TC,,20 ,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72285,CPT,DISKOGRAPY CRV/THRC RS&I,,,20 ,,RBRVS,1.16 ,2.99 ,2.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72285,CPT,DISKOGRAPY CRV/THRC RS&I,26,,20 ,,RBRVS,1.16 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72285,CPT,DISKOGRAPY CRV/THRC RS&I,TC,,20 ,,RBRVS,,2.61 ,2.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,72291,CPT,RAD S&I PERQ VRTPLS/SACRPLSTY PR VRT BODY FLUOR,,,20 ,,TotalUnits,,,,8.07 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,72291,CPT,RAD S&I PERQ VRTPLS/SACRPLSTY PR VRT BODY FLUOR,26,,20 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,72291,CPT,RAD S&I PERQ VRTPLS/SACRPLSTY PR VRT BODY FLUOR,TC,,20 ,,TotalUnits,,,,6.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,72292,CPT,RAD S&I PERQ VRTPLS/SACRPLSTY PER VRT BODY CT,,,20 ,,TotalUnits,,,,8.25 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,72292,CPT,RAD S&I PERQ VRTPLS/SACRPLSTY PER VRT BODY CT,26,,20 ,,TotalUnits,,,,1.91 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,72292,CPT,RAD S&I PERQ VRTPLS/SACRPLSTY PER VRT BODY CT,TC,,20 ,,TotalUnits,,,,6.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,72295,CPT,DISKOGRAPY LMBR RS&I,,,20 ,,RBRVS,0.83 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,72295,CPT,DISKOGRAPY LMBR RS&I,26,,20 ,,RBRVS,0.83 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,72295,CPT,DISKOGRAPY LMBR RS&I,TC,,20 ,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73000,CPT,RADEX CLAV COMPL,,,20 ,,RBRVS,0.16 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73000,CPT,RADEX CLAV COMPL,26,,20 ,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73000,CPT,RADEX CLAV COMPL,TC,,20 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73010,CPT,RADEX SCAPULA COMPL,,,20 ,,RBRVS,0.17 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73010,CPT,RADEX SCAPULA COMPL,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73010,CPT,RADEX SCAPULA COMPL,TC,,20 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73020,CPT,RADEX SHO 1 VIEW,,,20 ,,RBRVS,0.15 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73020,CPT,RADEX SHO 1 VIEW,26,,20 ,,RBRVS,0.15 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73020,CPT,RADEX SHO 1 VIEW,TC,,20 ,,RBRVS,,0.41 ,0.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73030,CPT,RADEX SHO COMPL MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.18 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73030,CPT,RADEX SHO COMPL MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73030,CPT,RADEX SHO COMPL MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73040,CPT,RADEX SHO ARTHG RS&I,,,20 ,,RBRVS,0.54 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73040,CPT,RADEX SHO ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73040,CPT,RADEX SHO ARTHG RS&I,TC,,20 ,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73050,CPT,RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ,,,20 ,,RBRVS,0.20 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73050,CPT,RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ,26,,20 ,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73050,CPT,RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ,TC,,20 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73060,CPT,RADEX HUM MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.17 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73060,CPT,RADEX HUM MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73060,CPT,RADEX HUM MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73070,CPT,RADEX ELBW 2 VIEWS,,,20 ,,RBRVS,0.15 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73070,CPT,RADEX ELBW 2 VIEWS,26,,20 ,,RBRVS,0.15 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73070,CPT,RADEX ELBW 2 VIEWS,TC,,20 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73080,CPT,RADEX ELBW COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73080,CPT,RADEX ELBW COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73080,CPT,RADEX ELBW COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73085,CPT,RADEX ELBW ARTHG RS&I,,,20 ,,RBRVS,0.54 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73085,CPT,RADEX ELBW ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73085,CPT,RADEX ELBW ARTHG RS&I,TC,,20 ,,RBRVS,,1.77 ,1.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73090,CPT,RADEX F/ARM 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73090,CPT,RADEX F/ARM 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73090,CPT,RADEX F/ARM 2 VIEWS,TC,,20 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73092,CPT,RADEX UXTR INFT MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73092,CPT,RADEX UXTR INFT MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73092,CPT,RADEX UXTR INFT MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73100,CPT,RADEX WRST 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73100,CPT,RADEX WRST 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73100,CPT,RADEX WRST 2 VIEWS,TC,,20 ,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73110,CPT,RADEX WRST COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73110,CPT,RADEX WRST COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73110,CPT,RADEX WRST COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73115,CPT,RADEX WRST ARTHG RS&I,,,20 ,,RBRVS,0.54 ,2.18 ,2.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73115,CPT,RADEX WRST ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73115,CPT,RADEX WRST ARTHG RS&I,TC,,20 ,,RBRVS,,1.98 ,1.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73120,CPT,RADEX HAND 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73120,CPT,RADEX HAND 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73120,CPT,RADEX HAND 2 VIEWS,TC,,20 ,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73130,CPT,RADEX HAND MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73130,CPT,RADEX HAND MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73130,CPT,RADEX HAND MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73140,CPT,RADEX FNGR MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.13 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73140,CPT,RADEX FNGR MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.13 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73140,CPT,RADEX FNGR MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73200,CPT,CT UXTR C-MATRL,,,20 ,,RBRVS,1.09 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73200,CPT,CT UXTR C-MATRL,26,,20 ,,RBRVS,1.09 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73200,CPT,CT UXTR C-MATRL,TC,,20 ,,RBRVS,,5.15 ,5.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73201,CPT,CT UXTR C+ MATRL,,,20 ,,RBRVS,1.16 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73201,CPT,CT UXTR C+ MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73201,CPT,CT UXTR C+ MATRL,TC,,20 ,,RBRVS,,6.37 ,6.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73202,CPT,CT UXTR C-/C+,,,20 ,,RBRVS,1.22 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73202,CPT,CT UXTR C-/C+,26,,20 ,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73202,CPT,CT UXTR C-/C+,TC,,20 ,,RBRVS,,8.52 ,8.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,,,20 ,,RBRVS,1.81 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,26,,20 ,,RBRVS,1.81 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,TC,,20 ,,RBRVS,,10.07 ,10.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73218,CPT,MRI UXTR OTH/THN JT C-MATRL,,,20 ,,RBRVS,1.35 ,12.40 ,12.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73218,CPT,MRI UXTR OTH/THN JT C-MATRL,26,,20 ,,RBRVS,1.35 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73218,CPT,MRI UXTR OTH/THN JT C-MATRL,TC,,20 ,,RBRVS,,11.93 ,11.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73219,CPT,MRI UXTR OTH/THN JT C+ MATRL,,,20 ,,RBRVS,1.62 ,13.49 ,13.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73219,CPT,MRI UXTR OTH/THN JT C+ MATRL,26,,20 ,,RBRVS,1.62 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73219,CPT,MRI UXTR OTH/THN JT C+ MATRL,TC,,20 ,,RBRVS,,12.91 ,12.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73220,CPT,MRI UXTR OTH/THN JT C-/C+,,,20 ,,RBRVS,2.15 ,18.18 ,18.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73220,CPT,MRI UXTR OTH/THN JT C-/C+,26,,20 ,,RBRVS,2.15 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73220,CPT,MRI UXTR OTH/THN JT C-/C+,TC,,20 ,,RBRVS,,17.41 ,17.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73221,CPT,MRI ANY JT UXTR C-MATRL,,,20 ,,RBRVS,1.35 ,11.66 ,11.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73221,CPT,MRI ANY JT UXTR C-MATRL,26,,20 ,,RBRVS,1.35 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73221,CPT,MRI ANY JT UXTR C-MATRL,TC,,20 ,,RBRVS,,11.18 ,11.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73222,CPT,MRI ANY JT UXTR C+ MATRL,,,20 ,,RBRVS,1.62 ,12.70 ,12.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73222,CPT,MRI ANY JT UXTR C+ MATRL,26,,20 ,,RBRVS,1.62 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73222,CPT,MRI ANY JT UXTR C+ MATRL,TC,,20 ,,RBRVS,,12.12 ,12.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73223,CPT,MRI ANY JT UXTR C-/C+,,,20 ,,RBRVS,2.15 ,17.23 ,17.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73223,CPT,MRI ANY JT UXTR C-/C+,26,,20 ,,RBRVS,2.15 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73223,CPT,MRI ANY JT UXTR C-/C+,TC,,20 ,,RBRVS,,16.47 ,16.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73225,CPT,MRA UXTR C+-MATRL,,,20 ,,RBRVS,1.73 ,15.48 ,15.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73225,CPT,MRA UXTR C+-MATRL,26,,20 ,,RBRVS,1.73 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73225,CPT,MRA UXTR C+-MATRL,TC,,20 ,,RBRVS,,14.86 ,14.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73500,CPT,RADEX HIP UNI 1 VIEW,,,20 ,,RBRVS,0.17 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73500,CPT,RADEX HIP UNI 1 VIEW,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73500,CPT,RADEX HIP UNI 1 VIEW,TC,,20 ,,RBRVS,,0.43 ,0.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73510,CPT,RADEX HIP UNI COMPL MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.21 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73510,CPT,RADEX HIP UNI COMPL MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.21 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73510,CPT,RADEX HIP UNI COMPL MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73520,CPT,RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS,,,20 ,,RBRVS,0.26 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73520,CPT,RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS,26,,20 ,,RBRVS,0.26 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73520,CPT,RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS,TC,,20 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73525,CPT,RADEX HIP ARTHG RS&I,,,20 ,,RBRVS,0.54 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73525,CPT,RADEX HIP ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73525,CPT,RADEX HIP ARTHG RS&I,TC,,20 ,,RBRVS,,1.78 ,1.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73530,CPT,RADEX HIP OPRATIVE PX,,,20 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,73530,CPT,RADEX HIP OPRATIVE PX,26,,20 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,73530,CPT,RADEX HIP OPRATIVE PX,TC,,20 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,73540,CPT,RADEX PELVIS&HIPS INFT/CHLD MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.20 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73540,CPT,RADEX PELVIS&HIPS INFT/CHLD MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73540,CPT,RADEX PELVIS&HIPS INFT/CHLD MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73542,CPT,RAD XM SI JT ARTHG RS&I,,,20 ,,RBRVS,0.59 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73542,CPT,RAD XM SI JT ARTHG RS&I,26,,20 ,,RBRVS,0.59 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73542,CPT,RAD XM SI JT ARTHG RS&I,TC,,20 ,,RBRVS,,1.31 ,1.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73550,CPT,RADEX FEMUR 2 VIEWS,,,20 ,,RBRVS,0.17 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73550,CPT,RADEX FEMUR 2 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73550,CPT,RADEX FEMUR 2 VIEWS,TC,,20 ,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73560,CPT,RADEX KNE 1/2 VIEWS,,,20 ,,RBRVS,0.17 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73560,CPT,RADEX KNE 1/2 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73560,CPT,RADEX KNE 1/2 VIEWS,TC,,20 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73562,CPT,RADEX KNE 3 VIEWS,,,20 ,,RBRVS,0.18 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73562,CPT,RADEX KNE 3 VIEWS,26,,20 ,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73562,CPT,RADEX KNE 3 VIEWS,TC,,20 ,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73564,CPT,RADEX KNE COMPL 4/MORE VIEWS,,,20 ,,RBRVS,0.22 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73564,CPT,RADEX KNE COMPL 4/MORE VIEWS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73564,CPT,RADEX KNE COMPL 4/MORE VIEWS,TC,,20 ,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73565,CPT,RADEX KNE BTH KNES STANDING ANTEROPOST,,,20 ,,RBRVS,0.17 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73565,CPT,RADEX KNE BTH KNES STANDING ANTEROPOST,26,,20 ,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73565,CPT,RADEX KNE BTH KNES STANDING ANTEROPOST,TC,,20 ,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73580,CPT,RADEX KNE ARTHG RS&I,,,20 ,,RBRVS,0.54 ,2.70 ,2.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73580,CPT,RADEX KNE ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73580,CPT,RADEX KNE ARTHG RS&I,TC,,20 ,,RBRVS,,2.48 ,2.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73590,CPT,RADEX TIBFIB 2 VIEWS,,,20 ,,RBRVS,0.17 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73590,CPT,RADEX TIBFIB 2 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73590,CPT,RADEX TIBFIB 2 VIEWS,TC,,20 ,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73592,CPT,RADEX LXTR INFT MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73592,CPT,RADEX LXTR INFT MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73592,CPT,RADEX LXTR INFT MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73600,CPT,RADEX ANKLE 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73600,CPT,RADEX ANKLE 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73600,CPT,RADEX ANKLE 2 VIEWS,TC,,20 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73610,CPT,RADEX ANKLE COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73610,CPT,RADEX ANKLE COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73610,CPT,RADEX ANKLE COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73615,CPT,RADEX ANKLE ARTHG RS&I,,,20 ,,RBRVS,0.54 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73615,CPT,RADEX ANKLE ARTHG RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73615,CPT,RADEX ANKLE ARTHG RS&I,TC,,20 ,,RBRVS,,1.88 ,1.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73620,CPT,RADEX FOOT 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73620,CPT,RADEX FOOT 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73620,CPT,RADEX FOOT 2 VIEWS,TC,,20 ,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73630,CPT,RADEX FOOT COMPL MINIMUM 3 VIEWS,,,20 ,,RBRVS,0.17 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73630,CPT,RADEX FOOT COMPL MINIMUM 3 VIEWS,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73630,CPT,RADEX FOOT COMPL MINIMUM 3 VIEWS,TC,,20 ,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.16 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73660,CPT,RADEX TOE MINIMUM 2 VIEWS,,,20 ,,RBRVS,0.13 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73660,CPT,RADEX TOE MINIMUM 2 VIEWS,26,,20 ,,RBRVS,0.13 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73660,CPT,RADEX TOE MINIMUM 2 VIEWS,TC,,20 ,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73700,CPT,CT LXTR C-MATRL,,,20 ,,RBRVS,1.09 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73700,CPT,CT LXTR C-MATRL,26,,20 ,,RBRVS,1.09 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73700,CPT,CT LXTR C-MATRL,TC,,20 ,,RBRVS,,5.16 ,5.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73701,CPT,CT LXTR C+ MATRL,,,20 ,,RBRVS,1.16 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73701,CPT,CT LXTR C+ MATRL,26,,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73701,CPT,CT LXTR C+ MATRL,TC,,20 ,,RBRVS,,6.43 ,6.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73702,CPT,CT LXTR C-/C+,,,20 ,,RBRVS,1.22 ,8.98 ,8.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73702,CPT,CT LXTR C-/C+,26,,20 ,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73702,CPT,CT LXTR C-/C+,TC,,20 ,,RBRVS,,8.54 ,8.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,,,20 ,,RBRVS,1.90 ,11.83 ,11.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,26,,20 ,,RBRVS,1.90 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,TC,,20 ,,RBRVS,,11.12 ,11.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73718,CPT,MRI LXTR OTH/THN JT C-MATRL,,,20 ,,RBRVS,1.35 ,12.17 ,12.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73718,CPT,MRI LXTR OTH/THN JT C-MATRL,26,,20 ,,RBRVS,1.35 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73718,CPT,MRI LXTR OTH/THN JT C-MATRL,TC,,20 ,,RBRVS,,11.69 ,11.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73719,CPT,MRI IMG LXTR OTH/THN JT C+ MATRL,,,20 ,,RBRVS,1.62 ,13.33 ,13.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73719,CPT,MRI IMG LXTR OTH/THN JT C+ MATRL,26,,20 ,,RBRVS,1.62 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73719,CPT,MRI IMG LXTR OTH/THN JT C+ MATRL,TC,,20 ,,RBRVS,,12.76 ,12.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73720,CPT,MRI LXTR OTH/THN JT C-/C+,,,20 ,,RBRVS,2.15 ,18.18 ,18.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73720,CPT,MRI LXTR OTH/THN JT C-/C+,26,,20 ,,RBRVS,2.15 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73720,CPT,MRI LXTR OTH/THN JT C-/C+,TC,,20 ,,RBRVS,,17.41 ,17.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73721,CPT,MRI ANY JT LXTR C-MATRL,,,20 ,,RBRVS,1.35 ,11.90 ,11.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73721,CPT,MRI ANY JT LXTR C-MATRL,26,,20 ,,RBRVS,1.35 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73721,CPT,MRI ANY JT LXTR C-MATRL,TC,,20 ,,RBRVS,,11.42 ,11.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73722,CPT,MRI ANY JT LXTR C+ MATRL,,,20 ,,RBRVS,1.62 ,12.84 ,12.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73722,CPT,MRI ANY JT LXTR C+ MATRL,26,,20 ,,RBRVS,1.62 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73722,CPT,MRI ANY JT LXTR C+ MATRL,TC,,20 ,,RBRVS,,12.25 ,12.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73723,CPT,MRI ANY JT LXTR C-/C+,,,20 ,,RBRVS,2.15 ,17.19 ,17.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73723,CPT,MRI ANY JT LXTR C-/C+,26,,20 ,,RBRVS,2.15 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73723,CPT,MRI ANY JT LXTR C-/C+,TC,,20 ,,RBRVS,,16.42 ,16.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,73725,CPT,MRA LXTR C+-MATRL,,,20 ,,RBRVS,1.82 ,14.14 ,14.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,73725,CPT,MRA LXTR C+-MATRL,26,,20 ,,RBRVS,1.82 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,73725,CPT,MRA LXTR C+-MATRL,TC,,20 ,,RBRVS,,13.48 ,13.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74000,CPT,RADEX ABD 1 ANTEROPOST VIEW,,,20 ,,RBRVS,0.18 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74000,CPT,RADEX ABD 1 ANTEROPOST VIEW,26,,20 ,,RBRVS,0.18 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74000,CPT,RADEX ABD 1 ANTEROPOST VIEW,TC,,20 ,,RBRVS,,0.42 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,,,20 ,,RBRVS,0.23 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,26,,20 ,,RBRVS,0.23 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,TC,,20 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74020,CPT,RADEX ABD COMPL W/DCBTS&/ERC VIEWS,,,20 ,,RBRVS,0.27 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74020,CPT,RADEX ABD COMPL W/DCBTS&/ERC VIEWS,26,,20 ,,RBRVS,0.27 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74020,CPT,RADEX ABD COMPL W/DCBTS&/ERC VIEWS,TC,,20 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,,,20 ,,RBRVS,0.32 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,26,,20 ,,RBRVS,0.32 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,TC,,20 ,,RBRVS,,0.82 ,0.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74150,CPT,CT ABD C-MATRL,,,20 ,,RBRVS,1.19 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74150,CPT,CT ABD C-MATRL,26,,20 ,,RBRVS,1.19 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74150,CPT,CT ABD C-MATRL,TC,,20 ,,RBRVS,,5.02 ,5.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74160,CPT,CT ABD C+ MATRL,,,20 ,,RBRVS,1.27 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74160,CPT,CT ABD C+ MATRL,26,,20 ,,RBRVS,1.27 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74160,CPT,CT ABD C+ MATRL,TC,,20 ,,RBRVS,,7.16 ,7.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74170,CPT,CT ABD C-/C+,,,20 ,,RBRVS,1.40 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74170,CPT,CT ABD C-/C+,26,,20 ,,RBRVS,1.40 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74170,CPT,CT ABD C-/C+,TC,,20 ,,RBRVS,,9.79 ,9.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,,,20 ,,RBRVS,1.90 ,12.05 ,12.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,26,,20 ,,RBRVS,1.90 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,TC,,20 ,,RBRVS,,11.36 ,11.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74176,CPT,CT ABD & PELVIS W/O CONTRAST,,,20 ,,RBRVS,1.74 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74176,CPT,CT ABD & PELVIS W/O CONTRAST,26,,20 ,,RBRVS,1.74 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74176,CPT,CT ABD & PELVIS W/O CONTRAST,TC,,20 ,,RBRVS,,3.89 ,3.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74177,CPT,CT ABDOMEN&PELVIS W/CONTRAST,,,20 ,,RBRVS,1.82 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74177,CPT,CT ABDOMEN&PELVIS W/CONTRAST,26,,20 ,,RBRVS,1.82 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74177,CPT,CT ABDOMEN&PELVIS W/CONTRAST,TC,,20 ,,RBRVS,,7.42 ,7.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74178,CPT,CT ABD&PELV 1+ SECTION/REGNS,,,20 ,,RBRVS,2.01 ,10.57 ,10.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74178,CPT,CT ABD&PELV 1+ SECTION/REGNS,26,,20 ,,RBRVS,2.01 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74178,CPT,CT ABD&PELV 1+ SECTION/REGNS,TC,,20 ,,RBRVS,,9.81 ,9.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74181,CPT,MRI ABD C-MATRL,,,20 ,,RBRVS,1.46 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74181,CPT,MRI ABD C-MATRL,26,,20 ,,RBRVS,1.46 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74181,CPT,MRI ABD C-MATRL,TC,,20 ,,RBRVS,,10.40 ,10.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74182,CPT,MRI ABD C+ MATRL,,,20 ,,RBRVS,1.73 ,14.84 ,14.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74182,CPT,MRI ABD C+ MATRL,26,,20 ,,RBRVS,1.73 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74182,CPT,MRI ABD C+ MATRL,TC,,20 ,,RBRVS,,14.22 ,14.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74183,CPT,MRI ABD C-/C+,,,20 ,,RBRVS,2.26 ,18.15 ,18.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74183,CPT,MRI ABD C-/C+,26,,20 ,,RBRVS,2.26 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74183,CPT,MRI ABD C-/C+,TC,,20 ,,RBRVS,,17.35 ,17.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74185,CPT,MRA ABD C+-MATRL,,,20 ,,RBRVS,1.80 ,14.09 ,14.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74185,CPT,MRA ABD C+-MATRL,26,,20 ,,RBRVS,1.80 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74185,CPT,MRA ABD C+-MATRL,TC,,20 ,,RBRVS,,13.44 ,13.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74190,CPT,PRITONEOGRAM RS&I,,,20 ,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74190,CPT,PRITONEOGRAM RS&I,26,,20 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74190,CPT,PRITONEOGRAM RS&I,TC,,20 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74210,CPT,RADEX PHARYNX&/CRV ESOPH,,,20 ,,RBRVS,0.36 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74210,CPT,RADEX PHARYNX&/CRV ESOPH,26,,20 ,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74210,CPT,RADEX PHARYNX&/CRV ESOPH,TC,,20 ,,RBRVS,,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74220,CPT,RADEX ESOPH,,,20 ,,RBRVS,0.46 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74220,CPT,RADEX ESOPH,26,,20 ,,RBRVS,0.46 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74220,CPT,RADEX ESOPH,TC,,20 ,,RBRVS,,1.69 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74230,CPT,SWLNG FUNCJ W/CINERADIOGRAPY/VIDRADIOGRAPY,,,20 ,,RBRVS,0.53 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74230,CPT,SWLNG FUNCJ W/CINERADIOGRAPY/VIDRADIOGRAPY,26,,20 ,,RBRVS,0.53 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74230,CPT,SWLNG FUNCJ W/CINERADIOGRAPY/VIDRADIOGRAPY,TC,,20 ,,RBRVS,,1.63 ,1.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74235,CPT,RMVL FB ESOPHGL W/USE BALO CATH RS&I,,,20 ,,RBRVS,1.19 ,3.49 ,3.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74235,CPT,RMVL FB ESOPHGL W/USE BALO CATH RS&I,26,,20 ,,RBRVS,1.19 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74235,CPT,RMVL FB ESOPHGL W/USE BALO CATH RS&I,TC,,20 ,,RBRVS,,3.03 ,3.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74240,CPT,RADEX GI TRC UPR +-DLYD FLMS W/O KUB,,,20 ,,RBRVS,0.69 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74240,CPT,RADEX GI TRC UPR +-DLYD FLMS W/O KUB,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74240,CPT,RADEX GI TRC UPR +-DLYD FLMS W/O KUB,TC,,20 ,,RBRVS,,1.90 ,1.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74241,CPT,RADEX GI TRC UPR +-DLYD FLMS W/KUB,,,20 ,,RBRVS,0.69 ,2.35 ,2.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74241,CPT,RADEX GI TRC UPR +-DLYD FLMS W/KUB,26,,20 ,,RBRVS,0.69 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74241,CPT,RADEX GI TRC UPR +-DLYD FLMS W/KUB,TC,,20 ,,RBRVS,,2.11 ,2.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74245,CPT,RADEX GI TRC UPR W/SM INT W/MLT SRL FLMS,,,20 ,,RBRVS,0.91 ,3.64 ,3.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74245,CPT,RADEX GI TRC UPR W/SM INT W/MLT SRL FLMS,26,,20 ,,RBRVS,0.91 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74245,CPT,RADEX GI TRC UPR W/SM INT W/MLT SRL FLMS,TC,,20 ,,RBRVS,,3.31 ,3.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74246,CPT,RADEX GI UPR C+ +-GLUC/DLYD FLMS W/O KUB,,,20 ,,RBRVS,0.69 ,2.56 ,2.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74246,CPT,RADEX GI UPR C+ +-GLUC/DLYD FLMS W/O KUB,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74246,CPT,RADEX GI UPR C+ +-GLUC/DLYD FLMS W/O KUB,TC,,20 ,,RBRVS,,2.31 ,2.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74247,CPT,RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB,,,20 ,,RBRVS,0.69 ,2.90 ,2.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74247,CPT,RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74247,CPT,RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB,TC,,20 ,,RBRVS,,2.65 ,2.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74249,CPT,RADEX GI UPR C+ +-GLUC W/SM INT FOLLW-THRU,,,20 ,,RBRVS,0.91 ,3.98 ,3.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74249,CPT,RADEX GI UPR C+ +-GLUC W/SM INT FOLLW-THRU,26,,20 ,,RBRVS,0.91 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74249,CPT,RADEX GI UPR C+ +-GLUC W/SM INT FOLLW-THRU,TC,,20 ,,RBRVS,,3.65 ,3.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74250,CPT,RADEX SM INT W/MLT SRL FLMS,,,20 ,,RBRVS,0.47 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74250,CPT,RADEX SM INT W/MLT SRL FLMS,26,,20 ,,RBRVS,0.47 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74250,CPT,RADEX SM INT W/MLT SRL FLMS,TC,,20 ,,RBRVS,,2.07 ,2.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74251,CPT,RADEX SM INT W/MLT SRL FLMS VIA ENTEROCLSS TUBE,,,20 ,,RBRVS,0.69 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74251,CPT,RADEX SM INT W/MLT SRL FLMS VIA ENTEROCLSS TUBE,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74251,CPT,RADEX SM INT W/MLT SRL FLMS VIA ENTEROCLSS TUBE,TC,,20 ,,RBRVS,,7.93 ,7.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74260,CPT,DUODENOGRAPY HYPOTONIC,,,20 ,,RBRVS,0.50 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74260,CPT,DUODENOGRAPY HYPOTONIC,26,,20 ,,RBRVS,0.50 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74260,CPT,DUODENOGRAPY HYPOTONIC,TC,,20 ,,RBRVS,,6.69 ,6.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS NO CONTRAST,,,20 ,,RBRVS,2.28 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS NO CONTRAST,26,,20 ,,RBRVS,2.28 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS NO CONTRAST,TC,,20 ,,RBRVS,,8.21 ,8.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,,,20 ,,RBRVS,2.50 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,26,,20 ,,RBRVS,2.50 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,TC,,20 ,,RBRVS,,9.30 ,9.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,,,20 ,,RBRVS,2.28 ,17.04 ,17.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,26,,20 ,,RBRVS,2.28 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,TC,,20 ,,RBRVS,,16.21 ,16.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74270,CPT,RADEX COLON BARIUM ENEMA +-KUB,,,20 ,,RBRVS,0.69 ,3.19 ,3.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74270,CPT,RADEX COLON BARIUM ENEMA +-KUB,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74270,CPT,RADEX COLON BARIUM ENEMA +-KUB,TC,,20 ,,RBRVS,,2.94 ,2.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74280,CPT,RADEX COLON C+ W/SPEC HI DNS BARIUM +-GLUC,,,20 ,,RBRVS,0.99 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74280,CPT,RADEX COLON C+ W/SPEC HI DNS BARIUM +-GLUC,26,,20 ,,RBRVS,0.99 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74280,CPT,RADEX COLON C+ W/SPEC HI DNS BARIUM +-GLUC,TC,,20 ,,RBRVS,,4.04 ,4.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74283,CPT,THER ENEMA C+ RDCTJ INTUSSUSCEPTION/OBSTRCJ,,,20 ,,RBRVS,2.02 ,3.42 ,3.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74283,CPT,THER ENEMA C+ RDCTJ INTUSSUSCEPTION/OBSTRCJ,26,,20 ,,RBRVS,2.02 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74283,CPT,THER ENEMA C+ RDCTJ INTUSSUSCEPTION/OBSTRCJ,TC,,20 ,,RBRVS,,2.70 ,2.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74290,CPT,CCG ORAL CNTRST,,,20 ,,RBRVS,0.32 ,1.42 ,1.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74290,CPT,CCG ORAL CNTRST,26,,20 ,,RBRVS,0.32 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74290,CPT,CCG ORAL CNTRST,TC,,20 ,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74291,CPT,CCG ORAL CNTRST ADDL/REPEAT XM/MLT D XM,,,20 ,,RBRVS,0.20 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74291,CPT,CCG ORAL CNTRST ADDL/REPEAT XM/MLT D XM,26,,20 ,,RBRVS,0.20 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74291,CPT,CCG ORAL CNTRST ADDL/REPEAT XM/MLT D XM,TC,,20 ,,RBRVS,,1.28 ,1.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74300,CPT,CHOLANGRPH&/PCG INTRAOP RS&I,,,20 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74300,CPT,CHOLANGRPH&/PCG INTRAOP RS&I,26,,20 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74300,CPT,CHOLANGRPH&/PCG INTRAOP RS&I,TC,,20 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74301,CPT,CHOLANGRPH&/PCG ADDL SET INTRAOP RS&I,,,20 ,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74301,CPT,CHOLANGRPH&/PCG ADDL SET INTRAOP RS&I,26,,20 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74301,CPT,CHOLANGRPH&/PCG ADDL SET INTRAOP RS&I,TC,,20 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74305,CPT,CHOLANGRPH&/PCG THRU CATH RS&I,,,20 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74305,CPT,CHOLANGRPH&/PCG THRU CATH RS&I,26,,20 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74305,CPT,CHOLANGRPH&/PCG THRU CATH RS&I,TC,,20 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74320,CPT,CHOLANGRPH PRQ TRANSHEPATC RS&I,,,20 ,,RBRVS,0.54 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74320,CPT,CHOLANGRPH PRQ TRANSHEPATC RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74320,CPT,CHOLANGRPH PRQ TRANSHEPATC RS&I,TC,,20 ,,RBRVS,,2.14 ,2.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74327,CPT,PO BILIARY ST1 RMVL PRQ RS&I,,,20 ,,RBRVS,0.70 ,2.75 ,2.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74327,CPT,PO BILIARY ST1 RMVL PRQ RS&I,26,,20 ,,RBRVS,0.70 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74327,CPT,PO BILIARY ST1 RMVL PRQ RS&I,TC,,20 ,,RBRVS,,2.49 ,2.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74328,CPT,NDSC CATHJ BILIARY DUX SYS RS&I,,,20 ,,TotalUnits,,,,3.42 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74328,CPT,NDSC CATHJ BILIARY DUX SYS RS&I,26,,20 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74328,CPT,NDSC CATHJ BILIARY DUX SYS RS&I,TC,,20 ,,TotalUnits,,,,2.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74329,CPT,NDSC CATHJ PNCRTC DUX SYS RS&I,,,20 ,,TotalUnits,,,,2.79 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74329,CPT,NDSC CATHJ PNCRTC DUX SYS RS&I,26,,20 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74329,CPT,NDSC CATHJ PNCRTC DUX SYS RS&I,TC,,20 ,,TotalUnits,,,,1.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUX SYSS RS&I,,,20 ,,TotalUnits,,,,4.20 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUX SYSS RS&I,26,,20 ,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUX SYSS RS&I,TC,,20 ,,TotalUnits,,,,2.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74340,CPT,INTRO LONG GI TUBE W/MLT FLUOR&FLMS RS&I,,,20 ,,TotalUnits,,,,2.05 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74340,CPT,INTRO LONG GI TUBE W/MLT FLUOR&FLMS RS&I,26,,20 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74340,CPT,INTRO LONG GI TUBE W/MLT FLUOR&FLMS RS&I,TC,,20 ,,TotalUnits,,,,1.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74355,CPT,PRQ PLMT ENTEROCLSS TUBE RS&I,,,20 ,,TotalUnits,,,,3.08 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74355,CPT,PRQ PLMT ENTEROCLSS TUBE RS&I,26,,20 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74355,CPT,PRQ PLMT ENTEROCLSS TUBE RS&I,TC,,20 ,,TotalUnits,,,,2.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74360,CPT,INTRAL DILAT STRIXS&/OBSTRCJS RS&I,,,20 ,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74360,CPT,INTRAL DILAT STRIXS&/OBSTRCJS RS&I,26,,20 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74360,CPT,INTRAL DILAT STRIXS&/OBSTRCJS RS&I,TC,,20 ,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUX STRIX RS&I,,,20 ,,TotalUnits,,,,3.08 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUX STRIX RS&I,26,,20 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUX STRIX RS&I,TC,,20 ,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74400,CPT,UROGRAPY PLOG IV +-KUB +-TOMOG,,,20 ,,RBRVS,0.49 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74400,CPT,UROGRAPY PLOG IV +-KUB +-TOMOG,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74400,CPT,UROGRAPY PLOG IV +-KUB +-TOMOG,TC,,20 ,,RBRVS,,2.21 ,2.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74410,CPT,UROGRAPY NFS DRIP TQ&/BOLUS TQ,,,20 ,,RBRVS,0.49 ,2.50 ,2.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74410,CPT,UROGRAPY NFS DRIP TQ&/BOLUS TQ,26,,20 ,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74410,CPT,UROGRAPY NFS DRIP TQ&/BOLUS TQ,TC,,20 ,,RBRVS,,2.32 ,2.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74415,CPT,UROGRAPY NFS DRIP TQ&/BOLUS TQ W/NEPHROTOMOG,,,20 ,,RBRVS,0.49 ,2.99 ,2.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74415,CPT,UROGRAPY NFS DRIP TQ&/BOLUS TQ W/NEPHROTOMOG,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74415,CPT,UROGRAPY NFS DRIP TQ&/BOLUS TQ W/NEPHROTOMOG,TC,,20 ,,RBRVS,,2.82 ,2.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74420,CPT,"X-RAY, URINARY TRACT EXAM WITH CONTRAST MATERIAL",,,20 ,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74420,CPT,"X-RAY, URINARY TRACT EXAM WITH CONTRAST MATERIAL",26,,20 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74420,CPT,"X-RAY, URINARY TRACT EXAM WITH CONTRAST MATERIAL",TC,,20 ,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74425,CPT,UROGRAPY ANTEGRADE RS&I,,,20 ,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74425,CPT,UROGRAPY ANTEGRADE RS&I,26,,20 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74425,CPT,UROGRAPY ANTEGRADE RS&I,TC,,20 ,,TotalUnits,,,,1.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74430,CPT,CSTOGRAPY MINIMUM 3 VIEWS RS&I,,,20 ,,RBRVS,0.32 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74430,CPT,CSTOGRAPY MINIMUM 3 VIEWS RS&I,26,,20 ,,RBRVS,0.32 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74430,CPT,CSTOGRAPY MINIMUM 3 VIEWS RS&I,TC,,20 ,,RBRVS,,1.64 ,1.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,,,20 ,,RBRVS,0.38 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,26,,20 ,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,TC,,20 ,,RBRVS,,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74445,CPT,C/P/A CAVERNOSOGRAPY RS&I,,,20 ,,TotalUnits,,,,3.10 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74445,CPT,C/P/A CAVERNOSOGRAPY RS&I,26,,20 ,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74445,CPT,C/P/A CAVERNOSOGRAPY RS&I,TC,,20 ,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74450,CPT,URETHROCSTOGRAPY RTRGR RS&I,,,20 ,,TotalUnits,,,,2.28 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74450,CPT,URETHROCSTOGRAPY RTRGR RS&I,26,,20 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74450,CPT,URETHROCSTOGRAPY RTRGR RS&I,TC,,20 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74455,CPT,URETHROCSTOGRAPY VOIDING RS&I,,,20 ,,RBRVS,0.33 ,2.02 ,2.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74455,CPT,URETHROCSTOGRAPY VOIDING RS&I,26,,20 ,,RBRVS,0.33 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74455,CPT,URETHROCSTOGRAPY VOIDING RS&I,TC,,20 ,,RBRVS,,1.89 ,1.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74470,CPT,RADEX RNL CST STD TRANSLMBR C+ RS&I,,,20 ,,TotalUnits,,,,2.32 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74470,CPT,RADEX RNL CST STD TRANSLMBR C+ RS&I,26,,20 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74470,CPT,RADEX RNL CST STD TRANSLMBR C+ RS&I,TC,,20 ,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74475,CPT,INTRO CATH IN RNL PELVIS DRG&/NJX PRQ RS&I,,,20 ,,RBRVS,0.54 ,2.50 ,2.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74475,CPT,INTRO CATH IN RNL PELVIS DRG&/NJX PRQ RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74475,CPT,INTRO CATH IN RNL PELVIS DRG&/NJX PRQ RS&I,TC,,20 ,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74480,CPT,INTRO URTRL CATH/STENT PRQ RS&I,,,20 ,,RBRVS,0.54 ,2.51 ,2.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74480,CPT,INTRO URTRL CATH/STENT PRQ RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74480,CPT,INTRO URTRL CATH/STENT PRQ RS&I,TC,,20 ,,RBRVS,,2.31 ,2.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74485,CPT,DILAT NFROS URTRS/URT RS&I,,,20 ,,RBRVS,0.54 ,2.42 ,2.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74485,CPT,DILAT NFROS URTRS/URT RS&I,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74485,CPT,DILAT NFROS URTRS/URT RS&I,TC,,20 ,,RBRVS,,2.22 ,2.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74710,CPT,PELVIMETRY +-PLACENTAL LOCLZJ,,,20 ,,RBRVS,0.34 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74710,CPT,PELVIMETRY +-PLACENTAL LOCLZJ,26,,20 ,,RBRVS,0.34 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74710,CPT,PELVIMETRY +-PLACENTAL LOCLZJ,TC,,20 ,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74740,CPT,HSG RS&I,,,20 ,,RBRVS,0.38 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,74740,CPT,HSG RS&I,26,,20 ,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,74740,CPT,HSG RS&I,TC,,20 ,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,74742,CPT,TRANSCRV CATHJ FLP TUBE RS&I,,,20 ,,TotalUnits,,,,2.61 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74742,CPT,TRANSCRV CATHJ FLP TUBE RS&I,26,,20 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74742,CPT,TRANSCRV CATHJ FLP TUBE RS&I,TC,,20 ,,TotalUnits,,,,1.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,74775,CPT,PRINEOGRAM,,,20 ,,TotalUnits,,,,3.00 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,74775,CPT,PRINEOGRAM,26,,20 ,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,74775,CPT,PRINEOGRAM,TC,,20 ,,TotalUnits,,,,2.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,,,20 ,,RBRVS,2.35 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,26,,20 ,,RBRVS,2.35 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,TC,,20 ,,RBRVS,,8.92 ,8.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75559,CPT,CARDIAC MRI W/O CONTRAST W STRESS IMAGING,,,20 ,,RBRVS,2.95 ,14.99 ,14.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75559,CPT,CARDIAC MRI W/O CONTRAST W STRESS IMAGING,26,,20 ,,RBRVS,2.95 ,1.26 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75559,CPT,CARDIAC MRI W/O CONTRAST W STRESS IMAGING,TC,,20 ,,RBRVS,,13.73 ,13.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75561,CPT,CARDIAC MRI W/W/O CONTRAST & FURTHER SEQ,,,20 ,,RBRVS,2.60 ,13.96 ,13.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75561,CPT,CARDIAC MRI W/W/O CONTRAST & FURTHER SEQ,26,,20 ,,RBRVS,2.60 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75561,CPT,CARDIAC MRI W/W/O CONTRAST & FURTHER SEQ,TC,,20 ,,RBRVS,,12.92 ,12.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75563,CPT,CARDIAC MRI W/W/O CONTRAST W STRESS,,,20 ,,RBRVS,3.00 ,17.40 ,17.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75563,CPT,CARDIAC MRI W/W/O CONTRAST W STRESS,26,,20 ,,RBRVS,3.00 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75563,CPT,CARDIAC MRI W/W/O CONTRAST W STRESS,TC,,20 ,,RBRVS,,16.06 ,16.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,,,20 ,,RBRVS,0.25 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,26,,20 ,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,TC,,20 ,,RBRVS,,2.17 ,2.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,,,20 ,,RBRVS,0.58 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,26,,20 ,,RBRVS,0.58 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,TC,,20 ,,RBRVS,,1.73 ,1.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,,,20 ,,RBRVS,1.75 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,26,,20 ,,RBRVS,1.75 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,TC,,20 ,,RBRVS,,6.07 ,6.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT DX,,,20 ,,RBRVS,2.55 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT DX,26,,20 ,,RBRVS,2.55 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT DX,TC,,20 ,,RBRVS,,8.81 ,8.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,,,20 ,,RBRVS,2.40 ,16.36 ,16.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,26,,20 ,,RBRVS,2.40 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,TC,,20 ,,RBRVS,,15.60 ,15.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75600,CPT,AORTOGRAPY THRC W/O SRLOGRAPY RS&I,,,20 ,,RBRVS,0.49 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75600,CPT,AORTOGRAPY THRC W/O SRLOGRAPY RS&I,26,,20 ,,RBRVS,0.49 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75600,CPT,AORTOGRAPY THRC W/O SRLOGRAPY RS&I,TC,,20 ,,RBRVS,,6.91 ,6.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75605,CPT,AORTOGRAPY THRC SRLOGRAPY RS&I,,,20 ,,RBRVS,1.14 ,5.14 ,5.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75605,CPT,AORTOGRAPY THRC SRLOGRAPY RS&I,26,,20 ,,RBRVS,1.14 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75605,CPT,AORTOGRAPY THRC SRLOGRAPY RS&I,TC,,20 ,,RBRVS,,4.68 ,4.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75625,CPT,AORTOGRAPY ABDL SRLOGRAPY RS&I,,,20 ,,RBRVS,1.14 ,5.08 ,5.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75625,CPT,AORTOGRAPY ABDL SRLOGRAPY RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75625,CPT,AORTOGRAPY ABDL SRLOGRAPY RS&I,TC,,20 ,,RBRVS,,4.66 ,4.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75630,CPT,AORTOGRAPY ABDL BI ILIOFEM LXTR CATH RS&I,,,20 ,,RBRVS,1.79 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75630,CPT,AORTOGRAPY ABDL BI ILIOFEM LXTR CATH RS&I,26,,20 ,,RBRVS,1.79 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75630,CPT,AORTOGRAPY ABDL BI ILIOFEM LXTR CATH RS&I,TC,,20 ,,RBRVS,,4.80 ,4.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75635,CPT,CTA AA&BI ILIOFEM LXTR RS&I C-/C+ POST-PXESSING,,,20 ,,RBRVS,2.40 ,13.24 ,13.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75635,CPT,CTA AA&BI ILIOFEM LXTR RS&I C-/C+ POST-PXESSING,26,,20 ,,RBRVS,2.40 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75635,CPT,CTA AA&BI ILIOFEM LXTR RS&I C-/C+ POST-PXESSING,TC,,20 ,,RBRVS,,12.33 ,12.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75650,CPT,ANGRPH CERVICOCERE CATH W/VSL ORIGIN RS&I,,,20 ,,RBRVS,1.49 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75650,CPT,ANGRPH CERVICOCERE CATH W/VSL ORIGIN RS&I,26,,20 ,,RBRVS,1.49 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75650,CPT,ANGRPH CERVICOCERE CATH W/VSL ORIGIN RS&I,TC,,20 ,,RBRVS,,4.68 ,4.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75658,CPT,ANGRPH BRACH RTRGR RS&I,,,20 ,,RBRVS,1.31 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75658,CPT,ANGRPH BRACH RTRGR RS&I,26,,20 ,,RBRVS,1.31 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75658,CPT,ANGRPH BRACH RTRGR RS&I,TC,,20 ,,RBRVS,,5.00 ,5.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75660,CPT,ANGRPH XTRNL CRTD UNI SLCTV RS&I,,,20 ,,RBRVS,1.31 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75660,CPT,ANGRPH XTRNL CRTD UNI SLCTV RS&I,26,,20 ,,RBRVS,1.31 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75660,CPT,ANGRPH XTRNL CRTD UNI SLCTV RS&I,TC,,20 ,,RBRVS,,5.06 ,5.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75662,CPT,ANGRPH XTRNL CRTD BI SLCTV RS&I,,,20 ,,RBRVS,1.66 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75662,CPT,ANGRPH XTRNL CRTD BI SLCTV RS&I,26,,20 ,,RBRVS,1.66 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75662,CPT,ANGRPH XTRNL CRTD BI SLCTV RS&I,TC,,20 ,,RBRVS,,5.68 ,5.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75665,CPT,ANGRPH CRTD CERE UNI RS&I,,,20 ,,RBRVS,1.31 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75665,CPT,ANGRPH CRTD CERE UNI RS&I,26,,20 ,,RBRVS,1.31 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75665,CPT,ANGRPH CRTD CERE UNI RS&I,TC,,20 ,,RBRVS,,5.26 ,5.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75671,CPT,ANGRPH CRTD CERE BI RS&I,,,20 ,,RBRVS,1.66 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75671,CPT,ANGRPH CRTD CERE BI RS&I,26,,20 ,,RBRVS,1.66 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75671,CPT,ANGRPH CRTD CERE BI RS&I,TC,,20 ,,RBRVS,,5.87 ,5.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75676,CPT,ANGRPH CRTD CRV UNI RS&I,,,20 ,,RBRVS,1.31 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75676,CPT,ANGRPH CRTD CRV UNI RS&I,26,,20 ,,RBRVS,1.31 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75676,CPT,ANGRPH CRTD CRV UNI RS&I,TC,,20 ,,RBRVS,,5.05 ,5.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75680,CPT,ANGRPH CRTD CRV BI RS&I,,,20 ,,RBRVS,1.66 ,6.09 ,6.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75680,CPT,ANGRPH CRTD CRV BI RS&I,26,,20 ,,RBRVS,1.66 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75680,CPT,ANGRPH CRTD CRV BI RS&I,TC,,20 ,,RBRVS,,5.45 ,5.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75685,CPT,ANGRPH VRT CRV&/ICRA RS&I,,,20 ,,RBRVS,1.31 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75685,CPT,ANGRPH VRT CRV&/ICRA RS&I,26,,20 ,,RBRVS,1.31 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75685,CPT,ANGRPH VRT CRV&/ICRA RS&I,TC,,20 ,,RBRVS,,5.06 ,5.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75705,CPT,ANGRPH SPI SLCTV RS&I,,,20 ,,RBRVS,2.18 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75705,CPT,ANGRPH SPI SLCTV RS&I,26,,20 ,,RBRVS,2.18 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75705,CPT,ANGRPH SPI SLCTV RS&I,TC,,20 ,,RBRVS,,5.05 ,5.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75710,CPT,ANGRPH XTR UNI RS&I,,,20 ,,RBRVS,1.14 ,5.53 ,5.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75710,CPT,ANGRPH XTR UNI RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75710,CPT,ANGRPH XTR UNI RS&I,TC,,20 ,,RBRVS,,5.11 ,5.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75716,CPT,ANGRPH XTR BI RS&I,,,20 ,,RBRVS,1.31 ,6.26 ,6.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75716,CPT,ANGRPH XTR BI RS&I,26,,20 ,,RBRVS,1.31 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75716,CPT,ANGRPH XTR BI RS&I,TC,,20 ,,RBRVS,,5.78 ,5.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75722,CPT,ANGRPH RNL UNI SLCTV W/FLUSH AORTOGRAM RS&I,,,20 ,,RBRVS,1.14 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75722,CPT,ANGRPH RNL UNI SLCTV W/FLUSH AORTOGRAM RS&I,26,,20 ,,RBRVS,1.14 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75722,CPT,ANGRPH RNL UNI SLCTV W/FLUSH AORTOGRAM RS&I,TC,,20 ,,RBRVS,,4.94 ,4.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75724,CPT,ANGRPH RNL BI SLCTV W/FLUSH AORTOGRAM RS&I,,,20 ,,RBRVS,1.49 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75724,CPT,ANGRPH RNL BI SLCTV W/FLUSH AORTOGRAM RS&I,26,,20 ,,RBRVS,1.49 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75724,CPT,ANGRPH RNL BI SLCTV W/FLUSH AORTOGRAM RS&I,TC,,20 ,,RBRVS,,5.57 ,5.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75726,CPT,ANGRPH VISC SLCTV/SUPRASLCTV RS&I,,,20 ,,RBRVS,1.14 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75726,CPT,ANGRPH VISC SLCTV/SUPRASLCTV RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75726,CPT,ANGRPH VISC SLCTV/SUPRASLCTV RS&I,TC,,20 ,,RBRVS,,5.03 ,5.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75731,CPT,ANGRPH ADRNL UNI SLCTV RS&I,,,20 ,,RBRVS,1.14 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75731,CPT,ANGRPH ADRNL UNI SLCTV RS&I,26,,20 ,,RBRVS,1.14 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75731,CPT,ANGRPH ADRNL UNI SLCTV RS&I,TC,,20 ,,RBRVS,,5.10 ,5.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75733,CPT,ANGRPH ADRNL BI SLCTV RS&I,,,20 ,,RBRVS,1.31 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75733,CPT,ANGRPH ADRNL BI SLCTV RS&I,26,,20 ,,RBRVS,1.31 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75733,CPT,ANGRPH ADRNL BI SLCTV RS&I,TC,,20 ,,RBRVS,,5.88 ,5.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75736,CPT,ANGRPH PEL SLCTV/SUPRASLCTV RS&I,,,20 ,,RBRVS,1.14 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75736,CPT,ANGRPH PEL SLCTV/SUPRASLCTV RS&I,26,,20 ,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75736,CPT,ANGRPH PEL SLCTV/SUPRASLCTV RS&I,TC,,20 ,,RBRVS,,5.05 ,5.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75741,CPT,ANGRPH PULM UNI SLCTV RS&I,,,20 ,,RBRVS,1.31 ,5.00 ,5.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75741,CPT,ANGRPH PULM UNI SLCTV RS&I,26,,20 ,,RBRVS,1.31 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75741,CPT,ANGRPH PULM UNI SLCTV RS&I,TC,,20 ,,RBRVS,,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75743,CPT,ANGRPH PULM BI SLCTV RS&I,,,20 ,,RBRVS,1.66 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75743,CPT,ANGRPH PULM BI SLCTV RS&I,26,,20 ,,RBRVS,1.66 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75743,CPT,ANGRPH PULM BI SLCTV RS&I,TC,,20 ,,RBRVS,,4.73 ,4.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75746,CPT,ANGRPH PULM NONSLCTV CATH/VEN NJX RS&I,,,20 ,,RBRVS,1.14 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75746,CPT,ANGRPH PULM NONSLCTV CATH/VEN NJX RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75746,CPT,ANGRPH PULM NONSLCTV CATH/VEN NJX RS&I,TC,,20 ,,RBRVS,,4.85 ,4.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75756,CPT,ANGRPH INT MAM RS&I,,,20 ,,RBRVS,1.14 ,5.67 ,5.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75756,CPT,ANGRPH INT MAM RS&I,26,,20 ,,RBRVS,1.14 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75756,CPT,ANGRPH INT MAM RS&I,TC,,20 ,,RBRVS,,5.16 ,5.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,,,20 ,,RBRVS,0.36 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,26,,20 ,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,TC,,20 ,,RBRVS,,4.23 ,4.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR S&I,,,20 ,,RBRVS,1.71 ,6.65 ,6.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR S&I,26,,20 ,,RBRVS,1.71 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR S&I,TC,,20 ,,RBRVS,,6.12 ,6.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75801,CPT,LYMPHANGRPH XTR ONLY UNI RS&I,,,20 ,,RBRVS,0.81 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75801,CPT,LYMPHANGRPH XTR ONLY UNI RS&I,26,,20 ,,RBRVS,0.81 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75801,CPT,LYMPHANGRPH XTR ONLY UNI RS&I,TC,,20 ,,RBRVS,,5.61 ,5.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75803,CPT,LYMPHANGRPH XTR ONLY BI RS&I,,,20 ,,RBRVS,1.17 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75803,CPT,LYMPHANGRPH XTR ONLY BI RS&I,26,,20 ,,RBRVS,1.17 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75803,CPT,LYMPHANGRPH XTR ONLY BI RS&I,TC,,20 ,,RBRVS,,5.62 ,5.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75805,CPT,LYMPHANGRPH PEL/ABDL UNI RS&I,,,20 ,,RBRVS,0.81 ,6.54 ,6.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75805,CPT,LYMPHANGRPH PEL/ABDL UNI RS&I,26,,20 ,,RBRVS,0.81 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75805,CPT,LYMPHANGRPH PEL/ABDL UNI RS&I,TC,,20 ,,RBRVS,,6.24 ,6.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75807,CPT,LYMPHANGRPH PEL/ABDL BI RS&I,,,20 ,,RBRVS,1.17 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75807,CPT,LYMPHANGRPH PEL/ABDL BI RS&I,26,,20 ,,RBRVS,1.17 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75807,CPT,LYMPHANGRPH PEL/ABDL BI RS&I,TC,,20 ,,RBRVS,,6.35 ,6.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75809,CPT,SHUNTOGRAM NDWELLG NONVASC SHUNT RS&I,,,20 ,,RBRVS,0.47 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75809,CPT,SHUNTOGRAM NDWELLG NONVASC SHUNT RS&I,26,,20 ,,RBRVS,0.47 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75809,CPT,SHUNTOGRAM NDWELLG NONVASC SHUNT RS&I,TC,,20 ,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75810,CPT,SPLENOPORTOGRAPY RS&I,,,20 ,,RBRVS,1.14 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75810,CPT,SPLENOPORTOGRAPY RS&I,26,,20 ,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75810,CPT,SPLENOPORTOGRAPY RS&I,TC,,20 ,,RBRVS,,12.61 ,12.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75820,CPT,VNGRPH XTR UNI RS&I,,,20 ,,RBRVS,0.70 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75820,CPT,VNGRPH XTR UNI RS&I,26,,20 ,,RBRVS,0.70 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75820,CPT,VNGRPH XTR UNI RS&I,TC,,20 ,,RBRVS,,2.25 ,2.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75822,CPT,VNGRPH XTR BI RS&I,,,20 ,,RBRVS,1.06 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75822,CPT,VNGRPH XTR BI RS&I,26,,20 ,,RBRVS,1.06 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75822,CPT,VNGRPH XTR BI RS&I,TC,,20 ,,RBRVS,,2.49 ,2.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75825,CPT,VNGRPH CAVAL INF SRLOGRAPY RS&I,,,20 ,,RBRVS,1.14 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75825,CPT,VNGRPH CAVAL INF SRLOGRAPY RS&I,26,,20 ,,RBRVS,1.14 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75825,CPT,VNGRPH CAVAL INF SRLOGRAPY RS&I,TC,,20 ,,RBRVS,,4.43 ,4.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75827,CPT,VNGRPH CAVAL SUPRIOR SRLOGRAPY RS&I,,,20 ,,RBRVS,1.14 ,4.86 ,4.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75827,CPT,VNGRPH CAVAL SUPRIOR SRLOGRAPY RS&I,26,,20 ,,RBRVS,1.14 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75827,CPT,VNGRPH CAVAL SUPRIOR SRLOGRAPY RS&I,TC,,20 ,,RBRVS,,4.48 ,4.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75831,CPT,VNGRPH RNL UNI SLCTV RS&I,,,20 ,,RBRVS,1.14 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75831,CPT,VNGRPH RNL UNI SLCTV RS&I,26,,20 ,,RBRVS,1.14 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75831,CPT,VNGRPH RNL UNI SLCTV RS&I,TC,,20 ,,RBRVS,,4.52 ,4.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75833,CPT,VNGRPH RNL BI SLCTV RS&I,,,20 ,,RBRVS,1.49 ,5.41 ,5.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75833,CPT,VNGRPH RNL BI SLCTV RS&I,26,,20 ,,RBRVS,1.49 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75833,CPT,VNGRPH RNL BI SLCTV RS&I,TC,,20 ,,RBRVS,,4.90 ,4.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75840,CPT,VNGRPH ADRNL UNI SLCTV RS&I,,,20 ,,RBRVS,1.14 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75840,CPT,VNGRPH ADRNL UNI SLCTV RS&I,26,,20 ,,RBRVS,1.14 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75840,CPT,VNGRPH ADRNL UNI SLCTV RS&I,TC,,20 ,,RBRVS,,4.45 ,4.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75842,CPT,VNGRPH ADRNL BI SLCTV RS&I,,,20 ,,RBRVS,1.49 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75842,CPT,VNGRPH ADRNL BI SLCTV RS&I,26,,20 ,,RBRVS,1.49 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75842,CPT,VNGRPH ADRNL BI SLCTV RS&I,TC,,20 ,,RBRVS,,4.89 ,4.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75860,CPT,VNGRPH VEN SINUS/JUG CATH RS&I,,,20 ,,RBRVS,1.14 ,5.03 ,5.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75860,CPT,VNGRPH VEN SINUS/JUG CATH RS&I,26,,20 ,,RBRVS,1.14 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75860,CPT,VNGRPH VEN SINUS/JUG CATH RS&I,TC,,20 ,,RBRVS,,4.58 ,4.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75870,CPT,VNGRPH SUPRIOR SGTL SINUS RS&I,,,20 ,,RBRVS,1.14 ,5.03 ,5.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75870,CPT,VNGRPH SUPRIOR SGTL SINUS RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75870,CPT,VNGRPH SUPRIOR SGTL SINUS RS&I,TC,,20 ,,RBRVS,,4.61 ,4.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75872,CPT,VNGRPH EDRL RS&I,,,20 ,,RBRVS,1.14 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75872,CPT,VNGRPH EDRL RS&I,26,,20 ,,RBRVS,1.14 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75872,CPT,VNGRPH EDRL RS&I,TC,,20 ,,RBRVS,,5.75 ,5.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75880,CPT,VNGRPH ORB RS&I,,,20 ,,RBRVS,0.70 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75880,CPT,VNGRPH ORB RS&I,26,,20 ,,RBRVS,0.70 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75880,CPT,VNGRPH ORB RS&I,TC,,20 ,,RBRVS,,2.33 ,2.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,,,20 ,,RBRVS,1.44 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,26,,20 ,,RBRVS,1.44 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,TC,,20 ,,RBRVS,,4.52 ,4.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVAL RS&I,,,20 ,,RBRVS,1.44 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVAL RS&I,26,,20 ,,RBRVS,1.44 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVAL RS&I,TC,,20 ,,RBRVS,,4.59 ,4.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,,,20 ,,RBRVS,1.14 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,TC,,20 ,,RBRVS,,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,,,20 ,,RBRVS,1.14 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,26,,20 ,,RBRVS,1.14 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,TC,,20 ,,RBRVS,,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75893,CPT,VEN SAMPLING THRU CATH +-ANGRPH RS&I,,,20 ,,RBRVS,0.54 ,4.68 ,4.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75893,CPT,VEN SAMPLING THRU CATH +-ANGRPH RS&I,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75893,CPT,VEN SAMPLING THRU CATH +-ANGRPH RS&I,TC,,20 ,,RBRVS,,4.49 ,4.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75894,CPT,TCAT THER EMBOLIZATION ANY METH RS&I,,,20 ,,TotalUnits,,,,22.39 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75894,CPT,TCAT THER EMBOLIZATION ANY METH RS&I,26,,20 ,,TotalUnits,,,,1.78 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75894,CPT,TCAT THER EMBOLIZATION ANY METH RS&I,TC,,20 ,,TotalUnits,,,,20.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75896,CPT,TCAT THER NFS ANY METH RS&I,,,20 ,,TotalUnits,,,,21.80 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75896,CPT,TCAT THER NFS ANY METH RS&I,26,,20 ,,TotalUnits,,,,1.81 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75896,CPT,TCAT THER NFS ANY METH RS&I,TC,,20 ,,TotalUnits,,,,19.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75898,CPT,ANGRPH CATH F-UP STD TCAT THER EMBOLIZATION/NFS,,,20 ,,TotalUnits,,,,4.05 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75898,CPT,ANGRPH CATH F-UP STD TCAT THER EMBOLIZATION/NFS,26,,20 ,,TotalUnits,,,,2.28 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75898,CPT,ANGRPH CATH F-UP STD TCAT THER EMBOLIZATION/NFS,TC,,20 ,,TotalUnits,,,,1.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75900,CPT,EXCHNG CATH THROMBOLYTIC THER C+ MNTR RS&I,,,20 ,,TotalUnits,,,,8.25 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75900,CPT,EXCHNG CATH THROMBOLYTIC THER C+ MNTR RS&I,26,,20 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75900,CPT,EXCHNG CATH THROMBOLYTIC THER C+ MNTR RS&I,TC,,20 ,,TotalUnits,,,,7.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75901,CPT,MCHNL RMVL PRICATH OBSTR MATRL RS&I,,,20 ,,RBRVS,0.49 ,3.60 ,3.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75901,CPT,MCHNL RMVL PRICATH OBSTR MATRL RS&I,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75901,CPT,MCHNL RMVL PRICATH OBSTR MATRL RS&I,TC,,20 ,,RBRVS,,3.43 ,3.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75902,CPT,MCHNL RMVL INTRAL OBSTR MATRL RS&I,,,20 ,,RBRVS,0.39 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75902,CPT,MCHNL RMVL INTRAL OBSTR MATRL RS&I,26,,20 ,,RBRVS,0.39 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75902,CPT,MCHNL RMVL INTRAL OBSTR MATRL RS&I,TC,,20 ,,RBRVS,,1.45 ,1.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75940,CPT,PRQ PLMT IVC FILTER RS&I,,,20 ,,TotalUnits,,,,12.00 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75940,CPT,PRQ PLMT IVC FILTER RS&I,26,,20 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75940,CPT,PRQ PLMT IVC FILTER RS&I,TC,,20 ,,TotalUnits,,,,11.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75945,CPT,IV US RS&I 1ST VSL,,,20 ,,TotalUnits,,,,6.63 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75945,CPT,IV US RS&I 1ST VSL,26,,20 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75945,CPT,IV US RS&I 1ST VSL,TC,,20 ,,TotalUnits,,,,6.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75946,CPT,IV US RS&I EA NON-C VSL,,,20 ,,TotalUnits,,,,3.61 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75946,CPT,IV US RS&I EA NON-C VSL,26,,20 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75946,CPT,IV US RS&I EA NON-C VSL,TC,,20 ,,TotalUnits,,,,3.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75952,CPT,EVASC RPR INFRARNL AAA/DSJ RS&I,,,20 ,,TotalUnits,,,,11.42 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75952,CPT,EVASC RPR INFRARNL AAA/DSJ RS&I,26,,20 ,,TotalUnits,,,,5.91 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75952,CPT,EVASC RPR INFRARNL AAA/DSJ RS&I,TC,,20 ,,TotalUnits,,,,5.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75953,CPT,PLMT XTN PROSTH EVASC RPR INFRARNL RS&I,,,20 ,,TotalUnits,,,,3.22 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75953,CPT,PLMT XTN PROSTH EVASC RPR INFRARNL RS&I,26,,20 ,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75953,CPT,PLMT XTN PROSTH EVASC RPR INFRARNL RS&I,TC,,20 ,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75954,CPT,EVASC RPR ILIAC ART ARYSM MALFRMJ/TRAUMA RS&I,,,20 ,,TotalUnits,,,,7.28 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75954,CPT,EVASC RPR ILIAC ART ARYSM MALFRMJ/TRAUMA RS&I,26,,20 ,,TotalUnits,,,,2.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75954,CPT,EVASC RPR ILIAC ART ARYSM MALFRMJ/TRAUMA RS&I,TC,,20 ,,TotalUnits,,,,4.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75956,CPT,EVASC RPR DTA COVERAGE L SUBCLA ORIGIN RS&I,,,20 ,,RBRVS,7.00 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75956,CPT,EVASC RPR DTA COVERAGE L SUBCLA ORIGIN RS&I,26,,20 ,,RBRVS,7.00 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75957,CPT,EVASC RPR DTA X COVERAGE L SUBCLA ORIGIN RS&I,,,20 ,,RBRVS,6.00 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75957,CPT,EVASC RPR DTA X COVERAGE L SUBCLA ORIGIN RS&I,26,,20 ,,RBRVS,6.00 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75958,CPT,PLMT PROX XTN PROSTH EVASC RPR DTA RS&I,,,20 ,,RBRVS,4.00 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75958,CPT,PLMT PROX XTN PROSTH EVASC RPR DTA RS&I,26,,20 ,,RBRVS,4.00 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75959,CPT,PLMT DSTL XTN PROSTH AFTER EVASC RPR DTA RS&I,,,20 ,,RBRVS,3.50 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75959,CPT,PLMT DSTL XTN PROSTH AFTER EVASC RPR DTA RS&I,26,,20 ,,RBRVS,3.50 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75960,CPT,TCAT INTRO IV STENT PRQ&/OPN RS&I EA VSL,,,20 ,,RBRVS,0.82 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75960,CPT,TCAT INTRO IV STENT PRQ&/OPN RS&I EA VSL,26,,20 ,,RBRVS,0.82 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75960,CPT,TCAT INTRO IV STENT PRQ&/OPN RS&I EA VSL,TC,,20 ,,RBRVS,,4.67 ,4.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75961,CPT,TCAT RETRIEVAL PRQ IV FB RS&I,,,20 ,,RBRVS,4.24 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75961,CPT,TCAT RETRIEVAL PRQ IV FB RS&I,26,,20 ,,RBRVS,4.24 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75961,CPT,TCAT RETRIEVAL PRQ IV FB RS&I,TC,,20 ,,RBRVS,,4.49 ,4.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75962,CPT,TRLUML BALO ANGIOP PRPH ART RS&I,,,20 ,,RBRVS,0.54 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75962,CPT,TRLUML BALO ANGIOP PRPH ART RS&I,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75962,CPT,TRLUML BALO ANGIOP PRPH ART RS&I,TC,,20 ,,RBRVS,,5.54 ,5.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75964,CPT,TRLUML BALO ANGIOP EA PRPH ART RS&I,,,20 ,,RBRVS,0.36 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75964,CPT,TRLUML BALO ANGIOP EA PRPH ART RS&I,26,,20 ,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75964,CPT,TRLUML BALO ANGIOP EA PRPH ART RS&I,TC,,20 ,,RBRVS,,3.32 ,3.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75966,CPT,TRLUML BALO ANGIOP RNL/OTH VISC ART RS&I,,,20 ,,RBRVS,1.31 ,6.19 ,6.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75966,CPT,TRLUML BALO ANGIOP RNL/OTH VISC ART RS&I,26,,20 ,,RBRVS,1.31 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75966,CPT,TRLUML BALO ANGIOP RNL/OTH VISC ART RS&I,TC,,20 ,,RBRVS,,5.67 ,5.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75968,CPT,TRLUML BALO ANGIOP EA VISC ART RS&I,,,20 ,,RBRVS,0.36 ,3.42 ,3.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75968,CPT,TRLUML BALO ANGIOP EA VISC ART RS&I,26,,20 ,,RBRVS,0.36 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75968,CPT,TRLUML BALO ANGIOP EA VISC ART RS&I,TC,,20 ,,RBRVS,,3.28 ,3.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75970,CPT,TCAT BX RS&I,,,20 ,,TotalUnits,,,,11.93 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75970,CPT,TCAT BX RS&I,26,,20 ,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75970,CPT,TCAT BX RS&I,TC,,20 ,,TotalUnits,,,,10.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75978,CPT,TRLUML BALO ANGIOP VEN RS&I,,,20 ,,RBRVS,0.54 ,5.67 ,5.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75978,CPT,TRLUML BALO ANGIOP VEN RS&I,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75978,CPT,TRLUML BALO ANGIOP VEN RS&I,TC,,20 ,,RBRVS,,5.48 ,5.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75980,CPT,PRQ TRANSHEPATC BILIARY DRG C+ MNTR RS&I,,,20 ,,TotalUnits,,,,7.66 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75980,CPT,PRQ TRANSHEPATC BILIARY DRG C+ MNTR RS&I,26,,20 ,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75980,CPT,PRQ TRANSHEPATC BILIARY DRG C+ MNTR RS&I,TC,,20 ,,TotalUnits,,,,5.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75982,CPT,PRQ BILIARY DRG/DRG STENT RS&I,,,20 ,,TotalUnits,,,,8.10 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,75982,CPT,PRQ BILIARY DRG/DRG STENT RS&I,26,,20 ,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,75982,CPT,PRQ BILIARY DRG/DRG STENT RS&I,TC,,20 ,,TotalUnits,,,,6.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,75984,CPT,CHNG PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,,,20 ,,RBRVS,0.72 ,2.28 ,2.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75984,CPT,CHNG PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,26,,20 ,,RBRVS,0.72 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75984,CPT,CHNG PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,TC,,20 ,,RBRVS,,2.01 ,2.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,75989,CPT,RAD GID PRQ DRG W/PLMT CATH RS&I,,,20 ,,RBRVS,1.19 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,75989,CPT,RAD GID PRQ DRG W/PLMT CATH RS&I,26,,20 ,,RBRVS,1.19 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,75989,CPT,RAD GID PRQ DRG W/PLMT CATH RS&I,TC,,20 ,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76000,CPT,FLUOR SPX <1 HR PHYS TM OTH/THN 71023/71034,,,20 ,,RBRVS,0.17 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76000,CPT,FLUOR SPX <1 HR PHYS TM OTH/THN 71023/71034,26,,20 ,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76000,CPT,FLUOR SPX <1 HR PHYS TM OTH/THN 71023/71034,TC,,20 ,,RBRVS,,2.43 ,2.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76001,CPT,FLUOR PHYS TM > 1 HR ASSISTING NON-RAD PHYS,,,20 ,,RBRVS,0.67 ,3.04 ,3.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76001,CPT,FLUOR PHYS TM > 1 HR ASSISTING NON-RAD PHYS,26,,20 ,,RBRVS,0.67 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76001,CPT,FLUOR PHYS TM > 1 HR ASSISTING NON-RAD PHYS,TC,,20 ,,RBRVS,,2.79 ,2.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76010,CPT,RADEX FROM NOSE RECTUM FB 1 VIEW CHLD,,,20 ,,RBRVS,0.18 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76010,CPT,RADEX FROM NOSE RECTUM FB 1 VIEW CHLD,,PC,20 ,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76010,CPT,RADEX FROM NOSE RECTUM FB 1 VIEW CHLD,,TC,20 ,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76080,CPT,RAD XM ABSC/FSTL/SINUS TRC RAD S&I,,,20 ,,RBRVS,0.54 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76080,CPT,RAD XM ABSC/FSTL/SINUS TRC RAD S&I,,PC,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76080,CPT,RAD XM ABSC/FSTL/SINUS TRC RAD S&I,,TC,20 ,,RBRVS,,0.91 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76098,CPT,RAD XM SURG SPEC,,,20 ,,RBRVS,0.16 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76098,CPT,RAD XM SURG SPEC,,PC,20 ,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76098,CPT,RAD XM SURG SPEC,,TC,20 ,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76100,CPT,RADEX 1 PLNE BDY SCTJ OTH/THN UROGRAPY,,,20 ,,RBRVS,0.58 ,2.79 ,2.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76100,CPT,RADEX 1 PLNE BDY SCTJ OTH/THN UROGRAPY,,PC,20 ,,RBRVS,0.58 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76100,CPT,RADEX 1 PLNE BDY SCTJ OTH/THN UROGRAPY,,TC,20 ,,RBRVS,,2.57 ,2.57 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,,20 ,,RBRVS,0.58 ,4.14 ,4.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,PC,20 ,,RBRVS,0.58 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,TC,20 ,,RBRVS,,3.90 ,3.90 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,,20 ,,RBRVS,0.58 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,PC,20 ,,RBRVS,0.58 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,TC,20 ,,RBRVS,,5.53 ,5.53 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,,20 ,,RBRVS,0.38 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,PC,20 ,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,TC,20 ,,RBRVS,,1.48 ,1.48 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE XM,,,20 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE XM,,PC,20 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE XM,,TC,20 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,76140,CPT,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,,,20 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76376,CPT,3D RNDR I&R CT MRI US/OTH X REQ POSTPCX,,,20 ,,RBRVS,0.20 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76376,CPT,3D RNDR I&R CT MRI US/OTH X REQ POSTPCX,26,,20 ,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76376,CPT,3D RNDR I&R CT MRI US/OTH X REQ POSTPCX,TC,,20 ,,RBRVS,,1.69 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76377,CPT,3D RNDR I&R CT MRI US/OTH REQ POSTPCX,,,20 ,,RBRVS,0.79 ,1.81 ,1.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76377,CPT,3D RNDR I&R CT MRI US/OTH REQ POSTPCX,26,,20 ,,RBRVS,0.79 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76377,CPT,3D RNDR I&R CT MRI US/OTH REQ POSTPCX,TC,,20 ,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76380,CPT,CT LMTD/LOCLZD F-UP STD,,,20 ,,RBRVS,0.98 ,4.47 ,4.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76380,CPT,CT LMTD/LOCLZD F-UP STD,26,,20 ,,RBRVS,0.98 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76380,CPT,CT LMTD/LOCLZD F-UP STD,TC,,20 ,,RBRVS,,4.12 ,4.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76390,CPT,MRI SPECTROSCOPY,,,20 ,,RBRVS,1.40 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76390,CPT,MRI SPECTROSCOPY,26,,20 ,,RBRVS,1.40 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76390,CPT,MRI SPECTROSCOPY,TC,,20 ,,RBRVS,,10.25 ,10.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76496,CPT,UNLIS FLUOR PX,,,20 ,,TotalUnits,,,,1.78 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76496,CPT,UNLIS FLUOR PX,26,,20 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76496,CPT,UNLIS FLUOR PX,TC,,20 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76497,CPT,UNLIS CT PX,,,20 ,,TotalUnits,,,,5.69 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76497,CPT,UNLIS CT PX,26,,20 ,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76497,CPT,UNLIS CT PX,TC,,20 ,,TotalUnits,,,,4.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76498,CPT,UNLIS MRI PX,,,20 ,,TotalUnits,,,,8.10 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76498,CPT,UNLIS MRI PX,26,,20 ,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76498,CPT,UNLIS MRI PX,TC,,20 ,,TotalUnits,,,,6.87 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76499,CPT,UNLIS DX RADIOGRAPIC PX,,,20 ,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76499,CPT,UNLIS DX RADIOGRAPIC PX,26,,20 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76499,CPT,UNLIS DX RADIOGRAPIC PX,TC,,20 ,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76506,CPT,ECHOENCEPHALOGRAPY REAL TIME IMAGING,,,20 ,,RBRVS,0.63 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76506,CPT,ECHOENCEPHALOGRAPY REAL TIME IMAGING,26,,20 ,,RBRVS,0.63 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76506,CPT,ECHOENCEPHALOGRAPY REAL TIME IMAGING,TC,,20 ,,RBRVS,,2.25 ,2.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,,,20 ,,RBRVS,1.55 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,26,,20 ,,RBRVS,1.55 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,TC,,20 ,,RBRVS,,1.84 ,1.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76511,CPT,OPH US DX QUAN A-SCAN ONLY,,,20 ,,RBRVS,0.94 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76511,CPT,OPH US DX QUAN A-SCAN ONLY,26,,20 ,,RBRVS,0.94 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76511,CPT,OPH US DX QUAN A-SCAN ONLY,TC,,20 ,,RBRVS,,1.24 ,1.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76512,CPT,OPH US DX B-SCAN +-A-SCAN,,,20 ,,RBRVS,0.94 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76512,CPT,OPH US DX B-SCAN +-A-SCAN,26,,20 ,,RBRVS,0.94 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76512,CPT,OPH US DX B-SCAN +-A-SCAN,TC,,20 ,,RBRVS,,1.04 ,1.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,,,20 ,,RBRVS,0.66 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,26,,20 ,,RBRVS,0.66 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,TC,,20 ,,RBRVS,,1.33 ,1.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76514,CPT,OPH US DX CRNL PACHYMETRY UNI/BI,,,20 ,,RBRVS,0.17 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76514,CPT,OPH US DX CRNL PACHYMETRY UNI/BI,26,,20 ,,RBRVS,0.17 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76514,CPT,OPH US DX CRNL PACHYMETRY UNI/BI,TC,,20 ,,RBRVS,,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76516,CPT,OPH BMTRY US ECHOGRAPY A-SCAN,,,20 ,,RBRVS,0.54 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76516,CPT,OPH BMTRY US ECHOGRAPY A-SCAN,26,,20 ,,RBRVS,0.54 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76516,CPT,OPH BMTRY US ECHOGRAPY A-SCAN,TC,,20 ,,RBRVS,,1.05 ,1.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,,,20 ,,RBRVS,0.54 ,1.42 ,1.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,26,,20 ,,RBRVS,0.54 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,TC,,20 ,,RBRVS,,1.17 ,1.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76529,CPT,OPH ULTRASONIC FB LOCLZJ,,,20 ,,RBRVS,0.57 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76529,CPT,OPH ULTRASONIC FB LOCLZJ,26,,20 ,,RBRVS,0.57 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76529,CPT,OPH ULTRASONIC FB LOCLZJ,TC,,20 ,,RBRVS,,1.02 ,1.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76536,CPT,US SOFT TISS HEAD&NCK R-T IMG,,,20 ,,RBRVS,0.56 ,2.42 ,2.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76536,CPT,US SOFT TISS HEAD&NCK R-T IMG,26,,20 ,,RBRVS,0.56 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76536,CPT,US SOFT TISS HEAD&NCK R-T IMG,TC,,20 ,,RBRVS,,2.23 ,2.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76604,CPT,US CHEST R-T W/IMAGE DOCUMENTATION,,,20 ,,RBRVS,0.55 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76604,CPT,US CHEST R-T W/IMAGE DOCUMENTATION,26,,20 ,,RBRVS,0.55 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76604,CPT,US CHEST R-T W/IMAGE DOCUMENTATION,TC,,20 ,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76645,CPT,US BREAST R-T W/IMAGE DOCUMENTATION,,,20 ,,RBRVS,0.54 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76645,CPT,US BREAST R-T W/IMAGE DOCUMENTATION,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76645,CPT,US BREAST R-T W/IMAGE DOCUMENTATION,TC,,20 ,,RBRVS,,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76700,CPT,US ABDOMINAL R-T W/IMAGE DOCUMENTATION,,,20 ,,RBRVS,0.81 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76700,CPT,US ABDOMINAL R-T W/IMAGE DOCUMENTATION,26,,20 ,,RBRVS,0.81 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76700,CPT,US ABDOMINAL R-T W/IMAGE DOCUMENTATION,TC,,20 ,,RBRVS,,2.53 ,2.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76705,CPT,ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED,,,20 ,,RBRVS,0.59 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76705,CPT,ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED,26,,20 ,,RBRVS,0.59 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76705,CPT,ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED,TC,,20 ,,RBRVS,,1.95 ,1.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76770,CPT,US RETROPERITONEAL R-T W/IMAGE COMPL,,,20 ,,RBRVS,0.74 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76770,CPT,US RETROPERITONEAL R-T W/IMAGE COMPL,26,,20 ,,RBRVS,0.74 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76770,CPT,US RETROPERITONEAL R-T W/IMAGE COMPL,TC,,20 ,,RBRVS,,2.45 ,2.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76775,CPT,US RPR B-SCAN&/R-T IMG LMTD,,,20 ,,RBRVS,0.58 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76775,CPT,US RPR B-SCAN&/R-T IMG LMTD,26,,20 ,,RBRVS,0.58 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76775,CPT,US RPR B-SCAN&/R-T IMG LMTD,TC,,20 ,,RBRVS,,2.12 ,2.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76776,CPT,US TRNSPL KDN R-T IMG +- DUPLEX DOP STD,,,20 ,,RBRVS,0.76 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76776,CPT,US TRNSPL KDN R-T IMG +- DUPLEX DOP STD,26,,20 ,,RBRVS,0.76 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76776,CPT,US TRNSPL KDN R-T IMG +- DUPLEX DOP STD,TC,,20 ,,RBRVS,,2.85 ,2.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76800,CPT,US SPI CANAL&CNTS,,,20 ,,RBRVS,1.13 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76800,CPT,US SPI CANAL&CNTS,26,,20 ,,RBRVS,1.13 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76800,CPT,US SPI CANAL&CNTS,TC,,20 ,,RBRVS,,1.87 ,1.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76801,CPT,US PG UTER IMG F&MAT 14 WK TABDL 1/1ST GESTATION,,,20 ,,RBRVS,0.99 ,2.44 ,2.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76801,CPT,US PG UTER IMG F&MAT 14 WK TABDL 1/1ST GESTATION,26,,20 ,,RBRVS,0.99 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76801,CPT,US PG UTER IMG F&MAT 14 WK TABDL 1/1ST GESTATION,TC,,20 ,,RBRVS,,2.09 ,2.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76802,CPT,US PG UTER F&MAT 14 WK TABDL EA GESTATION,,,20 ,,RBRVS,0.83 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76802,CPT,US PG UTER F&MAT 14 WK TABDL EA GESTATION,26,,20 ,,RBRVS,0.83 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76802,CPT,US PG UTER F&MAT 14 WK TABDL EA GESTATION,TC,,20 ,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76805,CPT,US PG UTER F&MAT AFTER 1ST TRI 1/1ST GESTATION,,,20 ,,RBRVS,0.99 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76805,CPT,US PG UTER F&MAT AFTER 1ST TRI 1/1ST GESTATION,26,,20 ,,RBRVS,0.99 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76805,CPT,US PG UTER F&MAT AFTER 1ST TRI 1/1ST GESTATION,TC,,20 ,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76810,CPT,US PG UTER F&MAT AFTER 1ST TRI ABDL EA GESTATION,,,20 ,,RBRVS,0.98 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76810,CPT,US PG UTER F&MAT AFTER 1ST TRI ABDL EA GESTATION,26,,20 ,,RBRVS,0.98 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76810,CPT,US PG UTER F&MAT AFTER 1ST TRI ABDL EA GESTATION,TC,,20 ,,RBRVS,,1.25 ,1.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76811,CPT,US PG UTER F&MAT DETAILED FTL XM 1ST GESTATION,,,20 ,,RBRVS,1.90 ,3.27 ,3.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76811,CPT,US PG UTER F&MAT DETAILED FTL XM 1ST GESTATION,26,,20 ,,RBRVS,1.90 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76811,CPT,US PG UTER F&MAT DETAILED FTL XM 1ST GESTATION,TC,,20 ,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76812,CPT,US PG UTER F&MAT DETAILED FTL ANTMC XM EA,,,20 ,,RBRVS,1.78 ,3.49 ,3.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76812,CPT,US PG UTER F&MAT DETAILED FTL ANTMC XM EA,26,,20 ,,RBRVS,1.78 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76812,CPT,US PG UTER F&MAT DETAILED FTL ANTMC XM EA,TC,,20 ,,RBRVS,,2.88 ,2.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,,,20 ,,RBRVS,1.18 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,26,,20 ,,RBRVS,1.18 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,TC,,20 ,,RBRVS,,1.78 ,1.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,,,20 ,,RBRVS,0.99 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,26,,20 ,,RBRVS,0.99 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,TC,,20 ,,RBRVS,,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76815,CPT,US PG UTER R-T IMG LMTD 1+ FETUSES,,,20 ,,RBRVS,0.65 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76815,CPT,US PG UTER R-T IMG LMTD 1+ FETUSES,26,,20 ,,RBRVS,0.65 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76815,CPT,US PG UTER R-T IMG LMTD 1+ FETUSES,TC,,20 ,,RBRVS,,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76816,CPT,US PG UTER R-T IMG F-UP TABDL APPR PR FETUS,,,20 ,,RBRVS,0.85 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76816,CPT,US PG UTER R-T IMG F-UP TABDL APPR PR FETUS,26,,20 ,,RBRVS,0.85 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76816,CPT,US PG UTER R-T IMG F-UP TABDL APPR PR FETUS,TC,,20 ,,RBRVS,,1.87 ,1.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76817,CPT,US PG UTER R-T IMG TRVG,,,20 ,,RBRVS,0.75 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76817,CPT,US PG UTER R-T IMG TRVG,26,,20 ,,RBRVS,0.75 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76817,CPT,US PG UTER R-T IMG TRVG,TC,,20 ,,RBRVS,,1.69 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76818,CPT,FTL BIOPHYSICAL PROFILE NON-STRS TSTG,,,20 ,,RBRVS,1.05 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76818,CPT,FTL BIOPHYSICAL PROFILE NON-STRS TSTG,26,,20 ,,RBRVS,1.05 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76818,CPT,FTL BIOPHYSICAL PROFILE NON-STRS TSTG,TC,,20 ,,RBRVS,,1.79 ,1.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76819,CPT,FTL BIOPHYSICAL PROFILE W/O NON-STRS TSTG,,,20 ,,RBRVS,0.77 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76819,CPT,FTL BIOPHYSICAL PROFILE W/O NON-STRS TSTG,26,,20 ,,RBRVS,0.77 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76819,CPT,FTL BIOPHYSICAL PROFILE W/O NON-STRS TSTG,TC,,20 ,,RBRVS,,1.39 ,1.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76820,CPT,DOP VELOCIMETRY FTL UMBILICAL ART,,,20 ,,RBRVS,0.50 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76820,CPT,DOP VELOCIMETRY FTL UMBILICAL ART,26,,20 ,,RBRVS,0.50 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76820,CPT,DOP VELOCIMETRY FTL UMBILICAL ART,TC,,20 ,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76821,CPT,DOP VELOCIMETRY FTL MIDDLE CERE ART,,,20 ,,RBRVS,0.70 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76821,CPT,DOP VELOCIMETRY FTL MIDDLE CERE ART,26,,20 ,,RBRVS,0.70 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76821,CPT,DOP VELOCIMETRY FTL MIDDLE CERE ART,TC,,20 ,,RBRVS,,1.60 ,1.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76825,CPT,ECHO FTL CV SYS R-T REC,,,20 ,,RBRVS,1.67 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76825,CPT,ECHO FTL CV SYS R-T REC,26,,20 ,,RBRVS,1.67 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76825,CPT,ECHO FTL CV SYS R-T REC,TC,,20 ,,RBRVS,,3.38 ,3.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76826,CPT,ECHO FTL CV SYS R-T REC REPEAT STD,,,20 ,,RBRVS,0.83 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76826,CPT,ECHO FTL CV SYS R-T REC REPEAT STD,26,,20 ,,RBRVS,0.83 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76826,CPT,ECHO FTL CV SYS R-T REC REPEAT STD,TC,,20 ,,RBRVS,,2.06 ,2.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76827,CPT,DOP ECHO FTL SPECTRAL DISPLAY COMPL,,,20 ,,RBRVS,0.58 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76827,CPT,DOP ECHO FTL SPECTRAL DISPLAY COMPL,26,,20 ,,RBRVS,0.58 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76827,CPT,DOP ECHO FTL SPECTRAL DISPLAY COMPL,TC,,20 ,,RBRVS,,1.03 ,1.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76828,CPT,DOP ECHO FTL PLSD SPECTRAL DISPLAY REPEAT STD,,,20 ,,RBRVS,0.56 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76828,CPT,DOP ECHO FTL PLSD SPECTRAL DISPLAY REPEAT STD,26,,20 ,,RBRVS,0.56 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76828,CPT,DOP ECHO FTL PLSD SPECTRAL DISPLAY REPEAT STD,TC,,20 ,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76830,CPT,US TRVG,,,20 ,,RBRVS,0.69 ,2.51 ,2.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76830,CPT,US TRVG,26,,20 ,,RBRVS,0.69 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76830,CPT,US TRVG,TC,,20 ,,RBRVS,,2.27 ,2.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76831,CPT,SALINE NFS SHG SIS COL FLO DOP PFRMD,,,20 ,,RBRVS,0.72 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76831,CPT,SALINE NFS SHG SIS COL FLO DOP PFRMD,26,,20 ,,RBRVS,0.72 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76831,CPT,SALINE NFS SHG SIS COL FLO DOP PFRMD,TC,,20 ,,RBRVS,,2.25 ,2.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76856,CPT,US PELVIC NONOB REAL-TIME IMG COMPLETE,,,20 ,,RBRVS,0.69 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76856,CPT,US PELVIC NONOB REAL-TIME IMG COMPLETE,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76856,CPT,US PELVIC NONOB REAL-TIME IMG COMPLETE,TC,,20 ,,RBRVS,,2.27 ,2.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76857,CPT,US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97,,,20 ,,RBRVS,0.38 ,2.27 ,2.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76857,CPT,US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97,26,,20 ,,RBRVS,0.38 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76857,CPT,US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97,TC,,20 ,,RBRVS,,2.12 ,2.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76870,CPT,US SCROTUM&CNTS,,,20 ,,RBRVS,0.64 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76870,CPT,US SCROTUM&CNTS,26,,20 ,,RBRVS,0.64 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76870,CPT,US SCROTUM&CNTS,TC,,20 ,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76872,CPT,US TRANSRCT,,,20 ,,RBRVS,0.69 ,3.02 ,3.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76872,CPT,US TRANSRCT,26,,20 ,,RBRVS,0.69 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76872,CPT,US TRANSRCT,TC,,20 ,,RBRVS,,2.75 ,2.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76873,CPT,US TRANSRCT PRST8 VOL STD BRACHYTX PLNNING SPX,,,20 ,,RBRVS,1.55 ,3.17 ,3.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76873,CPT,US TRANSRCT PRST8 VOL STD BRACHYTX PLNNING SPX,26,,20 ,,RBRVS,1.55 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76873,CPT,US TRANSRCT PRST8 VOL STD BRACHYTX PLNNING SPX,TC,,20 ,,RBRVS,,2.59 ,2.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76881,CPT,US XTR NON-VASC COMPLETE,,,20 ,,RBRVS,0.59 ,2.76 ,2.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76881,CPT,US XTR NON-VASC COMPLETE,26,,20 ,,RBRVS,0.59 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76881,CPT,US XTR NON-VASC COMPLETE,TC,,20 ,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76882,CPT,US XTR NON-VASC LMTD,,,20 ,,RBRVS,0.41 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76882,CPT,US XTR NON-VASC LMTD,26,,20 ,,RBRVS,0.41 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76882,CPT,US XTR NON-VASC LMTD,TC,,20 ,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS MNPJ,,,20 ,,RBRVS,0.74 ,2.92 ,2.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS MNPJ,26,,20 ,,RBRVS,0.74 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS MNPJ,TC,,20 ,,RBRVS,,2.66 ,2.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76886,CPT,US INFT HIPS R-T IMG LMTD STATIC X PHYS MNPJ,,,20 ,,RBRVS,0.62 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76886,CPT,US INFT HIPS R-T IMG LMTD STATIC X PHYS MNPJ,26,,20 ,,RBRVS,0.62 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76886,CPT,US INFT HIPS R-T IMG LMTD STATIC X PHYS MNPJ,TC,,20 ,,RBRVS,,1.97 ,1.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76930,CPT,US PRICARDIOCNTS IMG S&I,,,20 ,,RBRVS,0.67 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76930,CPT,US PRICARDIOCNTS IMG S&I,26,,20 ,,RBRVS,0.67 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76930,CPT,US PRICARDIOCNTS IMG S&I,TC,,20 ,,RBRVS,,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76932,CPT,US ENDOMYOCRD BX IMG S&I,,,20 ,,TotalUnits,,,,2.33 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76932,CPT,US ENDOMYOCRD BX IMG S&I,26,,20 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76932,CPT,US ENDOMYOCRD BX IMG S&I,TC,,20 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,,,20 ,,RBRVS,1.99 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,26,,20 ,,RBRVS,1.99 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,TC,,20 ,,RBRVS,,5.40 ,5.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,,,20 ,,RBRVS,0.30 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,26,,20 ,,RBRVS,0.30 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,TC,,20 ,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,,,20 ,,TotalUnits,,,,4.27 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,26,,20 ,,TotalUnits,,,,2.69 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,TC,,20 ,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,,,20 ,,TotalUnits,,,,2.38 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,26,,20 ,,TotalUnits,,,,1.81 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,TC,,20 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76942,CPT,US NDL PLMT IMG S&I,,,20 ,,RBRVS,0.67 ,4.32 ,4.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76942,CPT,US NDL PLMT IMG S&I,26,,20 ,,RBRVS,0.67 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76942,CPT,US NDL PLMT IMG S&I,TC,,20 ,,RBRVS,,4.08 ,4.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76945,CPT,US CHORNC VILLUS SAMPLING IMG S&I,,,20 ,,TotalUnits,,,,2.30 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76945,CPT,US CHORNC VILLUS SAMPLING IMG S&I,26,,20 ,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76945,CPT,US CHORNC VILLUS SAMPLING IMG S&I,TC,,20 ,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76946,CPT,US AMNIOCNTS IMG S&I,,,20 ,,RBRVS,0.38 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76946,CPT,US AMNIOCNTS IMG S&I,26,,20 ,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76946,CPT,US AMNIOCNTS IMG S&I,TC,,20 ,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76948,CPT,US ASPIR OVA IMG S&I,,,20 ,,RBRVS,0.38 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76948,CPT,US ASPIR OVA IMG S&I,26,,20 ,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76948,CPT,US ASPIR OVA IMG S&I,TC,,20 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76950,CPT,US PLMT RADJ THER FLDS,,,20 ,,RBRVS,0.58 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76950,CPT,US PLMT RADJ THER FLDS,26,,20 ,,RBRVS,0.58 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76950,CPT,US PLMT RADJ THER FLDS,TC,,20 ,,RBRVS,,1.06 ,1.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76965,CPT,US NTRSTL RADIOELMNT APPL,,,20 ,,RBRVS,1.34 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76965,CPT,US NTRSTL RADIOELMNT APPL,26,,20 ,,RBRVS,1.34 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76965,CPT,US NTRSTL RADIOELMNT APPL,TC,,20 ,,RBRVS,,1.60 ,1.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76970,CPT,US STD F-UP SPEC,,,20 ,,RBRVS,0.40 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76970,CPT,US STD F-UP SPEC,26,,20 ,,RBRVS,0.40 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76970,CPT,US STD F-UP SPEC,TC,,20 ,,RBRVS,,1.81 ,1.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76975,CPT,GI NDSC US S&I,,,20 ,,TotalUnits,,,,3.86 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76975,CPT,GI NDSC US S&I,26,,20 ,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,76975,CPT,GI NDSC US S&I,TC,,20 ,,TotalUnits,,,,2.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,76977,CPT,US B1 DNS MEAS&INTERPJ PRPH SIT ANY METH,,,20 ,,RBRVS,0.05 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76977,CPT,US B1 DNS MEAS&INTERPJ PRPH SIT ANY METH,26,,20 ,,RBRVS,0.05 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76977,CPT,US B1 DNS MEAS&INTERPJ PRPH SIT ANY METH,TC,,20 ,,RBRVS,,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,76998,CPT,ULTRASONIC GUIDANCE INTRAOPERATIVE,,,20 ,,RBRVS,1.20 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,76998,CPT,ULTRASONIC GUIDANCE INTRAOPERATIVE,26,,20 ,,RBRVS,1.20 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,76999,CPT,UNLIS US PX,,,20 ,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,76999,CPT,UNLIS US PX,,PC,20 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,76999,CPT,UNLIS US PX,,TC,20 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,77001,CPT,FLUOR GID CTR VAD PLMT RPLCMT/RMVL,,,20 ,,RBRVS,0.38 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77001,CPT,FLUOR GID CTR VAD PLMT RPLCMT/RMVL,26,,20 ,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77001,CPT,FLUOR GID CTR VAD PLMT RPLCMT/RMVL,TC,,20 ,,RBRVS,,2.33 ,2.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,,,20 ,,RBRVS,0.54 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,TC,,20 ,,RBRVS,,1.17 ,1.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77003,CPT,FLUOR GID & LOCLZJ NDL/CATH SPI DX/THER NJX,,,20 ,,RBRVS,0.60 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77003,CPT,FLUOR GID & LOCLZJ NDL/CATH SPI DX/THER NJX,26,,20 ,,RBRVS,0.60 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77003,CPT,FLUOR GID & LOCLZJ NDL/CATH SPI DX/THER NJX,TC,,20 ,,RBRVS,,0.80 ,0.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,,20 ,,RBRVS,1.21 ,17.62 ,17.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,PC,20 ,,RBRVS,1.21 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,TC,20 ,,RBRVS,,17.18 ,17.18 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,,20 ,,RBRVS,1.16 ,3.51 ,3.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,PC,20 ,,RBRVS,1.16 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,TC,20 ,,RBRVS,,3.09 ,3.09 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,,20 ,,TotalUnits,,,,19.31 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,PC,20 ,,TotalUnits,,,,5.45 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,TC,20 ,,TotalUnits,,,,13.86 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,,20 ,,RBRVS,0.85 ,4.14 ,4.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,PC,20 ,,RBRVS,0.85 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,TC,20 ,,RBRVS,,3.83 ,3.83 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,,,20 ,,RBRVS,1.50 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,26,,20 ,,RBRVS,1.50 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,TC,,20 ,,RBRVS,,9.40 ,9.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,,,20 ,,TotalUnits,,,,23.37 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,26,,20 ,,TotalUnits,,,,5.70 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,TC,,20 ,,TotalUnits,,,,17.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,77031,CPT,STRTCTC LOCLZJ GID BREAST BX/NEEDLE PLACEMENT,,,20 ,,RBRVS,1.59 ,2.98 ,2.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77031,CPT,STRTCTC LOCLZJ GID BREAST BX/NEEDLE PLACEMENT,26,,20 ,,RBRVS,1.59 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77031,CPT,STRTCTC LOCLZJ GID BREAST BX/NEEDLE PLACEMENT,TC,,20 ,,RBRVS,,2.42 ,2.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77032,CPT,MAMMOGRAPHIC GID NEEDLE PLACEMENTT BREAST,,,20 ,,RBRVS,0.56 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77032,CPT,MAMMOGRAPHIC GID NEEDLE PLACEMENTT BREAST,26,,20 ,,RBRVS,0.56 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77032,CPT,MAMMOGRAPHIC GID NEEDLE PLACEMENTT BREAST,TC,,20 ,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77051,CPT,COMPUTER-AIDED DETECTION DX MAMMOGRAPHY,,,20 ,,RBRVS,0.06 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77051,CPT,COMPUTER-AIDED DETECTION DX MAMMOGRAPHY,26,,20 ,,RBRVS,0.06 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77051,CPT,COMPUTER-AIDED DETECTION DX MAMMOGRAPHY,TC,,20 ,,RBRVS,,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77052,CPT,COMPUTER-AIDED DETECTION SCREENING MAMMOGRAPHY,,,20 ,,RBRVS,0.06 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77052,CPT,COMPUTER-AIDED DETECTION SCREENING MAMMOGRAPHY,26,,20 ,,RBRVS,0.06 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77052,CPT,COMPUTER-AIDED DETECTION SCREENING MAMMOGRAPHY,TC,,20 ,,RBRVS,,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,,,20 ,,RBRVS,0.36 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,26,,20 ,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,TC,,20 ,,RBRVS,,1.37 ,1.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,,,20 ,,RBRVS,0.45 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,26,,20 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,TC,,20 ,,RBRVS,,1.89 ,1.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77055,CPT,MAMMOGRAPHY UNILATERAL,,,20 ,,RBRVS,0.70 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77055,CPT,MAMMOGRAPHY UNILATERAL,26,,20 ,,RBRVS,0.70 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77055,CPT,MAMMOGRAPHY UNILATERAL,TC,,20 ,,RBRVS,,1.29 ,1.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77056,CPT,MAMMOGRAPHY BILATERAL,,,20 ,,RBRVS,0.87 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77056,CPT,MAMMOGRAPHY BILATERAL,26,,20 ,,RBRVS,0.87 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77056,CPT,MAMMOGRAPHY BILATERAL,TC,,20 ,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77057,CPT,SCREENING MAMMOGRAPHY BILATERAL,,,20 ,,RBRVS,0.70 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77057,CPT,SCREENING MAMMOGRAPHY BILATERAL,26,,20 ,,RBRVS,0.70 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77057,CPT,SCREENING MAMMOGRAPHY BILATERAL,TC,,20 ,,RBRVS,,1.18 ,1.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77058,CPT,MRI BREAST UNILATERAL,,,20 ,,RBRVS,1.63 ,18.60 ,18.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77058,CPT,MRI BREAST UNILATERAL,26,,20 ,,RBRVS,1.63 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77058,CPT,MRI BREAST UNILATERAL,TC,,20 ,,RBRVS,,18.02 ,18.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77059,CPT,MRI BREAST BILATERAL,,,20 ,,RBRVS,1.63 ,19.70 ,19.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77059,CPT,MRI BREAST BILATERAL,26,,20 ,,RBRVS,1.63 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77059,CPT,MRI BREAST BILATERAL,TC,,20 ,,RBRVS,,19.12 ,19.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77071,CPT,MANUAL APPL STRESS PFRMD PHYS JOINT RADIOGRAPHY,,PC,20 ,,RBRVS,0.41 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77072,CPT,BONE AGE STUDIES,,,20 ,,RBRVS,0.19 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77072,CPT,BONE AGE STUDIES,26,,20 ,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77072,CPT,BONE AGE STUDIES,TC,,20 ,,RBRVS,,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77073,CPT,BONE LENGTH STUDIES,,,20 ,,RBRVS,0.27 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77073,CPT,BONE LENGTH STUDIES,26,,20 ,,RBRVS,0.27 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77073,CPT,BONE LENGTH STUDIES,TC,,20 ,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,,,20 ,,RBRVS,0.45 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,26,,20 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,TC,,20 ,,RBRVS,,1.19 ,1.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,,,20 ,,RBRVS,0.54 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,26,,20 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,TC,,20 ,,RBRVS,,1.91 ,1.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,,,20 ,,RBRVS,0.70 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,26,,20 ,,RBRVS,0.70 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,TC,,20 ,,RBRVS,,1.60 ,1.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,,,20 ,,RBRVS,0.31 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,26,,20 ,,RBRVS,0.31 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,TC,,20 ,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77078,CPT,CT BONE MINERAL DENSITY STUDY 1+ SITS AXIAL SKEL,,,20 ,,RBRVS,0.25 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77078,CPT,CT BONE MINERAL DENSITY STUDY 1+ SITS AXIAL SKEL,26,,20 ,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77078,CPT,CT BONE MINERAL DENSITY STUDY 1+ SITS AXIAL SKEL,TC,,20 ,,RBRVS,,3.80 ,3.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77079,CPT,CT BONE MINERAL DENSITY STUDY 1+ SITS APPND,,,20 ,,RBRVS,0.22 ,1.20 ,1.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77079,CPT,CT BONE MINERAL DENSITY STUDY 1+ SITS APPND,26,,20 ,,RBRVS,0.22 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77079,CPT,CT BONE MINERAL DENSITY STUDY 1+ SITS APPND,TC,,20 ,,RBRVS,,1.13 ,1.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77080,CPT,DXA BONE DENSITY STUDY 1+ SITS AXIAL SKEL,,,20 ,,RBRVS,0.22 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77080,CPT,DXA BONE DENSITY STUDY 1+ SITS AXIAL SKEL,26,,20 ,,RBRVS,0.22 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77080,CPT,DXA BONE DENSITY STUDY 1+ SITS AXIAL SKEL,TC,,20 ,,RBRVS,,2.23 ,2.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77081,CPT,DXA BONE DENSITY STUDY 1+ SITS APPENDICULAR SKEL,,,20 ,,RBRVS,0.22 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77081,CPT,DXA BONE DENSITY STUDY 1+ SITS APPENDICULAR SKEL,26,,20 ,,RBRVS,0.22 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77081,CPT,DXA BONE DENSITY STUDY 1+ SITS APPENDICULAR SKEL,TC,,20 ,,RBRVS,,0.47 ,0.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77082,CPT,DXA BONE DENSITY STUDY VERTEBRAL FRACTURE,,,20 ,,RBRVS,0.12 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77082,CPT,DXA BONE DENSITY STUDY VERTEBRAL FRACTURE,26,,20 ,,RBRVS,0.12 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77082,CPT,DXA BONE DENSITY STUDY VERTEBRAL FRACTURE,TC,,20 ,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77083,CPT,RADIOGRAPHIC ABSORPTIOMETRY 1+ SITS,,,20 ,,RBRVS,0.20 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77083,CPT,RADIOGRAPHIC ABSORPTIOMETRY 1+ SITS,26,,20 ,,RBRVS,0.20 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77083,CPT,RADIOGRAPHIC ABSORPTIOMETRY 1+ SITS,TC,,20 ,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77084,CPT,BONE MARROW BLOOD SUPPLY,,,20 ,,RBRVS,1.60 ,12.46 ,12.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77084,CPT,BONE MARROW BLOOD SUPPLY,26,,20 ,,RBRVS,1.60 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77084,CPT,BONE MARROW BLOOD SUPPLY,TC,,20 ,,RBRVS,,11.88 ,11.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77261,CPT,THER RAD TX PLNNING SMPL,,PC,20 ,,RBRVS,1.39 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77262,CPT,THER RAD TX PLNNING INTRM,,PC,20 ,,RBRVS,2.11 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77263,CPT,THER RAD TX PLNNING CPLX,,PC,20 ,,RBRVS,3.14 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77280,CPT,THER RAD SIMULAJ-AIDED FLD SETTING SMPL,,,20 ,,RBRVS,0.70 ,4.23 ,4.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77280,CPT,THER RAD SIMULAJ-AIDED FLD SETTING SMPL,26,,20 ,,RBRVS,0.70 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77280,CPT,THER RAD SIMULAJ-AIDED FLD SETTING SMPL,TC,,20 ,,RBRVS,,3.97 ,3.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77285,CPT,THER RAD SIMULAJ-AIDED FLD SETTING INTRM,,,20 ,,RBRVS,1.05 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77285,CPT,THER RAD SIMULAJ-AIDED FLD SETTING INTRM,26,,20 ,,RBRVS,1.05 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77285,CPT,THER RAD SIMULAJ-AIDED FLD SETTING INTRM,TC,,20 ,,RBRVS,,7.13 ,7.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77290,CPT,THER RAD SIMULAJ-AIDED FLD SETTING CPLX,,,20 ,,RBRVS,1.56 ,11.99 ,11.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77290,CPT,THER RAD SIMULAJ-AIDED FLD SETTING CPLX,26,,20 ,,RBRVS,1.56 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77290,CPT,THER RAD SIMULAJ-AIDED FLD SETTING CPLX,TC,,20 ,,RBRVS,,11.42 ,11.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77295,CPT,THER RAD SIMULAJ-AIDED FLD SETTING 3-DIMENSIONAL,,,20 ,,RBRVS,4.56 ,11.68 ,11.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77295,CPT,THER RAD SIMULAJ-AIDED FLD SETTING 3-DIMENSIONAL,26,,20 ,,RBRVS,4.56 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77295,CPT,THER RAD SIMULAJ-AIDED FLD SETTING 3-DIMENSIONAL,TC,,20 ,,RBRVS,,10.01 ,10.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77299,CPT,UNLIS PX THER RAD CLINICAL TX PLNNING,,,20 ,,TotalUnits,,,,10.49 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,77299,CPT,UNLIS PX THER RAD CLINICAL TX PLNNING,26,,20 ,,TotalUnits,,,,1.76 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,77299,CPT,UNLIS PX THER RAD CLINICAL TX PLNNING,TC,,20 ,,TotalUnits,,,,8.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,77300,CPT,BASIC RADJ DOSIM CAL,,,20 ,,RBRVS,0.62 ,1.25 ,1.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77300,CPT,BASIC RADJ DOSIM CAL,26,,20 ,,RBRVS,0.62 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77300,CPT,BASIC RADJ DOSIM CAL,TC,,20 ,,RBRVS,,1.02 ,1.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,,,20 ,,RBRVS,7.99 ,51.44 ,51.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,26,,20 ,,RBRVS,7.99 ,2.93 ,2.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,TC,,20 ,,RBRVS,,48.51 ,48.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77305,CPT,TELETHX ISODOSE PLN SMPL,,,20 ,,RBRVS,0.70 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77305,CPT,TELETHX ISODOSE PLN SMPL,26,,20 ,,RBRVS,0.70 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77305,CPT,TELETHX ISODOSE PLN SMPL,TC,,20 ,,RBRVS,,0.88 ,0.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77310,CPT,TELETHX ISODOSE PLN INTRM,,,20 ,,RBRVS,1.05 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77310,CPT,TELETHX ISODOSE PLN INTRM,26,,20 ,,RBRVS,1.05 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77310,CPT,TELETHX ISODOSE PLN INTRM,TC,,20 ,,RBRVS,,1.16 ,1.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77315,CPT,TELETHX ISODOSE PLN CPLX,,,20 ,,RBRVS,1.56 ,2.32 ,2.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77315,CPT,TELETHX ISODOSE PLN CPLX,26,,20 ,,RBRVS,1.56 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77315,CPT,TELETHX ISODOSE PLN CPLX,TC,,20 ,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,,,20 ,,RBRVS,0.95 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,26,,20 ,,RBRVS,0.95 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,TC,,20 ,,RBRVS,,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77326,CPT,BRACHYTX ISODOSE PLN SMPL,,,20 ,,RBRVS,0.93 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77326,CPT,BRACHYTX ISODOSE PLN SMPL,26,,20 ,,RBRVS,0.93 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77326,CPT,BRACHYTX ISODOSE PLN SMPL,TC,,20 ,,RBRVS,,2.55 ,2.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77327,CPT,BRACHYTX ISODOSE PLN INTRM,,,20 ,,RBRVS,1.39 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77327,CPT,BRACHYTX ISODOSE PLN INTRM,26,,20 ,,RBRVS,1.39 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77327,CPT,BRACHYTX ISODOSE PLN INTRM,TC,,20 ,,RBRVS,,3.52 ,3.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77328,CPT,BRACHYTX ISODOSE PLN CPLX,,,20 ,,RBRVS,2.09 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77328,CPT,BRACHYTX ISODOSE PLN CPLX,26,,20 ,,RBRVS,2.09 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77328,CPT,BRACHYTX ISODOSE PLN CPLX,TC,,20 ,,RBRVS,,4.52 ,4.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,,,20 ,,RBRVS,0.87 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,26,,20 ,,RBRVS,0.87 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,TC,,20 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77332,CPT,TX DEV DESIGN&CONSTJ SMPL SMPL BLK SMPL BOLUS,,,20 ,,RBRVS,0.54 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77332,CPT,TX DEV DESIGN&CONSTJ SMPL SMPL BLK SMPL BOLUS,26,,20 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77332,CPT,TX DEV DESIGN&CONSTJ SMPL SMPL BLK SMPL BOLUS,TC,,20 ,,RBRVS,,1.33 ,1.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77333,CPT,TX DEV DESIGN&CONSTJ INTRM,,,20 ,,RBRVS,0.84 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77333,CPT,TX DEV DESIGN&CONSTJ INTRM,26,,20 ,,RBRVS,0.84 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77333,CPT,TX DEV DESIGN&CONSTJ INTRM,TC,,20 ,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77334,CPT,TX DEV DESIGN&CONSTJ CPLX,,,20 ,,RBRVS,1.24 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77334,CPT,TX DEV DESIGN&CONSTJ CPLX,26,,20 ,,RBRVS,1.24 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77334,CPT,TX DEV DESIGN&CONSTJ CPLX,TC,,20 ,,RBRVS,,2.44 ,2.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77336,CPT,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,,TC,20 ,,RBRVS,,1.47 ,1.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,,20 ,,RBRVS,4.29 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,PC,20 ,,RBRVS,4.29 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,TC,20 ,,RBRVS,,6.94 ,6.94 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,77370,CPT,SPEC MEDICAL RADJ PHYSICS CONSLTJ,,TC,20 ,,RBRVS,,3.05 ,3.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77371,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,,TC,20 ,,RBRVS,6.53 ,30.71 ,30.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77372,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,,TC,20 ,,RBRVS,,22.23 ,22.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77373,CPT,STEREOTACTIC BODY RADIATION DELIVERY,,TC,20 ,,RBRVS,,41.29 ,41.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,,20 ,,TotalUnits,,,,7.83 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,PC,20 ,,TotalUnits,,,,3.20 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,TC,20 ,,TotalUnits,,,,4.63 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,77401,CPT,RADJ DLVR SUPFC&/ORTHO VOLTAGE,,TC,20 ,,RBRVS,,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77402,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL <5MEV,,TC,20 ,,RBRVS,,3.75 ,3.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77403,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 6-10MEV,,TC,20 ,,RBRVS,,3.30 ,3.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77404,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 11-19MEV,,TC,20 ,,RBRVS,,3.65 ,3.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77406,CPT,RADJ DLVR 1 AREA 1/PRLL OPSD PORTS SMPL 20MEV/<,,TC,20 ,,RBRVS,,3.69 ,3.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77407,CPT,RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS <5MEV,,TC,20 ,,RBRVS,,6.10 ,6.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77408,CPT,RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS 6-1MEV,,TC,20 ,,RBRVS,,4.47 ,4.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77409,CPT,RADJ DLVR 2 AREAS 3/>PORTS 1 MLT BLKS 11-19MEV,,TC,20 ,,RBRVS,,4.95 ,4.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77411,CPT,RADJ DLVR 2 AREAS 3/> PORTS 1 TX AREA 20 MEV/<,,TC,20 ,,RBRVS,,4.92 ,4.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77412,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING <5MEV,,TC,20 ,,RBRVS,,5.80 ,5.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77413,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING 6-10MEV,,TC,20 ,,RBRVS,,5.84 ,5.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77414,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING 11-19MEV,,TC,20 ,,RBRVS,,6.52 ,6.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77416,CPT,RADJ DLVR 3/> AREAS CUSTOM BLKING 20MEV/<,,TC,20 ,,RBRVS,,6.55 ,6.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77417,CPT,THER RAD PORT FLM,,TC,20 ,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,0,1,1,20110101,77418,CPT,NTSTY MODUL DLVR 1/MLT FLDS/ARCS PR TX SESSION,,TC,20 ,,RBRVS,,13.84 ,13.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77421,CPT,STRSC X-RAY GDN LOCLZJ TARGET VOL DLVR RADJ THER,,,20 ,,RBRVS,0.39 ,2.56 ,2.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77421,CPT,STRSC X-RAY GDN LOCLZJ TARGET VOL DLVR RADJ THER,26,,20 ,,RBRVS,0.39 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77421,CPT,STRSC X-RAY GDN LOCLZJ TARGET VOL DLVR RADJ THER,TC,,20 ,,RBRVS,,2.42 ,2.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77422,CPT,HI NRG NEUTRON RADJ TX DLVR 1 TX AREA,,TC,20 ,,RBRVS,,5.54 ,5.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77423,CPT,HI NRG NEUTRON RADJ TX DLVR 1/> ISOCENTER,,TC,20 ,,RBRVS,,6.31 ,6.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77427,CPT,RADJ TX MGMT 5 TXS,,PC,20 ,,RBRVS,3.70 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77431,CPT,RADJ THER MGMT COMPL 1/2 FXJS ONLY,,PC,20 ,,RBRVS,1.81 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77432,CPT,STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION,,PC,20 ,,RBRVS,7.92 ,2.98 ,2.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77435,CPT,STEREOTACTIC BODY RADIATION MANAGEMENT,,PC,20 ,,RBRVS,13.00 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77470,CPT,SPEC TX PX,,,20 ,,RBRVS,2.09 ,3.87 ,3.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77470,CPT,SPEC TX PX,26,,20 ,,RBRVS,2.09 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77470,CPT,SPEC TX PX,TC,,20 ,,RBRVS,,3.10 ,3.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77499,CPT,UNLIS THER RAD TX MGMT,,,20 ,,TotalUnits,,,,6.52 ,,$0.00,$0.00,1,1,0,0,0,1,20110101,77499,CPT,UNLIS THER RAD TX MGMT,,PC,20 ,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,77499,CPT,UNLIS THER RAD TX MGMT,,TC,20 ,,TotalUnits,,,,5.40 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,77520,CPT,PROTON TX DLVR SMPL W/O COMPENSATION,,TC,20 ,,TotalUnits,,,,17.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,77522,CPT,PROTON TX DLVR SMPL COMPENSATION,,TC,20 ,,TotalUnits,,,,16.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,77523,CPT,PROTON TX DLVR INTRM,,TC,20 ,,TotalUnits,,,,18.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,77525,CPT,PROTON TX DLVR CPLX,,TC,20 ,,TotalUnits,,,,20.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,77600,CPT,HYPRTHM XTRNLLY GEN SUPFC,,,20 ,,RBRVS,1.56 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77600,CPT,HYPRTHM XTRNLLY GEN SUPFC,26,,20 ,,RBRVS,1.56 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77600,CPT,HYPRTHM XTRNLLY GEN SUPFC,TC,,20 ,,RBRVS,,8.23 ,8.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77605,CPT,HYPRTHM XTRNLLY GEN DP,,,20 ,,RBRVS,2.09 ,18.56 ,18.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77605,CPT,HYPRTHM XTRNLLY GEN DP,26,,20 ,,RBRVS,2.09 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77605,CPT,HYPRTHM XTRNLLY GEN DP,TC,,20 ,,RBRVS,,17.91 ,17.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77610,CPT,HYPRTHM GEN NTRSTL PRB 5/FEWER,,,20 ,,RBRVS,1.56 ,15.52 ,15.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77610,CPT,HYPRTHM GEN NTRSTL PRB 5/FEWER,26,,20 ,,RBRVS,1.56 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77610,CPT,HYPRTHM GEN NTRSTL PRB 5/FEWER,TC,,20 ,,RBRVS,,14.99 ,14.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77615,CPT,HYPRTHM GEN NTRSTL PRB > 5,,,20 ,,RBRVS,2.09 ,22.55 ,22.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77615,CPT,HYPRTHM GEN NTRSTL PRB > 5,26,,20 ,,RBRVS,2.09 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77615,CPT,HYPRTHM GEN NTRSTL PRB > 5,TC,,20 ,,RBRVS,,21.79 ,21.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77620,CPT,HYPRTHM GEN INTRCV PRB,,,20 ,,RBRVS,1.56 ,9.82 ,9.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77620,CPT,HYPRTHM GEN INTRCV PRB,26,,20 ,,RBRVS,1.56 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77620,CPT,HYPRTHM GEN INTRCV PRB,TC,,20 ,,RBRVS,,9.32 ,9.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO F-UP CARE,,,20 ,,RBRVS,5.00 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO F-UP CARE,26,,20 ,,RBRVS,5.00 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO F-UP CARE,TC,,20 ,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77761,CPT,INTRCV RADJ SRC APPL SMPL,,,20 ,,RBRVS,3.85 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77761,CPT,INTRCV RADJ SRC APPL SMPL,26,,20 ,,RBRVS,3.85 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77761,CPT,INTRCV RADJ SRC APPL SMPL,TC,,20 ,,RBRVS,,4.46 ,4.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77762,CPT,INTRCV RADJ SRC APPL INTRM,,,20 ,,RBRVS,5.76 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77762,CPT,INTRCV RADJ SRC APPL INTRM,26,,20 ,,RBRVS,5.76 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77762,CPT,INTRCV RADJ SRC APPL INTRM,TC,,20 ,,RBRVS,,5.23 ,5.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77763,CPT,INTRCV RADJ SRC APPL CPLX,,,20 ,,RBRVS,8.66 ,9.90 ,9.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77763,CPT,INTRCV RADJ SRC APPL CPLX,26,,20 ,,RBRVS,8.66 ,3.14 ,3.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77763,CPT,INTRCV RADJ SRC APPL CPLX,TC,,20 ,,RBRVS,,6.76 ,6.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77776,CPT,NTRSTL RADJ SRC APPL SMPL,,,20 ,,RBRVS,4.70 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77776,CPT,NTRSTL RADJ SRC APPL SMPL,26,,20 ,,RBRVS,4.70 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77776,CPT,NTRSTL RADJ SRC APPL SMPL,TC,,20 ,,RBRVS,,4.79 ,4.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77777,CPT,NTRSTL RADJ SRC APPL INTRM,,,20 ,,RBRVS,7.52 ,7.96 ,7.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77777,CPT,NTRSTL RADJ SRC APPL INTRM,26,,20 ,,RBRVS,7.52 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77777,CPT,NTRSTL RADJ SRC APPL INTRM,TC,,20 ,,RBRVS,,5.18 ,5.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77778,CPT,NTRSTL RADJ SRC APPL CPLX,,,20 ,,RBRVS,11.32 ,11.09 ,11.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77778,CPT,NTRSTL RADJ SRC APPL CPLX,26,,20 ,,RBRVS,11.32 ,4.13 ,4.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77778,CPT,NTRSTL RADJ SRC APPL CPLX,TC,,20 ,,RBRVS,,6.96 ,6.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77785,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 1 CHANNEL,,,20 ,,RBRVS,1.42 ,3.98 ,3.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77785,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 1 CHANNEL,26,,20 ,,RBRVS,1.42 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77785,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 1 CHANNEL,TC,,20 ,,RBRVS,,3.45 ,3.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77786,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 2-12 CHANNEL,,,20 ,,RBRVS,3.25 ,11.81 ,11.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77786,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 2-12 CHANNEL,26,,20 ,,RBRVS,3.25 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77786,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX 2-12 CHANNEL,TC,,20 ,,RBRVS,,10.67 ,10.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77787,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX > 12 CHANNEL,,,20 ,,RBRVS,4.89 ,18.30 ,18.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77787,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX > 12 CHANNEL,26,,20 ,,RBRVS,4.89 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77787,CPT,REMOTE AFTLD RADIONUCLIDE BRACHYTX > 12 CHANNEL,TC,,20 ,,RBRVS,,16.47 ,16.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77789,CPT,SURF APPL RADJ SRC,,,20 ,,RBRVS,1.14 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77789,CPT,SURF APPL RADJ SRC,26,,20 ,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77789,CPT,SURF APPL RADJ SRC,TC,,20 ,,RBRVS,,1.34 ,1.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77790,CPT,SUPVJ HANDLING LOADING RADJ SRC,,,20 ,,RBRVS,1.05 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,77790,CPT,SUPVJ HANDLING LOADING RADJ SRC,26,,20 ,,RBRVS,1.05 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,77790,CPT,SUPVJ HANDLING LOADING RADJ SRC,TC,,20 ,,RBRVS,,0.97 ,0.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,77799,CPT,UNLIS CLINICAL BRACHYTX,,,20 ,,TotalUnits,,,,7.18 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,77799,CPT,UNLIS CLINICAL BRACHYTX,26,,20 ,,TotalUnits,,,,3.53 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,77799,CPT,UNLIS CLINICAL BRACHYTX,TC,,20 ,,TotalUnits,,,,3.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78000,CPT,THYR UPTK 1 DETER,,,20 ,,RBRVS,0.19 ,1.63 ,1.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78000,CPT,THYR UPTK 1 DETER,26,,20 ,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78000,CPT,THYR UPTK 1 DETER,TC,,20 ,,RBRVS,,1.56 ,1.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78001,CPT,THYR UPTK MLT DETERS,,,20 ,,RBRVS,0.26 ,2.07 ,2.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78001,CPT,THYR UPTK MLT DETERS,26,,20 ,,RBRVS,0.26 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78001,CPT,THYR UPTK MLT DETERS,TC,,20 ,,RBRVS,,1.97 ,1.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78003,CPT,THYR UPTK STIMJ SUPRJ/DSCHRG X 1ST UPTK STD,,,20 ,,RBRVS,0.33 ,1.71 ,1.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78003,CPT,THYR UPTK STIMJ SUPRJ/DSCHRG X 1ST UPTK STD,26,,20 ,,RBRVS,0.33 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78003,CPT,THYR UPTK STIMJ SUPRJ/DSCHRG X 1ST UPTK STD,TC,,20 ,,RBRVS,,1.59 ,1.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78006,CPT,THYR IMG UPTK 1 DETER,,,20 ,,RBRVS,0.49 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78006,CPT,THYR IMG UPTK 1 DETER,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78006,CPT,THYR IMG UPTK 1 DETER,TC,,20 ,,RBRVS,,5.19 ,5.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78007,CPT,THYR IMG UPTK MLT DETERS,,,20 ,,RBRVS,0.50 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78007,CPT,THYR IMG UPTK MLT DETERS,26,,20 ,,RBRVS,0.50 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78007,CPT,THYR IMG UPTK MLT DETERS,TC,,20 ,,RBRVS,,3.50 ,3.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78010,CPT,THYR IMG ONLY,,,20 ,,RBRVS,0.39 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78010,CPT,THYR IMG ONLY,26,,20 ,,RBRVS,0.39 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78010,CPT,THYR IMG ONLY,TC,,20 ,,RBRVS,,3.52 ,3.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78011,CPT,THYR IMG VASC FLO,,,20 ,,RBRVS,0.45 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78011,CPT,THYR IMG VASC FLO,26,,20 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78011,CPT,THYR IMG VASC FLO,TC,,20 ,,RBRVS,,3.92 ,3.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78015,CPT,THYR CARC METASTASES IMG LMTD AREA,,,20 ,,RBRVS,0.67 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78015,CPT,THYR CARC METASTASES IMG LMTD AREA,26,,20 ,,RBRVS,0.67 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78015,CPT,THYR CARC METASTASES IMG LMTD AREA,TC,,20 ,,RBRVS,,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78016,CPT,THYR CARC METASTASES IMG ADDL STD,,,20 ,,RBRVS,0.82 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78016,CPT,THYR CARC METASTASES IMG ADDL STD,26,,20 ,,RBRVS,0.82 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78016,CPT,THYR CARC METASTASES IMG ADDL STD,TC,,20 ,,RBRVS,,6.90 ,6.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78018,CPT,THYR CARC METASTASES IMG WHBDY,,,20 ,,RBRVS,0.86 ,7.29 ,7.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78018,CPT,THYR CARC METASTASES IMG WHBDY,26,,20 ,,RBRVS,0.86 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78018,CPT,THYR CARC METASTASES IMG WHBDY,TC,,20 ,,RBRVS,,6.99 ,6.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78020,CPT,THYR CARC METASTASES UPTK,,,20 ,,RBRVS,0.60 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78020,CPT,THYR CARC METASTASES UPTK,26,,20 ,,RBRVS,0.60 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78020,CPT,THYR CARC METASTASES UPTK,TC,,20 ,,RBRVS,,1.48 ,1.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78070,CPT,PARATHYR IMG,,,20 ,,RBRVS,0.82 ,3.58 ,3.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78070,CPT,PARATHYR IMG,26,,20 ,,RBRVS,0.82 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78070,CPT,PARATHYR IMG,TC,,20 ,,RBRVS,,3.29 ,3.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78075,CPT,ADRNL IMG CORTEX&/MEDULLA,,,20 ,,RBRVS,0.74 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78075,CPT,ADRNL IMG CORTEX&/MEDULLA,26,,20 ,,RBRVS,0.74 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78075,CPT,ADRNL IMG CORTEX&/MEDULLA,TC,,20 ,,RBRVS,,9.77 ,9.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78099,CPT,UNLIS ENDOC PX DX NUC MED,,,20 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78099,CPT,UNLIS ENDOC PX DX NUC MED,26,,20 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78099,CPT,UNLIS ENDOC PX DX NUC MED,TC,,20 ,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78102,CPT,B1 MARROW IMG LMTD AREA,,,20 ,,RBRVS,0.55 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78102,CPT,B1 MARROW IMG LMTD AREA,26,,20 ,,RBRVS,0.55 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78102,CPT,B1 MARROW IMG LMTD AREA,TC,,20 ,,RBRVS,,3.49 ,3.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78103,CPT,B1 MARROW IMG MLT AREAS,,,20 ,,RBRVS,0.75 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78103,CPT,B1 MARROW IMG MLT AREAS,26,,20 ,,RBRVS,0.75 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78103,CPT,B1 MARROW IMG MLT AREAS,TC,,20 ,,RBRVS,,4.64 ,4.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78104,CPT,B1 MARROW IMG WHBDY,,,20 ,,RBRVS,0.80 ,5.64 ,5.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78104,CPT,B1 MARROW IMG WHBDY,26,,20 ,,RBRVS,0.80 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78104,CPT,B1 MARROW IMG WHBDY,TC,,20 ,,RBRVS,,5.35 ,5.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78110,CPT,PLSM VOL RP VOL-DIL TQ SPX 1 SAMPLING,,,20 ,,RBRVS,0.19 ,1.87 ,1.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78110,CPT,PLSM VOL RP VOL-DIL TQ SPX 1 SAMPLING,26,,20 ,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78110,CPT,PLSM VOL RP VOL-DIL TQ SPX 1 SAMPLING,TC,,20 ,,RBRVS,,1.80 ,1.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78111,CPT,PLSM VOL RP VOL-DIL TQ SPX MLT SAMPLINGS,,,20 ,,RBRVS,0.22 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78111,CPT,PLSM VOL RP VOL-DIL TQ SPX MLT SAMPLINGS,26,,20 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78111,CPT,PLSM VOL RP VOL-DIL TQ SPX MLT SAMPLINGS,TC,,20 ,,RBRVS,,2.08 ,2.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78120,CPT,RBC VOL DETER SPX 1 SAMPLING,,,20 ,,RBRVS,0.23 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78120,CPT,RBC VOL DETER SPX 1 SAMPLING,26,,20 ,,RBRVS,0.23 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78120,CPT,RBC VOL DETER SPX 1 SAMPLING,TC,,20 ,,RBRVS,,1.90 ,1.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78121,CPT,RBC VOL DETER SPX MLT SAMPLINGS,,,20 ,,RBRVS,0.32 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78121,CPT,RBC VOL DETER SPX MLT SAMPLINGS,26,,20 ,,RBRVS,0.32 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78121,CPT,RBC VOL DETER SPX MLT SAMPLINGS,TC,,20 ,,RBRVS,,2.11 ,2.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78122,CPT,WHL BLD VOL DETER RP VOL-DIL TQ,,,20 ,,RBRVS,0.45 ,2.65 ,2.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78122,CPT,WHL BLD VOL DETER RP VOL-DIL TQ,26,,20 ,,RBRVS,0.45 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78122,CPT,WHL BLD VOL DETER RP VOL-DIL TQ,TC,,20 ,,RBRVS,,2.50 ,2.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78130,CPT,RBC SURV STD,,,20 ,,RBRVS,0.61 ,3.36 ,3.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78130,CPT,RBC SURV STD,26,,20 ,,RBRVS,0.61 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78130,CPT,RBC SURV STD,TC,,20 ,,RBRVS,,3.14 ,3.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78135,CPT,RBC SURV STD DIFFIAL ORGAN/TISS KIN,,,20 ,,RBRVS,0.64 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78135,CPT,RBC SURV STD DIFFIAL ORGAN/TISS KIN,26,,20 ,,RBRVS,0.64 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78135,CPT,RBC SURV STD DIFFIAL ORGAN/TISS KIN,TC,,20 ,,RBRVS,,7.67 ,7.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78140,CPT,LBLD RBC SQSJ DIFFIAL ORGAN/TISS,,,20 ,,RBRVS,0.61 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78140,CPT,LBLD RBC SQSJ DIFFIAL ORGAN/TISS,26,,20 ,,RBRVS,0.61 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78140,CPT,LBLD RBC SQSJ DIFFIAL ORGAN/TISS,TC,,20 ,,RBRVS,,2.86 ,2.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78185,CPT,SPLEEN IMG ONLY +-VASC FLO,,,20 ,,RBRVS,0.40 ,4.58 ,4.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78185,CPT,SPLEEN IMG ONLY +-VASC FLO,26,,20 ,,RBRVS,0.40 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78185,CPT,SPLEEN IMG ONLY +-VASC FLO,TC,,20 ,,RBRVS,,4.44 ,4.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78190,CPT,KIN STD PLTLT SURV +-DIFFIAL ORGAN/TISS LOCLZJ,,,20 ,,RBRVS,1.09 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78190,CPT,KIN STD PLTLT SURV +-DIFFIAL ORGAN/TISS LOCLZJ,26,,20 ,,RBRVS,1.09 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78190,CPT,KIN STD PLTLT SURV +-DIFFIAL ORGAN/TISS LOCLZJ,TC,,20 ,,RBRVS,,8.40 ,8.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78191,CPT,PLTLT SURV STD,,,20 ,,RBRVS,0.61 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78191,CPT,PLTLT SURV STD,26,,20 ,,RBRVS,0.61 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78191,CPT,PLTLT SURV STD,TC,,20 ,,RBRVS,,3.96 ,3.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78195,CPT,LYMPHATICS&LYMPH NOD IMG,,,20 ,,RBRVS,1.20 ,7.68 ,7.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78195,CPT,LYMPHATICS&LYMPH NOD IMG,26,,20 ,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78195,CPT,LYMPHATICS&LYMPH NOD IMG,TC,,20 ,,RBRVS,,7.25 ,7.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,,,20 ,,TotalUnits,,,,2.06 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,26,,20 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,TC,,20 ,,TotalUnits,,,,1.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78201,CPT,LVR IMG STATIC ONLY,,,20 ,,RBRVS,0.44 ,4.19 ,4.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78201,CPT,LVR IMG STATIC ONLY,26,,20 ,,RBRVS,0.44 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78201,CPT,LVR IMG STATIC ONLY,TC,,20 ,,RBRVS,,4.04 ,4.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78202,CPT,LVR IMG VASC FLO,,,20 ,,RBRVS,0.51 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78202,CPT,LVR IMG VASC FLO,26,,20 ,,RBRVS,0.51 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78202,CPT,LVR IMG VASC FLO,TC,,20 ,,RBRVS,,4.53 ,4.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78205,CPT,LVR IMG SPECT,,,20 ,,RBRVS,0.71 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78205,CPT,LVR IMG SPECT,26,,20 ,,RBRVS,0.71 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78205,CPT,LVR IMG SPECT,TC,,20 ,,RBRVS,,5.03 ,5.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78206,CPT,LVR IMG SPECT VASC FLO,,,20 ,,RBRVS,0.96 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78206,CPT,LVR IMG SPECT VASC FLO,26,,20 ,,RBRVS,0.96 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78206,CPT,LVR IMG SPECT VASC FLO,TC,,20 ,,RBRVS,,7.61 ,7.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78215,CPT,LVR&SPLEEN IMG STATIC ONLY,,,20 ,,RBRVS,0.49 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78215,CPT,LVR&SPLEEN IMG STATIC ONLY,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78215,CPT,LVR&SPLEEN IMG STATIC ONLY,TC,,20 ,,RBRVS,,4.19 ,4.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78216,CPT,LVR&SPLEEN IMG VASC FLO,,,20 ,,RBRVS,0.57 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78216,CPT,LVR&SPLEEN IMG VASC FLO,26,,20 ,,RBRVS,0.57 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78216,CPT,LVR&SPLEEN IMG VASC FLO,TC,,20 ,,RBRVS,,2.71 ,2.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78220,CPT,LVR FUNCJ STD HEPATBL AGT SRL IMAGES,,,20 ,,RBRVS,0.49 ,3.13 ,3.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78220,CPT,LVR FUNCJ STD HEPATBL AGT SRL IMAGES,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78220,CPT,LVR FUNCJ STD HEPATBL AGT SRL IMAGES,TC,,20 ,,RBRVS,,2.96 ,2.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78223,CPT,HEPATBL DUX SYS IMG GLBLDR,,,20 ,,RBRVS,0.84 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78223,CPT,HEPATBL DUX SYS IMG GLBLDR,26,,20 ,,RBRVS,0.84 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78223,CPT,HEPATBL DUX SYS IMG GLBLDR,TC,,20 ,,RBRVS,,7.12 ,7.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78230,CPT,SALIVARY GLND IMG,,,20 ,,RBRVS,0.45 ,3.71 ,3.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78230,CPT,SALIVARY GLND IMG,26,,20 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78230,CPT,SALIVARY GLND IMG,TC,,20 ,,RBRVS,,3.55 ,3.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78231,CPT,SALIVARY GLND IMG SRL IMAGES,,,20 ,,RBRVS,0.52 ,2.85 ,2.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78231,CPT,SALIVARY GLND IMG SRL IMAGES,26,,20 ,,RBRVS,0.52 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78231,CPT,SALIVARY GLND IMG SRL IMAGES,TC,,20 ,,RBRVS,,2.67 ,2.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78232,CPT,SALIVARY GLND FUNCJ STD,,,20 ,,RBRVS,0.47 ,2.79 ,2.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78232,CPT,SALIVARY GLND FUNCJ STD,26,,20 ,,RBRVS,0.47 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78232,CPT,SALIVARY GLND FUNCJ STD,TC,,20 ,,RBRVS,,2.64 ,2.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78258,CPT,ESOPHGL MOTILITY,,,20 ,,RBRVS,0.74 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78258,CPT,ESOPHGL MOTILITY,26,,20 ,,RBRVS,0.74 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78258,CPT,ESOPHGL MOTILITY,TC,,20 ,,RBRVS,,4.84 ,4.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78261,CPT,GSTR MUCOSA IMG,,,20 ,,RBRVS,0.69 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78261,CPT,GSTR MUCOSA IMG,26,,20 ,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78261,CPT,GSTR MUCOSA IMG,TC,,20 ,,RBRVS,,5.38 ,5.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78262,CPT,G-ESOP RFLX STD,,,20 ,,RBRVS,0.68 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78262,CPT,G-ESOP RFLX STD,26,,20 ,,RBRVS,0.68 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78262,CPT,G-ESOP RFLX STD,TC,,20 ,,RBRVS,,5.32 ,5.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78264,CPT,GSTR EMPTYING STD,,,20 ,,RBRVS,0.78 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78264,CPT,GSTR EMPTYING STD,26,,20 ,,RBRVS,0.78 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78264,CPT,GSTR EMPTYING STD,TC,,20 ,,RBRVS,,6.17 ,6.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78267,CPT,UREA BRTH TST C-14 ISOTOPIC ACQUISJ ALYS,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78268,CPT,UREA BRTH TST C-14 ISOTOPIC ALYS,,,17 ,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78270,CPT,VIT B-12 ABSRPJ STD W/O INTRNSC FACTOR,,,20 ,,RBRVS,0.20 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78270,CPT,VIT B-12 ABSRPJ STD W/O INTRNSC FACTOR,26,,20 ,,RBRVS,0.20 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78270,CPT,VIT B-12 ABSRPJ STD W/O INTRNSC FACTOR,TC,,20 ,,RBRVS,,1.78 ,1.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78271,CPT,VIT B-12 ABSRPJ STD INTRNSC FACTOR,,,20 ,,RBRVS,0.20 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78271,CPT,VIT B-12 ABSRPJ STD INTRNSC FACTOR,26,,20 ,,RBRVS,0.20 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78271,CPT,VIT B-12 ABSRPJ STD INTRNSC FACTOR,TC,,20 ,,RBRVS,,1.88 ,1.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78272,CPT,VIT B-12 ABSRPJ STD CMBN W/&W/O INTRNSC FACTOR,,,20 ,,RBRVS,0.27 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78272,CPT,VIT B-12 ABSRPJ STD CMBN W/&W/O INTRNSC FACTOR,26,,20 ,,RBRVS,0.27 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78272,CPT,VIT B-12 ABSRPJ STD CMBN W/&W/O INTRNSC FACTOR,TC,,20 ,,RBRVS,,1.97 ,1.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78278,CPT,AQT GI BLD LOSS IMG,,,20 ,,RBRVS,0.99 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78278,CPT,AQT GI BLD LOSS IMG,26,,20 ,,RBRVS,0.99 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78278,CPT,AQT GI BLD LOSS IMG,TC,,20 ,,RBRVS,,7.38 ,7.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78282,CPT,GI PROTEIN LOSS,,,20 ,,RBRVS,0.38 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78282,CPT,GI PROTEIN LOSS,26,,20 ,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78282,CPT,GI PROTEIN LOSS,TC,,20 ,,RBRVS,,1.54 ,1.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78290,CPT,INT IMG,,,20 ,,RBRVS,0.68 ,7.29 ,7.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78290,CPT,INT IMG,26,,20 ,,RBRVS,0.68 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78290,CPT,INT IMG,TC,,20 ,,RBRVS,,7.04 ,7.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78291,CPT,PRTL-VEN SHUNT PATENCY TST,,,20 ,,RBRVS,0.88 ,5.49 ,5.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78291,CPT,PRTL-VEN SHUNT PATENCY TST,26,,20 ,,RBRVS,0.88 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78291,CPT,PRTL-VEN SHUNT PATENCY TST,TC,,20 ,,RBRVS,,5.18 ,5.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78299,CPT,UNLIS GI PX DX NUC MED,,,20 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78299,CPT,UNLIS GI PX DX NUC MED,26,,20 ,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78299,CPT,UNLIS GI PX DX NUC MED,TC,,20 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78300,CPT,B1&/JT IMG LMTD AREA,,,20 ,,RBRVS,0.62 ,3.83 ,3.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78300,CPT,B1&/JT IMG LMTD AREA,26,,20 ,,RBRVS,0.62 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78300,CPT,B1&/JT IMG LMTD AREA,TC,,20 ,,RBRVS,,3.61 ,3.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78305,CPT,B1&/JT IMG MLT AREAS,,,20 ,,RBRVS,0.83 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78305,CPT,B1&/JT IMG MLT AREAS,26,,20 ,,RBRVS,0.83 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78305,CPT,B1&/JT IMG MLT AREAS,TC,,20 ,,RBRVS,,4.77 ,4.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78306,CPT,B1&/JT IMG WHBDY,,,20 ,,RBRVS,0.86 ,5.62 ,5.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78306,CPT,B1&/JT IMG WHBDY,26,,20 ,,RBRVS,0.86 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78306,CPT,B1&/JT IMG WHBDY,TC,,20 ,,RBRVS,,5.31 ,5.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78315,CPT,B1&/JT IMG 3 PHASE STD,,,20 ,,RBRVS,1.02 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78315,CPT,B1&/JT IMG 3 PHASE STD,26,,20 ,,RBRVS,1.02 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78315,CPT,B1&/JT IMG 3 PHASE STD,TC,,20 ,,RBRVS,,7.35 ,7.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78320,CPT,B1&/JT IMG TOMOG SPECT,,,20 ,,RBRVS,1.04 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78320,CPT,B1&/JT IMG TOMOG SPECT,26,,20 ,,RBRVS,1.04 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78320,CPT,B1&/JT IMG TOMOG SPECT,TC,,20 ,,RBRVS,,5.02 ,5.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78350,CPT,B1 DNS STD 1+ SITS 1 PHTN ABSRPTM,,,20 ,,RBRVS,0.22 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78350,CPT,B1 DNS STD 1+ SITS 1 PHTN ABSRPTM,26,,20 ,,RBRVS,0.22 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78350,CPT,B1 DNS STD 1+ SITS 1 PHTN ABSRPTM,TC,,20 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78351,CPT,B1 DNS STD 1+ SITS DUAL PHTN ABSRPTM 1+ SITS,,,20 ,,RBRVS,0.30 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78399,CPT,UNLIS MUSCSKEL PX DX NUC MED,,,20 ,,TotalUnits,,,,8.91 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78399,CPT,UNLIS MUSCSKEL PX DX NUC MED,,PC,20 ,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,78399,CPT,UNLIS MUSCSKEL PX DX NUC MED,,TC,20 ,,TotalUnits,,,,7.30 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,78414,CPT,DETER CTR C-V HEMODYN NON-IMG +-RX 1/MLT,,,20 ,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78414,CPT,DETER CTR C-V HEMODYN NON-IMG +-RX 1/MLT,26,,20 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78414,CPT,DETER CTR C-V HEMODYN NON-IMG +-RX 1/MLT,TC,,20 ,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78428,CPT,CAR SHUNT DETCJ,,,20 ,,RBRVS,0.78 ,4.33 ,4.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78428,CPT,CAR SHUNT DETCJ,26,,20 ,,RBRVS,0.78 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78428,CPT,CAR SHUNT DETCJ,TC,,20 ,,RBRVS,,4.02 ,4.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78445,CPT,NON-CAR VASC FLO IMG,,,20 ,,RBRVS,0.49 ,3.86 ,3.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78445,CPT,NON-CAR VASC FLO IMG,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78445,CPT,NON-CAR VASC FLO IMG,TC,,20 ,,RBRVS,,3.69 ,3.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,,,20 ,,RBRVS,1.38 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,26,,20 ,,RBRVS,1.38 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,TC,,20 ,,RBRVS,,6.82 ,6.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,,,20 ,,RBRVS,1.62 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,26,,20 ,,RBRVS,1.62 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,TC,,20 ,,RBRVS,,9.98 ,9.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,,,20 ,,RBRVS,1.00 ,6.42 ,6.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,26,,20 ,,RBRVS,1.00 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,TC,,20 ,,RBRVS,,6.11 ,6.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,,,20 ,,RBRVS,1.34 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,26,,20 ,,RBRVS,1.34 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,TC,,20 ,,RBRVS,,8.80 ,8.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78456,CPT,AQT VEN THROMBOSIS IMG PEPTIDE,,,20 ,,RBRVS,1.00 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78456,CPT,AQT VEN THROMBOSIS IMG PEPTIDE,26,,20 ,,RBRVS,1.00 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78456,CPT,AQT VEN THROMBOSIS IMG PEPTIDE,TC,,20 ,,RBRVS,,7.55 ,7.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78457,CPT,VEN THROMBOSIS IMG VENOGRAM UNI,,,20 ,,RBRVS,0.77 ,4.21 ,4.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78457,CPT,VEN THROMBOSIS IMG VENOGRAM UNI,26,,20 ,,RBRVS,0.77 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78457,CPT,VEN THROMBOSIS IMG VENOGRAM UNI,TC,,20 ,,RBRVS,,3.94 ,3.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78458,CPT,VEN THROMBOSIS IMG VENOGRAM BI,,,20 ,,RBRVS,0.90 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78458,CPT,VEN THROMBOSIS IMG VENOGRAM BI,26,,20 ,,RBRVS,0.90 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78458,CPT,VEN THROMBOSIS IMG VENOGRAM BI,TC,,20 ,,RBRVS,,4.05 ,4.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78459,CPT,MYOCRD IMG P+ EMIJ TOMOG METAB EVAL,,,20 ,,TotalUnits,,,,8.44 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78459,CPT,MYOCRD IMG P+ EMIJ TOMOG METAB EVAL,26,,20 ,,TotalUnits,,,,2.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78459,CPT,MYOCRD IMG P+ EMIJ TOMOG METAB EVAL,TC,,20 ,,TotalUnits,,,,6.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78466,CPT,MYOCRD IMG INFARCT AVID PLNR QUAL/QUAN,,,20 ,,RBRVS,0.69 ,3.97 ,3.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78466,CPT,MYOCRD IMG INFARCT AVID PLNR QUAL/QUAN,26,,20 ,,RBRVS,0.69 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78466,CPT,MYOCRD IMG INFARCT AVID PLNR QUAL/QUAN,TC,,20 ,,RBRVS,,3.70 ,3.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,,,20 ,,RBRVS,0.80 ,5.00 ,5.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,26,,20 ,,RBRVS,0.80 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,TC,,20 ,,RBRVS,,4.65 ,4.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78469,CPT,MYOCRD IMG INFARCT AVID PLNR TOMOG SPECT +-QUAN,,,20 ,,RBRVS,0.92 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78469,CPT,MYOCRD IMG INFARCT AVID PLNR TOMOG SPECT +-QUAN,26,,20 ,,RBRVS,0.92 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78469,CPT,MYOCRD IMG INFARCT AVID PLNR TOMOG SPECT +-QUAN,TC,,20 ,,RBRVS,,5.32 ,5.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78472,CPT,CARD BPI GTD =BRM PLNR 1 STD REST/STRS,,,20 ,,RBRVS,0.98 ,5.67 ,5.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78472,CPT,CARD BPI GTD =BRM PLNR 1 STD REST/STRS,26,,20 ,,RBRVS,0.98 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78472,CPT,CARD BPI GTD =BRM PLNR 1 STD REST/STRS,TC,,20 ,,RBRVS,,5.28 ,5.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78473,CPT,CARD BPI GTD =BRM MLT STD WALL MOTION STD,,,20 ,,RBRVS,1.47 ,7.50 ,7.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78473,CPT,CARD BPI GTD =BRM MLT STD WALL MOTION STD,26,,20 ,,RBRVS,1.47 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78473,CPT,CARD BPI GTD =BRM MLT STD WALL MOTION STD,TC,,20 ,,RBRVS,,6.89 ,6.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78481,CPT,CARD BPI PLNR 1ST PS 1 STD PLUS EJEC FXJ,,,20 ,,RBRVS,0.98 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78481,CPT,CARD BPI PLNR 1ST PS 1 STD PLUS EJEC FXJ,26,,20 ,,RBRVS,0.98 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78481,CPT,CARD BPI PLNR 1ST PS 1 STD PLUS EJEC FXJ,TC,,20 ,,RBRVS,,4.30 ,4.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78483,CPT,CARD BPI PLNR 1ST PS MLT STD PLUS EJEC FXJ,,,20 ,,RBRVS,1.47 ,6.54 ,6.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78483,CPT,CARD BPI PLNR 1ST PS MLT STD PLUS EJEC FXJ,26,,20 ,,RBRVS,1.47 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78483,CPT,CARD BPI PLNR 1ST PS MLT STD PLUS EJEC FXJ,TC,,20 ,,RBRVS,,5.86 ,5.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78491,CPT,MYOCRD IMG P+ EMIJ TOMOG PRFUJ 1 STD,,,20 ,,TotalUnits,,,,8.55 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78491,CPT,MYOCRD IMG P+ EMIJ TOMOG PRFUJ 1 STD,26,,20 ,,TotalUnits,,,,2.12 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78491,CPT,MYOCRD IMG P+ EMIJ TOMOG PRFUJ 1 STD,TC,,20 ,,TotalUnits,,,,6.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78492,CPT,MYOCRD IMG P+ EMIJ TOMOG PRFUJ MLT STD,,,20 ,,TotalUnits,,,,10.78 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78492,CPT,MYOCRD IMG P+ EMIJ TOMOG PRFUJ MLT STD,26,,20 ,,TotalUnits,,,,2.67 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78492,CPT,MYOCRD IMG P+ EMIJ TOMOG PRFUJ MLT STD,TC,,20 ,,TotalUnits,,,,8.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78494,CPT,CARD BPI GTD =BRM SPECT REST WALL MOTION,,,20 ,,RBRVS,1.19 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78494,CPT,CARD BPI GTD =BRM SPECT REST WALL MOTION,26,,20 ,,RBRVS,1.19 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78494,CPT,CARD BPI GTD =BRM SPECT REST WALL MOTION,TC,,20 ,,RBRVS,,5.51 ,5.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78496,CPT,CARD BPI GTD =BRM 1 STD REST R VENTR EJEC FXJ,,,20 ,,RBRVS,0.50 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78496,CPT,CARD BPI GTD =BRM 1 STD REST R VENTR EJEC FXJ,26,,20 ,,RBRVS,0.50 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78496,CPT,CARD BPI GTD =BRM 1 STD REST R VENTR EJEC FXJ,TC,,20 ,,RBRVS,,1.82 ,1.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78499,CPT,UNLIS CV DX NUC MED,,,20 ,,TotalUnits,,,,5.57 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78499,CPT,UNLIS CV DX NUC MED,26,,20 ,,TotalUnits,,,,1.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78499,CPT,UNLIS CV DX NUC MED,TC,,20 ,,TotalUnits,,,,3.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78580,CPT,PULM PI PART,,,20 ,,RBRVS,0.74 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78580,CPT,PULM PI PART,26,,20 ,,RBRVS,0.74 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78580,CPT,PULM PI PART,TC,,20 ,,RBRVS,,4.42 ,4.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78584,CPT,PULM PI PART VNTJ 1 BRTH,,,20 ,,RBRVS,0.99 ,3.03 ,3.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78584,CPT,PULM PI PART VNTJ 1 BRTH,26,,20 ,,RBRVS,0.99 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78584,CPT,PULM PI PART VNTJ 1 BRTH,TC,,20 ,,RBRVS,,2.67 ,2.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78585,CPT,PULM PI PART VNTJ RBRTHING&WSHOT +-1 BRTH,,,20 ,,RBRVS,1.09 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78585,CPT,PULM PI PART VNTJ RBRTHING&WSHOT +-1 BRTH,26,,20 ,,RBRVS,1.09 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78585,CPT,PULM PI PART VNTJ RBRTHING&WSHOT +-1 BRTH,TC,,20 ,,RBRVS,,7.52 ,7.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78586,CPT,PULM VI AERSL 1 PROJECTION,,,20 ,,RBRVS,0.40 ,3.78 ,3.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78586,CPT,PULM VI AERSL 1 PROJECTION,26,,20 ,,RBRVS,0.40 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78586,CPT,PULM VI AERSL 1 PROJECTION,TC,,20 ,,RBRVS,,3.64 ,3.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78587,CPT,PULM VI AERSL MLT PRJCJ,,,20 ,,RBRVS,0.49 ,4.79 ,4.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78587,CPT,PULM VI AERSL MLT PRJCJ,26,,20 ,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78587,CPT,PULM VI AERSL MLT PRJCJ,TC,,20 ,,RBRVS,,4.61 ,4.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78588,CPT,PULM PI PART VNTJ IMG AERSL 1/MLT PRJCJ,,,20 ,,RBRVS,1.09 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78588,CPT,PULM PI PART VNTJ IMG AERSL 1/MLT PRJCJ,26,,20 ,,RBRVS,1.09 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78588,CPT,PULM PI PART VNTJ IMG AERSL 1/MLT PRJCJ,TC,,20 ,,RBRVS,,7.08 ,7.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78591,CPT,PULM VI GASEOUS 1 PRJCJ,,,20 ,,RBRVS,0.40 ,3.82 ,3.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78591,CPT,PULM VI GASEOUS 1 PRJCJ,26,,20 ,,RBRVS,0.40 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78591,CPT,PULM VI GASEOUS 1 PRJCJ,TC,,20 ,,RBRVS,,3.68 ,3.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78593,CPT,PULM VI GASEOUS RBRTHING&WSHOT 1 PRJCJ,,,20 ,,RBRVS,0.49 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78593,CPT,PULM VI GASEOUS RBRTHING&WSHOT 1 PRJCJ,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78593,CPT,PULM VI GASEOUS RBRTHING&WSHOT 1 PRJCJ,TC,,20 ,,RBRVS,,4.29 ,4.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78594,CPT,PULM VI GASEOUS RBRTHING&WSHOT MLT PRJCJ,,,20 ,,RBRVS,0.53 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78594,CPT,PULM VI GASEOUS RBRTHING&WSHOT MLT PRJCJ,26,,20 ,,RBRVS,0.53 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78594,CPT,PULM VI GASEOUS RBRTHING&WSHOT MLT PRJCJ,TC,,20 ,,RBRVS,,4.93 ,4.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78596,CPT,PULM QUAN DIFFIAL FUNCJ VNTJ/PRFUJ STD,,,20 ,,RBRVS,1.27 ,8.30 ,8.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78596,CPT,PULM QUAN DIFFIAL FUNCJ VNTJ/PRFUJ STD,26,,20 ,,RBRVS,1.27 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78596,CPT,PULM QUAN DIFFIAL FUNCJ VNTJ/PRFUJ STD,TC,,20 ,,RBRVS,,7.88 ,7.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78599,CPT,UNLIS RESPIR PX DX NUC MED,,,20 ,,TotalUnits,,,,4.02 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78599,CPT,UNLIS RESPIR PX DX NUC MED,26,,20 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78599,CPT,UNLIS RESPIR PX DX NUC MED,TC,,20 ,,TotalUnits,,,,3.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,,,20 ,,RBRVS,0.44 ,4.11 ,4.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,26,,20 ,,RBRVS,0.44 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,TC,,20 ,,RBRVS,,3.95 ,3.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78601,CPT,BRAIN IMAGING >4 STATIC VIEWS W VASCULAR FLOW,,,20 ,,RBRVS,0.51 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78601,CPT,BRAIN IMAGING >4 STATIC VIEWS W VASCULAR FLOW,26,,20 ,,RBRVS,0.51 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78601,CPT,BRAIN IMAGING >4 STATIC VIEWS W VASCULAR FLOW,TC,,20 ,,RBRVS,,4.70 ,4.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78605,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS,,,20 ,,RBRVS,0.53 ,4.49 ,4.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78605,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS,26,,20 ,,RBRVS,0.53 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78605,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS,TC,,20 ,,RBRVS,,4.29 ,4.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,,,20 ,,RBRVS,0.64 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,26,,20 ,,RBRVS,0.64 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,TC,,20 ,,RBRVS,,7.26 ,7.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,,,20 ,,RBRVS,1.23 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,26,,20 ,,RBRVS,1.23 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,TC,,20 ,,RBRVS,,7.68 ,7.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78608,CPT,BRN IMG P+ EMIJ TOMOG METAB EVAL,,,20 ,,TotalUnits,,,,11.81 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78608,CPT,BRN IMG P+ EMIJ TOMOG METAB EVAL,,PC,20 ,,TotalUnits,,,,2.03 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,78608,CPT,BRN IMG P+ EMIJ TOMOG METAB EVAL,,TC,20 ,,TotalUnits,,,,9.78 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,78609,CPT,BRN IMG P+ EMIJ TOMOG PRFUJ EVAL,,,20 ,,TotalUnits,,,,8.04 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78609,CPT,BRN IMG P+ EMIJ TOMOG PRFUJ EVAL,,PC,20 ,,TotalUnits,,,,2.01 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,78609,CPT,BRN IMG P+ EMIJ TOMOG PRFUJ EVAL,,TC,20 ,,TotalUnits,,,,6.03 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,78610,CPT,BRN IMG VASC FLO ONLY,,,20 ,,RBRVS,0.30 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78610,CPT,BRN IMG VASC FLO ONLY,26,,20 ,,RBRVS,0.30 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78610,CPT,BRN IMG VASC FLO ONLY,TC,,20 ,,RBRVS,,4.13 ,4.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78630,CPT,CEREBSP FLU FLO IMG X INTRO MATRL CISTRNG,,,20 ,,RBRVS,0.68 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78630,CPT,CEREBSP FLU FLO IMG X INTRO MATRL CISTRNG,26,,20 ,,RBRVS,0.68 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78630,CPT,CEREBSP FLU FLO IMG X INTRO MATRL CISTRNG,TC,,20 ,,RBRVS,,7.54 ,7.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78635,CPT,CEREBSP FLU FLO IMG X INTRO MATRL VENTRG,,,20 ,,RBRVS,0.61 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78635,CPT,CEREBSP FLU FLO IMG X INTRO MATRL VENTRG,26,,20 ,,RBRVS,0.61 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78635,CPT,CEREBSP FLU FLO IMG X INTRO MATRL VENTRG,TC,,20 ,,RBRVS,,7.09 ,7.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78645,CPT,CEREBSP FLU FLO IMG X INTRO MATRL SHUNT EVAL,,,20 ,,RBRVS,0.57 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78645,CPT,CEREBSP FLU FLO IMG X INTRO MATRL SHUNT EVAL,26,,20 ,,RBRVS,0.57 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78645,CPT,CEREBSP FLU FLO IMG X INTRO MATRL SHUNT EVAL,TC,,20 ,,RBRVS,,7.12 ,7.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78647,CPT,CEREBSP FLU FLO IMG X INTRO MATRL TOMOG SPECT,,,20 ,,RBRVS,0.90 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78647,CPT,CEREBSP FLU FLO IMG X INTRO MATRL TOMOG SPECT,26,,20 ,,RBRVS,0.90 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78647,CPT,CEREBSP FLU FLO IMG X INTRO MATRL TOMOG SPECT,TC,,20 ,,RBRVS,,7.26 ,7.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78650,CPT,CEREBSP FLU LEAKAGE DETCJ&LOCLZJ,,,20 ,,RBRVS,0.61 ,7.63 ,7.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78650,CPT,CEREBSP FLU LEAKAGE DETCJ&LOCLZJ,26,,20 ,,RBRVS,0.61 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78650,CPT,CEREBSP FLU LEAKAGE DETCJ&LOCLZJ,TC,,20 ,,RBRVS,,7.42 ,7.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78660,CPT,RP DACRYOCSTOGRAPY,,,20 ,,RBRVS,0.53 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78660,CPT,RP DACRYOCSTOGRAPY,26,,20 ,,RBRVS,0.53 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78660,CPT,RP DACRYOCSTOGRAPY,TC,,20 ,,RBRVS,,3.62 ,3.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78699,CPT,UNLIS NRVS SYS PX DX NUC MED,,,20 ,,TotalUnits,,,,2.01 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78699,CPT,UNLIS NRVS SYS PX DX NUC MED,26,,20 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78699,CPT,UNLIS NRVS SYS PX DX NUC MED,TC,,20 ,,TotalUnits,,,,1.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78700,CPT,KIDNEY IMAGING MORPHOLOGY,,,20 ,,RBRVS,0.45 ,4.00 ,4.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78700,CPT,KIDNEY IMAGING MORPHOLOGY,26,,20 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78700,CPT,KIDNEY IMAGING MORPHOLOGY,TC,,20 ,,RBRVS,,3.84 ,3.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78701,CPT,KDN IMG VASC FLO,,,20 ,,RBRVS,0.49 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78701,CPT,KDN IMG VASC FLO,26,,20 ,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78701,CPT,KDN IMG VASC FLO,TC,,20 ,,RBRVS,,4.73 ,4.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,,,20 ,,RBRVS,0.96 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,26,,20 ,,RBRVS,0.96 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,TC,,20 ,,RBRVS,,4.86 ,4.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W RX,,,20 ,,RBRVS,1.21 ,3.64 ,3.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W RX,26,,20 ,,RBRVS,1.21 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W RX,TC,,20 ,,RBRVS,,3.21 ,3.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,,,20 ,,RBRVS,1.41 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,26,,20 ,,RBRVS,1.41 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,TC,,20 ,,RBRVS,,7.41 ,7.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,,,20 ,,RBRVS,0.66 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,26,,20 ,,RBRVS,0.66 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,TC,,20 ,,RBRVS,,4.98 ,4.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78725,CPT,KDN FUNCJ STD NON-IMG RADIOISOTOPIC STD,,,20 ,,RBRVS,0.38 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78725,CPT,KDN FUNCJ STD NON-IMG RADIOISOTOPIC STD,26,,20 ,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78725,CPT,KDN FUNCJ STD NON-IMG RADIOISOTOPIC STD,TC,,20 ,,RBRVS,,2.10 ,2.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78730,CPT,URINARY BLADDER RESIDUAL STUDY,,,20 ,,RBRVS,0.15 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78730,CPT,URINARY BLADDER RESIDUAL STUDY,26,,20 ,,RBRVS,0.15 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78730,CPT,URINARY BLADDER RESIDUAL STUDY,TC,,20 ,,RBRVS,,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78740,CPT,URTRL RFLX STD RP VOIDING CSTOGRAM,,,20 ,,RBRVS,0.57 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78740,CPT,URTRL RFLX STD RP VOIDING CSTOGRAM,26,,20 ,,RBRVS,0.57 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78740,CPT,URTRL RFLX STD RP VOIDING CSTOGRAM,TC,,20 ,,RBRVS,,4.71 ,4.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,,,20 ,,RBRVS,0.71 ,4.66 ,4.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,26,,20 ,,RBRVS,0.71 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,TC,,20 ,,RBRVS,,4.40 ,4.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78799,CPT,UNLIS GENITOUR DX NUC MED,,,20 ,,TotalUnits,,,,8.08 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78799,CPT,UNLIS GENITOUR DX NUC MED,26,,20 ,,TotalUnits,,,,2.33 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78799,CPT,UNLIS GENITOUR DX NUC MED,TC,,20 ,,TotalUnits,,,,5.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78800,CPT,RP LOCLZJ TUM/DSTRBJ AGT LMTD AREA,,,20 ,,RBRVS,0.66 ,4.13 ,4.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78800,CPT,RP LOCLZJ TUM/DSTRBJ AGT LMTD AREA,26,,20 ,,RBRVS,0.66 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78800,CPT,RP LOCLZJ TUM/DSTRBJ AGT LMTD AREA,TC,,20 ,,RBRVS,,3.90 ,3.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78801,CPT,RP LOCLZJ TUM/DSTRBJ AGT MLT AREAS,,,20 ,,RBRVS,0.79 ,5.60 ,5.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78801,CPT,RP LOCLZJ TUM/DSTRBJ AGT MLT AREAS,26,,20 ,,RBRVS,0.79 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78801,CPT,RP LOCLZJ TUM/DSTRBJ AGT MLT AREAS,TC,,20 ,,RBRVS,,5.32 ,5.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78802,CPT,RP LOCLZJ TUM/DSTRBJ AGT WHBDY 1 D IMG,,,20 ,,RBRVS,0.86 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78802,CPT,RP LOCLZJ TUM/DSTRBJ AGT WHBDY 1 D IMG,26,,20 ,,RBRVS,0.86 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78802,CPT,RP LOCLZJ TUM/DSTRBJ AGT WHBDY 1 D IMG,TC,,20 ,,RBRVS,,7.18 ,7.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78803,CPT,RP LOCLZJ TUM/DSTRBJ AGT TOMOG SPECT,,,20 ,,RBRVS,1.09 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78803,CPT,RP LOCLZJ TUM/DSTRBJ AGT TOMOG SPECT,26,,20 ,,RBRVS,1.09 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78803,CPT,RP LOCLZJ TUM/DSTRBJ AGT TOMOG SPECT,TC,,20 ,,RBRVS,,7.63 ,7.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78804,CPT,RP LOCLZJ TUM/DSTRBJ AGT WHBDY REQ 2/> D IMG,,,20 ,,RBRVS,1.07 ,13.81 ,13.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78804,CPT,RP LOCLZJ TUM/DSTRBJ AGT WHBDY REQ 2/> D IMG,26,,20 ,,RBRVS,1.07 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78804,CPT,RP LOCLZJ TUM/DSTRBJ AGT WHBDY REQ 2/> D IMG,TC,,20 ,,RBRVS,,13.42 ,13.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LMTD AREA,,,20 ,,RBRVS,0.73 ,4.01 ,4.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LMTD AREA,26,,20 ,,RBRVS,0.73 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LMTD AREA,TC,,20 ,,RBRVS,,3.75 ,3.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHBDY,,,20 ,,RBRVS,0.86 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHBDY,26,,20 ,,RBRVS,0.86 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHBDY,TC,,20 ,,RBRVS,,7.52 ,7.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,,,20 ,,RBRVS,1.09 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,26,,20 ,,RBRVS,1.09 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,TC,,20 ,,RBRVS,,7.62 ,7.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,78808,CPT,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,,,20 ,,RBRVS,0.18 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,,,20 ,,TotalUnits,,,,15.49 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,26,,20 ,,TotalUnits,,,,2.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,TC,,20 ,,TotalUnits,,,,13.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,,,20 ,,TotalUnits,,,,19.19 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,26,,20 ,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,TC,,20 ,,TotalUnits,,,,16.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78813,CPT,PET IMAGING WHOLE BODY,,,20 ,,TotalUnits,,,,19.88 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78813,CPT,PET IMAGING WHOLE BODY,26,,20 ,,TotalUnits,,,,2.72 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78813,CPT,PET IMAGING WHOLE BODY,TC,,20 ,,TotalUnits,,,,17.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,,,20 ,,TotalUnits,,,,21.73 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,26,,20 ,,TotalUnits,,,,2.98 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,TC,,20 ,,TotalUnits,,,,18.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,,,20 ,,TotalUnits,,,,23.93 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,26,,20 ,,TotalUnits,,,,3.31 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,TC,,20 ,,TotalUnits,,,,20.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,,,20 ,,TotalUnits,,,,24.58 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,26,,20 ,,TotalUnits,,,,3.39 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,TC,,20 ,,TotalUnits,,,,21.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,78999,CPT,UNLIS MISC DX NUC MED,,,20 ,,TotalUnits,,,,3.49 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,78999,CPT,UNLIS MISC DX NUC MED,26,,20 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,78999,CPT,UNLIS MISC DX NUC MED,TC,,20 ,,TotalUnits,,,,3.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,79005,CPT,RP THER ORAL ADMN,,,20 ,,RBRVS,1.80 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,79005,CPT,RP THER ORAL ADMN,26,,20 ,,RBRVS,1.80 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,79005,CPT,RP THER ORAL ADMN,TC,,20 ,,RBRVS,,1.49 ,1.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,79101,CPT,RP THER IV ADMN,,,20 ,,RBRVS,1.96 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,79101,CPT,RP THER IV ADMN,26,,20 ,,RBRVS,1.96 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,79101,CPT,RP THER IV ADMN,TC,,20 ,,RBRVS,,1.62 ,1.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,79200,CPT,RP THER INTRCV ADMN,,,20 ,,RBRVS,1.99 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,79200,CPT,RP THER INTRCV ADMN,26,,20 ,,RBRVS,1.99 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,79200,CPT,RP THER INTRCV ADMN,TC,,20 ,,RBRVS,,1.80 ,1.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,79300,CPT,RP THER NTRSTL RADACT COL ADMN,,,20 ,,RBRVS,1.60 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,79300,CPT,RP THER NTRSTL RADACT COL ADMN,26,,20 ,,RBRVS,1.60 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,79300,CPT,RP THER NTRSTL RADACT COL ADMN,TC,,20 ,,RBRVS,,1.43 ,1.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTB IV NFS,,,20 ,,RBRVS,2.25 ,3.35 ,3.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTB IV NFS,26,,20 ,,RBRVS,2.25 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTB IV NFS,TC,,20 ,,RBRVS,,2.52 ,2.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,79440,CPT,RP THER INTRA-ARTICULAR ADMN,,,20 ,,RBRVS,1.99 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,79440,CPT,RP THER INTRA-ARTICULAR ADMN,26,,20 ,,RBRVS,1.99 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,79440,CPT,RP THER INTRA-ARTICULAR ADMN,TC,,20 ,,RBRVS,,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,79445,CPT,RP THER IA PART ADMN,,,20 ,,TotalUnits,,,,8.97 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,79445,CPT,RP THER IA PART ADMN,26,,20 ,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,79445,CPT,RP THER IA PART ADMN,TC,,20 ,,TotalUnits,,,,5.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,79999,CPT,RP THER UNLIS PX,,,20 ,,TotalUnits,,,,3.59 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,79999,CPT,RP THER UNLIS PX,,PC,20 ,,TotalUnits,,,,2.17 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,79999,CPT,RP THER UNLIS PX,,TC,20 ,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,80047,CPT,BASIC METABOLIC PANEL CALCIUM IONIZED,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80048,CPT,BASIC METABOLIC PANEL CALCIUM TOTAL,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80050,CPT,GENERAL HLTH PANEL,,,17 ,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80051,CPT,ELECTROLYTE PANEL,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80053,CPT,COMPRE METAB PANEL,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80055,CPT,OB PANEL,,,17 ,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80061,CPT,LIPID PANEL,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80069,CPT,RNL FUNCJ PANEL,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80074,CPT,AQT HEP PANEL,,,17 ,,TotalUnits,,,,1.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80076,CPT,HEPATC FUNCJ PANEL,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80100,CPT,DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80101,CPT,DRUG SCR QUAL 1 DRUG CLASS METH EA DRUG CLASS,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80102,CPT,DRUG CONFIRMATION EA PX,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80103,CPT,TISS PREPJ DRUG ALYS,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80150,CPT,AMIKACIN,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80152,CPT,AMITRIPTYLINE,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80154,CPT,BENZODIAZEPINES,,,17 ,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80156,CPT,CARBAMAZEPINE TOT,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80157,CPT,CARBAMAZEPINE FR,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80158,CPT,CYCLOSPORINE,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80160,CPT,DESIPRAMINE,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80162,CPT,DIGOXIN,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80164,CPT,DIPROPYLACETIC ACID,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80166,CPT,DOXEPIN,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80168,CPT,ETHOSUXIMIDE,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80170,CPT,GENTAMICIN,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80172,CPT,GOLD,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80173,CPT,HALOPRIDOL,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80174,CPT,IMIPRAMINE,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80176,CPT,LIDOCAINE,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80178,CPT,LITHIUM,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80182,CPT,NORTRIPTYLINE,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80184,CPT,PHENOBARBITAL,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80185,CPT,PHENYTOIN TOT,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80186,CPT,PHENYTOIN FR,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80188,CPT,PRIMIDONE,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80190,CPT,PROCAINAMIDE,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80192,CPT,PROCAINAMIDE METABOLITES,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80194,CPT,QUINIDINE,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80195,CPT,SIROLIMUS,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80196,CPT,SALICYLATE,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80197,CPT,TACROLIMUS,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80198,CPT,THEOPHYLLINE,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80200,CPT,TOBRAMYCIN,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80201,CPT,TOPIRAMATE,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80202,CPT,VANCOMYCIN,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80299,CPT,QUAN DRUG NES,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80400,CPT,ACTH STIMJ PANEL ADRNL INSUFFICIENCY,,,17 ,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80402,CPT,ACTH STIMJ PANEL 21 HYDROXYLASE DEFNCY,,,17 ,,TotalUnits,,,,3.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80406,CPT,ACTH STIMJ PANEL 3 BETA-HYDROXYDEHYD DEFNCY,,,17 ,,TotalUnits,,,,3.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80408,CPT,ALDOSTERONE SUPRJ EVAL PANEL,,,17 ,,TotalUnits,,,,4.88 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80410,CPT,CALCITONIN STIMJ PANEL,,,17 ,,TotalUnits,,,,3.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80412,CPT,CORTICOTROPIC RELEASING HORM STIMJ PANEL,,,17 ,,TotalUnits,,,,12.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80414,CPT,CHORNC GONAD STIMJ PANEL TSTOSTERONE RSPSE,,,17 ,,TotalUnits,,,,2.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80415,CPT,CHORNC GONAD STIMJ PANEL ESTRADIOL RSPSE,,,17 ,,TotalUnits,,,,2.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80416,CPT,RNL VEIN RENIN STIMJ PANEL,,,17 ,,TotalUnits,,,,5.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80417,CPT,PRPH VEIN RENIN STIMJ PANEL,,,17 ,,TotalUnits,,,,1.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80418,CPT,CMBN RAPID ANT PITUITARY EVAL PANEL,,,17 ,,TotalUnits,,,,22.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80420,CPT,DXMETHASONE SUPRJ PANEL 48 HR,,,17 ,,TotalUnits,,,,2.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80422,CPT,GLUC TOLERANCE PANEL INSULINOMA,,,17 ,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80424,CPT,GLUC TOLERANCE PANEL PHEOCHROMOCYTOMA,,,17 ,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80426,CPT,GONAD RELEASING HORM STIMJ PANEL,,,17 ,,TotalUnits,,,,5.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80428,CPT,GROWTH HORM STIMJ PANEL,,,17 ,,TotalUnits,,,,2.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80430,CPT,GROWTH HORM SUPRJ PANEL GLUC ADMN,,,17 ,,TotalUnits,,,,3.05 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80432,CPT,INSULIN-INDUCED C-PEPTIDE SUPRJ PANEL,,,17 ,,TotalUnits,,,,5.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80434,CPT,INSULIN TOLERANCE PANEL ACTH INSUFFICIENCY,,,17 ,,TotalUnits,,,,3.93 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80435,CPT,INSULIN TOLERANCE PANEL GROWTH HORM DEFNCY,,,17 ,,TotalUnits,,,,4.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80436,CPT,METYRAPONE PANEL,,,17 ,,TotalUnits,,,,3.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80438,CPT,TRH STIMJ PANEL 1 HR,,,17 ,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80439,CPT,TRH STIMJ PANEL 2 HR,,,17 ,,TotalUnits,,,,2.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80440,CPT,TRH STIMJ PANEL HYPRPROLACTINEMIA,,,17 ,,TotalUnits,,,,2.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,80500,CPT,CLIN PATH CONSLTJ LIMITED,,,17 ,,RBRVS,0.37 ,0.12 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,80502,CPT,CLIN PATH CONSLTJ COMPRE,,,17 ,,RBRVS,1.33 ,0.37 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,81000,CPT,URNLS DIP STICK/TABLET RGNT NON-AUTO MIC,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81001,CPT,URNLS DIP STICK/TABLET RGNT AUTO MIC,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81002,CPT,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC,,,17 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81003,CPT,URNLS DIP STICK/TABLET RGNT AUTO W/O MIC,,,17 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81005,CPT,URNLS QUAL/SEMIQUAN XCPT IAS,,,17 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81007,CPT,URNLS BACTERIURIA SCR XCPT CULTURE/DIPSTICK,,,17 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81015,CPT,URNLS MCRSCP ONLY,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81020,CPT,URNLS 2/3 GLASS TST,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81025,CPT,URINE PREGNANCY TST VIS COLOR CMPRSN METHS,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81050,CPT,VOL MEAS TMD COLLJ EA,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,81099,CPT,UNLIS URNLS,,,17 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82000,CPT,ACETALDEHYDE BLD,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82003,CPT,ACETAMINOPHEN,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82009,CPT,ACETONE/OTH KETONE BODIES SERUM QUAL,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82010,CPT,ACETONE/OTH KETONE BODIES SERUM QUAN,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82013,CPT,ACETYLCHOLINESTERASE,,,17 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82016,CPT,ACYLCARNITINES QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82017,CPT,ACYLCARNITINES QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82024,CPT,ADRENOCORTICOTROPIC HORM,,,17 ,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82030,CPT,ADENOSINE 5-MONOPHOSPHATE CYCLIC,,,17 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82040,CPT,ALBUMIN SERUM PLASMA/WHOLE BLOOD,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82042,CPT,ALBUMIN URINE/OTH SRC QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82043,CPT,ALBUMIN URINE MICROALBUMIN QUAN,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82044,CPT,ALBUMIN URINE MICROALBUMIN SEMIQUAN,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82045,CPT,ALBUMIN ISCHEMIA MODF,,,17 ,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82055,CPT,ALCOHOL ANY SPEC XCPT BRTH,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82075,CPT,ALCOHOL BRTH,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82085,CPT,ALDOLASE,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82088,CPT,ALDOSTERONE,,,17 ,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82101,CPT,ALKALOIDS URINE QUAN,,,17 ,,TotalUnits,,,,1.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82103,CPT,ALPHA-1-ANTITRYPSIN TOT,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82104,CPT,ALPHA-1-ANTITRYPSIN PHEXYP,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82105,CPT,ALPHA-FETOPROTEIN SERUM,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82106,CPT,ALPHA-FETOPROTEIN AMNIOTIC FLU,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82107,CPT,AFP-L3 FRACTION ISOFORM AND TOTAL AFP,,,17 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82108,CPT,ALUMINUM,,,17 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82120,CPT,AMINES VAG FLU QUAL,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82127,CPT,AMINO ACIDS 1 QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82128,CPT,AMINO ACIDS MLT QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82131,CPT,AMINO ACIDS 1 QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82135,CPT,AMINOLEVULINIC ACID DELTA,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82136,CPT,AMINO ACIDS 2-5 AMINO ACIDS QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82139,CPT,AMINO ACIDS 6/> AMINO ACIDS QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82140,CPT,AMMONIA,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82143,CPT,AMNIOTIC FLU SCAN,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82145,CPT,AMPHETAMINE/METHAMPHETAMINE,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82150,CPT,AMYLASE,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82154,CPT,ANDROSTANEDIOL GLUCURONIDE,,,17 ,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82157,CPT,ANDROSTENEDIONE,,,17 ,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82160,CPT,ANDROSTERONE,,,17 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82163,CPT,ANGIOTENSIN II,,,17 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82164,CPT,ANGIOTENSIN I-CONVERTING ENZYME,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82172,CPT,APOLIPOPROTEIN EA,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82175,CPT,ARSENIC,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82180,CPT,ASCORBIC ACID BLD,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82190,CPT,ATOMIC ABSRPJ SPECTROSCOPY EA ANAL,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82205,CPT,BARBITURATES NES,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82232,CPT,BETA-2 MICROGLOBULIN,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82239,CPT,BILE ACIDS TOT,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82240,CPT,BILE ACIDS CHOLYLGLYCINE,,,17 ,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82247,CPT,BILIRUBIN TOT,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82248,CPT,BILIRUBIN DIR,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82252,CPT,BILIRUBIN FECES QUAL,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82261,CPT,BIOTINIDASE EA SPEC,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82270,CPT,BLD OCLT PROXIDASE ACTV QUAL FECES 1 DETER,,,17 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82271,CPT,BLD OCLT PROXIDASE ACTV QUAL OTH SRCS,,,17 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82272,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,,,17 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82274,CPT,BLD OCLT FECAL HGB DETER IA QUAL FECES 1-3,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82286,CPT,BRADYKININ,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82300,CPT,CADMIUM,,,17 ,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82306,CPT,25 HYDROXY INCLUDES FRACTIONS IF PERFORMED,,,17 ,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82308,CPT,CALCITONIN,,,17 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82310,CPT,CALCIUM TOT,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82330,CPT,CALCIUM IONIZED,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82331,CPT,CALCIUM AFTER CALCIUM NFS TST,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82340,CPT,CALCIUM URINE QUAN TMD SPEC,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82355,CPT,ST1 QUAL ALYS,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82360,CPT,ST1 QUAN ALYS CHEM,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82365,CPT,ST1 INFRARED SPECTROSCOPY,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82370,CPT,ST1 X-RAY DIFFXJ,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82373,CPT,CARBOHYDRATE DEFICIENT TRRIN,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82374,CPT,CARBON DIOXIDE,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82375,CPT,CARBOXYHEMOGLOBIN QUANTITATIVE,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82376,CPT,CARBOXYHEMOGLOBIN QUALITATIVE,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82378,CPT,CARCINOEMBRYONIC AG,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82379,CPT,CARNITINE QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82380,CPT,CAROTENE,,,17 ,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82382,CPT,CATECHOLAMINES TOT URINE,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82383,CPT,CATECHOLAMINES BLD,,,17 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82384,CPT,CATECHOLAMINES FXJATED,,,17 ,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82387,CPT,CATHEPSIN-D,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82390,CPT,CERULOPLASMIN,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82397,CPT,CHEMILUMINESCENT ASSAY,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82415,CPT,CHLORAMPHENICOL,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82435,CPT,CHLORIDE BLD,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82436,CPT,CHLORIDE URINE,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82438,CPT,CHLORIDE OTH SRC,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82441,CPT,CHLORINATED HYDROCARBONS SCR,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82465,CPT,CHOLESTEROL SERUM/WHL BLD TOT,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82480,CPT,CHOLINESTERASE SERUM,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82482,CPT,CHOLINESTERASE RBC,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82485,CPT,CHONDROITIN B SULFATE QUAN,,,17 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82486,CPT,CHROM QUAL COLUMN ANAL NES,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82487,CPT,CHROM QUAL PAPR 1-DIMENSIONAL ANAL NES,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82488,CPT,CHROM QUAL PAPR 2-DIMENSIONAL ANAL NES,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82489,CPT,CHROM QUAL THIN LYR ANAL NES,,,17 ,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82491,CPT,CHROM QUAN COLUMN 1 ANAL NES,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82492,CPT,CHROM QUAN COLUMN MLT ANALS,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82495,CPT,CHROMIUM,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82507,CPT,CITRATE,,,17 ,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82520,CPT,COCAINE/METABOLITE,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82523,CPT,COLLAGEN CROSS LINKS ANY METH,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82525,CPT,COPPR,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82528,CPT,CORTICOSTERONE,,,17 ,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82530,CPT,CORTISOL FR,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82533,CPT,CORTISOL TOT,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82540,CPT,CREATINE,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82541,CPT,COL-CHR/MS QUAL 1 STATIONARY&MOBILE PHASE,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82542,CPT,COL-CHR/MS QUAN 1 STATIONARY&MOBILE PHASE,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82543,CPT,COL-CHR/MS STABLE ISOTOPE DIL 1 ANAL,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82544,CPT,COL-CHR/MS STABLE ISOTOPE DIL MLT ANALS,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82550,CPT,CREATINE KINASE TOT,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82552,CPT,CREATINE KINASE ISOENZYMES,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82553,CPT,CREATINE KINASE MB FXJ ONLY,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82554,CPT,CREATINE KINASE ISOFORMS,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82565,CPT,CREATININE BLD,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82570,CPT,CREATININE OTH SRC,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82575,CPT,CREATININE CLEARANCE,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82585,CPT,CRYOFIBRN,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82595,CPT,CRYOGLOBULIN QUAL/SEMI-QUAN,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82600,CPT,CYANIDE,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82607,CPT,CYANOCOBALAMIN,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82608,CPT,CYANOCOBALAMIN UNSAT BNDNG CAP,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82610,CPT,CYSTATIN C,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82615,CPT,CSTINE&HOMOCSTINE URINE QUAL,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82626,CPT,DEHYDROEPIANDROSTERONE,,,17 ,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82627,CPT,DEHYDROEPIANDROSTERONE-SULFATE,,,17 ,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82633,CPT,DESOXYCORTICOSTERONE 11-,,,17 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82634,CPT,DEOXYCORTISOL 11-,,,17 ,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82638,CPT,DIBUCAINE NUMBER,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82646,CPT,DIHYDROCODEINONE,,,17 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82649,CPT,DIHYDROMORPHINONE,,,17 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82651,CPT,DIHYDROTSTOSTERONE,,,17 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82652,CPT,1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED,,,17 ,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82654,CPT,DIMETHADIONE,,,17 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82656,CPT,ELASTASE PNCRTC FECAL QUAL/SEMI-QUAN,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82657,CPT,NZM ACTV CELLS/TISS NONRADACT SUBSTRATE EA,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82658,CPT,NZM ACTV CELLS/TISS RADACT SUBSTRATE EA,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82664,CPT,ELECTROP TQ NES,,,17 ,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82666,CPT,EPIANDROSTERONE,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82668,CPT,ERYTHROPOIETIN,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82670,CPT,ESTRADIOL,,,17 ,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82671,CPT,STRGNS FXJATED,,,17 ,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82672,CPT,STRGNS TOT,,,17 ,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82677,CPT,ESTRIOL,,,17 ,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82679,CPT,ESTRONE,,,17 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82690,CPT,ETHCHLORVYNOL,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82693,CPT,ETHYLENE GLYCOL,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82696,CPT,ETIOCHOLANOLONE,,,17 ,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82705,CPT,FAT/LIPIDS FECES QUAL,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82710,CPT,FAT/LIPIDS FECES QUAN,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82715,CPT,FAT DIFFIAL FECES QUAN,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82725,CPT,FATTY ACIDS NONESTERIFIED,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82726,CPT,VERY LONG CHAIN FATTY ACIDS,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82728,CPT,FERRITIN,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82731,CPT,FTL FIBRONECTIN CERVICOVAG SECRETIONS SEMI-QUAN,,,17 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82735,CPT,FLUORIDE,,,17 ,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82742,CPT,FLURAZEPAM,,,17 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82746,CPT,FOLIC ACID SERUM,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82747,CPT,FOLIC ACID RBC,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82757,CPT,FRUCTOSE SEMEN,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82759,CPT,GALACTOKINASE RBC,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82760,CPT,GALACTOSE,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82775,CPT,GALACTOSE-1-PHOSPHATE URIDYL TRASE QUAN,,,17 ,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82776,CPT,GALACTOSE-1-PHOSPHATE URIDYL TRASE SCR,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82784,CPT,GAMMAGLOBULIN IGA IGD IGG IGM EACH,,,17 ,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82785,CPT,GAMMAGLOBULIN IGE,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82787,CPT,GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82800,CPT,GASES BLD PH ONLY,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82803,CPT,GASES BLD PH CALCULATED O2 SATURATION,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82805,CPT,GASES BLD PH DIR MEAS XCPT PLS OXIMTRY,,,17 ,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82810,CPT,GASES BLD O2 SATURATION ONLY DIR MEAS,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82820,CPT,HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN,,,17 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82930,CPT,GASTRIC ANALY W/PH EA SPEC,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82938,CPT,GASTRIN AFTER SECRETIN STIMJ,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82941,CPT,GASTRIN,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82943,CPT,GLUC,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82945,CPT,GLUC BDY FLU OTH/THN BLD,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82946,CPT,GLUC TOLERANCE TST,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82947,CPT,GLUC QUAN BLD,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82948,CPT,GLUC BLD RGNT STRIP,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82950,CPT,GLUC POST GLUC DOSE GLUC,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82951,CPT,GLUC TOLERANCE TST GTT 3 SPEC GLUC,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82952,CPT,GLUC TOLERANCE TST EA > 3 SPEC,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82953,CPT,GLUC TOLBUTAMIDE TOLERANCE TST,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82955,CPT,GLUC-6-PHOSPHATE DEHYD QUAN,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82960,CPT,GLUC-6-PHOSPHATE DEHYD SCR,,,17 ,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82962,CPT,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,,,17 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82963,CPT,GLUCOSIDASE BETA,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82965,CPT,GLUTAMATE DEHYD,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82975,CPT,GLUTAMINE,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82977,CPT,GLUTAMYLTRASE GAMMA,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82978,CPT,GLUTATHIONE,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82979,CPT,GLUTATHIONE REDUXASE RBC,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82980,CPT,GLUTETHIMIDE,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,82985,CPT,GLYCATED PROTEIN,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83001,CPT,GONAD FOLLICLE STIMULATING HORM,,,17 ,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83002,CPT,GONAD LTNZNG HORM,,,17 ,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83003,CPT,GROWTH HORM HUMAN,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83008,CPT,GUANOSINE MONOPHOSPHATE CYCLIC,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83009,CPT,HPYLORI BLD NON-RADACT ISOTOPE,,,17 ,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83010,CPT,HAPTOGLOBIN QUAN,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83012,CPT,HAPTOGLOBIN PHEXYP,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83013,CPT,HPYLORI BRTH NON-RADACT ISOTOPE,,,17 ,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83014,CPT,HPYLORI DRUG ADMN,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83015,CPT,HEAVY METAL SCR,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83018,CPT,HEAVY METAL QUAN EA,,,17 ,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83020,CPT,HGB FXJ&QUAN ELECTROPHORESIS,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,83020,CPT,HGB FXJ&QUAN ELECTROPHORESIS,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,83021,CPT,HGB FXJ&QUAN CHROM,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83026,CPT,HGB COPPR SULFATE METH NON-AUTO,,,17 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83030,CPT,HGB F CHEM,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83033,CPT,HGB F QUAL,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83036,CPT,HGB GLYCOSYLATED,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83037,CPT,HGB GLYCOSYLATED DEV CLEARED FDA HOME USE,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83045,CPT,HGB METHGB QUAL,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83050,CPT,HGB METHGB QUAN,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83051,CPT,HGB PLSM,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83055,CPT,HGB SULFHGB QUAL,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83060,CPT,HGB SULFHGB QUAN,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83065,CPT,HGB THERMOLABILE,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83068,CPT,HGB UNSTABLE SCR,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83069,CPT,HGB URINE,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83070,CPT,HEMOSIDERIN QUAL,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83071,CPT,HEMOSIDERIN QUAN,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83080,CPT,B-HEXOSAMINIDASE EA ASSAY,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83088,CPT,HISTAM,,,17 ,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83090,CPT,HOMOCSTEINE,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83150,CPT,HOMOVANILLIC ACID,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83491,CPT,HYDROXYCORTICOSTRDS 17,,,17 ,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83497,CPT,HYDROXYINDOLACETIC ACID 5,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83498,CPT,HYDROXYPROGST 17-D,,,17 ,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83499,CPT,HYDROXYPROGST 20-,,,17 ,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83500,CPT,HYDROXYPROLINE FR,,,17 ,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83505,CPT,HYDROXYPROLINE TOT,,,17 ,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83516,CPT,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83518,CPT,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83519,CPT,IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83520,CPT,IMMUNOASSAY ANALYTE QUANTITATIVE NOS,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83525,CPT,INSULIN TOT,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83527,CPT,INSULIN FR,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83528,CPT,INTRNSC FACTOR,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83540,CPT,IRON,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83550,CPT,IRON BNDNG CAP,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83570,CPT,ISOCITRIC DEHYD,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83582,CPT,KETOGENIC STRDS FXJ,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83586,CPT,KETOSTRDS 17 TOT,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83593,CPT,KETOSTRDS 17-FXJ,,,17 ,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83605,CPT,LACTATE,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83615,CPT,LACTATE DEHYD,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83625,CPT,LACTATE DEHYD ISOENZYMES SEP&QUAN,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83630,CPT,LACTOFERRIN FECAL QUAL,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83631,CPT,LACTOFERRIN FECAL QUAN,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83632,CPT,LACTOGEN HPL HUMAN CHORNC SOMAT,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83633,CPT,LACTOSE URINE QUAL,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83634,CPT,LACTOSE URINE QUAN,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83655,CPT,LEAD,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83661,CPT,FTL LNG MATRT ASSMT L/S RATIO,,,17 ,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83662,CPT,FTL LNG MATRT ASSMT FOAM STABILITY TST,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83663,CPT,FTL LNG MATRT ASSMT FLUORESCENCE POLARIZATION,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83664,CPT,FTL LNG MATRT ASSMT LAMELLAR BDY DNS,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83670,CPT,LEUCINE AMINOPEPTIDASE LAP,,,17 ,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83690,CPT,LIPASE,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83695,CPT,LIPOPROTEIN A,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83698,CPT,LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2,,,17 ,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83700,CPT,LIPOPROTEIN BLD ELECTROP SEP&QUAN,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83701,CPT,LIPOPROTEIN BLD HR SUBCLASSES,,,17 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83704,CPT,LIPOPROTEIN BLD QUAN NUMBERS&SUBCLASSES,,,17 ,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83718,CPT,LIPOPROTEIN DIR MEAS HI DNS CHOLESTEROL,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83719,CPT,LIPOPROTEIN DIR MEAS VLDL CHOLESTEROL,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83721,CPT,LIPOPROTEIN DIR MEAS LDL CHOLESTEROL,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83727,CPT,LTNZNG RELEASING FACTOR,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83735,CPT,MAGNESIUM,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83775,CPT,MALATE DEHYD,,,17 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83785,CPT,MANGANESE,,,17 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83788,CPT,MASS SPECT&TANDEM MASS SPECT ANAL QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83789,CPT,MASS SPECT&TANDEM MASS SPECT ANAL QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83805,CPT,MEPROBAMATE,,,17 ,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83825,CPT,MERCURY QUAN,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83835,CPT,METANEPHRINES,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83840,CPT,METHADONE,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83857,CPT,METHEMALBUMIN,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83858,CPT,METHSUXIMIDE,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83861,CPT,MICROFLUID ANALY TEARS,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83864,CPT,MUCOPOLYSACS ACID QUAN,,,17 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83866,CPT,MUCOPOLYSACS ACID SCR,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83872,CPT,MUCIN SYNVAL FLU ROPES TST,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83873,CPT,MYELIN BASIC PROTEIN CEREBSP FLU,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83874,CPT,MYOGLOBIN,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83876,CPT,MYELOPEROXIDASE MPO,,,17 ,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83880,CPT,NATRIURETIC PEPTIDE,,,17 ,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83883,CPT,NEPHELOMETRY EA ANAL NES,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83885,CPT,NICKEL,,,17 ,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83887,CPT,NICOTINE,,,17 ,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83890,CPT,MOLEC DIAG ISOL/XTRJ EA NUCLEIC ACID TYPE,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83891,CPT,MOLEC ISOL/XTRJ HP NUCLEIC ACID EA TYPE,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83892,CPT,MOLEC ENZYMATIC DIGESTION EA ENZYME TX,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83893,CPT,MOLEC DOT/SLOT BLOT EA NUCLEIC ACID PREPJ,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83894,CPT,MOLEC SEP GEL ELECTROPHORESIS EACH PREPJ,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83896,CPT,MOLEC NUCLEIC ACID PRB EA,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83897,CPT,MOLEC NUCLEIC ACID TR EA NUCLEIC ACID PREPJ,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83898,CPT,MOLECULAR DX AMPLIFICATION TARGET EA SEQUENCE,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83900,CPT,MOLECULAR DX AMP TARGET MULTIPLEX 1ST 2 SEQ,,,17 ,,TotalUnits,,,,1.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83901,CPT,MOLECULAR DX AMP TARGET MULTIPLEX EA ADDL SEQ,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83902,CPT,MOLEC REVERSE TRANSCRIPTION,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83903,CPT,MOLEC MUTATION SCANNING PROPERTIES 1 SGM EACH,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83904,CPT,MOLEC MUTATION ID SEQUENCING 1 SGM EA SGM,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83905,CPT,MOLEC MUTATION ALLELE TRANSCRIPTION 1 SGM EA,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83906,CPT,MOLEC MUTATION ALLELE SPEC TRANSLATION 1 SGM EA,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83907,CPT,MOLEC LSS CELLS PRIOR NUCLEIC ACID XTRJ,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83908,CPT,MOLECULAR DX AMPLIFICATION SIGNAL EA SEQUENCE,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83909,CPT,MOLEC SEP&ID HR TQ,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83912,CPT,MOLEC DX I&R,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,83912,CPT,MOLEC DX I&R,26,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,83913,CPT,MOLECULAR DIAGNOSTICS RNA STABILIZATION,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83914,CPT,MUTATION ID ENZYMATIC LIG/PRIMER XTN 1 SGM EA,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83915,CPT,NUCLEOTIDASE 5'-,,,17 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83916,CPT,OLIGOCLONAL IMMUNE,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83918,CPT,ORGANIC ACIDS TOT QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83919,CPT,ORGANIC ACIDS QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83921,CPT,ORGANIC ACID 1 QUAN,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83925,CPT,OPIATE(S) DRUG AND METABOLITES EACH PROCEDURE,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83930,CPT,OSMOLALITY BLD,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83935,CPT,OSMOLALITY URINE,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83937,CPT,OSTEOCALCIN,,,17 ,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83945,CPT,OXALATE,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83950,CPT,ONCOPROTEIN HER-2/NEU,,,17 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83951,CPT,ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP,,,17 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83970,CPT,PARATHORM,,,17 ,,TotalUnits,,,,1.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83986,CPT,PH BODY FLUID NOS,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83987,CPT,PH EXHALED BREATH CONDENSATE,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83992,CPT,PHENCYCLIDINE,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,83993,CPT,CALPROTECTIN FECAL,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84022,CPT,PHEXHIAZINE,,,17 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84030,CPT,PHENYLALA9 BLD,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84035,CPT,PHENYLKETONES QUAL,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84060,CPT,PHOSPHATASE ACID TOT,,,17 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84061,CPT,PHOSPHATASE ACID FORENSIC XM,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84066,CPT,PHOSPHATASE ACID PROSTATIC,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84075,CPT,PHOSPHATASE ALKALINE,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84078,CPT,PHOSPHATASE ALKALINE HEAT STABLE TOT X W/,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84080,CPT,PHOSPHATASE ALKALINE ISOENZYMES,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84081,CPT,PHOSPHATIDYLGLYCEROL,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84085,CPT,PHOSPHOGLUCONATE 6-DEHYD RBC,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84087,CPT,PHOSPHOHEXOSE ISOMERASE,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84100,CPT,PHOSPHORUS INORGANIC,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84105,CPT,PHOSPHORUS INORGANIC URINE,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84106,CPT,PORPHOBILINOGEN URINE QUAL,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84110,CPT,PORPHOBILINOGEN URINE QUAN,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84112,CPT,PLACENTA ALPHA MICRO IG C/V,,,17 ,,TotalUnits,,,,2.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84119,CPT,PORPHYRINS URINE QUAL,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84120,CPT,PORPHYRINS URINE QUAN&FXJ,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84126,CPT,PORPHYRINS FECES QUAN,,,17 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84127,CPT,PORPHYRINS FECES QUAL,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84132,CPT,POTASSIUM SERUM PLASMA/WHOLE BLOOD,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84133,CPT,POTASSIUM URINE,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84134,CPT,PREALBUMIN,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84135,CPT,PREGNANEDIOL,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84138,CPT,PREGNANETRIOL,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84140,CPT,PREGNENOLONE,,,17 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84143,CPT,17-HYDROXYPREGNENOLONE,,,17 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84144,CPT,PROGST,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84145,CPT,PROCALCITONIN (PCT),,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84146,CPT,PROLACTIN,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84150,CPT,PROSTAGLNDIN EA,,,17 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84152,CPT,PRST8 SPEC AG CPLXED DIR MEAS,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84153,CPT,PRST8 SPEC AG TOT,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84154,CPT,PRST8 SPEC AG FR,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84155,CPT,PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84156,CPT,PROTEIN TOT XCPT REFRACTOMETRY URINE,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84157,CPT,PROTEIN TOT XCPT REFRACTOMETRY OTH SRC,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84160,CPT,PROTEIN TOT REFRACTOMETRY ANY SRC,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84163,CPT,PREGNANCY-ASSOCIATED PLSM PROTEIN-A,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84165,CPT,PROTEIN ELECTROP FXJ&QUAN SERUM,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,84165,CPT,PROTEIN ELECTROP FXJ&QUAN SERUM,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,84166,CPT,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATION,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,84166,CPT,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATION,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,84181,CPT,PROTEIN WSTRN BLOT I&R BLD/OTH FLU,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,84181,CPT,PROTEIN WSTRN BLOT I&R BLD/OTH FLU,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,84182,CPT,PROTEIN WSTRN BLOT BLD/OTH FLU IMMUNOLOGICAL,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,84182,CPT,PROTEIN WSTRN BLOT BLD/OTH FLU IMMUNOLOGICAL,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,84202,CPT,PROTOPORPHYRIN RBC QUAN,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84203,CPT,PROTOPORPHYRIN RBC SCR,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84206,CPT,PROINSULIN,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84207,CPT,PYRIDOXAL PHOSPHATE,,,17 ,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84210,CPT,PYRUVATE,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84220,CPT,PYRUVATE KINASE,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84228,CPT,QUININE,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84233,CPT,RCPTR ASSAY STRGN,,,17 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84234,CPT,RCPTR ASSAY PROGST,,,17 ,,TotalUnits,,,,2.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84235,CPT,RCPTR ASSAY ENDOC OTH/THN STRGN/PROGST,,,17 ,,TotalUnits,,,,2.03 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84238,CPT,RCPTR ASSAY NON-ENDOC SPEC RCPTR,,,17 ,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84244,CPT,RENIN,,,17 ,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84252,CPT,RIBOFLAVIN,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84255,CPT,SELENIUM,,,17 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84260,CPT,SEROTONIN,,,17 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84270,CPT,SEX HORM BNDNG GLOBULIN,,,17 ,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84275,CPT,SIALIC ACID,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84285,CPT,SILICA,,,17 ,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84295,CPT,SODIUM SERUM PLASMA OR WHOLE BLOOD,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84300,CPT,SODIUM URINE,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84302,CPT,SODIUM OTH SRC,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84305,CPT,SOMATOMEDIN,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84307,CPT,SOMATOSTATIN,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84311,CPT,SPECTROPHOTOMETRY ANAL NES,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84315,CPT,SPEC GRAVITY XCPT URINE,,,17 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84375,CPT,SUGARS CHROMATOGRAPIC TLC/PAPR CHROM,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84376,CPT,SUGARS MONO DI&OLIGOS 1 QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84377,CPT,SUGARS MONO DI&OLIGOS MLT QUAL EA SPEC,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84378,CPT,SUGARS MONO DI&OLIGOS 1 QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84379,CPT,SUGARS MONO DI&OLIGOS MLT QUAN EA SPEC,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84392,CPT,SULFATE URINE,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84402,CPT,TSTOSTERONE FR,,,17 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84403,CPT,TSTOSTERONE TOT,,,17 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84425,CPT,THIAMINE,,,17 ,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84430,CPT,THIOCYANATE,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84431,CPT,THROMBOXANE METABOLITE W/WO THROMBOXANE URINE,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84432,CPT,THYROGLOBULIN,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84436,CPT,THYROXINE TOT,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84437,CPT,THYROXINE REQ ELUTION,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84439,CPT,THYROXINE FR,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84442,CPT,THYROXINE BNDNG GLOBULIN,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84443,CPT,THYR STIMULATING HORM,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84445,CPT,THYR STIMULATING IGS,,,17 ,,TotalUnits,,,,1.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84446,CPT,TOCOPHEROL ALPHA,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84449,CPT,TRANSCORTIN,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84450,CPT,TRANSFERASE ASPARTATE AMINO,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84460,CPT,TRANSFERASE ALANINE AMINO,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84466,CPT,TRANSFERRIN,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84478,CPT,TRIGLYCERIDES,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84479,CPT,THYR HORM UPTK/THYR HORM BNDNG RATIO,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84480,CPT,TRIIODOTHYRO9 T3 TOT,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84481,CPT,TRIIODOTHYRO9 T3 FR,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84482,CPT,TRIIODOTHYRO9 T3 REVERSE,,,17 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84484,CPT,TROPONIN QUAN,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84485,CPT,TRYPSIN DUOL FLU,,,17 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84488,CPT,TRYPSIN FECES QUAL,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84490,CPT,TRYPSIN FECES QUAN 24-HR COLLJ,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84510,CPT,TYROSINE,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84512,CPT,TROPONIN QUAL,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84520,CPT,UREA N QUAN,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84525,CPT,UREA N SEMIQUAN,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84540,CPT,UREA N URINE,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84545,CPT,UREA N CLEARANCE,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84550,CPT,URIC ACID BLD,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84560,CPT,URIC ACID OTH SRC,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84577,CPT,UROBILINOGEN FECES QUAN,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84578,CPT,UROBILINOGEN URINE QUAL,,,17 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84580,CPT,UROBILINOGEN URINE QUAN TMD SPEC,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84583,CPT,UROBILINOGEN URINE SEMIQUAN,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84585,CPT,VANILLYLMANDELIC ACID URINE,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84586,CPT,VASOACTIVE INTSTINAL PEPTIDE,,,17 ,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84588,CPT,VASOPRESSIN,,,17 ,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84590,CPT,VIT,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84591,CPT,VIT NOS,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84597,CPT,VIT K,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84600,CPT,VOLATILES,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84620,CPT,XYLOSE ABSRPJ TST BLD&/URINE,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84630,CPT,ZINC,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84681,CPT,C-PEPTIDE,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84702,CPT,GONAD CHORNC QUAN,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84703,CPT,GONAD CHORNC QUAL,,,17 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84704,CPT,GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84830,CPT,OVUL TSTS VIS COLOR CMPRSN METHS,,,17 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,84999,CPT,UNLIS CHEMISTRY,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85002,CPT,BLEEDING TM,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85004,CPT,BLD# AUTO DIFFIAL WBC CNT,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85007,CPT,BLD# BLD SMR MCRSCP XM MNL DIFFIAL WBC CNT,,,17 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85008,CPT,BLD# BLD SMR MCRSCP XM W/O MNL DIFFIAL WBC CNT,,,17 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85009,CPT,BLD# MNL DIFFIAL WBC CNT BUFFY COAT,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85013,CPT,BLD# SPUN MICROHEMATOCRIT,,,17 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85014,CPT,BLD# HEMATOCRIT,,,17 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85018,CPT,BLD# HGB,,,17 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85025,CPT,BLD# COMPL AUTO HHRWP&AUTO DIFFIAL,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85027,CPT,BLD# COMPL AUTO HHRWP,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85032,CPT,BLD# MNL C-CNT RBC WBC/PLTLT EA,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85041,CPT,BLD# RED BLD CELL AUTO,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85044,CPT,BLD# RETICULOCYTE MNL,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85045,CPT,BLD# RETICULOCYTE AUTO,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85046,CPT,BLD# RETICULOCYTES AUTO 1+ CELL MEAS,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85048,CPT,BLD# WBC AUTO,,,17 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85049,CPT,BLD# PLTLT AUTO,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85055,CPT,RETICULATED PLTLT ASSAY,,,17 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85060,CPT,BLD SMR PRPH INTERPJ PHYS WRTTN REPRT,,,17 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,85097,CPT,B1 MARROW SMR INTERPJ,,,17 ,,RBRVS,0.94 ,0.32 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,85130,CPT,CHROMOGENIC SUBSTRATE ASSAY,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85170,CPT,CLOT RETRCJ,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85175,CPT,CLOT LSS TM WHL BLD DIL,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85210,CPT,CLTNG FACTOR II PROTHROMBIN SPEC,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85220,CPT,CLTNG FACTOR V ACG/PROACCELERIN LABILE FACTOR,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85230,CPT,CLTNG FACTOR VII PROCONVERTIN STABLE FACTOR,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85240,CPT,CLTNG FACTOR VIII AHG 1 STG,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85244,CPT,CLTNG FACTOR VIII RELATED AG,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85245,CPT,CLTNG FACTOR VIII VW FACTOR RISTOCETIN COFACTOR,,,17 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85246,CPT,CLTNG FACTOR VIII VW FACTOR AG,,,17 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85247,CPT,CLTNG FACTOR VIII MULTMTRIC ALYS,,,17 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85250,CPT,CLTNG FACTOR IX PTC/CHRISTMAS,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85260,CPT,CLTNG FACTOR X STUART-PROWER,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85270,CPT,CLTNG FACTOR XI PTA,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85280,CPT,CLTNG FACTOR XII HAGEMAN,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85290,CPT,CLTNG FACTOR XIII FIBRIN STABILIZING,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85291,CPT,CLTNG FACTOR XIII FIBRIN STABILIZING SCR SOLUB,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85292,CPT,CLTNG PREKALLIKREIN ASSAY FLETCHER FACTOR ASSAY,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85293,CPT,CLTNG HI MOLEC WEIGHT KININOGEN ASSAY,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85300,CPT,CLTNG NHBTORS ANTITHROMBIN III ACTV,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85301,CPT,CLTNG NHBTORS ANTITHROMBIN III AG ASSAY,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85302,CPT,CLTNG NHBTORS PROTEIN C AG,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85303,CPT,CLTNG NHBTORS PROTEIN C ACTV,,,17 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85305,CPT,CLTNG NHBTORS PROTEIN S TOT,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85306,CPT,CLTNG NHBTORS PROTEIN S FR,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85307,CPT,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85335,CPT,FACTOR NHBTOR TST,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85337,CPT,THROMBOMODULIN,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85345,CPT,COAGJ TM LEE&WHITE,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85347,CPT,COAGJ TM ACTIVATED,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85348,CPT,COAGJ TM OTH METHS,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85360,CPT,EUGLOBULIN LSS,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85362,CPT,FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85366,CPT,FIBRIN DGRADJ SPLT PRODUXS PARACOAGJ,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85370,CPT,FIBRIN DGRADJ SPLT PRODUXS QUAN,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85378,CPT,FIBRIN DGRADJ PRODUXS D-DIMER QUAL/SEMIQUAN,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85379,CPT,FIBRIN DGRADJ PRODUXS D-DIMER QUAN,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85380,CPT,FIBRIN DGRADJ PRODUXS D-DIMER ULTRSENS,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85384,CPT,FIBRN ACTV,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85385,CPT,FIBRN AG,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85390,CPT,FIBRINOLYSINS/COAGULOPATHY SCR I&R,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,85390,CPT,FIBRINOLYSINS/COAGULOPATHY SCR I&R,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,85396,CPT,COAGJ/FBRNLYS ASSAY WHL BLD USE ADDITIVE PR D,,,17 ,,RBRVS,0.37 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,85397,CPT,COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL,,,17 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85400,CPT,FBRNLYC FACTORS&NHBTORS PLASMIN,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85410,CPT,FBRNLYC FACTORS&NHBTORS ALPHA-2 ANTIPLASMIN,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85415,CPT,FBRNLYC FACTORS&NHBTORS PLSMNG ACTIVATOR,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85420,CPT,FBRNLYC FACTORS&NHBTORS PLSMNG XCPT AGIC ASSAY,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85421,CPT,FBRNLYC FACTORS&NHBTORS PLSMNG AGIC ASSAY,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85441,CPT,HEINZ BODIES DIR,,,17 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85445,CPT,HEINZ BODIES INDUCED ACETYL PHENYLHYDRAZINE,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85460,CPT,HGB/RBCS FTL F&MAT HEMRRG DIFFIAL LSS,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85461,CPT,HGB/RBCS FTL F&MAT HEMRRG ROSETTE,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85475,CPT,HEMOLYSIN ACID,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85520,CPT,HEPARIN ASSAY,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85525,CPT,HEPARIN NEUTRALIZATION,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85530,CPT,HEPARIN-PROTAMINE TOLERANCE TST,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85536,CPT,IRON STAIN PRPH BLD,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85540,CPT,WBC ALKALINE PHOSPHATASE CNT,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85547,CPT,MCHNL FRAGILITY RBC,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85549,CPT,MURAMIDASE,,,17 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85555,CPT,OSMOTIC FRAGILITY RBC UNINCUBATED,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85557,CPT,OSMOTIC FRAGILITY RBC INCUBATED,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85576,CPT,PLTLT AGGREGATION EA AGT,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,85576,CPT,PLTLT AGGREGATION EA AGT,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,85597,CPT,PLTLT NEUTRALIZATION,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85598,CPT,HEXAGNAL PHOSPH PLTLT NEUTRL,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85610,CPT,PROTHROMBIN TM,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85611,CPT,PROTHROMBIN TM SUBJ PLSM FXJS EA,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85612,CPT,RUSSELL VIPR VENOM TM UNDILD,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85613,CPT,RUSSELL VIPR VENOM TM DILD,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85635,CPT,REPTILASE TST,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85651,CPT,SEDIMENTATION RATE RBC NON-AUTO,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85652,CPT,SEDIMENTATION RATE RBC AUTO,,,17 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85660,CPT,SICKLING RBC RDCTJ,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85670,CPT,THROMBIN TM PLSM,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85675,CPT,THROMBIN TM TITER,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85705,CPT,THROMBOPLASTIN NHBTION TISS,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85730,CPT,THROMBOPLASTIN TM PRTL PLSM/WHL BLD,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85732,CPT,THROMBOPLASTIN TM PRTL SUBJ PLSM FXJS EA,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85810,CPT,VISCOSITY,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,85999,CPT,UNLIS HEMATOLOGY&COAGJ,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86000,CPT,AGGLUTININS FEBRILE EA AG,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86001,CPT,ALLG SPEC IGG QUAN/SEMIQUAN EA ALLG,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86003,CPT,ALLG SPEC IGE QUAN/SEMIQUAN EA ALLG,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86005,CPT,ALLG SPEC IGE QUAL MULTIALLG SCR,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86021,CPT,ANTB ID WBC ANTIBODIES,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86022,CPT,ANTB ID PLTLT ANTIBODIES,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86023,CPT,ANTB ID PLTLT ASSOCIATED IG ASSAY,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86038,CPT,ANA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86039,CPT,ANA TITER,,,17 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86060,CPT,ANTISTREPTOLYSIN 0 TITER,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86063,CPT,ANTISTREPTOLYSIN 0 SCR,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86077,CPT,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REPRT,,,17 ,,RBRVS,0.94 ,0.34 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86078,CPT,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,,,17 ,,RBRVS,0.94 ,0.34 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86079,CPT,BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT,,,17 ,,RBRVS,0.94 ,0.35 ,0.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86140,CPT,C-REACTIVE PROTEIN,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86141,CPT,C-REACTIVE PROTEIN HI SENSITIVITY,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86146,CPT,BETA 2 GLYCOPROTEIN I ANTB EA,,,17 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86147,CPT,CARDIOLIPIN ANTB EA IG CLASS,,,17 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86148,CPT,ANTI-PHOSPHATIDYLSERINE ANTB,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86155,CPT,CHEMOTAXIS ASSAY SPEC METH,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86156,CPT,COLD AGGLUTININ SCR,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86157,CPT,COLD AGGLUTININ TITER,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86160,CPT,COMPLEMENT AG EA COMPONENT,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86161,CPT,COMPLEMENT FUNCJAL ACTV EA COMPONENT,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86162,CPT,COMPLEMENT TOT HEMOLYTIC,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86171,CPT,COMPLEMENT FIXJ TSTS EA AG,,,17 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86185,CPT,CNTERIMMUNOELECTROPHORESIS EA AG,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86200,CPT,CYCLIC CITRULLINATED PEPTIDE ANTB,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86215,CPT,DEOXYRIBONUCLEASE ANTB,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86225,CPT,DNA ANTB NATIVE/2 STRANDED,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86226,CPT,DNA ANTB 1 STRANDED,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86235,CPT,XTRCABLE NUC AG ANTB ANY METH EA ANTB,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86243,CPT,FC RCPTR,,,17 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86255,CPT,FLUORESCENT NONNFCT AGT ANTB SCR EA ANTB,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86255,CPT,FLUORESCENT NONNFCT AGT ANTB SCR EA ANTB,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86256,CPT,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTB,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86256,CPT,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTB,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86277,CPT,GROWTH HORM HUMAN ANTB,,,17 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86280,CPT,HEMAGGLUJ NHBTION TST,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86294,CPT,IA TUM AG QUAL/SEMIQUAN,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86300,CPT,IA TUM AG QUAN CA 15-3,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86301,CPT,IA TUM AG QUAN CA 19-9,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86304,CPT,IA TUM AG QUAN CA 125,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86305,CPT,HUMAN EPIDIDYMIS PROTEIN 4 (HE4),,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86308,CPT,HTROPHL ANTIBODIES SCR,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86309,CPT,HTROPHL ANTIBODIES TITER,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86310,CPT,HTROPHL ANTIBODIES TIT AFTER ABSRPJ,,,17 ,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86316,CPT,IA TUM AG OTH AG QUAN EA,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86317,CPT,IA NFCT AGT ANTB QUAN NOS,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86318,CPT,IA NFCT AGT ANTB QUAL/SEMIQUAN 1 STEP METH,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86320,CPT,IMMUNOELECTROPHORESIS SERUM,,,17 ,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86320,CPT,IMMUNOELECTROPHORESIS SERUM,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86325,CPT,IMMUNOELECTROPHORESIS OTH FLUS CONCENTRATION,,,17 ,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86325,CPT,IMMUNOELECTROPHORESIS OTH FLUS CONCENTRATION,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86327,CPT,IMMUNOELECTROPHORESIS CROSSED,,,17 ,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86327,CPT,IMMUNOELECTROPHORESIS CROSSED,26,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86329,CPT,IMMUNODIFFUSION NES,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86331,CPT,IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTB,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86332,CPT,IMMUNE CPLX ASSAY,,,17 ,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86334,CPT,IMMUNOFIXJ ELECTROPHORESIS SERUM,,,17 ,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86334,CPT,IMMUNOFIXJ ELECTROPHORESIS SERUM,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86335,CPT,IMMUNOFIXJ ELECTROPHORESIS OTH FLU,,,17 ,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,86335,CPT,IMMUNOFIXJ ELECTROPHORESIS OTH FLU,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,86336,CPT,INHIBIN,,,17 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86337,CPT,INSULIN ANTIBODIES,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86340,CPT,INTRNSC FACTOR ANTIBODIES,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86341,CPT,ISLET CELL ANTB,,,17 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86343,CPT,WBC HISTAM RLS TST,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86344,CPT,WBC PHAGOCYTOSIS,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86352,CPT,CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKER,,,17 ,,TotalUnits,,,,2.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86353,CPT,LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,,,17 ,,TotalUnits,,,,1.90 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86355,CPT,B CELLS TOT CNT,,,17 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86356,CPT,MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,,,17 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86357,CPT,NATURAL KILLER CELLS TOT CNT,,,17 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86359,CPT,T CELLS TOT CNT,,,17 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86360,CPT,T CELLS ABSOLUTE CD4&CD8 CNT RATIO,,,17 ,,TotalUnits,,,,1.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86361,CPT,T CELLS ABSOLUTE CD4 CNT,,,17 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86367,CPT,STEM CELLS TOT CNT,,,17 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86376,CPT,MICROSOMAL ANTIBODIES EA,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86378,CPT,MIGRATION NHBTORY FACTOR TST MIF,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86382,CPT,NEUTRALIZATION TST VIRAL,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86384,CPT,NITROBLUE TETRAZOLIUM DYE TST NTD,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86403,CPT,PART AGGLUJ SCR EA ANTB,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86406,CPT,PART AGGLUJ TITER EA ANTB,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86430,CPT,RHEUMATOID FACTOR QUAL,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86431,CPT,RHEUMATOID FACTOR QUAN,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86480,CPT,TUBERCULOSIS TST CELL MEDIATED IMMUNITY,,,17 ,,TotalUnits,,,,2.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86481,CPT,TB AG RESPONSE T-CELL SUSP,,,17 ,,TotalUnits,,,,2.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86485,CPT,SKN TST CANDIDA,,TC,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86486,CPT,SKIN TEST UNLISTED ANTIGEN EACH,,TC,17 ,,RBRVS,,0.12 ,0.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86490,CPT,SKN TST COCCIDIOIDOMYCOSIS,,TC,17 ,,RBRVS,,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86510,CPT,SKN TST HISTOPLASMOSIS,,TC,17 ,,RBRVS,,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86580,CPT,SKN TST TUBERCULOSIS ID,,TC,17 ,,RBRVS,,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,86590,CPT,STREPTOKINASE ANTB,,,17 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86592,CPT,SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86593,CPT,SYPHILIS TST QUAN,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86602,CPT,ANTB ACTINOMYCES,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86603,CPT,ANTB ADENOVIRUS,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86606,CPT,ANTB ASPRGILLUS,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86609,CPT,ANTB BACTERIUM NES,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86611,CPT,ANTB BARTONELLA,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86612,CPT,ANTB BLASTOMYCES,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86615,CPT,ANTB BORDETELLA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86617,CPT,ANTB BORRELIA BURGDORFERI CONFIRMATORY TST,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86618,CPT,ANTB BORRELIA BURGDORFERI LYME DISEASE,,,17 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86619,CPT,ANTB BORRELIA RELAPSING FEVER,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86622,CPT,ANTB BRUCELLA,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86625,CPT,ANTB CAMPYLOBACTER,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86628,CPT,ANTB CANDIDA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86631,CPT,ANTB CHLAMYDIA,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86632,CPT,ANTB CHLAMYDIA IGM,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86635,CPT,ANTB COCCIDIOIDES,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86638,CPT,ANTB COXIELLA BRNETII Q FEVER,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86641,CPT,ANTB CRYPTOCOCCUS,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86644,CPT,ANTB CMV CMV,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86645,CPT,ANTB CMV CMV IGM,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86648,CPT,ANTB DIPHTHERIA,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86651,CPT,ANTB ENCEPHALITIS CALIFORNIA LA CROSSE,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86652,CPT,ANTB ENCEPHALITIS EASTERN EQUINE,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86653,CPT,ANTB ENCEPHALITIS ST. LOUIS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86654,CPT,ANTB ENCEPHALITIS WSTRN EQUINE,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86658,CPT,ANTB ENTEROVIRUS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86663,CPT,ANTB EPSTEIN-BARR EB VIRUS EARLY AG EA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86664,CPT,ANTB EPSTEIN-BARR EB VIRUS NUC AG EBNA,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86665,CPT,ANTB EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86666,CPT,ANTB EHRLICHIA,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86668,CPT,ANTB FRANCISELLA TULARENSIS,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86671,CPT,ANTB FUNGUS NES,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86674,CPT,ANTB GIARDIA LAMBLIA,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86677,CPT,ANTB HELICOBACTER PYLORI,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86682,CPT,ANTB HELMINTH NES,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86684,CPT,ANTB HAEMOPHILUS INF,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86687,CPT,ANTB HTLV-I,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86688,CPT,ANTB HTLV-II,,,17 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86689,CPT,ANTB HTLV/HIV ANTB CONFIRMATORY TST,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86692,CPT,ANTB HEP DELTA AGT,,,17 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86694,CPT,ANTB HERPES SMPLX NON-SPEC TYP TST,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86695,CPT,ANTB HERPES SMPLX TYP 1,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86696,CPT,ANTB HERPES SMPLX TYP 2,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86698,CPT,ANTB HISTOPLSM,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86701,CPT,ANTB HIV-1,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86702,CPT,ANTB HIV-2,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86703,CPT,ANTB HIV-1&HIV-2 1 ASSAY,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86704,CPT,HEP B CORE ANTB HBCAB TOT,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86705,CPT,HEP B CORE ANTB HBCAB IGM ANTB,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86706,CPT,HEP B SURF ANTB HBSAB,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86707,CPT,HEP BE ANTB HBEAB,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86708,CPT,HEP ANTB HAAB TOT,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86709,CPT,HEP ANTB HAAB IGM ANTB,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86710,CPT,ANTB INF VIRUS,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86713,CPT,ANTB LEGIONELLA,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86717,CPT,ANTB LEISHMANIA,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86720,CPT,ANTB LEPTOSPIRA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86723,CPT,ANTB LISTERIA MONOCYTOGENES,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86727,CPT,ANTB LYMPHOCYTIC CHORIOMENINGITIS,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86729,CPT,ANTB LYMPHOGRANULOMA VENEREUM,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86732,CPT,ANTB MUCORMYCOSIS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86735,CPT,ANTB MUMPS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86738,CPT,ANTB MYCOPLSM,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86741,CPT,ANTB NEISSERIA MENINGITIDIS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86744,CPT,ANTB NOCARDIA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86747,CPT,ANTB PARVOVIRUS,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86750,CPT,ANTB PLASMODIUM MALARIA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86753,CPT,ANTB PROTOZOA NES,,,17 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86756,CPT,ANTB RSV,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86757,CPT,ANTB RICKETTSIA,,,17 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86759,CPT,ANTB ROTAVIRUS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86762,CPT,ANTB RUBELLA,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86765,CPT,ANTB RUBEOLA,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86768,CPT,ANTB SALMONELLA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86771,CPT,ANTB SHIGELLA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86774,CPT,ANTB TETANUS,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86777,CPT,ANTB TOXOPLSM,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86778,CPT,ANTB TOXOPLSM IGM,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86780,CPT,ANTIBODY TREPONEMA PALLIDUM,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86784,CPT,ANTB TRICHINELLA,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86787,CPT,ANTB VARICELLA-ZOSTER,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86788,CPT,ANTIBODY WEST NILE VIRUS IGM,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86789,CPT,ANTIBODY WEST NILE VIRUS,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86790,CPT,ANTB VIRUS NES,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86793,CPT,ANTB YERSINIA,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86800,CPT,THYROGLOBULIN ANTB,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86803,CPT,HEP C ANTB,,,17 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86804,CPT,HEP C ANTB CONFIRMATORY TST,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86805,CPT,LPHOCYTOTOXICITY ASSAY VIS CROSSMATCH TITRJ,,,17 ,,TotalUnits,,,,2.03 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86806,CPT,LPHOCYTOTOXICITY ASSAY VIS CROSSMATCH W/O TITRJ,,,17 ,,TotalUnits,,,,1.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86807,CPT,SERUM SCR % REACTIVE ANTB STANDARD METH,,,17 ,,TotalUnits,,,,1.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86808,CPT,SERUM SCR % REACTIVE ANTB PRA QUICK METH,,,17 ,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86812,CPT,HLA TYPING B/C 1 AG,,,17 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86813,CPT,HLA TYPING B/C MLT AGS,,,17 ,,TotalUnits,,,,2.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86816,CPT,HLA TYPING DR/DQ 1 AG,,,17 ,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86817,CPT,HLA TYPING DR/DQ MLT AGS,,,17 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86821,CPT,HLA TYPING LYMPHOCYTE CULTURE MIXED,,,17 ,,TotalUnits,,,,2.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86822,CPT,HLA TYPING LYMPHOCYTE CULTURE PRIMED,,,17 ,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86825,CPT,HLA CROSSMATCH NONCYTOTOXIC 1ST SERUM/DILUTION,,,17 ,,TotalUnits,,,,3.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86826,CPT,HLA CROSSMATCH NONCYTOTOXIC EA+ SERUM/DILUTION,,,17 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86849,CPT,UNLIS IMMUNOLOGY,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86850,CPT,ANTB SCR RBC EA SERUM TQ,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86860,CPT,ANTB ELUTION EA ELUTION,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86870,CPT,ANTB ID RBC ANTIBODIES EA PANEL EA SERUM TQ,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86880,CPT,ANTIHUMAN GLOBULIN DIR EA ANTISERUM,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86885,CPT,ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86886,CPT,ANTIHUMAN GLOBULIN INDIRECT EA ANTIBODY TITER,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86890,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE PREDEPOSITED,,,17 ,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86891,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE SALVAGE,,,17 ,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86900,CPT,BLD TYPING ABO,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86901,CPT,BLD TYPING RH D,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86902,CPT,BLOOD TYPE ANTIGEN DONOR EA,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86904,CPT,BLD TYPING AG SCR UNIT PT SERUM SCR,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86905,CPT,BLD TYPING RBC AGS OTH/THN ABO/RH D EA,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86906,CPT,BLD TYPING RH PHEXYPING COMPL,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86910,CPT,BLD TYPING PATERNITY PR INDIV ABO RH&MN,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86911,CPT,BLD TYPING PATERNITY PR INDIV EA AG SYS,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86920,CPT,COMPATIBILITY EA UNIT IMMT SPIN,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86921,CPT,COMPATIBILITY EA UNIT INCUBATION,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86922,CPT,COMPATIBILITY EA UNIT ANTIGLOBULIN,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86923,CPT,COMPATIBILITY EA UNIT ELEC,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86927,CPT,FRSH FROZEN PLSM THAWING EA UNIT,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86930,CPT,FROZEN BLD EA UNIT FRZING PREPJ,,,17 ,,TotalUnits,,,,2.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86931,CPT,FROZEN BLD EA UNIT THAWING,,,17 ,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86932,CPT,FROZEN BLD EA UNIT FRZING PREPJ&THAWING,,,17 ,,TotalUnits,,,,2.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86940,CPT,HEMOLYSINS&AGGLUTININS AUTO SCR EA,,,17 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86941,CPT,HEMOLYSINS&AGGLUTININS INCUBATED,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86945,CPT,IRRADJ BLD PRODUX EA UNIT,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86950,CPT,WBC TRANSFUSION,,,17 ,,TotalUnits,,,,1.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86960,CPT,VOL RDCTJ BLD/BLD PRODUX EA UNIT,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86965,CPT,PLING PLTLTS/OTH BLD PRODUXS,,,17 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86970,CPT,PRTX RBC ANTB CHEM AGT/DRUGS,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86971,CPT,PRTX RBC ANTB INCUBATION NZM EA,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86972,CPT,PRTX RBC ANTB DNS GRADIENT SEP,,,17 ,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86975,CPT,PRTX SRM INCUBATION DRUGS EA,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86976,CPT,PRTX SRM ANTB ID DIL,,,17 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86977,CPT,PRTX SRM ANTB ID INCUBATION NHBTORS EA,,,17 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86978,CPT,PRTX SRM ANTB ID DIFFIAL RBC ABSRPJ,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86985,CPT,SPLTTING BLD/BLD PRODUXS EA UNIT,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,86999,CPT,UNLIS TRANSFUSION MED,,,17 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87001,CPT,ANIMAL INOCULATION SM ANIMAL OBS,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87003,CPT,ANIMAL INOCULATION SM ANIMAL OBS&DSJ,,,17 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87015,CPT,CONCENTRATION NFCT AGT,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87040,CPT,CUL BACT BLD AERC ISOL,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87045,CPT,CUL BACT STL AERC ISOL SALMONELLA&SHIGELLA,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87046,CPT,CUL BACT STL AERC ADDL PATHOGENS&ID EA,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87070,CPT,CUL BACT XCPT URINE BLD/STL AERC ISOL,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87071,CPT,CUL BACT QUAN AERC ISOL XCPT UR BLD/STOOL,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87073,CPT,CUL BACT QUAN ANAERC ISOL XCPT UR BLD/STOOL,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87075,CPT,CUL BACT BLD ANAERC ISOL,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87076,CPT,CUL BACT ANAERC ADDL METHS DEFINITIVE EA ISOL,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87077,CPT,CUL BACT AERC ADDL METHS DEFINITIVE EA ISOL,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87081,CPT,CUL PRSMPTV PTHGNC ORGANISMS SCR,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87084,CPT,CUL PRSMPTV PTHGNC ORGANISMS SCR DNS CHART,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87086,CPT,CUL BACT QUAN COLONY CNT URINE,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87088,CPT,CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87101,CPT,CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87102,CPT,CUL FNGI MOLD/YEAST PRSMPTV ID OTH XCPT BLD,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87103,CPT,CUL FNGI MOLD/YEAST ISOL PRSMPTV ID ISOL BLD,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87106,CPT,CUL FNGI DEFINITIVE ID EA ORGANISM YEAST,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87107,CPT,CUL FNGI DEFINITIVE ID EA ORGANISM MOLD,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87109,CPT,CUL MYCOPLSM ANY SRC,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87110,CPT,CUL CHLAMYDIA ANY SRC,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87116,CPT,CUL TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87118,CPT,CUL MYCOBACTERIAL DEFINITIVE ID EA ISOL,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87140,CPT,CULTYP IMFLUOR METH EA ANTISERUM,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87143,CPT,CULTYP GAS LIQ CHROM/HI PRESS LIQ CHROM,,,17 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87147,CPT,CULTYP IMMUNOLOGIC OTH/THN IMFLUOR PR ANTISERUM,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87149,CPT,CULTYP NUC ACID DIR PRB CULT/ISOLATE EA ORGNISM,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87150,CPT,CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87152,CPT,CULTYP ID PLS FLD GEL TYP,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87153,CPT,CULTYP NUCLEIC ACID SEQUENCING METH EA ISOLATE,,,17 ,,TotalUnits,,,,4.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87158,CPT,CULTYP OTH METHS,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87164,CPT,DARK FLD XM ANY SRC SPEC COLLJ,,,17 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,87164,CPT,DARK FLD XM ANY SRC SPEC COLLJ,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,87166,CPT,DARK FLD XM ANY SRC W/O COLLJ,,,17 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87168,CPT,MACROSCOPIC XM ARTHROPOD,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87169,CPT,MACROSCOPIC XM PARASIT,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87172,CPT,PINWORM XM,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87176,CPT,HOMOGENIZATION TISS CUL,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87177,CPT,OVA&PARASITS DIR SMRS CONCENTRATION&ID,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87181,CPT,SC STD ANTMCRB AGT AGAR DIL METH PR AGT,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87184,CPT,SC STD ANTMCRB AGT DISK METH PR PLATE,,,17 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87185,CPT,SC STD ANTMCRB AGT ENZYME DETCJ PR NZM,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87186,CPT,SC ANTMCRB MICRODIL/AGAR EA MULTI-ANTMCRB PLATE,,,17 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87187,CPT,SC ANTMCRB MICRODIL/AGAR DIL MLC EA PLATE,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87188,CPT,SC STD ANTMCRB AGT MACROBROTH DIL METH EA AGT,,,17 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87190,CPT,SC ANTMCRB MYCOBACTERIA PROPRTN EA AGT,,,17 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87197,CPT,SERUM BACTERICIDAL TITER,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87205,CPT,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87206,CPT,SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASITS,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87207,CPT,SMR PRIM SRC SPEC STAIN BODIES/PARASITS,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,87207,CPT,SMR PRIM SRC SPEC STAIN BODIES/PARASITS,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,87209,CPT,SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,,,17 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87210,CPT,SMR PRIM SRC WET MOUNT NFCT AGT,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87220,CPT,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87230,CPT,TOXIN/ANTITOXIN ASSAY TISS CUL,,,17 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87250,CPT,VIRUS INOCULATION EGGS/SM ANIMAL OBS&DSJ,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87252,CPT,VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,,,17 ,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87253,CPT,VIRUS TISS CUL ADDL STD/ID EA ISOLATE,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87254,CPT,VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87255,CPT,VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,,,17 ,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87260,CPT,IAADI ADENOVIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87265,CPT,IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87267,CPT,IAADI ENTEROVIRUS DIR FLUORESCENT ANTB,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87269,CPT,IAADI GIARDIA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87270,CPT,IAADI CHLAMYDIA TRACHOMATIS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87271,CPT,IAADICMV DIR FLUORESCENT ANTB,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87272,CPT,IAADI CRYPTOSPORIDIUM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87273,CPT,IAADI HERPES SMPLX VIRUS TYP 2,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87274,CPT,IAADI HERPES SMPLX VIRUS TYP 1,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87275,CPT,IAADI INF B VIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87276,CPT,IAADI INF VIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87277,CPT,IAADI LEGIONELLA MICDADEI,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87278,CPT,IAADI LEGIONELLA PNEUMOPHILA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87279,CPT,IAADI PARAINF VIRUS EA TYP,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87280,CPT,IAADI RSV,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87281,CPT,IAADI PNEUMOCSTIS CARINII,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87283,CPT,IAADI RUBEOLA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87285,CPT,IAADI TREPONEMA PALLIDUM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87290,CPT,IAADI VARICELLA ZOSTER VIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87299,CPT,IAADI NOS EA ORGANISM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87300,CPT,IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87301,CPT,IAAD EIA ADENOVIRUS ENTERIC TYP 40/41,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87305,CPT,IAAD EIA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87320,CPT,IAAD EIA CHLAMYDIA TRACHOMATIS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87324,CPT,IAAD EIA CLOSTRIDIUM DIFFICILE TOXIN,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87327,CPT,IAAD EIA CRYPTOCOCCUS NEOFORMANS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87328,CPT,IAAD EIA CRYPTOSPORIDIUM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87329,CPT,IAAD EIA GIARDIA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87332,CPT,IAAD EIA CMV,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87335,CPT,IAAD EIA ESCHERICHIA COLI 0157,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87336,CPT,IAAD EIA ENTAMOEBA HISTOLYTICA DISPAR GRP,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87337,CPT,IAAD EIA ENTAMOEBA HISTOLYTICA GRP,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87338,CPT,IAAD EIA HPYLORI STOOL,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87339,CPT,IAAD EIA HPYLORI,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87340,CPT,IAAD EIA HEP B SURF AG,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87341,CPT,IAAD EIA HEP B SURF AG NEUTRALIZATION,,,17 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87350,CPT,IAAD EIA HEP BE AG,,,17 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87380,CPT,IAAD EIA HEP DELTA AGT,,,17 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87385,CPT,IAAD EIA HISTOPLSM CAPSULATUM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87390,CPT,IAAD EIA HIV-1,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87391,CPT,IAAD EIA HIV-2,,,17 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87400,CPT,IAAD EIA INF/B EA,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87420,CPT,IAAD EIA RSV,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87425,CPT,IAAD EIA ROTAVIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87427,CPT,IAAD EIA SHIGA-LIKE TOXIN,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87430,CPT,IAAD EIA STREPTOCOCCUS GRP,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87449,CPT,IAAD EIA NOS EA ORGANISM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87450,CPT,IAAD EIA NOS EA ORGANISM,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87451,CPT,IAAD EIA POLYV MLT ORGANISMS EA POLYV ANTISERUM,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87470,CPT,IADNA BARTONELLA DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87471,CPT,IADNA BARTONELLA AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87472,CPT,IADNA BARTONELLA QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87475,CPT,IADNA BORRELIA BURGDORFERI DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87476,CPT,IADNA BORRELIA BURGDORFERI AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87477,CPT,IADNA BORRELIA BURGDORFERI QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87480,CPT,IADNA CANDIDA SPECIES DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87481,CPT,IADNA CANDIDA SPECIES AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87482,CPT,IADNA CANDIDA SPECIES QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87485,CPT,IADNA CHLAMYDIA PNEUMONIAE DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87486,CPT,IADNA CHLAMYDIA PNEUMONIAE AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87487,CPT,IADNA CHLAMYDIA PNEUMONIAE QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87490,CPT,IADNA CHLAMYDIA TRACHOMATIS DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87491,CPT,IADNA CHLAMYDIA TRACHOMATIS AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87492,CPT,IADNA CHLAMYDIA TRACHOMATIS QUAN,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87493,CPT,INF AGENT DET NUC ACID CLOSTRIDIUM AMP PROBE,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87495,CPT,IADNA CMV DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87496,CPT,IADNA CMV AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87497,CPT,IADNA CMV QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87498,CPT,IADNA ENTEROVIRUS AMPLIFIED PROBE TECHNIQUE,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87500,CPT,INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87501,CPT,INFLUENZA DNA AMP PROB 1+,,,17 ,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87502,CPT,INFLUENZA DNA AMP PROBE,,,17 ,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87503,CPT,INFLUENZA DNA AMP PROB ADDL,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87510,CPT,IADNA GARDNERELLA VAGIS DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87511,CPT,IADNA GARDNERELLA VAGIS AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87512,CPT,IADNA GARDNERELLA VAGIS QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87515,CPT,IADNA HEP B VIRUS DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87516,CPT,IADNA HEP B VIRUS AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87517,CPT,IADNA HEP B VIRUS QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87520,CPT,IADNA HEP C DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87521,CPT,IADNA HEP C AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87522,CPT,IADNA HEP C QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87525,CPT,IADNA HEP G DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87526,CPT,IADNA HEP G AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87527,CPT,IADNA HEP G QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87528,CPT,IADNA HERPES SMPLX VIRUS DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87529,CPT,IADNA HERPES SMPLX VIRUS AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87530,CPT,IADNA HERPES SMPLX VIRUS QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87531,CPT,IADNA HERPES VIRUS-6 DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87532,CPT,IADNA HERPES VIRUS-6 AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87533,CPT,IADNA HERPES VIRUS-6 QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87534,CPT,IADNA HIV-1 DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87535,CPT,IADNA HIV-1 AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87536,CPT,IADNA HIV-1 QUAN,,,17 ,,TotalUnits,,,,3.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87537,CPT,IADNA HIV-2 DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87538,CPT,IADNA HIV-2 AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87539,CPT,IADNA HIV-2 QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87540,CPT,IADNA LEGIONELLA PNEUMOPHILA DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87541,CPT,IADNA LEGIONELLA PNEUMOPHILA AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87542,CPT,IADNA LEGIONELLA PNEUMOPHILA QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87550,CPT,IADNA MYCOBACTERIA SPECIES DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87551,CPT,IADNA MYCOBACTERIA SPECIES AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87552,CPT,IADNA MYCOBACTERIA SPECIES QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87555,CPT,IADNA MYCOBACTERIA TUBERCULOSIS DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87556,CPT,IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87557,CPT,IADNA MYCOBACTERIA TUBERCULOSIS QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87560,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87561,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87562,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87580,CPT,IADNA MYCOPLSM PNEUMONIAE DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87581,CPT,IADNA MYCOPLSM PNEUMONIAE AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87582,CPT,IADNA MYCOPLSM PNEUMONIAE QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87590,CPT,IADNA NEISSERIA GONORRHOEAE DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87591,CPT,IADNA NEISSERIA GONORRHOEAE AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87592,CPT,IADNA NEISSERIA GONORRHOEAE QUAN,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87620,CPT,IADNA PAPLMVIRUS HUMAN DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87621,CPT,IADNA PAPLMVIRUS HUMAN AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87622,CPT,IADNA PAPLMVIRUS HUMAN QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87640,CPT,IADNA S. AUREUS AMP PRB TQ,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87641,CPT,IADNA S. AUREUS METHICILLIN RESISTANT AMP PRB TQ,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87650,CPT,IADNA STREPTOCOCCUS GRP DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87651,CPT,IADNA STREPTOCOCCUS GRP AMP PRB,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87652,CPT,IADNA STREPTOCOCCUS GRP QUAN,,,17 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87653,CPT,IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87660,CPT,IADNA TRICHOMONAS VAGIS DIR PRB,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87797,CPT,IADNA NOS DIR PRB EA ORGANISM,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87798,CPT,IADNA NOS AMP PRB EA ORGANISM,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87799,CPT,IADNA NOS QUAN EA ORGANISM,,,17 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87800,CPT,IADNA MLT ORGANISMS DIR PRB,,,17 ,,TotalUnits,,,,1.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87801,CPT,IADNA MLT ORGANISMS AMP PRB,,,17 ,,TotalUnits,,,,2.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87802,CPT,IAADIADOO STREPTOCOCCUS GRP B,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87803,CPT,IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87804,CPT,IAADIADOO INF,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87807,CPT,IAADIADOO RSV,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87808,CPT,IAADIADOO TRICHOMONAS VAGINALIS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87809,CPT,INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87810,CPT,CHLAMYDIA TRACHOMATIS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87850,CPT,IAADIADOO NEISSERIA GONORRHOEAE,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87880,CPT,IAADIADOO STREPTOCOCCUS GRP,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87899,CPT,IAADIADOO NOS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87900,CPT,NFCT AGT DRUG SC PHEXYP PREDICT,,,17 ,,TotalUnits,,,,5.06 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87901,CPT,NFCT AGT GEXYP HIV 1,,,17 ,,TotalUnits,,,,10.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87902,CPT,NFCT AGT GEXYP HEP C VIRUS,,,17 ,,TotalUnits,,,,10.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87903,CPT,NFCT AGT PHEXYP RESISTANCE TISS CUL HIV 1 1-10,,,17 ,,TotalUnits,,,,18.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87904,CPT,NFCT AGT PHEXYP RESISTANCE TISS CUL HIV 1 EA 1-5,,,17 ,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87905,CPT,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87906,CPT,GENOTYPE DNA HIV REVERSE T,,,17 ,,TotalUnits,,,,4.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,87999,CPT,UNLIS MICROBIOLOGY,,,17 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88000,CPT,NECROPSY GROSS XM W/O CNS,,,17 ,,TotalUnits,,,,5.44 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88005,CPT,NECROPSY GROSS XM BRN,,,17 ,,TotalUnits,,,,6.26 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88007,CPT,NECROPSY GROSS XM BRN&SPI CORD,,,17 ,,TotalUnits,,,,6.80 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88012,CPT,NECROPSY GROSS XM INFT BRN,,,17 ,,TotalUnits,,,,4.90 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88014,CPT,NECROPSY GROSS XM STILLBORN/NB BRN,,,17 ,,TotalUnits,,,,4.90 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88016,CPT,NECROPSY GROSS XM MACERATED STILLBORN,,,17 ,,TotalUnits,,,,6.26 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88020,CPT,NECROPSY GROSS&MCRSCP W/O CNS,,,17 ,,TotalUnits,,,,8.43 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88025,CPT,NECROPSY GROSS&MCRSCP BRN,,,17 ,,TotalUnits,,,,9.25 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88027,CPT,NECROPSY GROSS&MCRSCP BRN&SPI CORD,,,17 ,,TotalUnits,,,,10.06 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88028,CPT,NECROPSY GROSS&MCRSCP INFT BRN,,,17 ,,TotalUnits,,,,4.90 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88029,CPT,NECROPSY GROSS&MCRSCP STILLBORN/NB BRN,,,17 ,,TotalUnits,,,,4.90 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88036,CPT,NECROPSY LMTD GROSS&/MCRSCP REGIONAL,,,17 ,,TotalUnits,,,,2.72 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88037,CPT,NECROPSY LMTD GROSS&/MCRSCP 1 ORGAN,,,17 ,,TotalUnits,,,,2.18 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88040,CPT,NECROPSY FORENSIC XM,,,17 ,,TotalUnits,,,,13.60 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88045,CPT,NECROPSY CORONER'S CALL,,,17 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88099,CPT,UNLIS NECROPSY,,,17 ,,TotalUnits,,,,8.43 ,,$0.00,$0.00,1,0,1,0,1,1,20110101,88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,,,17 ,,RBRVS,0.56 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,26,,17 ,,RBRVS,0.56 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,TC,,17 ,,RBRVS,,0.92 ,0.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,,,17 ,,RBRVS,0.56 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,26,,17 ,,RBRVS,0.56 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,TC,,17 ,,RBRVS,,1.32 ,1.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88107,CPT,CYTP FLU BR/WA XCPT C/V SMRS&FILTER INTERPJ,,,17 ,,RBRVS,0.76 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88107,CPT,CYTP FLU BR/WA XCPT C/V SMRS&FILTER INTERPJ,26,,17 ,,RBRVS,0.76 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88107,CPT,CYTP FLU BR/WA XCPT C/V SMRS&FILTER INTERPJ,TC,,17 ,,RBRVS,,1.58 ,1.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88108,CPT,CYTP CONCENTRATION SMRS&INTERPJ,,,17 ,,RBRVS,0.56 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88108,CPT,CYTP CONCENTRATION SMRS&INTERPJ,26,,17 ,,RBRVS,0.56 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88108,CPT,CYTP CONCENTRATION SMRS&INTERPJ,TC,,17 ,,RBRVS,,1.20 ,1.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,,,17 ,,RBRVS,1.18 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,26,,17 ,,RBRVS,1.18 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,TC,,17 ,,RBRVS,,1.18 ,1.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88120,CPT,CYTP URNE 3-5 PROBES EA SPEC,,,17 ,,RBRVS,1.20 ,12.22 ,12.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88120,CPT,CYTP URNE 3-5 PROBES EA SPEC,26,,17 ,,RBRVS,1.20 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88120,CPT,CYTP URNE 3-5 PROBES EA SPEC,TC,,17 ,,RBRVS,,11.91 ,11.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88121,CPT,CYTP URINE 3-5 PROBES CMPTR,,,17 ,,RBRVS,1.00 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88121,CPT,CYTP URINE 3-5 PROBES CMPTR,26,,17 ,,RBRVS,1.00 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88121,CPT,CYTP URINE 3-5 PROBES CMPTR,TC,,17 ,,RBRVS,,10.00 ,10.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88125,CPT,CYTP FORENSIC,,,17 ,,RBRVS,0.26 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88125,CPT,CYTP FORENSIC,26,,17 ,,RBRVS,0.26 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88125,CPT,CYTP FORENSIC,TC,,17 ,,RBRVS,,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88130,CPT,SEX CHROMATIN ID BARR BODIES,,,17 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88140,CPT,SEX CHROMATIN ID PRPH BLD SMR,,,17 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88141,CPT,CYTP C/V REQ INTERPJ PHYS,,PC,17 ,,RBRVS,0.42 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88142,CPT,CYTP C/V FLU AUTO THIN MNL PHYS,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88143,CPT,CYTP C/V FLU AUTO THIN MNL SCR&RESCR PHYS,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88147,CPT,CYTP SMRS C/V SCR AUTO SYS PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88148,CPT,CYTP SMRS C/V SCR AUTO SYS MNL RESCR PHYS,,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88150,CPT,CYTP SLIDES C/V MNL SCR UNDER PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88152,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88153,CPT,CYTP SLIDES C/V MNL SCR&RESCR PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88154,CPT,CYTP SLIDES C/V MNL SCR&CPTR-RESCR CELL S&R PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88155,CPT,CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL,,,17 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,,,17 ,,RBRVS,0.50 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,26,,17 ,,RBRVS,0.50 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,TC,,17 ,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,,,17 ,,RBRVS,0.50 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,26,,17 ,,RBRVS,0.50 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,TC,,17 ,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,,,17 ,,RBRVS,0.76 ,1.26 ,1.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,26,,17 ,,RBRVS,0.76 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,TC,,17 ,,RBRVS,,1.02 ,1.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88164,CPT,CYTP SLIDES C/V MNL SCR PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88165,CPT,CYTP SLIDES C/V MNL SCR&RESCR PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88166,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88167,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR CELL S&R PHYS,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHISTOLOGIC STD,,,17 ,,RBRVS,0.60 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHISTOLOGIC STD,26,,17 ,,RBRVS,0.60 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHISTOLOGIC STD,TC,,17 ,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88173,CPT,CYTP FINE NDL ASPIRATE I&R,,,17 ,,RBRVS,1.39 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88173,CPT,CYTP FINE NDL ASPIRATE I&R,26,,17 ,,RBRVS,1.39 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88173,CPT,CYTP FINE NDL ASPIRATE I&R,TC,,17 ,,RBRVS,,1.73 ,1.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88174,CPT,CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88175,CPT,CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS,,,17 ,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88177,CPT,CYTP C/V AUTO THIN LYR ADDL,,,17 ,,RBRVS,0.42 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88177,CPT,CYTP C/V AUTO THIN LYR ADDL,26,,17 ,,RBRVS,0.42 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88177,CPT,CYTP C/V AUTO THIN LYR ADDL,TC,,17 ,,RBRVS,,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88182,CPT,FLO CYTOMETRY CELL CYCLE/DNA ALYS,,,17 ,,RBRVS,0.77 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88182,CPT,FLO CYTOMETRY CELL CYCLE/DNA ALYS,26,,17 ,,RBRVS,0.77 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88182,CPT,FLO CYTOMETRY CELL CYCLE/DNA ALYS,TC,,17 ,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88184,CPT,FLO CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST,,TC,17 ,,RBRVS,,2.13 ,2.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88185,CPT,FLO CYTOMETRY CELL SURF MARKER TECHL ONLY EA,,TC,17 ,,RBRVS,,1.27 ,1.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88187,CPT,FLO CYTOMETRY INTERPJ 2-8 MARKERS,,PC,17 ,,RBRVS,1.36 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88188,CPT,FLO CYTOMETRY INTERPJ 9-15 MARKERS,,PC,17 ,,RBRVS,1.69 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88189,CPT,FLO CYTOMETRY INTERPJ 16/> MARKERS,,PC,17 ,,RBRVS,2.23 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88199,CPT,UNLIS CYTP,,,17 ,,TotalUnits,,,,2.13 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,88199,CPT,UNLIS CYTP,,PC,17 ,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,88199,CPT,UNLIS CYTP,,TC,17 ,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,88230,CPT,TISS CUL NON-NEO DISORDERS LYMPHOCYTE,,,17 ,,TotalUnits,,,,4.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88233,CPT,TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX,,,17 ,,TotalUnits,,,,5.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88235,CPT,TISS CUL NON-NEO DISORDERS AMNIOTIC/CHORNC CELLS,,,17 ,,TotalUnits,,,,5.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88237,CPT,TISS CUL NEO DISORDERS B1 MARROW BLD CELLS,,,17 ,,TotalUnits,,,,4.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88239,CPT,TISS CUL NEO DISORDERS SOLID TUM,,,17 ,,TotalUnits,,,,5.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88240,CPT,CRYOPRSRV FRZING&STORAGE CELLS EA CELL LINE,,,17 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88241,CPT,THAWING&XPNSJ FROZEN CELLS EA ALIQUOT,,,17 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88245,CPT,CHRMSM BRKG BASELINE SISTER 20-25 CLL,,,17 ,,TotalUnits,,,,5.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88248,CPT,CHRMSM BRKG BASELINE BRKG 50-100 CLL,,,17 ,,TotalUnits,,,,6.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88249,CPT,CHRMSM BRKG SYNDS SCORE 100 CLL,,,17 ,,TotalUnits,,,,6.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88261,CPT,CHRMSM CNT 5 CLL 1KARYOTYP BANDING,,,17 ,,TotalUnits,,,,6.87 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88262,CPT,CHRMSM CNT 15-20 CLL 2KARYOTYP BANDING,,,17 ,,TotalUnits,,,,4.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88263,CPT,CHRMSM CNT 45 CLL MOSAICISM 2KARYOTYP,,,17 ,,TotalUnits,,,,5.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88264,CPT,CHRMSM ANALYZE 20-25 CELLS,,,17 ,,TotalUnits,,,,4.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88267,CPT,CHRMSM ALYS AMNIOTIC/VILLUS 15 CLL 1KARYOTYP,,,17 ,,TotalUnits,,,,6.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88269,CPT,CHRMSM SITU AMNIOTIC CLL 6-12 COLONIES 1KARYOTYP,,,17 ,,TotalUnits,,,,6.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88271,CPT,MOLEC CYTOGENETICS DNA PRB EA,,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88272,CPT,MOLEC CYTG CHRMOML ISH 3-5 CLL,,,17 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88273,CPT,MOLEC CYTG CHRMOML ISH 10-30 CLL,,,17 ,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88274,CPT,MOLEC CYTG INTERPHASE ISH 25-99 CLL,,,17 ,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88275,CPT,MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL,,,17 ,,TotalUnits,,,,1.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88280,CPT,CHRMSM ALYS ADDL KARYOTYP EA STD,,,17 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88283,CPT,CHRMSM ALYS ADDL SPECIZED BANDING,,,17 ,,TotalUnits,,,,2.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88285,CPT,CHRMSM ALYS ADDL CELLS CNTED EA STD,,,17 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88289,CPT,CHRMSM ALYS ADDL HR STD,,,17 ,,TotalUnits,,,,1.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88291,CPT,CYTOGENETICS&MOLEC CYTOGENETICS I&R,,PC,17 ,,RBRVS,0.52 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88299,CPT,UNLIS CYTOGENETIC STD,,,17 ,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88300,CPT,LVL I-SURG PATH GROSS XM ONLY,,,17 ,,RBRVS,0.08 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88300,CPT,LVL I-SURG PATH GROSS XM ONLY,26,,17 ,,RBRVS,0.08 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88300,CPT,LVL I-SURG PATH GROSS XM ONLY,TC,,17 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88302,CPT,LVL II-SURG PATH GROSS&MCRSCP XM,,,17 ,,RBRVS,0.13 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88302,CPT,LVL II-SURG PATH GROSS&MCRSCP XM,26,,17 ,,RBRVS,0.13 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88302,CPT,LVL II-SURG PATH GROSS&MCRSCP XM,TC,,17 ,,RBRVS,,1.14 ,1.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88304,CPT,LEVEL III-SURG PATH GROSS&MICROSCOPIC XM,,,17 ,,RBRVS,0.22 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88304,CPT,LEVEL III-SURG PATH GROSS&MICROSCOPIC XM,26,,17 ,,RBRVS,0.22 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88304,CPT,LEVEL III-SURG PATH GROSS&MICROSCOPIC XM,TC,,17 ,,RBRVS,,1.37 ,1.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88305,CPT,LVL IV-SURG PATH GROSS&MCRSCP XM,,,17 ,,RBRVS,0.75 ,2.04 ,2.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88305,CPT,LVL IV-SURG PATH GROSS&MCRSCP XM,26,,17 ,,RBRVS,0.75 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88305,CPT,LVL IV-SURG PATH GROSS&MCRSCP XM,TC,,17 ,,RBRVS,,1.79 ,1.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88307,CPT,LVL V-SURG PATH GROSS&MCRSCP XM,,,17 ,,RBRVS,1.59 ,4.14 ,4.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88307,CPT,LVL V-SURG PATH GROSS&MCRSCP XM,26,,17 ,,RBRVS,1.59 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88307,CPT,LVL V-SURG PATH GROSS&MCRSCP XM,TC,,17 ,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88309,CPT,LVL VI-SURG PATH GROSS&MCRSCP XM,,,17 ,,RBRVS,2.80 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88309,CPT,LVL VI-SURG PATH GROSS&MCRSCP XM,26,,17 ,,RBRVS,2.80 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88309,CPT,LVL VI-SURG PATH GROSS&MCRSCP XM,TC,,17 ,,RBRVS,,4.93 ,4.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88311,CPT,DECALCIFICATION PX,,,17 ,,RBRVS,0.24 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88311,CPT,DECALCIFICATION PX,26,,17 ,,RBRVS,0.24 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88311,CPT,DECALCIFICATION PX,TC,,17 ,,RBRVS,,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88312,CPT,SPECIAL STAINS GROUP 1 MICROORGANISMS I&R EACH,,,17 ,,RBRVS,0.54 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88312,CPT,SPECIAL STAINS GROUP 1 MICROORGANISMS I&R EACH,26,,17 ,,RBRVS,0.54 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88312,CPT,SPECIAL STAINS GROUP 1 MICROORGANISMS I&R EACH,TC,,17 ,,RBRVS,,1.98 ,1.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88313,CPT,SPECIAL STAINS GROUP II ALL OTHER I&R EACH,,,17 ,,RBRVS,0.24 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88313,CPT,SPECIAL STAINS GROUP II ALL OTHER I&R EACH,26,,17 ,,RBRVS,0.24 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88313,CPT,SPECIAL STAINS GROUP II ALL OTHER I&R EACH,TC,,17 ,,RBRVS,,1.65 ,1.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88314,CPT,SPECIAL STAINS HISTOCHEMICAL W/FROZEN SECTION,,,17 ,,RBRVS,0.45 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88314,CPT,SPECIAL STAINS HISTOCHEMICAL W/FROZEN SECTION,26,,17 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88314,CPT,SPECIAL STAINS HISTOCHEMICAL W/FROZEN SECTION,TC,,17 ,,RBRVS,,1.74 ,1.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88318,CPT,DETERMINATIVE HISTOCHEMISTRY ID CHEM COMPONENTS,,,17 ,,RBRVS,0.42 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88318,CPT,DETERMINATIVE HISTOCHEMISTRY ID CHEM COMPONENTS,26,,17 ,,RBRVS,0.42 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88318,CPT,DETERMINATIVE HISTOCHEMISTRY ID CHEM COMPONENTS,TC,,17 ,,RBRVS,,2.13 ,2.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88319,CPT,DETERMINATIVE HCHEM/CCHEM ID NZM EA,,,17 ,,RBRVS,0.53 ,3.19 ,3.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88319,CPT,DETERMINATIVE HCHEM/CCHEM ID NZM EA,26,,17 ,,RBRVS,0.53 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88319,CPT,DETERMINATIVE HCHEM/CCHEM ID NZM EA,TC,,17 ,,RBRVS,,3.01 ,3.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88321,CPT,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,,,17 ,,RBRVS,1.63 ,0.53 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88323,CPT,CONSLTJ&REPRT MATRL REQ PREPJ SLIDES,,,17 ,,RBRVS,1.83 ,2.00 ,2.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88323,CPT,CONSLTJ&REPRT MATRL REQ PREPJ SLIDES,26,,17 ,,RBRVS,1.83 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88323,CPT,CONSLTJ&REPRT MATRL REQ PREPJ SLIDES,TC,,17 ,,RBRVS,,1.51 ,1.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88325,CPT,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,,,17 ,,RBRVS,2.50 ,0.88 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88329,CPT,PATH CONSLTJ SURG,,,17 ,,RBRVS,0.67 ,0.24 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,,,17 ,,RBRVS,1.19 ,1.22 ,1.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,26,,17 ,,RBRVS,1.19 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,TC,,17 ,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88332,CPT,PATH CONSLTJ SURG EA BLK FROZEN SCTJ,,,17 ,,RBRVS,0.59 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88332,CPT,PATH CONSLTJ SURG EA BLK FROZEN SCTJ,26,,17 ,,RBRVS,0.59 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88332,CPT,PATH CONSLTJ SURG EA BLK FROZEN SCTJ,TC,,17 ,,RBRVS,,0.27 ,0.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88333,CPT,PATH CONSLTJ SURG CYTOLOGIC XM 1ST SIT,,,17 ,,RBRVS,1.20 ,1.28 ,1.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88333,CPT,PATH CONSLTJ SURG CYTOLOGIC XM 1ST SIT,26,,17 ,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88333,CPT,PATH CONSLTJ SURG CYTOLOGIC XM 1ST SIT,TC,,17 ,,RBRVS,,0.85 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88334,CPT,PATH CONSLTJ SURG CYTOLOGIC XM EA SIT,,,17 ,,RBRVS,0.73 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88334,CPT,PATH CONSLTJ SURG CYTOLOGIC XM EA SIT,26,,17 ,,RBRVS,0.73 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88334,CPT,PATH CONSLTJ SURG CYTOLOGIC XM EA SIT,TC,,17 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88342,CPT,IMCYTCHM TISS IMMUNOPROXIDASE EA ANTB,,,17 ,,RBRVS,0.85 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88342,CPT,IMCYTCHM TISS IMMUNOPROXIDASE EA ANTB,26,,17 ,,RBRVS,0.85 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88342,CPT,IMCYTCHM TISS IMMUNOPROXIDASE EA ANTB,TC,,17 ,,RBRVS,,1.57 ,1.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88346,CPT,IMFLUOR STD EA ANTB DIR METH,,,17 ,,RBRVS,0.86 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88346,CPT,IMFLUOR STD EA ANTB DIR METH,26,,17 ,,RBRVS,0.86 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88346,CPT,IMFLUOR STD EA ANTB DIR METH,TC,,17 ,,RBRVS,,1.54 ,1.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88347,CPT,IMFLUOR STD EA ANTB INDIR METH,,,17 ,,RBRVS,0.86 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88347,CPT,IMFLUOR STD EA ANTB INDIR METH,26,,17 ,,RBRVS,0.86 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88347,CPT,IMFLUOR STD EA ANTB INDIR METH,TC,,17 ,,RBRVS,,1.01 ,1.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88348,CPT,ELECTRON MIC DX,,,17 ,,RBRVS,1.51 ,15.54 ,15.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88348,CPT,ELECTRON MIC DX,26,,17 ,,RBRVS,1.51 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88348,CPT,ELECTRON MIC DX,TC,,17 ,,RBRVS,,15.05 ,15.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88349,CPT,ELECTRON MIC SCANNING,,,17 ,,RBRVS,0.76 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88349,CPT,ELECTRON MIC SCANNING,26,,17 ,,RBRVS,0.76 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88349,CPT,ELECTRON MIC SCANNING,TC,,17 ,,RBRVS,,7.49 ,7.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88355,CPT,M/PHMTRC ALYS SKEL MUSC,,,17 ,,RBRVS,1.85 ,4.14 ,4.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88355,CPT,M/PHMTRC ALYS SKEL MUSC,26,,17 ,,RBRVS,1.85 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88355,CPT,M/PHMTRC ALYS SKEL MUSC,TC,,17 ,,RBRVS,,3.67 ,3.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88356,CPT,M/PHMTRC ALYS NRV,,,17 ,,RBRVS,3.02 ,4.59 ,4.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88356,CPT,M/PHMTRC ALYS NRV,26,,17 ,,RBRVS,3.02 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88356,CPT,M/PHMTRC ALYS NRV,TC,,17 ,,RBRVS,,3.94 ,3.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88358,CPT,M/PHMTRC ALYS TUM,,,17 ,,RBRVS,0.95 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88358,CPT,M/PHMTRC ALYS TUM,26,,17 ,,RBRVS,0.95 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88358,CPT,M/PHMTRC ALYS TUM,TC,,17 ,,RBRVS,,0.81 ,0.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88360,CPT,M/PHMTRC ALYS TUM IMHCHEM EA ANTB MNL,,,17 ,,RBRVS,1.10 ,2.13 ,2.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88360,CPT,M/PHMTRC ALYS TUM IMHCHEM EA ANTB MNL,26,,17 ,,RBRVS,1.10 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88360,CPT,M/PHMTRC ALYS TUM IMHCHEM EA ANTB MNL,TC,,17 ,,RBRVS,,1.79 ,1.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88361,CPT,M/PHMTRC ALYS TUM IMHCHEM EA ANTB CPTR,,,17 ,,RBRVS,1.18 ,2.77 ,2.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88361,CPT,M/PHMTRC ALYS TUM IMHCHEM EA ANTB CPTR,26,,17 ,,RBRVS,1.18 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88361,CPT,M/PHMTRC ALYS TUM IMHCHEM EA ANTB CPTR,TC,,17 ,,RBRVS,,2.43 ,2.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88362,CPT,NRV TEASING PREPJS,,,17 ,,RBRVS,2.17 ,4.99 ,4.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88362,CPT,NRV TEASING PREPJS,26,,17 ,,RBRVS,2.17 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88362,CPT,NRV TEASING PREPJS,TC,,17 ,,RBRVS,,4.28 ,4.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88363,CPT,XM ARCHIVE TISSUE MOLEC ANAL,,,17 ,,RBRVS,0.37 ,0.72 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88365,CPT,SITU HYBRIDIZATION EA PRB,,,17 ,,RBRVS,1.20 ,3.07 ,3.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88365,CPT,SITU HYBRIDIZATION EA PRB,26,,17 ,,RBRVS,1.20 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88365,CPT,SITU HYBRIDIZATION EA PRB,TC,,17 ,,RBRVS,,2.70 ,2.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88367,CPT,M/PHMTRC ALYS ISH EA PRB CPTR-ASST TECHNOLOGY,,,17 ,,RBRVS,1.30 ,5.15 ,5.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88367,CPT,M/PHMTRC ALYS ISH EA PRB CPTR-ASST TECHNOLOGY,26,,17 ,,RBRVS,1.30 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88367,CPT,M/PHMTRC ALYS ISH EA PRB CPTR-ASST TECHNOLOGY,TC,,17 ,,RBRVS,,4.80 ,4.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88368,CPT,M/PHMTRC ALYS ISH EA PRB MNL,,,17 ,,RBRVS,1.40 ,4.26 ,4.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88368,CPT,M/PHMTRC ALYS ISH EA PRB MNL,26,,17 ,,RBRVS,1.40 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88368,CPT,M/PHMTRC ALYS ISH EA PRB MNL,TC,,17 ,,RBRVS,,3.93 ,3.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88371,CPT,PROTEIN ALYS WSTRN BLOT I&R,,,17 ,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,88371,CPT,PROTEIN ALYS WSTRN BLOT I&R,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,88372,CPT,PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA,,,17 ,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,88372,CPT,PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA,26,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,,,17 ,,RBRVS,1.56 ,3.69 ,3.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,26,,17 ,,RBRVS,1.56 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,TC,,17 ,,RBRVS,,3.16 ,3.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,,,17 ,,RBRVS,1.18 ,4.11 ,4.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,26,,17 ,,RBRVS,1.18 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,TC,,17 ,,RBRVS,,3.77 ,3.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88384,CPT,RA-BASED EVAL MLT MOLEC PRBS 11 THRU 50 PRBS,,,17 ,,TotalUnits,,,,6.47 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,88384,CPT,RA-BASED EVAL MLT MOLEC PRBS 11 THRU 50 PRBS,26,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,88384,CPT,RA-BASED EVAL MLT MOLEC PRBS 11 THRU 50 PRBS,TC,,17 ,,TotalUnits,,,,5.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88385,CPT,RA-BASED EVAL MLT MOLEC PRBS 51 THRU 250 PRBS,,,17 ,,RBRVS,1.50 ,15.40 ,15.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88385,CPT,RA-BASED EVAL MLT MOLEC PRBS 51 THRU 250 PRBS,26,,17 ,,RBRVS,1.50 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88385,CPT,RA-BASED EVAL MLT MOLEC PRBS 51 THRU 250 PRBS,TC,,17 ,,RBRVS,,14.99 ,14.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88386,CPT,RA-BASED EVAL MLT MOLEC PRBS 251 THRU 500 PRBS,,,17 ,,RBRVS,1.88 ,15.91 ,15.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88386,CPT,RA-BASED EVAL MLT MOLEC PRBS 251 THRU 500 PRBS,26,,17 ,,RBRVS,1.88 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,88386,CPT,RA-BASED EVAL MLT MOLEC PRBS 251 THRU 500 PRBS,TC,,17 ,,RBRVS,,15.23 ,15.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,,17 ,,RBRVS,0.62 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,PC,17 ,,RBRVS,0.62 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,TC,17 ,,RBRVS,,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SEC,,,17 ,,RBRVS,0.45 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SEC,,PC,17 ,,RBRVS,0.45 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SEC,,TC,17 ,,RBRVS,,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,88399,CPT,UNLIS SURG PATH PX,,,17 ,,TotalUnits,,,,4.46 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,88399,CPT,UNLIS SURG PATH PX,,PC,17 ,,TotalUnits,,,,1.60 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,88399,CPT,UNLIS SURG PATH PX,,TC,17 ,,TotalUnits,,,,2.86 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,88720,CPT,BILIRUBIN TOTAL TRANSCUTANEOUS,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88738,CPT,HGB QUANTITATIVE TRANSCUTANEOUS,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88740,CPT,HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,88741,CPT,HEMOGLOBIN QUANTITATIVE TC PER DAY METHEMOGLOBIN,,,17 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89049,CPT,CAFFEINE HALOTHANE CONTRCURE,,,17 ,,RBRVS,1.40 ,0.41 ,5.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,89050,CPT,C-CNT MISC BDY FLUS XCPT BLD,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89051,CPT,C-CNT MISC BDY FLUS XCPT BLD DIFFIAL CNT,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89055,CPT,WBC ASSMT FECAL QUAL/SEMIQUAN,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89060,CPT,CRYSTAL ID LIGHT MIC ALYS TISSUE/ANY FLU,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,89060,CPT,CRYSTAL ID LIGHT MIC ALYS TISSUE/ANY FLU,26,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,89125,CPT,FAT STAIN FECES URINE/RESPIR SECRETIONS,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89160,CPT,MEAT FIBERS FECES,,,17 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89190,CPT,NSL SMR EOSINOPHILS,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89220,CPT,SPTM OBTG SPEC AERSL INDUCED SPX,,TC,17 ,,RBRVS,,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,89230,CPT,SWEAT COLLJ IONTOPHORESIS,,TC,17 ,,RBRVS,,0.11 ,0.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,89240,CPT,UNLIS MISC PATH,,,17 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89250,CPT,CUL OOCYTE/EMBRYO < 4 D,,,17 ,,TotalUnits,,,,11.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89251,CPT,CUL OOCYTE/EMBRYO < 4 D CO-CULT OCYTE/EMBRY,,,17 ,,TotalUnits,,,,12.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89253,CPT,ASSTD EMBRYO HATCHING MICROTQS ANY METH,,,17 ,,TotalUnits,,,,5.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89254,CPT,OOCYTE ID FROM FOLLICULAR FLU,,,17 ,,TotalUnits,,,,6.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89255,CPT,PREPJ EMBRYO TR,,,17 ,,TotalUnits,,,,4.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89257,CPT,SPRM ID FROM ASPIR OTH/THN SEMINAL,,,17 ,,TotalUnits,,,,5.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89258,CPT,CRYOPRSRV EMBRYO,,,17 ,,TotalUnits,,,,5.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89259,CPT,CRYOPRSRV SPRM,,,17 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89260,CPT,SPRM ISOL SMPL PREP INSEMINATION/DX SEMEN ALYS,,,17 ,,TotalUnits,,,,1.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89261,CPT,SPRM ISOL CPLX PREP INSEMINATION/DX SEMEN ALYS,,,17 ,,TotalUnits,,,,2.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89264,CPT,SPRM ID FROM TSTIS TISS FRSH/CRYOPRSRVD,,,17 ,,TotalUnits,,,,5.04 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89268,CPT,INSEMINATION OOCYTES,,,17 ,,TotalUnits,,,,4.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89272,CPT,EXTND CUL OOCYTE/EMBRYO 4-7 D,,,17 ,,TotalUnits,,,,8.36 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89280,CPT,ASSTD FERTILIZATION MICROTQ </EQUAL 10 OOCYTES,,,17 ,,TotalUnits,,,,12.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89281,CPT,ASSTD FERTILIZATION MICROTQ > 10 OOCYTES,,,17 ,,TotalUnits,,,,14.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89290,CPT,BX OOCYTE MICROTQ </EQUAL 5 EMBRY,,,17 ,,TotalUnits,,,,22.24 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89291,CPT,BX OOCYTE MICROTQ > 5 EMBRY,,,17 ,,TotalUnits,,,,14.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89300,CPT,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89310,CPT,SEMEN ALYS MOTILITY&CNT X W/HUHNER TST,,,17 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89320,CPT,SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89321,CPT,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89322,CPT,SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,,,17 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89325,CPT,SPRM ANTIBODIES,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89329,CPT,SPRM EVAL HAMSTER PENETRATION TST,,,17 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89330,CPT,SPRM EVAL CRV MUCUS PENETRATION,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89331,CPT,SPERM EVALUATION RETROGRADE EJACULATION URINE,,,17 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89342,CPT,STORAGE PR YR EMBRYO,,,17 ,,TotalUnits,,,,2.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89343,CPT,STORAGE PR YR SPRM/SEMEN,,,17 ,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89352,CPT,THAWING CRYOPRSRVD EMBRYO,,,17 ,,TotalUnits,,,,5.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89353,CPT,THAWING CRYOPRSRVD SPRM/SEMEN EA ALIQUOT,,,17 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,89398,CPT,UNLISTED REPRODUCTIVE MEDICINE LAB PROCEDURE,,,17 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90281,CPT,IMMUNE GLOBULIN IG HUMAN IM USE,,,22 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90283,CPT,IMMUNE GLOBULIN IGIV HUMAN IV USE,,,22 ,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90284,CPT,IMMUNE GLOBULIN HUMAN SUBQ INFUSION 100 MG EA,,,22 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90287,CPT,BOTULINUM ANTITOXIN EQUINE ANY ROUTE,,,22 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90296,CPT,DIPHTHERIA ANTITOXIN EQUINE ANY ROUTE,,,22 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90371,CPT,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,,,22 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90375,CPT,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,,,22 ,,TotalUnits,,,,2.90 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90376,CPT,RABIES IG HEAT-TREATED HUMAN IM/SUBQ,,,22 ,,TotalUnits,,,,2.90 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90378,CPT,RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E,,,22 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90384,CPT,RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM,,,22 ,,TotalUnits,,,,1.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90385,CPT,RHO(D) IMMUNE GLOBULIN HUMAN MINI-DOSE IM,,,22 ,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90386,CPT,RHO(D) IMMUNE GLOBULIN HUMAN IV,,,22 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90389,CPT,TETANUS IMMUNE GLOBULIN TIG HUMAN IM,,,22 ,,TotalUnits,,,,1.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90396,CPT,VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM,,,22 ,,TotalUnits,,,,2.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90399,CPT,UNLISTED IMMUNE GLOBULIN,,,22 ,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90460,CPT,IMADM ANY ROUTE 1ST VAC/TOX,,,9 ,,RBRVS,0.17 ,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90461,CPT,INADM ANY ROUTE ADDL VAC/TOX,,,9 ,,RBRVS,0.15 ,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90470,CPT,IMMUNE ADMIN H1N1 IM/NASAL,,,9 ,,RBRVS,0.20 ,0.42 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90471,CPT,IMADM PRQ ID SUBQ/IM NJXS 1 VACC,,,9 ,,RBRVS,0.17 ,0.41 ,0.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90472,CPT,IMADM PRQ ID SUBQ/IM NJXS EA VACC,,,9 ,,RBRVS,0.15 ,0.06 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90473,CPT,IMADM INTRANSL/ORAL 1 VACC,,,9 ,,RBRVS,0.17 ,0.05 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90474,CPT,IMADM INTRANSL/ORAL EA VACC,,,9 ,,RBRVS,0.15 ,0.05 ,0.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90476,CPT,ADENOVIRUS VACCINE TYPE 4 LIVE ORAL,,,9 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90477,CPT,ADENOVIRUS VACCINE TYPE 7 LIVE FOR ORAL,,,9 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90581,CPT,ANTHRAX VACCINE SUBCUTANEOUS USE,,,9 ,,RBRVS,,2.81 ,2.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,90585,CPT,BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ,,,9 ,,TotalUnits,,,,3.64 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90586,CPT,BCG BLDR CANCER LIVE INTRAVESICAL,,,9 ,,TotalUnits,,,,5.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90632,CPT,HEPATITIS A VACCINE ADULT FOR INTRAMUSCULAR USE,,,9 ,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90633,CPT,HEPATITIS A VACCINE PEDIATRIC 2 DOSE SCHEDULE IM,,,9 ,,TotalUnits,,,,1.07 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90634,CPT,HEPATITIS A VACCINE PEDIATRIC 3 DOSE SCHEDULE IM,,,9 ,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90636,CPT,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,,,9 ,,TotalUnits,,,,2.82 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90645,CPT,HEMOPHILUS INFLUENZA B VACC HBOC CONJ 4 DOSE IM,,,9 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90646,CPT,HEMOPHILUS INFLUENZA B VACCINE PRP-D BOOSTER IM,,,9 ,,TotalUnits,,,,1.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90647,CPT,HEMOPHILUS INFLUENZA B VACCINE PRP-OMP 3 DOSE IM,,,9 ,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90648,CPT,HEMOPHILUS INFLUENZA B VACCINE PRP-T 4 DOSE IM,,,9 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90649,CPT,HUMAN PAPILLOMA VIRUS VACCINE QUADRIV 3 DOSE IM,,,9 ,,TotalUnits,,,,3.69 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90650,CPT,HPV VACCINE BIVALENT 3 DOSE IM,,,9 ,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90654,CPT,"FLU VACCINE NO PRESERV, ID",,,9 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90655,CPT,INFLUENZA VIRUS VACC SPLIT PRSRV FREE 6-35 MO IM,,,9 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90656,CPT,INFLUENZA VIRUS VACC SPLIT PRSRV FR 3 YEARS + IM,,,9 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90657,CPT,INFLUENZA VIRUS VACCINE SPLIT VIRUS 6-35 MO IM,,,9 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90658,CPT,INFLUENZA VIRUS VACCINE SPLIT VIRUS 3 YEARS + IM,,,9 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90660,CPT,INFLUENZA VIRUS VACCINE LIVE INTRANASAL,,,9 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90661,CPT,INFLUENZA VACCINE CELL CULT PRSRV FREE IM,,,9 ,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90662,CPT,INFLUENZA VACCINE SPLT PRSRV FREE INC ANTIGEN IM,,,9 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90664,CPT,FLU VACC PANDEMIC LIVE NASAL ,,,9 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90665,CPT,LYME DISEASE VACCINE ADULT DOSAGE IM,,,9 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90666,CPT,FLU VACC PANDEMIC NO PRSV IM ,,,9 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90667,CPT,FLU VACC PANDEMIC ADJ IM ,,,9 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90668,CPT,FLU VACC PANDEMIC SPLT V IM ,,,9 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90669,CPT,PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM,,,9 ,,TotalUnits,,,,2.31 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90675,CPT,RABIES VACCINE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,5.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90676,CPT,RABIES VACCINE INTRADERMAL,,,9 ,,TotalUnits,,,,2.94 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90680,CPT,ROTAVIRUS VACCINE PENTAVALENT 3 DOSE LIVE ORAL,,,9 ,,TotalUnits,,,,2.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90681,CPT,ROTAVIRUS VACC HUMAN ATTENUATED 2 DOSE LIVE ORAL,,,9 ,,TotalUnits,,,,2.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90690,CPT,TYPHOID VACCINE LIVE ORAL,,,9 ,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90691,CPT,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,,,9 ,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90692,CPT,TYPHOID VACC H-P INACTIVATED SUBQ/INTRADERMAL,,,9 ,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90693,CPT,TYPHOID VACCINE AKD SUBQ U.S. MILITARY,,,9 ,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90696,CPT,DTAP-IPV INACTIVATED IF ADMIN PTS AGE 4-6 YRS IM,,,9 ,,TotalUnits,,,,1.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90698,CPT,DTAP-HIB-IPV VACCINE IM,,,9 ,,TotalUnits,,,,2.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90700,CPT,DTAP VACCINE < 7 YR IM,,,9 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90701,CPT,DIPHTHERIA TETANUS TOXOID PERTUSSIS VACCINE IM,,,9 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90702,CPT,DIPHTHERIA TETANUS TOXOID ADSORBED < 7 YR IM,,,9 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90703,CPT,TETANUS TOXOID ADSORBED INTRAMUSCULAR,,,9 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90704,CPT,MUMPS VIRUS VACCINE LIVE SUBCUTANEOUS,,,9 ,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90705,CPT,MEASLES VIRUS VACCINE LIVE SUBCUTANEOUS,,,9 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90706,CPT,RUBELLA VIRUS VACCINE LIVE SUBCUTANEOUS,,,9 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90707,CPT,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,,,9 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90708,CPT,MEASLES & RUBELLA VIRUS VACCINE LIVE SUBQ,,,9 ,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90710,CPT,MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ,,,9 ,,TotalUnits,,,,3.88 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90712,CPT,POLIOVIRUS VACCINE ANY LIVE ORAL,,,9 ,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90713,CPT,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,,,9 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90714,CPT,TD TOXOIDS ADSORBED PRSRV FR 7 YR + IM,,,9 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90715,CPT,TDAP VACCINE 7 YR + IM,,,9 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90716,CPT,VARICELLA VIRUS VACCINE LIVE SUBQ,,,9 ,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90717,CPT,YELLOW FEVER VACCINE LIVE SUBQ,,,9 ,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90718,CPT,TETANUS & DIPHTHERIA TOXOIDS ADSORBED 7 YR + IM,,,9 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90719,CPT,DIPHTHERIA TOXOID INTRAMUSCULAR,,,9 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90720,CPT,DTP-HIB VACCINE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90721,CPT,DTAP-HIB VACCINE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90723,CPT,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90725,CPT,CHOLERA VACCINE INJECTABLE,,,9 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90727,CPT,PLAGUE VACCINE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90732,CPT,PNEUMOCOCCAL POLYSAC VACCINE 23-V 2 YR + SUBQ/IM,,,9 ,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90733,CPT,MENINGOCOCCAL POLYSAC VACCINE SUBCUTANEOUS,,,9 ,,TotalUnits,,,,2.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90734,CPT,MENINGOCOCCAL CONJ VACCINE TETRAVALENT IM,,,9 ,,TotalUnits,,,,2.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90735,CPT,JAPANESE ENCEPHALITIS VIRUS VACCINE SUBCUTANEOUS,,,9 ,,TotalUnits,,,,3.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90736,CPT,ZOSTER SHINGLES VACCINE LIVE SUBCUTANEOUS,,,9 ,,TotalUnits,,,,4.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90738,CPT,JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM,,,9 ,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90740,CPT,HEPATITIS B VACCINE DIALYSIS DOSAGE 3 DOSE IM,,,9 ,,TotalUnits,,,,5.58 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90743,CPT,HEPATITIS B VACCINE ADOLESCENT 2 DOSE IM,,,9 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90744,CPT,HEPATITIS B VACCINE PEDIATRIC3 DOSE IM,,,9 ,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90746,CPT,HEPATITIS B VACCINE ADULT DOSAGE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90747,CPT,HEPATITIS B VACCINE DIALYSIS DOSAGE 4 DOSE IM,,,9 ,,TotalUnits,,,,6.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90748,CPT,HEPB-HIB VACCINE INTRAMUSCULAR,,,9 ,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90749,CPT,UNLISTED VACCINE/TOXOID,,,9 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,90801,CPT,PSYC DX INTERVIEW XM,,,16 ,,RBRVS,2.80 ,0.65 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90802,CPT,IA PSYC DX INTERVIEW XM W/PLAY,,,16 ,,RBRVS,3.01 ,0.71 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90804,CPT,IPI-OB-M/S OFFICE 20-30 MIN,,,16 ,,RBRVS,1.21 ,0.23 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90805,CPT,IPI-OB-M/S OFFICE 20-30 MIN MEDICAL E/M,,,16 ,,RBRVS,1.37 ,0.28 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90806,CPT,IPI-OB-M/S OFFICE 45-50 MIN,,,16 ,,RBRVS,1.86 ,0.36 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90807,CPT,IPI-OB-M/S OFFICE 45-50 MIN MEDICAL E/M,,,16 ,,RBRVS,2.02 ,0.41 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90808,CPT,IPI-OB-M/S OFFICE 75-80 MIN,,,16 ,,RBRVS,2.79 ,0.54 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90809,CPT,IPI-OB-M/S OFFICE 75-80 MIN MEDICAL E/M,,,16 ,,RBRVS,2.95 ,0.62 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90810,CPT,INDIV PSYCTX IA 20-30 MIN,,,16 ,,RBRVS,1.32 ,0.26 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90811,CPT,INDIV PSYCTX IA 20-30 MIN MEDICAL E/M,,,16 ,,RBRVS,1.48 ,0.31 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90812,CPT,INDIV PSYCTX IA 45-50 MIN,,,16 ,,RBRVS,1.97 ,0.38 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90813,CPT,INDIV PSYCTX IA 45-50 MIN MEDICAL E/M,,,16 ,,RBRVS,2.13 ,0.44 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90814,CPT,INDIV PSYCTX IA 75-80 MIN,,,16 ,,RBRVS,2.90 ,0.61 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90815,CPT,INDIV PSYCTX IA 75-80 MIN MEDICAL E/M,,,16 ,,RBRVS,3.06 ,0.64 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90816,CPT,IPI-OB-M/S I/P 20-30 MIN,,,16 ,,RBRVS,1.25 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90817,CPT,IPI-OB-M/S I/P 20-30 MIN MEDICAL E/M,,,16 ,,RBRVS,1.41 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90818,CPT,IPI-OB-M/S I/P 45-50 MIN,,,16 ,,RBRVS,1.89 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90819,CPT,IPI-OB-M/S I/P 45-50 MIN MEDICAL E/M,,,16 ,,RBRVS,2.05 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90821,CPT,IPI-OB-M/S I/P 75-80 MIN,,,16 ,,RBRVS,2.83 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90822,CPT,IPI-OB-M/S I/P 75-80 MIN MEDICAL E/M,,,16 ,,RBRVS,2.99 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90823,CPT,INDIV PSYCTX IA I/P 20-30 MIN,,,16 ,,RBRVS,1.36 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90824,CPT,INDIV PSYCTX IA I/P 20-30 MIN MEDICAL E/M,,,16 ,,RBRVS,1.52 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90826,CPT,INDIV PSYCTX IA I/P 45-50 MIN,,,16 ,,RBRVS,2.01 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90827,CPT,INDIV PSYCTX IA I/P 45-50 MIN MEDICAL E/M,,,16 ,,RBRVS,2.16 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90828,CPT,INDIV PSYCTX IA I/P 75-80 MIN,,,16 ,,RBRVS,2.94 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90829,CPT,INDIV PSYCTX IA I/P 75-80 MIN MEDICAL E/M,,,16 ,,RBRVS,3.10 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90845,CPT,PSYCHOALYS,,,16 ,,RBRVS,1.79 ,0.38 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90846,CPT,FAM PSYCTX W/O PT PRESENT,,,16 ,,RBRVS,1.83 ,0.46 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90847,CPT,FAM PSYCTX W/PT PRESENT,,,16 ,,RBRVS,2.21 ,0.53 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90849,CPT,MLT-FAM GRP PSYCTX,,,16 ,,RBRVS,0.59 ,0.21 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90853,CPT,GRP PSYCTX,,,16 ,,RBRVS,0.59 ,0.21 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90857,CPT,IA GRP PSYCTX,,,16 ,,RBRVS,0.63 ,0.22 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90862,CPT,PHARMACOLOGIC MGMT MIN MEDICAL PSYCTX,,,16 ,,RBRVS,0.95 ,0.28 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90865,CPT,NARCOSYNTHESIS PSYC DX&THER PURPOSES,,,16 ,,RBRVS,2.84 ,0.70 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90870,CPT,ELECTROCONVULSIVE THER,,,16 ,,RBRVS,1.88 ,0.43 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90875,CPT,INDIV PSYCPHYSTX BFB TRAINJ 20-30 MIN,,,16 ,,RBRVS,1.20 ,0.43 ,0.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90876,CPT,INDIV PSYCPHYSTX BFB TRAINJ 45-50 MIN,,,16 ,,RBRVS,1.90 ,0.68 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90880,CPT,HYPXH,,,16 ,,RBRVS,2.19 ,0.44 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90882,CPT,ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT,,,16 ,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,90885,CPT,PSYC EVAL HOSP RECORDS DX PURPOSES,,,16 ,,RBRVS,0.97 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90887,CPT,INTERPJ/EXPLNAJ RESULTS PSYC XMS FAM,,,16 ,,RBRVS,1.48 ,0.53 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90889,CPT,PREPJ REPORT PSYC STATUS,,,16 ,,TotalUnits,,,,2.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,90899,CPT,UNLIS PSYC SVC/PX,,,16 ,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,90901,CPT,BFB TRAINJ ANY MODALITY,,,14 ,,RBRVS,0.41 ,0.12 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90911,CPT,BFB TRAINJ PRNL MUSC,,,14 ,,RBRVS,0.89 ,0.32 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90935,CPT,HEMO PX W/1 PHYS EVAL,,,14 ,,RBRVS,1.22 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90937,CPT,HEMO REPEATED EVAL +-REVJ DIAL RX,,,14 ,,RBRVS,2.11 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90940,CPT,HEMO ACCESS FLO STD,,,14 ,,TotalUnits,,,,1.28 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,90945,CPT,DIAL OTH/THN HEMO 1 PHYS EVAL,,,14 ,,RBRVS,1.28 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90947,CPT,DIAL OTH/THN HEMO REPEATED PHYS EVALS,,,14 ,,RBRVS,2.16 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90951,CPT,ESRD RELATED SVC MONTHLY <2 YR OLD 4/>VISITS,,,14 ,,RBRVS,18.46 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90952,CPT,ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS,,,14 ,,RBRVS,7.07 ,12.37 ,12.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90953,CPT,ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT,,,14 ,,RBRVS,4.72 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90954,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/>VISITS,,,14 ,,RBRVS,15.98 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90955,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,,,14 ,,RBRVS,8.79 ,3.44 ,3.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90956,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,,,14 ,,RBRVS,5.95 ,2.28 ,2.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90957,CPT,ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/>VISITS,,,14 ,,RBRVS,12.52 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90958,CPT,ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS,,,14 ,,RBRVS,8.34 ,3.38 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90959,CPT,ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT,,,14 ,,RBRVS,5.50 ,2.14 ,2.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90960,CPT,ESRD RELATED SVC MONTHLY 20&> YR OLD 4/> VISITS,,,14 ,,RBRVS,5.18 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90961,CPT,ESRD RELATED SVC MONTHLY 20&> YR OLD 2/3 VISITS,,,14 ,,RBRVS,4.26 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90962,CPT,ESRD RELATED SVC MONTHLY 20&> YR OLD 1 VISIT,,,14 ,,RBRVS,3.15 ,1.32 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90963,CPT,ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD,,,14 ,,RBRVS,10.56 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90964,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,,,14 ,,RBRVS,9.14 ,3.26 ,3.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90965,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD,,,14 ,,RBRVS,8.69 ,3.13 ,3.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90966,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,,,14 ,,RBRVS,4.26 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90967,CPT,ESRD RELATED SVC <FULL MONTH < 2 YR OLD,,,14 ,,RBRVS,0.35 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90968,CPT,ESRD RELATED SVC <FULL MONTH 2-11 YR OLD,,,14 ,,RBRVS,0.30 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90969,CPT,ESRD RELATED SVC <FULL MONTH 12-19 YR OLD,,,14 ,,RBRVS,0.29 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90970,CPT,ESRD RELATED SVC <FULL MONTH 20&> YR OLD,,,14 ,,RBRVS,0.14 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90989,CPT,DIAL TRAINJ COMPLD COURSE,,,14 ,,TotalUnits,,,,8.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,90993,CPT,DIAL TRAINJ COURSE X COMPLD PR SESS,,,14 ,,TotalUnits,,,,1.73 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,90997,CPT,HEMOPRFJ,,,14 ,,RBRVS,1.84 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,90999,CPT,UNLIS DIAL I/P/O/P,,,14 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,91010,CPT,ESOPHGL MOTILITY STD,,,14 ,,RBRVS,1.25 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91010,CPT,ESOPHGL MOTILITY STD,26,,14 ,,RBRVS,1.25 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91010,CPT,ESOPHGL MOTILITY STD,TC,,14 ,,RBRVS,,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91013,CPT,ESOPHGL MOTIL W/STIM/PERFUS,,,14 ,,RBRVS,0.18 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91013,CPT,ESOPHGL MOTIL W/STIM/PERFUS,26,,14 ,,RBRVS,0.18 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91013,CPT,ESOPHGL MOTIL W/STIM/PERFUS,TC,,14 ,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91020,CPT,GSTR MOTILITY STD,,,14 ,,RBRVS,1.44 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91020,CPT,GSTR MOTILITY STD,26,,14 ,,RBRVS,1.44 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91020,CPT,GSTR MOTILITY STD,TC,,14 ,,RBRVS,,4.01 ,4.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91022,CPT,DUOL MOTILITY STD,,,14 ,,RBRVS,1.44 ,3.42 ,3.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91022,CPT,DUOL MOTILITY STD,26,,14 ,,RBRVS,1.44 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91022,CPT,DUOL MOTILITY STD,TC,,14 ,,RBRVS,,2.75 ,2.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91030,CPT,ESOPH ACID PRFJ TST ESOPHAGITIS,,,14 ,,RBRVS,0.91 ,2.72 ,2.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91030,CPT,ESOPH ACID PRFJ TST ESOPHAGITIS,26,,14 ,,RBRVS,0.91 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91030,CPT,ESOPH ACID PRFJ TST ESOPHAGITIS,TC,,14 ,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91034,CPT,ESOPH G-ESOP RFLX NCATH ELTRD PLMT,,,14 ,,RBRVS,0.97 ,4.19 ,4.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91034,CPT,ESOPH G-ESOP RFLX NCATH ELTRD PLMT,26,,14 ,,RBRVS,0.97 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91034,CPT,ESOPH G-ESOP RFLX NCATH ELTRD PLMT,TC,,14 ,,RBRVS,,3.77 ,3.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91035,CPT,ESOPH G-ESOP RFLX TLMTR ELTRD PLMT,,,14 ,,RBRVS,1.59 ,10.81 ,10.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91035,CPT,ESOPH G-ESOP RFLX TLMTR ELTRD PLMT,26,,14 ,,RBRVS,1.59 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91035,CPT,ESOPH G-ESOP RFLX TLMTR ELTRD PLMT,TC,,14 ,,RBRVS,,10.11 ,10.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91037,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PLMT,,,14 ,,RBRVS,0.97 ,3.21 ,3.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91037,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PLMT,26,,14 ,,RBRVS,0.97 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91037,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PLMT,TC,,14 ,,RBRVS,,2.78 ,2.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,,,14 ,,RBRVS,1.10 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,26,,14 ,,RBRVS,1.10 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,TC,,14 ,,RBRVS,,2.08 ,2.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91040,CPT,ESOPHGL BALO DISTENSION PROVOCATION STD,,,14 ,,RBRVS,0.97 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91040,CPT,ESOPHGL BALO DISTENSION PROVOCATION STD,26,,14 ,,RBRVS,0.97 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91040,CPT,ESOPHGL BALO DISTENSION PROVOCATION STD,TC,,14 ,,RBRVS,,8.05 ,8.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91065,CPT,BRTH HYDROGEN TST,,,14 ,,RBRVS,0.20 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91065,CPT,BRTH HYDROGEN TST,26,,14 ,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91065,CPT,BRTH HYDROGEN TST,TC,,14 ,,RBRVS,,1.47 ,1.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91110,CPT,GI TRC IMG INTRAL ESOPH THRU ILE PHYS I&R,,,14 ,,RBRVS,3.64 ,20.09 ,20.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91110,CPT,GI TRC IMG INTRAL ESOPH THRU ILE PHYS I&R,26,,14 ,,RBRVS,3.64 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91110,CPT,GI TRC IMG INTRAL ESOPH THRU ILE PHYS I&R,TC,,14 ,,RBRVS,,18.44 ,18.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS,,,21 ,,RBRVS,1.00 ,17.68 ,17.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS,26,,21 ,,RBRVS,1.00 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS,TC,,21 ,,RBRVS,,17.21 ,17.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91117,CPT,COLON MOTILITY 6 HR STUDY,,,14 ,,RBRVS,2.45 ,1.36 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91120,CPT,RCT SENSATION TONE&COMPLIANCE,,,14 ,,RBRVS,0.97 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91120,CPT,RCT SENSATION TONE&COMPLIANCE,26,,14 ,,RBRVS,0.97 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91120,CPT,RCT SENSATION TONE&COMPLIANCE,TC,,14 ,,RBRVS,,9.00 ,9.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91122,CPT,ANRCT MANO,,,14 ,,RBRVS,1.77 ,4.22 ,4.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91122,CPT,ANRCT MANO,26,,14 ,,RBRVS,1.77 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91122,CPT,ANRCT MANO,TC,,14 ,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91132,CPT,EGG DX TC,,,14 ,,RBRVS,0.52 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91132,CPT,EGG DX TC,26,,14 ,,RBRVS,0.52 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91132,CPT,EGG DX TC,TC,,14 ,,RBRVS,,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91133,CPT,EGG DX TC PROVOCATIVE TSTG,,,14 ,,RBRVS,0.66 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,91133,CPT,EGG DX TC PROVOCATIVE TSTG,26,,14 ,,RBRVS,0.66 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,91133,CPT,EGG DX TC PROVOCATIVE TSTG,TC,,14 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,91299,CPT,UNLIS DX GASTROENTEROLOGY,,,14 ,,TotalUnits,,,,21.26 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,91299,CPT,UNLIS DX GASTROENTEROLOGY,,PC,14 ,,TotalUnits,,,,6.87 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,91299,CPT,UNLIS DX GASTROENTEROLOGY,,TC,14 ,,TotalUnits,,,,14.39 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,92002,CPT,OPH MEDICAL XM&EVAL INTRM NEW PT,,,23 ,,RBRVS,0.88 ,0.33 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92004,CPT,OPH MEDICAL XM&EVAL COMPRE NEW PT 1+ VST,,,23 ,,RBRVS,1.82 ,0.71 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92012,CPT,OPH MEDICAL XM&EVAL INTRM EST PT,,,23 ,,RBRVS,0.92 ,0.38 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92014,CPT,OPH MEDICAL XM&EVAL COMPRE EST PT 1+ VST,,,23 ,,RBRVS,1.42 ,0.57 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92015,CPT,DETER REFRACTIVE STATE,,,23 ,,RBRVS,0.38 ,0.13 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92018,CPT,OPH XM&EVAL ANES +-MNPJ GLOBE COMPL,,,14 ,,RBRVS,2.50 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92019,CPT,OPH XM&EVAL ANES +-MNPJ GLOBE LMTD,,,14 ,,RBRVS,1.31 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92020,CPT,GONIOSCOPY SPX,,,14 ,,RBRVS,0.37 ,0.16 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,,,14 ,,RBRVS,0.35 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,26,,14 ,,RBRVS,0.35 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,TC,,14 ,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92060,CPT,SENSIMOTR XM W/MLT MEAS OC DEVIJ W/I&R SPX,,,14 ,,RBRVS,0.69 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92060,CPT,SENSIMOTR XM W/MLT MEAS OC DEVIJ W/I&R SPX,26,,14 ,,RBRVS,0.69 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92060,CPT,SENSIMOTR XM W/MLT MEAS OC DEVIJ W/I&R SPX,TC,,14 ,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92065,CPT,ORTHOPTIC&/PLEOPTIC TRAINJ,,,14 ,,RBRVS,0.37 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92065,CPT,ORTHOPTIC&/PLEOPTIC TRAINJ,26,,14 ,,RBRVS,0.37 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92065,CPT,ORTHOPTIC&/PLEOPTIC TRAINJ,TC,,14 ,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92070,CPT,FITG C-LENS TX DISEASE SUPPLY LENS,,,14 ,,RBRVS,0.70 ,0.29 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92081,CPT,VIS FLD XM UNI/BI I&R LMTD XM,,,14 ,,RBRVS,0.36 ,1.00 ,1.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92081,CPT,VIS FLD XM UNI/BI I&R LMTD XM,26,,14 ,,RBRVS,0.36 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92081,CPT,VIS FLD XM UNI/BI I&R LMTD XM,TC,,14 ,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92082,CPT,VIS FLD XM UNI/BI I&R INTRM XM,,,14 ,,RBRVS,0.44 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92082,CPT,VIS FLD XM UNI/BI I&R INTRM XM,26,,14 ,,RBRVS,0.44 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92082,CPT,VIS FLD XM UNI/BI I&R INTRM XM,TC,,14 ,,RBRVS,,1.20 ,1.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92083,CPT,VIS FLD XM UNI/BI I&R EXTND XM,,,14 ,,RBRVS,0.50 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92083,CPT,VIS FLD XM UNI/BI I&R EXTND XM,26,,14 ,,RBRVS,0.50 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92083,CPT,VIS FLD XM UNI/BI I&R EXTND XM,TC,,14 ,,RBRVS,,1.37 ,1.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92100,CPT,SRL TNMTRY SPX MLT MEAS IO PRESS,,,14 ,,RBRVS,0.92 ,0.36 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92120,CPT,TNGRPHY I&R REC INDENTAJ TNMTR SUCJ,,,14 ,,RBRVS,0.81 ,0.32 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92130,CPT,TNGRPHY WATER PROVOCATION,,,14 ,,RBRVS,0.81 ,0.35 ,1.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92132,CPT,CMPTR OPHTH DX IMG ANT SEGMT,,,14 ,,RBRVS,0.35 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92132,CPT,CMPTR OPHTH DX IMG ANT SEGMT,26,,14 ,,RBRVS,0.35 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92132,CPT,CMPTR OPHTH DX IMG ANT SEGMT,TC,,14 ,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92133,CPT,CMPTR OPHTH IMG OPTIC NERVE,,,14 ,,RBRVS,0.50 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92133,CPT,CMPTR OPHTH IMG OPTIC NERVE,26,,14 ,,RBRVS,0.50 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92133,CPT,CMPTR OPHTH IMG OPTIC NERVE,TC,,14 ,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92134,CPT,CPTR OPHTH DX IMG POST SEGMT,,,14 ,,RBRVS,0.50 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92134,CPT,CPTR OPHTH DX IMG POST SEGMT,26,,14 ,,RBRVS,0.50 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92134,CPT,CPTR OPHTH DX IMG POST SEGMT,TC,,14 ,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,,,14 ,,RBRVS,0.54 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,26,,14 ,,RBRVS,0.54 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,TC,,14 ,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92140,CPT,PROVOCATIVE TSTS GLC I&R W/O TNGRPHY,,,14 ,,RBRVS,0.50 ,0.19 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92225,CPT,OPSCPY EXTND RTA DRAWING I&R 1ST,,,14 ,,RBRVS,0.38 ,0.16 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92226,CPT,OPSCPY EXTND RTA DRAWING I&R SBSQ,,,14 ,,RBRVS,0.33 ,0.15 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92227,CPT,REMOTE DX RETINAL IMAGING,,,14 ,,RBRVS,,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92228,CPT,REMOTE RETINAL IMAGING MGMT,,,14 ,,RBRVS,0.30 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92228,CPT,REMOTE RETINAL IMAGING MGMT,26,,14 ,,RBRVS,0.30 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92228,CPT,REMOTE RETINAL IMAGING MGMT,TC,,14 ,,RBRVS,,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92230,CPT,FLUORESCEIN ANGIOSCOPY I&R,,,14 ,,RBRVS,0.60 ,0.24 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92235,CPT,FLUORESCEIN ANGRPH I&R,,,14 ,,RBRVS,0.81 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92235,CPT,FLUORESCEIN ANGRPH I&R,26,,14 ,,RBRVS,0.81 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92235,CPT,FLUORESCEIN ANGRPH I&R,TC,,14 ,,RBRVS,,2.08 ,2.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92240,CPT,INDOCYA9-GREEN ANGRPH I&R,,,14 ,,RBRVS,1.10 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92240,CPT,INDOCYA9-GREEN ANGRPH I&R,26,,14 ,,RBRVS,1.10 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92240,CPT,INDOCYA9-GREEN ANGRPH I&R,TC,,14 ,,RBRVS,,4.42 ,4.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92250,CPT,FUNDUS PHTGRPHY I&R,,,14 ,,RBRVS,0.44 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92250,CPT,FUNDUS PHTGRPHY I&R,26,,14 ,,RBRVS,0.44 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92250,CPT,FUNDUS PHTGRPHY I&R,TC,,14 ,,RBRVS,,1.23 ,1.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92260,CPT,OPHTHALMODYNAMOMETRY,,,14 ,,RBRVS,0.20 ,0.09 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92265,CPT,NDL OCULOEMG 1+ EO MUSC 1/OU I&R,,,14 ,,RBRVS,0.81 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92265,CPT,NDL OCULOEMG 1+ EO MUSC 1/OU I&R,26,,14 ,,RBRVS,0.81 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92265,CPT,NDL OCULOEMG 1+ EO MUSC 1/OU I&R,TC,,14 ,,RBRVS,,0.87 ,0.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92270,CPT,ELECTRO-OCULOGRAPY I&R,,,14 ,,RBRVS,0.81 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92270,CPT,ELECTRO-OCULOGRAPY I&R,26,,14 ,,RBRVS,0.81 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92270,CPT,ELECTRO-OCULOGRAPY I&R,TC,,14 ,,RBRVS,,1.15 ,1.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92275,CPT,ELECTRORETINOGRAPY I&R,,,14 ,,RBRVS,1.01 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92275,CPT,ELECTRORETINOGRAPY I&R,26,,14 ,,RBRVS,1.01 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92275,CPT,ELECTRORETINOGRAPY I&R,TC,,14 ,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92283,CPT,COLOR VIS XM EXTND ANOMALOSCOPE/EQUIV,,,14 ,,RBRVS,0.17 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92283,CPT,COLOR VIS XM EXTND ANOMALOSCOPE/EQUIV,26,,14 ,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92283,CPT,COLOR VIS XM EXTND ANOMALOSCOPE/EQUIV,TC,,14 ,,RBRVS,,0.95 ,0.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92284,CPT,DARK ADAPTATION XM I&R,,,14 ,,RBRVS,0.24 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92284,CPT,DARK ADAPTATION XM I&R,26,,14 ,,RBRVS,0.24 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92284,CPT,DARK ADAPTATION XM I&R,TC,,14 ,,RBRVS,,1.21 ,1.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92285,CPT,XTRNL OC PHTGRPHY I&R PROGRESS,,,14 ,,RBRVS,0.20 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92285,CPT,XTRNL OC PHTGRPHY I&R PROGRESS,26,,14 ,,RBRVS,0.20 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92285,CPT,XTRNL OC PHTGRPHY I&R PROGRESS,TC,,14 ,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92286,CPT,SPEC ANT SGM PHTGRPHY I&R SPECLR ENDOTHELIAL,,,14 ,,RBRVS,0.66 ,2.37 ,2.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92286,CPT,SPEC ANT SGM PHTGRPHY I&R SPECLR ENDOTHELIAL,26,,14 ,,RBRVS,0.66 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92286,CPT,SPEC ANT SGM PHTGRPHY I&R SPECLR ENDOTHELIAL,TC,,14 ,,RBRVS,,2.09 ,2.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92287,CPT,SPEC ANT SGM PHTGRPHY I&R FLUORESCEIN ANGRPH,,,14 ,,RBRVS,0.81 ,0.35 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92310,CPT,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,,,23 ,,RBRVS,1.17 ,0.42 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92311,CPT,RX&FITG C-LENS SUPVJ CRNL LENS APHK 1O,,,14 ,,RBRVS,1.08 ,0.38 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92312,CPT,RX&FITG C-LENS SUPVJ CRNL LENS APHK OU,,,14 ,,RBRVS,1.26 ,0.45 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92313,CPT,RX&FITG C-LENS SUPVJ CRNLSCLRL LENS,,,14 ,,RBRVS,0.92 ,0.37 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92314,CPT,RX C-LENS SUPVJ&DIRION FITG TECH OU XCPT APHK,,,23 ,,RBRVS,0.69 ,0.25 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92315,CPT,RX C-LENS SUPVJ FITG TECH CRNL APHK 1O,,,14 ,,RBRVS,0.45 ,0.15 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92316,CPT,RX C-LENS SUPVJ FITG TECH CRNL APHK OU,,,14 ,,RBRVS,0.68 ,0.29 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92317,CPT,RX C-LENS SUPVJ FITG TECH CRNLSCLRL,,,14 ,,RBRVS,0.45 ,0.12 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92325,CPT,MODIFICAJ C-LENS SPX SUPVJ ADAPTATION,,,14 ,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92326,CPT,RPLCMT C-LENS,,,14 ,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92340,CPT,FITG SPECTLS XCPT APHK MONOFOCAL,,,14 ,,RBRVS,0.37 ,0.13 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92341,CPT,FITG SPECTLS XCPT APHK BIFOCAL,,,14 ,,RBRVS,0.47 ,0.17 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92342,CPT,FITG SPECTLS XCPT APHK MLTFCL,,,14 ,,RBRVS,0.53 ,0.19 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92352,CPT,FITG SPECTL PROSTH APHK MONOFOCAL,,,14 ,,RBRVS,0.37 ,0.13 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92353,CPT,FITG SPECTL PROSTH APHK MLTFCL,,,14 ,,RBRVS,0.50 ,0.18 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92354,CPT,FITG SPECTL MOUNTED LW VIS AID 1 ELMNT,,,14 ,,RBRVS,,1.95 ,1.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92355,CPT,FITG SPECTL MOUNTED LW VIS AID TLSCP,,,14 ,,RBRVS,,1.23 ,1.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92358,CPT,PROSTH APHK TEMP DISPOSABLE/LOAN MATRLS,,,14 ,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92370,CPT,RPR&REFITG SPECTLS XCPT APHK,,,14 ,,RBRVS,0.32 ,0.11 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92371,CPT,RPR&REFITG SPECTLS SPECTL PROSTH APHK,,,14 ,,RBRVS,,0.34 ,0.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92499,CPT,UNLIS OPH SVC,,,14 ,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,92499,CPT,UNLIS OPH SVC,,PC,14 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,92499,CPT,UNLIS OPH SVC,,TC,14 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,92502,CPT,OTOLARYNGOLOGIC XM ANES,,,14 ,,RBRVS,1.51 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92504,CPT,BINOC MIC,,,14 ,,RBRVS,0.18 ,0.08 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92506,CPT,EVAL SP LANG VOICE COMUNICAJ&/AUD,,,8 ,,RBRVS,0.86 ,0.34 ,3.36 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92507,CPT,TX SP LANG COMUNICAJ PCX DISORDER INDIV,,,8 ,,RBRVS,0.52 ,0.19 ,1.23 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92508,CPT,TX SP LANG COMUNICAJ PCX DISORDER 2/>,,,8 ,,RBRVS,0.26 ,0.11 ,0.60 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92511,CPT,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,,,14 ,,RBRVS,0.84 ,0.73 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92512,CPT,NSL FUNCJ STD,,,14 ,,RBRVS,0.55 ,0.21 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92516,CPT,FACIAL NRV FUNCJ STD,,,14 ,,RBRVS,0.43 ,0.18 ,1.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92520,CPT,LARYN FUNCJ STD,,,14 ,,RBRVS,0.75 ,0.31 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92526,CPT,TX SWLNG DYSF&/ORAL FUNCJ FEEDING,,,14 ,,RBRVS,1.34 ,0.27 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92531,CPT,SPON NYSTAGMUS GAZE,,,14 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92532,CPT,POSAL NYSTAGMUS TST,,,14 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92533,CPT,CALORIC VSTBLR TST EA IRRIGATION,,,14 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92534,CPT,OKN TST,,,14 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,,,14 ,,RBRVS,1.50 ,1.09 ,1.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,,PC,14 ,,RBRVS,1.50 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,,TC,14 ,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,92541,CPT,SPON NYSTAGMUS TST,,,14 ,,RBRVS,0.40 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92541,CPT,SPON NYSTAGMUS TST,26,,14 ,,RBRVS,0.40 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92541,CPT,SPON NYSTAGMUS TST,TC,,14 ,,RBRVS,,0.81 ,0.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92542,CPT,POSAL NYSTAGMUS TST,,,14 ,,RBRVS,0.33 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92542,CPT,POSAL NYSTAGMUS TST,26,,14 ,,RBRVS,0.33 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92542,CPT,POSAL NYSTAGMUS TST,TC,,14 ,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92543,CPT,CALORIC VSTBLR TST EA IRRIGATION REC,,,14 ,,RBRVS,0.10 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92543,CPT,CALORIC VSTBLR TST EA IRRIGATION REC,26,,14 ,,RBRVS,0.10 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92543,CPT,CALORIC VSTBLR TST EA IRRIGATION REC,TC,,14 ,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92544,CPT,OKN TST BIDIREC FOVEAL/PRPH STIMJ REC,,,14 ,,RBRVS,0.26 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92544,CPT,OKN TST BIDIREC FOVEAL/PRPH STIMJ REC,26,,14 ,,RBRVS,0.26 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92544,CPT,OKN TST BIDIREC FOVEAL/PRPH STIMJ REC,TC,,14 ,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92545,CPT,OSCILLATING TRACKING TST W/REC,,,14 ,,RBRVS,0.23 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92545,CPT,OSCILLATING TRACKING TST W/REC,26,,14 ,,RBRVS,0.23 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92545,CPT,OSCILLATING TRACKING TST W/REC,TC,,14 ,,RBRVS,,0.73 ,0.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92546,CPT,SINUSOIDAL VER AXIS ROTATIONAL TSTG,,,14 ,,RBRVS,0.29 ,2.00 ,2.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92546,CPT,SINUSOIDAL VER AXIS ROTATIONAL TSTG,26,,14 ,,RBRVS,0.29 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92546,CPT,SINUSOIDAL VER AXIS ROTATIONAL TSTG,TC,,14 ,,RBRVS,,1.89 ,1.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92547,CPT,USE VER ELTRDS,,TC,14 ,,RBRVS,,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,0,1,1,20110101,92548,CPT,CPTRIZED DYNAMIC POSTUROGRAPY,,,14 ,,RBRVS,0.50 ,2.00 ,2.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92548,CPT,CPTRIZED DYNAMIC POSTUROGRAPY,26,,14 ,,RBRVS,0.50 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92548,CPT,CPTRIZED DYNAMIC POSTUROGRAPY,TC,,14 ,,RBRVS,,1.81 ,1.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92550,CPT,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,,,8 ,,RBRVS,0.35 ,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92551,CPT,SCR TST PURE TONE AIR ONLY,,,8 ,,RBRVS,,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92552,CPT,PURE TONE AUDIOMTRY AIR ONLY,,TC,8 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92553,CPT,PURE TONE AUDIOMTRY AIR&B1,,TC,8 ,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92555,CPT,SP AUDIOMTRY THRESHOLD,,TC,8 ,,RBRVS,,0.42 ,0.42 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92556,CPT,SP AUDIOMTRY THRESHOLD SP RECOGNIJ,,TC,8 ,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92557,CPT,COMPRE AUDIOMTRY THRESHOLD EVAL SP RECOGNIJ,,,8 ,,RBRVS,0.60 ,0.42 ,0.50 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92559,CPT,AUDIOMETRIC TSTG GRPS,,,8 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92560,CPT,BEKESY AUDIOMTRY SCR,,,8 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92561,CPT,BEKESY AUDIOMTRY DX,,TC,8 ,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92562,CPT,LOUDNESS BALANCE BINAURAL/MONAURAL,,TC,8 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92563,CPT,TONE DECAY,,TC,8 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92564,CPT,SHORT INCREMENT SENSITIVITY INDEX,,TC,8 ,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92565,CPT,STENGER TST PURE TONE,,TC,8 ,,RBRVS,,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92567,CPT,TYMPANOMETRY,,,8 ,,RBRVS,0.20 ,0.16 ,0.22 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92568,CPT,ACOUS RFLX THRESHOLD,,,8 ,,RBRVS,0.29 ,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92570,CPT,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,,,8 ,,RBRVS,0.55 ,0.25 ,0.30 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92571,CPT,FILTERED SP,,TC,8 ,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92572,CPT,STAGGERED SPONDAIC WORD,,TC,8 ,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92575,CPT,SENSORINEURAL ACUITY LVL,,TC,8 ,,RBRVS,,1.05 ,1.05 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92576,CPT,SYNTH SENTENCE ID,,TC,8 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92577,CPT,STENGER SP,,TC,8 ,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92579,CPT,VIS RNFCMT AUDIOMTRY,,,8 ,,RBRVS,0.70 ,0.37 ,0.47 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92582,CPT,CONDITIONING PLAY AUDIOMTRY,,TC,8 ,,RBRVS,,1.15 ,1.15 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92583,CPT,SELECT PICTURE AUDIOMTRY,,TC,8 ,,RBRVS,,0.88 ,0.88 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92584,CPT,ELECTROCOCHLEOGRAPY,,TC,8 ,,RBRVS,,1.64 ,1.64 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92585,CPT,AEP ERA&/TSTG CNS COMPRE,,,8 ,,RBRVS,0.50 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92585,CPT,AEP ERA&/TSTG CNS COMPRE,26,,8 ,,RBRVS,0.50 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92585,CPT,AEP ERA&/TSTG CNS COMPRE,TC,,8 ,,RBRVS,,2.02 ,2.02 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92586,CPT,AEP ERA&/TSTG CNS LMTD,,TC,8 ,,RBRVS,,1.64 ,1.64 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92587,CPT,EVOKED OTOACOUS EMIJS LMTD,,,8 ,,RBRVS,0.13 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92587,CPT,EVOKED OTOACOUS EMIJS LMTD,26,,8 ,,RBRVS,0.13 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92587,CPT,EVOKED OTOACOUS EMIJS LMTD,TC,,8 ,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92588,CPT,EVOKED OTOACOUS EMIJS COMPRE/DX EVAL,,,8 ,,RBRVS,0.36 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,92588,CPT,EVOKED OTOACOUS EMIJS COMPRE/DX EVAL,26,,8 ,,RBRVS,0.36 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92588,CPT,EVOKED OTOACOUS EMIJS COMPRE/DX EVAL,TC,,8 ,,RBRVS,,1.13 ,1.13 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92590,CPT,HEARING AID XM&SELECTION MONAURAL,,,8 ,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92591,CPT,HEARING AID XM&SELECTION BINAURAL,,,8 ,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92592,CPT,HEARING AID CHECK MONAURAL,,,8 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92593,CPT,HEARING AID CHECK BINAURAL,,,8 ,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92594,CPT,ELECTROACOUS EVAL HEARING AID MONAURAL,,,8 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92595,CPT,ELECTROACOUS EVAL HEARING AID BINAURAL,,,8 ,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92596,CPT,EAR PROTECTOR ATTENUATION MEAS,,TC,8 ,,RBRVS,,1.03 ,1.03 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92597,CPT,EVAL&/FITG VOICE PROSTC DEV SUPPLEMENT O-SP,,,8 ,,RBRVS,1.26 ,0.41 ,1.61 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92601,CPT,ALYS COCHLEAR IMPLT PT <7 YR PRGRMG,,,14 ,,RBRVS,2.30 ,1.39 ,1.78 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92602,CPT,ALYS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG,,,14 ,,RBRVS,1.30 ,0.86 ,1.27 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92603,CPT,ALYS COCHLEAR IMPLT 7 YR/> PRGRMG,,,14 ,,RBRVS,2.25 ,1.13 ,1.51 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92604,CPT,ALYS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG,,,14 ,,RBRVS,1.25 ,0.66 ,0.97 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92606,CPT,THER SVC N-SP-GENRATJ DEV PRGRMG&MODIFICAJ,,,14 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,92607,CPT,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,,,14 ,,RBRVS,,4.32 ,4.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92608,CPT,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,,,14 ,,RBRVS,,0.88 ,0.88 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92609,CPT,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,,,14 ,,RBRVS,,2.34 ,2.34 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92610,CPT,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,,,14 ,,RBRVS,1.30 ,0.57 ,1.79 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92611,CPT,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,,,14 ,,RBRVS,1.34 ,1.97 ,1.97 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,92612,CPT,FLX FIBOPT NDSC EVAL SWLNG C/V REC,,,14 ,,RBRVS,1.27 ,0.53 ,2.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92613,CPT,FLX FIBOPT NDSC EVAL SWLNG C/V REC PHYS I&R,,,14 ,,RBRVS,0.71 ,0.30 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92614,CPT,FLX FIBOPT NDSC EVAL LARYN SENS C/V REC,,,14 ,,RBRVS,1.27 ,0.54 ,2.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92615,CPT,FLX FIBOPT NDSC EVAL LARYN SENS PHYS I&R,,,14 ,,RBRVS,0.63 ,0.27 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92616,CPT,FLX FIBOPT NDSC EVAL SWLNG&LARYN SENS C/V REC,,,14 ,,RBRVS,1.88 ,0.77 ,3.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,92617,CPT,FLX FIBOPT NDSC EVAL SWLNG&LARYN SENS PHYS I&R,,,14 ,,RBRVS,0.79 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92620,CPT,EVAL CTR AUD FUNCJ W/REPRT 1ST 60 MIN,,,14 ,,RBRVS,1.50 ,0.52 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92621,CPT,EVAL CTR AUD FUNCJ W/REPRT EA 15 MIN,,,14 ,,RBRVS,0.35 ,0.11 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92625,CPT,ASSMT TINNITUS,,,14 ,,RBRVS,1.15 ,0.43 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92626,CPT,EVAL AUD RHAB STATUS 1ST HR,,,14 ,,RBRVS,1.40 ,0.71 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92627,CPT,EVAL AUD RHAB STATUS EA 15 MIN,,,14 ,,RBRVS,0.33 ,0.18 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92630,CPT,AUD RHAB PRELNG HEARING LOSS,,,14 ,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92633,CPT,AUD RHAB POST-LNGL HEARING LOSS,,,14 ,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92640,CPT,ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR,,,14 ,,RBRVS,1.76 ,0.36 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92700,CPT,UNLIS OTORHINOLARYNGOLOGICAL SVC,,,14 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92950,CPT,CARDIOPULM RESUSCITATION,,,4 ,,RBRVS,3.79 ,0.86 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92953,CPT,TEMP TC PACG,,,4 ,,RBRVS,0.23 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92960,CPT,CARDIOVERSION ELECTIVE ARRHYT XTRNL,,,4 ,,RBRVS,2.25 ,1.29 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92961,CPT,CARDIOVERSION ELECTIVE ARRHYT INT SPX,,,4 ,,RBRVS,4.59 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92970,CPT,CARDIOASSIST-METH CRC ASSIST INT,,,4 ,,RBRVS,3.51 ,1.32 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92971,CPT,CARDIOASSIST-METH CRC ASSIST XTRNL,,,4 ,,RBRVS,1.77 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92973,CPT,PRQ TRLUML C THRMBC,,,21 ,,RBRVS,3.28 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92974,CPT,TCAT PLMT RADJ DLVR DEV SBSQ C IV BRACHYTX,,,21 ,,RBRVS,3.00 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92975,CPT,THROMBOLSS C INTRAC NFS SLCTV C ANGRPH,,,4 ,,RBRVS,7.24 ,3.35 ,3.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92977,CPT,THROMBOLSS C IV NFS,,,4 ,,RBRVS,,2.79 ,2.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92978,CPT,IV US C VSL DX&/THER 1ST VSL,,,4 ,,TotalUnits,,,,7.41 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,92978,CPT,IV US C VSL DX&/THER 1ST VSL,26,,4 ,,TotalUnits,,,,2.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92978,CPT,IV US C VSL DX&/THER 1ST VSL,TC,,4 ,,TotalUnits,,,,4.78 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,92979,CPT,IV US C VSL DX&/THER EA VSL,,,4 ,,TotalUnits,,,,3.96 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,92979,CPT,IV US C VSL DX&/THER EA VSL,26,,4 ,,TotalUnits,,,,2.11 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92979,CPT,IV US C VSL DX&/THER EA VSL,TC,,4 ,,TotalUnits,,,,1.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,92980,CPT,TCAT PLMT AN INTRAC STENT PRQ 1 VSL,,,21 ,,RBRVS,14.82 ,7.10 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92981,CPT,TCAT PLMT INTRAC STENT PRQ EA VSL,,,21 ,,RBRVS,4.16 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92982,CPT,PRQ TRLUML C BALO ANGIOP 1 VSL,,,21 ,,RBRVS,10.96 ,5.30 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92984,CPT,PRQ TRLUML C BALO ANGIOP EA VSL,,,21 ,,RBRVS,2.97 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92986,CPT,PRQ BALO VLVP AORTIC VALVE,,,21 ,,RBRVS,22.85 ,13.43 ,13.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92987,CPT,PRQ BALO VLVP MITRAL VALVE,,,21 ,,RBRVS,23.63 ,13.88 ,13.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92990,CPT,PRQ BALO VLVP PULM VALVE,,,21 ,,RBRVS,18.27 ,10.76 ,10.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92992,CPT,ATR SEPTECT/SEPTOST TRANSVNS BALO,,,21 ,,TotalUnits,,,,30.66 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,92993,CPT,ATR SEPTECT/SEPTOST BLADE METH,,,21 ,,RBRVS,8.06 ,14.10 ,14.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92995,CPT,PRQ TRLUML C ATHRC 1 VSL,,,21 ,,RBRVS,12.07 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92996,CPT,PRQ TRLUML C ATHRC EA VSL,,,21 ,,RBRVS,3.26 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92997,CPT,PRQ TRLUML P-ART BALO ANGIOP 1 VSL,,,21 ,,RBRVS,11.98 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,92998,CPT,PRQ TRLUML P-ART BALO ANGIOP EA VSL,,,21 ,,RBRVS,5.99 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93000,CPT,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,,,4 ,,RBRVS,0.17 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93005,CPT,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,,TC,4 ,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93010,CPT,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,,PC,4 ,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93015,CPT,CV STRS TST XERS&/OR RX CONT ECG PHYS SI&R,,,4 ,,RBRVS,0.75 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93016,CPT,CV STRS TST XERS&/OR RX CONT ECG PHYS SUPVJ,,PC,4 ,,RBRVS,0.45 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93017,CPT,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,,TC,4 ,,RBRVS,,1.45 ,1.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93018,CPT,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,,PC,4 ,,RBRVS,0.30 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93024,CPT,ERGONOVINE PROVOCATION TST,,,4 ,,RBRVS,1.17 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93024,CPT,ERGONOVINE PROVOCATION TST,26,,4 ,,RBRVS,1.17 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93024,CPT,ERGONOVINE PROVOCATION TST,TC,,4 ,,RBRVS,,1.50 ,1.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93025,CPT,MICROV T-WAVE ALTERNANS F/ASSMT VENTR ARRHYTS,,,4 ,,RBRVS,0.75 ,4.61 ,4.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93025,CPT,MICROV T-WAVE ALTERNANS F/ASSMT VENTR ARRHYTS,26,,4 ,,RBRVS,0.75 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93025,CPT,MICROV T-WAVE ALTERNANS F/ASSMT VENTR ARRHYTS,TC,,4 ,,RBRVS,,4.27 ,4.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93040,CPT,RHYTHM ECG 1-3 LDS W/I&R,,,4 ,,RBRVS,0.16 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93041,CPT,RHYTHM ECG 1-3 LDS TRCG ONLY W/O I&R,,TC,4 ,,RBRVS,,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93042,CPT,RHYTHM ECG 1-3 LDS I&R ONLY,,PC,4 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93224,CPT,WEARABLE ECG 24 HR W/VIS SUPIMPOS SCAN PHYS R&I,,,4 ,,RBRVS,0.52 ,2.37 ,2.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93225,CPT,WEARABLE ECG 24 HR W/VISUAL SUPIMPOS SCAN REC,,TC,4 ,,RBRVS,,0.85 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93226,CPT,WEARABLE ECG 24 HR W/VIS SUPIMPOS SCAN A/R,,TC,4 ,,RBRVS,,1.28 ,1.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93227,CPT,WEARABLE ECG 24 HR W/VIS SUPIMPOS SCAN PHYS R&I,,PC,4 ,,RBRVS,0.52 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93228,CPT,WEARABLE MOBILE CV TELEMETRY W/PHYS R&I W/REPORT,,PC,4 ,,RBRVS,0.52 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93229,CPT,WEARABLE MOBILE CV TELEMETRY W/TECHNICAL SUPPORT,,TC,4 ,,TotalUnits,,,,22.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93268,CPT,WR PT ACTIVATED 24 HR ECG TRANSMIS PHYSICIAN R&I,,,4 ,,RBRVS,0.52 ,6.22 ,6.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93270,CPT,WR PT ACTIVATED 24 HR ECG RECORDING,,TC,4 ,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93271,CPT,WR PT ACTIVATED 24 HR ECGR REC TRANSMISS&ALYS,,TC,4 ,,RBRVS,,5.56 ,5.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93272,CPT,WEARABLE PATIENT ACTIVATED 24 HR ECG PHYS R&I,,PC,4 ,,RBRVS,0.52 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93278,CPT,SAECG +-ECG,,,4 ,,RBRVS,0.25 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93278,CPT,SAECG +-ECG,26,,4 ,,RBRVS,0.25 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93278,CPT,SAECG +-ECG,TC,,4 ,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,,,4 ,,RBRVS,0.65 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,26,,4 ,,RBRVS,0.65 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,TC,,4 ,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,,,4 ,,RBRVS,0.77 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,26,,4 ,,RBRVS,0.77 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,TC,,4 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,,,4 ,,RBRVS,0.90 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,26,,4 ,,RBRVS,0.90 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,TC,,4 ,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93282,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN 1 LD CARD/DFB,,,4 ,,RBRVS,0.85 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93282,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN 1 LD CARD/DFB,26,,4 ,,RBRVS,0.85 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93282,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN 1 LD CARD/DFB,TC,,4 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93283,CPT,PROGRM EVAL IMPLANTABLE IN PRSN DUAL L CARD/DFB,,,4 ,,RBRVS,1.15 ,1.20 ,1.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93283,CPT,PROGRM EVAL IMPLANTABLE IN PRSN DUAL L CARD/DFB,26,,4 ,,RBRVS,1.15 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93283,CPT,PROGRM EVAL IMPLANTABLE IN PRSN DUAL L CARD/DFB,TC,,4 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93284,CPT,PROGRM EVAL IMPLANTABLE IN PRSN MLT LD CARD/DFB,,,4 ,,RBRVS,1.25 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93284,CPT,PROGRM EVAL IMPLANTABLE IN PRSN MLT LD CARD/DFB,26,,4 ,,RBRVS,1.25 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93284,CPT,PROGRM EVAL IMPLANTABLE IN PRSN MLT LD CARD/DFB,TC,,4 ,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,,,4 ,,RBRVS,0.52 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,26,,4 ,,RBRVS,0.52 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,TC,,4 ,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,,,4 ,,RBRVS,0.30 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,26,,4 ,,RBRVS,0.30 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,TC,,4 ,,RBRVS,,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93287,CPT,PERI-PX EVAL&PROGRAM CARDIOVERTER/DEFIBRILLATOR,,,4 ,,RBRVS,0.45 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93287,CPT,PERI-PX EVAL&PROGRAM CARDIOVERTER/DEFIBRILLATOR,26,,4 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93287,CPT,PERI-PX EVAL&PROGRAM CARDIOVERTER/DEFIBRILLATOR,TC,,4 ,,RBRVS,,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,,,4 ,,RBRVS,0.43 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,26,,4 ,,RBRVS,0.43 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,TC,,4 ,,RBRVS,,0.46 ,0.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93289,CPT,INTERROGATION EVAL F2F 1/DUAL/MLT LEADS CVDFB,,,4 ,,RBRVS,0.92 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93289,CPT,INTERROGATION EVAL F2F 1/DUAL/MLT LEADS CVDFB,26,,4 ,,RBRVS,0.92 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93289,CPT,INTERROGATION EVAL F2F 1/DUAL/MLT LEADS CVDFB,TC,,4 ,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,,,4 ,,RBRVS,0.43 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,26,,4 ,,RBRVS,0.43 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,TC,,4 ,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,,,4 ,,RBRVS,0.43 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,26,,4 ,,RBRVS,0.43 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,TC,,4 ,,RBRVS,,0.42 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,,,4 ,,RBRVS,0.43 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,26,,4 ,,RBRVS,0.43 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,TC,,4 ,,RBRVS,,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,,,4 ,,RBRVS,0.32 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,26,,4 ,,RBRVS,0.32 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,TC,,4 ,,RBRVS,,1.04 ,1.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93294,CPT,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LEAD PM,,PC,4 ,,RBRVS,0.65 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93295,CPT,INTERROGATION EVAL REMOTE </90 D 1/2/> LD CVDFB,,PC,4 ,,RBRVS,1.29 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93296,CPT,INTERROGATION REMOTE </90 D TECHNICIAN REVIEW,,TC,4 ,,RBRVS,,0.94 ,0.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93297,CPT,INTERROGATION EVAL REMOTE </30 D CV MNTR SYS,,PC,4 ,,RBRVS,0.52 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93298,CPT,INTERROGATION EVALUATION REMOTE </30 D ILR SYS,,PC,4 ,,RBRVS,0.52 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93299,CPT,INTERROGATION EVAL REMOTE </30 D TECH REVIEW,,TC,4 ,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93303,CPT,TTHRC F/CGEN CAR ANOMAL COMPL,,,4 ,,RBRVS,1.30 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93303,CPT,TTHRC F/CGEN CAR ANOMAL COMPL,26,,4 ,,RBRVS,1.30 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93303,CPT,TTHRC F/CGEN CAR ANOMAL COMPL,TC,,4 ,,RBRVS,,3.76 ,3.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93304,CPT,TTHRC F/CGEN CAR ANOMAL F-UP/LMTD STD,,,4 ,,RBRVS,0.75 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93304,CPT,TTHRC F/CGEN CAR ANOMAL F-UP/LMTD STD,26,,4 ,,RBRVS,0.75 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93304,CPT,TTHRC F/CGEN CAR ANOMAL F-UP/LMTD STD,TC,,4 ,,RBRVS,,2.48 ,2.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93306,CPT,ECHO TTHRC R-T 2D -+M-MODE COMPL SPEC&COLOR DOP,,,4 ,,RBRVS,1.30 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93306,CPT,ECHO TTHRC R-T 2D -+M-MODE COMPL SPEC&COLOR DOP,26,,4 ,,RBRVS,1.30 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93306,CPT,ECHO TTHRC R-T 2D -+M-MODE COMPL SPEC&COLOR DOP,TC,,4 ,,RBRVS,,4.64 ,4.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93307,CPT,TTHRC R-T IMG 2D +-M-MODE REC COMPL,,,4 ,,RBRVS,0.92 ,3.31 ,3.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93307,CPT,TTHRC R-T IMG 2D +-M-MODE REC COMPL,26,,4 ,,RBRVS,0.92 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93307,CPT,TTHRC R-T IMG 2D +-M-MODE REC COMPL,TC,,4 ,,RBRVS,,2.90 ,2.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93308,CPT,TTHRC R-T IMG 2D +-M-MODE REC F-UP/LMTD,,,4 ,,RBRVS,0.53 ,2.31 ,2.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93308,CPT,TTHRC R-T IMG 2D +-M-MODE REC F-UP/LMTD,26,,4 ,,RBRVS,0.53 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93308,CPT,TTHRC R-T IMG 2D +-M-MODE REC F-UP/LMTD,TC,,4 ,,RBRVS,,2.07 ,2.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93312,CPT,TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R,,,4 ,,RBRVS,2.20 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93312,CPT,TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R,26,,4 ,,RBRVS,2.20 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93312,CPT,TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R,TC,,4 ,,RBRVS,,5.44 ,5.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93313,CPT,TEE R-T IMG 2D W/PROBE PLMT ONLY,,,4 ,,RBRVS,0.95 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93314,CPT,TEE R-T IMG 2D IMG ACQUISJ I&R ONLY,,,4 ,,RBRVS,1.25 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93314,CPT,TEE R-T IMG 2D IMG ACQUISJ I&R ONLY,26,,4 ,,RBRVS,1.25 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93314,CPT,TEE R-T IMG 2D IMG ACQUISJ I&R ONLY,TC,,4 ,,RBRVS,,5.63 ,5.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93315,CPT,TEE CGEN CAR ANOML PRB ACQUISJ I&R,,,4 ,,TotalUnits,,,,5.86 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93315,CPT,TEE CGEN CAR ANOML PRB ACQUISJ I&R,26,,4 ,,TotalUnits,,,,3.95 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93315,CPT,TEE CGEN CAR ANOML PRB ACQUISJ I&R,TC,,4 ,,TotalUnits,,,,1.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93316,CPT,TEE CGEN CAR ANOML PLMT PRB ONLY,,,4 ,,RBRVS,0.95 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93317,CPT,TEE CGEN CAR ANOML IMG ACQUISJ I&R,,,4 ,,TotalUnits,,,,3.78 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93317,CPT,TEE CGEN CAR ANOML IMG ACQUISJ I&R,26,,4 ,,TotalUnits,,,,2.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93317,CPT,TEE CGEN CAR ANOML IMG ACQUISJ I&R,TC,,4 ,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93318,CPT,TEE W/PROB F/MNTR PURPOSES W/ASSMT CA PUMP FUNCJ,,,4 ,,TotalUnits,,,,4.43 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93318,CPT,TEE W/PROB F/MNTR PURPOSES W/ASSMT CA PUMP FUNCJ,26,,4 ,,TotalUnits,,,,2.97 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93318,CPT,TEE W/PROB F/MNTR PURPOSES W/ASSMT CA PUMP FUNCJ,TC,,4 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93320,CPT,DOP ECHO COMPL,,,4 ,,RBRVS,0.38 ,1.46 ,1.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93320,CPT,DOP ECHO COMPL,26,,4 ,,RBRVS,0.38 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93320,CPT,DOP ECHO COMPL,TC,,4 ,,RBRVS,,1.29 ,1.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93321,CPT,DOP ECHO P-W&/OR CONT W/SPECTRAL F-UP/LMTD STD,,,4 ,,RBRVS,0.15 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93321,CPT,DOP ECHO P-W&/OR CONT W/SPECTRAL F-UP/LMTD STD,26,,4 ,,RBRVS,0.15 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93321,CPT,DOP ECHO P-W&/OR CONT W/SPECTRAL F-UP/LMTD STD,TC,,4 ,,RBRVS,,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93325,CPT,DOP ECHO COLOR FLO VEL MAPG,,,4 ,,RBRVS,0.07 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93325,CPT,DOP ECHO COLOR FLO VEL MAPG,26,,4 ,,RBRVS,0.07 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93325,CPT,DOP ECHO COLOR FLO VEL MAPG,TC,,4 ,,RBRVS,,0.99 ,0.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93350,CPT,ECHO TTHRC R-T 2D -+M-MODE COMPLETE REST&STRS,,,4 ,,RBRVS,1.46 ,4.12 ,4.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93350,CPT,ECHO TTHRC R-T 2D -+M-MODE COMPLETE REST&STRS,26,,4 ,,RBRVS,1.46 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93350,CPT,ECHO TTHRC R-T 2D -+M-MODE COMPLETE REST&STRS,TC,,4 ,,RBRVS,,3.45 ,3.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93351,CPT,ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG,,,4 ,,RBRVS,1.75 ,4.89 ,4.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93351,CPT,ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG,26,,4 ,,RBRVS,1.75 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93351,CPT,ECHO TTHRC R-T 2D -+M-MODE REST&STRS CONT ECG,TC,,4 ,,RBRVS,,4.04 ,4.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93352,CPT,USE OF ECHO CONTRAST AGENT DURING STRESS ECHO,,,4 ,,RBRVS,0.19 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93451,CPT,RIGHT HEART CATH,,,21 ,,RBRVS,2.72 ,19.21 ,19.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93451,CPT,RIGHT HEART CATH,26,,21 ,,RBRVS,2.72 ,1.07 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93451,CPT,RIGHT HEART CATH,TC,,21 ,,RBRVS,,18.14 ,18.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93452,CPT,LEFT HRT CATH W/VENTRCLGRPHY,,,21 ,,RBRVS,4.75 ,19.19 ,19.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93452,CPT,LEFT HRT CATH W/VENTRCLGRPHY,26,,21 ,,RBRVS,4.75 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93452,CPT,LEFT HRT CATH W/VENTRCLGRPHY,TC,,21 ,,RBRVS,,17.33 ,17.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93453,CPT,R&L HRT CATH W/VENTRICLGRPHY,,,21 ,,RBRVS,6.24 ,25.10 ,25.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93453,CPT,R&L HRT CATH W/VENTRICLGRPHY,26,,21 ,,RBRVS,6.24 ,2.44 ,2.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93453,CPT,R&L HRT CATH W/VENTRICLGRPHY,TC,,21 ,,RBRVS,,22.66 ,22.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93454,CPT,CORONARY ARTERY ANGIO S&I,,,21 ,,RBRVS,4.79 ,19.94 ,19.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93454,CPT,CORONARY ARTERY ANGIO S&I,26,,21 ,,RBRVS,4.79 ,1.88 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93454,CPT,CORONARY ARTERY ANGIO S&I,TC,,21 ,,RBRVS,,18.06 ,18.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93455,CPT,CORONARY ART/GRFT ANGIO S&I,,,21 ,,RBRVS,5.54 ,23.33 ,23.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93455,CPT,CORONARY ART/GRFT ANGIO S&I,26,,21 ,,RBRVS,5.54 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93455,CPT,CORONARY ART/GRFT ANGIO S&I,TC,,21 ,,RBRVS,,21.16 ,21.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93456,CPT,R HRT CORONARY ARTERY ANGIO,,,21 ,,RBRVS,6.15 ,24.78 ,24.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93456,CPT,R HRT CORONARY ARTERY ANGIO,26,,21 ,,RBRVS,6.15 ,2.41 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93456,CPT,R HRT CORONARY ARTERY ANGIO,TC,,21 ,,RBRVS,,22.37 ,22.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93457,CPT,R HRT ART/GRFT ANGIO,,,21 ,,RBRVS,6.89 ,28.18 ,28.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93457,CPT,R HRT ART/GRFT ANGIO,26,,21 ,,RBRVS,6.89 ,2.70 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93457,CPT,R HRT ART/GRFT ANGIO,TC,,21 ,,RBRVS,,25.48 ,25.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93458,CPT,L HRT ARTERY/VENTRICLE ANGIO,,,21 ,,RBRVS,5.85 ,23.97 ,23.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93458,CPT,L HRT ARTERY/VENTRICLE ANGIO,26,,21 ,,RBRVS,5.85 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93458,CPT,L HRT ARTERY/VENTRICLE ANGIO,TC,,21 ,,RBRVS,,21.68 ,21.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93459,CPT,L HRT ART/GRFT ANGIO,,,21 ,,RBRVS,6.60 ,26.33 ,26.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93459,CPT,L HRT ART/GRFT ANGIO,26,,21 ,,RBRVS,6.60 ,2.58 ,2.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93459,CPT,L HRT ART/GRFT ANGIO,TC,,21 ,,RBRVS,,23.75 ,23.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93460,CPT,R&L HRT ART/VENTRICLE ANGIO,,,21 ,,RBRVS,7.35 ,27.83 ,27.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93460,CPT,R&L HRT ART/VENTRICLE ANGIO,26,,21 ,,RBRVS,7.35 ,2.88 ,2.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93460,CPT,R&L HRT ART/VENTRICLE ANGIO,TC,,21 ,,RBRVS,,24.95 ,24.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93461,CPT,R&L HRT ART/VENTRICLE ANGIO,,,21 ,,RBRVS,8.10 ,32.26 ,32.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93461,CPT,R&L HRT ART/VENTRICLE ANGIO,26,,21 ,,RBRVS,8.10 ,3.17 ,3.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93461,CPT,R&L HRT ART/VENTRICLE ANGIO,TC,,21 ,,RBRVS,,29.09 ,29.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93462,CPT,L HRT CATH TRNSPTL PUNCTURE,,,21 ,,RBRVS,3.73 ,1.48 ,1.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93463,CPT,DRUG ADMIN & HEMODYNMIC MEAS,,,21 ,,RBRVS,2.00 ,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93464,CPT,EXERCISE W/HEMODYNAMIC MEAS,,,21 ,,RBRVS,1.80 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93464,CPT,EXERCISE W/HEMODYNAMIC MEAS,26,,21 ,,RBRVS,1.80 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93464,CPT,EXERCISE W/HEMODYNAMIC MEAS,TC,,21 ,,RBRVS,,4.63 ,4.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93503,CPT,INSJ&PLMT FLO DIRED CATH F/MNTR PURPOSES,,,21 ,,RBRVS,2.91 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93505,CPT,ENDOMYOCARDIAL BIOPSY,,,21 ,,RBRVS,4.37 ,15.84 ,15.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93505,CPT,ENDOMYOCARDIAL BIOPSY,26,,21 ,,RBRVS,4.37 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93505,CPT,ENDOMYOCARDIAL BIOPSY,TC,,21 ,,RBRVS,,13.85 ,13.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93530,CPT,R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY,,,21 ,,TotalUnits,,,,33.70 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93530,CPT,R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY,26,,21 ,,TotalUnits,,,,6.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93530,CPT,R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY,TC,,21 ,,TotalUnits,,,,27.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93531,CPT,CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMALY,,,21 ,,TotalUnits,,,,88.17 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93531,CPT,CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMALY,26,,21 ,,TotalUnits,,,,11.94 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93531,CPT,CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMALY,TC,,21 ,,TotalUnits,,,,76.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93532,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN,,,21 ,,TotalUnits,,,,93.91 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93532,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN,26,,21 ,,TotalUnits,,,,14.18 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93532,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN,TC,,21 ,,TotalUnits,,,,79.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93533,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN,,,21 ,,TotalUnits,,,,88.70 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93533,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN,26,,21 ,,TotalUnits,,,,9.52 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93533,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN,TC,,21 ,,TotalUnits,,,,79.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93561,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS,,,4 ,,TotalUnits,,,,2.10 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93561,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS,26,,4 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93561,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS,TC,,4 ,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93562,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEAS,,,4 ,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93562,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEAS,26,,4 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93562,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEAS,TC,,4 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93563,CPT,INJECT CONGENITAL CARD CATH,,,4 ,,RBRVS,1.11 ,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93564,CPT,INJECT HRT CONGNTL ART/GRFT,,,4 ,,RBRVS,1.13 ,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93565,CPT,INJECT L VENTR/ATRIAL ANGIO,,,4 ,,RBRVS,0.86 ,0.34 ,0.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93566,CPT,INJECT R VENTR/ATRIAL ANGIO,,,4 ,,RBRVS,0.86 ,4.06 ,0.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93567,CPT,INJECT SUPRVLV AORTOGRAPHY,,,4 ,,RBRVS,0.97 ,3.08 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93568,CPT,INJECT PULM ART HRT CATH,,,4 ,,RBRVS,0.88 ,3.56 ,0.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93571,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,,,4 ,,TotalUnits,,,,8.13 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93571,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,26,,4 ,,TotalUnits,,,,2.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93571,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,TC,,4 ,,TotalUnits,,,,5.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93572,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,,,4 ,,TotalUnits,,,,4.99 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93572,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,26,,4 ,,TotalUnits,,,,2.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93572,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,TC,,4 ,,TotalUnits,,,,2.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93580,CPT,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,,,21 ,,RBRVS,17.97 ,8.45 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93581,CPT,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,,,21 ,,RBRVS,24.39 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93600,CPT,BUNDLE OF HIS RECORDING,,,4 ,,TotalUnits,,,,3.99 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93600,CPT,BUNDLE OF HIS RECORDING,26,,4 ,,TotalUnits,,,,3.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93600,CPT,BUNDLE OF HIS RECORDING,TC,,4 ,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93602,CPT,INTRA-ATRIAL RECORDING,,,4 ,,TotalUnits,,,,4.25 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93602,CPT,INTRA-ATRIAL RECORDING,26,,4 ,,TotalUnits,,,,3.06 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93602,CPT,INTRA-ATRIAL RECORDING,TC,,4 ,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93603,CPT,R VENTRICULAR REC,,,4 ,,TotalUnits,,,,4.86 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93603,CPT,R VENTRICULAR REC,26,,4 ,,TotalUnits,,,,3.06 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93603,CPT,R VENTRICULAR REC,TC,,4 ,,TotalUnits,,,,1.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93609,CPT,INTRA-VNTR MAPG TCHYCAR SIT W/CATH MNPJ,,,4 ,,TotalUnits,,,,8.96 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93609,CPT,INTRA-VNTR MAPG TCHYCAR SIT W/CATH MNPJ,26,,4 ,,TotalUnits,,,,7.28 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93609,CPT,INTRA-VNTR MAPG TCHYCAR SIT W/CATH MNPJ,TC,,4 ,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93610,CPT,INTRA-ATRIAL PACING,,,4 ,,TotalUnits,,,,4.42 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93610,CPT,INTRA-ATRIAL PACING,26,,4 ,,TotalUnits,,,,4.36 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93610,CPT,INTRA-ATRIAL PACING,TC,,4 ,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93612,CPT,INTRAVENTRICAL PACING,,,4 ,,TotalUnits,,,,6.01 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93612,CPT,INTRAVENTRICAL PACING,26,,4 ,,TotalUnits,,,,4.33 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93612,CPT,INTRAVENTRICAL PACING,TC,,4 ,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93613,CPT,ICAR EPHYS 3-DIMENSIONAL MAPG,,,4 ,,RBRVS,6.99 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93615,CPT,ESOPHGL REC ATR EGRM +-VENTR EGRM,,,4 ,,TotalUnits,,,,1.81 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93615,CPT,ESOPHGL REC ATR EGRM +-VENTR EGRM,26,,4 ,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93615,CPT,ESOPHGL REC ATR EGRM +-VENTR EGRM,TC,,4 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93616,CPT,ESOPHGL REC ATR EGRM +-VENTR EGRM W/PACG,,,4 ,,TotalUnits,,,,2.43 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93616,CPT,ESOPHGL REC ATR EGRM +-VENTR EGRM W/PACG,26,,4 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93616,CPT,ESOPHGL REC ATR EGRM +-VENTR EGRM W/PACG,TC,,4 ,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93618,CPT,INDCTJ ARRHYT ELEC PACG,,,4 ,,TotalUnits,,,,9.54 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93618,CPT,INDCTJ ARRHYT ELEC PACG,26,,4 ,,TotalUnits,,,,6.24 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93618,CPT,INDCTJ ARRHYT ELEC PACG,TC,,4 ,,TotalUnits,,,,3.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93619,CPT,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,,,4 ,,TotalUnits,,,,15.54 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93619,CPT,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,26,,4 ,,TotalUnits,,,,10.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93619,CPT,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,TC,,4 ,,TotalUnits,,,,4.77 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93620,CPT,COMPRE ELECTROPHYSIOLOGIC W/ ARRHYT HMIA INDUCT,,,4 ,,TotalUnits,,,,18.38 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93620,CPT,COMPRE ELECTROPHYSIOLOGIC W/ ARRHYT HMIA INDUCT,26,,4 ,,TotalUnits,,,,16.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93620,CPT,COMPRE ELECTROPHYSIOLOGIC W/ ARRHYT HMIA INDUCT,TC,,4 ,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93621,CPT,COMPRE ELECTROPHYSIOLOGIC W/L ATR PAC/REC,,,4 ,,TotalUnits,,,,4.52 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93621,CPT,COMPRE ELECTROPHYSIOLOGIC W/L ATR PAC/REC,26,,4 ,,TotalUnits,,,,3.07 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93621,CPT,COMPRE ELECTROPHYSIOLOGIC W/L ATR PAC/REC,TC,,4 ,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93622,CPT,COMPRE ELECTROPHYSIOLOGIC W/L VENTR PAC/REC,,,4 ,,TotalUnits,,,,5.99 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93622,CPT,COMPRE ELECTROPHYSIOLOGIC W/L VENTR PAC/REC,26,,4 ,,TotalUnits,,,,4.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93622,CPT,COMPRE ELECTROPHYSIOLOGIC W/L VENTR PAC/REC,TC,,4 ,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93623,CPT,PROGRAMMED STIMJ&PACG AFTER IV DRUG NFS,,,4 ,,TotalUnits,,,,5.55 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93623,CPT,PROGRAMMED STIMJ&PACG AFTER IV DRUG NFS,26,,4 ,,TotalUnits,,,,4.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93623,CPT,PROGRAMMED STIMJ&PACG AFTER IV DRUG NFS,TC,,4 ,,TotalUnits,,,,1.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93624,CPT,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,,,4 ,,TotalUnits,,,,8.48 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93624,CPT,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,26,,4 ,,TotalUnits,,,,7.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93624,CPT,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,TC,,4 ,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93631,CPT,INTRAOP EPICAR&ENDOCAR PACG&MAPG,,,4 ,,TotalUnits,,,,13.42 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93631,CPT,INTRAOP EPICAR&ENDOCAR PACG&MAPG,26,,4 ,,TotalUnits,,,,10.29 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93631,CPT,INTRAOP EPICAR&ENDOCAR PACG&MAPG,TC,,4 ,,TotalUnits,,,,3.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93640,CPT,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,,,4 ,,TotalUnits,,,,11.29 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93640,CPT,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,26,,4 ,,TotalUnits,,,,5.11 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93640,CPT,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,TC,,4 ,,TotalUnits,,,,6.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93641,CPT,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,,,4 ,,TotalUnits,,,,12.99 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93641,CPT,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,26,,4 ,,TotalUnits,,,,8.64 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93641,CPT,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,TC,,4 ,,TotalUnits,,,,4.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93642,CPT,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,,,4 ,,RBRVS,4.88 ,7.06 ,7.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93642,CPT,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,26,,4 ,,RBRVS,4.88 ,2.32 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93642,CPT,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,TC,,4 ,,RBRVS,,4.74 ,4.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93650,CPT,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,,,4 ,,RBRVS,10.49 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93651,CPT,ICAR CATH ABLTJ ARRHYTGNIC FOC SUPVENTR TCHYCAR,,,4 ,,RBRVS,16.23 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93652,CPT,ICAR CATH ABLATION ARRHYTGNIC FOC VENTR TCHYCAR,,,4 ,,RBRVS,17.65 ,8.13 ,8.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93660,CPT,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,,,4 ,,RBRVS,1.89 ,2.63 ,2.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93660,CPT,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,26,,4 ,,RBRVS,1.89 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93660,CPT,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,TC,,4 ,,RBRVS,,1.76 ,1.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93662,CPT,ICE DURING THER/DX IVNTJ INCL IMG S&I,,,4 ,,TotalUnits,,,,5.65 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93662,CPT,ICE DURING THER/DX IVNTJ INCL IMG S&I,26,,4 ,,TotalUnits,,,,4.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93662,CPT,ICE DURING THER/DX IVNTJ INCL IMG S&I,TC,,4 ,,TotalUnits,,,,1.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93668,CPT,PRPH ARTL DISEASE RHAB PR SESS,,,4 ,,RBRVS,,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93701,CPT,BIOIMPD THRC ELEC,,TC,4 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,0,0,0,1,20110101,93701,CPT,BIOIMPD THRC ELEC,26,,4 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,93701,CPT,BIOIMPD THRC ELEC,TC,,4 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,93720,CPT,PLETHYSMOGRAPY TOT BDY W/I&R,,,4 ,,RBRVS,0.17 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93721,CPT,PLETHYSMOGRAPY TOT BDY TRCG ONLY W/O I&R,,TC,4 ,,RBRVS,,0.99 ,0.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93722,CPT,PLETHYSMOGRAPY TOT BDY I&R ONLY,,PC,4 ,,RBRVS,0.17 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93724,CPT,ELEC ALYS ANTITACHYCARDIA PM SYSTEM,,,4 ,,RBRVS,4.88 ,3.63 ,3.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93724,CPT,ELEC ALYS ANTITACHYCARDIA PM SYSTEM,26,,4 ,,RBRVS,4.88 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93724,CPT,ELEC ALYS ANTITACHYCARDIA PM SYSTEM,TC,,4 ,,RBRVS,,1.40 ,1.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93740,CPT,TEMPRATURE GRADIENT STD,,,4 ,,RBRVS,0.16 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93740,CPT,TEMPRATURE GRADIENT STD,26,,4 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93740,CPT,TEMPRATURE GRADIENT STD,TC,,4 ,,RBRVS,,0.04 ,0.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93750,CPT,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,,,4 ,,RBRVS,0.92 ,0.30 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93770,CPT,DETER VEN PRESS,,,4 ,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93770,CPT,DETER VEN PRESS,26,,4 ,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93770,CPT,DETER VEN PRESS,TC,,4 ,,RBRVS,,0.01 ,0.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93784,CPT,AMBL BLD PRESS W/TAPE&/DISK 24+ HR ALYS I&R,,,4 ,,RBRVS,0.38 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93786,CPT,AMBL BLD PRESS W/TAPE&/DISK 24+ HR + REC ONLY,,TC,4 ,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93788,CPT,AMBL BLD PRESS W/TAPE/DISK 24+ HR ALYS W/REPRT,,TC,4 ,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93790,CPT,AMBL BLD PRESS TAPE&/DISK 24+ HR PHYS REV W/I&R,,PC,4 ,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93797,CPT,PHYS SVCS F/O/P CAR RHAB W/O CONT ECG MNTR,,,4 ,,RBRVS,0.18 ,0.08 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93798,CPT,PHYS SVCS F/O/P CAR RHAB W/CONT ECG MNTR,,,4 ,,RBRVS,0.28 ,0.12 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93799,CPT,UNLIS CV SVC/PX,,,4 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,93799,CPT,UNLIS CV SVC/PX,,PC,4 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,93799,CPT,UNLIS CV SVC/PX,,TC,4 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,93875,CPT,N-INVAS PHYSIOLOGIC STD XTRC ART COMPL BI STD,,,14 ,,RBRVS,0.22 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93875,CPT,N-INVAS PHYSIOLOGIC STD XTRC ART COMPL BI STD,26,,14 ,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93875,CPT,N-INVAS PHYSIOLOGIC STD XTRC ART COMPL BI STD,TC,,14 ,,RBRVS,,2.40 ,2.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93880,CPT,DUP-SCAN XTRC ART COMPL BI STD,,,14 ,,RBRVS,0.60 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93880,CPT,DUP-SCAN XTRC ART COMPL BI STD,26,,14 ,,RBRVS,0.60 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93880,CPT,DUP-SCAN XTRC ART COMPL BI STD,TC,,14 ,,RBRVS,,5.63 ,5.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93882,CPT,DUP-SCAN XTRC ART UNI/LMTD STD,,,14 ,,RBRVS,0.40 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93882,CPT,DUP-SCAN XTRC ART UNI/LMTD STD,26,,14 ,,RBRVS,0.40 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93882,CPT,DUP-SCAN XTRC ART UNI/LMTD STD,TC,,14 ,,RBRVS,,3.82 ,3.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93886,CPT,TCD STD ICRA ART COMPL STD,,,14 ,,RBRVS,0.94 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93886,CPT,TCD STD ICRA ART COMPL STD,26,,14 ,,RBRVS,0.94 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93886,CPT,TCD STD ICRA ART COMPL STD,TC,,14 ,,RBRVS,,6.89 ,6.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93888,CPT,TCD STD ICRA ART LMTD STD,,,14 ,,RBRVS,0.62 ,4.79 ,4.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93888,CPT,TCD STD ICRA ART LMTD STD,26,,14 ,,RBRVS,0.62 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93888,CPT,TCD STD ICRA ART LMTD STD,TC,,14 ,,RBRVS,,4.57 ,4.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93890,CPT,TCD STD ICRA ART VASOREACTV STD,,,14 ,,RBRVS,1.00 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93890,CPT,TCD STD ICRA ART VASOREACTV STD,26,,14 ,,RBRVS,1.00 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93890,CPT,TCD STD ICRA ART VASOREACTV STD,TC,,14 ,,RBRVS,,5.77 ,5.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93892,CPT,TCD STD ICRA ART EMBOLI DETCJ W/O IV MBUBB NJX,,,14 ,,RBRVS,1.15 ,7.03 ,7.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93892,CPT,TCD STD ICRA ART EMBOLI DETCJ W/O IV MBUBB NJX,26,,14 ,,RBRVS,1.15 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93892,CPT,TCD STD ICRA ART EMBOLI DETCJ W/O IV MBUBB NJX,TC,,14 ,,RBRVS,,6.64 ,6.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93893,CPT,TCD STD ICRA ART EMBOLI DETCJ W/IV MBUBB NJX,,,14 ,,RBRVS,1.15 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93893,CPT,TCD STD ICRA ART EMBOLI DETCJ W/IV MBUBB NJX,26,,14 ,,RBRVS,1.15 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93893,CPT,TCD STD ICRA ART EMBOLI DETCJ W/IV MBUBB NJX,TC,,14 ,,RBRVS,,6.45 ,6.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93922,CPT,N-INVAS PHYSIOLOGIC STD UPR/LXTR ART 1 LVL BI,,,14 ,,RBRVS,0.25 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93922,CPT,N-INVAS PHYSIOLOGIC STD UPR/LXTR ART 1 LVL BI,26,,14 ,,RBRVS,0.25 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93922,CPT,N-INVAS PHYSIOLOGIC STD UPR/LXTR ART 1 LVL BI,TC,,14 ,,RBRVS,,2.87 ,2.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93923,CPT,N-INVAS PHYSIOLOGIC STD UPR/LXTR BLAT MLT LVL BI,,,14 ,,RBRVS,0.45 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93923,CPT,N-INVAS PHYSIOLOGIC STD UPR/LXTR BLAT MLT LVL BI,26,,14 ,,RBRVS,0.45 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93923,CPT,N-INVAS PHYSIOLOGIC STD UPR/LXTR BLAT MLT LVL BI,TC,,14 ,,RBRVS,,4.31 ,4.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART REST FLWG STRS,,,14 ,,RBRVS,0.50 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART REST FLWG STRS,26,,14 ,,RBRVS,0.50 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART REST FLWG STRS,TC,,14 ,,RBRVS,,5.37 ,5.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STD,,,14 ,,RBRVS,0.58 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STD,26,,14 ,,RBRVS,0.58 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STD,TC,,14 ,,RBRVS,,7.34 ,7.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD,,,14 ,,RBRVS,0.39 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD,26,,14 ,,RBRVS,0.39 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD,TC,,14 ,,RBRVS,,4.70 ,4.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STD,,,14 ,,RBRVS,0.46 ,5.91 ,5.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STD,26,,14 ,,RBRVS,0.46 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STD,TC,,14 ,,RBRVS,,5.75 ,5.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STD,,,14 ,,RBRVS,0.31 ,3.94 ,3.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STD,26,,14 ,,RBRVS,0.31 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STD,TC,,14 ,,RBRVS,,3.84 ,3.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,,,14 ,,RBRVS,0.35 ,2.90 ,2.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,26,,14 ,,RBRVS,0.35 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,TC,,14 ,,RBRVS,,2.78 ,2.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93970,CPT,DUP-SCAN XTR VEINS COMPL BI STD,,,14 ,,RBRVS,0.68 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93970,CPT,DUP-SCAN XTR VEINS COMPL BI STD,26,,14 ,,RBRVS,0.68 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93970,CPT,DUP-SCAN XTR VEINS COMPL BI STD,TC,,14 ,,RBRVS,,5.67 ,5.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93971,CPT,DUP-SCAN XTR VEINS UNI/LMTD STD,,,14 ,,RBRVS,0.45 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93971,CPT,DUP-SCAN XTR VEINS UNI/LMTD STD,26,,14 ,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93971,CPT,DUP-SCAN XTR VEINS UNI/LMTD STD,TC,,14 ,,RBRVS,,3.73 ,3.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COMPL,,,14 ,,RBRVS,1.80 ,8.04 ,8.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COMPL,26,,14 ,,RBRVS,1.80 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COMPL,TC,,14 ,,RBRVS,,7.40 ,7.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMTD,,,14 ,,RBRVS,1.21 ,4.43 ,4.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMTD,26,,14 ,,RBRVS,1.21 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMTD,TC,,14 ,,RBRVS,,4.00 ,4.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPL,,,14 ,,RBRVS,0.65 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPL,26,,14 ,,RBRVS,0.65 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPL,TC,,14 ,,RBRVS,,5.32 ,5.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,,,14 ,,RBRVS,0.44 ,3.85 ,3.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,26,,14 ,,RBRVS,0.44 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,TC,,14 ,,RBRVS,,3.70 ,3.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,,,14 ,,RBRVS,1.25 ,3.39 ,3.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,26,,14 ,,RBRVS,1.25 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,TC,,14 ,,RBRVS,,2.91 ,2.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,,,14 ,,RBRVS,0.44 ,2.75 ,2.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,26,,14 ,,RBRVS,0.44 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,TC,,14 ,,RBRVS,,2.59 ,2.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,93982,CPT,IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC,,,14 ,,RBRVS,0.30 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93990,CPT,DUP-SCAN OF HEMODIALYSIS ACCESS,,,14 ,,RBRVS,0.25 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,93990,CPT,DUP-SCAN OF HEMODIALYSIS ACCESS,26,,14 ,,RBRVS,0.25 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,93990,CPT,DUP-SCAN OF HEMODIALYSIS ACCESS,TC,,14 ,,RBRVS,,4.91 ,4.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94002,CPT,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,,,14 ,,RBRVS,1.99 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94003,CPT,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DAY,,,14 ,,RBRVS,1.37 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94004,CPT,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,,,14 ,,RBRVS,1.00 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94005,CPT,HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>,,,14 ,,RBRVS,1.50 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94010,CPT,SPMTRY W/VC EXPIRATORY FLO +-MXML VOL VNTJ,,,14 ,,RBRVS,0.17 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94010,CPT,SPMTRY W/VC EXPIRATORY FLO +-MXML VOL VNTJ,26,,14 ,,RBRVS,0.17 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94010,CPT,SPMTRY W/VC EXPIRATORY FLO +-MXML VOL VNTJ,TC,,14 ,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94011,CPT,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT-2 YR,,,14 ,,RBRVS,2.00 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94012,CPT,MEAS SPIRO FORCD EXP FLO PRE&POST BRONCH INF-2Y,,,14 ,,RBRVS,3.10 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94013,CPT,MEAS LUNG VOLUMES INFANT OR CHILD THRU 2 YRS,,,14 ,,RBRVS,0.66 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94014,CPT,PT-INTIT SPIROMETRIC REC 30 D PD PHYS R&I,,,14 ,,RBRVS,0.52 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94015,CPT,PT-INTIT SPIROMETRIC REC 30 D PD RECORDING,,TC,14 ,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94016,CPT,PT-INTIT SPIROMETRIC REC 30-D PD PHYS R&I ONLY,,PC,14 ,,RBRVS,0.52 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,,,14 ,,RBRVS,0.31 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,26,,14 ,,RBRVS,0.31 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,TC,,14 ,,RBRVS,,1.15 ,1.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,,,14 ,,RBRVS,0.60 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,26,,14 ,,RBRVS,0.60 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,TC,,14 ,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94150,CPT,VC TOT SPX,,,14 ,,RBRVS,0.07 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94150,CPT,VC TOT SPX,26,,14 ,,RBRVS,0.07 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94150,CPT,VC TOT SPX,TC,,14 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94200,CPT,MAX BRTHING CAP MXML VOL VNTJ,,,14 ,,RBRVS,0.11 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94200,CPT,MAX BRTHING CAP MXML VOL VNTJ,26,,14 ,,RBRVS,0.11 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94200,CPT,MAX BRTHING CAP MXML VOL VNTJ,TC,,14 ,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94240,CPT,FUNCTIONAL RESIDUAL CAPACITY OR RESIDUAL VOLUME,,,14 ,,RBRVS,0.26 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94240,CPT,FUNCTIONAL RESIDUAL CAPACITY OR RESIDUAL VOLUME,26,,14 ,,RBRVS,0.26 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94240,CPT,FUNCTIONAL RESIDUAL CAPACITY OR RESIDUAL VOLUME,TC,,14 ,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94250,CPT,EXP GAS COLLJ QUAN 1 PX SPX,,,14 ,,RBRVS,0.11 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94250,CPT,EXP GAS COLLJ QUAN 1 PX SPX,26,,14 ,,RBRVS,0.11 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94250,CPT,EXP GAS COLLJ QUAN 1 PX SPX,TC,,14 ,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94260,CPT,THRC GAS VOL,,,14 ,,RBRVS,0.13 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94260,CPT,THRC GAS VOL,26,,14 ,,RBRVS,0.13 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94260,CPT,THRC GAS VOL,TC,,14 ,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94350,CPT,DETER MALDISTRIBJ OF INSPIRED GAS N WSHOT CURVE,,,14 ,,RBRVS,0.26 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94350,CPT,DETER MALDISTRIBJ OF INSPIRED GAS N WSHOT CURVE,26,,14 ,,RBRVS,0.26 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94350,CPT,DETER MALDISTRIBJ OF INSPIRED GAS N WSHOT CURVE,TC,,14 ,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94360,CPT,DETER RESIST TO AIRFLO OSCILLATORY/PLETHYSMOGRAP,,,14 ,,RBRVS,0.26 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94360,CPT,DETER RESIST TO AIRFLO OSCILLATORY/PLETHYSMOGRAP,26,,14 ,,RBRVS,0.26 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94360,CPT,DETER RESIST TO AIRFLO OSCILLATORY/PLETHYSMOGRAP,TC,,14 ,,RBRVS,,0.80 ,0.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94370,CPT,DETER AIRWY CLOSING VOL 1 BRTH TSTS,,,14 ,,RBRVS,0.26 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94370,CPT,DETER AIRWY CLOSING VOL 1 BRTH TSTS,26,,14 ,,RBRVS,0.26 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94370,CPT,DETER AIRWY CLOSING VOL 1 BRTH TSTS,TC,,14 ,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94375,CPT,RESPIR FLO VOL LOOP,,,14 ,,RBRVS,0.31 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94375,CPT,RESPIR FLO VOL LOOP,26,,14 ,,RBRVS,0.31 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94375,CPT,RESPIR FLO VOL LOOP,TC,,14 ,,RBRVS,,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94400,CPT,BRTHING RSPSE CO2 CO2 RSPSE CURVE,,,14 ,,RBRVS,0.40 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94400,CPT,BRTHING RSPSE CO2 CO2 RSPSE CURVE,26,,14 ,,RBRVS,0.40 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94400,CPT,BRTHING RSPSE CO2 CO2 RSPSE CURVE,TC,,14 ,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94450,CPT,BRTHING RSPSE HYPOXIA HYPOXIA RSPSE CURVE,,,14 ,,RBRVS,0.40 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94450,CPT,BRTHING RSPSE HYPOXIA HYPOXIA RSPSE CURVE,26,,14 ,,RBRVS,0.40 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94450,CPT,BRTHING RSPSE HYPOXIA HYPOXIA RSPSE CURVE,TC,,14 ,,RBRVS,,0.95 ,0.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94452,CPT,HAST W/PHYS I&R,,,14 ,,RBRVS,0.31 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94452,CPT,HAST W/PHYS I&R,26,,14 ,,RBRVS,0.31 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94452,CPT,HAST W/PHYS I&R,TC,,14 ,,RBRVS,,1.08 ,1.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94453,CPT,HAST W/PHYS I&R W/SUPPL O2 TITRJ,,,14 ,,RBRVS,0.40 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94453,CPT,HAST W/PHYS I&R W/SUPPL O2 TITRJ,26,,14 ,,RBRVS,0.40 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94453,CPT,HAST W/PHYS I&R W/SUPPL O2 TITRJ,TC,,14 ,,RBRVS,,1.48 ,1.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94610,CPT,INTRAPULMONARY SURFACTANT ADMINISTRATION,,,14 ,,RBRVS,1.16 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94620,CPT,PULM STRS TSTG SMPL,,,14 ,,RBRVS,0.64 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94620,CPT,PULM STRS TSTG SMPL,26,,14 ,,RBRVS,0.64 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94620,CPT,PULM STRS TSTG SMPL,TC,,14 ,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94621,CPT,PULM STRS TSTG CPLX,,,14 ,,RBRVS,1.42 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94621,CPT,PULM STRS TSTG CPLX,26,,14 ,,RBRVS,1.42 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94621,CPT,PULM STRS TSTG CPLX,TC,,14 ,,RBRVS,,2.39 ,2.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94640,CPT,PRESS/N-PRESS INHLJ TX F/AAO/SPTM INDCTJ,,,14 ,,RBRVS,,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,94642,CPT,AERSL INHLJ PENTAMIDINE F/PCP TX/PROPH,,,14 ,,TotalUnits,,,,1.26 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,94644,CPT,CONTINUOUS INHALATION TREATMENT 1ST HR,,,14 ,,RBRVS,,0.95 ,0.95 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,94645,CPT,CONTINUOUS INHALATION TREATMENT EA ADDL HR,,,14 ,,RBRVS,,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,94660,CPT,CPAP VNTJ CPAP INITIATION&MGMT,,,14 ,,RBRVS,0.76 ,0.21 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94662,CPT,CNP VNTJ CNP INITIATION&MGMT,,,14 ,,RBRVS,0.76 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94664,CPT,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IPPB,,,14 ,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,94667,CPT,MNPJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,,,14 ,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,94668,CPT,MNPJ CH FACILITATE LNG FUNCJ SBSQ,,,14 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,94680,CPT,O2 UPTK EXP GAS ALYS REST&XERS DIR SMPL,,,14 ,,RBRVS,0.26 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94680,CPT,O2 UPTK EXP GAS ALYS REST&XERS DIR SMPL,26,,14 ,,RBRVS,0.26 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94680,CPT,O2 UPTK EXP GAS ALYS REST&XERS DIR SMPL,TC,,14 ,,RBRVS,,1.16 ,1.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,,,14 ,,RBRVS,0.20 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,26,,14 ,,RBRVS,0.20 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,TC,,14 ,,RBRVS,,1.28 ,1.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94690,CPT,O2 UPTK EXP GAS ALYS REST INDIR SPX,,,14 ,,RBRVS,0.07 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94690,CPT,O2 UPTK EXP GAS ALYS REST INDIR SPX,26,,14 ,,RBRVS,0.07 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94690,CPT,O2 UPTK EXP GAS ALYS REST INDIR SPX,TC,,14 ,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94720,CPT,CARBON MONOXIDE DIFFW/CAP,,,14 ,,RBRVS,0.26 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94720,CPT,CARBON MONOXIDE DIFFW/CAP,26,,14 ,,RBRVS,0.26 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94720,CPT,CARBON MONOXIDE DIFFW/CAP,TC,,14 ,,RBRVS,,1.01 ,1.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94725,CPT,MEMB DIFFUSION CAP,,,14 ,,RBRVS,0.26 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94725,CPT,MEMB DIFFUSION CAP,26,,14 ,,RBRVS,0.26 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94725,CPT,MEMB DIFFUSION CAP,TC,,14 ,,RBRVS,,1.27 ,1.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94750,CPT,PULM COMPLIANCE STD,,,14 ,,RBRVS,0.23 ,1.70 ,1.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94750,CPT,PULM COMPLIANCE STD,26,,14 ,,RBRVS,0.23 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94750,CPT,PULM COMPLIANCE STD,TC,,14 ,,RBRVS,,1.64 ,1.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94760,CPT,N-INVAS EAR/PLS OXIMTRY F/O2 SAT 1 DETER,,TC,14 ,,RBRVS,,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,0,1,1,20110101,94761,CPT,N-INVAS EAR/PLS OXIMTRY F/O2 SAT MLT DETERS,,TC,14 ,,RBRVS,,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,0,1,1,20110101,94762,CPT,N-INVAS EAR/PLS OXIMTRY F/O2 SAT OVRNIT MNTR,,TC,14 ,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,,,14 ,,RBRVS,0.15 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,26,,14 ,,RBRVS,0.15 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,TC,,14 ,,RBRVS,,0.74 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,94772,CPT,CIRCADIAN RESPIR PATTERN REC 12-24 HR INFT,,,14 ,,TotalUnits,,,,3.43 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,94772,CPT,CIRCADIAN RESPIR PATTERN REC 12-24 HR INFT,26,,14 ,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,94772,CPT,CIRCADIAN RESPIR PATTERN REC 12-24 HR INFT,TC,,14 ,,TotalUnits,,,,2.06 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,94774,CPT,PED APNEA MONITOR ATTACHMENT PHYS I&R,,,14 ,,TotalUnits,,,,2.71 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,94776,CPT,PED APNEA MONITOR ANALYSES COMPUTER,,TC,14 ,,TotalUnits,,,,1.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,94777,CPT,PED APNEA MONITOR PHYSICIAN REVIEW,,PC,14 ,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,94799,CPT,UNLIS PULM SVC/PX,,,14 ,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,94799,CPT,UNLIS PULM SVC/PX,,PC,14 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,94799,CPT,UNLIS PULM SVC/PX,,TC,14 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,95004,CPT,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,,2 ,,RBRVS,0.01 ,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95010,CPT,PERQ TSTS SEQL&INCRL RX/BIOLOGIC/VNM IMMT RXN,,,2 ,,RBRVS,0.15 ,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95012,CPT,NITRIC OXIDE EXPIRED GAS DETERMINATION,,,2 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95015,CPT,IQ TSTS SEQL&INCRL RX/BIOLOGIC/VNM IMMT RXN,,,2 ,,RBRVS,0.15 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95024,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,,2 ,,RBRVS,0.01 ,0.17 ,0.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95027,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,,,2 ,,RBRVS,0.01 ,0.11 ,0.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95028,CPT,IQ TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,,TC,2 ,,RBRVS,,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95044,CPT,PATCH/APPL TST SPEC NUMBER TSTS,,,2 ,,RBRVS,,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95052,CPT,PHOTO PATCH TST SPEC NUMBER TSTS,,,2 ,,RBRVS,,0.17 ,0.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95056,CPT,PHOTO TSTS,,,2 ,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95060,CPT,OPH MUC MEMB TSTS,,TC,2 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95065,CPT,DIR NSL MUC MEMB TST,,TC,2 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95070,CPT,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,,TC,2 ,,RBRVS,,1.05 ,1.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95071,CPT,INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES,,TC,2 ,,RBRVS,,1.31 ,1.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95075,CPT,INGESTION CHALLENGE TEST,,,2 ,,RBRVS,0.95 ,0.33 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95115,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,,,1 ,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95117,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,,,1 ,,RBRVS,,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95120,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX,,,1 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95125,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJXS,,,1 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95130,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 1 STING INSECT,,,1 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95131,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 2 STING INSECT,,,1 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95132,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 3 INSECT,,,1 ,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95133,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 4 INSECT,,,1 ,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95134,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 5 INSECT,,,1 ,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95144,CPT,SUPVJ OF PREPJ&PRV AGS F/ALLG IMMNTX 1 DOSE VIAL,,,1 ,,RBRVS,0.06 ,0.02 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95145,CPT,SUPVJ OF PREPJ&PRV AGS F/ALLG IMMNTX 1 INSECT,,,1 ,,RBRVS,0.06 ,0.02 ,0.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95146,CPT,SUPVJ OF PREPJ&PRV AGS F/ALLG IMMNTX 2 INSECT,,,1 ,,RBRVS,0.06 ,0.02 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95147,CPT,SUPVJ PREPJ&PRV AGS F/ALLG IMMNTX 3 INSECT,,,1 ,,RBRVS,0.06 ,0.02 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95148,CPT,SUPVJ PREPJ&PRV AGS F/ALLG IMMNTX 4 INSECT,,,1 ,,RBRVS,0.06 ,0.02 ,0.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95149,CPT,SUPVJ PREPJ&PRV AGS F/ALLG IMMNTX 5 INSECT,,,1 ,,RBRVS,0.06 ,0.02 ,1.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95165,CPT,SUPVJ PREPJ&PRV AGS F/ALLG IMMNTX 1/MLT AGS,,,1 ,,RBRVS,0.06 ,0.02 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95170,CPT,SUPVJ PREPJ&PRV AGS F/ALLG IMMNTX WHL BDY INSECT,,,1 ,,RBRVS,0.06 ,0.02 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95180,CPT,RAPID DESENSITIZATION PX EA HR,,,1 ,,RBRVS,2.01 ,0.87 ,1.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95199,CPT,UNLIS ALL/CLINICAL IMMUNOLOGIC SVC/PX,,,1 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95250,CPT,GLUC MNTR CONT REC FROM INTERSTITIAL TISS FLUID,,TC,14 ,,RBRVS,,3.60 ,3.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95251,CPT,GLUC MNTR CONT REC FROM NTRSTL TISS FLU I&R,,PC,14 ,,RBRVS,0.85 ,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,95800,CPT,SLP STDY UNATTENDED,,,14 ,,RBRVS,1.05 ,37.51 ,37.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95800,CPT,SLP STDY UNATTENDED,26,,14 ,,RBRVS,1.05 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95800,CPT,SLP STDY UNATTENDED,TC,,14 ,,RBRVS,,36.89 ,36.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95801,CPT,SLP STDY UNATND W/ANAL,,,14 ,,RBRVS,1.00 ,64.32 ,64.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95801,CPT,SLP STDY UNATND W/ANAL,26,,14 ,,RBRVS,1.00 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95801,CPT,SLP STDY UNATND W/ANAL,TC,,14 ,,RBRVS,,63.85 ,63.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,,,14 ,,RBRVS,1.00 ,2.37 ,2.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,26,,14 ,,RBRVS,1.00 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,TC,,14 ,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,,,14 ,,RBRVS,1.88 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,26,,14 ,,RBRVS,1.88 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,TC,,14 ,,RBRVS,,8.16 ,8.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATTN,,,14 ,,RBRVS,1.66 ,3.79 ,3.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATTN,26,,14 ,,RBRVS,1.66 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATTN,TC,,14 ,,RBRVS,,3.27 ,3.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,,,14 ,,RBRVS,1.66 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,26,,14 ,,RBRVS,1.66 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,TC,,14 ,,RBRVS,,10.68 ,10.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95808,CPT,POLYSM SLEEP STAGING 1-3 ADDL PARAM,,,14 ,,RBRVS,2.65 ,15.28 ,15.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95808,CPT,POLYSM SLEEP STAGING 1-3 ADDL PARAM,26,,14 ,,RBRVS,2.65 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95808,CPT,POLYSM SLEEP STAGING 1-3 ADDL PARAM,TC,,14 ,,RBRVS,,14.46 ,14.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95810,CPT,POLYSM SLEEP STAGING 4/> ADDL PARAM,,,14 ,,RBRVS,3.52 ,17.08 ,17.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95810,CPT,POLYSM SLEEP STAGING 4/> ADDL PARAM,26,,14 ,,RBRVS,3.52 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95810,CPT,POLYSM SLEEP STAGING 4/> ADDL PARAM,TC,,14 ,,RBRVS,,16.04 ,16.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95811,CPT,POLYSM SLEEP STAGING 4/> ADDL PARAM W/CPAP TX,,,14 ,,RBRVS,3.79 ,18.94 ,18.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95811,CPT,POLYSM SLEEP STAGING 4/> ADDL PARAM W/CPAP TX,26,,14 ,,RBRVS,3.79 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95811,CPT,POLYSM SLEEP STAGING 4/> ADDL PARAM W/CPAP TX,TC,,14 ,,RBRVS,,17.82 ,17.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95812,CPT,EEG EXTND MNTR 41-60 MIN,,,14 ,,RBRVS,1.08 ,6.10 ,6.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95812,CPT,EEG EXTND MNTR 41-60 MIN,26,,14 ,,RBRVS,1.08 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95812,CPT,EEG EXTND MNTR 41-60 MIN,TC,,14 ,,RBRVS,,5.73 ,5.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95813,CPT,EEG EXTND MNTR > 1 HR,,,14 ,,RBRVS,1.73 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95813,CPT,EEG EXTND MNTR > 1 HR,26,,14 ,,RBRVS,1.73 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95813,CPT,EEG EXTND MNTR > 1 HR,TC,,14 ,,RBRVS,,6.27 ,6.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95816,CPT,EEG W/REC AWAKE&DROWSY,,,14 ,,RBRVS,1.08 ,5.50 ,5.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95816,CPT,EEG W/REC AWAKE&DROWSY,26,,14 ,,RBRVS,1.08 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95816,CPT,EEG W/REC AWAKE&DROWSY,TC,,14 ,,RBRVS,,5.13 ,5.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95819,CPT,EEG W/REC AWAKE&ASLEEP,,,14 ,,RBRVS,1.08 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95819,CPT,EEG W/REC AWAKE&ASLEEP,26,,14 ,,RBRVS,1.08 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95819,CPT,EEG W/REC AWAKE&ASLEEP,TC,,14 ,,RBRVS,,5.76 ,5.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95822,CPT,EEG REC COMA/SLEEP ONLY,,,14 ,,RBRVS,1.08 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95822,CPT,EEG REC COMA/SLEEP ONLY,26,,14 ,,RBRVS,1.08 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95822,CPT,EEG REC COMA/SLEEP ONLY,TC,,14 ,,RBRVS,,5.50 ,5.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95824,CPT,EEG CERE DEATH EVAL ONLY,,,14 ,,TotalUnits,,,,5.98 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,95824,CPT,EEG CERE DEATH EVAL ONLY,26,,14 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,95824,CPT,EEG CERE DEATH EVAL ONLY,TC,,14 ,,TotalUnits,,,,4.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95827,CPT,EEG ALL NIGHT REC,,,14 ,,RBRVS,1.08 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95827,CPT,EEG ALL NIGHT REC,26,,14 ,,RBRVS,1.08 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95827,CPT,EEG ALL NIGHT REC,TC,,14 ,,RBRVS,,10.81 ,10.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95829,CPT,ELECTROCORTICOGRAM SURG SPX,,,14 ,,RBRVS,6.20 ,29.17 ,29.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95829,CPT,ELECTROCORTICOGRAM SURG SPX,26,,14 ,,RBRVS,6.20 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95829,CPT,ELECTROCORTICOGRAM SURG SPX,TC,,14 ,,RBRVS,,27.01 ,27.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95830,CPT,INSJ BY PHYS OF SPHENOIDAL ELTRDS F/EEG REC,,,14 ,,RBRVS,1.70 ,0.57 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95831,CPT,MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK,,,14 ,,RBRVS,0.28 ,0.10 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95832,CPT,MUSC TSTG MNL W/REPRT HAND +-CMPRSN NML SIDE,,,14 ,,RBRVS,0.29 ,0.11 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95833,CPT,MUSC TSTG MNL W/REPRT TOT EVAL BDY EX HANDS,,,14 ,,RBRVS,0.47 ,0.16 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95834,CPT,MUSC TSTG MNL W/REPRT TOT EVAL BDY W/HANDS,,,14 ,,RBRVS,0.60 ,0.19 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95851,CPT,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPINE,,,14 ,,RBRVS,0.16 ,0.05 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95852,CPT,ROM MEAS&REPRT HAND +-CMPRSN NML SIDE,,,14 ,,RBRVS,0.11 ,0.04 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95857,CPT,TENSILON TST F/MYASTHENIA GRAVIS,,,14 ,,RBRVS,0.53 ,0.21 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95860,CPT,NDL EMG 1 XTR +-RELATED PARASPI AREAS,,,14 ,,RBRVS,0.96 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95860,CPT,NDL EMG 1 XTR +-RELATED PARASPI AREAS,26,,14 ,,RBRVS,0.96 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95860,CPT,NDL EMG 1 XTR +-RELATED PARASPI AREAS,TC,,14 ,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95861,CPT,NDL EMG 2 XTR +-RELATED PARASPI AREAS,,,14 ,,RBRVS,1.54 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95861,CPT,NDL EMG 2 XTR +-RELATED PARASPI AREAS,26,,14 ,,RBRVS,1.54 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95861,CPT,NDL EMG 2 XTR +-RELATED PARASPI AREAS,TC,,14 ,,RBRVS,,1.15 ,1.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95863,CPT,NDL EMG 3 XTR +-RELATED PARASPI AREAS,,,14 ,,RBRVS,1.87 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95863,CPT,NDL EMG 3 XTR +-RELATED PARASPI AREAS,26,,14 ,,RBRVS,1.87 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95863,CPT,NDL EMG 3 XTR +-RELATED PARASPI AREAS,TC,,14 ,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95864,CPT,NDL EMG 4 XTR +-RELATED PARASPI AREAS,,,14 ,,RBRVS,1.99 ,2.42 ,2.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95864,CPT,NDL EMG 4 XTR +-RELATED PARASPI AREAS,26,,14 ,,RBRVS,1.99 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95864,CPT,NDL EMG 4 XTR +-RELATED PARASPI AREAS,TC,,14 ,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95865,CPT,NDL EMG LARX,,,14 ,,RBRVS,1.57 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95865,CPT,NDL EMG LARX,26,,14 ,,RBRVS,1.57 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95865,CPT,NDL EMG LARX,TC,,14 ,,RBRVS,,0.88 ,0.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95866,CPT,NDL EMG HEMIDPHRM,,,14 ,,RBRVS,1.25 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95866,CPT,NDL EMG HEMIDPHRM,26,,14 ,,RBRVS,1.25 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95866,CPT,NDL EMG HEMIDPHRM,TC,,14 ,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95867,CPT,NDL EMG CRNL NRV SUPPLIED MUSC UNI,,,14 ,,RBRVS,0.79 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95867,CPT,NDL EMG CRNL NRV SUPPLIED MUSC UNI,26,,14 ,,RBRVS,0.79 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95867,CPT,NDL EMG CRNL NRV SUPPLIED MUSC UNI,TC,,14 ,,RBRVS,,0.89 ,0.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95868,CPT,NDL EMG CRNL NRV SUPPLIED MUSC BI,,,14 ,,RBRVS,1.18 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95868,CPT,NDL EMG CRNL NRV SUPPLIED MUSC BI,26,,14 ,,RBRVS,1.18 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95868,CPT,NDL EMG CRNL NRV SUPPLIED MUSC BI,TC,,14 ,,RBRVS,,1.09 ,1.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95869,CPT,NDL EMG THRC PARASPI MUSC EXCLUDING T1/T12,,,14 ,,RBRVS,0.37 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95869,CPT,NDL EMG THRC PARASPI MUSC EXCLUDING T1/T12,26,,14 ,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95869,CPT,NDL EMG THRC PARASPI MUSC EXCLUDING T1/T12,TC,,14 ,,RBRVS,,0.85 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95870,CPT,NDL EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,,,14 ,,RBRVS,0.37 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95870,CPT,NDL EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,26,,14 ,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95870,CPT,NDL EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,TC,,14 ,,RBRVS,,0.81 ,0.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95872,CPT,NDL EMG W/1 FIBER ELTRD QUAN MEAS JITTER,,,14 ,,RBRVS,2.88 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95872,CPT,NDL EMG W/1 FIBER ELTRD QUAN MEAS JITTER,26,,14 ,,RBRVS,2.88 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95872,CPT,NDL EMG W/1 FIBER ELTRD QUAN MEAS JITTER,TC,,14 ,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95873,CPT,ESTIM GDN CONJUNCT CHEMODNRVTJ,,,14 ,,RBRVS,0.37 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95873,CPT,ESTIM GDN CONJUNCT CHEMODNRVTJ,26,,14 ,,RBRVS,0.37 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95873,CPT,ESTIM GDN CONJUNCT CHEMODNRVTJ,TC,,14 ,,RBRVS,,0.82 ,0.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95874,CPT,NDL EMG GDN CONJUNCT CHEMODNRVTJ,,,14 ,,RBRVS,0.37 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95874,CPT,NDL EMG GDN CONJUNCT CHEMODNRVTJ,26,,14 ,,RBRVS,0.37 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95874,CPT,NDL EMG GDN CONJUNCT CHEMODNRVTJ,TC,,14 ,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,,,14 ,,RBRVS,1.10 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,26,,14 ,,RBRVS,1.10 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,TC,,14 ,,RBRVS,,1.10 ,1.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95900,CPT,NRV CNDJ AMPLT&STD EA NRV MOTOR W/O F-WAVE STD,,,14 ,,RBRVS,0.42 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95900,CPT,NRV CNDJ AMPLT&STD EA NRV MOTOR W/O F-WAVE STD,26,,14 ,,RBRVS,0.42 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95900,CPT,NRV CNDJ AMPLT&STD EA NRV MOTOR W/O F-WAVE STD,TC,,14 ,,RBRVS,,0.90 ,0.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95903,CPT,NRV CNDJ AMPLT&STD EA NRV MOTOR W/F-WAVE STD,,,14 ,,RBRVS,0.60 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95903,CPT,NRV CNDJ AMPLT&STD EA NRV MOTOR W/F-WAVE STD,26,,14 ,,RBRVS,0.60 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95903,CPT,NRV CNDJ AMPLT&STD EA NRV MOTOR W/F-WAVE STD,TC,,14 ,,RBRVS,,0.91 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95904,CPT,NRV CNDJ AMPLT&STD EA NRV SENS,,,14 ,,RBRVS,0.34 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95904,CPT,NRV CNDJ AMPLT&STD EA NRV SENS,26,,14 ,,RBRVS,0.34 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95904,CPT,NRV CNDJ AMPLT&STD EA NRV SENS,TC,,14 ,,RBRVS,,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,,,14 ,,RBRVS,0.05 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,26,,14 ,,RBRVS,0.05 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,TC,,14 ,,RBRVS,,2.01 ,2.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95920,CPT,INTRAOP NEUROPHYSIOLOGY TSTG PR HR,,,14 ,,RBRVS,2.11 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95920,CPT,INTRAOP NEUROPHYSIOLOGY TSTG PR HR,26,,14 ,,RBRVS,2.11 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95920,CPT,INTRAOP NEUROPHYSIOLOGY TSTG PR HR,TC,,14 ,,RBRVS,,1.20 ,1.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,,,14 ,,RBRVS,0.90 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,26,,14 ,,RBRVS,0.90 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,TC,,14 ,,RBRVS,,0.81 ,0.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,,,14 ,,RBRVS,0.96 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,26,,14 ,,RBRVS,0.96 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,TC,,14 ,,RBRVS,,1.17 ,1.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95923,CPT,TSTG ANS FUNCJ SUDOMOTOR,,,14 ,,RBRVS,0.90 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95923,CPT,TSTG ANS FUNCJ SUDOMOTOR,26,,14 ,,RBRVS,0.90 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95923,CPT,TSTG ANS FUNCJ SUDOMOTOR,TC,,14 ,,RBRVS,,2.16 ,2.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,,,14 ,,RBRVS,0.54 ,2.99 ,2.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,26,,14 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,TC,,14 ,,RBRVS,,2.80 ,2.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,,,14 ,,RBRVS,0.54 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,26,,14 ,,RBRVS,0.54 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,TC,,14 ,,RBRVS,,2.72 ,2.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,,,14 ,,RBRVS,0.54 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,26,,14 ,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,TC,,14 ,,RBRVS,,2.63 ,2.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,,,14 ,,RBRVS,1.50 ,4.02 ,4.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,26,,14 ,,RBRVS,1.50 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,TC,,14 ,,RBRVS,,3.50 ,3.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,,,14 ,,RBRVS,1.50 ,4.35 ,4.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,26,,14 ,,RBRVS,1.50 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,TC,,14 ,,RBRVS,,3.82 ,3.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,,,14 ,,RBRVS,0.35 ,2.73 ,2.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,26,,14 ,,RBRVS,0.35 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,TC,,14 ,,RBRVS,,2.60 ,2.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95933,CPT,ORBICULARIS OCULI REFLEX ELECTRODX TSTG,,,14 ,,RBRVS,0.59 ,1.20 ,1.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95933,CPT,ORBICULARIS OCULI REFLEX ELECTRODX TSTG,26,,14 ,,RBRVS,0.59 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95933,CPT,ORBICULARIS OCULI REFLEX ELECTRODX TSTG,TC,,14 ,,RBRVS,,0.99 ,0.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95934,CPT,H-REFLEX AMPLT&LATENCY GASTRCN/SOLEUS MUSC,,,14 ,,RBRVS,0.51 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95934,CPT,H-REFLEX AMPLT&LATENCY GASTRCN/SOLEUS MUSC,26,,14 ,,RBRVS,0.51 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95934,CPT,H-REFLEX AMPLT&LATENCY GASTRCN/SOLEUS MUSC,TC,,14 ,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95936,CPT,H-REFLEX AMPLT&LATENCY OTH/THN GASTRCN/SOLEUS,,,14 ,,RBRVS,0.55 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95936,CPT,H-REFLEX AMPLT&LATENCY OTH/THN GASTRCN/SOLEUS,26,,14 ,,RBRVS,0.55 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95936,CPT,H-REFLEX AMPLT&LATENCY OTH/THN GASTRCN/SOLEUS,TC,,14 ,,RBRVS,,0.42 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,,,14 ,,RBRVS,0.65 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,26,,14 ,,RBRVS,0.65 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,TC,,14 ,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95950,CPT,MNTR F/ID&LATERALIZATION CERE SEIZ FOC EEG,,,14 ,,RBRVS,1.51 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95950,CPT,MNTR F/ID&LATERALIZATION CERE SEIZ FOC EEG,26,,14 ,,RBRVS,1.51 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95950,CPT,MNTR F/ID&LATERALIZATION CERE SEIZ FOC EEG,TC,,14 ,,RBRVS,,4.68 ,4.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95951,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CABLE/RADIO EEG/VID,,,14 ,,TotalUnits,,,,13.21 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,95951,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CABLE/RADIO EEG/VID,26,,14 ,,TotalUnits,,,,8.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,95951,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CABLE/RADIO EEG/VID,TC,,14 ,,TotalUnits,,,,5.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95953,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CPTR PORTABLE EEG,,,14 ,,RBRVS,3.30 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95953,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CPTR PORTABLE EEG,26,,14 ,,RBRVS,3.30 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95953,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CPTR PORTABLE EEG,TC,,14 ,,RBRVS,,6.93 ,6.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95954,CPT,RX/PHYSICAL ACTIVAJ PHYS ATTN DURING EEG ACTIVAJ,,,14 ,,RBRVS,2.45 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95954,CPT,RX/PHYSICAL ACTIVAJ PHYS ATTN DURING EEG ACTIVAJ,26,,14 ,,RBRVS,2.45 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95954,CPT,RX/PHYSICAL ACTIVAJ PHYS ATTN DURING EEG ACTIVAJ,TC,,14 ,,RBRVS,,4.08 ,4.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95955,CPT,EEG NONICRA SURG,,,14 ,,RBRVS,1.01 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95955,CPT,EEG NONICRA SURG,26,,14 ,,RBRVS,1.01 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95955,CPT,EEG NONICRA SURG,TC,,14 ,,RBRVS,,2.56 ,2.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95956,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CABLE/RADIO EEG,,,14 ,,RBRVS,3.08 ,16.59 ,16.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95956,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CABLE/RADIO EEG,26,,14 ,,RBRVS,3.08 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95956,CPT,MNTR F/LOCLZJ CERE SEIZ FOC CABLE/RADIO EEG,TC,,14 ,,RBRVS,,15.53 ,15.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95957,CPT,DGTAL ALYS EEG,,,14 ,,RBRVS,1.98 ,5.78 ,5.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95957,CPT,DGTAL ALYS EEG,26,,14 ,,RBRVS,1.98 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95957,CPT,DGTAL ALYS EEG,TC,,14 ,,RBRVS,,5.09 ,5.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95958,CPT,WADA ACTIVJ TST F/HEMISPHERIC FUNCJ W/EEG MNTR,,,14 ,,RBRVS,4.24 ,6.71 ,6.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95958,CPT,WADA ACTIVJ TST F/HEMISPHERIC FUNCJ W/EEG MNTR,26,,14 ,,RBRVS,4.24 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95958,CPT,WADA ACTIVJ TST F/HEMISPHERIC FUNCJ W/EEG MNTR,TC,,14 ,,RBRVS,,5.24 ,5.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95961,CPT,FUNCJAL CORT&SUBCORT MAPG ELTRDS 1 HR PHYS ATTN,,,14 ,,RBRVS,2.97 ,3.26 ,3.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95961,CPT,FUNCJAL CORT&SUBCORT MAPG ELTRDS 1 HR PHYS ATTN,26,,14 ,,RBRVS,2.97 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95961,CPT,FUNCJAL CORT&SUBCORT MAPG ELTRDS 1 HR PHYS ATTN,TC,,14 ,,RBRVS,,2.18 ,2.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95962,CPT,FUNCJAL CORT&SUBCORT MAPG ELTRDS EA HR PHYS ATTN,,,14 ,,RBRVS,3.21 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95962,CPT,FUNCJAL CORT&SUBCORT MAPG ELTRDS EA HR PHYS ATTN,26,,14 ,,RBRVS,3.21 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95962,CPT,FUNCJAL CORT&SUBCORT MAPG ELTRDS EA HR PHYS ATTN,TC,,14 ,,RBRVS,,1.40 ,1.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95965,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/SPON ACTV,,,14 ,,RBRVS,7.99 ,46.45 ,46.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95965,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/SPON ACTV,26,,14 ,,RBRVS,7.99 ,2.98 ,2.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95965,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/SPON ACTV,TC,,14 ,,RBRVS,,43.47 ,43.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95966,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/EVOKED FLD 1,,,14 ,,RBRVS,3.99 ,23.24 ,23.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,95966,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/EVOKED FLD 1,26,,14 ,,RBRVS,3.99 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95966,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/EVOKED FLD 1,TC,,14 ,,RBRVS,,21.74 ,21.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,95967,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/EVOKED FLDS EA,,,14 ,,TotalUnits,,,,23.60 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,95967,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/EVOKED FLDS EA,26,,14 ,,TotalUnits,,,,4.72 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,95967,CPT,MAGNETOENCEPHALOGRAPY REC&ALYS F/EVOKED FLDS EA,TC,,14 ,,TotalUnits,,,,18.88 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,95970,CPT,ELEC ALYS NSTIM PLS GEN BRN/SC/PERPH W/O REPRGRM,,,14 ,,RBRVS,0.45 ,0.14 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95971,CPT,ELEC ALYS NSTIM PLS GEN SMPL SC/PERPH W/PRGRMG,,,14 ,,RBRVS,0.78 ,0.27 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95972,CPT,ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH 1ST HR,,,14 ,,RBRVS,1.50 ,0.50 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95973,CPT,ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH EA 30 MIN,,,14 ,,RBRVS,0.92 ,0.29 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95974,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR,,,14 ,,RBRVS,3.00 ,1.00 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95975,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN,,,14 ,,RBRVS,1.70 ,0.59 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95978,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR,,,14 ,,RBRVS,3.50 ,1.22 ,2.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95979,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN,,,14 ,,RBRVS,1.64 ,0.58 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95980,CPT,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,,,14 ,,RBRVS,0.80 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95981,CPT,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,,,14 ,,RBRVS,0.30 ,0.13 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95982,CPT,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,,,14 ,,RBRVS,0.65 ,0.23 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95990,CPT,RFL&MAIN IMPLT PMP/RSVR F/DRUG DLVR SPI/BRN,,,14 ,,RBRVS,,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95991,CPT,RFL&MAIN IMPLT PMP/RSVR RX DLVR SPI/BRN BY PHYS,,,14 ,,RBRVS,0.77 ,0.21 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95992,CPT,CANALITH REPOSITIONING PROCEDURE,,,14 ,,RBRVS,0.75 ,0.26 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,95999,CPT,UNLIS NEUROLOGICAL/NEUROMUSCULAR DX PX,,,14 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,96000,CPT,COMPRE CPTR MTN ALYS VIDEO TAPING 3-D KINEMATICS,,,14 ,,RBRVS,1.80 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96001,CPT,COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG,,,14 ,,RBRVS,2.15 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96002,CPT,DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC,,,14 ,,RBRVS,0.41 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96003,CPT,DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC,,,14 ,,RBRVS,0.37 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96004,CPT,PHYS R&I CPTR MTN ALYS WALKG/FUNCJAL ACTV REPRT,,PC,14 ,,RBRVS,2.14 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96020,CPT,TEST SELECTION & ADMN FUNCTIONAL BRAIN MAPPING,26,,14 ,,TotalUnits,,,,4.70 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,96040,CPT,MEDICAL GENETICS COUNSELING EA 30 MIN,,,14 ,,RBRVS,,1.10 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96101,CPT,PSYCHOLOGICAL TESTING PR HR F2F TIME W/PT,,,16 ,,RBRVS,1.86 ,0.38 ,0.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96102,CPT,PSYCL TSTG PR HR ADMN BY TECH PR HR,,,16 ,,RBRVS,0.50 ,0.12 ,0.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96103,CPT,PSYCL TSTG PR HR ADMN BY CPTR W/PROF I&R,,,16 ,,RBRVS,0.51 ,0.14 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96105,CPT,ASSMT APHASIA W/I&R PR HR,,,16 ,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96110,CPT,DEVELOPMENTAL TSTG LMTD W/I&R,,,16 ,,RBRVS,,0.19 ,0.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96111,CPT,DEVELOPMENTAL TSTG EXTND W/I&R,,,16 ,,RBRVS,2.60 ,0.79 ,0.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96116,CPT,NUBHVL STATUS XM PR HR F2F W/PT INTERPJ&PREPJ,,,16 ,,RBRVS,1.86 ,0.47 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96118,CPT,NUROPSYC TESTING PR HR F2F W/PT + INTERPJ TIME,,,16 ,,RBRVS,1.86 ,0.37 ,0.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96119,CPT,NUROPSYC TSTG WPROF I&R ADMN BY TECH PR HR,,,16 ,,RBRVS,0.55 ,0.12 ,1.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96120,CPT,NUROPSYC TSTG ADMN BY CPTR W/PROF I&R,,,16 ,,RBRVS,0.51 ,0.13 ,1.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96125,CPT,STANDARDIZED COGNITIVE PERFORMANCE TESTING,,,16 ,,RBRVS,1.70 ,0.45 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96150,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN F2F W/PT 1ST ASSMT,,,16 ,,RBRVS,0.50 ,0.10 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96151,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN F2F W/PT RE-ASSMT,,,16 ,,RBRVS,0.48 ,0.10 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96152,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN F2F INDIV,,,16 ,,RBRVS,0.46 ,0.09 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96153,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN F2F GRP 2/> PTS,,,16 ,,RBRVS,0.10 ,0.02 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96154,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN F2F FAM W/PT,,,16 ,,RBRVS,0.45 ,0.09 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96155,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN F2F FAM W/O PT,,,16 ,,RBRVS,0.44 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,96360,CPT,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,,,22 ,,RBRVS,0.17 ,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96361,CPT,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,,,22 ,,RBRVS,0.09 ,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96365,CPT,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST >1 HOUR,,,22 ,,RBRVS,0.21 ,1.60 ,1.60 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96366,CPT,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,,,22 ,,RBRVS,0.18 ,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96367,CPT,IV NFS THER PROPH/DX ADDL SEQUENTIAL NFS >1 HR,,,22 ,,RBRVS,0.19 ,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96368,CPT,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,,,22 ,,RBRVS,0.17 ,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96369,CPT,SUBCUTANEOUS INFUSION INITIAL 1 HR W/PUMP SET-UP,,,22 ,,RBRVS,0.21 ,3.80 ,3.80 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96370,CPT,SUBCUTANEOUS INFUSION EACH ADDITIONAL HOUR,,,22 ,,RBRVS,0.18 ,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96371,CPT,SUBQ INFUSION ADDITIONAL PUMP INFUSION SITE,,,22 ,,RBRVS,,2.07 ,2.07 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96372,CPT,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,,,22 ,,RBRVS,0.17 ,0.41 ,0.41 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96373,CPT,THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,,,22 ,,RBRVS,0.17 ,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96374,CPT,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,,,22 ,,RBRVS,0.18 ,1.26 ,1.26 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96375,CPT,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG,,,22 ,,RBRVS,0.10 ,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,96376,CPT,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,,,22 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,96379,CPT,UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS,,,22 ,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,96401,CPT,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,,,14 ,,RBRVS,0.21 ,1.63 ,1.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96402,CPT,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,,,14 ,,RBRVS,0.19 ,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96405,CPT,CHEMOTX ADMN ILESN UP&W/7 <,,,14 ,,RBRVS,0.52 ,0.26 ,1.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96406,CPT,CHEMOTX ADMN ILESN > 7,,,14 ,,RBRVS,0.80 ,0.35 ,2.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96409,CPT,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,,,14 ,,RBRVS,0.24 ,2.69 ,2.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96411,CPT,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,,,14 ,,RBRVS,0.20 ,1.45 ,1.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96413,CPT,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,,,14 ,,RBRVS,0.28 ,3.56 ,3.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96415,CPT,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,,,14 ,,RBRVS,0.19 ,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96416,CPT,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,,,14 ,,RBRVS,0.21 ,3.99 ,3.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96417,CPT,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,,,14 ,,RBRVS,0.21 ,1.69 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96420,CPT,CHEMOTX ADMN IA PUSH TQ,,,14 ,,RBRVS,0.17 ,2.64 ,2.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96422,CPT,CHEMOTX ADMN IA NFS TQ UP 1 HR,,,14 ,,RBRVS,0.17 ,4.38 ,4.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96423,CPT,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,,,14 ,,RBRVS,0.17 ,1.89 ,1.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96425,CPT,CHEMOTX ADMN IA NFS > 8 HR PRTBLE IMPLTBL PMP,,,14 ,,RBRVS,0.17 ,4.39 ,4.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96440,CPT,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,,,14 ,,RBRVS,2.37 ,1.13 ,15.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96446,CPT,CHEMOTX ADMN PRTL CAVITY,,,14 ,,RBRVS,0.37 ,4.79 ,0.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96450,CPT,CHEMOTX ADMN CNS REQ&W/SPI PNXR,,,14 ,,RBRVS,1.53 ,0.78 ,3.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96521,CPT,RFL/MAIN PORTABLE PMP,,,14 ,,RBRVS,0.21 ,3.17 ,3.17 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,96522,CPT,RFL/MAIN IMPLTABLE PMP/RSVR F/DRUG DLVR SYSIC,,,14 ,,RBRVS,0.21 ,2.65 ,2.65 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,96523,CPT,IRRIGATION IMPLTED VAD F/DRUG DLVR SYSS,,,14 ,,RBRVS,0.04 ,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,96542,CPT,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1+ AGENTS,,,14 ,,RBRVS,0.75 ,0.43 ,2.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96549,CPT,UNLIS CHEMOTX PX,,,14 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,96567,CPT,PDT XTRNL APPL LIGHT DSTR LES SKN BY ACTIVJ RX,,,14 ,,RBRVS,,3.24 ,3.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96570,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,,,14 ,,RBRVS,1.10 ,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96571,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,,,14 ,,RBRVS,0.55 ,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96900,CPT,ACTIXH ULTRAVIOLET LIGHT,,,14 ,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96902,CPT,MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM,,,14 ,,RBRVS,0.41 ,0.14 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96904,CPT,WHOLE BODY INTEGUMENTARY PHOTOGRAPHY,,,14 ,,RBRVS,,1.73 ,1.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96910,CPT,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,,,14 ,,RBRVS,,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96912,CPT,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,,,14 ,,RBRVS,,2.20 ,2.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96913,CPT,PHOTOCHEMOTX F/PHOTORESPONSIVE DERMATOSES,,,14 ,,RBRVS,,3.04 ,3.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96920,CPT,LASER TX F/PSORIASIS TOT AREA < 250 CM,,,14 ,,RBRVS,1.15 ,0.62 ,3.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96921,CPT,LASER TX F/PSORIASIS 250-500 SQ CM,,,14 ,,RBRVS,1.17 ,0.59 ,3.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96922,CPT,LASER TX F/PSORIASIS > 500 SQ CM,,,14 ,,RBRVS,2.10 ,1.07 ,4.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,96999,CPT,UNLIS SPEC DERMATOLOGICAL SVC/PX,,,14 ,,TotalUnits,,,,1.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,97001,CPT,PHYSICAL THER EVAL,,,19 ,,RBRVS,1.20 ,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97002,CPT,PHYSICAL THER RE-EVAL,,,19 ,,RBRVS,0.60 ,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97003,CPT,OCCUPATIONAL THER EVAL,,,19 ,,RBRVS,1.20 ,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97004,CPT,OCCUPATIONAL THER RE-EVAL,,,19 ,,RBRVS,0.60 ,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97005,CPT,ATHLETIC TRAINJ EVAL,,,19 ,,TotalUnits,,,,1.51 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97006,CPT,ATHLETIC TRAINJ RE-EVAL,,,19 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97010,CPT,APPL MODALITY 1+ AREAS HOT/COLD PACKS,,,19 ,,RBRVS,0.06 ,0.07 ,0.07 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97012,CPT,APPL MODALITY 1+ AREAS TRCJ MCHNL,,,19 ,,RBRVS,0.25 ,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97014,CPT,APPL MODALITY 1+ AREAS ELEC STIMJ UNATTN,,,19 ,,RBRVS,0.18 ,0.19 ,0.19 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97016,CPT,APPL MODALITY 1+ AREAS VASOPNEUMATIC DEV,,,19 ,,RBRVS,0.18 ,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97018,CPT,APPL MODALITY 1+ AREAS PARAFFIN BATH,,,19 ,,RBRVS,0.06 ,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97022,CPT,APPL MODALITY 1+ AREAS WP,,,19 ,,RBRVS,0.17 ,0.33 ,0.33 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97024,CPT,APPL MODALITY 1+ AREAS DTHRM,,,19 ,,RBRVS,0.06 ,0.09 ,0.09 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97026,CPT,APPL MODALITY 1+ AREAS INFRARED,,,19 ,,RBRVS,0.06 ,0.07 ,0.07 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97028,CPT,APPL MODALITY 1+ AREAS ULTRAVIOLET,,,19 ,,RBRVS,0.08 ,0.09 ,0.09 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97032,CPT,APPL MODALITY 1+ AREAS ELEC STIMJ EA 15 MIN,,,19 ,,RBRVS,0.25 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97033,CPT,APPL MODALITY 1+ AREAS IONTOPHORESIS EA 15 MIN,,,19 ,,RBRVS,0.26 ,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97034,CPT,APPL MODALITY 1+ AREAS CNTRST BATHS EA 15 MIN,,,19 ,,RBRVS,0.21 ,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97035,CPT,APPL MODALITY 1+ AREAS US EA 15 MIN,,,19 ,,RBRVS,0.21 ,0.11 ,0.11 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97036,CPT,APPL MODALITY 1+ AREAS HUBBARD TANK EA 15 MIN,,,19 ,,RBRVS,0.28 ,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97039,CPT,UNLIS MODALITY SPEC TYP&TM IF CONSTANT ATTN,,,19 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97110,CPT,THER PX 1+ AREAS EA 15 MIN THER XERSS,,,19 ,,RBRVS,0.45 ,0.33 ,0.33 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97112,CPT,THER PX 1+ AREAS EA 15 MIN NEUROMUSC REEDUCAJ,,,19 ,,RBRVS,0.45 ,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97113,CPT,THER PX 1+ AREAS EA 15 MIN AQUATIC THER W/XERSS,,,19 ,,RBRVS,0.44 ,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97116,CPT,THER PX 1+ AREAS EA 15 MIN GAIT TRAINJ W/STAIR,,,19 ,,RBRVS,0.40 ,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97124,CPT,THER PX 1+ AREAS EA 15 MIN MASSAGE,,,19 ,,RBRVS,0.35 ,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97139,CPT,UNLIS THER PX SPEC,,,19 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97140,CPT,MNL THER TQS 1+ REGIONS EA 15 MIN,,,19 ,,RBRVS,0.43 ,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97150,CPT,THER PX GRP 2/> INDIVS,,,19 ,,RBRVS,0.27 ,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97530,CPT,THER ACTV DIR PT CONTACT BY PROVIDER EA 15 MIN,,,19 ,,RBRVS,0.44 ,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97532,CPT,DEVELOPMENT OF COGNITIVE SKILLS EA 15 MIN,,,19 ,,RBRVS,0.44 ,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97533,CPT,SENSORY INTEGRATIVE TQS EA 15 MIN,,,19 ,,RBRVS,0.44 ,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97535,CPT,SELF-CARE/HOME MGMT TRAINING EA 15 MIN,,,19 ,,RBRVS,0.45 ,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97537,CPT,COMMUNITY/WORK REINTEGRATION TRAINJ EA 15 MIN,,,19 ,,RBRVS,0.45 ,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97542,CPT,WHEELCHAIR MGMT EA 15 MIN,,,19 ,,RBRVS,0.45 ,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97545,CPT,WORK HARDENING/CONDITIONING 1ST 2 HR,,,19 ,,TotalUnits,,,,2.84 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97546,CPT,WORK HARDENING/CONDITIONING EA HR,,,19 ,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97597,CPT,RMVL DEVITAL TISS SLCTV DBRDMT W/O ANES 20 CM,,,14 ,,RBRVS,0.58 ,0.23 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,97598,CPT,RMVL DEVITAL TISS SLCTV DBRDMT W/O ANES > 20 CM,,,14 ,,RBRVS,0.80 ,0.30 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,97602,CPT,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,,,14 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,97605,CPT,NEG PRESS WND THER </EQUAL 50 SQ CM,,,14 ,,RBRVS,0.55 ,0.15 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,97606,CPT,NEG PRESS WND THER > 50 SQ CM,,,14 ,,RBRVS,0.60 ,0.16 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,97750,CPT,PHYSICAL PERFORMANCE TST/MEAS W/RPRT 15 MIN,,,19 ,,RBRVS,0.45 ,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97755,CPT,ASSTV TECHN ASSMT DIR CNTCT W/REPRT 15 MIN,,,19 ,,RBRVS,0.62 ,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97760,CPT,ORTHOTIC MGMT&TRAINJ UXTR LXTR&/TRNK EA 15 MIN,,,19 ,,RBRVS,0.45 ,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97761,CPT,PROSTC TRAINJ UPR&/LXTR EA 15 MIN,,,19 ,,RBRVS,0.45 ,0.34 ,0.34 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97762,CPT,CHECKOUT F/ORTHOTIC/PROSTC USE EST PT EA 15 MIN,,,19 ,,RBRVS,0.25 ,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,97799,CPT,UNLIS PHYSICAL MED/RHAB SVC/PX,,,19 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,97802,CPT,MED NUTR THER 1ST ASSMT&IVNTJ INDIV EA 15 MIN,,,14 ,,RBRVS,0.53 ,0.22 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,97803,CPT,MED NUTR THER RE-ASSMT&IVNTJ INDIV EA 15 MIN,,,14 ,,RBRVS,0.45 ,0.19 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,97804,CPT,MED NUTR THER GRP2/> INDIV EA 30 MIN,,,14 ,,RBRVS,0.25 ,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,97810,CPT,ACUP 1/> NDLS W/O ELEC STIMJ 1ST 15 MIN,,,14 ,,RBRVS,0.60 ,0.22 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,97811,CPT,ACUP 1/> NDLS W/O ELEC STIMJ EA 15 MIN,,,14 ,,RBRVS,0.50 ,0.18 ,0.22 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,97813,CPT,ACUP 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,,,14 ,,RBRVS,0.65 ,0.24 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,97814,CPT,ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ,,,14 ,,RBRVS,0.55 ,0.20 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98925,CPT,OSTEOPATHIC MANIPULATIVE TX 1-2 BDY REGIONS,,,19 ,,RBRVS,0.45 ,0.14 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,98926,CPT,OSTEOPATHIC MANIPULATIVE TX 3-4 BDY REGIONS,,,19 ,,RBRVS,0.65 ,0.21 ,0.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,98927,CPT,OSTEOPATHIC MANIPULATIVE TX 5-6 BDY REGIONS,,,19 ,,RBRVS,0.87 ,0.26 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,98928,CPT,OSTEOPATHIC MANIPULATIVE TX 7-8 BDY REGIONS,,,19 ,,RBRVS,1.03 ,0.31 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,98929,CPT,OSTEOPATHIC MANIPULATIVE TX 9-10 BDY REGIONS,,,19 ,,RBRVS,1.19 ,0.36 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,98940,CPT,CMT SPI 1-2 REGIONS,,,5 ,,RBRVS,0.45 ,0.12 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98941,CPT,CMT SPI 3-4 REGIONS,,,5 ,,RBRVS,0.65 ,0.18 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98942,CPT,CMT SPI 5 REGIONS,,,5 ,,RBRVS,0.87 ,0.25 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98943,CPT,CMT XTRSPI 1+ REGIONS,,,5 ,,RBRVS,0.40 ,0.14 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98960,CPT,EDUCAJ&TRAINJ F/PT SELF-MGMT BY NONPHYS 1 PT,,,14 ,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98961,CPT,EDUCAJ&TRAINJ F/PT SELF-MGMT BY NONPHYS 2-4 PT,,,14 ,,RBRVS,,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98962,CPT,EDUCAJ&TRAINJ F/PT SELF-MGMT BY NONPHYS 5-8 PTS,,,14 ,,RBRVS,,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98966,CPT,NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN,,,15 ,,RBRVS,0.25 ,0.08 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98967,CPT,NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN,,,15 ,,RBRVS,0.50 ,0.18 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98968,CPT,NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN,,,15 ,,RBRVS,0.75 ,0.26 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,98969,CPT,NONPHYSICIAN ONLINE ASSESSMENT AND MANAGEMENT,,,15 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99000,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,,,14 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99001,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,,,14 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99002,CPT,HANDLING CONVEY/ANY OTH SVC INVG DEV FIT BY PHYS,,,14 ,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99024,CPT,PO F-UP VST RELATED TO ORIGINAL PX,,,14 ,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99026,CPT,HOSP MANDATED CALL SVC IN-HOSP EA HR,,,14 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99027,CPT,HOSP MANDATED CALL SVC OUT-OF-HOSP EA HR,,,14 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99050,CPT,SVCS PRV OFFICE OTH/THN REG SCHEDD HRS,,,15 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99051,CPT,SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS,,,15 ,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99053,CPT,SVC PRV BTW 10 PM&8 AM AT 24-HR FAC,,,15 ,,TotalUnits,,,,1.28 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99056,CPT,SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT,,,15 ,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99058,CPT,SVC PRV EMER BASIS OFFICE DISRUPTS OFFICE SVCS,,,15 ,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99060,CPT,SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC,,,15 ,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99070,CPT,SUPPLIES&MATERIALS PRV BY PHYS >&ABOVE,,,14 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,99071,CPT,EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST,,,14 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,99075,CPT,MEDICAL TSTIMONY,,,14 ,,TotalUnits,,,,2.41 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99078,CPT,PHYS EDUCATIONAL SVCS RENDERED PTS GRP SETTING,,,14 ,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99080,CPT,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,,,14 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99082,CPT,UNUSUAL TRAVEL,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99090,CPT,ALYS CLINICAL DATA STORED CPTRS,,,14 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99091,CPT,COLLJ&INTERPJ PHYSIO DATA DIG STRD/TRANS 30 MIN,,,14 ,,RBRVS,1.10 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99100,CPT,ANES F/PT EXTREME AGE UNDER 1 YR&> 70,,,14 ,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99116,CPT,ANES COMP UTILIZATION TOT BDY HYPOTHMIA,,,14 ,,TotalUnits,,,,1.71 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99135,CPT,ANES COMP UTILIZATION CTRLLED HYPOTENSION,,,14 ,,TotalUnits,,,,4.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99140,CPT,ANES COMP EMER CONDITIONS SPEC,,,14 ,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99143,CPT,M-SEDATJ BY SM PHYS PERFRMG SVC < 5 YR,,,14 ,,TotalUnits,,,,1.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99144,CPT,M-SEDAJ BY SM PHYS PERFRMG SVC 5+ YR,,,14 ,,TotalUnits,,,,1.24 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99145,CPT,M-SEDAJ BY SM PHYS PERFRMG SVC EA 15 MIN,,,14 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99148,CPT,M-SEDATION BY PHYS OTH/THN HC PROF PERFRMG < 5,,,14 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99149,CPT,M-SEDATION BY PHYS OTH/THN HC PROF PERFRMG 5+,,,14 ,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99150,CPT,M-SEDAJ PHYS OTH/THN HC PROF PERFRMG EA 15 MIN,,,14 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99170,CPT,COLLJ/INT PHYSIO DATA DIG STRD/TRANS MINIM 30MIN,,,14 ,,RBRVS,1.75 ,0.77 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99172,CPT,VSL FUNC SCRNG AUTO SEMI-AUTO BI QUAN DETERM,,,23 ,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,99173,CPT,SCREENING,,,23 ,,RBRVS,,0.06 ,0.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,99174,CPT,OCULAR PHOTOSCREENING INTERPRETATION BILATERAL,,,23 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,99175,CPT,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,,,14 ,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,99183,CPT,PHYS ATTN&SUPVJ HYPRBARIC OXYGEN THER PR SESS,,,14 ,,RBRVS,2.34 ,0.69 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99190,CPT,ASSEM/OPRATN PMP OXTJ/HEAT EXCHNGR EA HR,,,14 ,,TotalUnits,,,,12.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99191,CPT,ASSEM/OPRATN PMP OXTJ/HEAT EXCHNGR 3/4 HR,,,14 ,,TotalUnits,,,,8.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99192,CPT,ASSEM/OPRATN PMP OXTJ/HEAT EXCHNGR 1/2 HR,,,14 ,,TotalUnits,,,,6.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99195,CPT,PHLEBOTOMY THER SPX,,,14 ,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,99199,CPT,UNLIS SPEC SVC PX/REPRT,,,14 ,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,99201,CPT,OFFICE OUTPT NEW 10 MIN,,,15 ,,RBRVS,0.48 ,0.18 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99202,CPT,OFFICE OUTPT NEW 20 MINUTES,,,15 ,,RBRVS,0.93 ,0.35 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99203,CPT,OFFICE OUTPT NEW 30 MIN,,,15 ,,RBRVS,1.42 ,0.50 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99204,CPT,OFFICE OUTPT NEW 45 MIN,,,15 ,,RBRVS,2.43 ,0.82 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99205,CPT,OFFICE OUTPT NEW 60 MIN,,,15 ,,RBRVS,3.17 ,1.04 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99211,CPT,OFFICE O/P EST 5 MIN,,,15 ,,RBRVS,0.18 ,0.06 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99212,CPT,OFFICE OUTPT EST 10 MIN,,,15 ,,RBRVS,0.48 ,0.17 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99213,CPT,OFFICE OUTPT EST15 MIN,,,15 ,,RBRVS,0.97 ,0.32 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99214,CPT,OFFICE OUTPT EST 25 MIN,,,15 ,,RBRVS,1.50 ,0.49 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99215,CPT,OFFICE OUTPT EST 40 MIN,,,15 ,,RBRVS,2.11 ,0.70 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99217,CPT,OBS CARE DSCHRG D MGMT,,,10 ,,RBRVS,1.28 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99218,CPT,1ST OBS CARE PR D LOW SEVERITY,,,10 ,,RBRVS,1.28 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99219,CPT,1ST OBS CARE PR D MODERATE SEVERITY,,,10 ,,RBRVS,2.14 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99220,CPT,1ST OBS CARE PR D HIGH SEVERITY,,,10 ,,RBRVS,2.99 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99221,CPT,1ST HOSP CARE PR D 30 MIN,,,10 ,,RBRVS,1.92 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99222,CPT,1ST HOSP CARE PR D 50 MIN,,,10 ,,RBRVS,2.61 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99223,CPT,1ST HOSP CARE PR D 70 MIN,,,10 ,,RBRVS,3.86 ,1.20 ,1.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99224,CPT,SUBSEQUENT OBSERVATION CARE,,,10 ,,RBRVS,0.54 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99225,CPT,SUBSEQUENT OBSERVATION CARE,,,10 ,,RBRVS,0.96 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99226,CPT,SUBSEQUENT OBSERVATION CARE,,,10 ,,RBRVS,1.44 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99231,CPT,SBSQ HOSP CARE PR D 15 MIN,,,10 ,,RBRVS,0.76 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99232,CPT,SBSQ HOSP CARE PR D 25 MIN,,,10 ,,RBRVS,1.39 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99233,CPT,SBSQ HOSP CARE PR D 35 MIN,,,10 ,,RBRVS,2.00 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99234,CPT,OBS/I/P HOSP CARE LOW SEVERITY,,,10 ,,RBRVS,2.56 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99235,CPT,OBS/I/P HOSP CARE MODERATE SEVERITY,,,10 ,,RBRVS,3.41 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99236,CPT,OBS/I/P HOSP CARE HIGH SEVERITY,,,10 ,,RBRVS,4.26 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99238,CPT,HOSP DSCHRG D MGMT 30 MIN/<,,,10 ,,RBRVS,1.28 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99239,CPT,HOSP DSCHRG D MGMT > 30 MIN,,,10 ,,RBRVS,1.90 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99241,CPT,OFFICE CONSLTJ 15 MIN,,,6 ,,RBRVS,0.64 ,0.24 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99242,CPT,OFFICE CONSLTJ 30 MIN,,,6 ,,RBRVS,1.34 ,0.51 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99243,CPT,OFFICE CONSLTJ 40 MIN,,,6 ,,RBRVS,1.88 ,0.71 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99244,CPT,OFFICE CONSLTJ 60 MIN,,,6 ,,RBRVS,3.02 ,1.14 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99245,CPT,OFFICE CONSLTJ 80 MIN,,,6 ,,RBRVS,3.77 ,1.38 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99251,CPT,1ST INPT CONSLTJ 20 MIN,,,6 ,,RBRVS,1.00 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99252,CPT,1ST INPT CONSLTJ 40 MIN,,,6 ,,RBRVS,1.50 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99253,CPT,1ST INPT CONSLTJ 55 MIN,,,6 ,,RBRVS,2.27 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99254,CPT,1ST INPT CONSLTJ 80 MIN,,,6 ,,RBRVS,3.29 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99255,CPT,1ST INPT CONSLTJ 110 MIN,,,6 ,,RBRVS,4.00 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99281,CPT,EMER DEPT SELF LIMITED/MINOR,,,7 ,,RBRVS,0.45 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99282,CPT,EMER DEPT LOW TO MODERATE SEVERITY,,,7 ,,RBRVS,0.88 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99283,CPT,EMER DEPT MODERATE SEVERITY,,,7 ,,RBRVS,1.34 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99284,CPT,EMER DEPT HI SEVERITY&URGENT EVAL,,,7 ,,RBRVS,2.56 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99285,CPT,EMER DEPT HIGH SEVERITY&THREAT FUNCJ,,,7 ,,RBRVS,3.80 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99288,CPT,PHYS DIRION EMS ADVD LIFE SUPPORT,,,7 ,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99291,CPT,CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN,,,10 ,,RBRVS,4.50 ,1.24 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99292,CPT,CC E/M CRITICALLY ILL/INJURED EA 30 MIN,,,10 ,,RBRVS,2.25 ,0.62 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99304,CPT,1ST NF CARE PR D E/M LW SEVERITY,,,10 ,,RBRVS,1.64 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99305,CPT,1ST NF CARE PR D E/M MOD SEVERITY,,,10 ,,RBRVS,2.35 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99306,CPT,1ST NF CARE PR D E/M HI SEVERITY,,,10 ,,RBRVS,3.06 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99307,CPT,SBSQ NF CARE PR D E/M STABLE,,,10 ,,RBRVS,0.76 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99308,CPT,SBSQ NF CARE PR D E/M MINOR COMPLCTJ,,,10 ,,RBRVS,1.16 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99309,CPT,SBSQ NF CARE PR D E/M NEW PROBLEM,,,10 ,,RBRVS,1.55 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99310,CPT,SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM,,,10 ,,RBRVS,2.35 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99315,CPT,NF DSCHRG D MGMT 30 MIN/<,,,10 ,,RBRVS,1.13 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99316,CPT,NF DSCHRG D MGMT > 30 MIN,,,10 ,,RBRVS,1.50 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99318,CPT,E/M PT INVG ANNUAL NF ASSMT,,,10 ,,RBRVS,1.71 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99324,CPT,DOM/R-HOME LW SEVERITY,,,15 ,,RBRVS,1.01 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99325,CPT,DOM/R-HOME E/M NEW PT MOD SEVERITY,,,15 ,,RBRVS,1.52 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99326,CPT,DOM/R-HOME E/M NEW PT MOD HI SEVERITY,,,15 ,,RBRVS,2.63 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99327,CPT,DOM/R-HOME E/M NEW PT HI SEVERITY,,,15 ,,RBRVS,3.46 ,1.20 ,1.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99328,CPT,DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM,,,15 ,,RBRVS,4.09 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99334,CPT,DOM/R-HOME E/M EST PT SELF-LMTD/MINOR,,,15 ,,RBRVS,1.07 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99335,CPT,DOM/R-HOME E/M EST PT LW MOD SEVERITY,,,15 ,,RBRVS,1.72 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99336,CPT,DOM/R-HOME E/M EST PT MOD HI SEVERITY,,,15 ,,RBRVS,2.46 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99337,CPT,DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM,,,15 ,,RBRVS,3.58 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99339,CPT,INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 15-29 MIN,,,15 ,,RBRVS,1.25 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99340,CPT,INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>,,,15 ,,RBRVS,1.80 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99341,CPT,HOME VST NEW PT LOW SEVERITY,,,15 ,,RBRVS,1.01 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99342,CPT,HOME VST NEW PT MOD SEVERITY,,,15 ,,RBRVS,1.52 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99343,CPT,HOME VST NEW PT MOD TO HI SEVERITY,,,15 ,,RBRVS,2.53 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99344,CPT,HOME VST NEW PT HI SEVERITY,,,15 ,,RBRVS,3.38 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99345,CPT,HOME VST NEW PT UNSTABLE/SIGNIFICANT NEW PROBLEM,,,15 ,,RBRVS,4.09 ,1.40 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99347,CPT,HOME VST EST PT SELF LIMITED/MINOR,,,15 ,,RBRVS,1.00 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99348,CPT,HOME VST EST PT LOW TO MOD SEVERITY,,,15 ,,RBRVS,1.56 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99349,CPT,HOME VST EST PT MOD TO HI SEVERITY,,,15 ,,RBRVS,2.33 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99350,CPT,HOME VST EST PT UNSTABLE/SIGNIFICANT NEW PROBLEM,,,15 ,,RBRVS,3.28 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99354,CPT,PROLNG PHYS SVC OFFICE O/P DIR CONTACT 1ST HR,,,15 ,,RBRVS,1.77 ,0.60 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99355,CPT,PROLNG PHYS SVC OFFICE O/P DIR CONTACT EA 30 MIN,,,15 ,,RBRVS,1.77 ,0.57 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99356,CPT,PROLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR,,,10 ,,RBRVS,1.71 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99357,CPT,PROLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN,,,10 ,,RBRVS,1.71 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99358,CPT,PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR,,,15 ,,RBRVS,2.10 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99359,CPT,PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MIN,,,15 ,,RBRVS,1.00 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99360,CPT,PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MIN,,,14 ,,RBRVS,1.20 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99363,CPT,ANTICOAGULANT MGMT OUTPATIENT 1ST 90 DAYS,,,14 ,,RBRVS,1.65 ,0.57 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99364,CPT,ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS,,,14 ,,RBRVS,0.63 ,0.22 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99366,CPT,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,,,15 ,,RBRVS,0.82 ,0.28 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99367,CPT,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,,,15 ,,RBRVS,1.10 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99368,CPT,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,,,15 ,,RBRVS,0.72 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99374,CPT,PHYS SUPVJ PT HOME HLTH AGENCY MO 15-29 MINUTES,,,15 ,,RBRVS,1.10 ,0.39 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99375,CPT,PHYS SUPVJ PT HOME HLTH AGENCY MO 30 MIN/>,,,15 ,,RBRVS,1.73 ,0.78 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99377,CPT,PHYS SUPVJ HOSPICE PT MO 15-29 MIN,,,15 ,,RBRVS,1.10 ,0.39 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99378,CPT,PHYS SUPVJ HOSPICE PT MO 30 MIN/>,,,15 ,,RBRVS,1.73 ,0.86 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99379,CPT,PHYS SUPVJ NF PT MO 15-29 MIN,,,15 ,,RBRVS,1.10 ,0.39 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99380,CPT,PHYS SUPVJ NF PT MO 30 MIN/>,,,15 ,,RBRVS,1.73 ,0.62 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99381,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT < 1YR,,,24 ,,RBRVS,1.19 ,0.42 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99382,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT AGE 1-4 YRS,,,24 ,,RBRVS,1.36 ,0.48 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99383,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT AGE 5-11 YRS,,,18 ,,RBRVS,1.36 ,0.48 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99384,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT AGE 12-17 YR,,,18 ,,RBRVS,1.53 ,0.55 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99385,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT AGE 18-39YRS,,,18 ,,RBRVS,1.53 ,0.55 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99386,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT AGE 40-64YRS,,,18 ,,RBRVS,1.88 ,0.67 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99387,CPT,1ST PREVENTIVE MEDICINE NEW PATIENT AGE 65YRS&>,,,18 ,,RBRVS,2.06 ,0.74 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99391,CPT,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1YR,,,24 ,,RBRVS,1.02 ,0.36 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99392,CPT,PERIODIC PREVENTIVE MED EST PATIENT AGE 1-4YRS,,,24 ,,RBRVS,1.19 ,0.42 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99393,CPT,PERIODIC PREVENTIVE MED EST PATIENT AGE 5-11YRS,,,18 ,,RBRVS,1.19 ,0.42 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99394,CPT,PERIODIC PREVENTIVE MED EST PATIENT AGE 12-17YRS,,,18 ,,RBRVS,1.36 ,0.48 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99395,CPT,PERIODIC PREVENTIVE MED EST PATIENT AGE 18-39YRS,,,18 ,,RBRVS,1.36 ,0.48 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99396,CPT,PERIODIC PREVENTIVE MED EST PATIENT AGE 40-64YRS,,,18 ,,RBRVS,1.53 ,0.55 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99397,CPT,PERIODIC PREVENTIVE MED EST PATIENT AGE 65YRS&>,,,18 ,,RBRVS,1.71 ,0.62 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99401,CPT,PREV MED CNSL INDIV SPX 15 MIN,,,18 ,,RBRVS,0.48 ,0.17 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99402,CPT,PREV MED CNSL INDIV SPX 30 MIN,,,18 ,,RBRVS,0.98 ,0.35 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99403,CPT,PREV MED CNSL INDIV SPX 45 MIN,,,18 ,,RBRVS,1.46 ,0.52 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99404,CPT,PREV MED CNSL INDIV SPX 60 MIN,,,18 ,,RBRVS,1.95 ,0.70 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99406,CPT,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,,,14 ,,RBRVS,0.24 ,0.08 ,0.12 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,99407,CPT,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,,,14 ,,RBRVS,0.50 ,0.16 ,0.19 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,99408,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,,,16 ,,RBRVS,0.65 ,0.23 ,0.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,99409,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVEN >30 MIN,,,16 ,,RBRVS,1.30 ,0.46 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,99411,CPT,PREV MED CNSL GRP SPX 30 MIN,,,18 ,,RBRVS,0.15 ,0.05 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99412,CPT,PREV MED CNSL GRP SPX 60 MIN,,,18 ,,RBRVS,0.25 ,0.09 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99420,CPT,ADMN&INTERPJ HLTH RISK ASSMT INSTRUMENT,,,18 ,,RBRVS,,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99429,CPT,UNLIS PREV MED SVC,,,18 ,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99441,CPT,PHYSICIAN TELEPHONE EVALUATION 5-10 MIN,,,15 ,,RBRVS,0.25 ,0.08 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99442,CPT,PHYSICIAN TELEPHONE EVALUATION 11-20 MIN,,,15 ,,RBRVS,0.50 ,0.18 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99443,CPT,PHYSICIAN TELEPHONE EVALUATION 21-30 MIN,,,15 ,,RBRVS,0.75 ,0.26 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99444,CPT,PHYSICIAN ONLINE EVALUATION & MANAGEMENT SERVICE,,,15 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99450,CPT,BASIC LIFE AND/OR DBLT XM,,,14 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99455,CPT,WORK RELATED/MED DBLT XM TREATING PHYS,,,14 ,,TotalUnits,,,,2.80 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99456,CPT,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,,,14 ,,TotalUnits,,,,5.02 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99460,CPT,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,,,10 ,,RBRVS,1.17 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99461,CPT,1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER,,,24 ,,RBRVS,1.26 ,0.44 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99462,CPT,SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN,,,10 ,,RBRVS,0.62 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99463,CPT,1ST HOSP/BIRTHING CENTER NB ADMIT&DSCHG SM DATE,,,10 ,,RBRVS,1.50 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99464,CPT,ATTN AT DELIVERY& 1ST STABILIZATION OF NEWBORN,,,10 ,,RBRVS,1.50 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99465,CPT,DELIVERY/BIRTHING ROOM RESUSCITATION,,,10 ,,RBRVS,2.93 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99466,CPT,CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN,,,10 ,,RBRVS,4.79 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99467,CPT,CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN,,,10 ,,RBRVS,2.40 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99468,CPT,1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<,,,10 ,,RBRVS,18.46 ,5.22 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99469,CPT,SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<,,,10 ,,RBRVS,7.99 ,2.36 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99471,CPT,INITIAL PED CRITICAL CARE 29 D THRU 24 MO,,,10 ,,RBRVS,15.98 ,4.75 ,4.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99472,CPT,SUBSEQUENT PED CRITICAL CARE 29 D THRU 24 MO,,,10 ,,RBRVS,7.99 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99475,CPT,INITIAL PED CRITICAL CARE 2 THRU 5 YEARS,,,10 ,,RBRVS,11.25 ,3.03 ,3.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99476,CPT,SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS,,,10 ,,RBRVS,6.75 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99477,CPT,INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL,,,10 ,,RBRVS,7.00 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99478,CPT,SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS,,,10 ,,RBRVS,2.75 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99479,CPT,SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS,,,10 ,,RBRVS,2.50 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99480,CPT,SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS,,,10 ,,RBRVS,2.40 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,99499,CPT,UNLIS E/M SVC,,,15 ,,TotalUnits,,,,1.76 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,99500,CPT,HOME VST PRENATAL MNTR&ASSMT,,,14 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99501,CPT,HOME VST POSTNATAL ASSMT&F-UP CARE,,,14 ,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99502,CPT,HOME VST NB CARE&ASSMT,,,14 ,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99503,CPT,HOME VST RESPIR THER CARE,,,14 ,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99504,CPT,HOME VST MCHNL VNTJ CARE,,,14 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99505,CPT,HOME VST STOMA CARE&MAINT CLST&CSTOST,,,14 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99506,CPT,HOME VST IM NJXS,,,14 ,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99507,CPT,HOME VST CARE&MAINT CATH,,,14 ,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99509,CPT,HOME VST ASSISTANCE DAILY LIV&PRSONAL CARE,,,14 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99510,CPT,HOME VST INDIV FAM/MARRIAGE CNSL,,,14 ,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99511,CPT,HOME VST FECAL IMPACTION MGMT&ENEMA ADMN,,,14 ,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99512,CPT,HOME VST HEMO,,,14 ,,TotalUnits,,,,5.35 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99600,CPT,UNLIS HOME VST SVC/PX,,,14 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99601,CPT,HOME NFS/SPECTY DRUG ADMN PR VST <2 HR,,,14 ,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99602,CPT,HOME NFS/SPECTY DRUG ADMN PR VST <2 HR EA HR,,,14 ,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,99605,CPT,MEDICATION THERAPY 1ST 15 MIN NEW PATIENT,,,14 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,99606,CPT,MEDICATION THERAPY F2F 1ST 15 MIN ESTABLISHED PT,,,14 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,99607,CPT,MEDICATION THERAPY F2F EA ADDITIONAL 15 MIN,,,14 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,A4206,HCPCS,1 CC STERILE SYRINGE&NEEDLE,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4207,HCPCS,2 CC STERILE SYRINGE&NEEDLE,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4208,HCPCS,3 CC STERILE SYRINGE&NEEDLE,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4209,HCPCS,5+ CC STERILE SYRINGE&NEEDLE,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4210,HCPCS,NONNEEDLE INJECTION DEVICE,,,28 ,,NW,,,,,,$846.43,$0.00,1,1,1,0,0,1,20110101,A4211,HCPCS,SUPP FOR SELF-ADM INJECTIONS,,,28 ,,NW,,,,,,$6.43,$0.00,1,1,1,0,0,1,20110101,A4212,HCPCS,NON CORING NEEDLE OR STYLET,,,28 ,,NW,,,,,,$14.79,$0.00,1,1,1,0,0,1,20110101,A4213,HCPCS,20+ CC SYRINGE ONLY,,,28 ,,NW,,,,,,$2.00,$0.00,1,1,1,0,0,1,20110101,A4215,HCPCS,STERILE NEEDLE,,,28 ,,NW,,,,,,$0.90,$0.00,1,1,1,0,0,1,20110101,A4216,HCPCS,"STERILE WATER/SALINE, 10 ML",,,28 ,,NW,,,,,,$0.72,$0.00,1,1,1,0,0,1,20110101,A4217,HCPCS,"STERILE WATER/SALINE, 500 ML",,,28 ,,NW,,,,,,$4.88,$0.00,1,1,1,0,0,1,20110101,A4217,HCPCS,"STERILE WATER/SALINE, 500 ML",AU,,28 ,,NW,,,,,,$4.88,$0.00,1,1,1,0,0,1,20110101,A4218,HCPCS,STERILE SALINE OR WATER,,,28 ,,NW,,,,,,$3.17,$0.00,1,1,1,0,0,1,20110101,A4220,HCPCS,INFUSION PUMP REFILL KIT,,,28 ,,NW,,,,,,$80.03,$0.00,1,1,1,0,0,1,20110101,A4221,HCPCS,MAINT DRUG INFUS CATH PER WK,,,28 ,,NW,,,,,,$46.10,$0.00,1,1,1,0,0,1,20110101,A4222,HCPCS,INFUSION SUPPLIES WITH PUMP,,,28 ,,NW,,,,,,$88.77,$0.00,1,1,1,0,0,1,20110101,A4223,HCPCS,INFUSION SUPPLIES W/O PUMP,,,28 ,,NW,,,,,,$134.18,$0.00,1,1,1,0,0,1,20110101,A4230,HCPCS,INFUS INSULIN PUMP NON NEEDL,,,28 ,,NW,,,,,,$26.44,$0.00,1,1,1,0,0,1,20110101,A4231,HCPCS,INFUSION INSULIN PUMP NEEDLE,,,28 ,,NW,,,,,,$10.40,$0.00,1,1,1,0,0,1,20110101,A4232,HCPCS,SYRINGE W/NEEDLE INSULIN 3CC,,,28 ,,NW,,,,,,$4.72,$0.00,1,1,1,0,0,1,20110101,A4233,HCPCS,ALKALIN BATT FOR GLUCOSE MON,,,28 ,,NW,,,,,,$4.10,$0.00,1,1,1,1,1,1,20110101,A4233,HCPCS,ALKALIN BATT FOR GLUCOSE MON,NU,,28 ,,NW,,,,,,$4.10,$0.00,1,1,1,1,1,1,20110101,A4234,HCPCS,J-CELL BATT FOR GLUCOSE MON,,,28 ,,NW,,,,,,$16.85,$0.00,1,1,1,1,1,1,20110101,A4234,HCPCS,J-CELL BATT FOR GLUCOSE MON,NU,,28 ,,NW,,,,,,$16.85,$0.00,1,1,1,1,1,1,20110101,A4235,HCPCS,LITHIUM BATT FOR GLUCOSE MON,,,28 ,,NW,,,,,,$12.04,$0.00,1,1,1,1,1,1,20110101,A4235,HCPCS,LITHIUM BATT FOR GLUCOSE MON,NU,,28 ,,NW,,,,,,$12.04,$0.00,1,1,1,1,1,1,20110101,A4236,HCPCS,SILVR OXIDE BATT GLUCOSE MON,,,28 ,,NW,,,,,,$8.62,$0.00,1,1,1,1,1,1,20110101,A4236,HCPCS,SILVR OXIDE BATT GLUCOSE MON,NU,,28 ,,NW,,,,,,$8.62,$0.00,1,1,1,1,1,1,20110101,A4244,HCPCS,ALCOHOL OR PEROXIDE PER PINT,,,28 ,,NW,,,,,,$2.00,$0.00,1,1,1,0,0,1,20110101,A4245,HCPCS,ALCOHOL WIPES PER BOX,,,28 ,,NW,,,,,,$4.95,$0.00,1,1,1,0,0,1,20110101,A4246,HCPCS,BETADINE/PHISOHEX SOLUTION,,,28 ,,NW,,,,,,$5.94,$0.00,1,1,1,0,0,1,20110101,A4247,HCPCS,BETADINE/IODINE SWABS/WIPES,,,28 ,,NW,,,,,,$7.91,$0.00,1,1,1,0,0,1,20110101,A4248,HCPCS,CHLORHEXIDINE ANTISEPT,,,28 ,,NW,,,,,,$3.75,$0.00,1,1,1,0,0,1,20110101,A4250,HCPCS,URINE REAGENT STRIPS/TABLETS,,,28 ,,NW,,,,,,$23.95,$0.00,1,1,1,0,0,1,20110101,A4252,HCPCS,BLOOD KETONE TEST OR STRIP,,,28 ,,NW,,,,,,$9.75,$0.00,1,1,1,0,0,1,20110101,A4253,HCPCS,BLOOD GLUCOSE/REAGENT STRIPS,,,28 ,,NW,,,,,,$68.55,$0.00,1,1,1,0,0,1,20110101,A4253,HCPCS,BLOOD GLUCOSE/REAGENT STRIPS,NU,,28 ,,NW,,,,,,$68.55,$0.00,1,1,1,0,0,1,20110101,A4255,HCPCS,GLUCOSE MONITOR PLATFORMS,,,28 ,,NW,,,,,,$11.09,$0.00,1,1,1,0,0,1,20110101,A4256,HCPCS,CALIBRATOR SOLUTION/CHIPS,,,28 ,,NW,,,,,,$23.96,$0.00,1,1,1,0,0,1,20110101,A4256,HCPCS,CALIBRATOR SOLUTION/CHIPS,KL,,28 ,,NW,,,,,,$21.25,$0.00,1,1,1,0,0,1,20110101,A4257,HCPCS,REPLACE LENSSHIELD CARTRIDGE,,,28 ,,NW,,,,,,$27.95,$0.00,1,1,1,0,0,1,20110101,A4258,HCPCS,LANCET DEVICE EACH,,,28 ,,NW,,,,,,$37.64,$0.00,1,1,1,0,0,1,20110101,A4258,HCPCS,LANCET DEVICE EACH,KL,,28 ,,NW,,,,,,$33.05,$0.00,1,1,1,0,0,1,20110101,A4259,HCPCS,LANCETS PER BOX,,,28 ,,NW,,,,,,$26.16,$0.00,1,1,1,0,0,1,20110101,A4259,HCPCS,LANCETS PER BOX,KL,,28 ,,NW,,,,,,$23.14,$0.00,1,1,1,0,0,1,20110101,A4261,HCPCS,CERVICAL CAP CONTRACEPTIVE,,,28 ,,NW,,,,,,$63.40,$0.00,1,1,1,1,1,1,20110101,A4262,HCPCS,TEMPORARY TEAR DUCT PLUG,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4263,HCPCS,PERMANENT TEAR DUCT PLUG,,,28 ,,NW,,,,,,$45.77,$0.00,1,1,1,0,0,1,20110101,A4265,HCPCS,PARAFFIN,,,28 ,,NW,,,,,,$5.63,$0.00,1,1,1,0,0,1,20110101,A4266,HCPCS,DIAPHRAGM,,,28 ,,NW,,,,,,$37.36,$0.00,1,1,1,1,1,1,20110101,A4267,HCPCS,MALE CONDOM,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,1,1,1,20110101,A4268,HCPCS,FEMALE CONDOM,,,28 ,,NW,,,,,,$1.86,$0.00,1,1,1,1,1,1,20110101,A4269,HCPCS,SPERMICIDE,,,28 ,,NW,,,,,,$2.00,$0.00,1,1,1,1,1,1,20110101,A4270,HCPCS,DISPOSABLE ENDOSCOPE SHEATH,,,28 ,,NW,,,,,,$34.82,$0.00,1,1,1,0,0,1,20110101,A4280,HCPCS,BRST PRSTHS ADHSV ATTCHMNT,,,28 ,,NW,,,,,,$10.25,$0.00,1,1,1,0,0,1,20110101,A4281,HCPCS,REPLACEMENT BREASTPUMP TUBE,,,28 ,,NW,,,,,,$21.56,$0.00,1,1,1,1,1,1,20110101,A4282,HCPCS,REPLACEMENT BREASTPUMP ADPT,,,28 ,,NW,,,,,,$3.80,$0.00,1,1,1,1,1,1,20110101,A4284,HCPCS,REPLCMNT BREAST PUMP SHIELD,,,28 ,,NW,,,,,,$24.50,$0.00,1,1,1,1,1,1,20110101,A4285,HCPCS,REPLCMNT BREAST PUMP BOTTLE,,,28 ,,NW,,,,,,$9.11,$0.00,1,1,1,1,1,1,20110101,A4290,HCPCS,SACRAL NERVE STIM TEST LEAD,,,28 ,,NW,,,,,,$692.45,$0.00,1,1,1,0,0,1,20110101,A4300,HCPCS,CATH IMPL VASC ACCESS PORTAL,,,28 ,,NW,,,,,,$26.34,$0.00,1,1,1,0,0,1,20110101,A4301,HCPCS,IMPLANTABLE ACCESS SYST PERC,,,28 ,,NW,,,,,,$19.59,$0.00,1,1,1,0,0,1,20110101,A4305,HCPCS,DRUG DELIVERY SYSTEM >=50 ML,,,28 ,,NW,,,,,,$19.59,$0.00,1,1,1,0,0,1,20110101,A4306,HCPCS,DRUG DELIVERY SYSTEM <=50 ML,,,28 ,,NW,,,,,,$24.50,$0.00,1,1,1,0,0,1,20110101,A4310,HCPCS,INSERT TRAY W/O BAG/CATH,,,28 ,,NW,,,,,,$12.18,$0.00,1,1,1,0,0,1,20110101,A4311,HCPCS,CATHETER W/O BAG 2-WAY LATEX,,,28 ,,NW,,,,,,$19.86,$0.00,1,1,1,0,0,1,20110101,A4312,HCPCS,CATH W/O BAG 2-WAY SILICONE,,,28 ,,NW,,,,,,$22.79,$0.00,1,1,1,0,0,1,20110101,A4313,HCPCS,CATHETER W/BAG 3-WAY,,,28 ,,NW,,,,,,$23.34,$0.00,1,1,1,0,0,1,20110101,A4314,HCPCS,CATH W/DRAINAGE 2-WAY LATEX,,,28 ,,NW,,,,,,$29.25,$0.00,1,1,1,0,0,1,20110101,A4315,HCPCS,CATH W/DRAINAGE 2-WAY SILCNE,,,28 ,,NW,,,,,,$30.30,$0.00,1,1,1,0,0,1,20110101,A4316,HCPCS,CATH W/DRAINAGE 3-WAY,,,28 ,,NW,,,,,,$32.22,$0.00,1,1,1,0,0,1,20110101,A4320,HCPCS,IRRIGATION TRAY,,,28 ,,NW,,,,,,$8.24,$0.00,1,1,1,0,0,1,20110101,A4321,HCPCS,CATH THERAPEUTIC IRRIG AGENT,,,28 ,,NW,,,,,,$7.96,$0.00,1,1,1,0,0,1,20110101,A4322,HCPCS,IRRIGATION SYRINGE,,,28 ,,NW,,,,,,$4.93,$0.00,1,1,1,0,0,1,20110101,A4326,HCPCS,MALE EXTERNAL CATHETER,,,28 ,,NW,,,,,,$16.44,$0.00,1,1,1,0,0,1,20110101,A4327,HCPCS,FEM URINARY COLLECT DEV CUP,,,28 ,,NW,,,,,,$47.11,$0.00,1,1,1,0,0,1,20110101,A4328,HCPCS,FEM URINARY COLLECT POUCH,,,28 ,,NW,,,,,,$16.30,$0.00,1,1,1,0,0,1,20110101,A4330,HCPCS,STOOL COLLECTION POUCH,,,28 ,,NW,,,,,,$11.34,$0.00,1,1,1,0,0,1,20110101,A4331,HCPCS,EXTENSION DRAINAGE TUBING,,,28 ,,NW,,,,,,$5.29,$0.00,1,1,1,0,0,1,20110101,A4332,HCPCS,LUBE STERILE PACKET,,,28 ,,NW,,,,,,$0.21,$0.00,1,1,1,0,0,1,20110101,A4333,HCPCS,URINARY CATH ANCHOR DEVICE,,,28 ,,NW,,,,,,$4.27,$0.00,1,1,1,0,0,1,20110101,A4334,HCPCS,URINARY CATH LEG STRAP,,,28 ,,NW,,,,,,$9.53,$0.00,1,1,1,0,0,1,20110101,A4335,HCPCS,INCONTINENCE SUPPLY,,,28 ,,NW,,,,,,$5.29,$0.00,1,1,1,0,0,1,20110101,A4336,HCPCS,URETHRAL INSERT,,,28 ,,NW,,,,,,$2.41,$0.00,1,1,1,0,0,1,20110101,A4338,HCPCS,INDWELLING CATHETER LATEX,,,28 ,,NW,,,,,,$17.86,$0.00,1,1,1,0,0,1,20110101,A4340,HCPCS,INDWELLING CATHETER SPECIAL,,,28 ,,NW,,,,,,$34.28,$0.00,1,1,1,0,0,1,20110101,A4344,HCPCS,CATH INDW FOLEY 2 WAY SILICN,,,28 ,,NW,,,,,,$20.98,$0.00,1,1,1,0,0,1,20110101,A4346,HCPCS,CATH INDW FOLEY 3 WAY,,,28 ,,NW,,,,,,$23.98,$0.00,1,1,1,0,0,1,20110101,A4349,HCPCS,DISPOSABLE MALE EXTERNAL CAT,,,28 ,,NW,,,,,,$3.37,$0.00,1,1,1,0,0,1,20110101,A4351,HCPCS,STRAIGHT TIP URINE CATHETER,,,28 ,,NW,,,,,,$2.85,$0.00,1,1,1,0,0,1,20110101,A4352,HCPCS,COUDE TIP URINARY CATHETER,,,28 ,,NW,,,,,,$10.12,$0.00,1,1,1,0,0,1,20110101,A4353,HCPCS,INTERMITTENT URINARY CATH,,,28 ,,NW,,,,,,$11.59,$0.00,1,1,1,0,0,1,20110101,A4354,HCPCS,CATH INSERTION TRAY W/BAG,,,28 ,,NW,,,,,,$17.40,$0.00,1,1,1,0,0,1,20110101,A4355,HCPCS,BLADDER IRRIGATION TUBING,,,28 ,,NW,,,,,,$14.35,$0.00,1,1,1,0,0,1,20110101,A4356,HCPCS,EXT URETH CLMP OR COMPR DVC,,,28 ,,NW,,,,,,$46.94,$0.00,1,1,1,0,0,1,20110101,A4357,HCPCS,BEDSIDE DRAINAGE BAG,,,28 ,,NW,,,,,,$15.40,$0.00,1,1,1,0,0,1,20110101,A4358,HCPCS,URINARY LEG OR ABDOMEN BAG,,,28 ,,NW,,,,,,$10.49,$0.00,1,1,1,0,0,1,20110101,A4360,HCPCS,DISPOSABLE EXT URETHRAL DEV,,,28 ,,NW,,,,,,$0.78,$0.00,1,1,1,0,0,1,20110101,A4361,HCPCS,OSTOMY FACE PLATE,,,28 ,,NW,,,,,,$23.34,$0.00,1,1,1,0,0,1,20110101,A4362,HCPCS,SOLID SKIN BARRIER,,,28 ,,NW,,,,,,$5.46,$0.00,1,1,1,0,0,1,20110101,A4363,HCPCS,"OSTOMY CLAMP, REPLACEMENT",,,28 ,,NW,,,,,,$3.78,$0.00,1,1,1,0,0,1,20110101,A4364,HCPCS,"ADHESIVE, LIQUID OR EQUAL",,,28 ,,NW,,,,,,$5.30,$0.00,1,1,1,0,0,1,20110101,A4366,HCPCS,OSTOMY VENT,,,28 ,,NW,,,,,,$2.53,$0.00,1,1,1,0,0,1,20110101,A4367,HCPCS,OSTOMY BELT,,,28 ,,NW,,,,,,$11.64,$0.00,1,1,1,0,0,1,20110101,A4368,HCPCS,OSTOMY FILTER,,,28 ,,NW,,,,,,$0.43,$0.00,1,1,1,0,0,1,20110101,A4369,HCPCS,SKIN BARRIER LIQUID PER OZ,,,28 ,,NW,,,,,,$3.87,$0.00,1,1,1,0,0,1,20110101,A4371,HCPCS,SKIN BARRIER POWDER PER OZ,,,28 ,,NW,,,,,,$6.04,$0.00,1,1,1,0,0,1,20110101,A4372,HCPCS,SKIN BARRIER SOLID 4X4 EQUIV,,,28 ,,NW,,,,,,$6.94,$0.00,1,1,1,0,0,1,20110101,A4373,HCPCS,SKIN BARRIER WITH FLANGE,,,28 ,,NW,,,,,,$10.40,$0.00,1,1,1,0,0,1,20110101,A4375,HCPCS,DRAINABLE PLASTIC PCH W FCPL,,,28 ,,NW,,,,,,$22.78,$0.00,1,1,1,0,0,1,20110101,A4376,HCPCS,DRAINABLE RUBBER PCH W FCPLT,,,28 ,,NW,,,,,,$50.61,$0.00,1,1,1,0,0,1,20110101,A4377,HCPCS,DRAINABLE PLSTIC PCH W/O FP,,,28 ,,NW,,,,,,$7.11,$0.00,1,1,1,0,0,1,20110101,A4378,HCPCS,DRAINABLE RUBBER PCH W/O FP,,,28 ,,NW,,,,,,$35.20,$0.00,1,1,1,0,0,1,20110101,A4379,HCPCS,URINARY PLASTIC POUCH W FCPL,,,28 ,,NW,,,,,,$20.80,$0.00,1,1,1,0,0,1,20110101,A4380,HCPCS,URINARY RUBBER POUCH W FCPLT,,,28 ,,NW,,,,,,$41.23,$0.00,1,1,1,0,0,1,20110101,A4381,HCPCS,URINARY PLASTIC POUCH W/O FP,,,28 ,,NW,,,,,,$7.65,$0.00,1,1,1,0,0,1,20110101,A4382,HCPCS,URINARY HVY PLSTC PCH W/O FP,,,28 ,,NW,,,,,,$29.59,$0.00,1,1,1,0,0,1,20110101,A4383,HCPCS,URINARY RUBBER POUCH W/O FP,,,28 ,,NW,,,,,,$32.86,$0.00,1,1,1,0,0,1,20110101,A4384,HCPCS,OSTOMY FACEPLT/SILICONE RING,,,28 ,,NW,,,,,,$15.85,$0.00,1,1,1,0,0,1,20110101,A4385,HCPCS,OST SKN BARRIER SLD EXT WEAR,,,28 ,,NW,,,,,,$8.47,$0.00,1,1,1,0,0,1,20110101,A4387,HCPCS,OST CLSD POUCH W ATT ST BARR,,,28 ,,NW,,,,,,$5.91,$0.00,1,1,1,0,0,1,20110101,A4388,HCPCS,DRAINABLE PCH W EX WEAR BARR,,,28 ,,NW,,,,,,$7.24,$0.00,1,1,1,0,0,1,20110101,A4389,HCPCS,DRAINABLE PCH W ST WEAR BARR,,,28 ,,NW,,,,,,$10.31,$0.00,1,1,1,0,0,1,20110101,A4390,HCPCS,DRAINABLE PCH EX WEAR CONVEX,,,28 ,,NW,,,,,,$15.84,$0.00,1,1,1,0,0,1,20110101,A4391,HCPCS,URINARY POUCH W EX WEAR BARR,,,28 ,,NW,,,,,,$11.71,$0.00,1,1,1,0,0,1,20110101,A4392,HCPCS,URINARY POUCH W ST WEAR BARR,,,28 ,,NW,,,,,,$13.54,$0.00,1,1,1,0,0,1,20110101,A4393,HCPCS,URINE PCH W EX WEAR BAR CONV,,,28 ,,NW,,,,,,$14.96,$0.00,1,1,1,0,0,1,20110101,A4394,HCPCS,OSTOMY POUCH LIQ DEODORANT,,,28 ,,NW,,,,,,$4.30,$0.00,1,1,1,0,0,1,20110101,A4395,HCPCS,OSTOMY POUCH SOLID DEODORANT,,,28 ,,NW,,,,,,$0.08,$0.00,1,1,1,0,0,1,20110101,A4396,HCPCS,PERISTOMAL HERNIA SUPPRT BLT,,,28 ,,NW,,,,,,$44.09,$0.00,1,1,1,0,0,1,20110101,A4397,HCPCS,IRRIGATION SUPPLY SLEEVE,,,28 ,,NW,,,,,,$7.34,$0.00,1,1,1,0,0,1,20110101,A4398,HCPCS,OSTOMY IRRIGATION BAG,,,28 ,,NW,,,,,,$19.43,$0.00,1,1,1,0,0,1,20110101,A4399,HCPCS,OSTOMY IRRIG CONE/CATH W BRS,,,28 ,,NW,,,,,,$17.62,$0.00,1,1,1,0,0,1,20110101,A4400,HCPCS,OSTOMY IRRIGATION SET,,,28 ,,NW,,,,,,$48.99,$0.00,1,1,1,0,0,1,20110101,A4402,HCPCS,LUBRICANT PER OUNCE,,,28 ,,NW,,,,,,$2.57,$0.00,1,1,1,0,0,1,20110101,A4404,HCPCS,OSTOMY RING EACH,,,28 ,,NW,,,,,,$2.74,$0.00,1,1,1,0,0,1,20110101,A4405,HCPCS,NONPECTIN BASED OSTOMY PASTE,,,28 ,,NW,,,,,,$5.65,$0.00,1,1,1,0,0,1,20110101,A4406,HCPCS,PECTIN BASED OSTOMY PASTE,,,28 ,,NW,,,,,,$9.52,$0.00,1,1,1,0,0,1,20110101,A4407,HCPCS,"EXT WEAR OST SKN BARR <=4SQ""",,,28 ,,NW,,,,,,$14.50,$0.00,1,1,1,0,0,1,20110101,A4408,HCPCS,"EXT WEAR OST SKN BARR >4SQ""",,,28 ,,NW,,,,,,$16.08,$0.00,1,1,1,0,0,1,20110101,A4409,HCPCS,OST SKN BARR CONVEX <=4 SQ I,,,28 ,,NW,,,,,,$10.30,$0.00,1,1,1,0,0,1,20110101,A4410,HCPCS,OST SKN BARR EXTND >4 SQ,,,28 ,,NW,,,,,,$14.96,$0.00,1,1,1,0,0,1,20110101,A4411,HCPCS,OST SKN BARR EXTND =4SQ,,,28 ,,NW,,,,,,$8.46,$0.00,1,1,1,0,0,1,20110101,A4412,HCPCS,OST POUCH DRAIN HIGH OUTPUT,,,28 ,,NW,,,,,,$4.50,$0.00,1,1,1,0,0,1,20110101,A4413,HCPCS,2 PC DRAINABLE OST POUCH,,,28 ,,NW,,,,,,$9.13,$0.00,1,1,1,0,0,1,20110101,A4414,HCPCS,OST SKNBAR W/O CONV<=4 SQ IN,,,28 ,,NW,,,,,,$8.18,$0.00,1,1,1,0,0,1,20110101,A4415,HCPCS,OST SKN BARR W/O CONV >4 SQI,,,28 ,,NW,,,,,,$9.94,$0.00,1,1,1,0,0,1,20110101,A4416,HCPCS,OST PCH CLSD W BARRIER/FILTR,,,28 ,,NW,,,,,,$5.33,$0.00,1,1,1,0,0,1,20110101,A4417,HCPCS,OST PCH W BAR/BLTINCONV/FLTR,,,28 ,,NW,,,,,,$7.22,$0.00,1,1,1,0,0,1,20110101,A4418,HCPCS,OST PCH CLSD W/O BAR W FILTR,,,28 ,,NW,,,,,,$3.51,$0.00,1,1,1,0,0,1,20110101,A4419,HCPCS,OST PCH FOR BAR W FLANGE/FLT,,,28 ,,NW,,,,,,$3.38,$0.00,1,1,1,0,0,1,20110101,A4420,HCPCS,OST PCH CLSD FOR BAR W LK FL,,,28 ,,NW,,,,,,$3.16,$0.00,1,1,1,0,0,1,20110101,A4421,HCPCS,OSTOMY SUPPLY MISC,,,28 ,,NW,,,,,,$5.30,$0.00,1,1,1,0,0,1,20110101,A4422,HCPCS,OST POUCH ABSORBENT MATERIAL,,,28 ,,NW,,,,,,$0.21,$0.00,1,1,1,0,0,1,20110101,A4423,HCPCS,OST PCH FOR BAR W LK FL/FLTR,,,28 ,,NW,,,,,,$3.60,$0.00,1,1,1,0,0,1,20110101,A4424,HCPCS,OST PCH DRAIN W BAR & FILTER,,,28 ,,NW,,,,,,$9.21,$0.00,1,1,1,0,0,1,20110101,A4425,HCPCS,OST PCH DRAIN FOR BARRIER FL,,,28 ,,NW,,,,,,$6.94,$0.00,1,1,1,0,0,1,20110101,A4426,HCPCS,OST PCH DRAIN 2 PIECE SYSTEM,,,28 ,,NW,,,,,,$5.30,$0.00,1,1,1,0,0,1,20110101,A4427,HCPCS,OST PCH DRAIN/BARR LK FLNG/F,,,28 ,,NW,,,,,,$5.39,$0.00,1,1,1,0,0,1,20110101,A4428,HCPCS,URINE OST POUCH W FAUCET/TAP,,,28 ,,NW,,,,,,$12.62,$0.00,1,1,1,0,0,1,20110101,A4429,HCPCS,URINE OST POUCH W BLTINCONV,,,28 ,,NW,,,,,,$15.65,$0.00,1,1,1,0,0,1,20110101,A4430,HCPCS,OST URINE PCH W B/BLTIN CONV,,,28 ,,NW,,,,,,$16.03,$0.00,1,1,1,0,0,1,20110101,A4431,HCPCS,OST PCH URINE W BARRIER/TAPV,,,28 ,,NW,,,,,,$12.05,$0.00,1,1,1,0,0,1,20110101,A4432,HCPCS,OS PCH URINE W BAR/FANGE/TAP,,,28 ,,NW,,,,,,$6.96,$0.00,1,1,1,0,0,1,20110101,A4433,HCPCS,URINE OST PCH BAR W LOCK FLN,,,28 ,,NW,,,,,,$6.48,$0.00,1,1,1,0,0,1,20110101,A4434,HCPCS,OST PCH URINE W LOCK FLNG/FT,,,28 ,,NW,,,,,,$7.29,$0.00,1,1,1,0,0,1,20110101,A4450,HCPCS,NON-WATERPROOF TAPE,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4450,HCPCS,NON-WATERPROOF TAPE,AU,,28 ,,NW,,,,,,$0.14,$0.00,1,1,1,0,0,1,20110101,A4450,HCPCS,NON-WATERPROOF TAPE,AV,,28 ,,NW,,,,,,$0.14,$0.00,1,1,1,0,0,1,20110101,A4450,HCPCS,NON-WATERPROOF TAPE,AW,,28 ,,NW,,,,,,$0.19,$0.00,1,1,1,0,0,1,20110101,A4452,HCPCS,WATERPROOF TAPE,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A4452,HCPCS,WATERPROOF TAPE,AU,,28 ,,NW,,,,,,$0.61,$0.00,1,1,1,0,0,1,20110101,A4452,HCPCS,WATERPROOF TAPE,AV,,28 ,,NW,,,,,,$0.61,$0.00,1,1,1,0,0,1,20110101,A4452,HCPCS,WATERPROOF TAPE,AW,,28 ,,NW,,,,,,$0.68,$0.00,1,1,1,0,0,1,20110101,A4455,HCPCS,ADHESIVE REMOVER PER OUNCE,,,28 ,,NW,,,,,,$2.25,$0.00,1,1,1,0,0,1,20110101,A4456,HCPCS,"ADHESIVE REMOVER, WIPES",,,28 ,,NW,,,,,,$0.42,$0.00,1,1,1,0,0,1,20110101,A4458,HCPCS,REUSABLE ENEMA BAG,,,28 ,,NW,,,,,,$19.92,$0.00,1,1,1,0,0,1,20110101,A4461,HCPCS,SURGICL DRESS HOLD NON-REUSE,,,28 ,,NW,,,,,,$5.46,$0.00,1,1,1,0,0,1,20110101,A4463,HCPCS,SURGICAL DRESS HOLDER REUSE,,,28 ,,NW,,,,,,$19.23,$0.00,1,1,1,0,0,1,20110101,A4465,HCPCS,NON-ELASTIC EXTREMITY BINDER,,,28 ,,NW,,,,,,$15.77,$0.00,1,1,1,0,0,1,20110101,A4466,HCPCS,ELASTIC GARMENT/COVERING,,,28 ,,NW,,,,,,$78.59,$0.00,1,1,1,0,0,1,20110101,A4470,HCPCS,GRAVLEE JET WASHER,,,28 ,,NW,,,,,,$10.86,$0.00,1,1,1,0,0,1,20110101,A4480,HCPCS,VABRA ASPIRATOR,,,28 ,,NW,,,,,,$8.89,$0.00,1,1,1,0,0,1,20110101,A4481,HCPCS,TRACHEOSTOMA FILTER,,,28 ,,NW,,,,,,$1.04,$0.00,1,1,1,0,0,1,20110101,A4483,HCPCS,MOISTURE EXCHANGER,,,28 ,,NW,,,,,,$12.99,$0.00,1,1,1,0,0,1,20110101,A4490,HCPCS,ABOVE KNEE SURGICAL STOCKING,,,28 ,,NW,,,,,,$11.84,$0.00,1,1,1,0,0,1,20110101,A4495,HCPCS,THIGH LENGTH SURG STOCKING,,,28 ,,NW,,,,,,$11.84,$0.00,1,1,1,0,0,1,20110101,A4500,HCPCS,BELOW KNEE SURGICAL STOCKING,,,28 ,,NW,,,,,,$8.89,$0.00,1,1,1,0,0,1,20110101,A4510,HCPCS,FULL LENGTH SURG STOCKING,,,28 ,,NW,,,,,,$19.04,$0.00,1,1,1,0,0,1,20110101,A4520,HCPCS,INCONTINENCE GARMENT ANYTYPE,,,28 ,,NW,,,,,,$1.35,$0.00,1,1,1,0,0,1,20110101,A4550,HCPCS,SURGICAL TRAYS,,,28 ,,NW,,,,,,$35.41,$0.00,1,1,1,0,0,1,20110101,A4554,HCPCS,DISPOSABLE UNDERPADS,,,28 ,,NW,,,,,,$4.95,$0.00,1,1,1,0,0,1,20110101,A4556,HCPCS,"ELECTRODES, PAIR",,,28 ,,NW,,,,,,$25.20,$0.00,1,1,1,0,0,1,20110101,A4557,HCPCS,"LEAD WIRES, PAIR",,,28 ,,NW,,,,,,$40.28,$0.00,1,1,1,0,0,1,20110101,A4558,HCPCS,CONDUCTIVE GEL OR PASTE,,,28 ,,NW,,,,,,$13.84,$0.00,1,1,1,0,0,1,20110101,A4559,HCPCS,COUPLING GEL OR PASTE,,,28 ,,NW,,,,,,$0.29,$0.00,1,1,1,0,0,1,20110101,A4561,HCPCS,"PESSARY RUBBER, ANY TYPE",,,28 ,,NW,,,,,,$25.49,$0.00,1,1,1,0,0,1,20110101,A4562,HCPCS,"PESSARY, NON RUBBER,ANY TYPE",,,28 ,,NW,,,,,,$52.94,$0.00,1,1,1,0,0,1,20110101,A4565,HCPCS,SLINGS,,,28 ,,NW,,,,,,$12.83,$0.00,1,1,1,0,0,1,20110101,A4570,HCPCS,SPLINT,,,28 ,,NW,,,,,,$23.95,$0.00,1,1,1,0,0,1,20110101,A4575,HCPCS,HYPERBARIC O2 CHAMBER DISPS,,,28 ,,NW,,,,,,$982.70,$0.00,1,1,1,0,0,1,20110101,A4580,HCPCS,CAST SUPPLIES (PLASTER),,,28 ,,NW,,,,,,$66.13,$0.00,1,1,1,0,0,1,20110101,A4590,HCPCS,SPECIAL CASTING MATERIAL,,,28 ,,NW,,,,,,$44.68,$0.00,1,1,1,0,0,1,20110101,A4595,HCPCS,TENS SUPPL 2 LEAD PER MONTH,,,28 ,,NW,,,,,,$57.52,$0.00,1,1,1,0,0,1,20110101,A4600,HCPCS,"SLEEVE, INTER LIMB COMP DEV",,,28 ,,NW,,,,,,$114.44,$0.00,1,1,1,1,1,1,20110101,A4601,HCPCS,"LITH ION BATT, NON-PROS USE",,,28 ,,NW,,,,,,$2.56,$0.00,1,1,1,1,1,1,20110101,A4604,HCPCS,TUBING WITH HEATING ELEMENT,,,28 ,,NW,,,,,,$117.36,$0.00,1,1,1,1,1,1,20110101,A4604,HCPCS,TUBING WITH HEATING ELEMENT,NU,,28 ,,NW,,,,,,$117.36,$0.00,1,1,1,1,1,1,20110101,A4605,HCPCS,TRACH SUCTION CATH CLOSE SYS,,,28 ,,NW,,,,,,$34.71,$0.00,1,1,1,1,1,1,20110101,A4605,HCPCS,TRACH SUCTION CATH CLOSE SYS,NU,,28 ,,NW,,,,,,$34.71,$0.00,1,1,1,1,1,1,20110101,A4606,HCPCS,OXYGEN PROBE USED W OXIMETER,,,28 ,,NW,,,,,,$66.49,$0.00,1,1,1,1,1,1,20110101,A4608,HCPCS,TRANSTRACHEAL OXYGEN CATH,,,28 ,,NW,,,,,,$99.22,$0.00,1,1,1,1,1,1,20110101,A4611,HCPCS,HEAVY DUTY BATTERY,,,28 ,,NW,,,,,,$417.87,$0.00,1,1,1,1,1,1,20110101,A4611,HCPCS,HEAVY DUTY BATTERY,NU,,28 ,,NW,,,,,,$417.87,$0.00,1,1,1,1,1,1,20110101,A4611,HCPCS,HEAVY DUTY BATTERY,RR,,28 ,,NW,,,,,,$39.05,$0.00,1,1,1,1,1,1,20110101,A4611,HCPCS,HEAVY DUTY BATTERY,UE,,28 ,,NW,,,,,,$307.73,$0.00,1,1,1,1,1,1,20110101,A4612,HCPCS,BATTERY CABLES,,,28 ,,NW,,,,,,$160.75,$0.00,1,1,1,1,1,1,20110101,A4612,HCPCS,BATTERY CABLES,NU,,28 ,,NW,,,,,,$160.75,$0.00,1,1,1,1,1,1,20110101,A4612,HCPCS,BATTERY CABLES,RR,,28 ,,NW,,,,,,$18.52,$0.00,1,1,1,1,1,1,20110101,A4612,HCPCS,BATTERY CABLES,UE,,28 ,,NW,,,,,,$116.79,$0.00,1,1,1,1,1,1,20110101,A4613,HCPCS,BATTERY CHARGER,,,28 ,,NW,,,,,,$302.97,$0.00,1,1,1,1,1,1,20110101,A4613,HCPCS,BATTERY CHARGER,NU,,28 ,,NW,,,,,,$302.97,$0.00,1,1,1,1,1,1,20110101,A4613,HCPCS,BATTERY CHARGER,RR,,28 ,,NW,,,,,,$29.14,$0.00,1,1,1,1,1,1,20110101,A4613,HCPCS,BATTERY CHARGER,UE,,28 ,,NW,,,,,,$212.97,$0.00,1,1,1,1,1,1,20110101,A4614,HCPCS,HAND-HELD PEFR METER,,,28 ,,NW,,,,,,$28.81,$0.00,1,1,1,1,1,1,20110101,A4615,HCPCS,CANNULA NASAL,,,28 ,,NW,,,,,,$2.27,$0.00,1,1,1,1,1,1,20110101,A4616,HCPCS,TUBING (OXYGEN) PER FOOT,,,28 ,,NW,,,,,,$1.43,$0.00,1,1,1,1,1,1,20110101,A4617,HCPCS,MOUTH PIECE,,,28 ,,NW,,,,,,$3.33,$0.00,1,1,1,1,1,1,20110101,A4618,HCPCS,BREATHING CIRCUITS,,,28 ,,NW,,,,,,$13.96,$0.00,1,1,1,1,1,1,20110101,A4618,HCPCS,BREATHING CIRCUITS,NU,,28 ,,NW,,,,,,$13.96,$0.00,1,1,1,1,1,1,20110101,A4618,HCPCS,BREATHING CIRCUITS,RR,,28 ,,NW,,,,,,$1.61,$0.00,1,1,1,1,1,1,20110101,A4618,HCPCS,BREATHING CIRCUITS,UE,,28 ,,NW,,,,,,$10.49,$0.00,1,1,1,1,1,1,20110101,A4619,HCPCS,FACE TENT,,,28 ,,NW,,,,,,$2.49,$0.00,1,1,1,1,1,1,20110101,A4620,HCPCS,VARIABLE CONCENTRATION MASK,,,28 ,,NW,,,,,,$2.22,$0.00,1,1,1,1,1,1,20110101,A4623,HCPCS,TRACHEOSTOMY INNER CANNULA,,,28 ,,NW,,,,,,$9.99,$0.00,1,1,1,1,1,1,20110101,A4624,HCPCS,TRACHEAL SUCTION TUBE,,,28 ,,NW,,,,,,$6.88,$0.00,1,1,1,1,1,1,20110101,A4624,HCPCS,TRACHEAL SUCTION TUBE,NU,,28 ,,NW,,,,,,$6.88,$0.00,1,1,1,1,1,1,20110101,A4625,HCPCS,TRACH CARE KIT FOR NEW TRACH,,,28 ,,NW,,,,,,$10.94,$0.00,1,1,1,1,1,1,20110101,A4626,HCPCS,TRACHEOSTOMY CLEANING BRUSH,,,28 ,,NW,,,,,,$4.87,$0.00,1,1,1,1,1,1,20110101,A4627,HCPCS,SPACER BAG/RESERVOIR,,,28 ,,NW,,,,,,$30.69,$0.00,1,1,1,1,1,1,20110101,A4628,HCPCS,OROPHARYNGEAL SUCTION CATH,,,28 ,,NW,,,,,,$6.14,$0.00,1,1,1,1,1,1,20110101,A4628,HCPCS,OROPHARYNGEAL SUCTION CATH,NU,,28 ,,NW,,,,,,$6.14,$0.00,1,1,1,1,1,1,20110101,A4629,HCPCS,TRACHEOSTOMY CARE KIT,,,28 ,,NW,,,,,,$7.67,$0.00,1,1,1,1,1,1,20110101,A4630,HCPCS,REPL BAT T.E.N.S. OWN BY PT,,,28 ,,NW,,,,,,$14.98,$0.00,1,1,1,1,1,1,20110101,A4630,HCPCS,REPL BAT T.E.N.S. OWN BY PT,NU,,28 ,,NW,,,,,,$14.98,$0.00,1,1,1,1,1,1,20110101,A4633,HCPCS,UVL REPLACEMENT BULB,,,28 ,,NW,,,,,,$80.36,$0.00,1,1,1,1,1,1,20110101,A4633,HCPCS,UVL REPLACEMENT BULB,NU,,28 ,,NW,,,,,,$80.36,$0.00,1,1,1,1,1,1,20110101,A4634,HCPCS,REPLACEMENT BULB TH LIGHTBOX,,,28 ,,NW,,,,,,$42.88,$0.00,1,1,1,1,1,1,20110101,A4635,HCPCS,UNDERARM CRUTCH PAD,,,28 ,,NW,,,,,,$13.15,$0.00,1,1,1,1,1,1,20110101,A4635,HCPCS,UNDERARM CRUTCH PAD,NU,,28 ,,NW,,,,,,$13.15,$0.00,1,1,1,1,1,1,20110101,A4635,HCPCS,UNDERARM CRUTCH PAD,RR,,28 ,,NW,,,,,,$1.77,$0.00,1,1,1,1,1,1,20110101,A4635,HCPCS,UNDERARM CRUTCH PAD,UE,,28 ,,NW,,,,,,$8.78,$0.00,1,1,1,1,1,1,20110101,A4636,HCPCS,HANDGRIP FOR CANE ETC,,,28 ,,NW,,,,,,$17.81,$0.00,1,1,1,1,1,1,20110101,A4636,HCPCS,HANDGRIP FOR CANE ETC,NU,,28 ,,NW,,,,,,$17.81,$0.00,1,1,1,1,1,1,20110101,A4636,HCPCS,HANDGRIP FOR CANE ETC,RR,,28 ,,NW,,,,,,$2.03,$0.00,1,1,1,1,1,1,20110101,A4636,HCPCS,HANDGRIP FOR CANE ETC,UE,,28 ,,NW,,,,,,$14.18,$0.00,1,1,1,1,1,1,20110101,A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,,,28 ,,NW,,,,,,$10.30,$0.00,1,1,1,1,1,1,20110101,A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,NU,,28 ,,NW,,,,,,$10.30,$0.00,1,1,1,1,1,1,20110101,A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,RR,,28 ,,NW,,,,,,$1.45,$0.00,1,1,1,1,1,1,20110101,A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,UE,,28 ,,NW,,,,,,$7.78,$0.00,1,1,1,1,1,1,20110101,A4638,HCPCS,REPL BATT PULSE GEN SYS,,,28 ,,NW,,,,,,"$9,867.32",$0.00,1,1,1,1,1,1,20110101,A4638,HCPCS,REPL BATT PULSE GEN SYS,NU,,28 ,,NW,,,,,,"$9,867.32",$0.00,1,1,1,1,1,1,20110101,A4638,HCPCS,REPL BATT PULSE GEN SYS,RR,,28 ,,NW,,,,,,"$1,039.43",$0.00,1,1,1,1,1,1,20110101,A4638,HCPCS,REPL BATT PULSE GEN SYS,UE,,28 ,,NW,,,,,,"$7,416.60",$0.00,1,1,1,1,1,1,20110101,A4639,HCPCS,INFRARED HT SYS REPLCMNT PAD,,,28 ,,NW,,,,,,$675.90,$0.00,1,1,1,1,1,1,20110101,A4639,HCPCS,INFRARED HT SYS REPLCMNT PAD,NU,,28 ,,NW,,,,,,$675.90,$0.00,1,1,1,1,1,1,20110101,A4640,HCPCS,ALTERNATING PRESSURE PAD,,,28 ,,NW,,,,,,$118.26,$0.00,1,1,1,1,1,1,20110101,A4640,HCPCS,ALTERNATING PRESSURE PAD,NU,,28 ,,NW,,,,,,$118.26,$0.00,1,1,1,1,1,1,20110101,A4640,HCPCS,ALTERNATING PRESSURE PAD,RR,,28 ,,NW,,,,,,$15.22,$0.00,1,1,1,1,1,1,20110101,A4640,HCPCS,ALTERNATING PRESSURE PAD,UE,,28 ,,NW,,,,,,$81.72,$0.00,1,1,1,1,1,1,20110101,A4641,HCPCS,RADIOPHARM DX AGENT NOC,,,28 ,,NW,,,,,,$33.36,$0.00,1,1,1,0,0,1,20110101,A4642,HCPCS,IN111 SATUMOMAB,,,28 ,,NW,,,,,,$24.54,$0.00,1,1,1,0,0,1,20110101,A4648,HCPCS,IMPLANTABLE TISSUE MARKER,,,28 ,,NW,,,,,,$236.48,$0.00,1,1,1,0,0,1,20110101,A4649,HCPCS,SURGICAL SUPPLIES,,,28 ,,NW,,,,,,$0.78,$0.00,1,1,1,0,0,1,20110101,A4651,HCPCS,CALIBRATED MICROCAP TUBE,,,28 ,,NW,,,,,,$4.00,$0.00,1,1,1,0,0,1,20110101,A4652,HCPCS,MICROCAPILLARY TUBE SEALANT,,,28 ,,NW,,,,,,$1.34,$0.00,1,1,1,0,0,1,20110101,A4653,HCPCS,PD CATHETER ANCHOR BELT,,,28 ,,NW,,,,,,$65.31,$0.00,1,1,1,0,0,1,20110101,A4657,HCPCS,SYRINGE W/WO NEEDLE,,,28 ,,NW,,,,,,$1.14,$0.00,1,1,1,0,0,1,20110101,A4660,HCPCS,SPHYG/BP APP W CUFF AND STET,,,28 ,,NW,,,,,,$31.53,$0.00,1,1,1,0,0,1,20110101,A4663,HCPCS,DIALYSIS BLOOD PRESSURE CUFF,,,28 ,,NW,,,,,,$47.86,$0.00,1,1,1,0,0,1,20110101,A4670,HCPCS,"AUTOMATIC BP MONITOR, DIAL",,,28 ,,NW,,,,,,$129.23,$0.00,1,1,1,0,0,1,20110101,A4671,HCPCS,DISPOSABLE CYCLER SET,,,28 ,,NW,,,,,,$42.12,$0.00,1,1,1,0,0,1,20110101,A4672,HCPCS,"DRAINAGE EXT LINE, DIALYSIS",,,28 ,,NW,,,,,,$19.52,$0.00,1,1,1,0,0,1,20110101,A4673,HCPCS,EXT LINE W EASY LOCK CONNECT,,,28 ,,NW,,,,,,$13.90,$0.00,1,1,1,0,0,1,20110101,A4674,HCPCS,"CHEM/ANTISEPT SOLUTION, 8OZ",,,28 ,,NW,,,,,,$2.61,$0.00,1,1,1,0,0,1,20110101,A4680,HCPCS,"ACTIVATED CARBON FILTER, EA",,,28 ,,NW,,,,,,$118.92,$0.00,1,1,1,0,0,1,20110101,A4690,HCPCS,"DIALYZER, EACH",,,28 ,,NW,,,,,,"$1,127.05",$0.00,1,1,1,0,0,1,20110101,A4706,HCPCS,BICARBONATE CONC SOL PER GAL,,,28 ,,NW,,,,,,$25.10,$0.00,1,1,1,0,0,1,20110101,A4707,HCPCS,BICARBONATE CONC POW PER PAC,,,28 ,,NW,,,,,,$15.53,$0.00,1,1,1,0,0,1,20110101,A4708,HCPCS,ACETATE CONC SOL PER GALLON,,,28 ,,NW,,,,,,$19.25,$0.00,1,1,1,0,0,1,20110101,A4709,HCPCS,ACID CONC SOL PER GALLON,,,28 ,,NW,,,,,,$29.65,$0.00,1,1,1,0,0,1,20110101,A4714,HCPCS,TREATED WATER PER GALLON,,,28 ,,NW,,,,,,$6.70,$0.00,1,1,1,0,0,1,20110101,A4719,HCPCS,Y SET TUBING,,,28 ,,NW,,,,,,$25.60,$0.00,1,1,1,0,0,1,20110101,A4720,HCPCS,DIALYSAT SOL FLD VOL > 249CC,,,28 ,,NW,,,,,,$27.30,$0.00,1,1,1,0,0,1,20110101,A4721,HCPCS,DIALYSAT SOL FLD VOL > 999CC,,,28 ,,NW,,,,,,$33.61,$0.00,1,1,1,0,0,1,20110101,A4722,HCPCS,DIALYS SOL FLD VOL > 1999CC,,,28 ,,NW,,,,,,$39.92,$0.00,1,1,1,0,0,1,20110101,A4723,HCPCS,DIALYS SOL FLD VOL > 2999CC,,,28 ,,NW,,,,,,$46.23,$0.00,1,1,1,0,0,1,20110101,A4724,HCPCS,DIALYS SOL FLD VOL > 3999CC,,,28 ,,NW,,,,,,$52.54,$0.00,1,1,1,0,0,1,20110101,A4725,HCPCS,DIALYS SOL FLD VOL > 4999CC,,,28 ,,NW,,,,,,$58.85,$0.00,1,1,1,0,0,1,20110101,A4726,HCPCS,DIALYS SOL FLD VOL > 5999CC,,,28 ,,NW,,,,,,$48.01,$0.00,1,1,1,0,0,1,20110101,A4728,HCPCS,"DIALYSATE SOLUTION, NON-DEX",,,28 ,,NW,,,,,,$16.88,$0.00,1,1,1,0,0,1,20110101,A4730,HCPCS,"FISTULA CANNULATION SET, EA",,,28 ,,NW,,,,,,$3.30,$0.00,1,1,1,0,0,1,20110101,A4736,HCPCS,"TOPICAL ANESTHETIC, PER GRAM",,,28 ,,NW,,,,,,$38.25,$0.00,1,1,1,0,0,1,20110101,A4737,HCPCS,INJ ANESTHETIC PER 10 ML,,,28 ,,NW,,,,,,$3.80,$0.00,1,1,1,0,0,1,20110101,A4740,HCPCS,SHUNT ACCESSORY,,,28 ,,NW,,,,,,$43.53,$0.00,1,1,1,0,0,1,20110101,A4750,HCPCS,ART OR VENOUS BLOOD TUBING,,,28 ,,NW,,,,,,$26.40,$0.00,1,1,1,0,0,1,20110101,A4755,HCPCS,COMB ART/VENOUS BLOOD TUBING,,,28 ,,NW,,,,,,$27.13,$0.00,1,1,1,0,0,1,20110101,A4760,HCPCS,"DIALYSATE SOL TEST KIT, EACH",,,28 ,,NW,,,,,,$156.25,$0.00,1,1,1,0,0,1,20110101,A4765,HCPCS,DIALYSATE CONC POW PER PACK,,,28 ,,NW,,,,,,$35.05,$0.00,1,1,1,0,0,1,20110101,A4766,HCPCS,DIALYSATE CONC SOL ADD 10 ML,,,28 ,,NW,,,,,,$35.05,$0.00,1,1,1,0,0,1,20110101,A4770,HCPCS,BLOOD COLLECTION TUBE/VACUUM,,,28 ,,NW,,,,,,$23.69,$0.00,1,1,1,0,0,1,20110101,A4771,HCPCS,SERUM CLOTTING TIME TUBE,,,28 ,,NW,,,,,,$10.45,$0.00,1,1,1,0,0,1,20110101,A4772,HCPCS,BLOOD GLUCOSE TEST STRIPS,,,28 ,,NW,,,,,,$44.21,$0.00,1,1,1,0,0,1,20110101,A4773,HCPCS,OCCULT BLOOD TEST STRIPS,,,28 ,,NW,,,,,,$31.53,$0.00,1,1,1,0,0,1,20110101,A4774,HCPCS,AMMONIA TEST STRIPS,,,28 ,,NW,,,,,,$13.06,$0.00,1,1,1,0,0,1,20110101,A4802,HCPCS,PROTAMINE SULFATE PER 50 MG,,,28 ,,NW,,,,,,$8.64,$0.00,1,1,1,0,0,1,20110101,A4860,HCPCS,DISPOSABLE CATHETER TIPS,,,28 ,,NW,,,,,,$10.00,$0.00,1,1,1,0,0,1,20110101,A4870,HCPCS,PLUMB/ELEC WK HM HEMO EQUIP,,,28 ,,NW,,,,,,$210.84,$0.00,1,1,1,0,0,1,20110101,A4890,HCPCS,REPAIR/MAINT CONT HEMO EQUIP,,,28 ,,NW,,,,,,$26.77,$0.00,1,1,1,0,0,1,20110101,A4911,HCPCS,DRAIN BAG/BOTTLE,,,28 ,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20110101,A4913,HCPCS,MISC DIALYSIS SUPPLIES NOC,,,28 ,,NW,,,,,,$129.23,$0.00,1,1,1,0,0,1,20110101,A4918,HCPCS,VENOUS PRESSURE CLAMP,,,28 ,,NW,,,,,,$6.70,$0.00,1,1,1,0,0,1,20110101,A4927,HCPCS,NON-STERILE GLOVES,,,28 ,,NW,,,,,,$8.31,$0.00,1,1,1,0,0,1,20110101,A4928,HCPCS,SURGICAL MASK,,,28 ,,NW,,,,,,$0.99,$0.00,1,1,1,0,0,1,20110101,A4929,HCPCS,"TOURNIQUET FOR DIALYSIS, EA",,,28 ,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20110101,A4930,HCPCS,"STERILE, GLOVES PER PAIR",,,28 ,,NW,,,,,,$1.40,$0.00,1,1,1,0,0,1,20110101,A4931,HCPCS,REUSABLE ORAL THERMOMETER,,,28 ,,NW,,,,,,$13.06,$0.00,1,1,1,0,0,1,20110101,A5051,HCPCS,POUCH CLSD W BARR ATTACHED,,,28 ,,NW,,,,,,$3.45,$0.00,1,1,1,0,0,1,20110101,A5052,HCPCS,CLSD OSTOMY POUCH W/O BARR,,,28 ,,NW,,,,,,$2.49,$0.00,1,1,1,0,0,1,20110101,A5053,HCPCS,CLSD OSTOMY POUCH FACEPLATE,,,28 ,,NW,,,,,,$2.77,$0.00,1,1,1,0,0,1,20110101,A5054,HCPCS,CLSD OSTOMY POUCH W/FLANGE,,,28 ,,NW,,,,,,$2.99,$0.00,1,1,1,0,0,1,20110101,A5055,HCPCS,STOMA CAP,,,28 ,,NW,,,,,,$2.35,$0.00,1,1,1,0,0,1,20110101,A5061,HCPCS,POUCH DRAINABLE W BARRIER AT,,,28 ,,NW,,,,,,$5.85,$0.00,1,1,1,0,0,1,20110101,A5062,HCPCS,DRNBLE OSTOMY POUCH W/O BARR,,,28 ,,NW,,,,,,$3.59,$0.00,1,1,1,0,0,1,20110101,A5063,HCPCS,DRAIN OSTOMY POUCH W/FLANGE,,,28 ,,NW,,,,,,$4.50,$0.00,1,1,1,0,0,1,20110101,A5071,HCPCS,URINARY POUCH W/BARRIER,,,28 ,,NW,,,,,,$9.96,$0.00,1,1,1,0,0,1,20110101,A5072,HCPCS,URINARY POUCH W/O BARRIER,,,28 ,,NW,,,,,,$5.65,$0.00,1,1,1,0,0,1,20110101,A5073,HCPCS,URINARY POUCH ON BARR W/FLNG,,,28 ,,NW,,,,,,$5.18,$0.00,1,1,1,0,0,1,20110101,A5081,HCPCS,CONTINENT STOMA PLUG,,,28 ,,NW,,,,,,$5.19,$0.00,1,1,1,0,0,1,20110101,A5082,HCPCS,CONTINENT STOMA CATHETER,,,28 ,,NW,,,,,,$17.15,$0.00,1,1,1,0,0,1,20110101,A5083,HCPCS,STOMA ABSORPTIVE COVER,,,28 ,,NW,,,,,,$1.06,$0.00,1,1,1,0,0,1,20110101,A5093,HCPCS,OSTOMY ACCESSORY CONVEX INSE,,,28 ,,NW,,,,,,$3.15,$0.00,1,1,1,0,0,1,20110101,A5102,HCPCS,BEDSIDE DRAIN BTL W/WO TUBE,,,28 ,,NW,,,,,,$27.58,$0.00,1,1,1,0,0,1,20110101,A5105,HCPCS,URINARY SUSPENSORY,,,28 ,,NW,,,,,,$43.23,$0.00,1,1,1,0,0,1,20110101,A5112,HCPCS,URINARY LEG BAG,,,28 ,,NW,,,,,,$37.28,$0.00,1,1,1,0,0,1,20110101,A5113,HCPCS,LATEX LEG STRAP,,,28 ,,NW,,,,,,$7.29,$0.00,1,1,1,0,0,1,20110101,A5114,HCPCS,FOAM/FABRIC LEG STRAP,,,28 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,A5120,HCPCS,"SKIN BARRIER, WIPE OR SWAB",,,28 ,,NW,,,,,,$0.41,$0.00,1,1,1,0,0,1,20110101,A5120,HCPCS,"SKIN BARRIER, WIPE OR SWAB",AU,,28 ,,NW,,,,,,$0.41,$0.00,1,1,1,0,0,1,20110101,A5120,HCPCS,"SKIN BARRIER, WIPE OR SWAB",AV,,28 ,,NW,,,,,,$0.40,$0.00,1,1,1,0,0,1,20110101,A5121,HCPCS,SOLID SKIN BARRIER 6X6,,,28 ,,NW,,,,,,$11.71,$0.00,1,1,1,0,0,1,20110101,A5122,HCPCS,SOLID SKIN BARRIER 8X8,,,28 ,,NW,,,,,,$18.21,$0.00,1,1,1,0,0,1,20110101,A5126,HCPCS,DISK/FOAM PAD +OR- ADHESIVE,,,28 ,,NW,,,,,,$2.04,$0.00,1,1,1,0,0,1,20110101,A5131,HCPCS,APPLIANCE CLEANER,,,28 ,,NW,,,,,,$20.71,$0.00,1,1,1,0,0,1,20110101,A5200,HCPCS,PERCUTANEOUS CATHETER ANCHOR,,,28 ,,NW,,,,,,$17.38,$0.00,1,1,1,0,0,1,20110101,A5500,HCPCS,DIAB SHOE FOR DENSITY INSERT,,,28 ,,NW,,,,,,$93.27,$0.00,1,1,1,0,0,1,20110101,A5501,HCPCS,DIABETIC CUSTOM MOLDED SHOE,,,28 ,,NW,,,,,,$278.15,$0.00,1,1,1,0,0,1,20110101,A5503,HCPCS,DIABETIC SHOE W/ROLLER/ROCKR,,,28 ,,NW,,,,,,$43.74,$0.00,1,1,1,0,0,1,20110101,A5504,HCPCS,DIABETIC SHOE WITH WEDGE,,,28 ,,NW,,,,,,$43.74,$0.00,1,1,1,0,0,1,20110101,A5505,HCPCS,DIAB SHOE W/METATARSAL BAR,,,28 ,,NW,,,,,,$43.74,$0.00,1,1,1,0,0,1,20110101,A5506,HCPCS,DIABETIC SHOE W/OFF SET HEEL,,,28 ,,NW,,,,,,$43.74,$0.00,1,1,1,0,0,1,20110101,A5507,HCPCS,MODIFICATION DIABETIC SHOE,,,28 ,,NW,,,,,,$43.74,$0.00,1,1,1,0,0,1,20110101,A5508,HCPCS,DIABETIC DELUXE SHOE,,,28 ,,NW,,,,,,$43.74,$0.00,1,1,1,0,0,1,20110101,A5510,HCPCS,COMPRESSION FORM SHOE INSERT,,,28 ,,NW,,,,,,$64.60,$0.00,1,1,1,0,0,1,20110101,A5512,HCPCS,MULTI DEN INSERT DIRECT FORM,,,28 ,,NW,,,,,,$40.47,$0.00,1,1,1,0,0,1,20110101,A5513,HCPCS,MULTI DEN INSERT CUSTOM MOLD,,,28 ,,NW,,,,,,$58.39,$0.00,1,1,1,0,0,1,20110101,A6000,HCPCS,WOUND WARMING WOUND COVER,,,28 ,,NW,,,,,,$67.66,$0.00,1,1,1,0,0,1,20110101,A6010,HCPCS,COLLAGEN BASED WOUND FILLER,,,28 ,,NW,,,,,,$35.39,$0.00,1,1,1,0,0,1,20110101,A6011,HCPCS,COLLAGEN GEL/PASTE WOUND FIL,,,28 ,,NW,,,,,,$3.79,$0.00,1,1,1,0,0,1,20110101,A6021,HCPCS,COLLAGEN DRESSING <=16 SQ IN,,,28 ,,NW,,,,,,$26.28,$0.00,1,1,1,0,0,1,20110101,A6022,HCPCS,COLLAGEN DRSG>16<=48 SQ IN,,,28 ,,NW,,,,,,$26.28,$0.00,1,1,1,0,0,1,20110101,A6023,HCPCS,COLLAGEN DRESSING >48 SQ IN,,,28 ,,NW,,,,,,$181.24,$0.00,1,1,1,0,0,1,20110101,A6024,HCPCS,COLLAGEN DSG WOUND FILLER,,,28 ,,NW,,,,,,$10.26,$0.00,1,1,1,0,0,1,20110101,A6025,HCPCS,"SILICONE GEL SHEET, EACH",,,28 ,,NW,,,,,,$30.50,$0.00,1,1,1,0,0,1,20110101,A6154,HCPCS,WOUND POUCH EACH,,,28 ,,NW,,,,,,$20.10,$0.00,1,1,1,0,0,1,20110101,A6196,HCPCS,ALGINATE DRESSING <=16 SQ IN,,,28 ,,NW,,,,,,$12.18,$0.00,1,1,1,0,0,1,20110101,A6197,HCPCS,ALGINATE DRSG >16 <=48 SQ IN,,,28 ,,NW,,,,,,$22.10,$0.00,1,1,1,0,0,1,20110101,A6198,HCPCS,ALGINATE DRESSING > 48 SQ IN,,,28 ,,NW,,,,,,$32.00,$0.00,1,1,1,0,0,1,20110101,A6199,HCPCS,ALGINATE DRSG WOUND FILLER,,,28 ,,NW,,,,,,$8.77,$0.00,1,1,1,0,0,1,20110101,A6203,HCPCS,COMPOSITE DRSG <= 16 SQ IN,,,28 ,,NW,,,,,,$5.58,$0.00,1,1,1,0,0,1,20110101,A6204,HCPCS,COMPOSITE DRSG >16<=48 SQ IN,,,28 ,,NW,,,,,,$10.33,$0.00,1,1,1,0,0,1,20110101,A6205,HCPCS,COMPOSITE DRSG > 48 SQ IN,,,28 ,,NW,,,,,,$16.17,$0.00,1,1,1,0,0,1,20110101,A6206,HCPCS,CONTACT LAYER <= 16 SQ IN,,,28 ,,NW,,,,,,$7.91,$0.00,1,1,1,0,0,1,20110101,A6207,HCPCS,CONTACT LAYER >16<= 48 SQ IN,,,28 ,,NW,,,,,,$12.16,$0.00,1,1,1,0,0,1,20110101,A6208,HCPCS,CONTACT LAYER > 48 SQ IN,,,28 ,,NW,,,,,,$74.43,$0.00,1,1,1,0,0,1,20110101,A6209,HCPCS,FOAM DRSG <=16 SQ IN W/O BDR,,,28 ,,NW,,,,,,$12.39,$0.00,1,1,1,0,0,1,20110101,A6210,HCPCS,FOAM DRG >16<=48 SQ IN W/O B,,,28 ,,NW,,,,,,$25.29,$0.00,1,1,1,0,0,1,20110101,A6211,HCPCS,FOAM DRG > 48 SQ IN W/O BRDR,,,28 ,,NW,,,,,,$33.94,$0.00,1,1,1,0,0,1,20110101,A6212,HCPCS,FOAM DRG <=16 SQ IN W/BORDER,,,28 ,,NW,,,,,,$15.93,$0.00,1,1,1,0,0,1,20110101,A6213,HCPCS,FOAM DRG >16<=48 SQ IN W/BDR,,,28 ,,NW,,,,,,$27.77,$0.00,1,1,1,0,0,1,20110101,A6214,HCPCS,FOAM DRG > 48 SQ IN W/BORDER,,,28 ,,NW,,,,,,$16.46,$0.00,1,1,1,0,0,1,20110101,A6215,HCPCS,FOAM DRESSING WOUND FILLER,,,28 ,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20110101,A6216,HCPCS,NON-STERILE GAUZE<=16 SQ IN,,,28 ,,NW,,,,,,$0.08,$0.00,1,1,1,0,0,1,20110101,A6217,HCPCS,NON-STERILE GAUZE>16<=48 SQ,,,28 ,,NW,,,,,,$1.48,$0.00,1,1,1,0,0,1,20110101,A6218,HCPCS,NON-STERILE GAUZE > 48 SQ IN,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A6219,HCPCS,GAUZE <= 16 SQ IN W/BORDER,,,28 ,,NW,,,,,,$1.61,$0.00,1,1,1,0,0,1,20110101,A6220,HCPCS,GAUZE >16 <=48 SQ IN W/BORDR,,,28 ,,NW,,,,,,$4.30,$0.00,1,1,1,0,0,1,20110101,A6221,HCPCS,GAUZE > 48 SQ IN W/BORDER,,,28 ,,NW,,,,,,$6.87,$0.00,1,1,1,0,0,1,20110101,A6222,HCPCS,GAUZE <=16 IN NO W/SAL W/O B,,,28 ,,NW,,,,,,$3.56,$0.00,1,1,1,0,0,1,20110101,A6223,HCPCS,GAUZE >16<=48 NO W/SAL W/O B,,,28 ,,NW,,,,,,$4.03,$0.00,1,1,1,0,0,1,20110101,A6224,HCPCS,GAUZE > 48 IN NO W/SAL W/O B,,,28 ,,NW,,,,,,$6.00,$0.00,1,1,1,0,0,1,20110101,A6228,HCPCS,GAUZE <= 16 SQ IN WATER/SAL,,,28 ,,NW,,,,,,$2.99,$0.00,1,1,1,0,0,1,20110101,A6229,HCPCS,GAUZE >16<=48 SQ IN WATR/SAL,,,28 ,,NW,,,,,,$6.00,$0.00,1,1,1,0,0,1,20110101,A6230,HCPCS,GAUZE > 48 SQ IN WATER/SALNE,,,28 ,,NW,,,,,,$5.94,$0.00,1,1,1,0,0,1,20110101,A6231,HCPCS,HYDROGEL DSG<=16 SQ IN,,,28 ,,NW,,,,,,$7.74,$0.00,1,1,1,0,0,1,20110101,A6232,HCPCS,HYDROGEL DSG>16<=48 SQ IN,,,28 ,,NW,,,,,,$11.39,$0.00,1,1,1,0,0,1,20110101,A6233,HCPCS,HYDROGEL DRESSING >48 SQ IN,,,28 ,,NW,,,,,,$24.61,$0.00,1,1,1,0,0,1,20110101,A6234,HCPCS,HYDROCOLLD DRG <=16 W/O BDR,,,28 ,,NW,,,,,,$10.84,$0.00,1,1,1,0,0,1,20110101,A6235,HCPCS,HYDROCOLLD DRG >16<=48 W/O B,,,28 ,,NW,,,,,,$22.45,$0.00,1,1,1,0,0,1,20110101,A6236,HCPCS,HYDROCOLLD DRG > 48 IN W/O B,,,28 ,,NW,,,,,,$31.99,$0.00,1,1,1,0,0,1,20110101,A6237,HCPCS,HYDROCOLLD DRG <=16 IN W/BDR,,,28 ,,NW,,,,,,$13.11,$0.00,1,1,1,0,0,1,20110101,A6238,HCPCS,HYDROCOLLD DRG >16<=48 W/BDR,,,28 ,,NW,,,,,,$27.91,$0.00,1,1,1,0,0,1,20110101,A6239,HCPCS,HYDROCOLLD DRG > 48 IN W/BDR,,,28 ,,NW,,,,,,$38.70,$0.00,1,1,1,0,0,1,20110101,A6240,HCPCS,HYDROCOLLD DRG FILLER PASTE,,,28 ,,NW,,,,,,$18.25,$0.00,1,1,1,0,0,1,20110101,A6241,HCPCS,HYDROCOLLOID DRG FILLER DRY,,,28 ,,NW,,,,,,$4.28,$0.00,1,1,1,0,0,1,20110101,A6242,HCPCS,HYDROGEL DRG <=16 IN W/O BDR,,,28 ,,NW,,,,,,$10.06,$0.00,1,1,1,0,0,1,20110101,A6243,HCPCS,HYDROGEL DRG >16<=48 W/O BDR,,,28 ,,NW,,,,,,$18.32,$0.00,1,1,1,0,0,1,20110101,A6244,HCPCS,HYDROGEL DRG >48 IN W/O BDR,,,28 ,,NW,,,,,,$43.01,$0.00,1,1,1,0,0,1,20110101,A6245,HCPCS,HYDROGEL DRG <= 16 IN W/BDR,,,28 ,,NW,,,,,,$12.04,$0.00,1,1,1,0,0,1,20110101,A6246,HCPCS,HYDROGEL DRG >16<=48 IN W/B,,,28 ,,NW,,,,,,$16.13,$0.00,1,1,1,0,0,1,20110101,A6247,HCPCS,HYDROGEL DRG > 48 SQ IN W/B,,,28 ,,NW,,,,,,$28.82,$0.00,1,1,1,0,0,1,20110101,A6248,HCPCS,HYDROGEL DRSG GEL FILLER,,,28 ,,NW,,,,,,$21.91,$0.00,1,1,1,0,0,1,20110101,A6250,HCPCS,SKIN SEAL PROTECT MOISTURIZR,,,28 ,,NW,,,,,,$3.03,$0.00,1,1,1,0,0,1,20110101,A6251,HCPCS,ABSORPT DRG <=16 SQ IN W/O B,,,28 ,,NW,,,,,,$3.32,$0.00,1,1,1,0,0,1,20110101,A6252,HCPCS,ABSORPT DRG >16 <=48 W/O BDR,,,28 ,,NW,,,,,,$5.41,$0.00,1,1,1,0,0,1,20110101,A6253,HCPCS,ABSORPT DRG > 48 SQ IN W/O B,,,28 ,,NW,,,,,,$10.53,$0.00,1,1,1,0,0,1,20110101,A6254,HCPCS,ABSORPT DRG <=16 SQ IN W/BDR,,,28 ,,NW,,,,,,$2.03,$0.00,1,1,1,0,0,1,20110101,A6255,HCPCS,ABSORPT DRG >16<=48 IN W/BDR,,,28 ,,NW,,,,,,$5.04,$0.00,1,1,1,0,0,1,20110101,A6256,HCPCS,ABSORPT DRG > 48 SQ IN W/BDR,,,28 ,,NW,,,,,,$12.24,$0.00,1,1,1,0,0,1,20110101,A6257,HCPCS,TRANSPARENT FILM <= 16 SQ IN,,,28 ,,NW,,,,,,$2.57,$0.00,1,1,1,0,0,1,20110101,A6258,HCPCS,TRANSPARENT FILM >16<=48 IN,,,28 ,,NW,,,,,,$7.15,$0.00,1,1,1,0,0,1,20110101,A6259,HCPCS,TRANSPARENT FILM > 48 SQ IN,,,28 ,,NW,,,,,,$17.06,$0.00,1,1,1,0,0,1,20110101,A6260,HCPCS,WOUND CLEANSER ANY TYPE/SIZE,,,28 ,,NW,,,,,,$2.00,$0.00,1,1,1,0,0,1,20110101,A6261,HCPCS,WOUND FILLER GEL/PASTE /OZ,,,28 ,,NW,,,,,,$6.92,$0.00,1,1,1,0,0,1,20110101,A6262,HCPCS,WOUND FILLER DRY FORM / GRAM,,,28 ,,NW,,,,,,$2.00,$0.00,1,1,1,0,0,1,20110101,A6266,HCPCS,IMPREG GAUZE NO H20/SAL/YARD,,,28 ,,NW,,,,,,$3.21,$0.00,1,1,1,0,0,1,20110101,A6402,HCPCS,STERILE GAUZE <= 16 SQ IN,,,28 ,,NW,,,,,,$0.21,$0.00,1,1,1,0,0,1,20110101,A6403,HCPCS,STERILE GAUZE>16 <= 48 SQ IN,,,28 ,,NW,,,,,,$0.72,$0.00,1,1,1,0,0,1,20110101,A6404,HCPCS,STERILE GAUZE > 48 SQ IN,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A6407,HCPCS,"PACKING STRIPS, NON-IMPREG",,,28 ,,NW,,,,,,$3.13,$0.00,1,1,1,0,0,1,20110101,A6410,HCPCS,STERILE EYE PAD,,,28 ,,NW,,,,,,$0.66,$0.00,1,1,1,0,0,1,20110101,A6411,HCPCS,NON-STERILE EYE PAD,,,28 ,,NW,,,,,,$0.66,$0.00,1,1,1,0,0,1,20110101,A6412,HCPCS,OCCLUSIVE EYE PATCH,,,28 ,,NW,,,,,,$1.01,$0.00,1,1,1,0,0,1,20110101,A6413,HCPCS,"ADHESIVE BANDAGE, FIRST-AID",,,28 ,,NW,,,,,,$2.55,$0.00,1,1,1,0,0,1,20110101,A6441,HCPCS,"PAD BAND W>=3"" <5""/YD",,,28 ,,NW,,,,,,$1.13,$0.00,1,1,1,0,0,1,20110101,A6442,HCPCS,"CONFORM BAND N/S W<3""/YD",,,28 ,,NW,,,,,,$0.29,$0.00,1,1,1,0,0,1,20110101,A6443,HCPCS,"CONFORM BAND N/S W>=3""<5""/YD",,,28 ,,NW,,,,,,$0.48,$0.00,1,1,1,0,0,1,20110101,A6444,HCPCS,"CONFORM BAND N/S W>=5""/YD",,,28 ,,NW,,,,,,$0.95,$0.00,1,1,1,0,0,1,20110101,A6445,HCPCS,"CONFORM BAND S W <3""/YD",,,28 ,,NW,,,,,,$0.55,$0.00,1,1,1,0,0,1,20110101,A6446,HCPCS,"CONFORM BAND S W>=3"" <5""/YD",,,28 ,,NW,,,,,,$0.69,$0.00,1,1,1,0,0,1,20110101,A6447,HCPCS,"CONFORM BAND S W >=5""/YD",,,28 ,,NW,,,,,,$1.13,$0.00,1,1,1,0,0,1,20110101,A6448,HCPCS,"LT COMPRES BAND <3""/YD",,,28 ,,NW,,,,,,$1.95,$0.00,1,1,1,0,0,1,20110101,A6449,HCPCS,"LT COMPRES BAND >=3"" <5""/YD",,,28 ,,NW,,,,,,$2.93,$0.00,1,1,1,0,0,1,20110101,A6450,HCPCS,"LT COMPRES BAND >=5""/YD",,,28 ,,NW,,,,,,$7.30,$0.00,1,1,1,0,0,1,20110101,A6451,HCPCS,"MOD COMPRES BAND W>=3""<5""/YD",,,28 ,,NW,,,,,,$9.39,$0.00,1,1,1,0,0,1,20110101,A6452,HCPCS,"HIGH COMPRES BAND W>=3""<5""YD",,,28 ,,NW,,,,,,$9.80,$0.00,1,1,1,0,0,1,20110101,A6453,HCPCS,"SELF-ADHER BAND W <3""/YD",,,28 ,,NW,,,,,,$1.03,$0.00,1,1,1,0,0,1,20110101,A6454,HCPCS,"SELF-ADHER BAND W>=3"" <5""/YD",,,28 ,,NW,,,,,,$1.30,$0.00,1,1,1,0,0,1,20110101,A6455,HCPCS,"SELF-ADHER BAND >=5""/YD",,,28 ,,NW,,,,,,$2.33,$0.00,1,1,1,0,0,1,20110101,A6456,HCPCS,"ZINC PASTE BAND W >=3""<5""/YD",,,28 ,,NW,,,,,,$2.14,$0.00,1,1,1,0,0,1,20110101,A6457,HCPCS,TUBULAR DRESSING,,,28 ,,NW,,,,,,$1.92,$0.00,1,1,1,0,0,1,20110101,A6504,HCPCS,CMPRSBURNGARMENT GLOVE-WRIST,,,28 ,,NW,,,,,,$342.34,$0.00,1,1,1,0,0,1,20110101,A6505,HCPCS,CMPRSBURNGARMENT GLOVE-ELBOW,,,28 ,,NW,,,,,,$178.59,$0.00,1,1,1,0,0,1,20110101,A6506,HCPCS,CMPRSBURNGRMNT GLOVE-AXILLA,,,28 ,,NW,,,,,,$101.44,$0.00,1,1,1,0,0,1,20110101,A6507,HCPCS,CMPRS BURNGARMENT FOOT-KNEE,,,28 ,,NW,,,,,,$138.99,$0.00,1,1,1,0,0,1,20110101,A6509,HCPCS,COMPRES BURN GARMENT JACKET,,,28 ,,NW,,,,,,$654.57,$0.00,1,1,1,0,0,1,20110101,A6510,HCPCS,COMPRES BURN GARMENT LEOTARD,,,28 ,,NW,,,,,,$281.19,$0.00,1,1,1,0,0,1,20110101,A6511,HCPCS,COMPRES BURN GARMENT PANTY,,,28 ,,NW,,,,,,$607.15,$0.00,1,1,1,0,0,1,20110101,A6512,HCPCS,"COMPRES BURN GARMENT, NOC",,,28 ,,NW,,,,,,$16.28,$0.00,1,1,1,0,0,1,20110101,A6530,HCPCS,COMPRESSION STOCKING BK18-30,,,28 ,,NW,,,,,,$47.32,$0.00,1,1,1,0,0,1,20110101,A6531,HCPCS,COMPRESSION STOCKING BK30-40,,,28 ,,NW,,,,,,$46.65,$0.00,1,1,1,0,0,1,20110101,A6531,HCPCS,COMPRESSION STOCKING BK30-40,AW,,28 ,,NW,,,,,,$46.65,$0.00,1,1,1,0,0,1,20110101,A6532,HCPCS,COMPRESSION STOCKING BK40-50,,,28 ,,NW,,,,,,$62.85,$0.00,1,1,1,0,0,1,20110101,A6532,HCPCS,COMPRESSION STOCKING BK40-50,AW,,28 ,,NW,,,,,,$62.85,$0.00,1,1,1,0,0,1,20110101,A6533,HCPCS,GC STOCKING THIGHLNGTH 18-30,,,28 ,,NW,,,,,,$67.40,$0.00,1,1,1,0,0,1,20110101,A6534,HCPCS,GC STOCKING THIGHLNGTH 30-40,,,28 ,,NW,,,,,,$77.67,$0.00,1,1,1,0,0,1,20110101,A6535,HCPCS,GC STOCKING THIGHLNGTH 40-50,,,28 ,,NW,,,,,,$101.19,$0.00,1,1,1,0,0,1,20110101,A6536,HCPCS,GC STOCKING FULL LNGTH 18-30,,,28 ,,NW,,,,,,$88.33,$0.00,1,1,1,0,0,1,20110101,A6537,HCPCS,GC STOCKING FULL LNGTH 30-40,,,28 ,,NW,,,,,,$89.19,$0.00,1,1,1,0,0,1,20110101,A6538,HCPCS,GC STOCKING FULL LNGTH 40-50,,,28 ,,NW,,,,,,$91.30,$0.00,1,1,1,0,0,1,20110101,A6539,HCPCS,GC STOCKING WAISTLNGTH 18-30,,,28 ,,NW,,,,,,$136.77,$0.00,1,1,1,0,0,1,20110101,A6540,HCPCS,GC STOCKING WAISTLNGTH 30-40,,,28 ,,NW,,,,,,$130.76,$0.00,1,1,1,0,0,1,20110101,A6541,HCPCS,GC STOCKING WAISTLNGTH 40-50,,,28 ,,NW,,,,,,$180.97,$0.00,1,1,1,0,0,1,20110101,A6544,HCPCS,GC STOCKING GARTER BELT,,,28 ,,NW,,,,,,$50.72,$0.00,1,1,1,0,0,1,20110101,A6545,HCPCS,GRAD COMP NON-ELASTIC BK,,,28 ,,NW,,,,,,$85.02,$0.00,1,1,1,0,0,1,20110101,A6545,HCPCS,GRAD COMP NON-ELASTIC BK,AW,,28 ,,NW,,,,,,$85.02,$0.00,1,1,1,0,0,1,20110101,A6549,HCPCS,G COMPRESSION STOCKING,,,28 ,,NW,,,,,,$132.60,$0.00,1,1,1,0,0,1,20110101,A6550,HCPCS,NEG PRES WOUND THER DRSG SET,,,28 ,,NW,,,,,,$48.12,$0.00,1,1,1,0,0,1,20110101,A7000,HCPCS,DISPOSABLE CANISTER FOR PUMP,,,28 ,,NW,,,,,,$35.63,$0.00,1,1,1,0,0,1,20110101,A7000,HCPCS,DISPOSABLE CANISTER FOR PUMP,NU,,28 ,,NW,,,,,,$35.63,$0.00,1,1,1,0,0,1,20110101,A7001,HCPCS,NONDISPOSABLE PUMP CANISTER,,,28 ,,NW,,,,,,$62.01,$0.00,1,1,1,0,0,1,20110101,A7001,HCPCS,NONDISPOSABLE PUMP CANISTER,NU,,28 ,,NW,,,,,,$62.01,$0.00,1,1,1,0,0,1,20110101,A7002,HCPCS,TUBING USED W SUCTION PUMP,,,28 ,,NW,,,,,,$9.88,$0.00,1,1,1,0,0,1,20110101,A7002,HCPCS,TUBING USED W SUCTION PUMP,NU,,28 ,,NW,,,,,,$9.88,$0.00,1,1,1,0,0,1,20110101,A7003,HCPCS,NEBULIZER ADMINISTRATION SET,,,28 ,,NW,,,,,,$7.25,$0.00,1,1,1,0,0,1,20110101,A7003,HCPCS,NEBULIZER ADMINISTRATION SET,NU,,28 ,,NW,,,,,,$7.25,$0.00,1,1,1,0,0,1,20110101,A7004,HCPCS,DISPOSABLE NEBULIZER SML VOL,,,28 ,,NW,,,,,,$4.59,$0.00,1,1,1,0,0,1,20110101,A7004,HCPCS,DISPOSABLE NEBULIZER SML VOL,NU,,28 ,,NW,,,,,,$4.59,$0.00,1,1,1,0,0,1,20110101,A7005,HCPCS,NONDISPOSABLE NEBULIZER SET,,,28 ,,NW,,,,,,$57.66,$0.00,1,1,1,0,0,1,20110101,A7005,HCPCS,NONDISPOSABLE NEBULIZER SET,NU,,28 ,,NW,,,,,,$57.66,$0.00,1,1,1,0,0,1,20110101,A7006,HCPCS,FILTERED NEBULIZER ADMIN SET,,,28 ,,NW,,,,,,$21.59,$0.00,1,1,1,0,0,1,20110101,A7006,HCPCS,FILTERED NEBULIZER ADMIN SET,NU,,28 ,,NW,,,,,,$21.59,$0.00,1,1,1,0,0,1,20110101,A7007,HCPCS,LG VOL NEBULIZER DISPOSABLE,,,28 ,,NW,,,,,,$12.14,$0.00,1,1,1,0,0,1,20110101,A7007,HCPCS,LG VOL NEBULIZER DISPOSABLE,NU,,28 ,,NW,,,,,,$12.14,$0.00,1,1,1,0,0,1,20110101,A7008,HCPCS,DISPOSABLE NEBULIZER PREFILL,,,28 ,,NW,,,,,,$23.71,$0.00,1,1,1,0,0,1,20110101,A7008,HCPCS,DISPOSABLE NEBULIZER PREFILL,NU,,28 ,,NW,,,,,,$23.71,$0.00,1,1,1,0,0,1,20110101,A7009,HCPCS,NEBULIZER RESERVOIR BOTTLE,,,28 ,,NW,,,,,,$79.85,$0.00,1,1,1,0,0,1,20110101,A7009,HCPCS,NEBULIZER RESERVOIR BOTTLE,NU,,28 ,,NW,,,,,,$79.85,$0.00,1,1,1,0,0,1,20110101,A7010,HCPCS,DISPOSABLE CORRUGATED TUBING,,,28 ,,NW,,,,,,$45.76,$0.00,1,1,1,0,0,1,20110101,A7010,HCPCS,DISPOSABLE CORRUGATED TUBING,NU,,28 ,,NW,,,,,,$45.76,$0.00,1,1,1,0,0,1,20110101,A7011,HCPCS,NONDISPOS CORRUGATED TUBING,,,28 ,,NW,,,,,,$31.13,$0.00,1,1,1,0,0,1,20110101,A7012,HCPCS,NEBULIZER WATER COLLEC DEVIC,,,28 ,,NW,,,,,,$9.92,$0.00,1,1,1,0,0,1,20110101,A7012,HCPCS,NEBULIZER WATER COLLEC DEVIC,NU,,28 ,,NW,,,,,,$9.92,$0.00,1,1,1,0,0,1,20110101,A7013,HCPCS,DISPOSABLE COMPRESSOR FILTER,,,28 ,,NW,,,,,,$2.14,$0.00,1,1,1,0,0,1,20110101,A7013,HCPCS,DISPOSABLE COMPRESSOR FILTER,NU,,28 ,,NW,,,,,,$2.14,$0.00,1,1,1,0,0,1,20110101,A7014,HCPCS,COMPRESSOR NONDISPOS FILTER,,,28 ,,NW,,,,,,$12.12,$0.00,1,1,1,0,0,1,20110101,A7014,HCPCS,COMPRESSOR NONDISPOS FILTER,NU,,28 ,,NW,,,,,,$12.12,$0.00,1,1,1,0,0,1,20110101,A7015,HCPCS,AEROSOL MASK USED W NEBULIZE,,,28 ,,NW,,,,,,$4.94,$0.00,1,1,1,0,0,1,20110101,A7015,HCPCS,AEROSOL MASK USED W NEBULIZE,NU,,28 ,,NW,,,,,,$4.94,$0.00,1,1,1,0,0,1,20110101,A7016,HCPCS,NEBULIZER DOME & MOUTHPIECE,,,28 ,,NW,,,,,,$17.27,$0.00,1,1,1,0,0,1,20110101,A7016,HCPCS,NEBULIZER DOME & MOUTHPIECE,NU,,28 ,,NW,,,,,,$17.27,$0.00,1,1,1,0,0,1,20110101,A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,,,28 ,,NW,,,,,,$303.33,$0.00,1,1,1,0,0,1,20110101,A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,NU,,28 ,,NW,,,,,,$303.33,$0.00,1,1,1,0,0,1,20110101,A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,RR,,28 ,,NW,,,,,,$29.15,$0.00,1,1,1,0,0,1,20110101,A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,UE,,28 ,,NW,,,,,,$221.81,$0.00,1,1,1,0,0,1,20110101,A7018,HCPCS,WATER DISTILLED W/NEBULIZER,,,28 ,,NW,,,,,,$1.00,$0.00,1,1,1,0,0,1,20110101,A7020,HCPCS,"INTERFACE, COUGH STIM DEVICE",,,28 ,,NW,,,,,,"$9,430.33",$0.00,1,1,1,0,0,1,20110101,A7025,HCPCS,REPLACE CHEST COMPRESS VEST,,,28 ,,NW,,,,,,"$1,035.23",$0.00,1,1,1,0,0,1,20110101,A7025,HCPCS,REPLACE CHEST COMPRESS VEST,NU,,28 ,,NW,,,,,,"$1,035.23",$0.00,1,1,1,0,0,1,20110101,A7026,HCPCS,REPLACE CHST CMPRSS SYS HOSE,,,28 ,,NW,,,,,,$57.60,$0.00,1,1,1,0,0,1,20110101,A7026,HCPCS,REPLACE CHST CMPRSS SYS HOSE,NU,,28 ,,NW,,,,,,$57.60,$0.00,1,1,1,0,0,1,20110101,A7027,HCPCS,COMBINATION ORAL/NASAL MASK,,,28 ,,NW,,,,,,$423.31,$0.00,1,1,1,0,0,1,20110101,A7027,HCPCS,COMBINATION ORAL/NASAL MASK,NU,,28 ,,NW,,,,,,$423.31,$0.00,1,1,1,0,0,1,20110101,A7028,HCPCS,REPL ORAL CUSHION COMBO MASK,,,28 ,,NW,,,,,,$97.81,$0.00,1,1,1,0,0,1,20110101,A7028,HCPCS,REPL ORAL CUSHION COMBO MASK,NU,,28 ,,NW,,,,,,$97.81,$0.00,1,1,1,0,0,1,20110101,A7029,HCPCS,REPL NASAL PILLOW COMB MASK,,,28 ,,NW,,,,,,$41.82,$0.00,1,1,1,0,0,1,20110101,A7029,HCPCS,REPL NASAL PILLOW COMB MASK,NU,,28 ,,NW,,,,,,$41.82,$0.00,1,1,1,0,0,1,20110101,A7030,HCPCS,CPAP FULL FACE MASK,,,28 ,,NW,,,,,,$372.78,$0.00,1,1,1,0,0,1,20110101,A7030,HCPCS,CPAP FULL FACE MASK,NU,,28 ,,NW,,,,,,$372.78,$0.00,1,1,1,0,0,1,20110101,A7031,HCPCS,REPLACEMENT FACEMASK INTERFA,,,28 ,,NW,,,,,,$123.57,$0.00,1,1,1,0,0,1,20110101,A7031,HCPCS,REPLACEMENT FACEMASK INTERFA,NU,,28 ,,NW,,,,,,$123.57,$0.00,1,1,1,0,0,1,20110101,A7032,HCPCS,REPLACEMENT NASAL CUSHION,,,28 ,,NW,,,,,,$69.05,$0.00,1,1,1,0,0,1,20110101,A7032,HCPCS,REPLACEMENT NASAL CUSHION,NU,,28 ,,NW,,,,,,$69.05,$0.00,1,1,1,0,0,1,20110101,A7033,HCPCS,REPLACEMENT NASAL PILLOWS,,,28 ,,NW,,,,,,$49.69,$0.00,1,1,1,0,0,1,20110101,A7033,HCPCS,REPLACEMENT NASAL PILLOWS,NU,,28 ,,NW,,,,,,$49.69,$0.00,1,1,1,0,0,1,20110101,A7034,HCPCS,NASAL APPLICATION DEVICE,,,28 ,,NW,,,,,,$223.92,$0.00,1,1,1,0,0,1,20110101,A7034,HCPCS,NASAL APPLICATION DEVICE,NU,,28 ,,NW,,,,,,$223.92,$0.00,1,1,1,0,0,1,20110101,A7035,HCPCS,POS AIRWAY PRESS HEADGEAR,,,28 ,,NW,,,,,,$64.57,$0.00,1,1,1,0,0,1,20110101,A7035,HCPCS,POS AIRWAY PRESS HEADGEAR,NU,,28 ,,NW,,,,,,$64.57,$0.00,1,1,1,0,0,1,20110101,A7036,HCPCS,POS AIRWAY PRESS CHINSTRAP,,,28 ,,NW,,,,,,$31.00,$0.00,1,1,1,0,0,1,20110101,A7036,HCPCS,POS AIRWAY PRESS CHINSTRAP,NU,,28 ,,NW,,,,,,$31.00,$0.00,1,1,1,0,0,1,20110101,A7037,HCPCS,POS AIRWAY PRESSURE TUBING,,,28 ,,NW,,,,,,$68.55,$0.00,1,1,1,0,0,1,20110101,A7037,HCPCS,POS AIRWAY PRESSURE TUBING,NU,,28 ,,NW,,,,,,$68.55,$0.00,1,1,1,0,0,1,20110101,A7038,HCPCS,POS AIRWAY PRESSURE FILTER,,,28 ,,NW,,,,,,$11.92,$0.00,1,1,1,0,0,1,20110101,A7038,HCPCS,POS AIRWAY PRESSURE FILTER,NU,,28 ,,NW,,,,,,$11.92,$0.00,1,1,1,0,0,1,20110101,A7039,HCPCS,"FILTER, NON DISPOSABLE W PAP",,,28 ,,NW,,,,,,$27.18,$0.00,1,1,1,0,0,1,20110101,A7039,HCPCS,"FILTER, NON DISPOSABLE W PAP",NU,,28 ,,NW,,,,,,$27.18,$0.00,1,1,1,0,0,1,20110101,A7040,HCPCS,ONE WAY CHEST DRAIN VALVE,,,28 ,,NW,,,,,,$43.52,$0.00,1,1,1,0,0,1,20110101,A7041,HCPCS,WATER SEAL DRAIN CONTAINER,,,28 ,,NW,,,,,,$75.58,$0.00,1,1,1,0,0,1,20110101,A7042,HCPCS,IMPLANTED PLEURAL CATHETER,,,28 ,,NW,,,,,,$172.05,$0.00,1,1,1,0,0,1,20110101,A7043,HCPCS,VACUUM DRAINAGEBOTTLE/TUBING,,,28 ,,NW,,,,,,$33.17,$0.00,1,1,1,0,0,1,20110101,A7044,HCPCS,PAP ORAL INTERFACE,,,28 ,,NW,,,,,,$230.78,$0.00,1,1,1,0,0,1,20110101,A7044,HCPCS,PAP ORAL INTERFACE,NU,,28 ,,NW,,,,,,$230.78,$0.00,1,1,1,0,0,1,20110101,A7045,HCPCS,REPL EXHALATION PORT FOR PAP,,,28 ,,NW,,,,,,$35.42,$0.00,1,1,1,0,0,1,20110101,A7045,HCPCS,REPL EXHALATION PORT FOR PAP,NU,,28 ,,NW,,,,,,$35.42,$0.00,1,1,1,0,0,1,20110101,A7045,HCPCS,REPL EXHALATION PORT FOR PAP,RR,,28 ,,NW,,,,,,$4.63,$0.00,1,1,1,0,0,1,20110101,A7045,HCPCS,REPL EXHALATION PORT FOR PAP,UE,,28 ,,NW,,,,,,$27.63,$0.00,1,1,1,0,0,1,20110101,A7046,HCPCS,"REPL WATER CHAMBER, PAP DEV",,,28 ,,NW,,,,,,$35.49,$0.00,1,1,1,0,0,1,20110101,A7046,HCPCS,"REPL WATER CHAMBER, PAP DEV",NU,,28 ,,NW,,,,,,$35.49,$0.00,1,1,1,0,0,1,20110101,A7501,HCPCS,TRACHEOSTOMA VALVE W DIAPHRA,,,28 ,,NW,,,,,,$103.18,$0.00,1,1,1,0,0,1,20110101,A7502,HCPCS,REPLACEMENT DIAPHRAGM/FPLATE,,,28 ,,NW,,,,,,$52.73,$0.00,1,1,1,0,0,1,20110101,A7503,HCPCS,HMES FILTER HOLDER OR CAP,,,28 ,,NW,,,,,,$17.42,$0.00,1,1,1,0,0,1,20110101,A7504,HCPCS,TRACHEOSTOMA HMES FILTER,,,28 ,,NW,,,,,,$1.13,$0.00,1,1,1,0,0,1,20110101,A7505,HCPCS,HMES OR TRACH VALVE HOUSING,,,28 ,,NW,,,,,,$7.76,$0.00,1,1,1,0,0,1,20110101,A7506,HCPCS,HMES/TRACHVALVE ADHESIVEDISK,,,28 ,,NW,,,,,,$0.56,$0.00,1,1,1,0,0,1,20110101,A7507,HCPCS,INTEGRATED FILTER & HOLDER,,,28 ,,NW,,,,,,$4.14,$0.00,1,1,1,0,0,1,20110101,A7508,HCPCS,HOUSING & INTEGRATED ADHESIV,,,28 ,,NW,,,,,,$4.77,$0.00,1,1,1,0,0,1,20110101,A7509,HCPCS,HEAT & MOISTURE EXCHANGE SYS,,,28 ,,NW,,,,,,$2.36,$0.00,1,1,1,0,0,1,20110101,A7520,HCPCS,TRACH/LARYN TUBE NON-CUFFED,,,28 ,,NW,,,,,,$70.68,$0.00,1,1,1,0,0,1,20110101,A7521,HCPCS,TRACH/LARYN TUBE CUFFED,,,28 ,,NW,,,,,,$70.08,$0.00,1,1,1,0,0,1,20110101,A7522,HCPCS,TRACH/LARYN TUBE STAINLESS,,,28 ,,NW,,,,,,$67.43,$0.00,1,1,1,0,0,1,20110101,A7523,HCPCS,TRACHEOSTOMY SHOWER PROTECT,,,28 ,,NW,,,,,,$8.82,$0.00,1,1,1,0,0,1,20110101,A7524,HCPCS,TRACHEOSTOMA STENT/STUD/BTTN,,,28 ,,NW,,,,,,$112.66,$0.00,1,1,1,0,0,1,20110101,A7525,HCPCS,TRACHEOSTOMY MASK,,,28 ,,NW,,,,,,$4.00,$0.00,1,1,1,0,0,1,20110101,A7526,HCPCS,TRACHEOSTOMY TUBE COLLAR,,,28 ,,NW,,,,,,$6.53,$0.00,1,1,1,0,0,1,20110101,A7527,HCPCS,TRACH/LARYN TUBE PLUG/STOP,,,28 ,,NW,,,,,,$6.94,$0.00,1,1,1,0,0,1,20110101,A8000,HCPCS,SOFT PROTECT HELMET PREFAB,,,28 ,,NW,,,,,,$350.31,$0.00,1,1,1,1,1,1,20110101,A8000,HCPCS,SOFT PROTECT HELMET PREFAB,NU,,28 ,,NW,,,,,,$350.31,$0.00,1,1,1,1,1,1,20110101,A8000,HCPCS,SOFT PROTECT HELMET PREFAB,RR,,28 ,,NW,,,,,,$32.73,$0.00,1,1,1,1,1,1,20110101,A8000,HCPCS,SOFT PROTECT HELMET PREFAB,UE,,28 ,,NW,,,,,,$257.09,$0.00,1,1,1,1,1,1,20110101,A8001,HCPCS,HARD PROTECT HELMET PREFAB,,,28 ,,NW,,,,,,$350.31,$0.00,1,1,1,1,1,1,20110101,A8001,HCPCS,HARD PROTECT HELMET PREFAB,NU,,28 ,,NW,,,,,,$350.31,$0.00,1,1,1,1,1,1,20110101,A8001,HCPCS,HARD PROTECT HELMET PREFAB,RR,,28 ,,NW,,,,,,$32.73,$0.00,1,1,1,1,1,1,20110101,A8001,HCPCS,HARD PROTECT HELMET PREFAB,UE,,28 ,,NW,,,,,,$257.09,$0.00,1,1,1,1,1,1,20110101,A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,,,28 ,,NW,,,,,,$962.85,$0.00,1,1,1,1,1,1,20110101,A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,NU,,28 ,,NW,,,,,,$962.85,$0.00,1,1,1,1,1,1,20110101,A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,RR,,28 ,,NW,,,,,,$105.38,$0.00,1,1,1,1,1,1,20110101,A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,UE,,28 ,,NW,,,,,,$725.08,$0.00,1,1,1,1,1,1,20110101,A8003,HCPCS,HARD PROTECT HELMET CUSTOM,,,28 ,,NW,,,,,,$767.93,$0.00,1,1,1,1,1,1,20110101,A8003,HCPCS,HARD PROTECT HELMET CUSTOM,NU,,28 ,,NW,,,,,,$767.93,$0.00,1,1,1,1,1,1,20110101,A8003,HCPCS,HARD PROTECT HELMET CUSTOM,RR,,28 ,,NW,,,,,,$53.01,$0.00,1,1,1,1,1,1,20110101,A8003,HCPCS,HARD PROTECT HELMET CUSTOM,UE,,28 ,,NW,,,,,,$739.80,$0.00,1,1,1,1,1,1,20110101,A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",,,28 ,,NW,,,,,,$171.51,$0.00,1,1,1,1,1,1,20110101,A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",NU,,28 ,,NW,,,,,,$171.51,$0.00,1,1,1,1,1,1,20110101,A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",RR,,28 ,,NW,,,,,,$18.07,$0.00,1,1,1,1,1,1,20110101,A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",UE,,28 ,,NW,,,,,,$128.91,$0.00,1,1,1,1,1,1,20110101,A9150,HCPCS,MISC/EXPER NON-PRESCRIPT DRU,,,29 ,,NW,,,,,,$13.24,$0.00,1,1,1,0,0,1,20110101,A9152,HCPCS,SINGLE VITAMIN NOS,,,29 ,,NW,,,,,,$35.54,$0.00,1,1,1,0,0,1,20110101,A9153,HCPCS,MULTI-VITAMIN NOS,,,29 ,,NW,,,,,,$30.18,$0.00,1,1,1,0,0,1,20110101,A9155,HCPCS,ARTIFICIAL SALIVA,,,29 ,,NW,,,,,,$6.99,$0.00,1,1,1,0,0,1,20110101,A9180,HCPCS,"LICE TREATMENT, TOPICAL",,,29 ,,NW,,,,,,$160.35,$0.00,1,1,1,0,0,1,20110101,A9270,HCPCS,NON-COVERED ITEM OR SERVICE,,,28 ,,NW,,,,,,$55.09,$0.00,1,1,1,0,0,1,20110101,A9273,HCPCS,HOT/COLD H2OBOT/CAP/COL/WRAP,,,28 ,,NW,,,,,,$19.04,$0.00,1,1,1,1,1,1,20110101,A9274,HCPCS,EXT AMB INSULIN DELIVERY SYS,,,28 ,,NW,,,,,,$62.40,$0.00,1,1,1,1,1,1,20110101,A9275,HCPCS,DISP HOME GLUCOSE MONITOR,,,28 ,,NW,,,,,,$16.64,$0.00,1,1,1,1,1,1,20110101,A9276,HCPCS,"DISPOSABLE SENSOR, CGM SYS",,,28 ,,NW,,,,,,$19.24,$0.00,1,1,1,1,1,1,20110101,A9277,HCPCS,"EXTERNAL TRANSMITTER, CGM",,,28 ,,NW,,,,,,$900.75,$0.00,1,1,1,1,1,1,20110101,A9278,HCPCS,"EXTERNAL RECEIVER, CGM SYS",,,28 ,,NW,,,,,,"$1,163.49",$0.00,1,1,1,1,1,1,20110101,A9279,HCPCS,MONITORING FEATURE/DEVICENOC,,,28 ,,NW,,,,,,$44.86,$0.00,1,1,1,1,1,1,20110101,A9280,HCPCS,"ALERT DEVICE, NOC",,,28 ,,NW,,,,,,$44.86,$0.00,1,1,1,1,1,1,20110101,A9281,HCPCS,REACHING/GRABBING DEVICE,,,28 ,,NW,,,,,,$60.15,$0.00,1,1,1,1,1,1,20110101,A9282,HCPCS,WIG ANY TYPE,,,28 ,,NW,,,,,,$419.73,$0.00,1,1,1,1,1,1,20110101,A9284,HCPCS,NON-ELECTRONIC SPIROMETER,,,28 ,,NW,,,,,,$157.32,$0.00,1,1,1,1,1,1,20110101,A9300,HCPCS,EXERCISE EQUIPMENT,,,28 ,,NW,,,,,,$14.08,$0.00,1,1,1,1,1,1,20110101,A9500,HCPCS,TC99M SESTAMIBI,,,28 ,,NW,,,,,,$210.88,$0.00,1,1,1,0,0,1,20110101,A9501,HCPCS,TECHNETIUM TC-99M TEBOROXIME,,,28 ,,NW,,,,,,$386.40,$0.00,1,1,1,0,0,1,20110101,A9502,HCPCS,TC99M TETROFOSMIN,,,28 ,,NW,,,,,,$220.84,$0.00,1,1,1,0,0,1,20110101,A9503,HCPCS,TC99M MEDRONATE,,,28 ,,NW,,,,,,$62.01,$0.00,1,1,1,0,0,1,20110101,A9504,HCPCS,TC99M APCITIDE,,,28 ,,NW,,,,,,$276.24,$0.00,1,1,1,0,0,1,20110101,A9505,HCPCS,TL201 THALLIUM,,,28 ,,NW,,,,,,$95.52,$0.00,1,1,1,0,0,1,20110101,A9507,HCPCS,IN111 CAPROMAB,,,28 ,,NW,,,,,,"$5,628.87",$0.00,1,1,1,0,0,1,20110101,A9508,HCPCS,"I131 IODOBENGUATE, DX",,,28 ,,NW,,,,,,$41.60,$0.00,1,1,1,0,0,1,20110101,A9509,HCPCS,IODINE I-123 SOD IODIDE MIL,,,28 ,,NW,,,,,,$95.34,$0.00,1,1,1,0,0,1,20110101,A9510,HCPCS,TC99M DISOFENIN,,,28 ,,NW,,,,,,$96.23,$0.00,1,1,1,0,0,1,20110101,A9512,HCPCS,TC99M PERTECHNETATE,,,28 ,,NW,,,,,,$4.13,$0.00,1,1,1,0,0,1,20110101,A9516,HCPCS,IODINE I-123 SOD IODIDE MIC,,,28 ,,NW,,,,,,$1.27,$0.00,1,1,1,0,0,1,20110101,A9517,HCPCS,"I131 IODIDE CAP, RX",,,28 ,,NW,,,,,,$44.61,$0.00,1,1,1,0,0,1,20110101,A9521,HCPCS,TC99M EXAMETAZIME,,,28 ,,NW,,,,,,"$1,055.38",$0.00,1,1,1,0,0,1,20110101,A9524,HCPCS,"I131 SERUM ALBUMIN, DX",,,28 ,,NW,,,,,,$212.52,$0.00,1,1,1,0,0,1,20110101,A9526,HCPCS,NITROGEN N-13 AMMONIA,,,28 ,,NW,,,,,,$489.76,$0.00,1,1,1,0,0,1,20110101,A9527,HCPCS,IODINE I-125 SODIUM IODIDE,,,28 ,,NW,,,,,,$128.80,$0.00,1,1,1,0,0,1,20110101,A9528,HCPCS,"IODINE I-131 IODIDE CAP, DX",,,28 ,,NW,,,,,,$183.96,$0.00,1,1,1,0,0,1,20110101,A9529,HCPCS,"I131 IODIDE SOL, DX",,,28 ,,NW,,,,,,$65.69,$0.00,1,1,1,0,0,1,20110101,A9530,HCPCS,"I131 IODIDE SOL, RX",,,28 ,,NW,,,,,,$36.27,$0.00,1,1,1,0,0,1,20110101,A9531,HCPCS,I131 MAX 100UCI,,,28 ,,NW,,,,,,$15.63,$0.00,1,1,1,0,0,1,20110101,A9532,HCPCS,"I125 SERUM ALBUMIN, DX",,,28 ,,NW,,,,,,$567.04,$0.00,1,1,1,0,0,1,20110101,A9536,HCPCS,TC99M DEPREOTIDE,,,28 ,,NW,,,,,,$708.40,$0.00,1,1,1,0,0,1,20110101,A9537,HCPCS,TC99M MEBROFENIN,,,28 ,,NW,,,,,,$96.11,$0.00,1,1,1,0,0,1,20110101,A9538,HCPCS,TC99M PYROPHOSPHATE,,,28 ,,NW,,,,,,$72.60,$0.00,1,1,1,0,0,1,20110101,A9539,HCPCS,TC99M PENTETATE,,,28 ,,NW,,,,,,$61.48,$0.00,1,1,1,0,0,1,20110101,A9540,HCPCS,TC99M MAA,,,28 ,,NW,,,,,,$63.60,$0.00,1,1,1,0,0,1,20110101,A9541,HCPCS,TC99M SULFUR COLLOID,,,28 ,,NW,,,,,,$85.14,$0.00,1,1,1,0,0,1,20110101,A9546,HCPCS,CO57/58,,,28 ,,NW,,,,,,$26.69,$0.00,1,1,1,0,0,1,20110101,A9547,HCPCS,IN111 OXYQUINOLINE,,,28 ,,NW,,,,,,"$1,088.88",$0.00,1,1,1,0,0,1,20110101,A9548,HCPCS,IN111 PENTETATE,,,28 ,,NW,,,,,,$490.58,$0.00,1,1,1,0,0,1,20110101,A9550,HCPCS,TC99M GLUCEPTATE,,,28 ,,NW,,,,,,$43.79,$0.00,1,1,1,0,0,1,20110101,A9551,HCPCS,TC99M SUCCIMER,,,28 ,,NW,,,,,,$360.64,$0.00,1,1,1,0,0,1,20110101,A9552,HCPCS,F18 FDG,,,28 ,,NW,,,,,,$679.95,$0.00,1,1,1,0,0,1,20110101,A9554,HCPCS,"I125 IOTHALAMATE, DX",,,28 ,,NW,,,,,,$966.00,$0.00,1,1,1,0,0,1,20110101,A9555,HCPCS,RB82 RUBIDIUM,,,28 ,,NW,,,,,,$673.09,$0.00,1,1,1,0,0,1,20110101,A9556,HCPCS,GA67 GALLIUM,,,28 ,,NW,,,,,,$64.31,$0.00,1,1,1,0,0,1,20110101,A9557,HCPCS,TC99M BICISATE,,,28 ,,NW,,,,,,$322.00,$0.00,1,1,1,0,0,1,20110101,A9558,HCPCS,XE133 XENON 10MCI,,,28 ,,NW,,,,,,$118.77,$0.00,1,1,1,0,0,1,20110101,A9560,HCPCS,TC99M LABELED RBC,,,28 ,,NW,,,,,,$135.00,$0.00,1,1,1,0,0,1,20110101,A9561,HCPCS,TC99M OXIDRONATE,,,28 ,,NW,,,,,,$62.73,$0.00,1,1,1,0,0,1,20110101,A9562,HCPCS,TC99M MERTIATIDE,,,28 ,,NW,,,,,,$436.68,$0.00,1,1,1,0,0,1,20110101,A9564,HCPCS,P32 CHROMIC PHOSPHATE,,,28 ,,NW,,,,,,$418.63,$0.00,1,1,1,0,0,1,20110101,A9567,HCPCS,TECHNETIUM TC-99M AEROSOL,,,28 ,,NW,,,,,,$80.14,$0.00,1,1,1,0,0,1,20110101,A9569,HCPCS,TECHNETIUM TC-99M AUTO WBC,,,28 ,,NW,,,,,,$2.58,$0.00,1,1,1,0,0,1,20110101,A9570,HCPCS,INDIUM IN-111 AUTO WBC,,,28 ,,NW,,,,,,$298.39,$0.00,1,1,1,0,0,1,20110101,A9571,HCPCS,INDIUM IN-111 AUTO PLATELET,,,28 ,,NW,,,,,,$13.34,$0.00,1,1,1,0,0,1,20110101,A9572,HCPCS,INDIUM IN-111 PENTETREOTIDE,,,28 ,,NW,,,,,,$869.40,$0.00,1,1,1,0,0,1,20110101,A9576,HCPCS,INJ PROHANCE MULTIPACK,,,28 ,,NW,,,,,,$10.02,$0.00,1,1,1,0,0,1,20110101,A9577,HCPCS,INJ MULTIHANCE,,,28 ,,NW,,,,,,$7.71,$0.00,1,1,1,0,0,1,20110101,A9578,HCPCS,INJ MULTIHANCE MULTIPACK,,,28 ,,NW,,,,,,$10.27,$0.00,1,1,1,0,0,1,20110101,A9579,HCPCS,"GAD-BASE MR CONTRAST NOS,1ML",,,28 ,,NW,,,,,,$7.38,$0.00,1,1,1,0,0,1,20110101,A9580,HCPCS,SODIUM FLUORIDE F-18,,,28 ,,NW,,,,,,$449.78,$0.00,1,1,1,0,0,1,20110101,A9581,HCPCS,GADOXETATE DISODIUM INJ,,,28 ,,NW,,,,,,$50.59,$0.00,1,1,1,0,0,1,20110101,A9582,HCPCS,IODINE I-123 IOBENGUANE,,,28 ,,NW,,,,,,$2.83,$0.00,1,1,1,0,0,1,20110101,A9583,HCPCS,GADOFOSVESET TRISODIUM INJ,,,28 ,,NW,,,,,,"$5,995.96",$0.00,1,1,1,0,0,1,20110101,A9600,HCPCS,SR89 STRONTIUM,,,28 ,,NW,,,,,,"$1,058.01",$0.00,1,1,1,0,0,1,20110101,A9604,HCPCS,SM 153 LEXIDRONAM,,,28 ,,NW,,,,,,"$9,908.26",$0.00,1,1,1,0,0,1,20110101,A9698,HCPCS,NON-RAD CONTRAST MATERIALNOC,,,28 ,,NW,,,,,,$44.86,$0.00,1,1,1,0,0,1,20110101,A9699,HCPCS,RADIOPHARM RX AGENT NOC,,,28 ,,NW,,,,,,$44.86,$0.00,1,1,1,0,0,1,20110101,A9700,HCPCS,ECHOCARDIOGRAPHY CONTRAST,,,28 ,,NW,,,,,,$247.95,$0.00,1,1,1,0,0,1,20110101,A9900,HCPCS,SUPPLY/ACCESSORY/SERVICE,,,28 ,,NW,,,,,,$54.58,$0.00,1,1,1,0,0,1,20110101,A9901,HCPCS,DELIVERY/SET UP/DISPENSING,,,28 ,,NW,,,,,,$170.69,$0.00,1,1,1,0,0,1,20110101,A9999,HCPCS,"DME SUPPLY OR ACCESSORY, NOS",,,28 ,,NW,,,,,,$44.86,$0.00,1,1,1,0,0,1,20110101,B4034,HCPCS,ENTER FEED SUPKIT SYR BY DAY,,,28 ,,NW,,,,,,$10.36,$0.00,1,1,1,0,0,1,20110101,B4035,HCPCS,ENTERAL FEED SUPP PUMP PER D,,,28 ,,NW,,,,,,$22.70,$0.00,1,1,1,0,0,1,20110101,B4036,HCPCS,ENTERAL FEED SUP KIT GRAV BY,,,28 ,,NW,,,,,,$14.57,$0.00,1,1,1,0,0,1,20110101,B4081,HCPCS,ENTERAL NG TUBING W/ STYLET,,,28 ,,NW,,,,,,$44.89,$0.00,1,1,1,0,0,1,20110101,B4082,HCPCS,ENTERAL NG TUBING W/O STYLET,,,28 ,,NW,,,,,,$32.55,$0.00,1,1,1,0,0,1,20110101,B4083,HCPCS,ENTERAL STOMACH TUBE LEVINE,,,28 ,,NW,,,,,,$4.04,$0.00,1,1,1,0,0,1,20110101,B4087,HCPCS,"GASTRO/JEJUNO TUBE, STD",,,28 ,,NW,,,,,,$76.20,$0.00,1,1,1,0,0,1,20110101,B4088,HCPCS,"GASTRO/JEJUNO TUBE, LOW-PRO",,,28 ,,NW,,,,,,$76.20,$0.00,1,1,1,0,0,1,20110101,B4100,HCPCS,FOOD THICKENER ORAL,,,28 ,,NW,,,,,,$1.05,$0.00,1,1,1,0,0,1,20110101,B4102,HCPCS,EF ADULT FLUIDS AND ELECTRO,,,28 ,,NW,,,,,,$10.37,$0.00,1,1,1,0,0,1,20110101,B4103,HCPCS,EF PED FLUID AND ELECTROLYTE,,,28 ,,NW,,,,,,$11.42,$0.00,1,1,1,0,0,1,20110101,B4104,HCPCS,ADDITIVE FOR ENTERAL FORMULA,,,28 ,,NW,,,,,,$8.85,$0.00,1,1,1,0,0,1,20110101,B4149,HCPCS,EF BLENDERIZED FOODS,,,28 ,,NW,,,,,,$2.64,$0.00,1,1,1,0,0,1,20110101,B4150,HCPCS,EF COMPLET W/INTACT NUTRIENT,,,28 ,,NW,,,,,,$1.25,$0.00,1,1,1,0,0,1,20110101,B4152,HCPCS,EF CALORIE DENSE>/=1.5KCAL,,,28 ,,NW,,,,,,$1.07,$0.00,1,1,1,0,0,1,20110101,B4153,HCPCS,EF HYDROLYZED/AMINO ACIDS,,,28 ,,NW,,,,,,$3.17,$0.00,1,1,1,0,0,1,20110101,B4154,HCPCS,EF SPEC METABOLIC NONINHERIT,,,28 ,,NW,,,,,,$2.10,$0.00,1,1,1,0,0,1,20110101,B4155,HCPCS,EF INCOMPLETE/MODULAR,,,28 ,,NW,,,,,,$1.68,$0.00,1,1,1,0,0,1,20110101,B4157,HCPCS,EF SPECIAL METABOLIC INHERIT,,,28 ,,NW,,,,,,$8.93,$0.00,1,1,1,0,0,1,20110101,B4158,HCPCS,EF PED COMPLETE INTACT NUT,,,28 ,,NW,,,,,,$3.94,$0.00,1,1,1,0,0,1,20110101,B4159,HCPCS,EF PED COMPLETE SOY BASED,,,28 ,,NW,,,,,,$4.37,$0.00,1,1,1,0,0,1,20110101,B4160,HCPCS,EF PED CALORIC DENSE>/=0.7KC,,,28 ,,NW,,,,,,$3.69,$0.00,1,1,1,0,0,1,20110101,B4161,HCPCS,EF PED HYDROLYZED/AMINO ACID,,,28 ,,NW,,,,,,$9.61,$0.00,1,1,1,0,0,1,20110101,B4162,HCPCS,EF PED SPECMETABOLIC INHERIT,,,28 ,,NW,,,,,,$13.60,$0.00,1,1,1,0,0,1,20110101,B4164,HCPCS,PARENTERAL 50% DEXTROSE SOLU,,,28 ,,NW,,,,,,$39.31,$0.00,1,1,1,0,0,1,20110101,B4168,HCPCS,PARENTERAL SOL AMINO ACID 3.,,,28 ,,NW,,,,,,$58.79,$0.00,1,1,1,0,0,1,20110101,B4172,HCPCS,PARENTERAL SOL AMINO ACID 5.,,,28 ,,NW,,,,,,$87.79,$0.00,1,1,1,0,0,1,20110101,B4176,HCPCS,PARENTERAL SOL AMINO ACID 7-,,,28 ,,NW,,,,,,$116.79,$0.00,1,1,1,0,0,1,20110101,B4178,HCPCS,PARENTERAL SOL AMINO ACID >,,,28 ,,NW,,,,,,$140.86,$0.00,1,1,1,0,0,1,20110101,B4180,HCPCS,PARENTERAL SOL CARB > 50%,,,28 ,,NW,,,,,,$57.82,$0.00,1,1,1,0,0,1,20110101,B4185,HCPCS,PARENTERAL SOL 10 GM LIPIDS,,,28 ,,NW,,,,,,$24.88,$0.00,1,1,1,0,0,1,20110101,B4189,HCPCS,PARENTERAL SOL AMINO ACID &,,,28 ,,NW,,,,,,$441.92,$0.00,1,1,1,0,0,1,20110101,B4193,HCPCS,PARENTERAL SOL 52-73 GM PROT,,,28 ,,NW,,,,,,$572.03,$0.00,1,1,1,0,0,1,20110101,B4197,HCPCS,PARENTERAL SOL 74-100 GM PRO,,,28 ,,NW,,,,,,$697.11,$0.00,1,1,1,0,0,1,20110101,B4199,HCPCS,PARENTERAL SOL > 100GM PROTE,,,28 ,,NW,,,,,,$797.06,$0.00,1,1,1,0,0,1,20110101,B4216,HCPCS,PARENTERAL NUTRITION ADDITIV,,,28 ,,NW,,,,,,$16.08,$0.00,1,1,1,0,0,1,20110101,B4220,HCPCS,PARENTERAL SUPPLY KIT PREMIX,,,28 ,,NW,,,,,,$16.80,$0.00,1,1,1,0,0,1,20110101,B4222,HCPCS,PARENTERAL SUPPLY KIT HOMEMI,,,28 ,,NW,,,,,,$21.46,$0.00,1,1,1,0,0,1,20110101,B4224,HCPCS,PARENTERAL ADMINISTRATION KI,,,28 ,,NW,,,,,,$59.39,$0.00,1,1,1,0,0,1,20110101,B5000,HCPCS,PARENTERAL SOL RENAL-AMIROSY,,,28 ,,NW,,,,,,$26.51,$0.00,1,1,1,0,0,1,20110101,B5100,HCPCS,PARENTERAL SOL HEPATIC-FREAM,,,28 ,,NW,,,,,,$8.39,$0.00,1,1,1,0,0,1,20110101,B5200,HCPCS,PARENTERAL SOL STRES-BRNCH C,,,28 ,,NW,,,,,,$532.51,$0.00,1,1,1,0,0,1,20110101,B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,,,28 ,,NW,,,,,,"$2,727.42",$0.00,1,1,1,0,0,1,20110101,B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,NU,,28 ,,NW,,,,,,"$2,727.42",$0.00,1,1,1,0,0,1,20110101,B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,RR,,28 ,,NW,,,,,,$247.66,$0.00,1,1,1,0,0,1,20110101,B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,UE,,28 ,,NW,,,,,,"$2,044.74",$0.00,1,1,1,0,0,1,20110101,B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,,,28 ,,NW,,,,,,"$2,727.42",$0.00,1,1,1,0,0,1,20110101,B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,NU,,28 ,,NW,,,,,,"$2,727.42",$0.00,1,1,1,0,0,1,20110101,B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,RR,,28 ,,NW,,,,,,$261.21,$0.00,1,1,1,0,0,1,20110101,B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,UE,,28 ,,NW,,,,,,"$2,044.74",$0.00,1,1,1,0,0,1,20110101,B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,,,28 ,,NW,,,,,,"$6,316.37",$0.00,1,1,1,0,0,1,20110101,B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,NU,,28 ,,NW,,,,,,"$6,316.37",$0.00,1,1,1,0,0,1,20110101,B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,RR,,28 ,,NW,,,,,,$997.18,$0.00,1,1,1,0,0,1,20110101,B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,UE,,28 ,,NW,,,,,,"$4,736.44",$0.00,1,1,1,0,0,1,20110101,B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,,,28 ,,NW,,,,,,"$6,316.37",$0.00,1,1,1,0,0,1,20110101,B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,NU,,28 ,,NW,,,,,,"$6,316.37",$0.00,1,1,1,0,0,1,20110101,B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,RR,,28 ,,NW,,,,,,$997.18,$0.00,1,1,1,0,0,1,20110101,B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,UE,,28 ,,NW,,,,,,"$4,736.44",$0.00,1,1,1,0,0,1,20110101,B9998,HCPCS,ENTERAL SUPP NOT OTHERWISE C,,,28 ,,NW,,,,,,$261.21,$0.00,1,1,1,0,0,1,20110101,B9999,HCPCS,PARENTERAL SUPP NOT OTHRWS C,,,28 ,,NW,,,,,,$261.21,$0.00,1,1,1,0,0,1,20110101,C1300,HCPCS,HYPERBARIC OXYGEN,,,28 ,,NW,,,,,,$574.71,$0.00,1,1,1,1,1,1,20110101,C1713,HCPCS,"ANCHOR/SCREW BN/BN,TIS/BN",,,28 ,,NW,,,,,,"$1,111.51",$0.00,1,1,1,1,1,1,20110101,C1714,HCPCS,"CATH, TRANS ATHERECTOMY, DIR",,,28 ,,NW,,,,,,$298.33,$0.00,1,1,1,1,1,1,20110101,C1715,HCPCS,BRACHYTHERAPY NEEDLE,,,28 ,,NW,,,,,,$40.03,$0.00,1,1,1,1,1,1,20110101,C1717,HCPCS,"BRACHYTX, NON-STR,HDR IR-192",,,28 ,,NW,,,,,,$887.60,$0.00,1,1,1,1,1,1,20110101,C1721,HCPCS,"AICD, DUAL CHAMBER",,,28 ,,NW,,,,,,"$30,291.83",$0.00,1,1,1,1,1,1,20110101,C1722,HCPCS,"AICD, SINGLE CHAMBER",,,28 ,,NW,,,,,,"$23,490.55",$0.00,1,1,1,1,1,1,20110101,C1724,HCPCS,"CATH, TRANS ATHEREC,ROTATION",,,28 ,,NW,,,,,,$658.38,$0.00,1,1,1,1,1,1,20110101,C1725,HCPCS,"CATH, TRANSLUMIN NON-LASER",,,28 ,,NW,,,,,,"$1,253.19",$0.00,1,1,1,1,1,1,20110101,C1726,HCPCS,"CATH, BAL DIL, NON-VASCULAR",,,28 ,,NW,,,,,,$469.10,$0.00,1,1,1,1,1,1,20110101,C1727,HCPCS,"CATH, BAL TIS DIS, NON-VAS",,,28 ,,NW,,,,,,$532.29,$0.00,1,1,1,1,1,1,20110101,C1729,HCPCS,"CATH, DRAINAGE",,,28 ,,NW,,,,,,$155.59,$0.00,1,1,1,1,1,1,20110101,C1730,HCPCS,"CATH, EP, 19 OR FEW ELECT",,,28 ,,NW,,,,,,"$1,612.58",$0.00,1,1,1,1,1,1,20110101,C1731,HCPCS,"CATH, EP, 20 OR MORE ELEC",,,28 ,,NW,,,,,,"$4,447.54",$0.00,1,1,1,1,1,1,20110101,C1732,HCPCS,"CATH, EP, DIAG/ABL, 3D/VECT",,,28 ,,NW,,,,,,"$4,447.54",$0.00,1,1,1,1,1,1,20110101,C1733,HCPCS,"CATH, EP, OTHR THAN COOL-TIP",,,28 ,,NW,,,,,,"$1,612.58",$0.00,1,1,1,1,1,1,20110101,C1750,HCPCS,"CATH, HEMODIALYSIS,LONG-TERM",,,28 ,,NW,,,,,,$765.98,$0.00,1,1,1,1,1,1,20110101,C1751,HCPCS,"CATH, INF, PER/CENT/MIDLINE",,,28 ,,NW,,,,,,$77.17,$0.00,1,1,1,1,1,1,20110101,C1752,HCPCS,"CATH,HEMODIALYSIS,SHORT-TERM",,,28 ,,NW,,,,,,$507.97,$0.00,1,1,1,1,1,1,20110101,C1753,HCPCS,"CATH, INTRAVAS ULTRASOUND",,,28 ,,NW,,,,,,"$1,250.81",$0.00,1,1,1,1,1,1,20110101,C1754,HCPCS,"CATHETER, INTRADISCAL",,,28 ,,NW,,,,,,$121.23,$0.00,1,1,1,1,1,1,20110101,C1755,HCPCS,"CATHETER, INTRASPINAL",,,28 ,,NW,,,,,,$696.92,$0.00,1,1,1,1,1,1,20110101,C1756,HCPCS,"CATH, PACING, TRANSESOPH",,,28 ,,NW,,,,,,"$1,063.93",$0.00,1,1,1,1,1,1,20110101,C1757,HCPCS,"CATH, THROMBECTOMY/EMBOLECT",,,28 ,,NW,,,,,,"$2,631.06",$0.00,1,1,1,1,1,1,20110101,C1758,HCPCS,"CATHETER, URETERAL",,,28 ,,NW,,,,,,$288.65,$0.00,1,1,1,1,1,1,20110101,C1759,HCPCS,"CATH, INTRA ECHOCARDIOGRAPHY",,,28 ,,NW,,,,,,"$3,530.71",$0.00,1,1,1,1,1,1,20110101,C1760,HCPCS,"CLOSURE DEV, VASC",,,28 ,,NW,,,,,,"$1,067.03",$0.00,1,1,1,1,1,1,20110101,C1762,HCPCS,"CONN TISS, HUMAN(INC FASCIA)",,,28 ,,NW,,,,,,"$2,949.34",$0.00,1,1,1,1,1,1,20110101,C1763,HCPCS,"CONN TISS, NON-HUMAN",,,28 ,,NW,,,,,,"$1,574.27",$0.00,1,1,1,1,1,1,20110101,C1764,HCPCS,"EVENT RECORDER, CARDIAC",,,28 ,,NW,,,,,,"$2,738.44",$0.00,1,1,1,1,1,1,20110101,C1765,HCPCS,ADHESION BARRIER,,,28 ,,NW,,,,,,$376.59,$0.00,1,1,1,1,1,1,20110101,C1766,HCPCS,"INTRO/SHEATH,STRBLE,NON-PEEL",,,28 ,,NW,,,,,,$543.50,$0.00,1,1,1,1,1,1,20110101,C1767,HCPCS,"GENERATOR, NEURO NON-RECHARG",,,28 ,,NW,,,,,,"$15,775.11",$0.00,1,1,1,1,1,1,20110101,C1768,HCPCS,"GRAFT, VASCULAR",,,28 ,,NW,,,,,,"$2,510.22",$0.00,1,1,1,1,1,1,20110101,C1769,HCPCS,GUIDE WIRE,,,28 ,,NW,,,,,,$396.44,$0.00,1,1,1,1,1,1,20110101,C1770,HCPCS,"IMAGING COIL, MR, INSERTABLE",,,28 ,,NW,,,,,,$306.91,$0.00,1,1,1,1,1,1,20110101,C1771,HCPCS,"REP DEV, URINARY, W/SLING",,,28 ,,NW,,,,,,"$4,118.39",$0.00,1,1,1,1,1,1,20110101,C1772,HCPCS,"INFUSION PUMP, PROGRAMMABLE",,,28 ,,NW,,,,,,$391.08,$0.00,1,1,1,1,1,1,20110101,C1776,HCPCS,JOINT DEVICE (IMPLANTABLE),,,28 ,,NW,,,,,,"$4,111.86",$0.00,1,1,1,1,1,1,20110101,C1777,HCPCS,"LEAD, AICD, ENDO SINGLE COIL",,,28 ,,NW,,,,,,"$4,604.63",$0.00,1,1,1,1,1,1,20110101,C1778,HCPCS,"LEAD, NEUROSTIMULATOR",,,28 ,,NW,,,,,,$951.00,$0.00,1,1,1,1,1,1,20110101,C1779,HCPCS,"LEAD, PMKR, TRANSVENOUS VDD",,,28 ,,NW,,,,,,"$2,780.93",$0.00,1,1,1,1,1,1,20110101,C1781,HCPCS,MESH (IMPLANTABLE),,,28 ,,NW,,,,,,$356.59,$0.00,1,1,1,1,1,1,20110101,C1782,HCPCS,MORCELLATOR,,,28 ,,NW,,,,,,$344.28,$0.00,1,1,1,1,1,1,20110101,C1783,HCPCS,"OCULAR IMP, AQUEOUS DRAIN DE",,,28 ,,NW,,,,,,"$1,270.85",$0.00,1,1,1,1,1,1,20110101,C1784,HCPCS,"OCULAR DEV, INTRAOP, DET RET",,,28 ,,NW,,,,,,"$2,221.78",$0.00,1,1,1,1,1,1,20110101,C1785,HCPCS,"PMKR, DUAL, RATE-RESP",,,28 ,,NW,,,,,,"$8,244.09",$0.00,1,1,1,1,1,1,20110101,C1786,HCPCS,"PMKR, SINGLE, RATE-RESP",,,28 ,,NW,,,,,,"$7,513.95",$0.00,1,1,1,1,1,1,20110101,C1787,HCPCS,"PATIENT PROGR, NEUROSTIM",,,28 ,,NW,,,,,,"$5,727.29",$0.00,1,1,1,1,1,1,20110101,C1788,HCPCS,"PORT, INDWELLING, IMP",,,28 ,,NW,,,,,,$832.22,$0.00,1,1,1,1,1,1,20110101,C1789,HCPCS,"PROSTHESIS, BREAST, IMP",,,28 ,,NW,,,,,,$857.47,$0.00,1,1,1,1,1,1,20110101,C1813,HCPCS,"PROSTHESIS, PENILE, INFLATAB",,,28 ,,NW,,,,,,"$3,888.13",$0.00,1,1,1,1,1,1,20110101,C1815,HCPCS,"PROS, URINARY SPH, IMP",,,28 ,,NW,,,,,,"$3,428.39",$0.00,1,1,1,1,1,1,20110101,C1816,HCPCS,"RECEIVER/TRANSMITTER, NEURO",,,28 ,,NW,,,,,,$997.38,$0.00,1,1,1,1,1,1,20110101,C1817,HCPCS,SEPTAL DEFECT IMP SYS,,,28 ,,NW,,,,,,"$6,886.56",$0.00,1,1,1,1,1,1,20110101,C1818,HCPCS,INTEGRATED KERATOPROSTHESIS,,,28 ,,NW,,,,,,"$4,495.03",$0.00,1,1,1,1,1,1,20110101,C1820,HCPCS,GENERATOR NEURO RECHG BAT SY,,,28 ,,NW,,,,,,"$12,258.79",$0.00,1,1,1,1,1,1,20110101,C1821,HCPCS,INTERSPINOUS IMPLANT,,,28 ,,NW,,,,,,"$3,843.64",$0.00,1,1,1,1,1,1,20110101,C1874,HCPCS,"STENT, COATED/COV W/DEL SYS",,,28 ,,NW,,,,,,"$3,031.52",$0.00,1,1,1,1,1,1,20110101,C1875,HCPCS,"STENT, COATED/COV W/O DEL SY",,,28 ,,NW,,,,,,"$3,213.64",$0.00,1,1,1,1,1,1,20110101,C1876,HCPCS,"STENT, NON-COA/NON-COV W/DEL",,,28 ,,NW,,,,,,"$2,781.44",$0.00,1,1,1,1,1,1,20110101,C1877,HCPCS,"STENT, NON-COAT/COV W/O DEL",,,28 ,,NW,,,,,,"$2,825.07",$0.00,1,1,1,1,1,1,20110101,C1878,HCPCS,MATRL FOR VOCAL CORD,,,28 ,,NW,,,,,,$680.08,$0.00,1,1,1,1,1,1,20110101,C1879,HCPCS,"TISSUE MARKER, IMPLANTABLE",,,28 ,,NW,,,,,,$178.21,$0.00,1,1,1,1,1,1,20110101,C1880,HCPCS,VENA CAVA FILTER,,,28 ,,NW,,,,,,"$2,008.56",$0.00,1,1,1,1,1,1,20110101,C1881,HCPCS,DIALYSIS ACCESS SYSTEM,,,28 ,,NW,,,,,,$438.71,$0.00,1,1,1,1,1,1,20110101,C1882,HCPCS,"AICD, OTHER THAN SING/DUAL",,,28 ,,NW,,,,,,"$41,387.48",$0.00,1,1,1,1,1,1,20110101,C1883,HCPCS,"ADAPT/EXT, PACING/NEURO LEAD",,,28 ,,NW,,,,,,"$2,494.52",$0.00,1,1,1,1,1,1,20110101,C1884,HCPCS,EMBOLIZATION PROTECT SYST,,,28 ,,NW,,,,,,$257.58,$0.00,1,1,1,1,1,1,20110101,C1885,HCPCS,"CATH, TRANSLUMIN ANGIO LASER",,,28 ,,NW,,,,,,$293.56,$0.00,1,1,1,1,1,1,20110101,C1887,HCPCS,"CATHETER, GUIDING",,,28 ,,NW,,,,,,$56.15,$0.00,1,1,1,1,1,1,20110101,C1888,HCPCS,ENDOVAS NON-CARDIAC ABL CATH,,,28 ,,NW,,,,,,"$1,095.55",$0.00,1,1,1,1,1,1,20110101,C1891,HCPCS,"INFUSION PUMP,NON-PROG, PERM",,,28 ,,NW,,,,,,"$6,866.90",$0.00,1,1,1,1,1,1,20110101,C1892,HCPCS,"INTRO/SHEATH,FIXED,PEEL-AWAY",,,28 ,,NW,,,,,,"$1,017.74",$0.00,1,1,1,1,1,1,20110101,C1893,HCPCS,"INTRO/SHEATH, FIXED,NON-PEEL",,,28 ,,NW,,,,,,$543.50,$0.00,1,1,1,1,1,1,20110101,C1894,HCPCS,"INTRO/SHEATH, NON-LASER",,,28 ,,NW,,,,,,$141.43,$0.00,1,1,1,1,1,1,20110101,C1895,HCPCS,"LEAD, AICD, ENDO DUAL COIL",,,28 ,,NW,,,,,,"$6,811.96",$0.00,1,1,1,1,1,1,20110101,C1896,HCPCS,"LEAD, AICD, NON SING/DUAL",,,28 ,,NW,,,,,,"$4,763.83",$0.00,1,1,1,1,1,1,20110101,C1897,HCPCS,"LEAD, NEUROSTIM TEST KIT",,,28 ,,NW,,,,,,"$2,323.86",$0.00,1,1,1,1,1,1,20110101,C1898,HCPCS,"LEAD, PMKR, OTHER THAN TRANS",,,28 ,,NW,,,,,,"$1,444.48",$0.00,1,1,1,1,1,1,20110101,C1899,HCPCS,"LEAD, PMKR/AICD COMBINATION",,,28 ,,NW,,,,,,"$4,594.17",$0.00,1,1,1,1,1,1,20110101,C1900,HCPCS,"LEAD, CORONARY VENOUS",,,28 ,,NW,,,,,,"$5,164.39",$0.00,1,1,1,1,1,1,20110101,C2614,HCPCS,"PROBE, PERC LUMB DISC",,,28 ,,NW,,,,,,$718.95,$0.00,1,1,1,1,1,1,20110101,C2615,HCPCS,"SEALANT, PULMONARY, LIQUID",,,28 ,,NW,,,,,,$799.70,$0.00,1,1,1,1,1,1,20110101,C2617,HCPCS,"STENT, NON-COR, TEM W/O DEL",,,28 ,,NW,,,,,,"$2,565.84",$0.00,1,1,1,1,1,1,20110101,C2618,HCPCS,"PROBE, CRYOABLATION",,,28 ,,NW,,,,,,"$2,246.01",$0.00,1,1,1,1,1,1,20110101,C2619,HCPCS,"PMKR, DUAL, NON RATE-RESP",,,28 ,,NW,,,,,,"$6,973.52",$0.00,1,1,1,1,1,1,20110101,C2620,HCPCS,"PMKR, SINGLE, NON RATE-RESP",,,28 ,,NW,,,,,,"$10,110.36",$0.00,1,1,1,1,1,1,20110101,C2621,HCPCS,"PMKR, OTHER THAN SING/DUAL",,,28 ,,NW,,,,,,"$18,959.27",$0.00,1,1,1,1,1,1,20110101,C2622,HCPCS,"PROSTHESIS, PENILE, NON-INF",,,28 ,,NW,,,,,,"$4,210.82",$0.00,1,1,1,1,1,1,20110101,C2625,HCPCS,"STENT, NON-COR, TEM W/DEL SY",,,28 ,,NW,,,,,,"$2,624.40",$0.00,1,1,1,1,1,1,20110101,C2626,HCPCS,"INFUSION PUMP, NON-PROG,TEMP",,,28 ,,NW,,,,,,"$8,256.38",$0.00,1,1,1,1,1,1,20110101,C2627,HCPCS,"CATH, SUPRAPUBIC/CYSTOSCOPIC",,,28 ,,NW,,,,,,$618.32,$0.00,1,1,1,1,1,1,20110101,C2628,HCPCS,"CATHETER, OCCLUSION",,,28 ,,NW,,,,,,$341.02,$0.00,1,1,1,1,1,1,20110101,C2631,HCPCS,"REP DEV, URINARY, W/O SLING",,,28 ,,NW,,,,,,"$2,836.92",$0.00,1,1,1,1,1,1,20110101,C2638,HCPCS,"BRACHYTX, STRANDED, I-125",,,28 ,,NW,,,,,,$106.31,$0.00,1,1,1,1,1,1,20110101,C2639,HCPCS,"BRACHYTX, NON-STRANDED,I-125",,,28 ,,NW,,,,,,$51.68,$0.00,1,1,1,1,1,1,20110101,C2641,HCPCS,"BRACHYTX, NON-STRANDED,P-103",,,28 ,,NW,,,,,,$65.24,$0.00,1,1,1,1,1,1,20110101,C2698,HCPCS,"BRACHYTX, STRANDED, NOS",,,28 ,,NW,,,,,,"$2,510.22",$0.00,1,1,1,1,1,1,20110101,C2699,HCPCS,"BRACHYTX, NON-STRANDED, NOS",,,28 ,,NW,,,,,,"$2,510.22",$0.00,1,1,1,1,1,1,20110101,C8908,HCPCS,"MRI W/O FOL W/CONT, BREAST,",,,20 ,,TotalUnits,,,,16.38 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,C9113,HCPCS,"INJ PANTOPRAZOLE SODIUM, VIA",,,29 ,,NW,,,,,,$162.02,$0.00,1,1,1,0,0,1,20110101,C9121,HCPCS,"INJECTION, ARGATROBAN",,,29 ,,NW,,,,,,$187.64,$0.00,1,1,1,0,0,1,20110101,C9248,HCPCS,"INJ, CLEVIDIPINE BUTYRATE",,,29 ,,NW,,,,,,$9.94,$0.00,1,1,1,0,0,1,20110101,C9250,HCPCS,ARTISS FIBRIN SEALANT,,,29 ,,NW,,,,,,$683.16,$0.00,1,1,1,0,0,1,20110101,C9254,HCPCS,"INJECTION, LACOSAMIDE",,,29 ,,NW,,,,,,$1.07,$0.00,1,1,1,0,0,1,20110101,C9257,HCPCS,BEVACIZUMAB INJECTION,,,29 ,,NW,,,,,,$68.14,$0.00,1,1,1,0,0,1,20110101,C9359,HCPCS,"IMPLNT,BON VOID FILLER-PUTTY",,,28 ,,NW,,,,,,"$1,552.70",$0.00,1,1,1,1,1,1,20110101,C9360,HCPCS,"SURGIMEND, NEONATAL",,,28 ,,NW,,,,,,$56.73,$0.00,1,1,1,1,1,1,20110101,C9361,HCPCS,NEUROMEND NERVE WRAP,,,28 ,,NW,,,,,,"$1,264.81",$0.00,1,1,1,1,1,1,20110101,C9362,HCPCS,"IMPLNT,BON VOID FILLER-STRIP",,,28 ,,NW,,,,,,$252.43,$0.00,1,1,1,1,1,1,20110101,C9363,HCPCS,INTEGRA MESHED BIL WOUND MAT,,,28 ,,NW,,,,,,$99.66,$0.00,1,1,1,1,1,1,20110101,C9364,HCPCS,"PORCINE IMPLANT, PERMACOL",,,28 ,,NW,,,,,,$87.67,$0.00,1,1,1,1,1,1,20110101,C9367,HCPCS,ENDOFORM DERMAL TEMPLATE,,,28 ,,NW,,,,,,$21.82,$0.00,1,1,1,0,0,1,20110101,C9800,HCPCS,DERMAL FILLER INJ PX/SUPPL,,,28 ,,NW,,,,,,"$1,510.86",$0.00,1,1,1,0,0,1,20110101,D0120,HCPCS,PERIODIC ORAL EVALUATION,,,25 ,,NW,,,,,,$51.34,$0.00,1,0,1,1,1,1,20110101,D0140,HCPCS,LIMIT ORAL EVAL PROBLM FOCUS,,,25 ,,NW,,,,,,$79.25,$0.00,1,0,1,1,1,1,20110101,D0145,HCPCS,"ORAL EVALUATION, PT < 3YRS",,,25 ,,NW,,,,,,$72.98,$0.00,1,0,1,1,1,1,20110101,D0150,HCPCS,COMPREHENSVE ORAL EVALUATION,,,25 ,,NW,,,,,,$87.41,$0.00,1,0,1,1,1,1,20110101,D0160,HCPCS,EXTENSV ORAL EVAL PROB FOCUS,,,25 ,,NW,,,,,,$169.30,$0.00,1,0,1,1,1,1,20110101,D0170,HCPCS,"RE-EVAL,EST PT,PROBLEM FOCUS",,,25 ,,NW,,,,,,$71.50,$0.00,1,0,1,1,1,1,20110101,D0180,HCPCS,COMP PERIODONTAL EVALUATION,,,25 ,,NW,,,,,,$103.07,$0.00,1,0,1,1,1,1,20110101,D0210,HCPCS,INTRAOR COMPLETE FILM SERIES,,,25 ,,NW,,,,,,$137.02,$0.00,1,0,1,1,1,1,20110101,D0220,HCPCS,INTRAORAL PERIAPICAL FIRST F,,,25 ,,NW,,,,,,$29.47,$0.00,1,0,1,1,1,1,20110101,D0230,HCPCS,INTRAORAL PERIAPICAL EA ADD,,,25 ,,NW,,,,,,$24.97,$0.00,1,0,1,1,1,1,20110101,D0240,HCPCS,INTRAORAL OCCLUSAL FILM,,,25 ,,NW,,,,,,$42.87,$0.00,1,0,1,1,1,1,20110101,D0250,HCPCS,EXTRAORAL FIRST FILM,,,25 ,,NW,,,,,,$63.93,$0.00,1,0,1,1,1,1,20110101,D0260,HCPCS,EXTRAORAL EA ADDITIONAL FILM,,,25 ,,NW,,,,,,$56.27,$0.00,1,0,1,1,1,1,20110101,D0270,HCPCS,DENTAL BITEWING SINGLE FILM,,,25 ,,NW,,,,,,$29.28,$0.00,1,0,1,1,1,1,20110101,D0272,HCPCS,DENTAL BITEWINGS TWO FILMS,,,25 ,,NW,,,,,,$45.70,$0.00,1,0,1,1,1,1,20110101,D0273,HCPCS,BITEWINGS - THREE FILMS,,,25 ,,NW,,,,,,$55.65,$0.00,1,0,1,1,1,1,20110101,D0274,HCPCS,DENTAL BITEWINGS FOUR FILMS,,,25 ,,NW,,,,,,$65.79,$0.00,1,0,1,1,1,1,20110101,D0277,HCPCS,VERT BITEWINGS-SEV TO EIGHT,,,25 ,,NW,,,,,,$98.57,$0.00,1,0,1,1,1,1,20110101,D0290,HCPCS,DENTAL FILM SKULL/FACIAL BON,,,25 ,,NW,,,,,,$129.48,$0.00,1,0,1,1,1,1,20110101,D0310,HCPCS,DENTAL SALIOGRAPHY,,,25 ,,NW,,,,,,$318.96,$0.00,1,0,1,1,1,1,20110101,D0320,HCPCS,DENTAL TMJ ARTHROGRAM INCL I,,,25 ,,NW,,,,,,$690.60,$0.00,1,0,1,1,1,1,20110101,D0321,HCPCS,DENTAL OTHER TMJ FILMS,,,25 ,,NW,,,,,,$214.24,$0.00,1,0,1,1,1,1,20110101,D0322,HCPCS,DENTAL TOMOGRAPHIC SURVEY,,,25 ,,NW,,,,,,$498.53,$0.00,1,0,1,1,1,1,20110101,D0330,HCPCS,DENTAL PANORAMIC FILM,,,25 ,,NW,,,,,,$113.80,$0.00,1,0,1,1,1,1,20110101,D0340,HCPCS,DENTAL CEPHALOMETRIC FILM,,,25 ,,NW,,,,,,$124.54,$0.00,1,0,1,1,1,1,20110101,D0350,HCPCS,ORAL/FACIAL PHOTO IMAGES,,,25 ,,NW,,,,,,$68.08,$0.00,1,0,1,1,1,1,20110101,D0360,HCPCS,CONE BEAM CT,,,25 ,,NW,,,,,,$580.53,$0.00,1,0,1,1,1,1,20110101,D0362,HCPCS,"CONE BEAM, TWO DIMENSIONAL",,,25 ,,NW,,,,,,$409.84,$0.00,1,0,1,1,1,1,20110101,D0363,HCPCS,"CONE BEAM, THREE DIMENSIONAL",,,25 ,,NW,,,,,,$465.27,$0.00,1,0,1,1,1,1,20110101,D0415,HCPCS,COLLECTION OF MICROORGANISMS,,,25 ,,NW,,,,,,$42.62,$0.00,1,0,1,1,1,1,20110101,D0416,HCPCS,VIRAL CULTURE,,,25 ,,NW,,,,,,$61.27,$0.00,1,0,1,1,1,1,20110101,D0417,HCPCS,COLLECT & PREP SALIVA SAMPLE,,,25 ,,NW,,,,,,$76.43,$0.00,1,0,1,1,1,1,20110101,D0418,HCPCS,ANALYSIS OF SALIVA SAMPLE,,,25 ,,NW,,,,,,$86.67,$0.00,1,0,1,1,1,1,20110101,D0421,HCPCS,GEN TST SUSCEPT ORAL DISEASE,,,25 ,,NW,,,,,,$62.15,$0.00,1,0,1,1,1,1,20110101,D0425,HCPCS,CARIES SUSCEPTIBILITY TEST,,,25 ,,NW,,,,,,$34.38,$0.00,1,0,1,1,1,1,20110101,D0431,HCPCS,DIAG TST DETECT MUCOS ABNORM,,,25 ,,NW,,,,,,$69.47,$0.00,1,0,1,1,1,1,20110101,D0460,HCPCS,PULP VITALITY TEST,,,25 ,,NW,,,,,,$58.64,$0.00,1,0,1,1,1,1,20110101,D0470,HCPCS,DIAGNOSTIC CASTS,,,25 ,,NW,,,,,,$121.46,$0.00,1,0,1,1,1,1,20110101,D0472,HCPCS,"GROSS EXAM, PREP & REPORT",,,25 ,,NW,,,,,,$117.18,$0.00,1,0,1,1,1,1,20110101,D0473,HCPCS,"MICRO EXAM, PREP & REPORT",,,25 ,,NW,,,,,,$179.53,$0.00,1,0,1,1,1,1,20110101,D0474,HCPCS,MICRO W EXAM OF SURG MARGINS,,,25 ,,NW,,,,,,$221.24,$0.00,1,0,1,1,1,1,20110101,D0475,HCPCS,DECALCIFICATION PROCEDURE,,,25 ,,NW,,,,,,$86.76,$0.00,1,0,1,1,1,1,20110101,D0476,HCPCS,SPEC STAINS FOR MICROORGANIS,,,25 ,,NW,,,,,,$82.11,$0.00,1,0,1,1,1,1,20110101,D0477,HCPCS,SPEC STAINS NOT FOR MICROORG,,,25 ,,NW,,,,,,$217.33,$0.00,1,0,1,1,1,1,20110101,D0478,HCPCS,IMMUNOHISTOCHEMICAL STAINS,,,25 ,,NW,,,,,,$172.67,$0.00,1,0,1,1,1,1,20110101,D0479,HCPCS,TISSUE IN-SITU HYBRIDIZATION,,,25 ,,NW,,,,,,$229.53,$0.00,1,0,1,1,1,1,20110101,D0480,HCPCS,CYTOPATH SMEAR PREP & REPORT,,,25 ,,NW,,,,,,$131.47,$0.00,1,0,1,1,1,1,20110101,D0481,HCPCS,ELECTRON MICROSCOPY DIAGNOST,,,25 ,,NW,,,,,,$137.76,$0.00,1,0,1,1,1,1,20110101,D0482,HCPCS,DIRECT IMMUNOFLUORESCENCE,,,25 ,,NW,,,,,,$133.74,$0.00,1,0,1,1,1,1,20110101,D0483,HCPCS,INDIRECT IMMUNOFLUORESCENCE,,,25 ,,NW,,,,,,$140.53,$0.00,1,0,1,1,1,1,20110101,D0484,HCPCS,CONSULT SLIDES PREP ELSEWHER,,,25 ,,NW,,,,,,$178.06,$0.00,1,0,1,1,1,1,20110101,D0485,HCPCS,CONSULT INC PREP OF SLIDES,,,25 ,,NW,,,,,,$219.59,$0.00,1,0,1,1,1,1,20110101,D0486,HCPCS,ACCESSION OF BRUSH BIOPSY,,,25 ,,NW,,,,,,$170.10,$0.00,1,0,1,1,1,1,20110101,D0502,HCPCS,OTHER ORAL PATHOLOGY PROCEDU,,,25 ,,NW,,,,,,$173.22,$0.00,1,0,1,1,1,1,20110101,D0999,HCPCS,UNSPECIFIED DIAGNOSTIC PROCE,,,25 ,,NW,,,,,,$51.34,$0.00,1,0,1,1,1,1,20110101,D1110,HCPCS,DENTAL PROPHYLAXIS ADULT,,,25 ,,NW,,,,,,$94.11,$0.00,1,0,1,1,1,1,20110101,D1120,HCPCS,DENTAL PROPHYLAXIS CHILD,,,25 ,,NW,,,,,,$69.98,$0.00,1,0,1,1,1,1,20110101,D1203,HCPCS,TOPICAL APP FLUORIDE CHILD,,,25 ,,NW,,,,,,$38.06,$0.00,1,0,1,1,1,1,20110101,D1204,HCPCS,TOPICAL APP FLUORIDE ADULT,,,25 ,,NW,,,,,,$37.72,$0.00,1,0,1,1,1,1,20110101,D1206,HCPCS,TOPICAL FLUORIDE VARNISH,,,25 ,,NW,,,,,,$50.17,$0.00,1,0,1,1,1,1,20110101,D1310,HCPCS,NUTRI COUNSEL-CONTROL CARIES,,,25 ,,NW,,,,,,$58.96,$0.00,1,0,1,1,1,1,20110101,D1320,HCPCS,TOBACCO COUNSELING,,,25 ,,NW,,,,,,$63.83,$0.00,1,0,1,1,1,1,20110101,D1330,HCPCS,ORAL HYGIENE INSTRUCTION,,,25 ,,NW,,,,,,$58.39,$0.00,1,0,1,1,1,1,20110101,D1351,HCPCS,DENTAL SEALANT PER TOOTH,,,25 ,,NW,,,,,,$55.77,$0.00,1,0,1,1,1,1,20110101,D1510,HCPCS,SPACE MAINTAINER FXD UNILAT,,,26 ,,NW,,,,,,$342.30,$0.00,1,0,1,1,1,1,20110101,D1515,HCPCS,FIXED BILAT SPACE MAINTAINER,,,26 ,,NW,,,,,,$490.88,$0.00,1,0,1,1,1,1,20110101,D1520,HCPCS,REMOVE UNILAT SPACE MAINTAIN,,,26 ,,NW,,,,,,$401.89,$0.00,1,0,1,1,1,1,20110101,D1525,HCPCS,REMOVE BILAT SPACE MAINTAIN,,,26 ,,NW,,,,,,$574.15,$0.00,1,0,1,1,1,1,20110101,D1550,HCPCS,RECEMENT SPACE MAINTAINER,,,26 ,,NW,,,,,,$81.16,$0.00,1,0,1,1,1,1,20110101,D1555,HCPCS,REMOVE FIX SPACE MAINTAINER,,,26 ,,NW,,,,,,$79.18,$0.00,1,0,1,1,1,1,20110101,D2140,HCPCS,AMALGAM ONE SURFACE PERMANEN,,,26 ,,NW,,,,,,$151.91,$0.00,1,0,1,1,1,1,20110101,D2150,HCPCS,AMALGAM TWO SURFACES PERMANE,,,26 ,,NW,,,,,,$188.44,$0.00,1,0,1,1,1,1,20110101,D2160,HCPCS,AMALGAM THREE SURFACES PERMA,,,26 ,,NW,,,,,,$228.84,$0.00,1,0,1,1,1,1,20110101,D2161,HCPCS,AMALGAM 4 OR > SURFACES PERM,,,26 ,,NW,,,,,,$271.01,$0.00,1,0,1,1,1,1,20110101,D2330,HCPCS,RESIN ONE SURFACE-ANTERIOR,,,26 ,,NW,,,,,,$164.15,$0.00,1,0,1,1,1,1,20110101,D2331,HCPCS,RESIN TWO SURFACES-ANTERIOR,,,26 ,,NW,,,,,,$200.23,$0.00,1,0,1,1,1,1,20110101,D2332,HCPCS,RESIN THREE SURFACES-ANTERIO,,,26 ,,NW,,,,,,$243.93,$0.00,1,0,1,1,1,1,20110101,D2335,HCPCS,RESIN 4/> SURF OR W INCIS AN,,,26 ,,NW,,,,,,$295.31,$0.00,1,0,1,1,1,1,20110101,D2390,HCPCS,ANT RESIN-BASED CMPST CROWN,,,26 ,,NW,,,,,,$381.29,$0.00,1,0,1,1,1,1,20110101,D2391,HCPCS,POST 1 SRFC RESINBASED CMPST,,,26 ,,NW,,,,,,$180.04,$0.00,1,0,1,1,1,1,20110101,D2392,HCPCS,POST 2 SRFC RESINBASED CMPST,,,26 ,,NW,,,,,,$233.20,$0.00,1,0,1,1,1,1,20110101,D2393,HCPCS,POST 3 SRFC RESINBASED CMPST,,,26 ,,NW,,,,,,$290.79,$0.00,1,0,1,1,1,1,20110101,D2394,HCPCS,POST >=4SRFC RESINBASE CMPST,,,26 ,,NW,,,,,,$345.30,$0.00,1,0,1,1,1,1,20110101,D2410,HCPCS,DENTAL GOLD FOIL ONE SURFACE,,,27 ,,NW,,,,,,$344.84,$0.00,1,0,1,1,1,1,20110101,D2420,HCPCS,DENTAL GOLD FOIL TWO SURFACE,,,27 ,,NW,,,,,,$687.85,$0.00,1,0,1,1,1,1,20110101,D2430,HCPCS,DENTAL GOLD FOIL THREE SURFA,,,27 ,,NW,,,,,,$869.38,$0.00,1,0,1,1,1,1,20110101,D2510,HCPCS,DENTAL INLAY METALIC 1 SURF,,,27 ,,NW,,,,,,$904.92,$0.00,1,0,1,1,1,1,20110101,D2520,HCPCS,DENTAL INLAY METALLIC 2 SURF,,,27 ,,NW,,,,,,$990.12,$0.00,1,0,1,1,1,1,20110101,D2530,HCPCS,DENTAL INLAY METL 3/MORE SUR,,,27 ,,NW,,,,,,"$1,088.02",$0.00,1,0,1,1,1,1,20110101,D2542,HCPCS,DENTAL ONLAY METALLIC 2 SURF,,,27 ,,NW,,,,,,"$1,120.58",$0.00,1,0,1,1,1,1,20110101,D2543,HCPCS,DENTAL ONLAY METALLIC 3 SURF,,,27 ,,NW,,,,,,"$1,141.21",$0.00,1,0,1,1,1,1,20110101,D2544,HCPCS,DENTAL ONLAY METL 4/MORE SUR,,,27 ,,NW,,,,,,"$1,168.53",$0.00,1,0,1,1,1,1,20110101,D2610,HCPCS,INLAY PORCELAIN/CERAMIC 1 SU,,,27 ,,NW,,,,,,$989.70,$0.00,1,0,1,1,1,1,20110101,D2620,HCPCS,INLAY PORCELAIN/CERAMIC 2 SU,,,27 ,,NW,,,,,,"$1,035.96",$0.00,1,0,1,1,1,1,20110101,D2630,HCPCS,DENTAL ONLAY PORC 3/MORE SUR,,,27 ,,NW,,,,,,"$1,097.97",$0.00,1,0,1,1,1,1,20110101,D2642,HCPCS,DENTAL ONLAY PORCELIN 2 SURF,,,27 ,,NW,,,,,,"$1,143.12",$0.00,1,0,1,1,1,1,20110101,D2643,HCPCS,DENTAL ONLAY PORCELIN 3 SURF,,,27 ,,NW,,,,,,"$1,160.26",$0.00,1,0,1,1,1,1,20110101,D2644,HCPCS,DENTAL ONLAY PORC 4/MORE SUR,,,27 ,,NW,,,,,,"$1,201.69",$0.00,1,0,1,1,1,1,20110101,D2650,HCPCS,INLAY COMPOSITE/RESIN ONE SU,,,27 ,,NW,,,,,,$768.97,$0.00,1,0,1,1,1,1,20110101,D2651,HCPCS,INLAY COMPOSITE/RESIN TWO SU,,,27 ,,NW,,,,,,$871.28,$0.00,1,0,1,1,1,1,20110101,D2652,HCPCS,DENTAL INLAY RESIN 3/MRE SUR,,,27 ,,NW,,,,,,$927.71,$0.00,1,0,1,1,1,1,20110101,D2662,HCPCS,DENTAL ONLAY RESIN 2 SURFACE,,,27 ,,NW,,,,,,$913.81,$0.00,1,0,1,1,1,1,20110101,D2663,HCPCS,DENTAL ONLAY RESIN 3 SURFACE,,,27 ,,NW,,,,,,$973.07,$0.00,1,0,1,1,1,1,20110101,D2664,HCPCS,DENTAL ONLAY RESIN 4/MRE SUR,,,27 ,,NW,,,,,,"$1,021.11",$0.00,1,0,1,1,1,1,20110101,D2710,HCPCS,CROWN RESIN-BASED INDIRECT,,,27 ,,NW,,,,,,$570.89,$0.00,1,0,1,1,1,1,20110101,D2712,HCPCS,CROWN 3/4 RESIN-BASED COMPOS,,,27 ,,NW,,,,,,$745.36,$0.00,1,0,1,1,1,1,20110101,D2720,HCPCS,CROWN RESIN W/ HIGH NOBLE ME,,,27 ,,NW,,,,,,"$1,098.48",$0.00,1,0,1,1,1,1,20110101,D2721,HCPCS,CROWN RESIN W/ BASE METAL,,,27 ,,NW,,,,,,"$1,010.17",$0.00,1,0,1,1,1,1,20110101,D2722,HCPCS,CROWN RESIN W/ NOBLE METAL,,,27 ,,NW,,,,,,"$1,038.67",$0.00,1,0,1,1,1,1,20110101,D2740,HCPCS,CROWN PORCELAIN/CERAMIC SUBS,,,27 ,,NW,,,,,,"$1,194.29",$0.00,1,0,1,1,1,1,20110101,D2750,HCPCS,CROWN PORCELAIN W/ H NOBLE M,,,27 ,,NW,,,,,,"$1,133.28",$0.00,1,0,1,1,1,1,20110101,D2751,HCPCS,CROWN PORCELAIN FUSED BASE M,,,27 ,,NW,,,,,,"$1,046.95",$0.00,1,0,1,1,1,1,20110101,D2752,HCPCS,CROWN PORCELAIN W/ NOBLE MET,,,27 ,,NW,,,,,,"$1,071.36",$0.00,1,0,1,1,1,1,20110101,D2780,HCPCS,CROWN 3/4 CAST HI NOBLE MET,,,27 ,,NW,,,,,,"$1,144.46",$0.00,1,0,1,1,1,1,20110101,D2781,HCPCS,CROWN 3/4 CAST BASE METAL,,,27 ,,NW,,,,,,"$1,089.36",$0.00,1,0,1,1,1,1,20110101,D2782,HCPCS,CROWN 3/4 CAST NOBLE METAL,,,27 ,,NW,,,,,,"$1,120.14",$0.00,1,0,1,1,1,1,20110101,D2783,HCPCS,CROWN 3/4 PORCELAIN/CERAMIC,,,27 ,,NW,,,,,,"$1,166.25",$0.00,1,0,1,1,1,1,20110101,D2790,HCPCS,CROWN FULL CAST HIGH NOBLE M,,,27 ,,NW,,,,,,"$1,120.72",$0.00,1,0,1,1,1,1,20110101,D2791,HCPCS,CROWN FULL CAST BASE METAL,,,27 ,,NW,,,,,,"$1,053.86",$0.00,1,0,1,1,1,1,20110101,D2792,HCPCS,CROWN FULL CAST NOBLE METAL,,,27 ,,NW,,,,,,"$1,093.33",$0.00,1,0,1,1,1,1,20110101,D2794,HCPCS,CROWN-TITANIUM,,,27 ,,NW,,,,,,"$1,117.51",$0.00,1,0,1,1,1,1,20110101,D2799,HCPCS,PROVISIONAL CROWN,,,27 ,,NW,,,,,,$443.73,$0.00,1,0,1,1,1,1,20110101,D2910,HCPCS,RECEMENT INLAY ONLAY OR PART,,,27 ,,NW,,,,,,$108.80,$0.00,1,0,1,1,1,1,20110101,D2915,HCPCS,RECEMENT CAST OR PREFAB POST,,,27 ,,NW,,,,,,$108.78,$0.00,1,0,1,1,1,1,20110101,D2920,HCPCS,DENTAL RECEMENT CROWN,,,27 ,,NW,,,,,,$107.85,$0.00,1,0,1,1,1,1,20110101,D2930,HCPCS,PREFAB STNLSS STEEL CRWN PRI,,,27 ,,NW,,,,,,$277.50,$0.00,1,0,1,1,1,1,20110101,D2931,HCPCS,PREFAB STNLSS STEEL CROWN PE,,,27 ,,NW,,,,,,$324.60,$0.00,1,0,1,1,1,1,20110101,D2932,HCPCS,PREFABRICATED RESIN CROWN,,,27 ,,NW,,,,,,$344.17,$0.00,1,0,1,1,1,1,20110101,D2933,HCPCS,PREFAB STAINLESS STEEL CROWN,,,27 ,,NW,,,,,,$373.44,$0.00,1,0,1,1,1,1,20110101,D2934,HCPCS,PREFAB STEEL CROWN PRIMARY,,,27 ,,NW,,,,,,$376.94,$0.00,1,0,1,1,1,1,20110101,D2940,HCPCS,DENTAL SEDATIVE FILLING,,,27 ,,NW,,,,,,$116.24,$0.00,1,0,1,1,1,1,20110101,D2950,HCPCS,CORE BUILD-UP INCL ANY PINS,,,27 ,,NW,,,,,,$277.55,$0.00,1,0,1,1,1,1,20110101,D2951,HCPCS,TOOTH PIN RETENTION,,,27 ,,NW,,,,,,$65.50,$0.00,1,0,1,1,1,1,20110101,D2952,HCPCS,POST AND CORE CAST + CROWN,,,27 ,,NW,,,,,,$431.99,$0.00,1,0,1,1,1,1,20110101,D2953,HCPCS,EACH ADDTNL CAST POST,,,27 ,,NW,,,,,,$263.67,$0.00,1,0,1,1,1,1,20110101,D2954,HCPCS,PREFAB POST/CORE + CROWN,,,27 ,,NW,,,,,,$348.07,$0.00,1,0,1,1,1,1,20110101,D2955,HCPCS,POST REMOVAL,,,27 ,,NW,,,,,,$297.98,$0.00,1,0,1,1,1,1,20110101,D2957,HCPCS,EACH ADDTNL PREFAB POST,,,27 ,,NW,,,,,,$185.00,$0.00,1,0,1,1,1,1,20110101,D2960,HCPCS,LAMINATE LABIAL VENEER,,,27 ,,NW,,,,,,$719.16,$0.00,1,0,1,1,1,1,20110101,D2961,HCPCS,LAB LABIAL VENEER RESIN,,,27 ,,NW,,,,,,"$1,015.10",$0.00,1,0,1,1,1,1,20110101,D2962,HCPCS,LAB LABIAL VENEER PORCELAIN,,,27 ,,NW,,,,,,"$1,163.49",$0.00,1,0,1,1,1,1,20110101,D2970,HCPCS,TEMP CROWN (FRACTURED TOOTH),,,27 ,,NW,,,,,,$324.88,$0.00,1,0,1,1,1,1,20110101,D2971,HCPCS,ADD PROC CONSTRUCT NEW CROWN,,,27 ,,NW,,,,,,$159.51,$0.00,1,0,1,1,1,1,20110101,D2975,HCPCS,COPING,,,27 ,,NW,,,,,,$549.68,$0.00,1,0,1,1,1,1,20110101,D2980,HCPCS,CROWN REPAIR,,,27 ,,NW,,,,,,$289.74,$0.00,1,0,1,1,1,1,20110101,D2999,HCPCS,DENTAL UNSPEC RESTORATIVE PR,,,27 ,,NW,,,,,,$233.20,$0.00,1,0,1,1,1,1,20110101,D3110,HCPCS,PULP CAP DIRECT,,,26 ,,NW,,,,,,$87.08,$0.00,1,0,1,1,1,1,20110101,D3120,HCPCS,PULP CAP INDIRECT,,,26 ,,NW,,,,,,$80.02,$0.00,1,0,1,1,1,1,20110101,D3220,HCPCS,THERAPEUTIC PULPOTOMY,,,26 ,,NW,,,,,,$195.61,$0.00,1,0,1,1,1,1,20110101,D3221,HCPCS,GROSS PULPAL DEBRIDEMENT,,,26 ,,NW,,,,,,$220.15,$0.00,1,0,1,1,1,1,20110101,D3222,HCPCS,PART PULP FOR APEXOGENESIS,,,26 ,,NW,,,,,,$256.08,$0.00,1,0,1,1,1,1,20110101,D3230,HCPCS,PULPAL THERAPY ANTERIOR PRIM,,,26 ,,NW,,,,,,$245.48,$0.00,1,0,1,1,1,1,20110101,D3240,HCPCS,PULPAL THERAPY POSTERIOR PRI,,,26 ,,NW,,,,,,$287.71,$0.00,1,0,1,1,1,1,20110101,D3310,HCPCS,"END THXPY, ANTERIOR TOOTH",,,26 ,,NW,,,,,,$786.35,$0.00,1,0,1,1,1,1,20110101,D3320,HCPCS,"END THXPY, BICUSPID TOOTH",,,26 ,,NW,,,,,,$918.88,$0.00,1,0,1,1,1,1,20110101,D3330,HCPCS,"END THXPY, MOLAR",,,26 ,,NW,,,,,,"$1,125.40",$0.00,1,0,1,1,1,1,20110101,D3331,HCPCS,NON-SURG TX ROOT CANAL OBS,,,26 ,,NW,,,,,,$425.14,$0.00,1,0,1,1,1,1,20110101,D3332,HCPCS,INCOMPLETE ENDODONTIC TX,,,26 ,,NW,,,,,,$495.81,$0.00,1,0,1,1,1,1,20110101,D3333,HCPCS,INTERNAL ROOT REPAIR,,,26 ,,NW,,,,,,$326.96,$0.00,1,0,1,1,1,1,20110101,D3346,HCPCS,RETREAT ROOT CANAL ANTERIOR,,,26 ,,NW,,,,,,$989.59,$0.00,1,0,1,1,1,1,20110101,D3347,HCPCS,RETREAT ROOT CANAL BICUSPID,,,26 ,,NW,,,,,,"$1,141.39",$0.00,1,0,1,1,1,1,20110101,D3348,HCPCS,RETREAT ROOT CANAL MOLAR,,,26 ,,NW,,,,,,"$1,358.79",$0.00,1,0,1,1,1,1,20110101,D3351,HCPCS,APEXIFICATION/RECALC INITIAL,,,26 ,,NW,,,,,,$394.53,$0.00,1,0,1,1,1,1,20110101,D3352,HCPCS,APEXIFICATION/RECALC INTERIM,,,26 ,,NW,,,,,,$232.26,$0.00,1,0,1,1,1,1,20110101,D3353,HCPCS,APEXIFICATION/RECALC FINAL,,,26 ,,NW,,,,,,$612.14,$0.00,1,0,1,1,1,1,20110101,D3410,HCPCS,APICOECT/PERIRAD SURG ANTER,,,26 ,,NW,,,,,,$853.84,$0.00,1,0,1,1,1,1,20110101,D3421,HCPCS,ROOT SURGERY BICUSPID,,,26 ,,NW,,,,,,$940.79,$0.00,1,0,1,1,1,1,20110101,D3425,HCPCS,ROOT SURGERY MOLAR,,,26 ,,NW,,,,,,"$1,054.42",$0.00,1,0,1,1,1,1,20110101,D3426,HCPCS,ROOT SURGERY EA ADD ROOT,,,26 ,,NW,,,,,,$389.21,$0.00,1,0,1,1,1,1,20110101,D3430,HCPCS,RETROGRADE FILLING,,,26 ,,NW,,,,,,$279.56,$0.00,1,0,1,1,1,1,20110101,D3450,HCPCS,ROOT AMPUTATION,,,26 ,,NW,,,,,,$578.15,$0.00,1,0,1,1,1,1,20110101,D3460,HCPCS,ENDODONTIC ENDOSSEOUS IMPLAN,,,26 ,,NW,,,,,,"$1,995.33",$0.00,1,0,1,1,1,1,20110101,D3470,HCPCS,INTENTIONAL REPLANTATION,,,26 ,,NW,,,,,,$962.44,$0.00,1,0,1,1,1,1,20110101,D3910,HCPCS,ISOLATION- TOOTH W RUBB DAM,,,26 ,,NW,,,,,,$195.24,$0.00,1,0,1,1,1,1,20110101,D3920,HCPCS,TOOTH SPLITTING,,,26 ,,NW,,,,,,$461.28,$0.00,1,0,1,1,1,1,20110101,D3950,HCPCS,CANAL PREP/FITTING OF DOWEL,,,26 ,,NW,,,,,,$211.50,$0.00,1,0,1,1,1,1,20110101,D3999,HCPCS,ENDODONTIC PROCEDURE,,,26 ,,NW,,,,,,$918.88,$0.00,1,0,1,1,1,1,20110101,D4210,HCPCS,GINGIVECTOMY/PLASTY PER QUAD,,,26 ,,NW,,,,,,$672.28,$0.00,1,0,1,1,1,1,20110101,D4211,HCPCS,GINGIVECTOMY/PLASTY PER TOOT,,,26 ,,NW,,,,,,$304.93,$0.00,1,0,1,1,1,1,20110101,D4230,HCPCS,ANA CROWN EXP 4 OR> PER QUAD,,,26 ,,NW,,,,,,$913.37,$0.00,1,0,1,1,1,1,20110101,D4231,HCPCS,ANA CROWN EXP 1-3 PER QUAD,,,26 ,,NW,,,,,,$511.09,$0.00,1,0,1,1,1,1,20110101,D4240,HCPCS,GINGIVAL FLAP PROC W/ PLANIN,,,26 ,,NW,,,,,,$842.87,$0.00,1,0,1,1,1,1,20110101,D4241,HCPCS,GNGVL FLAP W ROOTPLAN 1-3 TH,,,26 ,,NW,,,,,,$612.52,$0.00,1,0,1,1,1,1,20110101,D4245,HCPCS,APICALLY POSITIONED FLAP,,,26 ,,NW,,,,,,$735.10,$0.00,1,0,1,1,1,1,20110101,D4249,HCPCS,CROWN LENGTHEN HARD TISSUE,,,26 ,,NW,,,,,,$923.43,$0.00,1,0,1,1,1,1,20110101,D4260,HCPCS,OSSEOUS SURGERY PER QUADRANT,,,26 ,,NW,,,,,,"$1,308.35",$0.00,1,0,1,1,1,1,20110101,D4261,HCPCS,OSSEOUS SURGL-3TEETHPERQUAD,,,26 ,,NW,,,,,,$937.93,$0.00,1,0,1,1,1,1,20110101,D4263,HCPCS,BONE REPLCE GRAFT FIRST SITE,,,26 ,,NW,,,,,,$635.92,$0.00,1,0,1,1,1,1,20110101,D4264,HCPCS,BONE REPLCE GRAFT EACH ADD,,,26 ,,NW,,,,,,$484.61,$0.00,1,0,1,1,1,1,20110101,D4265,HCPCS,BIO MTRLS TO AID SOFT/OS REG,,,26 ,,NW,,,,,,$553.88,$0.00,1,0,1,1,1,1,20110101,D4266,HCPCS,GUIDED TISS REGEN RESORBLE,,,26 ,,NW,,,,,,$689.22,$0.00,1,0,1,1,1,1,20110101,D4267,HCPCS,GUIDED TISS REGEN NONRESORB,,,26 ,,NW,,,,,,$801.99,$0.00,1,0,1,1,1,1,20110101,D4268,HCPCS,SURGICAL REVISION PROCEDURE,,,26 ,,NW,,,,,,$717.11,$0.00,1,0,1,1,1,1,20110101,D4270,HCPCS,PEDICLE SOFT TISSUE GRAFT PR,,,26 ,,NW,,,,,,$985.84,$0.00,1,0,1,1,1,1,20110101,D4271,HCPCS,FREE SOFT TISSUE GRAFT PROC,,,26 ,,NW,,,,,,"$1,049.44",$0.00,1,0,1,1,1,1,20110101,D4273,HCPCS,SUBEPITHELIAL TISSUE GRAFT,,,26 ,,NW,,,,,,"$1,232.19",$0.00,1,0,1,1,1,1,20110101,D4274,HCPCS,DISTAL/PROXIMAL WEDGE PROC,,,26 ,,NW,,,,,,$719.40,$0.00,1,0,1,1,1,1,20110101,D4275,HCPCS,SOFT TISSUE ALLOGRAFT,,,26 ,,NW,,,,,,"$1,069.87",$0.00,1,0,1,1,1,1,20110101,D4276,HCPCS,CON TISSUE W DBLE PED GRAFT,,,26 ,,NW,,,,,,"$1,516.83",$0.00,1,0,1,1,1,1,20110101,D4320,HCPCS,PROVISION SPLNT INTRACORONAL,,,26 ,,NW,,,,,,$466.55,$0.00,1,0,1,1,1,1,20110101,D4321,HCPCS,PROVISIONAL SPLINT EXTRACORO,,,26 ,,NW,,,,,,$428.21,$0.00,1,0,1,1,1,1,20110101,D4341,HCPCS,PERIODONTAL SCALING & ROOT,,,26 ,,NW,,,,,,$260.89,$0.00,1,0,1,1,1,1,20110101,D4342,HCPCS,PERIODONTAL SCALING 1-3TEETH,,,26 ,,NW,,,,,,$175.54,$0.00,1,0,1,1,1,1,20110101,D4355,HCPCS,FULL MOUTH DEBRIDEMENT,,,26 ,,NW,,,,,,$180.22,$0.00,1,0,1,1,1,1,20110101,D4381,HCPCS,LOCALIZED DELIVERY ANTIMICRO,,,26 ,,NW,,,,,,$123.71,$0.00,1,0,1,1,1,1,20110101,D4910,HCPCS,PERIODONTAL MAINT PROCEDURES,,,26 ,,NW,,,,,,$145.47,$0.00,1,0,1,1,1,1,20110101,D4920,HCPCS,UNSCHEDULED DRESSING CHANGE,,,26 ,,NW,,,,,,$103.57,$0.00,1,0,1,1,1,1,20110101,D4999,HCPCS,UNSPECIFIED PERIODONTAL PROC,,,26 ,,NW,,,,,,$175.54,$0.00,1,0,1,1,1,1,20110101,D5110,HCPCS,DENTURES COMPLETE MAXILLARY,,,27 ,,NW,,,,,,"$1,625.32",$0.00,1,0,1,1,1,1,20110101,D5120,HCPCS,DENTURES COMPLETE MANDIBLE,,,27 ,,NW,,,,,,"$1,623.81",$0.00,1,0,1,1,1,1,20110101,D5130,HCPCS,DENTURES IMMEDIAT MAXILLARY,,,27 ,,NW,,,,,,"$1,750.13",$0.00,1,0,1,1,1,1,20110101,D5140,HCPCS,DENTURES IMMEDIAT MANDIBLE,,,27 ,,NW,,,,,,"$1,742.04",$0.00,1,0,1,1,1,1,20110101,D5211,HCPCS,DENTURES MAXILL PART RESIN,,,27 ,,NW,,,,,,"$1,294.01",$0.00,1,0,1,1,1,1,20110101,D5212,HCPCS,DENTURES MAND PART RESIN,,,27 ,,NW,,,,,,"$1,397.30",$0.00,1,0,1,1,1,1,20110101,D5213,HCPCS,DENTURES MAXILL PART METAL,,,27 ,,NW,,,,,,"$1,744.10",$0.00,1,0,1,1,1,1,20110101,D5214,HCPCS,DENTURES MANDIBL PART METAL,,,27 ,,NW,,,,,,"$1,749.33",$0.00,1,0,1,1,1,1,20110101,D5225,HCPCS,MAXILLARY PART DENTURE FLEX,,,27 ,,NW,,,,,,"$1,498.38",$0.00,1,0,1,1,1,1,20110101,D5226,HCPCS,MANDIBULAR PART DENTURE FLEX,,,27 ,,NW,,,,,,"$1,573.92",$0.00,1,0,1,1,1,1,20110101,D5281,HCPCS,REMOVABLE PARTIAL DENTURE,,,27 ,,NW,,,,,,$979.34,$0.00,1,0,1,1,1,1,20110101,D5410,HCPCS,DENTURES ADJUST CMPLT MAXIL,,,27 ,,NW,,,,,,$88.85,$0.00,1,0,1,1,1,1,20110101,D5411,HCPCS,DENTURES ADJUST CMPLT MAND,,,27 ,,NW,,,,,,$87.79,$0.00,1,0,1,1,1,1,20110101,D5421,HCPCS,DENTURES ADJUST PART MAXILL,,,27 ,,NW,,,,,,$89.55,$0.00,1,0,1,1,1,1,20110101,D5422,HCPCS,DENTURES ADJUST PART MANDBL,,,27 ,,NW,,,,,,$89.55,$0.00,1,0,1,1,1,1,20110101,D5510,HCPCS,DENTUR REPR BROKEN COMPL BAS,,,27 ,,NW,,,,,,$196.57,$0.00,1,0,1,1,1,1,20110101,D5520,HCPCS,REPLACE DENTURE TEETH COMPLT,,,27 ,,NW,,,,,,$168.00,$0.00,1,0,1,1,1,1,20110101,D5610,HCPCS,DENTURES REPAIR RESIN BASE,,,27 ,,NW,,,,,,$198.44,$0.00,1,0,1,1,1,1,20110101,D5620,HCPCS,REP PART DENTURE CAST FRAME,,,27 ,,NW,,,,,,$253.10,$0.00,1,0,1,1,1,1,20110101,D5630,HCPCS,REP PARTIAL DENTURE CLASP,,,27 ,,NW,,,,,,$254.50,$0.00,1,0,1,1,1,1,20110101,D5640,HCPCS,REPLACE PART DENTURE TEETH,,,27 ,,NW,,,,,,$175.12,$0.00,1,0,1,1,1,1,20110101,D5650,HCPCS,ADD TOOTH TO PARTIAL DENTURE,,,27 ,,NW,,,,,,$218.94,$0.00,1,0,1,1,1,1,20110101,D5660,HCPCS,ADD CLASP TO PARTIAL DENTURE,,,27 ,,NW,,,,,,$260.90,$0.00,1,0,1,1,1,1,20110101,D5670,HCPCS,REPLC TTH&ACRLC ON MTL FRMWK,,,27 ,,NW,,,,,,$672.00,$0.00,1,0,1,1,1,1,20110101,D5671,HCPCS,REPLC TTH&ACRLC MANDIBULAR,,,27 ,,NW,,,,,,$693.44,$0.00,1,0,1,1,1,1,20110101,D5710,HCPCS,DENTURES REBASE CMPLT MAXIL,,,27 ,,NW,,,,,,$595.69,$0.00,1,0,1,1,1,1,20110101,D5711,HCPCS,DENTURES REBASE CMPLT MAND,,,27 ,,NW,,,,,,$579.37,$0.00,1,0,1,1,1,1,20110101,D5720,HCPCS,DENTURES REBASE PART MAXILL,,,27 ,,NW,,,,,,$570.08,$0.00,1,0,1,1,1,1,20110101,D5721,HCPCS,DENTURES REBASE PART MANDBL,,,27 ,,NW,,,,,,$574.31,$0.00,1,0,1,1,1,1,20110101,D5730,HCPCS,DENTURE RELN CMPLT MAXIL CH,,,27 ,,NW,,,,,,$368.54,$0.00,1,0,1,1,1,1,20110101,D5731,HCPCS,DENTURE RELN CMPLT MAND CHR,,,27 ,,NW,,,,,,$364.67,$0.00,1,0,1,1,1,1,20110101,D5740,HCPCS,DENTURE RELN PART MAXIL CHR,,,27 ,,NW,,,,,,$346.81,$0.00,1,0,1,1,1,1,20110101,D5741,HCPCS,DENTURE RELN PART MAND CHR,,,27 ,,NW,,,,,,$349.62,$0.00,1,0,1,1,1,1,20110101,D5750,HCPCS,DENTURE RELN CMPLT MAX LAB,,,27 ,,NW,,,,,,$472.40,$0.00,1,0,1,1,1,1,20110101,D5751,HCPCS,DENTURE RELN CMPLT MAND LAB,,,27 ,,NW,,,,,,$471.35,$0.00,1,0,1,1,1,1,20110101,D5760,HCPCS,DENTURE RELN PART MAXIL LAB,,,27 ,,NW,,,,,,$471.85,$0.00,1,0,1,1,1,1,20110101,D5761,HCPCS,DENTURE RELN PART MAND LAB,,,27 ,,NW,,,,,,$471.84,$0.00,1,0,1,1,1,1,20110101,D5810,HCPCS,DENTURE INTERM CMPLT MAXILL,,,27 ,,NW,,,,,,$816.21,$0.00,1,0,1,1,1,1,20110101,D5811,HCPCS,DENTURE INTERM CMPLT MANDBL,,,27 ,,NW,,,,,,$836.93,$0.00,1,0,1,1,1,1,20110101,D5820,HCPCS,DENTURE INTERM PART MAXILL,,,27 ,,NW,,,,,,$644.46,$0.00,1,0,1,1,1,1,20110101,D5821,HCPCS,DENTURE INTERM PART MANDBL,,,27 ,,NW,,,,,,$662.44,$0.00,1,0,1,1,1,1,20110101,D5850,HCPCS,DENTURE TISS CONDITN MAXILL,,,27 ,,NW,,,,,,$179.77,$0.00,1,0,1,1,1,1,20110101,D5851,HCPCS,DENTURE TISS CONDTIN MANDBL,,,27 ,,NW,,,,,,$178.36,$0.00,1,0,1,1,1,1,20110101,D5860,HCPCS,OVERDENTURE COMPLETE,,,27 ,,NW,,,,,,"$2,274.93",$0.00,1,0,1,1,1,1,20110101,D5861,HCPCS,OVERDENTURE PARTIAL,,,27 ,,NW,,,,,,"$2,042.70",$0.00,1,0,1,1,1,1,20110101,D5862,HCPCS,PRECISION ATTACHMENT,,,27 ,,NW,,,,,,$695.49,$0.00,1,0,1,1,1,1,20110101,D5867,HCPCS,REPLACEMENT OF PRECISION ATT,,,27 ,,NW,,,,,,$281.90,$0.00,1,0,1,1,1,1,20110101,D5875,HCPCS,PROSTHESIS MODIFICATION,,,27 ,,NW,,,,,,$444.42,$0.00,1,0,1,1,1,1,20110101,D5899,HCPCS,REMOVABLE PROSTHODONTIC PROC,,,27 ,,NW,,,,,,$644.46,$0.00,1,0,1,1,1,1,20110101,D5911,HCPCS,FACIAL MOULAGE SECTIONAL,,,27 ,,NW,,,,,,$388.40,$0.00,1,0,1,1,1,1,20110101,D5912,HCPCS,FACIAL MOULAGE COMPLETE,,,27 ,,NW,,,,,,$370.27,$0.00,1,0,1,1,1,1,20110101,D5913,HCPCS,NASAL PROSTHESIS,,,27 ,,NW,,,,,,"$7,797.04",$0.00,1,0,1,1,1,1,20110101,D5914,HCPCS,AURICULAR PROSTHESIS,,,27 ,,NW,,,,,,"$7,797.04",$0.00,1,0,1,1,1,1,20110101,D5915,HCPCS,ORBITAL PROSTHESIS,,,27 ,,NW,,,,,,"$10,551.45",$0.00,1,0,1,1,1,1,20110101,D5916,HCPCS,OCULAR PROSTHESIS,,,27 ,,NW,,,,,,"$2,814.34",$0.00,1,0,1,1,1,1,20110101,D5919,HCPCS,FACIAL PROSTHESIS,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5922,HCPCS,NASAL SEPTAL PROSTHESIS,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5923,HCPCS,OCULAR PROSTHESIS INTERIM,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5924,HCPCS,CRANIAL PROSTHESIS,,,27 ,,NW,,,,,,"$1,003.52",$0.00,1,0,1,1,1,1,20110101,D5925,HCPCS,FACIAL AUGMENTATION IMPLANT,,,27 ,,NW,,,,,,$322.82,$0.00,1,0,1,1,1,1,20110101,D5926,HCPCS,REPLACEMENT NASAL PROSTHESIS,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5927,HCPCS,AURICULAR REPLACEMENT,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5928,HCPCS,ORBITAL REPLACEMENT,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5929,HCPCS,FACIAL REPLACEMENT,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5931,HCPCS,SURGICAL OBTURATOR,,,27 ,,NW,,,,,,"$3,729.31",$0.00,1,0,1,1,1,1,20110101,D5932,HCPCS,POSTSURGICAL OBTURATOR,,,27 ,,NW,,,,,,"$6,651.44",$0.00,1,0,1,1,1,1,20110101,D5933,HCPCS,REFITTING OF OBTURATOR,,,27 ,,NW,,,,,,$263.90,$0.00,1,0,1,1,1,1,20110101,D5934,HCPCS,MANDIBULAR FLANGE PROSTHESIS,,,27 ,,NW,,,,,,"$7,156.39",$0.00,1,0,1,1,1,1,20110101,D5935,HCPCS,MANDIBULAR DENTURE PROSTH,,,27 ,,NW,,,,,,"$6,226.71",$0.00,1,0,1,1,1,1,20110101,D5936,HCPCS,TEMP OBTURATOR PROSTHESIS,,,27 ,,NW,,,,,,"$7,336.28",$0.00,1,0,1,1,1,1,20110101,D5937,HCPCS,TRISMUS APPLIANCE,,,27 ,,NW,,,,,,$743.85,$0.00,1,0,1,1,1,1,20110101,D5951,HCPCS,FEEDING AID,,,27 ,,NW,,,,,,"$1,064.90",$0.00,1,0,1,1,1,1,20110101,D5952,HCPCS,PEDIATRIC SPEECH AID,,,27 ,,NW,,,,,,"$3,710.72",$0.00,1,0,1,1,1,1,20110101,D5953,HCPCS,ADULT SPEECH AID,,,27 ,,NW,,,,,,"$7,392.16",$0.00,1,0,1,1,1,1,20110101,D5954,HCPCS,SUPERIMPOSED PROSTHESIS,,,27 ,,NW,,,,,,"$6,850.08",$0.00,1,0,1,1,1,1,20110101,D5955,HCPCS,PALATAL LIFT PROSTHESIS,,,27 ,,NW,,,,,,"$6,335.94",$0.00,1,0,1,1,1,1,20110101,D5958,HCPCS,INTRAORAL CON DEF INTER PLT,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5959,HCPCS,INTRAORAL CON DEF MOD PALAT,,,27 ,,NW,,,,,,"$1,317.39",$0.00,1,0,1,1,1,1,20110101,D5960,HCPCS,MODIFY SPEECH AID PROSTHESIS,,,27 ,,NW,,,,,,$475.18,$0.00,1,0,1,1,1,1,20110101,D5982,HCPCS,SURGICAL STENT,,,27 ,,NW,,,,,,$509.61,$0.00,1,0,1,1,1,1,20110101,D5983,HCPCS,RADIATION APPLICATOR,,,27 ,,NW,,,,,,"$1,147.19",$0.00,1,0,1,1,1,1,20110101,D5984,HCPCS,RADIATION SHIELD,,,27 ,,NW,,,,,,"$1,397.12",$0.00,1,0,1,1,1,1,20110101,D5985,HCPCS,RADIATION CONE LOCATOR,,,27 ,,NW,,,,,,"$1,397.12",$0.00,1,0,1,1,1,1,20110101,D5986,HCPCS,FLUORIDE APPLICATOR,,,27 ,,NW,,,,,,$186.17,$0.00,1,0,1,1,1,1,20110101,D5987,HCPCS,COMMISSURE SPLINT,,,27 ,,NW,,,,,,"$1,771.48",$0.00,1,0,1,1,1,1,20110101,D5988,HCPCS,SURGICAL SPLINT,,,27 ,,NW,,,,,,$486.38,$0.00,1,0,1,1,1,1,20110101,D5991,HCPCS,TOPICAL MEDICAMENT CARRIER,,,27 ,,NW,,,,,,$206.52,$0.00,1,0,1,1,1,1,20110101,D5999,HCPCS,MAXILLOFACIAL PROSTHESIS,,,27 ,,NW,,,,,,$509.61,$0.00,1,0,1,1,1,1,20110101,D6010,HCPCS,ODONTICS ENDOSTEAL IMPLANT,,,27 ,,NW,,,,,,"$2,295.94",$0.00,1,0,1,1,1,1,20110101,D6012,HCPCS,ENDOSTEAL IMPLANT,,,27 ,,NW,,,,,,"$1,824.61",$0.00,1,0,1,1,1,1,20110101,D6040,HCPCS,ODONTICS EPOSTEAL IMPLANT,,,27 ,,NW,,,,,,"$8,732.93",$0.00,1,0,1,1,1,1,20110101,D6050,HCPCS,ODONTICS TRANSOSTEAL IMPLNT,,,27 ,,NW,,,,,,"$6,266.15",$0.00,1,0,1,1,1,1,20110101,D6053,HCPCS,IMPLNT/ABTMNT SPPRT REMV DNT,,,27 ,,NW,,,,,,"$2,512.15",$0.00,1,0,1,1,1,1,20110101,D6054,HCPCS,IMPLNT/ABTMNT SPPRT REMVPRTL,,,27 ,,NW,,,,,,"$2,364.80",$0.00,1,0,1,1,1,1,20110101,D6055,HCPCS,IMPLANT CONNECTING BAR,,,27 ,,NW,,,,,,$964.79,$0.00,1,0,1,1,1,1,20110101,D6056,HCPCS,PREFABRICATED ABUTMENT,,,27 ,,NW,,,,,,$689.57,$0.00,1,0,1,1,1,1,20110101,D6057,HCPCS,CUSTOM ABUTMENT,,,27 ,,NW,,,,,,$882.50,$0.00,1,0,1,1,1,1,20110101,D6058,HCPCS,ABUTMENT SUPPORTED CROWN,,,27 ,,NW,,,,,,"$1,544.28",$0.00,1,0,1,1,1,1,20110101,D6059,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,531.14",$0.00,1,0,1,1,1,1,20110101,D6060,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,424.13",$0.00,1,0,1,1,1,1,20110101,D6061,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,470.27",$0.00,1,0,1,1,1,1,20110101,D6062,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,496.37",$0.00,1,0,1,1,1,1,20110101,D6063,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,360.71",$0.00,1,0,1,1,1,1,20110101,D6064,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,466.43",$0.00,1,0,1,1,1,1,20110101,D6065,HCPCS,IMPLANT SUPPORTED CROWN,,,27 ,,NW,,,,,,"$1,593.49",$0.00,1,0,1,1,1,1,20110101,D6066,HCPCS,IMPLANT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,579.53",$0.00,1,0,1,1,1,1,20110101,D6067,HCPCS,IMPLANT SUPPORTED MTL CROWN,,,27 ,,NW,,,,,,"$1,573.93",$0.00,1,0,1,1,1,1,20110101,D6068,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,490.92",$0.00,1,0,1,1,1,1,20110101,D6069,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,534.32",$0.00,1,0,1,1,1,1,20110101,D6070,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,424.48",$0.00,1,0,1,1,1,1,20110101,D6071,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,447.74",$0.00,1,0,1,1,1,1,20110101,D6072,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,503.06",$0.00,1,0,1,1,1,1,20110101,D6073,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,429.75",$0.00,1,0,1,1,1,1,20110101,D6074,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,502.75",$0.00,1,0,1,1,1,1,20110101,D6075,HCPCS,IMPLANT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,567.89",$0.00,1,0,1,1,1,1,20110101,D6076,HCPCS,IMPLANT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,553.56",$0.00,1,0,1,1,1,1,20110101,D6077,HCPCS,IMPLANT SUPPORTED RETAINER,,,27 ,,NW,,,,,,"$1,491.70",$0.00,1,0,1,1,1,1,20110101,D6078,HCPCS,IMPLNT/ABUT SUPRTD FIXD DENT,,,27 ,,NW,,,,,,"$7,226.74",$0.00,1,0,1,1,1,1,20110101,D6079,HCPCS,IMPLNT/ABUT SUPRTD FIXD DENT,,,27 ,,NW,,,,,,"$4,448.79",$0.00,1,0,1,1,1,1,20110101,D6080,HCPCS,IMPLANT MAINTENANCE,,,27 ,,NW,,,,,,$128.16,$0.00,1,0,1,1,1,1,20110101,D6090,HCPCS,REPAIR IMPLANT,,,27 ,,NW,,,,,,$573.91,$0.00,1,0,1,1,1,1,20110101,D6091,HCPCS,REPL SEMI/PRECISION ATTACH,,,27 ,,NW,,,,,,$541.83,$0.00,1,0,1,1,1,1,20110101,D6092,HCPCS,RECEMENT SUPP CROWN,,,27 ,,NW,,,,,,$138.13,$0.00,1,0,1,1,1,1,20110101,D6093,HCPCS,RECEMENT SUPP PART DENTURE,,,27 ,,NW,,,,,,$174.62,$0.00,1,0,1,1,1,1,20110101,D6094,HCPCS,ABUT SUPPORT CROWN TITANIUM,,,27 ,,NW,,,,,,"$1,435.55",$0.00,1,0,1,1,1,1,20110101,D6095,HCPCS,ODONTICS REPR ABUTMENT,,,27 ,,NW,,,,,,$560.93,$0.00,1,0,1,1,1,1,20110101,D6100,HCPCS,REMOVAL OF IMPLANT,,,27 ,,NW,,,,,,$716.91,$0.00,1,0,1,1,1,1,20110101,D6190,HCPCS,RADIO/SURGICAL IMPLANT INDEX,,,27 ,,NW,,,,,,$306.05,$0.00,1,0,1,1,1,1,20110101,D6194,HCPCS,ABUT SUPPORT RETAINER TITANI,,,27 ,,NW,,,,,,"$1,412.61",$0.00,1,0,1,1,1,1,20110101,D6199,HCPCS,IMPLANT PROCEDURE,,,27 ,,NW,,,,,,"$1,544.28",$0.00,1,0,1,1,1,1,20110101,D6205,HCPCS,PONTIC-INDIRECT RESIN BASED,,,27 ,,NW,,,,,,$865.18,$0.00,1,0,1,1,1,1,20110101,D6210,HCPCS,PROSTHODONT HIGH NOBLE METAL,,,27 ,,NW,,,,,,"$1,108.42",$0.00,1,0,1,1,1,1,20110101,D6211,HCPCS,BRIDGE BASE METAL CAST,,,27 ,,NW,,,,,,"$1,038.47",$0.00,1,0,1,1,1,1,20110101,D6212,HCPCS,BRIDGE NOBLE METAL CAST,,,27 ,,NW,,,,,,"$1,098.15",$0.00,1,0,1,1,1,1,20110101,D6214,HCPCS,PONTIC TITANIUM,,,27 ,,NW,,,,,,"$1,320.12",$0.00,1,0,1,1,1,1,20110101,D6240,HCPCS,BRIDGE PORCELAIN HIGH NOBLE,,,27 ,,NW,,,,,,"$1,123.54",$0.00,1,0,1,1,1,1,20110101,D6241,HCPCS,BRIDGE PORCELAIN BASE METAL,,,27 ,,NW,,,,,,"$1,028.94",$0.00,1,0,1,1,1,1,20110101,D6242,HCPCS,BRIDGE PORCELAIN NOBEL METAL,,,27 ,,NW,,,,,,"$1,072.36",$0.00,1,0,1,1,1,1,20110101,D6245,HCPCS,BRIDGE PORCELAIN/CERAMIC,,,27 ,,NW,,,,,,"$1,179.83",$0.00,1,0,1,1,1,1,20110101,D6250,HCPCS,BRIDGE RESIN W/HIGH NOBLE,,,27 ,,NW,,,,,,"$1,086.42",$0.00,1,0,1,1,1,1,20110101,D6251,HCPCS,BRIDGE RESIN BASE METAL,,,27 ,,NW,,,,,,"$1,045.45",$0.00,1,0,1,1,1,1,20110101,D6252,HCPCS,BRIDGE RESIN W/NOBLE METAL,,,27 ,,NW,,,,,,"$1,056.25",$0.00,1,0,1,1,1,1,20110101,D6253,HCPCS,PROVISIONAL PONTIC,,,27 ,,NW,,,,,,$570.90,$0.00,1,0,1,1,1,1,20110101,D6545,HCPCS,DENTAL RETAINR CAST METL,,,27 ,,NW,,,,,,$617.90,$0.00,1,0,1,1,1,1,20110101,D6548,HCPCS,PORCELAIN/CERAMIC RETAINER,,,27 ,,NW,,,,,,$693.11,$0.00,1,0,1,1,1,1,20110101,D6600,HCPCS,PORCELAIN/CERAMIC INLAY 2SRF,,,27 ,,NW,,,,,,$947.11,$0.00,1,0,1,1,1,1,20110101,D6601,HCPCS,PORC/CERAM INLAY >= 3 SURFAC,,,27 ,,NW,,,,,,"$1,050.20",$0.00,1,0,1,1,1,1,20110101,D6602,HCPCS,CST HGH NBLE MTL INLAY 2 SRF,,,27 ,,NW,,,,,,$941.31,$0.00,1,0,1,1,1,1,20110101,D6603,HCPCS,CST HGH NBLE MTL INLAY >=3SR,,,27 ,,NW,,,,,,"$1,066.52",$0.00,1,0,1,1,1,1,20110101,D6604,HCPCS,CST BSE MTL INLAY 2 SURFACES,,,27 ,,NW,,,,,,$903.04,$0.00,1,0,1,1,1,1,20110101,D6605,HCPCS,CST BSE MTL INLAY >= 3 SURFA,,,27 ,,NW,,,,,,"$1,129.82",$0.00,1,0,1,1,1,1,20110101,D6606,HCPCS,CAST NOBLE METAL INLAY 2 SUR,,,27 ,,NW,,,,,,$900.68,$0.00,1,0,1,1,1,1,20110101,D6607,HCPCS,CST NOBLE MTL INLAY >=3 SURF,,,27 ,,NW,,,,,,"$1,058.47",$0.00,1,0,1,1,1,1,20110101,D6608,HCPCS,ONLAY PORC/CRMC 2 SURFACES,,,27 ,,NW,,,,,,"$1,021.30",$0.00,1,0,1,1,1,1,20110101,D6609,HCPCS,ONLAY PORC/CRMC >=3 SURFACES,,,27 ,,NW,,,,,,"$1,102.47",$0.00,1,0,1,1,1,1,20110101,D6610,HCPCS,ONLAY CST HGH NBL MTL 2 SRFC,,,27 ,,NW,,,,,,$998.14,$0.00,1,0,1,1,1,1,20110101,D6611,HCPCS,ONLAY CST HGH NBL MTL >=3SRF,,,27 ,,NW,,,,,,"$1,156.79",$0.00,1,0,1,1,1,1,20110101,D6612,HCPCS,ONLAY CST BASE MTL 2 SURFACE,,,27 ,,NW,,,,,,$963.62,$0.00,1,0,1,1,1,1,20110101,D6613,HCPCS,ONLAY CST BASE MTL >=3 SURFA,,,27 ,,NW,,,,,,"$1,062.91",$0.00,1,0,1,1,1,1,20110101,D6614,HCPCS,ONLAY CST NBL MTL 2 SURFACES,,,27 ,,NW,,,,,,$986.28,$0.00,1,0,1,1,1,1,20110101,D6615,HCPCS,ONLAY CST NBL MTL >=3 SURFAC,,,27 ,,NW,,,,,,"$1,125.15",$0.00,1,0,1,1,1,1,20110101,D6624,HCPCS,INLAY TITANIUM,,,27 ,,NW,,,,,,"$1,073.43",$0.00,1,0,1,1,1,1,20110101,D6634,HCPCS,ONLAY TITANIUM,,,27 ,,NW,,,,,,"$1,037.84",$0.00,1,0,1,1,1,1,20110101,D6710,HCPCS,CROWN-INDIRECT RESIN BASED,,,27 ,,NW,,,,,,$994.59,$0.00,1,0,1,1,1,1,20110101,D6720,HCPCS,RETAIN CROWN RESIN W HI NBLE,,,27 ,,NW,,,,,,"$1,093.17",$0.00,1,0,1,1,1,1,20110101,D6721,HCPCS,CROWN RESIN W/BASE METAL,,,27 ,,NW,,,,,,"$1,030.75",$0.00,1,0,1,1,1,1,20110101,D6722,HCPCS,CROWN RESIN W/NOBLE METAL,,,27 ,,NW,,,,,,"$1,062.07",$0.00,1,0,1,1,1,1,20110101,D6740,HCPCS,CROWN PORCELAIN/CERAMIC,,,27 ,,NW,,,,,,"$1,194.41",$0.00,1,0,1,1,1,1,20110101,D6750,HCPCS,CROWN PORCELAIN HIGH NOBLE,,,27 ,,NW,,,,,,"$1,132.07",$0.00,1,0,1,1,1,1,20110101,D6751,HCPCS,CROWN PORCELAIN BASE METAL,,,27 ,,NW,,,,,,"$1,035.70",$0.00,1,0,1,1,1,1,20110101,D6752,HCPCS,CROWN PORCELAIN NOBLE METAL,,,27 ,,NW,,,,,,"$1,066.51",$0.00,1,0,1,1,1,1,20110101,D6780,HCPCS,CROWN 3/4 HIGH NOBLE METAL,,,27 ,,NW,,,,,,"$1,098.57",$0.00,1,0,1,1,1,1,20110101,D6781,HCPCS,CROWN 3/4 CAST BASED METAL,,,27 ,,NW,,,,,,"$1,110.67",$0.00,1,0,1,1,1,1,20110101,D6782,HCPCS,CROWN 3/4 CAST NOBLE METAL,,,27 ,,NW,,,,,,"$1,108.20",$0.00,1,0,1,1,1,1,20110101,D6783,HCPCS,CROWN 3/4 PORCELAIN/CERAMIC,,,27 ,,NW,,,,,,"$1,132.17",$0.00,1,0,1,1,1,1,20110101,D6790,HCPCS,CROWN FULL HIGH NOBLE METAL,,,27 ,,NW,,,,,,"$1,105.50",$0.00,1,0,1,1,1,1,20110101,D6791,HCPCS,CROWN FULL BASE METAL CAST,,,27 ,,NW,,,,,,"$1,034.20",$0.00,1,0,1,1,1,1,20110101,D6792,HCPCS,CROWN FULL NOBLE METAL CAST,,,27 ,,NW,,,,,,"$1,090.48",$0.00,1,0,1,1,1,1,20110101,D6793,HCPCS,PROVISIONAL RETAINER CROWN,,,27 ,,NW,,,,,,$475.35,$0.00,1,0,1,1,1,1,20110101,D6794,HCPCS,CROWN TITANIUM,,,27 ,,NW,,,,,,"$1,292.10",$0.00,1,0,1,1,1,1,20110101,D6920,HCPCS,DENTAL CONNECTOR BAR,,,27 ,,NW,,,,,,$260.46,$0.00,1,0,1,1,1,1,20110101,D6930,HCPCS,DENTAL RECEMENT BRIDGE,,,27 ,,NW,,,,,,$163.51,$0.00,1,0,1,1,1,1,20110101,D6940,HCPCS,STRESS BREAKER,,,27 ,,NW,,,,,,$385.01,$0.00,1,0,1,1,1,1,20110101,D6950,HCPCS,PRECISION ATTACHMENT,,,27 ,,NW,,,,,,$646.34,$0.00,1,0,1,1,1,1,20110101,D6970,HCPCS,POST & CORE PLUS RETAINER,,,27 ,,NW,,,,,,$431.12,$0.00,1,0,1,1,1,1,20110101,D6972,HCPCS,PREFAB POST & CORE PLUS RETA,,,27 ,,NW,,,,,,$348.49,$0.00,1,0,1,1,1,1,20110101,D6973,HCPCS,CORE BUILD UP FOR RETAINER,,,27 ,,NW,,,,,,$276.27,$0.00,1,0,1,1,1,1,20110101,D6975,HCPCS,COPING METAL,,,27 ,,NW,,,,,,$752.61,$0.00,1,0,1,1,1,1,20110101,D6976,HCPCS,EACH ADDTNL CAST POST,,,27 ,,NW,,,,,,$249.08,$0.00,1,0,1,1,1,1,20110101,D6977,HCPCS,EACH ADDTL PREFAB POST,,,27 ,,NW,,,,,,$183.49,$0.00,1,0,1,1,1,1,20110101,D6980,HCPCS,BRIDGE REPAIR,,,27 ,,NW,,,,,,$369.95,$0.00,1,0,1,1,1,1,20110101,D6985,HCPCS,PEDIATRIC PARTIAL DENTURE FX,,,27 ,,NW,,,,,,$743.31,$0.00,1,0,1,1,1,1,20110101,D6999,HCPCS,FIXED PROSTHODONTIC PROC,,,27 ,,NW,,,,,,"$1,123.54",$0.00,1,0,1,1,1,1,20110101,D7111,HCPCS,EXTRACTION CORONAL REMNANTS,,,26 ,,NW,,,,,,$132.23,$0.00,1,0,1,1,1,1,20110101,D7140,HCPCS,EXTRACTION ERUPTED TOOTH/EXR,,,26 ,,NW,,,,,,$169.74,$0.00,1,0,1,1,1,1,20110101,D7210,HCPCS,REM IMP TOOTH W MUCOPER FLP,,,26 ,,NW,,,,,,$288.24,$0.00,1,0,1,1,1,1,20110101,D7220,HCPCS,IMPACT TOOTH REMOV SOFT TISS,,,26 ,,NW,,,,,,$338.72,$0.00,1,0,1,1,1,1,20110101,D7230,HCPCS,IMPACT TOOTH REMOV PART BONY,,,26 ,,NW,,,,,,$431.71,$0.00,1,0,1,1,1,1,20110101,D7240,HCPCS,IMPACT TOOTH REMOV COMP BONY,,,26 ,,NW,,,,,,$513.92,$0.00,1,0,1,1,1,1,20110101,D7241,HCPCS,IMPACT TOOTH REM BONY W/COMP,,,26 ,,NW,,,,,,$634.40,$0.00,1,0,1,1,1,1,20110101,D7250,HCPCS,TOOTH ROOT REMOVAL,,,26 ,,NW,,,,,,$308.17,$0.00,1,0,1,1,1,1,20110101,D7260,HCPCS,ORAL ANTRAL FISTULA CLOSURE,,,26 ,,NW,,,,,,"$1,438.90",$0.00,1,0,1,1,1,1,20110101,D7261,HCPCS,PRIMARY CLOSURE SINUS PERF,,,26 ,,NW,,,,,,$782.30,$0.00,1,0,1,1,1,1,20110101,D7270,HCPCS,TOOTH REIMPLANTATION,,,26 ,,NW,,,,,,$563.05,$0.00,1,0,1,1,1,1,20110101,D7272,HCPCS,TOOTH TRANSPLANTATION,,,26 ,,NW,,,,,,$718.09,$0.00,1,0,1,1,1,1,20110101,D7280,HCPCS,EXPOSURE IMPACT TOOTH ORTHOD,,,26 ,,NW,,,,,,$538.22,$0.00,1,0,1,1,1,1,20110101,D7282,HCPCS,MOBILIZE ERUPTED/MALPOS TOOT,,,26 ,,NW,,,,,,$390.16,$0.00,1,0,1,1,1,1,20110101,D7283,HCPCS,PLACE DEVICE IMPACTED TOOTH,,,26 ,,NW,,,,,,$223.68,$0.00,1,0,1,1,1,1,20110101,D7285,HCPCS,BIOPSY OF ORAL TISSUE HARD,,,26 ,,NW,,,,,,$733.14,$0.00,1,0,1,1,1,1,20110101,D7286,HCPCS,BIOPSY OF ORAL TISSUE SOFT,,,26 ,,NW,,,,,,$402.64,$0.00,1,0,1,1,1,1,20110101,D7287,HCPCS,EXFOLIATIVE CYTOLOG COLLECT,,,26 ,,NW,,,,,,$188.03,$0.00,1,0,1,1,1,1,20110101,D7288,HCPCS,BRUSH BIOPSY,,,26 ,,NW,,,,,,$192.55,$0.00,1,0,1,1,1,1,20110101,D7290,HCPCS,REPOSITIONING OF TEETH,,,26 ,,NW,,,,,,$501.50,$0.00,1,0,1,1,1,1,20110101,D7291,HCPCS,TRANSSEPTAL FIBEROTOMY,,,26 ,,NW,,,,,,$253.71,$0.00,1,0,1,1,1,1,20110101,D7292,HCPCS,SCREW RETAINED PLATE,,,26 ,,NW,,,,,,$781.65,$0.00,1,0,1,1,1,1,20110101,D7293,HCPCS,TEMP ANCHORAGE DEV W FLAP,,,26 ,,NW,,,,,,$488.53,$0.00,1,0,1,1,1,1,20110101,D7294,HCPCS,TEMP ANCHORAGE DEV W/O FLAP,,,26 ,,NW,,,,,,$398.31,$0.00,1,0,1,1,1,1,20110101,D7310,HCPCS,ALVEOPLASTY W/ EXTRACTION,,,26 ,,NW,,,,,,$319.98,$0.00,1,0,1,1,1,1,20110101,D7311,HCPCS,ALVEOLOPLASTY W/EXTRACT 1-3,,,26 ,,NW,,,,,,$307.31,$0.00,1,0,1,1,1,1,20110101,D7320,HCPCS,ALVEOPLASTY W/O EXTRACTION,,,26 ,,NW,,,,,,$490.78,$0.00,1,0,1,1,1,1,20110101,D7321,HCPCS,ALVEOLOPLASTY NOT W/EXTRACTS,,,26 ,,NW,,,,,,$439.61,$0.00,1,0,1,1,1,1,20110101,D7340,HCPCS,VESTIBULOPLASTY RIDGE EXTENS,,,26 ,,NW,,,,,,"$1,410.32",$0.00,1,0,1,1,1,1,20110101,D7350,HCPCS,VESTIBULOPLASTY EXTEN GRAFT,,,26 ,,NW,,,,,,"$2,313.75",$0.00,1,0,1,1,1,1,20110101,D7410,HCPCS,RAD EXC LESION UP TO 1.25 CM,,,26 ,,NW,,,,,,$494.32,$0.00,1,0,1,1,1,1,20110101,D7411,HCPCS,EXCISION BENIGN LESION>1.25C,,,26 ,,NW,,,,,,$759.11,$0.00,1,0,1,1,1,1,20110101,D7412,HCPCS,EXCISION BENIGN LESION COMPL,,,26 ,,NW,,,,,,"$1,343.75",$0.00,1,0,1,1,1,1,20110101,D7413,HCPCS,EXCISION MALIG LESION<=1.25C,,,26 ,,NW,,,,,,$963.61,$0.00,1,0,1,1,1,1,20110101,D7414,HCPCS,EXCISION MALIG LESION>1.25CM,,,26 ,,NW,,,,,,"$1,422.13",$0.00,1,0,1,1,1,1,20110101,D7415,HCPCS,EXCISION MALIG LES COMPLICAT,,,26 ,,NW,,,,,,"$1,494.26",$0.00,1,0,1,1,1,1,20110101,D7440,HCPCS,MALIG TUMOR EXC TO 1.25 CM,,,26 ,,NW,,,,,,$696.01,$0.00,1,0,1,1,1,1,20110101,D7441,HCPCS,MALIG TUMOR > 1.25 CM,,,26 ,,NW,,,,,,"$1,709.02",$0.00,1,0,1,1,1,1,20110101,D7450,HCPCS,REM ODONTOGEN CYST TO 1.25CM,,,26 ,,NW,,,,,,$790.98,$0.00,1,0,1,1,1,1,20110101,D7451,HCPCS,REM ODONTOGEN CYST > 1.25 CM,,,26 ,,NW,,,,,,"$1,146.38",$0.00,1,0,1,1,1,1,20110101,D7460,HCPCS,REM NONODONTO CYST TO 1.25CM,,,26 ,,NW,,,,,,$758.41,$0.00,1,0,1,1,1,1,20110101,D7461,HCPCS,REM NONODONTO CYST > 1.25 CM,,,26 ,,NW,,,,,,"$1,180.55",$0.00,1,0,1,1,1,1,20110101,D7465,HCPCS,LESION DESTRUCTION,,,26 ,,NW,,,,,,$475.20,$0.00,1,0,1,1,1,1,20110101,D7471,HCPCS,REM EXOSTOSIS ANY SITE,,,26 ,,NW,,,,,,$936.16,$0.00,1,0,1,1,1,1,20110101,D7472,HCPCS,REMOVAL OF TORUS PALATINUS,,,26 ,,NW,,,,,,"$1,140.95",$0.00,1,0,1,1,1,1,20110101,D7473,HCPCS,REMOVE TORUS MANDIBULARIS,,,26 ,,NW,,,,,,"$1,059.05",$0.00,1,0,1,1,1,1,20110101,D7485,HCPCS,SURG REDUCT OSSEOUSTUBEROSIT,,,26 ,,NW,,,,,,$942.26,$0.00,1,0,1,1,1,1,20110101,D7490,HCPCS,MAXILLA OR MANDIBLE RESECTIO,,,26 ,,NW,,,,,,"$9,271.56",$0.00,1,0,1,1,1,1,20110101,D7510,HCPCS,I&D ABSC INTRAORAL SOFT TISS,,,26 ,,NW,,,,,,$298.76,$0.00,1,0,1,1,1,1,20110101,D7511,HCPCS,INCISION/DRAIN ABSCESS INTRA,,,26 ,,NW,,,,,,$458.04,$0.00,1,0,1,1,1,1,20110101,D7520,HCPCS,I&D ABSCESS EXTRAORAL,,,26 ,,NW,,,,,,$693.61,$0.00,1,0,1,1,1,1,20110101,D7521,HCPCS,INCISION/DRAIN ABSCESS EXTRA,,,26 ,,NW,,,,,,$762.65,$0.00,1,0,1,1,1,1,20110101,D7530,HCPCS,REMOVAL FB SKIN/AREOLAR TISS,,,26 ,,NW,,,,,,$470.53,$0.00,1,0,1,1,1,1,20110101,D7540,HCPCS,REMOVAL OF FB REACTION,,,26 ,,NW,,,,,,$688.79,$0.00,1,0,1,1,1,1,20110101,D7550,HCPCS,REMOVAL OF SLOUGHED OFF BONE,,,26 ,,NW,,,,,,$501.51,$0.00,1,0,1,1,1,1,20110101,D7560,HCPCS,MAXILLARY SINUSOTOMY,,,26 ,,NW,,,,,,"$2,444.40",$0.00,1,0,1,1,1,1,20110101,D7610,HCPCS,MAXILLA OPEN REDUCT SIMPLE,,,26 ,,NW,,,,,,"$5,100.93",$0.00,1,0,1,1,1,1,20110101,D7620,HCPCS,CLSD REDUCT SIMPL MAXILLA FX,,,26 ,,NW,,,,,,"$3,976.65",$0.00,1,0,1,1,1,1,20110101,D7630,HCPCS,OPEN RED SIMPL MANDIBLE FX,,,26 ,,NW,,,,,,"$5,486.73",$0.00,1,0,1,1,1,1,20110101,D7640,HCPCS,CLSD RED SIMPL MANDIBLE FX,,,26 ,,NW,,,,,,"$3,930.92",$0.00,1,0,1,1,1,1,20110101,D7650,HCPCS,OPEN RED SIMP MALAR/ZYGOM FX,,,26 ,,NW,,,,,,"$3,816.03",$0.00,1,0,1,1,1,1,20110101,D7660,HCPCS,CLSD RED SIMP MALAR/ZYGOM FX,,,26 ,,NW,,,,,,"$2,761.22",$0.00,1,0,1,1,1,1,20110101,D7670,HCPCS,CLOSD RDUCTN SPLINT ALVEOLUS,,,26 ,,NW,,,,,,"$1,715.01",$0.00,1,0,1,1,1,1,20110101,D7671,HCPCS,ALVEOLUS OPEN REDUCTION,,,26 ,,NW,,,,,,"$1,479.30",$0.00,1,0,1,1,1,1,20110101,D7680,HCPCS,REDUCT SIMPLE FACIAL BONE FX,,,26 ,,NW,,,,,,"$9,032.07",$0.00,1,0,1,1,1,1,20110101,D7710,HCPCS,MAXILLA OPEN REDUCT COMPOUND,,,26 ,,NW,,,,,,"$5,817.01",$0.00,1,0,1,1,1,1,20110101,D7720,HCPCS,CLSD REDUCT COMPD MAXILLA FX,,,26 ,,NW,,,,,,"$3,756.80",$0.00,1,0,1,1,1,1,20110101,D7730,HCPCS,OPEN REDUCT COMPD MANDBLE FX,,,26 ,,NW,,,,,,"$6,680.29",$0.00,1,0,1,1,1,1,20110101,D7740,HCPCS,CLSD REDUCT COMPD MANDBLE FX,,,26 ,,NW,,,,,,"$4,174.68",$0.00,1,0,1,1,1,1,20110101,D7750,HCPCS,OPEN RED COMP MALAR/ZYGMA FX,,,26 ,,NW,,,,,,"$4,648.25",$0.00,1,0,1,1,1,1,20110101,D7760,HCPCS,CLSD RED COMP MALAR/ZYGMA FX,,,26 ,,NW,,,,,,"$2,275.66",$0.00,1,0,1,1,1,1,20110101,D7770,HCPCS,OPEN REDUC COMPD ALVEOLUS FX,,,26 ,,NW,,,,,,"$2,874.32",$0.00,1,0,1,1,1,1,20110101,D7771,HCPCS,ALVEOLUS CLSD REDUC STBLZ TE,,,26 ,,NW,,,,,,"$2,208.12",$0.00,1,0,1,1,1,1,20110101,D7780,HCPCS,REDUCT COMPND FACIAL BONE FX,,,26 ,,NW,,,,,,"$11,942.09",$0.00,1,0,1,1,1,1,20110101,D7810,HCPCS,TMJ OPEN REDUCT-DISLOCATION,,,26 ,,NW,,,,,,"$5,425.21",$0.00,1,0,1,1,1,1,20110101,D7820,HCPCS,CLOSED TMP MANIPULATION,,,26 ,,NW,,,,,,$862.07,$0.00,1,0,1,1,1,1,20110101,D7830,HCPCS,TMJ MANIPULATION UNDER ANEST,,,26 ,,NW,,,,,,$719.92,$0.00,1,0,1,1,1,1,20110101,D7840,HCPCS,REMOVAL OF TMJ CONDYLE,,,26 ,,NW,,,,,,"$7,275.33",$0.00,1,0,1,1,1,1,20110101,D7850,HCPCS,TMJ MENISCECTOMY,,,26 ,,NW,,,,,,"$6,622.39",$0.00,1,0,1,1,1,1,20110101,D7852,HCPCS,TMJ REPAIR OF JOINT DISC,,,26 ,,NW,,,,,,"$7,214.37",$0.00,1,0,1,1,1,1,20110101,D7854,HCPCS,TMJ EXCISN OF JOINT MEMBRANE,,,26 ,,NW,,,,,,"$7,260.40",$0.00,1,0,1,1,1,1,20110101,D7856,HCPCS,TMJ CUTTING OF A MUSCLE,,,26 ,,NW,,,,,,"$5,067.61",$0.00,1,0,1,1,1,1,20110101,D7858,HCPCS,TMJ RECONSTRUCTION,,,26 ,,NW,,,,,,"$16,400.59",$0.00,1,0,1,1,1,1,20110101,D7860,HCPCS,TMJ CUTTING INTO JOINT,,,26 ,,NW,,,,,,"$7,623.19",$0.00,1,0,1,1,1,1,20110101,D7865,HCPCS,TMJ RESHAPING COMPONENTS,,,26 ,,NW,,,,,,"$10,686.23",$0.00,1,0,1,1,1,1,20110101,D7870,HCPCS,TMJ ASPIRATION JOINT FLUID,,,26 ,,NW,,,,,,$454.56,$0.00,1,0,1,1,1,1,20110101,D7871,HCPCS,LYSIS + LAVAGE W CATHETERS,,,26 ,,NW,,,,,,$801.81,$0.00,1,0,1,1,1,1,20110101,D7872,HCPCS,TMJ DIAGNOSTIC ARTHROSCOPY,,,26 ,,NW,,,,,,"$3,973.50",$0.00,1,0,1,1,1,1,20110101,D7873,HCPCS,TMJ ARTHROSCOPY LYSIS ADHESN,,,26 ,,NW,,,,,,"$5,217.45",$0.00,1,0,1,1,1,1,20110101,D7874,HCPCS,TMJ ARTHROSCOPY DISC REPOSIT,,,26 ,,NW,,,,,,"$6,862.58",$0.00,1,0,1,1,1,1,20110101,D7875,HCPCS,TMJ ARTHROSCOPY SYNOVECTOMY,,,26 ,,NW,,,,,,"$7,518.08",$0.00,1,0,1,1,1,1,20110101,D7876,HCPCS,TMJ ARTHROSCOPY DISCECTOMY,,,26 ,,NW,,,,,,"$8,105.61",$0.00,1,0,1,1,1,1,20110101,D7877,HCPCS,TMJ ARTHROSCOPY DEBRIDEMENT,,,26 ,,NW,,,,,,"$7,153.91",$0.00,1,0,1,1,1,1,20110101,D7880,HCPCS,OCCLUSAL ORTHOTIC APPLIANCE,,,26 ,,NW,,,,,,$989.56,$0.00,1,0,1,1,1,1,20110101,D7899,HCPCS,TMJ UNSPECIFIED THERAPY,,,26 ,,NW,,,,,,$989.56,$0.00,1,0,1,1,1,1,20110101,D7910,HCPCS,DENT SUTUR RECENT WND TO 5CM,,,26 ,,NW,,,,,,$403.71,$0.00,1,0,1,1,1,1,20110101,D7911,HCPCS,DENTAL SUTURE WOUND TO 5 CM,,,26 ,,NW,,,,,,$510.25,$0.00,1,0,1,1,1,1,20110101,D7912,HCPCS,SUTURE COMPLICATE WND > 5 CM,,,26 ,,NW,,,,,,$951.02,$0.00,1,0,1,1,1,1,20110101,D7920,HCPCS,DENTAL SKIN GRAFT,,,26 ,,NW,,,,,,"$3,576.50",$0.00,1,0,1,1,1,1,20110101,D7940,HCPCS,RESHAPING BONE ORTHOGNATHIC,,,26 ,,NW,,,,,,"$2,732.72",$0.00,1,0,1,1,1,1,20110101,D7941,HCPCS,BONE CUTTING RAMUS CLOSED,,,26 ,,NW,,,,,,"$9,432.33",$0.00,1,0,1,1,1,1,20110101,D7943,HCPCS,CUTTING RAMUS OPEN W/GRAFT,,,26 ,,NW,,,,,,"$8,078.35",$0.00,1,0,1,1,1,1,20110101,D7944,HCPCS,BONE CUTTING SEGMENTED,,,26 ,,NW,,,,,,"$6,743.81",$0.00,1,0,1,1,1,1,20110101,D7945,HCPCS,BONE CUTTING BODY MANDIBLE,,,26 ,,NW,,,,,,"$8,960.60",$0.00,1,0,1,1,1,1,20110101,D7946,HCPCS,RECONSTRUCTION MAXILLA TOTAL,,,26 ,,NW,,,,,,"$10,473.35",$0.00,1,0,1,1,1,1,20110101,D7947,HCPCS,RECONSTRUCT MAXILLA SEGMENT,,,26 ,,NW,,,,,,"$10,608.50",$0.00,1,0,1,1,1,1,20110101,D7948,HCPCS,RECONSTRUCT MIDFACE NO GRAFT,,,26 ,,NW,,,,,,"$13,171.45",$0.00,1,0,1,1,1,1,20110101,D7949,HCPCS,RECONSTRUCT MIDFACE W/GRAFT,,,26 ,,NW,,,,,,"$16,650.21",$0.00,1,0,1,1,1,1,20110101,D7950,HCPCS,MANDIBLE GRAFT,,,26 ,,NW,,,,,,"$2,565.56",$0.00,1,0,1,1,1,1,20110101,D7951,HCPCS,SINUS AUG W BONE/BONE SUP,,,26 ,,NW,,,,,,"$3,047.27",$0.00,1,0,1,1,1,1,20110101,D7953,HCPCS,BONE REPLACEMENT GRAFT,,,26 ,,NW,,,,,,$374.34,$0.00,1,0,1,1,1,1,20110101,D7955,HCPCS,REPAIR MAXILLOFACIAL DEFECTS,,,26 ,,NW,,,,,,"$2,805.83",$0.00,1,0,1,1,1,1,20110101,D7960,HCPCS,FRENULECTOMY/FRENULOTOMY,,,26 ,,NW,,,,,,$499.67,$0.00,1,0,1,1,1,1,20110101,D7963,HCPCS,FRENULOPLASTY,,,26 ,,NW,,,,,,$624.00,$0.00,1,0,1,1,1,1,20110101,D7970,HCPCS,EXCISION HYPERPLASTIC TISSUE,,,26 ,,NW,,,,,,$582.16,$0.00,1,0,1,1,1,1,20110101,D7971,HCPCS,EXCISION PERICORONAL GINGIVA,,,26 ,,NW,,,,,,$272.71,$0.00,1,0,1,1,1,1,20110101,D7972,HCPCS,SURG REDCT FIBROUS TUBEROSIT,,,26 ,,NW,,,,,,$818.16,$0.00,1,0,1,1,1,1,20110101,D7980,HCPCS,SIALOLITHOTOMY,,,26 ,,NW,,,,,,$925.06,$0.00,1,0,1,1,1,1,20110101,D7981,HCPCS,EXCISION OF SALIVARY GLAND,,,26 ,,NW,,,,,,$617.52,$0.00,1,0,1,1,1,1,20110101,D7982,HCPCS,SIALODOCHOPLASTY,,,26 ,,NW,,,,,,"$1,825.36",$0.00,1,0,1,1,1,1,20110101,D7983,HCPCS,CLOSURE OF SALIVARY FISTULA,,,26 ,,NW,,,,,,"$2,081.27",$0.00,1,0,1,1,1,1,20110101,D7990,HCPCS,EMERGENCY TRACHEOTOMY,,,26 ,,NW,,,,,,"$1,856.18",$0.00,1,0,1,1,1,1,20110101,D7991,HCPCS,DENTAL CORONOIDECTOMY,,,26 ,,NW,,,,,,"$4,871.81",$0.00,1,0,1,1,1,1,20110101,D7995,HCPCS,SYNTHETIC GRAFT FACIAL BONES,,,26 ,,NW,,,,,,$464.46,$0.00,1,0,1,1,1,1,20110101,D7996,HCPCS,IMPLANT MANDIBLE FOR AUGMENT,,,26 ,,NW,,,,,,"$1,952.85",$0.00,1,0,1,1,1,1,20110101,D7997,HCPCS,APPLIANCE REMOVAL,,,26 ,,NW,,,,,,$360.67,$0.00,1,0,1,1,1,1,20110101,D7998,HCPCS,INTRAORAL PLACE OF FIX DEV,,,26 ,,NW,,,,,,"$2,322.46",$0.00,1,0,1,1,1,1,20110101,D7999,HCPCS,ORAL SURGERY PROCEDURE,,,26 ,,NW,,,,,,$374.34,$0.00,1,0,1,1,1,1,20110101,D8010,HCPCS,LIMITED DENTAL TX PRIMARY,,,27 ,,NW,,,,,,"$2,288.52",$0.00,1,0,1,1,1,1,20110101,D8020,HCPCS,LIMITED DENTAL TX TRANSITION,,,27 ,,NW,,,,,,"$2,583.21",$0.00,1,0,1,1,1,1,20110101,D8030,HCPCS,LIMITED DENTAL TX ADOLESCENT,,,27 ,,NW,,,,,,"$3,058.68",$0.00,1,0,1,1,1,1,20110101,D8040,HCPCS,LIMITED DENTAL TX ADULT,,,27 ,,NW,,,,,,"$3,396.21",$0.00,1,0,1,1,1,1,20110101,D8050,HCPCS,INTERCEP DENTAL TX PRIMARY,,,27 ,,NW,,,,,,"$2,772.35",$0.00,1,0,1,1,1,1,20110101,D8060,HCPCS,INTERCEP DENTAL TX TRANSITN,,,27 ,,NW,,,,,,"$3,006.43",$0.00,1,0,1,1,1,1,20110101,D8070,HCPCS,COMPRE DENTAL TX TRANSITION,,,27 ,,NW,,,,,,"$5,563.52",$0.00,1,0,1,1,1,1,20110101,D8080,HCPCS,COMPRE DENTAL TX ADOLESCENT,,,27 ,,NW,,,,,,"$5,536.35",$0.00,1,0,1,1,1,1,20110101,D8090,HCPCS,COMPRE DENTAL TX ADULT,,,27 ,,NW,,,,,,"$5,788.19",$0.00,1,0,1,1,1,1,20110101,D8210,HCPCS,ORTHODONTIC REM APPLIANCE TX,,,27 ,,NW,,,,,,$954.07,$0.00,1,0,1,1,1,1,20110101,D8220,HCPCS,FIXED APPLIANCE THERAPY HABT,,,27 ,,NW,,,,,,"$1,054.39",$0.00,1,0,1,1,1,1,20110101,D8660,HCPCS,PREORTHODONTIC TX VISIT,,,27 ,,NW,,,,,,$398.14,$0.00,1,0,1,1,1,1,20110101,D8670,HCPCS,PERIODIC ORTHODONTC TX VISIT,,,27 ,,NW,,,,,,$273.79,$0.00,1,0,1,1,1,1,20110101,D8680,HCPCS,ORTHODONTIC RETENTION,,,27 ,,NW,,,,,,$610.27,$0.00,1,0,1,1,1,1,20110101,D8690,HCPCS,ORTHODONTIC TREATMENT,,,27 ,,NW,,,,,,$290.51,$0.00,1,0,1,1,1,1,20110101,D8691,HCPCS,REPAIR ORTHO APPLIANCE,,,27 ,,NW,,,,,,$221.54,$0.00,1,0,1,1,1,1,20110101,D8692,HCPCS,REPLACEMENT RETAINER,,,27 ,,NW,,,,,,$349.03,$0.00,1,0,1,1,1,1,20110101,D8693,HCPCS,REBOND/CEMENT/REPAIR RETAIN,,,27 ,,NW,,,,,,$377.24,$0.00,1,0,1,1,1,1,20110101,D8999,HCPCS,ORTHODONTIC PROCEDURE,,,27 ,,NW,,,,,,$273.79,$0.00,1,0,1,1,1,1,20110101,D9110,HCPCS,TX DENTAL PAIN MINOR PROC,,,26 ,,NW,,,,,,$127.13,$0.00,1,0,1,1,1,1,20110101,D9120,HCPCS,FIX PARTIAL DENTURE SECTION,,,27 ,,NW,,,,,,$188.07,$0.00,1,0,1,1,1,1,20110101,D9210,HCPCS,DENT ANESTHESIA W/O SURGERY,,,26 ,,NW,,,,,,$56.47,$0.00,1,0,1,1,1,1,20110101,D9211,HCPCS,REGIONAL BLOCK ANESTHESIA,,,26 ,,NW,,,,,,$44.56,$0.00,1,0,1,1,1,1,20110101,D9212,HCPCS,TRIGEMINAL BLOCK ANESTHESIA,,,26 ,,NW,,,,,,$73.58,$0.00,1,0,1,1,1,1,20110101,D9215,HCPCS,LOCAL ANESTHESIA,,,26 ,,NW,,,,,,$47.03,$0.00,1,0,1,1,1,1,20110101,D9220,HCPCS,GENERAL ANESTHESIA,,,26 ,,NW,,,,,,$424.87,$0.00,1,0,1,1,1,1,20110101,D9221,HCPCS,GENERAL ANESTHESIA EA AD 15M,,,26 ,,NW,,,,,,$181.80,$0.00,1,0,1,1,1,1,20110101,D9230,HCPCS,ANALGESIA,,,26 ,,NW,,,,,,$74.18,$0.00,1,0,1,1,1,1,20110101,D9241,HCPCS,INTRAVENOUS SEDATION,,,26 ,,NW,,,,,,$386.06,$0.00,1,0,1,1,1,1,20110101,D9242,HCPCS,IV SEDATION EA AD 30 M,,,26 ,,NW,,,,,,$163.96,$0.00,1,0,1,1,1,1,20110101,D9248,HCPCS,SEDATION (NON-IV),,,26 ,,NW,,,,,,$127.82,$0.00,1,0,1,1,1,1,20110101,D9310,HCPCS,DENTAL CONSULTATION,,,25 ,,NW,,,,,,$141.23,$0.00,1,0,1,1,1,1,20110101,D9410,HCPCS,DENTAL HOUSE CALL,,,25 ,,NW,,,,,,$114.13,$0.00,1,0,1,1,1,1,20110101,D9420,HCPCS,HOSPITAL CALL,,,25 ,,NW,,,,,,$298.74,$0.00,1,0,1,1,1,1,20110101,D9430,HCPCS,OFFICE VISIT DURING HOURS,,,25 ,,NW,,,,,,$76.12,$0.00,1,0,1,1,1,1,20110101,D9440,HCPCS,OFFICE VISIT AFTER HOURS,,,25 ,,NW,,,,,,$142.02,$0.00,1,0,1,1,1,1,20110101,D9450,HCPCS,CASE PRESENTATION TX PLAN,,,25 ,,NW,,,,,,$57.12,$0.00,1,0,1,1,1,1,20110101,D9610,HCPCS,DENT THERAPEUTIC DRUG INJECT,,,27 ,,NW,,,,,,$94.41,$0.00,1,0,1,1,1,1,20110101,D9612,HCPCS,THERA PAR DRUGS 2 OR > ADMIN,,,27 ,,NW,,,,,,$145.18,$0.00,1,0,1,1,1,1,20110101,D9630,HCPCS,OTHER DRUGS/MEDICAMENTS,,,27 ,,NW,,,,,,$47.76,$0.00,1,0,1,1,1,1,20110101,D9910,HCPCS,DENT APPL DESENSITIZING MED,,,27 ,,NW,,,,,,$61.70,$0.00,1,0,1,1,1,1,20110101,D9911,HCPCS,APPL DESENSITIZING RESIN,,,27 ,,NW,,,,,,$79.17,$0.00,1,0,1,1,1,1,20110101,D9920,HCPCS,BEHAVIOR MANAGEMENT,,,27 ,,NW,,,,,,$150.10,$0.00,1,0,1,1,1,1,20110101,D9930,HCPCS,TREATMENT OF COMPLICATIONS,,,27 ,,NW,,,,,,$124.89,$0.00,1,0,1,1,1,1,20110101,D9940,HCPCS,DENTAL OCCLUSAL GUARD,,,27 ,,NW,,,,,,$576.79,$0.00,1,0,1,1,1,1,20110101,D9941,HCPCS,FABRICATION ATHLETIC GUARD,,,27 ,,NW,,,,,,$211.88,$0.00,1,0,1,1,1,1,20110101,D9942,HCPCS,REPAIR/RELINE OCCLUSAL GUARD,,,27 ,,NW,,,,,,$220.92,$0.00,1,0,1,1,1,1,20110101,D9950,HCPCS,OCCLUSION ANALYSIS,,,27 ,,NW,,,,,,$353.57,$0.00,1,0,1,1,1,1,20110101,D9951,HCPCS,LIMITED OCCLUSAL ADJUSTMENT,,,27 ,,NW,,,,,,$166.95,$0.00,1,0,1,1,1,1,20110101,D9952,HCPCS,COMPLETE OCCLUSAL ADJUSTMENT,,,27 ,,NW,,,,,,$696.89,$0.00,1,0,1,1,1,1,20110101,D9970,HCPCS,ENAMEL MICROABRASION,,,27 ,,NW,,,,,,$78.80,$0.00,1,0,1,1,1,1,20110101,D9971,HCPCS,ODONTOPLASTY 1-2 TEETH,,,27 ,,NW,,,,,,$98.42,$0.00,1,0,1,1,1,1,20110101,D9972,HCPCS,EXTRNL BLEACHING PER ARCH,,,27 ,,NW,,,,,,$343.15,$0.00,1,0,1,1,1,1,20110101,D9973,HCPCS,EXTRNL BLEACHING PER TOOTH,,,27 ,,NW,,,,,,$61.62,$0.00,1,0,1,1,1,1,20110101,D9974,HCPCS,INTRNL BLEACHING PER TOOTH,,,27 ,,NW,,,,,,$301.91,$0.00,1,0,1,1,1,1,20110101,D9999,HCPCS,ADJUNCTIVE PROCEDURE,,,27 ,,NW,,,,,,$127.13,$0.00,1,0,1,1,1,1,20110101,E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,,,28 ,,NW,,,,,,$41.69,$0.00,1,1,1,1,1,1,20110101,E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,NU,,28 ,,NW,,,,,,$41.69,$0.00,1,1,1,1,1,1,20110101,E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,RR,,28 ,,NW,,,,,,$14.79,$0.00,1,1,1,1,1,1,20110101,E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,UE,,28 ,,NW,,,,,,$33.59,$0.00,1,1,1,1,1,1,20110101,E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,,,28 ,,NW,,,,,,$94.51,$0.00,1,1,1,1,1,1,20110101,E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,NU,,28 ,,NW,,,,,,$94.51,$0.00,1,1,1,1,1,1,20110101,E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,RR,,28 ,,NW,,,,,,$19.83,$0.00,1,1,1,1,1,1,20110101,E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,UE,,28 ,,NW,,,,,,$72.13,$0.00,1,1,1,1,1,1,20110101,E0110,HCPCS,CRUTCH FOREARM PAIR,,,28 ,,NW,,,,,,$155.92,$0.00,1,1,1,1,1,1,20110101,E0110,HCPCS,CRUTCH FOREARM PAIR,NU,,28 ,,NW,,,,,,$155.92,$0.00,1,1,1,1,1,1,20110101,E0110,HCPCS,CRUTCH FOREARM PAIR,RR,,28 ,,NW,,,,,,$32.19,$0.00,1,1,1,1,1,1,20110101,E0110,HCPCS,CRUTCH FOREARM PAIR,UE,,28 ,,NW,,,,,,$111.17,$0.00,1,1,1,1,1,1,20110101,E0111,HCPCS,CRUTCH FOREARM EACH,,,28 ,,NW,,,,,,$99.47,$0.00,1,1,1,1,1,1,20110101,E0111,HCPCS,CRUTCH FOREARM EACH,NU,,28 ,,NW,,,,,,$99.47,$0.00,1,1,1,1,1,1,20110101,E0111,HCPCS,CRUTCH FOREARM EACH,RR,,28 ,,NW,,,,,,$18.94,$0.00,1,1,1,1,1,1,20110101,E0111,HCPCS,CRUTCH FOREARM EACH,UE,,28 ,,NW,,,,,,$75.76,$0.00,1,1,1,1,1,1,20110101,E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,,,28 ,,NW,,,,,,$69.37,$0.00,1,1,1,1,1,1,20110101,E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,NU,,28 ,,NW,,,,,,$69.37,$0.00,1,1,1,1,1,1,20110101,E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,RR,,28 ,,NW,,,,,,$21.52,$0.00,1,1,1,1,1,1,20110101,E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,UE,,28 ,,NW,,,,,,$54.20,$0.00,1,1,1,1,1,1,20110101,E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,,,28 ,,NW,,,,,,$41.19,$0.00,1,1,1,1,1,1,20110101,E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,NU,,28 ,,NW,,,,,,$41.19,$0.00,1,1,1,1,1,1,20110101,E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,RR,,28 ,,NW,,,,,,$13.32,$0.00,1,1,1,1,1,1,20110101,E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,UE,,28 ,,NW,,,,,,$31.97,$0.00,1,1,1,1,1,1,20110101,E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,,,28 ,,NW,,,,,,$86.45,$0.00,1,1,1,1,1,1,20110101,E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,NU,,28 ,,NW,,,,,,$86.45,$0.00,1,1,1,1,1,1,20110101,E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,RR,,28 ,,NW,,,,,,$19.19,$0.00,1,1,1,1,1,1,20110101,E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,UE,,28 ,,NW,,,,,,$66.27,$0.00,1,1,1,1,1,1,20110101,E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,,,28 ,,NW,,,,,,$50.79,$0.00,1,1,1,1,1,1,20110101,E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,NU,,28 ,,NW,,,,,,$50.79,$0.00,1,1,1,1,1,1,20110101,E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,RR,,28 ,,NW,,,,,,$13.55,$0.00,1,1,1,1,1,1,20110101,E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,UE,,28 ,,NW,,,,,,$39.29,$0.00,1,1,1,1,1,1,20110101,E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,,,28 ,,NW,,,,,,$446.05,$0.00,1,1,1,1,1,1,20110101,E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,NU,,28 ,,NW,,,,,,$446.05,$0.00,1,1,1,1,1,1,20110101,E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,RR,,28 ,,NW,,,,,,$40.00,$0.00,1,1,1,1,1,1,20110101,E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,UE,,28 ,,NW,,,,,,$328.91,$0.00,1,1,1,1,1,1,20110101,E0118,HCPCS,CRUTCH SUBSTITUTE,,,28 ,,NW,,,,,,$340.66,$0.00,1,1,1,1,1,1,20110101,E0118,HCPCS,CRUTCH SUBSTITUTE,RR,,28 ,,NW,,,,,,$35.89,$0.00,1,1,1,1,1,1,20110101,E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,,,28 ,,NW,,,,,,$119.17,$0.00,1,1,1,1,1,1,20110101,E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,NU,,28 ,,NW,,,,,,$119.17,$0.00,1,1,1,1,1,1,20110101,E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,RR,,28 ,,NW,,,,,,$29.84,$0.00,1,1,1,1,1,1,20110101,E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,UE,,28 ,,NW,,,,,,$88.78,$0.00,1,1,1,1,1,1,20110101,E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,,,28 ,,NW,,,,,,$148.26,$0.00,1,1,1,1,1,1,20110101,E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,NU,,28 ,,NW,,,,,,$148.26,$0.00,1,1,1,1,1,1,20110101,E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,RR,,28 ,,NW,,,,,,$30.89,$0.00,1,1,1,1,1,1,20110101,E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,UE,,28 ,,NW,,,,,,$106.52,$0.00,1,1,1,1,1,1,20110101,E0140,HCPCS,WALKER W TRUNK SUPPORT,,,28 ,,NW,,,,,,$733.51,$0.00,1,1,1,1,1,1,20110101,E0140,HCPCS,WALKER W TRUNK SUPPORT,NU,,28 ,,NW,,,,,,$733.51,$0.00,1,1,1,1,1,1,20110101,E0140,HCPCS,WALKER W TRUNK SUPPORT,RR,,28 ,,NW,,,,,,$61.94,$0.00,1,1,1,1,1,1,20110101,E0140,HCPCS,WALKER W TRUNK SUPPORT,UE,,28 ,,NW,,,,,,$544.48,$0.00,1,1,1,1,1,1,20110101,E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,,,28 ,,NW,,,,,,$211.67,$0.00,1,1,1,1,1,1,20110101,E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,NU,,28 ,,NW,,,,,,$211.67,$0.00,1,1,1,1,1,1,20110101,E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,RR,,28 ,,NW,,,,,,$37.82,$0.00,1,1,1,1,1,1,20110101,E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,UE,,28 ,,NW,,,,,,$151.35,$0.00,1,1,1,1,1,1,20110101,E0143,HCPCS,WALKER FOLDING WHEELED W/O S,,,28 ,,NW,,,,,,$219.37,$0.00,1,1,1,1,1,1,20110101,E0143,HCPCS,WALKER FOLDING WHEELED W/O S,NU,,28 ,,NW,,,,,,$219.37,$0.00,1,1,1,1,1,1,20110101,E0143,HCPCS,WALKER FOLDING WHEELED W/O S,RR,,28 ,,NW,,,,,,$37.19,$0.00,1,1,1,1,1,1,20110101,E0143,HCPCS,WALKER FOLDING WHEELED W/O S,UE,,28 ,,NW,,,,,,$155.62,$0.00,1,1,1,1,1,1,20110101,E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,,,28 ,,NW,,,,,,$644.92,$0.00,1,1,1,1,1,1,20110101,E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,NU,,28 ,,NW,,,,,,$644.92,$0.00,1,1,1,1,1,1,20110101,E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,RR,,28 ,,NW,,,,,,$53.80,$0.00,1,1,1,1,1,1,20110101,E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,UE,,28 ,,NW,,,,,,$464.27,$0.00,1,1,1,1,1,1,20110101,E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,,,28 ,,NW,,,,,,"$1,182.35",$0.00,1,1,1,1,1,1,20110101,E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,NU,,28 ,,NW,,,,,,"$1,182.35",$0.00,1,1,1,1,1,1,20110101,E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,RR,,28 ,,NW,,,,,,$97.81,$0.00,1,1,1,1,1,1,20110101,E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,UE,,28 ,,NW,,,,,,$881.14,$0.00,1,1,1,1,1,1,20110101,E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,,,28 ,,NW,,,,,,$243.66,$0.00,1,1,1,1,1,1,20110101,E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,NU,,28 ,,NW,,,,,,$243.66,$0.00,1,1,1,1,1,1,20110101,E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,RR,,28 ,,NW,,,,,,$24.63,$0.00,1,1,1,1,1,1,20110101,E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,UE,,28 ,,NW,,,,,,$177.06,$0.00,1,1,1,1,1,1,20110101,E0149,HCPCS,HEAVY DUTY WHEELED WALKER,,,28 ,,NW,,,,,,$445.24,$0.00,1,1,1,1,1,1,20110101,E0149,HCPCS,HEAVY DUTY WHEELED WALKER,NU,,28 ,,NW,,,,,,$445.24,$0.00,1,1,1,1,1,1,20110101,E0149,HCPCS,HEAVY DUTY WHEELED WALKER,RR,,28 ,,NW,,,,,,$39.97,$0.00,1,1,1,1,1,1,20110101,E0149,HCPCS,HEAVY DUTY WHEELED WALKER,UE,,28 ,,NW,,,,,,$328.23,$0.00,1,1,1,1,1,1,20110101,E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,,,28 ,,NW,,,,,,$137.32,$0.00,1,1,1,1,1,1,20110101,E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,NU,,28 ,,NW,,,,,,$137.32,$0.00,1,1,1,1,1,1,20110101,E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,RR,,28 ,,NW,,,,,,$18.30,$0.00,1,1,1,1,1,1,20110101,E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,UE,,28 ,,NW,,,,,,$97.31,$0.00,1,1,1,1,1,1,20110101,E0154,HCPCS,WALKER PLATFORM ATTACHMENT,,,28 ,,NW,,,,,,$118.43,$0.00,1,1,1,1,1,1,20110101,E0154,HCPCS,WALKER PLATFORM ATTACHMENT,NU,,28 ,,NW,,,,,,$118.43,$0.00,1,1,1,1,1,1,20110101,E0154,HCPCS,WALKER PLATFORM ATTACHMENT,RR,,28 ,,NW,,,,,,$17.34,$0.00,1,1,1,1,1,1,20110101,E0154,HCPCS,WALKER PLATFORM ATTACHMENT,UE,,28 ,,NW,,,,,,$85.78,$0.00,1,1,1,1,1,1,20110101,E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",,,28 ,,NW,,,,,,$51.98,$0.00,1,1,1,1,1,1,20110101,E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",NU,,28 ,,NW,,,,,,$51.98,$0.00,1,1,1,1,1,1,20110101,E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",RR,,28 ,,NW,,,,,,$8.66,$0.00,1,1,1,1,1,1,20110101,E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",UE,,28 ,,NW,,,,,,$40.57,$0.00,1,1,1,1,1,1,20110101,E0156,HCPCS,WALKER SEAT ATTACHMENT,,,28 ,,NW,,,,,,$44.20,$0.00,1,1,1,1,1,1,20110101,E0156,HCPCS,WALKER SEAT ATTACHMENT,NU,,28 ,,NW,,,,,,$44.20,$0.00,1,1,1,1,1,1,20110101,E0156,HCPCS,WALKER SEAT ATTACHMENT,RR,,28 ,,NW,,,,,,$7.37,$0.00,1,1,1,1,1,1,20110101,E0156,HCPCS,WALKER SEAT ATTACHMENT,UE,,28 ,,NW,,,,,,$34.26,$0.00,1,1,1,1,1,1,20110101,E0157,HCPCS,WALKER CRUTCH ATTACHMENT,,,28 ,,NW,,,,,,$133.51,$0.00,1,1,1,1,1,1,20110101,E0157,HCPCS,WALKER CRUTCH ATTACHMENT,NU,,28 ,,NW,,,,,,$133.51,$0.00,1,1,1,1,1,1,20110101,E0157,HCPCS,WALKER CRUTCH ATTACHMENT,RR,,28 ,,NW,,,,,,$17.45,$0.00,1,1,1,1,1,1,20110101,E0157,HCPCS,WALKER CRUTCH ATTACHMENT,UE,,28 ,,NW,,,,,,$94.48,$0.00,1,1,1,1,1,1,20110101,E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,,,28 ,,NW,,,,,,$52.70,$0.00,1,1,1,1,1,1,20110101,E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,NU,,28 ,,NW,,,,,,$52.70,$0.00,1,1,1,1,1,1,20110101,E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,RR,,28 ,,NW,,,,,,$7.92,$0.00,1,1,1,1,1,1,20110101,E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,UE,,28 ,,NW,,,,,,$40.82,$0.00,1,1,1,1,1,1,20110101,E0159,HCPCS,BRAKE FOR WHEELED WALKER,,,28 ,,NW,,,,,,$32.85,$0.00,1,1,1,1,1,1,20110101,E0159,HCPCS,BRAKE FOR WHEELED WALKER,NU,,28 ,,NW,,,,,,$32.85,$0.00,1,1,1,1,1,1,20110101,E0159,HCPCS,BRAKE FOR WHEELED WALKER,RR,,28 ,,NW,,,,,,$4.34,$0.00,1,1,1,1,1,1,20110101,E0159,HCPCS,BRAKE FOR WHEELED WALKER,UE,,28 ,,NW,,,,,,$25.73,$0.00,1,1,1,1,1,1,20110101,E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,,,28 ,,NW,,,,,,$61.35,$0.00,1,1,1,1,1,1,20110101,E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,NU,,28 ,,NW,,,,,,$61.35,$0.00,1,1,1,1,1,1,20110101,E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,RR,,28 ,,NW,,,,,,$11.41,$0.00,1,1,1,1,1,1,20110101,E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,UE,,28 ,,NW,,,,,,$47.48,$0.00,1,1,1,1,1,1,20110101,E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,,,28 ,,NW,,,,,,$49.90,$0.00,1,1,1,1,1,1,20110101,E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,NU,,28 ,,NW,,,,,,$49.90,$0.00,1,1,1,1,1,1,20110101,E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,RR,,28 ,,NW,,,,,,$9.03,$0.00,1,1,1,1,1,1,20110101,E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,UE,,28 ,,NW,,,,,,$38.43,$0.00,1,1,1,1,1,1,20110101,E0162,HCPCS,SITZ BATH CHAIR,,,28 ,,NW,,,,,,$302.79,$0.00,1,1,1,1,1,1,20110101,E0162,HCPCS,SITZ BATH CHAIR,NU,,28 ,,NW,,,,,,$302.79,$0.00,1,1,1,1,1,1,20110101,E0162,HCPCS,SITZ BATH CHAIR,RR,,28 ,,NW,,,,,,$30.31,$0.00,1,1,1,1,1,1,20110101,E0162,HCPCS,SITZ BATH CHAIR,UE,,28 ,,NW,,,,,,$228.44,$0.00,1,1,1,1,1,1,20110101,E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,,,28 ,,NW,,,,,,$238.98,$0.00,1,1,1,1,1,1,20110101,E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,NU,,28 ,,NW,,,,,,$238.98,$0.00,1,1,1,1,1,1,20110101,E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,RR,,28 ,,NW,,,,,,$47.77,$0.00,1,1,1,1,1,1,20110101,E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,UE,,28 ,,NW,,,,,,$174.64,$0.00,1,1,1,1,1,1,20110101,E0165,HCPCS,COMMODE CHAIR WITH DETACHARM,,,28 ,,NW,,,,,,$350.14,$0.00,1,1,1,1,1,1,20110101,E0165,HCPCS,COMMODE CHAIR WITH DETACHARM,RR,,28 ,,NW,,,,,,$36.88,$0.00,1,1,1,1,1,1,20110101,E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,,,28 ,,NW,,,,,,$25.64,$0.00,1,1,1,1,1,1,20110101,E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,NU,,28 ,,NW,,,,,,$25.64,$0.00,1,1,1,1,1,1,20110101,E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,RR,,28 ,,NW,,,,,,$3.30,$0.00,1,1,1,1,1,1,20110101,E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,UE,,28 ,,NW,,,,,,$20.55,$0.00,1,1,1,1,1,1,20110101,E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,,,28 ,,NW,,,,,,$344.40,$0.00,1,1,1,1,1,1,20110101,E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,NU,,28 ,,NW,,,,,,$344.40,$0.00,1,1,1,1,1,1,20110101,E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,RR,,28 ,,NW,,,,,,$32.36,$0.00,1,1,1,1,1,1,20110101,E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,UE,,28 ,,NW,,,,,,$252.60,$0.00,1,1,1,1,1,1,20110101,E0170,HCPCS,COMMODE CHAIR ELECTRIC,,,28 ,,NW,,,,,,"$3,495.71",$0.00,1,1,1,1,1,1,20110101,E0170,HCPCS,COMMODE CHAIR ELECTRIC,RR,,28 ,,NW,,,,,,$368.24,$0.00,1,1,1,1,1,1,20110101,E0171,HCPCS,COMMODE CHAIR NON-ELECTRIC,,,28 ,,NW,,,,,,$549.77,$0.00,1,1,1,1,1,1,20110101,E0171,HCPCS,COMMODE CHAIR NON-ELECTRIC,RR,,28 ,,NW,,,,,,$57.91,$0.00,1,1,1,1,1,1,20110101,E0172,HCPCS,SEAT LIFT MECHANISM TOILET,,,28 ,,NW,,,,,,$210.71,$0.00,1,1,1,1,1,1,20110101,E0175,HCPCS,COMMODE CHAIR FOOT REST,,,28 ,,NW,,,,,,$128.23,$0.00,1,1,1,1,1,1,20110101,E0175,HCPCS,COMMODE CHAIR FOOT REST,NU,,28 ,,NW,,,,,,$128.23,$0.00,1,1,1,1,1,1,20110101,E0175,HCPCS,COMMODE CHAIR FOOT REST,RR,,28 ,,NW,,,,,,$15.77,$0.00,1,1,1,1,1,1,20110101,E0175,HCPCS,COMMODE CHAIR FOOT REST,UE,,28 ,,NW,,,,,,$88.87,$0.00,1,1,1,1,1,1,20110101,E0181,HCPCS,PRESS PAD ALTERNATING W/ PUM,,,28 ,,NW,,,,,,$499.20,$0.00,1,1,1,1,1,1,20110101,E0181,HCPCS,PRESS PAD ALTERNATING W/ PUM,RR,,28 ,,NW,,,,,,$52.59,$0.00,1,1,1,1,1,1,20110101,E0182,HCPCS,"REPLACE PUMP, ALT PRESS PAD",,,28 ,,NW,,,,,,$467.68,$0.00,1,1,1,1,1,1,20110101,E0182,HCPCS,"REPLACE PUMP, ALT PRESS PAD",RR,,28 ,,NW,,,,,,$49.27,$0.00,1,1,1,1,1,1,20110101,E0184,HCPCS,DRY PRESSURE MATTRESS,,,28 ,,NW,,,,,,$413.92,$0.00,1,1,1,1,1,1,20110101,E0184,HCPCS,DRY PRESSURE MATTRESS,NU,,28 ,,NW,,,,,,$413.92,$0.00,1,1,1,1,1,1,20110101,E0184,HCPCS,DRY PRESSURE MATTRESS,RR,,28 ,,NW,,,,,,$48.47,$0.00,1,1,1,1,1,1,20110101,E0184,HCPCS,DRY PRESSURE MATTRESS,UE,,28 ,,NW,,,,,,$312.10,$0.00,1,1,1,1,1,1,20110101,E0185,HCPCS,GEL PRESSURE MATTRESS PAD,,,28 ,,NW,,,,,,$706.21,$0.00,1,1,1,1,1,1,20110101,E0185,HCPCS,GEL PRESSURE MATTRESS PAD,NU,,28 ,,NW,,,,,,$706.21,$0.00,1,1,1,1,1,1,20110101,E0185,HCPCS,GEL PRESSURE MATTRESS PAD,RR,,28 ,,NW,,,,,,$84.27,$0.00,1,1,1,1,1,1,20110101,E0185,HCPCS,GEL PRESSURE MATTRESS PAD,UE,,28 ,,NW,,,,,,$539.92,$0.00,1,1,1,1,1,1,20110101,E0186,HCPCS,AIR PRESSURE MATTRESS,,,28 ,,NW,,,,,,$383.27,$0.00,1,1,1,1,1,1,20110101,E0186,HCPCS,AIR PRESSURE MATTRESS,RR,,28 ,,NW,,,,,,$40.37,$0.00,1,1,1,1,1,1,20110101,E0187,HCPCS,WATER PRESSURE MATTRESS,,,28 ,,NW,,,,,,$429.71,$0.00,1,1,1,1,1,1,20110101,E0187,HCPCS,WATER PRESSURE MATTRESS,RR,,28 ,,NW,,,,,,$45.27,$0.00,1,1,1,1,1,1,20110101,E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,,,28 ,,NW,,,,,,$50.91,$0.00,1,1,1,1,1,1,20110101,E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,NU,,28 ,,NW,,,,,,$50.91,$0.00,1,1,1,1,1,1,20110101,E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,RR,,28 ,,NW,,,,,,$8.09,$0.00,1,1,1,1,1,1,20110101,E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,UE,,28 ,,NW,,,,,,$39.25,$0.00,1,1,1,1,1,1,20110101,E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,,,28 ,,NW,,,,,,$97.89,$0.00,1,1,1,1,1,1,20110101,E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,NU,,28 ,,NW,,,,,,$97.89,$0.00,1,1,1,1,1,1,20110101,E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,RR,,28 ,,NW,,,,,,$14.38,$0.00,1,1,1,1,1,1,20110101,E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,UE,,28 ,,NW,,,,,,$73.23,$0.00,1,1,1,1,1,1,20110101,E0190,HCPCS,POSITIONING CUSHION,,,28 ,,NW,,,,,,$65.66,$0.00,1,1,1,1,1,1,20110101,E0191,HCPCS,PROTECTOR HEEL OR ELBOW,,,28 ,,NW,,,,,,$21.49,$0.00,1,1,1,1,1,1,20110101,E0191,HCPCS,PROTECTOR HEEL OR ELBOW,NU,,28 ,,NW,,,,,,$21.49,$0.00,1,1,1,1,1,1,20110101,E0191,HCPCS,PROTECTOR HEEL OR ELBOW,RR,,28 ,,NW,,,,,,$2.58,$0.00,1,1,1,1,1,1,20110101,E0191,HCPCS,PROTECTOR HEEL OR ELBOW,UE,,28 ,,NW,,,,,,$17.16,$0.00,1,1,1,1,1,1,20110101,E0193,HCPCS,POWERED AIR FLOTATION BED,,,28 ,,NW,,,,,,"$12,126.48",$0.00,1,1,1,1,1,1,20110101,E0193,HCPCS,POWERED AIR FLOTATION BED,RR,,28 ,,NW,,,,,,"$1,277.41",$0.00,1,1,1,1,1,1,20110101,E0194,HCPCS,AIR FLUIDIZED BED,,,28 ,,NW,,,,,,"$47,008.14",$0.00,1,1,1,1,1,1,20110101,E0194,HCPCS,AIR FLUIDIZED BED,RR,,28 ,,NW,,,,,,"$4,951.88",$0.00,1,1,1,1,1,1,20110101,E0194,HCPCS,AIR FLUIDIZED BED,UE,,28 ,,NW,,,,,,"$37,481.69",$0.00,1,1,1,1,1,1,20110101,E0196,HCPCS,GEL PRESSURE MATTRESS,,,28 ,,NW,,,,,,$613.94,$0.00,1,1,1,1,1,1,20110101,E0196,HCPCS,GEL PRESSURE MATTRESS,RR,,28 ,,NW,,,,,,$64.67,$0.00,1,1,1,1,1,1,20110101,E0196,HCPCS,GEL PRESSURE MATTRESS,UE,,28 ,,NW,,,,,,$422.19,$0.00,1,1,1,1,1,1,20110101,E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,,,28 ,,NW,,,,,,$479.91,$0.00,1,1,1,1,1,1,20110101,E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,NU,,28 ,,NW,,,,,,$479.91,$0.00,1,1,1,1,1,1,20110101,E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,RR,,28 ,,NW,,,,,,$57.17,$0.00,1,1,1,1,1,1,20110101,E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,UE,,28 ,,NW,,,,,,$415.40,$0.00,1,1,1,1,1,1,20110101,E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,,,28 ,,NW,,,,,,$484.93,$0.00,1,1,1,1,1,1,20110101,E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,NU,,28 ,,NW,,,,,,$484.93,$0.00,1,1,1,1,1,1,20110101,E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,RR,,28 ,,NW,,,,,,$44.91,$0.00,1,1,1,1,1,1,20110101,E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,UE,,28 ,,NW,,,,,,$363.57,$0.00,1,1,1,1,1,1,20110101,E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,,,28 ,,NW,,,,,,$61.60,$0.00,1,1,1,1,1,1,20110101,E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,NU,,28 ,,NW,,,,,,$61.60,$0.00,1,1,1,1,1,1,20110101,E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,RR,,28 ,,NW,,,,,,$9.13,$0.00,1,1,1,1,1,1,20110101,E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,UE,,28 ,,NW,,,,,,$48.45,$0.00,1,1,1,1,1,1,20110101,E0200,HCPCS,HEAT LAMP WITHOUT STAND,,,28 ,,NW,,,,,,$162.68,$0.00,1,1,1,1,1,1,20110101,E0200,HCPCS,HEAT LAMP WITHOUT STAND,NU,,28 ,,NW,,,,,,$162.68,$0.00,1,1,1,1,1,1,20110101,E0200,HCPCS,HEAT LAMP WITHOUT STAND,RR,,28 ,,NW,,,,,,$23.70,$0.00,1,1,1,1,1,1,20110101,E0200,HCPCS,HEAT LAMP WITHOUT STAND,UE,,28 ,,NW,,,,,,$116.41,$0.00,1,1,1,1,1,1,20110101,E0202,HCPCS,PHOTOTHERAPY LIGHT W/ PHOTOM,,,28 ,,NW,,,,,,"$1,145.00",$0.00,1,1,1,1,1,1,20110101,E0202,HCPCS,PHOTOTHERAPY LIGHT W/ PHOTOM,RR,,28 ,,NW,,,,,,$120.62,$0.00,1,1,1,1,1,1,20110101,E0203,HCPCS,THERAPEUTIC LIGHTBOX TABLETP,,,28 ,,NW,,,,,,$457.17,$0.00,1,1,1,1,1,1,20110101,E0205,HCPCS,HEAT LAMP WITH STAND,,,28 ,,NW,,,,,,$415.69,$0.00,1,1,1,1,1,1,20110101,E0205,HCPCS,HEAT LAMP WITH STAND,NU,,28 ,,NW,,,,,,$415.69,$0.00,1,1,1,1,1,1,20110101,E0205,HCPCS,HEAT LAMP WITH STAND,RR,,28 ,,NW,,,,,,$42.71,$0.00,1,1,1,1,1,1,20110101,E0205,HCPCS,HEAT LAMP WITH STAND,UE,,28 ,,NW,,,,,,$306.09,$0.00,1,1,1,1,1,1,20110101,E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,,,28 ,,NW,,,,,,$61.14,$0.00,1,1,1,1,1,1,20110101,E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,NU,,28 ,,NW,,,,,,$61.14,$0.00,1,1,1,1,1,1,20110101,E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,RR,,28 ,,NW,,,,,,$8.84,$0.00,1,1,1,1,1,1,20110101,E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,UE,,28 ,,NW,,,,,,$46.91,$0.00,1,1,1,1,1,1,20110101,E0215,HCPCS,ELECTRIC HEAT PAD MOIST,,,28 ,,NW,,,,,,$138.29,$0.00,1,1,1,1,1,1,20110101,E0215,HCPCS,ELECTRIC HEAT PAD MOIST,NU,,28 ,,NW,,,,,,$138.29,$0.00,1,1,1,1,1,1,20110101,E0215,HCPCS,ELECTRIC HEAT PAD MOIST,RR,,28 ,,NW,,,,,,$17.79,$0.00,1,1,1,1,1,1,20110101,E0215,HCPCS,ELECTRIC HEAT PAD MOIST,UE,,28 ,,NW,,,,,,$98.26,$0.00,1,1,1,1,1,1,20110101,E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,,,28 ,,NW,,,,,,"$1,105.95",$0.00,1,1,1,1,1,1,20110101,E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,NU,,28 ,,NW,,,,,,"$1,105.95",$0.00,1,1,1,1,1,1,20110101,E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,RR,,28 ,,NW,,,,,,$102.67,$0.00,1,1,1,1,1,1,20110101,E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,UE,,28 ,,NW,,,,,,$823.73,$0.00,1,1,1,1,1,1,20110101,E0218,HCPCS,WATER CIRC COLD PAD W PUMP,,,28 ,,NW,,,,,,$376.40,$0.00,1,1,1,1,1,1,20110101,E0221,HCPCS,INFRARED HEATING PAD SYSTEM,,,28 ,,NW,,,,,,$548.31,$0.00,1,1,1,1,1,1,20110101,E0225,HCPCS,HYDROCOLLATOR UNIT,,,28 ,,NW,,,,,,$859.20,$0.00,1,1,1,1,1,1,20110101,E0225,HCPCS,HYDROCOLLATOR UNIT,NU,,28 ,,NW,,,,,,$859.20,$0.00,1,1,1,1,1,1,20110101,E0225,HCPCS,HYDROCOLLATOR UNIT,RR,,28 ,,NW,,,,,,$70.43,$0.00,1,1,1,1,1,1,20110101,E0225,HCPCS,HYDROCOLLATOR UNIT,UE,,28 ,,NW,,,,,,$638.13,$0.00,1,1,1,1,1,1,20110101,E0231,HCPCS,WOUND WARMING DEVICE,,,28 ,,NW,,,,,,$422.32,$0.00,1,1,1,1,1,1,20110101,E0231,HCPCS,WOUND WARMING DEVICE,RR,,28 ,,NW,,,,,,$46.22,$0.00,1,1,1,1,1,1,20110101,E0232,HCPCS,WARMING CARD FOR NWT,,,28 ,,NW,,,,,,$133.21,$0.00,1,1,1,1,1,1,20110101,E0235,HCPCS,PARAFFIN BATH UNIT PORTABLE,,,28 ,,NW,,,,,,$338.07,$0.00,1,1,1,1,1,1,20110101,E0235,HCPCS,PARAFFIN BATH UNIT PORTABLE,RR,,28 ,,NW,,,,,,$35.61,$0.00,1,1,1,1,1,1,20110101,E0235,HCPCS,PARAFFIN BATH UNIT PORTABLE,UE,,28 ,,NW,,,,,,$294.59,$0.00,1,1,1,1,1,1,20110101,E0236,HCPCS,PUMP FOR WATER CIRCULATING P,,,28 ,,NW,,,,,,$773.79,$0.00,1,1,1,1,1,1,20110101,E0236,HCPCS,PUMP FOR WATER CIRCULATING P,RR,,28 ,,NW,,,,,,$81.51,$0.00,1,1,1,1,1,1,20110101,E0236,HCPCS,PUMP FOR WATER CIRCULATING P,UE,,28 ,,NW,,,,,,$581.61,$0.00,1,1,1,1,1,1,20110101,E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,,,28 ,,NW,,,,,,"$1,024.15",$0.00,1,1,1,1,1,1,20110101,E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,NU,,28 ,,NW,,,,,,"$1,024.15",$0.00,1,1,1,1,1,1,20110101,E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,RR,,28 ,,NW,,,,,,$84.22,$0.00,1,1,1,1,1,1,20110101,E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,UE,,28 ,,NW,,,,,,$762.48,$0.00,1,1,1,1,1,1,20110101,E0240,HCPCS,BATH/SHOWER CHAIR,,,28 ,,NW,,,,,,$70.66,$0.00,1,1,1,1,1,1,20110101,E0241,HCPCS,BATH TUB WALL RAIL,,,28 ,,NW,,,,,,$53.54,$0.00,1,1,1,1,1,1,20110101,E0242,HCPCS,BATH TUB RAIL FLOOR,,,28 ,,NW,,,,,,$123.83,$0.00,1,1,1,1,1,1,20110101,E0243,HCPCS,TOILET RAIL,,,28 ,,NW,,,,,,$93.84,$0.00,1,1,1,1,1,1,20110101,E0244,HCPCS,TOILET SEAT RAISED,,,28 ,,NW,,,,,,$71.12,$0.00,1,1,1,1,1,1,20110101,E0245,HCPCS,TUB STOOL OR BENCH,,,28 ,,NW,,,,,,$122.68,$0.00,1,1,1,1,1,1,20110101,E0246,HCPCS,TRANSFER TUB RAIL ATTACHMENT,,,28 ,,NW,,,,,,$174.60,$0.00,1,1,1,1,1,1,20110101,E0247,HCPCS,TRANS BENCH W/WO COMM OPEN,,,28 ,,NW,,,,,,$121.51,$0.00,1,1,1,1,1,1,20110101,E0248,HCPCS,HDTRANS BENCH W/WO COMM OPEN,,,28 ,,NW,,,,,,$215.61,$0.00,1,1,1,1,1,1,20110101,E0249,HCPCS,PAD WATER CIRCULATING HEAT U,,,28 ,,NW,,,,,,$204.64,$0.00,1,1,1,1,1,1,20110101,E0249,HCPCS,PAD WATER CIRCULATING HEAT U,NU,,28 ,,NW,,,,,,$204.64,$0.00,1,1,1,1,1,1,20110101,E0249,HCPCS,PAD WATER CIRCULATING HEAT U,RR,,28 ,,NW,,,,,,$23.33,$0.00,1,1,1,1,1,1,20110101,E0249,HCPCS,PAD WATER CIRCULATING HEAT U,UE,,28 ,,NW,,,,,,$147.82,$0.00,1,1,1,1,1,1,20110101,E0250,HCPCS,HOSP BED FIXED HT W/ MATTRES,,,28 ,,NW,,,,,,"$1,575.69",$0.00,1,1,1,1,1,1,20110101,E0250,HCPCS,HOSP BED FIXED HT W/ MATTRES,RR,,28 ,,NW,,,,,,$165.98,$0.00,1,1,1,1,1,1,20110101,E0250,HCPCS,HOSP BED FIXED HT W/ MATTRES,UE,,28 ,,NW,,,,,,"$1,017.85",$0.00,1,1,1,1,1,1,20110101,E0251,HCPCS,HOSP BED FIXD HT W/O MATTRES,,,28 ,,NW,,,,,,"$1,207.26",$0.00,1,1,1,1,1,1,20110101,E0251,HCPCS,HOSP BED FIXD HT W/O MATTRES,RR,,28 ,,NW,,,,,,$127.17,$0.00,1,1,1,1,1,1,20110101,E0251,HCPCS,HOSP BED FIXD HT W/O MATTRES,UE,,28 ,,NW,,,,,,$783.20,$0.00,1,1,1,1,1,1,20110101,E0255,HCPCS,HOSPITAL BED VAR HT W/ MATTR,,,28 ,,NW,,,,,,"$1,893.96",$0.00,1,1,1,1,1,1,20110101,E0255,HCPCS,HOSPITAL BED VAR HT W/ MATTR,RR,,28 ,,NW,,,,,,$199.51,$0.00,1,1,1,1,1,1,20110101,E0255,HCPCS,HOSPITAL BED VAR HT W/ MATTR,UE,,28 ,,NW,,,,,,"$1,213.52",$0.00,1,1,1,1,1,1,20110101,E0256,HCPCS,HOSPITAL BED VAR HT W/O MATT,,,28 ,,NW,,,,,,"$1,322.96",$0.00,1,1,1,1,1,1,20110101,E0256,HCPCS,HOSPITAL BED VAR HT W/O MATT,RR,,28 ,,NW,,,,,,$139.36,$0.00,1,1,1,1,1,1,20110101,E0256,HCPCS,HOSPITAL BED VAR HT W/O MATT,UE,,28 ,,NW,,,,,,$875.62,$0.00,1,1,1,1,1,1,20110101,E0260,HCPCS,HOSP BED SEMI-ELECTR W/ MATT,,,28 ,,NW,,,,,,"$2,320.54",$0.00,1,1,1,1,1,1,20110101,E0260,HCPCS,HOSP BED SEMI-ELECTR W/ MATT,RR,,28 ,,NW,,,,,,$244.45,$0.00,1,1,1,1,1,1,20110101,E0260,HCPCS,HOSP BED SEMI-ELECTR W/ MATT,UE,,28 ,,NW,,,,,,"$1,744.19",$0.00,1,1,1,1,1,1,20110101,E0261,HCPCS,HOSP BED SEMI-ELECTR W/O MAT,,,28 ,,NW,,,,,,"$2,157.81",$0.00,1,1,1,1,1,1,20110101,E0261,HCPCS,HOSP BED SEMI-ELECTR W/O MAT,RR,,28 ,,NW,,,,,,$227.31,$0.00,1,1,1,1,1,1,20110101,E0261,HCPCS,HOSP BED SEMI-ELECTR W/O MAT,UE,,28 ,,NW,,,,,,"$1,406.30",$0.00,1,1,1,1,1,1,20110101,E0265,HCPCS,HOSP BED TOTAL ELECTR W/ MAT,,,28 ,,NW,,,,,,"$3,008.21",$0.00,1,1,1,1,1,1,20110101,E0265,HCPCS,HOSP BED TOTAL ELECTR W/ MAT,RR,,28 ,,NW,,,,,,$316.89,$0.00,1,1,1,1,1,1,20110101,E0265,HCPCS,HOSP BED TOTAL ELECTR W/ MAT,UE,,28 ,,NW,,,,,,"$2,030.84",$0.00,1,1,1,1,1,1,20110101,E0266,HCPCS,HOSP BED TOTAL ELEC W/O MATT,,,28 ,,NW,,,,,,"$2,731.03",$0.00,1,1,1,1,1,1,20110101,E0266,HCPCS,HOSP BED TOTAL ELEC W/O MATT,RR,,28 ,,NW,,,,,,$287.69,$0.00,1,1,1,1,1,1,20110101,E0266,HCPCS,HOSP BED TOTAL ELEC W/O MATT,UE,,28 ,,NW,,,,,,"$1,809.90",$0.00,1,1,1,1,1,1,20110101,E0270,HCPCS,HOSPITAL BED INSTITUTIONAL T,,,28 ,,NW,,,,,,$416.15,$0.00,1,1,1,1,1,1,20110101,E0270,HCPCS,HOSPITAL BED INSTITUTIONAL T,RR,,28 ,,NW,,,,,,$43.84,$0.00,1,1,1,1,1,1,20110101,E0270,HCPCS,HOSPITAL BED INSTITUTIONAL T,UE,,28 ,,NW,,,,,,$312.79,$0.00,1,1,1,1,1,1,20110101,E0271,HCPCS,MATTRESS INNERSPRING,,,28 ,,NW,,,,,,$335.34,$0.00,1,1,1,1,1,1,20110101,E0271,HCPCS,MATTRESS INNERSPRING,NU,,28 ,,NW,,,,,,$335.34,$0.00,1,1,1,1,1,1,20110101,E0271,HCPCS,MATTRESS INNERSPRING,RR,,28 ,,NW,,,,,,$38.55,$0.00,1,1,1,1,1,1,20110101,E0271,HCPCS,MATTRESS INNERSPRING,UE,,28 ,,NW,,,,,,$270.38,$0.00,1,1,1,1,1,1,20110101,E0272,HCPCS,MATTRESS FOAM RUBBER,,,28 ,,NW,,,,,,$317.84,$0.00,1,1,1,1,1,1,20110101,E0272,HCPCS,MATTRESS FOAM RUBBER,NU,,28 ,,NW,,,,,,$317.84,$0.00,1,1,1,1,1,1,20110101,E0272,HCPCS,MATTRESS FOAM RUBBER,RR,,28 ,,NW,,,,,,$35.35,$0.00,1,1,1,1,1,1,20110101,E0272,HCPCS,MATTRESS FOAM RUBBER,UE,,28 ,,NW,,,,,,$245.45,$0.00,1,1,1,1,1,1,20110101,E0273,HCPCS,BED BOARD,,,28 ,,NW,,,,,,$53.01,$0.00,1,1,1,1,1,1,20110101,E0273,HCPCS,BED BOARD,RR,,28 ,,NW,,,,,,$21.98,$0.00,1,1,1,1,1,1,20110101,E0273,HCPCS,BED BOARD,UE,,28 ,,NW,,,,,,$44.26,$0.00,1,1,1,1,1,1,20110101,E0274,HCPCS,OVER-BED TABLE,,,28 ,,NW,,,,,,$97.18,$0.00,1,1,1,1,1,1,20110101,E0274,HCPCS,OVER-BED TABLE,RR,,28 ,,NW,,,,,,$39.62,$0.00,1,1,1,1,1,1,20110101,E0274,HCPCS,OVER-BED TABLE,UE,,28 ,,NW,,,,,,$73.04,$0.00,1,1,1,1,1,1,20110101,E0275,HCPCS,BED PAN STANDARD,,,28 ,,NW,,,,,,$31.27,$0.00,1,1,1,1,1,1,20110101,E0275,HCPCS,BED PAN STANDARD,NU,,28 ,,NW,,,,,,$31.27,$0.00,1,1,1,1,1,1,20110101,E0275,HCPCS,BED PAN STANDARD,RR,,28 ,,NW,,,,,,$4.18,$0.00,1,1,1,1,1,1,20110101,E0275,HCPCS,BED PAN STANDARD,UE,,28 ,,NW,,,,,,$24.52,$0.00,1,1,1,1,1,1,20110101,E0276,HCPCS,BED PAN FRACTURE,,,28 ,,NW,,,,,,$27.76,$0.00,1,1,1,1,1,1,20110101,E0276,HCPCS,BED PAN FRACTURE,NU,,28 ,,NW,,,,,,$27.76,$0.00,1,1,1,1,1,1,20110101,E0276,HCPCS,BED PAN FRACTURE,RR,,28 ,,NW,,,,,,$4.11,$0.00,1,1,1,1,1,1,20110101,E0276,HCPCS,BED PAN FRACTURE,UE,,28 ,,NW,,,,,,$22.83,$0.00,1,1,1,1,1,1,20110101,E0277,HCPCS,POWERED PRES-REDU AIR MATTRS,,,28 ,,NW,,,,,,"$9,640.47",$0.00,1,1,1,1,1,1,20110101,E0277,HCPCS,POWERED PRES-REDU AIR MATTRS,RR,,28 ,,NW,,,,,,"$1,015.54",$0.00,1,1,1,1,1,1,20110101,E0277,HCPCS,POWERED PRES-REDU AIR MATTRS,UE,,28 ,,NW,,,,,,"$7,246.09",$0.00,1,1,1,1,1,1,20110101,E0280,HCPCS,BED CRADLE,,,28 ,,NW,,,,,,$65.46,$0.00,1,1,1,1,1,1,20110101,E0280,HCPCS,BED CRADLE,NU,,28 ,,NW,,,,,,$65.46,$0.00,1,1,1,1,1,1,20110101,E0280,HCPCS,BED CRADLE,RR,,28 ,,NW,,,,,,$6.78,$0.00,1,1,1,1,1,1,20110101,E0280,HCPCS,BED CRADLE,UE,,28 ,,NW,,,,,,$49.02,$0.00,1,1,1,1,1,1,20110101,E0290,HCPCS,HOSP BED FX HT W/O RAILS W/M,,,28 ,,NW,,,,,,"$1,180.66",$0.00,1,1,1,1,1,1,20110101,E0290,HCPCS,HOSP BED FX HT W/O RAILS W/M,RR,,28 ,,NW,,,,,,$124.37,$0.00,1,1,1,1,1,1,20110101,E0290,HCPCS,HOSP BED FX HT W/O RAILS W/M,UE,,28 ,,NW,,,,,,$789.70,$0.00,1,1,1,1,1,1,20110101,E0291,HCPCS,HOSP BED FX HT W/O RAIL W/O,,,28 ,,NW,,,,,,$848.97,$0.00,1,1,1,1,1,1,20110101,E0291,HCPCS,HOSP BED FX HT W/O RAIL W/O,RR,,28 ,,NW,,,,,,$89.43,$0.00,1,1,1,1,1,1,20110101,E0291,HCPCS,HOSP BED FX HT W/O RAIL W/O,UE,,28 ,,NW,,,,,,$587.53,$0.00,1,1,1,1,1,1,20110101,E0292,HCPCS,HOSP BED VAR HT W/O RAIL W/O,,,28 ,,NW,,,,,,"$1,330.46",$0.00,1,1,1,1,1,1,20110101,E0292,HCPCS,HOSP BED VAR HT W/O RAIL W/O,RR,,28 ,,NW,,,,,,$140.15,$0.00,1,1,1,1,1,1,20110101,E0292,HCPCS,HOSP BED VAR HT W/O RAIL W/O,UE,,28 ,,NW,,,,,,$882.12,$0.00,1,1,1,1,1,1,20110101,E0293,HCPCS,HOSP BED VAR HT W/O RAIL W/,,,28 ,,NW,,,,,,"$1,134.89",$0.00,1,1,1,1,1,1,20110101,E0293,HCPCS,HOSP BED VAR HT W/O RAIL W/,RR,,28 ,,NW,,,,,,$119.55,$0.00,1,1,1,1,1,1,20110101,E0293,HCPCS,HOSP BED VAR HT W/O RAIL W/,UE,,28 ,,NW,,,,,,$757.93,$0.00,1,1,1,1,1,1,20110101,E0294,HCPCS,HOSP BED SEMI-ELECT W/ MATTR,,,28 ,,NW,,,,,,"$2,098.65",$0.00,1,1,1,1,1,1,20110101,E0294,HCPCS,HOSP BED SEMI-ELECT W/ MATTR,RR,,28 ,,NW,,,,,,$221.07,$0.00,1,1,1,1,1,1,20110101,E0294,HCPCS,HOSP BED SEMI-ELECT W/ MATTR,UE,,28 ,,NW,,,,,,"$1,344.20",$0.00,1,1,1,1,1,1,20110101,E0295,HCPCS,HOSP BED SEMI-ELECT W/O MATT,,,28 ,,NW,,,,,,"$2,036.50",$0.00,1,1,1,1,1,1,20110101,E0295,HCPCS,HOSP BED SEMI-ELECT W/O MATT,RR,,28 ,,NW,,,,,,$214.53,$0.00,1,1,1,1,1,1,20110101,E0295,HCPCS,HOSP BED SEMI-ELECT W/O MATT,UE,,28 ,,NW,,,,,,"$1,311.71",$0.00,1,1,1,1,1,1,20110101,E0296,HCPCS,HOSP BED TOTAL ELECT W/ MATT,,,28 ,,NW,,,,,,"$2,475.42",$0.00,1,1,1,1,1,1,20110101,E0296,HCPCS,HOSP BED TOTAL ELECT W/ MATT,RR,,28 ,,NW,,,,,,$260.76,$0.00,1,1,1,1,1,1,20110101,E0296,HCPCS,HOSP BED TOTAL ELECT W/ MATT,UE,,28 ,,NW,,,,,,"$1,677.05",$0.00,1,1,1,1,1,1,20110101,E0297,HCPCS,HOSP BED TOTAL ELECT W/O MAT,,,28 ,,NW,,,,,,"$2,236.43",$0.00,1,1,1,1,1,1,20110101,E0297,HCPCS,HOSP BED TOTAL ELECT W/O MAT,RR,,28 ,,NW,,,,,,$235.59,$0.00,1,1,1,1,1,1,20110101,E0297,HCPCS,HOSP BED TOTAL ELECT W/O MAT,UE,,28 ,,NW,,,,,,"$1,443.84",$0.00,1,1,1,1,1,1,20110101,E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,,,28 ,,NW,,,,,,"$4,000.46",$0.00,1,1,1,1,1,1,20110101,E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,NU,,28 ,,NW,,,,,,"$4,000.46",$0.00,1,1,1,1,1,1,20110101,E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,RR,,28 ,,NW,,,,,,$444.06,$0.00,1,1,1,1,1,1,20110101,E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,UE,,28 ,,NW,,,,,,"$3,012.57",$0.00,1,1,1,1,1,1,20110101,E0301,HCPCS,"HD HOSP BED, 350-600 LBS",,,28 ,,NW,,,,,,"$3,938.72",$0.00,1,1,1,1,1,1,20110101,E0301,HCPCS,"HD HOSP BED, 350-600 LBS",RR,,28 ,,NW,,,,,,$414.91,$0.00,1,1,1,1,1,1,20110101,E0302,HCPCS,EX HD HOSP BED > 600 LBS,,,28 ,,NW,,,,,,"$9,905.75",$0.00,1,1,1,1,1,1,20110101,E0302,HCPCS,EX HD HOSP BED > 600 LBS,RR,,28 ,,NW,,,,,,"$1,043.48",$0.00,1,1,1,1,1,1,20110101,E0303,HCPCS,HOSP BED HVY DTY XTRA WIDE,,,28 ,,NW,,,,,,"$4,377.79",$0.00,1,1,1,1,1,1,20110101,E0303,HCPCS,HOSP BED HVY DTY XTRA WIDE,RR,,28 ,,NW,,,,,,$461.16,$0.00,1,1,1,1,1,1,20110101,E0304,HCPCS,HOSP BED XTRA HVY DTY X WIDE,,,28 ,,NW,,,,,,"$10,634.71",$0.00,1,1,1,1,1,1,20110101,E0304,HCPCS,HOSP BED XTRA HVY DTY X WIDE,RR,,28 ,,NW,,,,,,"$1,120.27",$0.00,1,1,1,1,1,1,20110101,E0305,HCPCS,RAILS BED SIDE HALF LENGTH,,,28 ,,NW,,,,,,$281.45,$0.00,1,1,1,1,1,1,20110101,E0305,HCPCS,RAILS BED SIDE HALF LENGTH,RR,,28 ,,NW,,,,,,$29.65,$0.00,1,1,1,1,1,1,20110101,E0305,HCPCS,RAILS BED SIDE HALF LENGTH,UE,,28 ,,NW,,,,,,$225.08,$0.00,1,1,1,1,1,1,20110101,E0310,HCPCS,RAILS BED SIDE FULL LENGTH,,,28 ,,NW,,,,,,$305.99,$0.00,1,1,1,1,1,1,20110101,E0310,HCPCS,RAILS BED SIDE FULL LENGTH,NU,,28 ,,NW,,,,,,$305.99,$0.00,1,1,1,1,1,1,20110101,E0310,HCPCS,RAILS BED SIDE FULL LENGTH,RR,,28 ,,NW,,,,,,$38.43,$0.00,1,1,1,1,1,1,20110101,E0310,HCPCS,RAILS BED SIDE FULL LENGTH,UE,,28 ,,NW,,,,,,$245.59,$0.00,1,1,1,1,1,1,20110101,E0315,HCPCS,BED ACCESSORY BRD/TBL/SUPPRT,,,28 ,,NW,,,,,,$111.06,$0.00,1,1,1,1,1,1,20110101,E0316,HCPCS,BED SAFETY ENCLOSURE,,,28 ,,NW,,,,,,"$3,165.40",$0.00,1,1,1,1,1,1,20110101,E0316,HCPCS,BED SAFETY ENCLOSURE,RR,,28 ,,NW,,,,,,$333.45,$0.00,1,1,1,1,1,1,20110101,E0325,HCPCS,URINAL MALE JUG-TYPE,,,28 ,,NW,,,,,,$21.39,$0.00,1,1,1,1,1,1,20110101,E0325,HCPCS,URINAL MALE JUG-TYPE,NU,,28 ,,NW,,,,,,$21.39,$0.00,1,1,1,1,1,1,20110101,E0325,HCPCS,URINAL MALE JUG-TYPE,RR,,28 ,,NW,,,,,,$3.96,$0.00,1,1,1,1,1,1,20110101,E0325,HCPCS,URINAL MALE JUG-TYPE,UE,,28 ,,NW,,,,,,$15.81,$0.00,1,1,1,1,1,1,20110101,E0326,HCPCS,URINAL FEMALE JUG-TYPE,,,28 ,,NW,,,,,,$22.86,$0.00,1,1,1,1,1,1,20110101,E0326,HCPCS,URINAL FEMALE JUG-TYPE,NU,,28 ,,NW,,,,,,$22.86,$0.00,1,1,1,1,1,1,20110101,E0326,HCPCS,URINAL FEMALE JUG-TYPE,RR,,28 ,,NW,,,,,,$3.19,$0.00,1,1,1,1,1,1,20110101,E0326,HCPCS,URINAL FEMALE JUG-TYPE,UE,,28 ,,NW,,,,,,$18.22,$0.00,1,1,1,1,1,1,20110101,E0328,HCPCS,"PED HOSPITAL BED, MANUAL",,,28 ,,NW,,,,,,$96.73,$0.00,1,1,1,1,1,1,20110101,E0329,HCPCS,PED HOSPITAL BED SEMI/ELECT,,,28 ,,NW,,,,,,$546.73,$0.00,1,1,1,1,1,1,20110101,E0352,HCPCS,DISPOSABLE PACK W/BOWEL SYST,,,28 ,,NW,,,,,,$15.36,$0.00,1,1,1,1,1,1,20110101,E0370,HCPCS,AIR ELEVATOR FOR HEEL,,,28 ,,NW,,,,,,$56.47,$0.00,1,1,1,1,1,1,20110101,E0371,HCPCS,NONPOWER MATTRESS OVERLAY,,,28 ,,NW,,,,,,"$8,380.76",$0.00,1,1,1,1,1,1,20110101,E0371,HCPCS,NONPOWER MATTRESS OVERLAY,RR,,28 ,,NW,,,,,,$882.84,$0.00,1,1,1,1,1,1,20110101,E0372,HCPCS,POWERED AIR MATTRESS OVERLAY,,,28 ,,NW,,,,,,"$10,215.32",$0.00,1,1,1,1,1,1,20110101,E0372,HCPCS,POWERED AIR MATTRESS OVERLAY,RR,,28 ,,NW,,,,,,"$1,076.09",$0.00,1,1,1,1,1,1,20110101,E0373,HCPCS,NONPOWERED PRESSURE MATTRESS,,,28 ,,NW,,,,,,"$11,699.86",$0.00,1,1,1,1,1,1,20110101,E0373,HCPCS,NONPOWERED PRESSURE MATTRESS,RR,,28 ,,NW,,,,,,"$1,232.47",$0.00,1,1,1,1,1,1,20110101,E0424,HCPCS,STATIONARY COMPRESSED GAS 02,,,28 ,,NW,,,,,,"$4,907.60",$0.00,1,1,1,1,1,1,20110101,E0424,HCPCS,STATIONARY COMPRESSED GAS 02,RR,,28 ,,NW,,,,,,$516.97,$0.00,1,1,1,1,1,1,20110101,E0425,HCPCS,GAS SYSTEM STATIONARY COMPRE,,,28 ,,NW,,,,,,"$9,770.20",$0.00,1,1,1,1,1,1,20110101,E0425,HCPCS,GAS SYSTEM STATIONARY COMPRE,NU,,28 ,,NW,,,,,,"$9,770.20",$0.00,1,1,1,1,1,1,20110101,E0430,HCPCS,OXYGEN SYSTEM GAS PORTABLE,,,28 ,,NW,,,,,,"$4,415.78",$0.00,1,1,1,1,1,1,20110101,E0430,HCPCS,OXYGEN SYSTEM GAS PORTABLE,NU,,28 ,,NW,,,,,,"$4,415.78",$0.00,1,1,1,1,1,1,20110101,E0430,HCPCS,OXYGEN SYSTEM GAS PORTABLE,UE,,28 ,,NW,,,,,,"$3,307.66",$0.00,1,1,1,1,1,1,20110101,E0431,HCPCS,PORTABLE GASEOUS 02,,,28 ,,NW,,,,,,$693.26,$0.00,1,1,1,1,1,1,20110101,E0431,HCPCS,PORTABLE GASEOUS 02,RR,,28 ,,NW,,,,,,$73.03,$0.00,1,1,1,1,1,1,20110101,E0433,HCPCS,PORTABLE LIQUID OXYGEN SYS,,,28 ,,NW,,,,,,"$1,360.43",$0.00,1,1,1,1,1,1,20110101,E0433,HCPCS,PORTABLE LIQUID OXYGEN SYS,RR,,28 ,,NW,,,,,,$143.31,$0.00,1,1,1,1,1,1,20110101,E0434,HCPCS,PORTABLE LIQUID 02,,,28 ,,NW,,,,,,$693.26,$0.00,1,1,1,1,1,1,20110101,E0434,HCPCS,PORTABLE LIQUID 02,RR,,28 ,,NW,,,,,,$73.03,$0.00,1,1,1,1,1,1,20110101,E0435,HCPCS,OXYGEN SYSTEM LIQUID PORTABL,,,28 ,,NW,,,,,,"$3,030.95",$0.00,1,1,1,1,1,1,20110101,E0435,HCPCS,OXYGEN SYSTEM LIQUID PORTABL,NU,,28 ,,NW,,,,,,"$3,030.95",$0.00,1,1,1,1,1,1,20110101,E0435,HCPCS,OXYGEN SYSTEM LIQUID PORTABL,UE,,28 ,,NW,,,,,,"$2,269.36",$0.00,1,1,1,1,1,1,20110101,E0439,HCPCS,STATIONARY LIQUID 02,,,28 ,,NW,,,,,,"$4,907.60",$0.00,1,1,1,1,1,1,20110101,E0439,HCPCS,STATIONARY LIQUID 02,RR,,28 ,,NW,,,,,,$516.97,$0.00,1,1,1,1,1,1,20110101,E0440,HCPCS,OXYGEN SYSTEM LIQUID STATION,,,28 ,,NW,,,,,,"$6,170.42",$0.00,1,1,1,1,1,1,20110101,E0440,HCPCS,OXYGEN SYSTEM LIQUID STATION,NU,,28 ,,NW,,,,,,"$6,170.42",$0.00,1,1,1,1,1,1,20110101,E0440,HCPCS,OXYGEN SYSTEM LIQUID STATION,UE,,28 ,,NW,,,,,,"$4,623.96",$0.00,1,1,1,1,1,1,20110101,E0441,HCPCS,"STATIONARY O2 CONTENTS, GAS",,,28 ,,NW,,,,,,$222.69,$0.00,1,1,1,1,1,1,20110101,E0442,HCPCS,"STATIONARY O2 CONTENTS, LIQ",,,28 ,,NW,,,,,,$222.69,$0.00,1,1,1,1,1,1,20110101,E0443,HCPCS,"PORTABLE 02 CONTENTS, GAS",,,28 ,,NW,,,,,,$222.69,$0.00,1,1,1,1,1,1,20110101,E0444,HCPCS,"PORTABLE 02 CONTENTS, LIQUID",,,28 ,,NW,,,,,,$222.69,$0.00,1,1,1,1,1,1,20110101,E0445,HCPCS,OXIMETER NON-INVASIVE,,,28 ,,NW,,,,,,$336.84,$0.00,1,1,1,1,1,1,20110101,E0450,HCPCS,VOL CONTROL VENT INVASIV INT,,,28 ,,NW,,,,,,"$7,701.38",$0.00,1,1,1,1,1,1,20110101,E0450,HCPCS,VOL CONTROL VENT INVASIV INT,NU,,28 ,,NW,,,,,,"$7,701.38",$0.00,1,1,1,1,1,1,20110101,E0450,HCPCS,VOL CONTROL VENT INVASIV INT,RR,,28 ,,NW,,,,,,"$2,219.16",$0.00,1,1,1,1,1,1,20110101,E0450,HCPCS,VOL CONTROL VENT INVASIV INT,UE,,28 ,,NW,,,,,,"$5,778.16",$0.00,1,1,1,1,1,1,20110101,E0455,HCPCS,OXYGEN TENT EXCL CROUP/PED T,,,28 ,,NW,,,,,,$37.31,$0.00,1,1,1,1,1,1,20110101,E0457,HCPCS,CHEST SHELL,,,28 ,,NW,,,,,,"$1,472.01",$0.00,1,1,1,1,1,1,20110101,E0457,HCPCS,CHEST SHELL,NU,,28 ,,NW,,,,,,"$1,472.01",$0.00,1,1,1,1,1,1,20110101,E0457,HCPCS,CHEST SHELL,RR,,28 ,,NW,,,,,,$126.77,$0.00,1,1,1,1,1,1,20110101,E0457,HCPCS,CHEST SHELL,UE,,28 ,,NW,,,,,,"$1,098.24",$0.00,1,1,1,1,1,1,20110101,E0459,HCPCS,CHEST WRAP,,,28 ,,NW,,,,,,"$1,224.52",$0.00,1,1,1,1,1,1,20110101,E0459,HCPCS,CHEST WRAP,NU,,28 ,,NW,,,,,,"$1,224.52",$0.00,1,1,1,1,1,1,20110101,E0459,HCPCS,CHEST WRAP,RR,,28 ,,NW,,,,,,$96.36,$0.00,1,1,1,1,1,1,20110101,E0459,HCPCS,CHEST WRAP,UE,,28 ,,NW,,,,,,$913.01,$0.00,1,1,1,1,1,1,20110101,E0460,HCPCS,NEG PRESS VENT PORTABL/STATN,,,28 ,,NW,,,,,,"$17,955.19",$0.00,1,1,1,1,1,1,20110101,E0460,HCPCS,NEG PRESS VENT PORTABL/STATN,NU,,28 ,,NW,,,,,,"$17,955.19",$0.00,1,1,1,1,1,1,20110101,E0460,HCPCS,NEG PRESS VENT PORTABL/STATN,RR,,28 ,,NW,,,,,,"$1,643.81",$0.00,1,1,1,1,1,1,20110101,E0460,HCPCS,NEG PRESS VENT PORTABL/STATN,UE,,28 ,,NW,,,,,,"$13,461.30",$0.00,1,1,1,1,1,1,20110101,E0461,HCPCS,VOL CONTROL VENT NONINV INT,,,28 ,,NW,,,,,,"$20,779.24",$0.00,1,1,1,1,1,1,20110101,E0461,HCPCS,VOL CONTROL VENT NONINV INT,RR,,28 ,,NW,,,,,,"$2,188.90",$0.00,1,1,1,1,1,1,20110101,E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,,,28 ,,NW,,,,,,"$4,518.17",$0.00,1,1,1,1,1,1,20110101,E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,NU,,28 ,,NW,,,,,,"$4,518.17",$0.00,1,1,1,1,1,1,20110101,E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,RR,,28 ,,NW,,,,,,$500.13,$0.00,1,1,1,1,1,1,20110101,E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,UE,,28 ,,NW,,,,,,"$3,400.50",$0.00,1,1,1,1,1,1,20110101,E0463,HCPCS,PRESS SUPP VENT INVASIVE INT,,,28 ,,NW,,,,,,"$32,258.06",$0.00,1,1,1,1,1,1,20110101,E0463,HCPCS,PRESS SUPP VENT INVASIVE INT,RR,,28 ,,NW,,,,,,"$3,398.09",$0.00,1,1,1,1,1,1,20110101,E0464,HCPCS,PRESS SUPP VENT NONINV INT,,,28 ,,NW,,,,,,"$32,258.06",$0.00,1,1,1,1,1,1,20110101,E0464,HCPCS,PRESS SUPP VENT NONINV INT,RR,,28 ,,NW,,,,,,"$3,398.09",$0.00,1,1,1,1,1,1,20110101,E0470,HCPCS,RAD W/O BACKUP NON-INV INTFC,,,28 ,,NW,,,,,,"$4,668.66",$0.00,1,1,1,1,1,1,20110101,E0470,HCPCS,RAD W/O BACKUP NON-INV INTFC,RR,,28 ,,NW,,,,,,$491.80,$0.00,1,1,1,1,1,1,20110101,E0471,HCPCS,RAD W/BACKUP NON INV INTRFC,,,28 ,,NW,,,,,,"$11,808.60",$0.00,1,1,1,1,1,1,20110101,E0471,HCPCS,RAD W/BACKUP NON INV INTRFC,RR,,28 ,,NW,,,,,,"$1,243.93",$0.00,1,1,1,1,1,1,20110101,E0472,HCPCS,RAD W BACKUP INVASIVE INTRFC,,,28 ,,NW,,,,,,"$11,808.60",$0.00,1,1,1,1,1,1,20110101,E0472,HCPCS,RAD W BACKUP INVASIVE INTRFC,RR,,28 ,,NW,,,,,,"$1,243.93",$0.00,1,1,1,1,1,1,20110101,E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,,,28 ,,NW,,,,,,"$1,053.76",$0.00,1,1,1,1,1,1,20110101,E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,NU,,28 ,,NW,,,,,,"$1,053.76",$0.00,1,1,1,1,1,1,20110101,E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,RR,,28 ,,NW,,,,,,$81.15,$0.00,1,1,1,1,1,1,20110101,E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,UE,,28 ,,NW,,,,,,$784.94,$0.00,1,1,1,1,1,1,20110101,E0481,HCPCS,INTRPULMNRY PERCUSS VENT SYS,,,28 ,,NW,,,,,,$723.13,$0.00,1,1,1,1,1,1,20110101,E0482,HCPCS,COUGH STIMULATING DEVICE,,,28 ,,NW,,,,,,"$9,430.33",$0.00,1,1,1,1,1,1,20110101,E0482,HCPCS,COUGH STIMULATING DEVICE,RR,,28 ,,NW,,,,,,$993.40,$0.00,1,1,1,1,1,1,20110101,E0483,HCPCS,CHEST COMPRESSION GEN SYSTEM,,,28 ,,NW,,,,,,"$24,332.44",$0.00,1,1,1,1,1,1,20110101,E0483,HCPCS,CHEST COMPRESSION GEN SYSTEM,RR,,28 ,,NW,,,,,,"$2,563.20",$0.00,1,1,1,1,1,1,20110101,E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,,,28 ,,NW,,,,,,$72.74,$0.00,1,1,1,1,1,1,20110101,E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,NU,,28 ,,NW,,,,,,$72.74,$0.00,1,1,1,1,1,1,20110101,E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,RR,,28 ,,NW,,,,,,$10.17,$0.00,1,1,1,1,1,1,20110101,E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,UE,,28 ,,NW,,,,,,$55.65,$0.00,1,1,1,1,1,1,20110101,E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,,,28 ,,NW,,,,,,"$2,886.59",$0.00,1,1,1,1,1,1,20110101,E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,NU,,28 ,,NW,,,,,,"$2,886.59",$0.00,1,1,1,1,1,1,20110101,E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,RR,,28 ,,NW,,,,,,$315.91,$0.00,1,1,1,1,1,1,20110101,E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,UE,,28 ,,NW,,,,,,"$2,173.78",$0.00,1,1,1,1,1,1,20110101,E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,,,28 ,,NW,,,,,,"$3,026.07",$0.00,1,1,1,1,1,1,20110101,E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,NU,,28 ,,NW,,,,,,"$3,026.07",$0.00,1,1,1,1,1,1,20110101,E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,RR,,28 ,,NW,,,,,,$331.17,$0.00,1,1,1,1,1,1,20110101,E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,UE,,28 ,,NW,,,,,,"$2,278.83",$0.00,1,1,1,1,1,1,20110101,E0487,HCPCS,ELECTRONIC SPIROMETER,,,28 ,,NW,,,,,,$239.81,$0.00,1,1,1,1,1,1,20110101,E0500,HCPCS,IPPB ALL TYPES,,,28 ,,NW,,,,,,"$2,667.87",$0.00,1,1,1,1,1,1,20110101,E0500,HCPCS,IPPB ALL TYPES,NU,,28 ,,NW,,,,,,"$2,667.87",$0.00,1,1,1,1,1,1,20110101,E0500,HCPCS,IPPB ALL TYPES,RR,,28 ,,NW,,,,,,$236.15,$0.00,1,1,1,1,1,1,20110101,E0500,HCPCS,IPPB ALL TYPES,UE,,28 ,,NW,,,,,,"$1,995.23",$0.00,1,1,1,1,1,1,20110101,E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,,,28 ,,NW,,,,,,"$1,206.06",$0.00,1,1,1,1,1,1,20110101,E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,NU,,28 ,,NW,,,,,,"$1,206.06",$0.00,1,1,1,1,1,1,20110101,E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,RR,,28 ,,NW,,,,,,$93.23,$0.00,1,1,1,1,1,1,20110101,E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,UE,,28 ,,NW,,,,,,$899.16,$0.00,1,1,1,1,1,1,20110101,E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,,,28 ,,NW,,,,,,$6.56,$0.00,1,1,1,1,1,1,20110101,E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,NU,,28 ,,NW,,,,,,$6.56,$0.00,1,1,1,1,1,1,20110101,E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,RR,,28 ,,NW,,,,,,$0.69,$0.00,1,1,1,1,1,1,20110101,E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,UE,,28 ,,NW,,,,,,$2.68,$0.00,1,1,1,1,1,1,20110101,E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,,,28 ,,NW,,,,,,$311.55,$0.00,1,1,1,1,1,1,20110101,E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,NU,,28 ,,NW,,,,,,$311.55,$0.00,1,1,1,1,1,1,20110101,E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,RR,,28 ,,NW,,,,,,$34.89,$0.00,1,1,1,1,1,1,20110101,E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,UE,,28 ,,NW,,,,,,$227.99,$0.00,1,1,1,1,1,1,20110101,E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,,,28 ,,NW,,,,,,$201.72,$0.00,1,1,1,1,1,1,20110101,E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,NU,,28 ,,NW,,,,,,$201.72,$0.00,1,1,1,1,1,1,20110101,E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,RR,,28 ,,NW,,,,,,$21.39,$0.00,1,1,1,1,1,1,20110101,E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,UE,,28 ,,NW,,,,,,$145.61,$0.00,1,1,1,1,1,1,20110101,E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,,,28 ,,NW,,,,,,$608.79,$0.00,1,1,1,1,1,1,20110101,E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,NU,,28 ,,NW,,,,,,$608.79,$0.00,1,1,1,1,1,1,20110101,E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,RR,,28 ,,NW,,,,,,$52.41,$0.00,1,1,1,1,1,1,20110101,E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,UE,,28 ,,NW,,,,,,$450.92,$0.00,1,1,1,1,1,1,20110101,E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,,,28 ,,NW,,,,,,"$1,472.58",$0.00,1,1,1,1,1,1,20110101,E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,NU,,28 ,,NW,,,,,,"$1,472.58",$0.00,1,1,1,1,1,1,20110101,E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,RR,,28 ,,NW,,,,,,$118.09,$0.00,1,1,1,1,1,1,20110101,E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,UE,,28 ,,NW,,,,,,"$1,098.76",$0.00,1,1,1,1,1,1,20110101,E0570,HCPCS,NEBULIZER WITH COMPRESSION,,,28 ,,NW,,,,,,$324.34,$0.00,1,1,1,1,1,1,20110101,E0570,HCPCS,NEBULIZER WITH COMPRESSION,NU,,28 ,,NW,,,,,,$324.34,$0.00,1,1,1,1,1,1,20110101,E0570,HCPCS,NEBULIZER WITH COMPRESSION,RR,,28 ,,NW,,,,,,$34.17,$0.00,1,1,1,1,1,1,20110101,E0570,HCPCS,NEBULIZER WITH COMPRESSION,UE,,28 ,,NW,,,,,,$243.79,$0.00,1,1,1,1,1,1,20110101,E0571,HCPCS,AEROSOL COMPRESSOR FOR SVNEB,,,28 ,,NW,,,,,,$554.66,$0.00,1,1,1,1,1,1,20110101,E0571,HCPCS,AEROSOL COMPRESSOR FOR SVNEB,RR,,28 ,,NW,,,,,,$58.43,$0.00,1,1,1,1,1,1,20110101,E0572,HCPCS,AEROSOL COMPRESSOR ADJUST PR,,,28 ,,NW,,,,,,$990.97,$0.00,1,1,1,1,1,1,20110101,E0572,HCPCS,AEROSOL COMPRESSOR ADJUST PR,RR,,28 ,,NW,,,,,,$104.39,$0.00,1,1,1,1,1,1,20110101,E0574,HCPCS,ULTRASONIC GENERATOR W SVNEB,,,28 ,,NW,,,,,,"$1,055.76",$0.00,1,1,1,1,1,1,20110101,E0574,HCPCS,ULTRASONIC GENERATOR W SVNEB,RR,,28 ,,NW,,,,,,$111.22,$0.00,1,1,1,1,1,1,20110101,E0575,HCPCS,NEBULIZER ULTRASONIC,,,28 ,,NW,,,,,,"$2,495.96",$0.00,1,1,1,1,1,1,20110101,E0575,HCPCS,NEBULIZER ULTRASONIC,NU,,28 ,,NW,,,,,,"$2,495.96",$0.00,1,1,1,1,1,1,20110101,E0575,HCPCS,NEBULIZER ULTRASONIC,RR,,28 ,,NW,,,,,,$218.26,$0.00,1,1,1,1,1,1,20110101,E0575,HCPCS,NEBULIZER ULTRASONIC,UE,,28 ,,NW,,,,,,"$1,866.01",$0.00,1,1,1,1,1,1,20110101,E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,,,28 ,,NW,,,,,,$258.32,$0.00,1,1,1,1,1,1,20110101,E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,NU,,28 ,,NW,,,,,,$258.32,$0.00,1,1,1,1,1,1,20110101,E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,RR,,28 ,,NW,,,,,,$25.73,$0.00,1,1,1,1,1,1,20110101,E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,UE,,28 ,,NW,,,,,,$188.04,$0.00,1,1,1,1,1,1,20110101,E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,,,28 ,,NW,,,,,,$836.86,$0.00,1,1,1,1,1,1,20110101,E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,NU,,28 ,,NW,,,,,,$836.86,$0.00,1,1,1,1,1,1,20110101,E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,RR,,28 ,,NW,,,,,,$66.33,$0.00,1,1,1,1,1,1,20110101,E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,UE,,28 ,,NW,,,,,,$622.26,$0.00,1,1,1,1,1,1,20110101,E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,,,28 ,,NW,,,,,,"$1,099.92",$0.00,1,1,1,1,1,1,20110101,E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,NU,,28 ,,NW,,,,,,"$1,099.92",$0.00,1,1,1,1,1,1,20110101,E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,RR,,28 ,,NW,,,,,,$85.45,$0.00,1,1,1,1,1,1,20110101,E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,UE,,28 ,,NW,,,,,,$819.55,$0.00,1,1,1,1,1,1,20110101,E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,,,28 ,,NW,,,,,,"$2,336.75",$0.00,1,1,1,1,1,1,20110101,E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,NU,,28 ,,NW,,,,,,"$2,336.75",$0.00,1,1,1,1,1,1,20110101,E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,RR,,28 ,,NW,,,,,,$199.76,$0.00,1,1,1,1,1,1,20110101,E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,UE,,28 ,,NW,,,,,,"$1,747.17",$0.00,1,1,1,1,1,1,20110101,E0602,HCPCS,MANUAL BREAST PUMP,,,28 ,,NW,,,,,,$59.03,$0.00,1,1,1,1,1,1,20110101,E0602,HCPCS,MANUAL BREAST PUMP,NU,,28 ,,NW,,,,,,$59.03,$0.00,1,1,1,1,1,1,20110101,E0602,HCPCS,MANUAL BREAST PUMP,RR,,28 ,,NW,,,,,,$8.18,$0.00,1,1,1,1,1,1,20110101,E0602,HCPCS,MANUAL BREAST PUMP,UE,,28 ,,NW,,,,,,$45.35,$0.00,1,1,1,1,1,1,20110101,E0603,HCPCS,ELECTRIC BREAST PUMP,,,28 ,,NW,,,,,,$183.83,$0.00,1,1,1,1,1,1,20110101,E0603,HCPCS,ELECTRIC BREAST PUMP,NU,,28 ,,NW,,,,,,$183.83,$0.00,1,1,1,1,1,1,20110101,E0603,HCPCS,ELECTRIC BREAST PUMP,RR,,28 ,,NW,,,,,,$57.06,$0.00,1,1,1,1,1,1,20110101,E0603,HCPCS,ELECTRIC BREAST PUMP,UE,,28 ,,NW,,,,,,$142.29,$0.00,1,1,1,1,1,1,20110101,E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,,,28 ,,NW,,,,,,$570.34,$0.00,1,1,1,1,1,1,20110101,E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,NU,,28 ,,NW,,,,,,$570.34,$0.00,1,1,1,1,1,1,20110101,E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,RR,,28 ,,NW,,,,,,$205.75,$0.00,1,1,1,1,1,1,20110101,E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,UE,,28 ,,NW,,,,,,$422.66,$0.00,1,1,1,1,1,1,20110101,E0605,HCPCS,VAPORIZER ROOM TYPE,,,28 ,,NW,,,,,,$52.75,$0.00,1,1,1,1,1,1,20110101,E0605,HCPCS,VAPORIZER ROOM TYPE,NU,,28 ,,NW,,,,,,$52.75,$0.00,1,1,1,1,1,1,20110101,E0605,HCPCS,VAPORIZER ROOM TYPE,RR,,28 ,,NW,,,,,,$8.82,$0.00,1,1,1,1,1,1,20110101,E0605,HCPCS,VAPORIZER ROOM TYPE,UE,,28 ,,NW,,,,,,$43.24,$0.00,1,1,1,1,1,1,20110101,E0606,HCPCS,DRAINAGE BOARD POSTURAL,,,28 ,,NW,,,,,,$539.19,$0.00,1,1,1,1,1,1,20110101,E0606,HCPCS,DRAINAGE BOARD POSTURAL,NU,,28 ,,NW,,,,,,$539.19,$0.00,1,1,1,1,1,1,20110101,E0606,HCPCS,DRAINAGE BOARD POSTURAL,RR,,28 ,,NW,,,,,,$44.21,$0.00,1,1,1,1,1,1,20110101,E0606,HCPCS,DRAINAGE BOARD POSTURAL,UE,,28 ,,NW,,,,,,$399.58,$0.00,1,1,1,1,1,1,20110101,E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,,,28 ,,NW,,,,,,$139.98,$0.00,1,1,1,1,1,1,20110101,E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,NU,,28 ,,NW,,,,,,$139.98,$0.00,1,1,1,1,1,1,20110101,E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,RR,,28 ,,NW,,,,,,$16.70,$0.00,1,1,1,1,1,1,20110101,E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,UE,,28 ,,NW,,,,,,$99.29,$0.00,1,1,1,1,1,1,20110101,E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,,,28 ,,NW,,,,,,$540.59,$0.00,1,1,1,1,1,1,20110101,E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,NU,,28 ,,NW,,,,,,$540.59,$0.00,1,1,1,1,1,1,20110101,E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,RR,,28 ,,NW,,,,,,$49.44,$0.00,1,1,1,1,1,1,20110101,E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,UE,,28 ,,NW,,,,,,$399.68,$0.00,1,1,1,1,1,1,20110101,E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,,,28 ,,NW,,,,,,"$1,086.67",$0.00,1,1,1,1,1,1,20110101,E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,NU,,28 ,,NW,,,,,,"$1,086.67",$0.00,1,1,1,1,1,1,20110101,E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,RR,,28 ,,NW,,,,,,$111.11,$0.00,1,1,1,1,1,1,20110101,E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,UE,,28 ,,NW,,,,,,$807.73,$0.00,1,1,1,1,1,1,20110101,E0616,HCPCS,CARDIAC EVENT RECORDER,,,28 ,,NW,,,,,,"$7,566.77",$0.00,1,1,1,1,1,1,20110101,E0617,HCPCS,AUTOMATIC EXT DEFIBRILLATOR,,,28 ,,NW,,,,,,"$14,599.63",$0.00,1,1,1,1,1,1,20110101,E0617,HCPCS,AUTOMATIC EXT DEFIBRILLATOR,RR,,28 ,,NW,,,,,,"$1,537.94",$0.00,1,1,1,1,1,1,20110101,E0618,HCPCS,APNEA MONITOR,,,28 ,,NW,,,,,,"$5,870.68",$0.00,1,1,1,1,1,1,20110101,E0618,HCPCS,APNEA MONITOR,RR,,28 ,,NW,,,,,,$618.42,$0.00,1,1,1,1,1,1,20110101,E0619,HCPCS,APNEA MONITOR W RECORDER,,,28 ,,NW,,,,,,$593.15,$0.00,1,1,1,1,1,1,20110101,E0619,HCPCS,APNEA MONITOR W RECORDER,RR,,28 ,,NW,,,,,,$62.48,$0.00,1,1,1,1,1,1,20110101,E0620,HCPCS,CAP BLD SKIN PIERCING LASER,,,28 ,,NW,,,,,,"$2,104.12",$0.00,1,1,1,1,1,1,20110101,E0620,HCPCS,CAP BLD SKIN PIERCING LASER,NU,,28 ,,NW,,,,,,"$2,104.12",$0.00,1,1,1,1,1,1,20110101,E0620,HCPCS,CAP BLD SKIN PIERCING LASER,RR,,28 ,,NW,,,,,,$189.96,$0.00,1,1,1,1,1,1,20110101,E0620,HCPCS,CAP BLD SKIN PIERCING LASER,UE,,28 ,,NW,,,,,,"$1,572.41",$0.00,1,1,1,1,1,1,20110101,E0621,HCPCS,PATIENT LIFT SLING OR SEAT,,,28 ,,NW,,,,,,$194.34,$0.00,1,1,1,1,1,1,20110101,E0621,HCPCS,PATIENT LIFT SLING OR SEAT,NU,,28 ,,NW,,,,,,$194.34,$0.00,1,1,1,1,1,1,20110101,E0621,HCPCS,PATIENT LIFT SLING OR SEAT,RR,,28 ,,NW,,,,,,$20.53,$0.00,1,1,1,1,1,1,20110101,E0621,HCPCS,PATIENT LIFT SLING OR SEAT,UE,,28 ,,NW,,,,,,$140.87,$0.00,1,1,1,1,1,1,20110101,E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,,,28 ,,NW,,,,,,"$1,875.36",$0.00,1,1,1,1,1,1,20110101,E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,NU,,28 ,,NW,,,,,,"$1,875.36",$0.00,1,1,1,1,1,1,20110101,E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,RR,,28 ,,NW,,,,,,$193.37,$0.00,1,1,1,1,1,1,20110101,E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,UE,,28 ,,NW,,,,,,"$1,387.76",$0.00,1,1,1,1,1,1,20110101,E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,,,28 ,,NW,,,,,,$787.34,$0.00,1,1,1,1,1,1,20110101,E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,NU,,28 ,,NW,,,,,,$787.34,$0.00,1,1,1,1,1,1,20110101,E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,RR,,28 ,,NW,,,,,,$66.03,$0.00,1,1,1,1,1,1,20110101,E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,UE,,28 ,,NW,,,,,,$584.80,$0.00,1,1,1,1,1,1,20110101,E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,,,28 ,,NW,,,,,,$787.34,$0.00,1,1,1,1,1,1,20110101,E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,NU,,28 ,,NW,,,,,,$787.34,$0.00,1,1,1,1,1,1,20110101,E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,RR,,28 ,,NW,,,,,,$66.03,$0.00,1,1,1,1,1,1,20110101,E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,UE,,28 ,,NW,,,,,,$584.80,$0.00,1,1,1,1,1,1,20110101,E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,,,28 ,,NW,,,,,,$773.63,$0.00,1,1,1,1,1,1,20110101,E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,NU,,28 ,,NW,,,,,,$773.63,$0.00,1,1,1,1,1,1,20110101,E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,RR,,28 ,,NW,,,,,,$64.98,$0.00,1,1,1,1,1,1,20110101,E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,UE,,28 ,,NW,,,,,,$574.49,$0.00,1,1,1,1,1,1,20110101,E0630,HCPCS,PATIENT LIFT HYDRAULIC,,,28 ,,NW,,,,,,"$2,474.04",$0.00,1,1,1,1,1,1,20110101,E0630,HCPCS,PATIENT LIFT HYDRAULIC,NU,,28 ,,NW,,,,,,"$2,474.04",$0.00,1,1,1,1,1,1,20110101,E0630,HCPCS,PATIENT LIFT HYDRAULIC,RR,,28 ,,NW,,,,,,$213.53,$0.00,1,1,1,1,1,1,20110101,E0630,HCPCS,PATIENT LIFT HYDRAULIC,UE,,28 ,,NW,,,,,,"$1,849.86",$0.00,1,1,1,1,1,1,20110101,E0635,HCPCS,PATIENT LIFT ELECTRIC,,,28 ,,NW,,,,,,"$2,975.93",$0.00,1,1,1,1,1,1,20110101,E0635,HCPCS,PATIENT LIFT ELECTRIC,NU,,28 ,,NW,,,,,,"$2,975.93",$0.00,1,1,1,1,1,1,20110101,E0635,HCPCS,PATIENT LIFT ELECTRIC,RR,,28 ,,NW,,,,,,$257.14,$0.00,1,1,1,1,1,1,20110101,E0635,HCPCS,PATIENT LIFT ELECTRIC,UE,,28 ,,NW,,,,,,"$2,225.98",$0.00,1,1,1,1,1,1,20110101,E0636,HCPCS,PT SUPPORT & POSITIONING SYS,,,28 ,,NW,,,,,,"$24,134.53",$0.00,1,1,1,1,1,1,20110101,E0636,HCPCS,PT SUPPORT & POSITIONING SYS,RR,,28 ,,NW,,,,,,"$2,542.35",$0.00,1,1,1,1,1,1,20110101,E0637,HCPCS,COMBINATION SIT TO STAND SYS,,,28 ,,NW,,,,,,"$1,405.32",$0.00,1,1,1,1,1,1,20110101,E0638,HCPCS,STANDING FRAME SYS,,,28 ,,NW,,,,,,"$2,404.67",$0.00,1,1,1,1,1,1,20110101,E0640,HCPCS,FIXED PATIENT LIFT SYSTEM,,,28 ,,NW,,,,,,"$1,643.62",$0.00,1,1,1,1,1,1,20110101,E0641,HCPCS,MULTI-POSITION STND FRAM SYS,,,28 ,,NW,,,,,,"$1,184.45",$0.00,1,1,1,1,1,1,20110101,E0642,HCPCS,DYNAMIC STANDING FRAME,,,28 ,,NW,,,,,,"$3,688.50",$0.00,1,1,1,1,1,1,20110101,E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,,,28 ,,NW,,,,,,"$1,646.14",$0.00,1,1,1,1,1,1,20110101,E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,NU,,28 ,,NW,,,,,,"$1,646.14",$0.00,1,1,1,1,1,1,20110101,E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,RR,,28 ,,NW,,,,,,$183.50,$0.00,1,1,1,1,1,1,20110101,E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,UE,,28 ,,NW,,,,,,"$1,222.50",$0.00,1,1,1,1,1,1,20110101,E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,,,28 ,,NW,,,,,,"$2,085.39",$0.00,1,1,1,1,1,1,20110101,E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,NU,,28 ,,NW,,,,,,"$2,085.39",$0.00,1,1,1,1,1,1,20110101,E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,RR,,28 ,,NW,,,,,,$194.80,$0.00,1,1,1,1,1,1,20110101,E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,UE,,28 ,,NW,,,,,,"$1,558.38",$0.00,1,1,1,1,1,1,20110101,E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,,,28 ,,NW,,,,,,"$12,512.99",$0.00,1,1,1,1,1,1,20110101,E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,NU,,28 ,,NW,,,,,,"$12,512.99",$0.00,1,1,1,1,1,1,20110101,E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,RR,,28 ,,NW,,,,,,"$1,201.19",$0.00,1,1,1,1,1,1,20110101,E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,UE,,28 ,,NW,,,,,,"$9,279.00",$0.00,1,1,1,1,1,1,20110101,E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,,,28 ,,NW,,,,,,$228.45,$0.00,1,1,1,1,1,1,20110101,E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,NU,,28 ,,NW,,,,,,$228.45,$0.00,1,1,1,1,1,1,20110101,E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,RR,,28 ,,NW,,,,,,$25.84,$0.00,1,1,1,1,1,1,20110101,E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,UE,,28 ,,NW,,,,,,$166.80,$0.00,1,1,1,1,1,1,20110101,E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,,,28 ,,NW,,,,,,"$1,382.50",$0.00,1,1,1,1,1,1,20110101,E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,NU,,28 ,,NW,,,,,,"$1,382.50",$0.00,1,1,1,1,1,1,20110101,E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,RR,,28 ,,NW,,,,,,$117.66,$0.00,1,1,1,1,1,1,20110101,E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,UE,,28 ,,NW,,,,,,"$1,031.34",$0.00,1,1,1,1,1,1,20110101,E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,,,28 ,,NW,,,,,,"$1,297.44",$0.00,1,1,1,1,1,1,20110101,E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,NU,,28 ,,NW,,,,,,"$1,297.44",$0.00,1,1,1,1,1,1,20110101,E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,RR,,28 ,,NW,,,,,,$109.09,$0.00,1,1,1,1,1,1,20110101,E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,UE,,28 ,,NW,,,,,,$967.48,$0.00,1,1,1,1,1,1,20110101,E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,,,28 ,,NW,,,,,,$344.68,$0.00,1,1,1,1,1,1,20110101,E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,NU,,28 ,,NW,,,,,,$344.68,$0.00,1,1,1,1,1,1,20110101,E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,RR,,28 ,,NW,,,,,,$33.23,$0.00,1,1,1,1,1,1,20110101,E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,UE,,28 ,,NW,,,,,,$252.23,$0.00,1,1,1,1,1,1,20110101,E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,,,28 ,,NW,,,,,,$291.43,$0.00,1,1,1,1,1,1,20110101,E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,NU,,28 ,,NW,,,,,,$291.43,$0.00,1,1,1,1,1,1,20110101,E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,RR,,28 ,,NW,,,,,,$29.00,$0.00,1,1,1,1,1,1,20110101,E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,UE,,28 ,,NW,,,,,,$211.29,$0.00,1,1,1,1,1,1,20110101,E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,,,28 ,,NW,,,,,,$295.41,$0.00,1,1,1,1,1,1,20110101,E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,NU,,28 ,,NW,,,,,,$295.41,$0.00,1,1,1,1,1,1,20110101,E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,RR,,28 ,,NW,,,,,,$29.33,$0.00,1,1,1,1,1,1,20110101,E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,UE,,28 ,,NW,,,,,,$216.46,$0.00,1,1,1,1,1,1,20110101,E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,,,28 ,,NW,,,,,,$749.85,$0.00,1,1,1,1,1,1,20110101,E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,NU,,28 ,,NW,,,,,,$749.85,$0.00,1,1,1,1,1,1,20110101,E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,RR,,28 ,,NW,,,,,,$69.75,$0.00,1,1,1,1,1,1,20110101,E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,UE,,28 ,,NW,,,,,,$556.71,$0.00,1,1,1,1,1,1,20110101,E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,,,28 ,,NW,,,,,,$993.99,$0.00,1,1,1,1,1,1,20110101,E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,NU,,28 ,,NW,,,,,,$993.99,$0.00,1,1,1,1,1,1,20110101,E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,RR,,28 ,,NW,,,,,,$80.77,$0.00,1,1,1,1,1,1,20110101,E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,UE,,28 ,,NW,,,,,,$739.85,$0.00,1,1,1,1,1,1,20110101,E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,,,28 ,,NW,,,,,,$413.98,$0.00,1,1,1,1,1,1,20110101,E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,NU,,28 ,,NW,,,,,,$413.98,$0.00,1,1,1,1,1,1,20110101,E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,RR,,28 ,,NW,,,,,,$37.60,$0.00,1,1,1,1,1,1,20110101,E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,UE,,28 ,,NW,,,,,,$304.85,$0.00,1,1,1,1,1,1,20110101,E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,,,28 ,,NW,,,,,,$987.95,$0.00,1,1,1,1,1,1,20110101,E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,NU,,28 ,,NW,,,,,,$987.95,$0.00,1,1,1,1,1,1,20110101,E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,RR,,28 ,,NW,,,,,,$81.32,$0.00,1,1,1,1,1,1,20110101,E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,UE,,28 ,,NW,,,,,,$735.27,$0.00,1,1,1,1,1,1,20110101,E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,,,28 ,,NW,,,,,,$762.59,$0.00,1,1,1,1,1,1,20110101,E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,NU,,28 ,,NW,,,,,,$762.59,$0.00,1,1,1,1,1,1,20110101,E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,RR,,28 ,,NW,,,,,,$64.15,$0.00,1,1,1,1,1,1,20110101,E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,UE,,28 ,,NW,,,,,,$566.28,$0.00,1,1,1,1,1,1,20110101,E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,,,28 ,,NW,,,,,,$629.83,$0.00,1,1,1,1,1,1,20110101,E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,NU,,28 ,,NW,,,,,,$629.83,$0.00,1,1,1,1,1,1,20110101,E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,RR,,28 ,,NW,,,,,,$54.03,$0.00,1,1,1,1,1,1,20110101,E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,UE,,28 ,,NW,,,,,,$466.75,$0.00,1,1,1,1,1,1,20110101,E0675,HCPCS,PNEUMATIC COMPRESSION DEVICE,,,28 ,,NW,,,,,,"$8,663.93",$0.00,1,1,1,1,1,1,20110101,E0675,HCPCS,PNEUMATIC COMPRESSION DEVICE,RR,,28 ,,NW,,,,,,$912.67,$0.00,1,1,1,1,1,1,20110101,E0676,HCPCS,INTER LIMB COMPRESS DEV NOS,,,28 ,,NW,,,,,,$194.80,$0.00,1,1,1,1,1,1,20110101,E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,,,28 ,,NW,,,,,,"$2,162.98",$0.00,1,1,1,1,1,1,20110101,E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,NU,,28 ,,NW,,,,,,"$2,162.98",$0.00,1,1,1,1,1,1,20110101,E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,RR,,28 ,,NW,,,,,,$195.87,$0.00,1,1,1,1,1,1,20110101,E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,UE,,28 ,,NW,,,,,,"$1,616.56",$0.00,1,1,1,1,1,1,20110101,E0692,HCPCS,UVL SYS PANEL 4 FT,,,28 ,,NW,,,,,,"$2,721.88",$0.00,1,1,1,1,1,1,20110101,E0692,HCPCS,UVL SYS PANEL 4 FT,NU,,28 ,,NW,,,,,,"$2,721.88",$0.00,1,1,1,1,1,1,20110101,E0692,HCPCS,UVL SYS PANEL 4 FT,RR,,28 ,,NW,,,,,,$251.69,$0.00,1,1,1,1,1,1,20110101,E0692,HCPCS,UVL SYS PANEL 4 FT,UE,,28 ,,NW,,,,,,"$2,035.76",$0.00,1,1,1,1,1,1,20110101,E0693,HCPCS,UVL SYS PANEL 6 FT,,,28 ,,NW,,,,,,"$3,360.64",$0.00,1,1,1,1,1,1,20110101,E0693,HCPCS,UVL SYS PANEL 6 FT,NU,,28 ,,NW,,,,,,"$3,360.64",$0.00,1,1,1,1,1,1,20110101,E0693,HCPCS,UVL SYS PANEL 6 FT,RR,,28 ,,NW,,,,,,$315.66,$0.00,1,1,1,1,1,1,20110101,E0693,HCPCS,UVL SYS PANEL 6 FT,UE,,28 ,,NW,,,,,,"$2,514.81",$0.00,1,1,1,1,1,1,20110101,E0694,HCPCS,UVL MD CABINET SYS 6 FT,,,28 ,,NW,,,,,,"$10,746.08",$0.00,1,1,1,1,1,1,20110101,E0694,HCPCS,UVL MD CABINET SYS 6 FT,NU,,28 ,,NW,,,,,,"$10,746.08",$0.00,1,1,1,1,1,1,20110101,E0694,HCPCS,UVL MD CABINET SYS 6 FT,RR,,28 ,,NW,,,,,,"$1,054.18",$0.00,1,1,1,1,1,1,20110101,E0694,HCPCS,UVL MD CABINET SYS 6 FT,UE,,28 ,,NW,,,,,,"$8,053.95",$0.00,1,1,1,1,1,1,20110101,E0700,HCPCS,SAFETY EQUIPMENT,,,28 ,,NW,,,,,,$69.49,$0.00,1,1,1,1,1,1,20110101,E0705,HCPCS,TRANSFER DEVICE,,,28 ,,NW,,,,,,$102.21,$0.00,1,1,1,1,1,1,20110101,E0705,HCPCS,TRANSFER DEVICE,NU,,28 ,,NW,,,,,,$102.21,$0.00,1,1,1,1,1,1,20110101,E0705,HCPCS,TRANSFER DEVICE,RR,,28 ,,NW,,,,,,$13.99,$0.00,1,1,1,1,1,1,20110101,E0705,HCPCS,TRANSFER DEVICE,UE,,28 ,,NW,,,,,,$74.37,$0.00,1,1,1,1,1,1,20110101,E0710,HCPCS,RESTRAINTS ANY TYPE,,,28 ,,NW,,,,,,$31.62,$0.00,1,1,1,1,1,1,20110101,E0720,HCPCS,TENS TWO LEAD,,,28 ,,NW,,,,,,$821.17,$0.00,1,1,1,1,1,1,20110101,E0720,HCPCS,TENS TWO LEAD,NU,,28 ,,NW,,,,,,$821.17,$0.00,1,1,1,1,1,1,20110101,E0720,HCPCS,TENS TWO LEAD,RR,,28 ,,NW,,,,,,$72.87,$0.00,1,1,1,1,1,1,20110101,E0720,HCPCS,TENS TWO LEAD,UE,,28 ,,NW,,,,,,$653.41,$0.00,1,1,1,1,1,1,20110101,E0730,HCPCS,TENS FOUR LEAD,,,28 ,,NW,,,,,,$836.38,$0.00,1,1,1,1,1,1,20110101,E0730,HCPCS,TENS FOUR LEAD,NU,,28 ,,NW,,,,,,$836.38,$0.00,1,1,1,1,1,1,20110101,E0730,HCPCS,TENS FOUR LEAD,RR,,28 ,,NW,,,,,,$73.75,$0.00,1,1,1,1,1,1,20110101,E0730,HCPCS,TENS FOUR LEAD,UE,,28 ,,NW,,,,,,$658.03,$0.00,1,1,1,1,1,1,20110101,E0731,HCPCS,CONDUCTIVE GARMENT FOR TENS/,,,28 ,,NW,,,,,,$792.86,$0.00,1,1,1,1,1,1,20110101,E0731,HCPCS,CONDUCTIVE GARMENT FOR TENS/,NU,,28 ,,NW,,,,,,$792.86,$0.00,1,1,1,1,1,1,20110101,E0731,HCPCS,CONDUCTIVE GARMENT FOR TENS/,RR,,28 ,,NW,,,,,,$83.52,$0.00,1,1,1,1,1,1,20110101,E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,,,28 ,,NW,,,,,,"$1,249.09",$0.00,1,1,1,1,1,1,20110101,E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,NU,,28 ,,NW,,,,,,"$1,249.09",$0.00,1,1,1,1,1,1,20110101,E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,RR,,28 ,,NW,,,,,,$104.48,$0.00,1,1,1,1,1,1,20110101,E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,UE,,28 ,,NW,,,,,,$931.22,$0.00,1,1,1,1,1,1,20110101,E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,,,28 ,,NW,,,,,,"$2,221.37",$0.00,1,1,1,1,1,1,20110101,E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,NU,,28 ,,NW,,,,,,"$2,221.37",$0.00,1,1,1,1,1,1,20110101,E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,RR,,28 ,,NW,,,,,,$186.77,$0.00,1,1,1,1,1,1,20110101,E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,UE,,28 ,,NW,,,,,,"$1,660.64",$0.00,1,1,1,1,1,1,20110101,E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,,,28 ,,NW,,,,,,"$2,170.60",$0.00,1,1,1,1,1,1,20110101,E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,NU,,28 ,,NW,,,,,,"$2,170.60",$0.00,1,1,1,1,1,1,20110101,E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,RR,,28 ,,NW,,,,,,$183.88,$0.00,1,1,1,1,1,1,20110101,E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,UE,,28 ,,NW,,,,,,"$1,622.57",$0.00,1,1,1,1,1,1,20110101,E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,,,28 ,,NW,,,,,,$198.27,$0.00,1,1,1,1,1,1,20110101,E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,NU,,28 ,,NW,,,,,,$198.27,$0.00,1,1,1,1,1,1,20110101,E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,RR,,28 ,,NW,,,,,,$21.70,$0.00,1,1,1,1,1,1,20110101,E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,UE,,28 ,,NW,,,,,,$149.31,$0.00,1,1,1,1,1,1,20110101,E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,,,28 ,,NW,,,,,,"$9,042.54",$0.00,1,1,1,1,1,1,20110101,E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,NU,,28 ,,NW,,,,,,"$9,042.54",$0.00,1,1,1,1,1,1,20110101,E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,RR,,28 ,,NW,,,,,,$881.28,$0.00,1,1,1,1,1,1,20110101,E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,UE,,28 ,,NW,,,,,,"$6,726.29",$0.00,1,1,1,1,1,1,20110101,E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,,,28 ,,NW,,,,,,"$9,444.23",$0.00,1,1,1,1,1,1,20110101,E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,NU,,28 ,,NW,,,,,,"$9,444.23",$0.00,1,1,1,1,1,1,20110101,E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,RR,,28 ,,NW,,,,,,$923.99,$0.00,1,1,1,1,1,1,20110101,E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,UE,,28 ,,NW,,,,,,"$7,077.52",$0.00,1,1,1,1,1,1,20110101,E0749,HCPCS,ELEC OSTEOGEN STIM IMPLANTED,,,28 ,,NW,,,,,,"$5,973.39",$0.00,1,1,1,1,1,1,20110101,E0749,HCPCS,ELEC OSTEOGEN STIM IMPLANTED,RR,,28 ,,NW,,,,,,$629.24,$0.00,1,1,1,1,1,1,20110101,E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,,,28 ,,NW,,,,,,"$7,841.30",$0.00,1,1,1,1,1,1,20110101,E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,NU,,28 ,,NW,,,,,,"$7,841.30",$0.00,1,1,1,1,1,1,20110101,E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,RR,,28 ,,NW,,,,,,$763.74,$0.00,1,1,1,1,1,1,20110101,E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,UE,,28 ,,NW,,,,,,"$5,875.30",$0.00,1,1,1,1,1,1,20110101,E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,,,28 ,,NW,,,,,,"$2,482.68",$0.00,1,1,1,1,1,1,20110101,E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,NU,,28 ,,NW,,,,,,"$2,482.68",$0.00,1,1,1,1,1,1,20110101,E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,RR,,28 ,,NW,,,,,,$227.86,$0.00,1,1,1,1,1,1,20110101,E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,UE,,28 ,,NW,,,,,,"$1,856.29",$0.00,1,1,1,1,1,1,20110101,E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,,,28 ,,NW,,,,,,"$26,895.50",$0.00,1,1,1,1,1,1,20110101,E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,NU,,28 ,,NW,,,,,,"$26,895.50",$0.00,1,1,1,1,1,1,20110101,E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,RR,,28 ,,NW,,,,,,"$2,669.09",$0.00,1,1,1,1,1,1,20110101,E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,UE,,28 ,,NW,,,,,,"$20,165.97",$0.00,1,1,1,1,1,1,20110101,E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,,,28 ,,NW,,,,,,$181.95,$0.00,1,1,1,1,1,1,20110101,E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,NU,,28 ,,NW,,,,,,$181.95,$0.00,1,1,1,1,1,1,20110101,E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,RR,,28 ,,NW,,,,,,$19.94,$0.00,1,1,1,1,1,1,20110101,E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,UE,,28 ,,NW,,,,,,$130.85,$0.00,1,1,1,1,1,1,20110101,E0769,HCPCS,ELECTRIC WOUND TREATMENT DEV,,,28 ,,NW,,,,,,$73.75,$0.00,1,1,1,1,1,1,20110101,E0770,HCPCS,FUNCTIONAL ELECTRIC STIM NOS,,,28 ,,NW,,,,,,$73.75,$0.00,1,1,1,1,1,1,20110101,E0776,HCPCS,IV POLE,,,28 ,,NW,,,,,,$302.32,$0.00,1,1,1,1,1,1,20110101,E0776,HCPCS,IV POLE,NU,,28 ,,NW,,,,,,$302.32,$0.00,1,1,1,1,1,1,20110101,E0776,HCPCS,IV POLE,RR,,28 ,,NW,,,,,,$36.71,$0.00,1,1,1,1,1,1,20110101,E0776,HCPCS,IV POLE,UE,,28 ,,NW,,,,,,$216.98,$0.00,1,1,1,1,1,1,20110101,E0779,HCPCS,AMB INFUSION PUMP MECHANICAL,,,28 ,,NW,,,,,,$328.69,$0.00,1,1,1,1,1,1,20110101,E0779,HCPCS,AMB INFUSION PUMP MECHANICAL,RR,,28 ,,NW,,,,,,$34.62,$0.00,1,1,1,1,1,1,20110101,E0780,HCPCS,MECH AMB INFUSION PUMP <8HRS,,,28 ,,NW,,,,,,$23.66,$0.00,1,1,1,1,1,1,20110101,E0780,HCPCS,MECH AMB INFUSION PUMP <8HRS,NU,,28 ,,NW,,,,,,$23.55,$0.00,1,1,1,1,1,1,20110101,E0781,HCPCS,EXTERNAL AMBULATORY INFUS PU,,,28 ,,NW,,,,,,"$5,659.02",$0.00,1,1,1,1,1,1,20110101,E0781,HCPCS,EXTERNAL AMBULATORY INFUS PU,RR,,28 ,,NW,,,,,,$596.13,$0.00,1,1,1,1,1,1,20110101,E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,,,28 ,,NW,,,,,,"$9,837.87",$0.00,1,1,1,1,1,1,20110101,E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,NU,,28 ,,NW,,,,,,"$9,837.87",$0.00,1,1,1,1,1,1,20110101,E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,RR,,28 ,,NW,,,,,,$963.40,$0.00,1,1,1,1,1,1,20110101,E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,UE,,28 ,,NW,,,,,,"$7,372.74",$0.00,1,1,1,1,1,1,20110101,E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,,,28 ,,NW,,,,,,"$19,409.38",$0.00,1,1,1,1,1,1,20110101,E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,NU,,28 ,,NW,,,,,,"$19,409.38",$0.00,1,1,1,1,1,1,20110101,E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,RR,,28 ,,NW,,,,,,"$1,920.55",$0.00,1,1,1,1,1,1,20110101,E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,UE,,28 ,,NW,,,,,,"$14,551.38",$0.00,1,1,1,1,1,1,20110101,E0784,HCPCS,EXT AMB INFUSN PUMP INSULIN,,,28 ,,NW,,,,,,"$9,425.35",$0.00,1,1,1,1,1,1,20110101,E0784,HCPCS,EXT AMB INFUSN PUMP INSULIN,RR,,28 ,,NW,,,,,,$992.87,$0.00,1,1,1,1,1,1,20110101,E0785,HCPCS,REPLACEMENT IMPL PUMP CATHET,,,28 ,,NW,,,,,,"$1,135.68",$0.00,1,1,1,1,1,1,20110101,E0785,HCPCS,REPLACEMENT IMPL PUMP CATHET,KF,,28 ,,NW,,,,,,"$1,075.90",$0.00,1,1,1,1,1,1,20110101,E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,,,28 ,,NW,,,,,,"$18,905.69",$0.00,1,1,1,1,1,1,20110101,E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,NU,,28 ,,NW,,,,,,"$18,905.69",$0.00,1,1,1,1,1,1,20110101,E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,RR,,28 ,,NW,,,,,,"$1,870.13",$0.00,1,1,1,1,1,1,20110101,E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,UE,,28 ,,NW,,,,,,"$14,173.61",$0.00,1,1,1,1,1,1,20110101,E0791,HCPCS,PARENTERAL INFUSION PUMP STA,,,28 ,,NW,,,,,,"$5,487.12",$0.00,1,1,1,1,1,1,20110101,E0791,HCPCS,PARENTERAL INFUSION PUMP STA,RR,,28 ,,NW,,,,,,$548.25,$0.00,1,1,1,1,1,1,20110101,E0791,HCPCS,PARENTERAL INFUSION PUMP STA,UE,,28 ,,NW,,,,,,"$4,132.16",$0.00,1,1,1,1,1,1,20110101,E0830,HCPCS,AMBULATORY TRACTION DEVICE,,,28 ,,NW,,,,,,"$3,073.23",$0.00,1,1,1,1,1,1,20110101,E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,,,28 ,,NW,,,,,,$143.53,$0.00,1,1,1,1,1,1,20110101,E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,NU,,28 ,,NW,,,,,,$143.53,$0.00,1,1,1,1,1,1,20110101,E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,RR,,28 ,,NW,,,,,,$32.52,$0.00,1,1,1,1,1,1,20110101,E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,UE,,28 ,,NW,,,,,,$107.19,$0.00,1,1,1,1,1,1,20110101,E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,,,28 ,,NW,,,,,,"$1,230.72",$0.00,1,1,1,1,1,1,20110101,E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,NU,,28 ,,NW,,,,,,"$1,230.72",$0.00,1,1,1,1,1,1,20110101,E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,RR,,28 ,,NW,,,,,,$102.65,$0.00,1,1,1,1,1,1,20110101,E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,UE,,28 ,,NW,,,,,,$917.30,$0.00,1,1,1,1,1,1,20110101,E0850,HCPCS,TRACTION STAND FREE STANDING,,,28 ,,NW,,,,,,$205.48,$0.00,1,1,1,1,1,1,20110101,E0850,HCPCS,TRACTION STAND FREE STANDING,NU,,28 ,,NW,,,,,,$205.48,$0.00,1,1,1,1,1,1,20110101,E0850,HCPCS,TRACTION STAND FREE STANDING,RR,,28 ,,NW,,,,,,$28.28,$0.00,1,1,1,1,1,1,20110101,E0850,HCPCS,TRACTION STAND FREE STANDING,UE,,28 ,,NW,,,,,,$154.84,$0.00,1,1,1,1,1,1,20110101,E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,,,28 ,,NW,,,,,,"$1,190.40",$0.00,1,1,1,1,1,1,20110101,E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,NU,,28 ,,NW,,,,,,"$1,190.40",$0.00,1,1,1,1,1,1,20110101,E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,RR,,28 ,,NW,,,,,,$98.63,$0.00,1,1,1,1,1,1,20110101,E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,UE,,28 ,,NW,,,,,,$887.10,$0.00,1,1,1,1,1,1,20110101,E0856,HCPCS,CERVIC COLLAR W AIR BLADDER,,,28 ,,NW,,,,,,$351.96,$0.00,1,1,1,1,1,1,20110101,E0856,HCPCS,CERVIC COLLAR W AIR BLADDER,NU,,28 ,,NW,,,,,,$351.96,$0.00,1,1,1,1,1,1,20110101,E0856,HCPCS,CERVIC COLLAR W AIR BLADDER,RR,,28 ,,NW,,,,,,$32.87,$0.00,1,1,1,1,1,1,20110101,E0856,HCPCS,CERVIC COLLAR W AIR BLADDER,UE,,28 ,,NW,,,,,,$258.32,$0.00,1,1,1,1,1,1,20110101,E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,,,28 ,,NW,,,,,,$74.59,$0.00,1,1,1,1,1,1,20110101,E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,NU,,28 ,,NW,,,,,,$74.59,$0.00,1,1,1,1,1,1,20110101,E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,RR,,28 ,,NW,,,,,,$12.55,$0.00,1,1,1,1,1,1,20110101,E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,UE,,28 ,,NW,,,,,,$57.42,$0.00,1,1,1,1,1,1,20110101,E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,,,28 ,,NW,,,,,,$223.49,$0.00,1,1,1,1,1,1,20110101,E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,NU,,28 ,,NW,,,,,,$223.49,$0.00,1,1,1,1,1,1,20110101,E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,RR,,28 ,,NW,,,,,,$27.00,$0.00,1,1,1,1,1,1,20110101,E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,UE,,28 ,,NW,,,,,,$168.80,$0.00,1,1,1,1,1,1,20110101,E0880,HCPCS,TRAC STAND FREE STAND EXTREM,,,28 ,,NW,,,,,,$235.02,$0.00,1,1,1,1,1,1,20110101,E0880,HCPCS,TRAC STAND FREE STAND EXTREM,NU,,28 ,,NW,,,,,,$235.02,$0.00,1,1,1,1,1,1,20110101,E0880,HCPCS,TRAC STAND FREE STAND EXTREM,RR,,28 ,,NW,,,,,,$38.34,$0.00,1,1,1,1,1,1,20110101,E0880,HCPCS,TRAC STAND FREE STAND EXTREM,UE,,28 ,,NW,,,,,,$181.02,$0.00,1,1,1,1,1,1,20110101,E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,,,28 ,,NW,,,,,,$228.80,$0.00,1,1,1,1,1,1,20110101,E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,NU,,28 ,,NW,,,,,,$228.80,$0.00,1,1,1,1,1,1,20110101,E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,RR,,28 ,,NW,,,,,,$64.87,$0.00,1,1,1,1,1,1,20110101,E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,UE,,28 ,,NW,,,,,,$184.62,$0.00,1,1,1,1,1,1,20110101,E0900,HCPCS,TRAC STAND FREE STAND PELVIC,,,28 ,,NW,,,,,,$242.26,$0.00,1,1,1,1,1,1,20110101,E0900,HCPCS,TRAC STAND FREE STAND PELVIC,NU,,28 ,,NW,,,,,,$242.26,$0.00,1,1,1,1,1,1,20110101,E0900,HCPCS,TRAC STAND FREE STAND PELVIC,RR,,28 ,,NW,,,,,,$53.52,$0.00,1,1,1,1,1,1,20110101,E0900,HCPCS,TRAC STAND FREE STAND PELVIC,UE,,28 ,,NW,,,,,,$187.17,$0.00,1,1,1,1,1,1,20110101,E0910,HCPCS,TRAPEZE BAR ATTACHED TO BED,,,28 ,,NW,,,,,,$322.61,$0.00,1,1,1,1,1,1,20110101,E0910,HCPCS,TRAPEZE BAR ATTACHED TO BED,RR,,28 ,,NW,,,,,,$33.98,$0.00,1,1,1,1,1,1,20110101,E0910,HCPCS,TRAPEZE BAR ATTACHED TO BED,UE,,28 ,,NW,,,,,,$247.47,$0.00,1,1,1,1,1,1,20110101,E0911,HCPCS,HD TRAPEZE BAR ATTACH TO BED,,,28 ,,NW,,,,,,$844.10,$0.00,1,1,1,1,1,1,20110101,E0911,HCPCS,HD TRAPEZE BAR ATTACH TO BED,RR,,28 ,,NW,,,,,,$88.92,$0.00,1,1,1,1,1,1,20110101,E0912,HCPCS,HD TRAPEZE BAR FREE STANDING,,,28 ,,NW,,,,,,"$1,942.35",$0.00,1,1,1,1,1,1,20110101,E0912,HCPCS,HD TRAPEZE BAR FREE STANDING,RR,,28 ,,NW,,,,,,$204.61,$0.00,1,1,1,1,1,1,20110101,E0920,HCPCS,FRACTURE FRAME ATTACHED TO B,,,28 ,,NW,,,,,,$852.84,$0.00,1,1,1,1,1,1,20110101,E0920,HCPCS,FRACTURE FRAME ATTACHED TO B,RR,,28 ,,NW,,,,,,$89.84,$0.00,1,1,1,1,1,1,20110101,E0920,HCPCS,FRACTURE FRAME ATTACHED TO B,UE,,28 ,,NW,,,,,,$579.59,$0.00,1,1,1,1,1,1,20110101,E0930,HCPCS,FRACTURE FRAME FREE STANDING,,,28 ,,NW,,,,,,$847.39,$0.00,1,1,1,1,1,1,20110101,E0930,HCPCS,FRACTURE FRAME FREE STANDING,RR,,28 ,,NW,,,,,,$89.26,$0.00,1,1,1,1,1,1,20110101,E0930,HCPCS,FRACTURE FRAME FREE STANDING,UE,,28 ,,NW,,,,,,$636.93,$0.00,1,1,1,1,1,1,20110101,E0935,HCPCS,CONT PAS MOTION EXERCISE DEV,,,28 ,,NW,,,,,,$416.29,$0.00,1,1,1,1,1,1,20110101,E0935,HCPCS,CONT PAS MOTION EXERCISE DEV,RR,,28 ,,NW,,,,,,$43.85,$0.00,1,1,1,1,1,1,20110101,E0936,HCPCS,"CPM DEVICE, OTHER THAN KNEE",,,28 ,,NW,,,,,,$85.83,$0.00,1,1,1,1,1,1,20110101,E0936,HCPCS,"CPM DEVICE, OTHER THAN KNEE",RR,,28 ,,NW,,,,,,$9.04,$0.00,1,1,1,1,1,1,20110101,E0940,HCPCS,TRAPEZE BAR FREE STANDING,,,28 ,,NW,,,,,,$558.26,$0.00,1,1,1,1,1,1,20110101,E0940,HCPCS,TRAPEZE BAR FREE STANDING,RR,,28 ,,NW,,,,,,$58.81,$0.00,1,1,1,1,1,1,20110101,E0940,HCPCS,TRAPEZE BAR FREE STANDING,UE,,28 ,,NW,,,,,,$393.31,$0.00,1,1,1,1,1,1,20110101,E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,,,28 ,,NW,,,,,,$825.78,$0.00,1,1,1,1,1,1,20110101,E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,NU,,28 ,,NW,,,,,,$825.78,$0.00,1,1,1,1,1,1,20110101,E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,RR,,28 ,,NW,,,,,,$86.99,$0.00,1,1,1,1,1,1,20110101,E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,UE,,28 ,,NW,,,,,,$620.68,$0.00,1,1,1,1,1,1,20110101,E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,,,28 ,,NW,,,,,,$39.09,$0.00,1,1,1,1,1,1,20110101,E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,NU,,28 ,,NW,,,,,,$39.09,$0.00,1,1,1,1,1,1,20110101,E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,RR,,28 ,,NW,,,,,,$4.30,$0.00,1,1,1,1,1,1,20110101,E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,UE,,28 ,,NW,,,,,,$29.23,$0.00,1,1,1,1,1,1,20110101,E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,,,28 ,,NW,,,,,,$75.33,$0.00,1,1,1,1,1,1,20110101,E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,NU,,28 ,,NW,,,,,,$75.33,$0.00,1,1,1,1,1,1,20110101,E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,RR,,28 ,,NW,,,,,,$7.05,$0.00,1,1,1,1,1,1,20110101,E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,UE,,28 ,,NW,,,,,,$56.29,$0.00,1,1,1,1,1,1,20110101,E0945,HCPCS,BELT/HARNESS EXTREMITY,,,28 ,,NW,,,,,,$74.51,$0.00,1,1,1,1,1,1,20110101,E0945,HCPCS,BELT/HARNESS EXTREMITY,NU,,28 ,,NW,,,,,,$74.51,$0.00,1,1,1,1,1,1,20110101,E0945,HCPCS,BELT/HARNESS EXTREMITY,RR,,28 ,,NW,,,,,,$6.95,$0.00,1,1,1,1,1,1,20110101,E0945,HCPCS,BELT/HARNESS EXTREMITY,UE,,28 ,,NW,,,,,,$57.09,$0.00,1,1,1,1,1,1,20110101,E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,,,28 ,,NW,,,,,,"$1,073.91",$0.00,1,1,1,1,1,1,20110101,E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,NU,,28 ,,NW,,,,,,"$1,073.91",$0.00,1,1,1,1,1,1,20110101,E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,RR,,28 ,,NW,,,,,,$113.13,$0.00,1,1,1,1,1,1,20110101,E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,UE,,28 ,,NW,,,,,,$807.18,$0.00,1,1,1,1,1,1,20110101,E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,,,28 ,,NW,,,,,,$949.05,$0.00,1,1,1,1,1,1,20110101,E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,NU,,28 ,,NW,,,,,,$949.05,$0.00,1,1,1,1,1,1,20110101,E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,RR,,28 ,,NW,,,,,,$120.79,$0.00,1,1,1,1,1,1,20110101,E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,UE,,28 ,,NW,,,,,,$724.01,$0.00,1,1,1,1,1,1,20110101,E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,,,28 ,,NW,,,,,,$930.67,$0.00,1,1,1,1,1,1,20110101,E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,NU,,28 ,,NW,,,,,,$930.67,$0.00,1,1,1,1,1,1,20110101,E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,RR,,28 ,,NW,,,,,,$112.93,$0.00,1,1,1,1,1,1,20110101,E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,UE,,28 ,,NW,,,,,,$676.53,$0.00,1,1,1,1,1,1,20110101,E0950,HCPCS,TRAY,,,28 ,,NW,,,,,,$281.89,$0.00,1,1,1,1,1,1,20110101,E0950,HCPCS,TRAY,NU,,28 ,,NW,,,,,,$281.89,$0.00,1,1,1,1,1,1,20110101,E0950,HCPCS,TRAY,RR,,28 ,,NW,,,,,,$31.98,$0.00,1,1,1,1,1,1,20110101,E0950,HCPCS,TRAY,UE,,28 ,,NW,,,,,,$225.84,$0.00,1,1,1,1,1,1,20110101,E0951,HCPCS,LOOP HEEL,,,28 ,,NW,,,,,,$61.03,$0.00,1,1,1,1,1,1,20110101,E0951,HCPCS,LOOP HEEL,NU,,28 ,,NW,,,,,,$61.03,$0.00,1,1,1,1,1,1,20110101,E0951,HCPCS,LOOP HEEL,RR,,28 ,,NW,,,,,,$5.82,$0.00,1,1,1,1,1,1,20110101,E0951,HCPCS,LOOP HEEL,UE,,28 ,,NW,,,,,,$45.39,$0.00,1,1,1,1,1,1,20110101,E0952,HCPCS,"TOE LOOP/HOLDER, EACH",,,28 ,,NW,,,,,,$58.91,$0.00,1,1,1,1,1,1,20110101,E0952,HCPCS,"TOE LOOP/HOLDER, EACH",NU,,28 ,,NW,,,,,,$58.91,$0.00,1,1,1,1,1,1,20110101,E0952,HCPCS,"TOE LOOP/HOLDER, EACH",RR,,28 ,,NW,,,,,,$5.66,$0.00,1,1,1,1,1,1,20110101,E0952,HCPCS,"TOE LOOP/HOLDER, EACH",UE,,28 ,,NW,,,,,,$43.95,$0.00,1,1,1,1,1,1,20110101,E0955,HCPCS,CUSHIONED HEADREST,,,28 ,,NW,,,,,,$524.41,$0.00,1,1,1,1,1,1,20110101,E0955,HCPCS,CUSHIONED HEADREST,NU,,28 ,,NW,,,,,,$524.41,$0.00,1,1,1,1,1,1,20110101,E0955,HCPCS,CUSHIONED HEADREST,RR,,28 ,,NW,,,,,,$67.73,$0.00,1,1,1,1,1,1,20110101,E0955,HCPCS,CUSHIONED HEADREST,UE,,28 ,,NW,,,,,,$407.78,$0.00,1,1,1,1,1,1,20110101,E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,,,28 ,,NW,,,,,,$285.37,$0.00,1,1,1,1,1,1,20110101,E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,NU,,28 ,,NW,,,,,,$285.37,$0.00,1,1,1,1,1,1,20110101,E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,RR,,28 ,,NW,,,,,,$32.35,$0.00,1,1,1,1,1,1,20110101,E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,UE,,28 ,,NW,,,,,,$228.51,$0.00,1,1,1,1,1,1,20110101,E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,,,28 ,,NW,,,,,,$376.17,$0.00,1,1,1,1,1,1,20110101,E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,NU,,28 ,,NW,,,,,,$376.17,$0.00,1,1,1,1,1,1,20110101,E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,RR,,28 ,,NW,,,,,,$45.74,$0.00,1,1,1,1,1,1,20110101,E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,UE,,28 ,,NW,,,,,,$296.60,$0.00,1,1,1,1,1,1,20110101,E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,,,28 ,,NW,,,,,,$747.36,$0.00,1,1,1,1,1,1,20110101,E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,NU,,28 ,,NW,,,,,,$747.36,$0.00,1,1,1,1,1,1,20110101,E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,RR,,28 ,,NW,,,,,,$74.79,$0.00,1,1,1,1,1,1,20110101,E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,UE,,28 ,,NW,,,,,,$563.13,$0.00,1,1,1,1,1,1,20110101,E0959,HCPCS,AMPUTEE ADAPTER,,,28 ,,NW,,,,,,$75.58,$0.00,1,1,1,1,1,1,20110101,E0959,HCPCS,AMPUTEE ADAPTER,NU,,28 ,,NW,,,,,,$75.58,$0.00,1,1,1,1,1,1,20110101,E0959,HCPCS,AMPUTEE ADAPTER,RR,,28 ,,NW,,,,,,$7.06,$0.00,1,1,1,1,1,1,20110101,E0959,HCPCS,AMPUTEE ADAPTER,UE,,28 ,,NW,,,,,,$56.85,$0.00,1,1,1,1,1,1,20110101,E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,,,28 ,,NW,,,,,,$267.84,$0.00,1,1,1,1,1,1,20110101,E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,NU,,28 ,,NW,,,,,,$267.84,$0.00,1,1,1,1,1,1,20110101,E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,RR,,28 ,,NW,,,,,,$29.75,$0.00,1,1,1,1,1,1,20110101,E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,UE,,28 ,,NW,,,,,,$215.37,$0.00,1,1,1,1,1,1,20110101,E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,,,28 ,,NW,,,,,,$48.82,$0.00,1,1,1,1,1,1,20110101,E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,NU,,28 ,,NW,,,,,,$48.82,$0.00,1,1,1,1,1,1,20110101,E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,RR,,28 ,,NW,,,,,,$4.78,$0.00,1,1,1,1,1,1,20110101,E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,UE,,28 ,,NW,,,,,,$24.00,$0.00,1,1,1,1,1,1,20110101,E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,,,28 ,,NW,,,,,,$125.21,$0.00,1,1,1,1,1,1,20110101,E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,NU,,28 ,,NW,,,,,,$125.21,$0.00,1,1,1,1,1,1,20110101,E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,RR,,28 ,,NW,,,,,,$11.55,$0.00,1,1,1,1,1,1,20110101,E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,UE,,28 ,,NW,,,,,,$93.58,$0.00,1,1,1,1,1,1,20110101,E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,,,28 ,,NW,,,,,,$118.68,$0.00,1,1,1,1,1,1,20110101,E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,NU,,28 ,,NW,,,,,,$118.68,$0.00,1,1,1,1,1,1,20110101,E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,RR,,28 ,,NW,,,,,,$11.03,$0.00,1,1,1,1,1,1,20110101,E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,UE,,28 ,,NW,,,,,,$88.66,$0.00,1,1,1,1,1,1,20110101,E0968,HCPCS,WHEELCHAIR COMMODE SEAT,,,28 ,,NW,,,,,,$352.34,$0.00,1,1,1,1,1,1,20110101,E0968,HCPCS,WHEELCHAIR COMMODE SEAT,NU,,28 ,,NW,,,,,,$352.34,$0.00,1,1,1,1,1,1,20110101,E0968,HCPCS,WHEELCHAIR COMMODE SEAT,RR,,28 ,,NW,,,,,,$30.49,$0.00,1,1,1,1,1,1,20110101,E0968,HCPCS,WHEELCHAIR COMMODE SEAT,UE,,28 ,,NW,,,,,,$244.19,$0.00,1,1,1,1,1,1,20110101,E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,,,28 ,,NW,,,,,,$244.65,$0.00,1,1,1,1,1,1,20110101,E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,NU,,28 ,,NW,,,,,,$244.65,$0.00,1,1,1,1,1,1,20110101,E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,RR,,28 ,,NW,,,,,,$26.08,$0.00,1,1,1,1,1,1,20110101,E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,UE,,28 ,,NW,,,,,,$198.78,$0.00,1,1,1,1,1,1,20110101,E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,,,28 ,,NW,,,,,,$90.61,$0.00,1,1,1,1,1,1,20110101,E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,NU,,28 ,,NW,,,,,,$90.61,$0.00,1,1,1,1,1,1,20110101,E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,RR,,28 ,,NW,,,,,,$7.75,$0.00,1,1,1,1,1,1,20110101,E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,UE,,28 ,,NW,,,,,,$67.63,$0.00,1,1,1,1,1,1,20110101,E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,,,28 ,,NW,,,,,,$78.23,$0.00,1,1,1,1,1,1,20110101,E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,NU,,28 ,,NW,,,,,,$78.23,$0.00,1,1,1,1,1,1,20110101,E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,RR,,28 ,,NW,,,,,,$7.27,$0.00,1,1,1,1,1,1,20110101,E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,UE,,28 ,,NW,,,,,,$58.37,$0.00,1,1,1,1,1,1,20110101,E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,,,28 ,,NW,,,,,,$301.50,$0.00,1,1,1,1,1,1,20110101,E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,NU,,28 ,,NW,,,,,,$301.50,$0.00,1,1,1,1,1,1,20110101,E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,RR,,28 ,,NW,,,,,,$33.35,$0.00,1,1,1,1,1,1,20110101,E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,UE,,28 ,,NW,,,,,,$241.76,$0.00,1,1,1,1,1,1,20110101,E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,,,28 ,,NW,,,,,,$135.04,$0.00,1,1,1,1,1,1,20110101,E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,NU,,28 ,,NW,,,,,,$135.04,$0.00,1,1,1,1,1,1,20110101,E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,RR,,28 ,,NW,,,,,,$13.33,$0.00,1,1,1,1,1,1,20110101,E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,UE,,28 ,,NW,,,,,,$102.50,$0.00,1,1,1,1,1,1,20110101,E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",,,28 ,,NW,,,,,,$136.33,$0.00,1,1,1,1,1,1,20110101,E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",NU,,28 ,,NW,,,,,,$136.33,$0.00,1,1,1,1,1,1,20110101,E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",RR,,28 ,,NW,,,,,,$12.61,$0.00,1,1,1,1,1,1,20110101,E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",UE,,28 ,,NW,,,,,,$101.19,$0.00,1,1,1,1,1,1,20110101,E0980,HCPCS,WHEELCHAIR SAFETY VEST,,,28 ,,NW,,,,,,$54.70,$0.00,1,1,1,1,1,1,20110101,E0980,HCPCS,WHEELCHAIR SAFETY VEST,NU,,28 ,,NW,,,,,,$54.70,$0.00,1,1,1,1,1,1,20110101,E0980,HCPCS,WHEELCHAIR SAFETY VEST,RR,,28 ,,NW,,,,,,$5.06,$0.00,1,1,1,1,1,1,20110101,E0980,HCPCS,WHEELCHAIR SAFETY VEST,UE,,28 ,,NW,,,,,,$40.55,$0.00,1,1,1,1,1,1,20110101,E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",,,28 ,,NW,,,,,,$153.05,$0.00,1,1,1,1,1,1,20110101,E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",NU,,28 ,,NW,,,,,,$153.05,$0.00,1,1,1,1,1,1,20110101,E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",RR,,28 ,,NW,,,,,,$14.35,$0.00,1,1,1,1,1,1,20110101,E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",UE,,28 ,,NW,,,,,,$115.27,$0.00,1,1,1,1,1,1,20110101,E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",,,28 ,,NW,,,,,,$162.08,$0.00,1,1,1,1,1,1,20110101,E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",NU,,28 ,,NW,,,,,,$162.08,$0.00,1,1,1,1,1,1,20110101,E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",RR,,28 ,,NW,,,,,,$15.09,$0.00,1,1,1,1,1,1,20110101,E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",UE,,28 ,,NW,,,,,,$121.41,$0.00,1,1,1,1,1,1,20110101,E0983,HCPCS,ADD PWR JOYSTICK,,,28 ,,NW,,,,,,"$3,365.35",$0.00,1,1,1,1,1,1,20110101,E0983,HCPCS,ADD PWR JOYSTICK,RR,,28 ,,NW,,,,,,$359.66,$0.00,1,1,1,1,1,1,20110101,E0984,HCPCS,ADD PWR TILLER,,,28 ,,NW,,,,,,"$2,253.62",$0.00,1,1,1,1,1,1,20110101,E0984,HCPCS,ADD PWR TILLER,NU,,28 ,,NW,,,,,,"$2,253.62",$0.00,1,1,1,1,1,1,20110101,E0984,HCPCS,ADD PWR TILLER,RR,,28 ,,NW,,,,,,$260.81,$0.00,1,1,1,1,1,1,20110101,E0984,HCPCS,ADD PWR TILLER,UE,,28 ,,NW,,,,,,"$1,747.54",$0.00,1,1,1,1,1,1,20110101,E0985,HCPCS,W/C SEAT LIFT MECHANISM,,,28 ,,NW,,,,,,$309.29,$0.00,1,1,1,1,1,1,20110101,E0985,HCPCS,W/C SEAT LIFT MECHANISM,NU,,28 ,,NW,,,,,,$309.29,$0.00,1,1,1,1,1,1,20110101,E0985,HCPCS,W/C SEAT LIFT MECHANISM,RR,,28 ,,NW,,,,,,$35.89,$0.00,1,1,1,1,1,1,20110101,E0985,HCPCS,W/C SEAT LIFT MECHANISM,UE,,28 ,,NW,,,,,,$246.43,$0.00,1,1,1,1,1,1,20110101,E0986,HCPCS,MAN W/C PUSH-RIM POW ASSIST,,,28 ,,NW,,,,,,"$6,085.78",$0.00,1,1,1,1,1,1,20110101,E0986,HCPCS,MAN W/C PUSH-RIM POW ASSIST,NU,,28 ,,NW,,,,,,"$6,085.78",$0.00,1,1,1,1,1,1,20110101,E0986,HCPCS,MAN W/C PUSH-RIM POW ASSIST,RR,,28 ,,NW,,,,,,$660.71,$0.00,1,1,1,1,1,1,20110101,E0986,HCPCS,MAN W/C PUSH-RIM POW ASSIST,UE,,28 ,,NW,,,,,,"$4,578.84",$0.00,1,1,1,1,1,1,20110101,E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,,,28 ,,NW,,,,,,$313.93,$0.00,1,1,1,1,1,1,20110101,E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,NU,,28 ,,NW,,,,,,$313.93,$0.00,1,1,1,1,1,1,20110101,E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,RR,,28 ,,NW,,,,,,$41.35,$0.00,1,1,1,1,1,1,20110101,E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,UE,,28 ,,NW,,,,,,$254.16,$0.00,1,1,1,1,1,1,20110101,E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,,,28 ,,NW,,,,,,$162.48,$0.00,1,1,1,1,1,1,20110101,E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,NU,,28 ,,NW,,,,,,$162.48,$0.00,1,1,1,1,1,1,20110101,E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,RR,,28 ,,NW,,,,,,$14.71,$0.00,1,1,1,1,1,1,20110101,E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,UE,,28 ,,NW,,,,,,$121.54,$0.00,1,1,1,1,1,1,20110101,E0994,HCPCS,WHEELCHAIR ARM REST,,,28 ,,NW,,,,,,$29.37,$0.00,1,1,1,1,1,1,20110101,E0994,HCPCS,WHEELCHAIR ARM REST,NU,,28 ,,NW,,,,,,$29.37,$0.00,1,1,1,1,1,1,20110101,E0994,HCPCS,WHEELCHAIR ARM REST,RR,,28 ,,NW,,,,,,$2.73,$0.00,1,1,1,1,1,1,20110101,E0994,HCPCS,WHEELCHAIR ARM REST,UE,,28 ,,NW,,,,,,$21.74,$0.00,1,1,1,1,1,1,20110101,E0995,HCPCS,WHEELCHAIR CALF REST,,,28 ,,NW,,,,,,$95.81,$0.00,1,1,1,1,1,1,20110101,E0995,HCPCS,WHEELCHAIR CALF REST,NU,,28 ,,NW,,,,,,$95.81,$0.00,1,1,1,1,1,1,20110101,E0995,HCPCS,WHEELCHAIR CALF REST,RR,,28 ,,NW,,,,,,$8.94,$0.00,1,1,1,1,1,1,20110101,E0995,HCPCS,WHEELCHAIR CALF REST,UE,,28 ,,NW,,,,,,$71.49,$0.00,1,1,1,1,1,1,20110101,E1002,HCPCS,PWR SEAT TILT,,,28 ,,NW,,,,,,"$9,409.94",$0.00,1,1,1,1,1,1,20110101,E1002,HCPCS,PWR SEAT TILT,NU,,28 ,,NW,,,,,,"$9,409.94",$0.00,1,1,1,1,1,1,20110101,E1002,HCPCS,PWR SEAT TILT,RR,,28 ,,NW,,,,,,$993.12,$0.00,1,1,1,1,1,1,20110101,E1002,HCPCS,PWR SEAT TILT,UE,,28 ,,NW,,,,,,"$7,071.92",$0.00,1,1,1,1,1,1,20110101,E1003,HCPCS,PWR SEAT RECLINE,,,28 ,,NW,,,,,,"$10,190.03",$0.00,1,1,1,1,1,1,20110101,E1003,HCPCS,PWR SEAT RECLINE,NU,,28 ,,NW,,,,,,"$10,190.03",$0.00,1,1,1,1,1,1,20110101,E1003,HCPCS,PWR SEAT RECLINE,RR,,28 ,,NW,,,,,,"$1,071.15",$0.00,1,1,1,1,1,1,20110101,E1003,HCPCS,PWR SEAT RECLINE,UE,,28 ,,NW,,,,,,"$7,657.00",$0.00,1,1,1,1,1,1,20110101,E1004,HCPCS,PWR SEAT RECLINE MECH,,,28 ,,NW,,,,,,"$11,292.33",$0.00,1,1,1,1,1,1,20110101,E1004,HCPCS,PWR SEAT RECLINE MECH,NU,,28 ,,NW,,,,,,"$11,292.33",$0.00,1,1,1,1,1,1,20110101,E1004,HCPCS,PWR SEAT RECLINE MECH,RR,,28 ,,NW,,,,,,"$1,181.35",$0.00,1,1,1,1,1,1,20110101,E1004,HCPCS,PWR SEAT RECLINE MECH,UE,,28 ,,NW,,,,,,"$8,483.68",$0.00,1,1,1,1,1,1,20110101,E1005,HCPCS,PWR SEAT RECLINE PWR,,,28 ,,NW,,,,,,"$12,218.29",$0.00,1,1,1,1,1,1,20110101,E1005,HCPCS,PWR SEAT RECLINE PWR,NU,,28 ,,NW,,,,,,"$12,218.29",$0.00,1,1,1,1,1,1,20110101,E1005,HCPCS,PWR SEAT RECLINE PWR,RR,,28 ,,NW,,,,,,"$1,273.94",$0.00,1,1,1,1,1,1,20110101,E1005,HCPCS,PWR SEAT RECLINE PWR,UE,,28 ,,NW,,,,,,"$9,178.22",$0.00,1,1,1,1,1,1,20110101,E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,,,28 ,,NW,,,,,,"$14,953.23",$0.00,1,1,1,1,1,1,20110101,E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,NU,,28 ,,NW,,,,,,"$14,953.23",$0.00,1,1,1,1,1,1,20110101,E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,RR,,28 ,,NW,,,,,,"$1,547.40",$0.00,1,1,1,1,1,1,20110101,E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,UE,,28 ,,NW,,,,,,"$11,229.41",$0.00,1,1,1,1,1,1,20110101,E1007,HCPCS,PWR SEAT COMBO W/SHEAR,,,28 ,,NW,,,,,,"$20,226.74",$0.00,1,1,1,1,1,1,20110101,E1007,HCPCS,PWR SEAT COMBO W/SHEAR,NU,,28 ,,NW,,,,,,"$20,226.74",$0.00,1,1,1,1,1,1,20110101,E1007,HCPCS,PWR SEAT COMBO W/SHEAR,RR,,28 ,,NW,,,,,,"$2,074.82",$0.00,1,1,1,1,1,1,20110101,E1007,HCPCS,PWR SEAT COMBO W/SHEAR,UE,,28 ,,NW,,,,,,"$15,184.52",$0.00,1,1,1,1,1,1,20110101,E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,,,28 ,,NW,,,,,,"$20,228.55",$0.00,1,1,1,1,1,1,20110101,E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,NU,,28 ,,NW,,,,,,"$20,228.55",$0.00,1,1,1,1,1,1,20110101,E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,RR,,28 ,,NW,,,,,,"$2,074.97",$0.00,1,1,1,1,1,1,20110101,E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,UE,,28 ,,NW,,,,,,"$15,185.92",$0.00,1,1,1,1,1,1,20110101,E1009,HCPCS,ADD MECH LEG ELEVATION,,,28 ,,NW,,,,,,"$2,472.50",$0.00,1,1,1,1,1,1,20110101,E1009,HCPCS,ADD MECH LEG ELEVATION,NU,,28 ,,NW,,,,,,"$2,472.50",$0.00,1,1,1,1,1,1,20110101,E1009,HCPCS,ADD MECH LEG ELEVATION,RR,,28 ,,NW,,,,,,$268.76,$0.00,1,1,1,1,1,1,20110101,E1009,HCPCS,ADD MECH LEG ELEVATION,UE,,28 ,,NW,,,,,,"$1,861.31",$0.00,1,1,1,1,1,1,20110101,E1010,HCPCS,ADD PWR LEG ELEVATION,,,28 ,,NW,,,,,,"$2,696.99",$0.00,1,1,1,1,1,1,20110101,E1010,HCPCS,ADD PWR LEG ELEVATION,NU,,28 ,,NW,,,,,,"$2,696.99",$0.00,1,1,1,1,1,1,20110101,E1010,HCPCS,ADD PWR LEG ELEVATION,RR,,28 ,,NW,,,,,,$321.83,$0.00,1,1,1,1,1,1,20110101,E1010,HCPCS,ADD PWR LEG ELEVATION,UE,,28 ,,NW,,,,,,"$2,037.26",$0.00,1,1,1,1,1,1,20110101,E1014,HCPCS,RECLINING BACK ADD PED W/C,,,28 ,,NW,,,,,,$510.41,$0.00,1,1,1,1,1,1,20110101,E1014,HCPCS,RECLINING BACK ADD PED W/C,NU,,28 ,,NW,,,,,,$510.41,$0.00,1,1,1,1,1,1,20110101,E1014,HCPCS,RECLINING BACK ADD PED W/C,RR,,28 ,,NW,,,,,,$65.64,$0.00,1,1,1,1,1,1,20110101,E1014,HCPCS,RECLINING BACK ADD PED W/C,UE,,28 ,,NW,,,,,,$397.27,$0.00,1,1,1,1,1,1,20110101,E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,,,28 ,,NW,,,,,,$200.06,$0.00,1,1,1,1,1,1,20110101,E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,NU,,28 ,,NW,,,,,,$200.06,$0.00,1,1,1,1,1,1,20110101,E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,RR,,28 ,,NW,,,,,,$19.67,$0.00,1,1,1,1,1,1,20110101,E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,UE,,28 ,,NW,,,,,,$156.41,$0.00,1,1,1,1,1,1,20110101,E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,,,28 ,,NW,,,,,,$360.90,$0.00,1,1,1,1,1,1,20110101,E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,NU,,28 ,,NW,,,,,,$360.90,$0.00,1,1,1,1,1,1,20110101,E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,RR,,28 ,,NW,,,,,,$43.53,$0.00,1,1,1,1,1,1,20110101,E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,UE,,28 ,,NW,,,,,,$285.13,$0.00,1,1,1,1,1,1,20110101,E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,,,28 ,,NW,,,,,,"$1,179.94",$0.00,1,1,1,1,1,1,20110101,E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,NU,,28 ,,NW,,,,,,"$1,179.94",$0.00,1,1,1,1,1,1,20110101,E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,RR,,28 ,,NW,,,,,,$128.59,$0.00,1,1,1,1,1,1,20110101,E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,UE,,28 ,,NW,,,,,,$888.38,$0.00,1,1,1,1,1,1,20110101,E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,,,28 ,,NW,,,,,,$537.15,$0.00,1,1,1,1,1,1,20110101,E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,NU,,28 ,,NW,,,,,,$537.15,$0.00,1,1,1,1,1,1,20110101,E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,RR,,28 ,,NW,,,,,,$58.56,$0.00,1,1,1,1,1,1,20110101,E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,UE,,28 ,,NW,,,,,,$404.43,$0.00,1,1,1,1,1,1,20110101,E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,,,28 ,,NW,,,,,,$619.54,$0.00,1,1,1,1,1,1,20110101,E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,NU,,28 ,,NW,,,,,,$619.54,$0.00,1,1,1,1,1,1,20110101,E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,RR,,28 ,,NW,,,,,,$81.71,$0.00,1,1,1,1,1,1,20110101,E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,UE,,28 ,,NW,,,,,,$479.12,$0.00,1,1,1,1,1,1,20110101,E1028,HCPCS,W/C MANUAL SWINGAWAY,,,28 ,,NW,,,,,,$534.47,$0.00,1,1,1,1,1,1,20110101,E1028,HCPCS,W/C MANUAL SWINGAWAY,NU,,28 ,,NW,,,,,,$534.47,$0.00,1,1,1,1,1,1,20110101,E1028,HCPCS,W/C MANUAL SWINGAWAY,RR,,28 ,,NW,,,,,,$69.17,$0.00,1,1,1,1,1,1,20110101,E1028,HCPCS,W/C MANUAL SWINGAWAY,UE,,28 ,,NW,,,,,,$415.30,$0.00,1,1,1,1,1,1,20110101,E1029,HCPCS,W/C VENT TRAY FIXED,,,28 ,,NW,,,,,,$910.56,$0.00,1,1,1,1,1,1,20110101,E1029,HCPCS,W/C VENT TRAY FIXED,NU,,28 ,,NW,,,,,,$910.56,$0.00,1,1,1,1,1,1,20110101,E1029,HCPCS,W/C VENT TRAY FIXED,RR,,28 ,,NW,,,,,,$124.83,$0.00,1,1,1,1,1,1,20110101,E1029,HCPCS,W/C VENT TRAY FIXED,UE,,28 ,,NW,,,,,,$697.39,$0.00,1,1,1,1,1,1,20110101,E1030,HCPCS,W/C VENT TRAY GIMBALED,,,28 ,,NW,,,,,,"$2,746.56",$0.00,1,1,1,1,1,1,20110101,E1030,HCPCS,W/C VENT TRAY GIMBALED,NU,,28 ,,NW,,,,,,"$2,746.56",$0.00,1,1,1,1,1,1,20110101,E1030,HCPCS,W/C VENT TRAY GIMBALED,RR,,28 ,,NW,,,,,,$326.79,$0.00,1,1,1,1,1,1,20110101,E1030,HCPCS,W/C VENT TRAY GIMBALED,UE,,28 ,,NW,,,,,,"$2,074.41",$0.00,1,1,1,1,1,1,20110101,E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,,,28 ,,NW,,,,,,$749.08,$0.00,1,1,1,1,1,1,20110101,E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,NU,,28 ,,NW,,,,,,$749.08,$0.00,1,1,1,1,1,1,20110101,E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,RR,,28 ,,NW,,,,,,$86.54,$0.00,1,1,1,1,1,1,20110101,E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,UE,,28 ,,NW,,,,,,$569.07,$0.00,1,1,1,1,1,1,20110101,E1035,HCPCS,PATIENT TRANSFER SYSTEM <300,,,28 ,,NW,,,,,,"$7,658.31",$0.00,1,1,1,1,1,1,20110101,E1035,HCPCS,PATIENT TRANSFER SYSTEM <300,RR,,28 ,,NW,,,,,,$817.81,$0.00,1,1,1,1,1,1,20110101,E1036,HCPCS,PATIENT TRANSFER SYSTEM >300,,,28 ,,NW,,,,,,"$13,710.46",$0.00,1,1,1,1,1,1,20110101,E1036,HCPCS,PATIENT TRANSFER SYSTEM >300,RR,,28 ,,NW,,,,,,"$1,444.27",$0.00,1,1,1,1,1,1,20110101,E1037,HCPCS,"TRANSPORT CHAIR, PED SIZE",,,28 ,,NW,,,,,,"$1,797.66",$0.00,1,1,1,1,1,1,20110101,E1037,HCPCS,"TRANSPORT CHAIR, PED SIZE",RR,,28 ,,NW,,,,,,$192.35,$0.00,1,1,1,1,1,1,20110101,E1038,HCPCS,TRANSPORT CHAIR PT WT<=300LB,,,28 ,,NW,,,,,,$296.48,$0.00,1,1,1,1,1,1,20110101,E1038,HCPCS,TRANSPORT CHAIR PT WT<=300LB,RR,,28 ,,NW,,,,,,$31.72,$0.00,1,1,1,1,1,1,20110101,E1039,HCPCS,TRANSPORT CHAIR PT WT >300LB,,,28 ,,NW,,,,,,$573.48,$0.00,1,1,1,1,1,1,20110101,E1039,HCPCS,TRANSPORT CHAIR PT WT >300LB,RR,,28 ,,NW,,,,,,$61.38,$0.00,1,1,1,1,1,1,20110101,E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,,,28 ,,NW,,,,,,"$1,728.83",$0.00,1,1,1,1,1,1,20110101,E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,NU,,28 ,,NW,,,,,,"$1,728.83",$0.00,1,1,1,1,1,1,20110101,E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,RR,,28 ,,NW,,,,,,$177.02,$0.00,1,1,1,1,1,1,20110101,E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,UE,,28 ,,NW,,,,,,"$1,299.69",$0.00,1,1,1,1,1,1,20110101,E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,,,28 ,,NW,,,,,,"$2,138.08",$0.00,1,1,1,1,1,1,20110101,E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,NU,,28 ,,NW,,,,,,"$2,138.08",$0.00,1,1,1,1,1,1,20110101,E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,RR,,28 ,,NW,,,,,,$225.23,$0.00,1,1,1,1,1,1,20110101,E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,UE,,28 ,,NW,,,,,,"$1,606.19",$0.00,1,1,1,1,1,1,20110101,E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,,,28 ,,NW,,,,,,"$1,858.82",$0.00,1,1,1,1,1,1,20110101,E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,NU,,28 ,,NW,,,,,,"$1,858.82",$0.00,1,1,1,1,1,1,20110101,E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,RR,,28 ,,NW,,,,,,$186.88,$0.00,1,1,1,1,1,1,20110101,E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,UE,,28 ,,NW,,,,,,"$1,397.07",$0.00,1,1,1,1,1,1,20110101,E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,,,28 ,,NW,,,,,,"$1,339.57",$0.00,1,1,1,1,1,1,20110101,E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,NU,,28 ,,NW,,,,,,"$1,339.57",$0.00,1,1,1,1,1,1,20110101,E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,RR,,28 ,,NW,,,,,,$132.43,$0.00,1,1,1,1,1,1,20110101,E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,UE,,28 ,,NW,,,,,,"$1,007.44",$0.00,1,1,1,1,1,1,20110101,E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,,,28 ,,NW,,,,,,"$1,666.06",$0.00,1,1,1,1,1,1,20110101,E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,NU,,28 ,,NW,,,,,,"$1,666.06",$0.00,1,1,1,1,1,1,20110101,E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,RR,,28 ,,NW,,,,,,$171.49,$0.00,1,1,1,1,1,1,20110101,E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,UE,,28 ,,NW,,,,,,"$1,252.36",$0.00,1,1,1,1,1,1,20110101,E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,,,28 ,,NW,,,,,,"$1,031.20",$0.00,1,1,1,1,1,1,20110101,E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,NU,,28 ,,NW,,,,,,"$1,031.20",$0.00,1,1,1,1,1,1,20110101,E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,RR,,28 ,,NW,,,,,,$140.90,$0.00,1,1,1,1,1,1,20110101,E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,UE,,28 ,,NW,,,,,,$756.78,$0.00,1,1,1,1,1,1,20110101,E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,,,28 ,,NW,,,,,,"$1,243.50",$0.00,1,1,1,1,1,1,20110101,E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,NU,,28 ,,NW,,,,,,"$1,243.50",$0.00,1,1,1,1,1,1,20110101,E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,RR,,28 ,,NW,,,,,,$156.22,$0.00,1,1,1,1,1,1,20110101,E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,UE,,28 ,,NW,,,,,,$918.84,$0.00,1,1,1,1,1,1,20110101,E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,,,28 ,,NW,,,,,,"$2,144.98",$0.00,1,1,1,1,1,1,20110101,E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,NU,,28 ,,NW,,,,,,"$2,144.98",$0.00,1,1,1,1,1,1,20110101,E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,RR,,28 ,,NW,,,,,,$207.45,$0.00,1,1,1,1,1,1,20110101,E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,UE,,28 ,,NW,,,,,,"$1,611.46",$0.00,1,1,1,1,1,1,20110101,E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,,,28 ,,NW,,,,,,"$2,554.59",$0.00,1,1,1,1,1,1,20110101,E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,NU,,28 ,,NW,,,,,,"$2,554.59",$0.00,1,1,1,1,1,1,20110101,E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,RR,,28 ,,NW,,,,,,$232.11,$0.00,1,1,1,1,1,1,20110101,E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,UE,,28 ,,NW,,,,,,"$1,918.78",$0.00,1,1,1,1,1,1,20110101,E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,,,28 ,,NW,,,,,,"$1,631.52",$0.00,1,1,1,1,1,1,20110101,E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,NU,,28 ,,NW,,,,,,"$1,631.52",$0.00,1,1,1,1,1,1,20110101,E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,RR,,28 ,,NW,,,,,,$215.26,$0.00,1,1,1,1,1,1,20110101,E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,UE,,28 ,,NW,,,,,,"$1,238.09",$0.00,1,1,1,1,1,1,20110101,E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,,,28 ,,NW,,,,,,"$1,680.18",$0.00,1,1,1,1,1,1,20110101,E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,NU,,28 ,,NW,,,,,,"$1,680.18",$0.00,1,1,1,1,1,1,20110101,E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,RR,,28 ,,NW,,,,,,$215.26,$0.00,1,1,1,1,1,1,20110101,E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,UE,,28 ,,NW,,,,,,"$1,243.50",$0.00,1,1,1,1,1,1,20110101,E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,,,28 ,,NW,,,,,,"$2,179.23",$0.00,1,1,1,1,1,1,20110101,E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,NU,,28 ,,NW,,,,,,"$2,179.23",$0.00,1,1,1,1,1,1,20110101,E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,RR,,28 ,,NW,,,,,,$207.68,$0.00,1,1,1,1,1,1,20110101,E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,UE,,28 ,,NW,,,,,,"$1,637.17",$0.00,1,1,1,1,1,1,20110101,E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,,,28 ,,NW,,,,,,"$1,875.54",$0.00,1,1,1,1,1,1,20110101,E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,NU,,28 ,,NW,,,,,,"$1,875.54",$0.00,1,1,1,1,1,1,20110101,E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,RR,,28 ,,NW,,,,,,$187.18,$0.00,1,1,1,1,1,1,20110101,E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,UE,,28 ,,NW,,,,,,"$1,409.70",$0.00,1,1,1,1,1,1,20110101,E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,,,28 ,,NW,,,,,,"$1,762.26",$0.00,1,1,1,1,1,1,20110101,E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,NU,,28 ,,NW,,,,,,"$1,762.26",$0.00,1,1,1,1,1,1,20110101,E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,RR,,28 ,,NW,,,,,,$177.62,$0.00,1,1,1,1,1,1,20110101,E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,UE,,28 ,,NW,,,,,,"$1,289.80",$0.00,1,1,1,1,1,1,20110101,E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,,,28 ,,NW,,,,,,"$1,726.01",$0.00,1,1,1,1,1,1,20110101,E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,NU,,28 ,,NW,,,,,,"$1,726.01",$0.00,1,1,1,1,1,1,20110101,E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,RR,,28 ,,NW,,,,,,$173.50,$0.00,1,1,1,1,1,1,20110101,E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,UE,,28 ,,NW,,,,,,"$1,297.60",$0.00,1,1,1,1,1,1,20110101,E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,,,28 ,,NW,,,,,,$681.87,$0.00,1,1,1,1,1,1,20110101,E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,NU,,28 ,,NW,,,,,,$681.87,$0.00,1,1,1,1,1,1,20110101,E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,RR,,28 ,,NW,,,,,,$89.85,$0.00,1,1,1,1,1,1,20110101,E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,UE,,28 ,,NW,,,,,,$532.04,$0.00,1,1,1,1,1,1,20110101,E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,,,28 ,,NW,,,,,,$956.48,$0.00,1,1,1,1,1,1,20110101,E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,NU,,28 ,,NW,,,,,,$956.48,$0.00,1,1,1,1,1,1,20110101,E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,RR,,28 ,,NW,,,,,,$129.70,$0.00,1,1,1,1,1,1,20110101,E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,UE,,28 ,,NW,,,,,,$694.47,$0.00,1,1,1,1,1,1,20110101,E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,,,28 ,,NW,,,,,,"$1,387.26",$0.00,1,1,1,1,1,1,20110101,E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,NU,,28 ,,NW,,,,,,"$1,387.26",$0.00,1,1,1,1,1,1,20110101,E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,RR,,28 ,,NW,,,,,,$140.69,$0.00,1,1,1,1,1,1,20110101,E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,UE,,28 ,,NW,,,,,,"$1,043.69",$0.00,1,1,1,1,1,1,20110101,E1160,HCPCS,WHEELCHAIR FIXED ARMS,,,28 ,,NW,,,,,,"$1,065.68",$0.00,1,1,1,1,1,1,20110101,E1160,HCPCS,WHEELCHAIR FIXED ARMS,NU,,28 ,,NW,,,,,,"$1,065.68",$0.00,1,1,1,1,1,1,20110101,E1160,HCPCS,WHEELCHAIR FIXED ARMS,RR,,28 ,,NW,,,,,,$108.87,$0.00,1,1,1,1,1,1,20110101,E1160,HCPCS,WHEELCHAIR FIXED ARMS,UE,,28 ,,NW,,,,,,$801.96,$0.00,1,1,1,1,1,1,20110101,E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,,,28 ,,NW,,,,,,"$2,990.02",$0.00,1,1,1,1,1,1,20110101,E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,NU,,28 ,,NW,,,,,,"$2,990.02",$0.00,1,1,1,1,1,1,20110101,E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,RR,,28 ,,NW,,,,,,$351.13,$0.00,1,1,1,1,1,1,20110101,E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,UE,,28 ,,NW,,,,,,"$2,257.02",$0.00,1,1,1,1,1,1,20110101,E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,,,28 ,,NW,,,,,,"$1,254.37",$0.00,1,1,1,1,1,1,20110101,E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,NU,,28 ,,NW,,,,,,"$1,254.37",$0.00,1,1,1,1,1,1,20110101,E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,RR,,28 ,,NW,,,,,,$149.00,$0.00,1,1,1,1,1,1,20110101,E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,UE,,28 ,,NW,,,,,,$957.25,$0.00,1,1,1,1,1,1,20110101,E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,,,28 ,,NW,,,,,,"$1,132.81",$0.00,1,1,1,1,1,1,20110101,E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,NU,,28 ,,NW,,,,,,"$1,132.81",$0.00,1,1,1,1,1,1,20110101,E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,RR,,28 ,,NW,,,,,,$137.26,$0.00,1,1,1,1,1,1,20110101,E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,UE,,28 ,,NW,,,,,,$865.90,$0.00,1,1,1,1,1,1,20110101,E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,,,28 ,,NW,,,,,,"$2,052.28",$0.00,1,1,1,1,1,1,20110101,E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,NU,,28 ,,NW,,,,,,"$2,052.28",$0.00,1,1,1,1,1,1,20110101,E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,RR,,28 ,,NW,,,,,,$170.01,$0.00,1,1,1,1,1,1,20110101,E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,UE,,28 ,,NW,,,,,,"$1,543.75",$0.00,1,1,1,1,1,1,20110101,E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,,,28 ,,NW,,,,,,"$2,123.12",$0.00,1,1,1,1,1,1,20110101,E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,NU,,28 ,,NW,,,,,,"$2,123.12",$0.00,1,1,1,1,1,1,20110101,E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,RR,,28 ,,NW,,,,,,$174.25,$0.00,1,1,1,1,1,1,20110101,E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,UE,,28 ,,NW,,,,,,"$1,596.76",$0.00,1,1,1,1,1,1,20110101,E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,,,28 ,,NW,,,,,,"$2,449.10",$0.00,1,1,1,1,1,1,20110101,E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,NU,,28 ,,NW,,,,,,"$2,449.10",$0.00,1,1,1,1,1,1,20110101,E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,RR,,28 ,,NW,,,,,,$193.25,$0.00,1,1,1,1,1,1,20110101,E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,UE,,28 ,,NW,,,,,,"$1,841.70",$0.00,1,1,1,1,1,1,20110101,E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,,,28 ,,NW,,,,,,"$2,626.89",$0.00,1,1,1,1,1,1,20110101,E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,NU,,28 ,,NW,,,,,,"$2,626.89",$0.00,1,1,1,1,1,1,20110101,E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,RR,,28 ,,NW,,,,,,$203.21,$0.00,1,1,1,1,1,1,20110101,E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,UE,,28 ,,NW,,,,,,"$1,974.65",$0.00,1,1,1,1,1,1,20110101,E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,,,28 ,,NW,,,,,,"$1,825.17",$0.00,1,1,1,1,1,1,20110101,E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,NU,,28 ,,NW,,,,,,"$1,825.17",$0.00,1,1,1,1,1,1,20110101,E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,RR,,28 ,,NW,,,,,,$150.66,$0.00,1,1,1,1,1,1,20110101,E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,UE,,28 ,,NW,,,,,,"$1,373.69",$0.00,1,1,1,1,1,1,20110101,E1220,HCPCS,WHLCHR SPECIAL SIZE/CONSTRC,,,28 ,,NW,,,,,,"$4,522.55",$0.00,1,1,1,1,1,1,20110101,E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,,,28 ,,NW,,,,,,$812.59,$0.00,1,1,1,1,1,1,20110101,E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,NU,,28 ,,NW,,,,,,$812.59,$0.00,1,1,1,1,1,1,20110101,E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,RR,,28 ,,NW,,,,,,$81.17,$0.00,1,1,1,1,1,1,20110101,E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,UE,,28 ,,NW,,,,,,$612.46,$0.00,1,1,1,1,1,1,20110101,E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,,,28 ,,NW,,,,,,"$1,154.97",$0.00,1,1,1,1,1,1,20110101,E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,NU,,28 ,,NW,,,,,,"$1,154.97",$0.00,1,1,1,1,1,1,20110101,E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,RR,,28 ,,NW,,,,,,$118.71,$0.00,1,1,1,1,1,1,20110101,E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,UE,,28 ,,NW,,,,,,$868.82,$0.00,1,1,1,1,1,1,20110101,E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,,,28 ,,NW,,,,,,"$1,259.72",$0.00,1,1,1,1,1,1,20110101,E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,NU,,28 ,,NW,,,,,,"$1,259.72",$0.00,1,1,1,1,1,1,20110101,E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,RR,,28 ,,NW,,,,,,$126.27,$0.00,1,1,1,1,1,1,20110101,E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,UE,,28 ,,NW,,,,,,$947.49,$0.00,1,1,1,1,1,1,20110101,E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,,,28 ,,NW,,,,,,"$1,380.36",$0.00,1,1,1,1,1,1,20110101,E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,NU,,28 ,,NW,,,,,,"$1,380.36",$0.00,1,1,1,1,1,1,20110101,E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,RR,,28 ,,NW,,,,,,$138.23,$0.00,1,1,1,1,1,1,20110101,E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,UE,,28 ,,NW,,,,,,"$1,037.97",$0.00,1,1,1,1,1,1,20110101,E1225,HCPCS,MANUAL SEMI-RECLINING BACK,,,28 ,,NW,,,,,,$773.89,$0.00,1,1,1,1,1,1,20110101,E1225,HCPCS,MANUAL SEMI-RECLINING BACK,NU,,28 ,,NW,,,,,,$773.89,$0.00,1,1,1,1,1,1,20110101,E1225,HCPCS,MANUAL SEMI-RECLINING BACK,RR,,28 ,,NW,,,,,,$75.66,$0.00,1,1,1,1,1,1,20110101,E1225,HCPCS,MANUAL SEMI-RECLINING BACK,UE,,28 ,,NW,,,,,,$574.68,$0.00,1,1,1,1,1,1,20110101,E1226,HCPCS,MANUAL FULLY RECLINING BACK,,,28 ,,NW,,,,,,$683.27,$0.00,1,1,1,1,1,1,20110101,E1226,HCPCS,MANUAL FULLY RECLINING BACK,NU,,28 ,,NW,,,,,,$683.27,$0.00,1,1,1,1,1,1,20110101,E1226,HCPCS,MANUAL FULLY RECLINING BACK,RR,,28 ,,NW,,,,,,$94.12,$0.00,1,1,1,1,1,1,20110101,E1226,HCPCS,MANUAL FULLY RECLINING BACK,UE,,28 ,,NW,,,,,,$527.09,$0.00,1,1,1,1,1,1,20110101,E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,,,28 ,,NW,,,,,,$380.36,$0.00,1,1,1,1,1,1,20110101,E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,NU,,28 ,,NW,,,,,,$380.36,$0.00,1,1,1,1,1,1,20110101,E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,RR,,28 ,,NW,,,,,,$46.38,$0.00,1,1,1,1,1,1,20110101,E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,UE,,28 ,,NW,,,,,,$299.86,$0.00,1,1,1,1,1,1,20110101,E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,,,28 ,,NW,,,,,,$559.53,$0.00,1,1,1,1,1,1,20110101,E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,NU,,28 ,,NW,,,,,,$559.53,$0.00,1,1,1,1,1,1,20110101,E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,RR,,28 ,,NW,,,,,,$45.67,$0.00,1,1,1,1,1,1,20110101,E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,UE,,28 ,,NW,,,,,,$311.54,$0.00,1,1,1,1,1,1,20110101,E1229,HCPCS,PEDIATRIC WHEELCHAIR NOS,,,28 ,,NW,,,,,,"$1,459.13",$0.00,1,1,1,1,1,1,20110101,E1230,HCPCS,POWER OPERATED VEHICLE,,,28 ,,NW,,,,,,"$2,648.79",$0.00,1,1,1,1,1,1,20110101,E1230,HCPCS,POWER OPERATED VEHICLE,NU,,28 ,,NW,,,,,,"$2,648.79",$0.00,1,1,1,1,1,1,20110101,E1230,HCPCS,POWER OPERATED VEHICLE,RR,,28 ,,NW,,,,,,$314.87,$0.00,1,1,1,1,1,1,20110101,E1230,HCPCS,POWER OPERATED VEHICLE,UE,,28 ,,NW,,,,,,"$2,074.83",$0.00,1,1,1,1,1,1,20110101,E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,,,28 ,,NW,,,,,,"$2,796.01",$0.00,1,1,1,1,1,1,20110101,E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,NU,,28 ,,NW,,,,,,"$2,796.01",$0.00,1,1,1,1,1,1,20110101,E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,RR,,28 ,,NW,,,,,,$306.00,$0.00,1,1,1,1,1,1,20110101,E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,UE,,28 ,,NW,,,,,,"$2,105.57",$0.00,1,1,1,1,1,1,20110101,E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,,,28 ,,NW,,,,,,"$2,707.88",$0.00,1,1,1,1,1,1,20110101,E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,NU,,28 ,,NW,,,,,,"$2,707.88",$0.00,1,1,1,1,1,1,20110101,E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,RR,,28 ,,NW,,,,,,$322.92,$0.00,1,1,1,1,1,1,20110101,E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,UE,,28 ,,NW,,,,,,"$2,045.40",$0.00,1,1,1,1,1,1,20110101,E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,,,28 ,,NW,,,,,,"$2,803.70",$0.00,1,1,1,1,1,1,20110101,E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,NU,,28 ,,NW,,,,,,"$2,803.70",$0.00,1,1,1,1,1,1,20110101,E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,RR,,28 ,,NW,,,,,,$332.49,$0.00,1,1,1,1,1,1,20110101,E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,UE,,28 ,,NW,,,,,,"$2,117.24",$0.00,1,1,1,1,1,1,20110101,E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,,,28 ,,NW,,,,,,"$2,448.31",$0.00,1,1,1,1,1,1,20110101,E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,NU,,28 ,,NW,,,,,,"$2,448.31",$0.00,1,1,1,1,1,1,20110101,E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,RR,,28 ,,NW,,,,,,$296.98,$0.00,1,1,1,1,1,1,20110101,E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,UE,,28 ,,NW,,,,,,"$1,850.70",$0.00,1,1,1,1,1,1,20110101,E1235,HCPCS,RIGID PED WC ADJUSTABLE,,,28 ,,NW,,,,,,"$2,359.68",$0.00,1,1,1,1,1,1,20110101,E1235,HCPCS,RIGID PED WC ADJUSTABLE,NU,,28 ,,NW,,,,,,"$2,359.68",$0.00,1,1,1,1,1,1,20110101,E1235,HCPCS,RIGID PED WC ADJUSTABLE,RR,,28 ,,NW,,,,,,$288.11,$0.00,1,1,1,1,1,1,20110101,E1235,HCPCS,RIGID PED WC ADJUSTABLE,UE,,28 ,,NW,,,,,,"$1,784.24",$0.00,1,1,1,1,1,1,20110101,E1236,HCPCS,FOLDING PED WC ADJUSTABLE,,,28 ,,NW,,,,,,"$2,088.67",$0.00,1,1,1,1,1,1,20110101,E1236,HCPCS,FOLDING PED WC ADJUSTABLE,NU,,28 ,,NW,,,,,,"$2,088.67",$0.00,1,1,1,1,1,1,20110101,E1236,HCPCS,FOLDING PED WC ADJUSTABLE,RR,,28 ,,NW,,,,,,$260.99,$0.00,1,1,1,1,1,1,20110101,E1236,HCPCS,FOLDING PED WC ADJUSTABLE,UE,,28 ,,NW,,,,,,"$1,580.98",$0.00,1,1,1,1,1,1,20110101,E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,,,28 ,,NW,,,,,,"$2,106.41",$0.00,1,1,1,1,1,1,20110101,E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,NU,,28 ,,NW,,,,,,"$2,106.41",$0.00,1,1,1,1,1,1,20110101,E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,RR,,28 ,,NW,,,,,,$262.77,$0.00,1,1,1,1,1,1,20110101,E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,UE,,28 ,,NW,,,,,,"$1,594.30",$0.00,1,1,1,1,1,1,20110101,E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,,,28 ,,NW,,,,,,"$2,088.67",$0.00,1,1,1,1,1,1,20110101,E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,NU,,28 ,,NW,,,,,,"$2,088.67",$0.00,1,1,1,1,1,1,20110101,E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,RR,,28 ,,NW,,,,,,$260.99,$0.00,1,1,1,1,1,1,20110101,E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,UE,,28 ,,NW,,,,,,"$1,580.98",$0.00,1,1,1,1,1,1,20110101,E1239,HCPCS,PED POWER WHEELCHAIR NOS,,,28 ,,NW,,,,,,"$1,459.13",$0.00,1,1,1,1,1,1,20110101,E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,,,28 ,,NW,,,,,,"$1,188.30",$0.00,1,1,1,1,1,1,20110101,E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,NU,,28 ,,NW,,,,,,"$1,188.30",$0.00,1,1,1,1,1,1,20110101,E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,RR,,28 ,,NW,,,,,,$175.04,$0.00,1,1,1,1,1,1,20110101,E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,UE,,28 ,,NW,,,,,,$905.83,$0.00,1,1,1,1,1,1,20110101,E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,,,28 ,,NW,,,,,,"$1,018.96",$0.00,1,1,1,1,1,1,20110101,E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,NU,,28 ,,NW,,,,,,"$1,018.96",$0.00,1,1,1,1,1,1,20110101,E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,RR,,28 ,,NW,,,,,,$126.33,$0.00,1,1,1,1,1,1,20110101,E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,UE,,28 ,,NW,,,,,,$819.26,$0.00,1,1,1,1,1,1,20110101,E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,,,28 ,,NW,,,,,,"$1,181.02",$0.00,1,1,1,1,1,1,20110101,E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,NU,,28 ,,NW,,,,,,"$1,181.02",$0.00,1,1,1,1,1,1,20110101,E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,RR,,28 ,,NW,,,,,,$162.35,$0.00,1,1,1,1,1,1,20110101,E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,UE,,28 ,,NW,,,,,,$944.05,$0.00,1,1,1,1,1,1,20110101,E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,,,28 ,,NW,,,,,,$924.24,$0.00,1,1,1,1,1,1,20110101,E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,NU,,28 ,,NW,,,,,,$924.24,$0.00,1,1,1,1,1,1,20110101,E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,RR,,28 ,,NW,,,,,,$134.10,$0.00,1,1,1,1,1,1,20110101,E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,UE,,28 ,,NW,,,,,,$707.83,$0.00,1,1,1,1,1,1,20110101,E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,,,28 ,,NW,,,,,,"$1,498.28",$0.00,1,1,1,1,1,1,20110101,E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,NU,,28 ,,NW,,,,,,"$1,498.28",$0.00,1,1,1,1,1,1,20110101,E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,RR,,28 ,,NW,,,,,,$210.06,$0.00,1,1,1,1,1,1,20110101,E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,UE,,28 ,,NW,,,,,,"$1,138.18",$0.00,1,1,1,1,1,1,20110101,E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,,,28 ,,NW,,,,,,"$1,505.52",$0.00,1,1,1,1,1,1,20110101,E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,NU,,28 ,,NW,,,,,,"$1,505.52",$0.00,1,1,1,1,1,1,20110101,E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,RR,,28 ,,NW,,,,,,$202.66,$0.00,1,1,1,1,1,1,20110101,E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,UE,,28 ,,NW,,,,,,"$1,118.71",$0.00,1,1,1,1,1,1,20110101,E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,,,28 ,,NW,,,,,,"$1,555.39",$0.00,1,1,1,1,1,1,20110101,E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,NU,,28 ,,NW,,,,,,"$1,555.39",$0.00,1,1,1,1,1,1,20110101,E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,RR,,28 ,,NW,,,,,,$207.75,$0.00,1,1,1,1,1,1,20110101,E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,UE,,28 ,,NW,,,,,,"$1,150.05",$0.00,1,1,1,1,1,1,20110101,E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,,,28 ,,NW,,,,,,"$1,390.86",$0.00,1,1,1,1,1,1,20110101,E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,NU,,28 ,,NW,,,,,,"$1,390.86",$0.00,1,1,1,1,1,1,20110101,E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,RR,,28 ,,NW,,,,,,$201.95,$0.00,1,1,1,1,1,1,20110101,E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,UE,,28 ,,NW,,,,,,"$1,057.58",$0.00,1,1,1,1,1,1,20110101,E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,,,28 ,,NW,,,,,,$616.76,$0.00,1,1,1,1,1,1,20110101,E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,NU,,28 ,,NW,,,,,,$616.76,$0.00,1,1,1,1,1,1,20110101,E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,RR,,28 ,,NW,,,,,,$82.92,$0.00,1,1,1,1,1,1,20110101,E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,UE,,28 ,,NW,,,,,,$477.02,$0.00,1,1,1,1,1,1,20110101,E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,,,28 ,,NW,,,,,,$174.35,$0.00,1,1,1,1,1,1,20110101,E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,NU,,28 ,,NW,,,,,,$174.35,$0.00,1,1,1,1,1,1,20110101,E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,RR,,28 ,,NW,,,,,,$18.78,$0.00,1,1,1,1,1,1,20110101,E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,UE,,28 ,,NW,,,,,,$130.62,$0.00,1,1,1,1,1,1,20110101,E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,,,28 ,,NW,,,,,,$547.92,$0.00,1,1,1,1,1,1,20110101,E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,NU,,28 ,,NW,,,,,,$547.92,$0.00,1,1,1,1,1,1,20110101,E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,RR,,28 ,,NW,,,,,,$72.34,$0.00,1,1,1,1,1,1,20110101,E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,UE,,28 ,,NW,,,,,,$425.42,$0.00,1,1,1,1,1,1,20110101,E1300,HCPCS,WHIRLPOOL PORTABLE,,,28 ,,NW,,,,,,$207.58,$0.00,1,1,1,1,1,1,20110101,E1300,HCPCS,WHIRLPOOL PORTABLE,NU,,28 ,,NW,,,,,,$207.58,$0.00,1,1,1,1,1,1,20110101,E1300,HCPCS,WHIRLPOOL PORTABLE,RR,,28 ,,NW,,,,,,$21.87,$0.00,1,1,1,1,1,1,20110101,E1300,HCPCS,WHIRLPOOL PORTABLE,UE,,28 ,,NW,,,,,,$156.03,$0.00,1,1,1,1,1,1,20110101,E1310,HCPCS,WHIRLPOOL NON-PORTABLE,,,28 ,,NW,,,,,,"$4,866.17",$0.00,1,1,1,1,1,1,20110101,E1310,HCPCS,WHIRLPOOL NON-PORTABLE,NU,,28 ,,NW,,,,,,"$4,866.17",$0.00,1,1,1,1,1,1,20110101,E1310,HCPCS,WHIRLPOOL NON-PORTABLE,RR,,28 ,,NW,,,,,,$398.43,$0.00,1,1,1,1,1,1,20110101,E1310,HCPCS,WHIRLPOOL NON-PORTABLE,UE,,28 ,,NW,,,,,,"$3,643.96",$0.00,1,1,1,1,1,1,20110101,E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,,,28 ,,NW,,,,,,$76.04,$0.00,1,1,1,1,1,1,20110101,E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,NU,,28 ,,NW,,,,,,$76.04,$0.00,1,1,1,1,1,1,20110101,E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,RR,,28 ,,NW,,,,,,$8.01,$0.00,1,1,1,1,1,1,20110101,E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,UE,,28 ,,NW,,,,,,$57.15,$0.00,1,1,1,1,1,1,20110101,E1354,HCPCS,"WHEELED CART, PORT CYL/CONC",,,28 ,,NW,,,,,,$149.43,$0.00,1,1,1,1,1,1,20110101,E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,,,28 ,,NW,,,,,,$53.44,$0.00,1,1,1,1,1,1,20110101,E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,NU,,28 ,,NW,,,,,,$53.44,$0.00,1,1,1,1,1,1,20110101,E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,RR,,28 ,,NW,,,,,,$4.84,$0.00,1,1,1,1,1,1,20110101,E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,UE,,28 ,,NW,,,,,,$40.17,$0.00,1,1,1,1,1,1,20110101,E1356,HCPCS,"BATT PACK/CART, PORT CONC",,,28 ,,NW,,,,,,$126.97,$0.00,1,1,1,1,1,1,20110101,E1357,HCPCS,"BATTERY CHARGER, PORT CONC",,,28 ,,NW,,,,,,$250.80,$0.00,1,1,1,1,1,1,20110101,E1358,HCPCS,"DC POWER ADAPTER, PORT CONC",,,28 ,,NW,,,,,,$134.47,$0.00,1,1,1,1,1,1,20110101,E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,,,28 ,,NW,,,,,,$348.23,$0.00,1,1,1,1,1,1,20110101,E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,NU,,28 ,,NW,,,,,,$348.23,$0.00,1,1,1,1,1,1,20110101,E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,RR,,28 ,,NW,,,,,,$45.64,$0.00,1,1,1,1,1,1,20110101,E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,UE,,28 ,,NW,,,,,,$251.23,$0.00,1,1,1,1,1,1,20110101,E1390,HCPCS,OXYGEN CONCENTRATOR,,,28 ,,NW,,,,,,"$4,907.60",$0.00,1,1,1,1,1,1,20110101,E1390,HCPCS,OXYGEN CONCENTRATOR,NU,,28 ,,NW,,,,,,"$4,907.60",$0.00,1,1,1,1,1,1,20110101,E1390,HCPCS,OXYGEN CONCENTRATOR,RR,,28 ,,NW,,,,,,$516.97,$0.00,1,1,1,1,1,1,20110101,E1391,HCPCS,"OXYGEN CONCENTRATOR, DUAL",,,28 ,,NW,,,,,,"$4,907.60",$0.00,1,1,1,1,1,1,20110101,E1391,HCPCS,"OXYGEN CONCENTRATOR, DUAL",RR,,28 ,,NW,,,,,,$516.97,$0.00,1,1,1,1,1,1,20110101,E1392,HCPCS,PORTABLE OXYGEN CONCENTRATOR,,,28 ,,NW,,,,,,"$1,360.43",$0.00,1,1,1,1,1,1,20110101,E1392,HCPCS,PORTABLE OXYGEN CONCENTRATOR,RR,,28 ,,NW,,,,,,$143.31,$0.00,1,1,1,1,1,1,20110101,E1399,HCPCS,DURABLE MEDICAL EQUIPMENT MI,,,28 ,,NW,,,,,,$152.96,$0.00,1,1,1,1,1,1,20110101,E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,,,28 ,,NW,,,,,,"$5,933.23",$0.00,1,1,1,1,1,1,20110101,E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,NU,,28 ,,NW,,,,,,"$5,933.23",$0.00,1,1,1,1,1,1,20110101,E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,RR,,28 ,,NW,,,,,,$625.01,$0.00,1,1,1,1,1,1,20110101,E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,UE,,28 ,,NW,,,,,,"$4,459.61",$0.00,1,1,1,1,1,1,20110101,E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,,,28 ,,NW,,,,,,"$5,401.19",$0.00,1,1,1,1,1,1,20110101,E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,NU,,28 ,,NW,,,,,,"$5,401.19",$0.00,1,1,1,1,1,1,20110101,E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,RR,,28 ,,NW,,,,,,$568.97,$0.00,1,1,1,1,1,1,20110101,E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,UE,,28 ,,NW,,,,,,"$4,059.71",$0.00,1,1,1,1,1,1,20110101,E1500,HCPCS,CENTRIFUGE,,,28 ,,NW,,,,,,$261.30,$0.00,1,1,1,1,1,1,20110101,E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,,,28 ,,NW,,,,,,"$2,329.34",$0.00,1,1,1,1,1,1,20110101,E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,NU,,28 ,,NW,,,,,,"$2,329.34",$0.00,1,1,1,1,1,1,20110101,E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,RR,,28 ,,NW,,,,,,$245.37,$0.00,1,1,1,1,1,1,20110101,E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,UE,,28 ,,NW,,,,,,"$1,754.14",$0.00,1,1,1,1,1,1,20110101,E1520,HCPCS,HEPARIN INFUSION PUMP,,,28 ,,NW,,,,,,"$1,200.21",$0.00,1,1,1,1,1,1,20110101,E1520,HCPCS,HEPARIN INFUSION PUMP,NU,,28 ,,NW,,,,,,"$1,200.21",$0.00,1,1,1,1,1,1,20110101,E1520,HCPCS,HEPARIN INFUSION PUMP,RR,,28 ,,NW,,,,,,$123.75,$0.00,1,1,1,1,1,1,20110101,E1520,HCPCS,HEPARIN INFUSION PUMP,UE,,28 ,,NW,,,,,,$888.15,$0.00,1,1,1,1,1,1,20110101,E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,,,28 ,,NW,,,,,,"$1,706.96",$0.00,1,1,1,1,1,1,20110101,E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,NU,,28 ,,NW,,,,,,"$1,706.96",$0.00,1,1,1,1,1,1,20110101,E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,RR,,28 ,,NW,,,,,,$176.02,$0.00,1,1,1,1,1,1,20110101,E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,UE,,28 ,,NW,,,,,,"$1,280.58",$0.00,1,1,1,1,1,1,20110101,E1540,HCPCS,REPLACEMENT PRESSURE ALARM,,,28 ,,NW,,,,,,$421.30,$0.00,1,1,1,1,1,1,20110101,E1540,HCPCS,REPLACEMENT PRESSURE ALARM,NU,,28 ,,NW,,,,,,$421.30,$0.00,1,1,1,1,1,1,20110101,E1540,HCPCS,REPLACEMENT PRESSURE ALARM,RR,,28 ,,NW,,,,,,$46.11,$0.00,1,1,1,1,1,1,20110101,E1540,HCPCS,REPLACEMENT PRESSURE ALARM,UE,,28 ,,NW,,,,,,$317.27,$0.00,1,1,1,1,1,1,20110101,E1550,HCPCS,BATH CONDUCTIVITY METER,,,28 ,,NW,,,,,,$482.27,$0.00,1,1,1,1,1,1,20110101,E1550,HCPCS,BATH CONDUCTIVITY METER,NU,,28 ,,NW,,,,,,$482.27,$0.00,1,1,1,1,1,1,20110101,E1550,HCPCS,BATH CONDUCTIVITY METER,RR,,28 ,,NW,,,,,,$52.78,$0.00,1,1,1,1,1,1,20110101,E1550,HCPCS,BATH CONDUCTIVITY METER,UE,,28 ,,NW,,,,,,$363.19,$0.00,1,1,1,1,1,1,20110101,E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,,,28 ,,NW,,,,,,"$1,975.22",$0.00,1,1,1,1,1,1,20110101,E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,NU,,28 ,,NW,,,,,,"$1,975.22",$0.00,1,1,1,1,1,1,20110101,E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,RR,,28 ,,NW,,,,,,$203.67,$0.00,1,1,1,1,1,1,20110101,E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,UE,,28 ,,NW,,,,,,"$1,461.66",$0.00,1,1,1,1,1,1,20110101,E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,,,28 ,,NW,,,,,,"$1,575.71",$0.00,1,1,1,1,1,1,20110101,E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,NU,,28 ,,NW,,,,,,"$1,575.71",$0.00,1,1,1,1,1,1,20110101,E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,RR,,28 ,,NW,,,,,,$172.45,$0.00,1,1,1,1,1,1,20110101,E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,UE,,28 ,,NW,,,,,,"$1,186.61",$0.00,1,1,1,1,1,1,20110101,E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,,,28 ,,NW,,,,,,$103.61,$0.00,1,1,1,1,1,1,20110101,E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,NU,,28 ,,NW,,,,,,$103.61,$0.00,1,1,1,1,1,1,20110101,E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,RR,,28 ,,NW,,,,,,$10.69,$0.00,1,1,1,1,1,1,20110101,E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,UE,,28 ,,NW,,,,,,$76.67,$0.00,1,1,1,1,1,1,20110101,E1590,HCPCS,HEMODIALYSIS MACHINE,,,28 ,,NW,,,,,,"$2,635.01",$0.00,1,1,1,1,1,1,20110101,E1590,HCPCS,HEMODIALYSIS MACHINE,NU,,28 ,,NW,,,,,,"$2,635.01",$0.00,1,1,1,1,1,1,20110101,E1590,HCPCS,HEMODIALYSIS MACHINE,RR,,28 ,,NW,,,,,,$288.37,$0.00,1,1,1,1,1,1,20110101,E1590,HCPCS,HEMODIALYSIS MACHINE,UE,,28 ,,NW,,,,,,"$1,984.33",$0.00,1,1,1,1,1,1,20110101,E1592,HCPCS,AUTO INTERM PERITONEAL DIALY,,,28 ,,NW,,,,,,$7.26,$0.00,1,1,1,1,1,1,20110101,E1594,HCPCS,CYCLER DIALYSIS MACHINE,,,28 ,,NW,,,,,,"$6,955.63",$0.00,1,1,1,1,1,1,20110101,E1594,HCPCS,CYCLER DIALYSIS MACHINE,NU,,28 ,,NW,,,,,,"$6,955.63",$0.00,1,1,1,1,1,1,20110101,E1594,HCPCS,CYCLER DIALYSIS MACHINE,RR,,28 ,,NW,,,,,,$761.22,$0.00,1,1,1,1,1,1,20110101,E1594,HCPCS,CYCLER DIALYSIS MACHINE,UE,,28 ,,NW,,,,,,"$5,238.03",$0.00,1,1,1,1,1,1,20110101,E1600,HCPCS,DELI/INSTALL CHRG HEMO EQUIP,,,28 ,,NW,,,,,,$201.12,$0.00,1,1,1,1,1,1,20110101,E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,,,28 ,,NW,,,,,,"$3,214.79",$0.00,1,1,1,1,1,1,20110101,E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,NU,,28 ,,NW,,,,,,"$3,214.79",$0.00,1,1,1,1,1,1,20110101,E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,RR,,28 ,,NW,,,,,,$351.83,$0.00,1,1,1,1,1,1,20110101,E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,UE,,28 ,,NW,,,,,,"$2,420.95",$0.00,1,1,1,1,1,1,20110101,E1615,HCPCS,DEIONIZER H2O PURI SYSTEM,,,28 ,,NW,,,,,,$969.82,$0.00,1,1,1,1,1,1,20110101,E1620,HCPCS,REPLACEMENT BLOOD PUMP,,,28 ,,NW,,,,,,$580.45,$0.00,1,1,1,1,1,1,20110101,E1625,HCPCS,WATER SOFTENING SYSTEM,,,28 ,,NW,,,,,,"$3,069.62",$0.00,1,1,1,1,1,1,20110101,E1630,HCPCS,RECIPROCATING PERITONEAL DIA,,,28 ,,NW,,,,,,$191.92,$0.00,1,1,1,1,1,1,20110101,E1634,HCPCS,PERITONEAL DIALYSIS CLAMP,,,28 ,,NW,,,,,,$11.76,$0.00,1,1,1,1,1,1,20110101,E1635,HCPCS,COMPACT TRAVEL HEMODIALYZER,,,28 ,,NW,,,,,,$437.02,$0.00,1,1,1,1,1,1,20110101,E1636,HCPCS,SORBENT CARTRIDGES PER 10,,,28 ,,NW,,,,,,$63.70,$0.00,1,1,1,1,1,1,20110101,E1637,HCPCS,"HEMOSTATS FOR DIALYSIS, EACH",,,28 ,,NW,,,,,,$43.11,$0.00,1,1,1,1,1,1,20110101,E1639,HCPCS,DIALYSIS SCALE,,,28 ,,NW,,,,,,$215.57,$0.00,1,1,1,1,1,1,20110101,E1699,HCPCS,DIALYSIS EQUIPMENT NOC,,,28 ,,NW,,,,,,$205.09,$0.00,1,1,1,1,1,1,20110101,E1700,HCPCS,JAW MOTION REHAB SYSTEM,,,28 ,,NW,,,,,,$768.09,$0.00,1,1,1,1,1,1,20110101,E1700,HCPCS,JAW MOTION REHAB SYSTEM,NU,,28 ,,NW,,,,,,$768.09,$0.00,1,1,1,1,1,1,20110101,E1700,HCPCS,JAW MOTION REHAB SYSTEM,RR,,28 ,,NW,,,,,,$63.34,$0.00,1,1,1,1,1,1,20110101,E1700,HCPCS,JAW MOTION REHAB SYSTEM,UE,,28 ,,NW,,,,,,$569.36,$0.00,1,1,1,1,1,1,20110101,E1701,HCPCS,REPL CUSHIONS FOR JAW MOTION,,,28 ,,NW,,,,,,$23.40,$0.00,1,1,1,1,1,1,20110101,E1702,HCPCS,REPL MEASR SCALES JAW MOTION,,,28 ,,NW,,,,,,$43.73,$0.00,1,1,1,1,1,1,20110101,E1800,HCPCS,ADJUST ELBOW EXT/FLEX DEVICE,,,28 ,,NW,,,,,,"$2,402.51",$0.00,1,1,1,1,1,1,20110101,E1800,HCPCS,ADJUST ELBOW EXT/FLEX DEVICE,RR,,28 ,,NW,,,,,,$253.08,$0.00,1,1,1,1,1,1,20110101,E1801,HCPCS,SPS ELBOW DEVICE,,,28 ,,NW,,,,,,"$2,678.38",$0.00,1,1,1,1,1,1,20110101,E1801,HCPCS,SPS ELBOW DEVICE,RR,,28 ,,NW,,,,,,$282.14,$0.00,1,1,1,1,1,1,20110101,E1802,HCPCS,ADJST FOREARM PRO/SUP DEVICE,,,28 ,,NW,,,,,,"$7,330.42",$0.00,1,1,1,1,1,1,20110101,E1802,HCPCS,ADJST FOREARM PRO/SUP DEVICE,RR,,28 ,,NW,,,,,,$772.19,$0.00,1,1,1,1,1,1,20110101,E1805,HCPCS,ADJUST WRIST EXT/FLEX DEVICE,,,28 ,,NW,,,,,,"$2,521.77",$0.00,1,1,1,1,1,1,20110101,E1805,HCPCS,ADJUST WRIST EXT/FLEX DEVICE,RR,,28 ,,NW,,,,,,$265.65,$0.00,1,1,1,1,1,1,20110101,E1806,HCPCS,SPS WRIST DEVICE,,,28 ,,NW,,,,,,"$2,160.15",$0.00,1,1,1,1,1,1,20110101,E1806,HCPCS,SPS WRIST DEVICE,RR,,28 ,,NW,,,,,,$227.55,$0.00,1,1,1,1,1,1,20110101,E1810,HCPCS,ADJUST KNEE EXT/FLEX DEVICE,,,28 ,,NW,,,,,,"$2,476.80",$0.00,1,1,1,1,1,1,20110101,E1810,HCPCS,ADJUST KNEE EXT/FLEX DEVICE,RR,,28 ,,NW,,,,,,$260.91,$0.00,1,1,1,1,1,1,20110101,E1811,HCPCS,SPS KNEE DEVICE,,,28 ,,NW,,,,,,"$2,793.27",$0.00,1,1,1,1,1,1,20110101,E1811,HCPCS,SPS KNEE DEVICE,RR,,28 ,,NW,,,,,,$294.25,$0.00,1,1,1,1,1,1,20110101,E1812,HCPCS,KNEE EXT/FLEX W ACT RES CTRL,,,28 ,,NW,,,,,,"$1,770.11",$0.00,1,1,1,1,1,1,20110101,E1812,HCPCS,KNEE EXT/FLEX W ACT RES CTRL,RR,,28 ,,NW,,,,,,$186.46,$0.00,1,1,1,1,1,1,20110101,E1815,HCPCS,ADJUST ANKLE EXT/FLEX DEVICE,,,28 ,,NW,,,,,,"$2,522.36",$0.00,1,1,1,1,1,1,20110101,E1815,HCPCS,ADJUST ANKLE EXT/FLEX DEVICE,RR,,28 ,,NW,,,,,,$265.71,$0.00,1,1,1,1,1,1,20110101,E1816,HCPCS,SPS ANKLE DEVICE,,,28 ,,NW,,,,,,"$2,840.51",$0.00,1,1,1,1,1,1,20110101,E1816,HCPCS,SPS ANKLE DEVICE,RR,,28 ,,NW,,,,,,$299.22,$0.00,1,1,1,1,1,1,20110101,E1818,HCPCS,SPS FOREARM DEVICE,,,28 ,,NW,,,,,,"$2,904.34",$0.00,1,1,1,1,1,1,20110101,E1818,HCPCS,SPS FOREARM DEVICE,RR,,28 ,,NW,,,,,,$305.95,$0.00,1,1,1,1,1,1,20110101,E1820,HCPCS,SOFT INTERFACE MATERIAL,,,28 ,,NW,,,,,,$171.77,$0.00,1,1,1,1,1,1,20110101,E1820,HCPCS,SOFT INTERFACE MATERIAL,NU,,28 ,,NW,,,,,,$171.77,$0.00,1,1,1,1,1,1,20110101,E1820,HCPCS,SOFT INTERFACE MATERIAL,RR,,28 ,,NW,,,,,,$19.15,$0.00,1,1,1,1,1,1,20110101,E1820,HCPCS,SOFT INTERFACE MATERIAL,UE,,28 ,,NW,,,,,,$123.16,$0.00,1,1,1,1,1,1,20110101,E1821,HCPCS,REPLACEMENT INTERFACE SPSD,,,28 ,,NW,,,,,,$233.30,$0.00,1,1,1,1,1,1,20110101,E1821,HCPCS,REPLACEMENT INTERFACE SPSD,NU,,28 ,,NW,,,,,,$233.30,$0.00,1,1,1,1,1,1,20110101,E1821,HCPCS,REPLACEMENT INTERFACE SPSD,RR,,28 ,,NW,,,,,,$23.80,$0.00,1,1,1,1,1,1,20110101,E1821,HCPCS,REPLACEMENT INTERFACE SPSD,UE,,28 ,,NW,,,,,,$169.35,$0.00,1,1,1,1,1,1,20110101,E1825,HCPCS,ADJUST FINGER EXT/FLEX DEVC,,,28 ,,NW,,,,,,"$2,521.77",$0.00,1,1,1,1,1,1,20110101,E1825,HCPCS,ADJUST FINGER EXT/FLEX DEVC,RR,,28 ,,NW,,,,,,$265.65,$0.00,1,1,1,1,1,1,20110101,E1830,HCPCS,ADJUST TOE EXT/FLEX DEVICE,,,28 ,,NW,,,,,,"$2,521.77",$0.00,1,1,1,1,1,1,20110101,E1830,HCPCS,ADJUST TOE EXT/FLEX DEVICE,RR,,28 ,,NW,,,,,,$265.65,$0.00,1,1,1,1,1,1,20110101,E1831,HCPCS,STATIC STR TOE DEV EXT/FLEX,,,28 ,,NW,,,,,,"$2,521.77",$0.00,1,1,1,1,1,1,20110101,E1840,HCPCS,ADJ SHOULDER EXT/FLEX DEVICE,,,28 ,,NW,,,,,,"$8,454.27",$0.00,1,1,1,1,1,1,20110101,E1840,HCPCS,ADJ SHOULDER EXT/FLEX DEVICE,RR,,28 ,,NW,,,,,,$890.58,$0.00,1,1,1,1,1,1,20110101,E1841,HCPCS,STATIC STR SHLDR DEV ROM ADJ,,,28 ,,NW,,,,,,"$10,244.40",$0.00,1,1,1,1,1,1,20110101,E1841,HCPCS,STATIC STR SHLDR DEV ROM ADJ,RR,,28 ,,NW,,,,,,"$1,079.15",$0.00,1,1,1,1,1,1,20110101,E1902,HCPCS,AAC NON-ELECTRONIC BOARD,,,28 ,,NW,,,,,,"$2,657.98",$0.00,1,1,1,1,1,1,20110101,E2000,HCPCS,GASTRIC SUCTION PUMP HME MDL,,,28 ,,NW,,,,,,$946.96,$0.00,1,1,1,1,1,1,20110101,E2000,HCPCS,GASTRIC SUCTION PUMP HME MDL,RR,,28 ,,NW,,,,,,$99.75,$0.00,1,1,1,1,1,1,20110101,E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,,,28 ,,NW,,,,,,"$1,408.67",$0.00,1,1,1,1,1,1,20110101,E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,NU,,28 ,,NW,,,,,,"$1,408.67",$0.00,1,1,1,1,1,1,20110101,E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,RR,,28 ,,NW,,,,,,$121.78,$0.00,1,1,1,1,1,1,20110101,E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,UE,,28 ,,NW,,,,,,"$1,054.42",$0.00,1,1,1,1,1,1,20110101,E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,,,28 ,,NW,,,,,,$435.95,$0.00,1,1,1,1,1,1,20110101,E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,NU,,28 ,,NW,,,,,,$435.95,$0.00,1,1,1,1,1,1,20110101,E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,RR,,28 ,,NW,,,,,,$39.26,$0.00,1,1,1,1,1,1,20110101,E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,UE,,28 ,,NW,,,,,,$321.29,$0.00,1,1,1,1,1,1,20110101,E2120,HCPCS,PULSE GEN SYS TX ENDOLYMP FL,,,28 ,,NW,,,,,,"$6,331.17",$0.00,1,1,1,1,1,1,20110101,E2120,HCPCS,PULSE GEN SYS TX ENDOLYMP FL,RR,,28 ,,NW,,,,,,$666.93,$0.00,1,1,1,1,1,1,20110101,E2201,HCPCS,MAN W/CH ACC SEAT W>=20ö<24ö,,,28 ,,NW,,,,,,$520.28,$0.00,1,1,1,1,1,1,20110101,E2201,HCPCS,MAN W/CH ACC SEAT W>=20ö<24ö,NU,,28 ,,NW,,,,,,$520.28,$0.00,1,1,1,1,1,1,20110101,E2201,HCPCS,MAN W/CH ACC SEAT W>=20ö<24ö,RR,,28 ,,NW,,,,,,$67.09,$0.00,1,1,1,1,1,1,20110101,E2201,HCPCS,MAN W/CH ACC SEAT W>=20ö<24ö,UE,,28 ,,NW,,,,,,$404.69,$0.00,1,1,1,1,1,1,20110101,E2202,HCPCS,SEAT WIDTH 24-27 IN,,,28 ,,NW,,,,,,$645.28,$0.00,1,1,1,1,1,1,20110101,E2202,HCPCS,SEAT WIDTH 24-27 IN,NU,,28 ,,NW,,,,,,$645.28,$0.00,1,1,1,1,1,1,20110101,E2202,HCPCS,SEAT WIDTH 24-27 IN,RR,,28 ,,NW,,,,,,$85.59,$0.00,1,1,1,1,1,1,20110101,E2202,HCPCS,SEAT WIDTH 24-27 IN,UE,,28 ,,NW,,,,,,$498.47,$0.00,1,1,1,1,1,1,20110101,E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,,,28 ,,NW,,,,,,$651.56,$0.00,1,1,1,1,1,1,20110101,E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,NU,,28 ,,NW,,,,,,$651.56,$0.00,1,1,1,1,1,1,20110101,E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,RR,,28 ,,NW,,,,,,$86.48,$0.00,1,1,1,1,1,1,20110101,E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,UE,,28 ,,NW,,,,,,$503.14,$0.00,1,1,1,1,1,1,20110101,E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,,,28 ,,NW,,,,,,"$1,065.90",$0.00,1,1,1,1,1,1,20110101,E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,NU,,28 ,,NW,,,,,,"$1,065.90",$0.00,1,1,1,1,1,1,20110101,E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,RR,,28 ,,NW,,,,,,$147.85,$0.00,1,1,1,1,1,1,20110101,E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,UE,,28 ,,NW,,,,,,$813.90,$0.00,1,1,1,1,1,1,20110101,E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",,,28 ,,NW,,,,,,$58.35,$0.00,1,1,1,1,1,1,20110101,E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",NU,,28 ,,NW,,,,,,$58.35,$0.00,1,1,1,1,1,1,20110101,E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",RR,,28 ,,NW,,,,,,$5.37,$0.00,1,1,1,1,1,1,20110101,E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",UE,,28 ,,NW,,,,,,$43.47,$0.00,1,1,1,1,1,1,20110101,E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,,,28 ,,NW,,,,,,$73.00,$0.00,1,1,1,1,1,1,20110101,E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,NU,,28 ,,NW,,,,,,$73.00,$0.00,1,1,1,1,1,1,20110101,E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,RR,,28 ,,NW,,,,,,$6.76,$0.00,1,1,1,1,1,1,20110101,E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,UE,,28 ,,NW,,,,,,$54.41,$0.00,1,1,1,1,1,1,20110101,E2207,HCPCS,CRUTCH AND CANE HOLDER,,,28 ,,NW,,,,,,$77.88,$0.00,1,1,1,1,1,1,20110101,E2207,HCPCS,CRUTCH AND CANE HOLDER,NU,,28 ,,NW,,,,,,$77.88,$0.00,1,1,1,1,1,1,20110101,E2207,HCPCS,CRUTCH AND CANE HOLDER,RR,,28 ,,NW,,,,,,$7.24,$0.00,1,1,1,1,1,1,20110101,E2207,HCPCS,CRUTCH AND CANE HOLDER,UE,,28 ,,NW,,,,,,$58.07,$0.00,1,1,1,1,1,1,20110101,E2208,HCPCS,CYLINDER TANK CARRIER,,,28 ,,NW,,,,,,$331.00,$0.00,1,1,1,1,1,1,20110101,E2208,HCPCS,CYLINDER TANK CARRIER,NU,,28 ,,NW,,,,,,$331.00,$0.00,1,1,1,1,1,1,20110101,E2208,HCPCS,CYLINDER TANK CARRIER,RR,,28 ,,NW,,,,,,$39.04,$0.00,1,1,1,1,1,1,20110101,E2208,HCPCS,CYLINDER TANK CARRIER,UE,,28 ,,NW,,,,,,$262.74,$0.00,1,1,1,1,1,1,20110101,E2209,HCPCS,ARM TROUGH EACH,,,28 ,,NW,,,,,,$304.30,$0.00,1,1,1,1,1,1,20110101,E2209,HCPCS,ARM TROUGH EACH,NU,,28 ,,NW,,,,,,$304.30,$0.00,1,1,1,1,1,1,20110101,E2209,HCPCS,ARM TROUGH EACH,RR,,28 ,,NW,,,,,,$35.17,$0.00,1,1,1,1,1,1,20110101,E2209,HCPCS,ARM TROUGH EACH,UE,,28 ,,NW,,,,,,$242.72,$0.00,1,1,1,1,1,1,20110101,E2210,HCPCS,WHEELCHAIR BEARINGS,,,28 ,,NW,,,,,,$21.04,$0.00,1,1,1,1,1,1,20110101,E2210,HCPCS,WHEELCHAIR BEARINGS,NU,,28 ,,NW,,,,,,$21.04,$0.00,1,1,1,1,1,1,20110101,E2210,HCPCS,WHEELCHAIR BEARINGS,RR,,28 ,,NW,,,,,,$1.89,$0.00,1,1,1,1,1,1,20110101,E2210,HCPCS,WHEELCHAIR BEARINGS,UE,,28 ,,NW,,,,,,$15.51,$0.00,1,1,1,1,1,1,20110101,E2211,HCPCS,PNEUMATIC PROPULSION TIRE,,,28 ,,NW,,,,,,$69.61,$0.00,1,1,1,1,1,1,20110101,E2211,HCPCS,PNEUMATIC PROPULSION TIRE,NU,,28 ,,NW,,,,,,$69.61,$0.00,1,1,1,1,1,1,20110101,E2211,HCPCS,PNEUMATIC PROPULSION TIRE,RR,,28 ,,NW,,,,,,$6.39,$0.00,1,1,1,1,1,1,20110101,E2211,HCPCS,PNEUMATIC PROPULSION TIRE,UE,,28 ,,NW,,,,,,$49.75,$0.00,1,1,1,1,1,1,20110101,E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,,,28 ,,NW,,,,,,$9.86,$0.00,1,1,1,1,1,1,20110101,E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,NU,,28 ,,NW,,,,,,$9.86,$0.00,1,1,1,1,1,1,20110101,E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,RR,,28 ,,NW,,,,,,$0.89,$0.00,1,1,1,1,1,1,20110101,E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,UE,,28 ,,NW,,,,,,$7.37,$0.00,1,1,1,1,1,1,20110101,E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,,,28 ,,NW,,,,,,$54.23,$0.00,1,1,1,1,1,1,20110101,E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,NU,,28 ,,NW,,,,,,$54.23,$0.00,1,1,1,1,1,1,20110101,E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,RR,,28 ,,NW,,,,,,$5.04,$0.00,1,1,1,1,1,1,20110101,E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,UE,,28 ,,NW,,,,,,$40.30,$0.00,1,1,1,1,1,1,20110101,E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,,,28 ,,NW,,,,,,$59.47,$0.00,1,1,1,1,1,1,20110101,E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,NU,,28 ,,NW,,,,,,$59.47,$0.00,1,1,1,1,1,1,20110101,E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,RR,,28 ,,NW,,,,,,$6.08,$0.00,1,1,1,1,1,1,20110101,E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,UE,,28 ,,NW,,,,,,$44.29,$0.00,1,1,1,1,1,1,20110101,E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,,,28 ,,NW,,,,,,$16.20,$0.00,1,1,1,1,1,1,20110101,E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,NU,,28 ,,NW,,,,,,$16.20,$0.00,1,1,1,1,1,1,20110101,E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,RR,,28 ,,NW,,,,,,$1.47,$0.00,1,1,1,1,1,1,20110101,E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,UE,,28 ,,NW,,,,,,$12.08,$0.00,1,1,1,1,1,1,20110101,E2216,HCPCS,FOAM FILLED PROPULSION TIRE,,,28 ,,NW,,,,,,$73.95,$0.00,1,1,1,1,1,1,20110101,E2216,HCPCS,FOAM FILLED PROPULSION TIRE,NU,,28 ,,NW,,,,,,$73.95,$0.00,1,1,1,1,1,1,20110101,E2216,HCPCS,FOAM FILLED PROPULSION TIRE,RR,,28 ,,NW,,,,,,$7.86,$0.00,1,1,1,1,1,1,20110101,E2216,HCPCS,FOAM FILLED PROPULSION TIRE,UE,,28 ,,NW,,,,,,$55.61,$0.00,1,1,1,1,1,1,20110101,E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,,,28 ,,NW,,,,,,$74.23,$0.00,1,1,1,1,1,1,20110101,E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,NU,,28 ,,NW,,,,,,$74.23,$0.00,1,1,1,1,1,1,20110101,E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,RR,,28 ,,NW,,,,,,$7.93,$0.00,1,1,1,1,1,1,20110101,E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,UE,,28 ,,NW,,,,,,$55.83,$0.00,1,1,1,1,1,1,20110101,E2218,HCPCS,FOAM PROPULSION TIRE EACH,,,28 ,,NW,,,,,,$251.33,$0.00,1,1,1,1,1,1,20110101,E2218,HCPCS,FOAM PROPULSION TIRE EACH,NU,,28 ,,NW,,,,,,$251.33,$0.00,1,1,1,1,1,1,20110101,E2218,HCPCS,FOAM PROPULSION TIRE EACH,RR,,28 ,,NW,,,,,,$27.33,$0.00,1,1,1,1,1,1,20110101,E2218,HCPCS,FOAM PROPULSION TIRE EACH,UE,,28 ,,NW,,,,,,$189.20,$0.00,1,1,1,1,1,1,20110101,E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,,,28 ,,NW,,,,,,$71.72,$0.00,1,1,1,1,1,1,20110101,E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,NU,,28 ,,NW,,,,,,$71.72,$0.00,1,1,1,1,1,1,20110101,E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,RR,,28 ,,NW,,,,,,$7.47,$0.00,1,1,1,1,1,1,20110101,E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,UE,,28 ,,NW,,,,,,$53.46,$0.00,1,1,1,1,1,1,20110101,E2220,HCPCS,SOLID PROPULSION TIRE EACH,,,28 ,,NW,,,,,,$48.04,$0.00,1,1,1,1,1,1,20110101,E2220,HCPCS,SOLID PROPULSION TIRE EACH,NU,,28 ,,NW,,,,,,$48.04,$0.00,1,1,1,1,1,1,20110101,E2220,HCPCS,SOLID PROPULSION TIRE EACH,RR,,28 ,,NW,,,,,,$4.32,$0.00,1,1,1,1,1,1,20110101,E2220,HCPCS,SOLID PROPULSION TIRE EACH,UE,,28 ,,NW,,,,,,$36.47,$0.00,1,1,1,1,1,1,20110101,E2221,HCPCS,SOLID CASTER TIRE EACH,,,28 ,,NW,,,,,,$45.35,$0.00,1,1,1,1,1,1,20110101,E2221,HCPCS,SOLID CASTER TIRE EACH,NU,,28 ,,NW,,,,,,$45.35,$0.00,1,1,1,1,1,1,20110101,E2221,HCPCS,SOLID CASTER TIRE EACH,RR,,28 ,,NW,,,,,,$4.22,$0.00,1,1,1,1,1,1,20110101,E2221,HCPCS,SOLID CASTER TIRE EACH,UE,,28 ,,NW,,,,,,$33.70,$0.00,1,1,1,1,1,1,20110101,E2222,HCPCS,SOLID CASTER INTEGRATED WHL,,,28 ,,NW,,,,,,$37.28,$0.00,1,1,1,1,1,1,20110101,E2222,HCPCS,SOLID CASTER INTEGRATED WHL,NU,,28 ,,NW,,,,,,$37.28,$0.00,1,1,1,1,1,1,20110101,E2222,HCPCS,SOLID CASTER INTEGRATED WHL,RR,,28 ,,NW,,,,,,$3.41,$0.00,1,1,1,1,1,1,20110101,E2222,HCPCS,SOLID CASTER INTEGRATED WHL,UE,,28 ,,NW,,,,,,$27.65,$0.00,1,1,1,1,1,1,20110101,E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,,,28 ,,NW,,,,,,$161.64,$0.00,1,1,1,1,1,1,20110101,E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,NU,,28 ,,NW,,,,,,$161.64,$0.00,1,1,1,1,1,1,20110101,E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,RR,,28 ,,NW,,,,,,$15.78,$0.00,1,1,1,1,1,1,20110101,E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,UE,,28 ,,NW,,,,,,$120.71,$0.00,1,1,1,1,1,1,20110101,E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,,,28 ,,NW,,,,,,$30.57,$0.00,1,1,1,1,1,1,20110101,E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,NU,,28 ,,NW,,,,,,$30.57,$0.00,1,1,1,1,1,1,20110101,E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,RR,,28 ,,NW,,,,,,$2.83,$0.00,1,1,1,1,1,1,20110101,E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,UE,,28 ,,NW,,,,,,$22.57,$0.00,1,1,1,1,1,1,20110101,E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,,,28 ,,NW,,,,,,$68.25,$0.00,1,1,1,1,1,1,20110101,E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,NU,,28 ,,NW,,,,,,$68.25,$0.00,1,1,1,1,1,1,20110101,E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,RR,,28 ,,NW,,,,,,$6.32,$0.00,1,1,1,1,1,1,20110101,E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,UE,,28 ,,NW,,,,,,$50.84,$0.00,1,1,1,1,1,1,20110101,E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,,,28 ,,NW,,,,,,"$2,221.38",$0.00,1,1,1,1,1,1,20110101,E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,NU,,28 ,,NW,,,,,,"$2,221.38",$0.00,1,1,1,1,1,1,20110101,E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,RR,,28 ,,NW,,,,,,$274.27,$0.00,1,1,1,1,1,1,20110101,E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,UE,,28 ,,NW,,,,,,"$1,680.51",$0.00,1,1,1,1,1,1,20110101,E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",,,28 ,,NW,,,,,,"$1,218.15",$0.00,1,1,1,1,1,1,20110101,E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",NU,,28 ,,NW,,,,,,"$1,218.15",$0.00,1,1,1,1,1,1,20110101,E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",RR,,28 ,,NW,,,,,,$170.35,$0.00,1,1,1,1,1,1,20110101,E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",UE,,28 ,,NW,,,,,,$928.12,$0.00,1,1,1,1,1,1,20110101,E2230,HCPCS,MANUAL STANDING SYSTEM,,,28 ,,NW,,,,,,"$2,035.96",$0.00,1,1,1,1,1,1,20110101,E2231,HCPCS,SOLID SEAT SUPPORT BASE,,,28 ,,NW,,,,,,$248.36,$0.00,1,1,1,1,1,1,20110101,E2231,HCPCS,SOLID SEAT SUPPORT BASE,NU,,28 ,,NW,,,,,,$248.36,$0.00,1,1,1,1,1,1,20110101,E2231,HCPCS,SOLID SEAT SUPPORT BASE,RR,,28 ,,NW,,,,,,$26.85,$0.00,1,1,1,1,1,1,20110101,E2231,HCPCS,SOLID SEAT SUPPORT BASE,UE,,28 ,,NW,,,,,,$200.73,$0.00,1,1,1,1,1,1,20110101,E2295,HCPCS,PED DYNAMIC SEATING FRAME,,,28 ,,NW,,,,,,$147.79,$0.00,1,1,1,1,1,1,20110101,E2300,HCPCS,PWR SEAT ELEVATION SYS,,,28 ,,NW,,,,,,"$1,957.68",$0.00,1,1,1,1,1,1,20110101,E2301,HCPCS,PWR STANDING,,,28 ,,NW,,,,,,"$3,778.23",$0.00,1,1,1,1,1,1,20110101,E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,,,28 ,,NW,,,,,,"$2,758.03",$0.00,1,1,1,1,1,1,20110101,E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,NU,,28 ,,NW,,,,,,"$2,758.03",$0.00,1,1,1,1,1,1,20110101,E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,RR,,28 ,,NW,,,,,,$327.91,$0.00,1,1,1,1,1,1,20110101,E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,UE,,28 ,,NW,,,,,,"$2,082.99",$0.00,1,1,1,1,1,1,20110101,E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,,,28 ,,NW,,,,,,"$5,524.40",$0.00,1,1,1,1,1,1,20110101,E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,NU,,28 ,,NW,,,,,,"$5,524.40",$0.00,1,1,1,1,1,1,20110101,E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,RR,,28 ,,NW,,,,,,$604.59,$0.00,1,1,1,1,1,1,20110101,E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,UE,,28 ,,NW,,,,,,"$4,157.78",$0.00,1,1,1,1,1,1,20110101,E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,,,28 ,,NW,,,,,,"$5,648.20",$0.00,1,1,1,1,1,1,20110101,E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,NU,,28 ,,NW,,,,,,"$5,648.20",$0.00,1,1,1,1,1,1,20110101,E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,RR,,28 ,,NW,,,,,,$616.94,$0.00,1,1,1,1,1,1,20110101,E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,UE,,28 ,,NW,,,,,,"$4,250.63",$0.00,1,1,1,1,1,1,20110101,E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",,,28 ,,NW,,,,,,$448.06,$0.00,1,1,1,1,1,1,20110101,E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",NU,,28 ,,NW,,,,,,$448.06,$0.00,1,1,1,1,1,1,20110101,E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",RR,,28 ,,NW,,,,,,$56.41,$0.00,1,1,1,1,1,1,20110101,E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",UE,,28 ,,NW,,,,,,$350.53,$0.00,1,1,1,1,1,1,20110101,E2321,HCPCS,HAND INTERFACE JOYSTICK,,,28 ,,NW,,,,,,"$6,489.18",$0.00,1,1,1,1,1,1,20110101,E2321,HCPCS,HAND INTERFACE JOYSTICK,NU,,28 ,,NW,,,,,,"$6,489.18",$0.00,1,1,1,1,1,1,20110101,E2321,HCPCS,HAND INTERFACE JOYSTICK,RR,,28 ,,NW,,,,,,$701.07,$0.00,1,1,1,1,1,1,20110101,E2321,HCPCS,HAND INTERFACE JOYSTICK,UE,,28 ,,NW,,,,,,"$4,881.39",$0.00,1,1,1,1,1,1,20110101,E2322,HCPCS,MULT MECH SWITCHES,,,28 ,,NW,,,,,,"$6,239.84",$0.00,1,1,1,1,1,1,20110101,E2322,HCPCS,MULT MECH SWITCHES,NU,,28 ,,NW,,,,,,"$6,239.84",$0.00,1,1,1,1,1,1,20110101,E2322,HCPCS,MULT MECH SWITCHES,RR,,28 ,,NW,,,,,,$676.09,$0.00,1,1,1,1,1,1,20110101,E2322,HCPCS,MULT MECH SWITCHES,UE,,28 ,,NW,,,,,,"$4,694.38",$0.00,1,1,1,1,1,1,20110101,E2323,HCPCS,SPECIAL JOYSTICK HANDLE,,,28 ,,NW,,,,,,$217.49,$0.00,1,1,1,1,1,1,20110101,E2323,HCPCS,SPECIAL JOYSTICK HANDLE,NU,,28 ,,NW,,,,,,$217.49,$0.00,1,1,1,1,1,1,20110101,E2323,HCPCS,SPECIAL JOYSTICK HANDLE,RR,,28 ,,NW,,,,,,$22.29,$0.00,1,1,1,1,1,1,20110101,E2323,HCPCS,SPECIAL JOYSTICK HANDLE,UE,,28 ,,NW,,,,,,$175.27,$0.00,1,1,1,1,1,1,20110101,E2324,HCPCS,CHIN CUP INTERFACE,,,28 ,,NW,,,,,,$148.29,$0.00,1,1,1,1,1,1,20110101,E2324,HCPCS,CHIN CUP INTERFACE,NU,,28 ,,NW,,,,,,$148.29,$0.00,1,1,1,1,1,1,20110101,E2324,HCPCS,CHIN CUP INTERFACE,RR,,28 ,,NW,,,,,,$13.75,$0.00,1,1,1,1,1,1,20110101,E2324,HCPCS,CHIN CUP INTERFACE,UE,,28 ,,NW,,,,,,$110.90,$0.00,1,1,1,1,1,1,20110101,E2325,HCPCS,SIP AND PUFF INTERFACE,,,28 ,,NW,,,,,,"$3,165.47",$0.00,1,1,1,1,1,1,20110101,E2325,HCPCS,SIP AND PUFF INTERFACE,NU,,28 ,,NW,,,,,,"$3,165.47",$0.00,1,1,1,1,1,1,20110101,E2325,HCPCS,SIP AND PUFF INTERFACE,RR,,28 ,,NW,,,,,,$368.71,$0.00,1,1,1,1,1,1,20110101,E2325,HCPCS,SIP AND PUFF INTERFACE,UE,,28 ,,NW,,,,,,"$2,388.61",$0.00,1,1,1,1,1,1,20110101,E2326,HCPCS,BREATH TUBE KIT,,,28 ,,NW,,,,,,$858.88,$0.00,1,1,1,1,1,1,20110101,E2326,HCPCS,BREATH TUBE KIT,NU,,28 ,,NW,,,,,,$858.88,$0.00,1,1,1,1,1,1,20110101,E2326,HCPCS,BREATH TUBE KIT,RR,,28 ,,NW,,,,,,$117.25,$0.00,1,1,1,1,1,1,20110101,E2326,HCPCS,BREATH TUBE KIT,UE,,28 ,,NW,,,,,,$658.61,$0.00,1,1,1,1,1,1,20110101,E2327,HCPCS,HEAD CONTROL INTERFACE MECH,,,28 ,,NW,,,,,,"$10,324.58",$0.00,1,1,1,1,1,1,20110101,E2327,HCPCS,HEAD CONTROL INTERFACE MECH,NU,,28 ,,NW,,,,,,"$10,324.58",$0.00,1,1,1,1,1,1,20110101,E2327,HCPCS,HEAD CONTROL INTERFACE MECH,RR,,28 ,,NW,,,,,,"$1,084.58",$0.00,1,1,1,1,1,1,20110101,E2327,HCPCS,HEAD CONTROL INTERFACE MECH,UE,,28 ,,NW,,,,,,"$7,760.29",$0.00,1,1,1,1,1,1,20110101,E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,,,28 ,,NW,,,,,,"$11,491.38",$0.00,1,1,1,1,1,1,20110101,E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,NU,,28 ,,NW,,,,,,"$11,491.38",$0.00,1,1,1,1,1,1,20110101,E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,RR,,28 ,,NW,,,,,,"$1,201.25",$0.00,1,1,1,1,1,1,20110101,E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,UE,,28 ,,NW,,,,,,"$8,633.04",$0.00,1,1,1,1,1,1,20110101,E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,,,28 ,,NW,,,,,,"$4,132.94",$0.00,1,1,1,1,1,1,20110101,E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,NU,,28 ,,NW,,,,,,"$4,132.94",$0.00,1,1,1,1,1,1,20110101,E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,RR,,28 ,,NW,,,,,,$465.41,$0.00,1,1,1,1,1,1,20110101,E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,UE,,28 ,,NW,,,,,,"$3,114.18",$0.00,1,1,1,1,1,1,20110101,E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,,,28 ,,NW,,,,,,"$7,953.74",$0.00,1,1,1,1,1,1,20110101,E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,NU,,28 ,,NW,,,,,,"$7,953.74",$0.00,1,1,1,1,1,1,20110101,E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,RR,,28 ,,NW,,,,,,$847.48,$0.00,1,1,1,1,1,1,20110101,E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,UE,,28 ,,NW,,,,,,"$5,979.81",$0.00,1,1,1,1,1,1,20110101,E2331,HCPCS,ATTENDANT CONTROL,,,28 ,,NW,,,,,,$815.29,$0.00,1,1,1,1,1,1,20110101,E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,,,28 ,,NW,,,,,,$502.00,$0.00,1,1,1,1,1,1,20110101,E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,NU,,28 ,,NW,,,,,,$502.00,$0.00,1,1,1,1,1,1,20110101,E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,RR,,28 ,,NW,,,,,,$64.40,$0.00,1,1,1,1,1,1,20110101,E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,UE,,28 ,,NW,,,,,,$391.01,$0.00,1,1,1,1,1,1,20110101,E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,,,28 ,,NW,,,,,,$724.10,$0.00,1,1,1,1,1,1,20110101,E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,NU,,28 ,,NW,,,,,,$724.10,$0.00,1,1,1,1,1,1,20110101,E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,RR,,28 ,,NW,,,,,,$97.25,$0.00,1,1,1,1,1,1,20110101,E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,UE,,28 ,,NW,,,,,,$557.56,$0.00,1,1,1,1,1,1,20110101,E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,,,28 ,,NW,,,,,,$613.06,$0.00,1,1,1,1,1,1,20110101,E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,NU,,28 ,,NW,,,,,,$613.06,$0.00,1,1,1,1,1,1,20110101,E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,RR,,28 ,,NW,,,,,,$80.82,$0.00,1,1,1,1,1,1,20110101,E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,UE,,28 ,,NW,,,,,,$474.28,$0.00,1,1,1,1,1,1,20110101,E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,,,28 ,,NW,,,,,,$946.17,$0.00,1,1,1,1,1,1,20110101,E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,NU,,28 ,,NW,,,,,,$946.17,$0.00,1,1,1,1,1,1,20110101,E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,RR,,28 ,,NW,,,,,,$130.09,$0.00,1,1,1,1,1,1,20110101,E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,UE,,28 ,,NW,,,,,,$724.10,$0.00,1,1,1,1,1,1,20110101,E2351,HCPCS,ELECTRONIC SGD INTERFACE,,,28 ,,NW,,,,,,"$1,669.87",$0.00,1,1,1,1,1,1,20110101,E2351,HCPCS,ELECTRONIC SGD INTERFACE,NU,,28 ,,NW,,,,,,"$1,669.87",$0.00,1,1,1,1,1,1,20110101,E2351,HCPCS,ELECTRONIC SGD INTERFACE,RR,,28 ,,NW,,,,,,$219.15,$0.00,1,1,1,1,1,1,20110101,E2351,HCPCS,ELECTRONIC SGD INTERFACE,UE,,28 ,,NW,,,,,,"$1,266.85",$0.00,1,1,1,1,1,1,20110101,E2360,HCPCS,22NF NONSEALED LEADACID,,,28 ,,NW,,,,,,$188.46,$0.00,1,1,1,1,1,1,20110101,E2360,HCPCS,22NF NONSEALED LEADACID,NU,,28 ,,NW,,,,,,$188.46,$0.00,1,1,1,1,1,1,20110101,E2360,HCPCS,22NF NONSEALED LEADACID,RR,,28 ,,NW,,,,,,$18.10,$0.00,1,1,1,1,1,1,20110101,E2360,HCPCS,22NF NONSEALED LEADACID,UE,,28 ,,NW,,,,,,$143.87,$0.00,1,1,1,1,1,1,20110101,E2361,HCPCS,22NF SEALED LEADACID BATTERY,,,28 ,,NW,,,,,,$378.53,$0.00,1,1,1,1,1,1,20110101,E2361,HCPCS,22NF SEALED LEADACID BATTERY,NU,,28 ,,NW,,,,,,$378.53,$0.00,1,1,1,1,1,1,20110101,E2361,HCPCS,22NF SEALED LEADACID BATTERY,RR,,28 ,,NW,,,,,,$46.12,$0.00,1,1,1,1,1,1,20110101,E2361,HCPCS,22NF SEALED LEADACID BATTERY,UE,,28 ,,NW,,,,,,$298.41,$0.00,1,1,1,1,1,1,20110101,E2362,HCPCS,GR24 NONSEALED LEADACID,,,28 ,,NW,,,,,,$166.74,$0.00,1,1,1,1,1,1,20110101,E2362,HCPCS,GR24 NONSEALED LEADACID,NU,,28 ,,NW,,,,,,$166.74,$0.00,1,1,1,1,1,1,20110101,E2362,HCPCS,GR24 NONSEALED LEADACID,RR,,28 ,,NW,,,,,,$15.51,$0.00,1,1,1,1,1,1,20110101,E2362,HCPCS,GR24 NONSEALED LEADACID,UE,,28 ,,NW,,,,,,$124.71,$0.00,1,1,1,1,1,1,20110101,E2363,HCPCS,GR24 SEALED LEADACID BATTERY,,,28 ,,NW,,,,,,$485.55,$0.00,1,1,1,1,1,1,20110101,E2363,HCPCS,GR24 SEALED LEADACID BATTERY,NU,,28 ,,NW,,,,,,$485.55,$0.00,1,1,1,1,1,1,20110101,E2363,HCPCS,GR24 SEALED LEADACID BATTERY,RR,,28 ,,NW,,,,,,$61.98,$0.00,1,1,1,1,1,1,20110101,E2363,HCPCS,GR24 SEALED LEADACID BATTERY,UE,,28 ,,NW,,,,,,$378.65,$0.00,1,1,1,1,1,1,20110101,E2364,HCPCS,U1NONSEALED LEADACID BATTERY,,,28 ,,NW,,,,,,$188.46,$0.00,1,1,1,1,1,1,20110101,E2364,HCPCS,U1NONSEALED LEADACID BATTERY,NU,,28 ,,NW,,,,,,$188.46,$0.00,1,1,1,1,1,1,20110101,E2364,HCPCS,U1NONSEALED LEADACID BATTERY,RR,,28 ,,NW,,,,,,$18.10,$0.00,1,1,1,1,1,1,20110101,E2364,HCPCS,U1NONSEALED LEADACID BATTERY,UE,,28 ,,NW,,,,,,$143.86,$0.00,1,1,1,1,1,1,20110101,E2365,HCPCS,U1 SEALED LEADACID BATTERY,,,28 ,,NW,,,,,,$315.82,$0.00,1,1,1,1,1,1,20110101,E2365,HCPCS,U1 SEALED LEADACID BATTERY,NU,,28 ,,NW,,,,,,$315.82,$0.00,1,1,1,1,1,1,20110101,E2365,HCPCS,U1 SEALED LEADACID BATTERY,RR,,28 ,,NW,,,,,,$36.82,$0.00,1,1,1,1,1,1,20110101,E2365,HCPCS,U1 SEALED LEADACID BATTERY,UE,,28 ,,NW,,,,,,$251.46,$0.00,1,1,1,1,1,1,20110101,E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",,,28 ,,NW,,,,,,$629.20,$0.00,1,1,1,1,1,1,20110101,E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",NU,,28 ,,NW,,,,,,$629.20,$0.00,1,1,1,1,1,1,20110101,E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",RR,,28 ,,NW,,,,,,$83.44,$0.00,1,1,1,1,1,1,20110101,E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",UE,,28 ,,NW,,,,,,$486.71,$0.00,1,1,1,1,1,1,20110101,E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",,,28 ,,NW,,,,,,"$1,024.86",$0.00,1,1,1,1,1,1,20110101,E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",NU,,28 ,,NW,,,,,,"$1,024.86",$0.00,1,1,1,1,1,1,20110101,E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",RR,,28 ,,NW,,,,,,$141.78,$0.00,1,1,1,1,1,1,20110101,E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",UE,,28 ,,NW,,,,,,$783.13,$0.00,1,1,1,1,1,1,20110101,E2368,HCPCS,POWER WC MOTOR REPLACEMENT,,,28 ,,NW,,,,,,"$1,249.81",$0.00,1,1,1,1,1,1,20110101,E2368,HCPCS,POWER WC MOTOR REPLACEMENT,NU,,28 ,,NW,,,,,,"$1,249.81",$0.00,1,1,1,1,1,1,20110101,E2368,HCPCS,POWER WC MOTOR REPLACEMENT,RR,,28 ,,NW,,,,,,$174.72,$0.00,1,1,1,1,1,1,20110101,E2368,HCPCS,POWER WC MOTOR REPLACEMENT,UE,,28 ,,NW,,,,,,$951.85,$0.00,1,1,1,1,1,1,20110101,E2369,HCPCS,PWR WC GEAR BOX REPLACEMENT,,,28 ,,NW,,,,,,"$1,096.08",$0.00,1,1,1,1,1,1,20110101,E2369,HCPCS,PWR WC GEAR BOX REPLACEMENT,NU,,28 ,,NW,,,,,,"$1,096.08",$0.00,1,1,1,1,1,1,20110101,E2369,HCPCS,PWR WC GEAR BOX REPLACEMENT,RR,,28 ,,NW,,,,,,$152.33,$0.00,1,1,1,1,1,1,20110101,E2369,HCPCS,PWR WC GEAR BOX REPLACEMENT,UE,,28 ,,NW,,,,,,$836.51,$0.00,1,1,1,1,1,1,20110101,E2370,HCPCS,PWR WC MOTOR/GEAR BOX COMBO,,,28 ,,NW,,,,,,"$1,910.31",$0.00,1,1,1,1,1,1,20110101,E2370,HCPCS,PWR WC MOTOR/GEAR BOX COMBO,NU,,28 ,,NW,,,,,,"$1,910.31",$0.00,1,1,1,1,1,1,20110101,E2370,HCPCS,PWR WC MOTOR/GEAR BOX COMBO,RR,,28 ,,NW,,,,,,$243.16,$0.00,1,1,1,1,1,1,20110101,E2370,HCPCS,PWR WC MOTOR/GEAR BOX COMBO,UE,,28 ,,NW,,,,,,"$1,447.20",$0.00,1,1,1,1,1,1,20110101,E2371,HCPCS,GR27 SEALED LEADACID BATTERY,,,28 ,,NW,,,,,,$405.72,$0.00,1,1,1,1,1,1,20110101,E2371,HCPCS,GR27 SEALED LEADACID BATTERY,NU,,28 ,,NW,,,,,,$405.72,$0.00,1,1,1,1,1,1,20110101,E2371,HCPCS,GR27 SEALED LEADACID BATTERY,RR,,28 ,,NW,,,,,,$50.15,$0.00,1,1,1,1,1,1,20110101,E2371,HCPCS,GR27 SEALED LEADACID BATTERY,UE,,28 ,,NW,,,,,,$318.78,$0.00,1,1,1,1,1,1,20110101,E2372,HCPCS,GR27 NON-SEALED LEADACID,,,28 ,,NW,,,,,,"$1,063.01",$0.00,1,1,1,1,1,1,20110101,E2372,HCPCS,GR27 NON-SEALED LEADACID,NU,,28 ,,NW,,,,,,"$1,063.01",$0.00,1,1,1,1,1,1,20110101,E2372,HCPCS,GR27 NON-SEALED LEADACID,RR,,28 ,,NW,,,,,,$115.11,$0.00,1,1,1,1,1,1,20110101,E2372,HCPCS,GR27 NON-SEALED LEADACID,UE,,28 ,,NW,,,,,,$800.09,$0.00,1,1,1,1,1,1,20110101,E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,,,28 ,,NW,,,,,,"$3,091.95",$0.00,1,1,1,1,1,1,20110101,E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,NU,,28 ,,NW,,,,,,"$3,091.95",$0.00,1,1,1,1,1,1,20110101,E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,RR,,28 ,,NW,,,,,,$361.33,$0.00,1,1,1,1,1,1,20110101,E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,UE,,28 ,,NW,,,,,,"$2,333.49",$0.00,1,1,1,1,1,1,20110101,E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,,,28 ,,NW,,,,,,"$1,290.07",$0.00,1,1,1,1,1,1,20110101,E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,NU,,28 ,,NW,,,,,,"$1,290.07",$0.00,1,1,1,1,1,1,20110101,E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,RR,,28 ,,NW,,,,,,$179.47,$0.00,1,1,1,1,1,1,20110101,E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,UE,,28 ,,NW,,,,,,$982.07,$0.00,1,1,1,1,1,1,20110101,E2375,HCPCS,NON-EXPANDABLE CONTROLLER,,,28 ,,NW,,,,,,"$2,034.28",$0.00,1,1,1,1,1,1,20110101,E2375,HCPCS,NON-EXPANDABLE CONTROLLER,NU,,28 ,,NW,,,,,,"$2,034.28",$0.00,1,1,1,1,1,1,20110101,E2375,HCPCS,NON-EXPANDABLE CONTROLLER,RR,,28 ,,NW,,,,,,$255.53,$0.00,1,1,1,1,1,1,20110101,E2375,HCPCS,NON-EXPANDABLE CONTROLLER,UE,,28 ,,NW,,,,,,"$1,540.13",$0.00,1,1,1,1,1,1,20110101,E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",,,28 ,,NW,,,,,,"$3,154.94",$0.00,1,1,1,1,1,1,20110101,E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",NU,,28 ,,NW,,,,,,"$3,154.94",$0.00,1,1,1,1,1,1,20110101,E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",RR,,28 ,,NW,,,,,,$367.63,$0.00,1,1,1,1,1,1,20110101,E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",UE,,28 ,,NW,,,,,,"$2,380.73",$0.00,1,1,1,1,1,1,20110101,E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",,,28 ,,NW,,,,,,"$1,178.61",$0.00,1,1,1,1,1,1,20110101,E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",NU,,28 ,,NW,,,,,,"$1,178.61",$0.00,1,1,1,1,1,1,20110101,E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",RR,,28 ,,NW,,,,,,$164.48,$0.00,1,1,1,1,1,1,20110101,E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",UE,,28 ,,NW,,,,,,$898.47,$0.00,1,1,1,1,1,1,20110101,E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,,,28 ,,NW,,,,,,$232.99,$0.00,1,1,1,1,1,1,20110101,E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,NU,,28 ,,NW,,,,,,$232.99,$0.00,1,1,1,1,1,1,20110101,E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,RR,,28 ,,NW,,,,,,$24.59,$0.00,1,1,1,1,1,1,20110101,E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,UE,,28 ,,NW,,,,,,$189.09,$0.00,1,1,1,1,1,1,20110101,E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",,,28 ,,NW,,,,,,$69.32,$0.00,1,1,1,1,1,1,20110101,E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",NU,,28 ,,NW,,,,,,$69.32,$0.00,1,1,1,1,1,1,20110101,E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",RR,,28 ,,NW,,,,,,$6.39,$0.00,1,1,1,1,1,1,20110101,E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",UE,,28 ,,NW,,,,,,$51.64,$0.00,1,1,1,1,1,1,20110101,E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",,,28 ,,NW,,,,,,$407.10,$0.00,1,1,1,1,1,1,20110101,E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",NU,,28 ,,NW,,,,,,$407.10,$0.00,1,1,1,1,1,1,20110101,E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",RR,,28 ,,NW,,,,,,$50.34,$0.00,1,1,1,1,1,1,20110101,E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",UE,,28 ,,NW,,,,,,$319.82,$0.00,1,1,1,1,1,1,20110101,E2384,HCPCS,PNEUMATIC CASTER TIRE,,,28 ,,NW,,,,,,$243.95,$0.00,1,1,1,1,1,1,20110101,E2384,HCPCS,PNEUMATIC CASTER TIRE,NU,,28 ,,NW,,,,,,$243.95,$0.00,1,1,1,1,1,1,20110101,E2384,HCPCS,PNEUMATIC CASTER TIRE,RR,,28 ,,NW,,,,,,$26.24,$0.00,1,1,1,1,1,1,20110101,E2384,HCPCS,PNEUMATIC CASTER TIRE,UE,,28 ,,NW,,,,,,$197.43,$0.00,1,1,1,1,1,1,20110101,E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",,,28 ,,NW,,,,,,$167.38,$0.00,1,1,1,1,1,1,20110101,E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",NU,,28 ,,NW,,,,,,$167.38,$0.00,1,1,1,1,1,1,20110101,E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",RR,,28 ,,NW,,,,,,$15.56,$0.00,1,1,1,1,1,1,20110101,E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",UE,,28 ,,NW,,,,,,$124.94,$0.00,1,1,1,1,1,1,20110101,E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,,,28 ,,NW,,,,,,$403.95,$0.00,1,1,1,1,1,1,20110101,E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,NU,,28 ,,NW,,,,,,$403.95,$0.00,1,1,1,1,1,1,20110101,E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,RR,,28 ,,NW,,,,,,$49.86,$0.00,1,1,1,1,1,1,20110101,E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,UE,,28 ,,NW,,,,,,$317.43,$0.00,1,1,1,1,1,1,20110101,E2387,HCPCS,FOAM FILLED CASTER TIRE,,,28 ,,NW,,,,,,$210.16,$0.00,1,1,1,1,1,1,20110101,E2387,HCPCS,FOAM FILLED CASTER TIRE,NU,,28 ,,NW,,,,,,$210.16,$0.00,1,1,1,1,1,1,20110101,E2387,HCPCS,FOAM FILLED CASTER TIRE,RR,,28 ,,NW,,,,,,$21.20,$0.00,1,1,1,1,1,1,20110101,E2387,HCPCS,FOAM FILLED CASTER TIRE,UE,,28 ,,NW,,,,,,$167.70,$0.00,1,1,1,1,1,1,20110101,E2388,HCPCS,FOAM DRIVE WHEEL TIRE,,,28 ,,NW,,,,,,$170.72,$0.00,1,1,1,1,1,1,20110101,E2388,HCPCS,FOAM DRIVE WHEEL TIRE,NU,,28 ,,NW,,,,,,$170.72,$0.00,1,1,1,1,1,1,20110101,E2388,HCPCS,FOAM DRIVE WHEEL TIRE,RR,,28 ,,NW,,,,,,$15.88,$0.00,1,1,1,1,1,1,20110101,E2388,HCPCS,FOAM DRIVE WHEEL TIRE,UE,,28 ,,NW,,,,,,$127.73,$0.00,1,1,1,1,1,1,20110101,E2389,HCPCS,FOAM CASTER TIRE,,,28 ,,NW,,,,,,$92.08,$0.00,1,1,1,1,1,1,20110101,E2389,HCPCS,FOAM CASTER TIRE,NU,,28 ,,NW,,,,,,$92.08,$0.00,1,1,1,1,1,1,20110101,E2389,HCPCS,FOAM CASTER TIRE,RR,,28 ,,NW,,,,,,$8.57,$0.00,1,1,1,1,1,1,20110101,E2389,HCPCS,FOAM CASTER TIRE,UE,,28 ,,NW,,,,,,$68.70,$0.00,1,1,1,1,1,1,20110101,E2390,HCPCS,SOLID DRIVE WHEEL TIRE,,,28 ,,NW,,,,,,$144.76,$0.00,1,1,1,1,1,1,20110101,E2390,HCPCS,SOLID DRIVE WHEEL TIRE,NU,,28 ,,NW,,,,,,$144.76,$0.00,1,1,1,1,1,1,20110101,E2390,HCPCS,SOLID DRIVE WHEEL TIRE,RR,,28 ,,NW,,,,,,$13.45,$0.00,1,1,1,1,1,1,20110101,E2390,HCPCS,SOLID DRIVE WHEEL TIRE,UE,,28 ,,NW,,,,,,$108.16,$0.00,1,1,1,1,1,1,20110101,E2391,HCPCS,SOLID CASTER TIRE,,,28 ,,NW,,,,,,$68.66,$0.00,1,1,1,1,1,1,20110101,E2391,HCPCS,SOLID CASTER TIRE,NU,,28 ,,NW,,,,,,$68.66,$0.00,1,1,1,1,1,1,20110101,E2391,HCPCS,SOLID CASTER TIRE,RR,,28 ,,NW,,,,,,$6.37,$0.00,1,1,1,1,1,1,20110101,E2391,HCPCS,SOLID CASTER TIRE,UE,,28 ,,NW,,,,,,$51.18,$0.00,1,1,1,1,1,1,20110101,E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",,,28 ,,NW,,,,,,$180.77,$0.00,1,1,1,1,1,1,20110101,E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",NU,,28 ,,NW,,,,,,$180.77,$0.00,1,1,1,1,1,1,20110101,E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",RR,,28 ,,NW,,,,,,$17.10,$0.00,1,1,1,1,1,1,20110101,E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",UE,,28 ,,NW,,,,,,$136.64,$0.00,1,1,1,1,1,1,20110101,E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,,,28 ,,NW,,,,,,$235.01,$0.00,1,1,1,1,1,1,20110101,E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,NU,,28 ,,NW,,,,,,$235.01,$0.00,1,1,1,1,1,1,20110101,E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,RR,,28 ,,NW,,,,,,$24.91,$0.00,1,1,1,1,1,1,20110101,E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,UE,,28 ,,NW,,,,,,$190.75,$0.00,1,1,1,1,1,1,20110101,E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,,,28 ,,NW,,,,,,$182.62,$0.00,1,1,1,1,1,1,20110101,E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,NU,,28 ,,NW,,,,,,$182.62,$0.00,1,1,1,1,1,1,20110101,E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,RR,,28 ,,NW,,,,,,$17.30,$0.00,1,1,1,1,1,1,20110101,E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,UE,,28 ,,NW,,,,,,$138.42,$0.00,1,1,1,1,1,1,20110101,E2396,HCPCS,CASTER FORK,,,28 ,,NW,,,,,,$203.22,$0.00,1,1,1,1,1,1,20110101,E2396,HCPCS,CASTER FORK,NU,,28 ,,NW,,,,,,$203.22,$0.00,1,1,1,1,1,1,20110101,E2396,HCPCS,CASTER FORK,RR,,28 ,,NW,,,,,,$21.59,$0.00,1,1,1,1,1,1,20110101,E2396,HCPCS,CASTER FORK,UE,,28 ,,NW,,,,,,$159.95,$0.00,1,1,1,1,1,1,20110101,E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",,,28 ,,NW,,,,,,$571.12,$0.00,1,1,1,1,1,1,20110101,E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",NU,,28 ,,NW,,,,,,$571.12,$0.00,1,1,1,1,1,1,20110101,E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",RR,,28 ,,NW,,,,,,$74.60,$0.00,1,1,1,1,1,1,20110101,E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",UE,,28 ,,NW,,,,,,$442.80,$0.00,1,1,1,1,1,1,20110101,E2402,HCPCS,NEG PRESS WOUND THERAPY PUMP,,,28 ,,NW,,,,,,"$33,944.74",$0.00,1,1,1,1,1,1,20110101,E2402,HCPCS,NEG PRESS WOUND THERAPY PUMP,RR,,28 ,,NW,,,,,,"$3,575.77",$0.00,1,1,1,1,1,1,20110101,E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,,,28 ,,NW,,,,,,$928.49,$0.00,1,1,1,1,1,1,20110101,E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,NU,,28 ,,NW,,,,,,$928.49,$0.00,1,1,1,1,1,1,20110101,E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,RR,,28 ,,NW,,,,,,$76.79,$0.00,1,1,1,1,1,1,20110101,E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,UE,,28 ,,NW,,,,,,$690.68,$0.00,1,1,1,1,1,1,20110101,E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,,,28 ,,NW,,,,,,"$2,885.89",$0.00,1,1,1,1,1,1,20110101,E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,NU,,28 ,,NW,,,,,,"$2,885.89",$0.00,1,1,1,1,1,1,20110101,E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,RR,,28 ,,NW,,,,,,$268.19,$0.00,1,1,1,1,1,1,20110101,E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,UE,,28 ,,NW,,,,,,"$2,158.76",$0.00,1,1,1,1,1,1,20110101,E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,,,28 ,,NW,,,,,,"$3,814.12",$0.00,1,1,1,1,1,1,20110101,E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,NU,,28 ,,NW,,,,,,"$3,814.12",$0.00,1,1,1,1,1,1,20110101,E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,RR,,28 ,,NW,,,,,,$361.04,$0.00,1,1,1,1,1,1,20110101,E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,UE,,28 ,,NW,,,,,,"$2,854.87",$0.00,1,1,1,1,1,1,20110101,E2506,HCPCS,SGD PREREC MSG > 40 MIN,,,28 ,,NW,,,,,,"$5,603.20",$0.00,1,1,1,1,1,1,20110101,E2506,HCPCS,SGD PREREC MSG > 40 MIN,NU,,28 ,,NW,,,,,,"$5,603.20",$0.00,1,1,1,1,1,1,20110101,E2506,HCPCS,SGD PREREC MSG > 40 MIN,RR,,28 ,,NW,,,,,,$539.87,$0.00,1,1,1,1,1,1,20110101,E2506,HCPCS,SGD PREREC MSG > 40 MIN,UE,,28 ,,NW,,,,,,"$4,196.64",$0.00,1,1,1,1,1,1,20110101,E2508,HCPCS,SGD SPELLING PHYS CONTACT,,,28 ,,NW,,,,,,"$8,676.81",$0.00,1,1,1,1,1,1,20110101,E2508,HCPCS,SGD SPELLING PHYS CONTACT,NU,,28 ,,NW,,,,,,"$8,676.81",$0.00,1,1,1,1,1,1,20110101,E2508,HCPCS,SGD SPELLING PHYS CONTACT,RR,,28 ,,NW,,,,,,$847.27,$0.00,1,1,1,1,1,1,20110101,E2508,HCPCS,SGD SPELLING PHYS CONTACT,UE,,28 ,,NW,,,,,,"$6,501.96",$0.00,1,1,1,1,1,1,20110101,E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,,,28 ,,NW,,,,,,"$16,439.94",$0.00,1,1,1,1,1,1,20110101,E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,NU,,28 ,,NW,,,,,,"$16,439.94",$0.00,1,1,1,1,1,1,20110101,E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,RR,,28 ,,NW,,,,,,"$1,623.56",$0.00,1,1,1,1,1,1,20110101,E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,UE,,28 ,,NW,,,,,,"$12,324.27",$0.00,1,1,1,1,1,1,20110101,E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,,,28 ,,NW,,,,,,$586.97,$0.00,1,1,1,1,1,1,20110101,E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,NU,,28 ,,NW,,,,,,$586.97,$0.00,1,1,1,1,1,1,20110101,E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,RR,,28 ,,NW,,,,,,$61.83,$0.00,1,1,1,1,1,1,20110101,E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,UE,,28 ,,NW,,,,,,$441.19,$0.00,1,1,1,1,1,1,20110101,E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",,,28 ,,NW,,,,,,"$1,177.49",$0.00,1,1,1,1,1,1,20110101,E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",NU,,28 ,,NW,,,,,,"$1,177.49",$0.00,1,1,1,1,1,1,20110101,E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",RR,,28 ,,NW,,,,,,$124.04,$0.00,1,1,1,1,1,1,20110101,E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",UE,,28 ,,NW,,,,,,$885.04,$0.00,1,1,1,1,1,1,20110101,E2599,HCPCS,SGD ACCESSORY NOC,,,28 ,,NW,,,,,,$386.90,$0.00,1,1,1,1,1,1,20110101,E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,,,28 ,,NW,,,,,,$199.03,$0.00,1,1,1,1,1,1,20110101,E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,NU,,28 ,,NW,,,,,,$199.03,$0.00,1,1,1,1,1,1,20110101,E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,RR,,28 ,,NW,,,,,,$19.60,$0.00,1,1,1,1,1,1,20110101,E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,UE,,28 ,,NW,,,,,,$155.28,$0.00,1,1,1,1,1,1,20110101,E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,,,28 ,,NW,,,,,,$333.41,$0.00,1,1,1,1,1,1,20110101,E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,NU,,28 ,,NW,,,,,,$333.41,$0.00,1,1,1,1,1,1,20110101,E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,RR,,28 ,,NW,,,,,,$39.44,$0.00,1,1,1,1,1,1,20110101,E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,UE,,28 ,,NW,,,,,,$264.54,$0.00,1,1,1,1,1,1,20110101,E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,,,28 ,,NW,,,,,,$407.68,$0.00,1,1,1,1,1,1,20110101,E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,NU,,28 ,,NW,,,,,,$407.68,$0.00,1,1,1,1,1,1,20110101,E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,RR,,28 ,,NW,,,,,,$50.46,$0.00,1,1,1,1,1,1,20110101,E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,UE,,28 ,,NW,,,,,,$320.23,$0.00,1,1,1,1,1,1,20110101,E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,,,28 ,,NW,,,,,,$492.63,$0.00,1,1,1,1,1,1,20110101,E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,NU,,28 ,,NW,,,,,,$492.63,$0.00,1,1,1,1,1,1,20110101,E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,RR,,28 ,,NW,,,,,,$62.95,$0.00,1,1,1,1,1,1,20110101,E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,UE,,28 ,,NW,,,,,,$384.01,$0.00,1,1,1,1,1,1,20110101,E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,,,28 ,,NW,,,,,,$678.98,$0.00,1,1,1,1,1,1,20110101,E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,NU,,28 ,,NW,,,,,,$678.98,$0.00,1,1,1,1,1,1,20110101,E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,RR,,28 ,,NW,,,,,,$90.62,$0.00,1,1,1,1,1,1,20110101,E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,UE,,28 ,,NW,,,,,,$523.79,$0.00,1,1,1,1,1,1,20110101,E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,,,28 ,,NW,,,,,,"$1,026.83",$0.00,1,1,1,1,1,1,20110101,E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,NU,,28 ,,NW,,,,,,"$1,026.83",$0.00,1,1,1,1,1,1,20110101,E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,RR,,28 ,,NW,,,,,,$142.11,$0.00,1,1,1,1,1,1,20110101,E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,UE,,28 ,,NW,,,,,,$784.58,$0.00,1,1,1,1,1,1,20110101,E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,,,28 ,,NW,,,,,,$726.68,$0.00,1,1,1,1,1,1,20110101,E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,NU,,28 ,,NW,,,,,,$726.68,$0.00,1,1,1,1,1,1,20110101,E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,RR,,28 ,,NW,,,,,,$97.66,$0.00,1,1,1,1,1,1,20110101,E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,UE,,28 ,,NW,,,,,,$559.51,$0.00,1,1,1,1,1,1,20110101,E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,,,28 ,,NW,,,,,,$861.06,$0.00,1,1,1,1,1,1,20110101,E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,NU,,28 ,,NW,,,,,,$861.06,$0.00,1,1,1,1,1,1,20110101,E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,RR,,28 ,,NW,,,,,,$117.48,$0.00,1,1,1,1,1,1,20110101,E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,UE,,28 ,,NW,,,,,,$660.29,$0.00,1,1,1,1,1,1,20110101,E2609,HCPCS,CUSTOM FABRICATE W/C CUSHION,,,28 ,,NW,,,,,,$579.26,$0.00,1,1,1,1,1,1,20110101,E2610,HCPCS,POWERED W/C CUSHION,,,28 ,,NW,,,,,,$412.89,$0.00,1,1,1,1,1,1,20110101,E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,,,28 ,,NW,,,,,,$778.61,$0.00,1,1,1,1,1,1,20110101,E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,NU,,28 ,,NW,,,,,,$778.61,$0.00,1,1,1,1,1,1,20110101,E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,RR,,28 ,,NW,,,,,,$105.29,$0.00,1,1,1,1,1,1,20110101,E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,UE,,28 ,,NW,,,,,,$598.49,$0.00,1,1,1,1,1,1,20110101,E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,,,28 ,,NW,,,,,,"$1,032.85",$0.00,1,1,1,1,1,1,20110101,E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,NU,,28 ,,NW,,,,,,"$1,032.85",$0.00,1,1,1,1,1,1,20110101,E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,RR,,28 ,,NW,,,,,,$142.93,$0.00,1,1,1,1,1,1,20110101,E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,UE,,28 ,,NW,,,,,,$789.08,$0.00,1,1,1,1,1,1,20110101,E2613,HCPCS,POSITION BACK CUSH WD <22IN,,,28 ,,NW,,,,,,$964.78,$0.00,1,1,1,1,1,1,20110101,E2613,HCPCS,POSITION BACK CUSH WD <22IN,NU,,28 ,,NW,,,,,,$964.78,$0.00,1,1,1,1,1,1,20110101,E2613,HCPCS,POSITION BACK CUSH WD <22IN,RR,,28 ,,NW,,,,,,$132.90,$0.00,1,1,1,1,1,1,20110101,E2613,HCPCS,POSITION BACK CUSH WD <22IN,UE,,28 ,,NW,,,,,,$738.07,$0.00,1,1,1,1,1,1,20110101,E2614,HCPCS,POSITION BACK CUSH WD>=22IN,,,28 ,,NW,,,,,,"$1,312.94",$0.00,1,1,1,1,1,1,20110101,E2614,HCPCS,POSITION BACK CUSH WD>=22IN,NU,,28 ,,NW,,,,,,"$1,312.94",$0.00,1,1,1,1,1,1,20110101,E2614,HCPCS,POSITION BACK CUSH WD>=22IN,RR,,28 ,,NW,,,,,,$182.20,$0.00,1,1,1,1,1,1,20110101,E2614,HCPCS,POSITION BACK CUSH WD>=22IN,UE,,28 ,,NW,,,,,,$999.23,$0.00,1,1,1,1,1,1,20110101,E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,,,28 ,,NW,,,,,,"$1,101.57",$0.00,1,1,1,1,1,1,20110101,E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,NU,,28 ,,NW,,,,,,"$1,101.57",$0.00,1,1,1,1,1,1,20110101,E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,RR,,28 ,,NW,,,,,,$153.13,$0.00,1,1,1,1,1,1,20110101,E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,UE,,28 ,,NW,,,,,,$840.62,$0.00,1,1,1,1,1,1,20110101,E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,,,28 ,,NW,,,,,,"$1,462.09",$0.00,1,1,1,1,1,1,20110101,E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,NU,,28 ,,NW,,,,,,"$1,462.09",$0.00,1,1,1,1,1,1,20110101,E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,RR,,28 ,,NW,,,,,,$198.34,$0.00,1,1,1,1,1,1,20110101,E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,UE,,28 ,,NW,,,,,,"$1,111.09",$0.00,1,1,1,1,1,1,20110101,E2617,HCPCS,CUSTOM FAB W/C BACK CUSHION,,,28 ,,NW,,,,,,$925.95,$0.00,1,1,1,1,1,1,20110101,E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,,,28 ,,NW,,,,,,$173.77,$0.00,1,1,1,1,1,1,20110101,E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,NU,,28 ,,NW,,,,,,$173.77,$0.00,1,1,1,1,1,1,20110101,E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,RR,,28 ,,NW,,,,,,$16.18,$0.00,1,1,1,1,1,1,20110101,E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,UE,,28 ,,NW,,,,,,$130.16,$0.00,1,1,1,1,1,1,20110101,E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,,,28 ,,NW,,,,,,"$1,321.64",$0.00,1,1,1,1,1,1,20110101,E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,NU,,28 ,,NW,,,,,,"$1,321.64",$0.00,1,1,1,1,1,1,20110101,E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,RR,,28 ,,NW,,,,,,$183.22,$0.00,1,1,1,1,1,1,20110101,E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,UE,,28 ,,NW,,,,,,"$1,005.73",$0.00,1,1,1,1,1,1,20110101,E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,,,28 ,,NW,,,,,,"$1,384.07",$0.00,1,1,1,1,1,1,20110101,E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,NU,,28 ,,NW,,,,,,"$1,384.07",$0.00,1,1,1,1,1,1,20110101,E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,RR,,28 ,,NW,,,,,,$190.51,$0.00,1,1,1,1,1,1,20110101,E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,UE,,28 ,,NW,,,,,,"$1,052.55",$0.00,1,1,1,1,1,1,20110101,E2622,HCPCS,ADJ SKIN PRO W/C CUS WD<22IN,,,28 ,,NW,,,,,,"$1,321.64",$0.00,1,1,1,1,1,1,20110101,E2623,HCPCS,ADJ SKIN PRO WC CUS WD>=22IN,,,28 ,,NW,,,,,,"$1,384.07",$0.00,1,1,1,1,1,1,20110101,E2624,HCPCS,ADJ SKIN PRO/POS CUS<22IN,,,28 ,,NW,,,,,,"$1,321.64",$0.00,1,1,1,1,1,1,20110101,E2625,HCPCS,ADJ SKIN PRO/POS WC CUS>=22,,,28 ,,NW,,,,,,"$1,384.07",$0.00,1,1,1,1,1,1,20110101,G0008,HCPCS,ADMIN INFLUENZA VIRUS VAC,,,9 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0009,HCPCS,ADMIN PNEUMOCOCCAL VACCINE,,,9 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0010,HCPCS,ADMIN HEPATITIS B VACCINE,,,9 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0027,HCPCS,SEMEN ANALYSIS,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0101,HCPCS,CA SCREEN;PELVIC/BREAST EXAM,,,18 ,,RBRVS,0.45 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0102,HCPCS,PROSTATE CA SCREENING; DRE,,,18 ,,RBRVS,0.17 ,0.06 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0103,HCPCS,PSA SCREENING,,,17 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0104,HCPCS,CA SCREEN;FLEXI SIGMOIDSCOPE,,,21 ,,RBRVS,0.96 ,0.62 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0105,HCPCS,COLORECTAL SCRN; HI RISK IND,,,21 ,,RBRVS,3.69 ,1.82 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,,,20 ,,RBRVS,0.99 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,26,,20 ,,RBRVS,0.99 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,TC,,20 ,,RBRVS,,4.04 ,4.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0108,HCPCS,DIAB MANAGE TRN PER INDIV,,,14 ,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0109,HCPCS,DIAB MANAGE TRN IND/GROUP,,,14 ,,RBRVS,,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0117,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,,14 ,,RBRVS,0.45 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0118,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,,14 ,,RBRVS,0.17 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,,,20 ,,RBRVS,0.99 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,26,,20 ,,RBRVS,0.99 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,TC,,20 ,,RBRVS,,4.04 ,4.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0121,HCPCS,COLON CA SCRN NOT HI RSK IND,,,21 ,,RBRVS,3.69 ,1.82 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0122,HCPCS,COLON CA SCRN; BARIUM ENEMA,,,20 ,,RBRVS,0.99 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0122,HCPCS,COLON CA SCRN; BARIUM ENEMA,26,,20 ,,RBRVS,0.99 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0122,HCPCS,COLON CA SCRN; BARIUM ENEMA,TC,,20 ,,RBRVS,,5.28 ,5.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0123,HCPCS,SCREEN CERV/VAG THIN LAYER,,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0124,HCPCS,SCREEN C/V THIN LAYER BY MD,,,17 ,,RBRVS,0.42 ,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0127,HCPCS,TRIM NAIL(S),,,21 ,,RBRVS,0.17 ,0.05 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0128,HCPCS,CORF SKILLED NURSING SERVICE,,,14 ,,RBRVS,0.08 ,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,,,20 ,,RBRVS,0.22 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,26,,20 ,,RBRVS,0.22 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,TC,,20 ,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0141,HCPCS,"SCR C/V CYTO,AUTOSYS AND MD",,,17 ,,RBRVS,0.42 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0143,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,,17 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0144,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,,17 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0145,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,,17 ,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0147,HCPCS,"SCR C/V CYTO, AUTOMATED SYS",,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0148,HCPCS,"SCR C/V CYTO, AUTOSYS, RESCR",,,17 ,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0151,HCPCS,"HHCP-SERV OF PT,EA 15 MIN",,,14 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0152,HCPCS,"HHCP-SERV OF OT,EA 15 MIN",,,14 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0153,HCPCS,"HHCP-SVS OF S/L PATH,EA 15MN",,,14 ,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0154,HCPCS,"HHCP-SVS OF RN,EA 15 MIN",,,14 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0155,HCPCS,"HHCP-SVS OF CSW,EA 15 MIN",,,14 ,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0156,HCPCS,"HHCP-SVS OF AIDE,EA 15 MIN",,,14 ,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0157,HCPCS,HHC PT ASSISTANT EA 15 ,,,14 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0158,HCPCS,HHC OT ASSISTANT EA 15,,,14 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0159,HCPCS,HHC PT MAINT EA 15 MIN,,,14 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0160,HCPCS,HHC OCCUP THERAPY EA 15,,,14 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0161,HCPCS,HHC SLP EA 15 MIN,,,14 ,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0162,HCPCS,"HHC RN E&M PLAN SVS, 15 MIN",,,14 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0163,HCPCS,HHC LPN/RN OBS/ASSES EA 15,,,14 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0164,HCPCS,HHC LIS NURSE TRAIN EA 15,,,14 ,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,G0166,HCPCS,"EXTRNL COUNTERPULSE, PER TX",,,14 ,,RBRVS,0.07 ,3.93 ,3.93 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0168,HCPCS,WOUND CLOSURE BY ADHESIVE,,,21 ,,RBRVS,0.45 ,0.23 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0175,HCPCS,"OPPS SERVICE,SCHED TEAM CONF",,,14 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0176,HCPCS,OPPS/PHP;ACTIVITY THERAPY,,,16 ,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0177,HCPCS,OPPS/PHP; TRAIN & EDUC SERV,,,16 ,,TotalUnits,,,,2.04 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0179,HCPCS,MD RECERTIFICATION HHA PT,,,15 ,,RBRVS,0.45 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0180,HCPCS,MD CERTIFICATION HHA PATIENT,,,15 ,,RBRVS,0.67 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0181,HCPCS,HOME HEALTH CARE SUPERVISION,,,15 ,,RBRVS,1.73 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0182,HCPCS,HOSPICE CARE SUPERVISION,,,15 ,,RBRVS,1.73 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0186,HCPCS,"DSTRY EYE LESN,FDR VSSL TECH",,,14 ,,TotalUnits,,,,9.21 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0202,HCPCS,SCREENINGMAMMOGRAPHYDIGITAL,,,20 ,,RBRVS,0.70 ,2.84 ,2.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0202,HCPCS,SCREENINGMAMMOGRAPHYDIGITAL,26,,20 ,,RBRVS,0.70 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0202,HCPCS,SCREENINGMAMMOGRAPHYDIGITAL,TC,,20 ,,RBRVS,,2.60 ,2.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,,20 ,,RBRVS,0.87 ,3.34 ,3.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,26,,20 ,,RBRVS,0.87 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,TC,,20 ,,RBRVS,,3.04 ,3.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,,20 ,,RBRVS,0.70 ,2.63 ,2.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,26,,20 ,,RBRVS,0.70 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,TC,,20 ,,RBRVS,,2.39 ,2.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,,,20 ,,TotalUnits,,,,28.08 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,26,,20 ,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,TC,,20 ,,TotalUnits,,,,26.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,,,20 ,,TotalUnits,,,,26.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,26,,20 ,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,TC,,20 ,,TotalUnits,,,,24.85 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0237,HCPCS,THERAPEUTIC PROCD STRG ENDUR,,,14 ,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0238,HCPCS,"OTH RESP PROC, INDIV",,,14 ,,RBRVS,,0.27 ,0.27 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0239,HCPCS,"OTH RESP PROC, GROUP",,,14 ,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0245,HCPCS,INITIAL FOOT EXAM PT LOPS,,,15 ,,RBRVS,0.88 ,0.35 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0246,HCPCS,FOLLOWUP EVAL OF FOOT PT LOP,,,15 ,,RBRVS,0.45 ,0.17 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0247,HCPCS,ROUTINE FOOTCARE PT W LOPS,,,15 ,,RBRVS,0.50 ,0.17 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0248,HCPCS,DEMONSTRATE USE HOME INR MON,,TC,14 ,,RBRVS,,3.83 ,3.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0249,HCPCS,PROVIDE INR TEST MATER/EQUIP,,TC,14 ,,RBRVS,,3.33 ,3.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0250,HCPCS,MD INR TEST REVIE INTER MGMT,,PC,4 ,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0252,HCPCS,PET IMAGING INITIAL DX,,,20 ,,RBRVS,1.50 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0252,HCPCS,PET IMAGING INITIAL DX,26,,20 ,,RBRVS,1.50 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0255,HCPCS,CURRENT PERCEP THRESHOLD TST,,,14 ,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0255,HCPCS,CURRENT PERCEP THRESHOLD TST,26,,14 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0255,HCPCS,CURRENT PERCEP THRESHOLD TST,TC,,14 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0257,HCPCS,UNSCHED DIALYSIS ESRD PT HOS,,,14 ,,TotalUnits,,,,7.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0259,HCPCS,INJECT FOR SACROILIAC JOINT,,,21 ,,TotalUnits,,,,4.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0260,HCPCS,INJ FOR SACROILIAC JT ANESTH,,,21 ,,TotalUnits,,,,13.90 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0268,HCPCS,REMOVAL OF IMPACTED WAX MD,,,14 ,,RBRVS,0.61 ,0.24 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0269,HCPCS,OCCLUSIVE DEVICE IN VEIN ART,,,21 ,,TotalUnits,,,,4.34 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0270,HCPCS,MNT SUBS TX FOR CHANGE DX,,,14 ,,RBRVS,0.45 ,0.19 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0271,HCPCS,GROUP MNT 2 OR MORE 30 MINS,,,14 ,,RBRVS,0.25 ,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0275,HCPCS,"RENAL ANGIO, CARDIAC CATH",,,20 ,,RBRVS,0.25 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0278,HCPCS,"ILIAC ART ANGIO,CARDIAC CATH",,,20 ,,RBRVS,0.25 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0281,HCPCS,ELEC STIM UNATTEND FOR PRESS,,,19 ,,RBRVS,0.18 ,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0282,HCPCS,ELECT STIM WOUND CARE NOT PD,,,19 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0283,HCPCS,ELEC STIM OTHER THAN WOUND,,,19 ,,RBRVS,0.18 ,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0288,HCPCS,"RECON, CTA FOR SURG PLAN",,TC,20 ,,RBRVS,,2.79 ,2.79 ,,,$0.00,$0.00,1,0,1,0,1,1,20110101,G0289,HCPCS,"ARTHRO, LOOSE BODY + CHONDRO",,,21 ,,RBRVS,1.48 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0290,HCPCS,"DRUG-ELUTING STENTS, SINGLE",,,21 ,,TotalUnits,,,,90.75 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0293,HCPCS,"NON-COV SURG PROC,CLIN TRIAL",,,14 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0295,HCPCS,ELECTROMAGNETIC THERAPY ONC,,,19 ,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0306,HCPCS,CBC/DIFFWBC W/O PLATELET,,,17 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0307,HCPCS,CBC WITHOUT PLATELET,,,17 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0328,HCPCS,FECAL BLOOD SCRN IMMUNOASSAY,,,17 ,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0329,HCPCS,ELECTROMAGNTIC TX FOR ULCERS,,,19 ,,RBRVS,0.06 ,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0333,HCPCS,DISPENSE FEE INITIAL 30 DAY,,,28 ,,NW,,,,,,$75.03,$0.00,1,1,1,0,0,1,20110101,G0337,HCPCS,HOSPICE EVALUATION PREELECTI,,,15 ,,RBRVS,1.42 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0339,HCPCS,"ROBOT LIN-RADSURG COM, FIRST",,,21 ,,TotalUnits,,,,134.05 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0340,HCPCS,ROBT LIN-RADSURG FRACTX 2-5,,,21 ,,TotalUnits,,,,135.41 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0341,HCPCS,PERCUTANEOUS ISLET CELLTRANS,,,21 ,,RBRVS,6.98 ,14.34 ,14.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0342,HCPCS,LAPAROSCOPY ISLET CELL TRANS,,,21 ,,RBRVS,11.92 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0343,HCPCS,LAPAROTOMY ISLET CELL TRANSP,,,21 ,,RBRVS,19.85 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0364,HCPCS,BONE MARROW ASPIRATE &BIOPSY,,,21 ,,RBRVS,0.16 ,0.07 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,,,14 ,,RBRVS,0.25 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,26,,14 ,,RBRVS,0.25 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,TC,,14 ,,RBRVS,,4.91 ,4.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0372,HCPCS,MD SERVICE REQUIRED FOR PMD,,,14 ,,RBRVS,0.17 ,0.05 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0378,HCPCS,HOSPITAL OBSERVATION PER HR,,,10 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0382,HCPCS,LEV 3 HOSP TYPE B ED VISIT,,,7 ,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,,,20 ,,RBRVS,0.58 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,26,,20 ,,RBRVS,0.58 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,TC,,20 ,,RBRVS,,2.12 ,2.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0396,HCPCS,ALCOHOL/SUBS INTERV 15-30MN,,,16 ,,RBRVS,0.65 ,0.18 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0397,HCPCS,ALCOHOL/SUBS INTERV >30 MIN,,,16 ,,RBRVS,1.30 ,0.39 ,0.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,,14 ,,TotalUnits,,,,2.37 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,PC,14 ,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,0,20110101,G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,TC,14 ,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,0,20110101,G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,,,14 ,,TotalUnits,,,,5.26 ,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,26,,14 ,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,TC,,14 ,,TotalUnits,,,,3.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0402,HCPCS,INITIAL PREVENTIVE EXAM,,,18 ,,RBRVS,2.30 ,1.32 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0403,HCPCS,EKG FOR INITIAL PREVENT EXAM,,,18 ,,RBRVS,0.17 ,0.34 ,0.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0404,HCPCS,EKG TRACING FOR INITIAL PREV,,TC,18 ,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0405,HCPCS,EKG INTERPRET & REPORT PREVE,,PC,18 ,,RBRVS,0.17 ,0.05 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0406,HCPCS,TELHEALTH INPT CONSULT 15MIN,,,6 ,,RBRVS,0.76 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0407,HCPCS,TELHEATH INPT CONSULT 25MIN,,,6 ,,RBRVS,1.39 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0408,HCPCS,TELHEALTH INPT CONSULT 35MIN,,,6 ,,RBRVS,2.00 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0409,HCPCS,CORF RELATED SERV 15 MINS EA,,,16 ,,RBRVS,,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0410,HCPCS,GRP PSYCH PARTIAL HOSP 45-50,,,16 ,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0412,HCPCS,OPEN TX ILIAC SPINE UNI/BIL,,,21 ,,RBRVS,10.45 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0413,HCPCS,PELVIC RING FRACTURE UNI/BIL,,,21 ,,RBRVS,15.73 ,9.99 ,9.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0414,HCPCS,PELVIC RING FX TREAT INT FIX,,,21 ,,RBRVS,14.65 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0415,HCPCS,OPEN TX POST PELVIC FXCTURE,,,21 ,,RBRVS,20.93 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0416,HCPCS,SAT BIOPSY PROSTATE 1-20 SPC,,,17 ,,RBRVS,3.09 ,13.96 ,13.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0416,HCPCS,SAT BIOPSY PROSTATE 1-20 SPC,,PC,17 ,,RBRVS,3.09 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,G0416,HCPCS,SAT BIOPSY PROSTATE 1-20 SPC,,TC,17 ,,RBRVS,,12.14 ,12.14 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,G0417,HCPCS,SAT BIOPSY PROSTATE 21-40,,,17 ,,RBRVS,5.86 ,27.26 ,27.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0417,HCPCS,SAT BIOPSY PROSTATE 21-40,,PC,17 ,,RBRVS,5.86 ,3.55 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,G0417,HCPCS,SAT BIOPSY PROSTATE 21-40,,TC,17 ,,RBRVS,,23.71 ,23.71 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,G0418,HCPCS,SAT BIOPSY PROSTATE 41-60,,,17 ,,RBRVS,10.30 ,46.56 ,46.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0418,HCPCS,SAT BIOPSY PROSTATE 41-60,,PC,17 ,,RBRVS,10.30 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,G0418,HCPCS,SAT BIOPSY PROSTATE 41-60,,TC,17 ,,RBRVS,,40.50 ,40.50 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,G0419,HCPCS,SAT BIOPSY PROSTATE: >60,,,17 ,,RBRVS,11.61 ,55.86 ,55.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,G0419,HCPCS,SAT BIOPSY PROSTATE: >60,,PC,17 ,,RBRVS,11.61 ,7.26 ,7.26 ,,,$0.00,$0.00,1,0,1,1,1,0,20110101,G0419,HCPCS,SAT BIOPSY PROSTATE: >60,,TC,17 ,,RBRVS,,48.60 ,48.60 ,,,$0.00,$0.00,1,1,1,0,1,0,20110101,G0420,HCPCS,ED SVC CKD IND PER SESSION,,,14 ,,RBRVS,2.12 ,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0421,HCPCS,ED SVC CKD GRP PER SESSION,,,14 ,,RBRVS,0.50 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0422,HCPCS,INTENS CARDIAC REHAB W/EXERC,,,4 ,,RBRVS,0.60 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0423,HCPCS,INTENS CARDIAC REHAB NO EXER,,,4 ,,RBRVS,0.60 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0424,HCPCS,PULMONARY REHAB W EXER,,,14 ,,RBRVS,0.18 ,0.07 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0425,HCPCS,INPT TELEHEALTH CONSULT 30M,,,6 ,,RBRVS,1.92 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0426,HCPCS,INPT TELEHEALTH CONSULT 50M,,,6 ,,RBRVS,2.61 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0427,HCPCS,INPT TELEHEALTH CON 70/>M,,,6 ,,RBRVS,3.86 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0429,HCPCS,DERMAL FILLER INJECT FOR LDS,,,14 ,,RBRVS,1.19 ,0.58 ,1.30 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0431,HCPCS,DRUG SCREEN SINGLE CLASS,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0433,HCPCS,ELISA HIV-1/ HIV-2 SCREEN,,,17 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0434,HCPCS,DRUG SCREEN MULTI DRUG CLASS,,,17 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0435,HCPCS,ORAL HIV-1/HIV-2 SCREEN,,,17 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G0436,HCPCS,TOBACCO-USE COUNSEL 3-10 MIN,,,14 ,,RBRVS,0.24 ,0.16 ,0.10 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0437,HCPCS,TOBACCO-USE COUNSEL>10MIN,,,14 ,,RBRVS,0.50 ,0.30 ,0.24 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G0438,HCPCS,"PPPS, INITIAL VISIT",,,15 ,,RBRVS,2.43 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0439,HCPCS,"PPPS, SUBSEQ VISIT",,,15 ,,RBRVS,1.50 ,1.63 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0440,HCPCS,SKIN/DERMAL SUBS INIT 25OR<,,,14 ,,RBRVS,2.22 ,2.72 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G0441,HCPCS,SKIN/DERMAL SUBS EACH ADDITION,,,14 ,,RBRVS,0.50 ,0.82 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8397,HCPCS,DIL MACULA/FUNDUS EXAM/W DOC,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8417,HCPCS,CALC BMI ABV UP PARAM F/U,,,14 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8420,HCPCS,CALC BMI NORM PARAMETERS,,,14 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8427,HCPCS,DOC MEDS VERIFIED W/PT OR RE,,,14 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8428,HCPCS,MEDS DOCUMENT W/O VERIFICA,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8440,HCPCS,PAIN ASSESS F/U PLN DOCUMENT,,,14 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8447,HCPCS,PT VIS DOC USE CCHIT CER EHR,,,14 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8448,HCPCS,PT VIS DOC W/NON-CCHIT EHR,,,14 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8482,HCPCS,FLU IMMUNIZE ORDER/ADMIN,,,14 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G8485,HCPCS,"REPORT, DIABETES MEASURES",,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G8553,HCPCS,1 RX VIA QUALIFIED ERX SYS,,,14 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9001,HCPCS,"MCCD, INITIAL RATE",,,14 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9002,HCPCS,"MCCD,MAINTENANCE RATE",,,14 ,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9003,HCPCS,"MCCD, RISK ADJ HI, INITIAL",,,14 ,,TotalUnits,,,,3.37 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9004,HCPCS,"MCCD, RISK ADJ LO, INITIAL",,,14 ,,TotalUnits,,,,1.22 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9005,HCPCS,"MCCD, RISK ADJ, MAINTENANCE",,,14 ,,TotalUnits,,,,2.11 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9006,HCPCS,"MCCD, HOME MONITORING",,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9007,HCPCS,"MCCD, SCH TEAM CONF",,,14 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9008,HCPCS,"MCCD,PHYS COOR-CARE OVRSGHT",,,14 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9009,HCPCS,"MCCD, RISK ADJ, LEVEL 3",,,14 ,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9010,HCPCS,"MCCD, RISK ADJ, LEVEL 4",,,14 ,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9011,HCPCS,"MCCD, RISK ADJ, LEVEL 5",,,14 ,,TotalUnits,,,,3.47 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9012,HCPCS,OTHER SPECIFIED CASE MGMT,,,14 ,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9016,HCPCS,DEMO-SMOKING CESSATION COUN,,,14 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,G9017,HCPCS,AMANTADINE HCL 100MG ORAL,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,G9018,HCPCS,"ZANAMIVIR,INHALATION PWD 10M",,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,G9019,HCPCS,OSELTAMIVIR PHOSPHATE 75MG,,,29 ,,NW,,,,,,$16.23,$0.00,1,1,1,0,0,1,20110101,G9020,HCPCS,RIMANTADINE HCL 100MG ORAL,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,G9033,HCPCS,AMANTADINE HCL ORAL BRAND,,,29 ,,NW,,,,,,$60.63,$0.00,1,1,1,0,0,1,20110101,G9034,HCPCS,"ZANAMIVIR, INH PWDR, BRAND",,,29 ,,NW,,,,,,$48.39,$0.00,1,1,1,0,0,1,20110101,G9036,HCPCS,"RIMANTADINE HCL, BRAND",,,29 ,,NW,,,,,,$187.67,$0.00,1,1,1,0,0,1,20110101,G9041,HCPCS,LOW VISION REHAB OCCUPATIONA,,,19 ,,RBRVS,0.69 ,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G9042,HCPCS,LOW VISION REHAB ORIENT/MOBI,,,19 ,,RBRVS,0.25 ,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G9043,HCPCS,LOW VISION LOWVISION THERAPI,,,19 ,,RBRVS,0.25 ,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G9044,HCPCS,LOW VISION REHABILATE TEACHE,,,19 ,,RBRVS,0.24 ,0.19 ,0.19 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,G9051,HCPCS,ONCOLOGY TX DECISION-MGMT,,,14 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9052,HCPCS,ONC SURVEILLANCE FOR DISEASE,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9056,HCPCS,ONC PRAC MGMT ADHERES GUIDE,,,14 ,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9064,HCPCS,ONC DX NSCLC STG2 NO PROGRES,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9065,HCPCS,ONC DX NSCLC STG3A NO PROGRE,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9066,HCPCS,ONC DX NSCLC STG3B-4 METASTA,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9069,HCPCS,ONC DX SCLC/NSCLC EXT AT DX,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9071,HCPCS,"ONC DX BRST STG1-2B HR,NOPRO",,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9072,HCPCS,ONC DX BRST STG1-2 NOPROGRES,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9073,HCPCS,"ONC DX BRST STG3-HR, NO PRO",,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9075,HCPCS,ONC DX BRST METASTIC/ RECUR,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9084,HCPCS,"ONC DX COLON T1-3,N1-2,NO PR",,,14 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9086,HCPCS,ONC DX COLON T1-4 NO DX PROG,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9087,HCPCS,ONC DX COLON METAS EVID DX,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9088,HCPCS,ONC DX COLON METAS NOEVID DX,,,14 ,,TotalUnits,,,,0.07 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9098,HCPCS,ONC DX ESOPHAGEAL METS RECUR,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9107,HCPCS,ONC DX PANCREATIC UNRESECTAB,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9115,HCPCS,ONC DX OVARIAN STG3/4 NOPROG,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9123,HCPCS,ONC DX CML CHRONIC PHASE,,,14 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9124,HCPCS,ONC DX CML ACCELER PHASE,,,14 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9129,HCPCS,ONC DX MULT MYELOMA STG2 HIG,,,14 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9130,HCPCS,ONC DX MULTI MYELOMA UNKNOWN,,,14 ,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9135,HCPCS,ONC DX NHL STG 3-4 NOT RELAP,,,14 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,G9141,HCPCS,"INFLUENZA A H1N1,ADMIN W COU",,,9 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,G9142,HCPCS,"INFLUENZA A H1N1, VACCINE",,,9 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0001,HCPCS,ALCOHOL AND/OR DRUG ASSESS,,,16 ,,TotalUnits,,,,2.19 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0002,HCPCS,ALCOHOL AND/OR DRUG SCREENIN,,,16 ,,TotalUnits,,,,3.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0003,HCPCS,ALCOHOL AND/OR DRUG SCREENIN,,,16 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0004,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0005,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0006,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0010,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,2.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0011,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,7.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0014,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,5.32 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0015,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,2.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0016,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0017,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,3.07 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0018,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,4.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0019,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,2.07 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0020,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0022,HCPCS,ALCOHOL AND/OR DRUG INTERVEN,,,16 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0024,HCPCS,ALCOHOL AND/OR DRUG PREVENTI,,,16 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0025,HCPCS,ALCOHOL AND/OR DRUG PREVENTI,,,16 ,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0031,HCPCS,MH HEALTH ASSESS BY NON-MD,,,16 ,,TotalUnits,,,,1.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0032,HCPCS,MH SVC PLAN DEV BY NON-MD,,,16 ,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0033,HCPCS,ORAL MED ADM DIRECT OBSERVE,,,16 ,,TotalUnits,,,,2.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0034,HCPCS,MED TRNG & SUPPORT PER 15MIN,,,16 ,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0035,HCPCS,MH PARTIAL HOSP TX UNDER 24H,,,16 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0036,HCPCS,COMM PSY FACE-FACE PER 15MIN,,,16 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0037,HCPCS,COMM PSY SUP TX PGM PER DIEM,,,16 ,,TotalUnits,,,,2.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0038,HCPCS,SELF-HELP/PEER SVC PER 15MIN,,,16 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0039,HCPCS,ASSER COM TX FACE-FACE/15MIN,,,16 ,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0040,HCPCS,ASSERT COMM TX PGM PER DIEM,,,16 ,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0041,HCPCS,FOS C CHLD NON-THER PER DIEM,,,16 ,,TotalUnits,,,,1.54 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0043,HCPCS,"SUPPORTED HOUSING, PER DIEM",,,16 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0044,HCPCS,"SUPPORTED HOUSING, PER MONTH",,,16 ,,TotalUnits,,,,9.57 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0045,HCPCS,RESPITE NOT-IN-HOME PER DIEM,,,16 ,,TotalUnits,,,,2.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0046,HCPCS,"MENTAL HEALTH SERVICE, NOS",,,16 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0048,HCPCS,SPEC COLL NON-BLOOD:A/D TEST,,,16 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H0050,HCPCS,ALCOHOL/DRUG SERVICE 15 MIN,,,16 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H1000,HCPCS,PRENATAL CARE ATRISK ASSESSM,,,16 ,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H1001,HCPCS,ANTEPARTUM MANAGEMENT,,,16 ,,TotalUnits,,,,2.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H1002,HCPCS,CARECOORDINATION PRENATAL,,,16 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H1003,HCPCS,PRENATAL AT RISK EDUCATION,,,16 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H1004,HCPCS,FOLLOW UP HOME VISIT/PRENTAL,,,16 ,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H1005,HCPCS,PRENATALCARE ENHANCED SRV PK,,,16 ,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2000,HCPCS,COMP MULTIDISIPLN EVALUATION,,,16 ,,TotalUnits,,,,1.94 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2010,HCPCS,COMPREHENSIVE MED SVC 15 MIN,,,16 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2011,HCPCS,"CRISIS INTERVEN SVC, 15 MIN",,,16 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2012,HCPCS,"BEHAV HLTH DAY TREAT, PER HR",,,16 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2013,HCPCS,"PSYCH HLTH FAC SVC, PER DIEM",,,16 ,,TotalUnits,,,,2.33 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2014,HCPCS,"SKILLS TRAIN AND DEV, 15 MIN",,,16 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2015,HCPCS,"COMP COMM SUPP SVC, 15 MIN",,,16 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2017,HCPCS,"PSYSOC REHAB SVC, PER 15 MIN",,,16 ,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2018,HCPCS,"PSYSOC REHAB SVC, PER DIEM",,,16 ,,TotalUnits,,,,1.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2019,HCPCS,"THER BEHAV SVC, PER 15 MIN",,,16 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2020,HCPCS,"THER BEHAV SVC, PER DIEM",,,16 ,,TotalUnits,,,,1.56 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2021,HCPCS,"COM WRAP-AROUND SV, 15 MIN",,,16 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2022,HCPCS,"COM WRAP-AROUND SV, PER DIEM",,,16 ,,TotalUnits,,,,3.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2023,HCPCS,"SUPPORTED EMPLOY, PER 15 MIN",,,16 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2024,HCPCS,"SUPPORTED EMPLOY, PER DIEM",,,16 ,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2026,HCPCS,"SUPP MAINT EMPLOY, PER DIEM",,,16 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2029,HCPCS,"SEX OFFEND TX SVC, PER DIEM",,,16 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2032,HCPCS,"ACTIVITY THERAPY, PER 15 MIN",,,16 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2033,HCPCS,MULTISYS THER/JUVENILE 15MIN,,,16 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2035,HCPCS,"A/D TX PROGRAM, PER HOUR",,,16 ,,TotalUnits,,,,1.73 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,H2036,HCPCS,"A/D TX PROGRAM, PER DIEM",,,16 ,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,J0120,HCPCS,TETRACYCLIN INJECTION,,,29 ,,NW,,,,,,$60.98,$0.00,1,1,1,0,0,1,20110101,J0129,HCPCS,ABATACEPT INJECTION,,,29 ,,NW,,,,,,$43.66,$0.00,1,1,1,0,0,1,20110101,J0130,HCPCS,ABCIXIMAB INJECTION,,,29 ,,NW,,,,,,"$1,117.00",$0.00,1,1,1,0,0,1,20110101,J0132,HCPCS,ACETYLCYSTEINE INJECTION,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J0133,HCPCS,ACYCLOVIR INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0135,HCPCS,ADALIMUMAB INJECTION,,,29 ,,NW,,,,,,$828.55,$0.00,1,1,1,0,0,1,20110101,J0150,HCPCS,INJECTION ADENOSINE 6 MG,,,29 ,,NW,,,,,,$26.61,$0.00,1,1,1,0,0,1,20110101,J0152,HCPCS,ADENOSINE INJECTION,,,29 ,,NW,,,,,,$174.17,$0.00,1,1,1,0,0,1,20110101,J0171,HCPCS,ADRENALIN EPINEPHRINE INJECT,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J0180,HCPCS,AGALSIDASE BETA INJECTION,,,29 ,,NW,,,,,,$277.24,$0.00,1,1,1,0,0,1,20110101,J0190,HCPCS,INJ BIPERIDEN LACTATE/5 MG,,,29 ,,NW,,,,,,$3.86,$0.00,1,1,1,0,0,1,20110101,J0200,HCPCS,ALATROFLOXACIN MESYLATE,,,29 ,,NW,,,,,,$31.92,$0.00,1,1,1,0,0,1,20110101,J0205,HCPCS,ALGLUCERASE INJECTION,,,29 ,,NW,,,,,,$88.15,$0.00,1,1,1,0,0,1,20110101,J0207,HCPCS,AMIFOSTINE,,,29 ,,NW,,,,,,$778.48,$0.00,1,1,1,0,0,1,20110101,J0210,HCPCS,METHYLDOPATE HCL INJECTION,,,29 ,,NW,,,,,,$33.07,$0.00,1,1,1,0,0,1,20110101,J0215,HCPCS,ALEFACEPT,,,29 ,,NW,,,,,,$65.17,$0.00,1,1,1,0,0,1,20110101,J0220,HCPCS,ALGLUCOSIDASE ALFA INJECTION,,,29 ,,NW,,,,,,$258.70,$0.00,1,1,1,0,0,1,20110101,J0256,HCPCS,ALPHA 1 PROTEINASE INHIBITOR,,,29 ,,NW,,,,,,$11.04,$0.00,1,1,1,0,0,1,20110101,J0270,HCPCS,ALPROSTADIL FOR INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J0275,HCPCS,ALPROSTADIL URETHRAL SUPPOS,,,29 ,,NW,,,,,,$54.79,$0.00,1,1,1,0,0,1,20110101,J0278,HCPCS,AMIKACIN SULFATE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0280,HCPCS,AMINOPHYLLIN 250 MG INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0282,HCPCS,AMIODARONE HCL,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0285,HCPCS,AMPHOTERICIN B,,,29 ,,NW,,,,,,$29.58,$0.00,1,1,1,0,0,1,20110101,J0287,HCPCS,AMPHOTERICIN B LIPID COMPLEX,,,29 ,,NW,,,,,,$23.64,$0.00,1,1,1,0,0,1,20110101,J0288,HCPCS,AMPHO B CHOLESTERYL SULFATE,,,29 ,,NW,,,,,,$28.09,$0.00,1,1,1,0,0,1,20110101,J0289,HCPCS,AMPHOTERICIN B LIPOSOME INJ,,,29 ,,NW,,,,,,$35.51,$0.00,1,1,1,0,0,1,20110101,J0290,HCPCS,AMPICILLIN 500 MG INJ,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J0295,HCPCS,AMPICILLIN SODIUM PER 1.5 GM,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J0300,HCPCS,AMOBARBITAL 125 MG INJ,,,29 ,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20110101,J0330,HCPCS,SUCCINYCHOLINE CHLORIDE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0348,HCPCS,ANIDULAFUNGIN INJECTION,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J0350,HCPCS,INJECTION ANISTREPLASE 30 U,,,29 ,,NW,,,,,,$236.32,$0.00,1,1,1,0,0,1,20110101,J0360,HCPCS,HYDRALAZINE HCL INJECTION,,,29 ,,NW,,,,,,$12.52,$0.00,1,1,1,0,0,1,20110101,J0364,HCPCS,APOMORPHINE HYDROCHLORIDE,,,29 ,,NW,,,,,,$12.52,$0.00,1,1,1,0,0,1,20110101,J0365,HCPCS,"APROTONIN, 10,000 KIU",,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J0380,HCPCS,INJ METARAMINOL BITARTRATE,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J0390,HCPCS,CHLOROQUINE INJECTION,,,29 ,,NW,,,,,,$200.27,$0.00,1,1,1,0,0,1,20110101,J0395,HCPCS,ARBUTAMINE HCL INJECTION,,,29 ,,NW,,,,,,$26.70,$0.00,1,1,1,0,0,1,20110101,J0400,HCPCS,ARIPIPRAZOLE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0456,HCPCS,AZITHROMYCIN,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J0461,HCPCS,ATROPINE SULFATE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0470,HCPCS,DIMECAPROL INJECTION,,,29 ,,NW,,,,,,$59.98,$0.00,1,1,1,0,0,1,20110101,J0475,HCPCS,BACLOFEN 10 MG INJECTION,,,29 ,,NW,,,,,,$416.64,$0.00,1,1,1,0,0,1,20110101,J0476,HCPCS,BACLOFEN INTRATHECAL TRIAL,,,29 ,,NW,,,,,,$151.18,$0.00,1,1,1,0,0,1,20110101,J0480,HCPCS,BASILIXIMAB,,,29 ,,NW,,,,,,"$4,854.06",$0.00,1,1,1,0,0,1,20110101,J0500,HCPCS,DICYCLOMINE INJECTION,,,29 ,,NW,,,,,,$45.89,$0.00,1,1,1,0,0,1,20110101,J0515,HCPCS,INJ BENZTROPINE MESYLATE,,,29 ,,NW,,,,,,$97.05,$0.00,1,1,1,0,0,1,20110101,J0520,HCPCS,BETHANECHOL CHLORIDE INJECT,,,29 ,,NW,,,,,,$7.47,$0.00,1,1,1,0,0,1,20110101,J0561,HCPCS,PENICILLIN G BENZATHINE INJ,,,29 ,,NW,,,,,,$97.79,$0.00,1,1,1,0,0,1,20110101,J0583,HCPCS,BIVALIRUDIN,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J0585,HCPCS,"INJECTION,ONABOTULINUMTOXINA",,,29 ,,NW,,,,,,$14.75,$0.00,1,1,1,0,0,1,20110101,J0586,HCPCS,ABOBOTULINUMTOXINA,,,29 ,,NW,,,,,,$19.19,$0.00,1,1,1,0,0,1,20110101,J0587,HCPCS,"INJ, RIMABOTULINUMTOXINB",,,29 ,,NW,,,,,,$25.13,$0.00,1,1,1,0,0,1,20110101,J0592,HCPCS,BUPRENORPHINE HYDROCHLORIDE,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J0594,HCPCS,BUSULFAN INJECTION,,,29 ,,NW,,,,,,$36.99,$0.00,1,1,1,0,0,1,20110101,J0595,HCPCS,BUTORPHANOL TARTRATE 1 MG,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J0597,HCPCS,"C-1 ESTERASE, BERINERT",,,29 ,,NW,,,,,,$89.64,$0.00,1,1,1,0,0,1,20110101,J0598,HCPCS,C1 ESTERASE INHIBITOR INJ,,,29 ,,NW,,,,,,$89.64,$0.00,1,1,1,0,0,1,20110101,J0600,HCPCS,EDETATE CALCIUM DISODIUM INJ,,,29 ,,NW,,,,,,$124.63,$0.00,1,1,1,0,0,1,20110101,J0610,HCPCS,CALCIUM GLUCONATE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0620,HCPCS,CALCIUM GLYCER & LACT/10 ML,,,29 ,,NW,,,,,,$26.61,$0.00,1,1,1,0,0,1,20110101,J0630,HCPCS,CALCITONIN SALMON INJECTION,,,29 ,,NW,,,,,,$108.18,$0.00,1,1,1,0,0,1,20110101,J0636,HCPCS,INJ CALCITRIOL PER 0.1 MCG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0637,HCPCS,CASPOFUNGIN ACETATE,,,29 ,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20110101,J0640,HCPCS,LEUCOVORIN CALCIUM INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J0641,HCPCS,LEVOLEUCOVORIN INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J0670,HCPCS,INJ MEPIVACAINE HCL/10 ML,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J0690,HCPCS,CEFAZOLIN SODIUM INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J0692,HCPCS,CEFEPIME HCL FOR INJECTION,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J0694,HCPCS,CEFOXITIN SODIUM INJECTION,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J0696,HCPCS,CEFTRIAXONE SODIUM INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J0697,HCPCS,STERILE CEFUROXIME INJECTION,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J0698,HCPCS,CEFOTAXIME SODIUM INJECTION,,,29 ,,NW,,,,,,$12.52,$0.00,1,1,1,0,0,1,20110101,J0702,HCPCS,BETAMETHASONE ACET&SOD PHOSP,,,29 ,,NW,,,,,,$16.23,$0.00,1,1,1,0,0,1,20110101,J0706,HCPCS,CAFFEINE CITRATE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0710,HCPCS,CEPHAPIRIN SODIUM INJECTION,,,29 ,,NW,,,,,,$14.13,$0.00,1,1,1,0,0,1,20110101,J0713,HCPCS,INJ CEFTAZIDIME PER 500 MG,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J0715,HCPCS,CEFTIZOXIME SODIUM / 500 MG,,,29 ,,NW,,,,,,$15.45,$0.00,1,1,1,0,0,1,20110101,J0718,HCPCS,CERTOLIZUMAB PEGOL INJ,,,29 ,,NW,,,,,,$11.04,$0.00,1,1,1,0,0,1,20110101,J0720,HCPCS,CHLORAMPHENICOL SODIUM INJEC,,,29 ,,NW,,,,,,$28.09,$0.00,1,1,1,0,0,1,20110101,J0725,HCPCS,CHORIONIC GONADOTROPIN/1000U,,,29 ,,NW,,,,,,$19.94,$0.00,1,1,1,0,0,1,20110101,J0735,HCPCS,CLONIDINE HYDROCHLORIDE,,,29 ,,NW,,,,,,$161.56,$0.00,1,1,1,0,0,1,20110101,J0740,HCPCS,CIDOFOVIR INJECTION,,,29 ,,NW,,,,,,"$1,802.88",$0.00,1,1,1,0,0,1,20110101,J0743,HCPCS,CILASTATIN SODIUM INJECTION,,,29 ,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20110101,J0744,HCPCS,CIPROFLOXACIN IV,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J0745,HCPCS,INJ CODEINE PHOSPHATE /30 MG,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J0760,HCPCS,COLCHICINE INJECTION,,,29 ,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20110101,J0770,HCPCS,COLISTIMETHATE SODIUM INJ,,,29 ,,NW,,,,,,$37.73,$0.00,1,1,1,0,0,1,20110101,J0780,HCPCS,PROCHLORPERAZINE INJECTION,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J0795,HCPCS,CORTICORELIN OVINE TRIFLUTAL,,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J0800,HCPCS,CORTICOTROPIN INJECTION,,,29 ,,NW,,,,,,"$5,963.00",$0.00,1,1,1,0,0,1,20110101,J0833,HCPCS,COSYNTROPIN INJECTION NOS,,,29 ,,NW,,,,,,$134.13,$0.00,1,1,1,0,0,1,20110101,J0834,HCPCS,COSYNTROPIN CORTROSYN INJ,,,29 ,,NW,,,,,,$182.33,$0.00,1,1,1,0,0,1,20110101,J0850,HCPCS,CYTOMEGALOVIRUS IMM IV /VIAL,,,29 ,,NW,,,,,,"$2,081.26",$0.00,1,1,1,0,0,1,20110101,J0878,HCPCS,DAPTOMYCIN INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J0881,HCPCS,"DARBEPOETIN ALFA, NON-ESRD",,,29 ,,NW,,,,,,$8.83,$0.00,1,1,1,0,0,1,20110101,J0882,HCPCS,"DARBEPOETIN ALFA, ESRD USE",,,29 ,,NW,,,,,,$8.83,$0.00,1,1,1,0,0,1,20110101,J0885,HCPCS,"EPOETIN ALFA, NON-ESRD",,,29 ,,NW,,,,,,$22.90,$0.00,1,1,1,0,0,1,20110101,J0886,HCPCS,EPOETIN ALFA 1000 UNITS ESRD,,,29 ,,NW,,,,,,$22.90,$0.00,1,1,1,0,0,1,20110101,J0894,HCPCS,DECITABINE INJECTION,,,29 ,,NW,,,,,,$64.43,$0.00,1,1,1,0,0,1,20110101,J0895,HCPCS,DEFEROXAMINE MESYLATE INJ,,,29 ,,NW,,,,,,$25.13,$0.00,1,1,1,0,0,1,20110101,J0900,HCPCS,TESTOSTERONE ENANTHATE INJ,,,29 ,,NW,,,,,,$27.22,$0.00,1,1,1,0,0,1,20110101,J0945,HCPCS,BROMPHENIRAMINE MALEATE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1000,HCPCS,DEPO-ESTRADIOL CYPIONATE INJ,,,29 ,,NW,,,,,,$17.71,$0.00,1,1,1,0,0,1,20110101,J1020,HCPCS,METHYLPREDNISOLONE 20 MG INJ,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J1030,HCPCS,METHYLPREDNISOLONE 40 MG INJ,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J1040,HCPCS,METHYLPREDNISOLONE 80 MG INJ,,,29 ,,NW,,,,,,$16.23,$0.00,1,1,1,0,0,1,20110101,J1051,HCPCS,MEDROXYPROGESTERONE INJ,,,29 ,,NW,,,,,,$21.42,$0.00,1,1,1,0,0,1,20110101,J1055,HCPCS,MEDRXYPROGESTER ACETATE INJ,,,29 ,,NW,,,,,,$109.66,$0.00,1,1,1,0,0,1,20110101,J1056,HCPCS,MA/EC CONTRACEPTIVEINJECTION,,,29 ,,NW,,,,,,$54.05,$0.00,1,1,1,0,0,1,20110101,J1060,HCPCS,TESTOSTERONE CYPIONATE 1 ML,,,29 ,,NW,,,,,,$11.93,$0.00,1,1,1,0,0,1,20110101,J1070,HCPCS,TESTOSTERONE CYPIONAT 100 MG,,,29 ,,NW,,,,,,$11.04,$0.00,1,1,1,0,0,1,20110101,J1080,HCPCS,TESTOSTERONE CYPIONAT 200 MG,,,29 ,,NW,,,,,,$12.52,$0.00,1,1,1,0,0,1,20110101,J1094,HCPCS,INJ DEXAMETHASONE ACETATE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1100,HCPCS,DEXAMETHASONE SODIUM PHOS,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1110,HCPCS,INJ DIHYDROERGOTAMINE MESYLT,,,29 ,,NW,,,,,,$46.63,$0.00,1,1,1,0,0,1,20110101,J1120,HCPCS,ACETAZOLAMID SODIUM INJECTIO,,,29 ,,NW,,,,,,$59.24,$0.00,1,1,1,0,0,1,20110101,J1160,HCPCS,DIGOXIN INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J1162,HCPCS,DIGOXIN IMMUNE FAB (OVINE),,,29 ,,NW,,,,,,"$1,173.78",$0.00,1,1,1,0,0,1,20110101,J1165,HCPCS,PHENYTOIN SODIUM INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J1170,HCPCS,HYDROMORPHONE INJECTION,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J1180,HCPCS,DYPHYLLINE INJECTION,,,29 ,,NW,,,,,,$16.95,$0.00,1,1,1,0,0,1,20110101,J1190,HCPCS,DEXRAZOXANE HCL INJECTION,,,29 ,,NW,,,,,,$532.77,$0.00,1,1,1,0,0,1,20110101,J1200,HCPCS,DIPHENHYDRAMINE HCL INJECTIO,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J1205,HCPCS,CHLOROTHIAZIDE SODIUM INJ,,,29 ,,NW,,,,,,$474.17,$0.00,1,1,1,0,0,1,20110101,J1212,HCPCS,DIMETHYL SULFOXIDE 50% 50 ML,,,29 ,,NW,,,,,,$145.25,$0.00,1,1,1,0,0,1,20110101,J1230,HCPCS,METHADONE INJECTION,,,29 ,,NW,,,,,,$16.23,$0.00,1,1,1,0,0,1,20110101,J1240,HCPCS,DIMENHYDRINATE INJECTION,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J1245,HCPCS,DIPYRIDAMOLE INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J1250,HCPCS,INJ DOBUTAMINE HCL/250 MG,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J1260,HCPCS,DOLASETRON MESYLATE,,,29 ,,NW,,,,,,$18.05,$0.00,1,1,1,0,0,1,20110101,J1265,HCPCS,DOPAMINE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1267,HCPCS,DORIPENEM INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J1270,HCPCS,"INJECTION, DOXERCALCIFEROL",,,29 ,,NW,,,,,,$8.83,$0.00,1,1,1,0,0,1,20110101,J1300,HCPCS,ECULIZUMAB INJECTION,,,29 ,,NW,,,,,,$376.60,$0.00,1,1,1,0,0,1,20110101,J1320,HCPCS,AMITRIPTYLINE INJECTION,,,29 ,,NW,,,,,,$77.24,$0.00,1,1,1,0,0,1,20110101,J1324,HCPCS,ENFUVIRTIDE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1325,HCPCS,EPOPROSTENOL INJECTION,,,29 ,,NW,,,,,,$31.06,$0.00,1,1,1,0,0,1,20110101,J1327,HCPCS,EPTIFIBATIDE INJECTION,,,29 ,,NW,,,,,,$43.66,$0.00,1,1,1,0,0,1,20110101,J1330,HCPCS,ERGONOVINE MALEATE INJECTION,,,29 ,,NW,,,,,,$6.96,$0.00,1,1,1,0,0,1,20110101,J1335,HCPCS,ERTAPENEM INJECTION,,,29 ,,NW,,,,,,$59.24,$0.00,1,1,1,0,0,1,20110101,J1364,HCPCS,ERYTHRO LACTOBIONATE /500 MG,,,29 ,,NW,,,,,,$20.68,$0.00,1,1,1,0,0,1,20110101,J1380,HCPCS,ESTRADIOL VALERATE 10 MG INJ,,,29 ,,NW,,,,,,$20.68,$0.00,1,1,1,0,0,1,20110101,J1410,HCPCS,INJ ESTROGEN CONJUGATE 25 MG,,,29 ,,NW,,,,,,$190.48,$0.00,1,1,1,0,0,1,20110101,J1430,HCPCS,ETHANOLAMINE OLEATE 100 MG,,,29 ,,NW,,,,,,$305.42,$0.00,1,1,1,0,0,1,20110101,J1435,HCPCS,INJECTION ESTRONE PER 1 MG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1436,HCPCS,ETIDRONATE DISODIUM INJ,,,29 ,,NW,,,,,,$190.75,$0.00,1,1,1,0,0,1,20110101,J1438,HCPCS,ETANERCEPT INJECTION,,,29 ,,NW,,,,,,$394.40,$0.00,1,1,1,0,0,1,20110101,J1440,HCPCS,FILGRASTIM 300 MCG INJECTION,,,29 ,,NW,,,,,,$470.50,$0.00,1,1,1,0,0,1,20110101,J1441,HCPCS,FILGRASTIM 480 MCG INJECTION,,,29 ,,NW,,,,,,$795.58,$0.00,1,1,1,0,0,1,20110101,J1450,HCPCS,FLUCONAZOLE,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J1451,HCPCS,"FOMEPIZOLE, 15 MG",,,29 ,,NW,,,,,,$19.19,$0.00,1,1,1,0,0,1,20110101,J1452,HCPCS,INTRAOCULAR FOMIVIRSEN NA,,,29 ,,NW,,,,,,"$2,129.85",$0.00,1,1,1,0,0,1,20110101,J1453,HCPCS,FOSAPREPITANT INJECTION,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J1455,HCPCS,FOSCARNET SODIUM INJECTION,,,29 ,,NW,,,,,,$24.39,$0.00,1,1,1,0,0,1,20110101,J1457,HCPCS,GALLIUM NITRATE INJECTION,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J1458,HCPCS,GALSULFASE INJECTION,,,29 ,,NW,,,,,,$737.89,$0.00,1,1,1,0,0,1,20110101,J1459,HCPCS,INJ IVIG PRIVIGEN 500 MG,,,29 ,,NW,,,,,,$74.07,$0.00,1,1,1,0,0,1,20110101,J1460,HCPCS,GAMMA GLOBULIN 1 CC INJ,,,29 ,,NW,,,,,,$39.96,$0.00,1,1,1,0,0,1,20110101,J1560,HCPCS,GAMMA GLOBULIN > 10 CC INJ,,,29 ,,NW,,,,,,$367.70,$0.00,1,1,1,0,0,1,20110101,J1561,HCPCS,GAMUNEX INJECTION,,,29 ,,NW,,,,,,$79.26,$0.00,1,1,1,0,0,1,20110101,J1562,HCPCS,"VIVAGLOBIN, INJ",,,29 ,,NW,,,,,,$18.45,$0.00,1,1,1,0,0,1,20110101,J1566,HCPCS,"IMMUNE GLOBULIN, POWDER",,,29 ,,NW,,,,,,$65.17,$0.00,1,1,1,0,0,1,20110101,J1568,HCPCS,OCTAGAM INJECTION,,,29 ,,NW,,,,,,$79.26,$0.00,1,1,1,0,0,1,20110101,J1569,HCPCS,GAMMAGARD LIQUID INJECTION,,,29 ,,NW,,,,,,$80.74,$0.00,1,1,1,0,0,1,20110101,J1570,HCPCS,GANCICLOVIR SODIUM INJECTION,,,29 ,,NW,,,,,,$110.40,$0.00,1,1,1,0,0,1,20110101,J1571,HCPCS,HEPAGAM B IM INJECTION,,,29 ,,NW,,,,,,$105.21,$0.00,1,1,1,0,0,1,20110101,J1572,HCPCS,FLEBOGAMMA INJECTION,,,29 ,,NW,,,,,,$77.03,$0.00,1,1,1,0,0,1,20110101,J1573,HCPCS,"HEPAGAM B INTRAVENOUS, INJ",,,29 ,,NW,,,,,,$105.21,$0.00,1,1,1,0,0,1,20110101,J1580,HCPCS,GARAMYCIN GENTAMICIN INJ,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J1590,HCPCS,GATIFLOXACIN INJECTION,,,29 ,,NW,,,,,,$2.57,$0.00,1,1,1,0,0,1,20110101,J1595,HCPCS,INJECTION GLATIRAMER ACETATE,,,29 ,,NW,,,,,,"$3,901.71",$0.00,1,1,1,0,0,1,20110101,J1600,HCPCS,GOLD SODIUM THIOMALEATE INJ,,,29 ,,NW,,,,,,$31.80,$0.00,1,1,1,0,0,1,20110101,J1610,HCPCS,GLUCAGON HYDROCHLORIDE/1 MG,,,29 ,,NW,,,,,,$175.65,$0.00,1,1,1,0,0,1,20110101,J1620,HCPCS,GONADORELIN HYDROCH/ 100 MCG,,,29 ,,NW,,,,,,$602.15,$0.00,1,1,1,0,0,1,20110101,J1626,HCPCS,GRANISETRON HCL INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J1630,HCPCS,HALOPERIDOL INJECTION,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J1631,HCPCS,HALOPERIDOL DECANOATE INJ,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J1640,HCPCS,"HEMIN, 1 MG",,,29 ,,NW,,,,,,$20.68,$0.00,1,1,1,0,0,1,20110101,J1642,HCPCS,INJ HEPARIN SODIUM PER 10 U,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1644,HCPCS,INJ HEPARIN SODIUM PER 1000U,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1645,HCPCS,DALTEPARIN SODIUM,,,29 ,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20110101,J1650,HCPCS,INJ ENOXAPARIN SODIUM,,,29 ,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20110101,J1652,HCPCS,FONDAPARINUX SODIUM,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J1655,HCPCS,TINZAPARIN SODIUM INJECTION,,,29 ,,NW,,,,,,$8.83,$0.00,1,1,1,0,0,1,20110101,J1670,HCPCS,TETANUS IMMUNE GLOBULIN INJ,,,29 ,,NW,,,,,,$465.93,$0.00,1,1,1,0,0,1,20110101,J1675,HCPCS,HISTRELIN ACETATE,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J1680,HCPCS,HUMAN FIBRINOGEN CONC INJ,,,29 ,,NW,,,,,,$1.61,$0.00,1,1,1,0,0,1,20110101,J1700,HCPCS,HYDROCORTISONE ACETATE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1710,HCPCS,HYDROCORTISONE SODIUM PH INJ,,,29 ,,NW,,,,,,$18.95,$0.00,1,1,1,0,0,1,20110101,J1720,HCPCS,HYDROCORTISONE SODIUM SUCC I,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J1730,HCPCS,DIAZOXIDE INJECTION,,,29 ,,NW,,,,,,$209.02,$0.00,1,1,1,0,0,1,20110101,J1740,HCPCS,IBANDRONATE SODIUM INJECTION,,,29 ,,NW,,,,,,$293.55,$0.00,1,1,1,0,0,1,20110101,J1742,HCPCS,IBUTILIDE FUMARATE INJECTION,,,29 ,,NW,,,,,,$578.56,$0.00,1,1,1,0,0,1,20110101,J1743,HCPCS,IDURSULFASE INJECTION,,,29 ,,NW,,,,,,"$1,029.09",$0.00,1,1,1,0,0,1,20110101,J1745,HCPCS,INFLIXIMAB INJECTION,,,29 ,,NW,,,,,,$121.52,$0.00,1,1,1,0,0,1,20110101,J1750,HCPCS,INJ IRON DEXTRAN,,,29 ,,NW,,,,,,$28.83,$0.00,1,1,1,0,0,1,20110101,J1756,HCPCS,IRON SUCROSE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1786,HCPCS,IMUGLUCERASE INJECTION,,,29 ,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20110101,J1790,HCPCS,DROPERIDOL INJECTION,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J1800,HCPCS,PROPRANOLOL INJECTION,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J1810,HCPCS,DROPERIDOL/FENTANYL INJ,,,29 ,,NW,,,,,,$21.69,$0.00,1,1,1,0,0,1,20110101,J1815,HCPCS,INSULIN INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1817,HCPCS,INSULIN FOR INSULIN PUMP USE,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J1826,HCPCS,INTERFERON BETA-1A INJ,,,29 ,,NW,,,,,,$718.66,$0.00,1,1,1,0,0,1,20110101,J1830,HCPCS,INTERFERON BETA-1B / .25 MG,,,29 ,,NW,,,,,,$366.53,$0.00,1,1,1,0,0,1,20110101,J1835,HCPCS,ITRACONAZOLE INJECTION,,,29 ,,NW,,,,,,$88.90,$0.00,1,1,1,0,0,1,20110101,J1840,HCPCS,KANAMYCIN SULFATE 500 MG INJ,,,29 ,,NW,,,,,,$19.19,$0.00,1,1,1,0,0,1,20110101,J1850,HCPCS,KANAMYCIN SULFATE 75 MG INJ,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J1885,HCPCS,KETOROLAC TROMETHAMINE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1890,HCPCS,CEPHALOTHIN SODIUM INJECTION,,,29 ,,NW,,,,,,$25.00,$0.00,1,1,1,0,0,1,20110101,J1930,HCPCS,LANREOTIDE INJECTION,,,29 ,,NW,,,,,,$62.20,$0.00,1,1,1,0,0,1,20110101,J1931,HCPCS,LARONIDASE INJECTION,,,29 ,,NW,,,,,,$54.79,$0.00,1,1,1,0,0,1,20110101,J1940,HCPCS,FUROSEMIDE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1945,HCPCS,LEPIRUDIN,,,29 ,,NW,,,,,,$480.58,$0.00,1,1,1,0,0,1,20110101,J1950,HCPCS,LEUPROLIDE ACETATE /3.75 MG,,,29 ,,NW,,,,,,"$1,205.83",$0.00,1,1,1,0,0,1,20110101,J1953,HCPCS,LEVETIRACETAM INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J1955,HCPCS,INJ LEVOCARNITINE PER 1 GM,,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J1956,HCPCS,LEVOFLOXACIN INJECTION,,,29 ,,NW,,,,,,$14.75,$0.00,1,1,1,0,0,1,20110101,J1960,HCPCS,LEVORPHANOL TARTRATE INJ,,,29 ,,NW,,,,,,$8.83,$0.00,1,1,1,0,0,1,20110101,J1980,HCPCS,HYOSCYAMINE SULFATE INJ,,,29 ,,NW,,,,,,$24.39,$0.00,1,1,1,0,0,1,20110101,J1990,HCPCS,CHLORDIAZEPOXIDE INJECTION,,,29 ,,NW,,,,,,$45.15,$0.00,1,1,1,0,0,1,20110101,J2001,HCPCS,LIDOCAINE INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2010,HCPCS,LINCOMYCIN INJECTION,,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J2020,HCPCS,LINEZOLID INJECTION,,,29 ,,NW,,,,,,$70.36,$0.00,1,1,1,0,0,1,20110101,J2060,HCPCS,LORAZEPAM INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J2150,HCPCS,MANNITOL INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J2170,HCPCS,MECASERMIN INJECTION,,,29 ,,NW,,,,,,$17.71,$0.00,1,1,1,0,0,1,20110101,J2175,HCPCS,MEPERIDINE HYDROCHL /100 MG,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J2180,HCPCS,MEPERIDINE/PROMETHAZINE INJ,,,29 ,,NW,,,,,,$19.19,$0.00,1,1,1,0,0,1,20110101,J2185,HCPCS,MEROPENEM,,,29 ,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20110101,J2210,HCPCS,METHYLERGONOVIN MALEATE INJ,,,29 ,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20110101,J2248,HCPCS,MICAFUNGIN SODIUM INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J2250,HCPCS,INJ MIDAZOLAM HYDROCHLORIDE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2260,HCPCS,INJ MILRINONE LACTATE / 5 MG,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J2270,HCPCS,MORPHINE SULFATE INJECTION,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J2271,HCPCS,MORPHINE SO4 INJECTION 100MG,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J2275,HCPCS,MORPHINE SULFATE INJECTION,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J2278,HCPCS,ZICONOTIDE INJECTION,,,29 ,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20110101,J2280,HCPCS,"INJ, MOXIFLOXACIN 100 MG",,,29 ,,NW,,,,,,$8.83,$0.00,1,1,1,0,0,1,20110101,J2300,HCPCS,INJ NALBUPHINE HYDROCHLORIDE,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J2310,HCPCS,INJ NALOXONE HYDROCHLORIDE,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J2315,HCPCS,"NALTREXONE, DEPOT FORM",,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J2320,HCPCS,NANDROLONE DECANOATE 50 MG,,,29 ,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20110101,J2323,HCPCS,NATALIZUMAB INJECTION,,,29 ,,NW,,,,,,$21.42,$0.00,1,1,1,0,0,1,20110101,J2325,HCPCS,NESIRITIDE INJECTION,,,29 ,,NW,,,,,,$84.45,$0.00,1,1,1,0,0,1,20110101,J2353,HCPCS,"OCTREOTIDE INJECTION, DEPOT",,,29 ,,NW,,,,,,$227.56,$0.00,1,1,1,0,0,1,20110101,J2354,HCPCS,"OCTREOTIDE INJ, NON-DEPOT",,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J2355,HCPCS,OPRELVEKIN INJECTION,,,29 ,,NW,,,,,,$507.13,$0.00,1,1,1,0,0,1,20110101,J2357,HCPCS,OMALIZUMAB INJECTION,,,29 ,,NW,,,,,,$43.66,$0.00,1,1,1,0,0,1,20110101,J2360,HCPCS,ORPHENADRINE INJECTION,,,29 ,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20110101,J2370,HCPCS,PHENYLEPHRINE HCL INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J2400,HCPCS,CHLOROPROCAINE HCL INJECTION,,,29 ,,NW,,,,,,$28.83,$0.00,1,1,1,0,0,1,20110101,J2405,HCPCS,ONDANSETRON HCL INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2410,HCPCS,OXYMORPHONE HCL INJECTION,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J2425,HCPCS,PALIFERMIN INJECTION,,,29 ,,NW,,,,,,$26.61,$0.00,1,1,1,0,0,1,20110101,J2426,HCPCS,PALIPERIDONE PALMITATE INJ,,,29 ,,NW,,,,,,$33.28,$0.00,1,1,1,0,0,1,20110101,J2430,HCPCS,PAMIDRONATE DISODIUM /30 MG,,,29 ,,NW,,,,,,$33.28,$0.00,1,1,1,0,0,1,20110101,J2440,HCPCS,PAPAVERIN HCL INJECTION,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J2460,HCPCS,OXYTETRACYCLINE INJECTION,,,29 ,,NW,,,,,,$1.99,$0.00,1,1,1,0,0,1,20110101,J2469,HCPCS,PALONOSETRON HCL,,,29 ,,NW,,,,,,$41.44,$0.00,1,1,1,0,0,1,20110101,J2501,HCPCS,PARICALCITOL,,,29 ,,NW,,,,,,$11.04,$0.00,1,1,1,0,0,1,20110101,J2503,HCPCS,PEGAPTANIB SODIUM INJECTION,,,29 ,,NW,,,,,,"$2,443.88",$0.00,1,1,1,0,0,1,20110101,J2504,HCPCS,"PEGADEMASE BOVINE, 25 IU",,,29 ,,NW,,,,,,$513.54,$0.00,1,1,1,0,0,1,20110101,J2505,HCPCS,"INJECTION, PEGFILGRASTIM 6MG",,,29 ,,NW,,,,,,"$6,035.34",$0.00,1,1,1,0,0,1,20110101,J2510,HCPCS,PENICILLIN G PROCAINE INJ,,,29 ,,NW,,,,,,$26.61,$0.00,1,1,1,0,0,1,20110101,J2513,HCPCS,PENTASTARCH 10% SOLUTION,,,29 ,,NW,,,,,,$8.62,$0.00,1,1,1,0,0,1,20110101,J2515,HCPCS,PENTOBARBITAL SODIUM INJ,,,29 ,,NW,,,,,,$28.83,$0.00,1,1,1,0,0,1,20110101,J2540,HCPCS,PENICILLIN G POTASSIUM INJ,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J2543,HCPCS,PIPERACILLIN/TAZOBACTAM,,,29 ,,NW,,,,,,$14.75,$0.00,1,1,1,0,0,1,20110101,J2545,HCPCS,PENTAMIDINE NON-COMP UNIT,,,29 ,,NW,,,,,,$99.28,$0.00,1,1,1,0,0,1,20110101,J2550,HCPCS,PROMETHAZINE HCL INJECTION,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J2560,HCPCS,PHENOBARBITAL SODIUM INJ,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J2562,HCPCS,PLERIXAFOR INJECTION,,,29 ,,NW,,,,,,$563.91,$0.00,1,1,1,0,0,1,20110101,J2590,HCPCS,OXYTOCIN INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2597,HCPCS,INJ DESMOPRESSIN ACETATE,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J2650,HCPCS,PREDNISOLONE ACETATE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2670,HCPCS,TOTAZOLINE HCL INJECTION,,,29 ,,NW,,,,,,$10.99,$0.00,1,1,1,0,0,1,20110101,J2675,HCPCS,INJ PROGESTERONE PER 50 MG,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J2680,HCPCS,FLUPHENAZINE DECANOATE 25 MG,,,29 ,,NW,,,,,,$16.23,$0.00,1,1,1,0,0,1,20110101,J2690,HCPCS,PROCAINAMIDE HCL INJECTION,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J2700,HCPCS,OXACILLIN SODIUM INJECITON,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J2710,HCPCS,NEOSTIGMINE METHYLSLFTE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2720,HCPCS,INJ PROTAMINE SULFATE/10 MG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2724,HCPCS,PROTEIN C CONCENTRATE,,,29 ,,NW,,,,,,$28.09,$0.00,1,1,1,0,0,1,20110101,J2725,HCPCS,INJ PROTIRELIN PER 250 MCG,,,29 ,,NW,,,,,,$78.34,$0.00,1,1,1,0,0,1,20110101,J2730,HCPCS,PRALIDOXIME CHLORIDE INJ,,,29 ,,NW,,,,,,$183.07,$0.00,1,1,1,0,0,1,20110101,J2760,HCPCS,PHENTOLAINE MESYLATE INJ,,,29 ,,NW,,,,,,$112.62,$0.00,1,1,1,0,0,1,20110101,J2765,HCPCS,METOCLOPRAMIDE HCL INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2770,HCPCS,QUINUPRISTIN/DALFOPRISTIN,,,29 ,,NW,,,,,,$316.54,$0.00,1,1,1,0,0,1,20110101,J2778,HCPCS,RANIBIZUMAB INJECTION,,,29 ,,NW,,,,,,$905.47,$0.00,1,1,1,0,0,1,20110101,J2780,HCPCS,RANITIDINE HYDROCHLORIDE INJ,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J2783,HCPCS,RASBURICASE,,,29 ,,NW,,,,,,$357.32,$0.00,1,1,1,0,0,1,20110101,J2785,HCPCS,REGADENOSON INJECTION,,,29 ,,NW,,,,,,$106.69,$0.00,1,1,1,0,0,1,20110101,J2788,HCPCS,RHO D IMMUNE GLOBULIN 50 MCG,,,29 ,,NW,,,,,,$58.49,$0.00,1,1,1,0,0,1,20110101,J2790,HCPCS,RHO D IMMUNE GLOBULIN INJ,,,29 ,,NW,,,,,,$178.62,$0.00,1,1,1,0,0,1,20110101,J2791,HCPCS,RHOPHYLAC INJECTION,,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J2792,HCPCS,"RHO(D) IMMUNE GLOBULIN H, SD",,,29 ,,NW,,,,,,$43.66,$0.00,1,1,1,0,0,1,20110101,J2793,HCPCS,RILONACEPT INJECTION,,,29 ,,NW,,,,,,$46.63,$0.00,1,1,1,0,0,1,20110101,J2794,HCPCS,"RISPERIDONE, LONG ACTING",,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J2795,HCPCS,ROPIVACAINE HCL INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2796,HCPCS,ROMIPLOSTIM INJECTION,,,29 ,,NW,,,,,,$92.60,$0.00,1,1,1,0,0,1,20110101,J2800,HCPCS,METHOCARBAMOL INJECTION,,,29 ,,NW,,,,,,$59.24,$0.00,1,1,1,0,0,1,20110101,J2805,HCPCS,SINCALIDE INJECTION,,,29 ,,NW,,,,,,$149.70,$0.00,1,1,1,0,0,1,20110101,J2810,HCPCS,INJ THEOPHYLLINE PER 40 MG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J2820,HCPCS,SARGRAMOSTIM INJECTION,,,29 ,,NW,,,,,,$54.79,$0.00,1,1,1,0,0,1,20110101,J2850,HCPCS,INJ SECRETIN SYNTHETIC HUMAN,,,29 ,,NW,,,,,,$44.41,$0.00,1,1,1,0,0,1,20110101,J2910,HCPCS,AUROTHIOGLUCOSE INJECITON,,,29 ,,NW,,,,,,$73.48,$0.00,1,1,1,0,0,1,20110101,J2916,HCPCS,NA FERRIC GLUCONATE COMPLEX,,,29 ,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20110101,J2920,HCPCS,METHYLPREDNISOLONE INJECTION,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J2930,HCPCS,METHYLPREDNISOLONE INJECTION,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J2940,HCPCS,SOMATREM INJECTION,,,29 ,,NW,,,,,,$119.64,$0.00,1,1,1,0,0,1,20110101,J2941,HCPCS,SOMATROPIN INJECTION,,,29 ,,NW,,,,,,$94.09,$0.00,1,1,1,0,0,1,20110101,J2950,HCPCS,PROMAZINE HCL INJECTION,,,29 ,,NW,,,,,,$31.43,$0.00,1,1,1,0,0,1,20110101,J2993,HCPCS,RETEPLASE INJECTION,,,29 ,,NW,,,,,,"$3,290.92",$0.00,1,1,1,0,0,1,20110101,J2995,HCPCS,INJ STREPTOKINASE /250000 IU,,,29 ,,NW,,,,,,$152.67,$0.00,1,1,1,0,0,1,20110101,J2997,HCPCS,ALTEPLASE RECOMBINANT,,,29 ,,NW,,,,,,$81.48,$0.00,1,1,1,0,0,1,20110101,J3000,HCPCS,STREPTOMYCIN INJECTION,,,29 ,,NW,,,,,,$18.45,$0.00,1,1,1,0,0,1,20110101,J3010,HCPCS,FENTANYL CITRATE INJECITON,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3030,HCPCS,SUMATRIPTAN SUCCINATE / 6 MG,,,29 ,,NW,,,,,,$100.02,$0.00,1,1,1,0,0,1,20110101,J3070,HCPCS,PENTAZOCINE INJECTION,,,29 ,,NW,,,,,,$21.42,$0.00,1,1,1,0,0,1,20110101,J3101,HCPCS,TENECTEPLASE INJECTION,,,29 ,,NW,,,,,,$97.79,$0.00,1,1,1,0,0,1,20110101,J3105,HCPCS,TERBUTALINE SULFATE INJ,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J3110,HCPCS,TERIPARATIDE INJECTION,,,29 ,,NW,,,,,,$19.94,$0.00,1,1,1,0,0,1,20110101,J3120,HCPCS,TESTOSTERONE ENANTHATE INJ,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J3130,HCPCS,TESTOSTERONE ENANTHATE INJ,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J3140,HCPCS,TESTOSTERONE SUSPENSION INJ,,,29 ,,NW,,,,,,$27.70,$0.00,1,1,1,0,0,1,20110101,J3150,HCPCS,TESTOSTERON PROPIONATE INJ,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J3230,HCPCS,CHLORPROMAZINE HCL INJECTION,,,29 ,,NW,,,,,,$21.42,$0.00,1,1,1,0,0,1,20110101,J3240,HCPCS,THYROTROPIN INJECTION,,,29 ,,NW,,,,,,"$2,515.31",$0.00,1,1,1,0,0,1,20110101,J3243,HCPCS,TIGECYCLINE INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J3246,HCPCS,TIROFIBAN HCL,,,29 ,,NW,,,,,,$19.19,$0.00,1,1,1,0,0,1,20110101,J3250,HCPCS,TRIMETHOBENZAMIDE HCL INJ,,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J3260,HCPCS,TOBRAMYCIN SULFATE INJECTION,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J3265,HCPCS,INJECTION TORSEMIDE 10 MG/ML,,,29 ,,NW,,,,,,$6.64,$0.00,1,1,1,0,0,1,20110101,J3280,HCPCS,THIETHYLPERAZINE MALEATE INJ,,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J3285,HCPCS,TREPROSTINIL INJECTION,,,29 ,,NW,,,,,,$116.33,$0.00,1,1,1,0,0,1,20110101,J3300,HCPCS,TRIAMCINOLONE A INJ PRS-FREE,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J3301,HCPCS,TRIAMCINOLONE ACET INJ NOS,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J3302,HCPCS,TRIAMCINOLONE DIACETATE INJ,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3303,HCPCS,TRIAMCINOLONE HEXACETONL INJ,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J3305,HCPCS,INJ TRIMETREXATE GLUCORONATE,,,29 ,,NW,,,,,,$100.13,$0.00,1,1,1,0,0,1,20110101,J3310,HCPCS,PERPHENAZINE INJECITON,,,29 ,,NW,,,,,,$44.24,$0.00,1,1,1,0,0,1,20110101,J3315,HCPCS,TRIPTORELIN PAMOATE,,,29 ,,NW,,,,,,$334.33,$0.00,1,1,1,0,0,1,20110101,J3320,HCPCS,SPECTINOMYCN DI-HCL INJ,,,29 ,,NW,,,,,,$80.75,$0.00,1,1,1,0,0,1,20110101,J3350,HCPCS,UREA INJECTION,,,29 ,,NW,,,,,,$28.04,$0.00,1,1,1,0,0,1,20110101,J3355,HCPCS,"UROFOLLITROPIN, 75 IU",,,29 ,,NW,,,,,,$125.97,$0.00,1,1,1,0,0,1,20110101,J3360,HCPCS,DIAZEPAM INJECTION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J3364,HCPCS,UROKINASE 5000 IU INJECTION,,,29 ,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20110101,J3365,HCPCS,"UROKINASE 250,000 IU INJ",,,29 ,,NW,,,,,,"$1,035.50",$0.00,1,1,1,0,0,1,20110101,J3370,HCPCS,VANCOMYCIN HCL INJECTION,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J3396,HCPCS,VERTEPORFIN INJECTION,,,29 ,,NW,,,,,,$22.90,$0.00,1,1,1,0,0,1,20110101,J3400,HCPCS,TRIFLUPROMAZINE HCL INJ,,,29 ,,NW,,,,,,$36.26,$0.00,1,1,1,0,0,1,20110101,J3410,HCPCS,HYDROXYZINE HCL INJECTION,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J3411,HCPCS,THIAMINE HCL 100 MG,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J3415,HCPCS,PYRIDOXINE HCL 100 MG,,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J3420,HCPCS,VITAMIN B12 INJECTION,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3430,HCPCS,VITAMIN K PHYTONADIONE INJ,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J3465,HCPCS,"INJECTION, VORICONAZOLE",,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J3470,HCPCS,HYALURONIDASE INJECTION,,,29 ,,NW,,,,,,$45.89,$0.00,1,1,1,0,0,1,20110101,J3471,HCPCS,"OVINE, UP TO 999 USP UNITS",,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3472,HCPCS,"OVINE, 1000 USP UNITS",,,29 ,,NW,,,,,,$280.95,$0.00,1,1,1,0,0,1,20110101,J3473,HCPCS,HYALURONIDASE RECOMBINANT,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J3475,HCPCS,INJ MAGNESIUM SULFATE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3480,HCPCS,INJ POTASSIUM CHLORIDE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3485,HCPCS,ZIDOVUDINE,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J3486,HCPCS,ZIPRASIDONE MESYLATE,,,29 ,,NW,,,,,,$16.23,$0.00,1,1,1,0,0,1,20110101,J3487,HCPCS,ZOLEDRONIC ACID,,,29 ,,NW,,,,,,$449.44,$0.00,1,1,1,0,0,1,20110101,J3488,HCPCS,RECLAST INJECTION,,,29 ,,NW,,,,,,$453.11,$0.00,1,1,1,0,0,1,20110101,J3490,HCPCS,DRUGS UNCLASSIFIED INJECTION,,,29 ,,NW,,,,,,$6.09,$0.00,1,1,1,0,0,1,20110101,J3520,HCPCS,EDETATE DISODIUM PER 150 MG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J3530,HCPCS,NASAL VACCINE INHALATION,,,29 ,,NW,,,,,,$48.60,$0.00,1,1,1,0,1,1,20110101,J3535,HCPCS,METERED DOSE INHALER DRUG,,,29 ,,NW,,,,,,$16.56,$0.00,1,1,1,0,0,1,20110101,J3570,HCPCS,LAETRILE AMYGDALIN VIT B17,,,29 ,,NW,,,,,,$51.61,$0.00,1,1,1,0,0,1,20110101,J3590,HCPCS,UNCLASSIFIED BIOLOGICS,,,29 ,,NW,,,,,,$19.33,$0.00,1,1,1,0,0,1,20110101,J7030,HCPCS,NORMAL SALINE SOLUTION INFUS,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7040,HCPCS,NORMAL SALINE SOLUTION INFUS,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7042,HCPCS,5% DEXTROSE/NORMAL SALINE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7050,HCPCS,NORMAL SALINE SOLUTION INFUS,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7060,HCPCS,5% DEXTROSE/WATER,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J7070,HCPCS,D5W INFUSION,,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J7100,HCPCS,DEXTRAN 40 INFUSION,,,29 ,,NW,,,,,,$44.41,$0.00,1,1,1,0,0,1,20110101,J7110,HCPCS,DEXTRAN 75 INFUSION,,,29 ,,NW,,,,,,$28.83,$0.00,1,1,1,0,0,1,20110101,J7120,HCPCS,RINGERS LACTATE INFUSION,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J7130,HCPCS,HYPERTONIC SALINE SOLUTION,,,29 ,,NW,,,,,,$9.71,$0.00,1,1,1,0,0,1,20110101,J7185,HCPCS,XYNTHA INJ,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J7186,HCPCS,ANTIHEMOPHILIC VIII/VWF COMP,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7187,HCPCS,"HUMATE-P, INJ",,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7189,HCPCS,FACTOR VIIA,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J7190,HCPCS,FACTOR VIII,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7191,HCPCS,FACTOR VIII (PORCINE),,,29 ,,NW,,,,,,$5.85,$0.00,1,1,1,0,0,1,20110101,J7192,HCPCS,FACTOR VIII RECOMBINANT NOS,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J7193,HCPCS,FACTOR IX NON-RECOMBINANT,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7194,HCPCS,FACTOR IX COMPLEX,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7195,HCPCS,FACTOR IX RECOMBINANT,,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,J7196,HCPCS,ANTITHROMBIN RECOMBINANT,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J7197,HCPCS,ANTITHROMBIN III INJECTION,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J7198,HCPCS,ANTI-INHIBITOR,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J7199,HCPCS,HEMOPHILIA CLOT FACTOR NOC,,,29 ,,NW,,,,,,$1.28,$0.00,1,1,1,0,0,1,20110101,J7300,HCPCS,INTRAUT COPPER CONTRACEPTIVE,,,29 ,,NW,,,,,,$830.38,$0.00,1,1,1,1,1,1,20110101,J7302,HCPCS,LEVONORGESTREL IU CONTRACEPT,,,29 ,,NW,,,,,,$868.84,$0.00,1,1,1,1,1,1,20110101,J7303,HCPCS,CONTRACEPTIVE VAGINAL RING,,,29 ,,NW,,,,,,$77.03,$0.00,1,1,1,1,1,1,20110101,J7304,HCPCS,CONTRACEPTIVE HORMONE PATCH,,,29 ,,NW,,,,,,$46.79,$0.00,1,1,1,1,1,1,20110101,J7306,HCPCS,LEVONORGESTREL IMPLANT SYS,,,29 ,,NW,,,,,,$868.84,$0.00,1,1,1,1,1,1,20110101,J7307,HCPCS,ETONOGESTREL IMPLANT SYSTEM,,,29 ,,NW,,,,,,"$1,042.68",$0.00,1,1,1,1,1,1,20110101,J7308,HCPCS,AMINOLEVULINIC ACID HCL TOP,,,29 ,,NW,,,,,,$277.98,$0.00,1,1,1,0,0,1,20110101,J7310,HCPCS,GANCICLOVIR LONG ACT IMPLANT,,,29 ,,NW,,,,,,"$42,018.57",$0.00,1,1,1,0,0,1,20110101,J7311,HCPCS,FLUOCINOLONE ACETONIDE IMPLT,,,29 ,,NW,,,,,,"$47,941.45",$0.00,1,1,1,0,0,1,20110101,J7321,HCPCS,HYALGAN/SUPARTZ INJ PER DOSE,,,29 ,,NW,,,,,,$183.07,$0.00,1,1,1,0,0,1,20110101,J7323,HCPCS,EUFLEXXA INJ PER DOSE,,,29 ,,NW,,,,,,$239.42,$0.00,1,1,1,0,0,1,20110101,J7324,HCPCS,ORTHOVISC INJ PER DOSE,,,29 ,,NW,,,,,,$354.36,$0.00,1,1,1,0,0,1,20110101,J7325,HCPCS,SYNVISC OR SYNVISC-ONE,,,29 ,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20110101,J7330,HCPCS,CULTURED CHONDROCYTES IMPLNT,,,29 ,,NW,,,,,,"$64,459.22",$0.00,1,1,1,0,0,1,20110101,J7335,HCPCS,CAPSAICIN 8% PATCH,,,29 ,,NW,,,,,,$75.00,$0.00,1,1,1,0,0,1,20110101,J7500,HCPCS,AZATHIOPRINE ORAL 50MG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7501,HCPCS,AZATHIOPRINE PARENTERAL,,,29 ,,NW,,,,,,$198.64,$0.00,1,1,1,0,0,1,20110101,J7502,HCPCS,CYCLOSPORINE ORAL 100 MG,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J7504,HCPCS,LYMPHOCYTE IMMUNE GLOBULIN,,,29 ,,NW,,,,,,"$1,157.29",$0.00,1,1,1,0,0,1,20110101,J7505,HCPCS,MONOCLONAL ANTIBODIES,,,29 ,,NW,,,,,,"$2,714.93",$0.00,1,1,1,0,0,1,20110101,J7506,HCPCS,PREDNISONE ORAL,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7507,HCPCS,TACROLIMUS ORAL PER 1 MG,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J7509,HCPCS,METHYLPREDNISOLONE ORAL,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7510,HCPCS,PREDNISOLONE ORAL PER 5 MG,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7511,HCPCS,ANTITHYMOCYTE GLOBULN RABBIT,,,29 ,,NW,,,,,,$896.31,$0.00,1,1,1,0,0,1,20110101,J7513,HCPCS,"DACLIZUMAB, PARENTERAL",,,29 ,,NW,,,,,,"$1,205.83",$0.00,1,1,1,0,0,1,20110101,J7515,HCPCS,CYCLOSPORINE ORAL 25 MG,,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,J7516,HCPCS,CYCLOSPORIN PARENTERAL 250MG,,,29 ,,NW,,,,,,$52.56,$0.00,1,1,1,0,0,1,20110101,J7517,HCPCS,MYCOPHENOLATE MOFETIL ORAL,,,29 ,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20110101,J7518,HCPCS,MYCOPHENOLIC ACID,,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J7520,HCPCS,"SIROLIMUS, ORAL",,,29 ,,NW,,,,,,$23.64,$0.00,1,1,1,0,0,1,20110101,J7525,HCPCS,TACROLIMUS INJECTION,,,29 ,,NW,,,,,,$283.91,$0.00,1,1,1,0,0,1,20110101,J7599,HCPCS,IMMUNOSUPPRESSIVE DRUG NOC,,,29 ,,NW,,,,,,$5.79,$0.00,1,1,1,0,0,1,20110101,J7604,HCPCS,ACETYLCYSTEINE COMP UNIT,,,29 ,,NW,,,,,,$14.74,$0.00,1,1,1,0,0,1,20110101,J7605,HCPCS,ARFORMOTEROL NON-COMP UNIT,,,29 ,,NW,,,,,,$14.00,$0.00,1,1,1,0,0,1,20110101,J7606,HCPCS,"FORMOTEROL FUMARATE, INH",,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J7607,HCPCS,LEVALBUTEROL COMP CON,,,29 ,,NW,,,,,,$6.27,$0.00,1,1,1,0,0,1,20110101,J7608,HCPCS,ACETYLCYSTEINE NON-COMP UNIT,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J7609,HCPCS,ALBUTEROL COMP UNIT,,,29 ,,NW,,,,,,$11.79,$0.00,1,1,1,0,0,1,20110101,J7610,HCPCS,ALBUTEROL COMP CON,,,29 ,,NW,,,,,,$7.91,$0.00,1,1,1,0,0,1,20110101,J7611,HCPCS,ALBUTEROL NON-COMP CON,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7612,HCPCS,LEVALBUTEROL NON-COMP CON,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7613,HCPCS,ALBUTEROL NON-COMP UNIT,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7614,HCPCS,LEVALBUTEROL NON-COMP UNIT,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7615,HCPCS,LEVALBUTEROL COMP UNIT,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,J7620,HCPCS,ALBUTEROL IPRATROP NON-COMP,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7622,HCPCS,BECLOMETHASONE COMP UNIT,,,29 ,,NW,,,,,,$13.35,$0.00,1,1,1,0,0,1,20110101,J7624,HCPCS,BETAMETHASONE COMP UNIT,,,29 ,,NW,,,,,,$3.86,$0.00,1,1,1,0,0,1,20110101,J7626,HCPCS,BUDESONIDE NON-COMP UNIT,,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J7627,HCPCS,BUDESONIDE COMP UNIT,,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J7628,HCPCS,BITOLTEROL MESYLATE COMP CON,,,29 ,,NW,,,,,,$5.43,$0.00,1,1,1,0,0,1,20110101,J7629,HCPCS,BITOLTEROL MESYLATE COMP UNT,,,29 ,,NW,,,,,,$5.43,$0.00,1,1,1,0,0,1,20110101,J7631,HCPCS,CROMOLYN SODIUM NONCOMP UNIT,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7632,HCPCS,CROMOLYN SODIUM COMP UNIT,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7633,HCPCS,BUDESONIDE NON-COMP CON,,,29 ,,NW,,,,,,$24.98,$0.00,1,1,1,0,0,1,20110101,J7634,HCPCS,BUDESONIDE COMP CON,,,29 ,,NW,,,,,,$45.06,$0.00,1,1,1,0,0,1,20110101,J7635,HCPCS,ATROPINE COMP CON,,,29 ,,NW,,,,,,$33.74,$0.00,1,1,1,0,0,1,20110101,J7636,HCPCS,ATROPINE COMP UNIT,,,29 ,,NW,,,,,,$12.48,$0.00,1,1,1,0,0,1,20110101,J7637,HCPCS,DEXAMETHASONE COMP CON,,,29 ,,NW,,,,,,$0.95,$0.00,1,1,1,0,0,1,20110101,J7638,HCPCS,DEXAMETHASONE COMP UNIT,,,29 ,,NW,,,,,,$0.95,$0.00,1,1,1,0,0,1,20110101,J7639,HCPCS,DORNASE ALFA NON-COMP UNIT,,,29 ,,NW,,,,,,$54.79,$0.00,1,1,1,0,0,1,20110101,J7640,HCPCS,FORMOTEROL COMP UNIT,,,29 ,,NW,,,,,,$28.78,$0.00,1,1,1,0,0,1,20110101,J7641,HCPCS,FLUNISOLIDE COMP UNIT,,,29 ,,NW,,,,,,$25.13,$0.00,1,1,1,0,0,1,20110101,J7642,HCPCS,GLYCOPYRROLATE COMP CON,,,29 ,,NW,,,,,,$0.70,$0.00,1,1,1,0,0,1,20110101,J7643,HCPCS,GLYCOPYRROLATE COMP UNIT,,,29 ,,NW,,,,,,$0.70,$0.00,1,1,1,0,0,1,20110101,J7644,HCPCS,IPRATROPIUM BROMIDE NON-COMP,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7645,HCPCS,IPRATROPIUM BROMIDE COMP,,,29 ,,NW,,,,,,$14.42,$0.00,1,1,1,0,0,1,20110101,J7648,HCPCS,ISOETHARINE NON-COMP CON,,,29 ,,NW,,,,,,$1.99,$0.00,1,1,1,0,0,1,20110101,J7649,HCPCS,ISOETHARINE NON-COMP UNIT,,,29 ,,NW,,,,,,$1.99,$0.00,1,1,1,0,0,1,20110101,J7650,HCPCS,ISOETHARINE COMP UNIT,,,29 ,,NW,,,,,,$5.89,$0.00,1,1,1,0,0,1,20110101,J7657,HCPCS,ISOPROTERENOL COMP CON,,,29 ,,NW,,,,,,$8.01,$0.00,1,1,1,0,0,1,20110101,J7658,HCPCS,ISOPROTERENOL NON-COMP CON,,,29 ,,NW,,,,,,$10.99,$0.00,1,1,1,0,0,1,20110101,J7659,HCPCS,ISOPROTERENOL NON-COMP UNIT,,,29 ,,NW,,,,,,$10.99,$0.00,1,1,1,0,0,1,20110101,J7660,HCPCS,ISOPROTERENOL COMP UNIT,,,29 ,,NW,,,,,,$1.33,$0.00,1,1,1,0,0,1,20110101,J7667,HCPCS,METAPROTERENOL COMP CON,,,29 ,,NW,,,,,,$10.68,$0.00,1,1,1,0,0,1,20110101,J7668,HCPCS,METAPROTERENOL NON-COMP CON,,,29 ,,NW,,,,,,$0.22,$0.00,1,1,1,0,0,1,20110101,J7669,HCPCS,METAPROTERENOL NON-COMP UNIT,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7674,HCPCS,"METHACHOLINE CHLORIDE, NEB",,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J7676,HCPCS,PENTAMIDINE COMP UNIT DOSE,,,29 ,,NW,,,,,,$484.04,$0.00,1,1,1,0,0,1,20110101,J7680,HCPCS,TERBUTALINE SULF COMP CON,,,29 ,,NW,,,,,,$29.58,$0.00,1,1,1,0,0,1,20110101,J7681,HCPCS,TERBUTALINE SULF COMP UNIT,,,29 ,,NW,,,,,,$29.58,$0.00,1,1,1,0,0,1,20110101,J7682,HCPCS,TOBRAMYCIN NON-COMP UNIT,,,29 ,,NW,,,,,,$154.89,$0.00,1,1,1,0,0,1,20110101,J7683,HCPCS,TRIAMCINOLONE COMP CON,,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J7684,HCPCS,TRIAMCINOLONE COMP UNIT,,,29 ,,NW,,,,,,$10.06,$0.00,1,1,1,0,0,1,20110101,J7685,HCPCS,TOBRAMYCIN COMP UNIT,,,29 ,,NW,,,,,,$124.49,$0.00,1,1,1,0,0,1,20110101,J7699,HCPCS,INHALATION SOLUTION FOR DME,,,29 ,,NW,,,,,,$7.72,$0.00,1,1,1,0,0,1,20110101,J7799,HCPCS,NON-INHALATION DRUG FOR DME,,,29 ,,NW,,,,,,$11.93,$0.00,1,1,1,0,0,1,20110101,J8498,HCPCS,ANTIEMETIC RECTAL/SUPP NOS,,,29 ,,NW,,,,,,$1.28,$0.00,1,1,1,0,0,1,20110101,J8499,HCPCS,ORAL PRESCRIP DRUG NON CHEMO,,,29 ,,NW,,,,,,$1.33,$0.00,1,1,1,0,0,1,20110101,J8501,HCPCS,ORAL APREPITANT,,,29 ,,NW,,,,,,$15.49,$0.00,1,1,1,0,0,1,20110101,J8510,HCPCS,ORAL BUSULFAN,,,29 ,,NW,,,,,,$15.04,$0.00,1,1,1,0,0,1,20110101,J8515,HCPCS,"CABERGOLINE, ORAL 0.25MG",,,29 ,,NW,,,,,,$9.93,$0.00,1,1,1,0,0,1,20110101,J8520,HCPCS,"CAPECITABINE, ORAL, 150 MG",,,29 ,,NW,,,,,,$28.57,$0.00,1,1,1,0,0,1,20110101,J8521,HCPCS,"CAPECITABINE, ORAL, 500 MG",,,29 ,,NW,,,,,,$84.06,$0.00,1,1,1,0,0,1,20110101,J8530,HCPCS,CYCLOPHOSPHAMIDE ORAL 25 MG,,,29 ,,NW,,,,,,$3.01,$0.00,1,1,1,0,0,1,20110101,J8540,HCPCS,ORAL DEXAMETHASONE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,J8560,HCPCS,ETOPOSIDE ORAL 50 MG,,,29 ,,NW,,,,,,$96.95,$0.00,1,1,1,0,0,1,20110101,J8565,HCPCS,GEFITINIB ORAL,,,29 ,,NW,,,,,,$111.88,$0.00,1,1,1,0,0,1,20110101,J8597,HCPCS,ANTIEMETIC DRUG ORAL NOS,,,29 ,,NW,,,,,,$805.10,$0.00,1,1,1,0,0,1,20110101,J8600,HCPCS,MELPHALAN ORAL 2 MG,,,29 ,,NW,,,,,,$19.55,$0.00,1,1,1,0,0,1,20110101,J8610,HCPCS,METHOTREXATE ORAL 2.5 MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,J8650,HCPCS,NABILONE ORAL,,,29 ,,NW,,,,,,$35.51,$0.00,1,1,1,0,0,1,20110101,J8700,HCPCS,TEMOZOLOMIDE,,,29 ,,NW,,,,,,$37.60,$0.00,1,1,1,0,0,1,20110101,J8705,HCPCS,TOPOTECAN ORAL,,,29 ,,NW,,,,,,$197.65,$0.00,1,1,1,0,0,1,20110101,J8999,HCPCS,ORAL PRESCRIPTION DRUG CHEMO,,,29 ,,NW,,,,,,$8.60,$0.00,1,1,1,0,0,1,20110101,J9000,HCPCS,DOXORUBICIN HCL INJECTION,,,29 ,,NW,,,,,,$12.03,$0.00,1,1,1,0,0,1,20110101,J9001,HCPCS,DOXORUBICIN HCL LIPOSOME INJ,,,29 ,,NW,,,,,,"$1,110.59",$0.00,1,1,1,0,0,1,20110101,J9010,HCPCS,ALEMTUZUMAB INJECTION,,,29 ,,NW,,,,,,"$1,360.58",$0.00,1,1,1,0,0,1,20110101,J9015,HCPCS,ALDESLEUKIN INJECTION,,,29 ,,NW,,,,,,"$1,965.92",$0.00,1,1,1,0,0,1,20110101,J9017,HCPCS,ARSENIC TRIOXIDE INJECTION,,,29 ,,NW,,,,,,$116.28,$0.00,1,1,1,0,0,1,20110101,J9020,HCPCS,ASPARAGINASE INJECTION,,,29 ,,NW,,,,,,$167.84,$0.00,1,1,1,0,0,1,20110101,J9025,HCPCS,AZACITIDINE INJECTION,,,29 ,,NW,,,,,,$21.05,$0.00,1,1,1,0,0,1,20110101,J9027,HCPCS,CLOFARABINE INJECTION,,,29 ,,NW,,,,,,$237.94,$0.00,1,1,1,0,0,1,20110101,J9031,HCPCS,BCG LIVE INTRAVESICAL VAC,,,29 ,,NW,,,,,,$275.79,$0.00,1,1,1,0,0,1,20110101,J9033,HCPCS,BENDAMUSTINE INJECTION,,,29 ,,NW,,,,,,$75.20,$0.00,1,1,1,0,0,1,20110101,J9035,HCPCS,BEVACIZUMAB INJECTION,,,29 ,,NW,,,,,,$121.52,$0.00,1,1,1,0,0,1,20110101,J9040,HCPCS,BLEOMYCIN SULFATE INJECTION,,,29 ,,NW,,,,,,$92.92,$0.00,1,1,1,0,0,1,20110101,J9041,HCPCS,BORTEZOMIB INJECTION,,,29 ,,NW,,,,,,$82.96,$0.00,1,1,1,0,0,1,20110101,J9045,HCPCS,CARBOPLATIN INJECTION,,,29 ,,NW,,,,,,$16.54,$0.00,1,1,1,0,0,1,20110101,J9050,HCPCS,CARMUSTINE INJECTION,,,29 ,,NW,,,,,,$419.99,$0.00,1,1,1,0,0,1,20110101,J9055,HCPCS,CETUXIMAB INJECTION,,,29 ,,NW,,,,,,$103.73,$0.00,1,1,1,0,0,1,20110101,J9060,HCPCS,CISPLATIN 10 MG INJECTION,,,29 ,,NW,,,,,,$7.52,$0.00,1,1,1,0,0,1,20110101,J9065,HCPCS,INJ CLADRIBINE PER 1 MG,,,29 ,,NW,,,,,,$90.50,$0.00,1,1,1,0,0,1,20110101,J9070,HCPCS,CYCLOPHOSPHAMIDE 100 MG INJ,,,29 ,,NW,,,,,,$21.05,$0.00,1,1,1,0,0,1,20110101,J9098,HCPCS,CYTARABINE LIPOSOME INJ,,,29 ,,NW,,,,,,"$1,061.14",$0.00,1,1,1,0,0,1,20110101,J9100,HCPCS,CYTARABINE HCL 100 MG INJ,,,29 ,,NW,,,,,,$6.02,$0.00,1,1,1,0,0,1,20110101,J9120,HCPCS,DACTINOMYCIN INJECTION,,,29 ,,NW,,,,,,"$1,281.97",$0.00,1,1,1,0,0,1,20110101,J9130,HCPCS,DACARBAZINE 100 MG INJ,,,29 ,,NW,,,,,,$15.04,$0.00,1,1,1,0,0,1,20110101,J9150,HCPCS,DAUNORUBICIN INJECTION,,,29 ,,NW,,,,,,$103.39,$0.00,1,1,1,0,0,1,20110101,J9151,HCPCS,DAUNORUBICIN CITRATE INJ,,,29 ,,NW,,,,,,$160.59,$0.00,1,1,1,0,0,1,20110101,J9155,HCPCS,DEGARELIX INJECTION,,,29 ,,NW,,,,,,$7.73,$0.00,1,1,1,0,0,1,20110101,J9160,HCPCS,DENILEUKIN DIFTITOX INJ,,,29 ,,NW,,,,,,"$3,734.13",$0.00,1,1,1,0,0,1,20110101,J9165,HCPCS,DIETHYLSTILBESTROL INJECTION,,,29 ,,NW,,,,,,$54.75,$0.00,1,1,1,0,0,1,20110101,J9171,HCPCS,DOCETAXEL INJECTION,,,29 ,,NW,,,,,,$39.96,$0.00,1,1,1,0,0,1,20110101,J9175,HCPCS,ELLIOTTS B SOLUTION PER ML,,,29 ,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20110101,J9178,HCPCS,"INJ, EPIRUBICIN HCL, 2 MG",,,29 ,,NW,,,,,,$6.62,$0.00,1,1,1,0,0,1,20110101,J9181,HCPCS,ETOPOSIDE INJECTION,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,J9185,HCPCS,FLUDARABINE PHOSPHATE INJ,,,29 ,,NW,,,,,,$287.07,$0.00,1,1,1,0,0,1,20110101,J9190,HCPCS,FLUOROURACIL INJECTION,,,29 ,,NW,,,,,,$6.02,$0.00,1,1,1,0,0,1,20110101,J9200,HCPCS,FLOXURIDINE INJECTION,,,29 ,,NW,,,,,,$129.17,$0.00,1,1,1,0,0,1,20110101,J9201,HCPCS,GEMCITABINE HCL INJECTION,,,29 ,,NW,,,,,,$359.57,$0.00,1,1,1,0,0,1,20110101,J9202,HCPCS,GOSERELIN ACETATE IMPLANT,,,29 ,,NW,,,,,,$467.52,$0.00,1,1,1,0,0,1,20110101,J9206,HCPCS,IRINOTECAN INJECTION,,,29 ,,NW,,,,,,$27.07,$0.00,1,1,1,0,0,1,20110101,J9207,HCPCS,IXABEPILONE INJECTION,,,29 ,,NW,,,,,,$174.28,$0.00,1,1,1,0,0,1,20110101,J9208,HCPCS,IFOSFOMIDE INJECTION,,,29 ,,NW,,,,,,$100.97,$0.00,1,1,1,0,0,1,20110101,J9209,HCPCS,MESNA INJECTION,,,29 ,,NW,,,,,,$18.05,$0.00,1,1,1,0,0,1,20110101,J9211,HCPCS,IDARUBICIN HCL INJECTION,,,29 ,,NW,,,,,,$150.12,$0.00,1,1,1,0,0,1,20110101,J9212,HCPCS,INTERFERON ALFACON-1 INJ,,,29 ,,NW,,,,,,$13.26,$0.00,1,1,1,0,0,1,20110101,J9213,HCPCS,INTERFERON ALFA-2A INJ,,,29 ,,NW,,,,,,$111.45,$0.00,1,1,1,0,0,1,20110101,J9214,HCPCS,INTERFERON ALFA-2B INJ,,,29 ,,NW,,,,,,$64.67,$0.00,1,1,1,0,0,1,20110101,J9215,HCPCS,INTERFERON ALFA-N3 INJ,,,29 ,,NW,,,,,,$69.18,$0.00,1,1,1,0,0,1,20110101,J9216,HCPCS,INTERFERON GAMMA 1-B INJ,,,29 ,,NW,,,,,,$976.65,$0.00,1,1,1,0,0,1,20110101,J9217,HCPCS,LEUPROLIDE ACETATE SUSPNSION,,,29 ,,NW,,,,,,$483.63,$0.00,1,1,1,0,0,1,20110101,J9218,HCPCS,LEUPROLIDE ACETATE INJECITON,,,29 ,,NW,,,,,,$16.54,$0.00,1,1,1,0,0,1,20110101,J9219,HCPCS,LEUPROLIDE ACETATE IMPLANT,,,29 ,,NW,,,,,,"$8,494.16",$0.00,1,1,1,0,0,1,20110101,J9225,HCPCS,VANTAS IMPLANT,,,29 ,,NW,,,,,,"$2,929.28",$0.00,1,1,1,0,0,1,20110101,J9226,HCPCS,SUPPRELIN LA IMPLANT,,,29 ,,NW,,,,,,"$24,375.83",$0.00,1,1,1,0,0,1,20110101,J9230,HCPCS,MECHLORETHAMINE HCL INJ,,,29 ,,NW,,,,,,$372.46,$0.00,1,1,1,0,0,1,20110101,J9245,HCPCS,INJ MELPHALAN HYDROCHL 50 MG,,,29 ,,NW,,,,,,"$2,937.08",$0.00,1,1,1,0,0,1,20110101,J9250,HCPCS,METHOTREXATE SODIUM INJ,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,J9260,HCPCS,METHOTREXATE SODIUM INJ,,,29 ,,NW,,,,,,$7.52,$0.00,1,1,1,0,0,1,20110101,J9261,HCPCS,NELARABINE INJECTION,,,29 ,,NW,,,,,,$216.44,$0.00,1,1,1,0,0,1,20110101,J9263,HCPCS,OXALIPLATIN,,,29 ,,NW,,,,,,$18.05,$0.00,1,1,1,0,0,1,20110101,J9264,HCPCS,PACLITAXEL PROTEIN BOUND,,,29 ,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20110101,J9265,HCPCS,PACLITAXEL INJECTION,,,29 ,,NW,,,,,,$46.62,$0.00,1,1,1,0,0,1,20110101,J9266,HCPCS,PEGASPARGASE INJECTION,,,29 ,,NW,,,,,,"$5,070.03",$0.00,1,1,1,0,0,1,20110101,J9268,HCPCS,PENTOSTATIN INJECTION,,,29 ,,NW,,,,,,"$2,714.48",$0.00,1,1,1,0,0,1,20110101,J9270,HCPCS,PLICAMYCIN (MITHRAMYCIN) INJ,,,29 ,,NW,,,,,,$293.91,$0.00,1,1,1,0,0,1,20110101,J9280,HCPCS,MITOMYCIN 5 MG INJ,,,29 ,,NW,,,,,,$79.22,$0.00,1,1,1,0,0,1,20110101,J9293,HCPCS,MITOXANTRONE HYDROCHL / 5 MG,,,29 ,,NW,,,,,,$124.34,$0.00,1,1,1,0,0,1,20110101,J9300,HCPCS,GEMTUZUMAB OZOGAMICIN INJ,,,29 ,,NW,,,,,,"$5,025.03",$0.00,1,1,1,0,0,1,20110101,J9303,HCPCS,PANITUMUMAB INJECTION,,,29 ,,NW,,,,,,$225.84,$0.00,1,1,1,0,0,1,20110101,J9305,HCPCS,PEMETREXED INJECTION,,,29 ,,NW,,,,,,$107.43,$0.00,1,1,1,0,0,1,20110101,J9310,HCPCS,RITUXIMAB INJECTION,,,29 ,,NW,,,,,,"$1,300.50",$0.00,1,1,1,0,0,1,20110101,J9320,HCPCS,STREPTOZOCIN INJECTION,,,29 ,,NW,,,,,,$647.97,$0.00,1,1,1,0,0,1,20110101,J9328,HCPCS,TEMOZOLOMIDE INJECTION,,,29 ,,NW,,,,,,$19.55,$0.00,1,1,1,0,0,1,20110101,J9330,HCPCS,TEMSIROLIMUS INJECTION,,,29 ,,NW,,,,,,$146.09,$0.00,1,1,1,0,0,1,20110101,J9340,HCPCS,THIOTEPA INJECTION,,,29 ,,NW,,,,,,$283.04,$0.00,1,1,1,0,0,1,20110101,J9351,HCPCS,TOPOTECAN INJECTION,,,29 ,,NW,,,,,,"$2,347.77",$0.00,1,1,1,0,0,1,20110101,J9355,HCPCS,TRASTUZUMAB INJECTION,,,29 ,,NW,,,,,,$137.84,$0.00,1,1,1,0,0,1,20110101,J9357,HCPCS,VALRUBICIN INJECTION,,,29 ,,NW,,,,,,"$2,290.04",$0.00,1,1,1,0,0,1,20110101,J9360,HCPCS,VINBLASTINE SULFATE INJ,,,29 ,,NW,,,,,,$4.51,$0.00,1,1,1,0,0,1,20110101,J9370,HCPCS,VINCRISTINE SULFATE 1 MG INJ,,,29 ,,NW,,,,,,$18.05,$0.00,1,1,1,0,0,1,20110101,J9390,HCPCS,VINORELBINE TARTRATE INJ,,,29 ,,NW,,,,,,$42.11,$0.00,1,1,1,0,0,1,20110101,J9395,HCPCS,"INJECTION, FULVESTRANT",,,29 ,,NW,,,,,,$170.46,$0.00,1,1,1,0,0,1,20110101,J9600,HCPCS,PORFIMER SODIUM INJECTION,,,29 ,,NW,,,,,,"$5,513.42",$0.00,1,1,1,0,0,1,20110101,J9999,HCPCS,CHEMOTHERAPY DRUG,,,29 ,,NW,,,,,,$47.73,$0.00,1,1,1,0,0,1,20110101,K0001,HCPCS,STANDARD WHEELCHAIR,,,28 ,,NW,,,,,,$873.57,$0.00,1,1,1,1,1,1,20110101,K0001,HCPCS,STANDARD WHEELCHAIR,NU,,28 ,,NW,,,,,,$873.57,$0.00,1,1,1,1,1,1,20110101,K0001,HCPCS,STANDARD WHEELCHAIR,RR,,28 ,,NW,,,,,,$93.51,$0.00,1,1,1,1,1,1,20110101,K0001,HCPCS,STANDARD WHEELCHAIR,UE,,28 ,,NW,,,,,,$657.13,$0.00,1,1,1,1,1,1,20110101,K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,,,28 ,,NW,,,,,,"$1,364.08",$0.00,1,1,1,1,1,1,20110101,K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,NU,,28 ,,NW,,,,,,"$1,364.08",$0.00,1,1,1,1,1,1,20110101,K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,RR,,28 ,,NW,,,,,,$141.02,$0.00,1,1,1,1,1,1,20110101,K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,UE,,28 ,,NW,,,,,,"$1,020.66",$0.00,1,1,1,1,1,1,20110101,K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,,,28 ,,NW,,,,,,"$1,491.11",$0.00,1,1,1,1,1,1,20110101,K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,NU,,28 ,,NW,,,,,,"$1,491.11",$0.00,1,1,1,1,1,1,20110101,K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,RR,,28 ,,NW,,,,,,$154.04,$0.00,1,1,1,1,1,1,20110101,K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,UE,,28 ,,NW,,,,,,"$1,114.73",$0.00,1,1,1,1,1,1,20110101,K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,,,28 ,,NW,,,,,,"$2,212.16",$0.00,1,1,1,1,1,1,20110101,K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,NU,,28 ,,NW,,,,,,"$2,212.16",$0.00,1,1,1,1,1,1,20110101,K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,RR,,28 ,,NW,,,,,,$211.95,$0.00,1,1,1,1,1,1,20110101,K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,UE,,28 ,,NW,,,,,,"$1,651.14",$0.00,1,1,1,1,1,1,20110101,K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,,,28 ,,NW,,,,,,"$2,341.61",$0.00,1,1,1,1,1,1,20110101,K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,NU,,28 ,,NW,,,,,,"$2,341.61",$0.00,1,1,1,1,1,1,20110101,K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,RR,,28 ,,NW,,,,,,$311.18,$0.00,1,1,1,1,1,1,20110101,K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,UE,,28 ,,NW,,,,,,"$2,196.87",$0.00,1,1,1,1,1,1,20110101,K0006,HCPCS,HEAVY DUTY WHEELCHAIR,,,28 ,,NW,,,,,,"$2,077.52",$0.00,1,1,1,1,1,1,20110101,K0006,HCPCS,HEAVY DUTY WHEELCHAIR,NU,,28 ,,NW,,,,,,"$2,077.52",$0.00,1,1,1,1,1,1,20110101,K0006,HCPCS,HEAVY DUTY WHEELCHAIR,RR,,28 ,,NW,,,,,,$202.93,$0.00,1,1,1,1,1,1,20110101,K0006,HCPCS,HEAVY DUTY WHEELCHAIR,UE,,28 ,,NW,,,,,,"$1,550.78",$0.00,1,1,1,1,1,1,20110101,K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,,,28 ,,NW,,,,,,"$2,946.79",$0.00,1,1,1,1,1,1,20110101,K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,NU,,28 ,,NW,,,,,,"$2,946.79",$0.00,1,1,1,1,1,1,20110101,K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,RR,,28 ,,NW,,,,,,$274.03,$0.00,1,1,1,1,1,1,20110101,K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,UE,,28 ,,NW,,,,,,"$2,197.01",$0.00,1,1,1,1,1,1,20110101,K0009,HCPCS,OTHER MANUAL WHEELCHAIR/BASE,,,28 ,,NW,,,,,,$808.70,$0.00,1,1,1,1,1,1,20110101,K0010,HCPCS,STND WT FRAME POWER WHLCHR,,,28 ,,NW,,,,,,"$4,255.88",$0.00,1,1,1,1,1,1,20110101,K0010,HCPCS,STND WT FRAME POWER WHLCHR,NU,,28 ,,NW,,,,,,"$4,255.88",$0.00,1,1,1,1,1,1,20110101,K0010,HCPCS,STND WT FRAME POWER WHLCHR,RR,,28 ,,NW,,,,,,$546.43,$0.00,1,1,1,1,1,1,20110101,K0010,HCPCS,STND WT FRAME POWER WHLCHR,UE,,28 ,,NW,,,,,,"$3,203.80",$0.00,1,1,1,1,1,1,20110101,K0011,HCPCS,STND WT PWR WHLCHR W CONTROL,,,28 ,,NW,,,,,,"$12,947.56",$0.00,1,1,1,1,1,1,20110101,K0011,HCPCS,STND WT PWR WHLCHR W CONTROL,NU,,28 ,,NW,,,,,,"$12,947.56",$0.00,1,1,1,1,1,1,20110101,K0011,HCPCS,STND WT PWR WHLCHR W CONTROL,RR,,28 ,,NW,,,,,,"$1,382.28",$0.00,1,1,1,1,1,1,20110101,K0012,HCPCS,LTWT PORTBL POWER WHLCHR,,,28 ,,NW,,,,,,"$4,204.39",$0.00,1,1,1,1,1,1,20110101,K0012,HCPCS,LTWT PORTBL POWER WHLCHR,RR,,28 ,,NW,,,,,,$449.20,$0.00,1,1,1,1,1,1,20110101,K0014,HCPCS,OTHER POWER WHLCHR BASE,,,28 ,,NW,,,,,,"$3,729.51",$0.00,1,1,1,1,1,1,20110101,K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,,,28 ,,NW,,,,,,$475.53,$0.00,1,1,1,1,1,1,20110101,K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,NU,,28 ,,NW,,,,,,$475.53,$0.00,1,1,1,1,1,1,20110101,K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,RR,,28 ,,NW,,,,,,$60.44,$0.00,1,1,1,1,1,1,20110101,K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,UE,,28 ,,NW,,,,,,$371.10,$0.00,1,1,1,1,1,1,20110101,K0017,HCPCS,DETACH ADJUST ARMREST BASE,,,28 ,,NW,,,,,,$172.56,$0.00,1,1,1,1,1,1,20110101,K0017,HCPCS,DETACH ADJUST ARMREST BASE,NU,,28 ,,NW,,,,,,$172.56,$0.00,1,1,1,1,1,1,20110101,K0017,HCPCS,DETACH ADJUST ARMREST BASE,RR,,28 ,,NW,,,,,,$16.05,$0.00,1,1,1,1,1,1,20110101,K0017,HCPCS,DETACH ADJUST ARMREST BASE,UE,,28 ,,NW,,,,,,$129.07,$0.00,1,1,1,1,1,1,20110101,K0018,HCPCS,DETACH ADJUST ARMRST UPPER,,,28 ,,NW,,,,,,$95.81,$0.00,1,1,1,1,1,1,20110101,K0018,HCPCS,DETACH ADJUST ARMRST UPPER,NU,,28 ,,NW,,,,,,$95.81,$0.00,1,1,1,1,1,1,20110101,K0018,HCPCS,DETACH ADJUST ARMRST UPPER,RR,,28 ,,NW,,,,,,$8.85,$0.00,1,1,1,1,1,1,20110101,K0018,HCPCS,DETACH ADJUST ARMRST UPPER,UE,,28 ,,NW,,,,,,$71.55,$0.00,1,1,1,1,1,1,20110101,K0019,HCPCS,ARM PAD EACH,,,28 ,,NW,,,,,,$56.34,$0.00,1,1,1,1,1,1,20110101,K0019,HCPCS,ARM PAD EACH,NU,,28 ,,NW,,,,,,$56.34,$0.00,1,1,1,1,1,1,20110101,K0019,HCPCS,ARM PAD EACH,RR,,28 ,,NW,,,,,,$5.22,$0.00,1,1,1,1,1,1,20110101,K0019,HCPCS,ARM PAD EACH,UE,,28 ,,NW,,,,,,$41.90,$0.00,1,1,1,1,1,1,20110101,K0020,HCPCS,FIXED ADJUST ARMREST PAIR,,,28 ,,NW,,,,,,$156.73,$0.00,1,1,1,1,1,1,20110101,K0020,HCPCS,FIXED ADJUST ARMREST PAIR,NU,,28 ,,NW,,,,,,$156.73,$0.00,1,1,1,1,1,1,20110101,K0020,HCPCS,FIXED ADJUST ARMREST PAIR,RR,,28 ,,NW,,,,,,$14.58,$0.00,1,1,1,1,1,1,20110101,K0020,HCPCS,FIXED ADJUST ARMREST PAIR,UE,,28 ,,NW,,,,,,$117.17,$0.00,1,1,1,1,1,1,20110101,K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,,,28 ,,NW,,,,,,$157.34,$0.00,1,1,1,1,1,1,20110101,K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,NU,,28 ,,NW,,,,,,$157.34,$0.00,1,1,1,1,1,1,20110101,K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,RR,,28 ,,NW,,,,,,$13.13,$0.00,1,1,1,1,1,1,20110101,K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,UE,,28 ,,NW,,,,,,$117.72,$0.00,1,1,1,1,1,1,20110101,K0038,HCPCS,LEG STRAP EACH,,,28 ,,NW,,,,,,$81.20,$0.00,1,1,1,1,1,1,20110101,K0038,HCPCS,LEG STRAP EACH,NU,,28 ,,NW,,,,,,$81.20,$0.00,1,1,1,1,1,1,20110101,K0038,HCPCS,LEG STRAP EACH,RR,,28 ,,NW,,,,,,$7.54,$0.00,1,1,1,1,1,1,20110101,K0038,HCPCS,LEG STRAP EACH,UE,,28 ,,NW,,,,,,$60.57,$0.00,1,1,1,1,1,1,20110101,K0039,HCPCS,LEG STRAP H STYLE EACH,,,28 ,,NW,,,,,,$180.26,$0.00,1,1,1,1,1,1,20110101,K0039,HCPCS,LEG STRAP H STYLE EACH,NU,,28 ,,NW,,,,,,$180.26,$0.00,1,1,1,1,1,1,20110101,K0039,HCPCS,LEG STRAP H STYLE EACH,RR,,28 ,,NW,,,,,,$17.04,$0.00,1,1,1,1,1,1,20110101,K0039,HCPCS,LEG STRAP H STYLE EACH,UE,,28 ,,NW,,,,,,$136.15,$0.00,1,1,1,1,1,1,20110101,K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,,,28 ,,NW,,,,,,$229.59,$0.00,1,1,1,1,1,1,20110101,K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,NU,,28 ,,NW,,,,,,$229.59,$0.00,1,1,1,1,1,1,20110101,K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,RR,,28 ,,NW,,,,,,$24.02,$0.00,1,1,1,1,1,1,20110101,K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,UE,,28 ,,NW,,,,,,$186.02,$0.00,1,1,1,1,1,1,20110101,K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,,,28 ,,NW,,,,,,$177.65,$0.00,1,1,1,1,1,1,20110101,K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,NU,,28 ,,NW,,,,,,$177.65,$0.00,1,1,1,1,1,1,20110101,K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,RR,,28 ,,NW,,,,,,$16.71,$0.00,1,1,1,1,1,1,20110101,K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,UE,,28 ,,NW,,,,,,$133.69,$0.00,1,1,1,1,1,1,20110101,K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,,,28 ,,NW,,,,,,$116.06,$0.00,1,1,1,1,1,1,20110101,K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,NU,,28 ,,NW,,,,,,$116.06,$0.00,1,1,1,1,1,1,20110101,K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,RR,,28 ,,NW,,,,,,$10.76,$0.00,1,1,1,1,1,1,20110101,K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,UE,,28 ,,NW,,,,,,$86.71,$0.00,1,1,1,1,1,1,20110101,K0043,HCPCS,FTRST LOWER EXTENSION TUBE,,,28 ,,NW,,,,,,$65.11,$0.00,1,1,1,1,1,1,20110101,K0043,HCPCS,FTRST LOWER EXTENSION TUBE,NU,,28 ,,NW,,,,,,$65.11,$0.00,1,1,1,1,1,1,20110101,K0043,HCPCS,FTRST LOWER EXTENSION TUBE,RR,,28 ,,NW,,,,,,$6.03,$0.00,1,1,1,1,1,1,20110101,K0043,HCPCS,FTRST LOWER EXTENSION TUBE,UE,,28 ,,NW,,,,,,$48.52,$0.00,1,1,1,1,1,1,20110101,K0044,HCPCS,FTRST UPPER HANGER BRACKET,,,28 ,,NW,,,,,,$55.28,$0.00,1,1,1,1,1,1,20110101,K0044,HCPCS,FTRST UPPER HANGER BRACKET,NU,,28 ,,NW,,,,,,$55.28,$0.00,1,1,1,1,1,1,20110101,K0044,HCPCS,FTRST UPPER HANGER BRACKET,RR,,28 ,,NW,,,,,,$5.13,$0.00,1,1,1,1,1,1,20110101,K0044,HCPCS,FTRST UPPER HANGER BRACKET,UE,,28 ,,NW,,,,,,$41.10,$0.00,1,1,1,1,1,1,20110101,K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,,,28 ,,NW,,,,,,$188.28,$0.00,1,1,1,1,1,1,20110101,K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,NU,,28 ,,NW,,,,,,$188.28,$0.00,1,1,1,1,1,1,20110101,K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,RR,,28 ,,NW,,,,,,$18.39,$0.00,1,1,1,1,1,1,20110101,K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,UE,,28 ,,NW,,,,,,$143.68,$0.00,1,1,1,1,1,1,20110101,K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,,,28 ,,NW,,,,,,$65.11,$0.00,1,1,1,1,1,1,20110101,K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,NU,,28 ,,NW,,,,,,$65.11,$0.00,1,1,1,1,1,1,20110101,K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,RR,,28 ,,NW,,,,,,$6.03,$0.00,1,1,1,1,1,1,20110101,K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,UE,,28 ,,NW,,,,,,$48.53,$0.00,1,1,1,1,1,1,20110101,K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,,,28 ,,NW,,,,,,$233.74,$0.00,1,1,1,1,1,1,20110101,K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,NU,,28 ,,NW,,,,,,$233.74,$0.00,1,1,1,1,1,1,20110101,K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,RR,,28 ,,NW,,,,,,$24.73,$0.00,1,1,1,1,1,1,20110101,K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,UE,,28 ,,NW,,,,,,$189.71,$0.00,1,1,1,1,1,1,20110101,K0050,HCPCS,RATCHET ASSEMBLY,,,28 ,,NW,,,,,,$109.25,$0.00,1,1,1,1,1,1,20110101,K0050,HCPCS,RATCHET ASSEMBLY,NU,,28 ,,NW,,,,,,$109.25,$0.00,1,1,1,1,1,1,20110101,K0050,HCPCS,RATCHET ASSEMBLY,RR,,28 ,,NW,,,,,,$10.11,$0.00,1,1,1,1,1,1,20110101,K0050,HCPCS,RATCHET ASSEMBLY,UE,,28 ,,NW,,,,,,$81.64,$0.00,1,1,1,1,1,1,20110101,K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,,,28 ,,NW,,,,,,$176.78,$0.00,1,1,1,1,1,1,20110101,K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,NU,,28 ,,NW,,,,,,$176.78,$0.00,1,1,1,1,1,1,20110101,K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,RR,,28 ,,NW,,,,,,$16.63,$0.00,1,1,1,1,1,1,20110101,K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,UE,,28 ,,NW,,,,,,$132.85,$0.00,1,1,1,1,1,1,20110101,K0052,HCPCS,SWINGAWAY DETACH FOOTREST,,,28 ,,NW,,,,,,$270.45,$0.00,1,1,1,1,1,1,20110101,K0052,HCPCS,SWINGAWAY DETACH FOOTREST,NU,,28 ,,NW,,,,,,$270.45,$0.00,1,1,1,1,1,1,20110101,K0052,HCPCS,SWINGAWAY DETACH FOOTREST,RR,,28 ,,NW,,,,,,$30.11,$0.00,1,1,1,1,1,1,20110101,K0052,HCPCS,SWINGAWAY DETACH FOOTREST,UE,,28 ,,NW,,,,,,$217.29,$0.00,1,1,1,1,1,1,20110101,K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,,,28 ,,NW,,,,,,$292.45,$0.00,1,1,1,1,1,1,20110101,K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,NU,,28 ,,NW,,,,,,$292.45,$0.00,1,1,1,1,1,1,20110101,K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,RR,,28 ,,NW,,,,,,$33.34,$0.00,1,1,1,1,1,1,20110101,K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,UE,,28 ,,NW,,,,,,$233.82,$0.00,1,1,1,1,1,1,20110101,K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,,,28 ,,NW,,,,,,$172.39,$0.00,1,1,1,1,1,1,20110101,K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,NU,,28 ,,NW,,,,,,$172.39,$0.00,1,1,1,1,1,1,20110101,K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,RR,,28 ,,NW,,,,,,$16.05,$0.00,1,1,1,1,1,1,20110101,K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,UE,,28 ,,NW,,,,,,$128.99,$0.00,1,1,1,1,1,1,20110101,K0065,HCPCS,SPOKE PROTECTORS,,,28 ,,NW,,,,,,$79.90,$0.00,1,1,1,1,1,1,20110101,K0065,HCPCS,SPOKE PROTECTORS,NU,,28 ,,NW,,,,,,$79.90,$0.00,1,1,1,1,1,1,20110101,K0065,HCPCS,SPOKE PROTECTORS,RR,,28 ,,NW,,,,,,$7.41,$0.00,1,1,1,1,1,1,20110101,K0065,HCPCS,SPOKE PROTECTORS,UE,,28 ,,NW,,,,,,$59.59,$0.00,1,1,1,1,1,1,20110101,K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,,,28 ,,NW,,,,,,$179.62,$0.00,1,1,1,1,1,1,20110101,K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,NU,,28 ,,NW,,,,,,$179.62,$0.00,1,1,1,1,1,1,20110101,K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,RR,,28 ,,NW,,,,,,$17.27,$0.00,1,1,1,1,1,1,20110101,K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,UE,,28 ,,NW,,,,,,$135.56,$0.00,1,1,1,1,1,1,20110101,K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,,,28 ,,NW,,,,,,$284.01,$0.00,1,1,1,1,1,1,20110101,K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,NU,,28 ,,NW,,,,,,$284.01,$0.00,1,1,1,1,1,1,20110101,K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,RR,,28 ,,NW,,,,,,$32.13,$0.00,1,1,1,1,1,1,20110101,K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,UE,,28 ,,NW,,,,,,$227.43,$0.00,1,1,1,1,1,1,20110101,K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,,,28 ,,NW,,,,,,$192.81,$0.00,1,1,1,1,1,1,20110101,K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,NU,,28 ,,NW,,,,,,$192.81,$0.00,1,1,1,1,1,1,20110101,K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,RR,,28 ,,NW,,,,,,$18.64,$0.00,1,1,1,1,1,1,20110101,K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,UE,,28 ,,NW,,,,,,$148.38,$0.00,1,1,1,1,1,1,20110101,K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,,,28 ,,NW,,,,,,$118.22,$0.00,1,1,1,1,1,1,20110101,K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,NU,,28 ,,NW,,,,,,$118.22,$0.00,1,1,1,1,1,1,20110101,K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,RR,,28 ,,NW,,,,,,$10.98,$0.00,1,1,1,1,1,1,20110101,K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,UE,,28 ,,NW,,,,,,$88.33,$0.00,1,1,1,1,1,1,20110101,K0073,HCPCS,CASTER PIN LOCK EACH,,,28 ,,NW,,,,,,$61.04,$0.00,1,1,1,1,1,1,20110101,K0073,HCPCS,CASTER PIN LOCK EACH,NU,,28 ,,NW,,,,,,$61.04,$0.00,1,1,1,1,1,1,20110101,K0073,HCPCS,CASTER PIN LOCK EACH,RR,,28 ,,NW,,,,,,$5.66,$0.00,1,1,1,1,1,1,20110101,K0073,HCPCS,CASTER PIN LOCK EACH,UE,,28 ,,NW,,,,,,$45.44,$0.00,1,1,1,1,1,1,20110101,K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,,,28 ,,NW,,,,,,$106.19,$0.00,1,1,1,1,1,1,20110101,K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,NU,,28 ,,NW,,,,,,$106.19,$0.00,1,1,1,1,1,1,20110101,K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,RR,,28 ,,NW,,,,,,$9.86,$0.00,1,1,1,1,1,1,20110101,K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,UE,,28 ,,NW,,,,,,$79.31,$0.00,1,1,1,1,1,1,20110101,K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,,,28 ,,NW,,,,,,$89.87,$0.00,1,1,1,1,1,1,20110101,K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,NU,,28 ,,NW,,,,,,$89.87,$0.00,1,1,1,1,1,1,20110101,K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,RR,,28 ,,NW,,,,,,$8.36,$0.00,1,1,1,1,1,1,20110101,K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,UE,,28 ,,NW,,,,,,$67.05,$0.00,1,1,1,1,1,1,20110101,K0105,HCPCS,IV HANGER,,,28 ,,NW,,,,,,$178.95,$0.00,1,1,1,1,1,1,20110101,K0105,HCPCS,IV HANGER,NU,,28 ,,NW,,,,,,$178.95,$0.00,1,1,1,1,1,1,20110101,K0105,HCPCS,IV HANGER,RR,,28 ,,NW,,,,,,$16.81,$0.00,1,1,1,1,1,1,20110101,K0105,HCPCS,IV HANGER,UE,,28 ,,NW,,,,,,$134.94,$0.00,1,1,1,1,1,1,20110101,K0108,HCPCS,W/C COMPONENT-ACCESSORY NOS,,,28 ,,NW,,,,,,$151.49,$0.00,1,1,1,1,1,1,20110101,K0195,HCPCS,ELEVATING WHLCHAIR LEG RESTS,,,28 ,,NW,,,,,,$634.82,$0.00,1,1,1,1,1,1,20110101,K0195,HCPCS,ELEVATING WHLCHAIR LEG RESTS,RR,,28 ,,NW,,,,,,$67.95,$0.00,1,1,1,1,1,1,20110101,K0455,HCPCS,PUMP UNINTERRUPTED INFUSION,,,28 ,,NW,,,,,,"$5,659.02",$0.00,1,1,1,1,1,1,20110101,K0455,HCPCS,PUMP UNINTERRUPTED INFUSION,RR,,28 ,,NW,,,,,,$596.13,$0.00,1,1,1,1,1,1,20110101,K0462,HCPCS,TEMPORARY REPLACEMENT EQPMNT,,,28 ,,NW,,,,,,$643.12,$0.00,1,1,1,1,1,1,20110101,K0552,HCPCS,SUPPLY/EXT INF PUMP SYR TYPE,,,28 ,,NW,,,,,,$7.25,$0.00,1,1,1,1,1,1,20110101,K0601,HCPCS,REPL BATT SILVER OXIDE 1.5 V,,,28 ,,NW,,,,,,$3.05,$0.00,1,1,1,1,1,1,20110101,K0601,HCPCS,REPL BATT SILVER OXIDE 1.5 V,NU,,28 ,,NW,,,,,,$3.05,$0.00,1,1,1,1,1,1,20110101,K0602,HCPCS,REPL BATT SILVER OXIDE 3 V,,,28 ,,NW,,,,,,$16.11,$0.00,1,1,1,1,1,1,20110101,K0602,HCPCS,REPL BATT SILVER OXIDE 3 V,NU,,28 ,,NW,,,,,,$16.11,$0.00,1,1,1,1,1,1,20110101,K0603,HCPCS,REPL BATT ALKALINE 1.5 V,,,28 ,,NW,,,,,,$1.58,$0.00,1,1,1,1,1,1,20110101,K0603,HCPCS,REPL BATT ALKALINE 1.5 V,NU,,28 ,,NW,,,,,,$1.58,$0.00,1,1,1,1,1,1,20110101,K0604,HCPCS,REPL BATT LITHIUM 3.6 V,,,28 ,,NW,,,,,,$15.60,$0.00,1,1,1,1,1,1,20110101,K0604,HCPCS,REPL BATT LITHIUM 3.6 V,NU,,28 ,,NW,,,,,,$15.60,$0.00,1,1,1,1,1,1,20110101,K0605,HCPCS,REPL BATT LITHIUM 4.5 V,,,28 ,,NW,,,,,,$31.37,$0.00,1,1,1,1,1,1,20110101,K0605,HCPCS,REPL BATT LITHIUM 4.5 V,NU,,28 ,,NW,,,,,,$31.37,$0.00,1,1,1,1,1,1,20110101,K0606,HCPCS,AED GARMENT W ELEC ANALYSIS,,,28 ,,NW,,,,,,"$57,931.62",$0.00,1,1,1,1,1,1,20110101,K0606,HCPCS,AED GARMENT W ELEC ANALYSIS,KF,,28 ,,NW,,,,,,"$57,931.62",$0.00,1,1,1,1,1,1,20110101,K0606,HCPCS,AED GARMENT W ELEC ANALYSIS,RR,,28 ,,NW,,,,,,"$6,102.57",$0.00,1,1,1,1,1,1,20110101,K0607,HCPCS,REPL BATT FOR AED,,,28 ,,NW,,,,,,$974.24,$0.00,1,1,1,1,1,1,20110101,K0607,HCPCS,REPL BATT FOR AED,NU,,28 ,,NW,,,,,,$974.24,$0.00,1,1,1,1,1,1,20110101,K0607,HCPCS,REPL BATT FOR AED,RR,,28 ,,NW,,,,,,$80.29,$0.00,1,1,1,1,1,1,20110101,K0607,HCPCS,REPL BATT FOR AED,UE,,28 ,,NW,,,,,,$725.01,$0.00,1,1,1,1,1,1,20110101,K0608,HCPCS,REPL GARMENT FOR AED,,,28 ,,NW,,,,,,$599.47,$0.00,1,1,1,1,1,1,20110101,K0608,HCPCS,REPL GARMENT FOR AED,NU,,28 ,,NW,,,,,,$599.47,$0.00,1,1,1,1,1,1,20110101,K0608,HCPCS,REPL GARMENT FOR AED,RR,,28 ,,NW,,,,,,$51.77,$0.00,1,1,1,1,1,1,20110101,K0608,HCPCS,REPL GARMENT FOR AED,UE,,28 ,,NW,,,,,,$443.94,$0.00,1,1,1,1,1,1,20110101,K0609,HCPCS,REPL ELECTRODE FOR AED,,,28 ,,NW,,,,,,"$2,154.15",$0.00,1,1,1,1,1,1,20110101,K0609,HCPCS,REPL ELECTRODE FOR AED,KF,,28 ,,NW,,,,,,"$2,154.15",$0.00,1,1,1,1,1,1,20110101,K0669,HCPCS,SEAT/BACK CUS NO DMEPDAC VER,,,28 ,,NW,,,,,,$506.13,$0.00,1,1,1,1,1,1,20110101,K0669,HCPCS,SEAT/BACK CUS NO DMEPDAC VER,NU,,28 ,,NW,,,,,,$506.13,$0.00,1,1,1,1,1,1,20110101,K0672,HCPCS,REMOVABLE SOFT INTERFACE LE,,,28 ,,NW,,,,,,$153.89,$0.00,1,1,1,1,1,1,20110101,K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,,,28 ,,NW,,,,,,"$4,170.70",$0.00,1,1,1,1,1,1,20110101,K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,NU,,28 ,,NW,,,,,,"$4,170.70",$0.00,1,1,1,1,1,1,20110101,K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,RR,,28 ,,NW,,,,,,$396.64,$0.00,1,1,1,1,1,1,20110101,K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,UE,,28 ,,NW,,,,,,"$3,122.34",$0.00,1,1,1,1,1,1,20110101,K0733,HCPCS,12-24HR SEALED LEAD ACID,,,28 ,,NW,,,,,,$101.81,$0.00,1,1,1,1,1,1,20110101,K0733,HCPCS,12-24HR SEALED LEAD ACID,NU,,28 ,,NW,,,,,,$101.81,$0.00,1,1,1,1,1,1,20110101,K0733,HCPCS,12-24HR SEALED LEAD ACID,RR,,28 ,,NW,,,,,,$9.52,$0.00,1,1,1,1,1,1,20110101,K0733,HCPCS,12-24HR SEALED LEAD ACID,UE,,28 ,,NW,,,,,,$76.07,$0.00,1,1,1,1,1,1,20110101,K0738,HCPCS,PORTABLE GAS OXYGEN SYSTEM,,,28 ,,NW,,,,,,"$1,360.43",$0.00,1,1,1,1,1,1,20110101,K0738,HCPCS,PORTABLE GAS OXYGEN SYSTEM,RR,,28 ,,NW,,,,,,$143.31,$0.00,1,1,1,1,1,1,20110101,K0739,HCPCS,REPAIR/SVC DME NON-OXYGEN EQ,,,28 ,,NW,,,,,,$24.53,$0.00,1,1,1,1,1,1,20110101,K0740,HCPCS,REPAIR/SVC OXYGEN EQUIPMENT,,,28 ,,NW,,,,,,$13.78,$0.00,1,1,1,1,1,1,20110101,K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,,,28 ,,NW,,,,,,"$1,438.71",$0.00,1,1,1,1,1,1,20110101,K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,NU,,28 ,,NW,,,,,,"$1,438.71",$0.00,1,1,1,1,1,1,20110101,K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,RR,,28 ,,NW,,,,,,$196.00,$0.00,1,1,1,1,1,1,20110101,K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,UE,,28 ,,NW,,,,,,"$1,093.52",$0.00,1,1,1,1,1,1,20110101,K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,,,28 ,,NW,,,,,,"$2,284.05",$0.00,1,1,1,1,1,1,20110101,K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,NU,,28 ,,NW,,,,,,"$2,284.05",$0.00,1,1,1,1,1,1,20110101,K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,RR,,28 ,,NW,,,,,,$280.50,$0.00,1,1,1,1,1,1,20110101,K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,UE,,28 ,,NW,,,,,,"$1,727.50",$0.00,1,1,1,1,1,1,20110101,K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,,,28 ,,NW,,,,,,"$2,577.18",$0.00,1,1,1,1,1,1,20110101,K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,NU,,28 ,,NW,,,,,,"$2,577.18",$0.00,1,1,1,1,1,1,20110101,K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,RR,,28 ,,NW,,,,,,$309.83,$0.00,1,1,1,1,1,1,20110101,K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,UE,,28 ,,NW,,,,,,"$1,947.37",$0.00,1,1,1,1,1,1,20110101,K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,,,28 ,,NW,,,,,,"$1,728.32",$0.00,1,1,1,1,1,1,20110101,K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,NU,,28 ,,NW,,,,,,"$1,728.32",$0.00,1,1,1,1,1,1,20110101,K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,RR,,28 ,,NW,,,,,,$224.95,$0.00,1,1,1,1,1,1,20110101,K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,UE,,28 ,,NW,,,,,,"$1,310.71",$0.00,1,1,1,1,1,1,20110101,K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,,,28 ,,NW,,,,,,"$2,592.55",$0.00,1,1,1,1,1,1,20110101,K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,NU,,28 ,,NW,,,,,,"$2,592.55",$0.00,1,1,1,1,1,1,20110101,K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,RR,,28 ,,NW,,,,,,$311.38,$0.00,1,1,1,1,1,1,20110101,K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,UE,,28 ,,NW,,,,,,"$1,958.91",$0.00,1,1,1,1,1,1,20110101,K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,,,28 ,,NW,,,,,,"$3,979.52",$0.00,1,1,1,1,1,1,20110101,K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,NU,,28 ,,NW,,,,,,"$3,979.52",$0.00,1,1,1,1,1,1,20110101,K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,RR,,28 ,,NW,,,,,,$450.07,$0.00,1,1,1,1,1,1,20110101,K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,UE,,28 ,,NW,,,,,,"$2,999.11",$0.00,1,1,1,1,1,1,20110101,K0812,HCPCS,POWER OPERATED VEHICLE NOC,,,28 ,,NW,,,,,,"$1,173.24",$0.00,1,1,1,1,1,1,20110101,K0813,HCPCS,PWC GP 1 STD PORT SEAT/BACK,,,28 ,,NW,,,,,,"$2,952.32",$0.00,1,1,1,1,1,1,20110101,K0813,HCPCS,PWC GP 1 STD PORT SEAT/BACK,RR,,28 ,,NW,,,,,,$315.58,$0.00,1,1,1,1,1,1,20110101,K0814,HCPCS,PWC GP 1 STD PORT CAP CHAIR,,,28 ,,NW,,,,,,"$3,628.35",$0.00,1,1,1,1,1,1,20110101,K0814,HCPCS,PWC GP 1 STD PORT CAP CHAIR,RR,,28 ,,NW,,,,,,$387.73,$0.00,1,1,1,1,1,1,20110101,K0815,HCPCS,PWC GP 1 STD SEAT/BACK,,,28 ,,NW,,,,,,"$4,057.21",$0.00,1,1,1,1,1,1,20110101,K0815,HCPCS,PWC GP 1 STD SEAT/BACK,RR,,28 ,,NW,,,,,,$433.49,$0.00,1,1,1,1,1,1,20110101,K0816,HCPCS,PWC GP 1 STD CAP CHAIR,,,28 ,,NW,,,,,,"$3,908.14",$0.00,1,1,1,1,1,1,20110101,K0816,HCPCS,PWC GP 1 STD CAP CHAIR,RR,,28 ,,NW,,,,,,$417.59,$0.00,1,1,1,1,1,1,20110101,K0820,HCPCS,PWC GP 2 STD PORT SEAT/BACK,,,28 ,,NW,,,,,,"$3,116.65",$0.00,1,1,1,1,1,1,20110101,K0820,HCPCS,PWC GP 2 STD PORT SEAT/BACK,RR,,28 ,,NW,,,,,,$333.12,$0.00,1,1,1,1,1,1,20110101,K0821,HCPCS,PWC GP 2 STD PORT CAP CHAIR,,,28 ,,NW,,,,,,"$3,848.42",$0.00,1,1,1,1,1,1,20110101,K0821,HCPCS,PWC GP 2 STD PORT CAP CHAIR,RR,,28 ,,NW,,,,,,$411.21,$0.00,1,1,1,1,1,1,20110101,K0822,HCPCS,PWC GP 2 STD SEAT/BACK,,,28 ,,NW,,,,,,"$4,538.71",$0.00,1,1,1,1,1,1,20110101,K0822,HCPCS,PWC GP 2 STD SEAT/BACK,RR,,28 ,,NW,,,,,,$484.88,$0.00,1,1,1,1,1,1,20110101,K0823,HCPCS,PWC GP 2 STD CAP CHAIR,,,28 ,,NW,,,,,,"$4,564.93",$0.00,1,1,1,1,1,1,20110101,K0823,HCPCS,PWC GP 2 STD CAP CHAIR,RR,,28 ,,NW,,,,,,$487.68,$0.00,1,1,1,1,1,1,20110101,K0824,HCPCS,PWC GP 2 HD SEAT/BACK,,,28 ,,NW,,,,,,"$5,384.61",$0.00,1,1,1,1,1,1,20110101,K0824,HCPCS,PWC GP 2 HD SEAT/BACK,RR,,28 ,,NW,,,,,,$575.16,$0.00,1,1,1,1,1,1,20110101,K0825,HCPCS,PWC GP 2 HD CAP CHAIR,,,28 ,,NW,,,,,,"$4,974.77",$0.00,1,1,1,1,1,1,20110101,K0825,HCPCS,PWC GP 2 HD CAP CHAIR,RR,,28 ,,NW,,,,,,$531.42,$0.00,1,1,1,1,1,1,20110101,K0826,HCPCS,PWC GP 2 VHD SEAT/BACK,,,28 ,,NW,,,,,,"$6,812.42",$0.00,1,1,1,1,1,1,20110101,K0826,HCPCS,PWC GP 2 VHD SEAT/BACK,RR,,28 ,,NW,,,,,,$727.53,$0.00,1,1,1,1,1,1,20110101,K0827,HCPCS,PWC GP VHD CAP CHAIR,,,28 ,,NW,,,,,,"$5,873.30",$0.00,1,1,1,1,1,1,20110101,K0827,HCPCS,PWC GP VHD CAP CHAIR,RR,,28 ,,NW,,,,,,$627.31,$0.00,1,1,1,1,1,1,20110101,K0828,HCPCS,PWC GP 2 XTRA HD SEAT/BACK,,,28 ,,NW,,,,,,"$7,451.84",$0.00,1,1,1,1,1,1,20110101,K0828,HCPCS,PWC GP 2 XTRA HD SEAT/BACK,RR,,28 ,,NW,,,,,,$795.77,$0.00,1,1,1,1,1,1,20110101,K0829,HCPCS,PWC GP 2 XTRA HD CAP CHAIR,,,28 ,,NW,,,,,,"$6,886.84",$0.00,1,1,1,1,1,1,20110101,K0829,HCPCS,PWC GP 2 XTRA HD CAP CHAIR,RR,,28 ,,NW,,,,,,$735.48,$0.00,1,1,1,1,1,1,20110101,K0830,HCPCS,PWC GP2 STD SEAT ELEVATE S/B,,,28 ,,NW,,,,,,"$1,219.22",$0.00,1,1,1,1,1,1,20110101,K0831,HCPCS,PWC GP2 STD SEAT ELEVATE CAP,,,28 ,,NW,,,,,,"$1,661.21",$0.00,1,1,1,1,1,1,20110101,K0835,HCPCS,PWC GP2 STD SING POW OPT S/B,,,28 ,,NW,,,,,,"$4,598.65",$0.00,1,1,1,1,1,1,20110101,K0835,HCPCS,PWC GP2 STD SING POW OPT S/B,RR,,28 ,,NW,,,,,,$491.28,$0.00,1,1,1,1,1,1,20110101,K0836,HCPCS,PWC GP2 STD SING POW OPT CAP,,,28 ,,NW,,,,,,"$4,748.94",$0.00,1,1,1,1,1,1,20110101,K0836,HCPCS,PWC GP2 STD SING POW OPT CAP,RR,,28 ,,NW,,,,,,$507.32,$0.00,1,1,1,1,1,1,20110101,K0837,HCPCS,PWC GP 2 HD SING POW OPT S/B,,,28 ,,NW,,,,,,"$5,384.61",$0.00,1,1,1,1,1,1,20110101,K0837,HCPCS,PWC GP 2 HD SING POW OPT S/B,RR,,28 ,,NW,,,,,,$575.16,$0.00,1,1,1,1,1,1,20110101,K0838,HCPCS,PWC GP 2 HD SING POW OPT CAP,,,28 ,,NW,,,,,,"$4,873.80",$0.00,1,1,1,1,1,1,20110101,K0838,HCPCS,PWC GP 2 HD SING POW OPT CAP,RR,,28 ,,NW,,,,,,$520.64,$0.00,1,1,1,1,1,1,20110101,K0839,HCPCS,PWC GP2 VHD SING POW OPT S/B,,,28 ,,NW,,,,,,"$6,812.42",$0.00,1,1,1,1,1,1,20110101,K0839,HCPCS,PWC GP2 VHD SING POW OPT S/B,RR,,28 ,,NW,,,,,,$727.53,$0.00,1,1,1,1,1,1,20110101,K0840,HCPCS,PWC GP2 XHD SING POW OPT S/B,,,28 ,,NW,,,,,,"$10,044.15",$0.00,1,1,1,1,1,1,20110101,K0840,HCPCS,PWC GP2 XHD SING POW OPT S/B,RR,,28 ,,NW,,,,,,"$1,072.42",$0.00,1,1,1,1,1,1,20110101,K0841,HCPCS,PWC GP2 STD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$4,860.09",$0.00,1,1,1,1,1,1,20110101,K0841,HCPCS,PWC GP2 STD MULT POW OPT S/B,RR,,28 ,,NW,,,,,,$519.18,$0.00,1,1,1,1,1,1,20110101,K0842,HCPCS,PWC GP2 STD MULT POW OPT CAP,,,28 ,,NW,,,,,,"$4,860.09",$0.00,1,1,1,1,1,1,20110101,K0842,HCPCS,PWC GP2 STD MULT POW OPT CAP,RR,,28 ,,NW,,,,,,$519.18,$0.00,1,1,1,1,1,1,20110101,K0843,HCPCS,PWC GP2 HD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$5,741.81",$0.00,1,1,1,1,1,1,20110101,K0843,HCPCS,PWC GP2 HD MULT POW OPT S/B,RR,,28 ,,NW,,,,,,$613.28,$0.00,1,1,1,1,1,1,20110101,K0848,HCPCS,PWC GP 3 STD SEAT/BACK,,,28 ,,NW,,,,,,"$5,826.74",$0.00,1,1,1,1,1,1,20110101,K0848,HCPCS,PWC GP 3 STD SEAT/BACK,RR,,28 ,,NW,,,,,,$622.34,$0.00,1,1,1,1,1,1,20110101,K0849,HCPCS,PWC GP 3 STD CAP CHAIR,,,28 ,,NW,,,,,,"$5,622.82",$0.00,1,1,1,1,1,1,20110101,K0849,HCPCS,PWC GP 3 STD CAP CHAIR,RR,,28 ,,NW,,,,,,$600.58,$0.00,1,1,1,1,1,1,20110101,K0850,HCPCS,PWC GP 3 HD SEAT/BACK,,,28 ,,NW,,,,,,"$6,672.86",$0.00,1,1,1,1,1,1,20110101,K0850,HCPCS,PWC GP 3 HD SEAT/BACK,RR,,28 ,,NW,,,,,,$712.64,$0.00,1,1,1,1,1,1,20110101,K0851,HCPCS,PWC GP 3 HD CAP CHAIR,,,28 ,,NW,,,,,,"$6,436.53",$0.00,1,1,1,1,1,1,20110101,K0851,HCPCS,PWC GP 3 HD CAP CHAIR,RR,,28 ,,NW,,,,,,$687.42,$0.00,1,1,1,1,1,1,20110101,K0852,HCPCS,PWC GP 3 VHD SEAT/BACK,,,28 ,,NW,,,,,,"$7,626.46",$0.00,1,1,1,1,1,1,20110101,K0852,HCPCS,PWC GP 3 VHD SEAT/BACK,RR,,28 ,,NW,,,,,,$814.41,$0.00,1,1,1,1,1,1,20110101,K0853,HCPCS,PWC GP 3 VHD CAP CHAIR,,,28 ,,NW,,,,,,"$7,819.55",$0.00,1,1,1,1,1,1,20110101,K0853,HCPCS,PWC GP 3 VHD CAP CHAIR,RR,,28 ,,NW,,,,,,$835.02,$0.00,1,1,1,1,1,1,20110101,K0854,HCPCS,PWC GP 3 XHD SEAT/BACK,,,28 ,,NW,,,,,,"$10,184.49",$0.00,1,1,1,1,1,1,20110101,K0854,HCPCS,PWC GP 3 XHD SEAT/BACK,RR,,28 ,,NW,,,,,,"$1,087.40",$0.00,1,1,1,1,1,1,20110101,K0855,HCPCS,PWC GP 3 XHD CAP CHAIR,,,28 ,,NW,,,,,,"$9,650.56",$0.00,1,1,1,1,1,1,20110101,K0855,HCPCS,PWC GP 3 XHD CAP CHAIR,RR,,28 ,,NW,,,,,,"$1,030.42",$0.00,1,1,1,1,1,1,20110101,K0856,HCPCS,PWC GP3 STD SING POW OPT S/B,,,28 ,,NW,,,,,,"$6,214.91",$0.00,1,1,1,1,1,1,20110101,K0856,HCPCS,PWC GP3 STD SING POW OPT S/B,RR,,28 ,,NW,,,,,,$663.77,$0.00,1,1,1,1,1,1,20110101,K0857,HCPCS,PWC GP3 STD SING POW OPT CAP,,,28 ,,NW,,,,,,"$6,328.70",$0.00,1,1,1,1,1,1,20110101,K0857,HCPCS,PWC GP3 STD SING POW OPT CAP,RR,,28 ,,NW,,,,,,$675.91,$0.00,1,1,1,1,1,1,20110101,K0858,HCPCS,PWC GP3 HD SING POW OPT S/B,,,28 ,,NW,,,,,,"$7,581.34",$0.00,1,1,1,1,1,1,20110101,K0858,HCPCS,PWC GP3 HD SING POW OPT S/B,RR,,28 ,,NW,,,,,,$809.59,$0.00,1,1,1,1,1,1,20110101,K0859,HCPCS,PWC GP3 HD SING POW OPT CAP,,,28 ,,NW,,,,,,"$7,255.21",$0.00,1,1,1,1,1,1,20110101,K0859,HCPCS,PWC GP3 HD SING POW OPT CAP,RR,,28 ,,NW,,,,,,$774.79,$0.00,1,1,1,1,1,1,20110101,K0860,HCPCS,PWC GP3 VHD SING POW OPT S/B,,,28 ,,NW,,,,,,"$10,600.41",$0.00,1,1,1,1,1,1,20110101,K0860,HCPCS,PWC GP3 VHD SING POW OPT S/B,RR,,28 ,,NW,,,,,,"$1,131.79",$0.00,1,1,1,1,1,1,20110101,K0861,HCPCS,PWC GP3 STD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$13,548.48",$0.00,1,1,1,1,1,1,20110101,K0861,HCPCS,PWC GP3 STD MULT POW OPT S/B,RR,,28 ,,NW,,,,,,"$1,446.41",$0.00,1,1,1,1,1,1,20110101,K0862,HCPCS,PWC GP3 HD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$7,581.34",$0.00,1,1,1,1,1,1,20110101,K0862,HCPCS,PWC GP3 HD MULT POW OPT S/B,RR,,28 ,,NW,,,,,,$809.59,$0.00,1,1,1,1,1,1,20110101,K0863,HCPCS,PWC GP3 VHD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$10,600.41",$0.00,1,1,1,1,1,1,20110101,K0863,HCPCS,PWC GP3 VHD MULT POW OPT S/B,RR,,28 ,,NW,,,,,,"$1,131.79",$0.00,1,1,1,1,1,1,20110101,K0864,HCPCS,PWC GP3 XHD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$12,512.37",$0.00,1,1,1,1,1,1,20110101,K0864,HCPCS,PWC GP3 XHD MULT POW OPT S/B,RR,,28 ,,NW,,,,,,"$1,335.84",$0.00,1,1,1,1,1,1,20110101,K0868,HCPCS,PWC GP 4 STD SEAT/BACK,,,28 ,,NW,,,,,,"$5,121.69",$0.00,1,1,1,1,1,1,20110101,K0869,HCPCS,PWC GP 4 STD CAP CHAIR,,,28 ,,NW,,,,,,"$2,715.85",$0.00,1,1,1,1,1,1,20110101,K0870,HCPCS,PWC GP 4 HD SEAT/BACK,,,28 ,,NW,,,,,,"$6,038.49",$0.00,1,1,1,1,1,1,20110101,K0871,HCPCS,PWC GP 4 VHD SEAT/BACK,,,28 ,,NW,,,,,,"$6,266.81",$0.00,1,1,1,1,1,1,20110101,K0877,HCPCS,PWC GP4 STD SING POW OPT S/B,,,28 ,,NW,,,,,,"$6,538.20",$0.00,1,1,1,1,1,1,20110101,K0878,HCPCS,PWC GP4 STD SING POW OPT CAP,,,28 ,,NW,,,,,,"$3,466.97",$0.00,1,1,1,1,1,1,20110101,K0879,HCPCS,PWC GP4 HD SING POW OPT S/B,,,28 ,,NW,,,,,,"$4,130.29",$0.00,1,1,1,1,1,1,20110101,K0880,HCPCS,PWC GP4 VHD SING POW OPT S/B,,,28 ,,NW,,,,,,"$2,786.65",$0.00,1,1,1,1,1,1,20110101,K0884,HCPCS,PWC GP4 STD MULT POW OPT S/B,,,28 ,,NW,,,,,,"$6,704.15",$0.00,1,1,1,1,1,1,20110101,K0885,HCPCS,PWC GP4 STD MULT POW OPT CAP,,,28 ,,NW,,,,,,"$6,732.18",$0.00,1,1,1,1,1,1,20110101,K0886,HCPCS,PWC GP4 HD MULT POW S/B,,,28 ,,NW,,,,,,"$5,387.89",$0.00,1,1,1,1,1,1,20110101,K0890,HCPCS,PWC GP5 PED SING POW OPT S/B,,,28 ,,NW,,,,,,"$3,024.83",$0.00,1,1,1,1,1,1,20110101,K0891,HCPCS,PWC GP5 PED MULT POW OPT S/B,,,28 ,,NW,,,,,,"$3,101.60",$0.00,1,1,1,1,1,1,20110101,K0898,HCPCS,POWER WHEELCHAIR NOC,,,28 ,,NW,,,,,,"$2,983.21",$0.00,1,1,1,1,1,1,20110101,K0899,HCPCS,POW MOBIL DEV NO DME PDAC,,,28 ,,NW,,,,,,"$3,154.52",$0.00,1,1,1,1,1,1,20110101,L0112,HCPCS,CRANIAL CERVICAL ORTHOSIS,,,28 ,,NW,,,,,,"$2,001.00",$0.00,1,1,1,1,1,1,20110101,L0113,HCPCS,CRANIAL CERVICAL TORTICOLLIS,,,28 ,,NW,,,,,,$369.72,$0.00,1,1,1,1,1,1,20110101,L0120,HCPCS,CERV FLEXIBLE NON-ADJUSTABLE,,,28 ,,NW,,,,,,$37.91,$0.00,1,1,1,1,1,1,20110101,L0130,HCPCS,FLEX THERMOPLASTIC COLLAR MO,,,28 ,,NW,,,,,,$214.33,$0.00,1,1,1,1,1,1,20110101,L0140,HCPCS,CERVICAL SEMI-RIGID ADJUSTAB,,,28 ,,NW,,,,,,$82.49,$0.00,1,1,1,1,1,1,20110101,L0150,HCPCS,CERV SEMI-RIG ADJ MOLDED CHN,,,28 ,,NW,,,,,,$143.61,$0.00,1,1,1,1,1,1,20110101,L0160,HCPCS,CERV SEMI-RIG WIRE OCC/MAND,,,28 ,,NW,,,,,,$203.74,$0.00,1,1,1,1,1,1,20110101,L0170,HCPCS,CERVICAL COLLAR MOLDED TO PT,,,28 ,,NW,,,,,,$993.69,$0.00,1,1,1,1,1,1,20110101,L0172,HCPCS,CERV COL THERMPLAS FOAM 2 PI,,,28 ,,NW,,,,,,$170.12,$0.00,1,1,1,1,1,1,20110101,L0174,HCPCS,CERV COL FOAM 2 PIECE W THOR,,,28 ,,NW,,,,,,$367.45,$0.00,1,1,1,1,1,1,20110101,L0180,HCPCS,CER POST COL OCC/MAN SUP ADJ,,,28 ,,NW,,,,,,$537.65,$0.00,1,1,1,1,1,1,20110101,L0190,HCPCS,CERV COLLAR SUPP ADJ CERV BA,,,28 ,,NW,,,,,,$735.53,$0.00,1,1,1,1,1,1,20110101,L0200,HCPCS,CERV COL SUPP ADJ BAR & THOR,,,28 ,,NW,,,,,,$772.46,$0.00,1,1,1,1,1,1,20110101,L0220,HCPCS,THOR RIB BELT CUSTOM FABRICA,,,28 ,,NW,,,,,,$158.04,$0.00,1,1,1,1,1,1,20110101,L0430,HCPCS,DEWALL POSTURE PROTECTOR,,,28 ,,NW,,,,,,"$2,070.97",$0.00,1,1,1,1,1,1,20110101,L0450,HCPCS,TLSO FLEX PREFAB THORACIC,,,28 ,,NW,,,,,,$227.69,$0.00,1,1,1,1,1,1,20110101,L0452,HCPCS,TLSO FLEX CUSTOM FAB THORACI,,,28 ,,NW,,,,,,$343.53,$0.00,1,1,1,1,1,1,20110101,L0454,HCPCS,TLSO FLEX PREFAB SACROCOC-T9,,,28 ,,NW,,,,,,$459.37,$0.00,1,1,1,1,1,1,20110101,L0456,HCPCS,TLSO FLEX PREFAB,,,28 ,,NW,,,,,,"$1,407.90",$0.00,1,1,1,1,1,1,20110101,L0458,HCPCS,TLSO 2MOD SYMPHIS-XIPHO PRE,,,28 ,,NW,,,,,,"$1,257.44",$0.00,1,1,1,1,1,1,20110101,L0460,HCPCS,TLSO2MOD SYMPHYSIS-STERN PRE,,,28 ,,NW,,,,,,"$1,421.43",$0.00,1,1,1,1,1,1,20110101,L0462,HCPCS,TLSO 3MOD SACRO-SCAP PRE,,,28 ,,NW,,,,,,"$1,779.85",$0.00,1,1,1,1,1,1,20110101,L0464,HCPCS,TLSO 4MOD SACRO-SCAP PRE,,,28 ,,NW,,,,,,"$2,128.12",$0.00,1,1,1,1,1,1,20110101,L0466,HCPCS,TLSO RIGID FRAME PRE SOFT AP,,,28 ,,NW,,,,,,$533.50,$0.00,1,1,1,1,1,1,20110101,L0468,HCPCS,TLSO RIGID FRAME PREFAB PELV,,,28 ,,NW,,,,,,$670.10,$0.00,1,1,1,1,1,1,20110101,L0470,HCPCS,TLSO RIGID FRAME PRE SUBCLAV,,,28 ,,NW,,,,,,$951.78,$0.00,1,1,1,1,1,1,20110101,L0472,HCPCS,TLSO RIGID FRAME HYPEREX PRE,,,28 ,,NW,,,,,,$590.21,$0.00,1,1,1,1,1,1,20110101,L0480,HCPCS,TLSO RIGID PLASTIC CUSTOM FA,,,28 ,,NW,,,,,,"$2,134.12",$0.00,1,1,1,1,1,1,20110101,L0482,HCPCS,TLSO RIGID LINED CUSTOM FAB,,,28 ,,NW,,,,,,"$2,352.16",$0.00,1,1,1,1,1,1,20110101,L0484,HCPCS,TLSO RIGID PLASTIC CUST FAB,,,28 ,,NW,,,,,,"$2,620.30",$0.00,1,1,1,1,1,1,20110101,L0486,HCPCS,TLSO RIGIDLINED CUST FAB TWO,,,28 ,,NW,,,,,,"$2,786.84",$0.00,1,1,1,1,1,1,20110101,L0488,HCPCS,TLSO RIGID LINED PRE ONE PIE,,,28 ,,NW,,,,,,"$1,421.43",$0.00,1,1,1,1,1,1,20110101,L0490,HCPCS,TLSO RIGID PLASTIC PRE ONE,,,28 ,,NW,,,,,,$365.73,$0.00,1,1,1,1,1,1,20110101,L0491,HCPCS,TLSO 2 PIECE RIGID SHELL,,,28 ,,NW,,,,,,"$1,076.11",$0.00,1,1,1,1,1,1,20110101,L0492,HCPCS,TLSO 3 PIECE RIGID SHELL,,,28 ,,NW,,,,,,$688.88,$0.00,1,1,1,1,1,1,20110101,L0621,HCPCS,SIO FLEX PELVISACRAL PREFAB,,,28 ,,NW,,,,,,$120.69,$0.00,1,1,1,1,1,1,20110101,L0622,HCPCS,SIO FLEX PELVISACRAL CUSTOM,,,28 ,,NW,,,,,,$352.82,$0.00,1,1,1,1,1,1,20110101,L0623,HCPCS,SIO PANEL PREFAB,,,28 ,,NW,,,,,,$74.78,$0.00,1,1,1,1,1,1,20110101,L0624,HCPCS,SIO PANEL CUSTOM,,,28 ,,NW,,,,,,$101.20,$0.00,1,1,1,1,1,1,20110101,L0625,HCPCS,LO FLEXIBL L1-BELOW L5 PRE,,,28 ,,NW,,,,,,$70.15,$0.00,1,1,1,1,1,1,20110101,L0626,HCPCS,LO SAG STAYS/PANELS PRE-FAB,,,28 ,,NW,,,,,,$97.57,$0.00,1,1,1,1,1,1,20110101,L0627,HCPCS,LO SAGITT RIGID PANEL PREFAB,,,28 ,,NW,,,,,,$553.45,$0.00,1,1,1,1,1,1,20110101,L0628,HCPCS,LO FLEX W/O RIGID STAYS PRE,,,28 ,,NW,,,,,,$104.69,$0.00,1,1,1,1,1,1,20110101,L0629,HCPCS,LSO FLEX W/RIGID STAYS CUST,,,28 ,,NW,,,,,,$133.45,$0.00,1,1,1,1,1,1,20110101,L0630,HCPCS,LSO POST RIGID PANEL PRE,,,28 ,,NW,,,,,,$198.33,$0.00,1,1,1,1,1,1,20110101,L0631,HCPCS,LSO SAG-CORO RIGID FRAME PRE,,,28 ,,NW,,,,,,"$1,454.85",$0.00,1,1,1,1,1,1,20110101,L0632,HCPCS,LSO SAG RIGID FRAME CUST,,,28 ,,NW,,,,,,"$2,019.51",$0.00,1,1,1,1,1,1,20110101,L0633,HCPCS,LSO FLEXION CONTROL PREFAB,,,28 ,,NW,,,,,,$371.43,$0.00,1,1,1,1,1,1,20110101,L0634,HCPCS,LSO FLEXION CONTROL CUSTOM,,,28 ,,NW,,,,,,$515.59,$0.00,1,1,1,1,1,1,20110101,L0635,HCPCS,LSO SAGIT RIGID PANEL PREFAB,,,28 ,,NW,,,,,,"$1,467.22",$0.00,1,1,1,1,1,1,20110101,L0636,HCPCS,LSO SAGITTAL RIGID PANEL CUS,,,28 ,,NW,,,,,,"$2,157.42",$0.00,1,1,1,1,1,1,20110101,L0637,HCPCS,LSO SAG-CORONAL PANEL PREFAB,,,28 ,,NW,,,,,,"$1,735.51",$0.00,1,1,1,1,1,1,20110101,L0638,HCPCS,LSO SAG-CORONAL PANEL CUSTOM,,,28 ,,NW,,,,,,"$1,882.82",$0.00,1,1,1,1,1,1,20110101,L0639,HCPCS,LSO S/C SHELL/PANEL PREFAB,,,28 ,,NW,,,,,,"$1,735.51",$0.00,1,1,1,1,1,1,20110101,L0640,HCPCS,LSO S/C SHELL/PANEL CUSTOM,,,28 ,,NW,,,,,,"$1,483.76",$0.00,1,1,1,1,1,1,20110101,L0700,HCPCS,CTLSO A-P-L CONTROL MOLDED,,,28 ,,NW,,,,,,"$3,063.80",$0.00,1,1,1,1,1,1,20110101,L0710,HCPCS,CTLSO A-P-L CONTROL W/ INTER,,,28 ,,NW,,,,,,"$3,246.18",$0.00,1,1,1,1,1,1,20110101,L0810,HCPCS,HALO CERVICAL INTO JCKT VEST,,,28 ,,NW,,,,,,"$3,917.89",$0.00,1,1,1,1,1,1,20110101,L0820,HCPCS,HALO CERVICAL INTO BODY JACK,,,28 ,,NW,,,,,,"$3,217.85",$0.00,1,1,1,1,1,1,20110101,L0830,HCPCS,HALO CERV INTO MILWAUKEE TYP,,,28 ,,NW,,,,,,"$4,801.45",$0.00,1,1,1,1,1,1,20110101,L0859,HCPCS,MRI COMPATIBLE SYSTEM,,,28 ,,NW,,,,,,"$1,747.01",$0.00,1,1,1,1,1,1,20110101,L0861,HCPCS,HALO REPL LINER/INTERFACE,,,28 ,,NW,,,,,,$267.12,$0.00,1,1,1,1,1,1,20110101,L0970,HCPCS,TLSO CORSET FRONT,,,28 ,,NW,,,,,,$148.96,$0.00,1,1,1,1,1,1,20110101,L0972,HCPCS,LSO CORSET FRONT,,,28 ,,NW,,,,,,$137.87,$0.00,1,1,1,1,1,1,20110101,L0974,HCPCS,TLSO FULL CORSET,,,28 ,,NW,,,,,,$237.05,$0.00,1,1,1,1,1,1,20110101,L0976,HCPCS,LSO FULL CORSET,,,28 ,,NW,,,,,,$205.78,$0.00,1,1,1,1,1,1,20110101,L0978,HCPCS,AXILLARY CRUTCH EXTENSION,,,28 ,,NW,,,,,,$245.41,$0.00,1,1,1,1,1,1,20110101,L0980,HCPCS,PERONEAL STRAPS PAIR,,,28 ,,NW,,,,,,$25.73,$0.00,1,1,1,1,1,1,20110101,L0982,HCPCS,STOCKING SUPP GRIPS SET OF F,,,28 ,,NW,,,,,,$24.57,$0.00,1,1,1,1,1,1,20110101,L0984,HCPCS,PROTECTIVE BODY SOCK EACH,,,28 ,,NW,,,,,,$79.15,$0.00,1,1,1,1,1,1,20110101,L0999,HCPCS,ADD TO SPINAL ORTHOSIS NOS,,,28 ,,NW,,,,,,$137.87,$0.00,1,1,1,1,1,1,20110101,L1000,HCPCS,CTLSO MILWAUKE INITIAL MODEL,,,28 ,,NW,,,,,,"$3,055.82",$0.00,1,1,1,1,1,1,20110101,L1001,HCPCS,CTLSO INFANT IMMOBILIZER,,,28 ,,NW,,,,,,$57.50,$0.00,1,1,1,1,1,1,20110101,L1005,HCPCS,TENSION BASED SCOLIOSIS ORTH,,,28 ,,NW,,,,,,"$4,638.28",$0.00,1,1,1,1,1,1,20110101,L1010,HCPCS,CTLSO AXILLA SLING,,,28 ,,NW,,,,,,$91.66,$0.00,1,1,1,1,1,1,20110101,L1020,HCPCS,KYPHOSIS PAD,,,28 ,,NW,,,,,,$122.39,$0.00,1,1,1,1,1,1,20110101,L1025,HCPCS,KYPHOSIS PAD FLOATING,,,28 ,,NW,,,,,,$168.49,$0.00,1,1,1,1,1,1,20110101,L1030,HCPCS,LUMBAR BOLSTER PAD,,,28 ,,NW,,,,,,$88.14,$0.00,1,1,1,1,1,1,20110101,L1040,HCPCS,LUMBAR OR LUMBAR RIB PAD,,,28 ,,NW,,,,,,$108.74,$0.00,1,1,1,1,1,1,20110101,L1050,HCPCS,STERNAL PAD,,,28 ,,NW,,,,,,$115.18,$0.00,1,1,1,1,1,1,20110101,L1060,HCPCS,THORACIC PAD,,,28 ,,NW,,,,,,$127.94,$0.00,1,1,1,1,1,1,20110101,L1070,HCPCS,TRAPEZIUS SLING,,,28 ,,NW,,,,,,$124.91,$0.00,1,1,1,1,1,1,20110101,L1080,HCPCS,OUTRIGGER,,,28 ,,NW,,,,,,$74.30,$0.00,1,1,1,1,1,1,20110101,L1085,HCPCS,OUTRIGGER BIL W/ VERT EXTENS,,,28 ,,NW,,,,,,$209.43,$0.00,1,1,1,1,1,1,20110101,L1090,HCPCS,LUMBAR SLING,,,28 ,,NW,,,,,,$122.57,$0.00,1,1,1,1,1,1,20110101,L1100,HCPCS,RING FLANGE PLASTIC/LEATHER,,,28 ,,NW,,,,,,$212.57,$0.00,1,1,1,1,1,1,20110101,L1110,HCPCS,RING FLANGE PLAS/LEATHER MOL,,,28 ,,NW,,,,,,$358.96,$0.00,1,1,1,1,1,1,20110101,L1120,HCPCS,COVERS FOR UPRIGHT EACH,,,28 ,,NW,,,,,,$54.67,$0.00,1,1,1,1,1,1,20110101,L1200,HCPCS,FURNSH INITIAL ORTHOSIS ONLY,,,28 ,,NW,,,,,,"$2,483.32",$0.00,1,1,1,1,1,1,20110101,L1210,HCPCS,LATERAL THORACIC EXTENSION,,,28 ,,NW,,,,,,$348.15,$0.00,1,1,1,1,1,1,20110101,L1220,HCPCS,ANTERIOR THORACIC EXTENSION,,,28 ,,NW,,,,,,$304.42,$0.00,1,1,1,1,1,1,20110101,L1230,HCPCS,MILWAUKEE TYPE SUPERSTRUCTUR,,,28 ,,NW,,,,,,$823.82,$0.00,1,1,1,1,1,1,20110101,L1240,HCPCS,LUMBAR DEROTATION PAD,,,28 ,,NW,,,,,,$107.49,$0.00,1,1,1,1,1,1,20110101,L1250,HCPCS,ANTERIOR ASIS PAD,,,28 ,,NW,,,,,,$98.94,$0.00,1,1,1,1,1,1,20110101,L1260,HCPCS,ANTERIOR THORACIC DEROTATION,,,28 ,,NW,,,,,,$105.21,$0.00,1,1,1,1,1,1,20110101,L1270,HCPCS,ABDOMINAL PAD,,,28 ,,NW,,,,,,$105.41,$0.00,1,1,1,1,1,1,20110101,L1280,HCPCS,RIB GUSSET (ELASTIC) EACH,,,28 ,,NW,,,,,,$113.09,$0.00,1,1,1,1,1,1,20110101,L1290,HCPCS,LATERAL TROCHANTERIC PAD,,,28 ,,NW,,,,,,$104.71,$0.00,1,1,1,1,1,1,20110101,L1300,HCPCS,BODY JACKET MOLD TO PATIENT,,,28 ,,NW,,,,,,"$2,598.52",$0.00,1,1,1,1,1,1,20110101,L1310,HCPCS,POST-OPERATIVE BODY JACKET,,,28 ,,NW,,,,,,"$2,624.13",$0.00,1,1,1,1,1,1,20110101,L1499,HCPCS,SPINAL ORTHOSIS NOS,,,28 ,,NW,,,,,,"$2,598.52",$0.00,1,1,1,1,1,1,20110101,L1500,HCPCS,THKAO MOBILITY FRAME,,,28 ,,NW,,,,,,"$2,883.67",$0.00,1,1,1,1,1,1,20110101,L1510,HCPCS,THKAO STANDING FRAME,,,28 ,,NW,,,,,,"$1,827.41",$0.00,1,1,1,1,1,1,20110101,L1520,HCPCS,THKAO SWIVEL WALKER,,,28 ,,NW,,,,,,"$3,668.60",$0.00,1,1,1,1,1,1,20110101,L1600,HCPCS,ABDUCT HIP FLEX FREJKA W CVR,,,28 ,,NW,,,,,,$165.43,$0.00,1,1,1,1,1,1,20110101,L1610,HCPCS,ABDUCT HIP FLEX FREJKA COVR,,,28 ,,NW,,,,,,$61.91,$0.00,1,1,1,1,1,1,20110101,L1620,HCPCS,ABDUCT HIP FLEX PAVLIK HARNE,,,28 ,,NW,,,,,,$176.67,$0.00,1,1,1,1,1,1,20110101,L1630,HCPCS,ABDUCT CONTROL HIP SEMI-FLEX,,,28 ,,NW,,,,,,$214.53,$0.00,1,1,1,1,1,1,20110101,L1640,HCPCS,PELV BAND/SPREAD BAR THIGH C,,,28 ,,NW,,,,,,$647.60,$0.00,1,1,1,1,1,1,20110101,L1650,HCPCS,HO ABDUCTION HIP ADJUSTABLE,,,28 ,,NW,,,,,,$303.99,$0.00,1,1,1,1,1,1,20110101,L1652,HCPCS,HO BI THIGHCUFFS W SPRDR BAR,,,28 ,,NW,,,,,,$473.49,$0.00,1,1,1,1,1,1,20110101,L1660,HCPCS,HO ABDUCTION STATIC PLASTIC,,,28 ,,NW,,,,,,$212.50,$0.00,1,1,1,1,1,1,20110101,L1680,HCPCS,PELVIC & HIP CONTROL THIGH C,,,28 ,,NW,,,,,,"$1,860.28",$0.00,1,1,1,1,1,1,20110101,L1685,HCPCS,POST-OP HIP ABDUCT CUSTOM FA,,,28 ,,NW,,,,,,"$1,800.74",$0.00,1,1,1,1,1,1,20110101,L1686,HCPCS,HO POST-OP HIP ABDUCTION,,,28 ,,NW,,,,,,"$1,407.35",$0.00,1,1,1,1,1,1,20110101,L1690,HCPCS,COMBINATION BILATERAL HO,,,28 ,,NW,,,,,,"$2,783.14",$0.00,1,1,1,1,1,1,20110101,L1700,HCPCS,LEG PERTHES ORTH TORONTO TYP,,,28 ,,NW,,,,,,"$2,341.15",$0.00,1,1,1,1,1,1,20110101,L1710,HCPCS,LEGG PERTHES ORTH NEWINGTON,,,28 ,,NW,,,,,,"$2,823.72",$0.00,1,1,1,1,1,1,20110101,L1720,HCPCS,LEGG PERTHES ORTHOSIS TRILAT,,,28 ,,NW,,,,,,"$2,062.42",$0.00,1,1,1,1,1,1,20110101,L1730,HCPCS,LEGG PERTHES ORTH SCOTTISH R,,,28 ,,NW,,,,,,"$1,710.85",$0.00,1,1,1,1,1,1,20110101,L1755,HCPCS,LEGG PERTHES PATTEN BOTTOM T,,,28 ,,NW,,,,,,"$2,420.90",$0.00,1,1,1,1,1,1,20110101,L1810,HCPCS,KO ELASTIC WITH JOINTS,,,28 ,,NW,,,,,,$133.69,$0.00,1,1,1,1,1,1,20110101,L1820,HCPCS,KO ELAS W/ CONDYLE PADS & JO,,,28 ,,NW,,,,,,$169.07,$0.00,1,1,1,1,1,1,20110101,L1830,HCPCS,KO IMMOBILIZER CANVAS LONGIT,,,28 ,,NW,,,,,,$117.46,$0.00,1,1,1,1,1,1,20110101,L1831,HCPCS,KNEE ORTH POS LOCKING JOINT,,,28 ,,NW,,,,,,$382.48,$0.00,1,1,1,1,1,1,20110101,L1832,HCPCS,KO ADJ JNT POS RIGID SUPPORT,,,28 ,,NW,,,,,,$953.08,$0.00,1,1,1,1,1,1,20110101,L1834,HCPCS,KO W/0 JOINT RIGID MOLDED TO,,,28 ,,NW,,,,,,"$1,152.18",$0.00,1,1,1,1,1,1,20110101,L1836,HCPCS,RIGID KO WO JOINTS,,,28 ,,NW,,,,,,$164.10,$0.00,1,1,1,1,1,1,20110101,L1840,HCPCS,KO DEROT ANT CRUCIATE CUSTOM,,,28 ,,NW,,,,,,"$1,411.52",$0.00,1,1,1,1,1,1,20110101,L1843,HCPCS,KO SINGLE UPRIGHT CUSTOM FIT,,,28 ,,NW,,,,,,"$1,265.39",$0.00,1,1,1,1,1,1,20110101,L1844,HCPCS,KO W/ADJ JT ROT CNTRL MOLDED,,,28 ,,NW,,,,,,"$2,388.15",$0.00,1,1,1,1,1,1,20110101,L1845,HCPCS,KO W/ ADJ FLEX/EXT ROTAT CUS,,,28 ,,NW,,,,,,"$1,223.81",$0.00,1,1,1,1,1,1,20110101,L1846,HCPCS,KO W ADJ FLEX/EXT ROTAT MOLD,,,28 ,,NW,,,,,,"$1,722.90",$0.00,1,1,1,1,1,1,20110101,L1847,HCPCS,KO ADJUSTABLE W AIR CHAMBERS,,,28 ,,NW,,,,,,$793.74,$0.00,1,1,1,1,1,1,20110101,L1850,HCPCS,KO SWEDISH TYPE,,,28 ,,NW,,,,,,$397.24,$0.00,1,1,1,1,1,1,20110101,L1860,HCPCS,KO SUPRACONDYLAR SOCKET MOLD,,,28 ,,NW,,,,,,"$1,656.47",$0.00,1,1,1,1,1,1,20110101,L1900,HCPCS,AFO SPRNG WIR DRSFLX CALF BD,,,28 ,,NW,,,,,,$368.47,$0.00,1,1,1,1,1,1,20110101,L1902,HCPCS,AFO ANKLE GAUNTLET,,,28 ,,NW,,,,,,$106.43,$0.00,1,1,1,1,1,1,20110101,L1904,HCPCS,AFO MOLDED ANKLE GAUNTLET,,,28 ,,NW,,,,,,$665.08,$0.00,1,1,1,1,1,1,20110101,L1906,HCPCS,AFO MULTILIGAMENTUS ANKLE SU,,,28 ,,NW,,,,,,$154.44,$0.00,1,1,1,1,1,1,20110101,L1907,HCPCS,AFO SUPRAMALLEOLAR CUSTOM,,,28 ,,NW,,,,,,$775.47,$0.00,1,1,1,1,1,1,20110101,L1910,HCPCS,AFO SING BAR CLASP ATTACH SH,,,28 ,,NW,,,,,,$371.16,$0.00,1,1,1,1,1,1,20110101,L1920,HCPCS,AFO SING UPRIGHT W/ ADJUST S,,,28 ,,NW,,,,,,$480.86,$0.00,1,1,1,1,1,1,20110101,L1930,HCPCS,AFO PLASTIC,,,28 ,,NW,,,,,,$325.49,$0.00,1,1,1,1,1,1,20110101,L1932,HCPCS,AFO RIG ANT TIB PREFAB TCF/=,,,28 ,,NW,,,,,,"$1,258.20",$0.00,1,1,1,1,1,1,20110101,L1940,HCPCS,AFO MOLDED TO PATIENT PLASTI,,,28 ,,NW,,,,,,$723.25,$0.00,1,1,1,1,1,1,20110101,L1945,HCPCS,AFO MOLDED PLAS RIG ANT TIB,,,28 ,,NW,,,,,,"$1,441.15",$0.00,1,1,1,1,1,1,20110101,L1950,HCPCS,AFO SPIRAL MOLDED TO PT PLAS,,,28 ,,NW,,,,,,"$1,124.25",$0.00,1,1,1,1,1,1,20110101,L1951,HCPCS,AFO SPIRAL PREFABRICATED,,,28 ,,NW,,,,,,"$1,181.29",$0.00,1,1,1,1,1,1,20110101,L1960,HCPCS,AFO POS SOLID ANK PLASTIC MO,,,28 ,,NW,,,,,,$825.23,$0.00,1,1,1,1,1,1,20110101,L1970,HCPCS,AFO PLASTIC MOLDED W/ANKLE J,,,28 ,,NW,,,,,,"$1,040.32",$0.00,1,1,1,1,1,1,20110101,L1971,HCPCS,"AFO W/ANKLE JOINT, PREFAB",,,28 ,,NW,,,,,,$637.87,$0.00,1,1,1,1,1,1,20110101,L1980,HCPCS,AFO SING SOLID STIRRUP CALF,,,28 ,,NW,,,,,,$527.46,$0.00,1,1,1,1,1,1,20110101,L1990,HCPCS,AFO DOUB SOLID STIRRUP CALF,,,28 ,,NW,,,,,,$651.06,$0.00,1,1,1,1,1,1,20110101,L2000,HCPCS,KAFO SING FRE STIRR THI/CALF,,,28 ,,NW,,,,,,"$1,529.08",$0.00,1,1,1,1,1,1,20110101,L2005,HCPCS,KAFO SNG/DBL MECHANICAL ACT,,,28 ,,NW,,,,,,"$5,952.32",$0.00,1,1,1,1,1,1,20110101,L2010,HCPCS,KAFO SNG SOLID STIRRUP W/O J,,,28 ,,NW,,,,,,"$1,395.47",$0.00,1,1,1,1,1,1,20110101,L2020,HCPCS,KAFO DBL SOLID STIRRUP BAND/,,,28 ,,NW,,,,,,"$1,728.00",$0.00,1,1,1,1,1,1,20110101,L2030,HCPCS,KAFO DBL SOLID STIRRUP W/O J,,,28 ,,NW,,,,,,"$1,550.52",$0.00,1,1,1,1,1,1,20110101,L2034,HCPCS,KAFO PLA SIN UP W/WO K/A CUS,,,28 ,,NW,,,,,,"$2,950.38",$0.00,1,1,1,1,1,1,20110101,L2035,HCPCS,KAFO PLASTIC PEDIATRIC SIZE,,,28 ,,NW,,,,,,$212.91,$0.00,1,1,1,1,1,1,20110101,L2036,HCPCS,KAFO PLAS DOUB FREE KNEE MOL,,,28 ,,NW,,,,,,"$2,807.57",$0.00,1,1,1,1,1,1,20110101,L2037,HCPCS,KAFO PLAS SING FREE KNEE MOL,,,28 ,,NW,,,,,,"$2,550.84",$0.00,1,1,1,1,1,1,20110101,L2038,HCPCS,KAFO W/O JOINT MULTI-AXIS AN,,,28 ,,NW,,,,,,"$2,123.91",$0.00,1,1,1,1,1,1,20110101,L2040,HCPCS,HKAFO TORSION BIL ROT STRAPS,,,28 ,,NW,,,,,,$225.09,$0.00,1,1,1,1,1,1,20110101,L2050,HCPCS,HKAFO TORSION CABLE HIP PELV,,,28 ,,NW,,,,,,$689.76,$0.00,1,1,1,1,1,1,20110101,L2060,HCPCS,HKAFO TORSION BALL BEARING J,,,28 ,,NW,,,,,,$855.90,$0.00,1,1,1,1,1,1,20110101,L2070,HCPCS,HKAFO TORSION UNILAT ROT STR,,,28 ,,NW,,,,,,$177.85,$0.00,1,1,1,1,1,1,20110101,L2080,HCPCS,HKAFO UNILAT TORSION CABLE,,,28 ,,NW,,,,,,$510.66,$0.00,1,1,1,1,1,1,20110101,L2090,HCPCS,HKAFO UNILAT TORSION BALL BR,,,28 ,,NW,,,,,,$641.07,$0.00,1,1,1,1,1,1,20110101,L2106,HCPCS,AFO TIB FX CAST PLASTER MOLD,,,28 ,,NW,,,,,,"$1,049.64",$0.00,1,1,1,1,1,1,20110101,L2108,HCPCS,AFO TIB FX CAST MOLDED TO PT,,,28 ,,NW,,,,,,"$1,615.92",$0.00,1,1,1,1,1,1,20110101,L2112,HCPCS,AFO TIBIAL FRACTURE SOFT,,,28 ,,NW,,,,,,$698.77,$0.00,1,1,1,1,1,1,20110101,L2114,HCPCS,AFO TIB FX SEMI-RIGID,,,28 ,,NW,,,,,,$880.98,$0.00,1,1,1,1,1,1,20110101,L2116,HCPCS,AFO TIBIAL FRACTURE RIGID,,,28 ,,NW,,,,,,"$1,083.63",$0.00,1,1,1,1,1,1,20110101,L2126,HCPCS,KAFO FEM FX CAST THERMOPLAS,,,28 ,,NW,,,,,,"$1,817.62",$0.00,1,1,1,1,1,1,20110101,L2128,HCPCS,KAFO FEM FX CAST MOLDED TO P,,,28 ,,NW,,,,,,"$2,550.96",$0.00,1,1,1,1,1,1,20110101,L2132,HCPCS,KAFO FEMORAL FX CAST SOFT,,,28 ,,NW,,,,,,"$1,219.46",$0.00,1,1,1,1,1,1,20110101,L2134,HCPCS,KAFO FEM FX CAST SEMI-RIGID,,,28 ,,NW,,,,,,"$1,524.40",$0.00,1,1,1,1,1,1,20110101,L2136,HCPCS,KAFO FEMORAL FX CAST RIGID,,,28 ,,NW,,,,,,"$1,814.13",$0.00,1,1,1,1,1,1,20110101,L2180,HCPCS,PLAS SHOE INSERT W ANK JOINT,,,28 ,,NW,,,,,,$156.93,$0.00,1,1,1,1,1,1,20110101,L2182,HCPCS,DROP LOCK KNEE,,,28 ,,NW,,,,,,$123.97,$0.00,1,1,1,1,1,1,20110101,L2184,HCPCS,LIMITED MOTION KNEE JOINT,,,28 ,,NW,,,,,,$158.49,$0.00,1,1,1,1,1,1,20110101,L2186,HCPCS,ADJ MOTION KNEE JNT LERMAN T,,,28 ,,NW,,,,,,$192.55,$0.00,1,1,1,1,1,1,20110101,L2188,HCPCS,QUADRILATERAL BRIM,,,28 ,,NW,,,,,,$425.61,$0.00,1,1,1,1,1,1,20110101,L2190,HCPCS,WAIST BELT,,,28 ,,NW,,,,,,$112.08,$0.00,1,1,1,1,1,1,20110101,L2192,HCPCS,PELVIC BAND & BELT THIGH FLA,,,28 ,,NW,,,,,,$508.36,$0.00,1,1,1,1,1,1,20110101,L2200,HCPCS,LIMITED ANKLE MOTION EA JNT,,,28 ,,NW,,,,,,$66.00,$0.00,1,1,1,1,1,1,20110101,L2210,HCPCS,DORSIFLEXION ASSIST EACH JOI,,,28 ,,NW,,,,,,$88.58,$0.00,1,1,1,1,1,1,20110101,L2220,HCPCS,DORSI & PLANTAR FLEX ASS/RES,,,28 ,,NW,,,,,,$108.09,$0.00,1,1,1,1,1,1,20110101,L2230,HCPCS,SPLIT FLAT CALIPER STIRR & P,,,28 ,,NW,,,,,,$102.83,$0.00,1,1,1,1,1,1,20110101,L2232,HCPCS,"ROCKER BOTTOM, CONTACT AFO",,,28 ,,NW,,,,,,$121.58,$0.00,1,1,1,1,1,1,20110101,L2240,HCPCS,ROUND CALIPER AND PLATE ATTA,,,28 ,,NW,,,,,,$110.34,$0.00,1,1,1,1,1,1,20110101,L2250,HCPCS,FOOT PLATE MOLDED STIRRUP AT,,,28 ,,NW,,,,,,$489.49,$0.00,1,1,1,1,1,1,20110101,L2260,HCPCS,REINFORCED SOLID STIRRUP,,,28 ,,NW,,,,,,$258.33,$0.00,1,1,1,1,1,1,20110101,L2265,HCPCS,LONG TONGUE STIRRUP,,,28 ,,NW,,,,,,$158.18,$0.00,1,1,1,1,1,1,20110101,L2270,HCPCS,VARUS/VALGUS STRAP PADDED/LI,,,28 ,,NW,,,,,,$72.51,$0.00,1,1,1,1,1,1,20110101,L2275,HCPCS,PLASTIC MOD LOW EXT PAD/LINE,,,28 ,,NW,,,,,,$161.27,$0.00,1,1,1,1,1,1,20110101,L2280,HCPCS,MOLDED INNER BOOT,,,28 ,,NW,,,,,,$668.35,$0.00,1,1,1,1,1,1,20110101,L2300,HCPCS,ABDUCTION BAR JOINTED ADJUST,,,28 ,,NW,,,,,,$379.30,$0.00,1,1,1,1,1,1,20110101,L2310,HCPCS,ABDUCTION BAR-STRAIGHT,,,28 ,,NW,,,,,,$161.68,$0.00,1,1,1,1,1,1,20110101,L2320,HCPCS,NON-MOLDED LACER,,,28 ,,NW,,,,,,$269.07,$0.00,1,1,1,1,1,1,20110101,L2330,HCPCS,LACER MOLDED TO PATIENT MODE,,,28 ,,NW,,,,,,$561.16,$0.00,1,1,1,1,1,1,20110101,L2335,HCPCS,ANTERIOR SWING BAND,,,28 ,,NW,,,,,,$317.45,$0.00,1,1,1,1,1,1,20110101,L2340,HCPCS,PRE-TIBIAL SHELL MOLDED TO P,,,28 ,,NW,,,,,,$674.44,$0.00,1,1,1,1,1,1,20110101,L2350,HCPCS,PROSTHETIC TYPE SOCKET MOLDE,,,28 ,,NW,,,,,,"$1,336.46",$0.00,1,1,1,1,1,1,20110101,L2360,HCPCS,EXTENDED STEEL SHANK,,,28 ,,NW,,,,,,$71.65,$0.00,1,1,1,1,1,1,20110101,L2370,HCPCS,PATTEN BOTTOM,,,28 ,,NW,,,,,,$381.48,$0.00,1,1,1,1,1,1,20110101,L2375,HCPCS,TORSION ANK & HALF SOLID STI,,,28 ,,NW,,,,,,$151.72,$0.00,1,1,1,1,1,1,20110101,L2380,HCPCS,TORSION STRAIGHT KNEE JOINT,,,28 ,,NW,,,,,,$162.68,$0.00,1,1,1,1,1,1,20110101,L2385,HCPCS,STRAIGHT KNEE JOINT HEAVY DU,,,28 ,,NW,,,,,,$177.52,$0.00,1,1,1,1,1,1,20110101,L2387,HCPCS,ADD LE POLY KNEE CUSTOM KAFO,,,28 ,,NW,,,,,,$220.13,$0.00,1,1,1,1,1,1,20110101,L2390,HCPCS,OFFSET KNEE JOINT EACH,,,28 ,,NW,,,,,,$139.32,$0.00,1,1,1,1,1,1,20110101,L2395,HCPCS,OFFSET KNEE JOINT HEAVY DUTY,,,28 ,,NW,,,,,,$201.42,$0.00,1,1,1,1,1,1,20110101,L2397,HCPCS,SUSPENSION SLEEVE LOWER EXT,,,28 ,,NW,,,,,,$144.81,$0.00,1,1,1,1,1,1,20110101,L2405,HCPCS,KNEE JOINT DROP LOCK EA JNT,,,28 ,,NW,,,,,,$108.65,$0.00,1,1,1,1,1,1,20110101,L2415,HCPCS,KNEE JOINT CAM LOCK EACH JOI,,,28 ,,NW,,,,,,$149.76,$0.00,1,1,1,1,1,1,20110101,L2425,HCPCS,KNEE DISC/DIAL LOCK/ADJ FLEX,,,28 ,,NW,,,,,,$175.99,$0.00,1,1,1,1,1,1,20110101,L2430,HCPCS,KNEE JNT RATCHET LOCK EA JNT,,,28 ,,NW,,,,,,$175.99,$0.00,1,1,1,1,1,1,20110101,L2492,HCPCS,KNEE LIFT LOOP DROP LOCK RIN,,,28 ,,NW,,,,,,$135.84,$0.00,1,1,1,1,1,1,20110101,L2500,HCPCS,THI/GLUT/ISCHIA WGT BEARING,,,28 ,,NW,,,,,,$433.89,$0.00,1,1,1,1,1,1,20110101,L2510,HCPCS,TH/WGHT BEAR QUAD-LAT BRIM M,,,28 ,,NW,,,,,,"$1,121.01",$0.00,1,1,1,1,1,1,20110101,L2520,HCPCS,TH/WGHT BEAR QUAD-LAT BRIM C,,,28 ,,NW,,,,,,$688.49,$0.00,1,1,1,1,1,1,20110101,L2525,HCPCS,TH/WGHT BEAR NAR M-L BRIM MO,,,28 ,,NW,,,,,,"$1,877.28",$0.00,1,1,1,1,1,1,20110101,L2526,HCPCS,TH/WGHT BEAR NAR M-L BRIM CU,,,28 ,,NW,,,,,,"$1,020.28",$0.00,1,1,1,1,1,1,20110101,L2530,HCPCS,THIGH/WGHT BEAR LACER NON-MO,,,28 ,,NW,,,,,,$317.14,$0.00,1,1,1,1,1,1,20110101,L2540,HCPCS,THIGH/WGHT BEAR LACER MOLDED,,,28 ,,NW,,,,,,$606.89,$0.00,1,1,1,1,1,1,20110101,L2550,HCPCS,THIGH/WGHT BEAR HIGH ROLL CU,,,28 ,,NW,,,,,,$402.72,$0.00,1,1,1,1,1,1,20110101,L2570,HCPCS,HIP CLEVIS TYPE 2 POSIT JNT,,,28 ,,NW,,,,,,$722.44,$0.00,1,1,1,1,1,1,20110101,L2580,HCPCS,PELVIC CONTROL PELVIC SLING,,,28 ,,NW,,,,,,$688.58,$0.00,1,1,1,1,1,1,20110101,L2600,HCPCS,HIP CLEVIS/THRUST BEARING FR,,,28 ,,NW,,,,,,$277.95,$0.00,1,1,1,1,1,1,20110101,L2610,HCPCS,HIP CLEVIS/THRUST BEARING LO,,,28 ,,NW,,,,,,$333.93,$0.00,1,1,1,1,1,1,20110101,L2620,HCPCS,PELVIC CONTROL HIP HEAVY DUT,,,28 ,,NW,,,,,,$378.02,$0.00,1,1,1,1,1,1,20110101,L2622,HCPCS,HIP JOINT ADJUSTABLE FLEXION,,,28 ,,NW,,,,,,$437.09,$0.00,1,1,1,1,1,1,20110101,L2624,HCPCS,HIP ADJ FLEX EXT ABDUCT CONT,,,28 ,,NW,,,,,,$490.13,$0.00,1,1,1,1,1,1,20110101,L2627,HCPCS,PLASTIC MOLD RECIPRO HIP & C,,,28 ,,NW,,,,,,"$2,575.82",$0.00,1,1,1,1,1,1,20110101,L2628,HCPCS,METAL FRAME RECIPRO HIP & CA,,,28 ,,NW,,,,,,"$2,506.83",$0.00,1,1,1,1,1,1,20110101,L2630,HCPCS,PELVIC CONTROL BAND & BELT U,,,28 ,,NW,,,,,,$335.50,$0.00,1,1,1,1,1,1,20110101,L2640,HCPCS,PELVIC CONTROL BAND & BELT B,,,28 ,,NW,,,,,,$477.11,$0.00,1,1,1,1,1,1,20110101,L2650,HCPCS,PELV & THOR CONTROL GLUTEAL,,,28 ,,NW,,,,,,$157.24,$0.00,1,1,1,1,1,1,20110101,L2660,HCPCS,THORACIC CONTROL THORACIC BA,,,28 ,,NW,,,,,,$238.41,$0.00,1,1,1,1,1,1,20110101,L2670,HCPCS,THORAC CONT PARASPINAL UPRIG,,,28 ,,NW,,,,,,$219.03,$0.00,1,1,1,1,1,1,20110101,L2680,HCPCS,THORAC CONT LAT SUPPORT UPRI,,,28 ,,NW,,,,,,$202.63,$0.00,1,1,1,1,1,1,20110101,L2750,HCPCS,PLATING CHROME/NICKEL PR BAR,,,28 ,,NW,,,,,,$106.34,$0.00,1,1,1,1,1,1,20110101,L2755,HCPCS,CARBON GRAPHITE LAMINATION,,,28 ,,NW,,,,,,$160.85,$0.00,1,1,1,1,1,1,20110101,L2760,HCPCS,EXTENSION PER EXTENSION PER,,,28 ,,NW,,,,,,$82.02,$0.00,1,1,1,1,1,1,20110101,L2768,HCPCS,ORTHO SIDEBAR DISCONNECT,,,28 ,,NW,,,,,,$160.34,$0.00,1,1,1,1,1,1,20110101,L2780,HCPCS,NON-CORROSIVE FINISH,,,28 ,,NW,,,,,,$89.41,$0.00,1,1,1,1,1,1,20110101,L2785,HCPCS,DROP LOCK RETAINER EACH,,,28 ,,NW,,,,,,$45.30,$0.00,1,1,1,1,1,1,20110101,L2795,HCPCS,KNEE CONTROL FULL KNEECAP,,,28 ,,NW,,,,,,$111.58,$0.00,1,1,1,1,1,1,20110101,L2800,HCPCS,KNEE CAP MEDIAL OR LATERAL P,,,28 ,,NW,,,,,,$137.51,$0.00,1,1,1,1,1,1,20110101,L2810,HCPCS,KNEE CONTROL CONDYLAR PAD,,,28 ,,NW,,,,,,$104.71,$0.00,1,1,1,1,1,1,20110101,L2820,HCPCS,SOFT INTERFACE BELOW KNEE SE,,,28 ,,NW,,,,,,$112.36,$0.00,1,1,1,1,1,1,20110101,L2830,HCPCS,SOFT INTERFACE ABOVE KNEE SE,,,28 ,,NW,,,,,,$122.49,$0.00,1,1,1,1,1,1,20110101,L2840,HCPCS,TIBIAL LENGTH SOCK FX OR EQU,,,28 ,,NW,,,,,,$60.56,$0.00,1,1,1,1,1,1,20110101,L2850,HCPCS,FEMORAL LGTH SOCK FX OR EQUA,,,28 ,,NW,,,,,,$80.79,$0.00,1,1,1,1,1,1,20110101,L2999,HCPCS,LOWER EXTREMITY ORTHOSIS NOS,,,28 ,,NW,,,,,,$160.85,$0.00,1,1,1,1,1,1,20110101,L3000,HCPCS,FT INSERT UCB BERKELEY SHELL,,,28 ,,NW,,,,,,$411.49,$0.00,1,1,1,1,1,1,20110101,L3001,HCPCS,FOOT INSERT REMOV MOLDED SPE,,,28 ,,NW,,,,,,$162.70,$0.00,1,1,1,1,1,1,20110101,L3002,HCPCS,FOOT INSERT PLASTAZOTE OR EQ,,,28 ,,NW,,,,,,$197.78,$0.00,1,1,1,1,1,1,20110101,L3003,HCPCS,FOOT INSERT SILICONE GEL EAC,,,28 ,,NW,,,,,,$213.05,$0.00,1,1,1,1,1,1,20110101,L3010,HCPCS,FOOT LONGITUDINAL ARCH SUPPO,,,28 ,,NW,,,,,,$213.05,$0.00,1,1,1,1,1,1,20110101,L3020,HCPCS,FOOT LONGITUD/METATARSAL SUP,,,28 ,,NW,,,,,,$242.03,$0.00,1,1,1,1,1,1,20110101,L3030,HCPCS,FOOT ARCH SUPPORT REMOV PREM,,,28 ,,NW,,,,,,$95.60,$0.00,1,1,1,1,1,1,20110101,L3031,HCPCS,FOOT LAMIN/PREPREG COMPOSITE,,,28 ,,NW,,,,,,$168.75,$0.00,1,1,1,1,1,1,20110101,L3040,HCPCS,FT ARCH SUPRT PREMOLD LONGIT,,,28 ,,NW,,,,,,$60.51,$0.00,1,1,1,1,1,1,20110101,L3050,HCPCS,FOOT ARCH SUPP PREMOLD METAT,,,28 ,,NW,,,,,,$60.51,$0.00,1,1,1,1,1,1,20110101,L3060,HCPCS,FOOT ARCH SUPP LONGITUD/META,,,28 ,,NW,,,,,,$92.54,$0.00,1,1,1,1,1,1,20110101,L3070,HCPCS,ARCH SUPRT ATT TO SHO LONGIT,,,28 ,,NW,,,,,,$42.19,$0.00,1,1,1,1,1,1,20110101,L3080,HCPCS,ARCH SUPP ATT TO SHOE METATA,,,28 ,,NW,,,,,,$42.19,$0.00,1,1,1,1,1,1,20110101,L3090,HCPCS,ARCH SUPP ATT TO SHOE LONG/M,,,28 ,,NW,,,,,,$52.91,$0.00,1,1,1,1,1,1,20110101,L3100,HCPCS,HALLUS-VALGUS NGHT DYNAMIC S,,,28 ,,NW,,,,,,$55.93,$0.00,1,1,1,1,1,1,20110101,L3140,HCPCS,ABDUCTION ROTATION BAR SHOE,,,28 ,,NW,,,,,,$110.86,$0.00,1,1,1,1,1,1,20110101,L3150,HCPCS,ABDUCT ROTATION BAR W/O SHOE,,,28 ,,NW,,,,,,$101.70,$0.00,1,1,1,1,1,1,20110101,L3160,HCPCS,SHOE STYLED POSITIONING DEV,,,28 ,,NW,,,,,,$26.40,$0.00,1,1,1,1,1,1,20110101,L3170,HCPCS,FOOT PLASTIC HEEL STABILIZER,,,28 ,,NW,,,,,,$65.11,$0.00,1,1,1,1,1,1,20110101,L3201,HCPCS,OXFORD W SUPINAT/PRONAT INF,,,28 ,,NW,,,,,,$89.08,$0.00,1,1,1,1,1,1,20110101,L3202,HCPCS,OXFORD W/ SUPINAT/PRONATOR C,,,28 ,,NW,,,,,,$88.22,$0.00,1,1,1,1,1,1,20110101,L3203,HCPCS,OXFORD W/ SUPINATOR/PRONATOR,,,28 ,,NW,,,,,,$85.64,$0.00,1,1,1,1,1,1,20110101,L3204,HCPCS,HIGHTOP W/ SUPP/PRONATOR INF,,,28 ,,NW,,,,,,$85.64,$0.00,1,1,1,1,1,1,20110101,L3206,HCPCS,HIGHTOP W/ SUPP/PRONATOR CHI,,,28 ,,NW,,,,,,$89.08,$0.00,1,1,1,1,1,1,20110101,L3207,HCPCS,HIGHTOP W/ SUPP/PRONATOR JUN,,,28 ,,NW,,,,,,$90.79,$0.00,1,1,1,1,1,1,20110101,L3208,HCPCS,SURGICAL BOOT EACH INFANT,,,28 ,,NW,,,,,,$49.58,$0.00,1,1,1,1,1,1,20110101,L3209,HCPCS,SURGICAL BOOT EACH CHILD,,,28 ,,NW,,,,,,$68.47,$0.00,1,1,1,1,1,1,20110101,L3211,HCPCS,SURGICAL BOOT EACH JUNIOR,,,28 ,,NW,,,,,,$72.76,$0.00,1,1,1,1,1,1,20110101,L3212,HCPCS,BENESCH BOOT PAIR INFANT,,,28 ,,NW,,,,,,$99.38,$0.00,1,1,1,1,1,1,20110101,L3213,HCPCS,BENESCH BOOT PAIR CHILD,,,28 ,,NW,,,,,,$119.13,$0.00,1,1,1,1,1,1,20110101,L3214,HCPCS,BENESCH BOOT PAIR JUNIOR,,,28 ,,NW,,,,,,$126.85,$0.00,1,1,1,1,1,1,20110101,L3215,HCPCS,ORTHOPEDIC FTWEAR LADIES OXF,,,28 ,,NW,,,,,,$160.34,$0.00,1,1,1,1,1,1,20110101,L3216,HCPCS,ORTHOPED LADIES SHOES DPTH I,,,28 ,,NW,,,,,,$192.96,$0.00,1,1,1,1,1,1,20110101,L3217,HCPCS,LADIES SHOES HIGHTOP DEPTH I,,,28 ,,NW,,,,,,$208.42,$0.00,1,1,1,1,1,1,20110101,L3219,HCPCS,ORTHOPEDIC MENS SHOES OXFORD,,,28 ,,NW,,,,,,$179.23,$0.00,1,1,1,1,1,1,20110101,L3221,HCPCS,ORTHOPEDIC MENS SHOES DPTH I,,,28 ,,NW,,,,,,$214.43,$0.00,1,1,1,1,1,1,20110101,L3222,HCPCS,MENS SHOES HIGHTOP DEPTH INL,,,28 ,,NW,,,,,,$235.89,$0.00,1,1,1,1,1,1,20110101,L3224,HCPCS,WOMAN'S SHOE OXFORD BRACE,,,28 ,,NW,,,,,,$80.00,$0.00,1,1,1,1,1,1,20110101,L3225,HCPCS,MAN'S SHOE OXFORD BRACE,,,28 ,,NW,,,,,,$90.43,$0.00,1,1,1,1,1,1,20110101,L3230,HCPCS,CUSTOM SHOES DEPTH INLAY,,,28 ,,NW,,,,,,$284.85,$0.00,1,1,1,1,1,1,20110101,L3250,HCPCS,CUSTOM MOLD SHOE REMOV PROST,,,28 ,,NW,,,,,,$600.38,$0.00,1,1,1,1,1,1,20110101,L3251,HCPCS,SHOE MOLDED TO PT SILICONE S,,,28 ,,NW,,,,,,$77.06,$0.00,1,1,1,1,1,1,20110101,L3252,HCPCS,SHOE MOLDED PLASTAZOTE CUST,,,28 ,,NW,,,,,,$306.87,$0.00,1,1,1,1,1,1,20110101,L3253,HCPCS,SHOE MOLDED PLASTAZOTE CUST,,,28 ,,NW,,,,,,$77.06,$0.00,1,1,1,1,1,1,20110101,L3254,HCPCS,ORTH FOOT NON-STNDARD SIZE/W,,,28 ,,NW,,,,,,$86.83,$0.00,1,1,1,1,1,1,20110101,L3255,HCPCS,ORTH FOOT NON-STANDARD SIZE/,,,28 ,,NW,,,,,,$369.54,$0.00,1,1,1,1,1,1,20110101,L3257,HCPCS,ORTH FOOT ADD CHARGE SPLIT S,,,28 ,,NW,,,,,,$56.45,$0.00,1,1,1,1,1,1,20110101,L3260,HCPCS,AMBULATORY SURGICAL BOOT EAC,,,28 ,,NW,,,,,,$34.13,$0.00,1,1,1,1,1,1,20110101,L3265,HCPCS,PLASTAZOTE SANDAL EACH,,,28 ,,NW,,,,,,$36.70,$0.00,1,1,1,1,1,1,20110101,L3300,HCPCS,SHO LIFT TAPER TO METATARSAL,,,28 ,,NW,,,,,,$66.61,$0.00,1,1,1,1,1,1,20110101,L3310,HCPCS,SHOE LIFT ELEV HEEL/SOLE NEO,,,28 ,,NW,,,,,,$101.70,$0.00,1,1,1,1,1,1,20110101,L3320,HCPCS,SHOE LIFT ELEV HEEL/SOLE COR,,,28 ,,NW,,,,,,$200.69,$0.00,1,1,1,1,1,1,20110101,L3330,HCPCS,LIFTS ELEVATION METAL EXTENS,,,28 ,,NW,,,,,,$780.23,$0.00,1,1,1,1,1,1,20110101,L3332,HCPCS,SHOE LIFTS TAPERED TO ONE-HA,,,28 ,,NW,,,,,,$92.54,$0.00,1,1,1,1,1,1,20110101,L3334,HCPCS,SHOE LIFTS ELEVATION HEEL /I,,,28 ,,NW,,,,,,$49.83,$0.00,1,1,1,1,1,1,20110101,L3340,HCPCS,SHOE WEDGE SACH,,,28 ,,NW,,,,,,$106.30,$0.00,1,1,1,1,1,1,20110101,L3350,HCPCS,SHOE HEEL WEDGE,,,28 ,,NW,,,,,,$31.53,$0.00,1,1,1,1,1,1,20110101,L3360,HCPCS,SHOE SOLE WEDGE OUTSIDE SOLE,,,28 ,,NW,,,,,,$46.78,$0.00,1,1,1,1,1,1,20110101,L3370,HCPCS,SHOE SOLE WEDGE BETWEEN SOLE,,,28 ,,NW,,,,,,$63.55,$0.00,1,1,1,1,1,1,20110101,L3380,HCPCS,SHOE CLUBFOOT WEDGE,,,28 ,,NW,,,,,,$63.55,$0.00,1,1,1,1,1,1,20110101,L3390,HCPCS,SHOE OUTFLARE WEDGE,,,28 ,,NW,,,,,,$63.55,$0.00,1,1,1,1,1,1,20110101,L3400,HCPCS,SHOE METATARSAL BAR WEDGE RO,,,28 ,,NW,,,,,,$52.91,$0.00,1,1,1,1,1,1,20110101,L3410,HCPCS,SHOE METATARSAL BAR BETWEEN,,,28 ,,NW,,,,,,$115.43,$0.00,1,1,1,1,1,1,20110101,L3420,HCPCS,FULL SOLE/HEEL WEDGE BTWEEN,,,28 ,,NW,,,,,,$69.66,$0.00,1,1,1,1,1,1,20110101,L3430,HCPCS,SHO HEEL COUNT PLAST REINFOR,,,28 ,,NW,,,,,,$196.27,$0.00,1,1,1,1,1,1,20110101,L3440,HCPCS,HEEL LEATHER REINFORCED,,,28 ,,NW,,,,,,$95.60,$0.00,1,1,1,1,1,1,20110101,L3450,HCPCS,SHOE HEEL SACH CUSHION TYPE,,,28 ,,NW,,,,,,$130.67,$0.00,1,1,1,1,1,1,20110101,L3455,HCPCS,SHOE HEEL NEW LEATHER STANDA,,,28 ,,NW,,,,,,$52.91,$0.00,1,1,1,1,1,1,20110101,L3460,HCPCS,SHOE HEEL NEW RUBBER STANDAR,,,28 ,,NW,,,,,,$45.24,$0.00,1,1,1,1,1,1,20110101,L3465,HCPCS,SHOE HEEL THOMAS WITH WEDGE,,,28 ,,NW,,,,,,$74.25,$0.00,1,1,1,1,1,1,20110101,L3470,HCPCS,SHOE HEEL THOMAS EXTEND TO B,,,28 ,,NW,,,,,,$78.81,$0.00,1,1,1,1,1,1,20110101,L3480,HCPCS,SHOE HEEL PAD & DEPRESS FOR,,,28 ,,NW,,,,,,$78.81,$0.00,1,1,1,1,1,1,20110101,L3485,HCPCS,SHOE HEEL PAD REMOVABLE FOR,,,28 ,,NW,,,,,,$34.13,$0.00,1,1,1,1,1,1,20110101,L3500,HCPCS,ORTHO SHOE ADD LEATHER INSOL,,,28 ,,NW,,,,,,$39.16,$0.00,1,1,1,1,1,1,20110101,L3510,HCPCS,ORTHOPEDIC SHOE ADD RUB INSL,,,28 ,,NW,,,,,,$39.16,$0.00,1,1,1,1,1,1,20110101,L3520,HCPCS,O SHOE ADD FELT W LEATH INSL,,,28 ,,NW,,,,,,$42.19,$0.00,1,1,1,1,1,1,20110101,L3530,HCPCS,ORTHO SHOE ADD HALF SOLE,,,28 ,,NW,,,,,,$42.19,$0.00,1,1,1,1,1,1,20110101,L3540,HCPCS,ORTHO SHOE ADD FULL SOLE,,,28 ,,NW,,,,,,$65.11,$0.00,1,1,1,1,1,1,20110101,L3550,HCPCS,O SHOE ADD STANDARD TOE TAP,,,28 ,,NW,,,,,,$14.76,$0.00,1,1,1,1,1,1,20110101,L3560,HCPCS,O SHOE ADD HORSESHOE TOE TAP,,,28 ,,NW,,,,,,$31.53,$0.00,1,1,1,1,1,1,20110101,L3570,HCPCS,O SHOE ADD INSTEP EXTENSION,,,28 ,,NW,,,,,,$106.30,$0.00,1,1,1,1,1,1,20110101,L3580,HCPCS,O SHOE ADD INSTEP VELCRO CLO,,,28 ,,NW,,,,,,$81.87,$0.00,1,1,1,1,1,1,20110101,L3590,HCPCS,O SHOE CONVERT TO SOF COUNTE,,,28 ,,NW,,,,,,$68.14,$0.00,1,1,1,1,1,1,20110101,L3595,HCPCS,ORTHO SHOE ADD MARCH BAR,,,28 ,,NW,,,,,,$54.40,$0.00,1,1,1,1,1,1,20110101,L3600,HCPCS,TRANS SHOE CALIP PLATE EXIST,,,28 ,,NW,,,,,,$95.60,$0.00,1,1,1,1,1,1,20110101,L3610,HCPCS,TRANS SHOE CALIPER PLATE NEW,,,28 ,,NW,,,,,,$124.57,$0.00,1,1,1,1,1,1,20110101,L3620,HCPCS,TRANS SHOE SOLID STIRRUP EXI,,,28 ,,NW,,,,,,$95.60,$0.00,1,1,1,1,1,1,20110101,L3630,HCPCS,TRANS SHOE SOLID STIRRUP NEW,,,28 ,,NW,,,,,,$124.57,$0.00,1,1,1,1,1,1,20110101,L3640,HCPCS,SHOE DENNIS BROWNE SPLINT BO,,,28 ,,NW,,,,,,$55.93,$0.00,1,1,1,1,1,1,20110101,L3649,HCPCS,ORTHOPEDIC SHOE MODIFICA NOS,,,28 ,,NW,,,,,,$95.60,$0.00,1,1,1,1,1,1,20110101,L3650,HCPCS,SHLDER FIG 8 ABDUCT RESTRAIN,,,28 ,,NW,,,,,,$79.84,$0.00,1,1,1,1,1,1,20110101,L3671,HCPCS,SO CAP DESIGN W/O JNTS CF,,,28 ,,NW,,,,,,"$1,152.32",$0.00,1,1,1,1,1,1,20110101,L3677,HCPCS,SO HARD PLASTIC STABILIZER,,,28 ,,NW,,,,,,$219.58,$0.00,1,1,1,1,1,1,20110101,L3702,HCPCS,EO W/O JOINTS CF,,,28 ,,NW,,,,,,$336.31,$0.00,1,1,1,1,1,1,20110101,L3710,HCPCS,ELBOW ELASTIC WITH METAL JOI,,,28 ,,NW,,,,,,$160.70,$0.00,1,1,1,1,1,1,20110101,L3720,HCPCS,FOREARM/ARM CUFFS FREE MOTIO,,,28 ,,NW,,,,,,$969.68,$0.00,1,1,1,1,1,1,20110101,L3730,HCPCS,FOREARM/ARM CUFFS EXT/FLEX A,,,28 ,,NW,,,,,,"$1,356.44",$0.00,1,1,1,1,1,1,20110101,L3740,HCPCS,CUFFS ADJ LOCK W/ ACTIVE CON,,,28 ,,NW,,,,,,"$1,597.32",$0.00,1,1,1,1,1,1,20110101,L3760,HCPCS,"EO WITHJOINT, PREFABRICATED",,,28 ,,NW,,,,,,$617.96,$0.00,1,1,1,1,1,1,20110101,L3762,HCPCS,RIGID EO WO JOINTS,,,28 ,,NW,,,,,,$121.45,$0.00,1,1,1,1,1,1,20110101,L3763,HCPCS,EWHO RIGID W/O JNTS CF,,,28 ,,NW,,,,,,$962.36,$0.00,1,1,1,1,1,1,20110101,L3764,HCPCS,EWHO W/JOINT(S) CF,,,28 ,,NW,,,,,,"$1,082.77",$0.00,1,1,1,1,1,1,20110101,L3765,HCPCS,EWHFO RIGID W/O JNTS CF,,,28 ,,NW,,,,,,"$1,660.31",$0.00,1,1,1,1,1,1,20110101,L3766,HCPCS,EWHFO W/JOINT(S) CF,,,28 ,,NW,,,,,,"$1,761.00",$0.00,1,1,1,1,1,1,20110101,L3806,HCPCS,WHFO W/JOINT(S) CUSTOM FAB,,,28 ,,NW,,,,,,$556.86,$0.00,1,1,1,1,1,1,20110101,L3807,HCPCS,"WHFO,NO JOINT, PREFABRICATED",,,28 ,,NW,,,,,,$284.74,$0.00,1,1,1,1,1,1,20110101,L3808,HCPCS,"WHFO, RIGID W/O JOINTS",,,28 ,,NW,,,,,,$450.74,$0.00,1,1,1,1,1,1,20110101,L3900,HCPCS,HINGE EXTENSION/FLEX WRIST/F,,,28 ,,NW,,,,,,"$1,953.78",$0.00,1,1,1,1,1,1,20110101,L3901,HCPCS,HINGE EXT/FLEX WRIST FINGER,,,28 ,,NW,,,,,,"$2,422.28",$0.00,1,1,1,1,1,1,20110101,L3904,HCPCS,WHFO ELECTRIC CUSTOM FITTED,,,28 ,,NW,,,,,,"$4,457.01",$0.00,1,1,1,1,1,1,20110101,L3905,HCPCS,WHO W/NONTORSION JNT(S) CF,,,28 ,,NW,,,,,,"$1,273.11",$0.00,1,1,1,1,1,1,20110101,L3906,HCPCS,WHO W/O JOINTS CF,,,28 ,,NW,,,,,,$559.17,$0.00,1,1,1,1,1,1,20110101,L3908,HCPCS,WRIST COCK-UP NON-MOLDED,,,28 ,,NW,,,,,,$81.42,$0.00,1,1,1,1,1,1,20110101,L3912,HCPCS,FLEX GLOVE W/ELASTIC FINGER,,,28 ,,NW,,,,,,$125.80,$0.00,1,1,1,1,1,1,20110101,L3913,HCPCS,HFO W/O JOINTS CF,,,28 ,,NW,,,,,,$312.44,$0.00,1,1,1,1,1,1,20110101,L3915,HCPCS,WHO W NONTOR JNT(S) PREFAB,,,28 ,,NW,,,,,,$659.91,$0.00,1,1,1,1,1,1,20110101,L3917,HCPCS,PREFAB METACARPL FX ORTHOSIS,,,28 ,,NW,,,,,,$119.37,$0.00,1,1,1,1,1,1,20110101,L3919,HCPCS,HO W/O JOINTS CF,,,28 ,,NW,,,,,,$312.44,$0.00,1,1,1,1,1,1,20110101,L3921,HCPCS,HFO W/JOINT(S) CF,,,28 ,,NW,,,,,,$379.56,$0.00,1,1,1,1,1,1,20110101,L3923,HCPCS,HFO W/O JOINTS PF,,,28 ,,NW,,,,,,$104.71,$0.00,1,1,1,1,1,1,20110101,L3925,HCPCS,FO PIP/DIP WITH JOINT/SPRING,,,28 ,,NW,,,,,,$67.13,$0.00,1,1,1,1,1,1,20110101,L3927,HCPCS,FO PIP/DIP W/O JOINT/SPRING,,,28 ,,NW,,,,,,$42.26,$0.00,1,1,1,1,1,1,20110101,L3929,HCPCS,"HFO NONTORSION JOINT, PREFAB",,,28 ,,NW,,,,,,$103.83,$0.00,1,1,1,1,1,1,20110101,L3931,HCPCS,WHFO NONTORSION JOINT PREFAB,,,28 ,,NW,,,,,,$232.18,$0.00,1,1,1,1,1,1,20110101,L3933,HCPCS,FO W/O JOINTS CF,,,28 ,,NW,,,,,,$236.97,$0.00,1,1,1,1,1,1,20110101,L3935,HCPCS,FO NONTORSION JOINT CF,,,28 ,,NW,,,,,,$245.92,$0.00,1,1,1,1,1,1,20110101,L3956,HCPCS,ADD JOINT UPPER EXT ORTHOSIS,,,28 ,,NW,,,,,,$91.87,$0.00,1,1,1,1,1,1,20110101,L3960,HCPCS,SEWHO AIRPLAN DESIG ABDU POS,,,28 ,,NW,,,,,,"$1,082.91",$0.00,1,1,1,1,1,1,20110101,L3961,HCPCS,SEWHO CAP DESIGN W/O JNTS CF,,,28 ,,NW,,,,,,"$2,190.54",$0.00,1,1,1,1,1,1,20110101,L3962,HCPCS,SEWHO ERBS PALSEY DESIGN ABD,,,28 ,,NW,,,,,,"$1,041.92",$0.00,1,1,1,1,1,1,20110101,L3964,HCPCS,SEO MOBILE ARM SUP ATT TO WC,,,28 ,,NW,,,,,,$993.70,$0.00,1,1,1,1,1,1,20110101,L3964,HCPCS,SEO MOBILE ARM SUP ATT TO WC,NU,,28 ,,NW,,,,,,$993.70,$0.00,1,1,1,1,1,1,20110101,L3964,HCPCS,SEO MOBILE ARM SUP ATT TO WC,RR,,28 ,,NW,,,,,,$89.43,$0.00,1,1,1,1,1,1,20110101,L3964,HCPCS,SEO MOBILE ARM SUP ATT TO WC,UE,,28 ,,NW,,,,,,$733.11,$0.00,1,1,1,1,1,1,20110101,L3965,HCPCS,ARM SUPP ATT TO WC RANCHO TY,,,28 ,,NW,,,,,,"$1,567.08",$0.00,1,1,1,1,1,1,20110101,L3965,HCPCS,ARM SUPP ATT TO WC RANCHO TY,NU,,28 ,,NW,,,,,,"$1,567.08",$0.00,1,1,1,1,1,1,20110101,L3965,HCPCS,ARM SUPP ATT TO WC RANCHO TY,RR,,28 ,,NW,,,,,,$136.43,$0.00,1,1,1,1,1,1,20110101,L3965,HCPCS,ARM SUPP ATT TO WC RANCHO TY,UE,,28 ,,NW,,,,,,"$1,163.18",$0.00,1,1,1,1,1,1,20110101,L3966,HCPCS,MOBILE ARM SUPPORTS RECLININ,,,28 ,,NW,,,,,,"$1,183.01",$0.00,1,1,1,1,1,1,20110101,L3966,HCPCS,MOBILE ARM SUPPORTS RECLININ,NU,,28 ,,NW,,,,,,"$1,183.01",$0.00,1,1,1,1,1,1,20110101,L3966,HCPCS,MOBILE ARM SUPPORTS RECLININ,RR,,28 ,,NW,,,,,,$104.95,$0.00,1,1,1,1,1,1,20110101,L3966,HCPCS,MOBILE ARM SUPPORTS RECLININ,UE,,28 ,,NW,,,,,,$875.14,$0.00,1,1,1,1,1,1,20110101,L3967,HCPCS,SEWHO AIRPLANE W/O JNTS CF,,,28 ,,NW,,,,,,"$2,595.05",$0.00,1,1,1,1,1,1,20110101,L3968,HCPCS,FRICTION DAMPENING ARM SUPP,,,28 ,,NW,,,,,,"$1,520.26",$0.00,1,1,1,1,1,1,20110101,L3968,HCPCS,FRICTION DAMPENING ARM SUPP,NU,,28 ,,NW,,,,,,"$1,520.26",$0.00,1,1,1,1,1,1,20110101,L3968,HCPCS,FRICTION DAMPENING ARM SUPP,RR,,28 ,,NW,,,,,,$132.55,$0.00,1,1,1,1,1,1,20110101,L3968,HCPCS,FRICTION DAMPENING ARM SUPP,UE,,28 ,,NW,,,,,,"$1,128.08",$0.00,1,1,1,1,1,1,20110101,L3969,HCPCS,MONOSUSPENSION ARM/HAND SUPP,,,28 ,,NW,,,,,,"$1,045.61",$0.00,1,1,1,1,1,1,20110101,L3969,HCPCS,MONOSUSPENSION ARM/HAND SUPP,NU,,28 ,,NW,,,,,,"$1,045.61",$0.00,1,1,1,1,1,1,20110101,L3969,HCPCS,MONOSUSPENSION ARM/HAND SUPP,RR,,28 ,,NW,,,,,,$93.69,$0.00,1,1,1,1,1,1,20110101,L3969,HCPCS,MONOSUSPENSION ARM/HAND SUPP,UE,,28 ,,NW,,,,,,$772.06,$0.00,1,1,1,1,1,1,20110101,L3970,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,,,28 ,,NW,,,,,,$390.66,$0.00,1,1,1,1,1,1,20110101,L3970,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,NU,,28 ,,NW,,,,,,$390.66,$0.00,1,1,1,1,1,1,20110101,L3970,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,RR,,28 ,,NW,,,,,,$40.04,$0.00,1,1,1,1,1,1,20110101,L3970,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,UE,,28 ,,NW,,,,,,$280.86,$0.00,1,1,1,1,1,1,20110101,L3971,HCPCS,SEWHO CAP DESIGN W/JNT(S) CF,,,28 ,,NW,,,,,,"$2,460.83",$0.00,1,1,1,1,1,1,20110101,L3972,HCPCS,OFFSET/LAT ROCKER ARM W/ ELA,,,28 ,,NW,,,,,,$232.83,$0.00,1,1,1,1,1,1,20110101,L3972,HCPCS,OFFSET/LAT ROCKER ARM W/ ELA,NU,,28 ,,NW,,,,,,$232.83,$0.00,1,1,1,1,1,1,20110101,L3972,HCPCS,OFFSET/LAT ROCKER ARM W/ ELA,RR,,28 ,,NW,,,,,,$26.95,$0.00,1,1,1,1,1,1,20110101,L3972,HCPCS,OFFSET/LAT ROCKER ARM W/ ELA,UE,,28 ,,NW,,,,,,$175.64,$0.00,1,1,1,1,1,1,20110101,L3973,HCPCS,SEWHO AIRPLANE W/JNT(S) CF,,,28 ,,NW,,,,,,"$2,595.05",$0.00,1,1,1,1,1,1,20110101,L3974,HCPCS,MOBILE ARM SUPPORT SUPINATOR,,,28 ,,NW,,,,,,$197.57,$0.00,1,1,1,1,1,1,20110101,L3974,HCPCS,MOBILE ARM SUPPORT SUPINATOR,NU,,28 ,,NW,,,,,,$197.57,$0.00,1,1,1,1,1,1,20110101,L3974,HCPCS,MOBILE ARM SUPPORT SUPINATOR,RR,,28 ,,NW,,,,,,$23.43,$0.00,1,1,1,1,1,1,20110101,L3974,HCPCS,MOBILE ARM SUPPORT SUPINATOR,UE,,28 ,,NW,,,,,,$149.20,$0.00,1,1,1,1,1,1,20110101,L3975,HCPCS,SEWHFO CAP DESIGN W/O JNT CF,,,28 ,,NW,,,,,,"$2,190.54",$0.00,1,1,1,1,1,1,20110101,L3976,HCPCS,SEWHFO AIRPLANE W/O JNTS CF,,,28 ,,NW,,,,,,"$2,190.54",$0.00,1,1,1,1,1,1,20110101,L3977,HCPCS,SEWHFO CAP DESGN W/JNT(S) CF,,,28 ,,NW,,,,,,"$2,460.83",$0.00,1,1,1,1,1,1,20110101,L3978,HCPCS,SEWHFO AIRPLANE W/JNT(S) CF,,,28 ,,NW,,,,,,"$2,595.05",$0.00,1,1,1,1,1,1,20110101,L3980,HCPCS,UPP EXT FX ORTHOSIS HUMERAL,,,28 ,,NW,,,,,,$436.94,$0.00,1,1,1,1,1,1,20110101,L3982,HCPCS,UPPER EXT FX ORTHOSIS RAD/UL,,,28 ,,NW,,,,,,$519.85,$0.00,1,1,1,1,1,1,20110101,L3984,HCPCS,UPPER EXT FX ORTHOSIS WRIST,,,28 ,,NW,,,,,,$477.43,$0.00,1,1,1,1,1,1,20110101,L3995,HCPCS,SOCK FRACTURE OR EQUAL EACH,,,28 ,,NW,,,,,,$46.62,$0.00,1,1,1,1,1,1,20110101,L3999,HCPCS,UPPER LIMB ORTHOSIS NOS,,,28 ,,NW,,,,,,$44.71,$0.00,1,1,1,1,1,1,20110101,L4000,HCPCS,REPL GIRDLE MILWAUKEE ORTH,,,28 ,,NW,,,,,,"$1,917.34",$0.00,1,1,1,1,1,1,20110101,L4002,HCPCS,"REPLACE STRAP, ANY ORTHOSIS",,,28 ,,NW,,,,,,$57.47,$0.00,1,1,1,1,1,1,20110101,L4010,HCPCS,REPLACE TRILATERAL SOCKET BR,,,28 ,,NW,,,,,,"$1,024.09",$0.00,1,1,1,1,1,1,20110101,L4020,HCPCS,REPLACE QUADLAT SOCKET BRIM,,,28 ,,NW,,,,,,"$1,338.23",$0.00,1,1,1,1,1,1,20110101,L4030,HCPCS,REPLACE SOCKET BRIM CUST FIT,,,28 ,,NW,,,,,,$779.78,$0.00,1,1,1,1,1,1,20110101,L4040,HCPCS,REPLACE MOLDED THIGH LACER,,,28 ,,NW,,,,,,$581.13,$0.00,1,1,1,1,1,1,20110101,L4045,HCPCS,REPLACE NON-MOLDED THIGH LAC,,,28 ,,NW,,,,,,$442.57,$0.00,1,1,1,1,1,1,20110101,L4050,HCPCS,REPLACE MOLDED CALF LACER,,,28 ,,NW,,,,,,$593.27,$0.00,1,1,1,1,1,1,20110101,L4055,HCPCS,REPLACE NON-MOLDED CALF LACE,,,28 ,,NW,,,,,,$350.56,$0.00,1,1,1,1,1,1,20110101,L4060,HCPCS,REPLACE HIGH ROLL CUFF,,,28 ,,NW,,,,,,$433.71,$0.00,1,1,1,1,1,1,20110101,L4070,HCPCS,REPLACE PROX & DIST UPRIGHT,,,28 ,,NW,,,,,,$390.39,$0.00,1,1,1,1,1,1,20110101,L4080,HCPCS,REPL MET BAND KAFO-AFO PROX,,,28 ,,NW,,,,,,$128.81,$0.00,1,1,1,1,1,1,20110101,L4090,HCPCS,REPL MET BAND KAFO-AFO CALF/,,,28 ,,NW,,,,,,$119.35,$0.00,1,1,1,1,1,1,20110101,L4100,HCPCS,REPL LEATH CUFF KAFO PROX TH,,,28 ,,NW,,,,,,$138.44,$0.00,1,1,1,1,1,1,20110101,L4110,HCPCS,REPL LEATH CUFF KAFO-AFO CAL,,,28 ,,NW,,,,,,$112.47,$0.00,1,1,1,1,1,1,20110101,L4130,HCPCS,REPLACE PRETIBIAL SHELL,,,28 ,,NW,,,,,,$731.52,$0.00,1,1,1,1,1,1,20110101,L4205,HCPCS,ORTHO DVC REPAIR PER 15 MIN,,,28 ,,NW,,,,,,$37.13,$0.00,1,1,1,1,1,1,20110101,L4210,HCPCS,ORTH DEV REPAIR/REPL MINOR P,,,28 ,,NW,,,,,,$42.43,$0.00,1,1,1,1,1,1,20110101,L4350,HCPCS,ANKLE CONTROL ORTHOSI PREFAB,,,28 ,,NW,,,,,,$119.89,$0.00,1,1,1,1,1,1,20110101,L4360,HCPCS,PNEUMATI WALKING BOOT PREFAB,,,28 ,,NW,,,,,,$366.30,$0.00,1,1,1,1,1,1,20110101,L4370,HCPCS,PNEUMATIC FULL LEG SPLINT,,,28 ,,NW,,,,,,$238.17,$0.00,1,1,1,1,1,1,20110101,L4380,HCPCS,PNEUMATIC KNEE SPLINT,,,28 ,,NW,,,,,,$136.92,$0.00,1,1,1,1,1,1,20110101,L4386,HCPCS,NON-PNEUM WALK BOOT PREFAB,,,28 ,,NW,,,,,,$194.24,$0.00,1,1,1,1,1,1,20110101,L4392,HCPCS,REPLACE AFO SOFT INTERFACE,,,28 ,,NW,,,,,,$32.21,$0.00,1,1,1,1,1,1,20110101,L4394,HCPCS,REPLACE FOOT DROP SPINT,,,28 ,,NW,,,,,,$24.61,$0.00,1,1,1,1,1,1,20110101,L4396,HCPCS,STATIC AFO,,,28 ,,NW,,,,,,$204.66,$0.00,1,1,1,1,1,1,20110101,L4398,HCPCS,FOOT DROP SPLINT RECUMBENT,,,28 ,,NW,,,,,,$96.41,$0.00,1,1,1,1,1,1,20110101,L4631,HCPCS,"AFO, WALK BOOT TYPE, CUS FAB",,,28 ,,NW,,,,,,$366.30,$0.00,1,1,1,1,1,1,20110101,L5000,HCPCS,SHO INSERT W ARCH TOE FILLER,,,28 ,,NW,,,,,,$781.57,$0.00,1,1,1,1,1,1,20110101,L5010,HCPCS,MOLD SOCKET ANK HGT W/ TOE F,,,28 ,,NW,,,,,,"$2,010.53",$0.00,1,1,1,1,1,1,20110101,L5020,HCPCS,TIBIAL TUBERCLE HGT W/ TOE F,,,28 ,,NW,,,,,,"$3,314.56",$0.00,1,1,1,1,1,1,20110101,L5050,HCPCS,ANK SYMES MOLD SCKT SACH FT,,,28 ,,NW,,,,,,"$3,754.43",$0.00,1,1,1,1,1,1,20110101,L5060,HCPCS,SYMES MET FR LEATH SOCKET AR,,,28 ,,NW,,,,,,"$4,707.80",$0.00,1,1,1,1,1,1,20110101,L5100,HCPCS,MOLDED SOCKET SHIN SACH FOOT,,,28 ,,NW,,,,,,"$3,797.48",$0.00,1,1,1,1,1,1,20110101,L5105,HCPCS,PLAST SOCKET JTS/THGH LACER,,,28 ,,NW,,,,,,"$5,708.01",$0.00,1,1,1,1,1,1,20110101,L5150,HCPCS,MOLD SCKT EXT KNEE SHIN SACH,,,28 ,,NW,,,,,,"$5,863.04",$0.00,1,1,1,1,1,1,20110101,L5160,HCPCS,MOLD SOCKET BENT KNEE SHIN S,,,28 ,,NW,,,,,,"$6,358.36",$0.00,1,1,1,1,1,1,20110101,L5200,HCPCS,KNE SING AXIS FRIC SHIN SACH,,,28 ,,NW,,,,,,"$5,380.45",$0.00,1,1,1,1,1,1,20110101,L5210,HCPCS,NO KNEE/ANKLE JOINTS W/ FT B,,,28 ,,NW,,,,,,"$4,030.65",$0.00,1,1,1,1,1,1,20110101,L5220,HCPCS,NO KNEE JOINT WITH ARTIC ALI,,,28 ,,NW,,,,,,"$4,598.46",$0.00,1,1,1,1,1,1,20110101,L5230,HCPCS,FEM FOCAL DEFIC CONSTANT FRI,,,28 ,,NW,,,,,,"$6,327.70",$0.00,1,1,1,1,1,1,20110101,L5250,HCPCS,HIP CANAD SING AXI CONS FRIC,,,28 ,,NW,,,,,,"$8,460.59",$0.00,1,1,1,1,1,1,20110101,L5270,HCPCS,TILT TABLE LOCKING HIP SING,,,28 ,,NW,,,,,,"$8,535.69",$0.00,1,1,1,1,1,1,20110101,L5280,HCPCS,HEMIPELVECT CANAD SING AXIS,,,28 ,,NW,,,,,,"$8,576.84",$0.00,1,1,1,1,1,1,20110101,L5301,HCPCS,BK MOLD SOCKET SACH FT ENDO,,,28 ,,NW,,,,,,"$3,884.77",$0.00,1,1,1,1,1,1,20110101,L5311,HCPCS,"KNEE DISART, SACH FT, ENDO",,,28 ,,NW,,,,,,"$5,575.79",$0.00,1,1,1,1,1,1,20110101,L5321,HCPCS,AK OPEN END SACH,,,28 ,,NW,,,,,,"$5,504.67",$0.00,1,1,1,1,1,1,20110101,L5331,HCPCS,HIP DISART CANADIAN SACH FT,,,28 ,,NW,,,,,,"$7,780.73",$0.00,1,1,1,1,1,1,20110101,L5341,HCPCS,HEMIPELVECTOMY CANADIAN SACH,,,28 ,,NW,,,,,,"$8,376.97",$0.00,1,1,1,1,1,1,20110101,L5400,HCPCS,POSTOP DRESS & 1 CAST CHG BK,,,28 ,,NW,,,,,,"$2,019.04",$0.00,1,1,1,1,1,1,20110101,L5410,HCPCS,POSTOP DSG BK EA ADD CAST CH,,,28 ,,NW,,,,,,$626.27,$0.00,1,1,1,1,1,1,20110101,L5420,HCPCS,POSTOP DSG & 1 CAST CHG AK/D,,,28 ,,NW,,,,,,"$2,569.01",$0.00,1,1,1,1,1,1,20110101,L5430,HCPCS,POSTOP DSG AK EA ADD CAST CH,,,28 ,,NW,,,,,,$803.20,$0.00,1,1,1,1,1,1,20110101,L5450,HCPCS,POSTOP APP NON-WGT BEAR DSG,,,28 ,,NW,,,,,,$613.36,$0.00,1,1,1,1,1,1,20110101,L5460,HCPCS,POSTOP APP NON-WGT BEAR DSG,,,28 ,,NW,,,,,,$830.93,$0.00,1,1,1,1,1,1,20110101,L5500,HCPCS,INIT BK PTB PLASTER DIRECT,,,28 ,,NW,,,,,,"$2,077.91",$0.00,1,1,1,1,1,1,20110101,L5505,HCPCS,INIT AK ISCHAL PLSTR DIRECT,,,28 ,,NW,,,,,,"$2,899.11",$0.00,1,1,1,1,1,1,20110101,L5510,HCPCS,PREP BK PTB PLASTER MOLDED,,,28 ,,NW,,,,,,"$2,352.38",$0.00,1,1,1,1,1,1,20110101,L5520,HCPCS,PERP BK PTB THERMOPLS DIRECT,,,28 ,,NW,,,,,,"$2,401.70",$0.00,1,1,1,1,1,1,20110101,L5530,HCPCS,PREP BK PTB THERMOPLS MOLDED,,,28 ,,NW,,,,,,"$2,837.78",$0.00,1,1,1,1,1,1,20110101,L5535,HCPCS,PREP BK PTB OPEN END SOCKET,,,28 ,,NW,,,,,,"$2,818.91",$0.00,1,1,1,1,1,1,20110101,L5540,HCPCS,PREP BK PTB LAMINATED SOCKET,,,28 ,,NW,,,,,,"$2,971.22",$0.00,1,1,1,1,1,1,20110101,L5560,HCPCS,PREP AK ISCHIAL PLAST MOLDED,,,28 ,,NW,,,,,,"$3,217.03",$0.00,1,1,1,1,1,1,20110101,L5570,HCPCS,PREP AK ISCHIAL DIRECT FORM,,,28 ,,NW,,,,,,"$3,342.06",$0.00,1,1,1,1,1,1,20110101,L5580,HCPCS,PREP AK ISCHIAL THERMO MOLD,,,28 ,,NW,,,,,,"$3,903.93",$0.00,1,1,1,1,1,1,20110101,L5585,HCPCS,PREP AK ISCHIAL OPEN END,,,28 ,,NW,,,,,,"$4,168.10",$0.00,1,1,1,1,1,1,20110101,L5590,HCPCS,PREP AK ISCHIAL LAMINATED,,,28 ,,NW,,,,,,"$4,013.32",$0.00,1,1,1,1,1,1,20110101,L5595,HCPCS,HIP DISARTIC SACH THERMOPLS,,,28 ,,NW,,,,,,"$6,614.52",$0.00,1,1,1,1,1,1,20110101,L5600,HCPCS,HIP DISART SACH LAMINAT MOLD,,,28 ,,NW,,,,,,"$7,358.19",$0.00,1,1,1,1,1,1,20110101,L5610,HCPCS,ABOVE KNEE HYDRACADENCE,,,28 ,,NW,,,,,,"$3,401.09",$0.00,1,1,1,1,1,1,20110101,L5611,HCPCS,AK 4 BAR LINK W/FRIC SWING,,,28 ,,NW,,,,,,"$2,500.35",$0.00,1,1,1,1,1,1,20110101,L5613,HCPCS,AK 4 BAR LING W/HYDRAUL SWIG,,,28 ,,NW,,,,,,"$3,902.14",$0.00,1,1,1,1,1,1,20110101,L5614,HCPCS,4-BAR LINK ABOVE KNEE W/SWNG,,,28 ,,NW,,,,,,"$2,428.18",$0.00,1,1,1,1,1,1,20110101,L5616,HCPCS,AK UNIV MULTIPLEX SYS FRICT,,,28 ,,NW,,,,,,"$2,124.16",$0.00,1,1,1,1,1,1,20110101,L5617,HCPCS,AK/BK SELF-ALIGNING UNIT EA,,,28 ,,NW,,,,,,$775.99,$0.00,1,1,1,1,1,1,20110101,L5618,HCPCS,TEST SOCKET SYMES,,,28 ,,NW,,,,,,$406.16,$0.00,1,1,1,1,1,1,20110101,L5620,HCPCS,TEST SOCKET BELOW KNEE,,,28 ,,NW,,,,,,$400.61,$0.00,1,1,1,1,1,1,20110101,L5622,HCPCS,TEST SOCKET KNEE DISARTICULA,,,28 ,,NW,,,,,,$555.34,$0.00,1,1,1,1,1,1,20110101,L5624,HCPCS,TEST SOCKET ABOVE KNEE,,,28 ,,NW,,,,,,$553.23,$0.00,1,1,1,1,1,1,20110101,L5626,HCPCS,TEST SOCKET HIP DISARTICULAT,,,28 ,,NW,,,,,,$744.42,$0.00,1,1,1,1,1,1,20110101,L5628,HCPCS,TEST SOCKET HEMIPELVECTOMY,,,28 ,,NW,,,,,,$749.67,$0.00,1,1,1,1,1,1,20110101,L5629,HCPCS,BELOW KNEE ACRYLIC SOCKET,,,28 ,,NW,,,,,,$472.54,$0.00,1,1,1,1,1,1,20110101,L5630,HCPCS,SYME TYP EXPANDABL WALL SCKT,,,28 ,,NW,,,,,,$693.35,$0.00,1,1,1,1,1,1,20110101,L5631,HCPCS,AK/KNEE DISARTIC ACRYLIC SOC,,,28 ,,NW,,,,,,$668.28,$0.00,1,1,1,1,1,1,20110101,L5632,HCPCS,SYMES TYPE PTB BRIM DESIGN S,,,28 ,,NW,,,,,,$314.20,$0.00,1,1,1,1,1,1,20110101,L5634,HCPCS,SYMES TYPE POSTER OPENING SO,,,28 ,,NW,,,,,,$455.94,$0.00,1,1,1,1,1,1,20110101,L5636,HCPCS,SYMES TYPE MEDIAL OPENING SO,,,28 ,,NW,,,,,,$352.89,$0.00,1,1,1,1,1,1,20110101,L5637,HCPCS,BELOW KNEE TOTAL CONTACT,,,28 ,,NW,,,,,,$462.35,$0.00,1,1,1,1,1,1,20110101,L5638,HCPCS,BELOW KNEE LEATHER SOCKET,,,28 ,,NW,,,,,,$781.28,$0.00,1,1,1,1,1,1,20110101,L5639,HCPCS,BELOW KNEE WOOD SOCKET,,,28 ,,NW,,,,,,"$1,792.46",$0.00,1,1,1,1,1,1,20110101,L5640,HCPCS,KNEE DISARTICULAT LEATHER SO,,,28 ,,NW,,,,,,"$1,010.72",$0.00,1,1,1,1,1,1,20110101,L5642,HCPCS,ABOVE KNEE LEATHER SOCKET,,,28 ,,NW,,,,,,$921.59,$0.00,1,1,1,1,1,1,20110101,L5643,HCPCS,HIP FLEX INNER SOCKET EXT FR,,,28 ,,NW,,,,,,"$2,453.97",$0.00,1,1,1,1,1,1,20110101,L5644,HCPCS,ABOVE KNEE WOOD SOCKET,,,28 ,,NW,,,,,,$870.96,$0.00,1,1,1,1,1,1,20110101,L5645,HCPCS,BK FLEX INNER SOCKET EXT FRA,,,28 ,,NW,,,,,,"$1,217.29",$0.00,1,1,1,1,1,1,20110101,L5646,HCPCS,BELOW KNEE CUSHION SOCKET,,,28 ,,NW,,,,,,$832.01,$0.00,1,1,1,1,1,1,20110101,L5647,HCPCS,BELOW KNEE SUCTION SOCKET,,,28 ,,NW,,,,,,"$1,236.28",$0.00,1,1,1,1,1,1,20110101,L5648,HCPCS,ABOVE KNEE CUSHION SOCKET,,,28 ,,NW,,,,,,$983.28,$0.00,1,1,1,1,1,1,20110101,L5649,HCPCS,ISCH CONTAINMT/NARROW M-L SO,,,28 ,,NW,,,,,,"$3,159.90",$0.00,1,1,1,1,1,1,20110101,L5650,HCPCS,TOT CONTACT AK/KNEE DISART S,,,28 ,,NW,,,,,,$759.50,$0.00,1,1,1,1,1,1,20110101,L5651,HCPCS,AK FLEX INNER SOCKET EXT FRA,,,28 ,,NW,,,,,,"$1,895.24",$0.00,1,1,1,1,1,1,20110101,L5652,HCPCS,SUCTION SUSP AK/KNEE DISART,,,28 ,,NW,,,,,,$618.45,$0.00,1,1,1,1,1,1,20110101,L5653,HCPCS,KNEE DISART EXPAND WALL SOCK,,,28 ,,NW,,,,,,$876.95,$0.00,1,1,1,1,1,1,20110101,L5654,HCPCS,SOCKET INSERT SYMES,,,28 ,,NW,,,,,,$499.67,$0.00,1,1,1,1,1,1,20110101,L5655,HCPCS,SOCKET INSERT BELOW KNEE,,,28 ,,NW,,,,,,$400.45,$0.00,1,1,1,1,1,1,20110101,L5656,HCPCS,SOCKET INSERT KNEE ARTICULAT,,,28 ,,NW,,,,,,$575.99,$0.00,1,1,1,1,1,1,20110101,L5658,HCPCS,SOCKET INSERT ABOVE KNEE,,,28 ,,NW,,,,,,$538.26,$0.00,1,1,1,1,1,1,20110101,L5661,HCPCS,MULTI-DUROMETER SYMES,,,28 ,,NW,,,,,,$920.83,$0.00,1,1,1,1,1,1,20110101,L5665,HCPCS,MULTI-DUROMETER BELOW KNEE,,,28 ,,NW,,,,,,$793.23,$0.00,1,1,1,1,1,1,20110101,L5666,HCPCS,BELOW KNEE CUFF SUSPENSION,,,28 ,,NW,,,,,,$100.81,$0.00,1,1,1,1,1,1,20110101,L5668,HCPCS,SOCKET INSERT W/O LOCK LOWER,,,28 ,,NW,,,,,,$145.45,$0.00,1,1,1,1,1,1,20110101,L5670,HCPCS,BK MOLDED SUPRACONDYLAR SUSP,,,28 ,,NW,,,,,,$402.60,$0.00,1,1,1,1,1,1,20110101,L5671,HCPCS,BK/AK LOCKING MECHANISM,,,28 ,,NW,,,,,,$788.82,$0.00,1,1,1,1,1,1,20110101,L5672,HCPCS,BK REMOVABLE MEDIAL BRIM SUS,,,28 ,,NW,,,,,,$431.54,$0.00,1,1,1,1,1,1,20110101,L5673,HCPCS,SOCKET INSERT W LOCK MECH,,,28 ,,NW,,,,,,"$1,043.66",$0.00,1,1,1,1,1,1,20110101,L5676,HCPCS,BK KNEE JOINTS SINGLE AXIS P,,,28 ,,NW,,,,,,$548.97,$0.00,1,1,1,1,1,1,20110101,L5677,HCPCS,BK KNEE JOINTS POLYCENTRIC P,,,28 ,,NW,,,,,,$779.45,$0.00,1,1,1,1,1,1,20110101,L5678,HCPCS,BK JOINT COVERS PAIR,,,28 ,,NW,,,,,,$57.82,$0.00,1,1,1,1,1,1,20110101,L5679,HCPCS,SOCKET INSERT W/O LOCK MECH,,,28 ,,NW,,,,,,$861.61,$0.00,1,1,1,1,1,1,20110101,L5680,HCPCS,BK THIGH LACER NON-MOLDED,,,28 ,,NW,,,,,,$442.97,$0.00,1,1,1,1,1,1,20110101,L5681,HCPCS,INTL CUSTM CONG/LATYP INSERT,,,28 ,,NW,,,,,,"$1,881.56",$0.00,1,1,1,1,1,1,20110101,L5682,HCPCS,BK THIGH LACER GLUT/ISCHIA M,,,28 ,,NW,,,,,,$946.46,$0.00,1,1,1,1,1,1,20110101,L5683,HCPCS,INITIAL CUSTOM SOCKET INSERT,,,28 ,,NW,,,,,,"$1,881.56",$0.00,1,1,1,1,1,1,20110101,L5684,HCPCS,BK FORK STRAP,,,28 ,,NW,,,,,,$68.30,$0.00,1,1,1,1,1,1,20110101,L5685,HCPCS,BELOW KNEE SUS/SEAL SLEEVE,,,28 ,,NW,,,,,,$157.99,$0.00,1,1,1,1,1,1,20110101,L5686,HCPCS,BK BACK CHECK,,,28 ,,NW,,,,,,$74.84,$0.00,1,1,1,1,1,1,20110101,L5688,HCPCS,BK WAIST BELT WEBBING,,,28 ,,NW,,,,,,$88.07,$0.00,1,1,1,1,1,1,20110101,L5690,HCPCS,BK WAIST BELT PADDED AND LIN,,,28 ,,NW,,,,,,$140.91,$0.00,1,1,1,1,1,1,20110101,L5692,HCPCS,AK PELVIC CONTROL BELT LIGHT,,,28 ,,NW,,,,,,$184.35,$0.00,1,1,1,1,1,1,20110101,L5694,HCPCS,AK PELVIC CONTROL BELT PAD/L,,,28 ,,NW,,,,,,$252.84,$0.00,1,1,1,1,1,1,20110101,L5695,HCPCS,AK SLEEVE SUSP NEOPRENE/EQUA,,,28 ,,NW,,,,,,$228.97,$0.00,1,1,1,1,1,1,20110101,L5696,HCPCS,AK/KNEE DISARTIC PELVIC JOIN,,,28 ,,NW,,,,,,$261.79,$0.00,1,1,1,1,1,1,20110101,L5697,HCPCS,AK/KNEE DISARTIC PELVIC BAND,,,28 ,,NW,,,,,,$112.46,$0.00,1,1,1,1,1,1,20110101,L5698,HCPCS,AK/KNEE DISARTIC SILESIAN BA,,,28 ,,NW,,,,,,$153.53,$0.00,1,1,1,1,1,1,20110101,L5699,HCPCS,SHOULDER HARNESS,,,28 ,,NW,,,,,,$268.03,$0.00,1,1,1,1,1,1,20110101,L5700,HCPCS,REPLACE SOCKET BELOW KNEE,,,28 ,,NW,,,,,,"$4,475.45",$0.00,1,1,1,1,1,1,20110101,L5701,HCPCS,REPLACE SOCKET ABOVE KNEE,,,28 ,,NW,,,,,,"$5,509.81",$0.00,1,1,1,1,1,1,20110101,L5702,HCPCS,REPLACE SOCKET HIP,,,28 ,,NW,,,,,,"$7,050.64",$0.00,1,1,1,1,1,1,20110101,L5703,HCPCS,SYMES ANKLE W/O (SACH) FOOT,,,28 ,,NW,,,,,,"$3,446.65",$0.00,1,1,1,1,1,1,20110101,L5704,HCPCS,CUSTOM SHAPE COVER BK,,,28 ,,NW,,,,,,$809.76,$0.00,1,1,1,1,1,1,20110101,L5705,HCPCS,CUSTOM SHAPE COVER AK,,,28 ,,NW,,,,,,"$1,466.93",$0.00,1,1,1,1,1,1,20110101,L5706,HCPCS,CUSTOM SHAPE CVR KNEE DISART,,,28 ,,NW,,,,,,"$1,438.03",$0.00,1,1,1,1,1,1,20110101,L5707,HCPCS,CUSTOM SHAPE CVR HIP DISART,,,28 ,,NW,,,,,,"$1,966.58",$0.00,1,1,1,1,1,1,20110101,L5710,HCPCS,KNE-SHIN EXO SNG AXI MNL LOC,,,28 ,,NW,,,,,,$544.93,$0.00,1,1,1,1,1,1,20110101,L5711,HCPCS,KNEE-SHIN EXO MNL LOCK ULTRA,,,28 ,,NW,,,,,,$815.39,$0.00,1,1,1,1,1,1,20110101,L5712,HCPCS,KNEE-SHIN EXO FRICT SWG & ST,,,28 ,,NW,,,,,,$671.46,$0.00,1,1,1,1,1,1,20110101,L5714,HCPCS,KNEE-SHIN EXO VARIABLE FRICT,,,28 ,,NW,,,,,,$630.18,$0.00,1,1,1,1,1,1,20110101,L5716,HCPCS,KNEE-SHIN EXO MECH STANCE PH,,,28 ,,NW,,,,,,"$1,168.48",$0.00,1,1,1,1,1,1,20110101,L5718,HCPCS,KNEE-SHIN EXO FRCT SWG & STA,,,28 ,,NW,,,,,,"$1,418.20",$0.00,1,1,1,1,1,1,20110101,L5722,HCPCS,KNEE-SHIN PNEUM SWG FRCT EXO,,,28 ,,NW,,,,,,"$1,436.43",$0.00,1,1,1,1,1,1,20110101,L5724,HCPCS,KNEE-SHIN EXO FLUID SWING PH,,,28 ,,NW,,,,,,"$2,522.18",$0.00,1,1,1,1,1,1,20110101,L5726,HCPCS,KNEE-SHIN EXT JNTS FLD SWG E,,,28 ,,NW,,,,,,"$2,854.17",$0.00,1,1,1,1,1,1,20110101,L5728,HCPCS,KNEE-SHIN FLUID SWG & STANCE,,,28 ,,NW,,,,,,"$3,825.70",$0.00,1,1,1,1,1,1,20110101,L5780,HCPCS,KNEE-SHIN PNEUM/HYDRA PNEUM,,,28 ,,NW,,,,,,"$1,845.65",$0.00,1,1,1,1,1,1,20110101,L5781,HCPCS,LOWER LIMB PROS VACUUM PUMP,,,28 ,,NW,,,,,,"$5,821.95",$0.00,1,1,1,1,1,1,20110101,L5782,HCPCS,HD LOW LIMB PROS VACUUM PUMP,,,28 ,,NW,,,,,,"$6,140.29",$0.00,1,1,1,1,1,1,20110101,L5785,HCPCS,EXOSKELETAL BK ULTRALT MATER,,,28 ,,NW,,,,,,$786.90,$0.00,1,1,1,1,1,1,20110101,L5790,HCPCS,EXOSKELETAL AK ULTRA-LIGHT M,,,28 ,,NW,,,,,,"$1,119.45",$0.00,1,1,1,1,1,1,20110101,L5795,HCPCS,EXOSKEL HIP ULTRA-LIGHT MATE,,,28 ,,NW,,,,,,"$1,732.71",$0.00,1,1,1,1,1,1,20110101,L5810,HCPCS,ENDOSKEL KNEE-SHIN MNL LOCK,,,28 ,,NW,,,,,,$761.24,$0.00,1,1,1,1,1,1,20110101,L5811,HCPCS,ENDO KNEE-SHIN MNL LCK ULTRA,,,28 ,,NW,,,,,,"$1,142.94",$0.00,1,1,1,1,1,1,20110101,L5812,HCPCS,ENDO KNEE-SHIN FRCT SWG & ST,,,28 ,,NW,,,,,,$869.16,$0.00,1,1,1,1,1,1,20110101,L5814,HCPCS,ENDO KNEE-SHIN HYDRAL SWG PH,,,28 ,,NW,,,,,,"$5,402.38",$0.00,1,1,1,1,1,1,20110101,L5816,HCPCS,ENDO KNEE-SHIN POLYC MCH STA,,,28 ,,NW,,,,,,"$1,316.55",$0.00,1,1,1,1,1,1,20110101,L5818,HCPCS,ENDO KNEE-SHIN FRCT SWG & ST,,,28 ,,NW,,,,,,"$1,504.80",$0.00,1,1,1,1,1,1,20110101,L5822,HCPCS,ENDO KNEE-SHIN PNEUM SWG FRC,,,28 ,,NW,,,,,,"$2,597.57",$0.00,1,1,1,1,1,1,20110101,L5824,HCPCS,ENDO KNEE-SHIN FLUID SWING P,,,28 ,,NW,,,,,,"$2,519.29",$0.00,1,1,1,1,1,1,20110101,L5826,HCPCS,MINIATURE KNEE JOINT,,,28 ,,NW,,,,,,"$4,556.81",$0.00,1,1,1,1,1,1,20110101,L5828,HCPCS,ENDO KNEE-SHIN FLUID SWG/STA,,,28 ,,NW,,,,,,"$4,545.20",$0.00,1,1,1,1,1,1,20110101,L5830,HCPCS,ENDO KNEE-SHIN PNEUM/SWG PHA,,,28 ,,NW,,,,,,"$3,091.87",$0.00,1,1,1,1,1,1,20110101,L5840,HCPCS,MULTI-AXIAL KNEE/SHIN SYSTEM,,,28 ,,NW,,,,,,"$5,471.77",$0.00,1,1,1,1,1,1,20110101,L5845,HCPCS,KNEE-SHIN SYS STANCE FLEXION,,,28 ,,NW,,,,,,"$2,581.24",$0.00,1,1,1,1,1,1,20110101,L5848,HCPCS,KNEE-SHIN SYS HYDRAUL STANCE,,,28 ,,NW,,,,,,"$1,529.19",$0.00,1,1,1,1,1,1,20110101,L5850,HCPCS,ENDO AK/HIP KNEE EXTENS ASSI,,,28 ,,NW,,,,,,$167.51,$0.00,1,1,1,1,1,1,20110101,L5855,HCPCS,MECH HIP EXTENSION ASSIST,,,28 ,,NW,,,,,,$463.80,$0.00,1,1,1,1,1,1,20110101,L5856,HCPCS,ELEC KNEE-SHIN SWING/STANCE,,,28 ,,NW,,,,,,"$35,207.21",$0.00,1,1,1,1,1,1,20110101,L5857,HCPCS,ELEC KNEE-SHIN SWING ONLY,,,28 ,,NW,,,,,,"$12,483.97",$0.00,1,1,1,1,1,1,20110101,L5858,HCPCS,STANCE PHASE ONLY,,,28 ,,NW,,,,,,"$27,219.38",$0.00,1,1,1,1,1,1,20110101,L5910,HCPCS,ENDO BELOW KNEE ALIGNABLE SY,,,28 ,,NW,,,,,,$525.20,$0.00,1,1,1,1,1,1,20110101,L5920,HCPCS,ENDO AK/HIP ALIGNABLE SYSTEM,,,28 ,,NW,,,,,,$784.84,$0.00,1,1,1,1,1,1,20110101,L5925,HCPCS,ABOVE KNEE MANUAL LOCK,,,28 ,,NW,,,,,,$540.19,$0.00,1,1,1,1,1,1,20110101,L5930,HCPCS,HIGH ACTIVITY KNEE FRAME,,,28 ,,NW,,,,,,"$4,911.48",$0.00,1,1,1,1,1,1,20110101,L5940,HCPCS,ENDO BK ULTRA-LIGHT MATERIAL,,,28 ,,NW,,,,,,$759.27,$0.00,1,1,1,1,1,1,20110101,L5950,HCPCS,ENDO AK ULTRA-LIGHT MATERIAL,,,28 ,,NW,,,,,,"$1,194.79",$0.00,1,1,1,1,1,1,20110101,L5960,HCPCS,ENDO HIP ULTRA-LIGHT MATERIA,,,28 ,,NW,,,,,,"$1,546.14",$0.00,1,1,1,1,1,1,20110101,L5961,HCPCS,"ENDO POLY HIP, PNEU/HYD/ROT",,,28 ,,NW,,,,,,"$1,546.14",$0.00,1,1,1,1,1,1,20110101,L5962,HCPCS,BELOW KNEE FLEX COVER SYSTEM,,,28 ,,NW,,,,,,$915.89,$0.00,1,1,1,1,1,1,20110101,L5964,HCPCS,ABOVE KNEE FLEX COVER SYSTEM,,,28 ,,NW,,,,,,"$1,490.67",$0.00,1,1,1,1,1,1,20110101,L5966,HCPCS,HIP FLEXIBLE COVER SYSTEM,,,28 ,,NW,,,,,,"$1,930.52",$0.00,1,1,1,1,1,1,20110101,L5968,HCPCS,MULTIAXIAL ANKLE W DORSIFLEX,,,28 ,,NW,,,,,,"$5,283.13",$0.00,1,1,1,1,1,1,20110101,L5970,HCPCS,FOOT EXTERNAL KEEL SACH FOOT,,,28 ,,NW,,,,,,$282.30,$0.00,1,1,1,1,1,1,20110101,L5971,HCPCS,"SACH FOOT, REPLACEMENT",,,28 ,,NW,,,,,,$282.30,$0.00,1,1,1,1,1,1,20110101,L5972,HCPCS,FLEXIBLE KEEL FOOT,,,28 ,,NW,,,,,,$545.02,$0.00,1,1,1,1,1,1,20110101,L5973,HCPCS,ANK-FOOT SYS DORS-PLANT FLEX,,,28 ,,NW,,,,,,"$25,544.03",$0.00,1,1,1,1,1,1,20110101,L5974,HCPCS,FOOT SINGLE AXIS ANKLE/FOOT,,,28 ,,NW,,,,,,$339.52,$0.00,1,1,1,1,1,1,20110101,L5975,HCPCS,COMBO ANKLE/FOOT PROSTHESIS,,,28 ,,NW,,,,,,$631.69,$0.00,1,1,1,1,1,1,20110101,L5976,HCPCS,ENERGY STORING FOOT,,,28 ,,NW,,,,,,$877.55,$0.00,1,1,1,1,1,1,20110101,L5978,HCPCS,FT PROSTH MULTIAXIAL ANKL/FT,,,28 ,,NW,,,,,,$434.68,$0.00,1,1,1,1,1,1,20110101,L5979,HCPCS,MULTI-AXIAL ANKLE/FT PROSTH,,,28 ,,NW,,,,,,"$3,666.62",$0.00,1,1,1,1,1,1,20110101,L5980,HCPCS,FLEX FOOT SYSTEM,,,28 ,,NW,,,,,,"$5,912.05",$0.00,1,1,1,1,1,1,20110101,L5981,HCPCS,FLEX-WALK SYS LOW EXT PROSTH,,,28 ,,NW,,,,,,"$4,646.25",$0.00,1,1,1,1,1,1,20110101,L5982,HCPCS,EXOSKELETAL AXIAL ROTATION U,,,28 ,,NW,,,,,,$913.67,$0.00,1,1,1,1,1,1,20110101,L5984,HCPCS,ENDOSKELETAL AXIAL ROTATION,,,28 ,,NW,,,,,,$900.00,$0.00,1,1,1,1,1,1,20110101,L5985,HCPCS,LWR EXT DYNAMIC PROSTH PYLON,,,28 ,,NW,,,,,,$367.62,$0.00,1,1,1,1,1,1,20110101,L5986,HCPCS,MULTI-AXIAL ROTATION UNIT,,,28 ,,NW,,,,,,"$1,004.57",$0.00,1,1,1,1,1,1,20110101,L5987,HCPCS,SHANK FT W VERT LOAD PYLON,,,28 ,,NW,,,,,,"$10,509.81",$0.00,1,1,1,1,1,1,20110101,L5988,HCPCS,VERTICAL SHOCK REDUCING PYLO,,,28 ,,NW,,,,,,"$2,882.49",$0.00,1,1,1,1,1,1,20110101,L5990,HCPCS,USER ADJUSTABLE HEEL HEIGHT,,,28 ,,NW,,,,,,"$2,613.27",$0.00,1,1,1,1,1,1,20110101,L5999,HCPCS,LOWR EXTREMITY PROSTHES NOS,,,28 ,,NW,,,,,,$784.84,$0.00,1,1,1,1,1,1,20110101,L6000,HCPCS,PAR HAND ROBIN-AIDS THUM REM,,,28 ,,NW,,,,,,"$2,213.75",$0.00,1,1,1,1,1,1,20110101,L6010,HCPCS,HAND ROBIN-AIDS LITTLE/RING,,,28 ,,NW,,,,,,"$2,451.49",$0.00,1,1,1,1,1,1,20110101,L6020,HCPCS,PART HAND ROBIN-AIDS NO FING,,,28 ,,NW,,,,,,"$2,288.93",$0.00,1,1,1,1,1,1,20110101,L6025,HCPCS,PART HAND DISART MYOELECTRIC,,,28 ,,NW,,,,,,"$11,692.45",$0.00,1,1,1,1,1,1,20110101,L6050,HCPCS,WRST MLD SCK FLX HNG TRI PAD,,,28 ,,NW,,,,,,"$3,224.97",$0.00,1,1,1,1,1,1,20110101,L6055,HCPCS,WRST MOLD SOCK W/EXP INTERFA,,,28 ,,NW,,,,,,"$4,344.16",$0.00,1,1,1,1,1,1,20110101,L6100,HCPCS,ELB MOLD SOCK FLEX HINGE PAD,,,28 ,,NW,,,,,,"$3,214.54",$0.00,1,1,1,1,1,1,20110101,L6110,HCPCS,ELBOW MOLD SOCK SUSPENSION T,,,28 ,,NW,,,,,,"$3,515.23",$0.00,1,1,1,1,1,1,20110101,L6120,HCPCS,ELBOW MOLD DOUB SPLT SOC STE,,,28 ,,NW,,,,,,"$4,042.93",$0.00,1,1,1,1,1,1,20110101,L6130,HCPCS,ELBOW STUMP ACTIVATED LOCK H,,,28 ,,NW,,,,,,"$4,323.60",$0.00,1,1,1,1,1,1,20110101,L6200,HCPCS,ELBOW MOLD OUTSID LOCK HINGE,,,28 ,,NW,,,,,,"$4,546.82",$0.00,1,1,1,1,1,1,20110101,L6205,HCPCS,ELBOW MOLDED W/ EXPAND INTER,,,28 ,,NW,,,,,,"$6,040.99",$0.00,1,1,1,1,1,1,20110101,L6250,HCPCS,ELBOW INTER LOC ELBOW FORARM,,,28 ,,NW,,,,,,"$4,512.61",$0.00,1,1,1,1,1,1,20110101,L6300,HCPCS,SHLDER DISART INT LOCK ELBOW,,,28 ,,NW,,,,,,"$6,254.74",$0.00,1,1,1,1,1,1,20110101,L6310,HCPCS,SHOULDER PASSIVE RESTOR COMP,,,28 ,,NW,,,,,,"$5,116.07",$0.00,1,1,1,1,1,1,20110101,L6320,HCPCS,SHOULDER PASSIVE RESTOR CAP,,,28 ,,NW,,,,,,"$2,802.48",$0.00,1,1,1,1,1,1,20110101,L6350,HCPCS,THORACIC INTERN LOCK ELBOW,,,28 ,,NW,,,,,,"$6,601.80",$0.00,1,1,1,1,1,1,20110101,L6360,HCPCS,THORACIC PASSIVE RESTOR COMP,,,28 ,,NW,,,,,,"$5,336.20",$0.00,1,1,1,1,1,1,20110101,L6370,HCPCS,THORACIC PASSIVE RESTOR CAP,,,28 ,,NW,,,,,,"$3,435.45",$0.00,1,1,1,1,1,1,20110101,L6380,HCPCS,POSTOP DSG CAST CHG WRST/ELB,,,28 ,,NW,,,,,,"$1,874.83",$0.00,1,1,1,1,1,1,20110101,L6382,HCPCS,POSTOP DSG CAST CHG ELB DIS/,,,28 ,,NW,,,,,,"$2,432.15",$0.00,1,1,1,1,1,1,20110101,L6384,HCPCS,POSTOP DSG CAST CHG SHLDER/T,,,28 ,,NW,,,,,,"$3,161.05",$0.00,1,1,1,1,1,1,20110101,L6386,HCPCS,POSTOP EA CAST CHG & REALIGN,,,28 ,,NW,,,,,,$636.56,$0.00,1,1,1,1,1,1,20110101,L6388,HCPCS,POSTOP APPLICAT RIGID DSG ON,,,28 ,,NW,,,,,,$673.91,$0.00,1,1,1,1,1,1,20110101,L6400,HCPCS,BELOW ELBOW PROSTH TISS SHAP,,,28 ,,NW,,,,,,"$3,810.46",$0.00,1,1,1,1,1,1,20110101,L6450,HCPCS,ELB DISART PROSTH TISS SHAP,,,28 ,,NW,,,,,,"$4,953.30",$0.00,1,1,1,1,1,1,20110101,L6500,HCPCS,ABOVE ELBOW PROSTH TISS SHAP,,,28 ,,NW,,,,,,"$4,892.66",$0.00,1,1,1,1,1,1,20110101,L6550,HCPCS,SHLDR DISAR PROSTH TISS SHAP,,,28 ,,NW,,,,,,"$6,236.26",$0.00,1,1,1,1,1,1,20110101,L6570,HCPCS,SCAP THORAC PROSTH TISS SHAP,,,28 ,,NW,,,,,,"$7,183.38",$0.00,1,1,1,1,1,1,20110101,L6580,HCPCS,WRIST/ELBOW BOWDEN CABLE MOL,,,28 ,,NW,,,,,,"$2,517.98",$0.00,1,1,1,1,1,1,20110101,L6582,HCPCS,WRIST/ELBOW BOWDEN CBL DIR F,,,28 ,,NW,,,,,,"$2,160.87",$0.00,1,1,1,1,1,1,20110101,L6584,HCPCS,ELBOW FAIR LEAD CABLE MOLDED,,,28 ,,NW,,,,,,"$3,333.89",$0.00,1,1,1,1,1,1,20110101,L6586,HCPCS,ELBOW FAIR LEAD CABLE DIR FO,,,28 ,,NW,,,,,,"$3,019.79",$0.00,1,1,1,1,1,1,20110101,L6588,HCPCS,SHDR FAIR LEAD CABLE MOLDED,,,28 ,,NW,,,,,,"$4,621.95",$0.00,1,1,1,1,1,1,20110101,L6590,HCPCS,SHDR FAIR LEAD CABLE DIRECT,,,28 ,,NW,,,,,,"$4,228.35",$0.00,1,1,1,1,1,1,20110101,L6600,HCPCS,POLYCENTRIC HINGE PAIR,,,28 ,,NW,,,,,,$275.62,$0.00,1,1,1,1,1,1,20110101,L6605,HCPCS,SINGLE PIVOT HINGE PAIR,,,28 ,,NW,,,,,,$272.02,$0.00,1,1,1,1,1,1,20110101,L6610,HCPCS,FLEXIBLE METAL HINGE PAIR,,,28 ,,NW,,,,,,$236.85,$0.00,1,1,1,1,1,1,20110101,L6611,HCPCS,"ADDITIONAL SWITCH, EXT POWER",,,28 ,,NW,,,,,,$555.57,$0.00,1,1,1,1,1,1,20110101,L6615,HCPCS,DISCONNECT LOCKING WRIST UNI,,,28 ,,NW,,,,,,$239.52,$0.00,1,1,1,1,1,1,20110101,L6616,HCPCS,DISCONNECT INSERT LOCKING WR,,,28 ,,NW,,,,,,$90.97,$0.00,1,1,1,1,1,1,20110101,L6620,HCPCS,FLEXION/EXTENSION WRIST UNIT,,,28 ,,NW,,,,,,$454.50,$0.00,1,1,1,1,1,1,20110101,L6621,HCPCS,FLEX/EXT WRIST W/WO FRICTION,,,28 ,,NW,,,,,,"$3,307.40",$0.00,1,1,1,1,1,1,20110101,L6623,HCPCS,SPRING-ASS ROT WRST W/ LATCH,,,28 ,,NW,,,,,,"$1,008.20",$0.00,1,1,1,1,1,1,20110101,L6624,HCPCS,FLEX/EXT/ROTATION WRIST UNIT,,,28 ,,NW,,,,,,"$5,477.05",$0.00,1,1,1,1,1,1,20110101,L6625,HCPCS,ROTATION WRST W/ CABLE LOCK,,,28 ,,NW,,,,,,$849.54,$0.00,1,1,1,1,1,1,20110101,L6628,HCPCS,QUICK DISCONN HOOK ADAPTER O,,,28 ,,NW,,,,,,$722.56,$0.00,1,1,1,1,1,1,20110101,L6629,HCPCS,LAMINATION COLLAR W/ COUPLIN,,,28 ,,NW,,,,,,$206.03,$0.00,1,1,1,1,1,1,20110101,L6630,HCPCS,STAINLESS STEEL ANY WRIST,,,28 ,,NW,,,,,,$304.49,$0.00,1,1,1,1,1,1,20110101,L6632,HCPCS,LATEX SUSPENSION SLEEVE EACH,,,28 ,,NW,,,,,,$86.93,$0.00,1,1,1,1,1,1,20110101,L6635,HCPCS,LIFT ASSIST FOR ELBOW,,,28 ,,NW,,,,,,$251.75,$0.00,1,1,1,1,1,1,20110101,L6637,HCPCS,NUDGE CONTROL ELBOW LOCK,,,28 ,,NW,,,,,,$550.82,$0.00,1,1,1,1,1,1,20110101,L6638,HCPCS,ELEC LOCK ON MANUAL PW ELBOW,,,28 ,,NW,,,,,,"$3,620.54",$0.00,1,1,1,1,1,1,20110101,L6640,HCPCS,SHOULDER ABDUCTION JOINT PAI,,,28 ,,NW,,,,,,$426.12,$0.00,1,1,1,1,1,1,20110101,L6641,HCPCS,EXCURSION AMPLIFIER PULLEY T,,,28 ,,NW,,,,,,$231.30,$0.00,1,1,1,1,1,1,20110101,L6642,HCPCS,EXCURSION AMPLIFIER LEVER TY,,,28 ,,NW,,,,,,$327.09,$0.00,1,1,1,1,1,1,20110101,L6645,HCPCS,SHOULDER FLEXION-ABDUCTION J,,,28 ,,NW,,,,,,$504.01,$0.00,1,1,1,1,1,1,20110101,L6646,HCPCS,MULTIPO LOCKING SHOULDER JNT,,,28 ,,NW,,,,,,"$4,578.98",$0.00,1,1,1,1,1,1,20110101,L6647,HCPCS,SHOULDER LOCK ACTUATOR,,,28 ,,NW,,,,,,$713.32,$0.00,1,1,1,1,1,1,20110101,L6648,HCPCS,EXT PWRD SHLDER LOCK/UNLOCK,,,28 ,,NW,,,,,,"$4,724.09",$0.00,1,1,1,1,1,1,20110101,L6650,HCPCS,SHOULDER UNIVERSAL JOINT,,,28 ,,NW,,,,,,$537.95,$0.00,1,1,1,1,1,1,20110101,L6655,HCPCS,STANDARD CONTROL CABLE EXTRA,,,28 ,,NW,,,,,,$107.10,$0.00,1,1,1,1,1,1,20110101,L6660,HCPCS,HEAVY DUTY CONTROL CABLE,,,28 ,,NW,,,,,,$128.35,$0.00,1,1,1,1,1,1,20110101,L6665,HCPCS,TEFLON OR EQUAL CABLE LINING,,,28 ,,NW,,,,,,$64.81,$0.00,1,1,1,1,1,1,20110101,L6670,HCPCS,HOOK TO HAND CABLE ADAPTER,,,28 ,,NW,,,,,,$70.57,$0.00,1,1,1,1,1,1,20110101,L6672,HCPCS,HARNESS CHEST/SHLDER SADDLE,,,28 ,,NW,,,,,,$245.54,$0.00,1,1,1,1,1,1,20110101,L6675,HCPCS,HARNESS FIGURE OF 8 SING CON,,,28 ,,NW,,,,,,$159.93,$0.00,1,1,1,1,1,1,20110101,L6676,HCPCS,HARNESS FIGURE OF 8 DUAL CON,,,28 ,,NW,,,,,,$170.41,$0.00,1,1,1,1,1,1,20110101,L6677,HCPCS,UE TRIPLE CONTROL HARNESS,,,28 ,,NW,,,,,,$386.74,$0.00,1,1,1,1,1,1,20110101,L6680,HCPCS,TEST SOCK WRIST DISART/BEL E,,,28 ,,NW,,,,,,$355.26,$0.00,1,1,1,1,1,1,20110101,L6682,HCPCS,TEST SOCK ELBW DISART/ABOVE,,,28 ,,NW,,,,,,$385.08,$0.00,1,1,1,1,1,1,20110101,L6684,HCPCS,TEST SOCKET SHLDR DISART/THO,,,28 ,,NW,,,,,,$549.62,$0.00,1,1,1,1,1,1,20110101,L6686,HCPCS,SUCTION SOCKET,,,28 ,,NW,,,,,,$985.85,$0.00,1,1,1,1,1,1,20110101,L6687,HCPCS,FRAME TYP SOCKET BEL ELBOW/W,,,28 ,,NW,,,,,,$813.27,$0.00,1,1,1,1,1,1,20110101,L6688,HCPCS,FRAME TYP SOCK ABOVE ELB/DIS,,,28 ,,NW,,,,,,$842.73,$0.00,1,1,1,1,1,1,20110101,L6689,HCPCS,FRAME TYP SOCKET SHOULDER DI,,,28 ,,NW,,,,,,"$1,042.52",$0.00,1,1,1,1,1,1,20110101,L6690,HCPCS,FRAME TYP SOCK INTERSCAP-THO,,,28 ,,NW,,,,,,"$1,119.62",$0.00,1,1,1,1,1,1,20110101,L6691,HCPCS,REMOVABLE INSERT EACH,,,28 ,,NW,,,,,,$520.40,$0.00,1,1,1,1,1,1,20110101,L6692,HCPCS,SILICONE GEL INSERT OR EQUAL,,,28 ,,NW,,,,,,$881.18,$0.00,1,1,1,1,1,1,20110101,L6693,HCPCS,LOCKINGELBOW FOREARM CNTRBAL,,,28 ,,NW,,,,,,"$4,116.83",$0.00,1,1,1,1,1,1,20110101,L6694,HCPCS,ELBOW SOCKET INS USE W/LOCK,,,28 ,,NW,,,,,,"$1,043.66",$0.00,1,1,1,1,1,1,20110101,L6695,HCPCS,ELBOW SOCKET INS USE W/O LCK,,,28 ,,NW,,,,,,$861.61,$0.00,1,1,1,1,1,1,20110101,L6696,HCPCS,CUS ELBO SKT IN FOR CON/ATYP,,,28 ,,NW,,,,,,"$1,881.56",$0.00,1,1,1,1,1,1,20110101,L6697,HCPCS,CUS ELBO SKT IN NOT CON/ATYP,,,28 ,,NW,,,,,,"$1,881.56",$0.00,1,1,1,1,1,1,20110101,L6698,HCPCS,BELOW/ABOVE ELBOW LOCK MECH,,,28 ,,NW,,,,,,$788.82,$0.00,1,1,1,1,1,1,20110101,L6703,HCPCS,"TERM DEV, PASSIVE HAND MITT",,,28 ,,NW,,,,,,$483.40,$0.00,1,1,1,1,1,1,20110101,L6704,HCPCS,"TERM DEV, SPORT/REC/WORK ATT",,,28 ,,NW,,,,,,$932.83,$0.00,1,1,1,1,1,1,20110101,L6706,HCPCS,TERM DEV MECH HOOK VOL OPEN,,,28 ,,NW,,,,,,$528.56,$0.00,1,1,1,1,1,1,20110101,L6707,HCPCS,TERM DEV MECH HOOK VOL CLOSE,,,28 ,,NW,,,,,,"$2,082.80",$0.00,1,1,1,1,1,1,20110101,L6708,HCPCS,TERM DEV MECH HAND VOL OPEN,,,28 ,,NW,,,,,,"$1,350.27",$0.00,1,1,1,1,1,1,20110101,L6709,HCPCS,TERM DEV MECH HAND VOL CLOSE,,,28 ,,NW,,,,,,"$1,977.36",$0.00,1,1,1,1,1,1,20110101,L6711,HCPCS,"PED TERM DEV, HOOK, VOL OPEN",,,28 ,,NW,,,,,,$937.91,$0.00,1,1,1,1,1,1,20110101,L6712,HCPCS,"PED TERM DEV, HOOK, VOL CLOS",,,28 ,,NW,,,,,,"$1,767.68",$0.00,1,1,1,1,1,1,20110101,L6713,HCPCS,"PED TERM DEV, HAND, VOL OPEN",,,28 ,,NW,,,,,,"$2,243.69",$0.00,1,1,1,1,1,1,20110101,L6714,HCPCS,"PED TERM DEV, HAND, VOL CLOS",,,28 ,,NW,,,,,,"$1,892.98",$0.00,1,1,1,1,1,1,20110101,L6721,HCPCS,"HOOK/HAND, HVY DTY, VOL OPEN",,,28 ,,NW,,,,,,"$3,402.27",$0.00,1,1,1,1,1,1,20110101,L6722,HCPCS,"HOOK/HAND, HVY DTY, VOL CLOS",,,28 ,,NW,,,,,,"$2,926.32",$0.00,1,1,1,1,1,1,20110101,L6805,HCPCS,TERM DEV MODIFIER WRIST UNIT,,,28 ,,NW,,,,,,$522.83,$0.00,1,1,1,1,1,1,20110101,L6810,HCPCS,TERM DEV PRECISION PINCH DEV,,,28 ,,NW,,,,,,$256.03,$0.00,1,1,1,1,1,1,20110101,L6881,HCPCS,TERM DEV AUTO GRASP FEATURE,,,28 ,,NW,,,,,,"$5,949.70",$0.00,1,1,1,1,1,1,20110101,L6882,HCPCS,MICROPROCESSOR CONTROL UPLMB,,,28 ,,NW,,,,,,"$4,501.42",$0.00,1,1,1,1,1,1,20110101,L6883,HCPCS,REPLC SOCKT BELOW E/W DISA,,,28 ,,NW,,,,,,"$2,608.22",$0.00,1,1,1,1,1,1,20110101,L6884,HCPCS,REPLC SOCKT ABOVE ELBOW DISA,,,28 ,,NW,,,,,,"$3,757.54",$0.00,1,1,1,1,1,1,20110101,L6885,HCPCS,REPLC SOCKT SHLDR DIS/INTERC,,,28 ,,NW,,,,,,"$5,336.20",$0.00,1,1,1,1,1,1,20110101,L6890,HCPCS,PREFAB GLOVE FOR TERM DEVICE,,,28 ,,NW,,,,,,$240.17,$0.00,1,1,1,1,1,1,20110101,L6895,HCPCS,CUSTOM GLOVE FOR TERM DEVICE,,,28 ,,NW,,,,,,$851.44,$0.00,1,1,1,1,1,1,20110101,L6900,HCPCS,HAND RESTORAT THUMB/1 FINGER,,,28 ,,NW,,,,,,"$2,592.42",$0.00,1,1,1,1,1,1,20110101,L6905,HCPCS,HAND RESTORATION MULTIPLE FI,,,28 ,,NW,,,,,,"$2,523.51",$0.00,1,1,1,1,1,1,20110101,L6910,HCPCS,HAND RESTORATION NO FINGERS,,,28 ,,NW,,,,,,"$2,437.36",$0.00,1,1,1,1,1,1,20110101,L6915,HCPCS,HAND RESTORATION REPLACMNT G,,,28 ,,NW,,,,,,"$1,025.47",$0.00,1,1,1,1,1,1,20110101,L6920,HCPCS,WRIST DISARTICUL SWITCH CTRL,,,28 ,,NW,,,,,,"$10,920.70",$0.00,1,1,1,1,1,1,20110101,L6925,HCPCS,WRIST DISART MYOELECTRONIC C,,,28 ,,NW,,,,,,"$12,498.36",$0.00,1,1,1,1,1,1,20110101,L6930,HCPCS,BELOW ELBOW SWITCH CONTROL,,,28 ,,NW,,,,,,"$10,816.55",$0.00,1,1,1,1,1,1,20110101,L6935,HCPCS,BELOW ELBOW MYOELECTRONIC CT,,,28 ,,NW,,,,,,"$12,669.26",$0.00,1,1,1,1,1,1,20110101,L6940,HCPCS,ELBOW DISARTICULATION SWITCH,,,28 ,,NW,,,,,,"$13,937.80",$0.00,1,1,1,1,1,1,20110101,L6945,HCPCS,ELBOW DISART MYOELECTRONIC C,,,28 ,,NW,,,,,,"$16,018.33",$0.00,1,1,1,1,1,1,20110101,L6950,HCPCS,ABOVE ELBOW SWITCH CONTROL,,,28 ,,NW,,,,,,"$15,053.88",$0.00,1,1,1,1,1,1,20110101,L6955,HCPCS,ABOVE ELBOW MYOELECTRONIC CT,,,28 ,,NW,,,,,,"$18,041.46",$0.00,1,1,1,1,1,1,20110101,L6960,HCPCS,SHLDR DISARTIC SWITCH CONTRO,,,28 ,,NW,,,,,,"$19,120.41",$0.00,1,1,1,1,1,1,20110101,L6965,HCPCS,SHLDR DISARTIC MYOELECTRONIC,,,28 ,,NW,,,,,,"$22,538.20",$0.00,1,1,1,1,1,1,20110101,L6970,HCPCS,INTERSCAPULAR-THOR SWITCH CT,,,28 ,,NW,,,,,,"$23,584.17",$0.00,1,1,1,1,1,1,20110101,L6975,HCPCS,INTERSCAP-THOR MYOELECTRONIC,,,28 ,,NW,,,,,,"$25,938.99",$0.00,1,1,1,1,1,1,20110101,L7007,HCPCS,ADULT ELECTRIC HAND,,,28 ,,NW,,,,,,"$5,386.28",$0.00,1,1,1,1,1,1,20110101,L7008,HCPCS,PEDIATRIC ELECTRIC HAND,,,28 ,,NW,,,,,,"$8,717.24",$0.00,1,1,1,1,1,1,20110101,L7009,HCPCS,ADULT ELECTRIC HOOK,,,28 ,,NW,,,,,,"$5,485.62",$0.00,1,1,1,1,1,1,20110101,L7040,HCPCS,PREHENSILE ACTUATOR,,,28 ,,NW,,,,,,"$4,396.84",$0.00,1,1,1,1,1,1,20110101,L7045,HCPCS,PEDIATRIC ELECTRIC HOOK,,,28 ,,NW,,,,,,"$2,424.73",$0.00,1,1,1,1,1,1,20110101,L7170,HCPCS,ELECTRONIC ELBOW HOSMER SWIT,,,28 ,,NW,,,,,,"$9,458.97",$0.00,1,1,1,1,1,1,20110101,L7180,HCPCS,ELECTRONIC ELBOW SEQUENTIAL,,,28 ,,NW,,,,,,"$53,695.97",$0.00,1,1,1,1,1,1,20110101,L7181,HCPCS,ELECTRONIC ELBO SIMULTANEOUS,,,28 ,,NW,,,,,,"$58,738.67",$0.00,1,1,1,1,1,1,20110101,L7185,HCPCS,ELECTRON ELBOW ADOLESCENT SW,,,28 ,,NW,,,,,,"$9,808.69",$0.00,1,1,1,1,1,1,20110101,L7186,HCPCS,ELECTRON ELBOW CHILD SWITCH,,,28 ,,NW,,,,,,"$14,557.28",$0.00,1,1,1,1,1,1,20110101,L7190,HCPCS,ELBOW ADOLESCENT MYOELECTRON,,,28 ,,NW,,,,,,"$12,346.28",$0.00,1,1,1,1,1,1,20110101,L7191,HCPCS,ELBOW CHILD MYOELECTRONIC CT,,,28 ,,NW,,,,,,"$15,232.05",$0.00,1,1,1,1,1,1,20110101,L7260,HCPCS,ELECTRON WRIST ROTATOR OTTO,,,28 ,,NW,,,,,,"$3,325.20",$0.00,1,1,1,1,1,1,20110101,L7261,HCPCS,ELECTRON WRIST ROTATOR UTAH,,,28 ,,NW,,,,,,"$6,217.36",$0.00,1,1,1,1,1,1,20110101,L7266,HCPCS,SERVO CONTROL STEEPER OR EQU,,,28 ,,NW,,,,,,"$1,514.54",$0.00,1,1,1,1,1,1,20110101,L7272,HCPCS,ANALOGUE CONTROL UNB OR EQUA,,,28 ,,NW,,,,,,"$3,258.32",$0.00,1,1,1,1,1,1,20110101,L7274,HCPCS,PROPORTIONAL CTL 12 VOLT UTA,,,28 ,,NW,,,,,,"$9,576.92",$0.00,1,1,1,1,1,1,20110101,L7360,HCPCS,SIX VOLT BAT OTTO BOCK/EQ EA,,,28 ,,NW,,,,,,$330.79,$0.00,1,1,1,1,1,1,20110101,L7362,HCPCS,BATTERY CHRGR SIX VOLT OTTO,,,28 ,,NW,,,,,,$353.34,$0.00,1,1,1,1,1,1,20110101,L7364,HCPCS,TWELVE VOLT BATTERY UTAH/EQU,,,28 ,,NW,,,,,,$659.62,$0.00,1,1,1,1,1,1,20110101,L7366,HCPCS,BATTERY CHRGR 12 VOLT UTAH/E,,,28 ,,NW,,,,,,$899.80,$0.00,1,1,1,1,1,1,20110101,L7367,HCPCS,REPLACEMNT LITHIUM IONBATTER,,,28 ,,NW,,,,,,$522.71,$0.00,1,1,1,1,1,1,20110101,L7368,HCPCS,LITHIUM ION BATTERY CHARGER,,,28 ,,NW,,,,,,$691.99,$0.00,1,1,1,1,1,1,20110101,L7400,HCPCS,"ADD UE PROST BE/WD, ULTLITE",,,28 ,,NW,,,,,,$401.18,$0.00,1,1,1,1,1,1,20110101,L7401,HCPCS,ADD UE PROST A/E ULTLITE MAT,,,28 ,,NW,,,,,,$454.90,$0.00,1,1,1,1,1,1,20110101,L7402,HCPCS,ADD UE PROST S/D ULTLITE MAT,,,28 ,,NW,,,,,,$495.14,$0.00,1,1,1,1,1,1,20110101,L7403,HCPCS,ADD UE PROST B/E ACRYLIC,,,28 ,,NW,,,,,,$491.82,$0.00,1,1,1,1,1,1,20110101,L7404,HCPCS,ADD UE PROST A/E ACRYLIC,,,28 ,,NW,,,,,,$766.98,$0.00,1,1,1,1,1,1,20110101,L7405,HCPCS,ADD UE PROST S/D ACRYLIC,,,28 ,,NW,,,,,,"$1,018.01",$0.00,1,1,1,1,1,1,20110101,L7499,HCPCS,UPPER EXTREMITY PROSTHES NOS,,,28 ,,NW,,,,,,$899.80,$0.00,1,1,1,1,1,1,20110101,L7500,HCPCS,PROSTHETIC DVC REPAIR HOURLY,,,28 ,,NW,,,,,,$192.33,$0.00,1,1,1,1,1,1,20110101,L7510,HCPCS,PROSTHETIC DEVICE REPAIR REP,,,28 ,,NW,,,,,,$40.10,$0.00,1,1,1,1,1,1,20110101,L7520,HCPCS,REPAIR PROSTHESIS PER 15 MIN,,,28 ,,NW,,,,,,$40.58,$0.00,1,1,1,1,1,1,20110101,L7600,HCPCS,PROSTHETIC DONNING SLEEVE,,,28 ,,NW,,,,,,$111.78,$0.00,1,1,1,1,1,1,20110101,L7900,HCPCS,MALE VACUUM ERECTION SYSTEM,,,28 ,,NW,,,,,,$736.97,$0.00,1,1,1,1,1,1,20110101,L8000,HCPCS,MASTECTOMY BRA,,,28 ,,NW,,,,,,$54.24,$0.00,1,1,1,1,1,1,20110101,L8001,HCPCS,BREAST PROSTHESIS BRA & FORM,,,28 ,,NW,,,,,,$154.80,$0.00,1,1,1,1,1,1,20110101,L8002,HCPCS,BRST PRSTH BRA & BILAT FORM,,,28 ,,NW,,,,,,$202.34,$0.00,1,1,1,1,1,1,20110101,L8010,HCPCS,MASTECTOMY SLEEVE,,,28 ,,NW,,,,,,$71.05,$0.00,1,1,1,1,1,1,20110101,L8015,HCPCS,EXT BREASTPROSTHESIS GARMENT,,,28 ,,NW,,,,,,$76.21,$0.00,1,1,1,1,1,1,20110101,L8020,HCPCS,MASTECTOMY FORM,,,28 ,,NW,,,,,,$285.08,$0.00,1,1,1,1,1,1,20110101,L8030,HCPCS,BREAST PROSTHES W/O ADHESIVE,,,28 ,,NW,,,,,,$462.30,$0.00,1,1,1,1,1,1,20110101,L8031,HCPCS,BREAST PROSTHESIS W ADHESIVE,,,28 ,,NW,,,,,,$462.30,$0.00,1,1,1,1,1,1,20110101,L8032,HCPCS,REUSABLE NIPPLE PROSTHESIS,,,28 ,,NW,,,,,,$51.22,$0.00,1,1,1,1,1,1,20110101,L8035,HCPCS,CUSTOM BREAST PROSTHESIS,,,28 ,,NW,,,,,,"$5,326.71",$0.00,1,1,1,1,1,1,20110101,L8039,HCPCS,BREAST PROSTHESIS NOS,,,28 ,,NW,,,,,,$54.24,$0.00,1,1,1,1,1,1,20110101,L8040,HCPCS,NASAL PROSTHESIS,,,28 ,,NW,,,,,,"$3,631.31",$0.00,1,1,1,1,1,1,20110101,L8040,HCPCS,NASAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$3,447.32",$0.00,1,1,1,1,1,1,20110101,L8040,HCPCS,NASAL PROSTHESIS,KN,,28 ,,NW,,,,,,"$1,423.42",$0.00,1,1,1,1,1,1,20110101,L8041,HCPCS,MIDFACIAL PROSTHESIS,,,28 ,,NW,,,,,,"$4,386.87",$0.00,1,1,1,1,1,1,20110101,L8041,HCPCS,MIDFACIAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$4,165.08",$0.00,1,1,1,1,1,1,20110101,L8041,HCPCS,MIDFACIAL PROSTHESIS,KN,,28 ,,NW,,,,,,"$1,725.66",$0.00,1,1,1,1,1,1,20110101,L8042,HCPCS,ORBITAL PROSTHESIS,,,28 ,,NW,,,,,,"$4,935.05",$0.00,1,1,1,1,1,1,20110101,L8042,HCPCS,ORBITAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$4,685.87",$0.00,1,1,1,1,1,1,20110101,L8042,HCPCS,ORBITAL PROSTHESIS,KN,,28 ,,NW,,,,,,"$1,944.92",$0.00,1,1,1,1,1,1,20110101,L8043,HCPCS,UPPER FACIAL PROSTHESIS,,,28 ,,NW,,,,,,"$5,533.09",$0.00,1,1,1,1,1,1,20110101,L8043,HCPCS,UPPER FACIAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$5,253.99",$0.00,1,1,1,1,1,1,20110101,L8043,HCPCS,UPPER FACIAL PROSTHESIS,KN,,28 ,,NW,,,,,,"$2,184.13",$0.00,1,1,1,1,1,1,20110101,L8044,HCPCS,HEMI-FACIAL PROSTHESIS,,,28 ,,NW,,,,,,"$6,131.10",$0.00,1,1,1,1,1,1,20110101,L8044,HCPCS,HEMI-FACIAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$5,822.13",$0.00,1,1,1,1,1,1,20110101,L8044,HCPCS,HEMI-FACIAL PROSTHESIS,KN,,28 ,,NW,,,,,,"$2,423.35",$0.00,1,1,1,1,1,1,20110101,L8045,HCPCS,AURICULAR PROSTHESIS,,,28 ,,NW,,,,,,"$4,036.94",$0.00,1,1,1,1,1,1,20110101,L8045,HCPCS,AURICULAR PROSTHESIS,KM,,28 ,,NW,,,,,,"$3,832.67",$0.00,1,1,1,1,1,1,20110101,L8045,HCPCS,AURICULAR PROSTHESIS,KN,,28 ,,NW,,,,,,"$1,585.68",$0.00,1,1,1,1,1,1,20110101,L8046,HCPCS,PARTIAL FACIAL PROSTHESIS,,,28 ,,NW,,,,,,"$3,938.34",$0.00,1,1,1,1,1,1,20110101,L8046,HCPCS,PARTIAL FACIAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$3,739.00",$0.00,1,1,1,1,1,1,20110101,L8046,HCPCS,PARTIAL FACIAL PROSTHESIS,KN,,28 ,,NW,,,,,,"$1,546.23",$0.00,1,1,1,1,1,1,20110101,L8047,HCPCS,NASAL SEPTAL PROSTHESIS,,,28 ,,NW,,,,,,"$1,994.75",$0.00,1,1,1,1,1,1,20110101,L8047,HCPCS,NASAL SEPTAL PROSTHESIS,KM,,28 ,,NW,,,,,,"$1,892.60",$0.00,1,1,1,1,1,1,20110101,L8047,HCPCS,NASAL SEPTAL PROSTHESIS,KN,,28 ,,NW,,,,,,$768.81,$0.00,1,1,1,1,1,1,20110101,L8048,HCPCS,UNSPEC MAXILLOFACIAL PROSTH,,,28 ,,NW,,,,,,$579.75,$0.00,1,1,1,1,1,1,20110101,L8049,HCPCS,REPAIR MAXILLOFACIAL PROSTH,,,28 ,,NW,,,,,,$55.89,$0.00,1,1,1,1,1,1,20110101,L8300,HCPCS,TRUSS SINGLE W/ STANDARD PAD,,,28 ,,NW,,,,,,$117.91,$0.00,1,1,1,1,1,1,20110101,L8310,HCPCS,TRUSS DOUBLE W/ STANDARD PAD,,,28 ,,NW,,,,,,$189.15,$0.00,1,1,1,1,1,1,20110101,L8320,HCPCS,TRUSS ADDITION TO STD PAD WA,,,28 ,,NW,,,,,,$79.61,$0.00,1,1,1,1,1,1,20110101,L8330,HCPCS,TRUSS ADD TO STD PAD SCROTAL,,,28 ,,NW,,,,,,$73.83,$0.00,1,1,1,1,1,1,20110101,L8400,HCPCS,SHEATH BELOW KNEE,,,28 ,,NW,,,,,,$26.01,$0.00,1,1,1,1,1,1,20110101,L8410,HCPCS,SHEATH ABOVE KNEE,,,28 ,,NW,,,,,,$32.37,$0.00,1,1,1,1,1,1,20110101,L8415,HCPCS,SHEATH UPPER LIMB,,,28 ,,NW,,,,,,$32.06,$0.00,1,1,1,1,1,1,20110101,L8417,HCPCS,PROS SHEATH/SOCK W GEL CUSHN,,,28 ,,NW,,,,,,$94.45,$0.00,1,1,1,1,1,1,20110101,L8420,HCPCS,PROSTHETIC SOCK MULTI PLY BK,,,28 ,,NW,,,,,,$31.29,$0.00,1,1,1,1,1,1,20110101,L8430,HCPCS,PROSTHETIC SOCK MULTI PLY AK,,,28 ,,NW,,,,,,$34.39,$0.00,1,1,1,1,1,1,20110101,L8435,HCPCS,PROS SOCK MULTI PLY UPPER LM,,,28 ,,NW,,,,,,$32.90,$0.00,1,1,1,1,1,1,20110101,L8440,HCPCS,SHRINKER BELOW KNEE,,,28 ,,NW,,,,,,$62.90,$0.00,1,1,1,1,1,1,20110101,L8460,HCPCS,SHRINKER ABOVE KNEE,,,28 ,,NW,,,,,,$93.68,$0.00,1,1,1,1,1,1,20110101,L8465,HCPCS,SHRINKER UPPER LIMB,,,28 ,,NW,,,,,,$71.45,$0.00,1,1,1,1,1,1,20110101,L8470,HCPCS,PROS SOCK SINGLE PLY BK,,,28 ,,NW,,,,,,$12.12,$0.00,1,1,1,1,1,1,20110101,L8480,HCPCS,PROS SOCK SINGLE PLY AK,,,28 ,,NW,,,,,,$16.05,$0.00,1,1,1,1,1,1,20110101,L8485,HCPCS,PROS SOCK SINGLE PLY UPPER L,,,28 ,,NW,,,,,,$18.89,$0.00,1,1,1,1,1,1,20110101,L8499,HCPCS,UNLISTED MISC PROSTHETIC SER,,,28 ,,NW,,,,,,$12.12,$0.00,1,1,1,1,1,1,20110101,L8500,HCPCS,ARTIFICIAL LARYNX,,,28 ,,NW,,,,,,"$1,006.64",$0.00,1,1,1,1,1,1,20110101,L8501,HCPCS,TRACHEOSTOMY SPEAKING VALVE,,,28 ,,NW,,,,,,$157.68,$0.00,1,1,1,1,1,1,20110101,L8505,HCPCS,"ARTIFICIAL LARYNX, ACCESSORY",,,28 ,,NW,,,,,,$25.15,$0.00,1,1,1,1,1,1,20110101,L8507,HCPCS,TRACH-ESOPH VOICE PROS PT IN,,,28 ,,NW,,,,,,$54.42,$0.00,1,1,1,1,1,1,20110101,L8509,HCPCS,TRACH-ESOPH VOICE PROS MD IN,,,28 ,,NW,,,,,,$135.32,$0.00,1,1,1,1,1,1,20110101,L8510,HCPCS,VOICE AMPLIFIER,,,28 ,,NW,,,,,,$322.25,$0.00,1,1,1,1,1,1,20110101,L8511,HCPCS,INDWELLING TRACH INSERT,,,28 ,,NW,,,,,,$91.48,$0.00,1,1,1,1,1,1,20110101,L8512,HCPCS,GEL CAP FOR TRACH VOICE PROS,,,28 ,,NW,,,,,,$3.61,$0.00,1,1,1,1,1,1,20110101,L8513,HCPCS,TRACH PROS CLEANING DEVICE,,,28 ,,NW,,,,,,$8.63,$0.00,1,1,1,1,1,1,20110101,L8514,HCPCS,REPL TRACH PUNCTURE DILATOR,,,28 ,,NW,,,,,,$117.40,$0.00,1,1,1,1,1,1,20110101,L8515,HCPCS,GEL CAP APP DEVICE FOR TRACH,,,28 ,,NW,,,,,,$79.93,$0.00,1,1,1,1,1,1,20110101,L8600,HCPCS,IMPLANT BREAST SILICONE/EQ,,,28 ,,NW,,,,,,$946.51,$0.00,1,1,1,1,1,1,20110101,L8603,HCPCS,COLLAGEN IMP URINARY 2.5 ML,,,28 ,,NW,,,,,,$591.84,$0.00,1,1,1,1,1,1,20110101,L8606,HCPCS,SYNTHETIC IMPLNT URINARY 1ML,,,28 ,,NW,,,,,,$273.24,$0.00,1,1,1,1,1,1,20110101,L8609,HCPCS,ARTIFICIAL CORNEA,,,28 ,,NW,,,,,,"$9,449.32",$0.00,1,1,1,1,1,1,20110101,L8610,HCPCS,OCULAR IMPLANT,,,28 ,,NW,,,,,,$891.00,$0.00,1,1,1,1,1,1,20110101,L8612,HCPCS,AQUEOUS SHUNT PROSTHESIS,,,28 ,,NW,,,,,,$981.57,$0.00,1,1,1,1,1,1,20110101,L8613,HCPCS,OSSICULAR IMPLANT,,,28 ,,NW,,,,,,$402.90,$0.00,1,1,1,1,1,1,20110101,L8614,HCPCS,COCHLEAR DEVICE,,,28 ,,NW,,,,,,"$28,276.67",$0.00,1,1,1,1,1,1,20110101,L8615,HCPCS,COCH IMPLANT HEADSET REPLACE,,,28 ,,NW,,,,,,$608.96,$0.00,1,1,1,1,1,1,20110101,L8616,HCPCS,COCH IMPLANT MICROPHONE REPL,,,28 ,,NW,,,,,,$129.50,$0.00,1,1,1,1,1,1,20110101,L8617,HCPCS,COCH IMPLANT TRANS COIL REPL,,,28 ,,NW,,,,,,$113.62,$0.00,1,1,1,1,1,1,20110101,L8618,HCPCS,COCH IMPLANT TRAN CABLE REPL,,,28 ,,NW,,,,,,$35.38,$0.00,1,1,1,1,1,1,20110101,L8619,HCPCS,COCH IMP EXT PROC/CONTR RPLC,,,28 ,,NW,,,,,,"$12,109.50",$0.00,1,1,1,1,1,1,20110101,L8621,HCPCS,REPL ZINC AIR BATTERY,,,28 ,,NW,,,,,,$1.02,$0.00,1,1,1,1,1,1,20110101,L8622,HCPCS,REPL ALKALINE BATTERY,,,28 ,,NW,,,,,,$0.54,$0.00,1,1,1,1,1,1,20110101,L8623,HCPCS,"LITH ION BATT CID,NON-EARLVL",,,28 ,,NW,,,,,,$81.31,$0.00,1,1,1,1,1,1,20110101,L8624,HCPCS,"LITH ION BATT CID, EAR LEVEL",,,28 ,,NW,,,,,,$196.60,$0.00,1,1,1,1,1,1,20110101,L8627,HCPCS,CID EXT SPEECH PROCESS REPL,,,28 ,,NW,,,,,,"$10,345.14",$0.00,1,1,1,1,1,1,20110101,L8628,HCPCS,CID EXT CONTROLLER REPL,,,28 ,,NW,,,,,,"$1,794.28",$0.00,1,1,1,1,1,1,20110101,L8629,HCPCS,CID TRANSMIT COIL AND CABLE,,,28 ,,NW,,,,,,$219.26,$0.00,1,1,1,1,1,1,20110101,L8630,HCPCS,METACARPOPHALANGEAL IMPLANT,,,28 ,,NW,,,,,,$485.33,$0.00,1,1,1,1,1,1,20110101,L8631,HCPCS,MCP JOINT REPL 2 PC OR MORE,,,28 ,,NW,,,,,,"$3,175.57",$0.00,1,1,1,1,1,1,20110101,L8641,HCPCS,METATARSAL JOINT IMPLANT,,,28 ,,NW,,,,,,$489.08,$0.00,1,1,1,1,1,1,20110101,L8642,HCPCS,HALLUX IMPLANT,,,28 ,,NW,,,,,,$411.63,$0.00,1,1,1,1,1,1,20110101,L8658,HCPCS,INTERPHALANGEAL JOINT SPACER,,,28 ,,NW,,,,,,$421.35,$0.00,1,1,1,1,1,1,20110101,L8659,HCPCS,INTERPHALANGEAL JOINT REPL,,,28 ,,NW,,,,,,"$2,764.49",$0.00,1,1,1,1,1,1,20110101,L8670,HCPCS,"VASCULAR GRAFT, SYNTHETIC",,,28 ,,NW,,,,,,$765.10,$0.00,1,1,1,1,1,1,20110101,L8680,HCPCS,IMPLT NEUROSTIM ELCTR EACH,,,28 ,,NW,,,,,,$631.19,$0.00,1,1,1,1,1,1,20110101,L8681,HCPCS,PT PRGRM FOR IMPLT NEUROSTIM,,,28 ,,NW,,,,,,"$1,635.85",$0.00,1,1,1,1,1,1,20110101,L8682,HCPCS,IMPLT NEUROSTIM RADIOFQ REC,,,28 ,,NW,,,,,,"$8,772.82",$0.00,1,1,1,1,1,1,20110101,L8683,HCPCS,RADIOFQ TRSMTR FOR IMPLT NEU,,,28 ,,NW,,,,,,"$7,716.27",$0.00,1,1,1,1,1,1,20110101,L8684,HCPCS,RADIOF TRSMTR IMPLT SCRL NEU,,,28 ,,NW,,,,,,"$1,075.41",$0.00,1,1,1,1,1,1,20110101,L8685,HCPCS,IMPLT NROSTM PLS GEN SNG REC,,,28 ,,NW,,,,,,"$19,300.89",$0.00,1,1,1,1,1,1,20110101,L8686,HCPCS,IMPLT NROSTM PLS GEN SNG NON,,,28 ,,NW,,,,,,"$12,297.97",$0.00,1,1,1,1,1,1,20110101,L8687,HCPCS,IMPLT NROSTM PLS GEN DUA REC,,,28 ,,NW,,,,,,"$25,132.78",$0.00,1,1,1,1,1,1,20110101,L8688,HCPCS,IMPLT NROSTM PLS GEN DUA NON,,,28 ,,NW,,,,,,"$16,019.19",$0.00,1,1,1,1,1,1,20110101,L8689,HCPCS,EXTERNAL RECHARG SYS INTERN,,,28 ,,NW,,,,,,"$2,482.49",$0.00,1,1,1,1,1,1,20110101,L8690,HCPCS,"AUD OSSEO DEV, INT/EXT COMP",,,28 ,,NW,,,,,,"$6,931.62",$0.00,1,1,1,1,1,1,20110101,L8691,HCPCS,OSSEOINTEGRATED SND PROC RPL,,,28 ,,NW,,,,,,"$3,864.09",$0.00,1,1,1,1,1,1,20110101,L8695,HCPCS,EXTERNAL RECHARG SYS EXTERN,,,28 ,,NW,,,,,,$23.97,$0.00,1,1,1,1,1,1,20110101,L8699,HCPCS,PROSTHETIC IMPLANT NOS,,,28 ,,NW,,,,,,$388.73,$0.00,1,1,1,1,1,1,20110101,L9900,HCPCS,O&P SUPPLY/ACCESSORY/SERVICE,,,28 ,,NW,,,,,,$158.85,$0.00,1,1,1,1,1,1,20110101,M0064,HCPCS,VISIT FOR DRUG MONITORING,,,16 ,,RBRVS,0.37 ,0.08 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,M0076,HCPCS,PROLOTHERAPY,,,14 ,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,M0300,HCPCS,IV CHELATIONTHERAPY,,,4 ,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P2031,HCPCS,HAIR ANALYSIS,,,17 ,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P2038,HCPCS,BLOOD MUCOPROTEIN,,,17 ,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P3000,HCPCS,SCREEN PAP BY TECH W MD SUPV,,,17 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P3001,HCPCS,SCREENING PAP SMEAR BY PHYS,,,17 ,,RBRVS,0.42 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,P7001,HCPCS,CULTURE BACTERIAL URINE,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9010,HCPCS,WHOLE BLOOD FOR TRANSFUSION,,,14 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9011,HCPCS,BLOOD SPLIT UNIT,,,14 ,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9012,HCPCS,CRYOPRECIPITATE EACH UNIT,,,14 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9016,HCPCS,RBC LEUKOCYTES REDUCED,,,14 ,,TotalUnits,,,,3.98 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9017,HCPCS,PLASMA 1 DONOR FRZ W/IN 8 HR,,,14 ,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9019,HCPCS,"PLATELETS, EACH UNIT",,,14 ,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9020,HCPCS,PLAELET RICH PLASMA UNIT,,,14 ,,TotalUnits,,,,4.15 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9021,HCPCS,RED BLOOD CELLS UNIT,,,14 ,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9022,HCPCS,WASHED RED BLOOD CELLS UNIT,,,14 ,,TotalUnits,,,,1.30 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9031,HCPCS,PLATELETS LEUKOCYTES REDUCED,,,14 ,,TotalUnits,,,,1.95 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9032,HCPCS,"PLATELETS, IRRADIATED",,,14 ,,TotalUnits,,,,1.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9034,HCPCS,"PLATELETS, PHERESIS",,,14 ,,TotalUnits,,,,6.94 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9035,HCPCS,PLATELET PHERES LEUKOREDUCED,,,14 ,,TotalUnits,,,,7.76 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9037,HCPCS,PLATE PHERES LEUKOREDU IRRAD,,,14 ,,TotalUnits,,,,13.34 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9040,HCPCS,RBC LEUKOREDUCED IRRADIATED,,,14 ,,TotalUnits,,,,5.97 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9041,HCPCS,"ALBUMIN (HUMAN),5%, 50ML",,,14 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9043,HCPCS,"PLASMA PROTEIN FRACT,5%,50ML",,,14 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9045,HCPCS,"ALBUMIN (HUMAN), 5%, 250 ML",,,14 ,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9046,HCPCS,"ALBUMIN (HUMAN), 25%, 20 ML",,,14 ,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9047,HCPCS,"ALBUMIN (HUMAN), 25%, 50ML",,,14 ,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9048,HCPCS,"PLASMAPROTEIN FRACT,5%,250ML",,,14 ,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9053,HCPCS,"PLT, PHER, L/R CMV-NEG, IRR",,,14 ,,TotalUnits,,,,15.12 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9058,HCPCS,"RBC, L/R, CMV-NEG, IRRAD",,,14 ,,TotalUnits,,,,7.51 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9059,HCPCS,"PLASMA, FRZ BETWEEN 8-24HOUR",,,14 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9603,HCPCS,ONE-WAY ALLOW PRORATED MILES,,,17 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9604,HCPCS,ONE-WAY ALLOW PRORATED TRIP,,,17 ,,TotalUnits,,,,0.05 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9612,HCPCS,CATHETERIZE FOR URINE SPEC,,,17 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,P9615,HCPCS,URINE SPECIMEN COLLECT MULT,,,17 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0035,HCPCS,CARDIOKYMOGRAPHY,,,4 ,,RBRVS,0.17 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,Q0035,HCPCS,CARDIOKYMOGRAPHY,26,,4 ,,RBRVS,0.17 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,Q0035,HCPCS,CARDIOKYMOGRAPHY,TC,,4 ,,RBRVS,,0.27 ,0.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0081,HCPCS,INFUSION THER OTHER THAN CHE,,,22 ,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,Q0083,HCPCS,CHEMO BY OTHER THAN INFUSION,,,14 ,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0084,HCPCS,CHEMOTHERAPY BY INFUSION,,,14 ,,TotalUnits,,,,1.84 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0085,HCPCS,CHEMO BY BOTH INFUSION AND O,,,14 ,,TotalUnits,,,,6.14 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0091,HCPCS,OBTAINING SCREEN PAP SMEAR,,,17 ,,RBRVS,0.37 ,0.12 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0092,HCPCS,SET UP PORT XRAY EQUIPMENT,,TC,20 ,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,0,1,1,20110101,Q0111,HCPCS,WET MOUNTS/ W PREPARATIONS,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0112,HCPCS,POTASSIUM HYDROXIDE PREPS,,,17 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0113,HCPCS,PINWORM EXAMINATIONS,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0114,HCPCS,FERN TEST,,,17 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0115,HCPCS,POST-COITAL MUCOUS EXAM,,,17 ,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q0138,HCPCS,"FERUMOXYTOL, NON-ESRD",,,29 ,,NW,,,,,,$2.21,$0.00,1,1,1,0,0,1,20110101,Q0139,HCPCS,"FERUMOXYTOL, ESRD USE",,,28 ,,NW,,,,,,$51.11,$0.00,1,1,1,0,0,1,20110101,Q0144,HCPCS,"AZITHROMYCIN DIHYDRATE, ORAL",,,29 ,,NW,,,,,,$31.06,$0.00,1,1,1,0,0,1,20110101,Q0163,HCPCS,DIPHENHYDRAMINE HCL 50MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0164,HCPCS,PROCHLORPERAZINE MALEATE 5MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0165,HCPCS,PROCHLORPERAZINE MALEATE10MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0166,HCPCS,GRANISETRON HCL 1 MG ORAL,,,29 ,,NW,,,,,,$15.04,$0.00,1,1,1,0,0,1,20110101,Q0167,HCPCS,DRONABINOL 2.5MG ORAL,,,29 ,,NW,,,,,,$28.57,$0.00,1,1,1,0,0,1,20110101,Q0168,HCPCS,DRONABINOL 5MG ORAL,,,29 ,,NW,,,,,,$57.15,$0.00,1,1,1,0,0,1,20110101,Q0169,HCPCS,PROMETHAZINE HCL 12.5MG ORAL,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0170,HCPCS,PROMETHAZINE HCL 25 MG ORAL,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0171,HCPCS,CHLORPROMAZINE HCL 10MG ORAL,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0172,HCPCS,CHLORPROMAZINE HCL 25MG ORAL,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0173,HCPCS,TRIMETHOBENZAMIDE HCL 250MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0174,HCPCS,THIETHYLPERAZINE MALEATE10MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0175,HCPCS,PERPHENAZINE 4MG ORAL,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0176,HCPCS,PERPHENAZINE 8MG ORAL,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0177,HCPCS,HYDROXYZINE PAMOATE 25MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0178,HCPCS,HYDROXYZINE PAMOATE 50MG,,,29 ,,NW,,,,,,$1.50,$0.00,1,1,1,0,0,1,20110101,Q0179,HCPCS,ONDANSETRON HCL 8 MG ORAL,,,29 ,,NW,,,,,,$24.06,$0.00,1,1,1,0,0,1,20110101,Q0180,HCPCS,DOLASETRON MESYLATE ORAL,,,29 ,,NW,,,,,,$172.67,$0.00,1,1,1,0,0,1,20110101,Q0181,HCPCS,UNSPECIFIED ORAL ANTI-EMETIC,,,29 ,,NW,,,,,,$44.43,$0.00,1,1,1,0,0,1,20110101,Q0480,HCPCS,"DRIVER PNEUMATIC VAD, REP",,,28 ,,NW,,,,,,"$132,101.90",$0.00,1,1,1,1,1,1,20110101,Q0481,HCPCS,"MICROPRCSR CU ELEC VAD, REP",,,28 ,,NW,,,,,,"$21,272.44",$0.00,1,1,1,1,1,1,20110101,Q0482,HCPCS,"MICROPRCSR CU COMBO VAD, REP",,,28 ,,NW,,,,,,"$6,629.62",$0.00,1,1,1,1,1,1,20110101,Q0483,HCPCS,"MONITOR ELEC VAD, REP",,,28 ,,NW,,,,,,"$27,462.34",$0.00,1,1,1,1,1,1,20110101,Q0484,HCPCS,MONITOR ELEC OR COMB VAD REP,,,28 ,,NW,,,,,,"$5,294.02",$0.00,1,1,1,1,1,1,20110101,Q0485,HCPCS,"MONITOR CABLE ELEC VAD, REP",,,28 ,,NW,,,,,,$467.32,$0.00,1,1,1,1,1,1,20110101,Q0486,HCPCS,MON CABLE ELEC/PNEUM VAD REP,,,28 ,,NW,,,,,,$380.82,$0.00,1,1,1,1,1,1,20110101,Q0487,HCPCS,"LEADS ANY TYPE VAD, REP ONLY",,,28 ,,NW,,,,,,$452.37,$0.00,1,1,1,1,1,1,20110101,Q0488,HCPCS,"PWR PACK BASE ELEC VAD, REP",,,28 ,,NW,,,,,,"$20,551.50",$0.00,1,1,1,1,1,1,20110101,Q0489,HCPCS,"PWR PCK BASE COMBO VAD, REP",,,28 ,,NW,,,,,,"$23,801.92",$0.00,1,1,1,1,1,1,20110101,Q0490,HCPCS,"EMR PWR SOURCE ELEC VAD, REP",,,28 ,,NW,,,,,,$983.16,$0.00,1,1,1,1,1,1,20110101,Q0491,HCPCS,EMR PWR SOURCE COMBO VAD REP,,,28 ,,NW,,,,,,"$1,573.37",$0.00,1,1,1,1,1,1,20110101,Q0492,HCPCS,"EMR PWR CBL ELEC VAD, REP",,,28 ,,NW,,,,,,$111.10,$0.00,1,1,1,1,1,1,20110101,Q0493,HCPCS,"EMR PWR CBL COMBO VAD, REP",,,28 ,,NW,,,,,,$323.55,$0.00,1,1,1,1,1,1,20110101,Q0494,HCPCS,"EMR HD PMP ELEC/COMBO, REP",,,28 ,,NW,,,,,,$266.33,$0.00,1,1,1,1,1,1,20110101,Q0495,HCPCS,"CHARGER ELEC/COMBO VAD, REP",,,28 ,,NW,,,,,,"$6,080.46",$0.00,1,1,1,1,1,1,20110101,Q0496,HCPCS,"BATTERY ELEC/COMBO VAD, REP",,,28 ,,NW,,,,,,"$2,151.29",$0.00,1,1,1,1,1,1,20110101,Q0497,HCPCS,"BAT CLPS ELEC/COMB VAD, REP",,,28 ,,NW,,,,,,$638.40,$0.00,1,1,1,1,1,1,20110101,Q0498,HCPCS,"HOLSTER ELEC/COMBO VAD, REP",,,28 ,,NW,,,,,,$705.18,$0.00,1,1,1,1,1,1,20110101,Q0499,HCPCS,BELT/VEST ELEC/COMBO VAD REP,,,28 ,,NW,,,,,,$204.64,$0.00,1,1,1,1,1,1,20110101,Q0500,HCPCS,"FILTERS ELEC/COMBO VAD, REP",,,28 ,,NW,,,,,,$40.77,$0.00,1,1,1,1,1,1,20110101,Q0501,HCPCS,"SHWR COV ELEC/COMBO VAD, REP",,,28 ,,NW,,,,,,$700.84,$0.00,1,1,1,1,1,1,20110101,Q0502,HCPCS,"MOBILITY CART PNEUM VAD, REP",,,28 ,,NW,,,,,,$905.51,$0.00,1,1,1,1,1,1,20110101,Q0503,HCPCS,BATTERY PNEUM VAD REPLACEMNT,,,28 ,,NW,,,,,,"$1,859.53",$0.00,1,1,1,1,1,1,20110101,Q0504,HCPCS,"PWR ADPT PNEUM VAD, REP VEH",,,28 ,,NW,,,,,,$958.32,$0.00,1,1,1,1,1,1,20110101,Q0505,HCPCS,MISCL SUPPLY/ACCESSORY VAD,,,28 ,,NW,,,,,,$14.92,$0.00,1,1,1,1,1,1,20110101,Q0506,HCPCS,LITH-ION BATT ELEC/PNEUM VAD,,,28 ,,NW,,,,,,"$1,204.75",$0.00,1,1,1,1,1,1,20110101,Q0510,HCPCS,DISPENS FEE IMMUNOSUPRESSIVE,,,29 ,,NW,,,,,,$64.37,$0.00,1,1,1,0,0,1,20110101,Q0511,HCPCS,"SUP FEE ANTIEM,ANTICA,IMMUNO",,,29 ,,NW,,,,,,$31.75,$0.00,1,1,1,0,0,1,20110101,Q0512,HCPCS,PX SUP FEE ANTI-CAN SUB PRES,,,29 ,,NW,,,,,,$21.03,$0.00,1,1,1,0,0,1,20110101,Q0513,HCPCS,DISP FEE INHAL DRUGS/30 DAYS,,,29 ,,NW,,,,,,$57.77,$0.00,1,1,1,0,0,1,20110101,Q0514,HCPCS,DISP FEE INHAL DRUGS/90 DAYS,,,29 ,,NW,,,,,,$97.93,$0.00,1,1,1,0,0,1,20110101,Q0515,HCPCS,SERMORELIN ACETATE INJECTION,,,29 ,,NW,,,,,,$5.52,$0.00,1,1,1,0,0,1,20110101,Q1003,HCPCS,NTIOL CATEGORY 3,,,28 ,,NW,,,,,,$79.71,$0.00,1,1,1,0,1,1,20110101,Q2004,HCPCS,BLADDER CALCULI IRRIG SOL,,,29 ,,NW,,,,,,$34.02,$0.00,1,1,1,0,0,1,20110101,Q2009,HCPCS,FOSPHENYTOIN INJ PE,,,29 ,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20110101,Q2017,HCPCS,"TENIPOSIDE, 50 MG",,,29 ,,NW,,,,,,$743.03,$0.00,1,1,1,0,0,1,20110101,Q2026,HCPCS,RADIESSE INJECTION,,,14 ,,TotalUnits,,,,8.54 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,Q2027,HCPCS,SCULPTRA INJECTION,,,14 ,,TotalUnits,,,,8.54 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,Q2035,HCPCS,"AFLURIA VACC, 3 YRS & >, IM",,,14 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q2036,HCPCS,"FLULAVAL VACC, 3 YRS & >, IM",,,14 ,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q2037,HCPCS,"FLUVIRIN VACC, 3 YRS & >, IM",,,14 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q2038,HCPCS,"FLUZONE VACC, 3 YRS & >, IM",,,14 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q2039,HCPCS,"NOS FLU VACC, 3 YRS & >, IM",,,14 ,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,Q3001,HCPCS,BRACHYTHERAPY RADIOELEMENTS,,,28 ,,NW,,,,,,$92.20,$0.00,1,1,1,0,0,1,20110101,Q3014,HCPCS,TELEHEALTH FACILITY FEE,,,14 ,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,Q3025,HCPCS,IM INJ INTERFERON BETA 1-A,,,29 ,,NW,,,,,,$393.66,$0.00,1,1,1,0,0,1,20110101,Q3026,HCPCS,SUBC INJ INTERFERON BETA-1A,,,29 ,,NW,,,,,,$160.55,$0.00,1,1,1,0,0,1,20110101,Q4001,HCPCS,CAST SUP BODY CAST PLASTER,,,28 ,,NW,,,,,,$149.40,$0.00,1,1,1,0,0,1,20110101,Q4002,HCPCS,CAST SUP BODY CAST FIBERGLAS,,,28 ,,NW,,,,,,$310.29,$0.00,1,1,1,0,0,1,20110101,Q4003,HCPCS,CAST SUP SHOULDER CAST PLSTR,,,28 ,,NW,,,,,,$84.49,$0.00,1,1,1,0,0,1,20110101,Q4004,HCPCS,CAST SUP SHOULDER CAST FBRGL,,,28 ,,NW,,,,,,$171.21,$0.00,1,1,1,0,0,1,20110101,Q4005,HCPCS,CAST SUP LONG ARM ADULT PLST,,,28 ,,NW,,,,,,$49.59,$0.00,1,1,1,0,0,1,20110101,Q4006,HCPCS,CAST SUP LONG ARM ADULT FBRG,,,28 ,,NW,,,,,,$97.58,$0.00,1,1,1,0,0,1,20110101,Q4007,HCPCS,CAST SUP LONG ARM PED PLSTER,,,28 ,,NW,,,,,,$28.32,$0.00,1,1,1,0,0,1,20110101,Q4008,HCPCS,CAST SUP LONG ARM PED FBRGLS,,,28 ,,NW,,,,,,$52.31,$0.00,1,1,1,0,0,1,20110101,Q4009,HCPCS,CAST SUP SHT ARM ADULT PLSTR,,,28 ,,NW,,,,,,$39.77,$0.00,1,1,1,0,0,1,20110101,Q4010,HCPCS,CAST SUP SHT ARM ADULT FBRGL,,,28 ,,NW,,,,,,$76.86,$0.00,1,1,1,0,0,1,20110101,Q4011,HCPCS,CAST SUP SHT ARM PED PLASTER,,,28 ,,NW,,,,,,$23.41,$0.00,1,1,1,0,0,1,20110101,Q4012,HCPCS,CAST SUP SHT ARM PED FBRGLAS,,,28 ,,NW,,,,,,$41.95,$0.00,1,1,1,0,0,1,20110101,Q4013,HCPCS,CAST SUP GAUNTLET PLASTER,,,28 ,,NW,,,,,,$38.13,$0.00,1,1,1,0,0,1,20110101,Q4014,HCPCS,CAST SUP GAUNTLET FIBERGLASS,,,28 ,,NW,,,,,,$73.04,$0.00,1,1,1,0,0,1,20110101,Q4015,HCPCS,CAST SUP GAUNTLET PED PLSTER,,,28 ,,NW,,,,,,$22.86,$0.00,1,1,1,0,0,1,20110101,Q4016,HCPCS,CAST SUP GAUNTLET PED FBRGLS,,,28 ,,NW,,,,,,$39.77,$0.00,1,1,1,0,0,1,20110101,Q4017,HCPCS,CAST SUP LNG ARM SPLINT PLST,,,28 ,,NW,,,,,,$33.77,$0.00,1,1,1,0,0,1,20110101,Q4018,HCPCS,CAST SUP LNG ARM SPLINT FBRG,,,28 ,,NW,,,,,,$64.31,$0.00,1,1,1,0,0,1,20110101,Q4019,HCPCS,CAST SUP LNG ARM SPLNT PED P,,,28 ,,NW,,,,,,$20.68,$0.00,1,1,1,0,0,1,20110101,Q4020,HCPCS,CAST SUP LNG ARM SPLNT PED F,,,28 ,,NW,,,,,,$35.95,$0.00,1,1,1,0,0,1,20110101,Q4021,HCPCS,CAST SUP SHT ARM SPLINT PLST,,,28 ,,NW,,,,,,$33.77,$0.00,1,1,1,0,0,1,20110101,Q4022,HCPCS,CAST SUP SHT ARM SPLINT FBRG,,,28 ,,NW,,,,,,$64.31,$0.00,1,1,1,0,0,1,20110101,Q4023,HCPCS,CAST SUP SHT ARM SPLNT PED P,,,28 ,,NW,,,,,,$20.68,$0.00,1,1,1,0,0,1,20110101,Q4024,HCPCS,CAST SUP SHT ARM SPLNT PED F,,,28 ,,NW,,,,,,$35.95,$0.00,1,1,1,0,0,1,20110101,Q4025,HCPCS,CAST SUP HIP SPICA PLASTER,,,28 ,,NW,,,,,,$126.49,$0.00,1,1,1,0,0,1,20110101,Q4026,HCPCS,CAST SUP HIP SPICA FIBERGLAS,,,28 ,,NW,,,,,,$261.75,$0.00,1,1,1,0,0,1,20110101,Q4027,HCPCS,CAST SUP HIP SPICA PED PLSTR,,,28 ,,NW,,,,,,$67.04,$0.00,1,1,1,0,0,1,20110101,Q4028,HCPCS,CAST SUP HIP SPICA PED FBRGL,,,28 ,,NW,,,,,,$134.67,$0.00,1,1,1,0,0,1,20110101,Q4029,HCPCS,CAST SUP LONG LEG PLASTER,,,28 ,,NW,,,,,,$65.95,$0.00,1,1,1,0,0,1,20110101,Q4030,HCPCS,CAST SUP LONG LEG FIBERGLASS,,,28 ,,NW,,,,,,$132.49,$0.00,1,1,1,0,0,1,20110101,Q4031,HCPCS,CAST SUP LNG LEG PED PLASTER,,,28 ,,NW,,,,,,$36.50,$0.00,1,1,1,0,0,1,20110101,Q4032,HCPCS,CAST SUP LNG LEG PED FBRGLS,,,28 ,,NW,,,,,,$69.77,$0.00,1,1,1,0,0,1,20110101,Q4033,HCPCS,CAST SUP LNG LEG CYLINDER PL,,,28 ,,NW,,,,,,$57.22,$0.00,1,1,1,0,0,1,20110101,Q4034,HCPCS,CAST SUP LNG LEG CYLINDER FB,,,28 ,,NW,,,,,,$113.95,$0.00,1,1,1,0,0,1,20110101,Q4035,HCPCS,CAST SUP LNGLEG CYLNDR PED P,,,28 ,,NW,,,,,,$32.13,$0.00,1,1,1,0,0,1,20110101,Q4036,HCPCS,CAST SUP LNGLEG CYLNDR PED F,,,28 ,,NW,,,,,,$60.49,$0.00,1,1,1,0,0,1,20110101,Q4037,HCPCS,CAST SUP SHRT LEG PLASTER,,,28 ,,NW,,,,,,$74.68,$0.00,1,1,1,0,0,1,20110101,Q4038,HCPCS,CAST SUP SHRT LEG FIBERGLASS,,,28 ,,NW,,,,,,$151.03,$0.00,1,1,1,0,0,1,20110101,Q4039,HCPCS,CAST SUP SHRT LEG PED PLSTER,,,28 ,,NW,,,,,,$40.86,$0.00,1,1,1,0,0,1,20110101,Q4040,HCPCS,CAST SUP SHRT LEG PED FBRGLS,,,28 ,,NW,,,,,,$79.04,$0.00,1,1,1,0,0,1,20110101,Q4041,HCPCS,CAST SUP LNG LEG SPLNT PLSTR,,,28 ,,NW,,,,,,$45.77,$0.00,1,1,1,0,0,1,20110101,Q4042,HCPCS,CAST SUP LNG LEG SPLNT FBRGL,,,28 ,,NW,,,,,,$89.40,$0.00,1,1,1,0,0,1,20110101,Q4043,HCPCS,CAST SUP LNG LEG SPLNT PED P,,,28 ,,NW,,,,,,$26.68,$0.00,1,1,1,0,0,1,20110101,Q4044,HCPCS,CAST SUP LNG LEG SPLNT PED F,,,28 ,,NW,,,,,,$48.50,$0.00,1,1,1,0,0,1,20110101,Q4045,HCPCS,CAST SUP SHT LEG SPLNT PLSTR,,,28 ,,NW,,,,,,$32.13,$0.00,1,1,1,0,0,1,20110101,Q4046,HCPCS,CAST SUP SHT LEG SPLNT FBRGL,,,28 ,,NW,,,,,,$60.49,$0.00,1,1,1,0,0,1,20110101,Q4047,HCPCS,CAST SUP SHT LEG SPLNT PED P,,,28 ,,NW,,,,,,$19.59,$0.00,1,1,1,0,0,1,20110101,Q4048,HCPCS,CAST SUP SHT LEG SPLNT PED F,,,28 ,,NW,,,,,,$33.77,$0.00,1,1,1,0,0,1,20110101,Q4049,HCPCS,"FINGER SPLINT, STATIC",,,28 ,,NW,,,,,,$19.68,$0.00,1,1,1,0,0,1,20110101,Q4050,HCPCS,CAST SUPPLIES UNLISTED,,,28 ,,NW,,,,,,$41.53,$0.00,1,1,1,0,0,1,20110101,Q4051,HCPCS,SPLINT SUPPLIES MISC,,,28 ,,NW,,,,,,$26.63,$0.00,1,1,1,0,0,1,20110101,Q4074,HCPCS,ILOPROST NON-COMP UNIT DOSE,,,29 ,,NW,,,,,,$135.61,$0.00,1,1,1,0,0,1,20110101,Q4081,HCPCS,"EPOETIN ALFA, 100 UNITS ESRD",,,29 ,,NW,,,,,,$3.31,$0.00,1,1,1,0,0,1,20110101,Q4082,HCPCS,DRUG/BIO NOC PART B DRUG CAP,,,29 ,,NW,,,,,,"$2,634.30",$0.00,1,1,1,0,0,1,20110101,Q4100,HCPCS,"SKIN SUBSTITUTE, NOS",,,29 ,,NW,,,,,,$14.92,$0.00,1,1,1,0,0,1,20110101,Q4101,HCPCS,APLIGRAF SKIN SUB,,,29 ,,NW,,,,,,$71.84,$0.00,1,1,1,0,0,1,20110101,Q4102,HCPCS,OASIS WOUND MATRIX SKIN SUB,,,29 ,,NW,,,,,,$12.52,$0.00,1,1,1,0,0,1,20110101,Q4103,HCPCS,OASIS BURN MATRIX SKIN SUB,,,29 ,,NW,,,,,,$12.52,$0.00,1,1,1,0,0,1,20110101,Q4104,HCPCS,INTEGRA BMWD SKIN SUB,,,29 ,,NW,,,,,,$35.51,$0.00,1,1,1,0,0,1,20110101,Q4105,HCPCS,INTEGRA DRT SKIN SUB,,,29 ,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20110101,Q4106,HCPCS,DERMAGRAFT SKIN SUB,,,29 ,,NW,,,,,,$84.45,$0.00,1,1,1,0,0,1,20110101,Q4107,HCPCS,GRAFTJACKET SKIN SUB,,,29 ,,NW,,,,,,$194.19,$0.00,1,1,1,0,0,1,20110101,Q4108,HCPCS,INTEGRA MATRIX SKIN SUB,,,29 ,,NW,,,,,,$42.18,$0.00,1,1,1,0,0,1,20110101,Q4110,HCPCS,PRIMATRIX SKIN SUB,,,29 ,,NW,,,,,,$72.58,$0.00,1,1,1,0,0,1,20110101,Q4111,HCPCS,GAMMAGRAFT SKIN SUB,,,29 ,,NW,,,,,,$18.45,$0.00,1,1,1,0,0,1,20110101,Q4112,HCPCS,CYMETRA ALLOGRAFT,,,29 ,,NW,,,,,,$760.79,$0.00,1,1,1,0,0,1,20110101,Q4113,HCPCS,GRAFTJACKET EXPRESS ALLOGRAF,,,29 ,,NW,,,,,,$760.79,$0.00,1,1,1,0,0,1,20110101,Q4114,HCPCS,INTEGRA FLOWABLE WOUND MATRI,,,29 ,,NW,,,,,,"$2,241.51",$0.00,1,1,1,0,0,1,20110101,Q4115,HCPCS,ALLOSKIN SKIN SUB,,,29 ,,NW,,,,,,$18.45,$0.00,1,1,1,0,0,1,20110101,Q4116,HCPCS,ALLODERM SKIN SUB,,,29 ,,NW,,,,,,$69.62,$0.00,1,1,1,0,0,1,20110101,Q5001,HCPCS,HOSPICE IN PATIENT HOME,,,14 ,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,Q5002,HCPCS,HOSPICE IN ASSISTED LIVING,,,14 ,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,Q5003,HCPCS,HOSPICE IN LT/NON-SKILLED NF,,,14 ,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,Q5004,HCPCS,HOSPICE IN SNF,,,14 ,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,Q5005,HCPCS,"HOSPICE, INPATIENT HOSPITAL",,,14 ,,TotalUnits,,,,5.03 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,Q5006,HCPCS,HOSPICE IN HOSPICE FACILITY,,,14 ,,TotalUnits,,,,6.27 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,Q5010,HCPCS,HOSPICE HOME CARE IN HOSPICE,,,14 ,,TotalUnits,,,,6.27 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,Q9951,HCPCS,"LOCM >= 400 MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$2.19,$0.00,1,1,1,0,0,1,20110101,Q9953,HCPCS,"INJ FE-BASED MR CONTRAST,1ML",,,28 ,,NW,,,,,,$11.13,$0.00,1,1,1,0,0,1,20110101,Q9954,HCPCS,"ORAL MR CONTRAST, 100 ML",,,28 ,,NW,,,,,,$56.83,$0.00,1,1,1,0,0,1,20110101,Q9955,HCPCS,"INJ PERFLEXANE LIP MICROS,ML",,,28 ,,NW,,,,,,$3.86,$0.00,1,1,1,0,0,1,20110101,Q9956,HCPCS,"INJ OCTAFLUOROPROPANE MIC,ML",,,28 ,,NW,,,,,,$54.12,$0.00,1,1,1,0,0,1,20110101,Q9957,HCPCS,"INJ PERFLUTREN LIP MICROS,ML",,,28 ,,NW,,,,,,$151.60,$0.00,1,1,1,0,0,1,20110101,Q9958,HCPCS,"HOCM <=149 MG/ML IODINE, 1ML",,,28 ,,NW,,,,,,$0.08,$0.00,1,1,1,0,0,1,20110101,Q9959,HCPCS,"HOCM 150-199MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$0.52,$0.00,1,1,1,0,0,1,20110101,Q9960,HCPCS,"HOCM 200-249MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$1.02,$0.00,1,1,1,0,0,1,20110101,Q9961,HCPCS,"HOCM 250-299MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$1.52,$0.00,1,1,1,0,0,1,20110101,Q9962,HCPCS,"HOCM 300-349MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$1.57,$0.00,1,1,1,0,0,1,20110101,Q9963,HCPCS,"HOCM 350-399MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$1.47,$0.00,1,1,1,0,0,1,20110101,Q9964,HCPCS,"HOCM>= 400MG/ML IODINE, 1ML",,,28 ,,NW,,,,,,$2.40,$0.00,1,1,1,0,0,1,20110101,Q9965,HCPCS,"LOCM 100-199MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$3.00,$0.00,1,1,1,0,0,1,20110101,Q9966,HCPCS,"LOCM 200-299MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$3.21,$0.00,1,1,1,0,0,1,20110101,Q9967,HCPCS,"LOCM 300-399MG/ML IODINE,1ML",,,28 ,,NW,,,,,,$3.43,$0.00,1,1,1,0,0,1,20110101,R0070,HCPCS,TRANSPORT PORTABLE X-RAY,,TC,20 ,,TotalUnits,,,,1.05 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,R0075,HCPCS,TRANSPORT PORT X-RAY MULTIPL,,TC,20 ,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,R0076,HCPCS,TRANSPORT PORTABLE EKG,,,20 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S0012,HCPCS,"BUTORPHANOL TARTRATE, NASAL",,,28 ,,NW,,,,,,$133.52,$0.00,1,1,1,0,0,1,20110101,S0014,HCPCS,"TACRINE HYDROCHLORIDE, 10 MG",,,28 ,,NW,,,,,,$4.57,$0.00,1,1,1,0,0,1,20110101,S0017,HCPCS,"INJECTION, AMINOCAPROIC ACID",,,28 ,,NW,,,,,,$11.19,$0.00,1,1,1,0,0,1,20110101,S0020,HCPCS,"INJECTION, BUPIVICAINE HYDRO",,,28 ,,NW,,,,,,$8.12,$0.00,1,1,1,0,0,1,20110101,S0021,HCPCS,"INJECTION, CEFOPERAZONE SOD",,,28 ,,NW,,,,,,$6.48,$0.00,1,1,1,0,0,1,20110101,S0023,HCPCS,"INJECTION, CIMETIDINE HYDROC",,,28 ,,NW,,,,,,$5.62,$0.00,1,1,1,0,0,1,20110101,S0028,HCPCS,"INJECTION, FAMOTIDINE, 20 MG",,,28 ,,NW,,,,,,$3.84,$0.00,1,1,1,0,0,1,20110101,S0030,HCPCS,"INJECTION, METRONIDAZOLE",,,28 ,,NW,,,,,,$17.56,$0.00,1,1,1,0,0,1,20110101,S0032,HCPCS,"INJECTION, NAFCILLIN SODIUM",,,28 ,,NW,,,,,,$41.72,$0.00,1,1,1,0,0,1,20110101,S0034,HCPCS,"INJECTION, OFLOXACIN, 400 MG",,,28 ,,NW,,,,,,$29.08,$0.00,1,1,1,0,0,1,20110101,S0039,HCPCS,"INJECTION, SULFAMETHOXAZOLE",,,28 ,,NW,,,,,,$21.12,$0.00,1,1,1,0,0,1,20110101,S0040,HCPCS,"INJECTION, TICARCILLIN DISOD",,,28 ,,NW,,,,,,$27.95,$0.00,1,1,1,0,0,1,20110101,S0073,HCPCS,"INJECTION, AZTREONAM, 500 MG",,,28 ,,NW,,,,,,$32.80,$0.00,1,1,1,0,0,1,20110101,S0074,HCPCS,"INJECTION, CEFOTETAN DISODIU",,,28 ,,NW,,,,,,$50.48,$0.00,1,1,1,0,0,1,20110101,S0077,HCPCS,"INJECTION, CLINDAMYCIN PHOSP",,,28 ,,NW,,,,,,$6.55,$0.00,1,1,1,0,0,1,20110101,S0078,HCPCS,"INJECTION, FOSPHENYTOIN SODI",,,28 ,,NW,,,,,,$306.35,$0.00,1,1,1,0,0,1,20110101,S0080,HCPCS,"INJECTION, PENTAMIDINE ISETH",,,28 ,,NW,,,,,,$168.26,$0.00,1,1,1,0,0,1,20110101,S0081,HCPCS,"INJECTION, PIPERACILLIN SODI",,,28 ,,NW,,,,,,$5.88,$0.00,1,1,1,0,0,1,20110101,S0088,HCPCS,IMATINIB 100 MG,,,28 ,,NW,,,,,,$95.82,$0.00,1,1,1,0,0,1,20110101,S0090,HCPCS,"SILDENAFIL CITRATE, 25 MG",,,28 ,,NW,,,,,,$23.88,$0.00,1,1,1,0,0,1,20110101,S0091,HCPCS,GRANISETRON 1MG,,,28 ,,NW,,,,,,$141.44,$0.00,1,1,1,0,0,1,20110101,S0092,HCPCS,HYDROMORPHONE 250 MG,,,28 ,,NW,,,,,,$177.18,$0.00,1,1,1,0,0,1,20110101,S0093,HCPCS,MORPHINE 500 MG,,,28 ,,NW,,,,,,$30.38,$0.00,1,1,1,0,0,1,20110101,S0104,HCPCS,"ZIDOVUDINE, ORAL, 100 MG",,,28 ,,NW,,,,,,$3.16,$0.00,1,1,1,0,0,1,20110101,S0106,HCPCS,BUPROPION HCL SR 60 TABLETS,,,28 ,,NW,,,,,,$190.05,$0.00,1,1,1,0,0,1,20110101,S0108,HCPCS,MERCAPTOPURINE 50 MG,,,28 ,,NW,,,,,,$6.56,$0.00,1,1,1,0,0,1,20110101,S0109,HCPCS,METHADONE ORAL 5MG,,,28 ,,NW,,,,,,$0.49,$0.00,1,1,1,0,0,1,20110101,S0122,HCPCS,INJ MENOTROPINS 75 IU,,,28 ,,NW,,,,,,$106.64,$0.00,1,1,1,0,0,1,20110101,S0126,HCPCS,INJ FOLLITROPIN ALFA 75 IU,,,28 ,,NW,,,,,,$110.31,$0.00,1,1,1,0,0,1,20110101,S0128,HCPCS,INJ FOLLITROPIN BETA 75 IU,,,28 ,,NW,,,,,,$121.25,$0.00,1,1,1,0,0,1,20110101,S0132,HCPCS,INJ GANIRELIX ACETAT 250 MCG,,,28 ,,NW,,,,,,$158.38,$0.00,1,1,1,0,0,1,20110101,S0136,HCPCS,"CLOZAPINE, 25 MG",,,28 ,,NW,,,,,,$2.25,$0.00,1,1,1,0,0,1,20110101,S0137,HCPCS,"DIDANOSINE, 25 MG",,,28 ,,NW,,,,,,$14.55,$0.00,1,1,1,0,0,1,20110101,S0138,HCPCS,"FINASTERIDE, 5 MG",,,28 ,,NW,,,,,,$4.90,$0.00,1,1,1,0,0,1,20110101,S0139,HCPCS,"MINOXIDIL, 10 MG",,,28 ,,NW,,,,,,$1.94,$0.00,1,1,1,0,0,1,20110101,S0140,HCPCS,"SAQUINAVIR, 200 MG",,,28 ,,NW,,,,,,$3.27,$0.00,1,1,1,0,0,1,20110101,S0142,HCPCS,COLISTIMETHATE INH SOL MG,,,28 ,,NW,,,,,,$19.41,$0.00,1,1,1,0,0,1,20110101,S0145,HCPCS,PEG INTERFERON ALFA-2A/180,,,28 ,,NW,,,,,,$48.72,$0.00,1,1,1,0,0,1,20110101,S0155,HCPCS,EPOPROSTENOL DILUTANT,,,28 ,,NW,,,,,,$28.40,$0.00,1,1,1,0,0,1,20110101,S0156,HCPCS,"EXEMESTANE, 25 MG",,,28 ,,NW,,,,,,$14.62,$0.00,1,1,1,0,0,1,20110101,S0157,HCPCS,"BECAPLERMIN GEL 1%, 0.5 GM",,,28 ,,NW,,,,,,$30.56,$0.00,1,1,1,0,0,1,20110101,S0160,HCPCS,DEXTROAMPHETAMINE,,,28 ,,NW,,,,,,$0.69,$0.00,1,1,1,0,0,1,20110101,S0164,HCPCS,INJECTION PANTROPRAZOLE,,,28 ,,NW,,,,,,$27.97,$0.00,1,1,1,0,0,1,20110101,S0166,HCPCS,INJ OLANZAPINE 2.5MG,,,28 ,,NW,,,,,,$10.23,$0.00,1,1,1,0,0,1,20110101,S0170,HCPCS,ANASTROZOLE 1 MG,,,28 ,,NW,,,,,,$14.05,$0.00,1,1,1,0,0,1,20110101,S0171,HCPCS,BUMETANIDE 0.5 MG,,,28 ,,NW,,,,,,$2.07,$0.00,1,1,1,0,0,1,20110101,S0172,HCPCS,CHLORAMBUCIL 2 MG,,,28 ,,NW,,,,,,$3.85,$0.00,1,1,1,0,0,1,20110101,S0174,HCPCS,DOLASETRON 50 MG,,,28 ,,NW,,,,,,$90.02,$0.00,1,1,1,0,0,1,20110101,S0175,HCPCS,FLUTAMIDE 125 MG,,,28 ,,NW,,,,,,$3.72,$0.00,1,1,1,0,0,1,20110101,S0176,HCPCS,HYDROXYUREA 500 MG,,,28 ,,NW,,,,,,$1.99,$0.00,1,1,1,0,0,1,20110101,S0177,HCPCS,LEVAMISOLE 50 MG,,,28 ,,NW,,,,,,$8.65,$0.00,1,1,1,0,0,1,20110101,S0178,HCPCS,LOMUSTINE 10 MG,,,28 ,,NW,,,,,,$44.60,$0.00,1,1,1,0,0,1,20110101,S0179,HCPCS,MEGESTROL 20 MG,,,28 ,,NW,,,,,,$1.00,$0.00,1,1,1,0,0,1,20110101,S0181,HCPCS,ONDANSETRON 4 MG,,,28 ,,NW,,,,,,$32.27,$0.00,1,1,1,0,0,1,20110101,S0182,HCPCS,PROCARBAZINE 5 MG,,,28 ,,NW,,,,,,$78.83,$0.00,1,1,1,0,0,1,20110101,S0183,HCPCS,PROCHLORPERAZINE 5 MG,,,28 ,,NW,,,,,,$1.14,$0.00,1,1,1,0,0,1,20110101,S0187,HCPCS,TAMOXIFEN 10 MG,,,28 ,,NW,,,,,,$3.72,$0.00,1,1,1,0,0,1,20110101,S0189,HCPCS,TESTOSTERONE PELLET 75 MG,,,28 ,,NW,,,,,,$115.01,$0.00,1,1,1,0,0,1,20110101,S0190,HCPCS,"MIFEPRISTONE, ORAL, 200 MG",,,28 ,,NW,,,,,,$147.49,$0.00,1,1,1,0,0,1,20110101,S0191,HCPCS,"MISOPROSTOL, ORAL, 200 MCG",,,28 ,,NW,,,,,,$4.10,$0.00,1,1,1,0,0,1,20110101,S0195,HCPCS,PNEUMO VACCINE 5-9 YRS,,,28 ,,NW,,,,,,$63.84,$0.00,1,1,1,0,1,1,20110101,S0199,HCPCS,MED ABORTION INC ALL EX DRUG,,,12 ,,TotalUnits,,,,4.65 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0201,HCPCS,PARTIAL HOSPITALIZATION SERV,,,14 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S0207,HCPCS,PARAMEDICINTERCEP NONHOSPALS,,,14 ,,TotalUnits,,,,7.09 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S0208,HCPCS,PARAMED INTRCEPT NONVOL,,,14 ,,TotalUnits,,,,4.56 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S0209,HCPCS,WC VAN MILEAGE PER MI,,,14 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S0215,HCPCS,NONEMERG TRANSP MILEAGE,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S0220,HCPCS,MEDICAL CONFERENCE BY PHYSIC,,,15 ,,TotalUnits,,,,2.81 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0221,HCPCS,"MEDICAL CONFERENCE, 60 MIN",,,15 ,,RBRVS,1.42 ,0.44 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0255,HCPCS,HOSPICE REFER VISIT NONMD,,,15 ,,RBRVS,0.48 ,0.11 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0257,HCPCS,END OF LIFE COUNSELING,,,15 ,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0260,HCPCS,H&P FOR SURGERY,,,15 ,,TotalUnits,,,,1.44 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0265,HCPCS,GENETIC COUNSEL 15 MINS,,,14 ,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0302,HCPCS,COMPLETED EPSDT,,,18 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0315,HCPCS,DISEASE MANAGEMENT PROGRAM,,,14 ,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0316,HCPCS,FOLLOW-UP/REASSESSMENT,,,14 ,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0317,HCPCS,DISEASE MGMT PER DIEM,,,14 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0390,HCPCS,ROUT FOOT CARE PER VISIT,,,14 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0395,HCPCS,IMPRESSION CASTING FT,,,28 ,,NW,,,,,,$93.52,$0.00,1,1,1,0,1,1,20110101,S0400,HCPCS,GLOBAL ESWL KIDNEY,,,21 ,,RBRVS,9.64 ,6.13 ,17.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20110101,S0500,HCPCS,DISPOS CONT LENS,,,28 ,,NW,,,,,,$59.55,$0.00,1,1,1,1,1,1,20110101,S0504,HCPCS,SINGL PRSCRP LENS,,,28 ,,NW,,,,,,$118.30,$0.00,1,1,1,1,1,1,20110101,S0506,HCPCS,BIFOC PRSCP LENS,,,28 ,,NW,,,,,,$111.58,$0.00,1,1,1,1,1,1,20110101,S0508,HCPCS,TRIFOC PRSCRP LENS,,,28 ,,NW,,,,,,$116.18,$0.00,1,1,1,1,1,1,20110101,S0510,HCPCS,NON-PRSCRP LENS,,,28 ,,NW,,,,,,$35.43,$0.00,1,1,1,1,1,1,20110101,S0512,HCPCS,DAILY CONT LENS,,,28 ,,NW,,,,,,$117.69,$0.00,1,1,1,1,1,1,20110101,S0514,HCPCS,COLOR CONT LENS,,,28 ,,NW,,,,,,$165.33,$0.00,1,1,1,1,1,1,20110101,S0515,HCPCS,SCLERAL LENS LIQUID BANDAGE,,,28 ,,NW,,,,,,$365.74,$0.00,1,1,1,1,1,1,20110101,S0516,HCPCS,SAFETY FRAMES,,,28 ,,NW,,,,,,$136.18,$0.00,1,1,1,1,1,1,20110101,S0518,HCPCS,SUNGLASS FRAMES,,,28 ,,NW,,,,,,$42.96,$0.00,1,1,1,1,1,1,20110101,S0580,HCPCS,POLYCARB LENS,,,28 ,,NW,,,,,,$38.31,$0.00,1,1,1,1,1,1,20110101,S0581,HCPCS,NONSTND LENS,,,28 ,,NW,,,,,,$178.64,$0.00,1,1,1,1,1,1,20110101,S0592,HCPCS,COMP CONT LENS EVAL,,,23 ,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0595,HCPCS,NEW LENSES IN PTS OLD FRAME,,,28 ,,NW,,,,,,$6.85,$0.00,1,1,1,1,1,1,20110101,S0601,HCPCS,SCREENING PROCTOSCOPY,,,21 ,,RBRVS,0.55 ,0.38 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0610,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,,18 ,,TotalUnits,,,,2.79 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0612,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,,18 ,,TotalUnits,,,,1.95 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0613,HCPCS,ANN BREAST EXAM,,,18 ,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0618,HCPCS,AUDIOMETRY FOR HEARING AID,,,8 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S0620,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,,23 ,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0621,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,,23 ,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0622,HCPCS,PHYS EXAM FOR COLLEGE,,,14 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0625,HCPCS,DIGITAL SCREENING RETINA,,,14 ,,TotalUnits,,,,2.76 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0630,HCPCS,REMOVAL OF SUTURES,,,14 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0800,HCPCS,LASER IN SITU KERATOMILEUSIS,,,14 ,,TotalUnits,,,,15.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0810,HCPCS,PHOTOREFRACTIVE KERATECTOMY,,,14 ,,TotalUnits,,,,16.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S0812,HCPCS,PHOTOTHERAP KERATECT,,,14 ,,RBRVS,0.92 ,0.64 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S1001,HCPCS,DELUXE ITEM,,,28 ,,NW,,,,,,$21.52,$0.00,1,1,1,1,1,1,20110101,S1002,HCPCS,CUSTOM ITEM,,,28 ,,NW,,,,,,$21.83,$0.00,1,1,1,1,1,1,20110101,S1015,HCPCS,IV TUBING EXTENSION SET,,,28 ,,NW,,,,,,$34.85,$0.00,1,1,1,0,0,1,20110101,S1016,HCPCS,NON-PVC INTRAVENOUS ADMINIST,,,28 ,,NW,,,,,,$48.93,$0.00,1,1,1,0,0,1,20110101,S1040,HCPCS,CRANIAL REMOLDING ORTHOSIS,,,28 ,,NW,,,,,,$498.52,$0.00,1,1,1,1,1,1,20110101,S2053,HCPCS,TRANSPLANTATION OF SMALL INT,,,21 ,,RBRVS,83.29 ,27.76 ,27.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2054,HCPCS,TRANSPLANTATION OF MULTIVISC,,,21 ,,RBRVS,61.68 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2055,HCPCS,HARVESTING OF DONOR MULTIVIS,,,21 ,,RBRVS,61.68 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2060,HCPCS,LOBAR LUNG TRANSPLANTATION,,,21 ,,RBRVS,40.94 ,20.19 ,20.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2065,HCPCS,SIMULT PANC KIDN TRANS,,,21 ,,RBRVS,61.68 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2068,HCPCS,BREAST DIEP OR SIEA FLAP,,,21 ,,TotalUnits,,,,211.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2070,HCPCS,CYSTO LASER TX URETERAL CALC,,,21 ,,RBRVS,6.87 ,3.46 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2080,HCPCS,LAUP,,,21 ,,RBRVS,9.63 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2083,HCPCS,ADJUSTMENT GASTRIC BAND,,,21 ,,TotalUnits,,,,1.89 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2095,HCPCS,TRANSCATH EMBOLIZ MICROSPHER,,,21 ,,RBRVS,18.11 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2102,HCPCS,ISLET CELL TISSUE TRANSPLANT,,,21 ,,TotalUnits,,,,48.84 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2115,HCPCS,PERIACETABULAR OSTEOTOMY,,,21 ,,RBRVS,21.87 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2120,HCPCS,LOW DENSITY LIPOPROTEIN(LDL),,,17 ,,TotalUnits,,,,41.06 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2140,HCPCS,CORD BLOOD HARVESTING,,,21 ,,TotalUnits,,,,1.86 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2142,HCPCS,CORD BLOOD-DERIVED STEM-CELL,,,21 ,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2150,HCPCS,BMT HARV/TRANSPL 28D PKG,,,21 ,,RBRVS,2.24 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2152,HCPCS,SOLID ORGAN TRANSPL PKG,,,21 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2202,HCPCS,ECHOSCLEROTHERAPY,,,14 ,,RBRVS,1.09 ,0.64 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2205,HCPCS,MINIMALLY INVASIVE DIRECT CO,,,21 ,,RBRVS,33.64 ,12.57 ,12.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2206,HCPCS,MINIMALLY INVASIVE DIRECT CO,,,21 ,,RBRVS,39.77 ,14.75 ,14.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2207,HCPCS,MINIMALLY INVASIVE DIRECT CO,,,21 ,,RBRVS,34.87 ,12.92 ,12.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2225,HCPCS,MYRINGOTOMY LASER-ASSIST,,,21 ,,RBRVS,1.35 ,1.56 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2230,HCPCS,IMPLANT SEMI-IMP HEAR,,,21 ,,TotalUnits,,,,15.48 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2235,HCPCS,IMPLANT AUDITORY BRAIN IMP,,,21 ,,RBRVS,0.73 ,8.52 ,8.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2260,HCPCS,INDUCED ABORTION 17-24 WEEKS,,,12 ,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2265,HCPCS,INDUCED ABORTION 25-28 WKS,,,12 ,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2266,HCPCS,INDUCED ABORTION 29-31 WKS,,,12 ,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2267,HCPCS,INDUCED ABORTION 32 OR MORE,,,12 ,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2300,HCPCS,"ARTHROSCOPY, SHOULDER, SURGI",,,21 ,,TotalUnits,,,,12.49 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2340,HCPCS,CHEMODENERVATION OF ABDUCTOR,,,21 ,,RBRVS,3.86 ,1.65 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2341,HCPCS,CHEMODENERV ADDUCT VOCAL,,,21 ,,RBRVS,3.86 ,1.65 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2342,HCPCS,NASAL ENDOSCOP PO DEBRID,,,21 ,,RBRVS,2.98 ,1.39 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2348,HCPCS,DECOMPRESS DISC RF LUMBAR,,,21 ,,RBRVS,8.88 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2350,HCPCS,"DISKECTOMY, ANTERIOR, WITH D",,,21 ,,RBRVS,22.75 ,11.08 ,11.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2351,HCPCS,"DISKECTOMY, ANTERIOR, WITH D",,,21 ,,RBRVS,3.28 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2361,HCPCS,VERTEBROPLAST CERV ADDL,,,21 ,,RBRVS,4.30 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S2900,HCPCS,ROBOTIC SURGICAL SYSTEM,,,21 ,,TotalUnits,,,,13.28 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3005,HCPCS,EVAL SELF-ASSESS DEPRESSION,,,16 ,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3600,HCPCS,STAT LAB,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3601,HCPCS,STAT LAB HOME/NF,,,17 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3620,HCPCS,NEWBORN METABOLIC SCREENING,,,17 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S3625,HCPCS,MATERNAL TRIPLE SCREEN TEST,,,17 ,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3628,HCPCS,PAMG-1 RAPID ASSAY FOR ROM,,,17 ,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3630,HCPCS,EOSINOPHIL BLOOD COUNT,,,17 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3645,HCPCS,HIV-1 ANTIBODY TESTING OF OR,,,17 ,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3650,HCPCS,"SALIVA TEST, HORMONE LEVEL;",,,17 ,,TotalUnits,,,,3.09 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3652,HCPCS,"SALIVA TEST, HORMONE LEVEL;",,,17 ,,TotalUnits,,,,2.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3655,HCPCS,ANTISPERM ANTIBODIES TEST,,,17 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3820,HCPCS,COMP BRCA1/BRCA2,,,17 ,,TotalUnits,,,,20.18 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3822,HCPCS,SING MUTATION BRST/OVAR,,,17 ,,TotalUnits,,,,2.85 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3823,HCPCS,3 MUTATION BRST/OVAR,,,17 ,,TotalUnits,,,,3.46 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3830,HCPCS,GENE TEST HNPCC COMP,,,17 ,,TotalUnits,,,,13.26 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3833,HCPCS,COMP APC SEQUENCE,,,17 ,,TotalUnits,,,,13.04 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3835,HCPCS,GENE TEST CYSTIC FIBROSIS,,,17 ,,TotalUnits,,,,1.57 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3854,HCPCS,GENE PROFILE PANEL BREAST,,,17 ,,TotalUnits,,,,26.43 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S3900,HCPCS,SURFACE EMG,,,17 ,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4005,HCPCS,INTERIM LABOR FACILITY GLOBA,,,12 ,,TotalUnits,,,,13.24 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4011,HCPCS,IVF PACKAGE,,,14 ,,TotalUnits,,,,66.38 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4015,HCPCS,COMPLETE IVF NOS CASE RATE,,,14 ,,TotalUnits,,,,71.73 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4016,HCPCS,FROZEN IVF CASE RATE,,,14 ,,TotalUnits,,,,20.87 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4022,HCPCS,ASST OOCYTE FERT CASE RATE,,,14 ,,TotalUnits,,,,14.68 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4035,HCPCS,STIMULATED IUI CASE RATE,,,14 ,,TotalUnits,,,,17.70 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4040,HCPCS,MONIT STORE CRYO EMBRYO 30 D,,,14 ,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4042,HCPCS,OVULATION MGMT PER CYCLE,,,14 ,,TotalUnits,,,,3.70 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4981,HCPCS,INSERT LEVONORGESTREL IUS,,,14 ,,TotalUnits,,,,1.74 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S4989,HCPCS,CONTRACEPT IUD,,,28 ,,NW,,,,,,$710.74,$0.00,1,1,1,1,1,1,20110101,S4990,HCPCS,NICOTINE PATCH LEGEND,,,28 ,,NW,,,,,,$27.90,$0.00,1,1,1,0,0,1,20110101,S4993,HCPCS,CONTRACEPTIVE PILLS FOR BC,,,28 ,,NW,,,,,,$30.26,$0.00,1,1,1,1,1,1,20110101,S4995,HCPCS,SMOKING CESSATION GUM,,,28 ,,NW,,,,,,$59.43,$0.00,1,1,1,0,0,1,20110101,S5000,HCPCS,"PRESCRIPTION DRUG, GENERIC",,,28 ,,NW,,,,,,$20.78,$0.00,1,1,1,0,0,1,20110101,S5001,HCPCS,"PRESCRIPTION DRUG,BRAND NAME",,,28 ,,NW,,,,,,$88.78,$0.00,1,1,1,0,0,1,20110101,S5010,HCPCS,5% DEXTROSE AND 0.45% SALINE,,,28 ,,NW,,,,,,$21.28,$0.00,1,1,1,0,0,1,20110101,S5011,HCPCS,5% DEXTROSE IN LACTATED RING,,,28 ,,NW,,,,,,$22.89,$0.00,1,1,1,0,0,1,20110101,S5012,HCPCS,5% DEXTROSE WITH POTASSIUM,,,28 ,,NW,,,,,,$73.96,$0.00,1,1,1,0,0,1,20110101,S5013,HCPCS,5%DEXTROSE/0.45%SALINE1000ML,,,28 ,,NW,,,,,,$20.62,$0.00,1,1,1,0,0,1,20110101,S5014,HCPCS,D5W/0.45NS W KCL AND MGS04,,,28 ,,NW,,,,,,$12.44,$0.00,1,1,1,0,0,1,20110101,S5035,HCPCS,HIT ROUTINE DEVICE MAINT,,,14 ,,RBRVS,0.18 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5100,HCPCS,ADULT DAYCARE SERVICES 15MIN,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5102,HCPCS,ADULT DAY CARE PER DIEM,,,14 ,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5105,HCPCS,CENTERBASED DAY CARE PERDIEM,,,14 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5108,HCPCS,HOMECARE TRAIN PT 15 MIN,,,14 ,,RBRVS,0.45 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5109,HCPCS,HOMECARE TRAIN PT SESSION,,,14 ,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5110,HCPCS,FAMILY HOMECARE TRAINING 15M,,,14 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5111,HCPCS,FAMILY HOMECARE TRAIN/SESSIO,,,14 ,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5115,HCPCS,NONFAMILY HOMECARE TRAIN/15M,,,14 ,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5116,HCPCS,NONFAMILY HC TRAIN/SESSION,,,14 ,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5120,HCPCS,CHORE SERVICES PER 15 MIN,,,14 ,,TotalUnits,,,,0.04 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5125,HCPCS,ATTENDANT CARE SERVICE /15M,,,14 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5126,HCPCS,ATTENDANT CARE SERVICE /DIEM,,,14 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5135,HCPCS,ADULT COMPANIONCARE PER 15M,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5136,HCPCS,ADULT COMPANIONCARE PER DIEM,,,14 ,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5140,HCPCS,ADULT FOSTER CARE PER DIEM,,,14 ,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5145,HCPCS,CHILD FOSTERCARE TH PER DIEM,,,14 ,,TotalUnits,,,,1.07 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5150,HCPCS,UNSKILLED RESPITE CARE /15M,,,14 ,,TotalUnits,,,,0.04 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5151,HCPCS,UNSKILLED RESPITECARE /DIEM,,,14 ,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5161,HCPCS,EMER RSPNS SYS SERV PERMONTH,,,14 ,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5170,HCPCS,HOMEDELIVERED PREPARED MEAL,,,14 ,,TotalUnits,,,,0.05 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5180,HCPCS,HH RESPIRATORY THRPY IN EVAL,,,14 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5181,HCPCS,HH RESPIRATORY THRPY NOS/DAY,,,14 ,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5190,HCPCS,WELLNESS ASSESSMENT BY NONPH,,,14 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S5199,HCPCS,PERSONAL CARE ITEM NOS EACH,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,0,0,1,20110101,S5497,HCPCS,HIT CATH CARE NOC,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,1,1,1,20110101,S5498,HCPCS,HIT SIMPLE CATH CARE,,,28 ,,NW,,,,,,$36.01,$0.00,1,1,1,1,1,1,20110101,S5501,HCPCS,HIT COMPLEX CATH CARE,,,28 ,,NW,,,,,,$38.84,$0.00,1,1,1,1,1,1,20110101,S5502,HCPCS,HIT INTERIM CATH CARE,,,28 ,,NW,,,,,,$68.40,$0.00,1,1,1,1,1,1,20110101,S5517,HCPCS,HIT DECLOTTING KIT,,,28 ,,NW,,,,,,$79.09,$0.00,1,1,1,1,1,1,20110101,S5520,HCPCS,HIT PICC INSERT KIT,,,28 ,,NW,,,,,,$95.73,$0.00,1,1,1,1,1,1,20110101,S5521,HCPCS,HIT MIDLINE CATH INSERT KIT,,,28 ,,NW,,,,,,$141.59,$0.00,1,1,1,1,1,1,20110101,S5522,HCPCS,HIT PICC INSERT NO SUPP,,,14 ,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5523,HCPCS,HIP MIDLINE CATH INSERT KIT,,,14 ,,TotalUnits,,,,1.53 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S5550,HCPCS,INSULIN RAPID 5 U,,,28 ,,NW,,,,,,$0.14,$0.00,1,1,1,0,0,1,20110101,S5551,HCPCS,INSULIN MOST RAPID 5 U,,,28 ,,NW,,,,,,$0.14,$0.00,1,1,1,0,0,1,20110101,S5552,HCPCS,INSULIN INTERMED 5 U,,,28 ,,NW,,,,,,$0.14,$0.00,1,1,1,0,0,1,20110101,S5553,HCPCS,INSULIN LONG ACTING 5 U,,,28 ,,NW,,,,,,$0.14,$0.00,1,1,1,0,0,1,20110101,S5560,HCPCS,INSULIN REUSE PEN 1.5 ML,,,28 ,,NW,,,,,,$3.43,$0.00,1,1,1,1,1,1,20110101,S8030,HCPCS,TANTALUM RING APPLICATION,,,20 ,,RBRVS,9.46 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S8037,HCPCS,MRCP,,,20 ,,TotalUnits,,,,7.77 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S8040,HCPCS,TOPOGRAPHIC BRAIN MAPPING,,,14 ,,RBRVS,2.97 ,3.05 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S8049,HCPCS,INTRAOPERATIVE RADIATION THE,,,20 ,,RBRVS,,4.35 ,4.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20110101,S8080,HCPCS,SCINTIMAMMOGRAPHY,,,20 ,,TotalUnits,,,,3.57 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S8085,HCPCS,FLUORINE-18 FLUORODEOXYGLUCO,,,20 ,,TotalUnits,,,,2.91 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S8092,HCPCS,ELECTRON BEAM COMPUTED TOMOG,,,20 ,,TotalUnits,,,,2.28 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S8096,HCPCS,PORTABLE PEAK FLOW METER,,,28 ,,NW,,,,,,$41.06,$0.00,1,1,1,1,1,1,20110101,S8097,HCPCS,ASTHMA KIT,,,28 ,,NW,,,,,,$53.71,$0.00,1,1,1,1,1,1,20110101,S8100,HCPCS,SPACER WITHOUT MASK,,,28 ,,NW,,,,,,$21.78,$0.00,1,1,1,1,1,1,20110101,S8101,HCPCS,SPACER WITH MASK,,,28 ,,NW,,,,,,$40.71,$0.00,1,1,1,1,1,1,20110101,S8110,HCPCS,PEAK EXPIRATORY FLOW RATE (P,,,14 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S8120,HCPCS,O2 CONTENTS GAS CUBIC FT,,,14 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S8121,HCPCS,O2 CONTENTS LIQUID LB,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S8185,HCPCS,FLUTTER DEVICE,,,28 ,,NW,,,,,,$95.83,$0.00,1,1,1,1,1,1,20110101,S8186,HCPCS,SWIVEL ADAPTOR,,,28 ,,NW,,,,,,$18.29,$0.00,1,1,1,1,1,1,20110101,S8189,HCPCS,TRACH SUPPLY NOC,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,1,1,1,20110101,S8210,HCPCS,MUCUS TRAP,,,28 ,,NW,,,,,,$1.21,$0.00,1,1,1,1,1,1,20110101,S8262,HCPCS,MANDIB ORTHO REPOS DEVICE,,,28 ,,NW,,,,,,"$2,098.52",$0.00,1,1,1,1,1,1,20110101,S8265,HCPCS,HABERMAN FEEDER,,,28 ,,NW,,,,,,$63.27,$0.00,1,1,1,1,1,1,20110101,S8301,HCPCS,INFECT CONTROL SUPPLIES NOS,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,1,1,1,20110101,S8415,HCPCS,SUPPLIES FOR HOME DELIVERY,,,28 ,,NW,,,,,,$149.10,$0.00,1,1,1,1,1,1,20110101,S8420,HCPCS,CUSTOM GRADIENT SLEEV/GLOV,,,28 ,,NW,,,,,,$110.87,$0.00,1,1,1,1,1,1,20110101,S8421,HCPCS,READY GRADIENT SLEEV/GLOV,,,28 ,,NW,,,,,,$133.42,$0.00,1,1,1,1,1,1,20110101,S8422,HCPCS,CUSTOM GRAD SLEEVE MED,,,28 ,,NW,,,,,,$247.17,$0.00,1,1,1,1,1,1,20110101,S8423,HCPCS,CUSTOM GRAD SLEEVE HEAVY,,,28 ,,NW,,,,,,$146.05,$0.00,1,1,1,1,1,1,20110101,S8424,HCPCS,READY GRADIENT SLEEVE,,,28 ,,NW,,,,,,$90.44,$0.00,1,1,1,1,1,1,20110101,S8425,HCPCS,CUSTOM GRAD GLOVE MED,,,28 ,,NW,,,,,,$268.60,$0.00,1,1,1,1,1,1,20110101,S8426,HCPCS,CUSTOM GRAD GLOVE HEAVY,,,28 ,,NW,,,,,,$236.61,$0.00,1,1,1,1,1,1,20110101,S8427,HCPCS,READY GRADIENT GLOVE,,,28 ,,NW,,,,,,$152.82,$0.00,1,1,1,1,1,1,20110101,S8428,HCPCS,READY GRADIENT GAUNTLET,,,28 ,,NW,,,,,,$57.68,$0.00,1,1,1,1,1,1,20110101,S8429,HCPCS,GRADIENT PRESSURE WRAP,,,28 ,,NW,,,,,,$190.57,$0.00,1,1,1,1,1,1,20110101,S8430,HCPCS,PADDING FOR COMPRSSN BDG,,,28 ,,NW,,,,,,$21.66,$0.00,1,1,1,1,1,1,20110101,S8431,HCPCS,COMPRESSION BANDAGE,,,28 ,,NW,,,,,,$15.35,$0.00,1,1,1,1,1,1,20110101,S8450,HCPCS,SPLINT DIGIT,,,28 ,,NW,,,,,,$19.58,$0.00,1,1,1,1,1,1,20110101,S8451,HCPCS,SPLINT WRIST OR ANKLE,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,1,1,1,20110101,S8452,HCPCS,SPLINT ELBOW,,,28 ,,NW,,,,,,$17.81,$0.00,1,1,1,1,1,1,20110101,S8460,HCPCS,CAMISOLE POST-MAST,,,28 ,,NW,,,,,,$121.46,$0.00,1,1,1,1,1,1,20110101,S8490,HCPCS,100 INSULIN SYRINGES,,,28 ,,NW,,,,,,$1.21,$0.00,1,1,1,1,1,1,20110101,S8940,HCPCS,HIPPOTHERAPY PER SESSION,,,19 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S8948,HCPCS,LOW-LEVEL LASER TRMT 15 MIN,,,14 ,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S8950,HCPCS,"COMPLEX LYMPHEDEMA THERAPY,",,,14 ,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S8990,HCPCS,PT OR MANIP FOR MAINT,,,19 ,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S8999,HCPCS,RESUSCITATION BAG,,,28 ,,NW,,,,,,$218.95,$0.00,1,1,1,1,1,1,20110101,S9001,HCPCS,HOME UTERINE MONITOR WITH OR,,,28 ,,NW,,,,,,$111.42,$0.00,1,1,1,1,1,1,20110101,S9024,HCPCS,PARANASAL SINUS ULTRASOUND,,,20 ,,TotalUnits,,,,2.17 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9034,HCPCS,ESWL FOR GALLSTONES,,,21 ,,RBRVS,9.64 ,6.13 ,17.10 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9061,HCPCS,MEDICAL SUPPLIES AND EQUIPME,,,28 ,,NW,,,,,,$64.78,$0.00,1,1,1,1,1,1,20110101,S9075,HCPCS,SMOKING CESSATION TREATMENT,,,14 ,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9083,HCPCS,URGENT CARE CENTER GLOBAL,,,15 ,,TotalUnits,,,,1.90 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9088,HCPCS,SERVICES PROVIDED IN URGENT,,,15 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9090,HCPCS,VERTEBRAL AXIAL DECOMPRESSIO,,,14 ,,TotalUnits,,,,1.64 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9097,HCPCS,HOME VISIT WOUND CARE,,,14 ,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9098,HCPCS,HOME PHOTOTHERAPY VISIT,,,14 ,,TotalUnits,,,,1.89 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9109,HCPCS,CHF TELEMONITORING MONTH,,,4 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S9117,HCPCS,BACK SCHOOL VISIT,,,14 ,,RBRVS,0.17 ,0.06 ,0.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9122,HCPCS,HOME HEALTH AIDE OR CERTIFIE,,,14 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9123,HCPCS,NURSING CARE IN HOME RN,,,14 ,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9124,HCPCS,"NURSING CARE, IN THE HOME; B",,,14 ,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9125,HCPCS,"RESPITE CARE, IN THE HOME, P",,,14 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9126,HCPCS,"HOSPICE CARE, IN THE HOME, P",,,14 ,,TotalUnits,,,,1.38 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9127,HCPCS,"SOCIAL WORK VISIT, IN THE HO",,,14 ,,TotalUnits,,,,1.64 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9128,HCPCS,"SPEECH THERAPY, IN THE HOME,",,,14 ,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9129,HCPCS,"OCCUPATIONAL THERAPY, IN THE",,,14 ,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9131,HCPCS,PT IN THE HOME PER DIEM,,,14 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9140,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9141,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14 ,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9145,HCPCS,INSULIN PUMP INITIATION,,,14 ,,TotalUnits,,,,3.81 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9152,HCPCS,"SPEECH THERAPY, RE-EVAL",,,8 ,,TotalUnits,,,,2.94 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9208,HCPCS,HOME MGMT PRETERM LABOR,,,28 ,,NW,,,,,,$242.13,$0.00,1,1,1,1,1,1,20110101,S9211,HCPCS,HOME MGMT GEST HYPERTENSION,,,28 ,,NW,,,,,,$102.62,$0.00,1,1,1,1,1,1,20110101,S9212,HCPCS,HM POSTPAR HYPER PER DIEM,,,28 ,,NW,,,,,,$121.29,$0.00,1,1,1,1,1,1,20110101,S9213,HCPCS,HM PREECLAMP PER DIEM,,,28 ,,NW,,,,,,$239.42,$0.00,1,1,1,1,1,1,20110101,S9214,HCPCS,HM GEST DM PER DIEM,,,28 ,,NW,,,,,,$221.71,$0.00,1,1,1,1,1,1,20110101,S9325,HCPCS,HIT PAIN MGMT PER DIEM,,,28 ,,NW,,,,,,$123.67,$0.00,1,1,1,1,1,1,20110101,S9326,HCPCS,HIT CONT PAIN PER DIEM,,,28 ,,NW,,,,,,$175.60,$0.00,1,1,1,1,1,1,20110101,S9327,HCPCS,HIT INT PAIN PER DIEM,,,28 ,,NW,,,,,,$174.23,$0.00,1,1,1,1,1,1,20110101,S9328,HCPCS,HIT PAIN IMP PUMP DIEM,,,28 ,,NW,,,,,,$126.53,$0.00,1,1,1,1,1,1,20110101,S9329,HCPCS,HIT CHEMO PER DIEM,,,28 ,,NW,,,,,,$188.83,$0.00,1,1,1,1,1,1,20110101,S9330,HCPCS,HIT CONT CHEM DIEM,,,28 ,,NW,,,,,,$185.70,$0.00,1,1,1,1,1,1,20110101,S9331,HCPCS,HIT INTERMIT CHEMO DIEM,,,28 ,,NW,,,,,,$206.79,$0.00,1,1,1,1,1,1,20110101,S9335,HCPCS,HT HEMODIALYSIS DIEM,,,28 ,,NW,,,,,,$567.02,$0.00,1,1,1,1,1,1,20110101,S9336,HCPCS,HIT CONT ANTICOAG DIEM,,,28 ,,NW,,,,,,$177.60,$0.00,1,1,1,1,1,1,20110101,S9338,HCPCS,HIT IMMUNOTHERAPY DIEM,,,28 ,,NW,,,,,,$220.04,$0.00,1,1,1,1,1,1,20110101,S9339,HCPCS,HIT PERITON DIALYSIS DIEM,,,28 ,,NW,,,,,,$457.00,$0.00,1,1,1,1,1,1,20110101,S9340,HCPCS,HIT ENTERAL PER DIEM,,,28 ,,NW,,,,,,$73.39,$0.00,1,1,1,1,1,1,20110101,S9341,HCPCS,HIT ENTERAL GRAV DIEM,,,28 ,,NW,,,,,,$50.39,$0.00,1,1,1,1,1,1,20110101,S9342,HCPCS,HIT ENTERAL PUMP DIEM,,,28 ,,NW,,,,,,$54.11,$0.00,1,1,1,1,1,1,20110101,S9343,HCPCS,HIT ENTERAL BOLUS NURS,,,28 ,,NW,,,,,,$33.57,$0.00,1,1,1,1,1,1,20110101,S9345,HCPCS,HIT ANTI-HEMOPHIL DIEM,,,28 ,,NW,,,,,,$112.01,$0.00,1,1,1,1,1,1,20110101,S9346,HCPCS,HIT ALPHA-1-PROTEINAS DIEM,,,28 ,,NW,,,,,,$78.38,$0.00,1,1,1,1,1,1,20110101,S9347,HCPCS,HIT LONGTERM INFUSION DIEM,,,28 ,,NW,,,,,,$87.40,$0.00,1,1,1,1,1,1,20110101,S9348,HCPCS,HIT SYMPATHOMIM DIEM,,,28 ,,NW,,,,,,$193.86,$0.00,1,1,1,1,1,1,20110101,S9349,HCPCS,HIT TOCOLYSIS DIEM,,,28 ,,NW,,,,,,$279.64,$0.00,1,1,1,1,1,1,20110101,S9351,HCPCS,HIT CONT ANTIEMETIC DIEM,,,28 ,,NW,,,,,,$355.74,$0.00,1,1,1,1,1,1,20110101,S9353,HCPCS,HIT CONT INSULIN DIEM,,,28 ,,NW,,,,,,$486.42,$0.00,1,1,1,1,1,1,20110101,S9355,HCPCS,HIT CHELATION DIEM,,,28 ,,NW,,,,,,$145.26,$0.00,1,1,1,1,1,1,20110101,S9357,HCPCS,HIT ENZYME REPLACE DIEM,,,28 ,,NW,,,,,,$157.84,$0.00,1,1,1,1,1,1,20110101,S9359,HCPCS,HIT ANTI-TNF PER DIEM,,,28 ,,NW,,,,,,$288.87,$0.00,1,1,1,1,1,1,20110101,S9361,HCPCS,HIT DIURETIC INFUS DIEM,,,28 ,,NW,,,,,,$105.16,$0.00,1,1,1,1,1,1,20110101,S9363,HCPCS,HIT ANTI-SPASMOTIC DIEM,,,28 ,,NW,,,,,,$212.07,$0.00,1,1,1,1,1,1,20110101,S9364,HCPCS,HIT TPN TOTAL DIEM,,,28 ,,NW,,,,,,$330.65,$0.00,1,1,1,1,1,1,20110101,S9365,HCPCS,HIT TPN 1 LITER DIEM,,,28 ,,NW,,,,,,$381.07,$0.00,1,1,1,1,1,1,20110101,S9366,HCPCS,HIT TPN 2 LITER DIEM,,,28 ,,NW,,,,,,$465.02,$0.00,1,1,1,1,1,1,20110101,S9367,HCPCS,HIT TPN 3 LITER DIEM,,,28 ,,NW,,,,,,$517.79,$0.00,1,1,1,1,1,1,20110101,S9368,HCPCS,HIT TPN OVER 3L DIEM,,,28 ,,NW,,,,,,$453.71,$0.00,1,1,1,1,1,1,20110101,S9370,HCPCS,HT INJ ANTIEMETIC DIEM,,,28 ,,NW,,,,,,$134.37,$0.00,1,1,1,1,1,1,20110101,S9372,HCPCS,HT INJ ANTICOAG DIEM,,,28 ,,NW,,,,,,$91.12,$0.00,1,1,1,1,1,1,20110101,S9373,HCPCS,HIT HYDRA TOTAL DIEM,,,28 ,,NW,,,,,,$102.03,$0.00,1,1,1,1,1,1,20110101,S9374,HCPCS,HIT HYDRA 1 LITER DIEM,,,28 ,,NW,,,,,,$147.45,$0.00,1,1,1,1,1,1,20110101,S9375,HCPCS,HIT HYDRA 2 LITER DIEM,,,28 ,,NW,,,,,,$188.90,$0.00,1,1,1,1,1,1,20110101,S9376,HCPCS,HIT HYDRA 3 LITER DIEM,,,28 ,,NW,,,,,,$177.88,$0.00,1,1,1,1,1,1,20110101,S9377,HCPCS,HIT HYDRA OVER 3L DIEM,,,28 ,,NW,,,,,,$222.89,$0.00,1,1,1,1,1,1,20110101,S9379,HCPCS,HIT NOC PER DIEM,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,1,1,1,20110101,S9401,HCPCS,ANTICOAG CLINIC PER SESSION,,,14 ,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9430,HCPCS,PHARMACY COMP/DISP SERV,,,14 ,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9433,HCPCS,MEDICAL FOOD ORAL 100% NUTR,,,28 ,,NW,,,,,,$31.53,$0.00,1,1,1,0,1,1,20110101,S9434,HCPCS,MOD SOLID FOOD SUPPL,,,28 ,,NW,,,,,,$48.25,$0.00,1,1,1,0,1,1,20110101,S9435,HCPCS,MEDICAL FOODS FOR INBORN ERR,,,28 ,,NW,,,,,,$30.39,$0.00,1,1,1,0,1,1,20110101,S9436,HCPCS,LAMAZE CLASS,,,14 ,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9441,HCPCS,ASTHMA EDUCATION,,,14 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9442,HCPCS,BIRTHING CLASS,,,14 ,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9443,HCPCS,LACTATION CLASS,,,14 ,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9449,HCPCS,WEIGHT MGMT CLASS,,,14 ,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9451,HCPCS,EXERCISE CLASS,,,14 ,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9452,HCPCS,NUTRITION CLASS,,,14 ,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9453,HCPCS,SMOKING CESSATION CLASS,,,14 ,,TotalUnits,,,,1.53 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9455,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14 ,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9460,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14 ,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9465,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14 ,,TotalUnits,,,,1.26 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,S9470,HCPCS,"NUTRITIONAL COUNSELING, DIET",,,14 ,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S9474,HCPCS,ENTEROSTOMAL THERAPY BY A RE,,,14 ,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S9475,HCPCS,AMBULATORY SETTING SUBSTANCE,,,16 ,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,S9480,HCPCS,INTENSIVE OUTPATIENT PSYCHIA,,,16 ,,TotalUnits,,,,2.00 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S9484,HCPCS,CRISIS INTERVENTION PER HOUR,,,16 ,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S9485,HCPCS,CRISIS INTERVENTION MENTAL H,,,16 ,,TotalUnits,,,,4.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,S9490,HCPCS,HIT CORTICOSTEROID/DIEM,,,28 ,,NW,,,,,,$228.59,$0.00,1,1,1,1,1,1,20110101,S9494,HCPCS,HIT ANTIBIOTIC TOTAL DIEM,,,28 ,,NW,,,,,,$182.42,$0.00,1,1,1,1,1,1,20110101,S9497,HCPCS,HIT ANTIBIOTIC Q3H DIEM,,,28 ,,NW,,,,,,$261.12,$0.00,1,1,1,1,1,1,20110101,S9500,HCPCS,HIT ANTIBIOTIC Q24H DIEM,,,28 ,,NW,,,,,,$227.48,$0.00,1,1,1,1,1,1,20110101,S9501,HCPCS,HIT ANTIBIOTIC Q12H DIEM,,,28 ,,NW,,,,,,$255.20,$0.00,1,1,1,1,1,1,20110101,S9502,HCPCS,HIT ANTIBIOTIC Q8H DIEM,,,28 ,,NW,,,,,,$290.52,$0.00,1,1,1,1,1,1,20110101,S9503,HCPCS,HIT ANTIBIOTIC Q6H DIEM,,,28 ,,NW,,,,,,$293.66,$0.00,1,1,1,1,1,1,20110101,S9504,HCPCS,HIT ANTIBIOTIC Q4H DIEM,,,28 ,,NW,,,,,,$270.77,$0.00,1,1,1,1,1,1,20110101,S9529,HCPCS,VENIPUNCTURE HOME/SNF,,,28 ,,NW,,,,,,$90.97,$0.00,1,1,1,0,1,1,20110101,S9537,HCPCS,HT HEM HORM INJ DIEM,,,28 ,,NW,,,,,,$75.73,$0.00,1,1,1,1,1,1,20110101,S9538,HCPCS,HIT BLOOD PRODUCTS DIEM,,,28 ,,NW,,,,,,$245.64,$0.00,1,1,1,1,1,1,20110101,S9542,HCPCS,HT INJ NOC PER DIEM,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,1,1,1,20110101,S9558,HCPCS,HT INJ GROWTH HORM DIEM,,,28 ,,NW,,,,,,$32.91,$0.00,1,1,1,1,1,1,20110101,S9559,HCPCS,HIT INJ INTERFERON DIEM,,,28 ,,NW,,,,,,$309.31,$0.00,1,1,1,1,1,1,20110101,S9560,HCPCS,HT INJ HORMONE DIEM,,,28 ,,NW,,,,,,$84.23,$0.00,1,1,1,1,1,1,20110101,S9562,HCPCS,HT INJ PALIVIZUMAB DIEM,,,28 ,,NW,,,,,,$84.23,$0.00,1,1,1,1,1,1,20110101,S9590,HCPCS,HT IRRIGATION DIEM,,,28 ,,NW,,,,,,$120.89,$0.00,1,1,1,1,1,1,20110101,S9810,HCPCS,HT PHARM PER HOUR,,,28 ,,NW,,,,,,$47.82,$0.00,1,1,1,0,0,1,20110101,S9900,HCPCS,CHRISTIAN SCI PRACT VISIT,,,14 ,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9970,HCPCS,HEALTH CLUB MEMBERSHIP YR,,,14 ,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9981,HCPCS,MED RECORD COPY ADMIN,,,14 ,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9982,HCPCS,MED RECORD COPY PER PAGE,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9986,HCPCS,NOT MEDICALLY NECESSARY SVC,,,14 ,,TotalUnits,,,,8.22 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9988,HCPCS,SERV PART OF PHASE I TRIAL,,,14 ,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,S9990,HCPCS,SERVICES PROVIDED AS PART OF,,,14 ,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T1000,HCPCS,PRIVATE DUTY/INDEPENDENT NSG,,,15 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1001,HCPCS,NURSING ASSESSMENT/EVALUATN,,,15 ,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1002,HCPCS,RN SERVICES UP TO 15 MINUTES,,,15 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1003,HCPCS,LPN/LVN SERVICES UP TO 15MIN,,,15 ,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1004,HCPCS,NSG AIDE SERVICE UP TO 15MIN,,,15 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1005,HCPCS,RESPITE CARE SERVICE 15 MIN,,,15 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1006,HCPCS,FAMILY/COUPLE COUNSELING,,,16 ,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1007,HCPCS,TREATMENT PLAN DEVELOPMENT,,,16 ,,TotalUnits,,,,3.02 ,,$0.00,$0.00,1,1,1,0,1,1,20110101,T1009,HCPCS,CHILD SITTING SERVICES,,,14 ,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T1012,HCPCS,ALCOHOL/SUBSTANCE ABUSE SKIL,,,16 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T1013,HCPCS,SIGN LANG/ORAL INTERPRETER,,,14 ,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T1015,HCPCS,CLINIC SERVICE,,,15 ,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T1016,HCPCS,CASE MANAGEMENT,,,15 ,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1017,HCPCS,TARGETED CASE MANAGEMENT,,,15 ,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1019,HCPCS,PERSONAL CARE SER PER 15 MIN,,,15 ,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1020,HCPCS,PERSONAL CARE SER PER DIEM,,,15 ,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1021,HCPCS,HH AIDE OR CN AIDE PER VISIT,,,15 ,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1023,HCPCS,PROGRAM INTAKE ASSESSMENT,,,15 ,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1024,HCPCS,TEAM EVALUATION & MANAGEMENT,,,15 ,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1026,HCPCS,"PED COMPR CARE PKG, PER HOUR",,,15 ,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1027,HCPCS,FAMILY TRAINING & COUNSELING,,,16 ,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1028,HCPCS,HOME ENVIRONMENT ASSESSMENT,,,16 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T1030,HCPCS,RN HOME CARE PER DIEM,,,15 ,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1031,HCPCS,LPN HOME CARE PER DIEM,,,15 ,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T1502,HCPCS,MEDICATION ADMIN VISIT,,,15 ,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2001,HCPCS,N-ET; PATIENT ATTEND/ESCORT,,,14 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2003,HCPCS,N-ET; ENCOUNTER/TRIP,,,14 ,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2004,HCPCS,N-ET; COMMERC CARRIER PASS,,,14 ,,TotalUnits,,,,0.07 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2005,HCPCS,N-ET; STRETCHER VAN,,,14 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2007,HCPCS,NON-EMER TRANSPORT WAIT TIME,,,14 ,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2013,HCPCS,HABIL ED WAIVER PER HOUR,,,14 ,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2014,HCPCS,"HABIL PREVOC WAIVER, PER D",,,14 ,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2016,HCPCS,HABIL RES WAIVER PER DIEM,,,14 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2017,HCPCS,HABIL RES WAIVER 15 MIN,,,14 ,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2018,HCPCS,HABIL SUP EMPL WAIVER/DIEM,,,14 ,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2019,HCPCS,HABIL SUP EMPL WAIVER 15MIN,,,14 ,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2020,HCPCS,DAY HABIL WAIVER PER DIEM,,,14 ,,TotalUnits,,,,1.05 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2021,HCPCS,DAY HABIL WAIVER PER 15 MIN,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2022,HCPCS,"CASE MANAGEMENT, PER MONTH",,,14 ,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T2023,HCPCS,TARGETED CASE MGMT PER MONTH,,,14 ,,TotalUnits,,,,1.51 ,,$0.00,$0.00,1,0,1,1,1,1,20110101,T2025,HCPCS,"WAIVER SERVICE, NOS",,,14 ,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T2031,HCPCS,ASSIST LIVING WAIVER/DIEM,,,14 ,,TotalUnits,,,,2.47 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2032,HCPCS,"RES CARE, NOS WAIVER/MONTH",,,14 ,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2033,HCPCS,"RES, NOS WAIVER PER DIEM",,,14 ,,TotalUnits,,,,1.65 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2040,HCPCS,FINANCIAL MGT WAIVER/15MIN,,,14 ,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2042,HCPCS,HOSPICE ROUTINE HOME CARE,,,14 ,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2043,HCPCS,HOSPICE CONTINUOUS HOME CARE,,,14 ,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2045,HCPCS,HOSPICE GENERAL CARE,,,14 ,,TotalUnits,,,,5.70 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2046,HCPCS,"HOSPICE LONG TERM CARE, R&B",,,14 ,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2048,HCPCS,"BH LTC RES R&B, PER DIEM",,,14 ,,TotalUnits,,,,1.67 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2049,HCPCS,"N-ET; STRETCHER VAN, MILEAGE",,,14 ,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,1,1,1,20110101,T2101,HCPCS,BREAST MILK PROC/STORE/DIST,,,14 ,,TotalUnits,,,,0.03 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,T4521,HCPCS,ADULT SIZE BRIEF/DIAPER SM,,,28 ,,NW,,,,,,$1.28,$0.00,1,1,1,1,1,1,20110101,T4522,HCPCS,ADULT SIZE BRIEF/DIAPER MED,,,28 ,,NW,,,,,,$1.31,$0.00,1,1,1,1,1,1,20110101,T4523,HCPCS,ADULT SIZE BRIEF/DIAPER LG,,,28 ,,NW,,,,,,$1.40,$0.00,1,1,1,1,1,1,20110101,T4524,HCPCS,ADULT SIZE BRIEF/DIAPER XL,,,28 ,,NW,,,,,,$1.72,$0.00,1,1,1,1,1,1,20110101,T4525,HCPCS,ADULT SIZE PULL-ON SM,,,28 ,,NW,,,,,,$1.56,$0.00,1,1,1,1,1,1,20110101,T4526,HCPCS,ADULT SIZE PULL-ON MED,,,28 ,,NW,,,,,,$1.44,$0.00,1,1,1,1,1,1,20110101,T4527,HCPCS,ADULT SIZE PULL-ON LG,,,28 ,,NW,,,,,,$1.59,$0.00,1,1,1,1,1,1,20110101,T4528,HCPCS,ADULT SIZE PULL-ON XL,,,28 ,,NW,,,,,,$1.71,$0.00,1,1,1,1,1,1,20110101,T4529,HCPCS,PED SIZE BRIEF/DIAPER SM/MED,,,28 ,,NW,,,,,,$1.27,$0.00,1,1,1,1,1,1,20110101,T4530,HCPCS,PED SIZE BRIEF/DIAPER LG,,,28 ,,NW,,,,,,$1.45,$0.00,1,1,1,1,1,1,20110101,T4531,HCPCS,PED SIZE PULL-ON SM/MED,,,28 ,,NW,,,,,,$1.66,$0.00,1,1,1,1,1,1,20110101,T4532,HCPCS,PED SIZE PULL-ON LG,,,28 ,,NW,,,,,,$1.57,$0.00,1,1,1,1,1,1,20110101,T4533,HCPCS,YOUTH SIZE BRIEF/DIAPER,,,28 ,,NW,,,,,,$1.35,$0.00,1,1,1,1,1,1,20110101,T4534,HCPCS,YOUTH SIZE PULL-ON,,,28 ,,NW,,,,,,$1.68,$0.00,1,1,1,1,1,1,20110101,T4535,HCPCS,DISPOSABLE LINER/SHIELD/PAD,,,28 ,,NW,,,,,,$1.16,$0.00,1,1,1,1,1,1,20110101,T4536,HCPCS,REUSABLE PULL-ON ANY SIZE,,,28 ,,NW,,,,,,$1.33,$0.00,1,1,1,1,1,1,20110101,T4537,HCPCS,REUSABLE UNDERPAD BED SIZE,,,28 ,,NW,,,,,,$22.08,$0.00,1,1,1,1,1,1,20110101,T4539,HCPCS,REUSE DIAPER/BRIEF ANY SIZE,,,28 ,,NW,,,,,,$9.34,$0.00,1,1,1,1,1,1,20110101,T4540,HCPCS,REUSABLE UNDERPAD CHAIR SIZE,,,28 ,,NW,,,,,,$8.52,$0.00,1,1,1,1,1,1,20110101,T4541,HCPCS,LARGE DISPOSABLE UNDERPAD,,,28 ,,NW,,,,,,$1.11,$0.00,1,1,1,1,1,1,20110101,T4542,HCPCS,SMALL DISPOSABLE UNDERPAD,,,28 ,,NW,,,,,,$1.27,$0.00,1,1,1,1,1,1,20110101,T4543,HCPCS,DISP BARIATRIC BRIEF/DIAPER,,,28 ,,NW,,,,,,$1.97,$0.00,1,1,1,1,1,1,20110101,T5001,HCPCS,POSITION SEAT SPEC ORTH NEED,,,28 ,,NW,,,,,,$651.75,$0.00,1,1,1,1,1,1,20110101,T5999,HCPCS,"SUPPLY, NOS",,,28 ,,NW,,,,,,$21.56,$0.00,1,1,1,1,1,1,20110101,V2020,HCPCS,VISION SVCS FRAMES PURCHASES,,,28 ,,NW,,,,,,$92.74,$0.00,1,1,1,1,1,1,20110101,V2025,HCPCS,EYEGLASSES DELUX FRAMES,,,28 ,,NW,,,,,,$129.69,$0.00,1,1,1,1,1,1,20110101,V2100,HCPCS,LENS SPHER SINGLE PLANO 4.00,,,28 ,,NW,,,,,,$69.20,$0.00,1,1,1,1,1,1,20110101,V2101,HCPCS,SINGLE VISN SPHERE 4.12-7.00,,,28 ,,NW,,,,,,$72.90,$0.00,1,1,1,1,1,1,20110101,V2102,HCPCS,SINGL VISN SPHERE 7.12-20.00,,,28 ,,NW,,,,,,$89.06,$0.00,1,1,1,1,1,1,20110101,V2103,HCPCS,SPHEROCYLINDR 4.00D/12-2.00D,,,28 ,,NW,,,,,,$63.84,$0.00,1,1,1,1,1,1,20110101,V2104,HCPCS,SPHEROCYLINDR 4.00D/2.12-4D,,,28 ,,NW,,,,,,$67.07,$0.00,1,1,1,1,1,1,20110101,V2105,HCPCS,SPHEROCYLINDER 4.00D/4.25-6D,,,28 ,,NW,,,,,,$71.43,$0.00,1,1,1,1,1,1,20110101,V2106,HCPCS,SPHEROCYLINDER 4.00D/>6.00D,,,28 ,,NW,,,,,,$76.45,$0.00,1,1,1,1,1,1,20110101,V2107,HCPCS,SPHEROCYLINDER 4.25D/12-2D,,,28 ,,NW,,,,,,$75.82,$0.00,1,1,1,1,1,1,20110101,V2108,HCPCS,SPHEROCYLINDER 4.25D/2.12-4D,,,28 ,,NW,,,,,,$75.74,$0.00,1,1,1,1,1,1,20110101,V2109,HCPCS,SPHEROCYLINDER 4.25D/4.25-6D,,,28 ,,NW,,,,,,$82.41,$0.00,1,1,1,1,1,1,20110101,V2110,HCPCS,SPHEROCYLINDER 4.25D/OVER 6D,,,28 ,,NW,,,,,,$80.29,$0.00,1,1,1,1,1,1,20110101,V2111,HCPCS,SPHEROCYLINDR 7.25D/.25-2.25,,,28 ,,NW,,,,,,$83.73,$0.00,1,1,1,1,1,1,20110101,V2112,HCPCS,SPHEROCYLINDR 7.25D/2.25-4D,,,28 ,,NW,,,,,,$89.24,$0.00,1,1,1,1,1,1,20110101,V2113,HCPCS,SPHEROCYLINDR 7.25D/4.25-6D,,,28 ,,NW,,,,,,$95.88,$0.00,1,1,1,1,1,1,20110101,V2114,HCPCS,SPHEROCYLINDER OVER 12.00D,,,28 ,,NW,,,,,,$101.69,$0.00,1,1,1,1,1,1,20110101,V2115,HCPCS,LENS LENTICULAR BIFOCAL,,,28 ,,NW,,,,,,$106.96,$0.00,1,1,1,1,1,1,20110101,V2118,HCPCS,LENS ANISEIKONIC SINGLE,,,28 ,,NW,,,,,,$107.76,$0.00,1,1,1,1,1,1,20110101,V2121,HCPCS,"LENTICULAR LENS, SINGLE",,,28 ,,NW,,,,,,$109.38,$0.00,1,1,1,1,1,1,20110101,V2199,HCPCS,LENS SINGLE VISION NOT OTH C,,,28 ,,NW,,,,,,$69.20,$0.00,1,1,1,1,1,1,20110101,V2200,HCPCS,LENS SPHER BIFOC PLANO 4.00D,,,28 ,,NW,,,,,,$81.58,$0.00,1,1,1,1,1,1,20110101,V2201,HCPCS,LENS SPHERE BIFOCAL 4.12-7.0,,,28 ,,NW,,,,,,$87.05,$0.00,1,1,1,1,1,1,20110101,V2202,HCPCS,LENS SPHERE BIFOCAL 7.12-20.,,,28 ,,NW,,,,,,$94.84,$0.00,1,1,1,1,1,1,20110101,V2203,HCPCS,LENS SPHCYL BIFOCAL 4.00D/.1,,,28 ,,NW,,,,,,$82.73,$0.00,1,1,1,1,1,1,20110101,V2204,HCPCS,LENS SPHCY BIFOCAL 4.00D/2.1,,,28 ,,NW,,,,,,$84.82,$0.00,1,1,1,1,1,1,20110101,V2205,HCPCS,LENS SPHCY BIFOCAL 4.00D/4.2,,,28 ,,NW,,,,,,$88.70,$0.00,1,1,1,1,1,1,20110101,V2206,HCPCS,LENS SPHCY BIFOCAL 4.00D/OVE,,,28 ,,NW,,,,,,$94.91,$0.00,1,1,1,1,1,1,20110101,V2207,HCPCS,LENS SPHCY BIFOCAL 4.25-7D/.,,,28 ,,NW,,,,,,$88.29,$0.00,1,1,1,1,1,1,20110101,V2208,HCPCS,LENS SPHCY BIFOCAL 4.25-7/2.,,,28 ,,NW,,,,,,$91.13,$0.00,1,1,1,1,1,1,20110101,V2209,HCPCS,LENS SPHCY BIFOCAL 4.25-7/4.,,,28 ,,NW,,,,,,$94.87,$0.00,1,1,1,1,1,1,20110101,V2210,HCPCS,LENS SPHCY BIFOCAL 4.25-7/OV,,,28 ,,NW,,,,,,$102.89,$0.00,1,1,1,1,1,1,20110101,V2211,HCPCS,LENS SPHCY BIFO 7.25-12/.25-,,,28 ,,NW,,,,,,$103.87,$0.00,1,1,1,1,1,1,20110101,V2212,HCPCS,LENS SPHCYL BIFO 7.25-12/2.2,,,28 ,,NW,,,,,,$106.02,$0.00,1,1,1,1,1,1,20110101,V2213,HCPCS,LENS SPHCYL BIFO 7.25-12/4.2,,,28 ,,NW,,,,,,$106.36,$0.00,1,1,1,1,1,1,20110101,V2214,HCPCS,LENS SPHCYL BIFOCAL OVER 12.,,,28 ,,NW,,,,,,$114.15,$0.00,1,1,1,1,1,1,20110101,V2215,HCPCS,LENS LENTICULAR BIFOCAL,,,28 ,,NW,,,,,,$121.76,$0.00,1,1,1,1,1,1,20110101,V2218,HCPCS,LENS ANISEIKONIC BIFOCAL,,,28 ,,NW,,,,,,$131.95,$0.00,1,1,1,1,1,1,20110101,V2219,HCPCS,LENS BIFOCAL SEG WIDTH OVER,,,28 ,,NW,,,,,,$74.05,$0.00,1,1,1,1,1,1,20110101,V2220,HCPCS,LENS BIFOCAL ADD OVER 3.25D,,,28 ,,NW,,,,,,$67.74,$0.00,1,1,1,1,1,1,20110101,V2221,HCPCS,"LENTICULAR LENS, BIFOCAL",,,28 ,,NW,,,,,,$120.47,$0.00,1,1,1,1,1,1,20110101,V2299,HCPCS,LENS BIFOCAL SPECIALITY,,,28 ,,NW,,,,,,$61.80,$0.00,1,1,1,1,1,1,20110101,V2300,HCPCS,LENS SPHERE TRIFOCAL 4.00D,,,28 ,,NW,,,,,,$96.33,$0.00,1,1,1,1,1,1,20110101,V2301,HCPCS,LENS SPHERE TRIFOCAL 4.12-7.,,,28 ,,NW,,,,,,$108.97,$0.00,1,1,1,1,1,1,20110101,V2302,HCPCS,LENS SPHERE TRIFOCAL 7.12-20,,,28 ,,NW,,,,,,$110.75,$0.00,1,1,1,1,1,1,20110101,V2303,HCPCS,LENS SPHCY TRIFOCAL 4.0/.12-,,,28 ,,NW,,,,,,$95.89,$0.00,1,1,1,1,1,1,20110101,V2304,HCPCS,LENS SPHCY TRIFOCAL 4.0/2.25,,,28 ,,NW,,,,,,$98.66,$0.00,1,1,1,1,1,1,20110101,V2305,HCPCS,LENS SPHCY TRIFOCAL 4.0/4.25,,,28 ,,NW,,,,,,$108.22,$0.00,1,1,1,1,1,1,20110101,V2306,HCPCS,LENS SPHCYL TRIFOCAL 4.00/>6,,,28 ,,NW,,,,,,$110.74,$0.00,1,1,1,1,1,1,20110101,V2307,HCPCS,LENS SPHCY TRIFOCAL 4.25-7/.,,,28 ,,NW,,,,,,$106.62,$0.00,1,1,1,1,1,1,20110101,V2308,HCPCS,LENS SPHC TRIFOCAL 4.25-7/2.,,,28 ,,NW,,,,,,$109.84,$0.00,1,1,1,1,1,1,20110101,V2309,HCPCS,LENS SPHC TRIFOCAL 4.25-7/4.,,,28 ,,NW,,,,,,$118.83,$0.00,1,1,1,1,1,1,20110101,V2310,HCPCS,LENS SPHC TRIFOCAL 4.25-7/>6,,,28 ,,NW,,,,,,$117.66,$0.00,1,1,1,1,1,1,20110101,V2311,HCPCS,LENS SPHC TRIFO 7.25-12/.25-,,,28 ,,NW,,,,,,$124.01,$0.00,1,1,1,1,1,1,20110101,V2312,HCPCS,LENS SPHC TRIFO 7.25-12/2.25,,,28 ,,NW,,,,,,$122.16,$0.00,1,1,1,1,1,1,20110101,V2313,HCPCS,LENS SPHC TRIFO 7.25-12/4.25,,,28 ,,NW,,,,,,$135.39,$0.00,1,1,1,1,1,1,20110101,V2314,HCPCS,LENS SPHCYL TRIFOCAL OVER 12,,,28 ,,NW,,,,,,$140.27,$0.00,1,1,1,1,1,1,20110101,V2315,HCPCS,LENS LENTICULAR TRIFOCAL,,,28 ,,NW,,,,,,$155.64,$0.00,1,1,1,1,1,1,20110101,V2318,HCPCS,LENS ANISEIKONIC TRIFOCAL,,,28 ,,NW,,,,,,$183.48,$0.00,1,1,1,1,1,1,20110101,V2319,HCPCS,LENS TRIFOCAL SEG WIDTH > 28,,,28 ,,NW,,,,,,$79.73,$0.00,1,1,1,1,1,1,20110101,V2320,HCPCS,LENS TRIFOCAL ADD OVER 3.25D,,,28 ,,NW,,,,,,$85.41,$0.00,1,1,1,1,1,1,20110101,V2321,HCPCS,"LENTICULAR LENS, TRIFOCAL",,,28 ,,NW,,,,,,$153.06,$0.00,1,1,1,1,1,1,20110101,V2399,HCPCS,LENS TRIFOCAL SPECIALITY,,,28 ,,NW,,,,,,$150.56,$0.00,1,1,1,1,1,1,20110101,V2410,HCPCS,LENS VARIAB ASPHERICITY SING,,,28 ,,NW,,,,,,$124.76,$0.00,1,1,1,1,1,1,20110101,V2430,HCPCS,LENS VARIABLE ASPHERICITY BI,,,28 ,,NW,,,,,,$142.35,$0.00,1,1,1,1,1,1,20110101,V2499,HCPCS,VARIABLE ASPHERICITY LENS,,,28 ,,NW,,,,,,$142.35,$0.00,1,1,1,1,1,1,20110101,V2500,HCPCS,CONTACT LENS PMMA SPHERICAL,,,28 ,,NW,,,,,,$114.99,$0.00,1,1,1,1,1,1,20110101,V2501,HCPCS,CNTCT LENS PMMA-TORIC/PRISM,,,28 ,,NW,,,,,,$156.90,$0.00,1,1,1,1,1,1,20110101,V2502,HCPCS,CONTACT LENS PMMA BIFOCAL,,,28 ,,NW,,,,,,$193.64,$0.00,1,1,1,1,1,1,20110101,V2503,HCPCS,CNTCT LENS PMMA COLOR VISION,,,28 ,,NW,,,,,,$175.40,$0.00,1,1,1,1,1,1,20110101,V2510,HCPCS,CNTCT GAS PERMEABLE SPHERICL,,,28 ,,NW,,,,,,$145.56,$0.00,1,1,1,1,1,1,20110101,V2511,HCPCS,CNTCT TORIC PRISM BALLAST,,,28 ,,NW,,,,,,$199.71,$0.00,1,1,1,1,1,1,20110101,V2512,HCPCS,CNTCT LENS GAS PERMBL BIFOCL,,,28 ,,NW,,,,,,$232.02,$0.00,1,1,1,1,1,1,20110101,V2513,HCPCS,CONTACT LENS EXTENDED WEAR,,,28 ,,NW,,,,,,$205.76,$0.00,1,1,1,1,1,1,20110101,V2520,HCPCS,CONTACT LENS HYDROPHILIC,,,28 ,,NW,,,,,,$138.39,$0.00,1,1,1,1,1,1,20110101,V2521,HCPCS,CNTCT LENS HYDROPHILIC TORIC,,,28 ,,NW,,,,,,$218.75,$0.00,1,1,1,1,1,1,20110101,V2522,HCPCS,CNTCT LENS HYDROPHIL BIFOCL,,,28 ,,NW,,,,,,$220.10,$0.00,1,1,1,1,1,1,20110101,V2523,HCPCS,CNTCT LENS HYDROPHIL EXTEND,,,28 ,,NW,,,,,,$176.04,$0.00,1,1,1,1,1,1,20110101,V2530,HCPCS,CONTACT LENS GAS IMPERMEABLE,,,28 ,,NW,,,,,,$260.95,$0.00,1,1,1,1,1,1,20110101,V2531,HCPCS,CONTACT LENS GAS PERMEABLE,,,28 ,,NW,,,,,,$533.65,$0.00,1,1,1,1,1,1,20110101,V2599,HCPCS,CONTACT LENS/ES OTHER TYPE,,,28 ,,NW,,,,,,$142.35,$0.00,1,1,1,1,1,1,20110101,V2600,HCPCS,HAND HELD LOW VISION AIDS,,,28 ,,NW,,,,,,$135.10,$0.00,1,1,1,1,1,1,20110101,V2610,HCPCS,SINGLE LENS SPECTACLE MOUNT,,,28 ,,NW,,,,,,$125.50,$0.00,1,1,1,1,1,1,20110101,V2615,HCPCS,TELESCOP/OTHR COMPOUND LENS,,,28 ,,NW,,,,,,$400.14,$0.00,1,1,1,1,1,1,20110101,V2623,HCPCS,PLASTIC EYE PROSTH CUSTOM,,,28 ,,NW,,,,,,"$2,756.03",$0.00,1,1,1,1,1,1,20110101,V2624,HCPCS,POLISHING ARTIFICAL EYE,,,28 ,,NW,,,,,,$107.79,$0.00,1,1,1,1,1,1,20110101,V2625,HCPCS,ENLARGEMNT OF EYE PROSTHESIS,,,28 ,,NW,,,,,,$935.26,$0.00,1,1,1,1,1,1,20110101,V2626,HCPCS,REDUCTION OF EYE PROSTHESIS,,,28 ,,NW,,,,,,$380.73,$0.00,1,1,1,1,1,1,20110101,V2627,HCPCS,SCLERAL COVER SHELL,,,28 ,,NW,,,,,,"$3,907.22",$0.00,1,1,1,1,1,1,20110101,V2628,HCPCS,FABRICATION & FITTING,,,28 ,,NW,,,,,,$667.08,$0.00,1,1,1,1,1,1,20110101,V2629,HCPCS,PROSTHETIC EYE OTHER TYPE,,,28 ,,NW,,,,,,$135.10,$0.00,1,1,1,1,1,1,20110101,V2630,HCPCS,ANTER CHAMBER INTRAOCUL LENS,,,28 ,,NW,,,,,,$454.57,$0.00,1,1,1,0,1,1,20110101,V2631,HCPCS,IRIS SUPPORT INTRAOCLR LENS,,,28 ,,NW,,,,,,$347.72,$0.00,1,1,1,0,1,1,20110101,V2632,HCPCS,POST CHMBR INTRAOCULAR LENS,,,28 ,,NW,,,,,,$574.30,$0.00,1,1,1,0,1,1,20110101,V2700,HCPCS,BALANCE LENS,,,28 ,,NW,,,,,,$74.27,$0.00,1,1,1,1,1,1,20110101,V2702,HCPCS,DELUXE LENS FEATURE,,,28 ,,NW,,,,,,$14.97,$0.00,1,1,1,1,1,1,20110101,V2710,HCPCS,GLASS/PLASTIC SLAB OFF PRISM,,,28 ,,NW,,,,,,$97.34,$0.00,1,1,1,1,1,1,20110101,V2715,HCPCS,PRISM LENS/ES,,,28 ,,NW,,,,,,$19.89,$0.00,1,1,1,1,1,1,20110101,V2718,HCPCS,FRESNELL PRISM PRESS-ON LENS,,,28 ,,NW,,,,,,$48.89,$0.00,1,1,1,1,1,1,20110101,V2730,HCPCS,SPECIAL BASE CURVE,,,28 ,,NW,,,,,,$50.19,$0.00,1,1,1,1,1,1,20110101,V2744,HCPCS,TINT PHOTOCHROMATIC LENS/ES,,,28 ,,NW,,,,,,$35.75,$0.00,1,1,1,1,1,1,20110101,V2745,HCPCS,"TINT, ANY COLOR/SOLID/GRAD",,,28 ,,NW,,,,,,$13.64,$0.00,1,1,1,1,1,1,20110101,V2750,HCPCS,ANTI-REFLECTIVE COATING,,,28 ,,NW,,,,,,$48.92,$0.00,1,1,1,1,1,1,20110101,V2755,HCPCS,UV LENS/ES,,,28 ,,NW,,,,,,$34.59,$0.00,1,1,1,1,1,1,20110101,V2756,HCPCS,EYE GLASS CASE,,,28 ,,NW,,,,,,$6.34,$0.00,1,1,1,1,1,1,20110101,V2760,HCPCS,SCRATCH RESISTANT COATING,,,28 ,,NW,,,,,,$34.60,$0.00,1,1,1,1,1,1,20110101,V2761,HCPCS,MIRROR COATING,,,28 ,,NW,,,,,,$29.29,$0.00,1,1,1,1,1,1,20110101,V2762,HCPCS,"POLARIZATION, ANY LENS",,,28 ,,NW,,,,,,$83.38,$0.00,1,1,1,1,1,1,20110101,V2770,HCPCS,OCCLUDER LENS/ES,,,28 ,,NW,,,,,,$48.44,$0.00,1,1,1,1,1,1,20110101,V2780,HCPCS,OVERSIZE LENS/ES,,,28 ,,NW,,,,,,$21.62,$0.00,1,1,1,1,1,1,20110101,V2781,HCPCS,PROGRESSIVE LENS PER LENS,,,28 ,,NW,,,,,,$118.17,$0.00,1,1,1,1,1,1,20110101,V2782,HCPCS,"LENS, 1.54-1.65 P/1.60-1.79G",,,28 ,,NW,,,,,,$87.81,$0.00,1,1,1,1,1,1,20110101,V2783,HCPCS,"LENS, >= 1.66 P/>=1.80 G",,,28 ,,NW,,,,,,$95.45,$0.00,1,1,1,1,1,1,20110101,V2784,HCPCS,LENS POLYCARB OR EQUAL,,,28 ,,NW,,,,,,$71.84,$0.00,1,1,1,1,1,1,20110101,V2785,HCPCS,CORNEAL TISSUE PROCESSING,,,28 ,,NW,,,,,,"$4,096.13",$0.00,1,1,1,1,1,1,20110101,V2786,HCPCS,OCCUPATIONAL MULTIFOCAL LENS,,,28 ,,NW,,,,,,$113.16,$0.00,1,1,1,1,1,1,20110101,V2787,HCPCS,ASTIGMATISM-CORRECT FUNCTION,,,28 ,,NW,,,,,,$654.69,$0.00,1,1,1,1,1,1,20110101,V2788,HCPCS,PRESBYOPIA-CORRECT FUNCTION,,,28 ,,NW,,,,,,"$1,935.70",$0.00,1,1,1,1,1,1,20110101,V2790,HCPCS,AMNIOTIC MEMBRANE,,,28 ,,NW,,,,,,"$1,022.71",$0.00,1,1,1,0,1,1,20110101,V2797,HCPCS,VIS ITEM/SVC IN OTHER CODE,,,28 ,,NW,,,,,,$433.06,$0.00,1,1,1,1,1,1,20110101,V2799,HCPCS,MISCELLANEOUS VISION SERVICE,,,28 ,,NW,,,,,,$118.17,$0.00,1,1,1,0,1,1,20110101,V5008,HCPCS,HEARING SCREENING,,,8 ,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,V5010,HCPCS,ASSESSMENT FOR HEARING AID,,,8 ,,TotalUnits,,,,1.51 ,,$0.00,$0.00,1,1,1,0,0,1,20110101,V5011,HCPCS,HEARING AID FITTING/CHECKING,,,28 ,,NW,,,,,,$149.60,$0.00,1,1,1,1,1,1,20110101,V5014,HCPCS,HEARING AID REPAIR/MODIFYING,,,28 ,,NW,,,,,,$180.08,$0.00,1,1,1,1,1,1,20110101,V5020,HCPCS,CONFORMITY EVALUATION,,,28 ,,NW,,,,,,$84.37,$0.00,1,1,1,1,1,1,20110101,V5030,HCPCS,BODY-WORN HEARING AID AIR,,,28 ,,NW,,,,,,"$2,236.12",$0.00,1,1,1,1,1,1,20110101,V5040,HCPCS,BODY-WORN HEARING AID BONE,,,28 ,,NW,,,,,,"$1,619.89",$0.00,1,1,1,1,1,1,20110101,V5050,HCPCS,HEARING AID MONAURAL IN EAR,,,28 ,,NW,,,,,,"$1,924.57",$0.00,1,1,1,1,1,1,20110101,V5060,HCPCS,BEHIND EAR HEARING AID,,,28 ,,NW,,,,,,"$1,554.01",$0.00,1,1,1,1,1,1,20110101,V5070,HCPCS,GLASSES AIR CONDUCTION,,,28 ,,NW,,,,,,$716.82,$0.00,1,1,1,1,1,1,20110101,V5080,HCPCS,GLASSES BONE CONDUCTION,,,28 ,,NW,,,,,,"$2,302.00",$0.00,1,1,1,1,1,1,20110101,V5090,HCPCS,HEARING AID DISPENSING FEE,,,28 ,,NW,,,,,,$604.28,$0.00,1,1,1,1,1,1,20110101,V5100,HCPCS,BODY-WORN BILAT HEARING AID,,,28 ,,NW,,,,,,"$3,892.67",$0.00,1,1,1,1,1,1,20110101,V5110,HCPCS,HEARING AID DISPENSING FEE,,,28 ,,NW,,,,,,$620.75,$0.00,1,1,1,1,1,1,20110101,V5120,HCPCS,BODY-WORN BINAUR HEARING AID,,,28 ,,NW,,,,,,"$3,361.53",$0.00,1,1,1,1,1,1,20110101,V5130,HCPCS,IN EAR BINAURAL HEARING AID,,,28 ,,NW,,,,,,"$3,610.29",$0.00,1,1,1,1,1,1,20110101,V5140,HCPCS,BEHIND EAR BINAUR HEARING AI,,,28 ,,NW,,,,,,"$3,754.05",$0.00,1,1,1,1,1,1,20110101,V5150,HCPCS,GLASSES BINAURAL HEARING AID,,,28 ,,NW,,,,,,"$4,031.28",$0.00,1,1,1,1,1,1,20110101,V5160,HCPCS,DISPENSING FEE BINAURAL,,,28 ,,NW,,,,,,$808.77,$0.00,1,1,1,1,1,1,20110101,V5170,HCPCS,WITHIN EAR CROS HEARING AID,,,28 ,,NW,,,,,,"$2,702.75",$0.00,1,1,1,1,1,1,20110101,V5180,HCPCS,BEHIND EAR CROS HEARING AID,,,28 ,,NW,,,,,,"$2,236.12",$0.00,1,1,1,1,1,1,20110101,V5190,HCPCS,GLASSES CROS HEARING AID,,,28 ,,NW,,,,,,"$2,669.81",$0.00,1,1,1,1,1,1,20110101,V5200,HCPCS,CROS HEARING AID DISPENS FEE,,,28 ,,NW,,,,,,$612.51,$0.00,1,1,1,1,1,1,20110101,V5210,HCPCS,IN EAR BICROS HEARING AID,,,28 ,,NW,,,,,,"$2,964.89",$0.00,1,1,1,1,1,1,20110101,V5220,HCPCS,BEHIND EAR BICROS HEARING AI,,,28 ,,NW,,,,,,"$2,835.88",$0.00,1,1,1,1,1,1,20110101,V5230,HCPCS,GLASSES BICROS HEARING AID,,,28 ,,NW,,,,,,"$2,942.93",$0.00,1,1,1,1,1,1,20110101,V5240,HCPCS,DISPENSING FEE BICROS,,,28 ,,NW,,,,,,$645.45,$0.00,1,1,1,1,1,1,20110101,V5241,HCPCS,"DISPENSING FEE, MONAURAL",,,28 ,,NW,,,,,,$152.55,$0.00,1,1,1,1,1,1,20110101,V5242,HCPCS,"HEARING AID, MONAURAL, CIC",,,28 ,,NW,,,,,,"$1,728.86",$0.00,1,1,1,1,1,1,20110101,V5243,HCPCS,"HEARING AID, MONAURAL, ITC",,,28 ,,NW,,,,,,"$1,820.99",$0.00,1,1,1,1,1,1,20110101,V5244,HCPCS,"HEARING AID, PROG, MON, CIC",,,28 ,,NW,,,,,,"$2,394.90",$0.00,1,1,1,1,1,1,20110101,V5245,HCPCS,"HEARING AID, PROG, MON, ITC",,,28 ,,NW,,,,,,"$2,192.35",$0.00,1,1,1,1,1,1,20110101,V5246,HCPCS,"HEARING AID, PROG, MON, ITE",,,28 ,,NW,,,,,,"$2,022.51",$0.00,1,1,1,1,1,1,20110101,V5247,HCPCS,"HEARING AID, PROG, MON, BTE",,,28 ,,NW,,,,,,"$2,409.28",$0.00,1,1,1,1,1,1,20110101,V5248,HCPCS,"HEARING AID, BINAURAL, CIC",,,28 ,,NW,,,,,,"$2,225.88",$0.00,1,1,1,1,1,1,20110101,V5249,HCPCS,"HEARING AID, BINAURAL, ITC",,,28 ,,NW,,,,,,"$1,784.68",$0.00,1,1,1,1,1,1,20110101,V5250,HCPCS,"HEARING AID, PROG, BIN, CIC",,,28 ,,NW,,,,,,"$5,784.55",$0.00,1,1,1,1,1,1,20110101,V5251,HCPCS,"HEARING AID, PROG, BIN, ITC",,,28 ,,NW,,,,,,"$5,173.35",$0.00,1,1,1,1,1,1,20110101,V5252,HCPCS,"HEARING AID, PROG, BIN, ITE",,,28 ,,NW,,,,,,"$7,390.69",$0.00,1,1,1,1,1,1,20110101,V5253,HCPCS,"HEARING AID, PROG, BIN, BTE",,,28 ,,NW,,,,,,"$3,434.09",$0.00,1,1,1,1,1,1,20110101,V5254,HCPCS,"HEARING ID, DIGIT, MON, CIC",,,28 ,,NW,,,,,,"$4,063.59",$0.00,1,1,1,1,1,1,20110101,V5255,HCPCS,"HEARING AID, DIGIT, MON, ITC",,,28 ,,NW,,,,,,"$2,542.30",$0.00,1,1,1,1,1,1,20110101,V5256,HCPCS,"HEARING AID, DIGIT, MON, ITE",,,28 ,,NW,,,,,,"$2,149.26",$0.00,1,1,1,1,1,1,20110101,V5257,HCPCS,"HEARING AID, DIGIT, MON, BTE",,,28 ,,NW,,,,,,"$3,048.13",$0.00,1,1,1,1,1,1,20110101,V5258,HCPCS,"HEARING AID, DIGIT, BIN, CIC",,,28 ,,NW,,,,,,"$4,228.12",$0.00,1,1,1,1,1,1,20110101,V5259,HCPCS,"HEARING AID, DIGIT, BIN, ITC",,,28 ,,NW,,,,,,"$2,659.29",$0.00,1,1,1,1,1,1,20110101,V5260,HCPCS,"HEARING AID, DIGIT, BIN, ITE",,,28 ,,NW,,,,,,"$3,205.18",$0.00,1,1,1,1,1,1,20110101,V5261,HCPCS,"HEARING AID, DIGIT, BIN, BTE",,,28 ,,NW,,,,,,"$4,393.71",$0.00,1,1,1,1,1,1,20110101,V5262,HCPCS,"HEARING AID, DISP, MONAURAL",,,28 ,,NW,,,,,,$181.31,$0.00,1,1,1,1,1,1,20110101,V5263,HCPCS,"HEARING AID, DISP, BINAURAL",,,28 ,,NW,,,,,,$164.35,$0.00,1,1,1,1,1,1,20110101,V5264,HCPCS,EAR MOLD/INSERT,,,28 ,,NW,,,,,,$92.17,$0.00,1,1,1,1,1,1,20110101,V5265,HCPCS,"EAR MOLD/INSERT, DISP",,,28 ,,NW,,,,,,$93.70,$0.00,1,1,1,1,1,1,20110101,V5266,HCPCS,BATTERY FOR HEARING DEVICE,,,28 ,,NW,,,,,,$1.94,$0.00,1,1,1,1,1,1,20110101,V5267,HCPCS,HEARING AID SUPPLY/ACCESSORY,,,28 ,,NW,,,,,,$28.85,$0.00,1,1,1,1,1,1,20110101,V5268,HCPCS,ALD TELEPHONE AMPLIFIER,,,28 ,,NW,,,,,,$142.82,$0.00,1,1,1,1,1,1,20110101,V5269,HCPCS,"ALERTING DEVICE, ANY TYPE",,,28 ,,NW,,,,,,$155.66,$0.00,1,1,1,1,1,1,20110101,V5270,HCPCS,"ALD, TV AMPLIFIER, ANY TYPE",,,28 ,,NW,,,,,,$222.38,$0.00,1,1,1,1,1,1,20110101,V5271,HCPCS,"ALD, TV CAPTION DECODER",,,28 ,,NW,,,,,,$348.58,$0.00,1,1,1,1,1,1,20110101,V5272,HCPCS,TDD,,,28 ,,NW,,,,,,$295.47,$0.00,1,1,1,1,1,1,20110101,V5273,HCPCS,ALD FOR COCHLEAR IMPLANT,,,28 ,,NW,,,,,,$487.31,$0.00,1,1,1,1,1,1,20110101,V5274,HCPCS,ALD UNSPECIFIED,,,28 ,,NW,,,,,,$148.23,$0.00,1,1,1,1,1,1,20110101,V5275,HCPCS,EAR IMPRESSION,,,28 ,,NW,,,,,,$74.37,$0.00,1,1,1,1,1,1,20110101,V5298,HCPCS,HEARING AID NOC,,,28 ,,NW,,,,,,"$3,312.76",$0.00,1,1,1,1,1,1,20110101,V5299,HCPCS,HEARING SERVICE,,,28 ,,NW,,,,,,$65.75,$0.00,1,1,1,0,0,1,20110101,V5362,HCPCS,SPEECH SCREENING,,,8 ,,RBRVS,0.86 ,0.28 ,3.50 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,V5363,HCPCS,LANGUAGE SCREENING,,,8 ,,RBRVS,0.86 ,0.28 ,3.50 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,V5364,HCPCS,DYSPHAGIA SCREENING,,,8 ,,RBRVS,,1.70 ,1.70 ,,,$0.00,$0.00,1,1,1,0,0,1,20110101,